Representative analyses of garnet, plagioclase, orthopyroxene, ilmenite, hornblende and biotite for pre-tectonic mafic and metapelitic rocks in Gjelsvikfjella

A metamorphic petrological study, in conjunction with recent precise geochronometric data, revealed a complex P-T-t path for high-grade gneisses in a hitherto poorly understood sector of the Mesoproterozoic Maud Belt in East Antarctica. The Maud Belt is an extensive high-grade, polydeformed, metamorphic belt, which records two significant tectono-thermal episodes, once towards the end of the Mesoproterozoic and again towards the late Neoproterozoic/Cambrian. In contrast to previous models, most of the metamorphic mineral assemblages are related to a Pan-African tectono-thermal overprint, with only very few relics of late Mesoproterozoic granulite-facies mineral assemblages (M1) left in strain-protected domains. Petrological and mineral chemical evidence indicates a clockwise P-T-t path for the Pan-African orogeny. Peak metamorphic (M2b) conditions recorded by most rocks in the area (T = 709-785 °C and P = 7.0-9.5 kbar) during the Pan-African orogeny were attained subsequent to decompression from probably eclogite-facies metamorphic conditions (M2a). The new data acquired in this study, together with recent geochronological and geochemical data, permit the development of a geodynamic model for the Maud Belt that involves volcanic arc formation during the late Mesoproterozoic followed by extension at 1100 Ma and subsequent high-grade tectono-thermal reworking once during continent-continent collision at the end of the Mesoproterozoic (M1; 1090-1030 Ma) and again during the Pan-African orogeny (M2a, M2b) between 565 and 530 Ma. Post-peak metamorphic K-metasomatism under amphibolite-facies conditions (M2c) followed and is ascribed to post-orogenic bimodal magmatism between 500 and 480 Ma.

Health insurance competition in Germany – the role of advertising

In the 1990s, competition among public health insurance funds (‘sickness funds’) was introduced in Germany. As one means of competition, free choice of initial health funds and subsequent switching between them was made available to all insured. Since then, the number of funds has decreased substantially, and funds have had to engage in competitive strategies to remain in the market. In this paper, we want to analyse the funds' advertising activities in the face of the changed competitive environment. This has not been possible to date due to a lack of data. We use two new datasets to get a first insight into the potential effects of competition on funds' advertising strategies; one of the volume and cost of advertisements and one of their contents. Our results suggest that competition has been associated with an increase in the amount of advertising. As to the adverts themselves, we find that there was a decrease in the share of advertisements of a ‘general’ content in favour of advertisements of a more ‘fund-specific’ content. The data therefore indicate that once the market was open to switching of funds by the insured, funds' advertising efforts changed to differentiating their own perceived strengths from those of competitor funds. These observations allow us to draw some tentative conclusions about the relevance of (attempts of) risk selection by health funds via advertisements and about the general success of the pro-competitive legislation.

Age determination on monazite from Forefinger Point granulites, East Antarctica (Table 2.6-1)

Electron microprobe (EMP) dating on monazite in granulite- facies rocks from Forefinger Point, East Antarctica, yielded dominant ages of 500 Ma on matrix monazites.They are associated with secondary cordierite, biotite and sapphirine, formed during nearly isothermal decompression after the high P-T assemblages involving garnet, orthopyroxene and sillimanite. Older ages around 750-1000 Ma are detected in monazite cores and in monazite inclusions in garnet porphyroblast. Combining the available age data and the reaction textures, it becomes evident that the Forefinger Point granulites have been overprinted by a granulite-facies decompressional event of Pan-African age. Moreover, EMP monazite dating imply that the Forefinger Point granulites have experienced at least two stages of metamorphic evolution.

Invited lectures from a spatial orientation symposium in honor of Frederick Guedry, Day 2

This report contains the invited lectures from day 2 of a Spatial Orientation Symposium in honor of the late Dr. Frederick Guedry, held at the Institute of Human and Machine Cognition (IHMC) in Pensacola, Florida in November of 2010. The conference was sponsored by the Coalition Warfare Program of the Office of the Under Secretary of Defense for Acquisition, Technology, and Logistics. It was organized by Drs. Angus Rupert and Ben Lawson (USAARL) and hosted by Drs. Anil Raj and Ken Ford (IHMC). The lectures from day 1 are in Lawson et al., 2014. Day 2 includes lectures by Drs. Scott, Ben Lawson, Angus Rupert, Owen Black, Karen Atkins, Kim Gottshall, Anil Raj, and Måns Magnusson. The lectures focus on the structure, function and reflexes of the vestibular system, orientation perceptions, motion sickness, adaptation, and rehabilitation. This report also features banquet talks given by Drs. Lawson and Rupert, in which they honor Dr. Fred Guedry. Also featured is an interview with Dr. Guedry, conducted by a Navy historian, in which the reader can catch a glimpse into Dr. Guedry's wartime experiences and early days as a researcher.

The Affordable Care Act and the Transformation of US Health Care

The neoliberal period was accompanied by a momentous transformation within the US health care system.  As the result of a number of political and historical dynamics, the healthcare law signed by President Barack Obama in 2010 ‑the Affordable Care Act (ACA)‑ drew less on universal models from abroad than it did on earlier conservative healthcare reform proposals. This was in part the result of the influence of powerful corporate healthcare interests. While the ACA expands healthcare coverage, it does so incompletely and unevenly, with persistent uninsurance and disparities in access based on insurance status. Additionally, the law accommodates an overall shift towards a consumerist model of care characterized by high cost sharing at time of use. Finally, the law encourages the further consolidation of the healthcare sector, for instance into units named “Accountable Care Organizations” that closely resemble the health maintenance organizations favored by managed care advocates. The overall effect has been to maintain a fragmented system that is neither equitable nor efficient. A single payer universal system would, in contrast, help transform healthcare into a social right.

Riskfaktorer och förebyggande omvårdnadsåtgärder för UVI hos äldre kvinnor : En litteraturöversikt

Bakgrund: Urinvägsinfektion (UVI) är en av de vanligaste infektionerna hos äldre kvinnor. Escherichia coli (E-coli) är den vanligaste bakterien vid UVI. Äldre kvinnor lider när de är drabbade av UVI och det är sjuksköterskans uppgift att bland annat förebygga sjukdom och lindra lidande. Syfte: Att beskriva riskfaktorer och förebyggande omvårdnadsåtgärder mot UVI hos äldre kvinnor. Metod: Litteraturstudie, med databassökning genom databaser speciellt inriktade på vård och omvårdnad, CINAHL, PubMed, WEB OF SCIENCE och Medline. 15 artiklar har använts till resultatet. Resultat: Recidiverande UVI, diabetes, urininkontinens, smittspridning och förstoppning är riskfaktorer att drabbas av UVI. God hygien och regelbunden tillförsel av vätska ses som god evidensbaserad omvårdnadsåtgärd mot UVI. Ökad tillförsel av vätska förkastas, Tranbärstillägg behöver ytterligare forskning. Slutsats. Hög hygieniskstandard genom de basala hygienrutinerna är en viktig förebyggande åtgärd mot UVI.

Faktorer på avdelningen som påverkar den kortvariga sjukfrånvaron : En fallstudie av tre avdelningar med olika storlek

Bakgrund: Sjukfrånvaron är ett fenomen som snabbt ökar i Sverige idag. Detta är något som kostar stora summor pengar varje år men trots detta finns relativt lite forskning på området. Den forskning som finns i området undersöker till stor del endast den långvariga sjukfrånvaron. Författarna av denna studie har tydligt identifierat en lucka i forskningen vad gäller kortvarig sjukfrånvaro. Syfte: Denna studie syftar därmed att undersöka storleken på avdelningen samt chefens kommunikation och interaktions påverkan på kortvarig sjukfrånvaro. Resultat: Undersökningen resultat är sammanställt ur dels en enkät som de anställda på tre avdelningar inom ett internationellt produktionsföretag fått besvara och dels tre intervjuer genomförda med en HR-chef och två chefer över avdelningarna. Resultatet blev att fem kategorikoder identifierades; Avdelningens storlek, Chefens kommunikation och interaktion, Frånvarokultur, Arbetsuppgifter och Hälsoarbete. Slutsats: Den främsta slutsats som denna undersökning resulterat i är att storleken på avdelningen påverkar de anställdas möjlighet snarare än deras tendens till att vara kortvarigt sjukfrånvarande. Den faktor som istället anses påverka den kortvariga sjukfrånvaron är hur chefen kommunicerar och integrerar med de anställda. Fokus bör därmed läggas vid denna faktor i försök att antingen minska eller kontrollera den kortvariga sjukfrånvaron på avdelningen

Vi vill, vi kan men hur? : Att använda sig av anpassade verktyg för cheferna inom vård och omsorg för att förmedla sitt ledarskap till sina medarbetare

Vårt syfte med denna studie är att belysa de verktyg som kan erfordras för att enhetschefer ska kunna förmedla sitt ledarskap till sina medarbetare. Detta på grund av att medarbetarna inom kommunen inte är helt belåtna med ledarskapet från kommun eller sina chefer, vilket framgår i den medarbetarundersökning som genomfördes 2014 av kommunen. I samma medarbetarundersökning framkom det likaså att sjukskrivningar bland medarbetarna i kommunen kan beror på ledarskapet. Därför har vi valt att undersöka en del av kommunens enhetschefer och hur de ser på sitt eget ledarskap samt vad de kan göra för att få sina medarbetare att må bättre och förebygga sjukskrivningar. Då tiden inte fanns till att undersöka alla enhetschefer inom den valda kommunen, valdes vård och omsorgsförvaltningens enhetschefer ut för vår egen enkätundersökning. Resultatet av vår enkätundersökning utföll sig på så sätt att enhetscheferna erfordrar mer tid att ägna sig åt sina medarbetare och att administrativt stöd fordras för att underlätta enhetschefernas arbetsmiljö. Om enhetscheferna erhåller mer tid till att spendera med sina medarbetare kan det skapa ett starkare psykologiskt band emellan dem, vilket gör att tilliten från medarbetarna till enhetscheferna stärks. När tilliten stärks vågar medarbetarna vända sig till sina enhetschefer för att berätta hur de mår. Genom att plocka bort de administrativa uppgifterna och i stället ge dem till en assistent får enhetscheferna mer tid till att spendera med sin personal och utifrån detta kan de eventuellt få en översikt av hur verksamheten fungerar. Översikten gör att de kan fatta bättre strategiska beslut för deras verksamhet och medarbetare.

Ajustamento Mental ao Cancro do Pulmão: o papel da autocompaixão e do suporte social

A presente investigação pretendeu ver cumpridos três dos principais objetivos: 1) Estudar as variáveis sociodemográficas e clínicas que caracterizam os doentes com cancro do pulmão; 2) Explorar a relação entre o ajustamento mental ao cancro do pulmão, a autocompaixão, o suporte social e os estados emocionais negativos dos doentes; 3) Examinar o impacto da autocompaixão e do suporte social em relação ao ajustamento mental e aos estados emocionais negativos em doentes com cancro do pulmão. A amostra é constituída por 55 indivíduos (38 homens e 17 mulheres) diagnosticados com cancro do pulmão e com idades compreendidas entre os 44 e os 87 anos, acompanhados medicamente no Hospital de Dia de Oncologia do Centro Hospitalar e Universitário de Coimbra. Como instrumentos de medida para avaliar o ajustamento mental ao cancro, a autocompaixão, o suporte social e os estados emocionais negativos dos participantes foram utilizadas a Escala de Ajustamento Mental ao Cancro (MiniMac), a Escala de Autocompaixão (Selfcs), a Escala de Satisfação com o Suporte Social (Esss) e a Escala de Sintomatologia Psicopatológica (Eads-21). Os resultados obtidos revelaram uma associação significativa entre algumas variáveis clínicas, nomeadamente ser fumador, perceção da gravidade da doença, existência de antecedentes familiares com doença oncológica, e as variáveis em estudo (ajustamento mental, autocompaixão, suporte social e psicopatologia). Foram ainda encontradas correlações significativas entre o ajustamento mental e as estratégias de regulação emocional (autocompaixão), suporte social e psicopatologia. Por último, as análises de regressão linear múltipla mostraram que o modelo preditor da sintomatologia depressiva e do ajustamento mental (avaliado pela dimensão de desânimo) inclui o mindfulness como um preditor significativo. Já em relação ao modelo preditor do stress, o grau de satisfação com o suporte dos amigos revelou ser um contributo importante. Estes resultados têm implicações práticas, sugerindo que estes doentes podem no seu programa terapêutico beneficiar do desenvolvimento deste tipo de estratégias (novas formas de se relacionarem com as suas experiências emocionais e qualidade das suas redes sociais) no sentido de promover um melhor ajustamento mental à sua condição. / The current investigation intended to study three main objetives: 1) to study the sociodemographical and clinical variables which characterize those who suffer from lung cancer; 2) to explore the relation between the mental adjustment to lung cancer, selfcompassion, social support and the negative mental conditions of the sick person; 3) to analyse the impact of self-compassion and the social support in relation to the mental adjustment and to the negative mental conditions of a sick person with lung cancer. The sample is made of 55 individuals (38 males and 17 females) diagnosed with lung cancer, aged between 44 and 87 years old, using medicines at the Hospital de Dia de Oncologia do Centro Hospitalar e Universitário de Coimbra. The Mini Mental Adjustment to Cancer Scale (MiniMac), the Self-Compassion Scale (Selfcs), the Escala de Satisfação com o Suporte Social (Esss) and the Depression Anxiety Stress Scales (Eads-21) scales were used as measuring instruments of evaluation of the mental adjustment to lung cancer, selfcompassion, social support and the negative mental conditions of the sick person. The results revealed a significant association between some clinical variables (being a smoker, awareness of the gravity of sickness, precedent relatives who suffered from cancer) and the variables in study (mental adjustment, self-compassion, social support and psychopathology). There were also found significant correlations between mental adjustment and the strategies used for emotional adjustment (self-compassion), the social support and the psychopathology. At last the multiple linear regretting analysis has shown that the predictor model of depressive symptomatology and the mental adjustment (analysed by the discouragement dimension) includes mindfulness as a significant predictor. However in what concerns to the stress model predictor, the satisfaction level with friends support revealed itself has being of high importance. These results have practical consequences, suggesting that sick people can benefit in their therapeutic program of these kind of strategies (new ways of leading with their emotional experiences and the quality of their social relationships) so they can promote a better mental adjustment to their health condition.

Clinical and functional outcomes of acute lower extremity compartment syndrome at a Major Trauma Hospital

Background: Acute lower extremity compartment syndrome (CS) is a condition that untreated causes irreversible nerve and muscle ischemia. Treatment by decompression fasciotomy without delay prevents permanent disability. The use of intracompartmental pressure (iCP) measurement in uncertain situations aids in diagnosis of severe leg pain. As an infrequent complication of lower extremity trauma, consequences of CS include chronic pain, nerve injury, and contractures. The purpose of this study was to observe the clinical and functional outcomes for patients with lower extremity CS after fasciotomy. Methods: Retrospective chart analysis for patients with a discharge diagnosis of CS was performed. Physical demographics, employment status, activity at time of injury, injury severity score, fracture types, pain scores, hours to fasciotomy, iCP, serum creatine kinase levels, wound treatment regimen, length of hospital stay, and discharge facility were collected. Lower extremity neurologic examination, pain scores, orthopedic complications, and employment status at 30 days and 12 months after discharge were noted. Results: One hundred twenty‑four patients were enrolled in this study. One hundred and eight patients were assessed at 12 months. Eighty‑one percent were male. Motorized vehicles caused 51% of injuries in males. Forty‑one percent of injuries were tibia fractures. Acute kidney injury occurred in 2.4%. Mean peak serum creatine kinase levels were 58,600 units/ml. Gauze dressing was used in 78.9% of nonfracture patients and negative pressure wound vacuum therapy in 78.2% of fracture patients. About 21.6% of patients with CS had prior surgery. Nearly 12.9% of patients required leg amputation. Around 81.8% of amputees were male. Sixty‑seven percent of amputees had associated vascular injuries. Foot numbness occurred in 20.5% of patients and drop foot palsy in 18.2%. Osteomyelitis developed in 10.2% of patients and fracture nonunion in 6.8%. About 14.7% of patients underwent further orthopedic surgery. At long‑term follow‑up, 10.2% of patients reported moderate lower extremity pain and 69.2% had returned to work. Conclusion: Escalation in leg pain and changes in sensation are the cardinal signs for CS rather than reliance on assessing for firm compartments and pressures. The severity of nerve injury worsens with the delay in performing fasciotomy. Standardized diagnostic protocols and wound treatment strategies will result in improved outcomes from this complication.

Prétraitement d'un isolat de protéines de lin par haute pression hydrostatique : impacts sur la structure protéique, l'hydrolyse enzymatique et les capacités antioxydantes des hydrolysats finaux

Les graines de lin sont des oléagineux largement cultivés au Canada. Cependant, les résidus générés suite au processus d’extraction de l’huile contiennent une importante quantité de protéines et peuvent être valorisées dans l’alimentation humaine en raison, principalement, de certaines fractions peptidiques possédant des propriétés bioactives. Dans le cadre de ce travail, l’influence des hautes pressions hydrostatiques (HPH) sur un isolat de protéines de lin a été étudiée concernant les modifications de la structure protéique, l’hydrolyse enzymatique ainsi que l’activité antioxydante des hydrolysats. Ainsi, des solutions protéiques de lin (1% m/v) ont été soumises à un traitement de HPH à 600 MPa pendant 5 et 20 minutes, à 20°C et comparés à des échantillons non-pressurisés. Deux traitements subséquents d’hydrolyse ont été effectués suite au traitement ou non de pressurisation : une première hydrolyse trypsique suivie d’une deuxième par la pronase. Dans un premier temps, la caractérisation de l’isolat protéique de lin pressurisé et non pressurisé a été réalisée par spectrofluorimétrie et par une analyse de la taille des particules afin d’étudier l’effet de la pressurisation sur les HPH la matrice protéique végétale. Par la suite, les hydrolysats protéiques ont été caractérisés par HPLC-MS et leur capacité antioxydante a été déterminée par ORAC. Les résultats ont démontré que le niveau de pressurisation et la durée du traitement ont un impact sur la structure protéique en induisant la dissociation des protéines, et la formation d’agrégats. Ceux-ci seraient occasionnés par la décompression ou créés durant l’entreposage des isolats. Suite à l’hydrolyse enzymatique des solutions protéiques pressurisées ou non par la trypsine seule et par la trypsine-pronase, les analyses chromatographiques ont révélé que la concentration de certains peptides a été modifiée lorsque la trypsine seule était utilisée après un traitement à HPH. Enfin, les HPH ont amélioré la capacité antioxydante des hydrolysats obtenus lors de l’hydrolyse trypsine-pronase comparativement au contrôle non-pressurisé.

Effets des contraintes psychosociales au travail sur la détresse psychologique et les absences médicalement certifiées pour problèmes de santé mentale: une étude prospective de 5 ans

Contexte : Les effets cumulés des contraintes psychosociales du modèle déséquilibre efforts-reconnaissance (DER) sur la santé mentale sont peu connus. Aussi, peu d’études ont évalué les effets du DER sur des indicateurs objectifs de problèmes de santé mentale (PSM). Enfin, aucune étude prospective antérieure n’a évalué l’effet combiné des contraintes psychosociales du DER et du modèle demande-latitude (DL) et sur les PSM médicalement certifiés. La présente thèse vise à combler ces limites. Objectifs : 1) Mesurer l’effet de l’exposition cumulée au déséquilibre efforts-reconnaissance sur la prévalence de la détresse psychologique sur une période de cinq ans; 2) Mesurer l’effet du déséquilibre efforts-reconnaissance sur l’incidence des absences médicalement certifiées pour PSM sur une période de cinq ans; 3) Évaluer l’effet indépendant et l’effet combiné des contraintes psychosociales des modèles Demande-Latitude et Déséquilibre Efforts-Reconnaissance sur l’incidence des absences médicalement certifiées pour PSM sur une période de cinq ans. Méthodes : La cohorte était constituée de plus de 2000 hommes et femmes occupant des emplois de cols blancs. La collecte des données a été réalisée à trois reprises avec une moyenne de suivi de cinq ans. À chaque temps, les contraintes psychosociales et la détresse psychologique ont été mesurées à l’aide d’instruments validés. Les absences médicalement certifiées pour PSM ont été récoltées à partir des fichiers administratifs des employeurs. Les PSM ont été modélisés à l’aide des régressions log-binomiale et de Cox. Les analyses ont été réalisées séparément chez les hommes et les femmes, en ajustant pour les principaux facteurs de confusion. Résultats : Chez les hommes et les femmes, une exposition chronique au DER sur trois ans était associée à une prévalence plus élevée de la détresse psychologique. Les effets observés à trois ans ont persisté à cinq ans chez les hommes (Rapport de prévalence (RP)=1,91 (1,20–3,04)) et les femmes (RP=2,48 (1,97–3,11)). Ces effets étaient de plus grande amplitude que ceux observés en utilisant l’exposition initiale à l’entrée dans l’étude (de +0,30 à +0,94). Par ailleurs, les hommes et les femmes exposés au DER présentaient un risque plus élevé d’absences médicalement certifiées pour PSM (Risque relatif (RR)=1,38 (1,08–1,76)), comparés aux travailleurs non-exposés. La faible reconnaissance au travail était associée à un risque important d’absences pour PSM chez les hommes (RR=3,04 (1,46–6,33)) mais pas chez les femmes (RR=1,24 (0,90–1,72)). Chez les femmes uniquement, un effet indépendant du « job strain » (RR=1,50 (1,12–2,07)) et du DER (RR=1,34 (0,98–1,84)), ainsi qu’un effet de l’exposition combinée au « job strain » (demande psychologique élevée et faible latitude décisionnelle) et au DER (RR=1,97 (1,40–2,78)) sur le risque d’absences médicalement certifiées pour PSM ont également été observés. Conclusion : Les résultats de cette thèse supportent l’effet délétère de l’exposition au DER sur la prévalence de la détresse psychologique et sur le risque d’absences médicalement certifiées pour PSM chez les hommes et les femmes. Chez les hommes et les femmes, l’exposition cumulée au DER était associée à une prévalence élevée de la détresse psychologique à trois ans et à cinq ans. De plus, les contraintes psychosociales du DER ont été associées aux absences médicalement certifiés pour PSM. Chez les femmes particulièrement, un effet combiné du « job strain » et du DER était associé à un risque plus élevé d’absences médicalement certifiées pour PSM, que l’exposition à un seul des deux facteurs. Ces résultats suggèrent que la réduction des contraintes psychosociales au travail pourrait contribuer à réduire l’incidence des PSM, incluant les absences médicalement certifiées pour PSM.

Does the nasogastric tube has a role in elective colo-rectal surgery?

Introduction. Routine use of nasogastric tubes (NGT) after abdominal operations is intended to hasten the return of bowel function, diminish the risk of anastomotic leakage and prevent pulmonary complications. The aim of our study was to prospectively assess the tolerability and the safety of the non use of NGT after elective colorectal open operations. Patients and methods. Between March 2009 and December 2010, 110 consecutive patients underwent colo-rectal elective open surgery for neoplasm without nasogastric decompression. We analyzed the incidence of nausea and vomiting, the pulmonary complications, the return of bowel function the deep wound breakdown (fascial dehiscence) and the anastomotic leakage. Results. Only 15 patients (13,6%) reported nausea without vomiting immediately after surgery and 9 cases of vomiting were observed (8%), requiring the insertion of the NGT (nasogastric tube) in 5 (4,5%). A total of 105 patients (96,3%) were NGT free. No deep wound dehiscence was observed and only one real pneumonia occurred. Anastomotic dehiscence occured in 4 patients (3,6%) and a second surgical procedure was needed in three cases. The return of bowel function, except in the last four patients, occurred in 3,8 days average (range 2-7 days). Conclusion. We confirm the uselessness of the NGT in the framework of fast track program adopted in elective open colo-rectal surgery.

Two Cases of Arnold-Chiari Malformation with Respiratory Failure

Arnold–Chiari malformation is defined as downward displacement of the brainstem and cerebellum through the foramen magnum. It has different clinical presentations and four subtypes. It is known that downward migration of posterior fossa components through the foramen magnum and associated lower cranial nerve palsy and brainstem compression can cause respiratory failure. Acute respiratory failure could mark the onset of the disease. Posterior fossa decompression performed to treat primary disease can improve the central sleep abnormalities. As respiratory failure is rarely seen, this paper presents two cases of Arnold–Chiari malformation with respiratory failure.