A randomized control trial of nursing-based case management for patients with chronic obstructive pulmonary disease

This study assessed the impact of a randomized trial of nursing-based case management for patients with chronic obstructive pulmonary disease, their caregivers, and nursing and medical staff. Sixty-six patients were matched by FEV1 on admission to hospital, and randomized into an intervention or control group. Intervention group patients reported significantly less anxiety at 1 month postdischarge; however, this effect was not sustained. There was little difference between groups in terms of unplanned readmissions, depression, symptoms, support, and subjective well being. Interviews with patients and caregivers found that the case management improved access to resources and staff-patient communication. Interviews with nursing and medical staff found that case management improved communication between staff and enhanced patient care.

QCD thermal phase transition in the presence of a small chemical potential

We propose a new method to investigate the thermal properties of QCD with a small quark chemical potential mu. Derivatives of quark and gluonic observables with respect to mu are computed at mu=0 for two flavors of p4 improved staggered fermions with ma=0.1,0.2 on a 16(3)x4 lattice, and used to calculate the leading order Taylor expansion in mu of the location of the pseudocritical point about mu=0. This expansion should be well behaved for the small values of mu(q)/T(c)similar to0.1 relevant for BNL RHIC phenomenology, and predicts a critical curve T-c(mu) in reasonable agreement with estimates obtained using exact reweighting. In addition, we contrast the case of isoscalar and isovector chemical potentials, quantify the effect of munot equal0 on the equation of state, and comment on the complex phase of the fermion determinant in QCD with munot equal0.

Genotyping of methicillin-resistant Staphylococcus aureus by assaying for the presence of variable elements associated with mecA

The region surrounding mecA in methicillin-resistant Staphylococcus aureus (MRSA) is highly variable. We describe an approach for the rapid genotyping of MRSA by assaying for the presence or absence of variable or mobile elements previously shown to be associated with the mecA region.

A mechanistic model for carbon dioxide corrosion of mild steel in the presence of protective iron carbonate films - Part 3: Film growth model

A model of iron carbonate (FeCO3) film growth is proposed, which is an extension of the recent mechanistic model of carbon dioxide (CO2) corrosion by Nesic, et al. In the present model, the film growth occurs by precipitation of iron carbonate once saturation is exceeded. The kinetics of precipitation is dependent on temperature and local species concentrations that are calculated by solving the coupled species transport equations. Precipitation tends to build up a layer of FeCO3 on the surface of the steel and reduce the corrosion rate. On the other hand, the corrosion process induces voids under the precipitated film, thus increasing the porosity and leading to a higher corrosion rate. Depending on the environmental parameters such as temperature, pH, CO2 partial pressure, velocity, etc., the balance of the two processes can lead to a variety of outcomes. Very protective films and low corrosion rates are predicted at high pH, temperature, CO2 partial pressure, and Fe2+ ion concentration due to formation of dense protective films as expected. The model has been successfully calibrated against limited experimental data. Parametric testing of the model has been done to gain insight into the effect of various environmental parameters on iron carbonate film formation. The trends shown in the predictions agreed well with the general understanding of the CO2 corrosion process in the presence of iron carbonate films. The present model confirms that the concept of scaling tendency is a good tool for predicting the likelihood of protective iron carbonate film formation.

Numerical study of hydrogenic effective mass theory for an impurity P donor in Si in the presence of an electric field and interfaces

In this paper we examine the effects of varying several experimental parameters in the Kane quantum computer architecture: A-gate voltage, the qubit depth below the silicon oxide barrier, and the back gate depth to explore how these variables affect the electron density of the donor electron. In particular, we calculate the resonance frequency of the donor nuclei as a function of these parameters. To do this we calculated the donor electron wave function variationally using an effective-mass Hamiltonian approach, using a basis of deformed hydrogenic orbitals. This approach was then extended to include the electric-field Hamiltonian and the silicon host geometry. We found that the phosphorous donor electron wave function was very sensitive to all the experimental variables studied in our work, and thus to optimize the operation of these devices it is necessary to control all parameters varied in this paper.

Vasco da Gama and the Later Portuguese Colonial Presence in India

A chegada de Vasco da Gama à Índia marcou o início de uma nova era na história da Índia e do mundo. Foi um encontro marcado por colaboração e resistências. Tanto os indianos como os portugueses faziam cedências por necessidade ou por conveniências. Não se pode ignorar neste processo o impacto dos renegados portugueses que se espalharam pela Asia toda. Era o resultado da "grande soltura" após a morte de Afonso de Albuquerque que acreditava numa economia comandada. O império da sombra, tão bem descrito por Fernão Mendes Pinto prevaleceu.

Evaluation of a program to reduce back pain in nursing personnel

OBJECTIVE: To evaluate the effectiveness of a program designed to reduce back pain in nursing aides. METHODS: Female nursing aides from a university hospital who had suffered episodes of back pain for at least six months were included in the study. Participants were randomly divided into a control group and an intervention group. The intervention program involved a set of exercises and an educational component stressing the ergonomic aspect, administered twice a week during working hours for four months. All subjects answered a structured questionnaire and the intensity of pain was assessed before and after the program using a visual analogue scale (VAS). Student's t-test or the Wilcoxon Rank Sum Test for independent samples, and Chi-square test or the Exact Fisher test for categorical analysis, were used. The McNemar test and the Wilcoxon matched pairs test were used to compare the periods before and after the program. RESULTS: There was a statistically significant decrease in the frequency of cervical pain in the last two months and in the last seven days in the intervention group. There was also a reduction in cervical pain intensity in the two periods (2 months, 7 days) and lumbar pain intensity in the last 7 days. CONCLUSIONS: The results suggest that a program of regular exercise with an emphasis on ergonomics can reduce musculoskeletal symptoms in nursing personnel.

Porto: cidade amiga das pessoas idosas: um estudo centrado na visão de prestadores de serviços a pessoas idosas das freguesias de Cedofeita, Paranhos, St. Ildefonso, Bonfim e Campanhã

O envelhecimento da população é um fenómeno das sociedades contemporâneas simultâneo à crescente modificação do meio urbano. De modo a responder a estas alterações a Organização Mundial de Saúde (OMS) lançou o projeto Cidade Amiga das Pessoas Idosas que preconiza a adaptação das estruturas e serviços para que estes sejam acessíveis e promovam a inclusão dos cidadãos idosos. A presente investigação, de natureza qualitativa e exploratória, tem como objetivo verificar se a cidade do Porto possui características de uma cidade amiga das pessoas idosas através da visão de prestadores de serviços a pessoas idosas das freguesias de Paranhos, Cedofeita, St. Ildefonso, Bonfim e Campanhã. Pretende, assim, ser um contributo para o desenvolvimento do projeto Cidade Amiga das Pessoas Idosas na cidade portuense. Para tal, realizam-se 3 focus groups com prestadores de serviços selecionados a partir de uma amostragem por conveniência, onde se utiliza um guião de entrevista semi-estruturado com as seguintes categorias: espaços exteriores e edifícios, transportes, habitação, participação social, respeito e inclusão social, participação cívica e emprego, comunicação e informação e apoio comunitário e serviços de saúde. É possível verificar que os participantes partilham, de forma geral, uma imagem positiva da cidade do Porto, contudo, têm tendência a iniciar o discurso pelas características negativas da cidade. Colaboram também com sugestões de melhoria para a cidade. Pela perspetiva dos participantes é possível verificar que aspetos relacionados com espaços exteriores e edifícios, respeito e inclusão social e apoio comunitário e serviços de saúde se destacam pela negativa, enquanto aspetos intimos à participação social das pessoas idosas bem como, à comunicação e informação na cidade do Porto são na generalidade elogiados. Desta forma, indicam como positivo o aparecimento de novas iniciativas como as Universidades Seniores ou o projeto “Afetos” desenvolvido pela Misericórdia; as ofertas dirigidas à população sénior desenvolvidas pelas Juntas de Freguesia e a presença de jornais de distribuição gratuita, em espaços públicos. Por oposição, identificam como pouco amigo das pessoas idosas os passeios pouco largos, com obstáculos e pouco cuidados; a falta de casas de banho públicas; o desinvestimento em atividades intergeracionais e a carência de lares públicos na cidade.

Performance of microstrip antennas in the presence of EBG in an indoor localization system

Indoor localization systems in nowadays is a huge area of interest not only at academic but also at industry and commercial level. The correct location in these systems is strongly influenced by antennas performance which can provide several gains, bandwidths, polarizations and radiation patterns, due to large variety of antennas types and formats. This paper presents the design, manufacture and measurement of a compact microstrip antenna, for a 2.4 GHZ frequency band, enhanced with the use of Electromagnetic Band-Gap (EBG) structures, which improve the electromagnetic behavior of the conventional antennas. The microstrip antenna with an EBG structure integrated allows an improvement of the location system performance in about 25% to 30% relatively to a conventional microstrip antenna.