Validity of silhouette showcards as a measure of body size and obesity in a population in the African region : a practical research tool for general-purpose surveys.

BACKGROUND: The purpose of this study is to validate the Pulvers silhouette showcard as a measure of weight status in a population in the African region. This tool is particularly beneficial when scarce resources do not allow for direct anthropometric measurements due to limited survey time or lack of measurement technology in face-to-face general-purpose surveys or in mailed, online, or mobile device-based surveys. METHODS: A cross-sectional study was conducted in the Republic of Seychelles with a sample of 1240 adults. We compared self-reported body sizes measured by Pulvers' silhouette showcards to four measurements of body size and adiposity: body mass index (BMI), body fat percent measured, waist circumference, and waist to height ratio. The accuracy of silhouettes as an obesity indicator was examined using sex-specific receiver operator curve (ROC) analysis and the reliability of this tool to detect socioeconomic gradients in obesity was compared to BMI-based measurements. RESULTS: Our study supports silhouette body size showcards as a valid and reliable survey tool to measure self-reported body size and adiposity in an African population. The mean correlation coefficients of self-reported silhouettes with measured BMI were 0.80 in men and 0.81 in women (P < 0.001). The silhouette showcards also showed high accuracy for detecting obesity as per a BMI ≥ 30 (Area under curve, AUC: 0.91/0.89, SE: 0.01), which was comparable to other measured adiposity indicators: fat percent (AUC: 0.94/0.94, SE: 0.01), waist circumference (AUC: 0.95/0.94, SE: 0.01), and waist to height ratio (AUC: 0.95/0.94, SE: 0.01) amongst men and women, respectively. The use of silhouettes in detecting obesity differences among different socioeconomic groups resulted in similar magnitude, direction, and significance of association between obesity and socioeconomic status as when using measured BMI. CONCLUSIONS: This study highlights the validity and reliability of silhouettes as a survey tool for measuring obesity in a population in the African region. The ease of use and cost-effectiveness of this tool makes it an attractive alternative to measured BMI in the design of non-face-to-face online- or mobile device-based surveys as well as in-person general-purpose surveys of obesity in social sciences, where limited resources do not allow for direct anthropometric measurements.

Screening of mental health and substance users in frequent users of a general Swiss emergency department.

BACKGROUND: The objectives of this study were to determine the proportions of psychiatric and substance use disorders suffered by emergency departments' (EDs') frequent users compared to the mainstream ED population, to evaluate how effectively these disorders were diagnosed in both groups of patients by ED physicians, and to determine if these disorders were predictive of a frequent use of ED services. METHODS: This study is a cross-sectional study with concurrent and retrospective data collection. Between November 2009 and June 2010, patients' mental health and substance use disorders were identified prospectively in face-to-face research interviews using a screening questionnaire (i.e. researcher screening). These data were compared to the data obtained from a retrospective medical chart review performed in August 2011, searching for mental health and substance use disorders diagnosed by ED physicians and recorded in the patients' ED medical files (i.e. ED physician diagnosis). The sample consisted of 399 eligible adult patients (≥18 years old) admitted to the urban, general ED of a University Hospital. Among them, 389 patients completed the researcher screening. Two hundred and twenty frequent users defined by >4 ED visits in the previous twelve months were included and compared to 169 patients with ≤4 ED visits in the same period (control group). RESULTS: Researcher screening showed that ED frequent users were more likely than members of the control group to have an anxiety, depressive disorder, post-traumatic stress disorder (PTSD), or suffer from alcohol, illicit drug abuse/addiction. Reviewing the ED physician diagnosis, we found that the proportions of mental health and substance use disorders diagnosed by ED physicians were low both among ED frequent users and in the control group. Using multiple logistic regression analyses to predict frequent ED use, we found that ED patients who screened positive for psychiatric disorders only and those who screened positive for both psychiatric and substance use disorders were more likely to be ED frequent users compared to ED patients with no disorder. CONCLUSIONS: This study found high proportions of screened mental health and/or substance use disorders in ED frequent users, but it showed low rates of detection of such disorders in day-to-day ED activities which can be a cause for concern. Active screening for these disorders in this population, followed by an intervention and/or a referral for treatment by a case-management team may constitute a relevant intervention for integration into a general ED setting.

Differences between genders in coping: different strategies or different stressors?

These study analysed gender specificity in coping behaviours by taking into account the types of problem faced by Spanish adolescents attending school. It was focused on the ten problems most frequently reported by participants (828 adolescents, 355 boys, and 473 girls; Mage = 14.07, SD = 1.34), which were classified using a multi-axial classification system. Coping was examined as a two separate measures of approach and avoidance coping, and as a combined measure indicating the predominant use of coping, and total coping effort. A MANCOVA and subsequent univariate tests were conducted to analyse the specificity of coping according to problem and gender, controlled by age. The results showed that the percentage of types of problems reported by adolescents differed according to gender. The influence of gender on coping was scarcely relevant when the type of problem was controlled for. There were no gender differences when the predominant type of coping was considered, but when a total coping effort measure was analysed girls showed more coping efforts than boys to face interpersonal relationship problems and personal illness. Keywords: adolescence, coping, gender differences, stressors.

Le visage au-delà de l'apparence. Levinas et l'autre rive de l'éthique

In this article I look at the significance of Emmanuel Levinas' thought for an ethics of care. I argue that the meaning Levinas gives to the term « face » is a central aspect related to this issue. The face is in this French philosopher's view an ambiguous phenomenon, an enigma, that bears high ethical significance : beyond its physical appearance, the face of the other escapes every affort at representation, it indicates the way in which the representation of the other exceeds any idea of the other in me, and it is precisely this irreducibility of alterity that lights up its ethical meaning. In Levinas' view, to be oneself is to be for the other, and the otherness of the other manifests itself in the face-to-face encounter. Accordingly, responsibility is the response to the injunction, the interpellation, of the other's face, preceding the claim of justice, and humaneness is conceived as entangled in the other's face. Against this background, I suggest that Levinas' philosophical insight constitutes a turning point from a traditional to a new conception of responsibility that may bear great significance to a renewed understanding of an hermeneutics and an ethics of care.

Identifying pedagogical, technological and organizational barriers in virtual learning environments

Virtual learning environments are online spaces where learners interact with other learners, teachers, resources and the environment in itself. Although technology is meant to enhance the learning process, there are important issues regarding pedagogical and organizational aspects that must be addressed. In this paper we review the barriers detected in a virtual university which exclusively uses Internet as the main channel of communication, with no face-to-face requirements exceptthose related to final evaluation.

Web and education, a successful open entanglement

E-learning, understood as the intensive use of Information and Communication Technologies in mainly but not only) distance education, has radically changed the meaning of the latter. E-learning is an overused term which has been applied to any use of technology in education. Today, the most widely accepted meaning ofe-learning coincides with the fourth generation described by Taylor (1999), where there is an asynchronousprocess that allows students and teachers to interact in an educational process expressly designed in accordance with these principles. We prefer to speak of Internet-Based Learning or, better still, Web-Based Learning, for example, to explain the fact that distance education is carried out using the Internet, with the appearance of the virtual learning environment concept, a web space where the teaching and learning process is generated and supported (Sangrà, 2002). This entails overcoming the barriers of space and time of brickand mortar education (although we prefer the term face-to-face) or of classical distance education using broadcasting and adopting a completely asynchronous model that allows access to education by many more users, at any level (including secondary education, but primarily higher education and lifelong learning).

Social Networks for learning : wikis, blogs and tagging in education

Fast developments in information and communications technologies and changes in the behaviour of learners demand educational institutions to continuously evaluate their pedagogical approaches to the learning and teaching process, both in face-to-face and virtual classrooms.

Pares de nadons prematurs: afrontament de la situació i influència dels suports formals i informals

Lʼobjectiu general de la investigació és conèixer com viuen els pares lʼingrés hospitalari dʼun fill prematur en néixer, com afronten aquest fet així com la influència de les xarxes de suport formal i informal dʼaquesta població

A química medicinal na próxima década

Medicinal chemistry is multi, trans and inter disciplinary on its essence. It has a great deal of challenging Brazilian chemists in the next decade. The pharmacy school is essentially attached and has an important role in the development on the field that is still in domain of big pharmaceutical industries. This work shows the challenges to face and directions to jointly follow for a myriad of researchers throughout the country. The unnamed science has to work out through specific objectives in order to diminish the problems associated with human being health. A brief history is presented where the main goal is to devise chemistry, as a natural science, and many other interfaced disciplines.

Qual é o perfil do profissional de química que está sendo formado? Esse é o perfil de que a sociedade necessita?

In this paper, we present and discuss the chemist's education profile in Brazil from the points of view of the academy and the industry. We emphasize that the chemistry courses need urgently to face the following challenge: to improve the undergraduate's interdisciplinary approach, management abilities and interpersonal relationships.

The Transformation of Practical Teaching Focusing on Dialogic Learning

This study investigates the transformation of practical teaching in a Catalan school, connected to the design, implementation and development of project-based learning, and focusing on dialogic learning to investigate its limits and possibilities. Qualitative and design-based research (DBR) methods are applied. These methods are based on empirical educational research with the theory-driven of learning environments. DBR is proposed and applied using practical guidance for the teachers of the school. It can be associated with the current proposals for Embedding Social Sciences and Humanities in the Horizon 2020 Societal Challenges. This position statement defends the social sciences and the humanities as the most fundamental and important ideas to face all societal challenges. The results of this study show that before the training process, teachers apply dialogic learning in specific moments (for example, when they speak about the weekend); however, during the process and after the process, they work systematically with dialogic learning through the PEPT: they start and finish every activity with a individual and group reflection about their own processes, favouring motivation, reasoning and the implication of all the participants. These results prove that progressive transformations of teaching practice benefit cooperative work in class

REACH-tietämys ja – kokemukset suomalaisissa maahantuontiyrityksissä

Tämän työn tarkoituksena on tutkia suomalaisten maahantuontiyritysten REACH-tietämyksen tasoa sekä kokemuksia. EU:n uusi kemikaaliasetus REACH, (Registration, Evaluation and Authorization of Chemicals), astui voimaan 1.6.2007. Asetus siirsi vastuun kemikaalien turvallisuuden varmistamisesta kemikaalien valmistajille ja maahantuojille. REACHin myötä kemianteollisuuden vanhat käytännöt ja lainsäädäntö uudistuivat ja muutos asetti monet yritykset uudenlaisen tilanteen eteen. Teollisuuden päähuolena REACHin suhteen olivat sen mukanaan tuomat kustannukset, työmäärän lisääntyminen sekä itse asetuksen monimutkaisuus ja hankalaselkoisuus. Työn kirjallisuusosassa esitellään REACH-asetusta ja sen tavoitteita, asetuksen menettelyitä sekä Euroopan kemikaaliviraston ja Suomen REACH-neuvonnan toimintaa. Soveltavassa osassa tutkitaan millä tasolla tutkimuksen kohdeyritysten REACH-tietämys on, millaisia kokemuksia maahantuojilla on REACH-asetuksesta, mistä maahantuojat ovat saaneet REACH-tietoa ja minkälaisena he tätä tietoa pitävät. Työn tulosten perusteella saadaan tietoa erikokoisten maahantuontiyritysten REACH-tietämyksen ja – kokemusten eroista ja yhteneväisyyksistä. Lisäksi työssä kartoitetaan mitä REACH-neuvontaa tarjoavia tahoja maahantuojat ovat käyttäneet ja miten he arvioivat tarjottavan tiedon saatavuutta, luotettavuutta ja hyödyllisyyttä.

Desenvolupament d'un joc per torns parametritzable amb possibilitat multijugador i I.A.

Els jocs són una de les indústries de software més gran del món de la informàtica. Des dels primers jocs en blanc i negre que simulaven raquetes i una pilota, fins avui en dia, en que el desenvolupament d’un joc porta darrere un equip de professionals tant o més gran que el major dels projectes informàtics del món de les indústries, els jocs han evolucionat més que la majoria de programes. La possibilitat d’elaborar un joc és, a part d’una proposta temptadora (ja que difereix enormement de qualsevol pràctica feta durant la carrera), un repte de caire personal per algú que sempre ha estat en contacte amb videojocs i que, després d’adquirir una sèrie de coneixements indispensables, s’ha proposat d’intentar desenvolupar-ne un des de l’arrel. L’objectiu d’aquest treball és doncs això, aprendre com neix un joc partint de res, i veure totes les complicacions que sorgeixen a l’hora de desenvolupar-lo. Els resultats delt projecte mostren generosament el gran nombre de problemes que sorgeixen en un procés com aquest, però com a conclusions importants cal destacar la satisfacció envers els resultats obtinguts, així com els coneixements que s’han guanyat mitjançant el desenvolupament del programa.

Sistema de almacén y dispensación robotizada de productos farmacéuticos

Actualmente, las necesidades de mejora en gestión de stocks y la mayor disponibilidad de sistemas automáticos, están haciendo que muchas empresas inviertan en técnicas modernas para almacenamiento y manipulación de productos. Esta inquietud también ha llegado a las farmacias, que de forma lenta pero firme se van apuntando a su robotización. Uno de los principales problemas a los que se enfrentan las farmacias es la pérdida de tiempo en la gestión y búsqueda de medicamentos, provocando situaciones negativas como las esperas, la falta de tiempo para una atención más personalizada y como consecuencia, la pérdida de clientes. Este inconveniente y la necesidad de mejora en la gestión de los stocks han hecho que aparezcan los Sistemas de dispensación automática de productos farmacéuticos. El dispensador automático facilita el trabajo del farmacéutico al automatizar la búsqueda de la medicina requerida, aumentando la dedicación al cliente y reduciendo los tiempos no productivos y las colas. El presente estudio desarrolla un sistema de dispensación automático de fármacos aplicado a farmacias con una rotación de medicamentos media/ baja, valorando tanto su viabilidad técnica como económica. El almacén propuesto es de tipo caótico con sistema de carga, almacenamiento y descarga completamente automáticos. La mayoría de diseños y conceptos expuestos en este trabajo son de desarrollo propio del autor con el único objetivo de la búsqueda de nuevas soluciones para conseguir un sistema de almacenamiento efectivo y de máximo rendimiento.

L' Impacte de la mort en estudiants d'infermeria durant el seu primer període de pràctiques

La mort i el procés de morir són fets quotidians en les persones grans i, conseqüentment, en els centres sociosanitaris, on bona part de les persones usuàries són d’edat avançada. Tot i que es tracta d’un fenomen natural que s’inclou dins del cicle vital de les persones, en la nostra societat la mort encara provoca rebuig, por, ansietat, tristesa i inquietud. En aquest marc, les estudiants1 d’infermeria són un col·lectiu que poden patir especialment l’impacte de la mort. Primer, perquè com a membres de la societat tenen interioritzat el codi social preestablert envers aquest tema i, segon, perquè durant la seva formació estan en contacte amb persones que estan al final de la vida i poden presenciar vivències de mort. En el primer període de pràctiques dels estudis d’infermeria, les estudiants han de fer front a diverses situacions del dia a dia fins aleshores desconegudes. Els conflictes interpersonals amb l'equip de treball i la inseguretat sobre les habilitats i les competències professionals són alguns dels aspectes que acostumen a viure amb més tensió. Tot i això, el que més impacte els provoca és la cura de les persones al final de la vida. Davant d'una situació de tensió, la persona viu un component estressor, que suposa el punt d’inflexió. A partir d’aquí s’activen els components adaptatius, que és el que emocionalment fa que la persona pugui fer front a aquesta situació estressant. A més, hi ha un component de suport, que són les ajudes que té. Segons com es treballi el component adaptatiu farà que la persona reaccioni en un futur de forma més automàtica i inconscient o, al contrari, que la persona respongui de forma més conscient i intencionada. El present treball està concebut per comprendre quins elements psicosocials – components estressors i components de suport– poden afectar a les estudiants que presencien la vivència de la mort de malalts geriàtrics terminals en el primer període de pràctiques en un centre sociosanitari. S’ha dissenyat un estudi descriptiu transversal quantitatiu, de caràcter exploratori, per tal de descriure la freqüència i algunes característiques psicosocials al voltant de la mort en estudiants d'infermeria en el seu primer període de pràctiques, tant a nivell personal com a nivell professional. La mostra de l'estudi són 65 estudiants, la majoria són dones d'entre els 18 i els 29 anys –més d’un 90%–. Els resultats indiquen que un 80% dels futurs professionals estudiats han patit la mort d’alguna persona significativa al llarg de la seva vida; d'aquests, gairebé un de cada quatre presenta dol complicat. Quant a la vivència de mort en les pràctiques, el 83% l'ha experimentat. Tot i aquest elevat percentatge, no totes les experiències tenen una connotació negativa. En prop de la meitat dels casos, les morts són percebudes com una experiència enriquidora i natural. Els components estressors més impactants que les estudiants han viscut durant les pràctiques per la mort d’alguna persona malalta són: la reacció de la família del finat, el patiment que es genera al seu voltant, algun signe o símptoma físic experimentat pel malalt al final del procés, i la pròpia reacció emocional. Els components de suport expressats són: saber gestionar les pròpies emocions, tenir més formació sobre relació d’ ajuda i empatia, tenir més formació en control de símptomes i comunicació, per atendre usuaris –tant malalts com familiars- i que algú els informés i orientés en el procés. Altres resultats a tenir en compte són que la població estudiada té més preocupació o inquietud per la mort i el procés de morir de la persona estimada i menys per la pròpia mort. A més, tot i que la meitat no hagués escollit geriatria com opció a les primeres pràctiques clíniques, gairebé tot el grup estudiat ho recomanaria després d'haver viscut l'experiència. Les implicacions pràctiques d'aquest estudi porten a pensar que es pot reorientar la informació i preparació que es dóna a les estudiants d’infermeria abans del primer contacte amb la realitat dels centres sociosanitaris, així com també el paper de formació i suport que pot fer tant la persona tutora de pràctiques com les infermeres de referència dels diferents centres. En conclusió, caldria dissenyar estratègies formatives i de suport entorn a la preparació psicològica personal de l’estudiant; entorn a l’acompanyament, les cures pal·liatives i el dol; i valorar la seva eficiència en el futur.