Factores de riesgo para morbilidad materna extrema en gestantes

Introducción: La morbilidad materna extrema es un término usado para definir cualquier condición obstétrica severa que amenaza la vida y requiere una intervención médica urgente con el fin de prevenir la probable muerte materna. Con el presente estudio se pretendió evaluar los factores de riesgo para morbilidad materna extrema en las gestantes del Hospital Universitario Mayor. Metodología Se realizó un estudio de casos y controles, comparando pacientes con MME y sin MME en una relación de 1:1. Se realizó un muestreo aleatorio simple teniendo en cuenta 95% de la población apareadas por diagnóstico de ingreso. Resultados Se incluyeron un total de 110 pacientes (55 en cada grupo). Ambas poblaciones fueron comprables. Ser de estrato socioeconómico bajo (p 0,000), haber tenido 2 o menos partos (p 0,000), ser tipo de sangre negativo (p0.000) realizar entre 0-3 controles prenatales (p 0,000), tener antecedente de preeclampsia (p 0,000), hipotiroidismo (p 0,000), o trastorno bipolar (p 0,000), son factores de riesgo significativos para presentar MME. Entre los factores protectores están tener más de tres partos OR 0,60 (IC95%: 0,17-0,82, p=0,00) y 7 o más controles prenatales OR 0,23 (IC95%: 0,09-0,55, p=0,000). Resultados concordantes con la literatura Discusión: Es importante dar a conocer los resultados del presente estudio para promover las campañas de prevención primaria, secundaria y terciaria con el fin de evitar las altas complicaciones que se pueden presentar en las mujeres en edad fértil de nuestra población.

As atitudes dos professores face à inclusão de alunos com deficiência no Ensino Regular

As sociedades actuais caracterizam-se pela mudança, complexidade e diversidade cultural. De dia para dia assistimos cada vez mais à passagem das responsabilidades educativas da comunidade para a escola, assumindo esta, um papel preponderante na formação dos nossos jovens. O professor, é assim, considerado um elemento chave na construção de uma escola inclusiva e para que haja uma efectiva mudança da escola e das estratégias da sala de aula (Costa, 1999). O objectivo deste estudo é investigar as atitudes dos professores, determinando como estes percepcionam as suas Competências e de que forma essas atitudes são influenciadas, ou não, tendo em conta a experiência profissional, o grupo disciplinar a que pertencem, a experiência no ensino de alunos com deficiência e a formação inicial cujas áreas de estudo, estiveram directamente relacionados com a deficiência. A amostra deste estudo foi constituída por um total de 741 professores do ensino regular (534 afectos ao género feminino e 207 afectos ao género masculino). Foi aplicado o questionário APIAD – Atitudes dos Professores face à Inclusão de Alunos com Deficiência (Leitão, 2011), inferido através da resposta a 14 afirmações, em que cada uma delas deverá ser relacionado com 4 condições de deficiência (deficiência visual, deficiência auditiva, deficiência mental e deficiência motora). Concluiu-se então que, relativamente ao Grupo Disciplinar, as diferenças significativas se encontram entre os professores de Educação Física e os professores de Humanidades e de Ciências, sendo que os primeiros têm uma atitude mais positiva relativamente às suas competências. Quanto ao Contacto com a Deficiência, os resultados indicaram que os professores que têm experiência no ensino de alunos com deficiência têm uma atitude mais positiva relativamente às suas competências. No que se refere à Experiência Profissional, os nossos resultados encontram diferenças significativas entre os professores com menos anos de experiência e os professores com mais anos de experiência, sendo que os primeiros têm uma atitude mais positiva relativamente às suas competências Por último, em relação à Formação Inicial, os professores cujas áreas de estudo, na sua formação inicial, estiveram directamente relacionados com deficiência têm uma atitude mais positiva relativamente às suas competências. ABSTRACT: Today, societies are characterized by change, complexity and cultural diversity. Each day, we saw more and more responsibilities passing from the educational community to school, assuming that a major role in the formation of our youth. Teacher is considered a key element in the building of an inclusive school and for that there is a real change of school and classroom strategies (Costa, 1999). The purpose of this study is to investigate teacher´s attitudes, determining how they perceive their skills and how these attitudes are or aren´t influenced taking into account the professional experience, the subject group they belong to, the experience in students with those particular needs teaching and last, the initial training with chairs that had contact with people with needs. The study sample consisted in a total of 741 teachers of the regular education (534 allocated to the female and 207 assigned to the male gender). We used the questionnaire APIAD - Attitudes of teachers towards the Inclusion of Students with Disabilities (Leitão, 2011), inferred by the response to 14 statements, each one of them should be related to four conditions of disability (visual impairment, hearing impairment, mental retardation and physical disabilities). It was concluded then that for the Disciplinary Group, significant differences are found between the physical education teachers and teachers of Humanities and Sciences, and the former have a more positive attitude to their skills. How to contact the Disability, the results indicated that teachers who have experience teaching students with disabilities have a more positive attitude to their skills. With regard to professional experience, significant differences were found between teachers with fewer years of experience and teachers with more years of experience, and the former have a more positive attitude to their skills. Finally, regarding to initial training, teachers in their initial training formation who have contact with people with disabilities have a more positive attitude to their skills.

The influence of time on lead toxicity and bioaccumulation determined by the OECD earthworm toxicity test

Internationally agreed standard protocols for assessing chemical toxicity of contaminants in soil to worms assume that the test soil does not need to equilibrate with the chemical to be tested prior to the addition of the test organisms and that the chemical will exert any toxic effect upon the test organism within 28 days. Three experiments were carried out to investigate these assumptions. The first experiment was a standard toxicity test where lead nitrate was added to a soil in solution to give a range of concentrations. The mortality of the worms and the concentration of lead in the survivors were determined. The LC(50)s for 14 and 28 days were 5311 and 5395 mug(Pb) g(soil)(-1) respectively. The second experiment was a timed lead accumulation study with worms cultivated in soil containing either 3000 or 5000 mug(Pb) g(soil)(-1). The concentration of lead in the worms was determined at various sampling times. Uptake at so' Sol both concentrations was linear with time. Worms in the 5000 mug g(-1) soil accumulated lead at a faster rate (3.16 mug Pb g(tissue)(-1) day(-1)) tiss than those in the 3000 mug g(-1) soil (2.21 mug Pb-tissue g(-1) day(-1)). The third experiment was a timed experiment with worms cultivated in tiss soil containing 7000 mugPb g(soil)(-1). Soil and lead nitrate solution were mixed and stored at 20 degreesC. Worms were added at various times over a 35-day period. The time to death increased from 23 h, when worms were added directly after the lead was added to the soil, to 67 It when worms were added after the soil had equilibrated with the lead for 35 days. In artificially Pb-amended soils the worms accumulate Pb over the duration of their exposure to the Pb. Thus time limited toxicity tests may be terminated before worm body load has reached a toxic level. This could result in under-estimates of the toxicity of Pb to worms. As the equilibration time of artificially amended Pb-bearing soils increases the bioavailability of Pb decreases. Thus addition of worms shortly after addition of Pb to soils may result in the over-estimate of Pb toxicity to worms. The current OECD acute worm toxicity test fails to take these two phenomena into account thereby reducing the environmental relevance of the contaminant toxicities it is used to calculate. (C) 2002 Elsevier Science Ltd. All rights reserved.

UK commercial property lease structures: Landlord and tenant mismatch

UK commercial property lease structures have come under considerable scrutiny during the past decade since the property crash of the early 1990s. In particular, tenants complained that the system was unfair and that it has blocked business change. Government is committed, through its 2001 election manifesto, to promote flexibility and choice in the commercial property lettings market and a new voluntary Commercial Leases Code of Practice was launched in April 2002. This paper investigates whether occupiers are being offered the leases they require or whether there is a mismatch between occupier requirements and actual leases in the market. It draws together the substantial data now available on the actual terms of leases in the UK and surveys of corporate occupiers' attitude to their occupation requirements. Although the data indicated that UK leases have become shorter and more diverse since 1990, this is still not sufficient to meet the current requirements of many corporate occupiers. It is clear that the inability to manage entry and exit strategies is a major concern to occupiers. Lease length is the primary concern of tenants and a number of respondents comment on the mismatch between lease length in the UK and business planning horizons. The right to break and other problems with alienation clauses also pose serious difficulties for occupiers, thus reinforcing the mismatch. Other issues include repairing and insuring clauses and the type of review clause. There are differences in opinion between types of occupier. In particular, international corporate occupiers are significantly more concerned about the length of lease and the incidence of break clauses than national occupiers and private-sector tenants are significantly more concerned about leasing in general than public-sector occupiers. Proposed solutions by tenants are predictable and include shorter leases, more frequent breaks and relaxation of restrictions concerning alienation and other clauses. A significant number specify that they would pay more for shorter leases and other improved terms. Short leases would make many of the other terms more acceptable and this is why they are the main concern of corporate occupiers. Overall, the evidence suggests that there continues to be a gap between occupiers' lease requirements and those currently offered by the market. There are underlying structural factors that act as an inertial force on landlords and inhibit the changes which occupiers appear to want. Nevertheless, the findings raise future research questions concerning whether UK lease structures are a constraining factor on UK competitiveness.

Influence of socio-economic and cultural factors in rice varietal diversity management on-farm in Nepal

A questionnaire survey of 408 households explored the role of socio-economic and cultural factors in rice (Oryza sativa L.) varietal diversity management on-farm in two contrasting eco-sites in Nepal. Multiple regression outputs suggest that number of parcels of land, livestock number, number of rice ecosystems, agro-ecology (altitude), and use of chemical fertilizer have a significant positive influence on landrace diversity on-farm, while membership in farmers' groups linked to extension services has significant but negative influence on landrace diversity. Factors with significant positive influence on diversity of modern varieties on-farm were number of parcels of land and of rice ecosystems, access to irrigation, membership in farmers' groups, and use of insecticide. Within communities, resource-endowed households maintain significantly higher varietal diversity on-farm than resource-poor households and play a significant role in conserving landraces that are vulnerable to genetic erosion and those with socio-cultural and market-preferred traits. Resource-poor households also contribute to local diversity conservation but at lower richness and area coverage levels than resource-endowed households. Households where a female had assumed the role of head of household due to death or migrant work of her husband had less diversity due to lower labor availability. Landraces with socio-cultural and market-preferred traits are few in number but have potential to be conserved on-farm.

Categories of GM risk-benefit perceptions and their antecedents

The stated benefits and perceived risks of genetic modification (GM) cover very diverse issues, such as food safety, world food security, and the environment, that may differentially affect consumer acceptance. In this research, we hypothesize that consumers perceive up to eight dimensions: risks to business (farmers, agribusiness, etc.), benefits to business, risks and benefits to the environment, risks and benefits to the developing world, and risks and benefits to self and family. Moral concerns are also recognized. Using data collected in 2002 in the United States, France, and the UK, we investigate these different dimensions. Second, we analyze the extent to which the dimensions of risk-benefit perceptions can be explained by general attitudes widely used to explain food purchase behavior (such as general attitude to the environment, to technology, etc.), as well as by perceived knowledge of GM, level of education, and trust in various sources of information. In all locations, the majority of consumers only perceive a medium level of risk from GM products. Attitude to technology is the most important attitude variable—those with a positive attitude to technology in general also have a positive attitude to GM technology. More Americans than Europeans fall into this category. Those who trust government and the food industry tend to think GM technology is less risky, whereas those who trust activists believe the opposite. Americans are more trusting of the former, Europeans of the latter. Level of education is positively associated with benefit perceptions and negatively associated with moral concerns. Location continues to play a limited independent role in explaining perceptions even after these factors have been taken into account.

Ted Hughes: the development of a children's poet

This article looks at how Ted Hughes' poetry for children developed over more than 30 years of publication. It traces the movement from his earlier, more conventional rhyming poems, such as Meet My Folks! (1961) and Nessie the Mannerless Monster (1964), to the mature, free verse "animal poems" for older readers of Season Songs (1976c), Under the North Star (1981) and the "farmyard fable" What is the Truth? (1984). The article argues that the later lyrical poems for younger readers where Hughes returned to rhyme, The Cat and the Cuckoo (1987) and The Mermaid's Purse (1993), represent an undervalued final phase of Hughes' work for children which is rarely discussed by critics. The discussion considers Hughes' changing attitude to the concept of the "children's poet" at different periods of his career. Reference is made throughout to Hughes' own writing about children and poetry, such as Poetry in the Making (1967), and to parallel developments in his poetry for adults.

Different risk measures: different portfolio compositions?

Traditionally, the measure of risk used in portfolio optimisation models is the variance. However, alternative measures of risk have many theoretical and practical advantages and it is peculiar therefore that they are not used more frequently. This may be because of the difficulty in deciding which measure of risk is best and any attempt to compare different risk measures may be a futile exercise until a common risk measure can be identified. To overcome this, another approach is considered, comparing the portfolio holdings produced by different risk measures, rather than the risk return trade-off. In this way we can see whether the risk measures used produce asset allocations that are essentially the same or very different. The results indicate that the portfolio compositions produced by different risk measures vary quite markedly from measure to measure. These findings have a practical consequence for the investor or fund manager because they suggest that the choice of model depends very much on the individual’s attitude to risk rather than any theoretical and/or practical advantages of one model over another.

Social networks and occupational choice: the endogenous formation of attitudes and beliefs about tax compliance

The paper analyses the emergence of group-specific attitudes and beliefs about tax compliance when individuals interact in a social network. It develops a model in which taxpayers possess a range of individual characteristics – including attitude to risk, potential for success in self-employment, and the weight attached to the social custom for honesty – and make an occupational choice based on these characteristics. Occupations differ in the possibility for evading tax. The social network determines which taxpayers are linked, and information about auditing and compliance is transmitted at meetings between linked taxpayers. Using agent-based simulations, the analysis demonstrates how attitudes and beliefs endogenously emerge that differ across sub-groups of the population. Compliance behaviour is different across occupational groups, and this is reinforced by the development of group-specific attitudes and beliefs. Taxpayers self-select into occupations according to the degree of risk aversion, the subjective probability of audit is sustained above the objective probability, and the weight attached to the social custom differs across occupations. These factors combine to lead to compliance levels that differ across occupations.

Chaucer's presence in songes and sonettes

In an elegy to Wyatt published in Tottel’s Miscellany, Surrey claims that Wyatt ‘reft Chaucer the glory of his wit’. This statement, which both lauds and resists Chaucer, is a microcosm of the way Chaucer is treated throughout the Miscellany. In examining the collection’s paradoxical attitude to Chaucer, this essay focuses particularly on the Squire’s Tale, the Franklin’s Tale, Anelida and Arcite, the Legend of Good Women, and several short lyrics. In its interest in courtly love poetry and Petrarch, the Miscellany follows a trajectory in English poetry set by Chaucer. Its courtly verse is saturated with words, phrases, and tropes from his poetry. Rhyme royal, which he introduced into English poetry, is widely used. The Canterbury Tales has been fully assimilated and can be referred to allusively with the same confidence of the audience’s knowledge as is the case when referring to classical myth; in Wyatt’s ‘Myne owne Jhon Poins’, the speaker, disclaiming deceitfulness, says that he cannot ‘say that Pan/ Passeth Appollo in musike manifold:/ Praise syr Topas for a noble tale,/ And scorne the story that the knight tolde’ (lines 48-50). However, Chaucer’s poetry is also downplayed and contested in the Miscellany. ‘Truth’, the only poem of his which appears in the volume, is disingenuously placed in the ‘Uncertain Authors’ section. In addition, some of the most important elements of his work are strongly resisted in the Miscellany, either ignored, dismissed or challenged. These elements include Chaucer’s interest in variety of voice, his sympathetic engagement with women, particularly wronged women, and his interest in female speech and particularly female complaint. The Miscellany, by contrast, is dominated by male-voiced lyrics preoccupied with the pain inflicted on the lover by a lady who is frequently unfeeling, cruel, or faithless. Chaucer’s frequent focus on the cynical seduction and betrayal of female by male is reversed in the Miscellany, and the language and metaphors he uses to express male cruelty (e.g. the word ‘newfangleness’ and images of hooks, nets and traps) are usurped to describe the lady’s cruelty to the suffering lover. On occasion, poems in the Miscellany challenge specific Chaucerian texts; ‘On His Love Named White’ throws down a gauntlet to The Book of the Duchess, while two of Surrey’s poems implicitly take issue with the female falcon’s voice in the Squire’s Tale, giving the deceitful tercelet the opportunity to shout down the falcon’s charges. The essay thus shows that in many respects Tottel’s Miscellany is only superficially Chaucerian, and that it both passively and actively takes issue with Chaucer’s work.

A reappraisal of Baskerville's Greek types

Ιn the eighteenth century the printing of Greek texts continued to be central to scholarship and discourse. The typography of Greek texts could be characterised as a continuation of French models from the sixteenth century, with a gradual dilution of the complexity of ligatures and abbreviations, mostly through printers in the Low Countries. In Britain, Greek printing was dominated by the university presses, which reproduced conservatively the continental models – exemplified by Oxford's Fell types, which were Dutch adaptations of earlier French models. Hindsight allows us to identify a meaningful development in the Greek types cut by Alexander Wilson for the Foulis Press in Glasgow, but we can argue that in the middle of the eighteenth century Baskerville was considering Greek printing the typographic environment was ripe for a new style of Greek types. The opportunity to cut the types for a New Testament (in an twin edition that included a generous octavo and a large quarto version) would seem perfect for showcasing Baskerville's capacity for innovation. His Greek type maintained the cursive ductus of earlier models, but abandoned complex ligatures and any hint of scribal flourish. He homogenised the modulation of the letter strokes and the treatment of terminals, and normalised the horizontal alignments of all letters. Although the strokes are in some letters too delicate, the narrow set of the style composes a consistent, uniform texture that is a clean break from contemporaneous models. The argument is made that this is the first Greek typeface that can be described as fully typographic in the context of the technology of the time. It sets a pattern that was to be followed, without acknowledgement, by Richard Porson nearly a century and a half later. The typeface received little praise by typographic historians, and was condemned by Victor Scholderer in his retrospective of Greek typography. A survey of typeface reviews in the surrounding decades establishes that the commentators were mostly reproducing the views of an arbitrary typographic orthodoxy, for which only types with direct references to Renaissance models were acceptable. In these comments we detect a bias against someone considered an arriviste in the scholarly printing establishment, as well as a conservative attitude to typographic innovation.

Cavernous sinus thrombosis in a patient with facial myiasis

Cavernous sinus thrombosis is a severe encephalic complication of the cervicofacial infections that can lead to death if not treated in adequate time. Among the several etiologies related to the development of this infection, myiasis has not been reported, enforcing the importance of the report of a case of thrombosis of the cavernous sinus developed from a facial myiasis. (Quintessence Int 2010;41:e72-e74)

TRPV1 receptors are involved in protein nitration and Muller cell reaction in the acutely axotomized rat retina

We report here the protein expression of TRPV1 receptor in axotomized rat retinas and its possible participation in mechanisms involved in retinal ganglion cell (RGC) death. Adult rats were subjected to unilateral, intraorbital axotomy of the optic nerve, and the retinal tissue was removed for further processing. TRPV1 total protein expression decreased progressively after optic nerve transection, reaching 66.2% of control values 21 days after axotomy. The number of cells labeled for TRPV1 in the remnant GCL decreased after 21 days post-lesion (to 63%). Fluoro-jade B staining demonstrated that the activation of TRPV1 in acutely-lesioned eyes elicited more intense neuronal degeneration in the GCL and in the inner nuclear layer than in sham-operated retinas. A single intraocular injection of capsazepine (100 mu M), a TRPV1 antagonist, 5 days after optic nerve lesion, decreased the number of GFAP-expressing Muller cells (72.5% of control values) and also decreased protein nitration in the retinal vitreal margin (75.7% of control values), but did not affect lipid peroxidation. Furthermore, retinal explants were treated with capsaicin (100 mu M), and remarkable protein nitration was then present, which was reduced by blockers of the constitutive and inducible nitric oxide synthases (7-NI and aminoguanidine, respectively). TRPV1 activation also increased GFAP expression, which was reverted by both TRPV1 antagonism with capsazepine and by 7-NI and aminoguanidine. Given that Muller cells do not express TRPV1, we suppose that the increased GFAP expression in these cells might be elicited by TRPV1 activation and by its indirect effect upon nitric oxide overproduction and peroxynitrite formation. We incubated Fluorogold pre-labeled retinal explants in the presence of capsazepine (1 mu M) during 48 h. The numbers of surviving RGCs stained with fluorogold and the numbers of apoptotic cells in the GCL detected with TUNEL were similar in lesioned and control retinas. We conclude that TRPV1 receptor expression decreased after optic nerve injury due to death of TRPV1-containing cells. Furthermore, these data indicate that TRPV1 might be involved in intrinsic protein nitration and Muller cell reaction observed after optic nerve injury. (C) 2010 Elsevier Ltd. All rights reserved.

Additive effect of P10 immunization and chemotherapy in anergic mice challenged intratracheally with virulent yeasts of Paracoccidioides brasiliensis

Paracoccidioidomycosis is a systemic granulomatous disease manifested in the acute/subacute or chronic forms. The anergic cases of the acute/subacute form are most severe, leading to death threatening conditions. Drug treatment is required to control the disease but the response in anergic patients is generally poor. A 15-mer peptide from the major diagnostic antigen gp43, named P10, induces a T-CD4(+) helper-1 immune response in mice of different haplotypes and protects against intratracheal challenge with virulent P. brasiliensis. Presently, P10 immunization and chemotherapy were associated in an attempt to improve antifungal treatment in Balb/c mice made anergic by adding dexamethasone to the drinking water. The combined drug/peptide treatment significantly reduced the lung CFUs in infected anergic mice, largely preserved lung alveolar structure and prevented fungal dissemination to liver and spleen. Results recommend that a P10-based vaccine should be associated to chemotherapy for improved treatment of paracoccidioidomycosis aiming especially at anergic cases. (C) 2008 Elsevier Masson SAS. All rights reserved.