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Catheter Related Problems in Pediatric Oncology Treatment : A Technical Investigation Performed at Uppsala Akademsika SjukhusFjärstedt, Jenny January 2016 (has links)
In this project, problems related to loss of free flow in central venous catheter and implanted subcutaneous ports have been investigated. The catheters investigated in this project are intended for children with cancer diseases. The initial hypothesis was that the length, radius and curvature of the catheter would affect the flow. Two other things that can have a negative impact on the flow are if the catheter is squashed or kinked. Experiments and simulations have been performed in order to test the hypothesis and investigate how a deformation of the catheter affects the flow. The results from the experiments and simulations show that the length and radius of the catheter have major impact on the pressure drop, and hence the flow. The curvature of the catheter has less impact on the flow as long as the catheter is not kinked. Experiments with squashed catheters show a decrease in outlet pressure with a decrease of the catheter lumen. / Denna projektrapport ämnar undersöka problem relaterade till fritt flöde i centrala venkatetrar och inopererade subkutana portar. Katetrarna som testats i detta projekt är till för barn med cancersjukdomar. Den ursprungliga hypotesen var att längden, radien och krökningen hos katetern påverkar flödet. Ytterligare två saker som skulle kunna ha negativ effekt på flödet är om katetern är klämd eller veckad. För att testa hypotesen om hur deformationer av katetern påverkar flödet har experiment och simuleringar utförts. Resultaten från experiment och simuleringar visar att kateterns längd och radie har störst effekt på tryckfallet och därmed flödet. Krökningen på katetern har mindre betydelse, så länge katetern inte är veckad. Experiment med klämd kateter visar att utloppstrycket minskar med minskad kateterlumen.
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Design and function of CVC rolls as a flatness actuator in a cold rolling mill / Design och funktion av CVC-valsar som planhetsställdon i ett kallvalsverkJohannesson, Jonas January 2012 (has links)
When cold rolling thin steel strips with high tensile strength, reversible cluster mills are used. The customer’s demands are high on the products flatness, which is controlled by the different flatness actuators that the mill is equipped with. The objective of this thesis was to find an optimal CVC shape on the shifting inner second intermediate roll in the 20-high cluster mill KV96 at Sandvik Materials Technology in Sandviken. The project consisted of a theoretical calculation of the roll shape that can give the desired change of the strips flatness and practical development and testing of these rolls in the mill. The results showed that the flatness of the strips can be altered with up to 30 I-units at the edges and 20 I-units in the center with the use of an inner second intermediate roll of the CVC type as this study has concluded. In this work, three CVC shapes was developed using the calculation software Cluster. The rolls was then ground and verified in the mill. / Vid kallvalsning av tunna band med hög hållfasthet används reversibla mångvalsarsverk. Kundkraven är höga på produkternas planhet, vilken styrs av de planhetsställdon verket är utrustat med. Målsättningen med detta examensarbete var att finna en optimal CVC-form på den förskjutningsbara inre mellanvalsen i 20-valsarsverket KV96 vid Sandvik Materials Technology AB i Sandviken. Projektet har bestått av att teoretiskt beräkna den valsform som kan ge den önskade förändringen i planhetsmätarbilden samt att praktiskt ta fram och prova dessa valsar i verket. Resultaten visar att man kan påverka planheten på banden med upp till 30 I-enheter i kanten och 20 I-enheter i mitten med användandet av en inre mellanvals av CVC-typ som denna studie kommit fram till. I det här arbetet utvecklades, med hjälp av beräkningsprogrammet Cluster, tre CVC-valsgeometrier som sedan slipades fram och verifierades i valsverket.
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"Aplicação da bioinformática no estudo dos genes e enzimas envolvidos na síntese da goma fastidiana produzida pela xylella fastidiosa" / "Bioinformatic applied in studies of the enzymes involved in the biosynthesis of the exopolysaccharide, fastidian gum, produced by Xylella Fastidiosa"Muniz, João Renato Carvalho 25 April 2003 (has links)
Xylella fastidiosa é uma bactéria Gram-negativa, limitada ao xilema das plantas e o agente causador de diversas doenças em importantes plantações como citros, videiras, mirta, amêndoa, arbustos e café. Em citros, X. fastidiosa causa a Clorose Variegada dos Citros (CVC) ou amarelinho". Nove enzimas (GumB, C, D, E, F, H, J, K e M) estão envolvidas nas etapas biossintéticas de um polissacarídeo extracelular (EPS), chamado de goma fastidiana, um dos mecanismos envolvidos na patogênese da bactéria. Essas enzimas catalisam reações de adição de açúcares, polimerização e exportação do EPS através da membrana da bactéria. No presente trabalho, ferramentas de bioinformática foram utilizadas para o estudo e entendimento da biossíntese da goma fastidiana. As nove enzimas foram estudadas quanto ao seu conteúdo de estrutura secundária, análise de hidrofobicidade e das regiões transmembrânicas, classificação quanto as suas funções. A construção de modelos estruturais para as enzimas Gums através de comparação por homologia seqüencial mostrou ser um processo impossível, devido a falta de moléculas homólogas com estruturas tridimensionais conhecidas. Por outro lado, métodos de reconhecimento de enovelamento mostraram bons resultados e comparações entre as estruturas secundárias das enzimas Gums foram calculadas com a utilização dos programas GenThreader e THREADER 3.3. Modelos tridimensionais para as enzimas GumB, GumK, GumM, GumJ e GumC foram construídos com o programa MODELLER 6.0a e validados com o programa Procheck e VERIFY 3D. Para construção do modelo da GumH (enzima que catalisa a adição da GDP-manose em um lipídio carreador poliprenol), o GenThreader encontrou similaridades quando comparada a MurG (E.coli), 2-epimerase (E. coli), GtfB (Amycolatopsis orientalis) e beta-GT de fago T4. Todos os modelos são bastante semelhantes e compostos por dois domínios (alfa/beta), ambos similares ao motivo de ligação de nucleotídeos Rossmann fold e separados por uma fenda profunda, que, provavelmente, forma o sítio de ligação da GDP-manose. Estudos da interação entre proteína e substrato foram obtidos com a utilização do programa FLO. O alinhamento seqüencial da GumH com outras onze glicosiltransferases mostrou regiões bastante conservadas, incluindo o motivo EX7E presente no sítio de ligação do substrato na proteína. Considerações a respeito das interações do substrato GDP-manose com a enzima GumH e do mecanismo da reação foram feitas. Essas análises enfatizam o modelo obtido para a GumH, que representa a primeira estrutura proposta para as enzimas envolvidas na síntese da goma fastidiana. / Xylella fastidiosa is a xylem-dwelling, insect-transmitted gamma-protobacterium that causes pathogenicity in citrus plants and many others important crops such as grapevine, periwinkle, almond, oleander and coffee. In citrus plants, X. fastidiosa causes citrus variegated chlorosis (CVC) or amarelinho". Nine enzymes (GumB, C, D, E, F, H, J, K and M) are involved in the biosynthetic pathway of an exopolysaccharide (EPS) called fastidian gum which could be involved in the pathogenicity of the bacterium. These enzymes catalyses sugars addition reactions, polymerization and discharge of the EPS through the bacterias membrane. We have used bioinformatic tools to study these enzymes and to understand the gum biosynthesis. The nine enzymes were studied regarding to its secondary structure content, analysis of hidrophobicity and transmembrane regions, and yet function classification. The construction of structural models using sequential homology was shown to be impossible, due to the necessity of homologues molecules whose three-dimensional structures are known. On the other hand, pairwises comparisons of secondary structures showed good results and were realized with GenThreader and THREADER 3.3 programs. Three-dimensional structures to GumB, GumK, GumM, GumJ and GumC enzymes were constructed using MODELLER 6.0a and validated with Procheck and VERIFY 3D programs. To construct the model of GumH (enzyme that catalyse the addiction of a GDP-mannose on a polyprenol phosphate carrier), GenThreader found folding similarities when compared to MurG and UDP-Acetylglucosamine 2-Epimerase (from E. coli), GtfB (from Amycolatopsis orientalis) and beta-GT (from T4 phage). The models are very similar consisting of two alpha/beta open sheet domains, both alike in topology to the Rossmann nucleotide-binding folds, and separated by a deep cleft which probably forms the GDP-mannose binding site. Studies of the interaction between enzyme and docked substrate were carried out using the FLO program. The sequence alignment between GumH and another eleven glycosiltransferases showed several preserved regions including the EX7E motif present on the substrate binding site. The interactions between enzyme-GDP-mannose substrate and the mechanism of the reaction were studied. These analyses emphasize the three-dimensional model constructed for GumH that represents the first structural information for enzymes involved in fastidian gum synthesis.
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"Aplicação da bioinformática no estudo dos genes e enzimas envolvidos na síntese da goma fastidiana produzida pela xylella fastidiosa" / "Bioinformatic applied in studies of the enzymes involved in the biosynthesis of the exopolysaccharide, fastidian gum, produced by Xylella Fastidiosa"João Renato Carvalho Muniz 25 April 2003 (has links)
Xylella fastidiosa é uma bactéria Gram-negativa, limitada ao xilema das plantas e o agente causador de diversas doenças em importantes plantações como citros, videiras, mirta, amêndoa, arbustos e café. Em citros, X. fastidiosa causa a Clorose Variegada dos Citros (CVC) ou amarelinho. Nove enzimas (GumB, C, D, E, F, H, J, K e M) estão envolvidas nas etapas biossintéticas de um polissacarídeo extracelular (EPS), chamado de goma fastidiana, um dos mecanismos envolvidos na patogênese da bactéria. Essas enzimas catalisam reações de adição de açúcares, polimerização e exportação do EPS através da membrana da bactéria. No presente trabalho, ferramentas de bioinformática foram utilizadas para o estudo e entendimento da biossíntese da goma fastidiana. As nove enzimas foram estudadas quanto ao seu conteúdo de estrutura secundária, análise de hidrofobicidade e das regiões transmembrânicas, classificação quanto as suas funções. A construção de modelos estruturais para as enzimas Gums através de comparação por homologia seqüencial mostrou ser um processo impossível, devido a falta de moléculas homólogas com estruturas tridimensionais conhecidas. Por outro lado, métodos de reconhecimento de enovelamento mostraram bons resultados e comparações entre as estruturas secundárias das enzimas Gums foram calculadas com a utilização dos programas GenThreader e THREADER 3.3. Modelos tridimensionais para as enzimas GumB, GumK, GumM, GumJ e GumC foram construídos com o programa MODELLER 6.0a e validados com o programa Procheck e VERIFY 3D. Para construção do modelo da GumH (enzima que catalisa a adição da GDP-manose em um lipídio carreador poliprenol), o GenThreader encontrou similaridades quando comparada a MurG (E.coli), 2-epimerase (E. coli), GtfB (Amycolatopsis orientalis) e beta-GT de fago T4. Todos os modelos são bastante semelhantes e compostos por dois domínios (alfa/beta), ambos similares ao motivo de ligação de nucleotídeos Rossmann fold e separados por uma fenda profunda, que, provavelmente, forma o sítio de ligação da GDP-manose. Estudos da interação entre proteína e substrato foram obtidos com a utilização do programa FLO. O alinhamento seqüencial da GumH com outras onze glicosiltransferases mostrou regiões bastante conservadas, incluindo o motivo EX7E presente no sítio de ligação do substrato na proteína. Considerações a respeito das interações do substrato GDP-manose com a enzima GumH e do mecanismo da reação foram feitas. Essas análises enfatizam o modelo obtido para a GumH, que representa a primeira estrutura proposta para as enzimas envolvidas na síntese da goma fastidiana. / Xylella fastidiosa is a xylem-dwelling, insect-transmitted gamma-protobacterium that causes pathogenicity in citrus plants and many others important crops such as grapevine, periwinkle, almond, oleander and coffee. In citrus plants, X. fastidiosa causes citrus variegated chlorosis (CVC) or amarelinho. Nine enzymes (GumB, C, D, E, F, H, J, K and M) are involved in the biosynthetic pathway of an exopolysaccharide (EPS) called fastidian gum which could be involved in the pathogenicity of the bacterium. These enzymes catalyses sugars addition reactions, polymerization and discharge of the EPS through the bacterias membrane. We have used bioinformatic tools to study these enzymes and to understand the gum biosynthesis. The nine enzymes were studied regarding to its secondary structure content, analysis of hidrophobicity and transmembrane regions, and yet function classification. The construction of structural models using sequential homology was shown to be impossible, due to the necessity of homologues molecules whose three-dimensional structures are known. On the other hand, pairwises comparisons of secondary structures showed good results and were realized with GenThreader and THREADER 3.3 programs. Three-dimensional structures to GumB, GumK, GumM, GumJ and GumC enzymes were constructed using MODELLER 6.0a and validated with Procheck and VERIFY 3D programs. To construct the model of GumH (enzyme that catalyse the addiction of a GDP-mannose on a polyprenol phosphate carrier), GenThreader found folding similarities when compared to MurG and UDP-Acetylglucosamine 2-Epimerase (from E. coli), GtfB (from Amycolatopsis orientalis) and beta-GT (from T4 phage). The models are very similar consisting of two alpha/beta open sheet domains, both alike in topology to the Rossmann nucleotide-binding folds, and separated by a deep cleft which probably forms the GDP-mannose binding site. Studies of the interaction between enzyme and docked substrate were carried out using the FLO program. The sequence alignment between GumH and another eleven glycosiltransferases showed several preserved regions including the EX7E motif present on the substrate binding site. The interactions between enzyme-GDP-mannose substrate and the mechanism of the reaction were studied. These analyses emphasize the three-dimensional model constructed for GumH that represents the first structural information for enzymes involved in fastidian gum synthesis.
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Panorama do transporte rodoviário de madeira bruta e em toras na região do Arco de Desflorestamento na Amazônia / Overview of road transport of wood raw and logs in the Arc of Deforestation in AmazoniaLima, Mariana Peres de 02 October 2014 (has links)
A madeira é uma commoditie de extrema importância no Brasil e possui grande diversidade de utilização sendo matéria-prima para obtenção de energia, na forma de carvão e biomassa, produção de celulose e papel, construção civil, indústria farmacêutica etc. O modal rodoviário é a principal forma de transporte de carga florestal no Brasil, como também na região deste estudo denominada como \"Arco de Desflorestamento\". O objetivo deste trabalho foi elaborar um panorama do transporte rodoviário de madeira bruta e em toras, possibilitando o entendimento e a melhor compreensão da atividade de forma a subsidiar discussões a cerca da legislação e políticas públicas visando sua adequação à realidade da região em questão. O trabalho se estruturou em torno de um capítulo introdutório sobre o panorama atual, seis capítulos com estudos científicos e um capítulo contendo uma revisão bibliográfica geral de contextualização do cenário proposto. Os resultados destacaram a detecção de agentes internos: condutor, empresa, terceiros e externos: instituições fiscalizatórias, sociedade civil, e o mercado de madeira são componentes que interferem direta ou indiretamente na atividade. Críticas no processo de formação de preço do frete foram constatadas e novas metodologias para esta formação foram elaboradas. Novas equações para a determinação do frete foram propostas inserindo as variáveis quantitativas: volume de madeira (m³), distância (km) e horas efetivas (h), além das qualitativas como satisfação na atividade e permanência na atividade. O melhor coeficiente do modelo de frete encontrado foi R² = 0,973 e R² (adj) = 0,972. Em relação à frota constatou-se que a Combinação Veicular de Carga - CVC que mais se destaca é o biminhão (49,66%). Verificou-se também que o comprimento variável das toras, somado aos diâmetros muitas vezes irregulares nas diferentes extremidades do fuste, impede que a carga seja acomodada e disposta de forma organizada. Este fato gera um aumento dos espaços vazios que traz consequências graves à segurança do transporte rodoviário florestal ocasionando o excesso de comprimento, altura e lateral. A carga transportada ainda restringe o tipo de carroceria que é exclusiva para atividade, fato este que limita a possibilidade de transporte de outros tipos de cargas. O levantamento constatou que a frota possui uma idade média avançada (18,22 anos), fato este que dificulta os condutores adequarem-se à legislação em vigor que fixa requisitos técnicos de segurança para o transporte de toras de madeira bruta por veículo rodoviário de carga. Pontos falhos foram detectados na legislação, destacando-se as obrigatoriedades impostas pela resolução não se encontrarem em consonância com a realidade da frota, principalmente pela idade avançada, causando críticas dos condutores ao governo. Como resultado final deste estudo foi elaborado o panorama da atual situação e levantados os principais problemas, assim como indicadas possíveis soluções em termos de iniciativas e programas do governo para a renovação da frota de transporte de madeira bruta e em toras na região. / The wood is a very important commodity in Brazil and is very useful as has great diversity in the feedstock being material for several products such as: energy wood (coal and biomass), cellulosic production (pulp and paper), pharmaceutical, nautical industries and construction. In Brazil different transport modal to transporting forest load is used, but the mainly transport is through the road and in the region studied the name \"Arc of deforestation\" is the major way to dispose wood production. The need to provide an overview of transporting raw wood and logs make easier understanding and provide improvements in transport legislation and guide to policies to fit the reality of the region in question. This work was structured with an introductory chapter about the general problem, and six chapters more, based on scientific articles and literature review. This work in a general view obtained important results for constructing the panorama. The results showed different components agents internal (driver, direct and indirect companies), and external agents (institution of monitoring government, the society and the wood market) that can interfere directly or indirectly in the activity. The traditional methodology about freight was criticized and new methodologies were proposed to improve the method. New models for freight were also proposed inserting quantitative and qualitative variables and the best model coefficient was R² = 0.973 and R² (adj) = 0.972. The best model variables selected in this study were: timber volume (m³), distance (km), effective hours (he) for quantitative variables and for qualitative variables: satisfaction in the activity, and permanence in the work. Regarding the truck fleet it was found that about the CVC (combination vehicular cargo) truck trailer (6 axes) was the most ordinary in this study (49.66%). It has been found that the length of logs plus the irregular diameters in the different extremities of the logs impossible the correct stacking timber. Because of the spaces originates from the bad accommodation of the logs has serious consequences for the safety of wood road transporting generating an excessive cargo in length, height and width. This is a form of equivalence volumetric. Another problem is that the trailers exclusive for the activity and this fact limits the possibility of carrying other types of cargo, decreasing the competitiveness. This study allowed to establish that the fleet has an old average age and this fact hinders truck drivers to fit on the present legislation (Resolution n. 246 of July 2007.) This resolution fixes technical safety requirements for the road transportation of logs. In this resolution were detected a critical point that the obligation imposed is not compatible with the reality and the old average age of fleet (18.2 years), provoking criticism by the truck drivers about the government. This study was able to satisfy to proposed a new overview raising problems, indicating improvements and suggestions such as: initiatives and government programs for the renewal of the fleet log road transportation and changes in the public politicians.
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Improving Nurses' Knowledge to Reduce Catheter-Related Bloodstream Infection in Hemodialysis UnitKadium, Mohammed Jawad 01 January 2015 (has links)
Central venous catheters (CVCs) are commonly used as vascular access for patients who require hemodialysis. Infectious complications are a serious clinical problem, and they are associated with high rates of morbidity and mortality, prolonged hospital stay, and increased medical treatment costs. The purpose of theproject was to evaluate the effectiveness of educating registered dialysis nurses regarding CVC maintenance care to reduce catheter-related bloodstream infection (CRBSI) in a hemodialysis unit. The project question focused on the educational program derived from the evidence-based guidelines recommended by the Centers for Disease Control and Prevention (CDC) to improve registered dialysis nurses' knowledge regarding CVC maintenance care. The theoretical foundation of the study was based on Donabedian's structure-process-outcomes model. In this project, nurses considered a structural element and used a self-study module to improve the process of providing CVC maintenance care. A paired-samples ttest was conducted to compare knowledge scores of the participants in the posttest (n = 56) and knowledge scores of participants in the pretest (n = 57). The ttest was significantly higher for the posttest than scores for the pretest. The results suggested a statistically significant improvement in the registered dialysis nurses' knowledge following the educational intervention. This study contributes to social change by identifying an educational intervention that helped improving nurses' knowledge in hemodialysis unit, thus helping hemodialysis patients stay safer and possibly reducing infectious complications.
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Análise da expressão de genes relacionados à defesa em novos híbridos de citros resistentes à Clorose Variegada dos Citros e mapeamento de eQTL / Analysis of defense-related gene expression in new citrus hybrids resistant to Citrus Variegated Chlorosis and eQTL mappingMauricio, Fernanda Nara 29 August 2013 (has links)
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Previous issue date: 2013-08-29 / Brazil is the largest producer of sweet orange, but the productivity is not the highest due to disease problems. A major problem is the Citrus Variegated Chlorosis (CVC) caused by the bacterium Xylella fastidiosa, which promotes obstruction of the xylem, causing physiological disorders in plant and in advanced cases, affecting fruits, leading to production losses. In this study, hybrids obtained from controlled crosses between Murcott tangor [Citrus reticulata Blanco x Citrus sinensis (L.) Osbeck] and Pera sweet orange [Citrus sinensis (L.) Osbeck] were evaluated by analysis of symptoms, diagnosis through conventional and real time PCR (Polymerase Chain Reaction) , showing seven resistant hybrids, twenty-four tolerant hybrids and six susceptible hybrids. The expressions of thirteen genes [NBS-LRR - RGH1, Abscisic Acid (ABA), Thaumatin, Chitinase, Xa21 Kinase, Kinase CHRK1, Isoflavone Synthase, Protein Defense-Related Resistance - DRRP, No Product Set - SPD, Isoflavone Reductase, HCr2-0A, Ankyrin, Glutathione GST-22 associated with resistance were evaluated, and it was possible to relate the resistance to X. fastidiosa with gene expression. QTL (Quantitative Trait Loci) were mapped through the quantification of symptoms and bacterial concentration and expression QTL (eQTL) of genes were carried out with the evaluation of thirty-seven hybrids. / O Brasil é o maior produtor mundial de laranja, mas não apresenta maior produtividade devido a problemas fitossanitários. Um dos principais problemas é a Clorose Variegada dos Citros (CVC) causada pela bactéria Xylella fastidiosa, que promove a obstrução do xilema, causando desordens fisiológicas na planta e em casos avançados, afetando os frutos. A CVC acomete as variedades de Citrus sinensis (L.) Osbeck, conhecidas como laranjas-doce, sobre diferentes porta-enxertos, todavia não são encontrados sintomas em tangerinas e híbridos comerciais. Neste estudo, os híbridos obtidos a partir de cruzamentos controlados entre tangor Murcott [Citrus reticulata Blanco x Citrus sinensis (L.) Osbeck] com laranja Pera [Citrus sinensis (L.) Osbeck] foram avaliados através da análise dos sintomas, o diagnóstico por meio de PCR (Polymerase Chain Reaction) convencional e em tempo real, mostrando sete híbridos resistentes, vinte e quatro híbridos tolerantes e seis híbridos suscetíveis. As análises de expressões dos genes (NBS-LRR RGH1, Ácido Abscísico, Taumatina, Quitinase, Quinase Xa21, Quinase CHRK1, Isoflavone Sintase, Proteína de Defesa Relacionada com Resistência - PDRR, Sem Produto Definido - SPD, Isoflavona Redutase, HCr2- 0A, Anquirina e GST22) possibilitaram entender a relação entre a resistência a X. fastidiosa e a expressão gênica. Foram mapeados QTLs (Quantitative Trait Loci) através da quantificação de sintomas, concentração de bactérias. Baseados em um conjunto de resultados, foram detectados eQTLS (QTLs de expressão) de genes avaliados em trinta e sete híbridos.
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Panorama do transporte rodoviário de madeira bruta e em toras na região do Arco de Desflorestamento na Amazônia / Overview of road transport of wood raw and logs in the Arc of Deforestation in AmazoniaMariana Peres de Lima 02 October 2014 (has links)
A madeira é uma commoditie de extrema importância no Brasil e possui grande diversidade de utilização sendo matéria-prima para obtenção de energia, na forma de carvão e biomassa, produção de celulose e papel, construção civil, indústria farmacêutica etc. O modal rodoviário é a principal forma de transporte de carga florestal no Brasil, como também na região deste estudo denominada como \"Arco de Desflorestamento\". O objetivo deste trabalho foi elaborar um panorama do transporte rodoviário de madeira bruta e em toras, possibilitando o entendimento e a melhor compreensão da atividade de forma a subsidiar discussões a cerca da legislação e políticas públicas visando sua adequação à realidade da região em questão. O trabalho se estruturou em torno de um capítulo introdutório sobre o panorama atual, seis capítulos com estudos científicos e um capítulo contendo uma revisão bibliográfica geral de contextualização do cenário proposto. Os resultados destacaram a detecção de agentes internos: condutor, empresa, terceiros e externos: instituições fiscalizatórias, sociedade civil, e o mercado de madeira são componentes que interferem direta ou indiretamente na atividade. Críticas no processo de formação de preço do frete foram constatadas e novas metodologias para esta formação foram elaboradas. Novas equações para a determinação do frete foram propostas inserindo as variáveis quantitativas: volume de madeira (m³), distância (km) e horas efetivas (h), além das qualitativas como satisfação na atividade e permanência na atividade. O melhor coeficiente do modelo de frete encontrado foi R² = 0,973 e R² (adj) = 0,972. Em relação à frota constatou-se que a Combinação Veicular de Carga - CVC que mais se destaca é o biminhão (49,66%). Verificou-se também que o comprimento variável das toras, somado aos diâmetros muitas vezes irregulares nas diferentes extremidades do fuste, impede que a carga seja acomodada e disposta de forma organizada. Este fato gera um aumento dos espaços vazios que traz consequências graves à segurança do transporte rodoviário florestal ocasionando o excesso de comprimento, altura e lateral. A carga transportada ainda restringe o tipo de carroceria que é exclusiva para atividade, fato este que limita a possibilidade de transporte de outros tipos de cargas. O levantamento constatou que a frota possui uma idade média avançada (18,22 anos), fato este que dificulta os condutores adequarem-se à legislação em vigor que fixa requisitos técnicos de segurança para o transporte de toras de madeira bruta por veículo rodoviário de carga. Pontos falhos foram detectados na legislação, destacando-se as obrigatoriedades impostas pela resolução não se encontrarem em consonância com a realidade da frota, principalmente pela idade avançada, causando críticas dos condutores ao governo. Como resultado final deste estudo foi elaborado o panorama da atual situação e levantados os principais problemas, assim como indicadas possíveis soluções em termos de iniciativas e programas do governo para a renovação da frota de transporte de madeira bruta e em toras na região. / The wood is a very important commodity in Brazil and is very useful as has great diversity in the feedstock being material for several products such as: energy wood (coal and biomass), cellulosic production (pulp and paper), pharmaceutical, nautical industries and construction. In Brazil different transport modal to transporting forest load is used, but the mainly transport is through the road and in the region studied the name \"Arc of deforestation\" is the major way to dispose wood production. The need to provide an overview of transporting raw wood and logs make easier understanding and provide improvements in transport legislation and guide to policies to fit the reality of the region in question. This work was structured with an introductory chapter about the general problem, and six chapters more, based on scientific articles and literature review. This work in a general view obtained important results for constructing the panorama. The results showed different components agents internal (driver, direct and indirect companies), and external agents (institution of monitoring government, the society and the wood market) that can interfere directly or indirectly in the activity. The traditional methodology about freight was criticized and new methodologies were proposed to improve the method. New models for freight were also proposed inserting quantitative and qualitative variables and the best model coefficient was R² = 0.973 and R² (adj) = 0.972. The best model variables selected in this study were: timber volume (m³), distance (km), effective hours (he) for quantitative variables and for qualitative variables: satisfaction in the activity, and permanence in the work. Regarding the truck fleet it was found that about the CVC (combination vehicular cargo) truck trailer (6 axes) was the most ordinary in this study (49.66%). It has been found that the length of logs plus the irregular diameters in the different extremities of the logs impossible the correct stacking timber. Because of the spaces originates from the bad accommodation of the logs has serious consequences for the safety of wood road transporting generating an excessive cargo in length, height and width. This is a form of equivalence volumetric. Another problem is that the trailers exclusive for the activity and this fact limits the possibility of carrying other types of cargo, decreasing the competitiveness. This study allowed to establish that the fleet has an old average age and this fact hinders truck drivers to fit on the present legislation (Resolution n. 246 of July 2007.) This resolution fixes technical safety requirements for the road transportation of logs. In this resolution were detected a critical point that the obligation imposed is not compatible with the reality and the old average age of fleet (18.2 years), provoking criticism by the truck drivers about the government. This study was able to satisfy to proposed a new overview raising problems, indicating improvements and suggestions such as: initiatives and government programs for the renewal of the fleet log road transportation and changes in the public politicians.
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Reducing CLABSI Rate Among ICU PatientsWalker, Rita L. 01 January 2018 (has links)
Approximately 55% of intensive care unit (ICU) patients require the use of a central venous catheter (CVC). CVCs are often an essential component of care; however, CVCs can create avenues for pathogens to enter the bloodstream and cause a central line-associated bloodstream infections (CLABSI), which can lead to increased mortality and morbidity, prolonged length of stay, increased cost of care, decreased patient satisfaction, and increased workload. In 2017, the CLABSI rate at the project site was 4.3 per 1,000 catheter days as compared to the national rate of 0.8 per 1,000 catheter days. Based on Piaget's theory of constructivism, a simulation-based staff educational program was developed and implemented by ICU staff (n=20). Following the implementation of the simulation-based program, adherence to CVC maintenance guidelines improved from 41.5% to 87.9%. A sample t-test showed that this improvement was statistically significant and the CLABSI rate declined to 1.24 per 1,000 catheter days in the 4-week period following implementation of the program. Findings show that introducing a simulation-based training program might help to reduce CLABSI rates in the ICU setting and contribute to positive social change by improving health outcomes in ICU patients with a CVC.
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Using Systematic and Engaging Early Literacy Instruction and Digital Books to Teach At-Risk Kindergarteners to Read Target WordsHales, Audra Marie 02 December 2012 (has links) (PDF)
The purpose of this study was to examine the effects of using Systematic and Engaging Early Literacy (SEEL) intervention activities that incorporate digital books to teach kindergarteners to read. The study used a single-subject-multiple-baseline-across-behaviors design to compare kindergarten students' reading of comparable CVC words before and after intervention. Four students at-risk for reading difficulties were chosen for the study based on their performance on assessments and their teachers' recommendations. Students were divided into two dyads and received intervention three times a week for 25 minutes for approximately six weeks, or 18 total sessions. Baseline assessment data was collected prior to intervention, and performance on each target was monitored through the same assessment task after every intervention session. Students received SEEL instruction on one set of word targets while a comparable set was kept at baseline phase. After six intervention sessions on the first set of word targets, a second set was introduced while the first set was monitored for maintenance. Finally, a third set of target words was introduced and taught in six sessions, and the first two sets of words were monitored for maintenance. Instruction involved using meaningful and interactive activities that incorporated playful practice, multiple exposures to targets, explicit statement of the goal, and reciprocal teacher-student exchanges where students' contributions were acknowledged and incorporated into the lesson or meaning construction. After being exposed to the target words (orally and in writing), children were provided with additional opportunities to read and write the words within digital books created on the iPad.
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