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1.
BMC Health Serv Res ; 21(1): 163, 2021 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-33610192

RESUMO

BACKGROUND: Surgical Tray Rationalization (STR) consists of a systematic reduction in the number of surgical instruments to perform specific procedures without compromising patient safety while reducing losses in the sterilization and assembly of trays. STR is one example of initiatives to improve process performance that have been widely reported in industrial settings but only recently have gained popularity in healthcare organizations. METHODS: We conduct a scoping review of the literature to identify and map available evidence on surgical tray management. Five methodological stages are implemented and reported; they are: identifying research questions, identifying relevant studies, study selection, charting the data, and collating, summarizing and reporting the results. RESULTS: We reviewed forty-eight articles on STR, which were grouped according to their main proposed approaches: expert analysis, lean practices, and mathematical programming. We identify the most frequently used techniques within each approach and point to their potential contributions to operational and economic dimensions of STR. We also consolidate our findings, proposing a roadmap to STR with four generic steps (prepare, rationalize, implement, and consolidate) and recommended associated techniques. CONCLUSIONS: To the best of our knowledge, ours is the first study that reviews and systematizes the existing literature on the subject of STR. Our study closes with the proposition of future research directions, which are presented as nine research questions associated with the four generic steps proposed in the STR roadmap.


Assuntos
Racionalização , Instrumentos Cirúrgicos , Humanos , Esterilização
2.
Proc Natl Acad Sci U S A ; 118(6)2021 02 09.
Artigo em Inglês | MEDLINE | ID: mdl-33495361

RESUMO

Both liberals and conservatives believe that using facts in political discussions helps to foster mutual respect, but 15 studies-across multiple methodologies and issues-show that these beliefs are mistaken. Political opponents respect moral beliefs more when they are supported by personal experiences, not facts. The respect-inducing power of personal experiences is revealed by survey studies across various political topics, a field study of conversations about guns, an analysis of YouTube comments from abortion opinion videos, and an archival analysis of 137 interview transcripts from Fox News and CNN. The personal experiences most likely to encourage respect from opponents are issue-relevant and involve harm. Mediation analyses reveal that these harm-related personal experiences increase respect by increasing perceptions of rationality: everyone can appreciate that avoiding harm is rational, even in people who hold different beliefs about guns, taxes, immigration, and the environment. Studies show that people believe in the truth of both facts and personal experiences in nonmoral disagreement; however, in moral disagreements, subjective experiences seem truer (i.e., are doubted less) than objective facts. These results provide a concrete demonstration of how to bridge moral divides while also revealing how our intuitions can lead us astray. Stretching back to the Enlightenment, philosophers and scientists have privileged objective facts over experiences in the pursuit of truth. However, furnishing perceptions of truth within moral disagreements is better accomplished by sharing subjective experiences, not by providing facts.


Assuntos
Princípios Morais , Política , Análise de Variância , Atitude , Emoções , Humanos , Linguística , Modelos Teóricos , Racionalização , Mídias Sociais
3.
J Environ Manage ; 277: 111342, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33080433

RESUMO

Water quality is continuously changing because of anthropogenic origin of point and diffuses (non-point) pollution sources. Most of the time diffuse sources are not considered for rationalization of sampling sites as their accurate estimation is tedious and data intensive. The estimation of diffuse pollution is conventionally carried out using observed water quality data. These conventional approaches are data intensive and demands detailed information for a considerably long-time horizon and hence becomes challenging to implement in data-scarce regions. Also, diffuse pollution sources are characterized by spatio-temporal heterogeneity as they depend upon seasonal behavior of precipitation. The present study proposes an innovative semi-empirical approach of Seasonal Export Coefficients (SECs) for estimation of diffuse pollution loads, especially for tropical countries like India. This approach takes into account the effect of seasonality on the estimation of diffuse pollution loads, by considering seasonal heterogeneity of terrain and precipitation impact factors and land use applications. This seasonal heterogeneity is then tested for its possible impact on rationalization of water quality monitoring locations for Kali River basin in India. The SECs are estimated for available water quality dataset of 1999-2000 and are further used for simulation of nutrient loading for experimental years 2004-2005, 2009-2010, and 2014-2015. The resulting SECs for Kali river basin are: 2.03 (agricultural), 1.44 (fallow), and 0.92 (settlement) for monsoonal nitrate; while for non-monsoonal nitrate, SECs are 0.51 (agricultural), 0.23 (fallow), and 0.10 (settlement). The monsoonal phosphate SECs for land use classes - agricultural, fallow and settlement are 1.01, 0.68, and 0.25, while non-monsoonal phosphate SECs are 0.27, 0.14 and, 0.03 respectively. The seasonal variation of diffuse pollution sources is effectively captured by SECs. The proposed approach, by considering both point and diffuse pollution, is found efficient in determining optimum locations and number of monitoring sites where seasonal variations are found evident during experimental years.


Assuntos
Poluentes Químicos da Água , Qualidade da Água , Monitoramento Ambiental , Índia , Racionalização , Rios , Estações do Ano , Água , Poluentes Químicos da Água/análise , Poluição da Água/análise
5.
Waste Manag ; 118: 209-218, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32892097

RESUMO

Here we report over possible optimizations onboard cruise ships in the management of glass, paper and cellulosic waste, ranging from simple rationalization of the materials' use (for glass and paper) to the recovery of some of the energy embedded in paper and other cellulosic waste. This latter option is investigated considering two possibilities: i) the recovery of thermal energy from incinerator's flue gas by means of an absorption plant, ii) the production of syngas to be directly fed to the ship engines. For each option, we calculated the achievable benefits in terms of reduced fuel consumption, avoided CO2 emissions and cost savings (evaluated on the basis of the avoided fuel consumption). Finally, on the basis of the previously calculated benefits, we defined three different scenarios, each including the rationalization of glass and paper waste management, topped by different combinations of thermal energy recovery/syngas production. We then evaluated these scenarios in terms of environmental and economic benefits. This analysis showed that even trivial approaches, as a simple rationalization of paper consumption, can allow consistent advantages over existing waste management policies; moreover, syngas generators for treating cellulosic waste emerged as very effective tools for lowering the environmental impact of modern cruise ships. Joining these two strategies allows notable savings in terms of fuel, CO2 emissions and ship operational costs, and could represent a path for sizably reducing the environmental footprint of cruise ships.


Assuntos
Navios , Gerenciamento de Resíduos , Incineração , Racionalização
6.
Agora (Rio J.) ; 23(3): 2-10, set.-dez. 2020.
Artigo em Inglês | LILACS, Index Psicologia - Periódicos | ID: biblio-1130828

RESUMO

ABSTRACT: After the Occultation, the moment when the shiites' messiah disappeared, Shiism broke into two tendencies: the traditional-quietist and the rationalist-political. These two tendencies coexisted for centuries; only quite recently has their balance tilted towards the rationalist-political side, which brought about (principally) the Khomeini revolution in Iran. This article seeks to explore the mode of the social ties in Shia Islam from a psychoanalytic perspective, in terms of its original mystical practices as well as of the political and religious consequences of the decline of traditionalist discourse and the political emergence of "jurist-theologian" with its corollary, the Adversary.


Resumo: Depois da Ocultação, aquele momento em que o messias xiita desapareceu, o xiismo se dividiu em duas tendências: a tradicional-quietista e a racionalista-política. Essas duas tendências coexistiram durante séculos; só muito recentemente seu equilíbrio foi inclinado para o lado racionalista-político, o que provocou (principalmente) a revolução Khomeinista no Irã. Este artigo procura explorar o modo do vínculo social no Islã xiita a partir de uma perspectiva psicanalítica, em termos de suas práticas místicas originais, bem como das consequências políticas e religiosas do declínio do discurso tradicionalista e da emergência política da figura do "jurista-teólogo", com seu corolário, o Adversário.


Assuntos
Política , Psicanálise , Racionalização
7.
Proc Natl Acad Sci U S A ; 117(33): 19799-19808, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32759219

RESUMO

In multialternative risky choice, we are often faced with the opportunity to allocate our limited information-gathering capacity between several options before receiving feedback. In such cases, we face a natural trade-off between breadth-spreading our capacity across many options-and depth-gaining more information about a smaller number of options. Despite its broad relevance to daily life, including in many naturalistic foraging situations, the optimal strategy in the breadth-depth trade-off has not been delineated. Here, we formalize the breadth-depth dilemma through a finite-sample capacity model. We find that, if capacity is small (∼10 samples), it is optimal to draw one sample per alternative, favoring breadth. However, for larger capacities, a sharp transition is observed, and it becomes best to deeply sample a very small fraction of alternatives, which roughly decreases with the square root of capacity. Thus, ignoring most options, even when capacity is large enough to shallowly sample all of them, is a signature of optimal behavior. Our results also provide a rich casuistic for metareasoning in multialternative decisions with bounded capacity using close-to-optimal heuristics.


Assuntos
Tomada de Decisões , Heurística , Comportamento de Escolha , Humanos , Modelos Teóricos , Racionalização
8.
Biomacromolecules ; 21(8): 3069-3080, 2020 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-32619090

RESUMO

The hierarchical self-assembly of cellulose nanocrystals (CNCs) is an important phenomenon occurring naturally in plant cell walls. Utilization of this assembly for advanced applications requires a fundamental theoretical understanding of interactions between the CNCs, which is still incomplete. Hence, in this work, we used molecular dynamics simulations to study the effect of surface modification on the interactions between the CNCs and the resulting bundling process. We consider two types of common surface modifications of native CNCs, sulfated CNCs (SCNCs) and TEMPO-oxidized CNCs (TCNCs), in the presence of two types of counterions, Na+ and Ca2+, in solution. We used the umbrella sampling method to calculate the potential of the mean force (PMF), and we found that the strength of interaction between the modified CNCs decreases, compared with the native CNCs. The strength of interaction for TCNCs is almost similar to that for SCNCs at the same level of surface substitution, whereas the type of counterion has a strong effect on the PMF with a higher interaction energy between the CNCs in the presence of a divalent counterion as compared to a monovalent counterion. Finally, we studied the self-assembly of CNCs into a hexagonal bundle for the native CNCs and sulfated CNCs focusing on the twist of the bundle, bound water inside the bundle, inter-CNC gap, and interaction energy between the CNCs in the bundle, and the effect of the counterions on the morphology of the bundle. The equilibrium spacing of the CNCs within the bundle is found to be consistent with the results of PMF calculations for the minimum separation distance between the respective crystal surfaces.


Assuntos
Celulose , Nanopartículas , Polissacarídeos , Racionalização , Água
9.
Psicol. ciênc. prof ; 40: e191910, jan.-maio 2020.
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1140869

RESUMO

Este estudo consiste em compreender quais são as percepções, os sentimentos e as dificuldades atribuídos pelos profissionais da saúde ao cuidado no processo de morte de pacientes. Para tanto, realizou-se um estudo descritivo e exploratório, de cunho qualitativo. A pesquisa foi aprovada pelo Comitê de Ética, sob o número 1.463.168, e foram seguidas as diretrizes da Resolução 510/2016. A coleta de dados foi realizada por meio de entrevistas e observações. Foram entrevistados médicos e enfermeiros que atuam na unidade de clínica médica em um hospital de ensino do Rio Grande do Sul, sendo realizadas dezessete entrevistas, correspondendo à totalidade destes profissionais na unidade. Os dados obtidos foram submetidos à triangulação, a partir da análise de conteúdo. Os resultados mostraram que o cuidado no processo de morte de pacientes gera sentimentos como frustração, impotência, tristeza e compaixão. É comum, nesse sentido, a utilização de estratégias defensivas - como racionalização e distanciamento - por parte dos médicos responsáveis. Além disso, percebeu-se que o tempo de tratamento permite cuidados diferenciados e maior humanização no processo. Concluiu-se ser necessário levar em consideração as dificuldades individuais e coletivas, os sentimentos, as situações pessoais e interpessoais, bem como a satisfação/insatisfação dos profissionais...(AU)


This study analyzes the perceptions, feelings and difficulties attributed by health professionals about care in the death process of patients. A descriptive and exploratory study of qualitative nature was performed. The research was approved by the Ethics Committee, under number 1,463,168, and the guidelines of Resolution 510/2016. Seventeen medical professionals and nurses working in the medical clinic unit at a teaching hospital in Rio Grande do Sul were interviewed. The obtained data were subjected to triangulation via content analysis. The results showed that care in the death process of patients generates feelings like frustration, impotence, sadness and compassion. Defensive strategies such as rationalization and distancing were common. Treatment time allowed for differentiated care and greater humanization in the process. Taking into account individual and collective difficulties, feelings, personal and interpersonal situations, satisfaction/dissatisfaction of professionals was shown to be needed...(AU)


Este estudio busca comprender cuáles son las percepciones, los sentimientos y las dificultades atribuidas por los profesionales de la salud sobre el cuidado en el proceso de muerte de pacientes. Por ello, se realizó un estudio descriptivo y exploratorio, con enfoque cualitativo. La investigación fue aprobada por el Comité de Ética, bajo el número 1.463.168, y se cumplieron las directrices de la Resolución 510/2016. Para la recolección de datos, se aplicó entrevistas y observaciones. Se entrevistaron a profesionales médicos y a enfermeros que actúan en la unidad de clínica médica en un hospital escuela de Rio Grande do Sul (Brasil). Se realizaron diecisiete entrevistas, resultado de la totalidad de esos profesionales en la unidad. Los datos obtenidos se sometieron a la triangulación a partir del análisis de contenido. Los resultados demostraron que el cuidado en el proceso de muerte de pacientes genera sentimientos como frustración, impotencia, tristeza y compasión. Es común el uso de estrategias defensivas, como racionalización y alejamiento, por parte de los médicos tratantes. El tiempo de tratamiento permite cuidados diferenciados y mayor humanización en el proceso. Se concluyó que es necesario tener en cuenta en esta situación las dificultades individuales y colectivas, los sentimientos, las situaciones personales e interpersonales, así como la satisfacción/insatisfacción de los profesionales...(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Percepção , Médicos , Racionalização , Atitude Frente a Morte , Cuidados Paliativos na Terminalidade da Vida , Pessoal de Saúde , Assistência Integral à Saúde , Morte , Humanização da Assistência , Enfermeiras e Enfermeiros , Enfermeiros , Satisfação Pessoal , Terapêutica , Medicina Clínica , Saúde , Emoções , Empatia , Ética , Frustração , Tristeza
10.
Behav Brain Sci ; 43: e50, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32292136

RESUMO

Critical aspects of the "rationality of rationalizations" thesis are open empirical questions. These include the frequency with which past behavior determines attitudes (as opposed to attitudes causing future behaviors), the extent to which post hoc justifications take on a life of their own and shape future actions, and whether rationalizers experience benefits in well-being, social influence, performance, or other desirable outcomes.


Assuntos
Racionalização , Comportamento Sexual , Atitude , Prevalência
11.
Behav Brain Sci ; 43: e48, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32292137

RESUMO

The evidence for rationalisation, which motivates the target article, is exaggerated. Experimental evidence shows that rationalisation effects are small rather than gross and, I argue, largely silent on the pervasiveness and persistence of the phenomenon. At least some examples taken to show rationalisation also have an interpretation compatible with deliberate, knowing reason-responsiveness on the part of participants.


Assuntos
Racionalização
12.
Behav Brain Sci ; 43: e40, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32292138

RESUMO

Cushman argues that the function of rationalization is to attribute mental representations to ourselves, thereby making these representations available for future planning. I argue that such attribution is often not necessary and sometimes maladaptive. I suggest a different explanation of rationalization: making representations available to other agents, to facilitate cooperation, transmission, and the ratchet effect that underlies cumulative cultural evolution.


Assuntos
Evolução Cultural , Racionalização
13.
Behav Brain Sci ; 43: e34, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32292139

RESUMO

In this commentary, I highlight the relevance of Cushman's target article for the popular dual-process framework of thinking. I point to the problematic characterization of rationalization in traditional dual-process models and suggest that in line with recent advances, Cushman's rational rationalization account offers a way out of the rationalization paradox.


Assuntos
Racionalização
14.
Behav Brain Sci ; 43: e35, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32292140

RESUMO

According to Cushman, rationalization occurs when a person has performed an action and then concocts beliefs and desires that would have made it rational. We argue that this isn't the paradigmatic form of rationalization. Consequently, Cushman's explanation of the function and usefulness of rationalization is less broad-reaching than he intends. Cushman's account also obscures some of rationalization's pernicious consequences.


Assuntos
Racionalização
15.
Behav Brain Sci ; 43: e47, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32292141

RESUMO

Cushman characterizes rationalization as the inverse of rational reasoning, but this distinction is psychologically questionable. Coherence-based reasoning highlights a subtler form of bidirectionality: By distorting task attributes to make one course of action appear superior to its rivals, a patina of rationality is bestowed on the choice. This mechanism drives choice and action, rather than just following in their wake.


Assuntos
Resolução de Problemas , Racionalização
16.
Behav Brain Sci ; 43: e52, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32292142

RESUMO

In this commentary, we offer an additional function of rationalization. Namely, in certain social contexts, the proximal and ultimate function of beliefs and desires is social inclusion. In such contexts, rationalization often facilitates distortion of rather than approximation to truth. Understanding the role of social identity is not only timely and important, but also critical to fully understand the function(s) of rationalization.


Assuntos
Racionalização , Identificação Social
17.
Behav Brain Sci ; 43: e31, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32292143

RESUMO

Cushman argues that "rationalization is rational." We show that there is reasonable empirical clinical and forensic psychological evidence to support viewing rationalization as a quite suboptimal defense mechanism. Rationalization has been found to be associated not only with poorer emotional development, but also with a broad range of antisocial behavior, including not only shoplifting, but also pedophilia and murder.


Assuntos
Mecanismos de Defesa , Racionalização
18.
Behav Brain Sci ; 43: e29, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32292144

RESUMO

We agree with Cushman that rationalizations are the product of biological adaptations, but we disagree about their function. The data available do not show that rationalizations allow us to reason better and make better decisions. The data suggest instead that rationalizations serve reputation management goals, and that they affect our behaviors because we are held accountable by our peers.


Assuntos
Tomada de Decisões , Racionalização
19.
Behav Brain Sci ; 43: e44, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32292145

RESUMO

Cushman's theory has implications for the philosophical debate about the nature of folk psychological states, for it entails realism about propositional attitudes. I point out a tension within his view and suggest a different view upon which rationalization emerges as a consequence of the adaptiveness of mentalizing. This alternative avoids the strong metaphysical implications of Cushman's theory.


Assuntos
Atitude , Racionalização
20.
Behav Brain Sci ; 43: e30, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32292146

RESUMO

Cushman claims that post hoc rationalization of habitual behavior can improve future reasoning. His characterization of habits includes two components: (1) habitual behavior is a non-rational process, and (2) habitual behavior is sometimes rationalized. We argue that Cushman fails to show any habits that are apt targets for rationalization. Thus, it's unclear when - if ever - rationalizing habits would improve reasoning.


Assuntos
Hábitos , Racionalização
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