984 resultados para Rose, Gillian


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Pela repercussão de determinadas famílias serem estigmatizadas, considerando-se “disfuncionais” ou “desestruturadas” (Furniss, 1991; Marvasti, 1995), tivemos como objetivos favorecer a identificação de fatores socioculturais (e de estrutura familiar) e discriminar indicadores de mal-estar e risco familiar. Com uma metologia qualitativa, num contexto de investigação-ação (Bryman, 2008; Denzin & Lincoln, 2005), junto de crianças referenciadas para acolhimento institucional foi utilizado por estudantes de ensino superior um guião, para entrevistas individuais, face a face e semiestrutruradas (Harrison, Geddens, & Sharpe, 2006). Selecionamos para a amostra crianças a viverem em Centros de Acolhimento Temporário (CAT), incluindo-se 7 do sexo feminino e 7 do sexo masculino. Para análise dos dados recolhidos recorremos a metodologias visuais e de análise de discurso (Rose, 2005). Os resultados permitiram-nos identificar crises familiares graves e outras mudanças aludidas constatando-se ser desenhada a “pessoa especial” e uma família (Corman, 1967; Font, 1978). Os diálogos sobre as circunstâncias e atividades do quotidiano, revelaram que o insucesso escolar é uma manifestação de preocupação de quem tenta incentivar os mais novos na procura de amizades, na construção de uma maior autonomia, estabelecendo-lhes limites de conduta e apoio na criação de objetivos e nos seus esforços para dominarem a agressividade.

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Purpose: To evaluate how soft lens power affects rigid gas-permeable (RGP) lens power and visual acuity (VA) in piggyback fittings for keratoconus. Methods: Sixteen keratoconus subjects (30 eyes) were included in the study. Piggyback contact lens fittings combining Senofilcon-A soft lenses of −6.00, −3.00, +3.00 and +6.00 D with Rose K2 RGP contact lenses were performed. Corneal topography was taken on the naked eye and over each soft contact lens before fitting RGP lenses. Mean central keratometry, over-refraction, RGP back optic zone radius (BOZR) and estimated final power as well as VA were recorded and analyzed. Results: In comparison to the naked eye, the mean central keratometry flattened with both negative lens powers (p < 0.05 in all cases), did not change with the +3.00 soft lens power (p = 1.0); and steepened with the +6.00 soft lens power (p = 0.02). Rigid gas-permeable over-refraction did not change significantly between different soft lens powers (all p > 0.05). RGP’s BOZR decreased significantly with both positive in comparison with both negative soft lens powers (all p < 0.001), but no significant differences were found among negative- or positive-powers separately (both p > 0.05). Estimated RGP’s final power increased significantly with positive in comparison with negative lens powers (all p < 0.001), but no significant differences were found among negative or positive lens powers separately (both p > 0.05). Visual acuity did not change significantly between the different soft lens powers assessed (all p > 0.05). Conclusion: The use of negative-powered soft lenses in piggyback fitting reduces RGP lens power without impacting VA in keratoconus subjects.

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Tese de Doutoramento em Engenharia Eletrónica e Computadores.

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Dissertação de mestrado em Comunicação, Arte e Cultura

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In some regions of Brazil, especially where the water is scarce, drinking water is stored in water storage tanks. This practice gives the consumer the guarantee of available water. The water storage conditions such as the exposure to hot weather when the tanks are on rooftops allow the development of microorganisms and microbial biofilms which can deteriorate the water quality and increase the risk to human health [1,2]. This study describes the filamentous fungi (FF) detected in free water and biofilms in drinking water storage tanks in Recife - Pernambuco, Brazil. Five sampling times in triplicate were performed at two distinct points. Colony-forming units (CFU) of FF fungi were determined with 0.45 μm filtration membranes using peptone glucose rose Bengal agar (PGRBA). From the 30 samples analysed a total of 1136 CFU were obtained. The water biofilms were collected from samplers consisting of polyethylene coupons, previously installed in the reservoirs. These coupons were transferred to PGRBA plates and incubated using with the same conditions described for free FF. For the in situ detection of FF in biofilms the Calcofluor White staining technique was used. This procedure demonstrated FF forming biofilms on the surfaces of the coupons. Brazilian legislation does not define limits for FF in drinking water. However considering the potential risk of fungal contamination, the data obtained in this study will contribute to developing future quantitative and qualitative parameters for the presence of fungi in drinking water distribution systems in Brazil.

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OBJECTIVE: To study electrophysiological characteristics that enable the identification and ablation of sites of chagasic tachycardia. METHODS: Thirty-one patients with chronic Chagas' heart disease and sustained ventricular tachycardia (SVT) underwent electrophysiological study to map and ablate that arrhythmia. Fifteen patients had hemodinamically stable SVT reproducible by programmed ventricular stimulation, 9 men and 6 women with ages ranging from 37 to 67 years and ejection fraction varying from 0.17 to 0.64. Endocardial mapping was performed during SVT in all patients. Radiofrequency (RF) current was applied to sites of presystolic activity of at least 30 ms. Entrainment was used to identify reentrant circuits. In both successful and unsuccessful sites of RF current application, electrogram and entrainment were analyzed. RESULTS: Entrainment was obtained during all mapped SVT. In 70.5% of the sites we observed concealed entrainment and ventricular tachycardia termination in the first 15 seconds of RF current application. In the unsuccessful sites, significantly earlier electrical activity was seen than in the successful ones. Concealed entrainment was significantly associated with ventricular tachycardia termination. Bystander areas were not observed. CONCLUSION: The reentrant mechanism was responsible for the genesis of all tachycardias. In 70.5% of the studied sites, the endocardial participation of the slow conducting zone of reentrant circuits was shown. Concealed entrainment was the main electrophysiological parameter associated with successful RF current application. There was no electrophysiological evidence of bystander regions in the mapped circuits of SVT.

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OBJECTIVE: To characterize the risk profile for atherosclerosis (AS) in adolescents and young adults of a private university in São Paulo. METHODS: Clinical, nutritional, and laboratory parameters were evaluated in 209 students of both genders aged 17 to 25 years. In addition to determination of the lipid profile, the association of its abnormal values with other risk factors for AS was also investigated. RESULTS: Increased levels of total cholesterol, LDL-C and triglycerides (TG) were observed in 9.1%, 7.6% and 16.3% of the students, respectively, and decreased levels of HDL-C in 8.6% of them. Prevalence of the remaining risk factors analyzed was elevated: sedentary life style (78.9%); high intake of total fat (77.5%); high cholesterol intake (35.9%); smoking, hypertension (15.8%) and obesity (7.2%). There was an association between elevated LDL-C and TG levels and sedentary life style and body mass index. CONCLUSION: The high prevalence of risk factors for AS in young individuals draws attention to the need for adopting preventive plans.

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OBJECTIVE: Risk stratification of patients with nonsustained ventricular tachycardia (NSVT) and chronic chagasic cardiomyopathy (CCC). METHODS: Seventy eight patients with CCC and NSVT were consecutively and prospectively studied. All patients underwent to 24-hour Holter monitoring, radioisotopic ventriculography, left ventricular angiography, and electrophysiologic study. With programmed ventricular stimulation. RESULTS: Sustained monomorphic ventricular tachycardia (SMVT) was induced in 25 patients (32%), NSVT in 20 (25.6%) and ventricular fibrillation in 4 (5.1%). In 29 patients (37.2%) no arrhythmia was inducible. During a 55.7-month-follow-up, 22 (28.2%) patients died, 16 due to sudden death, 2 due to nonsudden cardiac death and 4 due to noncardiac death. Logistic regression analysis showed that induction was the independent and main variable that predicted the occurrence of subsequent events and cardiac death (probability of 2.56 and 2.17, respectively). The Mantel-Haenszel chi-square test showed that survival probability was significantly lower in the inducible group than in the noninductible group. The percentage of patients free of events was significantly higher in the noninducible group. CONCLUSION: Induction of SMVT during programmed ventricular stimulation was a predictor of arrhythmia occurrence cardiac death and general mortality in patients with CCC and NSVT.

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Dissertação de mestrado em Ordenamento e Valorização de Recursos Geológicos

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OBJECTIVE: To characterize the cardiac electrophysiologic effects of cocaine. METHODS: In 8 dogs (9-13 kg), electrophysiologic parameters and programmed stimulation were undertaken using transvenous catheters at baseline, and after cocaine intravenous infusion (12 mg/kg bolus followed by 0.22 mg/kg/min for 25 minutes). RESULTS: Cocaine plasma levels (n=5) rose to 6.73± 0.56 mg/mL. Cocaine did not affect sinus cycle length and arterial pressure. Cocaine prolonged P wave duration (54±6 vs 73±4 ms, P<0.001), PR interval (115±17 vs 164±15 ms, P<0.001), QRS duration (62±10 vs 88±14 ms, P<0.001), and QTc interval (344±28 vs 403±62 ms, P=0.03) but not JT interval (193±35 vs 226±53 ms, NS). Cocaine prolonged PA (9±6 vs 23±8 ms, P<0.001), AH (73±16 vs 92±15 ms; P=0.03), and HV (35±5 vs 45±3ms; P<0.001) intervals and Wenckebach point (247±26 vs 280±28 ms, P=0.04). An increase occurred in atrial (138±8 vs 184± 20 ms; P<0.001) and ventricular (160±15 vs 187±25 ms; P=0.03) refractoriness at a cycle length of 300 ms. Atrial arrhythmias were not induced in any dog. Ventricular fibrillation (VF) was induced in 2/8 dogs at baseline and 4/8 dogs after cocaine. CONCLUSION: High doses of cocaine exert significant class I effects and seem to enhance inducibility of VF but not of atrial arrhythmias.

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We report the case of implantation of metallic mitral and aortic valve prostheses 6 months earlier, with subsequent multiple embolic episodes. The anatomicopathological examination of the thrombus of the third embolic episode was compatible with Aspergillus sp, which was treated with amphotericin B, followed by oral itraconazole. On the fourth embolism, vegetations were visualized in the ascending aorta on echocardiography and resonance imaging, and the patient underwent replacement of the aortic segment by a Haemashield tube and exploration of the aortic prosthesis, which was preserved, because no signs of endocarditis were found. Four months later, the patient died due to cardiogenic shock secondary to acute myocardial infarction caused by probable coronary embolism and partial dysfunction of the aortic prosthesis.

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La administración estratégica está dominada por enfoques que consideran que el capital intelectual y el capital humano son fuente de ventaja competitiva (Brooking, 1996; Storey, 2007). Nuestro enfoque son competencias como activo intangible capaz de generar una ventaja competitiva sostenible en el tiempo. Estudiamos competencias directivas siguiendo el modelo del IESE (Abad Guerrero y Castillo Clavero, 2004). Los estudios previos tienden a enfocarse en grandes empresas; pero Larry Greiner (1998) había señalado que las prácticas de dirección que funcionan bien en una etapa de una empresa pueden desatar una crisis en otra. Por eso nos enfocamos en pymes, atendiendo a la gestión de implementación de sistemas ERP para la formalización de la gestión; al respecto, los líderes y sus diversas mezclas de competencias son un factor fundamental (Kroemmergard y Rose, 2002). En Argentina el 70% de las pymes son familiares (Davis, 2011). Mundialmente apenas el 8% de los negocios de familia alcanzan la tercera generación (Gallo, 1998; Barbeito y otros, 2004; Thornton, 2005; Kertész y otros, 2006; Müller, 2008); los trabajos sobre sucesión y relaciones familiares son los más publicados (Basco Rodrigo, et al., 2006). Para Fernández (2000) el fracaso de muchas pymes puede relacionarse con el estilo de liderazgo. El liderazgo es un tema de interés en la teoría y práctica administrativa actual (Hersey, Blanchard y Johnson, 2001; Storey, 2004; Robbins, 2004; Bass y Riggio, 2006, Yukl, 2008). Interesa el desafío que implica la dirección de empresas con diversas generaciones (García Lombardía, Stein y Pin, 2008). Observamos necesaria una investigación multidimensional que articule: estilo de liderazgo y valoración de competencias directivas por parte de dueños y/o gerentes de primera línea, con relación a las dificultades en la gestión del cambio generacional en la dirección de pymes familiares, atendiendo a las etapas de crecimiento de estas empresas y la aplicación de las TICs a la formalización de la gestión. Nuestra conjetura: las dificultades en la gestión del cambio generacional en la dirección de pymes familiares de la ciudad de Córdoba estarían relacionadas con el estilo de liderazgo y la valoración de competencias directivas intratégicas y de eficacia personal por parte de dueños y/o gerentes de primera línea de esas empresas. Planificamos una investigación de campo, no experimental, de dos etapas: exploratoria y asociativa; con diseño de investigación transaccional.

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FUNDAMENTO: A cardiopatia isquêmica é a doença responsável pelo maior número de mortes no mundo, sendo a angina sua principal manifestação. OBJETIVO: Determinar a prevalência de angina e de possível angina e sua distribuição conforme as principais características sócio-demográficas entre adultos com idade igual ou maior que 40 anos. MÉTODOS: Estudo transversal de base populacional com moradores da área urbana da cidade de Pelotas (RS) entre os meses de outubro e dezembro de 2007. Foi adotado o plano de amostragem por conglomerados em dois estágios - setores censitários e domicílios. As prevalências de angina e de possível angina foram definidas de acordo com o questionário de Rose. Essas condições foram avaliadas conforme as características sócio-demográficas: idade, sexo, cor da pele, condição econômica e escolaridade. Para a coleta dos dados, foram aplicados questionários padronizados por meio de entrevista com os indivíduos em seus domicílios. A taxa de não respondentes foi de 6,8%. RESULTADOS: A prevalência de angina entre os 1.680 indivíduos participantes do estudo foi de 8,2 % (IC 95%: 6,7 - 9,6), enquanto a de possível angina, 12,3% (IC 95%: 10,6 - 14,0). As prevalências de angina e de possível angina foram maiores entre os indivíduos do sexo feminino, de cor da pele preta/parda, de pior condição econômica e de menor escolaridade. A prevalência de angina foi maior entre indivíduos mais velhos. Não se observou diferença para possível angina. CONCLUSÃO: A prevalência de angina e de possível angina mostrou-se alta, acometendo cerca de 20% da população de Pelotas.

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FUNDAMENTO: No Brasil, são escassos os estudos sobre síndrome metabólica na população geral, mais raros são os que a correlacionam ao climatério. OBJETIVO: Determinar a prevalência da síndrome metabólica e seus componentes em mulheres climatéricas. MÉTODOS: Estudo transversal com 323 mulheres climatéricas, divididas em dois grupos: pré e pós-menopausadas. Foram avaliadas para presença de síndrome metabólica, segundo os critérios do National Cholesterol Education Program's (NCEP) e da International Diabetes Federation (IDF). Foi verificada a associação entre as variáveis estudadas e a síndrome metabólica por meio de análise uni e multivariada. Um p-valor < 0,05 foi considerado significante estatisticamente. RESULTADOS: A prevalência de síndrome metabólica no climatério foi de 34,7% (NCEP) e de 49,8% (IDF). Os componentes mais frequentes da síndrome metabólica foram o HDL-colesterol baixo, hipertensão arterial, obesidade abdominal, hipertrigliceridemia e diabete em ambos os critérios. A análise multivariada mostrou que a idade foi o fator de risco mais importante para o surgimento da síndrome metabólica (p < 0,001), que esteve presente em 44,4% (NCEP) e 61,5% (IDF) das mulheres menopausadas em comparação a 24% (NCEP) e 37% (IDF) daquelas na pré-menopausa. CONCLUSÃO: A prevalência de síndrome metabólica foi maior nas mulheres menopausadas que naquelas na pré-menopausa. O principal fator de risco para o aumento dessa prevalência foi a idade. A menopausa, quando analisada isoladamente, não se constituiu um fator de risco para a síndrome metabólica.