Omvårdnadsåtgärder till patienter med diagnosen KOL : En litteraturstudie

Bakgrund: Kronisk obstruktiv lungsjukdom(KOL) är en långsiktig sjukdom som tar tid innan den visar symtom. När patienten kommer och vill ha information och åtgärder för sina symtom har sjukdomsförloppet redan pågått ett tag. Eftersom den är långdragen är omvårdnadsåtgärderna olika beroende på vart i tiden man ligger i sjukdomen. År 2020 kommer denna patientgrupp vara den tredje största i världen, finns det omvårdnadsåtgärder som ökar livskvalitén för denna patientgrupp? Syfte: Syftet med litteraturstudien var att sammanställa resultat avseende forskning om omvårdnad vid kronisk obstruktiv lungsjukdom som leder till förbättrad livskvalité. Metod: Litteratur studie. Resultat: Kunskapsutbytet mellan patient och sjuksköterska: Hur viktigt det är med en klar och tydlig information vid möte mellan sjuksköterska och patient. Att ge stöd och trygghet: Viktigt att sjuksköterskan finns tillgänglig för patienten, underlätta för patienten: Sjuksköterskan har en viktig roll hos patienter med KOL för att förbättra deras förutsättningar för god livskvalité. Slutsats: Viktigt att skapa en tillit mellan sjuksköterskan och patienten, detta skapar trygghet och resulterar till en god fysisk omvårdnad. När trygghet och tillit har byggts upp mellan sjuksköterskan och patienten blir kommunikationen god och man kan tillsammans komma fram till den bästa lösningen för varje enskild patient.

Do higher moments really matter in portfolio choice?

We present explicit formulas for evaluating the difference between Markowitz weights and those from optimal portfolios, with the same given return, considering either asymmetry or kurtosis. We prove that, whenever the higher moment constraint is not binding, the weights are never the same. If, due to special features of the first and second moments, the difference might be negligible, in quite many cases it will be very significant. An appealing illustration, when the designer wants to incorporate an asset with quite heavy tails, but wants to moderate this effect, further supports the argument.

A logística militar e o serviço de intendência: uma análise do programa excelência gerencial do Exército Brasileiro

This study has the purpose to analyze some of the programs and measures adopted by the Brazilian Army, as well as eventual contributions, for the modernization of its Logistics. Thus, focus one of the main devices of logistic support of the Forces, the Quartermaster, approaching some roles performed by this Service that comprises the current conception of the Army Logistics. This modernization process is mainly developed through a excellence program implemented for the whole Army aiming, amongst other factors, the adoption of managerial practices leading to a better operational performance and to the improvement of the Institution' services and products quality: the Managerial Excellence Program of the Brazilian Army (PEG-EB). Here, the Logistics is deemed as key part for the organizational success and one of the main factors of competitive differential of companies, directly related to costs reduction and increase in the level of services provided for the customers. For the Army, the improvement and update of logistic doctrine emerge as priority for achieving the goals, especially focusing the need to integrated the logistics activities, in order to optimize the resources available, reduce costs and prioritize its actions. While searching for an integrated approach for its logistics, the Army created a central body with the responsibility to coordinate all the supply chain of its Units: the Logistic Department (D Log). This body centrally coordinates a major segment of logistics functions in the Forces. The conclusion states that the development of this mentality about the internal integration of activities will allow a rationalization of the management process, increasing the indexes of availability of material from military organizations, and consequently a serviceability gain for the Brazilian Army.

Essays on economic growth

A fundamental question in development economics is why some economies are rich and others poor. To illustrate the income per capita gap across economies consider that the average gross domestic product (GDP) per capita of the richest 10 percent of economies in the year 2010 was a factor of 40-fold that of the poorest 10 percent of economies. In other words, the average person in a rich economy produces in just over 9 days what the average person in a poor economy produces in an entire year. What are the factors that can explain this difference in standard of living across the world today? With this in view, this dissertation is a conjunction of three essays on the economic growth field which we seek a possible responses to this question. The first essay investigates the existence of resource misallocation in the Brazilian manufacturing sector and measures possible distortions in it. Using a similar method of measurement to the one developed by Hsieh and Klenow (2009) and firm-level data for 1996-2011 we find evidence of misallocation in the manufacturing sector during the observed period. Moreover, our results show that misallocation has been growing since 2005, and it presents a non-smooth dynamic. Significantly, we find that the Brazilian manufacturing sector operates at about 50% of its efficient product. With this, if capital and labor were optimally reallocated between firms and sectors we would obtain an aggregate output growth of approximately 110-180% depending on the mode in which the capital share is measured. We also find that the economic crisis did not have a substantial effect on the total productivity factor or on the sector's misallocation. However, small firms in particular seem to be strongly affected in a global crisis. Furthermore, the effects described would be attenuated if we consider linkages and complementarity effects among sectors. Despite Brazil's well-known high tax burden, there is not evidence that this is the main source of resource misallocation. Moreover, there is a distinct pattern of structural change between the manufacturing sectors in industrialized countries and those in developing countries. Therefore, the second essay demonstrate that this pattern differs because there are some factors that distort the relative prices and also affect the output productivity. For this, we present a multi-sector model of economic growth, where distortions affect the relative prices and the allocation of inputs. This phenomenon imply that change of the production structure or perpetuation of the harmful structures to the growth rate of aggregate output. We also demonstrate that in an environment with majority decision, this distortion can be enhanced and depends on the initial distribution of firms. Furthermore, distortions in relative prices would lead to increases in the degree of misallocation of resources, and that imply that there are distinct patterns of structural changes between economies. Finally, the calibrated results of the framework developed here converge with the structural change observed in the firm-level data of the Brazilian manufacturing sector. Thereafter, using a cross-industry cross-country approach, the third essay investigates the existence of an optimal level of competition to enhance economic growth. With that in mind, we try to show that this optimal level is different from industrialized and under development economies due to the technology frontier distance, the terms of trade, and each economy's idiosyncratic characteristics. Therefore, the difference in competition industry-country level is a channel to explain the output for worker gap between countries. The theoretical and empirical results imply the existence of an inverted-U relationship between competition and growth: starting for an initially low level of competition, higher competition stimulates innovation and output growth; starting from a high initial level of competition, higher competition has a negative effect on innovation and output growth. Given on average industries in industrialized economies present higher competition level. With that if we control for the terms of trade and the industry-country fixed effect, if the industries of the developing economy operated under the same competition levels as of the industrialized ones, there is a potential increase of output of 0.2-1.0% per year. This effect on the output growth rate depends on the competition measurement used.

Os impactos de barreiras não tarifárias no comércio internacional de produtos brasileiros

O avanço da tecnologia e o acesso fácil e rápido das pessoas à informação e a produtos estão contribuindo para o aumento da competição comercial entre empresas e até mesmo entre países. Contudo, é necessário criar controles e medidas para garantir a qualidade de produtos e serviços domésticos e importados para a população, sem que se comprometa o equilíbrio de mercado competitivo. Assim, o presente trabalho avalia os impactos de Barreiras Não Tarifárias utilizadas pelos importadores de produtos brasileiros sobre as exportações brasileiras no ano de 2013, em particular o uso dos tipos de barreiras técnicas e sanitárias. O uso desse tipo de instrumento tem aumentado desde que foi criado e assim, com a diminuição global de tarifas alfandegárias, tem recebido mais atenção por parte de Instituições e formuladores de políticas econômicas e comerciais. Encontrou-se que é significativo o impacto desse tipo de medida sobre os produtos brasileiros exportados de um modo geral, bem como por tipo de medida. Controlado por outros fatores, o impacto da medida é positivo, que sugere um aumento nas exportações. Esse mesmo impacto foi observado na medida do tipo técnica; todavia, foi observado o oposto na medida do tipo sanitária, o que sugere que esse tipo de medida contribui para a redução das exportações brasileiras.

Essays in applied econometrics

Using a unique dataset on Brazilian nominal and real yield curves combined with daily survey forecasts of macroeconomic variables such as GDP growth, inflation, and exchange rate movements, we identify the effect of surprises to the Brazilian interbank target rate on expected future nominal and real short rates, term premia, and inflation expectations. We find that positive surprises to target rates lead to higher expected nominal and real interest rates and reduced nominal and inflation term premia. We also find a strongly positive relation between both real and nominal term premia and measures of dispersion in survey forecasts. Uncertainty about future exchange rates is a particularly important driver of variations in Brazilian term premia.

High performance green buildings

This work aims to study and analyze strategies and measures to improve energy performance in residential and service buildings, in order to minimize energy losses and energy consumption. Due to the high energy dependence of European Union (EU), including Portugal and Slovenia, and high percentage of energy consumption in the building sector, there was a need to adopt strategies at European level with ambitious goals. This came to force EU - Member States to take measures to achieve the proposed targets for energy consumption reduction. To this end, EU - Member States have adapted the laws to their needs and formed specialized agencies and qualified experts on energy certification, which somehow evaluate buildings according to their performance. In this study, the external characteristics of the building in order to meet its thermal needs and from there to survey the existing and possible constructive solutions to be used at the envelope will be examined, in order to increase comfort and reduce the need of use technical means of air conditioning. The possibility of passive heating and ventilation systems also will be discussed. These techniques are developed in parallel with the deployment and design of the building. In this manner, to reduce the energy consumption, various techniques and technologies exploit natural resources. Thus, appear the more sustainable and efficient buildings, so-called Green Buildings have been appeared. The study ends with the identification of measures used in several buildings, proving the economic return in the medium to long term, as well as the satisfaction of their users.

Desenvolvimento de cerâmica vermelha utilizando rejeitos da construção civil

The Industry of the Civil Construction has been one of the sectors that most contribute to the pollution of the environment, due to the great amount of residues generated by the construction, demolition and the extraction of raw material. As a way of minimizing the environmental impacts generated by this industry, some governmental organizations have elaborated laws and measures about the disposal of residues from the building construction (CONAMA - resolution 307). This work has as objective the reutilization of residues compound of sand, concrete, cement, red bricks and blocks of cement and mortar for the production of red ceramic, with the objective of minimizing costs and environmental impacts. The investigated samples contained 0% to 50% of residues in weight, and they were sintered at temperatures of 950°C, 1000°C, 1050°C, 1100°C and 1150°C. After the sinterization, the samples were submitted to tests of absorption of water, linear retraction, resistance to bending, apparent porosity, specific density, XRD and SEM. Satisfactory results were obtained in all studied compositions, with the possible incorporation of up to 50% of residues in ceramic mass without great losses in the mechanical strength, giving better results to the incorporation of 30% of residues in the fabrication of ceramic parts, such as roofing tiles, bricks masonry and pierced bricks

Associação da frequência alélica dos polimorfismos dos genes do sistema renina angiotensina com a força muscular e pressão arterial de idosas

Physiological changes induced by the aging process is dynamic and progressive, reducing the adaptability and independence of older people and may be influenced by genetic and environmental factors. Thus the aim of this thesis was to investigate the association between polymorphism of the ACE gene ID and the phenotypes of muscular strength and blood pressure of 62 elderly Brazilian (67.35 ± 5.66 years) during a 16-week program of supervised training. The elderly women were stratified by age, with the group 1 (G1, n = 34) <70 years and group 2 (G2 n = 28) ≥ 70 years, and in three groups by ACE, ACE-II (n = 8) ACE- DD (n = 35) and ACE-ID (n = 19). The level of muscle strength was evaluated by the method of maximum repetitions and measures of blood pressure (BP) were measured before and after training (PAPré1 and PAPós1) and before and after each training session (PAPre2 and PAPós2), in place of training. DNA samples were isolated from peripheral blood leukocytes polymorphism and insertion / deletion (ID) of the ACE gene (rs1800795) was genotyped by polymerase chain reaction (PCR) plus PCR-confirmatory. The genotype distribution of the polymorphism ID attended the prerogatives of Hardy-Weitíherg. There was variation in power levels before and after training and the age between groups (t-test) and the ACE polymorphism (ANOVA) (p <0.05). Depending on the results it was concluded that resistance training helps to reduce SBP and increased muscle strength of upper and lower limbs when considering the age and ACE polymorphism. In this study the Elderly carriers of the D allele were more reactive to changes in BP resistance training. This study was multidisciplinary project involving researchers in the areas Medical, Physical Education, Pharmacy, Nutrition, Gerontology and Statistics. This fulfilled the requirements of the multidisciplinary Graduate Program in Health Sciences

Eugenol como anestésico para jundiá (Rhamdia voulezi) em diferentes pesos

The study aimed to find the better concentration of eugenol for anesthesia of silver catfish (Rhamdia voulezi) with different weights. Were used 240 catfish distributed in randomized blocks in factorial scheme (5x4) total 20 treatments, in others words, five different weights: 32,5; 75; 150; 300 e 450g and four eugenol concentrations: 50, 75, 100 e 125 mg.l(-1). For each treatment were used 12 fish randomly chosen and exposed individually for each concentration. After of anesthesia the fish were transferred for net-cage with 0,7m(3), being fed and observed by 96 hours for monitoring of mortality. The eugenol was efficient for anesthesia in silver catfish all concentrations and weights and after of 96 hours no mortality have been verified. At these experimental conditions the best concentration of eugenol for anesthetic inducing and recuperation of silver catfish with weight varying from 32,5 and 450 g is 50 mg.l(-1).

Períodos de interferência de trapoeraba (Commelina benghalensis Hort.) no crescimento inicial de eucalipto (Eucalyptus grandis W. Hill ex Maiden)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação econômica e desempenho de machos e fêmeas Canchim em confinamento alimentados com dietas à base de silagem de milho e concentrado ou cana-de-açúcar e concentrado contendo grãos de girassol

Objetivou-se avaliar os efeitos do fornecimento de dietas com silagem de milho ou com cana-de-açúcar + grãos de girassol e a influência da condição sexual do animal sobre o desempenho de bovinos jovens em confinamento e os resultados econômicos desse sistema de produção. Foram utilizados 30 animais Canchim (dez machos não-castrados, dez machos castrados e dez novilhas), com 15 meses de idade e 289 kg de peso corporal (PC), mantidos em baias individuais durante 105 dias. Todos os animais foram pesados no início do experimento e a cada 35 dias e, ao final do confinamento, foram abatidos em frigorífico comercial para realização das medidas de características de carcaça. Os machos não-castrados apresentaram maior ingestão de nutrientes em comparação às fêmeas, tanto em valores absolutos quanto em valores relativos ao PC. Os machos castrados apresentaram valores intermediários e não diferiram dos não-castrados e das fêmeas. Os machos não-castrados apresentaram maior ganho de peso diário e desenvolvimento muscular, representado pela maior área de olho-de-lombo. Também foram mais eficientes quanto à conversão alimentar e ao rendimento de carcaça. Não houve efeito das dietas sobre a ingestão de nutrientes, à exceção do EE, que foi maior para a dieta com cana-de-açúcar + semente de girassol, com mais teor desse nutriente. As dietas também não influenciaram o desempenho dos animais. A dieta com silagem de milho mostrou-se economicamente mais viável para terminação de bovinos jovens em confinamento. Os machos não-castrados são os mais adequados para exploração de bovinos jovens em confinamento, independentemente da dieta.

Pedagogia etnomatemática : ações e reflexões em matemática do Ensino Fundamental com um grupo sócio cultural específico

mongst the trends in Mathematics Education, which have as their object a more significant and criticallearning, is the Ethnomathematics. This field of knowledge, still very recent amongst us, besides analyzing an externalist history of the sciences in a search for a relationship between the development of the scientific disciplines and the socio-cultural context, goes beyond this externalism, for it also approaches the intimate relationships betwe_n cognition and culture. In fact, the Ethnomathematics proposes an alternative epistemological approach associated with a wider historiography. It struggles to understand the reality and come to the pedagogical action by means of a cognitive approach with strong cultural basis. But the difficulty of inserting the Ethnomathematics into the educational context is met by resistance from some mathematics educators who seem indifferent to the influence of the culture on the understanding of the mathematics ideas. It was with such concerns in mind that I started this paper that had as object to develop a curricular reorientation pedagogical proposal in mathematics education, at the levei of the 5th grade of the Ensino Fundamental (Elementary School), built from the mathematical knowledge of a vegetable farmers community, 30 km away from the center of Natal/RN, but in accordance with the teaching dimensions of mathematics of the 1 st and 2nd cycles proposed by the Parâmetros Curriculares Nacionais - PCN: Numbers and Operations, Space and Form, Units and Measures, and Information Treatment. To achieve that, I developed pedagogical activities from the mathematical concepts of the vegetable farmers of that community, explained in my dissertation research in the period 2000 through 2002. The pedagogical process was developed from August through Oecember 2007 with 24 students of the 5th Grade of the Ensino Fundamental (Elementary School) of the school of that community. The qualitative analysis of the data was conducted taking into account three categories of students: one made up of students that helped their parents in the work with vegetables. Another one by students whose parents and relatives worked with vegetables, though they did not participate directly of this working process and one third category of students that never worked with vegetables, not to mention their parents, but lived adjacent to that community. From the analyses and results of the data gathered by these three distinct categories of students, I concluded that those students that assisted their parents with the daily work with vegetables solved the problem-situations with understanding, and, sometimes, with enriching contributions to the proposed problems. The other categories of students, in spite of the various field researches to the gardens of that community, before and during the pedagogical activities, did not show the same results as those students/vegetable farmers, but showed interest and motivation in ali activities of the pedagogical process in that period

Considerações biométricas do sistema respiratório de carcará (Polyborus plancus)

Neste trabalho, foram estudados os parâmetros biométricos das vísceras que compõem o sistema respiratório de oito carcarás de ambos os sexos, com pesos corpóreos e idades diferentes. As aves foram eutanasiadas, evisceradas e dissecadas. em seguida os diferentes componentes do sistema respiratório foram estendidos em uma superfície plana, medidos com o auxílio de uma fita métrica em escala milimétrica e pesados em balança eletrônica de precisão. A análise estatística utilizada foi o teste T de Student com o nível de significância P≤0,05. Foi observado que, em carcarás fêmeas, o comprimento da laringe foi significativamente maior do que em carcarás machos. Além disso, a traquéia de carcarás fêmeas possui um menor comprimento do que a de galinha. Também foi observado que a relação entre o peso corpóreo e o peso da traquéia e do pulmão de carcarás é maior do que em Gallus gallus domesticus.

Diferentes dietas e pesos ao abate na produção de órgãos de cordeiros

O experimento foi conduzido com o objetivo de avaliar os pesos e porcentagens de órgãos em relação ao peso vivo ao abate (PVA), ao peso de corpo vazio (PCV) e ao peso total dos órgãos (PTO) de cordeiros inteiros 1/2 Ile de France 1/2 Ideal confinados, recebendo dietas com relações volumoso:concentrado de 50:50 e 30:70 e abatidos aos 30 ou 34 kg. Os parâmetros mensurados foram: língua, pulmões com traquéia, coração, fígado, pâncreas, timo, tireóide, adrenal, rins, testículos, baço, diafragma, bexiga, pênis e glândulas anexas. Os resultados obtidos revelaram diferenças entre os pesos ao abate nas porcentagens de língua, coração, pulmões com traquéia, diafragma, pâncreas, tireóide, baço e glândulas anexas em relação ao PVA; nas porcentagens de língua, pulmões com traquéia, fígado, pâncreas, baço e glândulas anexas em relação ao PCV e nas porcentagens de pulmões com traquéia, fígado, pâncreas, tireóide, baço e glândulas anexas em relação ao PTO. Dietas com diferentes relações volumoso:concentrado afetaram apenas as porcentagens de pâncreas em relação ao PVA, ao PCV e ao PTO. Verificaram-se interações entre relação volumoso:concentrado e peso vivo ao abate nos pesos dos pulmões com traquéia, fígado, pâncreas, tireóide e glândulas anexas.