842 resultados para smaltimento reflui on-site sanitation madagascar


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Dental microwear researchers consider exogenous grit or dust to be an important cause of microscopic wear on primate teeth. No study to date has examined the accumulation of such abrasives on foods eaten by primates in the forest. This investigation introduces a method to collect dust at various heights in the canopy. Results from dust collection studies conducted at the primate research stations at Ketambe in Indonesia, and Hacienda La Pacifica in Costa Rica indicate that 1) grit collects throughout the canopy in both open country and tropical rain forest environments; and 2) the sizes and concentrations of dust particles accumulated over a fixed period of time differ depending on site location and season of investigation. These results may hold important implications for the interpretation of microwear on primate teeth.

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BACKGROUND: Automated reporting of estimated glomerular filtration rate (eGFR) is a recent advance in laboratory information technology (IT) that generates a measure of kidney function with chemistry laboratory results to aid early detection of chronic kidney disease (CKD). Because accurate diagnosis of CKD is critical to optimal medical decision-making, several clinical practice guidelines have recommended the use of automated eGFR reporting. Since its introduction, automated eGFR reporting has not been uniformly implemented by U. S. laboratories despite the growing prevalence of CKD. CKD is highly prevalent within the Veterans Health Administration (VHA), and implementation of automated eGFR reporting within this integrated healthcare system has the potential to improve care. In July 2004, the VHA adopted automated eGFR reporting through a system-wide mandate for software implementation by individual VHA laboratories. This study examines the timing of software implementation by individual VHA laboratories and factors associated with implementation. METHODS: We performed a retrospective observational study of laboratories in VHA facilities from July 2004 to September 2009. Using laboratory data, we identified the status of implementation of automated eGFR reporting for each facility and the time to actual implementation from the date the VHA adopted its policy for automated eGFR reporting. Using survey and administrative data, we assessed facility organizational characteristics associated with implementation of automated eGFR reporting via bivariate analyses. RESULTS: Of 104 VHA laboratories, 88% implemented automated eGFR reporting in existing laboratory IT systems by the end of the study period. Time to initial implementation ranged from 0.2 to 4.0 years with a median of 1.8 years. All VHA facilities with on-site dialysis units implemented the eGFR software (52%, p<0.001). Other organizational characteristics were not statistically significant. CONCLUSIONS: The VHA did not have uniform implementation of automated eGFR reporting across its facilities. Facility-level organizational characteristics were not associated with implementation, and this suggests that decisions for implementation of this software are not related to facility-level quality improvement measures. Additional studies on implementation of laboratory IT, such as automated eGFR reporting, could identify factors that are related to more timely implementation and lead to better healthcare delivery.

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Following the integration of nurse and midwifery education into institutions of higher education in the United Kingdom, a number of studies have shown that a defined clinical framework for nursing and midwifery lecturers in practice areas is lacking. The aim of this study was to explore strategies that nurse and midwifery lecturers from one higher education institution in south east England can use to work collaboratively with nurses and midwives to promote the utilization of research findings in practice. A cross-sectional survey using a structured questionnaire was sent to a sample of 60 nurse and midwifery lecturers and 90 clinical managers. Response rates of 67% (40) and 69% (62) respectively were obtained. The main strategies suggested were to make clinical staff more aware of what research exist in their specialties; to help them to access research information from research databases; and to critically appraise this information. Other strategies were for teachers to run research workshops on site; to undertake joint research projects with clinical staff; to set up journal clubs or research interest groups; and to help formulate clinical guidelines and protocols which are explicitly research-based.

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Following the integration of nurse and midwifery education into institutions of higher education in the United Kingdom, a number of studies have shown that a defined clinical framework for nursing and midwifery lecturers in practice areas is lacking. The aim of this study was to explore strategies that nurse and midwifery lecturers from one higher education institution in south east England can use to work collaboratively with nurses and midwives to promote the utilization of research findings in practice. A cross-sectional survey using a structured questionnaire was sent to a sample of 60 nurse and midwifery lecturers and 90 clinical managers. Response rates of 67% (40) and 69% (62) respectively were obtained. The main strategies suggested were to make clinical staff more aware of what research exist in their specialties; to help them to access research information from research databases; and to critically appraise this information. Other strategies were for teachers to run research workshops on site; to undertake joint research projects with clinical staff; to set up journal clubs or research interest groups; and to help formulate clinical guidelines and protocols which are explicitly research-based.

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In advanced non-small cell lung cancer (NSCLC) platinum based chemotherapy with second generation drugs improves median survival (MS) to 8 months and 29% and 10% at 1 and 2 years. Platinum with a third generation drug can improve survival further (BMJ 1995;311: 899) (Spiro et al. Thorax 2004;59:828 Big Lung Trial; N Engl J Med 2003;346:92 ECOG study). NICE now recommends chemotherapy with platinum and a third generation drug for inoperable NSCLC as the first treatment modality. Methods: We audited survival of 176/461 consecutive patients referred for at least 3 courses of platinum and either gemcitabine or vinorelbine from July 2001 to December 2005. Minimal follow up 17 months. Chemotherapy was given on site. Radical radiotherapy for stage IIIA, palliative radiotherapy and second line drugs were given as felt appropriate. Results: 64% were male. 30 (17%) were <55 years ; 66 (37.5%) age 55–65 years; 63 (35.8%) aged 66–75 and 16 (9.1%) >75 years. 5 (2.8%) were stage II; 46 (26%) stage IIIA; 68 (38%) stage IIIB and 55 (30.8%) stage IV. 68 (38%) had 0– 2 courses; 63 (36%) 3 courses and 44 (25%) had 4 or more.

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A new approach to compute along-track velocity components by combining altimetry-based across-track components and front directions from remote sensing maps of surface chlorophyll concentration is proposed. The analysis focuses on the South Madagascar region characterized by the strong East Madagascar Current and sharp gradients of surface tracers. The results are compared against in-situ observations from three moorings along the Jason-1 track 196. Accurate information on the total velocity direction is the key factor for obtaining accurate estimates of along-track velocities. Although with some limitations, surface tracer fronts can be successfully used to retrieve such information.

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Queen's University Library was one of 202 libraries, including 57 members of the Association of Research Libraries (ARL), to survey its users in spring 2004 using the LibQUAL+ survey instrument. LibQUAL+ was designed by ARL to assist libraries in assessing the quality of their services and identifying areas for improvement. # Overall: Queen's scored higher than the average for all ARL participants and 1st among the 2004 Canadian participants. This relatively high rating is due to very high scores in the dimensions of Library as Place and Affect of Service. However, there is considerable need for improvement in the area of Information Control where Queen's rated well below the ARL average. # Affect of Service: Queen's strong overall ratings are supported by the many respondent comments praising customer service throughout the system. The ratings and survey comments indicate greatest appreciation by faculty and more experienced students (e.g. graduate students) for the instruction and on-site services provided by the libraries. The ratings also indicate that undergraduates, growing up with the web, want and expected to be able to access library resources independently and do not value these services as highly. The comments also indicated some specific areas for improvement throughout the library system. # Library as Place : All Queen's libraries except for Law ranked well above the ARL and Canadian averages. Overall, Library as Place ranked lowest in importance among the service dimensions for all ARL participants including Queen's. Comparative analysis of LibQUAL results since the survey began shows a decline in “desired” ratings for Library as Place. However, undergraduates continue to give strong "desired" ratings to certain aspects of Library as Place and a relatively high rating for "minimum expected" service. The comments from Queen's survey respondents and ARL's analyses of focus groups indicate that undergraduates value the library much more as a place to study and work with peers rather than for its on-site resources and services. # Information Control: This is the area in greatest need of attention. While it ranked highest in importance for all user groups by a wide margin, Queen's performed poorly in this category. Overall, Queen's ranked far below both the ARL average and the top three Canadian scores. However, the major dissatisfaction was concentrated in the humanities/social sciences (Stauffer primary users) and the health sciences (Bracken primary users) where the overall rating of perceived service quality ranked below the minimum expected service rating. Primary users of the Education, Engineering/Science and Law libraries rated this service dimension higher than the ARL average. The great success of the Canadian National Site License Program (CNSLP) is reflected in the high overall rating generated by Engineering/Science Library users. The low ratings from the humanities and social sciences are supported by respondents' comments and are generally consistent with other ARL participants.

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This paper presents a study of the residual strength of Pinus sylvestris, which has been subject to attack by the furniture beetle (Anobium punctatum). It is relatively easy to stop the infestation, but difficult to assess the structural soundness of the remaining timber. Removal and replacement of affected structural elements is usually difficult and expensive, particularly in buildings of historic interest. Current on-site assessment procedures are limited. The main object of the study was to develop an on-site test of timber quality: a test which can be carried out on the surface and also at varying depths into the timber. It is based on a probe pull-out technique using a portable load-measuring device. Pull-out force values have been correlated with both strength and energy absorbed as measured by compression testing on laboratory samples of both sound and infested timber. These two relationships are significant and could be used to assess whether remedial work is needed. In addition, work on the use of artificial borings to simulate the natural worming of timber is presented and the findings discussed.

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In the early 19th century the requirement for clear span industrial buildings brought about the development of a variety of timber truss types. The Belfast truss was introduced circa 1860 to meet the demand for efficient wide span industrial buildings. It has essentially a bow-string configuration with a curved top chord, straight horizontal bottom chord and close-spaced lattice web. Several thousand still exist in Ireland, many in buildings of historic significance. This paper sets out to demonstrate the efficiency of the Belfast truss and to show that, by modern structural design criteria, the concept, member sizes and joint details were well chosen. Trusses in historic buildings can be replicated almost exactly as originally fabricated. Results of a theoretical study are compared with the experimental behaviour of two full-scale trusses: one a replacement truss, tested in the laboratory; the other an 80-year-old truss tested on site. In addition, experimental results from a manufacturers archive material of full-scale truss tests carried out about 100 years ago are compared with theoretical models. As well as considering their significance in building conservation the paper proposes that Belfast trusses are an attractive sustainable alternative to other roof structures. The analysis, design, fabrication and testing of trusses have resulted in a better understanding of their behaviour which is not only of historic interest and fundamental to the repair/restoration of existing trusses, but also relevant to the design of modern timber trusses and the promotion of a sustainable form of roof construction.