Help-seeking for 'memory loss' by older adults in India : patient, caregiver and health providers' perspectives

ABSTRACT: Background. In India, prevalence rates of dementia and prodromal amnestic Mild Cognitive Impairment (MCI) are 3.1% and 4.3% respectively. Most Indians refer to the full spectrum of cognitive disorders simply as ‘memory loss.’ Barring prevention or cure, these conditions will rise rapidly with population aging. Evidence-based policies and practices can improve the lives of affected individuals and their caregivers, but will require timely and sustained uptake. Objectives. Framed by social cognitive theories of health behavior, this study explores the knowledge, attitudes and practices concerning cognitive impairment and related service use by older adults who screen positive for MCI, their primary caregivers, and health providers. Methods. I used the Montreal Cognitive Assessment to screen for cognitive impairment in memory camps in Mumbai. To achieve sampling diversity, I used maximum variation sampling. Ten adults aged 60+ who had no significant functional impairment but screened positive for MCI and their caregivers participated in separate focus groups. Four other such dyads and six doctors/ traditional healers completed in-depth interviews. Data were translated from Hindi or Marathi to English and analyzed in Atlas.ti using Framework Analysis. Findings. Knowledge and awareness of cognitive impairment and available resources were very low. Physicians attributed the condition to disease-induced pathology while lay persons blamed brain malfunction due to normal aging. Main attitudes were that this condition is not a disease, is not serious and/or is not treatable, and that it evokes stigma toward and among impaired persons, their families and providers. Low knowledge and poor attitudes impeded help-seeking. Conclusions. Cognitive disorders of aging will take a heavy toll on private lives and public resources in developing countries. Early detection, accurate diagnosis, systematic monitoring and quality care are needed to compress the period of morbidity and promote quality of life. Key stakeholders provide essential insights into how scientific and indigenous knowledge and sociocultural attitudes affect use and provision of resources.

Electrohysterogram signal component cataloging with spectral and time-frequency methods

The Electrohysterogram (EHG) is a new instrument for pregnancy monitoring. It measures the uterine muscle electrical signal, which is closely related with uterine contractions. The EHG is described as a viable alternative and a more precise instrument than the currently most widely used method for the description of uterine contractions: the external tocogram. The EHG has also been indicated as a promising tool in the assessment of preterm delivery risk. This work intends to contribute towards the EHG characterization through the inventory of its components which are: • Contractions; • Labor contractions; • Alvarez waves; • Fetal movements; • Long Duration Low Frequency Waves; The instruments used for cataloging were: Spectral Analysis, parametric and non-parametric, energy estimators, time-frequency methods and the tocogram annotated by expert physicians. The EHG and respective tocograms were obtained from the Icelandic 16-electrode Electrohysterogram Database. 288 components were classified. There is not a component database of this type available for consultation. The spectral analysis module and power estimation was added to Uterine Explorer, an EHG analysis software developed in FCT-UNL. The importance of this component database is related to the need to improve the understanding of the EHG which is a relatively complex signal, as well as contributing towards the detection of preterm birth. Preterm birth accounts for 10% of all births and is one of the most relevant obstetric conditions. Despite the technological and scientific advances in perinatal medicine, in developed countries, prematurity is the major cause of neonatal death. Although various risk factors such as previous preterm births, infection, uterine malformations, multiple gestation and short uterine cervix in second trimester, have been associated with this condition, its etiology remains unknown [1][2][3].

Airport pavements evaluation

The airport pavement deteriorates during service due to traffic and climate effects therefore systematic monitoring is required in order to assess their structural and functional condition. The aim of this work is to present the methodologies used nowadays for airport pavement evaluation and to contribute to their improvement in structural analysis area The main aspects that are addressed are the application of the Ground Penetrating Radar (GPR) and the use of the Falling Weight Deflectometer (FWD) tests, for structural evaluation, and the use of the GRIP tester and the measurement of texture depth of the wearing course layer, for the functional evaluation of the runway. Also, freeware computer softwares used to design new runways (FAARFIELD and COMFAA) are presented and examples are given. Case studies are described both for structural and functional evaluation.

Analysis and Treatment of a male portrait in oil and a study of the size layer with reconstructions from Vibert’s recipe (1892)

This thesis project concentrated on both the study and treatment of an early 20th century male portrait in oil from Colecção Caixa Geral de Depósitos, Lisbon, Portugal. The portrait of Januário Correia de Almeida, exhibits a tear (approximately 4.0 cm by 2.3 cm) associated with paint loss on the right upper side, where it is possible to observe an unusually thick size layer (approximately 50 microns) and an open weave mesh canvas. Size layers made from animal glue remain subject to severe dimensional changes due to changes in relative humidity (RH), thereby affecting the stability of the painting. In this case, the response to moisture of the size layer is minimal and the painting is largely uncracked with very little active flaking. This suggests that the size layer has undergone pre-treatment to render it unresponsive to moisture or water. Reconstructions based on late nineteenth century recipes using historically appropriate materials are used to explore various options for modifying the characteristics of gelatine, some of which may relate to the Portrait’s size layer. The thesis is separated into two parts: Part 1: Describes the history, condition, materials and techniques of the painting. It also details the treatment of Januário Correia de Almeida as well as the choices made and problems encountered during the treatment. Part 2: Discusses the history of commercial gelatine production, the choice of the appropriate animal source to extract the collagen to produce reconstructions of the portrait’s size layer as well as the characterization of selected reconstructions. The execution of a shallow textured infill led to one publication and one presentation: Abstract accepted for presentation and publication, International Meeting on Retouching of Cultural Heritage (RECH3), Francisco Brites, Leslie Carlyle and Raquel Marques, ‘’Hand building a Low Profile Textured Fill for a Large Loss’’.

Analysis and treatment of a nineteenth century portrait, study of Artsorb® and a proposal for a microclimate frame

The present work is divided in two parts: Part 1 is focused on the analysis and treatment of a 19th century portrait of Domingos Affonso, which belongs to the Ecomuseu Municipal do Seixal; and Part 2, which is entitled “The Microclimate Frame Project” is focused on the study of Artsorb® and on the planning of a microclimate frame for the painting. In Part 1, a study of the painting’s materials was performed using complementary analytical techniques and the painting’s condition was carefully evaluated. The painting exhibited signs of mould growth, and a more detailed investigation was made of this topic to understand if the fungal community was active and if it represented a real danger to the painting. A treatment was proposed, appropriate to the painting’s condition. A description of the treatment carried out, comprising the treatment options, is also present in this section. Within the study of the microclimate frame, in Part 2, the study of the potential corrosiveness of Artsorb® was a central subject. Artsorb® sheets are one of the most widely used materials for buffering relative humidity fluctuations in microclimate frames and its reported excellent performance is enhanced by its availability in lightweight sheets that can be easily placed inside microclimate frames. However, concerns have arisen regarding the presence of the corrosive salt lithium chloride in the composition of this buffer. Consequently, the present work also aimed to understand the potential risks of using Artsorb® and the possibility of avoiding exposure of lithium chloride to the artworks through the use of Tyvek®. Results from the preliminary tests seem to indicate that Artsorb® releases lithium chloride into air. This study also showed that a Tyvek® cover over Artsorb® reduces but does not eliminate evidence of chlorine contamination, and it significantly reduces the effectiveness of the buffering material. Considering that Artsorb® appears to be unsuitable due to the release of the corrosive salt, that Tyvek® was not efficient as a barrier for lithium chloride or as a permeable material to enable the proper functioning of Artsorb®, the buffering material proposed for the use in the microclimate frames is silica gel without indicator. Based on the choice of buffering material, as a result of this study, a microclimate frame is proposed.

An agent based architecture to support monitoring in plug and produce manufacturing systems using knowledge extraction

In recent years a set of production paradigms were proposed in order to capacitate manufacturers to meet the new market requirements, such as the shift in demand for highly customized products resulting in a shorter product life cycle, rather than the traditional mass production standardized consumables. These new paradigms advocate solutions capable of facing these requirements, empowering manufacturing systems with a high capacity to adapt along with elevated flexibility and robustness in order to deal with disturbances, like unexpected orders or malfunctions. Evolvable Production Systems propose a solution based on the usage of modularity and self-organization with a fine granularity level, supporting pluggability and in this way allowing companies to add and/or remove components during execution without any extra re-programming effort. However, current monitoring software was not designed to fully support these characteristics, being commonly based on centralized SCADA systems, incapable of re-adapting during execution to the unexpected plugging/unplugging of devices nor changes in the entire system’s topology. Considering these aspects, the work developed for this thesis encompasses a fully distributed agent-based architecture, capable of performing knowledge extraction at different levels of abstraction without sacrificing the capacity to add and/or remove monitoring entities, responsible for data extraction and analysis, during runtime.

A indústria de defesa na cooperação Brasil-Portugal

The global dynamics of alliances are strongly determined by the level of cooperation among states. This cooperation can be embodied in various aspects, but the level of defense and security cooperation becomes usually more doctrinal and lasting. By the nature of sovereignty that instills in the bilateral relationship, cooperation at defense and security level can leverages other forms of cooperation. The circumstances and relational balance between Brazil and Portugal seem to evolve towards distancing opportunities, despite they are culturally and institutionally untainted. The economic dynamics, the strategic projection in global sustainability terms, the scale and ambition of Brazilian regional leadership, contrasts with the actual context of Portugal, distancing himself both on the stage where they operate. On the other hand, the historical and cultural roots, the language, the affinity of the peoples of CPLP and some opportunities for economic niches, trend to attract both countries. The condition of Portugal in NATO and Europe, coupled with the ability to export technical and human resources to value-added for Brazil, seems also to become approaching factors. On the balance of these dynamics, there is a set of exogenous factors (economic, external global relations matrix, regional stability, among others), which are not always controlled by any of both countries. These factors call for strong capacity for foresight analysis and decision making, with the inherent risk. There is cooperation vectors that are not apparently penalized by geographic distance, or by the difference of realities. Among these vectors we shall highlight synergies in technological niches, highly tradable goods and, mostly, using the domain of dual technologies. The thirteen niches herein identified are: Monitoring, Navigation, Command and Control, Electronics, Optoelectronics, Communication and remote sensing, Information Technologies, Flight Simulation, Specialized Training, Fiber Optic Sensors, Materials Engineering, Nanotechnology and Communications. Cumulating with identified opportunities in traditional relational framework, both countries are growing (in geography and economic terms) into the Atlantic, making it a central element in the bilateral approach. By being at the same time a growing stage of disputes and which stability tends to be threatened, it will be done an analysis of these synergistic vectors, superimposed on the impact on Atlantic securitization process.

A new credit monitoring framework for agents' networks

The purpose of this work is to develop a practicable approach for Telecom firms to manage the credit risk exposition to their commercial agents’ network. Particularly it will try to approach the problem of credit concession to clients’ from a corporation perspective and explore the particular scenario of agents that are part of the commercial chain of the corporation and therefore are not end-users. The agents’ network that served as a model for the presented study is composed by companies that, at the same time, are both clients and suppliers of the Telecommunication Company. In that sense the credit exposition analysis must took into consideration all financial fluxes, both inbound and outbound. The current strain on the Financial Sector in Portugal, and other peripheral European economies, combined with the high leverage situation of most companies, generates an environment prone to credit default risk. Due to these circumstances managing credit risk exposure is becoming increasingly a critical function for every company Financial Department. The approach designed in the current study combined two traditional risk monitoring tools: credit risk scoring and credit limitation policies. The objective was to design a new credit monitoring framework that is more flexible, uses both external and internal relationship history to assess risk and takes into consideration commercial objectives inside the agents’ network. Although not explored at length, the blueprint of a Credit Governance model was created for implementing the new credit monitoring framework inside the telecom firm. The Telecom Company that served as a model for the present work decided to implement the new Credit Monitoring framework after this was presented to its Executive Commission.

Assessment of NDVI, land surface temperature and precipitation anomalies for drought monitoring in Bayankhongor province, Mongolia

During the last decade Mongolia’s region was characterized by a rapid increase of both severity and frequency of drought events, leading to pasture reduction. Drought monitoring and assessment plays an important role in the region’s early warning systems as a way to mitigate the negative impacts in social, economic and environmental sectors. Nowadays it is possible to access information related to the hydrologic cycle through remote sensing, which provides a continuous monitoring of variables over very large areas where the weather stations are sparse. The present thesis aimed to explore the possibility of using NDVI as a potential drought indicator by studying anomaly patterns and correlations with other two climate variables, LST and precipitation. The study covered the growing season (March to September) of a fifteen year period, between 2000 and 2014, for Bayankhongor province in southwest Mongolia. The datasets used were MODIS NDVI, LST and TRMM Precipitation, which processing and analysis was supported by QGIS software and Python programming language. Monthly anomaly correlations between NDVI-LST and NDVI-Precipitation were generated as well as temporal correlations for the growing season for known drought years (2001, 2002 and 2009). The results show that the three variables follow a seasonal pattern expected for a northern hemisphere region, with occurrence of the rainy season in the summer months. The values of both NDVI and precipitation are remarkably low while LST values are high, which is explained by the region’s climate and ecosystems. The NDVI average, generally, reached higher values with high precipitation values and low LST values. The year of 2001 was the driest year of the time-series, while 2003 was the wet year with healthier vegetation. Monthly correlations registered weak results with low significance, with exception of NDVI-LST and NDVI-Precipitation correlations for June, July and August of 2002. The temporal correlations for the growing season also revealed weak results. The overall relationship between the variables anomalies showed weak correlation results with low significance, which suggests that an accurate answer for predicting drought using the relation between NDVI, LST and Precipitation cannot be given. Additional research should take place in order to achieve more conclusive results. However the NDVI anomaly images show that NDVI is a suitable drought index for Bayankhongor province.