Impact of cancer-related symptom synergisms on health-related quality of life and performance status

To identify the impact of multiple symptoms and their co-occurrence on health-related quality of life (HRQOL) dimensions and performance status (PS), 115 outpatients with cancer, who were not receiving active cancer treatment and were recruited from, a university hospital in Sao Paulo, Brazil completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, the Beck Depression Inventory, and the Brief Pain Inventory. Karnofsky Performance Status scores also were completed. Application of TwoStep Cluster analysis resulted in two distinct patient subgroups based on 113 patient experiences with pain, depression, fatigue, insomnia, constipation, lack of appetite, dyspnea, nausea, vomiting, and diarrhea. One group had multiple and severe symptom subgroup and another had Less symptoms and with lower severity. Multiple and severe symptoms had worse PS, role functioning, and physical, emotional, cognitive, social, and overall HRQOL. Multiple and severe symptom subgroup was also six times as likely as lower severity to have poor role functioning;five times more likely to have poor emotional;four times more likely to have poor PS, physical, and overall HRQOL, and three times as likely to have poor cognitive and social HRQOL, independent of gender, age, level of education, and economic condition. Classification and Regression Tree analyses were undertaken to identify which co-occurring symptoms would best determine reduction in HRQOL and PS. Pain and fatigue were identified as indicators of reduction on physical HRQOL and PS. Fatigue and insomnia were associated with reduction in cognitive; depression and pain in social; and fatigue and constipation in role functioning. Only depression was associated with reduction in overall HRQOL. These data demonstrate that there is a synergic effect among distinct cancer symptoms that result in reduction in HRQOL dimensions and PS.

Complexity of human postural control in young and older adults during prolonged standing

Aging is known to have a degrading influence on many structures and functions of the human sensorimotor system. The present work assessed aging-related changes in postural sway using fractal and complexity measures of the center of pressure (COP) dynamics with the hypothesis that complexity and fractality decreases in the older individuals. Older subjects (68 +/- 4 years) and young adult subjects (28 +/- 7 years) performed a quiet stance task (60 s) and a prolonged standing task (30 min) where subjects were allowed to move freely. Long-range correlations (fractality) of the data were estimated by the detrended fluctuation analysis (DFA); changes in entropy were estimated by the multi-scale entropy (MSE) measure. The DFA results showed that the fractal dimension was lower for the older subjects in comparison to the young adults but the fractal dimensions of both groups were not different from a 1/f noise, for time intervals between 10 and 600 s. The MSE analysis performed with the typically applied adjustment to the criterion distance showed a higher degree of complexity in the older subjects, which is inconsistent with the hypothesis that complexity in the human physiological system decreases with aging. The same MSE analysis performed without adjustment showed no differences between the groups. Taken all results together, the decrease in total postural sway and long-range correlations in older individuals are signs of an adaptation process reflecting the diminishing ability to generate adequate responses on a longer time scale.

Cultural meaning of quality of life: perspectives of Brazilian burn patients

Purpose. This study was designed to explore the cultural meaning and dimensions of quality of life from the perspective of Brazilian burn patients. Method. A qualitative research approach was used. Nineteen burn patients and their close relatives participated in this ethnographic study. Data were collected by means of direct observation and semi-structured interviews, conducted in a hospital outpatient clinic and during visits to patients` homes. The following inter-related phases guided the analysis process: reading of the material and data reduction, data display, conclusion outlining and verification. Results. Participants reported that the quality of life is related to autonomy and the ability to work. The dimensions of quality of life included: resuming work and functional ability, body image, having leisure and interpersonal relationships. Their descriptions revealed their feelings and attitudes about resuming their previous activities and social lives, particularly concerning the work. Conclusion. For burn patients, quality of life is associated with the concept of normality, the satisfactory performance of social roles in the context of family life and the social world. The results showed the importance of the sociocultural dimension in the concept of quality of life for persons undergoing burn rehabilitation.

Aerodynamic study of three-dimensional larynx models using finite element methods

The airflow velocities and pressures are calculated from a three-dimensional model of the human larynx by using the finite element method. The laryngeal airflow is assumed to be incompressible, isothermal, steady, and created by fixed pressure drops. The influence of different laryngeal profiles (convergent, parallel, and divergent), glottal area, and dimensions of false vocal folds in the airflow are investigated. The results indicate that vertical and horizontal phase differences in the laryngeal tissue movements are influenced by the nonlinear pressure distribution across the glottal channel, and the glottal entrance shape influences the air pressure distribution inside the glottis. Additionally, the false vocal folds increase the glottal duct pressure drop by creating a new constricted channel in the larynx, and alter the airflow vortexes formed after the true vocal folds. (C) 2007 Elsevier Ltd. All rights reserved.

Efficiency and feasibility of product disassembly: A case-based study

The productivity associated with commonly available disassembly methods today seldomly makes disassembly the preferred end-of-life solution for massive take back product streams. Systematic reuse of parts or components, or recycling of pure material fractions are often not achievable in an economically sustainable way. In this paper a case-based review of current disassembly practices is used to analyse the factors influencing disassembly feasibility. Data mining techniques were used to identify major factors influencing the profitability of disassembly operations. Case characteristics such as involvement of the product manufacturer in the end-of-life treatment and continuous ownership are some of the important dimensions. Economic models demonstrate that the efficiency of disassembly operations should be increased an order of magnitude to assure the competitiveness of ecologically preferred, disassembly oriented end-of-life scenarios for large waste of electric and electronic equipment (WEEE) streams. Technological means available to increase the productivity of the disassembly operations are summarized. Automated disassembly techniques can contribute to the robustness of the process, but do not allow to overcome the efficiency gap if not combined with appropriate product design measures. Innovative, reversible joints, collectively activated by external trigger signals, form a promising approach to low cost, mass disassembly in this context. A short overview of the state-of-the-art in the development of such self-disassembling joints is included. (c) 2008 CIRP.

Environmental management system and human resource practices: is there a link between them in four Brazilian companies?

The aim of this article is to analyze the theoretical model proposed by [Jabbour CJC, Santos FCA. Relationships between human resource dimensions and environmental management in companies: proposal of a model. Journal of Cleaner Production 2008;16(1):5 1-8.] based on the data collected in four Brazilian companies. This model investigates how the phases of the environmental management system can be linked to human resource practices in order to attain continuous improvement of a company`s environmental performance. Our aim is to contribute to a field, which has little empirical evidence. Although the interaction between the phases of the environmental management system and human resource practices is recommended by the specialized literature [Daily BE Huang S. Achieving sustainability through attention to human resource factors in environmental management. International Journal of Operations and Production Management 2001:21(12):1539-52.], the results indicate that most of the theoretical assumptions could not be confirmed in these Brazilian companies. (C) 2008 Elsevier Ltd. All rights reserved.

Contributions of HRM throughout the stages of environmental management: methodological triangulation applied to companies in Brazil

The purpose of this research is to analyze the contribution of human resources management throughout the evolutionary stages of environmental management in Brazilian companies. A theoretical framework concerning environmental management and its evolution and the `greening` of the functional and competitive dimensions of human resource management were developed. A methodological triangulation was developed in two complimentary phases. In the first phase, data were collected from 94 Brazilian companies with ISO 14001 certification. The data collected were analyzed and processed using statistical techniques. The conclusions of the first phase supported the second phase of this empirical research. The second phase consisted of a study of multiple cases in four Brazilian companies. The results show evidence of the first known empirical study of contributions of human resource dimensions throughout the stages of environmental management in Brazilian manufacturing companies.

Timoshenko versus Euler beam theory: Pitfalls of a deterministic approach

The selection criteria for Euler-Bernoulli or Timoshenko beam theories are generally given by means of some deterministic rule involving beam dimensions. The Euler-Bernoulli beam theory is used to model the behavior of flexure-dominated (or ""long"") beams. The Timoshenko theory applies for shear-dominated (or ""short"") beams. In the mid-length range, both theories should be equivalent, and some agreement between them would be expected. Indeed, it is shown in the paper that, for some mid-length beams, the deterministic displacement responses for the two theories agrees very well. However, the article points out that the behavior of the two beam models is radically different in terms of uncertainty propagation. In the paper, some beam parameters are modeled as parameterized stochastic processes. The two formulations are implemented and solved via a Monte Carlo-Galerkin scheme. It is shown that, for uncertain elasticity modulus, propagation of uncertainty to the displacement response is much larger for Timoshenko beams than for Euler-Bernoulli beams. On the other hand, propagation of the uncertainty for random beam height is much larger for Euler beam displacements. Hence, any reliability or risk analysis becomes completely dependent on the beam theory employed. The authors believe this is not widely acknowledged by the structural safety or stochastic mechanics communities. (C) 2010 Elsevier Ltd. All rights reserved.

Effect of fibre morphology on flocculation of fibre-cement suspensions

The objective of the present research was to evaluate the effect of fibre morphology (e.g., length, width, fibrillation, broken ends, content of fines and number of fibres per gram) on flocculation and drainage properties of fibre-cement suspensions and on physical properties of the fibre-cement composites. Mechanical refining was used to change the morphological properties of Eucalyptus and Pinus pulps. Results show that the mechanical refining increased the size of the formed flocs and decreased the concentration of free small particles (with dimensions between 1 and 20 pm) as a consequence of the increased fibrillation and content of fines, which increased the capacity of the fibres to capture the mineral particles. High levels of refining were necessary for Pinus pulp to obtain cement retention values similar to those obtained by unrefined Eucalyptus pulp. This is due to the higher number of fibres per gram in Eucalyptus pulp than in Pinus pulp. Pulp refining improved the packing of the particles and, although decreased the drainage rate. it contributed to a less porous structure, which improved the microstructure of the composite. (C) 2009 Elsevier Ltd. All rights reserved.

Dimension stone for building facades: methodology for structural design

The importance of a careful selection of rocks used in building facade cladding is highlighted. A simple and viable methodology for the structural detailing of dimension stones and the verification of the global performance is presented based on a Strap software simulation. The results obtained proved the applicability of the proposed structural dimensioning methodology which represents an excellent simple tool for dimensioning rock slabs used for building facade cladding. The Strap software satisfactorily simulated the structural conditions of the stone slabs under the studied conditions, allowing the determination of alternative slab dimensions and the verification of the cladding strength at the support.

Influence of physical and geometrical parameters on three-dimensional load transfer mechanism at tunnel face

Three-dimensional discretizations used in numerical analyses of tunnel construction normally include excavation step lengths much shorter than tunnel cross-section dimensions. Simulations have usually worked around this problem by using excavation steps that are much larger than the actual physical steps used in a real tunnel excavation. In contrast, the analyses performed in this study were based on finely discretized meshes capable of reproducing the excavation lengths actually used in tunnels, and the results obtained for internal forces are up to 100% greater than those found in other analyses available in the literature. Whereas most reports conclude that internal forces depend on support delay length alone, this study shows that geometric path dependency (reflected by excavation round length) is very strong, even considering linear elasticity. Moreover, many other solutions found in the literature have also neglected the importance of the relative stiffness between the ground mass and support structure, probably owing to the relatively coarse meshes used in these studies. The analyses presented here show that relative stiffness may account for internal force discrepancies in the order of 60%. A dimensionless expression that takes all these parameters into account is presented as a good approximation for the load transfer mechanism at the tunnel face.

A comparison between neodymium doped alumina samples obtained by Pechini and sol-gel methods using thermo-stimulated luminescence and SEM

Neodymium doped and undoped aluminum oxide samples were obtained using two different techniques: Pechini and sol-gel. Fine grained powders were produced using both procedures, which were analyzed using Scanning Electron Microscopy (SEM) and Thermo-Stimulated Luminescence (TSL). Results showed that neodymium ions incorporation is responsible for the creation of two new TSL peaks (125 and 265 degrees C) and, also, for the enhancement of the intrinsic TSL peak at 190 degrees C. An explanation was proposed for these observations. SEM gave the dimensions of the clusters produced by each method, showing that those obtained by Pechini are smaller than the ones produced by sol-gel; it can also explain the higher emission supplied by the first one. (C) 2010 Elsevier B.V. All rights reserved.

The recent occurrence, establishment and potential impact of Geophagus proximus (Cichlidae : Perciformes) in the Tiete River reservoirs: an Amazonian fish species introduced in the Parana Basin (Brazil)

The introduction of allochthonous fish species happens constantly in large bodies of freshwater, like as the reservoirs of Parana Basin, located in Brazilian southeast, representing a threat for local biodiversity. The fish species Plagioscion squamosissimus and Cichla ocellaris were introduced from the 1970s in several water bodies of this basin and had successfully established themselves in all six reservoirs located in the middle and lower Tiete River (SP, Brazil), particularly. After six decades from the first recorded species introduction, this hydrographic system remains open to the invasion of further fish species, owing to widespread fish-farming activity and by the channels opened between this system and other reservoirs and river basin. This study was an effort to confirm the Geophagus proximus occurrence in the six Tiete River reservoirs, verifying the actual introduction status and analyzing its potential environmental impacts on local species by the analysis of the population structure (abundance, body dimensions and feeding habits). By the results, this species was confirmed in the Ibitinga, Nova Avanhandava and Tres Irmaos reservoirs. The abundance and feeding analysis shows, respectively, it is successfully established in the Tres Irmaos reservoir with the same feeding habitats of local species, such as Geophagus brasiliensis. It was further shown to be very likely that G. proximus would spread throughout the reservoir system of the middle and lower Tiete River, in the manner of P. squamosissimus and C. ocellaris, and the competition pressure for food resources between G. proximus and the local species which represents a potential environmental impact system. These scientific evidences fortifies the knowledge basin for the implantation of a fish management system, to control and reduce the abundance of the invader and to prevent its becoming established in all the Tiete River Basin, avoiding the disastrous consequences for the native species of Parana River Basin.

Learning Profile Identification Based on the Analysis of the User Context of Interaction

One of the e-learning environment goal is to attend the individual needs of students during the learning process. The adaptation of contents, activities and tools into different visualization or in a variety of content types is an important feature of this environment, bringing to the user the sensation that there are suitable workplaces to his profile in the same system. Nevertheless, it is important the investigation of student behaviour aspects, considering the context where the interaction happens, to achieve an efficient personalization process. The paper goal is to present an approach to identify the student learning profile analyzing the context of interaction. Besides this, the learning profile could be analyzed in different dimensions allows the system to deal with the different focus of the learning.

A geometrical approach of 3-D FEA for educational purposes applied to electrostatic fields

A geometrical approach of the finite-element analysis applied to electrostatic fields is presented. This approach is particularly well adapted to teaching Finite Elements in Electrical Engineering courses at undergraduate level. The procedure leads to the same system of algebraic equations as that derived by classical approaches, such as variational principle or weighted residuals for nodal elements with plane symmetry. It is shown that the extension of the original procedure to three dimensions is straightforward, provided the domain be meshed in first-order tetrahedral elements. The element matrices are derived by applying Maxwell`s equations in integral form to suitably chosen surfaces in the finite-element mesh.