(Re)thinking patient education and preparation in nuclear medicine and radiology departments: perspectives from technologists and recent-graduates

Patient-centered approach is gaining prominence in several areas of Medicine and is increasingly considered as an important paradigm for the provision of quality healthcare. The communication established between health professionals and patients in hospitals became increasingly seen as fundamental and to be valued, namely in areas such as Radiology (RD) or Nuclear Medicine (NM). Patient education is therefore a common practice in the NM and RD departments, mainly due to the lack of knowledge about this kind of procedures, which is believed to be a reality, based on our empirical evidence and on data not yet published. The aim of this study is to characterize current practices used in patient education in Portuguese Departments of Nuclear Medicine and Radiology.info:eu-repo/semantics/publishedVersio

Supersymmetric Higgs pair discovery prospects at hadron colliders

We study the potential of hadron colliders in the search for the pair production of neutral Higgs bosons in the framework of the Minimal Supersymmetric Standard Model. Using analytical expressions for the relevant amplitudes, we perform a detailed signal and background analysis, working out efficient kinematical cuts for the extraction of the signal. The important role of squark loop contributions to the signal is emphasised. If the signal is sufficiently enhanced by these contributions, it could even be observable at the next run of the upgraded Tevatron collider in the near future. At the LHC the pair production of light and heavy Higgs bosons might be detectable simultaneously.Comment: 5 pages, hep99, 6 figures; Presented at the International Europhysics Conference on High Energy Physics, Tampere, Finland, 15-21 July 199

Analysis on the Implementation of Clinical Performance Management Development in the Obstetric Inpatient Ward of Belu District General Hospital East Nusa Tenggara

Development of clinical performance management (PMKK) was an effort to develop managerialability and performance of midwives in implementing obstetric care service in the qualified healthservice institution. Based on the Indonesian Health Minister Decree no. 836/MENKES/SK/VI/ 2005 regarding PMKK, accordingly, that program would be implemented by Atambua DistrictGeneral Hospital (RSUD) in 2006 but in the reality that program was difficult to be implemented.The result of an evaluation showed that PMKK program had not run well.This study used applied observational design and qualitative approach. The main informants were7 midwives working at the obstetric inpatient wards of RSUD Atambua. Triangulation informantswere the head of the obstetric inpatient wards, head of the service unit, head of the service departmentand patients.Bureaucracy structure was specifically related to PMKK such as no workers decree, consequentlyclarity of their task form and responsibilities were difficult to know and understood. Standardoperating procedure, job description and performance indicator had been provided however theimplementation was based only on the rutinity. No DRK or monitoring and evaluation that weredesigned according to PMKK standard, but the implementation of discussion, monitoring andevaluation were done together and scheduled. In general, there was poor communication betweenworkers and their leaders specifically on PMKK. It could be seen that there was no PMKK programsocialization to midwives and as a results several midwives have no knowledge on PMKK program.No special team formed formally to implement PMKK program. Facilities for PMKK program hadnot been provided according to the need.Atambua district general hospital needs to assemble PMKK team. To improve midwivesunderstanding on PMKK program, the hospital needs to do socialization of the policies by increasingthe intensity of interactive forum between District Health Office and Hospital and also conductingspecial training on PMKK program annually. For program continuity, it is better to increase thefrequency of case reflection discussion, program monitoring and evaluation. It has to be scheduledproperly and using check list when conducting evaluation

Magnetic resonance imaging of the vocal tract: techniques and applications

Magnetic resonance (MR) imaging has been used to analyse and evaluate the vocal tract shape through different techniques and with promising results in several fields. Our purpose is to demonstrate the relevance of MR and image processing for the vocal tract study. The extraction of contours of the air cavities allowed the set-up of a number of 3D reconstruction image stacks by means of the combination of orthogonally oriented sets of slices for each articulatory gesture, as a new approach to solve the expected spatial under sampling of the imaging process. In result these models give improved information for the visualization of morphologic and anatomical aspects and are useful for partial measurements of the vocal tract shape in different situations. Potential use can be found in Medical and therapeutic applications as well as in acoustic articulatory speech modelling

Discourse and Configurations of Gender

My research paper is an investigation of the discourse of gender in relation to the work of Michel Foucault, Susan Bordo, Judith Butler and the artists Louise Bourgeois, Fiona Hall, Jo Spence and Neil Emmerson. I have applied Foucault's notion of the formation, necessity and operations of discourses as the basis from which ideas can be articulated, and the context within which notions of gender are formulated and challenged. I examine the processes in discourses, such as the imposition of disciplines to control the subject, which in turn are inscribed in the body of the subject by the subject, as they begin to perceive and define themselves in terms of the disciplines. I use this theory on the relationship between discourse-power-knowledge to analyse my work and that of the artists mentioned. The work of each artist is discussed in terms of the discourse of gender and the basis from which they critique its power, its effects on bodies and forms of representation through a marginal discourse. For the purposes of my work, the conclusion reached is that to disrupt the discourse of gender entails a continual questioning and awareness of its 'truths,' processes and effects. Description of Studio Work: The three major works examine the power and operations of the discourse of gender on bodies and how marginal discourses subvert these constructions. My works in paper, printmedia and metal, in two dimensions and three, reflect the effects through forms that seek to question limitations and extend our conception of male and female bodies. The wall piece, Out of Order, re-configures symbols and signs from the discourse of gender as a means of disrupting notions that gender is immutable. A swirling red line is woven through a densely layered mass of horizontal broken lines. The addition of symbols, X and Y chromosomes, numbers and other tokens of gender, appear at various points in this marginal discourse on conception of 'bodies.' Mammaphone, which accompanies Out of Order and Bullrushes, consists of an enlarged breast LP playing on a turntable. The 'tracks' are a litany of terms for the breast from slang and maternal discourses. The turntable that 'hosts' the LP sits on top of a stylised 'flight recorder's black box,' which suggests the hidden discourse on gender. Bullrushes, is an arrangement of 20 phallic-like forms each on a flexible metal rod that sways with the passage of air around the work. The work presents male bodies as durable, delicate and vulnerable despite the norms of the masculine discourse. The intention is to put into process an interrogation of the effects of gender on bodies and the possibilities for re-thinking the discourse of gender

Morfometria do trato vocal por ressonância magnética: simulação de padrões patológicos articulatórios

Introdução - A análise da forma ou morfometria de estruturas anatómicas, como o trato vocal, pode ser efetuada a partir de imagens bidimensionais (2D) como de aquisições volumétricas (3D) de ressonância magnética (RM). Esta técnica de imagem tem vindo a ter uma utilização crescente no estudo da produção da fala. Objetivos - Demonstrar como pode ser efetuada a morfometria do trato vocal a partir da imagem por ressonância magnética e ainda apresentar padrões anatómicos normais durante a produção das vogais [i a u] e dois padrões articulatórios patológicos em contexto simulado. Métodos - As imagens consideradas foram recolhidas a partir de aquisições 2D (Turbo Spin-eco) e 3D (Flash Gradiente-Eco) de RM em quatro sujeitos durante a produção das vogais em estudo; adicionalmente procedeu-se à avaliação de duas perturbações articulatórias usando o mesmo protocolo de RM. A morfometria do trato vocal foi extraída com recurso a técnicas manuais (para extração de cinco medidas articulatórias) e automáticas (para determinação de volumes) de processamento e análise de imagem. Resultados - Foi possível analisar todo o trato vocal, incluindo a posição e a forma dos articuladores, tendo por base cinco medidas descritivas do posicionamento destes órgãos durante a produção das vogais. A determinação destas medições permitiu identificar quais as estratégias mais comummente adotadas na produção de cada som, nomeadamente a postura articulatória e a variação de cada medida para cada um dos sujeitos em estudo. No contexto de voz falada intersujeitos, foi notória a variabilidade nos volumes estimados do trato vocal para cada som e, em especial, o aumento do volume do trato vocal na perturbação articulatória de sigmatismo. Conclusão - A imagem por RM é, sem dúvida, uma técnica promissora no estudo da fala, inócua, não-invasiva e que fornece informação fiável da morfometria do trato vocal.Introduction - The shape or morphologic analysis of anatomical structures, such as the vocal tract can be performed from two-dimensional (2D) or volumetric acquisitions (3D) of magnetic resonance imaging (MRI). This imaging technique has had an increasing use in the study of speech production. Objectives - To determine a method to perform the morphometric analysis of the vocal tract from magnetic resonance imaging; to present anatomical patterns during the normal speech production of some vowels and two pathological articulatory disorders in simulated context. Methods - The image data was collected from 2D (Turbo Spin Echo) and 3D (Flash Gradient Echo) acquisitions of MRI of four subjects during the production of three vowels; in addition, two articulatory disorders were assessed using this imaging protocol. The morphology of the vocal tract was extracted using manual and automatic techniques of image processing and analysis. Results - Based on five articulatory measurements, it was possible to study the entire vocal tract during vowel production, including the position and shape of the articulators involved. Based on these measurements, it was possible to identify the strategies most commonly adopted in the production of each sound, including the articulatory posture and the modification of each measure for the subjects under study. Concerning the voices of the different speakers, the variability in the assessed volumes of the vocal tract for each sound was found, and in particular, the increased vocal tract volume in the articulatory disorder - the sigmatism. Conclusion - MRI is a promising technique for speech production studies, safe, non-invasive and that provides reliable information concerning the morphometric analysis of the vocal tract

Utilização da Imagem por Ressonância Magnética nos Estudos sobre a Produção da Fala

A fala é uma ferramenta única de comunicação, que envolve um conjunto de órgãos que trabalham sincronamente na produção de sons. Os mecanismos envolvidos são complexos, sendo várias as técnicas de estudo da fala, quer do ponto de vista acústico, quer do ponto de vista morfológico. A ressonância magnética tem revelado potencialidades únicas no estudo do tracto vocal, e que são aqui destacadas. O principal objectivo deste estudo é dar a conhecer esta técnica de imagem e demonstrar a sua utilização no estudo da produção da fala, nomeadamente do Português Europeu. Através da recolha e análise de imagens foi possível a obtenção e construção de modelos tridimensionais do tracto vocal nas mais variadas posições articulatórias. Recorrendo a uma técnica de sincronização através de monitorização cardíaca e a aquisições de imagem ultra-rápidas foi possível também a captação dinâmica por sub-amostragem e a observação dos movimentos articulatórios envolvidos durante a produção de três sílabas. A caracterização morfológica e dinâmica do tracto vocal com base nas imagens de ressonância magnética é, face aos resultados obtidos, fiável e deveras importante para o conhecimento deste mecanismo. Para além disso, a informação obtida desperta um interesse multidisciplinar e aplicações diversas com potencialidades marcantes face aos esperados avanços tecnológicos desta técnica de imagem

Spectral degeneracy and escape dynamics for intermittent maps with a hole

We study intermittent maps from the point of view of metastability. Small neighbourhoods of an intermittent fixed point and their complements form pairs of almost-invariant sets. Treating the small neighbourhood as a hole, we first show that the absolutely continuous conditional invariant measures (ACCIMs) converge to the ACIM as the length of the small neighbourhood shrinks to zero. We then quantify how the escape dynamics from these almost-invariant sets are connected with the second eigenfunctions of Perron-Frobenius (transfer) operators when a small perturbation is applied near the intermittent fixed point. In particular, we describe precisely the scaling of the second eigenvalue with the perturbation size, provide upper and lower bounds, and demonstrate $L^1$ convergence of the positive part of the second eigenfunction to the ACIM as the perturbation goes to zero. This perturbation and associated eigenvalue scalings and convergence results are all compatible with Ulam's method and provide a formal explanation for the numerical behaviour of Ulam's method in this nonuniformly hyperbolic setting. The main results of the paper are illustrated with numerical computations.Comment: 34 page

Coupling between annual and ENSO timescales in the malaria-climate association in Colombia.

We present evidence that the El Niño phenomenon intensifies the annual cycle of malaria cases for Plasmodium vivax and Plasmodium falciparum in endemic areas of Colombia as a consequence of concomitant anomalies in the normal annual cycle of temperature and precipitation. We used simultaneous analyses of both variables at both timescales, as well as correlation and power spectral analyses of detailed spatial (municipal) and temporal (monthly) records. During "normal years," endemic malaria in rural Colombia exhibits a clear-cut "normal" annual cycle, which is tightly associated with prevalent climatic conditions, mainly mean temperature, precipitation, dew point, and river discharges. During historical El Niño events (interannual time scale), the timing of malaria outbreaks does not change from the annual cycle, but the number of cases intensifies. Such anomalies are associated with a consistent pattern of hydrological and climatic anomalies: increase in mean temperature, decrease in precipitation, increase in dew point, and decrease in river discharges, all of which favor malaria transmission. Such coupling explains why the effect appears stronger and more persistent during the second half of El Niño's year (0), and during the first half of the year (+1). We illustrate this finding with data for diverse localities in Buenaventura (on the Pacific coast) and Caucasia (along the Cauca river floodplain), but conclusions have been found valid for multiple localities throughout endemic regions of Colombia. The identified coupling between annual and interannual timescales in the climate-malaria system shed new light toward understanding the exact linkages between environmental, entomological, and epidemiological factors conductive to malaria outbreaks, and also imposes the coupling of those timescales in public health intervention programs