Variability of cortisol assays can confound the diagnosis of adrenal insufficiency in the critically ill population

Objective: To compare the total plasma cortisol values obtained from three widely used immunoassays and a high pressure liquid chromatography (HPLC) technique on samples obtained from patients with sepsis. Design and setting: Observational interventional in the general intensive care unit of a metropolitan hospital. Patients and participants: Patients admitted to the intensive care unit with a diagnosis of sepsis and fulfilling criteria of systemic inflammatory response syndrome. Interventions: Standard short synacthen test performed with 250 mu g cosyntropin. Measurements and results: Two of the three immunoassays returned results significantly higher than those obtained by HPLC: Immulite by 95% (95%CI 31-188%) and TDx by 79% (21-165%). The limits of agreement for all three immunoassays with HPLC ranged from -62% to 770%. In addition, by classifying the patients into responders and non-responders to ACTH by standard criteria there was concordance in all assays in only 44% of patients. Conclusions: Immunoassay estimation of total plasma cortisol in septic patients shows wide assay related variation that may have significant impact in the diagnosis of relative adrenal insufficiency.

Services for activities in group editing 'sage'

The project described in this thesis investigates the needs of a group of people working cooperatively in an OSI environment, and recommends tools and services to meet these needs. The project looks specifically at Services for Activities in Group Editing, and is identified as the `SAGE' project. The project uses case studies to identify user requirements and to determine common functionalities for a variety of group editing activities. A prototype is implemented in an X.400 environment to help refine user requirements, as a source of new ideas and to test the proposed functionalities. The conceptual modelling follows current CCITT proposals, but a new classification of group activities is proposed: Informative, Objective and Supportive application groups. It is proposed that each of these application groups have their own Service Agent. Use of this classification allows the possibility of developing three sets of tools which will cover a wide range of group activities, rather than developing tools for individual activities. Group editing is considered to be in the Supportive application group. A set of additional services and tools to support group editing are proposed in the context of the CCITT draft on group communication, X.gc. The proposed services and tools are mapped onto the X.400 series of recommendations, with the Abstract Service Definition of the operational objects defined, along with their associated component files, by extending the X.420 protocol functionality. It is proposed that each of the Informative, Objective and Supportive application groups should be implemented as a modified X.420 inter-personal messaging system.

Desenvolvimento de um painel sanduíche com carga de particulado oriundo de resíduo lignocelulósico para aplicação em produtos na área de equipamentos de proteção

This work aims to study and investigate the use of a hybrid composite polymer formed with blanket aramid (Kevlar 29) fiber blanket flax fiber and particulate dry endocarp of coconut (Cocos nucifera Linn), using as matrix an epoxy resin based thermoset for use in areas of protective equipment. Besides such material is used an aluminum plate, joined to the composite by means of glue based on epoxy and araldite commercial. The manufacturing process adopted was manual lamination (Hand Lay Up) to manufacture the hybrid composite. After the composite is prepared, an aluminum plate is subjected to pressure and glued to cure the adhesive. Layers of veil will also be used to separate the particulate from the linen blanket layer without disturbing the alignment of the fibers of the blankets. To characterize the mechanical and physical behavior was manufactured a plate of 800 x 600 mm of the hybrid composite, which were removed specimens for tests of water absorption to saturation; density; impact test (Charpy) and two test specimens for ballistic testing 220 mm x 200 mm to make a comparative study between the dry state and saturated water absorption and thus see the ballistic performance of these two conditions. The test was applied to make a comparative study of fracture in these two conditions, caused by penetrating ballistic missile (38 and 380). To test the impact (Charpy) will analyze the absorbed energy, fracture appearance and lateral contraction, also in dry condition and saturation of absorbed water, thereby analyzing situations where the impact load is relevant, such as bumps and shocks produced by stone, metal or wooden bars among others. The proposed configuration, along with the tests, has the purpose, application in the fields of equipment against ballistic impact, such as helmets; bullet proof vests; shields; protective packaging and other items to be identified in this research.

Terapia cognitivo-conductual centrada en el trauma para las víctimas de atentados terroristas: un estudio de efectividad con trastornos mentales a muy largo plazo

El terrorismo es un grave problema mundial que cada año afecta a un número muy elevado de personas. Solamente en el año 2014 se produjeron en el mundo 13.463 atentados terroristas que provocaron 32.727 muertos, 34.791 heridos y 9.428 secuestrados (National Consortium for the Study of Terrorism and Responses to Terrorism [START], 2015). En España el número de personas fallecidas por atentados terroristas en los últimos 45 años es de 1.220, a las que habría que sumar los miles de heridos y de familiares y allegados de personas fallecidas y heridas. Aunque la mayoría de las víctimas no desarrollarán trastornos mentales a causa de los atentados terroristas y conseguirán recuperarse sin secuelas psicopatológicas significativas, un porcentaje importante sufrirán un trastorno por estrés postraumático (TEPT), depresivo o de ansiedad (García-Vera y Sanz, 2010, 2015). Entre las víctimas directas, la prevalencia del TEPT se ha estimado entre un 10% y un 30% (DiMaggio y Galea, 2006; García-Vera y Sanz, 2015), la del trastorno depresivo mayor entre un 13,3% y un 47,7% y la de los trastornos de ansiedad entre un 6,1% y un 19,8% (García-Vera y Sanz, 2010; Salguero, Fernández-Berrocal, Iruarrizaga, Cano-Vindel, y Galea, 2011). Además, en muchos casos, tales trastornos no parecen remitir con el tiempo y parecen crónicos (García-Vera y Sanz, 2010; Morina, Wicherts, Lobbrecht y Priebe, 2014)...

Análisis Crítico y Complejo de los discursos periodísticos verbovisuales entre Bolivia y Chile en el contexto de la demanda por la soberanía marítima boliviana

Los medios de prensa tienen un rol determinante en la construcción, legitimación y representación de distintas realidades socioculturales, las cuales a su vez generan lineamientos institucionalizados de unas identidades nacionales sobre otras, creando relaciones desiguales en base de prejuicios y estereotipos. Los países vecinos cuentan con historias de unidad y conflictos, pero el tiempo a veces no es suficiente para cerrar viejas heridas, como ocurre con la Guerra del Pacífico (18791883). En este contexto se analizaron las noticias de los medios con mayor injerencia a nivel país: La Razón (Bolivia) y El Mercurio (Chile), donde, por medio de una herramienta metodológica de Análisis Crítico y Complejo del Discurso Verbovisual, se buscó dilucidar los procesos de construcción discursiva de cada Estadonación y confirmar cómo éstos se mantienen a través del tiempo.

Reciprocidades y gubernamentalidad tras la inserción del dispositivo religioso en cárceles de mediana y máxima seguridad de la provincia de Santa Fe (Argentina)

En el presente trabajo indagaremos sobre la reconfiguración de las dinámicas institucionales en dos cárceles de la provincia de Santa Fe, Argentina, tras la inserción del dispositivo religiosoevangélico- pentecostal. Los casos serán las penitenciarías n° 3 —mediana seguridad— y n° 11 — máxima seguridad—, y nos interrogaremos sobre las relaciones de reciprocidad que el dispositivo religioso configura en el encierro, en cómo dichas relaciones definen nuevas estrategias de gobierno por parte del servicio penitenciario y de qué manera se rediseñan las relaciones de poder en el dispositivo carcelario. Abordaje comparativo que responde a la hipótesis de que el dispositivo religioso-evangélicopentecostal construye matrices comunes de ordenamiento social, funcionamiento y reciprocidades en el encierro pero, al mismo tiempo, consolida su funcionamiento a raíz de una identificación precisa de las necesidades y oportunidades de los sujetos según atraviesen situaciones de ingreso o egreso carcelario.

Una experiencia de Arteterapia con mujeres con sobrepeso y obesidad

El presente artículo trata del proceso y desarrollo de una experiencia de aplicación de arteterapia con mujeres adultas en el contexto de un programa interdisciplinario de cambio de hábitos para el tratamiento de personas con sobrepeso y obesidad. Son además presentados brevemente, desde distintos autores, algunos antecedentes y puntos de relación entre el enfoque gestáltico y el arte-terapia, sirviendo como discusión que contextualiza la experiencia.

Hábitos de hidratación en estudiantes universitarios: relación con adhesión a la dieta mediterránea y medida ponderal del peso

Programa de doctorado: Avances en Traumatología, Medicina del Deporte, Cuidado de heridas (Interdepartamental) (Bienio 2008/2010)

José Ninot Ferran

[ES]José Ninot Ferrán nació en Rocafort de Queralt el 26 de febrero de 1864. Ejerció como médico en la Villa de Teguise hasta 1910. No creía en los microbios y si en la acupuntura. No desinfectaba las heridas y suturaba las heridas después de lavarlas con agua de la Mareta, líquido que consideraba una panacea en la práctica terapéutica. Autor del libro “La acupuntura en la práctica médica china”, impreso en Tenerife en 1936.

Correlación entre los resultados de valoración funcional y de fuerza de la rodilla en pacientes con rotura del ligamento cruzado anterior

Programa de doctorado: Avances en Traumatología. Medicina del Deporte. Cuidado de Heridas. La fecha de publicación es la fecha de lectura

El anciano institucionalizado: las caídas

Programa de doctorado: Avances en Traumatología, Medicina del Deporte, Cuidado de Heridas. La fecha de publicación es la fecha lectura. La fecha de publicación es la fecha de lectura

Effects of IFRS adoption on the financial statements of Nigerian listed entities: the case of oil and gas companies

On 28 July 2010, the Nigerian Federal Executive Council approved January 1, 2012 as the effective date for the convergence of Nigerian Statement of Accounting Standards (SAS) or Nigerian GAAP (NG-GAAP) with International Financial Reporting Standards (IFRS). By this pronouncement, all publicly listed companies and significant public interest entities in Nigeria were statutorily required to issue IFRS based financial statements for the year ended December, 2012. This study investigates the impact of the adoption of IFRS on the financial statements of Nigerian listed Oil and Gas entities using six years of data which covers three years before and three years after IFRS adoption in Nigeria and other African countries. First, the study evaluates the impact of IFRS adoption on the Exploration and Evaluation (E&E) expenditures of listed Oil and Gas companies. Second, it examines the impact of IFRS adoption on the provision for decommissioning of Oil and Gas installations and environmental rehabilitation expenditures. Third, the study analyses the impact of the adoption of IFRS on the average daily Crude Oil production cost per Barrel. Fourth, it examines the extent to which the adoption and implementation of IFRS affects the Key Performance Indicators (KPIs) of listed Oil and Gas companies. The study further explores the impact of IFRS adoption on the contractual relationships between Nigerian Government and Oil and Gas companies in terms of Joint Ventures (JVs) and Production Sharing Contracts (PSCs) as it relates to taxes, royalties, bonuses and Profit Oil Split. A Paired Samples t-test, Wilcoxon Signed Rank test and Gray’s (Gray, 1980) Index of Conservatism analyses were conducted simultaneously where the accounting numbers, financial ratios and industry specific performance measures of GAAP and IFRS were computed and analysed and the significance of the differences of the mean, median and Conservatism Index values were compared before and after IFRS adoption. Questionnaires were then administered to the key stakeholders in the adoption and implementation of IFRS and the responses collated and analysed. The results of the analyses reveal that most of the accounting numbers, financial ratios and industry specific performance measures examined changed significantly as a result of the transition from GAAP to IFRS. The E&E expenditures and the mean cost of Crude Oil production per barrel of Oil and Gas companies increased significantly. The GAAP values of inventories, GPM, ROA, Equity and TA were also significantly different from the IFRS values. However, the differences in the provision for decommissioning expenditures were not statistically significant. Gray’s (Gray, 1980) Conservatism Index shows that Oil and Gas companies were more conservative under GAAP when compared to the IFRS regime. The Questionnaire analyses reveal that IFRS based financial statements are of higher quality, easier to prepare and present to management and easier to compare among competitors across the Oil and Gas sector but slightly more difficult to audit compared to GAAP based financial statements. To my knowledge, this is the first empirical research to investigate the impact of IFRS adoption on the financial statements of listed Oil and Gas companies. The study will therefore make an enormous contribution to academic literature and body of knowledge and void the existing knowledge gap regarding the impact and implications of IFRS adoption on the financial statements of Oil and Gas companies.

Model jurysdykcji sądowej w postępowaniu sądowoadministracyjnym a konstytucyjne funkcje sądów administracyjnych

Wydział Prawa i Administracji: Katedra Prawa Konstytucyjnego