Experiences of COPD patients with existing smoking cessation programs and their preferences for improvement - a qualitative analysis

BACKGROUND: Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD). For current smokers who are diagnosed with COPD, their first treatment option is to stop smoking. Motivation is necessary for long-term smoking cessation; therefore, when designing smoking cessation programs, the patients' needs and preferences should be considered. We focused on COPD patients' experiences with existing smoking cessation programs and evaluated their preferences for the improvement of these programs. METHODS: We conducted 18 guideline-based interviews with COPD patients between April and June 2014 in Germany. Each patient with COPD, who was a current or past smoker and had made at least one attempt to quit smoking in the past 5 years, was included in the study. We audiotaped, verbatim transcribed, and evaluated the interviews, using content analysis. RESULTS: The patients had broad and different experiences with pharmaceutical, behavioral, and alternative approaches that supported or negatively influenced the smoking cessation process. Pharmaceuticals were viewed as an expensive alternative with many side effects although they helped to stop cravings for a few moments. Furthermore, the bad structure and impersonal content of the seminars for smoking cessation negatively influenced group cohesion, and therefore degrading the patients' motivation to stop smoking. Alternative methods, such as acupuncture and hypnosis were mostly ineffective in smoking cessation, but in some cases, served as motivational strategies. CONCLUSION: Negative experiences with smoking cessation were explained by the patients' lack of motivation or resolution. Other negative experiences, such as the structure of seminars for smoking cessation and the high price of pharmaceuticals should be addressed through policy changes to increase the patients' motivation to quit smoking.

Broad-scale mapping of seafloor habitats in the north-east Atlantic using existing environmental data

If marine management policies and actions are to achieve long-term sustainable use and management of the marine environment and its resources, they need to be informed by data giving the spatial distribution of seafloor habitats over large areas. Broad-scale seafloor habitat mapping is an approachwhich has the benefit of producing maps covering large extents at a reasonable cost. This approach was first investigated by Roff et al. (2003), who, acknowledging that benthic communities are strongly influenced by the physical characteristics of the seafloor, proposed overlaying mapped physical variables using a geographic information system (GIS) to produce an integrated map of the physical characteristics of the seafloor. In Europe the method was adapted to the marine section of the EUNIS (European Nature Information System) classification of habitat types under the MESH project, andwas applied at an operational level in 2011 under the EUSeaMap project. The present study compiled GIS layers for fundamental physical parameters in the northeast Atlantic, including (i) bathymetry, (ii) substrate type, (iii) light penetration depth and (iv) exposure to near-seafloor currents andwave action. Based on analyses of biological occurrences, significant thresholds were fine-tuned for each of the abiotic layers and later used in multi-criteria raster algebra for the integration of the layers into a seafloor habitat map. The final result was a harmonised broad-scale seafloor habitat map with a 250 m pixel size covering four extensive areas, i.e. Ireland, the Bay of Biscay, the Iberian Peninsula and the Azores. The map provided the first comprehensive perception of habitat spatial distribution for the Iberian Peninsula and the Azores, and fed into the initiative for a pan- European map initiated by the EUSeaMap project for Baltic, North, Celtic and Mediterranean seas.

DNI Measurements in the South of Portugal: Long Term Results through Direct Comparison with Global and Diffuse Radiation Measurements and Existing Time Series

The present work describes the measurement effort for direct normal irradiance (DNI) evaluation in the sunny south of Portugal, with a network of eight radiation measurement stations in several locations (including Évora) providing a good coverage of the region. This new initiative for DNI measurement will still need many years (typically 10 or more) to produce a time series which can claim having long term statistical value. This problem can, however, be temporarily mitigated by measuring DNI at the same time as GHI and DHI, in a place where long term series dating back, already exist for those two. It so happens that a long term series (20 years) of global and diffuse solar irradiation exists for the location Évora. So the expectation is to establish correlations with the goal of attributing at least some long term statistical significance to the short and recent DNI series. The paper describes the setup of the measuring stations and presents the preliminary measurements obtained. It further presents the first correlations of monthly averages between normal beam (DNI), global and diffuse radiation. It then uses these correlations, admittedly without acceptable statistical significance (short series of less than one year of measured data), to exemplify how to get a prediction of long term DNI for Évora. This preliminary obtained value is compared to that predicted by the commercial data from Meteonorm.

Arricchimento semantico nel contesto dell'Existing Building Information Modelling: aspetti metodologici e applicazione al caso della Rocca Estense di San Felice sul Panaro.

(ITA) L’industria mondiale odierna nel campo dell’architettura e dell’ingegneria si esprime quasi esclusivamente mediante l’approccio BIM, Building Information Modeling. Anche se sviluppato pensando alle nuove costruzioni ed ancora in via di perfezionamento, è entrato prepotentemente nei capitoli normativi di molti stati all’urlo dell“interoperability”. Su questo tema è recente l’interesse e la possibilità di adozione per l’intervento sul costruito, ovvero di Existing Building Information Modelling, eBIM. Gli studi applicativi-sperimentali in questo ambito sono sempre più numerosi e convergono, purtroppo, sulla delicata correlazione tra la gestione del contenuto semantico e la perdita di interoperabilità. Questa tesi si incentra sull’analisi di tale correlazione valutando in particolare l’aspetto metodologico-applicativo dell’arricchimento semantico adottando come caso studio la Torre Nord della Rocca Estense di San Felice sul Panaro. (ENG)Today's global industry in architecture and engineering fields, expresses itself almost entirely focusing on BIM, Building Information Modeling. Even though it was developed taking in consideration new buildings and the ones that are in the process of improvement, it has entered the regulatory chapters of many states in the hymn of "interoperability". Concerning this topic is recent the interest and possibility of adopting a process to intervene on the already built constructions, Existing Building Information Modeling, eBIM. Application-experimental studies in this area are increasingly numerous and unfortunately converge, on the delicate correlation between the management of the semantic content and the loss of interoperability. This thesis focuses on the analysis of this correlation by evaluating in particular the methodological-applicative aspect of semantic enrichment by adopting the North Tower of the Rocca Estense in San Felice sul Panaro as a case study.

Analyzing urban green adaptation opportunities: concepts, approaches, & strategies for existing neighborhoods

Over the last decades, the growing evidence of human-caused climate change has raised awareness of the consequences of exceeding global temperature by 2˚C. This awareness has led to a contemporary approach to the conceptualization and management of green adaptation policies in spatial planning. This thesis aims to develop a comprehensive methodology for assessing the adaptability of existing neighborhoods to green strategies. The reliability of the proposed method is examined in the cities of Bologna and Imola and proved to be applicable in other geoghraphical locations. This thesis integrates three key themes of conceptual and implementation principles for urban green adaptation. This thesis initially defines methods for narrowing uncertainties in urban planning energy forecasting modeling by exploring the roles of integrated energy planning. The second is by exploring green retrofitting strategies in building, this thesis examines the effects of various energy-saving factors in roofing scenarios including a green roof, rooftop greenhouse, and insolated roof. Lastly, this thesis analyzes green strategies in urban spaces to enhance thermal comfort through facing urban heat exposure related to urban heat island effects. The roles of integrated energy policies and green strategic thinking are discussed to highlight various aspects of green adaptation on the neighborhood scale. This thesis develops approaches by which cities can face the challenges of current green urban planning and connect the conceptual and practical aspects of green spatial planning. Another point that this thesis highlight is that due to the interdependency of individuals and places, it is difficult to assure whether all the adaptation policies on a large scale are enhancing the resiliency of the neighborhood or they are simply shuffling the vulnerability through the individuals and places. Besides, it asserts that neglecting to reflect on these reallocations of the effects generates serious complications, and will result in long-term dysfunctional consequences.

On the use of the exoskeleton for seismic improvement and integrated efficient technologies in existing buildings

The aim of this work is to investigate the seismic improvement obtained through external strengthening structures applied on existing reinforced concrete buildings. An innovative integration with pre-assembled technological envelope components is also presented with the aim of achieving a holistic renovation. Particular attention was paid to the timber solution with an innovative post-tensioned connection between cross-laminated timber panels, which was the subject of an experimental campaign

Strength and ductility of corroded strands within the framework of safety assessment of existing bridges

Existing bridges built in the last 50 years face challenges due to states far different than those envisaged when they were designed, due to increased loads, ageing of materials, and poor maintenance. For post-tensioned bridges, the need emerged for reliable engineering tools for the evaluation of their capacity in case of steel corrosion due to lack of mortar injection. This can lead to sudden brittle collapses, highlighting the need for proper maintenance and monitoring. This thesis proposes a peak strength model for corroded strands, introducing a “group coefficient” that aims at considering corrosion variability in the wires constituting the strands. The application of the introduced model in a deterministic approach leads to the proposal of strength curves for corroded strands, which represent useful engineering tools for estimating their maximum strength considering both geometry of the corrosion and steel material parameters. Together with the proposed ultimate displacement curves, constitutive laws of the steel material reduced by the effects of corrosion can be obtained. The effects of corroded strands on post-tensioned beams can be evaluated through the reduced bending moment-curvature diagram accounting for these reduced stress-strain relationships. The application of the introduced model in a probabilistic approach allows to estimate peak strength probability functions and consecutive design-oriented safety factors to consider corrosion effects in safety assessment verifications. Both approaches consider two procedures that are based on the knowledge level of the corrosion in the strands. On the sidelines of this main research line, this thesis also presents a study of a seismic upgrading intervention of a case-study bridge through HDRB isolators providing a simplified procedure for the identification of the correct device. The study also investigates the effects due to the variability of the shear modulus of the rubber material of the HDRB isolators on the structural response of the isolated bridge.

Analysis and improvements of an existing industrial hot stamping machine

The importance of product presentation in the marketing industry is well known. Labels are crucial for providing information to the buyer, but at a modest additional expense, a beautiful label with exquisite embellishments may also give the goods a sensation of high quality and elegance. Enhancing the capabilities of stamping machines is required to keep up with the increasing velocity of the production lines in the modern manufacturing industry and to offer new opportunities for customization. It’s in this context of improvements and refinements that this work takes place. The thesis was developed during an internship at Studio D, the firm that designs the mechanics of the machines produced by Cartes. The The aim of this work is to study possible upgrades for the existing hot stamping machines. The main focus of this work is centred on two objectives: first, evaluating the pressing forces generated by this machine and characterising how the mat used in the stamping process reacts to such forces. Second, propose a new conformation for the press mechanism in order to improve the rigidity and performance of the machines. The first objective is reached through a combined approach: the mat is crudely characterized with experimental data, while the frame of the machine is studied through FEM analysis. The results obtained are combined and used to upgrade a worksheet that allows to estimate the forces exerted by the machines. The second objective is reached with the proposal of new, improved designs for the main components of the machines.

Evaluation Of Fe Uptake And Translocation In Transgenic And Non-transgenic Soybean Plants Using Enriched Stable (57)fe As A Tracer.

A tracer experiment is carried out with transgenic T (variety M 7211 RR) and non-transgenic NT (variety MSOY 8200) soybean plants to evaluate if genetic modification can influence the uptake and translocation of Fe. A chelate of EDTA with enriched stable (57)Fe is applied to the plants cultivated in vermiculite plus substrate and the (57)Fe acts as a tracer. The exposure of plants to enriched (57)Fe causes the dilution of the natural previously existing Fe in the plant compartments and then the changed Fe isotopic ratio ((57)Fe/(56)Fe) is measured using a quadrupole-based inductively coupled plasma mass spectrometer equipped with a dynamic reaction cell (DRC). Mathematical calculations based on the isotope dilution methodology allow distinguishing the natural abundance Fe from the enriched Fe (incorporated during the experiment). The NT soybean plants acquire higher amounts of Fe from natural abundance (originally present in the soil) and from enriched Fe (coming from the (57)Fe-EDTA during the experiment) than T soybean ones, demonstrating that the NT soybean plants probably absorb higher amounts of Fe, independently of the source. The percentage of newly incorporated Fe (coming from the treatment) was approximately 2.0 and 1.1% for NT and T soybean plants, respectively. A higher fraction (90.1%) of enriched Fe is translocated to upper parts, and a slightly lower fraction (3.8%) is accumulated in the stems by NT plants than by T ones (85.1%; 5.1%). Moreover, in both plants, the Fe-EDTA facilitates the transport and translocation of Fe to the leaves. The genetic modification is probably responsible for differences observed between T and NT soybean plants.

Cervical Spine Involvement In Rheumatoid Arthritis--a Systematic Review.

Rheumatoid arthritis (RA) is a systemic chronic inflammatory disorder that can compromise the cervical spine in up to 80% of the cases. The most common radiological presentations of cervical involvement are atlantoaxial subluxation (AAS), cranial settling and subaxial subluxation (SAS). We performed a systematic review in the PubMed Database of articles published later 2005 to evaluate the prevalence, progression and risk factors for cervical spine involvement in RA patients. Articles were classified according to their level of evidence. Our literature review reported a wide range in the prevalence of cervical spine disease, probably explained by the different studied populations and disease characteristics. Uncontrolled RA is probably the main risk factor for developing a spinal instability. Adequate treatment with DMARD and BA can prevent development of cervical instabilities but did not avoid progression of a pre-existing injury. MRI is the best radiological method for diagnosis cervical spine involvement. AAS is the most common form of RA. Long term radiological follow-up is necessary to diagnosis patients with late instabilities and monitoring progression of diagnosed injuries.

Screening The Life Cycle Of Schistosoma Mansoni Using High-resolution Mass Spectrometry.

Schistosomiasis is a common tropical disease caused by Schistosoma species Schistosomiasis' pathogenesis is known to vary according to the worms' strain. Moreover, high parasitical virulence is directly related to eggs release and granulomatous inflammation in the host's organs. This virulence might be influenced by different classes of molecules, such as lipids. Therefore, better understanding of the metabolic profile of these organisms is necessary, especially for an increased potential of unraveling strain virulence mechanisms and resistance to existing treatments. In this report, direct-infusion electrospray high-resolution mass spectrometry (ESI(+)-HRMS) along with the lipidomic platform were employed to rapidly characterize and differentiate two Brazilian S. mansoni strains (BH and SE) in three stages of their life cycle: eggs, miracidia and cercariae, with samples from experimental animals (Swiss/SPF mice). Furthermore, urine samples of the infected and uninfected mice were analyzed to assess the possibility of direct diagnosis. All samples were differentiated using multivariate data analysis, PCA, which helped electing markers from distinct lipid classes; phospholipids, diacylglycerols and triacylglycerols, for example, clearly presented different intensities in some stages and strains, as well as in urine samples. This indicates that biochemical characterization of S. mansoni may help narrowing-down the investigation of new therapeutic targets according to strain composition and aggressiveness of disease. Interestingly, lipid profile of infected mice urine varies when compared to control samples, indicating that direct diagnosis of schistosomiasis from urine may be feasible.

Censored Linear Regression Models For Irregularly Observed Longitudinal Data Using The Multivariate-t Distribution.

In acquired immunodeficiency syndrome (AIDS) studies it is quite common to observe viral load measurements collected irregularly over time. Moreover, these measurements can be subjected to some upper and/or lower detection limits depending on the quantification assays. A complication arises when these continuous repeated measures have a heavy-tailed behavior. For such data structures, we propose a robust structure for a censored linear model based on the multivariate Student's t-distribution. To compensate for the autocorrelation existing among irregularly observed measures, a damped exponential correlation structure is employed. An efficient expectation maximization type algorithm is developed for computing the maximum likelihood estimates, obtaining as a by-product the standard errors of the fixed effects and the log-likelihood function. The proposed algorithm uses closed-form expressions at the E-step that rely on formulas for the mean and variance of a truncated multivariate Student's t-distribution. The methodology is illustrated through an application to an Human Immunodeficiency Virus-AIDS (HIV-AIDS) study and several simulation studies.

Diretrizes curriculares nacionais para o ensino médio: avaliação de documento

This text offers some contributions to the debate on the changes proposed to the National Curricular Directives to reform secondary education in Brazil. In the first part, the political and economic scene is evaluated as the context which generated the last stage of reforms in the educational field in the 90s. It questions the option for a model of structural reform (in the Brazilian case more restricted to the Program for Reform of Professional Education - PROEP) and of the curriculum, whose themes find their justification in the contemporary economic, social cultural and political context. It discusses the use of a model that bases itself on experiences developed in other countries and takes the international orientation of the multilateral organizations as its theoretical methodological reference, leaving out the peculiarities and injunctions of the Brazilian political administrative system. Such a policy measure can increase the tension and distance normally existing between government programs and the possibility of their real implementation in the school network. In the second part, it discusses the Resolution of the National Education Council, the Congress on Basic Education, no.3, of 16.698 that instituted the National Curricular Directives for secondary education, as well as the Legal Bases - Part I - of the National Curricular Parameters for secondary education. The analysis of official discourse takes Bardin's (1977, p. 209) proposals as its methodological reference for the models of structural analysis, seeking to make the implicit values and the connotations of the legal texts explicit

Reflexão sobre alguns desafios do ensino médio no Brasil hoje

The purpose of this article is to develop some ideas that may contribute to the debate about the secondary education in Brazil, giving emphasis to the conditions existing in the educational institutions, the ongoing educational policies and the challenges posed by the social, economic and political reality of the country. It is also discussed the political, social and economic importance of the expansion and the compulsory character of secondary education as well as the school's culture dimension, in its relationship to the so-called knowledge society. Finally, the role of secondary education for the youth and the new demands it poses for teachers are presented, among some others aspects.

Guia para a determinação da estabilidade de produtos químicos

Companies worldwide are reviewing their working process to avoid waste, become aligned with environmental management standards and to fulfill specifications defined for national and international regulations. In this context, it is important that Brazilian Chemical companies have a specific stability guide for their products. The main purpose of this work is to present a stability guide for chemical products based on the existing guides of the Pharmaceutical and Cosmetics segments. Furthermore, this work proposes to offer an additional period of shelf life for chemical products, provided they meet certain prerequisites.