MS

thesisIn June 1980 the Nurse Practitioner Pilot Project was initiated by the Nurse Practitioner Conference Group of Utah. Sixty-two of Utah's 192 registered nurse practitioners became participants in the Pilot Project. Senate Bill 198 allowed nurse practitioners in the state of Utah to prescribe medications while practicing according to protocols in collaboration with approved physicians over a two and one-half year period. The purpose of the research was to establish whether or not nurse practitioners adhered to protocols mandated by the law. An ex-post facto chart review of the nurse practitioner participants was done according to recorded subjective, objective, laboratory and care plan information. Data revealed that 9 7% of the sample was practicing at a level higher than the minimum requirements of the protocol guidelines. Demographic variables were not statistically significant in their relationship to nurse practitioners' adherence to protocols

Bisphosphonate-associated jaws osteonecrosis: an important complication of oncology treatment

Os bisfosfonatos são um grupo de medicamentos utilizados no tratamento de doenças malignas metastáticas e em outras doenças ósseas como osteoporose e doença de Paget. A despeito dos seus benefícios, uma importante complicação denominada de osteonecrose dos maxilares vem sendo observada nos pacientes usuários crônicos dos bisfosfonatos que se caracteriza clinicamente por exposições ósseas na região maxilofacial persistente, acompanhadas de osteomielite, geralmente sintomáticas e cujo tratamento é complexo. Este estudo tem por objetivo revisar a literatura sobre a osteonecrose associada ao uso dos bisfosfonatos, em especial, em oncologia, no período de 2003 a 2008. Serão apresentados e discutidos os fatores de risco, aspectos etiopatogênicos, clínicos, imagenológicos, terapêuticos e preventivos desta doença. Devido à dificuldade de tratamento da osteonecrose associada aos bisfosfonatos, o foco deve ser a prevenção, sendo o ideal a eliminação de quadros infecciosos orais antes da terapia com os bisfosfonatos ter sido iniciada e minimizar traumas em boca após o uso destes medicamentos.Bisphosphonates are drugs used in the treatment of malignant metastatic diseases and in other bone lesions such as osteoporosis and Paget´s disease. Besides their benefits, jaw osteonecrosis, an important side effect, has been observed in long-term users of these drugs. Jaw osteonecrosis is clinically characterized by prolonged maxillary and mandible bone exposure accompanied by osteomyelitis. These lesions are usually symptomatic and difficult to treat. This study has the objective of reviewing publications from 2003 to 2008 about bisphosphonate-associated jaw osteonecrosis, in particular in relation to oncology. Risk factors, and etiopathological, clinical, radiographic, therapeutic, and preventive aspects of this condition are presented and discussed. Due to the difficulty to treat this disease, the focus must be prevention, with the ideal therapy being the elimination of oral infections before treatment with bisphosphonates is initiated thereby attempting to minimize possible traumas to the mouth with the use of these medications

Designing intercultural space. A multi-scalar approach in the Albergheria neighbourhood in Palermo

Migration has always been a major driver of urban transformation stimulating opportunities and challenges for cities and encouraging architectural and urban designers for taking a proactive and dynamic role in responding to the crisis. Enhancing these changes, and designing intercultural spaces for local communities, is a complex and urgent spatial challenge, that should be addressed by a multi-scalar approach aiming to integrate urban, architectural and public spaces. This paper illustrates a research-action resulting from a collective work developed on key urban spaces of the Albergheria neighbourhood of Palermo, where a design-led research based on a multi-scalar regeneration approach (urban, architectural and public space) can reframe the role of architecture and spatial practices as agents of social, intercultural inclusion and spatial reactivation at different scales

Geração geométrica e modelagem automatizada de propulsores da Série-B de Wageningen

TCC (graduação) - Universidade Federal de Santa Catarina. Campus Joinville. Engenharia Naval.O presente trabalho consiste na automatização da geração de geometria e modelagem tridimensional de propulsores do tipo B-Series usando os softwares MATLAB e Rhinoceros. Uma rotina de MATLAB foi criada baseada na publicação original de Kuipper (1992) a respeito das Séries Wageningen. Todos os dados de entrada, como diâmetro, relação passo sobre diâmetro, razão de áreas expandidas e número de pás devem ser informados pelo usuário na interface gráfica e um arquivo contendo a geometria da pá do hélice será gerado. Para a modelagem automatizada, uma rotina em IronPython foi desenvolvida para ser executada no Rhinoceros com o arquivo gerado pelo MATLAB. Para se obter uma modelagem com superfícies de alta qualidade, foram desenvolvidas no MATLAB, durante a rotina de geração da geometria, curvas de tendência e interpolação de valores não existentes na publicação original sobre a série. Com isso pode-se suavizar as curvas que representam cada uma das seções, criando mais pontos para descrevê-las, seguindo uma curva do tipo spline mais suave que a obtida utilizando apenas os dados originais. Além da criação de seções extras para frações de raios intermediárias afim de se obter um maior controle sobre a geometria. A validação da automatização da geração geométrica e modelagem 3D se deu comparando-se um propulsor já projetado pela Marine Technical Services com um propulsor desenvolvido através das duas rotinas desenvolvidas para esse trabalho. Essa comparação foi feita de forma quantitativa comparando-se o valor de massa entre o propulsor desenvolvido e o de referência. Além do mais, inspeções visuais auxiliadas por ferramentas de análise do Rhinoceros foram usadas de forma qualitativa para validação da qualidade das formas e superfícies desenvolvidas. O comportamento da curva de áreas seccinionais também será analisado nessa etapa. Um erro percentual relativo muito pequeno quanto a massa dos propulsores foi encontrado, indício que o propulsor modelado no presente trabalho está muito semelhante ao projeto original. As análises visuais e curvas seccionais indicam a ausência defeitos graves nas superfícies.The current work consists in automating the generation and three-dimensional modeling of B-Series type thrusters using MATLAB and Rhinoceros 3D. A MATLAB script was created based on the original publication of Kuipper (1992) about the Wageningen Series. All the input data, as propeller diameter, pitch and diameter ratio, expanded area ratio and number of blades must be informed by the user in the graphic interface and the output will be a file with the blade geometry. For the automated modeling a script was developed in Iron Python to be run in Rhinoceros with the file generated by MATLAB. To obtain a high-quality surface when modelling, was developed in MATLAB inside the geometric generating script trend curves of data and interpolation of non-existing values in the original publication about the series. Using the fitted curves was possible to smooth out the curves representing each one of the sections, by creating more points do describe them and so following a spline curve smother than the one resulted from the original data. In addition, were created extra sections between the original radius fractions in order to obtain higher control about the geometry. In order to validate the whole process of geometric generating and automated modeling a propeller already designed by the Marine Technical Services will be compared with a propeller fully developed through the scripts of the present work. That comparation will be made qualitatively looking into the result for the propeller mass and polar moment of inertia between the developed propeller and the reference one. Furthermore, visual inspections assisted by the Rhinoceros analysis tolls will be used to evaluate, in a qualitatively way, the developed surfaces and forms. It will also be observed the sectional curve of areas behavior during this step. A tiny relative percent error was found about the mass of the propellers, an indication that the propeller developed in the present work is very similar to the original design. The visual analysis and the curve of sectional areas also indicates the absence of seriues erros in the surfaces

Quantifying the top-down effects of grazers on a rocky shore: selective grazing and the potential for competition

The effect of grazers on the diversity, distribution, and composition of their principal food source has rarely been described for the high intertidal zone of rocky shores, a model system for studying the potential effects of climate change. Along rocky, wave-swept shores in central California, the microphytobenthos (MPB) supports diverse assemblages of limpets and littorine snails, which, at current benign temperatures, could potentially partition food resources in a complementary fashion, thereby enhancing secondary productivity. Two limpet species in particular, Lottia scabra and L. austrodigitalis, may partition components of the MPB, and are likely to affect the composition of the MPB on which they graze. In this study, we describe the composition, nutritional value (C:N ratio), and fluorescence (an index of chlorophyll density) of ungrazed, L. scabra-grazed and L. austrodigitalis-grazed MPB, each as a function of temperature. Fluorescence decreased with increased average daily maximum temperature for ungrazed MPB, but temperature had no discernible effects on either fluorescence or the composition of the MPB of grazed assemblages. L. austrodigitalis and L. scabra did not partition the MPB, and did not exhibit complementarity. Both species exhibited an ordered grazing scheme, in which limpets grazed down certain components of the MPB before others, and grazing increased the C:N ratio of the MPB, decreasing its nutritional value. Taken together, these results suggest that L. austrodigitalis and L. scabra may experience increased competition as warming temperatures reduce the available MP

Legal financial obligations in the United States: A review of recent research

In the United States, legal financial obligations (LFOs) include many types of monetary sanctions. For example, fines are tied to specific offenses and imposed at conviction and fees charge people for the “use” of courts, prisons, and other public services. With the rise of mass incarceration, millions of people across the U.S. owe billions of dollars in LFOs. Yet despite the widespread use of monetary sanctions, it was not until the last decade that research began to uncover the vast system of LFOs embedded throughout U.S. laws and understand their far-reaching socioeconomic consequences. This paper reviews recent research on LFOs across three areas: (1) the political development of LFOs, (2) their implementation and enforcement, and (3) the consequences of LFOs on people, broader social networks, and the functioning of public institutions. We conclude with recommendations for future research that explores the hidden processes connecting these three areas and accounts for the fractured nature of the U.S. government

Efficacy of MRI in the differential diagnosis of odontogenic keratocyst: literature review

According to the World Health Organization (WHO 2017), the odontogenic keratocyst (OKC) is classified as an odon­togenic developmental cyst, with origins from the cellular remnants of the dental lamina. The characteristics of a high rate of cell proliferation, relapse and aggressive growth guide the choice of the type of surgical treatment for the lesion and, consequently, the prognosis. The use of Magnetic Resonance Imaging (MRI) for the differential diagnosis of odon­togenic lesions does not replace anatomopathological examination, but the types of protocols already described illustra­te the influence of these different protocols on the qualitative and quantitative description of keratocysts. We conclude that magnetic resonance imaging is valid as a tool to aid diagnosis of odontogenic lesions, especially for differential diagnosis studies between odontogenic keratocysts and ameloblastomas. De acordo com a Organização Mundial de Saúde (OMS, 2017), o ceratocisto odontogênico (CO) é classificado como um cisto odontogênico de desenvolvimento, com origem nos restos celulares da lâmina dentária. A alta taxa de proliferação celular, recaída e crescimento agressivo direciona a escolha do tipo de tratamento cirúrgico para a lesão e, consequentemente, para seu prognóstico. O uso da ressonância magnética (RM) para o diagnóstico diferencial das lesões odontogênicas não substitui os exames anatomopatológicos, mas os tipos de protocolos já descritos il­ustram a influência desses diferentes protocolos na descrição quantitativa e qualitativa dos ceratocistos. Concluímos que a ressonância magnética é válida como ferramenta de auxílio para o diagnóstico de lesões odontogênicas, principalmente em estudos de diagnóstico diferencial entre ceratocistos odontogênicos e ameloblastomas

O movimento ortodôntico não induz reabsorção cervical externa ou O movimento ortodôntico não altera cor, volume e nem induz inflamação gengival

Nesse trabalho, procurou-se explicar - anatômica e funcionalmente - como se estrutura e se organiza a região cervical dos dentes, para fundamentar os seguintes questionamentos: 1) Por que ocorre Reabsorção Cervical Externa na dentição humana?; 2) Por que na gengivite e na periodontite não se tem Reabsorção Cervical Externa?; 3) Por que depois do traumatismo dentário e da clareação interna pode ocorrer a Reabsorção Cervical Externa?; 4) Por que o movimento ortodôntico não altera a cor e o volume gengival durante o tratamento?; 5) Por que o movimento ortodôntico não induz Reabsorção Cervical Externa, mesmo sabendo-se que a região cervical pode ser muito exigida? A existência de antígenos sequestrados na dentina, a presença de janelas de dentina na região cervical de todos os dentes, a reação do epitélio juncional e a distribuição dos vasos sanguíneos gengivais podem justificar por que a Reabsorção Cervical Externa não ocorre e nem a cor e o volume gengival são alterados no movimento ortodôntico.This study sought to explain, both anatomically and functionally, how the cervical region of human teeth is structured and organized in order to address the following questions: 1) Why does External Cervical Resorption (ECR) occur in human dentition? 2) Why is there no ECR in gingivitis and periodontitis? 3) Why ECR can occur after dental trauma and internal bleaching? 4) Why does orthodontic movement not change the gingival color and volume during treatment? 5) Why does orthodontic movement not induce ECR although it is common knowledge that the cervical region can undergo much stress? The existence of sequestered antigens in the dentin, the presence of dentin gaps in the cervical region of all teeth, the reaction of the junctional epithelium and the gingival distribution of blood vessels may explain why ECR does not occur, nor do gingival color and volume change when teeth are orthodontically moved