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Ocorrência do vírus dengue em crianças de 0 a 10 anos no município de Manaus, Amazonas, 2008Façanha, Grecilane Palheta, 92-99218-2424 03 May 2010 (has links)
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Previous issue date: 2010-05-03 / During the second half of the twentieth century dengue spread through the tropical and
subtropical regions of the planet, threatening the health of 1/3 of world population. Currently,
the disease causes about 50 to 100 million cases per year, including more than 500 thousand
reported cases of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS),
severe disease. In Latin America, unlike Asia, the severe form is most prevalent in adults,
although recent studies show that it is occurring a shift of gravity to younger age groups,
especially in children under 15 years. In this paper we investigate blood samples from
children aged 0 to 10 years, in which was established by RT-PCR infectious virus serotypes
circulating within the city of Manaus / AM during 2008 in order to Epidemiological aspects of
the occurrence of the virus in childhood. Of the 94 children in the study, sixteen (17.0%) were
positive for dengue and DENV-3 was the only viral serotype identified. There was no
statistically significant association of the result of RT-PCR in relation to sex (p = 0.315). The
average time to diagnosis was 2.8 days (SD ± 0.98). All positive samples wreaked havoc in
the first quarter of 2008. All areas and eleven districts were positive for DENV-3. In
descending order, the neighborhoods that stood out were: Alvorada (18.75%), Compensa and
São José Operário (12.50% each). In this study 83.0% of children examined showed negative
for dengue by RT-PCR suggesting the occurrence of other febrile illnesses that need to be
clarified. / Durante a segunda metade do século XX a dengue se propagou através das regiões tropicais e
subtropicais do planeta, ameaçando a saúde de 1/3 da população mundial. Atualmente a
doença causa cerca de 50 a 100 milhões de casos por ano, incluindo-se mais de 500 mil casos
notificados de dengue hemorrágico (FHD) e síndrome do choque do dengue (SCD), formas
graves da doença. Na América Latina, ao contrário da Àsia, a forma grave é mais prevalente
em adultos, apesar de estudos recentes mostrarem que está ocorrendo um deslocamento da
gravidade para faixas etárias mais jovens, principalmente em menores de 15 anos. Nesse
estudo foram investigadas amostras de sangue de crianças na faixa etária de 0 a 10 anos, nas
quais se estabeleceu através da técnica de RT-PCR os sorotipos virais infectantes circulantes
no espaço urbano de Manaus/AM durante o ano de 2008 com o intuito de apresentar aspectos
epidemiológicos da ocorrência do vírus na infância. Das 94 crianças da casuística, dezesseis
(17,0%) foram positivas para dengue e o DENV-3 foi o único sorotipo viral identificado. Não
foi encontrada associação estatisticamente significante do resultado da RT-PCR em relação ao
sexo (p=0,315). O tempo médio de diagnóstico foi de 2,8 dias (Dp ± 0,98). Todas as amostras
positivas grassaram no primeiro trimestre de 2008. Todas as zonas e onze bairros foram
positivos para o DENV-3. Em ordem decrescente, os bairros que se destacaram foram:
Alvorada (18,75%), Compensa e São José Operário (12,50% cada). No presente estudo 83,0%
das crianças analisadas apresentaram resultado negativo para dengue através do RT-PCR
sugerindo a ocorrência de outras doenças febris que necessitam ser esclarecidas.
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Bedeutung genetischer Varianten für das Auftreten von Herzrhythmusstörungen bei Patienten mit intrakardialem Kardioverter-Defibrillator: Eine Pilotstudie zu kardiologisch relevanten Surrogatmarkern und Prädiktoren von Herzrhythmusstörungen / Relevance of genetic variants for the occurence of cardiac arrhythmias in patients with implantable cardioverter-defibrillator: A pilot study about relevant cardiological surrogate markers and predictors of cardiac arrhythmiasBusse, Stefanie 06 December 2016 (has links)
No description available.
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The effect of state clean indoor air laws on asthma discharges: a multi-state analysisJanuary 2013 (has links)
acase@tulane.edu
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Foreign birth and Cervical Cancer: Screening, HPV Awareness, and Acculturation in California, Stage and Survival in 18 Surveillance Epidemiology and End Results (SEER) RegistriesJanuary 2013 (has links)
Introduction: Previous literature indicates that foreign-born women have lower rates of cervical cancer testing and higher mortality rates when compared to U.S.-born women. Factors that influence receipt of cervical cancer screening among foreign-born women include acculturation and human papillomavirus (HPV) knowledge. Methods: In this cross-sectional study, the 2007 California Health Interview Survey (CHIS) was used to examine the impact of acculturation on cervical cancer screening and HPV knowledge and the 2000-2008 Surveillance Epidemiology and End Results (SEER) database was used to determine differences in stage of diagnosis and survival time. The study population included a total of 3,603,412 foreign-born and 6,749,557 U.S-born women in the CHIS between the age of 18 to 65 and a total of 10,733 U.S.-born and 5,069 foreign-born women in the SEER database. Logistic regression was used to examine the predictors for cervical cancer screening and Cox’s proportional hazards ratios were used to determine the effect of covariates on survival time. Kaplan-Meier survival analysis generated survival curves. Results: Acculturation levels were positively associated with ever having a Pap test, ever hearing about HPV, knowledge that HPV causes cancer and HPV does not cause AIDS, but not with current receipt of a Pap test, knowledge that HPV can be sexually transmitted and that HPV can go away without treatment. Women with low (0.38, (CI, 0.22, 0.66)) and medium (0.50, (CI, 0.39, 0.81) levels of acculturation were less likely to ever receive a Pap test and less likely to ever hear of HPV compared to highly acculturated women. Foreign-born women had a lower risk of death than U.S.-born women. Conclusions: Despite a reported lower risk of death, foreign-born women, particularly those less acculturated, may benefit from targeted interventions to increase cervical cancer screening utilization and general HPV awareness. / acase@tulane.edu
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Study of Malcolm Baldrige Health Care Criteria Effectiveness and Organizational PerformanceJanuary 2013 (has links)
This study investigated the impact of the Malcolm Baldrige Health Care Criteria for Performance Excellence (HCPE) on effectiveness in health care organizational performance. The quality of health care has tremendous social and economic consequences for the United States (U.S.), including lost wages, reduced productivity, higher legal expenses, and lower confidence in the health care system. Increasing health care productivity, efficiency, effectiveness, and quality offers critical means to reducing cost and improving U.S. economic performance, which is an objective of the Affordable Care Act enacted by Congress in 2010. This study compared Malcolm Baldrige National Quality Award recipients to competitors in their geographic markets using Centers for Medicare & Medicaid Services (CMS) performance measures to determine if there was a relationship between the use of the HCPE as a business model and the performance of health care organizations. This study included an analysis comparing 34 hospitals using the HCPE as an organizational business model to 153 hospitals in their geographic markets not using the HCPE. There were 42 CMS measures classified into 2 major categories focused on (1) patient experience measures and (2) clinical processes and outcome measures. The results showed that the study-identified hospitals that used the HCPE had values representing higher performance on all 10 patient experience measures than the non-HCPE hospitals, and that 9 of the 10 measures were statistically significant. Although the group mean differences were not statistically significant, the study results showed that HCPE hospitals had performance outcomes with mean values representing higher performance than the non-HCPE hospitals in 38 of the 42 (90%) of the study measures. These results should provide leadership with confidence that the HCPE serve as a valid model to align organizational design, strategy, systems, and human capital to create long-term effectiveness in an institutionalized high performance culture. / acase@tulane.edu
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Association Between CPOE Adoption Rates and Operating Costs in US HospitalsJanuary 2013 (has links)
acase@tulane.edu
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Carcass characteristics, fatty acids, stearoyl-coa desaturase gene expression and sensory evaluation of calf-fed and yearling-fed angus steersBrooks, Matthew Alan 15 May 2009 (has links)
There is a growing interest in documenting the effect of diet on the ability to convert saturated fatty acids (SFA) to monounsaturated fatty acids (MUFA) by modulating expression of the SCD gene. We propose that if cattle were raised to a constant body weight, their MUFA:SFA ratio will be the same regardless of being calf-fed (CF) or yearling-fed (YF). Twenty-four Angus cattle were acquired for this study. Cattle were slaughtered at weaning at 8 mo of age (SFCF, n=4), eight steers were assigned to the CF group and slaughtered at 12 mo of age (MFCF, n=4) and 16 mo of age (LFCF, n=4). Twelve cattle were assigned to the YF group and slaughtered at 12 mo of age (SFYF, n=4) 16 mo of age (MFYF, n=4) and market weight of 525 kg (LFYF, n=4). Cattle were then statistically analyzed based on time on high energy diet. Fatty acids from digesta, plasma, liver, L. dorsi, and s.c. and i.m. adipose tissue were all analyzed by FAME. In s.c. 18:1 and 16:1 were greatest in LFCF (41.27% and 5.58%, respectively, P = 0.05), and 18:0 and 16:0 did not differ between groups (P > 0.10). MUFA:SFA ratios of s.c. tended to be higher in LFCF animals (1.26) vs. LFYF (1.06, P = 0.10). However, there was no difference seen when comparing CF to YF animals (P = 0.26). MUFA:SFA ratio was higher in i.m. (P = 0.03) and also increased with age (P < .01). A trained sensory panel saw no significant differences between palatability of flavor characteristics of cooked steaks from LFCF, MFYF, or LFYF (P > 0.05). We showed increased SCD gene expression in the LFYF (248.41 to 1528.69 SCD/GAPDH, P = 0.01). Expression was higher in YF (P = 0.04), but their initial deposits of SFA, combined with the lack of SCD expression while on pastures, prevented the MUFA:SFA ratio from increasing at a rate fast enough to change the final ratios in the animal.
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How to re-design Supply Chains more effective when a web sales portal is applied? : Based on a web-sales implementation plan of Spare Parts in the Industrial Electronics IndustryHerrmann, Marc-Julian January 2011 (has links)
The following thesis counteracts the relationship of Supply Chain Design (SCD) and web-sales[1], and concentrates on the overall aim of “How to re-design Supply Chains more effective when a web sales portal is applied?”. In order to clarify this aim, following four research objectives are set: How does e-commerce connect to Supply Chain Design in general? What is required for a successful implementation of e-commerce? What are the costs and benefits by implementing e-commerce? Which potential risk factors in correspondence of the implementation of e-commerce may influence the whole SCD and e-commerce interaction process? Previous studies have not discussed the interaction of e-commerce and supply chain design on operational level at all, which accounts for a large portion of interests these days. When looking at the research objectives they have been solved in three process steps. First of all the general connection of e-commerce and Supply Chain Design had been analysed through an extensive literature review in form of i.e. suitable books and research papers. Results demonstrated that e-commerce helps to support and manage supply chain activities by offering relevant information. The connection between e-commerce and SCD insists of a close gearing. E-commerce helps to support and manage supply chain activities by offering relevant information about what kind of product is demanded, what is available in warehouses, which products are in the manufacturing processes, and which products will enter the physical facilities and customer sites. Following, research objectives two to four had been identified for which a literature review has created a firm basis on the status quo of current research studies. Combined with findings of developing a web-sales implementation plan for a leading group in power and automation technologies this work-out has been used as empirical research on how a real life company is carrying out these objectives. This plan had been worked out on-side the company, data has been obtained through interviews, observations, and internal system data. Requirements for a successful implementation of e-commerce are seen in strategic and organisational planning activities, as well as specific platform conditions. Concerning costs and benefits, monitoring and evaluating improvements, increasing customer satisfaction, and reducing order-cycle times stay in contrast to incidental fixed and variable costs which had been demonstrated through a detailed break-even analysis. Potential risk factors which had been identified can be countervailed through an appropriate risk management. Thirdly, the overall research question of “How to re-design Supply Chains more effective when a web sales portal is applied?” had been solved based on intermediate results of step one and two, combined with the project work-out, providing informative and sufficient data. The result is that in a first step a clear picture of which products and spare parts will be sold has to be defined. Secondly a precisely inventory management - discussing which parts to hold in stock, where to stock them, and how much to hold in stock - needs to be worked out. And thirdly, after analysing the possible and most plausible inventory strategy, possible distribution varieties need to be analysed. The most appropriate solution for the case company is represented in an Inventory-Distribution-Matrix. This research study has created a basis for the business unit of Power Electronics to improve possible efficiency. The knowledge and implementation steps operated for this implementation plan can be used for other business units in Switzerland and can be seen as a decision maker. Therefore this work-out has generated an enormous benefit for the case company. Instead of acting instinctively, decisions are based on qualitative and quantitative methodologies, data collection methods and data analysis techniques, and therefore follow a process strategy. [1]“Web-sales” in this context is associated with selling and buying information, products, or services via computer networks (Strader & Shaw, 1997), in this research study it is identical to “E-commerce”.
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Carcass characteristics, fatty acids, stearoyl-coa desaturase gene expression and sensory evaluation of calf-fed and yearling-fed angus steersBrooks, Matthew Alan 15 May 2009 (has links)
There is a growing interest in documenting the effect of diet on the ability to convert saturated fatty acids (SFA) to monounsaturated fatty acids (MUFA) by modulating expression of the SCD gene. We propose that if cattle were raised to a constant body weight, their MUFA:SFA ratio will be the same regardless of being calf-fed (CF) or yearling-fed (YF). Twenty-four Angus cattle were acquired for this study. Cattle were slaughtered at weaning at 8 mo of age (SFCF, n=4), eight steers were assigned to the CF group and slaughtered at 12 mo of age (MFCF, n=4) and 16 mo of age (LFCF, n=4). Twelve cattle were assigned to the YF group and slaughtered at 12 mo of age (SFYF, n=4) 16 mo of age (MFYF, n=4) and market weight of 525 kg (LFYF, n=4). Cattle were then statistically analyzed based on time on high energy diet. Fatty acids from digesta, plasma, liver, L. dorsi, and s.c. and i.m. adipose tissue were all analyzed by FAME. In s.c. 18:1 and 16:1 were greatest in LFCF (41.27% and 5.58%, respectively, P = 0.05), and 18:0 and 16:0 did not differ between groups (P > 0.10). MUFA:SFA ratios of s.c. tended to be higher in LFCF animals (1.26) vs. LFYF (1.06, P = 0.10). However, there was no difference seen when comparing CF to YF animals (P = 0.26). MUFA:SFA ratio was higher in i.m. (P = 0.03) and also increased with age (P < .01). A trained sensory panel saw no significant differences between palatability of flavor characteristics of cooked steaks from LFCF, MFYF, or LFYF (P > 0.05). We showed increased SCD gene expression in the LFYF (248.41 to 1528.69 SCD/GAPDH, P = 0.01). Expression was higher in YF (P = 0.04), but their initial deposits of SFA, combined with the lack of SCD expression while on pastures, prevented the MUFA:SFA ratio from increasing at a rate fast enough to change the final ratios in the animal.
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Examining the Ontoepistemological Underpinnings of Diversity Education Found in Interpersonal Communication TextbooksJeffries, Tammy L. 01 January 2013 (has links)
This project examines the ontoepistemological underpinnings of diversity education in the field of communication by focusing on the points where diversity, pedagogy and communication intersect. In this study I seek to understand how we come to know what we know about diversity, or the social construction of differentness, and how we share this information with others. I analyzed three popular interpersonal communication textbooks, examining the patterns revealed in the text, in order to address these questions.
This study uses three complimentary methods to reveal the number of occurrences that center on diversity in the text (content analysis), to interpret themes reflected by the patterns discovered in the text (thematic analysis) and a creative twist on the coding process that opens the analysis process to the coders and includes their input as participants to this study (reflexive content analysis). The results of this study revealed three-hundred ten occurrences of the social construction of difference across all three textbooks but only a portion of those, seventy-six, suggested social constructionist underpinnings of these constructs. This study shows how we have missed an opportunity at the introductory level to expand our student's knowledge of issues in diversity.
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