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Davis, Emily A. "Unamunian Microcosms: Four Short Stories in a New Translation into English." Diss., CLICK HERE for online access, 2008. http://contentdm.lib.byu.edu/ETD/image/etd2390.pdf.
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Maynou, i. Terri Josep. "Aprenentatge i comprensió dels nombres enters: Estudi de significats construïts per alumnes de 15 i 16 anys." Doctoral thesis, Universitat Autònoma de Barcelona, 2017. http://hdl.handle.net/10803/457584.
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La recerca de tesi doctoral, "Aprenentatge i comprensió dels nombres enters: Estudi de significats construïts per alumnes de 15 i 16 anys", s'inscriu en l'àrea de coneixement d'educació matemàtica, dins del domini d'estudis sobre l'aprenentatge matemàtic dels estudiants. El context de la recerca és un grup d'estudiants d'una escola catalana de secundària en el seu procés d'aprenentatge dels nombres enters. Aquest és un context empíric proper que serveix per comprendre els significats que els estudiants d'aquestes edats construeixen al voltant dels nombres enters, les seves propietats i operacions.
La pregunta que guia la recerca és la següent: ``Com comprenen els nombres enters un grup d'alumnes de tercer d'educació secundària obligatòria?" Per tal de donar resposta a la pregunta, es planteja una estratègia d'anàlisi centrada en l'assoliment dels següents objectius:
1) Identificar significats atribuïts als nombres enters atenent a la seva estructura i a la polisèmia del signe $-$ ; 2) Relacionar alguns d'aquests significats mitjançant la construcció de patrons de comprensió. S'infereix la rellevància donada a la diversitat de significats del signe $-$, d'una banda, i a la caracterització d'aspectes de la comprensió dels estudiant, de l'altra. L'estratègia d'anàlisi segueix una lògica qualitativa en la interpretació de respostes a qüestionaris i a entrevistes basades en qüestionaris.
Els supòsits per al disseny de qüestionaris i d'entrevistes es prenen de la literatura en l'àmbit de l'ensenyament i aprenentatge dels nombres enters. Es té també en compte el coneixement de la trajectòria curricular seguida pels alumnes participants fins el moment de la recollida de dades, molt particularment dels continguts vinculats a la introducció dels nombres enters i a la seva progressiva consolidació. Amb tot, es pensen preguntes que ajudin a refinar, a confirmar i eventualment a rebatre les expectatives sobre el grau de comprensió d'aquests continguts. En aquest punt, doncs, el disseny dels instruments de recollida de dades és una fase clau de la recerca.
Després de l'anàlisi específica de qüestionaris i d'entrevistes i de l'anàlisi creuada i global posterior, s'obtenen resultats sobre aspectes dels nombres enters que semblen especialment difícils de comprendre. Hi ha, per exemple, estudiants que desenvolupen maneres de re-significar nombres enters negatius a nombres naturals no enters a fi de simplificar tècniques d'operació, amb el corresponent risc de pèrdua del significat original de la tasca. En general, hi ha una tendència a no utilitzar llenguatge algebraic en aquelles tasques on els nombres enters es poden representar així. També hi ha una tendència generalitzada a un ús matemàticament ambigu del zero. Aquests i d'altres resultats són el punt de partida de l'elaboració de patrons de comprensió.
La caracterització de patrons de comprensió dels nombres enters és la principal aportació de la recerca. Per a l'elaboració de patrons, es combinen fonamentadament resultats preliminars sobre la comprensió de continguts específics vinculats als nombres enters (origen, signe $-$, llenguatge algebraic, etc.). S'arriba a un total de 12 patrons que informen sobre 12 estats dins de trajectòries d'aprenentatge. Malgrat que els patrons són un retrat situat en un temps concret, esdevenen una eina teòrica útil a l'hora d'entendre la varietat d'estats possibles en l'aprenentatge dels nombres enters.The PhD Dissertation "Learning and understanding integers: Study of the meanings constructed by students aged $15$ and $16$", is situated in the area of mathematics education research, particularly in the domain of student mathematics learning. The research context is a group of students of a Catalan secondary school in their processes of learning integers. The undertaken premise is that through such an empirical close context, we can examine the diverse meanings that students of these ages produce for the numerical set of integers, their properties and their operations. The guiding question of the investigation is as follows: ``How do 9th graders understand integers?" In order to answer it, an analytical strategy is carried out on the basis of two objectives: 1) To identify meanings related to the set of integers according to their structure and the polysemy of the minus sign; 2) To put these meanings into relation by building, when possible, patterns of understanding. It is inferred the relevance given to the plurality of meanings for the minus sign, and on the other hand, the examination of issues concerning student understanding. The analytical strategy follows a qualitative logic of inquiry in the interpretation of the answers to questionnaires and questionnaire-based interviews. The assumptions in the design of questionnaires and interviews draw on specific literature in the field of teaching and learning integers. It is also taken into account the curricular path followed by the participant students, specially of the taught contents during the introduction and development of integers at school. Nonetheless, the final questions are thought of as coherent within the 9th grade in that they are expect to help clarify, confirm and eventually produce new insights into student understanding. Hence, the data collecting tools are fundamental. Following the analysis of questionnaries and interviews as well as the successive cross and global analyses, we come to findings about difficulties in the learning of integers. There are, for example, students who develop ways to redefine negative integer numbers into natural non-integer numbers in order to simplify operating techniques, with the consequent risk of losing the meanings in the original task. More generally, there is a tendency to avoid algebraic language in the research tasks where integers can be represented in this language. Another tendency is the use of the number zero in the middle of ambiguous languages. The totally of findings are the point of departure for the development of patterns of understanding. The characterization of patterns of understanding integers is the main contribution of the research. To develop the patterns, preliminary findings about the meanings for specific contents related to integers (origin, minus sign, algebraic language, etc.), are grounded combined. At the end, twelve patterns are constructed which respectively correspond to twelve positions in the students processes of learning. Even though the patterns are a concrete position of a specific time in the learning, they become a useful theoretical tool in the comprehension of the variety of possible positions along the student learning processes of integers.
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Wallis, Christopher Daren. "To Enter, to be entered, to merge| The Role of Religious Experience in the Traditions of Tantric Shaivism." Thesis, University of California, Berkeley, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3686043.
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The present work comprises a detailed study of specific terms of discourse in the pre-twelfth century sources of esoteric "Tantric" Shaivism, both scriptural and exegetical, some of which are still unpublished and others of which are published only in the original Sanskrit. As a dissertation in South Asian Studies using the philological method, the primary purpose of the study is to ascertain the range of meanings of certain technical terms of great importance to the theology and practice of the Śaiva religion, namely āveśa, samāveśa, and śaktipāta. The work focuses on both the independent meaning and the intersection of these key terms, incorporating also the terms dīk&dotbelow;sā and vedha in the latter endeavor. The intersection of these terms constitutes a complex set of relationships, a nexus of ideas that lie at the very heart of the Śaiva tradition and which, due to the latter's widespread influence, came to be important in Tantric Buddhism and later forms of Hinduism as well. This thesis contends that samāveśa —meaning the fusion or commingling of one's self with the energy of one's deity and/or the consciousness of one's guru—is the key term that distinguishes Tantric Shaivism from mainstream (esp. Vaidika) Indian religion. This constitutes a reinterpretation and overcoding of the earlier meaning of āveśa, i.e. self-induced controlled possession by a deity.
Samāveśa is important to all forms of Shaivism, whether dualistic and ritualized (the Siddhanta) or nondual subitist charismatic forms (the Kaula). This thesis further contends that a philological study of samāveśa and related terms like śaktipāta demonstrates that religious experience (or evidence thereof) was considered central and indispensable to initiatory Shaivism throughout the medieval period. Śaktipāta was requisite to receive the basic level of initiation, and in the Kaula branch of the tradition, samāveśa denoted forms of religious experience that were necessary for aspirants to demonstrate in order to receive higher-level initiations. The former term is still commonly used in many Hindu communities today to designate a "spiritual awakening" or initiatory experience that is transmitted by a qualified guru.
Part One of this work is a comprehensive overview of the nature and structure of the Shaiva religion, providing important context to what follows. Part Two studies the key terms of (sam)āveśa, śaktipāta, etc. in a) early Sanskrit literature generally, b) Śaiva scriptures, and c) the abundant exegetical literature based on those scriptures.
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Stumm, Rebeca Lenize. "Enterros: momentos-específicos." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/27/27159/tde-05062011-222820/.
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A pesquisa refletiu sobre a ação poética de Enterro, capaz de romper com a continuidade em curso da imagem, instrumentalizando, ainda, o repetir e o registrar de outros Enterros por distintas autorias. A partir do Enterro de uma obra cerâmica na Avenida Paulista, em 2007, a imagem- documento dessa ação desencadeou outros Enterros realizados sob distintas interpretações, por participantes em diferentes lugares (2007-2010). Os pensamentos de Walter Benjamin e Gilles Deleuze apoiaram o entendimento do Enterro como ação que causa estranhamento e ruptura com o que está posto, deflagrando visualizações de outras realidades possíveis. Assim, o diferencial do trabalho apontou para o potencial dos Enterros produzirem momentos específicos de transformações de sentidos à ação, produção de imagens e autoria, possibilitando ao artista retomar seu trabalho a partir do sentido construído pelo outro, agir ora como participante, ora como autor, na mesma obra, em momentos diferentes.Research centered on the poetic action of a Burial, which presents a rupture within an image and its course, while providing instruments for the repetition and documentation of other Burials by distinct contributors. The piece initiates with the Burial of ceramics work of art on Avenida Paulista, in 2007, the image-document of this act led to other Burials carried out in various guises by participants in different locations (2007-2010). Walter Benjamin and Gilles Deleuze support the understanding that a Burial is an act that causes distancing and rupture, prompting visualizations of alternative realities. The work explores the potencial of these Burials to produce specific-moments that transform an act and its meaning, image production and authorship, allowing the artist to reclaim a work based on meanings assigned to it by others, while acting both as a participant and as author on the same piece at different times throughout its process.
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Forslund, Linda, and Fanny Hillius. "Enteral nutrition : En litteraturstudie om patienters upplevelser av att leva med enteral nutrition." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-39702.
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Athar, Nelofar, of Western Sydney Hawkesbury University, and Faculty of Science and Technology. "Development of indigenous enteral formulae." THESIS_FST_XXX_Athar_N.xml, 1995. http://handle.uws.edu.au:8081/1959.7/609.
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A procedure for preparing an enteral formula was developed, using Pakistani indigenous food items. The basis of development was that it would be nutritionally effective, easy to prepare and relatively cheap. 100 indigenous enteral diets were formulated using a computer aided master sheet in which various combinations were analysed. In order to prove the efficacy of these diets, a modified PER was carried out on 6 diets and results indicated a higher PER for the experimental diet. 29 formulations were shortlisted for preparation trials, and 2 main techniques were applied: incubation and cooking techniques. Physical and chemical analyses were carried out to assess the effect of preparation, the cooking methodologies were tried on various diets and 2 diets were shortlisted for human trials. To compare the efficacy of the indigenous enteral formula versus commercial formulae, a pilot study was carried out. Patient nutritional outcomes were assessed using biochemical parameters, and preliminary findings indicated that the experimental diet performed as well as the control diet.Doctor of Philosophy (PhD)
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Ahola, David, and To Jie Yin. "To be entered/Green Cargo." Thesis, Linköpings universitet, Kommunikations- och transportsystem, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-94540.
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Schemakonstruktion för järnvägspersonal är en stor utmaning. En orsak är att arbetsuppgifterna vid järnvägen kräver olika kunskaps- och kompetenskrav, samt att det finns många arbetsregler som utgör restriktioner för schemakonstruktionen. I detta examensarbete har en fallstudie utförts för datorstödd schemakonstruktion för personalbemanning. Examensarbetet har utförts vid avdelningen för bemanningsplanering som ansvarar för planering av personal vid två av Green Cargos olika bangårdar. Huvudsyftet med det här examensarbetet är att utreda skillnaderna i scheman som skapats manuellt respektive automatiskt med hjälp av programvaran BP. Schemajämförelserna ska också redovisa nyttan av det automatiska planeringssättet där det finns applicerat. Under arbetet genomfördes litteraturstudier samt en fallstudie. I fallstudien genomfördes testkörningar med olika schemakonstruktionsmetoder på två bangårdar. Det numeriska resultatet visar att den datorassisterade bemanningsmetoden innebär en förbättrad bemanningsplanering ur företagets synvinkel då produktionsbehovet kan täckas utan ökade kostnader. Detta innebär också en ökad flexibilitet i produktionsplaneringen då tjänstgöringsturer enkelt kan ändras. Det gör det också mycket enklare att tilldela personal olika arbetsuppgifter som de har kompetens för. Den optimeringsbaserade bemanningsplanen innebär inte en ökad arbetsbelastning för medarbetaren. Trots att fler bangårdstjänster kan bemannas genom att använda den datorassisterade metoden visar det sig att den totala utlagda arbetstiden inte alls ökar eller att den bara ökar marginellt för vissa medarbetare. När planering sker med programvaran styrs denna av parametrar som är lätta att ändra. Dessa inställningar av parametrar är avgörande för utseendet på schemat. Indata kan vara fridagsplanering, kompetenstillgång och produktionsbehov. De i sin tur avgör i betydande grad på hur balansen mellan livs- och ekonomiska kvalitetsmåtten ser ut för medarbetarna.
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Athar, Nelofar. "Development of indigenous enteral formulae /." View thesis View thesis, 1995. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030521.092507/index.html.
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Lee, Cheuk-hung, and 李卓雄. "Microbial contamination of enteral feeds." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31245596.
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Stephen, John R. "pH regulation in enteric bacteria." Thesis, University of Aberdeen, 1997. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=130919.
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Escherichia coli mutants impaired in growth and survival at low external pH in minimal medium were selected and attempts made to identify the disrupted genes. This study suggested that clpX, encoding a heat-shock induced protease and molecular chaperone, was functional in survival of E. coli at pH 3.3. Promoter probe plasmid libraries of Salmonella typhimurium LT2 DNA were created in E. coli and screened for acid-inducible transcriptional elements, and transcriptionally active fragments of degradative amino-acid decarboxylase genes recovered. Chromosomal gene fusions to the reporter gene lacZ in E. coli generated by Mu DII 1734 insertion were screened in a similar way and suggested that the gene encoding adenylate cyclase (cya) could be induced by mild cytoplasmic acidification. The sequence of a gene known to be inducible by cytoplasmic acidification, inaA, became available during the course of this study. The 5' region of this gene was used to generate a set of plasmids carrying fragments of the acid-inducible promoter transcriptionally fused to a luciferase based reporter system. Elements of the sequence required for induction by cytoplasmic acidification were identified. One of these reporter constructs was used to screen an E. coli Tn10 chromosomal insertional mutant library for genes involved in the regulation of inaA. One such mutant had a multiple antibiotic resistant (mar) phenotype. The disrupted loci in 2 other mutants were identified by inverse PCR, sequence analysis and database searches. Both were known only as open reading frames (ORFs) discovered during the sequencing of the entire E. coli genome, and were tentatively identified as yddB (closely linked to gadB and gadC; required for glutamate dependent acid resistance) and f300 (closely linked to pldA; required for detergent resistance). The promoter of f300 was shown to be sensitive to cytoplasmic acidification. The inaA promoter was also demonstrated to be induced at the onset of stationary phase, and to be independent of the stationary phase and weak-acid inducible σ factor RpoS and also of cAMP levels.
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Arjyal, Amit. "Clinical studies on enteric fever." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:7b82ceef-96de-4159-adcf-a06dc14c581a.
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I performed two randomised controlled trials (RCTs) to determine the best treatments for enteric fever in Kathmandu, Nepal, an area with a high proportion of nalidixic acid resistant S. Typhi and S. Paratyphi A isolates. I recruited 844 patients with suspected enteric fever to compare chloramphenicol versus gatifloxacin. 352 patients were culture confirmed. 14/175 patients treated with chloramphenicol and 12/177 patients treated with gatifloxacin experienced treatment failure (HR=0.86 (95% CI 0.40 to 1.86), p=0.70). The median times to fever clearance were 3.95 and 3.90 days, respectively (HR=1.06 [CI 0.86 to 1.32], p=0.59). The second RCT compared ofloxacin versus gatifloxacin and recruited 627 patients. Of the 170 patients infected with nalidixic acid resistant strains, the number of patients with treatment failure was 6/83 in the ofloxacin group and 5/87 in the gatifloxacin group (Hazard Ratio, HR=0.81, 95% CI 0.25 to 2.65; p=0.73); the median times to fever clearance were 4.7 and 3.3 days respectively (HR=1.59 [CI 1.16 to 2.18], p=0.004). I compared conventional blood culture against an electricity free culture approach. 66 of 304 patients with suspected enteric fever were positive for S. Typhi or S. Paratyphi A, 55 (85%) isolates were identified by the conventional blood culture and 60 (92%) isolates were identified by the experimental method. The percentages of positive and negative agreement for diagnosis of enteric fever were 90.9% and 96.0%, respectively. This electricity free blood culture system may have utility in resource-limited settings or potentially in disaster relief and refugee camps. I performed a literature review of RCTs of enteric fever which showed that trial design varied greatly. I was interested in the perspective of patients and what they regarded as cure. 1,481 patients were interviewed at the start of treatment, 860 (58%) reported that the resolution of fever would mean cure to them. At the completion of treatment, 877/1,448 (60.6%) reported that they felt cured when fever was completely gone. We suggest that fever clearance time is the best surrogate for clinical cure in patients with enteric fever and should be used as the primary outcome in future RCTs for the treatment of enteric fever.
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Buzid, Sultan. "Détection magnétique de matériaux enterrés." Reims, 2009. http://theses.univ-reims.fr/exl-doc/GED00001027.pdf.
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Cette contribution s’inscrit dans la continuité de travaux précédents développés au laboratoire. L’objectif est de concevoir un système «intelligent » et fiable d’identification des canalisations enterrées sans excavation. Pour cela un code détectable à distance doit être inséré dans le grillage avertisseur coloré couramment pour les travaux publics. Dans ces travaux de thèse, le code testé est réalisé dans un matériau magnétique. L’intérêt de ce matériau est qu’il possède une très grande perméabilité magnétique. Dans le dispositif développé, il est détectable à plus de un mètre de profondeur. Sa réponse est non-linéaire, elle contient des composantes harmoniques propres au matériau. L’agencement des différents éléments magnétiques définit une famille de codes, qui compte-tenu de leur faible épaisseur sont intégrables dans le grillage avertisseur actuel et assure la compatibilité avec les normes existantes. Dans ce mémoire, le comportement magnétique des matériaux nanocristallins est abordé pour permettre de comprendre les propriétés spécifiques et justifier le choix du matériau utilisé. La chaîne de mesure est développée, elle comprend : le fonctionnement du capteur, le système d’acquisition, le conditionnement des signaux. .This contribution has been developed in the following of previous work realised in the laboratory. The objective is to design a "smart" and reliable identification system of buried pipelines without excavation. For this purpose, a teledectectable code must be inserted into the existing coloured alarm net commonly used for public works. In this thesis work, a magnetic materiel is used and studied to conceive the code. Its main advantage is that it has a very high magnetic permeability. With the device developed in the laboratory, it is detectable at more than one meter deep. Its response is non-linear, it contains specific harmonic components. The combination of many magnetic elements defines a code family. Its low thickness allows it to be integrated into the existing net alarm used for public works and ensures compatibility with existing standards. In this contribution, the magnetic behaviour of nanocrystalline materials is discussed for understanding the specific properties and justifying the choice of the material. A specific processing is developed, it includes: sensor functioning, acquisition system, signal conditioning. .
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Silnik, María Alejandra. "Músicos de cuerpo entero." Bachelor's thesis, Universidad Nacional de Cuyo. Facultad de Educación Elemental y Especial, 2016. http://bdigital.uncu.edu.ar/10032.
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Este estudio de caso, se propone la descrpción y análisis en profundidad de la práctica pedagógica que implementa la Lic. Alejandra García Trabucco como docente de oboe en la FAD-UNCuyo. La misma se ha plasmado en el libro: Oboe para descubrir. Propuesta pedagógica para el estudio del oboe. Nivel.1. (García Trabucco, 2013, EDIUNC).
Se trata de una propuesta fundada en los recursos metacognitivos en el plano corporal que el instrumentista principiante aplica de manera espontánea y el tipo de mediación docente utilizada para promover su operativización en el aprendizaje inicial del oboe.Fil: Silnik, María Alejandra. Universidad Nacional de Cuyo. Facultad de Educación Elemental y Especial.
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Philips, Helen Louise. "Enteric and abortion chlamydia in sheep." Thesis, University of Liverpool, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.385154.
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Liu, Binlei. "Molecular biology of human enteric caliciviruses." Thesis, University of Southampton, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.242419.
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Josefsson, Christina, and Siverman Angelica Kanth. "Behandling med enteral nutrition : patientens upplevelser." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-20456.
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Behandling med enteral nutrition erbjuds de patienter som har tugg- och sväljsvårigheter främst av neurologiska orsaker. Behandling kan därför ske med nasogastrisk eller gastrostomisk sond. Gastrostomisk sond väljs då behandlingen planeras vara ett långvarigt alternativ. Forskning visar att enteral nutrition medför ökat oberoende och lättnad över att inte behöva vara orolig över sitt näringsintag. Sociala tillfällen som inkluderar mat och dryck upplevs dock som svåra. Det saknas tillräcklig uppföljning av hur behandlingen fungerar för dessa patienter i det dagliga livet, vilket kan medföra att patientens nutritionsbehov inte ses över.Syftet är att beskriva patienters upplevelser av behandling med enteral. Åtta personer med enteral nutrition har intervjuats och analyserats utifrån kvalitativ innehållsanalys. Resultatet av denna studie visar att upplevelsen av att inte kunna äta normalt skiljer sig åt beroende på patienternas utgångsläge, att förskrivningen av material har förbättrats sedan SÄRNÄR- teamet tagit över, men distributionen är däremot bristfällig. Vidare visar studien att information oftast är tillräcklig på specialistenheten, men sämre om patienten vårdas på annan enhet än den som är specialiserade på enteral nutrition. Att vänja sig vid nackdelar och se fördelar med enteral nutrition framkommer som betydelsefullt för dessa patienter och är avgörande för att gå vidare i livet. Patienterna upplever att omgivningen inte förstår deras situation. På grund av att inte kunna äta normalt saknar dessa patienter den sociala samvaron i samband med matsituationen och upplever ett utanförskap. Genom att patienters egna berättelser och livshistoria förs fram, kan det bidra till att utveckla och förbättra vården av enteral nutrition. Vår förhoppning är att resultatet från denna studie ska komma till nytta för SÄRNÄR – teamet i deras arbete med att följa upp patienter med enteral nutrition.Program: Specialistsjuksköterskeutbildning med inriktning mot distriktssköterska
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Cervo, Anamarta Sbeghen. "EVENTOS ADVERSOS EM TERAPIA NUTRICIONAL ENTERAL." Universidade Federal de Santa Maria, 2013. http://repositorio.ufsm.br/handle/1/7388.
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This study aims to determine the occurrence of adverse events related to the use of enteral nutrition in patients hospitalized at the University Hospital of Santa Maria (HUSM), based on the quality indicators. This is an exploratory study, longitudinal, descriptive study with a quantitative approach. Follow-up of 46 adult patients of both sexes aged was conducted from 18 years in the use of enteral nutritional therapy in the Intensive Care Unit and Adult Medical Clinic II, in the period January-May 2012. To collect the a semistructured data form with information about the identification data, sociodemographic and data quality indicators (inadvertent output, tube obstruction and received diet volume) was used. Among the patients treated there was a predominance of males (71.7%), aged between 41 and 80 years (69.6%), skin color / Caucasians (93.6%), single (51.1 %) with incomplete 1st grade (53.2%) and from Santa Maria (53.2%). The diagnoses had a higher frequency were related to neurological disorders (N = 18), respiratory (N = 12) and neoplastic (N = 12). The average number of days in which patients used the probe to enteral feeding was 18.5 days (SD = 8.6), minimum of three and maximum of 30 days. Among the reasons that led to the suspension of the diet are: pause for body care (N = 2, 2.4%), exams and procedures (N = 46, 54.8%), for nausea and vomiting (N = 29 , 34.5%) and delay in installation of new bottle for not available in the unit (N = 7, 8.3%). In the study period 39 inadvertent exits the probe and tube obstruction occurred, showing incidence rates of 4.6% and 2.1%, respectively. On average, patients stopped receiving 176.4 ml (± 117.8), with a median of 81.4 ml. 72 drugs administered by tube feeding of patients who used NE were also identified. We conclude that the use of quality indicators in nursing constitutes a useful tool to assess the quality of care.Este estudo tem como objetivo verificar a ocorrência de eventos adversos relacionados ao uso de nutrição enteral em pacientes internados no Hospital Universitário de Santa Maria (HUSM), tendo por base os indicadores de qualidade. Trata-se de um estudo exploratório, longitudinal, descritivo, com abordagem quantitativa. Foi realizado acompanhamento de 46 pacientes adultos de ambos os sexos com idade a partir de 18 anos, em uso de terapia nutricional enteral, na Unidade de Terapia Intensiva Adulto e Clínica Médica II, no período de janeiro a maio de 2012. Para a coleta dos dados foi utilizado um formulário semiestruturado com informações sobre os dados de identificação, caracterização sociodemográfica e dados sobre os indicadores de qualidade (saída inadvertida, obstrução da sonda e volume recebido da dieta). Dentre os pacientes acompanhados houve predomínio do sexo masculino (71,7%), com faixa etária entre 41 e 80 anos (69,6%), de cor da pele/raça branca (93,6%), solteiros (51,1%), com 1º grau incompleto (53,2%) e procedentes de Santa Maria (53,2%). Os diagnósticos que apresentaram maior frequência estavam relacionados aos distúrbios neurológicos (N=18), respiratórios (N=12) e neoplásicos (N=12). A média de dias em que os pacientes utilizaram a sonda para alimentação enteral foi de 18,5 dias (DP= 8,6), mínimo de três e máximo de 30 dias. Dentre os motivos que levaram à suspensão da dieta estão: pausa para higiene corporal (N=2; 2,4%), realização de exames e procedimentos (N=46; 54,8%), por náusea e vômito (N=29; 34,5%) e demora na instalação de novo frasco por não haver disponível na unidade (N=7; 8,3%). No período avaliado ocorreram 39 saídas inadvertidas da sonda e uma obstrução da sonda, evidenciando taxas de incidência de 4,6% e 2,1%, respectivamente. Em média os pacientes deixaram de receber 176,4 ml (±117,8), com mediana de 81,4 ml. Também foram identificados 72 medicamentos administrados pela sonda de alimentação dos pacientes que fizeram uso de NE. Conclui-se que o uso de indicadores de qualidade na enfermagem se constitui em uma ferramenta útil para avaliar a qualidade da assistência.
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Caddy, Sarah. "Characterisation of enteric viruses in dogs." Thesis, Imperial College London, 2015. http://hdl.handle.net/10044/1/39793.
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Human noroviruses (HuNoV) are a significant cause of viral gastroenteritis in man worldwide. Noroviruses are also associated with intestinal disease in multiple species, including dogs. Canine norovirus (CNV) was initially discovered in 2007 and the first aim of this thesis was to determine the prevalence of CNV in the UK dog population. qPCR screening of canine stool samples did not identify CNV RNA, but canine astroviruses (CaAstV) were serendipitously identified and subsequently characterized according to the second aim of this work. For serological screening, CNV virus-like particles (VLPs) to three CNV strains were produced. CNV circulation in the UK was confirmed by identification of CNV-specific antibodies in 60% of canine serum samples collected in 2012-2013. The third aim of this thesis was investigate to CNV interactions with host cells by identifying the cellular attachment factor for CNV. Synthetic carbohydrates and canine tissue samples were used to assess the binding specificity of CNV VLPs, and it was shown that antigens of the HBGA family were recognized. Phenotyping studies then demonstrated expression of HBGAs in dogs. As HuNoV also uses HBGAs to attach to cells, this raised concerns that dogs may be susceptible to HuNoV. Evaluating the zoonotic risk of enteric viruses in dogs was the final aim of this thesis. The susceptibility of dogs to HuNoV and hepatitis E virus (HEV) was determined by screening canine samples for the presence of HuNoV or HEV RNA and HuNoV or HEV-specific antibodies. Antibodies to both HuNoV and HEV were identified in dogs, and results confirmed HuNoV VLPs can bind to canine gastrointestinal samples. This data indicates that dogs are susceptible to HuNoV and HEV infections. In conclusion, this thesis has provided epidemiological and molecular characterization of CNV and CaAstV, in addition to highlighting the zoonotic potential for CNV, HuNoV and HEV in dogs.
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Malta, Monica Alexandre. "Predição de medidas antropometricas para a sondagem nasogastrica, determinadas por esofagogastroduodenoscopia." [s.n.], 2003. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313411.
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Orientador: Maria Isabel Pedreira de Freitas CeribelliDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Para se prevenir a desnutrição, provocada pela oferta de nutrientes menor que as necessidades reais do paciente, deve-se iniciar a terapia nutricional enteral precocemente, através de uma sonda, quando há a impossibilidade da reposição dos nutrientes necessários à alimentação do doente. Com intuito de se predizer medidas antropométricas para realizar a sondagem nasogástrica, usou-se neste estudo a esofagogastroduodenoscopia (EGDA) como padrão de uma medida como referência interna, determinante do comprimento necessário para a introdução do tubo de alimentação até o estômago. Medidas externas foram obtidas entre os pontos : ponta do nariz x lobo da orelha x apêndice xifóide x umbigo e altura correlacionadas com a medida padrão. Trata-se de estudo prospectivo, clínico e descritivo constituído por 140 usuários, encaminhados por demanda espontânea, à esofagogastroduodenoscopia diagnóstica. Para a análise dos dados utilizou-se a correlação linear e multivariada. Encontrou-se duas correlações estatisticamente significativas entre a linha zeta, identificada durante a EGDA, acrescida da distância da rima labial à arcada dentária superior, com a distância compreendida entre os pontos anatômicos lóbulo da orelha e apêndice xifóide (r=0.75) e desta linha com a altura ortostática (r= 0.72). Para se inserir a sonda de alimentação em estômago, de maneira a realizar o procedimento com segurança aos pacientes. Os resultados revelam a possibilidade de se usar a distância predita entre os pontos: lobo da orelha x apêndice xifóide x umbigo para servir como referência
Abstract: In order to prevent malnutrition due to a minor demand of the patient¿s real nutrient supplies, the enteral nutrition therapy must be started early through a feeding tube when the spontaneous feeding remain impossible. With the aim of predicting the anthropometric measures to perform the nasogastric probing, it was used, in this study, the esophagusgastroduodenuscopy(EGDA) as a standard to establish a measurement as an internal reference which determines the necessary length in order to perform the insertion of the feeding tube up to the stomach. External reference measurements were obtained through the points nose tip x earlobe x xiphoid appendix x umbilicus and height which were correlationed with the standard measurement. This is a prospective, clinical and descriptive study with 140 patients, referred as spontaneous request to the diagnostic. In order to do the data analysis, it was used a multivariate and linear correlation. Two it was found a significant statistically correlation: between the ¿zeta¿ line, identified during the esophagusgastroduodenuscopy(EGDA) , with the distance measured between the antomic points of the earlobe and xiphoid appendix ( r= 0.75) and from this line with the orthostatic height ( r=0.72). The results revealed the possibility of using the distance as a prediction measurement among the points: earlobe x xiphoid appendix x umbilicus to establish it as a reference measurement to insert the feeding tube into the stomach
Mestrado
Enfermagem e Trabalho
Mestre em Enfermagem
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Prada, Maria Camila Abramides 1974. "Dieta enteral em UTI : análise descritiva da adequação da prescrição e infusão e a ocorrência de complicações." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309089.
Full textAbstract:
Orientador: Elizete Aparecida LomaziDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Objetivos: Avaliar a adequação da prescrição e infusão de nutrição enteral e verificar a relação entre a adequação dos valores infundidos na nutrição enteral e a ocorrência de complicações em unidade de terapia intensiva de hospital terciário. Métodos: Estudo prospectivo descritivo, analítico, conduzido de setembro de 2010 a agosto de 2011. O estado nutricional dos pacientes foi avaliado por: prega cutânea tricipital, circunferência muscular do braço e circunferência do braço. A porcentagem de adequação das calorias e proteínas recebidas e calorias prescritas foram calculadas pela divisão dessas pelas necessidades calóricas e proteicas calculadas, até a alta da Unidade de Terapia Intensiva, óbito ou alta do suporte nutricional. As complicações verificadas foram relacionadas à adequação da infusão da NE e ao estado nutricional por meio do teste qui-quadrado. Resultados: A taxa de desnutrição foi de 29,4%, de eutrofia 60% e de obesidade 9,8%. A porcentagem de adequação da infusão calórica foi de 92,3%, enquanto a adequação da proteína recebida em relação às necessidades recomendadas foi de 65,8%. Os efeitos adversos registrados foram: diarreia (29,4%), vômitos (21,6%), débito de dieta pela SNE (11,8%), distensão abdominal (5,9%), hiperglicemia (78,4%), hipoglicemia (21,6%) e constipação (56,9%). A taxa de adequação da infusão calórica de 92,3% (DP±37,86) e taxa de adequação de infusão proteica de 68,8% (DP±40,16). Não houve associação estatística significativa entre complicações e excesso ou déficit de nutrição infundida, desnutrição ou obesidade. Conclusões: Cerca da metade dos pacientes não recebeu suas necessidades calóricas e proteicas e alguns pacientes receberam quantidade de calorias acima de suas necessidades. À internação, a avaliação nutricional revelou que a maioria dos pacientes estava eutrófica. Nenhuma das complicações foi associada à porcentagem de adequação da infusão de nutrição enteral
Abstract: Background: To evaluate the relationship between the amount of enteral nutrition infusion and the occurrence of complications. Methods: It is a prospective descriptive study conducted from September/2010 to August/2011 in an Intensive Care Unit of a public general hospital in Brazil. Triceps skinfold, upper arm circumference and upper arm muscle circumference were used to assess nutritional status. To assess the nutritional adequacy, the total amount of energy and protein received from enteral nutrition was divided by the amounts prescribed and estimated caloric and protein needs up to Intensive Care Unit discharge, death or enteral support ending. The relation between the adequacy of enteral nutrition infusion and the variables was crossed by the chi-square test. Results: Adverse effects percentages were the following: diarrhea (29.4%), vomiting (11.8%), abdominal bloating (21.6%) and constipation (56.9%). The nutritional assessment findings were 29.4% - underweight, 60% - normal weight 9.8% - obesity. Caloric infusion adequacy ratio were 92.3% (mean±37,9) and the protein infusion adequacy were 68,8% (mean±40,2). There was no statistical relation between enteral nutrition infusion and the occurrence of complications, or the nutritional status. Conclusions: Twenty-five percent of the patients didn't achieve their needs. Almost half of patients were underfeeding according to caloric and protein infusion adequacy and even those ones who were overfeeding did not presented any association to the complications studied
Mestrado
Saude da Criança e do Adolescente
Mestra em Ciências
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李潔怡 and Kit-yue Samson Lee. "Evaluation of enteral feeding support in mechanically ventilated, critically-ill patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B41710757.
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Ramalivhana, J., CL Obi, MNB Momba, B. Onabolu, JO Igumbor, M. Lukoto, TB Mulaudzi, et al. "Antibiotic resistance profiles and relatedness of enteric bacterial pathogens isolated from HIV/AIDS patients with and without diarrhoea and their household drinking water in rural communities in Limpopo Province South Africa." African Journal of Biotechnology, 2007. http://encore.tut.ac.za/iii/cpro/DigitalItemViewPage.external?sp=1001720.
Full textAbstract:
Antibiotic resistance profiles and the correlation of enteric bacterial pathogens from HIV positive individuals
with and without diarrhoea and their household drinking water were determined using the Kirby
Bauer disk diffusion and polymerase chain reaction methods respectively. The sef gene of Salmonella
enteritidis was amplified with the primer pair sefA-1 and sefA-2. The fliC gene of Salmonella typhimurium
was amplified with the primer pair flicA-1 and flicA-2. Heat-labile toxin (LT) primers (Lta and LTb) were
used to amplify Escherichia coli isolates and VirA1 and VirA2 for the Vir A gene of Shigella dysenteriae.
Results of antibiotic resistance profiles of enteric bacterial pathogens isolated from stool samples of HIV
positive and negative individuals with and without diarrhea and their household drinking water showed
very similar drug resistance patterns. Over 90% of all the organisms isolated from the various study
cohorts showed resistance to penicillin, cloxacillin and amoxicillin. Conversely, almost all the organisms
were sensitive to ciprofloxacin, gentamycin, meropenem and imipenem. About 50% of E. coli isolated
from the various study cohorts showed multiple antibiotic resistance to penicillin, amoxicillin, ampicillin,
erythromycin, tetracycline, doxycycline and cotri-moxazole ( PR, AR, APR, ER, TR, DXTR, and TSR ) whereas
less than 10% resistance was consistently reported for ofloxacin, gentamycin, meropenem cefotaxime,
cefuroxime and imipenem ( OFXS, GMS, MEMS, CTXS, CXMS and IMIS ). The majority of Salmonella and
Shigella isolates from all the groups were sensitive to ciprofloxacin, gentamicin, amikacin, meropenem,
imipenem, nalidixic acid, kanamycin, piperacillin-tazo bactam, cefuroxime, doxycyclin, cefepime and
ceftazidime (CIPS, GMS, AKS, MEMS, IMIS, NAS, KNS, DXTS, CXMS, CPMS, CAZS and PTZS). For
Campylobacter, over 30% of the isolates were resistant to erythromycin, ampicillin, tetracycline,
cotrimoxazole and ceftazidime (ER, APR TSR and CAZR) whereas over 85% were susceptible to
ciprofloxacin, ofloxacin, gentamycin, amikacin, mero-penem, and nalidixic acid (CIPS, OFXS, GMS, AKS,
MEMS and NAS). In addition to penicillin, amoxicillin, ampicillin and erythromycin, Aeromonas and
Plesiomonas spp were more resistant to chloramphenicol, but were susceptible to ciprofloxacin,
gentamycin, amikacin, meropenem, imipenem and nalidixic acid (CIPS, GMS, AKS, MEMS, IMIS and NAS).
Polymerase Chain Reaction (PCR) experiments using targeted species genes of S. enteritidis, S.
typhimurium, E. coli, Sh. dysenteriae showed that isolates from stool samples of HIV positive and HIV
negative individuals with and without diarrhoea were also present in the household drinking water of the
same study cohorts, suggesting that drinking water may have been the sources of the organisms in stool
sample. Furthermore, by showing that the primers were able to amplify the genes in both clinical and
environmental isolates, the link between the virulence of the pathogens was established
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Lee, Kit-yue Samson. "Evaluation of enteral feeding support in mechanically ventilated, critically-ill patients." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41710757.
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Villena, Perez Roxana. "Revisión crítica: evidencias de la nutrición enteral continua vs nutrición enteral intermitente en pacientes de cuidados intensivos." Bachelor's thesis, Universidad Católica Santo Toribio de Mogrovejo, 2020. http://hdl.handle.net/20.500.12423/2936.
Full textAbstract:
La nutrición enteral temprana se recomienda en pacientes adultos críticamente enfermos. Esta administración continua de nutrición enteral en pacientes críticos sigue siendo la práctica más común en todo el mundo; sin embargo, su práctica se ha cuestionado recientemente en favor de la administración de nutrición enteral intermitente, donde el volumen se infunde varias veces al día. Es por ello que se formula la pregunta clínica: ¿Cuáles son las evidencias de la nutrición enteral continua vs nutrición enteral intermitente en pacientes de cuidados intensivos?, la investigación empleará la metodología EBE, se eligieron las palabras claves según el MESH / DECS, teniendo como criterios de inclusión: Pacientes adultos críticos que estén en la unidad de cuidados intensivos. Y los criterios de exclusión: Pacientes pediátricos, Gestantes. Inmediatamente se procedió a investigar en las bases de datos: Pubmed, Epistemonikos, Sciencedirect, Google Académico y BVS; obteniendo 10 artículos de investigación; llegando a seleccionar los 10 artículos; los cuales fueron aprobados a través de la Guía de Validez y utilidad propuesto por Gálvez Toro. Para el análisis de comentario crítico se utilizó la lista de chequeo de CASPE- REV SISTEMATICA. En la respuesta a la pregunta clínica, el gran impacto de esta nutrición intermitente es la efectividad que tiene y la probabilidad de alcanzar el objetivo calórico, así mismo disminuye la invidencia de la broncoaspiración y la introducción de microorganismos patógenos al manipular los dispositivos de la alimentación, preparación y almacenamiento. Se identificó al nivel de evidencia según Scottish Intercollegiate Guidelines Network (SIGN) 1+ y grado de recomendación Moderada.
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Poon, Hiu-ching. "A study of the regulatory roles of Hedgehog in the enteric nervous system development by the conditional knockout of Patched1 enteric gene in the enteric neural crest cells." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42841604.
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Azevedo, Silvana de Oliveira. "Enfermagem em suporte nutricional: pesquisa qualitativa." Universidade Federal Fluminense, 2008. https://app.uff.br/riuff/handle/1/1419.
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Universidade Federal Fluminense
Mestrado Profissional em Enfermagem Assistencial
Nas metas do suporte nutricional, incluindo a identificação dos pacientes candidatos à prática de uma avaliação nutricional, destaca-se a capacidade de dirigir a terapêutica e conseqüentemente ministrar suporte que seja seguro e eficiente. Para isso, é importante que haja uma equipe interdisciplinar interagindo, cada qual com suas funções e responsabilidades. Suporte Nutricional tem como definição o conjunto de procedimentos terapêuticos para a manutenção ou recuperação do estado nutricional podendo ser através de uma Nutrição Oral Especializada (NOE), Nutrição Enteral (NE) ou Nutrição Parenteral (NP). Em unidades de internação de um hospital público de grande porte, observa-se a precariedade do planejamento do cuidado de enfermagem ao cliente que faz uso do Suporte Nutricional. Uma situação constante que se encontra na assistência a esses clientes é a suspensão do tratamento devido a diversos fatores, os quais ocorrem muitas vezes por falta de avaliação e desconhecimento do enfermeiro e da equipe de enfermagem em relação à terapêutica nutricional. O presente estudo tem como objeto o planejamento do cuidado de enfermagem ao cliente hospitalizado em Suporte Nutricional e objetiva: descrever o planejamento da assistência ao cliente em suporte nutricional realizado pelo enfermeiro, identificar as dificuldades enfrentadas pelo enfermeiro ao cuidado a clientes em suporte nutricional, e criar modelo de planejamento da assistência ao cliente em terapia nutricional com base em procedimentos operacionais padrão (POP). O estudo de abordagem qualitativa do tipo exploratório foi desenvolvido em treze unidades de internação do Hospital Universitário Antonio Pedro da Universidade Federal Fluminense que possuem clientes em suporte nutricional, tendo como sujeitos vinte e cinco enfermeiros. A coleta de dados se deu a partir de observação participante e entrevista semi-estruturada, utilizando-se como técnica de análise, a análise de conteúdo. Os resultados apontam para uma assistência ao cliente em suporte nutricional restrita a uma ação mecânica, sem instrumentos administrativos (normas e rotinas) que favoreçam uma assistência planejada, bem como o registro do processo de cuidar deste cliente. A nutrição, tanto enteral como parenteral, se mostrou como um cuidado pouco valorizado pelos profissionais em detrimento dos demais procedimentos inerentes ao cuidar. No sentido de uma prática e cuidado ao cliente em suporte nutricional mais segura e com qualidade, criaram-se os Procedimentos Operacionais Padrão (POP), com base nos resultados desta pesquisa, relacionados à Terapia Nutricional Enteral e Parenteral. Os POPs objetivam uma normalização de condutas e a disseminação de boas práticas nas unidades de internação para uma assistência de enfermagem efetiva. A atenção à nutrição do cliente hospitalizado deve ser um fator a ser observado na instituição estudada, uma vez que a eficácia da terapia nutricional também depende das ações do enfermeiro e de sua equipe. Por ser uma atividade especializada e sujeita a complicações e riscos em todas as etapas de sua implementação, faz-se necessário o preparo tanto da instituição quanto dos profissionais para a terapêutica nutricional de qualidade
In the matter of nutricional support, including the identification of patients who are candidates to a nutricional assessment practice, is distinguished by the capacity to direct therapeutic and offers a safe and efficient support . In order for this to happen, it is important that a interdisciplinar team work together with functions and responsibilities of their own. Nutricional support has as definition a set of therapeutic procedures that maintain or recover the nutricional state that can be through an Specialty Oral Nutrition (SON), Enteral Nutrition (EN) or Parenteral Nutrition (PN). In inpatient units of a great public hospital, its common to observe precarious planning of nurse care developed to patients that use Nutricional Support. Different factors are associated to the treatment suspension of these patients, most of the times due to the lack of evaluation and knowledge expected from the nurse and its team according to therapeutic nutrition. The present study presents the planning of nurse care to the patient hospitalized in Nutricional Support and aims to: describe the planning care of the patient in nutricional support realized by the nurse, identify difficulties of the nurse when caring with patients in nutricional support and also create a model of care planning to the patient in nutricional therapy according to standard of operational procedures (SOP). The study of qualitative exploratory approach, was developed in thirteen inpatient units of the University Hospital Antonio Pedro, located in the state of Rio de Janeiro of the Fluminense Federal University. The subjects weretwenty and five nurses. staff . The data was collected from Participant observation and semistructured interviews. The content analysis was used for data analysis . The results points to an patient care in nutricional support restricted to mechanic action, without administrative instruments (norms and routines) that favor a planning care, as well as the care process of this patient. The nutrition, enteral or parenteral, was figured as a not valued care procedure among the professionals comparing to other extant procudures. The results of this research related to the Enteral and Parenteral Nutricional Therapy, Standard of Operacional Procedure were created in order to afford a safe and efficient practice and patient care in nutricional support. These SOPs lens to a conduct normalization and the dissemination of good practice in the inpatient units for an effective nursing care. The nutrition of a hospitalized patient must be considered in the studied institution, once the effectiveness of nutricional therapy depends on nurse and its team actions. For being such a specialized activity makes it vulnerable to complications and risks in all stages of its implementation, so it´s necessary to prepare not only the institution but also the professionals for a quality in therapeutic nutricional
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Heimonen, Magnus. "Virtual Musicality : Soundtrack enters VR." Thesis, Högskolan i Skövde, Institutionen för informationsteknologi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-12824.
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Virtual Reality (VR) can potentially transport the user to another world. Outside of VR, musical soundtrack is usually placed outside of the scene, referred to as non-diegetic sound. In VR, this could potentially break immersion. Other ways to implement music have to be tested. A test was created consisting of three scenes with a wide selection of “listening modes”, or musical configurations. The listening modes ranged from non-diegetic stereo music via headphones to diegetic, played from speakers inside the VR spaces. 10 respondents played through the scenes in VR, experiencing every listening mode. Respondents then replied to a questionnaire gathering their thoughts on their experience. Results showed that immersion improved the more the experience corresponded to expectations from outside of VR. Non-diegetic listening modes were considered less immersive than diegetic listening modes. This study lays a basic foundation for further research on music in VR with initial guidelines for proper implementation.
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Leighton, Kim. "Improving enhanced surveillance of notifiable enteric illnesses." University of Western Australia. School of Population Health, 2005. http://theses.library.uwa.edu.au/adt-WU2005.0074.
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[Truncated abstract] Gastroenteritis is frequently associated with a food or water borne source and the investigation of such cases is undertaken to identify potential sources of infection. Where contaminated food or water are identified as the source of infection/intoxication, action may be taken to limit or prevent further people being affected, and in so doing limit costs to the health care system. This study was undertaken to determine if there is a more effective and efficient way to collect information from patients with certain enteric illnesses. This was based on a trial process of posting self-administered questionnaires with a reply-paid return envelope to the patient and compared with the existing process where local government Environmental Health Officers interview the patient and provide a report to the Department of Health. A limiting factor in the existing process is the time lapse between the onset of illness and follow-up by Environmental Health Officers (EHOs), which results in difficulties in contacting the patient and obtaining a dietary history. Furthermore, the existing system is resource intense, requiring officers to individually interview patients either in person or by telephone. The study was of those patients living in the Perth metropolitan area whose doctor notified the Department of Health that the patient had contracted any of three notifiable enteric illnesses (campylobacterosis, giardiasis or salmonellosis), and the patient was not part of a known outbreak and was assessed as not requiring urgent follow-up. The trial process was used for patients living in five local government areas and the return rate, timeliness of return and completeness of questionnaires in the trial process was compared with the reports returned under the existing process of investigation and reporting by EHOs from 24 metropolitan local government areas that were not part of the trial process. An estimate of the potential costs to local government and the Department of Health was undertaken for both the existing and trial processes of collecting information from patients. A survey of local government EHOs in the metropolitan area was also undertaken to assess the perception of EHOs about roles and responsibilities in the follow-up investigation, the use of the Enteric Disease Investigation Report (EDIR) and the limitations that they identified in the current investigation process.
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Hotson, Brenda L. "Quality of life with home enteral nutrition." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0006/MQ32135.pdf.
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Craig, J. S. "Studies of enteral nutrition in preterm infants." Thesis, Queen's University Belfast, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391112.
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Dingle, Kate Elizabeth. "The molecular characterisation of human enteric caliciviruses." Thesis, University of Southampton, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.296166.
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Robinson, Jayne. "The molecular biology of human enteric caliciviruses." Thesis, University of Southampton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.302313.
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Williams, Judith Carol. "Virion associated proteins of human enteric caliciviruses." Thesis, University of Southampton, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246231.
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Broomhead, Yvette. "The effects of enteric protozoa in turkeys /." Free to MU Campus, others may purchase, 2004. http://wwwlib.umi.com/cr/mo/fullcit?p1421120.
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Macarovscha, Greice Trevisan 1978. "Determinação de elementos metálicos em nutrição enteral." [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/249405.
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Orientador: Solange CadoreTese (doutorado) - Universidade Estadual de Campinas, Instituto de Química
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Resumo: A nutrição enteral é um alimento com finalidade de suprir todas as necessidades nutricionais de um indivíduo que está incapacitado de se alimentar da forma convencional. São alimentos encontrados comercialmente em forma sólida ou liquida, prontos para o consumo, cuja composição inclui carboidratos, proteínas, lipídios, vitaminas e minerais em quantidades suficientes para atingir a ingestão diária recomendada para um indivíduo saudável. A legislação brasileira regula os elementos metálicos essenciais e o limite máximo de contaminantes em alimentos. Para o estudo dessas espécies metálicas nas nutrições enterais, as técnicas de ICP OES e GF AAS foram utilizadas. As amostras foram analisadas por ICP OES após o tratamento em forno de microondas fechado. Após a otimização das condições experimentais do ICP OES (potência da RF, vazão de nebulização e vazão auxiliar) as espécies Al, As, Ba, Ca, Cd, Co, Cr, Cu, Fe , Hg, K , Mg, Mn, Mo, Na, Ni, Pb, Sb, Se, V e Zn tiveram sua exatidão avaliada através de experimentos de adição e recuperação, obtendo-se valores entre 90 e 110% e RSD menores que 5%, para a maior parte dos elementos. Ca, Fe, K, Mg, Mn, Na e Zn foram quantificados nas amostras enquanto que as espécies contaminantes (Cd, Hg, Pb e Se) e outros elementos essenciais (Cu, Cr, Mo, Se) não puderam ser quantificados pois estavam abaixo do LOQ do método. Com as condições de GF AAS (tempo e temperatura de pirólise e de atomização, uso de modificador químico) otimizadas e as amostras suspensas em CFA-C foram obtidas exatidões adequadas e RSD menores que 5% para as determinações de Al nas amostras. Diferentes tipos de embalagem não influenciaram o teor de Al nas amostras. Chumbo e cádmio também foram determinados por GF AAS, usando amostras mineralizadas em forno de micro-ondas fechado. Nas condições experimentais otimizadas a exatidão foi avaliada por um estudo de recuperação obtendo-se recuperações adequadas. O LOQ para Pb e Cd atendem os valores da legislação vigente. Essas espécies foram quantificadas nas amostras e todos os resultados observados se encontram abaixo do limite máximo tolerado de contaminantes. Um estudo de disponibilidade foi feito para avaliar a fração disponível dos elementos metálicos declarados na amostra. Esse estudo foi realizado in vitro, visando uma simulação dos processos digestivos e de absorção que ocorrem no trato gastrointestinal de um indivíduo. Os resultados mostraram que a disponibilidade dos elementos estudados nas amostras de nutrição enteral tornam esse tipo de alimento adequado para o seu fim
Abstract: Enteral nutrition is a food that aims to supply all the nutritional necessities of a person who is incapable of feeding in the conventional way. They are meals commercially available in solid or liquid forms, usually ready for consumption. These commercial meals include carbohydrates, proteins, lipids, vitamins and minerals in sufficient quantities in their composition, in order to reach the daily recommended amounts for a healthy individual. Brazilian legislation regulates the essential metallic elements and the maximum contaminants in food. For the study of metallic elements in enteral nutriments, the techniques of ICP-OES and GF AAS were used. ICP OES was used for the analysis after sample treatment in a closed microwave oven. After experimental optimization of the ICP OES parameters (RF power, nebulization flow, and auxiliary flow) the method accuracy was evaluated using addition and recovery experiments. For the majority of the elements recoveries between 90 and 110% and RSD less than 5% were obtained. Ca, Fe, K, Mg, Mn, Na and Zn were quantified in the samples. The contaminants species (Cd, Hg, Pb, Se) and the other essential elements (Cr, Cu, Mo, Se) were below the LOQ and could not be quantified. Using GF AAS optimized conditions (pyrolysis and atomization time and temperature and use of chemical modifiers) with the samples suspended in CFA-C it was possible to obtain adequate accuracies and RSD lower than 5% for the determination of Al in the enteral samples. Different types of packaging did not influence the content of Al in the samples. Lead and Cd were determined by GF AAS after sample treatment by microwave radiation. Under the optimized experimental conditions the method accuracy was evaluated by an addition and recovery study. The LOQ for Pb and Cd using GF AAS are in accordance with the values established by the legislation. The determination of Cd and Pb showed that the concentrations in all the samples analyzed are below the maximum tolerated value. A bioavailability study was carried out to evaluate the available fraction of the metallic elements declared in the sample¿s label. The in vitro study simulated the digestive and absorption processes that occur in the gastrointestinal treat of an individual. The results showed that the availability of elements in the samples of enteral nutrition make this type of food suitable for their purpose
Doutorado
Quimica Analitica
Doutor em Ciências
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Conocimiento, Dirección de Gestión del. "Journal of Parenteral & Enteral Nutrition (JPEN)." Wiley, 2004. http://hdl.handle.net/10757/655341.
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Terrasse, Guillaume. "Géodétection des réseaux enterrés par imagerie radar." Thesis, Paris, ENST, 2017. http://www.theses.fr/2017ENST0015/document.
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L’objectif de la thèse est d’améliorer les différents traitements et de proposer une visualisation claire et intuitive à l’opérateur des données en sortie d’un géoradar (radargramme) afin de pouvoir localiser de manière précise les réseaux de canalisations enfouis. Notamment, nous souhaitons mettre en évidence les hyperboles présentes dans les radargrammes car celles-ci sont caractéristiques de la présence d'une canalisation. Dans un premier temps nous nous sommes intéressés à la suppression de l’information inutile (clutter) pouvant gêner la détection des hyperboles. Nous avons ainsi proposé une méthode de filtrage du clutter et du bruit des radargrammes. Ensuite, nous avons travaillé sur l’élaboration d’une méthode permettant de détecter automatiquement les hyperboles dans un radargramme ainsi qu’une estimation de sa fonction mathématique dans des conditions quasi-temps réel. Et enfin nous avons également proposé une méthode de séparation de source permettant de distinguer le clutter et le signal utile du radargramme tout en ayant un impact minimal sur les hyperboles. Ces derniers travaux ouvrent d’autres possibilités pour le filtrage, le rehaussement ou la détection automatique d’hyperbolesThe thesis objective is to improve the different processing in order to make the data acquired by ground penetrating radar (B-scan) more understandable for the operators. Consequently, it will facilitate the pipe localisation. More particularly, we wish to highlight the hyperbolas in the B-scan because they point out the presence of a pipe. First of all, we are interested in removing all the useless information which might hide the hyperbolas. We proposed a filtering method removing unwanted reflections and noise. Then, we worked on an automatic hyperbola detection method and an estimation of their mathematical functions in quasi real time. Finally, we proposed a source separation method to distinguish the unwanted reflections from the hyperbolas with a minimal impact on them. This last work opens interesting perspectives in filtering, hyperbolas enhancement and hyperbola detection
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Mehta, Maitra Suhas. "Enter Ophelia, Distracted." Thesis, The University of Arizona, 2012. http://hdl.handle.net/10150/244474.
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Enter Ophelia, Distracted began as an attempt to enter a discourse about the iconic women of William Shakespeare's work. Initially I sought to interact with some of the Bard’s richest female characters to provide a new context for their roles and experiences - to assume their identities, in some cases. As the project progressed, however, I was so moved by deeply conversing with these women that my own perspective was forcibly altered. Thus many poems in this collection are introspective, reflecting my own struggle to contextualize myself in the world. Enter Ophelia, Distracted explores how we women relate to our environments and interpret life's deluge of images and sensations, while navigating what is "expected" of us. I chose to weave poems that consider Shakespeare’s women with poems that echo my own interior monologue. All pieces revel in rich, synesthetic images - many of which are reverent allusions to Shakespeare’s original language - and often ask disjointed questions. Enter Ophelia, Distracted magnifies the intense moments of life - of any life - and use Shakespeare’s women to underscore the timeless universality of experience. Ophelia's grievous loneliness is also mine.
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Beck, Ana Raquel Medeiros 1973. "Correlação entre medidas antropometricas e biometricas na inserção da sonda gastrica em pediatria." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313617.
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Orientador: Elizete Aparecida Lomazi da Costa PintoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Até 50% dos tubos gástricos podem ser posicionados inadequadamente. A diversidade de técnicas e de pontos de referência utilizados para estimar a locação de sondas gástricas contribui para ocorrência de erros de posicionamento. JUSTIFICATIVA: Estudos internacionais caracterizam-se por incluir amostras reduzidas, grande amplitude nas faixas etárias e etnias específicas. OBJETIVOS: 1. Identificar o grau de correlação entre a medida do esôfago, obtida por endoscopia digestiva alta (EDA) e as medidas antropométricas e biométricas externas, tomadas em 153 crianças brasileiras, na faixa etária de 2 a 12 anos; 2. Desenvolver modelos de predição gerando equações para inserção de sondas na transição esôfago-gástrica (TEG) e no corpo do estômago (CE); 3. Comparar os valores do estudo com a medida NEX (distância do nariz, ao lóbulo da orelha até o apêndice xifóide) e com estudos internacionais. MÉTODO: Estudo analítico, observacional e transversal. Os dados foram coletados no período de janeiro de 2006 a janeiro de 2008. As medidas de biometria mensuradas foram: 1. Externas: arcada dentária superior-subnasal, subnasal-tragus, tragus-apêndice xifóide, apêndice xifóide-umbigo, subnasal-apêndice xifóide, altura e comprimento do joelho; 2. Internas: arcada dentária superior e subnasal à transição esofagogástrica e ao corpo do estômago. Modelos de predição foram ajustados para essas medidas, utilizando análise de regressão linear múltipla. Os modelos obtidos neste estudo foram comparados com os modelos provenientes de estudos internacionais, utilizando-se o coeficiente de correlação de Pearson. RESULTADOS: Altura e comprimento do joelho apresentaram as mais fortes correlações com o comprimento do esôfago, respectivamente, 0,91 e 0,88. A correlação entre a medida NEX e a medida arcada dentária superior-TEG apresentou coeficiente de correlação foi r=0,81 e com a medida ADS-CE de r=0,72. Forte correlação foi obtida entre os modelos desenvolvidos nesse estudo e modelos internacionais, r=1,00. CONCLUSÕES: A medida da altura, seguida pela medida do comprimento do joelho, apresentaram as mais fortes correlações com a medida esofágica. A medida até o corpo gástrico apresentou correlações mais fracas que as encontradas com a TEG. A medida NEX apresentou grau de correlação inferior aos obtidos nas correlações antropométricas. Houve forte correlação entre os achados no presente estudo e os valores obtidos em casuísticas internacionais.
Abstract: Errors in placement of orogastric and nasogastric feeding tubes may occur in more than 50% of procedures. The diversity of techniques and landmarks definitions used for estimating gastric tube location contributes to inadequate placement. JUSTIFICATION: International studies have included reduced samples, wide range age subjects and specific ethnic groups. OBJECTIVES: 1. Identifying correlation values between endoscopic esophageal length and anthropometric and external biometric data obtained from 153 Brazilian children (2 - 12 years old). 2. Developing statistical predictive models for inserting tubes at esophageal-gastric transition and in gastric body. 3. Comparing correlation values obtained with presented models and those obtained from international sample and with NEX (nose to ear lobe and xiphoid) measurement. METHOD: Analytical, observational and crossectional study. Data were collected from January 2006 to January 2008. The biometric measurements were: 1. External: ADS-subnasal, subnasal-tragus, tragus-xiphoid process, xiphoid processumbilicus, subnasal-xiphoid process, height and knee length; 2. Internal: superior dental arch (SDA) subnasal to the esophageal-gastric transition and to the body gastric. Correlation and determination values were obtained using multiple linear regressions. Presently predictive models were compared to international data using Pearson test. RESULTS: 1. Internal values were best correlated with height followed by knee length, respectively, 0.91 and 0.88. Correlation value between NEX and internal measurements were inferior than correlation between height and knee length, r = 0,81. Strong correlation was found between presently developed models and international samples, r=1.00. CONCLUSION: Height, followed by knee length, presented the strongest linear correlation with internal measurements. Gastric body showed weaker correlation values when compared to TEG. The NEX was hence confirmed to having a weaker correlation with the esophageal length than height. There was a strong correlation between present values and those generated from international samples.
Doutorado
Doutor em Saude da Criança e do Adolescente
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Westfall, Una Elizabeth. "Physiological responses to different enteral feeding schedules in rats /." Thesis, Connect to this title online; UW restricted, 1990. http://hdl.handle.net/1773/7265.
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Juty, Navtej Singh. "On the cytochrome bd' terminal oxidase complex of the diazotroph Klebsiella pneumoniae." Thesis, University of Southampton, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.242201.
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Solfa, Fabiana Vieira [UNESP]. "Desperdício de dieta enteral em UTI: análise de modo de falhas e efeitos de danos ao paciente grave." Universidade Estadual Paulista (UNESP), 2014. http://hdl.handle.net/11449/123977.
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000830352.pdf: 1542887 bytes, checksum: 87f1a3d2a9d0941778faff708704bc13 (MD5)Introdução: O estudo surgiu em razão da necessidade de compreender o desperdício de dieta enteral na unidade de terapia intensiva. Diversos fatores contribuem para o desperdício de dieta enteral, podendo ser intrínsecos (intolerância gastrointestinal) ou extrínsecos ao paciente (exames, cirurgias), desde a prescrição da dieta até o final da sua administração. Duas formas de verificação do desperdício foram comparadas e testadas como hipóteses: a anotação de enfermagem e a medida direta do volume residual do frasco. A utilização da metodologia de Modo de Falhas e Análise de Efeitos na terapia nutricional e o estudo do desperdício da dieta trouxe pioneirismo ao estudo. Metodologia: O desperdício foi verificado por metodologia quantitativa, o volume anotado pela enfermagem e o volume medido no frasco. Foram avaliados também índices de gravidade dos pacientes e comparados com variáveis relacionadas à dieta enteral. As causas do desperdício poderiam ser encontradas em todas as etapas do processo de dieta enteral. Optou-se nesse trabalho, também, pela metodologia da análise do modo de falhas e efeitos (FMEA), mapeando as etapas, identificando os riscos potenciais e avaliando possíveis danos com pontuação acima de oito através da análise de causa raiz. Resultados/ Discussão: Houve diferença significativa em relação aos volumes de dieta desperdiçados segundo a anotação de enfermagem e o volume medido no frasco. O volume anotado pela enfermagem era maior que o medido. Esse fato pode levar a consequências importantes referentes à anotação inadequada por se tratar de um grande volume desperdiçado, segundo a anotação de enfermagem. Quanto aos índices de gravidade do paciente e variáveis referentes à dieta enteral, houve diferença significativa relacionada às variáveis sexo, idade, uso de droga vasoativa e tempo de internação. Assim, o desperdício foi maior entre os homens, não idosos, internados ...
Introduction: This study arose from the need to understand the waste of enteral nutrition in the intensive care unit. Several factors contributed to the waste of enteral feeding and may be intrinsic (gastrointestinal intolerance) or extrinsic to the patient (tests, surgeries), since the diet prescription moment until the end of its administration. Two ways of checking the waste were compared and tested as hypotheses: nurse diary and direct measurement of the residual volume of the bottle. The use of Failure Mode and Effects Analysis methodology in nutritional therapy and the study of diet waste brought originality to the work. Methodology: The waste was verified by quantitative methodology, the volume recorded by the nursing staff and the volume measured on the bottle. Severity scores of patients were also evaluated and compared with enteral nutrition-related variables. The causes of waste could be found at all stages of enteral feeding process, and in this study it was decided by the Failure Mode and Effect Analysis (FMEA) methodology, mapping process, identifying potential risks and evaluating probable damage with score above eight through root cause analysis. Results / Discussion: there was a significant difference between volumes of diet waste according to the nurse diaries and the volume measured on the bottle. The volume registered by the nursing staff was higher than the measured one. This fact may lead to important consequences regarding inappropriate notes once it's about a big volume wasted, according to the records of the nursing staff. As for patient severity scores and variables related to enteral feeding, there were meaningful differences related to sex, age, use of vasoactive drugs and hospitalization time. Thus, the waste was higher among men, not elderly, hospitalized for less than a week (waste per day), without the use of vasoactive drugs. Regarding process failures, most occurred in the period of suspension of the ...
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Lisboa, Caroline de Deus. "Preparo e administração de medicamentos por sondas em pacientes que recebem nutrição enteral." Universidade do Estado do Rio de Janeiro, 2011. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=2463.
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O objeto de estudo foi o preparo e a administração de medicamentos por cateter pela enfermagem em pacientes que recebem nutrição enteral. O objetivo geral foi investigar o padrão de preparo e administração dos medicamentos por cateter em pacientes que recebem nutrição enteral concomitante. Os objetivos específicos foram apresentar o perfil dos medicamentos preparados e administrados de acordo com a possibilidade de serem administrados por cateter enteral e avaliar o tipo e a freqüência de erros que ocorrem no preparo e administração de medicamentos por cateter. Tratou-se de uma pesquisa com desenho transversal de natureza observacional, sem modelo de intervenção. Foi desenvolvida em um hospital do Rio de Janeiro onde foram observados técnicos de enfermagem preparando e administrando medicamentos por cateter na Unidade de Terapia Intensiva. Foram observadas 350 doses de medicamentos sendo preparados e administrados. Os grupos de medicamentos prevalentes foram os que agem no Sistema Cardiovascular Renal com 164 doses (46,80%), seguido pelos que agem no Sistema Respiratório e Sangue com 12,85% e 12,56% respectivamente. Foram encontrados 19 medicamentos diferentes do primeiro grupo, dois no segundo e cinco no terceiro. As categorias de erro no preparo foram trituração, diluição e misturas. Encontrou-se uma taxa média de 67,71% no preparo de medicamentos. Comprimidos simples foram preparados errados em 72,54% das doses, e todos os comprimidos revestidos e de liberação prolongada foram triturados indevidamente entre sólidos a categoria de erro prevalente foi trituração com 45,47%, preparar misturando medicamentos foi um erro encontrado em quase 40% das doses de medicamentos sólidos. A trituração insuficiente ocorreu em 73,33% das doses de ácido fólico, do cloridrato de amiodarona (58,97%) e bromoprida (50,00%). A mistura com outros medicamentos ocorreu em 66,66% das doses de bromoprida, de besilato de anlodipina (53,33%), bamifilina (43,47%), ácido fólico (40,00%) e ácido acetilsalicílico (33,33%). Os erros na administração foram ausência de pausa e manejo indevido do cateter. A taxa média de erros na administração foi de 32,64%, distribuídas entre 17,14% para pausa e 48,14% para manejo do cateter. A ausência de lavagem do cateter antes foi o erro mais comum e o mais incomum foi não lavar o cateter após a administração. Os medicamentos mais envolvidos em erros na administração foram: cloridrato de amiodarona (n=39), captopril (n=33), cloridrato de hidralazina (n=7), levotiroxina sódica (n=7). Com relação à lavagem dos cateteres antes, ela não ocorreu em 330 doses de medicamentos. O preparo e administração inadequados de medicamentos podem levar à perdas na biodisponibilidade, diminuição do nível sérico e riscos de intoxicações para o paciente. Preparar e administrar medicamentos são procedimentos comuns, porém apresentou altas taxas de erros, o que talvez reflita pouco conhecimento desses profissionais sobre as boas práticas da terapia medicamentosa. Constata-se a necessidade de maior investimento de todos os profissionais envolvidos, médicos, enfermeiros e farmacêuticos nas questões que envolvam a segurança com medicamentos assim como repensar o processo de trabalho da enfermagem.This studys object was the medications preparation and administration by nursing probes in patients receiving enteral nutrition. The overall objective was to investigate the preparation pattern and drugs administration through tubes in patients receiving concomitant enteral nutrition. The specific objectives were to present the medications profile prepared and administered in accordance with the possibility to be administered by enteral probes and assess the errors type and frequency that occur in the medicines preparation and administration by probes. This was a cross-sectional survey of the observational nature without intervention model. It was developed in a hospital in Rio de Janeiro city, Brazil, observing practical nurses preparing and administering medications through tubes in the Intensive Care Unit. We observed the preparation of 350 medicines doses and subsequent administration to the patients. The prevalent drug groups were those acting on Cardiovascular Renal System with 164 doses (46.80%), followed by those acting on the Respiratory System and Blood with 12.85% and 12.56% respectively. We found 19 different drugs from the first group, two from the second group, and five in the third one. The error categories in the preparation were milling, mixing and dilution. We found a mean rate of 67.71% in medication preparation. Simple tablets were prepared by wrong way in 72.54% of the doses and all coated tablets and those of extended release were crushed incorrectly. Among solids, the prevalent error category was milling with 45.47%. The preparation by mixing drugs was an error in almost 40% from the solid drugs doses. The insufficient grinding occurred in 73.33% from the folic acid doses, amiodarone hydrochloride (58.97%), and from bromopride (50.00%). Mixing with other drugs occurred in 66.66% from bromopride doses, amlodipine besylate (53.33%), bamifilina (43.47%), folic acid (40.00%), and acetylsalicylic acid (33.33 %). The administration errors were no breaks and improper probe handling. The average errors rate of administration was 32.64%, being 17.14% for pause and 48.14% for the probe handling. Failure to wash the probe before administration was the most common mistake and not to wash the probe after that was the most unusual. The drugs most commonly involved in errors in the administration were amiodarone hydrochloride (n=39), captopril (n=33), hydralazine hydrochloride (n=7), and levothyroxine sodium (n=7). In 330 medication dosages, the probes were not washed, before the administration. The drugs inadequate preparation and administration can lead to losses in bioavailability, decreased serum levels, and risk of patient poisoning. Preparing and administering medications is a common procedure but showed high error rates, maybe reflecting little knowledge from these professionals about the best practices in drug therapy. There is a need for greater investment by all involved professionals, doctors, nurses, and pharmacists on issues involving the drug safety and rethink the process of nursing work.
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Solfa, Fabiana Vieira. "Desperdício de dieta enteral em UTI : análise de modo de falhas e efeitos de danos ao paciente grave /." Botucatu, 2014. http://hdl.handle.net/11449/123977.
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Orientador: Silvia Justina PapiniCoorientador: Sérgio Alberto Rupp de Paiva
Coorientador: Miriam Cristina Marques da Silva Paiva
Banca: Marina Nogueira Berbel Bufarah
Banca: Paula Azevedo Gaiola
Resumo: Introdução: O estudo surgiu em razão da necessidade de compreender o desperdício de dieta enteral na unidade de terapia intensiva. Diversos fatores contribuem para o desperdício de dieta enteral, podendo ser intrínsecos (intolerância gastrointestinal) ou extrínsecos ao paciente (exames, cirurgias), desde a prescrição da dieta até o final da sua administração. Duas formas de verificação do desperdício foram comparadas e testadas como hipóteses: a anotação de enfermagem e a medida direta do volume residual do frasco. A utilização da metodologia de Modo de Falhas e Análise de Efeitos na terapia nutricional e o estudo do desperdício da dieta trouxe pioneirismo ao estudo. Metodologia: O desperdício foi verificado por metodologia quantitativa, o volume anotado pela enfermagem e o volume medido no frasco. Foram avaliados também índices de gravidade dos pacientes e comparados com variáveis relacionadas à dieta enteral. As causas do desperdício poderiam ser encontradas em todas as etapas do processo de dieta enteral. Optou-se nesse trabalho, também, pela metodologia da análise do modo de falhas e efeitos (FMEA), mapeando as etapas, identificando os riscos potenciais e avaliando possíveis danos com pontuação acima de oito através da análise de causa raiz. Resultados/ Discussão: Houve diferença significativa em relação aos volumes de dieta desperdiçados segundo a anotação de enfermagem e o volume medido no frasco. O volume anotado pela enfermagem era maior que o medido. Esse fato pode levar a consequências importantes referentes à anotação inadequada por se tratar de um grande volume desperdiçado, segundo a anotação de enfermagem. Quanto aos índices de gravidade do paciente e variáveis referentes à dieta enteral, houve diferença significativa relacionada às variáveis sexo, idade, uso de droga vasoativa e tempo de internação. Assim, o desperdício foi maior entre os homens, não idosos, internados ...
Abstract: Introduction: This study arose from the need to understand the waste of enteral nutrition in the intensive care unit. Several factors contributed to the waste of enteral feeding and may be intrinsic (gastrointestinal intolerance) or extrinsic to the patient (tests, surgeries), since the diet prescription moment until the end of its administration. Two ways of checking the waste were compared and tested as hypotheses: nurse diary and direct measurement of the residual volume of the bottle. The use of Failure Mode and Effects Analysis methodology in nutritional therapy and the study of diet waste brought originality to the work. Methodology: The waste was verified by quantitative methodology, the volume recorded by the nursing staff and the volume measured on the bottle. Severity scores of patients were also evaluated and compared with enteral nutrition-related variables. The causes of waste could be found at all stages of enteral feeding process, and in this study it was decided by the Failure Mode and Effect Analysis (FMEA) methodology, mapping process, identifying potential risks and evaluating probable damage with score above eight through root cause analysis. Results / Discussion: there was a significant difference between volumes of diet waste according to the nurse diaries and the volume measured on the bottle. The volume registered by the nursing staff was higher than the measured one. This fact may lead to important consequences regarding inappropriate notes once it's about a big volume wasted, according to the records of the nursing staff. As for patient severity scores and variables related to enteral feeding, there were meaningful differences related to sex, age, use of vasoactive drugs and hospitalization time. Thus, the waste was higher among men, not elderly, hospitalized for less than a week (waste per day), without the use of vasoactive drugs. Regarding process failures, most occurred in the period of suspension of the ...
Mestre
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Dourthe, Cédric. "Tomographie microonde d'objets enterrés. Application à l'auscultation radar." Phd thesis, Ecole des Ponts ParisTech, 1997. http://tel.archives-ouvertes.fr/tel-00005615.
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Martínez, Fernández María del Carmen. "Códigos y grafos sobre anillos de enteros complejos." Doctoral thesis, Universidad de Cantabria, 2007. http://hdl.handle.net/10803/10699.
Full textAbstract:
El objetivo de esta tesis es definir códigos perfectos sobre diferentes espacios de señal multidimensionales. Para resolver este problema, esta memoria presenta una relación original entre las Teorías de Grafos, Números y Códigos. Uno de nuestros principales resultados es la propuesta de una métrica adecuada sobre constelaciones de señal de tipo cuadrático, hexagonal y cuatro-dimensional. Esta métrica es la distancia entre los vértices de una nueva clase de grafos de Cayley definidos sobre diferentes anillos de enteros, en concreto, los enteros de Gauss, Eisenstein-Jacobi y Lipschitz. Así, resolvemos el problema de Teoría de Grafos conocido como el cálculo del conjunto perfecto dominante sobre las familias de grafos definidas en esta memoria. Para cada caso, daremos una condición suficiente para obtener dicho conjunto. La obtención de estos conjuntos de dominación implica directamente la construcción de códigos perfectos sobre los alfabetos que se consideran.Además, se obtendrán algunos resultados de isomorfía y embebimiento de grafos. En particular, se establecerán las relaciones entre grafos circulantes, toroidales y los que se presentan en este trabajo. Más concretamente, se mostrará que siempre existen órdenes para los cuales un grafo Toro puede ser embebido en un grafo Gaussiano, de Esenstein-Jacobi o de Lipschitz. Esto implica que la conocida distancia de Lee es un caso particular de las métricas presentadas en este trabajo.The aim of this work is to define perfect codes for different multidimensional signal spaces. To solve this problem, this thesis presents an original relationship among the fields of Graph Theory, Number Theory and Coding Theory. One of our main findings is the proposal of a suitable metric over quadratic, hexagonal and four-dimensional constellations of signal points. This metric is the distance among vertices of a new class of Cayley graphs defined over integer rings, namely Gaussian integers, the Eisenstein-Jacobi integers and the Lipschitz integers.A problem in Graph Theory known as the perfect dominating set calculation is solved over the families of graphs defined in this memory. A sufficient condition for obtaining such a set is given for each case. The obtention of these sets of domination directly yields to the construction of perfect codes for the alphabets under consideration. In addition, some isomorphism and graph embedding results are going to be obtained. Specially, the relations between circulant, toroidal and the graphs presented in this work are stated. In particular, there always exist orders for which a Torus graph can be embedded in Gaussian, Eisenstein-Jacobi and Lipschitz graphs. This implies that the well-known Lee distance is a subcase of the metrics presented in this research.
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Tafazoli, Farideh. "Perturbation of the epithelial barrier by enteric pathogens /." Linköping : Univ, 2001. http://www.bibl.liu.se/liupubl/disp/disp2001/med702s.pdf.
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Jacobson, Magdalena. "Enteric diseases in pigs from weaning to slaughter /." Uppsala : Dept. of Large Animal Clinical Sciences, Swedish Univ. of Agricultural Sciences, 2003. http://epsilon.slu.se/v158.pdf.
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Castro, del Campo Nohelia. "Survival of Enteric Bacteria and Viruses in Biosolids." Diss., The University of Arizona, 2007. http://hdl.handle.net/10150/195414.
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In the developed world most of domestic sewage is treated by the activated sludge process, which results in large volumes of sludge or biosolids being produced. This results in millions of tons of biosolids produced each year in the United States, which must either be disposed of or recycled in some manner. Land application is seen as the most economical and beneficial way of handling biosolids. Although the United States Environmental Protection Agency supports and regulates the land application of biosolids, more research is needed to ensure its safe.The Appendix study A assessed the potential of Salmonella regrowth in Class A biosolids pellets and compost after land application. No Salmonella growth occurred in any of the soil/biosolids mixtures regardless of inoculum size or moisture content. While regrowth of Salmonella in biosolids may occur under saturated conditions it does not occur after Class A biosolid land application at typical agronomic rates. The Appendix B study evaluated the sensitivity of BGM and PLC/PRF/5 cell lines for detection of viruses as well as the occurrence and concentration of adenoviruses. The PLC/PRF/5 cell line was more sensitive for the detection of adenovirus and other enteroviruses in raw and Class B biosolids. The Appendix C study determined the potential of regrowth of Salmonella typhimurium in vermicompost and Class A biosolids alone and after addition to soil. In summary, no regrowth of Salmonella was observed, and the die-off of Salmonella was not different in soil, biosolids or vermicompost.
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Rodriguez, Roberto Alejandro. "Occurence of Enteric Viruses on Combined Sewer Overflows." Diss., The University of Arizona, 2007. http://hdl.handle.net/10150/194483.
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The goals of this dissertation were to determine the viral contribution of combined sewer overflows (CSO) to receiving waters during wet weather conditions, and to compare the use of the primary liver carcinoma (PLC/PRF/5) cells with the buffalo green monkey (BGM) cells for total culturable virus assay (TCV). To assess the contribution of CSO on the viral quality of the receiving water, samples of discharges and effluent receiving waters of three sewage reclamation plants located in Illinois were collected from June to October during two consecutive years. Samples were tested for TCV, adenovirus and norovirus. Viral concentration in the receiving water increases approximately ten times the concentration during CSO events in comparison with dry weather. An assessment comparing TCV by PLC/PRF/5 and BGM cells was also conducted using sewage samples collected before and after disinfection. PLC/PRF/5 cells detected between 10 to 50 times more viruses (?) than the BGM cells. Adenoviruses were detected in the PLC/PRF/5 cells, but not in the BGM cells. In conclusion, CSO events resulted in a significant increase in the concentration of viruses in the receiving waters and PLC/PRF/5 cells are more sensitive for enteric virus detection than the BGM cell line.