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1
Saker, Oliver John. "Mono- and tri-nuclear ruthenium complexes incorporating N-heterocyclic carbene ligands." Thesis, University of Bath, 2008. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.512305.
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2
Anthony, Guiot. "Modélisation et simulation du procédé de prépolissage automatique sur centre d'usinage 5 axes." Phd thesis, École normale supérieure de Cachan - ENS Cachan, 2012. http://tel.archives-ouvertes.fr/tel-00816769.
Повний текст джерелаАнотація:
La réalisation de formes complexes comme les moules ou les prothèses médicales nécessite l'utilisation d'opérations de super finition pour obtenir de faibles défauts géométriques, pouvant aller jusqu'au poli-miroir. Ces opérations de prépolissage et de polissage sont encore régulièrement réalisées manuellement. En effet, malgré des avantages en termes de répétabilité, de productivité et de qualité géométrique, les méthodes de polissage automatique sont peu utilisées, car elles nécessitent une mise au point importante. Les travaux de recherche présentés dans ce mémoire participent à la maîtrise du procédé de polissage automatique tout en contrôlant la qualité géométrique des pièces. Pour parvenir à cette maîtrise, un outil de simulation de l'enlèvement de matière est mis en place. Cet outil permet de simuler l'enlèvement de matière au cours d'une opération de prépolissage réalisée sur centre d'usinage 5 axes. Il se base sur un modèle du contact obtenu entre l'outil de pré-polissage et la pièce, ainsi que sur un modèle du pouvoir abrasif intégrant l'usure et l'encrassement du disque. Cette simulation permet de vérifier la régularité de l'abrasion sur une surface et d'identifier les zones pouvant faire apparaitre des défauts macro-géométriques importants. Une méthode est également proposée pour compenser les variations du pouvoir abrasif au cours du temps. La compensation s'effectue en optimisant les consignes de vitesse d'avance et/ou de fréquence de broche le long de la trajectoire. Cette méthode de pilotage permet d'obtenir un taux d'enlèvement de matière plus constant et ainsi de réduire les défauts géométriques générés pendant une opération de prépolissage.
3
Guiot, Anthony. "Modélisation et simulation du procédé de prépolissage automatique sur centre d'usinage 5 axes." Phd thesis, École normale supérieure de Cachan - ENS Cachan, 2012. http://tel.archives-ouvertes.fr/tel-01044984.
Повний текст джерелаАнотація:
La réalisation de formes complexes comme les moules ou les prothèses médicales nécessite l'utilisation d'opérations de super finition pour obtenir de faibles défauts géométriques, pouvant aller jusqu'au poli-miroir. Ces opérations de pré-polissage et de polissage sont encore régulièrement réalisées manuellement. En effet, malgré des avantages en termes de répétabilité, de productivité et de qualité géométrique, les méthodes de polissage automatique sont peu utilisées car elles nécessitent une mise au point importante. Les travaux de recherche présentés participent à la maîtrise du procédé de polissage automatique tout en contrôlant la qualité géométrique des pièces. Pour parvenir à cette maîtrise, un outil de simulation de l'enlèvement de matière est mis en place. Cet outil permet de simuler l'enlèvement de matière au cours d'une opération de prépolissage réalisée sur centre d'usinage 5 axes. Il se base sur un modèle du contact obtenu entre l'outil de pré-polissage et la pièce, ainsi que sur un modèle du pouvoir abrasif intégrant l'usure et l'encrassement du disque. Cette simulation permet de vérifier la régularité de l'abrasion sur une surface et d'identifier les zones pouvant faire apparaitre des défauts macro-géométriques importants. Une méthode est également proposée pour compenser les variations du pouvoir abrasif au cours du temps. La compensation s'effectue en optimisant les consignes de vitesse d'avance et/ou de fréquence de broche le long de la trajectoire. Cette méthode de pilotage permet d'obtenir un taux d'enlèvement de matière plus constant et ainsi de réduire les défauts géométriques générés pendant une opération de prépolissage.
4
FOISSOTTE, BERNADETTE. "Les sarcomes post-radiques : a propos de 5 cas recueillis au centre jean perrin." Clermont-Ferrand 1, 1988. http://www.theses.fr/1988CLF11008.
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5
Tournier, Christophe. "Contribution à l'amélioration de la qualité des surfaces fabriquées sur centre d'usinage à 5 axes." Habilitation à diriger des recherches, École normale supérieure de Cachan - ENS Cachan, 2009. http://tel.archives-ouvertes.fr/tel-00572727.
Повний текст джерелаАнотація:
Le thème abordé est celui de la fabrication de pièces de formes complexes sur centre d'usinage à 5 axes et plus particulièrement le point de vue de la génération de trajectoires et de leurs exécutions sur les machines. Quatre thèmes distincts seront abordés dans les quatre chapitres proposés : la prise en compte des performances cinématiques du couple MO-CN en FAO, la prise en compte du modèle géométrique de la machine en FAO, Les formats d'échange et de description des données dans la chaîne numérique de fabrication et enfin l'industrialisation du polissage automatique sur MOCN 5 axes. Enfin dans la troisième partie sont regroupés les articles publiés dans des revues internationales et qui sont proposés comme documents de références pour les développements de la deuxième partie.
6
Saint-Esprit, Congrégation du. "Mémoire Spiritaine: La France pays de missionnaires : Centre Saint-Louis de France -- Rome, 5 Octobre 2000." Congrégation du Saint-Esprit, 2001. http://digital.library.duq.edu/u?/cdm-memspir,4221.
Повний текст джерелаАнотація:
no. 13 -- (1ᵉ semestre 2001) -- Liminaire -- (pg. 3) -- Paul Coulon De la France, pays de missionnaires à La France pays de mission ? -- « La France, pays de missionnaires » -- (pg. 11) -- Jean-Dominique Durand -- Introduction à la journée d'études du Centre Saint-Louis de France Rome, 5 octobre 2000 -- (pg. 15) -- Mgr Ambrogio Spreafico --
« La France, pays de missionnaires » : introduction au thème de la journée -- (pg. 21) -- Alain Forest -- La modernité d'une société missionnaire : les débuts des Missions Étrangères de Paris -- (pg. 41) -- Philippe Delisle -- Congrégations enseignantes et missions extérieures. L'exemple des Frères de Ploërmel et des Sœurs de Saint-Joseph de Cluny aux Antilles françaises
(XIXᵉ siècle) -- (pg. 60) -- Philippe Laburthe-Tolra -- L'Œuvre de la congrégation du Saint-Esprit au Cameroun, de 1916 à 1960 -- (pg. 81) -- Mgr Paolo Giglioni -- Le réveil missionnaire au XIXᵉ siècle : charismes et congrégations missionnaires -- (pg. 97) -- Mgr Bernard A. Prince -- Le rôle des œuvres pontificales laïques dans l'expansion des missions -- (pg. 107) -- Claude Prudhomme -- Développement et mutations de l'idée missionnaire catholique au XXᵉ siècle. La place du mouvement missionnaire français -- (pg. 129) -- Mgr Olivier de Berranger -- De saint François Xavier à sainte Thérèse de Lisieux. Et après ? -- Autour des fondateurs -- (pg. 139) -- Michel Legrain -- Le Saint-Esprit et le Saint-Coeur de Marie : Après l'union, querelles avec l'archevêché de Paris (1849-1854)
7
Mažeika, Robertas. "Logistikos centras „logista“ aerouosto g. 5." Bachelor's thesis, Lithuanian Academic Libraries Network (LABT), 2013. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2013~D_20130619_091300-40980.
Повний текст джерелаАнотація:
Bakalaurinio baigiamajame darbe projektuojamas vieno aukšto ypatingas statinys – logistikos centras „Logista“. Pastatas projektuojamas Šiaulių miesto pramoniniame rajone, Aerouosto gatvėje. Bendras sklypo plotas 6831,68 m2, užstatymo plotas 1539,49 m2.In this final work is designed one-story special building – logistic centre „Logista“. Building is designed in industrail district of Šiauliai, Aerouosto street. Overall area is 6831,68 m2, built-up area 1539,49 m2.
8
ROSELEUR, BENEDICTE. "Efficacite du protocole 5-fluorouracile/acide folinique dans les cancers colorectaux metastatiques non pretraites : experience du centre oscar lambret 1985-1992." Lille 2, 1993. http://www.theses.fr/1993LIL2M009.
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9
Penard, Sébastien Agard Christian. "La consultation médico-sociale Jean Guillon du Centre Hospitalier Universitaire de Nantes bilan en 2004 après 5 ans d'activité /." [S.l.] : [s.n.], 2006. http://theses.univ-nantes.fr/thesemed/MEDpenard.pdf.
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10
Duranthon, Sophie. "Intoxications par les produits agricoles : bilan sur 5 années de données recueillies au centre anti-poison de Bordeaux (1990-1994)." Bordeaux 2, 1996. http://www.theses.fr/1996BOR2P007.
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11
Armsden, Sandra R. "The effect of a 5 day residential outdoor educational experience on the self-efficacy of selected Australian high school students." Thesis, Queensland University of Technology, 1995.
Знайти повний текст джерелаАнотація:
This study seeks to investigate the effect of a 5 day outdoor educational experience on the generalised self-efficacy of four Australian high school students. Specifically, it explored how the students conceptualise self-efficacy and whether they perceive a change in their own self-efficacy as a result of their experience. A key focus of the study was an investigation of the factors in their experience to which they attribute this change and if such a change is maintained.
To reconstruct the complex story of the outdoor educational experience for each student, a research design consisting of multi-method data collection in the form of a case study was used. Data collection techniques included participant observation,informal interviews, repertory grids and the use of a perceptual record (video, audio)of the students overt behaviours to conduct stimulated recall interviews. Through the process of triangulation of the data, the story emerged.
The data collection methods tend to reveal personal data of an affective nature and as such did disclose the student's personal reflections on their outdoor educational experience and generalised self-efficacy. Although distinctions in how the students construed their experience and generalised self-efficacy are evident, there are some
commonalties.
The students tend to construe confident people and confidence as being predominantly determined by aspects of the affective domain. Students use personal attributes such as caring, smart, sensitive and humorous as well as aspects of interaction with others to describe efficacious people. Constructs relating to attaining goals and achievements are used sparingly.
Immediately after the outdoor educational expe1ience the students perceive an increase in their generalised self-efficacy either through a closer association with their
'confident' people or through a disassociation with their people 'lacking confidence' or changes in both precepts. The changes in generalised self-efficacy were not necessarily maintained three months after the camp.
The students, when considering the outdoor educational expe1ience globally, focused on their level of emotional arousal, pa1ticularly enjoyment, as well as the need to
cooperate as a group. The group becomes a dominant factor in the student's outdoor educational expe1ience. The students recognise the power of the group through group
decisions and group support at stressful times. The concern for others becomes evident throughout the week. Whilst the four students recognise the group factor their reactions vary from wanting to be an active dominant member of the group to challenging the group at every opportunity.
The combined results indicate that a short term camp, that includes some adventure components, has the potential to be a powerful source of efficacy infonnation and thus increase a student's self-efficacy. The maintenance of increased generalised selfefficacy upon returning to the school environment remains a central issue. This study presents some evidence that increases can be maintained although it is acknowledged that further research is required.
12
LAMPS, FRANCK. "La biotelevigilance pour personnes agees au samu - centre 15 des hauts-de-seine : biotel 92 ; bilan de 5 annees de fonctionnement, perspectives d'avenir." Lille 2, 1993. http://www.theses.fr/1993LIL2M365.
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13
Carteron, Nathalie. "Les interférons : étude de la consommation et du coût à l'hôpital-sud du C.H.R. de Bordeaux : bilan de 5 années d'utilisation." Bordeaux 2, 1992. http://www.theses.fr/1992BOR2P034.
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14
Blumenthal, Roxanne. "The Competition Commission's non-referral of exclusivity clauses in the shopping centre lease context: a monumental misjudgement - A Section 5(1) analysis of anticompetitiveness." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/15185.
Повний текст джерелаАнотація:
This paper focuses on the common practice in commercial agreements of including exclusivity clauses in shopping centre lease agreements between a supermarket anchor tenant and the landlord of a shopping centre. It is the contention of this paper that such clause s are anticompetitive when considered specifically in light of section 5(1) of the South African Competition Act. In reaching this conclusion, relevant sect ions of the Act will be interpreted and analysed in the pertinent context, as will relevant case law and comparable foreign jurisprudence. The findings of South Africa's Competition Commission in 2013 with regard to the competitive nature of exclusivity clauses in the context of section 5(1), and the basis for their findings will be scrutinised. A conclusion , warranted and supported by the inferences drawn from an analysis of the aforementioned sources (legislation, case law and foreign jurisprudence), will be reached accordingly in support of a stance of resistance against exclusivity clauses in shopping centre leases between landlord and supermarkets . An argument in favour of a blanket prohibition of exclusivity clauses in shopping centre leases due to their anticompetitive nature that outweighs their efficiencies and justifications according to section 5(1) of the Act, is the predominant direction of this paper.
15
Cloutier, Sonia. "Le développement des interactions d'étayage entre l'éducatrice et les enfants de 4-5 ans, en contexte de jeux symboliques en centre de la petite enfance." Thesis, Université Laval, 2009. http://www.theses.ulaval.ca/2009/26153/26153.pdf.
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16
Kamaranzi, Bakunda Kaakaabaale. "Factors associated with late presentation of children under five and pregnant women with malaria for treatment at health units in Bungokho Health Sub District." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_9025_1363357146.
Повний текст джерелаАнотація:
Background: Malaria is the leading cause of death of Uganda&rsquo
s children under 5 years of age and the number-one cause of illness in adults in Uganda. The success of malaria treatment strategies is closely linked to the behavior of patients and caretakers of young children. In the case of malaria this includes accessing appropriate treatment for
suspected malaria in time. In Bungokho Sub County, in spite of the efforts by district health workers and the Ministry of Health to implement the malaria control, prevention and treatment strategies, pregnant women and caretakers of children under 5 years of age continue to present late for treatment in the health units resulting in possible avoidable
death or disability. Aim and objectives: The aim of this study was to explore the factors that lead to late presentation of children and pregnant women with malaria for treatment at health units. This was done by exploring the perceptions of caregivers of children under five years and pregnant women on the community&rsquo
s knowledge and understanding of the
symptoms and treatment of malaria
and describing perceptions of caregivers and pregnant women on health care provision at the health units and alternative treatment for malaria. Methods :The study was conducted in Bungokho Health sub-district, in Mbale district, Eastern Uganda over a two month period in 2009. It was a descriptive exploratory study using qualitative research methods. Four focus groups were carried out, two with caregivers of children under 5 years and two with pregnant women, with each focus group consisting of eight participants. Two caregivers and two pregnant women were identified from the focus groups for further indepth interviews. Four in-depth interviews were conducted with health unit staff from Bungokho HCVI. Notes were taken and observations made during the focus groups and interviews. The proceedings were audio-taped and recordings used to expand and clarify notes. Thematic content analysis was used to analyze the data and identify recurrent themes from the focus group discussions and
interviews of the reasons for late presentation for malaria treatment. Results: All caregivers were women, a significant majority of whom were peasants who had not gone beyond the primary education. Caregivers were aware of the general symptoms of malaria but associated more serious or dangerous symptoms with other causes including
witchcraft. Pregnant women, on the other hand, seemed to have sound knowledge of both the general and dangerous symptoms of malaria and were likely to attend the health
units timeously for reatment. Religious beliefs and practices, particularly belief in the healing ability of prayers prevented early reporting of malaria cases to health units leading
to late presentation. Alternative treatment of malaria from traditional herbalists was also sought by the communities particularly when the intensity of malaria was at its peak during the rainy season. Poverty in the community seemed to play a big role in shaping community preference for treatment sources, as well as early presentation to the health
units. It was found that the anticipated cost of laboratory tests and sundries at the health units deterred caregivers from taking children under five to health units. There was therefore a strong reliance (and preference for) community medicine distributor&rsquo
s (CMDs) because of free services and easy access. Lack of support from spouses (in particular husbands) coupled with the rude behavior of health workers towards caregivers and pregnant women discouraged visits to health units. The long waiting time and intermittent drug stock-outs also created a negative perception of service at the health units. Conclusions and recommendations: There is need for further sensitization of communities on the need to seek prompt treatment for children under five years of age at the health units (that is, within 24 hours of the onset of fever). Training and supervision of CMDs should be strengthened to ensure consistent supply of drugs, correct dosage of anti-malarial medication and improvements in the referrals to the health units. In order to improve
service delivery at the health units, there is need to review and strengthen human resource management of the health units, including staffing requirements and management
practices, such as support and supervision, patient care standards and client feedback mechanisms. It is also important that there are adequate stocks of anti-malarial drugs
and laboratory supplies at health units.
17
Gauthier, Mélanie. "Relation entre les comportements extériorisés et la stabilité de l'expérience de garde chez les enfants de 4 à 5 ans qui fréquentent un centre de la petite enfance." Master's thesis, Université Laval, 2015. http://hdl.handle.net/20.500.11794/26469.
Повний текст джерелаАнотація:
La présente recherche a pour but d’étudier la relation entre les comportements extériorisés et la stabilité de l’expérience de garde chez les enfants âgés de 4 à 5 ans qui fréquentent un centre de la petite enfance. L’échantillon est composé de 107 enfants (53 filles et 54 garçons), dont l’âge moyen se situe à 59,9 mois (É.T. = 4,8). Parallèlement, l’échantillon est constitué de 15 éducatrices provenant de cinq centres de la petite enfance de la région de Québec, ayant en moyenne 23,5 ans (É.T. = 7,8) d’expérience dans le domaine. Une analyse de covariance univariée (ANCOVA) a été réalisée entre les comportements extériorisés et la stabilité de l’expérience de garde, en tenant compte du genre. Les résultats ne montrent aucune différence significative entre les comportements extériorisés et la stabilité de l’expérience de garde des enfants, si l’on tient compte du genre. Ces résultats sont discutés en fonction des éléments susceptibles d’influencer les différences de genre dans les comportements extériorisés des enfants et ceux relatifs à la stabilité de l’expérience de garde.
18
BON, NGUYEN ROMUALD. "Etude de la diffusion Ve-e auprès de la tranche 5 du centre de production nucléaire du Bugey : simulation de l'expérience MUNU de mesure du moment magnétique du neutrino." Université Joseph Fourier (Grenoble), 1997. http://www.theses.fr/1997GRE10173.
Повний текст джерелаАнотація:
L'experience munu a pour but la mesure du moment magnetique du neutrino grace a l'etude de la diffusion antineutrino electronique-electron aupres d'un reacteur nucleaire. Cette these presente le travail de simulation par la methode monte-carlo de l'experience munu. Cette simulation a permis de mettre en evidence les parametres ayant une influence sur les grandeurs observables de l'experience (moment magnetique, angle de weinberg, parametres decrivant les oscillations de neutrinos) ainsi que de preciser la sensibilite a ces grandeurs. En particulier, il apparait que munu permet d'obtenir une limite sur le moment magnetique du neutrino a hauteur de 2 a 3 10#-#1#1 magnetons de bohr. Cette simulation a egalement permis de mettre au point les methodes statistiques les plus performantes pour l'exploitation des donnees de munu.
19
SAUVAGET, CATHERINE. "Description de la population prise en charge dans les 5 secteurs de psychiatrie generale du centre hospitalier specialise de saint-ave a partir des donnees sociodemographiques et du diagnostic de la fiche par patient." Rennes 1, 1992. http://www.theses.fr/1992REN1M008.
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20
Fresard, Pierre-Luc. "Evolution dégénérative des laxites antérieures chroniques du genou opérées : à propos d'une centaine de patients revus à plus de 5 ans : travail du centre d'orthopédie et de traumatologie du CHRU de Saint-Etienne (Pr G. Bousquet)." Saint-Etienne, 1991. http://www.theses.fr/1991STET6420.
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21
Wanner, Warren. "Jean Lecanuet, maire de Rouen : un homme d'État en son territoire (1953-1993)." Thesis, Normandie, 2019. http://www.theses.fr/2019NORMR112.
Повний текст джерелаАнотація:
Qui était Jean Lecanuet ? A travers le parcours politique atypique de l’homme d’Etat qu’était le sénateur-maire de Rouen, lequel s’est d’abord fait connaître sur le plan national, avant d’exister sur le plan local, nous tenterons de mettre en lumière le mécanisme du jeu des échelles par le biais d’un courant politique centriste si difficile à incarner et à cerner. Le pouvoir personnel de Lecanuet, si immense localement pendant plus de vingt-cinq ans sur Rouen et son département, la Seine-Maritime, a permis au centrisme démocrate social de dominer comme jamais il n’avait pu le faire auparavant les autres forces politiques, alliées ou rivales, de droite comme de gauche, écrasées par le système lecanuetiste. Pour autant, des interrogations demeurent. Ce véritable écrasement de la politique locale, départementale et régionale était-il nécessaire ? Que cherchait réellement à promouvoir Jean Lecanuet par le biais de ce territoire centriste qu’il s’est patiemment construit ? La notion de territoire est ici fondamentale. Car ce qu’il n’a pas réussi à effectuer nationalement – à savoir imposer une démocratie humaniste, sociale et européenne – Jean Lecanuet semble décidé à le réussir dans sa propre ville et à l’échelon départemental au cours des années 1970-1990. Ainsi, avec sa liste municipale Mieux Vivre à Rouen, il va s’évertuer à faire de Rouen une ville moderne, tournée vers l’horizon de l’an 2.000. Profondément amoureux de la ville aux cent clochers, Lecanuet parviendra à séduire les habitants par son talent oratoire, ses qualités d’homme politique de stature nationale et son travail acharné en leur faveur. Et même si les Rouennais n’ont pas toujours compris les choix politiques effectués par leur maire au cours de cette période mouvementée sur le plan électoral, ils lui vouent assurément une reconnaissance éternelle, qui perdure encore des décennies après sa mortWho was Jean Lecanuet? Through the atypical career path of the Senator-Mayor of Rouen, first known nationally, before being recognized a local level, we will try to highlight the mechanism of scales in a Centrist political movement so difficult to embody and understand. The personal power of Lecanuet, so vast locally during more than 25 years on Rouen and its department, allowed the social democratic centrism movement to prevail as never over the other political movements, allied or rival, right and left, crushed by the Lecanuetisme system. Nonetheless, the remain some questions. Is this political dominance over the local, departmental and regional levels necessary? What Jean Lecanuet was looking for when patiently building his centrist stronghold? The notion of territory is fundamental here. From the 1970s to the 1990s, Jean Lecanuet seems decided to establish in his own city and at a departmental scale what he failed nationally-establishing a humanist, social and European democracy. Through his municipal list “Mieux Vivre à Rouen” (A better life in Rouen), he will do his best to make Rouen become a modern city, focused on the upcoming 2000s. Deeply attached to the city of one hundred bell towers, Lecanuet will manage to entice the inhabitants thanks to his oratory skill, his national stature and his dedicated work in their favour. Despite that the inhabitants of Rouen did not always understand the political choices of their Mayor during this turbulent period, they certainly wish him eternal gratitude, that continues for decades after his death
22
KLOSOWSKI, SERGE. "Caracteristiques perinatales, socio-economiques et culturelles de la population accueillie a la maternite du centre hospitalier de lens : etude en population hospitaliere sur la periode du 5 janvier au 13 mai 1993 portant sur 1000 grossesses et 370 demandes d'interruption volontaire de grossesse." Lille 2, 1994. http://www.theses.fr/1994LIL2M070.
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23
Sádlo, Dominik. "Racionalizace obrábění skříní převodovek." Master's thesis, Vysoké učení technické v Brně. Fakulta strojního inženýrství, 2020. http://www.nusl.cz/ntk/nusl-417111.
Повний текст джерелаАнотація:
Content of the thesis is the proposal of new technology using machining centres, including five controlled axis. Benefit of implementation the new nechnology is investigated at machining example, which is the gear housing of a single stage gearbox, manufactured in the company. In the first part of the thesis, the general properties of gearboxes and their housings are analyzed, as well as the procedure of the current proces of the machining representative. In practical part of the thesis is proposed necessary tool equipment and jig equipment, needed for machining of the part. After that are analyzed and filled in time studies, provided by manufacturers of machining centres. On the bases of these studies, were calculated operating times and operating costs per one piece of the housing. In the part of technical and economical evaluation is calculated the return of initial investment, including costs for byuing new machining cente and cutting tools equipment. Finaly are evaluated the overal benefits of the new technology, given the needs of the company.
24
LaMalva, Kevin Joseph. "Failure Analysis of the World Trade Center 5 Building." Digital WPI, 2007. https://digitalcommons.wpi.edu/etd-theses/1178.
Повний текст джерелаАнотація:
This project involves a failure analysis of the internal structural collapse that occurred in World Trade Center 5 (WTC 5) due to fire exposure alone on September 11, 2001. It is hypothesized that the steel column-tree assembly failed during the heating phase of the fire. The results of this research have serious and far-reaching implications, for this method of construction is utilized in approximately 20,000 existing buildings and continues to be very popular. Catastrophic failure during the heating phase of a fire would endanger the lives of firefighters and building occupants undergoing extended egress times (e.g., high-rise buildings), or relying upon defend-in-place strategies (e.g., hospitals). Computer software was used to reconstruct the fire event and predict the structural performance of the assembly when exposed to the fire. Results from a finite element, thermal-stress model confirms this hypothesis, for it is concluded that the catastrophic, progressive structural collapse occurred approximately 2 hours into the fire exposure.
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Mello, Celso Abdon Lopes de. "Análise de CD10, BCL-6 e MUM1 em linfomas não Hodgkin de células B primários de mediastino." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5155/tde-02062010-161354/.
Повний текст джерелаАнотація:
INTRODUÇÃO: Os linfomas B atualmente podem ser agrupados de acordo semelhanças moleculares e imunoistoquímicas com o linfócito do centro germinativo (CG) ou linfócito ativado (LA/pós CG), sendo este de pior prognóstico. O objetivo deste trabalho foi analisar a expressão de CD10, BCL-6 e MUM1 em pacientes portadores de LBPM e correlacionar com prognóstico. MÉTODOS: análise retrospectiva das variáveis clínicas e de tratamento de 44 pacientes portadores de LBPM. Estudo imunoistoquímico de CD10, BCL-6 e MUM1 em 29 pacientes com material disponível. RESULTADOS: idade mediana foi de 28 anos e 70% eram do sexo feminino. A positividade para CD10, BCL-6 e MUM1 foi de: 24%, 65% e 58%. De acordo com o modelo de Hans, 38% foi classificado como CG e 62% como pós CG. A sobrevida global em 5 anos e sobrevida livre de doença foi de 47% e 81%, respectivamente. Resposta Completa após quimioterapia de primeira linha (p=0,0001), radioterapia de mediastino (p=0,004) e IPI (0,039) tiveram associação com a sobrevida. A positividade para MUM1 esteve associado a pior sobrevida global (p=0,014). Aplicando o modelo de Hans não foi observada nenhuma associação com sobrevida. Na análise multivariada apenas Resposta (RR 4,28 (IC 95% 1,3-13,6) e MUM1 (RR 3,54 (1,1-11,5) correlacionaram com a sobrevida. CONCLUSÃO: Para este grupo de pacientes com características clínicas homogêneas, resposta completa e expressão de MUM1 estiveram associados à sobrevida. A classificação deste linfoma em CG e pós-CG utilizando CD10, BCL-6 e MUM1 não se correlacionou com evolução. Estudos futuros com casuística maior são necessários para melhor definir os fatores prognósticos do LBPMINTRODUCTION: Primary Mediastinal Large B Cell Lymphoma (PMLBCL) is a distinct clinico-pathologic entity that differs from other Diffuse Large B Cell Lymphomas (DLBCL). Classification of DLBCL in GC and post-GC according can identify two subgroups of lymphomas with distinct prognosis. The aim of this study is to analyze the expression of CD10, BCL-6 and MUM1 in PMLBCL and correlate with prognosis. METHODS: retrospective analysis of clinical variables of 44 patients with PMLBCL and expression of CD10, BCL- 6 and MUM1 in 29 patients with available tissue. RESULTS: median age was 28 years and 70% of the patients were female. CD10, BCL-6 and MUM1 was positive in 24%, 65% and 58%, respectively. According to Hans classification, 38% were classified as GC and 62% as post-GC. Five year OS and DFS was 47% and 81%, respectively. In univariate analysis Complete Response (p=0.0001), Radiation therapy (p=0.004), IPI (0.039), and MUM1 expression (0.014) correlated with OS. No correlation was seen with Hans classification and survival. CONCLUSION: for this group of patients with homogeneous clinical features, response to therapy and MUM1 expression were associated with prognosis. The Hans algorithm proposed for aggressive lymphomas was not a predictive tool for survival in PMLBCL. Further studies are necessary to validate our finding and identify better prognostic variable for PMLBCL
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Reinisch, Cornelia. "An Arts Administration internship with the Contemporary Arts Center in New Orleans." ScholarWorks@UNO, 2004. http://scholarworks.uno.edu/aa_rpts/5.
Повний текст джерелаАнотація:
This detailed report of an internship at the Contemporary Arts Center in New Orleans, includes an organizational profile, a description of the activities performed during the internship, and an analysis of an organizational management challenge, a proposed resolution to the management challenge, and a discussion of the short and long range effects of the internship on the organization. Image and branding techniques are important aspects of the analysis and the resolution of the management challenge.
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Robert, Michèle. "Le granulome malin centro-facial : à propos de 5 cas." Montpellier 1, 1991. http://www.theses.fr/1991MON11164.
Повний текст джерела
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Junior, Franklin de Camargo. "Análise da propagação de incertezas no método de dinâmica inversa tridimensional para membro inferior durante a marcha em diferentes velocidades." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/5/5163/tde-27112012-090245/.
Повний текст джерелаАнотація:
O objetivo deste estudo foi investigar o efeito do erro na localização do centro de pressão (5 e 10 mm) nas incertezas de momentos articulares dos membros inferiores em diferentes velocidades de marcha (1,0, 1,5 e 2,0 m/s). Nossas hipóteses foram que: as incertezas absolutas de momento articular diminuam de distal para o proximal e da condição de maior para a de menor velocidade. Os momentos articulares de cinco adultos jovens saudáveis foram calculados pelo método bottom-up de dinâmica inversa 3D, na dependência do qual estimamos as incertezas propagadas. Os resultados indicaram que existe uma relação diretamente proporcional entre os erros do centro de pressão e as incertezas de momento articular. As incertezas absolutas nos picos de momento expressas no sistema de referência anatômico diminuíram de distal para proximal, confirmando nossa primeira hipótese, exceto para o momento de abdução. Da menor para a maior velocidade de marcha ocorreu um aumento da incerteza no momento (de até 0,04 Nm/kg), confirmando agora nossa segunda hipótese, exceto, mais uma vez, para abduções de joelho e quadril. E ainda, as incertezas relativas variaram dependendo do plano e articulação (entre 5 e 31%), sendo os momentos articulares de joelho os mais afetadosThe aim of this study was to investigate the effect of errors in the location of the center of pressure (5 and 10 mm) on lower limb joint moment uncertainties at different gait velocities (1.0, 1.5, and 2.0 m/s). Our hypotheses were that the absolute joint moment uncertainties would be gradually reduced from distal to proximal joints and from higher to lower velocities. Joint moments of five healthy young adults were calculated by inverse dynamics using the bottom-up approach, depending on which estimate the uncertainty propagated. Results indicated that there is a linear relationship between errors in center of pressure and joint moment uncertainties. The absolute moment peak uncertainties expressed on the anatomic reference frames decreased from distal to proximal joints, confirming our first hypothesis, except for the abduction moments. There was an increase in moment uncertainty (up to 0.04 Nm/kg for the 10 mm error in the center of pressure) from the lower to higher gait velocity, confirming our second hypothesis, although, once again, not for hip or knee abduction. Finally, depending on the plane of movement and the joint, relative uncertainties experienced variation (between 5 and 31%), and the knee joint moments were the most affected
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Hanzlík, Aleš. "Konstrukce naklápěcího otočného stolu." Master's thesis, Vysoké učení technické v Brně. Fakulta strojního inženýrství, 2011. http://www.nusl.cz/ntk/nusl-229937.
Повний текст джерелаАнотація:
The aim of this thesis is the design of the rotary tilting table controlled the fourth and fifth axis for CNC centrum.První part includes the search for pivotally tilting tables. The second part includes the choice of technical paremetrů pivotally tilting table for selected CNC center, design of possible options , selection of appropriate options, design of the selected option.
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Arroyo, Torres Elmer Jesús. "Hernioplastia Lichtenstein en el Centro Médico Naval "CMST". Experiencia de 5 años." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2004. https://hdl.handle.net/20.500.12672/1887.
Повний текст джерелаАнотація:
Desde 1988 hasta la actualidad, la técnica de Lichtenstein (1) ha sido, sin duda ,la de mayor aceptación a nivel mundial; sin presentar hasta el momento un pico de descenso en su utilización y sin las complicaciones asociadas a las técnicas laparoscópicas que actualmente cobran muchos adeptos.
La técnica de Lichtenstein ha demostrado su eficacia al ser aplicable para todo tipo de hernias en el orificio miopectíneo de Fruchaud, similar principio utilizado en las hernioplastías laparoscópicas; pero con la ventaja de ser aplicable a todo tipo de hernias inguinales y reproducible en centros hospitalarios de formación quirúrgica (2), y no presentar complicaciones reporatadas y costos tan elevados con la laparoscópica (3)
En el Centro Médico Naval “CMST”, uno de los principales centros de referencia en el área quirúrgica en nuestro país, dicha técnica se viene reproduciendo desde hace más de 5 años, sin contar aún con un estudio retrospectivo que nos oriente hacia los beneficios obtenidos en comparación con las técnicas clásicas convencionales ni con las nuevas técnicas laparoscópicas de abordaje transabdominal (6,11,26,33) y extraperitoneal (3)
Los resultados recogidos en la bibliografía, tras reparación de una hernia inguinal primaria sin empleo de material protésico son variables, dependiendo de la técnica realizada,(3,8), así como de la experiencia del cirujano, con tasas de recidiva que oscilan entre 1% y el 10% (9,10,38). Se considera que la principal causa de estos resultados es la aproximación de tejidos bajo tensión. Por ello han surgido técnicas que incluyen la colocación de prótesis sintéticas (malla) (4,5,49,16) sobre el defecto, dentro de ellas está la técnica de Lichtenstein con baja tasa de recidiva (menor al 1%) (7). Sin embargo no previene ni trata a las hernias femorales (tipo III C), tampoco protege totalmente el área defectuosa principal (preperitoneal).Tesis de segunda especialidad
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Bates, Allison Lynn. "An Investigation into the Interaction of Psychopathology, Personality, and Sleep Disturbances in Clients from a Community Mental Health Center." NSUWorks, 2010. http://nsuworks.nova.edu/cps_stuetd/5.
Повний текст джерелаАнотація:
Studies have found a relationship between psychopathology and sleep disturbances, as well as between psychopathology and personality traits. What has not received attention to date, however, is the interplay amongst all three factors: psychopathology, sleep disturbances, and personality characteristics. This study explores the interaction amongst the three areas, as well as examines specific relationships between psychopathology and sleep disturbances and personality and sleep disturbances.
Forty clients were recruited from a community mental health center. Participants were receiving outpatient psychological services, were over 18, and did not have a diagnosis of active psychosis or mental retardation. Participants completed 9 questionnaires covering items about demographic information, psychological concerns, sleep, personality style, and social desirability. They received a $10 gift card upon completion of the study.
Participants had a mean age of 47.6 (70% female, 77% Caucasian). Results indicated that individuals with more severe psychopathology had poorer sleep quality and greater insomnia severity; however, participants with longer histories of psychopathology did not have more dysfunctional beliefs and attitudes about sleep. Participants with more extraverted personality styles did not sleep less than individuals who were less extraverted, and those who were more neurotic did not exhibit poorer sleep quality or greater insomnia severity. Lastly, when examining the relationship amongst all three factors, it was found that psychopathology may be a better predictor of sleep disturbances than personality is (depending on how sleep was assessed), and personality and sleep disturbances are both significant predictors of psychopathology.
The results reinforce the interplay amongst psychopathology, personality, and sleep disturbances. Mental health professionals may want to place greater importance on the role of sleep in the treatment of psychological and personality disorders. Future research could replicate the study with a larger sample, utilize a different personality measure, or follow participants longitudinally from the start of their mental health treatment.
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Cavalcante, Neusa. "Ceplan : 50 anos em 5 tempos." reponame:Repositório Institucional da UnB, 2015. http://repositorio.unb.br/handle/10482/19975.
Повний текст джерелаАнотація:
Tese (doutorado)—Universidade de Brasília, Faculdade de Arquitetura e Urbanismo, Programa de Pesquisa e Pós-Graduação da Faculdade de Arquitetura e Urbanismo, 2015.Submitted by Fernanda Percia França (fernandafranca@bce.unb.br) on 2015-12-21T11:42:32Z No. of bitstreams: 1 2015_NeusaCavalcante.pdf: 57210954 bytes, checksum: ac37fa4afa0b5c2762cae292a7daf607 (MD5)
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O tema desta tese é a história do Centro de Planejamento Oscar Niemeyer (Ceplan), órgão de assessoria técnica da Universidade de Brasília, criado, em 1962, com a tripla missão institucional de planejar o campus e projetar seus edifícios; servir de suporte para a prática profissional de professores e alunos da Faculdade de Arquitetura e Urbanismo e, comprometendo-se com o projeto de desenvolvimento do país à época, contribuir com a produção de tecnologia no campo da arquitetura e da construção. Após atravessar distintos períodos, o Ceplan construiu uma trajetória que permanece restrita àqueles que a protagonizaram ou que dela são testemunhas. Afinada com a história cultural, a metodologia adotada contemplou tanto a pesquisa bibliográfica e documental como a história oral, a partir de depoimentos de arquitetos responsáveis pela produção do Ceplan ao longo de seus cinquenta anos de existência. Reconhecendo com as pesquisas teóricas a importância da memória para a historiografia contemporânea, as informações colhidas nos diversos depoimentos e a análise da produção arquitetônica de cada período vivenciado na atuação do Ceplan, pretendeu-se demonstrá-lo como um lugar de memória, e, mais que isso, como um patrimônio histórico e cultural da Universidade de Brasília, quiçá do Brasil, a ser preservado, vivo e atuante, para as futuras gerações. ______________________________________________________________________________________________ ABSTRACT
This thesis examines the history of the Centro de Planejamento Oscar Niemeyer (Ceplan), a technical advisory body of the Universidade de Brasília set up in 1962 with the threefold institutional mission of planning the university campus and designing its buildings, providing support to the professional practice of teachers and students of the School of Architecture and Urbanism, and committing to Brazil’s development project of the time by producing technology in the fields of architecture and construction. After undergoing different periods, Ceplan constructed a trajectory which remains restricted to those who played a leading part in it or simply witnessed it. In tune with cultural history, the methodology employed in this study comprises bibliographic and documentary research as well as oral history, the latter based on the accounts of architects responsible for Ceplan’s production over the past fifty years. By acknowledging the importance of memory in contemporary historiography, information extracted from the various testimonies, and the analysis of Ceplan’s architectural production throughout its history, this thesis aimed to shed light on Ceplan as a place of memory and, above all, as a historical and cultural heritage of Universidade de Brasília and maybe of Brazil itself, which must be preserved, in its living and active form, for future generations.
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Avilés, Medina Sebastián Miguel. "Valdivia de Paine 5 en el contexto del periodo alfarero temprano de Chile Centra." Tesis, Universidad de Chile, 2014. http://repositorio.uchile.cl/handle/2250/135904.
Повний текст джерела
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Mello, Guilherme Arantes. "Revisão do pensamento sanitário como foco no Centro de Saúde." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5137/tde-31082010-181535/.
Повний текст джерелаАнотація:
Sob o referencial da história das idéias, este estudo revisa o pensamento sanitarista brasileiro, norteado pela figura do Centro de Saúde. A reforma do Serviço Sanitário paulista de 1925 e a instituição das Unidades de Saúde da Família em 1994 definem os limites gerais da revisão. Considera-se a possibilidade de que o discurso sobre o Centro de Saúde inaugurou uma nova era epistemológica na saúde pública, definida pela dimensão individual da educação sanitária, em detrimento da medicina das cidades ou era bacteriana. As novas concepções surgiram, sustentaram e foram sustentadas pelo deslocamento da influência política e intelectual francesa para os Estados Unidos, materializada nas ações da Fundação Rockefeller, tendo por base a Universidade Johns Hopkins. São Paulo foi uma das cidades escolhidas para investimento maciço, como efeito demonstração do novo ideário. Embora a atuação institucional da Fundação tenha tido escala planetária, a apropriação discursiva e adaptação local se mostrou mais precoce e coesa na América Latina, dando ensejo a criação e fortalecimento de um verdadeiro pan-americanismo na saúde pública, com a participação do Brasil. No país, o discurso da era sanitária e seus corolários medicina preventiva, medicina integral, medicina comunitária e atenção básica/primária, foi clivado por três grandes matrizes políticas, que se sucederam e predominaram em momentos distintos: pensamento clássico, de matriz liberal e que dá significação cultural local às idéias que prevalecem no debate internacional a partir dos anos 1920; o pensamento radical, de matriz marxista, que aflora na segunda metade dos anos 1970, principalmente no seio da intelectualidade acadêmica; e o pensamento comunitário em saúde pública, de raízes no pensamento político da assistência social, estimulado pela estratégia da Saúde da Família nos anos 1990. O pensamento radical em saúde pública nasce sob incisiva oposição ao regime militar e ao pensamento clássico. Em sua matriz discursiva a saúde coletiva substitui as expressões anteriores e se concentra no determinantes sociais da saúde, relegando o debate setorial ao segundo plano. Embora sem a devida clareza, o pensamento comunitário recupera e busca atualizar muitas das concepções clássicas, sem fugir da composição com o discurso radical. Alguns conceitos originalmente ligados ao ideário dos Centros de Saúde se destacam ao longo do período analisado: integração (integralidade); descentralização (desconcentração); e socialização (universalidade). Num plano histórico mais abrangente, reconhece-se atualmente que a saúde pública brasileira esteve na essência de um projeto de construção nacional iniciado na Primeira República, mas efetivamente posto em ação na era Vargas. Os Centros de Saúde, hoje representados no ideário da Atenção Básica, não só participaram desta história, como, na realidade, lhe foram em grande parte seus protagonistasThis study reviews the history of ideas in the public health of Brazil. The reform of the Health Service of Sao Paulo in 1925 and the establishment of the Family Health Program in 1994 set the general limits of the review. It considers the possibility that the discourse on the Health Centre inaugurated a new epistemological era in public health, defined by the individual dimension of \"health education\", to the detriment of the \"medicine of the cities\" or \"bacterial era\". New concepts emerged, sustained and were sustained by the displacement of French intellectual and political influence for the United States, embodied in the actions of the Rockefeller Foundation, based on the Johns Hopkins University. São Paulo was one of the cities chosen for massive investment, as \"demonstration effect\" of those new ideas. Although the institutional performance of the Foundation has had a planetary scale, the discursive appropriation and local adaptation was earlier and more cohesive in Latin America, giving rise to creation and strengthening of a true Pan-Americanism in public health, with the participation of Brazil. Nationwide, the \"health education\" ideas and its corollaries \"preventive medicine\", \"comprehensive medicine\", \"community medicine and primary care, was cleaved by three major political perspectives that ensued and prevailed at different times. The \"classical thought\", in a liberal perspective, gave local significance to the ideas present in the international debate since the 1920s. The \"radical thought\", under a Marxist matrix, arouse in the second half of the 1970s, especially within academic intellectuals, and \"community thought\" in public health, stimulated by the Family Health Program in the 1990s. The radical thought in public health movement was strengthened in opposition to the military regime and the classical thought. \"Collective health\" replaced the previous expressions and focuses on social determinants of health, relegating the services organization in the background. Although lacking the necessary clarity, community thought recovers and seeks to update many of the classical concepts, in composition with the radical discourse. Some concepts originally linked to the ideals of the Health Centers are highlighted throughout the studied period: integration (comprehensiveness), decentralization and socialization (universality). In a broader historical view, it is current recognized the role of the Brazilian public health in the national identity construction started in the First Republic, but actually put into action in the Vargas era. Health Centres, today represented in the ideas of primary care, not only participated in this history, as indeed they were largely its protagonists
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Nemer, Sérgio Nogueira. "Avaliação da força muscular inspiratória (Pi Max), da atividade do centro respiratório (P 0.1) e da relação da atividade do centro respiratório/força muscular inspiratória (P 0.1 / Pi Max) sobre o desmame da ventilação mecânica." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/5/5150/tde-02082007-104326/.
Повний текст джерелаАнотація:
Introdução: a hipótese deste estudo é de que a Pressão inspiratória máxima, Pressão de oclusão traqueal e sua razão podem predizer a evolução do desmame da ventilação mecânica em uma população mista de Terapia Intensiva. Métodos: A Pi Max , P 0.1 e a razão P 0.1 / Pi Max foram mensuradas em setenta pacientes consecutivos , intubados ou traqueostomizados, e ventilados mecanicamente, que preencheram os critérios para desmame da ventilação mecânica. Após a mensuração da Pi Max, P 0.1 e ainda da freqüência respiratória e volume corrente em litros com o cálculo da relação FR/VC e do produto P 0.1 x FR/VC, os pacientes foram submetidos a um teste de respiração espontânea. Os pacientes que toleraram o teste de respiração espontânea e não precisaram retornar para a ventilação mecânica no período de 24 horas foram considerados desmamados. A sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo, diagnóstico de acurácia e a área sob a curva ROC (receiver operating characteristic curve) foram calculadas. Resultados: Os valores médios da P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC e P 0.1 x FR /VC foram de 2,49±1,2, -34,6±13, 0,07±0,01, 75,4±33 e 184,6±123 respectivamente para os pacientes desmamados e 4,36± 2,0, -32,1±11,0 , 0,15± 0,09, 148,4± 42 e 652,9± 358 para os não desmamados da ventilação mecânica. Todos os índices distinguiram entre os pacientes desmamados e não desmamados, à exceção da Pi Max. A sensibilidade para a P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC e P 0.1 x FR /VC foi de 78,85, 65,38, 80,77, 82,69, 88,46 respectivamente. A especificidade para a P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC e P 0.1 x FR /VC foi de 72,2, 38,8, 72,2, 83,3, 72,2 respectivamente. Os valores preditivos positivos para a P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC e P 0.1 x FR /VC foram respectivamente 89,1, 75,5, 89,3, 93,4 e 90,2. Os valores preditivos negativos para a P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC e P 0.1 x FR /VC foram respectivamente de 54,1, 28,0, 56,5, 62,5 e 68,4. O diagnóstico de acurácia para a P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC e P 0.1 x FR /VC foi respectivamente de 77,1, 58,5, 78,5, 82,8 e 84,2. As áreas abaixo da curva ROC para a P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC e P 0.1 x FR /VC foram respectivamente 0,76± 0,06, 0,52±0,08 , 0,78±0,06, 0,90±0,04 e 0,84±0,05. A comparação da áreas abaixo da curva ROC mostrou que os melhores índices foram a relação FR/VC, o produto P 0.1 x FR/VC e a relação P 0.1 / Pi Max não havendo diferença estatística entre eles. A pior área abaixo da curva ROC foi do índice Pi Max. Os índices de desmame da ventilação mecânica P 0.1, Pi Max e P 0.1/ Pi Max não foram diferentes estatisticamente entre os pacientes intubados e traqueostomizados. Conclusão: os melhores índices foram a relação FR/VC, o produto P 0.1 x FR/VC e a relação P 0.1 / Pi Max não havendo diferença estatística entre eles.Introduction: We hypothesized that maximal inspiratory pressure (Pi Max), airway tracheal occlusion pressure (P 0.1) and its ratio (P 0.1/Pi Max) can be used to predict weaning outcome in a mixed ICU mechanically ventilated patients. Methods: Pi Max, P 0.1 and P 0.1 / Pi Max ratio were measured in seventy consecutive intubated or tracheostomized, mechanically ventilated patients, who fulfilled weaning criteria. After these measurements of Pi Max, P0.1, respiratory rate and expiratory tidal volume (L) with the calculation of f / Vt ratio and the product P0.1x f / Vt , the patients were submitted to a spontaneous breathing trial (SBT) . Those who were able to sustain the SBT and had no need to return to mechanical ventilation in the following 24 hours were considered weaned. The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and Receiver- operating-characteristics (ROC) curves for this population were calculated. Results: The mean value of P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC e P 0.1 x FR /VC were 2,49 ±1,2, -34,6± 13, 0,07± 0,01, 75,4±33 and 184,6±123 respectively for the weaned patients and 4,36± 2,0, -32,1±11,0 , 0,15± 0,09, 148,4± 42 e 652,9± 358 for the not weaned patients. All the indexes distinguished between the weaned and not weaned patient, except for the Pi Max. The sensitivity for the P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC and P 0.1 x FR /VC were respectively 78,85, 65,38, 80,77, 82,69, 88,46. The specificity for P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC and P 0.1 x FR /VC were 72,2, 38,8, 72,2, 83,3, 72,2 respectively. The positive predictive value for P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC and P 0.1 x FR /VC were respectively 89,1, 75,5, 89,3, 93,4 e 90,2. The negative predictive value for P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC and P 0.1 x FR /VC were respectively 54,1, 28,0, 56,5, 62,5 e 68,4. The diagnostic accuracy for P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC and P 0.1 x FR /VC were respectively 77,1, 58,5, 78,5, 82,8 e 84,2. The area under the ROC curves for P 0.1 , Pi Max, P 0.1 / Pi Max, FR / VC and P 0.1 x FR /VC were respectively 0,76± 0,06, 0,52±0,08 , 0,78±0,06, 0,90±0,04 e 0,84±0,05. The comparison among the areas under the ROC curves showed that the best weaning indexes were f / Vt ratio, the product P 0.1 x f / Vt and the P0.1/ Pi Max ratio with no statistic differences among them. The Pi Max presented the smaller area under the ROC curve. The weaning indexes P 0.1, Pi Max e P 0.1/ Pi Max were not statistically different between intubated or tracheostomized patients. Conclusion: The best weaning indexes were f/Vt ratio , the product P 0.1 x f/Vt and the P 0.1 / Pi Max ratio with no statistically difference among them.
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Santos, Marcelo Otávio dos. "Modelagem numérica e experimental dos erros térmicos de um centro de usinagem CNC 5 eixos." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/3/3151/tde-04102018-072516/.
Повний текст джерелаАнотація:
Esta tese teve por objetivo desenvolver um algoritmo preciso e robusto capaz de compensar os erros térmicos volumétricos de um centro de usinagem 5 eixos em diferentes condições operacionais. O comportamento térmico da máquina foi modelado usando técnicas do método dos elementos finitos (MEF) com base na teoria do calor de atrito e calor de convecção, e validadas através dos vários campos de temperatura obtidos experimentalmente usando termopares e imagens térmicas. Os principais subsistemas da máquina foram inicialmente modelados, como o conjunto de fusos de esferas, guias lineares e motofuso, o que permitiu posteriormente a validação do comportamento termoelástico da máquina completa para onze ciclos de trabalho em vazio, seis ciclos de usinagem, nove ciclos de posicionamento e dois ciclos com temperatura ambiente variando, obtendo erros máximos inferiores a 9%, ao comparar os resultados numéricos com os resultados experimentais. A validação do modelo em elementos finitos permitiu usar os resultados obtidos para treinar e validar uma rede neural artificial (RNA) para prever os erros térmicos do centro de usinagem. Os desvios entre os erros térmicos previstos pela RNA e os calculados pelo MEF foram inferiores a 5%. Baseado nos resultados obtidos pelas medições das peças de trabalho usinadas foi possível formular e implementar um modelo de compensação dos erros térmicos no CNC do centro de usinagem, que obteve uma redução dos erros entre 62% e 100% nas peças usinadas com compensação. Foi também proposto um algoritmo de previsão e compensação dos erros térmicos para o centro de usinagem, baseado em todos os ciclos e simulações realizadas, e que se comparando com os resultados experimentais mostrou-se capaz de reduzir os erros térmicos entre 50% e 95%. Após sua validação, foi possível concluir que o algoritmo desenvolvido é uma ferramenta precisa e robusta para compensar os erros térmicos da máquina para várias condições de trabalho, podendo compensá-los mesmo com esta movendo-se a diferentes velocidades, em usinagem ou mesmo operando em temperatura ambiente variável.This thesis aims to develop an accurate and robust algorithm capable of compensating the volumetric thermal errors of a 5-axis machining center under different operating conditions. The thermal behavior of the machine was first modeled using finite element method (FEM) techniques based on theory of friction heat and convection heat, and validated with the various experimentally raised temperature fields using thermocouples and thermal imaging. The main machine subsystems were initially modeled, such as the ball screw system, linear guides and spindle, which allowed for validating of the thermoelastic behavior of the entire machine for eleven no load duty cycles, six cycles of machining, nine cycles of positioning and two cycles with varying ambient temperature, obtaining errors lower than 9%, when comparing the numerical results with the experimental results. The validation of the finite element model allowed for the use of the results obtained to train and validate an artificial neural network (ANN) for predicting the thermal errors of the machining center. The deviations between the thermal errors predicted by ANN and the FEM simulation results were less than 5%. Based on the results obtained by the measurements of the machined workpieces, it was possible to formulate and implement a model of compensation of the thermal errors in the CNC of the machining center, which obtained a reduction of errors of 62% and 100% of the machined parts with compensation. It was also proposed a thermal error prediction and compensation algorithm for the machining center, based on all cycles and simulations performed, and that, comparing with the experimental results, it was able to reduce the thermal errors between 50% and 95%. After its validation, it was possible to conclude that the developed algorithm is an accurate and robust tool to compensate the thermal errors of the machine for various duty conditions, being able to compensate the errors even when it is moving at different speeds, in machining process or even operating in variable ambient temperature.
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Batokova, Barbara. "Design for Organizational Intelligence in Non-Profits." Research Showcase @ CMU, 2011. http://repository.cmu.edu/theses/5.
Повний текст джерелаАнотація:
In many small to mid-size nonprofits, a large amount of knowledge and information is confined to local folders, hard copy formats or even specific people, making it inaccessible to those who could benefit from it. This informal practice causes duplication of efforts and prevents the organization from maintaining critical knowledge and learning from past experience.
Partnering with The Center for Victims of Violence and Crime (CVVC), a Pittsburgh-based human services nonprofit organization, I applied human-centered design methods to identify their specific informal knowledge and information processes and structures. Using the research findings, I developed a sustainable and systematic knowledge management practice that also takes into account the constraints of funding and time, which many nonprofits face.
To support this practice, I created a system with a hierarchical information architecture that is able to expand overtime to accommodate the growth of the organization and its programs. It enables clear organization, storage and retrieval of explicit knowledge documents as well as the related tacit knowledge, creating the necessary basis for sharing and collaboration. By simplifying and formalizing major administrative tasks, the system also streamlines organizational processes, allowing the staff to work more effectively.
Implemented with Microsoft SharePoint 2010, the system creates a trustworthy environment that is necessary to facilitate organizational learning and maintain critical knowledge, leading to sustainability and innovation.
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Leschke, Sophie Clara [Verfasser]. "Chirurgische endoskopische Ablation des isolierten Vorhofflimmerns- 5-Jahres Ergebnisse einer "Single-center"-Studie / Sophie Clara Leschke." Tübingen : Universitätsbibliothek Tübingen, 2020. http://d-nb.info/121650184X/34.
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Oliveira, Carlos Augusto Cardim de. ""Prática de medicina baseada em evidências em um centro de tratamento intensivo pediátrico"." Universidade de São Paulo, 2003. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-13082005-173825/.
Повний текст джерелаАнотація:
Objetivos: Estimar a concordância entre as práticas e as evidências disponíveis em uma unidade de terapia intensiva pediátrica. Métodos: Estudo retrospectivo de todos os pacientes internados durante 2001. As práticas foram classificadas em adequadas ou não-adequadas de acordo com recomendações. Esperava-se para as práticas recomendadas 90% de concordância, para as contra-indicadas, discordância de até 10% e para aquelas onde havia incertezas, 50%. Resultados: Foram selecionadas 114 publicações e avaliadas 253/275 internações (92%). O uso foi considerado apropriado para albumina em 47,6% (IC 95% 39% 55%); dopamina <3mg/kg/min 87,9% (83% 92%); sedação e analgesia 88,6% (87% 90%); transfusões de concentrado de hemácias 95,2% (92% 97%); profiliaxia de úlcera de estresse 89,7% (88% 91%).Objectives: Estimate the concordance between the practices and the evidence available in a pediatric intensive care unit. Methods: Retrospective study of all admitted patients during 2001. The practices were classified as adequate or non-adequate according to recommendations. It was expected 90% concordance for the recommended practices, while for non-adequate practices, discordance until 10% and for those where there was doubt, 50%. Results: 114 publications were selected and 253/275 admissions (92%) were evaluated. Use was considered appropriate for albumin in 47.6% (IC 95% 39% 55%); dopamine <3mg/kg/min 87.9% (83% 92%); sedation and analgesia 88.6% (87% 90%); red blood cell transfusions 95.2% (92% 97%); stress ulcer prophylaxis 89.7% (88% 91%).
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Molloy, Melanie A. "Ways to implement the practices of the Met school into a traditional grade 3-5 classroom /." [Denver, Colo.] : Regis University, 2006. http://165.236.235.140/lib/MMolloyPartI2006.pdf.
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Babintseva, A. G. "Perinatal risk factors of neonatal acute kidney injury in Ukraine: a 5-year retrospective single-center study." Thesis, БДМУ, 2020. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/17656.
Повний текст джерела
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Biggs, Robyn A. "5-and 6-Membered Hydrazides as Potential Catalysts for Diels-Alder Cycloadditions." Thesis, Université d'Ottawa / University of Ottawa, 2014. http://hdl.handle.net/10393/30723.
Повний текст джерелаАнотація:
Part A: Synthesis of 5- and 6-Membered Camphor-Based Hydrazides as Organocatalysts for Cycloaddition Reactions
The favorable environmental and reactivity qualities of organocatalysts are contributing to the popularization of this method for the acceleration of enantioselective reactions. Research in our group has been focused on the synthesis of camphor-derived hydrazide based organocatalysts for enantioselective cycloaddition processes. Recent results suggest that the presence of an exocyclic electron withdrawing group on the hydrazide moiety, as well as the incorporation of the hydrazide moiety into a 6-membered ring, may have a beneficial effect on the kinetics of the catalysts. A variety of camphor-based cyclic hydrazides have been synthesized and tested in Diels-Alder reactions, varying both the ring size and placement of the electron withdrawing group.
Part B: Synthesis of Isocampholenic Acids by the Rearrangement of Camphor Derivatives
A variety of substituted isocampholenic acid derivatives have been prepared by rearrangement of the camphor skeleton of a variety of tertiary alcohols derived from ketopinic acid. The reaction is highly reliable and retains the stereochemical information from the camphor scaffold. This rearrangement represents an efficient way to prepare synthetically useful isocampholenic acids. Mechanistic experiments show that the rearrangement does not involve exogenous water and that a short-lived carbocation is implicated in the reaction.
Part C: Diastereoselective Formation of Quaternary Centers from Stereodefined Trisubstituted Alkenes
Previous work in our laboratory has focused on the preparation of single-isomer tri- and tetra-substituted olefins. This methodology has been used in the construction of a variety of alkenyl esters in good to excellent yields. These alkenyl esters could then be transformed into the corresponding 3,3-disubstituted allyl boronates in a stereocontrolled fashion. There are a limited number of methods available to prepare single isomer 3,3-disubstituted allyl boronates, which can be important precursors in the stereoselective preparation of all-carbon quaternary centers. Our methodology has therefore been applied to the construction of single isomer 3,3-disubstituted allyl boronates and subsequently used in the stereoselective generation of all-carbon quaternary centers by the reaction of these allyl boronates with aldehydes.
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Sosa, Marta Gladys, Claudio Martínez, and Patricia Gómez. "Desnutrición en niños de 2 a 5 años que asisten al Centro de Salud nº 66 El Mirador." Bachelor's thesis, Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería, 2011. http://bdigital.uncu.edu.ar/6213.
Повний текст джерелаАнотація:
En el centro de salud Nº 66 “El Mirador" Rivadavia, se observó, un grupo etario, (niños de 2-5 años), con un marcado déficit nutricional. Esto marcó un interés que lleva a investigar más profundo para determinar los factores que afectan a este grupo en particular.
Los objetivos de este trabajo son: identificar factores que inciden en la desnutrición en niños de 2 a 5 años que asisten al centro de salud N° 66, analizar los recursos socio económico de la familia responsable de los niños, conocer hábitos alimenticios de la familia, determinar nivel cultural de los adultos responsables y establecer parámetros de grado de nutrición.Fil: Sosa, Marta Gladys. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..
Fil: Martínez, Claudio. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..
Fil: Gómez, Patricia. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..
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Silva, Bárbara Gabriela. "Exposição ao ruído em call center: headsets, sintomas auditivos e extra-auditivos de operadores de telemarketing." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/5/5170/tde-20032019-154223/.
Повний текст джерелаАнотація:
Introdução: A exposição ao ruído ocupacional pode trazer consequências negativas para a saúde auditiva e extra-auditiva dos trabalhadores. Há, na literatura, escassez de estudos que avaliem as condições de trabalho dos operadores de telemarketing, bem como da principal fonte de ruído (headset), que, na maioria dos call centers, é monoaural. Objetivo: Avaliar a exposição ao ruído no trabalho de operadores de telemarketing, buscando relacioná-la aos sintomas auditivos e extra-auditivos referidos, bem como avaliar a aplicabilidade dos headsets mono e binaural. Métodos: Estudo transversal observacional. Participaram 79 operadores de telemarketing, normo-ouvintes, de uma empresa multinacional. Foi realizada medição do ruído, com um audiodosímetro, pela técnica de microfone em ouvido real, por 20 minutos (10 com cada headset), durante ligações diárias dos teleoperadores. Adicionalmente, os participantes responderam a questionário para caracterização dos sintomas auditivos/extraauditivos e relato de preferência entre os headsets. Para a análise dos dados, utilizou-se medidas descritivas e testes de hipótese (Qui-quadrado, Wilcoxon e Mann-Whitney), com nível de significância de 5%. Resultados: Dos 79 participantes (média 22±4,2 anos), 50,64% trabalhavam no período matutino e 49,36% no período vespertino/noturno, sendo a maioria do sexo feminino (78,5%). Mais da metade da amostra relatou: episódios de dor ou infecções de ouvido (55,7%); utilização de estéreo pessoal (70,9%), por mais de uma hora diária, com intensidade acima da metade da capacidade do equipamento; não realizar o controle da intensidade do headset individual (68%). Quanto aos sintomas, 98,7% relataram pelo menos um sintoma auditivo e 88,6% pelo menos um extra-auditivo, sendo os mais frequentes: plenitude auricular (15,2%) e zumbido (13,4%), ansiedade (65,8%), dor de cabeça (34,2%) e estresse (17,7%). Observou-se associação entre as variáveis: intensidade de uso do headset individual e quantidade de sintomas auditivos (p=0,044) e extraauditivos (p=0,026); aumento abrupto de som e zumbido (p=0,020). Os níveis de pressão sonora provenientes do headset monoaural foram maiores que os do binaural para as medidas de pico (p < 0,001), intensidade máxima (p < 0,001) e equivalente (p=0,006). Com relação aos níveis de pressão sonora equivalentes, a média foi de 85,54 dB(A) para o headset monoaural, e de 76,57 dB(A) para o ambiente externo. Quanto à preferência, a maioria dos indivíduos (84,8%) manifestou-se a favor do headset binaural, sendo o principal motivo, proporcionar maior atenção e concentração para as chamadas. Na comparação dos níveis de pressão sonora equivalentes entre os headsets mono e binaurais, de acordo com a preferência de headset dos operadores, para aqueles que preferiram o binaural, verificou-se níveis de pressão sonora dos headsets binaurais significantemente menores quando comparados aos monoaurais (p=0,017), o que não ocorreu para os que preferiram o monoaural (p=0,976). Conclusões: Os níveis de pressão sonora equivalentes produzidos pelo headset monoaural, que é o utilizado neste call center, atingiram valores médios de 85,54 dB(A), com variação de 52,9 a 98,1 dB(A). A quantidade de sintomas auditivos e extra-auditivos referidos pelos operadores de telemarketing, apesar dos limiares auditivos estarem dentro da normalidade, sugere que a exposição a qual estão submetidos pode oferecer riscos para a saúde. O headset binaural, avaliado no presente estudo, demonstrou ser uma alternativa viável para estes trabalhadores e ambiente de trabalho, por produzir menores intensidades sonoras e melhorar a qualidade das chamadas, na perspectiva dos teleoperadores, quando comparado ao headset monoauralIntroduction: Being exposed to occupational noise may result in negative consequences to auditory and extra-auditory health of workers. In the literature, studies that assess the working conditions of telemarketers are scarce, as well as regarding the main source of noise (headset), which, in most call centers, is monaural. Purpose: To assess the exposure to noise of telemarketers, aiming to relate it to the auditory and extra-auditory symptoms mentioned by them, as well as to assess the applicability of mono and binaural headsets. Methods: Crosssectional observational study in which seventy-nine telemarketers from a multinational company participated. Noise measurement was performed with an audiodosimeter using the real ear microphone technique for 20 minutes (10 minutes using each headset) during daily calls to telemarketers. Additionally, the participants answered a questionnaire to characterize auditory / extra-auditory symptoms and reported their most preferably headsets. For the analysis of the data, we used descriptive measures and hypothesis tests (Chi-square, Wilcoxon and Mann-Whitney), with significance level of 5%. Results: Among the 79 participants (mean 22 ± 4.2 years), 50.64% worked in the morning period and 49.36% in the afternoon / evening period, with a majority of females (78.5%). More than half of the sample reported: episodes of pain or ear infections (55.7%); use of personal stereo (70.9%), for more than one hour per day, with intensity above half of the equipment capacity; and lack of monitoring the intensity of the individual headset (68%). Concerning the symptoms, 98.7% reported at least one auditory symptom and 88.6% had at least one extra-auditory one, being the most frequent: auricular fullness (15.2%) and tinnitus (13.4%), anxiety (65.8%), headache (34.2%) and stress (17.7%). We observed an association between the variables: intensity of use of the individual headset and amount of auditory (p = 0.044) and extra-auditory symptoms (p = 0.026); abrupt increase in sound and tinnitus (p = 0.020). The sound pressure levels from the monaural headset were greater than those of the binaural for peak measurements (p < 0.001), maximum intensity (p < 0.001) and equivalent (p = 0.006). Regarding equivalent sound pressure levels, the mean was 85.54 dB (A) for the monaural headset, and 76.57 dB (A) for the external environment. Regarding preference, the majority of individuals (84.8%) expressed support for the binaural headset, being the main reason, the fact that it provides greater attention and concentration capacity for the calls. In comparison to the equivalent sound pressure levels between mono and binaural headsets, according to the headset preference of the telemarketers, for those who preferred binaural, sound pressure levels of binaural headsets were significantly lower when compared to monoaural ones (p = 0.017), which did not occur for those who preferred the monoaural (p = 0.976). Conclusions: Equivalent sound pressure levels produced by the monaural headset, which is the one used in this call center, achieved mean values of 85.54 dB (A), ranging from 52.9 to 98.1 dB (A). The amount of auditory and extra-auditory symptoms reported by telemarketers, even though the hearing thresholds are within normal range, suggests that the noise exposure to which they undergo may jeopardize health. The binaural headset, assessed in the present study, has been shown to be a viable alternative for these workers and work environment, because it produces lower sound intensities and improve the quality of calls, from telemarketers\' perspective, when compared to the monaural headset
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Lozano, Pérez Antonio Abel. "Síntesis y caracterización de nuevos complejos de níquel(II). Modelos del centro activo de metaloenzimas." Doctoral thesis, Universidad de Murcia, 2005. http://hdl.handle.net/10803/11042.
Повний текст джерелаАнотація:
La presente memoria está estructurada en cinco capítulos donde se presentan los resultados de la investigación, acompañados por un capítulo en el que se describe la parte experimental, y por último, el capítulo de conclusiones. Se adjuntan cuatro anexos que recogen los espectros de masas (FAB+), IR, RMN y los datos cristalográficos. Por último, para cumplir con los requerimientos exigidos para optar a la mención de Doctorado Europeo se incluye un Abstract en inglés de la Tesis. En el Capítulo I se hace una introducción a las metaloenzimas que contienen níquel en su centro activo. En el Capítulo II se describe la reactividad del níquel frente a moléculas sencillas de interés biológico. En el Capítulo III se presentan los complejos de níquel pentacoordinado con ligandos carbonato puente que sirven como modelos de Anhidrasa carbónica y fijan CO2(g). En el Capítulo IV se describen los complejos modelo de la Hidrogenasa [Ni-Fe] y en el capítulo V se describen los modelos del centro activo de la Fosfotriesterasa, incluyendo un estudio cinético de la hidrólisis del tris(nitrofenil) fosfato mediante hidroxocomplejos de níquel.This Thesis is structured in five chapters that reports the results of the research, accompanied by a chapter that describes the experimental part, and finally, the concluding chapter. Experimental data of the synthesis and characterisation of the new complexes as mass spectra (FAB +), IR, NMR and crystallographic data, are annexed. Finally, following the requirements to obtain the mention of European Doctor we include anin English of the Thesis. Chapter I provide an introduction to the nickel-containing Metalloenzymes in their active site. Chapter II describes the reactivity of Nickel versus single molecules of biological interest. Chapter III presents pentacoordinate nickel complexes with carbonate-bridge ligand that served as models for Carbonic Anhydrase and CO2 fixation. Chapter IV describes the [Ni-Fe] Hydrogenase model complexes and Chapter V describes the models of the active site of the Phosphotriesterase, including a kinetic study of the hydrolysis of the tris(nitrophenyl)phosphate by nickel hydroxocomplexes.
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Marques, Ana Lucia Marinho. "Itinerários terapêuticos de sujeitos com problemáticas decorrentes do uso de álcool em um centro de atenção psicossocial." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5163/tde-07052010-143843/.
Повний текст джерелаАнотація:
Os problemas decorrentes do uso de álcool trazem impactos relevantes para o campo da saúde pública e levam ao desenvolvimento de políticas e propostas de tratamento baseadas em perspectivas e abordagens teórico-práticas que apresentam marcantes diferenças entre si, o que resulta na pluralidade de ofertas terapêuticas atuais. Tratase de questão complexa que envolve fatores de diversas ordens: socioculturais, econômicos, políticos, sócio-familiares e individuais. Tal complexidade deve ser considerada na construção das práticas de saúde e na compreensão dos processos de busca, escolha e adesão as propostas de tratamento, como interativos, relacionais e dotados de significados singulares. O presente estudo visou conhecer os itinerários terapêuticos de sujeitos com problemáticas decorrentes do uso prejudicial de álcool em um Centro de Atenção Psicossocial para usuários de álcool e outras drogas CAPSad. A pesquisa, de caráter qualitativo, foi orientada pela perspectiva etnometodológica, e empregou os procedimentos metodológicos de revisão bibliográfica, pesquisa documental, entrevistas semi-estruturadas, grupo focal, observação participante e construção de diário de campo. O trabalho de campo foi realizado no CAPSad Travessia, situado no município de Santana de Parnaíba/SP, no período de janeiro a março de 2009. Os resultados mostraram que os itinerários terapêuticos dos participantes foram compostos por um conjunto de ações sucessivas e muitas vezes sobrepostas. Os sujeitos tendem a recorrer simultaneamente a diversos lugares de tratamento e cuidado e chegam ao serviço de saúde sem a formulação clara do problema e nem tampouco com conhecimento sobre a proposta do serviço. Tal percurso não se configura como resultado de escolhas racionais prévias, mas da experiência construída no processo, que dota de significados as vivências e problemáticas relacionadas ao uso de álcool e a própria necessidade de busca de ajuda e enfrentamento do problema. Nesse processo, nota-se a importância das redes sócio relacionais, no contexto das quais são compartilhados os significados atribuídos às experiências e a orientação e sustentação dos processos de busca de ajuda. Concluímos que a preocupação em conhecer os saberes e práticas dos sujeitos na construção de seus itinerários terapêuticos deve compor as práticas de cuidado, desenvolvidas pelos profissionais nos serviços de saúde, comprometidas com o fortalecimento dos sujeitos individuais e coletivos, com a construção de direitos e cidadania e com a produção de saúde e de vidaProblems in consequence of the use of alcohol bring on relevant impacts to public health field and lead to the development of policies and treatment proposals based on perspectives and theoretical-practical approaches that present marked differences among them, resulting on the plurality of current therapeutic offers. This is a complex question that involves factors in several orders: sociocultural, economics, politics, socio-familiars and individuals. This complexity should be considered in the construction of health practices and understanding of the processes of search, choice and adherence to the treatment proposals, as interactive, relational and endowed of singular meanings. This study aimed to know the therapeutic itineraries of individuals with problems in consequence of harmful use of alcohol in a Psychosocial Care Center for users of alcohol and others substances CAPSad. The research used qualitative methods and was oriented by the ethnomethodological perspective. It employed the methodological procedures of bibliographical review, documental research, semi-structured interviews, focus group, participant observation and construction of field diary. The fieldwork was conducted in CAPSad Travessia, located in the city of Santana de Parnaíba/SP, from January to March of 2009. The results showed that the therapeutic itineraries of the participants were composed of a set of successive and often overlapping actions. The individuals tend to appeal simultaneously to several places of treatment and care and arrive to the health service without a clear formulation of the problem and neither informed about the proposal of the service. This pathway do not configure itself as a result of previous rational choices, but as the experience built during the process, which attributes meanings to the experiences and problems related to alcohol use and to the own necessity of help search and confrontation of the problem. In this process, it is possible to note the importance of social relational networks, in the context of which the meanings attributed to the experiences and the orientation and sustentation of process of help searching are shared. We conclude that the preoccupation in knowing the knowledge and practices of the individuals on the construction of their therapeutic itineraries must compose the care practices, developed by professionals in the health services, committed with the strengthening of individual and collective subjects, with the construction of rights and citizenship and with the production of health and life
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Mendes, Cibele. "Prática em transfusão de glóbulos vermelhos e índice de oxigenação em um centro de terapia intensiva pediátrico." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-08102007-090314/.
Повний текст джерелаАнотація:
A anemia é a causa primária de indicação de transfusão de glóbulos vermelhos e é especialmente prevalente e esperada em centros de terapia intensiva. Os benefícios das transfusões incluem aumento da oxigenação tissular, diminuição de hemorragias, tratamento da anemia e da hipovolemia. Os poucos estudos publicados têm demonstrado variações significativas nas práticas de transfusões de glóbulos vermelhos e o melhor momento para a indicação destas transfusões ainda não foi identificado. Objetivos Descrever a população de crianças que recebeu transfusão de glóbulos vermelhos com relação à faixa etária, concentração de hemoglobina (Hb) e taxa de hematócrito (HT), uso de saturação venosa central de oxigênio (SvO2), lactato sérico arterial, procedimentos terapêuticos e presença de disfunção de múltiplos órgãos e sistemas (DMOS). Métodos Estudo retrospectivo observacional, realizado no Centro de Terapia Intensiva Pediátrico (CTIP) do Instituto da Criança da Faculdade de Medicina da Universidade de São Paulo, em 2004, com crianças que receberam transfusão de glóbulos vermelhos. Descrevemos o número de pacientes, faixa etária, motivo de internação no CTIP, presença de doença de base e de DMOS, uso de SvO2, lactato sérico arterial, Hb, HT e procedimentos terapêuticos (ventilação mecânica, drogas vasoativas e métodos de substituição renal). Resultados A transfusão de glóbulos vermelhos foi realizada em 50% dos pacientes internados. A idade mediana foi de 18 meses e o principal motivo de internação foi insuficiência respiratória (35% dos casos). Doença de base estava presente em 84% dos casos e DMOS em 47% dos casos. Foram realizadas coletas de Hb e HT em todos os casos e de SvO2 e lactato sérico arterial em 24% dos casos. A mediana de Hb pré-transfusional foi de 7,8 g/dl. Os pacientes transfundidos estavam sendo submetidos a algum procedimento terapêutico em 82% dos casos. Conclusões São realizadas transfusões de glóbulos vermelhos em todas as idades. A concentração de hemoglobina e a taxa de hematócrito são os principais dados utilizados para a indicação destas transfusões. O lactato sérico arterial e a SvO2 são pouco utilizados para se indicar a transfusão de glóbulos vermelhos. A maioria dos pacientes transfundidos recebe algum procedimento terapêutico e, em muitos casos, são realizadas transfusões em pacientes que apresentam DMOS.Anemia is the primary cause of red blood cell transfusions and it is especially prevalent and even expected in critical care settings. The benefits of red blood cell transfusions include increase in tissue oxygenation, treatment of anemia and hypovolemia. There are substantial variations in transfusion practices and the optimal transfusion practice for various types of critically ill patients with anemia has not been established. Objectives To describe the clinical, hematological and therapeutic characteristics of children who received red blood cell transfusion in a Pediatric Intensive Care Unit (PICU). Methods Retrospective observational study, performed in the PICU of ?Instituto da Criança?, Medicine School of University of São Paulo, in 2004, with one hundred children who received red blood cell transfusion. We described the number of patients included in the study, age, reason for admission to the PICU, presence of baseline illness and multiple organ system failure (MODS), use of oxygen central venous saturation, arterial lactate, hemoglobin concentration (Hb), hematocrit (HT) and therapeutics procedures (mechanical ventilation, use of vasoactive drugs and renal replacement methods). Results The red blood cell transfusion occurred in 50% of the patients. Median age of patients was 18 months. The most common reason for admission was respiratory failure, in 35% of the cases. Baseline illness was present in 84% of the cases and MODS in 47% of the cases. Hb and HT were collected in all the cases and oxygen central venous saturation and arterial lactate were collected in 24% of the cases. The median pre-transfusion hemoglobin concentration was 7.8 g/dl. The patients were receiveing therapeutics procedures in 82% of the cases. Conclusions Red blood cell transfusions are performed in children of all ages. The hemoglobin concentration and hematocrit are the main reason to indicate the red blood cell transfusion. Arterial lactate and oxygen central venous saturation are rarely utilized. The majority of patients receive therapeutic procedures and, in many cases, patients with MODS are given red blood cell transfusions.
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Fornäs, Johan. "Advancing Cultural Studies : Report from an international workshop at Södertörn Conference Center, Lidingö near Stockholm, 4-5 February, 1999." Linköpings universitet, Advanced Cultural Studies Institute of Sweden, 1999. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-92644.
Повний текст джерелаАнотація:
In modernity, culture is everywhere. So is cultural studies, it seems. But cultural studies needs to be advanced, in two senses: to be promoted but also to be ameliorated. Culture is focal in late modern societies, and should be so in research. New encounters and innovative modes of study are necessary to deal with the new kinds of problems posed by current cultural developments. The international and interdisciplinary field of cultural studies well deserves to be spread, but also longs for regenerative initiatives. There is now in Sweden an option to take a decisive step in this direction. This is what this report argues for.With contributions by Pertti Alasuutari, Birgit Arve-Pares, Karin Becker, Svante Beckman, Peter Dahlgren, Kirsten Drotner, Olle Edström, Billy Ehn, Simon Frith, Marianne Gullestad, Ulf Hannerz, Jan Hjärpe, Arne Jarrick, Thomas Johansson, Lisbeth Larsson, Orvar Löfgren, Britta Lundgren, Anders Öhman, Janice Radway, Bo Reimer, Mats Rolen, Ove Sernhede, Britt-Marie Thurén and Mats Trondman.
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Ramalho, Karlos André Câmara. "Ciclo de 5 dias do vento em baixos níveis durante o trimestre seco do Centro de Lançamento de Alcântara." Instituto Nacional de Pesquisas Espaciais (INPE), 2018. http://urlib.net/sid.inpe.br/mtc-m21c/2018/08.16.21.49.
Повний текст джерелаАнотація:
Neste trabalho é caracterizado o Ciclo de 5 dias do vento em baixos níveis durante o trimestre seco do Centro de Lançamento de Alcântara (C5d). O ciclo é uma variabilidade que compreende uma banda de 3 a 9 dias, com picos médios em torno de 5 dias. As análises realizadas com base em dados da Torre Anemométrica do CLA e dados de reanálise do ERA-Interim sugerem que o ciclo ocorre, de forma típica, em cerca de um terço do trimestre SON, com significância estatística para 85% do período estudado. Os resultados mostram que o ciclo tem relação com as altas subtropicais do Atlântico Sul (OAS) e Norte (OAN) e, secundariamente, com anomalias de temperatura e ponto de orvalho (PO) na região do CLA. Períodos de máxima velocidade do vento ocorrem devido a alísios mais intensos que podem ser acelerados no limite continente oceano em dias relativamente mais quentes e secos. Períodos de mínima intensidade do vento ocorrem em dias de alísios menos intensos, resultado de menor influência das altas, os quais podem ser amplificados em cenários menos quentes e mais úmidos na região do CLA. A oscilação média de 5 dias é explicada, principalmente, pelas variações na configuração da ASAS em função dos transientes de latitude subtropicais.In this work the 5-day surface wind variability at Alcântara Launch Center (CLA), referred to as the "5-day cycle" (C5d), was studied for the the dry quarter (SON). The C5d is a variability in the 3 to 9 days band, with average power peaks at around 5 days. Data from the anemometric tower installed at the CLA and ERAIterim reanalysis were used. The results showed that the C5d strongly affects the wind signal in one-third of the dry quarter. The wind and pressure fields from the reanalysis data showed that the C5d is mainly related to changes in the position and strength of the Subtropical Highs. For instance, maximum (minimum) wind speed in the C5d occurs when the South Atlantic Subtropical High is stronger (weaker) and located west (east) of the climatological position. For a case when the C5d affected the CLA, a simulation with the WRF model ratified that the cycle is mainly influenced by the large scale circulation; mesoscale features had a complementary effect.
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Veneri, Valentina. "Riorganizzazione di un distribution center mediante le tecniche di lean production: il caso Gambro Dasco spa." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amslaurea.unibo.it/6382/.
Повний текст джерелаАнотація:
La Lean Production è un tema di estrema attualità per tutte le aziende che abbiano compreso l’importanza di produrre di più, con le risorse che si hanno a disposizione, eliminando sistematicamente tutte le attività che non creano valore aggiunto.
La Produzione Snella è diventato un metodo per incrementare la competitività, riducendo l’incertezza e aumentando il servizio fornito al cliente.
Nella realtà attuale vi è ancora una scarsa diffusione dei concetti Lean. Le cause di questo problema sono imputabili soprattutto alla cultura del management aziendale, alla mancanza di efficaci strumenti tecnologici a supporto, e in alcuni casi, la scarsa disponibilità delle imprese ad abbracciare la filosofica “snella”.
La presente tesi, dopo una panoramica introduttiva su l’origine e l’evoluzione del Pensiero Snello e l’analisi di tutti i tools disponibili per combattere lo spreco; si propone di analizzare l’applicazione degli stessi in Gambro Dasco, multinazionale biomedicale leader nella vendita delle sue apparecchiature per dialisi.