QUALIDADE DE VIDA E ESTRATÉGIAS DE ENFRENTAMENTO DE MULHERES COM E SEM LINFEDEMA APÓS CÂNCER DE MAMA

O linfedema no membro superior é uma complicação inerente ao tratamento de câncer de mama. Caracterizado pelo aumento do volume do membro, leva às limitações físicas e funcionais, e impacto negativo no âmbito psicológico e social. O objetivo deste estudo foi investigar a qualidade de vida e seus domínios, as estratégias de enfrentamento frente ao câncer de mama, e a correlação entre essas variáveis. Este estudo foi realizado em um centro de saúde dedicado às mulheres, por quatro meses. Os instrumentos de avaliação foram: questionário de caracterização geral e específico do câncer de mama, perimetria dos membros superiores; questionários de qualidade de vida da Organização Européia de Pesquisa e Tratamento do Câncer, EORTC QLQ-30 e BR-23; e Inventário de Estratégias de Coping. Foram entrevistadas 82 mulheres, idade média de 57,4 anos (DV12,3), submetidas a tratamento cirúrgico de mama unilateral e esvaziamento axilar, sem metástase. O linfedema apresentou-se em 39,03% (32) e parece não interferir muito na qualidade de vida das mulheres pós-câncer de mama, sendo a função social a mais prejudicada. Sintomas relacionados à quimioterapia e a mama incomodam as mulheres de ambos grupos, porém os sintomas relacionados aos braços foram estatisticamente maiores nas portadoras de linfedema. As estratégias mais utilizadas pelas entrevistadas para enfrentar o câncer foram a reavaliação, resolução de problemas, fuga, suporte social e autocontrole, somente o autocontrole foi estatisticamente maior nas mulheres com linfedema. As estratégias de resolução de problemas, autocontrole e baixo suporte social podem ter colaborado para o desencadeamento do linfedema. Conclui-se que o uso de estratégias ativas e positivas para enfrentar o câncer de mama parece resultar na boa adaptação psicossocial

An FTO variant is associated with Type 2 diabetes in South Asian populations after accounting for body mass index and waist circumference

Aims - A common variant, rs9939609, in the FTO (fat mass and obesity) gene is associated with adiposity in Europeans, explaining its relationship with diabetes. However, data are inconsistent in South Asians. Our aim was to investigate the association of the FTO rs9939609 variant with obesity, obesity-related traits and Type 2 diabetes in South Asian individuals, and to use meta-analyses to attempt to clarify to what extent BMI influences the association of FTO variants with diabetes in South Asians. Methods - We analysed rs9939609 in two studies of Pakistani individuals: 1666 adults aged = 40 years from the Karachi population-based Control of Blood Pressure and Risk Attenuation (COBRA) study and 2745 individuals of Punjabi ancestry who were part of a Type 2 diabetes case–control study (UK Asian Diabetes Study/Diabetes Genetics in Pakistan; UKADS/DGP). The main outcomes were BMI, waist circumference and diabetes. Regression analyses were performed to determine associations between FTO alleles and outcomes. Summary estimates were combined in a meta-analysis of 8091 South Asian individuals (3919 patients with Type 2 diabetes and 4172 control subjects), including those from two previous studies. Results - In the 4411 Pakistani individuals from this study, the age-, sex- and diabetes-adjusted association of FTO variant rs9939609 with BMI was 0.45 (95% CI 0.24–0.67) kg/m2 per A-allele (P = 3.0 × 10-5) and with waist circumference was 0.88 (95% CI 0.36–1.41) cm per A-allele (P = 0.001). The A-allele (30% frequency) was also significantly associated with Type 2 diabetes [per A-allele odds ratio (95% CI) 1.18 (1.07–1.30); P = 0.0009]. A meta-analysis of four South Asian studies with 8091 subjects showed that the FTO A-allele predisposes to Type 2 diabetes [1.22 (95% CI 1.14–1.31); P = 1.07 × 10-8] even after adjusting for BMI [1.18 (95% CI 1.10–1.27); P = 1.02 × 10-5] or waist circumference [1.18 (95% CI 1.10–1.27); P = 3.97 × 10-5]. Conclusions - The strong association between FTO genotype and BMI and waist circumference in South Asians is similar to that observed in Europeans. In contrast, the strong association of FTO genotype with diabetes is only partly accounted for by BMI.

Debate : arm's- length bodies and alternative models of service delivery

This article reflects on the UK coalition government’s ‘alternative models’ agenda, specifically in terms of the adoption of new models of service delivery by arm’s-length bodies (ALBs). It provides an overview of the alternative models agenda and discusses barriers to implementation. These include practical challenges involved in the set up of alternative models, the role of sponsor departments, and the effective communication of best practice. Finally, the article highlights some issues for further discussion.

Delegation in hard times:the financial management of arm's length bodies in the UK

This paper explores the effectiveness of financial management tools in regulating the use of resources by arm’s length bodies (ALBs) in a period of fiscal stress. The paper presents research undertaken into the implementation of a new financial management tool for ALBs in the UK since the 2008 financial crisis. Drawing on conflict ambiguity theory, the paper shows how the effectiveness of such tools is affected by deep-rooted tensions implicit within arm’s length governance. This gives rise to micro-level conflict over the means of achieving fiscal regulation, underpinned by macro-level ambiguity over the logic of governance pursued by the government.

High frequency inverter topologies integrated with the coupled inductor bridge arm

A new topology of the high frequency alternating current (HFAC) inverter bridge arm is proposed which comprises a coupled inductor, a switching device and an active clamp circuit. Based on it, new single-phase and threephase inverters are proposed and their operating states are analysed along with the traditional H-bridge inverter. Multiphase and multi-level isolated inverters are also developed using the HFAC bridge arm. Furthermore, based on the proposed HFAC, a front-end DC-DC converter is also developed for photovoltaic systems to demonstrate the application of the proposed HFAC converter. Simulation and experimental results from prototype converters are carried out to validate the proposed topologies which can be utilised widely in high frequency power conversion applications such as induction heating and wireless power transfer.

Biological factors affecting sea survival of Atlantic salmon Salmo salar L., in Western Arm Brook and an analysis of selection by the commercial fishery of nearby St. Barbe Bay, Newfoundland

The problems faced by scientists in charge of managing Atlantic salmon (Salmo salar) stocks are : i) how to maintain spawning runs consisting of repeat spawners and large multi-sea-winter (MSW) adults in the face of selective homewater and distant commercial fisheries and , ii) how to more accurately predict returns of adults. Using data from scales collected from maiden Atlantic salmon grilse from two locations on the Northern Peninsula of Newfoundland, St. Barbe Bay and Western Arm Brook, their length at smolting was back calculated. These data were then used to examine whether the St. Barbe commercial fishery is selective for salmon of particular smolt age and/or size. Analysis indicated that come commercial fishery selected larger, but not necessarily older adults that those escaping to Western Arm Brook over the period of this study, 1978-1987. It was determined that less than average size smolts survived better than above average size smolts. Slection for repeat spawners, large MSW salmon, and larger grilse has meant reductions in the proportions of these adults in the spawning runs on Western Arm Brook. This may impact the Western Arm Brook salmon stock by increasing the population instability. Sea survival was significantly correlated with selection by the commercial fishery. Characteristics of adults in Western Arm Brook during the period of study (1978-1987) did not help in explaining yearly variation in sea survival. The characteristics of smolts, however, when subjected to multiple regression analysis explained 57.2 percent of the yearly variation in sea survival.

A ROS-based Workspace Control and Trajectory Planner for a seven degrees of freedom Robotic arm

In this Bachelor Thesis I want to provide readers with tools and scripts for the control of a 7DOF manipulator, backed up by some theory of Robotics and Computer Science, in order to better contextualize the work done. In practice, we will see most common software, and developing environments, used to cope with our task: these include ROS, along with visual simulation by VREP and RVIZ, and an almost "stand-alone" ROS extension called MoveIt!, a very complete programming interface for trajectory planning and obstacle avoidance. As we will better appreciate and understand in the introduction chapter, the capability of detecting collision objects through a camera sensor, and re-plan to the desired end-effector pose, are not enough. In fact, this work is implemented in a more complex system, where recognition of particular objects is needed. Through a package of ROS and customized scripts, a detailed procedure will be provided on how to distinguish a particular object, retrieve its reference frame with respect to a known one, and then allow navigation to that target. Together with technical details, the aim is also to report working scripts and a specific appendix (A) you can refer to, if desiring to put things together.

Evaluación del rendimiento de un planificador de tareas sobre una plataforma heterogénea ARM+DSP de Texas Instruments

El presente trabajo estudia la viabilidad a la hora de aplicar un modelo de programación basado en la extracción de paralelismo a nivel de tareas sobre distintas arquitecturas heterogéneas basadas en un procesador multinúcleo de propósito general acelerado con uno o más aceleradores hardware. Se ha implementado una aplicación completa cuyo objetivo es la detección de bordes en una imagen (implementando el Algoritmo de Canny), y se ha evaluado en detalle su rendimiento sobre distintos tipos de arquitecturas, incluyendo CPUs multinúcleo de última generación, sistemas multi-GPU y una arquitectura objetivo basada en procesadores ARM Cortex-A15 acelerados mediante un DSP C66x de la compañía Texas Instruments. Los resultados experimentales demuestran la viabilidad de este tipo de implementación también para arquitecturas heterogéneas novedosas como esta última, e ilustran la facilidad de programación que introduce este tipo de modelos de programación sobre arquitecturas de propósito específico.

Data feedback and behavioural change intervention to improve primary care prescribing safety (EFIPPS) : multicentre, three arm, cluster-randomised controlled trial

Funding and trial registration: Scottish Government Chief Scientist Office grant CZH/3/17. ClinicalTrials.gov registration NCT01602705.

Control of posture and stability of the double-joint (Shoulder/Elbow) arm

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.