Does exhaled nitric oxide predict asthma exacerbation in children?

Asthma is a chronic complex disorder of the respiratory tract that affects millions of people globally, a large percentage of which are children. Triggered by a host of factors such as allergens and changes in temperature, the pathophysiologic and clinical indices vary among patients and have contributed to difficulties in overall management of asthma. Shortly after exhaled nitric oxide (eNO) was discovered in higher concentrations in asthma patients, it was shown to be superior to other markers such as PEFR, FEV1 and sputum eosinophils in screening asthma patients. Studies have also noted promising results regarding the use of eNO to predict asthma exacerbation in adults while in children, asthma symptoms have been observed to be good predictors of asthma exacerbation. Currently however, the potential of eNO as a predictor of asthma exacerbation in children is yet to be examined. The objective of this study was to assess eNO potential to predict asthma exacerbation in children by examining the relationship between eNO and changes in pulmonary function, asthma symptoms and rescue medication use.^ The primary study "Air Toxics and Asthma in Children" (ATAC), recruited children aged 9 to 14 years with labile persistent asthma diagnosed at least one year earlier. The data obtained from 30 study participants, included exhaled nitric oxide concentration, PEFR, FEV1, asthma symptoms and frequency of emergency medication use.^ Descriptive statistics, Pearson's and Spearman's correlation tests were followed by a simple linear regression in which eNO was the independent (predictor) variable while FEV1, PEFR, asthma symptoms and frequency of emergency medication use were the dependent (outcome) variables.^ Results showed that eNO was associated with percent change in FEV1, day time wheeze, night time shortness of breath, but correlated only weakly with PEFR, amplitude percent of mean PEFR, FEV1, percent change in FEV1 and asthma symptoms.^ Further research is imperative to better define the role of eNO and understand intrinsic pathologic mechanisms towards asthma management in children.^

Vertical distribution of relative numbers of the main groups of sound-scattering fishes in the Central Indian Ocean

Findings made in 31 catches with an Isaacs-Kidd midwater trawl in the light (09.00-16.00) and dark (21.00-04.00) periods of a day within a survey area of about 100 sq. miles with approximate center coordinates of 13°S and 78°E have been used to investigate vertical distribution of the main groups of sound-scattering fishes (35 species of the family Myctophidae and 16 species of other families). It has been shown that during daylight hours all fishes sink to depths deeper than 400 m. Data are presented concerning the fish population of night-time sound-scattering layers at depths of 70-150 m and about 400 m and of the daytime ones at depths of about 450 m.

Effect of ocean acidification and pH fluctuations on the growth and development of coralline algal recruits, and an associated benthic algal assemblage

Coralline algae are susceptible to the changes in the seawater carbonate system associated with ocean acidification (OA). However, the coastal environments in which corallines grow are subject to large daily pH fluctuations which may affect their responses to OA. Here, we followed the growth and development of the juvenile coralline alga Arthrocardia corymbosa, which had recruited into experimental conditions during a prior experiment, using a novel OA laboratory culture system to simulate the pH fluctuations observed within a kelp forest. Microscopic life history stages are considered more susceptible to environmental stress than adult stages; we compared the responses of newly recruited A. corymbosa to static and fluctuating seawater pH with those of their field-collected parents. Recruits were cultivated for 16 weeks under static pH 8.05 and 7.65, representing ambient and 4*preindustrial pCO2 concentrations, respectively, and two fluctuating pH treatments of daily (daytime pH = 8.45, night-time pH = 7.65) and daily (daytime pH = 8.05, night-time pH = 7.25). Positive growth rates of new recruits were recorded in all treatments, and were highest under static pH 8.05 and lowest under fluctuating pH 7.65. This pattern was similar to the adults' response, except that adults had zero growth under fluctuating pH 7.65. The % dry weight of MgCO3 in calcite of the juveniles was reduced from 10% at pH 8.05 to 8% at pH 7.65, but there was no effect of pH fluctuation. A wide range of fleshy macroalgae and at least 6 species of benthic diatoms recruited across all experimental treatments, from cryptic spores associated with the adult A. corymbosa. There was no effect of experimental treatment on the growth of the benthic diatoms. On the community level, pH-sensitive species may survive lower pH in the presence of diatoms and fleshy macroalgae, whose high metabolic activity may raise the pH of the local microhabitat.

Standard meteorological measurements on board of POLARSTERN during expedition ANT-IV (PS08, 4 cruises, south summer 1985/86) in the Atlantic and Weddell Sea, Antarctica

During the fourth Antarctic voyage ANT-IV of the research icebreaker POLARSTERN standard meteorological measurements have been performed. The measurements include 3-hourly synoptic observations as well as daily upper air soundings. The measurements started on September 6 1985 at Bremerhaven and were terminated at April 28 1986 in Punta Arenas. The 3-hourly synoptic observations are performed following the instructions of the FM 13 ships code defined by the World Meteorological Organization (WMO). The datasets include automatic measurements such as mean ship's speed, wind velocity, wind direction, air temperature, water temperature as well as visual observations such as total cloud amount, present weather, clouds, height and period of swell waves, ice classification. The visual observation are not performed during night time. For the upper air soundings VAISALA RS80 radiosondes, carried by helium-filled balloons (TOTEX 350 - 1500) were used. Data reception and evaluation were carried out by a MicroCora System (VAISALA). The upper air soundings include profile measurements of pressure, temperature, relative humidity and wind vector. Usually the soundings started at the heliport (10 m above sea level) and terminated between 15 and 37 km. The height of the measurements was calculated by applying the barometric formula. The wind vector was determined with the aid of the OMEGA navigation system.

Seawater carbonate chemistry and community calcification during Miyako Island (Japan) coral reef studies, 1994

Coral reefs are characterized by enormous carbonate production of the organisms. It is known that rapid calcification is linked to photosynthesis under control of the carbonate equilibrium in seawater. We have established a model simulating the coexisting states of photosynthesis and calcification in order to examine the effects of photosynthesis and calcification on the carbonate system in seawater. Supposing that the rates of photosynthesis and calcification are proportional to concentrations of their inorganic carbon source, the model calculations indicate that three kinds of unique interactions of the organic and inorganic carbon productions are expected. These are photosynthetic enhancement of calcification, calcification which benefits photosynthesis and carbonate dissolution induced by respiration. The first effect appears when the photosynthetic rate is more than approximately 1.2 larger than that of calcification. This effect is caused by the increase of CO3 content and carbonate saturation degree in seawater. If photosynthesis use molecular carbon dioxide, the second effect occurs when the calcification rate is more than approximately 1.6 times larger than that of photosynthesis. Time series model experiments indicate that photosynthesis and calcification potentially enhance each other and that organic and inorganic carbon is produced more efficiently in the coexisting system than in the isolated reactions. These coexisting effects on production enhancement of photosynthesis and calcification are expected to appear not only in the internal pool of organisms but also in a reef environment which is isolated from the outer ocean during low tide. According to the measurements on the fringing type Shiraho Reef in the Ryukyu Islands, the diurnal change of water properties (pH, total alkalinity, total carbon dioxide and carbonate saturation degree) were conspicuous. This environment offers an appropriate condition for the appearance of these coexisting effects. The photosynthetic enhancement of calcification and the respiratory inducement of decalcification were observed during day-time and night-time slack-water periods, respectively. These coexisting effects, especially the photosynthetic enhancement of calcification, appear to play important roles for fluorishing coral reef communities.

Bovedas Encamonadas: Origen, Evolucion, Geometria y Construccion entre los Siglos XVII y XVIII en el Virreinato de Perú

Desde la creación del Virreinato del Perú, en el siglo XVI, los arcos, bóvedas y cúpulas se acostumbraban a levantar con piedra y fábrica. Sin embargo estas tierras eran sacudidas periodicamente por terremotos, produciendo el colapso de la mayoría de estas edificaciones. Para el siglo XVII los alarifes ya habían experimentado diversas maneras de levantar bóvedas, sin haberse encontrado una respuesta razonable en términos de tiempo, economía y estabilidad frente a los sismos. En medio de este panorama se produjo la introducción de las bóvedas encamonadas a mediados del siglo XVII, consolidandose en el resto de la centuria hasta el punto de terminar convirtiéndose en un recurso tradicional y de estimada elaboración dentro de la arquitectura virreinal peruana. Las bóvedas encamonadas se realizaban con tablas de madera (camones) que se solapaban entre sí para formar arcos (cerchas), los cuales definían la forma que tendrían las bóvedas, y eran estabilizados lateralmente mediante correas. Sobre los arcos y correas se colocaba un cerramiento que podía ser un entablado, unos listones de madera o simplemente un tendido a base de cañas. En la mayoría de casos se finalizaba con un recubrimiento aislante de barro por el extradós y otro decorativo de yeso por el intradós. Precisamente estas bóvedas constituyen el objeto de la presente tesis, específicamente en su devenir histórico entre los siglos XVII y XVIII en el ámbito territorial del Virreinato del Perú, partiendo del examen de los tratados de arquitectura coetáneos y del estudio de las bóvedas de madera en España, para finalizar con el análisis de las características geométricas y constructivas que lograron definir en ellas los alarifes peruanos. Since the creation of the Viceroyalty of Peru, in the sixteenth century, arches, vaults and domes were accustomed to build with stone and masonry. However, these lands were periodically shaken by earthquakes, causing the collapse of most of these buildings. For the seventeenth century the master masons had already experienced several ways to build vaults, without having found a reasonable response in terms of time, economy and stability against earthquakes. Into this context the master carpenters introduced the wooden vaults since seventeenth century, and this constructive system was consolidated around the rest of the century to the end point of becoming a traditional and estimated resource of the Peruvian colonial architecture. The wooden vaults were made with timber planks (camones) that overlapped each other to form arches (cerchas), which defined the shape of the vaults, and were stabilized laterally by purlins. Above the arches and purlins placed planks, wooden strips or just cane. In most cases ended with a mud plaster insulating the extrados and a decorative gypsum plaster on the intrados. Precisely these vaults are the subject of this thesis, specifically in its historical way between the seventeenth and eighteenth centuries in the territory of the Viceroyalty of Peru. Since an examination of the architectural treatises and the Spanish wooden vaults, and concluding with the analysis of the geometric and constructive system that Peruvian builders were able to define on them.

La Casa Domínguez. Alejandro de la Sota: Construir - Habitar

La Tesis Doctoral nace con una intensa vocación pedagógica. La hipótesis de trabajo se establece en torno a una cuestión de interés personal, un tema sobre el que se vertebran, desde el comienzo del doctorado, los diferentes cursos y trabajos de investigación: LA CASA DOMÍNGUEZ como paradigma de la dialéctica en la obra de Alejandro de la Sota. La clasificación de la realidad en categorías antagónicas determina un orden conceptual polarizado, una red de filiaciones excluyentes sobre las que Sota construye su personal protocolo operativo: la arquitectura intelectual o popular, experimental o tradicional, universal o local, ligera o pesada, elevada o enterrada, etc. Se propone el abordaje de una cuestión latente en el conjunto de la obra ‘sotiana’, desde la disección y el análisis de una de sus obras más pequeñas: la casa Domínguez. Se trata de una organización sin precedentes, que eleva la estrategia dialéctica al paroxismo: la vivienda se separa en dos estratos independientes, la zona de día, elevada, y la zona de noche, enterrada; cada uno de los estratos establece su propio orden geométrico y constructivo, su propio lenguaje y carácter, su propia identidad e incluso su propio presupuesto. Las relaciones entre interior y exterior se especializan en función de la actividad o el reposo, estableciéndose una compleja red de relaciones, algunas evidentes y otras celosamente veladas, entre los diferentes niveles. La estancia destinada a las tareas activas se proyecta como un objeto de armazón ligero y piel fría; la precisa geometría del cubo delimita la estancia vigilante sobre el paisaje conquistado. La ladera habitada se destina al reposo y se configura como una topografía verde bajo la que se desarrollan los dormitorios en torno a patios, grietas y lucernarios, generando un paisaje propio: la construcción del objeto frente a la construcción del lugar La casa Domínguez constituye uno de los proyectos menos estudiados, y por lo tanto menos celebrados, de la obra de Don Alejandro. Las publicaciones sucesivas reproducen la documentación gráfica junto a la memoria (epopeya) que el propio Sota compone para la publicación del proyecto. Apenas un par de breves textos críticos de Miguel Ángel Baldellou y, recientemente de Moisés Puente, abordan la vivienda como tema monográfico. Sin embargo, la producción de proyecto y obra ocupó a De la Sota un periodo no inferior a diez años, con casi cien planos dibujados para dos versiones de proyecto, la primera de ellas, inédita. El empeño por determinar hasta el último detalle de la ‘pequeña’ obra, conduce a Sota a controlar incluso el mobiliario interior, como hiciera en otras obras ‘importantes’ como el Gobierno Civil de Tarragona, el colegio mayor César Carlos o el edificio de Correos y Telecomunicaciones de León. La complicidad del cliente, mantenida durante casi cuarenta años, habilita el despliegue de una importante colección de recursos y herramientas de proyecto. La elección de la casa Domínguez como tema central de la tesis persigue por lo tanto un triple objetivo: en primer lugar, el abordaje del proyecto como paradigma de la dialéctica ‘sotiana’, analizando la coherencia entre el discurso de carácter heroico y la obra finalmente construida; en segundo lugar, la investigación rigurosa, de corte científico, desde la disección y progresivo desmontaje del objeto arquitectónico; y por último, la reflexión sobre los temas y dispositivos de proyecto que codifican la identificación entre la acción de construir y el hecho de habitar, registrando los aciertos y valorando con actitud crítica aquellos elementos poco coherentes con el orden interno de la propuesta. This doctoral thesis is the fruit of a profound pedagogical vocation. The central hypothesis was inspired by a question of great personal interest, and this interest has, since the very beginning of the doctorate, been the driving force behind all subsequent lines of research and investigation. The “Casa Domínguez” represents a paradigm of the dialectics found in the work of Alejandro de la Sota. The perception of reality as antagonistic categories determines a polarized conceptual order, a network of mutually excluding associations upon which Sota builds his own personal operative protocol: intellectual or popular architecture, experimental or traditional, universal or local, heavy or light, above or below ground, etc. Through the analysis and dissection of the “Casa Domínguez”, one of Sota’s smallest projects, an attempt is made to approach the underlying question posed in “Sotian” work as a whole. This is about organization without precedent, raising the strategic dialectics to levels of paroxysm. The house is divided into two separate levels, the day-time level above ground, and the lower night-time level beneath the surface of the ground. Each level has its own geometrical and stuctural order, its own language and character, its own identity and even has its own construction budget. The interaction between the two areas is centered on the two functions of rest and activity, and this in turn establishes a complex relationship network between both, which is sometimes self-evident, but at other times jealously guarded. The living area designed for daily activity is presented as an object of light structure and delicate skin; the precise geometry of the cube delimiting the ever watchful living area’s domain over the land it has conquered. A green topography is created on the slope below which lies an area adapted for rest and relaxation. Two bedrooms, built around patios, skylights and light crevices, generate an entirely independent environment: the construction of an object as opposed to the creation of a landscape. The “Casa Domínguez” project has been subject to much less scrutiny and examination than Don Alejandro’s other works, and is consequently less well-known. A succession of journals have printed the blueprint document together with a poetic description (epopee), composed by Sota himself, to mark the project’s publication. There has, however, scarcely been more than two brief critical appraisals, those by Miguel Ángel Baldellou and more recently by Moisés Puente, that have regarded the project as a monographic work. The project and works nevertheless occupied no less than ten years of De La Sota’s life, with over a hundred draft drawings for two separate versions of the project, the first of which remains unpublished. The sheer determination to design this “small” work in the most meticulous detail, drove Sota to manage and select its interior furniture, as indeed he had previously done with more “important” works like the Tarragona Civil Government, César Carlos College, or the Post Office telecommunications building in León. Client collaboration, maintained over a period of almost forty years, has facilitated an impressive array of the project’s tools and resources. The choice of “Casa Domínguez” as the central subject matter of this thesis, was made in pursuance of a triple objective: firstly, to approach the project as a paradigm of the “Sotian” dialectic, the analysis of the discourse between the heroic character and the finished building; secondly, a rigorous scientific investigation, and progressive disassembling and dissecting of the architectonic object; and finally, a reflection on aspects of the project and its technology which codify the identification between the action of construction and the reality of living, thus marking its achievements, whilst at the same time subjecting incoherent elements of the proposal’s established order to a critical evaluation.

Improving the low-wind performance of the AERMOD atmospheric dispersion model for predicting short-range impacts of livestock ammonia emissions.

Short-range impacts to sensitive ecosystems as a result of ammonia emitted by livestock farms are often assessed using atmospheric dispersion modelling systems such as AERMOD. These assessments evaluate mean annual atmospheric concentrations of ammonia and nitrogen deposition rates at the ecosystem location for comparison with ecosystem damage thresholds. However, predictions of mean annual atmospheric concentrations can be dominated by periods of stable night-time conditions, which can contribute significantly to mean concentrations. AERMOD has been demonstrated to overestimate concentrations in certain stable low-wind conditions and so the model could potentially overestimate the short-range impacts of livestock ammonia emissions. This paper tests several modifications to the parameterisation of AERMOD (v12345) that aim to improve model predictions in low-wind conditions. The modifications are first described and then are applied to three pig farm case studies in the USA, Denmark and Spain to assess whether the modifications improve long-term mean ammonia concentration predictions through improved model performance. For these three case studies, most of the modifications tested improved model performance as a result of reducing the long-term mean concentration predictions, with the largest effect for low- or ground-level sources (e.g. slurry lagoons or naturally ventilated housing).

Steady state analysis of a storage integrated solar thermophotovoltaic (SISTPV) system

This paper presents the theoretical analysis of a storage integrated solar thermophotovoltaic (SISTPV) system operating in steady state. These systems combine thermophotovoltaic (TPV) technology and high temperature thermal storage phase-change materials (PCM) in the same unit, providing a great potential in terms of efficiency, cost reduction and storage energy density. The main attraction in the proposed system is its simplicity and modularity compared to conventional Concentrated Solar Power (CSP) technologies. This is mainly due to the absence of moving parts. In this paper we analyze the use of Silicon as the phase change material (PCM). Silicon is an excellent candidate because of its high melting point (1680 K) and its very high latent heat of fusion of 1800 kJ/kg, which is about ten times greater than the conventional PCMs like molten salts. For a simple system configuration, we have demonstrated that overall conversion efficiencies up to ?35% are approachable. Although higher efficiencies are expected by incorporating more advanced devices like multijunction TPV cells, narrow band selective emitters or adopting near-field TPV configurations as well as by enhancing the convective/conductive heat transfer within the PCM. In this paper, we also discuss about the optimum system configurations and provide the general guidelines for designing these systems. Preliminary estimates of night time operations indicate it is possible to achieve over 10 h of operation with a relatively small quantity of Silicon.

Floating Bare Tether as Upper Atmosphere Probe

Use of a (bare) conductive tape electrically floating in LEO as an effective e-beam source that produces artificial auroras, and is free of problems that have marred standard beams, is considered. Ambient ions impacting the tape with KeV energies over most of its length liberate secondary electrons, which race down the magnetic field and excite neutrals in the E-layer, resulting in auroral emissions. The tether would operate at night-time with both a power supply and a plasma contactor off; power and contactor would be on at daytime for reboost. The optimal tape thickness yielding a minimum mass for an autonomous system is determined; the alternative use of an electric thruster for day reboost, depending on mission duration, is discussed. Measurements of emission brightness from the spacecraft could allow determination of the (neutral) density vertical profile in the critical E-layer; the flux and energy in the beam, varying along the tether, allow imaging line-of-sight integrated emissions that mix effects with altitude-dependent neutral density and lead to a brightness peak in the beam footprint at the E-layer. Difficulties in tomographic inversion, to determine the density profile, result from beam broadening, due to elastic collisions, which flattens the peak, and to the highly nonlinear functional dependency of line-of-sight brightness. Some dynamical issues are discussed.

Evaluación de la tecnología CAES como sistema de almacenamiento de energía eólica. Caso de estudio en España

Se presenta a continuación un modelo de una planta del almacenamiento de energía mediante aire comprimido siguiendo un proceso adiabático. En esta planta la energía eólica sobrante se usa para comprimir aire mediante un tren de compresión de 25 MW, el aire comprimido será después almacenado en una caverna de sal a 770 metros de profundidad. La compresión se llevará a cabo por la noche, durante 6 horas, debido a los bajos precios de electricidad. Cuando los precios de la electricidad suben durante el día, el aire comprimido es extraído de la caverna de sal y es utilizado para producir energía en un tren de expansión de 70 MW durante 3 horas. La localización elegida para la planta es el norte de Burgos (Castilla y León, España), debido a la coincidencia de la existencia de muchos parques eólicos y una formación con las propiedades necesarias para el almacenamiento. El aspecto más importante de este proyecto es la utilización de un almacenamiento térmico que permitirá aprovechar el calor de la compresión para calentar el aire a la entrada de la expansión, eliminando combustibles fósiles del sistema. Por consiguiente, este proyecto es una atractiva solución en un posible futuro con emisiones de carbono restringidas, cuando la integración de energía renovable en la red eléctrica supone un reto importante. ABSTRACT: A model of an adiabatic compressed air energy storage plant is presented. In this plant surplus wind energy is used to compress air by means of a 25 MW compression train, the compressed air will be later stored in a salt cavern at 770 meters depth. Compression is carried out at night time, during 6 hours, because power prices are lower. When power prices go up during the day, the compressed air is withdrawn from the salt cavern and is used to produce energy in an expansion train of 70 MW during 3 hours. The chosen location for the plant is in the north of Burgos (Castilla y León, Spain), due to both the existence of several wind farms and a suitable storage facility with good properties at the same place. The relevance of this project is that it is provided with a thermal storage, which allows using the generated heat in the compression for re-heating the air before the expansion, eliminating fossil fuels from the system. Hence, this system is an attractive load balancing solution in a possibly carbon-constrained future, where the integration of renewable energy sources into the electric grid is a major challenge.

Incubation experiments to examine the production and loss of CH3I in surface seawater

In order to investigate production pathways of methyl iodide and controls on emissions from the surface ocean, a set of repeated in-vitro incubation experiments were performed over an annual cycle in the context of a time-series of in-situ measurements in Kiel Fjord (54.3 N, 10.1E). The incubation experiments revealed a diurnal variation of methyl iodide in samples exposed to natural light, with maxima during day time and losses during night hours. The amplitude of the daily accumulation varied seasonally and was not affected by filtration (0.2µm), consistent with a photochemical pathway for CH3I production. The methyl iodide loss rate during night time correlated with the concentration accumulated during daytime. Daily (24 hour) net production (Pnet) was similar in magnitude between in vitro and in situ mass balances. However, the estimated gross production (Pgross) of methyl iodide ranged from -0.07 to 2.24 pmol/day and were 5 times higher in summer than Pnet calculated from the in-situ study [Shi et al., 2014]. The large excess of Pgross over Pnet revealed by the in-vitro (incubation) experiments in summer is a consequence of large losses of CH3I by as-yet uncharacterized processes (e.g. biological degradation or chemical pathways other than Cl- substitution).

Costs of managing urinary and faecal incontinence in a sub-acute care facility: A "bottom-up" approach

Aims: To measure accurately the direct costs of managing urinary and faecal incontinence in the sub-acute care setting. Materials and Methods: Prospective observational study was undertaken in two sub-acute care units in a metropolitan hospital. A consecutive series of 29 consecutive patients with urinary and/or faecal incontinence, who were in-patients in a geriatric rehabilitation or subacute neurologic unit underwent routine timed voiding protocol, as per usual care. Face-to-face bedside recordings of all incontinence care, with detailed cost analysis, were undertaken. Results: A total of 3,621 occasions of continence care were costed. The median time per 24 hr spent caring for incontinence per patient was 109 min (interquartile range 88-140). Isolated urinary incontinence episodes occurred in 28 patients (96.5%), mixed urinary/faecal incontinence episodes observed in 79.3%, and episodes of pure faecal incontinence were seen in 62%. The median costs of incontinence care in the sub-acute setting was $49AU per 24 hr, the major share ($41) spent on staff wages. The incontinence tasks of toileting assistance, pad changes, bed changes and catheter care were spread evenly across the three 8 hr shifts of duty. Conclusions: As our population demographics include an increasingly greater portion of the elderly, for whom long term institutional care is becoming relatively more scarce, provision of care in the sub-acute unit that may allow rehabilitation and return to home warrants scrutiny. This is the first study that delineates the costs of managing urinary and faecal incontinence in the sub-acute care setting. Such costs are substantial and place a heavy burden upon night-time carets. (C) 2004 Wiley-Liss, Inc.

STRESS E REAJUSTAMENTO SOCIAL EM AUXILIARES DE ENFERMAGEM

O presente estudo teve por objetivos, levantar o perfil sócio-demográfico e cultural, de auxiliares de enfermagem, avaliar o grau e presença de sintomas de stress, avaliar e descrever reajustamento social tecendo relação entre variáveis relacionadas ao labor e o stress. Participaram desse estudo 126 auxiliares de enfermagem que cursavam técnico em enfermagem. Utilizou-se os instrumentos: a) questionário Sócio-demográfico e cultural; b) Escala de Reajustamento Social de Holmes-Rahe e c) Inventário de Sintomas de Stress de Lipp (ISSL). Os dados foram coletados em salas de aula, de três escolas técnicas da grande São Paulo e esses dados foram tratados estatisticamente pelos testes X² e r Person para as relações entre variáveis, com auxílio do programa SPSS versão 17. Os resultados indicaram uma predominância de pessoas do gênero feminino, casados, com idade mínima de 19 anos e máxima de 56 anos e com práticas religiosas católicas e evangélicas. Desses profissionais (79%) trabalhavam em um só emprego, com experiência na profissão de cinco anos e o setor com maior quantidade de profissionais foi o home care . A maioria dos profissionais exercia suas atividades no horário matutino, e estudava no horário noturno. O estudo indicou que 57,9% apresentaram grau de stress significativo. Dentro deste grau de stress significativo, 41,3% dos profissionais estavam na fase de resistência e 37,3% dos auxiliares com grau de stress significativo, apresentavam predominância de stress de natureza psicológica. Quanto ao reajustamento social, os auxiliares de enfermagem a maioria, que correspondia a 48,4% estava dentro da média, com chances razoáveis de adoecer, ou seja, apresentavam capacidade regular para adaptação aos eventos novos e desconhecidos que ocorrem durante a vida. Os resultados indicaram que os profissionais que apresentaram stress significativo obtiveram pontuação maior (média) na escala de reajustamento social, em comparação aos profissionais que não apresentaram stress, indicando que esses sujeitos tinham maior probabilidade de estarem adoecidos ou virem a adoecer.

Investigation into the biochemical changes in Tourette Syndrome with a potential for pharmacological manipulation

Kynurenine (KYN) is the first stable metabolite of the kynurenine pathway, which accounts for over 95% of tryptophan metabolism. Two previous studies by this research group reported elevated plasma KYN in Tourette syndrome (TS) patients when compared with age and sex matched controls and another study showed that KYN potentiated 5-HT2A-mediated head-shakes (HS) in rodents. These movements have been suggested to model tics in TS. This raised the questions how KYN acts in eliciting this response and whether it is an action of its own or of a further metabolite along the kynurenine pathway. In the liver, where most of the kynurenine pathway metabolism takes place under physiological conditions, the first and the rate limiting enzyme is tryptophan-dioxygenase (TDO) which can be induced by cortisol. In extrahepatic tissues the same step of the pathway is catalyzed by indoleamine-dioxygenase (IDO), which is induced by cytokines, predominantly interferon-y (INF-y). Plasma neopterin, which shows parallel increase with KYN following immune stimulation, was also found elevated in one of these studies positively correlating with KYN. In the present work animal studies suggested that KYN potentiates and quinolinic acid (QUINA) dose dependently inhibits the 5-HT2A-mediated HS response in mice. The potentiating effect seen with KYN was suggested to be an effect of KYN itself. Radioligand binding and phosphoinositide (PI) hydrolysis studies were done to explore the mechanisms by which kynurenine pathway metabolites could alter a 5-HT2A-receptor mediated response. None of the kynurenine pathway metabolites tested showed direct binding to 5-HT2A-receptors. PI hydrolysis studies with KYN and QUINA showed that KYN did not have any effect while QUINA inhibited 5-HT2A-mediated PI hydrolysis. Plasma cortisol determination in TS patients with elevated plasma KYN did not show elevated plasma cortisol levels, suggesting that the increase of plasma KYN in these TS patients is unlikely to be due to an increased TDO activity induced by increased cortisol. Attention deficit hyperactivity disorder (ADHD) is commonly associated with TS. Salivary cortisol detected in a group of children primarily affected with ADHD showed significantly lower salivary cortisol levels when compared with age and sex matched controls. Plasma tryptophan, KYN, neopterin, INF-y and KYN/tryptophan ratio and night-time urinary 6-sulphatoxymelatonin (aMT6s) excretion measured in a group of TS patients did not show any difference in their levels when compared with age and sex matched controls, but TS patients failed to show the expected positive correlation seen between plasma INF-y, neopterin and KYN and the negative correlation seen between plasma KYN and night-time urinary aMT6s excretion seen in healthy controls. The relevance of the kynurenine pathway, melatonin secretion and cortisol to Tourette Syndrome and associated conditions and the mechanism by which KYN and QUINA alter the 5-HT2A-receptor mediated HS response are discussed.