388 research outputs found

    Dynamic capabilities for accreditation: Evidence in the healthcare sector

    Get PDF
    The objective of this paper is to analyze the development of dynamic capabilities in the process of hospital accreditation, using case study methodology. Data were collected through semi-structured interviews, observation and document analysis and analyzed through content analysis techniques. We found that deliberate learning and relationships were the principal sources for capability creation, and that they were renewed and recombined along the way. Periods of convergence punctuated by strategic reorientation allowed us to conclude that the changes adhered to the punctuated equilibrium model. The outcomes of this study advance the findings documented in the literature about the construction of a formative path of dynamic capabilities, understanding the duality of operational and dynamic capabilities, and comprehending the mechanisms by which capabilities are developed

    Multiresponse Optimization of Inoculum Conditions for the Production of Amylases and Proteases by Aspergillus awamori in Solid-State Fermentation of Babassu Cake

    Get PDF
    This work aimed at investigating the simultaneous production of amylases and proteases by solid-state fermentation (SSF) of babassu cake using Aspergillus awamori IOC-3914. By means of experimental design techniques and the desirability function, optimum inoculum conditions (C/N ratio of propagation medium, inoculum age, and concentration of inoculum added to SSF medium) for the production of both groups of enzymes were found to be 25.8, 28.4 h, and 9.1 mg g−1, respectively. Significant influence of both initial C/N ratio and inoculum concentration was observed. Optimum amylolytic activities predicted by this multiresponse analysis were validated by independent experiments, thus indicating the efficacy of this approach

    Giant Keratocystic Odontogenic Tumor: Three Cases And Literature Review.

    Get PDF
    A keratocystic odontogenic tumor is a benign intra-bone mass originating from dental lamina or its residue. It represents 2-11% of jaw cysts, and has a slow but aggressive growth. The evaluation of molecular characteristics, immunohistochemistry, and genetic expression currently have no established classification regarding the evolution and pathophysiologic pattern of these lesions. This is a clinical retrospective study with a full analysis of patient history regarding physical evaluation, radiologic images, pathology results, and surgical resection. We performed a major literature review concerning current concepts relating to its biological characterization. Three cases of keratocystic odontogenic tumor were identified. Two of the cases were large, with aggressive behavior and significant bone destruction and recurrence, which had been overlooked for more than a decade. The third case had an early diagnosis, and the treatment led to full recovery and complete healing. The keratocystic odontogenic tumor is a benign lesion with slow growth, which lends itself to a more conservative treatment, even in cases of large lesions. A better understanding of these tumors, both at the biological and molecular level, could lead to guidelines for treatment and prognosis of such patients.25245-5

    Different Teaching Approaches and Use of Active Learning Strategies as Tools for Inter- and Transdisciplinary Education

    Get PDF
    This work reports a review on some of the ways in which education and research can be used to solve today’s complex problems by taking into account teaching and learning strategies that go beyond traditional teaching strategies. It revisits different teaching approaches and connects them directly to uni-, pluri-, multi-, inter-, and transdisciplinary attitudes, and how educational professionals think of the subject of teaching. This discussion reflects on how teachers tend to reproduce procedures they observed in their own graduation programs and why experienced teachers opt for inter- and transdisciplinary attitudes. Using a qualitative approach, this work illustrates the results from a Project-Based Learning strategy applied to a group of Major Engineering students to solve problems at the University’s Campus. Participants included 25 students engaged to Physics Engineering program supervised by different faculty members, experienced undergraduate and graduate students, and technicians, who had mentored the undergraduate students’ teams, all working in subjects closely related to the projects. The products developed by the teams show evidence that the students were motivated and engaged in the projects; this supports the premise that inter- and transdisciplinary approaches drive collaboration in the execution of projects, develop soft skills and permit knowledge development in an articulate and complex way thereby leading to a broader education of the students

    Amitriptilina e exercĂ­cio aerĂłbico ou amitriptilina isolada no tratamento da migrĂąnea crĂŽnica: um estudo randomizado e comparativo

    Get PDF
    To compare the preventive treatment benefits of amitriptyline and aerobic exercise or amitriptyline alone in patients with chronic migraine.Method Sixty patients, both genders, aged between 18 and 50 years, with a diagnosis of chronic migraine, were randomized in groups called amitriptyline and aerobic exercise or amitriptyline alone. The following parameters were evaluated: headache frequency, intensity and duration of headache, days of the analgesic medication use, body mass index (BMI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) scores. Results In the evaluated parameters, was observed decrease in headache frequency (p=0.001), moderate intensity (p=0.048), in headache duration (p=0.001), the body mass index (p=0.001), Beck Depression Inventory (p=0.001) and Beck Anxiety Inventory scores (p=0.001), when groups were compared in the end of third month. Conclusion In this study, the amitriptyline was an effective treatment for chronic migraine, but its efficacy was increased when combined with aerobic exercise.Comparar os benefĂ­cios do tratamento preventivo em pacientes com migrĂąnea crĂŽnica utilizando a amitriptilina associada ao exercĂ­cio aerĂłbico ou amitriptilina isolada.MĂ©todo Sessenta pacientes de ambos os sexos com idade entre 18 e 50 anos e com diagnĂłstico de migrĂąnea crĂŽnica foram randomizados para receber amitriptilina e orientados a: praticar exercĂ­cios aerĂłbicos ou somente a amitriptilina isolada. Os seguintes parĂąmetros foram avaliados: frequĂȘncia, intensidade e duração da cefaleia, dias de uso de medicação analgĂ©sica, Ă­ndice de massa corporal (IMC), e pontuação nas escalas de Beck Depression Inventory (BDI) e Beck Anxiety Inventory (BAI). Resultados Nos parĂąmetros avaliados, houve redução na frequĂȘncia da cefaleia (p=0,001), intensidade moderada (p=0,048), na duração (p=0,001), no Ă­ndice de massa corporal (p=0,001), e pontuação nas escalas Beck Depression Inventory (p=0,001) e Beck Anxiety Inventory (p=0,001), quando os grupos foram comparados ao final do terceiro mĂȘs. ConclusĂŁo A amitriptilina foi um tratamento eficaz para a migrĂąnea crĂŽnica, mas sua eficĂĄcia foi maior quando combinada com exercĂ­cio aerĂłbio.Universidade Federal de SĂŁo Paulo (UNIFESP) Departamento de Neurologia e NeurocirurgiaUNIFESP, Depto. de Neurologia e NeurocirurgiaSciEL

    Clinical and Nutritional characterization of patients with massive intestinal resection in RibeirĂŁo Preto, SP, Brazil

    Get PDF
    Background: Short bowel syndrome (SBS) is a clinical situation due to extensive intestinal resection or dysfunction of the absorptive system of the small intestine. When these patints are not submitted to nutritional therapy their maximum survival is six months. In Brazil there are few reference centers for the treatment and follow-up of these patients and information about their characterization is scarce. Objective: To describe enterectomized patients attended during the period from 1996 to 2007. Methods: All medical records of the patients attended at the Nutrology service of HCFMRP-USP were analyzed retrospectively. Data were collected and analyzed descriptively using the contingency test and the Wilcoxon- Mann-Whitney test for independent samples. Results: Thirty-eight patients with a mean age of 52 years at the time of enterectomy were analyzed, 47% of them males and 53% females. The main etiology of SBS was mesenteric ischemia (73%). Of these patients, 67% had some risk factor associated with atherosclerosis. No significant differences in eating habits were detected between the period before and after surgery. After surgery, 39% of the patients developed a significant weight loss and 79% developed some type of complication, surgical in 34%, infectious in 66% and of both types in 21%. Survival was 9.5 years. Conclusion: Extensive resections of the small bowel may be associated with atherosclerosis and represent an important nutritional risk, with a significant weight loss during the first year, which seems to be related to increased morbidity. Adequate nutritional therapy is associated with increased survival
    • 

    corecore