Manoeuvring between anxiety and control : Patients experience of learning to live with diabetes: a lifeworld phenomenological study

Research shows that people with diabetes want their lives to proceed as normally as possible, but some patients experience difficulty in reaching their desired goals with treatment. The learning process is a complex phenomenon interwoven into every facet of life. Patients and healthcare providers often have different perspectives in care which gives different expectations on what the patients need to learn and cope with. The aim of this study, therefore, is to describe the experience of learning to live with diabetes. Interviews were conducted with 12 patients afflicted with type 1 or type 2 diabetes. The interviews were then analysed with reference to the reflective lifeworld research approach. The analysis shows that when the afflicted realize that their bodies undergo changes and that blood sugar levels are not always balanced as earlier in life, they can adjust to their new conditions early. The afflicted must take responsibility for balancing their blood sugar levels and incorporating the illness into their lives. Achieving such goals necessitates knowledge. The search for knowledge and sensitivity to changes are constant requirements for people with diabetes. Learning is driven by the tension caused by the need for and dependence on safe blood sugar control, the fear of losing such control, and the fear of future complications. The most important responsibilities for these patients are aspiring to understand their bodies as lived bodies, ensuring safety and security, and acquiring the knowledge essential to making conscious choices.

Process evaluation of a knowledge translation intervention using facilitation of local stakeholder groups to improve neonatal survival in the Quang Ninh province, Vietnam

BACKGROUND: Annually, 2.8 million neonatal deaths occur worldwide, despite the fact that three-quarters of them could be prevented if available evidence-based interventions were used. Facilitation of community groups has been recognized as a promising method to translate knowledge into practice. In northern Vietnam, the Neonatal Health - Knowledge Into Practice trial evaluated facilitation of community groups (2008-2011) and succeeded in reducing the neonatal mortality rate (adjusted odds ratio, 0.51; 95 % confidence interval 0.30-0.89). The aim of this paper is to report on the process (implementation and mechanism of impact) of this intervention. METHODS: Process data were excerpted from diary information from meetings with facilitators and intervention groups, and from supervisor records of monthly meetings with facilitators. Data were analyzed using descriptive statistics. An evaluation including attributes and skills of facilitators (e.g., group management, communication, and commitment) was performed at the end of the intervention using a six-item instrument. Odds ratios were analyzed, adjusted for cluster randomization using general linear mixed models. RESULTS: To ensure eight active facilitators over 3 years, 11 Women's Union representatives were recruited and trained. Of the 44 intervention groups, composed of health staff and commune stakeholders, 43 completed their activities until the end of the study. In total, 95 % (n = 1508) of the intended monthly meetings with an intervention group and a facilitator were conducted. The overall attendance of intervention group members was 86 %. The groups identified 32 unique problems and implemented 39 unique actions. The identified problems targeted health issues concerning both women and neonates. Actions implemented were mainly communication activities. Communes supported by a group with a facilitator who was rated high on attributes and skills (n = 27) had lower odds of neonatal mortality (odds ratio, 0.37; 95 % confidence interval, 0.19-0.73) than control communes (n = 46). CONCLUSIONS: This evaluation identified several factors that might have influenced the outcomes of the trial: continuity of intervention groups' work, adequate attributes and skills of facilitators, and targeting problems along a continuum of care. Such factors are important to consider in scaling-up efforts.

Reservoir Management For Flood And Drought Protection Using Infinite Horizon Model Predictive Control

Model Predictive Control (MPC) is a control method that solves in real time an optimal control problem over a finite horizon. The finiteness of the horizon is both the reason of MPC's success and its main limitation. In operational water resources management, MPC has been in fact successfully employed for controlling systems with a relatively short memory, such as canals, where the horizon length is not an issue. For reservoirs, which have generally a longer memory, MPC applications are presently limited to short term management only. Short term reservoir management can be effectively used to deal with fast process, such as floods, but it is not capable of looking sufficiently ahead to handle long term issues, such as drought. To overcome this limitation, we propose an Infinite Horizon MPC (IH-MPC) solution that is particularly suitable for reservoir management. We propose to structure the input signal by use of orthogonal basis functions, therefore reducing the optimization argument to a finite number of variables, and making the control problem solvable in a reasonable time. We applied this solution for the management of the Manantali Reservoir. Manantali is a yearly reservoir located in Mali, on the Senegal river, affecting water systems of Mali, Senegal, and Mauritania. The long term horizon offered by IH-MPC is necessary to deal with the strongly seasonal climate of the region.

Decentralization and education performance: a first view to the Brazilian process

This paper analyses the impact of the decentralization in educational system that is taking place in Brazil in the last decade, as a result of several laws that encourage municipalities to invest in fundamental education. The proficiency tests undertaken by the government allows to follow some public schools in two points in time. Therefore we were able to create an experimental group with the schools that were under state system in the SAEB exam and have migrated to the municipality system by the time of Prova Brasil and a control group with the schools that were under the state system between the two exams and compare the difference in their results using a fixed effect panel data analysis. The difference in difference estimator indicates that there is no significant change in the performance of the students.

Anaerobic bio-digestion of concentrate obtained in the process of ultra filtration of effluents from tilapia processing unit

The objective of the present study was to evaluate the efficiency of the process of biodigestion of the protein concentrate resulting from the ultrafiltration of the effluent from a slaughterhouse freezer of Nile tilapia. Bench digesters were used with excrements and water (control) in comparison with a mixture of cattle manure and effluent from the stages of filleting and bleeding of tilapias. The effluent obtained in the continuous process (bleeding + filleting) was the one with highest accumulated population from the 37th day, as well as greatest daily production. Gases composition did not differ between the protein concentrates, but the gas obtained with the use of the effluent from the filleting stage presented highest methane gas average (78.05%) in comparison with those obtained in the bleeding stage (69.95%) and in the continuous process (70.02%) or by the control method (68.59%).

Secretory process of salivary glands of female Amblyomma cajennense (Acari: Ixodidae) ticks fed on resistant rabbits

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Degenerative process and cell death in salivary glands of Rhipicephalus sanguineus (Latreille, 1806) (Acari: Ixodidae) semi-engorged female exposed to the acaricide permethrin

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

APPLICATION of THE HAZARD ANALYSIS and CRITICAL CONTROL POINT (HACCP) SYSTEM on THE MUSHROOM PROCESSING LINE FOR FRESH CONSUMPTION

The Hazard Analysis and Critical Control Point (HACCP) is a preventive system that intends to guarantee the safety and harmlessness of food. It improves the quality of products as it eliminates possible defects during the process, and saves costs by practically eliminating final product inspection. This work describes the typical hazards encountered on the mushroom processing line for fresh consumption. Throughout the process, only the reception stage of mushrooms has been considered a critical control point (CCP). The main hazards at this stage were: the presence of unauthorised phytosanitary products; larger doses of such products than those permitted; the presence of pathogenic bacteria or thermo-stable enterotoxins. Putting into practice such knowledge would provide any industry that processes mushrooms for fresh consumption with a self-control HACCP-based system for its own productions.

Bundle Block Adjustment of CBERS-2B HRC Imagery Combining Control Points and Lines

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Dynamics of inter-modality re-weighting during human postural control

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Age-related changes in postural control sensory reweighting

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Automatic detection of thermal damage in grinding process by artificial neural network

Esse trabalho tem por objetivo o desenvolvimento de um sistema inteligente para detecção da queima no processo de retificação tangencial plana através da utilização de uma rede neural perceptron multi camadas, treinada para generalizar o processo e, conseqüentemente, obter o limiar de queima. em geral, a ocorrência da queima no processo de retificação pode ser detectada pelos parâmetros DPO e FKS. Porém esses parâmetros não são eficientes nas condições de usinagem usadas nesse trabalho. Os sinais de emissão acústica e potência elétrica do motor de acionamento do rebolo são variáveis de entrada e a variável de saída é a ocorrência da queima. No trabalho experimental, foram empregados um tipo de aço (ABNT 1045 temperado) e um tipo de rebolo denominado TARGA, modelo ART 3TG80.3 NVHB.

A control chart based on sample ranges for monitoring the covariance matrix of the multivariate processes

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

The Synthetic Control Chart Based on Two Sample Variances for Monitoring the Covariance Matrix

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Bivariate control charts with double sampling

In this article, we consider the T(2) chart with double sampling to control bivariate processes (BDS chart). During the first stage of the sampling, n(1) items of the sample are inspected and two quality characteristics (x; y) are measured. If the Hotelling statistic T(1)(2) for the mean vector of (x; y) is less than w, the sampling is interrupted. If the Hotelling statistic T(1)(2) is greater than CL(1), where CL(1) > w, the control chart signals an out-of-control condition. If w < T(1)(2) <= CL(1), the sampling goes on to the second stage, where the remaining n(2) items of the sample are inspected and T(2)(2) for the mean vector of the whole sample is computed. During the second stage of the sampling, the control chart signals an out-of-control condition when the statistic T(2)(2) is larger than CL(2). A comparative study shows that the BDS chart detects process disturbances faster than the standard bivariate T(2) chart and the adaptive bivariate T(2) charts with variable sample size and/or variable sampling interval.