A promotora de salud CVD intervention: Participant responses after Su Corazon, Su Vida education

In this study we sought to identify and understand feelings, benefits and barriers to making heart healthy behavioral changes by reviewing and analyzing participant responses to a follow-up telephone survey conducted as part of the HEART project (Health Education Awareness Research Team). Individuals who participated in HEART attended classes and received “Su Corazon, Su Vida” education. The HEART follow-up telephone survey was conducted only on those participants who were part of the experimental group. A total of 93 individuals from this group were successfully contacted for participation in the telephone survey after the classes ended. Quantitative data regarding ‘feelings’ and ‘difficulty making heart healthy behavioral changes’ were analyzed by calculating frequencies of each category of response for post-intervention weeks 9, 13, and 15. In addition, Wilcoxon rank-sum tests were conducted for post-intervention at weeks 9, 13, and 15 to measure associations between feelings and difficulties making heart healthy behavioral changes. Changes in responses over time for feelings and difficulties making heart healthy behavioral changes were looked at by counting differences in responses between pairs of follow up weeks. Qualitative responses to the survey were analyzed by categorizing content of responses under themes in order to identify factors related to feelings and difficulties making heart healthy behavioral changes. Telephone survey participants showed positive attitudes towards making nutritional and physical activity changes. Out of the 93 telephone survey respondents, 53 (57%) reported some type of physical activity change during the follow-up period while 46 (49%) reported specific changes in nutrition. Data from the “difficulty to making changes” responses were categorized under constructs from the Health Belief Model, perceived benefits and barriers. Overall, the barriers for physical activity were health issues, individual habits and time. Barriers to eating healthy were family support, individual habits, and knowledge. This study suggests that with respect to nutritional knowledge barriers, educational programs should explore other ways of teaching and familiarizing individuals with information sources that may be more appropriate for those populations not accustomed to them. For example, nutrition labels, portions, recipes, and use of photonovelas. Our findings of the barriers to changes in food preparation due to lack of family support may also suggest the need for the development of programs where influential partners or relatives are involved in order to create a more supportive environment which may provide more opportunity for change toward healthier lifestyle behaviors. Finally, the physical activity barriers found suggest that it may be beneficial to recommend appropriate exercises for those with specific health problems or those with time restrictions due to work or travel so that physical activity is not completely avoided.^

Systematic review of current trends of cardiovascular disease (CVD) and association between health insurance coverage and CVD mortality among women aged 60--65 in Texas in 2000--2011

Cardiovascular disease (CVD) is highly preventable, yet it is a leading cause of death among women in Texas. The primary goals of this research were to examine past and current trends of CVD, as well as identify whether there is an association between the insurance coverage and mortality from CVD among women aged 60–65 in Texas between 2000 and 2011. ^ The systematic review of the research is based on the guidelines and recommendations set by the Centre for Reviews and Dissemination for conducting reviews in health care. Over 47 citations of peer-reviewed articles from Ovid MEDLINE and PubMed databases and five websites were identified, of which 7 studies met inclusion criteria for the first systematic review to examine the trends of CVD in Texas. Ten citations of peer-reviewed articles from Ovid MEDLINE and PubMed databases and five web sites were reviewed for the second systematic review (to study the association between insurance coverage and cardiovascular health among Texas women 60–64 years of age), of which 3 studies met inclusion criteria and were included in the research. The results of the study highlighted key gaps in the existing literature and important areas for the further research, as well as determined directions for future public health CVD prevention programs in Texas. ^ Based on the conducted research, the major determinants of premature mortality among women attributed to cardiovascular disease are based on individual level characteristics, more specifically sex, age, race/ethnicity, and education. The results indicate that African American and non-Hispanic white women are more likely to have higher CVD mortality rates than Hispanic women due to higher prevalence of cardiac risk factors. The data also shows higher levels of mortality from CVD in the southeastern United States, with Texas ranking as the third state with the highest prevalence of CVD among women. According to the Texas Department of State Health Services, there are approximately 56,000 deaths caused by CVD annually in Texas, which represents about one death every ten minutes. Coronary artery disease and stroke were the causes of 31.2 percent of all female deaths in Texas in 2009, meaning that approximately 68 women die from any form of cardiac disease in Texas each day. ^ The data of the reviewed studies indicate that women' lack of health insurance was significantly associated with a higher prevalence of cardiovascular disease. The uninsured women were more likely to be unaware of their risk factors and more likely to have undiagnosed diabetes—a co-morbidity factor of CVD. One of the studies also reports strong correlation between state rates of uninsured and lower rates of preventive care. Given these strong correlations, those who were chronically uninsured were at a higher risk of mortality than the insured, due to prolonged periods of time without basic access to preventive and medical care. ^ Suggested recommendations to decrease CVD mortality rates in Texas are consistent with the existing literature and include state policy development that addresses elimination of health disparities, consideration of potential benefits of universal health coverage by the legislative policymakers, and maintenance of solid partnerships between public health agencies and hospitals to educate on, diagnose, and treat CVD among the female population in Texas. ^

Ozone and fine particulate matter association with CVD and COPD emergency room visits in Harris County, Texas: Spatiotemporal analysis

This study represents a secondary analysis of the merging of emergency room visits and daily ozone and PM2.5. Although the adverse health effects of ozone and fine particulate matter have been documented in the literature, evidence regarding the health risks of these two pollutants in Harris County, Texas, is limited. Harris County (Houston) has sufficiently unique characteristics that analysis of these relationships in this setting and with the ozone and industry issues in Houston is informative. The objective of this study was to investigate the association between the joint exposure to ozone and fine particulate matter, and emergency room diagnoses of chronic obstructive pulmonary disease and cardiovascular disease in Harris County, Texas, from 2004 to 2009, with zero and one day lags. ^ The study variables were daily emergency room visits for Harris County, Texas, from 2004 to 2009, temperature, relative humidity, east wind component, north wind component, ozone, and fine particulate matter. Information about each patient's age, race, and gender was also included. The two dichotomous outcomes were emergency room visits diagnoses for chronic obstructive pulmonary disease and cardiovascular disease. Estimates of ozone and PM2.5 were interpolated using kriging, in which estimates of the two pollutants were predicted from monitoring data for every case residence zip code for every day of the six years, over 3 million estimates (one of each pollutant for each case in the database). ^ Logistic regressions were conducted to estimate odds ratios of the two outcomes. Three analyses were conducted: one for all records, another for visits during the four months of April and September of 2005 and 2009, and a third one for visits from zip codes that are close to PM2.5 monitoring stations (east area of Harris County). The last two analyses were designed to investigate special temporal and spatial characteristics of the associations. ^ The dataset included all ER visits surveyed by Safety Net from 2004 to 2009, exceeding 3 million visits for all causes. There were 95,765 COPD and 96,596 CVD cases during this six year period. A 1-μg/m3 increase in PM2.5 on the same day was associated with a 1.0% increase in the odds of chronic obstructive pulmonary disease emergency room diagnoses, a 0.4% increase in the odds of cardiovascular disease emergency room diagnoses, and a 0.2% increase in the odds of cardiovascular disease emergency room diagnoses on the following day. A 1-ppb increase in ozone was associated with a 0.1% increase in the odds of chronic obstructive pulmonary disease emergency room diagnoses on the same day. These four percentages add up to 1.7% of ER visits. That is, over the period of six years, one unit increase for both ozone and PM2.5 (joint increase), resulted in about 55,286 (3,252,102 * 0.017) extra ER visits for CVD or COPD, or 9,214 extra ER visits per year. ^ After adjustment for age, race, gender, day of the week, temperature, relative humidity, east wind component, north wind component, and wind speed, there were statistically significant associations between emergency room chronic obstructive pulmonary disease diagnosis in Harris County, Texas, with joint exposure to ozone and fine particulate matter for the same day; and between emergency room cardiovascular disease diagnosis and exposure to PM2.5 of the same day and the previous day. ^ Despite the small association between the two air pollutants and the health outcomes, this study points to important findings. Namely, the need to identify reasons for the increase of CVD and COPD ER visits over the course of the project, the statistical association between humidity (or whatever other variables for which it may serve as a surrogate) and CVD and COPD cases, and the confirmatory finding that males and blacks have higher odds for the two outcomes, as consistent with other studies. ^ An important finding of this research suggests that the number and distribution of PM2.5 monitors in Harris County - although not evenly spaced geographically—are adequate to detect significant association between exposure and the two outcomes. In addition, this study points to other potential factors that contribute to the rising incidence rates of CVD and COPD ER visits in Harris County such as population increases, patient history, life style, and other pollutants. Finally, results of validation, using a subset of the data demonstrate the robustness of the models.^

Exploring polysilicon deposition conditions through a laboratory CVD prototype

Cost and energy consumption related to obtaining polysilicon impact significantly on the total photovoltaic module cost and its energy payback time. Process simplifications can be performed, leading to cost reductions. Nowadays, among several approaches currently pursued to produce the so called Solar Grade Silicon, the chemical route, named Siemens process, is the dominant one. At the Instituto de Energía Solar research on this topic is focused on the chemical route, in particular on the polysilicon deposition step by chemical vapor deposition (CVD) from Trichlorosilane through a laboratory prototype. Valuable information about the phenomena involved in the polysilicon deposition process and the operating conditions is obtained from our experiments. A particular feature of our system is the inclusion of a mass spectrometer. The present work comprises spectra characterization of the polysilicon deposition chemical reaction, temperature and inlet gas mixture composition influence on the deposition rate and analysis of polysilicon deposition conditions for the ?pop-corn' phenomenon to appear, based on experimental experience (Actas de la Special Issue: E-MRS 2012 Spring Meeting ? Symposium A

Radiation heat savings in polysilicon production: validation of results through a CVD laboratory prototype

This work aims at a deeper understanding of the energy loss phenomenon in polysilicon production reactors by the so-called Siemens process. Contributions to the energy consumption of the polysilicon deposition step are studied in this paper, focusing on the radiation heat loss phenomenon. A theoretical model for radiation heat loss calculations is experimentally validated with the help of a laboratory CVD prototype. Following the results of the model, relevant parameters that directly affect the amount of radiation heat losses are put forward. Numerical results of the model applied to a state-of-the-art industrial reactor show the influence of these parameters on energy consumption due to radiation per kilogram of silicon produced; the radiation heat loss can be reduced by 3.8% when the reactor inner wall radius is reduced from 0.78 to 0.70 m, by 25% when the wall emissivity is reduced from 0.5 to 0.3, and by 12% when the final rod diameter is increased from 12 to 15 cm.

Heat losses in a CVD reactor for polysilicon: comprehensive model and experimental validation

This work addresses heat losses in a CVD reactor for polysilicon production. Contributions to the energy consumption of the so-called Siemens process are evaluated, and a comprehensive model for heat loss is presented. A previously-developed model for radiative heat loss is combined with conductive heat loss theory and a new model for convective heat loss. Theoretical calculations are developed and theoretical energy consumption of the polysilicon deposition process is obtained. The model is validated by comparison with experimental results obtained using a laboratory-scale CVD reactor. Finally, the model is used to calculate heat consumption in a 36-rod industrial reactor; the energy consumption due to convective heat loss per kilogram of polysilicon produced is calculated to be 22-30 kWh/kg along a deposition process.

Electrical model for characterizing CVD graphene

Due to its extremely small thickness (0.35 nm), graphene is an intrinsic 2D nanomaterial. As in many other nanomaterials, its unique properties are derived from its exceptional dimensions. One of these properties is its linear dispersion equation that implies charge carriers with extraordinary high mobility. Therefore, the electronic properties of the material can lead to a big improvement in the performance of known electronic devices, or even result in novel devices for a post-silicon era.

Thermal shields for heat loss reduction in Siemens-type CVD reactors

The use of thermal shields to reduce radiation heat loss in Siemens-type CVD reactors is analyzed, both theoretically and experimentally. The potential savings from the use of the thermal shields is first explored using a radiation heat model that takes emissivity variations with wavelength into account, which is important for materials that do not behave as grey bodies. The theoretical calculations confirm that materials with lower surface emissivity lead to higher radiation savings. Assuming that radiation heat loss is responsible for around 50% of the total power consumption, a reduction of 32.9% and 15.5% is obtained if thermal shields with constant emissivities of 0.3 and 0.7 are considered, respectively. Experiments considering different thermal shields are conducted in a laboratory CVD reactor, confirming that the real materials do not behave as grey bodies, and proving that significant energy savings in the polysilicon deposition process are obtained. Using silicon as a thermal shield leads to energy savings of between 26.5-28.5%. For wavelength-dependent emissivities, the model shows that there are significant differences in radiation heat loss, of around 25%, when compared to that of constant emissivity. The results of the model highlight the importance of having reliable data on the emissivities within the relevant range of wavelengths, and at deposition temperatures, which remains a pending issue.

Determination of a refractive index and an extinction coefficient of standard production of CVD-graphene

The refractive index and extinction coefficient of chemical vapour deposition grown graphene are determined by ellipsometry analysis. Graphene films were grown on copper substrates and transferred as both monolayers and bilayers onto SiO2/Si substrates by using standard manufacturing procedures. The chemical nature and thickness of residual debris formed after the transfer process were elucidated using photoelectron spectroscopy. The real layered structure so deduced has been used instead of the nominal one as the input in the ellipsometry analysis of monolayer and bilayer graphene, transferred onto both native and thermal silicon oxide. The effect of these contamination layers on the optical properties of the stacked structure is noticeable both in the visible and the ultraviolet spectral regions, thus masking the graphene optical response. Finally, the use of heat treatment under a nitrogen atmosphere of the graphene-based stacked structures, as a method to reduce the water content of the sample, and its effect on the optical response of both graphene and the residual debris layer are presented. The Lorentz-Drude model proposed for the optical response of graphene fits fairly well the experimental ellipsometric data for all the analysed graphene-based stacked structures.

Uso de Data Mining e do ECR para incremento da competitividade de pequenas e médias empresas: um estudo multicaso sobre varejo e indústria alimentícia

O setor supermercadista sofreu grandes alterações nos últimos anos, principalmente com o avanço das tecnologias, a competição, a concentração e algumas insuficiências em seus processos. Estes e outros fatores favoreceram ao surgimento do movimento de ECR (Resposta de Consumidor Eficiente) que procura criar um relacionamento mais forte entre indústria e varejo através de novas visões para suas estratégias operacionais. A evolução das tecnologias de informação permitiram ao setor varejista gerar uma maior volume de dados a partir, principalmente, de seus check-outs. Entretanto, estes dados nem sempre são armazenados de forma correta ou utilizados de forma a se aproveitar a plenitude das informações neles contidas. O processo de transformar os dados em informação e conhecimento vem evoluindo constantemente. Uma das atuais metodologias de trabalhar dados é o Data Mining ou Mineração de Dados, que pode ser descrito como sendo uma variedade de ferramentas e estratégias que processam dados aumentando a utilidade destes em bancos de dados. Este trabalho analisa através de um estudo multicaso exploratório na região de Ribeirão Preto, no interior de São Paulo, a avaliação da capacidade do uso da tecnologia Data Mining para o fortalecimento do movimento ECR, principalmente em pequenos e médios varejistas e indústrias alimentícias, no sentido de oferecer a estes um diferencial de negociação para formação de alianças estratégias.

Dietary enrichment with almond (Prunus amygdalis) supplementation: effects on CVD risk biomarkers

Epidemiological evidence suggests that diets rich in fruits, vegetables and pulses reduce the risk of CVD. The Physicians Health Study has demonstrated reduction of CHD death with regular nut consumption1. One major modifiable risk factor for CHD is an unhealthy diet. Thus, an almondenrichment study has been undertaken to examine the benefit of almonds (Prunus amygdalis) in healthy individuals either with or without significant risk of vascular disease. Almonds contain various macronutrients (low SFA content, absence of cholesterol and high MUFA content) and micronutrients, including vitamin E, polyphenols and arginine, which afford vascular benefit. The effects of almond consumption (25 g/d for 4 weeks followed by 50 g/d for 4 weeks) were evaluated in three non-smoking subject groups: healthy male volunteers between the ages of 18 and 35 years (n 15); men at risk of heart disease between the ages of 18 and 35 years (n 12); mature men and women >50 years of age (n 18). A fourth control group (n 14) were followed over 8 weeks without dietary almond enrichment as a treatment control. None of the subjects withdrew from the study and 90% completed the study. The interim results of the study showed that in the three active groups there was little evidence for a change in total cholesterol, LDL-cholesterol or HDL-cholesterol. In the mature group there was a trend towards increasing HDL-cholesterol. The mature and ‘at-risk’ groups also showed a significant changes in systolic blood pressure (P<0.05) during almond consumption. The healthy group showed a decrease in diastolic blood pressure (P<0.05). The ‘at-risk’ group showed a significant increase (P<0.05) in flowmediated dilation after 8 weeks of almond consumption. Data analysis is ongoing, with completion of the study in November 2007. The beneficial effects of almond consumption on flow-mediated dilation and blood pressure may be attributed to the high content in almonds of arginine, which serves as a precursor to the vasodilatory molecule, NO.