The consumption of beauty products on famale young adults in Portugal. Recommenrations for the brand Lancôme to improve its store trafic

This project aims to explore the Portuguese Beauty and Cosmetics market, and to discuss the usage and purchase behaviour of young female adults, between 18 and 26 years old. After a market analysis based on secondary data, it evaluates the results of qualitative and quantitative research based on 9 interviews and 126 online questionnaires to explore the consumers’ reasoning when choosing products from this category – fragrances, skin care or make-up – as well as their attitude towards brands, with a special focus on the premium cosmetics brand Lancôme. Contrary to our expectations there was no statistically significant positive influence of the online touchpoints within this age segment’s purchase intention. However, results indicate that Lancôme is already being perceived by some as young and modern, but is still suffering the threat of Mass Market brands that are valued by this target, mainly due to a price sensitivity towards premium beauty brands.

Indications à la stimulation cardiaque dans la syncope vasovagale [Pacing in vasovagal syncope].

This article presents a critical review of the literature about the potential benefit of cardiac pacing in patients suffering from vasovagal or neurocardiogenic syncope. The manifestation of vasovagal syncope comprises some reflex bradycardia and vasoplegia resulting in cerebral hypoperfusion that ultimately leads to a loss of consciousness. The literature reports conflicting results of the potential benefit of cardiac pacing on the prevention of recurrence of vasovagal events. A detailed analysis of the inclusion criteria of these studies permits to clarify the discrepancy. Only patients older than 50 years with prolonged sinus pause at time of syncope benefit of the implantation of a cardiac pacemaker.

Acute Eosinophilic and Neutrophilic Pneumonia following Transarterial Chemoembolization with Drug-Eluting Beads Loaded with Doxorubicin for Hepatocellular Carcinoma: A Case Report.

At an intermediate or advanced stage, i.e. stage B or C, based on the Barcelona Clinic Liver Cancer classification of hepatocellular carcinoma (HCC), transarterial chemoembolization (TACE) may be offered as a treatment of palliative intent. We report the case of a patient suffering from acute respiratory distress syndrome after TACE with drug-eluting beads loaded with doxorubicin for HCC. To our knowledge, this is the first case described where a bronchoalveolar lavage was performed, and where significant levels of alveolar eosinophilia and neutrophilia were evident, attributed to a pulmonary toxicity of doxorubicin following liver chemoembolization. © 2014 S. Karger AG, Basel.

Bradykinin in blood and cerebrospinal fluid after acute cerebral lesions: correlations with cerebral edema and intracranial pressure.

Abstract Bradykinin (BK) was shown to stimulate the production of physiologically active metabolites, blood-brain barrier disruption, and brain edema. The aim of this prospective study was to measure BK concentrations in blood and cerebrospinal fluid (CSF) of patients with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and ischemic stroke and to correlate BK levels with the extent of cerebral edema and intracranial pressure (ICP). Blood and CSF samples of 29 patients suffering from acute cerebral lesions (TBI, 7; SAH,: 10; ICH, 8; ischemic stroke, 4) were collected for up to 8 days after insult. Seven patients with lumbar drainage were used as controls. Edema (5-point scale), ICP, and the GCS (Glasgow Coma Score) at the time of sample withdrawal were correlated with BK concentrations. Though all plasma-BK samples were not significantly elevated, CSF-BK levels of all patients were significantly elevated in overall (n=73) and early (≤72 h) measurements (n=55; 4.3±6.9 and 5.6±8.9 fmol/mL), compared to 1.2±0.7 fmol/mL of controls (p=0.05 and 0.006). Within 72 h after ictus, patients suffering from TBI (p=0.01), ICH (p=0.001), and ischemic stroke (p=0.02) showed significant increases. CSF-BK concentrations correlated with extent of edema formation (r=0.53; p<0.001) and with ICP (r=0.49; p<0.001). Our results demonstrate that acute cerebral lesions are associated with increased CSF-BK levels. Especially after TBI, subarachnoid and intracerebral hemorrhage CSF-BK levels correlate with extent of edema evolution and ICP. BK-blocking agents may turn out to be effective remedies in brain injuries.

Attaques cérébrovasculaires ischémiques multiples dues à une méningovasculite à Borrelia garinii. [Multiple ischemic strokes due to Borrelia garinii meningovasculitis].

The most frequent clinical manifestation of borreliosis in Switzerland is erythema migrans, with about 2500 patients each year. Neurological manifestations are rare, mostly hyperalgesic radiculitis (Bannwarth syndrome), aseptic meningitis or cranial nerve involvement. We report the first Swiss patient with meningovasculitis due to neuroborreliosis, with recurrent multiple ischemic strokes in multiple vascular territories. The treatment with ceftriaxone stopped the progression, but the patient is still suffering from severe invalidating cognitive disorders. We also comment on the pathophysiology and review the literature of other clinical cases.

Le suicide comme langage de l'oppression. Ethnographie d'un service d'urgences psychiatriques

Ce travail s'intéresse à la problématique du suicide à partir de l'émergence en Suisse, vers la fin des années '90, de la prévention du suicide comme préoccupation sociale et politique. Au début, ce sont les milieux associatifs qui ont soulevé à cette question en percevant le suicide comme le reflet d'une souffrance d'origine sociale. Par la suite, la prévention du suicide est progressivement devenue une problématique de santé publique appréhendée essentiellement sous le registre médical comme étant le symptôme d'une pathologie psychiatrique. Après une première partie consacrée aux processus sociopolitiques et aux transformations morales touchant le suicide et sa prévention, ce travail approfondit, au travers d'un terrain ethnographique, la prise en charge des personnes présentant des problématiques suicidaires au sein d'un service d'urgences psychiatriques.Malgré une approche se voulant biopsychosociale, l'analyse des discours et des pratiques soignantes montre que la dimension sociale est largement négligée, conduisant à une médicalisation de situations de détresse qui sont principalement de nature sociale. En effet, parmi la population qui fréquente le service, on observe une surreprésentation de personnes issues des classes sociales défavorisées présentant souvent des trajectoires biographiques particulièrement difficiles. Au fil des entretiens avec les patients émerge une analyse voyant la souffrance psychique et la prise en charge psychiatrique comme étant aujourd'hui une manière d'obtenir une reconnaissance sociale et symbolique. Les problématiques suicidaires peuvent ainsi être interprétées comme une forme d'expression, un langage au travers duquel s'exprime la position sociale défavorisée.En adoptant une posture militante construite à partir de la réalité ethnographique, les problématiques suicidaires sont analysées comme l'expression d'une condition d'oppression liée à un cadre social et économique de plus en plus contraignant, à des rapports de pouvoir inégaux ainsi qu'à une lecture individualisante, médicalisante et pathologisante des problèmes sociaux.The present thesis discusses suicide prevention in Switzerland, which emerged as a social and political issue at the end of the '90s. At first, this question was taken up by associations considering suicide as a reflection of social suffering. Thereafter, suicide prevention gradually became a public health matter conceived with a medical approach as a symptom of a psychiatric disease. The first part of this work analyzes the sociopolitical process and moral transformations concerning suicide and its prevention. The second part is based on an ethnographic fieldwork conducted in a psychiatric emergency unit that attends people who have tried to attempt their life or consider doing it. Through the analysis of discourses and practices of the medical staff, this research shows that the social aspect of suicide is widely neglected, leading to a medicalization of social problems. In fact, amongst patients attending the emergency unit, there is an over-­-representation of people from disadvantaged classes having very difficult life stories. Interviews with patients also revealed that psychic suffering and psychiatric treatment is nowadays a way to get social and symbolical recognition. Suicidal problems can be understood as a language expressing a disadvantaged social position. By adopting a militant position constructed from the ethnographic reality, suicide is analyzed as the expression of an oppressed condition related to a more and more restricted social and economic situation, to unequal power relations as well as to an individualistic, medical and pathological interpretation of social problems.

Engorgement des centres d'urgences: une raison légitime de refuser l'accès aux patients non urgents [Emergency department overcrowding: a legitimate reason to refuse access to urgent care for non-urgent patients?].

Non-urgent cases represent 30-40% of all ED consults; they contribute to overcrowding of emergency departments (ED), which could be reduced if they were denied emergency care. However, no triage instrument has demonstrated a high enough degree of accuracy to safely rule out serious medical conditions: patients suffering from life-threatening emergencies have been inappropriately denied care. Insurance companies have instituted financial penalties to discourage the use of ED as a source of non-urgent care, but this practice mainly restricts access for the underprivileged. More recent data suggest that in fact most patients consult for appropriate urgent reasons, or have no alternate access to urgent care. The safe reduction of overcrowding requires a reform of the healthcare system based on patients' needs rather than access barriers.

A fully echo-guided trans-apical aortic valve implantation.

The trans-apical aortic valve implantation (TA-AVI) is an established technique for high-risk patients requiring aortic valve replacement. Traditionally, preoperative (computed tomography (CT) scan, coronary angiogram) and intra-operative imaging (fluoroscopy) for stent-valve positioning and implantation require contrast medium injections. To preserve the renal function in elderly patients suffering from chronic renal insufficiency, a fully echo-guided trans-catheter valve implantation seems to be a reasonable alternative. We report the first successful TA-AVI procedure performed solely under trans-oesophageal echocardiogram control, in the absence of contrast medium injections.

Impact of international consensus guidelines on antiviral therapy of chronic hepatitis C patients in Switzerland.

To assess the impact of international consensus conference guidelines on the attitude of Swiss specialists when facing the decision to treat chronic hepatitis C patients. Questionnaires focusing on the personal situation and treatment decisions were mailed to 165 patients who were newly diagnosed with hepatitis C virus (HCV) infection and enrolled into the Swiss Hepatitis C Cohort Study during the years 2002-2004. Survey respondents (n = 86, 52.1%) were comparable to non-respondents with respect to severity of liver disease, history of substance abuse and psychiatric co-morbidities. Seventy percent of survey respondents reported having been offered antiviral treatment. Patients deferred from treatment had less advanced liver fibrosis, were more frequently infected with HCV genotypes 1 or 4 and presented more often with a history of depression. There were no differences regarding age, socio-economic background, alcohol abuse, intravenous drug abuse or methadone treatment when compared with patients to whom treatment was proposed. Ninety percent of eligible patients agreed to undergo treatment. Overall, 54.6% of respondents and 78.3% of those considered eligible had actually received antiviral therapy by 2007. Ninety-five percent of patients reported high satisfaction with their own hepatitis C management. Consistent with latest international consensus guidelines, patients enrolled in the Swiss Hepatitis C Cohort with a history of substance abuse were not withheld antiviral treatment. A multidisciplinary approach is warranted to provide antiviral treatment to patients suffering from depression.

Self-reported health needs and use of primary health care services by adolescents enrolled in post-mandatory schools or vocational training programmes in Switzerland.

BACKGROUND: The second Swiss Multicenter Adolescent Survey on Health (SMASH02) was conducted among a representative sample (n = 7428) of students and apprentices aged 16 to 20 from the three language areas of Switzerland during the year 2002. This paper reports on health needs expressed by adolescents and their use of health care services over the 12 months preceding the survey. METHODS: Nineteen cantons representing 80% of the resident population agreed to participate. A complex iterative random cluster sample of 600 classes was drawn with classes as primary sampling unit. The participation rate was 97.7% for the classes and 99.8% for the youths in attendance. The self-administered questionnaire included 565 items. The median rate of item non-response was 1.8%. Ethical and legal requirements applying to surveys of adolescent populations were respected. RESULTS: Overall more than 90% of adolescents felt in good to excellent health. Suffering often or very often from different physical complaints or pain was also reported such as headache (boys: 15.9%, girls: 37.4%), stomach-ache (boys: 9.7%, girls: 30.0%), joint pain (boys: 24.7%, girls: 29.5%) or back pain (boys: 24.3%, girls: 34.7%). Many adolescents reported a need for help on psychosocial and lifestyle issues, such as stress (boys: 28.5%, girls: 47.7%) or depression (boys: 18.9%, girls: 34.4%). Although about 75% of adolescents reported having consulted a general practitioner and about one-third having seen another specialist, reported reasons for visits do not correspond to the expressed needs. Less than 10% of adolescents had visited a psychiatrist, a family planning centre or a social worker. CONCLUSIONS: The reported rates of health services utilisation by adolescents does not match the substantial reported needs for help in various areas. This may indicate that the corresponding problems are not adequately detected and/or addressed by professionals from the health and social sectors.

Mechanical circulatory support for destination therapy.

Patients with chronic heart failure who are not eligible for heart transplant and whose life expectancy depends mainly on the heart disease may benefit from mechanical circulatory support. Mechanical circulatory support restores adequate cardiac output and organ perfusion and eventually improves patients' clinical condition, quality of life and life expectancy. This treatment is called destination therapy (DT) and we estimate that in Switzerland more than 120 patients per year could benefit from it. In the last 10 years, design of the devices, implantation techniques and prognoses have changed dramatically. The key to successful therapy with a left ventricular assist device is appropriate patient selection, although we are still working on the definition of reliable inclusion and exclusion criteria and optimal timing for surgical implantation. Devices providing best long-term results are continuous flow, rotary or axial blood pumps implanted using minimally invasive techniques on a beating heart. These new devices (Thoratec HeartMate II and HeartWare HVAD) have only a single moving part, and have improved durability with virtually 10 years freedom from mechanical failure. In selected patients, the overall actuarial survival of DT patients is 75% at 1 year and 62% at 2 years, with a clear improvement in quality of life compared with medical management only. Complications include bleeding and infections; their overall incidence is significantly lower than with previous devices and their management is well defined. DT is evolving into an effective and reasonably cost-effective treatment option for a growing population of patients not eligible for heart transplant, showing encouraging survival rates at 2 years and providing clear improvement in quality of life. The future is bright for people suffering from chronic heart failure.

Legal education in crisis: healing and humanizing Canadian law schools /

Western law schools are suffering from an identity and moral crisis. Many of the legal profession's problems can be traced to the law school environment, where students are taught to reason and practice in ways that are often at odds with their own personalities and values and even with generally accepted psychologically healthy practices. The idealism, ethic of care, and personal moral compasses of many students become eroded and even lost in the present legal education system. Formalism, rationalism, elitism, and big business values have become paramount. In such a moment of historical crisis, there exists the opportunity to create a new legal education story. This paper is a conceptual study of both my own Canadian legal education and the general legal education experience. It examines core problems and critiques of the existing Western legal education organizational and pedagogical paradigm to which Canadian law schools adhere. New approaches with the potential to enrich, humanize, and heal the Canadian law school experience are explored. Ultimately, the paper proposes a legal education system that is more interdisciplinary, theoretically and practically integrated, emotionally intelligent, technologically connected, morally accountable, spiritual, and humane. Specific pedagogical and curricular strategies are suggested, and recommendations for the future are offered. The dehumanizing aspects of the law school experience in Canada have rarely been studied. It is hoped that this thesis will fill a gap in the research and provide some insight into an issue that is of both academic and public importance, since the well-being of law students and lawyers affects the interests of their clients, the general public, and the integrity and future of the entire legal system.

Paradigms and prisons: a narrative of translation and transformation : my hero's journey from "at-risk" youth to teacher/learner in a jail setting /

All life is suffering. Life is the pursuit ofhappiness. These are two foundational Buddhist dictums that, in their simplicity, I have entirely misunderstood regarding their depth, misreading them as contradictory. Indeed, my superficial interpretations led me to Thoreau's life ofquiet desperation and deep depression. We come to know and bring understanding to our lives by storying them. My own Hero's Journey, the path from my egoic selftoward the universal Self, can be understood as the resultant translations and transformations. Inevitably each of us is involved in such a story, though most are unaware of the stages along our own Hero's journey. ' Narrative honours writing as a means of knowing. The contemplative reflection allows insight into our imprisoning paradigms, beliefs, behaviours, and blind spots. My research revisits and explores nodal experiences along my Hero's Journey through 4 categories: self, society, soil, and Self. While the value of this process of narrative inquiry lay in its ability to come to know and understand one's self, perhaps its greater value is of a more universal nature. My inquiry, while adding to the body of academic educational narrative literature, may also illuminate a path to educators, students, and all interested, encouraging a response to the call of their own Hero's journey. I am a teacher/learner in a jail setting, working with youth between the ages of 12 and 18 who have committed crimes such as armed robbery, assault, rape, and murder. As this thesis follows my continual development from egoic self/teacher/learner to universal Self/Teacher/Learner, it also enables me to both consciously and unconsciously open the ways in which I expand my care, compassion, and love to work with at-risk youth.

The nature of avidyÄ in Buddhism and VedÄ nta

This thesis deals with the nature of ignorance as it was interpreted in the Upani~adic tradition, specifically in Advaita Vedanta, and in early and Mahayana Buddhism , e specially in the Madhyamika school of Buddhism. The approach i s a historical and comparative one. It examines the early thoughts of both the upanis.a ds and Buddhism abou t avidya (ignorance), shows how the notion was treated by the more speculative and philosphically oriented schools which base d themselves on the e arly works, and sees how their views differ. The thesis will show that the Vedinta tended to treat avidya as a topic for metaphysical s peculation as t he s chool developed, drifting from its initial e xistential concerns, while the Madhyamika remained in contact with the e xistential concerns evident in the first discourses of the Buddha. The word "notion" has been chosen for use in referring t o avidya, even though it may have non-intellectual and emotional connotations, to avoid more popular a lternatives such as "concept" or "idea". In neither the Upani,ads, Advaita Vedanta, or Buddhism is ignorance merely a concept or an idea. Only in a secondary sense, in texts and speech , does it become one. Avidya has more to do with the lived situation in which man finds himself, with the subjectobject separation in which he f eels he exists, than with i i i intel lect ual constr ucts . Western thought has begun to r ealize the same with concerns such as being in modern ontology, and has chosen to speak about i t i n terms of the question of being . Avidya, however, i s not a 'question' . If q ue stions we r e to be put regarding the nature of a vidya , they would be more of t he sort "What is not avidya?", though e ven here l anguage bestows a status t o i t which avidya does not have. In considering a work of the Eastern tradition, we f ace t he danger of imposing Western concepts on it. Granted t hat avidya is customari ly r endered i n English as ignorance, the ways i n which the East and West view i gno rance di f f er. Pedagogically , the European cultures, grounded in the ancient Greek culture, view ignorance as a l ack or an emptiness. A child is i gnorant o f certain t hings and the purpose o f f ormal education , in f act if not in theory, is to fill him with enough knowledge so that he can cope wit h t he complexities and the e xpectations of s ociety. On another level, we feel t hat study and research will l ead t o the discovery o f solutions, which we now lack , for problems now defying solut i on . The East, on the o t her hand, sees avidya in a d i fferent light.Ignorance isn't a lack, but a presence. Religious and philosophical l iterature directs its efforts not towards acquiring something new, but at removing t.he ideas and opinions that individuals have formed about themselves and the world. When that is fully accomplished, say the sages , t hen Wisdom, which has been obscured by those opinions, will present itself. Nothing new has to be learned, t hough we do have t o 'learn' that much. The growing interest in t he West with Eastern religions and philosophies may, in time, influence our theoretical and practical approaches to education and learning, not only in the established educati onal institutions, but in religious , p sychological, and spiritual activities as well. However, the requirements o f this thesis do no t permit a formulation of revolutionary method or a call to action. It focuses instead on the textual arguments which attempt to convince readers that t he world in which they take themselves to exist is not, in essence, real, on the ways i n which the l imitations of language are disclosed, and on the provisional and limited schemes that are built up to help students see through their ignorance. The metaphysic s are provisional because they act only as spurs and guides. Both the Upanisadic and Buddhist traditions that will be dealt with here stress that language constantly fails to encompass the Real. So even terms s uch as 'the Real', 'Absolute', etc., serve only to lead to a transcendent experience . The sections dealing with the Upanisads and Advaita Vedanta show some of the historical evolution of the notion of avidya, how it was dealt with as maya , and the q uestions that arose as t o its locus. With Gau?apada we see the beginnings of a more abstract treatment of the topic, and , the influence of Buddhism. Though Sankhara' S interest was primarily directed towards constructing a philosophy to help others attain mok~a ( l iberation), he too introduced t echnica l t e rminology not found in the works of his predecessors. His work is impressive , but areas of it are incomplete. Numbers of his followers tried to complete the systematic presentation of his insi ghts . Their work focuses on expl anat i ons of adhyasa (superimposition ) , t he locus and object of ignorance , and the means by which Brahman takes itself to be the jiva and the world. The section on early Buddhism examines avidya in the context o f the four truths, together with dubkha (suffering), the r ole it p l ays in t he chain of dependent c ausation , a nd t he p r oblems that arise with t he doctrine of anatman. With t he doct rines of e arly Buddhism as a base, the Madhyamika elaborated questions that the Buddha had said t e nded not t o edi f ication. One of these had to do with own - being or svabhava. Thi s serves a s a centr e around which a discussion o f i gnorance unfolds, both i ndividual and coll ective ignorance. There follows a treatment of the cessation of ignorance as it is discussed within this school . The final secti on tries to present t he similarities and differences i n the natures o f ignorance i n t he two traditions and discusses the factors responsible for t hem . ACKNOWLEDGEMENTS I would like to thank Dr. Sinha for the time spent II and suggestions made on the section dealing with Sankara and the Advait.a Vedanta oommentators, and Dr. Sprung, who supervised, direoted, corrected and encouraged the thesis as a whole, but especially the section on Madhyamika, and the final comparison.

Buddhism and the earth : environmental thought in early Buddhist philosophy

Introduction Fundamental to the philosophy of Buddhism, is the insight that there is "unsatisfactohness" (dukkha) in the world and that it can be eliminated through the practice of the Noble Eight Fold Path. Buddhism also maintains that the world as we experience and entities that exist are bereft of any substantiality. Instead existence is manifest through dependent origination. All things are conditional; nothing is permanent. However, inherent in this dependent existence is the interconnectedness of all beings and their subjection to the cosmic law of karma. Part of cultivating the Eight Fold path includes a deep compassion for all other living things, 'trapped' within this cycle of dependent origination. This compassion or empathy (karuna) is crucial to the Buddhist path to enlightenment. It is this emphasis on karuna that shows itself in Mahayana Buddhism with respect to the theory of the boddhisatva (or Buddha-to-be) since the boddhisatva willingly postpones his/her own enlightenment to help others on the same path. One of the ramifications of the theory of dependent origination is that there is no anthropocentric bias placed on humans over the natural world. Paradoxically the doctrine of non-self becomes an ontology within Buddhism, culminating in the Mayahana realization that a common boundary exists between samsara and nirvana. Essential to this ontology is the life of dharma or a moral life. Ethics is not separated from ontology. As my thesis will show, this basic outlook of Buddhism has implications toward our understanding of the Buddhist world-view with respect to the current human predicament concerning the environment. While humans are the only ones who can 4 attain "Buddhahood", it is because of our ability to understand what it means to follow the Eight fold path and act accordingly. Because of the interconnectedness of all entities {dharmas), there is an ontological necessity to eliminate suffering and 'save the earth' because if we allow the earth to suffer, we ALL suffer. This can be understood as an ethical outlook which can be applied to our interaction with and treatment of the natural environment or environment in the broadest sense, not just trees plants rocks etc. It is an approach to samsara and all within it. It has been argued that there is no ontology in Buddhism due to its doctrine of "non-self". However, it is a goal of this thesis to argue that there does exist an original ontology in Buddhism; that according to it, the nature of Being is essentially neither "Being nor non-being nor not non-being" as illustrated by Nagarjuna. Within this ontology is engrained an ethic or 'right path' (samma marga) that is fundamental to our being and this includes a compassionate relationship to our environment. In this dissertation I endeavour to trace the implications that the Buddhist worldview has for the environmental issues that assail us in our age of technology. I will explore questions such as: can the Buddhist way of thinking help us comprehend and possibly resolve the environmental problems of our day and age? Are there any current environmental theories which are comparable to or share common ground with the classical Buddhist doctrines? I will elucidate some fundamental doctrines of early Buddhism from an environmental perspective as well as identify some comparable modern environmental theories such as deep ecology and general systems theory, that seem to share in the wisdom of classical Buddhism and have much to gain from a deeper appreciation of Buddhism.