Bakgrund: Diabetes mellitus är en kronisk sjukdom som ökar över hela världen. De drabbade individerna får diabetesrelaterade komplikationer som uppkommer vid sjukdomen, bland annat fotkomplikationer såsom fotsår som är vanligt förekommande. Komplikationerna leder till stort lidande för personen. Förutom att det leder till lidande för personen så medför det stora kostnader för hälso- och sjukvården. Uppkomst av fotsår kan motverkas och förhindras genom kunskap och utbildning. Syfte: Författarna vill i denna litteraturstudie belysa diabetespatienters behov av kunskap och undervisning gällande primär prevention av fotsår. Metod: Studien har utförts som en kvalitativ litteraturstudie där tio vetenskapliga artiklar har inkluderats. Artiklarna söktes via de två databaserna PubMed och CINAHL. De inkluderande artiklarna var med kvalitativ ansats. Resultatet av artiklarna bearbetades, analyserades, kvalitetsgranskades och sammanställdes. Resultat: Resultatet framfördes genom två huvudkategorier som är egenvårdsåtgärder och patientutbildning. Genom egenvård är patienterna delaktiga i sin vårdplan. Informationen av egenvårdsåtgärder ska inkluderas i första informationsmötet med patienten. I patientutbildning ges den information och rådgivningen som behövs för att patienten ska kunna hantera sin sjukdom. Dessutom leder patientutbildning till motivation och bättre hälsofrämjande vanor. Konklusion: För att fotsår ska undvikas bör patienten ha kunskaper om vilka komplikationer diabetes kan orsaka. Genom att ha en tydlig bild om hur komplikationerna förhindras leder det till förbättrad omhändertagandet av fötterna. Kommunikationen mellan patienten och vårdpersonalen är en avgörande faktor för hur väl informationen nås fram. / Background: Diabetes mellitus is a chronic disease that is on the rise worldwide. The affected individuals get diabetes-related complications that arise from the disease, including foot complications that are common. The complications lead to great suffering for the person. In addition to suffering for people, it also entails huge costs for health care. The onset of foot ulcers can be counteracted and prevented through knowledge and education. Purpose: In this literature study, the authors want to shed light on diabetic patients' need for knowledge and education regarding the primary prevention of foot ulcers. Method: The study was conducted as a qualitative literature study where ten scientific articles have been included. The articles were searched through the two databases PubMed and CINAHL. The included articles were with a qualitative approach. In the background, both qualitative and quantitative articles were included. Only qualitative articles were included in the results. The results of the articles were processed, reviewed and compiled. Results: The results were presented through two main categories, which are self-care measures and patient education. Through self-care, patients are involved in their care plan. The information of self-care measures must be included in the first information meeting with the patient. In patient education, the information and advice need to enable the patient to manage that their illness is provided. In addition, patient education leads to motivation and better health-promoting habits. Conclusion: To avoid foot ulcers, the patient should have knowledge of what complications diabetes can cause. By having a clear picture of how the complications are prevented, it leads to improved care of the feet. The communication between the patient and the care staff is a decisive factor in how well the information is obtained.

Made available in DSpace on 2014-12-17T14:55:12Z (GMT). No. of bitstreams: 1 HumbertoDA_TESE.pdf: 4762435 bytes, checksum: 20aae983d6895db90a85b0e2b107200f (MD5) Previous issue date: 2013-09-02 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / In the globalized world modern telecommunications have assumed key role within the company, causing a large increase in demand for the wireless technology of communication, which has been happening in recent years have greatly increased the number of applications using this technology. Due to this demand, new materials are developed to enable new control mechanisms and propagation of electromagnetic waves. The research to develop new technologies for wireless communication presents a multidisciplinary study that covers from the new geometries for passive antennas, active up to the development of materials for devices that improve the performance at the frequency range of operation. Recently, planar antennas have attracted interest due to their characteristics and advantages when compared with other types of antennas. In the area of mobile communications the need for antennas of this type has become increasingly used, due to intensive development, which needs to operate in multifrequency antennas and broadband. The microstrip antennas have narrow bandwidth due to the dielectric losses generated by irradiation. Another limitation is the degradation of the radiation pattern due to the generation of surface waves in the substrate. Some techniques have been developed to minimize this limitation of bandwidth, such as the study of type materials PBG - Photonic Band Gap, to form the dielectric material. This work has as main objective the development project of a slot resonator with multiple layers and use the type PBG substrate, which carried out the optimization from the numerical analysis and then designed the device initially proposed for the band electromagnetic spectrum between 3-9 GHz, which basically includes the band S to X. Was used as the dielectric material RT/Duroid 5870 and RT/Duroid 6010.LM where both are laminated ceramic-filled PTFE dielectric constants 2.33 and 10.2, respectively. Through an experimental investigation was conducted an analysis of the simulated versus measured by observing the behavior of the radiation characteristics from the height variation of the dielectric multilayer substrates. We also used the LTT method resonators structures rectangular slot with multiple layers of material photonic PBG in order to obtain the resonance frequency and the entire theory involving the electromagnetic parameters of the structure under consideration. xviii The analysis developed in this work was performed using the method LTT - Transverse Transmission Line, in the field of Fourier transform that uses a component propagating in the y direction (transverse to the real direction of propagation z), thus treating the general equations of the fields electric and magnetic and function. The PBG theory is applied to obtain the relative permittivity of the polarizations for the sep photonic composite substrates material. The results are obtained with the commercial software Ansoft HFSS, used for accurate analysis of the electromagnetic behavior of the planar device under study through the Finite Element Method (FEM). Numerical computational results are presented in graphical form in two and three dimensions, playing in the parameters of return loss, frequency of radiation and radiation diagram, radiation efficiency and surface current for the device under study, and have as substrates, photonic materials and had been simulated in an appropriate computational tool. With respect to the planar device design study are presented in the simulated and measured results that show good agreement with measurements made. These results are mainly in the identification of resonance modes and determining the characteristics of the designed device, such as resonant frequency, return loss and radiation pattern / No mundo globalizado moderno, as telecomunica??es assumiram um papel fundamental dentro das sociedades, provocando um grande aumento da demanda por tecnologia de comunica??o sem fio, isto vem acontecendo nos ?ltimos anos e tem aumentado bastante o n?mero de aplica??es que utilizam esta tecnologia. Em decorr?ncia dessa demanda, novos materiais s?o desenvolvidos no sentido de possibilitar novos mecanismos de controle e propaga??o de ondas eletromagn?ticas. A pesquisa para o desenvolvimento de novas tecnologias para comunica??o sem fios apresenta um car?ter multidisciplinar que abrange desde o estudo de novas geometrias para antenas passivas e ativas at? o de desenvolvimento de materiais para dispositivos que melhorem o desempenho naquela faixa de frequ?ncia de opera??o. Recentemente as antenas planares tem despertado interesses devido as suas caracter?sticas e vantagens que oferecem quando comparadas com os demais tipos de antenas. Na ?rea de comunica??es m?veis a necessidade de antenas desse tipo tem se tornado cada vez maior, devido ao seu intenso desenvolvimento, que necessita de antenas que operem em multifrequ?ncia e em banda larga. As antenas de microfita apresentam largura de banda estreita devido ?s perdas no diel?trico geradas pela irradia??o. Outra limita??o ? a degrada??o do diagrama de irradia??o devido ? gera??o de ondas de superf?cie no substrato. Algumas t?cnicas est?o sendo desenvolvidas para minimizar esta limita??o de banda, como ? o caso do estudo de materiais do tipo PBG Photonic Band Gap, para compor o material diel?trico. Este trabalho tem como objetivo principal o desenvolvimento do projeto de um ressoador de fenda com m?ltiplas camadas e com a utiliza??o de substrato do tipo PBG, onde foi realizada a otimiza??o a partir da analise num?rica e em seguida, projetado o dispositivo proposto inicialmente para a faixa do espectro eletromagn?tico compreendida entre 3-9 GHz, que inclui basicamente a banda S at? X. Foi utilizado como material diel?trico o RT/Duroid 5870 e RT/Duroid 6010.2LM onde ambos s?o laminados cer?micos PTFE com constantes diel?tricas de 2.33 e 10.2, respectivamente. Atrav?s de uma investiga??o experimental foi realizada uma an?lise dos resultados simulados versus medidos observando o comportamento das xvi caracter?sticas de radia??o a partir da varia??o da altura das multicamadas de subtrato diel?trico. Foi utilizado tamb?m o m?todo LTT ?s estruturas ressoadoras retangulares de fenda com m?ltiplas camadas, para a obten??o da freq??ncia de resson?ncia bem como toda a teoria que envolva os par?metros eletromagn?ticos da estrutura em estudo. As an?lises desenvolvidas neste trabalho foram realizadas com utiliza??o do m?todo LTT Linha de Transmiss?o Transversa, no dom?nio da Transformada de Fourier que utiliza uma componente de propaga??o na dire??o y (transversa ? dire??o real de propaga??o z), tratando assim as equa??es gerais dos campos el?tricos e magn?ticos em fun??o de yE e yH . A teoria PBG ser? aplicada para a obten??o da permissividade relativa para as polariza??es s e p dos substratos compostos de material fot?nico. Os resultados s?o obtidos com o software comercial Ansoft HFSS, usado para a an?lise precisa do comportamento eletromagn?tico do dispositivo planar em estudo, por meio do M?todo dos Elementos Finitos (FEM). Resultados num?rico-computacionais s?o apresentados em forma de gr?fico em duas e tr?s dimens?es, para aos par?metros de perda de retorno, frequ?ncia de radia??o, e diagrama de radia??o, efici?ncia de radia??o e densidade superficial de corrente para o dispositivo em estudo, e que tem como substratos, materiais fot?nicos e que fora simulado em uma ferramenta computacional apropriada. . No que diz respeito ao projeto do dispositivo planar em estudo s?o apresentados os resultados medidos e os simulados que apresentam boa concord?ncia com as medi??es efetuadas. Estes resultados consistem principalmente na identifica??o dos modos de resson?ncia e na determina??o das caracter?sticas do dispositivo projetado, como freq??ncia de resson?ncia, perda de retorno e diagrama de radia??o

Doctor of Philosophy (PhD) / Asthma is a chronic inflammatory disease of the airways. Corticosteroid medication is the most effective currently available treatment. Complications of corticosteroid therapy are dose-dependent, however, the clinical efficacy of varying doses of inhaled corticosteroids has been studied with mixed results. A randomized, double-blind, parallel group study was used to evaluate the inhaled corticosteroid dose-response relationship for clinical endpoints and in vitro parameters of underlying airway inflammation and remodelling. The mannitol provocation test with Forced Oscillation Technique (FOT) was used to derive potential dose-differentiating endpoints. In vitro inflammatory markers were measured in alveolar macrophages from bronchoalveolar lavage. Basement membrane thickness was measured from bronchial biopsies. Eleven nonasthmatic subjects were enrolled for comparison. This thesis addresses the null hypothesis that there is no significant difference in clinical and biological effects between low dose (200mcg/day, n=11) and high dose (1000mcg/day, n=11) treatment (for 6-7 weeks) with inhaled fluticasone propionate (FP) for a range of clinical outcomes and in vitro markers of airway inflammation and remodelling. Significant changes after FP included increased FEV1, reduced airway hyperresponsiveness (AHR) (by FOT and FEV1), exhaled nitric oxide and Juniper symptom score. In addition, significant reductions occurred in expression of GM-CSF, TNF-alpha and IL-1ra in macrophages. A lower baseline FOT-derived respiratory system conductance was predictive of a greater degree of improvement in symptoms. No statistically significant differences in the changes after treatment between low and high dose FP were found in spirometry, exhaled nitric oxide, symptom scores, AHR, alveolar macrophage cytokine levels (GM-CSF, TNF-alpha, IL-1ra, IL-10) and basement membrane thickness, although there were trends towards greater improvements in many of the parameters after high dose FP. Basement membrane thickness appeared to be reduced by high dose FP, although this reduction was not statistically significant. There was a weak, but statistically significant, negative correlation between basement membrane thickness and FOT-derived conductance (r2=0.135, p=0.042). With the recognition of the limitations in the interpretation of these data, the results suggest that, in previously steroid naïve mild to moderate asthmatics, there may be only minimal benefit derived from an additional 800µg/day of inhaled fluticasone above the low dose of 200µg/day.