Dissertations / Theses on the topic 'COMAH'
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Palomino, Yahuana Henry. "Biblioteca Municipal de Comas." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2016. http://hdl.handle.net/10757/620699.
Full textTorres, Estrada Javier. "Biblioteca pública en Comas." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2017. http://hdl.handle.net/10757/622548.
Full textContemporary libraries are not longer an exclusive place for collections; moreover, they are currently considered as spaces for constant learning with the main functions of gather, create, protect and spread information. Thus, its functional programming has become broader and more diverse than it used to be. The public library in Comas includes this new concept in order to satisfy the long-term needs and diversify the activities according to the changing society. The architectonic concept of the project raises from the analysis of the criteria of availability, topography, context and environmental topics of the location. There is a clear intention to unify the public space with the inner area through the intermediate space vision without the interruption of the activities inside this area. Regarding the functional part, the agenda is organized according to a transition criterion from public to private, always following their respective transit. The public library in Comas is eventually curtailed as a triggering project for culture, knowledge and leisure for Comas district.
García, Venegas Luis Román. "Representaciones de los jóvenes de Comas sobre sí mismos, Comas, Lima y el Perú." Master's thesis, Pontificia Universidad Católica del Perú, 2009. http://tesis.pucp.edu.pe/repositorio/handle/123456789/1406.
Full textTesis
Ochoa, Heredia Fernando André. "Centro de desarrollo juvenil en Comas." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2017. http://hdl.handle.net/10757/622218.
Full textAlegre, Calcina Gian Carlo Jorge. "Centro de Desarrollo Comunitario en Comas." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2020. http://hdl.handle.net/10757/652366.
Full textThe present work is based on the investigation of the criteria and guidelines to be taken in the development of the professional project of a Community Development Center in the Comas district, in which interaction with your city is achieved through an architecture permeable. It starts from the analysis of the needs in the city, which currently has a disaggregation in the access of services in sectors where there are higher levels of poverty, thus generating a variety of problems such as insecurity or loss of social fabric in the affected population. Based on the problems presented, spaces were proposed to achieve an improvement in the quality of life of people in a community; However, the design presented does not achieve the link with the inhabitants of the place, generating disinterest and little influx in the Centers. Through the analysis of benchmarks both at the national and international level of the typology and in emphasis of the project, an infrastructure is proposed that achieves the basic functions of the Community Centers and, in turn, allows for formal and spatial means to achieve interaction with the user.
Trabajo de investigación
Holeček, Martin. "Ocenění společnosti ComAp, spol. s r.o." Master's thesis, Vysoká škola ekonomická v Praze, 2008. http://www.nusl.cz/ntk/nusl-3388.
Full textSegura, Zúñiga Ximena. "Escuela de teatro experimental en Comas." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2018. http://hdl.handle.net/10757/625314.
Full textTesis
Pinto, Lynch Alexandra Camila. "Aldea Infantil SOS - Lima Norte: Comas." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2019. http://hdl.handle.net/10757/626126.
Full textAn SOS Children's Village is proposed in Lima Norte, district of Comas. This is the 4th district with the largest population of Lima and the second one with around 524 thousand 894 inhabitants according to INEI. This district has a 16% of poverty margin occupying the sixth place in Lima Norte and the third place to have 3.9 green areas per inhabitants. The first one is Santa Rosa with 18,751 inhab.) and the second one is Los Olivos (less poor district of Lima Norte: 9.75%). Today Lima Norte has the characteristics that will facilitate the development of the project itself, since it has large areas of land that can cover the size of the building required and remains a vulnerable sector of Lima in terms of Children who are victims of rejection, violence and abandonment. For this, four evaluation criteria were able to choose the appropriate district of Lima Norte according to SOS Children´s Villages, from which were: Poverty index, population density, number of green areas and the index of complaints about domestic violence and abandonment of home. Finally, it was finished choosing Comas for having the characteristics that are required for the establishment of the village. The construction of SOS Children´s Villages is planned not as traditional shelters, but through grouped homes that seek to assimilate the way of life of a real family.
Tesis
Fuentes, Gamboa Claudia Lucía. "Biblioteca Pública + Equipamiento Urbano en Comas." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2019. http://hdl.handle.net/10757/626412.
Full textThis thesis is about a public library of inter-district scope that responds to the need of Lima Norte for a public space that allows socio-cultural exchange, and that by sharing and interacting with different urban uses such as a police station, health center and kindergarten which are included in the design. This adds a civic value to the project and makes the existing public space, which converges different types of users who are invited to make use of the public library, reinforced. This generates that the public library can work as an additional instrument to education by providing adequate spaces and tools that complement those acquired in educational centers, encouraging the self-education of people. In this way, the project of a public library + urban equipment in Comas, becomes an urban, social, educational and cultural articulating space.
Tesis
Núñez, Ato Daniel Omar, and Fernández Helga Lili Valdivia. "Metodología para el acondicionamiento ambiental local y su aplicación en el distrito de Comas." Universidad Nacional Mayor de San Marcos. Programa Cybertesis PERÚ, 2006. http://www.cybertesis.edu.pe/sisbib/2006/valdivia_fh/html/index-frames.html.
Full textPrice, James. "Galaxies in the coma cluster." Thesis, University of Bristol, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.529836.
Full textJOUVE, MICHEL. "Coma, pancreatite, para-osteo-arthropathie." Saint-Etienne, 1988. http://www.theses.fr/1988STET6001.
Full textValdivia, Fernández Helga Lili, and Ato Daniel Omar Núñez. "Metodología para el acondicionamiento ambiental local y su aplicación en el distrito de Comas." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2006. https://hdl.handle.net/20.500.12672/1076.
Full textTesis
Maur, Nathalie. "Evaluation des modifications de charge thérapeutique induites par le flumazenil au cours des intoxications comateuses aux benzodiazépines." Lille 2, 1991. http://www.theses.fr/1991LIL2M026.
Full textFoster, M. J. "Cometary coma modelling in collisionless regime." Thesis, University of Kent, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310201.
Full textLOBO, CATARINA. "Contributions a l'analyse de l'amas coma." Paris 7, 1997. http://www.theses.fr/1997PA077051.
Full textAlinder, Simon. "Electron cooling in a cometary coma." Thesis, Uppsala universitet, Institutionen för fysik och astronomi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-324842.
Full textRymdsonden Rosetta från ESA undersökte kometen 67P/Churyumov Gerasimenkounder mer än två år, från augusti 2014 till slutet av september 2016.En Langumirprob användes för att undersökta plasmamiljön runt kometen, tillexempel elektronernas termiska energi. Den observerade termiska energin förelektronerna (eller elektrontemperaturen) var ganska hög, ca 5-10 eV undernästan hela uppdraget, men när kometen var nära perihelium detekterade instrumentenäven kalla elektroner, med en energi under 1 eV, distinkta från devarma. En hypotes är att dessa kalla elektroner bildas nära kärnan av att varmaelektroner genomgår inelastiska kollisioner med den neutrala gasen och tapparsin energi. I detta projekt utvecklar vi en modell för att studera elektronernasbeteende i koman. Modellen tar hänsyn till kollisioner med neutrala vattenmolekylersåväl som påverkan av ett radiellt ambipolärt elektriskt fält.
The, Lih-Sin. "The mass of the Coma cluster." Diss., The University of Arizona, 1989. http://hdl.handle.net/10150/184770.
Full textLeite, Juliana Valeria 1977. "Prognostic value of the blinking reflex to visual threat in comatous patients = Valor prognóstico do reflexo de piscar à ameaça visual em pacientes comatosos." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313507.
Full textDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-23T19:15:40Z (GMT). No. of bitstreams: 1 Leite_JulianaValeria_M.pdf: 641050 bytes, checksum: b62398f140661279efb6ea212dc9afcf (MD5) Previous issue date: 2013
Resumo: A avaliação do nível de consciência faz parte da rotina da equipe multiprofissional que conduz pacientes em coma. Sinais que possam representar a melhora do nível de consciência destes pacientes são constantemente buscados. Atualmente sabe-se que alguns fatores, como por exemplo, a resposta motora na escala de coma de Glasgow (ECG) e a apresentação do reflexo fotomotor apresentam valor prognóstico, porém nenhum deles é relacionado diretamente ao despertar destes pacientes. O objetivo deste estudo foi o de relacionar a presença do reflexo de piscar à ameaça visual (RPAV), com o despertar de pacientes comatosos e evidenciar o seu valor prognóstico. Para tanto foi feito um estudo retrospectivo com os dados obtidos em prontuários do serviço de arquivos médicos do Hospital das Clínicas da Universidade Estadual de Campinas (HC-UNICAMP) de pacientes internados nas enfermarias de neurologia clinica e neurocirurgia entre os períodos de abril de 2005 a abril de 2010. Foram selecionados 975 prontuários correspondentes ao diagnóstico de traumatismo cranioencefálico e acidente vascular encefálico. Destes, foram selecionados 119 prontuários de pacientes que se enquadraram nos critérios de inclusão representados pela resposta motora menor ou igual a quatro na ECG na admissão hospitalar e a descrição do RPAV durante o período de internação sendo excluídos os pacientes com resposta motora na admissão hospitalar superior a quatro, que não apresentassem a descrição da avaliação do RPAV ou que tivessem patologias neurológicas associadas às mencionadas como fator de seleção para os prontuários. Foram analisados os dados relativos ao sexo, diagnóstico clínico, resposta motora isolada e ao Glasgow total na admissão e alta hospitalar, a apresentação do RPAV durante o período de internação e a evolução clínica do paciente que foi representada pelo despertar, traduzido pela resposta motora seis ou cinco na ECG, evolução ao estado vegetativo persistente e óbito. A análise estatística demonstrou através da análise de regressão logística univariada e multivariada com critério Stepwise de seleção de variáveis uma associação entre a apresentação positiva do RPAV durante o período de internação e o despertar dos pacientes estudados (p<0.001). Todos os 51 pacientes que apresentaram o reflexo despertaram enquanto os pacientes que não apresentaram o reflexo não despertaram, evoluindo ao estado vegetativo persistente (24 pacientes) ou ao óbito (44 pacientes). Os pacientes que apresentaram o reflexo positivo durante o período de internação apresentaram uma maior possibilidade de despertar (11.685.00 vezes maior) dos que não o apresentaram adotando-se o nível de significância para os testes estatísticos de 5%, ou seja, p<0.05. O presente estudo demonstrou que o RPAV apresenta valor prognostico, estando sua apresentação positiva diretamente associada ao despertar destes pacientes
Abstract: The level of consciousness assessment is part of the hospital routine in comatose patients. Signs that may indicate cognitive improvement in these patients are constantly searched. Nowadays it is kwon that some features represent prognostic value, however, none relates directly with awakening in coma patients. The main purpose of this study was to associate the presence of the blinking reflex as a response to a visual threat with awakening in coma patients. We reviewed medical records from University of Campinas Clinical Hospital from patients diagnosed with stroke and traumatic brain injury (TBI) who stayed in the hospital neurological ward from April 2005 to April 2010. We reviewed 975 medical records. 119 patients were included; on admission they presented a score four or less for motor response in Glasgow Coma Scale (GCS) and description RPVA during hospitalization, being excluded patients with diagnoses other than those cited and motor response at admission more than four, which did not present the description of the assessment the blinking reflex or had neurological pathologies associated with those mentioned as selection factor for records. We gathered information from the charts regarding sex, disease, GCS total score, GCS motor score on admission and discharge, the presence or absence of the blinking reflex and level of consciousness on discharge, characterized as awakening, persistent vegetative state or death. Statistical analysis demonstrated through the analysis of univariate and multivariate logistic regression with stepwise selection criterion variables of a direct association between a positive blinking reflex of to visual threat during the period of hospitalization awakening in our cohort (p<0.001) . All the 51 patients with a positive reflex awoke, while patients with a negative reflex don't awakening evolved to persistent vegetative state (24) or death (44). A positive blinking reflex to visual threat during hospitalization increases the chance of awakening by 11.685.00 times when compared with patients with a negative reflex. The blinking reflex as a response to a threat has great prognostic value while its positivity is directly associated with awakening in coma patients
Mestrado
Ciencias Biomedicas
Mestra em Ciências Médicas
Palomino, Garcia Jorge Ciro, Manco Yessica Puchuri, Pumarica Victor Hugo Saldaña, and Quijano Adrián Gustavo Silva. "Índice de progreso social del distrito de Comas." Master's thesis, Pontificia Universidad Católica del Perú, 2019. http://hdl.handle.net/20.500.12404/15264.
Full textThe Social Progress Index (SPI) is a tool to measure the social progress of a specific population through social and environmental variables (Social Progress Imperative, 2018a) that are located within the dimensions of Basic human needs, Foundations of wellbeing and Opportunity. The objective of the research was to calculate the SPI of the Comas district through the methodology defined by the Social Progress Imperative and adapted by CENTRUM PUCP in the "IPS de Ciudades". With this, it was expected to identify the main social and environmental deficiencies of the district that serve as a reference for the implementation of the most appropriate initiatives for the it. The type of research used for the present study was quantitative, descriptive, transversal and non-experimental; since primary sources were used through a survey of 400 families and secondary sources through state publications. With the information obtained, the indicators of the components associated to the three dimensions of the Comas IPS could be measured and the analysis validated by means of various statistical tests. This measurement was applied in each of the three Macrozones identified in Comas and in the district in general, thereby determining that Comas has an IPS of 66.89 and that the three Macrozones have IPS of 67.92, 66.31 and 66.19, respectively. This rating places Comas with a Upper Middle Social Progress according to the standards defined by the Social Progress Imperative. The dimension that presents a better rating is that of Basic human needs with a score of 74.70, highlighting the high level of coverage of basic services such as water and electricity, although Shelther is a big problem in the district. On the other hand, the dimension with the lowest score was Opportunity with a score of 57.92. Within this dimension, stand out negatively with the worst rating the component of Access to higher education; and Personal rights component, due to limited citizen participation within the district.
Tesis
Zandbergen, Eveline Gea Jeannette. "Prediction of outcome in anoxic-ischaemic coma." [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2006. http://dare.uva.nl/document/35697.
Full textBeard, Richard. "Cometary dust coma modelling for spacecraft encounters." Thesis, University of Kent, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316191.
Full textAvénas, Sébastien. "Le coma hyperosmolaire : recherche de facteurs pronostiques." Montpellier 1, 1999. http://www.theses.fr/1999MON11062.
Full textDaltrozzo, Jérôme. "Assessment of cognitive functions in coma patients." Université Louis Pasteur (Strasbourg) (1971-2008), 2006. http://www.theses.fr/2006STR13047.
Full textYing, Zhong. "Motor and somatosensory evoked potential in coma /." Bern, 1991. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.
Full textFernandez, Maldonado Castro Ana María, and Márquez Carmen Gil. "La densificación de las barriadas: El caso de Comas." Universidad Nacional de Ingeniería. Programa Cybertesis PERÚ, 1989. http://cybertesis.uni.edu.pe/uni/1989/fernandez_ma/html/index-frames.html.
Full textPierce, Donna. "Formation and destruction of carbon monoxide in cometary comae." College Park, Md. : University of Maryland, 2006. http://hdl.handle.net/1903/3422.
Full textThesis research directed by: Astronomy. Title from t.p. of PDF. Includes bibliographical references. Published by UMI Dissertation Services, Ann Arbor, Mich. Also available in paper.
Llanos, Ferraris Diego Rafael Sahelices Fernández Benjamin. "Vsr-coma : un protocolo de coherencia cache con reemplazo para sistemas multicomputadores con gestión de memoria de tipo COMA /." [s.l.] : [s.n.], 2000. http://uvadoc.uva.es/handle/10324/104.
Full textTorres, Jacques-Henri. "Récepteur au n-méthyl-d-aspartate et souffrance neuronale du coma hypoglycémique." Montpellier 1, 1988. http://www.theses.fr/1988MON11381.
Full textFrancis, Matthew D. "Interspecific Competition Between Hygrophila polysperma and Ludwigia repens, Two Species of Importance in the Comal River, Texas." Thesis, University of North Texas, 1999. https://digital.library.unt.edu/ark:/67531/metadc278133/.
Full textCamacho, Mercado Christian Rafael. "Asociaciones de padres de familia (APAFAS), capital social y gestión educativa : un estudio comparativo sobre dos APAFAS y su impacto en la gestión educativa de dos escuelas públicas del distrito de Comas-Lima Metropolitana." Bachelor's thesis, Pontificia Universidad Católica del Perú, 2018. http://tesis.pucp.edu.pe/repositorio/handle/123456789/12260.
Full textTesis
Mäkinen, J. Teemu T. "SWAN Lyman alpha imager cometary hydrogen coma observations /." Helsinki : Finnish Meteorological Inst, 2001. http://www.gbv.de/dms/goettingen/342176471.pdf.
Full textWilkinson, Peter-Luke. "Antenna array receivers of DS-COMA wireless systems." Thesis, Imperial College London, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246676.
Full textZhan, Tiange. "Investigating EEG burst suppression for coma outcome prediction." Thesis, Massachusetts Institute of Technology, 2018. http://hdl.handle.net/1721.1/119913.
Full textThis electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.
"June 2018." Cataloged from student-submitted PDF version of thesis.
Includes bibliographical references (pages 97-100).
Every year, over 300,000 incidents of cardiac arrest occur in the United States. Of the people who are successfully resuscitated and brought to the hospital, approximately 80% remain unconscious for some amount of time Marion [2009]. Predicting whether or not a patient will wake up from coma, as well as the patient's neurological function after waking up, is an important task in guiding treatment decisions for physicians and family of the patient. This project seeks to improve this prediction process by analyzing features of the patients' EEG recordings during coma with the aim to determine quantitative metrics which are predictive of patients' outcome. Specifically, we focus on the analysis of the similarity of bursts during burst suppression, which has been hypothesized to be linked with poor outcome. Our work confirms that similarity of bursts is indeed linked with poor outcome, and we also find that dynamic time warping gives a viable alternative to the previously used method of cross-correlation as a measure of similarity of bursts, with good predictive power for patient outcome.
by Tiange Zhan.
M. Eng.
Moore, Stephen Anthony William. "Stellar populations in early-type Coma cluster galaxies." Thesis, Durham University, 2001. http://etheses.dur.ac.uk/3856/.
Full textAboud, Ana Claudia Souza Vazquez. "Pacientes em processo de coma : alterações da vida." Universidade do Estado do Rio de Janeiro, 2000. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=2087.
Full textPartindo da premissa de que o paciente em coma é um sujeito, e que o seu processo comatoso é uma alteração do estado de vida, em contraposição ao imaginário social que lhe atribui estereótipos de sono próximo a morte, inércia, suspensão de sua vida mental e impotência. Esta dissertação tem como objetivo demonstrar que o coma é demarcado no limite entre o caos e o desejo na medida em que cada paciente vivencia o processo comatoso de forma singular e demarcado conforme sua experiência subjetiva, implementando movimentos em direção a processos de vida ou de morte. Para tanto foram utilizados análise de casos clínicos, entrevistas com médicos, familiares e pacientes que saíram do coma, além de pesquisa bibliográfica, utilizando a psicanálise como arcabouço teórico que fundamenta as inferências e conclusões propostas nesta dissertação.
Assuming that the comatose patient is a human been, and that his comatose process is an altered state of life, in contrast to the picture that gives you social stereotypes sleep near death, inertia, suspension of your mental life and impotence. This dissertation aims to demonstrate that the coma is demarcated the border between chaos and desire in that each patient experiences the process of natural Comatose shape and marked according to their subjective experience, moves toward implementing processes of life or death . For this analysis of clinical cases, interviews with doctors, patients and family members who came out of the coma were used in addition to literature, using psychoanalysis as a theoretical framework that underlies the inferences and conclusions proposed in this dissertation.
Jappe, Rodrigo. "A postmodernist myth in Gilfriend in a Coma." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2011. http://hdl.handle.net/10183/33258.
Full textThe investigation of the novel Girlfriend in a Coma revealed some central elements that structure this work as myth and parody. The fictional world is characterized by a society incapable of changing its behavior or even realizing what is wrong with it. In the narrative some aesthetic resources are used which are related to magic realism because, along with the description of events coherent with human rationality, there are supernatural events performed by the divine. In this narrative, the ideology of hard work as the main structure of life in a democratic capitalist society is unveiled, taking into account some terrible effects felt by the characters, such as: overworking, drug addiction, anorexia and individualism. With the use of narrative theory and postmodernist theory, it is argued that this novel is a ‗new world myth‘ because it makes use of parody as a way to refute masternarratives and to suggest new cosmogonies based on the Canadian post-colonial experience.
Portilla, Salazar Elsa Liliana. "Los comedores populares de Lima como espacios de negociación." Master's thesis, Pontificia Universidad Católica del Perú, 2013. http://tesis.pucp.edu.pe/repositorio/handle/123456789/5201.
Full textTesis
Badalamenti, Roberto. "Programmazione PLCopen di un robot Comau e di macchine automatiche." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2018. http://amslaurea.unibo.it/17161/.
Full textHatcher, M. G. "COMAS development for concentration probing of gas phase discharge systems." Thesis, Swansea University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.637245.
Full textDallali, Houman. "Modelling and dynamic stabilisation of a compliant humanoid robot, CoMan." Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/modelling-and-dynamic-stabilisation-of-a-compliant-humanoid-robot-coman(474662c6-8f0a-4f21-9504-5c49cb509231).html.
Full textMarion, Vincent. "Aspects psychologiques du reveil du patient comateux." Nancy 1, 1990. http://www.theses.fr/1990NAN11243.
Full textMeisch, Jean-Paul. "Contribution à l'étude des méningites purulentes comateuses de l'adulte : stratégie diagnostisque et thérapeutique : à propos de 41 observations recueillies en réanimation médicale." Université Louis Pasteur (Strasbourg) (1971-2008), 1990. http://www.theses.fr/1990STR1M046.
Full textArteaga, Melgarejo Deisy Katiuscka, Huerta Stephany Barboza, Koosau Valeria Carolina Guevara, Gutierrez Ximena Angélica Gutierrez, and Suarez Ana Claudia Higashi. "“Ampay, me salvo y a toda mi familia”. Proyecto de Comunicación para el Desarrollo." Bachelor's thesis, Pontificia Universidad Católica del Perú, 2019. http://hdl.handle.net/20.500.12404/15952.
Full textThis document presents the project of Communication for Development “Ampay, me salvo y a toda mi familia” that addresses the communicational problem of the separation of adult neighbors from the urban areas of Comas with their responsibility on the stages of generation and segregation of solid waste management. Comas is one of the most polluted districts in the city of Lima, in which adults, target audience of the project, do bad environmental practices that affect their public and private spaces. That is, they have no environmental awareness, since their knowledge about environmental care is not reflected in their actions. Therefore, it is relevant to work in people’s attitudes and behaviors to contribute to the solution of this problem. The results of an investigation determined that the communicational objective of the project is to make visible the link between the bad environmental practices of the adult neighbors in the urban areas of Comas and its consequences on the well-being of their family to ensure that they carry out positive environmental practices in the stages of generation and segregation of solid waste in public and private spaces. In order to fulfill the objective, the project uses a fun and familiar methodology to encourage reflection and recognition of bad practices, so that neighbors can learn and perform good environmental practices. In this way, based on a communicational approach, the project wants neighbors to recognize their role in the problem of solid waste management in their district, to identify the good practices that are within their reach, to have the information of the necessary conditions to carry them out and finally, to perform new positive environmental practices in the stages of generation and segregation of solid waste in the public and private space.
Trabajo de investigación
Vale, Carla Cristina Soares de Oliveira do. "Paciente comatoso: sujeito e objeto." Universidade Federal de Juiz de Fora, 2014. https://repositorio.ufjf.br/jspui/handle/ufjf/563.
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CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
O objeto de pesquisa da presente investigação é a verificação de uma possível resposta emocional dos pacientes comatosos frente aos estímulos de seus familiares. Pretende-se identificar se o paciente comatoso internado na Unidade de Terapia Intensiva responde aos estímulos do visitante. E como objetivos específicos: Descrever as alterações das respostas fisiológicas monitoradas nos pacientes comatosos internados na UTI durante as visitas e destacar a importância ou não da comunicação verbal e não verbal com os pacientes comatosos. Atualmente, apesar dos avanços da Medicina e da Neurociência, ainda não se tem uma resposta precisa sobre o que se passa emocionalmente com o paciente em coma, o que demanda uma melhor compreensão dos seus processos emocionais. A pesquisa caracteriza-se por ser um estudo qualitativo, realizado na Unidade de Terapia Intensiva do Hospital Universitário da Universidade Federal de Juiz de Fora. Utilizou-se como metodologia a Análise do Conteúdo proposta por Bardin e a observação. A análise de conteúdo foi aplicada às entrevistas realizadas com os visitantes enquanto que a observação foi utilizada para identificar as alterações fisiológicas no momento da visita. A coleta de dados se deu em 45 dias de observação com pacientes que estavam dentro dos critérios de inclusão da pesquisa. Foram pesquisados 11 pacientes comatosos que estavam ligados a um monitor eletrônico multiparâmetros e à respiração artificial. Estes aparelhos mediam em tempo real os parâmetros fisiológicos que indicariam uma resposta do paciente frente ao estímulo do visitante (pressão arterial, frequência cardíaca e frequência respiratória). Essa medição foi feita antes, durante e depois das visitas e os dados foram registrados em uma planilha com o intuito de comparar os padrões fisiológicos e identificar alterações. Essa medição foi registrada em dois momentos sem estímulo (antes e depois da visita) e em três momentos com estímulo do visitante (durante a visita). A análise temática das entrevistas e do diário de campo resultou em três grandes categorias: 1- Respostas Emocionais nos pacientes comatosos, na qual se constatou a presença de respostas emocionais nos pacientes comatosos, identificadas através de dois aspectos: alterações fisiológicas e superficialização do nível de consciência; 2- A importância de um outro em que foi descrito os tipos de interação entre visitantes e pacientes, além de abordar a importância da visita na perspectiva do visitante; 3- Possibilidades de humanização no atendimento ao paciente comatoso onde foi discutida a relevância da atuação do psicólogo na UTI. Desta forma, a pesquisa indica a presença de respostas emocionais do paciente comatoso e possibilita informações para que se realizem o preparo da equipe multiprofissional para acolher os familiares que vivenciam este momento de crise estimulando de forma adequada e eficaz a interação dos binômios: “profissionais-família” e “família-doente”. Quanto ao binômio “profissional-paciente” a pesquisa contribui para a humanização combatendo a reificação do paciente em estado de coma. Como desdobramento desse estudo indica-se ainda novas pesquisas com outras tecnologias como a ressonância magnética e uma maior quantidade de pacientes.
Objective: The research aims at finding possible emotional responses to stimuli from their family members in comatose patients. It seeks to identify whether comatose patients admitted to the Intensive Care Unit respond to stimuli of visitors. The specific objectives: (i) to describe the changes in the monitored physiological responses in comatose ICU patients during family visits. (ii) To assess the degree of importance of verbal and nonverbal communication with comatose patients. Despite the advances in Medicine and Neuroscience, no answer to what precisely occurs with comatose patients is satisfactory, since further understanding of their emotional processes is still required. Methodology: The research comprises a qualitative study conducted in the Intensive Care Unit of the University Hospital of the Federal University of Juiz de Fora. Content Analysis (Bardin) of the visitors’ interviews and direct observation to identify the patients’ physiological changes during the family visits were used as methodology. The data collection lasted 45 days of direct observation of selected patients who met the criteria for inclusion in the survey. Eleven comatose patients connected to multi-parameter electronic monitors and artificial respirator were under scrutiny. These devices measured in real time physiological parameters that indicate a patient's response to the stimulus from the visitors (blood pressure, heart rate and respiratory rate). The measurements were conducted before, during and after the visits. The collected data were recorded in spreadsheets in order to compare physiological patterns and identify changes. One measurement was recorded at two moments without stimulation (before and after the visit), and another one three times with the visitor’s stimulus (during the visit). Results: A thematic analysis of the interviews and the field diary resulted in three major categories: (i) Emotional Responses in comatose patients, in which the presence of emotional responses were found and classified into two categories: physiological changes and superficialization of the consciousness’ level. (ii) The importance of the “other”, through which the types of interaction between visitors and patients were described, in addition to addressing the importance of the visit under a visitor's perspective. (iii) Possibilities of humanization in comatose patient care, in which the relevance of the psychologist in the ICU. Conclusion: The research indicates the presence of emotional responses in comatose patients and provides information on the preparation of a multidisciplinary team to sort out family members who best experience the moment of crisis and stimulate proper and effective interaction of the binomials: "Professional versus family" and "family versus patient." As for the binomial "physician versus patient", the research underscored the need for the humanization of such environments, and contended the reification of the patient in coma. The study also indicates the need for further research with other technologies such as magnetic resonance imaging with a larger number of patients.
Kirkham, Fenella Jane. "Cerebral haemodynamics in normal subjects and children in coma." Thesis, University of Cambridge, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.611486.
Full textThomas, Swapna. "Morphologic and genetic characterisation of the zebrafish mutant 'coma'." Thesis, King's College London (University of London), 2012. https://kclpure.kcl.ac.uk/portal/en/theses/morphologic-and-genetic-characterisation-of-the-zebrafish-mutant-coma(5ada0b43-d01d-4d62-b498-735ba3e64cb9).html.
Full textFalcão, Antonio Luis Eiras 1959. "Hemometabolismo cerebral : variações na fase aguda do coma traumatico." [s.n.], 1996. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312357.
Full textTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Neste trabalho desenvolvemos o estudo de 27 pacientes .adulto.s com traumatismo craniencefálico grave, com 3 a 8 pontos na escala de coma de Glasgow (ECG), avaliados prospectivamente segundo um protocolo cumulativo padronizado para tratamento da hipertensão intracraniana aguda. Este protocolo incluía medidas da pressão intracraniana{pIC) e da extração cerebral de oxigênio_{EC02) -como se segue: PIC <20 mmHg - cabeceira elevada a 30 graus, sedação, se necessária, e ventilação mecânica; PIC > ou = 20 -mmHg - -Cabeceira elevada a 30 graus, hiperventilação mantendo os valores da EC02 entre 24% e 42%, manitol 20% em infusão intravenosa rápida (0,5 a 19/kg/dose)-e, caso os valores da PIC não correspondessem ao tratamento anterior, o item seguinte seria terapia barbitúrica (2 a 4 mg/kg/hora) e, por último, cirurgia descompressiva. Analisamos as inter-relações hemometabólicas envolvendo: pressão arterial média (P AM), pressão intracraniana (PIC), pressão parcial de gás carbônico PAC02), extração cerebral de oxigênio (EC02,) pressão de perfusão cerebral (PPC), diferença artério-jugular do conteúdo de oxigênio (DAV02) e extração sistêmica de oxigênio (ES02). Concluímos que: 1) A EC02 está altamente relacionada com diferentes níveis de PaC02; 2) a PPC não se correlaciona com a EC02 ¿em quaisquer níveis de PIC;3) a EC02 e a PIC estão diretamente relacionadas durante a fase aguda de hipertensão intracraniana, sugerindo um importante papel da hemodinâmica cerebral, em relação aos problemas da pressão intracraniana; 4) durante a hiperventilação otimizada, existe um acoplamento entre EC02 e a ES02
Abstract: Twenty-seven adult patients with severe acute brain trauma, presenting with 3 to 8 points on the Glasgow Coma Scale, were prospectively evaluated according to a cumulative protocol for the management of acute intracranial hypertension, where intracranial pressure (ICP) and cerebral extraction of oxigen (CEOz) were measured and managed as follows: ICP < 20mmHg-.head tilt at 30degrees, Bedation if necessary, and mechanical ventilation; ICP > 20 mmHg- head tilt at 30 degrees, hyperventilation maintaining the CEOz in the 24% - 42% range, 20% manitol fast intravenous infusion (0.5 - 1 / kg/dose). If adequate ICP control below 20 mmHg was not achieved, barbiturate therapy (2 - 4mg/kg/hour) and even decompressive surgery were adopted. We then analyzed hemometabolic interrelationships involving: mean arterial pressure (MAP), ICP, PACO2, CEO2, cerebral perfusion pressure (CPP),arterio- jugular oxygen content difference (A VDO2) and systemic extraction of oxygen (SEO2). We concluded that: 1) CEO2 and PACO2 are closely related; 2) CPP and CEO2 are unrelated; 3) CEO2 and ICP are closely related in acute intracranial hypertension, suggesting 4 relevant role of cerebral hemodynamics in relation to lCP problems; 4) during optimized hyperventilation, CEO2 and SEO2 are coupled.
Doutorado
Neurociencias
Doutor em Fisiopatologia Medica
Simões, João Filipe Fernandes Lindo. "A influência da estimulação auditiva na pessoa em coma." Doctoral thesis, Universidade de Aveiro, 2011. http://hdl.handle.net/10773/6868.
Full textEste estudo teve como finalidade compreender os efeitos da estimulação auditiva com uma voz desconhecida e familiar, na pessoa em coma nos parâmetros e curvas monitorizados em ambiente de cuidados intensivos. A revisão da literatura acerca da comunicação verbal em cuidados intensivos e consequente análise de conteúdo foi utilizada para construir a mensagem estímulo, que foi refinada e validada por um grupo de peritos. Esta mensagem é constituída por três partes: apresentação e orientação, informação e avaliação funcional e estimulação, e serviu como referência para a gravação das mensagens no estudo que se seguiu. Neste estudo também foi traduzida, adaptada para a realidade Portuguesa e convertida em linguagem CIPE® a Coma Recovery Scale – Revised, que deu origem ao Instrumento de Avaliação da Recuperação do Coma da Universidade de Aveiro (IARCUA), que foi sujeito a testes de fiabilidade.Os resultados da análise sugerem que o referido instrumento pode ser utilizado com fiabilidade, mesmo quando existem algumas flutuações no estado clínico das pessoas. A correlação dos scores das subescalas foi elevada e superior aos resultados apresentados para a escala original, indicando que esta escala é um instrumento indicado para a avaliação da função neuro-comportamental. O estudo da influência da estimulação auditiva foi realizado com uma amostra de 10 pessoas em coma internadas no Serviço de Cuidados Intensivos do Hospital de Santo António, no ano de 2009, com total autorização da Comissão de Ética do referido Hospital, sendo a selecção baseada numa avaliação preliminar através do instrumento referido e avaliação dos potenciais evocados auditivos do tronco cerebral. A pessoa significativa foi seleccionada através da aplicação de testes sociométricos. A todos os participantes foram dadas informações escritas acerca do estudo e foi concedido um período de tempo para reflexão e posterior decisão acerca da autorização ou não da aplicação do estudo. O tempo total de recolha de dados foi de 45 minutos distribuídos equitativamente por três períodos: pré-estimulação, estimulação e pós-estimulação. Os valores recolhidos foram os das curvas de ECG, das pressões arteriais e pletismografia de pulso e dos parâmetros de frequência cardíaca, pressão arterial sistólica, diastólica e média, temperatura corporal periférica e saturação parcial de oxigénio, utilizando-se o programa Datex-Ohmeda S/5 Collect para o efeito. A análise estatística e clínica dos dados, foi realizada por períodos de estimulação e fases da mensagem estímulo, aplicando-se testes estatísticos e uma análise baseada em critérios de relevância clínica.Os resultados demonstraram que na estimulação com uma voz desconhecida se verificou um aumento dos valores da frequência cardíaca, dos valores das pressões arteriais sistólicas, diastólicas e médias, na transição entre os períodos de préestimulação e estimulação e que estes valores tendem a normalizar quando termina a estimulação. Estas alterações foram corroboradas pela análise dos intervalos RR e da curva de pressões arteriais. Em relação à estimulação com uma voz familiar, as pessoas também reagiram aquando da estimulação com aumento dos valores da frequência cardíaca e dos valores das pressões arteriais sistólicas, diastólicas e médias. No entanto em alguns casos verificámos que os valores destes parâmetros continuaram a aumentar no período de pós-estimulação, o que revela que os utentes desenvolveram episódios de ansiedade de separação. Relativamente à temperatura corporal periférica e saturação parcial de oxigénio, em ambos os casos, não verificámos alterações aquando da estimulação. Relativamente às fases da mensagem estímulo, durante a estimulação com uma voz desconhecida, os participantes apresentaram uma maior variabilidade nos valores da frequência cardíaca, pressões arteriais sistólica, diastólica e média na fase de avaliação funcional e estimulação. Esta constatação é corroborada pela análise das curvas monitorizadas. Em relação à estimulação com uma voz familiar, além de reagirem nos mesmos parâmetros com maior intensidade na fase de avaliação funcional e estimulação, os participantes também reagiram de forma relevante na fase de apresentação e orientação. Este estudo contribui para a reflexão sobre a prática comunicacional com as pessoas inconscientes, no sentido de sensibilizar os enfermeiros e outros profissionais de saúde para a importância da comunicação nas unidades de cuidados intensivos e contribuir igualmente para a melhoria da qualidade de cuidados.
This study aimed to understand the effects of auditory stimulation with an unknown and familiar voice on the patient in a coma. A systematic literature review on verbal communication in intensive care and subsequent content analysis were used to construct the stimulus message used in this study, which was refined and validated by an expert group. This message consists of three parts: presentation and orientation, information and functional assessment and stimulation, which was used as the basis for recording the stimulus messages. The Coma Recovery Scale – Revised (CRS-R) was translated, adapted to the Portuguese reality and converted into the ICNP® language resulting in the Instrumento de Avaliação da Recuperação do Coma da Universidade de Aveiro (IARCUA), which was subjected to reliability tests. The results of the analyses suggest that the instrument can be used reliably, even when there are some patient fluctuations. The correlation of the subscale was high and better than the results presented for the original CRS-R, indicating that this scale is a homogeneous measure of neurobehavioural function. The study of the influence of auditory stimulation was performed with a sample of 10 coma patients from the Intensive Care Service of the Hospital de Santo António - Porto, in the year of 2009, selected using IARCUA and auditory evoked potentials of the brainstem. The Hospital’s Ethics Committee gave full ethical approval. A significant person was selected using sociometric tests. All participants were given written information about the study and time to decide whether they wished that the patient take part, and they all gave written consent. The total time of data collection was 45 minutes divided equally by three periods: pre-stimulation, stimulation and poststimulation. The electrocardiographic signal, curve of arterial pressures and pulse plethysmography and parameters of heart rate, systolic, diastolic and mean arterial pressure, body temperature and oxygen saturation level, were recorded using Datex- Ohmeda S/5 Collect. Data analysis was performed for the periods and parts of the stimulation message using statistical tests (Friedman test and ANOVA for global comparisons, and Wilcoxon test and t test for multiple comparisons). Clinical relevance of the results was also considered. The results showed that stimulation with an unknown and familiar voice generated an increase in heart rate values and in the values of arterial pressure. This was corroborated by the analysis of monitorised curves. However, for a familiar voice the values of these parameters continued to increase post-stimulation, which revealed that participants developed episodes of separation anxiety. No changes in body temperature occurred during the stimulation.When the phases of the stimulus message were analysed, during the stimulation with an unknown voice, the functional assessment and stimulation phase showed a larger variability in the values of heart rate, arterial pressure and oxygen saturation level. This was corroborated by the analysis of the curves. Stimulation with a familiar voice resulted in greater changes for the same parameters during the functional assessment and stimulation phase and participants also presented relevant change during presentation and orientation phase. This study contributes to the reflection on the practice of communication with the unconscious patients, in order to sensitise the nurses and other health professionals to the importance of communication in the intensive care unit and to contribute to improving the quality of care.
Kadowaki, Jennifer, Dennis Zaritsky, and R. L. Donnerstein. "Spectroscopy of Ultra-diffuse Galaxies in the Coma Cluster." IOP PUBLISHING LTD, 2017. http://hdl.handle.net/10150/623844.
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