Child-care attendance and common morbidity: evidence of association in the literature and questions of design

Papers on child-care attendance as a risk factor for acute respiratory infections and diarrhea were reviewed. There was great variety among the studies with regard to the design, definition of exposure and definition of outcomes. All the traditional epidemiological study designs have been used. The studies varied in terms of how child-care attendance in general was defined, and for different settings. These definitions differed especially in relation to the minimum time of attendance required. The outcomes were also defined and measured in several different ways. The analyses performed were not always appropriate, leading to sets of results of uneven quality, and composed of different measures of association relating different exposures and outcomes, that made summarizing difficult. Despite that, the results reported were remarkably consistent. Only two of the papers reviewed failed to show some association between child-care attendance and increased acute respiratory infections, or diarrhea. On the other hand, the magnitude of the associations reported varied widely, especially for lower respiratory infections. Taken together, the studies so far published provide evidence that children attending child-care centers, especially those under three years of age, are at a higher risk of upper respiratory infections, lower respiratory infections, and diarrhea. The studies were not consistent, however, in relation to attendance at child-care homes. Children in such settings were sometimes similar to those in child-care centers, sometimes similar to those cared for at home, and sometimes presented an intermediate risk.

Application of wetland systems in the treatment of acid rock mine drainage

The presented work was conducted within the Dissertation / Internship, branch of Environmental Protection Technology, associated to the Master thesis in Chemical Engineering by the Instituto Superior de Engenharia do Porto and it was developed in the Aquatest a.s, headquartered in Prague, in Czech Republic. The ore mining exploitation in the Czech Republic began in the thirteenth century, and has been extended until the twentieth century, being now evident the consequences of the intensive extraction which includes contamination of soil and sub-soil by high concentrations of heavy metals. The mountain region of Zlaté Hory was chosen for the implementation of the remediation project, which consisted in the construction of three cells (tanks), the first to raise the pH, the second for the sedimentation of the formed precipitates and a third to increase the process efficiency in order to reduce high concentrations of metals, with special emphasis on iron, manganese and sulfates. This project was initiated in 2005, being pioneer in this country and is still ongoing due to the complex chemical and biological phenomenon’s inherent to the system. At the site where the project was implemented, there is a natural lagoon, thereby enabling a comparative study of the two systems (natural and artificial) regarding the efficiency of both in the reduction/ removal of the referred pollutants. The study aimed to assist and cooperate in the ongoing investigation at the company Aquatest, in terms of field work conducted in Zlaté Hory and in terms of research methodologies used in it. Thereby, it was carried out a survey and analysis of available data from 2005 to 2008, being complemented by the treatment of new data from 2009 to 2010. Moreover, a theoretical study of the chemical and biological processes that occurs in both systems was performed. Regarding the field work, an active participation in the collection and in situ sample analyzing of water and soil from the natural pond has been attained, with the supervision of Engineer, Irena Šupiková. Laboratory analysis of water and soil were carried out by laboratory technicians. It was found that the natural lagoon is more efficient in reducing iron and manganese, being obtained removal percentages of 100%. The artificial lagoon had a removal percentage of 90% and 33% for iron and manganese respectively. Despite the minor efficiency of the constructed wetland, it must be pointed out that this system was designed for the treatment and consequent reduction of iron. In this context, it can conclude that the main goal has been achieved. In the case of sulphates, the removal optimization is yet a goal to be achieved not only in the Czech Republic but also in other places where this type of contamination persists. In fact, in the natural lagoon and in the constructed wetland, removal efficiencies of 45% and 7% were obtained respectively. It has been speculated that the water at the entrance of both systems has different sources. The analysis of the collected data shows at the entrance of the natural pond, a concentration of 4.6 mg/L of total iron, 14.6 mg/L of manganese and 951 mg/L of sulphates. In the artificial pond, the concentrations are 27.7 mg/L, 8.1 mg/L and 382 mg/L respectively for iron, manganese and sulphates. During 2010 the investigation has been expanded. The study of soil samples has started in order to observe and evaluate the contribution of bacteria in the removal of heavy metals being in its early phase. Summarizing, this technology has revealed to be an interesting solution, since in addition to substantially reduce the mentioned contaminants, mostly iron, it combines the low cost of implementation with an reduced maintenance, and it can also be installed in recreation parks, providing habitats for plants and birds.

Diagnóstico de avarias em motores elétricos

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecânica

Reducing the number of membership functions in linguistic variables

Dissertation presented at Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia in fulfilment of the requirements for the Masters degree in Mathematics and Applications, specialization in Actuarial Sciences, Statistics and Operations Research

Sistema para a monitorização ativa com recurso ao cloud computing

O desenvolvimento de aplicações para dispositivos móveis já não é uma área recente, contudo continua a crescer a um ritmo veloz. É notório o avanço tecnológico dos últimos anos e a crescente popularidade destes dispositivos. Este avanço deve-se não só à grande evolução no que diz respeito às características destes dispositivos, mas também à possibilidade de criar aplicações inovadoras, práticas e passíveis de solucionar os problemas dos utilizadores em geral. Nesse sentido, as necessidades do quotidiano obrigam à implementação de soluções que satisfaçam os utilizadores, e nos dias de hoje, essa satisfação muitas vezes passa pelos dispositivos móveis, que já tem um papel fundamental na vida das pessoas. Atendendo ao aumento do número de raptos de crianças e à insegurança que se verifica nos dias de hoje, as quais dificultam a tarefa de todos os pais/cuidadores que procuraram manter as suas crianças a salvo, é relevante criar uma nova ferramenta capaz de os auxiliar nesta árdua tarefa. A partir desta realidade, e com vista a cumprir os aspetos acima mencionados, surge assim esta dissertação de mestrado. Esta aborda o estudo e implementação efetuados no sentido de desenvolver um sistema de monitorização de crianças. Assim, o objetivo deste projeto passa por desenvolver uma aplicação nativa para Android e um back-end, utilizando um servidor de base de dados NoSQL para o armazenamento da informação, aplicando os conceitos estudados e as tecnologias existentes. A solução tem como principais premissas: ser o mais user-friendly possível, a otimização, a escalabilidade para outras situações (outros tipos de monitorizações) e a aplicação das mais recentes tecnologias. Assim sendo, um dos estudos mais aprofundados nesta dissertação de mestrado está relacionado com as bases de dados NoSQL, dada a sua importância no projeto.

Healing replicas in a software component replication system

Dissertação para obtenção do Grau de Mestre em Engenharia Informática

Tradução e validação para Portugal do Patient Activation Measure 13 : em pessoas com Diabetes Mellitus tipo 2

RESUMO - Introdução: A Diabetes Mellitus Tipo 2 (DM2) tem uma elevada prevalência em todo o mundo, com impacto significativo a nível de Saúde Pública, na vida dos doentes e nos custos que lhe são associados. O Patiente Activation Measure 13 (PAM13) é um questionário que possibilita a avaliação das crenças, conhecimentos, motivação e capacidades de uma pessoa em relação à sua saúde; pelo que a sua utilização na DM2 é pertinente. Objetivos: Traduzir o PAM 13, versão curta, para Português de Portugal; Estabelecer as propriedades psicométricas da versão Portuguesa do PAM 13 (PAM13-P); Validar a PAM 13-P num grupo de pessoas com DM2. Material e métodos: O processo de tradução e adaptação cultural do questionário foi composto pelas fases: 1-Tradução, 2-Reconciliação e síntese, 3-Back translation, 4-Rever e sintetizar a Back translation, 5-Harmonização, 6-Revisão do comité de peritos, 7-Cognitive debriefing e 8-Avaliação final. Para validar o PAM13-P realizou-se um estudo observacional transversal analítico com uma amostra de conveniência, de pessoas com DM2, seguidas na Associação Protectora dos Diabéticos de Portugal. O questionário foi de autopreenchimento e foi consultado o processo clínico para obtenção da HbA1c. O tratamento estatístico foi realizado através do SPSS 21® e Winsteps v3.8.1®. Resultados e discussão: O processo de tradução e adaptação cultural foi realizado de acordo com as guidelines. Foram realizados 3 painéis de e-Delphi, com 21 participantes de áreas distintas, tendo-se obtido bons níveis de concordância. As principais modificações realizadas ao questionário foram a simplificação da linguagem e dos itens, obtendo-se as equivalências necessárias. O PAM13-P foi aplicado a 201 pessoas, sendo que a taxa de resposta foi de 83%. Na amostra analisada 57.3% eram homens. Obtiveram-se as médias de idade 67.1 anos e de duração de diabetes 17.3 anos. A média do score do PAM foi 58.5±10.1(41.8-90.5) pontos e 49,7% da amostra estava no nível 3 de ativação. Relativamente aos itens verificou-se que os itens mais difíceis foram o 13(56.1) e o 8(55.4) e o com menor dificuldade foi 4(38.5). As categorias de resposta tiveram um bom ajuste ao Modelo de Rasch. O ajustamento dos itens foi infit entre 0.779-1.177 e outfit entre 0.794-1.315. A fiabilidade dos indivíduos variou entre 0.77(real) e 0.83(modelo) e dos itens foi de 0.97 (real e modelo). O Alfa de Cronbach foi bom (α=0.82). Estas estatísticas foram semelhantes aos da validação do PAM13. Existiu uma relação entre o score do PAM e os itens de validação em 51%. Das variáveis analisadas, existia um relação do nível de ativação com a idade e com a HbA1c. Conclusões: O PAM13-P foi traduzido e adaptado culturalmente para Português e foi validado em pessoas com DM2, sendo as propriedades psicométricas boas.

The burden of chronic low back pain in the adult Portuguese population : an epidemiological population-based study under the scope of Epireumapt

RESUMO: Nos países desenvolvidos a lombalgia é a condição músculo-­‐esquelética mais prevalente. Quando evolui para um quadro crónico é responsável por um encargo económico bastante considerável, não só em relação aos indivíduos, mas também para a sociedade. A lombalgia crónica é por isso uma das principais causas de perda de produtividade e de perda de independência económica, nomeadamente através do absenteísmo (ausência do trabalho), do presenteísmo (perda de produtividade no trabalho, devido à capacidade diminuída provocada pela lombalgia) e da incapacidade para trabalhar (invalidez permanente, total ou parcial). Até à data, em Portugal, a prevalência e carga social da lombalgia crónica eram desconhecidas. Até agora não existiam estudos populacionais de grande dimensão sobre este tema. O objetivo principal desta tese foi determinar a prevalência de lombalgia crónica, e também avaliar a carga social que esta tem na população adulta Portuguesa. O trabalho de investigação foi desenvolvido no âmbito do Estudo Epidemiológico de Doenças Reumáticas em Portugal (EpiReumaPt). Este foi o primeiro estudo de larga escala e de base populacional, que determinou a prevalência de doenças reumáticas e músculo-­‐ esqueléticas na população adulta portuguesa. Foi realizado numa amostra aleatória e representativa, de 10.661 indivíduos do Continente, da Região Autónoma dos Açores e da Região Autónoma da Madeira, entre Setembro de 2011 e Dezembro de 2013. Esta tese foi dividida em duas secções. A primeira secção incluiu o detalhe das questões relativas ao desenvolvimento e gestão do EpiReumaPt, constituindo-­‐se como um guia prático sobre como realizar um estudo de base populacional de larga escala, em Portugal. A metodologia detalhada do EpiReumaPt foi também descrita nesta secção e incluiu os objectivos, o desenho do estudo, as características de recrutamento e a preparação de dados para análise. Nesta secção foram ainda descritos os principais resultados do EpiReumaPt. Estes evidenciaram que a lombalgia foi a condição músculo-­‐esquelética com maior prevalência na população adulta portuguesa.A segunda secção desta tese estimou a prevalência da lombalgia crónica ativa na população adulta Portuguesa, e avaliou a carga social esta condição. A lombalgia ativa foi definida com base na dor auto-­‐relatada no dia da entrevista e que persistia há pelo menos 90 dias (independentemente da causa). A lombalgia foi definida como dor na área definida entre a margem inferior das décimas segundas costelas até às pregas glúteas inferiores, com ou sem dor nos membros inferiores. A carga social foi medida tendo em conta os seguintes parâmetros: qualidade de vida, função, consumo de recursos de saúde, consumo de analgésicos e outros fármacos usados no alívio da dor, sintomas de ansiedade e sintomas de depressão. Os resultados mostraram que o consumo de recursos em saúde e a carga social da lombalgia crónica na população adulta Português é significativa. Também a incapacidade causada pela lombalgia crónica,nos indivíduos com idade ativa, é responsável por elevadas taxas de absenteísmo e má qualidade de vida, aos quais acresce o consequente ónus socioeconómico. Esta tese também concluiu que o consumo de analgésicos e outros medicamentos para alívio da dor, na população adulta portuguesa com lombalgia crónica ativa, é relativamente baixa. A maioria destes indivíduos não tomava nenhum medicamento analgésico, independentemente da intensidade da dor. Mesmo os indivíduos que reportaram dor intensa, apenas 4.0% estavam no primeiro degrau da escada analgésica da Organização Mundial de Saúde; 2.3% usavam opióides fracos e 0.03% usavam opióides fortes para controlar a dor (segundo e terceiro degrau da escada analgésica da Organização Mundial da Saúde). O trabalho de investigação também confirmou que a prevalência de sintomas de ansiedade e depressão entre os indivíduos adultos portugueses com lombalgia crónica ativa é elevada. Nestes indivíduos, registou-­‐se um consumo mais elevado de analgésicos e outros medicamentos para alívio da dor, quando comparados com os indivíduos com lombalgia crónica activa sem esses sintomas psicológicos. Os grupos terapêuticos mais utilizados foram os ansiolíticos, sedativos e hipnóticos, os antidepressivos e os anti-­‐inflamatórios não esteróides. A intensidade média da dor reportada foi também maior entre os indivíduos com lombalgia ativa e sintomas de ansiedade e/ou depressão. Também nestes, foi reportada pior função e pior estado de saúde. Em relação ao consumo de recursos de saúde foram encontradas diferenças significativas entre as duas populações: os indivíduos com lombalgia ativa e sintomas psicológicos concomitantes registaram maior número de consultas de psiquiatria de outras especialidades médicas, assim como precisaram de mais apoio domiciliário nos 12 meses prévios à entrevista do EpiReumaPt. Foram também identificados os fatores associados a sintomas isolados de ansiedade, a sintomas isolados de depressão e a sintomas de ansiedade e depressão. Resumindo,esta tese permitiu concluir que a lombalgia crónica é um problema de saúde comum na população adulta portuguesa, contribuindo para um elevado grau de incapacidade e que consequentemente afeta o desempenho laboral e o bem-­‐estar dos indivíduos. A lombalgia crónica é também responsável por um consumo considerável de recursos de saúde. Acresce ainda que os sintomas de ansiedade e depressão são comuns, entre os indivíduos com lombalgia crónica, contribuindo com uma carga social adicional.---------------------------------- ABSTRACT:Low Back Pain(LBP) is the most prevalent of musculoskeletal condition in developed countries.When it becomes chronic, LBP causesan enormous economic burden on individuals and society -­‐ it is one of the leading causes of loss of productivity and economic independence through absenteeism (time off work), presenteeism (lost productivity because of diminished capacity while at work) and work disability (permanent, partial or complete disablement for work purposes). In Portugal the prevalence and burden of LBP and chronic LBP (CLBP) were poorly defined. Until now no large population-­‐based studies have focused on this. The main aim of this thesis was to determine the prevalence of LBP and CLBP, and also to assess the burden of CLBP in the adult rtuguese population. The research work was developed under the scope of EpiReumaPt (the Portuguese Epidemiologic Study of Rheumatic Diseases). EpiReumaPt was the first national large population-­‐based and prevalence study of rheumatic and musculoskeletal diseases (RMD). It was performed among a randomized and representative sample of 10,661 adult Portuguese subjects recruited in Mainland, Azores and Madeira Islands, from September 2011 to December 2013. The first section of this thesis included detailed issues regarding the development and management of EpiReumaPt, and provided a practical guide on how to set-­‐up a large population-­‐based study in Portugal. The detailed methodology of EpiReumaPt, including its objectives,study design,recruitment features,and data preparation for analyses were also described. The main results from EpiReumaPt study were provided in this section and showed that LBP was the musculoskeletal condition with highest prevalence among Portuguese population. The second section of this thesis estimated the prevalence of active CLBP among adult Portuguese population, and assessed the social burden of this condition. Active CLBP was defined based on self-­‐reported pain on the day of the interview, and for most of the time for at least 90 days (independently from cause). LBP was defined as pain in the back area from the lower margin of the twelfth ribs to he lower gluteal folds, with or without pain referred to the lower limbs. Social burden was measured taking into account the following outcomes: quality of life, function, healthcare resources consumption, analgesic and other pain relief drugs intake, anxiety and depression symptoms. Results showed that the healthcare consumption and social burden of CLBP among adult Portuguese population were enormous, and the disability caused by CLBP among subjects in a working age provides high rates of absenteeism (work loss) and poor quality of life, with a consequent socioeconomic burden. This thesis also concluded that analgesic and other pain relief drugs untake among adult Portuguese population with active CLBP was very low. Most of the subjects with active CLBP did not take any analgesic drug regardless pain severity. Even when subjects self-­‐reported severe pain, only 24.0% were in the 1st step of the analgesic ladder,2.3% used weak analgesic opioids and 0.03% used strong opioids (2nd and 3rd step of WHO analgesic ladder, respectively) to control pain . The research work also confirmed that the prevalence of anxiety and depression symptoms among adult Portuguese subjects with active CLBP was high. Regarding pharmacological therapy, the intake of analgesic and other pain relief drugs was higher among subjects with anxiety and/or depression symptoms, when compared with subjects without these psychological symptoms. Anxiolytics, sedatives and hypnotics, antidepressants and NSAIDs intake had higher usage rates among these subjects. The pain severity mean was also higher among this subjects and function and health status was worse. Regarding healthcare resources consumption,significant differences between the two populations were found. Subjects with ctive CLBP and concomitant psychological symptoms had a higher number of psychiatrist and other physician visits. They also needed more home care in the previous 12 months. Factors associated with isolated symptoms of anxiety, depression,and concomitant anxiety and depression symptoms were also identified. Summarizing, we concluded that CLBP is a common health problem among adult Portuguese population contributing to disability and affecting labor performance, and the well being of subjects. it is also responsible for considerable healthcare resource consumption. Anxiety and depression symptoms are common among subjects with CLBP and provided an additional burden among them.

Diversity of the land resources in the Amazonian State of Rondônia, Brazil

Conflicting opinions are recorded in the literature concerning the suitability of Amazon lands for sustainable agriculture following deforestation. This article has been written to shed light on this question by summarizing climate, landform, soil and vegetation features from the findings of a land resource study of the Brazilian state of Rondônia in south-west Amazonia. The work, which followed the World Soils and Terrain Digital Database (SOTER) methodology, was financed by the World Bank. During the course of the survey special emphasis was given to studying soils; 2914 profiles were analyzed and recorded. The study identified a complex pattern of land units with clear differences in climate, landform, soils and native vegetation. Forested areas mosaic with lesser areas of natural savannas. The latter occur on both poorly-drained and well-drained, albeit nutrient deficient sandy soils. The tallest and most vigorous forests or their remnants were seen growing on well-drained soils formed from nutrient-rich parent materials. Many of these soils could, or are being used for productive agriculture. Soils developed on nutrient-poor parent materials support forests that are significantly lower in height, and would require large lime and fertilizer inputs for agriculture. Low forests with high palm populations and minor areas of wet land savannas cover the poorly drained soils. It is evident that forest clearing in the past was indiscriminant; this cannot be condoned. The diversity of land conditions found throughout Rondônia would suggest that many past studies in the Amazon have simply been too broad to identify significant soil differences.

A survey of distributed data aggregation algorithms

Distributed data aggregation is an important task, allowing the de- centralized determination of meaningful global properties, that can then be used to direct the execution of other applications. The resulting val- ues result from the distributed computation of functions like count, sum and average. Some application examples can found to determine the network size, total storage capacity, average load, majorities and many others. In the last decade, many di erent approaches have been pro- posed, with di erent trade-o s in terms of accuracy, reliability, message and time complexity. Due to the considerable amount and variety of ag- gregation algorithms, it can be di cult and time consuming to determine which techniques will be more appropriate to use in speci c settings, jus- tifying the existence of a survey to aid in this task. This work reviews the state of the art on distributed data aggregation algorithms, providing three main contributions. First, it formally de nes the concept of aggrega- tion, characterizing the di erent types of aggregation functions. Second, it succinctly describes the main aggregation techniques, organizing them in a taxonomy. Finally, it provides some guidelines toward the selection and use of the most relevant techniques, summarizing their principal characteristics.

Levitação literal na arquitetura: Desenvolvimento de um sistema de caixilharia Panoramah! com sistema de elevação eletromagnético

Tese de Mestrado Ciclo de Estudos Integrados Conducentes ao Grau de Mestre em Arquitectura Área de Especialização: Construção e Tecnologia

Effect of pH on Candida tropicalis virulence factors

Dissertação de mestrado em Bioengenharia

The diet of the black widow spider Latrodectus mirabilis (Theridiidae) in two cereal crops of central Argentina

The spider Latrodectus mirabilis (Holmberg, 1876) is commonly found in cereals crops of central Argentina. We studied its diet composition at the field and capture rate on leaf-cutting ants based on laboratory experiments. This study comprises the first approach that documents the diet of L. mirabilis in wheat and oat fields of central Argentina. We identified 1,004 prey items collected from its webs during the last phenological stages of both cereal crops. The prey composition was variable but the spiders prey mainly on ants (Formicidae, Hymenoptera), who represented more than 86% of the total. Meanwhile, in the capture rate experiences we registered a high proportion of ants captured by spiders at the beginning of experiences, capturing the half of the ants from total in the first four hours. Summarizing, we reported a polyphagous diet of this spider species in wheat and oat fields. Ants were the most important prey item of this spider, as found in other Latrodectus spiders around the world.

Family relationships and learning experiences in anxious vs. non-anxious families: Are there differences ?

L'objectif principal de ce travail était d'explorer les relations parent-enfant et les processus d'apprentissage familiaux associés aux troubles anxieux. A cet effet, des familles ayant un membre anxieux (la mère ou l'enfant) ont été comparées avec des familles n'ayant aucun membre anxieux. Dans une première étude, l'observation de l'interaction mère-enfant, pendant une situation standardisée de jeu, a révélé que les mères présentant un trouble panique étaient plus susceptibles de se montrer verbalement contrôlantes, critiques et moins sensibles aux besoins de l'enfant, que les mères qui ne présentaient pas de trouble panique. Une deuxième étude a examiné les perceptions des différents membres de la famille quant aux relations au sein de la famille et a indiqué que, par comparaison aux adolescents non-anxieux, les adolescents anxieux étaient plus enclins à éprouver un sentiment d'autonomie individuelle diminué par rapport à leurs parents. Finalement, une troisième étude s'est intéressée à déterminer l'impact d'expériences d'apprentissage moins directes dans l'étiologie de l'anxiété. Les résultats ont indiqué que les mères présentant un trouble panique étaient plus enclines à s'engager dans des comportements qui maintiennent la panique et à impliquer leurs enfants dans ces comportements, que les mères ne présentant pas de trouble panique. En se basant sur des recherches antérieures qui ont établi une relation entre le contrôle parental, la perception de contrôle chez l'enfant et les troubles anxieux, le présent travail non seulement confirme ce lien mais propose également un modèle pour résumer l'état actuel des connaissances concernant les processus familiaux et le développement des troubles anxieux. Deux routes ont été suggérées par lesquelles l'anxiété pourrait être transmise de manière intergénérationnelle. Chacune de ces routes attribue un rôle important à la perception de contrôle chez l'enfant. L'idée est que lorsque les enfants présentent une prédisposition à interpréter le comportement de leurs parents comme hors de leur contrôle, ils seraient plus enclins à développer de l'anxiété. A ce titre, la perception du contrôle représenterait un tampon entre le comportement de contrôle/surprotection des parents et le trouble anxieux chez l'enfant. - The principal objective of the present work was to explore parent-child relationships and family learning processes associated with anxiety disorders. To this purpose, families with and without an anxious family member (mother or child) were compared. In a first study, observation of mother-child interaction, during a standard play situation, revealed that mothers with panic disorder were more likely to display verbal control and criticism, and less likely to display sensitivity toward their children than mothers without panic disorder. A second study examined family members' perceptions of family relationships and indicated that compared to non-anxious adolescents, anxious adolescents were more prone to experience a diminished sense of individual autonomy in relation to their parents. Finally a third study was interested in determining the effect of less direct learning experiences in the aetiology of anxiety. Results indicated that mothers with panic disorder were more likely to engage in panic-maintaining behaviour and to involve their children in this behaviour than mothers without panic disorder. Based on previous research showing a relationship between parental control, children's perception of control, and anxiety disorders, the present work not only further adds evidence to support this link but also proposes a model summarizing the current knowledge concerning family processes and the development of anxiety disorders. Two pathways have been suggested through which anxiety may be intergenerationally transmitted. Both pathways assign an important role to children's perception of control. The idea is that whenever children have a predisposition towards interpreting their parents' behaviour as beyond of their control, they may be more prone to develop anxiety. As such, perceived control may represent a buffer between parental overcontrolling/overprotective behaviours and childhood anxiety disorder.

Adjuvant early breast cancer systemic therapies according to daily used technologies.

Prognosis of early breast cancer patients is significantly improved with the use of adjuvant therapies. Various guidelines have been proposed to select patients who will derive the most benefit from such treatments. However, classifications have limited usefulness in subsets of patients such as those with node negative breast cancer. The 2007 St. Paul de Vence Clinical Practice Recommendations proposed to consider adjuvant therapy in accordance with the 10-year relapse-free survival reduction estimated by Adjuvant! Online. However, many limitations remain regarding the use of Adjuvant! Online. Among them, adverse prognostic and/or predictive factors such as vascular invasion, mitotic activity, progesterone receptor negativity, and HER-2 expression are not incorporated in the routine clinical decision process. Our group has therefore issued guidelines based on the consideration of both Adjuvant! Online calculations and the prognostic and/or predictive effects of these markers. In addition, web-accessible comprehensive tables summarizing these recommendations are provided.