Eficacia y seguridad de la melatonina para el manejo de los trastornos del sueño en el autismo: meta-análisis

INTRODUCCIÓN: El 80% de los niños y adolescentes con trastornos del espectro autista (TEA) presenta algún trastorno del sueño, en cuya génesis al parecer intervienen alteraciones en la regulación de la melatonina. El objetivo de este metaanálisis fue determinar la eficacia y seguridad de la melatonina para el manejo de ciertos trastornos del sueño en niños con TEA. MÉTODOS: Tres revisores extrajeron los datos relevantes de los ensayos clínicos aleatorizados doble ciego de alta calidad publicados en bases de datos primarias, de ensayos clínicos, de revisiones sistemáticas y de literatura gris; además se realizó búsqueda en bola de nieve. Se analizaron los datos con RevMan 5.3. Se realizó un análisis del inverso de la varianza por un modelo de efectos aleatorios para las diferencias de medias de los desenlaces propuestos: duración del tiempo total, latencia de sueño y número de despertares nocturnos. Se evaluó la heterogeneidad interestudios con el parámetro I2 RESULTADOS: La búsqueda inicial arrojó 355 resultados, de los cuales tres cumplieron los criterios de selección. La melatonina resultó ser un medicamento seguro y eficaz para aumentar la duración total del sueño y disminuir la latencia de sueño en niños y adolescentes con TEA; hasta el momento la evidencia sobre el número de despertares nocturnos no es estadísticamente significativa. DISCUSIÓN: A la luz de la evidencia disponible, la melatonina es una elección segura y eficaz para el manejo de ciertos problemas del sueño en niños y adolescentes con TEA. Es necesario realizar estudios con mayores tamaños muestrales y comparados con otros medicamentos disponibles en el mercado.

La història del turisme a la ciutat de Girona

Breu itinerari per la història del turisme de la ciutat de Girona, estructurada en quatre períodes. En la primera etapa, s'assenten les bases de la imatge turística de la ciutat (1850 1900); el període artesanal (1900-1950) coincideix amb els primers passos de la indústria turística i la consolidació de l'ideal romàntic; seguidament, el període fordista (1950- 1980) és la fase de transformació radical del turisme i implica una concentració de la demanda en el litoral; i, finalment, el període postfordista (1980-2006), caracteritzat per la instauració de la democràcia, l'inici de l'esgotament del model tradicional i la densitat creixent de fluxos turístics al Barri Vell

A história do "turismo social" no Serviço Social do Comércio - SP

Este trabalho é fruto de uma investigação realizada no doutorado em História, Política e Bens Culturais do Centro de Pesquisa e Documentação de História Contemporânea do Brasil da Fundação Getulio Vargas - orientada pela profa. Dra. Bianca Freire-Medeiros - acerca da constituição e implementação do turismo social no Serviço Social do Comércio do estado de São Paulo (Sesc-SP), examinando as circunstâncias em que o lazer e as experiências turísticas tornam-se relevantes nas políticas e ações da entidade. Procurou-se entender as transformações e readequações que nortearam as iniciativas da instituição e como as modificações no conceito de turismo social no Brasil e no mundo vêm dialogando com suas diretrizes, posturas e intenções. A metodologia privilegiada na pesquisa foi a história oral temática, no intuito de fazer o registro da história do envolvimento de profissionais com o turismo social do Sesc-SP. Foram realizadas vinte e duas entrevistas com (ex)profissionais e feitas algumas visitas à Biblioteca do departamento nacional do Sesc (Sesc-DN) e ao setor de memória e documentação (Sesc-Memórias) do departamento regional paulista do Sesc, lugares que congregam documentos importantes relacionados à história do turismo na instituição. Espacialmente a pesquisa situa-se no Sesc-SP, repartição atuante e “atenta” às ideias e mudanças envolvendo o turismo social, e representativa na história do fenômeno, no Brasil e no mundo. A circunscrição temporal da pesquisa abarca desde 1979 - ano em que o Sesc de São Paulo passa a desenvolver excursões, passeios e viagens com maior frequência e tenta se aprofundar conceitualmente do turismo social ao se aproximar de órgãos internacionais de relevância política e científica na área - até as ações realizadas em 2013, ano no qual termino a pesquisa de campo e as entrevistas. Durante a trajetória da pesquisa, dialoguei com o período que antecede este recorte, acerca dos empreendimentos do Sesc relacionados as práticas de lazer e turismo, gerando o capítulo 2. Antes, no capítulo 1, tentei reconhecer o lugar do turismo social na história das atividades turísticas no mundo, entendendo-o enquanto oportunidade de efetivação do direito ao lazer. Para alcance dos intentos da tese, como fontes foram utilizados documentos produzidos em âmbito institucional, articulados com a fala dos indivíduos entrevistados, trabalho conjugado especialmente no capítulo 3, em que trago reflexões a respeito do turismo social desenvolvido pelo Sesc-SP. Dentre as análises alvitradas, descrevo a dificuldade encontrada pela entidade ao expandir suas atividades turísticas, vindo a sofrer represálias do setor privado. Deve-se destacar que foi possível perceber a metamorfose conceitual/prática por qual passara o turismo social no Sesc-SP, agregando diferentes conteúdos ao fenômeno e modificando seus processos de trabalho e práticas profissionais. Ressalto ainda o papel ideológico da administração regional do Sesc-SP dentro do Serviço Social do Comércio no Brasil, notadamente na área do turismo. Por fim, envolvo no debate da tese as políticas sociais de turismo, compreendido enquanto possibilidade de lazer.

East and Central China, 1841 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Karte von China mit dessen Eintheilung in 18 Provinzen, nach den neuesten u. zuverlässigsten Materialien entworfen, gezeichnet und bearbeitet von J. B. Roost ; in Stein grawirt v. D. Grasmüller. It was published der liter. artist. Anstalt der L.G. Cotta'schen Buchhandlung in 1841. Scale 1:6,500,000. Covers East and Central China, and the Korean Peninsula. Map in German. The image inside the map neatline is georeferenced to the surface of the earth and fit to the Asia North Lambert Conformal Conic coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, roads, territorial and provincial boundaries, shoreline features, and more.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.

East Asia, ca. 1749 (Image 1 of 2) (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Tartariae Sinensis mappa geographica : ex Tabulis specialibus RRPP Iesuitarum nec non Relationibus R.P. Gerbillon, per Dom d'Anville, ... primum A° 1732 nunc se ; nunc secundum LL. projectionis stereographicae in usum translationis Germanicae Historiae Sinens. Haldianae descripta per Tobiam Mayer. It was published by Curis Homannianorum Heredum ca. 1749. Scale [ca 1:5,250,000]. This layer is image 1 of 2 total images of the two sheet source map, representing the western portion of the map. Covers a portion of East Asia including North Korea, South Korea, Mongolia, and portions of China, Russia, and Japan. Map in Latin and French. The image inside the map neatline is georeferenced to the surface of the earth and fit to the Asia North Lambert Conformal Conic coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, territorial boundaries, roads, shoreline features, the Great Wall of China, and more. Relief shown pictorially. Includes notes.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.

East Asia, ca. 1749 (Image 2 of 2) (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Tartariae Sinensis mappa geographica : ex Tabulis specialibus RRPP Iesuitarum nec non Relationibus R.P. Gerbillon, per Dom d'Anville, ... primum A° 1732 nunc se ; nunc secundum LL. projectionis stereographicae in usum translationis Germanicae Historiae Sinens. Haldianae descripta per Tobiam Mayer. It was published by Curis Homannianorum Heredum ca. 1749. Scale [ca 1:5,250,000]. This layer is image 2 of 2 total images of the two sheet source map, representing the eastern portion of the map. Covers a portion of East Asia including North Korea, South Korea, Mongolia, and portions of China, Russia, and Japan. Map in Latin and French. The image inside the map neatline is georeferenced to the surface of the earth and fit to the Asia North Lambert Conformal Conic coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, territorial boundaries, roads, shoreline features, the Great Wall of China, and more. Relief shown pictorially. Includes notes.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.

East Asia, 1840 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Map of China : compiled from original surveys and sketches, by James Wyld. It was published by Jas. Wyld in 1840. Scale [ca. 1:15,000,000]. Covers East Asia including portion of China, North Korea, South Korea, Japan, Philippines, Vietnam, Laos, Thailand, Burma, and India.The image inside the map neatline is georeferenced to the surface of the earth and fit to the Asia North Lambert Conformal Conic coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, territorial and administrative boundaries, roads, the Great Wall of China, shoreline features, districts of trade and production, and more. Includes notes.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.

Identity, difference, and the dilemmas of inter-Korean relations: Insights from northern defectors and the German precedent

Questions of identity have become increasingly central to the study of foreign policy and security, particularly in constructivist debates. But very few of the resulting insights have been applied to the Korean situation, where discussions about security and inter-Korean relations remain dominated by strategic and geopolitical issues. The main task of this article is to address this shortcoming by examining the experience of North Korean defectors in South Korea and the precedent of German unification. Both of these domains of inquiry reveal that identity differences between North and South persist far beyond the ideological and political structures that created them in the first place. Born out of death, fear, and longing for revenge, these identity patterns lie at the heart of Korea's security dilemmas. Unless taken seriously by scholars and decision makers, the respective tensions between identity and difference will continue to cause major political problems. (Key words: Inter-Korean relations, North Korean defectors, German unification)

High P-T granulite relicts from the Imjingang belt, South Korea:Tectonic significance

This study presents a detailed description on crustal metamorphic signatures of garnet-clinopyroxene-quartz-rutile-bearing high P-T granulites, Samgot unit, Imajingang belt, northwestern Korean Peninsula that formed during Permo-Triassic regional metamorphism related to the amalgamation of East Asian continental fragments. Lenses and blocks of high P-T granulites and garnet-bearing leucosomes occur within mafic metamorphic rocks (mainly amphibolites). The mafic blocks comprise relicts of granoblastic garnet and clinopyroxene with medium-grained quartz and rutile. These relict mineral assemblages are confined to local micro-domains and constitute remnants of peak metamorphism. Plagioclase and amphibole form only as retrograde phases in medium ton coarse-grained moats that rim grain boundaries between relict peak mineral assemblages. This microstructure represents the reaction between garnet, clinopyroxene, quartz and rutile in the presence of melt to form amphibole, plagioclase and titanite with minor biotite. The leucosome domains consist of euhedral garnets within the quartz-K feldspar-plagioclase (granitic) matrix, probably representing peritectic garnet growth along with melting. The rare earth element (REE) composition of minerals also support the peritectic garnet growth with a positive Eu/Eu* (positive Eu anomaly), while the relict garnet shows a slight negative anomaly typical for high-grade granulites. The peak-metamorphic conditions calculated from thermodynamic modeling and compositional isopleths indicate a temperature around c. 900 degrees C at a pressure around c. 20 kbar. The present P-T path indicates a clear multi-stage decompression history with initial decompression and cooling followed by a stage of decompression during hydration possibly during Late Triassic exhumation. The results from this study together with the presence of eclogites from the Hongsung area suggest that the Imjingang area and the western Gyeonggi massif likely resided at crustal levels deeper than those of the eastern and southern part of the Gyeonggi massif. (C) 2009 International Association for Gondwana Research. Published by Elsevier B.V. All rights reserved.