Traumatic Brain Injury in Iowa Inpatient Hospital Data, 2003-2005

According to the Centers for Disease Control and Prevention, unintentional injury is the fifth leading cause of death for all age groups and the first leading cause of death for people from 1 to 44 years of age in the United States, while homicide remains the 2nd leading cause of death for 15 to 24 years old (CDC, 2006). In 2004, there were approximately 144,000 deaths due to unintentional injuries in the US; 53% of which represent people over 45 years of age (CDC, 2004). With 20,322 suicidal deaths and 13,170 homicidal deaths, intentional injury deaths affect mostly people under 45 years old. On average, there are 1,150 unintentional deaths per year in Iowa. In 2004, 37% of unintentional deaths were due to motor vehicle accidents (MTVCC) occurring across all age ranges and 30% were due to falls involving persons over 65 years of age 82% of the time (IDPH Health Stat Div., 2004). The most debilitating outcome of injury is traumatic brain injury, which is characterized by the irreversibility of its damages, long-term effects on quality of life, and healthcare costs. The latest data available from the CDC estimated that, nationally, 50,000 traumatic brain injured (TBI) people die each year; three times as many are hospitalized and more than twenty times as many are released from emergency room (ER) departments (CDC, 2006). Besides the TBI registry, brain injury data is also captured through three other data sources: 1) death certificates; 2) hospital inpatient data; and, 3) hospital outpatient data. The inpatient and outpatient hospital data are managed by the Iowa Hospital Association, which provides to Iowa Department of Public Health the hospital data without personal identifiers. (The hospitals send reports to the Agency of Health Care Research and Quality, which developed the Health Care Utilization Project and its product, the National Inpatient Sample).

Influència de l'educació sanitària en l'adaptació dels pacients ostomitzats a la nova situació produïda per l'ostomia digestiva

Introducció: Les persones ostomitzades presenten una sèrie de canvis de tipus fisiològic, psicològic i social, els quals els obliga a adaptar-se a la seva vida diària. Per adaptar-se a aquesta nova situació utilitzen una sèrie d'estratègies d'afrontament, sent l'acceptació el producte final. Per a que les estratègies adoptades siguin les més efectives, han de rebre una educació sanitària adequada.Contràriament, l'escassetat d'educació sanitària o l'educació sanitària inadequada que reben aquests pacients és un problema real que ens trobem en l'actualitat.Objectiu: Conèixer si l'educació sanitària rebuda pels pacients ostomitzats, té influencia en la seva adaptació a la nova situació produïda per l'ostomia digestiva.Metodologia: Estudi qualitatiu fenomenològic, on les dades es recolliran a través d'entrevistessemiestructurades a pacients amb ostomia digestiva, els quals van rebre l'alta hospitalària fa almenys 2 mesos. Les entrevistes seran gravades, transcrites i analitzades, utilitzant en aquest últim pas la triangulació d'investigadors. La mostra serà de tipus intencional, la seleccionaré a l'Hospital Universitàri de Bellvitge entre els pacients que acudeixen a la consulta de la infermera estomaterapeuta, i el seu tamany estarà definit per la saturació teòrica. L'estudi estarà reglat en tot moment pel dret a la intimitat, incloent en aquest l'anonimat i la confidencialitat, i el dret a la lliure decisió.Consideracions finals: Inclou una explicació argumentada sobre els meus punts febles i forts del treball, una reflexió sobre la satisfacció amb les competències que he adquirit i finalment una autoavaluació dels resultats del meu aprenentatge.

Cooperation of human tumor-reactive CD4+ and CD8+ T cells after redirection of their specificity by a high-affinity p53A2.1-specific TCR.

Efficient immune attack of malignant disease requires the concerted action of both CD8+ CTL and CD4+ Th cells. We used human leukocyte antigen (HLA)-A*0201 (A2.1) transgenic mice, in which the mouse CD8 molecule cannot efficiently interact with the alpha3 domain of A2.1, to generate a high-affinity, CD8-independent T cell receptor (TCR) specific for a commonly expressed, tumor-associated cytotoxic T lymphocyte (CTL) epitope derived from the human p53 tumor suppressor protein. Retroviral expression of this CD8-independent, p53-specific TCR into human T cells imparted the CD8+ T lymphocytes with broad tumor-specific CTL activity and turned CD4+ T cells into potent tumor-reactive, p53A2.1-specific Th cells. Both T cell subsets were cooperative and interacted synergistically with dendritic cell intermediates and tumor targets. The intentional redirection of both CD4+ Th cells and CD8+ CTL by the same high-affinity, CD8-independent, tumor-specific TCR could provide the basis for novel broad-spectrum cancer immunotherapeutics.

The underestimation of compliance to direct help requests explained by adaptive sampling

Helping behavior is any intentional behavior that benefits another living being or group (Hogg & Vaughan, 2010). People tend to underestimate the probability that others will comply with their direct requests for help (Flynn & Lake, 2008). This implies that when they need help, they will assess the probability of getting it (De Paulo, 1982, cited in Flynn & Lake, 2008) and then they will tend to estimate one that is actually lower than the real chance, so they may not even consider worth asking for it. Existing explanations for this phenomenon attribute it to a mistaken cost computation by the help seeker, who will emphasize the instrumental cost of “saying yes”, ignoring that the potential helper also needs to take into account the social cost of saying “no”. And the truth is that, especially in face-to-face interactions, the discomfort caused by refusing to help can be very high. In short, help seekers tend to fail to realize that it might be more costly to refuse to comply with a help request rather than accepting. A similar effect has been observed when estimating trustworthiness of people. Fetchenhauer and Dunning (2010) showed that people also tend to underestimate it. This bias is reduced when, instead of asymmetric feedback (getting feedback only when deciding to trust the other person), symmetric feedback (always given) was provided. This cause could as well be applicable to help seeking as people only receive feedback when they actually make their request but not otherwise. Fazio, Shook, and Eiser (2004) studied something that could be reinforcing these outcomes: Learning asymmetries. By means of a computer game called BeanFest, they showed that people learn better about negatively valenced objects (beans in this case) than about positively valenced ones. This learning asymmetry esteemed from “information gain being contingent on approach behavior” (p. 293), which could be identified with what Fetchenhauer and Dunning mention as ‘asymmetric feedback’, and hence also with help requests. Fazio et al. also found a generalization asymmetry in favor of negative attitudes versus positive ones. They attributed it to a negativity bias that “weights resemblance to a known negative more heavily than resemblance to a positive” (p. 300). Applied to help seeking scenarios, this would mean that when facing an unknown situation, people would tend to generalize and infer that is more likely that they get a negative rather than a positive outcome from it, so, along with what it was said before, people will be more inclined to think that they will get a “no” when requesting help. Denrell and Le Mens (2011) present a different perspective when trying to explain judgment biases in general. They deviate from the classical inappropriate information processing (depicted among other by Fiske & Taylor, 2007, and Tversky & Kahneman, 1974) and explain this in terms of ‘adaptive sampling’. Adaptive sampling is a sampling mechanism in which the selection of sample items is conditioned by the values of the variable of interest previously observed (Thompson, 2011). Sampling adaptively allows individuals to safeguard themselves from experiences they went through once and turned out to lay negative outcomes. However, it also prevents them from giving a second chance to those experiences to get an updated outcome that could maybe turn into a positive one, a more positive one, or just one that regresses to the mean, whatever direction that implies. That, as Denrell and Le Mens (2011) explained, makes sense: If you go to a restaurant, and you did not like the food, you do not choose that restaurant again. This is what we think could be happening when asking for help: When we get a “no”, we stop asking. And here, we want to provide a complementary explanation for the underestimation of the probability that others comply with our direct help requests based on adaptive sampling. First, we will develop and explain a model that represents the theory. Later on, we will test it empirically by means of experiments, and will elaborate on the analysis of its results.

Workplace Aggressive Behaviors: Three Essays

Abstract¦This thesis examines through three essays the role of the social context and of people concern for justice in explaining workplace aggressive behaviors.¦In the first essay, I argue that a work group instrumental climate - a climate emphasizing respect of organizational procedures -deters employees to manifest counterproductive work behaviors through informal sanctions (i.e., socio-emotional disapproval) they anticipate from it for misbehaving. A contrario, a work group affective climate - a climate concerned about others' well-being - leads employees to infer less informal sanctions and thus indirectly facilitates counterproductive work behaviors. I additionally expect these indirect effects to be conditional on employees' level of conscientiousness and agreeableness. Cross-level structural equations on cross-sectional data obtained from 158 employees in 26 work groups supported my expectations. By promoting collective responsibility for the respect of organizational rules and by knowing what their work group considers threatening their well-being, leaders may be able to prevent counterproductive work behaviors.¦Adopting an organizational justice perspective, the second essay provides a theoretical explanation of why and how collective deviance can emerge in a collective. In interdependent situations, employees use justice perceptions to infer others' cooperative intent. Even if moral transgressions (e.g., injustice) are ambiguous, their repetition and configuration within a team can lead employees to assign blame and develop collective cynicism toward the transgressor. Over time, collective cynicism - a shared belief about the transgressor's intentional lack of integrity - progressively constrains the diversity of employees' response to blame and leads collective deviance to emerge. This essay contributes to workplace deviance research by offering a theoretical framework for investigations of the phenomenon at the collective level. It organizations effort to manage and prevent deviance should consider.¦In the third essay, I solve an apparent contradiction in the literature showing that justice concerns sometimes lead employees to react aggressively to injustice and sometimes to refrain from it. Drawing from just-world theory, a cross-sectional field study and an experiment provide evidence that retaliatory tendencies following injustice are moderated by personal and general just-world beliefs. Whereas a high personal just-world belief facilitates retaliatory reactions to injustice, a high general just-world belief attenuates such reactions. This essay uncovers a dark side of personal just-world belief and a bright one of general just-world belief, and participates to extend just-world theory to the working context.

Estudios de los restos vegetales de diversas muestras procedentes del abrigo de Son Gallard- Son Marroig: el resultado de los analisis de fitolitos.

[spa] Los fitólitos son microrestos síliceos que reproducen el tejido celular de las plantas. Su identificación y cuantificación en un yacimiento arqueológico permiten obtener información sobre el tipo de plantas utilizadas en un contexto determinado así como su distribución. Fueron realizados análisis de fitolitos en diversos niveles correspondientes a diferentes períodos cronológicos del abrigo de Son Gallard-Son Marroig. Los resultados obtenidos señalan una deposición de carácter «antrópico» de materia vegetal en dos de los niveles analizados (TB3 y UE5), aunque sin una selección aparente del tipo de plantas depositadas. Por otro lado las muestras analizadas de la Covacha Este parecen indicar que se trata del suelo de hábitat del abrigo sin una deposición intencionada de materia vegetal, mas allá de la derivada por el uso continuado del abrigo. [eng] Phytoliths are silica microremains that reproduce the cellular tissue of plants. The identification and quantification of phytoliths in archaeological sediments, allows for a better understanding of the utilised plants in a pecific area as well as the distribution of the plants used. Phytolith analyses were performed on different levels from different periods in Son Gallard-Son Marroig rockshelter. The results obtained show an «anthropological» deposition of plants in two of the studied levels (TB3 and UE5), without apparent selection of plants. On the other hand, the samples analyzed from the Covacha Este seem to indicate the presence of vegetal remains product of the continued use of the soils with no intentional deposition.

Stab wounds in a Swiss emergency department: a series of 80 consecutive cases.

Background: Interpersonal violence is a worldwide social reality which seems to increasingly affect even the safest of countries, such as Switzerland. In this country, road traffic accidents, as well as professional and recreational activities, are the main providers of trauma-related injuries. The incidence of penetrative trauma related to stab wounds seems to be regularly increasing in our ED. The question arises of whether our strategies in trauma management are adapted to deal efficiently with these injuries.Methods: To answer this question, the study analysed patients admitted for intentional penetrative injuries in a tertiary urban emergency department (ED) during a 23 month period. Demographics, conditions of the assault, injury type and treatments applied were analysed.Results: Eighty patients admitted due to an intentional penetrating trauma accounted for 0.2% of the surgical practice of our ED. The assault occurred equally in a public or a private context, mainly affecting young males during the night and the weekend. Sixty six patients (83%) were treated as out-patients. Only 10 patients needed surgery. None of them required damage control surgery. No patient died and the mean hospital stay was 5.5 days.Conclusions: The prevalence of stab wounds in Switzerland is low. These injuries rarely need complex, surgical procedures. Observational strategies should be considered according to the patient status.

80 casos de Derecho de daños (2004-2008)

InDret presenta, por quinto año consecutivo, una selección de cuarenta sentencias sobre responsabilidad civil dictadas por el Tribunal Supremo que tratan cuestiones centrales del derecho de daños. El lector también encontrará en este trabajo las selecciones de 2004, 2005, 2006 y 2007 publicadas en números anteriores.

100 casos de derecho de daños (2004-2009)

InDret presenta, por sexto año consecutivo, una selección de veinte sentencias sobre responsabilidad civil dictadas por el Tribunal Supremo que tratan cuestiones centrales del derecho de daños. El lector también encontrará en este trabajo las selecciones de 2004, 2005, 2006, 2007 y 2008 publicadas en números anteriores.

40 casos de Derecho de daños (2004-2007)

InDret presenta, por cuarto año consecutivo, una selección de diez sentencias del Tribunal Supremo sobre cuestiones centrales del derecho de daños. El lector también encontrará en este trabajo las selecciones de 2004, 2005 y 2006 publicadas en números anteriores.

Evaluación de la educación emocional en el ciclo medio de Educación Primaria

El principal propósito de la educación consiste en favorecer el desarrollo integral de la persona, lo cual implica atender el aspecto cognitivo y afectivo. Tradicionalmente, se han priorizado sólo los contenidos cognitivos por este motivo queremos incidir sobre los afectos. El objetivo general de este trabajo de investigación que presentamos consiste en aplicar y evaluar un Programa de Educación Emocional (PEEP), integrado dentro del currículum de Primaria de ciclo medio que ayude a prevenir los efectos nocivos de las emociones negativas y facilite la relación consigo mismo y con los demás. Objetivo general que se constatara a partir de cuatro criterios: conseguir un mejor conocimiento de las propias emociones y de las emociones de los demás, desarrollar estrategias de regulación emocional, mejorar la autoestima, aprender habilidades de vida y socioemocionales. Pues, la finalidad es intervenir en la mejora de la educación emocional de los alumnos entre los 8 y los 10 años, en total 510 alumnos de los cuales 104 formaron la muestra de investigación. Fueron divididos en dos grupos el grupo experimental y el grupo control, ambos constituían una muestra homogénea y estadísticamente comparable por lo que podíamos plantearnos una intervención y valorar su incidencia. Los resultados indican que mejora el nivel de Educación Emocional (EE) de estos alumnos con un nivel de significación de p= 0,001. A partir de este momento, podemos concretar que los resultados conseguidos por los alumnos que han seguido la aplicación del programa mejoran significativamente. Este resultado, nos permite afirmar que el uso intencional del programa de educación emocional para mejorar el ámbito afectivo ha incidido positivamente en el proceso de aprendizaje de los alumnos. Sin embargo consideramos esencial llevar a cabo una formación y posterior evaluación del profesorado en EE, como paso previo necesario para una aplicación óptima del programa.

Estudios de los restos vegetales de diversas muestras procedentes del abrigo de Son Gallard- Son Marroig: el resultado de los analisis de fitolitos.

[spa] Los fitólitos son microrestos síliceos que reproducen el tejido celular de las plantas. Su identificación y cuantificación en un yacimiento arqueológico permiten obtener información sobre el tipo de plantas utilizadas en un contexto determinado así como su distribución. Fueron realizados análisis de fitolitos en diversos niveles correspondientes a diferentes períodos cronológicos del abrigo de Son Gallard-Son Marroig. Los resultados obtenidos señalan una deposición de carácter «antrópico» de materia vegetal en dos de los niveles analizados (TB3 y UE5), aunque sin una selección aparente del tipo de plantas depositadas. Por otro lado las muestras analizadas de la Covacha Este parecen indicar que se trata del suelo de hábitat del abrigo sin una deposición intencionada de materia vegetal, mas allá de la derivada por el uso continuado del abrigo. [eng] Phytoliths are silica microremains that reproduce the cellular tissue of plants. The identification and quantification of phytoliths in archaeological sediments, allows for a better understanding of the utilised plants in a pecific area as well as the distribution of the plants used. Phytolith analyses were performed on different levels from different periods in Son Gallard-Son Marroig rockshelter. The results obtained show an «anthropological» deposition of plants in two of the studied levels (TB3 and UE5), without apparent selection of plants. On the other hand, the samples analyzed from the Covacha Este seem to indicate the presence of vegetal remains product of the continued use of the soils with no intentional deposition.

Risques et bénéfices d'une approche interventionnelle face aux corps étrangers digestifs [Digestive foreign body management].

Foreign body (FB) ingestion is a frequent reason for gastroenterology consulting. Eighty percent of these ingestions are accidental and observed among paediatric subjects. However, intentional repetitive ingestions are also observed, especially amongst prisoners or psychiatric patients. Most FBs pass throughout the digestive tract without any complication and without any need for surgical or endoscopic intervention. Nevertheless, around 10-20% of cases require an endoscopy examination and 1% will lead to a surgical intervention. Management approaches should favor inter-disciplinarity, balance benefits and risks of FB removal based on its location, and integrate psychiatric comorbidities into the decision process.

Transient shear banding in time-dependent fluids

We study the dynamics of shear-band formation and evolution using a simple rheological model. The description couples the local structure and viscosity to the applied shear stress. We consider in detail the Couette geometry, where the model is solved iteratively with the Navier-Stokes equation to obtain the time evolution of the local velocity and viscosity fields. It is found that the underlying reason for dynamic effects is the nonhomogeneous shear distribution, which is amplified due to a positive feedback between the flow field and the viscosity response of the shear thinning fluid. This offers a simple explanation for the recent observations of transient shear banding in time-dependent fluids. Extensions to more complicated rheological systems are considered.

An Explanatory Approach to the Political Uses of ICT Initiatives for Participation : Institutions, Context, and Characteristics of the Actors

Political actors use ICTs in a different manner and in different degrees when it comes to achieving a closer relationship between the public and politicians. Usually, political parties develop ICT strategies only for electoral campaigning and therefore restrain ICT usages to providing information and establishing a few channels of communication. By contrast, local governments make much more use of ICT tools for participatory and deliberative purposes. These differences in usages have not been well explained in the literature because of a lack of a comprehensive explanatory model. This chapter seeks to build the basis for this model, that is, to establish which factors affect and condition different political uses of ICTs and which principles underlie that behaviour. We consider that political actors are intentional and their behaviour is mediated by the political institutions and the socioeconomic context of the country. Also, though, the actor¿s own characteristics, such as the type and size of the organization or the model of e-democracy that the actor upholds, can have an influence in launching ICT initiatives for approaching the public.