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Hydrogenation of nitrile butadiene rubber (NBR) has been carried out industrially for a number of years, producing a material with exceptional resilience to high temperatures and oxidative conditions. Current processes involve a batch reactor which is difficult to optimize further for larger scale production. A continuous process for this particular process is required in order to provide a large volume of production with consistent qualities. The integration of heat balance could be realized in a continuous process. A novel continuous process for hydrogenation of NBR has been developed in the present work. A multistage agitated contactor (MAC) was proposed as a gas liquid reactor for this process. Comprehensive hydrodynamic data have been acquired under various process conditions. The hydrodynamic behaviour under different operating variables such as stirring speed, liquid flow rate and gas flow rate has been understood through experimental study. It is found that an increase in stirring speed intensifies liquid backmixing while an increase liquid flow rate decreases liquid backmixing. The presence of gas flow helps in reducing liquid back mixing by two coupled effects: liquid entrainment effect due to a cocurrent operation manner and a strengthening effect of liquid flow rate due to its reduction of liquid hold-up. Contradictory conclusions regarding the effect of liquid viscosity on liquid backmixing in a MAC have been resolved through experimental investigation and computational fluid dynamics (CFD) simulations. It is shown that an increase in liquid velocity dampens turbulence which contributes to liquid phase backmixing within the reactor. The established hydrodynamic understanding of MACs in the present work widens its potential application for gas liquid process. Based on comprehensive understanding of the proposed reactor, a bench-scale prototype was designed and constructed in order to demonstrate hydrogenation performance. One more efficient catalyst for NBR hydrogenation, an osmium-based catalyst, was used in the present work. Hydrogenation degree of NBR in the continuous unit was investigated at operating conditions relevant to industrial applications. It is indicated from the experimental results that a desired hydrogenation degree of over 95% in 2.5% and 5% NBR solutions can be achieved at the conditions investigated. It is also shown that both system pressure and catalyst loading increase hydrogenation conversion. Mathematical modeling of the designed process was established by coupling the intrinsic catalytic hydrogenation from batch studies and flow behavior of the reactor. A cascade of stirred tanks with back flow (CTB) model was used to characterize the dynamic hydrogenation performance in a MAC. The comparison of experimental results and numerical prediction indicates that the established model could satisfactorily predict the hydrogenation in the designed process with consideration of approximately 30%-50% catalyst deactivated due to impurities and oxygen contamination in the polymer solution. A revised n CSTRs-in-series model was proposed to predict the hydrogenation degree at steady state and a good agreement was found when comparing the predicted results with the experimental data. A continuous process for hydrogenation at a pilot scale was designed based on the primary results from the bench scale process. A process with a capacity of 50 tons/year was targeted and the hydrogenation efficiency provided by the pilot scale unit has been estimated through the established reactor model.

Theatre is widely unrecognized for the compelling influence it has held in society throughout history. In this thesis, I specifically examine the implications surrounding the social protest theatre of black and Jewish American minority communities in the first half of the twentieth century. I discuss how their historical circumstance, culture, and idiosyncratic natures caused them to choose agitated propaganda theatre as an avenue for protest. I delve into the similarities in circumstance, but their theatre case studies separate the two communities in the end. I present case studies of each community, beginning with anti-lynching plays of the 1920s that were written by black American playwrights both in response to white supremacist propaganda theatre and to assert a dignified representation of the black community. However, their plays and protest movement never developed a larger popular following. My next minority theatre case study is an examination of 1930s Jewish labor drama created in protest of popular anti-Semitic theatre and poor labor conditions. The Jewish community differs from the black community in their case because the racist propaganda was produced by a man who was Jewish. Another difference is that their protest theatre was on the commercial stage by this point because of a rise in a Jewish middle class and improvement of circumstance. Both the Jewish protest theatre and labor reform movements were more successful. My conclusion is a summation of black and Jewish American theatre of the era with a case study of collaboration between the communities in George Gershwin’s operetta about black Americans, Porgy and Bess. I conclude that these two communities eventually departed from circumstance and therefore had differing theatrical, political, and social experiences in America during the 1930s.

Patienten med demens behöver vårdas av personal med erforderlig utbildning. Omvårdnaden av dess patienter är i högsta grad lika viktig som den medicinska vården. I syfte att belysa omvårdnad som förebygger och åtgärdar oro och agitation hos patienter med demenssjukdom användes en systematisk litteraturstudie. Intresseområdet definierades och en fråga ställdes till litteraturen relaterad till syftet, kriterier för avgränsning av artiklar, fastställdes, sökningar genomfördes i databaser och genom manuell sökning i tidskrifter. Relevanta artiklar granskades utifrån kvalitet och bevisvärde. Följande kategorier framkom genom innehållsanalys: Integritets stödjande vård, Bemötande av plockbeteende, Patient centrerad omvårdnad, Minskande av tvång och konfrontation, Konkreta omvårdnadsåtgärder/strategier och teknik. Kommunikation som var anpassad till patientens nivå av kognitiv förmåga och omvårdnadsplan, var det viktigaste. En arbetsmetod som var tillbakadragande/avledande/lämna ifred teknik, var en användbar arbetsmetod som minskade oro och agitation. Det viktigaste var att ha ett bemötande, anpassat med den specifika kunskap i omvårdnad/bemötande som finns. / Patients with dementia are in need of care by educated personal with required knowledge. Nursing is indeed just as important as medical care. To highlight nursing as a way to prevent and measure anxiety and agitation in patients with dementia a systematic literature study was carried out. Subject of interest was defined and a question related to the aim of the study was put to the literature, inclusion criteria were chosen. The literature search was carried out in Databases and manually in magazines. Relevant articles were examined from the perspective of quality and degree of evidence. The following categories appeared thru content analyse: Support of integrity, Refutation of a picking behaviour, Patient centred care,, Reducing compulsion and confrontation, Tangible nursing measures, techniques and strategies. Communication adapt to the patients level of understanding and nursing planning was found most important. Attitude of withdrawal/diversion/leave alone were useful working methods that may less anxiety and agitation. The main thing is however an adjustable encounter with the patient, using the specific knowledge of nursing measures.

Hydrogenation of nitrile butadiene rubber (NBR) has been carried out industrially for a number of years, producing a material with exceptional resilience to high temperatures and oxidative conditions. Current processes involve a batch reactor which is difficult to optimize further for larger scale production. A continuous process for this particular process is required in order to provide a large volume of production with consistent qualities. The integration of heat balance could be realized in a continuous process. A novel continuous process for hydrogenation of NBR has been developed in the present work. A multistage agitated contactor (MAC) was proposed as a gas liquid reactor for this process. Comprehensive hydrodynamic data have been acquired under various process conditions. The hydrodynamic behaviour under different operating variables such as stirring speed, liquid flow rate and gas flow rate has been understood through experimental study. It is found that an increase in stirring speed intensifies liquid backmixing while an increase liquid flow rate decreases liquid backmixing. The presence of gas flow helps in reducing liquid back mixing by two coupled effects: liquid entrainment effect due to a cocurrent operation manner and a strengthening effect of liquid flow rate due to its reduction of liquid hold-up. Contradictory conclusions regarding the effect of liquid viscosity on liquid backmixing in a MAC have been resolved through experimental investigation and computational fluid dynamics (CFD) simulations. It is shown that an increase in liquid velocity dampens turbulence which contributes to liquid phase backmixing within the reactor. The established hydrodynamic understanding of MACs in the present work widens its potential application for gas liquid process. Based on comprehensive understanding of the proposed reactor, a bench-scale prototype was designed and constructed in order to demonstrate hydrogenation performance. One more efficient catalyst for NBR hydrogenation, an osmium-based catalyst, was used in the present work. Hydrogenation degree of NBR in the continuous unit was investigated at operating conditions relevant to industrial applications. It is indicated from the experimental results that a desired hydrogenation degree of over 95% in 2.5% and 5% NBR solutions can be achieved at the conditions investigated. It is also shown that both system pressure and catalyst loading increase hydrogenation conversion. Mathematical modeling of the designed process was established by coupling the intrinsic catalytic hydrogenation from batch studies and flow behavior of the reactor. A cascade of stirred tanks with back flow (CTB) model was used to characterize the dynamic hydrogenation performance in a MAC. The comparison of experimental results and numerical prediction indicates that the established model could satisfactorily predict the hydrogenation in the designed process with consideration of approximately 30%-50% catalyst deactivated due to impurities and oxygen contamination in the polymer solution. A revised n CSTRs-in-series model was proposed to predict the hydrogenation degree at steady state and a good agreement was found when comparing the predicted results with the experimental data. A continuous process for hydrogenation at a pilot scale was designed based on the primary results from the bench scale process. A process with a capacity of 50 tons/year was targeted and the hydrogenation efficiency provided by the pilot scale unit has been estimated through the established reactor model.

abstract Background: Dementia affected patients have increasing problems with memory , impaired language ability, which affects communication and behaviour is considerable. These difficulties may provide an outlet for aggression, agitation and anxiety, and are common in dementia, which is exhausting for patients and their relatives and carers. Behavioural changes are common condition in patients with dementia and affects quality of life and cause unnecessary suffering . Pharmacological treatment that is inserted to relieve these symptoms have many side effects. Printed out more knowledge about non- pharmacological nursing interventions that can facilitate care for patients , relatives and carers are great. Aim: To describe non- pharmacological nursing interventions in dementia care . Method: A general literature review of thirteen scientific papers compiled and described in a result. Results: Compilation resulted in two themes,  Music in dementia care and Stimulation in dementia care and four subthemes, Singing in the care, Listening to music, Activities and Consolation and fillip that showed a dominant positive effect on dementia affected patients and carers and there by create opportunities for caring in dementia care . Conclusion: The different nursing interventions may be useful in dementia care when they show a dominant positive effect on various behavioural changes, it seems memory stimulant and promotes communication between patients and carers which favours caring . Keywords: Agitated behaviour, dementia, non- pharmacological, literature review, nursing. / Sammanfattning Bakgrund: Demensdrabbade patienter har tilltagande besvär med minnet, försämrad språkförmåga, vilket påverkar kommunikationen och beteende avsevärd. Dessa svårigheter kan ge utlopp till aggressivitet, oro och ångest och är vanliga vid demenssjukdomar vilket är ansträngande för både patienter, anhöriga och vårdare. Beteendeförändringar är vanligt förekommande tillstånd hos patienter med demens och påverkar livskvalitet och medför onödigt lidande. Farmakologisk behandling som sätts in för att lindra dessa symtom har många biverkningar. Behov utav ökad kunskap kring icke- farmakologiska omvårdnadsåtgärder som kan underlätta omvårdnaden för både patienter, anhöriga och vårdarna är stor. Syfte: Att beskriva icke- farmakologiska omvårdnadsåtgärder i demensvård. Metod: En allmän litteraturöversikt av tretton vetenskapliga artiklar som sammanställdes och beskrivs i ett resultat. Resultat: Sammanställningen resulterade i 2 teman, Musik i demensvård och Stimulans i demensvård och 4 subteman, Sång i omvårdnaden, Att lyssna på musik, Aktivitet och Tröst och stumulans som påvisade en dominerande positiv effekt på demensdrabbade patienter samt vårdarna och därigenom gynnande för vårdandet i demensvård. Slutsats: De olika omvårdnadsåtgärder kan vara användbara inom demensvården då dem visar på en dominerande positiv påverkan på olika beteendeförändringar, verkar minnesstimulerande samt främjar kommunikation mellan patienter och vårdare vilket gynnar vårdandet. Nyckelord: Agiterat beteende, demens, icke- farmakologisk, litteraturöversikt, omvårdnad

<p>Patienten med demens behöver vårdas av personal med erforderlig utbildning. Omvårdnaden av dess patienter är i högsta grad lika viktig som den medicinska vården. I syfte att belysa omvårdnad som förebygger och åtgärdar oro och agitation hos patienter med demenssjukdom användes en systematisk litteraturstudie. Intresseområdet definierades och en fråga ställdes till litteraturen relaterad till syftet, kriterier för avgränsning av artiklar, fastställdes, sökningar genomfördes i databaser och genom manuell sökning i tidskrifter. Relevanta artiklar granskades utifrån kvalitet och bevisvärde. Följande kategorier framkom genom innehållsanalys: Integritets stödjande vård, Bemötande av plockbeteende, Patient centrerad omvårdnad, Minskande av tvång och konfrontation, Konkreta omvårdnadsåtgärder/strategier och teknik. Kommunikation som var anpassad till patientens nivå av kognitiv förmåga och omvårdnadsplan, var det viktigaste. En arbetsmetod som var tillbakadragande/avledande/lämna ifred teknik, var en användbar arbetsmetod som minskade oro och agitation. Det viktigaste var att ha ett bemötande, anpassat med den specifika kunskap i omvårdnad/bemötande som finns.</p> / <p>Patients with dementia are in need of care by educated personal with required knowledge. Nursing is indeed just as important as medical care. To highlight nursing as a way to prevent and measure anxiety and agitation in patients with dementia a systematic literature study was carried out. Subject of interest was defined and a question related to the aim of the study was put to the literature, inclusion criteria were chosen. The literature search was carried out in Databases and manually in magazines. Relevant articles were examined from the perspective of quality and degree of evidence. The following categories appeared thru content analyse: Support of integrity, Refutation of a picking behaviour, Patient centred care,, Reducing compulsion and confrontation, Tangible nursing measures, techniques and strategies. Communication adapt to the patients level of understanding and nursing planning was found most important. Attitude of withdrawal/diversion/leave alone were useful working methods that may less anxiety and agitation. The main thing is however an adjustable encounter with the patient, using the specific knowledge of nursing measures.</p>

The purpose of the study was to examine the impact of a natural disaster on the mental health of a rural Maya community in the Philippines. Specifically, the study assessed how an individual’s housing conditions, the household size, and general utilities can have an impact on a person’s mental health. The study used a quantitative survey design with self-administered questionnaires. Center for Disease Control and Prevention Modified Community Assessment survey was used for this research investigation. A total of 84 participants completed the survey. Participants were asked of their perceptions regarding the habitability of their own homes, the safety of their homes, whether there was mold or water damage, the size of the household, whether the household was harboring guest and the presence of general utilities such as: running water, electricity, garbage pickup, natural gas, sewage service, and cell. Descriptive (e.g. mean and frequency,), chi-squares tests, and t-test were used to analyze the data. Findings of the study showed that there was a relationship between safety of the home, the presence of mold, water damage, and running water and whether one develops symptoms of anxiety/stress. The study also found a relationship amongst garbage pickup, sewage service and whether one develops symptoms of agitated behavior. Findings of the study suggest a need for advocacy to implement mental health programs as a relief effort to disaster victims.

There is some evidence about the efficacy of preferred music on agitation in elders with dementia; however, little is known about its effectiveness on agitation when implemented by nursing staff in long-term care facilities. Even less is known about use of preferred music for managing anxiety in those with dementia. This quasi-experimental study aimed to evaluate the implementation of a preferred music intervention delivered by nursing staff on agitation and anxiety of institutionalised elders with dementia. The sample comprised of 57 elders with dementia residing in two building complexes which provided similar care routines and staffing in a large Taiwanese residential care facility. These two building complexes were randomly assigned as the experimental and control group. Nursing staff in the experimental group received a facilitation program to prepare them for implementing the preferred music intervention; whereas nursing staff in the control group received no facilitation program. The music intervention based on each resident's music preferences was then provided by the trained nursing staff for 32 experimental residents twice a week for six weeks. Meanwhile, 25 residents in the control group only received the usual standard care without music. All residents were assessed by Cohen-Mansfield Agitation Inventory (CMAI) for overall and three subtypes of agitated behaviours and by Rating of Anxiety in Dementia for anxiety at baseline and week 6. Additionally, the modified CMAI measured the 30-minute occurrence of agitation at baseline, session 4, and session 12. The results indicate that institutionalised elders with dementia who received six weeks of preferred music intervention implemented by trained nursing staff had significant reductions on overall, three subtypes of agitated behaviours, anxiety, and 30-minute occurrence of agitation over time compared to those who received the usual standard care without music. Preferred music shows promise as a strategy for reducing agitation and anxiety in those with dementia when implemented by trained nursing staff. Such intervention can be incorporated into routine activities to improve the quality of care provided by nursing staff and the quality of life of those with dementia in long-term care settings. Our study results provide clinically relevant evidence which contribute to closing the gap between research and practice.

Fundação Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro / Os pacientes agressivos e/ou agitados correspondem a 10% de todas as internações em emergências psiquiátricas. Dependendo do grau de agitação, esses pacientes representam um risco para a integridade física, tanto para os profissionais que ali estão como para si mesmos. Dentre as alternativas para lidar com esses casos está a contenção física. Ainda que amplamente utilizada, seu uso é controverso e proibido em alguns países. No Brasil inexistem protocolos orientando o seu uso. O objetivo deste estudo foi conhecer a freqüência e os fatores associados a esta prática através de uma revisão sistemática e de um estudo em emergências psiquiátricas do município do Rio de Janeiro. A revisão identificou apenas quatro estudos, sendo três nos EUA e um na Índia. A freqüência de contenção em pacientes agitados e/ou agressivos nos serviços de emergência psiquiátrica variou de 14% até 59%. Os desenhos adotados, assim como as análises estatísticas, mostraram fragilidades para a investigação dos fatores explicativos para o uso de contenção física. O estudo nas emergências psiquiátricas do Rio de Janeiro lançou mão de informações sobre o uso de contenção física entre 298 pacientes participantes de um ensaio clínico comparando dois medicamentos para lidar com quadros de agitação psicomotora e comportamento agressivo nesses serviços. As variáveis investigadas foram aquelas coletadas antes da entrada do paciente no ensaio clínico. Portanto, variáveis que antecederam a decisão do médico conter o paciente. A análise dos dados fez uso do método Bayesiano. As prioris dos parâmetros utilizadas no modelo de regressão binária foram obtidas de um outro ensaio clínico, conduzido em uma das três emergências envolvidas no presente estudo. A freqüência no emprego da contenção física foi 24,5%, sem diferença entre os três hospitais. O estudo mostrou ainda que pacientes mais jovens, com quadros mais intensos, com suspeita diagnóstica de entrada de abuso de substâncias e que foram atendidos na parte da manhã apresentaram maior chance de serem fisicamente contidos. O presente trabalho aponta para a necessidade de conduzir estudos especificamente desenhados para avaliar a freqüência e os fatores associados com o uso de contenção física, os quais deverão subsidiar o desenvolvimento de protocolos sobre o uso desta prática em nosso meio. / Agressive and/or agitated patients corresponds to 10% of all patients in psychiatric emergencies. Depending on the severity of the agitation, these patients represent a great risk not only for their physical integrity, but also for professionals. Use of restraints is one among several ways of dealing with these cases. Although it is largely used, its indication is not so clear and some countries not even allow such practice. In Brazil we dont have any protocol for this practice. The objective of this study is to learn about the frequency and the factors associated with this practice by doing a systematic review and a study in some emergency rooms in Rio de Janeiro. The systematic review identified only four studies, three from the United States and one conducted in India. The frequency of restraints in psychiatric emergency rooms went from 14% to 59% for aggressive/agitated patients. The studies considered in our systematic review were not conducted with the same purpose as ours and the statistical analyses were not appropriated for identifying associations. The study in the psychiatric emergencies in Rio de Janeiro showed provided information on the use of physical restraints among 298 participant patients of a randomized clinical trial comparing two different drugs to deal with cases of psicomotor agitation and aggressive behavior in these services. The analyzed variables were those collected before the entrance of the patient in the clinical trial. This was done to guarantee that variables preceded the doctors decision to contain or not the patient. The analysis of the data made use of the Bayesian method. The prioris of the parameters used in the model of binary regression came from a similar study conducted in one of the three involved emergencies of the present study. The frequency in the use of the physical restraints was 24.5%, without difference between the three hospitals. The study also showed that younger patients, with more intense agitation, with suspicious initial diagnosis of abuse of substances and that they had been admitted in the morning presented a greater probability of being physically restrained. The present study points out the necessity to carry out other investigations specifically designed to evaluate the frequency and the factors associated with the use of physical restraint, aiming to subsidize the development of protocols on the use of physical restraints in our services.