Quality of life (QoL) in relation to disease severity in Brazilian Parkinson's patients as measured using the WHOQOL-BREF

This study aimed at evaluating and describing the QoL and its association with the severity of disease among Brazilian Parkinson's disease (PD) patients. In this cross-sectional study 68 PD patients were interviewed using the World Health Organization Quality of Life instrument Short Form (WHOQOL-BREF) and the Hoehn-Yahr (HY) scale. Analysis of variance, chi(2), Kruskal-Wallis and Mann-Whitney U-tests, Spearman and Cronbach reliability coefficients were used to analyze the data. The results indicate: (1) physical capacity was the domain that showed the most deterioration; (2) severity of PD is associated with QoL measured by WHOQOL-BREF; (3) overall QoL, working capacity, activities of daily living (ADL) and self-esteem are affected in both transitional periods in the progression of PD (mild to moderate and moderate to advanced). Satisfaction with general health, pain, energy, positive feelings, personal relationship and satisfaction with home are affected in the first period of transition while mobility, body image, sexual activity and access to information are affected in the second. This study mainly shows specific facets that are affected depending on the specific periods of PD progression, which can help to understand the impact of the disease, the effectiveness of care, and the demand for health care resources. (C) 2007 Elsevier B.V. All rights reserved.

¿Estudias o trabajas? El largo camino hacia la independencia económica de los jóvenes de América Latina

Este estudio es un aporte al diagnóstico de la transición de la escuela al trabajo entre jóvenes de 15 a 29 años, con una descripción actualizada y detallada de indicadores laborales por género para 18 países de la región.

Trabalho, alienação e adoecimento na produção de alumínio em Barcarena

Apresenta casos de adoecimento e demissão de trabalhadores da indústria de transformação mineral da empresa Alumínio do Brasil (ALBRAS) da Companhia Vale do Rio Doce (CVRD). Trata-se de um trabalho dissertativo que tem a finalidade de explicitar e compreender a relação de trabalho e a percepção dos problemas enfrentados no ambiente da empresa do ponto de vista dos trabalhadores, no contexto de situações de adoecimento e demissão. Das visitas realizadas em campo, em Barcarena e Abaetetuba, onde se encontram as instalações do empreendimento e grande parte dos ex-funcionários, pôde-se constatar que diversos trabalhadores reclamavam sobre a situação física e psicológica vinculada à demissão motivada por doença, que na visão dos trabalhadores foi adquirida nas tarefas executadas pelos mesmos na indústria, e que resulta, inclusive, na significativa perda da capacidade de trabalho dos mesmos. O objetivo principal é analisar algumas das razões que levaram esse grupo de trabalhadores a submeter-se a tais condições de trabalho, que na visão dos próprios trabalhadores, levaram ao adoecimento em conseqüência de esforços que realizavam nas tarefas de produção. O problema identificado é analisado através da interdisciplinariedade, com amplo enfoque sociológico, filosófico, econômico e jurídico, com fundamentação teórica marxista a partir da compreensão da mais-valia e da alienação no contexto do sistema capitalista. O trabalho aponta, ainda, distorções entre o caso investigado e as normas constitucionais: como é o entendimento constitucional para tratar aspectos econômicos e sociais e como é a realidade em que se inserem grandes empreendimentos na região Amazônica, como a ALBRAS, e seu envolvimento com a sociedade e o Estado.

Avaliação dos níveis de ruído e das soluções arquitetônicas adotadas em ambientes das unidades de urgência e emergência no município de Belém-PA

Nos grandes centros urbanos pode-se constatar que o nível de ruído é tão elevado que ameaça a integridade psicológica e física dos habitantes. Entretanto, observa-se que muito do ruído no ambiente hospitalar origina-se de dentro do hospital, tendo como uma das principais fontes geradoras de ruído nas unidades os equipamentos e a conversação entre a equipe hospitalar. A perda auditiva induzida pelo ruído (PAIR) é uma das consequências que o ruído elevado pode acarretar à saúde, entre outros danos. Assim, o ambiente hospitalar que deveria ser sereno e silencioso transforma-se em um espaço ruidoso e estressante, aumentando a ansiedade e a percepção dolorosa do paciente, reduzindo o sono e estendendo a convalescença. Objetivo: Avaliar as condições acústicas dos principais ambientes nas unidades de urgência e emergência no município de Belém, Estado do Pará, Brasil. Verificar a adequação às normas sanitárias e técnicas vigentes, com a simulação de um ambiente piloto validado com a utilização do software ODEON e apresentar soluções virtuais de condicionamento acústico. Material e Métodos: foi utilizado o equipamento Medidor de Nível Sonoro com certificado de calibração da Rede Brasileira de Calibração (RBC) para aferição dos NPS nos períodos diurno e noturno, de acordo com o estabelecido pela NBR 10.151 (2000), além da observação e identificação das fontes de ruído dos ambientes. Resultados: Os valores obtidos durante as aferições dos NPS nos ambientes do Hospital A foram de 58 dB(A) a 70 dB(A) e do Hospital B foram de 62 dB(A) a 70 dB(A). O ambiente piloto foi selecionado de acordo com os resultados e com o tempo de permanência da equipe de saúde e dos pacientes. Conclusão: foi desenvolvido o modelo computacional validado do ambiente piloto, gerando um modelo proposto com intervenções arquitetônicas visando o conforto acústico da equipe de saúde e dos pacientes. Os ambientes pesquisados não apresentaram níveis de ruído superiores a 85 dB(A), comprovando que não há risco ocupacional para as equipes de saúde. Entretanto, níveis de ruídos elevados, por mais que não causem PAIR nos trabalhadores, são responsáveis por estimular ou até mesmo por desencadear diversos sintomas que prejudicam a capacidade laborativa da equipe de saúde, além de aumentar a convalescença e prejudicar a recuperação dos pacientes.

Improvement of cardiac function with device-based diaphragmatic stimulation in chronic heart failure patients: the randomized, open-label, crossover Epiphrenic II Pilot Trial.

AIMS Device-based pacing-induced diaphragmatic stimulation (PIDS) may have therapeutic potential for chronic heart failure (HF) patients. We studied the effects of PIDS on cardiac function and functional outcomes. METHODS AND RESULTS In 24 chronic HF patients with CRT, an additional electrode was attached to the left diaphragm. Randomized into two groups, patients received the following PIDS modes for 3 weeks in a different sequence: (i) PIDS off (control group); (ii) PIDS 0 ms mode (PIDS simultaneously with ventricular CRT pulse); or (iii) PIDS optimized mode (PIDS with optimized delay to ventricular CRT pulse). For PIDS optimization, acoustic cardiography was used. Effects of each PIDS mode on dyspnoea, power during exercise testing, and LVEF were assessed. Dyspnoea improved with the PIDS 0 ms mode (P = 0.057) and the PIDS optimized mode (P = 0.034) as compared with the control group. Maximal power increased from median 100.5 W in the control group to 104.0 W in the PIDS 0 ms mode (P = 0.092) and 109.5 W in the PIDS optimized mode (P = 0.022). Median LVEF was 33.5% in the control group, 33.0% in the PIDS 0 ms mode, and 37.0% in the PIDS optimized mode (P = 0.763 and P = 0.009 as compared with the control group, respectively). PIDS was asymptomatic in all patients. CONCLUSION PIDS improves dyspnoea, working capacity, and LVEF in chronic HF patients over a 3 week period in addition to CRT. This pilot study demonstrates proof of principle of an innovative technology which should be confirmed in a larger sample. TRIAL REGISTRATION NCT00769678.

Dynamic intraligamentary stabilization and primary repair: A new concept for the treatment of knee dislocation.

BACKGROUND Traumatic knee dislocation represents a rare but devastating injury. Several controversies persist regarding type of treatment, surgical timing, graft selection, repair versus reconstruction of the medial and lateral structures, surgical techniques and postoperative rehabilitation. A new technique for primary ACL stabilization, dynamic intaligamentary stabilization (DIS) was developed at the authors' institution. The purpose of this study was to analyze the clinical and radiological outcomes of surgically treated traumatic knee dislocations by means of the DIS technique for the ACL, primary suturing for PCL, MCL and LCL. METHODS Between 2009 and 2012, 35 patients treated surgically for traumatic knee dislocation with primary anterior cruciate ligament (ACL) reconstruction with DIS, suturing of the posterior cruciate ligament (PCL) and primary complete repair of collaterals, were evaluated clinically (IKDC score, SF12 health survey, Lysholm score, Tegner score) and radiologically with a mean follow up of 2.2 years (range 1.00-3.50 years) years. Instrumented anterior-posterior translation was measured (KT-2000). RESULTS Anterior/posterior translation (KT-2000) for the healthy and injured limb was 4.8mm (range 3-8mm) and 7.3mm (range 5-10) (89N) respectively. Valgus and varus stress testing in 30° flexion was normal in 26 (75%) and 29 (83%) patients, respectively. The IKDC score was B in 29 (83%) and C in 6 (17%) patients, while the mean Tegner score was 6 (range 4-8). The mean Lysholm score was 90.83 (range 81-95) and mean SF-12 physical and mental scores were 54.1 (range 45-60) and 51.0 (range 39-62) respectively. In 2 patients, a secondary operation was performed. CONCLUSIONS Early, one stage reconstruction with DIS can achieve good functional results and patient satisfaction with overall restoration of sports and working capacity without graft requirements.

Effect of the porous structure in carbon materials for CO2 capture at atmospheric and high-pressure

Activated carbons prepared from petroleum pitch and using KOH as activating agent exhibit an excellent behavior in CO2 capture both at atmospheric (∼168 mg CO2/g at 298 K) and high pressure (∼1500 mg CO2/g at 298 K and 4.5 MPa). However, an exhaustive evaluation of the adsorption process shows that the optimum carbon structure, in terms of adsorption capacity, depends on the final application. Whereas narrow micropores (pores below 0.6 nm) govern the sorption behavior at 0.1 MPa, large micropores/small mesopores (pores below 2.0–3.0 nm) govern the sorption behavior at high pressure (4.5 MPa). Consequently, an optimum sorbent exhibiting a high working capacity for high pressure applications, e.g., pressure-swing adsorption units, will require a poorly-developed narrow microporous structure together with a highly-developed wide microporous and small mesoporous network. The appropriate design of the preparation conditions gives rise to carbon materials with an extremely high delivery capacity ∼1388 mg CO2/g between 4.5 MPa and 0.1 MPa. Consequently, this study provides guidelines for the design of carbon materials with an improved ability to remove carbon dioxide from the environment at atmospheric and high pressure.

Understanding sickness presenteeism through the experience of immigrant workers in a context of economic crisis

Background: Previous economic recessions show that immigrant workers may experience longer periods of unemployment, a situation that may lead employees to presenteeism, the act of working in spite of a health problem. This study explored perceptions about the factors that lead to presenteeism in immigrant workers considering the context of economic crisis. Methods: Six focus group discussions were held (February 2012), with men and women from Colombia, Ecuador, and Morocco (n = 44) living in Spain and selected by theoretical sample. A qualitative content analysis was performed. Results: Four categories were identified as factors that influence the occurrence of presenteeism in a context of economic crisis: poor employment conditions, fear of unemployment, employer/employee relationship, and difficulties in finding temporary replacement workers. Furthermore, musculoskeletal, respiratory, and mental problems were related to presenteeism. Conclusions: It is important to develop strategies to protect workers from negative working conditions that are associated with deterioration of health.

Sanctioning pregnancy:a psychological perspective on the paradoxes and culture of research

Pregnancy provides a very public, visual confirmation of femininity. It is a time of rapid physical and psychological adjustment for women and is surrounded by stereotyping, taboos and social expectations. This book seeks to examine these popular attitudes towards pregnancy and to consider how they influence women’s experiences of being pregnant. Sanctioning Pregnancy offers a unique critique of sociocultural constructions of pregnancy and the ways in which it is represented in contemporary culture, and examines the common myths which exist about diet, exercise and work in pregnancy, alongside notions of risk and media portrayals of pregnant women. Topics covered include: •Do pregnant women change their diet and why? •Is memory really impaired in pregnancy? •How risky behaviour is defined from exercise to employment •The biomedical domination of pregnancy research. Different theoretical standpoints are critically examined, including a medico-scientific model, feminist perspectives and bio-psychosocial and psychodynamic approaches. Table of Contents: Introduction. Cognition and Cognitive Dysfunction. Working and Employment. Dietary Change and Eating. Exercise and Activity. Pregnancy and Risk. Pregnancy Under Surveillance. Concluding Remarks. References/Bibliography. Index.

Centro de dia e lar: saúde mental de idosos e capacidade para o trabalho dos seus cuidadores formais

O Envelhecimento da população é uma realidade cada vez mais presente na nossa sociedade. A investigação junto da população idosa e dos seus cuidadores requer que sejam criadas condições para que, estes grupos, possam usufruir de uma boa qualidade de vida. Propõe-se analisar a capacidade de trabalho dos cuidadores formais de idosos em contexto institucional mas com modalidades de trabalho distintas, no Centro de Dia, onde praticam um horário diurno e fixo, em paralelo com o horário por turnos rotativos diurnos/noturnos praticados no Lar. Foi proposto também analisar o estado mental dos idosos dessas mesmas instituições. A amostra deste estudo contou com 90 participantes dos quais 50 idoso e 40 cuidadores formais. Utilizou-se para a recolha de dados com os idosos o MMSE – Mini-Mental State Examination e a GDS-30 – Escala de Depressão Geriátrica, com os cuidadores a Escala de Graffar e o ICT – Índice de Capacidade para o Trabalho. Os resultados demonstraram não existirem diferenças significativas ao nível da demência e da depressão entre os idosos do Lar e do Centro de Dia. Outros resultados refletiram, para os cuidadores formais, uma capacidade para o trabalho excelente, ligeiramente superior aos dados de referência. Não foi conseguida uma relação entre a saúde mental dos idosos e a capacidade de trabalho dos seus cuidadores formais o que pode retratar o sucesso das medidas de apoio e educação desenvolvidas nesta área.

Wastewater treatment by novel hybrid biological – ion exchange processes

This study presents two novel methods for treating important environmental contaminants from two different wastewater streams. One process utilizes the kinetic advantages and reliability of ion exchanging clinoptilolite in combination with biological treatment to remove ammonium from municipal sewage. A second process, HAMBgR (Hybrid Adsorption Membrane Biological Reactor), combines both ion exchange resin and bacteria into a single reactor to treat perchlorate contaminated waters. Combining physicochemical adsorptive treatment with biological treatment can provide synergistic benefits to the overall removal processes. Ion exchange removal solves some of the common operational reliability limitations of biological treatment, like slow response to environmental changes and leaching. Biological activity can in turn help reduce the economic and environmental challenges of ion exchange processes, like regenerant cost and brine disposal. The second section of this study presents continuous flow column experiments, used to demonstrate the ability of clinoptilolite to remove wastewater ammonium, as well as the effectiveness of salt regeneration using highly concentrated sea salt solutions. The working capacity of clinoptilolite more than doubled over the first few loading cycles, while regeneration recovered more than 98% of ammonium. Using the regenerant brine for subsequent halotolerant algae growth allowed for its repeated use, which could lead to cost savings and production of valuable algal biomass. The algae were able to uptake all ammonium in solution, and the brine was able to be used again with no loss in regeneration efficiency. This process has significant advantages over conventional biological nitrification; shorter retention times, wider range of operational conditions, and higher quality effluent free of nitrate. Also, since the clinoptilolite is continually regenerated and the regenerant is rejuvenated by algae, overall input costs are expected to be low. The third section of this study introduces the HAMBgR process for the elimination of perchlorate and presents batch isotherm experiments and pilot reactor tests. Results showed that a variety of ion-exchange resins can be effectively and repeatedly regenerated biologically, and maintain an acceptable working capacity. The presence of an adsorbent in the HAMBgR process improved bioreactor performance during operational fluctuations by providing a physicochemical backup to the biological process. Pilot reactor tests showed that the HAMBgR process reduced effluent perchlorate spikes by up to 97% in comparison to a conventional membrane bio-reactor (MBR) that was subject to sudden changes in influent conditions. Also, the HAMBgR process stimulated biological activity and lead to higher biomass concentrations during increased contaminant loading conditions. Conventional MBR systems can be converted into HAMBgR’s at a low cost, easily justifiable by the realized benefits. The concepts employed in the HAMBgR process can be adapted to treat other target contaminants, not just perchlorate.

Test de step y capacidad de trabajo en jugadoras de voleibol: la paradoja de un mejor rendimiento en las jugadoras mayores

El objetivo del presente estudio fue comparar dos pruebas submáximas de capacidad aeróbica, el YMCA step test y la prueba de capacidad de trabajo físico a 170 ppm (P170) de frecuencia cardíaca (FC), en jugadoras de voleibol femenino. Se analizaron en 152 participantes variables antropométricas, el rendimiento, la frecuencia cardiaca final (Stepend) y la frecuencia cardiaca en el primer minuto de recuperación (Steprec) en la prueba YMCA step test, la P170 fue analizada expresando los resultados en valores absolutos (P170,abs, W) y relativos (P170,rel, W.kg-1). Además, un subgrupo (n=14) fue analizado otra vez después de un año. Los resultados mostraron como el YMCA step test correlacionó altamente (Steprec) y muy altamente (Stepend) con la P170 rel (r = –0.58 and r = –0.76, p < 0.001, respectively), y con la P170,abs (r = –0.54 and r = –0.68, p < 0.001, respectively). No se encontraron correlaciones entre los porcentajes de cambio en los test de capacidad aeróbica después de un año (p>0.05). La edad presentó una correlación baja a moderada con todos los índices de capacidad aeróbica (0.23 ≤ ŇrŇ ≤ 0.45, p<0.05), viendo como las mayores edades tenían una mejor capacidad aeróbica. Basándonos en estos resultados podemos concluir que la prueba YMCA step test (especialmente el parámetro Stepend) y la P170 podrian ser utilizadas indistintamente por entrenadores y preparadores físicos para monitorizar la capacidad aeróbica de jugadoras de voleibol. El paradójico incremento de la capacidad aeróbica con la edad puede ser atribuido a los métodos de evaluación utilizados que están basados en la FC y al descenso de la FC máxima con la edad. Por lo tanto, estos test deberían ser utilizados solo con edades inferiores.

Working at night and work ability among nursing personnel: when precarious employment makes the diVerence

Purpose To test the association between night work and work ability, and verify whether the type of contractual employment has any inXuence over this association. Methods Permanent workers (N = 642) and workers with precarious jobs (temporary contract or outsourced; N = 552) were interviewed and Wlled out questionnaires concerning work hours and work ability index. They were classiWed into: never worked at night, ex-night workers, currently working up to Wve nights, and currently working at least six nights/2-week span. Results After adjusting for socio-demography and work variables, current night work was signiWcantly associated with inadequate WAI (vs. day work with no experience in night work) only for precarious workers (OR 2.00, CI 1.01- 3.95 and OR 1.85, CI 1.09-3.13 for those working up to Wve nights and those working at least six nights in 2 weeks, respectively). Conclusions Unequal opportunities at work and little experience in night work among precarious workers may explain their higher susceptibility to night work

Working hours, work-life conflict and health in precarious and "permanent" employment

OBJECTIVE: The expansion of precarious employment in OECD countries has been widely associated with negative health and safety effects. Although many shiftworkers are precariously employed, shiftwork research has concentrated on full-time workers in continuing employment. This paper examines the impact of precarious employment on working hours, work-life conflict and health by comparing casual employees to full-time, "permanent" employees working in the same occupations and workplaces. METHODS: Thirty-nine convergent interviews were conducted in two five-star hotels. The participants included 26 full-time and 13 casual (temporary) employees. They ranged in age from 19 to 61 years and included 17 females and 22 males. Working hours ranged from zero to 73 hours per week. RESULTS: Marked differences emerged between the reports of casual and full-time employees about working hours, work-life conflict and health. Casuals were more likely to work highly irregular hours over which they had little control. Their daily and weekly working hours ranged from very long to very short according to organisational requirements. Long working hours, combined with low predictability and control, produced greater disruption to family and social lives and poorer work-life balance for casuals. Uncoordinated hours across multiple jobs exacerbated these problems in some cases. Health-related issues reported to arise from work-life conflict included sleep disturbance, fatigue and disrupted exercise and dietary regimes. CONCLUSIONS:This study identified significant disadvantages of casual employment. In the same hotels, and doing largely the same jobs, casual employees had less desirable and predictable work schedules, greater work-life conflict and more associated health complaints than "permanent" workers.

Information leaflet concerning Working Visas / Work Authorisations for employment in Ireland

The growth of the Irish economy in recent years is resulting in shortages of skilled employees in some sectors such as information and computing technologies, construction professionals and across a broad range of medical, health and social care professions (including Medical Practitioners, nurses, speech and language therapists, occupational therapists, radiographers, physiotherapists, social workers) Download document here