Psychotherapeutic work with Families with Life-threatening Maternal Illness

This exploratory research study describes a child and adolescent psychotherapeutic clinical service offered to children/adolescents and their families with mothers with a life-threatening illness. The clinical service itself was also exploratory in nature. The research objectives of the study were (i) to explore whether this form of clinical work could be beneficial for such families in relieving distress and supporting their development; (ii) to discover the factors at play within and between the family members using an adaptation of Grounded Theory research methodology; and (iii) to add to the knowledge base for adults – family members and professionals – relating to, and dealing with, such children and adolescents. Descriptions and discussion of the therapeutic input and research study are given. Symptoms, which included emotional, behavioural, psychological, learning, and interpersonal difficulties, decreased in all the children/adolescents who were offered clinical treatment within an outpatient multidisciplinary Tier 3 Child and Adolescent Service (CAMHS). Six Themes were identified across the cases and these were named: Engagement, Parental Concern, Impact of Mother’s Illness, Defences, Sustaining Factors and Feeling Different. These Themes are discussed in the light of relevant published research. A literature review was undertaken and focuses on: epidemiological context; children’s understanding of death; impact of parental bereavement in childhood; the mourning process; anticipatory grief; psychoanalysis: mourning and trauma; children’s play and drawings as communication; and psychosocial therapeutic services. The thesis has particular relevance for child and adolescent psychotherapists and other mental health professionals who work within hospital and hospice settings.

Trafficking in human beings for for forced labour in domestic and international law: a comparative legal study of the kingdom of Saudi Arabia and the United Kingdom

This thesis examines the effect of combating of human trafficking as a crime. Special emphasis has been placed on forced labour and the rights of trafficked victims and their protection. The study explores various legislations undertaken at regional, national and international levels and considers rights of trafficked victims under international human rights and Islamic rights. The aim of the thesis is to provide a critical and comparative analysis of the legal systems of the Kingdom of Saudi Arabia (KSA) and the United Kingdom (UK) in terms of human trafficking. The thesis consists of eight chapter; each covering a different aspect of the study. It begins by providing background information regarding the issue of human trafficking and proceeds to examine developments of legal frameworks across the two jurisdictions to combat this crime and penalize the criminals. It seeks to examine the legal system pertaining to human trafficking for forced labour and analyse the three distinct platforms, that is, prevention, protection, and punishment, by comparing the legal systems of the KSA and the UK. The examination of both countries aims to identify the strength and weaknesses of the KSA system as compared to the UK system. Thus, it concludes that the KSA can improve its ranking from Tier 2 watch list to Tier 1 if reforms are introduced in the legislation and enforcement domains. The study also demonstrates how the UK and the KSA portray ‘human trafficking’ in their regional laws. A problem often faced during the information-gathering and investigation stages is the lack of available evidence against traffickers, a particular issue in the KSA. The thesis concludes that the transnational aspect of this phenomenon makes it necessary to establish a thorough and comprehensive legal framework to cover all matters pertaining to this crime, including the protection of victims and punishment of criminals in the KSA and the UK, including immigration and ‘kafala’ strategies that may be of value in future researches.

Fatores associados e preditores de quedas em idosos domiciliados de acordo com a Classificação Internacional da Funcionalidade, Incapacidade e Saúde

Objetivo geral da pesquisa foi identificar os fatores associados e preditivos de quedas em idosos domiciliados em uma cidade do Rio Grande do Sul, Brasil, considerando as características sociodemográficas e epidemiológicas e utilizando-se de fatores ambientais da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Objetivos específicos: identificar as características sociodemográficas e epidemiológicas de idosos domiciliados em uma cidade do Rio Grande do Sul, Brasil; descrever os fatores sociodemográficos e epidemiológicos que influenciam nas quedas em idosos domiciliados; Relacionar os fatores ambientais da Classificação Internacional de Funcionalidade, Incapacidade e Saúde em idosos domiciliados com riscos de quedas. Pesquisa epidemiológica transversal, ocorrida de junho a julho de 2013, com 167 idosos das áreas de abrangência de uma unidade básica de saúde. Critérios de inclusão na pesquisa: ambos os sexos, cadastrados e com residência fixa nas áreas de abrangência de uma unidade básica de saúde. Critérios de exclusão: idosos com alterações cognitivas. Utilizou-se entrevista estruturada com três etapas: levantamento das características dos idosos investigados; questões relacionadas às quedas; informações sobre os fatores ambientais da Classificação Internacional de Funcionalidade, Incapacidade e Saúde. Os dados foram agrupados para tratamento estatístico/descritivo. A média das idades 71 anos, com desvio padrão de 7,1. A maioria dos idosos era do sexo feminino, casados, com escolaridade de quatro e oito anos, residindo com filhos e companheiro, aposentados e com renda de um salário mínimo. As doenças mais prevalentes foram circulatórias, osteomusculares, e endócrinas e os idosos apresentaram pelo menos uma comorbidade. Dos 167 idosos, 65 caíram nos últimos doze meses, no ambiente domiciliar, com prevalência em: banheiro, cozinha e na rua, sendo as calçadas as mais destacadas. A maior proporção de permanência no chão foi de dez minutos, e a maioria dos idosos, após as quedas, não procuraram os serviços de saúde. Como tratamento para as quedas, obteve-se o não cirúrgico. Quanto à Classificação Internacional da Funcionalidade, Incapacidade e Saúde, houve destaque para o uso de medicações como fator influente nas quedas dos idosos domiciliados. Percebe-se a importância de avaliação constante por parte dos profissionais de saúde sobre os idosos caidores e não-caidores, no sentido de identificar os fatores de riscos intrínsecos e extrínsecos para implementar estratégias de prevenção que compreendam reabilitação da força muscular, equilíbrio e capacidade funcional, redução da polifarmácia, educação para o autocuidado e um olhar do enfermeiro voltado para os períodos e locais de maior incidência de quedas, melhorando desta forma a qualidade de vida dos idosos residentes em diferentes contextos. A pesquisa traz como contribuição social um re-olhar acerca do redimensionamento do cuidado à pessoa idosa que teve queda no próprio ambiente, a partir da Classificação Internacional de Funcionalidade, Incapacidade e Saúde.

Factors affecting fertility in frozen-thawed boar sperm

Frozen-thawed boar sperm holds the potential to have an impact on the future of the swine industry. Utilization of this technology could improve a swine producer’s ability to access top-tier genetics from around the world, to improve efficiency, profitability, and the quality of product to meet consumer demands. Effective application of frozen-thawed sperm can help reduce the potential risk associated with devastating economic loss due to the spread of disease. Frozen storage of boar sperm also provides a safeguard in the event of disease outbreaks, as genetic material from paternal lines can be preserved and banked for repopulation purposes. Historically these benefits have been masked by reduction in fertility measures such as litter size. The reduced fertility results from the damage sustained by the sperm cell during cryopreservation. However, increased understanding of this damage has lead to improved cryopreservation methods, ultimately increasing post-thaw viability and fertility. Enhancements in breeding technology have also resulted in a better understanding of the AI methods required to achieve acceptable farrowing rates and litter size. Fertility following AI with frozen-thawed sperm is approaching that of liquid stored sperm, and producers may soon reap the benefits of this technology. This thesis will outline the current swine industry, opportunities for utilizing frozen-thawed sperm, the main components of sperm, why they are susceptible to damage, and current freezing and breeding practices. Objective 1 was to develop a cryopreservation protocol for our lab that resulted in consistent post-thaw motility ( ≥ 40%) that would eventually be used by Illinois boar studs for domestic and international sale of frozen sperm. Evaluation with both manual microscopy and CASA methods were conducted to verify quality. A preliminary breeding trial was then conducted to test the fertility of sperm frozen with this method. There were 41 ejaculates from 23 boars used for freezing. Sperm were frozen at 1.4x109 sperm/mL, averaging 55.61.1% (meanSE) motility, following thaw. The samples assessed were not different (P>0.05) in motility when compared with manual or CASA systems, and results were most reliable at a 1:40 sperm dilution. In the preliminary breeding trial, gilts (n=14) were inseminated with either a single (n=10) or double (n=4) AI using 1, 2, or 4x109 motile, frozen-thawed sperm. Overall, the resulting pregnancy rates averaged 71.4% and numbers of normal fetuses per litter averaged 15.51.3 per litter. A feasibility study for freezing cost per ejaculate was estimated at $275/ejaculate or $11/dose of frozen-thawed semen at standard doses of 5x109 total frozen-thawed sperm. This cost estimate did not include genetic value, fixed equipment costs, depreciation, or variable lab space fees. Objective 2 focused on the proper methods for breeding with frozen-thawed boar sperm to achieve fertility. Our hypothesis was that increased numbers of inseminations and increased numbers of motile frozen-thawed sperm would improve pregnancy rate and litter size. Results showed acceptable fertility at high sperm numbers, but also the optimal method for insemination with the lowest dose tested. Gilts (n=111) responded to synchronization methods and were bred with 1, 2, or 4x109 motile frozen-thawed sperm from six boars using a single AI at 32 h, or a double AI, with the first AI at 24 and 32 h following estrus. Ultrasound was conducted at 12 h intervals to estimate the time of ovulation. On day 32 of gestation, overall pregnancy rate (73%) and number of normal fetuses per litter (10.80.5) across all treatments did not differ, and were not affected by number of motile sperm, or the interaction of number of motile sperm and number of inseminations. However, the number of inseminations tended to affect (P=0.14) the number of normal fetuses. Litter size increased with a double AI compared to single AI. Multiple inseminations helped to allow insemination to occur close to ovulation in response to variation in the time of ovulation. Both pregnancy rate and number of normal fetuses were greater when the time of the AI at 32 h occurred closer to the estimated time of ovulation (P<0.05). In addition, other factors such as presence of an abnormal ovary at day 30 decreased (P<0.001) pregnancy rate, while boar affected number of normal fetuses (P<0.01). Analysis of our data using a fertility index revealed doses of 2x109 motile sperm with multiple AI can achieve acceptable fertility with use of less sperm, when compared to AI using 4x109 motile sperm. The methods described here will investigate the potential for improved fertility when using frozen-thawed sperm, while accounting for variation in time of ovulation.

Determinantes da sustentabilidade financeira em diversos níveis de governo

Dissertação de Mestrado, Ciências Económicas e Empresariais, 18 de Julho de 2016, Universidade dos Açores.

Assessing the safety of Pseudomonas putida introduction in the environment: an overview of ecotoxicological tests.

Risk assessment guidelines for the environmental release of microbial agents are performed in a tiered sequence which includes evaluation of exposure effects on non target organisms. However, it becomes important to verify whether environmental risk assessment from temperate studies is applicable to tropical countries, as Brazil. Pseudomonas putida is a bacteria showing potential to be used for environmental applications as bioremediation and plant disease control. This study investigates the effects of this bacteria exposure on rodents and aquatic organisms (Daphnia similes) that are recommended to be used as non-target organism in environmental risk assessments. Also, the microbial activity in three different soils under P. putida exposure was evaluated. Rats did not show clinical alterations, although the agent was recovered 16 h after the exposure in lung homogenates. The bacteria did not reduce significantly the reproduction and survival of D. similis. The soil enzymatic activities presented fluctuating values after inoculation with bacteria. The measurement of perturbations in soil biochemical characteristics is presented as an alternative way of monitoring the overall effects of the microbial agent to be introduced even in first stage (Tier I) of the risk assessment in tropical ecosystems.

An updated evolutionary classification of CRISPR–Cas systems

The evolution of CRISPR–cas loci, which encode adaptive immune systems in archaea and bacteria, involves rapid changes, in particular numerous rearrangements of the locus architecture and horizontal transfer of complete loci or individual modules. These dynamics complicate straightforward phylogenetic classification, but here we present an approach combining the analysis of signature protein families and features of the architecture of cas loci that unambiguously partitions most CRISPR–cas loci into distinct classes, types and subtypes. The new classification retains the overall structure of the previous version but is expanded to now encompass two classes, five types and 16 subtypes. The relative stability of the classification suggests that the most prevalent variants of CRISPR–Cas systems are already known. However, the existence of rare, currently unclassifiable variants implies that additional types and subtypes remain to be characterized.

Patient experiences of a bariatric group programme for managing obesity:a qualitative interview study

Objectives: People with obesity experience a range of physical and psychological ill-health outcomes. This study examined patients’ experiences of a group-based programme for the management of morbid obesity delivered within the UK National Health Service. The focus of the study was on the emerging dynamic of the group and patients’ perceptions of its impact on health outcomes. Design: A qualitative interview study was conducted and involved patients recruited from a Tier 3 bariatric service in South West England. Verbatim transcripts were analysed using thematic analysis. Methods: Twenty patients (12 females) with a BMI ≥ 35 kg/m2 participated in a semi-structured one-to-one interview. Participants had been registered with the bariatric service for at least 6 months. None of the participants had had bariatric surgery. Results: Most participants felt that they had benefited from participating in the group programme and talked about the group as a resource for lifestyle change. Participants’ narratives centred on the emergence of a sense of self based upon their participation in the group: establishing psychological connections to other patients, or shared social identity, was regarded as a key mechanism through which the programme's educational material was accessed, and underpinned the experience of social support within the group. Through interaction with other patients, involving the sharing of personal experiences and challenges, participants came to experience their weight ‘problem’ through a collective lens that they felt empowered them to initiate and sustain individual lifestyle change. Discussion: Bariatric care groups have the potential to support lifestyle change and weight loss and may help address the psychological needs of patients. Nurturing a sense of shared social identity amongst patients with morbid obesity should be a core aim of the care pathway and may provide the foundation for successful translation of dietetic content in group programmes.

El rol de las redes de apoyo transnacional en la evolución del régimen de trata de personas en la región del mekong, 2004-2015

Con el fin de la unipolaridad no sólo se fortalecieron mecanismos de gobernanza global como los Regímenes Internacionales, sino también se fortalecieron actores no estatales. A pesar de la importancia que tomaron estos dos elementos aún no existe una teoría que explique exhaustivamente la relación que existe entre ellos. Es por lo anterior que, la investigación busca responder de qué manera el rol de las Redes de Apoyo Transnacional ha incidido en la evolución del régimen de tráfico de personas en la Región del Mekong. Asimismo tiene como objetivo comprender las relación entre el Régimen y las Redes de Apoyo Transnacional a través de la formulación de un caso de estudio basado en metodologías cualitativas, específicamente, en el análisis teórico-constructivista y el análisis de contenido de documentos producidos por actores estatales y no estatales.