Myths and Realities of Inter-professional Working

Introduction: Childhood cancers are rare and community based health care professionals have limited experience in caring for these children and often even less experience in providing their palliative care. It is well recognised that the provision of palliative care falls beyond the remit of any one profession, thus inter professional working is the standard model. This qualitative study aims to examine the experiences of the range of health care professionals involved in providing palliative care at home for children with cancer, focusing on how knowledge is exchanged; the level of communication and support both interprofessionally and at the community/specialist interface. It also aims to examine interprofessional collaboration in palliative care; identifying healthcare professional's perceptions of problems involved, interprofessional boundaries, specific areas of the organisation or provision of care that could be enhanced through changes in practice, support issues and the educational needs of health professionals. Methods The study involves three types of data collection; in-depth interviews, facilitated case discussion (FCD) and field notes from up to 20 cases (a "case" refers to the provision of palliative care to one child). Cases are selected from children who were treated at one regional childhood caner centre. For each case the community based health care professionals (for example the GP, community nurse or health visitor) involved in the care of the child at home are invited to participate in a one-to-one tape recorded in-depth interview followed by a group discussion in the form of a FCD. Field notes are completed following each interview. Data analysis follows a grounded theory approach. The term "social worlds theory" (SWT) his used to define a type of social organisation with no fixed or formal boundaries (such as membership boundaries), for example the range of health professionals that work together to provide palliative care. The boundaries of SW's are determined by the interaction and communication between recognised organisations, such as community nursing teams and general practitioners. SWT examines encounters between different professional groups and can be used to extend knowledge in both the organisation (for example general practice) and the content of what is being provisioned (for example, palliative care). The use of SWT in the analysis of the data is through examining the ethos of the different professions and the associated individual approaches to palliative care, exploring how this determines their roles in the provision of palliative care. Results 10 cases have so far been completed: 47 1:1 interviews (with a range of between 2-7 health care professionals being involved in each case): ( 9 x GP, 19 x CCN, 4 x DN, 3 x HV, 1 x HV assistant 7 x paediatric palliative care nurses, 1 x home support worker, 1 x OT, 1 x physiotherapist, 1 x community paediatrician) and 5 x FCD. The range of participants in the FCDs reflected that of the individual interview sampler. Data obtained to date gives clear insight into the personal experience of the individual health care professional in providing palliative care. Two themes emerging from the data will be focused upon: the continuity of care provision throughout treatment and palliation and the emotional burden experiences by the health care professional. Conclusions SWT can provide a useful framework in examining the social worlds of a disparate group of health care professionals working together for the first and maybe, the only time. A wide variation in the continuity of care provision has been found not only between professions, but also within professions. The emotional burden is evident across the professions.

On T-Semisimplicity of Iwasawa Modules and Some Computations with Z3-Extensions

Thesis (Ph.D.)--University of Washington, 2016-08

A formação de educadores para a pedagogia da alternância no Brasil nos movimentos italiano e francês: limitações e possibilidades

The Pedagogy of Alternation (PA), it is a type of education designed to rural people, whose perspective on the idea of combining theory and practice, alternating different times and spaces. On the Brazil, this education modality act from the perspective of two movements: Italian and French. Because it is a distinct mode of traditional, recommends that educators who work in this context also have a different outline. In this sense, it is relevant that there is a training for the educators that meets their needs. It is in these by understand how is the training of these professionals that the study proposes to analyze the educators training processes of PA on Brazil in movements Italian and French, presenting differences and similarities between them. For this, part it of a bibliographic and documental research, which were make initially theoretical surveys about expansion context of method, as well as theirtheoreticalandmethodologicalfoundationsandthePublicPolicybyeducators training. Then, were analyzed educational documents of both movements, laws, ordinances, statutes and field diaries, in order to verify how occurs the educators training process, and from that were stablished differences and similarities between both. The results point that in both movements there were advances in training processes, and despite of there were many similarities in trajectory of the movement, a multitude of issues boosted significant differences. On the Italian movement notes a greater harmony with the original principles of the PA, more engagement and organization by the movement. Because keeps collaborate ships with public authorities and institutions, without, however, losing its autonomy in decision-making and referrals to preserve the principles and foundations of this educational modality. This has encouraged and strengthened the educator’s formation and consequently the quality of education. On the other hand, the French movement it is shown weakened, especially in the state of Paraná, in which the movement is weakened. The small number of students, among other factors, pushed the closure of classes and consequently schools, this has interfered with the continuity of the movement. Many are the limitations by which the French movement has passed, especially with regard to training of their teachers, however, the search for new partner ships, as well as the community and the redemption of the original principles and foundations can be a way to paralyze this retraction and strengthens it.

Relatos y Redes de Política Pública de Niñez en Colombia 1991 - 2014

El presente estudio describe los cambios en la políticas públicas de niñez en Colombia entre 1991 y 2014, mediante el análisis tanto de las narrativas y contranarrativas de política gestadas en este periodo de tiempo, como de los factores que propiciaron la conformación de una red de política pública y el posterior desarrollo de diversos modos de interacción entre los grupos de actores identificados. Parte esta investigación de situar antecedentes y factores relevantes que permiten contrastar, por un lado, contenidos y perspectivas entre diferentes periodos de tiempo, y por otro lado, el número, tipo, y dinámica de relaciones entre los diversos actores involucrados en este campo antes de 1991, y posterior a este año hasta 2014. En síntesis, a través de los hallazgos y análisis realizados se busca no solo plantear qué se transformó entre 1991 y 2014 respecto a la construcción de la niñez como referente de políticas públicas, sino también, cómo se gestó esta transformación, con el fin de proveer elementos que permitan comprender principalmente los énfasis y las variaciones que han tenido las políticas públicas de niñez en el país, pero también, algunas continuidades por periodos más específicos de tiempo.

Mathematics and fiber arts

Mathematics can be found all over the world, even in what could be considered an unrelated area, like fiber arts. In knitting, crochet, and counted-thread embroidery, we can find concepts of algebra, graph theory, number theory, geometry of transformations, and symmetry, as well as computer science. For example, many fiber art pieces embody notions related with groups of symmetry. In this work, we focus on two areas of Mathematics associated with knitting, crochet, and cross-stitch works – number theory and geometry of transformations.

Genomic Copy Number Alterations Of Primary And Secondary Metastasizing Pleomorphic Adenomas.

Metastasizing pleomorphic adenoma (MPA) is a rare tumour, and its mechanism of metastasis still is unknown. To date, there has been no study on MPA genomics. We analysed primary and secondary MPAs with array comparative genomic hybridization to identify somatic copy number alterations and affected genes. Tumour DNA samples from primary (parotid salivary gland) and secondary (scalp skin) MPAs were subjected to array comparative genomic hybridization investigation, and the data were analysed with NEXUS COPY NUMBER DISCOVERY. The primary MPA showed copy number losses affecting 3p22.2p14.3 and 19p13.3p123, and a complex pattern of four different deletions at chromosome 6. The 3p deletion encompassed several genes: CTNNB1, SETD2, BAP1, and PBRM1, among others. The secondary MPA showed a genomic profile similar to that of the primary MPA, with acquisition of additional copy number changes affecting 9p24.3p13.1 (loss), 19q11q13.43 (gain), and 22q11.1q13.33 (gain). Our findings indicated a clonal origin of the secondary MPA, as both tumours shared a common profile of genomic copy number alterations. Furthermore, we were able to detect in the primary tumour a specific pattern of copy number alterations that could explain the metastasizing characteristic, whereas the secondary MPA showed a more unbalanced genome.

O judo; do modelo artesanal ao modelo cientifico : um estudo sobre as lutas, formação profissional e a construção do Hbitus

Universidade Estadual de Campinas . Faculdade de Educação Física

The bubbles or the boiling pot?: an ecosystemic approach to culture, environment and quality of life

For the diagnosis and prognosis of the problems of quality of life, a multidisciplinary ecosystemic approach encompasses four dimensions of being-in-the-world, as donors and recipients: intimate, interactive, social and biophysical. Social, cultural and environmental vulnerabilities are understood and dealt with, in different circumstances of space and time, as the conjugated effect of all dimensions of being-in-the-world, as they induce the events (deficits and assets), cope with consequences (desired or undesired) and contribute for change. Instead of fragmented and reduced representations of reality, diagnosis and prognosis of cultural, educational, environmental and health problems considers the connections (assets) and ruptures (deficits) between the different dimensions, providing a planning model to develop and evaluate research, teaching programmes, public policies and field projects. The methodology is participatory, experiential and reflexive; heuristic-hermeneutic processes unveil cultural and epistemic paradigms that orient subject-object relationships; giving people the opportunity to reflect on their own realities, engage in new experiences and find new ways to live better in a better world. The proposal is a creative model for thought and practice, providing many opportunities for discussion, debate and development of holistic projects integrating different scientific domains (social sciences, psychology, education, philosophy, etc.)

Impact of Manaus City on the Amazon Green Ocean atmosphere: ozone production, precursor sensitivity and aerosol load

As a contribution to the Large-Scale Biosphere-Atmosphere Experiment in Amazonia - Cooperative LBA Airborne Regional Experiment (LBA-CLAIRE-2001) field campaign in the heart of the Amazon Basin, we analyzed the temporal and spatial dynamics of the urban plume of Manaus City during the wet-to-dry season transition period in July 2001. During the flights, we performed vertical stacks of crosswind transects in the urban outflow downwind of Manaus City, measuring a comprehensive set of trace constituents including O(3), NO, NO(2), CO, VOC, CO(2), and H(2)O. Aerosol loads were characterized by concentrations of total aerosol number (CN) and cloud condensation nuclei (CCN), and by light scattering properties. Measurements over pristine rainforest areas during the campaign showed low levels of pollution from biomass burning or industrial emissions, representative of wet season background conditions. The urban plume of Manaus City was found to be joined by plumes from power plants south of the city, all showing evidence of very strong photochemical ozone formation. One episode is discussed in detail, where a threefold increase in ozone mixing ratios within the atmospheric boundary layer occurred within a 100 km travel distance downwind of Manaus. Observation-based estimates of the ozone production rates in the plume reached 15 ppb h(-1). Within the plume core, aerosol concentrations were strongly enhanced, with Delta CN/Delta CO ratios about one order of magnitude higher than observed in Amazon biomass burning plumes. Delta CN/Delta CO ratios tended to decrease with increasing transport time, indicative of a significant reduction in particle number by coagulation, and without substantial new particle nucleation occurring within the time/space observed. While in the background atmosphere a large fraction of the total particle number served as CCN (about 60-80% at 0.6% supersaturation), the CCN/CN ratios within the plume indicated that only a small fraction (16 +/- 12 %) of the plume particles were CCN. The fresh plume aerosols showed relatively weak light scattering efficiency. The CO-normalized CCN concentrations and light scattering coefficients increased with plume age in most cases, suggesting particle growth by condensation of soluble organic or inorganic species. We used a Single Column Chemistry and Transport Model (SCM) to infer the urban pollution emission fluxes of Manaus City, implying observed mixing ratios of CO, NO(x) and VOC. The model can reproduce the temporal/spatial distribution of ozone enhancements in the Manaus plume, both with and without accounting for the distinct (high NO(x)) contribution by the power plants; this way examining the sensitivity of ozone production to changes in the emission rates of NO(x). The VOC reactivity in the Manaus region was dominated by a high burden of biogenic isoprene from the background rainforest atmosphere, and therefore NO(x) control is assumed to be the most effective ozone abatement strategy. Both observations and models show that the agglomeration of NO(x) emission sources, like power plants, in a well-arranged area can decrease the ozone production efficiency in the near field of the urban populated cores. But on the other hand remote areas downwind of the city then bear the brunt, being exposed to increased ozone production and N-deposition. The simulated maximum stomatal ozone uptake fluxes were 4 nmol m(-2) s(-1) close to Manaus, and decreased only to about 2 nmol m(-2) s(-1) within a travel distance >1500 km downwind from Manaus, clearly exceeding the critical threshold level for broadleaf trees. Likewise, the simulated N deposition close to Manaus was similar to 70 kg N ha(-1) a(-1) decreasing only to about 30 kg N ha(-1) a(-1) after three days of simulation.

Elite athletes: Why does the 'fire' burn so brightly?

Background and Purpose: What drives some athletes to achieve at the highest level whilst other athletes fail to achieve their physical potential? Why does the ‘fire’ burn so brightly for some elite athletes and not for others? A good understanding of an athlete’s motivation is critical to a coach designing an appropriate motivational climate to realize an athlete’s physical talent. This paper examines the motivational processes of elite athletes within the framework of three major social-cognitive theories of motivation. Method: Participants were five male and five female elite track and field athletes from Australia who had finished in the top ten at either the Olympic Games and/or the World Championships in the last six years. Qualitative data were collected using semi-structured interviews. Results and Discussion: Inductive analyses revealed several major themes associated with the motivational processes of elite athletes: (a) they were highly driven by personal goals and achievement, (b) they had strong self-belief, and (c) track and field was central to their lives. The findings are discussed in light of recent social-cognitive theories of motivation, namely, self-determination theory, the hierarchical model of motivation, and achievement goal theory. Self-determined forms of motivation characterised the elite athletes in this study and, consistent with social-cognitive theories of motivation, it is suggested that goal accomplishment enhances perceptions of competence and consequently promotes self-determined forms of motivation.

Vortices and solitons in Bose-condensates

The new science of nonlinear atom optics and atom lasers is evolving rapidly. There are similarities between many related areas in modern photonic and atom optics, particularly at the mean-field level. In both cases we can often use classical nonlinear wave equations to describe classical solitons, vortices, and other nonlinear structure. Atom-molecular coupling can be used to play the role of second-harmonic generation. This leads to novel types of soliton. In addition, quantum effects at low densities are likely to be readily observable.

Magnetic characterization by SQUID and FMR of a biocompatible ferrofluid based on Fe(3)O(4)

Biocompatible superparamagnetic iron oxide nanoparticles of magnetite coated with dextran were magnetically characterized using the techniques of SQUID (superconducting quantum interference device) magnetometry and ferromagnetic resonance (FMR). The SQUID magnetometry characterization was performed by isothermal measurements under applied magnetic field using the methods of zero-field-cooling (ZFC) and field-cooling (FC). The magnetic behavior of the nanoparticles indicated their superparamagnetic nature and it was assumed that they consisted exclusively of monodomains. The transition to a blocked state was observed at the temperature T(B) = (43 +/- 1) K for frozen ferrofluid and at (52 +/- 1) K for the lyophilized ferrofluid samples. The FMR analysis showed that the derivative peak-to-peak linewidth (Delta H(PP)), gyromagnetic factor (g), number of spins (N(S)), and spin-spin relaxation time (T(2)) were strongly dependent on both temperature and super-exchange interaction. This information is important for possible nanotechnological applications, mainly those which are strongly dependent on the magnetic parameters.

The entrapment of particles by windbreaks

A theory is developed for calculating the entrapment of particles by a windbreak, with four results. (1) The fraction of particles in the oncoming flow which pass through the windbreak, or transmittance of the windbreak for particles (sigma), is related to the optical porosity (tau). The very simple approximation sigma=tau works well for most applications involving the interception of spray droplets by windbreaks. Results from a field experiment agree with the theoretical predictions. (2) A new equation for the bulk drag coefficient of a windbreak is tested against numerical, wind tunnel and field experiments. This enables the bleed velocity for the flow through the windbreak to be predicted in terms of the screen pressure coefficient (k) of the barrier. (3) The relationship between k and tau is different for a vegetative barrier than for a screen across a confined duct, implying a lower Fc for given tau. (4) The total deposition of particles to a windbreak is determined by a trade-off between particle absorption and throughflow, implying an optimum value of tau for maximum total deposition. For particles larger than 30 mum and vegetation elements smaller than 30 mm, this occurs near tau = 0.2. (C) 2001 Elsevier Science Ltd. All rights reserved.

Calculation of electric fields induced by body and head motion in high-field MRI

In modern magnetic resonance imaging (MRI), patients are exposed to strong, nonuniform static magnetic fields outside the central imaging region, in which the movement of the body may be able to induce electric currents in tissues which could be possibly harmful. This paper presents theoretical investigations into the spatial distribution of induced electric fields and currents in the patient when moving into the MRI scanner and also for head motion at various positions in the magnet. The numerical calculations are based on an efficient, quasi-static, finite-difference scheme and an anatomically realistic, full-body, male model. 3D field profiles from an actively shielded 4T magnet system are used and the body model projected through the field profile with a range of velocities. The simulation shows that it possible to induce electric fields/currents near the level of physiological significance under some circumstances and provides insight into the spatial characteristics of the induced fields. The results are extrapolated to very high field strengths and tabulated data shows the expected induced currents and fields with both movement velocity and field strength. (C) 2003 Elsevier Science (USA). All rights reserved.

Conjetura de Goldbach: uma visão aritmética

Dissertação de Mestrado, Matemática para Professores, 1 de Novembro de 2013, Universidade dos Açores.