Made available in DSpace on 2016-04-28T20:38:40Z (GMT). No. of bitstreams: 1 Neide Aparecida de Oliveira Santos Aoki.pdf: 866218 bytes, checksum: 1953aef49a9114bfc475ae778a1e8b0f (MD5) Previous issue date: 2013-05-17 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Civilization has experienced a new discomfort. Despite the great technological advances, there still exist feelings of mental inertia, of loneliness and of a non-sense life. Individuals are anonymous, suffer from abandonment with no chance for singularity. The psychoanalytic clinic today expresses this pounding symptom being the main complaints this vague sensation of emptiness, meaninfullness, difficulty in having an identity and love for oneself. Psychoanalysis has emphasized the increasing necessity to highlight what has conventionally been called the pathology of emptiness that is, the clinical approach that is close to psychosis, the relationship with others and the fragile egoic structure that represent neuvragic issues. Analysts are challenged to accept a relationship with nothing , to experience the abysm of no me without being absorbed by it. The opportunity of being with these patients has been a necessary topic for the psychoanalyst reflection. Literature presents the awakening of these questions alerting for its urgency. Therefore, this paper aims at exploring the emptiness experiences exposed by these patients with the theoretical about the theme in order to understand the peculiarities of such psychic behavior, to think of ways of reaching it, to look for literary and cinematographic works that give voice and form to this mental state once words are almost inexistent. So, there can be a deep ludic proximity of such primitive living experience of not being . Theory and art interact to try to reach the indescribable of the analytic involvement with such patients guided by the reasons that could be enhancing this lethargic mental state and the barriers that could prevent the changes. Would it be possible to exist some specification of the analytical work in such cases? Consequently the theoretical conceptual psychoanalytic referential was adopted. The core are the bionianas theories plus the contribution from Tustin and A. Ferro that broaden the Bion´s view concerning thought structures and autisticos functioning and emotions blunt. The illustrative artistic works such as A menina de lá by Guimarães Rosa, Bartley by Melville, A hora da estrela by Lispector, A sonata de outono by Bergamn and The Martin Child by Bass and Tolins display the live theory. This is an attempt to translate in a symbolic and representative way nuances of investigated themes. Patients and analysts dressed as characters were bestowed with the artist delicateness and with knowledge strength supported by theory. During the investigative way it is possible to conclude that feelings of emptiness and no meaning have their roots in early environmental failures. The mother presence attending the child´s necessities interfere with tolerance incapacity toward frustration when there is no available forms to deal with it. This fact leads to an affection and vital impulse blockage that develops inhibitions, emptiness sensation and boredom. These patients were prevented from having the minimal conditions to connect with themselves without threats. This way they refrain emotions as they are felt as a catastrophic threat. The relationship with these patients, therefore demands patience and vitality to approach a mind in which threat to bond is the main characteristic. This could help this abysm unspeakably bad / Atualmente, vivemos um novo mal-estar da civilização. A despeito de tantos avanços e desenvolvimentos, paira um sentimento de inércia mental, de isolamento e falta de sentido. A dor do desamparo parece aumentada, e os indivíduos se desfazem no anonimato, sem que haja espaço para a singularidade. Esse modo de viver e sentir se torna, pois, a sintomatologia latejante da clínica psicanalítica atual, em que as queixas têm sido de uma ausência de significado, de dificuldade para definir e gostar de si próprios, no que se convencionou denominar novas patologias do vazio. Trata-se, pois, de um funcionamento clínico que se aproxima da psicose, no qual a relação com o outro e a fragilidade da estrutura egóica representam pontos nevrálgicos. Descortina-se um convite aos analistas, o de ousar aceitarem a relação com o nada , experimentando o abismo do não-eu, sem que sejam por ele devorados. Diante dessa demanda, esta dissertação tem como objetivo explorar as vivências de vazio apresentadas por esses pacientes por meio do aprofundamento teórico sobre o tema, de modo a compreender as peculiaridades de tal funcionamento psíquico e pensar em modos de alcançá-lo. Para aprofundar o tema, foi adotado o referencial teórico-conceitual psicanalítico, tendo como eixo as teorias bionianas, acrescidas das contribuições de Tustin e A. Ferro, as quais ampliam o olhar de Bion no pensamento das estruturas e funcionamentos autísticos e embotamento das emoções. Haveria então alguma especificidade do trabalho analítico em tais casos? Também foram escolhidas obras literárias e cinematográficas para dar voz e forma a este estado mental em que as palavras pouco habitam, de modo a permitir uma aproximação profunda e lúdica dessa vivência tão primitiva do não ser, tendo como questões norteadoras os fatores que poderiam estar atuando como possíveis desencadeadores desse estado mental letárgico e quais os impeditivos das mudanças. São elas: A menina de lá , de Guimarães Rosa; Bartleby de Herman Melville; A hora da estrela , de Clarice Lispector; A Sonata de Outono de Ingmar Bergman e Martian Child , de Bass e Tolins, traduzem de forma simbólica e representativa nuances dos temas investigados. Pacientes e analista, vestidos de personagens, foram então contemplados com a delicadeza do artista e a firmeza do conhecimento sustentado pela teoria. Ao longo do percurso investigativo, foi possível concluir que os sentimentos de vazio e falta de sentido se enraízam em vivências precoces de falhas nos investimentos do ambiente, especialmente da figura materna, podendo prejudicar a capacidade de tolerância à frustração, bloqueio da afetividade e do impulso vital, gerando inibições, sensações de vazio e tédio. A esses mesmos pacientes faltaram as condições mínimas para que pudessem conectar-se consigo mesmos, de maneira menos ameaçadora, tornando-se defendidos em relação às emoções, sentidas como iminência de catástrofe. A relação com tais pacientes exige, assim, paciência e vitalidade, para que possamos nos aproximar de uma mente em que o ataque ao vínculo é a principal característica, ajudando a alfabetizar seu abismo até então inominável

Both economists and policy makers are interested in understanding the welfare effect of economic policies, especially in small open economies such as Turkey and Iran. This knowledge is crucial for priority setting in any informed policy discussion. This dissertation aims to study the impoverishing effect of high levels of out-of-pocket (OOP) payments in the health sector, referred to as catastrophic health expenditure (CHE), and investigates the impact of exchange rate pass-through (ERPT) on both the microeconomic and macroeconomic indicators of a country. For millions of people worldwide, health payments present a huge financial risk. A high rate of OOP health care payments can lead to CHE, which can force households to cut down their consumption, minimize access to their needs, or face poverty. This makes the design of financial risk protection necessary for governments in order to secure people against the financial hardship at the time of incurring CHE. This thesis comprises three essays. The first investigates financial risk protection indicators related to OOP health care payments through CHE mean positive overshoot and incidence and depth of impoverishment. This research observes that in the absence of universal health care insurance in Iran, together with a high share of OOP spending for health care (more than 52%), the Iranian households facing CHE will eventually face poverty. In the second essay, using a difference-in-differences propensity score matching approach, I seek to analyze the degree to which Iranian universal health care insurance protects households from high rates of OOP health expenditure. In this study, I evaluate the effect of the universal health insurance program on Iranian CHE. The results show that the program was successful in decreasing the rate of OOP health expenditures and CHE in Iran during the sample period. The third essay estimates the ERPT using product-level daily data on wholesale prices of imported agricultural products, where the identification is possible by using daily data on the domestic inflation rate. The results of standard empirical analyses are in line with existing studies that employ lower frequencies of data by showing evidence for incomplete daily ERPT of about 5 percent.

Thesis (Ph. D.)--Ohio State University, 2007. / Title from first page of PDF file. Includes bibliographical references (p. 340-375).

A quercetina é um flavonoide com alta atividade antioxidante reconhecida. Devido a este fato, a indústria alimentícia tem buscado alternativas para a aplicação deste bioativo como antioxidante em matrizes alimentícias. No entanto, incorporar a quercetina em formulações alimentícias pode ser desafiador, pois sua molécula tem relativo grau de hidrofobicidade. Os métodos de encapsulação em nanoemulsões podem tornar viável a proteção do flavonoide, bem como permitir sua dispersibilidade em meios aquosos . O objetivo do presente trabalho foi produzir nanoemulsões (fase oleosa: óleo de girassol) encapsulando quercetina pelo método do ponto de inversão da emulsão (EIP, emulsion inversion point), determinando parâmetros de operação que viabilizem um futuro escalonamento do processo, e a realização de um estudo de caso sobre a incorporação das nanodispersões em patê de frango. Os parâmetros de produção que foram avaliados foram : tipo e concentração de tensoativo (razão SOR, razão tensoativo:óleo), concentração de óleo, concentração de cosolvente e velocidade de agitação. Foram produzidas nanoemulsões utilizando dois tensoativos diferentes, Tween 80 e Brij 30. As porcentagens de quercetina encapsulada foram 0,15 e 0,30% (m/m). Dentre estas, a concentração de 0,30% foi a mais viável para a aplicação no patê de frango, por apresentar melhor distribuição de tamanho de gotícula (diâmetro hidrodinâmico), não apresentar variação significativa de oxidação lipídica e maior conservação da quercetina encapsulada por um período de 90 dias. Os valores de tensão interfacial obtidos mostram que a quercetina provoca abaixamento da tensão interfacial do sistema, o que pode indicar que a quercetina forma um complexo com os tensoativos utilizados, fato que influencia decisivamente na sua localização nas nanogotas. Das formulações testadas para patê de frango contendo quercetina, apenas a formulação usando quercetina livre não apresentou boa avaliação nos itens cor e sabor. Tal resultado justifica a necessidade da incorporação da quercetina em nanoemulsões para não causar alterações sensoriais no produto. / Quercetin is a flavonoid with recognized high antioxidant activity Due to this fact, the food industry has been trying to use it as an alternative as a preservative in food matrices. However, incorporating quercetin into food formulations may be challenging due to its relative degree of hydrophobicity. Encapsulation methods in nanoemulsions may render the protection of the flavonoid viable, as well as enable its dispersibility in aqueous media. The objective of the present study was to produce nanoemulsions (oil phase: sunflower oil) encapsulating quercetin by the emulsion inversion point method (EIP), determining operating parameters that enable a future process scale-up. A case study on the incorporation of nanodispersions into chicken patê was also carried out. The production parameters evaluated were: type and concentration of surfactant (SOR ratio, surfactant:oil ratio), soybean oil concentration, cosolvent concentration and stirring speed. Nanoemulsions were produced using two different surfactants, Tween 80 and Brij 30. The percentages of encapsulated quercetin were 0.15 and 0.30% (m / m). Among these, the concentration of 0.30% was the most feasible for application in chicken pâté, since it presented better droplet size distribution (hydrodynamic diameter), did not present significant variation of lipid oxidation and higher capacity of preserving encapsulated quercetina for a period of 90 days. The interfacial tension values obtained show that quercetin lowered the interfacial tension of the system, which may indicate that quercetin forms a complex with the surfactants used, a fact that decisively influences its location in the nanodroplets. Among the formulations tested in chicken pâté containing quercetin, only the formulation using free quercetin did not show good acceptance evaluation on the color and taste itens. Such an evaluation was important as it justifies the need for the incorporation of quercetin into nanoemulsions in order to not cause significant sensorial changes in the product.

abstract: In order to deploy autonomous multi-robot teams for humanitarian demining in Colombia, two key problems need to be addressed. First, a robotic controller with limited power that can completely cover a dynamic search area is needed. Second, the Colombian National Army (COLAR) needs to increase its science, technology and innovation (STI) capacity to help develop, build and maintain such robots. Using Thangavelautham's (2012, 2017) Artificial Neural Tissue (ANT) control algorithm, a robotic controller for an autonomous multi-robot team was developed. Trained by a simple genetic algorithm, ANT is an artificial neural network (ANN) controller with a sparse, coarse coding network architecture and adaptive activation functions. Starting from the exterior of open, basic geometric grid areas, computer simulations of an ANT multi-robot team with limited time steps, no central controller and limited a priori information, covered some areas completely in linear time, and other areas near completely in quasi-linear time, comparable to the theoretical cover time bounds of grid-based, ant pheromone, area coverage algorithms. To mitigate catastrophic forgetting, a new learning method for ANT, Lifelong Adaptive Neuronal Learning (LANL) was developed, where neural network weight parameters for a specific coverage task were frozen, and only the activation function and output behavior parameters were re-trained for a new coverage task. The performance of the LANL controllers were comparable to training all parameters ab initio, for a new ANT controller for the new coverage task. To increase COLAR's STI capacity, a proposal for a new STI officer corps, Project ÉLITE (Equipo de Líderes en Investigación y Tecnología del Ejército) was developed, where officers enroll in a research intensive, master of science program in applied mathematics or physics in Colombia, and conduct research in the US during their final year. ÉLITE is inspired by the Israel Defense Forces Talpiot program. / Dissertation/Thesis / Doctoral Dissertation Applied Mathematics for the Life and Social Sciences 2019

Background: Tuberculosis (TB) is a major global health threat that results not only in health consequences but also economic consequences. Since 2015 the World Health Organization (WHO) has developed a strategy with the aim of ending the global burden of TB by reducing TB-related deaths, reducing TB incidence, and eliminating the burden of TB-related catastrophic costs for patients and their families. In order to reach these targets, we need to implement effective TB diagnostic and care strategies that are feasible for both patients as well as the health care system. -- Methods: This study consists of two manuscripts which assess the economic burden of TB - one from the patient perspective and the other from the health system perspective. The first manuscript is a systematic review aimed to determine the costs incurred by patients and their households while receiving TB care with direct (medical and non-medical) as well as indirect costs being examined for the pre-diagnostic, post-diagnostic and total phase of care. It analyzed studies with varying patient populations from low-, middle-, and high-income settings to help estimate key factors that drive patient costs. Furthermore, it assessed the proportion of patients that incurred catastrophic costs and the coping strategies that they resorted to in order to offset the costs of TB care. The second manuscript is a modelling study which aimed to develop, parameterize and analyze a decision analytic model to determine the cost, health outcomes as measured by disability-adjusted life years (DALYs) averted and the cost-effectiveness of second-generation lateral flow lipoarabinomannan assay (SG LF-LAM) diagnostic algorithms in people living with HIV (PLHIV) per DALY averted. This model examined four different strategies - 1) the standard of care (SOC) Gene Xpert MTB/RIF only, 2) Gene Xpert MTB/RIF plus LF-LAM for all patients, 3) Gene Xpert MTB/RIF plus LF-LAM for patients with a negative Xpert result, and 4) Gene Xpert MTB/RIF plus LF-LAM for patients who are symptom negative. -- Results: A systematic review showed that total patient costs related to TB care ranged from a mean of $2.80 to $19,153.80 (2019 USD) with costs largely dependent on geographic location as well as patient population, Direct medical and indirect cost components were the largest source of costs for patients and their families while receiving TB care. Direct medical costs included the cost of medication, consultations, diagnostics, follow-up testing, and hospitalization while indirect costs mainly consisted of loss of income. The costs of TB care were considered catastrophic for the majority of patients resulting in them using coping strategies to offset the burden of costs. In the second manuscript, the cost-effectiveness analysis Xpert only was found to be dominated by Xpert + FujiLAM conditional on a negative Xpert with an ICER of 1,000 USD/per DALY averted compared to the standard of care (SOC) Xpert only. Sensitivity analysis found that variations in the key model parameters had an impact on the cost and effectiveness calculations obtained through the model. -- Conclusions: The burden of TB-related costs impact both patients and the health care system at all stages of TB care. Novel diagnostic strategies like the inclusion of FujiLAM for TB diagnosis in PLHIV are cost-effective tools that can aid in case detection and reduce severe outcomes of TB. In order to reduce the TB burden and achieve the "End TB" strategy goals, studies need to work to understand the key components involved in these costs as well as work to develop and implement effective, feasible interventions for TB diagnostics and care.

本文對重大傷病的醫療成本推估進行研究，并以癌症為例，利用台灣癌症中心及健保資料庫數據對其成本進行討論。分別對男性及女性罹患率最高的前十大癌症的發生率、首年生存率、持續生存率、原位癌的罹患率進行討論。 文中将醫療科技發展對於原位癌及早期癌症檢測對保險承保範圍及理賠產生的影響進行討論，並且以各個國家地區的重大傷病保險在早期治療過程中是否納入承保範圍進行歸納。本文以台灣的數據討論了乳癌原位癌及子宮頸原位癌的罹患狀況，并考慮時間趨勢下推估其醫療保險成本。 / This paper will study the cost of catastrophic illness. The paper will use the data from Taiwan Cancer Registry and Nation Health Insurance Research Database to examine the cost of cancer insurance. With the use of these data, we will look into factors such as sex, the highest prevalence rate of the top ten cancers, first-year survival rate, survival duration, and carcinoma in situ of the prevalence. This paper will also look into the effect of the insurance coverage because of the development of medical technology, and compare and contrast with laws and insurance’s terms of different countries. This paper will use Taiwan’s data to discuss the incidence rate of carcinoma and cervical carcinoma in situ, and research the time trend of the insurance cost.

Approved for public release, distribution is unlimited / Inter-domain routing connects individual pieces of Internet topology, creating an integral, global data delivery infrastructure. Currently, this critical function is performed by the Border Gateway Protocol (BGP) version 4 [RFC1771]. Like all routing protocols, BGP is vulnerable to instabilities that reduce its effectiveness. Among the causes of these instabilities are those which are maliciously induced. Although there are other causes, e.g., natural events and network anomalies, this thesis will focus exclusively on maliciously induced instabilities. Most current models that attempt to predict a BGP routing instability confine their focus to either macro- or micro-level metrics, but not to both. The inherent limitations of each of these forms of metric gives rise to an excessive rate of spurious alerts, both false positives and false negatives. It is the original intent of this thesis to develop an improved BGP instability prediction model by statistically combining BGP instability metrics with user level performance metrics. The motivation for such a model is twofold. 1) To provide sufficient prior warning of impending failure to facilitate proactive protection measures. 2) To improve warning reliability beyond existing models, by demonstrably reducing both false positives and false negatives. However, our analysis of actual network trace data shows that a widely used BGP instability metric, the total number of update messages received in a time period, is not a good indicator of future user level performance. / Civilian, Department of Defense

Sous l'ère moderne, où le commerce n'a plus de frontières physiques, les catastrophes causant des dommages à grande échelle se sont multipliées. Lorsque de telles catastrophes surviennent, l'utilisation de procédures de recours collectif pour juger de l'ensemble des litiges semble être la solution indiquée. Pourtant, l'expérience nous démontre qu'il n'en est rien... Bien que le même événement cause des dommages à de multiples victimes, le recours judiciaire demeure l'exercice d'un droit personnel. Le tribunal devra alors rechercher l'application de règles matérielles spécifiques à ce recours. En l'absence de règles spécifiques, les règles de conflit de lois du tribunal saisi seront applicables. Or, ces règles ne sont pas uniformes et entraînent une multiplicité de lois applicables. Conséquemment, il est opportun de s'interroger sur la pertinence de réunir des recours individuels en un seul recours. L'expérience américaine nous démontre les difficultés engendrées par la multiplicité de lois applicables à un recours collectif, bien que des solutions législatives et jurisprudentielles aient été proposées. Ces solutions demeurent imparfaites, tant au niveau de leur constitutionalité que du respect des droits fondamentaux. Devant la complexité occasionnée par le regroupement de ces litiges, les tribunaux sont réfractaires à leur autorisation, dès lors qu'une multiplicité de lois applicables est démontrée. Ainsi, la solution juridique la mieux adaptée aux recours collectifs internationaux demeure celle de saisir les tribunaux, de plusieurs recours collectifs distincts; chacun regroupé en fonction de la loi applicable à chaque recours, déterminée, au préalable, par l'analyse des règles de conflit de lois du tribunal saisi. / When a catastrophic accident occurs, involving numerous victims from different states, we could, instinctively believe that justice will be best served by consolidation of all claims arising from such event. However, this idea isn’t completely right... Ironically, while catastrophic accident is a collective event, the claims pertaining such event remain a personal right of action. Therefore, the court might select the law applicable to each claim in accordance with its own conflict of laws rules. Because those rules aren't similar among states, the law applicable to each claim will differ accordingly. Consequently, the judge hearing a multi-state class action pertaining the same event will need to deal with multiplicity of laws. Historically, American federal courts have almost systematically rejected consolidation of claims when a multiplicity of laws appears. Many solutions to overwhelm problems arising from multiplicity of laws have been raised by the legal communauty. To date, none of those solutions seems perfect. It brings the conclusion that the idea of an international class action to resolve in a single lawsuit, all claims resulting from a single accident, might be an utopia. However, efficiency of class actions proceedings remains. As soon as litigants determine, prior to the certification request, the law applicable to each individual claims, in accordance with the relevant conflict-of-laws rules, in order to join all claims that are similarly conducted by the same law. In doing so, problems related to diversity of laws in class actions are avoided.

Ce travail porte sur la description et la compréhension de l’inversion de phase catastrophique utilisée pour l’émulsification de produits visqueux, à travers l’analyse des effets de formulation et de procédé sur la fraction de phase dispersée à laquelle le processus se produit et sur les mécanismes mis en jeu. Les suivis rhéologique et conductimétrique simultanés in situ de l’émulsification ont permis, du point de vue procédé, de mettre en avant l’influence du débit d’addition de la phase aqueuse sur la formation d’émulsions multiples du type e/H/E lesquelles, en augmentant notablement la fraction de phase dispersée apparente, sont responsables de l’inversion dès de faibles fractions de phase dispersée ajoutée. Au niveau formulation, l’augmentation de la viscosité de l’huile induit de manière remarquable la tendance de cette phase à devenir le milieu dispersé, conduisant à une inversion pour de très faibles fractions de phase aqueuse et donc à des émulsions finales très concentrées (de 80 à 95% en volume). Le suivi au microscope du phénomène d’inversion de phase par l’intermédiaire d’un écoulement de type « squeezing flow », a permis d’établir les conditions et les mécanismes conduisant à une inversion complète ou seulement partielle. La viscosité relative des phases aqueuse et huileuse est responsable d’une inversion catastrophique suivant un mécanisme de type agglomération – coalescence plutôt que de type inclusion/fuite tel que généralement admis. L’établissement d’un modèle mathématique basé sur les bilans de population et le caractère fractal du phénomène a permis de décrire l’évolution de la taille des gouttes multiples ainsi que la fraction de phase dispersée ajoutée à laquelle l’inversion se produit / This study deals with the description and understanding of catastrophic phase inversion during high viscous oil emulsification, through the analysis of the effects of formulation and process variables on the dispersed phase fraction at which the inversion is triggered and on the involved mechanisms. The simultaneous follow – up in situ of viscosity and conductivity measurements allowed, from a process point of view, to emphasize on the effect that the aqueous phase addition rate has on the formation of multiple w/O/W emulsions. Due to the formation of w/o/W emulsions, the volume of the effective dispersed phase greatly increases while at the same time, if the aqueous phase is added by very small fractions inversion of the w/o/W system can occur. In relation with formulation, an increase in oil viscosity greatly increased the tendency of the oily phase to become the dispersed phase. At the same time, it promoted the formation of highly concentrated emulsions (about 80 to 95 % in volume) after the inversion had occurred. The microscopical follow-up of emulsion morphology by means of squeezing flow, allowed us to establish the conditions and mechanisms that lead to partial or complete inversion. Even though literature sources lead us believe that inversion will occur through the “inclusion/escape” mechanism, experimental results showed that the relative viscosity between the phases promoted inversion through the mechanism of “agglomeration – coalescence” rather than “inclusion/escape”. A mathematical model based on population balances and on the fractal nature of multiple emulsions allowed us to describe the multiples drop size and effective dispersed phase evolution until inversion phenomena