45 resultados para North Carolina Medical Care Commission.


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The disintegration of recovered paper is the first operation in the preparation of recycled pulp. It is known that the defibering process follows a first order kinetics from which it is possible to obtain the disintegration kinetic constant (KD) by means of different ways. The disintegration constant can be obtained from the Somerville index results (%lsv and from the dissipated energy per volume unit (Ss). The %slv is related to the quantity of non-defibrated paper, as a measure of the non-disintegrated fiber residual (percentage of flakes), which is expressed in disintegration time units. In this work, disintegration kinetics from recycled coated paper has been evaluated, working at 20 revise rotor speed and for different fiber consistency (6, 8, 10, 12 and 14%). The results showed that the values of experimental disintegration kinetic constant, Ko, through the analysis of Somerville index, as function of time. Increased, the disintegration time was drastically reduced. The calculation of the disintegration kinetic constant (modelled Ko), extracted from the Rayleigh’s dissipation function, showed a good correlation with the experimental values using the evolution of the Somerville index or with the dissipated energy

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This article analyzes hospital privatization by comparing costs and quality between different ownership forms. We put the attention on the distinction between public hospitals and private hospitals with public funding. Using information about Spanish hospitals, we have found that private hospitals provide services at a lower cost at expenses of lower quality. We observe that property rights theory is fulfilled at least for the Spanish hospital market. The way that Heath Authorities finance publicly funded hospitals may be responsible for the differences in incentives between public and private centers. We argue that the trade-off between costs and quality could be minimized by designing financing contracts with fixed and variable components.

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Award-winning

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Though there has been a great deal of work concerning the development of natural fibers in reinforced starch-based composites, there is still more to be done. In general, cellulose fibers have lower strength than glass fibers; however, their specific strength is not far from that of fiberglass. In this work, alpha-fibers were obtained from alpha-grass through a mild cooking process. The fibers were used to reinforce a starch-based biopolymer. Composites including 5 to 35% (w/w) alpha-grass fibers in their formulation were prepared, tested, and subsequently compared with those of wood- and fiberglass-reinforced polypropylene (PP). The term “high-performance” refers to the tensile strength of the studied composites and is mainly due to a good interphase, a good dispersion of the fibers inside the matrix, and a good aspect ratio. The tensile strength of the composites showed a linear evolution for fiber contents up to 35% (w/w). The strain at break of the composites decreased with the fiber content and showed the stiffening effects of the reinforcement. The prepared composites showed high mechanical properties, even approaching those of glass fiber reinforced composites

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One of the most relevant properties of composite materials to be considered is stiffness. Fiberglass has been used traditionally as a fibrous reinforcing element when stiff materials are required. However, natural fibers are been exploited as replacements for synthetic fibers to satisfy environmental concerns. Among the different natural fibers, wood fibers show the combination of relatively high aspect ratio, good specific stiffness and strength, low density, low cost, and less variability than other natural fibers of such those from annual crops. In this work, composites from polypropylene and stone groundwood fibers from softwood were prepared and mechanically characterized under tensile loads. The Young’s moduli of the ensuing composites were analyzed and their micromechanics aspects evaluated. The reinforcing effect of stone groundwood fibers was compared to that of conventional reinforcement such fiberglass. The Halpin-Tsai model with the modification proposed by Tsai-Pagano accounted fairly for the behavior of PP composites reinforced with stone groundwood fibers. It was also demonstrated that the aspect ratio of the reinforcement plays a role in the Young’s modulus of injection molded specimens

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This paper deals with the product design, engineering, and material selection intended for the manufacturing of an eco-friendly chair. The final product is expected to combine design attributes with technical and legal feasibility with the implementation of new bio-based materials. Considering the industrial design, a range of objectives and trends were determined after setting the market requirements, and the final concept was proposed and modeled. The product geometry, production technology, and legal specifications were the input data for product engineering. The material selection was based on the technical requirements. Polypropylene (PP) composite materials based on coupled-fiberglass, sized-fiberglass, and coupled-stone ground wood reinforcements were prepared and characterized. Final formulations based on these PP composites are proposed and justified

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Two vegetable wastes, cork bark and grape stalks, were investigated for the removal of methylene blue from aqueous solution. The effects of contact time, dye concentration, pH, and temperature on sorption were studied relative to adsorption on a commercially-activated carbon. The highest adsorption yield was obtained within the pH range 5 to 10 for grape stalks and 7 to 10 for cork bark. The sorption kinetics of dye onto activated carbon and grape stalks was very fast. Kinetics data were fitted to the pseudo-first and second order kinetic equations, and the values of the pseudo-second-order initial rate constants were found to be 1.69 mg g-1 min-1 for activated carbon, 2.24 mg g-1 min-1 for grape stalks, and 0.90 mg g-1 min-1 for cork bark. Langmuir maximum sorption capacities for activated carbon, grape stalks, and cork bark for methylene blue estimated by the Orthogonal Distance Regression method (ODR) were 157.5 mg g-1, 105.6 mg g-1, and 30.52 mg g-1, respectively. FTIR spectra indicated that carboxylic groups and lignin play a significant role in the sorption of methylene blue. Electrostatic forces, n-p interactions, cation-p, and p-p stacking interactions contribute to methylene blue sorption onto grape stalks and cork bark. Grape stalks can be considered an efficient biosorbent and as a viable alternative to activated carbon and ion-exchange resins for the removal of methylene blue

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The main objective of this research was to study the feasibility of incorporating organosolv semi-chemical triticale fibers as the reinforcing element in recycled high density polyethylene (HDPE). In the first step, triticale fibers were characterized in terms of chemical composition and compared with other biomass species (wheat, rye, softwood, and hardwood). Then, organosolv semi-chemical triticale fibers were prepared by the ethanolamine process. These fibers were characterized in terms of its yield, kappa number, fiber length/diameter ratio, fines, and viscosity; the obtained results were compared with those of eucalypt kraft pulp. In the second step, the prepared fibers were examined as a reinforcing element for recycled HDPE composites. Coupled and non-coupled HDPE composites were prepared and tested for tensile properties. Results showed that with the addition of the coupling agent maleated polyethylene (MAPE), the tensile properties of composites were significantly improved, as compared to non-coupled samples and the plain matrix. Furthermore, the influence of MAPE on the interfacial shear strength (IFSS) was studied. The contributions of both fibers and matrix to the composite strength were also studied. This was possible by the use of a numerical iterative method based on the Bowyer-Bader and Kelly-Tyson equations

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The disintegration of recovered paper is the first operation in the preparation of recycled pulp. It is known that the defibering process follows a first order kinetics from which it is possible to obtain the disintegration kinetic constant (KD) by means of different ways. The disintegration constant can be obtained from the Somerville index results (%lsv and from the dissipated energy per volume unit (Ss). The %slv is related to the quantity of non-defibrated paper, as a measure of the non-disintegrated fiber residual (percentage of flakes), which is expressed in disintegration time units. In this work, disintegration kinetics from recycled coated paper has been evaluated, working at 20 revise rotor speed and for different fiber consistency (6, 8, 10, 12 and 14%). The results showed that the values of experimental disintegration kinetic constant, Ko, through the analysis of Somerville index, as function of time. Increased, the disintegration time was drastically reduced. The calculation of the disintegration kinetic constant (modelled Ko), extracted from the Rayleigh’s dissipation function, showed a good correlation with the experimental values using the evolution of the Somerville index or with the dissipated energy

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Worldwide cultivation of corn is expanding, due in part to the increasing production of bioethanol. In consequence, huge amounts of corn stalks residues are been produced. Instead of incineration, we transformed the corn stalks into a semichemical pulp and successfully applied it as reinforcement in polypropylene composites. PP composites reinforced with 40% wt corn stalk single fibers were prepared, and their mechanical properties were evaluated. Through mechanical properties modeling of the composites, the intrinsic tensile strength of the cellulosic fibers that constitute the corn stalk have been determined

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Lignin was used as a natural adhesive to manufacture Vitis vinifera fiberboards. The fiberboards were produced at laboratory scale by adding powdered lignin to material that had previously been steam-exploded under optimized pretreatment and pressing conditions. The kraft lignin used was washed several times with an acidic solution to eliminate any contaminants and low molecular weight compounds. This research studied the effects of amounts of lignin ranging from 5% to 20% on the properties of Vitis vinifera fiberboards. The fiberboard properties evaluated were density, water resistance in terms of thickness swelling, water absorption, and the mechanical properties in terms of modulus of rupture, modulus of elasticity, and internal bond. Results showed that fiberboards made from Vitis vinifera without lignin addition had weaker mechanical properties. However, the fiberboards obtained using acid-washed kraft lignin as a natural adhesive had good mechanical and water resistance properties that fully satisfied the relevant standard specifications

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Chromium (VI) removal and its reduction to chromium (III) from aqueous solution by untreated and heat-treated Quercus cerris and heat-treated Quercus suber black agglomerate cork granules was investigated. Initial screening studies revealed that among the sorbents tested, untreated Q. cerris and Q. suber black agglomerate are the most efficient in the removal of Cr(VI) ions and were selected for adsorption essays. Heat treatment adversely affected chromium adsorption and chromium (VI) reduction in Q. cerris cork. The highest metal uptake was found at pH 3.0 for Q. cerris and pH 2.0 for black agglomerate. The experimental data fitted the Langmuir model and the calculated qmax was 22.98 mg/g in black agglomerate and 21.69 mg/g in untreated Q. cerris cork. The FTIR results indicated that while in black agglomerate, lignin is the sole component responsible for Cr(VI) sorption, and in untreated Q. cerris cork, suberin and polysaccharides also play a significant role on the sorption. The SEM-EDX results imply that chromium has a homogenous distribution within both cork granules. Also, phloemic residues in Q. cerris granules showed higher chromium concentration. The results obtained in this study show that untreated Q. cerris and black agglomerate cork granules can be an effective and economical alternative to more costly materials for the treatment of liquid wastes containing chromium

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Sin duda alguna, nadie está mejor situado que el paciente mismo a la hora de aprehender su propio punto de vista sobre la experiencia y el resultado de unos cuidados o unas intervenciones. Por ello solo mirando a través de los ojos del paciente veremos cómo mejorar los cuidados que dispensamos. Posibilitar unos cuidados realmente centrados en el paciente requiere una evaluación de dichos cuidados igualmente centrada en el paciente. Dicha evaluación únicamente será posible si, entre otros requisitos como el de la firmeza psicométrica, se considera el grado de incorporación de la perspectiva de los pacientes en el instrumento antes de seleccionar alguno entre los disponibles, o se estima previamente el grado de sensibilidad hacia dicha perspectiva en el caso de que únicamente existan cuestionarios desarrollados sin la participación directa de los pacientes. Asimismo, si el objetivo de alguna de vuestras investigaciones futuras fuera desarrollar un nuevo instrumento de medida, dicho grado de incorporación de la perspectiva del paciente es un aspecto primordial a considerar y fortalecer.

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In the last few years, Economic Theory has revised two basic ideas around the economics of the household: that family income is the result of the individual income of each of its members (income pooling), and that all family members living in the household have equal access to its resources. Unequal access to family resources (among women and men, on the one hand, and among the elderly, adults and children, on the other), is now understood as an input (for instance, that women eat less food and of worst quality than men), and as an output (for instance that women have poorer health, higher epidemic mortality, or are less tall than men as a result, among other things, of having received less food and poorer medical care, and/or of a heavier workload). Despite the fact that inequality in intra‐family consumption has become the center of attention in academic and international agencies, it can still not be found in the agenda of Economic History. In this paper we look at some of the resources consumed by Spanish families in the 19th century: food, alcoholic beverages, clothes and shoes. Medical topographies, our main source, suggest that unequal access to family resources among household members had a strong impact on their health and wellbeing.

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Breast cancer is the most prevalent neoplasm among women in the majority of countries worldwide. Breast cancer treatment include mastectomy which is associated to strong impact in women. Breast reconstruction is an option for many women to re-establish their body image and also to decrease psychological impact. However, breast reconstruction rates are low and many factors are involved in not undergoing breast reconstruction. Patient involvement in the decision-making process increases breast reconstruction rates and is associated to higher satisfaction and less anxiety and depression symptoms. More physician-patient relation and more education in terms of breast reconstruction are needed to achieve our objective. A new approach of medical care, called Patson Approach, is created in order to meet our goal with more patient involvement, as well as, physician and psychological counsellingObjective: to increase breast reconstruction rates in women who are candidates for breast reconstruction after mastectomy and are included in the Patson Approach compared to women included in the Standard ApproachMethods: the study design will be a randomized, controlled, open-label clinical trial. 62 patients will be recruited during two years and randomly divided in two groups, 31 will be included in the Standard Approach and 31 will be included in the Patson Approach. Preoperative and postoperative appointments are established in order to do a follow-up of the patients and collect all the data