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Di, Filippi Arturo. "Development and experimental validation of CPOx reforming dynamic model for fault detection and isolation in SOFC systems." Doctoral thesis, Universita degli studi di Salerno, 2015. http://hdl.handle.net/10556/1932.
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2013 - 2014In the present work an investigation of the reforming technologies available for Solid Oxide Fuel Cell (SOFC) systems and their basic concepts has been carried out, with the aim to describe, test and simulate the reforming process for fault diagnosis application. The final aim of a fault diagnosis activity for SOFC systems is to reach the required criteria for a commercial application, which, besides long lifetime and performance, include high reliability and safety at reasonable costs. The achievement of these targets is necessary to contribute promoting the SOFC technology and finally starting a mass production phase. In this thesis, the attention has been focused on the reforming reactor, responsible for the conversion of the inlet fuel in hydrogen, suitable source fuel for the SOFC. In particular, the Catalytic Partial Oxidation (CPOx) process has been analyzed. The CPOx reforming mechanism is the most attractive technology for the production of syngas or hydrogen in small-medium scale SOFC applications and Micro Combined Heat and Power (μCHP) systems. This is due to the ability of the CPOx reaction to be carried out in compact reactors with rapid dynamic response and with low heat capacity. The reaction is slightly exothermic and therefore does not require external heat to take place. In addition, CPOx technology does not require steam, as the media required for the reforming reaction is air, which is easily available for residential application. This mainly means that CPOx is independent from an external water source and any heating source. The hydrocarbon is both oxidized to CO2 and H2O, either partially or completely, and also converted to synthesis gas by endothermic steam reforming (according to the indirect CPOx mechanism). Despite these advantages, catalytic partial oxidation is less efficient than steam reforming. This indicates that it is most suitable for applications in which the system simplicity has the priority with respect to the hydrogen yield. The high surface temperatures can cause a local loss of activity of the catalyst, leading to the instable performance of the entire reactor. Nevertheless, in the CPOx process even a small difference in the operating air and fuel flow rates could lead to carbon deposition or oxidation of the catalyst, with serious consequences for the SOFC system and for the stack itself. It is therefore extremely important to develop a diagnosis tool able to investigate these phenomena and to detect and isolate the faults that may verify inside the reactor. The most common fault events likely to occur inside a CPOx reformer for SOFC applications have been analyzed through a Failure Mode and Effect Analysis (FMEA) and a Fault Tree Analysis (FTA). These analyses are aimed at identifying the main events responsible for the catalyst deactivation, together with their causes and effects on the SOFC system performance. The Catalytic Partial Oxidation mechanism has then been explored from both modelling and experimental points of view, with the aim to simulate the reforming process and identifying the thermodynamic optimal operating conditions at which natural gas may be converted to hydrogen. At the same time, the main fault scenarios likely to occur during the reforming phase have been analyzed, both in experiments and during simulations, to evaluate the capability of the developed model in performing effective fault detection and isolation for on-board diagnostic application. The CPOx dynamic model developed is based on the minimization of Gibbs free energy and can be easily reconfigured for describing a steam reforming mechanism. The simulation results give useful indication on how operating parameters such as the input conditions of reactants (inlet compositions and temperature) affect the reaction equilibrium and, in turn, the products composition and reactor outlet temperature. A sensitivity analysis for different operating conditions has been carried out. The transient behavior of the reforming reaction and the information about methane conversion and hydrogen selectivity complete the set of model results. The dynamic CPOx model has been validated through experimental data and its behavior during transients has been carefully analyzed during the variations in the set-points of operating phases. Both test data and reactor design were part of the activities performed within the EFESO project, funded by the Italian Ministry of Economic Development and led by Ariston Thermo Spa. The model results demonstrate that the CPOx dynamic model represents a useful tool for fault diagnosis application and its results provide an interesting benchmark for the design and working parameters of a CPOx reforming system for SOFC application. [edited by author]
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Metten, Matthias [Verfasser], Herbert [Akademischer Betreuer] Pfeifer, and Sven [Akademischer Betreuer] Kureti. "Analysis of carbon formation characteristics of real CPOX-reformate from diesel fuel on SOFC-anodes / Matthias Metten ; Herbert Pfeifer, Sven Kureti." Aachen : Universitätsbibliothek der RWTH Aachen, 2020. http://d-nb.info/1213267625/34.
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DE, SIMONE GIULIO. "Analisi teorica, progettazione e sperimentazione di sistemi per la produzione di idrogeno da idrocarburi." Doctoral thesis, Università degli Studi di Roma "Tor Vergata", 2009. http://hdl.handle.net/2108/1093.
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Nel presente lavoro sono state approfondite le tematiche relative alla riformulazione degli idrocarburi in sistemi compatti, applicabili a bordo di autoveicoli, in particolar modo quelle inerenti la progettazione. Sono stati sviluppati numerosi modelli di calcolo al fine di approntare uno strumento di fluidodinamica computazionale in grado di simulare i fenomeni che caratterizzano le diverse fasi del processo, e guidare la progettazione di detti sistemi. I modelli predisposti, prima di essere impiegati per la progettazione, sono stati ampiamente validati sulla base dei risultati sperimentali a disposizione: per quanto al reforming del gasolio si è fatto riferimento ad un reattore sviluppato nell’ambito di un progetto finanziato dall’Unione Europea denominato “Direct”, cui hanno partecipato enti di ricerca pubblici e privati ed aziende, per quanto al reforming del metano si è fatto riferimento alla letteratura scientifica. I modelli sono stati poi impiegati con successo nella progettazione di due reattori, il primo denominato “Prometer” è in grado di operare la riformulazione di combustibili liquidi, l’altro denominato “Syngas UTV” di quelli gassosi. I due sistemi sono stati concepiti in maniera da essere in grado di gestire combustibili diversi (sistemi multifuel), la sperimentazione in laboratorio si è però focalizzata sull’utilizzo di gasolio e metano. In particolare la scelta di sperimentare il reattore “Prometer” sul gasolio è dovuta al fatto che questi presenta caratteristiche che ne rendono particolarmente difficile la riformulazione senza incappare nella formazione di particolato, cui segue l’interruzione irreversibile del funzionamento del reattore. Per questo motivo lo sviluppo di sistemi stabili ed in grado di garantire durate di funzionamento adeguate, per l’ossidazione parziale del gasolio finalizzata alla produzione di idrogeno, rappresenta ancora un obiettivo per il mondo scientifico. I risultati della sperimentazione sono stati estremamente soddisfacenti, anche per la riformulazione del gasolio, sebbene in un unico ciclo di dottorato non sia stato possibile approfondire ulteriormente la sperimentazione, per l’ingente impegno di tempo che lo sviluppo dei sistemi ha richiesto. La prosecuzione delle attività di ricerca intraprese ha eccellenti possibilità di concludere favorevolmente verso la possibilità di giungere allo sviluppo di sistemi stabili ed in grado di operare senza produzione di particolato, che non è stata riscontrata nelle prime prove effettuate sul reattore. Per scongiurare tale evenienza si ritiene, sia sulla base delle evidenze sperimentali che dalle simulazioni effettuate, che le fasi di vaporizzazione e miscelazione abbiano un ruolo fondamentale.Scope of this work is to examine design issues concerning the reforming of the hydrocarbons in compact systems, which can be used for hydrogen generation onboard vehicles. Several models have been developed in order to build a comprehensive fluid dynamics tool to simulate physical and chemical phenomena that affect reforming process. Models have been extensively validated on results from scientific literature and "Direct" project, a research program funded by the European Union which concern Diesel fuel reforming. The models were then used successfully in the design of two reactors, the first called "Prometer", the other "Syngas UTV", which are capable of operating Catalytic Partial Oxidation (CPOx) of liquid fuels and gaseous fuels respectively. The two multifuel systems have been tested with Diesel fuel and methane. In particular, the choice of run "Prometer" reactor with Diesel fuel is due to the fact that gasoil CPOx is particularly difficult due to soot formation, which often involves fast and irreversible shutdown of the reactor. For this reason, the development of stable and long-life CPOx reactors for Diesel fuel is still an objective for scientific community. The experimental result were successful, even for Diesel reforming, since no soot formation was observed during experiments. To this goal, fuel vaporization and mixing were found to have a key role.
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Junior, Roberto Faris. "Descrição do perfil dentário e avaliação de fatores associados a cáries, obturações e perda dentária dos policiais militares da região bragantina." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-23022010-162725/.
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Apesar da cárie e suas consequências afligirem aproximadamente 90% da população mundial, alguns grupos populacionais continuam pouco estudados. Esta pesquisa teve como objetivo estudar estas doenças em uma população de policiais militares da Região Bragantina do Estado de São Paulo - Brasil. Esta população foi dividida em duas faixas etárias: uma que compreende dos 22 aos 34anos de idade, e outra dos 35 aos 51 anos a fim de comparar as duas gerações. A pesquisa foi realizada nas dependências da Unidade Integrada de Saúde (UIS) do 34º Batalhão de Polícia Militar do Interior (34º BPM/I), onde coletou-se alguns dados das fichas de odonto-legal dos policiais atendidos nesta unidade e que consentiram em participar do estudo. A pesquisa consistiu em fazer um levantamento epidemiológico da saúde bucal destes policiais através dos índices CPOD e CPOS e estudarmos alguns fatores de risco como hábitos de higiene oral, grau de instrução e consumo de alimentos cariogênicos, que possam estar ligados a estas doenças. A população estudada teve um grau de CPOD menor que o atual panorama brasileiro. A média de dentes ausentes nesta população é cerca de cinco vezes menor que a verificada no último levantamento epidemiológico (SB Brasil 2003) e a média de dentes hígidos se apresenta ligeiramente maior se comparada à faixa etária dos 35 a 44 anos no restante do país.Although caries and their consequences afflict approximately 90% of world population, some populations remain poorly studied. This research aimed to study these diseases in a population of military police from Região Bragantina of São Paulo - Brazil. This population was divided into two age groups: one comprising of 22 to 34 years old, and another 35 to 51 years in order to compare the two generations. The survey was conducted on the premises of the Integrated Health Service (UIS) of the 34th Military Police Battalion of the Interior (34º BPM/I), where it was collected some data sheets of odonto-legal officers of this unit serviced and who consented participate in the study. The research consisted in making an epidemiological survey of oral health of these officers through the DMF indexes and to assess some risk factors such as oral hygiene habits, educational level and consumption of cariogenic foods, which may be linked to these diseases. The study population had a degree of DMFT smaller than the current Brazilian context. The average number of missing teeth in this population is about five times lower than that seen in the last epidemiological survey (SB Brazil - 2003) and the mean sound teeth appears slightly larger compared to the age of 35 to 44 years in the rest of the country.
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Holm, Sophie, and Lena Lidén. "Smärtskattning med CPOT inom neurokirurgisk intensivvård." Thesis, Röda Korsets Högskola, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-662.
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Bakgrund: Sederade eller medvetslösa patienter kan inte verbalt kommunicera sin smärta. Smärta är svårt för sjukvårdspersonalen att bedöma om beteendebaserade smärtskattningsinstrument inte är implementerade. Forskning har visat att neurokirurgiska intensivvårdspatienter upplevt moderat till svår smärta under vårdtiden på intensivvårdsavdelningen och denna smärta har underbehandlats. Critical-Care Pain Observation Tool (CPOT) är ett smärtskattningsinstrument som nyligen validerats i Sverige för att kunna användas inom intensivvården på icke kommunikativa vuxna patienter, dock har neurokirurgiska intensivvårdspatienter exkluderats vid valideringen. Syfte: Syftet med denna studie var att undersöka intensivvårdssjuksköterskans uppfattning om CPOTs användbarhet inom neurokirurgisk intensivvård. Metod: Mixed-method enkätstudie. En implementering av ett beteendebaserat smärtskattningsinstrument. Resultat: Elva sjuksköterskor inom neurokirurgisk intensivvård deltog. Tio av elva sjuksköterskor ansåg det värt att implementera CPOT. Ingen av sjuksköterskorna använde något annat smärtskattningsinstrument än Visuell Analog Skala (VAS) vid studietillfället. I skattning på en skala från 0-10, om huruvida CPOT hjälpt sjuksköterskorna i deras bedömning och behandling av smärta, blev medianvärdet 5. Från de öppna frågorna identifierades sex kategorier: positivt, enkelt, bättre än VAS, utvärderingsmöjlighet, svårbedömt och okänsligt. Patienter i vila fick 0 – 5 CPOT poäng, med en median på 1. Vid nociceptiv procedur erhöll patienterna 0 – 7 poäng, med en median på 3. Maxpoängen i CPOT är 8. Slutsats: Intensivvårdssjuksköterskorna hade en positiv uppfattning av att använda CPOT inom neurokirurgisk intensivvård och de ansåg att CPOT är värt att implementera. CPOT gav högre poäng under nociceptiva procedurer än i vila. Klinisk betydelse: Studien kan leda till att CPOT implementeras.Background: Sedated and unconscious patients cannot verbally communicate their pain. Pain assessment is difficult for health care professionals when behavioural pain assessment tools are not implemented. Science has shown that neurosurgical intensive care patients experienced moderate to severe pain during their stay in the intensive care unit and that this pain has been undertreated. Critical-Care Pain Observation Tool (CPOT) is a pain assessment tool recently validated in Sweden for use in the intensive care unit on uncommunicative adult patients, however, neurosurgical patients were excluded in the validation. Aim: The aim of this study was to investigate the critical care nurses perception of CPOT’s usefulness in neurosurgical intensive care. Method: Mixed-method questionnaire study. An implementation of a behavioral pain assessment tool. Result: Eleven nurses in a neurosurgical intensive care unit participated. Ten of the eleven nurses considered CPOT worth implementing. None of the nurses used any other pain assessment tool than Visual Analogic Scale (VAS) at the time of the study. Rating on a scale from 0-10, whether CPOT helped the nurses in their assessment and treatment of pain, the median score was 5. From the opened-ended question, six categories were identified: positive, simple, better than VAS, evaluation opportunity, difficult to assess and insensitive. Patients at rest scored 0-5 in CPOT, with a median of 1. In nociceptive procedures, the patients scored 0-7, with a median of 3. The maximum score in CPOT is 8. Conclusion: The critical care nurses had a positive attitude towards using CPOT in neurosurgical intensive care and they considered CPOT worth implementing. CPOT gave higher scores in nociceptive procedures than at rest. Clinical relevance: The study may result in the implementation of CPOT.
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Thomas, Sobotka, and Wolfgang Lutz. "Misleading policy messages derived from the period TFR: Should we stop using it?" Federal Institute for Population Research, 2011. http://dx.doi.org/10.4232/10.CPoS-2010-15de.
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Discussions about fertility in developed countries refer almost exclusively to the period Total Fertility Rate (TFR). We argue that the use of this indicator frequently leads to incorrect interpretation of period fertility levels and trends, resulting in distorted policy conclusions and, potentially, in misguided policies. We illustrate this with four policy-relevant examples, drawn from contemporary Europe. These illustrations show that the TFR (a) inflates the presumed gap between fertility intentions and realised fertility, (b) erroneously suggests a significant fertility increase in many countries of Europe after the year 2000, (c) often exaggerates the level of immigrants fertility and (d) frequently suggests that family-related policies which led to shorter birth spacing in fact brought an upward swing in fertility level. There seems to be no policy-relevant question for which the period TFR would be the indicator of choice to be preferred over other existing measures.
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Ahuja, Irene. "Computerized Provider Order Entry (CPOE) using Systems Engineering." Digital Commons at Loyola Marymount University and Loyola Law School, 2013. https://digitalcommons.lmu.edu/etd/342.
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As engineering in the 21st century becomes increasingly politically, socially and technically complex, systems engineering has become an effective tool in managing multidimensional problems involving people and the services they use. This project addresses how systems engineering principles are invoked throughout the development of the Computerized Provider Order Entry (CPOE) process, a subset of Electronic Medical Records (EMR) and presents factors necessary for the successful implementation of CPOE. Through the review of current literature and interviews with CPOE vendor implementers, this paper explains how systems engineering, which has historically been used in the development of systems, products, manufacturing and missions, is evolving into service-oriented industries such as healthcare to manage complex development of EMR systems. The goal of this paper is to show that CPOE implementation is a necessary change for healthcare providers, even though the task may seem daunting. This paper demonstrates that by studying the systems engineering strategies that have worked for CPOE implementation at other organizations, future organizations can also find success.
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Andrae, Fredrik, and Li Haglund. "Införandet av smärtskattningsverktyget CPOT- hur påverkas intensivvårdspatienters smärt- och sederingsbehandling?" Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-326272.
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Bakgrund: Smärta hos intensivvårdspatienter är vanligt förekommande och kan medföra förlängd vårdtid och leda till flera negativa konsekvenser för patienten samt bidra till ökad mortalitet. Smärtskattning med ett validerat smärtskattningsinstrument som Critical-Care Pain Observation Tool (CPOT) kan underlätta smärtskattningen och förbättra smärtbehandlingen samt minska översedering. Syfte: Syftet med denna studie är att beskriva om införandet av smärtskattningsverktyget CPOT, anpassat för patienter i ventilatorbehandling, påverkar dygnsdoserna av smärtlindrande- och sederande läkemedel samt om sederingsbehandlingen förändras. Syftet är även att undersöka hur ofta sjuksköterskorna smärtskattar patienterna med CPOT och om antalet smärtskattningar överensstämmer med gällande rekommendationer. Metod: Kvantitativ journalgranskningsstudie med retrospektiv design. Vuxna patienter som ventilatorbehandlades under minst ett dygn på en intensivvårdsavdelning i Sverige inkluderades (n=55). Resultat: Totalt 55 patienter inkluderades i två grupper, före och efter införandet av CPOT. Doserna av smärtlindrande läkemedel ökade i gruppen som undersöktes efter att CPOT infördes. Patienterna erhöll i genomsnitt 1,4 mg morfin/kg/dygn jämfört med 1,1 mg morfin/kg/dygn innan införandet. Dosen av det sederande läkemedlet Propofol® minskade efter införandet av CPOT från 48,3 mg/kg/dygn till 47,5 mg/kg/dygn. Alla patienter i studiegruppen förutom två (92 %) smärtskattades vid minst ett tillfälle under mätdygnet efter införandet av CPOT. Slutsats: Doserna av smärtlindrande läkemedel var högre och doserna av det sederande läkemedlet Propofol® var lägre efter införandet av CPOT. Skillnaderna var dock inte statistiskt signifikanta. Patienterna i studiegruppen hade en något ytligare sederingsnivå enligt RASS-skalan. Patienterna smärtskattades med CPOT i genomsnitt 1,6 gånger under mätdygnet. Studien kan bidra till en ökad medvetenhet om vikten av att skatta smärta med ett validerat bedömningsinstrument hos intensivvårdspatienter.Background: Critically ill intensive care patients frequently experience pain and pain may lead to consequences such as prolonged length of hospital stay and increased mortality. The Critical-care Pain Observation Tool (CPOT) is a validated tool for pain assessment in mechanical ventilated patients and is used to enable pain assessment, improve pain management and reduce over-sedation. Aim: The aim is to examine if the implementation of CPOT affects the doses of analgetics, sedatives administered to the Intensive Care Unit (ICU) patients and/or the sedation levels using RASS-scores. The aim was also to study how often pain-assessments were performed by nurses. Method: A quantitative study with retrospective design, data was collected from patients’ medical records. Included were adult patients treated under mechanical ventilation >24h at an intensive care unit in Sweden (n=55). Results: For this study 55 patients were included and divided into two groups, before and after the introduction of CPOT at the intensive care unit. The amount of analgetics increased among the patients after CPOT was implemented, they were given 1,4 mg of morphine/kg/24h compared to 1,1 mg of morphine/kg/24h before the implementation. The amount of sedatives, Propofol®, given to the patients decreased from 48,3 mg/kg/24h to 47,5 mg/kg/24h after CPOT was implemented. CPOT was used to assess pain levels in all patients except for two (98%) after the implementation of CPOT. Conclusion: The doses of analgetics were higher and the doses of sedatives (Propofol®) were lower after the implementation of CPOT. However, the differences between groups were not statistically significant. Patients were less sedated, according to RASS-scores, after the implementation of CPOT. Nurses used CPOT on an average 1, 6 times/ 24 h. This study can be used to increase the awareness for the need of using a validated tool for assessing pain in ICU-patients.
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Subramaniam, Sivaraman. "Role of the Cpx pathway in Salmonella pathogenesis." Berlin mbv, 2009. http://d-nb.info/998073199/04.
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Braga, José Miguel Coutinho de Oliveira. "Avaliação do risco de cárie dentária na população pediátrica da clínica pedagógica da Faculdade de Ciências de Saúde da UFP." Master's thesis, [s.n.], 2015. http://hdl.handle.net/10284/5062.
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Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina DentáriaA cárie precoce da infância é uma doença infecciosa, transmissível e multifactorial e é também a doença mais prevalente na cavidade oral das crianças. Além dos factores etiológicos, há um conjunto de variáveis como as condições sócio-económicas, a educação e a influência parental que podem influenciar a saúde oral das crianças. Assim, conhecer os principais factores de risco torna-se essencial para prevenir/controlar a progressão da cárie dentária. O presente estudo teve como principal objectivo a avaliação do risco e da experiência (cpod e CPOD) de cárie em pacientes pediátricos da Clínica Pedagógica da Faculdade de Ciências de Saúde da Universidade Fernando Pessoa. No total foram avaliadas 48 crianças (dos 4 aos 16 anos). Além da determinação dos valores de cpod e CPOD, as crianças foram avaliadas de acordo com um índice socio-económico (classificação de Graffar) e de acordo com a Circular Normativa nº 9/DSE de 19/7/2006 da DGS (como indicador de avaliação de risco de cárie dentária). No final foi determinada a associação/relação entre os factores de risco estudados e a classificação do risco/experiência de cárie nas crianças. Concluiu-se que valores médios de cpod e CPOD registados foram superiores aos valores médios nacionais dos estudos realizados pela DGS e que o nível sócio-económico das famílias das crianças observadas era maioritariamente de classe média-baixa e baixa. Foi observada uma associação significativa entre o risco/prevalência de cárie e a classificação sócio-económica, verificando-se que crianças de famílias com menores rendimentos apresentavam maior risco e experiência de cárie. Os hábitos alimentares (nomeadamente a ingestão de alimentos cariogénicos), a higiene oral e a prevenção/motivação para a saúde oral (da mãe, e por inerência da criança) também se reflectiram ao nível do risco/experiência de cárie das criança observadas. Este estudo indicou que a Classificação Social Internacional de Graffar e o Questionário do Programa Nacional de Saúde Oral relativamente ao risco reflectem os principais factores associados à cárie dentária e permitem caracterizar de uma forma eficiente o risco de cárie nas crianças. De futuro deverá alargar-se este tipo de estudos a uma amostra mais alargada de crianças e provenientes de várias áreas do País. Early childhood caries is an infectious, transmissible and multifactor disease and it is also the most prevalent oral disease in children. Along with aetiological factors there is a set of variables including socio-economic conditions, education and parental influence that can affect children’s oral health. Thus, the knowledge on most important risk factors is essential to prevent/control the progression of dental caries. The main objective of the present study was to evaluate dental caries risk and experience (“cpod” and “CPOD” indexes) in children at the “Clínica Pedagógica da Faculdade de Ciências de Saúde da Universidade Fernando Pessoa”. In total, 48 children (aged 4-16 years) were observed. Along with the determination of “cpod” and “CPOD” values, children were classified according to the socio-economic classification of Graffar and according to the “Circular Normativa nº 9/DSE de 19/7/2006” of DGS (as an indicator for dental caries risk). Finally, the association/relation between risk factors and the classification/ experience of risk in children were assessed. Results showed that mean cpod and CPOD values were above the Portuguese national average as determined in studies by the DGS and that the majority of children observed belonged to medium-low or low income families. A significant association between dental caries risk/ experience and the socio-economic classification was observed. In particular, children from lower income families presented higher risk/experience of caries. Dietary habits (namely ingestion of cariogenic food), oral hygiene as well as motivation for oral health (by the mother and inherently by the child) were also associated with childhood caries risk/ experience. This study suggested that the International Social Classification of Graffar as well as the “Questionário do Programa Nacional de Saúde Oral” relative to caries risk reflect the main factors associated with caries in children and are able to effectively characterize dental caries risk. In the future, such type of studies should include a larger number of children and should be performed at different geographical areas in Portugal.
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Giri-Rachman, Ernawati Arifin. "The CPX two component regulatory system of V. cholerae." Thesis, University of Bristol, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274636.
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Hall, Radojković Brynhilde. "The Critical-Care Pain Observation Tool (CPOT) på NIVA : En enkätstudie om användbarhet." Thesis, Röda Korsets Högskola, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-1596.
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Bakgrund: Smärta är för intensivvårdspatienten en unik, subjektiv, obehaglig och flerdimensionell upplevelse. Intensivvårdssjuksköterskan har ett moraliskt ansvar att lindra patienternas smärta. Verbalt icke-kommunicerandepatienter kan inte skatta sin smärta med hjälp av Numeric Rating Scale (NRS). På en neurointensivvårdsavdelning (NIVA) i Stockholm har det beteendebaserade smärtskattningsverktyget- the Critical-Care Pain Observation Tool (CPOT), implementerats. Intensivvårdssjuksköterskorna på NIVA använder CPOT dagligen i sitt arbete. Som en del i implementeringsprocessen har denna enkätundersökning genomförts, med fokus på CPOT och dess användbarhet. Standarden ISO 9241-11 definierar begreppet användbarhet. Ledande komponenter i definitionen är – ändamålsenlighet och måluppfyllelse, effektivitet och tillfredsställelse. Syfte: Syftet med denna studie var att undersöka intensivvårdssjuksköterskors uppfattningar om användbarheten av the Critical-Care Pain Observation Tool – CPOT, hos verbalt icke kommunicerande patienter, på en neurointensivvårdsavdelning. Metod: Detta är en kvantitativ icke-experimentell tvärsnittsstudie. 32 intensivvårdssjuksköterskor har besvarat en enkät. Resultat och slutsats: Resultatet är en momentan mätning. Begreppet användbarhet har flera aspekter och resultatet kan tolkas på olika sätt. Intensivvårdssjuksköterskorna på NIVA har olika uppfattningar om CPOT och dess användbarhet. 84 % känner någon grad av tillfredsställelse med att använda CPOT på NIVA. De flesta uppfattar CPOT som effektiv. Respondenter har uttryckt svårigheter i att utföra smärtskattningar med hjälp av CPOT och delar av populationen ser brister i verktygets måluppfyllelse och ändamålsenlighet på NIVA. Klinisk betydelse: Implementeringsprocessen av CPOT på NIVA har en utvecklingspotential. Undersökningens resultat bör kunna användas vid fortsatt utvecklingsarbete i verksamheten.Background: Pain for the intensive care patient is a unique, subjective, unpleasant and multidimensional experience. The critical care nurse has a moral duty to relieve the patient’s pain. Non-verbal communicative intensive care patients can´t self-report and score their pain using the Numerical Rating Scale (NRS). At a neurological intensive care unit (neuro-ICU) in Stockholm, one behavior based pain scale, the Critical-Care PainObservational Tool (CPOT), has been implemented. The critical care nurses at the neuro-ICU use CPOT daily in their work. As a part of to the implementation process one self-administered questionnaire has been conducted with focus on the concept usability. The European Standard ISO 9241-11 defines the concept usability. Main components in the definition are the attainment of goals, suitability, effectiveness and satisfaction. Purpose: The aim of this research was to investigate critical care nurses’ perceptions of the usability of the Critical-Care Pain Observation Tool – CPOT, for non-verbal communicative patients, at a neurological intensive care unit. Method: The investigation is a quantitative questionnaire-based cross-sectional survey. 32 critical care nurses answered a questionnaire. Results and conclusion: The result is a momentary measurement. The concept usability has various aspects and the result can be interpreted in different ways. The critical care nurses at the neuro-ICU express varying opinions about CPOT and its usability. 84 % experience some degree of satisfaction using CPOTat the neuro-ICU. The majority perceive CPOT as effective. The respondents have expressed difficulties in carrying out pain assessments with the CPOT at the neuro-ICU, and part of the population see deficiencies in the tools goal attainment and suitability at the neuro-ICU. Clinical Significance: The implementation process of CPOT at the neuro-ICU shows potential for further development of CPOT within the organization. The results of the investigation should be able to be used for further development.
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Hoffstatter, John Arthur. "Preconceived Physician Attitude Toward Computerized Physician Order Entry (CPOE): Implications for Successful Implementation." UNF Digital Commons, 2004. http://digitalcommons.unf.edu/etd/240.
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There has been a societal and legislative push to implement computerized physician order entry (CPOE) systems throughout hospitals nationally in recent years due in large part to the public's awareness of an inordinate number of patient deaths due to medication errors in hospital settings. This mortality, and untold morbidity, became even more unacceptable when published findings suggested the majority of these 100,000 deaths each year could be avoided through the use of CPOE systems.
Yet acceptance has been slow and only a fraction of the hospitals have implemented this technology due to large start up costs, enormous technological requirements, and prior well-published failures of such attempts largely due to physicians' lack of acceptance.
A total of71 participants were surveyed whose daily responsibility involved the ordering of medications, to determine what attitudes they had concerning CPOE systems. This was done at a facility scheduled to implement such a system over the next year. The data showed evidence supporting many of the current implementation strategies, while suggesting modification of others.
Based on these findings, recommendations are made for future implementations with the hope of gaining enhanced physician acceptance and adoption, facilitating a more successful implementation of CPOE systems.
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Mana, Capelli Sebastian C. "CopB from Archaeoglobus fulgidus: a thermophilic Cu2+ transporting CPx-ATPase." Digital WPI, 2003. https://digitalcommons.wpi.edu/etd-theses/426.
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In this work we present the first characterization of a Cu2+-transporting ATPase. The thermophilic bacteria Archaeoglobus fulgidus contains two genes, CopA and CopB, encoding for CPx-ATPases. CopB belongs to the subgroup IB-4 of the CPX-ATPases. These enzymes are characterized by a CPH motif in the 6th transmembrane domain and a His-rich N-terminus metal binding domain (MBD). CopB was heterologously expressed in E. coli. Membranes were prepared and used to measure activity. CopB was active at high temperature (75º C), high ionic strength and pH 5.7. The enzyme was activated by Cu2+, and in to a lesser extent by Ag+ and Cu+. CopB showed a Vmax = 5 µmol/mg/h and a high apparent affinity (K1/2 = 0.28 ± 0.09 μM) for Cu2+. Uptake of 64Cu2+ into everted vesicles was also measured in order to show that Cu2+ is not only activating the enzyme but being transported. Compared with CopB-WT, CopB-T (lacking the N-terminus MBD) did not show any difference in its activation by the different metal ions, demonstrating that the cytoplasmic MBD has no role in the metal selectivity. CopB-T also showed a 40 % decrease in the ATPase activity. CopB-WT and CopB-T presented similar levels of phosphorylation. However, CopB-T exhibited a reduced rate of dephosphorylation (slower transition from the E2P to the E2 conformation). These observations suggest a regulatory role for the cytoplasmic MBD.
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Mana, Capelli Sebastian C. "CopB from Archaeoglobus fulgidus a thermophilic Cu²⁺ transporting CPx-ATPase." Link to electronic thesis, 2002. http://www.wpi.edu/Pubs/ETD/Available/etd-0428103-100252/.
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Sachidanandam, Sivanarulselvan. "Why Physicians Do Or Do not Use Computerized Physician Order Entry Systems: Applying the Technology Acceptance Model." Connect to this title online, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=bgsu1151258487.
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Furlan, Andrej. "Fullerene-like CNx and CPx Thin Films; Synthesis, Modeling, and Applications." Doctoral thesis, Linköping : Department of Physics, Chemistry and Biology, Linköpings universitet, 2009. http://www.bibl.liu.se/liupubl/disp/disp2009/tek1247s.pdf.
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Rosa, Rosimeire Takaki. "Detecção do polimorfismo genetico de Streptococcus mutans isolados de individuos livres de carie (CPOD=0)." [s.n.], 2001. http://repositorio.unicamp.br/jspui/handle/REPOSIP/288632.
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Orientador : Reginaldo Bruno GonçalvesDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: A presente pesquisa teve por objetivo analisar a variabilidade infraespecífica de cepas de Streptococcus mutans isoladas de indivíduos livres de cárie. Foram coletadas amostras de saliva total não estimulada, placa dental e de dorso de língua de indivíduos que apresentavam índice CPOD igual a zero. Após dispersão e diluição seriada das amostras, alíquotas de cada diluição foram inoculadas em meio Mitis Salivarius Bacitracina Agar (MSB). Após incubação em estufa de pC02 10% a 37°C, foram isoladas do meio colônias com morfologia típica de estreptococos, para posterior identificação por provas bioquímicas. As amostras foram incubadas em caldo de Infusão de Cérebro e Coração (BHI), centrifugadas e lavadas, sendo os sedimentos obtidos submetidos ao processo de extração das proteínas intracelulares. Os extratos protéicos foram separados por eletroforese em gel de amido e corados especificamente para a detecção do polimorfismo isoenzimático. Os géis foram analisados através dos sistemas enzimáticos: leucina aminopeptidase (LAP), manitol 1-fosfato desidrogenase (MIP), manose fosfato isomerase (MPI), nucleosídio fosforilase (NSP), fenilalanil leucina peptidase (PLP) e transaminase glutâmico-oxalacética (GOT). A análise comparativa dos perfis da eletroforese de isoenzimas (Multilocus Enzyme Electrophoresis-MLEE) dos isolados, acessada pela soma de todos sistemas enzimáticos, permitiu observar a ocorrência de dois ou mais clones de S. mutans nos diferentes sítios nestes voluntários. Os resultados obtidos mostram que pode ser encontrado mais de um tipo genético de S. mutans colonizando os diferentes sítios em um mesmo indivíduo
Abstract: The current research had as aim to analyze the infra-specific variability of Streptococcus mutans strains obtained from caries-free individuals. Non-stimulated whole saliva, dental biofilm and tongue dorsum samples were collected from subjects with DMFT = O. After dispersing and decimal dilutions, aliquots from each dilution were inoculated in Mitis Salivarius Bacitracin (MSB) agar plates, in duplicate. After growing at pCO2 100,/0 and 37°C, it was taken some S. mutans suspect colonies that were biochemically identified. S. mutans-positive colonies were grown in Brain Heart Infusion (BHI) broth, they were centrifuged and washed. The pellets were submitted to cell disruption and protein extraction. Protein extracts were separated by starch gel electrophoresis and specifically stained in order to obtain the isoenzymic polymorphism. The gels were analyzed for enzymatic systems: leucine amino peptidase (LAP), mannitol-l-phosphate dehydrogenase (MIP), mannose phosphate isomerase (MPI), nucleoside phosphorylase (NSP), phenylalanyl leucine peptidase (PLP) e glutamic-oxalacetic transaminase (GOT). The comparative analysis of MLEE profiles assessed by the sum of all enzymatic systems allowed the observation of occurrence of one or more S. mutans dones, varying in the different intra oral sites among these volunteers. The obtained results showed that it may be found more than one genetic type of such S. mutans colonizing different sites in a same subject
Mestrado
Mestre em Biologia e Patologia Buco-Dental
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Visinoni, André. "Le desequilibre psychopathique au cpoa (centre psychiatrique d'orientation et d'accueil) : aspects statistiques, cliniques et psychopathologiques." Reims, 1989. http://www.theses.fr/1989REIMM113.
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Crenshaw, Chelsea Leigh. "The effects of augmentation of coarse particulate organic matter in hyporheic sediments." Thesis, Virginia Tech, 2000. http://hdl.handle.net/10919/36070.
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Metabolic and biogeochemical processes in hyporheic zones may depend on inputs of coarse particulate organic matter. Our research focused on how differing quantity and quality of organic matter affects metabolism and nutrient retention in the hyporheic zone of a low-order Appalachian stream. We hypothesized that hyporheic metabolic rates should increase with organic matter additions because the biotic activity is limited by organic matter availability. Four sets (n=4 amendments/set) of plots were established on a tributary of Hugh White Creek, NC. Sediment was extracted and was either supplemented with leaves, wood, or plastic strips, or sediments remained unamended sediments. Following augmentation sediments were reimbedded and approximately three months later sediment was removed from each plot. Aerobic and anaerobic metabolism were measured as the change in O2, and CO2 in recirculating microcosms. At the same time, we monitored other possible terminal electron accepting processes and changes in nutrients. Aerobic metabolism was low in all treatments and respiratory quotients calculated for all treatments indicated that metabolism was dominated by anaerobic processes. Anaerobic and total (combined aerobic and anaerobic) respiration rates were significantly greater (P < 0.05) in plots treated with leaf organic matter compared to controls. Nutrient retention (NO3-N, NH4-N, and DOC) was enhanced in augmented treatments. Measured losses of dissolved organic carbon accounted for 50% total carbon liberated by respiration in amended sediments, whereas in unamended sediments loss of DOC represented only 7% of measured respiration. Augmentation with greater quality organic matter stimulated respiration in hyporheic sediments. Anaerobic processes dominated metabolic rates in both control and amended sediments. Enhanced metabolic rates increased retention of many solutes indicating that energy flow and nutrient dynamics in the subsurface of streams may depend upon the quantity and quality of imported carbon.Master of Science
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Carter, Henry M. "Relationship Between Hospital Performance Measures and 30-Day Readmission Rates." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2958.
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Medical errors occur at the prescription step due to lack adequate knowledge of medications by the physician, failure to adhere to policies and procedures, memory lapses, confusion in nomenclature, and illegible handwriting. Unfortunately, these errors can lead to patient readmission within 30 days of dismissal. Hospital leaders lose 0.25% to 1% of Medicare’s annual reimbursement for a patient readmitted within 30 days for the same illness. United States, lawmakers posited the use of health information technology, such as computerized physician order entry scores systems (CPOES), reduced hospital readmission, improved the quality of service, and reduced the cost of healthcare. Grounded in systems theory, the purpose of this correlational study was to examine the relationship between computerized physician order entry scores, medication reconciliation scores, and 30-day readmission rates. Archival data were collected from 117 hospitals in the southeastern region of the United States. Using multiple linear regression to analyze the data, the model as a whole did not significantly predict 30-day hospital readmission rate, F (2, 114) = 1.928, p = .150, R2 = .033. However, medical reconciliation scores provided a slightly higher contribution to the model (β = .173) than CPOES (β = .059. The implications for positive social change included the potential to provide hospital administrators with a better understanding of factors that may relate to 30-day readmission rates. Patients stand to benefit from improved service, decreased cost, and quality of healthcare.
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Furlan, Andrej. "Experiments and Theoretical Modeling of Fullerene-like CNx and CPx Thin Film Structures." Licentiate thesis, Linköping : Department of Physics, Chemistry and Biology, Linköpings universitet, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-8057.
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Rosa, Antonio Galvao Fortuna. "Características epidemiológicas da cárie dental na dentição permanente de escolares do grupo etário de 7 a 14 anos no Estado de São Paulo." Universidade de São Paulo, 1987. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-27072016-165532/.
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Em 1980 e 1982 foram realizados estudos epidemiológicos da cárie dental abrangendo a área geográfica do Estado de São Paulo. Os levantamentos foram realizados em todas escolas da rede estadual de ensino que possuíam assistência odontológica. Os examinadores receberam por escrito as instruções sobre critérios de exame e preenchimento das fichas. No primeiro levantamento foram examinados 270.736 escolares do grupo etário de 7 a 14 anos e em 1982 foram examinados 144.480 escolares do mesmo grupo etário, sendo utilizado o índice CPOD nos dois levantamentos. Foram coletados dados apenas referentes aos dentes permanentes e o processamento foi executado pela PRODESP (Processamento de Dados do Estado de são Paulo). Foram tabulados o número médio de dentes atacados pela cárie, segundo a idade e o sexo considerando-se: prevalência de cárie no grupo etário de 7 a 14 anos, dentes anteriores e posteriores, lado direito e lado esquerdo, dentes superiores e inferiores, primeiros molares e quadrantes. Foram também avaliados o número médio de dentes irrompidos, hígidos e necessidades de tratamento. Os resultados encontrados em 1982 são similares aos de 1980 e também semelhantes aos resultados obtidos em alguns estudos realizados em outras regiões do Brasil. O CPOD médio aos doze anos de idade foi 7,24 em 1980 e 7,13 em 1982, sendo mais do que o dobro da meta da Organização Mundial de Saúde para o ano 2.000 (CPOD 12 < 3).Epidemiological studies on dental caries were carried out covering a geographical area of the state of São Paulo, Brazil, in 1980 and 1982. All the schools belonging to the state teaching network, which had odontological assistance, took part in the surveys. The examiners received written instructions on the examination criteria as well as on how to fill out the charts. At the first survey, 270.736 school children of the 7-14 years age-group were examined and, in 1982, 144.480 school children of the same age-group were examined, being used in both surveys the DMFT index. The data collected refer only to permanent teeth; the processing was worked out by the PRODESP (Data processing of the State of São Paulo). The average number of teeth attacked by caries was computed according to age and sex, taking into account: caries prevalence in the 7-14 years age-group, anterior and posterior teeth, right and left sides, upper and lower teeth, first molars and quadrants. The average number of erupted, sound teeth, as well as the needs for treatment, were also estimated. The results found out for 1982 are similar to those of 1980, being a1so similar to the results of some studies carried out in other regions of Brazil. The average DMFT for the age of 12 years was 7.24 in 1980 and 7.13 in 1982, being more than the double of the value of the World Health Organization goal for the year of 2.000 (DMFT12 < 3).
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Lagos, Pérez Mauricio. "Prevalencia de caries dental y de pérdida de dientes en la población adulta mapuche-wuilliche de Isla Huapi, Provincia de Vladivia, Región de los Ríos, Chile." Tesis, Universidad de Chile, 2009. http://repositorio.uchile.cl/handle/2250/135316.
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Trabajo de Investigación Requisito para optar al Título de Cirujano DentistaAutor no autoriza el acceso a texto completo de su documento
La caries dental es una enfermedad de alta prevalencia y severidad en todas las poblaciones. En los países industrializados afecta a más de la mitad de la población y, debido a que el proceso es acumulativo, se presentan más individuos afectados a medida que aumenta la edad (Petersson y Bratthall 1996; Burt 2005; Griffin y cols. 2005). Distintos estudios muestran que la caries dental en determinados lugares afecta entre 5 a 10 dientes por individuo, siendo la principal causa de pérdida de dientes en adultos, lo que se traduce en menor calidad de vida de la población y alto costo económico tanto para los individuos como para el estado, lo que la convierte en un problema de salud publica (Papas y cols. 1992; Winn y cols. 1996; Slade y Spencer 1997; Fejerskov y kidd 2005). La organización mundial de la salud señala que las enfermedades crónicas asociadas a una pobre salud oral se encuentran en un constante aumento en los países en vías de desarrollo, particularmente las perdidas de dientes, de caries dental y prevalecías de enfermedad periodontal (Burt 2005; Petersen y Yamamoto 2005, WHO 1978). La caries dental se considera dentro del grupo de las enfermedades comunes y complejas o multifactoriales, como lo son el cáncer, la diabetes o las enfermedades cardiacas, donde existen varios factores etiológicos, como la acción de varios genes, factores ambientales, culturales, sociales y locales (Fejerskov 1997).
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Sousa, Maria da Luz Rosário de. "Risco de cárie: relação entre incidência de cárie e como variáveis manchas brancas, índice CPOS, superfícies de cárie e velocidade de fluxo de salivar." Universidade de São Paulo, 1995. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-01022018-114501/.
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O objetivo deste trabalho é analisar o Risco de Cárie através de variáveis microbiológicas: Risco Bacteriológico e da Resazurina (RB e RE); e de variáveis clínicas (superfícies de cárie, índice CPOS, manchas brancas e velocidade de fluxo salivar) designadas RF, num estudo longitudinal de 2 anos. A amostra inicial era de 97 escolares (11-13 anos) resgatando-se 55 ao final. Utilizou-se a técnica estatística Análise de Variância (ANOVA) e Comparações Múltiplas pelo Método de Tukey, com 5 por cento de significância, além do Teste de McNemar para verificar se RF era um bom triador dos grupos de risco. Os resultados mostraram que o teste RB (contagem de Streptococcus mutans na saliva) conseguiu determinar o grupo de alto risco que apresentou maior incidência de cáries. Este grupo foi melhor identificado quando a variável resposta foi incidência de cáries mais incidência de manchas brancas do que somente a incidência de cáries. Estes resultados foram semelhantes para RF. Não se conseguiu com RE, no entanto, diferenciar os grupos de risco ao nível de 5% de significância. Assim, conclui-se que tanto a variável microbiológica (RB) como as clínicas são bons parâmetros para determinar o grupo de alto risco de cárie.The purpose of the present study was to analyse the Risk of Caries, through microbials variables - Bacteriology and Resazurin Risk (RB and RE); and clinical variables (RF) over a 2-yr period. Data are based on 97 school children (11-13 years old), recovering 55 at the final of the study. ANOVA and Tukey Test were applied at 5 per cent of significance, in addition the McNemar Test was applied to verify if RF was a good selector of the risk groups. The results showed that RB Test (number of Streptococcus mutans in saliva) identified people at higher risk of developing dental caries. This group was better identified when the resultant variable was incidence of caries plus incipient smooth surface lesions than only incidence of caries. These results were the same for RF. RE can\'t identify the groups of risk at 5 per cent of significance. It was concluded that both microbial (RB), and clinical variables were good parameters to identify people at high caries risk.
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MUSSO, V. F. "Desigualdades na Distribuição da Cárie Dentária aos 12 Anos no Brasil." Universidade Federal do Espírito Santo, 2008. http://repositorio.ufes.br/handle/10/5391.
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Previous issue date: 2008-03-27Objetivo: Analisar as desigualdades na distribuição da cárie dentária entre crianças brasileiras na idade de 12 anos, caracterizando, nos planos individual e municipal, o grupo mais atingido pela doença. Método: Trata-se de um estudo de natureza quantitativa que utilizou dois desenhos. No primeiro, as unidades de análise foram indivíduos e no segundo, as unidades de análise foram agregados populacionais em municípios. A variável de desfecho foi o índice CPOD categorizado em 2 grupos: o grupo com maior severidade de cárie dentária e o grupo com menor severidade de cárie dentária. As medidas de experiência de cárie dentária foram obtidas dos levantamentos epidemiológicos de saúde bucal realizados no Brasil em 1986 e em 2002-2003. As informações sobre características socioeconômicas municipais foram obtidas no Atlas de Desenvolvimento Humano no Brasil. Resultados: Em 2003, no estudo de nível individual, o valor do índice CPOD aos 12 anos no grupo com maior severidade de cárie dentária foi 6 vezes maior que a média do CPOD no restante da população. A desigualdade na distribuição de cárie dentária, medida pelo coeficiente de Gini, aumentou 67,7% entre 1986 e 2003. O grupo com maior severidade de cárie dentária foi significativamente associado à condições sociodemográficas. Crianças do sexo feminino, estudantes de escolas públicas, estudantes de escolas localizadas em zona rural, residentes em municípios: sem água de abastecimento fluoretada, com porte menor que 100 mil habitantes e localizados na região Centro- Oeste apresentaram maior prevalência de CPOD > 4. No nível municipal, em 2003, a média do índice CPOD aos 12 anos nos municípios do grupo com maior severidade de cárie dentária foi 2 vezes maior que no restante dos municípios. Os municípios com maior severidade de cárie dentária apresentaram piores perfis de condições socioeconômicas e de provisão de água de abastecimento fluoretada. Apenas uma variável, o tempo de fluoretação das águas de abastecimento, correlacionou significativamente com o CPOD no grupo com maior severidade de cárie dentária. No grupo com menor severidade de cárie dentária, a análise de regressão linear múltipla, identificou apenas o tempo de fluoretação das águas de abastecimento e o percentual de domicílios ligados à rede geral de abastecimento de água como estatisticamente significantes com a variação do CPOD. Conclusão: Os resultados deste estudo evidenciam grandes diferenças na experiência de cárie dentária aos 12 anos no Brasil. Nesse sentido, destaca-se a necessidade de se conhecer o perfil da doença em unidades menores como os municípios. Reafirma-se o importante papel da água fluoretada no controle da doença e sugere-se, com base nas desigualdades observadas, que as políticas públicas de saúde bucal no Brasil sejam adequadas à magnitude das desigualdades identificadas, pois não apreender as diferenças entre populações pode significar a padronização das mesmas políticas de saúde para todos.
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Juergens, Jason M. "CPO leadership unique and innovative leadership characteristics of senior enlisted that sustain Naval operations /." Thesis, Monterey, California : Naval Postgraduate School, 2010. http://edocs.nps.edu/npspubs/scholarly/theses/2010/Mar/10Mar%5FJuergens.pdf.
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Thesis (M.S. in Management)--Naval Postgraduate School, March 2010.Thesis Advisor(s): Crawford, Alice M. ; Thornberry, Neal E. "March 2010." Description based on title screen as viewed on April 28, 2010. Author(s) subject terms: Manpower; Recruiting; Retention; Personnel/Attrition; Special Studies; Training; Leadership. Includes bibliographical references (p. 105-110). Also available in print.
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Legatzki, Antje. "Charakterisierung zweier CPx-Typ ATPasen und deren Zusammenwirken mit anderen Metall-Effluxsystemen in Ralstonia metallidurans." [S.l. : s.n.], 2003. http://deposit.ddb.de/cgi-bin/dokserv?idn=970626460.
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Favarini, Mariza Ochoa. "Escolares livres de cárie e severidade da doença aos 12 anos em dois distritos de saúde de Porto Alegre, 2002." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2003. http://hdl.handle.net/10183/3549.
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Conhecer o número de crianças livres de cárie, a prevalência e severidade dessa doença em escolares de 12 anos nos Distritos de Saúde Norte e Nordeste da cidade de Porto Alegre, bem como o SIC Index ( Índice Significante de Cárie) desses distritos, foi o objetivo desta pesquisa. A maior parte da metodologia foi baseada no Ministério de Saúde e na OMS. Foram utilizadas duas amostras independentes de escolares de 12 anos: uma amostra de 282 alunos do Distrito Norte e uma amostra de 220 escolares do Distrito Nordeste. Os dados foram coletados a partir de exames clínicos. Para conhecer a experiência de cárie foi utilizado o índice CPO-D. Utilizou-se o teste t para comparação das médias de CPO-D entre os dois distritos. Para avaliar as associações entre crianças livres de cárie, sexo, distritos e componentes do CPO-D utilizou-se o teste qui-quadrado, com um nível mínimo de significância de 5% para ambos os testes. O número de crianças livres de cáries cavitadas foi de 62,8% e 55,0% nas regiões Norte e Nordeste, respectivamente. O CPO-D foi de 0,89 no Distrito de Saúde Norte e 1,0 no Distrito de Saúde Nordeste. Não houve diferença significativa estatisticamente na proporção de crianças livres de cárie e nas médias de CPO-D entre os dois distritos. Porém, em relação aos componentes do CPO-D, houve diferença significativa estatisticamente entre os distritos. O Distrito de Saúde Norte apresentou um número maior de dentes restaurados e um número menor de dentes cariados e perdidos, indicando uma condição de acesso a tratamento odontológico maior do que no Distrito de Saúde Nordeste. Provavelmente isso se deve a uma maior vulnerabilidade social existente no Distrito Nordeste. Concluiu-se que mais da metade da população de 12 anos dos Distritos Norte e Nordeste da cidade de Porto Alegre encontra-se livre de lesões de cáries cavitadas; o índice de CPO-D médio dos dois distritos estudados indica uma prevalência muito baixa da doença, segundo classificação da OMS; não se encontrou diferenças entre os sexos em relação à experiência da doença; houve diferenças significativas entre os componentes de CPO-D em relação aos distritos; os molares inferiores foram os dentes mais atingidos pela cárie dentária; o SIC Index nos dois distritos estudados atingiu as metas propostas pela OMS para 2015, ou seja, apresentaram um CPO-D menor que 3,0.
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Jeldes, Andrade Gabriela Cristina. "Prevalencia de caries en población de escolares de 6 a 12 años, necesidad de tratamiento restaurador y recursos humanos necesarios para la Provincia de Santiago, Región Metropolitana." Tesis, Universidad de Chile, 2017. http://repositorio.uchile.cl/handle/2250/146552.
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Trabajo de Investigación Requisito para optar al Título de Cirujano DentistaIntroducción: La caries dental corresponde a la enfermedad crónica no transmisible más prevalente en Chile y el mundo, afectando dentición tanto primaria como permanente. Es importante el levantamiento de evidencia para poder trazar una línea base sobre la condición de salud oral en nuestro país y de esta forma ir comparando en el transcurso del tiempo la modificación de estas cifras, todo esto para evaluar el impacto de las distintas medidas llevadas a cabo para mejorar la salud de los grupos objetivos. El propósito de esta investigación es entregar datos epidemiológicos actualizados desde la última implementación de la Estrategia Nacional de Salud, contribuyendo al fortalecimiento de las políticas públicas en salud oral. Materiales y métodos: Se evaluaron 1340 escolares entre 6 y 12 años de edad, seleccionados aleatoriamente, de distinto estrato socioeconómico de 7 colegios de la Provincia de Santiago. Se realizó el examen clínico intraoral por dos examinadores calibrados que utilizaron los criterios de la OMS para determinar historia de lesiones de caries según los índices COPD/ceod. Se determinó prevalencia de caries dental mediante los índices COPD/ceod y necesidad de tratamiento restaurador de acuerdo al daño encontrado. A su vez, se realizó comparación de los índices entre los distintos estratos socioeconómicos, entre todas las edades de la muestra y sexo. Los datos fueron analizados mediante el programa estadístico SPSS y se realizaron pruebas no paramétricas de Kruskal-Wallis y U Mann-Whitney con un valor de significancia estadística del 95% (p<0,05). Resultados: La prevalencia de caries, de niños y niñas entre 6 y 12 años, en dentición permanente medida con COPD fue de 24,5%, mientras que para dentición primaria medida con ceod fue de 47,8%. La necesidad de tratamiento restaurador, en términos de dientes con lesiones de caries cavitadas, encontrada en la muestra de estudio correspondió a 200 dientes permanentes y 827 dientes primarios. Las horas profesionales necesarias destinadas a tratamiento restaurador para el daño encontrado en la muestra de estudio al momento del examen corresponde a 240 horas odontológicas para dentición permanente y 993 horas para dentición primaria. Conclusiones: La prevalencia de caries dental en escolares de 6 a 12 años de la Provincia de Santiago correspondió a cifras menores a las consignadas en el Diagnóstico de Salud Oral del Ministerio de Salud del año 2007. Por otra parte, la necesidad de tratamiento restaurador para las lesiones de caries cavitadas corresponde a 573.989 dientes permanentes y primarios, por lo que para cubrir esta necesidad de tratamiento restaurador, para los escolares del grupo estudiado, de la Provincia de Santiago, se necesitarían 688.788 horas odontológicas.
Adscrito a Proyecto FONIS-CONICYT SA14/D0056 "Prevalencia de la hipominerailzación incisivo molar en niños de 6 a 12 años y determinación de sus consecuencias clínicas"
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Knabben, Ramon Mendes. "Desenvolvimento do trailer-CPX e de uma mistura asfáltica de baixa emissão de ruído pneu-pavimento." reponame:Repositório Institucional da UFSC, 2017. https://repositorio.ufsc.br/xmlui/handle/123456789/181238.
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Tese (doutorado) - Universidade Federal de Santa Catarina, Centro Tecnológico, Programa de Pós-Graduação em Engenharia Civil, Florianópolis, 2017.Made available in DSpace on 2017-11-21T03:19:21Z (GMT). No. of bitstreams: 1 348631.pdf: 10546448 bytes, checksum: f274bd4590b9dc08c54aca56905af47b (MD5) Previous issue date: 2017
O ruído gerado pelo tráfego de veículos vem sendo prioridade nos estudos em diversos países desenvolvidos, pois se trata de um dos problemas ambientais mais relevantes, principalmente em zonas residenciais. Em muitos destes países, o ruído veicular é o primeiro critério de escolha do tipo de revestimento do pavimento. A geração e a propagação do ruído dos veículos são regidas por vários e diferentes mecanismos. O ruído gerado pela interação pneu-pavimento passa ser a fonte dominante quando o veículo trafega em velocidades acima de 50 km/h. No entanto, no futuro, em que os carros comuns serão substituídos por carros elétricos o ruído veicular será gerado principalmente pela interação pneu- pavimento para qualquer velocidade. Com isso, há que se buscar meios para a mitigação do ruído, seja através do desenvolvimento tecnológico dos pneus, ou principalmente, através do desenvolvimento dos revestimentos asfálticos de baixo ruído. Nesse trabalho foi desenvolvido um trailer com o objetivo de medir o ruído da interação pneu-pavimento em campo. O trailer é do modelo Trailer-CPX (Close Proximity Method), nome que se refere ao método normalizado de medição da interação pneu- pavimento. Foram realizadas as medições em campo utilizando o Trailer- CPX em diferentes tipos de revestimento de pavimento existentes. Ainda foi desenvolvida uma mistura asfáltica de elevada capacidade de absorção sonora com o objetivo de reduzir o ruído da interação pneu-pavimento, propiciando a geração de revestimentos de baixo ruído. Para tanto foi realizado a otimização da textura e da porosidade dessa mistura asfáltica avaliando-se o coeficiente de absorção sonora com o método normalizado que utiliza o tubo de impedância. Por fim, foram desenvolvidos modelos que possam prever o ruído gerado pela interação pneu-pavimento através das propriedades das misturas asfálticas e das características da superfície do revestimento. O Trailer-CPX foi construído e qualificado de acordo com norma ISO 11819-2 (2010) e todos os resultados das medições realizadas para a sua certificação foram atendidos. Os resultados dos ensaios com o Trailer mostraram que a macrotextura das misturas densas tem grande influência na geração do ruído pneu-pavimento. A camada porosa de atrito (CPA) foi a que apresentou menor índice de ruído (CPXI) quando comparada com os demais revestimentos estudados.
Abstract : The noise generated by the vehicle traffic is being priority in the studies in several developed countries, for it addresses one of the most relevant environmental problems, mainly in residential areas. In many of these countries, the vehicular noise is the first criteria of choice of the type of pavement surface. The generation and propagation of vehicle noise are governed by several and different mechanisms. The noise generated by the tire-pavement interaction comes to be the dominant source when the vehicle transits in speeds above 50 km/h. However, in a future, in which regular cars will be replaced by electric cars, the vehicular noise will be generated mainly by the tire-pavement interaction for any speed. With that, we have to seek means to the mitigation of this noise, either through the technological development of tires, or mainly, through the development of low noise asphaltic surface. In this study it was developed a trailer with the objective of measuring the tire-pavement interaction noise in the field. The trailer is of the Trailer-CPX (Close Proximity Method) model, name that refers to the measuring method of the tire- pavement interaction. The measurements in the field were performed using the Trailer-CPX in different types of existing pavement surface. Also in this study, it was developed an asphaltic mixture of high capacity of sound absorption with the objective of reducing the tire-pavement interaction noise, propitiating the generation of low noise coverings. In order to do that, it was carried out the optimization of the texture and the porosity of that asphaltic mixture evaluating the sound absorption coefficient with the normalized method that uses the impedance tube. Finally, it were developed methods that can predict the noise generated by the tire-pavement interaction through the properties of the asphaltic mixtures and of the characteristics of the surface. The Trailer-CPX was built and qualified in accordance with ISO 11819-2 (2010) and all the results of the measurements made for its certification were met. The results of the tests with the Trailer showed that the macrotexture of the dense mixtures has great influence in the generation of the tire-pavement noise. The porous asphalt was the one with the lowest noise index (CPXI) when compared to the other surface studied.
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Saxin, Jonathan. "Jämförelse av Polar Vantage V ”Konditionstest” med direkt mätning av VO2max." Thesis, Linnéuniversitetet, Institutionen för idrottsvetenskap (ID), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-104215.
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Bakgrund: Det finns flertalet modeller av pulsklockor på marknaden med funktioner som skall kunna uppskatta individens maximala syreupptagningsförmåga. En av dessa modeller är Polar Vantage V, som enligt tillverkaren kan uppskatta individens VO2max genom funktionen”konditionstest”. Testet utförs genom ett fem minuters vilotest. Testvärdet beräknas sedan från hjärtfrekvens samt personliga faktorer. Syfte: Studien jämförde Polar Vantage V uppskattade testvärde med en direkt mätning av VO2max, med frågeställningen om detta test var pålitligt och användbart i praktiken. Metod: En experimentell studiedesign användes som inkluderade 11 män samt 5 kvinnor som deltagare (N=16). Alla deltagare utförde Polar Vantage V’s konditionstest i vila, för att sedan utföra en maximal prestation utfört på löpband. För mätning av VO2max användes ergospirometri-systemet Jaeger®Vyntus CPX med halvmask. Resultat:Kendall Tau-b test visade signifikant starkt positivt samband mellan Vantage V’s testvärde och VO2max från Vyntus CPX. Wilcoxon Signed Rank test visade ingen signifikant skillnad mellan testvärdet (grupp medelvärde) från Vantage V och Vyntus CPX. Slutsats: På grund av stora individuella skillnader i testvärdet mätt med ”Konditionstestet” från Vantage V, bör individen tolka resultatet med aktsamhet. Vantage V’s ”Konditionstest” verkar emellertid kunna ge en bra uppskattning av VO2max på gruppnivå för friska vuxna i 20-36 års ålder.Background: There are several models of fitness devices on the market with functions that claims to have the capability to estimate the capacity of a individuals maximum oxygen uptake. One of these models is the Polar Vantage V fitness watch, which according to the manufacturer can estimate the VO2max through the function "Fitness test". The test is performed through a five-minute rest test. The test result is then calculated thru various variables such as the individuals resting heart rate and personal factors. Purpose: To assess the estimated test value of the Polar Vantage V “Fitness test” with a direct measurement of VO2max, with the research question whether this test was valid and useful in practice. Method: This study used an experimental design and included 11 men and 5 women as participants (N = 16). All participantsfirst performed the Polar Vantage V's “Fitness test”, then proceeded to perform a maximum performance using a treadmill. For measurement of VO2max, the cardiopulmonary exercisetesting system Jaeger®Vyntus CPX with half mask was used. Results: Kendall Tau-b test presented a significant strong positive relationship between Vantage V’s “Fitness test” and VO2max -value from the Vyntus CPX. The Wilcoxon Signed Rank test presented a nonsignificant difference between the test value (group mean value) from Vantage V “Fitness test”and VO2max from Vyntus CPX. Conclusion: Due to large individual differences in the test value measured by the "Fitness test" from Vantage V, one should interpret the test-result with care. However, the Vantage V "Fitness test" seems to be able to provide a good estimate of theVO2max at group level in healthy adults aged between 20-36.
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Morgan, Brendan C. "EFFECTS OF REDUCED DETRITUS ON INVERTEBRATE COMMUNITY STRUCTURE IN COSTA RICAN HEADWATER STREAMS." Kent State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=kent1430932604.
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Johnson, Marion. "Developing Policies and Guidelines to Prevent Medication Errors and ADEs in Nursing Homes." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2088.
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According to the National Patient Safety Foundation, more than 1.5 million Americans are affected by medication errors because of varied factors including miscommunication, bad handwriting, name confusion, poor packaging, and metric or other dosing unit errors. This project addressed medication errors and adverse drug events by developing policy and practice guidelines to support and aid the utilization of health information technology (HIT) systems in addressing medication errors and adverse drug events at a local nursing home in Cincinnati, Ohio. The National Quality Strategy Framework was used by a team of interdisciplinary stakeholders as a guide for the development of policies and practice guidelines. An interdisciplinary project team of institutional stakeholders was led by the DNP student through a review of literature to assess the effectiveness of current policies and guidelines and explore areas for improvement. New policy, practice guidelines, and educational materials were developed, along with plans for implementing and evaluating the policies in the institution. Policy and practice guidelines were shared with 4 scholars possessing expertise in health information technology to validate content of the products. Feedback was used to inform revision and preparation of final policy, practice guidelines, educational materials, and plans for implementation and evaluation. The implementation plan advocates a process that includes multiple stakeholders and institutional preparatory stages. The evaluation plan addresses multiple outcomes related to efficiency and patient safety, and proposes both intermediate and long-term evaluation based on comparisons of pre-post metrics routinely collected by the institution. Following implementation and evaluation, dissemination of results of the project may stimulate positive social change by reducing medication errors in similar health care institutions that adopt related measures.
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Farías, Alderete Fabián Alejandro. "Parámetros salivales en niños de 6 años de edad de la Zona Norte de la Región Metropolitana de nivel socioeconómico medio-bajo con diferentes índices de caries dental (COPD/ceod)." Tesis, Universidad de Chile, 2015. http://repositorio.uchile.cl/handle/2250/141436.
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Trabajo de Investigación Requisito para optar al Título de Cirujano DentistaIntroducción: La Caries dental es una enfermedad crónica, con etiología multifactorial y la más propagada a nivel mundial, donde la influencia de factores protectores o de riesgo, pueden modificar cómo los tejidos dentarios reaccionan a los desechos ácidos producidos por las bacterias. Uno de estos factores, es la saliva, que tiene un importante efecto protector contra la caries dental cuando sus múltiples características y funciones están normales. Objetivo: Correlacionar niveles de pH, capacidad buffer, carbohidratos, fluoruros y fosfatos en saliva, en niños de 6 años de edad de la zona norte de la Región Metropolitana de nivel socioeconómico medio-bajo y bajo con índices de caries dental (COPD/ceod). Materiales y Métodos: Estudio de tipo transversal, asociativo, aleatorizado y descriptivo. Se analizaron 56 muestras de saliva en niños de 6 años de edad de la zona norte de la región metropolitana de NSE medio-bajo y bajo con diferente índice de caries dental (COPD/ceod). El pH y la capacidad Buffer fueron determinados mediante uso de un microelectrodo de pH. Carbohidratos y fosfatos fueron analizados espectrofotométricamente y fluoruros mediante métodos de potenciometría. Para la normalidad de la distribución de datos se utilizó el test Shapiro Wilk. Las variables salivales medidas no presentaron distribución normal excepto el fluoruro con quien se utilizó el test de ANOVA con Bonferroni. Para determinar significancia estadística entre índice de caries y los factores de riesgo se utilizó el test de Kruskall Wallis. La asociación entre factores de riesgo e índice de caries, se determinó a través del análisis de regresión logística univariado y multivariado. Resultados: La concentración de fluoruros y de glucosa mostró estadística significativa (p<0.05) con el índice de caries dental (COPD/ceod). Se describe como factor de riesgo de caries el NSE. Conclusiones: Existen diferencias estadísticamente significativas en la concentración de fluoruros entre niños de 6 años de edad con diferente índice de caries dental. Existe asociatividad entre la concentración de fluoruros y la concentración de carbohidratos en saliva, con índice de caries dental (COPD/ceod) en niños de 6 años de la zona norte de la Región Metropolitana de NSE medio-bajo y bajo.
Adscrito a Proyecto FONIS SA 13/20205
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ROCHA, L. Z. "Aspectos Epidemiológicos e Percepção da Qualidade de Vida em Indivíduos Alcoolistas Sem Cirrose, Cirróticos Alcoolistas e Cirróticos Não Alcoolistas Assistidos no Hospital Universitário Cassiano Antônio Moraes Hucam, Portadores de Doença Periodontal e Perda Dentária." Universidade Federal do Espírito Santo, 2016. http://repositorio.ufes.br/handle/10/8205.
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Previous issue date: 2016-03-28Introdução: As doenças periodontais podem ser causas e consequências de doenças sistêmicas. A cirrose hepática é considerada um fator de risco para doenças periodontais e piora da qualidade de vida. Poucos trabalhos existem na literatura avaliando o impacto do alcoolismo na saúde bucal. Objetivos: levantar dados epidemiológicos e avaliar as condições bucais e qualidade de vida dos pacientes alcoolistas e cirróticos atendidos no Hospital Universitário Cassiano Antônio Moraes. Materiais e métodos: 112 alcoolistas não cirróticos, 50 cirróticos alcoolistas e 15 cirróticos não alcoolistas foram examinados, avaliando o estado dos dentes, da condição periodontal, do uso e necessidade de prótese e a qualidade de vida relacionada à saúde bucal. Resultados: dentes cariados foram observados em 34,82% dos alcoolistas, com média de 2,89 dentes, 30,00% dos cirróticos alcoolistas e 33,33% de cirróticos não alcoolistas. A perda dentária ocorreu em 69% de todos os pacientes avaliados, sendo observada em média 12,8 extrações. A maioria dos pacientes necessitava de próteses dentárias, mas não usavam. A condição periodontal mostrou-se elevada, demonstrando 5,1 e 5,6 sítios acometidos por nível clínico de inserção maior que 6 mm em cirróticos e alcoolistas, respectivamente. A qualidade de vida mostrou-se comprometida, semelhante aos pacientes com doenças periodontais. Conclusão: as condições periodontais dos pacientes alcoolistas crônicos apresentam comprometimento maior do que a população geral, semelhante aos pacientes com cirrose hepática.
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Aleixo, Rodrigo Queiroz. "Índice CPOD e prevalência de lesões bucais associadas à infecção pelo HIV : estudo transversal no serviço ambulatorial especializado de Porto Velho-RO." Universidade de Taubaté, 2008. http://www.bdtd.unitau.br/tedesimplificado/tde_busca/arquivo.php?codArquivo=506.
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Os portadores do vírus HIV, no curso da doença podem ser acometidos por manifestações oportunistas e/ou apresentar aumento do índice CPOD (dentes cariados, perdidos e obturados). O objetivo principal desse estudo transversal foi determinar o índice CPOD e a prevalência de lesões da mucosa bucal (Candidose, Eritema linear gengival, Leucoplasia pilosa oral, Herpes simples, Úlceras bucais, Sarcoma de Kaposi e Linfoma) em uma amostra de conveniência composta por 140 indivíduos infectados pelo HIV atendidos no Serviço Ambulatorial Especializado (SAE) de Porto Velho-RO. E, avaliar a associação entre os parâmetros bucais com a contagem de linfócitos TCD4, a quantificação de carga viral (CV) e o uso de terapia antiretroviral (TARV). Para tanto, foram realizados exames clínicos bucais para o levantamento de lesões de mucosa bucal e índice CPOD, bem como coleta de dados (gênero, idade, hábito de fumar, contagens CD4 e CV, uso de TARV) mediante entrevistas e análise de prontuários. Nos resultados, foram observados: idade média de 39 anos (10,7), contagem de TCD4 média de 380 cels/mm3, 53% dos indivíduos com CV indetectável, 24,2% dos indivíduos apresentaram lesões bucais e o índice CPOD médio foi 16,9, com alta proporção de dentes perdidos. A lesão mais comumente observada foi a candidose que mostrou relação com a contagem de TCD4 e a presença de leucoplasia pilosa foi associada com o aumento da CV. O uso regular da TARV mostrou relação com a baixa prevalência de lesões bucais, proporcionando melhor qualidade de vida aos indivíduos portadores de Aids. Foi possível concluir na amostra avaliada: baixa prevalência de lesões bucais; índice CPOD elevado. No que se refere à avaliação das associações: índice CPOD não relacionado com CV nem com TCD4; uso da TARV mostrou relação positiva com a redução das lesões bucais; indivíduos com maiores contagens TCD4 e menor CV tendem a apresentar menos lesões bucais.The HIV bearers, in the course of the disease can be affected by opportunistic infections and/or present increase in the DMFT index (decayed, missing and filled teeth). The main objective of this study was to determine DMFT index and the prevalence of lesions of the oral mucosa (Candidosis, Erythema linear gengival, Oral hairy leukoplakia, Herpes simplex, Mouth ulcers, Kaposis sarcoma and lymphoma) in a convenience sample of 140 people infected with HIV attended the Ambulatory Specialized Service Serviço Ambulatorial Especializado (SAE) from Porto Velho- RO. And, to evaluate the association between oral parameters with the counting of lymphocytes TCD4, the quantification of viral load (VL) and the use of antiretroviral therapy (ARVT). Oral clinical examinations were conducted for the lifting of oral lesions of the oral mucosa and DMFT index, and collecting data (gender, age, smoking, TCD4 and VL counts, use of ARVT) through interviews and analysis of medical records. Were observed: average age of 39 years ( 10.7), TCD4 count average of 380 cels/mm3, 53% of individuals with undetectable VL, 24.2% of individuals had oral lesions and DMFT index average was 16,9, with a high proportion of missing teeth. The lesion most commonly seen was the candodosis and the hairy leukoplakia presence was associated with increasing VL. The regular use of ARVT showed relationship with the low prevalence of oral lesions, providing better quality of life for people with AIDS. Could be concluded in the sample assessed: low prevalence of oral lesions; DMFT index high. Regarding the assessment of the associations: DMFT index not linked to VL or with TCD4; use of ARVT showed positive relationship with the reduction of oral lesions; people with TCD4 more counts and VL minor to present oral fewer injuries.
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Ribeiro, Inês da Conceição Aleixo. "Avaliação do comportamento da proteina recombinante CPX como marcador de diagnóstico e do sucesso terapeutico de leishmaniose canina." Master's thesis, Faculdade de Farmácia da Universidade do Porto, 2008. http://hdl.handle.net/10216/20760.
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Ribeiro, Inês da Conceição Aleixo. "Avaliação do comportamento da proteina recombinante CPX como marcador de diagnóstico e do sucesso terapeutico de leishmaniose canina." Dissertação, Faculdade de Farmácia da Universidade do Porto, 2008. http://hdl.handle.net/10216/20760.
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Malhani, Mohammed Ali A. "Investigating Trends in the Adoption of CPOE System for Medication Orders and Determining Factors Associated with Meeting Meaningful Use Criteria for Health Information Technology." Thesis, Howard University, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13419791.
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BACKGROUND: The 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act created meaningful use (MU) incentive program to promote the nationwide adoption of certified electronic health record (EHR) systems. Computerized physician order entry (CPOE) system is a part of the EHR system and a cornerstone of the MU incentive program, which helps to reduce prescribing errors and enhance care coordination for treatment between providers.
OBJECTIVES: The main objective of this study was to investigate trends in the adoption of CPOE system for medication orders and determine factors associated with meeting the meaningful use criteria for health information technology.
METHODS: A cross-sectional analysis was conducted using 10 years of data from the 2006–2015 National Ambulatory Medical Care Survey (NAMCS), 10 years of 2006–2015 data from the National Hospital Ambulatory Medical Care Survey (NHAMCS)—emergency department (ED) component, the 2016 American Hospital Association (AHA) Annual Survey Database, and the 2016 AHA Annual Survey Information Technology (IT) Supplement. The outcomes of the study included the adoption of CPOE for medication orders, drug-drug interaction alerts (DDI), guideline reminders, electronic prescribing (eRx), health information exchange (HIE), and compliance with the MU criteria. Descriptive statistics were calculated for all study variables. Bivariate analysis using the chi-square test was used to determine if there is a significant relationship between the adoption of CPOE for medication orders and timing (pre-post meaningful use). Chi-square test for trend was used to determine the significance of the change in the adoption of several EHR functionalities between 2006 and 2015. Logistic regression analyses were performed to identify factors that influence the adoption of several EHR functionalities. All analyses were performed using SAS 9.3 at an alpha of 0.05.
RESULTS: In NAMCS 2006–2015, the weighted surveyed physicians’ responses were weighted to represent 325,070 ambulatory based physicians throughout the U.S. The majority (66%) of respondents worked in group practices, and 34% worked as solo practitioners. The overall AHA annual survey sample had 6,239 hospitals. Of these, a total of 3,656 hospitals responded to the AHA IT supplement survey, representing a response rate of 59%. Primary care physicians’ adoption of CPOE systems for medication orders was significantly higher than specialists (p < 0.0001). The adoption of CPOE for medication orders was higher in the Post-MU incentive payments period (2012–2015) compared to pre-MU incentive payments period (2006–2011) in both the ambulatory care and ED settings (p < 0.0001). From 2006 through 2015 there was a statistically significant increase in the percent of ambulatory care practices adopting CPOE medication ordering system with clinical decision support (CDS) tools and eRx in the ambulatory care setting (p-trend < 0.001). In the same period, group practices compared to solo practices were significantly more likely to adopt these EHR functionalities (p < 0.0001). From 2013 to 2015, physician offices that generated > 50% of their revenue from Medicaid in the ambulatory care setting were less likely to adopt EHR systems that meet the MU criteria compared those generate ≤ 50% (p < 0.01).
CONCLUSION: Findings indicate that physician specialty, practice size, and percentage of revenue from Medicaid are significantly associated with the adoption of selected EHR functionalities. The CPOE for medication orders adoption rates significantly increased post-MU incentive payments. No significant association was found between for-profit hospitals and sending electronic notification to the patient’s primary care physician upon ED visit. These results may be important to design interventions to improve EHR adoption.
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Santos, Marcus Rogério Oliveira dos. "Análise do cadastro de prestadores de outros municípios (CPOM) de São Paulo na prevenção e no combate à simulação de estabelecimento prestador de serviço." reponame:Repositório Institucional do FGV, 2016. http://hdl.handle.net/10438/17176.
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The simulation of establishment is a phenomenon that usually occurs in a context where there is fiscal war between municipalities, but not necessarily. In this practice is common for service providers to use an establishment used as front organization in the municipality of lower taxation, at the same time that they are established in another property, in another municipality, with higher tax incidence, with all the elements for the service provision, however, declare that the services are provided by the first establishment. To prevent and combat this practice, in the year 2005, the Municipality of São Paulo established the Registration of services providers domiciled in other municipalities (CPOM) for intercity service benefits, when the taker is in São Paulo territory. However, simulations of establishment cases continue being judged by the Municipal Council of Taxes, which is an indication that the Registration may require adjustments to better fulfill its function. This paper aims to examine whether CPOM properly combat the simulation of establishment and, if the answer is negative, adjustments will be presented so that it fulfills the function for which it was implemented. These adjustments are intended to increase efficiency and provide an evidential context to detect and point simulations, improving its performance.
A simulação de estabelecimento é um fenômeno que normalmente ocorre num contexto em que há guerra fiscal entre os Municípios, mas não necessariamente. Nessa prática é comum os prestadores de serviço se utilizarem de um estabelecimento de fachada no Município de menor tributação, ao mesmo tempo em que estão estabelecidos em outro estabelecimento, em outro Município, de maior incidência tributária, com todos os elementos para a prestação do serviço, porém, declaram que os serviços são prestados pelo primeiro estabelecimento. Para prevenir e combater essa prática, no ano de 2005, o Município de São Paulo instituiu o Cadastro de Prestadores de Outros Municípios (CEPOM) para as prestações intermunicipais de serviço, quando o tomador estiver em território paulistano. Porém, casos de simulação de estabelecimento continuam sendo julgados pelo Conselho Municipal de Tributos, o que constitui um indício de que o Cadastro pode necessitar de ajustes para que melhor cumpra a sua função. O presente trabalho pretende analisar se o CPOM combate adequadamente a simulação de estabelecimento e, caso a resposta seja negativa, serão apresentados ajustes para que ele cumpra a função para a qual ele foi implementado. Tais ajustes têm como objetivo aumentar sua eficiência e fornecer um contexto probatório para detectar e apontar simulações, melhorando o seu desempenho.
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Cunningham, Thomas R. "A Behavioral Evaluation of the Transition to Electronic Prescribing in a Hospital Setting." Thesis, Virginia Tech, 2006. http://hdl.handle.net/10919/31873.
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The impact of Computerized Physician Order Entry (CPOE) on the dependent variables of medication-order compliance and time to first dose of antibiotic was investigated in this quasi-experimental study of a naturally-occurring CPOE intervention. The impact of CPOE on compliance and time to first dose was assessed by comparing measures of these variables from the intervention site and a non-equivalent control before and during intervention phases. Medication orders placed using CPOE were significantly more compliant than paper-based medication orders (p<.001), and first doses of antibiotic ordered using CPOE were delivered significantly faster than antibiotic orders placed using the paper-based system (p<.001). Findings support previous research indicating the positive impact of CPOE on patient safety as well as justify and enable future interventions to increase CPOE adoption and use among physicians. Additionally, data collected in this study will be used to provide behavior-based feedback to physicians as part of CPOE adoption and use intervention strategies to be explored in the forthcoming research.Master of Science
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Maynard, Marie-Aude. "Stockage d'impulsions lumineuses dans l'hélium métastable à température ambiante." Thesis, Université Paris-Saclay (ComUE), 2016. http://www.theses.fr/2016SACLS445/document.
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La nécessité de synchroniser les différentes étapes des protocoles d’information et de communication quantiques implique l’utilisation de mémoires quantiques. Différents systèmes physiques sont aujourd’hui explorés, parmi lesquels les ions en matrice cristalline, les atomes froids et les vapeurs atomiques. Le protocole de stockage le plus couramment utilisé se fonde sur le phénomène de Transparence Electromagnétiquement Induite (EIT) : une impulsion lumineuse est gravée dans la cohérence Raman entre les deux états fondamentaux d’un système atomique à trois niveaux en Lambda. Bien qu’elle ouvre des perspectives prometteuses, en termes d’efficacité, de fidélité et de temps de stockage, cette technique est néanmoins sensible aux effets déphasants, tels que des gradients de champs magnétiques.Dans ce mémoire, j’étudie tout d’abord le stockage d’impulsions lumineuses classiques par EIT dans une vapeur d’hélium métastable à température ambiante. Les résultats expérimentaux obtenus sont en accord avec les simulations numériques des équations de Maxwell-Bloch complètes du système et montrent notamment l’existence d’une phase supplémentaire acquise par l’impulsion restituée en configuration désaccordée. Cette phase s’explique par la propagation du faisceau sonde dans un milieu dispersif. Dans une deuxième partie, je mets expérimentalement en évidence, dans le même système, une nouvelle forme de stockage basée sur le phénomène d’Oscillations Cohérentes de Population (CPO), par nature plus robuste aux effets déphasants que l’EIT. Les simulations numériques permettent d’analyser plus précisément les mécanismes à l’œuvre dans une mémoire CPO et, notamment, l’influence de la phase relative entre les faisceaux signal et de couplage sur les efficacités de stockageThe need to synchronise quantum information and communication protocols implies the use of quantum memories. Different physical systems are investigated nowadays, among which ions in crystals, cold atoms and atomic vapours. The most common protocol is based on the Electromagnetically Induced Transparency (EIT) phenomenon: a light pulse is engraved in the Raman coherence of both ground states of an atomic Lambda–type three-level system. Though it opens promising perspectives, with respect to efficiency, fidelity and storage time, this technique is, however, sensitive to dephasing effects such as magnetic field gradients.In this thesis, I first study the storage of classical light pulses via EIT in a room- temperature metastable helium vapor. The obtained experimental results agree with the numerical simulation of the complete Maxwell-Bloch equations of the system. In particular, the existence of an extra phase acquired by the retrieved pulse is demonstrated in the detuned configuration, which can be explained by the propagation of the signal beam in the medium. In the second part, I experimentally isolate, in the same system, a new storage protocol based on the Coherent Population Oscillation (CPO) phenomenon, which is by nature more robust than EIT to dephasing effects. The numerical simulations allow us to precisely analyse the mechanisms involved in a CPO memory and, in particular, the influence of the relative phase between the signal and coupling beams on the storage efficiencies
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Tonello, Aline Sampieri. "Impacto de variaveis sociais e tendencia de carie e fluorose dentaria em escolares de 12 anos de idade em duas cidades do Sudeste brasileiro." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/289875.
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Orientador: Marcelo de Castro MeneghimTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: O presente trabalho, composto por dois estudos teve como objetivos: a) descrever as prevalências de cárie e fluorose dentária em escolares de 12 anos de idade de Piracicaba/SP e Iracemápolis/SP, Brasil, 2007 e comparar estes dados com outros levantamentos epidemiológicos realizados anteriormente, em Piracicaba para a cárie dentária (1971-2005) e para a fluorose dentária (1991-2001) e em Iracemápolis para a cárie e fluorose dentária (1991-2004); b) avaliar a experiência de cárie e a prevalência de fluorose dentária em escolares de 12 anos de idade de Piracicaba/SP, Brasil, 2007 e verificar a relação entre essas alterações e os fatores socioeconômicos e variáveis comportamentais relacionadas com a saúde bucal. A amostra constituiu de 724 escolares provenientes de escolas públicas e privadas de Piracicaba/SP e 197 escolares provenientes de escolas públicas de Iracemápolis/SP. Os exames foram realizados por um examinador previamente calibrado, no pátio das escolas, sob luz natural, com auxílio de espelho bucal plano, sonda IPC e escovação prévia, seguindo as recomendações da OMS. A cárie dentária foi avaliada utilizando os índices CPOD e SiC (Significant Caries Index), e a fluorose pelo índice T-F. As variáveis socioeconômicas (renda familiar, número de residentes na mesma casa, escolaridade do pai e da mãe e habitação) e as informações comportamentais foram obtidas por meio de um questionário semi estruturado enviado aos pais. A associação entre as variáveis dependentes (CPOD e fluorose) e as variáveis independentes (variáveis socioeconômicas e comportamentais) foi determinada por meio de análise de regressão logística múltilpa. O CPOD médio foi de 0,85 (dp=1,54) e 1,02 (dp=1,61) e o índice SiC de 2,52 (dp=1,72) e 2,83 (dp=1,60) em Piracicaba e Iracemápolis, respectivamente. A prevalência de fluorose foi de 29,4% e 25,4% em Piracicaba e Iracemápolis, respectivamente. Comparando o presente estudo com outros levantamentos realizados anteriormente, foi observada uma significativa redução da experiência de cárie em ambas as cidades, (90,12%) em Piracicaba e 85,07% em Iracemápolis (p<0,01). Com relação à prevalência da fluorose dentária, verificou-se um aumento de 44,1% em Piracicaba, observando uma menor prevalência entre alguns anos. Já em Iracemápolis, o aumento foi de 1170%. Com base no modelo de regressão logística múltipla, as crianças pertencentes a uma família com renda mensal inferior ou igual a quatro salários mínimos apresentaram 2,58 vezes mais chances de terem cárie (CPOD>0) do que aquelas pertencentes a uma família com renda mensal superior a quatro salários mínimos. Além disso, aquelas crianças que consultaram ao dentista apresentaram 4,27 vezes mais chances de serem diagnosticadas ou tratadas em relação à cárie do que aquelas que nunca foram ao dentista. Porém, em relação à fluorose, o modelo de regressão logística não foi significativo. Em conclusão, os resultados desta tese demonstraram uma contínua redução da experiência de cárie em ambas as cidades no decorrer dos anos. Em relação à fluorose dentária, verificou-se uma tendência de estabilização em Piracicaba, porém em Iracemápolis, observou-se um aumento constante. Adicionalmente, observou-se uma associação entre a presença de cárie e renda familiar mensal, como também entre cárie e consultas ao dentista. Entretanto, em relação à fluorose dentária, nenhuma das variáveis testadas foi associada com esta alteração
Abstract: The present study was composed by two papers which aims were: a) to describe the prevalence of dental caries and dental fluorosis in 12-years-old schoolchildren from Piracicaba/SP and Iracemápolis/SP, Brazil, 2007 and to compare current prevalence rates with those from previous epidemiological surveys developed in Piracicaba, for dental caries (1971-2005), and for dental fluorosis (1991-2001) and in Iracemápolis for dental caries and dental fluorosis (1991-2004); b) to evaluate the caries experience and dental fluorosis prevalence in 12-years-old schoolchildren from Piracicaba/SP, Brazil, 2007 and to verify the relationship between these trends, socioeconomic factors, and behavioral variables related to oral health. The sample consisted of 724 schoolchildren from public and private schools from Piracicaba/SP and 197 schoolchildren from public schools from Iracemápolis/SP. Examinations were executed by a previously calibrated examiner, in outdoor settings, under natural light, using dental mirror, CPI probe, and previous tooth brushing, followed the WHO recommendations. Dental caries was measured by DMFT and SiC (Significant Caries Index) indexes and dental fluorosis by T-F index. Socioeconomic variables (monthly income, number of residents in home, mother's and father's education and home ownership) and behavioral information were collected by means of a parental semi structured questionnaire. Then multiple logistic regression analyses using the stepwise procedure were performed in order to verify the relationship among the dependent variables (DMFT and fluorosis) and the independent variables (socioeconomic and behavioral variables). The mean of DMFT was 0.85 (SD=1.54) and 1.02 (SD=1.61) and the SiC Index was 2.52 (SD=1.72) and 2.83 (SD=1.60) in Piracicaba and Iracemápolis, respectively. The fluorosis prevalence was 29.4% and 25.4% in Piracicaba and Iracemápolis, respectively. Comparing the present study to another previous epidemiological surveys, in both towns, a significant caries reduction of 90.12% (Piracicaba) and of 85.07% (Iracemápolis) (p<0.01), have been observed. Concerning dental fluorosis prevalence, an increase of 44.1% was noted in Piracicaba, where a small prevalence was observed throughout the years. Although, the increase was 1170% in Iracemápolis. By means of multiple logistic regression model, children, whose family earned up to four minimum wages, were 2.58 more prone to have caries (DMFT>0) than those whose family earned over four minimum wages. Besides, those children who visited the dentist were 4.27 more prone of being diagnosed with dental caries and receive treatment in comparison to those who never had visited the dentist. However, for fluorosis prevalence the multiple logistic regression model was not significant. In conclusion, the results of this thesis demonstrated continuous decrease in dental caries experience in both Brazilian towns. Concerning dental fluorosis, stabilization trends were observed in Piracicaba. In Iracemápolis, however, a constant increase was noted. Moreover, significant associations between the presence of dental caries and monthly family income, as well as between dental caries and visiting to the dentist, were observed. However, in relation to dental fluorosis, no tested variable was associated with the disturb
Doutorado
Saude Coletiva
Doutor em Odontologia
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Motta, Rosineide Heringer da Silva. "ESTUDO EPIDEMIOLÓGICO DA CÁRIE DENTÁRIA E SUA RELAÇÃO COM AS CONDIÇÕES SOCIOECONÔMICAS EM ESCOLARES DO MUNICÍPIO DE CARATINGA-MG." reponame:Biblioteca Digital de Teses e Dissertações da UNEC, 2010. http://bibliotecadigital.unec.edu.br/bdtdunec/tde_busca/arquivo.php?codArquivo=200.
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A cárie dentária é uma doença que está presente em todas as populações, variando a sua prevalência e severidade, aumenta com a idade e pode causar grande impacto na qualidade de vida, interferindo nas atividades diárias. É um problema de saúde pública e ocorre entre 50% a 99% das pessoas, na maioria das comunidades, apresentando maior gravidade nos grupos socialmente marginalizados da população. Este estudo avaliou a prevalência de cárie dentária em crianças de 12 anos de idade, no período de 1993 a 2009, e a sua associação com as condições socioeconômicas em Caratinga-MG, onde é desenvolvido um programa de atenção à saúde bucal nas escolas públicas desde 1993. Dois tipos de informações foram reunidos: Dados da prevalência de cárie (CPO-D aos 12 anos) dos levantamentos epidemiológicos de saúde bucal realizados pelo departamento odontológico municipal e os dados sobre CPO-D e condições socioeconômicas que foram coletados pela pesquisadora, nas crianças de 12 anos das escolas públicas e privadas em 2009. Utilizaram-se os critérios da OMS (1991) para o levantamento de 1993 e OMS (1997) para os demais levantamentos. A amostra foi aleatória e estratificada quanto ao gênero. Os exames foram realizados nas escolas à luz natural, sem sonda exploratória. Através da análise estatística do teste de Kruscal-Wallis e Dunns, verificou-se uma queda significante (P= lt;0.0001) no CPO-D, de 4,90 em 1993, prevalência alta, segundo os critérios da OMS, para 2,16 em 2000 e 1,06 em 2008, considerada de prevalência baixa. O CPO-D em 2009 foi 1,00 nas escolas públicas e 0,58 nas escolas privadas, a média total foi de 0,79. Não apresentando diferença significativa entre os tipos de escolas e o gênero. Quanto aos componentes do CPO-D, observou-se uma diminuição no percentual de dentes cariados, um aumento dos obturados e a ausência de dentes perdidos, no último levantamento. O percentual de crianças livres de cárie (CPO-D=0) aumentou em 44%, indicando uma boa cobertura dos serviços assistenciais. As variáveis socioeconômicas avaliadas foram: número de pessoas no domicílio, escolaridade dos pais, renda salarial e número de bens. Resultados do teste Qui-quadrado demonstraram associação inversa significante entre prevalência de cárie e renda, posse de computador, microondas e aparelho de som. A prevalência da doença foi de 48% nas escolas públicas e de 32% nas escolas privadas. Apesar de existirem desigualdades socioeconômicas significantes entre as crianças das escolas públicas e privadas, não houve diferença significativa no CPO-D. Conclui-se que a fluoretação da água de abastecimento, o uso de dentifrícios fluoretados aliados à implementação do programa educativo e preventivo desenvolvido nas escolas públicas foram capazes de reduzir as desigualdades de saúde bucal influenciadas pelas diferenças socioeconômicas. Nesse sentido, confirma-se a importância da manutenção e ampliação dessas atividades, não só para reduzir a prevalência de cárie, mas também para atenuar o impacto das desigualdades socioeconômicas sobre as condições de saúde bucal.
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Romanow, Darryl S. "The Impact of IT-Enabled and Team Relational Coordination on Patient Satisfaction." Digital Archive @ GSU, 2013. http://digitalarchive.gsu.edu/cis_diss/52.
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Abstract
The 2009 American Recovery and Reinvestment Act has earmarked 27 billion dollars to promote the adoption of Health Information Technologies (HIT) in the US, and to gain access to these funds, providers must document “Meaningful Use” during the care process. While individual HIT use according to lean measures, including meaningful use, is prevalent in the IS literature, few studies have incorporated rich measures to account for the task, the technology, and the user in a team context. This dissertation conceptualizes Team Deep Structure Use of Computerized Provider Order Entry (CPOE) as an IT- enabled coordination mechanism, and Relational Coordination as the inherent ability of clinical teams to coordinate care spontaneously using informal, relationship based mechanisms. IT-enabled and Relational Coordination mechanisms are each evaluated across five maximally different patient conditions to simultaneously examine their impact on our outcome measure, Patient Satisfaction with the clinical care team.
The extant literature has established a deep understanding of IT adoption shortly after implementation, yet the literature is silent on the antecedents of IT use according to rich measures well after the shake down phase, a period in which the majority of organizations operate. We incorporate the Adaptive Structuration Theory (AST) constructs of Faithfulness of Appropriation, and Consensus on Appropriation as the focal antecedents of Deep Structure Use of the clinical system by team members. To our knowledge, no prior research has linked these two AST constructs to clinical outcomes through the incorporation of a rich use mediator such as Deep Structure Use of a Health IT.
To test our model, we relied on survey responses from 555 physicians, nurses and mid-levels which had cared for 261 patients across five patient conditions, ranging from vaginal birth, to organ transplant, as well as pneumonia, knee/hip replacement and cardiovascular surgery. Our results confirm that the Adaptive Structuration constructs of Faithfulness of Appropriation and Consensus on Appropriation, generate positive and statistically significant path coefficients predicting Team Deep Structure Use of CPOE. We also report differential effects on Patient Satisfaction with the care team resulting from technology use. Results range from a significant positive path coefficient (.285) associated with higher Team Deep Structure Use on combined Pneumonia and Organ Transplant teams, to a significant negative path coefficient (-.174) on cardiovascular surgery teams. As expected, Pneumonia, Organ Transplant and Cardiovascular Surgery teams all reported positive effects on Patient Satisfaction with the care team as a result of higher Relational Coordination scores. For teams caring for patient conditions consistently associated with a shorter length of stay, including vaginal birth and knee/hip replacement, higher reported use of IT- enabled, or Relational Coordination mechanisms, did not result in a significant increase in Patient Satisfaction.
This dissertation contributes to the growing Health IT literature, and has practical implications for clinicians, hospital administrators and Health IT professionals. This dissertation is the first to operationalize a rich measure of use of an HIT by clinical teams, and to simultaneously measure the impact of IT enabled and Relational Coordination mechanisms on Patient Satisfaction. Secondly, through the introduction of Adaptive Structuration constructs, our model establishes a methodology for predicting rich, nuanced use in teams well after the initial shake down phase associated with recent HIT implementation. Through the juxtaposition of the impact of IT-enabled and Relational Coordination mechanisms across patient conditions, practitioners can design interventions and adjust the level of resources applied to process improvement accordingly.
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Zein, Naïmah. "“CpdX”, a non-steroidal Selective Glucocorticoid Receptor Agonistic Modulator (SEGRAM) selectively triggers the beneficial anti-inflammatory activity of glucocorticoids, but not their long-term debilitating effects." Thesis, Strasbourg, 2018. http://www.theses.fr/2018STRAJ088.
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Lors de la liaison d’un glucocorticoïde (GC) naturel ou synthétique (par exemple, la Dexaméthasone) au récepteur des glucocorticoïdes (GR), les GCs régulent l’expression de gènes cibles soit par (i) transactivation par liaison ‘’directe’’ à un élément de liaison à l’ADN de type ‘’(+)GRE’’, (ii) transrépression ‘’directe’’ par liaison à un élément de type ‘’nGRE’’ ou (iii) transrépression ‘’indirecte’’ par interaction physique directe avec des facteurs de transcription pro-inflammatoires tels que AP-1 et NF-κB. Les effets anti-inflammatoires bénéfiques des GCs sont généralement attribués à la transrépression indirecte, alors que nombre de leurs effets secondaires pathologiques indésirables paraissent liés à la transactivation et/ou à la transrépression directe. Notre laboratoire a récemment découvert qu’un composé non-stéroïdien dénommé CpdX ainsi que ses dérivés deutérés, ne présentent ni la fonction de transactivation, ni celle de transrépression directe du GR, tout en stimulant son activité bénéfique de transrépression indirecte. Notre projet a consisté à caractériser un composé non-stéroïdien dit CpdX, ainsi que ses dérivés, quant à leurs activités thérapeutiques et à démontrer qu’elles sont semblables à celles des glucocorticoïdes anti-inflammatoires, couramment utilisés, tout en étant débarrassés de leurs effets pathologiques secondaires, tels que l’ostéoporose, l’atrophie cutanée et le syndrome métabolique. Pour atteindre nos objectifs, nous avons utilisés des modèles de souris présentant soit les affections cutanées (dermatites de contact ou atopique, psoriasis), l'asthme, l’arthrite rhumatismale, la colite ulcérative ou la conjonctivite allergique, associés à des études d’immunologie et de biologie moléculaire et cellulaire. Mon travail de thèse a démontré que CpdX, et certains de ses dérivés deutérés, présentent une activité anti-inflammatoire dans le traitement de ces modèles ‘’souris’’ (Partie I). Nous avons aussi montré que le traitement par CpdX et ses dérivés n’induit pas les effets secondaires pathologiques des glucocorticoïdes (Partie II), ouvrait ainsi la vue à une nouvelle ère dans le traitement à long-terme de maladies inflammatoires, sans provoquer les effets pathologiques indésirables des traitements actuels aux glucocorticoïdesUpon binding of natural or synthetic glucocorticoids (GCs) (e.g. Dexamethasone) to their glucocorticoid receptor (GR), GCs regulate the expression of target genes either by (i) direct transactivation through direct binding to “(+)GRE” DNA binding sites (DBS), (ii) direct transrepression through binding to “IR nGRE” DBSs or (iii) tethered indirect transrepression mediated through interaction with transactivators, such as NFkB, AP1, or STAT3 bound to their cognate DBSs. The beneficial anti-inflammatory effects of GCs have been generally ascribed to tethered transrepression, whereas many of their long-term undesirable side-effects could be due to transactivation and/or direct transrepression. Our laboratory recently reported that a non-steroidal compound, named CpdX, selectively lacks both direct transactivation and direct transrepression functions, while still exerting an indirect transrepression activity. The goal of our project was to characterize CpdX and some of its derivatives as effective anti-inflammatory drugs similar to glucocorticoids, but lacking their main deleterious side-effects, e.g. osteoporosis, skin atrophy and metabolic disorders. To this end, we have used experimental mouse model for skin disorders (atopic dermatitis, contact dermatitis, and psoriasis), asthma, rheumatoid arthritis, ulcerative colitis and allergic conjunctivitis, combined with immunology, molecular and cellular biology. My thesis studies have demonstrated that in mouse models, CpdX and its derivatives exhibit anti-inflammatory activities, which are similar to those of glucocorticoids (Part I). Importantly, we further show that CpdX and its derivatives do not exhibit the long-term debilitating side-effects of glucocorticoids (Part II). Thereby paving the way to a new era in the long-term therapy of major inflammatory diseases
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Mello, Marlos Tadeu Bezerra de. "Testes psicológicos, crianças e escolarização no Rio Grande do Sul (1940-1966)." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/131047.
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A presente dissertação descreve os testes psicológicos mencionados nos textos pedagógicos publicados na Revista do Ensino, entre os anos de 1939 e 1971, e no Boletim do Centro de Pesquisas e Orientação Educacionais, entre os anos de 1947 e 1966, ambos produzidos no Rio Grande do Sul. A análise histórica a partir da leitura atenta dos documentos permitiu a identificação e a descrição dos testes veiculados nos periódicos. O enfoque temático central desta pesquisa encontra-se na segunda parte deste trabalho, privilegiando a descrição dos testes, seus objetivos, seus modos de aplicação, correção e significação. O estudo argumenta, na sua primeira parte, que as ideias psicológicas dos testes já se encontravam presentes nos primeiros textos analisados, ainda que de forma simplificada e conectada intimamente aos saberes da medicina social, da psicologia experimental, da educação dos excepcionais e da higiene mental. No período examinado, os Testes ABC de Lourenço Filho e o Teste da Figura Humana de Florence Goodenough se destacaram como os instrumentos mais citados nos periódicos. A presente dissertação inclui-se entre os esforços que apontam a presença e a circulação dos testes psicológicos na esfera da escolarização no Rio Grande do Sul.The present dissertation aims to describe the psychological tests mentioned in the pedagogical texts that have been published in the Revista do Ensino, between the years of 1939 end 1971, and in the Boletim de Centro de Pesquisas e Orientações Educacionais, between the years of 1947 and 1966, both of them produced in Rio Grande do Sul. The historical analysis based on the attentive reading of the documents allowed do identify and describe the tests that have been published in the periodicals. The thematical focus of this research is displayed in the second part of this work, showing primarily the description of the tests, their aims, their possible ways of application, correction and sigification. The study argues, in his first part, that the psychological ideas of the tests are already found in the first analysed texts, even if in a simplified way and deeply conected with the knowledges of social medicine, of experimental psychology, of the education of the exceptional individuals and of mental care. In the examinated period, the Testes ABC of Lourenço Filho and the Teste da Figura Humana of Florence Goodenough have been the most mentioned in the periodicals. The present dissertation is included among the efforts of trying to indicate the presence and the circulation of the psychological tests in the scope of education in Rio Grande do Sul.
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Corner, Evelyn. "The Chelsea Critical Care Physical Assessment tool (CPAx) : validation and evaluation into the impact of a daily bedside scoring system which grades physical recovery from critical illness." Thesis, Imperial College London, 2017. http://hdl.handle.net/10044/1/54762.
Full textAbstract:
Muscle wasting is a common consequence of critical illness, leading to long-term physical morbidity. Early rehabilitation in the Critical Care Unit (CCU) is now the norm. Guidelines suggest that this rehabilitation should be goal-directed and based on comprehensive assessment of physical function, however there was no tool to assess physical function objectively. The aim was to evaluate the clinimetric properties of the Chelsea Critical Care Physical Assessment tool (CPAx); a tool designed to measure function in critical illness objectively; to explore the patient experience of the CPAx in early rehabilitation, and; to use the CPAx to evaluate common recovery trajectories. This was a convergent mixed methods study. Preparatory work included integration of the CPAx into clinical practice, allowing recording of daily CPAx. Observational cohort studies were completed to determine the validity, responsiveness, and floor/ceiling effect of the CPAx. The database was also used to explore daily functional recovery and to establish the minimal detectable change (MDC) of the CPAx. An eLearning module to teach clinicians how to use the CPAx was developed and distributed with evaluative questionnaires to determine the CPAx’s content validity. Case studies were embedded in the module for inter-rater reliability testing. Grounded-theory methodology with semi-structured interviews was used to explore the patient experience of the CPAx tool in early rehabilitation. The results showed that the CPAx is valid, reliable, responsive, and widely used; however, it is likely to have a ceiling effect after hospital discharge. The CPAx may have a role in goal setting for long-stay patients and help to fill in loss of life narrative after critical illness; however the CPAx is difficult to comprehend in the early days of CCU, which are overshadowed by delirium, sleep deprivation and fatigue. Function and CCU length of stay are closely associated, suggesting that function may influence length of stay.
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Slama, Jens. "Evaluation of a new measurement method for tire/road noise." Thesis, KTH, MWL Marcus Wallenberg Laboratoriet, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-100770.
Full textAbstract:
Noise is a growing health concern as urban residents increases rapidly and more reports of noise causing sleep disturbances and increasing the risk of cardiovascular health problems are published. Noise has a negative influence on life quality. This life quality deficiency also shows in housing and office pricing in noisy environments. Housing and office prices are often higher in quiet areas than in noisy areas. Therefore noise is both a health issue and has big economic consequences. The biggest contributor to the road traffic noise is the tire/road noise at speeds above 50km/h. Therefore this is an important aspect to monitor and the problem has to be alleviated. In this thesis the client Ramböll has gotten many contracts concerning the state of the roads from governmental institutes. As a part of the evaluation of the roads they want to implement the noise emission as a factor. This gives the government institutions another parameter that helps in the decision of which part of the road network to refurbish first. In the effort to decide what is best way for Ramböll to measure noise a new setup for measuring noise has been developed. The most used ways of measuring tire/road-noise is the close proximity (CPX) -method and the statistical pass-by (SPB) -method. These methods both give accurate results but they have drawbacks. The SPB measurements are time consuming and only give noise levels for a small patch of a road. CPX measurement on the other hand require costly and time consuming development of a measurement trailer. Certifying the trailer and maintenance work of it is expensive. So this report shows a first step in how to build a measurement setup and what aspects were taken into consideration when it was designed. A close proximity measurement setup in the form of a tube with a microphone placed inside it was built and installed underneath the measurement vehicle. The measurement setup designed and built was named the Tube-CPX measurement setup in this report. The measurements performed with this Tube-CPX measurement setup show promising results. Similarities between CPX measurement setup and the Tube-CPX setup have been found both in the frequency spectrum as well as in the relation with pass-by measurement noise levels. The repeatability of the Tube-CPX measurements is even better than the compared CPX measurements. Although results are promising more work is required before the Tube-CPX setup can be seen in operation at Ramböll. In particular the question which source causes which sound pressure is required to understand the measured levels. And also more controlled pass-by measurements have to be performed to determine the relation of the absolute values measured at the tire/road impact spot to the values that are most interesting, namely the sound pressure levels that the human at the side of the road depicts.