bluuebunny/crossref_metadata_2025 huggingface dataset:
Parametrizing the Reionization History with the Redshift Midpoint, Duration, and Asymmetry
Authors: Trac Hy
Published: May 2018

A new parametrization of the reionization history is presented to facilitate robust comparisons between different observations and with theory. The evolution of the ionization fraction with redshift can be effectively captured by specifying the midpoint, duration, and asymmetry parameters. Lagrange interpolating functions are then used to construct analytical curves that exactly fit corresponding ionization points. The shape parametrizations are excellent matches to theoretical results from radiation-hydrodynamic simulations. The comparative differences for reionization observables are: ionization fraction

, 21 cm brightness temperature

, Thomson optical depth

, and patchy kinetic Sunyaev–Zel’dovich angular power

. This accurate and flexible approach will allow parameter-space studies and self-consistent constraints on the reionization history from 21 cm, cosmic microwave background (CMB), and high-redshift galaxies and quasars.
Priorização de ações de eficiência energética para redes de hipermercados via análise multicritério
Authors: Ricardo Fábio José , Medeiros Lucio De , Salas Cresencio Silvio Seguras
Published: May 2018

Eficiência energética passou a ser um item de total importância no meio das organizações e foco de implantação para melhoria constante, especialmente em empresas que possuem seus processos de produção e/ou produto final comercializado com uma grande fatia dependente de equipamentos e máquinas ligados à energia elétrica, como o setor de hipermercados, em que a despesa com energia elétrica em uma planta tem grande representatividade nos custos. Este artigo apresenta uma metodologia criada para identificar e ranquear as lojas de uma rede de varejo de hipermercados, ligada ao setor de comercialização de alimentos, considerando critérios de eficiência energética, direta ou indiretamente, através da análise multicritério com a técnica AHP (Analytic Hierarchy Process). Os critérios de escolha categorizados em quantitativos e qualitativos abordam aspectos como contas de energia, temperatura média externa, dentre outros..Para as lojas menos eficientes os resultados permitem fornecer suporte necessário para a implantação de ações de melhorias, como substituição de equipamentos, reformas de áreas, troca de iluminação, etc., por sistemas mais eficientes, bem como a redução de multas por não conformidades com fatores de energia determinados pela ANEEL, como baixo fator de potência. O estudo de caso para se validar a metodologia foi desenvolvido em uma rede de hipermercados considerando 120 lojas em todo o território nacional. O ranking final, obtido pela aplicação do modelo, aponta as lojas que possuem maior ou menor índice para apoio decisório e priorização de ações de eficiência energética. Uma análise dos resultados é realizada e cita os fatores que estão ligados à eficiência energética, como, por exemplo, consumo de energia, multas por baixo fator de potência ou até mesmo a má qualidade de prestação dos serviços técnicos e que podem, isoladamente ou em conjunto, levar a loja a ter uma boa ou má colocação no ranking final.
Influência da administração científica nas organizações
Authors: Matos Filho Hélio Aparecido
Published: May 2018

A administração trás às empresas novos horizontes, baseados em suas teorias administrativas, uma das pioneiras é a administração científica, por Frederick W. Taylor, que mudou à época o modo de produção, enfatizando as tarefas e a organização racional do trabalho. A teoria cientifica tem sua influência nos dias atuais, as organizações mediante suas propostas de trabalho incluem partes ou o todo desta teoria em acordo com sua missão e visão de trabalho. É objeto de este estudo fornecer dados genéricos a respeito da administração cientifica para que se possam aprofundar os conhecimentos desta teoria; para que empresários possam direcionar seus objetivos de forma correta no mercado de trabalho. Para isso, a metodologia de pesquisa utilizada foi o levantamento bibliográfico de caráter exploratório e análise qualitativa. O papel do gestor exige conhecimento, habilidades e atitudes, não em separado, mas em conjunto para que a amplitude da organização se torne na medida certa para a tomada de decisões. A agregação de valor a produtos e serviços sobrevém de um contínuo e experiente projeto do que se quer e aonde se quer chegar; a colaboração dos stakeholders é imprescindível, as estratégias abrangem um arcabouço de teorias as quais unidas ou não sempre permearam a estrutura organizacional; seu estudo envolve a complexidade e difusão de ideias e ideais. A colaboração de Taylor por meio da teoria científica foi e continua a ser imprescindível nas organizações, na sua evolução e estruturação.
Controle estatístico no processo de envase de doce em massa: estudo de caso
Authors: Amancio Igor Roberto , Alfineto João José Medeiros , Machado Luiza Maria Pierini
Published: May 2018

O presente artigo trata de um estudo de caso realizado em uma indústria alimentícia localizada no interior do Estado de São Paulo fabricante de doces de frutas em barras. Foi conduzido um estudo para a análise do desempenho do processo de envase de um dos tipos de doce fabricados pela empresa. Inicialmente, foi realizada uma revisão bibliográfica abordando os principais conceitos técnicos e ferramentas da gestão da qualidade. A partir da coleta de amostras em quantidade necessária foram construídos os gráficos de controle. Com a aplicação do método pode-se identificar que mesmo sob controle estatístico há a necessidade de ajustar o processo através do deslocamento da média do atual processo, para a média da especificação, deste modo, reduzindo os desperdícios. Através deste estudo, foi possível destacar a importância da aplicação dos gráficos de controle, pois estes permitem monitorar o processo e identificar as causas comuns e especiais, além de permitir a identificação de configurações típicas, como tendências, saltos e ciclos, indicando quando agir no processo.
Procedimento para avaliação da qualidade do serviço de transporte fretado de funcionários por ônibus sob a ótica do usuário, empresa contratante e prestadora do serviço
Authors: Perini de Souza Noéle Bissoli , Coelho de Morais Neto Gregório , Alcântara Cardoso Patrícia
Published: May 2018

Este artigo tem como objetivo a proposição de um procedimento para avaliar a qualidade do serviço de transporte fretado de empregados e estabelecer uma correlação entre a visão dos agentes envolvidos – usuários, empresa contratante e prestadora do serviço. Para tanto, foi realizada uma análise dos GAPs da qualidade, ou seja, a partir de uma revisão bibliográfica pode-se levantar características que influenciam a qualidade do transporte de passageiros, e por tanto, as diferenças de suas percepções puderam ser identificadas, por meio de um experimento de campo. Dessa forma, puderam-se expor as características e percepções dos usuários, da empresa contratante e da prestadora do serviço de transporte de funcionários, bem como feita uma avaliação da qualidade do serviço de transporte fretado de empregados. Esse procedimento inova ao incluir a visão do prestador de serviço como terceiro agente no modelo. Inova também ao desdobrar o agente “cliente” em usuários e gestores do contrato e, também, a empresa contratada em motoristas e técnicos administrativos. Em consequência dessas inovações, os GAPs foram redefinidos e rearranjados no procedimento proposto.
¿Ubicaciones fortuitas? La Concepción y Santa Clara en la Ciudad de México, 1540-1585
Authors: Ramírez Méndez Jessica
Published: May 2018

La historiografía en torno a la Iglesia novohispana ha estudiado los innumerables escenarios en los que se manifestó el conflicto entre el clero regular y el secular. Precisamente, este trabajo ejemplifica cómo ése también se hizo presente en los procesos de fundación y establecimiento de los conventos de la Concepción y Santa Clara en la Ciudad de México en la segunda mitad del siglo XVI. Particularmente aborda la confrontación entre el diocesano y los franciscanos por la apropiación del espacio urbano.
Bombeiros, espias e vaqueanos: agentes da comunicação política no sul da América portuguesa (Rio Grande de São Pedro, sécs. XVIII-XIX)
Authors: Comissoli Adriano
Published: May 2018

La administración de los imperios de ultramar de la Era Moderna dependía en gran medida del mantenimiento de canales de comunicación entre sus diversas partes componentes. El artículo analiza la comunicación política de los portugueses en América, centrándose en espías que trabajaban en la cuenca del río de la Plata entre finales del siglo XVIII y principios del XIX. Evalúa así las modalidades de informantes y la logística utilizada, identificando y analizando el primer nivel de los operadores de la información, que atendían a los nombres de bomberos, espías y baquianos. La perspectiva inserta la actuación local en el amplio panorama de una historia Atlántica, estudiando los papeles de los agentes destinados a recoger y pasar información a comandantes militares y gobernadores, que configuraron una red de comunicación permanente y responsable de la producción de inteligencia a nivel inmediato e imperial.

[pt] A administração dos impérios ultramarinos da Era Moderna dependia em larga medida da manutenção de canais de comunicação entre suas diversas partes componentes. O artigo analisa a comunicação política para o caso português na América, com ênfase em espiões que atuaram na bacia do rio da Prata entre o final do século XVIII e o início do XIX. Avalia as modalidades de informantes e a logística envolvidas, identificando e analisando o primeiro nível dos operadores da informação, os quais atendiam pelas denominações de bombeiros, espias e vaqueanos. A perspectiva insere a atuação de nível local no panorama mais amplo de uma história Atlântica, compreendendo os papeis dos agentes destinados a coletar e repassar informações a comandantes militares e governadores como configurador de uma rede de comunicação permanente, responsável pela produção de inteligência em nível imediato e imperial.
Discursos y prácticas políticas hacia la infancia en la provincia de Buenos Aires. Niñas y niños a principios del siglo XX
Authors: De Paz Trueba Yolanda
Published: May 2018

Partiendo de la preocupación que representaba para las elites gobernantes e intelectuales de la Argentina de fines del siglo XIX y principios del XX la cuestión de la infancia abandonada y vulnerable, este trabajo se propone analizar los avatares por los que atravesaron las discusiones en torno a la instalación de un Patronato de Menores en la provincia de Buenos Aires. Especial atención recibirá en las páginas que siguen la relación entre la cuestión presupuestaria y la dimensión política, que se entrecruzaron en las discusiones parlamentarias. Sostengo que la centralización política y la cuestión de las autonomías municipales atravesaron las discusiones en materia de infancia.
La embajada española en Colombia: acción y proyectos para una política en Iberoamérica (1959-1962)
Authors: Cañellas Mas Antonio
Published: May 2018

El presente artículo analiza la misión diplomática de la embajada española en Colombia durante los primeros años sesenta, coincidiendo con el triunfo de la Revolución Cubana y la consolidación del sistema bipartidista del Frente Nacional pactado en el país andino. Dos hechos que marcarán nuestra línea de estudio, sobre todo a partir de las fuentes documentales españolas. Se trata de contextualizar las políticas del franquismo hacia Iberoamérica para adentrarnos en los proyectos del representante español en Bogotá. Tanto desde la óptica de las relaciones bilaterales, como en el diseño de sus propuestas para la definición de una estrategia global interamericana.
Invariant NKT Cells and Control of the Thymus Medulla
Authors: White Andrea J. , Lucas Beth , Jenkinson William E. , Anderson Graham
Published: May 2018

Most αβ T cells that form in the thymus are generated during mainstream conventional thymocyte development and involve the generation and selection of a diverse αβ TCR repertoire that recognizes self-peptide/MHC complexes. Additionally, the thymus also supports the production of T cell subsets that express αβ TCRs but display unique developmental and functional features distinct from conventional αβ T cells. These include multiple lineages of CD1d-restricted invariant NKT (iNKT) cells that express an invariant αβ TCR, branch off from mainstream thymocytes at the CD4+CD8+ stage, and are potent producers of polarizing cytokines. Importantly, and despite their differences, iNKT cells and conventional αβ T cells share common requirements for thymic epithelial microenvironments during their development. Moreover, emerging evidence suggests that constitutive cytokine production by iNKT cells influences both conventional thymocyte development and the intrathymic formation of additional innate CD8+ αβ T cells with memory-like properties. In this article, we review evidence for an intrathymic innate lymphocyte network in which iNKT cells play key roles in multiple aspects of thymus function.
Cartes topographiques : les éléments de base
Authors:   Natural Resources Canada
Published: May 2018

Les cartes topographiques établies par Ressources naturelles Canada (RNCan) offrent des renseignements détaillés sur un secteur donné et sont utilisées dans plusieurs contextes, notamment la préparation aux situations d'urgence,
l'aménagement urbain, l'exploitation des ressources et l'arpentage, ainsi que pour des activités comme le camping, le canotage, les raids sportifs, la chasse et la pêche.
Ce guide est conçu pour aider les utilisateurs à comprendre les éléments de base d'une carte topographique. Il offre un aperçu des concepts relatifs à la cartographie et contient des conseils sur l'utilisation des cartes topographiques, des explications sur les termes
techniques de même que des exemples de symboles utilisés pour représenter les caractéristiques topographiques sur les cartes.
Recognizing PGL$_3$ via generic 4-transitivity
Authors: Altınel Tuna , Wiscons Joshua
Published: May 2018

We show that the only transitive and generically 4-transitive action of a group of finite Morley rank on a set of Morley rank 2 is the natural action of PGL

_3

on the projective plane.
Open Notes in Teaching Clinics: A Multisite Survey of Residents to Identify Anticipated Attitudes and Guidance for Programs
Authors: Crotty Bradley H. , Anselmo Melissa , Clarke Deserae , Elmore Joann G. , Famiglio Linda M. , Fossa Alan , Flier Lydia , Green Jamie , Klein Jared W. , Leveille Suzanne , Lin Chen-Tan , Lyon Corey , Mejilla Roanne , Moles Matthew , Stametz Rebecca A. , Thompson Michelle , Walker Jan , Bell Sigall K.
Published: May 2018

Background 

Clinicians are increasingly sharing outpatient visit notes with patients through electronic portals. These open notes may bring about new educational opportunities as well as concerns to physicians-in-training and residency programs.

Objective 

We assessed anticipatory attitudes about open notes and explored factors influencing residents' propensity toward note transparency.

Methods 

Residents in primary care clinics at 4 teaching hospitals were surveyed prior to implementation of open notes. Main measures included resident attitudes toward open notes and the anticipated effect on patients, resident workload, and education. Data were stratified by site.

Results 

A total of 176 of 418 (42%) residents responded. Most residents indicated open notes would improve patient engagement, trust, and education but worried about overwhelming patients, residents being less candid, and workload. More than half of residents thought open notes were a good idea, and 32% (56 of 176) indicated they would encourage patients to read these notes. More than half wanted note-writing education and more feedback, and 72% (126 of 175) indicated patient feedback on residents' notes could improve communication skills. Attitudes about effects of open notes on safety, quality, trust, and medical education varied by site.

Conclusions 

Residents reported mixed feelings about the anticipated effects of sharing clinical notes with patients. They advocate for patient feedback on notes, yet worry about workload, supervision, and errors. Training site was correlated with many attitudes, suggesting local culture drives resident support for open notes. Strategies that address resident concerns and promote teaching and feedback related to notes may be helpful.
Emissions of methane in Europe inferred by total column measurements
Authors: Wunch Debra , Toon Geoffrey C. , Deutscher Nicholas M. , Hase Frank , Notholt Justus , Sussmann Ralf , Warneke Thorsten , Kuenen Jeroen , Denier van der Gon Hugo
Published: May 2018

Abstract. Using five long-running ground-based atmospheric observatories in Europe, we demonstrate the utility of long-term, stationary, ground-based measurements of atmospheric total columns for verifying annual methane emission inventories. Our results indicate that the methane emissions for the region in Europe between Orleans, Bremen, Bialystok, and Garmisch are overestimated by the state-of-the-art inventories Emission Database for Global Atmospheric Research (EDGAR) v4.2 FT2010 and TNO-MACC_III, possibly due to the disaggregation of emissions onto a grid. Uncertainties in the carbon monoxide inventories used to compute the methane emissions may contribute to the discrepancy between our inferred emissions and those from the inventories.
A UAV-based active AirCore system for measurements of greenhouse gases
Authors: Andersen Truls , Scheeren Bert , Peters Wouter , Chen Huilin
Published: May 2018

Abstract. We developed and field-tested an unmanned aerial vehicle (UAV)-based active AirCore for
atmospheric mole fraction measurements of CO2, CH4, and CO. The system
applies an alternative way of using the AirCore technique invented by NOAA.
As opposed to the conventional concept of passively sampling air using the
atmospheric pressure gradient during descent, the active AirCore collects
atmospheric air samples using a pump to pull the air through the tube during
flight, which opens up the possibility to spatially sample atmospheric air.
The active AirCore system used for this study weighs ∼ 1.1 kg. It
consists of a ∼ 50 m long stainless-steel tube, a small stainless-steel
tube filled with magnesium perchlorate, a KNF micropump, and a 45 µm
orifice working together to form a critical flow of dried atmospheric air
through the active AirCore. A cavity ring-down spectrometer (CRDS) was used
to analyze the air samples on site not more than 7 min after landing for
mole fraction measurements of CO2, CH4, and CO. We flew the active
AirCore system on a UAV near the atmospheric measurement station at Lutjewad,
located in the northwest of the city of Groningen in the Netherlands. Five
consecutive flights took place over a 5 h period on the same morning,
from sunrise until noon. We validated the measurements of CO2 and
CH4 from the active AirCore against those from the Lutjewad station at 60 m. The results show a good agreement between the measurements from the active
AirCore and the atmospheric station (N = 146; RCO22: 0.97 and
RCH42: 0.94; and mean differences: ΔCO2: 0.18 ppm
and ΔCH4: 5.13 ppb). The vertical and horizontal resolution (for
CH4) at typical UAV speeds of 1.5 and 2.5 m s−1 were determined to be
±24.7 to 29.3 and ±41.2 to 48.9 m, respectively, depending on the
storage time. The collapse of the nocturnal boundary layer and the buildup
of the mixed layer were clearly observed with three consecutive vertical
profile measurements in the early morning hours. Besides this, we furthermore
detected a CH4 hotspot in the coastal wetlands from a horizontal flight
north to the dike, which demonstrates the potential of this new active
AirCore method to measure at locations where other techniques have no
practical access.
Burning-derived vanillic acid in an Arctic ice core from Tunu, Northeastern Greenland
Authors: Grieman Mackenzie M. , Aydin Murat , McConnell Joseph R. , Saltzman Eric S.
Published: May 2018

Abstract. In this study, vanillic acid was measured in the Tunu ice core from northeastern Greenland in samples covering the past 1700 years. Vanillic acid is an aerosol-borne aromatic methoxy acid, produced by the combustion of lignin during biomass burning. Air mass trajectory analysis indicates that North American boreal forests are likely the major source region for biomass burning aerosols deposited to the ice core site. Vanillic acid levels in the Tunu ice core range from
The NASA Eulerian Snow on Sea Ice Model (NESOSIM): Initial model
development and analysis
Authors: Petty Alek A. , Webster Melinda , Boisvert Linette , Markus Thorsten
Published: May 2018

Abstract. The NASA Eulerian Snow On Sea Ice Model (NESOSIM) is a new open source model that produces daily estimates of the depth and density of snow on sea ice across the polar oceans. NESOSIM has been developed in a three-dimensional Eulerian framework and includes two (vertical) snow layers and several simple parameterizations to represent the key sources and sinks of snow on sea ice. The model is forced with daily inputs of snowfall and near-surface winds (from reanalyses), sea ice concentration (from satellite passive microwave data) and sea ice drift (from satellite feature tracking), during the accumulation season (August through April). In this study, we present the NESOSIM formulation, initial calibration efforts, sensitivity studies and validation efforts across an Arctic Ocean domain (100 km horizontal resolution). The simulated snow depth and density are calibrated with in-situ data collected on drifting ice stations during the 1980s. NESOSIM demonstrates very strong agreement with the in-situ seasonal cycles of snow depth and density, and shows good (moderate) agreement with the regional snow depth (density) distributions. The results exhibit strong sensitivity to the reanalysis-derived snowfall forcing data, with the MERRA/JRA-55 (ASR) derived snow depths generally higher (lower) than ERA-Interim. We derive a new median daily snowfall dataset from these three reanalysis datasets to improve reliability in our input snowfall data. NESOSIM is run for a contemporary period (2000 to 2015) and compared against snow depth estimates derived from NASA's Operation IceBridge (OIB) snow radar data from 2009–2015, showing moderate/strong agreement, especially in the 2012–2015 comparisons.
Convective suppression before and during the United States
Northern Great Plains Flash Drought of 2017
Authors: Gerken Tobias , Bromley Gabriel T. , Ruddell Benjamin L. , Williams Skylar , Stoy Paul C.
Published: May 2018

Abstract. Flash droughts tend to be disproportionately destructive because they intensify rapidly and are difficult to prepare for. We demonstrate that the 2017 U.S. Northern Great Plains (NGP) flash drought was preceded by a breakdown of land-atmosphere coupling. Severe drought conditions in the NGP were first identified by drought monitors in late May 2017 and rapidly progressed to exceptional drought in July. The likelihood of convective precipitation in May 2017 in northeastern Montana, however, resembled that of a typical August when rain is unlikely. Based on the lower tropospheric humidity index (HIlow), convective rain was suppressed by the atmosphere on nearly 50 % of days during March in NE Montana and central North Dakota, compared to 30 % during a normal year. Micrometeorological variables, including potential evapotranspiration, were neither anomalously high nor low before the onset of drought. Incorporating convective likelihood to drought forecasts would have noted that convective precipitation in the NGP was anomalously unlikely during the early growing season of 2017. It may therefore be useful to do so in regions that rely on convective precipitation.
Test equipment and its effect on the calibration of instrument transformers
Authors: Mohns Enrico , Räther Peter
Published: May 2018

Abstract. State-approved test centres in Germany supplying accuracy tests for instrument transformers must, in the future, provide measurement uncertainty budgets for their quality management systems. In this work, the cause of ratio error and phase displacement of instrument transformers are therefore discussed. The traceability to the national standards of PTB, the attainable uncertainty, and the permitted error limits of test equipment for testing instrument transformers are presented. Finally, an example of an uncertainty budget for a current transformer of the class 0,2 S is given.
Coastal vulnerability assessment: through regional to local
downscaling of wave characteristics along the Bay of Lalzit
(Albania)
Authors: De Leo Francesco , Besio Giovanni , Zolezzi Guido , Bezzi Marco
Published: May 2018

Abstract. Coastal vulnerability is evaluated against inundation risk triggered by waves run-up, through the employment of coastal vulnerability indexes (referred to as “CVI”) introduced by Bosom García and Jiménez Quintana (2011). CVI are assessed through different wave climate characterizations, referring to regional (offshore wave climate) or local (near-shore wave climate) scale. The study is set along the Lalzit bay, a coastal area nearby Durres (Albania). The analysis reveals that the results vary due to uncertainties inherent in the run-up estimation, showing that the computational procedure should be developed by taking into account detailed information about local wave climate, especially concerning seasonal behaviour and fluctuations. Different approaches in choosing wave characteristics for run-up estimation affect significantly the estimate of shoreline vulnerability. The analysis also shows the feasibility and challenges of applying CVI estimates in contexts characterized by limited data availability, through targeted field measurements of the coast geomorphology and an overall understanding of the recent coastal dynamics and related controlling factors.
Dome instability at Merapi volcano identified by drone photogrammetry and numerical modeling
Authors: Darmawan Herlan , Walter Thomas R. , Troll Valentin R. , Budi-Santoso Agus
Published: May 2018

Abstract. The growth of lava domes may cause gradual oversteepening and can lead to gravitational instability and eventual collapse to produce pyroclastic flows that may travel up to several kilometers from a volcano’s summit. At Merapi volcano, Indonesia, pyroclastic flows are a major hazard, frequently involving high numbers of casualties. After the VEI 4 eruption in 2010, a new lava dome developed on Merapi volcano and was structurally destabilized by six steam-driven explosions between 2012 and 2014. Previous studies revealed that the explosions produced elongated open fissures and a structurally delineated sector at the southern part of the dome complex. Here, we investigate the geometry, thermal fingerprint, and hazard potential of the delineated unstable dome sector by integrating drone-based geomorphologic data and forward-looking thermal infrared images. The sector located on the un-buttressed southern flank of the steep dome that is delineated by a horseshoe-shaped structure and we identify intense thermal and fumarolic activity along this structure, hosting the high temperatures of the current dome. From the morphology, structures, and thermal mapping, we conjecture that the horseshoe shaped structure may develop into a failure plane that could lead to gravitational collapse of the unstable dome sector. To further elaborate on this instability hypothesis, we calculate the factor of safety, and run a numerical model of the resulting block and ash flows depositional area using Titan2D. Results of factor of the safety analysis confirm dome instability, especially during typical rainfall events. The titan2D model suggests that a hypothetical gravitational collapse of the delineated unstable dome sector would travel southward for up to 4 km distance. This study highlights the relevance of structural development of lava domes, which can affect hazards even years after dome emplacement, and influences the development of thermal and fumarolic activity of cooling lava domes.
A focus on POCUS
Authors: Yi Alice , D'Andrea Dino
Published: May 2018

Dr Rob Arntfield is a trained emergency physician, intensivist, and traumatologist here at London Health Sciences Centre (LHSC). Passionate about the use of ultrasonography and teaching, Dr Arntfield co-authored Point of Care Ultrasound1 (POCUS), which was published in 2014. A self-described London “townie”, he attended Western for medical school and continued in his hometown for a double emergency medicine and intensive care residency before pursuing a fellowship in New York City. We sat down with Dr Arntfield to discuss his work in critical care, trauma, and the rise of POCUS in trauma medicine.
Feature Profile: Restoring confidence among survivors of domestic abuse
Authors: Corrado Ann Marie
Published: May 2018

Dr Mohammed Elahi earned his MD from the Schulich School of Medicine and Dentistry at Western University in 1993 and is now a Double Board Certified surgeon working in the Greater Toronto Area. He is one of three surgeons in Canada qualified in both Otolaryngology Head and Neck Surgery and Plastic and Reconstructive Surgery, and devotes time specifically to providing treatment to survivors of domestic abuse. In this interview, he explains how he became involved in this work and its importance. He describes the benefits of his treatment to his patients’ physical, emotional and psychological well-being, as it is the first step in healing. Finally, he provides advice for medical students and other health care practitioners on how to do more to help women recover from the health effects of domestic violence, and thus re-establish their lives with confidence.
Poverty: A clinical instrument for family physicians
Authors: Sivakumar Gayathri , Chau Brandon
Published: May 2018

The primary driver of health outcomes is not medical professionals and the treatment they provide, but rather the socioeconomic environments enveloping individuals from the time they are born until their last breath. Social determinants of health (SDOH), which are factors such as income, education, ethnicity, disability, and access to healthcare, create disparities in morbidities and mortalities across a social gradient. Poverty constitutes one of the most well-studied and well-acknowledged SDOH, with a wide-ranging and treacherous impact on one’s health and well-being. A new poverty tool, created by the College of Family Physicians of Canada and the Centre for Effective Practice, enables front-line clinicians to tackle the social challenges associated with a low socioeconomic status. Consideration of socioeconomic conditions in a clinical practice setting can improve health outcomes by optimizing clinical management decisions and reduce the burden on our healthcare system.
ECT: Examining a controversial therapy in the armamentarium of psychiatry
Authors: Puvanenthirarajah Nirushan , Ali Asma Amir
Published: May 2018

Historically, treatments for severe psychoses and affective disorders were nonexistent, and patients with mental disorders were transferred to asylums for public safety. This deficiency in treatment inspired the inception of somatic therapies, of which electroconvulsive therapy (ECT) was the most efficacious. This paper will outline the birth of ECT, the controversies leading to its decline, and the subsequent resurgence back into practice.
Decreased level of consciousness in a toddler with overgrowth syndrome
Authors: Fong Stephanie , Scott Alistair , Laczko Dora
Published: May 2018

Physicians caring for patients with rare diseases face unique challenges in managing symptoms, ordering diagnostic tests, and providing patients and families with anticipatory guidance. We describe the case of a toddler with overgrowth syndrome, and previously known ophthalmological and neurological findings, presenting with decreased level of consciousness (LOC) following a fall. We highlight the extensive workup undertaken in a patient with symptoms spanning multiple systems but lacking a unifying diagnosis. In this case, rapid whole exome sequencing identified a de novo CACNA1A gene mutation encoding a calcium channel subunit, located within chromosome region 19p13.13. We explore 19p13.13 Microdeletion Syndrome and compare our patient’s presentation to the cases described in the literature. Although our patient had several symptoms consistent with 19p13.13 Microdeletion Syndrome, others remain unexplained. This highlights the difficulty in determining a definitive diagnosis or treatment plan in the realm of rare diseases and emphasizes the need for further research into the disease process and development of novel therapies.
Pain management training in undergraduate medical education
Authors: Fong Stephanie , Morley-Forster Patricia
Published: May 2018

The pain curriculum in medical education across the globe is lacking, leaving medical trainees ill prepared to properly assess and design plans to address acute and chronic pain. Poorly managed pain has implications on the individual in the form of psychological, physical, and financial costs, and on the greater healthcare system and economy. Gaps in education have resulted in suboptimal opioid prescribing habits contributing to the current opioid epidemic, and the development of negative attitudes towards patients with chronic pain amongst healthcare providers. Studies researching existing pain education in undergraduate medical education in North America, the United Kingdom, and Europe have identified limited pain teaching, typically incorporated into other courses rather than given a designated place in the curriculum. Several barriers to improving the provision of pain education have been identified, including resource limitations and perceived importance in comparison to other content. Improving pain education in Canada should be a priority given recent updates to the Canadian Guideline for Opioid Therapy and Chronic Noncancer Pain which recommends a decrease to the maximum dose of morphine. Implementing these guidelines will require physicians to have the knowledge and ability to safely taper patients whose opioid doses exceed the upper limit. Enhancing pain education will require an interdisciplinary approach with students developing competence not only in the identification and appropriate management of pain, but learning the communication and motivational interviewing skills to display empathy and compassion when providing care to the chronic pain patient population.
The Schulich Pain Medicine residency
Authors: D'Andrea Dino , Dzongowski Emily N
Published: May 2018

Dr Bellingham completed his medical school and anesthesiology residency at Western University. He followed this with a fellowship in Chronic Pain Management at the University of Toronto, with a focus on interventional pain management using fluoroscopy and ultrasound guided techniques. Dr Bellingham returned to Western University to work in the Department of Anesthesia and Perioperative Medicine in his capacity as an anesthetist and as a chronic pain specialist. Here at Western, he directs the Pain Clinic at St. Joseph’s Health Care and also played a key role in the development of Canada’s first Pain Medicine residency program. We had an opportunity to chat with Dr Bellingham and discuss a wide range of topics including his choice of career path, the Pain Medicine residency program, and other pain medicine topics in the context of the current opioid epidemic.
Chronic pain management and the development of opioid use disorder
Authors: Robinson Lily , Yu Richard , Patel Salonee
Published: May 2018

Chronic pain is a common condition that impacts quality of life and often precipitates the need for medical attention. Despite evidence that long-term opioid use provides limited relief, prescription opioid therapy remains a cornerstone in the medical management of chronic non-cancer pain. Presently, 13% of Canadians are prescribed opioids for pain management, and physicians play a crucial role in preventing the development of opioid use disorders. However, Canadian physicians lack knowledge of and comfort with evidence-based principles of opioid stewardship. In this article, we aim to highlight ongoing Canadian efforts to address physician discomfort and improve clinical practice. We focus on 2017 Canadian guidelines that provide clinicians with evidence-based recommendations for opioid use in chronic non-cancer pain management. In addition, we call attention to provincial efforts to implement physician accountability measures. In reviewing the existing literature, we uncovered inadequacies in pain management curricula within the Canadian undergraduate and continuing medical education (CME) systems. We consulted the educational practices of the European Pain Federation and the Centers for Disease Control and Prevention to make recommendations for improvement to current Canadian pain curricula. Based on our findings, we recommend that (1) Canadian medical institutions expand upon current core pain curricula, (2) pain management education be made compulsory, (3) academic detailing be emphasized as a means of CME, and (4) multidisciplinary non-medical management of chronic pain be featured more extensively.
Conocimientos, representaciones y cambio sociocultural. El caso de la asociación intercultural "Sinzchi Warmi", Comunidad Ancestral Puerto Santa Ana, Provincia de Pastaza (Ecuador)
Authors: Tocancipá-Falla Jairo , Gualinga Liliana , León Henry Felipe , Pardo-Enríquez Dalton , Nieto Sara , Vargas Saadia
Published: May 2018

En este artículo se presenta un estudio de caso de la Asociación de mujeres conocida como Sinzchi Warmi [mujeres valientes], en la provincia de Pastaza (Ecuador), que da cuenta de los conocimientos, las representaciones que coexisten y los cambios sociales y culturales que se han presentado a través de su práctica alfarera en las últimas décadas. Algunos antropólogos que han trabajado en la región han planteado que los kichwas amazónicos —con sus diferencias regionales como los de Pastaza y Napo— tienen una capacidad de asimilar la diferencia social y cultural de los otros en su propia cultura. Nuestro caso apunta a revelar, más que una asimilación, una coexistencia de valores sociales y culturales —no exenta de conflictos— que se expresa en varias nacionalidades que comparten el mismo suelo kichwa manteniendo valores con sus normas y determinaciones sociales. Como estudio de caso constituye una contribución importante para destacar las relaciones interculturales y el grado de impacto producido por diversas fuerzas de cambio, como las políticas sociales agenciadas por los gobiernos central-regionales y por otras instituciones como la Iglesia y los cultos religiosos.
Hacer un desplazado: dimensiones institucionales y subjetivas del programa de atención a víctimas del conflicto armado en Colombia
Authors: Ruiz Romero Gabriel , Castaño Zapata Daniel
Published: May 2018

El artículo analiza la construcción de una población como objeto de asistencia estatal por su condición de víctima del conflicto armado colombiano. El objetivo del acercamiento es caracterizar la forma como el desarrollo de la política de asistencia a víctimas produce formas marginales de ciudadanía. En este desarrollo se postula la idea de que la política de atención a desplazados forzados parte de una concepción despolitizada del desplazamiento, concepción que se ve reflejada en los requisitos y formalidades de los dispositivos de asistencia. Estos dispositivos suponen una serie de prácticas de los beneficiarios que constituyen una forma de producción de subjetividad. El artículo concluye que, en tanto modalidad de administración de la excepción, la política pública de atención a víctimas del conflicto armado en Colombia ha conseguido crear y naturalizar el estatuto de víctima como forma precaria de acceso a derechos ciudadanos.
Los viajes y los dilemas del parentesco yaminawa (Amazonía peruana)
Authors: Pérez Gil Laura
Published: May 2018

Sea para visitar a parientes radicados en aldeas lejanas, o sea para ir a conseguir trabajo a otros lugares o a comprar mercancías en la ciudad, los Yaminawa parecen estar impelidos a un continuo desplazarse. Argumento en este texto que este movimiento incesante por un espacio definido antes como social y afectivo que como geográfico, tiene como motor la experiencia dilemática del parentesco, que presenta dimensiones tanto productivas como sociales y afectivas. A partir de la etnografía de estos dilemas, el texto plantea consideraciones sobre el significado de la Comunidad Nativa — como entidad territorial y social jurídicamente definida — para los Yaminawa.
Tanzania Graduate Employability: Perception of Human Resource Management Practitioners
Authors: Mwita Kelvin M
Published: May 2018

Higher Education Institutions (HEI’s) produce many qualified graduates in different fields of study annually but almost half of them become frustrated or desolate because they cannot secure jobs in the labour market and some have huge student loans to settle. Moreover, Tanzania education stakeholders have been arguing that the education offered is not adequately geared to integrate the individual into the strong competitive labour markets. The study used a sample of 100 human resource practitioners to assess their perception of Tanzania graduate employability. It was found that HR practitioners consider Tanzania graduate as average. It has been found that 52.6% of Human Resource practitioners disagree that Tanzania graduate quality is improving. Additionally 56.6 % believe that Tanzania graduate are not competent enough to compete for jobs in the East African labour market. The study recommends various measures to be taken by higher learning institutions, regulatory bodies, policy makers and students themselves.
RESIDUOS SÓLIDOS NA ÁREA URBANA DE FAZENDA RIO GRANDE/PR: A PRODUÇÃO SOCIOAMBIENTAL DO ESPAÇO URBANO NA CIDADE PERIFÉRICA
Authors: Alves João Batista , Mendonça Francisco De Assis , Dalbem Rafaela Pacheco
Published: May 2018

Este trabalho analisa a produção e o uso do espaço urbano e a disposição de resíduos sólidos em espaços abertos da cidade de Fazenda Rio Grande-PR. Realizou-se um diagnóstico de toda a cidade. Os locais de deposição foram identificados por coordenadas geográficas, o que culminou na produção de mapas em Software ArcGis. Verificou-se que todas as ruas da cidade estavam tomadas por disposição de resíduos em locais inadequados como calçadas, ruas e terrenos vagos. Nas áreas de maior densidade populacional, há uma maior deposição de lixo. Em menor escala, ocorre mesmo fato em setores censitários de menor renda. Essas condições denotam uma falha nos processos de gestão pública e da própria sociedade em lidar com seus resíduos, submetendo toda a comunidade a constantes riscos socioambientais. O estudo evidencia um exemplo da urbanização corporativa que se desenvolve nas cidades da periferia do capitalismo globalizado.
AS CONTRIBUIÇÕES DO PIBID PARA A CONSTRUÇÃO DO CONHECIMENTO DE CONTEÚDO DE GEOGRAFIA
Authors: Sene Michael Wellington , Gomes Marquiana De Freitas Vilas Boas
Published: May 2018

A formação inicial do professor oportuniza a aprendizagem de um conjunto de conhecimentos necessários à sua prática profissional, embora os saberes docentes integrem também as experiências pré-profissionais e aquelas obtidas na socialização do trabalho na escola. Neste sentido, há uma complexidade implícita ao processo formativo do professor, sendo fundamentais as experiências nas quais o mesmo possa estar em constante processo de ação-reflexão-ação. Os saberes docentes devem integrar os conhecimentos de conteúdo, didático do conteúdo, pedagógico e de contexto (GARCÍA, 1999) como pré-requisito ao processo de ensino e aprendizagem. Para isso, é importante que a formação inicial de professores integre organicamente universidade e escola, com vistas a promover ambiente propício a aquisição desses conhecimentos. Nesse contexto, e considerando a importância do Programa Institucional de Bolsas de Iniciação à Docência (PIBID) nos cursos de licenciatura, esse artigo visa identificar suas contribuições na construção dos Conhecimentos dos Conteúdos Geográficos - CCG pelos bolsistas nos cursos de formação inicial de professores de Geografia das universidades públicas do Estado do Paraná. A pesquisa combinou entrevistas, questionários, análise documental e observação participante, por meio da abordagem qualitativa, conforme Lüdke e André (1986). Os resultados apontam que o PIBID contribui significativamente para o aprofundamento dos CCG tais como: conceitos geográficos (lugar, paisagem, território, região, escala e rede), linguagens (mapas, textos, gráficos, mídias) e conteúdos básicos (cartografia, dinâmica natureza, dinâmica da sociedade, educação e preservação ambiental).
EXPANSÃO URBANA E FATORES DE RISCO À INUNDAÇÃO EM BOA VISTA – RR
Authors: Araújo Júnior Antônio Carlos Ribeiro , Tavares Júnior Stélio Soares
Published: May 2018

A região amazônica abriga a maior reserva de biodiversidade do planeta, todavia sua urbanização é muitas vezes mascarada por essa grandiosidade biológica. Neste contexto, discutir as inundações se torna pertinente, pois se trata de dinâmica natural presente na dinâmica da sociedade, sendo presentes e constantes na região amazônica, causando muitos transtornos, principalmente à população urbana. Assim, este manuscrito destaca ser necessário integrar variáveis físicas e sociais para avaliar processos relacionados a inundações no espaço urbano de forma a melhor planejar e gerir riscos à inundação na cidade de Boa Vista, Roraima, Amazônia setentrional, Brasil. Geoprocessamento foi utilizado para avaliar variáveis físicas relacionadas às inundações na cidade e por meio de levantamento documental foi avaliado como instrumentos responsáveis pela implantação de políticas públicas utilizam estas variáveis e as relacionam com variáveis sociais ligadas ao uso e ocupação espacial. Os resultados mostram que a integração de variáveis físicas as variáveis sociais ajudam a melhor ordenar o espaço urbano de maneira a evitar impactos relacionados à inundação. Para tanto, torna-se necessária esta integração nas políticas públicas relacionadas aos riscos à inundação, as quais são recorrentes na Amazônia.
Avaliação da vulnerabilidade ambiental de São Carlos – SP
Authors: Trevisan Diego Peruchi , Moschini Luiz Eduardo , César Dias Lívia Caroline , Gonçalves Juliano Costa
Published: May 2018

A análise das paisagens em seu contexto geográfico local e regional, tanto quanto os estudos das estruturas tipicamente urbanas ecológicas são essenciais para o estabelecimento de formas de crescimento compatíveis com as metas de desenvolvimento sustentável. Essa realidade revela a importância de um planejamento adequado do território. Desta forma, o presente estudo teve o objetivo de avaliar a vulnerabilidade ambiental em São Carlos-SP. Foram utilizados Sistemas de Informações Geográficas (SIGs) para mapear o uso e cobertura da terra, a declividade, a geologia e a pedologia, os quais deram suporte para aplicação do índice de Vulnerabilidade ambiental. As classes de baixa vulnerabilidade ambiental correlacionaram-se com as áreas de menores riscos aos efeitos da ocupação antrópica e as classes de alta vulnerabilidade ambiental correlacionaram-se com as áreas de altos riscos aos efeitos da ocupação antrópica. O grau de vulnerabilidade ambiental identificou principalmente valores baixos e médios de vulnerabilidade. O balanceamento dos pesos atribuídos as diferentes características da paisagem contribuíram de forma correlacionar os diversos compartimentos da paisagem sem considerar que uma ou outra característica possui maior influência em sua vulnerabilidade ambiental. As características ambientais de São Carlos contribuem para seu estado de vulnerabilidade que é potencializada principalmente pelas características econômicas ligadas as atividades agrícolas existentes na região.
PRÉ-TEXTUAIS
Authors: Ra'e Ga - O Espaço Geográfico em Análise Revista
Published: May 2018

PRÉ-TEXTUAIS