1000 resultados para Continuity Conditions


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Abstract: The objective of this work was to evaluate Trichoderma harzianum isolates for biological control of white mold in common bean (Phaseolus vulgaris). Five isolates were evaluated for biocontrol of white mold in 'Perola' common bean under field conditions, in the 2009 and 2010 crop seasons. A commercial isolate (1306) and a control treatment were included. Foliar applications at 2x109 conidia mL-1 were performed at 42 and 52 days after sowing (DAS), in 2009, and at 52 DAS in 2010. The CEN287, CEN316, and 1306 isolates decreased the number of Sclerotinia sclerotiorum apothecia per square meter in comparison to the control, in both crop seasons. CEN287, CEN316, and 1306 decreased white mold severity during the experimental period, when compared to the control.

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Although interpersonal continuity is commonly assumed to be essential for care, some patients prefer to attend a university outpatient clinic where physicians change regularly and interpersonal continuity of care is not ensured. The aim of this exploratory study was to evaluate the differences between patients attending a university outpatient clinic and patients frequenting a private practice, explore their patterns of care-seeking and their understanding of continued care. We conducted a cross-sectional study of patients attending the university medical outpatient clinic (OC) in Lausanne, Switzerland and ten randomly selected private general practices (PP). Eligible patients were >30 years, Swiss nationals or long term residents, with one or more chronic conditions and attending the same practice for >3 years. They were asked to complete a questionnaire on sociodemographic data, use of medical resources and reasons for choosing and remaining at the same practice. Semi-structured interviews were conducted with a randomly selected subset of 26 patients to further explore their preferences. 329 patient questionnaires were completed, 219 by PP and 110 by OC patients. OC patients tended to be of lower socioeconomic status than PP patients. The main reason for choosing a PP were personal recommendation, while a higher percentage of patients chose the OC because they could obtain a first appointment quickly. A higher percentage of PP patients accorded importance to physician communication skills and trust, whereas a higher percentage of OC patients favoured investigation facilities. Qualitative data suggested that although OC and PP patients reported different reasons for consulting, their expectations on the medical and relationship level were similar. Our study suggests that the two groups of patients belong to different social backgrounds, have different patterns of care-seeking and attach importance to different aspects of care continuity. However, patients' expectations and perceptions of the physician-patient relationship are similar.

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BACKGROUND: Regional rates of hospitalization for ambulatory care sensitive conditions (ACSC) are used to compare the availability and quality of ambulatory care but the risk adjustment for population health status is often minimal. The objectives of the study was to examine the impact of more extensive risk adjustment on regional comparisons and to investigate the relationship between various area-level factors and the properly adjusted rates. METHODS: Our study is an observational study based on routine data of 2 million anonymous insured in 26 Swiss cantons followed over one or two years. A binomial negative regression was modeled with increasingly detailed information on health status (age and gender only, inpatient diagnoses, outpatient conditions inferred from dispensed drugs and frequency of physician visits). Hospitalizations for ACSC were identified from principal diagnoses detecting 19 conditions, with an updated list of ICD-10 diagnostic codes. Co-morbidities and surgical procedures were used as exclusion criteria to improve the specificity of the detection of potentially avoidable hospitalizations. The impact of the adjustment approaches was measured by changes in the standardized ratios calculated with and without other data besides age and gender. RESULTS: 25% of cases identified by inpatient main diagnoses were removed by applying exclusion criteria. Cantonal ACSC hospitalizations rates varied from to 1.4 to 8.9 per 1,000 insured, per year. Morbidity inferred from diagnoses and drugs dramatically increased the predictive performance, the greatest effect found for conditions linked to an ACSC. More visits were associated with fewer PAH although very high users were at greater risk and subjects who had not consulted at negligible risk. By maximizing health status adjustment, two thirds of the cantons changed their adjusted ratio by more than 10 percent. Cantonal variations remained substantial but unexplained by supply or demand. CONCLUSION: Additional adjustment for health status is required when using ACSC to monitor ambulatory care. Drug-inferred morbidities are a promising approach.

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Teorian mukaan täydellisen kilpailun päästöoikeuskauppamarkkinoilla päästöoikeuden hinta muodostuu markkinoilla vallitsevan päästöjen vähentämisen rajakustannuksen perusteella. Euroopan päästökauppamarkkinoilla päästöjen vähentämisen kustannuksia nostavat suhteellisen lyhyet päästökauppajaksot ja epävarmuus järjestelmän jatkuvuudesta. Toisaalta päästökaupan osallistujien yhteenlaskettu päästöjen vähentämisen tarve lienee suhteellisen vähäinen ellei olematon ensimmäisellä päästökauppajaksolla. Euroopan päästökauppamarkkinoilla päästöjen vähentämisen tarve ja päästöjenvähentämisen kustannukset ovat osittain riippuvaisia muuttuvista tekijöistä. Päästöoikeuden hintaan voivat vaikuttaa päästökauppajakson aikana tapahtuva teollisuuden suhdannevaihtelu, polttoaineiden hintojen heilahtelut sekä säätilojen vaihtelu. Päästökaupan ensimmäisinä kuukausina päästöoikeuden hintakehityksellä on ollut yhteyksiä tekijöihin, joiden muutosten tulisikin vaikuttaa päästökauppamarkkinoiden tasapainoon. Näitä tekijöitä ovat esimerkiksi polttoainemarkkinoiden ja sähkömarkkinoiden hintakehitys sekä vaihtelut säätiloissa.

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RPE65 is a retinoid isomerase required for the production of 11-cis-retinal, the chromophore of both cone and rod visual pigments. We recently established an R91W knock-in mouse strain as homologous animal model for patients afflicted by this mutation in RPE65. These mice have impaired vision and can only synthesize minute amounts of 11-cis-retinal. Here, we investigated the consequences of this chromophore insufficiency on cone function and pathophysiology. We found that the R91W mutation caused cone opsin mislocalization and progressive geographic cone atrophy. Remnant visual function was mostly mediated by rods. Ablation of rod opsin corrected the localization of cone opsin and improved cone retinal function. Thus, our analyses indicate that under conditions of limited chromophore supply rods and cones compete for 11-cis-retinal that derives from regeneration pathway(s) which are reliant on RPE65. Due to their higher number and the instability of cone opsin, rods are privileged under this condition while cones suffer chromophore deficiency and degenerate. These findings reinforce the notion that in patients any effective gene therapy with RPE65 needs to target the cone-rich macula directly to locally restore the cones' chromophore supply outside the reach of rods.

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Tässä väitöstutkimuksessa tutkittiin fysikaaliskemiallisten olosuhteiden ja toimintaparametrien vaikutusta juustoheran fraktiointiin. Kirjallisuusosassa on käsitelty heran ympäristövaikutusta, heran hyödyntämistä ja heran käsittelyä kalvotekniikalla. Kokeellinen osa on jaettu kahteen osaan, joista ensimmäinen käsittelee ultrasuodatusta ja toinen nanosuodatusta juustoheran fraktioinnissa. Ultrasuodatuskalvon valinta tehtiin perustuen kalvon cut-off lukuun, joka oli määritetty polyetyleeniglykoliliuoksilla olosuhteissa, joissa konsentraatiopolariosaatioei häiritse mittausta. Kriittisen vuon konseptia käytettiin sopivan proteiinikonsentraation löytämiseksi ultrasuodatuskokeisiin, koska heraproteiinit ovat tunnetusti kalvoa likaavia aineita. Ultrasuodatuskokeissa tutkittiin heran eri komponenttien suodattumista kalvon läpi ja siihen vaikuttavia ominaisuuksia. Herapermeaattien peptidifraktiot analysoitiin kokoekskluusiokromatografialla ja MALDI-TOF massaspektrometrillä. Kokeissa käytettävien nanosuodatuskalvojen keskimääräinen huokoskoko analysoitiin neutraaleilla liukoisilla aineilla ja zeta-potentiaalit virtauspotentiaalimittauksilla. Aminohappoja käytettiin malliaineina tutkittaessa huokoskoon ja varauksen merkitystä erotuksessa. Aminohappojen retentioon vaikuttivat pH ja liuoksen ionivahvuus sekä molekyylien väliset vuorovaikutukset. Heran ultrasuodatuksessa tuotettu permeaatti, joka sisälsi pieniä peptidejä, laktoosia ja suoloja, nanosuodatettiin happamassa ja emäksisessä pH:ssa. Emäksisissä oloissa tehdyssä nanosuodatuksessa foulaantumista tapahtui vähemmän ja permeaattivuo oli parempi. Emäksisissä oloissa myös selektiivisyys laktoosin erotuksessa peptideistä oli parempi verrattuna selektiivisyyteen happamissa oloissa.

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The aim of this thesis was to produce information for the estimation of the flow balance of wood resin in mechanical pulping and to demonstrate the possibilities for improving the efficiency of deresination in practice. It was observed that chemical changes in wood resin take place only during peroxide bleaching, a significant amount of water dispersed wood resin is retained in the pulp mat during dewatering and the amount of wood resin in the solid phase of the process filtrates is very small. On the basis of this information there exist three parameters related to behaviour of wood resin that determine the flow balance in the process: 1. The liberation of wood resin to the pulp water phase 2. Theretention of water dispersed wood resin in dewatering 3. The proportion of wood resin degraded in the peroxide bleaching The effect of different factors on these parameters was evaluated with the help of laboratory studies and a literature survey. Also, information related to the values of these parameters in existing processes was obtained in mill measurements. With the help of this information, it was possible to evaluate the deresination efficiency and the effect of different factors on this efficiency in a pulping plant that produced low-freeness mechanical pulp. This evaluation showed that the wood resin content of mechanical pulp can be significantly decreased if there exists, in the process, a peroxide bleaching and subsequent washing stage. In the case of an optimal process configuration, as high as a 85 percent deresination efficiency seems to be possible with a water usage level of 8 m3/o.d.t.

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A study was carried out at Embrapa Semi-Árido, Petrolina-PE, Brazil, aiming to understand the gas exchange process of the umbu tree (Spondias tuberosa Arr. Cam.) in the dry and rainy seasons. Stomatal conductance, transpiration, photosynthesis and internal CO2 concentration were obtained with a portable infrared gas analyzer (IRGA). During the dry season the umbu tree showed a much lower stomatal conductance early in the morning, as soon as the vapor pressure deficit increased, apparently affecting CO2 assimilation more than transpiration. The highest values were detected around 6:00 am but decreased to the lowest points between 10:00 am and 2:00 pm. During the rainy season, however, stomatal conductance, transpiration and photosynthesis were significantly higher, reaching the highest values between 8:00 and 10:00 am and the lowest around 2:00 pm. It was also observed at 4:00 pm, mainly during the rainy season, an increase on these variables indicating that the umbu tree exhibits a two-picked daily course of gas exchange.