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Tizraoui, Adel. "Un nouveau modèle de sécurité pour les applications Internet Application à la téléphonie sur IP SIM IP." Paris 6, 2003. http://www.theses.fr/2003PA066321.
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Barki, Amira. "Mécanismes cryptographiques conciliant authentification et respect de la vie privée dans le contexte du M2M." Thesis, Compiègne, 2016. http://www.theses.fr/2016COMP2337.
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Les applications Machine-to-Machine (M2M) fournissent plus de confort aux utilisateurs et permettent une utilisation optimale des ressources. Toutefois, ces applications ne présentent pas que des avantages. Ces dernières peuvent engendrer des problèmes de sécurité, voire porter atteinte à la vie privée de leurs utilisateurs. Dans cette thèse, nous nous intéressons à la sécurité des applications M2M, et plus précisément à l'authentification et la préservation de la vie privée d'utilisateurs d'équipements M2M dotés d'une carte SIM. Dans une première partie, nous proposons cinq nouvelles primitives cryptographiques, à savoir un schéma de signature partiellement aveugle, deux schémas de codes d'authentification de messages, ainsi que deux schémas d'attestations anonymes. Ces nouvelles primitives sont plus efficaces, voire fournissent des fonctionnalités nouvelles par rapport aux schémas de l'état de l'art et sont adaptées aux environnements limités en ressources telles que les cartes SIMs. En nous appuyant sur ces primitives, nous construisons de nouveaux protocoles préservant la vie privée des utilisateurs. Plus précisément, nous introduisons un nouveau système de paiement anonyme efficace. Nous proposons également un protocole d’authentification et d’identification anonyme pour la nouvelle génération de cartes SIMs connue sous le nom d'Embedded SIM. Par ailleurs, nous construisons un système d'accréditations anonymes. Enfin, nous spécifions un système de vote électronique efficace rendant inutile toute forme de coercition à l'encontre d'un électeur. La sécurité de toutes nos contributions est prouvée dans le modèle de l'oracle aléatoire sous des hypothèses classiquesMachine to Machine (M2M) applications enable a better management of resources and provide users With greater cornfort. Unfortunately, they also entail serious security and privacy concerns. ln this thesis, we focus on M2M security, and particularly on the authentication and privacy issues of M2M applications involving a SIM card. ln the first part, we design five new cryptographic primitives and formally prove that they meet the expected security requirements. More precisely, they consist of a partially blind signature scheme, a sequential aggregate Message Authentication Codes (MAC) scheme, an algebraic MAC scheme and two pre-Direct Anonymous Attestation (pre-DAA) schemes. Some of the proposed schemes aim to achieve a particular property that was not provided by previous constructions whereas others intend to improve the efficiency of state-of-the-art schemes. Our five schemes do not require the userls device to compute pairings. Thus, they are suitable for resource constrained environments such as SIM cards. ln a second part, we rely on these primitives to propose new privacy-preserving protocols. More specifically, we design an efficient private eCash system. We also propose a protocol enabling anonymous authentication and identification of embedded SIMs (eSlMs). Furthermore, we rely on our algebraic MAC scheme to build a practical Keyed-Verification Anonymous Credentials (KVAC) system. Finally, based on our sequential aggregate MAC scheme, we introduce a remote electronic voting system that is coercion-resistant and practical for real polls. The security of our protocols is formally proven in the Random Oracle Model (ROM) under classical computational assumptions
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Webb, Scott A. "Psychological care of the injured athelte [sic]." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1036199.
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This study has examined the aspect of psychological care for the injured athlete at the Division 1A collegiate level. The specific areas examined were those of the mental impact of injury, services available, potential barriers, funding, and referrals. An additional aspect of this study that was examined was differences between conferences in the psychological care practices of the injured athlete. It was found that the largest barrier to successful psychological rehabilitation of the injured athlete was athlete compliance, despite support from others and available services. No significant differences were found to exist between conferences and the psychological care of the injured athlete.School of Physical Education
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Becic, Amila, and Larisa Sabanovic. "Palliativ vård : Önskan om att känna sig trygg." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap, HV, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-11944.
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Uppsatsen är gjord som en systematisk litteraturstudie med en kvalitativ ansats där nio artiklar analyserades. Litteraturstudiens syfte var att beskriva patientens upplevelse av att befinna sig i den sena fasen av den palliativa vården. Vårt resultat visade att patienter som befinner sig i den palliativa vården ville ha kontroll över livet, uppleva trygghet och värderade saker annorlunda. Trygghet upplevdes t.ex. när patienter kunde vårdas i det egna hemmet. Våra fynd visade att förtroende skapar en känsla av trygghet vilket leder till att välbefinnande förstärks och sjuksköterskan får bättre kunskap om patienten och patientens livsvärld. För att fördjupa oss i patientens upplevelse av den palliativa vården har vi använt oss av livsvärldsteori och teori om att finna mening med livet.
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Eriksson, Anna-Sara. "Hur tillgodogör sig klienter med missbruksproblematik dialektisk beteendeterapi inom tvångsvården?" Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-34805.
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Studier har visat att dialektisk beteendeterapi (DBT) är en tidskrävande integrerande behandlingsform. DBT beskrivs utifrån fyra hörnstenar: inlärningsteori, kognitiv teori, dialektisk filosofi och zenbuddistisk filosofi. DBT utvecklades för självskadebeteende, senare utvecklades den också för annan beteendeproblematik. Syftet med denna studie var att undersöka hur behandlare och behandlingsassistenter med DBT erfarenheter upplever att klienterna tillgodogör sig DBT-behandlingen och om män respektive kvinnor tillgodogör sig olika. En man och fem kvinnor i Sverige med olika yrkeserfarenheter inom DBT intervjuades mellan 45-60 minuter om hur DBT-behandling av klienter tillgodogörs på LVM-hem utifrån behandlarens perspektiv. Intervjuerna meningskoncentrerade och resulterade i fem teman: a) främja positiv utveckling; b) en ökad kunskap; c) en ökad självkontroll; d) en ökad självkänsla; e) ett ökat välbefinnande. Slutsatsen är att ökad kunskap om sin personlighet främjar positiv utveckling att tillgodogöra sig verktyg för att öka självkontrollen, vilket kan leda till ökad självkänsla som främjar till ett ökat välbefinnande.
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Gharani, Pedram. "Modeling spatial accessibility for in-vitro fertility (IVF) care services in Iowa." Thesis, University of Iowa, 2014. https://ir.uiowa.edu/etd/1459.
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Anagrius, Johanna. "Att berätta om sig själv eller inte : Rättspsykiatriska vårdares perspektiv." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-5027.
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Bakgrund: Vårdrelationen beskrivs som grunden till främjande hälsoprocesser. Relationen är ömsesidig men vårdaren har ansvaret och tar del av patientens berättelse för att vårda tillsammans med snarare än åt patienten. Det dubbla uppdraget samhällsskydd och vård komplicerar vårdrelationen i rättspsykiatrisk vård. Att vårda en patient som begått brott är inte lika självklart som att vårda en skuldfri. Viktigt inom rättspsykiatri är vardagligt umgänge där vårdaren hittar balansen mellan personligt och privat. Negativa känslor som rädsla kan göra vårdare inskränkta och kompromisslösa. En oväntad åtgärd utanför ramarna visas vara betydelsefull för återhämtning. Rättspsykiatriska patienter beskriver längtan efter trygga, vårdande relationer men kan mötas av maktutövande, nonchalans, hot och våld som ger en känsla av förvaring och icke-vård. Syfte: Att beskriva vårdares tankar om att berätta om sig själva och det privata för patienter i rättspsykiatrisk vård. Metod: Kvalitativ design med fokusgruppsintervjuer för datainsamling. Två fokusgruppsintervjuer med vårdare inom rättspsykiatrisk vård genomfördes. Materialet analyserades med kvalitativ innehållsanalys. Resultat: Resultatet genererade fyra huvudkategorier och tio subkategorier. Påverkande omständigheter: patientens behov och brottets karaktär, tidsaspekter och informationsflöde. Medvetenhet i vårdarrollen: beakta vem som hör och hantera konsekvenser, förmåga till gränsdragning och kommunikation. Nyckel till relation: att ge för att få, ärlighet, mänsklig kontakt och förtroende. Indifferens och lidande: lögner och distansering, negativa konsekvenser, varken behov eller mening. Diskussion: Resultatet diskuteras mot den teoretiska referensramen: Vårdandets symfoni som avhandlar vårdrelationen. Här återfinns många tankar som framkommer i denna studie.Background: The care relationship is described as the cornerstone of nursing processes. This relationship is mutual but the caregiver carries the responsibility and shares the patient's story in order to nurse together with rather than only nursing the patient. The dual mission, civil protection and nursing, complicates the relationship in forensic care. Nursing a patient who committed a crime is not as intuitive as relieving the suffering of an innocent patient. Important in forensic psychiatry is everyday socializing where the caregiver finds a balance between personal and private. Negative emotions such as fear can make carers narrow-minded and uncompromising while an unexpected action beyond the daily work routines can prove to be important for patient recovery. The forensic psychiatric patients express a desire for safe, caring relationships but can be met by an exercise of power, negligence, intimidation and violence that create a feeling of containment and non-care. Aim: To describe nurses' thoughts concerning their privacy and what to reveal about themselves to patients in forensic psychiatric care. Method: Qualitative design with focus group interviews for data collection. Two focus group interviews with caregivers in forensic psychiatry were conducted. The material was analyzed using qualitative content analysis. Results: The results generated four main categories and ten subcategories. Influencing factors: the patient's needs and the nature of the crime, timing and information flow. Awareness of caring role: consider who hears and deals with the consequences, ability to set boundaries and communication. Key to relationship: giving in order to receive, honesty, human contact and trust. Indifference and suffering: lies and distance, negative consequences, neither need nor meaning. Discussions: The results are discussed within the theoretical framework of ‘The Symphony of Care’, which discusses the phenomenon of the care relationship. Many caregivers’ reflections that emerge in the results can be identified within this context.
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Berglund, Malin, and Maria Kostecka. "Patientcentrerad vård och helhetssyn i vården - skiljer sig begreppen? : En litteraturstudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-142806.
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SAMMANFATTNING Begrepp som patientcentrerad vård och helhetssyn i vården verkar användas av olika yrkeskategorier, inom hälso- och sjukvård, vilket kan ur kvalitetssynpunkt kan resultera i oklarheter inom den kliniska verksamheten. Syfte: Syftet med studien var att ta reda på vilka likheter och skillnader begreppen patientcentrerad vård och helhetssyn i vården har i den vetenskapliga litteraturen. Begreppen söktes i databaserna CINAHL och PubMed. Metod: Den metod som används för att jämföra begreppen byggde på Segestens begreppsanalysmodell. Resultat: Det som främst skiljer begreppet helhetssyn i vården från patientcentrerad vård är den andliga dimensionens centrala roll. Resultatet visar även att ett patientcentrerat arbetssätt förbättrar ekonomiska resultat. Det är främst sjuksköterskor som använder sig av helhetssyn i vården. Patientcentrerad vård verkar användas främst av läkare men begreppet förekommer även bland sjuksköterskor. Det gemensamma för begreppen då det gäller karaktäristika, förutsättningar och konsekvenser, är det som definieras i kraven på god vård enligt hälso- och sjukvårdslagen. Slutsats: sjukvårdspersonalens arbetssätt och syn på patienten utifrån patientcentrerad vård och helhetssyn i vården värnar om patientens bästa. Det som skiljer begreppen kan bero på vilken yrkesgrupp som undersökts i respektive studie. Studier av begreppet patientcentrerad vård uppfattas vara mer genomförda på läkargruppen samtidigt som helhetssyn i vården tycks vara mer förekommande då det gäller sjuksköterskegruppen. Fler studier behövs för att identifiera användningen av dessa begrepp och om deras betydelse i den kliniska verksamheten.SUMMARY Concepts such as patient-centered care and holistic care seem to be used by different professions in healthcare. Looking upon these concepts from the aspect of quality, ambiguities can arise in clinical practice. Objective: The purpose of this study was to compare the similarities and differences between the concepts of patientcentered care and holistic care as they are presented in scientific literature. The terms were searched for in the databases CINAHL and PubMed. Method: The method used to compare the concepts was based on Segesten concept analysis model. Results: what differentiates the concept of holistic care of the patient-centered care is the central role of spiritual dimension. The results also show that a patient-centered care improves economic results. The term holistic health care seems to be used primarily by nurses, while patient-centered care seems to be used primarly by physicians, even though the term does occur among nurses. Conclusion: both patient-centered care and holistic care seem to have the same goal, that of preserving the patient`s best interests. What distinguishes the concepts may depend on the profession which was examined in each study. Research studies on patient-centered care have been carried out primarily on physicians, while studies on the holistic approach in health care have focused on nurses. More studies are needed to identify the use of these concepts and their importance in clinical practice. Nyckelord: Patient-centeredness, patient-centered care, holistic care, holistic nursing.
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Granlund, Lucie. "Det vårdande mötet när döden närmar sig." Thesis, Blekinge Tekniska Högskola, Sektionen för hälsa, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-1795.
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Att vårda en patient i livets slutskede innebär att bekanta sig med känslomässiga situationer som ofta påverkar sjuksköterskans omvårdnadshandling exempelvis effektiv symtomlindring. Syfte: Syftet med denna studie var att beskriva sjuksköterskans upplevelse av det vårdande mötet med patienten i samband med palliativ vård. Metod: Metoden var en litteraturstudie med kvalitativa ansatser. Sex vetenskapliga artiklar samlade in och användes som analysmaterial av denna studie. Innehållanalysen inspirerad av Graneheim och Ludman (2003) användes för att analysera insamlade data. Resultat: Resultatet visade att sjuksköterskan upplever tillfredställelse och välbefinnande om hon lyckas med att tillgodose patientens behov exempelvis smärta. Effektiv smärtlindring upplevdes som meningsfull och det innebar att hon hade betytt något för patienten och dess närstående. Däremot upplevdes hon stress, frustration, maktlöshet och konflikt när hennes omvårdnadshandling inte mött patientens behov. Samverkan mellan arbetsteamen och stöd från kollegor upplevdes som viktigt i den palliativa vården. Sjuksköterskan höll distans för att kunna hjälpa patienten. Slutsatsen: Sjuksköterskan behöver kunskap om smärtlindring samt kunskap om palliativ vård för att effektivt lindra patientens smärta. För att tillgodose patientens behov i sin helhet behöver hon tillräcklig med tid och frihet att själv planerar sitt arbete. Samarbetet med andra vårdteam och kollegornas stöd måste stärkas och ha ett gemensamt mål: patientens välbefinnande då kan sjuksköterskan uppleva välbefinnande.
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Sword, Lisa A. "A readiness assesment (sic) preparation for implementation of computerized physician order entry /." Menomonie, WI : University of Wisconsin--Stout, 2005. http://www.uwstout.edu/lib/thesis/2005/2005swordl.pdf.
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Frändberg, Charlotta. "Vem bryr sig? : Omsorgsetiska argument mot (ökad) handel med hushållstjänster." Thesis, Umeå universitet, Institutionen för idé- och samhällsstudier, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-149651.
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In this essay, I bring together the Swedish debate concerning tax subsidized household services – the so called RUT-deduction – with feminist care ethics, here represented mainly by philosopher Virginia Held. The first and main question asked, is how a care ethical argument against increased trade in housework can be formulated. The idea of the relational character of care as well as care representing an irreplaceable value, leads to the following argument: An increased trade in housework leads to less care and weakened care relations and this implies a loss both to individuals and to society. The second question posed, concerns the reach of the argument above: both with respect to what kind of housework that can reasonably be seen as part of the practice of care as well as within what type of relationships the idea of care practice applies. In this part I conclude that there is no ground for drawing a sharp line between housework which is, and housework which is not, part of care practice. The arguments presented are relevant for the discussion about what kind of gender equal society we should strive for. If justice is seen as a value superior to care, full time paid work for women as well as for men can be seen as a reasonable route towards gender equality. If the value of care and of care relations is placed alongside justice, other solutions than commodification of housework may be seen as needed.
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Willems, Sharon A. "Employee satisfaction and its affects (sic) on customer service in a healthcare facility." Menomonie, WI : University of Wisconsin--Stout, 2005. http://www.uwstout.edu/lib/thesis/2005/2005willemss.pdf.
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Graham, Elizabeth Miall Charlene. "An intensified pragmatism in repsonse [sic] to reproductive experiences and medicalization : a case study of Cape Breton women /." *McMaster only, 2003.
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Perianes, Lilian Berta Rihs. "Carie radicular em adultos e idosos de municipios com e sem agua de abastecimento publico fluoretada." [s.n.], 2003. http://repositorio.unicamp.br/jspui/handle/REPOSIP/288029.
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Orientador: Maria da Luz Rosario de SousaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Kurtinaityte, Laura. "E-HEALTH – THE USAGE OF ICT DEVELOPING HEALTH CARE SYSTEM : MULTIPLE-CASE STUDY OF EUROPEAN COUTRIES DENMARK AND LITHUANIA." Thesis, Halmstad University, School of Business and Engineering (SET), 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-779.
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Electronic health – this is the object of study work. The focus of research is European countries, which use Information and Communication Technologies improving their Health care system and it is not excepted is the country advanced in developing e-Health or it just started to create or improve this system. As it is a new Developing research area, there are not so many direct relevant researches about it previously found. Therefore it encourages the investigation of this topic, which according to European Commission and Enterprise Directorate General (2003) could reach greatest economy on saving costs in whole service sector. Thus the guidelines for efficient e-Health development should be given as soon as possible. The study work is exactly aimed on this.
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Camacho, Ulloa Camila. "La práctica de la tortura como des-integración del sujeto en Carne de perra de Fátima Sime." Tesis, Universidad de Chile, 2010. http://repositorio.uchile.cl/handle/2250/109992.
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Informe de Seminario para optar al grado de Licenciado en Lengua y Literatura Hispánica mención LiteraturaLa presente investigación se enmarca en el Seminario de Grado sobre la violencia en la narrativa chilena del siglo XX. Dentro de esta temática hemos escogido la novela postdictatorial Carne de Perra de la autora Fátima Sime, editada en el 2009.
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Axelsson, Isabelle, and Annika Karlsson. "Att kunna leva fram till döden. : En systematisk litteraturstudie om varför patienter i ett palliativt skede väljer att avsäga sig livsuppehållande vårdinsatser." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-52975.
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Haji, Diana Khaled, and Valmira Mazhiqi. "Sjuksköterskors erfarenheter av att vårda patienter som befinner sig i livets slutskede : En kvalitativ litteraturstudie." Thesis, Malmö universitet, Malmö högskola, Institutionen för vårdvetenskap (VV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-42805.
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Bakgrund: Drygt 90 000 personer avlider årligen i Sverige därav uppskattas mellan 70 000 och 75 000 personer att vara i behov av palliativ vård. Patienter som får vård vid livets slutskede befinner sig inom olika vårdformer, både inom öppen och sluten vård men även inom den kommunala vården. En god palliativ vård grundar sig i de fyra hörnstenarna: multiprofessionellt samarbete, symtomlindring, kommunikation, samt stödja närstående. Syfte: Syftet med litteraturstudien var att sammanställa vilka erfarenheter sjuksköterskor har av att vårda patienter i livets slutskede. Metod: Litteraturstudien baserades på tio kvalitativa studier som hittades genom sökningar i databaserna Cinahl och PubMed. Studierna kvalitetsgranskades med hjälp av SBU:s mall för kvalitetsgranskning av studier och SBU:s kvalitetsbedömning av vetenskapliga studier. Studiernas var publicerade under 2000-talet. Resultat: Resultatet delades in i fem kategorier: Sjuksköterskan och patientrelationen, Vikten av att skapa relationer med anhöriga, Behov av att kommunicera, Betydelsen av samarbete, och Känslor i mötet med palliativa patienter. Konklusion: Sjuksköterskorna beskrev att vård av patienter i livets slutskede är både emotionellt påfrestande men även lärorikt. För att inte bli allt för emotionellt påverkad var det viktigt att hitta en balans mellan närhet och avstånd. Sjuksköterskorna önskade få mer stöd och utbildning inom palliativ vård för att klara av arbetet och ge patienten en god omvårdnad.Background: Approximately 90 000 people die yearly in Sweden, and between 70 000 to 75 000 of those people are estimated to be in need of palliative care. The patients that get palliative care are in various forms of care, both in outpatient and inpatient care but also in the municipal care. Good palliative care has it´s common ground in four cornerstones: multidisciplinary collaborations, relief of symptoms, communication, and also offering support to the patient´s families. Purpose: The purpose of this literature study was to compile nurse´s experiences of taking care of patients in palliative care at the end of their life. Method: This literature study was based on ten qualitative studies that lay as ground for the results. The studies were found through searches in the databases Cinahl and PubMed. The studies were qualitative reviews with the help of SBU:s template for qualitative review of studies and SBU:s qualitative assessment of research studies. The studies were published in the 2000s. Results: The results were divided into the five following categories: The nurse and the patient relationship, The importance of creating relationships with the patient´s relatives, The need to communicate, The importance of collaboration, and The emotions when meeting patients in palliative care. Conclusion: The nurses described that caring for patients who are in the end of their life is both emotionally stressful but also educational. In order to not to be too emotionally affected, many described that it was important to find a balance between closeness and distance. The nurses wished to receive more support and education/training in palliative care in order to cope with the work and give the patients good nursing.
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Edin, Åsa, and Kathrina Danér. "Immobilisering av extremitetsfrakturer inom ambulanssjukvård : Ett pilotprojekt med SAM-splint." Thesis, Uppsala University, Department of Public Health and Caring Sciences, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-112558.
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Within the ambulance care in Uppsala County a vacuum splint is used to immobilize fractures on extremities. The research available on which method of immobilizing to prefer during pre-hospital treatment is limited.
The purpose of this pilot study was to examine the perceptions of the ambulance personal in Uppsala County on the issue of usability of SAM-splint and vacuum splint when immobilizing extremities. The project was also aimed at researching if SAM-splint could be seen as an alternative or a complement to vacuum splint, and to get an apprehension on any evident differences in patients’ perceived pain when treated with the two different approaches.
A descriptive comparative study was carried out. All patients, regardless of age and sex, with the need of immobilizing supposed fractures, were included. Patients with suspected femur fracture, collum fracture, or where pre-hospital care was not possible or in question, was excluded. The collection of data was done using a questionnaire designed by the students responsible for the project. The ambulance personal completed the questionnaire after having concluded the treatment.
The result showed that all patients with fractures to their extremities were immobilized. There were no evident differences in how the personal experienced the application of the two methods of immobilizing, but rather they were generally both perceived as easy to use. In Uppsala, where the paramedics had access to both SAM-splint and vacuum splint, the SAM-splint was the predominant choice.
Based on this pilot study it can be established that the ambulance personal experienced the methods for immobilizing as easy in the event of fractures to the extremities. The SAM-splint is to be seen as a complement to the vacuum splint. Any difference in perceived patient rated pain connected to the different methods of immobilizing was not to deduce.
Inom ambulanssjukvården i Uppsala län används vakuumsplint för immobilisering av extremitetsfrakturer. Forskning och kunskap om vilken immobiliseringsmetod som är att föredra vid prehospital handläggning av extremitetsfrakturer är begränsad.
Syftet med detta pilotprojekt var att i Uppsala län undersöka ambulanspersonalens uppfattning om användarvänligheten av vakuumsplint och SAM-splint vid immobilisering. Målet med projektet var även att ta reda på om SAM-splint kunde ses som alternativ eller komplement till vakuumsplintar samt om det fanns några uppenbara skillnader i patientskattad smärta mellan de olika immobiliseringsmetoderna.
En deskriptiv komparativ studie genomfördes där alla patienter oavsett ålder och kön i behov av immobilisering av misstänkta extremitetsfrakturer inkluderas. Patienter med misstänkt femurfraktur, collumfraktur eller där prehospital immobilisering ej varit möjlig eller aktuell exkluderades. Insamling av data har skett med hjälp av ett frågeformulär utformat av projektansvariga studenter. Frågeformuläret besvarades av vårdansvarig ambulanspersonal efter avslutat vårdtillfälle.
Resultatet visade att samtliga patienter med extremitetsfrakturer immobiliserades. Det fanns ingen uppenbar skillnad gällande personalupplevd applicering mellan de olika immobiliseringsmetoderna utan generellt uppfattades de enkla att använda. I Uppsala där ambulanspersonalen hade tillgång till både SAM-splint och vakuumsplint valdes övervägande SAM-splint.
Med detta pilotprojekt som grund kan sägas att ambulanspersonalen ansåg att immobiliseringsmetoderna var enkla att använda vid extremitetsfrakturer. SAM-splint kan ses som komplement till vakuumsplinten. Någon skillnad i patientskattad smärta mellan de båda immobiliseringsmetoderna framkom ej.
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Edlund, Anna-Karin, and Diana Elvin. "Att bry sig eller inte bry sig: om compassion fatigue : en litteraturöversikt om faktorer som kan leda till compassion fatigue." Thesis, Sophiahemmet Högskola, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3680.
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Compassion fatigue (CF) är ett begrepp som introducerades som en form av utmattning för sjuksköterskor. CF utvecklas från att känna ett obehag för medlidande till att i värsta fall övergå till att sjuksköterskan permanent har svårt att känna medlidande. Compassion fatigue användes första gången 1992 och det beskrevs som att sjuksköterskor glömde saker, dess uppmärksamhet minskade och de upplevde utmattning, trötthet, ilska samt kände sig sjuka. De brydde sig mindre och mindre och till slut inte alls.Syftet med denna studie var att beskriva de faktorer som kan orsaka compassion fatigue hos sjuksköterskor inom akutsjukvård.Metoden som användes var en litteraturöversikt. Databas sökningar gjordes via PubMed, CINAHL Complete och PsycINFO varav 18 artiklar inkluderades i resultatet. I denna litteraturöversikt användes både kvalitativa, kvantitativa och mixade artiklar, skrivna mellan 2009- 2019.I resultatet framkom det att de faktorer som kan orsaka CF var sociodemografiska, sociala, arbetsrelaterade, psykologiska och övriga faktorer såsom intag av olika substanser. Bland dessa faktorer fanns stress, chefsstöd och hantering av svåra situationer i form av exempelvis PsyCap.Slutsatsen var att Compassion fatigue är vanligt förekommande bland sjuksköterskor inom akutsjukvård och bör förebyggas för att sjuksköterskor ska kunna stanna kvar i yrket och ge en god och hållbar omvårdnad.Compassion fatigue (CF) is a concept that was introduced as a form of fatigue for nurses. CF develops from feeling uncomfortable for compassion to, in the worst case, transitioning to the fact that the nurse is permanently having difficulty feeling compassion. Compassion fatigue was first used in 1992 and it was described as nurses forgetting things, their attention diminished and they experienced fatigue, tiredness, anger and feeling sick. They cared less and less and, in the end, not at all.The purpose of this study was to describe the factors that can cause compassion fatigue in nurses in emergency care.The method used was a literature review. Database searches were done via PubMed, CINAHL complete and PsycINFO of which 18 articles were included in the result. This literature review used both qualitative, quantitative and mixed articles, written between 2009 and 2019.The results showed that the factors that could cause CF were socio-demographic, social, work-related, psychological and other factors such as the intake of various substances. Among these factors were stress, support from managers and coping with difficult situations, as for example, PsyCap.The conclusion was that Compassion fatigue is a common occurrence among nurses in emergency care and should be prevented in order for nurses to remain in the profession and provide good and sustainable nursing care.
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Lindgren, Jenny, and Sara Söderberg. "När döden närmar sig: sjuksköterskors erfarenheter av att vårda döende patienter på sjukhus : En litteraturstudie." Thesis, Umeå universitet, Institutionen för omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-131612.
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Bakgrund: Döden är något de flesta sjuksköterskor troligtvis möter under sin yrkeskarriär och att vårda döende patienter innebär att tillgodose patienten och anhörigas behov. Denna vård skapar många känslor och svårigheter som sjuksköterskan måste handskas med. Syfte: Syftet med denna litteraturstudie var att beskriva sjuksköterskans erfarenheter av att vårda döende patienter på sjukhus. Metod: En litteraturstudie där resultatet av nio kvalitativa studier granskades och sammanställdes med hjälp av Fribergs analysmetod. Använda databaser för sökningarna var Scopus, CINAHL och PubMed. Resultat: Litteraturstudien visar sjuksköterskornas strävan efter att tillgodose patientens behov och välbefinnande. Sjuksköterskornas roll i mötet med patient och anhöriga samt bristande förutsättningarna som upplevdes beskrivs. Sjuksköterskorna beskriver hur de blir känslomässigt påverkade samt behovet och användandet av resurser för att klara av att vårda döende patienter.Konklusion: Att vårda och sträva efter att eliminera lidande för patient och anhöriga kan skapa ett lidande för sjuksköterskan. Sjuksköterskorna beskriver ett behov av hanteringsstrategier och stöd i sitt eget lidande för att kunna känna medlidande. Vården beskrivs även som givande och bör bedrivas utifrån ett personcentrerat förhållningssätt där personen ses som en partner.
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Rosell, Carin, Maidy Zachrisson, and Madeleine Fagerlund. "”De är vana att dela med sig av oss” : Biologiska barns delaktighet i familjehemsprocessen." Thesis, Örebro University, Department of Behavioural, Social and Legal Sciences, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-367.
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Sammanfattning
Syftet med studien var att belysa hur familjehemsföräldrar uppfattar sina biologiska barns behov av stöd från socialtjänsten i familjehemsprocessen. De frågeställningar som legat till grund för studien är vilket stöd familjernas egna barn blir erbjudna från socialtjänsten och vilken form av stöd föräldrarna önskar för de egna barnen. Vidare på vilket sätt de egna barnen i ett familjehem är delaktiga i familjehemsprocessen.
Metoden som använts i studien är kvalitativ. Via information från familjehemsföräldrar har de biologiska barnens behov av stöd från socialtjänsten undersökts. Det skedde genom att intervjua fem familjehem som hade haft hemmaboende egna barn, under en period av minst tre till fem år, samtidigt som en fosterbarnsplacering. För att kunna besvara uppsatsens frågeställningar studerades tidigare forskning som till viss del belyser hur de biologiska barnen upplever sin situation.
Studiens teoretiska tolkningsram är förutom tidigare forskning också systemteori som visar på hur man i familjesystemets relationer påverkar varandra, samt utvecklingsteori som belyser barns behov och utveckling i olika åldrar.
Resultaten som framkommit i studien visar att de biologiska barnen bör synliggöras på ett tydligare sätt genom hela familjehemsprocessen. Vidare bör socialtjänsten se de biologiska barnen som en del av familjehemmet och erbjuda dem samma stöd, handledning och information som föräldrarna erbjuds.
“They are used to share us with others” - Biological children’s participation in the foster care process
Abstract
The purpose of this study was to enlighten how foster parents consider their biological children’s need of support from the Social services in the foster care process. The questions on which the study is based has been “Which support is actually offered from the Social services?” and “What form of support do the foster parents wish for their biological children?” Also “In which ways are the biological children part of the foster care process?”
The method used in the study is qualitative. Through information gathered from foster care parents, the biological children’s need of support has been examined. One of the criteria was that the five interviewed foster care homes had had biological children living at home, during a period of at least three to five years, coinciding with a foster care placement.
In order to answer the questions, raised for the study, previous research has been examined, which enlightens the situation of biological children in foster care families.
The studies theoretical frame of interpretation is, besides previous research, also system theory which shows how you, within the family systems relations affect each other, and development theory which enlightens children needs and development during various ages.
Results from the study shows the importance of making the biological children more visible during the entire foster care process.
Furthermore the Social service should see the biological course as part of the foster home, and offer them the same amount of support, guidance and information offered to the parents.
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Carlström, Ödegaard Anja, and Emma Fransson. "Patientens upplevelser av att befinna sig i livets slutskede : En litteraturöversikt." Thesis, University of Skövde, School of Life Sciences, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-4164.
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Tidigare forskning visade att omhändertagande möten med sjuksköterskan stärkte patientens självbild och skapade känslor av trygghet. Möten med sjuksköterskan som inte var omhändertagande skapade känslor av att bli nedbruten hos patienten. Patienterna ville vara delaktiga i sin egen vård. Det var inte lätt att vara anhörig till någon i livets slutskede. Det fanns inte mycket forskning skrivet om patientens upplevelser i livets slut. Syftet med studien är att beskriva patientens upplevelser av att befinna sig i livets slutskede. Studien var en litteraturöversikt med en kvalitativ ansats. I analysen jämfördes likheter och skillnader i studiernas resultat. Resultatet visade att en anpassad vård var av betydelse för patientens upplevelser av självständighet. När patienten befann sig tillsammans med familjen upplevdes samhörighet och välbefinnande. En god relation till sjuksköterskan betydde mycket för patienten i livets slutskede. En sämre relation till sjuksköterskan skapade känslor av att bli kränkt. Studien gav förståelse för vikten av att involvera patienten i sin egen vård. Studien bidrog även till en förståelse för betydelsen av att bekräfta varje patient som en individ.
Previous research showed that caring meetings with the nurse strengthened the patients self image and feelings of security. Uncaring meetings with the nurse created feelings of being broken. Patients wanted to be involved in their own care. Being next of kin to someone in the end of life was not easy. Little was written about patient experiences in the end of life. The aim of the study is to describe the patient’s experiences of being in the end of life. The study was a literature review with a qualitative approach. Differences and similarities in the results of the studies were compared in the analysis. The results showed that an adapted care was of importance for patient feelings of independence. Feelings of togetherness and wellbeing arose when the patients were together with the family. A good relation with the nurse meant a lot for the patient at the end of life. A bad relation to the nurse could create feelings of being violated. The study created an understanding of the importance to offer patients an opportunity to be involved in their own care. Furthermore it gave an understanding of the importance to confirm the patient as an individual.
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Karlstedt, Ewa. "Egenvård vid hjärtsvikt- en enkätstudie om vilka egenvårds åtgärder personer med hjärtsvikt säger sig använda i det dagliga livet." Thesis, Högskolan Dalarna, Omvårdnad, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:du-2930.
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Heart failure is an illness that requires life-long treatment and often affects everyday aspects of a person’s life. Self-care is a significant part of the treatment. Good self-care resources make it possible for people with heart failure to make the lifestyle changes they often need to maintain or improve their level of health. Self-care means having knowledge of and being able to recognize the symptoms and signs of deterioration that can occur with heart failure, so that the person can take appropriate measures – and it also means knowing when it is time to seek professional help. The significance of self-care for heart failure has increased and will increase even more in the future, when monitoring one’s condition will be left more and more to the people themselves and those who take care of them. The object of the study was to learn what self-care measures people with heart failure say they apply in everyday life. The quantitative method of a questionnaire study (The European Heart Failure Self-Care Behaviour Scale) was used. Of the 94 people registered at a heart failure unit who were asked to complete the questionnaire, 58 of them consented. The results showed that more than 95% of the people with heart failure applied the recommended self-care measure of taking the medicines prescribed by their doctor. Many also applied the self-care measures of taking a rest during the day (83%) and taking it easy when they felt out of breath (78%). On the other hand, the self-care measures of daily weight control were applied only by 41%, daily exercise by only 48% and salt and fluid restrictions by only 59%. The self-care measures of contacting a doctor/nurse when noticing problems or symptoms of deterioration were applied by only 36% of those who felt out of breath and by only 43% of those who felt increased fatigue. The conclusion is that there is a need to improve the knowledge about and confidence in self-care treatment for people with heart failure. One way of achieving this is to show that people with heart failure check for symptoms and apply measures in their homes as part of the treatment and that this leads to an increased quality of life.
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Helbig, Sylvia, A. Hähnel, Bettina Weigel, and Jürgen Hoyer. "Wartezeit für Psychotherapiepatienten – und wie sie zu nutzen ist." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-132399.
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Wartezeiten von durchschnittlich mehreren Monaten sind auch nach Inkrafttreten des Psychotherapeutengesetzes in der deutschen Psychotherapieversorgung die Regel. Behandlungsbedürftige Störungen, für die ein Behandlungswunsch besteht, unversorgt zu lassen, ist weder unter ethischen, noch praktischen und therapeutischen Gesichtspunkten vertretbar. Aus diesem Grund schlagen viele Praktiker ihren wartenden Patienten niedrigschwellige Selbsthilfeangebote vor, die von psychoedukativen Informationen über Bibliotherapie bis zu Gruppenangeboten reichen. Die vorliegende Arbeit gibt einen Überblick über verschiedene Möglichkeiten, wartende Psychotherapiepatienten gut auf die bevorstehende Therapie vorzubereiten und während der Wartezeit zugleich sekundäre Prävention zu betreiben. Hierbei muss nach unserer Einschätzung vor allem die Maxime gelten, dass die vorgeschlagenen Maßnahmen mit dem Rational der darauf folgenden Therapie vereinbar sein solltenEven after the new psychotherapy law has been implemented, waiting times of several months remain rather common in the German mental health care system. For ethical, practical, and therapeutic reasons, however, patients who are in serious need of treatment should not be left unattended. Many practitioners therefore suggest self-help treatments such as psychoeducational information, bibliotherapy, or supportive groups to their waiting patients. The present study provides an overview on possibilities of preparing waiting psychotherapy patients for their upcoming therapy as well as implementing secondary prevention during the waiting time. As a basic, we suggest that the proposed methods should be in line with the treatment rationale of the subsequent therapy
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
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Karlsson, Anette, and Sandra Lilja. "Varför vänder sig individen till 112 vid upplevd ohälsa : En intervjustudie med personer som av ambulanspersonal har bedömts som ”icke akuta”." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-16984.
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Vården ska ges på den nivå som bäst är anpassad efter patientens individuella tillstånd. Patient väljer ibland att vända sig till akutsjukvården då vårdbehovet egentligen inte är akut utan bättre kan behandlas inom primärvården. Tidigare forskning påvisar att patienter föredrar att söka sig till akutsjukvården framför primärvården då den är mer lättillgänglig samt att den uppfattas som bättre. Att det är flera personer som är inblandade i beslutet att kontakta larmcentralen samt att det är ett svårt beslut framkommer också i tidigare studier. Syftet med föreliggande studie är att beskriva patientens beslut att ringa larmcentral i stället för att ta kontakt med primärvården. Deltagarna i studien hade alla tackat ja och var inkluderade i projektet Vård på Rätt Vårdnivå och vi kom på så sätt i kontakt med dem. Studien har genomförts som en kvalitativ intervjustudie och är baserad på åtta informanter. Resultatet påvisar att beslutet att ringa larmcentralen i stället för att kontakta primärvårdens vårdcentral kan förstås som att 112 samtalet ersätter vårdcentralen som har begränsningar eller saknar akutmottagningens resurser. Att ringa larmcentralen kan också vara ett uttryck för ohälsa eller att ha förlorat kontrollen. Ofta är det någon annan än patienten som tar beslutet att ringa 112. Vårdcentralen väljs bort bland annat på grund av sämre tillgänglighet och begränsat vårdutbud i förhållande till akutmottagningen. Flera jourmottagningar i primärvårdens regi, ett ökat samarbete mellan akutsjukvården och primärvården samt regelbundna hälsokontroller som skall ges tätare med stigande ålder är förslag till kliniska implikationer. [Summary in English:] Care should be given at the best level suitable to the individual patient condition. Sometimes the patients choose to contact Emergency care when the actual need is not that urgent and can be better treated within the Primary care. Earlier research shows that patients prefer to get in contact to Emergency care prior to Primary care as it is easier to access and that it is perceived as a better option. Earlier studies also show that it’s difficult decision and more persons are often involved to decide to contact Emergency care. The purpose of this study is to describe the patient's decision to call the Emergency care instead of the Primary care. Persons participating in the study have all accepted and were already included in the project "care at the right level", and that was how we got in touch with them. The study was performed as a qualitative interview and based on eight informants. The result shows that the decision to call the Emergency care instead of the Primary care can be recognized as the 112 call replace Primary Care that is limited or do not the same resources as Emergency care. To call the Emergency care can also be an expression of suffering or that the patient lost control. Often it is someone else than the patient who makes the decision to call 112. The Primary care that is chosen away means limited availability and limited care in relation to Emergency care. More emergency receptions handled by the Primary care, greater corporation between emergency care and primary care and regular health checks more frequent as age increase is some proposals to clinical implications.Program: Specialistsjuksköterskeutbildning med inriktning mot distriktssköterska
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Hardt, Rubens [UNESP]. "Da carstificação em arenitos. Aproximação com o suporte de geotecnologias =: À propos de la karstfication dans les grès. Traitement par les technologies SIG." Universidade Estadual Paulista (UNESP), 2011. http://hdl.handle.net/11449/104403.
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hardt_r_dr_rcla.pdf: 4572815 bytes, checksum: 0c1bd7aa44b19280926515147be7a636 (MD5)L’existence de karsts dans les grès a été longtemps sujette à controverse, mais est de plus en plus acceptée depuis les dernières décennies par les karstologues. Le sous-sol d’une grande partie du territoire brésilien se constitue de grès et de métagrès. Des pluies abondantes, un couvert végétal et une matière organique abondante liés au climat tropical caractérisant majoritairement le pays, la présence d’oxydes de fer et de périodes d’érosion physicochimique prolongées ont favorisé l’altération chimique des quartz. Cette combinaison de facteurs a produit une grande variété de reliefs karstiques, ainsi que leur organisation sous la forme de systèmes karstiques gréseux. Quatre zones ont été étudiées en détail afin de comparer et de caractériser la morphologie karstique et les systèmes karstiques dans cette lithologie. Au Brésil, il s’agit de la Serra d’Itaqueri, de la Chapada dos Guimarães et de la région de Campos Gerais. En France, nous avons examiné les morphologies associées aux grès de la forêt de Fontainebleau. En outre, d'autres sites ont été visités afin de recueillir des données comparatives permettant une meilleure compréhension des processus morphogénétiques et de l'organisation des reliefs. Cette étude démontre la nature karstique des formes rencontrées et apporte une meilleure compréhension à leur intégration dans les paysages et leur intégration systémique. Les connaissances ainsi acquises autorisent la formulation d’une série d’hypothèses sur les processus impliqués dans la structuration de ces reliefs et des systèmes karstiques. L’influence de la végétation est soulignée, notamment comme... (Résumé complet accès életronique cidessous)
A carstificação dos arenitos já foi considerado um tema polêmico no passado, mas nas últimas décadas, vem sendo cada vez mais aceito pela comunidade de pesquisadores do carste. No Brasil, uma ampla área do território possui afloramentos de arenitos e meta-arenitos, e o clima tropical, com abundância de chuva e vegetação, associado a presença de matéria orgânica, óxidos de ferro, sais e longo tempo de exposição às intempéries, entre outros elementos, permitem uma aceleração do processo de intemperismo químico do quartzo, produzindo uma ampla variedade de formas cársticas, além de uma organização espacial, permitindo-se falar em Sistemas Cársticos em Arenitos. Visando a comparação e a caracterização da morfologia cárstica e dos sistemas cársticos nesta litologia, quatro áreas foram estudadas com maior grau de detalhamento, bem como outras áreas foram visitadas, com a ideia de fornecer subsídios comparativos na compreensão dos processos e organização, através do estudo das formas. As áreas estudadas foram a Serra de Itaqueri; a Chapada dos Guimarães, e a região dos Campos Gerais, no Brasil, e a região da Forêt de Fontainebleau, na França. Conseguiu-se, com isso, demonstrar a natureza cárstica das formas de relevo encontradas, entender a organização destas formas na paisagem e sua integração sistêmica, e fornecer subsídios para a formulação de hipóteses dos processos envolvidos na estruturação de tais formas e sistemas, sobretudo da importância da cobertura vegetal, como auxiliar na dissolução do quartzo, e do processo de “fantomização” da rocha (alteração “in situ”) e posterior remoção, por dissolução completa ou mecanicamente, da matéria alterada, resultando em formas e sistemas cársticos...
Karstification of sandstone was considered a controversial topic in the past, but has become increasingly accepted by karst researchers in recent decades. A large area of Brazil’s territory has sandstone and metasandstone outcrops. The country’s tropical climate, abundant rainfall and vegetation, allied to the presence of organic matter, iron oxides, salts and long weathering processes, among other factors, accelerate the chemical weathering of quartz. This combination of factors has produced a wide variety of karst landforms, as well as a spatial organization, that allows them to be referred to as Sandstone Karst Systems. Four areas were studied in great detail to compare and characterize the karst morphology and karst systems in this lithology. In addition, other areas were visited to collect comparative data to help shed further light on geological processes and the organization of landforms. The areas under study were Serra de Itaqueri, the Chapada dos Guimarães, and the region of Campos Gerais in Brazil, and the region of Forêt de Fontainebleau in France. This study allowed for the determination of the karst topography and an understanding of the organization of these landscape processes and their systemic integration. The knowledge thus gained served to underpin the formulation of hypotheses about the processes involved in the structuring of these landforms and systems, and above all the importance of vegetation as an aid for quartz dissolution, and about the process of rock phantomization (in situ alteration) and subsequent removal of modified material by complete dissolution or by mechanical means, resulting in karst landforms and systems. The aforementioned hypotheses served as the basis for a proposal to amend the definition of karst with respect to the term... (Complete abstract click electronic access below)
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Diakité, Abdoulaye Abou. "Application des cartes combinatoires à la modélisation géométrique et sémantique des bâtiments." Thesis, Lyon 1, 2015. http://www.theses.fr/2015LYO10281/document.
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Les modèles 3D de bâtiment sont largement utilisés dans l'industrie de la construction et sont nécessités par plusieurs applications telles que la représentation architecturale et les processus de simulation. Malheureusement, ces modèles manquent souvent d'informations d'une importance majeure pour permettre d'effectuer des opérations d'analyse et de calcul. Les modèles originaux sont alors souvent reconstruits par les différents acteurs qui les utilisent afin de les rendre plus adaptés à leur besoins. Dans le but de pallier ce problème, nous introduisons une approche permettant d'enrichir un modèle 3D de bâtiment et le rendre beaucoup plus interopérable. À partir de l'information géométrique seulement, nous rajoutons au modèle des informations topologiques et sémantiques. Une subdivision cellulaire de l'espace occupé par le bâtiment est d'abord effectuée en se basant sur sa géométrie, puis les relations topologiques entre les cellules sont reconstruites et explicitement définies. Des étiquettes sémantiques sont ensuite attribuées aux composants identifiés du bâtiment à l'aide de la topologie reconstruite et des règles heuristiques prédéfinies. Une structure de données topologique appelée carte combinatoire 3D (3-carte) est utilisée comme une base solide pour la mise au point des opération de reconstruction et le traitement des informations reconstruites. À partir du modèle enrichi, nous montrons comment extraire des données pour des applications dédiées, par exemple la simulation acoustique et lancer de rayon pour la navigation intérieure. Notre méthode se présente comme un pont entre les approches de modélisation et les applications d'analyse du bâtiment qui utilisent ces modèles. Il est entièrement automatique et présente des résultats intéressants sur plusieurs types de modèles3D building models are widely used in the civil engineering industry. While the models are needed by several applications, such as architectural representations and simulation processes, they often lack of information that are of major importance for the consistency of the calculations. The original models are then often rebuilt in the way that fits better to the intended applications. To overcome this drawback, we introduce a framework allowing to enrich a 3D model of a building presenting just a geometry, in a way more interoperable model, by adding to it topological and semantic information. A cellular subdivision of the building space is first performed relying on its geometry, then the topological relationships between the cells are explicitely defined. Semantic labels are then attributed to the identified components based on the topology and defined heuristic rules. A 3D combinatorial map data structure (3-map) is used to handle the reconstructed information. From the enriched model we show how to extract applications-driven information allowing to perform acoustic simulation and indoor ray tracing navigation. The approach stands as a bridge between the modeling approaches and the applications in building analysis using the model. It is fully automatic and present interesting results on several types of building models
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Claridge, Jeffrey A. "The Development of SIC-IR© to Assist with Diagnosing Infections in Critically Ill Trauma Patients: Moving Beyond the Fever Workup." Cleveland, Ohio : Case Western Reserve University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=case1213634730.
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Strandberg, Gunilla. "Beroende av vård : innebörden av fenomenet som det visar sig genom patienters, deras anhörigas och vårdares berättelser." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2002. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-94104.
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Silva, Ricardo de Castro e. 1958. "De Abaiara a Bissau = por uma (e)Educação com adolescentes, sem a adolescência." [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/251124.
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Orientador: Regina Maria dos SantosTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação
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Resumo: O objeto de pesquisa aqui desenvolvido é a interpelação da adolescência como etapa do desenvolvimento humano, definida pela ciência e instituída no século XX; como o momento de definição, caracterização e institucionalização de formas de educar e formar estes novos sujeitos. Esta definição não auxilia no trabalho da (e)Educação de adolescentes e nada diz sobre estes sujeitos. Estudos anteriores trouxeram a definição das adolescências e marcaram sua diversidade e multiplicidade. Este trabalho propõe a eliminação da adolescência, como definição de um sujeito, no campo da (e)Educação, fazendo com que os trabalhos avancem no sentido diminuir os efeitos da utilização da definição, sendo uma delas a sua própria morte, de diversas maneiras. Da Educação de adolescentes ou sobre eles, passamos à possibilidade da educação, como processo pedagógico e da Educação como instituição, com adolescentes, sem passar pela definição de adolescência. Michel Foucault é o autor central e quase único com o qual esta tese dialoga. No primeiro capítulo são apresentadas as noções da invenção da adolescência como problema; da aproximação da adolescência e anormalidade; das instituições de sequestro; da escola e do presídio como lugares de diciplinarização dos corpos; do sujeito de direito numa reflexão crítica sobre o Estatuto da Criança e do Adolescente (ECA). O segundo capítulo traz as noções do biopoder e da biopolítica, apontadas como outra forma de poder que atuam sobre a população, também dos e das adolescentes; e as noções do liberalismo, neoliberalismo e capital humano, centrais na compreensão da constituição da adolescência como período da formação do indivíduo produtivo. No terceiro capítulo, incorporam-se conceitos de Gilles Deleuze e Félix Guattari aos de Foucault, na tentativa de acrescentar novos elementos para constituir na (e)Educação formas de resistência e linhas de fuga.
Abstract: The object of the research here developed is the interpellation of adolescence as a stage in human development, defined by science and "invented", that is, instituted in the 20th century, therefore named the century of adolescence, as the moment of definition, characterization and institutionalization of the ways of educating an forming these new subjects. The defended thesis is that this definition does not help with working on the Education of adolescents and says nothing about these subjects. Previous studies evolved towards redefining adolescence, thus marking its diversity and multiplicity. The advance proposed by this paper is to eliminate adolescence as the definition of a subject in the field of Education, aiming for diminishing the effects of the use of such definition, where one of them is its own death, under different forms. From Education of or about adolescents we then go to Education as a pedagogical process and Education as an institution with adolescents, without going through the definition of adolescence. That way, we can recover the innovating potential of Education in contributing to the changes in the lives of individuals and in the reality surrounding them. Michel Foucault is the central and virtually only author with whom this thesis dialogues; through several of his works, from different times in his academic production, I could have access to the contents necessary for the elaboration and finalization of this thesis. In the first chapter the following ideas are presented: the invention of adolescence as a problem, with Cesar (1998) as a reference; the approximation of adolescence and abnormality, with Foucault (2001) and his genealogical study on the notion of an abnormal individual, arising in the late 18th century, as a reference; the kidnapping institutions, based on Foucault (2000); schools and prisons as places for the disciplining of bodies, aiming for the production of docile bodies for producing capital, with Foucault (1987) as a reference; and, finally, the subject of rights in a critical reflection about the Child and Adolescent Statute (Estatuto da Criança e do Adolescente - ECA), with Foucault (2003) as a reference. In the second chapter, I present the notions on biopower and biopolitics, based on the studies of Foucault (2008), as different forms of power acting on the population, including the adolescents. The notions of liberalism, neoliberalism and human capital are central in understanding adolescence as the time of forming a productive individual. In the third and last chapter, the concepts of Gilles Deleuze and Félix Guattari (1992) are incorporated to those of Foucault (2006), in an attempt to add new elements that may contribute to constitute forms of resistance and lines of escape in Education. The concepts addressed in this chapter are: the construction of concept as a function of Philosophy and the field of immanence; the care of oneself, parrhesia, ethos and problematization. After years of research about power and its forms of exercise in institutions, Foucault (2006) presented another possibility to face reality and the established politics; he went back to the Greeks and recovered the notion of caring of oneself, better translated into settling oneself down, interconnected to the knowledge of oneself and the practice of oneself.
Doutorado
Psicologia, Desenvolvimento Humano e Educação
Doutor em Educação
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Helbig, Sylvia, A. Hähnel, Bettina Weigel, and Jürgen Hoyer. "Wartezeit für Psychotherapiepatienten – und wie sie zu nutzen ist." Karger, 2004. https://tud.qucosa.de/id/qucosa%3A27449.
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Wartezeiten von durchschnittlich mehreren Monaten sind auch nach Inkrafttreten des Psychotherapeutengesetzes in der deutschen Psychotherapieversorgung die Regel. Behandlungsbedürftige Störungen, für die ein Behandlungswunsch besteht, unversorgt zu lassen, ist weder unter ethischen, noch praktischen und therapeutischen Gesichtspunkten vertretbar. Aus diesem Grund schlagen viele Praktiker ihren wartenden Patienten niedrigschwellige Selbsthilfeangebote vor, die von psychoedukativen Informationen über Bibliotherapie bis zu Gruppenangeboten reichen. Die vorliegende Arbeit gibt einen Überblick über verschiedene Möglichkeiten, wartende Psychotherapiepatienten gut auf die bevorstehende Therapie vorzubereiten und während der Wartezeit zugleich sekundäre Prävention zu betreiben. Hierbei muss nach unserer Einschätzung vor allem die Maxime gelten, dass die vorgeschlagenen Maßnahmen mit dem Rational der darauf folgenden Therapie vereinbar sein sollten.Even after the new psychotherapy law has been implemented, waiting times of several months remain rather common in the German mental health care system. For ethical, practical, and therapeutic reasons, however, patients who are in serious need of treatment should not be left unattended. Many practitioners therefore suggest self-help treatments such as psychoeducational information, bibliotherapy, or supportive groups to their waiting patients. The present study provides an overview on possibilities of preparing waiting psychotherapy patients for their upcoming therapy as well as implementing secondary prevention during the waiting time. As a basic, we suggest that the proposed methods should be in line with the treatment rationale of the subsequent therapy.
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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Cardoso, Ana Catarina Mora. "Aquisição e estruturação de informação geográfica para a Carta Municipal do espaço público de Odivelas." Master's thesis, Faculdade de Ciências Sociais e Humanas, Universidade Nova de Lisboa, 2012. http://hdl.handle.net/10362/7756.
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Relatório de Estágio apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Planeamento e Ordenamento do TerritórioO presente Relatório de Estágio tem por objectivo apresentar o trabalho efectuado durante o ano de estágio curricular, no âmbito da componente não lectiva do Mestrado em Gestão do Território, área de especialização em Planeamento e Ordenamento do Território. O estágio foi realizado na Câmara Municipal de Odivelas (CMO). As tarefas desenvolvidas foram integradas na primeira fase de um sub-projecto, designado “Caracterização da rede dos Espaços Exteriores de Vivência Colectiva (EEVC)”, em curso na CMO, com o objectivo de dar início à Carta Municipal do Espaço Público (CMEP). As acções desenvolvidas passaram pela inventariação, recolha de dados (trabalho de campo), avaliação, georreferenciação e carregamento de uma base de dados relativamente aos espaços exteriores e de vivência colectiva – parte integrante dos espaços públicos sobre a qual o sub-projecto se desenvolveu. No período pós estágio, e no sentido de complementar o trabalho efectuado durante o mesmo, criou-se uma geodatabase para estruturar a informação geográfica e, posteriormente, proceder a análise espacial (análises de vizinhança), numa distância de 50, 100, 150 e 200 metros em torno dos espaços públicos, bem como ao cálculo de alguns indicadores relacionados com o peso de cada grupo etário nas distâncias definidas. O estudo apresentado neste relatório pretende não só dar contributos para a CMEP, mas também como pretende destacar a potencialidade dos Sistemas de Informação Geográfica (SIG) – construção de bases de dados (geodatabases), estruturação de informação geográfica, análise espacial – no contexto da gestão municipal.
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Filgueras, Renata Schmidt. "Microbiota e teores de aminas bioativas na carne maturada de bovinos de corte, com e sem estimulação elétrica da carcaça." Universidade Federal de Pelotas, 2007. http://repositorio.ufpel.edu.br/handle/ri/1309.
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Previous issue date: 2007-06-16Samples of contra-filet (muscle Longissimus Dorsi) of 12 carcasses of Red Angus bovines and zebuines mixed breeds, knocked down with approximately 350 kg and 3 years of age, treated with or without electric stimulation of low voltage in the period post-mortem were vacuum-packed and stored under refrigeration ( 1,0±0,5ºC) for until 56 days. After 0, 7, 14, 35 and 56 days of maturation were made the determination of bioactive amines (putrescine, cadaverine, histamine, tiramine, serotonin, agmatine, tryptamine, feniletilamine, espermine and espermidine), standard count in plaque of aerobes microorganisms and total count of lactic bacteria. The count of microorganisms of the samples has correlated positively during the storage time (r>0,91 e p<0,001), achieving maximum scores of 6,67 and 7,6 LogUFC.g-1 for viable microorganisms aerobes and lactic bacteria, respectively, after 56 days. The breed variation of the animals and the electric stimulation of the carcass have not demonstrated to cause significant effects in the microbiotics and tenor of bioactive amines during the period observed, except as for the tenors of espermine, after 14 days, when a bigger concentration of such polyamine was detected in the mixed breed meat. Significant positive correlations (p<0,001), were also observed between the lactic bacteria count and the total of bioactive amines in the meat of carcass electrically stimulated, in both Red Angus and zebuines mixed breeds, which it did not occur in the meat of carcass without post-mortem electric stimulation. .
Aminas bioativas são bases orgânicas de baixo peso molecular encontradas em uma gama de alimentos de origem animal e vegetal e estão frequentemente envolvidas no desenvolvimento e potencialização de patologias humanas importantes, como desordens neurológicas, doenças gastrointestinais, hipo e hipertensão, respostas imunes anormais e câncer. O processo de maturação da carne bovina favorece o crescimento de bactérias anaeróbias facultativas, sobretudo bactérias láticas, as quais contribuem para a produção e aumento da concentração de aminas em alimentos. Amostras de contra-filé (músculo Longissimus Dorsi) de 12 carcaças de bovinos Red Angus e mestiços zebuínos, abatidos com aproximadamente 350kg e 3 anos de idade, com e sem estimulação elétrica da carcaça (estimulação de baixa voltagem), foram acondicionadas a vácuo e maturadas sob refrigeração por até 56 dias ( 1,0±0,5ºC). Aos 0, 7, 14, 35 e 56 dias de maturação foram efetuadas as determinações de aminas bioativas (putrescina, cadaverina, histamina, tiramina, serotonina, agmatina, triptamina, feniletilamina, espermina e espermidina), contagem total de bactérias láticas e contagem padrão em placa de microrganismos aeróbios. As contagens de bactérias láticas e microrganismos aeróbios correlacionaram-se positivamente com o tempo de maturação, atingindo ao final do período 6,67 e 7,6 LogUFC.g-1 para microrganismos aeróbios viáveis e bactérias láticas, respectivamente. Entre os diferentes tratamentos estudados, não foram observadas diferenças estatisticamente significativas nos teores de aminas bioativas e contagens de microrganismos (aeróbios e bactérias láticas), exceto aos 14 dias, quando os teores de espermina em amostras de carne de animais mestiços foram significativamente maiores (p<0,05) do que em carnes de Red Angus, com e sem estimulação elétrica. Em tratamentos iguais e ao longo do período de armazenamento houve aumento significativo tanto nas contagens de microrganismos aeróbios e bactérias lácticas quanto nos teores totais de aminas bioativas. Esse aumento é particularmente significativo a partir do 35º dia de maturação. Correlações positivas significativas (p<0,001) foram observadas entre contagem de bactérias láticas, total de aminas bioativas e tempo de maturação em amostras de carne de carcaças estimuladas eletricamente, tanto de animais Red Angus quanto mestiços zebuínos, o que não ocorreu nas carnes de carcaças que não sofreram estimulação elétrica post-mortem. .
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Carlman, Maria, and Carina Engqvist. "Hur skall patienter med metastaser till skelettet förhålla sig till fysisk aktivitet? : en litteraturstudie." Thesis, Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-5122.
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Background : Many cancer patients who get bone metastases live longer thanks to the successful research and development of medicines during recent years. Many studies show general health benefits from physical activity. For patients with bone metastases the possibility of physical activity perhaps should limit? Nurses at oncological units are often in lifelong contact with this group of patients. It´s therefore important to have knowledge about the bone metastases and how it influence the patient´s possibility of performing physical activity in order to support and encourage the patient to safely physical activity. Aim : To describe the patient´s possibility of physical activity with metastases to the bone. Method : A literature study. Results : The extension of the bone metastases shall be verified through X-ray. Based on the result estimation should be done regarding the risks for fractures. Few metastases allow the patient to perform more physical activity. No study showed that physical activity according to carefully elaborated exercise programmes will be of any risk for patients with bone metastases. Conclusions : The conclusion of this study was that research within nursing of the chosen problem is limited. The nurse is the one who often meets this group of patients in treatment and it is important that he/she has adequate knowledge about the individual patients’ possibilities to perform physical activity. Even if the result was not that big there is still a consensus among the articles included. Nevertheless this area seems to be fairly unexplored and more studies are needed to strengthen the evidence.
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Eymery, Céline. "Du texte à la carte : contribution de la géographie à la traduction spatiale de la loi Littoral : application en Bretagne." Thesis, Brest, 2014. http://www.theses.fr/2014BRES0104/document.
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Cette thèse propose une contribution de la géographie à la traduction spatiale de la loi Littoral. Depuis de nombreuses années, le littoral est devenu un espace sous pression. La loi no 86-2 du 03 janvier 1986 relative à l’aménagement, la protection et la mise en valeur du littoral est venue encadrer les usages du sol en bord de mer en autorisant le développement d’une urbanisation raisonnée tout en protégeant des espaces naturels. Afin de réglementer l’usage des espaces littoraux, par nature variés, cette « loi-cadre » a été volontairement conçue et rédigée avec des notions imprécises (l’agglomération, les espaces proches du rivage, les coupures d’urbanisation, etc.). Cette imprécision a fait et fait toujours l’objet de problèmes d’interprétation par les différents acteurs (les élus, les services de l’État, les propriétaires privés, etc.). L’esprit de la « loi Littoral » encourage à tenir compte des spécificités des territoires pour interpréter les notions de cette loi et les traduire dans les documents d’urbanisme. Dans ce contexte, la question de l’apport de la géographie dans l’interprétation de cette loi, notamment par la spatialisation de ces notions, se pose donc avec intérêt. L’hypothèse selon laquelle l’interprétation de la loi Littoral peut être éclairée par la « géographie juridique » est formulée. La thèse cherche à démontrer par des approches théoriques et méthodologiques que la géographie, au moyen de l’analyse spatiale et de la cartographie, permet d’apprécier ces notions en fonction des spécificités locales et des choix faits pour développer et préserver chaque territoire. Ainsi, l’utilisation de critères géographiques peut guider les acteurs vers une interprétation en adéquation avec la réalité des territoires. Dans cette optique, des outils et des méthodes de traitement de l’information spatiale sont utilisés à l’aide d’un système d'information géographique (SIG) pour cartographier des critères de géographie et tester différents seuils. La démonstration, mise en application sur des communes littorales bretonnes, met en avant que le choix des critères et des seuils dépend indéniablement du projet de territoireThis thesis proposes a contribution of geography to the spatial translation of the Coastal Law (Loi Littoral). For many years, the coast has become a space under pressure. Law No 86-2 of 3 January 1986 relating to coastal development, protection and enhancement was developed to regulate land uses on the seaside, thus allowing the development of a rational urbanisation while protecting natural areas. In order to regulate the usage of coastal areas, diverse in nature, this "framework law" was deliberately designed and written with imprecise notions (urban clusters, near-shore areas, gaps in urbanisation, etc.). This imprecision was and still is leading to problems of interpretation by different players (politicians, State services, private landowners, etc.). The spirit of the Coastal Law is to encourage the consideration of local specificities when interpreting the notions of this law and translating it into spatial planning documents. In this context, the question of the relevance of geography in the interpretation of the Coastal Law, including the spatial distribution of these notions, is therefore of interest.The assumption that the interpretation of the Coastal Law can be deepened by "legal geography" is thus formulated. The thesis seeks to demonstrate by theoretical and methodological approaches that geography, by means of spatial analysis and mapping, allows us to appreciate these notions on the basis of local conditions as well as the choices made to develop and preserve every land. Thus, the use of geographical criteria can guide stakeholders towards an interpretation in line with the reality of the territories. In this context, tools and methods for spatial information are used with the help of a geographic information system (GIS) to map the different criteria and test different thresholds. The demonstration, implemented on Breton coastal communities, highlights that the choice of criteria and thresholds is undeniably dependent of the territory's project
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Woods, Yvette. "The relationship of noncognitive variables and their contribution to attrition among health care specialists at Fort Sam Houston, TX." [College Station, Tex. : Texas A&M University, 2007. http://hdl.handle.net/1969.1/ETD-TAMU-1487.
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Shoubaki, Nadya, and Susanne Marklund. "Självskadebeteende : En litteraturstudie om sjuksköterskors attityder till patienter som skadar sig själva." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-1364.
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Bakgrund: Självskadebeteende har tidigare uppfattats som ett tecken på allvarlig psykisk sjukdom och det ansågs enbart vara mycket förvirrade människor som skadade sig själva. Studier visar att självskadebeteende oftast är något människor begår i ensamhet och majoriteten väljer heller inte att uppsöka sjukvård. Kunskap om självskadebeteende och attityder till patienter som skadar sig kan bidra till en ökad förståelse hos sjuksköterskor för fenomenet. Syfte: Syftet med denna litteraturstudie är att beskriva sjuksköterskors attityder till patienter med självskadebeteende. Metod: Uppsatsen är baserad på en litteraturstudie där nio artiklar analyserats med vägledning av Fribergs kriterier för analys av vetenskapliga studier. Resultat: Resultatet presenteras utifrån fyra huvudteman med 16 tillhörande subteman. De fyra huvudtemana är; sjuksköterskors föreställningar, sjuksköterskors känslor, sjuksköterskors värderingar samt sjuksköterskors handlingar. Resultatet visar att sjuksköterskors attityder till patienter med självskadebeteende är mångskiftande. Diskussion: Författarna skapade sex teman utifrån det i resultatet som kunde vara av intresse att lyfta fram. En diskussion kring dessa sex teman fördes sedan mot bakgrundsinformationen och Katie Erikssons teori om lidandet. Med hänsyn till vetskapen om att tankar och känslor inte alltid styr vårt handlande, valde författarna att inte dra slutsatsen att sjuksköterskor endera har positiva eller negativa attityder till patienter med självskadebeteende.
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Simões, Paulo Gaiotti. "Caracterização fisica de ambientes carsticos atraves de sensoriamento remoto e SIG : o caso do Parque Nacional Cavernas do Peruaçu - Januaria/ Itacarambi, MG." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/287497.
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Orientadores: Alvaro Penteado Crosta, Ivo KarmannDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Geociencias
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Resumo: Este trabalho aborda a caracterização do meio físico em ambientes cársticos com o emprego de técnicas de sensoriamento remoto e SIG, tomando como exemplo o Parque Nacional Cavernas do Peruaçu, municípios de Januária e Itacarambi, MG. A escolha desta área se deveu à alta relevância da região em termos de seu conteúdo espeleológico, arqueológico, geomorfológico e biótico, sendo uma mas mais importantes e expressivas áreas cársticas do Brasil. Para atingir o objetivo desta pesquisa, foram enfocados aspectos do meio físico, tais como geologia, geomorfologia, hidrografia e espeleologia. As técnicas de sensoriamento remoto utilizadas incluíram a espectroscopia de reflectância, voltada à análise qualitativa de amostras de carbonatos, e o processamento digital de imagens multiespectrais geradas por sensores orbitais, incluindo a geração e análise de composições coloridas, índice de vegetação, transformações e realces espectrais e classificações espectrais de elementos da superfície, tendo resultado em discriminações litológicas, litofaciológicas e de comunidades vegetais. A modelagem espacial de vários atributos geográficos da área de estudo foi realizada por meio de técnicas de SIG com o objetivo de analisar de forma integrada dados de fontes e formatos diversos, calcular parâmetros morfométricos, refinar mapas pré-existentes, produzir modelos tridimensionais realísticos, realizar análises espaciais e, por fim, gerar um mapa de potencial espeleológico, este último com a finalidade de servir de orientação a futuros trabalhos de exploração em campo. Foram analisados e discutidos os resultados e as limitações encontradas, no que tange a procedimentos empregados e características dos dados utilizados, como as imagens de sensoriamento remoto. O uso conjunto dessas geotecnologias atendeu aos objetivos propostos, demonstrando como o uso dessas ferramentas pode contribuir para diminuir a subjetividade das análises, proporcionando uma descrição quantitativa de elementos do ambientes cárstico, complementar aos estudos qualitativos existentes
Abstract: This dissertation deals with the characterization of karstic environments through the use of remote sensing and GIS techniques, using as a case study the Cavernas do Peruaçu National Park, located in Januária and Itacarambi counties, Minas Gerais State, Brazil. The selection of this area was due to its relevance in terms of the speleological, archeological, geomorphological and biotic contents, representing one of the most important karstic areas in Brazil. Aspects such as geology, geomorphology, hydrography and speleology were considered in the analysis of the physical environment of the study area. Remote sensing techniques comprised reflectance spectroscopy, used for the quantitative analysis of carbonate rocks, and digital image processing applied to imagery acquired by spaceborne sensors, including color composites, vegetation index, spectral enhancement and transforms and spectral classification of surface targets which resulted in lithologic, lithofaciologic and vegetation communities discrimination. Spatial modeling of geographic attributes was carried out by means of GIS techniques aiming to analyze multi-source map and image data, to calculate morphometric parameters, to refine pre-existing map, to produce realistic tridimensional models, to perform spatial analysis and, finally, to generate a map of the speleological potential, this latter with the purpose to orientate future exploration surveys in the field. Results and constraints were analyzed and discussed with respect to the procedures employed and the characteristics of the data employed, such as remote sensing imagery. The joint use of geotechnologies met the proposed objectives, demonstrating how the use of these tools may contribute to diminish the subjectivity of the analysis, allowing quantitative descriptions of karstic environments, complementing existing qualitative studies
Mestrado
Geologia e Recursos Naturais
Mestre em Geociências
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Ribeiro, Rafael Martins. "Implementação de um protocolo de sépsis, num serviço de urgência geral, sem via verde sépsis." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2019. http://hdl.handle.net/10400.26/29235.
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Mestrado em Enfermagem, Área de especialização: Enfermagem Médico-CirúrgicaEste relatório surge no âmbito do segundo Curso de Mestrado em Enfermagem na vertente enfermagem médico cirúrgica: pessoa em situação crítica. Em articulação com a formação teórica foi proposto a realização de dois estágios que permitissem desenvolver e aprofundar conhecimentos e competências, tendo escolhido a unidade de cuidados intensivos e o serviço de urgência geral, com intuito de desenvolver e adquirir competências especializadas em enfermagem e conhecimento estruturado em dois serviços de referência. O projeto major, de intervenção em serviço, foi elaborado no serviço de urgência, com o desígnio de implementação de um protocolo de sépsis, cujo objetivo foi melhorar a Qualidade e a Segurança dos cuidados ao doente com suspeita de infeção, através de um protocolo de sépsis. Os objetivos específicos consistiram em elaborar um protocolo de atuação em caso suspeito de sépsis, implementar e avaliar o mesmo, através da metodologia de projeto, dando resposta à circular normativa nº01/DQS/DQCO de 06/01/2010 da DGS. Neste trabalho é ainda feita uma análise reflexiva das competências de enfermeiro especialista em enfermagem médico-cirúrgica e de mestre adquiridas e desenvolvidas ao longo do percurso académico.
This report appears in the context of the second Master's course in nursing in the Medical Surgical Nursing section: person in critical situation. In conjunction with the theoretical formation, two stages were proposed to develop a deep knowledge and competences, having chosen the intensive care unit and the general urgency service, in order to develop Specialized nursing competencies and structured knowledge in two referral services. The major project of intervention in service was elaborated in the emergency department, for the implementation of a sepsis protocol, which aimed to improve the quality and safety of patient care with suspected infection, through a Sepsis protocol. The specific objectives were to develop a methodology project for elaboration and implementation of a sépsis protocol, guide by the national guidelines: No. 01/DQS/DQCO of 06/01/2010 of the DGS. In this work, a reflexive analysis of the competencies of nurse specialist in medical and surgical nursing and master acquired and developed along the academic course is also performed.
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Andersson, Sarah, and Andersson Marie Nilsson. "Det blir inte alltid som man tänkt sig : Föräldrars upplevelse av vistelsen på en neonatalavdelning." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-44131.
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Bakgrund: Årligen behöver cirka 11 500 barn vård på en neonatalavdelning, här vårdas för tidigt födda och vid födseln sjuka barn. Inläggningen är ofta en stressande upplevelse för föräldrarna till barnet. Sjuksköterskan har ett ansvar att vara lyhörd, respektfull och kommunicera väl med föräldrarna. Syfte: Syftet med studien var att belysa föräldrars upplevelse i samband med att barnet vårdas på en neonatalavdelning. Metod: Studien genomfördes som en litteraturstudie. Tre olika vetenskapliga databaser med omvårdnadsfokus användes och åtta resultatartiklar ingick i studien. Dessa artiklar analyserades med hjälp av innehållsanalys. Resultat: Framförallt framkom det att föräldrarna hade många emotionella upplevelser i samband med vistelsen på neonatalavdelningarna. Vidare lyftes betydelsen av kommunikation och information ifrån vårdpersonalen i samtliga artiklar. Delaktigheten i barnets vård och att få utföra föräldrauppgifter var av stor vikt. Konklusion: Behovet av stöd och kommunikation från sjuksköterskan till föräldrar var stort. Delaktigheten stärktes när föräldrarna involverades i vården, samt att deras anknytning till barnet förbättrades.Background: Annually, about 11,500 children need care in a neonatal ward, cared for here are premature children and children who are ill from birth. The hospitalization is often a stressful experience for the parents of the child. The nurse has a responsibility to be sensitive, respectful and communicate well with the parents. Aim: The purpose of the study was to shed light on parents’ experience in connecting with their child while being cared for in the neonatal ward. Method: The study was conducted as a literature study. Eight results articles were collected through three different scientific databases with a focus on nursing. These articles were then analyzed using a content analysis. Results: Above all, it appears that the parents have many emotional experiences in connection with the neonatal stay. The meaning of communication and information from healthcare professionals is seen together in all articles. The participation in their child's care and being able to perform parental tasks was of great importance. Conclusion: The need for support and communication from the nurse to parents was great. Participation was strengthened when the parents were involved in the care and their connection to the child improved.
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Girardi, Priscyla Borges Miyamoto de Araújo. "Custos comparativos entre a revascularização miocárdica com e sem circulação extracorpórea." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-10092009-115211/.
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INTRODUÇÃO: Técnicas cirúrgicas de revascularização miocárdica sem o uso de circulação extracorpórea (CEC) trouxeram esperanças de resultados operatórios com menor dano sistêmico, menor ocorrência de complicações clínicas e menor tempo de internação hospitalar gerando expectativas de menor custo hospitalar. OBJETIVOS: Avaliar o custo hospitalar em pacientes submetidos à cirurgia de revascularização miocárdica com e sem o uso de CEC, em portadores de doença multiarterial coronária estável com função ventricular preservada. MÉTODOS: Os custos hospitalares foram baseados na remuneração governamental vigente. Foram acrescentados nos custos, o uso de orteses, próteses, complicações e intercorrências clinicas. Foram considerados o tempo e os custos da permanência na UTI e de internação hospitalar. Não foram consideradas remuneração de profissionais médicos e equipe multiprofissional, bem como depreciação de materiais, taxa de administração predial, água luz, telefone, alimentação, exames laboratoriais de admissão e medicamentos. RESULTADOS: Entre janeiro de 2002 a Agosto de 2006 foram randomizados 131 pacientes para cirurgia com CEC e 128 pacientes sem CEC. As características clínicas basais foram semelhantes para os dois grupos. Os custos das intercorrências cirúrgicas foram significantemente menores (p<0,001) para pacientes do grupo SCEC comparados ao grupo CCEC (606,00 ± 525,00 vs 945,90 ± 440,00) bem como, os custos na UTI (432,20 ± 391,70 vs 717,70 ± 257,70) respectivamente. Entretanto, o custo final foi maior no grupo SCEC (6.877,00 ± 525,20 vs 5.305,00 ± 440,11; p<0.001) devido ao preço do estabilizador utilizado. Os tempos de permanência na sala cirúrgica foram (4,9 ± 1,1h vs 3,9 ± 1,0h), (p<0,001), na UTI (48,25 ± 17,2h vs 29,20 ± 26,1h) (p<0,001), com tempo de entubação (9,2 ± 4,5h vs 6,4 ± 5,1h) (p<0,001) para pacientes do grupo com CEC e sem CEC respectivamente. CONCLUSÃO: Esses resultados permitem concluir que a cirurgia de revascularização miocárdica sem circulação extracorpórea, proporcionou diminuição de custos operacionais relacionados com a diminuição de tempo de permanência em cada setor do tratamento cirúrgico. Todavia, o alto custo do estabilizador, determinou o aumento do custo final da cirurgia SCEC.INTRODUCTION: Techniques of coronary artery bypass grafting without the use of cardiopulmonary bypass (CPB) aim surgical results with less systemic damage, lower incidence of clinical complications and shorter hospitalization, generating expectations of lower hospital costs. OBJECTIVE: To evaluate the hospital cost in patients undergoing coronary artery bypass grafting with and without the use of CPB, in patients with multivessel coronary disease with stable preserved ventricular function. METHODS: Hospital costs were based on the current local government payment for the cardiac surgery. The use of orthoses, prostheses, and the clinical complications events were added in the cost. It was also added the duration of staying at ICU and total hospitalization period in the final cost. Yet, it was not considered remuneration of medical professionals as well as the cost of the depreciation of equipment, administration fee of land, water, electricity, phone, food, laboratory tests for admission and medicines. RESULTS: From January 2002 to August 2006, 131 patients and 128 patients were randomized for surgery with CPB and without CPB, respectively. The baseline characteristics were similar for both groups. The cost of surgical complications of the group without CPB were significantly lower compared to the group with CPB (606.00 ± 525.00 vs 945, 90 ± 440.00, p <0,001); as well as, the costs of ICU (432, 20 ± 391.70 vs 717.70 ± 257.70, p<0,001). Yet, the final cost was higher in the without CPB group (6.877,00 ± 525,20 vs 5.305,00 ± 440,11; p<0.001) due to the price of the Octopus stabilizer. Additionally, the occupation time at the operating room was (4.9 ± 1.1h vs 3, 9 ± 1.0h, p<0,001), at the ICU was (48.25 ± 17.2h vs 29, 20 ± 26.1h, p<0001) with intubations time (9.2 ± 4.5h vs 6, 4 ± 5.1h, p <0001) in the group with CPB and without CPB, respectively. CONCLUSION: These results showed that the coronary artery bypass grafting without cardiopulmonary bypass has decreased operational costs related to reduce length of stay in each sector of the surgical procedure. However, the high cost of the stabilizer lead to increased final cost of SCEC surgery.
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Cassell, Cynthia Houston Daniels Julie Lynn. "Health care service utilization and Medicaid costs among children [sic] with and without orofacial clefts in North Carolina, 1995-2002." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2007. http://dc.lib.unc.edu/u?/etd,1211.
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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2007.Title from electronic title page (viewed Mar. 26, 2008). "... in partial fulfillment of the requirement for the degree of Doctor of Philosophy in the Department of Maternal and Child Health, School of Public Health." Discipline: Maternal and Child Health; Department/School: Public Health.
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LIMA, Robson Ribeiro. "Carta geotécnica de aptidão à urbanização frente aos desastres naturais e induzidos elaborada para o município do Ipojuca-PE na escala de planejamento (1:25.000)." Universidade Federal de Pernambuco, 2016. https://repositorio.ufpe.br/handle/123456789/24522.
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TESE Robson Ribeiro Lima.pdf: 11700699 bytes, checksum: f09bd2fe67dffdd23d39fe0eee17c5be (MD5)Made available in DSpace on 2018-05-02T21:10:33Z (GMT). No. of bitstreams: 1 TESE Robson Ribeiro Lima.pdf: 11700699 bytes, checksum: f09bd2fe67dffdd23d39fe0eee17c5be (MD5) Previous issue date: 2016-03-31
Esta pesquisa faz parte do Projeto Elaboração de Cartas Geotécnicas de Aptidão à Urbanização no município do Ipojuca-PE, desenvolvido em parceria com a Universidade Federal de Pernambuco, por meio do Grupo de Engenharia Geotécnica de Encostas, Planícies e Desastres (Gegep), e o Ministério das Cidades. Os desastres naturais ocorridos nos últimos anos no Brasil alarmaram a sociedade e o poder público para seu devido enfrentamento, levando à busca de mecanismos de prevenção e mitigação. Em 2012, o governo federal criou a Lei n.º 12.608/2012, que instituiu a Política Nacional de Proteção e Defesa Civil, que abrange ações de prevenção, mitigação, preparação, resposta e recuperação voltada à proteção e defesa civil, cujo objetivo, dentre outros, consiste na definição de diretrizes para a ocupação urbana de forma adequada, tanto na escala de planejamento urbano quanto dos projetos de parcelamento do solo. Nos últimos anos, o município do Ipojuca vem passando por transformações espaciais bastante expressivas, apresentando um grande crescimento populacional de forma acelerada e desorganizada, decorrente da expansão do Complexo Industrial e Portuário de Suape. O resultado desse crescimento desorganizado é a ocupação de áreas de risco impróprias para moradia em planícies de inundação, fundo de vales e encostas de morros. Para ordenar o correto uso e ocupação do solo, faz-se necessário o adequado conhecimento dos atributos do meio físico. Este trabalho teve como objetivo elaborar a Carta Geotécnica de Aptidão à Urbanização frente aos Desastres Naturais para todo o município na escala de 1:25.000 para os processos de movimentos gravitacionais de massa, erosão, processos hidrológicos (alagamentos, enchentes e inundações) e processos geológicos correlatos (deformação de solos), de modo a gerar subsídios ao planejamento do uso e ocupação do meio físico urbano por meio da caracterização e delimitação de unidades geotécnicas. O desenvolvimento desta pesquisa de mapeamento seguiu basicamente a proposta metodológica do Gegep. A metodologia empregada fundamentou-se em Unidades de Terreno por meio da abordagem multitemática com sobreposição e cruzamentos de mapas temáticos de forma a se obter uma compartimentação. Além de analisar os parâmetros do meio físico, antrópico, uso e ocupação da terra e legislações vigentes, essa metodologia contou com reuniões técnicas com a participação de uma equipe de pesquisadores multidisciplinares e interdisciplinares (Gegep), alunos de graduação e pós-graduação e de gestores da prefeitura do município no fornecimento de informações e de materiais, no acompanhamento da elaboração integral dos estudos para elaboração da carta, no debate dos resultados obtidos e na validação das decisões. Todos os dados foram processados e armazenados no SIG, utilizando técnicas e ferramentas de Geoprocessamento por meio do software ArcGIS 10.1. Dessa forma, obteve-se uma carta geotécnica de aptidão à urbanização, em escala de planejamento, um quadro-legenda com a descrição sucinta das unidades geotécnicas de aptidão delimitadas no mapa com as seguintes classes: baixa, média e alta aptidão à urbanização e diretrizes/recomendações diferenciadas em cada unidade em função dos principais processos geodinâmicos. Esse documento constitui uma importante ferramenta para contribuir nas diversas ações de planejamento municipal. Contudo, por se tratar de uma escala de planejamento, sempre serão necessários estudos complementares que incluam sondagens diretas e outras investigações geotécnicas antes de sua ocupação, elaboração de para Parcelamento do Solo, em escala 1:10.000 ou maior, e Cartas de Risco em escala 1:5.000 ou maior.
This research is part of the Project Elaboration of Geotechnical Charts of Aptitude for Urbanization in the Municipality of Ipojuca-PE, developed in partnership with the Federal University of Pernambuco, through the Geotechnical Engineering Group of Slopes, Plains and Disasters – GEGEP, and the Ministry of the Cities. The natural disasters that occurred in recent years in Brazil alarmed the society and the public power for their proper confrontation, leading them to seek for mechanisms of prevention and mitigation. In 2012, the federal government created the law n.º 12.608/2012, that instituted the National Policy of Protection and Civil Defense, that covers actions to prevent, mitigate, prepare, respond and recover, focusing on protecting and civil defense, whose objective, among others, consists in defining guidelines for urban occupation in the proper way, in the scale of urban planning as well as projects of land subdivision. In recent years, the municipality of Ipojuca has been going through very expressive spatial transformations, presenting a large population growth in an accelerated and disorganized way, due to the installation of the Suape Port and Industrial Complex. The result of this disorganized growth is the occupation of risk areas unfit for housing in floodplains, valley bottoms and hillsides. To order the correct use and occupation of the land, it is necessary the appropriate knowledge of the physical environment attributes. The goal of this study is to elaborate the Geotechnical Charts of Aptitude for Urbanization based on Natural Disasters for the whole municipality in the scale of 1:25.000 in the municipality of Ipojuca for the processes of mass gravitational movements, mass transport (erosion), hydrological processes (floods) and related geological processes (soil deformation) in order to generate subsidies for planning the use and occupation of the physical-urban environment through the characterization and delimitation of geotechnical units. The development of this mapping research follows the Gegep methodological proposal. The methodology used was based on Terrain Units (TU’s) from the multi-thematic approach with overlapping and intersections of thematic maps in order to obtain a compartmentalization. In addition to analyzing the parameters of the physical and anthropic means, land use and occupation and current legislation, this methodology included technical meetings with the participation of a team of multidisciplinary and interdisciplinary researchers (Gegep), undergraduate and graduate students and Managers of the municipality’s city hall in the provision of information and materials, in the monitoring of the preparation of the studies for the preparation of the chart, in the discussion of the results obtained and in the validation of the decisions. All the data was processed and stored in a Geographic Information System (GIS) using Geoprocessing techniques and tools through ArcGIS 10.1 software. Thereby, a geotechnical chart of suitability for urbanization was made on a planning scale, a brief description of the geotechnical units of aptitude in the map legend display with the geotechnical units delimited in the map with the following classes: low, average and high aptitude for urbanization and different guidelines/recommendations in each unit due to the main geodynamic processes. This document constitutes an important tool to contribute to the various municipal planning actions. However, since this is a planning scale, complementary studies that include direct drilling and other geotechnical investigations before its occupation, the elaboration of a Geotechnical Chart of Urban Aptitude for Land Subdivision in a scale of 1:10,000 or greater, and Risk Cards in the scale of 1:5000 or greater will always be necessary.
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Payne, Liz. "Continuity of care and its effect on patients' motivation to initiate and maintain cardiac rehabilitation." Thesis, University of Bath, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.667738.
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Background: Despite national guidance and empirical support for its clinical and cost-effectiveness, cardiac rehabilitation (CR) is underused. Only 44% of patients go to CR, with angioplasty (Percutaneous Coronary Intervention; PCI) patients being least likely to attend (31% of 87,000). Aim: To investigate the relationship between ‘continuity of care’ and patients’ motivation towards CR, through the lens of self-determination theory, and develop a model to inform service design to increase CR uptake and adherence. Methods: A mixed methods approach was used. In Study 1, a theoretical model of continuity of care and motivational antecedents was tested with a cross-sectional sample of 107 PCI patients. To further explore interactions between continuity of care and motivation towards cardiac rehabilitation, a Critical Interpretive Synthesis of the extant literature was used in Study 2, and focus groups were carried out with patients and service providers in Study 3. Results: In Study 1, continuity of care positively predicted patients’ autonomous motivation towards CR, and this was partially mediated by autonomy support. Autonomy support was associated with CR attendance. In Studies 2 and 3, aspects of continuity of care with positive effects on attendance were identified. These included timely, appropriate information provision, relationships bridging CR phases and settings, and continuing management strategies incorporating trusting, warm staff-patient relationships, and positive encouragement and feedback about progress. The SDT constructs of autonomy support, need satisfaction, internalisation and quality of motivation helped to explain positive and negative influences of continuity on attendance. Conclusion: Continuity of care has a positive effect on patients’ motivation towards CR. The most enduring motivation comes from delivering continuity of care in an autonomy-supportive and competence-supportive way. Longitudinal research is needed to compare how need-supportive and need-thwarting aspects of continuity of care affect CR attendance and adherence, and whether these relationships are influenced by need satisfaction and need frustration.
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Ghazanfareeon, Karlsson Sofie. "Tillsammans men var för sig : Om särboenderelationer mellan äldre kvinnor och män i Sverige." Doctoral thesis, Umeå University, Social Welfare, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-699.
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Contemporary family life and intimate relationships today are characterised by increasing heterogeneity. In the growing body of research on this differentiation, the role of the elderly people has largely been ignored. But to an increasing extent the "young old" (65-74 years of age), in particular, are active participants in the process of the differentiation of intimate relationships. One of the least researched contributions of the elderly to the restructuring of contemporary intimate relationships is the establishment of lastint intimate relationships that do not include a mutual home, i.e. an alternative to marriage or other forms of cohabition. This type of relationship is referred to as Living Apart Together (henceforth LAT-relationships. In Swedish: särboende). The aim of this thesis is to examine LAT-relationships among elderly heterosexual individuals in Sweden, focusing in particular on the influence of this type of relationship on commitments, intimacy and autonomy. A major dilemma is the question of who should provide the care and service that ageing often demands. A pluralistic methodological approach has been adopted in the four differnt papers in this thesis, whick includes the use of a qualitative pilot study, a broad quantitative questionnaire study, a qualitative interview study and finally a qualitative study with a lifestory perspective.
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Košík, Juraj. "Determination of titanium dioxide nanoparticles in personal care products." Master's thesis, Vysoké učení technické v Brně. Fakulta chemická, 2016. http://www.nusl.cz/ntk/nusl-240803.
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Předkládaná diplomová práce se zabývá extrakcí nanočástic oxidu titaničitého z produktů osobní péče, konkrétně opalovacích krémů a následnou charakterizací těchto částic. Počet komerčně dostupných produktů s obsahem nanočástic TiO2 se neustále zvyšuje a to se sebou přináší potřebu vyhodnotit potenciální osud a nepřímou expozici TiO2 nanošástic o různých velikostí a tvarů a zkoumat jejich celý životní cyklus. Bylo zkoumáno použití ultrafiltrace a ultracentrifugace jako extrakční metody. Dvě metody pro extrakci TiO2 nanočástic byly vyvinuty a aplikovány na vzorky opalovacích krémů. Extrahované částice mohou být použity pro ekotoxikologické studie, případně experimenty v mesokosmu. Velikost částic byla stanovena pomocí metody dynamického rozptylu světla a transmisní elektronové mikroskopie.
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Hardt, Rubens. "Da carstificação em arenitos. Aproximação com o suporte de geotecnologias = À propos de la karstfication dans les grès. Traitement par les technologies SIG /." Rio Claro : [s.n.], 2011. http://hdl.handle.net/11449/104403.
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Orientador: Sérgio dos Anjos Ferreira PintoCoorientador: Joël Georges Marie Andre Rodet
Banca: Fabiano Tomazini da Conceição
Banca: Augusto Sarreiro Auler
Banca: Francisco Sergio Bernardes Ladeira
Banca: Benoit Laignel
Banca: Anne-Veronique Walter-Simonnet
Banca: Luc Denis Mathieu Willens
Em regime de cotutela de tese com a "Université de Rouen" - Docteur en Géologie (França)
Resumo: A carstificação dos arenitos já foi considerado um tema polêmico no passado, mas nas últimas décadas, vem sendo cada vez mais aceito pela comunidade de pesquisadores do carste. No Brasil, uma ampla área do território possui afloramentos de arenitos e meta-arenitos, e o clima tropical, com abundância de chuva e vegetação, associado a presença de matéria orgânica, óxidos de ferro, sais e longo tempo de exposição às intempéries, entre outros elementos, permitem uma aceleração do processo de intemperismo químico do quartzo, produzindo uma ampla variedade de formas cársticas, além de uma organização espacial, permitindo-se falar em Sistemas Cársticos em Arenitos. Visando a comparação e a caracterização da morfologia cárstica e dos sistemas cársticos nesta litologia, quatro áreas foram estudadas com maior grau de detalhamento, bem como outras áreas foram visitadas, com a ideia de fornecer subsídios comparativos na compreensão dos processos e organização, através do estudo das formas. As áreas estudadas foram a Serra de Itaqueri; a Chapada dos Guimarães, e a região dos Campos Gerais, no Brasil, e a região da Forêt de Fontainebleau, na França. Conseguiu-se, com isso, demonstrar a natureza cárstica das formas de relevo encontradas, entender a organização destas formas na paisagem e sua integração sistêmica, e fornecer subsídios para a formulação de hipóteses dos processos envolvidos na estruturação de tais formas e sistemas, sobretudo da importância da cobertura vegetal, como auxiliar na dissolução do quartzo, e do processo de "fantomização" da rocha (alteração "in situ") e posterior remoção, por dissolução completa ou mecanicamente, da matéria alterada, resultando em formas e sistemas cársticos... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Karstification of sandstone was considered a controversial topic in the past, but has become increasingly accepted by karst researchers in recent decades. A large area of Brazil's territory has sandstone and metasandstone outcrops. The country's tropical climate, abundant rainfall and vegetation, allied to the presence of organic matter, iron oxides, salts and long weathering processes, among other factors, accelerate the chemical weathering of quartz. This combination of factors has produced a wide variety of karst landforms, as well as a spatial organization, that allows them to be referred to as Sandstone Karst Systems. Four areas were studied in great detail to compare and characterize the karst morphology and karst systems in this lithology. In addition, other areas were visited to collect comparative data to help shed further light on geological processes and the organization of landforms. The areas under study were Serra de Itaqueri, the Chapada dos Guimarães, and the region of Campos Gerais in Brazil, and the region of Forêt de Fontainebleau in France. This study allowed for the determination of the karst topography and an understanding of the organization of these landscape processes and their systemic integration. The knowledge thus gained served to underpin the formulation of hypotheses about the processes involved in the structuring of these landforms and systems, and above all the importance of vegetation as an aid for quartz dissolution, and about the process of rock phantomization (in situ alteration) and subsequent removal of modified material by complete dissolution or by mechanical means, resulting in karst landforms and systems. The aforementioned hypotheses served as the basis for a proposal to amend the definition of karst with respect to the term... (Complete abstract click electronic access below)
Résumé: L'existence de karsts dans les grès a été longtemps sujette à controverse, mais est de plus en plus acceptée depuis les dernières décennies par les karstologues. Le sous-sol d'une grande partie du territoire brésilien se constitue de grès et de métagrès. Des pluies abondantes, un couvert végétal et une matière organique abondante liés au climat tropical caractérisant majoritairement le pays, la présence d'oxydes de fer et de périodes d'érosion physicochimique prolongées ont favorisé l'altération chimique des quartz. Cette combinaison de facteurs a produit une grande variété de reliefs karstiques, ainsi que leur organisation sous la forme de systèmes karstiques gréseux. Quatre zones ont été étudiées en détail afin de comparer et de caractériser la morphologie karstique et les systèmes karstiques dans cette lithologie. Au Brésil, il s'agit de la Serra d'Itaqueri, de la Chapada dos Guimarães et de la région de Campos Gerais. En France, nous avons examiné les morphologies associées aux grès de la forêt de Fontainebleau. En outre, d'autres sites ont été visités afin de recueillir des données comparatives permettant une meilleure compréhension des processus morphogénétiques et de l'organisation des reliefs. Cette étude démontre la nature karstique des formes rencontrées et apporte une meilleure compréhension à leur intégration dans les paysages et leur intégration systémique. Les connaissances ainsi acquises autorisent la formulation d'une série d'hypothèses sur les processus impliqués dans la structuration de ces reliefs et des systèmes karstiques. L'influence de la végétation est soulignée, notamment comme... (Résumé complet accès életronique cidessous)
Doutor
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Carvalho, Sandra Maria Moreira Costa de. "Os ditos sem acesso a saúde da população em situação de rua." Universidade Catolica de Salvador, 2014. http://ri.ucsal.br:8080/jspui/handle/123456730/269.
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Este trabalho se propõe a analisar o paradoxo existente desde 1988 entre a conquista de direitos sociais universais, tais como a saúde, e a falta de mecanismos para sua concretização na prática, analisando o acesso às políticas de saúde por parte das pessoas em situação de rua, percebido na restrição encontrada por essas pessoas na área da saúde, processo vivenciado no trabalho direto da autora, há mais de doze anos, com esse público nessas áreas. O método utilizado será o dialético crítico, com a realização de um estudo teórico empírico de abordagem qualitativa, realizado através de revisão bibliográfica, com consulta a autores que discutem a questão social, capitalismo, trabalho, pobreza extrema, políticas sociais e a situação de rua, além dos últimos censos realizados em Salvador e em âmbito nacional sobre a situação de pessoas nessas condições. Analisam-se a realidade de duas unidades de saúde, de atenção básica, do Centro Histórico de Salvador e as contradições no processo social, político e econômico de negação de direitos que permeia essa questão. O contexto brasileiro, mais especificamente do Centro Histórico de Salvador, demonstra a falta de dispositivos para acesso desses sujeitos a políticas fundamentais como a saúde. Entender essa situação implica considerar que a situação de rua precisa ser analisada na construção e reconstrução de políticas sociais que, ao mesmo tempo em que respondem formalmente às demandas apresentadas por esses sujeitos, contraditoriamente reforçam sua condição de despossuídos de direitos, por não se operacionalizarem na prática. Neste estudo, considera-se importante fundamentar brevemente a situação de rua atrelada à criação, configuração e reconfiguração histórica da pobreza extrema como expressão da questão social no sistema capitalista de produção, entender, na história e na atualidade brasileira e no Centro Histórico de Salvador, e o que se tem construído para a efetivação de direitos sociais dessas pessoas, e os entraves que impedem esse avanço.
This study aims to analyze the paradox since 1988 between the conquest of universal social rights, such as health and lack of mechanisms for their implementation in practice, analyzing access health policies for people living on the street, perceived the restriction found by these people in healthcare, process experienced in the direct work of the author, there are more than twelve years with this audience in these areas. The method used will be critical dialectic, where a theoretical study will be conducted through literature review in consultation with the authors argue that the social question, capitalism, labor, extreme poverty, social policy and the homeless and the last census conducted in Salvador and nationally on the situation of people in these conditions. We sought to analyze the social contradictions in the economic process, and denial of political rights that permeates this question. The Brazilian and more specifically Salvador context demonstrates the lack of access to these devices subject to fundamental policies such as health. Understand it means considering that the homeless need to be analyzed in the construction and reconstruction of social policy, which while formally respond to the demands presented by these subjects, paradoxically reinforce their status as dispossessed of rights, not operationalize in practice. In this study, it is considered important to briefly justify the situation of street tied to the creation, configuration and reconfiguration of historical extreme poverty as an expression of the social question in the capitalist system of production. We seek to understand the history and current Brazilian and Salvador, which has advanced in attaining social rights of these people, and what barriers hinder this progress.
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Baker, Martha C. "Defining the relationship of self-care agency to spirituality and cultural affiliation in Northeastern Oklhoma [sic] native American and Euro-American groups." free to MU campus, to others for purchase, 1999. http://wwwlib.umi.com/cr/mo/fullcit?p9946240.
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