898 resultados para nurse patient relationship


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Activated sludge floes are a flocculated mass of microorganisms, extracellular polymeric substances (EPS) and adsorbed organic and inorganic material. The structure of the floes is very heterogeneous and floes with very different properties and morphologies may occur, depending on the conditions in the activated sludge treatment plant and wastewater composition. Present thinking suggests that cations, such as calcium, create cationic bridges with EPS excreted by the bacteria and thereby hold the various floe constituents together. However, due to the complex and heterogeneous nature of activated sludge, the mechanisms have neither been thoroughly investigated nor successfully quantified. A better understanding and description of the biological flocculation process is necessary in order to establish more efficient operational strategies. The main aim of this study was to get a comprehensive and unique insight into the floe properties of activated sludge and to assess the relative impact of chemical and physical parameters. A variety of sludges from full scale treatment plants with different settling properties were characterised. The interrelationships between floe parameters such as composition of EPS, surface properties and floe structure, and their effect on the flocculation and separation properties were assessed. The results indicate that the EPS, both in terms of quantity and quality, are very important for the floe properties of the activated sludge. However, presence of filaments may alter the physical properties of the floes considerably. The EPS showed positive correlations to sludge volume index (SVI) if only sludges with low or moderate numbers of filaments were included. The surface properties were more affected by the composition of the EPS than by the number of filaments. The EPS showed positive correlation to negative surface charge and a negative correlation to relative hydrophobicity and flocculation ability. The negative correlation between flocculation ability and amount of EPS was surprising. The shear sensitivity, measured as degree of erosion of floes when subjected to shear, was more affected by floe size and number of filaments than amount of EPS.

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Twenty-one strains of Bacillus (10 B. stearothermophilus, 3 B. cereus, and 8 B. licheniformis strains) were assayed for spore surface hydrophobicity on the basis of three measures: contact angle measurement (CAM), microbial adhesion to hydrocarbons (MATH), and hydrophobic interaction chromatography (HIC). On the basis of the spore surface characteristics obtained from these assays, along with data on the heat resistance of these spores in water, eight strains of Bacillus (three B. stearothermophilus, three B. cereus, and two B. licheniformis strains) either suspended in water or adhering to stainless steel were exposed to sublethal heat treatments at 90 to 110degreesC to determine heat resistance (D-value). Significant increases in heat resistance (ranging from 3 to 400%) were observed for the eight strains adhering to stainless steel. No significant correlation was found between these heat resistance increases and spore surface characteristics as determined by the three hydrophobicity assays. There was a significant positive correlation between the hydrophobicity data obtained by the MATH assay and those obtained by the HIC assay, but these data did not correlate with those obtained by the CAM assay.

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High concentrations of ammonium ( up to 270 kg N/ha) have been observed in a Vertisol soil below 1 m depth near Warra in south-east Queensland. This study examined the possibility that increased water movement into the subsoil after the removal of native vegetation, and a subsequent increase in periods of waterlogging, could have triggered nitrate ammonification and be responsible for the production of ammonium. Two incubation experiments were conducted to test this hypothesis. The first involved the incubation of repacked cores that had been amended with 30 mg N/kg of 5 atom% N-15 nitrate under low oxygen conditions for a period of 360 days. Over this time period the N-15 enrichment of the exchangeable ammonium fraction was monitored in order to detect any reduction of nitrate to ammonium. The second experiment involved the incubation of soil amended with 30 mg N/ kg of 5 atom% N-15 nitrate under waterlogged and low oxygen conditions for 75 days. During this period the redox potential of the soil was monitored using a field test to determine if reducing conditions would develop in this soil over a period of waterlogging, combined with the monitoring of any nitrate reduction to ammonium. The results of these experiments indicated that a small amount of nitrate ammonification (< 0.1 mg N/ kg) could be observed in the Warra subsoil, but that unless the rate of reduction were to significantly increase with time, this could not account for the accumulation of ammonium observed in the field. The environmental conditions that would make either dissimilatory or abiotic nitrate ammonification favourable were not observed to develop. Consequently, it has been concluded that the observed nitrate ammonification occurred via an assimilatory pathway. Due to the low rate of microbial activity in this subsoil it is considered unlikely that this process was responsible for the subsoil ammonium accumulation at Warra.

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We examined the unique relations between the five dimensions of the Attachment Style Questionnaire (ASQ; Feeney, Noller, & Hanrahan, 1994) and depression and agoraphobic behavior (i.e., avoidance of situations where high anxiety is experienced). In addition, we examined mediation models in an attempt to clarify the link between adult attachment and these two dimensions of psychopathology. In testing these models, we administered the ASQ, General Self-Efficacy Scale, Agoraphobic Catastrophic Cognitions Questionnaire, Beck Depression Inventory, and the Mobility Inventory for Agoraphobia (a measure of the degree to which situations are avoided that are typically anxiety provoking for people with agoraphobia) to 122 participants (44 with agoraphobia, 25 with a current major depressive disorder, and 53 with no current psychopathology). The results showed that the insecure attachment dimensions of need for approval, preoccupation with relationships, and relationships as secondary were uniquely associated with depression and that general self-efficacy partly mediated the relationship between need for approval and depression. In contrast, only preoccupation with relationships was uniquely associated with agoraphobic behavior, and catastrophic cognitions about bodily sensations partly mediated this association.

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O trabalho investigou a dinâmica das relações conjugais após ocorrência de Infarto Agudo do Miocárdio em um dos cônjuges, a fim de identificar possíveis alterações na interação e no papel de cada cônjuge. Foram entrevistados 06 casais (30 a 53 anos casamento): 03 homens enfartados, 03 mulheres enfartadas (ocorrência entre 1,5 a 8 anos), com roteiros diferenciados para o (a) enfartado e o (a) companheiro. Nas entrevistas priorizamos: interações pessoais e conjugais pós-infarto/ diferenças de gênero. A análise de conteúdo evidenciou que predominaram nas relações conjugais aspectos que remetem ao papel tradicional de gênero, embora a dinâmica conjugal tenha sofrido algumas alterações frente ao impacto do infarto, por exemplo: aumento da divisão de tarefas domésticas, homens tornaram-se mais caseiros, mulheres começaram a participar da administração financeira, maior aproximação afetiva entre o casal. Tais considerações apontam que a ocorrência do infarto foi avaliada positivamente pelas mulheres em função das alterações de papéis e negativamente pelos homens frente às limitações e dependência.

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The objective of this study was to estimate simple and partial coefficients of correlation, as well as to divide their effects into direct and indirect using path analysis for custard apple tree traits. Twenty half-sibling progenies were evaluated in a randomized block design with five replicates, and plots consisting of four plants. Six traits were evaluated in the first cropping season (mean number of seeds per fruit and mean weight of the pericarp, pulp, pedicel, seeds per fruit, and the whole fruit), while five traits were evaluated in the first three cropping seasons (mean fruit length and width, total number of fruits ha-1, mean fruit weight (in both types of analyses), and fruit yield in kg ha-1). The results of this work led to the conclusion that doing selection based on simple correlation estimates may not be convenient, since not always a cause and effect relationship can be verified between two traits. Positive correlations were obtained between number of seeds and seed weight, and between number of fruits and yield. The greatest direct effects were those obtained for pulp weight on fruit weight and for mean number and weight of fruits on fruit yield. The most important indirect effects were obtained for number of seeds and pericarp weight, obtained via pulp weight, on fruit weight, and for fruit length and width, obtained via mean fruit weight, on fruit yield.

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ZigBee-based Remote Patient Monitoring

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The adoption of the “new public management” in the hospital sector brought about greater presence and power to professional managers in hospitals, thus increasing the risk of conflict in the doctor-manager relationship. Aiming to enrich the discussion on the factors that could be the bases for this conflict and considering the role of accounting, the study presented here corresponds, basically, to what we call “content analysis” of qualitative studies. The results demonstrate that the Portuguese doctors as the sample studied accept, in essence, the principles of enterprise management and recognize the use of accounting information in the scope of their functions as long as they are called to participate as legitimate actors, and authorities respect their desires to preserve a practice which they consider of quality.

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AIM: This work presents detailed experimental performance results from tests executed in the hospital environment for Health Monitoring for All (HM4All), a remote vital signs monitoring system based on a ZigBee® (ZigBee Alliance, San Ramon, CA) body sensor network (BSN). MATERIALS AND METHODS: Tests involved the use of six electrocardiogram (ECG) sensors operating in two different modes: the ECG mode involved the transmission of ECG waveform data and heart rate (HR) values to the ZigBee coordinator, whereas the HR mode included only the transmission of HR values. In the absence of hidden nodes, a non-beacon-enabled star network composed of sensing devices working on ECG mode kept the delivery ratio (DR) at 100%. RESULTS: When the network topology was changed to a 2-hop tree, the performance degraded slightly, resulting in an average DR of 98.56%. Although these performance outcomes may seem satisfactory, further investigation demonstrated that individual sensing devices went through transitory periods with low DR. Other tests have shown that ZigBee BSNs are highly susceptible to collisions owing to hidden nodes. Nevertheless, these tests have also shown that these networks can achieve high reliability if the amount of traffic is kept low. Contrary to what is typically shown in scientific articles and in manufacturers' documentation, the test outcomes presented in this article include temporal graphs of the DR achieved by each wireless sensor device. CONCLUSIONS: The test procedure and the approach used to represent its outcomes, which allow the identification of undesirable transitory periods of low reliability due to contention between devices, constitute the main contribution of this work.

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The success of dental implant-supported prosthesis is directly linked to the accuracy obtained during implant’s pose estimation (position and orientation). Although traditional impression techniques and recent digital acquisition methods are acceptably accurate, a simultaneously fast, accurate and operator-independent methodology is still lacking. Hereto, an image-based framework is proposed to estimate the patient-specific implant’s pose using cone-beam computed tomography (CBCT) and prior knowledge of implanted model. The pose estimation is accomplished in a threestep approach: (1) a region-of-interest is extracted from the CBCT data using 2 operator-defined points at the implant’s main axis; (2) a simulated CBCT volume of the known implanted model is generated through Feldkamp-Davis-Kress reconstruction and coarsely aligned to the defined axis; and (3) a voxel-based rigid registration is performed to optimally align both patient and simulated CBCT data, extracting the implant’s pose from the optimal transformation. Three experiments were performed to evaluate the framework: (1) an in silico study using 48 implants distributed through 12 tridimensional synthetic mandibular models; (2) an in vitro study using an artificial mandible with 2 dental implants acquired with an i-CAT system; and (3) two clinical case studies. The results shown positional errors of 67±34μm and 108μm, and angular misfits of 0.15±0.08º and 1.4º, for experiment 1 and 2, respectively. Moreover, in experiment 3, visual assessment of clinical data results shown a coherent alignment of the reference implant. Overall, a novel image-based framework for implants’ pose estimation from CBCT data was proposed, showing accurate results in agreement with dental prosthesis modelling requirements.

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As stated by the New Institutional Economics theory, transaction costs play a relevant role in economics and, according to the extent of such costs, agents make investment decisions. Actually, transaction costs may represent a disincentive to entrepreneurship. This work aims to verify whether transaction costs are related to investment rate and foreign direct investment rate (FDI) in different business environments. The results suggest that foreign investors do not have precise information about other countries as domestic investors do; as it is observed, only the relation between transaction costs and investment rate is significant. Furthermore, there is evidence that the business environments of BRIC countries are less developed when compared to business environments of other countries in the study

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This paper shows the results of the empirical study conducted in 186 tourist accommodation businesses in Spain certified under the "Q for Tourist Quality", own System Quality Management. It was raised with the purpose of analyzing the structure of the relationship between critical quality factors and results-social impact, how they operate and the level of their influence on obtaining these results within the company. Starting from a deep theoretical revision we propose a theoretical model together with the hypotheses to be tested, and we proceed to validation using the technique of Structural Equation Models. The results obtained show that companies wishing to improve their social impact should take into account that leadership is the most important factor to achieve it. Leadership indirectly affects the social impact through its influence on alliances and resources, quality policy/planning, personnel management and learning.

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The young athlete is physiologically unique from the adult and must be considered differently. The growth and development of their bones, muscles, nerves, and organs largely dictate their physiological and performance capacities (Bar–Or, 1983; Costill & Wilmore, 1994; Stager et al., 2008). Swimming performance, and the required times to reach a competition (TAC), shoud look for those diferences and should be compatibles with them.

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RESUMO: Considerando a identidade como um processo dinâmico de interacção social, afastando-nos da ideia de identidades pré-estabelecidas, ancoradas numa visão essencialista e, aproximando-nos de uma identidade profissional que se constrói através de sucessivas interacções, procurámos conhecer a identidade profissional do docente de enfermagem. Convictos de que o estudo da identidade pode oscilar entre um pólo individual e um estrutural, optámos pela dimensão biográfica como eixo estruturante deste trabalho. Efectuaram-se oito biografias a docentes integrados no conceito de perito com uma profissionalidade reflectida. Utilizámos ainda o focus group como método complementar. Constatámos que os actores deste estudo se sentem enfermeiros, embora a sua área de actuação seja a docência. Destacam a integração do ensino de enfermagem no ensino superior como determinante na mudança da sua representação social. Todos estes docentes se incluem nos grupos que apresentam um estatuto da identidade realizado ou outorgado. Das competências que devem estar presentes no docente de enfermagem, salientam-se a comunicação, actualização científica e relação, capazes de promover um ambiente que propicie as aprendizagens significativas, de internacionalização, de investigação, como um modelo de conduta a seguir, que participe na vida da organização e seja capaz de motivar o outro, mas sobretudo que seja um bom enfermeiro. ABSTRACT: Considering identity as a social dynamic integration process, departing from the concept of pre-established identities anchored in an essentialist vision, and approaching a professional identity built trough successive interaction, we aimed to know the professional identity of the nursing teacher. Believing that the identity study may oscillate between an individual and a structural pole, we have chosen the biographic dimension as the structural axis for this assignment. Eight biographies from teachers integrated in the expert with a reflective professional identity have been made. We have also used the focus group as a complementary method. We have seen that the actors of this study feel themselves as nurses although their working area is teaching. They point out the higher teaching of Nursing as a determinant in the change of their social representation. All of these teachers are included in the groups that present an identity status that has been fulfilled or attributed. From the skills that should be present in the nursing teacher, communication, scientific knowledge and relationship are indicated when these are able to provide significant learning, internationalization and research as a behaviour model to be followed regarding the life of the organization and that might incentive others, but above as a way to be a good nurse.

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RESUMO: Neste estudo investigou-se a influência dos meios audiovisuais na tomada de decisão pelos utentes em cirurgias oftalmológicas, especialmente nas cirurgias refractivas. A metodologia escolhida integrou métodos quantitativos e qualitativos, com o objectivo de abranger a máxima amplitude da descrição, explicação e compreensão do objecto a ser investigado. Procura-se evidenciar e analisar sentimentos, motivações e atitudes individuais, como escolhas e tomada de decisão, bem como, perceber a relação entre o processo de comunicação médico / paciente e a tomada de decisão. Foram usados: um questionário, material digital e vídeos com as principais cirurgias refractivas apresentadas aos utentes, com uma amostra de n= 150 participantes do Serviço de Oftalmologia da HOSPOR e SAMS Centro de 01 de Julho 2008 a 28 de Fevereiro de 2009, com a faixa etária de 20 a 80 anos, com diagnóstico escolhido. Os dados recolhidos foram analisados pelo SPSS 18. A fundamentação teórica está baseada no estudo da captação e disfunções no trajecto da imagem, observando-se os componentes da aquisição do conhecimento: sensação, percepção, pensamento, consciência, memória, imaginação, linguagem, informação, bem como bioética, comunicação médica e a tomada de decisão, na qual se valoriza a educação do Utente para decidir. O resultado desta investigação aponta para novos paradigmas nos processos de informação / decisão consciente, indicando a necessidade de se investir na educação e na informação médica humanizada aos utentes para haver maior conhecimento, participação, satisfação e eficácia na terapêutica a ser escolhida. ABSTRACT: This paper analyzes how information and communication technologies, in particular the media of some ophthalmologic surgery, can help better decisions meaning new ways of information and new relationship between doctor and patient. This study investigates how doctors take hold of technological resources and discuss the client`s decision. We used the quantitative and qualitative structured interview of client who are visually impaired, especially myopia / hyperopia / astigmatism, presbyopia and cataract. We used a questionnaire, material and digital videos with the leading refractive surgery presented to the clients, with a sample of n = 150 participants of the Department of Ophthalmology, and SAMS HOSPOR Center from 01 July 2008 to 28 February 2009, with range 20 to 80 years, diagnosed chosen. The data collected were analyzed by SPSS. The theoretical study is based on the capture and routing of image and perception, observing neuro-psycho-social components: sensation, perception, visual perception, consciousness, knowledge, memory, imagination, language, information, bioethics and decision-making, in which values education of user to decide. The result of this research points to new paradigms in information processing / conscious decision, indicating the necessity of investing in education and humane medical information to the Users in order to archive a greater awareness,participation, satisfaction and effectiveness in the treatment to choose.