Vocational Rehabilitation in Early Psychosis: Cluster Randomised Trial

Background Individual placement and support (IPS) is effective in helping patients return to work but is poorly implemented because of clinical ambivalence and fears of relapse. Aims To assess whether a motivational intervention (motivational interviewing) directed at clinical staff to address ambivalence about employment improved patients’ occupational outcomes. Method Two of four early intervention teams that already provided IPS were randomised to receive motivational interviewing training for clinicians, focused on attitudinal barriers to employment. The trial was registered with the International Standard Randomised Controlled Trial Register (ISRCTN71943786). Results Of 300 eligible participants, 159 consented to the research. Occupational outcomes were obtained for 134 patients (85%) at 12-month follow-up. More patients in the intervention teams than in the IPS-only teams achieved employment by 12 months (29/68 v. 12/66). A random effects logistic regression accounting for clustering by care coordinator, and adjusted for participants’ gender, ethnicity, educational and employment history and clinical status scores, confirmed superiority of the intervention (odds ratio = 4.3, 95% CI 1.5-16.6). Conclusions Employment outcomes were enhanced by addressing clinicians’ ambivalence about their patients returning to work.

Pertinencia de las remisiones y contra remisiones generadas en la red adscrita de servicios de salud de la ciudad de Manizales Caldas durante el año 2013

Determinar la pertinencia de las Remisiones y Contra remisiones generadas en la red adscrita de Servicios de Salud en la ciudad de Manizales- Caldas durante el año 2013. Caracterizar las remisiones, según oportunidad de la atención, disponibilidad de camas, uso de cama hospitalaria y criterios de gravedad de la remisión, en términos de necesidad, sitio o institución remitente y receptora.

Caso de estudio. Diferenciación en la prestación de servicios de Medicina Prepagada y Plan Obligatorio de Salud -POS

El Sistema Nacional de Salud, que regulaba la atención y coberturas en salud en todo el territorio nacional, se había estructurado como un modelo de operación determinado por el Estado colombiano, unía todas las modalidades de servicios de salud existentes prestados por instituciones tan variadas como empresas privadas, las cuales constituían su propio servicio para sus empleados; ejemplo: cajas de compensación, secretarías de salud, Instituto de Seguros Sociales, hospitales locales, lo que hacía que el Sistema fuera una colcha unida solamente por la normatividad teórica, adoleciendo de elementos que le permitieran llevar a cabo una atención de máxima calidad. La baja oportunidad en la prestación del servicio de salud, al igual que la baja cobertura y las pocas oportunidades de calidad de atención en salud se constituyeron en la base sobre la cual nacerían los servicios de salud prepagados.

Dissilicato de lítio

De forma a completar as necessidades estéticas, que são cada vez mais exigidas pela sociedade, as cerâmicas dentárias têm apresentado rápida evolução com o intuito de melhorar as suas propriedades físicas e mecânicas, como também óticas. O desenvolvimento de novos materiais permitiu a aplicação e o progresso dos sistemas totalmente cerâmicos utilizados na área da medicina dentária. Pelas suas características estéticas relativamente aos sistemas metalocerâmicos, rapidamente os sistemas totalmente cerâmicos ocuparam o seu lugar no mercado, levando à atenção de médicos dentistas, como dos próprios pacientes. Dentro destes sistemas totalmente cerâmicos, encontra-se a cerâmica reforçada com dissilicato de lítio. Esta revisão narrativa da literatura teve como objetivo descrever as características da cerâmica dissilicato de lítio de forma a tornar possível compreender em que situações clinicas poderá ser utilizada, bem como, de que forma é possível otimizar os processos laboratoriais. Para tal, foram utilizadas várias bases de dados, Pubmed, Scielo, JADA, e Science Direct, utilizando como palavras-chave: “Ceramic”, “Dental Ceramic” “Porcelain”, “Lithium Dissilicate”; “IPS e.max

Spiroacetals in the Colonization Behaviour of the Coffee Berry Borer: A 'Push-Pull' System

Coffee berries are known to release several volatile organic compounds, among which is the spiroacetal, conophthorin, an attractant for the coffee berry borer Hypothenemus hampei. Elucidating the effects of other spiroacetals released by coffee berries is critical to understanding their chemo-ecological roles in the host discrimination and colonization process of the coffee berry borer, and also for their potential use in the management of this pest. Here, we show that the coffee berry spiroacetals frontalin and 1,6-dioxaspiro [4.5] decane (referred thereafter as brocain), are also used as semiochemicals by the coffee berry borer for host colonization. Bioassays and chemical analyses showed that crowding coffee berry borers from 2 to 6 females per berry, reduced borer fecundity, which appeared to correlate with a decrease in the emission rates of conophthorin and frontalin over time. In contrast, the level of brocain did not vary significantly between borer-uninfested and infested berries. Brocain was attractive at lower doses, but repellent at higher doses while frontalin alone or in a blend was critical for avoidance. Field assays with a commercial attractant comprising a mixture of ethanol and methanol (1:1), combined with frontalin, confirmed the repellent effect of this compound by disrupting capture rates of H. hampei females by 77% in a coffee plantation. Overall, our results suggest that the levels of frontalin and conophthorin released by coffee berries determine the host colonization behaviour of H. hampei, possibly through a 'push-pull' system, whereby frontalin acts as the 'push' (repellent) and conophthorin acting as the 'pull' (attractant). Furthermore, our results reveal the potential use of frontalin as a repellent for management of this coffee pest.

Design de interfaces dinâmicos em sistemas de gestão de conteúdos

Relatório de Estágio para a obtenção do grau de Mestre na área de Educação e Comunicação Multimédia

Avaliação nutricional de estudantes do Instituto Politécnico de Santarém

O estudo apresentado avaliou a adequabilidade da ingesta de nutrientes e energia de estudantes do Instituto Politécnico de Santarém (IPS), através do preenchimento de um relatório alimentar de 24 horas, preenchido on line. Foram obtidas 103 respostas válidas para avaliação, maioritariamente do género feminino (77%), com uma idade média de 21 anos e valores de IMC normoponderais (78%). Cerca de metade dos participantes apresentou um estilo de vida sedentário. No geral, a alimentação caracterizou-se por elevados consumos de arroz, massa, batatas ou cereais de pequeno-almoço, de carne ou ovos, e consumos reduzidos de peixe, leguminosas e hortícolas crus ou cozinhados. O consumo de frutos e vegetais foi maioritariamente inferior ao recomendado, assim como a ingesta de energia e fibra. Ao contrário, a ingesta de lípidos totais e lípidos saturados foi superior ao recomendado na maioria dos participantes. A prevalência de inadequação de micronutrientes como cálcio, vitamina A, vitamina C e folatos foi próxima dos 50% ou superior. Perante os dados obtidos sugere-se uma melhoria dos hábitos alimentares e de estilo de vida, nomeadamente, o aumento do número de refeições realizadas, o aumento do consumo de frutos, hortícolas e leguminosas e o aumento da prática de atividade física.

e-Tutor : papel e intervenção na aprendizagem colaborativa em ambientes híbridos

Relatório de estágio apresentado à Escola Superior de Educação de Santarém para cumprimento dos requisitos necessários à obtenção do grau de mestre em Educação e Comunicação Multimédia

e-Tutor : papel e intervenção na aprendizagem colaborativa em ambientes híbridos

Relatório de estágio apresentado à Escola Superior de Educação de Santarém para cumprimento dos requisitos necessários à obtenção do grau de mestre em Educação e Comunicação Multimédia

Construção de modelos de interação in silico e in vitro do inibidor do tipo Kunitz de Adenanthera pavonina L. para as enzimas cisteínicas e serínicas

Serines proteinases inhibitors (PIs) are widely distributed in nature and are able to inhibit both in vitro and in vivo enzymatic activites. Seed PIs in than leguminous are classified in seven families, Bowman-Birk and Kunitz type families that most studied representing an important role in the first line of defense toward insects pests. Some Kunitz type inhibitors possess activities serine and cysteine for proteinases named bifunctional inhibitor, as ApTKI the inhibitor isolate from seed of Adenanthera pavonina. The A. pavonina inhibitor presenting the uncommon property and was used for interaction studies between proteinases serine (trypsin) and cysteine (papain). In order to determinate the in vitro interaction of ApTKI against enzymes inhibitor purification was carried cut by using chromatographic techniques and inhibition assays. The 3D model of the bifunctional inhibitor ApTKI was constructed SWISS-MODEL program by homology modeling using soybean trypsin inhibitor (STI, pdb:1ba7), as template which presented 40% of identity to A. pavonina inhibitor. Model quality was evaluated by PROCHECK program. Moreover in silico analyzes of formed complex between the enzymes and ApTKI was evaluated by HEX 4.5 program. In vitro results confirmed the inhibitory assays, where the inhibitor presented the ability to simultaneously inhibit trypsin and papain. The residues encountered in the inhibitor model of folder structural three-dimensional that make contact to enzymes target coud explain the specificity pattern against serine and cysteine proteinases

The “handwriting brain”: a motor/linguistic network with specialized “writing-specific” areas?

International audience

Health tourism trends in the United Kingdom: Are they net exporters of health services?

The study investigates the inbound and outbound health tourism in the United Kingdom (UK) to determine if the UK can be considered as a net exporter of health services. Although there is an increasing number of studies analysing the phenomenon of health tourism, little empirical data are available. This paper contributes to reducing this gap by providing reliable data on health tourism flows for the British case. Using microdata drawn from the International Passenger Survey (IPS) for the period 2000-2014, we estimate the flows, number of nights and expenditure of tourists looking for medical treatment who complete international visits of less than 12 months’ duration to and from the UK. In addition, we analyse the main destinations of UK residents (outbound health tourists), and country of origin of overseas residents (inbound health tourists). The results show the upward trend of inbound and outbound patients (163 and 364% during the period 2000-2014, respectively), the strong seasonality in outbound patients (lower during the summer), and the significant increase in the levels of expenditure of overseas residents since 2005. Poland, France, India and Hungry are the chosen countries by UK residents to be treated, whereas Irish Republic, Spain, United Arab Emirates and Greece are the main countries providing inbound health patients. Public policy considerations are given.

Representaciones sociales del derecho a la salud de los sujetos que acuden al punto por el derecho a la salud en Localidad de Suba – Bogotá

Tesis (Trabajadora Social).-- Universidad de La Salle. Facultad de Ciencias Económicas y sociales. Programa de Trabajo Social, 2014

Influence of implant-abutment angulations and crown material on stress distribution on central incisor: a 3D FEA

Aim: To investigate the effect of implant-abutment angulation and crown material on stress distribution of central incisors. Finite element method was used to simulate the clinical situation of a maxillary right central incisor restored by two different implant-abutment angulations, 15° and 25°, using two different crown materials (IPS E-Max CAD and zirconia). Methods: Two 3D finite element models were specially prepared for this research simulating the abutment angulations. Commercial engineering CAD/CAM package was used to model crown, implant abutment complex and bone (cortical and spongy) in 3D. Linear static analysis was performed by applying a 178 N oblique load. The obtained results were compared with former experimental results. Results: Implant Von Mises stress level was negligibly changed with increasing abutment angulation. The abutment with higher angulation is mechanically weaker and expected to fail at lower loading in comparison with the steeper one. Similarly, screw used with abutment angulation of 25° will fail at lower (about one-third) load value the failure load of similar screw used with abutment angulated by 15°. Conclusions: Bone (cortical and spongy) is insensitive to crown material. Increasing abutment angulation from 15° to 25°, increases stress on cortical bone by about 20% and reduces it by about 12% on spongy bone. Crown fracture resistance is dramatically reduced by increasing abutment angulation. Zirconia crown showed better performance than E-Max one.

Cited2 in mouse embryonic fibroblasts reprogramming

Dissertação de Mestrado, Ciências Biomédicas, Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, 2014