Impact of Childhood Cancer on Parents` Relationships: An Integrative Review

Purpose: The diagnosis of cancer and the treatment decisions associated with it may cause uncertainty, stress, and anxiety among parents. Emotional tensions can affect parents` relationships during the trajectory of the child`s cancer illness. We conducted an integrative review to examine the evidence related to the effects of childhood cancer on parents` relationships. Methods: An integrative literature search of studies published between 1997 and 2009 was conducted in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychology Information (PsycINFO), PubMed, Scopus, CUIDEN, and Latin American and Caribbean Health Science Literature (LILACS). The key words used were neoplasms, child, marriage, spouses, family relations, and nursing. Articles were reviewed if the (a) topic addressed parents` relationships during childhood cancer; (b) participants were mothers, fathers, or both; (c) design was either qualitative or quantitative; (d) language was English, Portuguese, or Spanish; (e) date of publication was between January 1997 and October 2009; and (f) abstract was available. Results: Fourteen articles met the search criteria and were reviewed using Cooper`s framework for integrative reviews. Four themes emerged: (a) changes in the parents` relationship during the trajectory of the child`s illness; (b) difficulty in communication between couples; (c) gender differences in parental stress and coping; and (d) role changes. Conclusions and Implications: Findings revealed positive and negative changes in parents` relationships, communication, stress, and roles. Nurses need to assess the impact of cancer diagnosis and treatments on parent relationships, offer support and encouragement, and allow expression of feelings. Future research is needed to develop and test interventions that increase parents` potentials and strengthen relationships during the challenging trajectory of their children`s cancer and treatment. Clinical Relevance: The multiple sources of stress and uncertainty associated with a child`s cancer diagnosis and treatment affect parents` relationships. Difficulties in communication appear frequently in parents` relationship. Our findings may guide healthcare professionals in identifying parents at risk for developing conflicts, communication problems, and lack of alignment between parents that could interfere with providing optimal care for their child with cancer. Healthcare professionals may promote dialogue and encourage parents to express their feelings, seek mutual support, and establish a partnership in dealing with the child`s illness.

The life impact of burns: the perspective from burn persons in Brazil during their rehabilitation phase

Method. Participants were 18 years of age or older, who had been discharged from hospitalisation between 6 months and 1 year before the interview, or who underwent reconstructive surgery during the previous year, or who were under outpatient follow-up awaiting reconstructive surgery. Data were collected by means of semi-structured interviews. Results. Thirty-eight of the 44 participants (86.4%) reported some type of changes associated with the burn injury, the treatment, or both, regarding the following aspects: work, leisure, relationships, religious ties, educational activities and habits (smoking, using alcohol and drugs and dressing style). The data showed a statistically significant association between burns on at least one of the upper limbs (with or without hands) and changes in work. Conclusions. Some of the aspects mentioned by the participants, such as work and leisure activities, need to be further researched in order to improve our understanding of the impact that these changes causes in the person`s life.

Altered left ventricular diastolic function in subjects with spinal cord injury

Study design: This is cross-sectional study. Objectives: The aim of this study is to investigate the cardiac structure and function of subjects with spinal cord injury (SCI) and the impact of metabolic, hemodynamic and inflammatory factors on these parameters. Setting: Sao Paulo, Brazil. Methods: Sixty-five nondiabetic, nonhypertensive, sedentary, nonsmoker men (34 with SCI and 31 healthy subjects) were evaluated by medical history, anthropometry, laboratory tests, analysis of hemodynamic and inflammatory parameters and echocardiography. Results: Subjects with SCI had lower systolic blood pressure and higher levels of C-reactive protein and tumor necrosis factor receptors than the healthy ones. Echocardiography data showed that the SCI group presented similar left ventricular (LV) structural and systolic parameters, but lower initial diastolic velocity (Em) (9.2 +/- 0.5 vs 12.3 +/- 0.5 cm s(-1); P<0.001) and higher peak early inflow velocity (E)/Em ratio (7.7 +/- 0.5 vs 6.1 +/- 0.3; P = 0.009) compared with the able-bodied group, even after adjustment for systolic blood pressure and C-reactive protein levels. Furthermore, injured subjects with E/Em >8 had lower peak spectral longitudinal contraction (Sm) (9.0 +/- 0.7 vs 11.6 +/- 0.4cm s(-1); P<0.001) and cardiac output (4.2 +/- 0.2 vs 5.0 +/- 0.21 min(-1); P = 0.029), as well as higher relative wall thickness (0.38 +/- 0.01 vs 0.35 +/- 0.01; P = 0.005), than individuals with SCI with E/Em<8, but similar age, body mass index, blood pressure, injury level, metabolic parameters and inflammatory marker levels. Conclusion: Subjects with SCI presented impaired LV diastolic function in comparison with able-bodied ones. Moreover, worse LV diastolic function was associated with a pattern of LV concentric remodeling and subclinical decreases in systolic function among injured subjects. Overall, these findings might contribute to explain the increased cardiovascular risk reported for individuals with SCI. Spinal Cord (2011) 49, 65-69; doi: 10.1038/sc.2010.88; published online 27 July 2010

Failure analysis of low velocity impact on thin composite laminates: Experimental and numerical approaches

The dynamic behavior of composite laminates is very complex because there are many concurrent phenomena during composite laminate failure under impact load. Fiber breakage, delaminations, matrix cracking, plastic deformations due to contact and large displacements are some effects which should be considered when a structure made from composite material is impacted by a foreign object. Thus, an investigation of the low velocity impact on laminated composite thin disks of epoxy resin reinforced by carbon fiber is presented. The influence of stacking sequence and energy impact was investigated using load-time histories, displacement-time histories and energy-time histories as well as images from NDE. Indentation tests results were compared to dynamic results, verifying the inertia effects when thin composite laminate was impacted by foreign object with low velocity. Finite element analysis (FEA) was developed, using Hill`s model and material models implemented by UMAT (User Material Subroutine) into software ABAQUS (TM), in order to simulate the failure mechanisms under indentation tests. (C) 2007 Elsevier Ltd. All rights reserved.

Alternative positional FEM applied to thermomechanical impact of truss structures

This paper presents a formulation to deal with dynamic thermomechanical problems by the finite element method. The proposed methodology is based on the minimum potential energy theorem written regarding nodal positions, not displacements, to solve the mechanical problem. The thermal problem is solved by a regular finite element method. Such formulation has the advantage of being simple and accurate. As a solution strategy, it has been used as a natural split of the thermomechanical problem, usually called isothermal split or isothermal staggered algorithm. Usual internal variables and the additive decomposition of the strain tensor have been adopted to model the plastic behavior. Four examples are presented to show the applicability of the technique. The results are compared with other authors` numerical solutions and experimental results. (C) 2010 Elsevier B.V. All rights reserved.

The recent occurrence, establishment and potential impact of Geophagus proximus (Cichlidae : Perciformes) in the Tiete River reservoirs: an Amazonian fish species introduced in the Parana Basin (Brazil)

The introduction of allochthonous fish species happens constantly in large bodies of freshwater, like as the reservoirs of Parana Basin, located in Brazilian southeast, representing a threat for local biodiversity. The fish species Plagioscion squamosissimus and Cichla ocellaris were introduced from the 1970s in several water bodies of this basin and had successfully established themselves in all six reservoirs located in the middle and lower Tiete River (SP, Brazil), particularly. After six decades from the first recorded species introduction, this hydrographic system remains open to the invasion of further fish species, owing to widespread fish-farming activity and by the channels opened between this system and other reservoirs and river basin. This study was an effort to confirm the Geophagus proximus occurrence in the six Tiete River reservoirs, verifying the actual introduction status and analyzing its potential environmental impacts on local species by the analysis of the population structure (abundance, body dimensions and feeding habits). By the results, this species was confirmed in the Ibitinga, Nova Avanhandava and Tres Irmaos reservoirs. The abundance and feeding analysis shows, respectively, it is successfully established in the Tres Irmaos reservoir with the same feeding habitats of local species, such as Geophagus brasiliensis. It was further shown to be very likely that G. proximus would spread throughout the reservoir system of the middle and lower Tiete River, in the manner of P. squamosissimus and C. ocellaris, and the competition pressure for food resources between G. proximus and the local species which represents a potential environmental impact system. These scientific evidences fortifies the knowledge basin for the implantation of a fish management system, to control and reduce the abundance of the invader and to prevent its becoming established in all the Tiete River Basin, avoiding the disastrous consequences for the native species of Parana River Basin.

Ozone oxidation of pulp and paper wastewater and its impact on molecular weight distribution of organic matter

The impact of ozone oxidation on removing high molecular weight (HMW) organics in order to improve the biodegradability of alkaline bleach plant effluent was investigated using a semi-batch reactor under different initial pH (12 and 7). After the ozonation process, the ratio of BOD5/COD increased from 0.07 to 0.16 and 0.22 for initial pH 12 and 7, respectively. Also, the effluent color decreased by 48% and 61% at initial pH 12 and pH 7, respectively. These changes were primarily driven by reductions of the HMW fractions of the effluent during ozonation.

Impact of transition oxides on growth stresses and texture of alumina scales formed during oxidation of iron aluminides

The internal stresses and crystallographic texture in alpha-Al(2)O(3) scales grown on iron aluminides at 1100 degrees C were determined in situ using synchrotron X-ray diffraction. In the first hour of oxidation, alpha-Al(2)O(3) was formed by direct nucleation and by conversion from transition oxides (either theta-Al(2)O(3) or a mixed Fe-Al oxide). A sharp texture develops connected with the direct nucleation of alpha-Al(2)O(3), in contrast to the weaker texture observed in alpha-Al(2)O(3) originated by previous transformations, which also yielded tensile stresses in early oxidation stages. (C) 2011 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Climate as the most important factor determining anti-fungal biocide performance in paint films

The effect of Pigment Volume Content (PVC) on fungal growth on acrylic paint formulations with and without biocide, exposed to weathering in three different climatic regions in Brazil for four years, was studied Latex paints. with PVC of 30%, 35% and 50%, were applied to autoclaved aerated concrete blocks pre-covered with acrylic sealer and acrylic plaster They were exposed to equatorial, tropical and temperate climates in north, south-east, and south Brazil Cladosporium was the most abundant fungal genus detected in the biofilm on the surfaces of all paint formulations at all sites after four years Heaviest fungal colonization occurred in the tropical south-east and lightest in the temperate south of the country, but more phototrophs, principally cyanobacteria, were detected in the equatorial region PVC and presence of biocides were shown to be of less importance than environmental conditions (irradiance, humidity and temperature) for biofilm formation and consequent discolouration These results have important implications for testing of paint formulations (C) 2010 Elsevier B V All rights reserved

Power Factor Calculation by the Finite Element Method

The use of finite element analysis (FEA) to design electrical motors has increased significantly in the past few years due the increasingly better performance of modern computers. Even though the analytical software remains the most used tool, the FEA is widely used to refine the analysis and gives the final design to be prototyped. The power factor, a standard data of motor manufactures data sheet is important because it shows how much reactive power is consumed by the motor. This data becomes important when the motor is connected to network. However, the calculation of power factor is not an easy task. Due to the saturation phenomena the input motor current has a high level of harmonics that cannot be neglected. In this work the FEA is used to evaluate a proposed (not limitative) methodology to estimate the power factor or displacement factor of a small single-phase induction motor. Results of simulations and test are compared.

A Power-Quality Index to Assess the Impact of Voltage Harmonic Distortions and Unbalance to Three-Phase Induction Motors

This paper discusses the need to simultaneously monitor voltage unbalance and harmonic distortions in addition to root-mean-square voltage values. An alternative way to obtain the parameters related to voltage unbalance at fundamental frequency as well as voltage harmonic distortions is here proposed, which is based on the representation of instantaneous values at the axes and at the instantaneous Euclidean norm. A new power-quality (PQ) index is then proposed to combine the effects of voltage unbalance and harmonic distortions. This new index is easily implemented into existing electronic power meters. This PQ index is determined from the analysis of temperature rise in induction motor windings, which were tested for long periods of time. This paper also shows that these voltage disturbances, which are harmful to the lifetime expectancy of motors, can be measured by alternative ways in relation to conventional methods. Although this paper deals with induction motors only, the results show the relevance for further studies on other pieces of equipment.

Learning about knowledge management for improving environmental impact assessment in a government agency: The Western Australian experience

How does knowledge management (KM) by a government agency responsible for environmental impact assessment (EIA) potentially contribute to better environmental assessment and management practice? Staff members at government agencies in charge of the EIA process are knowledge workers who perform judgement-oriented tasks highly reliant on individual expertise, but also grounded on the agency`s knowledge accumulated over the years. Part of an agency`s knowledge can be codified and stored in an organizational memory, but is subject to decay or loss if not properly managed. The EIA agency operating in Western Australia was used as a case study. Its KM initiatives were reviewed, knowledge repositories were identified and staff surveyed to gauge the utilisation and effectiveness of such repositories in enabling them to perform EIA tasks. Key elements of KM are the preparation of substantive guidance and spatial information management. It was found that treatment of cumulative impacts on the environment is very limited and information derived from project follow-up is not properly captured and stored, thus not used to create new knowledge and to improve practice and effectiveness. Other opportunities for improving organizational learning include the use of after-action reviews. The learning about knowledge management in EIA practice gained from Western Australian experience should be of value to agencies worldwide seeking to understand where best to direct their resources for their own knowledge repositories and environmental management practice. (C) 2011 Elsevier Ltd. All rights reserved.

On the classification of mixed construction and demolition waste aggregate by porosity and its impact on the mechanical performance of concrete

The properties of recycled aggregate produced from mixed (masonry and concrete) construction and demolition (C&D) waste are highly variable, and this restricts the use of such aggregate in structural concrete production. The development of classification techniques capable of reducing this variability is instrumental for quality control purposes and the production of high quality C&D aggregate. This paper investigates how the classification of C&D mixed coarse aggregate according to porosity influences the mechanical performance of concrete. Concretes using a variety of C&D aggregate porosity classes and different water/cement ratios were produced and the mechanical properties measured. For concretes produced with constant volume fractions of water, cement, natural sand and coarse aggregate from recycled mixed C&D waste, the compressive strength and Young modulus are direct exponential functions of the aggregate porosity. Sink and float technique is a simple laboratory density separation tool that facilitates the separation of cement particles with lower porosity, a difficult task when done only by visual sorting. For this experiment, separation using a 2.2 kg/dmA(3) suspension produced recycled aggregate (porosity less than 17%) which yielded good performance in concrete production. Industrial gravity separators may lead to the production of high quality recycled aggregate from mixed C&D waste for structural concrete applications.