316 resultados para BILIOPANCREATIC DIVERSION


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"March 1993."

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"October 1993."

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The formation of an aesthetically desirable urinary diversion through a continent bladder stoma requires a long-term commitment by both patient and urologist to monitoring patient progress and addressing problems, both urological and otherwise, which arise over time. In this manuscript, issues relating to physical aspects of surgical management are discussed. These include the nature of and siting of the stoma and its catheterising track, the continence mechanism, provision of a low-pressure storage system of adequate capacity and management of the bladder neck/urethra when incompetent. It is imperative that careful patient selection is practised at the outset when such surgery is contemplated, otherwise a satisfactory outcome is unlikely to ensue irrespective of the procedural skills employed operatively.

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Objectives: To determine the 12-month prevalence of substance-use disorders and psychological morbidity in an Australian arrestee population. Design: Cross-sectional descriptive study. Participants and setting: 288 police arrestees at the Brisbane City Police Watch House in February and March 2001. Outcome measures: Prevalence of drug and alcohol disorders; psychological caseness according to the 28-item General Health Questionnaire; demographics and index offences. Results: 86% of the arrestees had at least one substance-use disorder; most had multiple disorders. More than 80% were substance dependent. The predominant substances used were amphetamines, marijuana, opioids and alcohol. 82% of the men and 94% of the women were suffering significant psychological distress. Conclusions: Development of services for detoxification and treatment of this population is a pressing need. The findings provide crucial information for the planning and implementation of drug courts and court diversion systems.

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Background: The provision of free prescription medicine samples is a common and traditional marketing strategy used by pharmaceutical companies, but concerns have been raised about their influence on physician prescribing behavior and patient safety. Objective: We sought to investigate the knowledge, attitudes, and behaviors of Australian family physicians regarding the use of sample prescription medications. Methods: Qualitative and quantitative techniques were used, including (1) mailed questionnaires to family physicians, (2) semistructured interviews with family physicians, and (3) sample cupboard inventories. Results: A number of issues about samples were identified by the questionnaires (208) and interviews (17 doctors), including insufficient labeling, poor record keeping, diversion of stock (personal use by doctors.. their families, practice staff and pharmaceutical representatives), and wasting of expired stock. Prescription medicine samples also influenced prescribing behavior. Australian doctors were less likely to provide samples to patients on financial grounds compared with a previous study in the United States on medical residents. Six sample cupboards were inventoried. Median wholesale value of sample cupboards was AUD $4959 (range $2395-$8709), with 6% of stock expired. Very little generic medicine was included in the sample cupboards. Conclusions: Better methods are needed to meet legislative requirements and to ensure quality use of medicines (and optimal public health) with respect to prescription medicine samples. Doctors and practice staff require training on the appropriate handling and storage of prescription medications. Alternative ways for distribution of sample medications need to be investigated.

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This paper examines population trends in morphine prescriptions in Australia, and contrasts them with findings from annual surveys with regular injecting drug users (IDU). Data on morphine prescriptions from 1995 to 2003 were obtained from the Drug Monitoring System (DRUMS) run by the Australian Government Department of Health and Ageing. Data collected from regular IDU as part of the Australian Illicit Drug Reporting System (IDRS) were analysed (2001-2004). The rate of morphine prescription per person aged 15-54 years increased by 89% across Australia between 1995 and 2003 (from 46.3 to 85.9 mg per person). Almost half (46%) of IDU surveyed in 2004 reported illicit morphine use, with the highest rates in jurisdictions where heroin was less available. Recent morphine injectors were significantly more likely to be male, unemployed, out of treatment and homeless in comparison to IDU who had not injected morphine. They were also more likely to have injected other pharmaceutical drugs and to report injection related problems. Among those who had injected morphine recently, the most commonly reported injecting harms were morphine dependence (38%), difficulty finding veins into which to inject (36%) and scarring or bruising (27%). Morphine use and injection is a common practice among regular IDU in Australia. In some cases, morphine may be a substitute for illicit heroin; in others, it may be being used to treat heroin dependence where other pharmacotherapies, such as methadone and buprenorphine, are perceived as being unavailable or undesirable by IDU. Morphine injection appears to be associated with polydrug use, and with it, a range of problems related to drug injection. Further research is required to monitor and reduce morphine diversion and related harms by such polydrug injectors.

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At Brisbane Airport, the construction of a diversion channel for Kedron Brook exposed a former beach, low cliff and sand spit, which, with their associated sediments and acid sulfate soils, demonstrate a postglacial high sea-level 1.3 - 1.4 m above present mean sea-level. The beach appears to date from 4000 to 5000 y BP. It varies in level where it lies above soft ground; these variations, and sag depressions that follow buried streamlines, indicate sediment consolidation since withdrawal of the sea from the former shore. Most of the area consists of former estuarine deposits, mangrove and saline marshes, and stranded tidal flats on which acid sulfate soils are widely developed. The modern landforms mostly reproduce subsurface features, to the extent that the surface relief replicates the landscape transgressed by the sea 7000 years ago. A small rise of sea-level possibly to +0.65 m occurred about 2000-3000 years ago. Foredunes near the present shore that are related to a slightly lower level 1000 - 500 years ago (-0.25 m) are currently subject to wave erosion.

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Many people who go to gaol are mentally ill. Remandees, prisoner receptions or people in jails have a substantially higher rate of severe mental disorder than other prisoners and the general population. There are no completely satisfactory ways to screen for psychosis and few existing screening questionnaires are available for use in correctional establishments. The Screening Instrument for Psychosis (PS) was developed in the context of the Australian Mental Health Survey: Study of Low Prevalence Disorders. It can help indicate whether a person should be referred to mental health professional for a diagnostic evaluation and possible treatment and/or diversion. We trialled the PS in a high security remand and reception centre. Measures of validity and reliability are reported. (c) 2006 Published by Elsevier Inc.

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Diversion of the McArthur River for the zinc-lead mine and Aboriginal land.

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La Sequenza Sismica Emiliana del 2012 ha colpito la zona compresa tra Mirandola e Ferrara con notevoli manifestazioni cosismiche e post-sismiche secondarie, soprattutto legate al fenomeno della liquefazione delle sabbie e alla formazione di fratturazioni superficiali del terreno. A fronte del fatto che la deformazione principale, osservata tramite tecniche di remote-sensing, ha permesso di individuare la posizione della struttura generatrice, ci si è interrogati sul rapporto tra strutture profonde e manifestazioni secondarie superficiali. In questa tesi è stato svolto un lavoro di integrazione di dati a varia scala, dalla superficie al sottosuolo, fino profondità di alcuni chilometri, per analizzare il legame tra le strutture geologiche che hanno generato il sisma e gli effetti superficiali percepiti dagli osservatori. Questo, non solo in riferimento allo specifico del sisma emiliano del 2012, ma al fine di trarre utili informazioni in una prospettiva storica e geologica sugli effetti di un terremoto “tipico”, in una regione dove le strutture generatrici non affiorano in superficie. Gli elementi analizzati comprendono nuove acquisizioni e rielaborazioni di dati pregressi, e includono cartografie geomorfologiche, telerilevamenti, profili sismici a riflessione superficiale e profonda, stratigrafie e informazioni sulla caratterizzazione dell’area rispetto al rischio sismico. Parte dei dati di nuova acquisizione è il risultato dello sviluppo e la sperimentazione di metodologie innovative di prospezione sismica in corsi e specchi d’acqua continentali, che sono state utilizzate con successo lungo il Cavo Napoleonico, un canale artificiale che taglia ortogonalmente la zona di massima deformazione del sisma del 20 Maggio. Lo sviluppo della nuova metodologia di indagine geofisica, applicata ad un caso concreto, ha permesso di migliorare le tecniche di imaging del sottosuolo, oltre a segnalare nuove evidenze co-sismiche che rimanevano nascoste sotto le acque del canale, e a fornire elementi utili alla stratigrafia del terreno. Il confronto tra dati geofisici e dati geomorfologici ha permesso di cartografare con maggiore dettaglio i corpi e le forme sedimentarie superficiali legati alla divagazione fluviale dall’VIII sec a.C.. I dati geofisici, superficiali e profondi, hanno evidenziato il legame tra le strutture sismogeniche e le manifestazioni superficiali seguite al sisma emiliano. L’integrazione dei dati disponibili, sia nuovi che da letteratura, ha evidenziato il rapporto tra strutture profonde e sedimentazione, e ha permesso di calcolare i tassi geologici di sollevamento della struttura generatrice del sisma del 20 Maggio. I risultati di questo lavoro hanno implicazioni in vari ambiti, tra i quali la valutazione del rischio sismico e la microzonazione sismica, basata su una caratterizzazione geomorfologico-geologico-geofisica dettagliata dei primi 20 metri al di sotto della superficie topografica. Il sisma emiliano del 2012 ha infatti permesso di riconoscere l’importanza del substrato per lo sviluppo di fenomeni co- e post-sismici secondari, in un territorio fortemente eterogeneo come la Pianura Padana.

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Resiliência é definida como a capacidade das pessoas em enfrentar, vencer e serem fortalecidos ou transformados por experiências adversas. Estudos têm mostrado que pessoas resilientes adoecem menos e possuem melhor desempenho no trabalho, nas relações familiares e na vida, além da resiliência poder ser desenvolvida desde a infância até a velhice. Por sua vez, a meditação tem mostrado ser um recurso útil para a melhoria da saúde em geral, incluindo a qualidade de vida daqueles que a praticam por proporcionar maiores níveis de bem estar, melhoria nos relacionamentos interpessoais e redução de estresse. Parece que a meditação, assim como a resiliência, pode contribuir para melhores níveis de saúde da população. O objetivo deste estudo foi verificar os níveis de resiliência em idosos que meditam. Participaram 60 pessoas, sendo 78% mulheres, com idade média de 69 anos, 82% aposentados, 65% praticantes de meditação, 42% com baixa escolaridade e 60% católicos. O instrumento utilizado foi um questionário auto-aplicável, composto pela Escala de Avaliação de Resiliência (EAR) em sua forma reduzida e um questionário para coletar dados sociodemográficos dos participantes. Análise de variância revelou não haver diferença nos níveis de resiliência entre o grupo que medita uma vez ao dia e aquele que o faz mais do que uma vez ao dia. Médias fatoriais e desvios-padrão revelaram que os participantes possuem capacidade levemente acima da média de adaptarem-se positivamente diante das dificuldades da vida, persistindo para superar crises e adversidades, poucas vezes se resignando, embora algumas vezes não se julguem competentes para enfrentá-las. Para defrontarem as dificuldades da vida, contam com as crenças de que podem confiar no apoio de um ente ou algo superior e acreditam que podem aprender e melhorar com as adversidades.

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The aim of this work is to use systematic review methodology to answer the question “What are the current barriers to kerbside recycling of household waste in the UK?” A systematic search of electronic databases and journals was undertaken to identify academic published work. A critical scoping review of research published between 2000 – 2008 profiles theory and research design. The systematic review identified twelve relevant papers, of which seven contain original data. To define the current barriers the explanations of barriers were systematically aggregated into four main categories: household / individual behaviour; services / local situation; attitudes / motivation; information and knowledge. The purpose of the work is to inform future marketing campaigns which will assist the UK to reach the statutory targets of waste diversion. The synthesis will be useful to environmental professionals working in waste authorities and researchers and students. The framework offers an opportunity to develop better marketing and communications strategies to help more people recycle more things more often and will inform future recycling policy development.