A new concept in cancer care: The supportive care program

This article describes the findings of a pilot program designed to enter advanced prostate cancer patients into the hospice benefit while they are still being actively treated, but in situations where treatment is known to be primarily palliative in nature. The supportive care program (SCP) combines the medical model’s goal to prolong life with the goal of hospice to palliate symptoms and improve quality of life (QOL). The concept of a SCP was developed to create a team approach where advanced prostate cancer patients who are starting investigational chemotherapy are concurrently enrolled into a hospice program. The objectives were to identify whether SCP improved QOL and continuity of care while remaining cost-effective. Data were collected on patient quality of life, performance status, use of health care resources, and costs for the 36 enrolled patients. A comparison was made to a matched set of 23 control patients. Our findings indicate that the SCP contributes to continuity of care while being cost-effective.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66626/2/10.1177_104990919901600608.pd

The effect of collaboration and IT competency on reverse logistics competency - Evidence from Brazilian supply chain executives

Business models have being designed, worldwide, to create sustainability competencies and in particular to incorporate reverse logistics, but Brazilian executives have not yet fully adhered to Law 12,305 on solid waste and reverse logistics. What would be the Brazilian executives' perception about reverse logistics competency and the support provided by a collaborative and IT competency? The objective of the paper is to investigate the effects of collaboration and IT competency in developing reverse logistics competency, as a strategy, and its consequences in economic and environmental performance. A survey was performed with 320 Brazilian supply chain executives and analyzed using Structural Equation Modeling. The models demonstrated that collaboration has a direct positive influence on the development of reverse logistics competency, by executives' point of view. The moderation effect between collaboration and IT competency for reverse logistics was not confirmed, since it was adopted a strategic view of reverse logistics. Therefore, despite there was not a moderation effect, IT presented a lower direct effect on reverse logistics competency. Results reinforce that organizations that develop reverse logistics competency tend to improve their economic and environmental performances.info:eu-repo/semantics/publishedVersio

Baralho de Ligações Químicas: uma opção de jogo lúdico educativo

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Mucociliary clearance, airway inflammation and nasal symptoms in urban motorcyclists

OBJECTIVES: There is evidence that outdoor workers exposed to high levels of air pollution exhibit airway inflammation and increased airway symptoms. We hypothesized that these workers would experience increased airway symptoms and decreased nasal mucociliary clearance associated with their exposure to air pollution. METHODS: In total, 25 non-smoking commercial motorcyclists, aged 18-44 years, were included in this study. These drivers work 8-12 hours per day, 5 days per week, driving on urban streets. Nasal mucociliary clearance was measured by the saccharine transit test; airway acidification was measured by assessing the pH of exhaled breath condensate; and airway symptoms were measured by the Sino-nasal Outcome Test-20 questionnaire. To assess personal air pollution exposure, the subjects used a passive-diffusion nitrogen dioxide (NO2) concentration-monitoring system during the 14 days before each assessment. The associations between NO2 and the airway outcomes were analyzed using the Mann-Whitney test and the Chi-Square test. Clinicaltrials.gov: NCT01976039. RESULTS: Compared with clearance in healthy adult males, mucociliary clearance was decreased in 32% of the motorcyclists. Additionally, 64% of the motorcyclists had airway acidification and 92% experienced airway symptoms. The median personal NO2 exposure level was 75 mg/m3 for these subjects and a significant association was observed between NO2 and impaired mucociliary clearance (p = 0.036). CONCLUSION: Non-smoking commercial motorcyclists exhibit increased airway symptoms and airway acidification as well as decreased nasal mucociliary clearance, all of which are significantly associated with the amount of exposure to air pollution

Analysis Of The Dynamics Of Particles In A Precipitation Chamber By Sas Technique With Coaxial Injection System Using A One-way Coupling Euler-lagrange Approach

Precipitation processes such as SAS - Supercritical Antisolvent - based on supercritical fluids have been extensively used in the crystallization of a wide variety of materials in a controlled manner allowing one to obtain nanoscale particles which are almost spherical in shape. The understanding of the dynamics of the particles inside the precipitation chamber allows the decision for operating conditions that are favorable to the precipitation of particles of small size, but there is still a great experimental challenge. In this paper, a Euler-Lagrange approach with one-way coupling was proposed to evaluate the dynamics of particles in a chamber of SAS precipitation prescribing one distribution of particle diameters, assuming values within ranges specified from experimental values. From the software ANSYS CFX used to obtain the solution of the mathematical model, the following variables were analyzed: mixture velocity, the time of trajectory, the dead zones and the average diameter of the precipitated particles. Under an operating pressure of 120 bar and an operating temperature of 313 K, the results showed that the flow pattern is quite complex. There is high speed of mixture at the outlet of the capillary injection. In this region were also observed large changes in the mixture density and large variations in the composition of the mixture. Were observed large particle diameters around the chamber outlet pipe, which suggests that a change in the outlet position of the camera can improve the process yield. The model proved to be a quick and economically versatile tool for a better understanding of the dynamics of particles and, consequently, to select conditions that can give a better control over the performance of the SAS process.4381782