Tesi: "Physical diagnosis"

1

Axvik, Linda. "Automatic Diagnosis of Breast Tumoursin Ultrasound Images". Thesis, KTH, Tillämpad fysik, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-233752.

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2

Rozier, David. "Qualitative modelling and simulation of physical systems for a diagnostic purpose". Thesis, De Montfort University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391563.

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3

Ali, Ali Alawi. "Real time fault diagnosis using observer and physical parameter estimation". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ29966.pdf.

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4

Beckenkamp, Paula Regina. "Diagnosis, treatment and prognosis of ankle fractures". Thesis, The University of Sydney, 2015. http://hdl.handle.net/2123/14475.

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Ankle fracture is a common injury with increasing incidence. The aim of this thesis was to assess aspects of the diagnosis, treatment and prognosis of ankle fractures. A systematic review was conducted to examine the diagnostic accuracy of the Ottawa Ankle and Midfoot Rules, a clinical decision rule used to identify people with a low probability of fracture that do not require imaging. Data from 68 studies showed that the Rules have high sensitivity and low and heterogeneous specificity and that different health professional can apply the Rules without affecting accuracy. A randomised controlled trial including 214 people with isolated and uncomplicated ankle fracture was conducted to assess if a rehabilitation program is more effective and cost-effective than advice after immobilisation removal for ankle fracture and to assess if outcomes were moderated by two subgroups: fracture severity (more severe versus less severe) and age and gender (women aged 50 years and older versus women aged less than 50 years and all men). Participants were followed-up for 6 months and the primary outcomes were activity limitation (Lower Extremity Functional Scale) and quality of life (Assessment of Quality of Life). The trial showed that rehabilitation was not more effective than advice and that outcomes were not moderated by fracture severity or by age and gender. Finally, the prognosis of physical function, operationalised as levels of activity limitation and physical activity, was assessed in a systematic review and a longitudinal study. Physical function improved significantly in the short- to medium-term and plateaus, not reaching a complete recovery, in the long-term. People with ankle fracture were shown to be less active and more sedentary than the general population. This thesis provided robust evidence regarding the diagnosis, treatment and prognosis of ankle fractures.

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Santiago, Cristiane Maria Cordeiro. "Environmental analysis of basin SÃo Nicolau river(semiarid PiauÃ) from physical diagnosis conservacionista - PDC". Universidade Federal do CearÃ, 2014. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=13201.

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FundaÃÃo de Amparo Ã Pesquisa do Estado do CearÃ
The basin SÃo Nicolau river is located in north PiauÃ and crosses the territory in EW flowing to Sambito tributary of the Poti. Encompasses five municipalities of the state covering an area of 5.389.8 km2 and has been intensely busy with many uses generating sometimes degradational effects. The area has great importance about maintenance of water resources in this region besides forming ruiniform landscapes in semiarid area. Given the above, the objective was to make the environmental analysis the basin area especially considering the use of this water resource, and verify which state conservationist she presents and how enables the development of wide variety of activities. For this, we used the Physical Conservation Diagnosis (FCD), proceeding to the literature survey and mapping, geoprocessing and analysis of the parameters that make up the end of the DFC descriptive formula such as: Vegetation Cover Index (VCI), in two periods, Climate Index (CI) Rainfall erosivity (R), soil erodibility (K), Average Slope (DM) and drainage density (DD). The diagnostic result was expressed in the descriptive formula which showed the level of degradation/ preservation in the bowl is located. It is observed that there was a decreased risk of physical degradation in sectors A and B in the time interval between 1989 and 2010, in contrast, there was increased risk in C sector, which presented index of 10,54 in 1989 and 10,92 in 2010. However, the basin that showed the highest rate of degradation was the C sector. The lifting of fÃsicoambientais characteristics together with the results of the analysis of the forms of use and cover the basin contributed to the understanding of the results achieved. Thus, it is observed that the levels of degradation of the basin does not have quite pronounced, even because they have been reduced over the years, however it was not what happened in sector C which had major changes in terms of investments, infrastructure and activities at the same time interval. With this, it is necessary to conduct proper planning throughout the basin, especially in the C sector where the level of degradation was considerably increased in recent years. The shift in the use of resources and application of measures of active management on a larger scale would allow more appropriate management and development facing the sustainability of the region.
A Bacia HidrogrÃfica do rio SÃo Nicolau estÃ localizada no Norte do PiauÃ e cruza o territÃrio no sentido E-W atÃ desaguar no rio Sambito afluente do Poti. Engloba cinco municÃpios do Estado perfazendo uma Ãrea de 5.389,8 km2 e vem sendo intensamente ocupada com os mais diversos usos gerando, por vezes, efeitos degradacionais. A Ãrea possui grande importÃncia no que tange a manutenÃÃo dos recursos hÃdricos nessa regiÃo alÃm de formar paisagens ruiniformes no domÃnio semiÃrido. Diante do exposto, objetivou-se realizar a anÃlise ambiental na bacia considerando principalmente a Ãrea de aproveitamento desse recurso hÃdrico, verificando o estado conservacionista que ela apresenta e de que maneira possibilita o desenvolvimento de grande variedade de atividades. Para tanto, utilizou-se da metodologia do Diagnostico FÃsico Conservacionista (DFC) procedendo com o levantamento bibliogrÃfico e cartogrÃfico, tÃcnicas de geoprocessamento e anÃlise dos parÃmetros que compÃem a fÃrmula descritiva final do DFC tais como: Ãndice de Cobertura Vegetal (ICV), em dois perÃodos, Ãndice ClimÃtico (IC), Erosividade da Chuva (R), Erodibilidade dos Solos (K), Declividade MÃdia (DM) e Densidade de Drenagem (DD). O resultado do diagnÃstico foi expresso na fÃrmula descritiva a qual mostrou o nÃvel de degradaÃÃo/conservaÃÃo em que se encontra a bacia. Observa-se que houve uma diminuiÃÃo do risco de degradaÃÃo fÃsica nos setores A e B no intervalo de tempo analisado entre 1989 e 2010, em contrapartida, houve aumento do risco no setor C, o qual apresentou Ãndice de 10,54 em 1989 e de 10,92 em 2010. Contudo, a regiÃo da bacia que apresentou o maior Ãndice de degradaÃÃo foi o setor A. O levantamento das caracterÃsticas ambientais juntamente com os resultados da anÃlise das formas de uso e cobertura da bacia contribuÃram para a compreensÃo dos resultados alcanÃados. Assim, observa-se que os nÃveis de degradaÃÃo da bacia nÃo se apresentam bastante acentuados, inclusive pelo fato de terem sofrido uma diminuiÃÃo com o passar dos anos, contudo nÃo foi o que ocorreu no setor C o qual teve maiores modificaÃÃes em termos de investimentos, atividades e infraestrutura no mesmo intervalo de tempo. Com isso, se faz necessÃrio a realizaÃÃo do adequado planejamento em toda a bacia, de modo especial, no setor C onde apresentou aumento do nÃvel de degradaÃÃo nos Ãltimos anos. A reorientaÃÃo na utilizaÃÃo dos recursos e aplicaÃÃo de medidas de gestÃo atuantes numa escala maior possibilitaria um manejo mais apropriado e um desenvolvimento voltado a sustentabilidade da regiÃo.

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6

Keats, Melanie R. "Relationship between leisure time physical activity and psychosocial well-being in adolescents following cancer diagnosis". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ40067.pdf.

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7

Carey, Andrew J., Devin Johnson, George Obeng, Zia Rahman, Abdul Hannan e Jack Goldstein. "A Classic Presentation of Infective Endocarditis". Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/asrf/2018/schedule/140.

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Introduction: Advances in modern medicine have enabled early detection of infective diagnosis through blood cultures and echocardiography, which have been standardized by the widely accepted Modified Duke Criteria and have enabled rapid administration of antibiotics. As a consequence, the well-discussed and often variable clinical findings have become less common and have relegated to minor criteria in diagnosis. Fever is the single most common presenting symptom, whereas more specific signs such as petechiae may be seen in only 20-40% of patients. Even more rare are the pathognomonic Janeway lesions, Roth spots, and Osler nodes. Here we present a case in which early diagnosis was established through minor criteria manifest upon physical exam, and we highlight the timely insight provided from physical exam. Case: A 29-year-old man was admitted to the hospital for altered mental status, fever, vomiting, diarrhea, and vertigo. His past medical history included IV drug abuse, thrombotic thrombocytopenia, Hepatitis C, and seizures. Upon admission, his encephalopathy progressed rapidly, and he was mechanically ventilated and started on hemodialysis. Blood cultures grew Methicillin sensitive Staphylococcus aureus and Elizabethkingia meningosepticum and susceptibilities were attained. Echocardiography showed 3.1 cm vegetation on the aortic valve. By the Modified Duke Criteria, the diagnosis of infective endocarditis was confirmed. Discussion: The increasing incidence of complex infective endocarditis—including polymicrobial infection as well as the increasing resistance to antibiotic therapy—poses challenges to the rapid assessment and treatment necessary to mitigate the multi-organ involvement and the devastating consequences of septic emboli. Developments in medical technology have expedited both the diagnosis and treatment of infective endocarditis, which has subsequently decreased the extent and frequency of classical signs. Nonetheless, this case illustrates the unavoidable vitality of the physical exam, because this patient’s quick and clear presentation enabled diagnosis solely through physical exam. Empiric antibiotic treatment was started promptly and subsequently adjusted based on culture and susceptibilities.

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8

Wang, Caixia. "Diagnosis of physical and biological controls on phytoplankton distribution in the Gulf of Maine-Georges Bank region". Thesis, Massachusetts Institute of Technology, 1999. http://hdl.handle.net/1721.1/59508.

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Thesis (M.S.)--Joint Program in Physical Oceanography (Massachusetts Institute of Technology, Dept. of Earth, Atmospheric, and Planetary Sciences; and the Woods Hole Oceanographic Institution), 1999.
Includes bibliographical references (leaves 92-100).
The linkage between physics and biology is studied by applying a one-dimensional model and a two-dimensional model to the Sargasso Sea and the Gulf of Maine- Georges Bank region, respectively. The first model investigates the annual cycles of production and the response of the annual cycles to external forcing. The computed seasonal cycles compare reasonably well with the data. The spring bloom occurs after the winter mixing weakens and before the establishment of the summer stratification. Sensitivity experiments are also carried out, which basically provide information of how the internal bio-chemical parameters affect the biological system. The second model investigates the effect of the circulation field on the distribution of phytoplankton, and the relative importance of physical circulation and biological sources by using a data assimilation approach. The model results reveal seasonal and geographic variations of phytoplankton concentration, which compare well with data. The results verify that the seasonal cycles of phytoplankton are controlled by both the biological source and the physical advection, which themselves are functions of space and time. The biological source and the physical advection basically counterbalance each other. Advection controls the tendency of the phytoplankton concentration more often in the coastal region of the western Gulf of Maine than on Georges Bank, due to the small magnitude of the biological source in the former region, although the advection flux divergences have greater magnitudes on Georges Bank than in the coastal region of the western Gulf of Maine. It is also suggested by the model results that the two separated populations in the coastal region of the western Gulf of Maine and on Georges Bank are self-sustaining.
by Caixia Wang.
M.S.

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9

Hillerborg, Per. "Dynamic Model of a Diesel Engine for Diagnosis and Balancing". Thesis, KTH, Reglerteknik, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-107535.

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To monitor and control the combustion in a diesel engine one can study the speed signal from the ﬂywheel. The idea is that if individual cylinders give different amount of torque this will lead to variations in the ﬂywheel speed. A model which describes the cylinder torque based on ﬂywheel speed can be used to estimate the torque from individual cylinders. With this new knowledge of the individual performance of each cylinder the engine can be balanced. The balancing aim at making the speed of the ﬂywheel more even but also required a model with estimated cylinder torque as input. This model may also be used for testing new control algorithms easily and gaining understanding of the dynamics. In this thesis a time dissolved model is constructed to describe the cylinder pressure-, crankshaft-, ﬂywheel and damper dynamics. The model is based on a physical point of view by approximating the system into nodes containing mass, stiffness and friction. The inputs into the model are injection data from the engine management system (EMS) and a torque from a drive line. Ways to reduce the complexity of the model are investigated in order to invert the model to estimate the injection data based on ﬂywheel speed measurements. Measurementsare done in a test bed to receive data required for model simulation and validation. The result is that the main behavior of the dynamics is caught. The self oscillation behaviors in some operating points are however not caught which indicates that the model can not explain all behaviors. A reduced model works almost as well but of course looses more of the non stiffness behavior. As expected, the model equations can not be solved in real time. The result of the inverted reduced model depends on the ﬂywheel signal. When the signal contains little non stiffness behavior the result is good. An observer model based on the reduced model is suggested and tested in order to estimate the indicated torque from ﬂywheel data. The observer manages to detect errors in the injection.

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10

Xue, Yang. "Physically-Aware Diagnostic Resolution Enhancement for Digital Circuits". Research Showcase @ CMU, 2016. http://repository.cmu.edu/dissertations/720.

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Diagnosis is the first analysis step for uncovering the root cause of failure for a defective chip. It is a fast and non-destructive approach to preliminarily identify and locate possible defects in a failing chip. Despite many advances in diagnosis techniques, it is often the case, however, that resolution, i.e., the number of locations or candidates reported by diagnosis, exceeds the number of actual failing locations. To address this major challenge, a novel, machine-learning-based resolution improvement methodology named PADRE (Physically-Aware Diagnostic Resolution Enhancement) is described. PADRE uses easily-available tester and simulation data to extract features that uniquely characterize each candidate. PADRE applies machine learning to the features to identify candidates that correspond to the actual failure locations. Through various experiments, PADRE is shown to significantly improve resolution with virtually no negative impact on accuracy. Specifically, in simulation experiments, the number of defects that have perfect resolution is increased by 5x with little degradation of accuracy. An important investigation that typically follows diagnosis is Physical Failure Analysis (PFA), which can also provide information that is helpful for improving diagnosis. PADRE influences PFA within a novel, active learning (AL) based PFA selection approach. An active-learning based PADRE (AL PADRE) selects the most useful defects for PFA in order to improve diagnostic resolution. Experiments show AL PADRE can reach an accuracy of 90% with 60% less PFA, on average, compared to conventional defect selection for PFA. In addition, during the yield learning process, the failing mechanisms that lead to defective chips may change due to perturbations in the fabrication process. It is important for PADRE to perform robustly through the entire yield learning process. Therefore, additional techniques are developed to monitor the effectiveness of PADRE in real time, as well as to update PADRE efficiently and stably to cope with changing failure mechanisms.

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Reneker, Jennifer Christine. "Differential Diagnosis of Dizziness Following a Sports-Related Concussion". Kent State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=kent1445530345.

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12

Torstensson, Thomas. "Chronic Pelvic Pain Persisting after Childbirth : Diagnosis and Implications for Treatment". Doctoral thesis, Uppsala universitet, Allmänmedicin och preventivmedicin, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-211847.

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Objectives: To explore the pain mechanism and the origin of the pain and to evaluate a short-term pain relief treatment in women suffering from CPP persisting after childbirth in order to enable physiotherapeutic intervention. Material and methods: Thirty-six parous women with chronic pelvic pain persisting after childbirth were recruited at the Department of Physiotherapy, SundsvallHospital and by advertisements in newspapers and 29 parous women without chronic pelvic pain were recruited from an organized gynaecological screening at a midwifery surgery. All women were provoked by intra-pelvic palpation of 13 predetermined intra-pelvic landmarks. The provoked pain distribution was expressed in pain drawings and the pain intensity verbally on a Likert scale.Also, in a randomised controlled trial the 36 women with chronic pelvic pain were allocated to bilateral injection treatment with either triamcinolone or saline solutions, given once on the ischial spine with follow-up after four weeks. Results: Referred pain provoked on intra-pelvic landmarks follows a specific pattern. In general, pain provoked by palpation of the posterior intra-pelvic landmarks was mostly referred to the sacral region and pain provoked by palpation of the ischial and pubic bones was mostly referred to the groin and pubic regions. In women with chronic pelvic pain the provoked pain distribution area and pain intensity were magnified as compared to women without chronic pelvic pain. In the clinical trial decreased pain intensity, decreased distribution of pain and improved physical function was achieved among the triamcinolone treatment group as compared to the saline treatment group. Also, a positive correlation was shown between reduced pain intensity and improved function. Conclusions: Referred pain patterns provoked on intra-pelvic landmarks in women with chronic pelvic pain persisting after childbirth are consistent with sclerotomal sensory innervations and indicates allodynia and central sensitisation. This suggests that pain mapping can be used to evaluate and confirm the pain experience and contribute to diagnosis. Also, the pain intensity provoked by stimulation of the intra-pelvic landmarks is suggested to be useful to differentiate women with chronic pelvic pain from those without. Corticosteroid treatment to the ischial spine resulted in decreased pain and increased function.

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13

Bradshaw, Patrick T. Gammon Marilie D. "Post-diagnosis weight change, physical activity, and survival among women with breast cancer a longitudinal study with missing data /". Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2009. http://dc.lib.unc.edu/u?/etd,2868.

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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2009.
Title from electronic title page (viewed Jun. 4, 2010). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Epidemiology." Discipline: Epidemiology; Department/School: Public Health.

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14

Bergqvist, Saga. "Raman spectroscopy in neurosurgery". Thesis, Luleå tekniska universitet, Institutionen för teknikvetenskap och matematik, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-78665.

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Brain tumors or brain cancer is a disease than affects people of all ages. The median age of a person living with a brain tumor is 60 years, it is however a disease that affects children and young adults in high grade. Brain cancer is the second most common type of cancer among children and is also the most common cause of cancer related death among this group. To ensure that the damages on the brain is as small as possible, it is important that a tumor can be diagnosed and removed as early as possible. Previous methods of diagnosis is based on biopsy where a part of the tumor is removed and examinated by a pathologist. This is a time consuming process that also is biased by the human factor, there is therefore a need for a method that can be used \textit{in situ} with an unbiased result. One method that have shown great promise is photensitation with 5-Aminolevoluic acid (5-ALA). However, this method have shown to only work properly on tumors of high malignancy in adults. As a comlpiment to photosentisation, Raman spectroscopy have shown good promise in previous studies. This study was conducted to investigate the use of Raman spectroscopy as a tool for \textit{in situ} brain tumor diagnostics. The use of Raman spectroscopy was tested by comparing two previously performed studies, where they looked at a number of Raman bands from biological markers that are known to change in cancerous tissue as well as the intensity ratio between some Raman bands. A measurement system for Raman spectroscopy was designed and built at Luleå University of Technology where the system were evaluated on tissue samples from conventional meat i.e. pork and beef to ensure that is was possible to achieve spectroscopic information of protein and lipid content in tissue. The measurement system was then transported to Linköpings University where the measurements on six brain tissue samples where performed. The samples came from five different tumors of which one tumor was thought to come from a high malignant tumor based on preliminary histopathological analysis and four from low malignant or benign tumors. Two samples where obtained from the high malignant tumor that was photosentisized with 5-Aminolevoluic acid and one of the samples where illuminated with blue light prior to the Raman spectroscopic measurements. The spectroscopic data was pre-processed before analysis using conventional methods. The analysed spectra from the brain tissue samples showed presence of the Raman bands associated with brain tissue. It was also possible to see Raman bands associated with 5-ALA in the samples that had been photosentisized, however when the tissue had been illuminated with blue light it was also possible to see distinct Raman bands associated with brain tissue. One tissue sample also showed presence of reduced Neuroglobin (NGB). The composition of NGB is also known to change in tumorous tissue and could therefore be used in future work as a biological marker for brain tumors. When comparing the results obtained in this study with the two previously performed, one of the studies showed that two samples were from a tumor of high malignancy and the other from low malignant or benign tumors. This result was in accordance with the preliminary histopathological assessment of the brain tissue samples. When comparing the results to the other study, the results where contradictory and indicated that all tissue samples where from low malignant or benign tumors. The conclusion of this work is that Raman spectroscopy is possible to use as a tool for brain tumor diagnostics. It would be desirable to use this method in combination with 5-ALA staining since the Raman bands from brain tissue could be resolved when the tissue had been illuminated with blue light.
Hjärntumörer kan drabba människor i alla åldrar, medelåldern för människor som lever med en hjärntumör är 60 år, men det är ett tillstånd som även drabbar barn och unga i stor utsträckning. Hjärntumörer är den näst vanligaste cancerformen hos barn och är även den främsta orsaken till cancerrelaterad död i den åldergruppen. För att minimera skadorna på hjärnan är det viktigt att en tumör kan lokaliseras och tas bort så tidigt som möjligt. De metoder som används idag bygger framför allt på biopsi, där en del av tumören tas bort och undersöks av en histopatalog. Det är en process som tar lång tid och även påverkas av den mänskliga faktorn, det finns därmed ett behov av en metod som kan avändas \textit{in situ} som ger ett resultat som inte påverkas av den mänskliga faktorn. En metod som har visat lovande resultat är fotosensibilisering med 5-Aminolevulinsyra (5-ALA). Desvärre har den metoden bara visat sig fungera bra för högmaligna tumörer hos vuxna. Som ett komplement till fotosensibilisering har Ramanspektroskopi visat lovande resultat i tidigare genomförda studier. Det här arbetet genomfördes för att undersöka användningen av Ramanspektroskopi som ett verktyg för diagnostisering av hjärntumörer. Som grund användes två tidigare genomförda studier där de undersökte Ramanband från biologiska markörer i hjärnvävnad som ändras i cancerogen vävnad. De undersökte även hur den biokemiska sammansättningen av hjärnvävnaden ändrades genom att jämföra intensiteten av olika Ramanband. Ett mätsystem för Ramanspektroskopi designades och byggdes upp på Luleå Tekniska Universitet där det även testades på vävnad från kött (fläsk och biff). Därefter transporterades mätsystemet till Linköpings Universitet för att genomföra mätningar på sex olika vävnadsprov från fem hjärntumörer av olika malignitet. Baserat på en preliminär histopatalogisk bedömning var en av tumörerna högmalignt och de fyra andra tumörerna var antingen lågmalignta eller benigna. Två av proverna som undersöktes kom från den högmalignta tumören som även var fotosensibilierad med 5-Aminolevulinsyra, varav ett av proverna var belyst med blått ljus innan de Ramanspektroskopiska mätningarna genomfördes. Innan resultatet från Ramanspektroskopiska mätningarna analyserades behandlades datan med konventionella metoder i MatLab. I de resulterade spektrumen gick det att se tydliga Ramanband associerade med hjärnvävnad. Det gick även att se Ramanband associerade med 5-ALA i de två prover som var fotosensibiliserade och i det provet som var belyst med blått ljus innan de spektroskopiska mätningarna gjordes gick det även att se tydliga Ramanband associerade med hjärnvävnad. När resultatet analyserades gick det även att se spektra associerat med reducerat Neuroglobin (NGB) i ett av proverna. Sammansättningen av NGB är också någonting som ändras i cancerogen vävnad och skulle därför också kunna användas som en bilogisk markör för hjärntumörer i framtida studier. När resultaten från den här studien jämfördes med de tidigare studierna indikerade den ena studien att två av vävnadsproverna kom från en högmalignt tumör och att de resterande fyra från lågmaligna eller benigna tumörer, vilket stämmer överens med den preliminära diagnosticeringen av tumörerna. När resultatet istället jämfördes med den andra studien stämde inte resultatet lika bra med den preliminära diagnosticeringen av tumörerna. Metoden presenterad av Zhou m.fl. indikerade att alla tumörer kom från lågmaligna eller benigna tumörer. Slutsaten av det här arbetet är att Ramanspektroskopi skulle kunna användas som en metod för diagnosticering av hjärntumörer. Metoden skulle även fungera bra som ett komplement till fotosensibilisering med 5-ALA eftersom att det var möjligt att se Ramanband associerade med hjärnvävnad när vävnaden hade belysts med blått ljus.

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Thomas, Paul Simon Public Health &amp Community Medicine Faculty of Medicine UNSW. "Vertical and horizontal methods of peer learning in clinical examination skills". Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2003. http://handle.unsw.edu.au/1959.4/19370.

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Peer-learning enhances the learning experience of students, but little research in this area has studied medical students developing their clinical physical examination skills. This thesis describes two peer-learning processes to aid this skill development: peer???learning from advanced beginners to novices (vertical); and peer-to-peer learning (horizontal). The hypothesis was that the process would be effective and acceptable to tutors and tutees. Vertical Peer Teaching: After a successful pilot scheme using junior doctors to tutor medical students, senior medical students were engaged as tutors as the junior doctors were too busy. Following instruction in tutoring and defining teaching topics, they taught a group of junior students. Evaluation of both groups was by summative clinical examination scores, by interviews and questionnaires. Scores were compared with non-participating control subjects. Tutors showed a significantly superior examination performance compared with the control group. Tutees showed a non-significant improvement. Tutors considered their skills had improved, with increased confidence in both performance and teaching, particularly in the communication and metacognitive domains. Tutees indicated the process to be very useful, with increased opportunity for feedback and questioning. There was little evidence of a reduction in the barriers between the years, perhaps because the student tutors were viewed in the traditional role of 'experts' . Horizontal Peer Teaching: Same-level dyads using a videotaped examination skill and script were assessed by summative examination and subjectively. These skills showed a significant improvement when compared to a control group. Despite this effect and many positive aspects reported, there were some concerns with the process. Students felt that a videotape and a peer instead of an ???expert??? was not as good as a traditional tutorial. In conclusion, the peer-learning was successful in several domains. Vertical peer-learning was accepted by both tutors and tutees, and horizontal-peer learning had a positive influence upon examination results. Vertical peer-learning appears to conform to students??? expectations of the inequality between beginners and tutors who are advanced beginners or experts, while horizontal peer-learning is more challenging, even though it is effective. The latter may need careful introduction for the process to be acceptable to students.

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Hunter, Randee L. "Bioarchaeological Implications of a Differential Diagnosis of Diffuse Idiopathic Skeletal Hyperostosis (DISH) in Gorilla gorilla gorilla". The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1275077374.

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17

Kleman, Björn, e Henrik Lindgren. "Evaluation of model-based fault diagnosis combining physical insights and neural networks applied to an exhaust gas treatment system case study". Thesis, Linköpings universitet, Fordonssystem, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-176650.

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Fault diagnosis can be used to early detect faults in a technical system, which means that workshop service can be planned before a component is fully degraded. Fault diagnosis helps with avoiding downtime, accidents and can be used to reduce emissions for certain applications. Traditionally, however, diagnosis systems have been designed using ad hoc methods and a lot of system knowledge. Model-based diagnosis is a systematic way of designing diagnosis systems that is modular and offers high performance. A model-based diagnosis system can be designed by making use of mathematical models that are otherwise used for simulation and control applications. A downside of model-based diagnosis is the modeling effort needed when no accurate models are available, which can take a large amount of time. This has motivated the use of data-driven diagnosis. Data-driven methods do not require as much system knowledge and modeling effort though they require large amounts of data and data from faults that can be hard to gather. Hybrid fault diagnosis methods combining models and training data can take advantage of both approaches decreasing the amount of time needed for modeling and does not require data from faults. In this thesis work a combined data-driven and model-based fault diagnosis system has been developed and evaluated for the exhaust treatment system in a heavy-duty diesel engine truck. The diagnosis system combines physical insights and neural networks to detect and isolate faults for the exhaust treatment system. This diagnosis system is compared with another system developed during this thesis using only model-based methods. Experiments have been done by using data from a heavy-duty truck from Scania. The results show the effectiveness of both methods in an industrial setting. It is shown how model-based approaches can be used to improve diagnostic performance. The hybrid method is showed to be an efficient way of developing a diagnosis system. Some downsides are highlighted such as the performance of the system developed using data-driven and model-based methods depending on the quality of the training data. Future work regarding the modularity and transferability of the hybrid method can be done for further evaluation.

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Mack, Inocentio Damien. "Condition physique et santé : du diagnostic à l'activité physique personnalisée chez le senior (ASM Vitaly Test)". Thesis, Université Clermont Auvergne‎ (2017-2020), 2019. http://www.theses.fr/2019CLFAC054.

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L'objectif de la thèse était de créer et de tester un dispositif d'évaluation de la condition physique afin de permettre une reprise d'activité physique pour des personnes en bonne santé. Le dispositif doit permettre de créer une cohorte de sujets suivi dans leur activité physique et leur santé en partenariat avec des associations ou des établissements de soins
The objective of the thesis was to create and test a fitness assessment tool promoting resume of physical activity for healthy people. The device must make it possible to create a cohort of subjects followed in their physical activity and their health in partnership with associations or health care institutions

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Cisek, Katryna. "Rational Optimization of Small Molecules for Alzheimer’s Disease Premortem Diagnosis". The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1338325484.

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Pappada, Holly T. Renzhofer. "THE EXPERIENCE AND PSYCHO-SOCIAL IMPLICATIONS OF CHRONIC PAIN: THE IMPORTANCE OF A MEDICAL DIAGNOSIS". Case Western Reserve University School of Graduate Studies / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=case1586204447441831.

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21

Mohamed, Ahmed. "Fault-detection in Ambient Intelligence based on the modeling of physical effects". Phd thesis, Supélec, 2013. http://tel.archives-ouvertes.fr/tel-00995066.

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This thesis takes place in the field of Ambient Intelligence (AmI). AmI Systems are interactive systems composed of many heterogeneous components. From a hardware perspective these components can be divided into two main classes: sensors, using which the system observes its surroundings, and actuators, through which the system acts upon its surroundings in order to execute specific tasks.From a functional point of view, the goal of AmI Systems is to activate some actuators, based on data provided by some sensors. However, sensors and actuators may suffer failures. Our motivation in this thesis is to equip ambient systems with self fault detection capabilities. One of the particularities of AmI systems is that instances of physical resources (mainly sensors and actuators) are not necessarily known at design time; instead they are dynamically discovered at run-time. In consequence, one could not apply classical control theory to pre-determine closed control loops using the available sensors. We propose an approach in which the fault detection and diagnosis in AmI systems is dynamically done at run-time, while decoupling actuators and sensors at design time. We introduce a Fault Detection and Diagnosis framework modeling the generic characteristics of actuators and sensors, and the physical effects that are expected on the physical environment when a given action is performed by the system's actuators. These effects are then used at run-time to link actuators (that produce them) with the corresponding sensors (that detect them). Most importantly the mathematical model describing each effect allows the calculation of the expected readings of sensors. Comparing the predicted values with the actual values provided by sensors allows us to achieve fault-detection.

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Foster, Clare. "Experiences of physical activity by children with a diagnosis of obesity from the Bangladeshi community living in East London : an interpretative phenomenological analysis". Thesis, University of East London, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.532684.

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This study explored the experiences of physical activity of Bangladeshi adolescents diagnosed with obesity. It adopted a qualitative methodology using Interpretative Phenomenological Analysis and semi-structured interviews to explore this un-researched area. Physical activity generally declines In adolescence, and is especially low in Bangladeshi young people. It is an integral part of treatments for childhood obesity and therefore, it is important to maximise uptake and engagement. The study findings are reported as four main themes. Physical activity was understood to offer protection from health problems and facilitate weight loss. However, young people did physical activity for fun, weight loss and because it was a social experience, rather than for health reasons. The motivation of being with others, inclusion and friendships were high in the face of associated costs. Young people had to negotiate their dependency on adults for information about their health and for opportunities to do physical activity. Uptake of physical activity was limited by competing demands on time, proximity to home, ability to travel safely, and for females, by the presence of men and concerns over 'mixing'. However, when young people did access physical activity they enjoyed feeling energised, improved thinking, feeling lighter and the social approval physical changes offered. They disliked the physiological experiences associated with exertion and some young people were anxious about experiencing these. These findings are sample-specific; they cannot be extrapolated onto other groups in other areas. However, they highlight that many experiences were similar to the general population whilst some were culturally mediated. Young people accepted some personal responsibility for physical activity, which was problematic given the external barriers faced. Family norms, cultural norms, bullying and poverty are factors requiring attention in interventions. The findings are discussed in terms of the existing research base. Clinical and research implications are highlighted.

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Lehuby, Selma. "Relevância do exame clínico inicial de cavalos com cólica no estabelecimento de um diagnóstico médico e na determinação da opção terapêutica". Bachelor's thesis, Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária, 2011. http://hdl.handle.net/10400.5/3502.

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Dissertação de Mestrado Integrado em Medicina Veterinária
O termo cólica utiliza-se para designar uma síndrome comum a diferentes doenças e que se caracteriza por sinais de dor abdominal. Esta dor pode ter origem no tracto gastrointestinal ou não. No último caso, são denominadas “cólicas falsas”. Os dois tipos de cólicas apresentam sinais similares, podendo ser difícil diferenciá-las. Para tal, um exame físico completo deve ser realizado nos cavalos em cólica à sua chegada na clínica. Para além de diferenciar cólicas gastrointestinais de “cólicas falsas”, a avaliação da anamnese, do exame físico e dos testes laboratoriais deve permitir identificar qual o órgão ou conjunto de órgãos atingidos, fornecer um diagnóstico provisório e deve permitir decidir qual a opção terapêutica mais indicada. O exame físico consiste em avaliar o grau de dor, a distensão abdominal, o aparelho cardiovascular, a temperatura rectal e as fezes, mas também em realizar uma auscultação torácica e intestinal, uma intubação nasogástrica, uma palpação transrectal, uma ecografia e/ou uma radiografia abdominal, uma abdominocentese e por fim, análises sanguíneas. O objectivo deste trabalho consiste em verificar se o exame clínico realizado à chegada de um cavalo em cólica cumpre as suas funções, isto é, se permite diagnosticar correctamente a patologia causadora da cólica e se permite definir com exactidão qual a terapêutica necessária para a resolução da cólica. Os resultados obtidos permitem concluir que o diagnóstico definitivo na maioria das vezes não é alcançado, mas a zona do tracto gastrointestinal atingida e a terapêutica necessária são frequentemente reconhecidas.
ABSTRACT - Relevance of the initial physical examination of horses with colic in the establishment of a medical diagnosis and in the determination of the therapeutic option. - “Colic” is a term used to define a syndrome common to different diseases, which is characterized by signs of abdominal pain. This pain can originate in the gastrointestinal tract or not. In this last case, they are called “false colics”. The clinical signs in the two types of colic are similar, so it can be difficult to differentiate them. To do so, a complete physical exam should be performed in horses with colic at their arrival at the clinic. Besides distinguishing gastrointestinal colics from “false colics”, anamnesis, physical examination and laboratory tests assessment should allow the identification of the organ or organs affected, suggest a provisional diagnosis and enable the choice of the best-indicated therapeutic option. This physical exam should consist of: pain severity, abdominal distention, cardiovascular status, rectal temperature and feces assessment as well as thoracic and intestinal auscultation, nasogastric intubation, trans-rectal palpation, ultrassonography, radiography, abdominocentesis, and blood analysis. The purpose of this work is to confirm that the physical exam performed in horses with colic at their arrival at the clinic carries out its functions, in other words, if it enables the correct diagnosis of the pathology and allows the identification of the needed therapeutic. The results obtained enabled us to conclude that the definitive diagnosis is most of the time not achieved however, the affected portion of the gastrointestinal tract and the needed therapeutic are frequently identified.

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Santos, Fabiane Costa. "Diagnóstico da situação dos serviços ambulatoriais de reabilitação física no SUS na cidade de Salvador-Bahia". Dissertação apresentada ao Programa de Pós-Graduação em Saúde Coletiva, como requisito parcial para a obtenção do título de mestre em Saúde Comunitária, 2013. http://www.repositorio.ufba.br/ri/handle/ri/11451.

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Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-28T19:05:14Z (GMT) No. of bitstreams: 1 Diss Fabiane Costa Santos. 2013.pdf: 2025697 bytes, checksum: 32d1940f46251b1cee721713af55a8bb (MD5)
Made available in DSpace on 2013-05-28T19:05:14Z (GMT). No. of bitstreams: 1 Diss Fabiane Costa Santos. 2013.pdf: 2025697 bytes, checksum: 32d1940f46251b1cee721713af55a8bb (MD5) Previous issue date: 2013
Segundo o Relatório Mundial sobre a Deficiência, mais de um bilhão de pessoas são acometidas pelo problema e destas, 200 milhões enfrentam alterações de funcionalidade que comprometem suas atividades de vida diária. No Brasil, o envelhecimento populacional, o aumento da incidência de acidentes e violências e ainda outros agravos - que conferem ao indivíduo algum grau de deficiência - representam um desafio para o SUS, pautado na organização da assistência à saúde, dos cuidados básicos à reabilitação. Os serviços de reabilitação física encontram-se entre os principais problemas do sistema e apesar das políticas que normatizam a criação destas unidades, poucas conquistas foram evidenciadas, faltando implantar os planos desenvolvidos. Precariedade da oferta de atendimento multiprofissional e domiciliar, carência de dispensação de órteses e próteses e dificuldade de acesso foram problemas dos serviços de cinco capitais estudadas, e despertaram curiosidade em relação à situação de Salvador. Realizou-se um diagnóstico de doze serviços, com utilização de dados secundários do CNES e entrevistas com gerentes dos serviços e técnico da SESAB. O diagnóstico administrativo e o momento explicativo do planejamento situacional foram as referências teórico-metodológicas adotadas. Os resultados apontaram para insuficiência de unidades e infraestrutura, inexistência de serviço da rede própria municipal, problemas de gestão, organização e prestação de serviços, e divergência entre dados do CNES e a realidade dos estabelecimentos. O propósito de mudança da situação evidenciada exige a formação de sujeitos transformadores, visando impulsionar um movimento que resulte na concretização de ações de melhoria da assistência em reabilitação física em Salvador, Bahia.
Salvador

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Kareha, Stephen Michael. "Shoulder Symptom Irritability: Development and Testing of a New Construct". Diss., NSUWorks, 2018. https://nsuworks.nova.edu/hpd_pt_stuetd/73.

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Background: Physical therapists regularly make decisions regarding intervention intensity based upon pathoanatomy and symptom irritability, but the reliability and validity of classifying patients by symptom irritability are unknown. Purpose: Examine the reliability and construct validity of the shoulder symptom irritability classification (SSIC) system for the purposes of determining an appropriate treatment intensity. Design: Prospective repeated-measures cross-sectional single-blinded design. Methods: 101 consecutive subjects with primary complaints of shoulder pain were assessed by a pair of blinded raters. Raters recorded the SSIC level and selected the appropriate intervention intensities for the subjects. Data Analysis: Prevalence-adjusted, bias-adjusted Kappa for ordinal scales (PABAK-OS) and observed agreement were the primary measures of reliability. Analysis of variance (ANOVA) was used to compare functional disability across different levels of irritability. Receiver operating characteristic (ROC) curve analysis was utilized to derive cut-off scores for the patient-reported outcome (PRO) measures. Ordinal regression was utilized to compare the strength of patient-reported pain and disability in the determination of shoulder symptom irritability. Results: Inter-rater reliability (PABAK-OS) was 0.69 (95% Confidence Interval [CI] = 0.59, 0.78). ANOVA demonstrated significant differences in functional limitation between SSIC groups for all PRO measures. ROC curve analysis found significant cut-off scores for all PRO measures. Lastly, rater agreement between SSIC and treatment strategy was found to have PABAK-OS of 0.82 (95% CI 0.75, 0.88) with 80% agreement. Discussion: The inter-rater reliability of the SSIC system good and is not contingent upon experience or expertise. Despite lack of predominance of the function in the components of SSIC, functional limitation significantly influences SSIC along with aspects of pain that influence function. While the cut-off scores show promising results, further work is needed to validate the results. Ultimately, there appears to an excellent relationship between rater selected SSIC and treatment strategy demonstrating a foundation for construct validity of the SSIC. Therefore, the results of this study should serve as a foundation for future work for refinement of the SSIC as a component of the STAR-Shoulder diagnostic classification system. Clinical Significance: The shoulder symptom irritability classification scale is reliable and clinically useful for improvement of communication between medical providers.

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Elramli, Amal. "Effectiveness of community based physical activity on step count and sedentary behaviour in people with rheumatoid arthritis within the first five years of diagnosis". Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8491/.

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Background: Rheumatoid Arthritis (RA) is associated with increased risk of cardiovascular disease (CVD). Physical inactivity is a modifiable risk factors of CVD and frequently associated with impaired functional status and health related quality of life. Objectives: This single blind randomised controlled trial investigated the impact of a pedometer-supported walking and education programme (Walk for RA-WARA) on PA, sedentary time, PA self-efficacy, disease activity, functional capacity, quality of life and cardiovascular (CV) risk in people with RA. Methods: Seventy-six individuals, aged 56 (±15) years and within 5 years from RA diagnosis were randomly assigned to either the WARA intervention group (six weekly group education sessions and two booster sessions at 3 and 6 months) or the control group (single session). Demographic data were recorded and Body Mass Index (BMI), Waist-Hip ratio (WHR), Waist-Height ratio (WHtR), and blood pressure were measured. The primary outcomes were objectively measured PA profiles, daily step counts and time spent sedentary, using an activPALTM and self-reported using international physical activity questionnaire (IPAQ). Functional status was assessed with six-minute walk test (6MWT), health assessment questionnaire (HAQ), and hand grip strength. Rheumatoid arthritis quality of life (RAQoL) and PA Self-efficacy were evaluated. Blood samples were taken and the 10-year risk of CVD scores were calculated, using the Scottish Intercollegiate Guidelines Network (ASSIGN). Data were analysed descriptively and mixed generalised linear models (GLM) were used incorporating restricted maximum likelihood (REML) and post-hoc analyses. Interviews were undertaken with 10 people from the intervention and data were analysed thematically using the framework approach and NVivo 11 software. Results: The intervention group showed a significantly greater increase than the control group in steps/day at 3 months (by 3413 (1835-4990) steps/day, mean (95%CI)) (P < 0.001), and 6 months (3599 (2135-5062) steps/day) (P < 0.001) and a significant reduction in IPAQ weekday (P=0.014) and weekend sitting time (P=0.046). There were significant improvements in 6MWT (P < 0.001), PA self-efficacy (P=0.008), systolic blood pressure (P=0.002) and ASSIGN scores (P < 0.001) in the intervention group. Participants found education sessions, booster sessions, hand-outs, pedometer, PA diaries were important factors in increasing their step counts. In addition, they stated that WARA programme was enjoyable and helpful in terms of raising their knowledge regarding their condition. They also reported they felt much healthier and their mood had improved. Conclusions: The 6-month WARA intervention was effective in promoting PA, PA self-efficacy, physical function, and reducing the 10-year risk of CVD. The WARA programme may be a useful adjunct to current clinical practice in rheumatology.

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Packard, Stacie S. "EFFECTS OF VIGOROUS BOUTS OF PHYSICAL ACTIVITY IN ELEMENTARY STUDENTS WITH AND WITHOUT A DIAGNOSIS OF ATTENTION DEFICIT DISORDER: AN EXAMINATION OF HOW PHYSICAL ACTIVITY INFLUENCES THE ATTENTION AND CONCENTRATION OF STUDENTS IN THE SCHOOL ENVIRONMENT". Oxford, Ohio : Miami University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1182358294.

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Karlsson, Joakim, e Ola Gustafsson. "Specialpedagogers syn på matematiksvårigheter och dyskalkyli". Thesis, Malmö högskola, Fakulteten för lärande och samhälle (LS), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-35601.

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The purpose of this empirical study is to investigate special needs education teachers’ perception and knowledge before the concepts of mathematics difficulties and dyscalculia. We chose to emanate from three main questions. What meaning do the concepts of math difficulties and dyscalculia have for special needs education teachers? What do special needs education teachers think about the actuality regarding dyscalculia? What are the different approaches implemented by special needs education teachers towards mathematics difficulties and dyscalculia? Qualitative interviews were chosen as method because we believe that a survey would be too shallow and statistical. Responses may be too monotonous and short. By selecting interview as an information retrieval method gives us the opportunity to go more in depth with the help of supplementary questions, personal interaction and observation of the interviewee. The special needs education teachers we interviewed mostly agree with one another, however sometimes their perceptions differed which has led to an interesting and nuanced result. The result has given us many different approaches and beliefs facing difficulties in mathematics and dyscalculia, these makes us better equipped for our future students with difficulties in math. A definite conclusion from this study is that all our respondents jointly agreed that use of exploratory practical material and group works were suitable towards students with dyscalculia or math difficulties.

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Hillsäter, Johansson Emmely, e Maria Viding. "Astma/KOL sjuksköterskans erfarenhet av att motivera patienter med KOL diagnos till ökad fysisk aktivitet : En kvalitativ intervjustudie". Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-99007.

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Bakgrund: Kronisk obstruktiv lungsjukdom (KOL) är en av de vanligaste diagnoserna i primärvården. En viktig del av astma/KOL sjuksköterskans roll är att motivera patientgruppen till ökad fysisk aktivitet då de ofta är fysiskt inaktiva på grund av sitt hälsotillstånd. Syfte: Syftet med studien var att beskriva astma/KOL sjuksköterskans erfarenheter av att motivera patienter med KOL diagnos till ökad fysisk aktivitet. Metod: Kvalitativ design med induktiv ansats valdes som metod och nio semistrukturerade intervjuerna genomfördes. Intervjuerna analyserades med hjälp av kvalitativ innehållsanalys. Resultat: Två kategorier framkom i analysen. I den första kategorin Strategier beskrevs olika tillvägagångssätt för hur astma/KOL sjuksköterskan motiverade patienterna till ökad fysisk aktivitet. I den andra kategorin Samverkan med andra framkom vikten av att samverka med andra professioner för patientens bästa, men även en fungerande samverkan mellan astma/KOL sjuksköterskor var av stor vikt. Slutsats: Astma/KOL sjuksköterskan beskrev att det var viktigt att hitta individanpassade strategier för att kunna motivera till ökad fysisk aktivitet. Att hjälpa patienten att hantera känslor av skam och skuld som ett led i att motivera var betydelsefullt enligt sjuksköterskorna. Beroende på vilket sjukdomsstadie patienten befann sig i kunde sättet att motivera se olika ut, men det var alltid den enskilda individen som satte ramen för på vilket sätt sjuksköterskorna motiverade. Anhöriga involverades endast till liten del. Då patienterna ofta var i behov av styrda råd användes motiverande samtal (MI) endast i liten utsträckning. Interprofessionell samverkan och samverkan mellan astma/KOL sjuksköterskor har betydelse för en bra vård för patientgruppen. Om mer tid och resurser ges ökar detta förutsättningarna till en bra vård.
Background: Chronic obstructive pulmonary disease (COPD) is one of the most common diagnoses in primary care. An important part of the asthma/COPD nurses’ role is to motivate the patient group to increased physical activity, as they are often physically inactive due to their state of health. Aim: The aim of the study was to describe the asthma/COPD nurses’ experiences of motivating patients with COPD diagnosis to increased physical activity. Method: Qualitative design with an inductive approach was chosen as the method. Nine structured interviews were conducted. The interviews were analyzed using qualitative content analysis. Results: Two categories emerged in the analysis. The first category Strategies described different approaches for how the asthma/COPD nurse motivated patients to increase physical activity. In the second category Collaboration with others, the importance of collaborating with other professions for the patient´s benefit emerged, but also a functioning collaboration between asthma/COPD nurses was of great importance. Conclusion: The asthma/COPD nurse described that it was important to find individualized strategies to be able to motivate increased physical activity. Helping the patient deal with feelings of shame and guilt as part of motivating was important according to the nurses. Depending on the patients stage of illness the motivation could look different, but it was always the individual who set the framework in which way the nurses motivated. Relatives were only slightly involved. As patients were often in need of guided counseling, Motivational Interviewing (MI) was used only to a small extent. Interprofessional collaboration and collaboration between asthma/COPD nurses is important for good care for the patient group. If more time and resources are given, this can increase the conditions for a good care.

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Llanca-Vargas, Daniel. "Caractérisation de tunnels anciens en maçonnerie par des techniques d'auscultation non conventionnelles. Application au réseau RATP". Thesis, Clermont-Ferrand 2, 2014. http://www.theses.fr/2014CLF22434/document.

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De nos jours la quasi-totalité des grandes métropoles du monde comptent avec des réseaux de transport étendus et ont pour la plupart satisfait leurs besoins de construction d’ouvrages souterrains. Cependant le parc des ouvrages existants est vieillissant et une part importante est en service depuis plusieurs décennies, par conséquence, l’entretien et la pérennisation des infrastructures souterraines existantes un enjeu majeur pour la gestion et le développement des villes. En vue d’améliorer leur politique de maintenance, c’est-à-dire pérenniser leur patrimoine et le maintenir dans de bonnes conditions de sécurité et d’exploitation, il est nécessaire que les gestionnaires d’ouvrages puissent mettre à jour leurs techniques de diagnostic (AFTES, 2005). Il est donc impératif de disposer d’outils leur permettant de mieux évaluer l’état réel des ouvrages. Or les méthodes dont disposent à l’heure actuelle les gestionnaires sont le plus souvent soit insuffisantes pour apporter une information quantitative de qualité, soit mal adaptées aux contraintes de ces ouvrages. Dans ce contexte, le projet ANR MéDiTOSS « Méthodologie de Diagnostic des Tunnels et Ouvrages Souterrains en Service » vise à développer une nouvelle méthodologie de diagnostic adaptée à ce type d’ouvrage en caractérisant les différents composants de l’ouvrage (structure du revêtement, terrain encaissant ainsi que leur interface ou contact). L’objectif de cette thèse est de fournir au gestionnaire des indicateurs physiques et mécaniques lui permettant d’orienter sa politique de maintenance en s’appuyant sur une expertise plus certaine
Maintenance and sustainability of underground structures are the major tasks for infrastructures’ owners. To carry out these tasks, managers need to qualify the actual state of these facilities. There are very few operational methods to describe separately each component of an underground structure (structure lining, contact interface and surrounding soil). Most of them are mainly based on visual inspection. Nevertheless only the intrados of the tunnel is open to visual inspection. To improve their maintenance policy, that is to say sustain their heritage and keep it in good conditions of safety and operational, it is necessary that manager’s can update their diagnosis methods (AFTES, 2005). It is therefore imperative to have tools to better assess the actual condition of structures. However, the methods available at present managers are often either insufficient to provide quantitative information quality or poorly adapted to the constraints of these works. In this context, the ANR project MéDiTOSS "Methodology Diagnostic Tunnels and Underground Structures in Service" aims to develop a new diagnostic methodology adapted to this type of work characterizing the various components of the structure (structure of the lining, enclosing soil and their interface or contact). The objective of this thesis is to provide to the managers of physical and mechanical indicators that will guide its maintenance policy based on a certain expertise

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Ding, Ying. "The Use Of Tissue And Serum ”˜Omics' Methods To Characterize Disease". BYU ScholarsArchive, 2018. https://scholarsarchive.byu.edu/etd/7720.

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Preeclampsia (PE) is a multisystem disorder that contributes to maternal and fetal mortality and morbidity worldwide. It is characterized by de-novo hypertension and proteinuria or other maternal organ damage after 20 weeks of gestation. Evidence suggested that endogenous digitalis-like factor (EDLF) contributes to the pathogenesis of PE, and that the potential source of EDLF is the placenta. EDLF can inhibit the sodium pump (SP) specifically and may lead to hypertension, it has also been associated with hypoxia, oxidative stress and other abnormalitites present in PE.We studied whether normal human placenta responded to SP inhibition casued by EDLF with a change in abundance of lipids in the placental cytosol, and whether there was a characteristic set of lipid changes that could serve as a signature for EDLF exposure if there were such changes. Placenta tissues from 20 normal pregnancies were incubated for 48 hr in the presence and absence of ouabain, a widely studied EDLF, followed by tissue homogenization, lipid extraction, and the study of lipids using a mass spectrometery (MS) based lipidomics approach. 1207 lipidomic markers were surveyed by paired Student t-test, among which 26 markers had significantly different abundances between cases and control at the FDR=0.05 level. A set of 8 lipidomic markers were selected by a statistical model built with a sparse partial least squares discriminant analysis method (sPLS-DA) and a bootstrap procedure. All eight markers were then chemically characterized and partially identified using tandem MS. These markers might be used to identify placentas that have been previously exposed to EDLF in return.Endogenous peptides and small proteins might contribute to the pathophysiology of various diseases. Therefore, we investigated the potential peptidomic profile of placenta tissues in response to EDLF exposure as well. Placenta tissues from 20 normal pregnancies were incubated for 25 hr with and without the addition of ouabain, followed by homogenization, protein depletion, and the study of the peptides by a LC-MS based peptidomics approach. 275 peptidomic markers were evaluated by Student t-test. A set of 8 markers was chosen using a logistic regression model build with the Akaike information criterion (AIC). However, no peptidomics markers or set of markers showed specific, statististically significantly different changes in abundances between cases and controls after applying a false discovery rate (FDR) correction or using more conservative methods to overcome over-fitting. Using an optimal sPLS- DA, cross-validation studies and logistic regression models, we also found that the addition of any peptidomic marker to the previously selected lipidomic profile was unlikely to help identify placentas that had been exposed to EDLF.Alzheimer's disease (AD) is the most common form of dementia and the number of AD cases worldwide is currently estimated to be 36 million. The exact pathogenesis of AD remainsiielusive and available therapeutic strategies can only delay its progession temporarily. Several hypotheses have been proposed regarding the pathophysiology of AD and the beta-amyloid (AÎ²) hypothesis is considered the core mechanism. However, the majority of studies concerning AD, or AD biomarkers specifically, have ignored a potentially important variable that is gender, despite reported gender differences in the risk of developing AD, the risk factors, clinical symptoms and CSF biomarkers of the disease, among many other aspects.We analyzed data obtained from a previous study of diagnostic serum lipid biomarkers for AD with the consideration of potential gender difference. Firstly, we studied the interaction between gender and disease stage using analysis of variance (ANOVA) and analysis of covariance (ANCOVA). Lipid markers that showed statistically significant interaction were selected after applying a FDR correction. Secondly, using a lasso logistic regression model with binary classification (control vs. all AD stages), we identified gender-specific markers and found different coefficient estimates for different genders as well. Lastly, we build a new ordinal model with the addition of a gender-specific marker using a Bayesian lasso probit ordinal regression model. The predictive performance of the new model was found to be statistically significantly better than the previous model which was built without the consideration of gender.In conclusion, we successfully discovered, chemically characterized lipidomic markers indicative of EDLF exposure in placenta and detected gender-specific lipid markers for AD.

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Smith, Rebecca. "Segmentation and Fracture Detection in X-ray images for Traumatic Pelvic Injury". VCU Scholars Compass, 2010. http://scholarscompass.vcu.edu/etd/76.

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Due to the risk of complications such as hemorrhage, severe pelvic trauma is associated with a high mortality rate. Prompt medical treatment is therefore vital. However, the complexity of the injuries can make successful diagnosis and treatment challenging. By generating predictions and recommendations based on patient data, computer-aided decision support systems have the potential to assist physicians in improving outcomes. However, no current system considers features automatically extracted from medical images. This dissertation describes a system to extract diagnostic features from pelvic X-ray images that can be used as input to the prediction process; specifically, the presence of fracture and quantitative measures of displacement. Feature extraction requires prior identification of separate structures of interest within the pelvis. The proposed system therefore incorporates a hierarchical segmentation algorithm which is able to automatically extract multiple structures in a single pass, using a combination of anatomical knowledge and computational techniques such as directed Hough Transform. This algorithm also applies a novel Spline/ASM segmentation method which combines cubic spline interpolation with a deformable model approach which maintains curved contours and provides local control over segmentation. In order for the proposed system to be used as a component in a computerized decision support system, segmentation is designed to be entirely automatic. Furthermore, Spline/ASM is suitable for many other segmentation applications where the objects of interest show curved contours. After successful segmentation, fracture detection is performed on the pelvic ring and pubis structures, using an algorithm based on wavelet transform, anatomical information and boundary tracing. A method is also developed to calculate quantitative measures of symphysis pubis displacement that may indicate pelvic instability and prove useful in identifying fracture patterns. Finally, X-ray features are combined with patient demographics and physiological scores for generation of predictive rules for injury severity, with promising current results. This indicates the potential diagnostic value of the extracted features, and in turn the usefulness of the proposed radiograph analysis component in a larger decision support system.

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Hansson, Anna, e Nicole Marsnäs. "Fysisk aktivitet och upplevd fatigue hos kvinnor med bröstcancer". Thesis, Uppsala universitet, Åsenlöf: Fysioterapi, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-402692.

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Sammanfattning Bakgrund: Cancerfallen i Sverige fortsätter att öka. Bröstcancer är den vanligaste bland kvinnor, ungefär var tredje kvinna drabbas. Biverkningarna av cancerbehandlingar är många, en av de vanligaste är fatigue som försämrar livskvaliteten hos de drabbade. Fysisk aktivitet har visat sig fungera som en icke-farmakologisk behandling för att minska fatigue. Syfte: Syftet med denna studie var att undersöka sambandet mellan fysisk aktivitetsnivå och upplevd fatigue samt sambandet mellan tid sedan diagnos och upplevd fatigue hos kvinnor med bröstcancer. Metod: Tvärsnittsstudien har en kvantitativ design där mängden fysisk aktivitet och fatigue undersöktes med webbenkäter. Fysisk aktivitet undersöktes med The International Physical Activity Questionnaire (IPAQ-SF) och fatigue med Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F). Resultat: Resultatet av denna enkätstudie visade att 80% av respondenterna (n=70, medianålder 58 år) hade hög eller måttlig fysisk aktivitetsnivå, med ett medianvärde på 1 905 MET-minuter (metabol ekvivalent) per vecka. De hade även måttlig till svår fatigue, medianvärdet var 35 av 52 (n=70). Sambandet mellan fysisk aktivitet och fatigue var lågt, r=0,08, p=0,57. Mellan sjukdomsduration och upplevd fatigue var sambandet också lågt, r=0,08, p=0,49. Slutsats: Kvinnor med bröstcancer i denna studie har måttlig till hög aktivitetsnivå som överstiger den generella fysiska aktivitetsnivån hos Sveriges befolkning. Respondenterna upplever viss grad av fatigue som inte påverkades av sjukdomsduration. Någon signifikant korrelation kunde inte påvisas. Ytterligare forskning krävs för att fastställa hur relationen mellan sjukdomsduration och fatigue ser ut.
Abstract Background: The cases of cancer in Sweden continues to increase. Breast cancer is the most common form of female cancer. Cancer treatments side-affects are many, a common one is fatigue. Physical activity has shown to work as a nonpharmacological treatment to decrease fatigue. Aim: The aim of this study was to investigate the association between the level of physical activity and self-perceived fatigue, also to investigate the association between time since diagnosis and self-perceived fatigue in women with breast cancer. Method: This cross-sectional study has a quantitative design where physical activity and fatigue is examined with a web based questionaire. Physical activity was measured with The International Physical Activity Questionnaire (IPAQ-SF) and fatigue with Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F). Results: The results of this study showed that 80% of the respondents (n=70, median age 58 years) had high or moderate physical activity level, a median of 1 905 MET-minutes(metabolic equivalent)/week. The respondents (n=70) experienced a moderate to high fatigue, median value 35 of 52. The correlation between physical activity and fatigue was low, r=0,08, p=0,57 as well as between time since diagnosis and fatigue, r=0,08, p=0,49. Conclusion: Women with breast cancer in this study have shown to have a physical activity level that is higher than the average population of Sweden. They experienced fatigue, which was not affected of time since diagnosis. No significant correlation was shown in any of the questions at issue. Further research is necessary to determine how fatigue is affected by time since diagnosis.

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Treppo, Steven. "Physical diagnostics of cartilage degeneration". Thesis, Massachusetts Institute of Technology, 1999. http://hdl.handle.net/1721.1/85263.

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Thesis (Ph.D.)--Harvard--Massachusetts Institute of Technology Division of Health Sciences and Technology, February 1999.
"January 1999."
Includes bibliographical references (leaves 219-239).
by Steven Treppo.
Ph.D.

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35

Blagitz, Maiara Garcia. "Avaliação da relação do exame físico da glândula mamária de ovelhas da raça Santa Inês com o perfil citológico e bacteriológico do leite". Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/10/10136/tde-22052007-160910/.

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Com o objetivo de avaliar a relação entre o exame físico da glândula mamária de ovelhas com o leite, 292 ovelhas da raça Santa Inês foram examinadas. As amostras de leite foram submetidas ao exame bacteriológico, ao CMT e a CCS (automática e microscópica). Variações especificamente identificadas por inspeção da mama apresentaram alterações de celularidade observadas pelo CMT (p<0,002), na CCS automática (p<0,006), e na CCS microscópica diferencial para células mononucleares (p<0,03). Mamas pendulosas puderam ser associadas a maior isolamento bacteriológico (p<0,0006) e maior celularidade nas CCS automática (p<0,01) e microscópica (p<0,05). Na inspeção do teto foram encontradas diferenças no exame da CCS automática (p<0,002), no CMT (p<0,004) e na CCS microscópica diferencial para células mononucleares (p<0,005). Nos tetos com soluções de continuidade, foram observadas diferenças apenas no exame bacteriológico (p<0,03). Quanto à palpação da mama, foram observadas diferenças no exame bacteriológico (p<0,001), no CMT (p<0,01) e na CCS microscópica total (p<0,02) e diferencial para células polimorfonuleares (p<0,02) e para células mononucleares (p<0,0002). Quanto à palpação do teto, foram encontradas diferenças no CMT (p<0,01) e na CCS microscópica total (p<0,002) e diferencial para células polimorfonucleares (p<0,002) e para células mononucleares (p<0,002). Associando-se a inspeção à palpação das metades mamárias, observou-se diferenças na CCS automática (p<0,0002) e na CCS microscópica total (p<0,04) e diferencial para células mononucleares (p<0,01). No exame do fundo escuro, foram observadas diferenças no CMT (p<0,0001), na CCS automática (p<0,0001), e na CCS microscópica total (p<0,0001) e diferencial para células polimorfonucleares (p<0,0001) e mononucleares (p<0,0001). Quando associadas duas categorias do exame físico da glândula mamária, a inspeção e a palpação, e o exame do fundo escuro, foram observadas diferenças no CMT (p<0,0001), na CCS automática (p<0,0001) e na CCS microscópica total (p<0,0001) e diferencial para células mononucleares (p<0,0001). Nas ovelhas acompanhadas durante a lactação foram observadas diferenças na inspeção da mama (p<0,0001) e do teto (p<0,0001), na palpação da mama (p<0,005) e do teto (p<0,003), na inspeção e palpação das metades mamárias (p<0,04), na inspeção, palpação e fundo escuro das metades mamárias (p<0,03), na CCS automática (p<0,0001) e na CCS microscópica total (p<0,02) e diferencial para células polimorfonucleares (p<0,02) e para células mononucleares (p<0,02). Foi possível concluir que há relação entre o exame físico e o perfil celular e bacteriológico, mas que a inflamação da mama foi melhor identificada pelo CMT, através da inspeção da mama e do teto, da palpação da mama e do teto, do exame do fundo escuro e da avaliação da inspeção, palpação e fundo escuro das metades mamárias. A inflamação também foi identificada pela avaliação da CCS automática e/ou da CCS microscópica total e/ou diferencial através da inspeção da mama e do teto, pendulosidade da mama, palpação da mama e do teto, inspeção e palpação das metades mamárias, exame do fundo escuro e a inspeção, palpação e fundo escuro das metades mamárias. O processo infeccioso mamário pôde ser identificado através da pendulosidade mamária, presença de soluções de continuidade no teto e pela palpação da mama. A maior celularidade ocorreu no início da lactação. No final da lactação, houve maiores proporções de alterações na inspeção da mama e do teto e na palpação do teto. Nas fases intermediárias da lactação, as alterações na inspeção e palpação associadas e na inspeção, palpação e fundo escuro associados foram menores.
The aim of this work is to evaluate the relationship between the mammary gland physical examination of ewes and their milk. 292 ewes of Santa Inês breed were evaluated, and the milk samples were submitted to bacteriological examination, to CMT (California Mastitis Test), to automatic SCC (somatic cell count) and microscopic SCC. Specifically identified variations during the mama inspection had cellular alterations, observed in CMT (p<0,002), in automatic SCC (p<0,006) and in differential microscopic count for mononuclear cells (p<0,03). Pendulous mamas could be associated to the largest bacteriological isolation (p<0,0006) and the largest cellular in automatic SCC (p<0,01) and microscopic SCC (p<0,05). In the teat inspection, differences were found in the automatic SCC (p<0,002) in the CMT (p<0,004) and in differential microscopic count for mononuclear cells (p<0,005). In the teat with lesion, differences were observed only in bacteriological examination (p<0,03). In mamma palpation, there were observed differences in bacteriological examination (p<0,001), in CMT (p<0,01), in total microscopic count (p<0,02), differences to polymorphonuclear cells (p<0,02) and to mononuclear cells (p<0,0002). In teat palpation, differences were found in CMT (p<0,01), in total microscopic count (p<0,002) and differences to polymorphonuclear cells (p<0,002) and to mononuclear cells (p<0,002). Associating the inspection and palpation of mammary gland, differences were observed in automatic SCC (p<0,0002) and in total microscopic count (p<0,04) and differences to mononuclear cells (p<0,01). In tamis exam, differences were observed in the CMT (p<0,0001), in automatic SCC (p<0,0001), and in total microscopic count (p<0,0001) and differences to polymorphonuclear cells (p<0,0001) and mononuclear cells (p<0,0001). When the two categories of mammary gland physical exam, the inspection, the palpation, and the tamis exam were associated, there were observed differences in the CMT (p<0,0001), in the automatic SCC (p<0,0001) and in the total microscopic count (p<0,0001), and differences in the microscopic SCC to mononuclear cells (p<0,0001). In the ewes followed during the lactation there were differences in mamma inspection (p<0,0001), in teat (p<0,0001), in mamma palpation (p<0,005) and in teat (p<0,003), in the inspection and palpation of mammary gland (p<0,04), in inspection, palpation and tamis exam of mammary gland (p<0,03), in automatic SCC (p<0,0001) and in total microscopic count (p<0,02), and differences for polymorphonuclear cells (p<0,02) and to mononuclear cells (p<0,02). It can be concluded that there is a relationship among the physical exam and the cellular and bacteriological profile, but the mamma inflammation was better identified by the CMT, through inspection of mamma and teat, and mamma and teat palpation, and tamis exam and the evaluation by inspection, palpation and macroscopic assessment of the milk by mammary glands. The inflammation was also identified by the evaluation of automatic SCC and/or total microscopic count through inspection of mamma and teat, pendulous mamma, palpation of mamma and teat, inspection and palpation of mammary gland, tamis exam and the inspection, palpation and tamis exam of mammary gland and milk. The infection in mammary gland can be identified by pendulous mamma, lesion in teat and by palpation of mamma. The biggest cellular was found in early lactation. And in late lactation, there were found more alterations in mamma and teat inspection and palpation of teat. In the intermediate phases of lactation, the alterations in inspection and palpation associated and the inspection, palpation and the tamis exam associated were smaller.

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Chavango, Marta HermÃnia. "Environmental analysis of the watershed of the Mississippi River in IrauÃuba - CearÃ a contribution to the use of their land". Universidade Federal do CearÃ, 2014. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=13183.

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Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico
A bacia hidrogrÃfica do rio Missi (BHRM) compreende uma Ãrea de 148,4 Km2 situando-se entre as latitudes -3,7o e -3,8o e longitudes - 40o, e -39,7o e esta totalmente inserida na porÃÃo Noroeste do MunicÃpio de IrauÃuba na regiÃo Centro-Norte do Estado do CearÃ, isto Ã, na MicroregiÃo de Sobral. A rede de drenagem faz parte da bacia hidrogrÃfica do rio AracatiaÃu, apresenta solos rasos e uma vegetaÃÃo bastante degradada, caracteriza-se tambÃm por apresentar um Ãndice pluviomÃtrico que varia de 800 a 1250 mm, que nÃo favorecem boas condiÃÃes climÃticas. A crescente pressÃo sobre os recursos naturais, particularmente em bacias hidrogrÃficas vem comprometendo a dinÃmica dos sistemas ambientais, que se traduz no seu esgotamento, prejudicando sobre maneira a qualidade de vida de milhares de populaÃÃo. A Ãrea de estudo a presenta um Ãndice de umidade baixo e consequentemente, menor Ãndice efetivo de umidade e maior Ãndice de aridez, o que indica uma Ãrea com clima semiÃrido e com alta susceptibilidade ao processo de desertificaÃÃo. Contudo, diante deste cenÃrio, torna-se importante e urgente estabelecer formas de uso, com bases sustentÃveis evidenciando as potencialidades e limitaÃÃes impostas pelo meio ambiente natural. Assim, este estudo, fundamenta-se na caracterizaÃÃo dos componentes geoambientais (geologia, geomorfologia, solos, vegetaÃÃo e clima), bem como de parÃmetros ambientais (erosividade, erodibilidade, Ãndice climÃtico, classes de relevo) importantes para analisar o nÃvel de degradaÃÃo fÃsica em que se encontra a bacia e evidenciar potencialidades e limitaÃÃes da BHRM. Assim, neste estudo tem-se como objetivo principal: determinar o uso de seus recursos naturais e, subsidiariamente, estudar as caracterÃsticas de seu ambiente, identificar suas unidades ambientais e realizar o diagnÃstico fÃsico-conservacionista de suas terras. Visto que a combinaÃÃo dos elementos cria uma variedade de efeitos que tornam a Ãrea de estudo diferente no contexto regional, particularmente no semiÃrido Cearense. Neste caso, serÃ valorizada a metodologia que orienta para anÃlise da bacia hidrogrÃfica no caso a anÃlise sistÃmica que se adequa perfeitamente para a pesquisa, bem como no diagnÃstico fÃsico conservacionista que permite analisar o nÃvel da degradaÃÃo fÃsica de bacias hidrogrÃficas, pois, ajuda a analisar os indicadores potenciais de proteÃÃo ou degradaÃÃo dos recursos naturais renovÃveis de uma bacia hidrogrÃfica.
The basin of Missi river (BHRM) covers an area of 148.4 Km2 standing between latitudes -3, 7Â and -3, 8Â and longitude â 40Â, and -39, 7Â and is fully inserted into the Northwest portion of the IrauÃuba city in North Central region of the State of CearÃ in Sobral microregionThe state of CearÃ is not an exception, being one of the states that most suffers from desertification, especially in the hinterland. The uncontrolled exploitation of resources is reflected in the depletion affecting the dynamics of environmental systems, impairing the quality of life of millions of people. Considering the region climatic conditions, the watershed of the Missi River located in IrauÃuba municipality in the North Central region of the State of CearÃ, in the Sobral micro-region, comprises an area 1.461,22 KmÂ, located between latitudes 3Â 44 '46" South and longitude 39Â 47' 00" West, at an altitude of 152.52 meters, has a very shallow soils and degraded vegetation and is also characterized by having rainfall below 550 mm/year, with severe water deficit. The environmental analysis of the study area, the watershed of the Missi River, will be based on the characterization of geo-environmental components. The combination of these elements creates a variety of effects that make the study area different to the regional context, particularly in semi-arid CearÃ. In this context, it is important to understand the components of the environmental system of the basin, taking into account the issue of exploitation of natural resources sustainably enhance its planning. Therefore, it is important to recognize the components of the watershed environmental system, considering the sustainability of natural resources exploration through enhanced its planning mechanisms. However, this research considered on its main objective the development of an environmental study in the basin of Missi River through a systems approach and analysis of environmental parameters such as subsidies to environmental zoning and through the study look specifically: characterization of the study area by mapping thematic and geo-environmental parameters (geology, geomorphology, climate, soils and vegetation); conduct a socio-economic characterization from land use; propose ways to use the basin based on soil analysis, and propose an environmental zoning for land use planning.

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Mendes, Luciane Frizo. "A contribuição da fisioterapia em grupo na recuperação e reabilitação de pacientes com LER/DORT". Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-25032009-092642/.

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Introdução: As atividades com grupos complementando os procedimentos terapêuticos são freqüentemente utilizadas na área de saúde do trabalhador, especialmente para os pacientes com LER/DORT. Este estudo tem por objetivo avaliar os possíveis benefícios da associação do tratamento cinesioterapêutico convencional com dinâmicas de grupo e verificar se o tratamento fisioterapêutico em grupo potencializa os efeitos da cinesioterapia em pacientes com LER/DORT. Método: Participaram do estudo 24 pacientes com diagnóstico de LER/DORT que foram distribuídos aleatoriamente para os dois tipos de intervenção: individual e em grupo. O protocolo de cinesioterapia foi o mesmo para as duas intervenções e teve duração de dez sessões. Os pacientes submetidos à intervenção em grupo participaram de dinâmicas grupais com temáticas previamente estabelecidas para instigar a discussão de aspectos considerados importantes durante o tratamento. A análise das intervenções foi feita por meio da avaliação do quadro doloroso (EVA, Questionário de Dor de McGill e Questionário Nórdico de Sintomas Osteomusculares), da avaliação da funcionalidade (Questionário DASH) e da avaliação da amplitude de movimento das articulações dos membros superiores. Além disso, foi realizada uma entrevista semi-estruturada para avaliar qualitativamente o impacto dessas intervenções no quadro clínico e na qualidade de vida destes pacientes. Resultados: Na avaliação quantitativa do quadro doloroso foi observado que a intervenção em grupo não produziu efeitos para o controle da dor, especialmente para diminuição da intensidade álgica. A análise do questionário DASH revelou que o tratamento individual e o em grupo não produziram efeitos na funcionalidade das atividades de vida diária e do trabalho. O aumento da amplitude de movimento em todas as articulações de membros superiores em ambas as intervenções não foi considerado significativo. Entretanto, a análise qualitativa apontou que os pacientes que participaram da intervenção em grupo relataram uma percepção de melhora do quadro doloroso e da funcionalidade em suas vidas; houve uma reflexão gerada a partir das dinâmicas de grupo trazendo uma nova percepção de saúde e do adoecimento Conclusão: A intervenção em grupo não potencializou os efeitos da cinesioterapia no controle do quadro doloroso, na melhora da funcionalidade e no aumento das amplitudes de movimento das articulações de membros superiores, mas o tratamento cinesioterapêutico convencional associado a dinâmicas de grupo permitiu uma abordagem mais global do processo de adoecimento, recuperação e reabilitação do paciente com LER/DORT e modificou as estratégias de enfrentamento dos processos dolorosos e dos conflitos cotidianos desses indivíduos
Introduction: The group activities are often used to complement therapeutic procedures in the laborers health area, especially for RSI/WMSD patients. This studys aim is to evaluate the possible benefits of associating the conventional kinesiotherapeutic treatment with group dynamics and check if the group physical therapeutic treatment potentializes the effects of kinesiotherapy in RSI/WMSD patients. Method: Twenty four RSI/WMSD patients took part in the study. They were randomly distributed for both kinds of interventions: the individual and the group treatments. The kinesiotherapy protocol was the same for both interventions and it lasted ten sessions. The patients submitted to group intervention took part in group dynamics with previously established themes to instigate the debate on aspects considered important during treatment. The interventions analysis was performed by the evaluation of pain conditions (VAS, McGill Pain Questionnaire, NMQ), of functionality (DASH Questionnaire), and of the upper limb joint movements. Furthermore, a semi-structured interview was performed to qualitatively evaluate the impact of these interventions in these patients clinical condition and quality of life. Results: In the quantitative evaluation of the pain condition it was evidenced that the group intervention was not effective for pain control, especially in the decrease in the intensity of pain. The DASH questionnaires analysis revealed that the individual and the group treatments were not effective in the functionality of daily life and labor activities. The increase in the movement amplitude in every upper limb joint in both interventions was not considered significant. Nonetheless, the qualitative analysis pointed out that those patients who took part in the group intervention reported the perception of improvement in the pain condition and in functionality in their lives; a reflection born within the group dynamics brought a new perception on health and illness. Conclusion: The group intervention did not potentialize the effects of kinesiotherapy in controlling pain, in improving functionality, and in increasing movement amplitudes in the upper limb joints, but the conventional kinesiotherapeutic treatment associated to group dynamics allowed a more global approach of the RSI/WMSD patients illness, recovering, and rehabilitation process and modified the strategies for dealing with these individuals pain processes and daily conflicts

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38

Phua, Gailene. "Estimation of geometric properties of three-component signals for condition monitoring". Thesis, Université Grenoble Alpes (ComUE), 2016. http://www.theses.fr/2016GREAT004.

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La plupart des méthodes de surveillance des systèmes sont basées sur l'analyse et la caractérisation de grandeurs physiques qui sont par nature tridimensionnelles. Tracées dans un repère euclidien à trois dimensions, ces grandeurs parcourent en fonction du temps une trajectoire dont les caractéristiques géométriques sont représentatives de l'état du système surveillé. Les techniques classiques de surveillance des systèmes étudient les grandeurs mesurées composante par composante, sans prendre en compte leur nature tridimensionnelle et les propriétés géométriques de leur trajectoire. Une part importante de l'information est ainsi ignorée. Dans le cadre de ce travail de recherche, on se propose de développer une méthode d'analyse et de traitement de grandeurs à trois composantes permettant de mettre en évidence les spécificités géométriques des données et de fournir une information complémentaire pour la surveillance des systèmes. La méthode proposée a été appliquée à deux cas différents : la surveillance des creux de tension des réseaux de puissance triphasés et la surveillance des défauts de roulement des machines électriques tournantes. Dans ces deux cas, les résultats obtenus sont prometteurs et montrent que les indicateurs géométriques estimés mènent à de l'information complémentaire qui peut être utile pour la surveillance des systèmes
Most methods for condition monitoring are based on the analysis and characterization of physical quantities that are three-dimensional in nature. Plotted in a three-dimensional Euclidean space as a function of time, these quantities follow a trajectory whose geometric characteristics are representative of the state of the monitored system. Usual techniques of condition monitoring study the measured quantities component by component, without taking into account their three-dimensional nature and the geometric properties of their trajectory. A significant part of the information is thus ignored. In this research work, we would therefore like to develop a method for the analysis and processing of three-component quantities capable of highlighting the special geometric features of such data and providing complementary information for condition monitoring. The proposed method has been applied to two different cases: voltage dips monitoring in three-phase power networks and bearing faults monitoring in rotating electrical machines. In this two cases, the results obtained are promising and show that the estimated geometric indicators lead to complementary information that can be useful for condition monitoring

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39

Brink, Yolandi. "Sitting posture : a predictive factor for upper quadrant musculoskeletal pain in computing high school students". Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71876.

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Thesis (PhD)--Stellenbosch University, 2012.
Includes bibliography
ENGLISH ABSTRACT: Introduction: The increased prevalence of adolescent upper quadrant musculoskeletal pain (UQMP) is becoming a great concern to health professionals. The risk factors associated with adolescent UQMP are complex and multifactorial, including, among others sitting as a physical risk factor. However, no evidence exists to support sitting postural angles as a potential predictive factor for adolescent UQMP in computing high school students. Thus, the current project aimed to describe the three-dimensional (3D) sitting postural angles of computing South African high school students in a real-life setting, using a well-tested and documented posture measurement instrument. Methodology: This research project is comprised of seven related studies. Part I of the dissertation presents a systematic review describing the reliability and validity testing of posture measurement instruments. This is followed by three primary correlation and repeated measures observational studies aimed at ascertaining the reliability and validity of a newly developed 3D Posture Analysis Tool (3D-PAT) in the measurement of nine sitting postural angles of computing high school students. Part II of the dissertation presents a systematic review, that evaluates the latest published research evidence of whether sitting is related to UQMP, and, if so, to identify the elements of sitting that significantly contribute to UQMP. This review is followed by a description of a cohort study, with a prospective period of one year. The 3D-PAT was implemented in a clinical research setting in order to measure the 3D sitting posture of a cohort of asymptomatic computing high school students and in order to assess the outcome, seated-related UQMP, prospectively. The prospective study design enabled the research project to contribute to an understanding of any causative relationship between the exposure (sitting postural angles) and the outcome (seated-related UQMP) in a subgroup of adolescents (computer users). Results: After the first phase of psychometric testing of the 3D-PAT using high school students, the findings indicated that the instrument required modifications prior to further psychometric testing. The second phase of testing revealed that the 3D-PAT compared very well with the reference standard for measurement of the X-, Y- and Z-coordinates of the reflective markers on a mannequin. The findings from the phase three study, again using high school students, indicated that the 3D-PAT compared very well with the reference standard and justified its use for the measurement of six sitting postural angles of the upper quadrant in computing high school students. For the cohort study, a 60% response rate for participation was achieved at baseline, with 98% of the students participating at six-month and 80% at one-year follow up. Of the students, 33.5% complained of seated-related UQMP during the follow-up period. Exposure to increased head flexion (>80°) (ρ=0.0001) and the combination of increased head flexion and decreased cranio-cervical angles (ρ=0.007) were significant predictors of seated-related UQMP for those computing high school students complaining of pain greater than the 90th percentile for such. Conclusion: The project described in the current dissertation is the first research project to assess sitting postural angles in asymptomatic high school students, while they worked on desktop computers in a school computer classroom and to assess UQMP prospectively. The research project reports a causal relationship between increased head flexion and seated-related UQMP as increased head flexion was found to be a predictor of seated-related UQMP developing within six to 12 months for computing high school students with a pain score equal or greater than the 90th percentile for pain. The research project emphasises that further research is warranted to investigate the causal pathway between sitting posture and adolescents’ UQMP.
AFRIKAANSE OPSOMMING: Inleiding: Die stygende voorkoms van boonste-kwadrant muskuloskeletale-pyn (BKMP) onder adolessente is besig om ’n groot bron van kommer vir professionele gesondheidswerkers te word. Die risiko-faktore waarmee adolessente BKMP gepaard gaan, is kompleks en multifaktories. Dit sluit onder andere sit as ’n fisiese risiko-faktor in. Daar is egter nog geen bewyse om sittende posturale hoeke as potensiële voorspeller van adolessente BKMP te ondersteun nie. Dus beoog hierdie projek om die drie-dimensionele (3D) sittende posturale hoeke van Suid-Afrikaanse hoërskoolleerders wat ook rekenaargebruikers is, in ’n werklike omgewing te beskryf, deur gebruik te maak van ’n instrument wat postuur meet en wat goed getoets en gedokumenteerd is. Metodiek: Hierdie navorsingsprojek is saamgestel uit sewe studies. Gedeelte I van die proefskrif bied ’n sistematiese oorsig van betroubaarheids- en geldigheidstoetsing van instrumente wat postuur meet. Dit word gevolg deur drie primêre korrelasie studies en studies vir die waarneming van herhaalde meting wat die betroubaarheid en geldigheid van n nuut-ontwikkelde 3D instrument vir posturale analise (3D-PAT) bepaal, wanneer nege sittende posturale hoeke van hoërskoolleerders wat rekenaars gebruik, gemeet word. Gedeelte II van die proefskrif bied ’n sistematiese oorsig van die jongste gepubliseerde navorsing om te evalueer of daar bewyse is dat sit verband hou met BKMP, en, indien wel, om die elemente van sit wat betekenisvol bydra tot BKMP, te identifiseer. Die sistematiese oorsig word deur ’n beskrywing van ‘n jaarlange kohortstudie gevolg. Die 3D-PAT is gebruik in ’n kliniese-navorsingsraamwerk om die 3D-sitpostuur van ’n kohort simptoomvrye hoërskoolleerders wat rekenaargebruikers is, te meet en sitverwante BKMP as uitkoms in die vooruitsig te stel. Die studie ontwerp het dit vir die navorsingsprojek moontlik gemaak om ’n insiggewende bydrae te lewer tot begrip vir enige oorsaaklikheidsverwantskap tussen die blootstelling (sittende posturale hoeke) en die uitkoms (sitverwante BKMP) in ’n subgroup van adolessente (rekenaargebruikers). Resultate: Na afloop van die eerste psigometriese toesting van die 3D-PAT, waarin hoërskoolleerders gebruik is, het bevindings daarop gedui dat die instrument verander moet word voordat toetsing kan voortgaan. Die tweede fase van toetsing het getoon dat die 3D-PAT baie goed vergelyk met die verwysingstandaard vir die meet van die X-, Y- en Z-koördinate van die reflektiewe merkers op ’n mannekyn. Die bevindings van die derde fase van die studie, waartydens hoërskoolleerders weer gebruik is, het aangedui dat die 3D-PAT baie goed vergelyk met die verwysingstandaard. Dit het die gebruik van die instrument om ses sittende posturale hoeke van die boonste kwadrant van hoërskoolleerders wat rekenaars gebruik te meet, bevestig. Die kohortstudie het ’n 60%-reaksiesyfer vir deelname behaal tydens die basislynmetings, waarvan 98% leerders deelgeneem het aan die sesmaande-opvolgmetings en 80% aan die eenjaaropvolgmetings. ’n Totaal van 33.5% van die leerders het gekla van sitverwante BKMP gedurende die eenjaar opvolgperiode. Blootstelling aan ’n vergrootte kopfleksie-hoek (>80°) (ρ = 0.0001) en die kombinasie van ’n vergrootte kopfleksie- en verminderde kranio-servikale hoek (ρ = 0.007) was betekenisvolle voorspellers van sitverwante BKMP vir die hoërskoolleerders wat rekenaars gebruik en kla van groter pyn as die 90ste persentiel daarvan. Gevolgtrekking: Hierdie projek is die eerste navorsing wat sittende posturale hoeke van simptoomvrye hoërskoolleerders wat op tafelrekenaars in die skool se rekenaarklaskamer werk, meet en BKMP voorspel. Die navorsingsprojek rapporteer ‘n oorsaaklikheidsverwantskap tussen ‘n vergrootte kopfleksie-hoek en sitverwante BKMP omdat vergrootte kopfleksie ‘n voorspeller is van sitverwante BKMP wat binne ses tot 12 maande by hoërskoolleerders wat rekenaars gebruik, met ‘n pyntelling gelyk of groter as die 90ste persentiel van pyn, ontwikkel. Die navorsingsprojek beklemtoon dat verdere navorsing om die oorsaaklikheidsroete tussen sitpostuur en adolessente BKMP te ondersoek, geregverdig is.
Medical Research Council of South Africa
National Research Fund
Division of Research Development and Support of Stellenbosch University

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40

Conde, Ana Catarina Magalhães. "Avaliação fisioterapêutica na concussão em atletas: uma revisão bibliográfica". Bachelor's thesis, [s.n.], 2018. http://hdl.handle.net/10284/7088.

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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Fisioterapia
Introdução: a concussão, muito embora não seja das problemáticas mais discutidas no desporto, tem vindo a ganhar o seu espaço, sendo considerada uma emergência nesta área, e com maior relevância na área da investigação. Objetivo: perceber os métodos utlizados na realização de uma avaliação fisioterapêutica na concussão, em atletas. Metodologia: pesquisa realizada na Science Direct, Pubmed, B-on e outras fontes, com as palavras chave Concussion, Brain Injury, Head Trauma, Evaluation, Assessment, Exam, Diagnosis, Physical Therapy, Physiotherapy, Sport e com o operador de lógica AND e OR. Resultados: foram encontrados 10 artigos, abrangendo diversos parâmetros, nomeadamente a avaliação do equilíbrio, escalas e questionários, avaliação da coluna vertebral, avaliação do sistema vestibular e oculomotor e por fim, avaliação neuropsicológica, com o intuito de auxiliar no diagnóstico e identificação da concussão. Conclusão: através dos parâmetros avaliados, concluiu-se quais os que devem ser aplicados no momento da lesão e aplicados apenas a partir do segundo dia após esta.
Introduction: the concussion, although is not one of the most discussed problems in sports, it has been earning space, being considered an emergency in this area, and with greater relevance in research. Purpose: the aim of this study was understood which instruments are used for physical therapy assessment of concussion, in athletes. Methods: research realized in Science Direct, Pubmed, B-on and other sources, with the key-words Concussion, Brain Injury, Head Trauma, Evaluation, Assessment, Exam, Diagnosis, Physical Therapy, Physiotherapy, Sport and with the logic operator AND and OR. Results: were found 10 articles, that included various parameters, namely the balance assessment, scales and questionnaires, spine assessment, vestibular and oculomotor system assessment and finally, neuropsychological assessment, with the objective of assist in diagnosis and identification of concussion. Conclusion: through the evaluate parameters, it was concluded which were must be applied immediately after concussion, and which must be applied only after the second day after this injury.
N/A

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41

Girard, Sylvain. "Diagnostic du colmatage des générateurs de vapeur à l'aide de modèles physiques et statistiques". Phd thesis, Ecole Nationale Supérieure des Mines de Paris, 2012. http://pastel.archives-ouvertes.fr/pastel-00798355.

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Les générateurs de vapeur sont d'imposants échangeurs de chaleur qui alimentent les turbines des centrales nucléaires à eau pressurisée. Au cours de leur exploitation, des dépôts d'oxydes s'y accumulent et obstruent progressivement des trous prévus pour le passage du fluide. Ce phénomène, appelé colmatage, pose des problèmes de sûreté. Une méthode de diagnostic est nécessaire pour optimiser la stratégie de maintenance permettant de s'en prémunir. La piste explorée dans cette thèse est l'analyse de la réponse dynamique des générateurs de vapeur lors de transitoire de puissance, à l'aide d'un modèle physique monodimensionnel. Deux améliorations ont été apportées au modèle existant au cours de la thèse : la prise en compte des débits perpendiculaires à l'axe du générateur de vapeur et la modélisation du déséquilibre cinématique entre la phase liquide et la phase vapeur. Ces éléments ont ajouté des degrés de liberté permettant de mieux reproduire le comportement réel des générateurs de vapeur. Une nouvelle méthodologie de calage et de validation a alors été proposée afin de garantir la robustesse du modèle.Le problème inverse initial était mal posé car plusieurs configurations spatiales de colmatage peuvent donner des réponses identiques. La magnitude relative de l'effet des dépôts suivant leur localisation a été évaluée par analyse de sensibilité avec la méthode de Sobol'. La dimension de la sortie fonctionnelle du modèle a au préalable été réduite par une analyse en composantes principales.Enfin, une méthode de réduction de dimension appelée régression inverse par tranches a été mise en œuvre pour déterminer dessous-espaces de projection optimaux pour le diagnostic. Une méthode de diagnostic plus robuste et mieux maitrisée que celle existante a pu être proposée grâce à cette nouvelle formulation.

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Scapini, Gisele Patricia. "DIAGNÓSTICO FÍSICO CONSERVACIONISTA E SUA RELAÇÃO COM A SEDIMENTAÇÃO E PREFERÊNCIAS DA PAISAGEM". Universidade Federal de Santa Maria, 2006. http://repositorio.ufsm.br/handle/1/8674.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
The use and occupation of land have been occurred in an inadequated form many times in watersheds. Deforestations, farmings and fields planted in inadequate areas, in absence of Maintenancy treatments and urbanization without planning had been considered serious problems that generate ambient conflicts. These take to the environmental deterioration, soil erosion and natural landscapes depreciation. The Maintenancy Physical Diagnosis (MPD) is the most important ambient diagnostic since it has immediate and complete application in watersheds. It consists essentially in comparing the current use and the capacity of land use, having as a sample the watershed. The capacity of land use is determined through the ruggedness coefficient, which is obtained from the watershed relief and draining density. This type of environmental evaluation considers a better environmental life quality through a rational use of the physical, agricultural and urban space, with the pattern of available technician-scientific knowledge.The objective of this work had been to elaborate the MPD of Ibicuí-Mirim river watershed, to evaluate the use of the land in accordance with its natural vocation, aiming to identify the estimate of sedimentation and nevertheless analyze the landscape perceptions and preferences of the watershed in agreement with its use, thus to present adequate prognostics to the handling of the studied area. Through the MPD the potential use had been determined, conflicts of the land use, areas to plant trees, availability or excess of agriculture, areas that will be handled and found a deterioration of 33,31% in the watershed area. A susceptible sediment amount in order to be produced, of 38.866,74t/ano in the sediment had been evidenced, in the 1177,78 ha of total area. In relation to the landscape preference the methodology had been showed that the majority of people prefer the native forests landscapes, concluding thus, the importance of the MPD that in its essence indicates forestations to guarantee water infiltration, prevention of erosive episodes and in this way it guarantees natural landscapes that are most attractive for people.
O uso e ocupação da terra têm ocorrido de forma, muitas vezes, inadequada em Bacias Hidrográficas. Desmatamentos, lavouras e campos plantados em áreas inadequadas, ausência de tratos conservacionistas e urbanização sem planejamento são considerados problemas sérios que geram conflitos ambientais que levam à deterioração da ambiência, erosão do solo e depreciação das paisagens naturais. O Diagnóstico Físico Conservacionista (DFC) é o mais importante dos diagnósticos ambientais, uma vez que tem aplicação imediata e completa em sub-microbacias hidrográficas, e consiste, essencialmente, em comparar o uso atual com o uso potencial da terra (capacidade de uso), tendo como unidade de trabalho a sub-microbacia hidrográfica. O uso potencial terra é determinada através do coeficiente de rugosidade, o qual é obtido a partir da declividade e da densidade de drenagem das sub-microbacias. Este tipo de avaliação ambiental propõe uma melhor qualidade de vida ambiental através de uma utilização racional do espaço físico, rural e urbano, com os padrões do conhecimento técnico-científico disponíveis. O objetivo deste trabalho foi elaborar o DFC das sub-microbacias hidrográficas do Rio Ibicuí-Mirim/RS, para avaliar o uso da terra de acordo com sua vocação natural, a fim de identificar a estimativa de sedimentação em função do uso da terra e, ainda, analisar as percepções e preferências da paisagem conforme o uso da terra na sub-microbacia para, assim, apresentar prognósticos adequados ao manejo da área estudada. Por meio do DFC, determinou-se o uso potencial, conflitos de uso da terra, áreas a florestar, disponibilidade ou excesso em agricultura, áreas a serem trabalhadas. Encontrou-se uma deterioração de 33,31% da área da micro-bacia estudada. Foi constatada uma quantidade passível de ser produzida de 38.866,74ton/ano de sedimento, nos 1177,78 ha de área total. Com relação à preferência da paisagem a metodologia mostrou que a maioria das pessoas prefere paisagens com florestamento, concluindo-se, assim, a importância do DFC que, em sua essência, indica florestamentos para garantir infiltração de água, prevenção de episódios erosivos e, desta forma, garante paisagens naturais que são as mais atrativas para as pessoas.

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43

Arne, Mats. "Chronic Obstructive Pulmonary Disease : Patients´ Perspectives, Impact of the Disease and Utilization of Spirometry". Doctoral thesis, Uppsala universitet, Lungmedicin och allergologi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-113813.

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The overall aim of this thesis was to describe subjects with chronic obstructive pulmonary disease (COPD) from different perspectives. Focus was on patients at the time of diagnosis, impact of the disease in comparison to other chronic diseases, factors associated with good health and quality of life (QoL), and diagnostic spirometry in clinical practice. Methods: Qualitative method, grounded theory, was used to analyse patients´ perspectives at the time of diagnosis in a primary care setting (n=10). Public health surveys in the general population were used to compare chronic diseases (n=10,755) and analyse factors associated with health outcomes in COPD (n=1,475). Medical records and spirometry reports, from primary and secondary care, were analysed to assess diagnosis of COPD in clinical practice (n=533). Results: In clinical practice, 70% of patients at the time of diagnosis of COPD lacked spirometry results confirming the diagnosis. Factors related to consequences of smoking, shame and restrictions in physical activity (PA) in particular, were described by patients at the time of diagnosis of COPD. In general subjects with COPD (84%), rheumatoid arthritis (74%) and diabetes mellitus (72%) had an activity level considered too low to maintain good health. In COPD, the most important factor associated with good health and quality of life was a high level of PA. Odds ratios (OR (95%CI)) varied from 1.90 (1.47-2.44) to 7.57 (4.57-12.55) depending on the degree of PA, where subjects with the highest PA level had the best health and QoL. Conclusions: Subjects with COPD need to be diagnosed at an early stage, and health professionals should be aware that feelings of shame could delay patients from seeking care and thus obtaining a diagnosis. The use of spirometry and the diagnostic quality should be emphasised. In patients with COPD greater attention should be directed on increasing the physical activity level, as patients with a low level of physical activity display worse health and quality of life.

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Melato, Débora Soares. "Discussão de uma metodologia para diagnóstico e ações para redução de perdas de água: aplicação no sistema de abastecimento de água da Região Metropolitana de São Paulo". Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/3/3147/tde-17082010-092608/.

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O presente trabalho apresenta uma discussão de metodologia para o diagnóstico e ações para redução de perdas de água, auxiliando na determinação do perfil das perdas, permitindo uma melhor priorização das ações de combate e redução de perdas reais (físicas) e perdas aparentes (comerciais). Para o desenvolvimento desta metodologia, foi realizada uma ampla revisão bibliográfica, onde é apresentada a conceituação geral sobre perdas de água, suas causas e ocorrências, indicadores, ações para redução, e uma abordagem detalhada quanto às metodologias existentes para avaliação de perdas e ferramentas disponíveis para isto. A metodologia aqui aplicada desenvolve a avaliação das perdas através do balanço hídrico, utilizando o software gratuito desenvolvido pelo Banco Mundial (W-B Easy Calc - v1.17), e foi aplicada no sistema de abastecimento de água da Região Metropolitana de São Paulo (RMSP). Foram levantados os dados básicos de controle do sistema e realizados ensaios de campo, com medições de pressão e ensaios para determinação das perdas aparentes. Como estudo de caso, a metodologia foi aplicada em três setores de abastecimento da área central da RMSP, com características distintas. Os resultados do diagnóstico das perdas foram coerentes com as expectativas. Em função dos resultados, em cada setor deverá ser desenvolvida uma estratégia específica para a redução de perdas.
This study presents a discussion of a methodology for diagnosis and actions to reduce water losses, to assist in determining the profile of water losses, allowing a better prioritization of actions to combat and reduce real (physical) losses and apparent (commercial) losses. For developing the methodology, it was conducted an extensive bibliography review, where is presented the general concepts on water losses, its causes and events, indicators, actions to reduce, and a detailed discussion about the existing methodologies to assess losses and tools available for this. The applied methodology consists of an assessment of losses through the water balance, using free software developed by the World Bank (WB Easy Calc - v1.17) and it was applied in the water supply system in metropolitan region of Sao Paulo. To do this, it was necessary to collect basic data of system control and field tests, with pressure measurements and tests to determine apparent losses. As case study, the methodology was applied in three supply zones at the central area of metropolitan region of Sao Paulo, with different characteristics. The results of water losses diagnosis were consistent with expectations. With these results, a specific strategy should be developed in each sector for reducing losses.

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BARBOSA, LUANA. "DIAGNÓSTICO AMBIENTAL DA BACIA DO CÓRREGO BAIXA FUNDA EM ARAGUAÍNA – TO". Pontifícia Universidade Católica de Goiás, 2018. http://tede2.pucgoias.edu.br:8080/handle/tede/3967.

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The environmental impact of a river basin is responsible for most socio-environmental problems of a municipality, since water resources are intrinsic to urbanization. This work aims to perform an environmental diagnosis in the Baixa Funda stream basin in the municipality of Araguaína-TO. The methodology used consisted of a bibliographical survey and observational field analysis with a quantitative and qualitative approach of 10 points, through geoprocessing and collection of water samples planned for the months of March and September of 2017, comprising the rainy season and the dry season. water collection at three points (P1, P7 and P10): upstream end, intermediate point of the channel and downstream end of the stream. Where laboratory physicochemical analysis was performed of the following parameters: water temperature, pH, Turbidity, total phosphorus, total nitrogen, total residue, dissolved oxygen (DO); Biochemical Oxygen Demand (BOD), Chemical Oxygen Demand (COD), total coliforms and thermotolerant coliforms, which were analyzed in the rainy season and in the drought period of the stream. The results showed technogenic deposits, severe environmental impact, with irregular disposal of solid wastes often in fragments, such as plastics, various metals, household waste, sewage, among others. It was concluded that the anthropic action showed to be the main active agent in the removal of the vegetation cover, in soil and subsoil contamination, being active in the acceleration of processes such as erosion, sedimentation and degradation. It is essential to assess the environmental consequences, their impacts and propose short- , medium- and long-term solutions. The data presented demonstrate that the studied area is in the process of environmental degradation, according to physicochemical evaluation, which shows the contamination of the water in the evaluated points.
O impacto ambiental ocorrido em uma bacia hidrográfica é responsável pela maioria dos problemas socioambientais de um município, uma vez que os recursos hídricos estão intrínsecos à urbanização. Este trabalho tem como objetivo realizar diagnóstico ambiental na bacia hidrográfica do córrego Baixa Funda no município de Araguaína- TO. A metodologia utilizada constitui em levantamento bibliográfico e análise de campo observacional com abordagem quantitativa e qualitativa de 10 pontos, através de geoprocessamento e coleta de amostras de água planejado para os meses de março e setembro de 2017, compreendendo o período chuvoso e de estiagem realizando a coleta de água em três pontos (P1, P7 e P10): extremidade montante, ponto intermediário do canal e extremidade jusante do córrego. Onde foi feito análise físicoquímica laboratorial dos seguintes parâmetros: temperatura da água, pH, Turbidez, Fósforo total, Nitrogênio total, Resíduo total, Oxigênio Dissolvido (OD); Demanda Bioquímica de Oxigênio (DBO), Demanda Química de Oxigênio (DQO), Coliformes Totais e Coliformes Termotolerantes, estes em análise no período chuvoso e no período de estiagem do córrego. Os resultados apresentados constataram depósitos tecnogênicos, impacto ambientais graves, com disposição irregular de resíduos sólidos frequentemente em fragmentos, como plásticos, metais diversos, lixo doméstico, esgoto, dentre outros. Conclui-se que a ação antrópica se mostrou como sendo o principal vetor atuante na remoção da cobertura vegetal, na contaminação do solo e subsolo, sendo atuante na aceleração de processos como: erosões, assoreamentos e degradação. É fundamental avaliar as consequências ambientais, seus impactos e propor soluções a curto, médio e longo prazo. Os dados apresentados demonstram que a área estudada se encontra em processo de degradação ambiental, conforme avaliação físico-química, que mostra a contaminação da água nos pontos avaliados.

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46

Marshall, Trisha L. M. D. "Diagnostic Learning Opportunities: Increasing Physician Reporting of Suspected Diagnostic Errors". University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1592171499312483.

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47

Villela, Fernando Nadal Junqueira. "Análise da relação relevo-rocha-solo no contato planalto atlântico - depressão periférica paulista". Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/8/8135/tde-25052012-153126/.

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Este trabalho tem por finalidade estabelecer a abordagem integrada de fatores da paisagem segundo as formas de relevo, o substrato rochoso e os solos. Realiza-se uma compartimentação geomorfopedológica em escala de detalhe de uma área situada entre duas grandes unidades geomorfológicas, o Planalto Atlântico, escudo cristalino de modelado rugoso, e a Depressão Periférica Paulista, unidade de transição do Planalto para a Bacia Sedimentar do Paraná, com modelado colinoso esculpido sobre terrenos geralmente sedimentares. A transição destes dois domínios macro-compartimentados cria contrastes nas formas de relevo de acordo com a estrutura do substrato e os solos resultantes do intemperismo e da erosão. Modelados colinosos sustentados por litologias sedimentares alternam-se com colinas mais dissecadas sustentadas por litologias ígneas ou metamórficas, e Latossolos Vermelhos localizados em áreas de topos aplainados mudam para Cambissolos em áreas de ocorrência de colinas de baixo gradiente de relevo. Esta situação é comum na área de pesquisa considerada, que envolve uma pequena bacia hidrográfica e seu entorno, área rural do município de Sorocaba em franca expansão urbana. Para o entendimento da relação destes fatores supracitados visando o diagnóstico do meio físico em questão, fizeram-se necessários levantamentos geológicos, geomorfológicos e pedológicos na busca da relação relevo-rocha-solo para a área considerada. O trabalho resultou em compartimentos geomorfológicos e geomorfopedológicos e na melhor compreensão de algumas características funcionais do meio físico, tais como o condicionamento do modelado e do sistema de drenagem pela litoestrutura, a conjugação dos processos exógenos, morfologia das vertentes e variações litológicas na formação dos solos e o possível rebaixamento do relevo pela erosão geoquímica.
This work aims to establish the integrated approach to landscape factors according to the landforms, bedrock and soils. A geomorphopedological compartmenting is made in a detailed scale of an area between two major geomorphologic units, one being the Atlantic Plateau, crystalline shield of rough landforms, and the other the Peripheral Depression of Sao Paulo, a transition unit from Plateau to the Sedimentary Basin of Parana, whose smooth landforms are generally sculpted over sedimentary terrains. The transitions of these two macro-compartment domains create contrasts of relief forms according to the basement structure and soils originating from weathering and erosion. Smooth landforms supported by sedimentary lithotypes alternate with small hills of more dissected slopes sustained by igneous or metamorphic rocks, and Red Oxisols located in areas of flat summits change to Inceptisols in areas of smooth hills. This is a common situation at the research area, a small hydrographic basin and its rural surroundings in Sorocaba, a county undergoing remarkable urban expansion. To reach an understanding of the above mentioned factors relationship, aiming at a diagnosis of the physical environment under research, it was necessary to carry out geological, geomorphological and pedological surveys in order to search for the relief-rock-soil relationship to the area considered. The work resulted in geomorphological and geomorphopedological compartments and the better understanding of some functional characteristics of the physical environment, such as the control of landforms and drainage system by lithostructure, the combination of exogenous processes, slope morphology and lithologic variations in forming soils and the possibility of relief being degraded by geochemical erosion.

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48

Charron, Martin. "Gravity wave diagnosis using empirical normal modes". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0005/NQ44382.pdf.

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49

Chavango, Marta Hermínia. "Análise ambiental da bacia hidrográfica do rio Missi em Irauçuba – Ceará uma contribuição ao uso de suas terras". reponame:Repositório Institucional da UFC, 2014. http://www.repositorio.ufc.br/handle/riufc/16863.

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CHAVANGO, Marta Hermínia. Análise ambiental da bacia hidrográfica do rio Missi em Irauçuba – Ceará uma contribuição ao uso de suas terras. 2014. 82 f. : Dissertação (mestrado) - Universidade Federal do Ceará, Pró-Reitoria de Pesquisa e Pós-Graduação, Programa Regional de Pós-Graduação em Desenvolvimento e Meio Ambiente - PRODEMA, Fortaleza-CE, 2014.
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The basin of Missi river (BHRM) covers an area of 148.4 Km2 standing between latitudes -3, 7° and -3, 8° and longitude – 40°, and -39, 7° and is fully inserted into the Northwest portion of the Irauçuba city in North Central region of the State of Ceará in Sobral microregionThe state of Ceará is not an exception, being one of the states that most suffers from desertification, especially in the hinterland. The uncontrolled exploitation of resources is reflected in the depletion affecting the dynamics of environmental systems, impairing the quality of life of millions of people. Considering the region climatic conditions, the watershed of the Missi River located in Irauçuba municipality in the North Central region of the State of Ceará, in the Sobral micro-region, comprises an area 1.461,22 Km², located between latitudes 3º 44 '46" South and longitude 39º 47' 00" West, at an altitude of 152.52 meters, has a very shallow soils and degraded vegetation and is also characterized by having rainfall below 550 mm/year, with severe water deficit. The environmental analysis of the study area, the watershed of the Missi River, will be based on the characterization of geo-environmental components. The combination of these elements creates a variety of effects that make the study area different to the regional context, particularly in semi-arid Ceará. In this context, it is important to understand the components of the environmental system of the basin, taking into account the issue of exploitation of natural resources sustainably enhance its planning. Therefore, it is important to recognize the components of the watershed environmental system, considering the sustainability of natural resources exploration through enhanced its planning mechanisms. However, this research considered on its main objective the development of an environmental study in the basin of Missi River through a systems approach and analysis of environmental parameters such as subsidies to environmental zoning and through the study look specifically: characterization of the study area by mapping thematic and geo-environmental parameters (geology, geomorphology, climate, soils and vegetation); conduct a socio-economic characterization from land use; propose ways to use the basin based on soil analysis, and propose an environmental zoning for land use planning.
A bacia hidrográfica do rio Missi (BHRM) compreende uma área de 148,4 Km2 situando-se entre as latitudes -3,7o e -3,8o e longitudes - 40o, e -39,7o e esta totalmente inserida na porção Noroeste do Município de Irauçuba na região Centro-Norte do Estado do Ceará, isto é, na Microregião de Sobral. A rede de drenagem faz parte da bacia hidrográfica do rio Aracatiaçu, apresenta solos rasos e uma vegetação bastante degradada, caracteriza-se também por apresentar um índice pluviométrico que varia de 800 a 1250 mm, que não favorecem boas condições climáticas. A crescente pressão sobre os recursos naturais, particularmente em bacias hidrográficas vem comprometendo a dinâmica dos sistemas ambientais, que se traduz no seu esgotamento, prejudicando sobre maneira a qualidade de vida de milhares de população. A área de estudo a presenta um índice de umidade baixo e consequentemente, menor índice efetivo de umidade e maior índice de aridez, o que indica uma área com clima semiárido e com alta susceptibilidade ao processo de desertificação. Contudo, diante deste cenário, torna-se importante e urgente estabelecer formas de uso, com bases sustentáveis evidenciando as potencialidades e limitações impostas pelo meio ambiente natural. Assim, este estudo, fundamenta-se na caracterização dos componentes geoambientais (geologia, geomorfologia, solos, vegetação e clima), bem como de parâmetros ambientais (erosividade, erodibilidade, índice climático, classes de relevo) importantes para analisar o nível de degradação física em que se encontra a bacia e evidenciar potencialidades e limitações da BHRM. Assim, neste estudo tem-se como objetivo principal: determinar o uso de seus recursos naturais e, subsidiariamente, estudar as características de seu ambiente, identificar suas unidades ambientais e realizar o diagnóstico físico-conservacionista de suas terras. Visto que a combinação dos elementos cria uma variedade de efeitos que tornam a área de estudo diferente no contexto regional, particularmente no semiárido Cearense. Neste caso, será valorizada a metodologia que orienta para análise da bacia hidrográfica no caso a análise sistêmica que se adequa perfeitamente para a pesquisa, bem como no diagnóstico físico conservacionista que permite analisar o nível da degradação física de bacias hidrográficas, pois, ajuda a analisar os indicadores potenciais de proteção ou degradação dos recursos naturais renováveis de uma bacia hidrográfica.

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50

Hanson, Anne, e Petersson Josefin Holme. "Läkares upplevelser av svårigheter i vården av samsjukliga patienter". Thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-79221.

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Patienter med somatisk och psykiatrisk samsjuklighet är en sårbar och vårdmässigt komplex grupp som löper större risk, jämfört med normalpopulationen, att avlida i förtid till följd av sjukdomar som kunde ha förebyggts. Bristande socioekonomiska resurser tycks vara en förklaring men forskning visar också på sämre bemötande av patientgruppen samt att fler diagnostiska misstag görs vid samsjuklighet. Syftet med denna studie var att undersöka hur läkare inom somatiken upplever svårigheter i diagnostik och behandling gällande samsjukliga patienter. Semistrukturerade intervjuer genomfördes med tio läkare verksamma inom somatisk vård. Induktiv tematisk analys visade att läkarnas upplevelser kunde delas in i fyra teman; Osäkerhet, Relationen, Kapacitet och Integration. Resultaten visar att läkare upplever svårigheter kopplat till individen, patient-läkar-relationen och vården i stort. Kärnkategorin Otillräcklighet är beskrivande för samt genomsyrar samtliga teman och handlar om en otillräcklighet i hela vården, hos såväl patient som vårdpersonal och organisation. Dessa fynd bekräftar dels tidigare forskning och tillför fördjupade perspektiv i en svensk kontext. Behov finns av vidare kvantitativ forskning inom ämnet för ett mer generaliserbart resultat.
Patients with somatic and psychiatric comorbidity constitute a vulnerable and care-wise complex group at higher risk, compared to the general population, of premature death due to preventable diseases. A lack of socio-economic resources seems to be one explanation, but research also shows that these patients are subjected to worse interpersonal treatment and that more diagnostic mistakes are made in relation to comorbid patients. The purpose of this study was to investigate how physicians in the somatic care experience difficulties in diagnosis and treatment of comorbid patients. Semi-structured interviews were conducted with ten physicians in the somatic care. Inductive thematic analysis showed that the experiences could be categorized into four themes; Uncertainty, The relationship, Capacity and Integration. The results show that physicians experience difficulties relating to the individual, the patient-physician-relationship, and the care system as a whole. The core category Insufficiency is descriptive of all themes and refers to an insufficiency regarding the patient herself as well as the staff and the organization. The findings confirm previous research and adds an in-depth perspective in a Swedish context. There is a need for future quantitative research on this topic in order to generate more generalizable results.

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