THE ROLE OF PEST CONTROL OPERATORS IN VERTEBRATE PEST CONTROL

The National Pest Control Association, which I represent, accepts for membership those persons or firms which are actively engaged in the performance of structural pest control services for hire to the public at large and which are in sympathy with the purposes of the Association. The pest control operator in this context might be called a commercial pest control operator to distinguish him from those doing similar work but who are employed by governmental agencies or within large commercial organizations. Pest control is a growing industry with a gross annual income of 300-350 million dollars. It is estimated to contain more than 5,000 firms employing about 25,000 productive workers. Many of these servicemen, possibly 15,000, are doing vertebrate pest control every day as they combat commensal rodents. A much smaller number, usually specialists or persons normally doing super¬visory work, are also engaged in the control of pest birds and a variety of miscellaneous vertebrates. With approximately 15,000 servicemen making at least 10 contacts a day with the public, it is readily apparent that whatever opportunity the general public has to judge the success or failure of vertebrate pest control practice is largely influenced by the work of the pest control industry.

Introdução à identificação de sistemas utilizando o System Identification Toolbox do MATLAB em conjunto com o Arduino para o laboratório de controle linear

The education designed and planned in a clear and objective manner is of paramount importance for universities to prepare competent professionals for the labor market, and above all can serve the population with an efficient work. Specifically, in relation to engineering, conducting classes in the laboratories it is very important for the application of theory and development of the practical part of the student. The planning and preparation of laboratories, as well as laboratory equipment and activities should be developed in a succinct and clear way, showing to students how to apply in practice what has been learned in theory and often shows them why and where it can be used when they become engineers. This work uses the MATLAB together with the System Identification Toolbox and Arduino for the identification of linear systems in Linear Control Lab. MATLAB is a widely used program in the engineering area for numerical computation, signal processing, graphing, system identification, among other functions. Thus the introduction to MATLAB and consequently the identification of systems using the System Identification Toolbox becomes relevant in the formation of students to thereafter when necessary to identify a system the base and the concept has been seen. For this procedure the open source platform Arduino was used as a data acquisition board being the same also introduced to the student, offering them a range of software and hardware for learning, giving you every day more luggage to their training

APR e FMEA em trocador de calor de bomba

The modernization of the world made the speed, accuracy and reliability of all existing processes become increasingly necessary. For this evolution to occur every day, the evolution of the equipment was strategic, but not as much as needed. It is necessary for such equipment to ensure its function and, in case of failure, an early diagnosis to prevent loss. Therefore the evolution of maintainability and reliability in equipment is also paramount. Thus, the growth of forms of maintenance was driven by this scenario, forming maintenance philosophies. Among many, there is the RCM, which have its focus on the identification, parameters development and performance preview. One of those methodologies from this idea is the FMEA, process that has been studied and implemented this work, aiming the anticipation of failure modes and guidance for the use of a heat exchanger and a pump. This implementation has the aid of another process of RCM, the PHA, which was also shown and implemented, these results being used to start the FMEA process. The results show the activities with the highest chance of failure, presenting also the measures to be taken to avoid or minimize them. It is shown, in this paper, concern with the valves because they maintain control and system security, and its flaws related to accidents with possible danger to people and the whole system, emphasizing the priority of action

A construção social do mercado colaborativo de software livre durante o Governo Lula: agentes, estratégias e discursos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Is the food frequency consumption essential as covariate to estimate usual intake of episodically consumed foods?

BACKGROUNDS/OBJECTIVES: The aim of this paper is to verify the performance of the frequency of consumption as variable for prediction of the usual intakes of foods. SUBJECTS/METHODS: In total, 725 individuals who answered two nonconsecutive 24-h recall and one food frequency questionnaire (FFQ) in the 'Healthy Survey-Sao Paulo-Brazil'. An additional indicator variable indicating if one is usual consumer was created before analyzing. The Multiple Source Method and National Cancer Institute method were used to estimate usual intake of selected food considering different models of prediction: with no covariates; with FFQ; with FFQ plus indicator variable; and with only indicator variable. RESULTS: For foods that are consumed every day or almost every day, the inclusion of the FFQ and/or the indicator variable as covariates resulted in similar percentiles of consumption when compared with the model with no covariates. For episodically consumed foods, the models with FFQ plus indicator variable and with only indicator variable estimated similar percentiles of intake. CONCLUSIONS: The use of the indicator variable instead the FFQ appears as a good alternative to estimate usual intake of episodically consumed foods.

Quality of diet of working college students

Considering the scarcity of studies with young workers and the role of diet in the prevention of chronic diseases, the objective of the study was to assess the quality of diet of working college students. The present study investigated 43 university students, aged between 18 and 25 years old who had systematically being involved in a working activity in the past 6 months, paid or unpaid, at least 6 hours daily, five days a week. Dietary intake measured by seven dietary records covering every day of the week was used to calculate the Brazilian Healthy Eating Index Revised (B-HEIR). It was observed a low B-HEIR score (53.43,+/- 7.81) indicating a risk of a poor quality of diet, with high intake of sodium and sugar and low consumption of fruits and whole grains. This poor quality of diet can result in an inadequate nutritional status that may increase the risk of obesity and chronic diseases.

O cotidiano, o lúdico e as redes relacionais: a artesania do cuidar em terapia ocupacional no hospital

O objetivo deste trabalho é refletir sobre os modos de fazer, sentir e conduzir as ações de contar histórias em uma enfermaria pediátrica. Essas ações decorrem de atividades de extensão universitária, no âmbito da terapia ocupacional. A reflexão, realizada a partir da revisão de literatura e discussão sobre anotações de campo do projeto, pauta-se por norteadores teóricos baseados nas tecnologias do cuidado e no brincar dentro do contexto das intervenções no hospital, sob a perspectiva da integralidade e da humanização do cuidado. A contação de histórias é apresentada enquanto forma de promover escuta, acolhimento, afetações diversas e processos vinculares, possibilitando a constituição de uma rede de sustentabilidade relacional, envolvendo os atores que circulam na enfermaria. Reafirma, assim, as práticas profissionais em saúde no hospital a partir de uma construção permanente junto ao sujeito por meio de ferramentas tecnológicas singularizadoras que promovam encontros-acontecimentos.

Comparación entre la calidad de puestas naturales e inducidas, mediante inyección e implante de GnRHa, del pez de limón (Seriola dumerili).

[EN]For this study, a total of 19 greater amberjack (Seriola dumerili) broodstock were used. Females with oocites bigger than 600μ, and fluent males with a mean weight of 10.72±1.22 kg, fameles, and 10.77±2.33 kg males. The experimental tanks were circular tanks of 40 m3 capacity. One of the tanks were not induced and the other two were with GnRHa, one with injections and the other by implants. Best results, in all parameters studied were with natural spawns, with a 84.37% of fertilization, 92.21% of viable eggs at 24 hours of spawn, 96.60% of hatching, 69.91% of larvae one day after hatching and 10.78% of 5 day life larvae.

Sulla ricerca del minimo dei consumi per vetture sportive

La ricerca oggetto di questa tesi, come si evince dal titolo stesso, è volta alla riduzione dei consumi per vetture a forte carattere sportivo ed elevate prestazioni specifiche. In particolare, tutte le attività descritte fanno riferimento ad un ben definito modello di vettura, ovvero la Maserati Quattroporte. Lo scenario all’interno del quale questo lavoro si inquadra, è quello di una forte spinta alla riduzione dei cosiddetti gas serra, ossia dell’anidride carbonica, in linea con quelle che sono le disposizioni dettate dal protocollo di Kyoto. La necessità di ridurre l’immissione in atmosfera di CO2 sta condizionando tutti i settori della società: dal riscaldamento degli edifici privati a quello degli stabilimenti industriali, dalla generazione di energia ai processi produttivi in senso lato. Nell’ambito di questo panorama, chiaramente, sono chiamati ad uno sforzo considerevole i costruttori di automobili, alle quali è imputata una percentuale considerevole dell’anidride carbonica prodotta ogni giorno e riversata nell’atmosfera. Al delicato problema inquinamento ne va aggiunto uno forse ancor più contingente e diretto, legato a ragioni di carattere economico. I combustibili fossili, come tutti sanno, sono una fonte di energia non rinnovabile, la cui disponibilità è legata a giacimenti situati in opportune zone del pianeta e non inesauribili. Per di più, la situazione socio politica che il medio oriente sta affrontando, unita alla crescente domanda da parte di quei paesi in cui il processo di industrializzazione è partito da poco a ritmi vertiginosi, hanno letteralmente fatto lievitare il prezzo del petrolio. A causa di ciò, avere una vettura efficiente in senso lato e, quindi, a ridotti consumi, è a tutti gli effetti un contenuto di prodotto apprezzato dal punto di vista del marketing, anche per i segmenti vettura più alti. Nell’ambito di questa ricerca il problema dei consumi è stato affrontato come una conseguenza del comportamento globale della vettura in termini di efficienza, valutando il miglior compromesso fra le diverse aree funzionali costituenti il veicolo. Una parte consistente del lavoro è stata dedicata alla messa a punto di un modello di calcolo, attraverso il quale eseguire una serie di analisi di sensibilità sull’influenza dei diversi parametri vettura sul consumo complessivo di carburante. Sulla base di tali indicazioni, è stata proposta una modifica dei rapporti del cambio elettro-attuato con lo scopo di ottimizzare il compromesso tra consumi e prestazioni, senza inficiare considerevolmente queste ultime. La soluzione proposta è stata effettivamente realizzata e provata su vettura, dando la possibilità di verificare i risultati ed operare un’approfondita attività di correlazione del modello di calcolo per i consumi. Il beneficio ottenuto in termini di autonomia è stato decisamente significativo con riferimento sia ai cicli di omologazione europei, che a quelli statunitensi. Sono state inoltre analizzate le ripercussioni dal punto di vista delle prestazioni ed anche in questo caso i numerosi dati rilevati hanno permesso di migliorare il livello di correlazione del modello di simulazione per le prestazioni. La vettura con la nuova rapportatura proposta è stata poi confrontata con un prototipo di Maserati Quattroporte avente cambio automatico e convertitore di coppia. Questa ulteriore attività ha permesso di valutare il differente comportamento tra le due soluzioni, sia in termini di consumo istantaneo, che di consumo complessivo rilevato durante le principali missioni su banco a rulli previste dalle normative. L’ultima sezione del lavoro è stata dedicata alla valutazione dell’efficienza energetica del sistema vettura, intesa come resistenza all’avanzamento incontrata durante il moto ad una determinata velocità. Sono state indagate sperimentalmente le curve di “coast down” della Quattroporte e di alcune concorrenti e sono stati proposti degli interventi volti alla riduzione del coefficiente di penetrazione aerodinamica, pur con il vincolo di non alterare lo stile vettura.

Architectures and design patterns for functional design of logic control and diagnostics in industrial automation

Recently in most of the industrial automation process an ever increasing degree of automation has been observed. This increasing is motivated by the higher requirement of systems with great performance in terms of quality of products/services generated, productivity, efficiency and low costs in the design, realization and maintenance. This trend in the growth of complex automation systems is rapidly spreading over automated manufacturing systems (AMS), where the integration of the mechanical and electronic technology, typical of the Mechatronics, is merging with other technologies such as Informatics and the communication networks. An AMS is a very complex system that can be thought constituted by a set of flexible working stations, one or more transportation systems. To understand how this machine are important in our society let considerate that every day most of us use bottles of water or soda, buy product in box like food or cigarets and so on. Another important consideration from its complexity derive from the fact that the the consortium of machine producers has estimated around 350 types of manufacturing machine. A large number of manufacturing machine industry are presented in Italy and notably packaging machine industry,in particular a great concentration of this kind of industry is located in Bologna area; for this reason the Bologna area is called “packaging valley”. Usually, the various parts of the AMS interact among them in a concurrent and asynchronous way, and coordinate the parts of the machine to obtain a desiderated overall behaviour is an hard task. Often, this is the case in large scale systems, organized in a modular and distributed manner. Even if the success of a modern AMS from a functional and behavioural point of view is still to attribute to the design choices operated in the definition of the mechanical structure and electrical electronic architecture, the system that governs the control of the plant is becoming crucial, because of the large number of duties associated to it. Apart from the activity inherent to the automation of themachine cycles, the supervisory system is called to perform other main functions such as: emulating the behaviour of traditional mechanical members thus allowing a drastic constructive simplification of the machine and a crucial functional flexibility; dynamically adapting the control strategies according to the different productive needs and to the different operational scenarios; obtaining a high quality of the final product through the verification of the correctness of the processing; addressing the operator devoted to themachine to promptly and carefully take the actions devoted to establish or restore the optimal operating conditions; managing in real time information on diagnostics, as a support of the maintenance operations of the machine. The kind of facilities that designers can directly find on themarket, in terms of software component libraries provides in fact an adequate support as regard the implementation of either top-level or bottom-level functionalities, typically pertaining to the domains of user-friendly HMIs, closed-loop regulation and motion control, fieldbus-based interconnection of remote smart devices. What is still lacking is a reference framework comprising a comprehensive set of highly reusable logic control components that, focussing on the cross-cutting functionalities characterizing the automation domain, may help the designers in the process of modelling and structuring their applications according to the specific needs. Historically, the design and verification process for complex automated industrial systems is performed in empirical way, without a clear distinction between functional and technological-implementation concepts and without a systematic method to organically deal with the complete system. Traditionally, in the field of analog and digital control design and verification through formal and simulation tools have been adopted since a long time ago, at least for multivariable and/or nonlinear controllers for complex time-driven dynamics as in the fields of vehicles, aircrafts, robots, electric drives and complex power electronics equipments. Moving to the field of logic control, typical for industrial manufacturing automation, the design and verification process is approached in a completely different way, usually very “unstructured”. No clear distinction between functions and implementations, between functional architectures and technological architectures and platforms is considered. Probably this difference is due to the different “dynamical framework”of logic control with respect to analog/digital control. As a matter of facts, in logic control discrete-events dynamics replace time-driven dynamics; hence most of the formal and mathematical tools of analog/digital control cannot be directly migrated to logic control to enlighten the distinction between functions and implementations. In addition, in the common view of application technicians, logic control design is strictly connected to the adopted implementation technology (relays in the past, software nowadays), leading again to a deep confusion among functional view and technological view. In Industrial automation software engineering, concepts as modularity, encapsulation, composability and reusability are strongly emphasized and profitably realized in the so-calledobject-oriented methodologies. Industrial automation is receiving lately this approach, as testified by some IEC standards IEC 611313, IEC 61499 which have been considered in commercial products only recently. On the other hand, in the scientific and technical literature many contributions have been already proposed to establish a suitable modelling framework for industrial automation. During last years it was possible to note a considerable growth in the exploitation of innovative concepts and technologies from ICT world in industrial automation systems. For what concerns the logic control design, Model Based Design (MBD) is being imported in industrial automation from software engineering field. Another key-point in industrial automated systems is the growth of requirements in terms of availability, reliability and safety for technological systems. In other words, the control system should not only deal with the nominal behaviour, but should also deal with other important duties, such as diagnosis and faults isolations, recovery and safety management. Indeed, together with high performance, in complex systems fault occurrences increase. This is a consequence of the fact that, as it typically occurs in reliable mechatronic systems, in complex systems such as AMS, together with reliable mechanical elements, an increasing number of electronic devices are also present, that are more vulnerable by their own nature. The diagnosis problem and the faults isolation in a generic dynamical system consists in the design of an elaboration unit that, appropriately processing the inputs and outputs of the dynamical system, is also capable of detecting incipient faults on the plant devices, reconfiguring the control system so as to guarantee satisfactory performance. The designer should be able to formally verify the product, certifying that, in its final implementation, it will perform itsrequired function guarantying the desired level of reliability and safety; the next step is that of preventing faults and eventually reconfiguring the control system so that faults are tolerated. On this topic an important improvement to formal verification of logic control, fault diagnosis and fault tolerant control results derive from Discrete Event Systems theory. The aimof this work is to define a design pattern and a control architecture to help the designer of control logic in industrial automated systems. The work starts with a brief discussion on main characteristics and description of industrial automated systems on Chapter 1. In Chapter 2 a survey on the state of the software engineering paradigm applied to industrial automation is discussed. Chapter 3 presentes a architecture for industrial automated systems based on the new concept of Generalized Actuator showing its benefits, while in Chapter 4 this architecture is refined using a novel entity, the Generalized Device in order to have a better reusability and modularity of the control logic. In Chapter 5 a new approach will be present based on Discrete Event Systems for the problemof software formal verification and an active fault tolerant control architecture using online diagnostic. Finally conclusive remarks and some ideas on new directions to explore are given. In Appendix A are briefly reported some concepts and results about Discrete Event Systems which should help the reader in understanding some crucial points in chapter 5; while in Appendix B an overview on the experimental testbed of the Laboratory of Automation of University of Bologna, is reported to validated the approach presented in chapter 3, chapter 4 and chapter 5. In Appendix C some components model used in chapter 5 for formal verification are reported.

Effetto della temperatura di conservazione del latte, dalla raccolta all'affioramento, sulla microflora del latte, del sieroinnesto e del formaggio Trentingrana

This PhD research is part of a project addressed to improve the quality of Grana Trentino production. The objectives were to evaluated if milk storage and collection procedures may affect cheese-making technology and quality. Actually the milk is collected and delivered to the cheese factory just after milking in 50 L cans without refrigeration or in tanks cooled at 18 °C. This procedure is expensive (two deliveries each day) and the milk quality is difficult to preserve as temperatures are not controlled. The milk refrigeration at the farm could allow a single delivery to the dairy. Therefore it could be a good strategy to preserve raw milk quality and reduce cheese spoilage. This operation may, however, have the drawbacks of favouring the growth of psychrotrophic bacteria and changing the aptitude of milk to coagulation. With the aim of studying the effect on milk and cheese of traditional and new refrigerated technologies of milk storage, two different collection and creaming technologies were compared. The trials were replicated in three cheese factories manufacturing Grana Trentino. Every cheese-making day, about 1000 milk liters were collected from always the same two farms in the different collection procedures (single or double). Milk was processed to produce 2 wheels of Grana trentino every day. During the refrigerated trials, milk was collected and stored at the farm in a mixed tank at 12 or 8 °C and then was carried to the dairy in truck once a day. 112 cheese making day were followed: 56 for traditional technology and 56 for the refrigerated one. Each one of these two thechnologies lead to different ways of creaming: long time in the traditional one and shorter in the new one. For every cheese making day we recorded time, temperatures and pH during the milk processing to cheese. Whole milk before ceraming, cream and skim milk after creaming, vat milk and whey were sampled during every cheese-making day for analysis. After 18 months ripening we opened 46 cheese wheels for further chemical and microbiological analyses. The trials were performed with the aim of: 1 estimate the effect of storage temperatures on microbial communities, physico-chemical or/and rheological differences of milk and skim milk after creaming. 2 detect by culture dependent (plate counts) and indipendent (DGGE) methodolgies the microbial species present in whole, skimmed milk, cream and cheese sampled under the rind and in the core; 3 estimate the physico-chemical characteristics, the proteolytic activity, the content of free aminoacids and volatile compounds in 18 months ripened Grana Trentino cheeses from different storing and creaming of milk technologies. The results presented are remarkable since this is the first in-deep study presenting microbiological and chemical analysis of Grana Trentino that even if belonging to Grana Padano Consortium, it is clearly different in the milk and in the manufacturing technology.

„When we are disciplined, we can learn very well“: Schüler und Disziplin an einem Jungeninternat in Nordghana /// Arbeitspapiere / Institut für Ethnologie und Afrikastudien ; 91

Diese Arbeit analysiert den Alltag in einem gymnasialen Jungeninternat in der Upper West Region in Ghana und setzt diese Analyse in eine anthropologische Perspektive zum Staat. Angeregt durch die Überlegungen von Michel Foucault zu Disziplinarmechanismen und „Technologien des Selbst“ steht die alltägliche Disziplinierung der Schüler im Mittelpunkt dieser Arbeit. Dabei wird Disziplin nicht als restriktiv, übergeordnet und allgegenwärtig gedacht, sondern als etwas, das die Schüler aktiv mitgestalten. Einerseits sind die Schüler der Nandom Secondary School Disziplinartechniken ausgesetzt, die sich auf die Kontrolle ihrer Körper beziehen: Sie werden vereinheitlicht, klassifiziert, hierarchisiert, überwacht, geprüft und bestraft. Andererseits sind die Schüler keine übermächtigten Objekte einer totalen Institution, sondern sie wirken kreativ mit beim Flechten des Netzes aus Kontrolle und Freiräumen in ihrer Schule: Sie spielen eine wichtige Rolle bei der Kontrolle der Lehrer; sie erkennen und nutzen Freiräume, deren Rahmen sie mit den Lehrern aushandeln. Auch ihr Selbst bekommen die Schüler nicht von den Lehrern einfach diktiert. Zwar wird ihnen durch das Bild des guten Schülers eine bestimmte Sicht auf sich selbst nahe gelegt, doch wie sie dieses Bild aufnehmen, ablehnen oder umdeuten liegt in ihren eigenen Händen.

Abstinenzverhalten von Patienten mit alkoholtoxischer Leberzirrhose in der Wartezeit vor Lebertransplantation: Selbstauskunft versus Alkoholmarker

Die alkoholische Leberzirrhose ist eine anerkannte Indikation für eine Lebertransplantation. Die Prognose dieser Patientengruppe ist bei sicherer Langzeitabstinenz besser als diejenige von Patienten mit einer Leberzirrhose anderer Genese. Jeglicher Alkoholkonsum stellt eine absolute Kontraindikation für eine Transplantation dar. In vielen Ländern gibt es die Forderung nach einer sechsmonatigen Alkoholabstinenz sowie einer guten Compliance vor der Lebertransplantation. Zu deren Überprüfung stehen in der Praxis meist methodisch unzureichende Standards zur Verfügung. Mit der seit den 80er Jahren in der Rechtsmedizin etablierten Alkoholbegleitstoff-Analyse werden die Serumkonzentrationen von Ethanol und anderen Alkoholen und Begleitstoffen, wie z.B. dem Methanol, bestimmt. Methanol ist ein sensitiver und spezifischer Indikator für einen rezenten Alkoholkonsum, da es aufgrund von kompetitiver Hemmung der ADH durch exogen herbeigeführtes (konsumiertes) Ethanol im Serum akkumuliert. Die Alkoholbegleitstoff-Analyse eignet sich im klinischen Alltag zur Überprüfung eines rezenten Alkoholkonsums bei Patienten mit Alkoholismushintergrund. rnIn dieser Studie wurde der Methanoltest standardisiert bei 41 Patienten mit einer ALC auf der Warteliste für eine LTx angewandt. Es wurde bei 32 von 92 Blutuntersuchungen ein Rückfall nachgewiesen, während die Selbstauskunft und der Ethanoltest jeweils nur in 3 Fällen positiv ausfielen. Der Methanoltest wies also in 29 Fällen (1/3) einen rezenten Alkoholkonsum nach, der weder in der Selbstauskunft noch durch den Ethanoltest aufgedeckt worden war.rnEs konnte gezeigt werden, dass der Methanoltest als Bestandteil der Alkoholbegleitstoff-Analyse für die Überprüfung des Abstinenzverhaltens von Patienten mit alkoholtoxischer Leberzirrhose auf der Warteliste vor Transplantation besser geeignet ist als die Selbstauskunft und der direkte Nachweis von Ethanol im Blut der Patienten. In der Praxis zeigte sich, dass mit einer unangekündigten Untersuchung mehr Rückfälle diagnostiziert werden können als bei länger im Voraus geplanten Routine-Untersuchungsterminen. rn

Cognition in context: Evidence on affordances and verbal language

This thesis investigated affordances and verbal language to demonstrate the flexibility of embodied simulation processes. Starting from the assumption that both object/action understanding and language comprehension are tied to the context in which they take place, six studies clarified the factors that modulate simulation. The studies in chapter 4 and 5 investigated affordance activation in complex scenes, revealing the strong influence of the visual context, which included either objects and actions, on compatibility effects. The study in chapter 6 compared the simulation triggered by visual objects and objects names, showing differences depending on the kind of materials processed. The study in chapter 7 tested the predictions of the WAT theory, confirming that the different contexts in which words are acquired lead to the difference typically observed in the literature between concrete and abstract words. The study in chapter 8 on the grounding of abstract concepts tested the mapping of temporal contents on the spatial frame of reference of the mental timeline, showing that metaphoric congruency effects are not automatic, but flexibly mediated by the context determined by the goals of different tasks. The study in chapter 9 investigated the role of iconicity in verbal language, showing sound-to-shape correspondences when every-day object figures, result that validated the reality of sound-symbolism in ecological contexts. On the whole, this evidence favors embodied views of cognition, and supports the hypothesis of a high flexibility of simulation processes. The reported conceptual effects confirm that the context plays a crucial role in affordances emergence, metaphoric mappings activation and language grounding. In conclusion, this thesis highlights that in an embodied perspective cognition is necessarily situated and anchored to a specific context, as it is sustained by the existence of a specific body immersed in a specific environment.

Etablierung und Optimierung von Therapeutischem Drug Monitoring für die Psychopharmakotherapie von Patienten mit Substanzabhängigkeit

Therapeutisches Drug Monitoring (TDM) findet Anwendung in der Therapie mit Immunosuppressiva, Antibiotika, antiretroviraler Medikation, Antikonvulsiva, Antidepressiva und auch Antipsychotika, um die Effizienz zu steigern und das Risiko von Intoxikationen zu reduzieren. Jedoch ist die Anwendung von TDM für Substanzen, die Einsatz finden in der Rückfallprophylaxe, der Substitution oder dem Entzug von Abhängigkeitserkrankungen nicht etabliert. Für diese Arbeit wurde im ersten Schritt eine sensitive Rating-Skala mit 22 Items entwickelt, mit Hilfe derer der theoretische Nutzen von TDM in der Pharmakotherapie von substanzbezogenen Abhängigkeitserkrankungen auf der Basis von pharmakologischen Eigenschaften der Medikamente und von Patientencharakteristika evaluiert wurde. Die vorgenommene Einschätzung zeigte für Bupropion, Buprenorphin, Disulfiram (oder einen Metaboliten), Methadon (chirale Bestimmung wenn möglich) und Naltrexon einen potentiellen Nutzen von TDM.rnFür die meisten Medikamente, die zur Behandlung von Abhängigkeitserkrankungen zugelassen sind, fehlen valide Messverfahren für TDM. Im Alltag werden überwiegend Drogen Screening-Tests in Form immunologischer Schnelltests angewendet. Für die Anwendung von TDM wurden in dieser Arbeit chromatographische Verfahren für die Bestimmung von Naltrexon und 6β-Naltrexol, Bupropion und Hydroxybupropion sowie R,S-Methadon und R,S-2-Ethyliden-1,5-dimethyl-3,3-diphenylpyrrolidin entwickelt, optimiert und validiert. Es handelt sich dabei HPLC-UV-Methoden mit Säulenschaltung sowie zur Bestimmung von Naltrexon und 6β-Naltrexol zusätzlich eine LC-MS/MS-Methode. Voraussetzung für die Interpretation der Plasmaspiegel ist im Wesentlichen die Kenntnis eines therapeutischen Bereichs. Für Naltrexon und seinen aktiven Metaboliten 6β-Naltrexol konnte eine signifikante Korrelation zwischen dem auftretenden Craving und der Summenkonzentration gefunden werden. Mittels Receiver-Operation-Characteristics-Kurven-Analyse wurde ein Schwellenwert von 16,6 ng/ml ermittelt, oberhalb dessen mit einem erhöhten Ansprechen gerechnet werden kann. Für Levomethadon wurde bezüglich der Detoxifikationsbehandlung ein Zusammenhang in der prozentualen Reduktion des Plasmaspiegels und den objektiven und subjektiven Entzugssymptomen gefunden. rnDoch nicht nur die Wirkstoffe, sondern auch das Patientenmerkmal substanzbezogene Abhängigkeit wurde charakterisiert, zum einen bezüglich pharmakokinetischer Besonderheiten, zum anderen in Hinsicht auf die Therapietreue (Adhärenz). Für Patienten mit komorbider Substanzabhängigkeit konnte eine verminderte Adhärenz unabhängig von der Hauptdiagnose gezeigt werden. Die Betrachtung des Einflusses von veränderten Leberwerten zeigt für komorbide Patienten eine hohe Korrelation mit dem Metabolisiererstatus, nicht aber für Patienten ohne Substanzabhängigkeit.rnÜbergeordnetes Ziel von TDM ist die Erhöhung der Therapiesicherheit und die Steigerung der Therapieeffizienz. Dies ist jedoch nur möglich, wenn TDM im klinischen Alltag integriert ist und korrekt eingesetzt wird. Obwohl es klare Evidenz für TDM von psychiatrischer Medikation gibt, ist die Diskrepanz zwischen Laborempfehlung und der klinischen Umsetzung hoch. Durch Intensivierung der interdisziplinären Zusammenarbeit zwischen Ärzten und Labor, der Entwicklung von interaktivem TDM (iTDM), konnte die Qualität der Anwendung von TDM verbessert und das Risiko von unerwünschten Arzneimittelwirkungen vermindert werden. rnInsgesamt konnte durch die eigenen Untersuchungen gezeigt werden, dass TDM für die medikamentöse Einstellung von Patienten mit Abhängigkeitserkrankung sinnvoll ist und dass optimales TDM eine interdisziplinäre Zusammenarbeit erfordert.rn