Differences in lung function, growth parameters and frequency of hospital admissions between adolescents with cystic fibrosis-related diabetes and controls

As survival of patients with CF increases,glucose intolerance and cystic fibrosisrelated diabetes (CFRD),ar e increasingly recognised common complications. CFRD may be preceded by a pre-diabetic state. Using markers identified as being associated with CFRD may improve targeted screening. Aim: To identify features consistently predicting CFRD in paediatric patients. Patients diagnosed with CFRD between January 1997–January 2002 were compared with age and sex matched controls. Clinical,micr obiological, and hospitalisation data was collected at time of CFRD diagnosis,and at six monthly intervals for 3 yr prior to diagnosis. Eight patients with CFRD were identified,mean age 13.7 yr (S.D. 3.49) at time of diagnosis. Control patients underwent OGTT to ensure normal glucose tolerance. Patients with CFRD had a lower FEV1 up to 12 months prior to diagnosis however, this was only significant at diagnosis. There was no difference in weight and height z scores between the 2 groups; however,the decrease in weight and height z scores in the CFRD group over 3 yr prior to diagnosis was significant. Mean number of days in hospital and admissions per patient significantly increased in the CFRD group,6 months prior to diagnosis. No other significant differences were observed between the 2 groups. Conclusions: This study has shown a difference in lung function,gr owth parameters and frequency of hospital admissions between patients with CFRD and controls. These differences may be utilised as tools for targeted screening in the paediatricyadolescent population. Further larger scale studies are required to improve guidelines for targeted screening in this population.

Isolation and characterization of a cone snail protease with homology to CRISP proteins of the pathogenesis-related protein superfamily

The pathogenesis-related (PR) protein superfamily is widely distributed in the animal, plant, and fungal kingdoms and is implicated in human brain tumor growth and plant pathogenesis. The precise biological activity of PR proteins, however, has remained elusive. Here we report the characterization, cloning and structural homology modeling of Tex31 from the venom duct of Conus textile. Tex31 was isolated to >95% purity by activity-guided fractionation using a para-nitroanilide substrate based on the putative cleavage site residues found in the propeptide precursor of conotoxin TxVIA. Tex31 requires four residues including a leucine N-terminal of the cleavage site for efficient substrate processing. The sequence of Tex31 was determined using two degenerate PCR primers designed from N-terminal and tryptic digest Edman sequences. A BLAST search revealed that Tex31 was a member of the PR protein superfamily and most closely related to the CRISP family of mammalian proteins that have a cysteine-rich C-terminal tail. A homology model constructed from two PR proteins revealed that the likely catalytic residues in Tex31 fall within a structurally conserved domain found in PR proteins. Thus, it is possible that other PR proteins may also be substrate-specific proteases.

Sex- and race-related differences in cross-sectional geometry and bone density of the femoral mid-shaft in older adults

Background : Femoral shaft fracture incidence increases in older adults and is associated with low-energy trauma. Apart from bone density, the distribution and size of bone contributes to its strength. Aim : To examine if bone geometry and density of the femoral mid-shaft in older adults differs by sex and race, we studied 197 White women, 225 Black women, 242 White men, and 148 Black men aged 70-79 years participating in the Health, Aging, and Body Composition study; a prospective cohort study in the USA. A secondary purpose of the study was to examine the association of site-specific muscle and fat to bone geometry and density. Subjects and methods : Subjects were community-dwelling and reported no difficulty walking one-quarter of a mile or climbing stairs. Mid-femoral volumetric bone mineral density (vBMD, mg cm -3 ), total area (TA), cortical area (CA), medullary area (MA), cross-sectional moments of inertia (CSMI: I x , I y , J ), and muscle and fat areas (cm 2 ) were determined by computed tomography (CT; GE CT-9800, 10 mm slice thickness). Results : vBMD was greater in men than women with no difference by race ( p < 0.001). Bone areas and area moments of inertia were also greater in men than women ( p < 0.001), with Black women having higher values than White women for TA and CA. Standardizing geometric parameters for body size differences by dividing by powers of femur length did not negate the sex difference for TA and MA. Significant differences ( p < 0.05) among the four groups also remained for I x and J . Mid-thigh muscle area was an independent contributor to TA in all groups (Std beta = 0.181-0.351, p < 0.05) as well as CA in women (Std beta = 0.246-0.254, p < 0.01) and CSMI in White women (Std beta = 0.175-0.185, p < 0.05). Further, muscle area was a significant contributor to vBMD in Black women. Conclusion : These results indicate that bone geometry and density of the femoral diaphysis differs primarily by sex, rather than race, in older well-functioning adults. In addition, site-specific muscle area appears to have a potential contributory role to bone geometry parameters, especially in women.

Injury related risk behavior - a study of Australian skydivers

Risk taking behaviour has been identified as an important host-related determinant of injury in young adults. The aim of this study is to clarify the relationship between the two key elements of risk taking behaviour - ie, risk assessment and risk acceptance - in participants of a high risk sporting activity. Skydivers registered with the Australian Parachute Federation were sampled at several jump meetings held at three 'drop-zones' in North Eastern Australia. A cross sectional survey of 215 skydivers ascertained each subject's risk assessment of each of nine hypothetical sky diving scenes and whether or not they would jump in the described conditions. Variables which independently predicted an individual's risk assessment were age group (p < 0.05), gender (p < 0.05) and scene details (p < 0.001). Risk assessment was found to be a statistically significant predictor of the decision to jump, with a 22% decrease in the odds of jumping with every unit increase in risk assessment (OR = 0.78: 95% Cl; 0.76, 0.80). Gender was also found to be a statistically significant predictor of the decision to jump, with males being 19% more likely to jump than females, after controlling for age, experience, currency and risk assessment (OR = 1.19: 95% CI; 1.04, 1.38). The importance of these results is that, by quantifying the relationship between two key elements of risk taking behaviour and several important host factor determinants, they facilitate more informed discussion about the possible role of risk taking behaviour in the causation of injury.

Path-dependence, expectativas e regulação econômica : elementos de análise a partir de uma perspectiva pós-keynesiana

O artigo busca fazer uma relação entre a ocorrência de path-dependence, a natureza expectacional do investimento e as flutuações econômicas, a partir de um referencial pós-keynesiano de análise. Em um ambiente não-ergódico, a fim de que o sistema tenha uma relativa estabilidade no tempo, a regulação econômica requer muito mais do que simples ajustamentos incrementais. Tornam-se necessárias, e possíveis, modificações qualitativas do sistema econômico. Tais modificações são analisadas a partir do conceito de bifurcação.

Imagens da escola como mediadoras do processo formativo dos jovens no ensino da arte: diálogos com a história, memória e ambientes intraescolares

Esta pesquisa apresenta as imagens da escola como mediadoras do processo formativo dos jovens no ensino da Arte em diálogo com a história, memória e ambientes intraescolares. Inscreve-se no debate produzido pela linha de pesquisa em Educação e Linguagens. Analisa a formação dos jovens numa turma do terceiro ano do Ensino Médio na Escola Estadual de Ensino Médio “Hunney Everest Piovesan”, localizada no município de Cariacica no Estado do Espírito Santo. O estudo foi realizado em 2013 e tem como objetivo analisar as imagens escolares como mediadoras na formação dos estudantes do Ensino Médio no ensino da Arte em diálogo com a história, memória e ambientes intraescolares. Ao mesmo tempo, por meio de trabalho colaborativo, contribui para (re)construção da história da instituição, significando-a junto aos alunos e comunidade escolar. Por meio de intervenção artística com imagens da escola propõe reflexão crítica, analisando a formação dos jovens no terceiro ano do Ensino Médio. Para compreender os conceitos de mediação e meio social, estabelece um diálogo com as obras de Lev Semenovith Vigotski. A partir dos estudos de Maria Ciavatta e Schütz–Foerste procura entender a mediação imagética e sua dimensão educativa. Dialoga ainda com Frago, Escolano e Buffa, ampliando as reflexões sobre os ambientes intraescolares, dimensionando a imagética desses espaços e o senso de pertencimento à escola a partir da impregnação pela história e memória. A investigação pauta-se nos referenciais do método qualitativo e colaborativo de pesquisa. A produção dos dados contou com o recolhimento e análise documental de um conjunto de fontes primárias e secundárias formadas por livro de registro de funcionários da escola da década de 1970, diários de classe, recortes de jornais, convites de formaturas e registros fotográficos escolares dessa mesma década até a atualidade. Além desses documentos históricos, foram analisadas entrevistas de antigos alunos e questionários dos alunos do terceiro ano do Ensino Médio da instituição. Relata brevemente experiências de curto intercâmbio acadêmico realizado na Universidade de Ancara, na Turquia, com o objetivo de ampliar os horizontes de referência sociocultural, em especial com o contexto educacional do Ensino Médio euroasiático, identificando os espaços de formação dos jovens no contexto turco e suas relações com a educação brasileira. Esta experiência apresentada não integra a análise desta dissertação, mas projeta a discussão para novos estudos. A análise se elabora a partir da triangulação, entre outros, do referencial teórico com o processo de intervenção, produção de dados e no debate acadêmico em diferentes contextos. A partir da caminhada acadêmica permeada pela história e memória, inferimos que as imagens escolares medeiam o processo formativo dos jovens do terceiro ano do Ensino Médio no ensino da Arte. Contribuem para o cultivo da memória escolar, enquanto presença impregnada pela história da instituição, por meio da imagética dos seus ambientes intraescolares. Constatamos ainda que as imagens colaboram para o (re)conhecimento por parte desses sujeitos do seu papel ativo, autônomo e transformador da realidade escolar na qual estão inseridos.

Projovem adolescente em Venda Nova do Imigrante-ES e a vida dos jovens : conexões, capturas, escapes e apropriações

Esta dissertação teve como objetivo acompanhar os efeitos que o Projovem Adolescente no município de Venda Nova do Imigrante-ES tem produzido na vida dos jovens que integraram o serviço e como eles se apropriaram desse espaço. Quais as interferências e ressonâncias produzidas na trajetória de vida desses jovens que participam do Projovem Adolescente? A metodologia da pesquisa abarcou leitura de documentos relacionados à política nacional de assistência social, dados do CRAS do município relativos ao Projovem Adolescente e conversas com seis jovens que participaram do primeiro coletivo do serviço no período de 2010/2011. Partindo da contribuição de autores como Michel Foucault, traçamos análises de forma a discutir as interferências do biopoder nas políticas para juventude, os atravessamentos histórico-culturais presentes no município e apontamos as resistências e escapes dos jovens às tentativas totalizantes de captura de suas vidas. Todo o trajeto da pesquisa foi realizado a partir de uma estratégia metodológica em que esses jovens falassem por si, desconstruindo relações hegemônicas de tutela e aprisionamentos existenciais que teimam incidir sobre a juventude.

Morphological, physical and pedogenetic attributes related to water yield in small watersheds in Guarapari/ES, Brazil

Soil characteristics related to the genesis, land use and management are important factors in water dynamics in watersheds. This study evaluated physical, morphological and pedogenetic attributes related to water yield potential in small watersheds in Guarapari, ES, Brazil. The following representative profiles were selected, morphologically described and sampled in area of Atlantic Forest domain: Lithic Udifolists, Oxyaquic Udifluventes, Typic Paleudults, Typic Hapludults, Typic Hapludox, Oxic Dystrudepts and Typic Endoaquents. Samples were collected in the soil profiles for physical analysis. Measurements of field-saturated hydraulic conductivity and soil penetration resistance were perfomed in some profiles, which were under different uses. The Endoaquents of Limão Creek can be considered efficient as temporary water reservoirs. However, the use of artificial drainage tends to reduce this effect. Differential erosion was detected by the sand texture on the surface of the Typic Paleudults due to the low degree of clay flocculation, slope, high resistance to the penetration and low hydraulic conductivity of the Bt horizon, making it necessary to adopt soil management practices to increase the water infiltration. Under pasture, mainly in the cattle trails where the trampling is more intense, there was high resistance to penetration in the superficial layers of the Typic Hapludults. The Typic Hapludox have the greatest potential for water yield in the small watersheds because of its greater extent in the headwaters and their morphological and physical characteristics, which can result in increased aquifer recharge.

Effects of Age-Related Cognitive Deficits on EEG Phase Coherence

Body and brain undergo several changes with aging. One of these changes is the loss of neuroplasticity, which leads to the decrease of cognitive abilities. Hence the necessity of stopping or reversing these changes is of utmost importance to contemporary society. In the present work, electroencephalogram (EEG) markers of cognitive decline are sought whilst the subjects perform the Wisconsin Card Sorting Test (WCST). Considering the expected age-related cognitive deficits, WCST was applied to young and elder participants. The results suggest that coherence on theta and alpha EEG rhythms decrease with aging and increase with performance. Additionally, theta phase coherence seems more sensitive to performance, while alpha synchronization appears as a potential ageing marker.

Cognitive intervention protocol for age-related memory impairments

With the number of elderly people increasing tremendously worldwide, comes the need for effective methods to maintain or improve older adults' cognitive performance. Using continuous neurofeedback, through the use of EEG techniques, people can learn how to train and alter their brain electrical activity. A software platform that puts together the proposed rehabilitation methodology has been developed: a digital game protocol that supports neurofeedback training of alpha and theta rhythms, by reading the EEG activity and presenting it back to the subject, interleaved with neurocognitive tasks such as n-Back and Corsi Block-Tapping. This tool will be used as a potential rehabilitative platform for age-related memory impairments.

Certification and integration of environment with quality and safety – a path to sustained success

According to Wright [1] certification of products and processes began during the 1960’s in the manufacturing industry, as a tool to control and assure the quality/conformity of products and services provided by suppliers to customers/consumers. Thus, the series of ISO 9000 was published first time, in 1987 and it was been created with a flexible character, to be reviewed periodically. Later, were published others normative references, which highlight the ISO 14001 in 1996 and OHSAS 18001 in 1999. This was also, the natural sequence of the certification processes in the organizations, i.e., began with the certification of quality management systems (QMS) followed by the environmental management systems (EMS) and after for the Occupational Health and Safety Management System (OHSMS). Hence, a high percentage of organizations with an EMS, in accordance with the ISO 14001, had also implemented, a certified QMS, in accordance with ISO 9001. At first the implementation of a QMS was particularly relevant in high demanding activity sectors, like the automotive and aeronautical industries, but it has rapidly extended to every activity sector, becoming a common requisite of any company worldwide and a factor of competitiveness and survival. Due to the increasingly demanding environmental legislation in developed countries, companies nowadays are required to seriously take into consideration not only environmental aspects associated to the production chain itself, but also to the life cycle of their products.

O desenvolvimento dos "Diagnosis Related Groups"- DRGs. Metodologia de classificação de pacientes hospitalares

É descrito o processo de desenvolvimento do sistema de classificação de pacientes internados em hospitais que atendem casos agudos, denominada Diagnosis Relatd Group - DRGs, desenvolvido e difundido por pesquisadores da Universidade de Yale, USA. Esse sistema vem a ser um instrumento que permite a mensuração do produto hospitalar, principalmente sob o ponto de vista gerencial. São apresentadas considerações acerca do que é entendido como produto hospitalar, seguindo nos meandros do desenvolvimento dos primeiros DRGs, até a mais recente revisão do sistema. É descrita sua utilização em alguns países e diversos usos potenciais desse sistema, que abrangem desde o uso para pagamento a instrumento de controle de qualidade.

Health related quality of life in patients with refractory chronic heart failure undergoing cardiac resynchronization: type of therapeutic response

The benefits of cardiac resynchronization therapy (CRT) in the health-related quality of life (HRQL) are largely demonstrated in selected patients with severe congestive heart failure (CHF). However, the differences between responders and non-responders, with regard to the effect of CRT in the various dimensions that constitute HRQL are still a matter of discussion. Objective: To evaluate the impact of CRT on the HRQL of patients with CHF refractory to optimal pharmacological therapy, within 6 months after CRT. Methods: 43 patients, submitted to successful implantation of CRT, were evaluated in hospital just before intervention and in the outpatient clinic within 6 months after CRT. HRQL was analyzed based on the Kansas City Cardiomyopathy Questionnaire (KCCQ). Patients were classified as super-responders (ejection fraction of left ventricle - LVEF - ≥45% post-CRT), n=15, responders (sustained improvement in functional class and LVEF increased by 15%), n=19, and non-responders (no clinical or LVEF improvement), n=9. Results: In the group of super-responders, CRT was associated with an improvement in HRQL for the various fields and sums assessed (ρ<0.05); in responders, CRT has been associated with an improvement of HRQL in the various fields and sums, except in the self-efficacy dimension (ρ<0.05); in non-responders, CRT was not associated with improvement of HRQL. Conclusion: In a population with severe CHF undergoing CRT, the patients with clinical and echocardiographic positive response, obtained a favorable impact in all dimensions of HRQL, while the group without response to CRT showed no improvement. These data reinforces the importance of HRQL as a multidimensional tool for assessment of benefits in clinical practice.

Impacto da integração dos veículos eléctricos nos edifícios multi-habitacionais, nas redes de distribuição de baixa tensão e no diagrama de carga nacional

Associado à escassez dos combustíveis fósseis e ao desejado controlo de emissões nocivas para a atmosfera, assistimos no mundo ao desenvolvimento do um novo paradigma — a mobilidade eléctrica. Apesar das variações de maior ou menor arbítrio político dos governos, do excelente ou débil desenvolvimento tecnológico, relacionados com os veículos eléctricos, estamos perante um caminho, no que diz respeito à mobilidade eléctrica, que já não deve ser encarado como uma moda mas como uma orientação para o futuro da mobilidade. Portugal tendo dado mostras que pretende estar na dianteira deste desafio, necessita equacionar e compreender em que condições existirá uma infra-estrutura nacional capaz de fazer o veículo eléctrico vingar. Assim, neste trabalho, analisa-se o impacto da mobilidade eléctrica em algumas dessas infra-estruturas, nomeadamente nos edifícios multi-habitacionais e redes de distribuição em baixa tensão. São criados neste âmbito, quatro perfis de carregamento dos EVs nomeadamente: nas horas de chegada a casa; nas horas de vazio com início programado pelo condutor; nas horas de vazio controlado por operador de rede (“Smart Grid”); e um cenário que contempla a utilização do V2G. Com a obrigação legal de nos novos edifícios serem instaladas tomadas para veículos eléctricos, é estudado, com os cenários anteriores a possibilidade de continuar a conceber as instalações eléctricas, sem alterar algumas das disposições legais, ao abrigo dos regulamentos existentes. É também estudado, com os cenários criados e com a previsão da venda de veículos eléctricos até 2020, o impacto deste novo consumo no diagrama de carga do Sistema Eléctrico Nacional. Mostra-se assim que a introdução de sistemas inteligentes de distribuição de energia [Smartgrid e vehicle to grid” (V2G)] deverá ser encarada como a solução que por excelência contribuirá para um aproveitamento das infra-estruturas existentes e simultaneamente um uso acessível para os veículos eléctricos.

Paleomagnetic study of the Great Foum Zguid dyke (southern Morocco): A positive contact test related to metasomatic processes

When a paleomagnetic pole is sought for in an igneous body, the host rocks should be subjected to a contact test to assure that the determined paleopole has the age of the intrusion. If the contact test is positive, it precludes the possibility that the measured magnetization is a later effect. Therefore, we investigated the variations of the remanent magnetization along cross-sections of rocks hosting the Foum Zguid dyke (southern Morocco) and the dyke itself. A positive contact test was obtained, but it is mainly related with Chemical/Crystalline Remanent Magnetization due to metasomatic processes in the host-rocks during magma intrusion and cooling, and not only with Thermo-Remanent Magnetization as ordinarily assumed in standard studies. Paleomagnetic data obtained within the dyke then reflect the Earth magnetic field during emplacement of this well-dated (196.9 +/- 1.8 Ma) intrusion.