Aims: The aims of this research were to describe the signs and symptoms of dysphagia in people who are living with HIV/AIDS and to see what participant variables such as CD4 count, age and diagnosis affect dysphagia. Methods: This study was a descriptive, cross-sectional, quasi non-experimental design. The sampling method that was used for this research was non-probability and convenient. These patients were referred to the speech therapy and audiology department from various multidisciplinary team members for dysphagia assessments. There were 106 participants in total. Eighty participants underwent only a clinical bedside assessment and 26 underwent a bedside assessment as well as a modified barium swallow. The Mann Assessment of Swallowing Ability (MASA) was used to conduct the clinical bedside assessments and a modified barium swallow (MBS) was used as an objective measure. The data was analysed using both descriptive and inferential statistics. These tests included the Wilcoxon signed rank test, Spearman Rho test, Kruskal-Wallis and Mann Whitney U-test. Results: Descriptively, the results revealed that participants with neurological conditions appeared to present with more severe signs and symptoms of dysphagia. The results from the Wilcoxon signed rank test showed that participants with a neurological disorder experienced more severe signs and symptoms of dysphagia, except with laryngeal elevation. The Wilcoxon signed rank test also showed that older participants experienced more dysarthria and oral transit difficulties. The results from the Kruskal-Wallis test highlighted that participants with a lower CD4 count had more significant respiration and voice difficulties. The results from the Mann-Whitney U test showed that participants who were on a HAART regimen experienced increased difficulty in the pharyngeal phase and aspirated more frequently. The Spearman-Rho test results showed that the MASA was seen as a valid bedside assessment tool for assessing adult dysphagia in an acute hospital setting. Discussions: Dysphagia does occur in the HIV/AIDS population in South Africa in participants who have neurological conditions as well as opportunistic infections. The SLP needs to play a key role in the assessment and management of these patients. The MASA is a good assessment tool to use in settings where objective measures are not available.

Submitted by camilla martins (camillasmmartins@gmail.com) on 2017-03-24T17:51:47Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_EstimacaoLocalIncidencia.pdf: 4971817 bytes, checksum: 4744fadf79bcf26c484dcae5dfb89992 (MD5) / Approved for entry into archive by Edisangela Bastos (edisangela@ufpa.br) on 2017-03-27T14:35:40Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_EstimacaoLocalIncidencia.pdf: 4971817 bytes, checksum: 4744fadf79bcf26c484dcae5dfb89992 (MD5) / Made available in DSpace on 2017-03-27T14:35:40Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_EstimacaoLocalIncidencia.pdf: 4971817 bytes, checksum: 4744fadf79bcf26c484dcae5dfb89992 (MD5) Previous issue date: 2016-03-22 / CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico / Ao longo dos anos, os relâmpagos constituíram o ponto central das pesquisas de diversas comunidades científicas e tecnológicas em todo mundo, sem dúvida pela sua natureza agressiva e devastadora, mas principalmente pelos prejuízos causados no setor elétrico, logo é necessário esclarecer, o que é e para que serve um Sistema de Localização de Tempestades (SLT). Este trabalho propõe demonstrar o funcionamento de um algoritmo utilizado em SLT que serve para localizar, em termos geográficos, descargas atmosféricas, utilizando os tempos de chegada dos sinais eletromagnéticos nos elementos sensores. Para elaboração deste trabalho foi utilizado o formato de dados gerados por sensores LPATS IV pertencentes a (REDE DO SIPAM) e estes dados foram gerados de forma artificial para utilização no algoritmo. Esta localização será baseada em uma sequência finitas de regras que utilizará como ferramenta, a interseção de futuras hipérboles, resultantes da diferença dos tempos de chegada em cada sensor. O algoritmo é capaz de identificar o local de incidência da descarga atmosférica utilizando um simples sistema de três sensores. Cada par de sensores define duas hipérboles, em virtude de sua parte positiva e negativa formando duas interseções. Para análise do resultado é considerado o ponto de cruzamento mais próximo ao sensor que identificou a perturbação com menor tempo. Um estudo sobre a eletricidade atmosférica, tipos de raios, emissão de ondas eletromagnéticas durante tempestades, tipos de sensores eletromagnéticos e redes de detecção de raios deram subsídio para o projeto do algoritmo desenvolvido. / Over the years, lightning were the central point of researches in various scientific communities around the world, no doubt for its aggressive and devastating nature, but mostly for damage caused in the electricity sector, so it is necessary to clarify what is and what it is for a Lightning Location System (LLS). This work proposes to demonstrate the operation of the algorithm utilized in LLS that is used to locate in geographical terms, lightning, using the arrival times of electromagnetic signals in the sensors. In order to prepare this paper it was used the data format generated by LPATS IV sensors belonging to Amazon Protection System (SIPAM). These data were generated in an artificial way for use in the algorithm tests. The lightning location will be based on a finite sequence rules that use the intersection of hyperbolas, resulting from the difference of arrival times at each sensor. The algorithm is able to identify the lightning location incidence using a system with three sensors. Each pair of sensors defines two hyperbole forming a total of six, because each hyperbole has a bright side and a negative side, so there will be two intersections of three hyperboles. For analysis of the results is considered the nearest crossing point to the sensor that identified the electromagnetic disturbance faster. Studies about atmospheric electricity, lightning types, electromagnetic radiation during storms, types of electromagnetic sensors and lightning detection networks have given the knowledge to develop the algorithm.

The main subject in this research study is to try to understand the link between legitimacy upholding and CSR reporting, which in this case is sustainability reporting. In this research study we examine how companies’ legitimacy can be damaged by a scandal. This essay takes a closer look at 8 companies that have been through a scandal and this study aims to evaluate how and why they try to re-legitimize themselves after a scandal has happened. The study uses a qualitative content analysis where we have examined companies’ sustainability reports as a basis. We codified the sustainability reports are searched for underlying themes through an abductive analysis that could be used for evaluation. Our results suggest that organizations aim move from a symbolic to a substantial management style after a scandal with a concentration being on stakeholder appeals. Responsibility for the scandal can also deviate depending how big the scandals are as per our results. Our results are however highly anecdotal yet they provide a base for further research. Our results had been analyzed with the help of legitimacy theory, CSR in theory and stakeholder theory. / Huvudämnet i den här forskningsstudien är kopplingen mellan upprätthållandet legitimering av CSR och hållbarhetsredovisningen. I den här forskning studien undersöks hur företagens legitimitet kan skadas av en skandal. Uppsatsen tar en noggrannare titt på 8 företag som har varit med om en skandal och undersöker om och hur de försöker legitimera sig själv före och efter en skandal. Studien är skriven utifrån en kvalitativ innehållsanalys där vi har undersökt och använt företagens hållbarhetsredovisning som underlag till vårt studie i de här fallet. Vi har kodifierat hållbarhetsrapporterna där vi har sökt efter underliggande teman genom en abduktiv analys. Vårt resultat tyder på att organisationer siktar för att likna efter en substantiell managementstil efter en skandal, där fokus har varit att försöka tillfredsställa intressenterna. Ansvar över skandalen avviker beroende på hur stor skandalen är i hänsyn till vårt resultat. Resultatet i vår studie är anekdotisk dock får vi tillhandahålla en bas för vidare forskning gällande det här området. Vårt resultat har vi även analyserat med hjälp av teorin som vi har tillhandahållit, legitimitets teorin, CSR i teori och intressentteori.

Denna studie av första linjens situationsanpassade ledarskap uppvisar mångalikheter mellan respondenternas beslutsfattande, nivå av anpassningsbarhet ocheffektivitetsvärdering uppmätta efter Hershey och Blanchards ledarskapsmodell(SLT-Modellen) trots deras vitt skilda verksamhetsområden med första linjensoperativa ledarskap som gemensam nämnare.Denna studie påvisar att utifrån SLT-modellen och studiens respondenter att derasledarskap i första hand inte påverkas av de varierande organisationsstrukturella,kulturella eller geografiska miljöer de verkar i, utan främst av faktorer tillhörande ensituationsanpassad och aktivitetsstyrd verksamhet under med inslag av hög stressoch risk med tydliga regelverk. Studien påvisar likande resultat i ledarskapsstilar,effektivitet m.fl. som tidigare undersökning av polisära ledare som genomförts itidigt 1980-talets USA, trots de samhällsförändringar som skett under en tidsperiodav 40-år samt de geografiska och kulturella skillnader mot denna studiesrespondenter som uteslutande består av svenska individer, dock verksamma på eninternationell arena.Vidare bestyrker föreliggande studie den kritik av tidigare forskning av SLTmodellen, är frånvaro av laissez-faire ledarstilen. Dock framgår frånintervjufrågeställningarna att begräsningarna inte ligger hos de underställdasmognadsfas, engagemang eller vilja utan snarare inom ett verksamhetens specifikaområde med faktorer som ansvar, regelverk och aktivitetsbaserade uppdrag. Givet ien friare och mer oreglerad verksamhet skulle möjligtvis SLT-modellen nå längre.

Purpose To evaluate the effectiveness and safety of Selective Laser Trabeculoplasty (SLT) with the SLT mode of the VISULAS ® green laser in patients with primary open-angle glaucoma (POAG). Methods This prospective, interventional multicenter clinical investigation included patients with POAG who either needed a treatment escalation because the individual intraocular pressure (IOP) target was not met or treatment initiation and had an IOP ≥ 17 mmHg at baseline in the study eye. The study was conducted in five research centers across Germany. Approximately 100 laser applications were delivered to 360° of the trabecular meshwork. Glaucoma medications were not modified during the 3-month follow-up to allow evaluation of the sole effect of VISULAS ® green with SLT. Efficacy outcomes were postoperatively absolute and relative IOP changes at 1 and 3 months. Safety outcomes analyzed the rate of intra- and postoperative adverse events. Results Thirty-four eyes of 34 POAG patients were included. The overall mean number of preoperative glaucoma medications was 2.2 ± 1.4 in 29 treated eyes, 5 eyes were treatment naïve. Mean baseline IOP (mmHg) was 21.0 ± 2.69 and was reduced by − 3.53 ± 3.34 [95% CI − 4.61; − 2.45] and − 3.59 ± 3.41 [95% CI − 4.64; − 2.53] at the 1- and 3-month follow-up, respectively (p < 0.0001), with 48.5% of cases achieving a ≥ 20% IOP reduction at 3 months [95% CI = 30.8%; 66.5%]. The mean relative IOP reduction was − 16.4% and − 16.3% at 1 and 3 months, respectively (p < 0.0001). Potentially device- or procedure-related adverse events were mild to moderate and included 3 postoperative IOP-spikes and 6 reports regarding eye pain and discomfort. All were resolved without sequelae. Conclusions SLT performed with the VISULAS ® green laser achieved clinically significant additional IOP reductions in medically treated as well as in treatment naïve eyes with POAG and there were no relevant safety issues. The results are comparable to other reported SLT studies.

Atualmente, a Leucemia Linfocítica Crônica (LLC) pode ser dividida em dois grupos: um com mutações somáticas no gene da região variável da cadeia pesada da imunoglobulina (MIgVH) e outro sem mutações (NMIgVH). Alguns estudos mostraram que a expressão de CD38 na superfície das células B de LLC pode estar correlacionada com o estado mutacional do gene VHIg, entretanto, esses controversos. Estudos recentes mostraram que a expressão da proteína tirosina quinase Zap-70 está melhor associada com o estado mutacional do gene IgVH. O objetivo deste estudo foi avaliar a expressão de Zap-70 e CD38, por citometria de fluxo, nas células CD19+ de pacientes com LLC e correlacioná-los com o estádio clínico (EC), sobrevida livre de tratamento (SLT) e sobrevida global (SG). A expressão de Zap-70 e CD38 foi avaliada, em 144 de pacientes com LLC classificados nos estádios clínicos A, B e C de acordo com os critérios de Binet: 59 (41%) do EC-A, 38 (26%) do EC-B e 47 (33%) do EC-C. Foi observada menor positividade para Zap-70 e CD38 nos pacientes do EC-A do que nos EC-B e C. Quando avaliada a SLT nos pacientes do EC-A, os casos Zap-70+ assim como os CD38+ apresentaram menor SLT. A média de SG dos pacientes Zap-70+ e CD38+ foi menor quando comparado com os Zap-70- e CD38- entretanto quando correlacionada com o EC não foi observada diferença estatisticamente significante entre a expressão desses marcadores e o EC-A, B ou C. Pela analise combinada de CD38 e Zap-70, dividimos os pacientes em dois grupos (Zap-70-/CD38- e Zap-70+ ou CD38+). Observamos que a expressão positiva desses dois marcadores estava associada ao EC, uma vez que a grande maioria dos pacientes dos estádios B (74%) e C (66%) expressam Zap-70 ou CD38. Entretanto, os pacientes do EC-A, Zap-70+ ou CD38+, apresentaram SG menor quando comparado com os Zap-70-/CD38-. Essa diferença não foi observada nos pacientes do EC-B e do EC-C. Também foi observada menor SLT nos pacientes no EC-A, Zap-70+ ou CD38+. Esses resultados sugerem que análise combinada de Zap-70 e CD38 podem ser empregadas na avaliação dos pacientes do EC-A para se acompanhar a evolução clinica desse grupo de pacientes. Porém, estudos adicionais devem ser realizados para se validar a utilização clínica desses marcadores. / Actually, chronic lymphocytic leukemia (CLL) can be divided in two subsets: one with somatically mutated immunoglobulin heavy-chain variable-region genes (MIgVH) and other with unmutated sequences. (UMIgVH). Some studies have shown that CD38 expression in CLL cells are correlated with IgVH mutational status. However, the value of CD38 as surrogate IgVH mutational status is controversial. Recent studies, have found that Zap-70 protein tyrosine kinase expression is strongly associated with the mutational status IgVH. The aim of this study was to evaluate the Zap-70 and CD38 expression, for flow cytometry, in CD19+ LLC cells and correlate with the Binet’s staging system, treatment-free survival (TFS) and a overall survival (OS). Zap-70 and CD38 was evaluated, in 144 CLL patients that was classified in A, B and C Binet’s staging system: 59 (41%) in stage A, 38 (26%) in B and 47 (33%) in C. We observed low Zap-70 and CD38 expression in stage A patients than in stage B and C cases. When we analyzed the TFS in stage A patients Zap-70+ and CD38+ patients showed shorter TFS than Zap-70- and CD38-. Then we observed that the OS of Zap-70+ and CD38+ patients was, also, shorter than Zap-70- and CD38- cases. However, statistical differences was not found when Zap-70 and CD38 expression was correlated with stage A, B or C Binet’s staging system. To understand the associated Zap-70 and CD38 expression, we divided the CLL patients in two subgroups (Zap-70-/CD38 - and Zap-70+ or CD38+). We observed that CD38+ or Zap-70+ was associated Binet’s staging system, once most of stage B (74%) and C (66%) patients are Zap-70+ or CD38+. However, stage A patients, Zap-70+ or CD38+, showed shorter OS than Zap-70-/CD38-. These differences were not observed in stage B and C patients. Shorter TFS was also observed in the Zap-70+ or CD38+ stage A patients. These results suggest that combined analysis of Zap-70 and CD38 can be used to evaluate stage A patients to observe the clinical evolution of the disease. Nevertheless, other studies must be carried to confirm the clinical use of these markers.

Atualmente, a Leucemia Linfocítica Crônica (LLC) pode ser dividida em dois grupos: um com mutações somáticas no gene da região variável da cadeia pesada da imunoglobulina (MIgVH) e outro sem mutações (NMIgVH). Alguns estudos mostraram que a expressão de CD38 na superfície das células B de LLC pode estar correlacionada com o estado mutacional do gene VHIg, entretanto, esses controversos. Estudos recentes mostraram que a expressão da proteína tirosina quinase Zap-70 está melhor associada com o estado mutacional do gene IgVH. O objetivo deste estudo foi avaliar a expressão de Zap-70 e CD38, por citometria de fluxo, nas células CD19+ de pacientes com LLC e correlacioná-los com o estádio clínico (EC), sobrevida livre de tratamento (SLT) e sobrevida global (SG). A expressão de Zap-70 e CD38 foi avaliada, em 144 de pacientes com LLC classificados nos estádios clínicos A, B e C de acordo com os critérios de Binet: 59 (41%) do EC-A, 38 (26%) do EC-B e 47 (33%) do EC-C. Foi observada menor positividade para Zap-70 e CD38 nos pacientes do EC-A do que nos EC-B e C. Quando avaliada a SLT nos pacientes do EC-A, os casos Zap-70+ assim como os CD38+ apresentaram menor SLT. A média de SG dos pacientes Zap-70+ e CD38+ foi menor quando comparado com os Zap-70- e CD38- entretanto quando correlacionada com o EC não foi observada diferença estatisticamente significante entre a expressão desses marcadores e o EC-A, B ou C. Pela analise combinada de CD38 e Zap-70, dividimos os pacientes em dois grupos (Zap-70-/CD38- e Zap-70+ ou CD38+). Observamos que a expressão positiva desses dois marcadores estava associada ao EC, uma vez que a grande maioria dos pacientes dos estádios B (74%) e C (66%) expressam Zap-70 ou CD38. Entretanto, os pacientes do EC-A, Zap-70+ ou CD38+, apresentaram SG menor quando comparado com os Zap-70-/CD38-. Essa diferença não foi observada nos pacientes do EC-B e do EC-C. Também foi observada menor SLT nos pacientes no EC-A, Zap-70+ ou CD38+. Esses resultados sugerem que análise combinada de Zap-70 e CD38 podem ser empregadas na avaliação dos pacientes do EC-A para se acompanhar a evolução clinica desse grupo de pacientes. Porém, estudos adicionais devem ser realizados para se validar a utilização clínica desses marcadores. / Actually, chronic lymphocytic leukemia (CLL) can be divided in two subsets: one with somatically mutated immunoglobulin heavy-chain variable-region genes (MIgVH) and other with unmutated sequences. (UMIgVH). Some studies have shown that CD38 expression in CLL cells are correlated with IgVH mutational status. However, the value of CD38 as surrogate IgVH mutational status is controversial. Recent studies, have found that Zap-70 protein tyrosine kinase expression is strongly associated with the mutational status IgVH. The aim of this study was to evaluate the Zap-70 and CD38 expression, for flow cytometry, in CD19+ LLC cells and correlate with the Binet’s staging system, treatment-free survival (TFS) and a overall survival (OS). Zap-70 and CD38 was evaluated, in 144 CLL patients that was classified in A, B and C Binet’s staging system: 59 (41%) in stage A, 38 (26%) in B and 47 (33%) in C. We observed low Zap-70 and CD38 expression in stage A patients than in stage B and C cases. When we analyzed the TFS in stage A patients Zap-70+ and CD38+ patients showed shorter TFS than Zap-70- and CD38-. Then we observed that the OS of Zap-70+ and CD38+ patients was, also, shorter than Zap-70- and CD38- cases. However, statistical differences was not found when Zap-70 and CD38 expression was correlated with stage A, B or C Binet’s staging system. To understand the associated Zap-70 and CD38 expression, we divided the CLL patients in two subgroups (Zap-70-/CD38 - and Zap-70+ or CD38+). We observed that CD38+ or Zap-70+ was associated Binet’s staging system, once most of stage B (74%) and C (66%) patients are Zap-70+ or CD38+. However, stage A patients, Zap-70+ or CD38+, showed shorter OS than Zap-70-/CD38-. These differences were not observed in stage B and C patients. Shorter TFS was also observed in the Zap-70+ or CD38+ stage A patients. These results suggest that combined analysis of Zap-70 and CD38 can be used to evaluate stage A patients to observe the clinical evolution of the disease. Nevertheless, other studies must be carried to confirm the clinical use of these markers.

The present paper extends previous research in terms of integrating social learning with morality theories, under the framework of moral educators’ and their conflicting moral influences. Specifically, this study aims to investigate the impact of witnessing moral educators breaking (their) moral teachings on individual’s morality and criminal behavior using a sample of two countries, Sweden and Greece, with similar population but entirely different cultural and social characteristics. We focus on three research questions regarding the correlations and (i) the explanatory influence of witnessing this conflict on moral emotions and values by gender and country, (ii) its impact on traditional crime by gender and country and (iii) the impact that witnessing the conflict and morality mutually have on traditional crime in the two countries. Our findings emerge in three key points. First, we found that witnessing moral educators influenced both moral emotions differentially in each country and gender, but only affected Swedish males’ moral values. Secondly, our results showed that witnessing moral educators can explain a moderate to small variance of traditional crime only for males in the two countries. Lastly, we found that witnessing moral educators together with morality can explain a moderate variance of traditional crime in the two countries, while gender is highly important for both countries. Findings are discussed in relation to theory and previous research. Future research is recommended in order to expand the understanding of the cultural and social learning processes that inhibit (im)moral contexts and subsequently affect morality and offending.