During the initial heating of hydraulically bonded castable refractories, dehydration of cement phases causes build-up of high levels of internal steam pressure. If this pressure exceeds material strength, explosive spalling results. A probe capable of measuring internal steam pressures"in-situ" has been developed and tested. Correlation of cement calorimetry and pressure data suggests that castable heating schedules can be modified to reduce explosive spalling. / Master of Science

In geotechnical engineering, it has proven difficult to obtain reliable soil parameters for stiff clays. Laboratory testing results are often scattering due to the fissures and slickensides in these soils. Alternatively, in situ techniques offer a means to test the soils in place. This study focuses on in situ testing in Miocene stiff clays using an advanced nine strain arm self-boring pressuremeter (SBPM). This device was used to test the soils in both a self-boring and a simpler, non-boring mode (pre-bored or PBPM tests). The Miocene stiff clay was unique in that was sensitive and lacked of fissures and slickensides. The pressuremeter results could be compared to a range of other tests previously performed at the site. It is concluded that the SBPM provides accurate values of modulus and strength. Minor soil disturbance was found to have little effect when it could be anticipated. The simpler PBPM tests were not successful because of disturbance caused by borehole preparation. / Ph. D.

Call number: LD2668 .T4 1985 S99 / Master of Arts

published_or_final_version / Applied Geosciences / Master / Master of Science

L'hypertension artérielle (HTA) est un problème de santé sérieux qui affecte 22% des canadiens et dont les complications sont nombreuses. Ces complications peuvent être diminuées par un diagnostic précoce et un traitement efficace et plusieurs auteurs affirment que l'exactitude de la mesure de la pression artérielle (PA) est la pierre angulaire pour établir le diagnostic et assurer un suivi adéquat. Quoique cette mesure soit réalisée très fréquemment, des études réalisées ailleurs qu'au Québec indiquent que les connaissances des infirmières à l'égard de la mesure de la PA sont insuffisantes pour des éléments reconnus comme ayant une influence significative sur les résultats de la mesure de la PA. À notre connaissance, aucune étude concernant les connaissances des infirmières n'a été publiée au Canada. Cette étude a donc pour but de décrire les connaissances théoriques et pratiques des infirmières pour la mesure de la PA en regard des recommandations du Programme éducatif canadien pour le contrôle de l'hypertension artérielle (2004) et comparer les relations entre ces variables. Une enquête par questionnaire auto administré pour décrire les connaissances théoriques ainsi qu'une observation directe par échantillonnage exhaustif pour décrire les connaissances pratiques ont été utilisées pour un premier échantillon de 50 infirmières. Une enquête postale transversale par échantillonnage aléatoire a été utilisée pour décrire les connaissances théoriques auprès d'un deuxième échantillon de 307 infirmières. Les outils ont été testés pour leur validité et leur fidélité dans le cadre de cette étude. L'étude a été approuvée par le comité d'éthique du centre de recherche clinique du CHUS. Les résultats quant aux données sociodémographiques démontrent que les infirmières ayant participé à l'une ou l'autre partie de l'étude sont semblables aux autres infirmières du Québec à l'égard du genre, de l'âge, du type d'emploi et de l'expérience. Elles sont toutefois statistiquement différentes pour le niveau de formation. Le score obtenu par les infirmières des deux échantillons pour le questionnaire sur les connaissances théoriques est de moins de 60%. On peut donc conclure qu'il existe des lacunes importantes en regard des connaissances théoriques acquises. Par ailleurs, ces infirmières croient dans de très fortes proportions posséder les connaissances théoriques et pratiques nécessaires à une mesure exacte de la PA. Pour les connaissances pratiques, le score global des infirmières est de 38%. Force est de croire que malgré le processus de mise à jour annuel et d'implantation des recommandations canadiennes, les connaissances pratiques des infirmières ne sont pas équivalentes au contenu de ces recommandations. Les infirmières qui détiennent un niveau de formation supérieur, celles qui ont lu les recommandations et celles qui ont suivi une formation continue sur la mesure de la PA obtiennent de résultats légèrement supérieurs aux autres infirmières. Considérant la fréquence avec laquelle les infirmières mesurent la PA et l'impact que peut avoir une mesure inexacte, il est important d'entreprendre dès maintenant des actions concrètes pour améliorer cette situation en mettant en place des formations continues régulières sur le sujet et en s'assurant que les programmes de formation initiale incluent une formation théorique et pratique fondée sur les recommandations en vigueur. Il semble également crucial de stimuler l'implantation des recommandations du PECH auprès des infirmières et d'évaluer l'impact de ces mesures par la suite.

Analysis of care in patients at risk for arterial hypertension in pharmacy IV. Author: Lada Kotlanová Tutor: PharmDr. Josef Malý, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague Introduction and aim: Arterial hypertension (AH) belongs due to its pressure and atherosclerotic complications among very serious global health problems. The main goal of the therapy of AH is to prevent these complications, comprising early diagnosis and proper treatment plan. The aim of the study was to realize counselling in a pharmacy focused on clients with the risk of AH or already diagnosed AH. Metodology: Data were collected in a community pharmacy in Kralovice from September 2014 to January 2015. Prior to blood pressure measurement, the controlled interview was conducted with each client using special form which enabled to obtain important data from clients' history. Following data were obtained: socio-demographic characteristics of each client; their relationship to blood pressure measurement; risk factors of AH or atherosclerosis, respectively; disease history and use of drugs including food supplements. Results of blood pressure measurement, proposed intervention, or drug related problems were also subsequently recorded into the form thus...

Analysis of care in patients at risk for arterial hypertension in pharmacy III. Author: Petra Smíšková Tutor: PharmDr. Josef Malý, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague Introduction: Arterial hypertension belongs to the most common diseases of cardiovascular system, not only in the Czech Republic. Therefore it is very important to focus on its prevention and early diagnostics before the stage of health complications shows up. Objectives: The aim of this thesis was to realize and evaluate consulting activities in pharmacy focused on patients who have high risks of arterial hypertension or have been already diagnosed with it. Methodology: Data were collected in a public pharmacy in Prague from the end of April 2013 until the beginning of April 2014. The actual blood pressure measurement was preceded by obtaining of answers to selected questions through controlled interview. Acquired statements were written into the printed forms. It was focused on particicipant's socio-demographic characteristics, his relationship to the blood pressure measurement; occurrence of risk factors of arterial hypertension, it means atherosclerosis; disease in the anamnesis and the usage of drugs including food supplements. The results of blood...

A Thesis presented to the Department of Geophysics of the University of the Witwatersrand, Johannesburg / Violent failure of the rock surrounding under ground excavations forms a major hazard and obstacle in deep-level mining. (Abbreviation abstract) / AC 2018

O diagnóstico, controle e prevenção das doenças cardiovasculares, dentre elas a Hipertensão Arterial, dependem obrigatoriamente da obtenção de valores de pressão arterial precisos. Para isso, é fundamental que a medida da pressão arterial seja realizada de maneira correta, padronizada e com aparelhos calibrados, para subsidiar condutas multidisciplinares assertivas e garantir a segurança do paciente. A literatura traz evidências de que o conhecimento dos profissionais de saúde está aquém das recomendações de diretrizes, e a prática nem sempre cumpre todas as etapas da técnica. Estudos sugerem que esse problema pode estar relacionado à formação profissional, com evidências de falhas no conhecimento teórico e prático entre estudantes da área da saúde. Por outro lado, exige-se do profissional, principalmente em Terapia Intensiva, conhecimentos e habilidades complexas, que incluem manuseio de equipamentos, materiais e medicamentos de alto custo, o que por vezes, se traduz em sobrecarga de trabalho, e execução de rotinas de forma automatizada. Partindo da hipótese de que uma intervenção educativa pode melhorar o conhecimento, e assim, favorecer a prática isenta de erros, o presente estudo avaliou o efeito de uma intervenção educativa sobre o conhecimento teórico e prático de profissionais de enfermagem (n=31) de Unidade Coronariana, relativos à medida indireta da pressão arterial, num hospital-escola no interior paulista. Trata-se de um estudo quasi- experimental, do tipo antes e depois, para determinar o conhecimento prático, utilizou- se check list validado, que avaliou a execução da técnica em simulação clínica. Para o conhecimento teórico, optou-se por elaborar e validar um questionário para a população de profissionais de enfermagem de Unidade Coronariana, por meio de um estudo metodológico de validação de conteúdo, semântica e pré-teste, pelo método DISABIKIDS®. A etapa de validação produziu um questionário de conhecimento teórico da medida indireta da PA, com 28 questões, sendo 8 de caracterização sociodemográfica, e 20 relativas às etapas da medida indireta da PA, baseadas nas principais diretrizes disponíveis. Em seguida, implementou-se a intervenção educativa, com estratégias expositivo-dialogadas, baseadas na Teoria do Arco de Maguerez, com a observação da realidade na prática simulada. Os resultados evidenciaram melhora estatisticamente significante no conhecimento teórico e prático após a intervenção, nas etapas de Preparo do cliente, Preparo do ambiente, Posição do cliente, Cuidados com os aparelhos, e Obtenção e Registro dos valores (p<0.05). Resultados indicaram que algumas etapas da medida indireta da pressão arterial são mais valorizadas na prática, em detrimento do respectivo conhecimento teórico. Por outro lado, há etapas cujo conhecimento teórico é satisfatório, porém a prática foi discrepante. O questionário validado nesse estudo representa um instrumento viável para estudos que visem determinar conhecimento teórico da medida indireta da pressão arterial em profissionais de saúde, em todos os níveis de atenção. A melhoria do conhecimento foi efetiva na teoria e na pratica simulada. Etapas voltadas à Posição do Cliente parecem estar sendo executadas de forma automatizada, enquanto que etapas voltadas à Checagem da calibração, Medida da circunferência braquial, Anotação sem arredondamento de valores, podem estar sendo negligenciadas, até mesmo por sobrecarga de rotinas, e necessitam especial atenção nas intervenções educativas e supervisão diária. A utilização da simulação contribuiu fortemente para o cumprimento dos objetivos propostos, proporcionou ao participante a oportunidade de autoavaliação, de maneira espontânea, e foi o canal de discussões sobre problemas da prática da medida indireta da pressão arterial. Discutiu-se a importância da medida indireta da pressão arterial isenta de erros, a responsabilidade individual, que deve contemplar o conhecimento sobre prazos de calibração de aparelhos. Além disso, discutiu-se o papel da instituição na busca de rotinas padronizadas e políticas voltadas à gestão de equipamentos. Diante desses achados, entende-se que uma intervenção educativa sobre a medida indireta da pressão arterial, voltada aos profissionais da saúde, aplicada de maneira sistemática, com periodicidade alinhada às diretrizes, representa grande possibilidade de melhoria do conhecimento, fornece subsídios para melhoria da qualidade da assistência, para os clientes e seus familiares, merecedores de todos os esforços possíveis na busca e obtenção da assistência e promoção do cuidado seguro e isento de erros / The diagnostics, prevention and control of cardiovascular diseases, among them arterial hypertension, depends wholesomely in obtaining precise blood pressure values. For this reason, it is paramount that blood pressure be measured correctly, in a standardized manner, and by using calibrated monitors and apparatuses to allow assertive multidisciplinary actions and guarantee patient safety. Medical literature brings evidence that health professional knowledge falls short of the necessary recommendations and directives, and procedures not always fulfill all technique requirements. Studies suggest that this problem might relate to professional qualification, attesting to some flaws in theoretical and practical understanding among health care students. On the other hand, it is demanded from the health professional, especially in Intensive Care Units, a complex understanding of abilities and knowledge, which include the handling of intricate machines, materials and high cost medication, frequently leading to work overload and the automated execution of work routines. Bearing in mind that an educational intervention might improve overall comprehension and understanding, thus, favoring error-free practices, this current study has evaluated the effects of an educational intervention on the theoretical and practical knowledge of nursing health professionals (n=31) in a Coronary Unit, concerning indirect blood pressure measurement in a teaching hospital in the state of São Paulo. It is a quasi- experimental study, type before and after, to determine practical knowledge, a validated checklist was used to evaluate technique execution under clinical simulation. For theoretical knowledge, a questionnaire was elaborated and validated for our Coronary Unit health professionals thought content validation, methodological studies, semantics and pre-tests using DISABIKIDS(TM) method. Validation stage produced a 28-question questionnaire of theoretical knowledge for indirect blood pressure measurement comprising 8 questions on social-demographics and 20 on indirect blood pressure measurement sequence, based upon the main available directives. Following this stage, an educational intervention with dialogue-expository strategies was implemented based upon Maguerez Arch Theory by observing reality in our simulated practice. The results evidenced statistically significant improvement in practical and theoretical knowledge following intervention in these stages: Client preparation, Environment preparation, Client positioning, Monitors and apparatus upkeep, Value registration and acquisition (p<0.05). Results indicate that some stages of blood pressure measurement are overvalued in practice, in detriment of acquired theoretical instruction. On the other hand, there are stages whose theoretical knowledge is satisfactory, but their practice discrepant. The validated questionnaire in this study represents a viable instrument for studies aimed at determining theoretical knowledge in indirect blood pressure measurement by health care professionals encompassing all their levels of action. Knowledge improvement was effective both in theoretical and simulated practices. Stages related to Client positioning seem to have been carried out mechanically, while stages related to Calibration check, Brachial circumference measurement, Non-rounded-value annotations might have been neglected by routine work overload, and require special attention during educational interventions and daily supervision. The use of simulation has strongly contributed to the fulfillment of the proposed objectives, allowed the participants to spontaneously evaluate themselves and was a channel of discussion about practical problems in indirect blood pressure measurement. The importance of error-free indirect blood pressure measurement was discussed, along with the health professional responsibility which must also contemplate knowledge about apparatus calibration frequency. Furthermore, the role of the institution was discussed in the search for standardized policies concerning equipment management. In the light of such findings, it can be understood that an educational intervention about indirect blood pressure measurement aimed at health professionals, systematically applied, frequency-aligned with the ongoing directives represents great possible knowledge improvement, subsidizes improvement in quality assistance for clients and their families, the well-deserving recipients of all possible efforts for high quality assistance and error-free health care

A medida da pressão arterial é um procedimento fundamental para o diagnóstico e controle da hipertensão arterial. O objetivo do presente estudo foi identificar como é realizado o procedimento de medida indireta e registro da pressão arterial por profissionais de enfermagem. Trata-se de estudo quantitativo, observacional, de delineamento transversal. A amostra foi composta por 80 servidores lotados em cinco Unidades de Saúde do município de Londrina-Paraná, sendo 25 (31,3 %) enfermeiros, 24 (30%) técnicos de enfermagem e 31 (38,8 %) auxiliares de enfermagem. Para avaliar como os participantes realizam a medida indireta da pressão arterial, utilizamos como referência um instrumento formulado a partir das etapas para a medida da pressão descritas nas VI Diretrizes Brasileiras de Hipertensão. O registro do procedimento foi avaliado a partir de instrumento construído com base nas recomendações para registros de enfermagem do Conselho Regional de Enfermagem de São Paulo. Também identificamos a qualidade dos dispositivos utilizados para a medida da pressão arterial. Os resultados mostraram altos índices de \"não realização\" (93,8% a 100%) das etapas referentes ao preparo do paciente para a medida da pressão. As etapas relacionadas diretamente à obtenção do valor pressórico apresentaram índices de 3,8% a 100% na categoria \"incorreta\", sendo os piores resultados relacionados a inflação e deflação da bolsa de borracha. As etapas: \"obter a circunferência braquial no ponto médio do braço\" e \"selecionar manguito de tamanho adequado à circunferência do braço\" não foram realizadas por 100% e 96,3% dos participantes, respectivamente. Na sua totalidade, os profissionais se limitaram a registrar o valor da pressão arterial e, na maioria das anotações, não houve identificação do participante pelo registro profissional (96, 3%) ou pela assinatura (93,8%) e não há referência ao horário da anotação (70,9%). Em relação aos equipamentos, a calibração não é aferida na rotina dos serviços e não há disponibilidade de manguitos de tamanhos variados. Esses achados permitem concluir que há importantes lacunas relacionadas à prática adotada pela equipe de enfermagem para a medida da pressão arterial, indicando a necessidade de implementação de medidas educativas / Blood pressure measurement is an essential procedure to the diagnosis and control of hypertension. The aim of this study was to identify how the indirect measurement and recording of blood pressure was performed by members of the nursing profession. This is a quantitative, observational and cross-sectional study with a sample comprised of 80 professional workers from five different Health Centers in the municipality of Londrina, Paraná. Among these professional workers, twenty-five (31,1%) were nurses, 24 (30%) were nurse technicians and 31 (38,8%) were auxiliary nurses. In order to assess the way the participants performed the indirect measurement of blood pressure, a tool which is based on the steps proposed by the 6th Brazilian Guidelines for Hypertension for BP readings was used. In order to assess the recordings made by the workers, it was used a tool which is based on the recommendations put forward by the São Paulo Regional Board of Nursing for recordings in this field. The quality of the devices used for BP measurement was also inspected. The results of this study have showed that a large number of participants (93,8% to 100%) failed to follow the steps concerning the preparation of the patient for the reading. For the steps that were directly related to the measurement of the blood pressure itself, the percentages obtained for the \"incorrect\" category ranged from 3,8% to 100%. The worst results achieved in this case were those related to the inflation and deflation of the rubber bladder. Around 100% of the participants did not contemplate the step \"Obtaining the upper arm circumference at a middle point\" and 96,3% of them did not follow the step \"Choosing the appropriate cuff size for the upper arm circumference\". Most workers only recorded the blood pressure readings, therefore leaving out their professional registers (96,3), their signatures (93,8%) and the time the reading was done (70,9%). The calibration of the devices used in this procedure is not done on regular basis and there is only one size of cuff available. The findings of this study show that there are several important gaps that need to be filled in regard to the procedure adopted by the nursing staff when measuring blood pressure. They also indicate the need to implement professional training