957 resultados para 923
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Recent benthic foraminifera and their distribution in surface sediments were studied on a transect through the Peruvian oxygen minimum zone (OMZ) between 10 and 12°S. The OMZ with its steep gradients of oxygen concentrations allows to determine the oxygen-dependent changes of species compositions in a relatively small area. Our results from sediments of thirteen multicorer stations from 79 to 823 m water depth demonstrate that calcareous species, especially bolivinids dominate the assemblages throughout the OMZ. The depth distribution of several species matches distinct ranges of bottom water oxygen levels. The distribution pattern inferred a proxy which allows to estimate dissolved oxygen concentrations for reconstructing oxygen levels in the geological past.
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Several samples from the rhyolitic lavas encountered in Hole 841 B in the Tonga Forearc were made available by A. Ewart for potassiumargon (K-Ar) dating in an attempt to constrain the age of the eruptions. The material was supplied in crushed form and consisted primarily of volcanic glass together with some microphenocrysts made up mainly of plagioclase and quartz. Plagioclase could not be separated in sufficient amount for dating, especially as the potassium content of the plagioclase was quite low (~0.055% K). Petrographic examination of the volcanic glass indicated that it was remarkably fresh: it was clear, unaltered, and essentially isotopic. Thus, it was decided to attempt to date the volcanic glass.
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The effect of decreasing aragonite saturation state (Omega Arag) of seawater (elevated pCO2) on calcification rates of Acropora muricata was studied using nubbins prepared from parent colonies located at two sites of La Saline reef (La Réunion Island, western Indian Ocean): a back-reef site (BR) affected by nutrient-enriched groundwater discharge (mainly nitrate), and a reef flat site (RF) with low terrigenous inputs. Protein and chlorophyll a content of the nubbins, as well as zooxanthellae abundance, were lower at RF than BR. Nubbins were incubated at ~27°C over 2 h under sunlight, in filtered seawater manipulated to get differing initial pCO2 (1,440-340 µatm), Omega Arag (1.4-4.0), and dissolved inorganic carbon (DIC) concentrations (2,100-1,850 µmol kg-1). Increasing DIC concentrations at constant total alkalinity (AT) resulted in a decrease in Omega Arag and an increase in pCO2. AT at the beginning of the incubations was kept at a natural level of 2,193 +- 6 µmol kg-1 (mean +- SD). Net photosynthesis (NP) and calcification were calculated from changes in pH and AT during the incubations. Calcification decrease in response to doubling pCO2 relative to preindustrial level was 22% for RF nubbins. When normalized to surface area of the nubbins, (1) NP and calcification were higher at BR than RF, (2) NP increased in high pCO2 treatments at BR compared to low pCO2 treatments, and (3) calcification was not related to Omega Arag at BR. When normalized to NP, calcification was linearly related to Omega Arag at both sites, and the slopes of the relationships were not significantly different. The increase in NP at BR in the high pCO2 treatments may have increased calcification and thus masked the negative effect of low Omega Arag on calcification. Removing the effect of NP variations at BR showed that calcification declined in a similar manner with decreased Omega Arag (increased pCO2) whatever the nutrient loading.
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An expanded Cariaco Basin 14C chronology is tied to 230Th-dated Hulu Cave speleothem records in order to provide detailed marine-based 14C calibration for the past 50,000 years. The revised, high-resolution Cariaco 14C calibration record agrees well with data from 230Th-dated fossil corals back to 33 ka, with continued agreement despite increased scatter back to 50 ka, suggesting that the record provides accurate calibration back to the limits of radiocarbon dating. The calibration data document highly elevated Delta14C during the Glacial period. Carbon cycle box model simulations show that the majority of observed Delta14C change can be explained by increased 14C production. However, from 45 to 15 ka, Delta14C remains anomalously high, indicating that the distribution of radiocarbon between surface and deep ocean reservoirs was different than it is today. Additional observations of the magnitude, spatial extent and timing of deep ocean Delta14C shifts are critical for a complete understanding of observed Glacial Delta14C variability.
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An ethnobotanical survey of medicinal plants was carried out in the Central Middle Atlas in the years 2013 and 2014 to establish the catalog of medicinal plants used in traditional medicine in the treatment of diabetes. Thus, 1560 people were interviewed, using questionnaires. The latter enabled us to gather information on traditional healing practices of the local population including scientific name, French name, vernacular name, plant parts used , therapeutic indications , revenues and mode of administration. The results show that 76 medicinal species were inventoried in the study area. These plant species are included into 67 genus and 40 families. The most represented families are: Lamiaceae (12 species), Asteraceae and Brassicaceae species with 14 each. Of 76 medicinal species found in the region, four species are reported for the first time in the traditional treatment of diabetes in Morocco. They are Pistacia atlantica, Ptychotis verticillata, Anacyclus pyrethrum, Alyssum spinosum, Cistus albidus, Juniperus thurifera, Ephedra nebrodensis, Thymus algeriensis, Th. munbyanus, Th. zygis, Abelmoschus esculentus, Fraxinus augustifolia, Sorghum vulgare and, Eriobotrya japonica. The leaves are the most used organs (38%). The decoction is the dominant mode of preparation (50%) and administration is mostly for oral use (97%).
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El derecho a ser escuchado y participar en aquellos asuntos que afectan a los niños es un derecho fundamental de la infancia escasamente respetado por el adulto, quien tiende a silenciar su voz, infravalorando su visión y posible aportación. Ante esta realidad, la Escuela Infantil se erige como un marco privilegiado para la escucha y la participación de la infancia en aquellos temas que les afectan, contribuyendo a la formación de ciudadanos democráticos. A partir de un marco de escucha donde se concibe al pequeño como un sujeto activo, competente y experto en su propia vida, se ha llevado a cabo una investigación que ha adoptado el formato de estudio de caso, en la que se ha recogido a través de las técnicas del dibujo y de las conversaciones con niños, la visión que poseen los más pequeños sobre la Escuela Infantil, analizando el bienestar del niño en el contexto escolar, el sentido y finalidad que los niños otorgan a la escuela; el grado de satisfacción con la misma; sus gustos y preferencias en el contexto escolar; la autonomía y libertad que dicen poseer en la escuela; su visión sobre los aspectos organizativos que rigen el funcionamiento del centro y su perspectiva sobre cómo es y cómo les gustaría que fuera la participación de las familias en la escuela. Finalmente, se recogen sus propuestas de mejora para hacer de la Escuela Infantil a la que asisten su escuela ideal. Los resultados del estudio ponen de manifiesto la demanda de los niños de una Escuela Infantil diferente a la que conocen y la existencia de un pensamiento divergente del pensamiento adulto que es necesario escuchar y tener en consideración, siendo sus aportaciones de gran valía para poder iniciar procesos de innovación y mejora educativa.
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BACKGROUND: Prostate cancer might have high radiation-fraction sensitivity that would give a therapeutic advantage to hypofractionated treatment. We present a pre-planned analysis of the efficacy and side-effects of a randomised trial comparing conventional and hypofractionated radiotherapy after 5 years follow-up.
METHODS: CHHiP is a randomised, phase 3, non-inferiority trial that recruited men with localised prostate cancer (pT1b-T3aN0M0). Patients were randomly assigned (1:1:1) to conventional (74 Gy delivered in 37 fractions over 7·4 weeks) or one of two hypofractionated schedules (60 Gy in 20 fractions over 4 weeks or 57 Gy in 19 fractions over 3·8 weeks) all delivered with intensity-modulated techniques. Most patients were given radiotherapy with 3-6 months of neoadjuvant and concurrent androgen suppression. Randomisation was by computer-generated random permuted blocks, stratified by National Comprehensive Cancer Network (NCCN) risk group and radiotherapy treatment centre, and treatment allocation was not masked. The primary endpoint was time to biochemical or clinical failure; the critical hazard ratio (HR) for non-inferiority was 1·208. Analysis was by intention to treat. Long-term follow-up continues. The CHHiP trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN97182923.
FINDINGS: Between Oct 18, 2002, and June 17, 2011, 3216 men were enrolled from 71 centres and randomly assigned (74 Gy group, 1065 patients; 60 Gy group, 1074 patients; 57 Gy group, 1077 patients). Median follow-up was 62·4 months (IQR 53·9-77·0). The proportion of patients who were biochemical or clinical failure free at 5 years was 88·3% (95% CI 86·0-90·2) in the 74 Gy group, 90·6% (88·5-92·3) in the 60 Gy group, and 85·9% (83·4-88·0) in the 57 Gy group. 60 Gy was non-inferior to 74 Gy (HR 0·84 [90% CI 0·68-1·03], pNI=0·0018) but non-inferiority could not be claimed for 57 Gy compared with 74 Gy (HR 1·20 [0·99-1·46], pNI=0·48). Long-term side-effects were similar in the hypofractionated groups compared with the conventional group. There were no significant differences in either the proportion or cumulative incidence of side-effects 5 years after treatment using three clinician-reported as well as patient-reported outcome measures. The estimated cumulative 5 year incidence of Radiation Therapy Oncology Group (RTOG) grade 2 or worse bowel and bladder adverse events was 13·7% (111 events) and 9·1% (66 events) in the 74 Gy group, 11·9% (105 events) and 11·7% (88 events) in the 60 Gy group, 11·3% (95 events) and 6·6% (57 events) in the 57 Gy group, respectively. No treatment-related deaths were reported.
INTERPRETATION: Hypofractionated radiotherapy using 60 Gy in 20 fractions is non-inferior to conventional fractionation using 74 Gy in 37 fractions and is recommended as a new standard of care for external-beam radiotherapy of localised prostate cancer.
FUNDING: Cancer Research UK, Department of Health, and the National Institute for Health Research Cancer Research Network.
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Tese apresentada ao Programa de Doutorado em Administração da Universidade Municipal de São Caetano do Sul para a obtenção do título de Doutor em Administração
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Traditional utility analysis only calculates the value of a given selection procedure over random selection. This assumption is not only an inaccurate representation of staffing policy but also leads to overestimates of a device’s value. This paper presents a more accurate method for computing the validity of a selection battery for when there are multiple selection devices and multiple criteria. Application of the method is illustrated using previous utility analysis work and an actual case of administrative assistants with eight predictors and nine criteria. A final example also is provided that includes these advancements as well as other researchers’ advances in a combined utility model. Results reveal that accounting for multiple criteria and outcomes dramatically reduces the utility estimates of implementing new selection devices.
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Background Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine ‘mothers’ perception of recovery’ and ‘mothers’ satisfaction’ after PMD treatment of childhood febrile conditions, as likely drivers of mothers’ health-seeking behaviour, which must be targeted to reverse the trend. Methods Ugwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15–45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21–47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p < 0.05. Results Most participants in FGDs perceived that their child had delayed recovery, but were satisfied with PMDs’ treatment of childhood febrile conditions, for reasons that included politeness, caring attitude, drug availability, easy accessibility, flexibility in pricing, shorter waiting time, their God-fearing nature, and disposition as good listeners. Mothers’ satisfaction with PMDs’ treatment is significantly (p < 0.05) associated with mothers’ perception of recovery of their child (χ2 = 192.94, df = 4; p < 0.0001; Cramer’s V = 0.7079). However, predicting mothers’ satisfaction with PMDs’ treatment from a knowledge of mothers’ perception of recovery shows a high accord (lambda[A from B] = 0.8727), unlike when predicting mothers’ perception of recovery based on knowledge of mothers’ satisfaction with PMDs’ treatment (lambda[A from B] = 0.4727). Conclusions Mothers’ satisfaction could be the key ‘driver’ of mothers’ health-seeking behaviour and is less likely to be influenced by mothers’ perception of recovery of their child. Therefore, mothers’ negative perception of their child’s recovery may not induce proportionate decline in mothers’ health-seeking behaviour (patronage of PMDs), which might be influenced mainly by mothers’ satisfaction with the positive attributes of PMDs’ personality/practice and sets an important agenda for PHC reforms.