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1

Norris, Megan. "Examining the Autism Phenotype: The Structure of Autism Spectrum Disorders as Measured by the Autism Diagnostic Observation Schedule." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1281709680.

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2

Reeves, Ashleigh, Christopher Gregg, Michael K. Lindell, Timothy A. Joyner, and Bruce Houghton. "Resident stakeholder perceptions of lava flow hazard diversion strategies and protective measures for infrastructure and commercial and private property on Kīlauea and Mauna Loa volcanoes, Hawai‘i." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/asrf/2018/schedule/25.

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Анотація:
Decisions to interfere with the natural path of lava are constrained by geological, engineering and logistical factors; and legal, environmental and socio-cultural considerations. Lava flows erupted from several volcanoes around the world have threatened people and their property, motivating them to take actions to prevent or slow its advance by diverting the flow direction using channels, berms and explosives or obstructing the lava by quenching with water or armoring. Property to be protected has included government, public, commercial and private property ranging from cities and harbors to personal property. The earliest known attempt to influence the path of lava occurred in 1669 on Mount Etna, Italy, but more recent experience there occurred in the 1980s-90s. Several eruptions at Kīlauea and Mauna Loa volcanoes in Hawai‘i also provided abundant experience (1881, 1935, 1942, 1955, 1960 and several times during the on-going 1983- present eruption of Kīlauea). Additional experience relates to experimental tests and an untested berm on Mauna Loa. Most recently though, local businessmen on Kīlauea constructed earthen berms to protect their property and the local utility authority constructed novel protective structures around electric utility poles. Decisions to use mitigation strategies may be based on expert scientific opinion, but public opposition has been reported to alone be able to prevent lava mitigation. In 2014, public opinions about the use of traditional mitigation strategies (diversion by berms or bombing) to protect commercial and residential areas of Puna were mixed among residents, but there appeared to be no opposition to a new mitigation strategy that protected key areas of the electrical infrastructure and supply of electricity. To help understand public opinion about this and various mitigation strategies and people’s acceptance of additional risk to personal property to help protect important elements of their community, we conductied questionnaire surveys among residents on Kīlauea and Mauna Loa as part of a multi-university NSF Hazards SEES project. We evaluated crisis experience, hazard zonation, and community bondedness, in addition to socio-demographic and cultural factors, with beliefs concerning mitigation, including effectiveness of mitigation strategies for lava flows and others hazards; financial and legal considerations; and requirements for specialized knowledge, skills and cooperation.
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3

Mabry, Holly, and Daniel Jolley. "Using Analytic Tools to Measure Overall Trends and Growth Patterns in Digital Commons Collections." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/dcseug/2018/schedule/1.

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Digital Commons @ Gardner-Webb University was launched in Fall 2015 and currently has over 1300 papers including: theses and dissertations, journals in Education, Psychology, and Undergraduate Research, University Archives, and faculty scholarship activities. The repository has a small, but growing number of collections that continue to show significant year-to-year document download count increases, particularly in the nursing and education theses and dissertation collections. Digital Commons provides a number of ways to track collection statistics and identify repository access and download trends. This presentation will look at how we used the Digital Commons Dashboard report tool and Google Analytics to identify the most popular collections and where they’re being accessed on campus and globally. Using this data, we were able to write targeted metadata and include third party tools such as the Internet Archive BookReader in order to improve outreach to the campus and global scholarly community.
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4

Nagarajan, Balaji. "Analytic Evaluation of the Expectation and Variance of Different Performance Measures of a Schedule under Processing Time Variability." Thesis, Virginia Tech, 2003. http://hdl.handle.net/10919/31264.

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The realm of manufacturing is replete with instances of uncertainties in job processing times, machine statuses (up or down), demand fluctuations, due dates of jobs and job priorities. These uncertainties stem from the inability to gather accurate information about the various parameters (e.g., processing times, product demand) or to gain complete control over the different manufacturing processes that are involved. Hence, it becomes imperative on the part of a production manager to take into account the impact of uncertainty on the performance of the system on hand. This uncertainty, or variability, is of considerable importance in the scheduling of production tasks. A scheduling problem is primarily to allocate the jobs and determine their start times for processing on a single or multiple machines (resources) for the objective of optimizing a performance measure of interest. If the problem parameters of interest e.g., processing times, due dates, release dates are deterministic, the scheduling problem is relatively easier to solve than for the case when the information is uncertain about these parameters. From a practical point of view, the knowledge of these parameters is, most often than not, uncertain and it becomes necessary to develop a stochastic model of the scheduling system in order to analyze its performance. Investigation of the stochastic scheduling literature reveals that the preponderance of the work reported has dealt with optimizing the expected value of the performance measure. By focusing only on the expected value and ignoring the variance of the measure used, the scheduling problem becomes purely deterministic and the significant ramifications of schedule variability are essentially neglected. In many a practical cases, a scheduler would prefer to have a stable schedule with minimum variance than a schedule that has lower expected value and unknown (and possibly high) variance. Hence, it becomes apparent to define schedule efficiencies in terms of both the expectation and variance of the performance measure used. It could be easily perceived that the primary reasons for neglecting variance are the complications arising out of variance considerations and the difficulty of solving the underlying optimization problem. Moreover, research work to develop closed-form expressions or methodologies to determine the variance of the performance measures is very limited in the literature. However, conceivably, such an evaluation or analysis can only help a scheduler in making appropriate decisions in the face of uncertain environment. Additionally, these expressions and methodologies can be incorporated in various scheduling algorithms to determine efficient schedules in terms of both the expectation and variance. In our research work, we develop such analytic expressions and methodologies to determine the expectation and variance of different performance measures of a schedule. The performance measures considered are both completion time and tardiness based measures. The scheduling environments considered in our analysis involve a single machine, parallel machines, flow shops and job shops. The processing times of the jobs are modeled as independent random variables with known probability density functions. With the schedule given a priori, we develop closed-form expressions or devise methodologies to determine the expectation and variance of the performance measures of interest. We also describe in detail the approaches that we used for the various scheduling environments mentioned earlier. The developed expressions and methodologies were programmed in MATLAB R12 and illustrated with a few sample problems. It is our understanding that knowing the variance of the performance measure in addition to its expected value would aid in determining the appropriate schedule to use in practice. A scheduler would be in a better position to base his/her decisions having known the variability of the schedules and, consequently, can strike a balance between the expected value and variance.
Master of Science
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5

Higginson, Irene Julie. "The development, validity, reliability and practicality of a new measure of palliative care : the Support Team Assessment Schedule." Thesis, University College London (University of London), 1992. http://discovery.ucl.ac.uk/1317889/.

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Hospices and support teams offering palliative care have increased by over four fold in the U.K. during the last decade. However, evaluations have been limited, often because of a lack of suitable outcome measures. This study aimed to develop and test the validity and reliability of a measure of palliative care provided by support teams. Through detailed discussion of work objectives with care staff, assisted by review of the literature, the Support Team Assessment Schedule (STAS) was developed. STAS has 17 items, each scaled 0 (best) to 4 (worst), with definitions for each scale point. Median time to complete a STAS rating was 2 minutes (range <1- 15). Face validity was demonstrated by use in five settings. Criterion validity was assessed by comparing team ratings with ratings from patients and family members (or other carers) collected through interview. Patient and team ratings showed moderate correlations (rho ranging 0.45 - 0.66 for 5 out of 7 items): team ratings were usually closer to those of patients than those of family members. As a test of construct validity, quality of life (HCRA-QL) index items were shown to correlate with similar STAS items in patients more than four weeks before death (a STAS sub-scale of six items was correlated with the total HRCA-QL, Spearman rho -0.45). Reliability of STAS was assessed by comparing the ratings of different staff. Out of a total of 45 patient assessments, 16 items showed agreement or ratings within one score in 88% or more cases, Cohen's Kappas were greater than 0.48 (up to 0.87) and were highly significant (p < 0.0005). There were high correlation coefficients (Spearman's rho ranged 0.65 - 0.94). Split-half reliability and internal consistency was assessed using Spearman Brown coefficients and Cronbach's alpha for ratings at referral, at death or discharge, and on all weeks (combined). The coefficients ranged 0.68 - 0.89: slightly higher than the coefficients found for the HRCA-QL index. Serial scores of patients that improved (the majority) and deteriorated (a minority) under care, and results from first and last assessments of patients under the care of five support teams, indicate that the STAS was discriminating in practice. Although STAS was used to audit support team care the items are relevant to the assessment and evaluation of palliative care in other settings.
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6

Shchupak, Tatyana. "Convergent validity of two measures of childhood sexual abuse: Russell Sexual Abuse Interview Schedule and the Finkelhor Survey of Childhood Experiences." OpenSIUC, 2015. https://opensiuc.lib.siu.edu/dissertations/1092.

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This study investigated the convergent validity between two classical measures of childhood sexual abuse (CSA): the Russell Sexual Abuse Interview Schedule (Russell, 1983) and Finkelhor Survey of Childhood Experiences (Finkelhor, 1979). One hundred sixty eight participants were recruited from a Midwestern university. In addition to the two CSA measures, the following measures were also compared: a subject demographic information form, the Trauma Symptom Checklist-40 (Briere and Runtz, 1989), the Simple Screening Instrument for Substance Abuse (Center for Substance Abuse Treatment, 1994), and Rotter's Internal and External Locus of Control Scale (Rotter, 1966). This study provided support for convergent validity between the Finkelhor and the Russell. The majority of participants who reported CSA on the Finkelhor also reported CSA on the Russell, with more participants reporting CSA on the Russell. Although participants' responses on the Finkelhor were positively correlated with their responses on the Russell with respect to severity of the CSA, most participants did not receive the same rating for severity level on both measures. More participants endorsed experiencing CSA by a family member on the Russell than on the Finkelhor. There were significant positive relationships between presence, severity, and duration of abuse (as measured by the Finkelhor for some participants) and scores on the TSC-40, but fewer for the Russell. There were no significant relationships between identifying a family member as the perpetrator of the CSA on the Russell and Finkelhor and scores on the TSC-40 and scores for substance abuse. There were also no significant relationships between presence of CSA as measured by the Finkelhor and Russell and scores for substance abuse. The results of this study found support for discriminant validity for both CSA measures, as scores for neither measure correlated with scores on Rotter's I-E Scale. The results of this study suggest that more research needs to focus on developing consensus on the definition of CSA and on determining how to measure frequency, severity, and duration of CSA accurately. Research on how to measure the characteristics of CSA can yield important information about the relationships between these characteristics and negative outcomes, such as substance abuse, which can be used to inform treatment.
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7

Flores, Diego Gonzalo. "Asymmetry of Gains and Losses: Behavioral and Electrophysiological Measures." BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/6578.

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The purpose of this research was to explore the effects of small monetary or economic gains and/or losses on choice behavior through the use of a computerized game and to determine gain/loss ratio differences using both behavioral and electrophysiological measures. Participants (N=53) played the game in several 36 minute sessions. These sessions operated with concurrent variable-interval schedules for both rewards and penalties. Previously, asymmetrical effects of gains and losses have been identified through cognitive studies, primarily due to the work of nobel laureates Daniel Kahneman and Amos Tversky (1979). They found that the effect of a loss is twice (i.e., 2:1) that of a gain. Similar results have been observed in the behavioral laboratory as exemplified by the research of Rasmussen and Newland (2008), who found a 3:1 ratio for the effect of losses versus gains. The asymmetry of gains and losses was estimated behaviorally and through event-related brain potentials (ERPs) and the cognitive (Kahneman and Tversky) and behavioral (Rasmussen and Newland) discrepancy elucidated. In the game, the player moves an animated submarine around sea rocks to collect yellow coins and other treasures on the sea floor. Upon collecting a coin, one of three things can happen: The player triggers a penalty (loss), the player triggers a payoff (gain), or there is no change. The behavioral measures consisted in counting the number of clicks, reinforces, and punishers and then determining ratio differences between punished (loss) and no punished condition (gain) conditions. The obtained gain/loss ratio corresponded to an asymmetry of 2:1. Similarly ratio differences were found between male and female, virtual money and cash, risk averse versus risk seeking, and generosity versus profit behavior. Also, no ratio difference was found when players receive information about other player's performances in the game (players with information versus players without information). In electroencephalographic (EEG) studies, visual evoked potentials (VEPs) and ERPs components (e.g., P300) were examined. I found increased ERP amplitudes for the losses in relation to the gains that corresponded to the calculated behavioral asymmetry of 2:1. A correlational strategy was adopted that sought to identify neural correlates of choice consistent with cognitive and behavioral approaches. In addition, electro cortical ratio differences were observed between different sets of electrodes that corresponded to the front, middle, and back sections of the brain; differences between sessions, risk averse and risk seeking behavior and sessions with concurrent visual and auditory stimuli and only visual were also estimated.
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8

Heyns, Werner. "Urban congestion charging : road pricing as a traffic reduction measure / W. Heyns." Thesis, North-West University, 2005. http://hdl.handle.net/10394/523.

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Urban traffic congestion is recognised as a major problem by most people in world cities. However, the implementation of congestion reducing measures on a wide scale eludes most world cities suffering from traffic congestion, as many oppose the notion of road pricing and despite economists and transportation professionals having advocated its benefits for a number of decades. The effects of road pricing have attracted considerable attention from researchers examining its effects, as it is thought to hold the key in understanding and overcoming some inherent obstacles to implementation. Unfortunately, many of the attempts consider the effects in isolation and with hypothetical, idealised and analytical tools, sometimes loosing sight of the complexities of the problem. This research empirically investigates the effects of road pricing in London, and identifies factors, which may prove to sustain it as a traffic reduction instrument. The results indicate that an integrated approach has to be developed and implemented, based upon the recognition of local perceptions, concerns, aspirations and locally acceptable solutions, if the acceptance of road pricing is to be improved. The key to dealing with the effects of road pricing, is to encourage a concerted effort by various stakeholders developing strategies considering a range of differing initiatives, coordinating and managing them in the realm of the political-economic context in which they exist.
Thesis (M.Art. et Scien. (Town and Regional Planning))--North-West University, Potchefstroom Campus, 2005.
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9

Iglesias, Estellés Javier. "Study of the ventilation system in a warehouse and a cooking school : Impact of the use of a heat exchanger system and a more optimised operating schedule." Thesis, Högskolan i Gävle, Energisystem, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-26907.

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The motivation of this project is found on the past trend of growing greenhouse gases emissions and, also growing, energy use over the world that still remains. This trend overlaps with a more recent increase in the awareness regarding the effects of human activities towards the Earth ecosystems. Thus, the upgrade of the already-in-use systems is necessary to move towards greener and more modern technologies that permit continue with the economic growth while building more sustainable societies. Thereby, the research focuses on the improvement of the ventilation system of a warehouse building and a cooking school located in the same plot, in an industrial area in Gävle, Sweden. The current system conditions, even consisting in some cases in recirculating air handling units, doesn’t permit the utilisation of the waste heat by bringing it back to the system. The strategy used during the project follows a case study scheme: looking the system, understanding it in a complete way and designing the proper solution that fulfils the requirements. The study was approached as an energy audit: with several meetings with the company, collecting airflows data with the thermo-anemometer device, sketching the required building drawings and designing the optimal solution for the company. Finally, the project resulted in the selection of the proper air handling unit, equipped with a heat recovery system, and the design of its ventilation duct system that permit a heat energy savings derived of the heat demand used to heat the makeup air of about 67 %. Furthermore, the occupancy study helped design the new scheduling for the ventilation periods that reduce the electricity demand of the ventilation system by 30 %. Thus, was obtained a significant energy use reduction that results in a sizeable energy cost saving.
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10

Wockatz, Philip. ""WOW. FOR VOLVO" : cognition and affect combining forces to measure the immeasurable." Thesis, Linköping University, Department of Computer and Information Science, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-20990.

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11

Doležel, Jakub. "Stavebně technologická příprava výstavby bytového domu v Brně." Master's thesis, Vysoké učení technické v Brně. Fakulta stavební, 2017. http://www.nusl.cz/ntk/nusl-265578.

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This thesis focuses on developing technological preparation of the apartment house Kociánka in Brno. This work includes technical report, coordination situation transport routes, feasibility studies, time and financial plan object, building equipment, design of construction machines and equipment, schedule od work, technological prescription, itemized budget, inspection and test plan and dedicated the award to the assessment of traffic and the project of the traffic - engineering measures.
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12

Cosme, Inês Alexandra Silva. "Impactos e estratégias organizacionais de conciliação da esfera profissional e privada no emprego em regime de turnos : a dualidade de generos." Master's thesis, Instituto Superior de Economia e Gestão, 2016. http://hdl.handle.net/10400.5/12885.

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Анотація:
Mestrado em Gestão de Recursos Humanos
O tema escolhido para a realização do Trabalho Final de Mestrado em regime de Dissertação prende-se com “Impactos e estratégias organizacionais de conciliação da esfera profissional e privada no emprego em regime de turnos – a dualidade de géneros”. Neste âmbito é impreterível estudar o binómio trabalho-família para perceber como é feita a conciliação entre a esfera privada e a esfera pública. Numa abordagem mais específica, será estudado como surge esta conciliação entre os trabalhadores em regime de horário de turno. É relevante analisar a diferença de géneros no âmbito da conciliação, principalmente as circunstâncias exigidas a ambos os sexos, sendo necessário investigar se os impactos que o trabalho por turnos poderá trazer ao binómio diferem na dualidade de géneros, prendendo-se com as exigências da esfera privada e profissional de cada género. Seguidamente, é necessária uma interpretação à luz das estratégias e políticas organizacionais que estão ao dispor das organizações para lidar com a conciliação trabalho-família, com o objetivo de perceber a aplicabilidade e relevância das mesmas quando se trata de trabalhadores em regime de turnos.
The theme chosen to accomplish this thesis concerns “Impacts and organizational strategies of work-life balance on shift work – the duality of genres”. In this scope it is imperative to study the binomial work-family in order to understand how the reconciliation between private sphere and public sphere is done. In a more specific approach, it will be studied how does this conciliation appears among shift workers. It is relevant to assay the difference between genres under this conciliation, mainly the circumstances demanded to both genres, being necessary to investigate whether the impacts on shift workers differ in the duality of genres, linking it with public and private spheres demands. Lastly, it is required an interpretation according to the organizational strategies and policies available to organizations in order to them to be able to handle the work-life balance, with the aim to realize the applicability and relevance of them when it comes to working in shifts.
N/A
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13

Šafářová, Tereza. "Analýza a hodnocení rizik realizace úspory energie pomocí rekonstrukce školského zařízení." Master's thesis, Vysoké učení technické v Brně. Ústav soudního inženýrství, 2016. http://www.nusl.cz/ntk/nusl-241256.

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The thesis is focused on analysis and risk assessment during the reconstruction of the school building. The work will be used appropriate methods to a specific reconstruction of school, especially checklist and risk catalog. They will be determined by the ris ks that caused the failure to comply with the schedule of works and thus limit the operation of school and the surrounding area. These risks will be set out measures that should determine how these scenarios could have been avoided.
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14

Louw, Andries Barnabas. "Tools for the revision of a maintenance strategy for an explosives manufacturing plant, using asset management principles / A.B. Louw." Thesis, North-West University, 2009. http://hdl.handle.net/10394/3835.

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Анотація:
The research topic is: Tools for the revision of a maintenance strategy for an explosives manufacturing plant, using asset management principles. This research has specific reference to the SASOL Prillan plant based in SASOL, Sasolburg. The purpose of this research is to identify tools for the revision of a maintenance strategy for an explosives manufacturing plant, using asset management principles. These tools must be aimed to increase the proactive work capacity index, Figure 3, and to identify and/or develop tools that can be used by the engineering team of this explosives manufacturing plant to increase equipment reliability and performance. In this research assets include people. The meaning and application of asset management principles were researched and the tools needed to combine existing efforts and future needs are discussed. The human element to ensure the successful implementation of an asset management culture was researched and attributes of leaders and a change model is presented. This research was done into the wider engineering management discipline and not only maintenance. The method used to gather data was by means of interviews of a sample group within this organization. As this manufacturing unit makes use of subject matter experts, these support functions and plant personnel that were not interviewed, were issued with questionnaires to ensure that the sample group is a fair representation of the total manufacturing facility. To obtain a holistic view of potential shortcomings within the current maintenance strategy, all disciplines and levels within this operation were interviewed and commonalities of various asset management models were determined and used to define existing problem areas. This data was used to determine statistical correlations. The case study presented in Chapter 1 indicates that there is a case for change that can improve the proactive work capacity index of the engineering team. The results of this research confirm that there is in fact a real requirement to increase spares accuracy, improve on technical training as well as a need to establish visual performance indicators (dashboard) to measure overall equipment efficiency with the goal toTools for the revision of a maintenance strategy for an explosives manufacturing plant, using asset management principles increase equipment reliability and performance. The technical training referred to in this research reflects on training of people on equipment after investment in new technology. The current spares holding strategy is lacking equipment description accuracy. Furthermore, it is recommended that the implementation of career paths and development plans for individuals must be developed to create an environment of learning. The use of user status information captured on the computerized maintenance management system (SAP R/3) can add to the management of works orders and indicate where the focus must be to complete overdue work orders. Open work orders should be used to manage expenditure, to measure planning efficiency and to manage the cash flow of the business. The use of overall equipment efficiency and engineering efficiency measures is recommended and must be visually displayed on a “dashboard”. It was recommended that the engineering and operations personnel of this manufacturing plant be trained in asset management principles and that balanced scorecards are developed to ensure that the strategies of the various departments are aligned with the business strategy. Diagram 1 best illustrates the thinking and process flow of this research. The flow diagram shows five distinct stages and the appropriate objectives and/ or elements that were considered. The dissertation is also structured in this manner. All abbreviations, acronyms and definitions used in this document were listed in APPENDIX B
Thesis (M.Ing. (Development and Management Engineering))--North-West University, Potchefstroom Campus, 2009.
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15

Šaroun, Vít. "Stavebně technologický projekt domu pro seniory." Master's thesis, Vysoké učení technické v Brně. Fakulta stavební, 2018. http://www.nusl.cz/ntk/nusl-372003.

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The aim of the diploma thesis is to make the detailed design project of retirement home in Nové Město na Moravě. This thesis contains a construction technology, summary accompaying technical report, control and test plans, itemized budget, time and financial plan of the carcass object SO01. Finally there is also implementation scheme, situation of site equipment and construction details.
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16

Boucník, Jan. "Příprava realizace administrativních objektů Palmovka Park." Master's thesis, Vysoké učení technické v Brně. Fakulta stavební, 2018. http://www.nusl.cz/ntk/nusl-371812.

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Анотація:
The diploma thesis deals with the preparation of the construction of Palmovka Open Park III administrative building. It contains a technological regulation for drilled piles, technological regulation for reinforced concrete monolithic constructions, broader transport routes, study of the implementation of the main technological stages, design of building machines and mechanisms, control and testing plan for drilling piles and reinforced concrete constructions, risk and measures, time and financial plan, calculation according to THU, drawing of site equipment, cycle, timetable, item budget, selected technological details.
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17

Krejčí, Vlastimil. "Bytový dům Terasy Havlíčkova - vybrané části STP." Master's thesis, Vysoké učení technické v Brně. Fakulta stavební, 2012. http://www.nusl.cz/ntk/nusl-225617.

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Анотація:
Architectural and technological project of building the housing Terraces Havlickova contains technical report on construction technology project,coordination situation, building relationships with the wider transport routes, time and financial plan of the building object, study the implementation of major technological stages of a residential building,Project construction site, design of the main building machines,schedule of the main building construction object SO-01,plan for securing material resources for the construction of residential house,technological regulation for the implementation of excavations and roofs,inspection and test plan for the implementation of the excavations and roofs. The other award was prepared itemized budget apartment house SO-01, calculation of construction according to THU, health and safety plan and Listing of security risks and security measures on site
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18

Milligan, Patrick E. "The effects of random versus blocked practice schedules on underhand basketball free throw performance measures." 2002. http://www.oregonpdf.org.

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19

Guimarães, Serafim Miguel de Sousa Barreto. "Patient reported outcome measures in chronic kidney disease: analysis of self-reported indicators of experiencing chronic disease." Doctoral thesis, 2019. http://hdl.handle.net/10773/27993.

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Анотація:
There is often a discrepancy between clinical data, including laboratory tests, and the patients’ experience of being ill. The goal of this work was to search for Key Performance Indicators (KPI) of disease other than the usual numeric data. As research model, we have used Chronic Kidney Disease (CKD). Those indicators should express the experience of living with the disease and be sensible to medical decisions so that they can be targeted for intervention. In chapter 2, a contextualization of CKD is made, presenting an extensive list of the standard indicators that currently drive physicians’ decisions. A general approach to chronic diseases is presented in chapter 3, highlighting models of interventions. Some existing indicators are also covered. The experimental work is presented in chapter 4. Our hypothesis was based on a conceptual model which postulated that a given Patient Reported Outcome Measure (PROM) would be suitable for daily use in the clinical context provided that it would link predictors (demographic variables, comorbidity indices, estimates of Glomerular Filtration Rate – eGFR - and untoward events of the previous year) to Endpoints (death, dialysis, hospitalizations and emergency episodes) with statistically significant relationships and serve as indicator as surrogate of well-being. We conducted an observational study and recruited 60 patients with CKD to whom several questionnaires of PROM were administered: Short Physical Performance Battery (SPPB), World Health Organization Disability Assessment Schedule (WHODAS), Satisfaction With Life Scale (SWLS) and Kidney Disease Quality of Life (KDQoL). Follow-up period was 24 months. Lastly, we wanted to know the relevancy of the endpoints to the patients. For that, they were asked to rank six endpoints according to what they think their physician’s priority should be (avoid death, avoid dialysis, avoid worsening of lab tests, prevent further deterioration of medical condition, avoid hospital admissions and avoid emergency episodes). We conclude that: 1) SPPB could predict death, dialysis and hospital admissions. 2) WHODAS could predict death and dialysis. 3) Physical Functioning domain of KDQoL could predict death and hospital admissions. 4) Role Emotional domain of KDQoL could predict death. 5) Energy/Vitality domain of KDQoL could predict hospital admissions. 6) Role Physical domain of KDQoL could predict dialysis. 7) Mental Health domain of KDQoL could predict hospital admissions and emergency episodes. 8) Pain, Social Function and General Health domains of KDQoL, and SWLS were not useful in predicting any of the proposed endpoints. 9) The Cockcroft-Gault (CG) formula to compute eGFR is the only that could predict mortality. 10) All eGFR formulae predicted beginning of dialysis. 11) Only the CG formula could predict the scores of some PROM scales: SPPB, Physical Function domain of KDQoL and WHODAS. 12) Both the Charlson comorbidity scales (1987 and 2011) are useful for the prediction of studied endpoints: the first predicts death and hospital admissions while the second predicted mortality, dialysis, hospitalizations and emergency episodes. 13) The highest priority of patients is that their physician’s main concern should be to “Avoid death” whereas options “Avoid dialysis” and “Avoid worsening of laboratory tests” came next, in a tie. 14) Patients ranked “Avoid hospitalization” and “Avoid emergency episodes” in the last places, after all the others. Finally, 15) Eight possible schemes were drawn from the analysis of the conceptual model. Four of them have shown to have clinical utility. Longitudinal exploration of these PROM is needed in order to reinforce their clear place at office and bedside and in disease management.
Há frequentemente uma discrepância entre os dados clínicos, incluindo análises laboratoriais, e a experiência de se estar doente. O objetivo deste trabalho foi procurar indicadores-chave de desempenho de doença para além dos dados numéricos habituais. Como modelo de investigação, utilizamos a Doença Renal Crónica (DRC). Esses indicadores devem traduzir a experiência de viver com a doença e serem sensíveis às decisões médicas, para que possam ser alvo de intervenção. No capítulo 2, é feita uma contextualização da DRC, apresentando-se uma extensa lista dos indicadores que actualmente orientam as decisões dos médicos. No capítulo 3, faz-se uma abordagem geral das doenças crónicas, destacando modelos de gestão da doença crónica. Alguns indicadores actualmente usados também são referidos. O trabalho experimental é apresentado no capítulo 4. A nossa hipótese baseou-se num modelo conceptual que postulava que uma determinada medida de resultados autorelatados pelos doentes (PROM: Patient Reported Outcome Measures) seria adequada para uso diário em contexto clínico se tivesse uma correlação estatisticamente significativa entre os preditores (variáveis demográficas, índices de comorbilidade, estimativas de Taxa de Filtração Glomerular - TFGe - e eventos adversos do ano anterior) e os resultados (morte, diálise, hospitalizações e idas ao serviço de urgência), servindo assim como indicador de bem-estar. Realizámos um estudo observacional, tendo recrutado 60 doentes renais crónicos que responderam a vários questionários de PROM: “Short Physical Performance Battery” (SPPB), “World Health Organization Disability Assessment Schedule” (WHODAS), “Satisfaction With Life Scale” (SWLS) e “Kidney Disease Quality of Life” (KDQoL). O período de acompanhamento foi de 24 meses. Finalmente, estudámos a relevância dos resultados para os doentes. Para isso, foi-lhes pedido que classificassem seis desfechos, de acordo com o que acham que deveria ser a prioridade do seu médico (“evitar a morte”, “evitar a diálise”, “evitar o agravamento dos exames laboratoriais”, “evitar a deterioração do seu estado geral”, “evitar internamentos hospitalares” e “evitar idas ao serviço de urgência”). Os resultados permitiram concluir que: 1) O SPPB previu morte, diálise e hospitalizações. 2) O WHODAS previu morte e diálise. 3) O domínio Função Física do KDQoL previu morte e hospitalizações. 4) O domínio Saúde Mental do KDQoL previu morte. 5) O domínio Energia/vitalidade do KDQoL previu hospitalizações. 6) O domínio físico do KDQoL previu diálise. 7) Domínio de Saúde Mental do KDQoL previu hospitalizações e idas ao serviço de urgência. 8) Os domínios Dor, Função Social e Saúde Geral do KDQoL, bem como o SWLS não foram úteis na previsão de nenhum dos resultados propostos. 9) A fórmula de Cockcroft-Gault (CG) para calcular a TFGe é a única que previu a morte. 10) Todas as fórmulas de cálculo da TFGe previram o início da diálise. 11) Apenas a fórmula de CG pôde prever a pontuação de algumas escalas do PROM: SPPB, domínio da Função Física do KDQoL e WHODAS. 12) Ambas as escalas de comorbilidade de Charlson (de 1987 e 2011) são úteis para a predição dos resultados estudados: a primeira prevê mortes e internamentos hospitalares, enquanto a segunda prediz morte, diálise, hospitalizações e idas ao serviço de urgência. 13) A principal prioridade dos doentes é que a principal preocupação do seu médico seja “evitar a morte”, enquanto as opções “evitar diálise” e “evitar o agravamento dos exames laboratoriais” vêm a seguir, empatadas. 14) Os doentes classificaram as opções “evitar hospitalização” e “evitar episódios de urgência” nos últimos lugares, depois de todas as demais. Finalmente, 15) O modelo conceptual proposto permitiu identificar oito possibilidades diferentes de relação entre preditores, PROM e resultados. Quatro deles mostraram ter utilidade clínica. São necessários estudos longitudinais com PROM para reforçar o seu papel no consultório e na enfermaria, e também na gestão da doença.
Programa Doutoral em Ciências e Tecnologias da Saúde
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20

Chaterera, Forget. "Records survey and the management of public records in Zimbabwe." Diss., 2013. http://hdl.handle.net/10500/11961.

Повний текст джерела
Анотація:
The study investigated the role of records surveys in the management of public records in Zimbabwe. The goal was to determine how far records surveys were going in enhancing sound records management practices, thereby improving public service delivery, accountability and good governance. Through interviews, questionnaires and document review it was revealed that records surveys were struggling to attain their intended goal of nurturing sound records management practices in public registries. The lack of ideal mission statements, registry manuals, written disaster management plans, vital records protection programmes, adequate records management training, records retention and disposal schedules, top management support, financial constraints and unclear archival legislation were cited as some of the challenges affecting records and information management surveys from nurturing acceptable records management practices. A closer working relationship between the National Archives and public records management units was recommended.
Information Science
M. Inf. (Archival Science)
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21

Chaterera, Forget. "Records surveys and the management of public records in Zimbabwe." Diss., 2013. http://hdl.handle.net/10500/11961.

Повний текст джерела
Анотація:
The study investigated the role of records surveys in the management of public records in Zimbabwe. The goal was to determine how far records surveys were going in enhancing sound records management practices, thereby improving public service delivery, accountability and good governance. Through interviews, questionnaires and document review it was revealed that records surveys were struggling to attain their intended goal of nurturing sound records management practices in public registries. The lack of ideal mission statements, registry manuals, written disaster management plans, vital records protection programmes, adequate records management training, records retention and disposal schedules, top management support, financial constraints and unclear archival legislation were cited as some of the challenges affecting records and information management surveys from nurturing acceptable records management practices. A closer working relationship between the National Archives and public records management units was recommended.
Information Science
M. Inf. (Archival Science)
Стилі APA, Harvard, Vancouver, ISO та ін.
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