O objetivo do estudo foi determinar a composição e as características físico-químicas (pH, acidez, estabilidade ao álcool, sólidos totais, gordura, lactose, teor de extrato seco desengordurado e proteína total), contagem de células somáticas (CCS) e as frações de caseína (α-S1, α-S2, β e κ) dos leites identificados como leite instável não ácido (LINA) e de leites estáveis à prova de álcool a 78% (v/v). A amostragem contemplou todas as propriedades leiteiras fornecedoras de leite de um laticínio localizado no município de Casa Branca - Estado de São Paulo, nos meses de março, maio, julho e setembro de 2007. Considerou-se, como critério de identificação de LINA, a amostra de leite de conjunto de cada propriedade que apresentasse instabilidade à prova do álcool a 72% (v/v) e acidez inferior a 18ºD. Do total de amostras instáveis ao teste do álcool a 72% (v/v), 64,77% foram identificadas como LINA. A freqüência de amostras de LINA variou de acordo com o mês de amostragem, indicando uma possível influência sazonal sobre a ocorrência deste problema nos rebanhos analisados. No mês de julho, a incidência de LINA foi maior, coincidindo com o período seco, quando a disponibilidade e a qualidade das forragens são reduzidas. No mês de setembro, época de chuvas em que ocorre maior oferta de forragens de melhor qualidade, a incidência de LINA diminuiu. Em julho, houve um aumento significativo nos níveis de gordura, lactose e CCS, observando-se, porém, uma diminuição significativa nas concentrações de proteína bruta nas amostras. Neste mês, notou-se também uma menor concentração de κ-caseína no LINA, embora as diferenças entre as caseínas α-S1, α-S2, β e κ do LINA e do leite estável não tenham sido significativas nos meses de amostragem. Os resultados evidenciaram que a ocorrência de LINA é freqüente nos rebanhos leiteiros da região estudada, o que pode acarretar perdas significativas à indústria de laticínios e aos produtores devido ao descarte do leite. / The aim of this study was to determinate the composition and the physical-chemical characteristics (pH, acidity, alcohol stability, total solids, fat, lactose, non fat solids and total protein), somatic cells counts (SCC) and casein fractions (α-S1, α-S2, β and κ) of unstable non-acid and stable milks at the alcohol test at 78% (v/v). Samples were collected from all the dairy farms that provide milk to a dairy plant located in Casa Branca - São Paulo State. Sampling procedures were done on March, May, July and September 2007. Milk samples from each dairy farm presenting instability to alcohol test at 72% (v/v) and acidity less than 18ºD were considered as unstable non-acid milk. From the total of unstable samples to alcohol test at 72% (v/v), 64.77% were identified as unstable non-acid milk. The frequency of unstable non-acid milk samples varied according the month of sampling, hence indicating a possible seasonal influence on the occurrence of this problem in the dairy herds studied. On July, the incidence of unstable non-acid milk was higher, coinciding with the dry season, when the quality and availability of forage are reduced. On September, at rainfall season, when the availability and quality of forage are better, the incidence of unstable non-acid milk decreased. There was a significant increase in the levels of fat, lactose and SSC in samples collected on July, although a significant decrease was observed in the concentrations of total protein. In this month, a lower concentration of κ-casein was also noted in unstable non-acid milks. However, the differences between the α-S1, α-S2, β and κ casein of unstable non-acid milk and stable milk were not significant in all sampling months. Results showed that the occurrence of unstable non-acid milk is common in dairy herds in the studied area, which can cause significant losses to the dairy industry and dairy farms due to the discharging of milk.

We use transcendental shift-like automorphisms of Ck, k > 2 to construct two examples of non-degenerate entire mappings with prescribed ranges. The first example exhibits an entire mapping of Ck, k>2 whose range avoids a given polydisc but contains the complement of a slightly larger concentric polydisc. This generalizes a result of Dixon-Esterle in C2. The second example shows the existence of a Fatou-Bieberbach domain in Ck,k > 2 that is constrained to lie in a prescribed region. This is motivated by similar results of Buzzard and Rosay-Rudin. In the second part we compute the order and type of entire mappings that parametrize one dimensional unstable manifolds for shift-like polynomial automorphisms and show how they can be used to prove a Yoccoz type inequality for this class of automorphisms.

INTRODUÇÃO: A utilização de medidas diagnósticas e terapêuticas tem impacto significativo na morbidade e mortalidade associadas a síndromes miocárdicas isquêmicas instáveis (SIMI). A quantificação do uso destas medidas permite mensurar a qualidade no atendimento ao paciente por diferentes instituições de saúde, países ou regiões. Dados a respeito da utilização de medidas de desempenho no atendimento a pacientes com SIMI são escassos no Brasil, e a coleta de dados confiáveis a esse respeito é o objetivo do Registro Brasileiro de Síndromes Coronárias Agudas (BRACE). MÉTODOS: BRACE é um registo epidemiológico transversal, observacional de pacientes com SIMI. Para seleção dos hospitais foi adotada a metodologia de \"amostragem por conglomerados\", estratificada por região, característica de ensino (universitário ou não) e entidade mantenedora (público ou privado) para se obter uma imagem representativa de pacientes com SIMI no país. Escore de desempenho que varia de 0 a 100% foi desenvolvido para comparar os parâmetros estudados. As variáveis de desempenho isoladamente e as pontuações do escore foram comparados entre os tipos de instituições e a relação entre a pontuação de desempenho e os desfechos foram avaliados. RESULTADOS: 1.150 pacientes com idade média de 63 anos, 64% do sexo masculino, de 72 hospitais foram incluídos no registro. O escore desempenho médio para a população geral foi de 65,9% ± 20,1%. Instituições de ensino tiveram uma pontuação de desempenho significativamente mais elevada (71,4% ± 16,9%) em comparação com os hospitais não docentes (63,4% ± 21%; p < 0,001). A mortalidade hospitalar foi de 5,2%, e as variáveis que se correlacionaram significativamente e de forma independente com a mortalidade intra-hospitalar foram: idade - por ano (OR = 1,06, 95% IC 1,04-1,09, P < 0,001), doença renal crônica (OR = 3,59 , 95% IC 1,32-9,75, P= 0,012), angioplastia prévia (OR = 0,23, 95% IC 0,07-0,77, P= 0,017) e escore de desempenho - por ponto de aumento (OR = 0,97, 95% IC 0,96-0,98, P < 0,001). CONCLUSÃO: Os dados deste estudo demonstram que o uso de ferramentas de diagnóstico e abordagens terapêuticas para o tratamento das SIMI é distribuído de forma heterogênea e inferior ao ideal no Brasil, e que o escore de desempenho está associado de forma independente a mortalidade intrahospitalar / BACKGROUND: The use of diagnostic and therapeutic tools has a significant impact on morbidity and mortality associated with acute coronary syndromes (ACS). Data about the utilization of ACS performance measures are scarce in Brazil, and improving its reliable collection is an objective of the Brazilian Registry in Acute Coronary syndromEs (BRACE). METHODS: BRACE is a cross-sectional, observational epidemiological registry of ACS patients. Stratified \"cluster sampling\" methodology was adopted to obtain a representative picture of ACS in the country. A performance score varying from 0 to 100 was developed to compare the studied parameters. The performance measures alone and the performance scores were compared between institutions, and the relationship between the performance score and outcomes was evaluated. RESULTS: 1,150 patients median age 63 years, 64% male, from 72 hospitals were included in the registry. The mean performance score for the overall population was 65.9%±20.1%. Teaching institutions had a significantly higher performance score (71.4% ± 16.9%) compared to non-teaching hospitals (63.4% ± 21%; P < 0.001). In-hospital mortality was 5.2%, and the variables that correlated significantly and independently with in-hospital mortality included age - per year (OR=1.06, 95% CI 1.04-1.09, P < 0.001), chronic kidney disease (OR=3.59, 95% CI 1.32-9.75, P=0.012), prior angioplasty (OR=0.23, 95% CI 0.07-0.77, P=0.017) and performance score - per point increase (OR=0.97, 95% CI 0.96-0.98, P < 0.001). CONCLUSION: Data from this study demonstrate that use of diagnostic tools and therapeutic approaches for the management of ACS is heterogeneous and less than ideal in Brazil, and that performance score is independently associated with in-hospital mortality

We introduce numerical methods for the analysis of random dynamical systems. The subdivision and the continuation algorithm are powerful tools which will be demonstrated for a system from ship dynamics. With our software package we are able to show that the well known safe basin is a moving fractal set. We will also give a numerical approximation of the attracting invariant set (which contains a local attractor) and its evolution.

No description available.

Affecting the efficiency of stimulation a strenght endurance through exercies on unstable surface In our work we sought to verify the affecting the efficiency of a Strength programme of exercise on unstable surfaces for stimulation of strength endurance abilities, compared to a similar didactic programme conducted on stable surfaces, thus creating an alternative choice for coaches, teachers, and sports instructors. A major element of the didactic process is the quality of the strength training programme on stable and unstable surfaces. When evaluating the overall results of the tests before and after the experimental programme, we come to be of the opinion that the experimental programme manifested itself positively in effectiveness of stimulating strength abilities. The strength programme had an influence on increasing the persistence of strength in dynamic and static regimens. In the case of a strengthening programme on unstable surfaces there was a tendency towards greater growth in the number of repetitions as opposed to programme on a stable base at the beginning of the programme in the case of exercise in a dynamic regimen. Keywords: effectiveness, strength endurance preparation, unstable surfaces, stabilisation system.

Bakgrund: Emotionellt instabilt personlighetssyndrom (EIPS) formas oftast under tonåren och har en symtombild som innebära instabila relationer, förvrängd självbild och impulsivitet som kan innebära självskadehandlingar och självmord eller försök till detta. På grund av sitt syndrom kan patientgruppen vara i behov av sjukvård inom den somatiska såväl som den psykiatriska vården. Patientgruppen får ofta i samband med sjukvård utstå negativa uttryck från vårdpersonal, vilket kan leda till ett försämrat mående hos patientgruppen.  Syfte: Studiens syfte var att belysa erfarenheter av mötet med vårdpersonal hos patienter med EIPS.  Metod: Den genomförda studien är en kvalitativ litteraturstudie. I litteraturstudiens resultat inkluderades nio kvalitativa studier funna i databaserna Pubmed och Cinahl. Studierna kvalitetsgranskades enligt en bedömningsmall med kvalitativ inriktning av Olsson och Sörensen samt analyserades enligt Fribergs femstegsmodell. Resultat: Efter analys utformades två kategorier (att känna sig bekräftad och att få sin värdighet kränkt) och fem subkategorier (att bli sedd och hörd, att känna förtroende, att uppleva diskriminering, att inte bli tagen på allvar och att uppleva svek). Resultatet visar att patienter med EIPS hade erfarenheter av fördomar mot sin diagnos, diskriminering samt att inte bli tagen på allvar i möten med vården. Det rådde delade meningar hos patientgruppen vad gäller att känna sig bekräftad. Konklusion: Ett behov av att öka förståelsen för patienter med EIPS samt bättre strategier för vårdpersonalens bemötande identifierades, för att förbättra det vårdande mötet. Tidvattenmodellen anses kunna vara ett bra alternativ att arbeta efter i samband med vård av patientgruppen. / Background: Emotionally unstable personality disorder (EUPD) usually debuts in adolescence and is characterized by symptoms involving unstable relationships, distorted self-image and impulsivity. Such symptoms can lead to acts of self-harming and suicide or suicide attempts. Due to the syndrome, the patients are often in need of medical care, within the somatic, as well as the psychiatric care. The patients often have to endure negative expressions from the health care professionals, which can lead to worsened mental health among the patients.  Aim: The aim of this study was to illuminate experiences among patients with EUPD in the meeting with health care professionals.  Methods: This study was a qualitative literature study based on nine articles found in Pubmed and Cinahl. All articles were quality-examined using an assessment with a qualitative focus, formed by Olsson and Sörensen. The articles were analyzed inspired by Fribergs five-step model. Results: Based on the analysis, two categories (to feel acknowledge and to have one’s dignity violated) and five subcategories (to be seen and heard, to feel trusted, to experience discrimination, not to be taken seriously and to experience betrayal) were formed. The results show that patients with EUPD had experiences of prejudice against their diagnosis, discrimination and not being taken seriously by the health care professionals. There were divided opinions among the patients of feeling acknowledge as an individual. Conclusion: These findings indicate a need for increasing the understanding for the patients as well as better treatment strategies to improve the patients experiences when seeking care. The tidal model is a strategi considered to be a good alternative to use for improving the health care for patients with EUPD.

An experimental technique for conducting low speed impact of adhesively bonded automotive composite joints is presented. Based on the use of a modified drop tower, mode I, II, and mixed mode values for critical energy release rate were determined for a composite/epoxy system and used to create a fracture failure envelope. Because load measurements become erratic and unreliable at higher test rates, displacement-based relationships were used to quantify these energy release rates. Displacement data was collected with an imaging system that utilized edge detection to determine displacement profiles, end displacements, and opening displacements where applicable. Because of the resolution of the image-based approach used, determining crack length experimentally was extremely difficult. As a result, numerical methods were developed to objectively determine the crack length based on the available experimental data in mode I, II, and mixed mode I/II configurations. This numerical method uses a nonlinear fit to determine mode I crack lengths and a theoretical model based on cubic equations for mode II and mixed-mode I/II, where the coefficients of the equations are determined by using both boundary and transition conditions that are a result of the test setup. A double cantilever beam (DCB) geometry was chosen to collect mode I data, an end-loaded split (ELS) geometry was used for mode II, and a single leg bend (SLB) geometry was used for mixed-mode I/II. These geometries were used to determine the fracture characteristics of adhesively bonded automotive composites to create fracture failure envelopes as well as provide mode I, II, and mixed-mode I/II data to be used in finite element models. The chosen adhesive exhibited unstable, stick-slip crack growth, which resulted in very few data points being collected from each static DCB specimen as well as drastic drops in energy release rate between initiation and arrest points. Unstable growth also created issues in dynamic testing, as data points surrounding these "stick-slip" events were lost due to the insufficient sampling rate of the available imaging system. Issues also arose with differences between thick and thin composite adherend specimens. These differences could result from additional curing in thick adherend composite specimens due to the adherends retaining heat. DSC testing was conducted on uncured adhesive using a 2, 5, and 10 minute hold at the cure temperature, and significant additional curing was observed between the two and five minute cures. Due to the difference in relative stiffness between the 12 and 36 ply composite, the local loading rate at the crack tip was lower in the 12 ply adherends, possibly allowing for a larger plastic zone and thus a higher energy release rate. As a result, tests were conducted on 36 ply composite specimens at rates of 1 mm/min and 0.1 mm/min to determine if there were loading rate effects. This testing showed that higher initiation energy relase rates were found at the lower test rate, thus reinforcing the local loading rate theory. Due to issues with plastic deformation in aluminum adherends, mode II and mixed-mode I/II data were collected using only composite adherends. Only one data point was collected per specimen as the crack propagated directly into the composite after initiating from the precrack, thus multiple tests were conducted to collect sufficient data for constructing a failure envelope. Once mode I, II and mixed-mode I/II fracture data was collected, a fracture failure envelope was created. This failure envelope, combined with a predetermined factor of safety, could provide some of the necessary tools for design with this adhesive/composite system. / Master of Science

Bakgrund: Kvinnor med självskadebeteende skadar sig inte för att de vill ta livet av sig, utan för att lindra den psykiska smärtan och för att få kontroll över ångesten. Det är viktigt att vårdpersonalen ser hela människan och inte bara beteendet, kvinnor med självskadebeteende vill bli sedda och behandlade som alla andra patienter.  Syfte: Syftet var att beskriva kvinnors upplevelse av vården vid självskadebeteende. Metod: En kvalitativ studie gjordes utifrån en innebördsanalys. Fem självbiografier analyserades och bildade resultatet. Resultat: De fyra teman som återfinns i resultatet; att uppleva betydelsen av mötet mellan personal och kvinnor, att uppleva behandlingen som vårdande eller skadande, att uppleva betydelsen av att få bekräftelse vid vårdandet och att uppleva betydelsen av olika känslor vid vårdandet. Dessa teman visar att kvinnor med självskadebeteende vill bli sedda samt kunna känna en tillit till sjuksköterskor och annan vårdpersonal. Tid för samtal upplevs vara viktigt för att kvinnor ska få en bra vård. Slutsats: Kvinnors upplevelser är både positiva och negativa. Delaktighet och förklaringar kring självskadebeteendet och vårdandet upplevs vara viktigt för att få en god hälsa och en god vårdtid. / Background: Women with self-harm don’t cut themselves because they want to die, they do it to ease the psychic pain, and they get control over their angst. It is important that the nurses see the big picture in the person behind the self-harming behavior. Women with this behavior wants to be seen and treated like the other patients. Aim: Women’s experiences of health care in regards to self-harm. Methods: The study, was made with a qualitative meaning analysis. Five self-biographies where analyzed and became the results. Results: The four themes in the results; to experience the significance of the meeting between staff and women, to experience treatment as caring or damaged, to experience the importance of getting confirmation by caring and to experience the role of emotions in caring. These themes shows that the women wants to be seen and feel trust to the nurses and other professionals. Time and places for conversations are the women`s needs for having good treatment and care. Conclusion: Women’s experiences is positive and negative. Participation and explanation about their disease and treatment experience the woman as an important part of being able to feel good and to health care should be a good experience.

Η παρούσα διατριβή αποσκοπεί στη διερεύνηση της βέλτιστης μεθόδου θεραπείας για τα ασταθή κατάγματα κάτω πέρατος κερκίδας. Προς τούτο, μετά από μια σύντομη εισαγωγή, στο γενικό της μέρος η διατριβή παρουσιάζει στοιχεία ανατομικής και κινηματικής της πηχεοκαρπικής και της κάτω κερκιδοωλενικής. Στη συνέχεια γίνεται αναφορά στα κατάγματα του κάτω πέρατος της κερκίδος, τα προβλήματα που προκύπτουν κατά τη θεραπεία τους και το ρόλο των κυκλοτερών συστημάτων εξωτερικής οστεοσύνθεσης (Ilizarov). Στο ειδικό μέρος της διατριβής παρουσιάζεται η κλινική μελέτη που έγινε στην Ορθοπαιδική Κλινική του Πανεπιστημίου Πατρών και αφορούσε σε ασθενείς με κατάγματα κάτω πέρατος κερκίδος που αντιμετωπίστηκαν με κυκλοτερές σύστημα εξωτερικής οστεοσύνθεσης. / Unstable distal radius fractures remain a challenge for the treating orthopaedic surgeon. We present a retrospective follow-up study (mean follow-up 12.5 months) of 20 patients with 21 unstable distal radius fractures that were reduced in a closed manner and stabilized with a nonbridging Ilizarov external fixator. Subsequent insertion of olive wires for interfragmentary compression was performed in cases with intra-articular fractures. According to the overall evaluation proposed by Gartland and Werley scoring system 12 wrists were classified as excellent, 6 as good, 2 as fair and 1 as poor. Grade II pin-tract infection in distal fracture fragment was detected in 3 wires from a total of 78 (3.8%) and in 4 half pins out of a total of 9 (44.4%). Pronation was the most frequently impaired movement. This was restricted in 4 patients (19%) in whom a radioulnar transfixing wire was applied. Symptoms of irritation of superficial sensory branch of the radial nerve occurred in 3 patients with an olive wire applied in a closed manner in the distal fragment. Ilizarov method yields functional results comparable to that of other methods whilst it avoids wrist immobilization, open reduction and reoperation for implant removal. The method is associated with a low rate of major complication and satisfactory functional outcome.