Applying quantitative methods in the assessment of outcomes of pharmacotherapy of psoriasis

Healthcare providers and policy makers are faced with an ever-increasing number of medical publications. Searching for relevant information and keeping up to date with new research findings remains a constant challenge. It has been widely acknowledged that narrative reviews of the literature are susceptible to several types of bias and a systematic approach may protect against these biases. The aim of this thesis was to apply quantitative methods in the assessment of outcomes of topical therapies for psoriasis. In particular, to systematically examine the comparative efficacy, tolerability and cost-effectiveness of topical calcipotriol in the treatment of mild-to-moderate psoriasis. Over the years, a wide range of techniques have been used to evaluate the severity of psoriasis and the outcomes from treatment. This lack of standardisation complicates the direct comparison of results and ultimately the pooling of outcomes from different clinical trials. There is a clear requirement for more comprehensive tools for measuring drug efficacy and disease severity in psoriasis. Ideally, the outcome measures need to be simple, relevant, practical, and widely applicable, and the instruments should be reliable, valid and responsive. The results of the meta-analysis reported herein show that calcipotriol is an effective antipsoriatic agent. In the short-tenn, the pooled data found calcipotriol to be more effective than calcitriol, tacalcitol, coal tar and short-contact dithranol. Only potent corticosteroids appeared to have comparable efficacy, with less short-term side-effects. Potent corticosteroids also added to the antipsoriatic effect of calcipotriol, and appeared to suppress the occurrence of calcipotriol-induced irritation. There was insufficient evidence to support any large effects in favour of improvements in efficacy when calcipotriol is used in combination with systemic therapies in patients with severe psoriasis. However, there was a total absence of long-term morbidity data on the effectiveness of any of the interventions studied. Decision analysis showed that, from the perspective of the NHS as payer, the relatively small differences in efficacy between calcipotriol and short-contact dithranol lead to large differences in the direct cost of treating patients with mildto-moderate plaque psoriasis. Further research is needed to examine the clinical and economic issues affecting patients under treatment for psoriasis in the UK. In particular, the maintenance value and cost/benefit ratio for the various treatment strategies, and the assessment of patient's preferences has not yet been adequately addressed for this chronic recurring disease.

Challenges and limitations of intercultural training for inpatriates in German multinationals:a case study

Despite the increasing popularity of research on intercultural preparation and its effectiveness, research on training for inpatriates has not been developed with the same level of rigour as research on training for expatriates. Furthermore, research on intercultural training hardly ever includes the aspect of preparing for the corporate culture of a company. For expatriates coming from headquarters’ national culture and equipped with a good knowledge of headquarters’ corporate culture, it might be sufficient to address only the national culture of the location abroad. But can the same be said for inpatriates coming from a foreign subsidiary? Therefore the qualitative research of my thesis was aimed at finding out if intercultural training programmes that address only the national culture of the host country are sufficient to prepare inpatriates for working at headquarters. A case study using a German multinational company has been conducted in order to find out what kind of problems and irritations inpatriates at the company’s headquarters perceive at work. In order to determine whether the findings are related to the national or the corporate culture, Hall’s and Hofstede’s approaches to culture were used. The interview analysis produced the following conclusion: Although the researched company promotes standardised worldwide corporate guidelines, there are many differences between headquarters and subsidiaries regarding the interpretation and realisation of these guidelines. These differences cause irritation, confusion and problems for the inpatriates. Therefore an effective intercultural preparation for inpatriates should be tailor-made and take into account the aspect of corporate culture, as well as the specific roles and functions of inpatriates.

The detection of kinin activity in contact lens wear

Many factors can be, and have been, attributed to the appearance of complications in lens wear, but the greatest is associated with deposition. Reduced acuity, irritation and inflammatory responses are often referred to as adverse reactions arising as a result of deposition. In this study, particular attention was paid to the potential role of adsorbed proteins in activating, mediating and/or stimulating a host immune response, i.e., the hypothesis that the adsorption of certain proteins from the tears and ocular surfaces may actively affect successful lens wear. In particular, the purpose of this study was to investigate the presence of a group of proteins previously undiscovered in the ocular environment. The intention was to target a family of proteins/glycoproteins that have become prominent recently in a variety of inflammatory responses and disorders at many other mucosal associated sites around the body, e.g. in nasal rhinitis and in joint inflammation. The protein cascade in question is the kinin family of inflammatory mediators. The aim was to investigate their presence in the ocular environment, specifically in relation to contact lens wear, and consequently assess the implications of their discovery. High molecular weight kininogen (HMWK), with its central role in kinin responses, was investigated initially as the marker of kinin activity, with subsequent members examined thereafter.

Recurrent Tibial Tunnel Cyst Formation Following Anterior Cruciate Ligament Reconstruction and Interference Screw Removal

A unique case of a collegiate athlete who suffered an anterior cruciate ligament injury leading to the formation of a synovial cyst is described. The cyst, localized over the tibial tunnel, resulted from irritation caused by the removal of interference screws.

TRPV4 is necessary for trigeminal irritant pain and functions as a cellular formalin receptor.

Detection of external irritants by head nociceptor neurons has deep evolutionary roots. Irritant-induced aversive behavior is a popular pain model in laboratory animals. It is used widely in the formalin model, where formaldehyde is injected into the rodent paw, eliciting quantifiable nocifensive behavior that has a direct, tissue-injury-evoked phase, and a subsequent tonic phase caused by neural maladaptation. The formalin model has elucidated many antipain compounds and pain-modulating signaling pathways. We have adopted this model to trigeminally innervated territories in mice. In addition, we examined the involvement of TRPV4 channels in formalin-evoked trigeminal pain behavior because TRPV4 is abundantly expressed in trigeminal ganglion (TG) sensory neurons, and because we have recently defined TRPV4's role in response to airborne irritants and in a model for temporomandibular joint pain. We found TRPV4 to be important for trigeminal nocifensive behavior evoked by formalin whisker pad injections. This conclusion is supported by studies with Trpv4(-/-) mice and TRPV4-specific antagonists. Our results imply TRPV4 in MEK-ERK activation in TG sensory neurons. Furthermore, cellular studies in primary TG neurons and in heterologous TRPV4-expressing cells suggest that TRPV4 can be activated directly by formalin to gate Ca(2+). Using TRPA1-blocker and Trpa1(-/-) mice, we found that both TRP channels co-contribute to the formalin trigeminal pain response. These results imply TRPV4 as an important signaling molecule in irritation-evoked trigeminal pain. TRPV4-antagonistic therapies can therefore be envisioned as novel analgesics, possibly for specific targeting of trigeminal pain disorders, such as migraine, headaches, temporomandibular joint, facial, and dental pain, and irritation of trigeminally innervated surface epithelia.

Stress e Emergência Médica: níveis e factores de stress em profissionais de emergência pré–hospitalar

O stress é a doença da actualidade, devido à exigência e à pressão emocional que o meio pode exercer sobre todas as pessoas, quer no seu ambiente pessoal quer no ambiente profissional. O termo stress serve cada vez mais como justificação ou forma de expressão de irritações, mal-estar físico e mental, cansaço, ansiedade e depressões. Todavia torna-se pertinente percebermos a evolução do stress enquanto conceito e enquanto doença. Neste trabalho contextualizamos o stress no âmbito da Emergência Pré – Hospitalar, explorando-o, avaliando-o e analisando-o, de modo a podermos perceber os níveis de stress e de que forma os Profissionais de Emergência a ele estão sujeitos. Considerando a base teórica deste estudo definimos, como objectivo geral do trabalho, a avaliação de níveis e factores de stress percepcionados pelos profissionais de emergência médica e como objectivos específicos do estudo a descrever e caracterizar, a nível da região centro, os indivíduos que desempenham funções na emergência préhospitalar, verificar a percepção dos mesmos no que respeita ao stress na sua vida profissional, conhecer como percepcionam os níveis de stress em situações profissionais de emergência e identificar a sua percepção no que concerne aos níveis de stress diário no seu quotidiano. Com estes objectivos, utilizamos uma amostra de 184 profissionais de Emergência Médica divididos por quatro profissões [Médicos, Enfermeiros, Técnicos de Ambulância de Emergência (TAE) e Operadores de Central de Emergência Médica(OPCEM)], com idades compreendidas entre os 20 e os 56 anos. Realizámos ainda um estudo descritivo explorando os questionários de stress no INEM (Instituto Nacional de Emergência Médica) e o Questionário de Vulnerabilidade do Stress com variáveis do estudo demográfico. Podemos concluir que o stress está presente nas actividades de emergência. A sua presença relaciona-se, por um lado, com uma maior ou menor discriminação dos factores stressantes e, por outro, numa maior ou menor centração no sujeito, nomeadamente, um maior perfeccionismo e intolerância à frustração que se apresentam como distressantes para a actividade profissional de emergência. Os aspectos estudados permitem-nos clarificar o sentido e a utilidade do conceito, a sua operacionalidade e a sua importância nos profissionais de emergência. / Stress is the disease of our time, due to the requirement and emotional pressure that the media can have on all people, both in their personal environment and in the professional environment. The word stress increasingly serves as a justification or form of expression of irritation, physical discomfort and mental fatigue, anxiety and depression. However it is pertinent to realize the evolution of stress as a concept and as a disease. In this work, we contextualize under the stress of the Pre - Hospital Emergency, exploring it, assessing it and analyzing it, so you can see the stress levels and how the Emergency Professionals are subject to it. Whereas the theoretical basis of this study as a strategic objective of the work, the assessment of levels and stress factors perceived by medical emergency professionals and specific objectives of the study description and characterization, the level of the center, individuals who perform functions in pre-hospital emergency, check their perception with regard to the stress in your life, know how they experience the stress levels of professionals in emergency situations and identify the perceptions of individuals regarding the levels of daily stress in their daily lives. For this we used a sample of 184 professionals of Medical Emergency divided by four professions [(Doctors, Nurses, Technicians Ambulance Emergency (TAE), Operators of Emergency Medical Center (OPCEM)], aged 20 to 56 years. We conducted a descriptive study also exploring the questionnaires of stress in INEM(National Institute of Medical Emergency) and Vulnerability Questionnaire Stress with variables of the study population. We can conclude that stress is present in emergency activities. Its presence is related to, first, with more or less stressful factors of discrimination and, secondly, a greater or lesser concentration on the subject, in particular, greater perfectionism and intolerance to frustration that stand as unstressed for the activity of emergency professionals. The areas studied will clarify the meaning and usefulness of the concept, its operation and its importance in day-to-day occupation of emergency.

Contact dermatitis from shoes: an update

Contact dermatitis is a common inflammatory skin condition characterized by erythematous and pruritic skin lesions that occur after contact with a foreign substance. There are two forms of contact dermatitis: irritant and allergic. Irritant contact dermatitis is caused by the non–immune-modulated irritation of the skin by a substance, leading to skin changes. Allergic contact dermatitis is a delayed hypersensitivity reaction in which a foreign substance comes into contact with the skin; skin changes occur after reexposure to the substance. A medical condition referred to as “shoe dermatitis” is a form of contact dermatitis caused by the contact of the foot with parts of the shoe due to these materials. Shoe dermatitis is a diagnostic and therapeutic challenge and is a common type of contact dermatitis. It is imperative the foot and ankle physician become familiar with recognizing signs and symptoms of shoe dermatitis so that their patients can be accurately diagnosis and appropriately treated to avoid secondary infections and disability. This review will first present causative factors for the etiology of shoe contact dermatitis supported by clinical-based evidence as found in the medical literature. Secondly, a description of the signs and symptoms of shoe contact dermatitis will be presented in a narrative fashion. Finally, both treatment options and preventative measures to avoid shoe.

Credible or not : A study on the factors influencing consumers' credibility assessment of product placements on Instagram

Background: To align with the new trend of using social media in the marketing mix, product placement has been adapted to social media platforms as one strategy to create attention. Especially on Instagram, product placements have gained popularity among companies. While scholars have focused on measuring the effectiveness of the strategy, suggesting that credibility is one component necessary for success, a gap in the research is illuminated when focusing on what makes a product placement on Instagram credible. Previous studies regarding credibility and its relation to traditional media have concluded that there are some factors essential in consumers’ credibility evaluation process. Since social media differs from traditional media, there was a need to investigate the applicability of credibility to the social media platform Instagram. Purpose: The purpose of this thesis was to examine key factors of product placement on Instagram that influence credibility. Method: To meet the purpose of this thesis a study with a mixed method research design was conducted. The qualitative data was collected through semi-structured interviews with the intention to discover how consumers evaluate credibility. The scales and items developed from the findings of the qualitative study were tested using a questionnaire to identify which factors that have the most influence on consumers’ credibility assessment. Conclusions: The overall findings indicate that consumers evaluate credibility based upon source, message and receiver characteristics. The empirical evidence suggests that the Expertise of influencer, Professionalism of picture, Trustworthiness of influencer, Connection to influencer and Causes of irritation are the factors that have the most influence on consumers’ credibility assessment of product placement on Instagram. The findings further implies that it is not only the factor itself that influence, credibility can additionally be transferred from one factor to another.

Adaptación al español de una escala de motivación emprendedora

This study follows the theoretical framework put forward by Robichaud on entrepreneurial motivation. The objective was to adapt the original French scale of 17 items into Spanish and to analyze its psychometric properties. The participants in the present study were 981 Spanish employees (46.5 % men and 53.5 % women). After carrying out exploratory factor analyses and ESEM (RMSEA = .06; CFI = .95 and TLI = .95), revealed a structure comprised of three factors: Family security (a =.82), Independence and autonomy (a =.83), and Intrinsic motivations (a =.77). These three factors displayed adequate reliability. We also found evidence of validity with regard to a series of external correlates and various scales that have to do with workaholism, irritation and burnout. The present scale may prove useful for adequately identifying entrepreneurial motivation.

A tecnologia no ensino da interpretação

Tese de Mestrado em Tradução e Interpretação Especializadas Área Científica de Línguas e Culturas

‚Verständige Musikpraxis’ als Gegenstand von Musikunterricht zwischen Leiblichkeit und diskursivem Lernen

This article deals with a pedagogical concept called "Verständige Musikpraxis". It wants to elicit whether and if how its effects might be empirically relevant. Starting point is an analysis of a suite of 4 videotaped music lessons with an emphasis on singing in the classroom in primary schools. The taped lessons show a similarity in structure: a phase of practising is mostly followed by a phase of practical learning and reflection, which in turn is interrupting the process. In the phenomenological theory of learning this moment of irritation is a hallmark of the learning process per se. (DIPF/Orig.)

Efeito de uma intervenção de reabilitação psicomotora em pessoas idosas institucionalizadas ao nível de indicadores de saúde e do bem-estar

Objetivo: Investigar os benefícios de um programa de reabilitação psicomotora em pessoas idosas institucionalizadas ao nível de indicadores de saúde e do bem-estar. Metodologia: A amostra integrou 42 participantes (84±6.2 anos), dos quais 21 pertenciam ao grupo experimental (programa de reabilitação) e 21 ao grupo controlo. Os indicadores de saúde e bem-estar foram avaliados pelo Profile of Mood Stats (POMS), pela Escala de Dor (Instrumento P4), pela Perceção de Estado de Saúde (EQVAS) e pelo Índice de Barthel. Resultados: Os testes de comparação evidenciaram melhorias significativas no grupo experimental, nas variáveis depressão, irritação, confusão, principalmente no score total sem e com irritação da avaliação de estados emocionais e de humor, em relação à escala de dor as variáveis escala de dor1 e score total escala de dor foram as que tiveram melhorias significativas, p= <0.05. Conclusão: O programa de reabilitação psicomotora promoveu melhorias ao nível dos indicadores de saúde e do bem-estar das pessoas idosas institucionalizadas, com maior impacto nos estados emocionais e de humor e diminuição de intensidade de dor; Abstract: Effect of a psychomotor rehabilitation intervention in elderly people institutionalized at the level of health indicators and welfare. Objective: The aim is to investigate the benefits of a psychomotor rehabilitation program in orderly people institutionalized at the level of health indicators and welfare. Methodology: The sample consisted of 42 participants (84 ± 6.2 years), 21 of them belonged to the experimental group (rehabilitation program), and the other 21, to the control group. The following surveys were conducted by the Profile of Mood Stats (POMS), the Pain Scale (P4 Instrument), the Perception of Health Status (EQVAS) and the Barthel Index. Results: Significant improvements were observed in the experimental group, in the following dimensions: depression, anger, confusion, mainly in the total score with and without irritation assessment of emotional states and mood, regarding the pain scale, the variables pain scale and total average score were the ones that had higher significant improvements, p = <0.05. Conclusion: The psychomotor rehabilitation program led to improvements in health indicators and well-being of the institutionalized older ones, with greater impact on emotional states and mood and decrease in pain intensity.

O comportamento dos consumidores perante o recebimento de mensagens de SMS Marketing

Nos dias de hoje, os smartphones são cada vez mais vulgares no quotidiano das pessoas e com isto as empresas têm uma grande oportunidade para chegar aos seus consumidores e possíveis consumidores. Mas esta oportunidade, para alguns consumidores, gera um problema: invasão do seu espaço pessoal. O presente estudo tem como objetivo perceber como é que o consumidor valoriza a estratégia do SMS Marketing e qual a sua atitude perante a mesma, ou seja, uma vez que deu permissão para o recebimento deste tipo de SMS’s, interessa perceber se o consumidor dá importância a esta estratégia e como age quando as recebe. A metodologia utilizada é do tipo quantitativa, instrumentada através de questionários online a um tipo de amostragem por conveniência. Para analisar as hipóteses de estudo, foi realizada uma regressão linear múltipla. Os principais resultados indicam que apenas a dimensão Entretenimento (uma das características da publicidade por SMS) exerce influência nas intenções comportamentais dos consumidores. As estatísticas descritivas mostram que a dimensão Irritação é a que tem uma média mais elevada e o Entretenimento a média mais baixa o que indica a opinião dos consumidores em relação a esta estratégia.

Perceções e atitude acerca da publicidade nas redes sociais e nos motores de pesquisa : uma análise comparativa

Mestrado em Marketing