Estudio piloto sobre el manejo de la fluidoterapia intravenosa en pacientes adultos de un hospital de tercer nivel.

The purpose of intravenous fluid therapy (IFT) is to maintain or restore internal equilibrium by administering fluids and/or different electrolyte components. Its correct use and the prevention of complications arising from their misuse depend on the knowledge of the medical team on this subject. We analyzed this issue in different clinical areas of a tertiary hospital. MATERIAL AND METHODS We performed a descriptive cross-sectional pilot study via a questionnaire given to physicians specializing in internal medicine (IM) and digestive system surgery (SDS) who perform clinical practice in hospital units with unit dose drug dispensing system. We designed an anonymous questionnaire with 25 questions relative to knowledge of theory and practices, as well as the opinion of physicians regarding IFT. We evaluated the association between nominal qualitative variables with the Chi-square or Fisher's exact test. The behavior of the quantitative variables was assessed using the t-student test. The analysis of the data was generated using SAS/STAT, Version 9. RESULTS 28 questionnaires were collected from 13 surgeons and 15 digestive interns. Over 40% of specialists considered further education in IFT a necessity , especially regarding its prescription (SDS: 61.54%, IM: 71.43%). No statistically significant differences were found between the specialties in terms of perceived frequency of complications associated with IFT or in the frequency indication with the exception of hypovolemic shock, which is considered to be more prevalent in gastrointestinal surgery (p = 0.046). 90% of professionals prefer an individualized prescription. Statistically significant differences in terms of scores in the area of knowledge, with IM physicians achieving the highest scores (p = 0.014). There were also differences in attitude but they are not significant (p = 0.162). Knowledge of intravenous fluid increases with years of clinical experience (Spearman correlation coefficient = 0.386, p = 0.047). CONCLUSIONS The professionals who prescribe IFT perceive the need to design IFT training programs, together with the production of guides and consensus protocols.

Proangiogenic Factor PlGF Programs CD11b+ Myelomonocytes in Breast Cancer during Differentiation of Their Hematopoietic Progenitors.

Tumor-mobilized bone marrow-derived CD11b(+) myeloid cells promote tumor angiogenesis, but how and when these cells acquire proangiogenic properties is not fully elucidated. Here, we show that CD11b(+) myelomonocytic cells develop proangiogenic properties during their differentiation from CD34(+) hematopoietic progenitors and that placenta growth factor (PlGF) is critical in promoting this education. Cultures of human CD34(+) progenitors supplemented with conditioned medium from breast cancer cell lines or PlGF, but not from nontumorigenic breast epithelial lines, generate CD11b(+) cells capable of inducing endothelial cell sprouting in vitro and angiogenesis in vivo. An anti-Flt-1 mAb or soluble Flt-1 abolished the generation of proangiogenic activity during differentiation from progenitor cells. Moreover, inhibition of metalloproteinase activity, but not VEGF, during the endothelial sprouting assay blocked sprouting induced by these proangiogenic CD11b(+) myelomonocytes. In a mouse model of breast cancer, circulating CD11b(+) cells were proangiogenic in the sprouting assays. Silencing of PlGF in tumor cells prevented the generation of proangiogenic activity in circulating CD11b(+) cells, inhibited tumor blood flow, and slowed tumor growth. Peripheral blood of breast cancer patients at diagnosis, but not of healthy individuals, contained elevated levels of PlGF and circulating proangiogenic CD11b(+) myelomonocytes. Taken together, our results show that cancer cells can program proangiogenic activity in CD11b(+) myelomonocytes during differentiation of their progenitor cells in a PlGF-dependent manner. These findings impact breast cancer biology, detection, and treatment. Cancer Res; 71(11); 3781-91. ©2011 AACR.

The concentration of foreigners in French schools: interaction effects in place?

This paper explores the existence of negative peer-group pressures derived from the concentration of foreigners in French lower secondary schools. Using different dependent variables (number of years spent in lower secondary education, grades in 4th ‘and 3rd year and track election in upper secondary schooling) the analyses indicate that the much disputed existence of significant and negative effects of the concentration of foreign students in schools depends on the method used for the estimation. If we assume that the concentration of foreigners is a random and exogenous process, then the multivariate analyses confirm negative interactions. If, on the contrary, we question the assumption that this contextual information is not end the result of prior sorting mechanisms of individuals across social spaces, the concentration of foreigners has no statistical impact on attainment.

Explaining parental dedication to child care in Spain

The quality of the time dedicated to child care has potential positive effects on children’s life chances. However, the determinants of parental time allocation to child care remain largely unexplored, particularly in context undergoing rapid family change such as Spain. We assess two alternative explanations for differences between parents in the amount of time spent with children. The first, based in the relative resources hypothesis, links variation in time spent with children to the relative attributes (occupation, education or income) of one partner to the other. The second, derived from the social status hypothesis, suggests that variation in time spent with children is attributable to the relative social position of the pair (i.e. higher status couples spend more time with children regardless of within-couple difference).To investigate theses questions, we use a sample of adults (18-50) from the Spanish Time Use Survey (STUS) 2002-2003 (n=7,438). Limiting the analysis to adults who are married or in consensual unions, the STUS allows to assess both the quantity and quality of parental time spent with children. We find little support for the “relative resources hypothesis”. Instead, consistent with the “social status hypothesis”, we find that time spent on child care is attributable to the social position of the couple, regardless of between-parent differences in income of education.

Smoking trends in Switzerland, 1992-2007: a time for optimism?

Objective To assess trends in smoking status according to gender, age and educational level in the adult Swiss population. Methods Four national health interview surveys conducted between 1992 and 2007 in representative samples of the Swiss population. Results The prevalence of current smokers increased between 1992 and 1997, decreasing thereafter. In 2007, the prevalence of current smokers (32.0% of men and 23.8% of women) was lower than in 1992 (38.4% and 26.7%, respectively). Whereas the prevalence of current + former smoking decreased from 64.5% in 1992 to 59.3% in 2007 among men, it was similar among women during the same period (44.0% in 1992 and 43.9% in 2007). The prevalence of current + former smokers decreased from 47.2% in 1992 to 46.3% in 2007 in the lower education group (no education + primary), from 54.8% to 52.9% in subjects with secondary level education, and from 55.4% to 48.7% in subjects with university level education. The prevalence of current smokers decreased in all age groups. Finally, the amount of cigarette equivalents smoked per day decreased, but the amount of non-cigarette tobacco (alone or in combination with cigarettes) increased for both sexes. Conclusion The prevalence of smoking has been decreasing in the Swiss population, for both sexes and for most age groups and educational levels between 1992 and 2007. The health effects of the change in type of tobacco products consumed await further investigation.

Matka serkamolaiseen teatteriin : kohti sanatonta kerrontaa

A travelogue to serkamoan theater deals, just like its name implies, with the molding process of one theater opinion. It has been influenced by both Aristotle's poetry and Bertold Brecht's epic theater. Side by side with theater goes dance, whose development the thesis also considers briefly. Of today's theater makers, Päivi Ketonen (playback theater), Juha Hurme and Nigel Charnock (dance theater) have had a definitive impact on the Serkamoan theater view. Their relation to theater and dance is clarified in the interviews conducted by the writer, which can be found in their entirety among the appendices of this thesis. Serkamoan theater has also been influenced by the writer's studies in Portuguese theater school in 2004. In Portugal the writer had a chance to work a theater piece in a new cultural environment where, for example, a novel and paintings were used as inspiration. The strongest legacy from Portugal however was the desire to do theater that can be understood without words. Serkamoan theater considers the combinations of theater and dance in performing arts, agreeing with, among others, Pina Bausch's footsteps. Serkamoan theater ladles its inspiration from theater, dance, human being, human body and movement. It is theater that cannot be understood through intellect but through the heart.

Condom use with steady partners among heterosexual people living with HIV in Europe: testing the information-motivation-behavioral skills model.

Guided by a modified information-motivation-behavioral skills model, this study identified predictors of condom use among heterosexual people living with HIV with their steady partners. Consecutive patients at 14 European HIV outpatient clinics received an anonymous, standardized, self-administered questionnaire between March and December 2007. Data were analyzed using descriptive statistics and two-step backward elimination regression analyses stratified by gender. The survey included 651 participants (n = 364, 56% women; n = 287, 44%). Mean age was 39 years for women and 43 years for men. Most had acquired HIV sexually and more than half were in a serodiscordant relationship. Sixty-three percent (n = 229) of women and 59% of men (n = 169) reported at least one sexual encounter with a steady partner 6 months prior to the survey. Fifty-one percent (n = 116) of women and 59% of men (n = 99) used condoms consistently with that partner. In both genders, condom use was positively associated with subjective norm conducive to condom use, and self-efficacy to use condoms. Having a partner whose HIV status was positive or unknown reduced condom use. In men, higher education and knowledge about condom use additionally increased condom use, while the use of erectile-enhancing medication decreased it. For women, HIV disclosure to partners additionally reduced the likelihood of condom use. Positive attitudes to condom use and subjective norm increased self-efficacy in both genders, however, a number of gender-related differences appeared to influence self-efficacy. Service providers should pay attention to the identified predictors of condom use and adopt comprehensive and gender-related approaches for preventive interventions with people living with HIV.

Health education of diabetes as a chronic disease : transmission of information or active appropriation ?

Résumé du poster : Diabetes is both an important chronic disease and a real public health problem. It requires a great control over the body and a great mastery of the tools used in the daily struggle to reach a physiological balance. It is therefore a disease in which health education plays an important role, since patients are expected to reach a certain autonomy in the management of their disease. But how can the patients' autonomy be promoted? This is the question to which this study tried to answer from the perspective of socio-cultural psychology. The study was launched by the Cantonal Diabetes Program Vaud and aimed at evaluating a health education setting located in the east region of the Canton Vaud. It was based on both quantitative and qualitative methodological approaches. The results showed that there is a correlation between the number of hospitalizations and the quality of support provided by this particular health education setting. Moreover, the acquisition of expertise appears to be a distributed and collective process based upon the actors' active participation in various types of activities and involving and extended network. Further research is now required in order to examine how health education might be grasped through the lens of social-cultural psychology.

Solvability of mental health care in the Family Health Strategy: social representation of professionals and users

Objective To aprehend the social representations about the solvability in mental health care with users of the Family Health Strategy and professionals of family health teams and of the Center for Psychosocial Care. Method A qualitative study using semi-structured interviews for data collection, and the Alceste software for analysis. This software uses the Hierarchical Descending Classification based on the examination of lexical roots, considering the words as units and providing context in the corpus. Results The representations emerge in two opposing poles: the users require satisfaction with care and the professionals realize the need for improvement of health actions. Although the matricial support in mental health and the home visits are developed, the barriers related to investment in health, continuing education and organization of care persist. Conclusion The different representations enable improvements in customer service, solvability of care and aggregate knowledge and practices in the expanded perspective of health needs in the family, social and therapeutic context.


Three Continents, one Language: Studying English in a Portuguese Landscape (Brazil, Cape Verde and Portugal)

Unlike other languages, English has spread to all continents and become a truly global language, a process observable in countries, like Brazil, Cape Verde, and Portugal, located in three different continents, and sharing a common official language: Portuguese. This relatively recent development has contributed to the wide exposure to English and the growing influence of the language in their societies, being used with lingua franca communicative purposes, which raises pedagogical issues. Our aim is to map the exposure and use of English as a Lingua Franca in these Portuguese speaking countries through a comparative study of the results from three case studies (Berto 2009, Cavalheiro 2008 and Nunes 2010). By taking into consideration the findings from questionnaires answered by students and teachers of English, it compares and contrasts the respondents’ opinions on the profile of English teachers — native vs. non-native —, the varieties of English to be taught, and the language teaching resources available. In addition, it explores the learners’ interests, motives and purposes in relation to English and the potential communicative interactions between all speakers, so as to better understand ELF in English language education, and how these factors affect or should affect pedagogical practices in a Portuguese environment.

The History of the Office of Superintendent of Public Instruction in Iowa,1945.

History of the Office of Superintendent of Public Instruction in Iowa from when Iowa was a Territory to 1938

Education Task Force Report, August 2008

The Rebuild Iowa Education Task Force is composed of Iowans with experience and expertise related to the impact of the tornadoes, storms, and floods of 2008 on the educational system in Iowa. The massive damage greatly impacted educational facilities and enrollment, resulting in thousands of displaced students and significant long-term rebuilding needs. In addition, the education system is a “community center,” and in many ways acts as a first responder to Iowans experiencing the disasters. It is important to also recognize this role and the need for “non-educational” (and often non-quantifiable) supports as a part of the overall recovery effort. There are a few parts of the state that sustained significant structural and other damage as a result of the disasters. However, many school districts and educational institutions throughout the state experienced damage that resulted in re-allocating building usage, enrollment issues (because of housing and relocation issues in the community), or use of school facilities to assist in the recovery efforts (by housing displaced community agencies and providing temporary shelter for displaced Iowans). At this time, damage estimates are only estimates and numbers are revised often. Estimates of damage are being developed by multiple agencies, including FEMA, the Iowa Department of Education, insurance companies, and schools themselves, since there are many different types of damage to be assessed and repaired. In addition to structural damage, educational institutions and communities are trying to find ways to quantify sometimes unquantifiable data, such as future revenue capabilities, population declines, and impact on mental health in the long-term. The data provided in this report is preliminary and as up to date as possible; information is updated on a regular basis as assessments continue and damage estimates are finalized.

Supplemental Information to the August 2008 Education Task Force Report, August 2008

The Rebuild Iowa Education Task Force is composed of Iowans with experience and expertise related to the impact of the tornadoes, storms, and floods of 2008 on the educational system in Iowa. The massive damage greatly impacted educational facilities and enrollment, resulting in thousands of displaced students and significant long-term rebuilding needs. In addition, the education system is a “community center,” and in many ways acts as a first responder to Iowans experiencing the disasters. It is important to also recognize this role and the need for “non-educational” (and often non-quantifiable) supports as a part of the overall recovery effort. There are a few parts of the state that sustained significant structural and other damage as a result of the disasters. However, many school districts and educational institutions throughout the state experienced damage that resulted in re-allocating building usage, enrollment issues (because of housing and relocation issues in the community), or use of school facilities to assist in the recovery efforts (by housing displaced community agencies and providing temporary shelter for displaced Iowans). At this time, damage estimates are only estimates and numbers are revised often. Estimates of damage are being developed by multiple agencies, including FEMA, the Iowa Department of Education, insurance companies, and schools themselves, since there are many different types of damage to be assessed and repaired. In addition to structural damage, educational institutions and communities are trying to find ways to quantify sometimes unquantifiable data, such as future revenue capabilities, population declines, and impact on mental health in the long-term. The data provided in this report is preliminary and as up to date as possible; information is updated on a regular basis as assessments continue and damage estimates are finalized. Supplemental Information to the August 2008 Education Task Force Report

Parents’ Investments and Education Returns

[cat] Aquest article analitza la relació entre els ingressos dels pares i l’educació dels seus fills. En un context d’altruïsme perfecte, el model descriu les decisions dels pares sobre quant consumir i quant invertir en l’educació dels seus fills. El model prediu que els rendiments de l’educació en termes de sous haurien de ser lineals. Usant aquest model en una economia competitiva, es mostra com el resultat depèn dels subsidis o impostos del govern sobre l’educació. El compromís habitual igualtat-eficiència apareix en aquest context. Finalment, el model dóna intuïcions sobre la relació entre educació i productivitat.

Socio-demographic and behavioural determinants of weight gain in the Swiss population.

BackgroundIn Switzerland, socio-demographic and behavioural factors are associated with obesity, but no study ever assessed their impact on weight gain using prospective data.MethodsData from 4,469 participants (53.0% women), aged 35 to 75 years at baseline and followed for 5.5 years. Weight gain was considered as a rate (kg/year) or as gaining ¿5 kg during the study period.ResultsRate of weight gain was lower among participants who were older (mean¿±¿standard deviation: 0.46¿±¿0.92, 0.33¿±¿0.88, 0.21¿±¿0.86 and 0.06¿±¿0.74 kg/year in participants aged [35-45[, [45-55[, [55¿65[and [65+ years, respectively, P<0.001); physically active (0.27¿±¿0.82 vs. 0.35¿±¿0.95 kg/year for sedentary, P¿<¿0.005) or living in a couple (0.29¿±¿0.84 vs. 0.35¿±¿0.96 kg/year for living single, P¿<¿0.05), and higher among current smokers (0.41¿±¿0.97, 0.26¿±¿0.84 and 0.29±0.85 kg/year for current, former and never smokers, respectively, p<0.001). These findings were further confirmed by multivariable analysis. Multivariable logistic regression showed that receiving social help, being a current smoker or obese increased the likelihood of gaining ¿5Kg: Odds ratio (OR) and 95% confidence interval (CI) 1.43 (1.16-1.77); 1.63 (1.35-1.95) and 1.95 (1.57-2.43), respectively, while living in couple or being physically active decreased the risk: 0.73 (0.62-0.86) and 0.72 (0.62-0.83), respectively. No association was found between weight gain and gender, being born in Switzerland or education.ConclusionsIn Switzerland, financial difficulties (indicated by receiving social help) and current smoking were associated with increases in body weight over a 5 years follow-up. Living in couple, being older or physically active were protective against weight gain.