896 resultados para Pre-eclampsia and eclampsia


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Background: Malnutrition has a negative impact on optimal immune function, thus increasing susceptibility to morbidity and mortality among HIV positive patients. Evidence indicates that the prevalence of macro and micronutrient deficiencies (particularly magnesium, selenium, zinc, and vitamin C) has a negative impact on optimal immune function, through the progressive depletion of CD4 T-lymphocyte cells, which thereby increases susceptibility to morbidity and mortality among PLWH. Objective: To assess the short and long term effects of a nutrition sensitive intervention to delay the progression of human immune-deficiency virus (HIV) to AIDS among people living with HIV in Abuja, Nigeria. Methods: A randomized control trial was carried out on 400 PLWH (adult, male and female of different religious background) in Nigeria between January and December 2012. Out of these 400 participants, 100 were randomly selected for the pilot study, which took place over six months (January to June, 2012). The participants in the pilot study overlapped to form part of the scale-up participants (n 400) monitored from June to December 2012. The comparative effect of daily 354.92 kcal/d optimized meals consumed for six and twelve months was ascertained through the nutritional status and biochemical indices of the study participants (n=100 pilot interventions), who were and were not taking the intervention meal. The meal consisted of: Glycine max 50g (Soya bean); Pennisetum americanum 20g (Millet); Moringa oleifera 15g (Moringa); Daucus carota spp. sativa 15g (Carrot). Results: At the end of sixth month intervention, mean CD4 cell count (cell/mm3) for Pre-ART and ART Test groups increased by 6.31% and 12.12% respectively. Mean mid upper arm circumference (MUAC) for Pre-ART and ART Test groups increased by 2.72% and 2.52% within the same period (n 400). Comparatively, participants who overlapped from pilot to scale-up intervention (long term use, n 100) were assessed for 12 months. Mean CD4 cell count (cell/mm3) for Pre-ART and ART test groups increased by 2.21% and 12.14%. Mean MUAC for Pre-ART and ART test groups increased by 2.08% and 3.95% respectively. Moreover, student’s t-test analysis suggests a strong association between the intervention meal, MUAC, and CD4 count on long term use of optimized meal in the group of participants being treated with antiretroviral therapy (ART) (P<0.05). Conclusion: Although the achieved results take the form of specific technology, it suggests that a prolong consumption of the intervention meal will be suitable to sustain the gained improvements in the anthropometric and biochemical indices of PLWHIV in Nigeria.

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Background. In pre-school and primary education pupils differ in many abilities and competences (‘giftedness’). Yet mainstream educational practice seems rather homogeneous in providing age-based or grade-class subject matter approaches. Aims. To clarify whether pupils scoring initially at high ability level do develop and attain differently at school with respect to language and arithmetic compared with pupils displaying other initial ability levels. To investigate whether specific individual, family or educational variables co-vary with the attainment of these different types of pupils in school. Samples. Data from the large-scale PRIMA cohort study including a total of 8258 grade 2 and 4 pupils from 438 primary schools in The Netherlands. Methods. Secondary analyses were carried out to construct gain scores for both language and arithmetic proficiency and a number of behavioural, attitudinal, family and educational characteristics. The pupils were grouped into different ability categories (highly able; able; above average; average and below). Further analyses used Pearson correlations and analyses of variance both between and within ability categories. Cross-validation was done by introducing a cohort of younger pupils in pre-school and grouping both cohorts into decile groups based on initial ability in language and arithmetic. Results. Highly able pupils generally decreased in attainment in both language and arithmetic, whereas pupils in average and below average groups improved their language and arithmetic scores. Only with highly able pupils were some educational characteristics correlated with the pupils’ development in achievement, behaviour and attitudes. Conclusions. Pre-school and primary education should better match pupils’ differences in abilities and competences from their start in pre-school to improve their functioning, learning processes and outcomes. Recommendations for educational improvement strategies are presented in closing.

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PCR-based immunoglobulin (Ig)/T-cell receptor (TCR) clonality testing in suspected lymphoproliferations has largely been standardized and has consequently become technically feasible in a routine diagnostic setting. Standardization of the pre-analytical and post-analytical phases is now essential to prevent misinterpretation and incorrect conclusions derived from clonality data. As clonality testing is not a quantitative assay, but rather concerns recognition of molecular patterns, guidelines for reliable interpretation and reporting are mandatory. Here, the EuroClonality (BIOMED-2) consortium summarizes important pre- and post-analytical aspects of clonality testing, provides guidelines for interpretation of clonality testing results, and presents a uniform way to report the results of the Ig/TCR assays. Starting from an immunobiological concept, two levels to report Ig/TCR profiles are discerned: the technical description of individual (multiplex) PCR reactions and the overall molecular conclusion for B and T cells. Collectively, the EuroClonality (BIOMED-2) guidelines and consensus reporting system should help to improve the general performance level of clonality assessment and interpretation, which will directly impact on routine clinical management (standardized best-practice) in patients with suspected lymphoproliferations.

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The Cyprus dispute accurately portrays the evolution of the conflict from ‘warfare to lawfare’ enriched in politics; this research has proven that the Cyprus problem has been and will continue to be one of the most judicialised disputes across the globe. Notwithstanding the ‘normalisation’ of affairs between the two ethno-religious groups on the island since the division in 1974, the Republic of Cyprus’ (RoC) European Union (EU) membership in 2004 failed to catalyse reunification and terminate the legal, political and economic isolation of the Turkish Cypriot community. So the question is; why is it that the powerful legal order of the EU continuously fails to tame the tiny troublesome island of Cyprus? This is a thesis on the interrelationship of the EU legal order and the Cyprus problem. A literal and depoliticised interpretation of EU law has been maintained throughout the EU’s dealings with Cyprus, hence, pre-accession and post-accession. The research has brought to light that this literal interpretation of EU law vis-à-vis Cyprus has in actual fact deepened the division on the island. Pessimists outnumber optimists so far as resolving this problem is concerned, and rightly so if you look back over the last forty years of failed attempts to do just that, a diplomatic combat zone scattered with the bones of numerous mediators. This thesis will discuss how the decisions of the EU institutions, its Member States and specifically of the European Court of Justice, despite conforming to the EU legal order, have managed to disregard the principle of equality on the divided island and thus prevent the promised upgrade of the status of the Turkish Cypriot community since 2004. Indeed, whether a positive or negative reading of the Union’s position towards the Cyprus problem is adopted, the case remains valid for an organisation based on the rule of law to maintain legitimacy, democracy, clarity and equality to the decisions of its institutions. Overall, the aim of this research is to establish a link between the lack of success of the Union to build a bridge over troubled waters and the right of self-determination of the Turkish Cypriot community. The only way left for the EU to help resolve the Cyprus problem is to aim to broker a deal between the two Cypriot communities which will permit the recognition of the Turkish Republic of Northern Cyprus (TRNC) or at least the ‘Taiwanisation’ of Northern Cyprus. Albeit, there are many studies that address the impact of the EU on the conflict or the RoC, which represents the government that has monopolised EU accession, the argument advanced in this thesis is that despite the alleged Europeanisation of the Turkish Cypriot community, they are habitually disregarded because of the EU’s current legal framework and the Union’s lack of conflict transformation strategy vis-à-vis the island. Since the self-declared TRNC is not recognised and EU law is suspended in northern Cyprus in accordance with Protocol No 10 on Cyprus of the Act of Accession 2003, the Turkish-Cypriots represent an idiomatic partner of Brussels but the relations between the two resemble the experience of EU enlargement: the EU’s relevance to the community has been based on the prospects for EU accession (via reunification) and assistance towards preparation for potential EU integration through financial and technical aid. Undeniably, the pre-accession and postaccession strategy of Brussels in Cyprus has worsened the Cyprus problem and hindered the peace process. The time has come for the international community to formally acknowledge the existence of the TRNC.

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Abstract : Providing high-quality clinical experiences to prepare students for the complexities of the current health-care system has become a challenge for nurse educators. Additionally, there are concerns that the current model of clinical practice is suboptimal. Consequently, nursing programs have explored the partial replacement of traditional in-hospital clinical experiences with a simulated clinical experience. Despite research demonstrating numerous benefits to students following participation in simulation activities, insufficient research conducted within Québec exists to convince the governing bodies (Ordre des infirmières et des infirmiers du Québec, OIIQ; Ministère de L’Éducation supérieur, de la Recherche, de la Science et de la Technologie) to fully embrace simulation as part of nurse training. The purpose of this study was to examine the use of a simulated clinical experience (SCE) as a viable, partial pedagogical substitute for traditional clinical experience by examining the effects of a SCE on CEGEP nursing students’ perceptions of self-efficacy (confidence), and their ability to achieve course objectives. The findings will contribute new information to the current body of research in simulation. The specific case of obstetrical practice was examined. Based on two sections of the Nursing III-Health and Illness (180-30K-AB) course, the sample was comprised of 65 students (thirty-one students from section 0001 and thirty-four students from section 0002) whose mean age was 24.8 years. With two sections of the course available, the opportunity for comparison was possible. A triangulation mixed method design was used. An adapted version of Ravert’s (2004) Nursing Skills for Evaluation tool was utilized to collect data regarding students’ perceptions of confidence related to the nursing skills required for care of mothers and their newborns. Students’ performance and achievement of course objectives was measured through an Objective Structured Clinical Examination (OSCE) consisting of three marked stations designed to test the theoretical and clinical aspects of course content. The OSCE was administered at the end of the semester following completion of the traditional clinical experience. Students’ qualitative comments on the post -test survey, along with journal entries served to support the quantitative scale evaluation. Two of the twelve days (15 hours) allocated for obstetrical clinical experience were replaced by a SCE (17%) over the course of the semester. Students participated in various simulation activities developed to address a range of cognitive, psychomotor and critical thinking skills. Scenarios incorporating the use of human patient simulators, and designed using the Jeffries Framework (2005), exposed students to the care of families and infants during the perinatal period to both reflect and build upon class and course content in achievement of course objectives and program competencies. Active participation in all simulation activities exposed students to Bandura’s four main sources of experience (mastery experiences, vicarious experiences, social persuasion, and physiologic/emotional responses) to enhance the development of students’ self-efficacy. Results of the pre-test and post-test summative scores revealed a statistically significant increase in student confidence in performing skills related to maternal and newborn care (p < .0001) following participation in the SCE. Confidence pre-test and post-test scores were not affected by the students’ section. Skills related to the care of the post-partum mother following vaginal or Caesarean section delivery showed the greatest change in confidence ratings. OSCE results showed a mean total class score (both sections) of 57.4 (70.0 %) with normal distribution. Mean scores were 56.5 (68.9%) for section 0001 and 58.3 (71.1%) for section 0002. Total scores were similar between sections (p =0.342) based on pairwise comparison. Analysis of OSCE scores as compared to students’ final course grade revealed similar distributions. Finally, qualitative analysis identified how students’ perceived the SCE. Students cited gains in knowledge, development of psychomotor skills and improved clinical judgement following participation in simulation activities. These were attributed to the « hands on » practice obtained from working in small groups, a safe and authentic learning environment and one in which students could make mistakes and correct errors as having the greatest impact on learning through simulation.

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This publication constitutes the fruits of National Science Centre research projects (grant no 2011/01/M/HS3/02142 – 6 articles) and the National Programme for the Development of the Humanities (grant no 0108/NPH3/H12/82/2014 – 3 articles). We would like to acknowledge and at the same time express our sincere gratitude for the generosity shown by the following at the Adam Mickiewicz University in making this publication possible: the Dean of the Department of History, Institute of Pre-history and the Eastern Institute.

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Offshore structures with numerous applications in different environments throughout the world and used at different depths. Due to the expansion of marine industries, including offshore oil industry in Iran , particularly in the Persian Gulf region, in order to more accurately model these structures and to prevent incidents such as the Overturning of the platform serious damage to the South Pars Phase ١٣ was platforms, the use New Technic is essential technologies. One of the methods that are used in the construction of offshore wind turbines, using a pre-pile. In this method, a template is constructed with the dimensions specified in the workshop. After making templates using special vessels for placement in the desired location on the sea bed is carried, then the template is placed on the sea bed, Then, using a hammer for Pile Driving Operation Started Vibration hammer and fit the template of 3 or 4 piles of crushed within this template on the seabed . The next step piling, templates have been removed from the site And Jacket placed on piles. The system was installed on the deck on piles and Consequently Deck Load pile inserted on .It should be noted that the design of these types of platforms, base diameter of the pile diameter independent of the choice as one of the major advantages of this system is. This thesis examines a Template Fixed Platform in the oil Soroush Using the Pre-Piling and the Common Piling systems in the Persian Gulf were studied and the effect of different design compared to the Pre-Piling Platforms Persian Gulf were evaluated. The results suggest that Pre-Piling system compared with conventional systems piling in the Persian Gulf, as a more appropriate model structure and behavior Top Model economic efficiency is selected. It should be noted that all calculations and analyzes were performed using Software Abaqus.

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This publication constitutes the fruits of National Science Centre research projects (grant no 2011/01/M/HS3/02142 – 6 articles) and the National Programme for the Development of the Humanities (grant no 0108/NPH3/H12/82/2014 – 3 articles). We would like to acknowledge and at the same time express our sincere gratitude for the generosity shown by the following at the Adam Mickiewicz University in making this publication possible: the Dean of the Department of History, Institute of Pre-history and the Eastern Institute.

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This publication constitutes the fruits of National Science Centre research projects (grant no 2011/01/M/HS3/02142 – 6 articles) and the National Programme for the Development of the Humanities (grant no 0108/NPH3/H12/82/2014 – 3 articles). We would like to acknowledge and at the same time express our sincere gratitude for the generosity shown by the following at the Adam Mickiewicz University in making this publication possible: the Dean of the Department of History, Institute of Pre-history and the Eastern Institute.

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This publication constitutes the fruits of National Science Centre research projects (grant no 2011/01/M/HS3/02142 – 6 articles) and the National Programme for the Development of the Humanities (grant no 0108/NPH3/H12/82/2014 – 3 articles). We would like to acknowledge and at the same time express our sincere gratitude for the generosity shown by the following at the Adam Mickiewicz University in making this publication possible: the Dean of the Department of History, Institute of Pre-history and the Eastern Institute.

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This publication constitutes the fruits of National Science Centre research projects (grant no 2011/01/M/HS3/02142 – 6 articles) and the National Programme for the Development of the Humanities (grant no 0108/NPH3/H12/82/2014 – 3 articles). We would like to acknowledge and at the same time express our sincere gratitude for the generosity shown by the following at the Adam Mickiewicz University in making this publication possible: the Dean of the Department of History, Institute of Pre-history and the Eastern Institute.

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A gravidez é uma fase especial da vida, com diversas alterações nos sistemas hormonais, anatómicos, e na composição corporal da mulher. No entanto, não é claro que alterações biomecânicas tridimensionais ocorrerem. Através do acompanhamento da mulher na gravidez e pós-parto, os objetivos da presente tese foram: 1) determinar os parâmetros temporais e espaciais do ciclo da marcha; 2) descrever a cinemática angular do membro inferior; 3) calcular os momentos e potências articulares do tornozelo, joelho e coxofemoral, utilizando o cálculo por dinâmica inversa; 4) descrever as magnitudes dos picos dos momentos e potências articulares dos membros inferiores; 5) identificar possíveis diferenças entre as fases de recolha relativamente aos parâmetros biomecânicos; 6) descrever longitudinalmente a composição corporal as alterações morfológicas; 7) analisar a influência das alterações antropométricas na cinética articular. Os resultados mostram que as mulheres mantêm os parâmetros temporais e espaciais da marcha. A cinemática angular do membro inferior tem o mesmo padrão, no entanto, a magnitude de alguns picos, especialmente na bacia e coxofemoral durante a fase terminal do apoio, pré-balanço e de balanço, apresentam alterações significativas. A coxofemoral é a articulação com mais alterações na cinética articular, com um aumento da carga interna associada aos momentos articulares da coxofemoral no plano transversal. No entanto, diversos momentos e potências articulares revelam uma diminuição significativa para o final da gravidez e/ou um aumento entre alguns trimestres da gravidez e o pós-parto. Como esperado, a maioria das variáveis associadas à composição corporal e às dimensões corporais tem um aumento significativo durante a gravidez e uma diminuição no pós-parto. Os modelos desenvolvidos para prever a carga interna aplicada ao membro inferior da grávida através de variáveis antropométricas, incluem quatro modelos com variáveis associadas à quantidade de gordura, quatro modelos com variáveis associadas à massa corporal global, três modelos que incluem a massa livre de gordura, e um modelo que inclui a forma do tronco. Os altos valores do R2 ajustado, mostram que as alterações na composição corporal e morfologia, determinam em grande parte a cinética articular da mulher nesta fase particular da vida.

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Mestrado em Engenharia Alimentar - Instituto Superior de Agronomia - UL

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Discovery of microRNAs (miRNAs) relies on predictive models for characteristic features from miRNA precursors (pre-miRNAs). The short length of miRNA genes and the lack of pronounced sequence features complicate this task. To accommodate the peculiarities of plant and animal miRNAs systems, tools for both systems have evolved differently. However, these tools are biased towards the species for which they were primarily developed and, consequently, their predictive performance on data sets from other species of the same kingdom might be lower. While these biases are intrinsic to the species, their characterization can lead to computational approaches capable of diminishing their negative effect on the accuracy of pre-miRNAs predictive models. We investigate in this study how 45 predictive models induced for data sets from 45 species, distributed in eight subphyla/classes, perform when applied to a species different from the species used in its induction. Results: Our computational experiments show that the separability of pre-miRNAs and pseudo pre-miRNAs instances is species-dependent and no feature set performs well for all species, even within the same subphylum/class. Mitigating this species dependency, we show that an ensemble of classifiers reduced the classification errors for all 45 species. As the ensemble members were obtained using meaningful, and yet computationally viable feature sets, the ensembles also have a lower computational cost than individual classifiers that rely on energy stability parameters, which are of prohibitive computational cost in large scale applications. Conclusion: In this study, the combination of multiple pre-miRNAs feature sets and multiple learning biases enhanced the predictive accuracy of pre-miRNAs classifiers of 45 species. This is certainly a promising approach to be incorporated in miRNA discovery tools towards more accurate and less species-dependent tools.