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Müller, Paula Christina de Souza. „Adaptação transcultural e validação clínica do Difficult Intravenous Access Score - Diva Score - para uso no Brasil“. reponame:Repositório Institucional da UFPR, 2015. http://hdl.handle.net/1884/41871.
Der volle Inhalt der QuelleDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem. Defesa: Curitiba, 14/12/2015
Inclui referências : f. 80-89
Área de concentração: Prática profissional de enfermagem
Resumo: A Punção Intravenosa Periférica é considerada um dos procedimentos mais desgastante para crianças hospitalizadas, familiares e equipe de saúde. Para minimizar possíveis traumas, o uso de score de predição ao insucesso à primeira tentativa, no estabelecimento de PIP, já é uma realidade internacional. A tradução informal de instrumentos, desenvolvidos em nacionalidades diferentes compromete a qualidade dos resultados esperados com seu emprego. Portanto, procedeu-se a adaptação transcultural e validação clínica de instrumento aplicável à pediatria, o Difficult Intravenous Access score - DIVA score. Os seguintes passos foram implementados: 1. Tradução inicial; 2. Síntese das traduções; 3. Retro tradução; 4. Avaliação da documentação por comitê de juízes especialistas; 5. Pré-teste; 6. Apresentação da documentação aos juízes especialistas e autor do instrumento original. Com o emprego da metodologia proposta, obteve-se instrumento adaptado transculturalmente, que foi validado para uso confiável no Brasil, como recurso adjuvante à punção intravenosa de crianças. Os principais atributos que cercam a adaptação transcultural e validação de instrumento de saúde internacional, é sua aplicabilidade coerente, para que possam surtir efeitos positivos à nossa realidade. Destarte, tem-se um instrumento útil para diagnóstico do insucesso na primeira tentativa de punção e de risco de trauma vascular, que poderá, apontar pela adoção de recursos tecnológicos adjuvantes à venopunção, disponível para profissionais de saúde, sobretudo para a enfermagem, no território brasileiro. Descritores: Pesquisa Metodológica em Enfermagem; Estudos de Validação; Enfermagem Pediátrica; Hospitalização; Vasos Sanguíneos.
Abstract: The Peripheral Venipuncture is considered one of the most tiring processes for hospitalized children, family members and health team. In order to minimize possible traumas, the use of a failure prediction score to the first attempt, at establishing the Peripheral Venipuncture, is already an international reality. The informal translation of instruments, developed in different nationalities, compromises the quality of the expected results with its employment. Therefore, a transcultural adaptation and clinical validation of instrument applied to pediatrics, the Difficult Intravenous Access score – DIVA score. The following steps were implemented: 1. Initial translation; 2. Translations synthesis; 3. Back-translation; 4. Documentation evaluation by specialized judges committee. 5. Pretest. 6. Presentation of the documentation to the specialized judges and author of the original instrument. By employing the proposed methodology, it was obtained a transculturally-translated instrument that was validated for reliable use in Brazil as an adjuvant resource to the peripheral venipuncture of children. The main attribute that concerns the transcultural adaptation and the international health instrument validation is its consistent application so that they may result in positive effects to our reality. This way, we have an useful instrument for the diagnosis of failure on the first attempt of puncture and of vascular trauma risk, that may point to the adoption of adjuvant technological resources to the venipuncture, available to health professionals, above all to nursing, in Brazilian territory. Keywords: Nursing Methodology Research; Validation Studies; Pediatric Nursing; Hospitalization; Blood Vessels.
Capela, Renata Campos [UNESP]. „Equivalência métrica do Disease Activity Score (DAS 28) e Juvenile Arthritis Disease Activity Score (JADAS) na artrite idiopática juvenil“. Universidade Estadual Paulista (UNESP), 2012. http://hdl.handle.net/11449/106054.
Der volle Inhalt der QuelleCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
A atividade da artrite pode ser avaliada por diferentes instrumentos. Na Artrite Reumatóide (AR) o Disease Activity Score (DAS 28) e na Artrite Idiopática Juvenil (AIJ) o Juvenile Arthritis Disease Activity Score (JADAS) são utilizados na prática. Explorar a equivalência de medidas contínuas de atividade, o DAS 28 e as 3 versões do JADAS, pontuando 71, 27 e 10 articulações, em portadores de AIJ. Análise secundária de um ensaio clinico, testando o abatacepte em AIJ poliarticular, foi conduzida em 8 sujeitos durante 178 visitas, registrando-se a contagem articular, avaliação global pelo médico em escala analógica visual 0-10 (VAS-MD), avaliação global pelos pacientes/pais (VAS- P) e velocidade de hemossedimentação (VHS) normatizada para escala de 0-100. A comparação longitudinal foi por ANOVA ou modelo ajustado Gama. As observações pareadas entre o DAS 28 e JADAS 71, 27 e 10, respectivamente, foram analisadas por regressão linear após conversão logarítmica (ln). Medidas secundárias de desfecho da artrite como a capacidade funcional por meio do questionário “Childhood Health Assessment Questionnaire” (CHAQ), qualidade do sono por meio do Questionário de Hábitos do sono, limitação de atividades, peso, altura e adequação pondero-estatural foram avaliados de forma descritiva durante todas as visitas. As observações longitudinais das medidas primárias e secundárias de desfecho da artrite apresentaram diferença estatística entre a primeira e a segunda visita comparada as demais num total de 30 visitas e período de observação até 5 anos. As observações longitudinais indicaram diferença significante nos parâmetros DAS 28, JADAS 71, 27 e 10, VAS-MD, VAS-P entre as primeiras duas visitas do estudo original quando 5 atingiram a resposta ACR-Pedi 30 com melhora. A regressão linear para ajustamento do DAS 28 e JADAS resultou em fórmulas para conversão: DAS 28=1.263 x l.285 x In...
Arthritis activity may be assessed by different tools. For Rheumatoid Arthritis (RA), Disease Activity Score (DAS 28) and for Juvenile Idiopathic Arthritis (JIA) the Juvenile Arthritis Disease Activity Score (JADAS), are both used in practice. Explore equivalence of continuous measures of disease activity comparing DAS 28 and each of the 3 versions of JADAS based on 10-, 27- and 71- joint count, in patients with JIA. A secondary analysis of a randomized trial testing abatacept in polyarticular JIA was conducted. 178 assessments in 8 subjects were performed including standardized joint count, physician global assessment by Visual Analog Scale 0-10 (VAS-MD), global assessment by patients/parents (VAS-P) and erythrocyte sedimentation rate (ESR) normalized to 0-100 scale. Comparison by visit was done by ANOVA or gamma adjustment model. Paired observations of DAS 28 and JADAS 71-, 27- and 10-, respectively, were analysed by linear regression after logarithmic scale conversion (ln). Secondary outcome measures as functional capacity by CHAQ tool (Childhood Health Assessment Questionnaire), Sleep Habits Questionnaire, activity limitations, weight, length according to normative values were assessed by descriptive measures along all study visits. Longitudinal comparison of primary and secondary outcome measures resulted in significant difference among the first and second visits compared to the others making 30 visits until 5 years of long-term follow up. Longitudinal comparison by visit indicated significant difference in the first two visits of the original trial for the following parameters DAS 28, JADAS 71-, 27- and 10-, VAS-MD, VAS-P, when 5 subject reached ACR-Pedi 30 improvement response. Linear regression for adjustment between DAS 28 and each JADAS version resulted in transforming formulae: DAS 28=1.263 x ln (JADAS 71) - 1.267 (r2=0.81); DAS 28= 1.288 x ln (JADAS 27) – 1.297 (r2=0.80) e DAS 28= 1.285 x In ...
Capela, Renata Campos. „Equivalência métrica do Disease Activity Score (DAS 28) e Juvenile Arthritis Disease Activity Score (JADAS) na artrite idiopática juvenil /“. Botucatu : [s.n.], 2012. http://hdl.handle.net/11449/106054.
Der volle Inhalt der QuelleBanca: Virginia Paes Leme Ferriani
Banca: Simone Appenzeller
Banca: José Eduardo Corrente
Banca: Ivete Dalben
Resumo: A atividade da artrite pode ser avaliada por diferentes instrumentos. Na Artrite Reumatóide (AR) o Disease Activity Score (DAS 28) e na Artrite Idiopática Juvenil (AIJ) o Juvenile Arthritis Disease Activity Score (JADAS) são utilizados na prática. Explorar a equivalência de medidas contínuas de atividade, o DAS 28 e as 3 versões do JADAS, pontuando 71, 27 e 10 articulações, em portadores de AIJ. Análise secundária de um ensaio clinico, testando o abatacepte em AIJ poliarticular, foi conduzida em 8 sujeitos durante 178 visitas, registrando-se a contagem articular, avaliação global pelo médico em escala analógica visual 0-10 (VAS-MD), avaliação global pelos pacientes/pais (VAS- P) e velocidade de hemossedimentação (VHS) normatizada para escala de 0-100. A comparação longitudinal foi por ANOVA ou modelo ajustado Gama. As observações pareadas entre o DAS 28 e JADAS 71, 27 e 10, respectivamente, foram analisadas por regressão linear após conversão logarítmica (ln). Medidas secundárias de desfecho da artrite como a capacidade funcional por meio do questionário "Childhood Health Assessment Questionnaire" (CHAQ), qualidade do sono por meio do Questionário de Hábitos do sono, limitação de atividades, peso, altura e adequação pondero-estatural foram avaliados de forma descritiva durante todas as visitas. As observações longitudinais das medidas primárias e secundárias de desfecho da artrite apresentaram diferença estatística entre a primeira e a segunda visita comparada as demais num total de 30 visitas e período de observação até 5 anos. As observações longitudinais indicaram diferença significante nos parâmetros DAS 28, JADAS 71, 27 e 10, VAS-MD, VAS-P entre as primeiras duas visitas do estudo original quando 5 atingiram a resposta ACR-Pedi 30 com melhora. A regressão linear para ajustamento do DAS 28 e JADAS resultou em fórmulas para conversão: DAS 28=1.263 x l.285 x In ...
Abstract: Arthritis activity may be assessed by different tools. For Rheumatoid Arthritis (RA), Disease Activity Score (DAS 28) and for Juvenile Idiopathic Arthritis (JIA) the Juvenile Arthritis Disease Activity Score (JADAS), are both used in practice. Explore equivalence of continuous measures of disease activity comparing DAS 28 and each of the 3 versions of JADAS based on 10-, 27- and 71- joint count, in patients with JIA. A secondary analysis of a randomized trial testing abatacept in polyarticular JIA was conducted. 178 assessments in 8 subjects were performed including standardized joint count, physician global assessment by Visual Analog Scale 0-10 (VAS-MD), global assessment by patients/parents (VAS-P) and erythrocyte sedimentation rate (ESR) normalized to 0-100 scale. Comparison by visit was done by ANOVA or gamma adjustment model. Paired observations of DAS 28 and JADAS 71-, 27- and 10-, respectively, were analysed by linear regression after logarithmic scale conversion (ln). Secondary outcome measures as functional capacity by CHAQ tool (Childhood Health Assessment Questionnaire), Sleep Habits Questionnaire, activity limitations, weight, length according to normative values were assessed by descriptive measures along all study visits. Longitudinal comparison of primary and secondary outcome measures resulted in significant difference among the first and second visits compared to the others making 30 visits until 5 years of long-term follow up. Longitudinal comparison by visit indicated significant difference in the first two visits of the original trial for the following parameters DAS 28, JADAS 71-, 27- and 10-, VAS-MD, VAS-P, when 5 subject reached ACR-Pedi 30 improvement response. Linear regression for adjustment between DAS 28 and each JADAS version resulted in transforming formulae: DAS 28=1.263 x ln (JADAS 71) - 1.267 (r2=0.81); DAS 28= 1.288 x ln (JADAS 27) - 1.297 (r2=0.80) e DAS 28= 1.285 x In ...
Doutor
PEREIRA, ORLANDO MANSUR T. S. A. „THE E SCORE MODEL FOR THE PREDICTION OF BANKRUPTCY OF INTERNET COMPANIES“. PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2002. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=3327@1.
Der volle Inhalt der QuelleThe objective of this research is to propose a statistical model that could estimate the probability of occurrence of bankruptcy for Internet companies. After the recent and drastic losses of investment capital in companies in this new sector of the economy, financial institutions, individuals and all investors wish to know the real financial position of these companies called dotcom. This research selected American companies that have filed a petition under the United States Bankruptcy Code, between 1999 and 2001, and companies which have not done it, by convenience sampling, that list their shares on stock markets and operate in e-commerce, i.e. companies that sell their products or services through the Internet. The financial statements of these companies were also used to identify,by analyzing a T test of independent samples, the most significant variables for discriminating the two observed groups in the sample: the bankrupt and the nonbankrupt companies. After analyzing the variables statistical distributions, a logistic regression model revealed to be the more appropriate for the research, for not having the multivariate normality assumption. The conclusion of this research proposes a statistical model which indicates the probability of an Internet company becoming bankrupt or not, with a Nagelkerke R Squared of 0,887, and an overall percentage of correct prediction of 97,4 percent. The model uses several variables not previously included in similar previous financial difficulties prediction models.
Ahlklo, Yrr, und Carin Lind. „E, S or G? A study of ESG score and financial performance“. Thesis, KTH, Industriell ekonomi och organisation (Inst.), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-246008.
Der volle Inhalt der QuelleHållbarhet är inget nytt koncept inom finans, men dess popularitet och användning har ökat kraftigt. Dock är det fortfarande oklart hur hållbara investeringar förhåller sig till lönsamhet och avkastning. En av de mest använda hållbarhetsmåtten är ESG, som står för environmental, social and governance. I denna studie undersöker vi relationen mellan ESG-mått och lönsamhet, både marknads- och resultatbaserad. Vi delar också upp ESG i sina tre komponenter E, S, och G för att undersöka vilken faktor som har den starkaste relationen till lönsamhet. Detta görs genom en regressionsanalys med paneldata från ett urval av nordiska aktier och Sustainalytics ESG-mått. Vårt resultat visar ingen signifikant relation mellan ESG-mått och lönsamhet. Komponenten E visar den starkaste relationen till lönsamhet, ett signifikant och något negativt samband, men endast till en av tre responsvariabler. Vårt resultat indikerar således att inget samband verkar finnas mellan lönsamhet och dessa ESG-mått. Eftersom vår studie inte visar på något signifikant samband, blir vår rekommendation att investera i den aktien med högst ESG-mått, om man skulle välja mellan två annars lika aktier.
Castillo, Letícia Nunes Carreras Del. „Tradução, adaptação cultural e validação do Nonarthritic Hip Score para o Brasil“. Universidade do Estado do Rio de Janeiro, 2011. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=4771.
Der volle Inhalt der QuelleA avaliação da qualidade de vida tem sido cada vez mais utilizada pelos profissionais da área de saúde para mensurar o impacto de doenças na vida dos pacientes, bem como para avaliar os resultados dos tratamentos realizados. O crescente interesse por protocolos de pesquisa clínica em doenças não degenerativas do quadril tem encontrado muitos obstáculos na avaliação objetiva de seus resultados, principalmente nos estudos de observação de novas intervenções terapêuticas, como a artroscopia. O Nonarthritic Hip Score (NAHS) é um instrumento de avaliação clínica, desenvolvido originalmente em inglês, cujo objetivo é avaliar a função da articulação do quadril em pacientes jovens e fisicamente ativos. O objetivo desse estudo foi traduzir esse instrumento para a língua portuguesa, adaptá-lo para a cultura brasileira e validá-lo para que possa ser utilizado na avaliação de qualidade de vida de pacientes brasileiros com dor no quadril, sem doença degenerativa. A metodologia utilizada é a sugerida por Guillemin et al. (1993) e revisado por Beaton et al. (2000), que propuseram um conjunto de instruções padronizadas para adaptação cultural de instrumentos de qualidade de vida, incluindo cinco etapas: tradução, tradução de volta, revisão pelo comitê, pré-teste e teste, com reavaliação dos pesos dos escores, se relevante. A versão de consenso foi aplicada em 30 indivíduos. As questões sobre atividades esportivas e tarefas domésticas foram modificadas, para melhor adaptação à cultura brasileira. A versão brasileira do Nonarthritic Hip Score (NAHS-Brasil) foi respondida por 64 pacientes com dor no quadril, a fim de avaliar as propriedades de medida do instrumento: reprodutibilidade, consistência interna e validade. A reprodutibilidade foi 0,9, mostrando uma forte correlação; a consistência interna mostrou correlação entre 0,8 e 0,9, considerada boa e excelente; a validade foi considerada respectivamente boa e excelente; a correlação entre NAHS-Brasil e WOMAC foi 0,9; e a correlação entre o NAHS-Brasil e Questionário Algofuncional de Lequesne foi 0,79. O Nonarthritic Hip Score foi traduzido para a língua portuguesa e adaptado à cultura brasileira, de acordo com o conjunto de instruções padronizadas para adaptação cultural de instrumentos de qualidade de vida. Sua reprodutibilidade, consistência interna e validade foram também demonstradas.
The assessment of quality of life has been increasingly used by health professionals to measure the consequences of disease on patients' lives and evaluate the results of treatments. The growing interest in clinical research protocols of non-arthritic hip diseases has found many difficulties in dealing with the objective assessment of its results, especially in observational studies of new therapeutic interventions such as arthroscopy. The Nonarthritic Hip Score (NAHS) is a clinical assessment tool, originally developed in English to evaluate the function of the hip joint in young and physically active patients. The aim of this study was to translate this instrument into Portuguese, adapt it to the Brazilian culture and validate it, in order to evaluate quality of life of Brazilian patients with hip pain without osteoarthritis. The methodology used is suggested by Guillemin et al., (1993) and reviewed by Beaton et al., (2000), who proposed a set of standardized instructions for cultural adaptation of instruments for quality of life, including five steps: translation, back translation, review by committee, pre-test and test with a reassessment of the weights of scores, if relevant. The consensus version was administered to 30 individuals. Questions about sports and household chores were modified to better adapt to the Brazilian culture. The Brazilian version of Nonarthritic Hip Score (NAHS-Brasil) was answered by 64 patients with hip pain to evaluate the measurement properties of the instrument: reproducibility, internal consistency and validity. Reproducibility was 0.9, showing a strong correlation; the internal consistency showed a correlation between 0,8 and 0,9, considered good and excellent; the validity was considered good and excellent respectively; the correlation between NAHS-Brasil and WOMAC was 0,9, and the correlation between NAHS-Brasil and Lequesne Algofunctional Index was 0.79. The Nonarthritic Hip Score was translated into Portuguese and adapted to Brazilian culture, according to the instruction set of standardized instruments for cultural adaptation of quality of life. Its reliability, internal consistency and validity have also been demonstrated.
Cristino, Stefania <1972>. „Score istologico e allocazione dei "reni marginali": outcome a lungo termine del trapianto renale“. Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2008. http://amsdottorato.unibo.it/1084/.
Der volle Inhalt der QuelleBarison, Dherik. „Avaliação da qualidade de chamadas VoIP cifradas usando Mean opinion score e Traffic control“. [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/259456.
Der volle Inhalt der QuelleDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Elétrica e de Computação
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Resumo: A proposta desta dissertação é avaliar a qualidade de chamadas VoIP cifradas com diferentes algoritmos de criptografia através do OpenVPN, com o objetivo de identificar as diferenças de resultados entre os algoritmos de criptografia e também entre as chamadas cifradas e as não cifradas. Esta avaliação ocorrerá utilizando o MOS (Mean Opinion Score), um método que permite indicar a satisfação do usuário quanto a qualidade da comunicação. As chamadas VoIP cifradas irão ocorrer em diferentes cenários de rede que apresentam diversos problemas, tais como perda de pacotes, pacotes fora de seqüência, atraso, largura de banda de rede, etc. Estes cenários foram baseados em algumas situações reais de uso e serão emulados através da ferramenta Traffic Control do Linux, capaz de manipular os pacotes enviados por qualquer uma das interfaces de rede. Os cenários também terão diferentes larguras de banda de rede, para avaliar a influência das mesmas em algumas situações.
Abstract: The purpose of this work is to evaluate the quality of encrypted VoIP calls with different cipher algorithms through OpenVPN software, in order to identify differences in results between encryption algorithms and also differences between non-encrypted and encrypted calls. This evaluation will do by the MOS (Mean Opinion Score), a method to indicate user satisfaction of communication quality. The encrypted VoIP calls will occur in different network scenarios that present different problems, like packet loss, out-of-order packets, delay, network bandwidths, etc. These scenarios were based on some real situations of use and will be emulated with the Traffic Control tool from Linux, able of handling the packages sent by any available network interface. The scenarios will also have different network bandwidths to assess its importance in some situations.
Mestrado
Telecomunicações e Telemática
Mestre em Engenharia Elétrica
Monteiro, Laressa Manfio. „Indicadores de qualidade assistencial e Nursing Activities Score análise correlacional em um Hospital Especializado“. Botucatu, 2016. http://hdl.handle.net/11449/137790.
Der volle Inhalt der QuelleResumo: O processo reabilitador de uma criança com fissura labiopalatina requer acompanhamento periódico de uma equipe multiprofissional. A produção do cuidado durante a hospitalização destas crianças demanda da equipe de enfermagem tempo e habilidades específicas para identificar a participação ativa dos pais/responsáveis. A adequação quali-quantitativa dos profissionais de enfermagem associados as notificações dos eventos adversos permite atingir níveis de excelência com a assistência prestada, promove a documentação das ações e intervenções de enfermagem, auxilia o enfermeiro na tomada de decisão, além de dar visibilidade a profissão. Neste contexto, este estudo teve por objetivo correlacionar a carga de trabalho dos profissionais de enfermagem com os indicadores assistenciais “lesão de pele”, “saída não planejada de sonda oro/nasogastroenteral para aporte nutricional” e “extubação acidental de cânula nasofaríngea” em uma unidade de cuidados semi-intensiva pediátrica especializada, por meio da aplicação do Nursing Activities Score informatizado. Trata-se de um estudo exploratório, correlacional e descritivo, prospectivo, de delineamento observacional analítico. A execução da pesquisa foi aprovada pelos Comitês de Ética em Pesquisa: da Faculdade de Medicina de Botucatu, Universidade Estadual Paulista “Júlio de Mesquita Filho” – CAEE: 28714114.6.0000.5411, de 22/04/2014, e do Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo – CAAE: 28714114.6.3001.5441,... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The rehabilitating process of a child with clefts lip and palate requires periodic monitoring of a multiprofessional team. The production of care during hospitalization of these children demand of the nursing team time and specific skills to identify the active participation of parents/guardians. The quali-quantitative adequacy of nursing professionals associated with the notifications of adverse events allows to reach levels of excellence with the assistance provided, promotes the documentation of actions and nursing interventions, helps nurses in decision making, in addition to give visibility to the profession. In this context, this study aimed to correlate the workload of nursing professionals with care indicators "skin lesion", “exit not planned probe oro/nasogastroenteral for nutritional support” and “accidental extubation nasopharyngeal tube" in a pediatric semi-intensive care unit specialized, by means of application of the Nursing Activities Score computerized. This is an exploratory study, correlational and descriptive, prospective, observational analytic design. The execution of the study was approved by the Ethics Committee in Research at: the School of Medicine of Botucatu, University Estadual Paulista "Julio de Mesquita Filho" - CAEE: 28714114.6.0000.5411, 22/04/2014, and the Craniofacial Anomalies Rehabilitation Hospital, University of São Paulo - CAAE: 28714114.6.3001.5441, of 27/05/2014. The population consisted of all patients hospitalized in the unit, child... (Complete abstract click electronic access below)
Mestre
Nunes, Paula Alexandra Jacinta. „Sagres beer and its sponsorship strategy: will Sagres score with Sport Lisboa e Benfica?“ Master's thesis, NSBE - UNL, 2010. http://hdl.handle.net/10362/10292.
Der volle Inhalt der QuelleIn the last day of 2008, Sagres signed a “long-term” sponsorship contract with Sport Lisboa e Benfica that reinforced the support of the beer brand to football, as well as, to one of the greatest Portuguese sports clubs. This case reviews Sagres’ search for leadership in the Portuguese beer market along with its strategy of association with football. It focuses on understanding Sagres’ gains and the implications for the dynamics of the Portuguese beer market.
Otarola, Guillen Eddie Herbert. „Importancia del “score de lesiones” en el diagnóstico e investigación de enfermedades de aves“. Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2011. https://hdl.handle.net/20.500.12672/15235.
Der volle Inhalt der QuelleEl documento digital no refiere asesor
Los primeros estudios relacionados a calificación de lesiones fueron a aplicados para coccidiosis, con el fin de determinar la eficiencia de las drogas anticoccidiales y el momento en que era necesario una rotación de la droga. Con el mejoramiento genético de las aves de producción se incrementó la susceptibilidad a las enfermedades respiratorias causadas por virus y bacterias; a las enfermedades digestivas como las ocasionadas por clostridios; a las enfermedades ocasionadas por agentes inmunosupresores, y a las alteraciones del aparato locomotor. Todos estos problemas han hecho que hoy en día se evalúe mediante una escala de valoración o “score de lesiones” la intensidad de signos y lesiones de muchos más órganos que los afectados por la Coccidiosis. La aplicación del score de lesiones debe considerar de manera objetiva las diferencias que existen en grados de lesiones a nivel macroscópico y microscópico, tomando como base las diferencias entre los procesos agudos y crónicos de la infección. Además el desarrollo de nuevas vacunas ha hecho que la investigación sobre protección inmunológica vacunal sea cada vez más intensa, requiriendo de una herramienta, que permita evaluar y diferenciar la intensidad de signos y lesiones en órganos, asociadas a diferencias en patogenicidad entre cepas vacunales o agentes infecciosos, determinando el grado de severidad o protectividad de las mismas con la ayuda del score de lesiones, el cual utiliza variables semicuantitativas, siendo un método subjetivo por lo cual debe ser empleado o asesorado por personas con experiencia en este campo.
Trabajo de suficiencia profesional
Cheregati, Jarço Wigor Sampaio. „Determinantes do score de crédito e tempo até inadimplência para empréstimos comerciais a pessoas físicas“. reponame:Repositório Institucional da UnB, 2008. http://repositorio.unb.br/handle/10482/8109.
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O Novo Acordo de Basiléia (Basiléia II) permite aos bancos desenvolverem internamente abordagens para classificação de risco de acordo com as experiências em suas carteiras de crédito como uma das diretrizes que visam dar maior segurança ao sistema financeiro. Neste sentido, o objetivo deste trabalho é o de desenvolver um modelo estatístico de classificação de risco credit scoring a partir de informações sobre empréstimos concedidos no passado recente de uma carteira de crédito rotativo, tais como hábitos de pagamentos, variáveis cadastrais de perfil e comportamentais dos tomadores de crédito. Adicionalmente, será abordada a técnica de Análise de Sobrevivência, a qual busca estimar o tempo esperado até a default (inadimplência) de um contrato. As análises partem da definição da qualidade de crédito (bom ou ruim) e tempo observado até a inadimplência, sendo seguida pelo estudo das variáveis dos clientes que influenciam na capacidade destes em honrarem os compromissos de crédito obtidos. As técnicas empregadas para seleção das variáveis com relevância estatística para classificação dos bons e maus pagadores e tempo estimado até default foram a regressão logística (para o modelo de credit scoring) e Modelo de Riscos Proporcionais de Cox (para a Análise de Sobrevivência). Os resultados demonstram que é possível identificar antecipadamente o tempo esperado e a probabilidade de inadimplência dos tomadores de crédito, constituindo instrumentos de considerável relevância nas decisões afetas a políticas de concessão de crédito nas instituições financeiras. ______________________________________________________________________________ ABSTRACT
Basel II allows banks to develop risk classification techniques which incorporate experiences from their credit bureaus, granting wider security to the financial system. The aim of this work is the development of a statistical model of risk classification. This credit scoring model is based on information about past credit experience, such as payment habit and profile, and the behavioral variables of credit consumers. In addition, Survival Analysis, which attempts to estimate the time until a contract’s default occurs, will be used. The analysis starts with the definition of credit quality (good or bad) and the time until default for the contracts studied and is followed by the exploration of which variables are unconditionally related to default. Variables were selected for inclusion in the logistic regression (for the credit scoring model) and Cox Proportional Hazards Model (for the Survival Analysis model) based on their statistical significance in explaining default and time to default, respectively. The results demonstrate that it is possible to identify the time to default and the probability of default for customers who intend to contract credit, hence the models are shown to be important tools for the credit decision policies of financial companies.
Cintra, Lisley Keller Liidtke. „Adaptação cultural e validação do questionário de sintomas neurogenic bladder symptom score para o português“. Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/5/5153/tde-31102018-113311/.
Der volle Inhalt der QuelleINTRODUCTION: Until recent times, there was no specific tool to evaluate the symptoms of the lower urinary tract of patients with neurological diseases. Several instruments have been developed and recommended for evaluation of urinary symptoms in patients with lower urinary tract dysfunction, but because they do not capture the specificity of the neurogenic bladder, they present questions that are inapplicable or insufficient to evaluate the symptoms of this population. In 2014 it was introduced the Neurogenic Bladder Symptom Score (NBSS), specific for patients with a neurogenic bladder diagnosis. It contains questions about urinary incontinence, symptoms and methods of bladder emptying, complications associated with voiding dysfunction and quality of life. OBJECTIVE: This study aimed to perform the cultural adaptation and validation of the NBSS questionnaire for the Brazilian Portuguese. METHODS: The symptom questionnaire was culturally adapted according to international guidelines, following the steps of: translation, synthesis, back-translation, expert committee review, and pre-final version test. The version adapted for Brazil was applied in patients with neurogenic bladder diagnosis due to spinal cord injury or multiple sclerosis, who attended for medical appointments with physiatrist or urologist. The same patients answered the questionnaire again within 7 to 14 days (retest). Reliability was assessed by internal consistency, using Cronbach\'s alpha, and stability (test-retest), as assessed by Intraclass Correlation Coefficient. Patients who did not return for questionnaire reapplication or who reported changes in lower urinary tract symptoms during this period were excluded from the stability analysis. The criterion validity was evaluated by applying the Brazilian version of the Qualiveen-SF quality of life questionnaire and the result was measured using the Intraclass Correlation Coefficient. The validity of content was determined by the evaluation and judgment of the committee of experts. The construct validity was obtained by the comparison between the NBSS and the evaluation of the global function of the bladder, through analysis of variance. RESULTS: A total of 68 patients (57 men - 83.8%) with an average age of 38.9 (± 14.7) years participated in the study. There was good internal consistency of the Portuguese version, with Cronbach\'s alpha of 0.813. Stability (test / retest) was also high, with a Intraclass Correlation Coefficient of 0.8596 [0.7586-0.9202] (p < 0.0001). For criterion validity, the Intraclass Correlation Coefficient revealed a moderate correlation between the Portuguese version of the NBSS and the Qualiveen-SF questionnaire (r = 0.6552 [0.423-0.8151]; p < 0.0001). CONCLUSIONS: The results of the study demonstrated that the Brazilian version of the NBSS - Neurogenic Bladder Symptom Score shows good internal consistency, stability and ability to measure the correct construct. The process of cultural adaptation and validation of the NBSS questionnaire for Portuguese language in patients with neurogenic lower urinary tract dysfunction was concluded. The instrument is suitable for clinical and research use
Schardosim, Juliana Machado. „Adaptação transcultural e validação clínica do instrumento neonatal Skin Condition Score para uso no Brasil“. reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/67151.
Der volle Inhalt der QuelleSkin integrity is fundamental for the adaptation of a newborn (NB) to extrauterine life. The standardized assessment of neonatal skin conditions by nurses is essential to ensure that possible abnormalities are handled uniformly. The Neonatal Skin Condition Score (NSCS) is a widely used tool in countries where the language is English. The purpose of this study was to adapt the NSCS cross-culturally and validate it clinically for use in Brazil. The method used for cross-cultural adaptation was originally described by Beaton et al. Cross-cultural adaptation was conducted from June to December 2011. In this phase, the score was translated and adapted for use in Brazil, and the clarity of the prefinal version was evaluated. For that purpose, 38 healthcare workers were included in the study. The evaluation of the clarity of the scale was verified by Likert scale, resulting in a level of clarity above 80% in the three variables. After cross-cultural adaptation was proceeded a clinical validation, which was outlined by a cross-sectional observational study. Data for clinical validation were collected from May to July 2012. Were included in this phase newborns of any gestational age hospitalized in the Neonatal Intensive Care Unit (NICU) and in the Rooming-in Care (RIC) of Hospital de Clínicas de Porto Alegre (HCPA). The sample selection was made by convenience, comprising 47 NB in the NICU and 40 in the RIC. Obtained a total of 188 evaluations in the NICU and 160 in the RC; for each participant, two face-to-face and two evaluations using digital digital images were made. Statistical analyses of clinical validation evaluated intra and interobserver reliability using the following tests: Prevalence-Adjusted Bias-Adjusted Kappa (PABAK), intraclass correlation coefficient (ICC) and Bland-Altman plots. The item-by-item analysis of agreement revealed good concordance using PABAK in both units. The analysis of total scores according to ICC revealed satisfactory results only for the NICU, with interrater reliability of 0.88 (excellent) and intrarater reliability of 0.61 (good). In the OCU, intrarater reliability was 0.49 (moderate), and interrater reliability, 0.24 (fair). Bland-Altman plots revealed the variation between the scores intrarater and interrater in both units. In the NICU, was an average variation interrater of 0.24, with deviation of 1.38 up and 1.87 down while an average variation intrarater reliability observed was 0.1, with deviation of 0.83 up and 1.03 down. In the RIC, average variation of interrater reliability was 0.01, with deviation of 1.93 up and 1.91 down while the average variation of intrarater reliability was 0.04, with deviation of 1.51 up and 1.44 down. We concluded that the cross-cultural adaptation and clinical validation of NSCS is evidenced to use in NICU, is called Escala de Condição da Pele do Recém-Nascido (ECPRN) in the adapted version for Brazilian 8 portuguese. Further studies should be conducted in the RIC to validate the scale for use in this type of unit as well studies of interventions skin care using ECPRN.
Vanderlei, Marina Reghini. „Efeitos dos agrotóxicos Kraft®36EC e Score®250EC (e seus princípios ativos) em ecossistemas aquáticos: análises comparativas e ecossistêmicas“. Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/18/18139/tde-30052016-102950/.
Der volle Inhalt der QuelleWith the advent of agriculture, food production and consumer goods has expanded, however, environmental risks were also maximized due to the adoption of production techniques based on intensive use of agricultural inputs. This worldwide problem is more evident in developing countries which have agricultural production as the basis of its economy. Brazil is into this situation and since 2009 it is considered the largest consumer of the world\'s pesticides, creating a scenario of environmental risk and human health. The environmental effects from this study are related not only to loss of non-targeted species, since pesticides are nonselective, but also changes in the ecosystem level, which relates to the loss of functions and services generated by natural systems. Add to this complexity, the mode of action of each pesticide, their distribution in the different compartments (air, soil and water), the period of stay of each, the synergistic relationships resulting from interactions between different products, the formation of by-products in the process of degradation, among other factors, such as differences between the active ingredient and the commercial formulation in which there are so-called ingredients inert in the composition, which may be more toxic to species and ecosystems. Considering this approach, this research was developed based on the reality of a reference site, the municipality of Bom Repouso (MG/BR), in which the intensification of production of strawberry and potato has brought a series of social and environmental risks. Similar to other productive regions of the country, the use of pesticides is recurrent, widespread and unrestrained, highlighting the commercial formulations Kraft®36EC and Score®250EC, which, along with their active ingredients (abamectin and difenoconazole) have been evaluated by toxicity tests with representative species of different trophic levels of an aquatic ecosystem, generating information that have been evaluated at the species level and ecosystem, simulating the application scenario of the products on the reference location. The results showed differences on the sensitivity of species and what are the most appropriate to evaluate the toxic effects of both pesticides; the differential effects between the commercial formulation and the active ingredients; as well as the responses in terms of species and ecosystems, demonstrating the need for both to be considered in ecological risk assessment.
Rocha, André Gomes da. „Avaliação dos efeitos dos agrotóxicos Kraft® 36 EC e Score® 250 EC na flora, micro e mesofauna edáficas“. Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/18/18139/tde-30102017-164459/.
Der volle Inhalt der QuelleEnvironmental changes caused by humanity, especially by agriculture, have been a cause for concern throughout the world. The soils are one of the environmental compartments most impacted by the use of pesticides, which are widely used in modern agriculture. This research aimed at evaluating whether and how the insecticide Kraft® 36 EC (a.i. abamectin) and the fungicide Score® 250 EC (a.i. difenoconazole), isolated and in mixture, affect: a) the soil microbial communities (microbial biomass carbon, respiration, metabolic quotient and β-glucosidase enzyme); b) enchytraeid worms (reproduction of Enchytraeus crypticus in different densities and their trophic relation with microorganisms); and c) the flora (emergence and growth of tomato - Lycopersicon lycopersicum), over 84 days after contamination. The microbial indicators were not greatly impaired and expressed a functional redundancy, despite some variations due to the presence of pesticides. Nevertheless, the control group presented a greater stability than the contaminated ones, suggesting a greater robustness and stability of microorganisms over time, which are important factors for a better quality of the soil. In relation to E. crypticus tests, the importance of microorganisms on their diet was ratified, since positive correlations between the size of microbial communities and the enchytraeids rate of increase were observed. The different densities of E. crypticus were not significantly influenced by the effects of pesticides on the microorganisms. With respect to the growth and germination of tomato, higher values of height and dry mass of the seedlings were observed in contaminated groups. On the other hand, a higher growth tendency of the seedlings in the control soil was observed over time. Finally, considering the complexity of the Brazilian pesticide issue, we emphasize the importance of compliance of the recommendations on pesticides application and reinforce the initiative of decreasing their use.
BEZERRA, Márcia Francineli da Cunha. „Composição e abundância dos Copepoda (crustacea) planctônicos da costa do Amapá - Op. Norte IV (REVIZEE/SCORE NO)“. Universidade Federal do Pará, 2006. http://repositorio.ufpa.br/jspui/handle/2011/5202.
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CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico
CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
A caracterização da composição de Copepoda planctônicos, na costa do Amapá foi estudada, a partir de amostras coletadas através do programa REVIZEE, durante a Operação Norte IV, em 2001, realizada pelo navio Oceanográfico “Antares”, pertencente à Marinha do Brasil (H-40). A área estudada está inserida na ZEE Norte brasileiro no trecho entre o Cabo Orange e o Delta do rio Parnaíba, enquadrando-se nas seguintes coordenadas geográficas, LAT. 02º 25,92’N e LONG. 049º11,98’W (est. 102); LAT. 03º36,14’N e LONG. 048º24,71’W (est. 107); LAT. 05º32,39’N e LONG. 050º13,11’W (est.130); LAT. 04º23,64’N e LONG. 051º02,58’W (est.134). As coletas foram realizadas através de arrastos verticais com rede de zooplâncton, com malha de 200 μm, dotadas de fluxômetro. Após as coletas, as amostras foram fixadas com formol neutro a 4 %. Também foram coletados os fatores hidrológicos, onde a temperatura da água variou de 23, 72 ºC a 28,87 ºC na plataforma continental, enquanto na região oceânica variou de 12,69 ºC a 28,87 ºC. A salinidade, na plataforma continental, variou 24,00 PSU a 36,42 PSU, e na região oceânica a variação foi de 33,98 PSU a 36,62 PSU. A costa do Amapá foi considerado um ambiente estável, devido as poucas variações de salinidade e temperatura. Foram identificadas 84 espécies de Copepoda, das quais, destacaram-se como as mais freqüentes, Clausocalanus furcatus, Oithona setigera, Paracalanus parvus, Macrosetella gracilis, Oncaea media, Corycaeus speciosus, Farranula gracilis, Subeucalanus pileatus e Paracalanus sp. As altas densidades e dominância ocorreram para as espécies, Nannocalanus minor, Corycaeus (Corycaeus) speciosus, Clausocalanus furcalocalanus pavo, Paracalanus parvus, Parvocalanus crassirostris, Oithona setigera, Macrosetella gracilis, Farranula gracilis, Subcalanus pileatus, Euterpina acutifrons e Oncaea media, consideradas como indicadoras de oligotrofia na área estudada. Dentre estas, a espécie Subeucalanus pileatus foi a que mais se destacou, a qual ocorreu na maioria das estações. A diversidade foi considerada alta na maioria das estações, exceto na estação 127 (considerada baixa), por estar sendo influenciada pela pluma amazônica. Enquanto, a densidade apresentou resultados menores que 100 org.m-³ indicando a região oceânica como um ambiente oligotrófico, e apesar disso, a comunidade de Copepoda encontra-se em grande diversidade na área.
The characterization of the composition of planktonic copepods, on the coast of amapá studied, from samples collected through the program REVIZEE, by the Oceanographic Ship “Antares”, owned by the Brazilian Navy (H – 40), during Operation North IV in 2001. The studied area is inserted Economic Exclusive Zone (ZEE) in the Brazilian north stretch between the cape Orange and River Delta of Parnaíba, incorporating on the following geographic coordinates, LAT. 02º 25,92’N e LONG. 049º11,98’W (est. 102); LAT. 03º36,14’N e LONG. 048º24,71’W (est. 107); LAT. 05º32,39’N e LONG. 050º13,11’W (est. 130); LAT. 04º23,64’N e LONG. 051º02,58’W (est. 134). The samples were collected through vertical, hauls with net zooplankton, (mesh opening, 200 μm), with a flowmeter. After the collections the samples were fixed with neutral formalin to 4%. Also collected were the hydrological factors, where the water temperature ranged from 23, 72º C to 28,87 ºC in the continental shelf, while in the ocean ranged from 12,69 ºC a 28,87 ºC. The salinity in the in the continental shelf, ranged 24,00 PSU a 36,42 PSU, and in the ocean range was 33,98 PSU a 36,62 PSU. The Amapá of coast was considered a stable environment, because the few changes in salinity and temperature. Were identified 84 species of copepods, of which highlighted itself as the most frequent, Clausocalanus furcatus, Oithona setigera, Paracalanus parvus, Macrosetella gracilis, Oncaea media, Corycaeus speciosus, Farranula gracilis, Subeucalanus pileatus e Paracalanus sp. The highest densities and dominance occurred for the species, Nannocalanus minor, Corycaeus (Corycaeus) speciosus, Clausocalanus furcalocalanus pavo, Paracalanus parvus, Parvocalanus crassirostris, Oithona setigera, Macrosetella gracilis, Farranula gracilis, Subcalanus pileatus, Euterpina acutifrons e Oncaea media, considered as indicators oligotrofia of the studied area. Among these, the species Subeucalanus pileatus was that most stood out, which took place in most stations The diversity was considered high in most stations, except in the 127 (considered low), because it is influenced by Amazonas plume. While the density results showed that 100 org.m-³ children indicating the oceanicregion as an oligotrophic, environment and despite that, the of community of copepods in great diversity in the area.
Silveira, Luiz Felipe de Vasconcellos. „A avaliação do impacto de um treinamento utilizando Propensity Score Matching : uma abordagem não-paramétrica e semiparamétrica“. reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/147470.
Der volle Inhalt der QuelleThe goal of this thesis is to evaluate the impact of a job training program using propensity score matching methods with two types of approaches: a nonparametric e another semiparametric. For non-parametric estimation was used a method proposed by Li, Racine and Wooldridge (2009) and for the semiparametric model the Generalized Additive Model proposed by Hastie and Tibshirani (1990). The results indicate that both methods provide estimates as good or better than when parametrically estimated.
Cavalcanti, Ivanessa Thaiane do Nascimento. „Análise dos diferenciais de desempenho dos estudantes cotistas e não cotistas da UFBA pelo propensity score matching“. Faculdade de Economia, 2015. http://repositorio.ufba.br/ri/handle/ri/18125.
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CAPES
As políticas públicas visam reduzir as desigualdades existentes entre os diferentes grupos sociais. A ação afirmativa no ensino, por meio de concessão de cotas e mecanismos de permanência, consiste em uma vertente destas políticas e busca reduzir as diferenças no acesso e inclusão educacional. Esta dissertação objetiva verificar o efeito da Política de Cotas no ensino superior, mediante a análise do desempenho dos estudantes que ingressaram na UFBA a partir de 2005 e que graduaram até 2013. Para tanto, foi utilizado dois métodos econométricos. O primeiro consiste no Propensity Score Matching para analisar a diferença entre os grupos de indivíduos que participaram das cotas (grupo de tratamento) e não cotista (grupo controle). E segundo trata da Hipótese de Mismatch, que busca medir os níveis de incompatibilidade de educação entre os estudantes, pelo método Realized Matches ajustado. Por meio do efeito médio de tratamento dos grupos é possível identificar se a política de cotas teve o resultado esperado e se os estudantes ingressam e concluem os cursos com níveis de incompatibilidade de conhecimento diferentes. A apreciação do desempenho mostrou que os estudantes cotistas apresentam um desempenho inferior quando comparado aos alunos não cotistas. Há níveis de conhecimento diferentes entre os estudantes, entretanto, as diferenças tendem a reduzir durante o decorrer do curso.
Public policies aimed at reducing inequalities between different social groups. Affirmative action in education, by granting quotas and retention mechanisms, consists of a part of these policies and seeks to reduce differences in access and educational inclusion. This dissertation aims to verify the effect of the Quota Policy in higher education, by analysis of the performance of students who entered the UFBA from 2005 and graduated by 2013. Therefore, we used two econometric methods. The first is the propensity score matching to analyze the difference among groups of individuals who participated in the quotas (treatment group) and no shareholder (control group). The second deals with the Mismatch Hypothesis, which seeks to measure education incompatibility levels among students by the method Realized Matches adjusted. Through the average effect of treatment groups can be identified if the quota policy had the expected result and students enter and complete the courses with different knowledge levels of incompatibility. The assessment of the performance showed that quota students have a lower performance compared to non-quota students. There are different levels of knowledge among students, however, the differences tend to reduce during the course of the course.
Souza, de Oliveira Vanildo. „Distribuição e abundânia relativa de peixes e crustáceos capturados no programa REVIZEE/Score-NE na plataforma externa e talude da costa do Nordeste do Brasil“. Universidade Federal de Pernambuco, 2005. https://repositorio.ufpe.br/handle/123456789/8586.
Der volle Inhalt der QuelleDurante o período entre 27/10/1997 e 19/11/2000, foram realizados 27 cruzeiros de prospecções com espinhel-de-fundo e armadilhas de profundidade na plataforma externa e talude da costa nordestina, como parte das atividades do programa REVIZEE. A abundância relativa das espécies foi analisada a partir da captura por unidade de esforço (CPUE), em termos do número de indivíduos capturados por 100 anzóis no espinhel horizontal e número de indivíduos por covo por lance, no caso das armadilhas. Os perfis verticais de temperatura e salinidade indicaram presença de uma camada de mistura com cerca de 80m nos dois primeiros cruzeiros, enquanto que no terceiro e quarto a termoclina encontrou-se bastante próxima da superfície, a aproximadamente 20m de profundidade. Na prospecção com espinhel foram analisados a distribuição e abundância relativa de oito espécies de teleósteos e duas de elasmobrânquios. A diversidade das espécies apresentou uma tendência de declínio em função do aumento da profundidade. Foi observada uma segregação batimétrica entre as espécies, tendo sido as mesmas classificadas como: águas rasas (Lutjanus purpureus, Ocyurus crhysurus e Lutjanus vivanus), águas intermediárias(Lopholatilus villarii, Epinephelus niveatus e Etelis oculatus) e águas profundas (Squalus spp., Mustelus canis e Epinephelus morio). A distribuição vertical dos peixes foi influenciada pela presença da termoclina com a ocorrência de algumas espécies só se verificando abaixo da mesma. Já as quatro espécies de crustáceos estudadas (Chaceon fenneri, Rochinia crassa, Heterocarpus ensifer e Plesionika edwarisii) capturadas com covos, apresentaram uma distribuição vertical entre 100 e 600m, com características de espécies euribáticas e euritérmicas. Tanto os peixes quanto os crustáceos apresentaram uma clara segregação batimétrica, com maior abundância a partir dos 100m. Os gêneros Squalus e Mustelus, juntamente com Chaceon e Rochinia, Plesionika e Heterocarpus, parecem mais adaptados a grandes profundidades, diferentemente da maioria dos teleósteos. A ocorrência de crustáceos e peixes de profundidades abaixo de 100m no Nordeste, indica que eles dividem o mesmo ambiente e são influenciados por fatores comuns como temperatura e profundidade
Seiler, Nicole [Verfasser], und Heinz [Akademischer Betreuer] Schmidt. „Pflegekomplexmaßnahmen-Score Erwachsene – PKMS-E : Ein Spannungsfeld zwischen betriebswirtschaftlichen, pflegerischen und ethischen Aspekten / Nicole Seiler ; Betreuer: Heinz Schmidt“. Heidelberg : Universitätsbibliothek Heidelberg, 2017. http://d-nb.info/1177690551/34.
Der volle Inhalt der QuelleDucci, Adriana Janzantte. „Nursing Activities Score (NAS): estudo comparativo dos resultados da aplicação retrospectiva e prospectiva em Unidade de Terapia Intensiva“. Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-27092007-140248/.
Der volle Inhalt der QuelleThe using of measuring instruments of nursing workload prospectively is the fundamental interest, therefore the obtained pointing in retrospective way don´t show in real time nursing workload necessary to attend the requirements of patients care on the subsequent hours. The aims of this study were analysis NAS performing for prospective measuring of nursing workload in ICU and comparing them among NAS of prospective and retrospective application. It is methodological study developed in ICU of a private hospital of São Paulo city. The sample was constituted by 104 patients with ages equal or superior 18 years old, admitted in ICU that stayed there at least 24 hours in the first day of internation, during the period of September until November 2006. It has been collected demographic and internation data, SAP II, LODS and NAS of prospective and retrospective application. To compare the average of NAS and check the correlation and homogeneity between NAS retrospective and prospective had been used t-student test, Pearson Coefficients and Intraclass Correlation (ICC). To valuate the concordance among each item of NAS on the two ways of application had been used Kappa index. Patients of masculine sex were superior (55,8%), coming from first-aid clinic (35,6%) and they were admitted for clinical reasons (76,0%). The average pointing SAPSII and LODS were 31,8 and 2,9 points, respectively, with mortality of 17,3%. There was significative statistical difference (p< 0,001) between NAS average prospective and retrospective and moderate correlation (Pearson 0,65; ICC 0,623) between the measures. It had been observed that of the total 32 items of the instrument, at 11 werent possible to apply Kappa index due high percentage of concordance on a unique category of answers and that among 21 the analysis was possible, 10 items (47,6%) showed concordance equal or bigger than moderated, it was being only one item on the last classification (1a). In relation to the concordance for items, it was checked that some with high concordance (items 5, 10, 12, 14, and 20) and strong (9, 17, 18 and 21) they were referring to more objective data, with easy valuation and checking of nursery professionals and that generally don´t shown discordances as the type of caring that should be done. The items with sub-items (a, b and c) shown very weak concordance, or because of the subjective evaluation of searchers and nurses. Concluding that prospective NAS can be used when we wish to plan nursing care to will be afford, mainly, when we have the intention of distributing necessary nursing professional to afford assistance of quality during work schedule. However, there is the necessity of an effective uniformation among the ICU nursery for this projection become reliable
Bezerra, Leandro Ferro de Moraes. „ASSOCIAÇÃO ENTRE PESO PROSTÁTICO E SCORE DE GLEASON EM PACIENTES PORTADORES DE CÂNCER DE PRÓSTATA SUBMETIDOS A PROSTATECTOMIA RADICAL“. Pontifícia Universidade Católica de Goiás, 2014. http://localhost:8080/tede/handle/tede/2980.
Der volle Inhalt der QuelleIntroduction: Prostate cancer is one of he most frequent cancer types among men around the world and its global incidence has dramatically arrised on last decade. The prognostic factors already known are: Seric Prostatic Specific Antigen (PSA), Gleason Score and Clinical Stage. The prostate gland volume may be associated with these factors. Objecives: Evaluate a possible association between protate gland volume and the presence of high Gleason Score (7 or higher) on individuals with prostate cancer. Methods: We analyzed data from 139 files of patients who underwent radical prostatectomy for prostate cancer between march 2009 and november 2012. Prostate weight measured at prostatectomy was compared to other clinical variables (age, prostate specific antigen, PSA density) and pathological outcomes (final Gleason score, pathological stage). Patients were divided in 3 groups due to its prostate size (under 50grams, between 50-80grams and over 80grams). Multivariate logistic regression was used to assess prostate size as a predictor of high grade prostate cancer. RESULTS: The study population included 139 patients during march 2009 to november 2012, of whom 64 (46,04%) had Gleason Score 7 or higher. No association between low prostate weight and hight grade gleason score was found. This event were more frequent on intermediate group (prostate weight between 50 and 80 grams). We also did not find any association between prostate weight and any of the others paramters analysed between the 3 groups. Conclusions: No association between prostate size and hight grade Gleason score was found. Association between prostate size and any of the others paramters analysed between the 3 groups was not found either.
Introdução: O câncer de próstata é um dos cânceres mais frequentes entre homens no mundo e sua incidência global tem aumentado dramaticamente na última década. Os fatores prognósticos já conhecidos são: valores séricos do antígeno prostático específico (PSA), grau de diferenciação histológica (Score de Gleason) e estádio clínico. O peso da glândula prostática pode estar associado a estes fatores. Objetivo: Avaliar a possível associação entre volume da glândula prostática e a presença de perfil histológico desfavorável (Score de Gleason 7 ou acima) em sujeitos portadores de câncer de próstata. Material e Métodos: Foram analisados dados de 139 prontuários de indivíduos portadores de câncer de próstata submetidos a prostatectomia radical entre março de 2009 e dezembro de 2012. O tamanho prostático foi medido através da aferição de peso do espécime cirúrgico e foi comparado às outras variáveis clínicas (idade, PSA, densidade de PSA) e dados anátomo-patológicos (Score de Gleason e estádio patológico). Os casos foram separados em 3 grupos, relacionados ao peso prostático (abaixo de 50 gramas, entre 50 e 80 gramas e acima de 80 gramas). Análise multivariada foi usada para avaliar a associação entre o peso prostático e o tumor prostático de alto grau. Resultados: A população estudada incluiu 139 sujeitos submetidos a prostatectomia radical entre março de 2009 e novembro de 2012. Destes, 64 (46,04%) apresentavam Score de Gleason maior ou igual a 7. Não houve associação significativa entre baixo peso prostático (abaixo de 50 gramas) a presença de Score de Gleason de alto grau. Tal evento foi mais frequente no grupo com próstatas com peso entre 50 e 80 gramas. Também não foi evidenciado associação entre baixo volume prostático e demais fatores avaliados. Conclusão: Não foi encontrado associação entre baixo volume prostático e presença de Score de Gleason de alto grau assim como com os demais parâmetros avaliados.
ARATA, LINDA. „Il Ruolo dei Programmi Agro-ambientali: un'analisi attraverso il Propensity Score Matching e la Programmazione Matematica Positiva con il Rischio“. Doctoral thesis, Università Cattolica del Sacro Cuore, 2014. http://hdl.handle.net/10280/2469.
Der volle Inhalt der QuelleThe increasing attention to the relationship between agriculture and the environment and the rise in price volatility on agricultural markets has led to a new emphasis on agri-environmental policies as well as to a search for new risk management strategies for the farmer. The research objective of this PhD thesis is in line with this challenging context, since it provides an analysis of the EU agri-environmental schemes (AESs) from two viewpoints. First, an ex-post analysis aims at investigating the AESs for their traditional role as measures which encourage sustainable farming while compensating the farmer for the income foregone in five EU Member States. The effects of AESs participation on farmer’s production plans and economic performances differs widely across Member States and in some of them the environmental payment is not enough to compensate the income foregone of participants. This study has been performed by applying a semi-parametric technique which combines a Difference-in-Differences estimator with a Propensity Score Matching estimator. The second piece of research develops a new methodological proposal to incorporate risk into a farm level Positive Mathematical Programming (PMP) model. The model presents some innovations with respect to the previous literature and estimates simultaneously the resource shadow prices, the farm non-linear cost function and a farm-specific coefficient of absolute risk aversion. The proposed model has been applied to three farm samples and the estimation results confirm the calibration ability of the model and show values for risk aversion coefficients consistent with the literature. Finally different scenarios have been simulated to test the potential role of an AES as risk management tool under different scenarios of crop price volatility.
Pinto, João Filipe Cruz Correia. „Avaliação da amplificação do gene HER 2, determinada por Fish e Sish, em casos com score 0/1 + por imunohistoquímica“. Dissertação, Instituto de Ciências Biomédicas Abel Salazar, 2010. http://hdl.handle.net/10216/62310.
Der volle Inhalt der QuelleReis-Alves, Suiellen Carvalho 1982. „Modificação do sistema de pontuação FCSS (score de citometria) aprimora o diagnóstico diferencial entre citopenias periféricas reacionais e síndromes mielodisplásicas“. [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309689.
Der volle Inhalt der QuelleTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A imunofenotipagem é reconhecida como uma importante ferramenta para o diagnóstico das síndromes mielodisplásicas (SMD). O sistema de pontuação por citometria de fluxo descrito recentemente (FCSS) é útil para o diagnóstico diferencial, bem como para o prognóstico de SMD. Avaliamos se a inclusão de valores quantitativos de expressões anormais em células CD34+ e monócitos nesta pontuação poderia melhorar o seu valor diagnóstico. O FCSS modificado (FCSS -R) abrange 9 alterações granulocíticas, 8 monocíticas e 6 de células CD34+. A análise imunofenotípica foi realizada em células de medula óssea (MO) de 56 pacientes com SMD (76% com blastos na medula óssea <5%), 33 casos de citopenias reacionais e 41 doadores de medula óssea saudáveis de transplante alogênico (controles normais). As duas pontuações foram aplicadas em todos os casos. Embora tenhamos encontrado o desvio à esquerda assíncrono na maturação dos granulócitos, a diminuição das hematogônias e o aumento de monócitos CD16+, bem como casos isolados de co-expressões anormais no amadurecimento de precursores mielomonocíticos em citopenias reacionais, alterações qualitativas e quantitativas nos sub tipos de células mielóides CD34+ foram mais específicas de SMD. Ambas as pontuações permitiram discriminar SMD de citopenias reacionais, mas, de acordo com a área sob a curva ROC, o FCSS -R foi mais sensível (53% para FCSS e 94% para FCSS -R). Ambas as pontuações apresentaram especificidade de 100%. A inclusão de valores quantitativos de expressões anormais nas células CD34+ e monócitos em FCSS melhorou a sensibilidade de FCSS-R para o diagnóstico diferencial entre SMD e citopenias periféricas reacionias
Abstract: Immunophenotyping has been recognized as an important tool for diagnosis of myelodysplastic syndromes (MDS). The recently described flow cytometry scoring system (FCSS) is useful for the differential diagnosis as well as prognosis of MDS. We examined if the inclusion of quantitative values of abnormal expressions in CD34+ cells and monocytes in this score could improve its diagnostic value. The modified FCSS (FCSS-R) covers 9 granulocytic, 8 monocytic and 6 CD34+ cell abnormalities. Immunophenotypic analyzes were performed on bone marrow (BM) cells of 56 patients with MDS (76% with bone marrow blasts <5%), 33 cases of reactive cytopenias and 41 healthy bone marrow donors for allogeneic BM transplantation (normal controls). The two scores were applied in all cases. Although asynchronous shift to the left in the maturing granulocytes, decrease in hematogones and increase in CD16+ monocytes as well as isolated cases of abnormal co-expressions in maturing myelomonocytic precursors could be found in reactive PB cytopenias, the most important differences with MDS were seen in the subsets of myeloid CD34+ cells. Both scores allowed to discriminate MDS from reactive cytopenias, but, according to the area under the ROC curve FCSS-R was more sensitive (53% for FCSS and 94% for FCSS-R). Both scores had a specificity of 100%. The inclusion of quantitative values of abnormal expressions in CD34+ cells and monocytes in FCSS improved the sensibility of FCSS for the differential diagnosis between MDS and reactive peripheral cytopenias
Doutorado
Clinica Medica
Doutora em Clínica Médica
Pinto, João Filipe Cruz Correia. „Avaliação da amplificação do gene HER 2, determinada por Fish e Sish, em casos com score 0/1 + por imunohistoquímica“. Master's thesis, Instituto de Ciências Biomédicas Abel Salazar, 2010. http://hdl.handle.net/10216/62310.
Der volle Inhalt der QuelleMartins, Quenia Camille Soares. „Nursing activities score como instrumento para medida da carga de trabalho em unidade de hematologia e transplante de células tronco hematopoiéticas“. reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2013. http://hdl.handle.net/10183/87180.
Der volle Inhalt der QuelleINTRODUCTION: Quantifying human resources in nursing is an essential management tool in order to cater to the clients’ and the institution’s needs. Several instruments are used to classify and identify the nursing workload, however few have been assessed regarding their applicability in oncohematologic and HSCT patients. The Nursing Activities Score (NAS) has shown its effectiveness regarding this goal in several other specialties. OBJECTIVES: To assess the NAS behavior when measuring the nursing workload in a hematology and hematopoietic stem cell transplantation (HSCT) unit. METHODS: This is a prospective descriptive cohort study. In order to collect data the NAS was used for 90 consecutive days in a sample composed of 81 patients of all ages in 110 hospitalizations, up to a total of 2.344 observations. Patients hospitalized for less than 24 hours were excluded. The study was carried out at the Protected Environment Unit at the Hospital de Clínicas, in Porto Alegre, from September until December, 2011. Instruments applied were: NAS, Karnosfsky or Lansky (PS), Adult Comorbidity Evaluation (ACE-27), and the Perroca scale. Patients were divided into 4 groups: (I) Oncohematologic (II) Autologous HSCT (III) Related allogenic HSCT (IV) Unrelated allogenic HSCT. In order to analyze the difference between NAS scores among groups the Generalized Estimating Equations (GEE) method was used, and to assess the relation between NAS, performance status, and between NAS and degree of dependence the Spearman correlation was used. RESULTS: Out of the 81 patients, 46 (56.8%) were male, mean age of 42 years ( range 20-54) and average time of hospitalization was 16 days (range 7-28). The most frequent diagnosis was AML 23 (28.4%). Forty two patients (51.9%) belonged to group I, 17 (21%) to group II, 12 (14.8%) to group III, and 10 (12.3%) to group IV. 28 (34.6%) presented some comorbidity (ACE I). NAS scoring average adjusted to time of hospitalization for groups I, II, III, and IV was of 37.89 (95%CI 37,22- 43,98), 39.7 (95%CI 31,24-50,43), 46.18(95%CI35,47-50,47), and 50.76 (95%CI 40,73- 57,07), respectively (p=<0.001). A strong correlation between major and minor NAS scores for PS (rs= -0.75) p=0.000 and between degrees of dependence and workload was observed (r=0.79) p=0.000. CONCLUSIONS: A higher NAS score is evident for the allogenic transplant patient group, especially for the unrelated HSCT group. NAS seems an appropriate instrument to assess the workload in the context of oncohematologic patients and HSCT, showing strong correlation to PS and degree of dependence.
Medeiros, Junior Luis Carlos [UNIFESP]. „Estudo comparativo entre os métodos do índice de Norberg e Ofa Like Score para a avaliação de displasia coxofemoral em gatos“. Universidade Federal de São Paulo (UNIFESP), 2009. http://repositorio.unifesp.br/handle/11600/9510.
Der volle Inhalt der QuelleConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
A displasia coxofemoral em gatos tem sido um tema pouco explorado pela medicina veterinária, mesmo que, em tese de mestrado publicada pelo DDI / EPM / UNIFESP comprovou-se que 40% dos gatos possuem algum grau de displasia coxofemoral, quando avaliados pelo índice do ângulo de Norberg. No Brasil, este método é o padrão adotado para avaliação de displasia coxofemoral. Outro método aceito internacionalmente é o OFA Like Score realizado pela Orthopedic Foundation For Animals que avalia a articulação morfologicamente e também a porcentagem de cobertura da cabeça do fêmur pelo acetábulo, além do ângulo de Norberg e tem grande aceitação na maioria dos outros países. Objetivos: Esta pesquisa propõe avaliar a ocorrência de displasia coxofemoral nos animais da amostra através dos métodos do ângulo de Norberg e do OFA Like Score; classificar morfologicamente os animais da amostra segundo o padrão anatômico da OFA; estabelecer uma correlação, para gatos, entre os valores obtidos do ângulo de Norberg e do OFA Like Score e associálos à classificação morfológica, determinando valores de classificação, para gatos, segundo os métodos do ângulo de Norberg e do OFA Like Score. Resultados: Através dos dados obtidos foi possível estabelecer curvas de referência de ordem 2,5%, 50,0% e 97,5% entre a porcentagem de cobertura e o ângulo de Norberg para animais com articulação normal e para animais displásicos. Conclusão: A classificação para displasia coxofemoral em gatos deve ser revista uma vez que os valores, tanto da porcentagem de cobertura como do ângulo de Norberg, citados em literatura são diferentes dos obtidos nesta amostra.
Hip dysplasia in cats has been a theme little explored by veterinary medicine, even when a master’s degree thesis published by DDI / EPM / UNIFESP proved that 40% of cats show some degree of hip dysplasia when evaluated by the Norberg angle index. In Brazil, such method is the standard adopted to evaluate hip dysplasia. Another internationally accepted method is the OFA Like Score, performed by the Orthopedic Foundation For Animals, which morphologically evaluates the joint, as well as the femoral head’s percentage of coverage by the acetabulum, in addition to the Norberg angle, being broadly accepted in most countries. Purpose: This research intends to evaluate the occurrence of hip dysplasia in sampling animals by Norberg angle and OFA Like Score methods; to morphologically classify sampling animals according to OFA’s anatomic standard; to establish a correlation, for cats, between values obtained from Norberg angle and OFA Like Score, and to associate them to the morphological classification, establishing classification values for cats according to Norberg angle and OFA Like Score methods. Results: By means of the data obtained, it was possible to establish reference curves of 2.5%, 50.0% and 97.5% between the percentage of coverage and Norberg angle for animals with a normal joint and for dysplastic animals. Conclusion: Hip dysplasia classification for cats shall be reviewed, since both values, of percentage of coverage and Norberg angle mentioned in the literature differ from the ones obtained in this sample.
CNPq: 33009015037M5
TEDE
BV UNIFESP: Teses e dissertações
Kawaguchi, Yurika Maria Fogaça. „Validação cultural e confiabilidade das versões em português das escalas de mobilidade na UTI: Perme Intensive Care Unit Mobility Score e Intensive Care Unit Mobility Scale (IMS)“. Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5170/tde-26102017-093929/.
Der volle Inhalt der QuelleObjectives: Translate, cross cultural validate to Brazilian Portuguese language and analyze the inter-rater reliability with both instruments Perme Score and IMS. Methods: The translation process and the cross cultural validation followed the following steps: preparation, translation, synthesis, back translation, review, approval and pre-test. After this process the Brazilian Portuguese version of the both scales were used by two researchers to evaluated 103 critical care patients. The weighted kappa and Bland Altman analysis were used to verify inter rater agreement. Cronbach-? test was used to evaluate inter rate reliability. The correlation between the scales was verified by the Spearman correlation test. Results: Both scales, Perme escore e EMU, were translated to the Brazilian Portuguese. Most of the patients were male 56 (54%), mean age 52±18, SAPS 3 = 66 (24%). Respiratory failure was the most prevalent reason for admission (44%). Both scales showed an excellent inter rater agreement (k > 0,90) and reliability (alpha > 0,90) for all domains. Bland-Altman analysis showed a low bias between raters either for EMU (-0,048 ± 0,35) and Perme Escore (-0,06 ± 0,73). Upper and lower 95% limits of agreement were 0.64 to -0.73 for the EMU and 1.36 - 1.5 for the Perme Escore. Moreover, it also presented a strong positive correlation between the two instruments ( = 0,941). Conclusion: The Brazilian Portuguese version of the Perme Escore and EMU showed a high agreement and reliability between the raters
Zamparas, Grigorios. „Beethoven's Piano Concerto in E-Flat WoO 4: A Piano Reduction of the Full Orchestral Score Based on Jon Ceander Mitchell's Reconstruction“. Scholarly Repository, 2007. http://scholarlyrepository.miami.edu/oa_dissertations/6.
Der volle Inhalt der QuelleQueijo, Alda Ferreira. „Estudo comparativo da carga de trabalho de enfermagem em Unidades de Terapia Intensiva Geral e Especializadas, segundo o Nursing Activities Score (NAS)“. Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-11032008-112124/.
Der volle Inhalt der QuelleA transversal descriptive and comparative study analyzed the nursing workload in general and specialized Intensive Care Unit (ICU), according to Nursing Activities Score (NAS). The data were collected in four ICU: one General unit (ICU G), one Cardiovascular unit (ICU G) and two Neurological unit (ICU N) of a general, private, extra-large hospital, in São Paulo city. Three hundred patients admitted in the UTIs had participated of the study, with 24-hour minimum lenght of stay (LOS) in the ICU, from 08/21/2006 to 10/05/2006. It was included 100 patients of each unit. ICU N had been considered an only unit. There had been collected demographic and clinical data and applied the instruments Simplified Acute Physiology Score (SAPS II), Logistic Organ Dysfunction System (LODS) and the Nursing Activities Score (NAS) of the first 24 hours in the unit, respectively for measuring the severity of illness, the organic failure and the nursing workload. Data were analyzed by means of descriptive and inferencial statistics. The relation between the variables was made by means of Spearman´s coefficient correlation and for the comparison of the averages it had been used the tests of Mann Whitney, Krusskal-Wallis and Tukey. ICU G, ICU C and ICU N had been homogeneous in relation to gender (p=0,12) and lenght of stay (p=0,65), however had differed in relation to the age (p=0,01), origin (p=0,055), type of treatment (p=0,00) and discharge (p = 0,007). UTI G presented higher risk of mortality SAPS II (RM SAPS II) and risk of mortality LODS (RM LODS), comparativily to ICU C (p=0,00) and UTI N (p=0,00). About the nursing workload, ICU N presented, in average, lower values than ICU C (p=0,02) and UTI G (p = 0,03) means. The comparative analysis of NAS score and the demographic and clinical variables showed difference in age, origin and type of treatment. Patients who died in ICU G and N and male in ICU C had presented, in average, higher nursing workload. The correlation between the NAS score and the quantitative variables showed moderate correlation with the severity of illness (r=0,55; p=0,00) and organic failure (r=0,48; p=0,00) only in ICU G. The only variable with moderate correlation in the three ICU was LOS (p=0,00). The factors associated with nursing workload in ICU G were RM SAPS II and age; in ICU C, RM SAPS II, gender, age and RM LODS; and in ICU N, RM SAPS II and age. The results provide the possibility of adequacy of human resources in ICU in order to benefit patients, professionals and hospitals
Tavares, Carolina. „Taxonomia, distribuição e abundância da família Aristeidae (Penaeoidea: Dendrobranchiata) do talude da costa central do Brasil, coletada pelo Programa Revizee - Score Central“. Universidade Federal do Rio de Janeiro, 2005. http://hdl.handle.net/11422/3428.
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A família Aristeidae é típica de águas profundas, podem ser bentônicos ou da fauna meso ou batipelágica dos oceanos. São geralmente muito abundantes na coluna d’água, e por isso desempenham papel fundamental na cadeia trófica dos oceanos. A família atualmente é representada por nove gêneros, a maioria sendo largamente distribuída nos oceanos Atlântico e Indo-Pacífico. Desses gêneros, seis ocorrem no Atlântico ocidental. A fauna de Aristeidae é ainda pouco conhecida no Brasil, com apenas três espécies citadas para a costa brasileira: Plesiopenaeus edwarsianus (Jonhson, 1867), Aristaeomorpha foliacea (Risso, 1827) e Hepomadus tener Smith, 1884 O Programa Revizee - Score Central, realizou amostras entre o Rio Real (11º Sul) e o Cabo de São Tomé (22º Sul), a partir da qual foi formada uma grande coleção de crustáceos de mar profundo. Foram realizadas coletas entre maio de 1999 e julho de 2000, entre 200 e 2000 metros de profundidade. O material foi analisado, sendo encontradas oito espécies. Além das espécies já registradas para a costa brasileira, que tiveram sua distribuição latitudinal estendida, as seguintes espécies foram registradas pela primeira vez: Aristeus antillensis A. Milne Edwards & Bouvier, 1909, Hemipenaeus carpenteri Wood-Mason, 1891, Plesiopenaeus armatus (Bate, 1881), Plesiopenaeus coruscans (Wood-Mason, 1891) e Aristeus antennatus (Risso, 1816). Os resultados mostraram que algumas espécies de Aristeidae encontradas, apresentam maior abundância no estrato entre 500 e 750 metros, outras são mais abundantes entre 750 e 1250 metros, e as mais profundas apresentam maior abundância entre 1250 e 2000 metros. A correlação positiva entre áreas de aporte fluvial e maior abundância das espécies de Aristeidae foi observada. Uma chave de identificação para as espécies de Aristeidae do Brasil é fornecida.
The family Aristeidae is predominantly deep-water distributed, being either benthic dwellers or members of the meso and bathypelagic fauna. They have a greal abundance in the water column, and play a major role in the food chain of the oceans. The family as now defined consists of nine genera, most of them greatly distributed in Atlantic and Indo-Pacific oceans. Of these genera, six have been recorded from eastern Atlantic. The family Aristeidae in Brazil is poorly known, with only three species recorded from off the Brazilian coast: Plesiopenaeus edwarsianus (Jonhson, 1867), Aristaeomorpha foliacea (Risso, 1827) and Hepomadus tener Smith, 1884 The Revizee Program made trawlings between Rio Real (llºS) and Cabo de São Tomé (22º), and a large scientific collection of deep-sea crustaceans was formed. The Revizee trawlings were made between 1999 may and 2000 june, between 200-2000 meters depth. The material was examined and eight species were found. Besides those three species previously recorded from off Brazilian coast, that have their latitudinal distribution enlarged, five species are new records to Brazil: Aristeus antillensis A. Milne Edwards & Bouvier, 1909, Hemipenaeus carpenteri Wood-Mason, 1891, Plesiopenaeus armatus (Bate, 1881), Plesiopenaeus coruscans (Wood-Mason, 1891) and Aristeus antennatus (Risso, 1816). Results showed that, some Aristeidae species are greatly abundant between 500 and 750 meters, others are more abundant between 750 and 1250meters, and deeper ones are more abundant between 1250 and 2000 meters. A positive correlation between discharge of rivers and high abundance of Aristeidae species was observed. An identification key for Aristeidae species of Brazil is given.
Domingues, Cristiane de Alencar. „Trauma and injury severity score: análise de novos ajustes no índice“. Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-14102013-090011/.
Der volle Inhalt der QuelleIntroduction: Trauma and Injury Severity Score (TRISS) is considered the \"gold standard\" in the analysis of survival probability of trauma patients, despite its limitations. There have been several efforts to make it more accurate because of its important role in Trauma Quality Improvement Programmes. Objectives: To propose three new adjustments to the TRISS equation and compare their performances with the TRISS and TRISS-like originals and these indices and NTRISS with coefficients adjusted to the study population; identify if the multiple imputation technique increases the accuracy of the equations derived from databases with missing; and to compare the performance of the new models when derivatives and applied to different groups of trauma patients. Methods: This is a multicenter, retrospective study with trauma victims admitted to the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC FMUSP) and the Trauma Center at the University of California San Diego Medical Center (UCSD MC) for the period between January 1st, 2006 and December 31st, 2010. The information of patients were grouped into two different databases: derivation and testing; the first one served to derive the equations and the second was used to validate the equations generated. The model coefficients were established by logistic regression analysis. Receiver Operating Characteristic curve (ROC) was used to evaluate the performance of the models and De Long et al. algorithm to compare the areas under the curves (AUC). Results: The casuistic consisted of 2,416 patients from HC FMUSP (São Paulo, Brazil) and 8,172 participants from UCSD MC (San Diego, USA). The new models proposed were NTRISS-like which included the variables Best Motor Response (BMR), Systolic Blood Pressure (SBP), New Injury Severity Score (NISS) and age; TRISS SpO2 that included the variables Glasgow Coma Scale, SBP, saturation of peripheral oxygen (SpO2), Injury Severity Score and age; and NTRISS-like SpO2 (BMR + SBP + SpO2 + NISS + age). All equations had adjusted coefficients for blunt and penetrating trauma. The multiple imputation technique applied in the derivation of the equations did not improve the accuracy of the models. The original TRISS, and TRISS, TRISS-like and NTRISS with adjusted coefficients and the new proposals showed no statistically significant difference in performance. The new equations fitted to the São Paulo data and generated with information from San Diego showed different AUC when applied in the two patient groups in these localities. The accuracy was always higher when the equations were applied to the population of San Diego. Conclusions: The new models demonstrated good accuracy (about 89.5%) and similar performance to other TRISS adjustments previously published, and may be used in assessments of quality of care for traumatized. The survival probability scores adjustments to the local reality of its application did not improve its performance, a result that reinforces the uncertainty about the need for such adjustments, as the application site index.
Oliveira, Ezequiel Fernandes de. „Estudo do sono, função pulmonar, força muscular ventilatória e validação de dois instrumentos de evolução clínica de pacientes com miastenia gravis: Quantitative myasthenia gravis score e MG Composite Scale“. Universidade Nove de Julho, 2017. http://bibliotecatede.uninove.br/handle/tede/1903.
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Introduction: Our hypothesis is that patients with MG present a poor sleep due to the presence of respiratory disorders, compromised by the weakness of the ventilatory muscles, causing worsening of the clinical condition and quality of life. Objectives: To investigate the physiological pattern of sleep through polysomnography, to verify pulmonary function and ventilatory muscle strength through spirometry and manovacuometry, and to perform the translation, cultural adaptation and validation of two specific scales to evaluate the clinical evolution of patients with MG, denominated "Quantitative Test for Myasthenia Gravis" and "Composite Scale for Myasthenia Gravis". Material and methods: This is a cross-sectional study involving patients with MG. Clinical evaluations were performed at the UNINOVE Sleep Laboratory, at the Neuromuscular Diseases Research Unit at UNIFESP, at the Santa Casa de São Paulo Department of Neurology and at the Department of Neurology at the Hospital do Servidor Público Estadual of São Paulo. Results: The results of this thesis are separated into three studies. Study I: article entitled "Sleep, lung function and quality of life in patients with Myasthenia gravis: A cross-sectional study" published in the journal Neuromuscular Disorders. Study II: entitled "Brazilian- Portuguese translation, cross-cultural adaptation and validation of the Myasthenia Gravis Composite scale. A multicentric study." published in the journal Arquivos de Neuropsiquiatria. Study III: entitled "Quantitative Myasthenia gravis Score: a Brazilian multicenter study for translation, cultural adaptation and validation", published in the journal Arquivos de Neuropsiquiatria. Conclusion: Patients with MG presented a considerable presence of DRS with worsening quality of life. They presented reduced values in the maximum ventilatory pressures associated with normal values of pulmonary function. The translation and validation of the scales were performed successfully and we believe that the use of our Portuguese version from Brazil will assist in the care of patients with MG, including a more accurate monitoring of the clinical rehabilitation process.
Introdução: Nossa hipótese é que os pacientes com MG apresentam um sono de má qualidade devido a presença de distúrbios respiratórios, comprometido pela fraqueza dos músculos ventilatórios acarretando em piora da condição clinica e qualidade de vida. Objetivos: Investigar o padrão fisiológico do sono através da polissonografia, verificar a função pulmonar e a força muscular ventilatória através de espirometria e manovacuometria e realizar a tradução, adaptação cultural e validação de duas escalas específicas para avaliar a evolução clínica de pacientes com MG, denominados “Teste Quantitativo para Miastenia gravis" e "Escala composta para Miastenia gravis". Material e métodos: Trata-se de um estudo transversal envolvendo pacientes com MG. As avaliações clínicas foram realizadas no Laboratório do sono da UNINOVE, no Setor de Investigação de Doenças Neuromusculares da UNIFESP, no Departamento de Neurologia da Santa Casa de São Paulo e no Departamento de Neurologia do Hospital do Servidor Público Estadual de São Paulo. Resultados: Os resultados desta tese são separados em três estudos. Estudo I: artigo intitulado "Sono, função pulmonar e qualidade de vida em pacientes com Miastenia gravis: Um estudo transversal" publicado no periódico Neuromuscular Disorders. Estudo II: intitulado "Tradução, adaptação cultural e validação da escala Composta de Miastenia gravis para a língua portuguesa do Brasil: estudo multicêntrico" publicado no periódico Arquivos de Neuropsiquiatria. Estudo III: intitulado "Teste Quantitativo para Miastenia gravis: estudo multicêntrico brasileiro para tradução, adaptação cultural e validação. " publicado no periódico Arquivos de Neuropsiquiatria. Conclusão: Os pacientes com MG apresentaram uma presença considerável de DRS com piora na qualidade de vida. Apresentaram valores reduzidos nas pressões máximas ventilatória associados com valores normais de função pulmonar. A tradução e validação das escalas foram realizadas com sucesso e acreditamos que o uso da nossa versão em português do Brasil irá auxiliar no atendimento de pacientes com MG, incluindo um monitoramento mais preciso do processo de reabilitação clinica.
Mastroroberto, Marianna <1982>. „La Trombosi Portale Non-neoplastica nel Paziente Cirrotico: studio della prevalenza ed eventuale correlazione con i maggiori score di funzionalità epatica (CTP e MELD)“. Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7705/.
Der volle Inhalt der QuelleNon-neoplastic porta vein thrombosis (PVT) in cirrhotic patients is a frequent complication of liver cirrhosis. Yet, only confirmed data about its natural history are the association with variceal bleeding and low platelet count which influences this precarious coagulation balance. In our prospective study, from January 2013 to October 2015, we enrolled 253 cirrhotic patients (mean age 58,8 ± 10,3 (23 – 75) years) without a history of malignancy and/or hematological disease and who aren’t on oral anticoagulants or antiplatelet therapy taken for other reasons. Overall were subsequently studied according to the degree of liver disease using the Child-Pugh (CP) and Model for end-stage liver disease (MELD) scores, etiology, age and blood tests. Patient with PVT, of which 63,3% males, was significantly younger (51,9 ± 13,2 (23 – 75) yrs; P=0,004), with lesser platelet count (73,1 ± 48,1 (25 – 174); P = 0,001), INR > 1.25 in 54,5% of cases (P=0,024) and MELD >10 in 86,2% (P=0,001). INR and MELD considered as continuous variables were not significant as well as etiology, hematocrit, total Bilirubin, AST, ALT, Albumine, Creatinine and CP score and class. In multivariate analysis, only the platelet count was independently associated with the occurance of PVT (OR = 0.97, 95% CI: 0.96-0.99; P <0.001) confirming the literature. The inheritated thrombocytopenias (ITs) are a heterogeneous group of genetic disorders with different degrees of complexity and severity, characterized by a low platelets count associated or not with a bleeding tendency which varies from absent to very strict. This group of diseases, in the context of an extremely favorable substrate such as cirrhotic degeneration, would explain the heterogeneity of the cadres and random responses to anticoagulation. We have no data yet certain about this, but if this hypothesis be confirmed, the clinical approach to the disease might change dramatically.
Tortorelli, Júnior José [UNIFESP]. „Avaliação comparativa entre a densidade óptica da mandíbula e o T-score do fêmur e da coluna vertebral, obtido por meio da densitometria óssea, em pacientes candidatas a implantes dentários“. Universidade Federal de São Paulo (UNIFESP), 2007. http://repositorio.unifesp.br/handle/11600/21569.
Der volle Inhalt der QuelleObjetivo: Verificar se existe correlação entre os valores médios da densidade óptica (DO) apresentada pela imagem tomográfica computadorizada, num corte coronal da mandíbula, numa região de interesse (ROI), com o T-score da coluna vertebral e do colo do fêmur, obtido por meio da densitometria óssea, em pacientes candidatas a implantes dentários. Método: Estudo transversal prospectivo realizado em 25 pacientes do gênero feminino com idade média de 60 anos, de etnia variada, com mais de 5 anos de pós-menopausa, portadoras ou não de osteoporose, realizando ou não tratamento da osteoporose, edêntulas totais ou parciais, candidatas a implantes dentários. As pacientes realizaram os exames pré-operatórios exigidos pela equipe cirúrgica, tais como: radiografia panorâmica, radiografias periapicais, densitometria óssea, tomografia computadorizada, hemograma completo, tempo de sangramento, tempo de coagulação, tempo de protrombina, dosagem de glicose, cálcio, fosfatase alcalina e creatinina. Utilizou-se para análise o T-score do colo do fêmur e da coluna vertebral (L2-L4), obtidos na densitometria óssea, e a média dos valores de densidade óptica obtida na região de interesse, nos cortes coronais da TC da mandíbula, passando pelo forame mentual, abaixo do canal mandibular. Os valores obtidos foram submetidos à análise estatística. Resultado: Comparando a densidade óptica (DO) na ROI da TC da mandíbula com T-scor e da coluna vertebral L2-L4 e do colo do fêmur, observou-se que quanto maior T-score, maior é o valor médio da densidade óptica (DO) na ROI da TC. Aplicou-se o índice de correlação linear de Pearson e obteve-se o valor de 0,706 quando comparado com a coluna vertebral L2-L4, e, 0,627 quando comparado com o fêmur, considerados valores medianos. Conclusão: Existe correlação, estatisticamente significante, entre o T-score do colo do fêmur e da coluna vertebral L2-L4 e a média da densidade óptica da região de interesse da TC da mandíbula, demonstrando que o paciente que apresenta baixa DMO, da coluna e do fêmur, também apresenta baixa densidade óptica na TC da mandíbula.
Objective: To determine the correlation between the mean level of optical density(OD) observed in a region of interest (ROI) on the computerized tomographic (CT) imaging of a cross-section of the mandible, with the vertebrae and the femur’s neck T-score obtained by bone densitometry in women applying for dental implantation. Methods:This prospective cross sectional investigation studied 25 female patients aged 60 years old in average, of varied ethnic background, who had been in their post-menopausal period for over 5 years, either presenting with osteoporosis or not, either undergoing osteoporosis treatment or not, either partial- or totally edentulous applying for dental implantation. These patients were subject to all pre-operative examinations required by the surgical team, which included: panoramic radiography, peri-apical radiography, bone desitometry, CT scanning, full blood count, bleeding time, clotting time, prothrombine time, glucose, alkaline phosphatase and creatinine tests. The T-score of the patients’ right femur and lumbar vertebrae L2-L4 assessed through bone densitometry were compared with OD in the ROI determined on the coronal CT scans of the patient’s mandible passing through the mental foramen, comprising the mandible cross section area below the mandible canal. Results: The independent comparisons between mandible CT imaging OD and femur neck and vertebrae L2-L4 T-score showed that the higher the T-score, the higher the OD. Pearson’s linear correlation coefficiente between OD and T-score determinations was 0.706 for L2-L4 vertebrae and 0.627 for the femur, moderate correlations. Conclusion: There is a statistically significant correlation, between the T-score assessed in both the right femur and L2-L4 vertebrae, and the mean level of optical density (OD) obtained from CT scans, showing that the patient with low BMD, in the femur, and L@-L$ vertebrae also shows low OD on the CT of the mandible.
BV UNIFESP: Teses e dissertações
Vásquez, Vargas Alicia Elena. „Valor predictivo del estado nutricional de pacientes renales crónicos en hemodiálisis usando índices antropométricos comparado con el score de malnutrición e inflamación como método estándar“. Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2016. https://hdl.handle.net/20.500.12672/8341.
Der volle Inhalt der QuelleValora el estado nutricional de los pacientes crónicos en hemodiálisis usando índices antropométricos comparándolo con el score de malnutrición e inflamación como método estándar. El diseño de investigación es cuantitativa, observacional, transversal, prospectivo, descriptivo de asociación cruzada. Participan 99 pacientes (mayores de 20 años) renales crónicos en hemodiálisis regular del Centro de Diálisis María Auxiliadora e Instituto del Riñón de la ciudad de Chiclayo. Los parámetros antropométricos que se toman en cuenta son índice de masa corporal, circunferencia de brazo (adulto) y, circunferencia de pantorrilla (adulto mayor); los cuales son comparados con el score de malnutrición e inflamación. Las principales medidas de resultados: relación de índice de masa corporal y circunferencias (brazo y pantorrilla) con el score de malnutrición e inflamación. Según el índice de masa corporal, en el adulto joven, se obtiene que la delgadez alcanza el 3.9%, frente a un 31.4% obtenido de la circunferencia de brazo. En el adulto mayor, la delgadez alcanza un 31.3%, mientras que en la circunferencia de pantorrilla el 50% de los pacientes presentan desnutrición. Aplicando el score de malnutrición e inflamación, en la población adulta destaca la malnutrición leve con 41.2% y la malnutrición moderada en los adultos mayores con 35.4%. Se concluye que existe mayor relación entre las circunferencias de pantorrilla y de brazo respecto al índice de masa corporal frente al score de malnutrición e inflamación.
Trabajo académico
Queijo, Alda Ferreira. „Tradução para o português e validação de um instrumento de medida de carga de trabalho de enfermagem em Unidade de Terapia Intensiva: Nursing Activities Score (N.A.S.)“. Universidade de São Paulo, 2002. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-12112003-220346/.
Der volle Inhalt der QuelleQueijo, AF. Translation to portuguese and validation of a instrument to measure work load of nursing in the intensive care unit (ICU): NURSING ACTIVITIES SCORE (N.A.S.). [Dissertação]. São Paulo (SP): Escola de Enfermagem da USP; 2002. The present study aimed to translate into Portuguese and to evaluate the properties of measure of the Nursing Activities Score (NAS). The purpose of this instrument is to measure work load of nursing in the intensive care unit (ICU). The study was subdivided in two parts. The first composed of translation and cross-cultural adaptation; and second, in the analysis of the reliability and the validity of the instrument. After the process of translation into Portuguese language and cross-cultural adaptation, was carried through its application in 200 adult inpatients in ICUs, in order to get the measure of reliability. At once, this was obtained by the repeatable between two observers by the statistical test of Kappa that demonstrated one high concord (99,8%) and average Kappa of 0,99. At once, the analysis of the internal consistency verified for the Cronbach´s alpha coefficient disclosed that it possess 23 independent measures that do not hold consolidation or reduction. The NAS was also applied for the validities of criterion (competing) and constructo (convergent). The competing validity showed statisticaly significant correlatio between the TISS-28 and NAS (r=0,67; p<0,001), the same occurring when the analysis of regression was used (r2=94,4%; p<0,001). About the convergent validity, by the technique of the regression analysis, it was verified signicant association statisticaly between NAS and the index of gravity SAPS II, when was inserted to the model the changeable age (r2=99,8%, p<0,001). For the gotten results, in the Brazilian reality, the NAS revealed a trustworthy and valid instrument to measure work load of nursing in ICU.
Rodrigues, Daiane. „Comparação da prevalência de neuropatia e dos testes de screening para neuropatia diabética (Neuropathy Disability Score versus Michigan Neuropathy Screening Instrument) em homens e mulheres : diabéticos, obesos pré-diabéticos, obesos com síndrome metabólica, obesos sem pré-diabetes e síndrome metabólica e pós-cirurgia bariátrica“. reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2017. http://hdl.handle.net/10183/179831.
Der volle Inhalt der QuelleIntroduction: Peripheral polineuropathy (PNP) is seen in diabetics, however, studies have shown neuropathic alterations in patients with pre-diabetes (Pre-DM), Metabolic Syndrome (MS), obese and submitted to bariatric surgery (post-BS). Objective: To evaluate the prevalence of PNP among patients with Diabetes Mellitus (DM), obese grades II and III and pre-diabetes (OB-PRE-DM), obesity grades II and III and metabolic syndrome (OB-SM), obesity without PREDM and Ob No MS and Post-BS patients and to assess the sensitivity and specificity of Neuropathy Disability Score (NDS) compared to the Michigan Neuropathy Screening Instrument (MNSI). Method: A cross-sectional study was carried out in which PNP prevalence were evaluated through the MNSI and the Neuropathy NDS. The performance of the NDS was compared to the MNSI through Receiving Operating Characteristics Curves (ROC curves). Results: Considering MNSI scores ≥ 2.5 and ≥ 4 symptoms, MNSI ≥ 2.5 and ≥ 7 symptoms and NDS ≥ 3 in combination with NSS score ≥ 3, there was a higher prevalence of PNP in DM and Pre-DM vs Ob-SM and Ob No MS and in all vs. Post-BS when groups were compared to each other. The curves ROC showed that the best performance of NDS was ≥ 0.5. Conclusion: The prevalence of PNP described with MNSI is higher in relation to described with NDS. The low value obtained for the best performance of NDS suggest that we explore <3 scores to evaluate neuropathic alterations with this score.
Ferreira, Patricia Almeida. „Estudo de parâmetros bioquímicos de cães relacionando com condição corporal, jejum e alimentação“. Universidade Federal de Pelotas, 2012. http://repositorio.ufpel.edu.br/handle/ri/2471.
Der volle Inhalt der QuelleIn this work we have studied the relationship between biochemical metabolic parameters (of dogs) and body score, fasting and feeding. In order to evaluate the glycemia values, using a digital (portable) glucometer, it was used 6μL of venous and capillary blood. On the other hand, when we evaluated the glycemia, through enzymatic method (laboratory), only venous blood was used. To analyze the metabolic curve we have collected blood samples of fasting dogs and 0:30, 1:30, 3:00, 6:00, 9:00, and 12:00 hours after feeding with premium industrial food. The laboratorial analysis were realized by enzymatic determination through colorimetry. In order to correlate the body scores and dogs morphometry, we have defined the body score, the body mass index (BMI), and the average values of cutaneous fat at the right rib cage, thoracic, and tail base regions. Also, we have measured the thoracic and inguinal circumference ratio. To compare the body scores with the metabolism of carbohydrates and lipids the dogs were classified, according to their weight, as ideal weighted, overweighted and obese. We have measured the glycemia, cholesterol (total and fractions), and triglycerides. The glycemia average values, obtained with the portable glucometer, of capillary and venous blood were similar. The glycemic, VLDL fraction, and triglyceride levels are changed after feeding, while the other analyzed parameters (total cholesterol, HDL and LDL fractions) are not. The obese dogs presented higher BMI and subcutaneous fat values and lower circumference ratio values, when compared with the ideal weighted and overweighted ones. The VLDL fraction and triglyceride values were higher when measured at the obese dogs. It is concluded that the portable glucometer is reliable, since the average values of venous and capillary glycemia are similars. At the experiment conditions, it is possible to perform the biochemical analysis of glycemia, total and fraction cholesterol, and triglycerides values after 3h fasting. The analysis of body mass index, together with the subcutaneous fat values and the circumference ratio has proven to be a fast and effective method to classify dogs as ideal weighted, overweighted and obese. At the studied conditions, obese dogs presented higher triglycerides and VLDL cholesterol fraction levels, when compared with overweighted dogs.
O objetivo deste trabalho foi estudar os parâmetros bioquímicos metabólicos de cães relacionando com condição corporal, jejum e alimentação. Para avaliação da glicemia, com glicosímetro digital, foi utilizado 6μL de sangue capilar e venoso, e para dosagem pelo método enzimático foi utilizado sangue venoso. Para estudar a curva metabólica foram realizadas coletas sanguíneas em jejum e 0:30, 1:00, 1:30, 3:00, 6:00, 9:00 e 12:00 horas após o fornecimento de ração industrial premium. As análises laboratoriais foram feitas por determinação enzimática através da colorimetria. Para relacionar os escores corporais com a morfometria canina, definimos o escore corporal, o índice de massa corporal (IMC), as médias das dobras cutâneas e a razão entre as circunferências torácica e abdominal. Para comparar os escores corporais com o metabolismo de carboidratos e lipídios os cães foram classificados em peso ideal, sobrepeso e obeso. Mensurou-se a glicemia, o colesterol total, frações colesterêmicas e os triglicerídeos. Os valores médios da glicemia obtida por glicosímetro portátil, amostra capilar e venosa e pelo método enzimático laboratorial foram similares. Em relação à curva metabólica, os níveis glicêmicos, da fração VLDL e dos triglicérides, são alterados após a alimentação, enquanto os demais parâmetros analisados (colesterol total e frações HDL e LDL) não. Os cães obesos apresentaram maiores valores do IMC e das dobras cutâneas e menores valores da razão entre circunferências. Os valores da fração VLDL e os triglicerídeos foram maiores nos cães obesos. Conclui-se que as médias dos valores da glicemia capilar e venosa aferidas por glicosímetro digital são similares. Nas condições estudadas observamos que é possível fazer a análise bioquímica dos valores da glicemia, colesterol total, frações colesterêmica e triglicerídeos após 3 h de jejum. O índice de massa corporal juntamente com os valores das dobras cutâneas e da razão entre as circunferências dos cães são uma forma rápida e eficaz para classificar os cães nos escores corporais de peso ideal, sobrepeso e obeso. Nas condições estudadas, cães obesos apresentam níveis de triglicerídeos e fração colesterêmica VLDL mais elevados que em cães com sobrepeso.
Sanches, Ana Letícia Madeira. „Avaliação do efeito ambiental do inseticida Kraft 36EC® (abamectina) e do fungicida Score 250EC® (difenoconazol) por meio de análises ecotoxicológicas em diferentes estágios de vida do Danio rerio“. Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/18/18139/tde-13092018-172144/.
Der volle Inhalt der QuelleKraft 36EC® (a.s. abamectin) and Score 250EC® (a.s. difenoconazole) are intensely used pesticides in strawberry crops in tropical regions, even though they are classified as extremely toxic and very dangerous to the environment. Mixtures of agrochemicals are applied to agricultural crops and the presence of these compounds in water may potentiate toxic effects to non-target aquatic organisms. The contamination of edge-of-field water bodies through runoff and spray drift may compromise the local aquatic ecosystem due to the toxicity of these compounds to non-target organisms. Considering the potential ecological risks related with the use of these pesticides, the main objective of this research was to evaluate the environmental effects of the pesticides Kraft 36EC® and Score 250EC® and its active ingredients abamectin and difenoconazole, respectively. Acute toxicity tests were performed in the laboratory with the isolated compounds and their mixtures using zebrafish (Danio rerio) embryos and adults as test organism. A mesocosm experiment was also performed to evaluate the effects of simulated runoff and spray drift containing Kraft 36EC® and Score 250EC® individually and in mixtures. Besides lethality, selected biomarkers were also evaluated in the fish from the mesocosm and laboratory experiments. No significant differences were observed in effects of the active ingredients and their respective commercial formulations in acute fish tests after single exposure to each test compound. The acute mixture toxicity tests with the active ingredients showed that this mixture exerts a synergistic toxic effect to adult fish. The absence of the synergistic effect on exposures with the commercial formulations mixtures was also observed. Embryo exposure to Kraft 36EC® and Score 250EC® mixtures showed an antagonistic effect at low concentrations and synergistic effect at the highest. A significant increase was observed in the activity of the EROD biotransformation enzyme and in the levels of MDA in fish gills after exposure to Kraft 36EC®. An increase in GST activity, GPx and MDA levels, and a decrease of GR in fish gills was noted after fish exposure to difenoconazole and its commercial formulation. An increase in the responses of the biomarkers analyzed in the gills of the organisms exposed to the mixtures of both the active ingredients and the commercial formulations as compared to single-compound exposure was also observed. Exposure to simulated spray drift of Kraft 36EC® in the mesocosms promotes the greatest deleterious effects on metabolism of Danio rerio followed by exposures to the runoff contaminated with a Kraft 36EC® and Score 250EC® mixture. The commercial formulations Kraft 36EC® and Score 250EC® and their mixtures lead to significant changes in the detoxification metabolism resulting in oxidative stress to fish. Differences in biomarkers responses between the experiments performed in the mesocosms and the laboratory were noted and are due to the different concentrations tested; the ecological interactions between the communities present in the mesocosms and differences in environmental variables. The need and indications for future research related with the evaluation of pesticide toxicity, especially in tropical countries, are discussed.
Antunes, Nilson. „Influencia da ultrafiltração na remoção de mediadores inflamatorios durante circulação extracorporea e alterações da função organica monitorada pelo "Sequencial Organ Failure Assessment Score - SOFA" em pacientes submetidos a revascularização do miocar“. [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313474.
Der volle Inhalt der QuelleTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Objetivo: Investigar a eficácia da ultrafiltração na remoção de mediadores inflamatórios liberados pela circulação extracorpórea e correlacionar ultrafiltração com alterações da função orgânica de acordo com o "Seqüential Organ Failure Assessment Score". Métodos: Quarenta pacientes foram incluídos e randomizados em dois grupos: "sem ultrafiltração" (n=20; Grupo I) e "ultrafiltração" (n=20; Grupo II). Complementos 3 e 4 ativados, interleucina 1beta, 6, 8 e fator de necrose tumoral alfa foram dosados antes da indução anestésica (T1), 5 minutos antes da circulação extracorpórea (T2), no líquido ultrafiltrado (T3), 30 minutos (T4), 6 (T5), 12 (T6), 24 (T7), 36 (T8) e 48 (T9) horas após término da circulação extracorpórea. "Sequential Organ Failure Assessment Score" foi avaliado nos tempos 1, 6 e 9. Significância estatística foi estabelecida com p = 0,05. Resultados: No líquido ultrafiltrado, apenas níveis de fator de necrose tumoral alfa foram detectados. Níveis de complemento 3 ativado, nos tempos 5 e 7, e complemento 4 ativado, nos tempos 5 e 6, foram significativamente elevados no grupo sem ultrafiltração, e níveis de interleucina 6 foram elevados no grupo ultrafiltrado, nos tempos 7 e 8. Interleucina 1beta, 8, fator de necrose tumoral alfa, e "Sequential Organ Failure Assessment Score" não tiveram diferenças significantes entre os grupos. Conclusões: Ultrafiltração retira significativamente fator de necrose tumoral alfa, mas isto não influencia nos níveis séricos desta citocina. Ultrafiltração com o tipo de filtro usado neste estudo não filtra outros mediadores inflamatórios estudados e não diminui a disfunção orgânica no pós-operatório. Deverá ser usada apenas para controle volêmico nos pacientes submetidos à circulação extracorpórea.
Abstract: Objective: To investigate the effectiveness of ultrafiltration in removing inflammatory mediators released by cardiopulmonary bypass and to correlate ultrafiltration with alterations in organic function according to the Sequential Organ Failure Assessment Score. Methods: Forty patients were included and randomized into two groups: "no ultrafiltration" (n=20; Group I) and "ultrafiltration" (n=20; Group II). Activated complement 3 and 4, interleukins 1beta, 6, 8 and tumor necrosis factor alfa were measured prior to anesthesia induction (Time 1), 5 minutes before cardiopulmonary bypass (Time 2), in the ultrafiltrated fluid (Time 3), 30 minutes (Time 4), and 6 (Time 5), 12 (Time 6), 24 (Time 7), 36 (Time 8) and 48 (Time 9) hours following cardiopulmonary bypass. Sequential Organ Failure Assessment Score was evaluated at Time 1, 6 and 9. Statistical significance was established at p = 0.05. Results: In the ultrafiltrated fluid, only tumor necrosis factor alfa levels were detected. Levels of activated complement 3 at Times 5 and 7 and activated complement 4 at Times 5 and 6 were significantly higher in the unfiltered Group, and levels of interleukin 6 were higher in the filtered Group at Times 7 and 8. Interleukins 1beta, 8, tumor necrosis factor alfa, and the Sequential Organ Failure Assessment score were not significantly different between the groups. Conclusions: Ultrafiltration significantly filtered tumor necrosis factor alfa but did not influences serum levels of this cytokine. Ultrafiltration with the type of filter used in this study had no effect in organic dysfunction and should be used only for volemic control in patients undergoing cardiopulmonary bypass.
Universidade Estadual de Campi
Pesquisa Experimental
Doutor em Cirurgia
MINARDI, ANDREA. „Sicurezza alimentare nei Paesi in Via di Sviluppo: il caso studio del progetto “Produzione di cibo appropriato; sufficiente, sicuro e sostenibile"“. Doctoral thesis, Università Cattolica del Sacro Cuore, 2019. http://hdl.handle.net/10280/67851.
Der volle Inhalt der QuelleFood Insecurity (FI) affects especially poor rural people that rely on Subsistence Agriculture in developing countries. With the purpose to help the community that living in that conditions, in 2012 the Università Cattolica del Sacro Cuore and the Fondazione Romeo ed Enrica Invernizzi have started the “Production of appropriate food: safe sufficient and sustainable” project. The project aims to open Pilot Center in agreement with local Diocese to promote the Agricultural production Intensification agriculture and Diets that are sustainable (ethical, economic and environmental). The project is active in India (Meghalaya State) and the Democratic Republic of Congo (Lomami Province). Helped by the local team, information was collected on production and diets habits. An analysis of the impact that the project had on food security (availability and access) of the families involved was carried out on these data. Number of Chicken (India) and Household Dietary Diversity Score - HDDS (India and DRC) as a proxy for food availability and access, were respectively utilised. Thus, we used different Propensity Score Match approach (Logit + Nearest Neighbour and GenMatch) to evaluate the ATT (average treatment effect on the treated group). Regarding India, the number of chickens bred (as food availability) and the HDDS (food access) were analyzed. While the number of chickens bred is positive but not significant, the HDDS values of smallholder farmers involved in the project did not improved. Moving to DRC, only the HDDS was analyzed. In this case, the project had a positive impact on beneficiary families, but it was not significant. The results point out that diet improving (HDDS) advances the production, both in quality and quantity, but is not a sufficient condition per se. Furthermore, it is also essential to enhance the educational path which focuses on nutritional issues and the access to food from market.
Mantovani, Mario Eduardo de Faria 1979. „Perfurações traumáticas do esôfago : fatores preditivos de morbidade e mortalidade“. [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312952.
Der volle Inhalt der QuelleDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Lesões traumáticas do esôfago têm ocorrência rara, seu diagnóstico é difícil, e estão associadas a significativos níveis de morbidade e mortalidade. O objetivo deste estudo foi analisar epidemiologicamente essas lesões, os métodos diagnósticos, e identificar fatores preditivos relacionados a maior morbidade e mortalidade nos pacientes acometidos por este tipo de lesão. Foi realizado estudo retrospectivo, entre 1994 e 2012, com 25 pacientes operados por perfuração esofágica traumática nesse período. Mecanismo de trauma, parâmetros fisiológicos, localização, grau da lesão esofágica, presença de lesões associadas e índices de trauma foram analisados. O sexo masculino foi o mais acometido (88%), com faixa etária entre 15 e 65 anos (média de 29,2 anos), tendo FPAF como principal etiologia (68%) e acometendo principalmente o esôfago cervical (68%). Em 17 pacientes, a confirmação diagnóstica ocorreu por meio de exames subsidiários, sendo que os mais realizados foram Endoscopia Digestiva Alta e Tomografia Computadorizada. Nos demais 8 casos o diagnóstico foi intra-operatório. O intervalo de tempo entre o trauma e a cirurgia foi inferior a 6 horas em 40% dos traumas penetrantes e inferior a 24 horas em 80% dos casos, independente do mecanismo. A sutura acompanhada da drenagem foi o tratamento cirúrgico mais frequente (92% dos casos). A morbidade global foi 72%, sendo a pneumonia a complicação mais prevalente, e 48% decorrentes de complicações relacionadas diretamente à lesão esofágica, sendo a infecção de ferida operatória e a fístula as mais comuns. A mortalidade foi 16%, e ocorreu por choque hipovolêmico (2 casos) ou por sepse (2 casos). Valores de ISS maiores que 25 e grau da lesão OIS > 3 foram preditores para a ocorrência de fístula (24% dos casos). Não foi observado nenhum fator que isolado concorreu para o aparecimento de complicações em geral. Pacientes com idade superior a 54 anos, PAS na admissão inferior a 90 mmHg e TRISS menor que 0,5, foram identificados com maior mortalidade. Conclui-se que os fatores descritos estão associados a maior ocorrência de fístula e mortalidade, porém, por se tratar de casuística retrospectiva e pequena, novos estudos serão necessários para validação dessas informações
Abstract: Injuries to the esophagus are rare, with difficult diagnosis, and are commonly associated with significant morbidity and mortality. The aim of this study was to analyze the epidemiology of these lesions, diagnostic methods, trying to identify predictive factors related to increased morbidity and mortality in this specific population. A retrospective study of 25 patients submitted to surgery with traumatic penetrating esophageal injuries from 1994 to 2012 was performed. Mechanism of injury, physiologic measures, injury location, esophageal injury grade, presence of associated injuries and trauma scores were evaluated. Male patients were the most affected accounting for 88% of the cases, with ages between 15 and 65 years (mean 29.2 years). Gunshot injuries were the main etiology (68%) and happened more often in the cervical topography of the esophagus (68%). In 17 patients ancillary tests were performed to confirm the diagnosis, among these, the most performed tests were Upper Digestive Endoscopy and CT scan. In 8 cases, esophageal injuries were diagnosed intraoperatively. The length of time between trauma and surgery was less than 6 hours in 40% of the penetrating injuries and less than 24 hours in 80% overall, despite the mechanism of injury. The suture followed by drainage was the most frequent surgical method performed (92% of cases). The overall morbidity was 72%, with pneumonia as the most prevalent. 48% of the complications were directly related to the esophageal injury, and operative wound infection and fistula were the most common. Mortality was 16% and occurred in patients with hypovolemic shock (2 cases) or sepsis (2 cases). ISS values greater than 25 and the injury AAST-OIS grade > 3 were predictors for the occurrence of fistula (24% of cases). No other isolated factors were observed to contribute to the surge of general complications. Patients over 54 years old, SBP lower than 90 mmHg and TRISS lower than 0.5 on admission were identified with higher mortality. In conclusion, the factors described herein are associated with higher incidence of fistula and mortality, but due to a small and retrospective case series, further studies are required to validate this information
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências
Gesslin, Tyra, und Julia Grauers. „Den institutionella miljöns påverkan på E-betyg : En kvantitativ studie med fokus på skillnader mellan företag i industri- och utvecklingsländer“. Thesis, Högskolan i Gävle, Företagsekonomi, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-36027.
Der volle Inhalt der QuelleAim: ESG scores are the main basis for responsible investments decisions. An efficient capital allocation therefore requires the ratings to reflect companies’ actual sustainability performance. However, the scores have been found to be misleading as the underlying sustainability disclosures are affected by various different factors, including companies’ institutional environment, which can be attributed to an effort to be perceived as legitimate by society and stakeholders. This study is intending to identify relationships between the institutional environment and the environmental dimension (E) of the ESG score. To test the relationship, it is examined whether this has a practical equivalent in terms of the amount of greenhouse gas emissions. Method: The study is based on positivistic theory of science with a deductive approach and quantitative nature. Through a longitudinal design, data from 1969 companies over five years have been analysed. The empirical data of the study are obtained from the database Refinitiv Eikon and have been analysed in the statistical program IBM SPSS, mainly through linear regressions. Result & Conclusions: Positive relationships between the degree of economic development in a company’s country of operation and E-scores and propensity to provide ESG data has been established. Possible explanations are found the legitimacy, stakeholder and institutional theory, and are mainly related to institutional differences between countries. Furthermore, higher propensity to provide ESG data has a positive effect on data availability and data availability has a positive relationship with E-score. However, a negative relationship between developed countries and greenhouse gas emissions was found, meaning that the result does not provide evidence that the higher E-score found among companies in developed countries, is not equivalent to a higher level of sustainability in practice. Contribution of the thesis: The study contributes to the examination of the function of the ESG ratings which in previous research has been considered deficient. Although the study cannot confirm that the institutional environment has a crucial effect on the score other deficiencies in the ratings has been apparent. For example, the importance of the amount of published ESG data. This poses a problem because the propensity to provide ESG data is lower in developing countries. Suggestions for future research: To increase generalizability, an extended study including more rating agencies and all ESG dimensions is proposed. Further examination of the institutional environments effect, based on other aspects than economic development, and research to improve the rating agencies’ methods for data collection are needed.
Grundström, Gustav, und Isabelle Miedel. „Sustainable Investing : On the relation between sustainability rating and greenhouse gas emissions“. Thesis, Umeå universitet, Företagsekonomi, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-185219.
Der volle Inhalt der QuelleBorges, Junior Sergio Ricardo. „SEnsembles – uma abordagem para melhorar a qualidade das correspondências de instâncias disjuntas em estudos observacionais explorando características idênticas e ensembles de regressores“. Universidade Federal de São Carlos, 2016. https://repositorio.ufscar.br/handle/ufscar/8911.
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Introduction. The datasets used in observational studies have instances belonging to two distinct groups (i.e. treatment group and control group), which are compared in order to estimate the effect of the treatment over the results. For such, in one of the approaches, called Propensity Score Matching (PSM), the propensity score for the instances of both groups is estimated and, subsequently, the correspondence of these instances is performed based on the values for the propensity score. The propensity score is the probability of attribution of a treatment based on the observed characteristics (e.g. income, sex and age). In this context, the logistic regression is widely used to estimate the propensity score and there is an great variety of instance correspondence methods. Objective. This doctor´s thesis has as its main objective to investigate computational alternatives in order to improve the quality of the instance correspondence in datasets that are manipulated in observational studies. Methodology. Techniques that estimate the propensity score and methods to perform the instance correspondence in observational studies were investigated. Thus, it was possible to investigate how the identical characteristics of the instances could be exploited in a new process to perform correspondence and, how ensembles could substitute the logistic regression by estimating the propensity scores of the instances, in the context of the PSM process. Proposal. This thesis proposes a new approach in the context of the PSM process, called “SEnsembles”, which aims to improve the quality of instance correspondence based on two main processes, which use techniques that separately consider the identical characteristics of the instances and the ensembles of regressors, more precisely, bagging, random forest and boosting. Results. The proposed approach “SEnsembles” improves the quality of the instance correspondence for the majority of calipers used (i.e. zero, 0.05, 0.10, 0.15, 0.20, 0.25 and 0.30) when compared to the baseline Nearest Neighbor Matching (NNM). Based on the experiments, when there was an improvement over the baseline, the technique that separates the identical characteristics of the instances presented improvements of up to 53.8% in the quality of correspondence, with an average of gains of 12.1%; and only 2.7% of average in the reduction of the number of pairs of instances matched. The technique which substituted the logistic regression for ensembles of regressors, in turn, presented the best correspondence with the caliper zero and with the values 0.20, 0.25 and 0.30, with improvements of up to 36.3% and an average of gains of 12.7%; and a slightly reduction of 7.6% in the number of pairs of instances matched.
Introdução. Os conjuntos de dados manipulados em estudos observacionais possuem instâncias pertencentes a dois grupos distintos (i.e. grupo de tratamento e grupo de controle), as quais são comparadas para estimar o efeito do tratamento sobre os resultados. Para isso, em uma das abordagens, chamada de Propensity Score Matching (PSM), estima-se o escore de propensão para as instâncias de ambos os grupos e, em seguida, efetua-se a correspondência dessas instâncias com base nos valores dos escores de propensão. O escore de propensão é a probabilidade de atribuição de um tratamento com base nas características observadas (por exemplo, renda, sexo e idade). Neste contexto, a regressão logística é amplamente utilizada para estimar o escore de propensão e há uma ampla variedade de métodos de correspondência de instâncias. Objetivo. Esta pesquisa de doutorado tem como objetivo principal investigar alternativas computacionais para melhorar a qualidade das correspondências de instâncias em conjuntos de dados que são manipulados em estudos observacionais. Metodologia. Investigou-se técnicas que estimam o escore de propensão e métodos para se efetuar a correspondência das instâncias em estudos observacionais. Assim, foi possível investigar como as características idênticas das instâncias poderiam ser exploradas em um novo processo de correspondência e, como ensembles, mais precisamente, bagging, random forest e boosting, poderiam substituir a regressão logística ao estimar os escores de propensão das instâncias, no contexto do processo de PSM. Proposta. Esta pesquisa propõe uma nova abordagem no contexto do processo PSM, denominada “SEnsembles”, que visa melhorar a qualidade da correspondência das instâncias com base em 2 processos principais, os quais utilizam técnicas que considerem em separado as características idênticas das instâncias e os ensembles de regressores, mais precisamente, bagging, random forest e boosting. Resultados. A abordagem proposta “SEnsembles” melhorou a qualidade da correspondência de instâncias para a maioria dos calipers utilizado (zero, 0,05, 0,10, 0,15, 0,20, 0,25 e 0,30) quando comparada ao baseline Nearest Neighbor Matching (NNM). Com base nos experimentos, quando houve ganho, a técnica que separa as características idênticas das instâncias proporcionou ganhos de até 53,8% na qualidade da correspondência, com média de 12,1% de melhoria e 2,7% de redução média do número de pares de instâncias correspondidas. Já a técnica que substituiu a regressão logística pelos ensembles proporcionou as melhores correspondências com o caliper zero e com os valores 0,20, 0,25 e 0,30, com ganhos de até 36,3% e, com média de 12,7% de melhoria e 7,6% de redução do número de pares de instâncias correspondidas.
Sampaio, Aline Fernanda Camargo. „O uso da pontuação em atividades linguísticas e epilinguísticas: o gênero fábula em foco“. Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/48/48134/tde-09032016-100756/.
Der volle Inhalt der QuelleThe primary function of punctuation is to provide the writing language readability, enabling the understanding of both the silent reading and the oral reading (Dahlet, 2007). The few studies carried out around the teaching and score learning as well as the difficulties that students encounter to appropriate properly these signals, required the written text, prompted me to think of a research proposal which would help students of 5th year the Elementary School I. From a diagnostic and formative assessment (DaFA) of writing production (opinionated text) of these students in a communicative situation that offered them freedom of expression, it was possible to detect some difficulties inherent to the use of punctuation. It was proposed activities involving speaking, reading and writing, or language activities and epilinguistics containing procedures to sharpen perception and establish the reflection with respect to the use of punctuation, following the standard writing (didactic sequence based on the fable genre ).The literature review showed that the punctuation is a less valued topic in research on teaching and learning context of written language. In general, the theme is limited to practical application with an emphasis on prescriptive rules imposed by traditional grammar. In this research, we start from an interactional design language (Geraldi, 1996), understanding the text not as a finished structure (product), but as part of more global communication activities (Koch, 1997). The concept of linguistic activities and epilinguistics as well as reflections on the ways and waywardness to the teaching and learning of mother tongue. We base ourselves on the proposed studies by Franchi (1991, 1992), Semeghini-Siqueira (1977, 1998, 2015), Geraldi (2002) and Bezerra (2004). With regard to discussions of the speech genres, we take as a basis the theoretical contributions made explicit by Bakhtin (2000, 2003). Regarding the use of gender in schools, we rely on the perspective of the following authors: Dolz, Noverraz, Schneuwly (2004) and Gomes-Santos (2007). As methodological procedures goes, we turn to ethnographic research and action research, since it was carried out in loco monitoring of teaching practice in a school. Finally, we have found that the procedures adopted were effective because propitiated significant changes in the use of punctuation marks in the final steps of the didactic sequence.
Souza, Victor Hugo Delvalle. „Estimação de escores binomiais correlacionados: uma aplicação em Credit Scoring“. Universidade Federal de São Carlos, 2008. https://repositorio.ufscar.br/handle/ufscar/4520.
Der volle Inhalt der QuelleFinanciadora de Estudos e Projetos
For the most part of modelings in the credit risk area, the most widely used model is the credit scoring, and as the main statistical technique, the binary logistic regression, used to determine whether a customer is a good or bad payer. In this academic work an alternative methodology is proposed, where the estimative is formed based on the scores obtained by customers; this means the response follows a binomial distribution. In this modeling the combined estimate of scores of various products used by customers is included, considering the correlation between these scores.
Em grande parte das modelagens na área de risco de crédito, o modelo mais utilizado é o credit scoring, e como técnica estatística principal a regressão logistica binária, utilizada para decidir se um cliente é bom ou mau pagador. Neste trabalho propomos uma metodologia alternativa, onde a estimativa é feita diretamente nos escores dos clientes, com issa a resposta segue uma distribuição binomial. Nessa modelagem incluimos ainda a estimativa conjunta dos escores de vários produtos utilizados pelos clientes, levando em consideração a correlação existente entre estes escores.