795 resultados para Psychosocial adjustment
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Selostus: Maassa olevan nitraattitypen arviointi simulointimallin avulla
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Renal excretion of water and major electrolytes exhibits a significant circadian rhythm. This functional periodicity is believed to result, at least in part, from circadian changes in secretion/reabsorption capacities of the distal nephron and collecting ducts. Here, we studied the molecular mechanisms underlying circadian rhythms in the distal nephron segments, i.e., distal convoluted tubule (DCT) and connecting tubule (CNT) and the cortical collecting duct (CCD). Temporal expression analysis performed on microdissected mouse DCT/CNT or CCD revealed a marked circadian rhythmicity in the expression of a large number of genes crucially involved in various homeostatic functions of the kidney. This analysis also revealed that both DCT/CNT and CCD possess an intrinsic circadian timing system characterized by robust oscillations in the expression of circadian core clock genes (clock, bma11, npas2, per, cry, nr1d1) and clock-controlled Par bZip transcriptional factors dbp, hlf, and tef. The clock knockout mice or mice devoid of dbp/hlf/tef (triple knockout) exhibit significant changes in renal expression of several key regulators of water or sodium balance (vasopressin V2 receptor, aquaporin-2, aquaporin-4, alphaENaC). Functionally, the loss of clock leads to a complex phenotype characterized by partial diabetes insipidus, dysregulation of sodium excretion rhythms, and a significant decrease in blood pressure. Collectively, this study uncovers a major role of molecular clock in renal function.
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In Switzerland the new law on Health Insurance, effective since 1996, introduced pro competitive changes in the market of sickness funds. The legislator expected high mobility between sickness funds of both healthy and sick insured as open enrolment was introduced with the new law. That is why the risk adjustment scheme, that was already introduced 1993, was limited until 2005. However, consumer mobility remained low and risk selection strategies are still profitable, since risk-adjustment is based only on demographic variables. This paper describes risk adjustment, consumer mobility, risk selection activities of sickness funds and the impact of imperfect risk adjustment on the development of HMO and PPO models. The paper concludes with a description of the current political and scientific discussion in Switzerland.
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Efavirenz dosage adjustment in several patients with high EFV levels and presenting CNS toxicity have been successfully achieved in Switerland over the past seven years but many others have not beneficiated from dosage reduction owing to the lack of prospective studies evaluating the safety and clinical benefit of reduced dosage regimens.
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BACKGROUND: Mental disorders, common in primary care, are often associated with physical complaints. While exposure to psychosocial stressors and development or presence of principal mental disorders (i.e. depression, anxiety and somatoform disorders defined as multisomatoforme disorders) is commonly correlated, temporal association remains unproven. The study explores the onset of such disorders after exposure to psychosocial stressors in a cohort of primary care patients with at least one physical symptom. METHOD: The cohort study SODA (SOmatization, Depression and Anxiety) was conducted by 21 private-practice GPs and three fellow physicians in a Swiss academic primary care centre. GPs included patients via randomized daily identifiers. Depression, anxiety or somatoform disorders were identified by the full Patient Health Questionnaire (PHQ), a validated procedure to identify mental disorders based on DSM-IV criteria. The PHQ was also used to investigate exposure to psychosocial stressors (before the index consultation and during follow up) and the onset of principal mental disorders after one year of follow up. RESULTS: From November 2004 to July 2005, 1020 patients were screened for inclusion. 627 were eligible and 482 completed the PHQ one year later and were included in the analysis (77%). At one year, prevalence of principal mental disorders was 30/153 (19.6% CI95% 13.6; 26.8) for those initially exposed to a major psychosocial stressor and 26/329 (7.9% CI95% 5.2; 11.4) for those not. Stronger association exists between psychosocial stressors and depression (RR = 2.4) or anxiety (RR = 3.5) than multisomatoforme disorders (RR = 1.8). Patients who are "bothered a lot" (subjective distress) by a stressor are therefore 2.5 times (CI95% 1.5; 4.0) more likely to experience a mental disorder at one year. A history of psychiatric comorbidities or psychological treatment was not a confounding factor for developing a principal mental disorder after exposure to psychosocial stressors. CONCLUSION: This primary care study shows that patients with physical complaints exposed to psychosocial stressors had a higher risk for developing mental disorders one year later. This temporal association opens the field for further research in preventive care for mental diseases in primary care patients.
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This article studies alterations in the values, attitudes, and behaviors that emerged among U.S. citizens as a consequence of, and as a response to, the attacks of September 11, 2001. The study briefly examines the immediate reaction to the attack, before focusing on the collective reactions that characterized the behavior of the majority of the population between the events of 9/11 and the response to it in the form of intervention in Afghanistan. In studying this period an eight-phase sequential model (Botcharova, 2001) is used, where the initial phases center on the nation as the ingroup and the latter focus on the enemy who carried out the attack as the outgroup. The study is conducted from a psychosocial perspective and uses "social identity theory" (Tajfel & Turner, 1979, 1986) as the basic framework for interpreting and accounting for the collective reactions recorded. The main purpose of this paper is to show that the interpretation of these collective reactions is consistent with the postulates of social identity theory. The application of this theory provides a different and specific analysis of events. The study is based on data obtained from a variety of rigorous academic studies and opinion polls conducted in relation to the events of 9/11. In line with social identity theory, 9/11 had a marked impact on the importance attached by the majority of U.S. citizens to their identity as members of a nation. This in turn accentuated group differentiation and activated ingroup favoritism and outgroup discrimination (Tajfel & Turner, 1979, 1986). Ingroup favoritism strengthened group cohesion, feelings of solidarity, and identification with the most emblematic values of the U.S. nation, while outgroup discrimination induced U.S. citizens to conceive the enemy (al-Qaeda and its protectors) as the incarnation of evil, depersonalizing the group and venting their anger on it, and to give their backing to a military response, the eventual intervention in Afghanistan. Finally, and also in line with the postulates of social identity theory, as an alternative to the virtual bipolarization of the conflict (U.S. vs al-Qaeda), the activation of a higher level of identity in the ingroup is proposed, a group that includes the United States and the largest possible number of countries¿ including Islamic states¿in the search for a common, more legitimate and effective solution.
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This study analyses the fundamental components shaping the violence legitimation discourse of ETA (Euskadi Ta Askasuna). With this aim, a category system has been built, which organizes the psychosocial processes identified in previous studies related to violence legitimation. Based on the proposed category system, a content analysis was conducted on 21 statements of ETA, released between 1998 and 2011. An intraobserver and inter-observer reliability analysis reveals high level stability and replicability of the categorization. The results show, firstly, that outgroup components have a predominant presence over ingroup components. Secondly, in the components hierarchy, we observe that elements referring to identity come in first place, followed in similar frequencies by those related to violence representation and the definition of the situation.
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Este artículo analiza los componentes fundamentales que configuran el discurso legitimador de la violencia de ETA (Euskadi Ta Askatasuna). Con este objetivo, se construye un sistema de categorías, el cual organiza los procesos psicosociales identificados en investigaciones previas relacionadas con la legitimación de la violencia. A partir del sistema de categorías propuesto, se realiza un análisis de contenido en 21 comunicados de ETA publicados entre 1998 y 2011. El análisis de fiabilidad intraobservador e interobservador muestra una alta estabilidad y replicabilidad de la categorización. Los resultados muestran, en primer lugar, que los componentes exogrupales son predominantes respecto a los endogrupales. Segundo, en la jerarquización, se observa la preminencia de los elementos referidos a la identidad, seguido por frecuencias similares los relacionados con la representación de la violencia y la definición de la situación.
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This article studies alterations in the values, attitudes, and behaviors that emerged among U.S. citizens as a consequence of, and as a response to, the attacks of September 11, 2001. The study briefly examines the immediate reaction to the attack, before focusing on the collective reactions that characterized the behavior of the majority of the population between the events of 9/11 and the response to it in the form of intervention in Afghanistan. In studying this period an eight-phase sequential model (Botcharova, 2001) is used, where the initial phases center on the nation as the ingroup and the latter focus on the enemy who carried out the attack as the outgroup. The study is conducted from a psychosocial perspective and uses "social identity theory" (Tajfel & Turner, 1979, 1986) as the basic framework for interpreting and accounting for the collective reactions recorded. The main purpose of this paper is to show that the interpretation of these collective reactions is consistent with the postulates of social identity theory. The application of this theory provides a different and specific analysis of events. The study is based on data obtained from a variety of rigorous academic studies and opinion polls conducted in relation to the events of 9/11. In line with social identity theory, 9/11 had a marked impact on the importance attached by the majority of U.S. citizens to their identity as members of a nation. This in turn accentuated group differentiation and activated ingroup favoritism and outgroup discrimination (Tajfel & Turner, 1979, 1986). Ingroup favoritism strengthened group cohesion, feelings of solidarity, and identification with the most emblematic values of the U.S. nation, while outgroup discrimination induced U.S. citizens to conceive the enemy (al-Qaeda and its protectors) as the incarnation of evil, depersonalizing the group and venting their anger on it, and to give their backing to a military response, the eventual intervention in Afghanistan. Finally, and also in line with the postulates of social identity theory, as an alternative to the virtual bipolarization of the conflict (U.S. vs al-Qaeda), the activation of a higher level of identity in the ingroup is proposed, a group that includes the United States and the largest possible number of countries¿ including Islamic states¿in the search for a common, more legitimate and effective solution.
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This study analyses the fundamental components shaping the violence legitimation discourse of ETA (Euskadi Ta Askasuna). With this aim, a category system has been built, which organizes the psychosocial processes identified in previous studies related to violence legitimation. Based on the proposed category system, a content analysis was conducted on 21 statements of ETA, released between 1998 and 2011. An intraobserver and inter-observer reliability analysis reveals high level stability and replicability of the categorization. The results show, firstly, that outgroup components have a predominant presence over ingroup components. Secondly, in the components hierarchy, we observe that elements referring to identity come in first place, followed in similar frequencies by those related to violence representation and the definition of the situation.
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Résumé de l'étude La surveillance de la prescription des antibiotiques en milieu hospitalier est une des mesures recommandées pour prévenir l'émergence de bactéries résistantes. La consommation d'antibiotiques est généralement exprimée en termes de DDD (defined daily dose) rapporté au taux d'occupation (jours patients). Cette mesure ne tient cependant pas compte de la variation de la casuistique d'un service au cours du temps. La consommation d'antibiotiques est influencée par l'incidence des infections, qui peut être saisonnière ou varier selon les circonstances épidémiologiques, ainsi que par les habitudes des médecins en termes de prescription. Une échelle de mesure adaptée à ces paramètres est donc capitale pour rendre compte de la consommation d'antibiotiques au sein d'un service et identifier de possibles dérivations dans les habitudes de prescriptions. Nous avons émis l'hypothèse que le nombre de demandes d'hémocultures pouvait servir d'indicateur de la charge infectieuse d'un service. Une analyse préliminaire a permis d'établir une bonne relation entre ce paramètre et l'incidence d'événements infectieux en comparaison à d'autres paramètres testés (nombre de prélèvements microbiologiques provenant de sites stériles ou nombre total de prélèvements microbiologiques). Sur la base de cette hypothèse, nous avons analysé la consommation d'antibiotiques d'une unité de médecine générale (Service de Médecine Interne du CHUV) sur seize trimestres consécutifs en comparant deux échelles de mesures : la méthode standard en DDD par jours patients et une échelle ajustée à la charge infectieuse (DDD par nombre de demandes d'hémocultures). L'échelle ajustée aux hémocultures a permis d'identifier trois trimestres avec une consommation anormalement élevée qui n'avaient pas été classés comme tels par l'échelle standard (consommation dans les normes en DDD par jours patients). Une analyse détaillée d'un de ces trimestres a confirmé une incidence d'infections moins élevée en comparaison à un trimestre de référence (proche de la norme selon les deux échelles), alors que la corrélation entre infections et demandes d'hémocultures était similaire pour les deux périodes. De même, l'échelle ajustée ä la charge infectieuse a démontré une consommation dans la norme pour un trimestre avec une consommation en apparence trop élevée selon l'échelle standard en raison d'une incidence d'infections plus élevée pour cette période. Cette étude a donc permis une identification plus performante et plus précise de périodes avec des dérivations dans la pratique de la prescription des antibiotiques en utilisant une échelle de mesure ajustée à la charge infectieuse d'un service au cours du temps. Nous avons démontré que le nombre d'hémocultures prélevées était un indicateur stable de la charge infectieuse dans un service de médecine générale. Ceci ne permet cependant pas de généraliser l'usage de cet indicateur pour tous les types de service. La pratique des hémocultures peut, en effet, varier d'une unité à l'autre, ou entres différentes institutions. ll convient donc de tester la validité de ce paramètre dans un service avant de l'appliquer.
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The present study tested the effect of a school-based physical activity (PA) program on quality of life (QoL) in 540 elementary school children. First and fifth graders were randomly assigned to a PA program or a no-PA control condition during one academic year. QoL was assessed by the Child Health Questionnaire at baseline and postintervention. Based on mixed linear model analyses, physical QoL in first graders and physical and psychosocial QoL in fifth graders were not affected by the intervention. In first graders, the PA intervention had a positive impact on psychosocial QoL (effect size [d], 0.32; p < .05). Subpopulation analyses revealed that this effect was caused by an effect in urban (effect size [d], 0.38; p < .05) and overweight first graders (effect size [d], 0.45; p < .05). In conclusion, a school-based PA intervention had little effect on QoL in elementary school children.
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En el artículo se presenta la violencia doméstica como violencia política de género masculino. Se señalan el individualismo, la naturalización y el sexismo en el tratamiento de la violencia y la agresión así como de la identidad, por parte de la psicología tradicional, como factores que dificultan las intervenciones en la violencia doméstica. Los prejuicios, valores y estrategias de la sociedad patriarcal continúan influyendo en ellas. Desde la psicología crítica feminista se propone: a) una comprensión de la subjetividad, la diferencia sexo-género y la violencia como construcciones sociales; b) intervenciones menos autoritarias y que no participen en la reproducción del orden social; c) la incorporación de las resistencias desarrolladas; d) un análisis basado en las relaciones de poder y las prácticas discursivas