Análisis de la experiencia de los turistas con el uso del idioma inglés por parte de los guías de las agencias de viajes del Pool South Explorer Group

El crecimiento de la actividad turística ha permitido que exista una oferta muy variada de servicios para los turistas que llegan a un determinado país. Es de gran importancia conocer la percepción que tienen los turistas acerca de los servicios que contratan para saber si estos son de calidad puesto que un buen servicio finalmente lleva a un crecimiento de la actividad turística. En la ciudad de Cuenca se brindan varios servicios a los turistas, entre estos, los tours con guianza en el idioma inglés. En este caso de investigación se provee información sobre la percepción que tienen los turistas cuando realizan un tour en inglés con el servicio de los guías del pool de operadores South Explorer Group. Mediante encuestas se facilita información acerca del manejo del idioma inglés por parte del guia, específicamente en las áreas de expresión oral, interacción oral y compresión auditiva. El trabajo se compone de tres capítulos, el primero de ellos da a conocer la actividad turística mundial, nacional y local, aquí se detalla el incremento de visitantes y los países de donde provienen los turistas así como su idioma. El segundo capítulo contiene la clasificación de las agencias de viajes y los requisitos según la Ley para guiar en el país, así también se da a conocer la historia del pool de operadores y el perfil de turistas y guías que operan para esta alianza. El capítulo tres hace referencia a las encuestas aplicadas a los turistas y guías del pool así como también los resultados obtenidos mediante este instrumento. Por último, se da a conocer las conclusiones obtenidas y las recomendaciones pertinentes.

The Effects of Instrumental Touching on Infant Pain Perception and the Effects of Eutectic Mixture of Local Anesthetics (EMLA) on the Reduction of Pain

Background: Premature infants, who have to spend the first week of their lives in neonatal intensive care units (NICUs), experience pain and stress in numerous cases, and they are exposed to many invasive interventions. The studies have shown that uncontrolled pain experienced during early life has negative and long-term side effects, such as distress, and such experiences negatively affect the development of the central nervous system Objectives: The purpose of the study was to examine the effects of touching on infant pain perception and the effects of eutectic mixture of local anesthetic (EMLA) on the reduction of pain. Patients and Methods: Data for the study were collected between March and August 2012 from the neonatal clinic of a university hospital located in eastern Turkey. The population of the study consisted of premature infants who were undergoing treatment, completed the first month and who were approved for Hepatitis B vaccine. The study consisted of two experimental groups and one control group. Information forms, intervention follow-up forms, and Premature Infant Pain Profile (PIPP) were used to collect the data. EMLA cream was applied on the vastus lateralis muscles of the first experimental group before the vaccination. The second experimental group was vaccinated by imitation (placebo), without a needle tip or medicine. Vaccination was carried out using instrumental touch in this group. A routine vaccination was applied in the control group. Results: Mean pain scores of the group to which EMLA was applied were lower in a statistically significant way (P < 0.05) compared to the pain scores of the other groups. Moreover, it was determined that even though invasive intervention was not applied to the newborns, the touching caused them to feel pain just as in the placebo group (P < 0.005). Conclusions: The results demonstrated that EMLA was an effective method for reducing pain in premature newborns, and the use of instrumental touch for invasive intervention stimulated the pain perception in the newborns.

Assessment of the storage and disposal of medicines in some homes in Jos north local government area of Plateau State, Nigeria

Purpose: The purpose of this study was to assess the way medicines are stored and disposed in some households in Jos North Local Government Area (LGA) of Plateau State, Nigeria. Methods: A cross-sectional survey of 130 households in Jos was carried out using a questionnaire to ascertain practices associated with medicine storage and their disposal. Results: The results showed that 105 (80.8%) households had 635 medicines in their homes, 65.8% of which were unused medicines (3.2 unused medicines per household). Some households stored their medicines in bags/containers (76.2%) while others kept them in cup-boards/cabinets (21.96%), refrigerators (10.5%) or other places (3.3%). Methods for disposal of unused drugs varied among households with some disposing them in trash cans (70.5%) while other disposed them in toilets (19.0%) or burnt them (10.5%). Only 10.5% (n=11) of respondents knew how medicines were properly disposed. Conclusion: While most households store their medicines appropriately, majority of them adopt poor disposal methods for medicines they no longer need in their homes. Public health education on problem disposal of medicines is of the essence.

In situ epicatechin-loaded hydrogel implants for local drug delivery to spinal column for effective management of post-traumatic spinal injuries

Purpose: To prepare hydrogels loaded with epicatechin, a strong antioxidant, anti-inflammatory, and neuroprotective tea flavonoid, and characterise them in situ as a vehicle for prolonged and safer drug delivery in patients with post-traumatic spinal cord injury. Methods: Five in situ gel formulations were prepared using chitosan and evaluated in terms of their visual appearance, clarity, pH, viscosity, and in vitro drug release. In vivo anti-inflammatory activity was determined and compared with 2 % piroxicam gel as standard. Motor function activity in a rat model of spinal injury was examined comparatively with i.v. methylprednisolone as standard. Results: The N-methyl pyrrolidone solution (containing 1 % w/w epicatechin with 2 to 10 % w/w chitosan) of the in situ gel formulation had a uniform pH in the range of 4.01 ± 0.12 to 4.27 ± 0.02. High and uniform drug loading, ranging from 94.48 ± 1.28 to 98.08 ± 1.24 %, and good in vitro drug release (79.48 ± 2.84 to 96.48 ± 1.02 % after 7 days) were achieved. The in situ gel prepared from 1 % epicatechin and 2 % chitosan (E5) showed the greatest in vivo anti-inflammatory activity (60.58 % inhibition of paw oedema in standard carrageenan-induced hind rat paw oedema model, compared with 48.08 % for the standard). The gels showed significant therapeutic effectiveness against post-traumainduced spinal injury in rats. E5 elicited maximum motor activity (horizontal bar test) in the spinal injury rat model; the rats that received E5 treatment produced an activity score of 3.62 ± 0.02 at the end of 7 days, compared with 5.0 ± 0.20 following treatment with the standard. Conclusion: In situ epicatechin-loaded gel exhibits significant neuroprotective and anti-inflammatory effects, and therefore can potentially be used for prolonged and safe drug delivery in patients with traumatic spinal cord injury.

FROM GENES TO GENOMES: LOCAL ADAPTATION AND ADAPTIVE POTENTIAL IN TWO ARCTIC SEABIRDS

By investigating the mechanisms underlying the evolution and the maintenance of local adaptations we can help predict how species will adapt to future environmental change. In this thesis I investigate local adaptation and adaptive potential in thick-billed and common murres (Uria lomvia and U. aalge), two arctic seabirds of international conservation concern. Thanks to the recent development of new genomic methods, I address three major themes that are relevant for both the development of evolutionary theory and conservation: 1) the role of gene flow in the origin and maintenance of adaptation; 2) levels and distribution of standing genetic variation, and their contribution to adaptive potential; and 3) the genomic mechanisms maintaining an adaptive dimorphism within a single interbreeding population. First, I review the literature on genomics of local adaptation with gene flow and find that adaptation can be maintained despite gene flow, that gene flow itself can promote adaptation, and that genetic architecture is important in the origin and maintenance of local adaptations. Second, I genotype genome-wide markers and toll-like receptor genes (TLRs) to investigate local adaptation and adaptive potential in thick-billed murres. Thick-billed murres do not show signatures of local adaptation to their breeding grounds, but outlier loci group birds according to their non-breeding distributions, suggesting that selection and/or demographic connectivity in the winter may explain patterns of differentiation in this species. Genetic variation at TLRs does not decrease with increasing latitude as predicted, but tests of selection and measures of genetic diversity suggest differences in local selective regimes at most genes. Thick-billed murres show high levels of standing genetic variation and their adaptive potential will mostly depend on rate and magnitude of environmental change. Finally, I improve and annotate the assembly of the highly heterozygous genome of the thick-billed murre. Using this assembly as a reference, I perform whole genome analyses to investigate the genomic basis of an adaptive dimorphism in Atlantic common murres. I show for the first time that a 60 kb complex copy number variant in a non-coding region maintains differences in plumage and cold adaptation despite high gene flow.

Comparative survey of the relative impact of mRNA features on local ribosome profiling read density

Ribosome profiling (Ribo-seq), a promising technology for exploring ribosome decoding rates, is characterized by the presence of infrequent high peaks in ribosome footprint density and by long alignment gaps. Here, to reduce the impact of data heterogeneity we introduce a simple normalization method, Ribo-seq Unit Step Transformation (RUST). RUST is robust and outperforms other normalization techniques in the presence of heterogeneous noise. We illustrate how RUST can be used for identifying mRNA sequence features that affect ribosome footprint densities globally. We show that a few parameters extracted with RUST are sufficient for predicting experimental densities with high accuracy. Importantly the application of RUST to 30 publicly available Ribo-seq data sets revealed a substantial variation in sequence determinants of ribosome footprint frequencies, questioning the reliability of Ribo-seq as an accurate representation of local ribosome densities without prior quality control. This emphasizes our incomplete understanding of how protocol parameters affect ribosome footprint densities.

School belongingness and mental health functioning across the primary-secondary transition in a mainstream sample: Multi-group cross-lagged analyses

The relationship between school belongingness and mental health functioning before and after the primary-secondary school transition has not been previously investigated in students with and without disabilities. This study used a prospective longitudinal design to test the bi-directional relationships between these constructs, by surveying 266 students with and without disabilities and their parents, 6-months before and after the transition to secondary school. Cross-lagged multi-group analyses found student perception of belongingness in the final year of primary school to contribute to change in their mental health functioning a year later. The beneficial longitudinal effects of school belongingness on subsequent mental health functioning were evident in all student subgroups; even after accounting for prior mental health scores and the cross-time stability in mental health functioning and school belongingness scores. Findings of the current study substantiate the role of school contextual influences on early adolescent mental health functioning. They highlight the importance for primary and secondary schools to assess students' school belongingness and mental health functioning and transfer these records as part of the transition process, so that appropriate scaffolds are in place to support those in need. Longer term longitudinal studies are needed to increase the understanding of the temporal sequencing between school belongingness and mental health functioning of all mainstream students.

Low codimensional intrinsic regular submanifolds in the Heisenberg group H^n

The thesis mainly concerns the study of intrinsically regular submanifolds of low codimension in the Heisenberg group H^n, called H-regular surfaces of low codimension, from the point of view of geometric measure theory. We consider an H-regular surface of H^n of codimension k, with k between 1 and n, parametrized by a uniformly intrinsically differentiable map acting between two homogeneous complementary subgroups of H^n, with target subgroup horizontal of dimension k. In particular the considered submanifold is the intrinsic graph of the parametrization. We extend various results of Ambrosio, Serra Cassano and Vittone, available for the case when k = 1. We prove that the uniform intrinsic differentiability of the parametrizing map is equivalent to the existence and continuity of its intrinsic differential, to the local existence of a suitable approximating family of Euclidean regular maps, and, when the domain and the codomain of the map are orthogonal, to the existence and continuity of suitably defined intrinsic partial derivatives of the function. Successively, we present a series of area formulas, proved in collaboration with V. Magnani. They allow to compute the (2n+2−k)-dimensional spherical Hausdorff measure and the (2n+2−k)-dimensional centered Hausdorff measure of the parametrized H-regular surface, with respect to any homogeneous distance fixed on H^n. Furthermore, we focus on (G,M)-regular sets of G, where G and M are two arbitrary Carnot groups. Suitable implicit function theorems ensure the local existence of an intrinsic parametrization of such a set, at any of its points. We prove that it is uniformly intrinsically differentiable. Finally, we prove a coarea-type inequality for a continuously Pansu differentiable function acting between two Carnot groups endowed with homogeneous distances. We assume that the level sets of the function are uniformly lower Ahlfors regular and that the Pansu differential is everywhere surjective.

Performing inclusion and exclusion in the peer group. Children's social organization and peer socializing practices in the classroom

This PhD thesis investigates children’s peer practices in two primary schools in Italy, focusing on the ordinary and the Italian L2 classroom. The study is informed by the paradigm of language socialization and considers peer interactions as a ‘double opportunity space’, allowing both children’s co-construction of their social organization and children’s sociolinguistic development. These two foci of attention are explored on the basis of children’s social interaction and of the verbal, embodied, and material resources that children agentively deploy during their mundane activities in the peer group. The study is based on a video ethnography that lasted nine months. Approximately 30 hours of classroom interactions were video-recorded, transcribed, and analyzed with an approach that combines the micro-analytic instruments of Conversation Analysis and the use of ethnographic information. Three main social phenomena were selected for analysis: (a) children’s enactment of the role of the teacher, (b) children’s reproduction of must-formatted rules, and (c) children’s argumentative strategies during peer conflict. The analysis highlights the centrality of the institutional frame for children’s peer interactions in the classroom. Moreover, the study illustrates that children socialize their classmates to the linguistic, social, and moral expectations of the context in and through various practices. Notably, these practices are also germane to the local negotiation of children’s social organization and hierarchy. Therefore, the thesis underlines that children’s peer interactions are both a resource for children’s sociolinguistic development and a potentially problematic locus where social exclusion is constructed and brought to bear. These insights are relevant for teachers’ professional practice. Children’s peer interactions are a resource that can be integrated in everyday didactics. Nevertheless, the role of the teacher in supervising and steering children’s peer practices appears crucial: an acritical view of children’s autonomous work, often implied in teaching methods such as peer tutoring, needs to be problematized.

Multi-scalar critical theories: first steps for a non perturbative functional renormalization group analysis

In this work the fundamental ideas to study properties of QFTs with the functional Renormalization Group are presented and some examples illustrated. First the Wetterich equation for the effective average action and its flow in the local potential approximation (LPA) for a single scalar field is derived. This case is considered to illustrate some techniques used to solve the RG fixed point equation and study the properties of the critical theories in D dimensions. In particular the shooting methods for the ODE equation for the fixed point potential as well as the approach which studies a polynomial truncation with a finite number of couplings, which is convenient to study the critical exponents. We then study novel cases related to multi field scalar theories, deriving the flow equations for the LPA truncation, both without assuming any global symmetry and also specialising to cases with a given symmetry, using truncations based on polynomials of the symmetry invariants. This is used to study possible non perturbative solutions of critical theories which are extensions of known perturbative results, obtained in the epsilon expansion below the upper critical dimension.

Clinical Consequences Of Tityus Bahiensis And Tityus Serrulatus Scorpion Stings In The Region Of Campinas, Southeastern Brazil.

Scorpion stings account for most envenomations by venomous animals in Brazil. A retrospective study (1994-2011) of the clinical consequences of Tityus scorpion stings in 1327 patients treated at a university hospital in Campinas, southeastern Brazil, is reported. The clinical classification, based on outcome, was: dry sting (no envenoming), class I (only local manifestations), class II (systemic manifestations), class III (life-threatening manifestations, such as shock and/or cardiac failure requiring inotropic/vasopressor agents, and/or respiratory failure), and fatal. The median patient age was 27 years (interquartile interval = 15-42 years). Scorpions were brought for identification in 47.2% of cases (Tityus bahiensis 27.7%; Tityus serrulatus 19.5%). Sting severity was classified and each accounted for the following percentage of cases: dry stings - 3.4%, class I - 79.6%, class II - 15.1%, class III - 1.8% and fatal - 0.1%. Pain was the primary local manifestation (95.5%). Systemic manifestations such as vomiting, agitation, sweating, dyspnea, bradycardia, tachycardia, tachypnea, somnolence/lethargy, cutaneous paleness, hypothermia and hypotension were detected in class II or class III + fatal groups, but were significantly more frequent in the latter group. Class III and fatal cases occurred only in children <15 years old, with scorpions being identified in 13/25 cases (T. serrulatus, n = 12; T. bahiensis, n = 1). Laboratory blood abnormalities (hyperglycemia, hypokalemia, leukocytosis, elevations in serum total CK, CK-MB and troponin T, bicarbonate consumption and an increase in base deficit and blood lactate), electrocardiographic changes (ST segment) and echocardiographic alterations (ventricular ejected fraction <54%) were frequently detected in class III patients. Seventeen patients developed pulmonary edema, 16 had cardiac failure and seven had cardiogenic shock. These results indicate that most scorpion stings involved only local manifestations, mainly pain; the greatest severity was associated with stings by T. serrulatus and in children <15 years old.

Otorhinolaryngological Findings In A Group Of Patients With Rheumatic Diseases.

Otorhinolaryngological manifestations of rheumatologic diseases represent a great challenge not only to the generalistphysician but also to the ENT doctor andrheumatologist. They often represent early manifestations of an autoimmune disorder which requires prompt and aggressive immunosuppressive treatment. Auditory, nasal, laryngeal and eye symptoms can be the first manifestation of rheumatic diseases and their proper assessment helps the doctor to identify signs of disease activity. The objective of this study is to identify the ENT manifestations in patients with rheumatic diseases in a high complexity hospital, regarding facilitating an early diagnosis and treatment. We performed clinical and complete otorhinolaryngological evaluations in patients selected from the outpatient rheumatology in a standardized manner by the use of a standardized form filling during the secondhalf of 2010. In the study group, systemic lupus erythematosus (SLE) patients had predominantly laryngeal manifestations, while patients with Sjögren's syndrome showed a higher prevalence of otologic manifestations. Changes in audiometric tests were found in 53% of Wegener's granulomatosis (WG) patients, 80% of relapsing polychondritis (RP), 33% of systemic lupus erythematosus (SLE) and 50% of Churg-Strauss syndrome (SCS). Regarding nasal alterations, these were found so prevalent in all conditions, especially Churg-Strauss syndrome. This study demonstrated that most patients treated in our hospital has the ENT signs and symptoms commonly associated in previous studies on rheumatic diseases, but further studies with a larger number of patients must be made to establish such relations.

Urinary Tract Infection In Renal Transplant Recipients: Incidence, Risk Factors, And Impact On Graft Function.

Urinary tract infection (UTI) is the most common infection posttransplant. However, the risk factors for and the impact of UTIs remain controversial. The aim of this study was to identify the incidence of posttransplant UTIs in a series of renal transplant recipients from deceased donors. Secondary objectives were to identify: (1) the most frequent infectious agents; (2) risk factors related to donor; (3) risk factors related to recipients; and (4) impact of UTI on graft function. This was a retrospective analysis of medical records from renal transplant patients from January to December 2010. Local ethics committee approved the protocol. The incidence of UTI in this series was 34.2%. Risk factors for UTI were older age, (independent of gender), biopsy-proven acute rejection episodes, and kidneys from deceased donors (United Network for Organ Sharing criteria). For female patients, the number of pretransplant pregnancies was an additional risk factor. Recurrent UTI was observed in 44% of patients from the UTI group. The most common infectious agents were Escherichia coli and Klebsiella pneumoniae, for both isolated and recurrent UTI. No difference in renal graft function or immunosuppressive therapy was observed between groups after the 1-year follow-up. In this series, older age, previous pregnancy, kidneys from expanded criteria donors, and biopsy-proven acute rejection episodes were risk factors for posttransplant UTI. Recurrence of UTI was observed in 44%, with no negative impact on graft function or survival.

Molecular And Morphological Evidence Reveals A New Species In The Phyllomedusa Hypochondrialis Group (hylidae, Phyllomedusinae) From The Atlantic Forest Of The Highlands Of Southern Brazil.

The taxonomic status of a disjunctive population of Phyllomedusa from southern Brazil was diagnosed using molecular, chromosomal, and morphological approaches, which resulted in the recognition of a new species of the P. hypochondrialis group. Here, we describe P. rustica sp. n. from the Atlantic Forest biome, found in natural highland grassland formations on a plateau in the south of Brazil. Phylogenetic inferences placed P. rustica sp. n. in a subclade that includes P. rhodei + all the highland species of the clade. Chromosomal morphology is conservative, supporting the inference of homologies among the karyotypes of the species of this genus. Phyllomedusa rustica is apparently restricted to its type-locality, and we discuss the potential impact on the strategies applied to the conservation of the natural grassland formations found within the Brazilian Atlantic Forest biome in southern Brazil. We suggest that conservation strategies should be modified to guarantee the preservation of this species.

Rh, Kell, Duffy, Kidd And Diego Blood Group System Polymorphism In Brazilian Japanese Descendants.

Polymorphisms of Rh, Kell, Duffy, Kidd and Diego blood group systems were studied in 209 unrelated Brazilian Japanese descendants from South of Brazil. The methods used were multiplex-PCR, AS-PCR and RFLP-PCR. The differences in frequencies among the populations were evaluated using chi-square test. The frequencies for Rh, Kell, Kidd and Diego system were similar to those of the Japanese. RHCE(*)CC, RHCE(*)EE genotypes and FY(*)01 allele were lower and FY(*)01N.01 was higher than Japanese. These differences in the frequencies between Brazilian Japanese descendants and Japanese could indicate a gene flow in Brazilian population and reinforce the importance of this knowledge to achieve safe red blood cells.