42 resultados para physician shortage


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Several authors in the 17th century used the atomic hypothesis to explain observable phenomena. This paper analyzes some ideas about chemical transformation proposed by the English physician Walter Charleton. In Physiologia Epicuro-Gassendo-Charltoniana (London, 1654), Charleton examined philosophical aspects of the atomic theory, and suggested that the best explanation for all natural phenomena would be only in terms of atoms and their motions. Sometimes, however, he had to attribute to the atoms some kind of "internal virtue", to explain more complex properties of the matter. His idea of "element", and the little use of experimentation and quantification, also limited the range of Charleton's theory.

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The aim of this work is to show an experiment from which students can learn some of the main characteristics of buffer solutions. A mixture of some acid-base indicators, named as Yamada's indicator, can be used to estimate pH values in an acid-base titration of a buffer, with good approximation. In the experiment it is also possible to verify the relationship between the buffer capacity and the concentrations and the molar ratio of the components of a NH3 / NH4+ buffer solution. The shortage of experiments associated with the relative small importance given to many aspects of buffer solutions, is now explored with simplicity. In the proposed experiments, students prepare buffer solutions by themselves, calculate the pH, understand how acid-base indicators act and learn how buffer solutions work through graph constructed by sharing experimental data.

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The word gas was coined by the "chemical philosopher" Joan Baptista Van Helmont (1579 -- 1644) to name a very broad concept in his chemico-medical system. Eventually, some physicians who followed Helmontian ideas adopted the concept. The present paper aims to analyze the reception of the original idea of gas by an English Helmontian physician, George Thomson (1619 -- 1677). Thomson wrote that the "material cause" of the plague was a gas, and compared it to the "Gas of sulphur". He also related the human archeus to a gas, and explained some observations in the laboratory in terms of production of gases. We observe, however, that Thomson was not as interested as Van Helmont in discussing details about the structure of the matter. Thus, gas did not have the same relevance in Thomson's work as it had in Van Helmont's.

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The use of biomass as raw-material for obtaining chemicals, polymers and fuels is emerging as a clever alternative solution for the increasing energy demand, environmental awareness and petroleum shortage. In this work, some attempts in order to develop catalytic systems suitable for triglyceride transformation into fuels, polymers and intermediates are reviewed.

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Periodically, during petroleum shortage, fatty acids and their derivatives have been used as alternative fuels to those derived from petroleum. Different approaches have been proposed, including the use of neat fats and oils or their derivatives. Indeed, the utilization of biodiesel produced by alcoholysis of triacilglycerides or esterification of fatty acids, or hydrocarbons obtained from cracking of fatty materials were studied and used in several countries. Increasing concerns about energy security and climate changes have lead several countries, including Brazil, to start up biofuels programs. Different technologies are currently being developed in order to produce biofuels with economical feasibility. In this work are discussed alternative fatty raw-materials and processing technologies that are currently being studied in order to produce fuels suitable to sustainable substitute diesel fuel.

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Commonly used HPLC acetonitrile solvent has been through a worldwide shortage with a cost increase in 2008 and 2009. In order to get around this situation, a method by RP-HPLC employing methanol and aqueous acid mobile phase was developed and validated to evaluate simvastatin. The quality control assay and dissolution studies of this lipid-lowering drug were performed in diluents methanol and 0.01 M phosphate buffer with 0.5% SDS, pH 7, respectively. Dissolution test aliquots did not go through sample treatment, as described in USP SIM tablets monograph by ultraviolet spectrophotometry. The proposed method is fast, simple, feasible and robust.

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Coal, natural gas and petroleum-based liquid fuels are still the most widely used energy sources in modern society. The current scenario contrasts with the foreseen shortage of petroleum that was spread out in the beginning of the XXI century, when the concept of "energy security" emerged as an urgent agenda to ensure a good balance between energy supply and demand. Much beyond protecting refineries and oil ducts from terrorist attacks, these issues soon developed to a portfolio of measures related to process sustainability, involving at least three fundamental dimensions: (a) the need for technological breakthroughs to improve energy production worldwide; (b) the improvement of energy efficiency in all sectors of modern society; and (c) the increase of the social perception that education is a key-word towards a better use of our energy resources. Together with these technological, economic or social issues, "energy security" is also strongly influenced by environmental issues involving greenhouse gas emissions, loss of biodiversity in environmentally sensitive areas, pollution and poor solid waste management. For these and other reasons, the implementation of more sustainable practices in our currently available industrial facilities and the search for alternative energy sources that could partly replace the fossil fuels became a major priority throughout the world. Regarding fossil fuels, the main technological bottlenecks are related to the exploitation of less accessible petroleum resources such as those in the pre-salt layer, ranging from the proper characterization of these deep-water oil reservoirs, the development of lighter and more efficient equipment for both exploration and exploitation, the optimization of the drilling techniques, the achievement of further improvements in production yields and the establishment of specialized training programs for the technical staff. The production of natural gas from shale is also emerging in several countries but its production in large scale has several problems ranging from the unavoidable environmental impact of shale mining as well as to the bad consequences of its large scale exploitation in the past. The large scale use of coal has similar environmental problems, which are aggravated by difficulties in its proper characterization. Also, the mitigation of harmful gases and particulate matter that are released as a result of combustion is still depending on the development of new gas cleaning technologies including more efficient catalysts to improve its emission profile. On the other hand, biofuels are still struggling to fulfill their role in reducing our high dependence on fossil fuels. Fatty acid alkyl esters (biodiesel) from vegetable oils and ethanol from cane sucrose and corn starch are mature technologies whose market share is partially limited by the availability of their raw materials. For this reason, there has been a great effort to develop "second-generation" technologies to produce methanol, ethanol, butanol, biodiesel, biogas (methane), bio-oils, syngas and synthetic fuels from lower grade renewable feedstocks such as lignocellulosic materials whose consumption would not interfere with the rather sensitive issues of food security. Advanced fermentation processes are envisaged as "third generation" technologies and these are primarily linked to the use of algae feedstocks as well as other organisms that could produce biofuels or simply provide microbial biomass for the processes listed above. Due to the complexity and cost of their production chain, "third generation" technologies usually aim at high value added biofuels such as biojet fuel, biohydrogen and hydrocarbons with a fuel performance similar to diesel or gasoline, situations in which the use of genetically modified organisms is usually required. In general, the main challenges in this field could be summarized as follows: (a) the need for prospecting alternative sources of biomass that are not linked to the food chain; (b) the intensive use of green chemistry principles in our current industrial activities; (c) the development of mature technologies for the production of second and third generation biofuels; (d) the development of safe bioprocesses that are based on environmentally benign microorganisms; (e) the scale-up of potential technologies to a suitable demonstration scale; and (f) the full understanding of the technological and environmental implications of the food vs. fuel debate. On the basis of these, the main objective of this article is to stimulate the discussion and help the decision making regarding "energy security" issues and their challenges for modern society, in such a way to encourage the participation of the Brazilian Chemistry community in the design of a road map for a safer, sustainable and prosper future for our nation.

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ABSTRACT Background Medical students are a vulnerable population to develop depression and anxiety disorders. Objective To estimate the prevalence and associated factors of anxiety and depression among medical students. Methods A cross-sectional study with a random sample (n = 346) of medical students at a Brazilian university was performed. The Beck Depression Anxiety Inventory was used to measure anxiety and depression levels. Crude and adjusted analyses were performed using Poisson regression. Results The prevalence of anxiety was 35.5% and depression was 32.8%. The prevalence of anxiety and depression was 14% higher and 16% higher among women (p = 0.025 and p = 0.006, respectively). Students whose parents were not physicians reported 23% higher prevalence of anxiety (p = 0.006), and those who had physician parents reported 29% higher prevalence of depression (p = 0.034). Those who always or often felt pushed by their parents showed 22% higher prevalence of anxiety (p =.006) and 19% higher depression (p = 0.016). Students who had concerns over the future had 15% higher prevalence of depression (p = 0.017). Conclusion The prevalence of anxiety and depressive symptoms was higher than the average found in the general population.

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Techniques of evaluation of risks coming from inherent uncertainties to the agricultural activity should accompany planning studies. The risk analysis should be carried out by risk simulation using techniques as the Monte Carlo method. This study was carried out to develop a computer program so-called P-RISCO for the application of risky simulations on linear programming models, to apply to a case study, as well to test the results comparatively to the @RISK program. In the risk analysis it was observed that the average of the output variable total net present value, U, was considerably lower than the maximum U value obtained from the linear programming model. It was also verified that the enterprise will be front to expressive risk of shortage of water in the month of April, what doesn't happen for the cropping pattern obtained by the minimization of the irrigation requirement in the months of April in the four years. The scenario analysis indicated that the sale price of the passion fruit crop exercises expressive influence on the financial performance of the enterprise. In the comparative analysis it was verified the equivalence of P-RISCO and @RISK programs in the execution of the risk simulation for the considered scenario.

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ABSTRACT Soy harvest matches seasons with shortage of dry matter supply for ruminant feeding in most Brazilian soy-growing areas. Agricultural machinery-producing companies must have market perception, observing new opportunities and developing equipment to meet costumers’ needs. This paper aims to design, build, and test a device to collect soybean crop residues from the combine cleaning mechanism, consisting mainly of vegetable straw (chaff), and the other plant parts (stems) remain being deposited onto the ground. For equipment designing, we made use of the architectural design methodology proposed in the reference model for the agricultural machinery development process. The equipment was designed and built following the proposed methodology, then installed and put into operation in a John Deere 1165 combine. After initial testing and few adjustments, the device showed satisfactory chaff-collecting performance. The equipment consists of a screw conveyor assembled transversely to the combine and a centrifugal fan assembled on the side. The collected chaff is dumped into a trailer towed by tractor.

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Professional responsibility is an inherent factor to the medical activity. Therefore, the adoption of a healthy conduct based on good relationship between the physician and the patient, as well as the understanding of this professional of the several aspects involved in the inguinal hernia repairs, are considered the better means to protect himself against possible litigations with its patients. This issue provides a complete evaluation of medical and legal problems related to the inguinal hernia surgery, and discusses the care that surgeon must exercise during preoperative, intraoperative and postoperative periods. That authors also comment about medical error and its conception from the point of the new Civil Code.

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The colorectal cancer has become a world public health problem as a consequence of the great number of new cases which have been diagnosed each year and the existence of some conditions related to the disease's natural history that can be identified and the cancer prevented. Knowing the fact that 20% out of all colorectal cancers develops as part of a hereditary cancer syndrome, it is crucial that the physician (not only the surgeon) be updated with this entity, being able to recognize, and mainly, implement screening programs to identify family members at risk of developing cancer and to allow the intervention to prevent the occurrence of the adenoma-carcinoma sequence.