Carbon supported electrocatalysts prepared by the sol-gel method and their utilization for the oxidation of methanol in acid media

One of the key objectives in fuel-cell technology is to improve the performance of the anode catalyst for the alcohol oxidation and reduce Pt loading. Here, we show the use of six different electrocatalysts synthesized by the sol -gel method on carbon powder to promote the oxidation of methanol in acid media. The catalysts Pt-PbO(x) and Pt-(RuO(2)-PbO(x)) with 10% of catalyst load exhibited significantly enhanced catalytic activity toward the methanol oxidation reaction as compared to Pt-(RuO(2))/C and Pt/C electrodes. Cyclic voltammetry studies showed that the electrocatalysts Pt-PbO(x)/C and Pt-(RuO(2)-PbO(x))/C started the oxidation process at extremely low potentials and that they represent a good novelty to oxidize methanol. Furthermore, quasi-stationary polarization experiments and cronoamperometry studies showed the good performance of the Pt-PbO(x), Pt-(RuO(2)-PbO(x))/C and Pt-(RuO(2)-IrO(2))/C catalysts during the oxidation process. Thus, the addition of metallic Pt and PbO(x) onto high-area carbon powder, by the sol -gel route, constitutes an interesting way to prepare anodes with high catalytic activity for further applications in direct methanol fuel cell systems.

Condoms and Healthcare professionals : Risk-behavior and attitudes towards condom use

Alarming S.T.I’s percentages and low condom use motivated this research. Healthcare professional’s risk-behavior and attitudes towards risk-behavior were reviewed. Three hypotheses, aimed to test whether healthcare professionals working with S.T.I’s should have a different attitude, knowledge and behavior to condom use compared to healthcare professionals that did not work with S.T.I’s. Ninety-five participants working at a hospital in middle-Sweden answered a questionnaire, based on the Swedish UNGKAB09 research. Mann-Whitney analyses showed no significant difference between the two groups on knowledge, attitude and behavior. A high percentage of steady relationships, high homogeneity between groups as well the same attitudes and intentions could have been a reliability problem. The collected data was however interesting as a base for further research

Nurses' research utilization two years after graduation : a national survey ofassociated individual, organizational, and educational factors

Background. Nurses' research utilization (RU) as part of evidence-based practice is strongly emphasized in today's nursing education and clinical practice. The primary aim of RU is to provide high-quality nursing care to patients. Data on newly graduated nurses' RU are scarce, but a predominance of low use has been reported in recent studies. Factors associated with nurses' RU have previously been identified among individual and organizational/contextual factors, but there is a lack of knowledge about how these factors, including educational ones, interact with each other and with RU, particularly in nurses during the first years after graduation. The purpose of this study was therefore to identify factors that predict the probability for low RU among registered nurses two years after graduation. Methods. Data were collected as part of the LANE study (Longitudinal Analysis of Nursing Education), a Swedish national survey of nursing students and registered nurses. Data on nurses' instrumental, conceptual, and persuasive RU were collected two years after graduation (2007, n = 845), together with data on work contextual factors. Data on individual and educational factors were collected in the first year (2002) and last term of education (2004). Guided by an analytic schedule, bivariate analyses, followed by logistic regression modeling, were applied. Results. Of the variables associated with RU in the bivariate analyses, six were found to be significantly related to low RU in the final logistic regression model: work in the psychiatric setting, role ambiguity, sufficient staffing, low work challenge, being male, and low student activity. Conclusions. A number of factors associated with nurses' low extent of RU two years postgraduation were found, most of them potentially modifiable. These findings illustrate the multitude of factors related to low RU extent and take their interrelationships into account. This knowledge might serve as useful input in planning future studies aiming to improve nurses', specifically newly graduated nurses', RU.

Shared-decision making in designing new healthcare environments : ready to take off for improved quality

Background Successful implementation of new methods and models of healthcare to achieve better patient outcomes and safe, person-centered care is dependent on the physical environment of the healthcare architecture in which the healthcare is provided. Thus, decisions concerning healthcare architecture are critical because it affects people and work processes for many years and requires a long-term financial commitment from society. In this paper, we describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new healthcare environments. Discussion This paper discusses challenges and hindrances observed in the literature and from the authors extensive experiences in the field of planning and designing healthcare environments. An overview is presented of the challenges and new approaches for a process that involves the mutual exchange of knowledge among various stakeholders. Additionally, design approaches that balance the influence of specific and local requirements with general knowledge and evidence that should be encouraged are discussed. Summary We suggest a shared-decision making and collaborative planning and design process between representatives from healthcare, construction sector and architecture based on evidence and end-users’ perspectives. If carefully and systematically applied, this approach will support and develop a framework for creating high quality healthcare environments.

Healthcare providers balancing norms and practice : challenges and opportunities in providing contraceptive counselling to young people in Uganda - a qualitative study

BACKGROUND: Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. OBJECTIVE: This study aims to explore healthcare providers' (HCPs) perceptions and practices regarding contraceptive counselling to young people. DESIGN: We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC) but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. RESULTS: The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A) HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B) highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. CONCLUSIONS: Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy with practical guidelines should be implemented alongside in-service training including value clarification and attitude transformation to equip providers to be able to better cater to young people seeking sexual and reproductive health advice.

Provenance in Agent-mediated Healthcare Systems

Agent-oriented cooperation techniques and standardized electronic healthcare record exchange protocols can be used to combine information regarding different facets of a therapy received by a patient from different healthcare providers at different locations. Provenance is an innovative approach to trace events in complex distributed processes, dependencies between such events, and associated decisions by human actors. We focus on three aspects of provenance in agent-mediated healthcare systems: first, we define the provenance concept and show how it can be applied to agent-mediated healthcare applications; second, we investigate and provide a method for independent and autonomous healthcare agents to document the processes they are involved in without directly interacting with each other; and third, we show that this method solves the privacy issues of provenance in agent-mediated healthcare systems.

Relação entre os atributos de qualidade de um serviço de reabilitação ambulatorial e os padrões do modelo de acreditação Joint Commission on Accreditation of Healthcare Organizations : a visão do cliente

Mostra evidências de relação entre os atributos de qualidade de um serviço de realibilitação ambulatorial sob a percepção do cliente e os padrões do modelo internacional de acreditação de serviço de saúde.

Courts as healthcare policy-makers: the problem, the responses to the problem and problems in the responses

This article starts by analysing healthcare litigation in Brazil by means of a literature review of articles that contribute with empirical findings on this phenomenon. Based on this review, I argue that health care litigation in Brazil makes the public health system less fair and rational. In the second part of this article, I discuss the three most overarching responses to control the level of litigation and its impact on the public health system: (i) the public hearing held by the Supreme Federal Court and the criteria the court established thereafter; (ii) the recommendations by the National Council of Justice aimed at building courts’ institutional capacity; and (iii) the enactment of the Federal Law 12.401/11, which created a new health technology assessment system. I argue that latter is the best response because it keeps the substantive decisions on the allocation of healthcare resources in the institution that is in the best position to make them. Moreover, this legislation will make the decisions about provision of health treatments more explicit, making easier for courts to control the procedure and the reasons for these decisions.

Utilization of macrophyte biofilter in effluent from aquaculture: I. Floating plant

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Amylase utilization for the extrusion of dog diets

Effects of amylase addition on extruder parameters, cost of extrusion, kibble quality and digestibility of dog food were measured in two separate experiments. In experiment 1, 120 kilo-novo-alpha-amilase-unit (KNU)/kg of heat stable alpha-amylase produced by Bacillus licheniformis was added in liquid form during a preconditioning period. In experiment 23684 KNU/kg of heat stable alpha-amylase produced by Aspergillus oryzae was mixed with the ingredients before extrusion. The diets were processed in a single screw extruder and submitted to digestibility and on experiment 1 also to palatability tests. Digestibility was tested using 12 dogs, six per diet. Data were submitted to analysis of variance followed by F-test. Amylase addition altered extrusion parameters in both experiments (P<0.05), with higher output (kg of dry matter [DM]/h: 28% and 43% higher in experiments 1 and 2) and less electric energy consumption (kW to produce 100 kg DM: 22% and 29% lower in experiments 1 and 2). Kibble appearance and quality [density (g/L), cutting force (g), and starch gelatinization degree (%)] did not change with enzyme treatment (P>0.05). Likewise, enzyme addition did not change nutrient digestibility, fecal dry matter or food palatability (P<0.05). Taken together our results suggest that amylase promoted the breakdown of amylose chains, thereby reducing the dough viscosity and resistance inside the extruder which allowed for higher product flow and less electricity energy consumption without altering food quality. (C) 2012 Elsevier B.V. All rights reserved.

Kinetic Analysis of Substrate Utilization by Native and TNAP-, NPP1-, or PHOSPHO1-Deficient Matrix Vesicles

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Pearl millet utilization in ccommercial laying hen diets formulated on a total or digestible amino acid basis

An experiment was carried out to evaluate the effect of replacing corn with pearl millet in commercial layer diets, formulated according to the minimal requirements for total and digestible amino acids. Two hundred and forty Lohmann LSL laying hens with 25 weeks of age were distributed in a completely randomized experimental design according to a 2 x 5 factorial arrangement with 3 replicates of 8 birds. Feed was formulated on two amino acid basis (total or digestible) according to Rostagno et al. (2000) and there were five pearl millet inclusion levels (0%, 25%, 50%, 75%, and 100%). Performance and egg quality were evaluated during five periods of 21 days.At the end of each period, feed intake, egg production, egg weight and feed conversion were evaluated. In the last three days of each period, the following egg quality parameters were evaluated: Haugh Unit, yolk pigmentation index, egg specific weight, shell percentage and shell thickness. Digestible amino acid requirements resulted in decreased feed intake (p<0.01) and increased production costs per mass of eggs (kg) or per dozen eggs (p<0.01) compared to total amino acid requirements. There was a linear reduction in feed intake, egg production, egg weight and yolk pigmentation index with increasing inclusion levels of pearl millet. Therefore, increasing levels of replacement of corn by pearl millet affected bird performance negatively. Besides, production costs were higher with increasing pearl millet levels.

Modeling energy utilization in broiler breeders, laying hens and broilers

The factorial approach has been used to partition the energy requirements into maintenance, growth, and production. The coefficients determined for these purposes can be used to elaborate energy requirement models. These models consider the body weight, weight gain, egg production, and environmental temperature to determine the energy requirements for poultry. Predicting daily energy requirement models can help to establish better and more profitable feeding programs for poultry. Studies were conducted at UNESP-Jaboticabal to determine metabolizable energy (ME) requirement models for broiler breeders, laying hens, and broilers. These models were evaluated in performance trials and provided good adjustments. Therefore, they could be used to establish nutritional programs. This review aims to outline the results found at UNESP studies and to show the application of models in nutritional programs for broiler breeders, laying hens, and broilers.