Paulo Orosio : una interpretación de la historiografía providencialista cristiana ante la caída de Roma en el 410

Resumen: En el entramado histórico del mundo Romano, la vida política y religiosa se han visto imbricadas de modo particular. El mito político ha sido fundamental para hilvanar el devenir de los hechos históricos centrales en el modo de vida de los romanos. La caída de Roma o el fin de la Pars Occidentalis del Imperio Romano han servido de arquetipo histórico o de referente político para el resto de los Imperios del Mundo Occidental. En ese contexto se insertará este trabajo, que pretenderá echar luz a una temática rodeada por líneas historiográficas y analíticas no solo diferentes sino antagónicas. El centro de la discordia historiográfica de hoy se pondrá en sincronía con la discordia histórica de ayer, puesto que tanto los paganos como los cristianos forjaron durante la Tardo-antigüedad un mito de fin de ciclo, que le agrega una fascinación particular a esta temática. En este trabajo me abocaré a interpretar la postura del historiador romano - cristiano Paulo Orosio, quien describió su propia visión sobre los hechos que antecedieron y provocaron, la caída de Roma.

Modeling, numerical methods, and simulation for particle-fluid two-phase flow problems

In this paper, we study the issues of modeling, numerical methods, and simulation with comparison to experimental data for the particle-fluid two-phase flow problem involving a solid-liquid mixed medium. The physical situation being considered is a pulsed liquid fluidized bed. The mathematical model is based on the assumption of one-dimensional flows, incompressible in both particle and fluid phases, equal particle diameters, and the wall friction force on both phases being ignored. The model consists of a set of coupled differential equations describing the conservation of mass and momentum in both phases with coupling and interaction between the two phases. We demonstrate conditions under which the system is either mathematically well posed or ill posed. We consider the general model with additional physical viscosities and/or additional virtual mass forces, both of which stabilize the system. Two numerical methods, one of them is first-order accurate and the other fifth-order accurate, are used to solve the models. A change of variable technique effectively handles the changing domain and boundary conditions. The numerical methods are demonstrated to be stable and convergent through careful numerical experiments. Simulation results for realistic pulsed liquid fluidized bed are provided and compared with experimental data. (C) 2004 Elsevier Ltd. All rights reserved.

A BIEM optimization method for fracture dynamics inverse problem

In the present paper, based on the theory of dynamic boundary integral equation, an optimization method for crack identification is set up in the Laplace frequency space, where the direct problem is solved by the author's new type boundary integral equations and a method for choosing the high sensitive frequency region is proposed. The results show that the method proposed is successful in using the information of boundary elastic wave and overcoming the ill-posed difficulties on solution, and helpful to improve the identification precision.

Clinical factors associated with a Candida albicans Germ Tube Antibody positive test in Intensive Care Unit patients

Background: Poor outcomes of invasive candidiasis (IC) are associated with the difficulty in establishing the microbiological diagnosis at an early stage. New scores and laboratory tests have been developed in order to make an early therapeutic intervention in an attempt to reduce the high mortality associated with invasive fungal infections. Candida albicans IFA IgG has been recently commercialized for germ tube antibody detection (CAGTA). This test provides a rapid and simple diagnosis of IC (84.4% sensitivity and 94.7% specificity). The aim of this study is to identify the patients who could be benefited by the use of CAGTA test in critical care setting. Methods: A prospective, cohort, observational multicentre study was carried out in six medical/surgical Intensive care units (ICU) of tertiary-care Spanish hospitals. Candida albicans Germ Tube Antibody test was performed twice a week if predetermined risk factors were present, and serologically demonstrated candidiasis was considered if the testing serum dilution was >= 1: 160 in at least one sample and no other microbiological evidence of invasive candidiasis was found. Results: Fifty-three critically ill non-neutropenic patients (37.7% post surgery) were included. Twenty-two patients (41.5%) had CAGTA-positive results, none of them with positive blood culture for Candida. Neither corrected colonization index nor antifungal treatment had influence on CAGTA results. This finding could corroborate that the CAGTA may be an important biomarker to distinguish between colonization and infection in these patients. The presence of acute renal failure at the beginning of the study was more frequent in CAGTA-negative patients. Previous surgery was statistically more frequent in CAGTA-positive patients. Conclusions: This study identified previous surgery as the principal clinical factor associated with CAGTA-positive results and emphasises the utility of this promising technique, which was not influenced by high Candida colonization or antifungal treatment. Our results suggest that detection of CAGTA may be important for the diagnosis of invasive candidiasis in surgical patients admitted in ICU.

Nonlinear Fluid Damping In Structure-Wake Oscillators In Modeling Vortex-Induced Vibrations

A Nonlinear Fluid Damping (NFD) in the form of the square-velocity is applied in the response analysis of Vortex-induced Vibrations (VIV). Its nonlinear hydrodynamic effects oil the coupled wake and structure oscillators are investigated. A comparison between the coupled systems with the linear and nonlinear fluid dampings and experiments shows that the NFD model can well describe response characteristics, such as the amplification of body displacement at lock-in and frequency lock-ill, both at high and low mass ratios. Particularly, the predicted peak amplitude of the body in the Griffin plot is ill good agreement with experimental data and empirical equation, indicating the significant effect of the NFD on the structure motion.

The diagnostics of density distribution for inhomogeneous dense DT plasmas using fast protons

The density distribution of inhomogeneous dense deuterium-tritium plasmas in laser fusion is revealed by the energy loss of fast protons going through the plasma. In our simulation of a plasma density diagnostics, the fast protons used for the diagnostics may be generated in the laser-plasma interaction. Dividing a two-dimensional area into grids and knowing the initial and final energies of the protons, we can obtain a large linear and ill-posed equation set. for the densities of all grids, which is solved with the Tikhonov regularization method. We find that the accuracy of the set plan with four proton sources is better than those of the set plans with less than four proton sources. Also we have done the density reconstruction especially. for four proton sources with and without assuming circularly symmetrical density distribution, and find that the accuracy is better for the reconstruction assuming circular symmetry. The error is about 9% when no noise is added to the final energy for the reconstruction of four proton sources assuming circular symmetry. The accuracies for different random noises to final proton energies with four proton sources are also calculated.

Mathematical study of complex networks : brain, internet, and power grid

The dissertation is concerned with the mathematical study of various network problems. First, three real-world networks are considered: (i) the human brain network (ii) communication networks, (iii) electric power networks. Although these networks perform very different tasks, they share similar mathematical foundations. The high-level goal is to analyze and/or synthesis each of these systems from a “control and optimization” point of view. After studying these three real-world networks, two abstract network problems are also explored, which are motivated by power systems. The first one is “flow optimization over a flow network” and the second one is “nonlinear optimization over a generalized weighted graph”. The results derived in this dissertation are summarized below.

Brain Networks: Neuroimaging data reveals the coordinated activity of spatially distinct brain regions, which may be represented mathematically as a network of nodes (brain regions) and links (interdependencies). To obtain the brain connectivity network, the graphs associated with the correlation matrix and the inverse covariance matrix—describing marginal and conditional dependencies between brain regions—have been proposed in the literature. A question arises as to whether any of these graphs provides useful information about the brain connectivity. Due to the electrical properties of the brain, this problem will be investigated in the context of electrical circuits. First, we consider an electric circuit model and show that the inverse covariance matrix of the node voltages reveals the topology of the circuit. Second, we study the problem of finding the topology of the circuit based on only measurement. In this case, by assuming that the circuit is hidden inside a black box and only the nodal signals are available for measurement, the aim is to find the topology of the circuit when a limited number of samples are available. For this purpose, we deploy the graphical lasso technique to estimate a sparse inverse covariance matrix. It is shown that the graphical lasso may find most of the circuit topology if the exact covariance matrix is well-conditioned. However, it may fail to work well when this matrix is ill-conditioned. To deal with ill-conditioned matrices, we propose a small modification to the graphical lasso algorithm and demonstrate its performance. Finally, the technique developed in this work will be applied to the resting-state fMRI data of a number of healthy subjects.

Communication Networks: Congestion control techniques aim to adjust the transmission rates of competing users in the Internet in such a way that the network resources are shared efficiently. Despite the progress in the analysis and synthesis of the Internet congestion control, almost all existing fluid models of congestion control assume that every link in the path of a flow observes the original source rate. To address this issue, a more accurate model is derived in this work for the behavior of the network under an arbitrary congestion controller, which takes into account of the effect of buffering (queueing) on data flows. Using this model, it is proved that the well-known Internet congestion control algorithms may no longer be stable for the common pricing schemes, unless a sufficient condition is satisfied. It is also shown that these algorithms are guaranteed to be stable if a new pricing mechanism is used.

Electrical Power Networks: Optimal power flow (OPF) has been one of the most studied problems for power systems since its introduction by Carpentier in 1962. This problem is concerned with finding an optimal operating point of a power network minimizing the total power generation cost subject to network and physical constraints. It is well known that OPF is computationally hard to solve due to the nonlinear interrelation among the optimization variables. The objective is to identify a large class of networks over which every OPF problem can be solved in polynomial time. To this end, a convex relaxation is proposed, which solves the OPF problem exactly for every radial network and every meshed network with a sufficient number of phase shifters, provided power over-delivery is allowed. The concept of “power over-delivery” is equivalent to relaxing the power balance equations to inequality constraints.

Flow Networks: In this part of the dissertation, the minimum-cost flow problem over an arbitrary flow network is considered. In this problem, each node is associated with some possibly unknown injection, each line has two unknown flows at its ends related to each other via a nonlinear function, and all injections and flows need to satisfy certain box constraints. This problem, named generalized network flow (GNF), is highly non-convex due to its nonlinear equality constraints. Under the assumption of monotonicity and convexity of the flow and cost functions, a convex relaxation is proposed, which always finds the optimal injections. A primary application of this work is in the OPF problem. The results of this work on GNF prove that the relaxation on power balance equations (i.e., load over-delivery) is not needed in practice under a very mild angle assumption.

Generalized Weighted Graphs: Motivated by power optimizations, this part aims to find a global optimization technique for a nonlinear optimization defined over a generalized weighted graph. Every edge of this type of graph is associated with a weight set corresponding to the known parameters of the optimization (e.g., the coefficients). The motivation behind this problem is to investigate how the (hidden) structure of a given real/complex valued optimization makes the problem easy to solve, and indeed the generalized weighted graph is introduced to capture the structure of an optimization. Various sufficient conditions are derived, which relate the polynomial-time solvability of different classes of optimization problems to weak properties of the generalized weighted graph such as its topology and the sign definiteness of its weight sets. As an application, it is proved that a broad class of real and complex optimizations over power networks are polynomial-time solvable due to the passivity of transmission lines and transformers.

The deep ocean density structure at the Last Glacial Maximum : What was it and why?

The search for reliable proxies of past deep ocean temperature and salinity has proved difficult, thereby limiting our ability to understand the coupling of ocean circulation and climate over glacial-interglacial timescales. Previous inferences of deep ocean temperature and salinity from sediment pore fluid oxygen isotopes and chlorinity indicate that the deep ocean density structure at the Last Glacial Maximum (LGM, approximately 20,000 years BP) was set by salinity, and that the density contrast between northern and southern sourced deep waters was markedly greater than in the modern ocean. High density stratification could help explain the marked contrast in carbon isotope distribution recorded in the LGM ocean relative to that we observe today, but what made the ocean's density structure so different at the LGM? How did it evolve from one state to another? Further, given the sparsity of the LGM temperature and salinity data set, what else can we learn by increasing the spatial density of proxy records?

We investigate the cause and feasibility of a highly and salinity stratified deep ocean at the LGM and we work to increase the amount of information we can glean about the past ocean from pore fluid profiles of oxygen isotopes and chloride. Using a coupled ocean--sea ice--ice shelf cavity model we test whether the deep ocean density structure at the LGM can be explained by ice--ocean interactions over the Antarctic continental shelves, and show that a large contribution of the LGM salinity stratification can be explained through lower ocean temperature. In order to extract the maximum information from pore fluid profiles of oxygen isotopes and chloride we evaluate several inverse methods for ill-posed problems and their ability to recover bottom water histories from sediment pore fluid profiles. We demonstrate that Bayesian Markov Chain Monte Carlo parameter estimation techniques enable us to robustly recover the full solution space of bottom water histories, not only at the LGM, but through the most recent deglaciation and the Holocene up to the present. Finally, we evaluate a non-destructive pore fluid sampling technique, Rhizon samplers, in comparison to traditional squeezing methods and show that despite their promise, Rhizons are unlikely to be a good sampling tool for pore fluid measurements of oxygen isotopes and chloride.

Developmentally regulated transcription factors in Drosophila melanogaster

During early stages of Drosophila development the heat shock response cannot be induced. It is reasoned that the adverse effects on cell cycle and cell growth brought about by Hsp70 induction must outweigh the beneficial aspects of Hsp70 induction in the early embryo. Although the Drosophila heat shock transcription factor (dHSF) is abundant in the early embryo, it does not enter the nucleus in response to heat shock. In older embryos and in cultured cells the factor is localized within the nucleus in an apparent trimeric structure that binds DNA with high affinity. The domain responsible for nuclear localization upon stress resides between residues 390 and 420 of the dHSF. Using that domain as bait in a yeast two-hybrid system we now report the identification and cloning of a nuclear transport protein Drosophila karyopherin-α3(dKap- α3). Biochemical methods demonstrate that the dKap-α3 protein binds specifically to the dHSF's nuclear localization sequence (NLS). Furthermore, the dKap-α3 protein does not associate with NLSs that contain point mutations which are not transported in vivo. Nuclear docking studies also demonstrate specific nuclear targeting of the NLS substrate by dKap-α3.Consistant with previous studies demonstrating that early Drosophila embryos are refractory to heat shock as a result of dHSF nuclear exclusion, we demonstrate that the early embryo is deficient in dKap-α3 protein through cycle 12. From cycle 13 onward the transport factor is present and the dHSF is localized within the nucleus thus allowing the embryo to respond to heat shock.

The pair-rule gene fushi tarazu (ftz) is a well-studied zygotic segmentation gene that is necessary for the development of the even-numbered parasegments in Drosophila melanogastor. During early embryogenesis, ftz is expressed in a characteristic pattern of seven stripes, one in each of the even-numbered parasegments. With a view to understand how ftz is transcriptionally regulated, cDNAs that encode transcription factors that bind to the zebra element of the ftz promoter have been cloned. Chapter Ill reports the cloning and characterization of the eDNA encoding zeb-1 (zebra element binding protein), a novel steroid receptor-like molecule that specifically binds to a key regulatory element of the ftz promoter. In transient transfection assays employing Drosophila tissue culture cells, it has been shown that zeb-1 as well as a truncated zeb-1 polypeptide (zeb480) that lacks the putative ligand binding domain function as sequencespecific trans-activators of the ftz gene.

The Oct factors are members of the POU family of transcription factors that are shown to play important roles during development in mammals. Chapter IV reports the eDNA cloning and expression of a Drosophila Oct transcription factor. Whole mount in-situ hybridization experiments revealed that the spatial expression patterns of this gene during embryonic development have not yet been observed for any other gene. In early embryogenesis, its transcripts are transiently expressed as a wide uniform band from 20-40% of the egg length, very similar to that of gap genes. This pattern progressively resolves into a series of narrower stripes followed by expression in fourteen stripes. Subsequently, transcripts from this gene are expressed in the central nervous system and the brain. When expressed in the yeast Saccharomyces cerevisiae, this Drosophila factor functions as a strong, octamer-dependent activator of transcription. The data strongly suggest possible functions for the Oct factor in pattern formation in Drosophila that might transcend the boundaries of genetically defined segmentation genes.

Necessidades de orientação de enfermagem para o autocuidado visando a qualidade de vida de clientes em terapia de hemodiálise

Pressupondo que o conhecimento sobre a doença renal crônica (DRC) e seu tratamento, possibilita ao cliente entendimento e aceitação para conviver com esse agravo, favorecendo comportamentos de autocuidado, delimitou-se os problemas: Qual é a qualidade de vida de clientes com DRC submetidos à hemodiálise? Quais são as necessidades de orientação de enfermagem para o autocuidado desses clientes visando à promoção de sua qualidade de vida? Objetivos específicos: Identificar as características sóciodemográficas e nosológicas de clientes com DRC, em hemodiálise, associando às suas necessidades de orientação de enfermagem para o autocuidado; Identificar a qualidade de vida desses clientes, aplicando o questionário de Kidney Disease Quality of Life Short Form (KDQOL-SF); Relacionar as necessidades de orientação de enfermagem para o autocuidado com a qualidade de vida dos clientes com DRC em terapia de hemodiálise. Descreve-se como marco referencial a Teoria do Autocuidado de Orem, concepções de autocuidado e de qualidade de vida. Pesquisa descritiva, quantitativa, através da entrevista individual realizada na Unidade de Diálise da Enfermaria de Nefrologia do Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro, no período de agosto de 2008 a maio de 2009. Foram sujeitos de pesquisa 43 clientes. Foram utilizados: formulário para caracterização da clientela e levantamento das necessidades de autocuidado e o questionário KDQOL-SF para mensurar a qualidade de vida dos sujeitos. Resultados: Os clientes com doença renal crônica em terapia de hemodiálise são, em sua maioria, do sexo masculino (55%) e mantém união estável (81%); situando-se 39,53%, na faixa etária de 45 a 65 anos e 79,07% na categoria de aposentados. 37,54% têm ensino fundamental. Quanto às características nosológicas, 74,42% possuem hipertensão arterial, encontrando-se 83,72% em hemodiálise, há menos de um ano. A qualidade de vida desses clientes, avaliada pelo KDQOL-SF, obteve os menores escores nas dimensões: limitações causadas por problemas da saúde física; condição de trabalho; limitações causadas por problemas da saúde emocional; capacidade funcional e sobrecarga imposta pela doença renal. Relacionando esse resultado com o obtido no questionário para avaliação das necessidades de orientação de enfermagem para o autocuidado tem-se: problemas da saúde física relacionado com terapia nutricional, ingestão de líquidos, complicações da hemodiálise, anticoagulação e prática de atividade física; relacionadas a problemas de saúde emocional tem-se a associação a grupos e a atividades de lazer; e relacionada à capacidade funcional e sobrecarga da doença renal tem-se a prática de atividade física. Conclui-se que a enfermagem, além de administrar a realização das sessões de hemodiálise, tem papel fundamental na educação à saúde dos clientes, familiares e/ou acompanhantes. O apoio do enfermeiro ao cliente no processo de enfrentamento e tratamento da DRC, contribui para que este adquira habilidade nas ações de autocuidado e consequentemente favoreça sua qualidade de vida.

Do encontro ao sentido: o cuidado aos sujeitos adoecidos de câncer

Esta pesquisa objetivou compreender como se dão as práticas de cuidado dirigidas ao sujeito adoecido de câncer no cotidiano dos serviços de saúde. Para tanto, partimos do entendimento que o processo de adoecer traz repercussões nos modos de andar a vida dos sujeitos, especialmente no que diz respeito ao câncer, patologia que traz consigo metáforas ligadas à morte, sofrimento e dor. Ao dar início à busca pelos serviços de saúde, os sujeitos se deparam com uma série de entraves que podem não proporcionar alívio, não suprindo as necessidades que essa nova condição impõe. Encontramos, em muitos momentos, práticas que negam o caráter subjetivo da experiência da doença, não valorizando a narrativa dos sujeitos. Como trajetória metodológica, escolhemos desenvolver um estudo de natureza qualitativa, utilizando como instrumento privilegiado a entrevista semi aberta. Iniciamos as entrevistas com a consigna: conte como se deu o tratamento de sua doença desde a descoberta até o momento em que se encontra. Os dados coletados a partir do encontro com os sujeitos adoecidos foram complementados por informações contidas nos prontuários médicos, bem como por observações obtidas no momento da interação. O local de realização da pesquisa foi um hospital estadual de grande porte localizado na cidade de Fortaleza, estado do Ceará. As entrevistas foram realizadas no serviço de oncologia clínica do referido hospital. Ao todo foram entrevistados doze sujeitos que estavam em tratamento ambulatorial no serviço. Dos doze sujeitos, cinco eram mulheres e sete eram homens. As idades variaram de 29 a 65 anos. A análise dos dados se deu após imersão no material empírico, posteriormente materializado nas transcrições das entrevistas. Procuramos deixar que os sentidos aflorassem, confrontando com o material que já tínhamos disponível, surgindo daí as categorias empíricas. Dividimos as categorias em duas dimensões, a do sujeito e a da rede de serviços de saúde. Ao final da análise, constatamos alguns pontos que consideramos importantes no sentido de se tornarem dispositivos de mudança. Foi possível confirmar que os sujeitos sabem de si, e realizam um processo de construção do sentido sobre sua doença e das práticas terapêuticas. A doença produz mudanças no sujeito, e os força a ressignificarem sua rotina e hábitos de vida. Foi possível observar que o encontro com os serviços de saúde tem se dado de forma truncada. A luta pelo direito a saúde é árdua: pela demora na confirmação do diagnóstico, pela demora em conseguir marcar exames e receber seus resultados, pela falta de especialistas que saibam o que estão fazendo. Os sujeitos têm descoberto a doença quando esta se encontra avançada. A importância do diálogo, da escuta, da percepção do que o outro necessita é importante, por isso, valorizar os relatos dos sujeitos adoecidos de câncer se faz urgente.

Regional variations in upper mantle structure beneath North America

Several types of seismological data, including surface wave group and phase velocities, travel times from large explosions, and teleseismic travel time anomalies, have indicated that there are significant regional variations in the upper few hundred kilometers of the mantle beneath continental areas. Body wave travel times and amplitudes from large chemical and nuclear explosions are used in this study to delineate the details of these variations beneath North America.

As a preliminary step in this study, theoretical P wave travel times, apparent velocities, and amplitudes have been calculated for a number of proposed upper mantle models, those of Gutenberg, Jeffreys, Lehman, and Lukk and Nersesov. These quantities have been calculated for both P and S waves for model CIT11GB, which is derived from surface wave dispersion data. First arrival times for all the models except that of Lukk and Nersesov are in close agreement, but the travel time curves for later arrivals are both qualitatively and quantitatively very different. For model CIT11GB, there are two large, overlapping regions of triplication of the travel time curve, produced by regions of rapid velocity increase near depths of 400 and 600 km. Throughout the distance range from 10 to 40 degrees, the later arrivals produced by these discontinuities have larger amplitudes than the first arrivals. The amplitudes of body waves, in fact, are extremely sensitive to small variations in the velocity structure, and provide a powerful tool for studying structural details.

Most of eastern North America, including the Canadian Shield has a Pn velocity of about 8.1 km/sec, with a nearly abrupt increase in compressional velocity by ~ 0.3 km/sec near at a depth varying regionally between 60 and 90 km. Variations in the structure of this part of the mantle are significant even within the Canadian Shield. The low-velocity zone is a minor feature in eastern North America and is subject to pronounced regional variations. It is 30 to 50 km thick, and occurs somewhere in the depth range from 80 to 160 km. The velocity decrease is less than 0.2 km/sec.

Consideration of the absolute amplitudes indicates that the attenuation due to anelasticity is negligible for 2 hz waves in the upper 200 km along the southeastern and southwestern margins of the Canadian Shield. For compressional waves the average Q for this region is > 3000. The amplitudes also indicate that the velocity gradient is at least 2 x 10^-3 both above and below the low-velocity zone, implying that the temperature gradient is < 4.8°C/km if the regions are chemically homogeneous.

In western North America, the low-velocity zone is a pronounced feature, extending to the base of the crust and having minimum velocities of 7.7 to 7.8 km/sec. Beneath the Colorado Plateau and Southern Rocky Mountains provinces, there is a rapid velocity increase of about 0.3 km/sec, similar to that observed in eastern North America, but near a depth of 100 km.

Complicated travel time curves observed on profiles with stations in both eastern and western North America can be explained in detail by a model taking into account the lateral variations in the structure of the low-velocity zone. These variations involve primarily the velocity within the zone and the depth to the top of the zone; the depth to the bottom is, for both regions, between 140 and 160 km.

The depth to the transition zone near 400 km also varies regionally, by about 30-40 km. These differences imply variations of 250 °C in the temperature or 6 % in the iron content of the mantle, if the phase transformation of olivine to the spinel structure is assumed responsible. The structural variations at this depth are not correlated with those at shallower depths, and follow no obvious simple pattern.

The computer programs used in this study are described in the Appendices. The program TTINV (Appendix IV) fits spherically symmetric earth models to observed travel time data. The method, described in Appendix III, resembles conventional least-square fitting, using partial derivatives of the travel time with respect to the model parameters to perturb an initial model. The usual ill-conditioned nature of least-squares techniques is avoided by a technique which minimizes both the travel time residuals and the model perturbations.

Spherically symmetric earth models, however, have been found inadequate to explain most of the observed travel times in this study. TVT4, a computer program that performs ray theory calculations for a laterally inhomogeneous earth model, is described in Appendix II. Appendix I gives a derivation of seismic ray theory for an arbitrarily inhomogeneous earth model.

A organização do trabalho na Unidade de Doenças Infecto-contagiosas e a ocorrência de Burnout nos trabalhadores de Enfermagem

Na organização do trabalho hospitalar há vários determinantes que acarretam no desgaste psicofísico do trabalhador de enfermagem, mesmo com o discurso de que gostam da profissão e se sentem realizados em cuidar de pessoas enfermas, especialmente, no cuidado de clientes adoecidos com o HIV/Aids. A Psicodinâmica do Trabalho é uma ciência que possibilita analisar a configuração da organização laboral, a qual comprovadamente incide na dimensão subjetiva do trabalhador, identificando o sofrimento psíquico, o que potencializa o desenvolvimento de doenças mentais, entre elas a Síndrome de Burnout. Nesta perspectiva, o objeto deste estudo trata da organização do trabalho na Unidade de Doença Infecto-Contagiosa, espaço de cuidado de clientes com HIV/Aids e a ocorrência de Burnout entre os trabalhadores de enfermagem que atuam neste espaço laboral. A fim de apreender o objeto traçaram-se três objetivos: a) identificar a percepção dos trabalhadores acerca das características do trabalho de enfermagem no contexto da Unidade de Doença Infecto-Contagiosa, local de assistência ao cliente portador do HIV/Aids; b) descrever as repercussões no processo saúde-doença dos trabalhadores de enfermagem decorrente da assistência ao cliente com HIV/AIDS; e c) analisar as repercussões do processo saúde-doença dos trabalhadores de enfermagem com vistas à identificação de situações do aparecimento da Síndrome de Burnout. Para a realização desta pesquisa, optou-se pela abordagem qualitativa, de caráter descritivo e exploratório. Os dados foram obtidos nos meses de maio a agosto de 2010, utilizando as seguintes fontes de coleta de informações: a entrevista semi-estruturada e o formulário Maslach Burnout Inventory. Optou-se por analisar as informações através do Método de Análise Temática de Conteúdo. Os resultados indicaram que o perfil do profissional de enfermagem era composto por trabalhadores do sexo feminino, que estavam na faixa etária entre 44 e 54 anos de idade, na grande maioria técnicos de enfermagem com tempo médio de 2 a 10 anos de trabalho com clientes HIV/Aids. Verificou-se também que havia discrepâncias marcantes entre o trabalho prescrito e o real, o que acarretava sofrimento para o profissional de enfermagem. Constatou-se também que o sofrimento psíquico resultava da vivência cotidiana do processo de morte/morrer do cliente com HIV/Aids, pelo profissional de enfermagem. Além disso, este sofrimento era determinado também pela precarização das relações e das condições de trabalho. Concluiu-se que havia vários trabalhadores com fortes indícios de ocorrência de Burnout, tanto porque a organização do trabalho se configurava como incoerente e pouco racional como pelas características do processo de cuidar do cliente com HIV/Aids. Recomendam-se medidas que promovam a saúde dos trabalhadores de enfermagem e previnam os agravos em seus processos saúde-doença, tais como: a diminuição da carga emocional de trabalho, grupos de reflexão, ginástica laboral, entre outras. É preciso haver conscientização dos gestores, vontade política e estímulo da organização laboral para que os trabalhadores participem.

Potenciais interações medicamentosas com dano grave e sua relação com o aprazamento estabelecido por enfermeiros

Trata-se de estudo multicêntrico, com revisão retrospectiva de prontuário, que teve como objeto a associação entre o aprazamento de medicações intravenosas realizadas por enfermeiros e as potenciais interações medicamentosas (PIM) graves, encontradas em prescrições de pacientes críticos adultos hospitalizados. Os objetivos foram: a) apresentar os grupos medicamentosos e medicamentos prevalentes em cada Unidade de Tratamento Intensivo (UTI) pesquisada; b) descrever o perfil do aprazamento dos medicamentos intravenosos em cada UTI pesquisada; e, c) analisar a frequência das potenciais interações medicamentosas graves favorecidas pelo aprazamento feito por enfermeiros. Para coleta de dados foi utilizado um instrumento que contemplou o nome do medicamento, a dose, a via, a frequência de administração e os horários aprazados pelo enfermeiro, dando origem a um imenso banco de dados. Os dados foram coletados em 3 UTIs conveniadas ao SUS e pertencentes à Rede Sentinela. O levantamento das PIM foi feito de prescrição a prescrição, pareando-se todos os medicamentos intravenosos conforme critérios de inclusão, obtendo-se assim uma lista com as interações encontradas. As PIM foram identificadas nas bases Micromedex Drugs-Reax System.12 e Drugs.com. Foi encontrada uma chance quase três vezes maior (OR: 2,96) de PIM em prescrições com mais de 5 medicamentos. Às 6h foi encontrada nas UTIs A e B a maior chance de PIM. Na UTI C não foi encontrada prevalência nem OR significativa, assim como o número de doses comprometidas com PIM foi o menor entre todas as UTIs. Houve predomínio de medicamentos que atuam no sistema digestivo (31,99%), com destaque para ranitidina (44,08%). As UTI A e B seguem um mesmo padrão no que diz respeito a acumular o aprazamento, preferencialmente em quatro horários: 14h, 18h, 22h e 6h. A UTI C distribui seu aprazamento por nove horários, inclusive no horário de visitas (16h) e no início de plantão (08h e 20h). Na UTI A e B predominaram aprazamentos noturnos; na UTI C foram tarde e noite, sugerindo uma rotina organizada de acordo com o processo de trabalho de médicos, enfermagem e farmácia. Foram encontrados 47 PIM graves nos horários prevalentes. A UTI A apresentou o maior número de PIM graves (n=32). Destacam-se cinco medicamentos que, repetidamente, foram aprazados associados em PIM grave: haloperidol, metoclopramida, tramadol, furosemida e prometazina. Conclui-se que a rotina de atividades na UTI favorece o aprazamento padronizado e concentrado em poucos horários, logo a ocorrência de PIM graves, desconsiderando assim os aspectos farmacocinéticos e farmacodinâmicos dos medicamentos em uso concomitante.