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(Des)continuidade no ensino-aprendizagem de inglês na escola pública: aplicação e progressão de conteúdos no ensino médio / (Dis)continuity in English teaching-learning in public school: application and progression of content in secondary schoolFernandes Neto, João Queiroz [UNESP] 29 May 2017 (has links)
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Previous issue date: 2007-05-29 / Neste estudo, discorremos sobre a (des)continuidade no ensino-aprendizagem de inglês na escola pública (EP) relacionada à aplicação e progressão de conteúdos no ensino médio. Este objeto de estudo é caracterizado pela ocorrência de rupturas que podem desfavorecer a aplicação e progressão do ensino da disciplina, ocasionar o não cumprimento do planejamento pedagógico do professor e potencializar a fragmentação do aprendizado dos alunos durante o ensino médio. Este estudo pode ser caracterizado como pesquisa qualitativa com a utilização de questionário semiestruturado e de narrativas; da análise dos materiais didáticos (MDs), diários de classe (DCs), planos de ensino (PAEs), e da consulta à legislação e documentos oficiais pertinentes. Para a investigação do problema, partiu-se de uma visão de conteúdo que se direciona ao letramento e à formação integral do indivíduo. Para analisar o desenvolvimento dos conteúdos, foram abordados: a seleção e adequação dos conteúdos à realidade dos alunos e aos documentos oficiais; a organização e sistematização desses conteúdos; e a influência do contexto escolar. A pesquisa teve como participantes, duas professoras de inglês de uma mesma escola pública estadual, cujas visões foram analisadas como ponto de partida para a abordagem do problema. Foi investigada a ocorrência de rupturas através das três séries do ensino médio, considerando-se a continuidade progressiva dos conteúdos ao longo das séries; a sequência destes em relação aos anteriores e posteriores; e a integração destes com as demais áreas do conhecimento. A seleção e a adequação foram analisadas tendo em mente a desconstrução de uma visão segmentada de conhecimento a ser promovido pela disciplina, procurando verificar o relacionamento dos ensinamentos com o contexto do aluno, considerando-se os preceitos da legislação e a proposta curricular do sistema de ensino abordado. Foram abordados os sujeitos envolvidos no processo de ensino-aprendizagem de inglês, analisando a ocorrência da (des)continuidade nas dimensões em que cada um deles se situa. Procurou-se apontar as principais causas que contribuíram para a ocorrência da (des)continuidade em relação: à organização, à sistematização e às situações que a favoreceram. Foi analisada também a influência dos métodos de ensino utilizados sobre o objeto de estudo. Nessa perspectiva, este estudo busca contribuir para o trabalho dos professores de inglês que reconhecem e convivem com o problema da (des)continuidade no ensino-aprendizagem de inglês na escola pública, em relação à aplicação e progressão de conteúdos no ensino médio. / In this study, we discuss about the (dis)continuity of English teaching-learning in the public school concerning the application and progression of content in secondary education. This object of study is characterized by the occurrence of disruptions that may disfavor the application and progression of the English teaching; that may lead the teacher's pedagogical planning not to be fulfilled; and that may also favour the fragmentation of students' learning. This study can be characterized as a qualitative research, since it used semi-structured questionnaire and narratives, analysis of teaching materials, lesson plans, and researches in the legislation and official documents. For the investigation of the problem, we started with an underlay of the content that is directed to the literacy and integral formation of the individual. In order to analyze the development of the contents, the following were taking into account: the selection and adequacy of the contents to the students' reality and the official documents, the organization and systematization of these contents and the influence of the school context. This research had as participants two English teachers from a public school, whose points of view were analyzed as a starting point for approaching the problem. The occurrence of ruptures through the three grades high school was investigated considering the progressive continuity of contents throughout the series, the sequence of these in relation to the previous and subsequent ones, and the integration of these with other areas of knowledge. The subjects involved were observed by analyzing the occurrence of (dis)continuity in the dimensions in which each one of them is situated. We sought to identify the main causes that contributed to the occurrence of (dis)continuity in relation to the organization, the systematization and the situations that favored it. The influence of the teaching methods used was also analyzed. In this perspective, this study seeks to contribute to the teaching practice of English teachers who recognize and coexist with the problem of (dis)continuity in English teaching-learning in public schools, regarding the application and progression of contents in secondary education.
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Continuidades descontinuadas: reflexões sobre o encontro intersubjetivo com a Arte / Discontinued continuities: reflections on the itersubjective meeting with the artRenata Reinhoefer França 17 March 2008 (has links)
Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Essa dissertação propõe-se a refletir sobre o enigmático encontro intersubjetivo com a arte
por ser este um acontecimento vivo de troca entre espectador e obra, em ato. O ponto de partida
deste trabalho é de que, apesar de não haver dúvidas quanto à verdade humana que permeia a
experiência da arte, entramos constantemente na banalização de querer prová- la ou direcioná-la a
outro domínio que não o da arte ela mesma, o que faz com que a significância dessa questão fique
ameaçada. Com o objetivo de discutir isso, que desdobra-se na inesgotabilidade da transmissão
pela arte, faz uma articulação com a psicanálise, principalmente no campo das intensidades
afetivas que se referem a ordem da pré-linguagem verbal, justamente objetivando pensá-las em
sua relação com a arte pelo juízo estético, o conceito de senso comum e seus desdobramentos
contemporâneos. Trata também da incompletude da obra como força de movimento que a coloca
em perpétuo acabamento, na busca incessante de significação, e da crítica de arte como parte
desse movimento, como transmissão da verdade do encontro com a arte sendo em si outro
encontro, pela palavra, também em perpétuo acabamento / With the dissertation we aim to reflect upon the enigmatic intersubjective encounter
between observer and work of art. This encounter starts an endless journey in which the
experience of art keeps changing also remaining the same at its core that allows the continuity of
art through the ever-present. But even if we agree that one of the most important truths about art
lie on this human experience, we still often try to direct it to other competencies in order to prove
it right, which tends to diminish the relevance of such an encounter. With this in mind, well
carefully apply some concepts of psychoanalysis, mainly in the field of affective intensities
related to pre-verbal language (as the Uncanny), articulating its relation to art as aesthetic
experience. The never ending process of completeness puts the relationship between observer and
work in perpetual search for an end that never comes. This paradox, far from being something
that stops us, is what really puts us on the move, in search for new significations for what we
dont know. And writing about art, in this sense, is part of this movement towards the unknown,
is what allows us to create from its shadows still keeping its mystery alive
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Ensaios sobre o seguro desemprego no Brasil : teorias e evidênciasTeixeira, Gibran da Silva January 2013 (has links)
A presente tese de doutorado estuda duas questões referentes ao programa brasileiro de Seguro Desemprego: o impacto do benefício sobre o salário de reinserção dos trabalhadores beneficiados, bem como sobre o tempo de procura por emprego. No primeiro ensaio são apresentados alguns fatos estilizados referente ao problema de pesquisa, entre os quais destacam-se: i) Descrição Jurídica e os principais objetivos do Programa brasileiro de Seguro Desemprego; ii) O Status Quo do Programa Seguro Desemprego; iii) O Perfil do Trabalhador Beneficiado pelo Programa; iv) Salário de reinserção de trabalhadores contemplados e não contemplados pelo programa (2006-2009) com tempo de permanência no trabalho anterior entre um mês e onze meses; e v) Procura por emprego de trabalhadores contemplados e não contemplados pelo programa (2006-2010) com tempo de permanência no trabalho anterior entre um mês e onze meses. No segundo ensaio, avalia-se o impacto do benefício Seguro Desemprego sobre o salário de reinserção de seu público alvo, utilizando-se as Teorias de Job Search e do Capital Humano. Na estratégia empírica, utilizaram-se informações da Pesquisa Nacional por Amostra de Domicílio - PNAD no período de 2006 a 2009, bem como o método de regressão com descontinuidade. Os resultados indicaram que para o período avaliado, o programa de Seguro Desemprego vai de encontro com as teorias, visto que não se mostrou estatisticamente significativo para influenciar o salário de reinserção dos beneficiados. No terceiro ensaio, destaca-se o impacto do benefício sobre o tempo de procura por trabalho, utilizando-se como referenciais teóricos os modelos de assimetria de informação, mais especificamente o modelo de Moral Hazard. Para análise empírica da presença do risco moral no programa, foram utilizadas informações da Pesquisa de Emprego e Desemprego - PED, no período de 2006 a 2010, e as estimativas baseadas no método de regressão com descontinuidade. Os resultados indicaram que o programa Seguro Desemprego influenciou a procura por emprego dos trabalhadores chefes de família e também dos considerados filhos. Portanto, no período avaliado, constata-se que a procura por trabalho foi realizada de modo menos intensivo pelos chefes de família e jovens que receberam o benefício, e pela inexistência de instrumentos de controle da procura por emprego por parte do Governo, a presença do risco moral acabou configurando-se no grupo de trabalhadores avaliados. / This doctoral thesis studies two issues of the Brazilian Unemployment Insurance program: the impact of the benefit on the reemployment wage of beneficiaries, as well as, job search time for reemployment. In the first test, some stylized facts regarding the research problem are presented, among which we highlight: i) Legal description and key objectives of the Brazilian Unemployment Insurance program; ii) The Status Quo of the Unemployment Insurance program; iii) Profile of the workers who benefit through the program; iv) Reemployment wage of workers, covered and not covered by the (2006-2009) program, who worked between one and eleven months in their previous job; and v) job search of workers, covered and not covered by the (2006-2010) program. The second test assesses the impact of the Unemployment Insurance benefit on the reemployment wage, using the Job Search and Human Capital theories. In the empirical strategies, the National Survey by Household Sampling – (PNAD) information, during the 2006 to 2009 period was used plus the regression discontinuity method. The results indicated that, for the evaluated period, the Unemployment Insurance program meets the theories, since it was not statistically significant in influencing the beneficiaries’ reemployment wage benefit. The third test highlights the impact of the benefit on job hunting time, using as theoretical reference the information asymmetry model, more specifically the Moral Hazard model. For the empirical analysis of the presence of moral hazard in the program, we used information from the Job and Unemployment Research (PED), during the 2006-2010 period and estimates were based on the regression discontinuity method. The results indicated that the Unemployment Insurance program influenced the search for work or job hunting of household heads and, also those considered children. Therefore, it is noted that the demand for work during the evaluated period, was performed in a less intensive manner by family heads and young people who receive the benefit and, given the absence of Government job search control methods, the presence of moral hazard eventually settled on the Group of workers assessed.
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Ensaios sobre o seguro desemprego no Brasil : teorias e evidênciasTeixeira, Gibran da Silva January 2013 (has links)
A presente tese de doutorado estuda duas questões referentes ao programa brasileiro de Seguro Desemprego: o impacto do benefício sobre o salário de reinserção dos trabalhadores beneficiados, bem como sobre o tempo de procura por emprego. No primeiro ensaio são apresentados alguns fatos estilizados referente ao problema de pesquisa, entre os quais destacam-se: i) Descrição Jurídica e os principais objetivos do Programa brasileiro de Seguro Desemprego; ii) O Status Quo do Programa Seguro Desemprego; iii) O Perfil do Trabalhador Beneficiado pelo Programa; iv) Salário de reinserção de trabalhadores contemplados e não contemplados pelo programa (2006-2009) com tempo de permanência no trabalho anterior entre um mês e onze meses; e v) Procura por emprego de trabalhadores contemplados e não contemplados pelo programa (2006-2010) com tempo de permanência no trabalho anterior entre um mês e onze meses. No segundo ensaio, avalia-se o impacto do benefício Seguro Desemprego sobre o salário de reinserção de seu público alvo, utilizando-se as Teorias de Job Search e do Capital Humano. Na estratégia empírica, utilizaram-se informações da Pesquisa Nacional por Amostra de Domicílio - PNAD no período de 2006 a 2009, bem como o método de regressão com descontinuidade. Os resultados indicaram que para o período avaliado, o programa de Seguro Desemprego vai de encontro com as teorias, visto que não se mostrou estatisticamente significativo para influenciar o salário de reinserção dos beneficiados. No terceiro ensaio, destaca-se o impacto do benefício sobre o tempo de procura por trabalho, utilizando-se como referenciais teóricos os modelos de assimetria de informação, mais especificamente o modelo de Moral Hazard. Para análise empírica da presença do risco moral no programa, foram utilizadas informações da Pesquisa de Emprego e Desemprego - PED, no período de 2006 a 2010, e as estimativas baseadas no método de regressão com descontinuidade. Os resultados indicaram que o programa Seguro Desemprego influenciou a procura por emprego dos trabalhadores chefes de família e também dos considerados filhos. Portanto, no período avaliado, constata-se que a procura por trabalho foi realizada de modo menos intensivo pelos chefes de família e jovens que receberam o benefício, e pela inexistência de instrumentos de controle da procura por emprego por parte do Governo, a presença do risco moral acabou configurando-se no grupo de trabalhadores avaliados. / This doctoral thesis studies two issues of the Brazilian Unemployment Insurance program: the impact of the benefit on the reemployment wage of beneficiaries, as well as, job search time for reemployment. In the first test, some stylized facts regarding the research problem are presented, among which we highlight: i) Legal description and key objectives of the Brazilian Unemployment Insurance program; ii) The Status Quo of the Unemployment Insurance program; iii) Profile of the workers who benefit through the program; iv) Reemployment wage of workers, covered and not covered by the (2006-2009) program, who worked between one and eleven months in their previous job; and v) job search of workers, covered and not covered by the (2006-2010) program. The second test assesses the impact of the Unemployment Insurance benefit on the reemployment wage, using the Job Search and Human Capital theories. In the empirical strategies, the National Survey by Household Sampling – (PNAD) information, during the 2006 to 2009 period was used plus the regression discontinuity method. The results indicated that, for the evaluated period, the Unemployment Insurance program meets the theories, since it was not statistically significant in influencing the beneficiaries’ reemployment wage benefit. The third test highlights the impact of the benefit on job hunting time, using as theoretical reference the information asymmetry model, more specifically the Moral Hazard model. For the empirical analysis of the presence of moral hazard in the program, we used information from the Job and Unemployment Research (PED), during the 2006-2010 period and estimates were based on the regression discontinuity method. The results indicated that the Unemployment Insurance program influenced the search for work or job hunting of household heads and, also those considered children. Therefore, it is noted that the demand for work during the evaluated period, was performed in a less intensive manner by family heads and young people who receive the benefit and, given the absence of Government job search control methods, the presence of moral hazard eventually settled on the Group of workers assessed.
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Nature's choice? a study of the displacement of incumbents in electionsCanen, Nathan Joseph 05 June 2013 (has links)
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Previous issue date: 2013-06-05 / How do economic shocks affect the behaviour of elections in democracies? Using U.S. Congress electoral data, I test whether sudden shocks affect unequally incumbent par- ties and opponents. This is identified through, among other procedures, a regression discontinuity design. I consider possible theoretical channels for this effect, where cit- izens cannot perfectly observe whether their lack of public goods is due to an adverse shock, or due to private consumption by a politician. I find that, with observable shocks close to the election, there is no effect. Empirical evidence is consistent with the theory. / Como choques econômicos afetam eleições em democracias? Usando dados eleitorais do Congresso dos Estados Unidos, eu testo se choques adversos podem afetar desigualmente partidos incumbentes e oponentes. Esse efeito é identificado, entre vários procedimentos, por uma regressão em descontinuidade. Eu considero possibilidades teóricas para esse efeito, quando cidadãos não conseguem observar perfeitamente se a falta de bens públicos é devido a um choque adverso, ou a consumo privado do político. Quando o choque é observável, não há efeito; enquanto se não fosse, haveria. As evidências empíricas são consistentes com a teoria.
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La présence de l'objet dans le cinéma de Robert Bresson / The presence of the object in the cinema of Robert BressonSeo, Jung-Ah 30 January 2009 (has links)
Le « cinématographe » de Robert Bresson vise à atteindre la vérité du réel d’une façon différente du « cinéma », considéré comme le théâtre photographié. Le cinéma de Robert Bresson, qui est également le résultat de l’application de sa théorie, est constamment dans la négativité de l’image représentative. Le montage bressonien décompose le raccord classique et fragmente l’espace narratif. Dans ce contexte, l’objet dans le cinéma de Bresson, sans appuyer sur le rôle narratif et le sens symbolique, contribue à décomposer la cohérence et la continuité du récit filmique. Comparable à la nature morte hollandaise au XVIIème siècle, la singularité de l’objet dans les films de Bresson, est sa présence non narrative. L’objet matériel et concret s’oriente généralement vers les deux aspects : d’une part, l’objet en gros plan se déconnecte de l’acte et de l’évènement et fait les imaginer dans le hors-champ. La déconnection entre l’objet présenté et l’évènement imaginaire entraîne la problématique de la discontinuité. D’autre part, l’objet, par la composition avec le corps morcelé, produit l’acte et l’évènement qui restitue le récit d’une façon fragmentaire. Cette façon de déconnecter et de fragmenter l’évènement, c’est la manière, pour l’objet, de présenter le réel. Notre étude abordera comment l’objet matériel et non narratif figure l’apparition du réel. / The « cinématographe » of Robert Bresson, has the aim to reach the truth of the reality in a different way than the one commonly used in the « cinéma », considered as being the photographed theater. The cinema of Robert Bresson, which is also the result of the application of his theory, is constantly in the negativity of the represented image. The bressoniens montage breaks into parts the classic match and splits up the narrative space. In this context, the object in the cinema of Bresson, without pressing on the narrative role and the symbolic meaning, contributes to split up the coherence and the continuity of the cinematic narrative. Compared to the Dutch still life in the XVIIth century, the peculiarity of the object in the films of Bresson, is his non narrative presence. The material and concrete object turns generally towards both aspects : on one hand, the object disconnects from the act and from the event, and the disconnection involves in the question of discontinuity. On the other hand, by the composition with a part of the body, the object produces the act and the event which create the narrative in a fragmentary way. This discontinuity and the fragment is the way, for the object, of presenting the reality. Our study will devoted to approach how the material and not narrative object contribute to the appearance of the reality.
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Rock mechanics, failure phenomena with pre-existing cracks and internal fluid flow through cracks / Mécanique des roches, phénomènes de rupture avec la prise en compte des fissures existantes et l'écoulement du fluide interne à travers les fissuresNikolic, Mijo 28 September 2015 (has links)
Cette thèse aborde le problème de la rupture localisée dans les roches, qui caractérise un grand nombre d'applications dans le domaine du génie civil, tels que la rupture du barrage, effondrement des fondations, la stabilité des excavations ou les tunnels, les glissements de terrain et les éboulements. Le risque de rupture localisée devrait être mieux appréhendé pour mieux l'éviter. La rupture localisée dans les roches est généralement caractérisée par une une rupture soudaine et quasi-fragile sans avertissement sous forme de grandes déformations et visibles avant la rupture elle-même. Cela se produit également sous l'influence des hétérogénéités matériels, des fissures existantes et d'autres défauts initiaux.Les trois nouveaux modèles numériques, intégrant les mécanismes de ruptures localisées, l'hétérogénéité de la roche et des fissures existantes et d'autres défauts, sont présentés dans cette thèse. Le premier modèle propose une représentation en 2D de roche composite à deux phases, où la phase solide représente la roche intacte et la faible phase indique les défauts initiaux. Le deuxième modèle représente l'extension du modèle précédent vers un espace 3D, où est considéré un ensemble complet de mécanismes de ruptures en 3D. Les propriétés hétérogènes sont considérées ici par une distribution aléatoire en accord avec la variation statistique de Gausse. Ce modèle est également utilisé pour l'analyse de la roche intacte par spécimens possédant des écarts de formes géométriques qui influencent la résistance à la compression uni-axiale. Le troisième modèle est un modèle en 2D, traitant l’interaction volumétrique entre un fluide et la structure sous l’influence de l’écoulement du fluide à travers le milieu de la roche poreuse.L'approche des lattices discrètes est choisie pour construire un cadre général pour les trois modèles, où les cellules de Voronoï représentent les grains de roche tenus ensemble par les poutres de Timoshenko comme des liens de cohésion. La cinématique améliorée est caractérisée par l'approche intégrée des discontinuités comme un supplément à la cinématique standard de liens cohérents. Cela sert pour la propagation de la macro fissure dans tous les modes de ruptures et de leurs combinaisons, entre les grains de la roche. La formation de la zone du processus de rupture suivie par des microfissures coalescentes, précédant la rupture localisée, est aussi considérée dans les modèles. L’écoulement du fluide est régi par la loi de Darcy, tandis que les conditions de couplage obéissent à la théorie de poroélasticité de Biot.Les résultats des modèles numériques ont été vérifiés par des exemples de la littérature dans le cas des modèles en 2D. Le modèle en 3D a été validé suite aux résultats expérimentaux effectués sur 90 échantillons de roches, où sont considérées de légères déviations géométriques des spécimens.La présentation de ces modèles, ainsi que leurs aspects de mise en œuvre sont présentés en détail. L’approche avec une discontinuité intrinsèque et le caractère local des améliorations nécessaires à la simulation des discontinuités de déplacement orientent vers la condensation statique des degrés de liberté améliorés sont efficacement intégrés dans l’architecture des éléments finis. / This thesis deals with the problem of localized failure in rocks, which occurs often in civil engineering practice like in dam failure, foundation collapse, stability of excavaations, slopes and tunnels, landslides and rock falls. The risk of localized failure should be better understood in order to be prevented. The localized failure in rocks is usually characterized by a sudden and brittle failure without warning in a sense of larger and visible deformations prior to failure. This happens also under the strong influence of material heterogeneities, preexisting cracks and other defects.The three novel numerical models, incorporating the localized failure mechanisms, heterogeneity of rock and preexisting cracks and other defects, are presented in this thesis. First model deals with 2D plane strain two-phase rock composite, where stronger phase represents the intact rock and weaker phase initial defects. Second model represents the extension of the previous model towards the 3D space, where full set of 3D failure mechanisms is considered. Heterogeneous properties are taken here through the random distribution and Gauss statistical variation of material properties. The latter model is also used for the analysis of intact rock core specimens geometrical shape deviations influencing the uni-axial compressive strength. Third model is a 2D, dealing with volumetric fluid-structure interaction and localized failure under the influence of fluid flow throughthe porous rock medium.The discrete beam lattice approach is chosen for general framework for three models, where Voronoi cells represent the rock grains kept together by Timoshenko beams as cohesive links. The enhanced kinematics characterized for embedded discontinuity approach is added upon standard kinematics of cohesive links. This serves for the macro crack propagation in all failure modes and their combinations, between the rock grains. The fracture process zone formation followed by micro-cracks coalescence, preceding the localized failure, is considered as well. Fluid flow is governed by a Darcy law, while coupling conditions obey Biot's theory of poroplasticity. The results of the numerical models were verified by the benchmarks available from literature in 2D case. The 3D model was validated against the experimental results conducted on 90 rock specimens, where even slight geometrical deviations of specimens are considered.Presentation of these models, as well as their implementation aspects are given in full detail. Embedded discontinuity concept and the local nature of enhancements required to capture the displacement discontinuities leads to the very efficient approach with static condensation of enhanced degrees of freedom and technique that can be efficiently incorporated into finite element code architecture.
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Strukturní změny v intermetalických sloučeninách / Structural changes in intermetallic compoundsDoležal, Petr January 2015 (has links)
This diploma thesis is focused on the study of the structural phase transitions in intermetallic compounds LaPd2(Al,Ga)2 by low-temperature x-ray powder diffraction and macroscopic measurements on single crystals. The results obtained from powder diffraction at room temperature confirm that the compounds crystallize in tetragonal CaBe2Ge2 structure type (space group P4/nmm). At low temperature all the compounds undergo the same structural phase transition by lowering the symmetry to the orthorhombic space group Cmma. Although the structural transformation is of first order, the transition is not-manifested in step-like change of the phase at a certain temperature, but occurs in a broader temperature interval. In this interval the different phases coexist and transform gradually from high- to low- temperature phase. After application of hydrostatic pressure the structural transition is shifted to higher temperatures. Despite that the low temperature structures are of the same type, there is a difference between compounds containing Ga and Al in the discontinuity of the lattice parameters resulting in a distinct anomaly in electrical resistivity. In pressures >0.6 GPa this characteristic anomaly on single crystalline CePd2Al2 is changed, indicating a pressure- induced change of the low-temperature...
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BEHAVIOR AND DESIGN OF THE CRITICAL MEMBER IN STRUCTURES WITH IN-PLANE DISCONTINUOUS BRACED FRAMESNiraula, Manjil 01 September 2020 (has links)
When a structure with an in-plane discontinuous frame is used, a discontinuous load path is formed due to the irregularity. This is continuous load path can lead to the failure of certain elements and the structure as a whole when the structure is exposed to lateral loading. In this study, an in-plane discontinuous frame structure is exposed to gravity as well as lateral loading due to which a discontinuous load path is formed. Due to the discontinuous load path, higher value of axial load is developed on a beam which is generally designed considering it as a flexural member. The main objective of this thesis is to determine if the beam can be designated as the critical member in the in-plane discontinuous frame and the comparison of the critical element with the corresponding element in a frame that has no structural irregularities. The objective is also to design the critical member considering it as a beam-column element considering the combined effect of bending and compression.
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Evaluating South African policies for linkage to and retention in HIV care using quasi-experimental methodsKluberg, Sheryl 08 November 2017 (has links)
South Africa has the largest HIV-infected population in the world, with 2015 estimates of 7 million people living with HIV and 180,000 AIDS-related deaths. The South African government began scale-up of a public-sector HIV care and treatment program in 2004, and by the end of 2015, 3.4 million HIV-infected individuals were on antiretroviral therapy (ART).
When scale-up began in South Africa, ART was only available to HIV-infected individuals with CD4 counts ≤200 cells/µL or WHO clinical stage 4 disease. In 2010, treatment was extended to patients who were pregnant or who had tuberculosis and a CD4 ≤350 cells/µL, and in 2011, eligibility was extended to all patients with CD4 ≤350 cells/µL. In 2013 patients with WHO clinical stage 3 disease became eligible. In 2015, the eligibility threshold was increased to CD4 ≤500 cells/µL, and in 2016, the South African National Department of Health announced that the country would implement a “test and treat” strategy, offering free ART to all HIV-infected individuals, regardless of CD4 count.
This dissertation examines the effectiveness of several expansions and modifications to South Africa’s treatment program. In study 1, we investigated whether the 2011 extension of HIV treatment to patients with CD4 counts ≤350 cells/µL successfully increased the number of newly-eligible patients on treatment (those with CD4 counts between 201–350 cells/µL) without crowding out previously-eligible patients with more severe disease (CD4 counts ≤200 cells/µL), focusing on a network of rural clinics in KwaZulu-Natal. We found encouraging results, with newly-eligible patients (CD4 201–350) initiating treatment at a greater frequency (73.0 additional patients per month; 95% CI: 42.1; 103.9) and 47% faster than before (95% CI: 19%; 82%), while previously eligible patients (CD4 ≤200) experienced no decline in the number of patients initiating treatment or the speed of treatment uptake.
In study 2, we evaluated whether the introduction of a single-pill fixed-dose combination (FDC) treatment for ART initiators in South Africa had an impact on attrition from care compared to the previously-recommended multiple-pill regimen. We focused on an urban clinic in Johannesburg, using four different clinic attendance measures to define attrition (generally a combined measure of loss to follow-up and mortality). An intention-to-treat analysis revealed an estimated 11.3 percentage point decrease in attrition (95% CI: -22.0; -0.6) associated with the policy change, while a regression discontinuity analysis estimated an 18.0 percentage point drop in attrition (95% CI: -33.6; -2.4) associated with single-pill FDC treatment relative to multiple pills, controlling for unmeasured confounding.
In study 3, we used stratified instrumental variable analysis to examine whether the effect of FDCs on attrition varied across subsets of the patient population in the same Johannesburg clinic we evaluated in study 2. We saw larger effects among women (RD -0.25; 95% CI: -0.42; -0.09), non-anemic patients (RD -0.24; 95% CI: -0.41; -0.08), patients with early-stage (as opposed to advanced) clinical disease (RD -0.20; 95% CI: -0.32; -0.07), and those with high CD4 counts (for CD4 ≥350 cells/µL, RD -0.58; 95% CI: -1.58; 0.42). These results suggest that healthier patients saw the greatest improvement in retention in care following the switch from multiple-pill to single-pill regimens. In an era where the healthiest HIV-infected patients are now being targeted for ART treatment, FDCs can play a large role in preventing attrition from care.
These three studies depict an HIV program that has successfully grown to treat increasing numbers of patients using up-to-date strategies of care. Given the immense scale and cost of South Africa’s HIV treatment program, it is important to continue to monitor its effectiveness, especially as it introduces new treatments and strategies and adapts to the changing epidemic.
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