Beneficios da intervenção do enfermeiro de reabilitação na promoção da contingência urinária após AVC

Relatório de Estagio apresentado para obtenção do grau de Mestre na especialidade de Enfermagem de Reabilitação

A novel antigen capture ELISA for the specific detection of IgG antibodies to elephant endotheliotropic herpes virus

BACKGROUND Elephants are classified as critically endangered animals by the International Union for Conservation of Species (IUCN). Elephant endotheliotropic herpesvirus (EEHV) poses a large threat to breeding programs of captive Asian elephants by causing fatal haemorrhagic disease. EEHV infection is detected by PCR in samples from both clinically ill and asymptomatic elephants with an active infection, whereas latent carriers can be distinguished exclusively via serological assays. To date, identification of latent carriers has been challenging, since there are no serological assays capable of detecting seropositive elephants. RESULTS Here we describe a novel ELISA that specifically detects EEHV antibodies circulating in Asian elephant plasma/serum. Approximately 80 % of PCR positive elephants display EEHV-specific antibodies. Monitoring three Asian elephant herds from European zoos revealed that the serostatus of elephants within a herd varied from non-detectable to high titers. The antibody titers showed typical herpes-like rise-and-fall patterns in time which occur in all seropositive animals in the herd more or less simultaneously. CONCLUSIONS This study shows that the developed ELISA is suitable to detect antibodies specific to EEHV. It allows study of EEHV seroprevalence in Asian elephants. Results confirm that EEHV prevalence among Asian elephants (whether captive-born or wild-caught) is high.

Ataques de pânico: Aprender com o paciente

Dissertação de Mestrado apresentada no ISPA - Instituto Universitário

Planeamento e controlo de treino no segmento de ciclismo do triatlo do Benfica com vista às provas ITU

Relatório de Estágio apresentado para a obtenção do grau de Mestre em Desporto com especialização em Treino Desportivo

Beneficios da intervenção do enfermeiro de reabilitação na promoção da contingência urinária após AVC

Relatório de Estagio apresentado para obtenção do grau de Mestre na especialidade de Enfermagem de Reabilitação

Estructuración de los procesos y la función de recursos humanos alineados con el direccionamiento estratégico en Kathmandu restaurante

El direccionamiento estratégico está destinado para que las organizaciones cumplan con sus metas y tengan perdurabilidad en el tiempo; es una forma metodológica en la cual se establecen La formulación y el planteamiento estratégicos, se identifican las brechas entre el sueño de la empresa y su realidad, para desplegar la plata forma estratégica. Kathmandu es un restaurante conocido por su diversidad cultural gastronómica, ubicado en Usaquén al Norte de Bogotá. Su serviespacio reúne los sabores, aromas, decoración y elixires del oriente, su música incluye una fusión de sonidos que permite materializar la experiencia que quiere brindar para satisfacer las expectativas de sus comensales y brindarles una experiencia diferente. Los fines de semana presentan shows de danza de vientre, para acompañar la comida y el rato que dispongan disfrutar en este lugar. Este restaurante tiene un diferenciador en su servicio, que le ofrece una ventaja competitiva, Kathmandu brinda la posibilidad de que además del deleite de sus platos, los clientes puedan adquirir toda la decoración de este lugar, estas son artesanías originales traídas de Nepal, India, Tailandia, Indonesia y sus alrededores. Otro atrayente de este restaurante son los cocteles alusivos a las regiones del oriente, y la narguile que ofrece a sus clientes. Al pasar de los años, ciertos inconvenientes presentados en el negocio, con los clientes, el personal y las utilidades, han hecho que los gerentes se preocupen por encontrar la raíz del problema y buscar la solución óptima para perdurar en el tiempo con los mejores beneficios posibles, pues las estrategias que estaban implementando no van acorde a su misión y visión, por lo que es necesario realizar una restructuración de ciertos procesos enfocados al direccionamiento estratégico. Se realizó un análisis en una reunión junto a las directivas sobre cada área de la organización donde se evidenciaron problemas que deben ser tratados para hacer de Kathmandu una empresa más eficiente, eficaz y productiva. Y prepararla para afrontar los cambios que el tiempo le presente, en cuanto a preferencias de los clientes, competencia, entre otras, bien sean a corto, mediano o largo plazo. Algunos de los principales problemas encontrados son: el servicio al cliente, la selección adecuada de personal y capacitación de este, la falta de manejo de un conducto jerárquico y repartición de funciones entre los colaboradores, el informe adecuado sobre la inconformidad de los clientes con su solución, el manual de funciones, el manejo de inventarios y su rotación, verificación de calidad de los productos, manejo de proveedores, entre otros. Kathmandu, a pesar de tener problemas evidentes, es una empresa que por los servicios y productos que ofrece sigue generando buenas utilidades, por esto los gerentes no le habían prestado la debida atención a estos inconvenientes que están poniendo en juego la perdurabilidad de la empresa y que afecta la optimización de las utilidades y minimización de costes sin afectar la calidad brindada al cliente. El objetivo de este restaurante es que el área de recursos humanos sea restructurada en cada uno de los procesos para articularla al direccionamiento estratégico de Kathmandu; pues en esta área se generan la mayoría de los problemas presentados anteriormente. El presente proyecto pretende diseñar el direccionamiento estratégico del área recursos humanos del restaurante Kathmandu para superar la problemática identificada y garantizar la efectividad de sus procesos y adicionalmente evidenciar la creencia de éxito sostenido que se manejaba en este lugar. Este proyecto se realizara con una metodología mixta, para tener aspectos de la investigación cuantitativa y cualitativa y poder realizar una investigación más completa que lleve a una óptima solución del problema abarcado. Se utilizara el direccionamiento estratégico como herramienta para replantear el área de recursos humanos de la organización y alcanzar la efectividad en sus procesos.

Trattamento della stenosi valvolare aortica: nuovi scenari dalla biologia molecolare alle nuove tecnologie

La stenosi valvolare aortica è la più frequente patologia valvolare cardiaca nei paesi sviluppati come diretta conseguenza dell’aumentata aspettativa di vita. In Europa si stima che il numero di soggetti sintomatici per stenosi valvolare aortica aumenterà da 1.3 milioni nel 2025 a 2.1 milioni in 2050. Di conseguenza la stenosi aortica ha e avrà un forte impatto sulla salute pubblica e sui costi che ne determina, poiché spesso associata a un declino funzionale dei pazienti ed aumentata incidenza di ospedalizzazione. D’altra parte è noto che la stenosi valvolare aortica severa non trattata si associa a prognosi infausta con una sopravvivenza del 50% a 2 anni dall’insorgenza dei sintomi e del 20% a 5 anni. Ad oggi non esiste una terapia medica efficace per la stenosi valvolare aortica in quanto andando a costituire un’ostruzione meccanica, resta di competenza del cardiochirurgo o del cardiologo interventista. La sostituzione valvolare aortica, sia essa chirurgica o percutanea, resta pertanto il solo trattamento definitivo per la stenosi valvolare aortica. Nel tempo il rischio operatorio è estremamente diminuito e i vantaggi in termini di miglioramento della qualità di vita sono evidenti. Questo progetto di ricerca prevede pertanto un’analisi delle più recenti tecnologie per il trattamento chirurgico della stenosi valvolare aortica a partire dalla tipologia di approccio chirurgico, se mini-invasivo o tradizionale, fino all’utilizzo delle più recenti protesi biologiche sutureless studiandone i vantaggi, svantaggi e risultati. Prima ancora, tuttavia, saranno analizzati i meccanismi di biologia molecolare alla base dell’eziologia della stenosi aortica al fine di poter identificare precocemente i pazienti, di prevedere l’andamento della patologia e forse, in futuro, anche di ipotizzare una terapia farmacologica mirata.

Comparative constitutional design for divided societies: a model to explain vonstitutional asymmetries

Comparative studies on constitutional design for divided societies indicate that there is no magic formula to the challenges that these societies pose, as lots of factors influence constitutional design. In the literature on asymmetric federalism, the introduction of constitutional asymmetries is considered a flexible instrument of ethnic conflict resolution, as it provides a mixture of the two main theoretical approaches to constitutional design for divided societies (i.e., integration and accommodation). Indeed, constitutional asymmetries are a complex and multifaceted phenomenon, as their degree of intensity can vary across constitutional systems, and there are both legal and extra-legal factors that may explain such differences. This thesis argues that constitutional asymmetries provide a flexible model of constitutional design and aims to explore the legal factors that are most likely to explain the different degrees of constitutional asymmetry in divided multi-tiered systems. To this end, the research adopts a qualitative methodology, i.e., Qualitative Comparative Analysis (QCA), which allows an understanding of whether a condition or combination of conditions (i.e., the legal factors) determine the outcome (i.e., high, medium, low degree of constitutional asymmetry, or constitutional symmetry). The QCA is conducted on 16 divided multi-tiered systems, and for each case, the degree of constitutional asymmetry was analyzed by employing standardized indexes on subnational autonomy, allowing for a more precise measure of constitutional asymmetry than has previously been provided in the literature. Overall, the research confirms the complex nature of constitutional asymmetries, as the degrees of asymmetries vary substantially not only across systems but also within cases among the dimensions of subnational autonomy. The outcome of the Qualitative Comparative Analysis also confirms a path of complex causality since the different degrees of constitutional asymmetry always depend on several legal factors, that combined produce a low, medium, or high degree of constitutional asymmetry or, conversely, constitutional symmetry.

Perception or synthesized voice quality in connected speech by Cantonese speakers

Perceptual voice analysis is a subjective process. However, despite reports of varying degrees of intrajudge and interjudge reliability, it is widely used in clinical voice evaluation. One of the ways to improve the reliability of this procedure is to provide judges with signals as external standards so that comparison can be made in relation to these anchor signals. The present study used a Klatt speech synthesizer to create a set of speech signals with varying degree of three different voice qualities based on a Cantonese sentence. The primary objective of the study was to determine whether different abnormal voice qualities could be synthesized using the built-in synthesis parameters using a perceptual study. The second objective was to determine the relationship between acoustic characteristics of the synthesized signals and perceptual judgment. Twenty Cantonese-speaking speech pathologists with at least three years of clinical experience in perceptual voice evaluation were asked to undertake two tasks. The first was to decide whether the voice quality of the synthesized signals was normal or not. The second was to decide whether the abnormal signals should be described as rough, breathy, or vocal fry. The results showed that signals generated with a small degree of aspiration noise were perceived as breathiness while signals with a small degree of flutter or double pulsing were perceived as roughness. When the flutter or double pulsing increased further, tremor and vocal fry, rather than roughness, were perceived. Furthermore, the amount of aspiration noise, flutter, or double pulsing required for male voice stimuli was different from that required for the female voice stimuli with a similar level of perceptual breathiness and roughness. These findings showed that changes in perceived vocal quality could be achieved by systematic modifications of synthesis parameters. This opens up the possibility of using synthesized voice signals as external standards or anchors to improve the reliability of clinical perceptual voice evaluation. (C) 2002 Acoustical Society of America.

Measuring an effect size from dichotomized data : contrasted results whether using a correlation or an odds-ratio

It is well known that dichotomizing continuous data has the effect to decrease statistical power when the goal is to test for a statistical association between two variables. Modern researchers however are focusing not only on statistical significance but also on an estimation of the "effect size" (i.e., the strength of association between the variables) to judge whether a significant association is also clinically relevant. In this article, we are interested in the consequences of dichotomizing continuous data on the value of an effect size in some classical settings. It turns out that the conclusions will not be the same whether using a correlation or an odds ratio to summarize the strength of association between the variables: Whereas the value of a correlation is typically decreased by a factor pi/2 after each dichotomization, the value of an odds ratio is at the same time raised to the power 2. From a descriptive statistical point of view, it is thus not clear whether dichotomizing continuous data leads to a decrease or to an increase in the effect size, as illustrated using a data set to investigate the relationship between motor and intellectual functions in children and adolescents

The relationship between creativity and moral judgment

A sample of 50 male and female subjects ranging in age from 12 to 73 were divided into three groups according to the scale of maturity of moral judgment developed by Lawrence Kohlberg. Subjects were also tested on a measure of creativity developed by Torrance after the formulations of Guilford in order to test the hypothesis that the re^- lationship between creativity and maturity of moral judgment is curvilinear. Researchers have failed to develop any working hypothesis concerning the relationship between creativity and moral judgment or postulate any consistent theoretical framework concerning the possible relationship between these two constructs. The empirical investigation involved a scientific testing of a random selection of elementary subjects9 high school adolescents, and creative adults. Tests included Kohlberg8s Moral dilemmas and Guilford's Product Improvement Task. A trend analysis was conducted to reveal whether or not a curvilinear relationship existed between the independent variable (Moral Maturity Stages) and the de~ pe dent variable (creativity performance under each level). Curvilinear trends were observed in two out of four creativity subscales but were not statistically significant. It was concluded that these contradictory findings were due to the relatively small number of subjects tested, the narrow range or moral judgment scores, and the limited conception of creativity defined by the creativity measure used (The Product Improvement Task). It was suggested that an instrument assessing an identity status would be most useful as well as a creativity measure better suited for a theory of creativity essentially developmental in perspective.

The neuropsychology of male adults with High-Functioning Autism or Asperger Syndrome

Autism Spectrum Disorder (ASD) is diagnosed on the basis of behavioral symptoms, but cognitive abilities may also be useful in characterizing individuals with ASD. One hundred seventy-eight high-functioning male adults, half with ASD and half without, completed tasks assessing IQ, a broad range of cognitive skills, and autistic and comorbid symptomatology. The aims of the study were, first, to determine whether significant differences existed between cases and controls on cognitive tasks, and whether cognitive profiles, derived using a multivariate classification method with data from multiple cognitive tasks, could distinguish between the two groups. Second, to establish whether cognitive skill level was correlated with degree of autistic symptom severity, and third, whether cognitive skill level was correlated with degree of comorbid psychopathology. Fourth, cognitive characteristics of individuals with Asperger Syndrome (AS) and high-functioning autism (HFA) were compared. After controlling for IQ, ASD and control groups scored significantly differently on tasks of social cognition, motor performance, and executive function (P's < 0.05). To investigate cognitive profiles, 12 variables were entered into a support vector machine (SVM), which achieved good classification accuracy (81%) at a level significantly better than chance (P < 0.0001). After correcting for multiple correlations, there were no significant associations between cognitive performance and severity of either autistic or comorbid symptomatology. There were no significant differences between AS and HFA groups on the cognitive tasks. Cognitive classification models could be a useful aid to the diagnostic process when used in conjunction with other data sources-including clinical history.

Dentistry and HIV: University professors' role in establishing a basis for judgment

The aim of this study was to determine whether there are differences in the attitudes of Dentistry School Professors from two universities, one private and one public concerning HIV-positive patients or HIV-positive health care professionals. A questionnaire Was handled to all profession at the Araçatuba Dental School of São Paulo State University - FOA-UNESP (public) and Lins Dental School of the Piracicaba Methodist University - FOL-UNIMEP (private). When asked if they would be willing to be treated by an HIV-infected health care professional, 38.9% of the 77 professors at FOA-UNESP replied that they would accept only non-invasive treatments and 13% would not accept any kind of treatment; the same applied to 42.4% and 15.2% of the 33 FOL-UNIMEP professors. Among the 54 professors at FOA-UNESP and 27 at FOL-UNIMEP providing clinical service, only 31.5% and 18.5% stated that they treat HIV-infected persons like any other patient. The results were very similar in both schools. Although they reported that they taught their students not to act in a discriminatory manner towards HIV-positive patient the professors themselves showed prejudice towards infected patients and professionals. Consequently, this topic trust be further debated in the academic milieu.

Fundamental Dimensions of Social Judgment: Sociability and Morality as Distinct Characteristics of Social Warmth

The present dissertation focuses on the two basic dimensions of social judgment, i.e., warmth and competence. Previous research has shown that warmth and competence emerge as fundamental dimensions both at the interpersonal level and at the group level. Moreover, warmth judgments appear to be primary, reflecting the importance of first assessing others’ intentions before determining the other’s ability to carry out those intentions. Finally, it has been shown that warmth and competence judgments are predicted by perceived economic competition and status, respectively (for a review, see Cuddy, Fiske, & Glick, 2008). Building on this evidence, the present work intends to further explore the role of warmth and competence in social judgment, adopting a finer-grained level of analysis. Specifically, we consider warmth to be a dimension of evaluation that encompasses two distinct characteristics (i.e., sociability and morality) rather than as an undifferentiated dimension (see Leach, Ellemers, & Barreto, 2007). In a similar vein, both economic competition and symbolic competition are taken into account (see Stephan, Ybarra, & Morrison, 2009). In order to highlight the relevance of our empirical research, the first chapter reviews the literature in social psychology that has studied the warmth and competence dimensions. In the second chapter, across two studies, we examine the role of realistic and symbolic threats (akin economic and symbolic competition, respectively) in predicting the perception of sociability and morality of social groups. In study 1, we measure perceived realistic threat, symbolic threat, sociability, and morality with respect to 8 social groups. In study 2, we manipulate the level and type of threat of a fictitious group and measure perceived sociability and morality. The findings show that realistic threat and symbolic threat are differentially related to the sociability and morality components of warmth. Specifically, whereas realistic threat seems to be a stronger predictor of sociability than symbolic threat, symbolic threat emerges as better predictor of morality than realistic threat. Thus, extending prior research, we show that the types of threat are linked to different warmth stereotypes. In the third and the fourth chapter, we examine whether the sociability and morality components of warmth play distinct roles at different stages of group impression formation. More specifically, the third chapter focuses on the information-gathering process. Two studies experimentally investigate which traits are mostly selected when forming impressions about either ingroup or outgroup members. The results clearly show that perceivers are more interested in obtaining information about morality than about sociability when asked to form a global impression about others. The fourth chapter considers more properly the formulation of an evaluative impression. Thus, in the first study participants rate real groups on sociability, morality, and competence. In the second study, participants read an immigration scenario depicting an unfamiliar social group in terms of high (vs. low) morality, sociability, and competence. In both studies, participants are also asked to report their global impression of the group. The results show that global evaluations are better predicted by morality than by sociability and competence trait ascriptions. Taken together the third and the fourth chapters show that the dominance of warmth suggested by previous studies on impression formation might be better explained in terms of a greater effect of one of the two subcomponents (i.e., morality) over the other (i.e., sociability). In the general discussion, we discuss the relevance of our findings for intergroup relation and group perception, as well as for impression formation.