Endoluminal calprotectin measurement in assessment of pouchitis and a new index of disease activity: a pilot study

Pouchitis is the most common complication following proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis (UC). To provide a standardized definition of pouchitis clinical, endoscopic and histological markers were grouped and weighted in the pouch disease activity index (PDAI). However, the delay in the assessment of the final score due to the time requested for histological analysis remains the main obstacle to the index implementation in clinical practice so that the use of modified-PDAI (mPDAI) with exclusion of histologic subscore has been proposed. We tested the ability of calprotectin measurement in the pouch endoluminal content to mimic the histologic score as defined in the PDAI, the index that we adopted as gold standard for pouchitis diagnosis. Calprotectin was measured by ELISA in the pouch endoluminal content collected during endoscopy in 40 consecutive patients with J-pouch. In each patient PDAI and mPDAI were calculated and 15% of patients were erroneously classified by mPDAI. ROC analysis of calprotectin values vs. acute histological subscore ≥ 3 identified different calprotectin cut-off values with corresponding sensitivity and specificity allowing the definition and scoring of different range of calprotectin subscores. We incorporated the calprotectin score in the mPDAI obtaining a new score that shows the same specificity as PDAI for diagnosis of pouchitis and higher sensitivity when compared with mPDAI. The use of the proposed new score, once validated in a larger series of patients, might be useful in the early management of patients with symptoms of pouchitis.

THE ASSOCIATION OF DEMOGRAPHIC VARIABLES AND DIETARY HABITS ON BODY MASS INDEX OF FOREIGN-BORN POPULATION IN SOUTH KOREA

The Republic of Korea (Korea) has been composed of a single ethnic group and, until very recently, has had little or no experience with large-volume of immigrants. The country, once known for its large-scale emigration, has emerged as a popular destination. As the foreign-born populations continue to grow, they experience dietary pattern changes. Dietary changes of immigrants are often associated with weight increase and consequently the risk of non-communicable diseases such as diabetes. This study examined the association of demographic variables and dietary habits on Body Mass Index (BMI) of foreign nationals living in Korea, based on a cross-sectional sample of 193 foreign-born men (120) and women (73). A web-based survey program, Zoho survey, was used to capture self-reported region of origin, socio-demographic variables, weight, height, frequency of physical activity, and food frequencies. For the entire sample (n=193), the World Health Organization (WHO) classification and the Korean Society for the Study of Obesity cut-off points of BMI were used. The average BMI was 24.6 (SD=3.6) kg/m2. Significant associations were observed between BMI and age (χ² (8, N=193) =26.22, p<.01), gender (χ² (2, N=193) =11.45, p<.01), and religious affiliation (χ² (4, N=191) =9.53, p<.05). On average, participants had meat and carbonated drinks 2.2 times a week; high calorie foods 1.5 times a week; and, dairy products 2.4 times a week. A significant correlation (r=.14, p<.05) between BMI and eating meat was also observed. This study showed that the BMI varied with age, gender and religion. Frequent consumption of meat was associated with a significant increase in BMI. This increase in BMI could be associated with the dietary changes experienced by the newcomers or absence of more familiar products. Consequently, as the volume of immigrants continues to increase in Korea, it is imperative to consider designing and implementing public health policies specifically in relation to a healthy diet that can impact the prevalence of preventable chronic diseases. Thus, health education among foreign-born population in Korea should focus on reducing the intake of meat and high energy foods.

Effect on the disability index of adult patients with benign paroxysmal positional vertigo using vestibular rehabilitation and human movement

Objective: determine the effect on the disability index of adult patients with benign paroxysmal positional vertigo (BPPV) using vestibular rehabilitation therapy (VRT) and human movement. Subjects: six subjects with an average age of 49.5 ± 14.22 years who have been diagnosed with benign paroxysmal positional vertigo by an otolaryngologist. Instruments: the Dizziness Handicap Inventory and a questionnaire to determine impact on the quality of life of patients with this pathology (Ceballos and Vargas, 2004). Procedure: subjects underwent vestibular therapy for four weeks together with habituation and balance exercises in a semi-supervised manner. Two measurements were performed, one before and one after the vestibular therapy and researchers determined if there was any improvement in the physical, functional, and emotional dimensions. Statistical analysis: descriptive statistics and Student’s t-test of repeated measures were applied to analyze results obtained. Results: significant statistical differences were found in the physical dimension between the pre-test (19.33 ± 4.67 points) and post-test (13 ± 7.24 points) (t = 2.65; p < 0.05).  In contrast, no significant statistical differences were found in the functional (t = 2.44; p>0.05), emotional (t = 2.37; p>0.05) or general dimensions (t = 2.55; p>0.05). Conclusion: vestibular therapy with a semi-supervised human movement program improved the index of disability due to vertigo (physical dimension) in BPPV subjects.

Bimanual aiming and overt attention: one law for two hands

Reaching to interact with an object requires a compromise between the speed of the limb movement and the required end-point accuracy. The time it takes one hand to move to a target in a simple aiming task can be predicted reliably from Fitts' law, which states that movement time is a function of a combined measure of amplitude and accuracy constraints (the index of difficulty, ID). It has been assumed previously that Fitts' law is violated in bimanual aiming movements to targets of unequal ID. We present data from two experiments to show that this assumption is incorrect: if the attention demands of a bimanual aiming task are constant then the movements are well described by a Fitts' law relationship. Movement time therefore depends not only on ID but on other task conditions, which is a basic feature of Fitts' law. In a third experiment we show that eye movements are an important determinant of the attention demands in a bimanual aiming task. The results from the third experiment extend the findings of the first two experiments and show that bimanual aiming often relies on the strategic co-ordination of separate actions into a seamless behaviour. A number of the task specific strategies employed by the adult human nervous system were elucidated in the third experiment. The general strategic pattern observed in the hand trajectories was reflected by the pattern of eye movements recorded during the experiment. The results from all three experiments demonstrate that eye movements must be considered as an important constraint in bimanual aiming tasks.

University admission marks in Catalonia: Some highlights from the empirical research

The results of the examinations taken by graduated high school studentswho want to enrol at a Catalan university are here studied. To do so,the authors address several issues related to the equity of the system:reliability of grading, difficulty and discrimination power of the exams.The general emphasis is put upon the concurrent research and empiricalevidence about the properties of the examination items and scores. Aftera discussion about the limitations of the exams' format and appropriatenessof the instruments used in the study, the article concludes with somesuggestions to improve such examinations.

Gestão de Recursos Humanos no Terceiro Setor: O Caso das Instituições Particulares de Solidariedade Social

O presente trabalho tem como objetivo geral estudar a gestão de recursos humanos (GRH) no terceiro setor, focando-se especificamente nas Instituições Particulares de Solidariedade Social (IPSS). Estas organizações têm vindo a demonstrar um papel cada vez mais relevante nas comunidades em que se inserem, pela sua missão em prestar serviços de cariz social e pela atual relevância como entidades empregadoras. A diversidade presente nas IPSS ao nível da estrutura, funcionamento, dimensão, organização e dinâmicas internas, proporciona o estudo e reflexão das especificidades na GRH. Para isso, abordam-se um conjunto de aspetos: i) diferenças entre meio empresarial e terceiro setor na GRH; ii) implicações da diversidade de respostas sociais e suas especificidades na gestão de pessoas; iii) o papel do Instituto de Segurança Social e as implicações legais na gestão de pessoas; iv) a localização geográfica e acesso a recursos humanos qualificados; v) a perspetiva das IPSS sobre os recursos humanos; vi) o perfil profissional dos colaboradores das IPSS; vii) práticas quotidianas na gestão de recursos humanos nas IPSS; viii) características da GRH nas IPSS (administrativa ou estratégica); ix) responsáveis pela GRH nas IPSS; x) o papel dos órgãos sociais na GRH; xi) profissionalização versus voluntariado; xii) a GRH, certificação e qualidade; xiii) as tendências do terceiro setor na gestão de pessoas. Foi utilizada uma metodologia qualitativa e aplicada a técnica de entrevista para recolher o conhecimento, experiências e perspetivas de diferentes interlocutores do terceiro setor, dirigentes, técnicos superiores, diretores de serviço, investigadores e representantes nacionais e distritais das IPSS. Da sistematização e análise dos dados recolhidos retiraram-se várias conclusões. As pessoas são consideradas o recurso mais importante para estas organizações, pela natureza social e humana das atividades desenvolvidas, prestadas por pessoas e destinadas a pessoas. Neste sentido, é demonstrada a importância do potencial humano aquando do recrutamento e seleção, pela primazia de requisitos como o relacionamento interpessoal em detrimento das qualificações. O perfil profissional característico das IPSS reconhece a importância da polivalência, disponibilidade, comprometimento, confiança, proximidade afetiva, voluntarismo e sentido de missão dos colaboradores, os quais tendem a ser são vistos como investimento tanto quanto reúnam estes aspetos; caso contrário podem ser encarados como custo. Quanto à acessibilidade a recursos humanos, surgem diferentes modalidades, consoante fatores de localização, dimensão, formação e estrutura organizacional, bem como o fenómeno da fuga de mão de obra, indício da dificuldade em captar e reter recursos humanos. O modelo de GRH nas IPSS é de cariz tradicional, caracterizado por uma gestão porimproviso com diferentes níveis de sensibilidade e capacidade das IPSS, no que concerne à implementação de processos de GRH, tais como sistemas de progressão na carreira, recrutamento interno e sistemas de avaliação de desempenho. Quanto aos aspetos da motivação e satisfação profissional, é assumida a importância da proximidade e apoio aos colaboradores, indicativos de um sistema de recompensas informal. É percetível a resistência na aplicação de técnicas de desenvolvimento organizacional, comprovada pela limitação na formação dos quadros de colaboradores. No entanto as IPSS são confrontadas com a rigidez dos instrumentos legais. A responsabilidade pela GRH é mais ou menos partilhada entre a direção técnica e os órgãos sociais, condicionada pelo estilo de liderança e relação de confiança entre si, em norma, pouco clara quanto aos papéis e funções desempenhadas. Por fim, é percebida a necessidade de coexistência de uma gestão profissionalizada e de direções voluntárias mais capacitadas e sensibilizadas para o desenvolvimento de metodologias e estratégias de gestão de pessoas, adaptadas às especificidades das IPSS. Este trabalho pretende contribuir com um espaço de reflexão para a elaboração de respostas mais eficazes e inovadoras que proporcionem o desenvolvimento organizacional, face às necessidades e transformações do terceiro setor. / This work main objective is the study of human resource management (HRM) in the third sector. It is focused specifically on Instituições Particulares de Solidariedade Social [Private Institutions for Social Solidarity] (IPSS). These kind of organizations have demonstrated an increased value in the communities they are inserted in, by providing social care services and by generating new jobs in the local communities. The study and reflection of HRM specificities is based on the variety in the structure, the purpose, the size, the internal organization and the dynamics of the different IPSS. For this purpose we explored the following aspects : i) the differences between business community and the third sector in HRM; ii) the implications of social responses diversity in people management; iii) the role of the National Insurance Institute and the legal impact on people management; iv) the geographic location and the IPSS access to skilled human resources; v) the understanding of IPSS on human resources; vi) the professional profile of IPSS employees; vii) the daily practices in human resource management on the IPSS; viii) the characteristics of HRM in IPSS (managerial or strategic); ix) who is responsible for HRM in IPSS; x) the role of executive board in HRM; xi) professionalization versus voluntary work; xii) HRM, quality and certification; xiii) the third sector trends in people management. The qualitative method and the interview technique were applied in order to gather knowledge, experiences and perspectives from several sources such as, different partners of the third sector, managers, service directors, technicians, researchers and national and local IPSS representatives. The results indicate several conclusions. Firstly the human resources are the most important resource of IPSS organizations due to the social nature of the services provided by them but also the importance of, the individual and social, skills required for these activities that are provided by people and are directed to people. This demonstrates the importance of interpersonal skills over professional qualifications during recruitment and selection. The IPSS recognize in their professionals the importance of versatility, availability, commitment, confidence, emotional proximity, voluntarism and sense of mission. If an employee fulfills these requirements, is considered an investment; otherwise might be seen as a cost. Regarding the accessibility of IPSS to qualified human resources, we consider different models, depending on location, size and training and organizational structure as well as the phenomenon run of hand labor, defined as the index of difficulty in capturing and retaining human resources. The model of HRM in IPSS is traditional in its nature and is characterized by management based on improvisation at different levels, regarding the implementation ofHRM processes such as career advancement systems, internal recruitment and performance evaluation. In regards to motivation and job satisfaction, it is valued the proximity and the support to the employees, showing therefore an informal system of rewards. There is a noticeable resistance to the application of organizational techniques which is demonstrated by controlling the formation of employees. However the IPSS are required to face the rigidity of legal instruments. The responsibility for HRM is shared between the technical direction and the management bodies, which depends on leadership style and mutual trust, and is generally unclear about the roles and duties performed. Finally, it becomes evident the need for coexistence between a professional management and a voluntary management, more capable and more sensible to the development of methods and strategies for people management, specifically adapted to each IPSS. This paper aims to contribute with space for reflection in the development of more effective and innovative responses for the organizational development, given the needs and transformations of the third sector.

Refractive index tomography of turbid media by bifocal optical coherence refractometry

We demonstrate tomographic imaging of the refractive index of turbid media using bifocal optical coherence refractometry (BOCR). The technique, which is a variant of optical coherence tomography, is based on the measurement of the optical pathlength difference between two foci simultaneously present in a medium of interest. We describe a new method to axially shift the bifocal optical pathlength that avoids the need to physically relocate the objective lens or the sample during an axial scan, and present an experimental realization based on an adaptive liquid-crystal lens. We present experimental results, including video clips, which demonstrate refractive index tomography of a range of turbid liquid phantoms, as well as of human skin in vivo.

Genus and Braid Index Associated to Sequences of Renormalizable Lorenz Maps

We describe the Lorenz links generated by renormalizable Lorenz maps with reducible kneading invariant (K(f)(-), = K(f)(+)) = (X, Y) * (S, W) in terms of the links corresponding to each factor. This gives one new kind of operation that permits us to generate new knots and links from the ones corresponding to the factors of the *-product. Using this result we obtain explicit formulas for the genus and the braid index of this renormalizable Lorenz knots and links. Then we obtain explicit formulas for sequences of these invariants, associated to sequences of renormalizable Lorenz maps with kneading invariant (X, Y) * (S,W)*(n), concluding that both grow exponentially. This is specially relevant, since it is known that topological entropy is constant on the archipelagoes of renormalization.

Estimate of DMFT index using teeth most affected by dental caries in twelve-year-old children

The objective of the study was to develop regression models to describe the epidemiological profile of dental caries in 12-year-old children in an area of low prevalence of caries. Two distinct random probabilistic samples of schoolchildren (n=1,763) attending public and private schools in Piracicaba, Southeastern Brazil, were studied. Regression models were estimated as a function of the most affected teeth using data collected in 2005 and were validated using a 2001 database. The mean (SD) DMFT index was 1.7 (2.08) in 2001 and the regression equations estimated a DMFT index of 1.67 (1.98), which corresponds to 98.2% of the DMFT index in 2001. The study provided detailed data on the caries profile in 12-year-old children by using an updated analytical approach. Regression models can be an accurate and feasible method that can provide valuable information for the planning and evaluation of oral health services.

Effect of the exposure to maternal smoking during pregnancy and childhood on the body mass index until adolescence

OBJECTIVE Investigate the effect of exposure to smoking during pregnancy and early childhood on changes in the body mass index (BMI) from birth to adolescence.METHODS A population-based cohort of children (0-5 years old) from Cuiabá, Midwest Brazil, was assessed in 1999-2000 (n = 2,405). Between 2009 and 2011, the cohort was re-evaluated. Information about birth weight was obtained from medical records, and exposure to smoking during pregnancy and childhood was assessed at the first interview. Linear mixed effects models were used to estimate the association between exposure to maternal smoking during pregnancy and preschool age, and the body mass index of children at birth, childhood and adolescence.RESULTS Only 11.3% of the mothers reported smoking during pregnancy, but most of them (78.2%) also smoked during early childhood. Among mothers who smoked only during pregnancy (n = 59), 97.7% had smoked only in the first trimester. The changes in body mass index at birth and in childhood were similar for children exposed and those not exposed to maternal smoking. However, from childhood to adolescence the rate of change in the body mass index was higher among those exposed only during pregnancy than among those who were not exposed.CONCLUSIONS Exposure to smoking only during pregnancy, especially in the first trimester, seems to affect changes in the body mass index until adolescence, supporting guidelines that recommend women of childbearing age to stop smoking.

Recent droughts and the impact of North Atlantic Oscillation in Iberia; a spatiotemporal analysis based on vegetation temperature condition Index (VTCI)

Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.

Variant within the promoter region of the CHRNA3 gene associated with FTN dependence is not related to self-reported willingness to quit smoking.

INTRODUCTION: Common variation in the CHRNA5-CHRNA3-CHRNB4 gene region is robustly associated with smoking quantity. Conversely, the association between one of the most significant single nucleotide polymorphisms (SNPs; rs1051730 within the CHRNA3 gene) with perceived difficulty or willingness to quit smoking among current smokers is unknown. METHODS: Cross-sectional study including current smokers, 502 women, and 552 men. Heaviness of smoking index (HSI), difficulty, attempting, and intention to quit smoking were assessed by questionnaire. RESULTS: The rs1051730 SNP was associated with increased HSI (age, gender, and education-adjusted mean ± SE: 2.6 ± 0.1, 2.2 ± 0.1, and 2.0 ± 0.1 for AA, AG, and GG genotypes, respectively, p < .01). Multivariate logistic regression adjusting for gender, age, education, leisure-time physical activity, and personal history of cardiovascular or lung disease showed rs1051730 to be associated with higher smoking dependence (odds ratio [OR] and 95% CI for each additional A-allele: 1.38 [1.11-1.72] for smoking more than 20 cigarette equivalents/day; 1.31 [1.00-1.71] for an HSI ≥5 and 1.32 [1.05-1.65] for smoking 5 min after waking up) and borderline associated with difficulty to quit (OR = 1.29 [0.98-1.70]), but this relationship was no longer significant after adjusting for nicotine dependence. Also, no relationship was found with willingness (OR = 1.03 [0.85-1.26]), attempt (OR = 1.00 [0.83-1.20]), or preparation (OR = 0.95 [0.38-2.38]) to quit. Similar findings were obtained for other SNPs, but their effect on nicotine dependence was no longer significant after adjusting for rs1051730. Conclusions: These data confirm the effect of rs1051730 on nicotine dependence but failed to find any relationship with difficulty, willingness, and motivation to quit.

Assessment of free-living physical activity in humans: an overview of currently available and proposed new measures.

The number of physical activity measures and indexes used in the human literature is large and may result in some difficulty for the average investigator to choose the most appropriate measure. Accordingly, this review is intended to provide information on the utility and limitations of the various measures. Its primary focus is the objective assessment of free-living physical activity in humans based on physiological and biomechanical methods. The physical activity measures have been classified into three categories: Measures based on energy expenditure or oxygen uptake, such as activity energy expenditure, activity-related time equivalent, physical activity level, physical activity ratio, metabolic equivalent, and a new index of potential interest, daytime physical activity level. Measures based on heart rate monitoring, such as net heart rate, physical activity ratio heart rate, physical activity level heart rate, activity-related time equivalent, and daytime physical activity level heart rate. Measures based on whole-body accelerometry (counts/U time). Quantification of the velocity and duration of displacement in outdoor conditions by satellites using the Differential Global Positioning System may constitute a surrogate for physical activity, because walking is the primary activity of man in free-living conditions. A general outline of the measures and indexes described above is presented in tabular form, along with their respective definition, usual applications, advantages, and shortcomings. A practical example is given with typical values in obese and non-obese subjects. The various factors to be considered in the selection of physical activity methods include experimental goals, sample size, budget, cultural and social/environmental factors, physical burden for the subject, and statistical factors, such as accuracy and precision. It is concluded that no single current technique is able to quantify all aspects of physical activity under free-living conditions, requiring the use of complementary methods. In the future, physical activity sensors, which are of low-cost, small-sized, and convenient for subjects, investigators, and clinicians, are needed to reliably monitor, during extended periods in free-living situations, small changes in movements and grade as well as duration and intensity of typical physical activities.

Development and validation of the Family Vulnerability Index to Disability and Dependence (FVI-DD)

This exploratory, descriptive, cross-sectional, and quantitative study aimed to develop and validate an index of family vulnerability to disability and dependence (FVI-DD). This study was adapted from the Family Development Index, with the addition of social and health indicators of disability and dependence. The instrument was applied to 248 families in the city of Sao Paulo, followed by exploratory factor analysis. Factor validation was performed using the concurrent and discriminant validity of the Lawton scale and Katz Index. The descriptive level adopted for the study was p < 0.05. The final vulnerability index comprised 50 questions classified into seven factors contemplating social and health dimensions, and this index exhibited good internal consistency (Cronbach’s alpha = 0.82). FVI-DD was validated using both the Lawton scale and Katz Index. We conclude that FVI-DD can accurately and reliably assess family vulnerability to disability and dependence.

Cross-cultural adaptation of the Quality of Life Index Spinal Cord Injury - Version III

OBJECTIVE To translate and culturally adapt to Portuguese the Ferrans and Powers Quality of Life Index Spinal Cord Injury - Version III and characterize the sample in relation to sociodemographic and clinical aspects. METHOD A methodological study with view to cross-cultural adaptation, following the particular steps of this method: initial translation, translation synthesis, back-translation (translation back to the original language), review by a committee of judges and pretest of the final version. The pretest was carried out with 30 patients with spinal cord injury. RESULTS An index of 74 items divided into two parts (satisfaction/importance) was obtained. The criteria of semantic equivalence were evaluated as very adequate translation, higher than 87%, and vocabulary and were grammar higher than 86%. Idiomatic equivalence was higher than 74%, experimental greater than 78% and conceptual was greater than 70%. CONCLUSION After cross-cultural adaptation, the instrument proved semantic, idiomatic, experimental and conceptual adequacy, in addition to helping the evaluation of the quality of life of people with spinal cord injury.