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Sample records for ajustados ajusted clinical

  1. Los adjusted clinicals groups: Un sistema de clasificación de pacientes por ajuste de riesgos

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    Antonio Sicras-Mainar

    2013-06-01

    Full Text Available Los Adjusted Clinical Groups (ACG son un sistema de ajuste de riesgos que clasifica a las personas según su edad y sexo y las condiciones médicas que presentan, y estas personas tienen un consumo similar de recursos sanitarios durante un periodo. Fueron desarrollados por Starfield y Weiner (Universidad Johns Hopkins, EE. UU. 1991, y su objetivo es medir el grado de enfermedad en poblaciones de pacientes basándose en sus niveles de comorbilidad. Entre sus principales aplicaciones destacan: a evaluar la eficiencia en la utilización de los servicios sanitarios, b medir la comorbilidad de la población, y c programar la financiación o pago capitativo para grupos de proveedores. Entre las ventajas del sistema ACG destaca la necesidad de un número limitado de variables para cada paciente (edad, sexo y diagnósticos y que la unidad de medida es el paciente. Se comentan algunas características de este sistema de ajuste de riesgos poblacionales.

  2. A single incision adjustable sling-the AjustTM system for the treatment of female stress urinary incontinence:clinical analysis of 16 cases%单切口经阴道可调节AjustTM吊带治疗女性压力性尿失禁16例临床分析

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    樊文龙; 郭峰; 姜有涛; 倪泽称; 艾合买提; 艾克拜尔; 汪清

    2015-01-01

    Objectives To evaluate the efficacy and safety of the AjustTM system for the treatment of femalestress urinary incontinence(SUI).Methods From Apr 2013 to Nov 2013,16 cases of female patients with stress urinary incontinence in our hospital were enrolled in the study.All patients with primary urodynamic SUI were prospectively selected to receive the adjustable single incision AjustTM procedure,the clinical data was recorded and analyzed,inchided objective and subjective cure rate and operative complications.Results All 16 patients successfully completed the operation,operation success rate was 100%.The operative duration was 10-35 minx,the blood loss ranged from 10-35 ml.During the operation,there no bladder or urethral injury,no intestinal or vaginal injury,no perineum haematoma or incision infection,no voiding dysfunction or denovo urgency appeared.All of the 16 cases SUI were cured.With a follow-up from 6 months,no one recurrence.Conclusions The adjustable single incision AjustTM system was a minimally invasive technique for the treatment of female SUI and with fewer complications,the efficacy of AjustTM was good in a short term follow-up.%目的 评估AjustTM吊带系统手术治疗女性压力性尿失禁(SUI)的安全性和疗效.方法 2013年4月~2013年11月共收集SUI患者16例,应用单切口可调节AjustTM吊带系统进行治疗,记录并分析所有患者的临床资料,包括治愈率、满意度和手术并发症等.结果 16例手术均获得成功,手术时间为9~ 17min,失血量10 ~35mL,平均18±4.5mL.膀胱等盆腔脏器及尿道无损伤,围手术期无会阴血肿的发生,无切口感染发生.16例尿失禁均消失,随访半年无复发.结论 单切口A justTM吊带治疗SUI创伤小,并发症少,疗效良好.

  3. Ajuste escolar, rechazo y violencia en adolescentes.

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    Martínez Ferrer, Belén

    2009-01-01

    RESUMEN El objetivo general de esta tesis doctoral es analizar las relaciones existentes entre el contexto familiar, el escolar y la autoestima, en la predicción de tres indicadores de ajuste adolescente (ajuste escolar, rechazo escolar entre iguales y violencia/victimización escolar). Las variables consideradas en la investigación son: 1. Variables escolares: violencia escolar, victimización, rechazo entre iguales, actitud hacia la autoridad, actitud hacia la transgresión, actitud haci...

  4. Estilos relacionales parentales y ajuste adolescente

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    Oliva Delgado, Alfredo; Parra Jiménez, Agueda; Arranz Freijo, Enrique

    2008-01-01

    En este artículo se presentan los resultados de un estudio realizado sobre una muestra de 848 adolescentes de edades comprendidas entre los 12 y los 17 años, que cumplimentaron un cuestionario que incluía una escala con 6 dimensiones sobre su percepción del estilo parental o relacional materno y paterno y otros instrumentos para evaluar el ajuste adolescente. La realización de un análisis de conglomerados a partir de las puntuaciones en las 6 dimensiones que componían la escala re...

  5. El ajuste: origen de la crisis europea

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    Andrés Musacchio

    2013-01-01

    Full Text Available El objetivo del trabajo es analizar el impacto de las transformaciones institucionales en la Unión Europea desde los años ochenta, sobre las políticas de ajuste de los Estados nacionales ante shocks externos o problemas internos. La pérdida de instrumentos de política económica centró los ajustes en el mercado laboral y la seguridad social, impulsando una distribución regresiva del ingreso, el desmantelamiento parcial de los estados de bienestar y la precarización del empleo. Las tendencias se refuerzan con la necesidad de retener o captar inversiones en un contexto de fuerte competencia por su localización, que impulsa políticas "amigables" al capital, comprometiendo estándares laborales y de distribución del ingreso. Estas cuestiones tienen gran incidencia en la combinación de endeudamiento con estancamiento que se encuentran en la base de la crisis actual.

  6. AJUSTE DE MODELOS DE ELEMENTOS FINITOS

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    WILLIAM VÉLEZ

    2009-01-01

    Full Text Available El método del elemento finito es utilizado en todo el mundo como herramienta para analizar el comportamiento dinámico de sistemas estructurales. Sin embargo, se sabe que las predicciones efectuadas con el uso de modelos construidos empleando dicho método difieren de los resultados experimentales obtenidos a partir de ensayos de vibración en estructuras existentes. El área conocida en lengua inglesa como Model Updating, o Ajuste de Modelos, como se denomina en este documento, surgió como respuesta a dicha problemáticay apunta a efectuar correcciones paramétricas en los modelos de elementos finitos con el fin de lograr que las propiedades dinámicas analíticas se asemejen a sus contrapartes experimentales. El avance de esta disciplina durante los últimos veinte años ha sido vertiginoso; sin embargo, en el medio latinoamericano, y en particular en el colombiano, existe una difusión pobre de dicha temática. Este artículo presenta una revisión del estado del arte a la fecha de su publicación. Se espera que el presente trabajo motive la investigación en el campo del Ajuste de Modelos en centros diferentes a aquellos donde se ha concentrado hasta ahora el desarrollo de esta área y que a su vez provea información suficiente para que el sector industrial latinoamericano incluya dicha tecnología en sus prácticas.

  7. Ajuste estructural e informalidad en Guatemala

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    María José Paz Antolín

    2008-01-01

    Full Text Available Debido a la relevancia de las reformas económicas aplicadas para el desempeño económico de las últimas dos décadas son necesarios estudios que analicen estos vínculos. Éste es el objetivo del presente trabajo que se centra en la economía guatemalteca y en la evolución de sus condiciones laborales. El análisis tiene presente los rasgos comunes de las políticas de reforma llevadas a cabo pero se centra en lo distintivo del caso guatemalteco. En este sentido, destacan el contexto político y social y la particular forma de inserción en la economía mundial. Los distintos indicadores estudiados muestran cómo se ha producido un deterioro de las condiciones laborales, sobre todo por el crecimiento de la informalidad. Aunque éste ha sido un fenómeno típico en Guatemala su evolución presenta elementos novedosos vinculados precisamente con las políticas de ajuste.

  8. Efectos del tipo funcional de entrenamiento sobre el ajuste lector

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    Rosalinda Arroyo Hernández; Guadalupe Mares Cárdenas

    2009-01-01

    El presente trabajo tuvo por objetivo evaluar los efectos de entrenar cinco tipos de contacto con las relaciones entre objetos y sus elaboraciones lingüísticas sobre el ajuste lector de estudiantes universitarios. Primeramente los participantes fueron expuestos a una evaluación de ajuste lector, consistente en preguntas de diferente complejidad funcional, para posteriormente ser asignados aleatoriamente a uno de cinco grupos experimentales diferenciados por el nivel de complejidad funcional d...

  9. Comparación entre Factores de Ajuste Multiplicativos y Aditivos para Producción por Lactancia en un Hato Holstein

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    Arboleda Zapata Elkin Mauricio

    1995-09-01

    Full Text Available La presente investigación se efectuó a partir de 558 registros de lactancia tomados del hato Holstein Paysandú el cual está situado en el corregimiento Santa Elena de Medellín en una zona ecológica de bosque húmedo montano bajo (bh-MB y pertenece a la Facultad de Ciencias Agropecuarias de la Universidad Nacional de Colombia, Sede Medellín. El objetivo propuesto fué determinar las ventajas comparativas entre factores de ajuste multiplicativos y aditivos para producción por lactancia. Para ello se trabajó con datos ajustados a 305 días, en vista de la muy alta significancia observada para el efecto duración de la lactancia. Después de confirmar por medio del programa de mínimos cuadrados de Harvey, 1988, que los factores medio-ambientales más influyentes sobre la producción ajustada a 305 días son el año de parto, los días abiertos previos y el número de partos (P£0.01, así como la edad y la época de parto (P£0.05, se procedió a ajustar por estos efectos mediante factores de corrección multiplicativos y aditivos. Inicialmente se utilizó como base la subclase de máxima producción para cada efecto y a ellas fueron llevados los demás registros; luego se obtuvieron factores aditivos mediante el uso de constantes estimadas por el programa Harvey y multiplicativos a partir de la media de mínimos cuadrados. Una vez ajustados los datos se corrió nuevamente el modelo inicial, con el fin de cuantificar la varianza residual presente tanto para factores de ajuste multiplicativos como aditivos, a los dos niveles propuestos. La comparación se realizó mirando las relaciones de la tabla F y las varianzas residuales entre grupos y dentro de ellos. Aunque no se presentaron diferencias marcadas, se observa que, en general los factores de ajuste aditivos tuvieron un mejor comportamiento que los multiplicativos, pues con el empleo de estos últimos queda una pequeña variación sin remover; en tanto que con factores de ajuste

  10. LA POLÍTICA SOCIAL EN TIEMPOS DE AJUSTE

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    Leonardo Garnier Rímolo

    2011-09-01

    Full Text Available La política social está nuevamente de moda. Hace unos años, eran la estabilización y el ajuste los temas que dominaban la literatura, los debates y hasta las conversaciones de los economistas. Hoy, es cada vez más frecuente la referencia a la pobreza, el costo social del ajuste, el rostro humano de la política económica, el gasto social, la salud, la educación, en fin, todos aquellos temas relativos a la calidad de vida y el desarrollo humano. A diferencia del pasado, sin embargo, este redescubrimiento de los objetivos sociales del desarrollo no olvida, sino que parte precisamente del reconocimiento de las limitaciones materiales y financieras que enfrentan las sociedades menos desarrolladas. La discusión actual busca redefinir el sentido de la política social en los tiempos del ajuste o, si se quiere, redefinir los procesos de ajuste a la luz de su verdadero objetivo: el desarrollo social.

  11. Ajustes Conversacionales para el Aprendizaje de Contenidos en L2

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    Berta de Dios

    2010-07-01

    Full Text Available Este trabajo pretende describir las interacciones conversacionales entre el alumnado en las aulas AICLE. Nos preguntamos si hay un vínculo entre las características de las interacciones y el aprendizaje de contenidos no lingüísticos y, si es así, qué tipo de ajustes fomentan dicho aprendizaje. Las aulas AICLE son los entornos ideales para estudiar el vínculo entre ajustes conversacionales y aprendizaje de contenidos porque, al no ser en la lengua materna del alumnado, se dan más ajustes conversacionales que en las clases en lengua materna.---------------------------------------------This article pursues to describe conversational adjustments among students in CLIL classes. We wonder if there is a link between the characteristics of the interactions and the learning of non-linguistic contents and, if there is, what kind of adjustments promote such learning. CLIL classes are the ideal environments to study the link between conversational adjustments and the learning of contents because, since they are not in the students’ mother tongue, conversational adjustments occur more frequently than in classes in mother tongue.

  12. Policentrismo urbano y ajuste del sistema de ciudades en Galicia

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    Precedo Ledo, Andrés; Míguez Iglesias, Alberto

    2012-01-01

    El sistema urbano de Galicia constituye un caso interesante para estudiar la evolución y ajuste de un sistema policéntrico de ciudades a la etapa postindustrial, así como su apertura al sistema urbano global. En este estudio partimos de la hipótesis de que las ciudades medias pueden posicionarse como ciudades subglobales mediante procesos de innovación y creatividad, que aportan una ventaja comparativa de competitividad basada en la calidad de vida. También en esto las ciudades...

  13. Revocatoria del mandato: experiencias, dificultades y ajustes necesarios

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    William W. Jimu00E9nez

    2001-01-01

    Full Text Available En 1994 se introdujo en Colombia la figura de la Revocatoria del Mandato a los alcaldes y gobernadores como mecanismo tendiente al fortalecimiento de la democracia local. El presente artículo realiza un análisis de los 10 casos de revocatorias realizados hasta el 2.000. Con base en datos electorales registrados, la opinión de algunos expertos y el testimonio directo de actores involucrados; se presentan las dificultades, logros y limitaciones encontrados. En general, se observa la inoperancia, poco uso, alta abstención electoral e ineficacia política de la revocatoria. Finalmente, se realizan algunas recomendaciones con miras a realizar ajustes necesarios y urgentes.

  14. Estudo comparativo de diferentes prescrições de braquetes pré-ajustados em modelos virtuais pelo Método de Elementos Finitos Comparative study of different pre-adjusted brackets prescriptions on virtual models, by Finite Elements Method

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    Murilo Fernando Neuppmann Feres

    2009-08-01

    Full Text Available OBJETIVOS: comparar os efeitos de diferentes prescrições de braquetes pré-ajustados na movimentação dentária dos dentes anterossuperiores, por meio da utilização do Método de Elementos Finitos (MEF. MÉTODOS: foi utilizado um modelo tridimensional composto por um incisivo central, um incisivo lateral e um canino, todos do hemiarco superior esquerdo. Esses elementos foram submetidos à atuação de vetores de força que simularam a ação dos pré-ajustes de angulação e torque dos braquetes das prescrições de Alexander, Andrews, Capelozza, MBT, Ricketts e Roth. Após a simulação, os dados referentes ao deslocamento espacial dos pontos incisais e apicais foram registrados de forma que o novo posicionamento admitido pelos longos eixos dentários e seus pontos constituintes fossem determinados. RESULTADOS: a maioria das prescrições se comportou similarmente em relação aos parâmetros avaliados. As diferenças significativas encontradas no estudo se referem ao incisivo lateral superior que continha o braquete com a prescrição de Ricketts, que apresentou uma menor inclinação vestibular de seu longo eixo. Além disso, o canino superior da mesma prescrição apresentou uma maior inclinação de seu longo eixo para mesial e uma maior inclinação vestibular de seu longo eixo em relação às outras. A avaliação qualitativa da movimentação do incisivo central superior indicou um maior deslocamento distal dos ápices radiculares para as prescrições cujos autores estipularam maiores valores de angulação (Andrews, Capelozza, Roth e Alexander, e um maior deslocamento vestibular da coroa para as prescrições que estipularam os maiores valores de torque para os incisivos centrais (Ricketts, MBT, Alexander e Roth.AIM: The aim of the present study was to compare the effects of different prescriptions on anterior superior tooth movement simulation through a Finite Element Method (FEM. METHODS: It was utilized a 3D model, which was

  15. Una década de ajuste estructural en Nicaragua

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    Oscar Catalán Aravena.

    2001-12-01

    Full Text Available Se analizan las políticas macroeconómicas de estabilización y ajuste estructural llevadas a cabo en Nicaragua durante el último decenio y se trata de explicar el porqué de los pobres resultados obtenidos. Aunque el país vivió en ese período una elevadísima polarización, las políticas aplicadas han tenido continuidad y sus contenidos han sido similares durante los tres períodos de gobierno analizados. En este análisis se distinguen cuatro fases: 1988-1989 de reformas del Gobierno Sandinista; 1990-1993 en que el Gobierno de Barrios de Chamorro controla la hiperinflación e implementa el primer acuerdo "stand by" con el FMI; 1994-1996 en que el mismo gobierno implementa el primer acuerdo Enhanced Structural Adjustment Facilities (ESAF con el FMI y se inicia la recuperación económica; y 1997 en que, bajo la presidencia de Alemán, se implementa el segundo acuerdo ESAF con el FMI.

  16. O aparelho pré-ajustado: sua evolução e suas prescrições The pre-adjusted appliance: evolution and prescriptions

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    Vicente de Sousa Brito Júnior

    2006-06-01

    Full Text Available Este trabalho revisou as prescrições de braquetes pré-ajustados existentes no mercado, abordando as variações dos valores de inclinação, angulação e rotação dentária. A revisão reporta desde a origem do conceito de uso de arcos retangulares em acessórios com secções retangulares até os atuais modelos de braquetes autoligados e outros braquetes com formatos diferenciados.This research intended to review all the available prescriptions of pre-adjusted orthodontic appliances in the market and to discuss the justification of the authors as to the prescribed angulation, inclination and rotation suggested. The review encompassed the rectangular wire application in Edgewise brackets, until the implementation of self ligation, and many other kinds of brackets with distinct shapes according to the utilized technique. It was clear the great variety of many orthodontic mechanotherapy and brackets prescriptions, demonstrating that Orthodontics is a science with many possible alternatives.

  17. Capacidade máxima de adsorção de fósforo e constante de energia em Latossolo Bruno em razão de diferentes ajustes do modelo Langmuir

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    Clovisson Menotti Boeira de Oliveira

    2014-12-01

    Full Text Available A capacidade máxima de adsorção de fósforo (CMAP é um parâmetro bastante útil para caracterizar a capacidade de adsorção de fósforo (P do solo e, por isso, o modelo de Langmuir, que possibilita essa estimativa, é bastante difundido. Porém, se o ajuste da equação for realizado por modelos não lineares ou linearizados, ou se forem escolhidos modelos de região única ou múltiplas, nem sempre os valores estimados da CMAP e da constante de energia de ligação (k são semelhantes. O objetivo deste trabalho foi avaliar o efeito do uso de diferentes métodos de ajuste do modelo de Langmuir sobre os valores estimados de CMAP e k. Para isso, utilizouse um único solo de alta capacidade de adsorção de P, o qual foi misturado a quantidades crescentes de areia lavada, construindo-se sistemas com capacidades de sorção crescentes, mas com a fase sólida constituída da mesma mineralogia. Foi utilizado solo do horizonte B de um Latossolo Bruno com 800 g kg-1 de argila, o qual foi misturado com areia em quantidades para obterem-se solos artificiais com 0, 200, 400, 600 e 800 g kg-1 de argila. Esses solos artificiais foram incubados por 30 dias com calcário para elevar o pH(H2O até 6,0 e, após, foram secos em estufa e peneirados. Foram realizadas as isotermas de adsorção e os dados ajustados pelo modelo de Langmuir, usando os seguintes métodos: NLin - não linear com região única; L-1R - linearização com região única; L-2RG - linearização com duas regiões, ajuste gráfico; L-3RG - linearização com três regiões, ajuste gráfico; L-2RE linerização com duas regiões, ajuste estatístico. Os resultados evidenciaram que todos os métodos utilizados estimaram valores de CMAP proporcionais ao teor de argila dos solos e poderiam ser usados para caracterizar os solos. Contudo, quando utilizados ajustes com mais de uma região de adsorção, os valores da CMAP para a última região foram sensivelmente superiores

  18. Predicción del Ajuste Diádico en una Muestra Nuevoleonesa

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    Jose Moral de la Rubia

    2008-01-01

    Full Text Available El objetivo del presente estudio es predecir el ajuste diádico con variables sociodemográficas, religiosas, sexuales, de estados emocionales y personalidad. La muestra consta de 100 parejas casadas. Como instrumento de medida se emplea un cuestionario integrado por preguntas cerradas y escalas para medir ajuste diádico, satisfacción sexual, alexitimia, ansiedad, depresión, afectos positivos y negativos, deseabilidad social y engrandecimiento marital. Los datos se analizan por correlación, análisis factorial y regresión. El ajuste diádico se asocia con el engrandecimiento marital, ansiedad-rasgo, satisfacción sexual; con alexitimia y depresión especialmente en hombres; y con menor fuerza, con niveles bajos de afectos negativos y altos de positivos. Al factorizar los correlatos interrelacionados del ajuste diádico surge un factor de neuroticismo y emociones negativas que es el principal predictor de falta de ajuste. Se considera que el engrandecimiento marital se debe interpretar como autoengaño y enamoramiento mejor que como manejo de la impresión.

  19. AJUSTE PSICOSOCIAL, BIENESTAR SUBJETIVO Y OCIO EN ADULTOS MAYORES JUBILADOS MEXICANOS

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    Christian Oswaldo Acosta Quiroz

    2015-01-01

    Full Text Available El objetivo de este estudio fue establecer la relación entre ajuste psicosocial en la jubilación,bienestar subjetivo, actividades de ocio y variables sociodemográficas en adultos mayores ju-bilados mexicanos. Participaron 181 adultos mayores con una edad media de 69.12 años y untiempo medio de jubilación de 11.21 años. Los resultados indican que el ajuste psicosocial enla jubilación y el bienestar subjetivo se relacionan significativamente entre sí y con las variablessociodemográficas de sexo, nivel de estudios, estatus de salud y estado civil. A su vez, se re-lacionan con la frecuencia de actividades de ocio (con diferencias entre hombres y mujeres.Estas variables deben tenerse en cuenta para fomentar un mayor ajuste psicosocial y bienestarsubjetivo en adultos mayores jubilados.

  20. Variabilidade do risco do tempo de permanência ajustado para lactentes de muito baixo peso ao nascer entre centros da Neocosur South American Network

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    Guillermo Marshall

    2012-12-01

    Full Text Available OBJETIVOS: Desenvolver um modelo de predição para o tempo de permanência hospitalar (TPH em lactentes de muito baixo peso ao nascer (MBPN e comparar esse resultado entre 20 centros de uma rede neonatal, visto que o TPH é utilizado como uma medida da qualidade da assistência em lactentes de MBPN. MÉTODOS: Utilizamos dados coletados prospectivamente de 7.599 lactentes com peso ao nascer entre 500 e 1.500 g no período entre os anos de 2001 a 2008. O modelo de regressão de Cox foi empregado para desenvolver dois modelos de predição: um modelo prévio com dados do nascimento e outro posterior, que acrescenta morbidades relevantes dos primeiros 30 dias de vida. RESULTADOS: A mediana do TPH estimado e ajustado a partir do nascimento foi de 59 dias; 28 dias depois do tempo de sobrevida de 30 dias. Houve uma alta correlação entre os modelos (r = 0,92. O TPH esperado e o TPH observado variaram bastante entre os centros, mesmo depois de correção para as morbidades relevantes após 30 dias. O TPH mediano (variação: 45-70 dias e a idade concepcional na alta hospitalar (variação: 36,4-39,9 semanas refletem uma variabilidade alta entre centros. CONCLUSÃO: Um modelo simples, com fatores apresentados no nascimento, pode predizer o TPH de um lactente de MBPN em uma rede neonatal. Observou-se uma variabilidade nos TPHs considerável entre unidades de terapia intensiva neonatal. Especulamos que os resultados sejam provenientes das diferenças entre as práticas dos centros.

  1. Rasgos psicológicos asociados al ajuste personal y social de estudiantes adolescentes

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    Droguett Latorre, Linda

    2014-01-01

    264 p. El ajuste social y personal de los estudiantes adolescentes se presenta en la actualidad como un tema muy relevante como objeto de análisis así como las posibles medidas de intervención para promoverlo. En este nuevo siglo, los avances tecnológicos y científicos promueven en los y las adolescentes cambios de actitud, de pensamiento así como de expectativas en cuanto a su futuro tanto personal como profesional y laboral, por lo que es muy importante que, tanto su ajuste personal ...

  2. AJUSTE PSICOSOCIAL, BIENESTAR SUBJETIVO Y OCIO EN ADULTOS MAYORES JUBILADOS MEXICANOS

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    Christian Oswaldo Acosta Quiroz; Javier José Vales García; Ramón René Palacio Cinco

    2015-01-01

    El objetivo de este estudio fue establecer la relación entre ajuste psicosocial en la jubilación,bienestar subjetivo, actividades de ocio y variables sociodemográficas en adultos mayores ju-bilados mexicanos. Participaron 181 adultos mayores con una edad media de 69.12 años y untiempo medio de jubilación de 11.21 años. Los resultados indican que el ajuste psicosocial enla jubilación y el bienestar subjetivo se relacionan significativamente entre sí y con las variablessociodemográficas de sexo...

  3. EL FACTOR DE SOSTENIBILIDAD DEL SISTEMA PÚBLICO DE PENSIONES Y SU ENTRADA EN VIGOR. EL FACTOR DE EQUIDAD INTERGENERACIONAL “AJUSTADO A LA EDAD DE ACCESO A LA JUBILACIÓN”

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    Augusto Hoyo Lao

    2014-05-01

    Full Text Available La introducción del factor de sostenibilidad en el sistema de pensiones de la Seguridad Social y la elección del año base de aplicación constituyen decisiones de gran trascendencia debido a sus efectos reductores (acumulativos en el cálculo de las pensiones iniciales y en la revalorización de todas las pensiones. Este trabajo analiza los efectos de la aplicación anticipada del Factor de Equidad Intergeneracional (FEI, como propone el comité de expertos designado por el Gobierno de España, en concurrencia con la reforma paramétrica de la Ley 27/2011, cuantificando la reducción en las pensiones de jubilación que se causen en 2027 en torno al 26%.Se señala que la anticipación de la aplicación del FEI al periodo de transición de la reforma de 2011 supondría una redundancia de medidas orientadas a compensar el incremento en el número de años de percepción de la pensión debido al progresivo aumento de la esperanza de vida a la edad de jubilación. Además, técnicamente, el FEI es un factor inadecuado para tal objetivo cuando las condiciones de acceso y de cálculo de la pensión de jubilación van cambiando, como ocurre durante el periodo transitorio de la Ley 27/2011, en el que se dificultan estas condiciones para las cohortes que alcancen la edad legal de retiro. Como aportación de este trabajo se sugiere la aplicación de un nuevo FEI “ajustado a la edad de acceso a la jubilación” que, cumpliendo el objetivo de poner límite a la mayor longevidad, se adapta a distintos periodos (transitorio o plena vigencia de la reforma de 2011 y situaciones (como la anticipación o demora en el acceso a la jubilación y, además, es menos sensible al año de referencia que se elija para vincular la prestación a la evolución de la esperanza de vida. Se incluyen también propuestas de ajuste de los parámetros de cálculo de la pensión de jubilación para el periodo posterior a 2027. The introduction of sustainability factor in the

  4. Carga de enfermedad en la comunidad autónoma de Cataluña utilizando años de vida ajustados por discapacidad (2005-2010

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    Anna Cuadras Andreu

    2014-01-01

    Full Text Available Fundamentos: La carga de enfermedad permite medir la salud de la población incluyendo mortalidad y morbididad. Los objetivos de este estudio son estimar la carga de enfermedad en Cataluña, comparar los resultados con España y con la comarca del Tarragonés, y evaluar la aportación de los registros locales en la estimación de la discapacidad. Métodos: Se calcularon los años de vida perdidos ajustados por discapacidad (AVAD para 123 causas utilizando la metodología descrita por la Organización Mundial de la Salud. Las tasas estandarizadas se compararon con las españolas. En la comarca del Tarragonés, se calcularon losAVAD, se compararon con Cataluña, y para los tumores malignos se calcularon los AVAD utilizando el registro local de incidencia de cáncer. Resultados: Los AVAD en Cataluña fueron 801.140 de media anual. El 60,3% se atribuyó a discapacidad y el 39,7% a mortalidad prematura. Neuropsiquiátricas (30,9%, tumores malignos (15,8% y cardiovasculares (11,3% fueron las principales causas en AVAD. La tasa estandarizada de las enfermedades respiratorias (7,5 por 1.000 fue significativamente superior a la española. Causas perinatales (3,1 por 1.000, lesiones intencionadas (2,2 por 1.000 y enfermedades del aparato digestivo (4,9 por 1.000 fueron significativamente superiores en el Tarragonés. Los AVAD para los tumores malignos se incrementaron un 13,4% utilizando la incidencia de casos para su cálculo. Conclusiones: Las enfermedades no transmisibles aportan la mayor parte de AVAD en Cataluña. Existen diferencias entre territorios en enfermedades respiratorias, perinatales, digestivas y lesiones intencionadas. Los registros locales pueden ser muy útiles en el cálculo de los AVAD.

  5. 单切口可调节AjustTM吊带治疗女性压力性尿失禁初步研究%Initial study with the AjustTM system: a single incision adjustable sling for the treatment of female stress urinary incontinence

    Institute of Scientific and Technical Information of China (English)

    张雪培; 任选义; 魏金星; 王智勇; 江雪霞; 刘建华

    2012-01-01

    Objective: To evaluate the efficacy and safety of the Ajust system for the treatment of female stress urinary incontinence(SUI). Method: From Sep 2012 to Oct 2012, 14 consecutive subjects were enrolled in the study. The age ranged from 38-68 years, the course of disease ranged from 1-5 years, parity ranged from 1-4 times,BM1 ranged from 20. 8-33. 9 kg/m2,the scores of ICI-Q-SF ranged from 7-15, the ALPP ranged from 3. 53-11. 86 kPa. And the Qmax ranged from 24-35 ml/s. All patients with primary urodynamic SUI were prospectively selected to receive the adjustable single incision Ajust Procedure, the clinical data was recorded and analyzed, included objective and subjective cure rate and operative complications. Result: The operative duration was 11-36 mins, the blood loss ranged from 15-45 ml. During the operation, 1 case of Fixed anchor of Ajust Was broke, there no bladder or urethral injury, no intestinal or vaginal injury, no perineum haematoma or incision infection, no voiding dysfunction or de novo urgency appeared. Only 2 cases of thigh pain occurred, which relieved by corresponding management. According to the definition of cure that deem to the disappear of incontinence and negative cough test. All of the 14 cases SUI were cured. With a follow-up from 1 to 5 weeks, no one recurrence. Conclusion; The adjustable single incision Ajust System was a minimally invasive technique for the treatment of female SUI and with fewer complications, the efficacy of Ajust Was good in a short-term follow-up.%目的:评估AjustTM吊带手术治疗女性压力性尿失禁(SUI)的安全性和疗效.方法:2012年9~10月共收集SUI患者14例,年龄38~68岁,病程1~5年,分娩1~4次.BMI20.8~33.9 kg/m2,国际尿失禁咨询委员会尿失禁问卷表简表(ICI Q-SF)评分7~15分,腹腔漏尿点压(ALPP)3.53~11.86 kPa,最大尿流率(Qmax)24~35 ml/s.应用单切口可调节AjustTM吊带系统进行治疗,记录并分析所有患者的临床资料,包括治愈率

  6. Desempenho dos ajustes do Trauma and Injury Severity Score (TRISS: revisão integrativa

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    Cristiane de Alencar Domingues

    2015-12-01

    Full Text Available RESUMO Objetivo identificar estudos que realizaram ajustes na equação do Trauma and InjurySeverity Score (TRISS e compararam a capacidade discriminatória da equação modificada com a original. Método Revisão integrativa de pesquisas publicadas entre 1990 e 2014 nas bases de dados LILACS, MEDLINE, PubMed e SciELO utilizando-se a palavra TRISS. Resultados foram incluídos 32 estudos na revisão. Dos 67 ajustes de equações do TRISS identificados, 35 (52,2% resultaram em melhora na acurácia do índice para predizer a probabilidade de sobrevida de vítimas de trauma. Ajustes dos coeficientes do TRISS à população de estudo foram frequentes, mas nem sempre melhoraram a capacidade preditiva dos modelos analisados. A substituição de variáveis fisiológicas do Revised Trauma Score (RTS e modificações do Injury Severity Score (ISS na equação original tiveram desempenho variado. A mudança na forma de inclusão da idade na equação, assim como a inserção do gênero, comorbidades e mecanismo do trauma apresentaram tendência de melhora do desempenho do TRISS. Conclusão Diferentes propostas de ajustes no TRISS foram identificadas nesta revisão e indicaram, principalmente, fragilidades do RTS no modelo original e necessidade de alteração da forma de inclusão da idade na equação para melhora da capacidade preditiva do índice.

  7. Impacto del ajuste por inflación financiero en la gestión empresarial

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    Oda Hilda Gómez de Angulo

    2009-01-01

    Full Text Available La inflación es un fenómeno económico que afecta la situación financiera de las organizaciones, por lo que existe la Declaración de Principios de Contabilidad No. 10 (DPC-10 que establece las normas para efectuar el ajuste por inflación a los estados financieros. Con el propósito de conocer el impacto de este ajuste, se seleccionaron dos empresas que realizan actividades diferentes. Se efectuó una revisión bibliográfica y documental de la DPC-10 y, con base a los informes al cierre de cada ejercicio económico de las empresas objeto de estudio, se recopilaron y prepararon los datos en una misma unidad de medida para efectos de comparación, análisis e interpretación. Los resultados obtenidos indican que en la empresa regida por la Comisión Nacional de Valores se justifica el ajuste por inflación financiero debido a la naturaleza de la estructura financiera y a que la toma de decisiones administrativas y legales se realiza con base a esta información; mientras que en la institución regida por la Superintendencia de Cajas de Ahorro no se justifica la presentación del ajuste por inflación financiero, ya que no aporta ningún valor agregado a la organización y la toma de decisiones se realiza con base a los estados financieros históricos.

  8. Hacia un sistema armonizado de ajuste de la dosis en un tratamiento fitosanitario

    OpenAIRE

    Camp, Ferran; Solanelles Batlle, Francesc; Garcia, F.; Escolà i Agustí, Alexandre; Sanz Cortiella, Ricardo; Rosell Polo, Joan Ramon; Planas de Martí, Santiago

    2012-01-01

    Tradicionalmente, las dosis indicadas en las etiquetas de los envases de los productos fitosanitarios se expresan en función de uno, o muy pocos, de los factores que intervienen en toda aplicación. El camino hacia la racionalización de las dosis pasa por la utilización de un sistema que integre el mayor número de condicionantes permitiendo así el ajuste de la dosis a las condiciones concretas de cada tratamiento.

  9. Incorporação da densidade no ajuste de dois modelos à curva de retenção de água no solo

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    C. A. Tormena

    2002-06-01

    Full Text Available A curva de retenção de água no solo é fundamental para o desenvolvimento de estudos relacionados com a dinâmica da água, com a modelagem de processos físicos do solo e crescimento das plantas. Normalmente, a curva de retenção é obtida por meio de medidas simultâneas do conteúdo de água (θ e do potencial mátrico da água no solo (ψ numa única amostra. Um procedimento alternativo consiste em utilizar várias amostras por ψ para descrever a curva de retenção. A utilização deste procedimento requer a incorporação dos fatores de variação existentes entre as amostras nos parâmetros das funções matemáticas utilizadas para descrever essa curva. O objetivo deste trabalho foi obter a curva de retenção, utilizando esta última sistemática, e ajustar duas diferentes funções não-lineares aos dados de θ(ψ. Amostras indeformadas (0,05 m de diâmetro e 0,05 m de altura foram obtidas num Latossolo Vermelho distroférrico cultivado com milho sob plantio direto e preparo convencional do solo. Foram retiradas 96 amostras por sistema de preparo, na profundidade de 0-0,10 m, na linha e na entrelinha da cultura. A curva de retenção foi obtida utilizando-se 12 ψ, sendo 16 amostras por ψ: oito por sistema de preparo e quatro por posição amostrada. Os modelos de Genuchten (1980 - VG e o de Hutson & Cass (1987 - HC foram ajustados aos dados. Funções relacionando os parâmetros dos modelos com as variáveis independentes preparo, posição de amostragem e densidade do solo (Ds os substituíram no ajuste dos dados. Não houve influência estatisticamente significativa dos sistemas de preparo e posição de amostragem (p > 0,05 no ajuste das funções aos dados . Com a função de VG obtiveram-se efeitos significativos da Ds no parâmetro n, o qual foi descrito por uma função quadrática da Ds. Resultado similar foi obtido com o parâmetro "a" da função de HC. A curva de retenção foi sensível às variações da Ds e o

  10. Ajuste de modelos estocásticos lineares e não-lineares para a descrição do perfil longitudinal de árvores Fitting linear and nonlinear stochastic models to describe longitudinal tree profile

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    Leonardo Machado Pires

    2007-10-01

    Full Text Available Os modelos polinomiais são mais difundidos no meio florestal brasileiro na descrição do perfil de árvores devido à sua facilidade de ajuste e precisão. O mesmo não ocorre com os modelos não-lineares, os quais possuem maior dificuldade de ajuste. Dentre os modelos não-lineares clássicos, na descrição do perfil, podem-se citar o de Gompertz, o Logístico e o de Weibull. Portanto, este estudo visou comparar os modelos lineares e não lineares para a descrição do perfil de árvores. As medidas de comparação foram o coeficiente de determinação (R², o erro-padrão residual (s yx, o coeficiente de determinação corrigido (R²ajustado, o gráfico dos resíduos e a facilidade de ajuste. Os resultados ressaltaram que, dentre os modelos não-lineares, o que obteve melhor desempenho, de forma geral, foi o modelo Logístico, apesar de o modelo de Gompertz ser melhor em termos de erro-padrão residual. Nos modelos lineares, o polinômio proposto por Pires & Calegario foi superior aos demais. Ao comparar os modelos não-lineares com os lineares, o modelo Logístico foi melhor em razão, principalmente, do fato de o comportamento dos dados ser não-linear, à baixa correlação entre os parâmetros e à fácil interpretação deles, facilitando a convergência e o ajuste.Polynomial models are most commonly used in Brazilian forestry for taper modeling due to its straightforwardly fitting and precision. The use of nonlinear regression classic models, like Gompertz, Logistic and Weibull, is not very common in Brazil. Therefore, this study aimed to verify the best nonlinear and linear models, and among these the best model to describe the longitudinal tree profile. The comparison measures were: R², syx, R²adjusted, residual graphics and fitting convergence. The results pointed out that among the non-linear models the best behavior, in general, was given by the Logistic model, although the Gompertz model was superior compared with the Weibull

  11. Identificação e modelagem da autocorrelação residual no ajuste do modelo de Wood às curvas de lactação de cabras Identification and modeling of residual autocorrelation in the adjustments of Wood’s model to lactation curves of goats

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    Ana Lúcia Puerro de Melo

    2011-10-01

    Full Text Available Objetivou-se com este trabalho apresentar uma metodologia de identificação e modelagem da autocorrelação residual considerando ajustes individuais do modelo de Wood às lactações de cabras leiteiras e também avaliar a influência de tal modelagem na qualidade do ajuste. O modelo de Wood foi ajustado individualmente às lactações, considerando três estruturas residuais. Na primeira, assumiu-se independência dos erros (EI para todas as lactações, na segunda, assumiu-se a estrutura de erros autoregressivos de primeira ordem (AR1 para todas as lactações e, na terceira, nomeada por EI-AR1, foi utilizada a estrutura de erros AR1 somente para as lactações que apresentaram autocorrelação residual, segundo o teste de Durbin-Watson, e de EI para as demais. As três situações de ajuste foram comparadas pelos percentuais de convergência e pelas médias dos quadrados médios dos erros (QME e dos coeficientes de determinação ajustados (R²aj. As médias dos QME e dos R²aj apresentaram valores semelhantes nas três situações de estrutura residual. No entanto, o modelo com estrutura EI-AR1 apresentou maior convergência, o que consiste em uma vantagem, já que permite que um maior número de animais seja avaliado quanto à sua curva de lactação. Portanto, em função da maior convergência obtida, o ajuste do modelo de Wood com a estrutura EI-AR1 consiste na opção mais indicada para grandes conjuntos de dados.The objective of this research was to present a methodology for identification and modeling of residual autocorrelation considering individual adjustments of the Wood's model to lactation dairy goats and evaluate the influence of such modeling in the quality of adjustment. The Wood's model was adjusted individually for lactations in three different ways, the first have assumed independence of errors (IE for all lactations, the second have assumed autoregressives first order errors (AR1 for all lactations and the third, named

  12. Representación de la Enfermedad, Afrontamiento y Ajuste en los Trastornos Alimentarios

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    Yolanda Quiles Marcos

    2009-01-01

    Full Text Available El objetivo de esta investigación es evaluar la representación de la enfermedad en pacientes con un trastorno alimentario (TA, así como su relación con el afrontamiento y el ajuste, utilizando como marco teórico el Modelo del Sentido Común de Leventhal. Método: Participaron 98 mujeres diagnosticadas de un TA. La media de edad fue 20.8 años (dt=5.61. Para evaluar la representación de la enfermedad se administró la adaptación española para los TA del Cuestionario de Percepción de la Enfermedad Revisado (IPQ-R. Resultados: Respecto a la identidad, los síntomas más señalados fueron la "pérdida de peso" (89.8% y las "alteraciones en la menstruación" (81.6%. Consideran que su enfermedad tiene una larga duración y serias consecuencias, así como que tienen control y siguiendo un tratamiento es posible su curación. El 21% de la varianza de las estrategias evitativas fue explicado por diferentes dimensiones de la representación de la enfermedad. Se confirman los efectos directos de la representación de la enfermedad sobre el ajuste, pero no los del afrontamiento. Conclusiones: Los resultados apoyan la necesidad de intervenir sobre las creencias que tienen estas pacientes sobre su enfermedad con el fin de mejorar su ajuste psicosocial.

  13. O ajuste gerencial e seus limites: a falha seqüencial em perspectiva comparada

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    Flávio da Cunha Rezende

    2008-08-01

    Full Text Available O artigo focaliza a explicação da falha seqüencial nas reformas gerenciais. Ele trata do problema dos limites do ajuste gerencial, em uma abordagem que tenta conectar teoria e dados empíricos, articulando três níveis de análise. O primeiro nível apresenta evidências comparativas da falha seqüencial das reformas nos governos nacionais a partir de um conjunto de indicadores voltados para compreender transformações no papel dos estados. O segundo nível analítico identifica, à luz da análise de um conjunto representativo de estudos comparativos da implementação de reformas, quatro mecanismos típicos presentes na explicação das falhas do ajuste gerencial. Busca-se configurar uma matriz explicativa de teorias sobre a falha seqüencial. Em seguida discute-se a experiência da reforma gerencial no contexto brasileiro, conferindo especial atenção para um dos mecanismos geradores da falha: o dilema do controle. As principais hipóteses são que guiam o artigo são que as reformas falham sequencialmente e existem pelo menos quatro mecanismos causais que produzem as reformas: a custos de transação envolvidos na produção das reformas; b legados de desempenho; c preponderância do ajuste fiscal e d o dilema do controle. Esses mecanismos atuam isolada ou combinadamente, reduzindo consideravelmente as chances de transformações do papel do Estado nos moldes gerenciais. As principais evidências analisadas no artigo permitem tornar consistente o argumento geral de que as reformas falharam nas tentativas de reduzir os gastos públicos, alterar padrões de alocação de recursos, reduzir a força de trabalho e transformar o papel do Estado. A principal conclusão é que as reformas falharam seqüencialmente e o ajuste gerencial exibe consideráveis limites, especialmente de natureza política.

  14. Ajuste del Índice de Pont para mujeres y hombres

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    Paula María Nava–Salcedo

    2014-07-01

    Full Text Available La forma de arco dental de mujeres y hombres es diferente, en los hombres es amplio y en mujeres de forma parabólica. En ortodoncia existen índices y métodos para la predicción del ancho y forma del arco ideal, uno de estos índices es el de Pont que no toma en cuenta las diferencias entre sexos. Objetivos: determinar la efectividad del índice de Pont al emplearlo en hombres y mujeres, realizar el ajuste si fuera necesario a las formulas del índice de Pont para poder aplicarlo en hombres y mujeres. Materiales y métodos: investigación descriptiva, no experimental y transversal. La muestra fue de 139 modelos de estudio, 94 de pacientes femeninos y 45 de pacientes masculinos, por lo que se seleccionaron 45 modelos de pacientes femeninos de forma aleatoria para igualar las muestras. Se compararon mediante una t de Student los valores reales de la muestra de hombres con los de las mujeres y el resultado del análisis de Pont en hombres y mujeres. Se realizó el ajuste de las constantes del índice de Pont para mujeres y  hombres, se aplicó a ambas poblaciones, el resultado se  comparó con los valores reales interpremolar e intermolar en maxilar y mandíbula. Resultados: el análisis de Pont no es efectivo para utilizarse en mujeres y hombres de Nayarit, se encontraron diferencias transversales entre ambas poblaciones, los ajustes realizados para la población femenina y masculinafue efectiva para utilizase en la población de Nayarit. Conclusiones: El índice de Pont no es aplicable debido a que sobreestima los valores de la población femenina y masculinade la población de Nayarit. Los ajustes realizados fueron efectivos y se recomienda evaluarlo en otras poblaciones.

  15. Proceso de ajuste emocional de padres cuyos hijos presentan algún tipo de discapacidad

    OpenAIRE

    Alcíbar Sánchez, B; Amador Velázquez, R.

    2014-01-01

    La discapacidad se vive desde diferentes perspectivas ya sea padre, hijo, hermano, etc., y cada uno trata de sobreponerse a esta situación dependiendo de los recursos con los que cuente cada persona ya que tiene un impacto social, familiar y psicológico. En cuanto a lo psicológico, se enfrentan un sin fin de emociones contradictorias necesitando ayuda de profesionales para un adecuado manejo de la situación. El estudio tuvo como objetivo la aplicación de la Escala de ajustes para padres con h...

  16. Ajustes entre pais e filhos adultos coabitantes: limite e transgressão

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    Celia Regina Henriques

    2011-12-01

    Full Text Available O objetivo deste trabalho é investigar a relação entre pais e filhos adultos coabitantes no ambiente doméstico familiar e sublinhar os aspectos transformadores dessa dimensão interativa. Empreendemos uma discussão teórica interdisciplinar, incluindo autores como Singly, Giddens, Berger e Luckman. Pesquisamos esse universo por meio de um estudo de campo, realizando entrevistas semiestruturadas com oito famílias cariocas de classe média. Foram entrevistadas, separadamente e depois em conjunto, quatro díades mãe-filho, três díades mãe-filha e uma díade pai-filha. Entre os temas que emergiram da análise dos dados, destacamos os ajustes cotidianos nas instâncias relacionais. Verificamos que, na dinâmica interativa, diferentes ajustes cotidianos são estabelecidos. Pais e filhos se autorizam a romper ou esticar as regras de convivência, revelando o aspecto poroso da relação e estabelecendo um contexto propício para se jogar com as regras. Evidencia-se um jogo de reconstrução constante em um movimento ilimitado de avanços e recuos na esfera relacional.

  17. Correlatos perceptivos e acústicos dos ajustes supraglóticos na disfonia Perceptive and acoustic correlates of supraglottis adjustments in dysfonia

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    Aline Magri

    2007-12-01

    Full Text Available OBJETIVO: avaliar os correlatos perceptivo-auditivos (ajustes supraglóticos e acústicos (formantes da qualidade vocal de indivíduos disfônicos com alterações glóticas, atendidos em ambulatório de fonoaudiologia de uma instituição hospitalar da cidade de São Paulo. MÉTODOS: o grupo estudado foi representado por amostras de voz de 20 indivíduos disfônicos com idades variadas entre 30 e 65 anos do sexo feminino (atendidos em um hospital da cidade de São Paulo e julgamentos perceptivo-auditivos da qualidade vocal por amostras avaliadas previamente por um grupo de juízes em atividade clínica. As amostras foram exploradas quanto à freqüência dos três primeiros formantes (F1, F2 e F3. Os valores foram considerados de forma qualitativa (comparados aos dados da análise perceptivo-auditiva e quantitativa (teste Qui-quadrado. RESULTADOS: os ajustes de qualidade vocal mais freqüentes foram laringe baixa, mandíbula fechada, lábios arredondados, corpo de língua abaixado, corpo de língua retraído, labiodentalização. Diferenças estatisticamente significantes foram encontradas para os valores de freqüência de F1 para os vocábulos "cata" (864 Hz e "gata" (814 Hz, p=0 e F3 para os vocábulos "cata" (2598 Hz e "gata" (2660 Hz, p=0,17 dos indivíduos do grupo estudado em relação aos valores de referência para o Português-Brasileiro. CONCLUSÃO: os ajustes de qualidade vocal identificados encontraram correspondência com a diminuição dos valores de F1 e F3 indicando tendências de ajustes do trato vocal.PURPOSE: to evaluate auditory perception (supraglottic adjustments and acoustic (formants of vocal quality in dysphonic individuals with glotic disorders, attended in a clinic a hospital in the city of São Paulo. METHODS: the studied was represented by voice samples taken form from 20 dysphonic people aged between 30 and 65 of the female gender (attended in a hospital in the city of Sao Paulo and the auditory perception

  18. EFECTOS DE ENTRENAR PARA CUMPLIR CRITERIOS DE CONGRUENCIA EN TAREAS DE AJUSTE LECTOR

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    Germán Morales-Chávez

    2010-01-01

    Full Text Available La presente investigación evaluó los efectos de entrenar estudiantes universitarios para satisfacer criterios de congruenciaen tareas de ajuste lector con base en parámetros de congruenciay de coherencia. El grupo experimental fue entrenadopara satisfacer criterios de congruencia y fue expuestoa dos pruebas de evaluación en satisfacción de criterios decongruencia y coherencia. El grupo control solo fue sometidoa las pruebas de evaluación. Los resultados revelan que elentrenamiento favoreció la satisfacción de criterios tanto decongruencia como de coherencia. Se discute la relevancia deldesempeño efectivo en una situación lectora con criterios decongruencia como condición para el desarrollo de conductaslectoras funcionalmente más complejas.

  19. Instituições, política e ajuste fiscal: o Brasil em perspectiva comparada

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    Loureiro Maria Rita

    2001-01-01

    Full Text Available Neste texto examinam-se as condições institucionais e políticas do ajuste fiscal. Mesmo considerando que as instituições afetam as estratégias dos atores e os resultados das políticas, supõe-se que o cumprimento das regras relativas ao controle fiscal dependem igualmente de certas condições políticas contingentes, como a coesão governamental. Embora a análise seja centrada no Brasil recente, são também confrontados casos de outros países - Estados Unidos, Holanda e Suécia - que também enfrentaram sérios problemas fiscais nos anos 80.

  20. Efectos de entrenar para cumplir criterios de congruencia en tareas de ajuste lector

    Directory of Open Access Journals (Sweden)

    Germán Morales-Chávez

    2010-01-01

    Full Text Available La presente investigación evaluó los efectos de entrenar estudiantes universitarios para satisfacer criterios de congruencia en tareas de ajuste lector con base en parámetros de congruencia y de coherencia. El grupo experimental fue entrenado para satisfacer criterios de congruencia y fue expuesto a dos pruebas de evaluación en satisfacción de criterios de congruencia y coherencia. El grupo control solo fue sometido a las pruebas de evaluación. Los resultados revelan que el entrenamiento favoreció la satisfacción de criterios tanto de congruencia como de coherencia. Se discute la relevancia del desempeño efectivo en una situación lectora con criterios de congruencia como condición para el desarrollo de conductas lectoras funcionalmente más complejas.

  1. El papel de la concertación social ante la política de ajuste

    Directory of Open Access Journals (Sweden)

    Juan Raso Delgue

    2015-10-01

    Full Text Available Contenido: Introducción. Ajuste. Modos de producción y concertación. Nuevos actores y nuevas dimensiones del conflictos. Las dimensiones de la nueva concertación. Contenidos de la nueva concertación. Conclusiones

  2. Ajustamento psicológico e perspectiva de velhice pessoal em adultos com deficiência física Ajuste psicológico e la perspectiva percibida del envejecimiento personal en adulto y adultos moyores con discapacidad física Psychological adjustment and personal aging perspective in adults and older adults with physical disability

    Directory of Open Access Journals (Sweden)

    Marineia Crosara de Resende

    2009-12-01

    Full Text Available Foram investigadas relações entre senso de ajustamento psicológico e perspectiva de velhice em adultos e idosos com deficiência física. Participaram 90 pessoas, de ambos os sexos, com idade entre 25 e 84 anos, que responderam aos instrumentos: questionários sociodemografico e sobre a deficiência física; Inventário Sheppard de Atitudes em Relação à Velhice Pessoal; Escala de Desenvolvimento Pessoal (ajustamento psicológico. Os índices de ajustamento pessoal foram de moderados a altos, mas as mulheres pontuaram mais baixo. Para toda a amostra, quanto maior o senso de ajustamento, mais positiva a perspectiva de velhice pessoal. Os com deficiência congênita e os mais ajustados psicologicamente mostraram perspectivas mais positivas de velhice pessoal. Concluiu-se que envelhecer com uma deficiência física é um processo que exige competência adaptativa e resiliência aos eventos de vida e aos desafios acarretados pela deficiência.Realizamos una investigación para analizar las relaciones entre el ajuste psicológico y la perspectiva percibida del envejecimiento personal en adulto y adultos mayores con discapacidad física. Materiales y método: 90 participantes, ambos géneros, adultos con 25 a 84 respondieron a cuestionarios contestados pidiendo la información sobre características socio demográficas y discapacidad; el inventario de Sheppard de actitudes acerca del propio envejecimiento; y una escala que determina el ajuste psicológico percibido. Resultados: Los índices del ajuste personal eran moderados y altos. Las mujeres tenían las cuentas más bajas. Había correlaciones positivas observadas entre el ajuste psicológico positivo y las actitudes positivas acerca del propio envejecimiento. Los que tenían discapacidad congénita y el ajuste psicológico más alto divulgado demostraron perspectivas más positivas del envejecimiento personal. Conclusión: El envejecer con discapacidad física es un proceso complejo que

  3. Tamanho e rigidez dos objetos influenciam os ajustes proximais e distais do alcance de crianças? Can size and rigidity of objects influence infant's proximal and distal adjustments of reaching?

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    Fernanda P. S. Silva

    2011-02-01

    Full Text Available CONTEXTUALIZAÇÃO: Objetos influenciam nos ajustes do alcance de lactentes, no entanto ainda não se investigou se esses ajustes se modificam em crianças com mais idade. OBJETIVOS: Verificar se o tamanho e a rigidez dos objetos influenciam os ajustes proximais e distais do alcance dos 6 aos 8 meses e aos 36 meses de idade. MÉTODOS: A nove crianças saudáveis foram apresentados: um objeto rígido grande, um rígido pequeno, um maleável grande e um maleável pequeno. Os alcances foram filmados e posteriormente analisados qualitativamente quanto aos ajustes proximais (alcance uni e bimanual e distais (orientação da mão horizontalizada, verticalizada e oblíqua; mão aberta, semiaberta e fechada e a preensão desses objetos (com e sem. Foram aplicados o Teste de Friedman e as comparações múltiplas de Dunn, considerando-se 0,05 como diferença significativa. RESULTADOS: Constatou-se que, aos 36 meses, houve mais alcances unimanuais do que nas idades anteriores e, em todas as idades, os alcances unimanuais foram realizados principalmente para os objetos pequenos. Aos 36 meses, as crianças orientaram a mão horizontalizada para tocar e apreender os objetos, enquanto que, aos 6 e 7 meses, a orientação foi oblíqua para tocar e verticalizada para apreendê-los, independentemente das propriedades dos objetos. No decorrer dos meses, tanto no início quanto no final do alcance, as mãos tornaram-se mais abertas, principalmente para tocar o objeto rígido grande, e as crianças realizaram cada vez mais alcances com preensão, principalmente para os objetos maleáveis ou objetos pequenos. CONCLUSÕES: De 6 a 36 meses, os alcances tornaram-se mais refinados e ajustados às propriedades mais discrepantes dos objetos apresentados, o que se observou pelas modificações nos ajustes proximais e distais.BACKGROUND: It has been found that objects influence the adjustments to reaching of breastfeeding infants, however, it has not been investigated

  4. Comparación entre varias poblaciones estándar para el ajuste por edades

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    Llorca Díaz Javier

    2000-01-01

    Full Text Available FUNDAMENTO: Analizar el efecto que tiene la elección de una población de referencia sobre diferentes indicadores derivados de las tasas de mortalidad ajustadas por edad. MÉTODOS: Las tasas de mortalidad por diferentes causas de muerte en España de 1971 a 1992 son ajustadas empleando cuatro poblaciones de referencia: poblaciones españolas de 1971 y 1992, población estándar europea y población estándar mundial. Los resultados obtenidos con las cuatro poblaciones se comparan empleando tres indicadores: diferencia entre las tasas de 1992 y 1971, razón entre las tasas de 1992 y 1971y cambio anual porcentual entre 1971 y 1992. RESULTADOS: En la mayor parte de las causas de muerte estudiadas incluyendo el total de causas, la cardiopatía isquémica y casi todos los tumores, la razón de tasas y el porcentaje de cambio anual son similares con independencia de cuál sea la población estándar empleada. En cambio, la diferencia de tasas es muy diferente en función de la población de referencia. En las enfermedades infecciosas y el cáncer de testículo se produce la situación contraria: la diferencia de tasas es robusta mientras que la razón de tasas varía con la población estándar. Finalmente, la mortalidad por neumonía, enfermedad de Parkinson y cáncer de encéfalo muestra cambios en los tres indicadores utilizados. CONCLUSIONES: Es necesario realizar un análisis de las tasas específicas por edad antes de proceder a su ajuste. Este análisis permite averiguar si el ajuste por edades es correcto y qué indicador (diferencia, razón o cambio porcentual será adecuado para realizar comparaciones.

  5. O dia seguinte: as credenciais da sobrevivência ao ajuste nas empresas

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    Guimarães Nadya Araujo

    1999-01-01

    Full Text Available O artigo tem por objetivo refletir sobre os nexos entre seletividade ocupacional e requerimentos de qualificação numa conjuntura de intensa reestruturação industrial. Para tanto, procura responder duas questões. Primeira: quem tem sobrevivido ao ajuste ocorrido no mercado de trabalho industrial no Brasil dos anos 90? Isto é, que credenciais de qualificação permitiram tal sobrevivência? Segunda: qual o tipo de inserção oferecida aos que lograram permanecer integrados a estas indústrias? Isto é, em que tipo de postos de trabalho sobreviveram tais trabalhadores remanescentes? Para ilustrar a análise, toma-se em consideração um segmento especial - a indústria química - exemplar pelas intensas mudanças que sofreu nos anos 90 e também pela prévia e elevada seletividade de seus critérios de recrutamento. A análise empírica se baseia em estatísticas do Ministério do Trabalho (Rais-Caged.

  6. Elementos para el análisis de los programas de ajuste

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    Villamizar Helena

    1991-12-01

    Full Text Available

    La aplicación de las políticas generales, preconizadas por los programas de ajuste en América Latina, en la mayoría de los casos no dieron los resultados deseados. Su éxito necesariamente requería del cumplimiento de ciertos supuestos y condiciones que permitieran que las políticas de "gestión de demanda no generaran efectos negativos sobre el crecimiento en el largo plazo. Al no cumplirse algunos de 105 supuestos teóricos básicos, y al no contar los países con flujos de capitales adecuados y con un entorno externo abierto, la aplicación de estos programas se tradujo en grandes sacrificios en el crecimiento y muchas veces en la perpetuación de situaciones recesivas. Puesto que la región aun no ha encontrado una verdadera vía de solución, se hace imperioso abordar la construcción de una nueva perspectiva teórica, basada en supuestos realistas, que permita abordar los apremiantes problemas del desarrollo latinoamericano.

  7. La influencia de las diferencias entre el padre y la madre sobre el ajuste adolescente

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    Antonia Jiménez-Iglesias

    2015-01-01

    Full Text Available Este trabajo se centra en analizar cómo influyen en el consumo de sustancias (tabaco, alcohol y cannabis y el bienestar psicológico adolescente (calidad de vida relacionada con la salud y satisfacción vital las diferencias entre el padre y la madre en afecto, promoción de la autonomía, revelación, interés y conocimiento. La muestra estuvo compuesta por 10170 chicos y chicas españoles de 13 a 18 años de familias biparentales que participaron en la edición 2006 del estudio Health Behaviour in School-aged Children (HBSC. Los resultados mostraron que los adolescentes que indicaron que su padre y madre coincidían en presentar altos niveles en las dimensiones familiares analizadas consumieron menos sustancias y tuvieron mejor bienestar psicológico. Por el contrario, el ajuste de los adolescentes cuyos progenitores (padre y madre tenían bajos niveles en esas dimensiones familiares fue peor. Concretamente, la dimensión más importante para el consumo de sustancias fue el conocimiento parental y para el bienestar psicológico lo fue el afecto parental; la revelación adolescente solo fue relevante para el consumo de alcohol y la calidad de vida, mientras que la promoción parental de la autonomía lo fue para la calidad de vida.

  8. Lucha popular, democracia, neoliberalismo: protesta popular en América Latina en los años del ajuste

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    Martha Cecilia García V.

    2010-08-01

    Full Text Available Margarita López Maya (editora. Lucha popular, democracia, neoliberalismo: protesta popular en América Latina en los años del ajuste. Caracas: Nueva Sociedad, 1999, 264 páginas. Este libro presenta una compilación de diez artículos elaborados por investigadores de Argentina, México, Colombia, Guatemala, Brasil, República Dominicana y Venezuela, producto de sus investigaciones sobre luchas y movimientos sociales en estos países. La intención del libro, según la compiladora, es tratar de llegar de manera conjunta a algunas hipótesis sobre los procesos de protesta y sus relaciones con el neoliberalismo y descubrir el modo en que los sectores más golpeados en sus expectativas y condiciones de vida por las políticas de ajuste han comenzado a demandar sus derechos.

  9. Avaliação das dimensões programáveis dos articuladores semi-ajustáveis

    OpenAIRE

    GRECO, Gustavo Diniz; Fialho, Denise Ligório; Lana, Ana Cláudia Carvalho; Jansen,Wellington Corrêa

    2016-01-01

    O articulador semi-ajustável tem o propósito de reproduzir as relações maxilomandibulares estáticas e, parcialmente, as dinâmicas. No entanto, parte destas características depende da qualidade da fabricação dos aparelhos. O objetivo foi aferir os componentes responsáveis pela determinação do ângulo de Bennett (AB), da eminência articular (EA) e da distância intercondilar (DI) do articulador semi-ajustável (ASA) Dentflex®. A amostra constituiu-se de 30 ASA novos dos alunos da Pontifícia Univer...

  10. Coefficient d'ajustement pour des processus de risque dans des contextes de dépendance

    OpenAIRE

    Cossette, Hélène; Marceau, Etienne; Maume-Deschamps, Véronique

    2009-01-01

    International audience; Nous étudions le coefficient d'ajustement de la théorie de la ruine dans un contexte de dépendance temporelle. Le coefficient d'ajustement, pour des données indépendantes a étudié par de nombreux auteurs. Nous utilisons ici la définition de Müller et Pflug pour des variables dépendantes. Nous construisons un estimateur consitant de ce coefficient dans un cadre de dépendance faible général. Pour des cas particuliers ayant un sens en théorie de la ruine / actuariat, nous...

  11. Teoría de las Contingencias Múltiples Dinámicamente Entrelazadas (Abriendo la caja negra del ajuste contingente

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    Lic. Jorge Washington Barrientos

    2013-12-01

    Full Text Available La teoría de las contingencias ha ocupado un rol destacado en el estudio del diseño de las estructuras organizacionales en los últimos cincuenta años. Sus contribuciones se han dirigido en distintas direcciones, una de ellas ha sido enumeración de factores de contingencia y la posterior identificación de relaciones entre estos y los elementos estructurales.Refinamientos posteriores han conceptualizado la respuesta sistémica que permite el ajuste (“fit” de la organización a los cambios en los factores de contingencia.Este trabajo se propone repasar críticamente las principales conceptualizaciones del ajuste estructural, y a la vez proponer una nueva variable interviniente en el marco de una teoría de contingencias múltiples dinámicamente entrelazadas.

  12. Ajuste al rol de género en mujeres con y sin trastornos de la conducta alimentaria

    OpenAIRE

    2014-01-01

    Los trastornos de la conducta alimentaria podrían estar relacionados con el ajuste al rol de género de quienes los padecen, es decir, con la distancia percibida entre las características que se acepta poseer y aquellas que conforman el ideal personal. Por tal motivo, con el fin de indagar si el ajuste al rol de género guarda relación con aquéllos, se evaluaron la autopercepción y el ideal del rol de género en una muestra de 154 mujeres con edades de entre 14 y 30 años, de las cuales 49 padecí...

  13. Inteligência emocional percebida (IEP) ajuste emocional e actividade física na terceira idade

    OpenAIRE

    2007-01-01

    O interesse deste estudo está centrado na forma como interage a inteligência emocional percebida (IEP) com a prática da actividade física e que peso específi co tem cada uma das variáveis estudadas sobre o ajuste emocional das pessoas nesta faixa etária e, consequentemente, na sua qualidade de vida.

  14. Comparação de alguns modelos matemáticos para o ajuste às curvas de lactação individuais de vacas da raça Caracu Comparison of some mathematical models for the adjustment of individual lactation curves of Caracu cows

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    L.E. Faro

    2002-06-01

    Full Text Available Foram ajustadas 7239 curvas de lactação de vacas Caracu, controladas semanalmente entre os anos de 1978 a 1988, pertencentes à Fazenda Chiqueirão, Poços de Caldas, MG. As funções utilizadas foram a linear hiperbólica (FLH, a quadrática logarítmica (FQL, a gama incompleta (FGI e a polinomial inversa (FPI. Os parâmetros foram estimados por meio de regressões não lineares, usando-se processos iterativos. A verificação da qualidade do ajuste baseou-se no coeficiente de determinação ajustado (R²A, no teste de Durbin-Watson (DW e nas médias e desvios-padrão estimados para os parâmetros e funções dos parâmetros dos modelos. Para a curva média, os R²A foram superiores a 0,90 para todas as funções. Bons ajustes, baseados nos R²A>0,80 foram obtidos, respectivamente, por 25,2%, 39,1%, 31,1% e 28,4% das lactações ajustadas pelas funções FLH, FQL, FGI e FPI. De acordo com o teste de DW, bons ajustes foram proporcionados para 29,4% das lactações ajustadas pela FLH, 54,9% pela FQL, 34,9% pela FGI e 29,6% pela FPI. Para ambos os critérios, a FQL foi superior às demais funções, indicando grande variação nas formas das curvas de lactação geradas pelos ajustes individuais. Curvas atípicas foram estimadas pelas funções, com picos ocorrendo antes do parto e algumas vezes após o término da lactação. Todas as funções apresentaram problemas quando ajustaram dados individuais.The present study was carried out to test the goodness of fit of different lactation curve functions for 7239 Caracu cows, belonging to Chiqueirão farm, Poços de Caldas - MG, weekly recorded from 1978 to 1988. The functions used to describe the lactation curves were: linear hyperbolic function (LHF; logarithmic quadratic function (LQF; incomplete gamma function (IGF and inverse polynomial function (IPF. Parameters were estimated by iterative methods. The criteria used to compare the models were the adjusted coefficient of determination (R

  15. Análisis de los parámetros nutricionales y ajuste de requerimientos de la nutrición parenteral de inicio en el paciente crítico postquirúrgico

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    Mª Carmen Herrero Domínguez-Berrneta

    2014-02-01

    Full Text Available Objetivos: Analizar los parámetros nutricionales en pacientes críticos postquirúrgicos en situación de estrés, su evolución y evaluar el grado de ajuste de la Nutrición Parenteral (NP de inicio a los requerimientos de las recomendaciones recientemente publicadas. Material y métodos: Estudio observacional, retrospectivo incluyendo pacientes críticos postquirúrgicos ingresados en una unidad de reanimación postquirúrgica en 2011 con prescripción de NP. Se recogieron datos demográficos, antropométricos, diagnóstico, parámetros nutricionales, mortalidad, estancia total y en Reanimación (REA, y complicaciones. Se comparó el tipo de NP pautada, con la individualización de los requerimientos por kg según las últimas recomendaciones publicadas de nutrición en el paciente crítico (ASPEN, ESPEN, SENPE: 18-30 kcal/kg, 0,8-1,5 g/kg/proteínas, 4 mg/kg/min/glucosa y 2-3 mg/kg/min/glucosa en pacientes con hiperglucemia de estrés, y 0,5-1 g/kg/día lípidos. Las variables analizadas fueron ajuste calórico, proteico y de glucosa en la NP de inicio, recuperación de la albúmina > 3 g/dl a día 10º y la posible asociación clínica con el número de complicaciones, mortalidad y estancia. Resultados: Se analizaron 60 pacientes. El 23,3% (14/60 presentaban al ingreso desnutrición con una pérdida significativa de peso previa a la intervención. La albúmina, reactante de fase aguda negativo, fue significativamente baja al inicio, media 1,9 g/dl (IC95% 1,83-2,12 indicando un alto grado de estrés metabólico de los pacientes postquirúrgicos. Las NP pautadas se ajustaron a las recomendaciones en kcal, proteínas y lípidos en un 68,3%, 71,7%, 80,4% respectivamente. El 57,1% estaban ajustados en glucosa aunque no se tuvo en cuenta el posible aporte en sueroterapia. En pacientes con IMC < 22 kg/m² (16/60 se observó que el 81,8% de las NP pautadas presentaban exceso calórico, 60% exceso proteico y 43,8% exceso de lípidos (p < 0,05. Un 34

  16. Inteligencia emocional y ajuste psicosocial en la adolescencia: El papel de la percepción emocional

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    José M. Salguero

    2011-12-01

    Full Text Available La inteligencia emocional (IE, definida como la habilidad para percibir, usar, comprender y regular las emociones, se ha mostrado como una variable importante a la hora de explicar el ajuste psicosocial de las personas. Pese a ello, la mayor parte de la investigación en torno a la IE ha sido realizada con muestras de población adulta y son escasos los trabajos que, utilizando medidas de ejecución, exploren su papel en la adolescencia. El objetivo del presente estudio fue el de analizar la influencia de la percepción emocional, una de las habilidades recogidas dentro de la IE, sobre el ajuste personal y social de una muestra de adolescentes españoles. Un total de 255 alumnos completaron una tarea de ejecución diseñada para evaluar la percepción emocional en la adolescencia así como diferentes medidas de ajuste social y personal. Los resultados de los análisis de correlación y regresión mostraron cómo los adolescentes con una mayor habilidad para reconocer los estados emocionales de los demás informaron de mejores relaciones sociales con iguales y padres, menor tensión en sus relaciones sociales, así como de un mayor nivel de confianza y competencia percibida. Además, estos resultados se mantuvieron tras controlar los efectos de la edad, el sexo y la personalidad. Se discuten los resultados en el contexto de la investigación sobre la inteligencia emocional y se proponen implicaciones prácticas para el diseño de programas de prevención y tratamiento

  17. RETIRO LABORAL Y AJUSTE A LA JUBILACIÓN DE HOMBRES Y MUJERES EN LA MEDIANA EDAD

    OpenAIRE

    Roxana Cruz Meléndez

    2011-01-01

    En este artículo se presentan los resultados de una investigación aplicada cuyo objeto de estudio fue un grupo de hombres exfuncionarios y mujeres exfuncionarias del área administrativa de la Universidad de Costa Rica (UCR) que se encuentran en la etapa de vida denominada "la mediana edad" y que enfrentan el proceso trabajo-retiro laboral. El estudio consistió en identificar los principales factores que inciden en el retiro laboral a una edad más temprana; la viviencia del proceso, el ajuste ...

  18. Consensos, participación ciudadana y ajuste estructural de las finanzas públicas en Colombia 1998 - 2002

    OpenAIRE

    Carlos Ariel Sanchez-Torres; Rodrigo Naranjo-Galves; Erick Rincón-Cárdenas; Edilberto Peña-González

    2010-01-01

    Este ensayo estudia el proceso de ajuste estructural de las finanzas públicas que ha tenido lugar en Colombia a partir de 1998, con el propósito de examinar desde un punto de vista jurídico-político, en qué medida dicho proceso es resultado de un consenso en la sociedad colombiana y cuáles son las consecuencias de su existencia o de su ausencia, teniendo en cuenta la importancia de la legitimación democrática y el concepto pacto fiscal. Para el efecto, parte de la noción de participación ...

  19. Velocidad de ajuste de la estructura de capital de empresas del sector minero metálico peruano

    OpenAIRE

    Isla López, José Octavio; Flores Orihuela, Alfonso Manuel; Valencia Ramírez, Hernán Octavio

    2015-01-01

    Trabajo de investigación (Magíster en Finanzas) -- Universidad del Pacífico, Escuela de Postgrado, 2015. Asesor: Jorge Eduardo Lladó Márquez. En la presente investigación, se estudia si las empresas del sector minero metálico peruano utilizan óptimamente su endeudamiento o si, por el contrario, incurren en costos que evitan que alcancen su estructura de capital objetivo instantáneamente. Asimismo, se evalúa el impacto de las condiciones macroeconómicas en la velocidad de ajuste hacia su...

  20. Teoría de las Contingencias Múltiples Dinámicamente Entrelazadas (Abriendo la caja negra del ajuste contingente)

    OpenAIRE

    Lic. Jorge Washington Barrientos

    2013-01-01

    La teoría de las contingencias ha ocupado un rol destacado en el estudio del diseño de las estructuras organizacionales en los últimos cincuenta años. Sus contribuciones se han dirigido en distintas direcciones, una de ellas ha sido enumeración de factores de contingencia y la posterior identificación de relaciones entre estos y los elementos estructurales.Refinamientos posteriores han conceptualizado la respuesta sistémica que permite el ajuste (“fit”) de la organización a los cambios en los...

  1. Lucha popular, democracia, neoliberalismo: protesta popular en américa latina en los años del ajuste

    OpenAIRE

    Martha Cecilia García V.

    2010-01-01

    Margarita López Maya (editora). Lucha popular, democracia, neoliberalismo: protesta popular en América Latina en los años del ajuste. Caracas: Nueva Sociedad, 1999, 264 páginas. Este libro presenta una compilación de diez artículos elaborados por investigadores de Argentina, México, Colombia, Guatemala, Brasil, República Dominicana y Venezuela, producto de sus investigaciones sobre luchas y movimientos sociales en estos países. La intención del libro, según la compiladora, es tratar de llegar...

  2. Ajustes Contábeis para o Cálculo do EVA: estudo sobre os procedimentos adotatos em empresas brasileiras

    Directory of Open Access Journals (Sweden)

    Eduardo Kazuo Kayo

    2008-06-01

    Full Text Available A geração de valor para o acionista está se tornando uma preocupação cada vez mais presente em resposta à pressão dos investidores e de conselhos de administração. Várias abordagens estão disponíveis, entre estas, uma linha de pensamento ligada ao Lucro Residual, o Valor Econômico Agregado (EVA, metodologia desenvolvida pela Stern Stewart & Co. Para cor-rigir as impropriedades percebidas na prática das demonstrações financeiras, alguns usuários da técnica do EVA ajustam os dados contábeis de acordo com os Princípios Contábeis Geralmente Aceitos, na expectativa de que tais ajustes produzam valores mais confiáveis e possam gerar ambiente propício aos comportamentos administrativos mais próximos ao ótimo esperado. A lógica e a mecânica por trás desses ajustes são tratadas ao longo do trabalho, investigando a possível correlação entre a percepção de entendimento do controller e a utilização dos métodos adotados pela organização.

  3. Historia Funcional de Morfologías Lingüísticas y su Efecto en un Ajuste Convencional

    Directory of Open Access Journals (Sweden)

    Nataly Yáñez Ramírez

    2011-01-01

    Full Text Available Se observó si diferentes historias funcionales construidas durante la adquisición de un conjunto de morfologías lingüísticas facilitaban un ajuste convencional. Participaron 24 estudiantes universitarios distribuidos en tres grupos, expuestos a entrenamientos construidos bajo la lógica de diferentes niveles de interacción: contextual, suplementario o selector (Ribes y López, 1985; y posteriormente se evaluó su ejecución en una tarea convencional. El entrenamiento cuyo criterio de ajuste era de tipo selector fue la que más facilitó tanto la adquisición de las morfologías lingüísticas como su uso en la tarea, efecto que pareció más evidente en los hablantes que en los escuchas. No se encontraron diferencias entre los entrenamientos contextual y suplementario. Los resultados se discuten en términos de sus implicaciones teóricas y metodológicas.

  4. Consensos, participación ciudadana y ajuste estructural de las finanzas públicas en Colombia 1998 - 2002

    Directory of Open Access Journals (Sweden)

    Carlos Ariel Sanchez-Torres

    2010-03-01

    Full Text Available Este ensayo estudia el proceso de ajuste estructural de las finanzas públicas que ha tenido lugar en Colombia a partir de 1998, con el propósito de examinar desde un punto de vista jurídico-político, en qué medida dicho proceso es resultado de un consenso en la sociedad colombiana y cuáles son las consecuencias de su existencia o de su ausencia, teniendo en cuenta la importancia de la legitimación democrática y el concepto pacto fiscal. Para el efecto, parte de la noción de participación ciudadana, de la importancia que esta institución tiene en Colombia a partir de 1991, así como de sus limitaciones. Luego se remonta al origen de la situación económica y fiscal que hizo necesario el ajuste y, luego, al acuerdo extendido con el Fondo Monetario Internacional, suscrito en 1999.

  5. Consumo de sustancias durante la adolescencia:trayectorias evolutivas y consecuencias para el ajuste psicológico

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    Alfredo Oliva

    2008-01-01

    Full Text Available Este estudio ha perseguido dos objetivos fundamentales: encontrar diferentes trayectorias en el consumo de sustancias a lo largo de la adolescencia y analizar las consecuencias que este consumo en la adolescencia temprana y media tiene para el ajuste emocional y comportamental al final de la adolescencia. El estudio, con un diseño descriptivo longitudinal mediante cuestionarios, se llevó a cabo sobre una muestra de 101 adolescentes (63 varones y 38 mujeres que fueron estudiados en 3 ocasiones: a los 13, 15 y 18 años de edad. Los resultados mostraron tres grupos de adolescentes en función de las trayectorias seguidas por su consumo de sustancias: consumo bajo, consumo ascendente y experimentación precoz. La comparación entre estos tres grupos indicó un mejor ajuste psicológico en la adolescencia tardía entre los varones y mujeres del grupo de experimentadores, mientras que los problemas de conducta fueron más frecuentes entre los incluidos en el grupo de consumo ascendente. Por otra parte, los análisis de regresión señalaron que el consumo moderado de sustancias en la adolescencia temprana estaba relacionado con una autoestima más alta y con menos problemas emocionales al final de la adolescencia, pero no con más problemas externos.

  6. Ajuste do modelo de Schumacher e Hall e aplicação de redes neurais artificiais para estimar volume de árvores de eucalipto Adjustment of the Schumacher and Hall model and application of artificial neural networks to estimate volume of eucalypt trees

    Directory of Open Access Journals (Sweden)

    Mayra Luiza Marques da Silva

    2009-12-01

    Full Text Available Objetivou-se, neste trabalho, avaliar o ajuste do modelo volumétrico de Schumacher e Hall por diferentes algoritmos, bem como a aplicação de redes neurais artificiais para estimação do volume de madeira de eucalipto em função do diâmetro a 1,30 m do solo (DAP, da altura total (Ht e do clone. Foram utilizadas 21 cubagens de povoamentos de clones de eucalipto com DAP variando de 4,5 a 28,3 cm e altura total de 6,6 a 33,8 m, num total de 862 árvores. O modelo volumétrico de Schumacher e Hall foi ajustado nas formas linear e não linear, com os seguintes algoritmos: Gauss-Newton, Quasi-Newton, Levenberg-Marquardt, Simplex, Hooke-Jeeves Pattern, Rosenbrock Pattern, Simplex, Hooke-Jeeves e Rosenbrock, utilizado simultaneamente com o método Quasi-Newton e com o princípio da Máxima Verossimilhança. Diferentes arquiteturas e modelos (Multilayer Perceptron MLP e Radial Basis Function RBF de redes neurais artificiais foram testados, sendo selecionadas as redes que melhor representaram os dados. As estimativas dos volumes foram avaliadas por gráficos de volume estimado em função do volume observado e pelo teste estatístico L&O. Assim, conclui-se que o ajuste do modelo de Schumacher e Hall pode ser usado na sua forma linear, com boa representatividade e sem apresentar tendenciosidade; os algoritmos Gauss-Newton, Quasi-Newton e Levenberg-Marquardt mostraram-se eficientes para o ajuste do modelo volumétrico de Schumacher e Hall, e as redes neurais artificiais apresentaram boa adequação ao problema, sendo elas altamente recomendadas para realizar prognose da produção de florestas plantadas.This research aimed at evaluating the adjustment of Schumacher and Hall volumetric model by different algorithms and the application of artificial neural networks to estimate the volume of wood of eucalyptus according to the diameter at breast height (DBH, total height (Ht of the clone. For such, 21 scalings of stands of eucalyptus clones were used with

  7. Elementos teóricos del ajuste estacional de series económicas utilizando X-12-ARIMA y TRAMO-SEATS

    OpenAIRE

    Francisco Villarreal

    2005-01-01

    Existen diversos métodos de ajuste estacional, los cuales son utilizados de manera rutinaria tanto en la producción, como en el análisis de series de tiempo económicas en Bancos Centrales, Oficinas de Estadística, así como en diversas agencias públicas y privadas. Si bien la disponibilidad de procedimientos automáticos de ajuste facilitan el procesamiento masivo de series, su uso indiscriminado puede convertir a los diferentes métodos en "cajas negras" para los usuarios. Con el fin de que los...

  8. RETIRO LABORAL Y AJUSTE A LA JUBILACIÓN DE HOMBRES Y MUJERES EN LA MEDIANA EDAD

    Directory of Open Access Journals (Sweden)

    Roxana Cruz Meléndez

    2011-01-01

    Full Text Available En este artículo se presentan los resultados de una investigación aplicada cuyo objeto de estudio fue un grupo de hombres exfuncionarios y mujeres exfuncionarias del área administrativa de la Universidad de Costa Rica (UCR que se encuentran en la etapa de vida denominada "la mediana edad" y que enfrentan el proceso trabajo-retiro laboral. El estudio consistió en identificar los principales factores que inciden en el retiro laboral a una edad más temprana; la viviencia del proceso, el ajuste a la jubilación y sus implicaciones a nivel personal y social. La información recopilada se obtuvo a partir de la técnica "la entrevista fenomenológica" concebida como una exploración profunda que proporciona datos de gran valor conceptual y humana; en ella, tanto la persona que entrevista como la entrevistada mantienen un compromiso para que la búsqueda de la información sea dentro de una relación empática. Partiendo de lo subjetivo por su historia de vida al mandato social por lo roles asignados y asumidos por la población en estudio. Los resultados obtenidos indican que pareciera que la valoración que cada uno de los participantes hace de su rol laboral y el significado del trabajo en sus vidas es determinante en el proceso de retiro laboral y su ajuste al rol de persona jubilada.

  9. Uso de modelos não-lineares para o ajuste de curvas de crescimento de cavalos pantaneiros

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    Sandra Aparecida Santos

    1999-07-01

    Full Text Available Dados de altura da cernelha e idade de 26 cavalos Pantaneiros, obtidos, na maioria, do nascimento até 36 meses, foram ajustados aos modelos de respostas não-lineares de Brody, Richards, Gompertz, Logístico, Weibull e Morgan-Mercer-Flodin. Estes seis modelos matemáticos foram comparados com o uso de uma medida de curvatura média e do erro médio quadrático combinado. O modelo de Weibull foi escolhido. A assíntota desta curva representa a altura esperada na maturidade. Os machos apresentaram um valor maior desta quantidade do que as fêmeas. O índice de maturidade, contudo, é maior para as fêmeas. Observou-se uma indicação de associação negativa entre altura na maturidade e índice de maturidade somente nas fêmeas. Tais resultados indicam que as fêmeas amadurecem mais cedo. Após testes de normalidade e homogeneidade de variância, as diferenças entre sexos foram analisadas com o uso do teste-t. Somente a altura da cernelha ao nascimento apresentou diferença significativa.

  10. Cirurgia de estrabismo ajustável no peroperatório com anestesia tópica em pacientes com orbitopatia de Graves Intraoperative adjustable strabismus surgery under drop anesthesia in patients with Graves' orbitopathy

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    Patrícia Grativol Costa

    2008-06-01

    Full Text Available OBJETIVO: Descrever as características clínicas pré-operatórias dos pacientes com estrabismo secundário à orbitopatia de Graves e os resultados da cirurgia com anestesia tópica e sutura ajustável. MÉTODOS: Estudo retrospectivo realizado no Hospital das Clínicas da Universidade de São Paulo. Foram pesquisados os prontuários de todos os pacientes atendidos no ambulatório de estrabismo no período de março de 1994 a maio de 2004. Destes, foram separados aqueles com estrabismo associado à orbitopatia de Graves submetidos à cirurgia ajustável com anestesia tópica. As características clínicas pré-operatórias e os resultados cirúrgicos foram levantados a partir desta análise. RESULTADOS: Foram incluídos 13 pacientes. O tipo de desvio mais freqüentemente encontrado foi esotropia com hipotropia. Em 9 pacientes modificou-se o retrocesso programado no pré-operatório. Três casos necessitaram de uma segunda cirurgia. Após 6 meses de seguimento, 8 dos 13 pacientes estavam ortotrópicos ou com foria pequena e com algum grau de estereopsia. CONCLUSÃO: Neste estudo observou-se que 62% (8/13 dos pacientes apresentavam hipotropia com esotropia, provavelmente por causa do comprometimento associado do reto inferior e reto medial. Nove dos 13 pacientes necessitaram de ajuste no peroperatório e apenas 3 foram reoperados, indicando a importância da técnica ajustável para melhor alinhamento ocular no pós-operatório, possibilitando obter resultados mais satisfatórios.PURPOSE: To report the clinical features of strabismus associated with Graves' orbitopathy, and the results of surgery with adjustable suture under drop anesthesia. METHODS: The charts of 13 patients who had surgical treatment for strabismus related to Graves' orbitopathy at Hospital das Clínicas of University of São Paulo were retrospectively reviewed. Ocular motility, sensorial examination and the follow-up after strabismus correction were studied. RESULTS

  11. Four Quarters of Football Helmet Safety

    Science.gov (United States)

    ... 082012 Pub. 348 AJUSTE CORRECTO UN JUEGO MÁS SEGURO 4 CUARTOS SOBRE LA SEGURIDAD DE LOS CASCOS ... faciales. Ajuste —El casco debe “sentirse” ajustado, sin espacio entre las almohadillas y la cabeza del atleta. ...

  12. Ajuste oclusal na Ortodontia: por que, quando e como? Occlusal adjustment in Orthodontics: why, when and how?

    Directory of Open Access Journals (Sweden)

    Roberto Carlos Bodart Brandão

    2008-06-01

    Full Text Available INTRODUÇÃO: o conhecimento sobre oclusão dentária deve ser considerado condição fundamental para a prática de uma Ortodontia de qualidade. O diagnóstico feito sem a manipulação do paciente em Relação Cêntrica pode levar à surpresa desagradável de se planejar o tratamento de uma má oclusão e se deparar com outra, depois dos primeiros arcos de nivelamento. Ao usar arcos retangulares, é importante a checagem dos contatos oclusais para se definir o tipo de movimento dentário necessário para o alcance do equilíbrio oclusal e, principalmente, verificar se este movimento é exeqüível. Durante o tratamento ortodôntico, devido à complexidade das superfícies oclusais, o ajuste oclusal por desgaste deve ser realizado para viabilizar movimentos dentários verticais, reduzindo o tempo de tratamento. Interferências oclusais são responsáveis tanto por efeitos adversos na biomecânica, quanto por aplicação de forças excessivas, que podem causar reabsorções radiculares. Após a Ortodontia, o ajuste oclusal é um dos determinantes da estabilização dentária, devendo-se obter, para cada dente posterior, contatos oclusais "A" e "B", ou "B" e "C" no sentido vestibulolingual, além dos contatos de "parada" e "equilíbrio" no sentido mesiodistal. Os dentes anteriores passam a funcionar em movimentos mandibulares, desocluindo de imediato os dentes posteriores, o que é denominado de guia anterior, visando equilíbrio muscular e proteção do sistema estomatognático. O desgaste seletivo não deve ser utilizado como substituto da movimentação ortodôntica. OBJETIVO: apresentar os princípios relacionados ao ajuste oclusal em Ortodontia.INTRODUCTION: The knowledge of dental occlusion should be considered the basic foundation to an excellent orthodontic practice. The patient’s diagnose without the centric relation assessment can take the orthodontist to an unpleasant surprises. The use of rectangular archwires requires occlusal

  13. Ajustement de la courbe de lactation de la chèvre locale dans les zones arides Tunisiennes

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    Ilyes Mekki

    2011-10-01

    Full Text Available Les performances laitières de la chèvre locale dans les zones arides tunisiennes dépendent des capacités génétiques de l’effet des conditions du milieu et du mode de conduite des troupeaux. L’objectif de cette étude est d’analyser les performances laitières de la chèvre locale en fonction de ces facteurs à travers l’ajustement de la courbe de lactation. De telles connaissances sont indispensables pour planifier la gestion raisonnable de cette ressource animale rustique dans des conditions naturelles difficiles. Les données utilisées pour cette étude sont issues de 10 campagnes de contrôle laitier réalisé au niveau d’un troupeau caprin expérimental conduit dans les régions arides. Suite à l’élaboration des données, l’application des procédures de régression non linéaire a identifié le modèle de Wood comme le plus adaptée pour l’ajustement de la courbe de lactation de la chèvre locale. Ce modèle a été appliqué pour estimer les paramètres de la lactation individuelle et l’étude des facteurs de variation. Les résultats d’ajustements des données montrent que la lactation de la chèvre locale évolue après la mise bas selon une trajectoire assez aplatie. Les performances de la chèvre locale sont assez réduites et similaires à celles observées pour des populations élevées dans des zones difficiles tunisiennes de point de vue climatique et pastorale. La moyenne de production initiale observée est de 720 g/j, le pic de lactation est observé au 17ème jour lorsqu’une chèvre produit en moyenne 980g/j. La réduction des potentialités laitières de la chèvre locale illustre les effets du processus de sélection naturelle qui a favorisé l’adaptation aux conditions difficiles des régions arides. Les résultats contribuent à la caractérisation de la chèvre locale et à la planification de son amélioration comme étant une ressource génétique locale et rustique.

  14. Cronograma de amostragem de alface cultivada em hidroponia para ajuste de curvas de crescimento vegetativo Sampling chronology of hydroponics lettuce plants for adjusting vegetative growth curves

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    Sidinei José Lopes

    2007-10-01

    Full Text Available O objetivo deste trabalho foi determinar o cronograma de amostragem de plantas de alface hidropônica, para ajuste de curvas de crescimento durante o período vegetativo. Foram realizados dois cultivos de alface, variedade Regina, de 8/9/2004 a 19/11/2004 (primavera/verão e 22/2/2005 a 24/5/2005 (verão/outono, em estufas de plástico do Dep. de Fitotecnia, da UFSM, Santa Maria, RS. A partir do ajuste do modelo co-seno com amostragem diária, registrada como padrão, diferentes intervalos entre as amostragens foram simulados para o ajuste do mesmo modelo. A fim de se encontrar o intervalo adequado, foi comparada a variância de falta de ajuste do modelo de amostragem diária com as variâncias de falta de ajuste dos modelos com diferentes intervalos de amostragens pelo teste F. Os cronogramas de amostragens para ajuste de curvas de crescimento de plantas de alface sob hidroponia, para experimentos de primavera/verão e verão/outono, possuem intervalos iguais a dois dias, para fitomassa seca total da planta e da folha; intervalos de quatro dias, para fitomassa de raiz; e, diariamente, para área foliar.The objective of this work was to determinate a sampling chronology to adjust lettuce hidroponic growth curves during its vegetative development. The variety Regina was grown from September 8, 2004 until November 19, 2004 (spring/summer and February 22, 2005 until May 24, 2005 (summer/fall. Plants were placed inside a plastic covered greenhouse in Santa Maria, RS, Brazil. Based on the adjusted cosine model, daily samples were taken as standard and different sampling intervals were simulated in order to better adjust the same model. To estimate de adequate sampling interval a comparison was conducted between the variance of lack of adjustment of the daily sampling with the variance of lack of adjustment of different samplings intervals using an F test. Sampling chronograms for adjusting crop growth curves of hydroponics lettuce plants for both

  15. Cronograma de amostragem de plantas de alface hidropônica para ajuste de curvas de crescimento Hydroponic lettuce sampling chronogram for fitting growth curves

    Directory of Open Access Journals (Sweden)

    Paula Machado dos Santos

    2007-12-01

    Full Text Available O ajuste de curvas de crescimento de plantas de alface durante seu ciclo necessita de amostragens no tempo, o que restringe o número de efeitos de tratamentos estudados. Com o objetivo de determinar o cronograma de amostragem de plantas de alface em hidroponia para o ajuste de curvas de crescimento até a fase de maturação das sementes, foram realizados dois cultivos em casa de vegetação durante a primavera e o outono, em área pertencente ao Departamento de Fitotecnia, na UFSM, Santa Maria, RS. A partir do ajuste de um modelo de crescimento com amostragem diária, simularam-se diferentes cronogramas de amostragem para o ajuste do mesmo modelo. Para encontrar o cronograma de maior intervalo entre amostragens, ou seja, menor número de coletas, foi comparado o ajuste do modelo de amostragem diária com os ajustes dos modelos dos diferentes intervalos de amostragens simulados, dois a dois, pelo teste F. Foram realizadas simulações considerando desde a data de transplante até a produção de sementes, para variáveis de fitomassa seca da planta e de partes da planta e área foliar. Em experimentos realizados com alface hidropônica na primavera, para o ciclo completo, recomendam-se amostragens a cada 3, 8, 20 e 9 dias para fitomassa seca relativa total da planta de alface, de folhas, de raiz e área foliar, respectivamente; enquanto que, para experimentos realizados no outono, é recomendável utilizar intervalos de amostragens a cada 2, 11, 12 e 11 dias, respectivamente.The fitting of growth curves for lettuce plants requires many samplings within o time interval, while can restrict the number of studied treatments. With the aim o determine sampling chronogram hidroponic lettuce for the fitting of growth curves until maturation of seeds. Two greenhouse trials were carried out in spring an autumn, at UFSM experimental area, Santa Maria, RS. Different sampling interval were simulated using the fitting of a daily model. The optimum sampling

  16. Propuesta metodológica para el ajuste curricular de las escuelas adscritas a la facultad de Ciencias Administrativa

    Directory of Open Access Journals (Sweden)

    Mercedes Inciarte Rodríguez

    2003-01-01

    Full Text Available El propósito de este estudio fue diseñar una propuesta metodológica para el ajuste curricular de la Facultad de Ciencias Administrativas de la Universidad Rafael Belloso Chacín, partiendo de la revisión y análisis de las diferentes escuelas que están adscritas a la Facultad, con el objetivo de modificar las currículas de estas escuelas, de tal manera que se logre contribuir significativamente al desarrollo de las sociedad a través de procesos formativos y de acuerdo a la realidad cambiante de las ciencias y la tecnología, pero sobre todo tomando en cuenta las nuevas formas de producción y la internacionalización de la economía a las que deben responder las escuelas, pertenecientes a esta Facultad, logrando así un perfil de la profesión para poder existir y subsistir, el cual satisfaga la necesidad social, al mismo tiempo con valores, que sean capaces de defender el ejercicio de su profesión, a través de los conocimientos técnicos, científicos que sustenten su formación, de tal manera que se logre una aceptación expresa por parte del conglomerado social al cual prestarán servicios. La metodología para el desarrollo del ajuste curricular de las Escuelas partiendo de reuniones de trabajo para realizar la revisión de los currículos, a través de una validación interna y externa para lograr la actualización de los contenidos, la aplicación de ejes: transversales, reducir la frondosidad curricular, revisión del No. de horas y unidades créditos y por último llevar las carreras a una duración de 4 años. Todo esto llevará a la implementación del nuevo currículo que responda a las necesidades reales de la sociedad.

  17. MicroFit: um software gratuito para desenvolvimento e ajuste de modelos matemáticos de crescimento bacteriano

    Directory of Open Access Journals (Sweden)

    Alisson Amorim Siqueira

    2014-12-01

    Full Text Available A conservação de alimentos é uma das práticas mais antigas apropriadas pela humanidade, entretanto as infecções alimentares ainda despontam como uma gravíssima questão de saúde pública em todo o mundo, levando a óbito milhares de pessoas todos os anos. Nesse contexto, os modelos de predição microbiológica surgem como uma importante ferramenta para aferição da segurança alimentar e avaliação do risco de contaminação de alimentos. Os parâmetros de predição do comportamento microbiano proporcionam um caminho rápido e relativamente econômico para obtenção de estimativas confiáveis sobre crescimento, inativação e sobrevivência durante a atividade de micro-organismos nos alimentos, de acordo com as condições de estocagem. Apesar da importância dos modelos de predição, as dificuldades de utilização e resolução dos mesmos, por consistirem de equações não lineares e sem solução analítica, impedem sua ampla utilização. A baixa disponibilidade de programas eletrônicos para análise de dados microbiológicos, bem como a falta de ferramentas que permitam a criação de modelos ou o ajuste de parâmetros de uma forma rápida e fácil são outros entraves ao uso dos modelos de crescimento microbiológico. Diante desse problema, esse artigo tem por objetivo descrever o processo de desenvolvimento de um software concebido para permitir o ajuste, criação e comparação de modelos microbiológicos de crescimento de bactérias. A partir do uso de ferramentas comumente empregadas nesse tipo de estudo e das necessidades não contempladas por elas, foi desenvolvido um programa autônomo, gratuito, dotado de uma interface objetiva e com mecanismos capazes de criar e avaliar facilmente modelos preditivos. Espera-se que o software desenvolvido neste trabalho possa facilitar a análise de dados do comportamento microbiano em alimentos e o controle de possíveis repercussões para o consumidor final.

  18. Aplicación de un modelo politómico de TRI para la obtención de medidas conmensurables en una escala de ajuste persona-organización

    OpenAIRE

    Ximénez, Carmen; Revuelta Menéndez, Javier

    1999-01-01

    En este artículo se aborda el problema del uso de métodos directos para la comprobación del criterio de ‘conmensurabilidad de unidades de medida’ en las medidas sobre ajuste persona-ambiente mediante la aplicación de un modelo politómico de rasgo latente. Se utilizó el modelo de respuesta nominal de Bock (1972; 1997) para evaluar el ajuste estadístico de las puntuaciones en las escalas de medida P y O de un cuestionario de ajuste persona-organización con datos reales de 591 sujetos. Los re...

  19. COMPARACIÓN DE HABILIDADES SOCIALES Y AJUSTE PSICOLÓGICO EN NIÑOS MEXICANOS DE TRES CONDICIONES

    Directory of Open Access Journals (Sweden)

    Claudia González Fragoso

    2014-01-01

    Full Text Available Las habilidades sociales en la infancia guardan una estrech a relación con aspectos como autoestima, ansiedad y depresión. Tales variables son indicadoras del ajuste psicológico, que puede alterarse en los niños que son víctimas de violencia o que viven en institucion es. Para contar con datos sobre niños mexicanos, el presente estudio exploratorio evaluó y comparó los niveles mostrados en habilidades sociales, autoestima, ansiedad y depresión en tres grupos de niños que se hallaban en condiciones de vida distintas: viviendo institucionalizados, en un albergue tempor al por ser víctimas de maltrato o en familia. A cada grupo de niños se les aplicaron cuatro instrumentos validados. Los resultados indican que los niños institucionalizados difirieron significativamente en todas las variables evaluadas en el estudio respecto a los niños que vivían en familia, y compartieron niveles similares de autoestima, ansiedad y depresión con los niños víctimas de maltrato. Estos, a su vez, difirieron de los niños que vivían en familia en esas variables y mostraron mayores índices de a gresión.

  20. Velocidad de ajuste del precio de las acciones por sector económico en la Bolsa Mexicana de Valores

    Directory of Open Access Journals (Sweden)

    Verónica Patricia Rodríguez Vázquez

    2009-01-01

    Full Text Available Este estudio analiza la velocidad de ajuste del precio de las acciones de la Bolsa Mexicana de Valores de enero de 1998 a diciembre de 2007; para ello, se agruparon las acciones por sectores económicos y se compararon con el Índice de Precios y Cotizaciones (IPC. Asimismo, se clasificó a los sectores económicos en fuertes y débiles, dependiendo del porcentaje de influencia dentro de la muestra del IPC. Entre los sectores fuertes se ubicó a comunicaciones y transportes, comercio, construcción e industria extractiva; mientras que en los débiles a transformación, servicios y varios. El modelo de regresión utilizado fue el propuesto por Marshall y Walker (2002, con el que se buscó comprobar que los sectores fuertes ajustaban más rápidamente sus precios que los sectores débiles con respecto a la rentabilidad del mercado. Se encontró que existe evidencia de que los retornos de los sectores fuertes se adelantan a los retornos de los sectores débiles, principalmente porque los primeros ajustan más rápidamente sus precios a los movimientos del mercado.

  1. Estableciendo nexos entre Políticas de Ajuste Estructural y su impacto ambiental: una discusión metodológica

    Directory of Open Access Journals (Sweden)

    Rosalba Ortiz

    2011-09-01

    Full Text Available Las políticas de Ajuste Estructural han sido la base de la política económica costarricense en los últimos 10 años, por lo cual, han tenido gran incidencia en el análisis de los procesos y relaciones de cualquier sector productivo. En este contexto, los efectos ambientales de los últimos años, están decididamente influenciados por estas políticas, pues aunque, los programas de Ajuste no tienen como propósito direccionar aspectos ambientales, al modificar algunos precios relativos, pueden propiciar un cambio en el patrón de uso de un recurso, y es así como, tienen un efecto directo o indirecto sobre el ambiente

  2. EL AJUSTE CONDUCTUAL, EMOCIONAL Y SOCIAL EN HERMANOS DE NIÑOS CON UN TRASTORNO DEL ESPECTRO AUTISTA. UNA REVISIÓN TEÓRICA

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    Raquel Ruiz Aparicio

    2015-09-01

    Full Text Available Las personas con Trastorno del Espectro Autista (TEA tienen características únicas y hay una falta de conocimiento sobre cómo estas características podrían influir en sus familias y en el ajuste conductual, emocional y social de sus hermanos. El presente estudio tiene el objetivo de centrarse en los hermanos de estas personas con TEA y realizar una revisión teórica relacionada con el ajuste conductual, emocional y social de hermanos de niños con TEA. Un total de 24 artículos han sido incluidos y analizados con el fin de encontrar resultados relevantes que puedan ayudar a entender las necesidades de estos hermanos. El estudio sugiere, en ocasiones, resultados diferentes pero identifica aquellos factores de riesgo que podrían impactar en el núcleo familiar y, principalmente, en los hermanos de niños con TEA.

  3. Autonomía y ajuste académico: un estudio con estudiantes portugueses de primer año

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    Ana Paula Soares

    2007-01-01

    Full Text Available Los niveles de autonomía psicológica de los alumnos desempeñan un papel importante en su ajuste a las presiones y desafíos de la vida universitaria. En este sentido, el presente estudio descriptivo analiza las relaciones entre los niveles de autonomía de los estudiantes en su entrada en la Enseñanza Superior y la calidad de su ajuste académico al final del primer año. Se aplicó el Iowa Developing Autonomy Inventory (IDAI en el inicio del año lectivo y el Questionário de Vivências Académicas (QVA al final de ese año a una muestra de 420 alumnos de primer año de la Universidade do Minho. Los resultados revelan que los alumnos poseen percepciones bastante positivas en cuanto a sus niveles de autonomía en las áreas de Gestión del tiempo, Movilidad e Interdependencia, y niveles más bajos en la Gestión del dinero, observándose algunas oscilaciones en función del género. Por otro lado, los alumnos cuya entrada en la Enseñanza Superior no implicó su abandono del hogar familiar, especialmente los de sexo masculino, presentan niveles más elevados de ajuste académico. Finalmente, los resultados sugieren que el ajuste académico se encuentra asociado a los niveles de autonomía de los alumnos, en particular en lo que concierne a la Gestión del tiempo, Independencia emocional de sus compañeros e Interdependencia.

  4. Apego y Ajuste Socio Emocional: Un Estudio en Embarazadas Primigestas Attachment and Socio-Emotional Adjustment: A Study in First Pregnant Women

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    Chamarrita Farkas

    2008-05-01

    Full Text Available Este artículo se centra en el estudio del apego adulto y su relación con el ajuste socioemocional durante el primer embarazo. Se utiliza una investigación descriptiva correlacional de carácter transversal. La muestra se compone de 139 embarazadas primigestas de 19 a 40 años y nivel socio-económico medio, medio bajo y bajo. El estilo de apego fue evaluado con el Cuestionario de Apego en Adultos, CaMir, y el ajuste socioemocional con el Cuestionario de Salud Mental, OQ-45.2. Se realizan análisis descriptivos de la muestra y correlaciones entre estilos de apego y las dimensiones del Cuestionario de Ajuste Socioemocional con el Coeficiente Producto Momento de Pearson. Los resultados muestran una relación significativa entre los estilos de apego y los indicadores de ajuste.This article focuses on the study of adult attachment and its relationship with socio-emotional adjustment during the first pregnacy. A correlational descriptive study using a cross-sectional design was conducted. The sample included 139 primípara females between 19 and 40 years of age, from medium, medium-low and low socioeconomic status. The attachment style was evaluated using the Attachment Questionnaire for Adults, CaMir, and the socio-emotional adjustment with the Mental Health Questionnaire, OQ-45.2. Descriptive analyses of the sample were conducted, and the bivariate correlations between attachment styles and adjustment was estimated. The results show a significant relation between attachment styles and adjustment indexes.

  5. Acontecimientos vitales estresantes, estilo de afrontamiento y ajuste adolescente: un análisis longitudinal de los efectos de moderación

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    Rosa María Estévez Campos

    2012-01-01

    Full Text Available El objetivo principal de este estudio fue analizar la relación entre la vivencia de los acontecimientos vitales estresantes y los problemas de ajuste emocional y comportamental durante la adolescencia, prestando atención al posible efecto moderador del estilo de afrontamiento. La muestra estuvo compuesta por 90 adolescentes que fueron seguidos durante seis años, desde su adolescencia media (15-16 años hasta la adultez emergente (21-22 años. Completaron cuestionarios sobre su vivencia de acontecimientos vitales estresantes, su estilo de afrontamiento y sus problemas de ajuste tanto emocionales como comportamentales. En un diseño longitudinal se analizó la evolución de cada estilo de afrontamiento según el sexo y se efectuaron análisis de moderación de las distintas estrategias de afrontamiento en la relación entre estresores vitales y el ajuste adolescente. Los resultados mostraron que las estrategias más aproximativas (búsqueda de ayuda y resolución de problemas aumentaron con la edad, mientras que las estrategias de evitación (cognitiva y conductual disminuyeron, aunque sólo algunas trayectorias fueron estadísticamente significativas. Respecto al sexo, las chicas utilizaron con mayor frecuencia estrategias de búsqueda de ayuda. Por otro lado, los análisis de moderación revelaron que solamente los estilos de afrontamiento de evitación moderaron la relación entre la presencia de estresores y el ajuste, aunque el efecto moderador fue diferente en función del tipo de estrategia de evitación empleada. Estos resultados contribuyen a esclarecer el posible efecto de las estrategias de evitación en la adaptación del adolescente a los acontecimientos vitales estresantes y la importancia de seguir profundizando en su estudio.

  6. Evaluación de tres sistemas de ajuste de riesgo como predictores del consumo de medicamentos y productos sanitarios en unidades polivalentes de hospitalización

    OpenAIRE

    2016-01-01

    Fundamentos: El uso de medicamentos y productos sanitarios constituye un componente significativo del gasto sanitario, vinculado con la calidad de la atención y la asignación eficiente de los recursos. Este estudio tuvo por objetivo evaluar en tres sistemas de ajuste de riesgos la capacidad predictiva del consumo de medicamentos y productos sanitarios de los sujetos ingresados en unidades polivalentes de hospitalización. Métodos: Estudio de los consumos de las unidades polivalentes de hospita...

  7. Comparação de alguns modelos matemáticos para ajuste à curva de lactação média de um rebanho da raça Caracu Comparison of some mathematical models for the adjustment of the average milking curve of caracu breed herd

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    Lenira El Faro

    1999-01-01

    Full Text Available No presente estudo foi estimada a curva de lactação média de 7239 lactações de vacas da raça Caracu, com base em 299.949 controles semanais. As funções ajustadas aos dados médios da curva de lactação foram Linear Hiperbólica e Quadrática Logarítmica, como lineares, e Gama Incompleta e Polinomial Inversa, como não-lineares. Os parâmetros foram estimados por meio de processos iterativos, método de Gauss-Newton. O Coeficiente de Determinação ajustado (R²A, o Teste de Durbin-Watson (DW e os desvios (% entre as produções totais (PTL observadas e estimadas foram usados como medida da qualidade do ajuste. Os resíduos estimados, apesar de pequenos, apresentaram correlação serial positiva, pois o teste DW foi significativo para as quatro funções estudadas, indicando violação da pressuposição de independência entre estes resíduos. Os R²A foram superiores a 97% e os desvios entre as PTL observadas e estimadas, mínimos, indicando que, de acordo com estes critérios, qualquer função poderia ser usada para ajustar a curva de lactação média desse rebanho. Quanto aos componentes da curva, a melhor aproximação foi obtida pela função Polinomial Inversa, para produção inicial, tempo e produção no pico. As funções Gama Incompleta e Quadrática Logarítmica apresentaram ajustes semelhantes, porém a primeira apresentou melhor definição dos parâmetros e componentes da curva de lactação.The present study was carried out to estimate the average lactation curve of 7239 lactations of Caracu cows based on 299,949 weekly records. The functions fitted to the mean data of the lactation curve were: Linear Hyperbolic and Logarithmic Quadratic as linear and Incomplete Gamma and Inverse Polynomial function as non-linear. The parameters were estimated by iterative methods, Gauss-Newton method. The adjusted Coefficient of Determination (R²A, the Durbin-Watson test (DW and the deviations (% from actual and predicted total milk

  8. El ajuste en el diseño organizativo como factor de éxito en los acuerdos de cooperación entre empresas

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    Luis Ángel Guerras-Martín

    2009-12-01

    Full Text Available El propósito de este artículo es el de analizar en qué medida el ajuste en el diseño organizativo afecta al éxito de los acuerdos de cooperación entre empresas. Para conseguir dicho propósito, se ha utilizado como referencia teórica el modelo de procesamiento de información. Este modelo fue propuesto originalmente por Galbraith para el análisis del diseño organizativo interno de una empresa, por lo que lo hemos adaptado a las características específicas del diseño externo (o de los acuerdos de cooperación y relacionadas con las necesidades y las capacidades de procesamiento de información. Además, se han desarrollado y utilizado distintos enfoques para medir el constructo “ajuste”. Los resultados obtenidos a partir de una muestra de acuerdos internacionales en I+D muestran que el ajuste entre las capacidades y las necesidades de información para llevar a cabo las tareas implicadas en el acuerdo tiene una influencia positiva en el éxito cuando las necesidades de información exceden a las capacidades. Cuando se utiliza un enfoque de eficiencia, los resultados muestran una relación opuesta entre ajuste y éxito.

  9. Conciencia emocional, estados de ánimo e indicadores de ajuste individual y social en niños de 8-12 años

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    Lidón Villanueva

    2014-05-01

    Full Text Available La conciencia emocional o experiencia consciente de la emoción es un concepto clave relacionado con diferentes indicadores de ajuste individual del menor, como las quejas somáticas. Esta relación, mediatizada por los estados de ánimo, se ha demostrado en población preadolescente y adolescente. Sin embargo, apenas se ha analizado en franjas de edad más bajas e incluyendo otros indicadores de ajuste a diferentes contextos, como la adaptación. Por ello, el objetivo de este trabajo es el de analizar la contribución de la conciencia emocional y los estados de ánimo, sobre diferentes indicadores de ajuste individual (quejas somáticas y de adaptación (evaluada a través del test TAMAI, en niños de 8-12 anos. Para ello, se administraron diferentes cuestionarios de autoinforme a 1423 menores con una media de 9.8 anos. Los resultados apoyan la influencia de la conciencia emocional (principalmente de la habilidad de diferenciar y comunicar verbalmente las emociones y analizar las propias emociones, reforzada por los estados de ánimo, no sólo sobre las quejas somáticas, sino sobre la inadaptación personal y social. Todo ello subraya la importancia, tanto de las habilidades emocionales como de los estados afectivos que las acompañan, en la vida cotidiana del menor.

  10. Diseño de un Modelo de Estimación de Retornos Ajustados por Riesgo para Actividades de Valoración en Mercados Emergentes (Design of a risk-adjusted rate of return model for the evaluation of projects and companies in Costa Rica

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    Manrique Hernández Ramírez

    2012-12-01

    Full Text Available El artículo explica un modelo ajustado para un mercado emergente que, a partir de la versión original del Capital Asset Pricing Model (CAPM, permite la estimación de rendimientos esperados sobre los recursos propios (KE para apoyar el cálculo del costo promedio ponderado de capital dentro de los procesos habituales de valoración de activos riesgosos, como es el caso del análisis de proyectos o empresas, situados en esos mercados. Para ello se toma como ejemplo de aplicación el caso costarricense. Sobre la base de la investigación realizada se logra crear un modelo dinámico y ajustado diseñado en hojas de cálculo, que permite la estimación de retornos exigidos por los socios a la realidad del mercado analizado, para gran cantidad de industrias y sujeto de sensibilización por parte de los usuarios finales de la herramienta teórico práctica.   ABSTRACT This article presents an adjusted model for an emerging market, based on the original Capital Asset Pricing Model, that estimates the expected yield of own resources of supporting the calculation of capital weighted average cost, in the usual risky assets valuation processes, as is the case of the analysis of projects or companies on such a market, and applying it to a Costa Rican case. Based on the investigation, a dynamic custom model based in worksheets is created for several industries, that allow the estimate of the required returns by investing partners for the market under study, and is capable of sensitivity modification by its final users.

  11. Los Programas de Desarrollo Rural en la Argentina (en el contexto del ajuste macroeconómico neoliberal

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    Mabel Manzanal

    2000-09-01

    Full Text Available Este trabajo expone las estrategias de los principales programas de desarrollo rural en la Argentina, y sus alcances y posibilidades en el contexto del ajuste macroeconómico neoliberal. Discute si se están dando, o no, los cursos de acción adecuados, y si es viable la asistencia a los pobres rurales, promovida por los organismos internacionales de financiamiento, frente al impacto negativo de las políticas neoliberales sobre los pequeños y medianos productores agropecuarios.El desarrollo rural se inicia en la Argentina junto con la recuperación democrática de la década del 80, pero las primeras acciones recién comienzan a ejecutarse a principios de los 90. Desde entonces se sucedieron y se superpusieron diferentes programas, que son el objeto de este artículoThis paper discusses the strategies of Argentina’s main rural development programs, and their accomplishments and possibilities in the context of neoliberal macroeconomic adjustment. It analyzes whether the actions being carried out are suitable and whether assistance to the rural poor (promoted by international financing organizations is feasible in the face of the neoliberal policies’ negative impact on small and intermediate farmers and ranchers. Although rural development programs began in Argentina with the restoration of democracy in the 1980s, the first significant actions were not taken until the 1990s. The different programs that have followed, often overlapping, are the object of our study

  12. La industria manufacturera en Centroamérica: Perspectivas del Ajuste a la nueva política comercial regional

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    Fernando RUEDA-JUNQUERA

    2009-11-01

    Full Text Available RESUMEN: La nueva política comercial del Mercado Común Centroamericano está dando lugar a cambios en los flujos comerciales, que inducirán un ajuste inter-/intraindustrial en el sector manufacturero regional. Este artículo presenta y analiza los principales resultados de un estudio empírico que evaluó el impacto del nuevo programa de integración regional en el patrón de especialización y comercio de manufacturas de cada país miembro. El enfoque empírico empleado conllevó la construcción de hojas de balance que integraron en una base comparable los datos de producción y comercio para el sector manufacturero de cada país. Asimismo, se obtuvieron dos grupos de ratios que midieron respectivamente, la importancia relativa de los mercados regional y mundial para los subsectores manufactureros de cada país, y el potencial de éstos para una especialización inter-/intraindustrial en los dos mercados.ABSTRACT: The new trade policy in the Central American Common Market is given rise to changes in trade flows that will induce an inter-/intraindustry adjustment in the regional manufacturing sector. This article presents and analyses the main results of an empirical study which assessed the impact of the new integration scheme on each member country's pattern of trade and specialisation in manufactures. The empirical approach used in the study involved the construction of balance sheets integrating production and trade data on a comparable basis for each country's manufacturing sector. Likewise, two groups of ratios were obtained. They measured respectively, the relative importance of the regional and world market for the manufacturing subsectors of each country and the subsectoral potential for an inter-/intraindustry specialisation in the two markets.

  13. Ajuste social em pacientes com transtorno afetivo bipolar, unipolar, distimia e depressão dupla Social disability in patients with bipolar and unipolar affective disorders, dysthymia and double depression

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    Adriana M Tucci

    2001-06-01

    Full Text Available OBJETIVOS: Dados internacionais mostram que os transtornos afetivos têm uma prevalência de, aproximadamente, 11,3% da população. Além disso, são uma das doenças que mais geram perdas sociais e nos relacionamentos familiares. O objetivo deste trabalho foi avaliar o ajuste social e familiar de pacientes com transtornos afetivos (bipolar, unipolar, distimia e com depressão dupla, comparando o resultado entre as categorias diagnósticas, além de verificar quais variáveis estão associadas e conduzem ao pior ajuste. MÉTODOS: Foram feitos a caracterização socioeconômica e demográfica e um levantamento dos dados de evolução e de história da doença por meio de um questionário elaborado para essa finalidade. Para a avaliação de ajuste social, utilizou-se a Escala de Avaliação da Incapacitação Psiquiátrica (DAS/OMS, 1998. O relacionamento familiar foi avaliado pelo Global Assessment of Relational Functioning Scale (GARF/APA, 1994. Foram estudados 100 pacientes em tratamento, por pelo menos seis meses, no Ambulatório de Psiquiatria da Faculdade de Medicina Unesp, Botucatu, SP. RESULTADOS/CONCLUSÕES: Com predomínio de mulheres, a maioria dos pacientes tinha no mínimo dois anos de seguimento, idade acima de 50 anos, baixa escolaridade e nível socioeconômico baixo. Não houve diferença estatística significativa quanto aos dados socioeconômicos e demográficos. Na análise de regressão logística, o diagnóstico e o relacionamento familiar tiveram papel significativo no resultado de ajustamento social. Os pacientes unipolares e os distímicos tiveram melhores resultados no ajustamento social e no relacionamento familiar do que os bipolares e aqueles com depressão dupla.OBJECTIVES: International data show that affective disorders have a prevalence of 11.3% in the general population. Besides that, they are responsible for social dysfunctioning and family relationship distress. The aim of this study was to assess social and

  14. Uso de variables sintomáticas para el ajuste de proyecciones de poblaciones menores. El caso del Gran Córdoba (Argentina), 2001-2016.

    OpenAIRE

    Leandro M. González

    2010-01-01

    González, Leandro M. Universidad Nacional de Córdoba (UNC) y Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET); Argentina. Se propone un procedimiento de ajuste de proyecciones de poblaciones menores, combinando las técnicas de proyecciones por componentes y variables sintomáticas. Si se dispone de dos o más proyecciones con diferentes hipótesis de migración, las variables sintomáticas permiten seleccionar la proyección más cercana o definir una nueva. La migración p...

  15. Inteligencia emocional autoinformada y ajuste perceptivo en la familia. Su relación con el clima familiar y la salud mental

    OpenAIRE

    Sánchez Núñez, María Trinidad

    2007-01-01

    Este trabajo se centra en la relación existente entre la inteligencia emocional autoinformada (IEA), medida a través de la tmms-24 (Fernández-Berrocal et al., 2004), y el parentesco familiar. Además se evalúa la inteligencia emocional percibida (IEP) por el resto de la familia sobre cada uno de los miembros de la misma. De este modo, se aprecia el grado de ajuste perceptivo de cada miembro, así como se solventan los inconvenientes, perceptivos y de deseabilidad social, derivados de las prueba...

  16. Ajuste de curvas de crescimento e deposição de nutrientes em linhagens de frangos de corte com análise econômica

    OpenAIRE

    Leandro Félix Demuner

    2016-01-01

    O estudo foi conduzido para estimar os parâmetros, avaliar e comparar os ajustes de curvas de crescimento corporal e dos componentes corporais físicos e químicos, de linhagens de frangos de corte sexados. Foram utilizados 1848 pintinhos de um dia de idade distribuídos em delineamento inteiramente casualizado com tratamentos em esquema fatorial hierárquico com os fatores: Sexo (Macho e Fêmea) e Linhagens (Cobb 500, Ross 308 e Hubbard Flex) dentro de cada sexo, totalizando seis tratamentos com ...

  17. Efecto en la respuesta temporal del parámetro ajustable del control adaptativo con modelo de referencia de primer orden

    OpenAIRE

    Vargas Tamani, Bruno; Universidad Nacional Mayor de San Marcos

    2014-01-01

    Se presentan los resultados experimentales del control adaptativo con modelo de referencia, de una planta que de acuerdo a su identificación previamente realizada se puede representar como un sistema de primer orden. Se elige como modelo de referencia también uno de primer orden con ganancia unitaria. Se realiza el análisis del controlador adaptativo, justificándose que su desempeño en lazo cerrado dependerá de la elección adecuada de un parámetro escalar ajustable. Se implementa el controlad...

  18. El doble ajuste de la estrategia de recursos humanos: Las percepciones de los trabajadores como nexo entre las políticas formuladas e implantadas

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    Natalia García Carbonell

    2013-12-01

    Full Text Available Objeto: Partiendo de los resultados inconsistentes que la literatura ha mostrado acerca de la relación entre el rendimiento organizativo y la dirección de recursos humanos, este estudio discute la asociación entre ambas variables desde una perspectiva de proceso. Para ello, diferenciaremos entre el doble ajuste definido (vertical y horizontal y el realmente alcanzado en la etapa de implantación de las prácticas.Diseño/metodología: La investigación presenta una revisión teórica de varios campos de la literatura en materia de dirección de recursos humanos (perspectiva del doble ajuste y la fortaleza del sistema de gestión.Aportaciones y resultados: el artículo concluye con la propuesta de un modelo teórico alternativo que explica la relación entre la función de recursos humanos y en desempeño organizativo, introduciendo las percepciones de los empleados acerca del sistema de gestión como variable mediadora.Implicaciones prácticas: Las conclusiones apuntan a la importancia de la comunicación organizativa en los procesos de RRHH, el papel del responsable de recursos humanos y el uso de la fortaleza del sistema de gestión como una herramienta de evaluación del ajuste de la estrategia implantada.Valor añadido: Este estudio contribuye a explicar los efectos de la estrategia de recursos humanos sobre los resultados organizativos poniendo énfasis en tres aspectos: (1 la consideración las percepciones de los trabajadores acerca del sistema de gestión de recursos humanos como una variable mediadora entre las estrategias de recursos humanos y el rendimiento, (2 la integración en un mismo estudio de las fases de formulación e implantación de la estrategia de recursos humanos y, (3 la introducción del constructo fortaleza del sistema de gestión de recursos humanos como una herramienta de valoración del ajuste vertical y horizontal en la fase de implantación.

  19. Aplicación del método de mínimos cuadrados al ajuste de curvas granulométricas de áridos

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    Olaya, Manuel

    1978-06-01

    Full Text Available A partir de la lectura del artículo original reseñado en la llamada (1, en el Departamento de Materiales de Construcción del I.E.T.c.c, se han comprobado algunos ajustes granuiométricos de áridos obtenidos por otros métodos clásicos con los resultados que se obtienen aplicando el presente método. La buena correspondencia entre unos y otros ha sido el motivo que ha impulsado a darlo mayor difusión.

  20. UNA APROXIMACIÓN TEÓRICA A LA VALORACIÓN DEL DOBLE AJUSTE EN EL DISEÑO DE LA ESTRATEGIA DE RECURSOS HUMANOS

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    García Carbonell, Natalia

    2013-05-01

    Full Text Available Tradicionalmente la literatura ha considerado la necesidad del doble ajuste, vertical y horizontal, de la estrategia de recursos humanos en las organizaciones. Su importancia estratégica ha sido demostrada en buena parte de los estudios empíricos planteados. Sin embargo, la complejidad de este proceso requiere de un análisis más profundo que permita identificar los elementos que lo hacen posible. En el presente trabajo, partiendo de la revisión de la literatura de las perspectivas de investigación en dirección estratégica de recursos humanos y del concepto «fortaleza del sistema de recursos humanos» propuesto por Bowen y Ostroff (2004, discutimos los 3 factores que integran dicho concepto y su relación con el ajuste del sistema. Como consecuencia de ello, definimos 3 proposiciones teóricas que explican la vinculación entre ambas dimensiones y la fortaleza del sistema.

  1. Afectividad inducida e impacto en la creatividad, crecimiento personal después del cambio y ajuste percibido al narrar una experiencia emocional intensa

    Directory of Open Access Journals (Sweden)

    Silvia da Costa

    2015-05-01

    Full Text Available Se examinan en un estudio experimental los efectos de la inducción de afectividad positiva en la creatividad y la importancia de las emociones como variables mediadoras. Se indujo alta y baja afectividad positiva pidiendo a las personas participantes que redactaran tres poemas haikus sobre dos estímulos de connotación positiva, alta (N = 28 y baja (N = 28. Las personas escribieron sobre su experiencia de enamoramiento más intenso y contestaron una escala sobre las emociones sentidas al redactar el texto, una medida de crecimiento personal y una tercera referida a la obtención de metas adaptativas después del episodio. En la condición de alta afectividad positiva se informó de más emociones positivas y menos negativas al narrar la experiencia, un mayor crecimiento personal y un mayor ajuste. Jueces independientes evaluaron como más originales el último poema y la narración de la experiencia en la condición de alta afectividad positiva. Un análisis mediacional mostró que las emociones positivas explicaban la influencia de la manipulación sobre el crecimiento personal y el ajuste percibido.

  2. El ajuste estructural neoliberal en el sector agrario latinoamericano en la era de la globalización

    Directory of Open Access Journals (Sweden)

    Francisco García Pascual

    2003-10-01

    productividad,  balanza comercial, precios implícitos en la producción y en la exportación o nivel de ingresos de  los agricultores – podemos comprobar fehacientemente que la brecha que ha separado históricamente a la agricultura latinoamericana de  los sectores agrarios de los Estados Unidos o de la  Unión Europea es cada vez mayor. Es más, los  grandes problemas que atenazaban al mundo  agrario en América Latina a principios de los  ochenta (baja productividad, distribución desigual  de los recursos productivos, exclusión social, desequilibrios territoriales, amén de la dependencia tecnológica y de la dependencia financiera del  sector siguen siendo la realidad mayoritaria  después de dos décadas de ajuste estructural.

  3. Desarrollo de un modelo de ajuste por el riesgo para el infarto agudo de miocardio en España: comparación con el modelo de Charlson y el modelo ices. Aplicaciones para medir resultados asistenciales

    OpenAIRE

    Juan Manuel Sendra Gutiérrez; Antonio Sarría-Santamera; Jesús Iñigo Martínez

    2006-01-01

    Fundamento: El infarto agudo de miocardio representa una importante carga de morbimortalidad en los países desarrollados. El objetivo de este trabajo es desarrollar un modelo de ajuste por el riesgo para evaluar los resultados del manejo de esta patología y comparar su desempeño con otros modelos. Métodos: Se desarrolla un modelo de ajuste de riesgo para el infarto agudo de miocardio mediante regresión logística con la información de una base de datos administrativa de ho...

  4. Estilos parentales de socialización y ajuste psicosocial de los adolescentes: un análisis de las influencias contextuales en el proceso de socialización

    OpenAIRE

    Alarcón Cebrián, Antonio

    2012-01-01

    Estilos parentales de socialización y ajuste psicosocial de los adolescentes: un análisis de las influencias contextuales en el proceso de socialización. El objetivo de esta tesis doctoral ha sido el análisis de las relaciones entre los estilos parentales de socialización y el ajuste psicosocial de los hijos, y si esa relación se encuentra moderada por los niveles de riesgo de los vecindarios en los que las familias viven. Utilizando un modelo teórico de la socialización parental basado e...

  5. Estudio del consumo de ácidos en el ajuste de pH en diferentes medios de fermentación alcohólica

    OpenAIRE

    Lixis Rojas-Sariol; Yaniris Lorenzo-Acosta; Fidel Domenech-López

    2011-01-01

    Se estudia la influencia de diferentes ácidos y nutrientes en el ajuste del pH de medios de fermentación alcohólica a partir de melaza de caña de azúcar. El objetivo es evaluar de manera preliminar la sustitución de compuestos azufrados por otros que no aporten azufre a los medios de fermentación, debido a que el contenido de sulfatos (SO2) presentes en las vinzas depende en gran medida del azufre que se incorpore a la fermentación alcohólica, mediante la adición de los nutrientes y ácidos qu...

  6. Validação de protocolos de montagem de um articulador semi-ajustável arcon e respectivo arco facial

    OpenAIRE

    Brito, Maria Inês Albuquerque Figueiredo da Costa

    2015-01-01

    Foi objectivo deste trabalho avaliar várias etapas da montagem e programação de um articulador semi-ajustável e arco facial, de modo a escolher as melhores técnicas numa população de nove pessoas . No arco facial foram avaliadas a posição sentada ou deitada do paciente e o melhor material de registo usado no garfo oclusal, de entre o silicone de adição vinylpolysiloxane e a cera godiva. Na programação do articulador foram avaliados tanto a influência da posição inicial de montagem, RC ou PIM,...

  7. Avaliação de métodos de ajuste de curvas de índice de local em povoa mento de eucalipto desbastados

    OpenAIRE

    Dias,Andrea Nogueira; Leite,Helio Garcia; Nogueira,Gilciano Saraiva; Rodrigues,Flávio Lopes

    2005-01-01

    Este estudo teve como objetivo comparar a eficiência dos métodos da curva-guia, equação das diferenças e predição de parâmetros para construir curvas de índices de local em povoamentos de eucalipto desbastados. Os dados utilizados foram provenientes de um experimento de desbastes pertencente à empresa Copener Florestal, atualmente Bahia Pulp, BA. Para ajuste dos modelos, utilizaram-se dados de sete remedições (27, 40, 50, 61, 76, 87 e 101 meses) de 48 parcelas, com área média de 2.600 m². Na ...

  8. Ajuste al retiro laboral en función del tipo de retiro y su voluntariedad desde una perspectiva de género

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    Kristina Potocnik

    2008-01-01

    Full Text Available En el presente trabajo examinamos el ajuste al retiro laboral, examinando la satisfacción con la jubilación y bienestar psicológico en una muestra de 260 prejubilados y jubilados. Se consideraron tres factores: el tipo de retiro (prejubilación o jubilación, la percepción de la medida en que la salida del rol laboral fue voluntaria (voluntariedad y el género. Los resultados muestran que las personas que se jubilaron y que lo hicieron voluntariamente perciben mayores niveles de satisfacción con la jubilación y bienestar psicológico en comparación con los que se prejubilaron y aquellos que lo hicieron obligatoriamente, respectivamente. Además se puso de manifiesto la interacción entre las variables consideradas en sus efectos sobre la satisfacción y el bienestar. En esta línea, entre los obligatoriamente prejubilados, las mujeres experimentan menor nivel de satisfacción con la jubilación que los hombres. Sin embargo, entre los obligatoriamente jubilados, son los hombres los que experimentan menor nivel de satisfacción con la jubilación. En relación a dichos resultados, el presente trabajo subraya la importancia de estudiar e intervenir sobre la mejora del ajuste en la experiencia del retiro laboral atendiendo tanto a las características de género como a las del proceso de transición (jubilación-prejubilación, voluntariedad-obligatoriedad.

  9. RÉGIMEN HÍDRICO Y AJUSTE OSMÓTICO EN VARIEDADES CUBANAS DE TRIGO (Triticum aestivum Y T. durum CULTIVADAS EN CONDICIONES DE SALINIDAD

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    Leandris Argentel

    2013-01-01

    Full Text Available Los potenciales hídrico y osmótico y el ajuste osmótico en 12 variedades cubanas de trigo pertenecientes a las especies Triticum aestivum y Triticum durum cultivadas en condiciones de salinidad fueron evaluados, siguiendo las metodologías para tales fines. Las plantas se establecieron en un invernadero en condiciones de hidroponía a un nivel de salinidad de 8 dS.m -1 , como control se montó un tratamiento con una conductividad eléctrica de 0,36 dS.m -1 . Las evaluaciones se realizaron a los 25 días posteriores a la germinación. Como resultado se obtuvo una significativa disminución de los valores del potencial hídrico en la mayoría de las variedades en todos los órganos medidos y se observó una significativa disminución de sus valores desde las raíces hasta las hojas para asegurar el gradiente hídrico. Las variedades que no disminuyeron significativamente su potencial hídrico mostraron comportamiento similar en los tres órganos evaluados aunque el gradiente de potenciales se mantuvo. El potencial osmótico disminuyó significativamente en todas las variedades y sus valores fueron inferiores a -0,6 MPa. Todas las variedades realizaron el ajuste osmótico, siendo el valor más significativo AO= 0,3 MPa en las variedades INIFAT RM-36, INIFAT RM-32, INIFAT RM-37. Se observó variabilidad en la respuesta al estrés salino entre variedades y especies para las tres variables evaluadas.

  10. Reseña: Cuba ¿Ajuste o transición? Impacto de la reforma en el contexto del restablecimiento de las relaciones con Estados Unidos, de Velia Cecilia Bobes (coord., México, Flacso, 2015, 165 pp.

    Directory of Open Access Journals (Sweden)

    Katya Rodríguez Gómez

    2015-12-01

    Full Text Available Reseña:Cuba ¿Ajuste o transición? Impacto de la reforma en el contexto del restablecimiento de las relaciones con Estados Unidos, de Velia Cecilia Bobes (coord., México, Flacso, 2015, 165 pp.

  11. HISTORIA FUNCIONAL DE MORFOLOGÍAS LINGÜÍSTICAS Y SU EFECTO EN UN AJUSTE CONVENCIONAL/ FUNCTIONAL HISTORY OF LINGUISTIC MORPHOLOGIES AND THEIR EFFECT ON A CONVENTIONAL ADJUSTMENT/ HISTÓRIA FUNCIONAL DE MORFOLOGIAS LINGÜÍSTICAS E SEU EFEITO EM UM AJUSTE CONVENCIONAL

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    Nataly Yáñez Ramírez

    2011-12-01

    Full Text Available Se observó si diferentes historias funcionales construidas durante la adquisición de un conjunto de morfologías lingüísticas facilitaban un ajuste convencional. Participaron 24 estudiantes universitarios distribuidos en tres grupos, expuestos a entrenamientos construidos bajo la lógica de diferentes niveles de interacción: contextual, suplementario o selector (Ribes y López, 1985; y posteriormente se evaluó su ejecución en una tarea convencional. El entrenamiento cuyo criterio de ajuste era de tipo selector fue la que más facilitó tanto la adquisición de las morfologías lingüísticas como su uso en la tarea, efecto que pareció más evidente en los hablantes que en los escuchas. No se encontraron diferencias entre los entrenamientos contextual y suplementario. Los resultados se discuten en términos de sus implicaciones teóricas y metodológicas.

  12. Linear study and bundle adjustment data fusion; Application to vision localization; Recherche lineaire et fusion de donnees par ajustement de faisceaux; Application a la localisation par vision

    Energy Technology Data Exchange (ETDEWEB)

    Michot, J.

    2010-12-09

    integrate this additional information directly into an extended bundle adjustment, by adding a constraint term in the weighted cost function. We evaluate three methods (based on machine learning or regularization) that dynamically select the weight associated to the constraint and show that these methods can be used in a real time multi-sensor SLAM, and validate them with different types of constraint on the orientation or on the scale. Experiments conducted on real video sequences show that this technique of constrained bundle adjustment reduces the drifts observed with the classical vision algorithms and improves the global accuracy of the positioning system. (author) [French] Les travaux presentes dans ce manuscrit concernent le domaine de la localisation et la reconstruction 3D par vision artificielle. Dans ce contexte, la trajectoire d'une camera et la structure 3D de la scene filmee sont initialement estimees par des algorithmes lineaires puis optimisees par un algorithme non-lineaire, l'ajustement de faisceaux. Cette these presente tout d'abord une technique de recherche de l'amplitude de deplacement (recherche lineaire), ou line search pour les algorithmes de minimisation iterative. La technique proposee est non iterative et peut etre rapidement implantee dans un ajustement de faisceaux traditionnel. Cette technique appelee recherche lineaire algebrique globale (G-ALS), ainsi que sa variante a deux dimensions (Two way-ALS), accelerent la convergence de l'algorithme d'ajustement de faisceaux. L'approximation de l'erreur de reprojection par une distance algebrique rend possible le calcul analytique d'une amplitude de deplacement efficace (ou de deux pour la variante Two way-ALS), par la resolution d'un polynome de degre 3 (G-ALS) ou 5 (Two way-ALS). Nos experimentations sur des donnees simulees et reelles montrent que cette amplitude, optimale en distance algebrique, est performante en distance euclidienne, et permet

  13. Evaluación de tres sistemas de ajuste de riesgo como predictores del consumo de medicamentos y productos sanitarios en unidades polivalentes de hospitalización

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    Ana María Mera Flores

    2016-01-01

    Full Text Available Fundamentos: El uso de medicamentos y productos sanitarios constituye un componente significativo del gasto sanitario, vinculado con la calidad de la atención y la asignación eficiente de los recursos. Este estudio tuvo por objetivo evaluar en tres sistemas de ajuste de riesgos la capacidad predictiva del consumo de medicamentos y productos sanitarios de los sujetos ingresados en unidades polivalentes de hospitalización. Métodos: Estudio de los consumos de las unidades polivalentes de hospitalización del Hospital de Fuenlabrada entre 2010 y 2013, utilizando información de las aplicaciones de farmacia y suministros y el Conjunto Mínimo de Datos Básicos. Se ajustaron modelos de regresión lineal para el índice de Comorbilidad de Charlson (ICH y el peso medio de los Grupos Relacionados por el Diagnóstico All Patients (AP-GRD y All Patiens Refined (APR_GRD, cada uno de ellos corregidos por el número de estancias. Resultados: Se comprobó la existencia de correlación estadísticamente significativa entre los consumos anuales y los predictores considerados (los coeficientes de Pearson fueron r=0,879 para ICH; r=0,622 para AP-GRD, y r=0,514 para APR-GRD; p<0,01. ICH corregido por el número de estancias fue la variable que mejor ajuste presentó para la trasformación logarítmica de los consumos (Ṝ2=0,863; p< 0,001. Conclusiones: La mayor capacidad predictiva del índice de comorbilidad de Charlson indica que el consumo de recursos depende más de la presencia concurrente de patología que de la complejidad de la casuística estimada para grupos isoconsumo, aun cuando se considere la gravedad o se corrija la complejidad resultante por la duración del episodio.

  14. Análise dos ajustes insulinoterápicos realizados a partir de dois esquemas de monitorização domiciliar em pacientes com diabetes mellitus do tipo 1 Análisis de los ajustes insulinoterápicos realizados a partir de dos esquemas de monitorización domiciliaria en pacientes con diabetes mellitus del tipo 1 Frequency and insulin adjustments among patients with type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Sonia Aurora Alves Grossi

    2006-12-01

    Full Text Available OBJETIVOS: Identificar a freqüência e magnitude nos ajustes das doses de insulina a partir de dois esquemas de monitorização domiciliar sangüíneo e urinário em pacientes com diabetes mellitus do tipo1 e avaliar a efetividade dos ajustes no controle metabólico. MÉTODOS: Amostra de 25 pacientes dividida em dois grupos. Osdo Grupo A realizaram monitorização domiciliar da glicemia capilar e osdo Grupo B, monitorização domiciliar da glicosúria, conforme esquemas preconizados. Estes esquemas possibilitaram construção de perfis e de ajustes insulinoterápicos. RESULTADOS: Houve 204 possibilidades de ajustes no Grupo A e 87 no Grupo B. Com relação às doses de insulina NPH matutina, no Grupo A foram implementados 95 (46,57%ajustes e no Grupo B 30 (34,48% (p= 0,03715. Os ajustes nas doses de insulina regular feitas antes do jantar também foram maiores no Grupo A ,22 (10,84%do que no Grupo B, 3 (3,45% (p=0,02852. O Grupo A, apresentou-se com melhor controle metabólico (HbA1c=10,17% quando comparado ao Grupo B (HbA1c=12,31%. CONCLUSÕES: A monitorização domiciliar da glicemia, possibilitou maior número de ajustes, maior número de aplicações e melhor controle metabólico.OBJETIVOS: Identificar la frecuencia y magnitud en los ajustes de las dosis de insulina a partir de dos esquemas de monitorización domiciliaria sanguíneo y urinario en pacientes con diabetes mellitus del tipo1 y evaluar la efectividad de los ajustes en el control metabólico. MÉTODOS: muestra de 25 pacientes dividida en dos grupos. Losdel Grupo A realizaron monitorización domiciliaria de la glicemia capilar y losdel Grupo B, monitorización domiciliaria de la glicosuria, conforme esquemas establecidos. Estos esquemas posibilitaron la construcción de perfiles y de ajustes insulinoterápicos. RESULTADOS: Hubo 204 posibilidades de ajustes en el Grupo A y 87 en el Grupo B. Con relación a las dosis de insulina NPH matutina, en el Grupo A fueron implementados 95

  15. ESTRATEGIA ITERATIVA DE AJUSTE DE CARGA APLICADA A LOCALIZACIÓN DE FALLAS EN SISTEMAS DE DISTRIBUCIÓN DE ENERGÍA

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    CESAR OROZCO-HENAO

    2013-01-01

    Full Text Available La metodología de localización propuesta está basada en una estrategia iterativa de ajuste de carga para sistemas de distribución. La estrategia utiliza las mediciones de tensión y corriente obtenidas en la cabecera del circuito, por lo tanto, considera cualquier variación presente en los instantes de falla y pre-falla. Además, utiliza un proceso de refinamiento en la estimación de la carga que tiene en cuenta el cálculo de la distancia a la falla de las iteraciones anteriores, para resolver de manera determinística el problema de localización de fallas. La localización de la falla se determina por la estimación de la distancia desde la cabecera del circuito al punto falla, la cual se obtiene a partir de un análisis de cortocircuito en función de los parámetros de fase del sistema. La metodología se valida en el sistema de prueba IEEE 34 nodos conformado por ramales monofásicos, bifásicos y trifásicos, para todos los tipos de fallas y considerando resistencias de falla entre 0Ω y 40Ω, en las cuales se presentan errores de estimación inferiores al 1%.

  16. Series de días hábiles en Colombia: una aplicación al ajuste del crecimiento industrial

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    Álvaro Montenegro García

    2014-06-01

    Full Text Available Si bien muchos economistas son conscientes del efecto de los días hábiles sobre la medición de la producción, aún es frecuente encontrar que estas cifras se analizan sin el correspondiente ajuste. En general, el número de días hábiles en un mes cambia de un año a otro, lo cual es cierto para todos los meses, no solo para los que contienen la Semana Santa. Este trabajo recopila la serie de días hábiles mensuales tomando en cuenta los festivos actuales y anteriores a la Ley Emiliani, y la utiliza para ajustar la serie de producción manufacturera del DANE. Para algunos meses, la diferencia entre la cifra de crecimiento industrial reportada por el DANE y la cifra ajustada por días hábiles puede acercarse a los 12 puntos porcentuales, en cualquier dirección

  17. Cálculo, mediante la aplicación del algoritmo de ajuste por mínimos cuadrados, de los componentes de velocidad para estaciones GNSS continuas

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    Jorge Moya Zamora

    2014-07-01

    Full Text Available El cálculo de la velocidad de una estación de observación continua GNSS representa un insumo fundamental en la geodesia moderna. El hecho de determinar la posición de las estaciones GNSS de forma diaria implica que se puedan establecer las series temporales de las estaciones, con base en las cuales se puede obtener información de la influencia de fenómenos que afecten el comportamiento de estas. En este artículo se plantea una descripción del algoritmo de ajuste por mínimos cuadrados adaptado y aplicado a la determinación de los componentes de velocidad de estaciones de observación continua. Además, se aplica este algoritmo para la calcular la velocidad de la estación ETCG, perteneciente al Sistema Geocéntrico para las Américas (SIRGAS.

  18. Reforma del Estado, Ajuste Neoliberal y Políticas Educacionales: la Formación en Psicología en Brasil

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    Oswaldo H. Yamamoto

    2004-01-01

    Full Text Available En el contexto de la llamada Reforma del Estado neoliberal, los países latinoamericanos pasaron, en los últimos veinte años, a reestructurar profundamente sus sistemas nacionales de educación. Partiendo de consideraciones sobre las características del ajuste neoliberal y sus consecuencias en el ámbito societario, de la participación de las agencias internacionales en la definición de las políticas en el campo educacional, de los cambios introducidos por la aprobación de la Ley de Directrices y Bases de la Educación Nacional, y de la situación del enseñanza de la Psicología en los niveles de licenciatura y posgrado, discútense las cuestiones que se plantean para el campo da Psicología en Brasil, como consecuencia de la reestructuración que está en proceso

  19. El Ajuste de la Ecuación de Regresión en Problemas Económicos: Mínimos Cuadráticos vs. Mínima Desviación Absoluta Media

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    Sira M. Allende

    2004-12-01

    Full Text Available Un estudio de la ineficiencia del ajuste mínimo cuadrático respecto al de de mínima suma de desviaciones absolutas es efectuado. Se analizan los comportamientos de estos criterios al trabajar con muestras censuradas o con el problema semi-lineal, con un proceso ARMA o con el problema multivariado. Cada análisis comparativo se completa utilizando un estudio numérico.

  20. Determinação de rotina do crômio em fezes, como marcador biológico, pelo método espectrofotométrico ajustado da 1,5-difenilcarbazida The spectrophotometric method on the routine of 1,5-diphenylcarbazide was adjusted on chromium determination in feces, after its utilization as a biological marker as chromium (III oxide

    Directory of Open Access Journals (Sweden)

    Hermann Bremer Neto

    2005-06-01

    Full Text Available O objetivo deste estudo foi ajustar o método espectrofotométrico da 1,5-difenilcarbazida à determinação do crômio em fezes, como marcador biológico, adequando-o à rotina laboratorial. Fatores que poderiam exercer interferência na transformação do crômio (III à crômio (VI foram testados, como a recuperação do metal, quantidade de amostra, quantidade e ordem de emprego dos ácidos oxidantes da digestão úmida, temperatura e tempo de digestão e perda por volatilização do crômio como cloreto de cromila, porém não se determinou estatisticamente interferência destes fatores. No método ajustado, a amostra é digerida pela clássica mistura ácida nítrica/perclórica, levando a oxidação do crômio (III a crômio (VI, e alíquota do extrato diluído é usado para reação com 1,5-difenilcarbazida; as absorbâncias são medidas a 550nm, utilizando-se de cubetas de um centímetro de caminho óptico, contra prova em branco conduzida simultaneamente. Dicromato de potássio foi empregado como substância de referência para obtenção da curva padrão na faixa de 0,25 - 2,5mg.mL-1 de Cr2O3 (1mg Cr2O3 º 1,9355mg K2Cr2O7.This work aims at adjusting the spectrophotometric method of 1,5-diphenylcarbazide for the determination of chromium in feces, as a biological marker. Factors that could interfere with the transformation of chromium (III into chromium (VI were tested, as the metal recovery, the sample amount, the amount and the order of use of the oxidant acids of the wet digestion, digestion temperature and digestion time, loss of chromium by volatilization as chromyl chlorid. However the interference of these factors were not statistically determined. In the adjusted method, the sample is classically digested by nitric/perchloric acid mixture leading to the oxidation of chromium (III to chromium (VI, and an aliquot of the diluted extract is used for reaction with 1,5-diphenylcarbazide; absorbance was measured at 550nm, using 1cm

  1. Variabilidade do risco do tempo de permanência ajustado para lactentes de muito baixo peso ao nascer entre centros da Neocosur South American Network Center variability in risk of adjusted length of stay for very low birth weight infants in the Neocosur South American Network

    Directory of Open Access Journals (Sweden)

    Guillermo Marshall

    2012-12-01

    Full Text Available OBJETIVOS: Desenvolver um modelo de predição para o tempo de permanência hospitalar (TPH em lactentes de muito baixo peso ao nascer (MBPN e comparar esse resultado entre 20 centros de uma rede neonatal, visto que o TPH é utilizado como uma medida da qualidade da assistência em lactentes de MBPN. MÉTODOS: Utilizamos dados coletados prospectivamente de 7.599 lactentes com peso ao nascer entre 500 e 1.500 g no período entre os anos de 2001 a 2008. O modelo de regressão de Cox foi empregado para desenvolver dois modelos de predição: um modelo prévio com dados do nascimento e outro posterior, que acrescenta morbidades relevantes dos primeiros 30 dias de vida. RESULTADOS: A mediana do TPH estimado e ajustado a partir do nascimento foi de 59 dias; 28 dias depois do tempo de sobrevida de 30 dias. Houve uma alta correlação entre os modelos (r = 0,92. O TPH esperado e o TPH observado variaram bastante entre os centros, mesmo depois de correção para as morbidades relevantes após 30 dias. O TPH mediano (variação: 45-70 dias e a idade concepcional na alta hospitalar (variação: 36,4-39,9 semanas refletem uma variabilidade alta entre centros. CONCLUSÃO: Um modelo simples, com fatores apresentados no nascimento, pode predizer o TPH de um lactente de MBPN em uma rede neonatal. Observou-se uma variabilidade nos TPHs considerável entre unidades de terapia intensiva neonatal. Especulamos que os resultados sejam provenientes das diferenças entre as práticas dos centros.OBJECTIVES: To develop a prediction model for hospital length of stay (LOS in very low birth weight (VLBW infants and to compare this outcome among 20 centers within a neonatal network. METHODS: Data from 7,599 infants with birth weights of 500-1,500 g born between the years 2001-2008 were prospectively collected. The Cox regression model was employed to develop two prediction models: an early model based upon variables present at birth, and a late one that adds relevant

  2. El papel de la categorización social y las diferencias sociodemográficas en la autoestima, el ajuste y el bienestar psicológicos de una muestra de inmigrantes

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    José Andrés Peña-Pinzón

    2014-05-01

    Full Text Available Se explora el efecto de la saliencia de la categorización social inmigrante y su interacción con diferencias sociodemográficas (nivel de estudios, situación laboral, sexo de los sujetos, en ajuste psicológico, bienestar psicológico y autoestima. 210 inmigrantes de origen sudamericano, residentes en las provincias de Granada y Almería, fueron distribuidos en dos condiciones experimentales: "saliencia baja/alta de la categorización social inmigrante". Encontramos efecto de la manipulación sobre las medidas de pertenencia e identidad (autoestima colectiva, autoestima individual, ansiedad (SA-45 y bienestar laboral. Cuando la saliencia de la categorización social es baja (vs. alta, los sujetos presentan mejor autoestima, menos ansiedad y menos bienestar laboral. El sexo se asocia con la manipulación experimental en las escalas privada y pública (autoestima colectiva y en somatización, depresión y ansiedad (SA45. Los hombres para los que es menos saliente su condición de inmigrante presentan resultados más óptimos. El nivel de estudios y la situación laboral se asocian con ajuste psicológico: los sujetos sin trabajo (vs. los que están trabajando y los de estudios básicos o sin estudios (vs. los de estudios medios o superiores presentan peor ajuste.

  3. Modelos para ajuste da produção de gases em silagens de girassol e milho Models for fit of gas production in sunflower and corn silages

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    Renius Mello

    2008-02-01

    Full Text Available O objetivo deste trabalho foi identificar entre os modelos Brody, Von Bertalanffy, Gompertz, France, Logístico, Logístico modificado e Logístico bicompartimental, aquele que apresenta maior qualidade de ajuste à curva de produção cumulativa de gases em silagens de girassol e milho. Os critérios adotados foram: coeficiente de determinação, quadrado médio do resíduo, análise gráfica das curvas observadas e estimadas, análise gráfica de dispersão dos resíduos estudentizados, erro percentual médio, eficiência relativa e número de iterações para atingir a convergência. Os modelos Brody, France e Logístico bicompartimental apresentaram os maiores valores de coeficiente de determinação em ambos os substratos, e a diferença entre eles pode ser considerada desprezível. Estes modelos apresentaram, também, os menores valores de quadrado médio do resíduo em silagens de girassol, e a diferença entre eles foi considerada desprezível. Os modelos Brody e France apresentaram menor quadrado médio do resíduo em silagens de milho. Todos os modelos apresentaram dispersão positiva dos resíduos em ambos os substratos após 144 horas de incubação. O modelo Brody apresentou menor erro percentual médio e número de iterações em ambos os substratos. Os modelos Logístico bicompartimental e France apresentaram maior eficiência relativa, respectivamente, em silagens de girassol e milho. Assim, o modelo Logístico bicompartimental apresenta maior qualidade de ajuste à curva de produção de gases em silagens de girassol e milho.The aim of this work was to identify among the Brody, Von Bertalanffy, Gompertz, France, Logistic, Modified logistic and Dual-pool logistic models, the one that presents the highest quality of fit for cumulative gas production curve in sunflower and corn silages. The quality of fit was evaluated by coefficient of determination, residual mean square, graphic analysis of the observed and estimated curves

  4. Modelo experimental de bandagem ajustável do tronco pulmonar para preparo rápido do ventrículo

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    DIAS Carlos A.

    2000-01-01

    Full Text Available OBJETIVO: Um dispositivo de bandagem do tronco pulmonar (TP com ajuste percutâneo foi desenvolvido com o objetivo de induzir a hipertrofia rápida do ventrículo subpulmonar. MATERIAL E MÉTODOS: Consiste de um manguito de silicone insuflável percutaneamente, através de um botão de silicone auto-selante. Os corações de 7 cabritos jovens (peso médio: 8,7 kg foram submetidos à sobrecarga sistólica imposta pelo dispositivo e avaliados sob os aspectos hemodinâmicos, ecocardiográficos e morfológicos. Foram extraídas biópsias basais do miocárdio do ventrículo direito (VD para análise microscópica (perímetro e área do miócito. O dispositivo foi implantado no TP. As pressões do VD, TP e aorta foram monitorizadas. Após convalescença, foi iniciado o protocolo de insuflação do dispositivo de bandagem do TP. Foi injetada água destilada no botão auto-selante (via percutânea, até que a pressão sistólica do VD atingisse 70% da pressão sistólica do VE. As avaliações ecocardiográfica e hemodinâmica foram realizadas a cada 24 horas. A sobrecarga sistólica do VD foi mantida por um período de 96 horas, com insuflações progressivas no limite máximo tolerado, a cada 24 horas. Após esse período, os animais foram sacrificados para análise morfológica dos corações. Outros 9 cabritos (peso médio: 7,7 kg foram utilizados como grupo controle, para análise do peso do VD. RESULTADOS: Após 96 horas de sobrecarga sistólica do VD, foi observado um aumento do gradiente sistólico VD/TP de 10,1±4,3 mmHg para 60,0±11,0 mmHg e da pressão sistólica no VD de 22,4±4,1 mmHg para 71,0±10,0 mmHg (p<0,0001. O ecocardiograma revelou aumento da espessura muscular do VD, de 4,4±0,5 mm para 7,3±1,7 mm (p=0,001. Quando comparado ao grupo controle, houve um ganho de peso de 74% do VD submetido à sobrecarga sistólica (p<0,0001. À microscopia óptica, foi observado aumento de 27% no perímetro e de 69% na área dos miócitos (p=0

  5. Ajuste psicosocial en agresores, víctimas puras y víctimas agresivas en la escuela. Psychosocial adjustment in aggressors, pure victims and aggressive

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    Estefanía Estévez

    2008-07-01

    Full Text Available

    En el presente estudio se examinan las diferencias entre cuatro categorías de adolescentes –agresores, víctimas puras, víctimas agresivas y estudiantes no implicados en problemas comportamentales o de victimización en la escuela– en relación con la autoestima, la sintomatología depresiva, el estrés percibido, el sentimiento de soledad, y una medida general de satisfacción con la vida. Los participantes fueron 1.319 adolescentes con edades comprendidas entre los 11 y los 16 años (47% chicos y escolarizados en siete centros públicos de enseñanza secundaria ubicados en Valencia (España. Los análisis de varianza indicaron la existencia de diferencias significativas entre las cuatro categorías de estudiantes. Así, los adolescentes no implicados mostraron un mejor ajuste psicosocial general: niveles más elevados de autoestima y satisfacción con la vida y niveles inferiores de sintomatología depresiva, estrés percibido y sentimiento de soledad. Las puntuaciones en este grupo fueron equivalentes a aquellas obtenidas por los agresores con respecto a la autoestima, la sintomatología depresiva y la soledad. Sin embargo, los agresores percibieron más estrés y expresaron menor satisfacción con sus vidas, como así también hicieron los otros dos grupos, a saber: víctimas puras y víctimas agresivas. Las víctimas mostraron los niveles más elevados de sentimiento de soledad.

    Palabras clave: Agresor, víctima, víctima agresiva, violencia escolar, ajuste psicosocial.

    The present study examined differences among four categories of adolescents –aggressors, pure victims, aggressive victims, and students not involved in behavioural or victimization problems at school– with respect to self-esteem, depressive symptomatology, perceived stress, feeling of loneliness, and a general measure of satisfaction with life. Participants were 1,319 adolescents aged from 11 to 16 years old (47% male and drawn from seven state

  6. Ajuste social y escolar de jóvenes víctimas de maltrato infantil en situación de acogimiento residencial

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    Alexander Muela

    2013-01-01

    Full Text Available El objetivo del presente trabajo consistió en examinar el ajuste social y escolar de jóvenes que habían sufrido maltrato en la infancia y se encontraban en situación de acogimiento residencial. Además, pretendíamos comprobar si existían diferencias entre los sujetos sometidos a distintas situaciones de desprotección infantil. En el estudio participaron 318 jóvenes residentes en la Comunidad Autónoma del País Vasco de edades comprendidas entre los 13 y los 18 años (M = 15.35, DT = 1.68 pertenecientes a tres colectivos. El primero de ellos estaba constituido por 69 jóvenes (31 mujeres y 38 varones víctimas de maltrato infantil que se hallaban bajo una medida de protección de acogimiento residencial. El segundo grupo estaba formado por 75 jóvenes (29 mujeres y 46 varones víctimas de maltrato infantil que se encontraban en situación de riesgo de desamparo. Por último, el tercer grupo estaba constituido por 174 jóvenes (95 mujeres y 79 varones que no habían sufrido maltrato. Los resultados pusieron de manifiesto que, independientemente de la situación de desprotección infantil en la que se encontrasen, los jóvenes víctimas de maltrato infantil mostraban mayores dificultades de adaptación social y escolar que los jóvenes que no habían sufrido maltrato en la infancia.

  7. Estudio del consumo de ácidos en el ajuste de pH en diferentes medios de fermentación alcohólica

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    Lixis Rojas-Sariol

    2011-01-01

    Full Text Available Se estudia la influencia de diferentes ácidos y nutrientes en el ajuste del pH de medios de fermentación alcohólica a partir de melaza de caña de azúcar. El objetivo es evaluar de manera preliminar la sustitución de compuestos azufrados por otros que no aporten azufre a los medios de fermentación, debido a que el contenido de sulfatos (SO2 presentes en las vinzas depende en gran medida del azufre que se incorpore a la fermentación alcohólica, mediante la adición de los nutrientes y ácidos que se empleen. Es importante que la vinaza tratada mediante digestión anaeróbia presente bajas concentraciones de sulfatos para minimizar en el biogás producido el contenido de H2S, evitar la corrosión del equipamiento empleado en el uso del biogás y disminuir los costos de desulfuración. Sin embargo, los resultados muestran que no es recomendable sustituir el ácido sulfúrico y el sulfato de amonio empleados industrialmente en los medios de fermentación alcohólica, ya que para alcanzar el valor de pH deseado se adicionan menores cantidades de ácido cuando se usa ácido sulfúrico en un medio de fermentación compuesto por fosfato de amonio y sulfato de amonio, además económicamente también es aconsejable usar este ácido, porque es más barato con respecto a los ácidos estudiados.

  8. ajustements temporels et syllabiques après l'effacement optionnel du schwa en français

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    Beltzung Jean-Marc

    2014-07-01

    Full Text Available Cet article traite des réajustements temporels et syllabiques provoqués par l’effacement optionnel du schwa dans le démonstratif /sə/ « ce » en français standard moderne. A cet effet, un corpus composé de six triplés syntaxiquement équivalents a été constitué. Chaque triplés comprend une phrase dans laquelle le démonstratif est pleinement réalisé, une phrase dans laquelle l'effacement du schwa provoque la formation d'une séquence consonantique dérivée de type [s'{p,t}] et une phrase sans démonstratif comprenant une séquence consonantique lexicale de type /s{p,t}/. Ce corpus a été enregistré par dix locuteurs francophones (5 hommes et 5 femmes et la durée segmentale de chaque triplés, relevée de manière systématique, a fait l’objet d’un traitement statistique sous R. Les résultats des différentes ANOVA suggèrent un allongement significatif du [s] des clusters dérivés par rapport aux clusters lexicaux. Dans un cadre strictement CV (Lowenstamm 1996, Scheer 2004, cet allongement peut découler de la différence de structure prosodique qui existe entre ces deux types de clusters. Selon nous, et ce indépendamment du cadre d'analyse, le but de cet allongement consiste à maintenir un contraste entre les clusters dérivés de l’effacement du schwa et les clusters lexicaux dans les formes de surface.

  9. COSTA RICA EN LA ENCRUCIJADA: LOS LÍMITES DEL AJUSTE ESTRUCTURAL Y LOS URGENTES DESAFÍOS DE LA REFORMA ECONÓMICA Y SOCIAL

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    Henry Manuel Mora Jiménez

    2011-09-01

    Full Text Available Aunque en Costa Rica no se ha seguido en los últimos quince años una política económica neoliberal a ultranza, sino una “a la tica”; todo el debate económico y el accionar del sector público durante este período ha sido permeable a la lógica del ajuste estructural. Pero la actual encrucijada obliga a “tirios y troyanos”, a críticos y defensores del ajuste, a superar este enfoque aún predominante. Independientemente de los logros y fracasos acumulados desde 1983 hasta la fecha, en el campo económico y social, el país debe, urgentemente, realizar un “viraje estratégico”, pues la sensación de estancamiento o lento crecimiento de los últimos años se ha convertido en cruda realidad, con el agravante de que ya no podemos seguir viviendo del pasado. En el texto se aborda la problemática nacional en las siguientes cinco áreas:Estabilidad macroeconómica: sin ser artificial, continúa siendo frágil, dependiente en alto grado de la entrada de capitales externos y arrastrando una crisis fiscal latente que recurrentemente estalla. Esto en gran parte se explica por los rasgos de inestabilidad estructural que aun persisten.Gobernabilidad y Reforma del Estado: el estilo de gobernabilidad moldeada durante el período 1950-1975 ya no es viable, y la vacilante reforma del Estado está contribuyendo solo de manera precaria a construir nuevas formas de gobernabilidad acordes con las exigencias de las modernas sociedades democráticas. La gran tarea por delante es reconstruir un Estado estratégico y solidario; que facilite la irrupción de la sociedad civil en la vida pública nacional.Transformación productiva y competitividad: avanza, pero sin un rumbo claro y seguro, pues se adolece de una estrategia nacional de desarrollo de la competitividad internacional, que supere prácticas anticuadas de intervención estatal y viejos pero maquillados dogmas antiestatales que conducen a visiones parciales sobre el papel de las empresas y del

  10. Caracterização dos perfis glicêmicos domiciliares como estratégia para os ajustes insulinoterápicos em pacientes com diabetes mellitus do tipo 1 Caracterización de los perfiles glicémicos domiciliares como estrategia para los ajustes insulino-terápicos en pacientes con diabetes mellitus tipo 1 Glycemic profiles in insulin adjustments in patients with type 1 diabetes mellitus

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    Sonia Aurora Alves Grossi

    2003-03-01

    Full Text Available O artigo tem como objetivo principal caracterizar os perfis glicêmicos domiciliares de pacientes com diabetes mellitus tipo1, a partir de um esquema de monitorização proposto, e adotá-los como estratégia de ajuste nas doses de insulina. Foram realizados 3259 testes, 781 antes do café, 752 antes do almoço, 765 antes do jantar, 740 antes de deitar e 221 pela madrugada. A média das glicemias nestes períodos ultrapassaram os limites superiores satisfatórios em 6,87%, 3,83%, 11,37%, 30,50% e 19,28% respectivamente. Estes dados forneceram subsídios para ajustes nos esquemas insulinoterápicos. Os níveis HbA1c não mudaram de forma significante com os ajustes realizados porém, foram mantidos em 10%.El objetivo principal de este artículo consiste en caracterizar los perfiles glicémicos domiciliares de los pacientes con diabetes mellitus tipo 1, a partir de un esquema propuesto de monitorización, para aplicarlo como estrategia, en los ajustes de las dosis de insulina. Fueron realizados 3.259 tests, de los cuales 781se hicieron antes del desayuno, 752 se realizaron antes del almuerzo, 765 antes de la merienda, 740 se hicieron antes de dormir y los 221 se hicieron en la madarugada. La media de las glicemias en estos períodos ultrapasaron los límites superiores satisfactorios em 6,8%, 3,83%, 11,37%, 30,50% y 19,28% respectivamente. Estos datos ofrecieron subsidios para poder ajustar los esquemas insulinoterápicos. Los niveles de HbA1c no variaron de forma significativa com los ajustes realizados y se mantuvieron em 10%.The goal of this paper is to characterize the glycemic profiles of patients with type 1 diabetes mellitus like a strategy in insulin adjustments. A total of 3259 tests were realized being 781 before breakfast, 752 before lunch, 765 before dinner and 740 before bed and 221 in the dawn. The average of the blood glucose tests in these periods oversteped the superior limits in 6,87%, 3,83%, 11,37%, 30,50% e 19,28% respectively

  11. Ajustes nos movimentos de alcançar e apreender objetos: impacto da Síndrome de Down Adjustments in the movements of reaching for and grasping objects: the impact of Down Syndrome

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    Mariana Martins dos Santos

    2012-06-01

    Full Text Available OBJETIVOS: verificar a influência das propriedades dos objetos nos ajustes realizados por lactentes típicos e com Síndrome de Down (SD dos quatro aos oito meses de idade ao alcançar e apreender objetos. MÉTODOS: 16 lactentes, avaliados uma vez ao mês dos 4 aos 8 meses, sendo oito típicos e oito com SD. Quatro objetos esféricos (maleável grande, maleável pequeno, rígido grande e rígido pequeno foram apresentados, e os cinco primeiros movimentos válidos foram registrados para análise das variáveis: ajuste proximal (uni e bimanual, ajuste distal (orientação da palma, abertura da mão e apreensão do objeto. RESULTADOS: os lactentes típicos apresentaram mais ajuste bimanual para objetos grandes aos seis e oito meses e os com SD aos sete meses. Quanto aos ajustes distais, os lactentes típicos variaram seu comportamento enquanto os com SD apresentaram uso predominante da posição oblíqua. Em geral, o grupo típico apresentou maior sucesso na apreensão dos objetos rígidos e maleável pequeno quando comparados aos lactentes com SD. CONCLUSÕES: Os lactentes com SD apresentaram menor variedade de ajustes o que levou a um menor sucesso na apreensão, possivelmente devido a restrições intrínsecas da SD.OBJECTIVES: to verify the influence that properties of objects have on the reaching and grasping adjustments made by infants with and without Down syndrome (DS between four to eight months of age. METHODS: 16 infants, eight typical and eight with DS, were evaluated once a month from months 4 to 8. Four spherical objects (large soft, small soft, large hard and small hard were offered and the first five valid movements were recorded for analysis of the variables: proximal adjustment (uni- and bimanual, distal adjustments (palm orientation, hand opening and grasping of the object. RESULTS: the typical infants displayed greater bimanual adjustment for large objects at six and eight months and those with DS at seven months. As for distal

  12. Bandagem ajustável do tronco pulmonar: IX: atividade da G6PD do miocárdio de cabras adultas submetido ao treinamento ventricular

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    Renato Samy Assad

    2013-12-01

    Full Text Available OBJETIVO: O aumento da atividade miocárdica da Glicose 6-Fosfato Desidrogenase tem sido demonstrado na insuficiência cardíaca. Este estudo avalia a atividade miocárdica da Glicose 6-Fosfato Desidrogenase no treinamento do ventrículo subpulmonar de cabras adultas. MÉTODOS: Foram utilizadas 18 cabras adultas, divididas em três grupos: convencional (bandagem fixa, sham e intermitente (bandagem ajustável; 12 horas diárias de sobrecarga. A sobrecarga sistólica (70% da pressão sistêmica foi mantida durante quatro semanas. As avaliações hemodinâmica e ecocardiográfica foram realizadas durante todo o estudo. Depois de cumprido o protocolo, os animais foram mortos para avaliação morfológica e da atividade da Glicose 6-Fosfato Desidrogenase dos ventrículos. RESULTADOS: Apesar de haver sobrecarga sistólica proporcionalmente menor no ventrículo subpulmonar do grupo intermitente (P=0,001, ambos os grupos de estudo apresentaram aumento da massa muscular de magnitude similar. Os grupos intermitente e convencional apresentaram aumento da massa de 55,7% e 36,7% (P<0,05, respectivamente, em comparação ao grupo sham. O conteúdo de água do miocárdio não variou entre os grupos estudados (P=0,27. O ecocardiograma demonstrou maior aumento (37,2% na espessura do ventrículo subpulmonar do grupo intermitente, em relação aos grupos sham e convencional (P<0,05. Foi observada maior atividade da Glicose 6-Fosfato Desidrogenase na hipertrofia miocárdica do ventrículo subpulmonar do grupo convencional, comparada aos grupos sham e intermitente (P=0,05. CONCLUSÃO: Ambos os grupos de treinamento ventricular desenvolveram hipertrofia ventricular, a despeito do menor tempo de sobrecarga sistólica no grupo intermitente. A maior atividade de Glicose 6-Fosfato Desidrogenase observada no grupo convencional pode refletir um desequilíbrio redox, com maior produção de fosfato de dinucleotídeo de nicotinamida e adenina e glutationa reduzida, um

  13. Drogodependientes vs. usuarios de salud mental con trastornos de personalidad: su relación con la calidad de vida, la psicopatología en Eje I, el ajuste psicológico y dinámica familiar

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    José Miguel Martínez-González

    2013-01-01

    Full Text Available El objetivo de este estudio ha sido analizar algunas variables de gran relevancia en el tratamiento de los trastornos de la personalidad como son la calidad de vida, el nivel de gravedad de ajuste psicológico, la concomitancia con psicopatología del Eje I y la percepción de dinámica familiar de estos pacientes. La muestra la componen 68 pacientes que presentan un trastorno de la personalidad de los que el 57.4 % son drogodependientes en tratamiento en un centro ambulatorio de atención a las drogodependencias y el 42.6 % son usuarios de un centro ambulatorio de salud mental que no presenta trastornos adictivos. Los resultados muestran que no existen diferencias significativas en calidad de vida ni gravedad de ajuste psicológico entre los pacientes en función de la drogadicción. Las diferencias parecen estar vinculadas a la concomitancia de psicopatología en el Eje I, porque los que no la presentan cuentan con un nivel de calidad de vida más elevado y mejor ajuste psicológico. Esto indica que la presencia de psicopatología en el Eje I, en pacientes con trastornos de la personalidad, incrementa la dificultad asociada al tratamiento de estos pacientes. En relación a la dinámica familiar se ha podido constatar que mientras el apego influye negativamente en la calidad de vida de estos pacientes, los recursos familiares la mejoran. Todo parece indicar que la calidad de vida autopercibida en pacientes con trastornos de la personalidad, drogodependientes o usuarios de salud mental, está determinada por la presencia concomitante de otra psicopatología en el Eje I. Esta concomitancia debe convertirse en objetivo de intervención terapéutica.

  14. El papel de la categorización social y las diferencias sociodemográficas en la autoestima, el ajuste y el bienestar psicológicos de una muestra de inmigrantes

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    José Andrés Peña-Pinzón; Carmen Gómez-Berrocal; Antonio Fernández-Parra

    2014-01-01

    Se explora el efecto de la saliencia de la categorización social inmigrante y su interacción con diferencias sociodemográficas (nivel de estudios, situación laboral, sexo) de los sujetos, en ajuste psicológico, bienestar psicológico y autoestima. 210 inmigrantes de origen sudamericano, residentes en las provincias de Granada y Almería, fueron distribuidos en dos condiciones experimentales: "saliencia baja/alta de la categorización social inmigrante". Encontramos efecto de la manipulación sobr...

  15. Estudio de las primeras consultas en un Centro de Salud Mental (II. Características clínicas, sucesos vitales, ajuste y apoyo social, motivación y expectativas.

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    Oscar Martínez Azumendi

    1997-01-01

    Full Text Available Proyecto de evaluación de 749 consultas consecutivas durante año y medio en un Centro de Salud Mental Comunitario. Se presentan las características y diferencias por sexos en relación con la sintomatolog��a diagnóstico, valoración global de la gravedad del caso, ajuste social, autoestima y apoyo social percibido. Además se describe el número y tipo de sucesos vitales referidos en los 6 meses anteriores, así como motivación y expectativas que traen al servicio.

  16. Avaliação estrutural da escala de ajustamento diádico Evaluacíon de la escala de ajuste conyugal Structural assessment of the dyadic adjustment scale

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    José Augusto Evangelho Hernandez

    2008-09-01

    Full Text Available O objetivo deste estudo foi avaliar a Escala de Ajustamento Diádico respondida por uma amostra não-probabilística de homens e mulheres brasileiros que estavam em relacionamento amoroso de diversos tipos. Os 542 sujeitos foram recrutados em diversos locais de Porto Alegre/RS e região metropolitana. Através da técnica estatística Análise Fatorial, este estudo realizou um exame da estrutura da escala. Os resultados obtidos foram comparados com o estudo original de construção do instrumento e outras confirmações subseqüentes. Através da comparação dos escores médios dos diferentes tipos de casais da amostra atual se pôde verificar o poder discriminativo do instrumento e, além disso, foi examinada sua fidedignidade. Apareceram evidências que dão razoável suporte à versão brasileira do instrumento para sua utilização na pesquisa e na clínica psicológica.El propósito del estudio presente fue evaluar la Escala de Ajuste Conyugal contestada por una muestra non-probabilistic de hombres y mujeres brasileños que estuvieron implicados con relaciones de amor de varias clases. Los 542 sujetos fueron reclutados en varios sitios en Porto Alegre/RS y su área metropolitana. Con la técnica de estadística del análisis factorial, este estudio examinó la estructura de la escala. Los resultados fueron comparados a la construcción original del instrumento y de otras confirmaciones subsecuentes. Comparando las puntuaciones promedio de las clases diferentes de parejas de la muestra presente, podemos verificar el poder discriminatorio del instrumento, además de esto, su fiabilidad fue examinada también. Pruebas mostradas, del apoyo razonable a la versión brasileña del instrumento para su uso en la investigación y en clínica de psicología.The Dyadic Adjustment Scale answered by a non-probabilistic sample of Brazilian males and females involved in different types of love relationships is assessed. The 542 subjects were recruited in

  17. Ajuste de modelos não-lineares em estudos de associação entre polimorfismos genéticos e crescimento em bovinos de corte Adjustment of nonlinear models in study of association between genetic polymorphisms and growth in beef cattle

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    Claudia Cristina Paro de Paz

    2004-12-01

    Full Text Available Foram utilizados dados de peso ao nascimento, ao desmame e mensais dos 8 aos 19 meses de idade de 11 classes de genótipos, formadas pela concatenação dos polimorfismos genéticos da kappa-caseína-HinfI (CSN3: AA e AB, do hormônio do crescimento-AluI (GH: LL e LV e da beta-lactoglobulina-HaeIII (LGB: AA, AB e BB (G1=AALLAA, G2=AALLAB, G3=AALLBB, G4=AALVAB, G5=AALVBB, G6=ABLLAA, G7=ABLLAB, G8=ABLLBB, G9=ABLVAA, G10=ABLVAB e G11=ABLVBB. As informações foram obtidas de animais de três grupos genéticos: ½Canchim-Nelore (CN, ½Angus-Nelore (AN e ½Simental-Nelore (SN, nascidos em 1998 e 1999 e pertencentes à Embrapa Pecuária Sudeste, São Carlos, SP. Dos cinco modelos estudados: Brody, Von Bertalanffy, Richards, Gompertz e Logístico, o último apresentou melhor qualidade de ajuste. As estimativas dos parâmetros A (valor assintótico, k (taxa de maturação e m (ponto de inflexão obtidas do modelo Logístico, ajustado para descrever o crescimento de cada animal, foram analisadas pelo método dos quadrados mínimos, por meio de um modelo linear, que incluiu, além da média geral, o efeito do genótipo, o ano de nascimento, o sexo e o manejo alimentar. Para os animais do grupo genético CN, os genótipos influenciaram significativamente as estimativas dos parâmetros A e k da curva de crescimento. O genótipo G3 apresentou valor inferior de A e superior de k em relação aos genótipos G7 e G8. Quanto aos grupos genéticos AN e SN, não foi observado efeito significativo do genótipo sobre nenhum dos três parâmetros. A aplicação da técnica de modelos não-lineares em estudos de associação entre polimorfismos genéticos e crescimento animal proporcionou uma análise detalhada do desenvolvimento dos animais de diferentes genótipos (genes: CSN3, GH e LGB.Weights at birth, at weaning and monthly from 8 to 19 months of age of the 11 genotype identified by combination of polymorphic RFLP's of the genes kappa-casein-HinfI (CSN3: AA and

  18. Efecto del ajuste del tratamiento al alta en los resultados a 30 días en los pacientes con diabetes mellitus atendidos por hipoglucemia en un servicio de urgencias hospitalario

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    R. Cuervo Pinto

    Full Text Available Fundamento. Determinar si ajustar el tratamiento antidiabético al alta se relaciona con los resultados a 30 días en los pacientes con diabetes mellitus atendidos por hipoglucemia en un servicio de urgencias (SU. Método. Estudio observacional de cohorte retrospectivo. Se incluyeron todos los pacientes con diabetes mellitus con hipoglucemia dados del alta desde SU entre 2012-2014. La variable resultado fue un evento adverso por cualquier causa a los 30 días. Resultados. El estudio se realizó en 203 pacientes con edad media de 69,7 (DE 18,9 mayoritariamente con diabetes mellitus tipo 2. El diagnóstico de hipoglucemia fue principal en 162 (79% y se realizó ajuste terapéutico en 98 (48% casos. El no ajuste de tratamiento fue un factor independiente asociado con un evento adverso a los 30 días (OR=2,82; IC 95%=1,34-5,93; p=0,006. Conclusiones. No ajustar el tratamiento antidiabético al alta del SU podría ser un factor independiente de sufrir un resultado adverso a los 30 días en los pacientes con diabetes mellitus que presentaron hipoglucemia en un SU.

  19. A Percepção Sobre a Aceitação e o Ajuste da Tecnologia como Determinantes do Uso do Comércio Eletrônico Como Canal de Compra

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    Debora Bobsin

    2010-02-01

    Full Text Available O objetivo deste trabalho é verificar se os fatores intenção de uso, facilidade de uso percebida e o ajuste entre a tecnologia e a tarefa de comprar impactam no uso efetivo da Internet como canal de compra. Através de uma pesquisa survey aplicada a 227 pessoas que já compraram pela Internet, chegou-se à conclusão de que a adequação entre a tecnologia e a tarefa explica a utilidade percebida pelos indivíduos. A intenção de usar o canal comércio eletrônico é fortemente explicada pela utilidade percebida e pelo ajuste da tecnologia e a tarefa a ser executada. Os resultados reforçam a ideia de que se aumentadas as informações que o site fornece ao usuário, melhor ele entenderá sua utilidade, e mais fácil perceberá a realização da compra.

  20. Teorías e hipótesis de régimen aplicadas al estudio de ajuste dinámico de los cauces aluviales

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    Conesa García, Carmelo

    2003-06-01

    Full Text Available Geomorphic approaches to describe and explain the equilibrium alluvial river channel form, and another approache porpuses to stable «regime» channel design, have relied on simple equations relating channel dimensions to sediment grain-size, gradient and discharge. These equations are either empirical «hydraulic geometry» equations, obtained from regression analysis of the main variables sampled in natural rivers, or «rational» regime equations derived from physical theory of hydraulics and sediment transport. In this work several theories and hypothesis on the river regime are shown in order to explain the dynamic adjustments of channels in connection with environmental changes: i theory of unit stream power, ii minimum energy dissipation rate , iii dispersive-force model, iv concepts of boundary shear stress and critical bank shear, v other regime relationships. Finally, the last part is devoted to the application of the regime theories in arid and semi-arid environments, by considering it a complex aspect, of great interest in the hydro-morphologic context and until the moment little studied.

    Las aproximaciones geomórficas para describir y explicar la forma de equilibrio de un cauce fluvial y los métodos propuestos para el diseño de cauces de «régimen » estable han contado siempre con ecuaciones simples que relacionan las dimensiones del cauce con el tipo de sedimento, pendiente y caudal. Estas ecuaciones son ecuaciones empíricas de «geometría hidráulica», obtenidas a partir del análisis de regresión de variables relevantes muestreadas en cursos de agua naturales o ecuaciones «racionales » de régimen derivadas a partir de la teoría física sobre hidráulica y transporte de sedimentos. En este trabajo se muestran diferentes teorías e hipótesis de régimen para explicar el ajuste dinámico de los cauces aluviales en relación con los cambios ambientales: i teoría de energía por unidad de corriente, ii tasa m

  1. Fluidos no período pós-operatório: efeitos da falta de ajuste ao peso corpóreo Líquidos en el período postoperatorio: efectos de la falta de ajuste al peso corporal Fluids in the postoperative period: effects of lack of adjustment to body weight

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    Alejandro Risso Vazquez

    2011-06-01

    Full Text Available OBJETIVO: Comparar as diferenças no equilíbrio hídrico e eletrolítico em pacientes com baixo e alto peso corpóreo no primeiro dia pós-operatório. MÉTODOS: Em um período de 18 meses avaliamos prospectivamente 150 pacientes durante as primeiras 24 horas após cirurgia, na unidade de terapia intensiva de um hospital universitário. Pacientes com baixo (90 kg foram comparados em termos de fornecimento e eliminação de fluidos. RESULTADOS: Não foram observadas diferenças significantes em termos de volume (4,334 ± 1,097 em versus 4,644 ± 1,957 mL/24 horas e composição dos fluidos administrados (481 ± 187 versus 586 ± 288 mEq [Na+]administrados em 24 horas. O débito urinário em 24 horas foi similar (2,474 ± 1,597 versus 2,208 ± 678 mL/24 horas, porém o grupo com baixo peso teve uma maior eliminação de eletrólitos (296 ± 195 versus 192 ± 117 mEq [Na+]urina/24 horas, p=0.0246. Quando os fluidos administrados foram ajustados ao peso corpóreo, o volume e quantidade de eletrólitos dos fluidos administrados foram maiores no grupo com baixo peso (79 ± 21 versus 47 ± 22 mL/ kg/24 horas, pOBJETIVO: Comparar las diferencias en el equilibrio de líquidos y electrolitos en los pacientes con bajo y alto peso en el primer día postoperatorio. MÉTODOS: Durante un período de 18 meses, evaluamos prospectivamente 150 pacientes, en las primeras 24 horas después de la cirugía, en una unidad de cuidados intensivos de un hospital escuela afiliado auna universidad. Se compararon pacientes con bajo ( 90 Kg en términos de ingesta y excreción urinariade agua y electrolitos. RESULTADOS: No se observaron diferencias significativas en el volumen (4,334 ± 1,097 vs. 4,644 ± 1,957 ml/24 hs. y la composición de los líquidos administrados (481 ± 187 vs. 586 ± 288 mEq [Na +]administrado/24 hs. El volumen de La diuresis en24 horas fue similar (2,474 ± 1,597 vs 2208 ± 678 ml/24 hs., pero el grupo de bajo peso mostró una mayor eliminación de

  2. Ajuste do modelo Chistiansen-Hargreaves para estimativa da evapotranspiração do feijão no cerrado Chistiansen-Hargreaves model adjustment for estimating evapotranspiration of bean crop in the Cerrado region

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    Omar C. Rocha

    2003-08-01

    Full Text Available Os produtores de feijão da região do Cerrado contam com apenas uma tecnologia, já estabelecida, para o manejo das irrigações: a tensiometria. Muito embora essa metodologia tenha alto potencial de uso não tem sido amplamente adotada pelos produtores, razão pela qual a utilização de modelos de estimativa de evapotranspiração tem se mostrado bastante aplicável à realidade da região. Assim, este trabalho tem o objetivo de avaliar o desempenho do modelo Chistiansen-Hargreaves na estimativa da evapotranspiração da cultura do Feijão Preto, no período seco do Cerrado brasileiro, almejando colocar à disposição dos produtores um modelo ajustado, que permita um manejo eficiente da irrigação no sistema produtivo da região. A evapotranspiração do feijoeiro foi medida com um lisímetro de pesagem. O experimento foi conduzido na Embrapa Cerrados, localizada em Planaltina, DF, Brasil. Quando calculado com coeficientes de cultura determinados na pesquisa e testado com o termo energético ajustado (S0 = 0,5 o modelo apresentou ótimo desempenho podendo, nesta condição, ser empregado com segurança no manejo de irrigação.Bean producers from the Brazilian Cerrado region have only one technology for the irrigation management: the measurement of the water tension in the soil through the use of tensiometers. Although this methodology has high potential, it has not been widely adopted by the producers. Thus, the utilization of models to estimate evapotranspiration estimate has shown to be applicable to the Cerrado region. So, this paper aims to evaluate the performance of the Chistiansen-Hargreaves model to estimate evapotranspiration of black bean crop in the dry season of the Brazilian Cerrado region. It also aims to provide producers an the adjusted model to estimate evapotranspiration which permit an efficient management for the agricultural irrigated system of the Cerrado region. The evapotranspiration of the black bean crop was

  3. Ajuste de un Modelo Hidrodinámico para una Columna con Empaques Estructurados usando Valores Experimentales Fit of an Hydrodynamic Model for a Structured Packing Column using Experimental Data

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    R.H. Chávez

    2004-01-01

    Full Text Available El objetivo del presente trabajo es ajustar un modelo hidrodinámico para columna empacada con empaque estructurado, partiendo de valores experimentales. Se comparan dos empaques, uno construido en el Instituto Nacional de Investigaciones Nucleares (ININ, de gasa de alambre de latón, y otro de la empresa Sulzer Ltda., de gasa de alambre de acero inoxidable. El modelo hidrodinámico se ajustó mediante la técnica de mínimos cuadrados con el método Levenberg-Marquardt para ecuaciones no lineales. Se obtuvieron las caídas de presión experimentales y teóricas determinadas por el modelo, así como los parámetros de ajuste del modelo tanto para el empaque ININ, como para el Sulzer BX. El empaque ININ mostró mayor caída de presión que el empaque Sulzer BX, debido a sus características geométricas. Se concluye que con la determinación de los parámetros de ajuste del modelo, se puede definir los regímenes del flujo de columnas que empleen empaque estructurado ININ y Sulzer BX.The objective of the present study is to fit a hydrodynamic model for a packed column with structured packing, based on experimental values. Two packing materials were used, one was made by the Instituto Nacional de Investigaciones Nucleares (ININ of the gauze type made of brass and the other by Sulzer Ltda., also of the gauze type but made of stainless steel. The hydrodynamic model was fit using the method of least squares using the Levenberg and Marquardt methodology for non-linear equations. Experimental and theoretical pressure drops were determined using the model, as well as the fitted parameters of the model both for ININ and Sulzer BX packings. The ININ packing has a higher pressure drop than the Sulzer BX, due to its geometric characteristics. It is concluded that by using the fitted parameters of the model, flow regimes in the column may be defined when using ININ or Sulzer BX structured packing

  4. Ajuste e balanceamento do portfólio de projetos: o caso de uma empresa do setor químico Project portfolio adjustment and balance: a case study in the chemical sector

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    Marisa Padovani

    2012-12-01

    Full Text Available O objetivo deste trabalho é compreender a etapa de ajuste no contexto da gestão do portfólio de projetos, destacando sua relação com os processos de categorização e balanceamento. A pesquisa realizada tem caráter qualitativo, sendo a abordagem adotada o estudo de caso longitudinal. A pesquisa foi desenvolvida em uma empresa do setor químico brasileiro. As evidências, de várias fontes, foram coletadas através de entrevistas, documentos e dados dos sistemas corporativos. Para a compreensão do portfólio de projetos da empresa foram coletados e analisados dados de mil projetos realizados entre 2001 e 2005. Os resultados indicam que maior atenção é dada à etapa de seleção, negligenciando a etapa de ajuste. A adoção de ferramentas de balanceamento permitiu evidenciar lacunas e fontes de desbalanceamento no portfólio de projetos, promovendo o debate entre os tomadores de decisão no que concerne ao viés introduzido pelos critérios adotados na etapa de seleção e levantando a necessidade de introdução de uma sistemática de ajuste e balanceamento. Observou-se que sem uma adequada categorização dos projetos da empresa seria difícil promover a análise de balanceamento.This article aims to understand the adjustment stage of project portfolio management, highlighting its relationship with the processes of categorization and balancing. It is a qualitative research. The longitudinal case study approach was adopted. The research was carried out in a Brazilian chemical company. Several sources of evidence were collected through interviews, documents and data from the enterprise's systems. Data from 1,000 projects between 2001 and 2005 were collected and analyzed in order to understand the project portfolio. The results indicated that more attention is given to the selection stage, neglecting the adjustment stage. The adoption of balancing tools showed gaps and sources of imbalance in the project portfolio, promoting discussion

  5. Eina d'extracció i ajust automàtic per a models específics de paràmetres de circuits microelectrònics

    OpenAIRE

    Barceló Adrover, Salvador

    2016-01-01

    En aquest projecte es desenvoluparà una eina de programari per a circuits micro/nanoelectrònics, que permeti automatitzar completament el procés d'extracció dels paràmetres de models analítics a nivell de cel·la estàndard o bloc lògic a partir de simulacions a nivell elèctric. L'objectiu és simplificar l'ajust de models analítics en base a llibreries tecnològiques completes de cel·les estàndards considerant diferents condicions d'operació. This project presents the development of a softwar...

  6. Influência do tamanho e da rigidez dos objetos nos ajustes proximais e distais do alcance de lactentes Influence of object size and rigidity on proximal and distal adjustments to infant reaching

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    NACF Rocha

    2006-09-01

    Full Text Available CONTEXTUALIZAÇÃO: Estudos têm identificado que as propriedades dos objetos induzem os ajustes no alcance; no entanto, poucos investigaram a influência específica do tamanho e rigidez dos objetos em lactentes jovens. OBJETIVO: Verificar se lactentes de 4 a 6 meses realizam ajustes proximais e distais ao alcançarem objetos de diferentes tamanhos e rigidez. MÉTODOS: Nove lactentes saudáveis foram posicionados em uma cadeira inclinada a 50º. Quatro objetos foram apresentados, um rígido grande (RG, um rígido pequeno (RP, um maleável grande (MG e um maleável pequeno (MP, por um período de 1 minuto cada. Em um total de 384 alcances, foram analisados os ajustes proximais (alcance uni e bimanual e distais (orientação da mão horizontal, vertical e oblíqua; mão aberta, fechada e semi-aberta e o sucesso do alcance dos objetos. RESULTADOS: Constatou-se ajuste bimanual para o objeto RG e unimanual para os demais. A orientação da mão oblíqua foi predominante no toque dos objetos, enquanto para a preensão dos mesmos, a predominância foi a vertical, principalmente para o objeto RG. A orientação horizontal não foi observada na preensão do objeto RG. A mão semi-aberta foi mais freqüente no início do alcance para todos os objetos, enquanto no toque do objeto RG a mão aberta foi predominante. O sucesso do alcance foi maior para os objetos maleáveis (MG, MP do que para os rígidos (RG e RP. CONCLUSÃO: Lactentes jovens estudados são capazes de planejar e ajustar seus movimentos baseados na percepção das propriedades físicas dos objetos, o que sugere interação percepção-ação.BACKGROUND: Studies have identified that object properties lead to adjustments to reaching. However, few have investigated the specific influence of object size and rigidity among young infants. OBJECTIVE: To verify whether four to six-month-old infants make proximal and distal adjustments when reaching for objects of different sizes and rigidity. METHOD

  7. Desarrollo de un modelo de ajuste por el riesgo para el infarto agudo de miocardio en España: comparación con el modelo de Charlson y el modelo ices. Aplicaciones para medir resultados asistenciales

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    Juan Manuel Sendra Gutiérrez

    2006-01-01

    Full Text Available Fundamento: El infarto agudo de miocardio representa una importante carga de morbimortalidad en los países desarrollados. El objetivo de este trabajo es desarrollar un modelo de ajuste por el riesgo para evaluar los resultados del manejo de esta patología y comparar su desempeño con otros modelos. Métodos: Se desarrolla un modelo de ajuste de riesgo para el infarto agudo de miocardio mediante regresión logística con la información de una base de datos administrativa de hospitales españoles, considerando la mortalidad intrahospitalaria como variable respuesta y variables propias del paciente como predictoras. Se compara su capacidad predictiva con la del modelo de Charlson y el modelo ICES. Los modelos se aplican para evaluar la mortalidad intrahospitalaria. Resultados: La edad (OR: 1,07; la localización anterolateral (OR: 2,32 e inferoposterior (OR:1,91; el shock cardiogénico (OR:39,99, las arritmias (OR: 94,43, la enfermedad cerebrovascular (OR:2,15 y la insuficiencia renal (OR:1,87 aparecen asociados con un mayor riesgo de mortalidad. El modelo desarrollado ofrece mejor capacidad predictiva (-2LL: 2240 que el modelo de Charlson (-2LL: 3073 y el modelo ICES (-2LL: 2366. No hay diferencias significativas en la mortalidad ajustada por el riesgo de los 23 hospitales estudiados, ni diferencias entre centros públicos y privados, ni por volumen de atención o nivel tecnológico. La coronariografía (RMAR: 0,66 y las intervenciones coronarias percutáneas (RMAR: 0,69 son procedimientos con efecto protector. Conclusiones: El modelo desarrollado puede constituir una herramienta útil para evaluar la práctica asistencial del infarto en centros hospitalarios.

  8. Ajuste de modelos de distribuição de probabilidade a séries horárias de velocidade do vento para o município de Ponta Grossa, Estado do Paraná - doi: 10.4025/actascitechnol.v33i4.7072

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    Maysa de Lima Leite

    2011-09-01

    Full Text Available Os objetivos deste trabalho foram avaliar o ajuste de dados horários de velocidade média do vento para Ponta Grossa, Estado do Paraná, às distribuições de probabilidade de Weibull, Rayleigh, Beta, Gama e Normal e analisar possíveis interferências das condições atmosféricas diurnas e noturnas no ajuste destes modelos. O teste de Kolmogorov-Smirnov foi utilizado para se comparar os ajustes e selecionar as melhores distribuições teóricas dentro de cada uma das 24h do dia em cada mês do ano, referentes ao período de janeiro de 1998 a dezembro de 2007. Os coeficientes de assimetria horários também foram utilizados para se caracterizar as distribuições de frequência. O maior ou menor grau de ajustamento dos dados médios horários de vento aos modelos probabilísticos avaliados foi influenciado pela hora do dia, e, no período noturno, entre zero e 5h, a distribuição de Weibull mostrou-se como a melhor opção de ajuste, seguida pelas distribuições Beta e Gama. No período diurno, os cinco modelos avaliados ajustaram adequadamente os dados médios horários de velocidade do vento, havendo, no entanto, alternância quanto à ordem do melhor ajuste.

  9. RETIRO LABORAL Y AJUSTE A LA JUBILACIÓN DE HOMBRES Y MUJERES EN LA MEDIANA EDAD (WORK RETIREMENT AND ADJUSTMENT TO RETIREMENT OF MEN AND WOMEN IN THE MIDDLE-AGED

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    Cruz Meléndez Roxana

    2011-04-01

    Full Text Available Resumen:En este artículo se presentan los resultados de una investigación aplicada cuyo objeto de estudio fue un grupo de hombres exfuncionarios y mujeres exfuncionarias del área administrativa de la Universidad de Costa Rica (UCR que se encuentran en la etapa de vida denominada “la mediana edad” y que enfrentan el proceso trabajo-retiro laboral. El estudio consistió en identificar los principales factores que inciden en el retiro laboral a una edad más temprana; la viviencia del proceso, el ajuste a la jubilación y sus implicaciones a nivel personal y social. La información recopilada se obtuvo a partir de la técnica “la entrevista fenomenológica” concebida como una exploración profunda que proporciona datos de gran valor conceptual y humana; en ella, tanto la persona que entrevista como la entrevistada mantienen un compromiso para que la búsqueda de la información sea dentro de una relación empática. Partiendo de lo subjetivo por su historia de vida al mandato social por lo roles asignados y asumidos por la población en estudio. Los resultados obtenidos indican que pareciera que la valoración que cada uno de los participantes hace de su rol laboral y el significado del trabajo en sus vidas es determinante en el proceso de retiro laboral y su ajuste al rol de persona jubilada.Abstract: This article presents the results of applied research study that was aimed at a group of men and women, former administrative staff of the University of Costa Rica that are in the stage of life called middle age and facing work-retirement process work. The study consist in identify the main factors affecting the removal from work at a younger age, the experiencing process, adjustment to retirement and its implications for personal and social level. Information collected was obtained from the technique "the phenomenological interview “conceived as a deep exploration that provides valuable data conceptual and human, in her interview both

  10. Programa de ajuste multiparamétrico de curvas de titulação potenciométricas de ácidos húmicos Multiparametric adjustment program of potentiometric titration curves of humic acids

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    Clausius Duque Gonçalves Reis

    2010-04-01

    Full Text Available Tendo em vista a dificuldade de determinação dos pontos de inflexão na curva de titulação potenciométrica de ácidos húmicos, por metodologias tradicionais, foi desenvolvido foi desenvolvido um programa na linguagem Delphi para ajuste multiparamétrico de dados de titulação potenciométrica. Para isso um processo iterativo para estimar as raízes de um polinômio, com base no método de Newton-Raphson, foi utilizado. Os dados das titulações potenciométricas de ácidos húmicos usados nas regressões foram obtidos em um sistema automatizado de titulação potenciométrica. O programa desenvolvido na linguagem Delphi permite maior versatilidade e facilidade de operação, com uma interação mais amigável com o usuário. As curvas de titulação potenciométricas ajustadas sobrepuseram-se quase que totalmente às curvas experimentais. Os valores de pKa e as percentagens de grupos tituláveis dos ácidos húmicos, parâmetros ajustáveis na regressão multiparamétrica, apresentaram valores comparáveis com dados da literatura.Regarding the difficulty of determining the inflection points in the potentiometric titration curve of humic acids by means of traditional methodologies, a Delphi program a Delphi program was developed for the multiparametric data adjustment in potentiometric titration. For this purpose, an iterative process was used, based on the Newton-Raphson method to estimate the roots of a polynomial. The humic acid potentiometric titration data, used in regressions, were obtained in an automated system of potentiometric titration. The program developed in Delphi language features greater versatility, ease of operation and better interaction with the user. The adjusted potentiometric titration curves overlap the experimental curves almost entirely. The pKa values and percentages of titrable groups of humic acids extracted from soil, adjustable parameters in the multiparametric regression, were comparable with those reported

  11. EFECTOS DE LA SALINIDAD EN LAS VARIABLES HÍDRICAS POTENCIALES HÍDRICO Y OSMÓTICO Y AJUSTE OSMÓTICO EN CULTIVARES CUBANOS DE TRIGO (Triticum aestivum L. Y T. durum L.

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    Leandris Argentel

    2013-01-01

    Full Text Available El experimento se desarrolló con el objetivo de evaluar el efecto de la salinidad en los potenciales hídrico y osmótico y el ajuste osmótico en 12 cultivares de trigo pertenecientes a las especies Triticum aestivum L. y Triticum durum L., en etapas iniciales del desarrollo, siguiendo las metodologías para su determinación. Las plantas se establecieron en un invernadero en condiciones de hidroponía aplicando, como primer tratamiento, una solución nutritiva salinizada a base de NaCl a una conductividad eléctrica de 8 dS.m-1. El tratamiento control consistió en la solución nutritiva sin salinidad significativa (0,36 dS.m-1. Las evaluaciones se realizaron a los 25 días posteriores a la germinación. Los resultados mostraron una significativa disminución de los valores del potencial hídrico en la mayoría de los cultivares en todos los órganos medidos y se observó una significativa disminución de sus valores desde las raíces hasta las hojas para asegurar el gradiente hídrico. Los cultivares que no disminuyeron significativamente su potencial hídrico mostraron comportamiento similar en los tres órganos evaluados aunque el gradiente de potenciales se mantuvo. El potencial osmótico disminuyó significativamente en todos los cultivares y sus valores fueron inferiores a -0,6 MPa. Todos los cultivares realizaron el ajuste osmótico, siendo el valor más significativo AO= 0,3 MPa en los cultivares INIFAT RM-36, INIFAT RM-32, INIFAT RM-37. Se observó variabilidad en la respuesta al estrés salino entre los cultivares y especies para las tres variables evaluadas.

  12. Sistemas homogéneos de ecuaciones diofánticas. Resolución y aplicación al ajuste automático de reacciones químicas

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    Recuero, Alfonso

    1984-06-01

    Full Text Available An algorithm to solve systems of linear homogeneous diophantine equations is given here. Subsequently, as an example of application, a method of heuristic search for the best solution is described; this fulfils certain conditions within an infinite space of solutions of various dimensions. Finally, an application of the algorithm and of the process of heuristic search for the best solution in adjusting chemical reactions is described. The listing in BASIC of the program of application mentioned is included, for the HP-75 portable computer.

    Se presenta un algoritmo de resolución de sistemas de ecuaciones diofánticas lineales y homogéneas. Seguidamente y como ejemplo de aplicación se describe un método de búsqueda heurística de una solución óptima que cumpla unas ciertas condiciones dentro de un espacio infinito de soluciones de varias dimensiones. Por último se describe la aplicación del algoritmo y del procedimiento de búsqueda heurística para el caso de ajuste de reacciones químicas. Se incluye el listado en BASIC del programa para el ordenador HP-75.

  13. A tecnologia da informação como suporte ao ajuste da previsão da demanda: um estudo de caso em uma empresa de bebidas carbonatadas

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    Alexandre Pereira Salgado Junior

    2010-08-01

    Full Text Available A gestão da cadeia de suprimentos é um problema que sempre instigou gestores por todo o mundo, ademais os modelos de previsão da demanda tradicionais não mais satisfazem os novos desafios da gestão dos estoques e da ruptura. Assim, novas soluções foram desenvolvidas, buscando-se melhorar os níveis de serviço prestados ao consumidor final. Dentre elas, destaca-se a utilização da TI que, por disponibilizar a informação em tempo real, pode contribuir para o ajuste dos modelos tradicionais de previsão da demanda. Desta forma, o objetivo desta pesquisa é analisar como a TI pode ajudar o segmento de bebidas a ajustar sua previsão de demanda. O método de pesquisa utilizado foi o estudo de caso, analisando uma empresa de bebidas carbonatadas, escolhida por conveniência. Para análise dos dados, utilizou-se a técnica de análise de conteúdo. Como principais resultados destacam-se melhorias no nível dos estoques, na ruptura e no nível de serviço.

  14. Las reformas de 2009 al Reglamento de la Corte Interamericana de Derechos Humanos: una regulación de prácticas existentes y un ajuste del Reglamento de noviembre de 2000

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    María Clara Galvis Patiño

    2009-12-01

    Full Text Available Durante su octogésimo segundo período ordinario de sesiones, celebrado en su sede en San José de Costa Rica, del 19 al 31 de enero de 2009, la Corte Interamericana de Derechos Humanos —en adelante también «la Corte Interamericana», «la Corte», «la Corte IDH» o «el Tribunal»— aprobó una serie de reformas puntuales del Reglamento de la Corte Interamericana de Derechos Humanos —en adelante, el «Reglamento1—, que entraron en vigencia el 24 de marzo de 20092. En este artículo, se referirá, en primer lugar, a los antecedentes y al contexto en el que tuvo lugar la reciente reforma del Reglamento de la Corte. Luego mencionaré algunos de sus temas y aspectos más destacados, los cuales tienen que ver, por una parte, con la reglamentación de prácticas que el alto Tribunal interamericano ha venido adoptando en los últimos años y, por otra, con el ajuste de aspectos puntuales del trámite de los casos contenidos en el reglamento adoptado en noviembre de 2000, que entró en vigencia el 1 de junio de 20013. Finalmente, me referiré a los temas pendientes que deben ser abordados en futuras reformas del reglamento de la Corte.

  15. Impacto da erva-moira na produção do tomateiro e ajuste de modelos matemáticos Impact of black nightshade on tomato plant production and mathematical model fitness

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    J.M Portugal

    2009-12-01

    Full Text Available Modelos matemáticos são úteis para estimar o impacto das infestantes nas culturas. Os objetivos deste trabalho foram: elucidar a interação de Solanum nigrum (ervamoira ou maria-pretinha com o tomateiro no sistema de sementeira direta e transplantado; e avaliar o impacto de diferentes densidades de infestação e períodos de tempo de competição na quantidade de frutos do tomateiro. Entre os anos 1991 e 2001, foram conduzidos cinco experimentos em campo na região tomaticultora de Portugal. Os experimentos seguiram o método aditivo, mantendo-se constante a densidade da cultura, enquanto o número de ervas-moiras variou entre 0 e 6 plantas m-2. Outro fator avaliado foi o período de convivência da infestante na cultura, incluindo os períodos do transplante/semeadura e o início da floração até a colheita. Os resultados de perda de produção foram ajustados aos modelos linear e hiperbólico. O comportamento das perdas de produção nas densidades mais baixas de erva-moira é do tipo linear. A erva-moira é uma espécie muito competitiva em relação ao tomateiro tanto quando a cultura é semeada quanto quando é transplantada. As perdas de produção foram maiores quando a cultura foi semeada, em comparação com a transplantada.Mathematical models are useful for estimating the impact of weeds on crops. The objectives of this study were to elucidate the interaction of Solanum nigrum (black nightshade with tomato plants in direct and transplanted sowing and to evaluate the impact of different infestation densities and competition time periods on tomato plant production. Between 1991 and 2001, five field experiments were conducted in the tomato growing region of Portugal using the additive method, keeping crop density constant, while changing the number of weeds from 0 and 6 plants m-2. The weed and crop coexistence period was also evaluated, from transplantation/sowing to the beginning of flowering or until harvest. The tomato yield

  16. Ajuste do modelo fototérmico de estimativa do desenvolvimento e do índice de área foliar de soja Adjustment of the photothermic model to estimate soybean development and leaf area index

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    Neila T. Toledo

    2010-03-01

    Full Text Available Visou-se neste estudo, realizar o ajuste do modelo de estimativa do desenvolvimento de populações de soja e da variação do índice de área foliar para a variedade IAS 5. Como fonte de variação na velocidade de desenvolvimento, diferentes épocas de plantio foram utilizadas em experimentos nos anos agrícolas de 2004/2005 (três datas e 2005/2006 (quatro datas no IRDeR (Instituto Regional de Desenvolvimento Rural localizado em Augusto Pestana, RS (28º 27' 17" S e 53º 54' 50" W, nos quais foram identificadas as datas em que ocorreram as principais fases do desenvolvimento da cultura da soja, seguindo a Escala Fenológica de Fehr & Caviness e estimados o índice de área foliar em quatro momentos: no final do período de instalação da população vegetal (V6; no início do florescimento (R1; início do enchimento de grãos (R5; e no início da maturação (R7. As variáveis meteorológicas temperaturas mínima e máxima diárias foram coletadas. Após o ajuste dos coeficientes genéticos, o modelo foi formatado no programa Stella 5.0. O modelo de estimativa do desenvolvimento da soja teve desempenho satisfatório, apresentando estimativas precisas para os dados que o determinaram. O modelo de estimativa do índice de área foliar apresentou estimativas satisfatórias.The present study was carried out to adjust the soy population development model and the leaf area index model for the IAS 5 cultivar. Different sowing dates were used in two experiments as source of development variation during 2004/2005 (three dates and 2005/2006 (four dates in the IRDeR (Instituto Regional de Desenvolvimento Rural located in Augusto Pestana, in the State of Rio Grande do Sul (28º 27' 17" S and 53º 54' 50" W. The main crop development phases were identified according to the Feher & Caviness phenological scale, and the leaf area index was determined in four occasions: at the final period of plant population installation (V6; at the beginning of flowering

  17. Observador Asintótico Ajustable para Reactores Bioquímicos: Aplicación a la Digestión Anaerobia A Tunable Asymptotic Observer for Biochemical Reactors: Application to Anaerobic Digestion

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    V. Alcaraz

    2004-01-01

    Full Text Available En este trabajo se propone un observador asintótico ajustable para sistemas dinámicos no lineales que pueden ser descritos por un conjunto de ecuaciones diferenciales ordinarias. A diferencia de los observadores asintóticos clásicos, este observador está provisto de ganancias variables que pueden ser ajustadas por el usuario. En la etapa inicial de la estimación, este observador es robusto frente a perturbaciones inducidas por un conocimiento parcial de los términos no lineales. Eventualmente, este observador es totalmente independiente de los términos no lineales, lo que le confiere una robustez total frente a cualquier perturbación inducida por estos términos. El observador es probado mediante simulaciones rigurosas y es aplicado a un modelo dinámico de digestión anaerobia para el tratamiento de aguas residuales, mostrando propiedades excelentes de convergencia, estabilidad y desempeño. La respuesta del observador propuesto es más rápida que la obtenida con los observadores asintóticos clásicosIn this paper a tunable asymptotic observer for non-linear dynamic systems that can be described by a set of ordinary differential equations, is proposed. In contrast with classical asymptotic observers, this one is provided with variable gains that can be tuned by the user. At the first stage of the estimation, the observer is robust against disturbances induced by poorly known non-linear terms. Eventually, the observer becomes fully independent of the nonlinear terms and thus robust against any disturbance induced by the nonlinear terms. The performance of the observer is tested through rigorous simulations in a dynamic anaerobic digestion model for wastewater treatment, showing excellent convergence and stability properties. Finally, it is shown that the proposed observer yields faster estimates than those obtained by using the classical asymptotic observers

  18. Errores en el Ajuste del Valor Posicional en Tareas de Estimación: un Estudio con Maestros en Formación (Error in the Adjustment of Positional Value in Computational Estimation Tasks: A Study with Elementary Preservice Teachers

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    Carlos de Castro

    2008-06-01

    Full Text Available En este estudio se analizan los errores, en el ajuste del valor posicional, en los que incurren maestros en formación en tareas de estimación de multiplicación y división con números naturales y decimales. Para ello, se elaboró una prueba de estimación compuesta por 24 cálculos directos, sin contexto, que se aplicó a 26 futuros maestros. Posteriormente se realizaron entrevistas para determinar los errores en los que incurrieron y se encontraron 8 tipos diferentes de errores. Los errores más frecuentes son los debidos a un conteo defectuoso de las posiciones para esta-blecer el orden de magnitud de los resultados y los que se producen al dividir un número por otro mayor añadiendo un cero de más al cociente. La colocación de la coma decimal en el resultado es, en todos los casos, una gran fuente de dificultad. In this study we analyze elementary preservice teachers’ errors, in the adjustment of positional value, in computational estimation tasks involving multiplication and division with integers and decimals. We designed an estimation test composed by 24 direct computations, without context, which we administered to 26 future teachers. Later we interviewed them to determine the errors made in estimation and found 8 different types of errors. The more frequent errors are the ones due to a wrong counting of positions to establish the order of magnitude of the results, and errors produced in division when the divisor is greater than the dividend by adding one extra cero to the quotient. Finding the place for the decimal point is, in all the cases, a great source of difficulty.

  19. Ajuste de metodologia da eletroforese de proteínas para obtenção de fenótipos isoenzimáticos de moranga Adjustment of the methodology of protein electrophoresis to obtain isozymatic phenotypes of pumpkin

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    Antonio Teixeira do Amaral Júnior

    1994-01-01

    Full Text Available Modificações no procedimento eletroforético foram introduzidas para uma satisfatória obtenção de fenótipos isoenzimáticos de moranga (Cucurbita maxima Duchesne. Extratos de folhas definitivas de oito acessos de moranga foram submetidos à análise eletroforética para revelação dos seguintes sistemas: esterase (EST; fosfatase ácida (ACP; transaminase do glutamato oxaloacetato (GOT, desidrogenase do malato (MDH e peroxidase (PO. Os resultados apontaram a ineficiência do tampão extrator utilizado e satisfatória qualidade do gel de amido de milho nas resoluções dos sistemas EST, ACP, GOT e MDH. Para o sistema PO, adequado efeito de peneiramento molecular só foi possível com a utilização do amido hidrolisado de batata (Sigma. Ajustes no tempo de cozimento do gel, manuseio da corrente elétrica, preparo de soluções corantes e tempo de revelação indicaram os melhores protocolos ao pro-cedimento eletroforético.Changes in the electrophoresis procedures were introduced to obtain a better isozymatic phenotypes of pumpkin (Cucurbita maxima Duchesne. Extracts of eight access of pumpkin's leaves were subjected to electrophoresis analysis in order to reveal the following systems: esterase (EST, acid phosphatase (ACP, glutamate oxaloacetate transaminase (GOT, malato dehydrogenase (MDH and peroxidase (PO. The results pointed out the inefficiency of the extractor buffer used, and the satisfactory quality of maize starch gel electrophoresis in the resolution of EST, ACP, GOT and MDH systems. For PO system a better effect of "molecular sieving" was only possible when potato starch gel (Sigma was used. Adjusting the starch cooking time, handling the electric current, preparing the staining solutions and revealing time indicated the best protocol to the electrophoresis process.

  20. Ajuste do método de Priestley-Taylor às condições climáticas locais Adjustment of the Priestley-Taylor method to local climatic conditions

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    Nilson A. Villa Nova

    2006-08-01

    Full Text Available A sustentabilidade da agricultura irrigada depende primariamente do manejo eficiente da irrigação, de modo a aumentar a produtividade primária de uma cultura em determinada localidade. A eficiência no uso de água pode ser melhorada pelo próprio esquema de irrigação adotado, sendo essencialmente governado pelas condições climáticas. O planejamento da irrigação e a tomada de decisão são funções do conhecimento da demanda evaporativa da atmosfera, sendo expressa pela demanda potencial (ETo. Em geral, quase todos os métodos de estimativa de ETo reportados na literatura referem-se a valores diários, incluindo-se nessa situação as perdas noturnas de evaporação, as quais serão expressivas apenas em alguns dias após a chuva ou irrigação. Desenvolveu-se, no presente estudo, método corrigido para estimar ETo, baseado no balanço de energia local, a partir de dados meteorológicos monitorados em postos de observação de superfície durante o período de luz. Para validação do método de Priestley-Taylor ajustado às condições locais, foram utilizados dados observados em estação meteorológica automática instalada em Piracicaba - SP, bem como medidas lisimétricas coletadas na Fazenda Areião da área experimental da ESALQ/USP. Estudos de regressão revelaram que o método proposto apresentou excelentes resultados quando comparado com o método de Penman-Monteith e com medidas realizadas em lisímetros de pesagem com célula de carga, dados os elevados valores de coeficiente de determinação obtidos, podendo ser recomendado, portanto, em estudos de avaliação de consumo de água das culturas em diversas localidades.The sustainability of irrigated agriculture depends primarily on the efficient management of irrigation in order to increase the crop primary productivity in a given site. The efficiency in water use can be enhanced by the irrigation schedule adopted, being mainly governed by the climatic conditions. The

  1. Evaluación del grado de ajuste de las revistas científicas españolas de ciencias de la salud a las normas internacionales de presentación de publicaciones periódicas

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    López-Cózar Emilio Delgado

    1997-01-01

    Full Text Available FUNDAMENTO: Se evalúa el cumplimiento, por parte de 205 revistas científicas españolas de ciencias de la salud, de las normas internacionales de presentación de publicaciones periódicas, con el fin de mejorar su calidad informativa, puesto que la normalización constituye un elemento importante en el éxito del proceso de transferencia de la información científica. MÉTODOS: Las revistas se identificaron a través de cinco bibliografías impresas y cuatro bases de datos bibliográficas. Se controlaron 136 preceptos extraídos de las normas internacionales de presentación de publicaciones periódicas emitidas por la International Standardization Organization (86% y de recomendaciones generadas por la UNESCO, el International Committee of Medical Journal Editors, el Council of Biology Editors y EJ Huth (14%. Para cada parámetro se valoraron tres niveles de evaluación (Inclusión, Presentación y Ubicación, por lo que el número total de ítemes evaluados fue de 342. RESULTADOS: El grado de normalización de las revistas biomédicas españolas estudiadas fue del 33,5% ± 8,5. Destacan por su buen ajuste los parámetros referidos a la identificación de la revista en las páginas del texto y al sumario del fascículo. Los aspectos más descuidados se concentran en el volumen y sumario analítico. Las revistas peor normalizadas son las auspiciadas por empresas y organismos de gestión. Las revistas anuales son las mejor estandarizadas. CONCLUSIONES: El bajo nivel de normalización que resulta no se debe a un deficiente cumplimiento generalizado de todos los parámetros sino más bien al incumplimiento completo de algunos de los mismos, en concreto: las normas que regulan el sumario analítico y la cubierta, sumario e índices de volumen. Para conseguir una mayor normalización de las revistas se propone un cambio en la política de difusión de las normas, la elaboración de guías y manuales para la confección de publicaciones cient

  2. LA REFORMA ECONÓMICA Y SU IMPACTO SOCIAL EN COSTA RICA DURANTE EL PERÍODO DE AJUSTE ESTRUCTURAL: apuntes críticos para el análisis

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    Rafael Arias Ramírez

    2007-12-01

    Full Text Available Resumen El objetivo de este artículo es analizar la reforma económica implementada en Costa Rica en los últimos veinticinco años como resultado de la aplicación de los programas y políticas de ajuste estructural. Para tal efecto se analiza el debate que acompañó el proceso de aprobación e implementación de los mencionados programas, el discurso de los mismos, su desempeño y algunos de sus principales efectos sociales. Esta reforma económica representó un cambio importante en el estilo de desarrollo y en las funciones del estado social vigentes desde la década de los 1950s. De ahí que resulte de gran interés analizar cuál fue el nuevo enfoque de desarrollo que se implementó a partir de la década de los años ochenta y los resultados del mismo en materia de crecimiento económico y equidad social. Esta publicación pretende servir de insumo para promover la tarea académica de repensar la política de desarrollo que la sociedad costarricense debe definir dentro del nuevo contexto de la globalización.   Abstract The objective of this article is to analyze the economic reform implemented in Costa Rica in the last twenty-five years as result of the application of the structural adjustment programs and policies. For such effect we analyze the debate that accompanied the process of approval and implementation of the mentioned programs, the speech of such, its performance and some of its main social effects. This economic reform represented an important change in the style of development and in the current functions of the social state from the decade of 1950s. Hence it results of big interest to analyze which was the new approach of development that was implemented from the decade of the eighties and the results of the same one on the subject of economic growth and social equity.This publication tries to serve as input to promote the academic task of rethinking the politics of development that the Costa Rican society must define

  3. A mortalidade materna nas capitais brasileiras: algumas características e estimativa de um fator de ajuste Maternal mortality in Brazilian State Capitals: some characteristics and estimates for an adjustment factor

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    Ruy Laurenti

    2004-12-01

    Full Text Available A mortalidade materna pode ser considerada um excelente indicador de saúde, não só da mulher, mas da população geral; mostra, também, iniqüidades. A redução da mortalidade materna é uma das principais metas, estando também incluída nas Metas do Desenvolvimento do Milênio da ONU. OBJETIVO: Conhecer a qualidade da informação da mortalidade de mulheres de 10 a 49 anos, e estimar a razão de mortalidade materna (RMM e os fatores de ajuste para os dados oficiais, no conjunto das capitais de estados brasileiros e Distrito Federal. METODOLOGIA: Adotou-se a metodologia RAMOS (a partir da declaração de óbito, entrevista no domicílio da mulher falecida, com preenchimento de questionário, sobre variáveis demográficas, epidemiológicas, clínicas e de acesso a serviços; seguiam-se consultas a prontuários médicos hospitalares e a laudos de autópsia. Após o resgate da informação, pôde ser feita análise das reais causas básicas, terminais e associadas. A população de estudo foi estimada em 7.332 mortes de mulheres de 10 a 49 anos, ocorridas no primeiro semestre de 2002, sendo 239 óbitos por causas maternas. A RMM foi de 54,3 por cem mil nascidos vivos (n.v., no conjunto de capitais, variando entre 42 por cem mil n.v. no Sul, e 73,2 por cem mil n.v. no Nordeste. O fator de ajuste para o conjunto das capitais brasileiras foi igual a 1,4; para as regiões (considerando apenas as capitais, variaram entre 1,08 na Região Norte e 1,83 na Região Sul. As mortes obstétricas diretas corresponderam a 67,1%, mostrando que assistência ao pré-natal, ao parto e ao puerpério deve ser aprimorada.INTRODUCTION: There is criticism as to the heterogeneity and reliability of mortality data in Brazilian Regions. However, official mortality statistics of State Capitals are more accurate and have adequate coverage. Reduction of maternal mortality is one of the world's major goals and it is measured by the Maternal Mortality Ratio. International

  4. L’exposition contrôlée à la lumière et à l’obscurité ajuste le rythme du cortisol salivaire chez les travailleurs de nuit

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    Anny Casademont

    2005-05-01

    Full Text Available Dans cette étude réalisée sur le terrain et en laboratoire, nous avons testé l’efficacité d’une intervention consistant à contrôler l’exposition à la lumière/obscurité de façon à favoriser l’adaptation circadienne au travail de nuit. Six travailleurs permanents de nuit (moyenne d’âge 37,1 ± σ : 8,1 ans avaient comme consigne de s’exposer de façon intermittente à une lumière blanche vive plein spectre (~2 000 lux au cours des 6 premières heures de leur quart de travail de 8 heures. Il leur était demandé de se protéger de la lumière solaire du matin avec des verres teintés (densité gris neutre, transmission visuelle de la lumière 15 % et de maintenir des épisodes réguliers de sommeil/obscurité dans une pièce très sombre. Ces épisodes devaient commencer 2 heures après la fin de chaque quart de travail de nuit. Cinq travailleurs du groupe contrôle (41,1 ± σ : 9,9 ans ont été étudiés alors qu’ils devaient uniquement maintenir un horaire régulier de sommeil/obscurité. Des procédures de routine constante, réalisées avant et après une série d’environ 12 quarts de travail de nuit s’échelonnant sur 3 semaines, ont montré chez les travailleurs du groupe traitement une variation significative dans l’heure d’apparition du pic de cortisol ainsi qu’un ajustement de ce rythme à un horaire de travail de nuit. Un plus petit changement de phase a été observé dans le groupe contrôle, ce qui suggère une adaptation partielle à l’horaire de travail de nuit. Nos résultats démontrent l’efficacité d’une exposition judicieuse à la lumière et à l’obscurité pour favoriser l’adaptation des rythmes physiologiques au travail de nuit.The efficacy of a light/darkness intervention designed to promote circadian adaptation to night shift work was tested in this combined field and laboratory study. Six permanent night shift workers (mean age: 37.1 / s: 8.1 years were instructed to

  5. THE INFLUENCE OF MANAGERIAL WORK DETERMINANTS ON THE PERCEPTION OF FITNESS BETWEEN TECHNOLOGY AND TASK: AN EXPLORATORY STUDY A INFLUÊNCIA DOS DETERMINANTES DO TRABALHO GERENCIAL NA PERCEPÇÃO DO AJUSTE ENTRE A TECNOLOGIA E A TAREFA: UM ESTUDO EXPLORATÓRIO

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    Mauri Leodir Löbler

    2010-12-01

    Full Text Available This paper investigates if the managerial work nature modifies the manager's perception regarding the adjustment of Information Technology (IT to their task. The indicators of managerial work, as experience and frequency of IT use and manager decision-making roles, were based on studies of Vlahos and Ferrat (1998 and Vlahos, Ferratt and Knoepfle (2004 as well as the task technology fit, reasoned from the Task-Technology Fit model (TTF (Goodhue, 1995. This paper contributes to understanding the IS as a support tool for the tasks that composed the manager's role in the organization. Through an exploratory study conducted with 238 managers, we observed that more increases the experience of the individual with the Information System (IS, greater the adjustment perceived for it, between the technology and the task running; and higher the user access the IS, greater the fit between the technology and their tasks. As for the decision-making roles, we identified the roles of manager/entrepreneur and conflict manager are those who envisage a better adaptation of technology to their work, getting through the IS support for the work to proceed more efficiently. Este artigo investiga se a natureza do trabalho gerencial modifica a percepção do gestor quanto ao ajuste da Tecnologia da Informação (TI à sua tarefa. Os indicadores do trabalho gerencial, como a experiência e frequência de uso da TI e papéis decisórios do gestor, foram baseados nos estudos de Vlahos e Ferrat (1998 e Vlahos, Ferratt e Knoepfle (2004, além do ajuste da tecnologia à tarefa, fundamentado a partir do modelo de Ajuste Tecnologia-Tarefa (TTF (Goodhue, 1995. O trabalho contribui no entendimento dos SI como ferramenta de suporte para a execução das tarefas que compõem o papel do gestor na organização. Através de um estudo exploratório, realizado junto a 238 gestores, observou-se que quanto mais aumenta a experiência do individuo com os Sistemas de Informação (SI, maior

  6. Comorbidity adjustment index for the international classification of diseases, 10 Índice de ajuste de co-morbilidad para la 10a revisión de la clasificación internacional de enfermedades Índice de ajuste de comorbidade para a 10a revisão da classificação internacional de doenças

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    Robert Antonio Ramiarina

    2008-08-01

    Full Text Available OBJECTIVE: To develop a Charlson-like comorbidity index based on clinical conditions and weights of the original Charlson comorbidity index. METHODS: Clinical conditions and weights were adapted from the International Classification of Diseases, 10th revision and applied to a single hospital admission diagnosis. The study included 3,733 patients over 18 years of age who were admitted to a public general hospital in the city of Rio de Janeiro, southeast Brazil, between Jan 2001 and Jan 2003. The index distribution was analyzed by gender, type of admission, blood transfusion, intensive care unit admission, age and length of hospital stay. Two logistic regression models were developed to predict in-hospital mortality including: a the aforementioned variables and the risk-adjustment index (full model; and b the risk-adjustment index and patient's age (reduced model. RESULTS: Of all patients analyzed, 22.3% had risk scores >1, and their mortality rate was 4.5% (66.0% of them had scores >1. Except for gender and type of admission, all variables were retained in the logistic regression. The models including the developed risk index had an area under the receiver operating characteristic curve of 0.86 (full model, and 0.76 (reduced model. Each unit increase in the risk score was associated with nearly 50% increase in the odds of in-hospital death. CONCLUSIONS: The risk index developed was able to effectively discriminate the odds of in-hospital death which can be useful when limited information is available from hospital databases.OBJETIVO: Desarrollar un índice de co-morbilidad a partir de las condiciones clínicas y de los pesos de índice original de co-morbilidad de Charlson. MÉTODOS: Las condiciones clínicas y pesos del índice de Charlson fueron adaptados según la Clasificación Internacional de Enfermedades - 10a Revisión, y aplicados al diagnóstico principal de internación hospitalaria. Fueron estudiados 3.733 pacientes arriba de 18 a

  7. Eficácia da técnica de sutura ajustável per-operatória simplificada para a correção de desvios horizontais: estudo prospectivo de 49 pacientes The efficacy of a simplified intraoperative adjustable suture for horizontal strabismus surgery: a prospective study of 49 patients

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    Mariza Polati

    2003-10-01

    Full Text Available OBJETIVO: Avaliar a eficácia de técnica simplificada de cirurgia ajustável per-operatória, sob anestesia geral, para a correção de desvios horizontais. MÉTODOS: Estudo prospectivo de 49 pacientes portadores de desvio horizontal, 22 com esotropia (ET e 27 com exotropia (XT, da Secção de Motilidade Ocular Extrínseca da Clínica Oftalmológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Todos os pacientes foram submetidos à cirurgia utilizando-se a técnica de ajuste per-operatório. O ajuste foi realizado comparando-se a medida do desvio em milímetros (mm do reflexo de luz na córnea no pré-operatório e a medida tomada no per-operatório, em plano anestésico profundo. Nas ET, o reflexo foi medido a partir do lado temporal do limbo e nas XT, do lado nasal. Todo o cálculo para o ajuste ou não, foi feito baseado nas medidas em milímetros, não se convertendo mm em dioptrias prismáticas, e nem se utilizando a pupila como ponto de referência. RESULTADOS: 28 pacientes (57,1% apresentaram alteração do desvio em plano anestésico profundo. Em 25 pacientes (51,0% foi necessária a realização do ajuste. Estabelecendo-se como critério de sucesso cirúrgico ortotropia, eso ou exotropia até 10 dioptrias prismáticas no pós-operatório após, no mínimo, 6 meses, a taxa de sucesso foi 75,6%. CONCLUSÃO: Os resultados mostraram que a técnica é eficiente. A técnica de cirurgia simplificada com ajuste per-operatório descrita pelos autores, oferece mais uma opção de tratamento cirúrgico visando diminuir o número de reoperações e aumentar a taxa de sucesso nas correções dos desvios, principalmente nos casos de mais difícil planejamento e que não colaboram para ajuste com anestesia tópica e/ou pós-operatório. Por ser técnica simplificada, pode ser mais facilmente realizada por cirurgiões menos experientes, aumentando a sua utilização em maior número de casos.PURPOSE: To evaluate

  8. Ajustes posturais antecipatórios e compensatórios ao pegar uma bola em condição de estabilidade e instabilidade postural Anticipatory and compensatory postural adjustments during catching a ball in condition of postural instability and stability

    Directory of Open Access Journals (Sweden)

    Vanessa Scariot

    2012-09-01

    Full Text Available Indivíduos jovens pré-selecionam suas estratégias de ajuste postural antes que uma perturbação externa ocorra, com base nas características da tarefa. Entretanto, ainda não é bem conhecido de que maneira o sistema nervoso central lida com os ajustes posturais antecipatórios e compensatórios, mediante alguns treinos de equilíbrio que são comumente usados na prática clínica da Fisioterapia. Treze adultos jovens receberam 20 perturbações posturais externas de pegar uma bola arremessada pelo experimentador sobre condições de estabilidade e instabilidade postural (sobre uma espuma. As atividades eletromiográficas dos músculos tríceps braquial (músculo focal, retoabdominal e paravertebral lombar foram avaliadas nas janelas de tempo típicas dos ajustes posturais antecipatórios e compensatórios, assim como o pico do deslocamento do centro de pressão corporal após a perturbação. A magnitude das integrais da atividade eletromiográfica do músculo tríceps braquial foi significativamente menor em condição de instabilidade postural, não houve diferença estatística entre as condições para as integrais da atividade eletromiográfica dos músculos retoabdominal e paravertebral lombar. O pico do deslocamento anteroposterior do centro de pressão corporal foi similar entre as duas condições. Treino de equilíbrio associado à perturbação externa da postura sobre espuma pode não ser mais eficaz ou eficiente do que sobre uma superfície estável, quando se pretende alterar a atividade dos músculos posturais do tronco. Além disso, este tipo de intervenção pode corroborar para diminuir a ativação antecipatória (ajustes posturais antecipatórios do músculo focal.Young individuals preselect their postural adjustment strategies before an external perturbation, based on the characteristics of the task. However, it is not well documented how the central nervous system deals with anticipatory and compensatory postural

  9. Técnica de sutura ajustável per-operatória simplificada para a correção de desvios horizontais: estudo de 153 casos Simplified intraoperative adjustable suture technique for horizontal strabismus surgery: a study of 153 cases

    Directory of Open Access Journals (Sweden)

    Iara Debert

    2007-02-01

    Full Text Available OBJETIVO: Avaliar a técnica de sutura ajustável per-operatória simplificada para a correção de desvio horizontal. MÉTODOS: Foram avaliados retrospectivamente os prontuários médicos de todos os pacientes que foram submetidos à cirurgia para correção de desvio horizontal utilizando a técnica de sutura ajustável per-operatória simplificada no setor de Motilidade Ocular Extrínseca do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo no período entre janeiro de 2001 e novembro de 2005. Por essa técnica, o ajuste foi calculado com base no reflexo luminoso na córnea, considerando a diferença entre a medida pré-operatória e sob plano anestésico profundo. RESULTADOS: Foram realizadas 153 cirurgias, sendo 73 (47,8% casos de esotropia (ET e 80 (52,2% de exotropia (XT. Após a anestesia, houve alteração do desvio em 123 (80,4% pacientes, sendo que destes, 69 (56,1% eram esotropia que diminuíram, 51 (41,5% eram exotropia que aumentaram e 3 (2,4% eram exotropia que diminuíram. Foi realizado o ajuste per-operatório em 60 (39,2% casos, sendo 30 (41,1% casos de esotropia e 30 (37,5% de exotropia. Os resultados pós-operatórios foram avaliados após seguimento mínimo de 180 dias, com taxa de sucesso (considerando ortotropia, sub ou supercorreção de até 10 dioptrias prismáticas de 71,6%. CONCLUSÕES: A técnica de sutura ajustável per-operatória simplificada, que foi apresentada em 2003 em um estudo com 49 pacientes operados pelo mesmo cirurgião, mostrou-se eficiente nessa série maior de casos e realizada por diferentes cirurgiões. É proposta para pacientes que não colaboram para outras técnicas de ajuste, visando aumentar o sucesso cirúrgico.PURPOSE: To evaluate the simplified intraoperative adjustable suture technique for horizontal strabismus surgery. METHODS: Data charts of all patients who underwent horizontal strabismus surgery by the simplified intraoperative adjustable suture technique

  10. Clinical Research and Clinical Trials

    Science.gov (United States)

    ... NICHD Publications Data Sharing and Other Resources Research Clinical Trials & Clinical Research Skip sharing on social media links ... health care providers, and researchers. Find NICHD-Supported Clinical Trials Use this link to find a list of ...

  11. Clinical Competence/Clinical Credibility.

    Science.gov (United States)

    Goorapah, David

    1997-01-01

    In interviews with 10 nurse teachers and 10 clinicians, respondents could describe clinical competence more fluently than clinical credibility. Responses raised the question of whether nursing teachers must be clinically competent/credible to teach nursing. (SK)

  12. Desempenho do Índice de Sustentabilidade Empresarial (ISE Sob a Perspectiva do Retorno Ajustado ao Risco: Sustentabilidade Gera Retorno?

    Directory of Open Access Journals (Sweden)

    Cinthya Muyrielle da Silva Nogueira

    2011-12-01

    Full Text Available Resumo: A exigência de uma maior responsabilidade social por parte das empresas, busca da sustentabilidade, entre outros fatores, contribuem para que surjam a oferta de investimentos conhecidos como Socialmente Responsáveis. Com o aumento da demanda por este tipo de investimento, assim como visando incentivá-lo, surge o Índice de Sustentabilidade Empresarial (ISE. O índice é referência para comparar o desempenho de empresas listadas na BOVESPA sob os aspectos da sustentabilidade. O presente trabalho se propõe a analisar o desempenho do ISE no que se refere ao seu retorno e risco, comparando-o ainda com os resultados dos demais índices da BOVESPA. Foi realizada então, uma pesquisa exploratória com dados secundários, onde os índices foram analisados e utilizou-se do Índice de Sharpe como ferramenta para avaliação da eficiência dos índices de ações. Observou-se que os resultados foram semelhantes e o ISE superou os resultados de alguns dos demais índices da BOVESPA, de forma que o investimento no ISE mostra-se válido tendo em vista seu desempenho histórico.

  13. Índice de Desempeño Integral ajustado a las localidades de Bogotá D.C.

    Directory of Open Access Journals (Sweden)

    María del Pilar Sánchez Muñoz

    2016-08-01

    Full Text Available Resumen En este documento se presenta un estudio de la descentralización fiscal y administrativa de las 19 localidades de Bogotá (Colombia, adaptando la metodología del Departamento Nacional de Planeación (DNP para medir el desempeño integral de los entes territoriales, específicamente con los componentes de eficacia y gestión para el periodo 2009-12. Se encontró que el nivel de cumplimiento de metas en los planes de desarrollo de cada localidad es medio, a pesar de que existe una descentralización administrativa en las formas de desconcentración y delegación. La investigación también mostró que, según el índice de gestión, las localidades no tienen autonomía para llevar a cabo proyectos de inversión ni obtener recursos propios, debido a los lineamientos de la Alcaldía Mayor de la ciudad.

  14. Clinical Trials

    Science.gov (United States)

    Clinical trials are research studies that test how well new medical approaches work in people. Each study answers ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a ...

  15. Preparo do ventrículo subpulmonar através de dois diferentes modelos ajustáveis de bandagem do tronco pulmonar: estudo experimental Preparation of the pulmonary ventricle for arterial switch operation using two adjustable devices for pulmonary trunk obstruction: an experimental study

    Directory of Open Access Journals (Sweden)

    Luiz Fernando CANÊO

    2001-03-01

    Full Text Available Dois modelos de dispositivos ajustáveis foram implantados em cabritos jovens, com o objetivo de avaliar suas capacidades de bandagem do tronco pulmonar (TP e eficiência no treinamento do ventrículo subpulmonar. Foram utilizados 3 grupos de 7 animais, submetidos ao implante de cateter balão (grupo I, implante de dispositivo de bandagem externa (grupo II e para obtenção dos pesos dos ventrículos direito (VD, esquerdo (VE e septo interventricular em condições normais (grupo controle. Os animais foram submetidos a ajustes progressivos dos dispositivos, a cada 24 horas, durante um período de 96 horas, avaliados através de monitorização hemodinâmica e ecocardiograma seriado. A hipertrofia ventricular foi avaliada através de parâmetros morfológicos e de microscopia óptica. Todos os animais concluíram o período de treinamento proposto. O gradiente VD-TP, a razão VD/VE e a pressão sistólica do VD foram significativamente maiores no grupo II (p0,05. O perímetro e a área dos miócitos mostraram um aumento significativo no final do treinamento, comparados à amostra retirada no momento do implante dos dispositivos. Observamos maior grau de estenose do TP com dispositivo de bandagem externa, porém ambos tiveram a capacidade e a eficiência de preparar o ventrículo subpulmonar.Two adjustable pulmonary artery banding devices were implanted in 14 young goats to evaluate their efficacy for the training of the pulmonary ventricle (right ventricle. An obstructing balloon catheter was placed in the lumen of the pulmonary artery in 7 animals (group I and other 7 animals (group II underwent implantation of an external pulmonary banding device. As a control group for septum, left and right ventricle weights a third group of 7 animals was used. Right ventricle (RV load was increased gradually, at 24 hours intervals, for 96 hours. RV muscle mass evolution was assessed by echocardiography and by optical microscopy. All animals completed the

  16. Clinical Trials

    Science.gov (United States)

    ... they are receiving. Other clinical trials involve a crossover design, where participants are randomly assigned to take a new treatment, a treatment already in use, and/or a placebo for a specified time ... If I am involved in a "crossover" clinical trial, can I go back to the ...

  17. Clinical Research

    DEFF Research Database (Denmark)

    Christensen, Irene

    2016-01-01

    This paper is about the logic of problem solving and the production of scientific knowledge through the utilisation of clinical research perspective. Ramp-up effectiveness, productivity, efficiency and organizational excellence are topics that continue to engage research and will continue doing s...... for years to come. This paper seeks to provide insights into ramp-up management studies through providing an agenda for conducting collaborative clinical research and extend this area by proposing how clinical research could be designed and executed in the Ramp- up management setting....

  18. Clinical photography.

    Science.gov (United States)

    Jakowenko, Janelle

    2009-01-01

    Digital cameras, when used correctly, can provide the basis for telemedicine services. The increasing sophistication of digital cameras, combined with the improved speed and availability of the Internet, make them an instrument that every health-care professional should be familiar with. Taking satisfactory images of patients requires clinical photography skills. Photographing charts, monitors, X-ray films and specimens also requires expertise. Image capture using digital cameras is often done with insufficient attention, which can lead to inaccurate study results. The procedures in clinical photography should not vary from camera to camera, or from country to country. Taking a photograph should be a standardised process. There are seven main scenarios in clinical photography and health professionals who use cameras should be familiar with all of them. Obtaining informed consent prior to photography should be a normal part of the clinical photography routine.

  19. Clinical Investigation.

    Science.gov (United States)

    1979-09-30

    Hiller, D.A., Elliott, J.P.: Tubal Ligation Syndrome Myth or Reality. Presented: Armed Forces Division of ACOG, New Orleans, Louisiana, October 1977...Molecular Weight Immunoreactive Glucagon Levels in Patients with the Post Prandial Syndrome . (Abst.) Western Society for Clinical Research, 1979. (3...Glucagon Levels in Patients witl the Post Prandial Syndrome . Presented: Western Society Meetings, Western Society for Clinical Research, February 1979. (3

  20. Clinical supervision.

    Science.gov (United States)

    Goorapah, D

    1997-05-01

    The introduction of clinical supervision to a wider sphere of nursing is being considered from a professional and organizational point of view. Positive views are being expressed about adopting this concept, although there are indications to suggest that there are also strong reservations. This paper examines the potential for its success amidst the scepticism that exists. One important question raised is whether clinical supervision will replace or run alongside other support systems.

  1. Os perfusionistas Brasileiros e o ajuste do rolete arterial: comparação entre a calibração estática e dinâmica Brazilian perfusionists and arterial roller pump adjustment: comparison between static and dynamic calibration method

    Directory of Open Access Journals (Sweden)

    Francisco Ubaldo Vieira Junior

    2011-06-01

    Full Text Available INTRODUÇÃO: Bombas de roletes desempenham um papel importante na circulação extracorpórea. No entanto, a oclusão dos roletes das bombas deve ser realizada de forma adequada e estas podem ser ajustadas, principalmente por dois métodos: estático e dinâmico. OBJETIVO: Investigar como os perfusionistas brasileiros ajustam as bombas de rolete arterial em seus serviços e testar o uso de um Dispositivo Auxiliar de Calibração que facilita o ajuste pelo método de calibração dinâmica. MÉTODOS: Foi instalada uma bomba de roletes com os acessórios necessários para a realização de sua calibração pelos métodos de velocidade de queda (calibração estática e calibração dinâmica durante o XXVIII Congresso Brasileiro de Circulação Extracorpórea. Foi solicitado aos perfusionistas que ajustassem uma bomba de roletes conforme procedimento normalmente utilizado em seu serviço. Após cada regulagem, foi medida a respectiva pressão pelo método de calibração dinâmica com o auxílio do dispositivo. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da UNICAMP, sob Nº 1144/2010. RESULTADOS: Participaram da pesquisa 56 perfusionistas. A média das 56 medidas de pressão de calibração dinâmica foi 434 ± 214 mmHg; 76% das medidas realizadas ficaram no intervalo preconizado para o uso da técnica de calibração dinâmica (entre 150 e 500 mmHg. CONCLUSÃO: Os perfusionistas brasileiros tendem a calibrar bombas de roletes com ajustes menos oclusivos. As amplitudes das medidas de pressão de calibração dinâmica tendem a ser menores para perfusionistas mais experientes. O dispositivo pode ser utilizado por perfusionistas para ajustar bombas de roletes com maior precisão e, principalmente, repetitividade e em alguns minutos.INTRODUCTION: Roller pumps play an important role in extracorporeal circulation. However, occlusion of the rollers should be adequately performed and this can be adjusted mainly by two methods: static and

  2. Una Técnica de Inteligencia Artificial para el Ajuste de uno de los Elementos que Definen una B-Spline Racional No Uniforme (NURBS A Technique of Artificial Intelligence to Fit one of the Elements that Define a Non-Uniform Rational B-Spline (NURBS

    Directory of Open Access Journals (Sweden)

    Sandra P Mateus

    2010-01-01

    Full Text Available Dentro de las técnicas existentes de Inteligencia Artificial, se escogieron y adaptaron dos Redes Neuronales Artificiales (RNA para realizar el ajuste de uno de los elementos que definen una B-Spline Racional No Uniforme (NURBS y con ello obtener un modelado adecuado de la NURBS. Los elementos escogidos fueron los puntos de control. Las RNA utilizadas son las de Función de Base Radial y las de Kohonen o Mapas Auto-organizativos. Con base en el análisis de resultados y la caracterización de las RNA, la Función de Base Radial tuvo un desempeño más adecuado y óptimo para un número elevado de datos, lo cual es una desventaja de los Mapas Auto-organizativos. En este modelo se tiene que realizar procesos extras para determinar la neurona ganadora y realizar el reajuste de los pesos.In the existing techniques of Artificial Intelligence, two Artificial Neural Networks (ANN were selected and adapted to fit one of the elements that define a Non-Uniform Rational B-Spline (NURBS and thus obtaining an appropriate modeling of the NURBS. The selected elements were the checkpoints. The ANN used were the Radial Basis Function and the Kohonen model or Self-Organizing Maps. Based on the analysis of the results and characterization of the ANN the Radial Basis Function had a more appropriate and optimum performance for a large number of data, which is a disadvantage of the Self-Organizing Maps. In this model, additional processes must be done to determine the winning neuron and the weights must be refitted.

  3. Clinical Trials

    Science.gov (United States)

    ... and her initial results. Nueva Esperanza Para Las Enfermedades Del Corazón 09/23/2014 Milena tuvo un ... Story 09/23/2014 Nueva Esperanza Para Las Enfermedades Del Corazón 09/23/2014 Children and Clinical ...

  4. Clinical biochemistry

    Science.gov (United States)

    Alexander, W. C.; Leach, C. S.; Fischer, C. L.

    1975-01-01

    The objectives of the biochemical studies conducted for the Apollo program were (1) to provide routine laboratory data for assessment of preflight crew physical status and for postflight comparisons; (2) to detect clinical or pathological abnormalities which might have required remedial action preflight; (3) to discover as early as possible any infectious disease process during the postflight quarantine periods following certain missions; and (4) to obtain fundamental medical knowledge relative to man's adjustment to and return from the space flight environment. The accumulated data presented suggest that these requirements were met by the program described. All changes ascribed to the space flight environment were subtle, whereas clinically significant changes were consistent with infrequent illnesses unrelated to the space flight exposure.

  5. Clinical Studies

    DEFF Research Database (Denmark)

    Pallesen, Ulla

    and repair? Have new materials improved longevity? Are there still clinical and material problems to be solved? And what has the highest impact on longevity of posterior resin restorations – the material, the dentist, the patient or the tooth? These matters will be discussed on the basis of the literature......Within the last 25 years composite resin materials have in many countries successively replaced amalgam as a restorative for posterior teeth. Resin materials and bonding systems are continuously being improved by the manufactures, adhesive procedures are now included in the curriculum of most...... universities and practicing dentists restore millions of teeth throughout the World with composite resin materials. Do we know enough about the clinical performance of these restorations over time? Numerous in vitro studies are being published on resin materials and adhesion, some of them attempting to imitate...

  6. Memory clinics

    OpenAIRE

    Jolley, D; Benbow, S M; Grizzell, M

    2006-01-01

    Memory clinics were first described in the 1980s. They have become accepted worldwide as useful vehicles for improving practice in the identification, investigation, and treatment of memory disorders, including dementia. They are provided in various settings, the setting determining clientele and practice. All aim to facilitate referral from GPs, other specialists, or by self referral, in the early stages of impairment, and to avoid the stigma associated with psychiatric services. They bring ...

  7. Clinical practice

    OpenAIRE

    2011-01-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2–2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the developing brain. Children with CP can have swallowing problems with severe drooling as one of the consequences. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity ...

  8. Ajuste macro, política monetaria y empleo

    Directory of Open Access Journals (Sweden)

    Jorge Iván González

    2000-04-01

    Full Text Available El artículo muestra que la política monetaria restrictiva ha sido uno de los factores que más ha incidido en el crecimiento del desempleo en Colombia durante la segunda mitad de los años noventa. La tasa de sacrificio de la política monetaria no ha sido cero, porque el costo de reducir la inflación ha sido muy elevado. La responsabilidad que tiene el manejo de la política monetaria en la crisis del sector real se hace más visible si se tiene en cuenta que no hay evidencia de que la menor demanda de trabajo esté asociada a los costos laborales y a las inflexibilidades del mercado laboral.

  9. Ajuste personal y actitudes ante la sexualidad y el amor

    Directory of Open Access Journals (Sweden)

    Pedro Pablo Vélez

    1977-01-01

    Full Text Available A comparíson of the attitudes toward sexuality and love was made among .hígh schoool students, college students and young couples. Significant differences were found in terms of adjustment. Women were better adjusted than men, couples better than college students, and the latter better than high school students.

  10. Incertidumbres y ajustes deseables a la Ley 1314 de 2009

    OpenAIRE

    Flórez Arias, Eric Jesús

    2011-01-01

    Este artículo es una reflexión sobre la Ley 1314 de 2009. La intención no es otra que compartir ciertas dudas que surgen al leer en forma detenida el texto de la ley. Por supuesto, también es positivo promover el debate para que temas de vital importancia para el ejercicio de la profesión, en este caso la contaduría pública, sean resueltos en forma oportuna y adecuada con la mayor participación posible de colegas de todas las especialidades. La reglamentación de esta ley es la gran oportunida...

  11. What Are Clinical Trials?

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Clinical Trials What Are Clinical Trials? Past Issues / Fall 2010 Table of Contents Clinical ... conducted all the time. The Different Phases of Clinical Trials Clinical trials related to drugs are classified into ...

  12. Participating in Clinical Trials

    Science.gov (United States)

    ... this page please turn Javascript on. Participating in Clinical Trials About Clinical Trials A Research Study With Human Subjects A clinical ... to treat or cure a disease. Phases of Clinical Trials Clinical trials of drugs are usually described based ...

  13. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Z > Participating in Clinical Trials: About Clinical Trials In This Topic About Clinical Trials Risks and Benefits ... of this page please turn Javascript on. Participating in Clinical Trials About Clinical Trials A Research Study ...

  14. Ajuste de curvas pelo método dos quadrados mínimos na elaboração de modelo matemático para estimativa da produção de soja no Estado de Rondônia

    Directory of Open Access Journals (Sweden)

    Romeu Cestaro

    2016-07-01

    Full Text Available Este artigo tem por objetivo abordar a utilização do ajuste de curvas pelo método dos quadrados mínimos na elaboração de um modelo matemático que seja capaz de estimar a produção de soja para a safra 2015/16 no Estado de Rondônia. Para tanto, dados referentes às safras de soja anteriores foram coletados a partir da base de dados da Companhia Nacional de Abastecimento (CONAB. Verificou-se que o modelo obtido realizou uma boa aproximação com a função tabelada, considerando-se que o maior erro relativo percentual observado tenha sido de 5,78% e erro relativo médio de 2,75%; além disso, a estimativa para a produção de soja em Rondônia para a safra 2015/16, dada pelo modelo, está bastante próxima da estimativa da CONAB para o mesmo período, apresentando uma diferença percentual de 1,39%.Palavras-chave: Métodos numéricos. Método dos Quadrados mínimos. Modelagem matemática. Produção de soja. Rondônia.Least-squares based curve fitting for developing a mathematical model to estimate soybean production in RondoniaAbstractThis paper intends to approach the use of least-squares based curve fitting for developing a mathematical model to estimate the soybean production for 2015/16 crop year in Rondônia. For this purpose, data on previous soybean crop years were collected from the Companhia Nacional de Abastecimento (CONAB database. It was found that the obtained model made a good approximation to the tabulated function, considering that the greatest relative error percentage observed was 5.78%, and average relative error of 2.75%; also, the estimate for soybean production in Rondonia for 2015/16 crop year, given by the model, is pretty close to CONAB estimate for the same period, presenting a percentage difference of 1.39%.Keywords: Numerical methods. Method of least squares. Mathematical modeling. Soybean production. Rondônia.

  15. Ajustes aos US-GAAPS: estudo empírico sobre sua relevância para empresas brasileiras com ADRs negociados na bolsa de Nova Iorque Adjustments to US-GAAPS: empirical study on their relevance for brazilian companies with ADR traded on the New York exchange

    Directory of Open Access Journals (Sweden)

    Fábio Moraes da Costa

    2007-06-01

    Full Text Available A relevância das informações disponibilizadas ao mercado por empresas brasileiras com American Depositary Recepts (ADRs negociados na Bolsa de Nova Iorque foi avaliada neste trabalho. Essas empresas devem atender à exigência da Securities and Exchange Commission e elaborar suas demonstrações contábeis de acordo com os United States Generally Accepted Accounting Principles (US-GAAP até 30 de junho, anualmente. Diante desse fato, dois conjuntos de informações estão disponíveis, promovendo a base de dados para o estudo da relevância das variáveis lucro líquido e patrimônio líquido para o período entre 1999 e 2003. Após a utilização do modelo desenvolvido por Ohlson (1995 e de seus desdobramentos posteriores, os resultados evidenciam que (1 as informações elaboradas segundo os princípios de contabilidade geralmente aceitos no Brasil são relevantes; (2 as informações em US-GAAP disponibilizadas em junho possuem menor ou igual relevância do que as divulgadas em abril e (3 os ajustes aos US-GAAP efetuados no patrimônio líquido são relevantes para o mercado de capitais brasileiro.This study evaluated the value-relevance of the information disclosed by Brazilian companies with American Depositary Receipts traded on the New York Stock Exchange. Those companies must comply with the requirement of the Securities and Exchange Commission and elaborate their financial statements according to the United States Generally Accepted Accounting Principles (US-GAAP until 30th of June, annually. Thus, two sets of information are available, providing data to evaluate the value-relevance of the variables net income and stockholders’ equity, from 1999 to 2003. After applying the model Ohlson developed in 1995 and its further developments, results indicate that (1 the information elaborated according to the generally accepted accounting principles in Brazil are value-relevant; (2 the relevance of the information in US-GAAP made available

  16. Clinical guidelines.

    Science.gov (United States)

    Uppal, Elaine

    2016-01-01

    This article is part of the Advancing practice series which is aimed at exploring practice issues in more depth, considering topics that are frequently encountered and facilitating the development of new insights. Elaine Uppal focuses on the importance of all midwives developing guideline writing skills to ensure that local, national and international midwifery/maternity guidelines are up to date, relevant and reflect midwifery knowledge alongside 'gold' standard evidence. The article aims to consider the development, use and critical appraisal of clinical guidelines. It will define and explain guidelines; discuss their development and dissemination; and consider issues relating to their use in practice. Techniques to critique and develop guidelines using the AGREE tool will be outlined in the form of practice challenges to be undertaken by the individual or in a group.

  17. Caracterização da interação genótipo-ambiente e comparação entre modelos para ajuste do ganho pós-demama de bovinos Devon via normas de reação Genotype by environment interaction characterization and model comparison for post weaning gain adjustment of Devon cattle via reaction norms

    Directory of Open Access Journals (Sweden)

    Marcela Bicca Bragança Corrêa

    2009-08-01

    Full Text Available Os objetivos com este estudo foram verificar a presença de interação genótipo-ambiente e comparar modelos para o ajuste do ganho pós-desmama padronizado para 345 dias de bovinos da raça Devon, via normas de reação obtidas por regressão aleatória. Foram utilizados 14.973 registros coletados pelo Programa de Melhoramento de Bovinos de Carne entre 1980 e 2005. Para análise dos dados, foi utilizado o programa INTERGEN. Primeiramente, foi rodado o modelo animal convencional (MA, para comparação e estimativas do gradiente ambiental, com base nos desvios dos grupos de contemporâneos, e, em seguida, rodados os modelos hierárquicos de normas de reação com variâncias residuais homogêneas (MHNR e heterogêneas (MHNRH. Nesses dois últimos, foram incluídos efeitos fixos de idade da vaca e idade do bezerro ao sobreano e efeitos aleatórios de grupos de contemporâneos e genéticos (nível e inclinação da norma de reação. No MHNR, as estimativas da variância residual, genética aditiva do nível e da inclinação da norma de reação e sua correlação genética foram, respectivamente, 272,02 ± 8,51; 340,38 ± 17,11; 0,119 ± 0,006 e 0,83 ± 0,01 e, no MHNRH, foram 401,96 ± 11,91; 177,86 ± 16,60; 0,076 ± 0,006 e 0,72 ± 0,02, respectivamente. A herdabilidade, bem como a variância genética, foi crescente no gradiente ambiental, caracterizando a existência de interação genótipo-ambiente. Com base nos Critérios de Informação Deviance, nos Fatores de Bayes e Pseudo Fatores de Bayes, o MHNR proporcionou melhor ajuste aos dados, sendo o mais apropriado para considerar a interação genótipo-ambiente dessa população.The objectives of this study were to verify the presence of the genotype by environment interaction and to compare different models to fit Devon cattle post weaning gain standardized to 345 days, via reaction norms obtained by random regression. Data from 14,973 calves collected by the beef cattle improvement

  18. [Clinical research VI. Clinical relevance].

    Science.gov (United States)

    Talavera, Juan O; Rivas-Ruiz, Rodolfo

    2011-01-01

    Usually, in clinical practice the maneuver selected is the one that achieves a favorable outcome with a direct percentage of superiority of at least 10 %, or when the number needed to treat is approximately equal to 10. While this percentage difference is practical for estimating the magnitude of an association, we need to differentiate the impact measures (attributable risk, preventable fraction), measures of association (RR, OR, HR), and frequency measures (incidence and prevalence) applicable when the outcome is nominal. And we must identify ways to measure the strength of association and the magnitude of the association when the outcome variable is quantitative. It is not uncommon to interpret the measures of association as if they were impact measures. For example, for a RR of 0.68, it is common to assume a 32 % reduction of the outcome, but we must consider that this is a relative reduction, which comes from relations of 0.4/0.6, 0.04/0.06, or 0.00004/0.00006. However the direct reduction is 20 % (60 % - 40 %), 2 %, and 2 per 100,000, respectively. Therefore, to estimate the impact of a maneuver it is important to have the direct difference and/or NNT.

  19. Modelos de ajuste e métodos para a determinação da curva de retenção de água de um Latossolo-vermelho-amarelo Adjustment models and methods for determining the soil water retention curve of a red-yellow Latosol

    Directory of Open Access Journals (Sweden)

    Wanderley Andrade Costa

    2008-04-01

    Full Text Available A caracterização da capacidade de retenção de água de um solo é fundamental para a descrição do fluxo de água através dele e para o adequado manejo da irrigação. São apresentadas comparações entre curvas de retenção de água do solo: ajustadas pelos modelos propostos por van Genuchten e por Hutson & Cass; obtidas pelo método do WP4 usando processo de umedecimento e de secagem; obtidas pelo método da centrífuga utilizando amostras deformadas e indeformadas; e obtidas pelo WP4 e centrífuga, usando um processo de secagem e amostra deformada. Amostras deformadas e indeformadas foram coletadas com trados específicos em um Latossolo Vermelho-Amarelo (LVA, textura argilosa. Foram determinadas as propriedades hídricas do solo necessárias à elaboração das curvas de retenção de água obtidas por análise de regressão. O modelo de van Genuchten possibilitou o melhor ajuste nas diversas situações estudadas. Considerando o processo de secagem, o teor de água útil obtido superou em 13 % o resultado do processo de umedecimento e evidenciou reduzido efeito de histerese. A amostra deformada apresentou-se com um teor de água útil superior 61,7 % ao valor obtido para a amostra indeformada. Entre os métodos estudados, verificou-se que aquele que usa o WP4 subestimou os dados obtidos pela centrífuga. Verificou-se que há diferenças entre amostra deformada e indeformada e os métodos utilizados na obtenção da curva de retenção.The characterization of the soil water retention capacity is fundamental for an adequate irrigation management and water flow description. We present comparisons of soil water retention curves adjusted in distinct ways: by the models proposed by van Genuchten and by Hutson & Cass; by the WP4 method in a wetting and drying process; by the centrifuge method using disturbed as well as undisturbed soil samples; and by the WP4 and centrifuge using a drying process and disturbed soil samples. Disturbed and

  20. Types of Treatment: Clinical Trials

    Science.gov (United States)

    ... Disease Information Treatment Types of Treatment Clinical Trials Clinical Trials Clinical Trials SHARE: Print Glossary Taking part in a clinical ... for cancer are based on previous clinical trials. Clinical Trial Service: LLS provides personalized clinical trial navigation when ...

  1. Future requirements. Clinical investigations

    DEFF Research Database (Denmark)

    Qvist, V.

    2002-01-01

    Biocompatability, Cariology, Clinical trials, Dental materials, Helath services research, Human, Pedodontics......Biocompatability, Cariology, Clinical trials, Dental materials, Helath services research, Human, Pedodontics...

  2. Limites: a questão do manejo clínico hoje Limits: the issue of clinical management today

    Directory of Open Access Journals (Sweden)

    Walter Firmo de Oliveira Cruz

    2012-12-01

    Full Text Available Objetiva-se refletir sobre a necessidade de transformação na técnica psicanalítica, considerando o intrapsíquico e o intersubjetivo. A frequência de insucessos nos atendimentos indica a necessidade da discussão de novos parâmetros. A forma de abordar o tema buscou ultrapassar fronteiras entre as escolas psicanalíticas. Procurou-se caracterizar as manifestações subjetivas contemporâneas articulando-as às condições de oferta do trabalho analítico, visando eventuais ajustes no manejo clínico.This article offers a reflection on the need for change in psychoanalytical technique to account for intrapsychic and intersubjective processes. The failure rate in psychotherapeutic practice indicates that new criteria need to be discussed. Approaches to this topic sought to cross borders between different psychoanalytical schools of thought. Contemporary subjective manifestations were characterized and linked with the terms of offer of analytical work to suggest possible changes in clinical management.

  3. Clinical toxicology: clinical science to public health.

    Science.gov (United States)

    Bateman, D N

    2005-11-01

    1. The aims of the present paper are to: (i) review progress in clinical toxicology over the past 40 years and to place it in the context of modern health care by describing its development; and (ii) illustrate the use of clinical toxicology data from Scotland, in particular, as a tool for informing clinical care and public health policy with respect to drugs. 2. A historical literature review was conducted with amalgamation and comparison of a series of published and unpublished clinical toxicology datasets from NPIS Edinburgh and other sources. 3. Clinical databases within poisons treatment centres offer an important method of collecting data on the clinical effects of drugs in overdose. These data can be used to increase knowledge on drug toxicity mechanisms that inform licensing decisions, contribute to evidence-based care and clinical management. Combination of this material with national morbidity datasets provides another valuable approach that can inform public health prevention strategies. 4. In conclusion, clinical toxicology datasets offer clinical pharmacologists a new study area. Clinical toxicology treatment units and poisons information services offer an important health resource.

  4. Uses of clinical algorithms.

    Science.gov (United States)

    Margolis, C Z

    1983-02-04

    The clinical algorithm (flow chart) is a text format that is specially suited for representing a sequence of clinical decisions, for teaching clinical decision making, and for guiding patient care. A representative clinical algorithm is described in detail; five steps for writing an algorithm and seven steps for writing a set of algorithms are outlined. Five clinical education and patient care uses of algorithms are then discussed, including a map for teaching clinical decision making and protocol charts for guiding step-by-step care of specific problems. Clinical algorithms are compared as to their clinical usefulness with decision analysis. Three objections to clinical algorithms are answered, including the one that they restrict thinking. It is concluded that methods should be sought for writing clinical algorithms that represent expert consensus. A clinical algorithm could then be written for any area of medical decision making that can be standardized. Medical practice could then be taught more effectively, monitored accurately, and understood better.

  5. Clinical Trials in Vision Research

    Science.gov (United States)

    ... Eye Health Information > Clinical Trials in Vision Research Clinical Trials in Vision Research Clinical studies depend on people ... vision research in the United States. Basics of Clinical Trials What is a clinical trial? Clinical trials are ...

  6. History of clinical pharmacy and clinical pharmacology.

    Science.gov (United States)

    Miller, R R

    1981-04-01

    The purpose of the Symposium on Clinical Pharmacy and Clinical Pharmacology is to describe the present and future functional roles of clinical pharmacists and clinical pharmacologists in drug research, professional education, and patient care. Clinical pharmacy is a relatively new professional discipline, being only about 15 years old. This new breed of pharmacists is patient rather than drug product oriented. The discipline arose out of dissatisfaction with old practice norms and the pressing need for a health professional with a comprehensive knowledge of the therapeutic use of drugs. The clinical pharmacy movement began at the University of Michigan in the early 1960s, but much of the pioneering work was done by David Burkholder, Paul Parker, and Charles Walton at the University of Kentucky in the latter part of the 1960s. Clinical pharmacology is a professional discipline that combines basic pharmacology and clinical medicine. Its development began in the early 1950s, primarily as a result of the efforts of Harry Gold. It has had a slower growth than clinical pharmacy but it has made many important contributions to our knowledge of human pharmacology and the rational use of drugs.

  7. Development of clinical scientists.

    Science.gov (United States)

    Smith, R V

    1987-01-01

    The education and training of clinical scientists has served society in several ways. For academic pharmacy, the emergence of clinical science has provided research and scholarship opportunities for clinical faculty development. Clinical scientists have also begun to play important roles in industrial drug research and development. For all faculty and students, clinical science research reinforces a "research mindset" that will become increasingly important as our society moves from a production/extraction to an information-based economy. Pharmacy will best evolve by increasing its commitment to clinical science research. In the process, academic pharmacy must continue to improve and support excellent education and training programs for clinical scientists.

  8. Clinical approach to clinical herbal toxicity.

    Science.gov (United States)

    Tovar, Richard T

    2009-02-01

    This article is a review of the history and current status of herbs in the United States. The clinical effects of herbs and herbal medicine will be reviewed with respect to side effects and clinical toxicity. Treatment of herbal toxicity will be described where indicated.

  9. Clinical grades: upward bound.

    Science.gov (United States)

    Walsh, Catherine M; Seldomridge, Lisa A

    2005-04-01

    This study examined the relationship of grades earned in paired theory and clinical courses. Data collected during academic years 1997 to 2002 confirmed that grade inflation exists in clinical nursing courses. Problems involved in awarding grades for clinical performance are discussed (e.g., standards of clinical performance, methods used in evaluation of clinical performance, the impossibility of faculty omnipresence, the influence of student effort in grading, the effect of recency, the challenges of keeping good anecdotal records). Solutions to grading problems are proposed, including dividing up performance into agreed-on elements, measurement of these elements on a grading scale that allows for more differentiation of quality in evaluating clinical performance, assigning grades from the beginning of a clinical course, emphasizing all three domains of clinical practice, and evaluating student performance in both laboratory and, clinical settings.

  10. How Do Clinical Trials Work?

    Science.gov (United States)

    ... Studies NHLBI Trials Clinical Trial Websites How Do Clinical Trials Work? If you take part in a clinical ... protect patients and help produce reliable study results. Clinical Trial Protocol Each clinical trial has a master plan ...

  11. Informed Consent (Clinical Trials)

    Science.gov (United States)

    ... Research Cancer Treatment Types of Treatment Side Effects Clinical Trials Information A to Z List of Cancer Drugs ... Staging Prognosis Treatment Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings & Cancer ...

  12. Research Areas - Clinical Trials

    Science.gov (United States)

    Information about NCI programs and initiatives that sponsor, conduct, develop, or support clinical trials, including NCI’s Clinical Trial Network (NCTN) and NCI Community Oncology Research Program (NCORP) initiatives.

  13. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... trial is to find out if an experimental drug, therapy, medical device, lifestyle change, or test will ... disease. Phases of Clinical Trials Clinical trials of drugs are usually described based on their phase. The ...

  14. NIH Clinical Centers

    Data.gov (United States)

    Federal Laboratory Consortium — The NIH Clinical Center consists of two main facilities: The Mark O. Hatfield Clinical Research Center, which opened in 2005, houses inpatient units, day hospitals,...

  15. Evidence of clinical competence.

    Science.gov (United States)

    Lejonqvist, Gun-Britt; Eriksson, Katie; Meretoja, Riitta

    2012-06-01

    This cross-sectional research used a qualitative questionnaire to explore clinical competence in nursing. The aim was to look for evidence of how clinical competence showed itself in practice. In the research, the views from both education and working life are combined to broadly explore and describe clinical competence from the perspective of students, clinical preceptors and teachers. The questions were formulated on how clinical competence is characterised and experienced, what contributes to it and how it is maintained, and on the relation between clinical competence and evidence-based care. The answers were analysed by inductive content analysis. The results showed that clinical competence in practice is encountering, knowing, performing, maturing and improving. Clinical competence is an ongoing process, rather than a state and manifests itself in an ontological and a contextual dimension.

  16. Fertility Clinic Success Rates

    Science.gov (United States)

    ... and Autism 2013 Assisted Reproductive Technology Fertility Clinic Success Rates Report Recommend on Facebook Tweet Share Compartir 2013 ART Fertility Clinic Success Rates Report [PDF - 1MB] Bookmarks and thumbnails are ...

  17. Clinical Laboratory Fee Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — Outpatient clinical laboratory services are paid based on a fee schedule in accordance with Section 1833(h) of the Social Security Act. The clinical laboratory fee...

  18. Spina Bifida Clinic Directory

    Science.gov (United States)

    ... edu Special Health Care Services Spinal Cord Clinic Wesley Medical Arts Tower Building (pediatric-will refer adults) ... to age 25) Clinic 6L, One Medical Center Dr. Lebanon, NH 03756 (603) 653-9623 http://chad. ...

  19. The Clinical Method and the Clinical Dilemmas.

    Directory of Open Access Journals (Sweden)

    Luis Alberto Corona Martinez

    2011-10-01

    Full Text Available The term ‘’clinic’’, among other meanings, refers to any information that suggests the presence of an illness and is obtained through questioning and physical examination processes that take place in the course of doctor-patient relationship. The purpose of this article is to summarize the challenges and dilemmas to be considered by students and young doctors in the patient's clinical approach, which completes the vision of the unquestionable positive role of clinical medical diagnosis. Different factors that can diminish the quality of obtained clinical information, thus interfering with the diagnostic process, have been classified into four groups: dependent on disease process, dependent on the individual patient or the source of information, dependent on the setting where information was obtained and dependent on the physician. As a generalization we state that the existence of the so-called challenges or dilemmas in clinical approach imply limitations to the clinical information obtained to be used with total reliability. Nevertheless, these dilemmas do not detract, nor even slightly, the values of clinical approach in the diagnostic process.

  20. University cardiology clinic.

    Science.gov (United States)

    Borozanov, V

    2013-01-01

    In distant 1972, within framework of the Internal Clinic, a cardiologic department was organized which was soon, on 29.XII.1974, transformed into the Cardiology Clinic, later the Institute for Heart Diseases, and in 2008 was renamed the University Cardiology Clinic. The greater part of its foundation was possible owing to Prof. Dimitar Arsov and Prof. Radovan Percinkovski, who was the clinic's first director in the period from 1974 to 1984. In 1985, the Clinic moved into its own new building, and in that way was physically detached from the Internal Clinics. Until its move to the new building, the Clinic functioned in the Internal Clinics building, organized as an outpatient polyclinic and inpatient infirmary department with clinical beds, a coronary intensive care unit and a haemodynamics laboratory equipped with the most modern equipment of that time. Today the Clinic functions through two integral divisions: an inpatient infirmary department which comprises an intensive coronary care unit and fourteen wards which altogether have 139 clinical beds, and the diagnostic centre which comprises an emergency clinic and day hospital, a communal and consultative outpatients' clinic functioning on a daily basis, through which some 300-350 patients pass every day, and diagnostic laboratories with a capacity of nearly 100 non-invasive and 20-30 invasive diagnostic procedures daily. The Clinic is a teaching base, and its doctors are educators of students at the Medical, Dental and Pharmacy Faculties, and also of students at the High School for Nurses and X-ray technicians, but also for those in Internal Medicine and especially Cardiology. The Clinic is also a base for scientific Masters' and post-doctoral studies, and such higher degrees are achieved not only by doctors who work here, but also by doctors from Medical Centres both in the country and abroad. Doctors working in this institution publish widely, not only a great number of books and monographs, but also original

  1. Learning clinical reasoning.

    Science.gov (United States)

    Pinnock, Ralph; Welch, Paul

    2014-04-01

    Errors in clinical reasoning continue to account for significant morbidity and mortality, despite evidence-based guidelines and improved technology. Experts in clinical reasoning often use unconscious cognitive processes that they are not aware of unless they explain how they are thinking. Understanding the intuitive and analytical thinking processes provides a guide for instruction. How knowledge is stored is critical to expertise in clinical reasoning. Curricula should be designed so that trainees store knowledge in a way that is clinically relevant. Competence in clinical reasoning is acquired by supervised practice with effective feedback. Clinicians must recognise the common errors in clinical reasoning and how to avoid them. Trainees can learn clinical reasoning effectively in everyday practice if teachers provide guidance on the cognitive processes involved in making diagnostic decisions.

  2. Integrating clinical research into clinical decision making

    Directory of Open Access Journals (Sweden)

    Mark R Tonelli

    2011-01-01

    Full Text Available Evidence-based medicine has placed a general priority on knowledge gained from clinical research for clinical decision making. However, knowledge derived from empiric, population-based research, while valued for its ability to limit bias, is not directly applicable to the care of individual patients. The gap between clinical research and individual patient care centers on the fact that empiric research is not generally designed to answer questions of direct relevance to individual patients. Clinicians must utilize other forms of medical knowledge, including pathophysiologic rationale and clinical experience, in order to arrive at the best medical decision for a particular patient. In addition, clinicians must also elucidate and account for the goals and values of individual patients as well as barriers and facilitators of care inherent in the system in which they practice. Evidence-based guidelines and protocols, then, can never be prescriptive. Clinicians must continue to rely on clinical judgment, negotiating potentially conflicting warrants for action, in an effort to arrive at the best decision for a particular patient.

  3. Clinical research informatics

    CERN Document Server

    Richesson, Rachel L

    2012-01-01

    This book provides foundational coverage of key areas, concepts, constructs, and approaches of medical informatics as it applies to clinical research activities, in both current settings and in light of emerging policies. The field of clinical research is fully characterized (in terms of study design and overarching business processes), and there is emphasis on information management aspects and informatics implications (including needed activities) within various clinical research environments. The purpose of the book is to provide an overview of clinical research (types), activities, and are

  4. American Association for Clinical Chemistry

    Science.gov (United States)

    ... Education Credits Certification Resources Career Guidance Publications Clinical Chemistry Clinical Laboratory News The Journal of Applied Laboratory Medicine Clinical and Forensic Toxicology News Clinical Laboratory Marketplace Books and Multimedia ...

  5. Predictors of Clinical Performance

    Science.gov (United States)

    Turner, Edward; And Others

    1974-01-01

    In a search for predictors of clinical competence, 50 third-year medical students studying pediatrics were videotaped during their interview and physical examination of outpatients. Consideration should be given to the possible value of psychological tests as predictors of clinical competence. (Author)

  6. Developing Clinical Competence

    NARCIS (Netherlands)

    P.F. Wimmers (Paul)

    2006-01-01

    textabstractThe development of clinical competence is the main purpose of medical education. The long road to become clinically competent starts on the first day of medical school, and every institution strives to select the best students. The responsibility of medical schools is to train th

  7. Overview of clinical cytogenetics.

    Science.gov (United States)

    Korf, B R

    2001-08-01

    This unit provides an introduction to clinical cytogenetics. It opens with indications for prenatal and postnatal chromosome analysis, followed by a brief discussion of the applications of fluorescence in situ hybridization (FISH). It suggests tissue sources for prenatal and postnatal analysis, and closes with a review of numerical and structural chromosome abnormalities. This unit provides an introduction to clinical cytogenetics.

  8. Clinical Trial Basics

    Science.gov (United States)

    ... How Am I Protected? Mark Bowden / iStock Ethical guidelines The goal of clinical research is to develop knowledge that improves human ... data and decide whether the results have medical importance. Results from clinical trials are often published in peer-reviewed scientific ...

  9. [Arthritis and clinical history].

    Science.gov (United States)

    Silva, Lígia; Sampaio, Luzia; Pinto, José; Ventura, Francisco S

    2011-01-01

    In front of a patient with arthritis, clinical good-sense tells that the most probable diagnosis are the most prevalent ones. Nevertheless, we have to exclude a multiplicity of other aetiologies, less frequent, but with highest implications in the therapeutic conduct. Infections by Brucella and by Borrelia are rare causes of chronic arthritis, yet are diagnosis to consider, even when the clinical manifestations aren't the most typical, as there still exist endemic areas in Portugal. Here we report two clinical cases about patients with arthritis for more than one year, subject to ineffective exams ant treatments. Only the clinical history could put on evidence clinical-epidemiological data, suggestive of Brucellosis and Lyme Disease, namely the professional contact with infected animals, and the history of probable erythema migrans, that pointed toward the correct diagnosis. So, with directed therapeutic, there was complete resolution of the inflammatory symptoms.

  10. The new clinical leader.

    Science.gov (United States)

    Oates, Kim

    2012-06-01

    The complexity and cost of health care, along with a greater need for accountability calls for a new style of clinical leadership. The new clinical leader will lead reform by putting the needs of the patient first and foremost, looking at current and planned services from the patient's point of view as well as the clinician's. Excellent clinical skills will remain essential but will be supplemented by a focus on team work and mentoring, patient safety, clear communication and reduction in waste and inefficiency, leading to better financial outcomes. The new clinical leaders will understand the importance of consulting widely and engaging colleagues in creating change to improve patient care. They will develop trusting and mutually respectful relationships with health service management and be able to negotiate the delicate balance between clinical judgement, resource constraints and personal loyalties by keeping the best outcome for the patient at the forefront of their thinking.

  11. Clinical Pathway for Thyroidectomy.

    Science.gov (United States)

    Villar del Moral, Jesús María; Soria Aledo, Víctor; Colina Alonso, Alberto; Flores Pastor, Benito; Gutiérrez Rodríguez, María Teresa; Ortega Serrano, Joaquín; Parra Hidalgo, Pedro; Ros López, Susana

    2015-05-01

    Clinical pathways are care plans applicable to patient care procedures that present variations in practice and a predictable clinical course. They are designed not as a substitute for clinical judgment, but rather as a means to improve the effectiveness and efficiency of the procedures. This clinical pathway is the result of a collaborative work of the Sections of Endocrine Surgery and Quality Management of the Spanish Association of Surgeons. It attempts to provide a framework for standardizing the performance of thyroidectomy, the most frequently performed operation in endocrine surgery. Along with the usual documents of clinical pathways (temporary matrix, variance tracking and information sheets, assessment indicators and a satisfaction questionnaire) it includes a review of the scientific evidence around different aspects of pre, intra and postoperative management. Among others, antibiotic and antithrombotic prophylaxis, preoperative preparation in hyperthyroidism, intraoperative neuromonitoring and systems for obtaining hemostasis are included, along with management of postoperative hypocalcemia.

  12. Situated clinical cognition.

    Science.gov (United States)

    Timpka, T

    1995-10-01

    The features characterizing study of clinical cognition in situ are formulated as: Re-cognition of context, culture, history and affect. Socializing and phenomenalistic elements are again included in the research agenda. Interest for representations: an analysis level is reserved for the symbols, rules and images relevant to define in models of clinical cognition. De-emphasis on computer modeling: investigations focus on the 'functional systems' in which computers are involved. Rootedness in classical philosophical problems: issues concerning situated clinical cognition are connected to the width of available theoretical literature. Belief in interdisciplinary studies: productive interactions between the new and traditional disciplines is anticipated, implying that new shared methods have to be developed. When scientific perspectives are broadened, a new balance has to be found between the relevance of the subject of study and methodological rigor. The situated clinical cognition framework is to allow for moving between models, theories, and perspectives, as it does not presuppose a singular model of clinical thinking.

  13. Collaboration across clinical silos.

    Science.gov (United States)

    Mohler, M Jane

    2013-01-01

    We face significant challenges to healthcare integration as well as tremendous opportunities to advance healthcare reform as we endeavor to provide a coordinated continuum of high-value services to defined populations for which we are clinically and fiscally accountable. As we move away from fee-for-service and poorly coordinated care toward value-based and bundled care, systems such as UnityPoint Health and clinical entities such as Piedmont Heart are leading the way, breaking down their clinical silos, improving value and access, and gaining patient loyalty. Evidence points us to sound principles that can inform the clinical integration process. Health systems must reinvent themselves, reengineer clinical operations, and streamline processes, all of which require collaboration across traditional silos, both inside our organizations and outside into our wider communities, to ensure that our patients receive the safe, high-value care they deserve.

  14. Gait analysis: clinical facts.

    Science.gov (United States)

    Baker, Richard; Esquenazi, Alberto; Benedetti, Maria G; Desloovere, Kaat

    2016-08-01

    Gait analysis is a well-established tool for the quantitative assessment of gait disturbances providing functional diagnosis, assessment for treatment planning, and monitoring of disease progress. There is a large volume of literature on the research use of gait analysis, but evidence on its clinical routine use supports a favorable cost-benefit ratio in a limited number of conditions. Initially gait analysis was introduced to clinical practice to improve the management of children with cerebral palsy. However, there is good evidence to extend its use to patients with various upper motor neuron diseases, and to lower limb amputation. Thereby, the methodology for properly conducting and interpreting the exam is of paramount relevance. Appropriateness of gait analysis prescription and reliability of data obtained are required in the clinical environment. This paper provides an overview on guidelines for managing a clinical gait analysis service and on the principal clinical domains of its application: cerebral palsy, stroke, traumatic brain injury and lower limb amputation.

  15. Clinical Research Methodology 2: Observational Clinical Research.

    Science.gov (United States)

    Sessler, Daniel I; Imrey, Peter B

    2015-10-01

    Case-control and cohort studies are invaluable research tools and provide the strongest feasible research designs for addressing some questions. Case-control studies usually involve retrospective data collection. Cohort studies can involve retrospective, ambidirectional, or prospective data collection. Observational studies are subject to errors attributable to selection bias, confounding, measurement bias, and reverse causation-in addition to errors of chance. Confounding can be statistically controlled to the extent that potential factors are known and accurately measured, but, in practice, bias and unknown confounders usually remain additional potential sources of error, often of unknown magnitude and clinical impact. Causality-the most clinically useful relation between exposure and outcome-can rarely be definitively determined from observational studies because intentional, controlled manipulations of exposures are not involved. In this article, we review several types of observational clinical research: case series, comparative case-control and cohort studies, and hybrid designs in which case-control analyses are performed on selected members of cohorts. We also discuss the analytic issues that arise when groups to be compared in an observational study, such as patients receiving different therapies, are not comparable in other respects.

  16. Clinical PET application

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang Moo; Hong, Song W.; Choi, Chang W.; Yang, Seong Dae [Korea Cancer Center Hospital, Seoul (Korea)

    1997-12-01

    PET gives various methabolic images, and is very important, new diagnostic modality in clinical oncology. In Korea Cancer Center Hospital, PET is installed as a research tool of long-mid-term atomic research project. For the efficient use of PET for clinical and research projects, income from the patients should be managed to get the raw material, equipment, manpower, and also for the clinical PET research. 1. Support the clinical application of PET in oncology. 2. Budgetary management of income, costs for raw material, equipment, manpower, and the clinical PET research project. In this year, 250 cases of PET images were obtained, which resulted total income of 180,000,000 won. 50,000,000 won was deposited for the 1998 PET clinical research. Second year PET clinical research should be managed under unified project. Increased demand for {sup 18}FDG in and outside KCCH need more than 2 times production of {sup 18}FDG in a day purchase of HPLC pump and {sup 68}Ga pin source which was delayed due to economic crisis, should be done early in 1998. (author). 2 figs., 3 tabs.

  17. Clinical microbiology informatics.

    Science.gov (United States)

    Rhoads, Daniel D; Sintchenko, Vitali; Rauch, Carol A; Pantanowitz, Liron

    2014-10-01

    The clinical microbiology laboratory has responsibilities ranging from characterizing the causative agent in a patient's infection to helping detect global disease outbreaks. All of these processes are increasingly becoming partnered more intimately with informatics. Effective application of informatics tools can increase the accuracy, timeliness, and completeness of microbiology testing while decreasing the laboratory workload, which can lead to optimized laboratory workflow and decreased costs. Informatics is poised to be increasingly relevant in clinical microbiology, with the advent of total laboratory automation, complex instrument interfaces, electronic health records, clinical decision support tools, and the clinical implementation of microbial genome sequencing. This review discusses the diverse informatics aspects that are relevant to the clinical microbiology laboratory, including the following: the microbiology laboratory information system, decision support tools, expert systems, instrument interfaces, total laboratory automation, telemicrobiology, automated image analysis, nucleic acid sequence databases, electronic reporting of infectious agents to public health agencies, and disease outbreak surveillance. The breadth and utility of informatics tools used in clinical microbiology have made them indispensable to contemporary clinical and laboratory practice. Continued advances in technology and development of these informatics tools will further improve patient and public health care in the future.

  18. Mindfulness and clinical psychology.

    Science.gov (United States)

    Childs, David

    2011-09-01

    Does mindfulness offer more to psychology than a useful therapeutic technique? This paper argues that it can also establish a state of presence which is understood in relation to the practice of phenomenology. Mindfulness is then both linked to a Western intellectual tradition and offers that tradition a systematic method. This is an opening for psychological investigation of the non-conceptual basis of everyday experience. The combination of this theoretical stance with the increasingly widespread practical training of clinical psychologists in mindfulness has broad implications for clinical practice; this is illustrated in relation to the descriptive approach to clinical problems, qualitative research, and reflective practice.

  19. Automation in Clinical Microbiology

    Science.gov (United States)

    Ledeboer, Nathan A.

    2013-01-01

    Historically, the trend toward automation in clinical pathology laboratories has largely bypassed the clinical microbiology laboratory. In this article, we review the historical impediments to automation in the microbiology laboratory and offer insight into the reasons why we believe that we are on the cusp of a dramatic change that will sweep a wave of automation into clinical microbiology laboratories. We review the currently available specimen-processing instruments as well as the total laboratory automation solutions. Lastly, we outline the types of studies that will need to be performed to fully assess the benefits of automation in microbiology laboratories. PMID:23515547

  20. [Midwifery clinical practicum education].

    Science.gov (United States)

    Kao, Chien-Huei; Gau, Meei-Ling

    2013-06-01

    Midwifery is a practical facet of the health sciences that emphasizes professional competence-oriented teaching and learning. Cognitive and practical processes integrate and build midwifery student professional knowledge, attitudes, and skills. Clinical education is a teaching method and strategy used to prepare midwifery students for professional practice. Midwifery clinical teaching plans are designed using literature review, expert opinions, and student comments and determine total required hours and caseloads. Midwifery clinical teaching activities and methods promote self-reflection, childbirth education fundamentals, learning by role model observation, and learning role function through overseas observership programs. This paper discusses midwifery education dilemmas and coping methods in Taiwan.

  1. Clinical Case Registries (CCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Clinical Case Registries (CCR) replaced the former Immunology Case Registry and the Hepatitis C Case Registry with local and national databases. The CCR:HIV and...

  2. Hepatitis C: Clinical Trials

    Science.gov (United States)

    ... and Public Home » Hepatitis C » Treatment Decisions Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... can I find out about participating in a hepatitis C clinical trial? Many trials are being conducted ...

  3. Clinical leadership project.

    Science.gov (United States)

    Kling, Vera G

    2010-11-01

    Nurse educators seek innovative strategies to maximize student learning in the classroom and clinical settings. Students enrolled in a nursing leadership and management course often find they spend more clinical time observing leaders than practicing the necessary skills to lead others in the provision of nursing care. In addition, opportunities to explore the nurse educator role often do not exist in baccalaureate nursing education, despite the shortage of nurse educators. An experience was developed in a baccalaureate nursing program to give senior students, under supervision of faculty, the opportunity to lead and evaluate lower-level students providing patient care in the clinical setting and to experience the role of nursing faculty. Feedback from senior students was positive, and students noted increased proficiency in leadership ability and critical thinking. Student interest in the nurse educator role was also enhanced. Program expansion and evaluation with faculty, clinical staff, and patients are planned.

  4. Fidelity in clinical simulation

    DEFF Research Database (Denmark)

    Jensen, Sanne; Nøhr, Christian; Rasmussen, Stine Loft

    2013-01-01

    Clinical simulation may be used to identify user needs for context sensitive functionalities in e-Health. The objective with this paper is to describe how user requirements and use cases in a large EHR-platform procurement may be validated by clinical simulation using a very low-fidelity prototype...... without any existing test data. Instead of using test scenarios and use cases, the healthcare professionals who are participating in the clinical simulation are generating both scenario and patient data themselves. We found that this approach allows for an imaginative discussion, not restricted by known...... functionalities and limitations, of the ideal EHR-platform. Subsequently, we discuss benefits and challenges of using an extremely low fidelity environment and discuss the degree of fidelity necessary for conducting clinical simulation....

  5. Clinical specular microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, L.W.; Laing, R.A.

    1987-01-01

    This book provides the general ophthalmologist with a guide to the clinical applications of specular microscopy. Important material is included on laser injury, cataract surgery, corneal transplants, glaucoma, uveitis, and trauma.

  6. Celiac disease: clinical observations

    Directory of Open Access Journals (Sweden)

    Yu. A. Emel’yanova

    2016-01-01

    Full Text Available Presented clinical cases of patients with a diagnosis of gluten enteropathy in treatment in the department of gastroenterology Regional Clinical Hospital. The case is of interest to doctors of different specialties for the differential diagnosis of anemia and malabsorption syndrome, demonstrate both the classic version, and atypical forms of the disease course. Diagnosis of celiac disease is based on three key positions: clinical findings, histology and serological markers. The clinical picture of celiac disease is characterized by pronounced polymorphism, by going beyond the a gastroenterological pathology. For screening of gluten sensitive celiac typically used an antibody to tissue transglutaminase. Morphological research of the mucous membrane of the small intestine is the determining criterion in the diagnosis of celiac disease. The use of specific gluten-free diet leads to the positive dynamics of the disease and improve the quality of life of patients.

  7. Health Clinic Cost Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — Healthcare Cost Report Information System (HCRIS) Dataset - Independent Rural Health Clinic and Freestanding Federally Qualified Health Center (HCLINIC).This data...

  8. Understanding Clinical Alarm Safety.

    Science.gov (United States)

    Lukasewicz, Carol L; Mattox, Elizabeth Andersson

    2015-08-01

    Patient safety organizations and health care accreditation agencies recognize the significance of clinical alarm hazards. The Association for the Advancement of Medical Instrumentation, a nonprofit organization focused on development and use of safe and effective medical equipment, identifies alarm management as a major issue for health care organizations. ECRI Institute, a nonprofit organization that researches approaches for improving patient safety and quality of care, identifies alarm hazards as the most significant of the "Top Ten Health Technology Hazards" for 2014. A new Joint Commission National Patient Safety Goal focusing on clinical alarm safety contains new requirements for accredited hospitals to be fully implemented by 2016. Through a fictional unfolding case study, this article reviews selected contributing factors to clinical alarm hazards present in inpatient, high-acuity settings. Understanding these factors improves contributions by nurses to clinical alarm safety practice.

  9. NIH Pediatric Rheumatology Clinic

    Science.gov (United States)

    ... to diagnose and treat children with arthritis, periodic fever syndromes, and rheumatic diseases. This clinic will also help doctors and ... are juvenile arthritis including spondyloarthritis, lupus, and periodic ... how juvenile rheumatic diseases affect them and what treatments work best. ...

  10. Alagille syndrome: clinical perspectives

    Directory of Open Access Journals (Sweden)

    Saleh M

    2016-06-01

    Full Text Available Maha Saleh,1 Binita M Kamath,2 David Chitayat1,3 1Division of Clinical and Metabolic Genetics, 2Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Hospital for Sick Children, 3Department of Obstetrics and Gynecology, Prenatal Diagnosis and Medical Genetics Program, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada Abstract: Alagille syndrome is an autosomal dominant, complex multisystem disorder characterized by the presence of three out of five major clinical criteria: cholestasis with bile duct paucity on liver biopsy, congenital cardiac defects (with particular involvement of the pulmonary arteries, posterior embryotoxon in the eye, characteristic facial features, and butterfly vertebrae. Renal and vascular abnormalities can also occur. Inter- and intrafamilial variabilities in the clinical manifestations are common. We reviewed the clinical features and management as well as the molecular basis of Alagille syndrome. Keywords: Alagille syndrome, ALGS, genetics, liver 

  11. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... a disease. A clinical trial may compare experimental products or tests to those already available or may ... Institutes of Health | U.S. Department of Health & Human Services Customer Support | Accessibility | Copyright | Privacy | Viewers and Players

  12. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    Kraus, V B; Blanco, F J; Englund, M

    2015-01-01

    The objective of this work was to describe requirements for inclusion of soluble biomarkers in osteoarthritis (OA) clinical trials and progress toward OA-related biomarker qualification. The Guidelines for Biomarkers Working Group, representing experts in the field of OA biomarker research from...... of reasons but in particular, to determine whether biomarkers are useful in identifying those individuals most likely to receive clinically important benefits from an intervention; and to determine whether biomarkers are useful for identifying individuals at earlier stages of OA in order to institute...... both academia and industry, convened to discuss issues related to soluble biomarkers and to make recommendations for their use in OA clinical trials based on current knowledge and anticipated benefits. This document summarizes current guidance on use of biomarkers in OA clinical trials...

  13. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... experimental drug, therapy, medical device, lifestyle change, or test will help treat, find, or prevent a disease. A clinical trial may compare experimental products or tests to those already available or may compare existing ...

  14. ClinicalTrials.gov

    Data.gov (United States)

    U.S. Department of Health & Human Services — Provides patients, family members, health care professionals, and members of the public easy access to information on clinical trials for a wide range of diseases...

  15. Falsificationism and clinical trials.

    Science.gov (United States)

    Senn, S J

    1991-11-01

    The relevance of the philosophy of Sir Karl Popper to the planning, conduct and analysis of clinical trials is examined. It is shown that blinding and randomization can only be regarded as valuable for the purpose of refuting universal hypotheses. The purpose of inclusion criteria is also examined. It is concluded that a misplaced belief in induction is responsible for many false notions regarding clinical trials.

  16. Clinical studies involving probiotics

    OpenAIRE

    Degnan, Fred H

    2012-01-01

    Researchers from a diverse array of scientific disciplines have focused and continue to focus on opportunities and areas for responsible clinical research involving the possible beneficial health effects of “probiotics.” Investigators and researchers should be aware that not all clinical research involving probiotics reasonably falls within the requirements of the “investigational new drug” (IND) rubric administered and enforced by the US Food and Drug Administration. In determining whether a...

  17. The clinical nanomedicine handbook

    CERN Document Server

    Brenner, Sara

    2013-01-01

    Designed to foster a stronger awareness and exploration of the subject by practicing clinicians, medical researchers and scientists, The Clinical Nanomedicine Handbook discusses the integration of nanotechnology, biology, and medicine from a clinical point of view. The book highlights relevant research and applications by specialty; it examines nanotechnology in depth, and the potential to solve medical problems. It also increases literacy in nanotechnology, and allows for more effective communication and collaboration between disciplines. Details worldwide developments in nanomedicine Provide

  18. Clinical Nursing Records Study

    Science.gov (United States)

    1991-08-01

    for Sam Houston, Texas MAJ Joanne Burton , AN, Clinical Head Nurse, Psychiatry MAJ Shelby Christian, AN, Clinical Head Nurse, OB/GYN MAJ Melissa Opio...Specify Level) Parenting, Potential Alteration In Decubitus Ulcer Self-Care Deficit, Total (Specify Level) Social Isolation Fluid Volume Deficit. Potential...METABOLIC PATTERN Self-Care Dieficit. Total (Specify Level) SiX alizaticni Alterations ifl Decubitus ulcer S-If-Batingrla.v~qene Oeticit 601?Cif Levet

  19. Clinical research: regulatory issues.

    Science.gov (United States)

    Wermeling, D P

    1999-02-01

    The regulatory issues faced by institutions performing clinical research are described. Many institutions do not have on staff an expert who understands the regulatory issues involved in managing investigational new drug research and who knows the institution's obligations under the federal rules. Because pharmacists understand the FDA regulations that apply to the management of drugs in clinical research, institutions are asking pharmacists to expand their role and manage clinical research offices. Many authorities govern various aspects of investigational drug research. FDA has published regulations for good clinical practice (GCP), and the International Conference on Harmonisation is developing an international standard for the proper management of clinical trials. The guidelines published by the Joint Commission on Accreditation of Healthcare Organizations aim to protect patients who are in the institution to receive health care and also participate in clinical trials. The Social Security Administration Acts specifically state that only items and services that are reasonable and necessary for the diagnosis and treatment of injury or disease can be billed to the government; research-related billings are excluded from coverage. Proper management of drug research is crucial to the success of a research program that is integrated with patient care.

  20. Fundamentals of clinical trials

    CERN Document Server

    Friedman, Lawrence M; DeMets, David L; Reboussin, David M; Granger, Christopher B

    2015-01-01

    This is the fifth edition of a very successful textbook on clinical trials methodology, written by recognized leaders who have long and extensive experience in all areas of clinical trials. The three authors of the first four editions have been joined by two others who add great expertise.  Most chapters have been revised considerably from the fourth edition.  A chapter on regulatory issues has been included and the chapter on data monitoring has been split into two and expanded.  Many contemporary clinical trial examples have been added.  There is much new material on adverse events, adherence, issues in analysis, electronic data, data sharing, and international trials.  This book is intended for the clinical researcher who is interested in designing a clinical trial and developing a protocol. It is also of value to researchers and practitioners who must critically evaluate the literature of published clinical trials and assess the merits of each trial and the implications for the care and treatment of ...

  1. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... about Children and Clinical Studies Importance of Children in Clinical Studies Children have often had to accept ... treatments based on what is known to work in adults. To improve clinical care of children, more ...

  2. Structured assessments of clinical competence.

    Science.gov (United States)

    Boursicot, Katharine A M

    2010-06-01

    Clinical teachers are often involved in assessing clinical competence in the workplace, in universities and colleges. Assessments commonly used to formally assess clinical competence include long and short cases and the objective structured clinical examination which, if well designed, is a fair and reliable method of assessing clinical competence.

  3. Análisis del ajuste marginal y el ajuste interno en sistemas CAD-CAM de óxido de circonio

    OpenAIRE

    Ortega Sánchez, Rocío

    2013-01-01

    El interés por la estética dental ha estado íntimamente ligado a la historia y evolución de la Prótesis Dental, pero es a finales del siglo XIX cuando se desarrollan como materiales restauradores las cerámicas, y a comienzos del siglo XX cuando se confecciona la primera corona de recubrimiento total cerámica. Las cerámicas convencionales tenían su indicación limitada a restauraciones unitarias en los sectores anteriores debido fundamentalmente a su limitada resistencia a la fractura,...

  4. Análisis del ajuste marginal y el ajuste interno en sistemas CAD-CAM de óxido de circonio

    OpenAIRE

    Ortega Sánchez, Rocío

    2012-01-01

    El interés por la estética dental ha estado íntimamente ligado a la historia y evolución de la Prótesis Dental, pero es a finales del siglo XIX cuando se desarrollan como materiales restauradores las cerámicas, y a comienzos del siglo XX cuando se confecciona la primera corona de recubrimiento total cerámica. Las cerámicas convencionales tenían su indicación limitada a restauraciones unitarias en los sectores anteriores debido fundamentalmente a su limitada resistencia a la fractura,...

  5. Clinical outcomes of the inclusion of the therapeutic drug monitoring report in the electronic clinical record.

    Science.gov (United States)

    Sáez Belló, Marina; Moya Gil, Ana; López Montenegro Soria, M Ángeles; Sánchez Sancho, Pablo; Frias Ruiz, Pau; Climente Martí, Mónica

    2016-09-01

    Objetivos: Valorar la integración del informe de monitorización farmacocinética (IMFC) en la historia clínica electrónica (HCE). Método: Estudio observacional ambispectivo de cohortes de 149 días de duración: PRE (retrospectiva, 49 días) con emisión del IMFC en papel y POST (prospectiva, 100 días) con emisión del IMFC integrado en HCE. Criterios de exclusión: Pacientes no ingresados, solicitudes de monitorización farmacocinética de unidades de críticos y neonatos, así como monitorizaciones cuyo objetivo no era el ajuste posológico.

  6. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application and comp......It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application...... and compliance with CPGs in most areas of clinical practice are deficient. Computerization of CPGs has been brought forward as a method to disseminate and to support application of CPGs. Until now, CPG-computerization has focused on development of formal expressions of CPGs. The developed systems have, however......, not gained any extensive application in clinical practice. The basic assumption in this thesis is that the scanty penetration is due to an inappropriate design process when designing computerized CPGs for clinical work practice. This thesis examines the application of guidance within areas where CPG...

  7. Danish clinical databases: An overview

    DEFF Research Database (Denmark)

    Green, Anders

    2011-01-01

    Clinical databases contain data related to diagnostic procedures, treatments and outcomes. In 2001, a scheme was introduced for the approval, supervision and support to clinical databases in Denmark....

  8. Transgressive first clinical experiences

    DEFF Research Database (Denmark)

    Jensen, Carsten Juul; Jeppesen, Lise Kofoed; Drachmann, Merete

    2014-01-01

    This Study seeks to comprehend learning experiences of nursing students during their first clinical in-service placement. This Paper is part of a longitudinal development project interviewing the Student Nurse after each one of the five clinical in-service placements and then one year after...... to advanced beginner, and adjusting to the workplace community. The conclusion is that the learning of nursing students during their first clinical in-service placement appears informal and not founded on evident best practice....... graduation as a Nurse. The Study has a qualitative methodology, inspired by Michael Eraut’s thoughts on learning in the workplace. When the workplace perspective is applied, learning seems to be concentrated on actual situations which the Learner is in, in contrast to employing constructed concepts...

  9. Pediatric anthrax clinical management.

    Science.gov (United States)

    Bradley, John S; Peacock, Georgina; Krug, Steven E; Bower, William A; Cohn, Amanda C; Meaney-Delman, Dana; Pavia, Andrew T

    2014-05-01

    Anthrax is a zoonotic disease caused by Bacillus anthracis, which has multiple routes of infection in humans, manifesting in different initial presentations of disease. Because B anthracis has the potential to be used as a biological weapon and can rapidly progress to systemic anthrax with high mortality in those who are exposed and untreated, clinical guidance that can be quickly implemented must be in place before any intentional release of the agent. This document provides clinical guidance for the prophylaxis and treatment of neonates, infants, children, adolescents, and young adults up to the age of 21 (referred to as "children") in the event of a deliberate B anthracis release and offers guidance in areas where the unique characteristics of children dictate a different clinical recommendation from adults.

  10. [Clinical variants of acne].

    Science.gov (United States)

    Jansen, T; Grabbe, S; Plewig, G

    2005-11-01

    Acne is a very common dermatosis with characteristic clinical features. It is a polymorphic disease. The clinical expression ranges from non-inflammatory closed and open comedones to inflammatory papules, pustules, and nodules. Most patients have a mixture of non-inflammatory and inflammatory lesions, although some have predominantly one or the other. Acne varies in severity from a very distressing, socially disabling disorder to a state that has been regarded as physiological by some authors. The most severe forms of acne are acne fulminans and acne inversa. Although acne may occur in all age groups, it is most prevalent during adolescence. It is not known why acne subsides in most patients but persists into adulthood in some. Certain medications may be associated with provocation, perpetuation, or exacerbation of pre-existing acne or with acneiform eruptions. Acne-like disorders include rosacea, pseudofolliculitis barbae, and other conditions that share clinical features with acne.

  11. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    . The analysis focuses on the emergence of general clinical work practice demands on guidance • An analysis of guidance demands from clinical work practice and business strategy, focusing on implications for the design of computerised CPGs. In my research, I have applied observation studies, interviews...... is comprised by fieldwork in three oncology departments and a case study of advanced life support. Although close to all patients within oncology are treated according to a CPG, I found limited application of physical CPGs and web-based CPG portals. However, I found comprehensive application of activity...... feasible • Designed in a way that provides room for local adaptations of guidance • Designed with focus on specific business strategic aims Further, based on my findings, I will suggest that design of computerized CPGs should be based on: 1) scrutinization of the clinical work practice, 2) articulation...

  12. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    McAlindon, T. E.; Driban, J. B.; Henrotin, Y.;

    2015-01-01

    The goal of this document is to update the original OARSI recommendations specifically for the design, conduct, and reporting of clinical trials that target symptom or structure modification among individuals with knee osteoarthritis (OA). To develop recommendations for the design, conduct...... and index knee, describing interventions, patient-reported and physical performance measures, structural outcome measures, biochemical biomarkers, and reporting recommendations. In summary, the working group identified 25 recommendations that represent the current best practices regarding clinical trials...... that target symptom or structure modification among individuals with knee OA. These updated recommendations incorporate novel technologies (e.g., magnetic resonance imaging (MRI)) and strategies to address the heterogeneity of knee OA....

  13. [Antidotes in clinical toxicology].

    Science.gov (United States)

    Hruby, K

    2013-09-01

    This overview describes antidotes, and their clinical pharmacology, that have an established significance in the currently practiced clinical toxicology because of their proven effectiveness in the treatment of serious poisonings. For the proper, efficient, and targeted use of an antidote, pharmacological knowledge is required, which is a central subject of this article. Current data from the literature are used as reference along with the accumulated experiences about possible adverse effects in order to include them in therapeutic considerations. The dosage of antidotes is the subject of several other review articles and is therefore not included in this synopsis.

  14. Clinical Evaluation of Tinnitus.

    Science.gov (United States)

    Hertzano, Ronna; Teplitzky, Taylor B; Eisenman, David J

    2016-05-01

    The clinical evaluation of patients with tinnitus differs based on whether the tinnitus is subjective or objective. Subjective tinnitus is usually associated with a hearing loss, and therefore, the clinical evaluation is focused on an otologic and audiologic evaluation with adjunct imaging/tests as necessary. Objective tinnitus is divided into perception of an abnormal somatosound or abnormal perception of a normal somatosound. The distinction between these categories is usually possible based on a history, physical examination, and audiogram, leading to directed imaging to identify the underlying abnormality.

  15. Toward transparent clinical policies.

    Science.gov (United States)

    Shiffman, Richard N; Marcuse, Edgar K; Moyer, Virginia A; Neuspiel, Daniel R; Hodgson, Elizabeth Susan; Glade, Gordon; Harbaugh, Norman; Miller, Marlene R; Sevilla, Xavier; Simpson, Lisa; Takata, Glenn

    2008-03-01

    Clinical policies of professional societies such as the American Academy of Pediatrics are valued highly, not only by clinicians who provide direct health care to children but also by many others who rely on the professional expertise of these organizations, including parents, employers, insurers, and legislators. The utility of a policy depends, in large part, on the degree to which its purpose and basis are clear to policy users, an attribute known as the policy's transparency. This statement describes the critical importance and special value of transparency in clinical policies, guidelines, and recommendations; helps identify obstacles to achieving transparency; and suggests several approaches to overcome these obstacles.

  16. Spreadsheets in Clinical Medicine

    CERN Document Server

    Croll, Grenville J

    2006-01-01

    There is overwhelming evidence that the continued and widespread use of untested spreadsheets in business gives rise to regular, significant and unexpected financial losses. Whilst this is worrying, it is perhaps a relatively minor concern compared with the risks arising from the use of poorly constructed and/or untested spreadsheets in medicine, a practice that is already occurring. This article is intended as a warning that the use of poorly constructed and/or untested spreadsheets in clinical medicine cannot be tolerated. It supports this warning by reporting on potentially serious weaknesses found while testing a limited number of publicly available clinical spreadsheets.

  17. Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions.

    Science.gov (United States)

    Hunter, Sharyn; Arthur, Carol

    2016-05-01

    Graduate nurses may have knowledge and adequate clinical psychomotor skills however they have been identified as lacking the clinical reasoning skills to deliver safe, effective care suggesting contemporary educational approaches do not always facilitate the development of nursing students' clinical reasoning. While nursing literature explicates the concept of clinical reasoning and develops models that demonstrate clinical reasoning, there is very little published about nursing students and clinical reasoning during clinical placements. Semi-structured interviews were conducted with ten clinical educators to gain an understanding of how they recognised, developed and appraised nursing students' clinical reasoning while on clinical placement. This study found variability in the clinical educators' conceptualisation, recognition, and facilitation of students' clinical reasoning. Although most of the clinical educators conceptualised clinical reasoning as a process those who did not demonstrated the greatest variability in the recognition and facilitation of students' clinical reasoning. The clinical educators in this study also described being unable to adequately appraise a student's clinical reasoning during clinical placement with the use of the current performance assessment tool.

  18. CME ON CLINICAL RESEARCH

    Directory of Open Access Journals (Sweden)

    Suneel. I. Majagi

    2012-06-01

    Full Text Available Safety and efficacy are the two major concerns for any drug therapy. Globally clinical research plays an inevitable role in bringing a new molecule into the market after its synthesis by the pharmaceutical industries. Availability of large patient population, highly educated and skilled manpower, wide spectrum of diseases and favorable economic environment imply India’s potential as a global hub for clinical research. Pharmaceutical companies and Clinical Research Organization (CROs will require many trained personnel to carry out the clinical research. Keeping in mind these facts a CME with the theme of “Clinical research” had been jointly organized by the Dept of pharmacology, K.L.E University’s J.N.M.C, Belgaum and Indian Pharmacological Society (I.P.S, Belgaum branch on 20th February 2010. In the first scientific session, Dr.P.A.Patil (JNMC spoke on “Preclinical studies”. In vitro and in vivo experiments of various doses of ‘study drug’ can obtain preliminary efficacy, toxicity and pharmacokinetic information suggesting the scientific merit for further development as an investigational new drug (IND. Local or systemic toxicity studies can be conducted (ex: urine analysis, blood biochemical assay, gross and microscopic pathology etc. Dr. B.J. Mahendra Kumar (KLE University’s College of pharmacy talked on “Role of Drug Controller General of India (DCGI in Clinical Trials”. He explained about Drug and cosmetic acts/rules, requirements/guidelines for permission to import and/or to manufacture new drugs or to undertake clinical trials i.e. Schedule Y and its appendices. Dr.N.M.Patil (JNMC elaborated about “Ethical issues in clinical trials”. Ethics is required to: avoid exploitation of the subjects (maintain safety and wellbeing, protect vulnerable groups, children, disabled, elderly etc. Independent Ethics Committees (IEC and Institutional Review Boards (IRB are concerned with medical ethics. IECs review, regulate

  19. Clinical guidelines, clinical pathways and protocols of care

    OpenAIRE

    Angélica Román

    2012-01-01

    The article points out that the importance of standardization of clinical practices has been established in clinical management, which helps solve the problems of variability by developing documents based on the available scientific evidence. The article claims that healthcare culture has increasingly recognized the importance of standardization of clinical practices and provides a conceptual difference between clinical practice guidelines, protocols and algorithms. Clinical pathways and clin...

  20. Prolactinomas : clinical studies

    NARCIS (Netherlands)

    Kars, Marleen

    2008-01-01

    Prolactinoma are treated with dopamine agonists, which are effective in reducing prolactin and tumor size. Studies reporting clinical and radiological outcome are scarce. The study described in chapter 2, assesses long-term outcome in patients treated with dopamine agonists for macroprolactinoma. An

  1. Clinical Mastery of Hypnosis.

    Science.gov (United States)

    Horevitz, Richard P.

    Hypnosis is an increasingly popular clinical intervention. The number of training courses in hypnosis is growing each year. Research on hypnosis training appears to show that limited exposure to training, as is typical in the common 3 to 5 day format of mass training, produces limited results. Only when training is extended over time do the…

  2. Assessment of Clinical Competence.

    Science.gov (United States)

    Newble, David I.

    1979-01-01

    Reviews current approaches to the examination of medical students' clinical competence, mentioning differences in approaches adopted in Australia, Great Britain, and North America. Test methods used in examination are discussed critically and their separate strengths and weaknesses are highlighted. Newer approaches involving multiple methods and…

  3. Validating clinical competence.

    Science.gov (United States)

    Chappell, Kathy; Koithan, Mary

    2012-07-01

    Professional registered nurses must be competent to provide care in today's fast-paced, highly technical clinical environment. Competency programs designed to teach and evaluate essential knowledge, skills, and abilities of registered nurses are one method organizations may use to demonstrate nursing proficiency.

  4. Evaluation of Clinical Competence.

    Science.gov (United States)

    Newble, David I.

    In Australia the usual evaluation of whether a student will perform adequately as a doctor is a subjective evaluation of his clinical performance, usually at the completion of five or six years at medical school. The evaluation is performed on an inadequate and uncontrolled patient sample and appears to be subject to many errors. Recent work…

  5. Clinical Positioning Space

    DEFF Research Database (Denmark)

    Williams, Lars Peter Hedegaard; Christensen, Mette Krogh; Rytter, Carsten

    2014-01-01

    In this article, we present a case study of residents’ clinical experiences and communication in outpatient oncology consultations. We apply positioning theory, a dynamic alternative to role theory, to investigate how oncology residents and patients situate themselves as persons with rights and d...

  6. Hepatitis C: Clinical Trials

    Science.gov (United States)

    ... will not know if you are taking the medicine or the placebo until the clinical trial is over. How do ... can already get by prescription ) or sugar pills ( placebos ) with the new medicine may last longer than Phases I and II ...

  7. The Unstructured Clinical Interview

    Science.gov (United States)

    Jones, Karyn Dayle

    2010-01-01

    In mental health, family, and community counseling settings, master's-level counselors engage in unstructured clinical interviewing to develop diagnoses based on the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.; "DSM-IV-TR"; American Psychiatric Association, 2000). Although counselors receive education about…

  8. Participating in Clinical Trials

    Medline Plus

    Full Text Available skip navigation Help Search home health topics A-Z Videos A-Z about us Customer Support NIH SeniorHealth Built with You in Mind Resize Text: A A A Change Contrast print sign up Share Home > Health topics A-Z > Participating in Clinical Trials: About ...

  9. Clinical Process Intelligence

    DEFF Research Database (Denmark)

    Vilstrup Pedersen, Klaus

    2006-01-01

    .e. local guidelines. From a knowledge management point of view, this externalization of generalized processes, gives the opportunity to learn from, evaluate and optimize the processes. "Clinical Process Intelligence" (CPI), will denote the goal of getting generalized insight into patient centered health...

  10. [Management in clinical nutrition].

    Science.gov (United States)

    Alvarez, J; Monereo, S; Ortiz, P; Salido, C

    2004-01-01

    Terms such as management, costs, efficacy, efficiency, etc. that are so common in the discourse of managers are now beginning to appear in the vocabulary of clinicians. Management in Clinical Nutrition is an innovative aspect of interest among health-care professionals dealing with the needs of undernourished patients or those at risk of malnutrition. The basic goal of this paper is to show that the tools for clinical management of hospitals are applicable to such a multidisciplinary and complex speciality as clinical nutrition and also to propose the measures needed to improve our information systems and optimize management in this field. The very concept of hospitals has changed, as has their activity, over the years. Hospitals are nowadays no longer just a charitable institution but has become a service company, a public utility for the promotion of good health and they have to be managed in accordance with criteria of efficacy, efficiency, equity and quality. The concepts of Evidence-Based Medicine (EBM) and Cost-Effective Medicine (CEM) are of evident importance in the different ways of managing health-care services. Good clinical practice is the combination of EBM and CEM. This review defines the various cost studies of fundamental importance when taking decisions in hospital management and analyzes such clinical management tools as analytical accounting, Minimum Hospital Database Set (MHDS) and encoding systems, among others, thus facilitating an analysis of the usefulness of data in clinical nutrition management systems. Finally, after reviewing some specific examples, measures are proposed to optimize current information systems. The medical staff and those of us responsible for Nutrition Units operate in hospitals as part of a centralized service transferring information to the various departments where the patient is physically located (Surgery, Internal Medicine, Digestive, ICU, etc.). One of the priority goals in micro-management and middle management

  11. Computers and clinical arrhythmias.

    Science.gov (United States)

    Knoebel, S B; Lovelace, D E

    1983-02-01

    Cardiac arrhythmias are ubiquitous in normal and abnormal hearts. These disorders may be life-threatening or benign, symptomatic or unrecognized. Arrhythmias may be the precursor of sudden death, a cause or effect of cardiac failure, a clinical reflection of acute or chronic disorders, or a manifestation of extracardiac conditions. Progress is being made toward unraveling the diagnostic and therapeutic problems involved in arrhythmogenesis. Many of the advances would not be possible, however, without the availability of computer technology. To preserve the proper balance and purposeful progression of computer usage, engineers and physicians have been exhorted not to work independently in this field. Both should learn some of the other's trade. The two disciplines need to come together to solve important problems with computers in cardiology. The intent of this article was to acquaint the practicing cardiologist with some of the extant and envisioned computer applications and some of the problems with both. We conclude that computer-based database management systems are necessary for sorting out the clinical factors of relevance for arrhythmogenesis, but computer database management systems are beset with problems that will require sophisticated solutions. The technology for detecting arrhythmias on routine electrocardiograms is quite good but human over-reading is still required, and the rationale for computer application in this setting is questionable. Systems for qualitative, continuous monitoring and review of extended time ECG recordings are adequate with proper noise rejection algorithms and editing capabilities. The systems are limited presently for clinical application to the recognition of ectopic rhythms and significant pauses. Attention should now be turned to the clinical goals for detection and quantification of arrhythmias. We should be asking the following questions: How quantitative do systems need to be? Are computers required for the detection of

  12. Clinical physiopathology of hypernatremia

    Directory of Open Access Journals (Sweden)

    F. Sgambato

    2013-05-01

    Full Text Available BACKGROUND The maintenance of sodium levels at normal ranges has to be considered one of the most important and crucial physiological balance in order to preserve life. The increase of natremia determines the leakage of H2O from the inside of cells and the consequent brain cells withering, that causes encephalopathy at different stages and in some cases it can even lead to death. AIM OF THE STUDY The fundamentals of general physiopathology are analysed together with systems of compensation and brain adaptation in the three different aetiopathogenetic forms: primary increase of sodium (hypervolemic and haedematose form; missed introduction of pure water (mainly euvolemic form, with no aedema; loss of hypotonic fluids (hypovolemic form with dehydration. The three different clinical entities with their relative clinical approaches have been described.

  13. Clinical Supervision in Denmark

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard

    2011-01-01

    Aim: Supervision is a vital factor in the professional development of psychotherapists, and was rated by novice therapists as the most important factor in their own current development (Orlinsky & Rønnestad, 2005). Paradoxically, the standard version of the Development of Psychotherapists Common...... Core Questionnaire (DPCCQ) has only few questions on supervision. To rectify this limitation, a recent Danish version of the DPCCQ included two new sections on supervision, one focusing on supervisees and another on supervisors and their supervisory training. This paper presents our initial findings...... on giving and receiving clinical supervision as reported by therapists in Denmark. Method: Currently, the Danish sample consists of 350 clinical psychologist doing psychotherapy who completed DPCCQ. Data are currently being prepared for statistical analysis. Results: This paper will focus primarily...

  14. [Clinical diagnosis of dyslexia].

    Science.gov (United States)

    Martínez Hermosillo, A; Balderas Gil, A

    1980-01-01

    In 5 years of experience at the Instituto Nacional de la Comunicacion Humana, 302 clinical histories showed the diagnosis of dyslexia. The following parameters were studied: age, sex, heredofamilial history, gestation, psychomotor development, clinical picture, examination of the language (type, reading, spontaneous writing, dictation, mathematic concepts), laterality, scholarship, scholar failures, psychological study. The following results were obtained: Dyslexia was more important or frequent between 5 to 8.9 years of age. Males predominated 3:1. The heredofamilial history was important. Dyslexia prevailed in products of the first gestations. A high disturbance was found in the psychomotor development of a large percent of dyslexic patients. Examination of language was also important. Dyslexia was more frequent in right-handed patients. Scholar failures in one or more instances were found. The psychological study must be done. If dyslexia is diagnosed on time, it may be prevented and all unwanted sequelae may be avoided.

  15. Clinical Applications for Estetrol

    Directory of Open Access Journals (Sweden)

    Visser M

    2010-01-01

    Full Text Available In this paper the potential clinical applications for the human fetal estrogen estetrol (E4 are presented based on recently obtained data in preclinical and clinical studies. In the past E4 has been classified as a weak estrogen due to its rather low estrogen receptor affinity. However, recent research has demonstrated that due to its favorable pharmacokinetic properties, especially the slow elimination and long half-life, E4 is an effective orally bioavailable estrogen agonist with estrogen antagonistic effects on the breast in the presence of estradiol. Based on the pharmacokinetic properties, the pharmacological profile and the safety and efficacy results in human studies, E4 seems potentially suitable as a drug for human use in applications such as hormone replacement therapy (vaginal atrophy and vasomotor symptoms, contraception, osteoporosis and breast cancer.

  16. Mosaicism and clinical genetics.

    Science.gov (United States)

    Spinner, Nancy B; Conlin, Laura K

    2014-12-01

    With the introduction of increasingly sensitive technologies for mutation detection such as chromosomal microarrays and next-generation sequencing, the importance of mosaicism for human disease is being more fully appreciated. Mosaicism can occur for any type of mutation, either at the chromosomal or DNA sequence level, and while in many cases mosaicism can modify the clinical effects of a syndrome, there are many alterations that can only occur in mosaic form as the mutation is lethal when present in every cell. Mosaicism can have a wide range of effects, from early pregnancy loss, to organ specific pathology, to modification of clinical syndromes. Recent evidence reveals that generation of mosaic alterations is associated with aging, and our ability to detect mosaic alterations sheds light on normal and pathologic changes across the lifespan.

  17. [Clinically documented fungal infections].

    Science.gov (United States)

    Kakeya, Hiroshi; Kohno, Shigeru

    2008-12-01

    Proven fungal infections are diagnosed by histological/microbiological evidence of fungi at the site of infection and positive blood culture (fungemia). However, invasive diagnosing examinations are not always applied for all of immunocompromised patients. Clinically documented invasive fungal infections are diagnosed by typical radiological findings such as halo sign on chest CT plus positive serological/molecular evidence of fungi. Serological tests of Aspergillus galactomannan antigen and beta-glucan for aspergillosis and cryptococcal glucuronoxylomannan antigen for cryptococcosis are useful. Hence, none of reliable serological tests for zygomycosis are available so far. In this article, risk factors, sign and symptoms, and diagnostic methods for clinically documented cases of invasive aspergillosis, pulmonary cryptococcosis, and zygomycosis with diabates, are reviewed.

  18. Evidence and clinical judgement.

    Science.gov (United States)

    Macnaughton, R J

    1998-05-01

    Widespread acceptance of the neologism 'evidence-based medicine' (EBM) has had the consequences of obscuring what evidence really is, and of eroding the importance of judgement in clinical situations. In this essay I seek to correct this lack of balance in the view of clinical encounters as portrayed by EBM. A better understanding of what evidence is can be obtained by looking beyond medicine to the way in which scientists and detectives view evidence. In both spheres, the importance of judgement is emphasized, even if it is a technical type of judgement. Clinicians also employ a technical kind of judgement, similar to that in science and detective work, when assessing the evidence relating to the truth of a diagnosis for an individual patient; but judgements relating to the ongoing care and treatment of that patient are based on what Aristotle calls phronesis or 'practical wisdom'.

  19. [Neuroethics in clinical practice].

    Science.gov (United States)

    Krug, H

    2009-08-01

    In recent years the ability of neuroscience to identify and intervene in mental functions has progressed immensely, which raises several anthropologic and ethical questions. Meanwhile neuroethics arose as a new interdisciplinary field for critical analysis of neuroscientific actions and ethical reflection on the increasing knowledge of the human brain, with regard to society and politics. This article provides a survey of neuroethical implications for clinical practice.

  20. Horizons in clinical nanomedicine

    CERN Document Server

    Karagkiozaki, Varvara

    2014-01-01

    Nanomedicine-the application of nanotechnology to health sciences-has the potential to address many important medical problems by exploiting the advanced physicochemical characteristics of nanostructured materials and devices. It can revolutionize conventional medicine by offering cutting-edge developments in the processes of diagnosing, treating, and preventing diseases, injuries, or genetic disorders. Thus, clinical nanomedicine holds promise to preserve and improve human health.This book provides a comprehensive overview on the forefront developments of nanotechnology in various domains of

  1. Tianeptine - A Clinical Review.

    OpenAIRE

    More Patil Vidita; More Patil Vrunda; Yadav KS; Gomes M

    2016-01-01

    Depression is a wide spread disorder. The development of effective pharmacotherapy for major depression is important because it is such a widespread and debilitating mental disorder. The following review is based on the preclinical and clinical studies carried out on Tianeptine, an atypical antidepressant that lowers the adverse effects of stress on brain and memory. It is one of the many drugs being tested these days in the market as nootropics; it is presented as a “Smart Drug”. These are b...

  2. [Clinical spectrum of neuroborreliosis].

    Science.gov (United States)

    Owecki, Michał K; Kozubski, Wojciech

    2007-01-01

    Lyme disease is a multisystem infectious disease with a wide variety of symptoms involving the skin as well as nervous, musculosceletal and cardiovascular systems. Lyme disease is caused by spirochaete Borrelia burgdorferi transmitted by Ixodes tics in endemic regions. The diverse manifestations of neuroborreliosis require it to be included in differential diagnosis of many neurological disorders. The paper reviews the spectrum of clinical symptoms of nervous system involvement in early and late Lyme disease.

  3. [Guidelines for clinical practice].

    Science.gov (United States)

    Vleugels, A M

    1997-01-01

    Clinical practice guidelines are systematically developed statements that are intended to support medical decision making in well-defined clinical situations. Essentially, their object is to reduce the variability in medical practice, to improve quality, and to make appropriated control of the financial resources possible. Internationally, ever more organisations, associations, and institutions are concerned with the development of guidelines in many different areas of care. Making implicit knowledge explicit is one of the associated advantages of guidelines: they have a potential utility in training, in process evaluation, and in the reevaluation of outcome studies. In liability issues, their existence has a double effect: they can be used to justify medical behaviour, and they constitute a generally accepted reference point. A derivative problem is the legal liability of the compilers of the guidelines. The principle of the guideline approach can be challenged academically: science cannot give a definition of optimal care with absolute certainty. What is called objectivity often rests on methodologically disputable analyses; also the opinion of opinion leaders is not always a guarantee for scientific soundness. Moreover, patients are not all identical: biological variability, situational factors, patient expectations, and other elements play a role in this differentiation. Clinicians are often hesitant with respect to clinical guidelines: they are afraid of cookbook medicine and curtailment of their professional autonomy. Patients fear reduction of individualization of care and the use of guidelines as a rationing instrument. The effects of the introduction of clinical practice guidelines on medical practice, on the results and on the cost of care vary but are generally considered to be favourable. The choice of appropriate strategies in development, dissemination, and implementation turns out to be of critical importance. The article ends with concrete

  4. Clinical versus actuarial judgment.

    Science.gov (United States)

    Dawes, R M; Faust, D; Meehl, P E

    1989-03-31

    Professionals are frequently consulted to diagnose and predict human behavior; optimal treatment and planning often hinge on the consultant's judgmental accuracy. The consultant may rely on one of two contrasting approaches to decision-making--the clinical and actuarial methods. Research comparing these two approaches shows the actuarial method to be superior. Factors underlying the greater accuracy of actuarial methods, sources of resistance to the scientific findings, and the benefits of increased reliance on actuarial approaches are discussed.

  5. Clinical highlights from Amsterdam

    Directory of Open Access Journals (Sweden)

    Jouke T. Annema

    2016-07-01

    Full Text Available This article contains highlights and a selection of the scientific advances from the Clinical Assembly that were presented at the 2015 European Respiratory Society International Congress in Amsterdam, the Netherlands. The most relevant topics for clinicians will be discussed, covering a wide range of areas including interventional pulmonology, rehabilitation and chronic care, thoracic imaging, diffuse and parenchymal lung diseases, and general practice and primary care. In this comprehensive review, exciting novel data will be discussed and put into perspective.

  6. Psychiatrists and clinical psychologists

    Directory of Open Access Journals (Sweden)

    Ajai R. Singh

    2006-03-01

    Full Text Available Psychiatrists and clinical psychologists share an inevitable, if rather uneasy, relationship. So very much like a modern marriage. Can't do without it, can't get out of it. Both sides contemplate divorce often. Think of separation by mutual consent. Even keep threatening as they rave and rant. Have secret, and not so secret, flings on the side. But, like the proverbial homing bird, or the conservative Indian arranged marriage, have no option but to stick it out with each other. Psychiatrists are otherwise good people. But that does not make them immune to handling clinical psychologists with the condescending tolerance and patronizing acceptance that teachers, for example, have towards rambling students. Or the rich have towards the poor. This does not take long to get converted into exasperation and smirky asides in the less charitable amongst the psychiatrists. Not that clinical psychologists are very helpful in motivating the psychiatrists to change for the better. For they, like most people in their position, over react and get aggressive when confronted with this attitude. And understandably so. However, it is time both realized their attitudes were not helpful either for mutual interaction, or growth of the Mental Health Movement at large. We can understand why psychiatrists behave the way they do. They are exposed to this same condescending-patronising attitude from their own peers in the medical profession. Their medical colleagues have yet to develop a feeling of healthy respect for psychiatry. Psychiatrists, no doubt, feel this is unjustified, but their peers are still in a position to deny them the respect and acceptance they seek. What they get from their medical colleagues, they unwittingly pass on to their clinical psychologist colleagues. But understanding why it occurs does not absolve them of their responsibility to behave more rationally, rather than emotionally, with the latter. [No abstract available.

  7. Rural health clinics infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Olson, K.

    1997-12-01

    The author discusses programs which were directed at the installation of photovoltaic power systems in rural health clinics. The objectives included: vaccine refrigeration; ice pack freezing; lighting; communications; medical appliances; sterilization; water purification; and income generation. The paper discusses two case histories, one in the Dominican Republic and one in Colombia. The author summarizes the results of the programs, both successes and failures, and offers an array of conclusions with regard to the implementation of future programs of this general nature.

  8. Clinical multiphoton FLIM tomography

    Science.gov (United States)

    König, Karsten

    2012-03-01

    This paper gives an overview on current clinical high resolution multiphoton fluorescence lifetime imaging in volunteers and patients. Fluorescence lifetime imaging (FLIM) in Life Sciences was introduced in Jena/Germany in 1988/89 based on a ZEISS confocal picosecond dye laser scanning microscope equipped with a single photon counting unit. The porphyrin distribution in living cells and living tumor-bearing mice was studied with high spatial, temporal, and spectral resolution. Ten years later, time-gated cameras were employed to detect dental caries in volunteers based on one-photon excitation of autofluorescent bacteria with long fluorescence lifetimes. Nowadays, one-photon FLIM based on picosecond VIS laser diodes are used to study ocular diseases in humans. Already one decade ago, first clinical twophoton FLIM images in humans were taken with the certified clinical multiphoton femtosecond laser tomograph DermaInspectTM. Multiphoton tomographs with FLIM modules are now operating in hospitals at Brisbane, Tokyo, Berlin, Paris, London, Modena and other European cities. Multiple FLIM detectors allow spectral FLIM with a temporal resolution down to 20 ps (MCP) / 250 ps (PMT) and a spectral resolution of 10 nm. Major FLIM applications include the detection of intradermal sunscreen and tattoo nanoparticles, the detection of different melanin types, the early diagnosis of dermatitis and malignant melanoma, as well as the measurement of therapeutic effects in pateints suffering from dermatitis. So far, more than 1,000 patients and volunteers have been investigated with the clinical multiphoton FLIM tomographs DermaInspectTM and MPTflexTM.

  9. Myocarditis in Clinical Practice.

    Science.gov (United States)

    Sinagra, Gianfranco; Anzini, Marco; Pereira, Naveen L; Bussani, Rossana; Finocchiaro, Gherardo; Bartunek, Jozef; Merlo, Marco

    2016-09-01

    Myocarditis is a polymorphic disease characterized by great variability in clinical presentation and evolution. Patients presenting with severe left ventricular dysfunction and life-threatening arrhythmias represent a demanding challenge for the clinician. Modern techniques of cardiovascular imaging and the exhaustive molecular evaluation of the myocardium with endomyocardial biopsy have provided valuable insight into the pathophysiology of this disease, and several clinical registries have unraveled the disease's long-term evolution and prognosis. However, uncertainties persist in crucial practical issues in the management of patients. This article critically reviews current information for evidence-based management, offering a rational and practical approach to patients with myocarditis. For this review, we searched the PubMed and MEDLINE databases for articles published from January 1, 1980, through December 31, 2015, using the following terms: myocarditis, inflammatory cardiomyopathy, and endomyocardial biopsy. Articles were selected for inclusion if they represented primary data or were review articles published in high-impact journals. In particular, a risk-oriented approach is proposed. The different patterns of presentation of myocarditis are classified as low-, intermediate-, and high-risk syndromes according to the most recent evidence on prognosis, clinical findings, and both invasive and noninvasive testing, and appropriate management strategies are proposed for each risk class.

  10. Gateways to clinical trials.

    Science.gov (United States)

    Bayés, M; Rabasseda, X; Prous, J R

    2007-01-01

    Gateways to Clinical Trials are a guide to the most recent clinical trials in current literature and congresses. The data the following tables have been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issues focuses on the following selection of drugs: 4'-Thio-ara-C, 5-methyltetrahydrofolate; ABT-089, AD-237, AF-37702, alvocidib hydrochloride, apricitabine, armodafinil, atrasentan, AVE-5883, avian influenza vaccine, azimilide hydrochloride; Banoxantrone, BIBF-1120; CD34+ cells, certolizumab pegol, CHIR-258, cilansetron, CoFactor, CX-3543, cystemustine; D-003, dexloxiglumide, DMXB-anabaseine; Ecogramostim, elcometrine, elcometrine/ethinylestradiol, etravirine; Fenretinide, fingolimod hydrochloride, fospropofol disodium; Gaboxadol, gestodene, glutamine; Human insulin, hyaluronic acid; Incyclinide, indacaterol, ispronicline, istradefylline; Labradimil, lamifiban, lapatinib, L-arginine hydrochloride, liposomal cisplatin, liposome encapsulated paclitaxel, LY-517717; Manidipine hydrochloride/delapril hydrochloride, maraviroc, MBP(82-98), MD-0727, MDX-214, melanotan I, MMR vaccine; Nacystelyn, nalfurafine hydrochloride, nibentan, nilotinib, NK-105; OBI-1, oblimersen sodium, olmesartan medoxomil, olmesartan medoxomil/hydrochlorothiazide, oregovomab; Pexelizumab, PG-116800, PG-CPT, PHA-794428, prasugrel; RC-3095, rDNA insulin, RFB4(dsFv)-PE38, rhEndostatin, rhenium Re-186 etidronate, rhGM-CSF, roflumilast, romidepsin; Sarcosine, SGLU1, SGN-40, succinobucol; TAU, teduglutide, telatinib, tesofensine, tipifarnib, tirapazamine, TKA-731, tolvaptan, trabectedin; Vaccimel, vatalanib succinate, velafermin, vildagliptin, vinflunine; XP-19986; YM-155.

  11. Neurosurgery and clinical engineering.

    Science.gov (United States)

    Salcman, M; Samaras, G M

    1978-01-01

    Modern technology has profoundly altered the clinical practice of neurosurgery. For a wide variety of conditions, patients are being implanted with active and passive devices or treated with advanced microsurgical instrumentation. After surgery, such patients are sent to modern intensive-care units employing the latest advances in patient monitoring and computer technology. We contend that the responsibilities of the Clinical Engineer extend beyond simple installation and maintenance of equipment and systems. It is essential that he take part in the continuing education of non-technical personnel who must make use of the equipment in ways that are meaningful in the care of the patient and to the progress of clinical science. This point is illustrated by our experience with a neurosurgical intensive-care unit. It is also the thesis of this paper that the design and maintenance of increasingly sophisticated biomedical systems will benefit from the use of an interdisciplinary approach at the very inception of a project. This approach is illustrated by our current development of a multibeam microwave hyperthermia system for possible use in the treatment of brain tumors.

  12. Basic and clinical immunology

    Science.gov (United States)

    Chinen, Javier; Shearer, William T.

    2003-01-01

    Progress in immunology continues to grow exponentially every year. New applications of this knowledge are being developed for a broad range of clinical conditions. Conversely, the study of primary and secondary immunodeficiencies is helping to elucidate the intricate mechanisms of the immune system. We have selected a few of the most significant contributions to the fields of basic and clinical immunology published between October 2001 and October 2002. Our choice of topics in basic immunology included the description of T-bet as a determinant factor for T(H)1 differentiation, the role of the activation-induced cytosine deaminase gene in B-cell development, the characterization of CD4(+)CD25(+) regulatory T cells, and the use of dynamic imaging to study MHC class II transport and T-cell and dendritic cell membrane interactions. Articles related to clinical immunology that were selected for review include the description of immunodeficiency caused by caspase 8 deficiency; a case series report on X-linked agammaglobulinemia; the mechanism of action, efficacy, and complications of intravenous immunoglobulin; mechanisms of autoimmunity diseases; and advances in HIV pathogenesis and vaccine development. We also reviewed two articles that explore the possible alterations of the immune system caused by spaceflights, a new field with increasing importance as human space expeditions become a reality in the 21st century.

  13. STRUCTURED CLINICAL EVALUATION

    Directory of Open Access Journals (Sweden)

    Arabela Maria Barbosa Sampaio

    2014-05-01

    Full Text Available In a world experiencing profound technological and socio-political changes in areas of knowledge and capacity, healthcare can not remain static. A new kind of professional is required, whose practice is based on ethics, scientific standards, integrity, citizenship, and health promotion, who develops skills beyond healthcare, such as decision making, communication,leadership, management, and continuing education. No single method can assess all of these elements (knowledge, skills, and attitudes, and only a combination of methods is able to produce a valid evaluation. An alternative method exists: structured clinical assessments based on observation of "to do, or how to do" that aim to complete this evaluation by focusing attention on the performance of specific skills. In order to broaden the scope of evaluation methods that have been used in health education, this article, a literature review, intends to offer readers an overview of the diverse types of structured clinical evaluation, emphasizing Objective Structured Clinical Examination, the most widely used in Brazil, with a goal of advancing opportunities for health professionals to make use of this evaluative tool.

  14. Biomarkers in clinical medicine.

    Science.gov (United States)

    Chen, Xiao-He; Huang, Shuwen; Kerr, David

    2011-01-01

    Biomarkers have been used in clinical medicine for decades. With the rise of genomics and other advances in molecular biology, biomarker studies have entered a whole new era and hold promise for early diagnosis and effective treatment of many diseases. A biomarker is a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes or pharmacologic responses to a therapeutic intervention (1). They can be classified into five categories based on their application in different disease stages: 1) antecedent biomarkers to identify the risk of developing an illness, 2) screening biomarkers to screen for subclinical disease, 3) diagnostic biomarkers to recognize overt disease, 4) staging biomarkers to categorise disease severity, and 5) prognostic biomarkers to predict future disease course, including recurrence, response to therapy, and monitoring efficacy of therapy (1). Biomarkers can indicate a variety of health or disease characteristics, including the level or type of exposure to an environmental factor, genetic susceptibility, genetic responses to environmental exposures, markers of subclinical or clinical disease, or indicators of response to therapy. This chapter will focus on how these biomarkers have been used in preventive medicine, diagnostics, therapeutics and prognostics, as well as public health and their current status in clinical practice.

  15. The IMPACT clinic

    Science.gov (United States)

    Tracy, C. Shawn; Bell, Stephanie H.; Nickell, Leslie A.; Charles, Jocelyn; Upshur, Ross E.G.

    2013-01-01

    Abstract Problem addressed The growing number of elderly patients with multiple chronic conditions presents an urgent challenge in primary care. Current practice models are not well suited to addressing the complex health care needs of this patient population. Objective of program The primary objective of the IMPACT (Interprofessional Model of Practice for Aging and Complex Treatments) clinic was to design and evaluate a new interprofessional model of care for community-dwelling seniors with complex health care needs. A secondary objective was to explore the potential of this new model as an interprofessional training opportunity. Program description The IMPACT clinic is an innovative new model of interprofessional primary care for elderly patients with complex health care needs. The comprehensive team comprises family physicians, a community nurse, a pharmacist, a physiotherapist, an occupational therapist, a dietitian, and a community social worker. The model is designed to accommodate trainees from each discipline. Patient appointments are 1.5 to 2 hours in length, during which time a diverse range of medical, functional, and psychosocial issues are investigated by the full interprofessional team. Conclusion The IMPACT model is congruent with ongoing policy initiatives in primary care reform and enhanced community-based care for seniors. The clinic has been pilot-tested in 1 family practice unit and modeled at 3 other sites with positive feedback from patients and families, clinicians, and trainees. Evaluation data indicate that interprofessional primary care models hold great promise for the growing challenge of managing complex chronic disease. PMID:23486816

  16. Ageism and clinical research.

    Science.gov (United States)

    Briggs, R; Robinson, S; O'Neill, D

    2012-10-01

    Despite being the most significant consumers of health care resources and medications worldwide, recent international research has highlighted the under-representation of older participants from clinical trials. This creates problems for physicians as the patients seen in clinical practice are not representative of those on which medical treatments and interventions have been trialled, and we need to consider whether results (both negative and positive) from these trials are applicable to these patients. Our aim was to gauge whether exclusion of older people was prevalent in research proposals submitted to Dublin teaching hospitals. We audited all clinical research proposals submitted to the Research Ethics committee (REC) covering the teaching hospitals attached to Trinity College Dublin (TCD) from July 2008 to July 2011 inclusive, recording exclusion of patients based on an arbitrary upper age limit. Of the 226 relevant trials studied, 31(13.7%) excluded participants based solely on an arbitrary upper age limit. 22 (9.8%) of the relevant trials were submitted by geriatricians, none of which excluded patients based solely on age. Over 50% (12 of 22) trials submitted by neurology/psychiatry excluded patients based on an upper age limit. The mean upper age limit used over all trials as a cut-off was 69.2 years of age. As well as this, the majority of the remaining trials also contained other exclusion criteria, especially those based on cognitive function which further limited participation of older people. While we found that a significant proportion of clinical trials submitted to the TCD REC still excluded patients based arbitrarily on an upper age limit, participation rates of older people seem to be higher in this Irish centre than that seen in international trials. Significant room for improvement still remains however and there needs to be a promotion of greater awareness of the need for developing, testing and licensing medicines so that it mirrors the

  17. Construction of ethics in clinical research: clinical trials registration

    OpenAIRE

    C. A. Caramori

    2007-01-01

    Scientific development that has been achieved through decades finds in clinical research a great possibility of translating findings to human health application. Evidence given by clinical trials allows everyone to have access to the best health services. However, the millionaire world of pharmaceutical industries has stained clinical research with doubt and improbability. Study results (fruits of controlled clinical trials) and scientific publications (selective, manipulated and with wrong c...

  18. Construction of ethics in clinical research: clinical trials registration

    Directory of Open Access Journals (Sweden)

    C. A. Caramori

    2007-01-01

    Full Text Available Scientific development that has been achieved through decades finds in clinical research a great possibility of translating findings to human health application. Evidence given by clinical trials allows everyone to have access to the best health services. However, the millionaire world of pharmaceutical industries has stained clinical research with doubt and improbability. Study results (fruits of controlled clinical trials and scientific publications (selective, manipulated and with wrong conclusions led to an inappropriate clinical practice, favoring the involved economic aspect. In 2005, the International Committee of Medical Journal Editors (ICMJE, supported by the World Association of Medical Editors, started demanding as a requisite for publication that all clinical trials be registered at the database ClinicalTrials.gov. In 2006, the World Health Organization (WHO created the International Clinical Trial Registry Platform (ICTRP, which gathers several registry centers from all over the world, and required that all researchers and pharmaceutical industries register clinical trials. Such obligatory registration has progressed and will extend to all scientific journals indexed in all worldwide databases. Registration of clinical trials means another step of clinical research towards transparency, ethics and impartiality, resulting in real evidence to the forthcoming changes in clinical practice as well as in the health situation.

  19. Gateways to clinical trials.

    Science.gov (United States)

    Bayés, M; Rabasseda, X; Prous, J R

    2005-04-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity. prous.com. This issue focuses on the following selection of drugs: ABX-IL-8, Acclaim, adalimumab, AGI-1067, alagebrium chloride, alemtuzumab, Alequel, Androgel, anti-IL-12 MAb, AOD-9604, aripiprazole, atomoxetine hydrochloride; Biphasic insulin aspart, bosentan, botulinum toxin type B, bovine lactoferrin, brivudine; Cantuzumab mertansine, CB-1954, CDB-4124, CEA-TRICOM, choriogonadotropin alfa, cilansetron, CpG-10101, CpG-7909, CTL-102, CTL-102/CB-1954; DAC:GRF, darbepoetin alfa, davanat-1, decitabine, del-1 Genemedicine, dexanabinol, dextofisopam, dnaJP1, dronedarone hydrochloride, dutasteride; Ecogramostim, eletriptan, emtricitabine, EPI-hNE-4, eplerenone, eplivanserin fumarate, erlotinib hydrochloride, ertapenem sodium, escitalopram oxalate, esomeprazole magnesium, etoricoxib, ezetimibe; Falecalcitriol, fingolimod hydrochloride; Gepirone hydrochloride; HBV-ISS, HSV-2 theracine, human insulin; Imatinib mesylate, Indiplon, insulin glargine, ISAtx-247; L612 HuMAb, levodopa/carbidopa/entacapone, lidocaine/prilocaine, LL-2113AD, lucinactant, LY-156735; Meclinertant, metelimumab, morphine hydrochloride, morphine-6-glucuronide; Natalizumab, nimotuzumab, NX-1207, NYVAC-HIV C; Omalizumab, onercept, osanetant; PABA, palosuran sulfate, parathyroid hormone (human recombinant), parecoxib sodium, PBI-1402, PCK-3145, peginterferon alfa-2a, peginterferon alfa-2b, peginterferon alfa-2b/ribavirin, pemetrexed disodium, pimecrolimus, PINC, pregabalin; Ramelteon, rasagiline mesilate, rasburicase, rimonabant hydrochloride, RO-0098557, rofecoxib, rosiglitazone maleate/metformin hydrochloride; Safinamide mesilate, SHL-749, sitaxsentan sodium, sparfosic acid, SprayGel, squalamine, St. John's Wort

  20. Classification and clinical assessment

    Directory of Open Access Journals (Sweden)

    F. Cantini

    2012-06-01

    Full Text Available There are at least nine classification criteria for psoriatic arthritis (PsA that have been proposed and used in clinical studies. With the exception of the ESSG and Bennett rules, all of the other criteria sets have a good performance in identifying PsA patients. As the CASPAR criteria are based on a robust study methodology, they are considered the current reference standard. However, if there seems to be no doubt that they are very good to classify PsA patients (very high specificity, they might be not sensitive enough to diagnose patients with unknown early PsA. The vast clinical heterogeneity of PsA makes its assessment very challenging. Peripheral joint involvement is measured by 78/76 joint counts, spine involvement by the instruments used for ankylosing spondylitis (AS, dactylitis by involved digit count or by the Leeds dactylitis index, enthesitis by the number of affected entheses (several indices available and psoriasis by the Psoriasis Area and Severity Index (PASI. Peripheral joint damage can be assessed by a modified van der Heijde-Sharp scoring system and axial damage by the methods used for AS or by the Psoriatic Arthritis Spondylitis Radiology Index (PASRI. As in other arthritides, global evaluation of disease activity and severity by patient and physician and assessment of disability and quality of life are widely used. Finally, composite indices that capture several clinical manifestations of PsA have been proposed and a new instrument, the Psoriatic ARthritis Disease Activity Score (PASDAS, is currently being developed.

  1. Clinical pharmacology of deferasirox.

    Science.gov (United States)

    Tanaka, Chiaki

    2014-08-01

    Iron accumulation is a consequence of regular red cell transfusions, and can occur as a result of ineffective erythropoiesis secondary to increased intestinal iron absorption, in patients with various anemias. Without appropriate treatment, iron overload can lead to increased morbidity and mortality. Deferasirox is an oral iron chelator effective for reduction of body iron in iron-overloaded patients with transfusion-dependent anemias and non-transfusion-dependent thalassemia, with a well-established safety profile. This review summarizes the clinical pharmacokinetics, pharmacodynamics, and drug-drug interaction profile of deferasirox, and the claims supporting once-daily dosing for effective chelation. Sustained labile plasma iron suppression is observed with no rebound between doses, protecting organs from potential tissue damage. Increased iron excretion positively correlates with increased deferasirox exposure; to optimize iron removal transfusional iron intake, body iron burden and safety parameters should also be considered. Deferasirox dispersible tablets should be taken ≥30 min before food due to an effect of food on bioavailability. Dosing is consistent across pediatric and adult patients and there is no ethnic sensitivity. Dose adjustment is required for patients with hepatic impairment and may be considered upon coadministration with strong uridine diphosphate glucuronosyltransferase inducers or bile acid sequestrants (coadministration should be avoided where possible), and patients should be monitored upon coadministration with cytochrome P450 (CYP) 3A4/5, CYP2C8, or CYP1A2 substrates. Coadministration with hydroxyurea, a fetal hemoglobin modulator, does not appear to impact deferasirox pharmacokinetics. In summary, a substantial body of clinical and pharmacokinetic data are available for deferasirox to guide its optimal use in multiple patient populations and clinical circumstances.

  2. Shared clinical decision making

    Science.gov (United States)

    AlHaqwi, Ali I.; AlDrees, Turki M.; AlRumayyan, Ahmad; AlFarhan, Ali I.; Alotaibi, Sultan S.; AlKhashan, Hesham I.; Badri, Motasim

    2015-01-01

    Objectives: To determine preferences of patients regarding their involvement in the clinical decision making process and the related factors in Saudi Arabia. Methods: This cross-sectional study was conducted in a major family practice center in King Abdulaziz Medical City, Riyadh, Saudi Arabia, between March and May 2012. Multivariate multinomial regression models were fitted to identify factors associated with patients preferences. Results: The study included 236 participants. The most preferred decision-making style was shared decision-making (57%), followed by paternalistic (28%), and informed consumerism (14%). The preference for shared clinical decision making was significantly higher among male patients and those with higher level of education, whereas paternalism was significantly higher among older patients and those with chronic health conditions, and consumerism was significantly higher in younger age groups. In multivariate multinomial regression analysis, compared with the shared group, the consumerism group were more likely to be female [adjusted odds ratio (AOR) =2.87, 95% confidence interval [CI] 1.31-6.27, p=0.008] and non-dyslipidemic (AOR=2.90, 95% CI: 1.03-8.09, p=0.04), and the paternalism group were more likely to be older (AOR=1.03, 95% CI: 1.01-1.05, p=0.04), and female (AOR=2.47, 95% CI: 1.32-4.06, p=0.008). Conclusion: Preferences of patients for involvement in the clinical decision-making varied considerably. In our setting, underlying factors that influence these preferences identified in this study should be considered and tailored individually to achieve optimal treatment outcomes. PMID:26620990

  3. Philosophy of clinical psychopharmacology.

    Science.gov (United States)

    Aragona, Massimiliano

    2013-03-01

    The renewal of the philosophical debate in psychiatry is one exciting news of recent years. However, its use in psychopharmacology may be problematic, ranging from self-confinement into the realm of values (which leaves the evidence-based domain unchallenged) to complete rejection of scientific evidence. In this paper philosophy is conceived as a conceptual audit of clinical psychopharmacology. Its function is to criticise the epistemological and methodological problems of current neopositivist, ingenuously realist and evidence-servant psychiatry from within the scientific stance and with the aim of aiding psychopharmacologists in practicing a more self-aware, critical and possibly useful clinical practice. Three examples are discussed to suggest that psychopharmacological practice needs conceptual clarification. At the diagnostic level it is shown that the crisis of the current diagnostic system and the problem of comorbidity strongly influence psychopharmacological results, new conceptualizations more respondent to the psychopharmacological requirements being needed. Heterogeneity of research samples, lack of specificity of psychotropic drugs, difficult generalizability of results, need of a phenomenological study of drug-induced psychopathological changes are discussed herein. At the methodological level the merits and limits of evidence-based practice are considered, arguing that clinicians should know the best available evidence but that guidelines should not be constrictive (due to several methodological biases and rhetorical tricks of which the clinician should be aware, sometimes respondent to extra-scientific, economical requests). At the epistemological level it is shown that the clinical stance is shaped by implicit philosophical beliefs about the mind/body problem (reductionism, dualism, interactionism, pragmatism), and that philosophy can aid physicians to be more aware of their beliefs in order to choose the most useful view and to practice coherently

  4. HIV/AIDS Clinical Trials

    Science.gov (United States)

    ... Home Apps APIs Widgets Order Publications Skip Nav HIV/AIDS Clinical Trials Home > Clinical Trials Español small ... Renal (Kidney) Complications/Damage Skin Diseases FDA-Approved HIV Drugs Abacavir Atazanavir Atripla Cobicistat Combivir Complera Darunavir ...

  5. Clinical Investigator Inspector List (CLIIL)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Clinical Investigator Inspection List (CLIIL) contains names, addresses, and other pertinent information gathered from inspections of clinical investigators who...

  6. Clinical management of agnosia.

    Science.gov (United States)

    Burns, Martha S

    2004-01-01

    Agnosia is a neurological recognition deficit that affects a single modality. Visual agnosias include pure object agnosia, prosopagnosia, akinetopsia, and pure alexia. Auditory agnosias include pure word deafness, phonagnosia, and pure sound agnosia. New neuroimaging tools have permitted scientists to better understand the loci of lesions that cause various agnosias and from that knowledge to develop theories about the processing networks that contribute to perception and recognition in each modality. These research data, in turn, inform the rehabilitation process. By utilizing current knowledge about neuroprocessing networks, clinical professionals can differentially diagnose agnosias from aphasia and other cognitive deficits. Practical approaches to treatment of agnosia will follow once the diagnosis is established.

  7. [Clinical aspects of salmonellosis].

    Science.gov (United States)

    Cuzin-Ferrand, L; Auvergnat, J C

    1992-11-15

    Salmonellosis includes two groups of diseases: typhoid fever and non-typhic infections. Epidemiological and clinical features are different in each group. Typhoid fever is a major health problem in developing countries. It realizes septicemia and endotoxinic symptoms, and has not to be forgotten when the patient is back from travelling. Non-typhic infections in most cases produce acute feverish diarrhea, conforming with collective food toxi-infection. Non digestive localizations are usually the fact of underlying diseases, and are able to kill the patient.

  8. Understanding Oracle Clinical

    CERN Document Server

    Johnson, Joan

    2007-01-01

    This Short Cut is written to assist you, an Oracle Clinical Developer, with many of the tasks and decisions you may encounter on an occasional basis. These tasks involve study setup and maintenance, account maintenance, handling discrepancies, preparing data sets for analysis, batch-loading data, altering system-level settings and defining standard processes. A working knowledge of screen setup and procedure coding is assumed. Remote Data Capture (RDC), which moves data entry from the CRO or pharmaceutical company to the sites, is fast becoming the preferred way to gather and clean data for

  9. Tianeptine - A Clinical Review.

    Directory of Open Access Journals (Sweden)

    More Patil Vidita

    2016-06-01

    Full Text Available Depression is a wide spread disorder. The development of effective pharmacotherapy for major depression is important because it is such a widespread and debilitating mental disorder. The following review is based on the preclinical and clinical studies carried out on Tianeptine, an atypical antidepressant that lowers the adverse effects of stress on brain and memory. It is one of the many drugs being tested these days in the market as nootropics; it is presented as a “Smart Drug”. These are believed to be of low-risk and work to improve, enhance, or repair damage done to the brain via injury or disease.

  10. Pharmacogenetics: transforming clinical medicine.

    Science.gov (United States)

    Newman, W G

    2012-01-01

    Pharmacogenetics, the study of genetic variation relevant to drug metabolism, is a rapidly evolving area of medicine. This brief review will consider some of the recent advances where inherited genetic variants have been associated with either drug efficacy or toxicity. Examples of where pharmacogenetic testing has been adopted into clinical practice will be provided as well as a look at its likely development over the next decade. Finally, the large increase in genetic testing of tumour tissue samples to predict response to molecularly targeted treatments in cancer will be considered.

  11. Rosacea: a clinical review

    Directory of Open Access Journals (Sweden)

    Carsten Sauer Mikkelsen

    2016-06-01

    Full Text Available Rosacea is a field within dermatology with new insight within immunological research and new treatment-algorithm. Patient education on rosacea and appropriate treatments is an important aspect in helping patients succeed with therapy. Treatment should be tailored to each individual patient, taking into account: symptoms, trigger factors, patients’ wishes, most bothersome symptoms, psychological aspect, individual needs. A combination of clinical therapies to treat different symptoms concomitantly may offer the best possible outcomes for the patient. In this review article we describe these aspects.

  12. Is a clinical sociolinguistics possible?

    Science.gov (United States)

    Ball, M J

    1992-01-01

    This paper considers the idea of developing a clinical sociolinguistics. Various areas of the field are examined, and the importance of the 'core' area of the correlation of non-linguistic variables with linguistic variables stressed. Issues concerning language and class, region, sex, age and context of utterance are investigated, together with the implications for clinical linguistics. Finally, the difficulty of integrating such issues into clinical assessment is explored, and a tentative step forward suggested along the lines of a 'clinical sociolinguistic checklist'.

  13. Clinical sensitivity: the inseparability of ethical perceptiveness and clinical knowledge.

    Science.gov (United States)

    Nortvedt, P

    2001-01-01

    This article argues that there is an important connection between ethical sensitivity and clinical competency in nursing. This is more than a defense for ethical attitudes and virtues in clinical practice, however. I will show in what way ethical sensitivity is important not only to moral judgment, but to professional clinical knowledge and judgment as well. Drawing on central insights from continental philosophy, Husserl, Heidegger, Levinas and Foucault, as well as classical virtue theory, the article elucidates the inseparability of ethical sensitivity and clinical knowledge in nursing. Ethical sensitivity has bearing upon clinical knowledge and awareness in two important ways. First, what we consider relevant clinical knowledge and therapeutic measures frequently encounter the realities of clinical conditions, realities which embody certain moral qualities and appeal to moral values. In clinical nursing, it is important to understand how this encounter between professional knowledge and moral values informs clinical action, making it morally as well as professionally proper. Second, sensitivity to vulnerability qualifies clinical knowledge in the way that it alerts clinical sensitivity altogether. Perception of morally salient features informs the nurse about significant changes in the patient's pathological condition. The ability to be touched morally by the patient's condition, his or her vulnerability or vitality and positive experience is epistemologically and prognostically significant.

  14. Ethics and clinical trials.

    Science.gov (United States)

    Chassany, O; Duracinský, M

    1999-01-01

    The current reference guideline about ethics in clinical trials is the Declaration of Helsinki of human rights in medical research. Three major principles are emphasised: respect of the patient to accept or not to participate in a trial, the constraints and the presumed risks must be acceptable for patients included in a study, and vulnerable subjects should not participate in studies. The investigator is responsible for obtaining a free and well-informed consent from patients before their inclusion in a study. Where possible, a new drug should always first be compared to placebo in order to prove its superiority. Else, a small-sized trial comparing a new drug versus a reference treatment can lead to an erroneous conclusion of absence of difference. Moreover, good results or improvement are obtained in at least 30% of cases with placebo, whatever the disease. The use of placebo is unethical in life-threatening diseases and when an effective proved drug exists. The use of placebo is ethical in severe diseases with no efficient drug, in some severe diseases even when an active reference treatment is available, and in all moderate and functional diseases. In order to detect flawed studies, most journals now ask for any manuscript submitted and reporting results of a randomised clinical trial to join a checklist in order to verify the quality of the trial. Finally, it remains the responsibility of the doctor to decide whether or not a protocol is ethical, to participate or not and to include patients or not.

  15. Hypomagnesemia: a clinical perspective

    Directory of Open Access Journals (Sweden)

    Pham PC

    2014-06-01

    Full Text Available Phuong-Chi T Pham,1 Phuong-Anh T Pham,2 Son V Pham,3 Phuong-Truc T Pham,4 Phuong-Mai T Pham,5 Phuong-Thu T Pham61Olive View–UCLA Medical Center, Los Angeles, CA, USA; 2Veterans Administration Central California Health Care System, Fresno, CA, USA; 3South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, TX, USA; 4Pennsylvania State University Wilkes-Barre, Lehman, PA, USA; 5Greater Los Angeles Veterans Administration, Sepulveda, CA, USA; 6David Geffen School of Medicine at UCLA, Los Angeles, CA, USAAbstract: Although magnesium is involved in a wide spectrum of vital functions in normal human physiology, the significance of hypomagnesemia and necessity for its treatment are under-recognized and underappreciated in clinical practice. In the current review, we first present an overview of the clinical significance of hypomagnesemia and normal magnesium metabolism, with a focus on renal magnesium handling. Subsequently, we review the literature for both congenital and acquired hypomagnesemic conditions that affect the various steps in normal magnesium metabolism. Finally, we present an approach to the routine evaluation and suggested management of hypomagnesemia.Keywords: hypomagnesemia, magnesium, diabetes mellitus, alcohol, TRPM6, cisplatin

  16. Clinical Verification of Homeopathy

    Directory of Open Access Journals (Sweden)

    Michel Van Wassenhoven

    2011-07-01

    Full Text Available The world is changing! This is certainly true regarding the homeopathic practice and access to homeopathic medicine. Therefore our first priority at the ECH-LMHI [1] has been to produce a yearly report on the scientific framework of homeopathy. In the 2010 version a new chapter about epidemic diseases has been added including the Leptospirosis survey on the Cuban population. A second priority has been to review the definition of the homeopathic medicines respecting the new framework generated by the official registration procedure and the WHO report. We are working now on a documented (Materia Medica and provings list of homeopathic remedies to facilitate the registration of our remedies. The new challenges are: first of all more good research proposals and as such more funding (possible through ISCHI + Blackie Foundation as examples [2]; international acceptance of new guidelines for proving and clinical verification of homeopathic symptoms (Proposals are ready for discussion; total reconsideration of the homeopathic repertories including results of the clinical verification of the symptoms. The world is changing, we are part of the world and changes are needed also for homeopathy!

  17. Freud's early clinical work.

    Science.gov (United States)

    Vogel, L Z

    1994-01-01

    Freud became a medical practitioner because it was impossible for him to pursue the desired career of a microscopic researcher. His education and training had not prepared him for the task of being a practicing physician. In his private practice he began treating some very intelligent, chaotic, demanding, volatile and disturbed patients. Anna von Lieben was one of these patients whom Freud treated very intensively for a long period of time. Elise Gomperz was another talented and severely pained early patient of Freud. Over a number of years, Freud was her psychiatrist and provided her with attentive care using a variety of treatment methods that were available to him at that time. Emmy von N.'s condition was also fluctuating and very demanding. The dramatic sense and chronic clinical course of these patients is compatible with the contemporary diagnostic category of Borderline Personality Disorder. Freud provided these patients with long-term supportive care while he attempted to cure them. At the same time, Freud committed himself to the theory of radical cure and downplayed the supportive, draining and difficult clinical work that he was doing.

  18. Gateways to clinical trials.

    Science.gov (United States)

    Bayes, M; Rabasseda, X; Prous, J R

    2005-01-01

    Gateways to Clinical Trials are a guide to the most recent clinical trials in current literature and congresses. The data in the following tables have been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: (-)-Epigallocatechin gallate; ACP-103, Ad.Egr.TNF.11 D, adalimumab, AF-IL 12, AIDSVAX gp120 B/B, alefacept, alemtuzumab, a-Galactosylceramide, ALVAC vCP 1452, alvimopan hydrate, alvocidib hydrochloride, aminolevulinic acid hydrochloride, aminolevulinic acid methyl ester, anakinra, anidulafungin, antarelix, aprepitant, aripiprazole, arsenic sulfide, asoprisnil, atazanavir sulfate, atomoxetine hydrochloride; Bevacizumab, bimatoprost, BMS-184476, bortezomib, bosentan, botulinum toxin type B, BrachySil, brivudine; Caffeine, calcipotriol/betamethasone dipropionate, cannabidiol, capsaicin for injection, caspofungin acetate, CC-4047, cetuximab, CGP-36742, clofazimine, CpG-7909, Cypher; Darbepoetin alfa, dextromethorphan/quinidine sulfate, dimethylfumarate, dronabinol/cannabidiol, drotrecogin alfa (activated), duloxetine hydrochloride, dutasteride; Ecogramostim, efalizumab, eletriptan, emtricitabine, enfuvirtide, eplerenone, esomeprazole magnesium, estradiol acetate, eszopiclone, etoricoxib, exenatide, ezetimibe, ezetimibe/simvastatin; Fampridine, fondaparinux sodium, fosamprenavir calcium; Gefitinib, GPI-0100; hA 20, HTU-PA, human insulin, HuOKT 3 gamma 1(Ala 234-Ala 235), hyaluronic acid; Icatibant, imatinib mesylate, Indiplon, INKP-100, INKP-102, iodine (I131) tositumomab, istradefylline, IV gamma-globulin, ivabradine hydrochloride, ixabepilone; Lacosamide, landiolol, lanthanum carbonate, lasofoxifene tartrate, LB-80380, lenalidomide, lidocaine/tetracaine, linezolid, liposomal doxorubicin, liposomal vincristine sulfate, lopinavir, lopinavir/ritonavir, lumiracoxib, lurtotecan; Maribavir, morphine glucuronide, MVA-5 T

  19. CLINICAL, EPIDEMIOLOGICAL AND MYCOLOGICA

    Directory of Open Access Journals (Sweden)

    Ratheesh T

    2014-09-01

    Full Text Available BACKGROUND: Tinea versicolor is a chronic, mild, usually asymptomatic infection of the stratum corneum. The lesions are discrete or confluent and appear as discolored or hypo pigmented areas of the skin. The affected areas are located principally on the chest, abdomen, upper extremities and back. The etiologic agent is the lipophilic yeast Pityrosporum orbiculare, part of the normal flora of the human skin. This study is undertaken to know “clinical, patterns of the disease with respect to morphology and distribution, associated conditions and epidemiological factors like age, sex distribution and seasonal variation of the disease”. METHODS: Two hundred patients of tinea versicolor were selected. Patients belonging to the age group of above 10 years and below 60 years belonging to both sexes were selected and included in the study group after taking consent. A detailed history was taken with particular reference to onset, duration, symptoms and treatment taken and were recorded. Factors like – seasonal variation, family history and presence of any associated illnesses was also noted. A thorough clinical examination was done with reference to the location, the color, the extent of the lesions, the margins, the type of lesions and the details were recorded. Potassium hydroxide (KOH examination and Wood’s lamp examination were done in all the patients before therapy. RESULTS: Out of 200 patients, majority of them belong to 2nd and 3rd decade of life (72%. The Male: Female ratio was 1.5:1. There was a family history of 16%. The trunk was the most common site involved. Majority of the patients had exacerbation in summer. The most common associated dermatoses were acne vulgaris, immunosuppression and infections. INTERPRETATION AND CONCLUSION: Tinea versicolor is a disease of worldwide distribution, although it is significantly more common in humid and tropical climates. The true incidence cannot be estimated precisely because the disease is

  20. Ajustes en la plantilla de la empresa a través del despido colectivo

    OpenAIRE

    Regueras Sánchez, María

    2015-01-01

    El despido colectivo ha sido objeto de importantes modificaciones legales en los últimos años, las cuales han constituido un nuevo modelo de despido colectivo. Por primera vez en nuestro país, esta forma de extinguir contratos de trabajo depende de la decisión empresarial, sin precisar de autorización administrativa. Estas modificaciones persiguen flexibilizar la utilización de esta vía extintiva por parte del empresario. El despido colectivo se encuentra regulado principalmente por e...

  1. AJUSTE A LA CRISIS Y MERCADO LABORAL (PERÚ 2008-2010

    Directory of Open Access Journals (Sweden)

    Norberto E. García

    2011-06-01

    Full Text Available The present paper analyses the adjustment of the Peruvian economy to the external shock caused by the global crisis in 2008-2010, with particular attention to: i the macroeconomic policies adopted to face the external shock; ii the consequences of the adjustment for the labor market; iii the importance of the high rates of economic growth recorded by Peru before the crisis in obtaining a soft adjustment to the external shock; iv the reasons that explained why the Peruvian economy does not suffer a recession and only decelerates growth, which allow us to understand why the adjustment to the external shock does not have a negative effect on the labor market – as a matter of fact there is a reduction of the unemployment rate during the crisis.

  2. Ajustement automatique des parametres de coupe pour l'obtention de stabilite dynamique en usinage

    Science.gov (United States)

    Tabet, Ricardo

    High speed machining has as principal limitation the dynamic stability of the cutting action which can generate premature wear of the machine spindle and the cutting tool, tool breakage and dimensional errors on the machined part. This phenomenon is known in the literature as chatter and is defined as being self-excited vibrations. This master thesis presents an approach applicable to manufacturing environments that allows eliminating chatter in real time during machining of aerospace aluminum alloys before the damaging effect can occur. A control algorithm is developed in order to detect chatter using a microphone and by analyzing the audio signal in the frequency domain. The analysis allows determining precisely the frequency at which the chatter occurs and therefore, the spindle speed is adjusted in order to make the tooth passing frequency equal to the detected chatter frequency. Also, a new feedrate is determined by keeping a constant chip load and within the physical limits of the cutting tool. The new cutting parameters are then sent out to the machine controller as a command using a communication interface between an external computer and the controller. Multiples experimental tests were conducted to validate the effectiveness to detect and suppress chatter. High speed machining tests, between 15 000 and 33 000 RPM, were performed in order to reflect real conditions for aerospace components manufacturing.

  3. AJUSTE, ESTRUCTURA Y AMBIENTE COMO FACTORES CLAVES EN LA TEORÍA DE CONTINGENCIAS

    OpenAIRE

    Juan J Pinto; Nini Yohanna Soto; Angélica Gutiérrez; Luis Javier Castillo

    2003-01-01

    Este artículo desarrolla la teoría de contingencias dentro del marco de la evolución de las teorías de la administración, basados en los estudios realizados por Burns y Stalker, Lawrence y Lorsh, Pradip Khandwall quienes hicieron grandes investigaciones en la década de los años 60 y 70 sobre el tema. También se hace un análisis de los aportes hechos por Henry Mintzberg, Van de Ven y Drazin y Stephen Robbins autores contemporáneos que han enriquecido el e...

  4. Ajuste, estructura y ambiente como factores claves en la teoría de contingencias

    OpenAIRE

    Pinto Jiménez, Juan de Jesús

    2003-01-01

    Este artículo desarrolla la teoría de contingencias dentro del marco de la evolución de las teorías de la administración,basados en los estudios realizados por Burns y Stalker,Lawrence y Lorsh, Pradip Khandwall quienes hicieron grandes investigaciones en la década de los años 60 y 70 sobre el tema. También se hace un análisis de los aportes hechos por Henry Mintzberg, Van de Ven y Drazin y Stephen Robbins autores contemporáneos que han enriquecido el entendimiento de la teoría de contingencia...

  5. Procedimiento incorrecto del ajuste de prestaciones a pensionados en el ISSS

    OpenAIRE

    Sorto Rivas, Francisco

    2010-01-01

    En el presente trabajo se analiza la práctica adoptada por los Institutos Previsionales de nuestro país, de ajustar las prestaciones otorgadas a sus afiliados, al descubrir posteriormente que los encargados de establecer el monto de beneficios correspondientes a sus derechos, se equivocaron o dieron por válida información falsa presentada por ellos para acreditar tiempos y salarios devengados en su oportunidad. Si bien es cierto que algunos de estos beneficios reconocidos originaron ingresos...

  6. Ajustes a la arquitectura del sistema general de salud de Colombia: una propuesta

    Directory of Open Access Journals (Sweden)

    Dov Chernichovsky

    2015-01-01

    Full Text Available El modelo de competencia regulada establecido por la Ley 100 de 1993 para el funcionamiento del sis- tema de salud en Colombia presenta fallas de mercado y fallas de gobierno. A la luz del modelo conceptual del « Paradigma Emergente » , este artículo presenta una propuesta de adaptación de la arquitectura del sistema de salud de Colombia a la arquitectura de sistemas internacionales considerados exitosos, identificando instituciones, roles y competencias. Dado lo anterior, las recomendaciones más importantes son: impulsar el sistema dual de competencia regulada en zonas densamente pobladas y monopolios en zonas sin densidad geográfica y regionalizar el sistema. También se sugiere la adopción de instrumentos de regulación de la oferta como el certificado de necesidad.

  7. Distribution transformer with automatic voltage adjustment - performance; Transformador de distribucion con ajuste automatico de tension - desempeno

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez Ruiz, Gustavo A.; Delgadillo Bocanegra, Alfonso; Betancourt Ramirez, Enrique [PROLEC-GE, Apodaca, Nuevo Leon (Mexico)]. E-mail: gustavo1.hernandez@ge.com; alfonso.delgadillobocanegra@ge.com; enrique.betancourt@ge.com; Ramirez Arredondo, Juan M. [CINVESTAV-Guadalajara, Zapopan, Jalisco (Mexico)]. E-mail: jramirez@gdl.cinvestav.mx

    2010-11-15

    In the electric power distribution systems, the power quality is strongly linked with the service stability voltage. In the radial kind systems, it is virtually impossible to achieve a flat voltage along the lines, so it is desirable to count with transformers that can adjust automatically the turns ratio. In this work, it is described the development and the performance of a transformer with an integrated electronic tap changer, that allows to change the turns ratio along the standard range of +/-5%, and it was identified the application limits of the technology. [Spanish] En los sistemas de distribucion de energia electrica, la calidad del suministro de energia esta fuertemente ligada con la estabilidad del voltaje de servicio. En sistemas de tipo radial, es virtualmente imposible mantener uniforme la tension a lo largo de las lineas, por lo que se hace deseable contar con transformadores que puedan ajustar automaticamente la relacion de transformacion. En este trabajo, se describe el desarrollo y desempeno de un transformador con switch electronico integrado, que permite variar la relacion de transformacion dentro del rango estandarizado de +/-5%, y se identifican los limites de aplicacion de la tecnologia.

  8. Reseña del libro: Ajuste Cultural de la persona con Discapacidad Intelectual

    Directory of Open Access Journals (Sweden)

    Maira Fernanda Hurtado Abril

    2013-06-01

    Full Text Available El presente trabajo realiza una breve exploración crítica del libro de Verdugo y Gutiérrez (2009, el cual tiene como eje central el análisis de la evolución del término “discapacidad” en los principales sistemas de acción, y la explicación de propuestas de intervención para la adaptabilidad de la persona con discapacidad intelectual. La lectura del libro transcurre de una manera armoniosa, clara y funcional para aquellos interesados en el tema (psicólogos, investigadores, terapeutas, educadores, familiares, buscando así la aplicación conjunta del modelo de una manera práctica y eficaz en la vida cotidiana de estas personas.

  9. Ajustes Dinámicos en las Tasas de Paro: España vs. Portugal

    OpenAIRE

    Roberto Bande

    2002-01-01

    En este trabajo se aborda la diferencia entre la tasa de desempleo en España y Portugal. Las teorías tradicionales explican los movimientos del desempleo como resultado de los movimientos de la Tasa Natural de Paro o como resultado de shocks temporales con efectos permanentes sobre el desempleo, bajo la hipótesis de histéresis. En este trabajo, se sigue el enfoque de la TeorÌa de la Reacción en Cadena, que interpreta los movimientos del desempleo como resultado de la interacción de un conjunt...

  10. AJUSTE, ESTRUCTURA Y AMBIENTE COMO FACTORES CLAVES EN LA TEORÍA DE CONTINGENCIAS

    Directory of Open Access Journals (Sweden)

    Juan De J. Pinto

    2003-01-01

    Full Text Available Este artículo desarrolla la teoría de contingencias dentro del marco de la evolución de las teorías de la administración, basados en los estudios realizados por Burns y Stalker, Lawrence y Lorsh, Pradip Khandwall quienes hicieron grandes investigaciones en la década de los años 60 y 70 sobre el tema. También se hace un análisis de los aportes hechos por Henry Mintzberg, Van de Ven y Drazin y Stephen Robbins autores contemporáneos que han enriquecido el entendimiento de la teoría de contingencias, determinando la influencia de esta teoría sobre la estrategia, la estructura y el ambiente.

  11. La crisis y el ajuste cubano en los noventa: apuntes en torno a lo social

    Directory of Open Access Journals (Sweden)

    María Teresa Valdés Fernández

    1996-01-01

    Full Text Available This paper outlines the role played by the social sector within development strategies designed in Cuba, as well as the effects that the recent economic situation and the adjustment derived therefrom have had on the social sector’s role. This constitutes a necessary antecedent for an understanding of the conditions in which a new model of social policies ought to be formulated in the future, in tune with the transformations already under way in the economy and which will doubtless continue.

  12. Adjustment model of thermoluminescence experimental data; Modelo de ajuste de datos experimentales de termoluminiscencia

    Energy Technology Data Exchange (ETDEWEB)

    Moreno y Moreno, A. [Departamento de Apoyo en Ciencias Aplicadas, Benemerita Universidad Autonoma de Puebla, 4 Sur 104, Centro Historico, 72000 Puebla (Mexico); Moreno B, A. [Facultad de Ciencias Quimicas, UNAM, 04510 Mexico D.F. (Mexico)

    2002-07-01

    This model adjusts the experimental results for thermoluminescence according to the equation: I (T) = I (a{sub i}* exp (-1/b{sub i} * (T-C{sub i})) where: a{sub i}, b{sub i}, c{sub i} are the i-Th peak adjusted to a gaussian curve. The adjustments of the curve can be operated manual or analytically using the macro function and the solver.xla complement installed previously in the computational system. In this work it is shown: 1. The information of experimental data from a LiF curve obtained from the Physics Institute of UNAM which the data adjustment model is operated in the macro type. 2. A LiF curve of four peaks obtained from Harshaw information simulated in Microsoft Excel, discussed in previous works, as a reference not in macro. (Author)

  13. Ajustes de resultados de ejercicios anteriores: protagonistas de la última década

    OpenAIRE

    Rondi, Gustavo R.; Casal, María del Carmen; Gómez, Melisa

    2010-01-01

    Los estados contables deben proveer información sobre el patrimonio del ente emisor y su evolución en el período que abarcan, para que sea utilizada por quienes toman decisiones económicas. Dichos estados incluyen información sobre las causas del resultado devengado en el período, la cual será empleada, entre otros usos, para evaluar la gestión de los administradores, predecir los resultados futuros, comparar el desempeño del emisor con el de otros, tomar decisiones societarias sobre distribu...

  14. Equilibrios de óxido-reducción. Ajuste de reacciones redox. VI.

    OpenAIRE

    Milla González, Miguel

    2014-01-01

    En este ejercicio se ajusta la ecuación química correspondiente al proceso de oxidación de manganeso(II) a permanganato con bismutato sódico sólido. Esta reacción sirve en análisis cualitativo para identificar el catión manganeso en disolución. Es importante establecer los cambios de estado de oxidación de las especies que intervienen y los electrones implicados. A partir de aquí, ajustar la ecuación es fácil. Se incluyen ejercicios de evaluación.

  15. RECURSOS PARA A EDUCAÇÃO E LIMITES DO AJUSTE FISCAL

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Ferreira Alves de Brito

    Full Text Available Resumo: Este artigo analisa o financiamento da rede pública estadual de Minas Gerais e a remuneração dos professores da rede entre 2003 e 2014. Focaliza a modernização da administração governamental e os efeitos do programa denominado "Choque de gestão" na aplicação dos recursos para a função educação e para a remuneração do magistério assim como analisa a limitação imposta pela Lei de Responsabilidade Fiscal para os gastos com pessoal. Para isso, foram analisados dados orçamentários e relatórios do Tribunal de Contas do Estado de Minas Gerais. O trabalho é parte da pesquisa "Remuneração de professores da educação básica pública: configurações, impactos, impasses e perspectivas", realizada para o Observatório da Educação. A pesquisa constatou a diminuição de recursos financeiros para a função educação em Minas Gerais e a não implantação do piso salarial profissional nacional para os professores da rede estadual de educação básica.

  16. Teaching Cases in Management - RIPASA: Venda e Ajuste com Minoritários

    Directory of Open Access Journals (Sweden)

    Roberto Borges Kerr

    2009-04-01

    Full Text Available In 2004, the Zogbi, Derani and Zarzur [ZDZ] holding began negotiations to sell control of Ripasa, an attractive growth opportunity for its competitors which would not alter the market equilibrium. National and international competitors will dispute this crown jewel, the smallest of the big cellulose and paper companies. The Ripasa Case is a detailed description of a real business situation, the acquisition of the control of Ripasa by Votorantim Celulose e Papel [VCP] and Suzano Bahia Sul, two competing companies that joined forces in a strategic alliance designed as a consortium to acquire the control of Ripasa. The Case analyzes the acquisition process and the complex agreement with minority stockholders. The main question under discussion is the price to be paid to the minority stockholders. The situation became more complex due to the ambiguity of Ripasa´s Social Statute, which allowed for more than one interpretation on the tag along rights and caused a conflict between agencies. The acquiring companies decided not to take into consideration the best practices of Corporate Governance, aggravating the problem and delaying a final agreement for eighteen months.

  17. Las ciudades y sus muros de cristal. Ajuste neoliberal en una experiencia del noroeste argentino

    Directory of Open Access Journals (Sweden)

    Liliana Bergesio

    2014-01-01

    Full Text Available En este artículo se discuten algunas consecuencias de las políticas neoliberales de la década de 1990 en Jujuy (Argentina, a partir del estudio de los cambios en el entramado urbano de su capital. Con el surgimiento y desarrollo explosivo del barrio Alto Comedero se observa cómo las políticas neoliberales profundizaron la separación entre sectores sociales, generando procesos de relegación de grupos desfavorecidos a zonas alejadas e invisibles de la ciudad, dejando marcas indelebles en el imaginario, las subjetividades y las condiciones materiales de vida de tales grupos.

  18. Desinfección de los conos de gutapercha. Sus efectos en el ajuste apical.

    OpenAIRE

    2013-01-01

    Una terapéutica endodóntica exitosa tiene como objetivo la eliminación de los microorganismos que se encuentran en el conducto radicular e impedir su reingreso.Los procedimientos endodónticos deberían ser entendidos como una sucesión de pasos de una cadena aséptica. La cavidad de apertura, aislamiento, instrumentación del conducto radicular, irrigación, medicación entre sesiones, obturación y finalmente, la restauración coronaria son todos eslabones de esa cadena.Los conos de gutapercha han s...

  19. Las ciudades y sus muros de cristal. Ajuste neoliberal en una experiencia del noroeste argentino

    OpenAIRE

    Liliana Bergesio; Laura Golovanevsky

    2014-01-01

    En este artículo se discuten algunas consecuencias de las políticas neoliberales de la década de 1990 en Jujuy (Argentina), a partir del estudio de los cambios en el entramado urbano de su capital. Con el surgimiento y desarrollo explosivo del barrio Alto Comedero se observa cómo las políticas neoliberales profundizaron la separación entre sectores sociales, generando procesos de relegación de grupos desfavorecidos a zonas alejadas e invisibles de la ciudad, dejando marcas indelebles en el im...

  20. Determination of methodology of automatic history matching; Determinacao de metodologia de ajuste automatizado de historico

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Jose Pedro Moura dos

    2000-01-01

    In management of hydrocarbon reservoirs the numeric simulation is a fundamental tool. The validation of a field model with production report is made through history matching which, many times, is done by trial and errors procedures consuming excessive computational time and human efforts. The objective of this work is to present a methodology for automation of the history matching using the program UNIPAR with the modules of parallel computing, sensibility analysis and optimization. Based on an example of an offshore field, analyses of the objective function (water production, oil production and average pressure of the reservoir) behavior were accomplished as function of the variations of reservoir parameters. It was verified that this behavior is very regular. After that, several adjustment situations were tested to define a procedure to be used for a history matching. (author) Ate aqui estao scanned.

  1. Política social e ajuste macroeconômico Social policy and macroeconomic adjustment

    Directory of Open Access Journals (Sweden)

    Nilson do Rosário Costa

    2002-01-01

    Full Text Available O objetivo do texto é fazer um balanço das respostas dos Estados de bem-estar social às mudanças provocadas pelo globalização nas décadas de 1980-1990. O texto mostra que a hipótese sobre o desmantelamento dos sistemas de bem-estar social não pode ser comprovada por falta de evidências de mudanças substanciais nos mecanismos de financiamento e eleição de beneficiários. O texto focaliza também os efeitos do processo de internacionalização da economia brasileira sobre o sistema de proteção social do país. Conclui que as restrições impostas aos gastos públicos limitou severamente a capacidade em promover políticas sociais abrangentes. Verificou-se na década, a opção por políticas sociais focalizadas e seletivas pela adoção do diagnóstico da baixa efetividade do sistema de proteção social brasileiro. O caso da política de saúde foi uma exceção em razão da capacidade de intermediação de interesses na arena setorial.This paper analyzes responses by welfare states to globalization in some OECD countries in the 1980s and 90s, demonstrating that the hypothesis concerning the dismantling of social welfare systems cannot be proven due to lack of evidence of substantial changes in the funding and selection of beneficiaries. The paper also focuses on the effects of internationalization of the Brazilian economy on the country's social protection system. The conclusion is that restrictions imposed on public expenditures severely limited the capacity to promote broad coverage in social policies. During the decade the option was made for targeted, selective social policies based on the adoption of a diagnosis of low effectiveness in the Brazilian social protection system. The case of health policy was an exception, due to capacity for interest mediation in the social arena.

  2. Diferencias entre universidades privadas y oficiales venezolanas: Algunos ajustes necesarios en el sector privado

    Directory of Open Access Journals (Sweden)

    Luis Fuenmayor Toro

    2003-01-01

    Full Text Available Este trabajo efectúa una caracterización preliminar de la universidad privada venezolana, a medio siglo de sus inicios. Se determinan algunas de sus fallas principales y propone correctivos factibles aprovechando las leyes de educación próximas a ser aprobadas. Los datos demuestran que las universidades privadas, a diferencia de las oficiales, tiene una planta docente mayoritariamente a tiempo convencional, ubicada principalmente en los más bajos escalafones académicos, con estudios de postgrado en una proporción menor que las universidades oficiales y prácticamente sin investigadores. La relación alumno/profesor es el doble de la del sector oficial y los postgrados universitarios que ofrecen son la quinta parte del total y sólo están acreditados el 10%, en contraposición con el 29% acreditado de las instituciones públicas. De estas comparaciones se extrae que la universidad privada está muy limitada para la realización de investigación y para el desarrollo de los postgrados que forman investigadores: maestrías y doctorados. Tiene además limitaciones subsanables en el pregrado, por no disponer de docentes contratados a altas dedicaciones, que dispongan de tiempo dentro de su dedicación para las consultas estudiantiles. Esto se puede resolver a través de un mandato legal que determine que un 33% de los docentes, sin contar autoridades y directivos, deban estar a dedicación exclusiva y repartidos homogéneamente entre todos los programas docentes institucionales. Estos docentes, también por mandato legal, dispondrían de un 30% de su tiempo para hacer investigación en unidades de universidades y otros centros oficiales, a las que serían adscritos formalmente. Ello mejoraría la academia de las instituciones privadas sin costos que hagan imposible estos importantes cambios.

  3. Clinical Reasoning Terms Included in Clinical Problem Solving Exercises?

    Science.gov (United States)

    Musgrove, John L; Morris, Jason; Estrada, Carlos A; Kraemer, Ryan R

    2016-05-01

    Background Published clinical problem solving exercises have emerged as a common tool to illustrate aspects of the clinical reasoning process. The specific clinical reasoning terms mentioned in such exercises is unknown. Objective We identified which clinical reasoning terms are mentioned in published clinical problem solving exercises and compared them to clinical reasoning terms given high priority by clinician educators. Methods A convenience sample of clinician educators prioritized a list of clinical reasoning terms (whether to include, weight percentage of top 20 terms). The authors then electronically searched the terms in the text of published reports of 4 internal medicine journals between January 2010 and May 2013. Results The top 5 clinical reasoning terms ranked by educators were dual-process thinking (weight percentage = 24%), problem representation (12%), illness scripts (9%), hypothesis generation (7%), and problem categorization (7%). The top clinical reasoning terms mentioned in the text of 79 published reports were context specificity (n = 20, 25%), bias (n = 13, 17%), dual-process thinking (n = 11, 14%), illness scripts (n = 11, 14%), and problem representation (n = 10, 13%). Context specificity and bias were not ranked highly by educators. Conclusions Some core concepts of modern clinical reasoning theory ranked highly by educators are mentioned explicitly in published clinical problem solving exercises. However, some highly ranked terms were not used, and some terms used were not ranked by the clinician educators. Effort to teach clinical reasoning to trainees may benefit from a common nomenclature of clinical reasoning terms.

  4. [Osteoporosis: a clinical perspective].

    Science.gov (United States)

    Matikainen, Niina

    2016-01-01

    Osteoporosis is defined by decreased bone density and microarchitectural deterioration that predispose to fragility fractures. The WHO diagnostic criteria of osteoporosis require bone densitometry but treatment is possible on the basis of high clinical fracture risk and can be assessed by the FRAX risk algorithm. All those subject to fracture risk should be advised about proper basic treatment of osteoporosis, including exercise, prevention of falls, smoking cessation, avoidance of alcohol intake, and dietary or supplemental abundance of calcium and vitamin D. Underlying diseases must be studied after diagnosis of osteoporosis even if treatment is initiated without densitometry. When indicated, specific osteoporosis therapy includes bisphosphonates, denosumab, teriparatide, strontium ranelate or SERMs. In hypogonadism, gonadal steroids may be indicated alone or in addition to a specific treatment. Treatment effect and continuation are assessed after 2 to 5 years.

  5. Rheumatoid Factors: Clinical Applications

    Directory of Open Access Journals (Sweden)

    Francesca Ingegnoli

    2013-01-01

    Full Text Available Rheumatoid factors are antibodies directed against the Fc region of immunoglobulin G. First detected in patients with rheumatoid arthritis 70 years ago, they can also be found in patients with other autoimmune and nonautoimmune conditions, as well as in healthy subjects. Rheumatoid factors form part of the workup for the differential diagnosis of arthropathies. In clinical practice, it is recommended to measure anti-cyclic citrullinated peptide antibodies and rheumatoid factors together because anti-cyclic citrullinated peptide antibodies alone are only moderately sensitive, and the combination of the two markers improves diagnostic accuracy, especially in the case of early rheumatoid arthritis. Furthermore, different rheumatoid factor isotypes alone or in combination can be helpful when managing rheumatoid arthritis patients, from the time of diagnosis until deciding on the choice of therapeutic strategy.

  6. Dabigatran in clinical practice

    DEFF Research Database (Denmark)

    Ageno, Walter; Eikelboom, John; Lip, Gregory Y H

    2016-01-01

    confirmed, but VKA use is complicated by need for regular monitoring of the international normalized ratio and multiple drug and food interactions. Dabigatran is an oral direct thrombin inhibitor that can be used with fixed doses, without the need for routine anticoagulation laboratory monitoring...... and the advantage of few drug or diet interactions. Dabigatran is effective for stroke and systemic thromboembolism in AF and for the prophylaxis and treatment of VTE. The drug has a good safety profile and consistently shows a reduction in intracranial hemorrhage risk compared to warfarin. A specific reversal...... agent for dabigatran has been approved by FDA and EU. This review provides a summary of publications assessing clinical utility of dabigatran for different indications....

  7. Developing Effective Clinical Trainers

    Directory of Open Access Journals (Sweden)

    Kevin Khamarko

    2012-05-01

    Full Text Available Continuing education and training provides a means to improve performance among health care professionals (HCP. Research shows, however, that continuing professional education activities have inconsistent effects on HCP competence, performance, and patient health outcomes. Furthermore, the trainer’s role as a facilitator of knowledge translation (KT has been understudied. To understand how clinical trainers support their trainees in translating what they learned into practice, we conducted 16 in-depth interviews with expert trainers. These interviews yielded a variety of KT-enhancing strategies, including tailoring training activities to their trainees’ needs. In addition, participants recommended trainers familiarize themselves with their trainees’ work environments, be able to identify their knowledge deficits, and devote time to provide trainees with post-training support. Creating an effective training, one that leads to transfer, requires active planning, communication, and command of the training topic by skilled trainers.

  8. Foundations of clinical logagogy.

    Science.gov (United States)

    Bühler, Karl-Ernst

    2003-01-01

    The meaning of the term "logagogy" is elucidated, and logagogic practices are outlined in the history of medicine. It is shown how the traditional medicine of India, Ayurveda, shows signs of logagogic practices (sattvavajaya), and that not only Ayurveda but also the famous Greek physician Galenus emphasize a philosophical approach to medicine. As Galenus's logagogic practices have their roots in the tradition of practical philosophy in Greek antiquity, the most important Greek schools of thought that are relevant to logagogic approaches are sketched. It is shown that the Stoics created a rationalistic system emphasizing the importance of the logos for human beings, and that Epicurus made advances in psychoeducation and cognitive reframing that are important for logagogic practices. These logagogic approaches of antiquity have been taken up by modern counseling in philosophical practices. The article closes with an outline of a clinical logagogy.

  9. Clinical management of neurocysticercosis.

    Science.gov (United States)

    Del Brutto, Oscar H

    2014-04-01

    Neurocysticercosis is the most common helminthic disease of the nervous system and a leading cause of acquired epilepsy worldwide. Differences in the number and location of lesions as well as in the severity of the immune response against the parasites, makes neurocysticercosis a complex disease. Therefore, a single therapeutic approach is not expected to be useful in every patient. Introduction of cysticidal drugs - praziquantel and albendazole - have changed the prognosis of thousands of patients with neurocysticercosis. While pioneer trials of therapy were flawed by a poor design, recent studies have shown that cysticidal drugs results in disappearance of lesions and clinical improvement in most cases. Nevertheless, some patients with parenchymal neurocysticercosis may be left with remaining cysts and may develop recurrent seizures after therapy, and many patients with subarachnoid cysts may need repeated courses of therapy. In addition, not all forms of the disease benefit from cysticidal drugs.

  10. [Dementia: clinic and diagnosis].

    Science.gov (United States)

    Estol, C J

    2001-12-01

    Decline of the cognitive functions necessary for activities of daily living results in a spectrum ranging from benign forgetfulness and minimal cognitive impairment to dementia. The latter is characterized by personality and behavioral changes. Alzheimer's disease is the most frequent cause of dementia affecting almost one of two people older than 80 years. Lewy body and cerebrovascular disease are also frequent causes of cognitive decline. Recent studies have revealed genetic aspects of Alzheimer's disease and the role of certain enzymes in the pathophysiology of fibrillary amyloid deposition. The aim in cognitive disease is an early diagnosis to initiate therapy and adapting measures in the patient's daily routines. The diagnosis is basically clinical with neuroimaging and neuropsychological tests' support. The EEG, SPECT, LP and other studies are only useful in a few specific scenarios. At present, a few promising therapies are being evaluated. Family support is of vital importance.

  11. Clinical application of PET

    Energy Technology Data Exchange (ETDEWEB)

    Lomena, Francisco [Hospital Clinico Villarroel, Barcelona (Spain). Nuclear Medicine]. E-mail: flomena@clinic.ub.es; Soler, Marina [CETIR Grup Medic. Esplkugues de Llobregat, Barcelona (Spain). PET Unit

    2005-10-15

    Positron emission tomography (PET) is an imaging modality that gives information on tissue metabolism and functionalism, different from other imaging techniques like computed tomography (CT) and magnetic resonance imaging (MRI), which provide anatomical or structural information. PET has reached its development in biomedical research because of its capacity to use analogous compounds of many endogenous substance as tracers, and to measure, in vivo and in a non-invasive way, their consumption by the different organs and tissues of the mammalian body. Fluorodeoxyglucose-F 18 (FDG) PET has been proven to be a tracer adequate for clinical use in oncology and in many neurological diseases, with an excellent cost-efficiency ratio. The current PET-CT scanners can come to be the best tools for exploring patients who suffer from cancer.(author)

  12. Clinical limitations of Invisalign.

    Science.gov (United States)

    Phan, Xiem; Ling, Paul H

    2007-04-01

    Adult patients seeking orthodontic treatment are increasingly motivated by esthetic considerations. The majority of these patients reject wearing labial fixed appliances and are looking instead to more esthetic treatment options, including lingual orthodontics and Invisalign appliances. Since Align Technology introduced the Invisalign appliance in 1999 in an extensive public campaign, the appliance has gained tremendous attention from adult patients and dental professionals. The transparency of the Invisalign appliance enhances its esthetic appeal for those adult patients who are averse to wearing conventional labial fixed orthodontic appliances. Although guidelines about the types of malocclusions that this technique can treat exist, few clinical studies have assessed the effectiveness of the appliance. A few recent studies have outlined some of the limitations associated with this technique that clinicians should recognize early before choosing treatment options.

  13. Trialing a new clinical clerkship record in Japanese clinical training

    Directory of Open Access Journals (Sweden)

    Nomura S

    2015-09-01

    Full Text Available Shosaku Nomura, Noboru Tanigawa, Yo Kinoshita, Koichi TomodaFirst Department of Internal Medicine, Kansai Medical University, Shinmachi, Hirakata, Osaka, JapanUndergraduate medical education has several problems.1,2 In particular, clinical training, which is the unique feature of medical education, tends to be performed less extensively. In Japan, the current clinical training method is clinical clerkship (CC. CC differs from conventional clinical training, which is study by observation. In CC, the student is a member of the medical team and participates in actual medical care. The student is allowed to practice medical actions in the definite range under the guidance and monitoring of a teaching doctor. Therefore, students can acquire practical clinical abilities. In their study of medical care, students are required to have their own sense of identity and personal responsibility. Clinical training is performed by CC following the original curriculum for diagnoses and treatments in various medical departments.

  14. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Health Information Center Health Professionals Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education Researchers Funding Training & Career Development ...

  15. Clinical Predictors of Psychopathology

    Directory of Open Access Journals (Sweden)

    Jorge Caraveo Anduaga

    2010-04-01

    Full Text Available Psychiatric disorders affect up to one third of patients with non-psychiatric diseases.1-5 Nevertheless, despite the high prevalence of psychopathology in general medical patients, only between 30-50% of all cases are detected.2,6-8 Some have suggested that the difficulty in the detection and diagnosis of mental disorders among patients who seek medical attention for other reasons, lies in the lack of screening questions that might alert the physician to the possibility of a psychiatric co-morbidity.9 Such questions would identify medical patients at high risk of psychiatric problems. Previous work on clinical predictors of psychopathology have identified the following: specific physical symptoms10-11; patient report of severity of illness11; recent stress12,13; low self-perception of health status13; and age less than 50.14 Two specific studies on the detection of psychopathology in the general medical population are worth highlighting. The first, by Jackson and his research team13 updating a 2001 study evaluating a prediction model with four parameters (recent stress, severity of physical symptoms, five or more specific symptoms, self-assessment of physical condition. They found that those patients who report recent stress, have five or more physical symptoms or a low self-perception of their health state are at a higher risk of having a psychiatric disorder. The second study, by Lowe et al. published in 2003,9 examines a series of factors that could serve as indicators of psychopathology in ambulatory medical (i.e. non-psychiatric patients. After evaluating several different models they found that the combination of four of factors (taken as a group had a high sensitivity (86%, specificity (100%, positive predictive value (100%, and negative predictive value (91%. This suggests that a physician could use the combination of these four indicators to evaluate for the presence of co morbid mental disorders. These factors are: self

  16. Nontraditional applications in clinical pathology.

    Science.gov (United States)

    Jordan, Holly L; Register, Thomas C; Tripathi, Niraj K; Bolliger, Anne Provencher; Everds, Nancy; Zelmanovic, David; Poitout, Florence; Bounous, Denise I; Wescott, Debra; Ramaiah, Shashi K

    2014-10-01

    Most published reviews of preclinical toxicological clinical pathology focus on the fundamental aspects of hematology, clinical chemistry, coagulation, and urinalysis in routine toxicology animal species, for example, rats, mice, dogs, and nonhuman primates. The objective of this continuing education course was to present and discuss contemporary examples of nonroutine applications of clinical pathology endpoints used in the drug development setting. Area experts discussed bone turnover markers of laboratory animal species, clinical pathology of pregnant and growing laboratory animals, clinical pathology of nonroutine laboratory animal species, and unique applications of the Siemens Advia(®) hematology analyzer. This article is a summary based on a presentation given at the 31st Annual Symposium of the Society of Toxicologic Pathology, during the Continuing Education Course titled "Nontraditional Applications of Clinical Pathology in Drug Discovery and Preclinical Toxicology."

  17. The Dynamo Clinical Trial

    Science.gov (United States)

    Ayres, Thomas R.

    2016-04-01

    The Dynamo Clinical Trial evaluates long-term stellar magnetic health through periodic X-ray examinations (by the Chandra Observatory). So far, there are only three subjects enrolled in the DTC: Alpha Centauri A (a solar-like G dwarf), Alpha Cen B (an early K dwarf, more active than the Sun), and Alpha Canis Majoris A (Procyon, a mid-F subgiant similar in activity to the Sun). Of these, Procyon is a new candidate, so it is too early to judge how it will fare. Of the other two, Alpha Cen B has responded well, with a steady magnetic heartbeat of about 8 years duration. The sickest of the bunch, Alpha Cen A, was in magnetic cardiac arrest during 2005-2010, but has begun responding to treatment in recent years, and seems to be successfully cycling again, perhaps achieving a new peak of magnetic health in the 2016 time frame. If this is the case, it has been 20 years since A's last healthful peak, significantly longer than the middle-aged Sun's 11-year magnetic heartbeat, but perhaps in line with Alpha Cen A's more senescent state (in terms of "relative evolutionary age," apparently an important driver of activity). (By the way, don't miss the exciting movie of the Alpha Cen stars' 20-year X-ray dance.)

  18. The clinical encounter revisited.

    Science.gov (United States)

    Schattner, Ami

    2014-04-01

    The patient-physician encounter is the pivotal starting point of any healthcare delivery, but it is subject to multiple process breakdowns and prevalent suboptimal performance. An overview of the techniques and components of a successful encounter valid for every setting and readily applicable is presented, stressing 7 rules: (1) ensuring optimal environment, tools, and teamwork; (2) viewing each encounter not only as a cognitive/biomedical challenge, but also as a personal one, and a learning opportunity; (3) adopting an attitude of curiosity, concentration, compassion, and commitment, and maintaining a systematic, orderly approach; (4) "simple is beautiful"-making the most of the basic clinical data and their many unique advantages; (5) minding "the silent dimension"-being attentive to the patient's identity and emotions; (6) following the "Holy Trinity" of gathering all information, consulting databases/colleagues, and tailoring gained knowledge to the individual patient; and (7) using the encounter as a "window of opportunity" to further the patient's health-not just the major problem, by addressing screening and prevention; promoting health literacy and shared decision-making; and establishing proper follow-up. Barriers to implementation identified can be overcome by continuous educational interventions. A high-quality encounter sets a virtuous cycle of patient-provider interaction and results in increasing satisfaction, adherence, and improved health outcomes.

  19. Pediatric DXA: clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Binkovitz, Larry A. [Columbus Children' s Hospital, Department of Radiology, Columbus, OH (United States); Sparke, Paul [Capital University, Department of Chemistry, Columbus, OH (United States); Henwood, Maria J. [Columbus Children' s Hospital, Department of Endocrinology, Columbus, OH (United States)

    2007-07-15

    Normal bone mineral accrual requires adequate dietary intake of calcium, vitamin D and other nutrients; hepatic and renal activation of vitamin D; normal hormone levels (thyroid, parathyroid, reproductive and growth hormones); and neuromuscular functioning with sufficient stress upon the skeleton to induce bone deposition. The presence of genetic or acquired diseases and the therapies that are used to treat them can also impact bone health. Since the introduction of clinical DXA in pediatrics in the early 1990s, there has been considerable investigation into the causes of low bone mineral density (BMD) in children. Pediatricians have also become aware of the role adequate bone mass accrual in childhood has in preventing osteoporotic fractures in late adulthood. Additionally, the availability of medications to improve BMD has increased with the development of bisphosphonates. These factors have led to the increased utilization of DXA in pediatrics. This review summarizes much of the previous research regarding BMD in children and is meant to assist radiologists and clinicians with DXA utilization and interpretation. (orig.)

  20. Pompe disease: clinical perspectives

    Directory of Open Access Journals (Sweden)

    Cabello JF

    2016-12-01

    Full Text Available Juan Francisco Cabello,1 Deborah Marsden21Genetics and Metabolic Disease Laboratory, Nutrition and Food Technology Institute (INTA, University of Chile, Santiago, Chile; 2Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA, USA Abstract: Pompe disease (acid alpha-glucosidase deficiency, OMIM 232300 is a rare lysosomal storage disorder due to autosomal recessive mutations in the GAA gene. It has also been called acid maltase deficiency and glycogen storage disease type II. There is a broad clinical presentation: the most severe form that presents in the first few months of life with cardiomyopathy and generalized muscle weakness that rapidly progresses to death from cardio-respiratory failure in the first year of life (infant-onset Pompe disease. A more slowly progressive disease, with little or no cardiac involvement, presents with proximal myopathy and/or pulmonary insufficiency, from the second year of life to late adulthood (late-onset Pompe disease. The recent development and introduction of enzyme replacement therapy with intravenous infusion of recombinant human acid alpha-glucosidase have made a major improvement in the morbidity and mortality of this disease. New therapies are also in development. With the availability of treatment, diagnostic methods have also improved, allowing for earlier recognition and potential early therapeutic intervention. The advent of newborn screening for Pompe disease may identify patients who can be treated before significant irreversible disease has occurred. Keywords: Pompe disease, glycogen storage disease, lysosomal storage disease, enzyme replacement therapy, gene therapy, chaperone therapy, genotype/phenotype, newborn screening

  1. Clinical biochemistry of aluminum

    Energy Technology Data Exchange (ETDEWEB)

    King, S.W.; Savory, J.; Wills, M.R.

    1981-05-01

    Aluminum toxicity has been implicated in the pathogenesis of a number of clinical disorders in patients with chronic renal failure on long-term intermittent hemodialysis treatment. The predominant disorders have been those involving either bone (osteomalacic dialysis osteodystrophy) or brain (dialysis encephalopathy). In nonuremic patients, an increased brain aluminum concentration has been implicated as a neurotoxic agent in the pathogenesis of Alzheimer's disease and was associated with experimental neurofibrillary degeneration in animals. The brain aluminum concentrations of patients dying with the syndrome of dialysis encephalopathy (dialysis dementia) are significantly higher than in dialyzed patients without the syndrome and in nondialyzed patients. Two potential sources for the increased tissue content of aluminum in patients on hemodialysis have been proposed: (1) intestinal absorption from aluminum containing phosphate-binding gels, and (2) transfer across the dialysis membrane from aluminum in the water used to prepare the dialysate. These findings, coupled with our everyday exposure to the ubiquitous occurrence of aluminum in nature, have created concerns over the potential toxicity of this metal.

  2. Clinical Practice. Postmenopausal Osteoporosis.

    Science.gov (United States)

    Black, Dennis M; Rosen, Clifford J

    2016-01-21

    Key Clinical Points Postmenopausal Osteoporosis Fractures and osteoporosis are common, particularly among older women, and hip fractures can be devastating. Treatment is generally recommended in postmenopausal women who have a bone mineral density T score of -2.5 or less, a history of spine or hip fracture, or a Fracture Risk Assessment Tool (FRAX) score indicating increased fracture risk. Bisphosphonates (generic) and denosumab reduce the risk of hip, nonvertebral, and vertebral fractures; bisphosphonates are commonly used as first-line treatment in women who do not have contraindications. Teriparatide reduces the risk of nonvertebral and vertebral fractures. Osteonecrosis of the jaw and atypical femur fractures have been reported with treatment but are rare. The benefit-to-risk ratio for osteoporosis treatment is strongly positive for most women with osteoporosis. Because benefits are retained after discontinuation of alendronate or zoledronic acid, drug holidays after 5 years of alendronate therapy or 3 years of zoledronic acid therapy may be considered for patients at lower risk for fracture.

  3. [Hydration in clinical practice].

    Science.gov (United States)

    Maristany, Cleofé Pérez-Portabella; Segurola Gurruchaga, Hegoi

    2011-01-01

    Water is an essential foundation for life, having both a regulatory and structural function. The former results from active and passive participation in all metabolic reactions, and its role in conserving and maintaining body temperature. Structurally speaking it is the major contributer to tissue mass, accounting for 60% of the basis of blood plasma, intracellular and intersticial fluid. Water is also part of the primary structures of life such as genetic material or proteins. Therefore, it is necessary that the nurse makes an early assessment of patients water needs to detect if there are signs of electrolyte imbalance. Dehydration can be a very serious problem, especially in children and the elderly. Dehydrations treatment with oral rehydration solution decreases the risk of developing hydration disorders, but even so, it is recommended to follow preventive measures to reduce the incidence and severity of dehydration. The key to having a proper hydration is prevention. Artificial nutrition encompasses the need for precise calculation of water needs in enteral nutrition as parenteral, so the nurse should be part of this process and use the tools for calculating the patient's requirements. All this helps to ensure an optimal nutritional status in patients at risk. Ethical dilemmas are becoming increasingly common in clinical practice. On the subject of artificial nutrition and hydration, there isn't yet any unanimous agreement regarding hydration as a basic care. It is necessary to take decisions in consensus with the health team, always thinking of the best interests of the patient.

  4. Crown lengthening: a clinical review.

    Science.gov (United States)

    Talbot, T R; Briggs, P F; Gibson, M T

    1993-09-01

    The use of crown lengthening surgery as an adjunct to restorative therapy was first suggested by Rosen and Gitnick. This technique is designed to increase the clinical crown heights of teeth requiring restoration following extensive wear through attrition, abrasion and erosion. This loss of tooth tissue and resulting clinical crown height may be localized to a few teeth or affect the entire dentition. This clinical problem is reflected by the increasing number of reports of treatment of the worn dentition.

  5. Photodynamic therapy in clinical practice

    OpenAIRE

    E. V. Filonenko; L. G. Serova

    2016-01-01

    The review is on opportunities and possibilities of application of photodynamic therapy in clinical practice. The advantages of this method are the targeting of effect on tumor foci and high efficiency along with low systemic toxicity. The results of the set of recent Russian and foreign clinical trials are represented in the review. The method is successfully used in clinical practice with both radical (for early vulvar, cervical cancer and pre-cancer, central early lung cancer, esophageal a...

  6. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Phases of Clinical Trials Cancer Treatment Types of Cancer Treatment Surgery Radiation Therapy Chemotherapy Immunotherapy Targeted Therapy Hormone Therapy Stem Cell Transplant Precision ...

  7. Clinical Data Warehousing - A Survey

    DEFF Research Database (Denmark)

    Pedersen, Torben Bach; Jensen, Christian Søndergaard

    1998-01-01

    In this article we present the concept of data warehousing, and its use in the clinical area. Clinical data warehousing will become very important in the near future, as healthcare enterprises need to gain more information from their clinical, administrative, and financial data, in order to improve...... quality and reduce costs. Adoption of data warehousing in health care has been slowed by lack of understanding of the benefits offered by the technology. This paper contributes by providing needed understanding, by introducing the opportunities offered by data warehousing, describing current efforts...... in the area, and providing criteria for comparing clinical data warehouse systems....

  8. In the Clinic. Smoking Cessation.

    Science.gov (United States)

    Patel, Manish S; Steinberg, Michael B

    2016-03-01

    This issue provides a clinical overview of smoking cessation, focusing on health consequences of smoking, prevention of smoking-related disease, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  9. Clinic Health Awareness Program Subsystem -

    Data.gov (United States)

    Department of Transportation — Clinic Health Awareness Program Subystem (CHAPS) is a comprehensive system for recording, reporting, and analyzing a patient’s medical information and managing an...

  10. Clinical outcomes in clinical trials of anti-HIV treatment

    DEFF Research Database (Denmark)

    Reekie, J; Mocroft, A; J, Neaton;

    2007-01-01

    Since the introduction of combination antiretroviral therapy, there has been a decrease in both AIDS-defining illnesses and deaths. This decrease meant that performing clinical trials with clinical outcomes in HIV infection became more time consuming and hence costly. Improved understanding...

  11. Designing for Anxiety Therapy, Bridging Clinical and Non-Clinical

    DEFF Research Database (Denmark)

    Bertelsen, Olav Wedege; Kramp, Gunnar

    2012-01-01

    In this position paper we discuss, in terms of the concept of boundary objects, how a mobile application, the MIKAT.app, bridge between clinical intervention in anxiety therapy, and life and coping strategies outside the clinic and across phases of being a person suffering from, or having suffered...

  12. Clinical outcomes in clinical trials of anti-HIV treatment

    DEFF Research Database (Denmark)

    Reekie, J; Mocroft, A; J, Neaton;

    2007-01-01

    Since the introduction of combination antiretroviral therapy, there has been a decrease in both AIDS-defining illnesses and deaths. This decrease meant that performing clinical trials with clinical outcomes in HIV infection became more time consuming and hence costly. Improved understanding and k...

  13. Bracket/wire play: what to expect from tipping prescription on pre-adjusted appliances Folga braquete/fio: o que esperar da prescrição para inclinação nos aparelhos pré-ajustados

    Directory of Open Access Journals (Sweden)

    Leopoldino Capelozza Filho

    2012-08-01

    Full Text Available INTRODUCTION: The opinion on the 'straight-wire' concept has been evolving since its origin, characterized by faithful followers or absolute skepticism. Currently, it seems reasonable to state that most professionals have a more realistic and critical viewpoint, with an attitude that reveals Orthodontics' maturity and greater knowledge on the technique. The most relevant criticisms refer to the impossibility of the both the Straight-Wire and the Standard systems to completely express the characteristics related to the brackets due to mechanical deficiencies, such as bracket/wire play. OBJECTIVES: A critical analysis of this relationship, which is unclear due to lack of studies, was the scope of this paper. METHODS: The compensatory treatment of two patients, using Capelozza's individualized brackets, works as the scenery for cephalometric evaluation of changes in incisor inclination produced by different dimensions of leveling archwires. RESULTS: The evaluation of these cases showed that, while the introduction of a 0.019 x 0.025-in stainless steel archwire in a 0.022 x 0.030-in slot did not produce significant changes in incisor inclination, the 0.021 x 0.025-in archwire was capable of changing it, mainly in mandibular incisors, and in the opposite direction to the compensation. CONCLUSION: Considering compensatory treatments, even when using an individualized prescription according to the malocclusion, the bracket/wire play seems to be a positive factor for malocclusion correction, without undesirable movements. Therefore, it seems reasonable to admit that, until a bracket system can have absolute individualization, the use of rectangular wires that still have a certain play with the bracket slot is advisable.INTRODUÇÃO: a opinião sobre o conceito Straight-Wire tem evoluído desde sua origem, caracterizada por seguidores fiéis ou ceticismo absoluto. Atualmente, parece razoável acreditar que a maioria dos profissionais tem uma visão mais realista e crítica, com uma postura que revela maturidade da Ortodontia e maior conhecimento sobre a técnica. As maiores críticas, e com fundamento, referem-se à impossibilidade do sistema, seja Straight-Wire ou Edgewise, expressar totalmente as características embutidas nos braquetes, devido a deficiências mecânicas como folga entre braquetes e fios. OBJETIVOS: uma análise crítica dessa relação mal explicada, pela carência de estudos, foi o escopo desse artigo. MÉTODOS: o tratamento compensatório de dois pacientes, realizados com braquetes individualizados Capelozza, serve de cenário para uma avaliação cefalométrica das alterações nas inclinações dos incisivos produzidas por diferentes calibres de arcos de nivelamento. Resultados: a avaliação dos casos mostrou que, enquanto a introdução do arco de nivelamento de aço 0,019" X 0,025" em canaleta 0,022" X 0,030" não produziu alterações significativas nas inclinações dos incisivos, o arco 0,021" X 0,025"foi capaz de alterá-las, principalmente nos incisivos inferiores, e em direção contrária ao sentido da compensação. CONCLUSÃO: em tratamentos compensatórios, mesmo buscando-se utilizar prescrição individualizada de acordo com a má oclusão, a folga entre braquete e fio parece ser um fator positivo para que ocorra a correção da oclusão, sem que movimentos indesejáveis aconteçam. Assim, parece razoável admitir que, até que um sistema de braquetes permita ter uma individualização absoluta, é recomendável a utilização de fios retangulares que preservem uma folga com a canaleta do braquete.

  14. Planejamento do balanço bancário: desenvolvimento de um modelo matemático de otimização do retorno econômico ajustado ao risco

    Directory of Open Access Journals (Sweden)

    Solange Garcia dos Reis

    2001-08-01

    Full Text Available Este trabalho consiste na concepção de um modelo matemático de otimização para auxiliar a escolha das categorias de ativos e passivos que comporão a estrutura patrimonial de uma instituição bancária em períodos futuros. O modelo de decisão dos gestores bancários, o qual é traduzido pelo modelo matemático, considera a necessidade de um processo de planejamento estruturado, no qual são escolhidas as alternativas que proporcionarão o maior retorno econômico e, simultaneamente, considera a necessidade de atendimento às limitações do ambiente operacional dos bancos: suas políticas internas em relação ao risco e liquidez, os relacionamentos contábeis do balanço a cada período do horizonte de planejamento, os requisitos normativos exigidos pelos reguladores bancários e as restrições relativas aos volumes de negociação suportáveis pelo mercado. A principal restrição abordada no modelo é a limitação de capital próprio para cobertura de riscos do portfólio. Esse aspecto é contemplado da perspectiva dos reguladores, por meio da modelagem dos requerimentos normativos de capital, e da perspectiva dos gestores, por meio da proposta de utilização de um modelo estatístico para mensuração do risco. O modelo matemático construído é caracterizado como um modelo de programação não-linear, multiperiódico e probabilístico.This paper is concerned with the construction of a mathematical optimization model that helps to choose the categories of assets and liabilities that will form the balance sheet of a bank in future periods. The mathematical model herein represents a decision model for bank managers. In its assumptions, it considers the necessity of a structural planning, in which there some alternatives have to be chosen to provide a better economic return. In addition, it also considers the necessity of meeting the constraints of a bank's operational environment: politics established by the Company regarding risk and liquidity, the accounting relations in the balance sheet from each period in the planning scope, the regulatory requirements defined by banking regulators, as well as the restrictions on acceptable volumes of trade. The major constraint in the model is the capital adequacy towards the coverage of portfolio risks.This aspect is considered not only from the regulators' perspective, which provides a formula to calculate the capital requirements, but also from the managers' perspective, represented by a suggested statistical model to measure risk. The present mathematical model is considered to be a non-linear programming, multi-periodic and probabilistic one.

  15. Risco nutricional em cirurgia avaliado pelo índice de massa corporal ajustado ou não para pacientes idosos Nutritional risk in surgery evaluated by body mass index adjusted or not to elderly patients

    Directory of Open Access Journals (Sweden)

    Alberto Bicudo-Salomão

    2006-09-01

    Full Text Available RACIONAL: O índice de massa corporal vem sendo usado indistintamente entre idosos ou não para a avaliação do estado nutricional. A hipótese deste trabalho é a de que em pacientes idosos um ponto de corte mais alto para o índice de massa corporal pode ter maior validade na aferição do risco nutricional em cirurgia. OBJETIVO: Avaliar a morbimortalidade em pacientes cirúrgicos idosos comparada a pacientes mais jovens e sua associação com valores baixos de índice de massa corporal utilizando-se um ponto de corte convencional (18,5 kg/m² e outro adaptado para pacientes com idade avançada (24 kg/m². PACIENTES E MÉTODOS: Um mil e novecentos e doze pacientes foram divididos em dois grupos: 65 anos (n = 285. Comparou-se nos dois grupos o tempo de internação e a morbimortalidade. Pacientes com idade >65 anos foram estratificados segundo o índice de massa corporal 65 anos (6 [1-75] dias vs. 4 [1-137] dias, assim como as complicações pós-operatórias (37/285; 13,0% vs. 109/1627; 6,7%; OR 2,1; IC95% 1,40-3,09 e óbitos (15/285; 5,3% vs. 34/1627; 2,1%; OR 2,6; IC95% 1,40-4,84. Em pacientes com índice de massa corporal BACKGROUND: Standard body mass index cut-off points for malnutrition are routinely used for adults independently of their age. The hypothesis of this study was that a cut-off point higher than the usual for the diagnosis of malnutrition might be more precise to access the nutritional risk of aged surgical patients. AIM: To evaluate the morbimortality in aged surgical patients and its association with nutritional status assessed by body mass index using either the standard and a higher cut-off point for malnutrition. PATIENTS AND METHODS: All patients admitted for operative procedures (n = 1,912 were allocated to either two groups: 65 years old (n = 285. The body mass index was used to access the nutritional status. Two different cut-off points for malnutrition (18.5 or 24 kg/m² were used in the group of older patients. Endpoints of the study were length of stay, morbidity and mortality. RESULTS: Length of stay was higher in patients over 65 years (6 [1-75] days vs. 4 [1-137] days. Both postoperative complications (37/285; 13.0% vs. 109/1627; 6,7%; OR 2,1; IC95% 1,40-3,09 and deaths (15/285; 5.3% vs. 34/1627; 2,1%; OR 2,6; IC95% 1,40-4,84 were most common in the older group. Using a higher cut-off (24 kg/m², the length of stay (8 [1-75] days vs. 4 [1-43] days, postoperative complications (28/152; 18.4% versus 9/133; 6.8%; OR 3,1; IC95% 1.41-6.86 and re-operations (16/152; 10.5% versus 3/133; 2.2%; OR 5.1; IC95% 1.45-17.91 were greater in malnourished patients. However these correlations were not statistically significant with the cut-off point for malnutrition in 18.5 kg/m². CONCLUSIONS: Morbimortality is higher in surgical patients over 65 years old. In these, the cut-off point set in 24 kg/m² was most associated with the occurrence of postoperative complications, re-operations and length of stay.

  16. Impacto económico de las enfermedades y pacientes atendidos en atención primaria. Adaptación de los grupos clínicos ajustados (ACGs) en nuestro medio.

    OpenAIRE

    Sicras Mainar, Antoni

    2002-01-01

    El objetivo general de este trabajo es medir el impacto económico de las enfermedades y pacientes atendidos en un Centro de Atención Primaria, así como describir el comportamiento y la adaptación de un sistema de clasificación de pacientes por iso-consumo de recursos (ACGs) en nuestro ámbito. Se efectúa un diseño observacional descriptivo de carácter exploratorio. El emplazamiento es en el Área básica de Salud Apenins-Montigalà de Badalona (centro urbano reformado y concertado), que atiende a...

  17. Avaliação de um modelo de distribuição diamétrica ajustado para povoamentos de Tectona grandis submetidos a desbaste Evaluation of a diametric distribution model adjusted for thinned Tectona grandis stands

    Directory of Open Access Journals (Sweden)

    Gilciano Saraiva Nogueira

    2006-06-01

    Full Text Available Este estudo teve como objetivo avaliar, do ponto de vista do realismo biológico, um modelo de distribuição diamétrica, bem como a eficiência do método dos ingressos porcentuais para determinação da idade técnica do primeiro e do segundo desbaste de povoamentos de teca (Tectona grandis L. f.. A avaliação consistiu em comparar as idades técnicas de desbaste obtidas pelo método dos ingressos porcentuais, as distribuições diamétricas projetadas para idades futuras e o comportamento da distribuição remanescente, após algumas simulações de desbaste, com a tendência lógica esperada. Pôde-se concluir que o modelo de distribuição diamétrica proposto gera estimativas que seguem uma tendência lógica do ponto de vista biológico e que o método dos ingressos porcentuais é adequado para determinar a idade técnica do primeiro e do segundo desbaste.The objective of this study was to evaluate, under the biological point of view, a diametric distribution model. Another objective was to evaluate the efficiency of the percentage of entries method to determine the technical age for the first and second thinning in teak (Tectona grandis L. f. stands. This evaluation was carried out by comparing the technical thinning ages obtained by the percentage of entries method, the diametric distributions projected for future ages and the behavior of the remaining distribution, after some thinning simulations, with the expected logical tendency. It was be concluded that the proposed diametric distribution model generates estimates which follow a logical tendency, biologically speaking and that the percentage of entries method is suitable to determine the technical age of the first and second thinning.

  18. Clinical aspects of telemedicine

    Science.gov (United States)

    Merrell, Ronald C.

    1991-01-01

    Communication among physicians is an essential in order to combine our experiences for the elucidation and application of new knowledge and for the accurate and uniform application of established medical practice. This communication requires an adequate understanding of the culture of the patient and the social context of disease and indeed the culture of the physician. Malnutrition in Bangladesh means caloric insufficiency, and a program to lower cholesterol would be impertinent, while a program to enhance the nutrition of patients in Texas by an international effort to import more grain would be ludicrous. In the same vein a public health effort to combat alcoholic cirrhosis in Mecca would be as silly as a program to increase fiber in the diet of the Bantu. Clinical communication must acknowledge the culture of the issue at hand and the differences in the experiential base of the physicians. Not only do geography and culture affect the potential differences in the experiential bases, but the world utilizes very different traditions of education and science in training physicians. We are influenced by the diseases we treat, and learn to look for the expected at least as much as we are attentive to the unexpected. A physician in Siberia would be much more likely to recognize frostbite than one from Buenos Aires, and the Argentine doctor would much more likely consider Chaga's Disease to explain abdominal pain than a colleague in Zurich. Beyond these obvious issues in communication among physicians we must deal with the many languages and idioms used in the world. An overview of using Telemedicine SpaceBridge after the earthquake in the Republic of Armenia in 1988 is presented.

  19. Clinical pharmacology of homoharringtonine

    Energy Technology Data Exchange (ETDEWEB)

    Savaraj, N.; Lu, K.; Dimery, I.; Feun, L.G.; Burgess, M.; Keating, M.; Loo, T.L.

    1986-12-01

    Clinical pharmacokinetics of homoharringtonine (HHT) were studied in eight patients who received uniformly labeled HHT at 3-4 mg/m2 (150 mu Ci) by continuous 6-hour infusion. The drug and metabolites were quantified by radiochemical and high-performance liquid chromatographic techniques. Computerized nonlinear least-square regression and curve stripping were used to characterize HHT and total (/sup 3/H)HHT equivalent pharmacokinetics. Unchanged HHT in the plasma declined biphasically, with an alpha-half-life of 0.5 +/- 0.1 hours and a beta-half-life of 9.3 +/- 1.4 hours. The total clearance of HHT was 177.4 +/- 27.7 ml X hour-1 X kg-1, and the apparent volume of distribution, estimated from the area under the drug concentration versus time curve, was 2.4 +/- 0.4 L X kg-1. Correspondingly, the total (/sup 3/H)HHT equivalent disappeared from the plasma in a triphasic manner. Compared with the pharmacokinetic parameters of unchanged HHT, the terminal half-life of total /sup 3/H was 67.5 +/- 7.5 hours, 7.4 times longer; the total clearance was 30.9 +/- 3.1 ml X hour-1 X kg-1, 5.5 times slower; but the volume of distribution by area was 2.7 +/- 0.1 L X kg-1, nearly the same. The 72-hour cumulative urinary excretion of total tritium was 28.2% of the administered dose and only 38.3% of this resided in unchanged HHT. Thus, urinary excretion was not a major route of elimination of HHT. Moreover, HHT underwent extensive metabolism; one major and two minor unidentified products were detected in both plasma and urine.

  20. Clinical reasoning as social deliberation

    DEFF Research Database (Denmark)

    2014-01-01

    In this paper I will challenge the individualistic model of clinical reasoning. I will argue that sometimes clinical practice is rather machine-like, and information is called to mind and weighed, but the clinician is not just calculating how to use particular means to reach fixed ends. Often...

  1. Evaluation of Practical Clinical Examinations.

    Science.gov (United States)

    Berrong, Joseph M.; And Others

    1983-01-01

    The effectiveness of practical examinations in assessing the clinical competence of dental students is discussed. A grading system that derives a significant portion of the senior student's grade from this type of examination is described. The impact of practical clinical examinations on two consecutive graduating classes was analyzed. (Author/MLW)

  2. Two Approaches to Clinical Supervision.

    Science.gov (United States)

    Anderson, Eugene M.

    Criteria are established for a definition of "clinical supervision" and the effectiveness of such supervisory programs in a student teaching context are considered. Two differing genres of clinical supervision are constructed: "supervision by pattern analysis" is contrasted with "supervision by performance objectives." An outline of procedural…

  3. Clinical Service of Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ The clinical practice of traditional Chinese medicine (TCM) faces three major challenges:(1)How to enhance its contribution on overall medical service quality? (2) How to best address the unmet medical needs in the contemporary society? (3)How to guarantee that the traditional perspective for disease diagnosis and treatment not be neglected in clinical practice?

  4. Clinical patterns in Parkinson's disease

    NARCIS (Netherlands)

    Rooden, Stephanie Maria van

    2012-01-01

    The clinical heterogeneity of Parkinson’s disease (PD) patients may reflect the existence of subtypes of the disease. PD subtypes have often been defined by a classification according to researcher-specified criteria, such as age-at-onset or predominant clinical motor features. The general objective

  5. Clinical databases in physical therapy.

    NARCIS (Netherlands)

    Swinkels, I.C.; Ende, C.H.M. van den; Bakker, D. de; Wees, P.J. van der; Hart, D.L.; Deutscher, D.; Bosch, W.J.H.M. van den; Dekker, J.

    2007-01-01

    Clinical databases in physical therapy provide increasing opportunities for research into physical therapy theory and practice. At present, information on the characteristics of existing databases is lacking. The purpose of this study was to identify clinical databases in which physical therapists r

  6. CLINICAL APPLICATION OF ACUPUNCTURE THERAPY

    Institute of Scientific and Technical Information of China (English)

    张玉倩; 李云芳; 王廷华

    2004-01-01

    In the present paper, the authors review some major effects of acupuncture in the treatment of clinical diseases and sum up some results of experimental researches on the mechanisms of acupuncture. Up to now, clinical practice and experimental researches demonstrate that acupuncture possesses good analgesic effect, integrative regulation effect on the functional activities of the body and defense-immune-potentiation effect.

  7. Clinical reporting: the practitioner's responsibility.

    Science.gov (United States)

    Mauser, W W

    1980-08-01

    Information contained in a clinical report represents new directions in the practice of physical therapy and provides the stimulus for reseach and growth in the profession. The responsibility of the practitioner to share information on problems and solutions generated in the practice of physical therapy is of paramount importance. A clinical report is one method by which this information can be disseminated.

  8. INTESTINAL TRANSPLANTATION - A CLINICAL UPDATE

    NARCIS (Netherlands)

    PLOEG, RJ; DALESSANDRO, AM

    1995-01-01

    Background: Until very recently the results of clinical small-bowel transplantation were disappointing. The latest developments indicate, however, that significant improvements have been made towards clinical application of this mode of therapy for patients with short-bowel syndrome. Methods: Becaus

  9. Mobile technology in clinical teaching.

    Science.gov (United States)

    Mackay, B J; Anderson, J; Harding, T

    2017-01-01

    Technology is having a profound effect on education in the 21st century and nurse educators are being challenged to integrate technological innovation to assist students in their learning. This paper reports a study on the introduction of smart mobile technology to support student learning in the clinical environment. In a climate of collaborative inquiry, clinical lecturers and two researchers from the same department carried out a project in three phases: formation, implementation and analysis. Following the formation phase, six clinical lecturers adopted iPads to support their clinical teaching (implementation phase). At this time they also kept reflective journals. In the analysis phase a thematic analysis of the data from the journals and from a focus group found both enabling and constraining factors influenced the use of iPads by clinical lecturers. The themes categorised as enablers were: resources and technology; and, management and technology support. Those identified as barriers or constraining factors were: clinical staff engagement; and lecturer experience with technology. Student engagement and learning, and connectivity were both enabling and constraining factors. This paper concludes that the use of a mobile device such as an iPad can enhance teaching in clinical settings but that in order for such devices to be successfully integrated into clinical teaching consideration needs to be given to professional development needs, adequate resourcing and technology support.

  10. Evidence-based clinical practice

    DEFF Research Database (Denmark)

    Gluud, Christian

    2002-01-01

    Evidence-based medicine combines the patient's preferences with clinical experience and the best research evidence. Randomized clinical trials are considered the most valid research design for evaluating health-care interventions. However, empirical research shows that intervention effects may be...

  11. Clinical polymorphism of endocrine ophthalmopathy

    Directory of Open Access Journals (Sweden)

    V. G. Likhvantseva

    2014-07-01

    Full Text Available Purpose: to analyze clinical polymorphism of endocrine ophthalmopathy in patients with Graves’ disease.Methods: Clinical and radiological data of 18 cases with clinical manifestations of lacrimal gland increase were analyzed and compared with data retrieved from 50 patients without increasing of lacrimal gland.Results: the characteristics of clinical manifestations of endocrine ophthalmopathy with lacrimal gland increase were presented. this form differs, as the organ of the target, along with orbital fat and/or eye muscles becomes the glandula lacrimalis. A correlation between fact involving, on the one hand, and the intensity and severity of the autoimmune process in orbit, on the other hand were identified.Conclusion: Involvement of this secretion organ in the autoimmune process makes the clinical course of endocrine ophthalmopa-thy more complicated, and leads to eye dry syndrome creation.

  12. Clinical polymorphism of endocrine ophthalmopathy

    Directory of Open Access Journals (Sweden)

    V. G. Likhvantseva

    2012-01-01

    Full Text Available Purpose: to analyze clinical polymorphism of endocrine ophthalmopathy in patients with Graves’ disease.Methods: Clinical and radiological data of 18 cases with clinical manifestations of lacrimal gland increase were analyzed and compared with data retrieved from 50 patients without increasing of lacrimal gland.Results: the characteristics of clinical manifestations of endocrine ophthalmopathy with lacrimal gland increase were presented. this form differs, as the organ of the target, along with orbital fat and/or eye muscles becomes the glandula lacrimalis. A correlation between fact involving, on the one hand, and the intensity and severity of the autoimmune process in orbit, on the other hand were identified.Conclusion: Involvement of this secretion organ in the autoimmune process makes the clinical course of endocrine ophthalmopa-thy more complicated, and leads to eye dry syndrome creation.

  13. Medical coding in clinical trials

    Directory of Open Access Journals (Sweden)

    Deven Babre

    2010-01-01

    Full Text Available Data generated in all clinical trial are recorded on the data collection instrument Case report Form / Electronic Case Report Form by investigators located at various sites in various countries. In multicentric clinical trials since different investigator or medically qualified experts are from different sites / centers recording the medical term(s uniformly is a big challenge. Medical coders from clinical data management team process these terms and perform medical coding. Medical coding is performed to categorize the medical terms reported appropriately so that they can be analyzed/reviewed. This article describes process which is used for medical coding in clinical data management and two most commonly used medical dictionaries MedDRA and WHO-DDE in brief. It is expected to help medical coders to understand the process of medical coding in clinical data management. Few common issues which the medical coder faces while performing medical coding, are also highlighted.

  14. [Hospital clinical ethics committees].

    Science.gov (United States)

    Gómez Velásquez, Luis; Gómez Espinosa, Luis Néstor

    2007-01-01

    The scientific and technological advances have been surprising, more in the two last decades, but they don't go united with to the ethical values of the medical professional practice, it has been totally escaped, specially when the biological subsistence, the maintenance of the life through apparatuses and the mechanisms that prolong the existence are who undergoes an alteration that until recently time was mortal shortly lapse. It is common listening that exist a crisis in the medical profession, but what really is it of human values, which as soon and taken into nowadays, actually professional account, which gives rise to a dehumanization towards the life, the health, the disease, the suffering and the death. The ideal of the doctor to give to service to the man in its life and health, as well to be conscious that the last biological process that must fulfill is the death, and when it appears, does not have considered as a actually professional failure. It has protect to the patient as the extreme cruelty therapeutic, that it has right a worthy death. It's taking to the birth of the hospital ethics committees, they have like function to analyze, to advise and to think about the ethical dilemmas that appear actually clinical or in the biomedical investigation. In 1982 in the UEA only 1% of its hospitals had a ethics committees; by 1988, it was 67% and the 100% in 2000. In Mexico the process of the formation by these committees begins, only in the Military Central Hospital, to count the ethics committee on 1983, also the Hospital no. 14 of the IMSS in Guadalajara, it works with regularity from 1995, with internal teaching of bioethic. The Secretariat of Health has asked the formation of the bioethical committees in each hospital, and order the it was be coordinated by the National Committee of Bioética. The integration of these committees is indispensable that their members have the knowledge necessary of bioética. The Mexican Society of Ortopedia, conscious of

  15. Clinical application of pet

    Directory of Open Access Journals (Sweden)

    Francisco Lomeña

    2005-10-01

    Full Text Available Positron emission tomography (PET is an imaging modality that gives information on tissue metabolism and functionalism, different from other imaging techniques like computed tomography (CT and magnetic resonance imaging (MRI, which provide anatomical or structural information. PET has reached its development in biomedical research because of its capacity to use analogous compounds of many endogenous substance as tracers, and to measure, in vivo and in a non-invasive way, their consumption by the different organs and tissues of the mammalian body. Fluordeoxyglucose-F18 (FDG PET has been proven to be a tracer adequate for clinical use in oncology and in many neurological diseases, with an excellent cost-efficiency ratio. The current PET-CT scanners can come to be the best tools for exploring patients who suffer from cancer.A tomografia por emissão de pósitrons (PET é uma técnica de diagnóstico por imagem que fornece informação sobre o metabolismo e funcionamento dos tecidos, diferente de outras técnicas de imagens como tomografia computadorizada (TC e ressonância magnética (RM, as quais fornecem informações estruturais ou anatômicas. O PET alcançou seu desenvolvimento em investigação biomédica devido à sua capacidade de usar traçadores análogos a muitas substâncias endógenas e de medir in vivo e de forma não invasiva seu consumo em diferentes órgãos e tecidos dos mamíferos 18Fluordesoxiglicose (FDG PET tem provado ser uma exploração de uso clínico com excelente relação custo benefício em oncologia e em muitas doenças neurológicas. Os atuais tomógrafos por PET-CT podem chegar a ser a melhor ferramenta de diagnóstico nos pacientes que sofrem de câncer.

  16. VIIP 2017 Clinical Update

    Science.gov (United States)

    Tarver, William

    2017-01-01

    INTRODUCTION: NASA's Space Medicine community knowledge regarding the "Vision Impairment Intracranial Pressure", or VIIP.has been evolving over time.. Various measures of occupational health related to this condition had to be determined and then plans/processes put into place. The most robust of these processes were inititated in 2010. This presentation will provide a clinic update of the astronaut occupational health data related to VIIP. METHODS: NASA and its international partners require its astronauts to undergo routine health measures deemed important to monitoring VIIP. The concern is that the spaceflight environment aboard ISS could cause some astronauts to have physiologic changes detrimental to either ongoing mission operations or long-term health related to the ocular system and possibly the CNS. Specific medical tests include but are not limited to brain/orbit MRI (NASA unique protocol), OCT, fundoscopy and ocular ultrasound. Measures are taken prior to spaceflight, in-flight and post-flight. Measures to be reported include incidence of disc edema, globe flattening, choroidal folds, ONSD and change in refractive error. RESULTS: 73 ISS astronauts have been evaluated at least partially for VIIP related measures. Of these individuals, approximately 1 in 7 have experienced disc edema. The prevalence of the other findings is more complicated as the medical testing has changed over time. Overall, 26 separate individuals have experienced at least one of the findings NASA has associated with VIIP Another confounding factor is most of the astronauts have prior spaceflight experience at the time of the "pre-flight" testing. DISCUSSION: In 2010 NASA and its US operating segment (USOS) partners (CSA, ESA and JAXA) began routine occupational monitoring and data collection for most VIIP related changes. Interpretation of that data is extremely challenging for several reasons. For example, the determination of disc edema is the most complete finding as we have had

  17. Social media in clinical trials.

    Science.gov (United States)

    Thompson, Michael A

    2014-01-01

    Social media has potential in clinical trials for pointing out trial issues, addressing barriers, educating, and engaging multiple groups involved in cancer clinical research. Social media is being used in clinical trials to highlight issues such as poor accrual and barriers; educate potential participants and physicians about clinical trial options; and is a potential indirect or direct method to improve accrual. We are moving from a passive "push" of information to patients to a "pull" of patients requesting information. Patients and advocates are often driving an otherwise reluctant health care system into communication. Online patient communities are creating new information repositories. Potential clinical trial participants are using the Twittersphere and other sources to learn about potential clinical trial options. We are seeing more organized patient-centric and patient-engaged forums with the potential to crowd source to improve clinical trial accrual and design. This is an evolving process that will meet many individual, institutional, and regulatory obstacles as we move forward in a changed research landscape.

  18. Clinical Practice in Portuguese Sexology.

    Science.gov (United States)

    Alarcão, Violeta; Ribeiro, Sofia; Almeida, Joana; Giami, Alain

    2016-12-02

    Few studies explore the clinicians' knowledge, attitudes, and practices regarding sexuality, despite their role in the sexual-health socialization process. This study focuses on Portuguese sexologists engaged in clinical practice. It aims to characterize sexologists' sex education and training and their clinical practices, including diagnostic and therapeutic approaches. This research followed the methodology of an European survey on sexology as a profession (Euro-Sexo). From the 91 respondents who completed questionnaires, 51 (56%) were active in clinical practice. Results indicate that the Portuguese clinical sexologist is significantly older, predominantly male, has had training in sexology, performs more scientific research, and is more engaged in teaching activities when compared to nonclinical working sexologists. This article describes the main sexual problems presented by patients to Portuguese clinical sexologists and highlights differences in the professional groups and approaches toward treating these problems by medical doctors and nonmedical professionals. Results reinforce the idea that there are intra-European differences in the educational background of sexologists and reveal important variations in Portuguese sexologists' education, training, and clinical practice. The representations and practices of the sexologists in Portugal, as in other European countries, are embedded in cultural scenarios and sexual cultures, with implications for the clinical practice.

  19. Clinical research before informed consent.

    Science.gov (United States)

    Miller, Franklin G

    2014-06-01

    Clinical research with patient-subjects was routinely conducted without informed consent for research participation prior to 1966. The aim of this article is to illuminate the moral climate of clinical research at this time, with particular attention to placebo-controlled trials in which patient-subjects often were not informed that they were participating in research or that they might receive a placebo intervention rather than standard medical treatment or an experimental treatment for their condition. An especially valuable window into the thinking of clinical investigators about their relationship with patient-subjects in the era before informed consent is afforded by reflection on two articles published by psychiatric researchers in 1966 and 1967, at the point of transition between clinical research conducted under the guise of medical care and clinical research based on consent following an invitation to participate and disclosure of material information about the study. Historical inquiry relating to the practice of clinical research without informed consent helps to put into perspective the moral progress associated with soliciting consent following disclosure of pertinent information; it also helps to shed light on an important issue in contemporary research ethics: the conditions under which it is ethical to conduct clinical research without informed consent.

  20. Binge eating disorder: from clinical research to clinical practice.

    Science.gov (United States)

    Goracci, Arianna; Casamassima, Francesco; Iovieno, Nadia; di Volo, Silvia; Benbow, Jim; Bolognesi, Simone; Fagiolini, Andrea

    2015-01-01

    This case report describes the clinical course of a young woman suffering from binge eating disorder (BED) associated with obesity. It illustrates the efficacy of different medications in the treatment of BED and related conditions and is followed by the comments and clinical observations of 2 practicing psychiatrists. The issues described in this paper have important clinical implications and are topical, given that BED is now recognized as a specific disorder in the new Diagnostic and Statistical Manual of Mental Disorders, fifth edition classification system, but neither the US Food and Drug Administration nor any other regulatory agency has yet approved a drug for treatment of this disease, despite its very prevalent and disabling nature. Growing evidence from the fields of psychopathology and neurobiology, including preclinical and clinical studies, converges to support the idea that "overeating" has much in common with other behavioral addictions, and substance abuse treatment agents may show promise for the treatment of BED.

  1. How GPs implement clinical guidelines in everyday clinical practice

    DEFF Research Database (Denmark)

    Videbæk Le, Jette; Hansen, Helle P; Riisgaard, Helle;

    2015-01-01

    . Interviews were recorded, transcribed verbatim and then analysed using systematic text condensation. RESULTS: Analysis of the interviews revealed three different approaches to the implementation of guidelines in clinical practice. In some practices the GPs prioritized time and resources on collective...

  2. Clinical photoacoustic imaging of cancer

    Directory of Open Access Journals (Sweden)

    Keerthi S. Valluru

    2016-10-01

    Full Text Available Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented.

  3. Clinical photoacoustic imaging of cancer.

    Science.gov (United States)

    Valluru, Keerthi S; Willmann, Juergen K

    2016-10-01

    Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented.

  4. Clinical Genetic Testing in Gastroenterology

    Science.gov (United States)

    Goodman, Russell P; Chung, Daniel C

    2016-01-01

    Rapid advances in genetics have led to an increased understanding of the genetic determinants of human disease, including many gastrointestinal (GI) disorders. Coupled with a proliferation of genetic testing services, this has resulted in a clinical landscape where commercially available genetic tests for GI disorders are now widely available. In this review, we discuss the current status of clinical genetic testing for GI illnesses, review the available testing options, and briefly discuss indications for and practical aspects of such testing. Our goal is to familiarize the practicing gastroenterologist with this rapidly changing and important aspect of clinical care. PMID:27124700

  5. Modern Management of Clinical Chorioamnionitis

    Directory of Open Access Journals (Sweden)

    Thomas Westover

    1995-01-01

    Full Text Available Clinical chorioamnionitis continues to contribute to fetal and maternal morbidity and mortality. Significant advances have been made in the last 20 years in understanding the pathophysiologic processes leading to chorioamnionitis. This review addresses the history, incidence, pathophysiology, host defenses, risk factors, diagnosis, and maternal and neonatal management of clinically evident chorioamnionitis. After a detailed review of the physiologic processes leading to clinical chorioamnionitis and sepsis, we present a modern management scheme designed to optimize perinatal outcome for both mother and fetus.

  6. Clinical photoacoustic imaging of cancer

    Energy Technology Data Exchange (ETDEWEB)

    Valluru, Keerthi S.; Willmann, Juergen K. [Dept. of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford (United States)

    2016-08-15

    Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented.

  7. Clinical photoacoustic imaging of cancer

    Science.gov (United States)

    2016-01-01

    Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented. PMID:27669961

  8. ¿Puede asociarse el sedentarismo con hallazgos clínicos de alarma de enfermedad crónica en adultos jóvenes?. Un análisis en el proyecto CHICAMOCHA / Can Sedentarism be Associated with Alarm Clinical Findings of Chronic Diseases in Young Adults?. An Analysis in CHICAMOCHA Project / Poderia associar-se o sedentarismo às conclusões clínicas de alarme de doenças crônicas em adultos jovens?. Análise no projeto CHICAMOCHA

    Directory of Open Access Journals (Sweden)

    Juan Carlos Villar-Centeno, MD., Esp., MsC., PhD.

    2015-07-01

    Full Text Available Introducción: La asociación entre sedentarismo y enfermedades crónicas no transmisibles (ECNT requiere décadas de exposición. Es posible que esta se manifieste más tempranamente, por algunos hallazgos clínicos en adultos jóvenes. Objetivo: Probar la hipótesis de que en adultos jóvenes el sedentarismo se asocia con algunos signos o síntomas de alarma para el desarrollo posterior de ECNT. Metodología: Usando la evaluación inicial (años 2000-2003 del proyecto CHICAMOCHA, en 1539 donantes de sangre clínicamente saludables con pruebas de tamización negativas (edad media 36, DE 8,3 años, 66% hombres se estudió la asociación entre sedentarismo y una serie de hallazgos clínicos. Se definió sedentarismo como reportar actividad física moderada-intensa ≤150 minutos/semana (incluyendo el trabajo. El desenlace primario fue el compuesto de 11 hallazgos (5 síntomas y 6 signos de alarma encontrados en la valoración médica. La asociación fue estimada usando un modelo regresión logística ajustado por covariables. Resultados: Se encontró que 56.9% (IC95% 54.3 – 59.3 de los participantes eran sedentarios. En el análisis multivariado, el sedentarismo se asoció positivamente con el estado civil soltero y negativamente con estar empleado. No se encontraron asociaciones significativas en el compuesto agregado de 5 síntomas (OR ajustado 1.07, IC95% 0.90 – 1.26, 6 signos (OR ajustado 1.01, IC95% 0.79 – 1.28. Sin embargo, se observó un gradiente positivo no significativo por el número de hallazgos presentes (1 hallazgo OR=0.91, IC95% 0.61 – 1.35, 2 hallazgos (OR=1.20, IC95% 0.84 – 1.73, 3 o más hallazgos (OR=1.31, IC95% 0.91 – 1.89. Conclusiones: Más de la mitad de la población estudiada se encontró sedentaria. Aunque este factor no se encontró asociado con signos o síntomas individualmente, se identificó un gradiente no significativo con el número de estos hallazgos, posiblemente relacionado con el tiempo de

  9. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Trials Information A to Z List of Cancer Drugs Complementary & Alternative Medicine (CAM) Questions to Ask about ... Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings & Cancer Adjusting to ...

  10. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Unusual Cancers of Childhood Treatment Childhood Cancer Genomics Study Findings Metastatic Cancer Metastatic Cancer Research Common Cancer ... Trials Insurance Coverage and Clinical Trials How to Work With Your Health Insurance Plan Federal Government Programs ...

  11. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Cancer Research and Discovery Stories of Discovery R&D Resources Conducting Clinical Trials Statistical Tools and Data ... about some of NCI's major research initiatives R&D Resources Tools and data sets for researchers Research ...

  12. A review of clinical guidelines.

    LENUS (Irish Health Repository)

    Andrews, E J

    2012-02-03

    BACKGROUND: Clinical guidelines are increasingly used in patient management but few clinicians are familiar with their origin or appropriate application. METHODS: A Medline search using the terms \\'clinical guidelines\\' and \\'practice guidelines\\' was conducted. Additional references were sourced by manual searching from the bibliographies of articles located. RESULTS AND CONCLUSION: Clinical guidelines originated in the USA in the early 1980s, initially as a cost containment exercise. Significant improvements in the process and outcomes of care have been demonstrated following their introduction, although the extent of improvement varies considerably. The principles for the development of guidelines are well established but many published guidelines fall short of these basic quality criteria. Guidelines are only one aspect of improving quality and should be used within a wider framework of promoting clinical effectiveness. Understanding their limitations as well as their potential benefits should enable clinicians to have a clearer view of their place in everyday practice.

  13. Clinical Decision Support (CDS) Inventory

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Clinical Decision Support (CDS) Inventory contains descriptions of past and present CDS projects across the Federal Government. It includes Federal projects,...

  14. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Trials Insurance Coverage and Clinical Trials How to Work With Your Health Insurance Plan Federal Government Programs Patient Safety Informed Consent Children's Assent Scientific Review Ending Trials Early Deciding to Take Part ...

  15. Clinical Information Support System (CISS)

    Data.gov (United States)

    Department of Veterans Affairs — Clinical Information Support System (CISS) is a web-based portal application that provides a framework of services for the VA enterprise and supplies an integration...

  16. [Research activity in clinical biochemistry

    DEFF Research Database (Denmark)

    Jorgensen, H.L.; Larsen, B.; Ingwersen, P.

    2008-01-01

    BACKGROUND: Quantitative bibliometric measurements of research activity are frequently used, e.g. for evaluating applicants for academic positions. The purpose of this investigation is to assess research activity within the medical speciality of Clinical Biochemistry by comparing it with a matched...... Clinical Biochemistry, 57 fulfilled the inclusion criteria. Each of these 57 was matched according to medical title with two randomly chosen specialists from other specialities, totaling 114. Using Medline and the Web of Science, the number of publications and the number of citations were then ascertained....... RESULTS: 25% of the 11,691 specialists held a PhD degree or doctoral degree, DMSci, (Clinical Biochemistry: 61%). The 171 specialists included in the study had 9,823 papers in Medline and 10,140 papers in the Web of Science. The number of Medline papers per specialist was 71 for Clinical Biochemistry...

  17. Evaluating the veterinary clinical teacher

    NARCIS (Netherlands)

    Boerboom, T.B.B.

    2011-01-01

    Introduction Providing clinical teachers with student feedback is an important part of faculty development. The current literature provides a range of instruments developed to generate student rating feedback. However, these instruments often lack a theoretical framework and evidence concerning thei

  18. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Lung Cancer Lymphoma Pancreatic Cancer ... Therapy Chemotherapy Immunotherapy Targeted Therapy Hormone Therapy Stem Cell Transplant Precision Medicine Side Effects Clinical Trials Information ...

  19. American Society of Clinical Oncology

    Science.gov (United States)

    ... of Interest Mobile App Privacy Policy Privacy Policy Social Media Policy Sponsor Policy Terms of Use American Society of Clinical Oncology ASCO Annual Meeting Register and Reserve Your Hotel June 2-6, 2017 | Chicago, Illinois Hotel Reservation & ...

  20. Doctor, Clinic, and Dental Visits

    Science.gov (United States)

    ... Viral Suppression Doctor, Clinical & Dental Visits Treatment Adherence Mental Health Substance Abuse Issues Sexual Health Nutrition & Food Safety Exercise Immunizations Aging with HIV/AIDS Women’s Health Housing ...

  1. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Report (RPPR) Grant Closeout Grant Resources NCI Grants Management Legal Requirements NCI Grant Policies Grants Management Contacts ...

  2. What Are Clinical Trial Phases?

    Science.gov (United States)

    ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Report (RPPR) Grant Closeout Grant Resources NCI Grants Management Legal Requirements NCI Grant Policies Grants Management Contacts ...

  3. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Contacts Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training ...

  4. Inquiry Teaching in Clinical Periodontics.

    Science.gov (United States)

    Heins, Paul J.; Mackenzie, Richard S.

    1987-01-01

    An adaptation of the inquiry method of teaching, which develops skills of information retrieval and reasoning through systematic questioning by the teacher, is proposed for instruction in clinical periodontics. (MSE)

  5. TB vaccines in clinical development

    OpenAIRE

    McShane, H; Ginsberg, AM; Ruhwald, M.; Mearns, H

    2016-01-01

    The 4th Global Forum on TB Vaccines, convened in Shanghai, China, from 21 – 24 April 2015, brought together a wide and diverse community involved in tuberculosis vaccine research and development to discuss the current status of, and future directions for this critical effort. This paper summarizes the sessions on TB Vaccines in Clinical Development, and Clinical Research: Data and Findings. Summaries of all sessions from the 4th Global Forum are compiled in a special supplement of Tuberculosi...

  6. Cleveland Clinic Rehabilitation Research Program

    Science.gov (United States)

    2015-12-01

    Maxwell-Faraday Equations. (B) Due to the nature of circular MS coils, negligible current is induced from the center of the MS coil, described as the...the patients prior to enrollment. Figure 6. iSCI patients with more functional gains from therapy had increased demyelination in the...Clinical and Translational Science Association’s Clinical Research Unit assistance has helped attenuate any safety threats. B. Publications and

  7. [Clinical gait analysis: user guide].

    Science.gov (United States)

    Armand, Stéphane; Bonnefoy-Mazure, Alice; Hoffmeyer, Pierre; De Coulon, Geraldo

    2015-10-14

    Clinical gait analysis has become an indispensable medical examination for the management of patients with complex gait disorders. As its name suggests, the purpose of this examination is to assess patients whilst they are walking in a laboratory setting. Measurements include: 3 dimensional joint motion, forces applied to joints, and electromyographic muscle activity. This quantitative data allows identification of walking deviations and to deduce the likely causes of these deviations thanks to the clinical data available for each patient.

  8. Electrochemical Sensors for Clinic Analysis

    OpenAIRE

    Guang Li; Jianming Zhang; Hui Xu; You Wang

    2008-01-01

    Demanded by modern medical diagnosis, advances in microfabrication technology have led to the development of fast, sensitive and selective electrochemical sensors for clinic analysis. This review addresses the principles behind electrochemical sensor design and fabrication, and introduces recent progress in the application of electrochemical sensors to analysis of clinical chemicals such as blood gases, electrolytes, metabolites, DNA and antibodies, including basic and applied research. Minia...

  9. Clinical Application of Nape Acupuncture

    Institute of Scientific and Technical Information of China (English)

    HUA Xiao-yin; CUI Yi-jun

    2003-01-01

    @@ Nape Acupuncture refers to an acupuncture method at nuchal region. It was initiated and applied in clinic by Dr. HUA Yan-ling from Shanghai Research Institute of Acupuncture and Meridian and it can be used for treating diseases of nervous, circulatory and motor systems. Especially, it is more effective for brain-origin diseases. The author ever studied this acupuncture method from Dr. Hua and found it was effective according to clinical application. Now several typical cases are reported as follows.

  10. Cleveland Clinic Rehabilitation Research Program

    Science.gov (United States)

    2014-10-01

    functional impairments of the arm and hand , effects are weak and invariable. Limited succcess of rehabilitation is speculated to be associated with...Award Number: W81XWH-11-1-0707 TITLE: Cleveland Clinic Rehabilitation Research Program PRINCIPAL INVESTIGATOR: Vernon Lin, MD PhD CONTRACTING...CONTRACT NUMBER Cleveland Clinic Rehabilitation Research Program 5b. GRANT NUMBER W81XWH-11-1-0707 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

  11. Clinical case of toxocariasis chorioretinitis

    Directory of Open Access Journals (Sweden)

    I. G. Pikhovskaia

    2014-07-01

    Full Text Available The clinical case of a toxocariasis chorioretinitis which is of interest for ophthalmologists is described. Insufficient knowledge of clinic and diagnostics of a lesion of eyes by Toxocara canis, their infrequent occurrence, similarity of the ophthalmologic picture with inflammatory diseases and eye neoplasms can be at the bottom of gross diagnostic mistake and wrong choice of treatment tactics.

  12. Clinical case of toxocariasis chorioretinitis

    Directory of Open Access Journals (Sweden)

    I. G. Pikhovskaia

    2013-01-01

    Full Text Available The clinical case of a toxocariasis chorioretinitis which is of interest for ophthalmologists is described. Insufficient knowledge of clinic and diagnostics of a lesion of eyes by Toxocara canis, their infrequent occurrence, similarity of the ophthalmologic picture with inflammatory diseases and eye neoplasms can be at the bottom of gross diagnostic mistake and wrong choice of treatment tactics.

  13. Clinical relevance in anesthesia journals

    DEFF Research Database (Denmark)

    Lauritsen, Jakob; Møller, Ann M

    2006-01-01

    The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles.......The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles....

  14. Ubiquitous Multicriteria Clinic Recommendation System.

    Science.gov (United States)

    Chen, Toly

    2016-05-01

    Advancements in information, communication, and sensor technologies have led to new opportunities in medical care and education. Patients in general prefer visiting the nearest clinic, attempt to avoid waiting for treatment, and have unequal preferences for different clinics and doctors. Therefore, to enable patients to compare multiple clinics, this study proposes a ubiquitous multicriteria clinic recommendation system. In this system, patients can send requests through their cell phones to the system server to obtain a clinic recommendation. Once the patient sends this information to the system, the system server first estimates the patient's speed according to the detection results of a global positioning system. It then applies a fuzzy integer nonlinear programming-ordered weighted average approach to assess four criteria and finally recommends a clinic with maximal utility to the patient. The proposed methodology was tested in a field experiment, and the experimental results showed that it is advantageous over two existing methods in elevating the utilities of recommendations. In addition, such an advantage was shown to be statistically significant.

  15. HIV/AIDS Clinical Trials Fact Sheet

    Science.gov (United States)

    ... and effective in people. What is an HIV/AIDS clinical trial? HIV/AIDS clinical trials help researchers ... to HIV Can anyone participate in an HIV/AIDS clinical trial? It depends on the study. Some ...

  16. Early Learner Engagement in the Clinical Workplace

    NARCIS (Netherlands)

    Chen, H.C.

    2015-01-01

    Introduction Recent calls for medical education reform advocate for the integration of knowledge with clinical experience through early clinical immersion. Yet, early learners rarely are invited to participate in workplace activities and early clinical experiences remain largely observational. We

  17. A guide to clinical trials for cancer

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000823.htm A guide to clinical trials for cancer To use ... trial and where to find one. What is a Clinical Trial for Cancer? Clinical trials for cancer ...

  18. Clinical Leadership: A Call to Action.

    Science.gov (United States)

    Grindel, Cecelia Gatson

    2016-01-01

    Clinical nurses are expected to assume leadership roles to enhance patient care and assure efficient work processes. Dimensions of clinical leadership and the essential knowledge and skills of the clinical leader are described.

  19. 78 FR 63988 - Clinical Investigator Training Course

    Science.gov (United States)

    2013-10-25

    ... investigators on issues of greatest importance for successful clinical research. Date and Time: The training... FDA to communicate directly with clinical investigators on issues of greatest importance for... medicine; Promote communication between clinical investigators and FDA; Enhance...

  20. Quality improvement in clinical documentation: does clinical governance work?

    Directory of Open Access Journals (Sweden)

    Dehghan M

    2013-12-01

    Full Text Available Mahlegha Dehghan,1 Dorsa Dehghan,2 Akbar Sheikhrabori,3 Masoume Sadeghi,4 Mehrdad Jalalian5 1Department of Medical Surgical Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, 2Department of Pediatric Nursing, School of Nursing and Midwifery, Islamic Azad University Kerman Branch, Kerman, 3Department of Medical Surgical Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, 4Research Center for Modeling in Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, 5Electronic Physician Journal, Mashhad, Iran Introduction: The quality of nursing documentation is still a challenge in the nursing profession and, thus, in the health care industry. One major quality improvement program is clinical governance, whose mission is to continuously improve the quality of patient care and overcome service quality problems. The aim of this study was to identify whether clinical governance improves the quality of nursing documentation. Methods: A quasi-experimental method was used to show nursing documentation quality improvement after a 2-year clinical governance implementation. Two hundred twenty random nursing documents were assessed structurally and by content using a valid and reliable researcher made checklist. Results: There were no differences between a nurse's demographic data before and after 2 years (P>0.05 and the nursing documentation score did not improve after a 2-year clinical governance program. Conclusion: Although some efforts were made to improve nursing documentation through clinical governance, these were not sufficient and more attempts are needed. Keywords: nursing documentation, clinical governance, quality improvement, nursing record

  1. Nocardial mycetoma: Diverse clinical presentations

    Directory of Open Access Journals (Sweden)

    Sharma Nand

    2008-01-01

    Full Text Available Nocardia spp are gram-positive, aerobic, acid-fast bacteria which exist as saprophytes in nature. Invasive disseminated infections are particularly common in immunocompromised or debilitated hosts. Superficial infections with Nocardia spp occur as a result of local trauma and contamination of the wound. Clinically, it presents as acute infection (abscesses or cellulitis, mycetoma, or sporotrichoid infection. Differential diagnosis includes eumycetoma, chromomycosis, blastomycosis, coccidioidomycosis, sporotrichosis, tuberculosis, botryomycosis, syphilis, yaws, and neoplasia. Its diagnosis is confirmed by demonstrating the causative organism in exudates (as granules, tissue specimens, or cultures. Early diagnosis will obviate need for drastic surgical measures as early institution of chemotherapy is effective in most patients. However, its diagnosis is often delayed due to diverse clinical presentations and for want of clinical suspicion, particularly in non-endemic areas. This paper presents 4 clinical forms of this not so uncommon disease, emphasizing the importance of high index of clinical suspicion, especially in non-endemic regions; and the significance of repeated examination of exudates for Nocardia granules for an early diagnosis.

  2. Clinical manifestations of organizing pneumonia

    Directory of Open Access Journals (Sweden)

    Martín Hunter

    2016-12-01

    Full Text Available Organizing pneumonia is a clinical entity asociated with nonspecific symptoms and radiological findings and abnormalities in pulmonary function tests. It is defined by the characteristic histopathological pattern: filling of alveoli and respiratory bronchioles by plugs of granulation tissue. It can be idiopathic (COP or secondary to other causes (SOP. It is an unusual finding and the clinical and radiographic findings are nonspecific. For specific diagnosis an invasive procedure has to be done, but often empirical treatment is started when there's a clinical suspicion. We describe the clinical characteristics of 13 patients with histological diagnosis of organizing pneumonia. Data was obtained from their medical records. The median age was 76 years and the median time to diagnosis from the onset of symptoms was 31 days. In 10 cases the diagnosis was made by transbronchial biopsy. 8 patients required hospitalization, 4 of them received high doses of steroids and 3 required ventilatory support. One patient died from a cause attributable to this entity and 5 relapsed. Dyspnea, cough and fever were the most frequent symptoms. Most patients had more than one tomographic pattern being the most common ground glass opacities and alveolar consolidation. Nine patients were diagnosed with COP and 4 with SOP. The most frequent underlying cause of SOP was drug toxicity. The clinical characteristics of the reported cases are consistent with previously published series. As an interesting feature, there was a group of patients that needed high doses of steroids and ventilatory support.

  3. Clinical Pearls in pediatric infections.

    Science.gov (United States)

    Singhi, Sunit; Mathew, Joseph; Jindal, Atul; Verma, Sanjay

    2011-12-01

    This series of Clinical Pearls presents four cases presenting with infection. Each of these cases had clinical clues to the correct diagnosis, which could be picked up on meticulous history, clinical examination, or basic laboratory investigations. The authors highlight the important lessons to be learnt from each case. The first is a 7 year old boy with recurrent respiratory tract infections since early life. Clinical examination revealed the presence of dextrocardia and situs inversus and bronchiectasis leading to a diagnosis of Primary Ciliary Dyskinesia. The second case is a 1.5-month-old infant who presented with meningitis and increasing head size since birth. CSF examination and CT scanning led to the correct diagnosis of congenital Toxoplasmosis. The next case is an infant with high grade fever and neck swelling. He had the rare Lemierre's syndrome comprising of oro-pharyngeal infection, suppurative thrompbophlebitis of the internal jugular vein and systemic dissemination of septic emboli. The fourth case is a 2-year-old infant with recurrent respiratory tract infections and discharging neck swellings from early life. Repeated testing for tuberculosis was negative. The diagnosis was Chronic granulomatous disease. The authors describe the clinical approach and investigations in these cases; along with an outline of the management.

  4. Recognizing Disjoint Clinical Concepts in Clinical Text Using Machine Learning-based Methods

    OpenAIRE

    Tang, Buzhou; Chen, Qingcai; Wang, Xiaolong; Wu, Yonghui; Zhang, Yaoyun; Jiang, Min; Wang, Jingqi; Xu, Hua

    2015-01-01

    Clinical concept recognition (CCR) is a fundamental task in clinical natural language processing (NLP) field. Almost all current machine learning-based CCR systems can only recognize clinical concepts of consecutive words (called consecutive clinical concepts, CCCs), but can do nothing about clinical concepts of disjoint words (called disjoint clinical concepts, DCCs), which widely exist in clinical text. In this paper, we proposed two novel types of representations for disjoint clinical conc...

  5. Betamethasone: A dermatological clinical evaluation.

    Science.gov (United States)

    DANTO, J L; STEWART, W D; MADDIN, W S; NELSON, A J

    1963-03-30

    The purpose of this study was to determine under carefully controlled clinical conditions the relative anti-inflammatory and anti-pruritic action of betamethasone as compared with prednisone and a placebo. A total of 130 consecutive patients with atopic dermatitis, primary irritant dermatitis, nummular eczema, allergic eczematous contact dermatitis, sweat retention, seborrheic dermatitis and pruritus were selected for study. Under the conditions of this clinical trial, the samples indicated a difference in anti-inflammatory and anti-pruritic response to the therapeutic agents used. The difference between betamethasone and the placebo was highly significant, and the difference in these measured responses was studied on the basis of a careful evaluation and statistically. The result of this study corroborates statistically our clinical impression regarding the therapeutic effect of betamethasone.

  6. Clinical utility of curcumin extract.

    Science.gov (United States)

    Asher, Gary N; Spelman, Kevin

    2013-01-01

    Turmeric root has been used medicinally in China and India for thousands of years. The active components are thought to be the curcuminoids, primarily curcumin, which is commonly available worldwide as a standardized extract. This article reviews the pharmacology of curcuminoids, their use and efficacy, potential adverse effects, and dosage and standardization. Preclinical studies point to mechanisms of action that are predominantly anti-inflammatory and antineoplastic, while early human clinical trials suggest beneficial effects for dyspepsia, peptic ulcer, inflammatory bowel disease, rheumatoid arthritis, osteoarthritis, uveitis, orbital pseudotumor, and pancreatic cancer. Curcumin is well-tolerated; the most common side effects are nausea and diarrhea. Theoretical interactions exist due to purported effects on metabolic enzymes and transport proteins, but clinical reports do not support any meaningful interactions. Nonetheless, caution, especially with chemotherapy agents, is advised. Late-phase clinical trials are still needed to confirm most beneficial effects.

  7. [Scientific concepts in clinical medicine].

    Science.gov (United States)

    Rogler, G

    2003-11-28

    The understanding of the scientific basis and the theory of knowledge are surprisingly heterogeneous in practical and clinical medicine. It is frequently influenced or based on the philosophical theory of critical rationalism founded by Sir Karl Popper. Because the theory of knowledge and the understanding of scientific truth is the central basis for cautious and good clinical practise it is necessary to discuss both points to avoid unscientific auto-immunisation against critique in a type of medicine that regards herself as science-based. Evidence-based medicine would not be possible without interpretation and explanation of existing data into the individual treatment context. Besides an inductive or deductive logic the historical and situative side-conditions of the gathering of knowledge and of experiments are of central importance for their interpretation and their relevance in clinical practice. This historical and situative context warrants reflection but must also be paid attention to in the reflections on medical ethics.

  8. Clinical use of brain volumetry.

    Science.gov (United States)

    Giorgio, Antonio; De Stefano, Nicola

    2013-01-01

    Magnetic resonance imaging (MRI)-based brain volumetry is increasingly being used in the clinical setting to assess brain volume changes from structural MR images in a range of neurologic conditions. Measures of brain volumes have been shown to be valid biomarkers of the clinical state and progression by offering high reliability and robust inferences on the underlying disease-related mechanisms. This review critically examines the different scenarios of the application of MRI-based brain volumetry in neurology: 1) supporting disease diagnosis, 2) understanding mechanisms and tracking clinical progression of disease, and 3) monitoring treatment effect. These aspects will be discussed in a wide range of neurologic conditions, with particular emphasis on Alzheimer's disease and multiple sclerosis.

  9. Clinical imaging of the pancreas

    Energy Technology Data Exchange (ETDEWEB)

    May, G.; Gardiner, R.

    1987-01-01

    Featuring more than 300 high-quality radiographs and scan images, clinical imaging of the pancreas systematically reviews all appropriate imaging modalities for diagnosing and evaluating a variety of commonly encountered pancreatic disorders. After presenting a succinct overview of pancreatic embryology, anatomy, and physiology, the authors establish the clinical indications-including postoperative patient evaluation-for radiologic examination of the pancreas. The diagnostic capabilities and limitations of currently available imaging techniques for the pancreas are thoroughly assessed, with carefully selected illustrations depicting the types of images and data obtained using these different techniques. The review of acute and chronic pancreatitis considers the clinical features and possible complications of their variant forms and offers guidance in selecting appropriate imaging studies.

  10. Clinical applications of power vectors.

    Science.gov (United States)

    Miller, Joseph M

    2009-06-01

    The study of infant vision is closely coupled to the study of the refraction, change in refraction over time, and the effect of spectacle correction on visual development. Frequently, reports are limited to descriptions of spherical equivalent or cylinder power without regard to axis, as data are frequently collected in the clinical format of sphere, cylinder, and axis (S, C, A). Conversion from clinical notation to a power vector representation of refraction allows unambiguous description of how refractions change over time and differ between repeated measurements. This article presents a series of examples of Microsoft Excel spreadsheet formulas that make the conversion from clinical notation to power vector format, and provides examples of useful applications of these methods.

  11. Development of clinical practice guidelines.

    Science.gov (United States)

    Hollon, Steven D; Areán, Patricia A; Craske, Michelle G; Crawford, Kermit A; Kivlahan, Daniel R; Magnavita, Jeffrey J; Ollendick, Thomas H; Sexton, Thomas L; Spring, Bonnie; Bufka, Lynn F; Galper, Daniel I; Kurtzman, Howard

    2014-01-01

    Clinical practice guidelines (CPGs) are intended to improve mental, behavioral, and physical health by promoting clinical practices that are based on the best available evidence. The American Psychological Association (APA) is committed to generating patient-focused CPGs that are scientifically sound, clinically useful, and informative for psychologists, other health professionals, training programs, policy makers, and the public. The Institute of Medicine (IOM) 2011 standards for generating CPGs represent current best practices in the field. These standards involve multidisciplinary guideline development panels charged with generating recommendations based on comprehensive systematic reviews of the evidence. The IOM standards will guide the APA as it generates CPGs that can be used to inform the general public and the practice community regarding the benefits and harms of various treatment options. CPG recommendations are advisory rather than compulsory. When used appropriately, high-quality guidelines can facilitate shared decision making and identify gaps in knowledge.

  12. Clinical development of Ebola vaccines.

    Science.gov (United States)

    Sridhar, Saranya

    2015-09-01

    The ongoing outbreak of Ebola virus disease in West Africa highlighted the lack of a licensed drug or vaccine to combat the disease and has renewed the urgency to develop a pipeline of Ebola vaccines. A number of different vaccine platforms are being developed by assessing preclinical efficacy in animal models and expediting clinical development. Over 15 different vaccines are in preclinical development and 8 vaccines are now in different stages of clinical evaluation. These vaccines include DNA vaccines, virus-like particles and viral vectors such as live replicating vesicular stomatitis virus (rVSV), human and chimpanzee adenovirus, and vaccinia virus. Recently, in preliminary results reported from the first phase III trial of an Ebola vaccine, the rVSV-vectored vaccine showed promising efficacy. This review charts this rapidly advancing area of research focusing on vaccines in clinical development and discusses the future opportunities and challenges faced in the licensure and deployment of Ebola vaccines.

  13. Unusual clinical manifestations of leptospirosis

    Directory of Open Access Journals (Sweden)

    Bal A

    2005-01-01

    Full Text Available Leptospirosis has protean clinical manifestations. The classical presentation of the disease is an acute biphasic febrile illness with or without jaundice. Unusual clinical manifestations may result from involvement of pulmonary, cardiovascular, neural, gastrointestinal, ocular and other systems. Immunological phenomena secondary to antigenic mimicry may also be an important component of many clinical features and may be responsible for reactive arthritis. Leptospirosis in early pregnancy may lead to fetal loss. There are a few reports of leptospirosis in HIV- infected individuals but no generalisation can be made due to paucity of data. It is important to bear in mind that leptospiral illness may be a significant component in cases of dual infections or in simultaneous infections with more than two pathogens.

  14. Vulnerability of the clinical method

    Directory of Open Access Journals (Sweden)

    José Carlos Hernández Aragonés

    2010-12-01

    Full Text Available This article is aimed at outlining the general aspects that undermine the use of the clinical method in everyday medical practice and also at exposing those that cause a negative effect on the use of the various steps leading to the correct diagnosis and treatment of a patient. A presentation is made on the issues and situations that may contribute not to take into account the clinical method and the requirements for its implementation. Finally, it is concluded that the importance and appropriate management of the clinical method is not still widely known and that the decline of the doctor-patient relationship is a key element that hinders its application.

  15. AMELOGENESIS IMPERFECTA: A CLINICAL REPORT

    Directory of Open Access Journals (Sweden)

    Veena

    2015-01-01

    Full Text Available AIM: This clinical case report describes the oral rehabilitation of a young adult female patient diagnosed with hypoplastic Amelogenesis imperfecta. SUMMARY : Amelogenesis Imperfecta is a hereditary condition that affects the formation of the enamel mineralization process of both the primary and secondary dentition. It is clinically and genetically heterogeneous grou p of condition that affects both the quantity and quality of the enamel structure resulting in extensive loss of tooth tissue , poor esthetics and tooth sensitivity. The main objective for the selected treatment was to enhance the esthetics , and restoring m asticatory function. Treatment was divided into phases which included removal of impacted canine , lengthening of the maxillary and mandibular clinical crowns , and placement of anterior and posterior crowns.

  16. [Clinical aspects of witchcraft delusions].

    Science.gov (United States)

    Pashkovskiĭ, V E

    2005-01-01

    To distinguish clinical variants and to specify nosologic entity of witchcraft delusions, 69 patients (10 males, aged 15-72 years) have been examined. It was found that witchcraft delusions exist in passive and active forms. In a passive form, the patient is sure that unknown (mystic) power damaged him/her; in an active form the patient, possessing a gift for unusual abilities, can influence the others (bewitches, heals, etc). Five clinical syndromes, in the structure of which the above delusions were found, namely, paranoiac-hypochondriac, hallucination-paranoid, depressive-paranoid, paraphrenic and delirious, were identified. Psychoses of schizophrenia spectrum were diagnosed in 52 patients, organic--in 8, alcoholic--in 7 and recurrent depressive disorder--in 2. Clinical significance of witchcraft delusions is closely related to its social aspect. Being combined with ideas of persecution, poisoning and damage, it results in the brutal forms of delusions defense and may be considered as an unfavorable prognostic trait.

  17. Clinical features of dysthymia and age: a clinical investigation.

    Science.gov (United States)

    Bellino, S; Patria, L; Ziero, S; Rocca, G; Bogetto, F

    2001-09-20

    A few authors have described the clinical picture of dysthymia in groups of elderly patients and pointed out differences from literature reports of dysthymia in younger adults. The present study, an attempt to analyze age effects on clinical characteristics of dysthymia throughout a lifetime, was performed in a sample of 106 patients, all aged > or =18 years, who were diagnosed according to DSM-IV. The patients were evaluated using: (1) a semistructured interview to assess clinical features, family history and previous treatments; (2) the Hamilton Depression Rating Scale; (3) the Interview for Recent Life Events; and (4) the Structured Clinical Interview for DSM-IV Disorders. Statistical analysis with stepwise logistic regression revealed that age was positively related to concomitant medical illnesses and to the total score of recent life events, but negatively related to the presence of avoidant or dependent personality disorders. The data suggested different etiologic pathways in older and younger patients. Dysthymia appeared to be associated in younger adults with abnormalities of personality; in the elderly, with a history of health problems and life losses.

  18. Clinical Decision Support Systems: A Useful Tool in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Kolostoumpis G.

    2012-01-01

    Full Text Available The possibility of supporting in decision – making shows an increase in recent years. Based on mathematic simulation tools, knowledge databases, processing methods, medical data and methods, artificial intelligence for coding of the available knowledge and for resolving complex problems arising into clinical practice. Aim: the aim of this review is to present the development of new methods and modern services, in clinical practice and the emergence in their implementation. Data and methods: the methodology that was followed included research of articles that referred to health sector and modern technologies, at the electronic data bases “pubmed” and “medline”. Results: Is a useful tool for medical experts using characteristics and medical data used by the doctors. Constitute innovation for the medical community, and ensure the support of clinical decisions with an overall way by providing a comprehensive solution in the light of the integration of computational decision support systems into clinical practice. Conclusions: Decision Support Systems contribute to improving the quality of health services with simultaneous impoundment of costs (i.e. avoid medical errors

  19. Gatekeepers for pragmatic clinical trials.

    Science.gov (United States)

    Whicher, Danielle M; Miller, Jennifer E; Dunham, Kelly M; Joffe, Steven

    2015-10-01

    To successfully implement a pragmatic clinical trial, investigators need access to numerous resources, including financial support, institutional infrastructure (e.g. clinics, facilities, staff), eligible patients, and patient data. Gatekeepers are people or entities who have the ability to allow or deny access to the resources required to support the conduct of clinical research. Based on this definition, gatekeepers relevant to the US clinical research enterprise include research sponsors, regulatory agencies, payers, health system and other organizational leadership, research team leadership, human research protections programs, advocacy and community groups, and clinicians. This article provides a framework to help guide gatekeepers' decision-making related to the use of resources for pragmatic clinical trials. Relevant ethical considerations for gatekeepers include (1) concern for the interests of individuals, groups, and communities affected by the gatekeepers' decisions, including protection from harm and maximization of benefits; (2) advancement of organizational mission and values; and (3) stewardship of financial, human, and other organizational resources. Separate from these ethical considerations, gatekeepers' actions will be guided by relevant federal, state, and local regulations. This framework also suggests that to further enhance the legitimacy of their decision-making, gatekeepers should adopt transparent processes that engage relevant stakeholders when feasible and appropriate. We apply this framework to the set of gatekeepers responsible for making decisions about resources necessary for pragmatic clinical trials in the United States, describing the relevance of the criteria in different situations and pointing out where conflicts among the criteria and relevant regulations may affect decision-making. Recognition of the complex set of considerations that should inform decision-making will guide gatekeepers in making justifiable choices regarding

  20. Positron emission tomography clinical practice

    CERN Document Server

    Valk, Peter E; Bailey, Dale L; Townsend, David W; Maisey, Michael N

    2006-01-01

    This book provides a contemporary reference to the science, technology and clinical applications of PET and PET/CT. The opening chapters summarize the scientific aspects of PET and PET/CT including physics, instrumentation, radiation dosimetry and radiation protection. A chapter on normal variants in FDG PET imaging serves as an introduction to the clinical chapters, which cover oncology applications and have been updated to include the impact of FDG PET/CT imaging in oncology. The book concludes with chapters on the use of PET and PET/CT in cardiology and neurology and PET imaging of infectio

  1. [Clinical studies on pramipexol retard].

    Science.gov (United States)

    Klivényi, Péter; Vécsei, László

    2010-05-30

    Pramipexol retard is the newest drug for the treatment of Parkinson's disease. The prolonged release of the agent in this preparation allows a more continuous dopaminergic stimulation than previous preparations, without reducing the agent's already known and proven clinical efficiency. In addition, it has a more favourable adverse effect profile than previous preparations, and patient compliance can also be better as it needs to be taken only once daily. These benefits have been proven in recent clinical studies, of which the most important ones are reviewed here.

  2. Developing clinical piano improvisation skills

    DEFF Research Database (Denmark)

    Wigram, Anthony Lewis

    2003-01-01

    Teaching piano improvisation skills for use in clinical work relies on the development of a range of musical techniques and therapeutic methods that are combined and integrated. Simple musical styles of playing such as melody dialogues, two chord accompaniments, walking basses (tonal and atonal), 6...... in a new direction. Structure and lack of structure play a balanced role in the clinical process, and reflects the skills of the therapist to musically meet the needs of the client. This workshop will provide teaching and practice tools for the participants that are intended to sustain the creativity...

  3. Clinical enzymology: an autobiographical history.

    Science.gov (United States)

    Goldberg, David M

    2005-07-24

    In this paper, I review the origins of Clinical Enzymology with special emphasis on the years between 1960 and 1980 when the greatest advances in the subject took place. These are described in relation to my own research interests and contributions, focusing upon subclinical hepatic damage caused by viral infection and by alcohol; myocardial infarction; detection of cervical carcinoma by vaginal fluid analysis; evaluation of pancreatic function; and the clinical implications of microsomal enzyme induction. Reasons are proposed for the failure of enzymology to attain the status of an autonomous medical specialty, in contrast to the success of similar fields of knowledge that grew up in the same era.

  4. Clinical virology in real time.

    Science.gov (United States)

    Niesters, Hubert G M

    2002-12-01

    The ability to detect nucleic acids has had and still has a major impact on diagnostics in clinical virology. Both quantitative and qualitative techniques, whether signal or target amplification based systems, are currently used routinely in most if not all virology laboratories. Technological improvements, from automated sample isolation to real time amplification technology, have given the ability to develop and introduce systems for most viruses of clinical interest, and to obtain clinical relevant information needed for optimal antiviral treatment options. Both polymerase chain reaction (PCR) and nucleic acid sequence-based amplification (NASBA) can currently be used together with real time detection to generate results in a short turn-around time and to determine whether variants relevant for antiviral resistance are present. These new technologies enable the introduction of an individual patient disease management concept. Within our clinical setting, we have introduced this e.g. for quantitative detection of Epstein-Barr Virus (EBV) in T-dell depleted allogeneic stem cell transplant patients. This enabled us to develop models for pre-emptive anti B-cell immunotherapy for EBV reactivation, thereby effectively reducing not the incidence of EBV-lymphoproliferative disease but the virus related mortality. Furthermore, additional clinically relevant viruses can now easily be detected simultaneously. It also becomes more feasible to introduce molecular testing for those viruses that can easily be detected using classical virological methods, like culture techniques or antigen detection. Prospective studies are needed to evaluate the clinical importance of the additional positive samples detected. It should however be made clear that a complete exchange of technologies is unlikely to occur, and that some complementary technologies should stay operational enabling the discovery of new viruses. The implementation of these molecular diagnostic technologies furthermore

  5. [Reading a clinical trial report].

    Science.gov (United States)

    Bergmann, J F; Chassany, O

    2000-04-15

    To improve medical knowledge by reading clinical trial reports it is necessary to check for the respect of the methodological rules, and to analyze and criticize the results. A control group and a randomisation are always necessary. Double blind assessment, sample size calculation, intention to treat analysis, a unique primary end point are also important. The conclusions of the trial are valid only for the population included and the clinical signification of the results, depending on the control treatment, has to be evaluated. Respect of the reading rules is necessary to assess the reliability of the conclusions, in order to promote evidence-based practice.

  6. Clinical advances on Cardiac Insuffiency

    Directory of Open Access Journals (Sweden)

    Angel Julio Romero Cabrera

    2007-06-01

    Full Text Available Cardiac insuffiency is a complex clinical syndrome which constitutes a common final path to get in by the majority of the cardiac diseases. Studies based on the communitarian surveys shows that from 30 to 40 % of the patients decease within the first year of the diagnosis. The rest of the patients (from 60 to 70 % die within the 5 years after being diagnosed. For this reason it has been called as the ¨cancer of cardiology¨. The objective of this article is to update the advances reached in the clinical and therapeutic aspects of this important syndrome.

  7. Trichinella infection and clinical disease

    DEFF Research Database (Denmark)

    Clausen, M R; Meyer, C N; Krantz, T;

    1996-01-01

    Trichinellosis is caused by ingestion of insufficiently cooked meat contaminated with infective larvae of Trichinella species. The clinical course is highly variable, ranging from no apparent infection to severe and even fatal disease. We report two illustrative cases of trichinellosis. Returning....... Life-threatening cardiopulmonary, renal and central nervous system complications developed. The patient recovered after several months. Her husband, who also ate the pork, did not have clinical symptoms, but an increased eosinophil count and a single larva in a muscle biopsy confirmed infection...

  8. Innovations in clinical trials informatics.

    Science.gov (United States)

    Summers, Ron; Vyas, Hiten; Dudhal, Nilesh; Doherty, Neil F; Coombs, Crispin R; Hepworth, Mark

    2008-01-01

    This paper will investigate innovations in information management for use in clinical trials. The application typifies a complex, adaptive, distributed and information-rich environment for which continuous innovation is necessary. Organisational innovation is highlighted as well as the technical innovations in workflow processes and their representation as an integrated set of web services. Benefits realization uncovers further innovations in the business strand of the work undertaken. Following the description of the development of this information management system, the semantic web is postulated as a possible solution to tame the complexity related to information management issues found within clinical trials support systems.

  9. Handbook of clinical nursing practice

    Energy Technology Data Exchange (ETDEWEB)

    Asheervath, J.; Blevins, D.R.

    1986-01-01

    Written in outline format, this reference will help nurses further their understanding of advanced nursing procedures. Information is provided on the physiological, psychological, environmental, and safety considerations of nursing activities associated with diagnostic and therapeutic procedures. Special consideration is given to the areas of pediatric nursing, nursing assessment, and selected radiologic and nuclear medicine procedures for each system. Contents: Clinical Introduction. Clinical Nursing Practice: Focus on Basics. Focus on Cardiovascular Function. Focus on Respiratory Function. Focus on Gastrointestinal Function. Focus on Renal and Genito-Urological Function. Focus on Neuro-Skeletal and Muscular Function. Appendices.

  10. [Clinical decision-making support systems in renal failure].

    Science.gov (United States)

    Martínez Bernabé, E; Paluzie-Ávila, G; Terre Ohme, S; Ruiz Poza, D; Parada Aradilla, M A; González Martínez, J; Albertí Valmaña, R; Castellvi Gordo, M

    2014-05-01

    Introducción: Los sistemas de soporte a la toma de decisiones clínicas utilizan característicasindividuales del paciente para generar recomendaciones a los clínicos.Objetivo: Evaluar el impacto de una herramienta de ajuste de fármacos en insuficienciarenal como sistema de soporte en la toma de decisiones clínicas encuanto al grado de aceptación de las intervenciones y el tiempo invertido por elfarmacéutico.Método: Estudio cuasi-experimental del tipo antes y después realizado en dos hospitalescomarcales. La intervención consistía en la incorporación de una alerta automatizadade función renal en la orden médica. Antes de la intervención (2007) semonitorizaron 40 fármacos. Se revisaron las analíticas de pacientes cuyo tratamientocontenía alguno de ellos. En caso de función renal alterada, se insertabauna recomendación de ajuste en la orden médica. Si el médico aceptaba, se considerabaéxito. El tiempo medio empleado fue 1 minuto/analítica consultada y 3minutos/recomendación. En 2008 se incorporó un sistema de recomendación automáticade ajuste según función renal de 100 fármacos con mensajes emergentes.En una fase posterior (2009) se evaluó y comparó el número de intervenciones y elporcentaje de éxito con la herramienta.Resultados: Fase previa: Se validaron 28.234 Ordenes Médicas Electrónicas, correspondientesa un promedio de 205 pacientes hospitalizados/día, y se revisaron 4.035analíticas. Se realizaron 121 intervenciones farmacéuticas (0,43% del total de órdenesmédicas). Se obtuvo éxito en el 33,06% de las intervenciones. El tiempo invertidopor el farmacéutico en consultar analíticas y realizar recomendaciones fue 73,3horas (67,25 horas correspondían a pacientes sin alteración de la función renal y enlos que no se realizó ninguna intervención). Fase posterior: Se validaron 26.584Ordenes Médicas Electrónicas, correspondientes a un promedio de 193 pacienteshospitalizados/día, y se realizaron 1.737 intervenciones

  11. Immunosensors in Clinical Laboratory Diagnostics.

    Science.gov (United States)

    Justino, Celine I L; Duarte, Armando C; Rocha-Santos, Teresa A P

    2016-01-01

    The application of simple, cost-effective, rapid, and accurate diagnostic technologies for detection and identification of cardiac and cancer biomarkers has been a central point in the clinical area. Biosensors have been recognized as efficient alternatives for the diagnostics of various diseases due to their specificity and potential for application on real samples. The role of nanotechnology in the construction of immunological biosensors, that is, immunosensors, has contributed to the improvement of sensitivity, since they are based in the affinity between antibody and antigen. Other analytes than biomarkers such as hormones, pathogenic bacteria, and virus have also been detected by immunosensors for clinical point-of-care applications. In this chapter, we first introduced the various types of immunosensors and discussed their applications in clinical diagnostics over the recent 6 years, mainly as point-of-care technologies for the determination of cardiac and cancer biomarkers, hormones, pathogenic bacteria, and virus. The future perspectives of these devices in the field of clinical diagnostics are also evaluated.

  12. Registration of randomized clinical trials

    DEFF Research Database (Denmark)

    Østervig, R M; Sonne, A; Rasmussen, L S

    2015-01-01

    starting enrolment before 2010 to 63.2% after 2010 (24/38, P clinical trials were registered at clinicaltrials.gov. CONCLUSION: Many published randomized controlled trials from Acta Anaesthesiologica Scandinavica were not adequately registered but the requirement of trial registration has...

  13. Clinical Trials in Your Community

    Science.gov (United States)

    The NCI Community Oncology Research Program (NCORP) is a national network of investigators, cancer care providers, academic institutions, and other organizations. NCORP conducts multi-site cancer clinical trials and studies in diverse populations in community-based healthcare systems across the United States and Puerto Rico.

  14. Randomized clinical trials in HEPATOLOGY

    DEFF Research Database (Denmark)

    Kjaergard, L L; Nikolova, D; Gluud, C

    1999-01-01

    Evidence shows that the quality of randomized clinical trials (RCTs) affects estimates of intervention efficacy, which is significantly exaggerated in low-quality trials. The present study examines the quality of all 235 RCTs published in HEPATOLOGY from the initiation in 1981 through August 1998...

  15. Teaching Techniques in Clinical Chemistry.

    Science.gov (United States)

    Wilson, Diane

    This master's thesis presents several instructional methods and techniques developed for each of eleven topics or subject areas in clinical chemistry: carbohydrate metabolism, lipid metabolism, diagnostic enzymology, endocrinology, toxicology, quality control, electrolytes, acid base balance, hepatic function, nonprotein nitrogenous compounds, and…

  16. Pulse Pressure in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Jiri Parenica

    2012-02-01

    Full Text Available The review presents basic information about the pulse pressure. The variables related to pulse pressure are briefly explained - arterial stiffness, arterial compliance, pulse wave velocity, pulse pressure amplification and augmentation index. We present some recent trials and observational studies that show the importance of pulse pressure in clinical practice. Briefly the possibilities of influencing the pulse pressure are discussed.

  17. Supervisees' Perception of Clinical Supervision

    Science.gov (United States)

    Willis, Lisa

    2010-01-01

    Supervisors must become aware of the possible conflicts that could arise during clinical supervision. It is important that supervisors communicate their roles and expectations effectively with their supervisees. This paper supports the notion that supervision is a mutual agreement between the supervisee and the supervisor and the roles of…

  18. How clinical decisions are made.

    Science.gov (United States)

    Bate, Louise; Hutchinson, Andrew; Underhill, Jonathan; Maskrey, Neal

    2012-10-01

    There is much variation in the implementation of the best available evidence into clinical practice. These gaps between evidence and practice are often a result of multiple individual decisions. When making a decision, there is so much potentially relevant information available, it is impossible to know or process it all (so called 'bounded rationality'). Usually, a limited amount of information is selected to reach a sufficiently satisfactory decision, a process known as satisficing. There are two key processes used in decision making: System 1 and System 2. System 1 involves fast, intuitive decisions; System 2 is a deliberate analytical approach, used to locate information which is not instantly recalled. Human beings unconsciously use System 1 processing whenever possible because it is quicker and requires less effort than System 2. In clinical practice, gaps between evidence and practice can occur when a clinician develops a pattern of knowledge, which is then relied on for decisions using System 1 processing, without the activation of a System 2 check against the best available evidence from high quality research. The processing of information and decision making may be influenced by a number of cognitive biases, of which the decision maker may be unaware. Interventions to encourage appropriate use of System 1 and System 2 processing have been shown to improve clinical decision making. Increased understanding of decision making processes and common sources of error should help clinical decision makers to minimize avoidable mistakes and increase the proportion of decisions that are better.

  19. Clinical Spectrum of Propionic Acidaemia

    Directory of Open Access Journals (Sweden)

    Muhammad Rafique

    2013-01-01

    Full Text Available Objectives. To evaluate the clinical features, physical findings, diagnosis, and laboratory parameters of the patients with propionic acidaemia (PA. Methods. The records of diagnosed cases of propionic acidaemia were reviewed, retrospectively. Results. Twenty-six patients with PA had 133 admissions. The majority (85% of the patients exhibited clinical manifestations in the 1st week of life. Regarding clinical features, lethargy, fever, poor feeding, vomiting, dehydration, muscular hypotonia, respiratory symptoms, encephalopathy, disturbance of tone and reflexes, and malnutrition were observed in 51–92% admissions. Metabolic crises, respiratory diseases, hyperammonaemia, metabolic acidosis, hypoalbuminaemia, and hypocalcaemia were observed in 30–96% admissions. Pancytopenia, ketonuria, hypoproteinemia, hypoglycaemia, and mildly disturbed liver enzymes were found in 12–41% admissions. Generalised brain oedema was detected in 17% and cerebral atrophy in 25% admissions. Gender-wise odd ratio analysis showed value of 1.9 for lethargy, 1.99 for respiratory diseases, 0.55 for anaemia, and 1.82 for hypocalcaemia. Conclusion. Propionic acidaemia usually presents with wide spectrum of clinical features and disturbances of laboratory parameters in early neonatal age. It is associated with significant complications which deteriorate the patients’ quality of life. Perhaps with early diagnosis of the disease and in time intervention, these may be preventable.

  20. Effect Size in Clinical Phonology

    Science.gov (United States)

    Gierut, Judith A.; Morrisette, Michele L.

    2011-01-01

    The purpose of this article is to motivate the use of effect size (ES) for single-subject research in clinical phonology, with an eye towards meta-analyses of treatment effects for children with phonological disorders. Standard mean difference (SMD) is introduced and illustrated as one ES well suited to the multiple baseline (MBL) design and…