Introdução. O modelo tecnocrático de assistência ao parto e nascimento propõe uma lógica organizacional com práticas não baseadas em evidências científicas cujos desfechos se contrapõem ao bem-estar materno e infantil. No setor público ocorrem partos com excesso de intervenções e altas taxas de cesarianas. No setor privado, a maioria das mulheres é submetida a cesáreas. Em ambas as situações, pergunta-se a quem e por que é vantajoso o que se prescreve. Objetivos. Revisar sistematicamente a produção científica nacional e internacional que trata das circunstâncias em que o tema dos conflitos de interesses nas indicações de cesárea é abordado. Material e método. Revisão sistemática abrangente da literatura disponível, segundo a metodologia do Instituto Joanna Briggs. Resultados. Foram identificados 4.135 textos em 4 bases de dados - The Cochrane Library, EconPapers, CINAHL e Medline - dos quais 41 foram analisados após a aplicação de critérios.de inclusão. Os idiomas encontrados foram: inglês, francês, português e espanhol, com predominância do primeiro. A maioria trouxe a palavra cesárea entre seus descritores. Foram recorrentes termos ligados à prática de profissionais e às diferentes formas de pagamento ou financiamento da assistência. As influências sobre a decisão por cesárea são abordadas em diferentes análises da assistência. Os principais atores envolvidos são médicos e mulheres. Foi possível identificar conflitos de duas naturezas: financeiros diretos e indiretos e não financeiros. Discussão. A literatura silencia sobre os conflitos de interesses entre provedores de cuidados e mulheres nas decisões por cesárea. Os interesses secundários problematizados nos textos foram nomeados fatores associados a conflito de interesses. A narrativa hegemônica (percepção do médico) se sobrepõe às outras e as obscurece. Conflitos de interesse são omitidos e surgem termos como incentivos financeiros e indução da demanda, frequentemente analisados sem considerar o desnível de poderes entre os atores envolvidos. Conclusões. O fenômeno é apenas implícito na literatura que problematiza os incentivos e a indução da demanda à prática de cesarianas. As circunstâncias são processos de análise da assistência obstétrica que investigam explicações e interferências nas variações das taxas de cesáreas. O ator com maior poder de influenciar o desfecho é o médico. A invisibilidade do conceito na literatura científica aponta para uma lacuna de conhecimento a ser preenchida. / Background. The technocratic model of childbirth care proposes a logical organizational with non-evidence based practices whose outcomes oppose the welfare of both mother and child. In the public sector births occur with excessive interventions and high rates of caesarean section. In the private sector, the majority of women are subjected to caesarean sections. In both situations, the question is to whom and why it is advantageous to perform those practices. Objectives. To review systematically national and international scientific literature which addresses the circumstances in which the issue of conflicts of interest in indications for cesarean section is approached Material and method. Comprehensive systematic review of the available literature, according to the methodology of the Joanna Briggs Institute. Results. 4,135 texts were identified in four data bases The Cochrane Library, EconPapers, CINAHL, Medline - of which 41 were analyzed after applying inclusion criteria. Languages found were English, French, Portuguese and Spanish, English being the most common. Most brought the word \"cesarean\" among their key terms. Recurrent terms were related to professional practice and the different forms of payment or financing healthcare. The influences on the decision for cesarean section are addressed in different healthcare analysis. The main actors involved are doctors and women. It was possible to identify conflicts of two natures: financial - direct and indirect - and non-financial. Discussion. Literature is silent about the conflicts of interest between care providers and women on decisions for cesarean sections. The secondary interests approached in the texts were named \"factors associated with conflict of interests.\" The hegemonic narrative (physicians perception) overlaps and obscures all others. Conflicts of interest are omitted and other terms such as financial incentives and supplier induced demand are often analyzed without considering the difference of power between the actors involved. Conclusions. The phenomenon is only implicit in the literature that discusses incentives and provider induced demand over the practice of cesarean sections. The circumstances are processes of analysis of obstetric care which investigate explanations and interferences on variations of cesarean section rates. The actor with the greatest power to influence the outcome is the doctor. The invisibility of the concept in the literature points out to a knowledge gap to be filled

The Xilinx Multiprocessor System-on-Chip (MPSoC) is a complex device that uses 16nm FinFET technology to combine multiple processors, a large amount of FPGA resources, and many I/O interfaces on a single chip die. These features make the MPSoC a high-performance and architecturally flexible device. The potential computing power makes the MPSoC ideal for many embedded applications including terrestrial and space applications. The MPSoC, however, does not have extensive radiation history as many other devices have. The extent of the effect that ionized particles may have on the MPSoC is not well established. To solve this problem, neutron radiation testing can be used to determine the device's susceptibility to single-event upsets (SEUs). Though this thesis is not intended to qualify the MPSoC for space, this work does provide useful neutron radiation test data that helps to characterize the susceptible nature of the device. This thesis summarizes the SEU results obtained from neutron testing on the UltraScale+ MPSoC ZU9EG device. A series of three neutron beam tests were performed on the MPSoC ZU9EG at Los Alamos National Laboratories (LANL). Testing was performed using a novel testing methodology to collect SEU counts on the programmable logic and the processing system simultaneously. These results show a 10.1× improvement of the programmable logic CRAM over the previous Xilinx UltraScale device series.

The Xilinx Multiprocessor System-on-Chip (MPSoC) is a complex device that uses 16nm FinFET technology to combine multiple processors, a large amount of FPGA resources, and many I/O interfaces on a single chip die. These features make the MPSoC a high-performance and architecturally flexible device. The potential computing power makes the MPSoC ideal for many embedded applications including terrestrial and space applications.The MPSoC, however, does not have extensive radiation history as many other devices have. The extent of the effect that ionized particles may have on the MPSoC is not well established. To solve this problem, neutron radiation testing can be used to determine the device's susceptibility to single-event upsets (SEUs). . Though this thesis is not intended to qualify the MPSoC for space, this work does provide useful neutron radiation test data that helps to characterize the susceptible nature of the device. This thesis summarizes the SEU results obtained from neutron testing on the UltraScale+ MPSoC ZU9EG device. A series of three neutron beam tests were performed on the MPSoC ZU9EG at Los Alamos National Laboratories (LANL). Testing was performed using a novel testing methodology to collect SEU counts on the programmable logic and the processing system simultaneously. These results show a $10.1 timess improvement of the programmable logic CRAM over the previous Xilinx UltraScale device series.

Tese de Mestrado Integrado. Engenharia Mecânica. Faculdade de Engenharia. Universidade do Porto. 2013

Cesarean section (CS) rates have generally increased across the world in the past decade. Reducing elective cesarean section (ECS) rates is imperative as many countries aim to maintain threshold CS rates at or below 15%, the level recommended by the United States' National Institutes of Health. Women are believed to consider ECS for various interconnected psychosocial reasons, but few quantitative studies have investigated these factors. This prospective cohort study was based on the social ecological model (SEM) and the theory of planned behavior (TPB) models, and identified the psychosocial predictors of ECS among 1,268 expectant women in 2 hospitals in Nairobi. Participants completed a structured questionnaire consisting of 10 validated psychosocial scales and were followed for actual mode of delivery (MoD) from hospital records and postnatal telephone interviews. The overall prevalence of CS and ECS were 16.0% and 6.4%, respectively; the CS rate was not statistically higher than the recommended 15% (p > 0.05). The combined CS incidence rate for these 2 hospitals was 83 per 1,000 births per month. Autonomy, fear of childbirth, pregnancy related anxiety, perceived social support from friends, and outcome expectancy for birth were statistically significant predictors of ECS, given the parity and age at first pregnancy, Ï?2(df = 19) = 77.735, p

This study was designed to present descriptive data from a survey of 201 school psychologists. Psychologists completed a survey addressing current practices for determining placement for students with ADHD including the role of school psychologists in determining placement, how often and who monitors services, where students are served, and what services are provided in each setting. Findings indicated that psychologists were involved less frequently in placement decisions and evaluation for Section 504 than in Special Education. Students with 504 plans received less frequent follow-up than students in Special Education. Results indicated that schools were generally following federal guidelines and recommendations from researchers for placement decisions, at least when the school psychologist was involved. Overall, service patterns for Section 504 and Special Education were similar; however, all interventions were reported more frequently in Special Education. Data indicated that empirically supported interventions may be underutilized in both settings for students with ADHD.

This project is concerned with obstetric complications and cesarean births in a Yucatec Maya community that has recently began interacting with global market economies and Western biomedicine. ​This research engages with maternal health, reproductive biology, colonial histories, and the global trend of increasing cesarean births. The Yucatec Maya are a short statured population [average adult female height 2010 = 143.2 cm] with historically low obstetric complications and maternal mortality. In the last 30 years, CS rates have risen to account for 25% of all births in this community. Because extreme short stature for population has been linked to obstructed labor and birth complications, this project was designed to determine if stature is impacting the rising rate of CS. Reproductive outcomes and obstetric complications were modeled against height in 3 age cohorts of mothers using one-way ANOVA with a Bonferroni-post hoc test and univariate general linear models. No statistical evidence was found to indicate that stature is related to reproductive outcomes or obstetric complications; however, there is an association between short stature and likelihood of cesarean birth. The dramatic change in birth mode in this population may be attributed to increased availability of biomedical resources, doctor-driven perceptions of indigenous women, and low capacity of rural public hospitals to serve numerous patients in labor.

Cesarean delivery is one of the most frequently performed surgical procedures in the United States with 1 in 3 women giving birth by cesarean section. Nurses play a significant role during the labor and delivery process; yet in a hospital in west Texas, nurses lacked knowledge of the current evidence-based obstetric guidelines that were developed to reduce the primary cesarean delivery rates and associated complications. The purpose of this project was to evaluate the content of educational materials developed to inform obstetrical nurses and midwives about labor support strategies to avoid cesarean delivery. Guided by Knowles's whole-part-whole model, a presentation was developed that included evidence-based guidelines and labor-support strategies for positioning and pain management to decrease the choice of cesarean section when not indicated. A 9-member panel with at least 5 years obstetrical expertise evaluated the materials. Based on a descriptive analysis of questionnaire data, experts had a 100% level of agreement that while the educational program material had the potential to promote nursing care practices that would decrease the number of primary cesarean deliveries, changing clinical delivery practices would likely be met with staff resistance. An evidence-based educational program with preventive strategies to decrease primary cesarean deliveries might produce positive social change by prompting obstetric teams to choose these preferred alternatives to avoid to cesarean delivery, and subsequently, decrease associated complication rates, promote faster maternal recovery after childbirth, and decrease the financial burden on the health care system.

Currently, Title II of the Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism (USA PATRIOT Act) Act of 2001 appears to be stalled as a result of controversy over the intent and meaning of the law. Proponents of the title advocate the necessity of the act to combat modern terrorism, whereas opponents warn of circumventions of the Fourth Amendment of the U.S. Constitution. Using punctuated equilibrium as the theoretical foundation, the purpose of this case study was to explore the dialogue and legal exchanges between the American Civil Liberties Union and the Department of Justice related to the National Security Agency's metadata collection program. In specific, the study sought to explore the nature of resistance to changes needed to mollify the controversies associated with Title II. Data for this study were acquired through publicly available documents and artifacts including transcripts of Congressional hearings, legal documents, and briefing statements from the US Department of Justice and the American Civil Liberties Union. These data were deductively coded according to the elements of PET and then subjected to thematic analysis. Findings indicate that supporters and opponents of the law are locked in a consistent ideological polarization, with supporters of the law touting the necessity of the authorizations in combatting terrorism and opponents arguing the law violates civil liberties. Neither side of the debate displayed a willingness to compromise or acknowledge the legitimacy of the other viewpoint. Legislators who accept the legitimacy of both researched viewpoints could create positive social change by refining the law to meet national security needs while preserving constitutional protections.

The Marion Plateau is a carbonate-platform complex on the passive northeast Australian margin. During ODP Leg 194, a series of eight sites, on two transects, were drilled through Oligocene to Holocene mixed carbonate and siliciclastic sediments that record the depositional history of the Marion Plateau. Major sediment constituents, including benthic foraminifers, were counted from thin sections made from samples taken from three drilling sites: bryozoan-dominated northern highstand platform site 1193 and northern lowstand ramp site 1194, and coralline red algae-dominated southern platform site 1196. Quantitative multivariate analysis of benthic foraminiferal assemblages revealed three paleoenvironmentally relevant groups of taxa. The first group, dominated by Amphistegina and Lepidocyclina, was found at all three sites and is interpreted to be representative of euphotic open-shelf deposition in less than 50 m water depth. The second group was dominated by Cycloclypeus, Operculina and planktonic foraminifers. This group was found at all three sites, but was more common from sites on the northern platform and is interpreted to represent deposition in deep, oligophotic water, in greater than 50 m water depth. The third group, consisting of soritids, alveolinids, Austrotrillina and Flosculinella, was found only in sediments from the southern platform and is interpreted to represent deposition in a restricted, shallow-marine environment, in less than 20 m water depth, consistent with a sea-grass meadow. These three groups of taxa record changing paleoenvironments on the Marion Plateau, and reveal the depositional histories of the Marion Plateau's carbonate platforms.