789 resultados para Good doctor
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Unless you’ve been living on a deserted island or stranded (or not?) like the pelagic castaway Jose Ivan (http://bit.ly/1fq6JsJ) for over a year, you could not possibly have missed the news thatGoogle’s mass digitization project, Google Books, won its case.
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This article studies a model where, as a consequence of private information, agents do not have incentive to invest in a desired joint project, or a public good, when they are unable to have prior discussion with their partners. As a result, the joint project is never undertaken and inefficiency is observed. Agastya, Menezes and Sengupta (2007) prove that with a prior stage of communication, with a binary message space, it is possible to have some efficiency gain since "all ex-ante and interim efficient equilibria exhibit a simple structure". We show that any finite message space does not provide efficiency gain on the simple structure discussed in that article. We use laboratory experiments to test these results. We find that people do contribute, even without communication, and that any kind of communication increases the probability of project implementation. We also observed that communication reduces the unproductive contribution, and that a large message space cannot provide efficiency gain relative to the binary one.
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According to Bourdieu (1994), there are social camps where the economic logic works upside down. Therefore, the expression ¿family business¿ is paradoxical because inside it resides two distinct and, sometimes, antagonistic logics: the business logic, whose goal is the profit, and the family logic, which aims at the common welfare. That is why one must consider the symbolical exchanges influences on the social relations more than in any other kind of company. Based on these concepts, this research presents an overview of the small and medium brazilian family business universe.
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The aim of this study was to establish the profile of the pharmacist technician responsible for community pharmacies in the city of Natal/RN, featuring personal elements, perceived their role and place of pharmaceutical care, levels of job satisfaction, type and quality of services provided in human and structural framework. To that end, we made an exploratory cross-sectional study applying a questionnaire containing open and closed questions, which was applied to pharmaceutical technicians responsible for community pharmacies in Natal/RN, from September 2010 to September 2011. The sample was established by calculating the simple random sample, with a confidence level of 95% and a significance level of 0.05. To evaluate the satisfaction level of the activities performed by pharmacists in community pharmacies was used Simple Satisfaction Scale (Likert, 1935). To assess the attitudes and perceptions of pharmacists in relation to aspects of pharmaceutical care, we used the Model Attitude toward the object (Fishbein, Ajzen, 1975). The answers were converted into data were analyzed statistically using Epi Info 3.5.2 The results showed that the strengths and weaknesses in relation to the profile of the pharmacist and their activities in community pharmacies in Natal/RN are not different in other cities in the country . The most important aspects were: 51% (n = 90) of the establishments visited, the pharmacist was absent; 46% (n = 80) did not have postgraduate and of those who are or have completed 33% (n = 51) are in the area of Clinical Analysis; 56% (n = 98) 08h for day work and 64% (n = 111) claim that this load influence its performance; 83% (n = 146) receive as salary, the floor pharmacist regarding the state of Rio Grande do Norte; 44% (n = 76) are unhappy about the salary, which is the main difficulty cited; 78% (n = 136) say they are always sought by users and the receptivity of these considered good (52%, n = 91). The activities of higher satisfaction are those related to pharmaceutical care and lower the administrative. As regards attitudes and perceptions, the score was more negative to the question 'if the pharmacist feels working as a team with the doctor', in which 59% (n = 103) responded 'never'. 49% (n = 86) reported being "able" to take questions from users and 39% (n = 68) are 'dissatisfied' with respect to the structure of the practice of pharmacy to pharmaceutical care. Action is needed on the obstacles to the exercise of the pharmacist in the solution and minimize the negative and positive stimulus to
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The processing of heavy oil produced in Brazil is an emergency action and a strategic plan to obtain self-sufficiency and economic surpluses. Seen in these terms, it is indispensable to invest in research to obtain new catalysts for obtaining light fraction of hydrocarbons from heavy fractions of petroleum. This dissertation for the degree of Doctor of Philosophy reports the materials preparation that combine the high catalytic activity of zeolites with the greater accessibility of the mesoporosity, more particularly the HZSM-5/MCM-41 hybrid, done by synthesis processes with less environmental impact than conventional ones. Innovative methodologies were developed for the synthesis of micro-mesoporous hybrid material by dual templating mechanism and from crystalline zeolitic aluminosilicate in the absence of organic template. The synthesis of hybrid with pore bimodal distribution took place from one-single organic directing agent aimed to eliminate the use of organic templates, acids of any kind or organic solvents like templating agent of crystalline zeolitic aluminosilicate together with temperature-programmed microwave-assisted, making the experimental procedures of preparation most practical and easy, with good reproducibility and low cost. The study about crystalline zeolitic aluminosilicate in the absence of organic template, especially MFI type, is based on use of H2O and Na+ cation playing a structural directing role in place of an organic template. Advanced characterization techniques such as X-Ray Diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM), Highresolution Transmission Electron Microscopy (HRTEM), Adsorption of N2 and CO2, kinetic studies by Thermogravimetric Analysis (TGA) and Pyrolysis coupled to Gas Chromatography/Mass Spectrometry (Pyrolysis-GC/MS) were employed in order to evaluate the synthesized materials. Achieve the proposed objectives, has made available a set of new methodologies for the synthesis of zeolite and hybrid micro-mesoporous material, these suitable for catalytic pyrolysis of heavy oils aimed at producing light fraction
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Infertility represents one of the main long-term consequences of the chemotherapy used for the adjuvant treatment of breast cancer. Approximately 60-65% of breast cancers express the nuclear hormone receptor in premenopausal women. Adjuvant endocrine therapy is an integral component of care for patients with hormone receptor-positive (HR+) tumours. The GnRH agonist (GnRHa) alone or in combination with tamoxifen produces results at least similar to those obtained with the different chemotherapy protocols in patients with HR+ breast cancer with respect to recurrence-free survival and overall survival. It is time to indicate adjuvant therapy with GnRHa associated with tamoxifen for patients with breast cancer (HR+ tumours) if they want to preserve their reproductive function. The evaluation of ovarian reserve tests: follicle stimulating hormone (FSH), anti-Mullerian hormone (AMH), inhibin B, antral follicle count (AFC) and ovarian volume 6 months, and 1 year after the end of therapy with GnRHa/tamoxifen must be realised. The recurrence-free survival and overall survival should be analysed. The major implication of this hypothesis will be to avoid adjuvant chemotherapy for patients with breast cancer (HR+ tumours) that request fertility preservation. It is expected that ovarian function should not be altered in almost all cases and subsequent pregnancy a real possibility. (C) 2012 Elsevier Ltd. All rights reserved.
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The Meriones unguiculatus (Mongolian) gerbil has demonstrated significant prostatic responses to hormonal treatments, and to drugs against human prostatic hyperplasia Spontaneous neoplasia develops in the older animals. Thirty gerbils (age 18 months) were divided into non-affected and prostatic lesion bearers and the prostate lesions were evaluated morphologically, immunohistochemically and quantitatively. The most frequent changes were in epithelial sites and, namely prostatic intraepithelial neoplasias, microinvasive carcinomas and adenocarcinomas. In the stromal compartment, cellular hyperplasia, when verified, was always associated with the sites of anomalous epithelium. Additionally, larger deposition of collagen fibrils, generating stromal fibrosis, was found in all the old gerbils analysed. The quantitative analysis showed that prostatic tissue proportions differed in altered areas, being specific for each lesion type. Isolated nuclear and nucleolar parameters were not effective in diagnosing the malign potential of lesions. However, the cellular proliferation and death indexes indicated larger cellular turnover in invasive lesions such as carcinomas. With these analyses, it could be verified that old gerbils present high propensity to develop spontaneous prostate changes and this may aid in a better understanding of the biological behaviour of human prostate cancer.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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We report an unusual case of a 37-year-old woman who presented in 1980 with a serous papillary cystadenocarcinoma of the ovary. The patient refused any treatment and the patient was lost to follow-up for 6 years. After this period of time she returned with an extremely large, cutaneous, cauliflower-type of metastasis located in the lower abdominal wall and measuring 20 x 20 cm. She received two courses of chemotherapy treatment consisting of intraperitoneal cisplatin (100 mg/m2) and intravenous epirubicin (50 mg/m2) every 3 weeks. After the second course of chemotherapy she received cobalt radiotherapy (5000 cGy). Subsequently, she received four more courses of chemotherapy with dramatic remission of the cutaneous metastasis. Shortly after chemotherapy, the patient underwent a laparotomy consisting of the resection of the abdominal wall including the cutaneous metastasis completed by total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. The patient is well after the surgery and without any evidence of residual disease after 6 years of follow up. This description illustrates a rare example of ovarian cancer with skin metastases and favorable outcome. (C) 1994 Academic Press, Inc.