Weight Management in Primary Care

Abstract Background: Obesity is a problem in present day primary care. Being overweight or obese affects more than one third of US adults, and has been known to lead to the development of hypertension, hyperlipidemia, type II diabetes, and an overall poor state of health. Dietary and physical activity changes are the first line treatment for overweight or obese patients. Primary care providers report feeling overburdened in treating the overweight and obese, citing a lack of time and resources as primary reasons this issue is not addressed during visits. Purpose: To address this problem, a toolkit was developed for use by providers and patients based on current US Department of Health and Human Services dietary and physical activity recommendations accompanied by a PowerPoint presentation by the DNP student. Outcome: Data collection consisted of pre- and post - toolkit intervention provider surveys. The toolkit was instituted into provider practice for a 45-day period, and a follow-up survey was conducted. The common response was that the toolkit was a valuable educational resource as a first step to weight management education. An overall increase in provider awareness was seen and an improvement of perceptions of weight management patient education. Conclusion: The use of an educational resource packet was helpful in giving primary care providers an efficient and effective way to begin the process of weight management with patients in need. Outside factors such as patient motivation and the patients’ socioeconomic status have been found to be barriers to weight management. Keywords: Obesity, Overweight, Hypertension, Hyperlipidemia, Type II Diabetes, Prevention Education, Weight management, Primary care, Toolkit, Lifestyle Modification

Analyzing the Stability of Relative Performance Differences Between Cloud and Embedded Environments

There has been a shift towards the software-defined vehicle in the automotive industry in recent years. In order to enable the correct behaviour of critical as well as non-critical software functions, like those found in Autonomous Driving/Driver Assistance subsystems, extensive software testing needs to be performed. The usage of embedded hardware for these tests is either very expensive or takes a prohibitively long time in relation to the fast development cycles in the industry. To reduce development bottlenecks, test frameworks executed in cloud environments that leverage the scalability of the cloud are an essential part of the development process. However, relying on more performant cloud hardware for the majority of tests means that performance problems will only become apparent in later development phases when software is deployed to the real target. However, if the performance relation between executing in the cloud and on the embedded target can be approximated with sufficient precision, the expressiveness of the executed tests can be improved. Moreover, as a fully integrated system consists of a large number of software components that, at any given time, exhibit an unknown mix of best-/average-/worst-case behaviour, it is critical to know whether the performance relation differs depending on the inputs. In this paper, we examine the relative performance differences between a physical ARM-based chipset and a cloud-based ARM-based virtual machine, using a generic benchmark and 2 algorithms representative of typical automotive workloads, modified to generate best-/average-/worst-case behaviour in a reproducible and controlled way and assess the performance differences. We determine that the performance difference factor is between 1.8 and 3.6 for synthetic benchmarks and around 2.0-2.8 for more representative benchmarks. These results indicate that it may be possible to relate cloud to embedded performance with acceptable precision, especially when workload characterization is taken into account

Bioenergia versus segurança alimentar : um desafio ao desenvolvimento sustentavel

Orientador: Mariano de Matos MacedoMonografia(Graduaçao) - Universidade Federal do Paraná,Setor de Ciencias Sociais Aplicadas, Curso de Ciencias EconômicasResumo: Este estudo concentra-se nas implicações da utilização da bioenergia, tanto nos benefícios ambientais da sua utilização, quanto na tênue relação com a segurança alimentar. A médio e longo prazos, a exaustão de fontes não-renováveis tende a acarretar maior aproveitamento energético da biomassa porque ela aparenta ser a maior e a mais sustentável fonte de energia renovável. Pode-se conceituar biomassa como sendo a bioenergia produzida a partir de produtos agropecuários e florestais. A partir desta definição, serão apresentadas neste estudo, a bioenergia provinda das principais fontes bioenergéticas como o etanol, o biodiesel, o uso das chamadas florestas energéticas, o aproveitamento de resíduos e dejetos, bem como os chamados biocombustíveis de segunda geração provindos da biomassa lignocelulósica e do uso do dimetilfurano. O Brasil se destaca entre as economias industrializadas com uma elevada participação das fontes renováveis em sua matriz energética. Estimativas mostram que 44,9% da energia fornecida no Brasil são de origem renovável, fato ilustrado por alguns privilégios naturais presente neste país, como a localização de quase todo o território nacional em regiões tropicais e chuvosas, oferecendo excelentes condições para a produção e o uso energético da biomassa em larga escala. A questão da concorrência do uso do solo entre alimentos e bioenergia é motivo de grande discussão. No caso do Brasil, observa-se que há terras agricultáveis disponíveis para ambas as agriculturas e não deve desperdiçar este privilégio, promovendo o desenvolvimento econômico e social, contribuindo para a geração de emprego e renda em nosso país, bem como ampliação da sustentabilidade de nosso planeta

Configuração básica e desempenho recente da cadeia produtiva de materiais plásticos

Resumo: A importância dos plásticos em nosso cotidiano é evidente uma vez que têm sido empregados como substitutos para diversos outros materiais, especialmente metal e madeira, estando presentes em praticamente todos os setores da economia. Há ainda um novo e promissor horizonte petrolífero no Brasil, posicionando-o entre os principais produtores de insumos para plásticos em âmbito mundial. Em face disso, a abordagem sistêmica, expressa através da ótica do encadeamento das operações de produção, se apresenta como alternativa capaz de inserir as unidades produtivas em um ambiente analítico mais amplo, de modo a possibilitar a reflexão e o planejamento deste segmento industrial. Assim sendo, este trabalho teve como objetivo principal obter a configuração da estrutura básica da cadeia produtiva de materiais plásticos, enfatizando a participação e contribuição do estado do Paraná para a cadeia em questão. Foi realizada a caracterização desta considerando as particularidades do Complexo Industrial Petroquímico – do qual faz parte – aplicando a abordagem teórica dos sistemas, de cadeias produtivas industriais e de encadeamentos generalizados ao desenvolvimento. Ao visualizar de maneira definida seu elos componentes foi possível identificar a sua distribuição geográfica, analisar o desempenho produtivo e a importância do comércio exterior. Realizou-se pesquisa do tipo bibliográfica e descritiva, fundamentando-se em estudos exploratórios, com o intuito de coletar informações e subsídios sobre o segmento em questão. Verificou-se ao longo deste estudo a concentração dos três primeiros elos, o que é decorrente da própria estrutura petroquímica, bem como a ausência do Estado do Paraná destas etapas de produção. Contudo, o Estado do Paraná se apresenta com uma expressiva parcela dos transformadores e da Reciclagem Plástica. Esta visão geral do processo de produção de materiais plásticos no Brasil oportunizou a verificação da existência de uma cadeia produtiva completa em âmbito nacional, que necessitará de novos investimentos para processar localmente o petróleo proveniente do Pré-sal, evitando que o Brasil se posicione como um mero exportador de petróleo bruto

Hydrothermal replacement of biogenic and abiogenic aragonite by Mg-carbonates – Relation between textural control on effective element fluxes and resulting carbonate phase

Dolomitization, i.e., the secondary replacement of calcite or aragonite (CaCO3) by dolomite (CaMg[CO3]2), is one of the most volumetrically important carbonate diagenetic processes. It occurs under near surface and shallow burial conditions and can significantly modify rock properties through changes in porosity and permeability. Dolomitization fronts are directly coupled to fluid pathways, which may be related to the initial porosity/permeability of the precursor limestone, an existing fault network or secondary porosity/permeability created through the replacement reaction. In this study, the textural control on the replacement of biogenic and abiogenic aragonite by Mg-carbonates, that are typical precursor phases in the dolomitization process, was experimentally studied under hydrothermal conditions. Aragonite samples with different textural and microstructural properties exhibiting a compact (inorganic aragonite single crystal), an intermediate (bivalve shell of Arctica islandica) and open porous structure (skeleton of coral Porites sp.) were reacted with a solution of 0.9 M MgCl2 and 0.015 M SrCl2 at 200 °C. The replacement of aragonite by a Ca-bearing magnesite and a Mg-Ca carbonate of non-stoichiometric dolomitic composition takes place via a dissolution-precipitation process and leads to the formation of a porous reaction front that progressively replaces the aragonite precursor. The reaction leads to the development of porosity within the reaction front and distinctive microstructures such as gaps and cavities at the reaction interface. The newly formed reaction rim consists of chemically distinct phases separated by sharp boundaries. It was found that the number of phases and their chemical variation decreases with increasing initial porosity and reactive surface area. This observation is explained by variations in effective element fluxes that result in differential chemical gradients in the fluid within the pore space of the reaction rim. Observed reaction rates are highest for the replacement of the initially highly porous coral and lowest for the compact structure of a single aragonite crystal. Therefore, the reaction progress equally depends on effective element fluxes between the fluid at the reaction interface and the bulk solution surrounding the test material as well as the reactive surface area. This study demonstrates that the textural and microstructural properties of the parent material have a significant influence on the chemical composition of the product phase. Moreover, our data highlight the importance of effective fluid-mediated element exchange between the fluid at the reaction interface and the bulk solution controlled by the local microstructure

A time-predictable operating system : towards a constant execution time

Zsfassung in dt. SpracheDie Anwendung von Echtzeitsystemen reicht von der Steuerung von Ampeln bis zur selbstständigen Navigation von Raumschiffen. Bei Echtzeitsystemen hängt die Korrekt- heit des Systemverhaltens nicht nur von der logischen Korrektheit aller Berechnungen sondern auch von dem Zeitpunkt zu welcher die Resultate vorliegen ab. Resultate die nicht innerhalb einer gewissen Zeitspanne vorliegen können katastrophale Auswirkun- gen haben. Um dies zu verhindern ist die Bestimmung der maximalen Reaktionszeit eines Programms von entscheidener Bedeutung.Betriebssystemmechanismen, welche die zeitliche Isolation aller Anwendungen garan- tieren, vereinfachen die zeitliche Analyse von Anwendungen. Die Bestimmung der ma- ximalen Ausführungszeit einer Anwendung ist ein wichtiger Schritt in der zeitlichen Analyse eines Systems. Aufgrund der Komplexität moderner Systeme stellt die Bestim- mung der maximalen Ausführungszeit leider immer noch einen hohen Aufwand dar. Diese Diplomarbeit beschreibt die Entwicklung eines Betriebssystems das zeitliche Iso- lation aller Programme gewährleistet. Weiters weisen alle Betriebssystemfunktionen konstante Ausführungszeiten auf, welche durch eine geringe Anzahl an Messungen be- stimmt werden können. Im weiteren Verlauf werden die verwendeten Programmieransätze und Betriebssystem- konzepte vorgestellt, sowie auf die Implementierung und die dabei gewonnen Erkennt- nisse eingegangen. Die Evaluierung zeigt, dass eine geringe Anzahl an Messungen ausreicht um das zeit- liche Verhalten aller Betriebssystemfunktionen zu bestimmen, sowie die Ausführungs- zeiten dieser konstant gehalten werden konnten.9

Weight Management in Primary Care

Abstract Background: Obesity is a problem in present day primary care. Being overweight or obese affects more than one third of US adults, and has been known to lead to the development of hypertension, hyperlipidemia, type II diabetes, and an overall poor state of health. Dietary and physical activity changes are the first line treatment for overweight or obese patients. Primary care providers report feeling overburdened in treating the overweight and obese, citing a lack of time and resources as primary reasons this issue is not addressed during visits. Purpose: To address this problem, a toolkit was developed for use by providers and patients based on current US Department of Health and Human Services dietary and physical activity recommendations accompanied by a PowerPoint presentation by the DNP student. Outcome: Data collection consisted of pre- and post - toolkit intervention provider surveys. The toolkit was instituted into provider practice for a 45-day period, and a follow-up survey was conducted. The common response was that the toolkit was a valuable educational resource as a first step to weight management education. An overall increase in provider awareness was seen and an improvement of perceptions of weight management patient education. Conclusion: The use of an educational resource packet was helpful in giving primary care providers an efficient and effective way to begin the process of weight management with patients in need. Outside factors such as patient motivation and the patients’ socioeconomic status have been found to be barriers to weight management. Keywords: Obesity, Overweight, Hypertension, Hyperlipidemia, Type II Diabetes, Prevention Education, Weight management, Primary care, Toolkit, Lifestyle Modification

Integrated development – essential condition for modernisation of rural areas

Inspiracją do podjęcia problematyki zintegrowanego rozwoju w kontekście procesu modernizacji wsi było z jednej strony przeświadczenie o pilnej potrzebie jego stymulowania, z drugiej obawa, aby nie był utożsamiany wyłącznie ze zintegrowanym systemem zarządzania. Wprawdzie od lat postulowana idea zintegrowanego rozwoju nie stanowi już novum, nadal jednak pozostaje w sferze deklaracji i nie przełożyła się na skuteczne mechanizmy funkcjonowania wspólnot lokalnych. Potrzeba jej dalszego popularyzowania nie wymaga więc szerokiego uzasadnienia. Na tle istoty modernizacji wsi, cech zintegrowanego zarządzania rozwojem, jego miejsca w przyszłej polityce UE 2014-2020 oraz w nowym systemie zintegrowanego planowania w Polsce, przedstawione będzie: miejsce obszarów wiejskich w systemie zintegrowanego zarządzania rozwojem, zadeklarowane w wybranych dokumentach strategicznych, rola inteligentnej specjalizacji regionów, dobre praktyki województwa opolskiego w stymulowaniu rozwoju, postulaty dotyczące dalszych działań sprzyjających zintegrowanemu rozwojowi, w tym modernizacji wsi.The inspiration to take up the issue of integrated development in the context of the modernization of the village was, on the one hand, the conviction of the urgent need of stimulation, on the other hand, there was a concern that it should not be identified entirely with the integrated management system. Although the idea of integrated development is no longer a novelty, but it still remains a declaration and not translated into effective mechanisms for the functioning of local communities. The need to popularise it further does not require an extensive justification. The essence of the modernisation of rural background, characteristics of the integrated management of development, its place in the future EU policy 2014-2020 and in the new system of integrated planning in Poland, will be presented: rural location in the system of integrated management development, declared in selected strategic documents, the role of smart specialization of regions, the Opolskie voivodeship good practice to stimulate development, recommendations for further actions conducive to integrated development, including modernization of the countryside

Configuração básica e desempenho recente da cadeia produtiva de materiais plásticos

Resumo: A importância dos plásticos em nosso cotidiano é evidente uma vez que têm sido empregados como substitutos para diversos outros materiais, especialmente metal e madeira, estando presentes em praticamente todos os setores da economia. Há ainda um novo e promissor horizonte petrolífero no Brasil, posicionando-o entre os principais produtores de insumos para plásticos em âmbito mundial. Em face disso, a abordagem sistêmica, expressa através da ótica do encadeamento das operações de produção, se apresenta como alternativa capaz de inserir as unidades produtivas em um ambiente analítico mais amplo, de modo a possibilitar a reflexão e o planejamento deste segmento industrial. Assim sendo, este trabalho teve como objetivo principal obter a configuração da estrutura básica da cadeia produtiva de materiais plásticos, enfatizando a participação e contribuição do estado do Paraná para a cadeia em questão. Foi realizada a caracterização desta considerando as particularidades do Complexo Industrial Petroquímico – do qual faz parte – aplicando a abordagem teórica dos sistemas, de cadeias produtivas industriais e de encadeamentos generalizados ao desenvolvimento. Ao visualizar de maneira definida seu elos componentes foi possível identificar a sua distribuição geográfica, analisar o desempenho produtivo e a importância do comércio exterior. Realizou-se pesquisa do tipo bibliográfica e descritiva, fundamentando-se em estudos exploratórios, com o intuito de coletar informações e subsídios sobre o segmento em questão. Verificou-se ao longo deste estudo a concentração dos três primeiros elos, o que é decorrente da própria estrutura petroquímica, bem como a ausência do Estado do Paraná destas etapas de produção. Contudo, o Estado do Paraná se apresenta com uma expressiva parcela dos transformadores e da Reciclagem Plástica. Esta visão geral do processo de produção de materiais plásticos no Brasil oportunizou a verificação da existência de uma cadeia produtiva completa em âmbito nacional, que necessitará de novos investimentos para processar localmente o petróleo proveniente do Pré-sal, evitando que o Brasil se posicione como um mero exportador de petróleo bruto