Depresión en pacientes con epilepsia: Revisión sistemática de la literatura

Esta revisión sistemática de la literatura tuvo como objetivo investigar sobre la depresión en personas con epilepsia en la última década (2005-2015), enfocándose en identificar en el paciente con epilepsia: características sociodemográficas, prevalencia de la depresión, tipos de intervención para el manejo de la depresión, factores asociados con la aparición y el mantenimiento de la depresión y por último, identificar las tendencias en investigación en el estudio de la depresión en pacientes con epilepsia. Se revisaron 103 artículos publicados entre 2005 y 2015 en bases de datos especializadas. Los resultados revelaron que la prevalencia de depresión en pacientes con epilepsia es diversa y oscila en un rango amplio entre 3 y 70 %, por otro lado, que las principales características sociodemográficas asociadas a la depresión está el ser mujer, tener un estado civil soltero y tener una edad comprendida entre los 25 y los 45 años. A esto se añade, que los tratamientos conformados por terapia psicológica y fármacos, son la mejor opción para garantizar la eficacia en los resultados del manejo de la depresión en los pacientes con epilepsia. Con respecto a los factores asociados a la aparición de la depresión en pacientes con epilepsia, se identificaron causas tanto neurobiológicas como psicosociales, asimismo los factores principales asociados al mantenimiento fueron una percepción de baja calidad de vida y una baja auto-eficacia. Y finalmente los tipos de investigación más comunes son de tipo aplicado, de carácter descriptivo, transversales y de medición cuantitativa.

Triple objective team mentoring: achieving learning objectives with chemical engineering students

A sophisticated style of mentoring has been found to be essential to support engineering student teams undertaking technically demanding, real-world problems as part of a Project-Centred Curriculum (PCC) at The University of Queensland. The term ‘triple-objective’ mentoring was coined to define mentoring that addresses not only the student’s technical goal achievement but also their time and team management. This is achieved through a number of formal mentor meetings that are informed by a confidential instrument which requires students to individually reflect on team processes prior to the meeting, and a checklist of technical requirements against which the interim student team progress and achievements are assessed. Triple-objective mentoring requires significant time input and coordination by the academic but has been shown to ensure effective student team work and learning undiminished by team dysfunction. Student feedback shows they value the process and agree that the tools developed to support the process are effective in developing and assessing team work and skills with average scores mostly above 3 on a four point scale.

A method to analyse the alignment of core values in collaborative networked organisations

Since collaborative networked organisations are usually formed by independent and heterogeneous entities, it is natural that each member holds his own set of values, and that conflicts among partners might emerge because of some misalignment of values. In contrast, it is often stated in literature that the alignment between the value systems of members involved in collaborative processes is a prerequisite for successful co-working. As a result, the issue of core value alignment in collaborative networks started to attract attention. However, methods to analyse such alignment are lacking mainly because the concept of 'alignment' in this context is still ill defined and shows a multifaceted nature. As a contribution to the area, this article introduces an approach based on causal models and graph theory for the analysis of core value alignment in collaborative networks. The potential application of the approach is then discussed in the virtual organisations' breeding environment context.

Parallel texts alignment

Trabalho apresentado no âmbito do Mestrado em Engenharia Informática, como requisito parcial para obtenção do grau de Mestre em Engenharia Informática

Sexual transmission of hepatitis C virus

In order to contribute to a better understanding of the forms of acquisition of hepatitis C virus (HCV) in Brazil, with special emphasis on sexual transmission, we determined the presence of HCV infection in regular partners and in non-sexual home communicants of blood donors seen at Fundação Pró-Sangue Hemocentro de São Paulo from January 1992 to July 1996. Of 154 blood donors with HCV infection (index cases), 111 had had regular partners for at least 6 months. Sixty-eight of 111 partners were evaluated for HCV infection. Of these, 8 (11.76%) were considered to have current or previous HCV infection; a history of sexually transmissible diseases and index cases with a positive HCV-RNA test were more prevalent among partners with HCV infection. Of the 68 index cases whose partners were studied, 56 had non-sexual home communicants. Of the total of 81 home communicants, 66 accepted to be evaluated for HCV infection. None of them was HCV-positive, suggesting that the high prevalence of HCV infection among partners may be attributed at least partially to sexual transmission.

Hepatite C

Estima-se que cerca de 3% da população mundial esteja infectada pelo vírus da hepatite C. Todos os que receberam transfusão de sangue ou seus componentes e os usuários de drogas podem estar infectados. Procedimentos odontológicos, médicos, tatuagem ou acupuntura também constituem fatores de risco. A infecção se cronifica em até 85% dos indivíduos, com evolução assintomática durante anos ou décadas e apresentação clínica variada. Para o diagnóstico, a determinação do anti-VHC revela-se muito sensível e a confirmação se faz pela determinação do RNA-VHC no sangue; o estadiamento da doença e a avaliação da atividade inflamatória pela biópsia hepática. O tratamento objetiva deter a progressão da doença hepática através da inibição da replicação viral. Devido à baixa eficácia terapêutica aliada a importantes efeitos colaterais do interferon e da ribavirina, esses medicamentos encontram indicações e contra-indicações específicas. Vários fatores preditivos de resposta ao tratamento, principalmente a carga viral e o genótipo do VHC, mostram-se úteis na avaliação dos pacientes.

Value creation in the nursing home real estate investment market - A case study

The underlying thesis examines the value drivers of direct investments in nursing home real estate in Germany. A survey among investors and operators is conducted in order to identify significant value drivers. Moreover, based on survey results, a framework for assessing German nursing home real estate is developed. This is applied in a case-study about the set-up of a nursing home value-add fund which will demonstrate the value creation process of redeveloping an existing nursing home real estate portfolio. Through a concluding analysis the sources of value creation, sensitivities and future prospects of direct investing into German nursing home real estate are concluded.

Hepatitis C prevalence and risk factors in hemodialysis patients in Central Brazil: a survey by polymerase chain reaction and serological methods

An hemodialysis population in Central Brazil was screened by polymerase chain reaction (PCR) and serological methods to assess the prevalence of hepatitis C virus (HCV) infection and to investigate associated risk factors. All hemodialysis patients (n=428) were interviewed in eight dialysis units in Goiânia city. Blood samples were collected and serum samples screened for anti-HCV antibodies by an enzyme-linked immunosorbent assay (ELISA). Positive samples were retested for confirmation with a line immunoassay (LIA). All samples were also tested for HCV RNA by the PCR. An overall prevalence of 46.7% (CI 95%: 42-51.5) was found, ranging from 20.7% (CI 95%: 8.8-38.1) to 90.4% (CI 95%: 79.9-96.4) depending on the dialysis unit. Of the 428 patients, 185 were found to be seropositive by ELISA, and 167 were confirmed positive by LIA, resulting in an anti-HCV prevalence of 39%. A total of 131 patients were HCV RNA-positive. HCV viremia was present in 63.5% of the anti-HCV-positive patients and in 10.3% of the anti-HCV-negative patients. Univariate analysis of risk factors showed that the number of previous blood transfusions, transfusion of blood before mandatory screening for anti-HCV, length of time on hemodialysis, and treatment in multiple units were associated with HCV positivity. However, multivariate analysis revealed that blood transfusion before screening for anti-HCV and length of time on hemodialysis were significantly associated with HCV infection in this population. These data suggest that nosocomial transmission may play a role in the spread of HCV in the dialysis units studied. In addition to anti-HCV screening, HCV RNA detection is necessary for the diagnosis of HCV infection in hemodialysis patients.

One-sided jet at milliarcsecond scales in LSI+61·303

We present Very Long Baseline Interferometry (VLBI) observations of the high mass X-ray binary LSI+61303, carried out with the European VLBI Network (EVN). Over the 11 hour observing run, performed 10 days after a radio outburst, the radio source showed a constant flux density, which allowed sensitive imaging of the emission distribution. The structure in the map shows a clear extension to the southeast. Comparing our data with previous VLBI observations we interpret the extension as a collimated radio jet as found in several other X-ray binaries. Assuming that the structure is the result of an expansion that started at the onset of the outburst, we derive an apparent expansion velocity of 0.003 c, which, in the context of Doppler boosting, corresponds to an intrinsic velocity of at least 0.4 c for an ejection close to the line of sight. From the apparent velocity in all available epochs we are able to establish variations in the ejection angle which imply a precessing accretion disk. Finally we point out that LSI+61303, like SS433 and Cygnus X-1, shows evidence for an emission region almost orthogonal to the relativistic jet.

Characterization of rapeseed (Brassica napus) oils by bulk C, O, H, and fatty acid C stable isotope analyses

Rapeseed (Brassica napus) oils differing in cultivar, sites of growth, and harvest year were characterized by fatty acid concentrations and carbon, hydrogen, and oxygen stable isotope analyses of bulk oils (delta(13)C(bulk), delta(2)H(bulk), delta(18)O(bulk) values) and individual fatty acids (delta(13)C(FA)). The delta(13)C(bulk), delta(2)H(bulk), and delta(18)O(bulk) values were determined by continuous flow combustion and high-temperature conversion elemental analyzer isotope ratio mass spectrometry (EA/IRMS, TC-EA/IRMS). The delta(13)C(FA) values were determined using gas chromatography-combustion isotope ratio mass spectrometry (GC/C/IRMS). For comparison, other C(3) vegetable oils rich in linolenic acid (flax and false flax oils) and rich in linoleic acid (poppy, sunflower, and safflower oils) were submitted to the same chemical and isotopic analyses. The bulk and molecular delta(13)C values were typical for C(3) plants. The delta(13)C value of palmitic acid (delta(13)C(16:0)) and n-3 alpha-linolenic acid (delta(13)C(18:3n-3)) differed (p < 0.001) between rape, flax, and poppy oils. Also within species, significant differences of delta(13)C(FA) were observed (p < 0.01). The hydrogen and oxygen isotope compositions of rape oil differed between cultivars (p < 0.05). Major differences in the individual delta(13)C(FA) values were found. A plant-specific carbon isotope fractionation occurs during the biosynthesis of the fatty acids and particularly during desaturation of C(18) acids in rape and flax. Bulk oil and specific fatty acid stable isotope analysis might be useful in tracing dietary lipids differing in their origin.

Asiakaslähtöinentilaus-toimitus-prosessin kehittäminen räätälöivässä yrityksessä

Tapa, jolla yritys vastaa sen räätälöityvien tuotteiden kysyntään, määrittää yrityksen menestymisen. Sen on ymmärrettävä mikä arvo asiakkaalle syntyy, kun sen yksilökohtaiset tarpeet otetaan huomioon tuotetta räätälöitäessä. Toisaalta, yrityksen on ymmärrettävä kustannus, joka näiden tarpeiden huomioon ottamimisesta syntyy. Yhdistämällä nämä tiedot oikein tilaus-toimitus-prosessin suunnittelussa ja valinnassa voidaan kutakin valittua asiakasta tai asiakasryhmää palvella kannattavasti. Tämän diplomityöntavoite on kehittää tutkimuksen toimeksiantajan Vahterus Oy:n tilaus-toimitus-prosessia. Perusteena ovat kolmen tärkeimmän asiakasryhmän tarpeet sekä tieto nykyisestä prosessista. Tutkimuksen teoreettinen perusta luodaan tutustumalla kirjallisuuteen räätälöinnistä, asiakaslähtöisyydestä sekä toimitus-prosessien eriyttämisestä. Order-winner ja order-qualifier kriteerien selvittäminen ja niiden käyttö oikean prosessin valinnassa muodostaa tutkimuksen teoreettisen ytimen. Empiriaosassa analysoitiin case-yrityksen nykyisen tilaus-toimitus-prosessin toiminta. Prosessin kehittämistyön pohjaksi selvitetettiin case-yrityksen kolmen tärkeimmän asiakasryhmän erityispiirteet ja tarpeet haastattelututkimuksella. tilaus-toimitus-prosessin analyysissä havaittiin huomattavaa asiakasryhmäkohtaista vaihtelua läpimenoajoissa. Tämä johtui tilatun tuotteen tyypistä sekä asiakkaiden erityisvaatimuksista. Haastattelututkimuksessa vahvistuinäkemys asiakasryhmien tilaus-toimitus-prosessille asettamien vaatimuksien selkeistä eroista. Johtopäätöksenä esitetään erilaisia toimitusstrategioita eri asiakasryhmille. Kustannus-tehokkuutta ja nopeutta vaativalle asiakasryhmälle prosessia tehostetaan suunnitteluprosessin automatisoinnilla. Joustavuutta vaativaa, korkeampia kustannuksia sallivaa asiakasryhmää palvellaan paremmin kehittämällä projektihallinnan ja myynnin työkaluja sekä henkilökunnan osaamista. Tutkimuksen tärkein kontribuutio yritykselle oli asiakasryhmien erojen tiedostaminen ja niiden huomioon ottaminen toimitustrategioiden ja organisaation jatkuvassa kehittämisessä.

Logististen palvelukonseptien kehittäminen

VALSSI- (Value Added Logistics Service Support) projektin tavoitteena on uusi varaosalogistiikan liiketoimintamuoto. Se tapahtuu tuomalla lisäarvopalveluita tilaustoimitusprosesseihin lisäämällä selkeitä tuotantoprosessiin liittyviä moduuleita palveluyrityksen toimintaan sekä hyödyntämällä tietojärjestelmiä teknologioina. Tämän diplomityön tavoitteena oli selvittää, kuvata ja kehittää VALSSI-projektiin osaa ottavan kohdeyrityksen, ValLog Oy:n palvelut modulaarisesti prosesseina. Muodostetuista prosesseista oli tavoitteena tehdä myös työkalu, jonka avulla voidaan esitellä asiakkaalle ValLog Oy:n palveluita myyntitilanteessa sekä selvittää asiakkaan palveluiden tarvekartoitusta. Lisäksi yhteistyössä Metso Paper Servicen kanssa oli tavoitteena kartoittaa vastaavatko ValLog Oy:n logistiikkaprosessit markkinoiden vaatimaa tarvetta sekä selvittää diplomityön perustyövaiheen, eli palveluprosessien kuvauksien tuloksia. ValLog Oy:n palvelukokonaisuus, 12 palvelukonseptia, avattiin prosesseiksi, jotka kuvataan vuokaavioina ja kirjallisena selostuksena. Niistä selviää palvelujen toimintojen väliset riippuvuudet eli koko toimintoketju sekä vuorovaikutussuhteet asiakkaan ja ValLog Oy:n välillä. Yhteistyössä Metso Oyj:n kanssa selvisi, että ValLog Oy:n palvelut ovat varaosalogistiikan tarpeisiin erittäin kattavat. Myyntityökaluksi tehdystä PowerPoint- prosessiesityksestä muodostui asiakkaalle selkeä käsitys palvelukokonaisuuksien kokoamisesta asiakastarvelähtöisesti. Uuden liiketoiminnan luomisessa kuvatut palveluprosessit toimivat peruskäsikirjana. Niissä palvelutoiminta muodostuu selkeistä tuotanto-prosessiin liittyvistä logistisista palvelukokonaisuuksista ja niiden analogia soveltuu myös muiden logistiikkayritysten liiketoiminnan selvittämiseen ja modulaariseen kuvaamiseen.

On Value Creation at an Industrial Intersection – Bioenergy in the Forest and Energy Sectors

The traditional forest industry is a good example of the changing nature of the competitive environment in many industries. Faced with drastic challenges forestindustry companies are forced to search for new value-creating strategies in order to create competitive advantage. The emerging bioenergy business is now offering promising avenues for value creation for both the forest and energy sectors because of their complementary resources and knowledge with respect to bioenergy production from forest-based biomass. The key objective of this dissertation is to examine the sources of sustainable competitive advantage and the value-creation opportunities that are emerging at the intersection between the forest and energy industries. The research topic is considered from different perspectives in order to provide a comprehensive view of the phenomenon. The study discusses the business opportunities that are related to producing bioenergy from forest-based biomass, and sheds light on the greatest challenges and threats influencing the success of collaboration between the forest and energy sectors. In addition, it identifies existing and potential bioenergy actors, and considers the resources and capabilities needed in order to prosper in the bioenergy field. The value-creation perspective is founded on strategic management accounting, the theoretical frameworks are adopted from the field of strategic management, and the future aspect is taken into account through the application of futures studies research methodology. This thesis consists of two parts. The first part provides a synthesis of the overall dissertation, and the second part comprises four complementary research papers. There search setting is explorative in nature, and both qualitative and quantitative research methods are used. As a result, the thesis lays the foundation for non-technological studies on bioenergy. It gives an example of how to study new value-creation opportunities at an industrial intersection, and discusses the main determinants affecting the value-creation process. In order to accomplish these objectives the phenomenon of value creation at the intersection between the forest and energy industries is theorized and connected with the dynamic resource-based view of the firm.

Value engineering of InnoTrackTM

Middle section module of InnoTrackTM moving walk was re-engineered according to value analysis process. Self-supporting steel structure for moving walk was created as a result of this process. Designed structure was verified and validated by prototype tests and finite element method calculations. Self-supporting steel structure replaces the original design of middle section module in InnoTrackTM. Designed structure provides higher satisfaction to customers’ needs and at the same time, it uses less resources. The redesigned middle section module provides higher value to the customer.