THE KNOWLEDGE ABOUT COMMUNICATION STRATEGIES WHEN TAKING CARE OF THE EMOTIONAL DIMENSION IN PALLIATIVE CARE

The aim of this qualitative study was to investigate existing knowledge and the use of communication strategies in emotional care for patients receiving palliative care in Brazil. It was performed from August, 2008, to July, 2009, with 303 health professionals who worked or had frequent contact with patients receiving palliative care, using a questionnaire. Data was submitted to descriptive and analytical statistical treatment. The professionals reported not knowing about communication strategies, showing a significant difference (p-value 0.0011) in comparing subjects with and without previous training in palliative care, showing that those who had received proper training know/use more communication strategies when providing care for their patients on an emotional level. The strategies most often cited were: careful listening, verbal reaffirmation of care, using open questions, and affective touch. We conclude that there is little knowledge and poor use of communication strategies among health professionals in towards the emotional care of patients receiving palliative care.

Shape analysis using fractal dimension: A curvature based approach

The present work shows a novel fractal dimension method for shape analysis. The proposed technique extracts descriptors from a shape by applying a multi-scale approach to the calculus of the fractal dimension. The fractal dimension is estimated by applying the curvature scale-space technique to the original shape. By applying a multi-scale transform to the calculus, we obtain a set of descriptors which is capable of describing the shape under investigation with high precision. We validate the computed descriptors in a classification process. The results demonstrate that the novel technique provides highly reliable descriptors, confirming the efficiency of the proposed method. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4757226]

An estimate on the fractal dimension of attractors of gradient-like dynamical systems

This paper is dedicated to estimate the fractal dimension of exponential global attractors of some generalized gradient-like semigroups in a general Banach space in terms of the maximum of the dimension of the local unstable manifolds of the isolated invariant sets, Lipschitz properties of the semigroup and the rate of exponential attraction. We also generalize this result for some special evolution processes, introducing a concept of Morse decomposition with pullback attractivity. Under suitable assumptions, if (A, A*) is an attractor-repeller pair for the attractor A of a semigroup {T(t) : t >= 0}, then the fractal dimension of A can be estimated in terms of the fractal dimension of the local unstable manifold of A*, the fractal dimension of A, the Lipschitz properties of the semigroup and the rate of the exponential attraction. The ingredients of the proof are the notion of generalized gradient-like semigroups and their regular attractors, Morse decomposition and a fine analysis of the structure of the attractors. As we said previously, we generalize this result for some evolution processes using the same basic ideas. (C) 2012 Elsevier Ltd. All rights reserved.

The ethical dimension f analyst's interventions facing institutional demands of CAPS

(The ethical dimension f analyst's interventions facing institutional demands of CAPS) Considering the complexities involved in setting up clinical work in the psychosocial field, analyst must question their own contributions toward improvements in this area. This issue is presented here as a considerable challenge, due to the limitations of psychoanalytic practice and, especially, the differences between conventional clinical practice and that carried out in institutional and political settings. From this perspective, we call attention to the notion of ethics as a differentiating and guiding concept for psychoanalytic practice in its contribution toward the treatment provided at CAPS.

Circuit board accident - organizational dimension hidden by prescribed safety

This study analyzes an accident in which two maintenance workers suffered severe burns while replacing a circuit breaker panel in a steel mill, following model of analysis and prevention of accidents (MAPA) developed with the objective of enlarging the perimeter of interventions and contributing to deconstruction of blame attribution practices. The study was based on materials produced by a health service team in an in-depth analysis of the accident. The analysis shows that decisions related to system modernization were taken without considering their implications in maintenance scheduling and creating conflicts of priorities and of interests between production and safety; and also reveals that the lack of a systemic perspective in safety management was its principal failure. To explain the accident as merely non-fulfillment of idealized formal safety rules feeds practices of blame attribution supported by alibi norms and inhibits possible prevention. In contrast, accident analyses undertaken in worker health surveillance services show potential to reveal origins of these events incubated in the history of the system ignored in practices guided by the traditional paradigm.

Structural properties and energetics of diffuse Rb-87 clusters in three-dimension

A correlated two-body basis function is used to describe the three-dimensional bosonic clusters interacting via two-body van der Waals potential. We calculate the ground state and the zero orbital angular momentum excited states for Rb-N clusters with up to N = 40. We solve the many-particle Schrodinger equation by potential harmonics expansion method, which keeps all possible two-body correlations in the calculation and determines the lowest effective many-body potential. We study energetics and structural properties for such diffuse clusters both at dimer and tuned scattering length. The motivation of the present study is to investigate the possibility of formation of N-body clusters interacting through the van der Waals interaction. We also compare the system with the well studied He, Ne, and Ar clusters. We also calculate correlation properties and observe the generalised Tjon line for large cluster. We test the validity of the shape-independent potential in the calculation of the ground state energy of such diffuse cluster. These are the first such calculations reported for Rb clusters. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4730972]

1(--) and 0(++) heavy four-quark and molecule states in QCD

We estimate the masses of the 1(--) heavy four-quark and molecule states by combining exponential Laplace (LSR) and finite energy (FESR) sum rules known perturbatively to lowest order (LO) in alpha(s) but including non-perturbative terms up to the complete dimension-six condensate contributions. This approach allows to fix more precisely the value of the QCD continuum threshold (often taken ad hoc) at which the optimal result is extracted. We use double ratio of sum rules (DRSR) for determining the SU(3) breakings terms. We also study the effects of the heavy quark mass definitions on these LO results. The SU(3) mass-splittings of about (50-110) MeV and the ones of about (250-300) MeV between the lowest ground states and their 1st radial excitations are (almost) heavy-flavor independent. The mass predictions summarized in Table 4 are compared with the ones in the literature (when available) and with the three Y-c(4260, 4360, 4660) and Y-b(10890) 1(--) experimental candidates. We conclude (to this order approximation) that the lowest observed state cannot be a pure 1(--) four-quark nor a pure molecule but may result from their mixings. We extend the above analyzes to the 0(++) four-quark and molecule states which are about (0.5-1) GeV heavier than the corresponding 1(--) states, while the splittings between the 0(++) lowest ground state and the 1st radial excitation is about (300-500) MeV. We complete the analysis by estimating the decay constants of the 1(--) and 0(++) four-quark states which are tiny and which exhibit a 1/M-Q behavior. Our predictions can be further tested using some alternative non-perturbative approaches or/and at LHCb and some other hadron factories. (c) 2012 Elsevier B.V. All rights reserved.

A comparative study on multiscale fractal dimension descriptors

Fractal theory presents a large number of applications to image and signal analysis. Although the fractal dimension can be used as an image object descriptor, a multiscale approach, such as multiscale fractal dimension (MFD), increases the amount of information extracted from an object. MFD provides a curve which describes object complexity along the scale. However, this curve presents much redundant information, which could be discarded without loss in performance. Thus, it is necessary the use of a descriptor technique to analyze this curve and also to reduce the dimensionality of these data by selecting its meaningful descriptors. This paper shows a comparative study among different techniques for MFD descriptors generation. It compares the use of well-known and state-of-the-art descriptors, such as Fourier, Wavelet, Polynomial Approximation (PA), Functional Data Analysis (FDA), Principal Component Analysis (PCA), Symbolic Aggregate Approximation (SAX), kernel PCA, Independent Component Analysis (ICA), geometrical and statistical features. The descriptors are evaluated in a classification experiment using Linear Discriminant Analysis over the descriptors computed from MFD curves from two data sets: generic shapes and rotated fish contours. Results indicate that PCA, FDA, PA and Wavelet Approximation provide the best MFD descriptors for recognition and classification tasks. (C) 2012 Elsevier B.V. All rights reserved.

Strongly correlated quantum gases in one dimension

In this work, we discuss some theoretical topics related to many-body physics in ultracold atomic and molecular gases. First, we present a comparison between experimental data and theoretical predictions in the context of quantum emulator of quantum field theories, finding good results which supports the efficiency of such simulators. In the second and third parts, we investigate several many-body properties of atomic and molecular gases confined in one dimension.

Ascending thoracic aorta dimension and outcomes in acute type B dissection (from the International Registry of Acute Aortic Dissection [IRAD])

It is not well known if the size of the ascending thoracic aorta at presentation predicts features of presentation, management, and outcomes in patients with acute type B aortic dissection. The International Registry of Acute Aortic Dissection (IRAD) database was queried for all patients with acute type B dissection who had documentation of ascending thoracic aortic size at time of presentation. Patients were categorized according to ascending thoracic aortic diameters ≤4.0, 4.1 to 4.5, and ≥4.6 cm. Four hundred eighteen patients met inclusion criteria; 291 patients (69.6%) were men with a mean age of 63.2 ± 13.5 years. Ascending thoracic aortic diameter ≤4.0 cm was noted in 250 patients (59.8%), 4.1 to 4.5 cm in 105 patients (25.1%), and ≥4.6 cm in 63 patients (15.1%). Patients with an ascending thoracic aortic diameter ≥4.6 cm were more likely to be men (p = 0.01) and have Marfan syndrome (p <0.001) and known bicuspid aortic valve disease (p = 0.003). In patients with an ascending thoracic aorta ≥4.1 cm, there was an increased incidence of surgical intervention (p = 0.013). In those with an ascending thoracic aorta ≥4.6 cm, the root, ascending aorta, arch, and aortic valve were more often involved in surgical repair. Patients with an ascending thoracic aorta ≤4.0 were more likely to have endovascular therapy than those with larger ascending thoracic aortas (p = 0.009). There was no difference in overall mortality or cause of death. In conclusion, ascending thoracic aortic enlargement in patients with acute type B aortic dissection is common. Although its presence does not appear to predict an increased risk of mortality, it is associated with more frequent open surgical intervention that often involves replacement of the proximal aorta. Those with smaller proximal aortas are more likely to receive endovascular therapy.

Minimal local anesthetic volume for peripheral nerve block: a new ultrasound-guided, nerve dimension-based method

BACKGROUND AND OBJECTIVES: Nerve blocks using local anesthetics are widely used. High volumes are usually injected, which may predispose patients to associated adverse events. Introduction of ultrasound guidance facilitates the reduction of volume, but the minimal effective volume is unknown. In this study, we estimated the 50% effective dose (ED50) and 95% effective dose (ED95) volume of 1% mepivacaine relative to the cross-sectional area of the nerve for an adequate sensory block. METHODS: To reduce the number of healthy volunteers, we used a volume reduction protocol using the up-and-down procedure according to the Dixon average method. The ulnar nerve was scanned at the proximal forearm, and the cross-sectional area was measured by ultrasound. In the first volunteer, a volume of 0.4 mL/mm of nerve cross-sectional area was injected under ultrasound guidance in close proximity to and around the nerve using a multiple injection technique. The volume in the next volunteer was reduced by 0.04 mL/mm in case of complete blockade and augmented by the same amount in case of incomplete sensory blockade within 20 mins. After 3 up-and-down cycles, ED50 and ED95 were estimated. Volunteers and physicians performing the block were blinded to the volume used. RESULTS: A total 17 of volunteers were investigated. The ED50 volume was 0.08 mL/mm (SD, 0.01 mL/mm), and the ED95 volume was 0.11 mL/mm (SD, 0.03 mL/mm). The mean cross-sectional area of the nerves was 6.2 mm (1.0 mm). CONCLUSIONS: Based on the ultrasound measured cross-sectional area and using ultrasound guidance, a mean volume of 0.7 mL represents the ED95 dose of 1% mepivacaine to block the ulnar nerve at the proximal forearm.