The complete non-sense book /

Mode of access: Internet.

Non-use of Formal Health Services in Malawi: Perceptions from Non-users

Background The study upon which this paper is based was undertaken to understand users’ and non-users’ perceptions concerning facilitators and barriers to equitable and universal access to health care in resource-poor countries such as Malawi. In this study, non-users of health services were defined as people who were not in need of health services or those who had stopped using them due to significant barriers. Methods A total of 80 interviews with non-users of health services were conducted in Rumphi, Ntchisi, Phalombe and Blantyre Districts of Malawi. Interviews focused on why informants were not using formal health services at the time of data collection. In order to identify non-users, snowballing was used health surveillance assistants, village headmen and community members also helped. One focus group discussion was also conducted with non-users of health services who were members of the Zion Church. Results Informants described themselves as non-users of health services due to several reasons: cost of health services; long distances to health facilities; poor attitude of health workers; belief in the effectiveness of traditional medicines; old age and their failure to walk. Others were non-users due to their disability; hence they could not walk over long distances or could not communicate effectively with health providers. Some of these non-users were complete non-users, namely members of the Zion Church and those who believed in traditional medicine, and they stated that nothing could be done to transform them into users of health services. Other non-users stated that they could become users if their challenges were addressed e.g. for those who were non-users of health services due to poor attitudes of health workers, they stated that if these health workers were transferred they would be able to access health services. Conclusions Public health education targeting both health workers and non-users, ensuring a functional outreach program and addressing other health system challenges such as shortage of drugs and human resources would assist in transforming non-users into users of health services.

Surveillance on the light-front gauge-fixing Lagrangians

In this work we propose two Lagrange multipliers with distinct coefficients for the light-front gauge that leads to the complete (non-reduced) propagator. This is accomplished via (n · A)2 + (∂ · A) 2 terms in the Lagrangian density. These lead to a well-defined and exact though Lorentz non invariant light-front propagator.

Spontaneous supersymmetry breaking in the 2d N=1 Wess-Zumino model

We study the phase diagram of the two-dimensional N = 1 Wess-Zumino model using Wilson fermions and the fermion loop formulation. We give a complete non-perturbative determination of the ground state structure in the continuum and infinite volume limit. We also present a determination of the particle spectrum in the supersymmetric phase, in the supersymmetry broken phase and across the supersymmetry breaking phase transition. In the supersymmetry broken phase we observe the emergence of the Goldstino particle.

Contribución del tablero y de la subestructura frente al pandeo global de pilas esbeltas de hormigón armado : determinación simplificada de una "coacción equivalente"

Las pilas de los puentes son elementos habitualmente verticales que, generalmente, se encuentran sometidos a un estado de flexión compuesta. Su altura significativa en muchas ocasiones y la gran resistencia de los materiales constituyentes de estos elementos – hormigón y acero – hace que se encuentren pilas de cierta esbeltez en la que los problemas de inestabilidad asociados al cálculo en segundo orden debido a la no linealidad geométrica deben ser considerados. Además, la mayoría de las pilas de nuestros puentes y viaductos están hechas de hormigón armado por lo que se debe considerar la fisuración del hormigón en las zonas en que esté traccionado. Es decir, el estudio del pandeo de pilas esbeltas de puentes requiere también la consideración de un cálculo en segundo orden mecánico, y no solo geométrico. Por otra parte, una pila de un viaducto no es un elemento que pueda considerarse como aislado; al contrario, su conexión con el tablero hace que aparezca una interacción entre la propia pila y aquél que, en cierta medida, supone una cierta coacción al movimiento de la propia cabeza de pila. Esto hace que el estudio de la inestabilidad de una pila esbelta de un puente no puede ser resuelto con la “teoría del pandeo de la pieza aislada”. Se plantea, entonces, la cuestión de intentar definir un procedimiento que permita abordar el problema complicado del pandeo de pilas esbeltas de puentes pero empleando herramientas de cálculo no tan complejas como las que resuelven “el pandeo global de una estructura multibarra, teniendo en cuenta todas las no linealidades, incluidas las de las coacciones”. Es decir, se trata de encontrar un procedimiento, que resulta ser iterativo, que resuelva el problema planteado de forma aproximada, pero suficientemente ajustada al resultado real, pero empleando programas “convencionales” de cálculo que sean capaces de : - por una parte, en la estructura completa: o calcular en régimen elástico lineal una estructura plana o espacial multibarra compleja; - por otra, en un modelo de una sola barra aislada: o considerar las no linealidades geométricas y mecánicas a nivel tensodeformacional, o considerar la no linealidad producida por la fisuración del hormigón, o considerar una coacción “elástica” en el extremo de la pieza. El objeto de este trabajo es precisamente la definición de ese procedimiento iterativo aproximado, la justificación de su validez, mediante su aplicación a diversos casos paramétricos, y la presentación de sus condicionantes y limitaciones. Además, para conseguir estos objetivos se han elaborado unos ábacos de nueva creación que permiten estimar la reducción de rigidez que supone la fisuración del hormigón en secciones huecas monocajón de hormigón armado. También se han creado unos novedosos diagramas de interacción axil-flector válidos para este tipo de secciones en flexión biaxial. Por último, hay que reseñar que otro de los objetivos de este trabajo – que, además, le da título - era cuantificar el valor de la coacción que existe en la cabeza de una pila debido a que el tablero transmite las cargas de una pila al resto de los integrantes de la subestructura y ésta, por tanto, colabora a reducir los movimientos de la cabeza de pila en cuestión. Es decir, la cabeza de una pila no está exenta lo cual mejora su comportamiento frente al pandeo. El régimen de trabajo de esta coacción es claramente no lineal, ya que la rigidez de las pilas depende de su grado de fisuración. Además, también influye cómo las afecta la no linealidad geométrica que, para la misma carga, aumenta la flexión de segundo orden de cada pila. En este documento se define cuánto vale esta coacción, cómo hay que calcularla y se comprueba su ajuste a los resultados obtenidos en el l modelo no lineal completo. The piers of the bridges are vertical elements where axial loads and bending moments are to be considered. They are often high and also the strength of the materials they are made of (concrete and steel) is also high. This means that slender piers are very common and, so, the instabilities produced by the second order effects due to the geometrical non linear effects are to be considered. In addition to this, the piers are usually made of reinforced concrete and, so, the effects of the cracking of the concrete should also be evaluated. That is, the analysis of the instabilities of te piers of a bridge should consider both the mechanical and the geometrical non linearities. Additionally, the pier of a bridge is not a single element, but just the opposite; the connection of the pier to the deck of the bridge means that the movements of the top of the pier are reduced compared to the situation of having a free end at the top of the pier. The connection between the pier and the deck is the reason why the instability of the pier cannot be analysed using “the buckling of a compressed single element method”. So, the question of defining an approximate method for analysing the buckling of the slender piers of a bridge but using a software less complex than what it is needed for analysing the “ global buckling of a multibeam structure considering all t”, is arisen. Then, the goal should be trying to find a procedure for analysing the said complex problem of the buckling of the slender piers of a bridge using a simplified method. This method could be an iterative (step by step) procedure, being accurate enough, using “normal” software having the following capabilities: - Related to the calculation of the global structure o Ability for calculating a multibesam strucutre using elastic analysis. - Related to the calculation of a single beam strcuture:: o Ability for taking into account the geometrical and mechanical () non linearities o Ability for taking into account the cracking of the concrete. o Ability for using partial stiff constraints (elastic springs) at the end of the elements One of the objectives of this document is just defining this simplified methodology, justifying the accuracy of the proposed procedure by using it on some different bridges and presenting the exclusions and limitations of the propose method. In addition to this, some new charts have been created for calculating the reduction of the stiffness of hollow cross sections made of reinforced concrete. Also, new charts for calculating the reinforcing of hollow cross sections under biaxial bending moments are also included in the document. Finally, it is to be said that another aim of the document – as it is stated on the title on the document – is defining the value of the constraint on the top of the pier because of the connection of the pier to the deck .. and to the other piers. That is, the top of the pier is not a free end of a beam and so the buckling resistance of the pier is significantly improved. This constraint is a non-elastic constraint because the stiffness of each pier depends on the level of cracking. Additionally, the geometrical non linearity is to be considered as there is an amplification of the bending moments due to the increasing of the movements of the top of the pier. This document is defining how this constraints is to be calculated; also the accuracy of the calculations is evaluated comparing the final results with the results of the complete non linear calculations

Validation of the Spanish version of mackey childbirth satisfaction rating scale

Background: The “Mackey Childbirth Satisfaction Rating Scale” (MCSRS) is a complete non-validated scale which includes the most important factors associated with maternal satisfaction. Our primary purpose was to describe the internal structure of the scale and validate the reliability and validity of concept of its Spanish version MCSRS-E. Methods: The MCSRS was translated into Spanish, back-translated and adapted to the Spanish population. It was then administered following a pilot test with women who met the study participant requirements. The scale structure was obtained by performing an exploratory factorial analysis using a sample of 304 women. The structures obtained were tested by conducting a confirmatory factorial analysis using a sample of 159 women. To test the validity of concept, the structure factors were correlated with expectations prior to childbirth experiences. McDonald’s omegas were calculated for each model to establish the reliability of each factor. The study was carried out at four University Hospitals; Alicante, Elche, Torrevieja and Vinalopo Salud of Elche. The inclusion criteria were women aged 18–45 years old who had just delivered a singleton live baby at 38–42 weeks through vaginal delivery. Women who had difficulty speaking and understanding Spanish were excluded. Results: The process generated 5 different possible internal structures in a nested model more consistent with the theory than other internal structures of the MCSRS applied hitherto. All of them had good levels of validation and reliability. Conclusions: This nested model to explain internal structure of MCSRS-E can accommodate different clinical practice scenarios better than the other structures applied to date, and it is a flexible tool which can be used to identify the aspects that should be changed to improve maternal satisfaction and hence maternal health.

Morbidity, survival, and site of recurrence after mediastinal lymph-node dissection versus systematic sampling after complete resection for non-small cell lung cancer

BACKGROUND: Mediastinal lymph-node dissection was compared to systematic mediastinal lymph-node sampling in patients undergoing complete resection for non-small cell lung cancer with respect to morbidity, duration of chest tube drainage and hospitalization, survival, disease-free survival, and site of recurrence. METHODS: A consecutive series of one hundred patients with non-small-cell lung cancer, clinical stage T1-3 N0-1 after standardized staging, was divided into two groups of 50 patients each, according to the technique of intraoperative mediastinal lymph-node assessment (dissection versus sampling). Mediastinal lymph-node dissection consisted of removal of all lymphatic tissues within defined anatomic landmarks of stations 2-4 and 7-9 on the right side, and stations 4-9 on the left side according to the classification of the American Thoracic Society. Systematic mediastinal lymph-node sampling consisted of harvesting of one or more representative lymph nodes from stations 2-4 and 7-9 on the right side, and stations 4-9 on the left side. RESULTS: All patients had complete resection. A mean follow-up time of 89 months was achieved in 92 patients. The two groups of patients were comparable with respect to age, gender, performance status, tumor stage, histology, extent of lung resection, and follow-up time. No significant difference was found between both groups regarding the duration of chest tube drainage, hospitalization, and morbidity. However, dissection required a longer operation time than sampling (179 +/- 38 min versus 149 +/- 37 min, p < 0.001). There was no significant difference in overall survival between the two groups; however, patients with stage I disease had a significantly longer disease-free survival after dissection than after sampling (60.2 +/- 7 versus 44.8 +/- 8 months, p < 0.03). Local recurrence was significantly higher after sampling than after dissection in patients with stage I tumor (12.5% versus 45%, p = 0.02) and in patients with nodal tumor negative mediastinum (N0/N1 disease) (46% versus 13%, p = 0.004). CONCLUSION: Our results suggest that mediastinal lymph-node dissection may provide a longer disease-free survival in stage I non-small cell lung cancer and, most importantly, a better local tumor control than mediastinal lymph-node sampling after complete resection for N0/N1 disease without leading to increased morbidity.

Long-term complete responses after 131I-tositumomab therapy for relapsed or refractory indolent non-Hodgkin's lymphoma.

We present the long-term results of 18 chemotherapy relapsed indolent (N = 12) or transformed (N = 6) NHL patients of a phase II anti-CD20 (131)I-tositumomab (Bexxar) therapy study. The biphasic therapy included two injections of 450 mg unlabelled antibody combined with (131)I-tositumomab once as dosimetric and once as therapeutic activity delivering 75 or 65 cGy whole-body radiation dose to patients with normal or reduced platelet counts, respectively. Two patients were not treated due to disease progression during dosimetry. The overall response rate was 81% in the 16 patients treated, including 50% CR/CRu and 31% PR. Median progression free survival of the 16 patients was 22.5 months. Median overall survival has not been reached after a median observation of 48 months. Median PFS of complete responders (CR/CRu) has not been reached and will be greater than 51 months. Short-term side effects were mainly haematological and transient. Among the relevant long-term side effects, one patient previously treated with CHOP chemotherapy died from secondary myelodysplasia. Four patients developed HAMA. In conclusion, (131)I-tositumomab RIT demonstrated durable responses especially in those patients who achieved a complete response. Six of eight CR/CRu are ongoing after 46-70 months.

A note on the attenuation of the sommerfeld effect of a non-ideal system taking into account a MR damper and the complete model of a DC motor

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Structural bases for a complete myotoxic mechanism: Crystal structures of two non-catalytic phospholipases A(2)-like from Bothrops brazili venom

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The model T Ford car, its construction, operation and repair; a complete practical treatise explaining the operating principles of all parts of the Ford automobile, with complete instructions for driving and maintenance; includes the most thorough and easily understood illustrated instructions on Ford repairing ever published; based on five years' experience of a Ford operator--invaluable to all Ford owners, dealers, salesmen, drivers and repair men--every phase of the subject treated in a non-technical yet comprehensive manner,

Mode of access: Internet.

American politics (non-partisan) from the beginning to date. Embodying a history of all the political parties with their views and records on all important questions. Great speeches on all great issues, the text of all existing political laws... Also a complete federal blue book...

Mode of access: Internet.

American politics (non-partisan) from the beginning to date. : Embodying a history of all the political parties, with their views and records on all important questions. Great speeches on all great issues, the text of all existing political laws ... Also a complete federal blue book ... /

Various pagings.

Enhancing non-refractory aerosol apportionment from an urban industrial site through receptor modelling of complete high time-resolution aerosol mass spectra

Receptor modelling was performed on quadrupole unit mass resolution aerosol mass spectrometer (Q-AMS) sub-micron particulate matter (PM) chemical speciation measurements from Windsor, Ontario, an industrial city situated across the Detroit River from Detroit, Michigan. Aerosol and trace gas measurements were collected on board Environment Canada’s CRUISER mobile laboratory. Positive matrix factorization (PMF) was performed on the AMS full particle-phase mass spectrum (PMFFull MS) encompassing both organic and inorganic components. This approach was compared to the more common method of analysing only the organic mass spectra (PMFOrg MS). PMF of the full mass spectrum revealed that variability in the non-refractory sub-micron aerosol concentration and composition was best explained by six factors: an amine-containing factor (Amine); an ammonium sulphate and oxygenated organic aerosol containing factor (Sulphate-OA); an ammonium nitrate and oxygenated organic aerosol containing factor (Nitrate-OA); an ammonium chloride containing factor (Chloride); a hydrocarbon like organic aerosol (HOA) factor; and a moderately oxygenated organic aerosol factor (OOA). PMF of the organic mass spectrum revealed three factors of similar composition to some of those revealed through PMFFull MS: Amine, HOA and OOA. Including both the inorganic and organic mass proved to be a beneficial approach to analysing the unit mass resolution AMS data for several reasons. First, it provided a method for potentially calculating more accurate sub-micron PM mass concentrations, particularly when unusual factors are present, in this case, an Amine factor. As this method does not rely on a priori knowledge of chemical species, it circumvents the need for any adjustments to the traditional AMS species fragmentation patterns to account for atypical species, and can thus lead to more complete factor profiles. It is expected that this method would be even more useful for HR-ToF-AMS data, due to the ability to better understand the chemical nature of atypical factors from high resolution mass spectra. Second, utilizing PMF to extract factors containing inorganic species allowed for the determination of extent of neutralization, which could have implications for aerosol parameterization. Third, subtler differences in organic aerosol components were resolved through the incorporation of inorganic mass into the PMF matrix. The additional temporal features provided by the inorganic aerosol components allowed for the resolution of more types of oxygenated organic aerosol than could be reliably re-solved from PMF of organics alone. Comparison of findings from the PMFFull MS and PMFOrg MS methods showed that for the Windsor airshed, the PMFFull MS method enabled additional conclusions to be drawn in terms of aerosol sources and chemical processes. While performing PMFOrg MS can provide important distinctions between types of organic aerosol, it is shown that including inorganic species in the PMF analysis can permit further apportionment of organics for unit mass resolution AMS mass spectra.