Stratégies de communication au service de la formation: quelques outils pratiques [Effective communication strategies to frame the trainer-trainee dialogue in the clinical setting].

Communication between trainer and trainee plays a central role in teaching and learning in the clinical environment. There are various strategies to frame the dialogue between trainee and trainer. These strategies allow trainers to be more effective in their supervision, which is important in our busy clinical environment. Communication strategies are well adapted to both in- and out-patient settings, to both under- and postgraduate contexts. This article presents three strategies that we think are particularly useful. They are meant to give feedback, to ask questions and to present a case.

Monotherapy or Polytherapy for First-Line Treatment of SE?

Status epilepticus (SE) is one of the most frequent neurologic emergencies, and a rapid and effective treatment is warranted. Current guidelines recommend a stepwise approach using a sequence of different antiepileptic drugs with benzodiazepines (BZD) being the first treatment proposed. To provide the more effective treatment as soon as possible, some authors have suggested using a combined polytherapy as first-line treatment. Strong evidence supports the use of benzodiazepines, mostly lorazepam and midazolam as initial monotherapy treatment for SE. Insufficient data are available to support the use of nonsedating antiepileptic drugs as phenytoin, valproic acid, or levetiracetam without a previous benzodiazepine administration. Studies assessing the role of a combined initial therapy are rare, if not missing. Moreover, owing the wide range of SE etiologies, a "one fits all" initial polytherapy seems difficult to achieve. After reviewing the available evidence, guidelines, and current practices regarding monotherapy and polytherapy as first-line treatment in SE in adults, the authors propose a rational algorithm for early antiseizure treatment in SE.

Proposta i aplicació pràctica per la millora de la velocitat amb canvi de direcció en un equip aleví de futbol femení

L’objectiu del present estudi es realitzar una proposta i una aplicació pràctica per comprovar els efectes d’entrenament que genera sobre la velocitat amb el canvi de direcció. Per poder dur a terme la investigació, es van reunir a 11 jugadores (11.25 ± 0.79 d’edat) d’un mateix equip que competeixen a la categoria aleví. Es va crear un grup experimental (GEX) format per sis jugadores, el qual va ser sotmès al programa d’entrenament juntament al realitzat habitualment amb el seu equip. Els exercicis realitzats en el programa eren de pliometria amb salts a tanques petites i a bancs, circuits de carreres amb canvis de direcció i exercicis pliomètrics de baix impacte mitjançant un treball de peus coordinatius a l’escala de coordinació, tot això, alternat amb els jocs tradicionals de persecució i oposició. Es va crear un segon grup, anomenat grup control (GC) format per cinc jugadores, les quals només van realitzar el seu treball de futbol habitual amb el seu equip. Els protocols d’avaluació van ser el Test Illinois i el T-Test abans de l’inici del programa i després de l’aplicació pràctica amb el grup experimental. Es va establir un nivell de significació de p<0.05. Els resultats al final de l’estudi van mostrar que el grup GEX va millorar de manera estadísticament significativa en els dos tests, tot i això, el grup GC va obtenir una millora encara més significativa que el GEX en el Test Illinois. Això ens demostra que el programa d’entrenament realitzat es més efectiu en T-Test que no pas en el Test Ilinois.

Chemistry and light - part 2: light and energy

The conversion of solar energy into more useful forms of energy, such as chemical fuels or electricity, is one of the central problems facing modern science. Progress in photochemistry and chemical synthesis has led to a point where light energy conversion by means of artificial molecular devices can be rationally attempted. In this article, a general approach towards this challenging goal is presented.

Simuloinnin hyödyntäminen ajoneuvon kestoikäanalyysissä

Diplomityö tehtiin Patria Land & Armament Oy:n toimeksiannosta. Patria Land & Armament Oy:n tuotteisiin kuuluvat vaativiin maasto-olosuhteisiin soveltuvat sotilasajoneuvot. Tuotesuunnittelussa otetaan huomioon ajoneuvon koko elinkaari, joten väsymismitoitus ja kestoikäanalyysit ovat suunnittelun tärkeitä osa-alueita. Kestoikäanalyysit ovat perinteisesti pohjautuneet mittausten avulla määritettyyn jännityshistoriaan. Työn tavoitteena oli tutkia tietokonesimuloinnin soveltuvuutta maastoajoneuvon jännityshistorian määrittämiseen. Selvityksen perusteella muodostettiin kohdeyrityksen tarpeisiin soveltuva ja kestoikäanalyysiä helpottava simulointiympäristö. Tietokonesimuloinnin tuloksien tarkkuutta tutkittiin mittaamalla todellisen ajoneuvon käyttäytymistä. Simulointiympäristö toteutettiin analysoimalla joustavia kappaleita ADAMS dynamiikkaohjelmistolla. Kappaleiden joustavuus mallinnettiin kelluvan koordinaatiston menetelmällä ja siihen käytettiin PATRAN/NASTRAN elementtimenetelmäohjelmistoa. Simulointiympäristön toimivuus testattiin case-esimerkin avulla. Esimerkissä tutkittiin AMV:n alatukivarren rasituksia. Tuloksista havaittiin, että simuloimalla on mahdollista tuottaa maastoajoneuvon rakenteiden jännityshistoria. Eri parametrien tutkiminen onnistuu vaivattomasti, mutta simuloimalla määritetyn kestoiän absoluuttisiin arvoihin tulee suhtautua varauksella.

Implications, large and small, from chemical education research for the teaching of chemistry

Research studies in chemical education pose a communication problem for chemists. Unlike the findings from other specializations in chemistry the findings in chemical education tend to be reported in education journals that are not readily accessible to most chemists or chemistry teachers. This lecture is an attempt to remedy this gap in communication. Research studies fall into three broad categories. (i) issues related to the content of chemistry itself, that is, What content to teach? And What meaning of each topic is to be conveyed? (ii) issues related to how chemical content is taught, such as, the role of lectures, practical work, particular pedagogies, etc. and (iii) issues related to its learning, that is, learning of concepts, conceptual change, motivation, etc. Findings in each of these categories of research over the last twenty years have drawn attention to opportunities for improving the quality of chemical education in each of the levels of formal education where chemistry is taught. Sometimes the research findings seem small since they, in fact, merely diagnose the actual problem in teaching and learning. At other times, the research findings are large because they provide a solution to these problems. What remains to be done is to disseminate the findings so that appropriate teaching occurs more widely, with its consequent gains in the quality of learning. Research findings, of these small and large types will be used to illustrate the potential of research to make the practice of chemical education more effective.

Akku ja vetypolttokenno sähköauton voimanlähteenä

Tässä kandidaatintyössä on käsitelty akkuja ja vetypolttokennoja sähköauton voimanlähteenä. Työssä on esitelty sähköautojen ja niiden voimanlähteiden teknologioiden periaatteita, energiankantajia, hyötysuhteita ja päästöjä. Lisäksi on tarkasteltu polttomoottorikäyttöisiä autotekniikoita vertailukohdan saamiseksi. Työn lopuksi on analysoitu sähköautojen markkinoita ja niiden yleistymiseen vaikuttavia tekijöitä. Sähköautot mahdollistavat vaihtoehtoisten energialähteiden käytön, joka antaa tilaisuuden saasteiden ja päästöjen keskitettyyn vähentämiseen ja talteenottoon. Niiden avulla päästään myös pois öljyriippuvuudesta ja paikallisesti aiheutuneista päästöistä. Nykyisten polttoaineiden helpon käsiteltävyyden, kohtuullisien energiatiheyksien ja laajojen infrastruktuurien vuoksi käytössä olevien tekniikoiden syrjäyttäminen on vaikeaa. Uusien tekniikoiden etuja ja haittoja voidaan tarkastella yksinkertaisilla metodeilla, kuten kustannusten, hyötysuhteiden, päästöjen ja polttoaineiden elinkaarien vertailulla. Vertailua vaikeuttaa tosin hintatasojen ja verotuksen eroavaisuudet eri maissa, ja se on siksi suoritettava osin maakohtaisesti. Suurimpia esteitä uusille tekniikoille ovat tällä hetkellä niiden tuomat lisäkustannukset, infrastruktuurien puuttuminen ja nykyisten polttoaineiden korvaaminen toisella.

Improving Label Space Usage for Ethernet Label Switched Paths

Ethernet is becoming the dominant aggregation technology for carrier transport networks; however, as it is a LAN technology, native bridged ethernet does not fulfill all the carrier requirements. One of the schemes proposed by the research community to make ethernet fulfill carrier requirements is ethernet VLAN-label switching (ELS). ELS allows the creation of label switched data paths using a 12-bit label encoded in the VLAN TAG control information field. Previous label switching technologies such as MPLS use more bits for encoding the label. Hence, they do not suffer from label sparsity issues as ELS might. This paper studies the sparsity issues resulting from the reduced ELS VLAN-label space and proposes the use of the label merging technique to improve label space usage. Experimental results show that label merging considerably improves label space usage

El proceso de valoración de programas preventivos en drogodependencias

Programs evaluation is one of the models developed in the field of Psychological Assessment for determining how interventions or programmes aimed at promoting changes in the social context work. Drug preventive interventions have been the specific object of this type of evaluation. The present study describes stages involved in evaluating drug preventive programs and contemplates the main considerations to take into account to make this type of evaluation more effective in line with recommendations by the main programs evaluation guides

Métodos imunoquímicos para análise de contaminantes ambientais: conceitos, estado da arte e perspectivas

Immunoassay techniques provide simple, powerful and inexpensive methods for analysis of environmental contaminants. However, the acceptance of immunoassays is dependent on the clear demonstration of quality and validity compared to more traditional techniques. In this review, primarily, the understanding and the fundamentals of immunoassay methods are given in order to make good use of immunoassays, especially of EIA tests. Special attention is given to the concepts related to the enzyme-linked immunosorbent assay (ELISA) formats, such as inhibition concentration at 50% (IC50), detection limit (LOD), cross-reactivity (CR %). It is also explained why some immunoassays are quantitative methods whereas others can only be used as screening methods. A list of main commercial kits for detection of priority pollutants is given in order to help analysts. Others formats, such as flow-injection immunoassay analysis (FIIA), immunoassay chromatography and immunosensors are also cited.

Creating dynamic continuous improvement system for Larox Corporation

Today´s organizations must have the ability to react to rapid changes in the market. These rapid changes cause pressure to continuously find new efficient ways to organize work practices. Increased competition requires businesses to become more effective and to pay attention to quality of management and to make people to understand their work's impact on the final result. The fundamentals in continmuois improvement are systematic and agile tackling of indentified individual process constraints and the fact tha nothin finally improves without changes. Successful continuous improvement requires management commitment, education, implementation, measurement, recognition and regeneration. These ingredients form the foundation, both for breakthrough projects and small step ongoing improvement activities. One part of the organization's management system are the quality tools, which provide systematic methodologies for identifying problems, defining their root causes, finding solutions, gathering and sorting of data, supporting decision making and implementing the changes, and many other management tasks. Organizational change management includes processes and tools for managing the people in an organizational level change. These tools include a structured approach, which can be used for effective transition of organizations through change. When combined with the understanding of change management of individuals, these tools provide a framework for managing people in change,

Palveluiden hankintaprosessin tehostaminen

Tämän pro gradu- tutkielman tavoitteena on löytää keinoja Yleisradio Oy:n palveluiden hankintaprosessiin tehostamiseen. Tarkastelussa huomioitiin hankintojen nykytila ja sen sisältämät ongelmat. Isona osana analysointia oli julkisten hankintojen sääntöjen ja säännösten peilaaminen hankintaprosessiin. Tutkimuksessa hyödynnetään kvalitatiivista tutkimusmenetelmää sekä case – tutkimusta. Tutkielman teoriaosa luo pohjan empiirisen osan analysoinnille, jossa nostetaan esiin julkisen hankinnan sääntöjen noudattamisen haasteet hankintaprosessissa. Tutkimuksessa ilmeni, että palveluiden hankinnan tehostaminen vaatii kaikilta sidosryhmiltä panostusta jokaiseen prosessin vaiheeseen. Tulevaisuudessa menestyksekkääseen palveluiden hankintaan tarvitaan selkeät pelisäännöt, joiden toteutumisessa jokaisella on vastuu

Utilização de diferentes tipos de policloretos de alumínio para purificação de hidrolisado de bagaço de cana através da técnica de coagulação e floculação

In order to investigate the action of the flocculating agents Panfloc and Panclar a full factorial design 2³ and a Central Composite design 2² were carried out. The control variables were the flocculant concentration, pH and temperature. The response variables were phenolic compounds reduction and spectral area reduction. The best conditions of treatment was hydrolyzate at pH 9 for both coagulants, but the use of Panfloc was more effective in the phenolic compounds reduction (73.9%) and spectral area reduction (65.8%).

Caracterização físico-química do fármaco antichagásico benznidazol

Currently, benznidazole (BNZ) is a unique therapeutic alternative available in Brazil to treat Chagas disease. Despite its traditional medical use, little is known about the chemical nature of this drug. A detailed study of the physicochemical properties of BNZ was performed using multiple assays. Thermal, diffractometric, morphological and reological drug profiles were obtained. The partition coefficient and solubility results allowed this drug to be classified as a class IV drug according to the biopharmaceutical classification system. This information will be useful for the development of more effective BNZ formulations and for establishing the quality profile of BNZ.

Wet oxidation of recalcitrant lignin waters: Experimental and kinetic studies

The dissertation is based on four articles dealing with recalcitrant lignin water purification. Lignin, a complicated substance and recalcitrant to most treatment technologies, inhibits seriously pulp and paper industry waste management. Therefore, lignin is studied, using WO as a process method for its degradation. A special attention is paid to the improvement in biodegradability and the reduction of lignin content, since they have special importance for any following biological treatment. In most cases wet oxidation is not used as a complete ' mineralization method but as a pre treatment in order to eliminate toxic components and to reduce the high level of organics produced. The combination of wet oxidation with a biological treatment can be a good option due to its effectiveness and its relatively low technology cost. The literature part gives an overview of Advanced Oxidation Processes (AOPs). A hot oxidation process, wet oxidation (WO), is investigated in detail and is the AOP process used in the research. The background and main principles of wet oxidation, its industrial applications, the combination of wet oxidation with other water treatment technologies, principal reactions in WO, and key aspects of modelling and reaction kinetics are presented. There is also given a wood composition and lignin characterization (chemical composition, structure and origin), lignin containing waters, lignin degradation and reuse possibilities, and purification practices for lignin containing waters. The aim of the research was to investigate the effect of the operating conditions of WO, such as temperature, partial pressure of oxygen, pH and initial concentration of wastewater, on the efficiency, and to enhance the process and estimate optimal conditions for WO of recalcitrant lignin waters. Two different waters are studied (a lignin water model solution and debarking water from paper industry) to give as appropriate conditions as possible. Due to the great importance of re using and minimizing the residues of industries, further research is carried out using residual ash of an Estonian power plant as a catalyst in wet oxidation of lignin-containing water. Developing a kinetic model that includes in the prediction such parameters as TOC gives the opportunity to estimate the amount of emerging inorganic substances (degradation rate of waste) and not only the decrease of COD and BOD. The degradation target compound, lignin is included into the model through its COD value (CODligning). Such a kinetic model can be valuable in developing WO treatment processes for lignin containing waters, or other wastewaters containing one or more target compounds. In the first article, wet oxidation of "pure" lignin water was investigated as a model case with the aim of degrading lignin and enhancing water biodegradability. The experiments were performed at various temperatures (110 -190°C), partial oxygen pressures (0.5 -1.5 MPa) and pH (5, 9 and 12). The experiments showed that increasing the temperature notably improved the processes efficiency. 75% lignin reduction was detected at the lowest temperature tested and lignin removal improved to 100% at 190°C. The effect of temperature on the COD removal rate was lower, but clearly detectable. 53% of organics were oxidized at 190°C. The effect of pH occurred mostly on lignin removal. Increasing the pH enhanced the lignin removal efficiency from 60% to nearly 100%. A good biodegradability ratio (over 0.5) was generally achieved. The aim of the second article was to develop a mathematical model for "pure" lignin wet oxidation using lumped characteristics of water (COD, BOD, TOC) and lignin concentration. The model agreed well with the experimental data (R2 = 0.93 at pH 5 and 12) and concentration changes during wet oxidation followed adequately the experimental results. The model also showed correctly the trend of biodegradability (BOD/COD) changes. In the third article, the purpose of the research was to estimate optimal conditions for wet oxidation (WO) of debarking water from the paper industry. The WO experiments were' performed at various temperatures, partial oxygen pressures and pH. The experiments showed that lignin degradation and organics removal are affected remarkably by temperature and pH. 78-97% lignin reduction was detected at different WO conditions. Initial pH 12 caused faster removal of tannins/lignin content; but initial pH 5 was more effective for removal of total organics, represented by COD and TOC. Most of the decrease in organic substances concentrations occurred in the first 60 minutes. The aim of the fourth article was to compare the behaviour of two reaction kinetic models, based on experiments of wet oxidation of industrial debarking water under different conditions. The simpler model took into account only the changes in COD, BOD and TOC; the advanced model was similar to the model used in the second article. Comparing the results of the models, the second model was found to be more suitable for describing the kinetics of wet oxidation of debarking water. The significance of the reactions involved was compared on the basis of the model: for instance, lignin degraded first to other chemically oxidizable compounds rather than directly to biodegradable products. Catalytic wet oxidation of lignin containing waters is briefly presented at the end of the dissertation. Two completely different catalysts were used: a commercial Pt catalyst and waste power plant ash. CWO showed good performance using 1 g/L of residual ash gave lignin removal of 86% and COD removal of 39% at 150°C (a lower temperature and pressure than with WO). It was noted that the ash catalyst caused a remarkable removal rate for lignin degradation already during the pre heating for `zero' time, 58% of lignin was degraded. In general, wet oxidation is not recommended for use as a complete mineralization method, but as a pre treatment phase to eliminate toxic or difficultly biodegradable components and to reduce the high level of organics. Biological treatment is an appropriate post treatment method since easily biodegradable organic matter remains after the WO process. The combination of wet oxidation with subsequent biological treatment can be an effective option for the treatment of lignin containing waters.