986 resultados para 342-U1409B
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STUDY OBJECTIVE: To assess whether having a good relationship with their mother was a protective factor against risky sexual behavior for female adolescents and whether it was independent of family structure. DESIGN: Cross-sectional survey of in-school adolescents aged 14-19 years. SETTING: Catalonia, in northeast Spain. PARTICIPANTS: A total of 3677 females divided according on whether they had a good (n=3335) or a bad (n=342) relationship with their mother. MAIN OUTCOME MEASURES: Rates of sexual activity and sexual behavior. RESULTS: Adolescents in the good relationship group were significantly younger, more likely to live in an intact family, to have a good relationship with their father and siblings, and to talk about sexuality and their partner with their mother. They were also less likely to have ever had sexual intercourse. Among those sexually experienced, they were significantly older at first intercourse and less likely to have multiple partners or a history of STI. After adjusting for potential confounders, females in the good relationship group were less likely to be sexually active and to have had multiple partners, independently of family structure. CONCLUSIONS: Having a good relationship with their mother is a protective factor against sexual intercourse and having multiple sexual partners independently of family structure. Communication between generations and having a good relationship with their father and siblings also play an important role.
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Objetivo: Conocer los hábitos higiénico-dietéticos de las mujeres embarazadas respecto al consumo de alimentos ricos en yodo durante el primer trimestre de la gestación. Material y método: Estudio observacional, descriptivo, transversal y multicéntrico. Se estudiaron las mujeres embarazadas en el primer trimestre de la gestación que acudieron a la consulta de control del embarazo del programa de atención a la salud sexual y reproductiva (ASSIR) de la Región Sanitaria del Ámbito Centro del Instituto Catalán de la Salud durante el año 2006. Para la recogida de datos se utilizó un cuestionario que cumplimentó la matrona en una entrevista individual en la primera visita de control de embarazo. Resultados: Se recogieron 823 cuestionarios cumplimentados. El 6% (50) de las gestantes no consumía pescado y el 83% (683) lo hacía menos de cuatro veces por semana. El 17% (138) no consumía leche y el 39% (324) bebía un vaso al día. El 42% (342) de las gestantes utilizaba sal yodada para la preparación y condimentación de los alimentos, frente al 50% (412) que no la empleaba. El 22% (184) de las gestantes tomaba algún tipo de suplemento de yodo, y el 18% (148) de la muestra manifestó ser fumadora. Conclusiones: Las mujeres embarazadas de nuestro ámbito de estudio tienen un consumo reducido de alimentos ricos en yodo. Además, tanto el consumo de sal yodada como la utilización de suplementos que contengan yodo durante el embarazo resultan también insuficientes.
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In the summer of 2008, the state of Iowa suffered from a series of severe storms that produced tornadoes and heavy rainfall, which resulted in widespread flooding. The Summer Storms1 lasted from late May through mid-August, with the most intense storms occurring over a month-long period from May 25 to June 25. The Summer Storms exacted a major human and economic toll on Iowa, resulting in 18 fatalities and 106 injuries, forcing the evacuation of approximately 38,000 Iowans, and impacting 21,000 housing units. Iowa’s public and private sectors suffered significant monetary damages. Eighty-six of the ninety-nine counties in the state were included in the Governor’s disaster declarations. Presidential disaster declarations made residents in 84 counties eligible for Public Assistance and 78 counties for Individual Assistance. The Rebuild Iowa Advisory Commission estimated $798.3 million in damages to publicly owned buildings and infrastructure, including damages of $53 million to public transportation and $342 million to public utilities.
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AIMS: To evaluate the effectiveness of brief alcohol intervention (BAI) in reducing alcohol use among hazardous drinkers treated in the emergency department (ED) after an injury; in addition it tests whether assessment of alcohol use without BAI is sufficient to reduce hazardous drinking. DESIGN: Randomized controlled clinical trial with 12-month follow-up conducted between January 2003 and June 2005. SETTING: Urban academic emergency department (ED) of the Lausanne University Hospital, Lausanne, Switzerland. PARTICIPANTS: A total of 5136 consecutive patients attending ED after an injury completed a seven-item general and a three-item alcohol screen and 1472 (28.7%) were positive for hazardous drinking according to the National Institute on Alcohol Abuse and Addiction definition; of these 987 (67.1%) were randomized into a BAI group (n = 310) or a control group with screening and assessment (n = 342) or a control group with screening only (n = 335) and then a total of 770 patients (78.0%) completed the 12-month follow-up procedures. INTERVENTION: A single 10-15-minute session of standardized BAI conducted by a trained research assistant. MEASUREMENTS: Percentage of participants who have changed to low-risk drinking at follow-up. FINDINGS: Data obtained at 12 months indicated that similar proportions were low-risk drinkers in BAI versus control groups with and without assessment (35.6%, 34.0%, 37.0%, respectively, P = 0.71). Data also indicated similar reductions in drinking frequency, quantity, binge drinking frequency and Alcohol Use Disorders Identification Test (AUDIT) scores across groups. All groups reported similar numbers of days hospitalized and numbers of medical consults in the last 12 months. A model including age groups, gender, AUDIT and injury severity scores indicated that BAI had no influence on the main alcohol use outcome. CONCLUSIONS: This study provides the evidence that a 10-15-minute BAI does not decrease alcohol use and health resource utilization in hazardous drinkers treated in the ED, and demonstrates that commonly found decreases in hazardous alcohol use in control groups cannot be attributed to the baseline alcohol assessment.
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The aim of this studywas to adapt and assess the psychometric properties of the Spanish version of the sMARS in terms of evidence of validity and reliability of scores. The sMARS was administered to 342 students and, in order to assess convergent and discriminant validity, several subsamples completed a series of related tests. The factorial structure of the sMARSwas analyzed by means of a confirmatory factor analysis and results showed that the three-factor structure reported in the original test fits well with the data. Thus, three dimensions were established in the test: math test, numerical task and math course anxiety. The results of this study provide sound evidence that demonstrates the good psychometric properties of the scores of the Spanish version of the sMARS: strong internal consistency, high 7-week testretest reliability and good convergent/discriminant validity were evident. Overall, this study provides an instrument that allows us to obtain valid and reliable math anxiety measurements. This instrument may be a useful tool for educators and psychologists interested in identifying individuals that may have a low level of math mastery because of their anxiety.
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Two reminiscences from the Cicero's speeches against Catiline in the letters of St Jerome and St Augustine.
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Atrial septal defects (ASDs) are typically asymptomatic in infancy and early childhood, and elective defect closure is usually performed at ages of 4 to 6 years. Severe pulmonary hypertension (PH) complicating an ASD is seen in adulthood and has only occasionally been reported in small children. A retrospective study was undertaken to evaluate the incidence of severe PH complicating an isolated ASD and requiring early surgical correction. During a 10-year period (1996 to 2006), 355 pediatric patients underwent treatment for isolated ASDs either surgically or by catheter intervention at 2 tertiary referral centers. Two hundred ninety-seven patients had secundum ASDs, and 58 had primum ASDs with mild to moderate mitral regurgitation. Eight infants were found with isolated ASDs (6 with secundum ASDs and 2 with primum ASDs) associated with significant PH, accounting for 2.2% of all patients with ASDs at the centers. These 8 infants had invasively measured pulmonary artery pressures of 50% to 100% of systemic pressure. They were operated in the first year of life and had complicated postoperative courses requiring specific treatment for PH for up to 16 weeks postoperatively. The ultimate outcomes in all 8 infants were good, with persistent normalization of pulmonary pressures during midterm follow-up of up to 60 months (median 28). All other patients with ASDs had normal pulmonary pressures, and the mean age at defect closure was significantly older, at 6.2 years for secundum ASDs and 3.2 years for primum ASDs. In conclusion, ASDs were rarely associated with significant PH in infancy but then required early surgery and were associated with excellent midterm outcomes in these patients.
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En l'actualitat, l'eficiència energètica en l'edificació és un dels conceptes més importants, notan sols per la política energètica Espanyola, sinó també Europea amb un objectiu d'estalvidel 20% el 2020. Dins el sector de l'edificació, les normatives sobre eficiència energèticas'incorporen a partir de la transposició de les directives europees 2002/91 i 2010/31, queobliga, entre d'altres, a la certificació energètica, no només d'edificis nous, sinó també delsedificis antics que es trobin en situació de lloguer o compra/venta. L'objecte del present projecte és fer un catàleg de solucions constructives típiques, que esdonen abans de l'aprovació i entrada en vigor del CTE a partir del RD 314/2006. El catàlegconsta de variacions en l'evolvent de l'edifici, variacions en la contribució solar i variacionsen les instal•lacions de climatització. Cadascuna d'aquestes combinacions s'analitzarà ambels programaris LIDER i CALENER, de forma que s'obtindrà una estimació de les emissionsde CO2 per a cada cas, i a partir del projecte de real decret de certificació d'edificis existents(encara en tramitació a data de redacció del full de projecte d'aquest projecte), s'assignaràuna qualificació energètica. D'aquesta manera, es podrà tenir una primera aproximació de laqualificació energètica dels edificis existents, a partir de les seves característiques.Pel que fa a les especificacions, es definirà un edifici unifamiliar aïllat, s'establiran un conjuntd'evolvents, s'especificaran quins espais de l'edifici són habitables i quins no, i es definiranun conjunt d'instal•lacions.L'abast de l'estudi comprendrà els edificis situats a la zona climàtica C2 de la província deGirona. Aquesta zona inclou els edificis que es troben a una alçada del nivell del mar deentre 0 m a 342 m (dins la província de Girona)
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BACKGROUND: Most patients with glioblastoma are older than 60 years, but treatment guidelines are based on trials in patients aged only up to 70 years. We did a randomised trial to assess the optimum palliative treatment in patients aged 60 years and older with glioblastoma. METHODS: Patients with newly diagnosed glioblastoma were recruited from Austria, Denmark, France, Norway, Sweden, Switzerland, and Turkey. They were assigned by a computer-generated randomisation schedule, stratified by centre, to receive temozolomide (200 mg/m(2) on days 1-5 of every 28 days for up to six cycles), hypofractionated radiotherapy (34·0 Gy administered in 3·4 Gy fractions over 2 weeks), or standard radiotherapy (60·0 Gy administered in 2·0 Gy fractions over 6 weeks). Patients and study staff were aware of treatment assignment. The primary endpoint was overall survival. Analyses were done by intention to treat. This trial is registered, number ISRCTN81470623. FINDINGS: 342 patients were enrolled, of whom 291 were randomised across three treatment groups (temozolomide n=93, hypofractionated radiotherapy n=98, standard radiotherapy n=100) and 51 of whom were randomised across only two groups (temozolomide n=26, hypofractionated radiotherapy n=25). In the three-group randomisation, in comparison with standard radiotherapy, median overall survival was significantly longer with temozolomide (8·3 months [95% CI 7·1-9·5; n=93] vs 6·0 months [95% CI 5·1-6·8; n=100], hazard ratio [HR] 0·70; 95% CI 0·52-0·93, p=0·01), but not with hypofractionated radiotherapy (7·5 months [6·5-8·6; n=98], HR 0·85 [0·64-1·12], p=0·24). For all patients who received temozolomide or hypofractionated radiotherapy (n=242) overall survival was similar (8·4 months [7·3-9·4; n=119] vs 7·4 months [6·4-8·4; n=123]; HR 0·82, 95% CI 0·63-1·06; p=0·12). For age older than 70 years, survival was better with temozolomide and with hypofractionated radiotherapy than with standard radiotherapy (HR for temozolomide vs standard radiotherapy 0·35 [0·21-0·56], p<0·0001; HR for hypofractionated vs standard radiotherapy 0·59 [95% CI 0·37-0·93], p=0·02). Patients treated with temozolomide who had tumour MGMT promoter methylation had significantly longer survival than those without MGMT promoter methylation (9·7 months [95% CI 8·0-11·4] vs 6·8 months [5·9-7·7]; HR 0·56 [95% CI 0·34-0·93], p=0·02), but no difference was noted between those with methylated and unmethylated MGMT promoter treated with radiotherapy (HR 0·97 [95% CI 0·69-1·38]; p=0·81). As expected, the most common grade 3-4 adverse events in the temozolomide group were neutropenia (n=12) and thrombocytopenia (n=18). Grade 3-5 infections in all randomisation groups were reported in 18 patients. Two patients had fatal infections (one in the temozolomide group and one in the standard radiotherapy group) and one in the temozolomide group with grade 2 thrombocytopenia died from complications after surgery for a gastrointestinal bleed. INTERPRETATION: Standard radiotherapy was associated with poor outcomes, especially in patients older than 70 years. Both temozolomide and hypofractionated radiotherapy should be considered as standard treatment options in elderly patients with glioblastoma. MGMT promoter methylation status might be a useful predictive marker for benefit from temozolomide. FUNDING: Merck, Lion's Cancer Research Foundation, University of Umeå, and the Swedish Cancer Society.
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Weekly letting report
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Référence bibliographique : Weigert, 342