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Prévalence et mécanismes des troubles respiratoires hypoxemiants du sommeil dans l’HTAP / Prevalence and mechanisms of sleep-related breathing disorders in pulmonary hypertension.Nicolas-Jilwan, Fadia 01 February 2012 (has links)
L’hypertension artérielle pulmonaire (HTAP) est définie par une pression artérielle moyenne >25 mmHg associée à une pression capillaire ≤ 15 mmHg. L’augmentation des résistances artérielles pulmonaires dans l’HTAP est associée à des phénomènes de vasoconstriction, de remodelage pariétal et de thrombose au niveau des artères pulmonaires de petit calibre. Plusieurs données expérimentales montrent que l’hypoxie est susceptible d’induire ces mêmes changements au niveau du lit artériel pulmonaire. De plus, d’après les petites cohortes étudiées dans la littérature, une hypoxémie nocturne (HN) serait fréquente dans l’HTAP pouvant se rencontrer chez presque 77% des malades. Les mécanismes de cette HN sont mal élucidés, en rapport avec une respiration périodique de type Cheyne Stokes (CS) pour certains auteurs, ou avec des apnées-hypopnées obstructives (AHO) du sommeil pour d’autres.Nous avons voulu ainsi explorer le sommeil des malades porteurs d’HTAP à la recherche de ces anomalies du sommeil et dans le but de déterminer leur prévalence et leurs mécanismes physiopathologiques. Quarante six malades hospitalisés dans le service de pneumologie de l’Hôpital Antoine Béclère, centre de référence national pour l’HTAP, ont bénéficié d’une nuit de polysomnographie (CIDELEC) avec une mesure de la capnographie transcutanée (TOSCA). Il s’agissait d’une population homogène comprenant 29 malades porteurs d’une HTAP idiopathique (HTAPI) et de 17 malades porteurs d’un coeur pulmonaire chronique postembolique (CPCPE), n’ayant pas d’anomalies fonctionnelles respiratoires sévères (VEMS etCPT ≥ 60 % de la théorique), ni d’obésité sévère (IMC < 35 Kg/m²), et stables depuis au moins 3mois, sous traitement spécifique optimal pour l’HTAP. Ces malades étaient pour la plupart en classe fonctionnelle II de la NYHA, parcouraient > 400m au test de marche de 6 minutes, etavaient un index cardiaque moyen mesuré sur le cathétérisme cardiaque droit dans les normes(3,2 ± 0,6 L/min/m²).La majorité (38/46 soit 82,6%) avaient une HN définie par un temps de sommeil passé avec uneSpO2 < 90%, > 60min et/ou un index de désaturation ≥ 20/h. Ces patients passaient 48.9 ± 35.9%de leur temps de sommeil avec une SpO2 < 90%. Le mécanisme le plus fréquemment rencontré(76% des malades désaturateurs) correspond à une hétérogénéité ventilation/perfusion (VA/Q)isolée ou associée à des AHO du sommeil. La prévalence des apnées-hypopnées (AH) était très élevée avec un index d’apnées-hypopnées (IAH) ≥ 5/h chez 89% des malades et un IAH moyende 24.9 ± 22.1/ h. La majorité de ces évènements était d’origine obstructive, seulement 4malades présentaient des AH de mécanisme central dont 3 avaient une respiration périodique de type CS. Un seul cas d’hypoventilation alvéolaire nocturne associé à un IAH obstructif modéré a été identifié, avec une désaturation nocturne prolongée concomitante d’une majoration significative de la capnie transcutanée de plus que 30 mmHg. Aucun facteur clinique ni hémodynamique n’a pu être identifié comme prédictif de la survenue de l’HN malgré certaines corrélations notées entre les paramètres de désaturation nocturne et la PaO2 diurne d’une part, et l’obstruction des petites voies aériennes d’autre part.Nous avons pu conclure que l’HN est fréquente dans l’HTAPI et dans le CPCPE, en rapport avec un déséquilibre VA/Q et/ou des AHO du sommeil. Reste à préciser dans des études ultérieures si la correction de cette HN aura des effets bénéfiques pour les patients en termes d’amélioration fonctionnelle, hémodynamique ou de réponse au traitement. / Precapillary pulmonary hypertension (PH) is defined by a mean pulmonary pressure > 25 mmHg associated with a normal wedge pressure (≤ 15 mmHg). Increase in vascular resistances in PH is due to vasoconstriction, vascular wall remodelling and thromboses of small pulmonary arterioles. Hypoxia is known to cause similar changes in pulmonary vasculature. Although some cohorts studies have shown that nocturnal hypoxemia (NH) is frequent in PH, accounting for up to 77% of cases, the mechanisms of this NH were not well established, being associated to periodic respiration like the Cheyne Stokes respiration (CS) by some authors, and to obstructive apneas-hypopneas (OAH) by others.The aim of our study was to search for sleep-related breathing disorders in PH, to determine their prevalence and their mechanisms. Fourty six patients hospitalized in the pulmonary department of Antoine Béclère Hospital, which is the national referral center for PH in France, underwent a one night polysomnography (CIDELEC) with a transcutaneous capnography (TOSCA). Our population was homogeneous with 29 patients having idiopathic pulmonary arterial hypertension (IPAH) and 17 patients having chronic thrombo-embolic PH (CTEPH). Patients had no severe functional limitation (FEV1 and TLC ≥ 60 % of predicted), nor severe obesity (BMI < 35 Kg/m²), and they were in a steady state with optimal PH treatment for at least three months. The majority of patients were in NYHA functional class II, had a 6 minutes walking distance > 400m and a mean cardiac index measured on right heart catheterization within normal ranges (3,2 ± 0,6 L/min/m²).Thirty eight out of the 46 patients (82,6%) had a NH as defined by a sleeping time spent with a SpO2 < 90%, > 60min and/or an oxygen desaturation index ≥ 20/h. These patients spent 48.9 ± 35.9% of their sleeping time with a SpO2 < 90%. The most frequent mechanism underlying theses abnormalities (76% of desaturators patients) was due to ventilation/perfusion (VA/Q) heterogeneity, isolated or associated to OAH. Apneas-hypopneas (AH) were frequent in PH patients with an AH index (AHI) ≥ 5/h in 89% of cases, and a mean AHI of 24.9 ± 22.1/ h. Most of these respiratory events were obstructive, only four patients had central AH with a CS pattern in 3 out them. A single case of alveolar hypoventilation associated with a moderate AHI was identified and was caracterized by a sustained nocturnal desaturation associated with a significant increase in transcutaneous CO2 pressure ( > 30 mmHg). No clinical nor hemodynamic factor was found to be predicting for NH, although minor correlations were found between nocturnal desaturation parameters and PaO2, and nocturnal desaturation parameters and small airways obstruction.We conclude that NH is frequent in IPAH and CTEPH, due to VA/Q mismatch and/or OAH. Future studies are needed to determine the impact of the correction of this NH on PH patients regarding their NYHA functionnal class, their hemodynamic parameters and their responsiveness to PH specific treatment.
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Bladder and brain function in children with severe nocturnal enuresis. / CUHK electronic theses & dissertations collectionJanuary 2005 (has links)
Conclusion. Impairment in bladder and brain functions was identified in children with severe NE. Post-treatment studies indicated that brain function normalized in parallel with amelioration of bladder dysfunction. Interaction between brain and bladder dysfunction is likely to have an important implication in the pathophysiology and resolution of NE. / Objective. To (1) investigate sleep pattern and cortical arousals in enuretic children; (2) assess brain and bladder function in enuretic children; (3) evaluate post-treatment brain and bladder functional changes in enuretic children and correlate these with the treatment outcomes. / Part II. Fifty-two patients with severe PNE and 15 normal controls were recruited. Bladder and brain functions (sleep arousal threshold, P300 ERPs latency and PPI of startle amplitude) in enuretic children were evaluated, and brain function was compared with normal controls. / Part II. Markedly reduced nocturnal FBC and impaired brain function were found in enuretic patients. Higher sleep arousal threshold was negatively correlated to lower FBC. Prolonged P300 ERPs and higher PPI of startle amplitude were positively correlated to a higher sleep arousal threshold. / Part III. NE episodes and bladder function were re-evaluated in 52 severely enuretic children (Part II) at 3 and 6 months on treatment. Brain function was re-evaluated in 41/52 enuretic children at 6 months on treatment. / Part III. Post-treatment FBC significantly increased, and sleep arousal threshold, number of awakenings, P300 ERPs latency and PPI of startle amplitude normalized in treatment responders. NE episodes reduction was significantly correlated to the improvement in FBC and brain function. Greater decrease in sleep arousal threshold was positively correlated to higher FBC increase. Higher P300 ERPs latency and PPI of startle amplitude reduction were positively correlated to greater decrease in sleep arousal threshold. / Patients and methods. Part I. Thirty-five children with refractory PNE and 21 normal controls were recruited. Overactive bladder contractions, NE episodes and volume in enuretic children, sleep stages and cortical arousals in all children were recorded. / Results. Part I. Underlying bladder dysfunction, abnormal sleep architecture and increased cortical arousal index were found in enuretic children. Cortical arousal index was positively correlated to the frequency of overactive bladder contractions. / Diao Mei. / "May 2005." / Adviser: Chung-Kwong Yeung. / Source: Dissertation Abstracts International, Volume: 67-07, Section: B, page: 3693. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 135-159). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract in English and Chinese. / School code: 1307.
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Parental Personality Domains and Predicting the Effectiveness of Treatment for Nocturnal EnuresisStapp, Lonnie M. 01 January 2015 (has links)
Worldwide, millions of children 5 years of age and older suffer with nocturnal enuresis,
also known as nighttime bedwetting. Nocturnal enuresis is a chronic elimination disorder
that while usually benign, too often results in the child being emotionally and physically
abused. Efforts to design effective treatments with low relapse rates have thus far been
thwarted by the array of organic and psychosocial variables related to its development.
Guided by the 5-factor theory of personality, this cross-sectional study investigated
whether a parent's personality characteristics significantly predict effective treatment for
a child's nocturnal enuresis. Effective treatment was defined as having no relapses of
symptoms in the 6 months following initial treatment success. A convenience sample of
parents (n = 165) was recruited from the online social network Facebook and other online
educational and support forums for parents seeking information on enuresis. Participants
completed the NEO-FFI-3 to measure their personality characteristics, and logistic
regression analyses were used to determine if parental personality characteristics,
parental history of childhood enuresis, and/or the child's gender were significant
predictors of effective treatment for a child's enuresis. None of these factors were found
to significantly predict effective treatment for enuresis. This study promotes positive
social change by identifying the need for an integrated biopsychosocial approach to
treating children with enuresis with effective evidence-based treatments. These
treatments are expected to result in fewer children exposed to the high rates of abuse and
the development of psychosocial disorders often associated with nocturnal enuresis
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Fodertillgång och stereotypa beteenden under natten hos Asiatisk elefant (Elephas maximus)Olby, Sara January 2011 (has links)
Animals in zoos live in more barren environments than their conspecifics in nature. In nature, elephants spend more than 75 % of the day foraging and have been observed lying down two hours during night. Stereotypies are common in many different species in zoos. Stereotypic behaviors may constitute up to 50 % of the daily activity budget of zoo elephants. Modern zoos try to reduce stereotypic behaviors by means of environmental enrichment. Three elephant cows at Kolmårdens Djurpark were observed during night to map their nocturnal behaviors and see how they changed with feeding enrichment. The elephants were lying down on their sides 25 % of the time observed. With feeding enrichment offered in the morning, the stereotypies was reduced in one individual from 43 % to 13 % (P<0.01) and the foraging was increased in two individuals from 45 % to 80 % (P<0.01) and from 45 % to 64 % (P<0.05). Increased food access increased foraging behavior and as environmental enrichment was able to reduce the stereotypic behaviors in these Asian elephant.
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Estimating Sources of Valley Fever Pathogen Propagation in Southern Arizona: A Remote Sensing ApproachPianalto, Frederick Scott January 2013 (has links)
Coccidioidomycosis (Valley Fever) is an environmentally-mediated respiratory disease caused by the inhalation of airborne spores from the fungi Coccidioides spp. The fungi reside in arid and semi-arid soils of the Americas. The disease has increased epidemically in Arizona and other areas within the last two decades. Despite this increase, the ecology of the fungi remains obscure, and environmental antecedents of the disease are largely unstudied. Two sources of soil disturbance, hypothesized to affect soil ecology and initiate spore dissemination, are investigated. Nocturnal desert rodents interact substantially with the soil substrate. Rodents are hypothesized to act as a reservoir of coccidioidomycosis, a mediator of soil properties, and a disseminator of fungal spores. Rodent distributions are poorly mapped for the study area. We build automated multi-linear regression models and decision tree models for ten rodent species using rodent trapping data from the Organ Pipe Cactus National Monument (ORPI) in southwest Arizona with a combination of surface temperature, a vegetation index and its texture, and a suite of topographic rasters. Surface temperature, derived from Landsat TM thermal images, is the most widely selected predictive variable in both automated methods. Construction-related soil disturbance (e.g. road construction, trenching, land stripping, and earthmoving) is a significant source of fugitive dust, which decreases air quality and may carry soil pathogens. Annual differencing of Landsat Thematic Mapper (TM) mid-infrared images is used to create change images, and thresholded change areas are associated with coordinates of local dust inspections. The output metric identifies source areas of soil disturbance, and it estimates the annual amount of dust-producing surface area for eastern Pima County spanning 1994 through 2009. Spatially explicit construction-related soil disturbance and rodent abundance data are compared with coccidioidomycosis incidence data using rank order correlation and regression methods. Construction-related soil disturbance correlates strongly with annual county-wide incidence. It also correlates with Tucson periphery incidence aggregated to zip codes. Abundance values for the desert pocket mouse (Chaetodipus penicillatus), derived from a soil-adjusted vegetation index, aspect (northing) and thermal radiance, correlate with total study period incidence aggregated to zip code.
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Trabalho noturno: representações sociais de enfermeiras de um hospital público de ensinoVeiga, Kátia Conceição Guimarães January 2009 (has links)
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Previous issue date: 2009 / Estudo de caso, descritivo e analítico, com abordagens quantitativa e qualitativa, fundamentado na Teoria das Representações Sociais e na Teoria do Núcleo Central, com o objetivo de apreender as representações sociais (RS) das enfermeiras de um hospital público de ensino, na cidade de Salvador-Bahia, sobre o trabalho noturno (TN) e analisar o processo de construção dessas RS a partir de sua estrutura. Participaram deste estudo 25 enfermeiras (89,3%) do serviço de assistência intermediária. Os dados foram coletados através das técnicas de Associação Livre de Palavras (TALP) e entrevista, em abril e maio de 2008. Os dados originários do TALP foram submetidos à análise fatorial de correspondência (AFC), pelo Software Tri-Deux Mots, e à análise do quadro de quatro casas, através do Software EVOC, e os da entrevista, à análise temática de conteúdo. A análise do quadro de quatro casas evidenciou que a estrutura da RS tem como elementos centrais responsabilidade, árduo, estresse, sofrimento e autonomia, e, como elementos periféricos, ética, necessidade financeira, dupla jornada, sobrecarga e iniciativa. A AFC revelada no jogo de oposições demonstrou no Fator 1 que as enfermeiras que trabalham nos turnos diurno e noturno simultaneamente estão em oposição às enfermeiras que trabalham no diurno e que tem um vinculo empregatício, evidenciando uma oposição entre os turnos de serviço. Diante disso, apreendeu-se das primeiras, as seguintes representações: estressante, autonomia, sofrimento, cansativo, dupla jornada e responsabilidade. Para essas últimas, o universo semântico presentado foi: dificuldade, dedicação, sacrifício, desgastante e dedicação. Em relação ao Fator 2, o procedimento de análise baseou-se na idade x tempo de serviço: as enfermeiras com idade igual ou maior que 41 anos e tempo de serviço superior a 20 anos, apresentou os seguintes campos semânticos: necessidade, sacrifício, dedicação, autonomia, dedicação, desgastante e dupla jornada; às evocações das enfermeiras com idade entre 30 e 40 anos e tempo de serviço de 10 a 19 anos foram: sofrimento, administração, continuidade, conhecimento, dificuldade e responsabilidade. A análise temática de conteúdo originou cinco categorias simbólicas, Concepções do TN (27,2%), Dimensão Ontológica do TN (16,7%), Aspectos Psicoafetivos do TN (20,6%), Viabilidade do TN (22,8%) e Valorização do TN (12,7%). Estes resultados conduzem à necessidade de reflexão das enfermeiras sobre essas representações para o desenvolvimento de estratégias de trabalho que contribuam com políticas de pessoal considerando a especificidade, subjetividade e complexidade do TN, com um modelo de prática inovadora, valorizando o TN e a trabalhadora, o enfrentamento dos problemas cotidianos e propiciando novas investigações para aprofundamento dessa temática. / Salvador
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The development and use of the bedwetting alarm for nocturnal enuresisTepper, Ute Hedwig 12 1900 (has links)
Since 1904 bedwetting alarms have been developed and scientifically
described for the treatment of nocturnal enuresis, also known as
bedwetting. Currently, several bedwetting alarms of various designs are
available on the overseas market. These can be imported to South
Africa at great cost. As affordable alarms were not readily available in
South Africa, there was a need to develop and evaluate a new unit.
In order to improve the efficacy of this new device, it was accompanied
by detailed user guidelines and instructions. The use of this alarm was
tested and the observations of thirteen bedwetting children recorded.
Additionally, a programme was developed to counsel enuretic children
with accompanying problems, and to assist the parents in dealing with
their child's bedwetting problem. The observations and findings will
be useful in practice and future research. / Psychology of Education / M. Ed. (Educational Psychology - Specialisation in Guidance and Counselling)
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Atenuação do descenso noturno na predição do início da albuminúria em diabéticos tipo 1 / Attenuation of night dreams in the prediction of the beginning of albuminuria in diabetics type 1Silva, Bruno Alves 23 February 2018 (has links)
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Previous issue date: 2018-02-23 / A presença de albuminúria constitui fator prognóstico desfavorável nos pacientes diabéticos do tipo 1 e precede a elevação da PA de consultório em três anos. A monitorização ambulatorial de pressão arterial (MAPA) pode identificar a atenuação ou desaparecimento do descenso noturno, o que prediz o risco cardiovascular, independentemente da pressão arterial de 24 h. Entretanto, apenas um estudo avaliou o papel preditivo da atenuação do descenso noturno para o desenvolvimento da albuminúria no diabetes do tipo 1. Assim, o objetivo do corrente trabalho é de avaliar, em coorte brasileira, se o descenso noturno atenuado pode predizer o desenvolvimento de albuminúria no diabetes do tipo 1. Foi realizado estudo observacional prospectivo que visou avaliar o poder preditivo da ausência ou atenuação do descenso noturno em relação ao surgimento de albuminúria em pacientes diabéticos tipo 1 normoalbuminúricos. Os pacientes foram submetidos à MAPA e dosada a albuminúria por mais de 2 vezes. Ao cabo de um ano a albuminúria foi reavaliada. A frequência de evolução para albuminúria ente os pacientes com descenso noturno ausente/atenuado ou presente foi comparada pelo teste de Fisher. As médias de pressão arterial (PA) foram comparadas por teste "t" para amostras independentes. Foi realizada regressão linear para avaliar a associação entre descenso noturno e elevação da albuminúria no seguimento. O nível de significância foi estabelecido em 5 %. Foram avaliados 24 pacientes com idade de 24 ±8,2 anos, seis pacientes do sexo masculino. Seis pacientes tinham descenso noturno presente para PA sistólica (PAS) (média de PAS em 24 h: 119±7,5mmHg) destes, apenas um evoluiu para albuminúria. Dos 18 que tinham descenso noturno atenuado para PAS (média de PAS em 24 h: 122±8,4mmHg; p=0,36 em relação aos pacientes descenso noturno presente), 14 evoluíram para albuminúria (p=0,01). Em relação à PA diastólica (PAD), 12 pacientes tinham descenso noturno presente (média de PAD em 24 h: 72±5,2mmHg), destes, 6 evoluíram para albuminúria. Dos outros 12 que tinham descenso noturno ausente (média de PAD em 24 h: 74±5,6mmHg; p=0,31 em relação aos pacientes com descenso noturno presente), 9 evoluíram com microalbuminúria (p=0,40). A porcentagem de descenso noturno da PAS apresentou coeficiente de correlação com a variação da albuminúria de 0,40; p= 0,061. A porcentagem de descenso noturno da PAD apresentou coeficiente de correlação com a variação da albuminúria de 0,46; p=0,027. Em conclusão, a evolução para albuminúria associou-se à classificação descenso noturno atenuado para PAS, mesmo com PAS em 24 horas normal. Ou seja, a atenuação do descenso noturno para PAS precedeu o início da nefropatia diabética incipiente no diabetes do tipo 1. Estes resultados ressaltam a importância da realização da MAPA no momento do diagnóstico, e no seguimento, dos pacientes diabéticos tipo 1. / The presence of albuminuria constitutes an unfavorable prognosis in type 1 diabetic patients and precedes an increase in office BP in three years. Ambulatory blood pressure monitoring (ABPM) can identify an attenuation or disappearance of noc-turnal descent, which predicts cardiovascular risk, regardless of blood pressure of 24 h. There is no type 1 diabetes. Thus, the objective of the current evaluation work, in a Brazilian cohort, whether the attenuated nocturnal decline may predict the devel-opment of albuminuria in type 1 diabetes. A prospective observational study was carried out to evaluate the predictive power of the absence or attenuation of the noc-turnal descent in relation to the appearance of albuminuria in type 1 diabetic normoalbuminuric patients. The patients were submitted to ABPM and dosed albu-minuria by more than 2 times. After one year and albuminuria for reassessment. The frequency of progression to albuminuria in patients with absent / attenuated or pre-sent nocturnal descent was compared by Fisher's test. Blood pressure (BP) averag-es were compared by "t" test for independent samples. Linear regression was per-formed to evaluate an association between nocturnal descent and elevated albumi-nuria at follow-up. The level of significance was set at 5%. Twenty-four patients, aged 24 ± 8.2 years, six male patients were evaluated. Six pa-tients had a nocturnal decrease in systolic BP (SBP) (mean SBP in 24 h: 119 ± 7.5 mmHg), only one had progressed to albuminuria. Of the 18 patients who had an at-tenuated nocturnal decrease in SBP (mean SBP at 24 h: 122 ± 8.4 mmHg, p = 0.36 in relation to the patients present at night), 14 developed albuminuria (p = 0.01). In relation to the diastolic BP (DBP), 12 patients had nocturnal decrease present (mean DBP in 24 h: 72 ± 5.2 mmHg), of these, 6 evolved into albuminuria. Of the 12 others who had a nocturnal descent absent (mean PAD at 24 h: 74 ± 5.6 mmHg, p = .31 compared to patients with nocturnal decrease), 9 developed microalbuminuria (p = 0.40). The percentage of nocturnal SBP decrease had a correlation coefficient with albuminuria variation of 0.40; p = 0.061. The percentage of nocturnal decrease in DBP presented a correlation coefficient with albuminuria variation of 0.46; p = 0.027. In conclusion, the progression to albuminuria was associated with an attenuated nocturnal descent for SBP, even with SBP at normal 24 hours. That is, attenuation of nocturnal descent into SBP preceded the onset of incipient diabetic nephropathy in type 1 diabetes. These results suggest that ABPM should be performed at the time of diagnosis and follow-up of type 1 diabetic patients.
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Investigação da camada limite planetária noturna na região metropolitana de São Paulo utilizando o modelo LES / Investigation of the nocturnal boundary layer in the Metropolitan Region of São PauloEduardo Wilde Bárbaro 23 August 2010 (has links)
O presente trabalho tem como objetivo investigar a evolução temporal e espacial da camada limite planetária (CLP) na cidade de São Paulo durante o período noturno, utilizando o modelo LES. Foram simulados os campos tridimensionais das três componentes da velocidade do vento, temperatura potencial e concentração de monóxido de carbono (CO). Três propriedades da CLP noturna em São Paulo foram analisadas: a) Altura da CLP estável (CLE); b) Jatos de baixos níveis (JBN); c) Dispersão turbulenta de CO. Foi analisado também o ciclo diurno dos fluxos turbulentos de calor sensível e de CO na superfície. Inicialmente foi desenvolvido um procedimento de validação para avaliar o desempenho do modelo LES na simulação das propriedades da CLP convectiva, neutra e estável, utilizando como referência os resultados de simulações consagrados na literatura. A validação foi realizada comparando os perfis verticais médios de velocidade horizontal, temperatura potencial, variância das componentes da velocidade e as componentes da equação do balanço de energia cinética turbulenta (ECT). Os resultados dessa comparação indicam que o modelo LES atual é capaz de reproduzir todas as características dos processos turbulentos destes escoamentos. Foram realizados quatro experimentos numéricos com o intuito de investigar a evolução diurna da CLP para a situação de inverno em São Paulo, usando como condições de contorno, valores horários médios mensais de temperatura potencial e concentração de monóxido de carbono observados em superfície durante o mês de junho em São Paulo. Esses experimentos utilizaram também como condição de contorno a situação média nos dias de céu claro (sem nuvem) no mês de junho em São Paulo. O impacto da intensidade do vento também foi analisado especificando-se como forçante externa o vento geostrófico igual a 5 m/s e 10 m/s de oeste. Os dados utilizados neste trabalho foram medidos na plataforma micrometeorológica do IAG-USP (temperatura do ar e fluxo turbulento de calor sensível) e na estação Lapa da CETESB (concentração de monóxido de carbono e velocidade do vento). Os resultados destas 4 simulações indicam que a altura da CLE foi simulada pelo modelo LES de forma consistente com as forçantes e condições de contorno usadas, indicando que durante o mês de junho em São Paulo a altura da CLE varia entre 100 m e 275 m (médias) e 62 m e 203 m (dias de céu claro). Verificou-se também que a turbulência da CLE é mantida pela produção mecânica de ECT e dissipada majoritariamente pela destruição térmica. A dissipação molecular tem um papel secundário e o transporte turbulento não afeta as propriedades da CLE. Os resultados indicam que as formulações empíricas utilizadas neste trabalho são capazes de reproduzir de forma equivalente a ordem de magnitude da altura da CLE simulada para São Paulo. O melhor resultado foi obtido com h = 700 u*. As simulações do JBN indicaram que para São Paulo o mecanismo de ajuste inercial gera máximos da ordem de 7,1 m/s em torno de 210 m as 05:30 HL (forçante de 5 m/s) e de 14,5 m/s em torno de 420 m e as 05:30 HL (forçante de 10 m/s). Foi observada uma intensificação da turbulência acima do topo da camada estável. A evolução espacial e temporal da concentração de CO simulado pelo modelo LES apresenta um padrão de dispersão turbulento compatível com o esperado para o inverno em São Paulo. Finalmente, o modelo LES é capaz de reproduzir as principais características da evolução diurna do fluxo de calor sensível e de monóxido de carbono da superfície observados no mês de junho na cidade de São Paulo. / The main objective of this work is to investigate the temporal and spatial evolutions of the planetary boundary layer (PBL) in the city of São Paulo during the nighttime period, using a large-eddy simulation (LES) model. It was simulated the 3-dimensional fields of the three components of the wind speed, potential temperature and carbon monoxide concentration. Three properties of nocturnal PBL were investigated: a) PBL depth; b) Low level jet (LLJ) and c) Turbulent dispersion of CO. The diurnal evolution of the turbulent fluxes of sensible heat and CO was also analyzed. Initially, a validation procedure was carried considering the performance of LES model in to simulate the behavior of the PBL for convective, neutral and stable conditions using as reference simulation results available in the literature. The validation was performed by comparing the mean vertical profiles of horizontal wind, potential temperature, variance of wind speed components and the turbulent kinetic energy (TKE) equation components. They indicated that the actual version of LES model is capable to simulate the entire cycle of the PBL diurnal evolution over a homogeneous and flat surface. Once validated, the LES model was applied to simulate the PBL for a complete diurnal cycle over a flat and homogeneous surface with aerodynamic roughness length representative of a typical urban area of São Paulo. Four simulations were designed to investigate the nighttime PBL evolution for winter conditions in São Paulo, using as input, monthly average hourly values of potential temperature and monoxide carbon observed at the surface during June in São Paulo. The mean condition for clear sky days observed in June in São Paulo was also considered as input in these simulations. The impact of wind intensity was also analyzed by considering as the external forcing in these simulations a constant background geostrophic wind of $5$ and $10 ms^{-1}$ from West. The dataset used in this work was observed in the micrometeorological platform of IAG (air temperature and sensible heat flux) and at the surface station of environmental agency of the state of São Paulo (CETESB) locate at Lapa (CO and wind speed). The results indicate that the height of stable PBL was simulated consistently with the boundary conditions and external forcing, indicating that during June the in São Paulo the PBL height may vary from 100m (mean condition) and 62m (clear days condition) at the beginning of the night to 275m (mean condition) and 203m (clear sky conditions) at the end of nighttime. It was verified that the turbulence in the Stable PBL is maintained by the mechanical production of TKE and dissipated, mainly, by the negative thermal production. Molecular dissipation has a secondary role and turbulent transport of TKE does not affect the stable PBL. All the empirical formulations used here reproduced the order of magnitude of the stable PBL height. The best performance was obtained by $h = 700 u_*$ and $h = 0.5 \\sqrt{\\frac{u_* L}{\\left|fight|}}$. The simulated nocturnal LLJ indicated that for São Paulo the inertial oscillation yields a maximum intensity is $7.1 ms^{-1}$ at $210m$ and 05:30LT (forcing of $5 ms^{-1}$) and $14.5 ms^{-1}$ at $420m$ at 05:30LT (forcing of $10 ms^{-1}$). In both cases the LLJ intensified the turbulence at the top of the stable PBL. The simulated spatial and temporal evolution of the carbon monoxide concentration shows a pattern of turbulent dispersion consistent with the expected one for winter time in the city of São Paulo. Finally, LES model is able to reproduce the main features of the diurnal evolution of turbulent sensible heat and carbon monoxide fluxes at the surface for São Paulo during the winter.
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Avaliação da qualidade de vida em crianças com enurese noturnaRangel, Raquel do Amaral 27 July 2009 (has links)
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Previous issue date: 2009-07-27 / A enurese noturna é uma desordem crônica que gera inúmeros problemas para a criança e seus pais e afeta cerca de 10% das crianças de sete anos de idade. O molhar a cama tem impactos negativos significantes, na auto estima e performance das crianças. O objetivo do presente estudo foi avaliar a qualidade de vida de crianças enuréticas, bem como sua associação com sexo e idade. Crianças enuréticas e crianças não-enuréticas responderam ao questionário AUQEI. Participaram do estudo 88 crianças, sendo 39 enuréticas (23 meninos) e 49 nãoenuréticas (27 meninos), com idade entre 6 e 11 anos de idade. As crianças enuréticas apresentaram prejuízo da qualidade de vida quando comparadas às crianças não enuréticas (35,9% x 16,3%, p=0,035). Não foram encontradas diferenças significativas, nas associações entre sexo e qualidade de vida e idade e qualidade de vida. Esses resultados sugerem que, as crianças com enurese noturna, têm 187% a mais de chances de ter prejuízo na qualidade de vida, quando comparadas com crianças não enuréticas. / Nocturnal enuresis is a chronic disorder that generates countless problems to the child and their parents affecting about 10% of seven-year-old children. “Bedwetting” has significantly negative impacts on the self-esteem and the performance of children. The aim of the current study is to assess the quality of like in enuretic children, as well as its association to sex and age. Enuretic and non-enuretic children answered the “AUQEI” questionnaire. The total number of participants was 88, 39 of which were enuretic (23 boys), and 49 non-enuretic (27 boys), from ages between 6 and 11. Enuretic children displayed loss in quality of life when compared to nonenuretic (35,9% x 16,3%, p=0,035). No significant differences were found, in the association of sex, gender and quality of like. These results suggest that, children with nocturnal enuresis have 187% more chances of having loss in quality of life, when compared to non-enuretic ones.
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