479 research outputs found
Joaquim Cardozo: um encontro com o deserto
No full textTese (doutorado) - Universidade Federal de Santa Catarina, Centro de Comunicação e Expressão. Programa de Pós-graduação em LiteraturaEste trabalho de pesquisa tenta provocar um encontro da poética de Joaquim Cardozo com o deserto. Ler o deserto como um fora, como uma contemplação, como um território sem marcas fixas e como assombração. O deserto como aquilo que pode interferir na história e interromper a catástrofe através de um pensamento da graça, de uma atenção. Uma leitura crítica da poética de Joaquim Cardozo a partir de seu procedimento com a escritura: súplica, esperança, sustentação do paradoxo e do contingente na imagem do deserto. A fala suplicante do homem trágico. Uma leitura que atravessa a produção de Joaquim Cardozo: poemas, teatro, textos sobre arte e arquitetura, a crítica de poesia e os relatos
Steady state off-axis sawtoothing in the Rijnhuizen Tokamak project
No full textA family of off-axis, or annular, instabilities has been studied using Thomson scattering, soft X-ray emission, and two electron cyclotron emission diagnostic systems. In the Rijnhuizen tokamak (RTP) [N. J. Lopes Cardozo , Plasma Physics and Controlled Nuclear Fusion Research 1992 (International Atomic Energy Agency, Vienna, 1993), Vol. 1, p. 271] these phenomena are invoked in a controlled way in discharges with specific (off-axis) deposition of electron cyclotron heating (ECH) and persist during most of the heating period, or during many current diffusion times. Based on coherent mode analysis at the crash time, the instabilities are associated with resonant surfaces near simple rational values of q (3/2, 2, and 3). A parameter study shows an increase of reheat rate and a decrease of sawtooth period with increasing ECH power and - in contrast to observations in other experiments - with increasing density as well. (C) 1999 American Institute of Physics. [S1070-664X(99)02210-7]
Hybrid absorber-foil technique to measure the electron temperature of 0.1–10-keV plasmas
No full textA atitude e a utilização do exame colpocitológico como prática preventiva: contribuições de enfermeiras vinculadas a duas instituições de saúde de Florianópolis /
No full textDissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde.Esta pesquisa tem por objetivo conhecer a atitude e a prática de enfermeiras em relação à prevenção do câncer do colo do útero, bem como identificar se estas, como mulheres, conhecem os fatores de risco a que estão expostas. Para isto foi realizado um estudo transversal com variáveis qualitativas e quantitativas, junto a profissionais enfermeiras de duas instituições de saúde de Florianópolis, sendo uma voltada ao atendimento de pacientes com diagnóstico de câncer e a outra de um hospital geral centrado na assistência, no ensino e na pesquisa. Em ambos os grupos de 25 enfermeiras, não se observaram percentuais muito diferenciados quanto à atitude e à prática em relação a prevenção do câncer cérvico uterino. Sendo que estas reconhecem a importância do exame colpocitológico, pois 86% das profissionais realizam este, 68% na preriodicidade de uma vez ao ano, 97,7% têm conhecimento do resultado e 72,1% guardam o mesmo consigo. Quanto ao conhecimento dos fatores de risco, que como mulheres, as profissionais estão expostas, estas demonstraram não conhecer alguns fatores de risco, e outros apesar de serem reconhecidos, a atitude não condiz com a prática referida. Fatores como a multiplicidade de parceiros, doenças sexualmente transmissíveis e a idade demonstraram ser reconhecidos como fatores de risco para o desenvolvimento do câncer cérvico-uterino. Em relação ao cuidar de si para cuidar do outro, 80% das enfermeiras do presente estudo concordam que o papel da Enfermagem é o cuidado ao ser humano; no entanto, apenas 66% das profissionais concordam que para cuidar eficazmente do outro, é preciso primeiro a prender a cuidar de si mesma
70-gene signature for clinical decision making in breast cancer
No full textThe aim of this thesis was to evaluate whether the use of the 70-gene signature (MammaPrint) can be improved by taking into account other factors to better define subgroups of breast cancer patients who are at risk of overtreatment, and for whom adjuvant systemic treatment (chemotherapy and/or endocrine therapy) could be safely omitted. In women older than 50 years with unfavorable clinical pathological characteristics, chemotherapy can be safely omitted in case of a low-risk 70-gene signature. In women younger than 50 years there may be some benefit from chemotherapy, but further research into the optimal treatment of these younger women is needed. Patients with stage I ER+/HER2- breast cancers who received no adjuvant systemic treatment had excellent survival outcomes, but had higher cumulative incidences of locoregional recurrences and contralateral breast cancers than patients who received endocrine therapy. Patients with 70-gene signature ultralow risk tumors had the best prognosis, and could be candidates for further de-escalation of treatment. Both the 70-gene signature and method of detection were significantly associated with breast cancer outcome, and incorporating both into (online) clinical risk prediction and decision-making tools will further optimize the prognostication for individual breast cancer patients. We evaluated the influence of the 70-gene signature on risk assessment and chemotherapy recommendation, and found that knowledge of the 70-gene signature result led to fewer patients being assessed as high risk, and fewer recommendations for chemotherapy, among European breast cancer specialists. Furthermore, we evaluated the association between a polygenic risk score (PRS) for breast cancer and outcome. The PRS313 was associated with favorable tumor characteristics and a low risk 70-gene signature. The PRS313 was not independently associated with prognosis
J Immigr Minor Health
No full textRefugees are at risk for psychiatric morbidity, yet little is known about their mental health conditions. We identified factors associated with depression symptoms among Bhutanese refugees in the US. We randomly selected adult Bhutanese refugees (N = 386) to complete a cross-sectional survey concerning demographics, mental health symptoms, and associated risk factors. The case definition for depression symptoms was 651.75 mean depression score on the Hopkins Symptom Checklist-25. More women (26%) than men (16%) reported depression symptoms (p = 0.0097). Higher odds of depression symptoms were associated with being a family provider, self-reported poor health, and inability to read and write Nepali (OR 4.6, 39.7 and 4.3, respectively) among men; and self-reported poor health and inability to read and write Nepali (OR 7.6, and 2.6 respectively) among women. US-settled Bhutanese refugees are at risk for depression. Providers should be aware of these concerns. Culturally appropriate mental health services should be made more accessible at a local level.CC999999/Intramural CDC HHSUnited States/U60/CCU007277/PHS HHSUnited States
Quality of life on randomized treatment for isolated systolic hypertension: results from the Syst-Eur Trial
No full textOBJECTIVE: To compare quality of life in elderly patients with isolated systolic hypertension allocated randomly to groups to receive placebo or active treatment in the Systolic Hypertension in the Elderly Trial. DESIGN: Double-blind randomized controlled trial. METHODS: Patients aged 60 years were allocated randomly to groups to receive first-line treatment with nitrendipine (with second- and third-line enalapril and hydrochlorothiazide) or placebo. Trained interviewers administered trail-making tests (Trail A and B), Brief Assessment Index (a measure of depressed mood) and four subscales from the Sickness Impact Profile (Ambulation, Social Interaction, Sleep and Rest, and Home work). RESULTS: Six hundred and ten patients completed a baseline and at least one follow-up questionnaire. Trail-making scores were slower in actively treated patients, especially in the first 6 months of follow-up when the between-group effect sizes were 0.25 [95% confidence interval (CI) 0.07 to 0.43] for Trail-making A and 0.13 (95% CI -0.05 to 0.31) for Trail-making B. Across the 4 years of follow-up, patients receiving active treatment were more likely to report problems on the Social Interaction scale than were placebo-treated patients (odds ratio 1.32, 95% CI 1.02 to 1.69), equivalent to a 7% difference. There were no significant differences between active and placebo treatment in the other Sickness Impact Profile dimensions or in the measure of depression. CONCLUSIONS: Active treatment in the Systolic Hypertension in Europe trial was associated with some small adverse impacts on quality of life
The linear plasma generator Magnum-PSI
No full textThe Dutch Institute for Fundamental Energy Research (DIFFER) has built the new experimental research facility Magnum-PSI. In Magnum-PSI, Plasma Surface Interaction (PSI) research for the nuclear fusion reactor ITER and reactors beyond ITER will be carried out. As such, it is essential that the experiment can access the high-density, lowtemperature regime relevant for the ITER divertor strike zones (electron density ne ~ 1020 – 1021 m-3 and electron temperature Te ~ 1 – 5 eV). Magnum-PSI is a linear plasma generator in which the interaction between a large (up to 10 cm) diameter plasma beam with a target material can be investigated. It will have a steady state high flux of 1023 - 1025 ions m-2 s-1 at a plasma temperature in the eV range confined by a magnetic field of 2.5 T. In this way, molecules and dust particles that come off the surface are confined and remain part of the plasma-surface interaction system. The work described in this thesis forms the basis for the design of the new machine and shows its excellent performance. The design makes sure that the ITER relevant regime of PSI can be accessed while having sufficient diagnostic access to the machine. Key elements are a low neutral gas density in the target region and a continuous magnetic field of sufficient magnitude. The neutral gas contribution to the surface interaction region coming directly from the source should be much lower than the plasma flux, and the magnetic field should be strong enough to guide the ionized particles from the source to the target and to confine particles of a certain size which are ionized after coming off the surface. The demands for a steady state magnetic field without limiting the diagnostic access to the machine have led to the design of a superconducting magnet with a 1.3 m warm bore and 16 radial access ports. This design is the result of a conceptual design study to optimize the following parameters: field strength and homogeneity, diagnostic transparency, inner diameter, ramp-up and down times, safety and costs (capital and running costs). The most cost effective cooling solution turned out to be a recondensing system, where the coils are submerged in liquid helium while the evaporated helium is stored in a gas balloon to be re-condensed by cryocoolers. The stray field of this large magnet is shielded by iron walls surrounding the experimental area. The dimensions and positions of these walls have been determined with a nonlinear finite element solver. The vacuum system must be capable of reaching the required neutral pressure in the target region while the plasma source puts in large quantities of gas to reach the high fluxes. This demand has led to the design of a 3 stage differentially pumped vacuum system, where the vacuum vessel consists of separate chambers divided by skimmers and pumped with their own pumping stations. In a comparative study between roots pumps, vapor boosters, cryopumps and turbo pumps, the roots pumps were identified as being the most reliable, economic and user friendly pump solution for these high gas loads. The pumps have been commissioned and the measured pump speeds are comparable to the calculated values. It was shown that the chosen pump solution is capable of reaching its requirements. Since the flow in Magnum-PSI is mostly in the rarified regime, a direct simulation Monte Carlo (DSMC) method was used to model the flows. Two stage differential pumping was modeled and applied in the linear plasma devices Pilot-PSI and PLEXIS. Both simulations and experiments showed that the optimum skimmer position depends on the position of the shock and therefore shifts for different gas parameters. In Magnum-PSI, a moveable plasma source is implemented which makes it possible to change the distance between source and skimmer for different operating conditions. Using DSMC simulations, the shape of the skimmer has been designed in such a way that it effectively stops neutrals from flowing to the next chamber, while having a minimum impact on the shock structure. During the commissioning phase of Magnum-PSI, the non-magnetized expansion of 5 Pa m3 s-1 (3 slm) argon in the differentially pumped vacuum vessel at low background pressures was studied. The behavior of the neutral component was studied with Rayleigh scattering measurements and DSMC simulations. Thomson scattering and double Langmuir probe measurements were performed on the ionized fraction. It was found that the electrons and neutral particles are not completely coupled in the shock front. The neutral fraction shows clear signs of invasion from hotter background gas, causing the average temperature and density to increase before the shock. This is also evident from the ionization ratio, which has been determined in front of and behind the first skimmer. This study has validated the design of the machine and has helped to understand the behavior of the gas flow. Due to a significant delay in the delivery of the superconducting magnet, Magnum-PSI has started operation as a pulsed machine using conventional electromagnets. To accommodate the smaller diameter coils, one of the vacuum chambers is temporarily removed leading to a two stage differentially pumped vacuum system. This results in a somewhat higher neutral pressure in the target region. The coils provide a magnetic field in the source region of 1.9 T for 6 seconds. Lower field settings with correspondingly longer pulse lengths are available. Due to the expanding magnetic field in the target region, the plasma beam expands a factor of 2.3 in diameter before it reaches the target. First experiments have been carried out on 5 Pa m3 s-1 (3 slm) magnetized hydrogen and deuterium plasma beams. Thomson scattering 25 mm in front of the target has yielded electron densities up to 3.6×1020 m-3 and electron temperatures up to 3.7 eV in a 25 mm (FWHM) diameter beam. Exposure of a tungsten target has led to average heat and particle fluxes well in excess of 4 MW m-2 and 1024 m-2 s-1 respectively. Using pressure and calorimetric measurements, it was shown that the plasma surface interaction is mainly determined by the incoming ion flux and not by neutrals coming directly from the source. The application of a differentially pumped vacuum vessel has led to an unprecedented high ionization efficiency of the plasma source. These first results validated the design of Magnum-PSI and have shown that ITER relevant conditions have been achieved
Can guidelines improve referral to elective surgical specialties for adults? A systematic review
No full textAim To assess effectiveness of guidelines for referral for
elective surgical assessment.
Method Systematic review with descriptive synthesis.
Data sources Medline, EMBASE, CINAHL and Cochrane
database up to 2008. Hand searches of journals and
websites.
Selection of studies Studies evaluated guidelines for
referral from primary to secondary care, for elective
surgical assessment for adults.
Outcome measures Appropriateness of referral (usually
measured as guideline compliance) including clinical
appropriateness, appropriateness of destination and of
pre-referral management (eg, diagnostic investigations),
general practitioner knowledge of referral
appropriateness, referral rates, health outcomes and
costs.
Results 24 eligible studies (5 randomised control trials,
6 cohort, 13 case series) included guidelines from UK,
Europe, Canada and the USA for referral for
musculoskeletal, urological, ENT, gynaecology, general
surgical and ophthalmological conditions. Interventions
varied from complex (“one-stop shops”) to simple
guidelines. Four randomized control trials reported
increases in appropriateness of pre-referral care
(diagnostic investigations and treatment). No evidence
was found for effects on practitioner knowledge. Mixed
evidence was reported on rates of referral and costs
(rates and costs increased, decreased or stayed the
same). Two studies reported on health outcomes finding
no change.
Conclusions Guidelines for elective surgical referral can
improve appropriateness of care by improving prereferral
investigation and treatment, but there is no
strong evidence in favour of other beneficial effects
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