Risk evaluation of diabetes mellitus by relation of chaotic globals to HRV

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Outpatient versus inpatient treatment for acute pulmonary embolism

Background: Pulmonary embolism (PE) is a common life-threatening cardiovascular condition, with an incidence of 23 to 69 new cases per 100,000 people per year. Outpatient treatment instead of traditional inpatient treatment in selected non-high-risk patients with acute PE might provide several advantages, such as reduction of hospitalizations, substantial cost saving and an improvement in health-related quality of life. Objectives: To compare the efficacy and safety of outpatient versus inpatient treatment for acute PE for the outcomes of all-cause and PE-related mortality; bleeding; and adverse events such as hemodynamic instability, recurrence of PE and patients'satisfaction.Search methodsThe Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator (TSC) searched the Specialised Register (last searched October 2014) and the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 9). The TSC also searched clinical trials databases. The review authors searched LILACS (last searched November 2014). Selection criteria: Randomized controlled trials of outpatient versus inpatient treatment in people diagnosed with acute PE. Data collection and analysis: Two review authors selected relevant trials, assessed methodological quality, and extracted and analyzed data. Main results: We included one study, involving 339 participants. We ranked the quality of the evidence as very low due to not blinding the outcome assessors, the small number of events with imprecision in the confidential interval (CI), the small sample size and it was not possible to verify publication bias. For all outcomes, the CIs were wide and included clinically significant treatment effects in both directions: short-term mortality (30 days) (RR 0.33, 95% CI 0.01 to 7.98, P = 0.49), long-term mortality (90 days) (RR 0.98, 95% CI 0.06 to 15.58, P = 0.99), major bleeding at 14 days (RR 4.91, 95% CI 0.24 to 101.57, P = 0.30) and 90 days (RR 6.88, 95% CI 0.36 to 134.14, P = 0.20), recurrent PE within 90 days (RR 2.95, 95% CI 0.12 to 71.85, P = 0.51) and participant satisfaction (RR 0.97, 95% CI 0.92 to 1.03, P = 0.30). PE-related mortality, minor bleeding, and adverse course such as hemodynamic instability and compliance were not assessed by the single included study. Authors' conclusions: Current very low quality evidence from one published randomized controlled trial did not provide sufficient evidence to assess the efficacy and safety of outpatient versus inpatient treatment for acute PE in overall mortality, bleeding and recurrence of PE adequately. Further well-conducted research is required before informed practice decisions can be made.

Surgical interventions for treating pectus excavatum

Background: Pectus excavatum is characterized by a depression of the anterior chest wall (sternum and lower costal cartilages) and is the most frequently occurring chest wall deformity. The prevalence ranges from 6.28 to 12 cases per 1000 around the world. Generally pectus excavatum is present at birth or is identified after a few weeks or months; however, sometimes it becomes evident only at puberty. The consequence of the condition on a individual's life is variable, some live a normal life and others have physical and psychological symptoms such as: precordial pain after exercises; impairments of pulmonary and cardiac function; shyness and social isolation. For many years, sub-perichondrial resection of the costal cartilages, with or without transverse cuneiform osteotomy of the sternum and placement of a substernal support, called conventional surgery, was the most accepted option for surgical repair of these patients. From 1997 a new surgical repair called, minimally invasive surgery, became available. This less invasive surgical option consists of the retrosternal placement of a curved metal bar, without resections of the costal cartilages or sternum osteotomy, and is performed by videothoracoscopy. However, many aspects that relate to the benefits and harms of both techniques have not been defined. Objectives: To evaluate the effectiveness and safety of the conventional surgery compared with minimally invasive surgery for treating people with pectus excavatum. Search methods: With the aim of increasing the sensitivity of the search strategy we used only terms related to the individual's condition (pectus excavatum); terms related to the interventions, outcomes and types of studies were not included. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, LILACS, and ICTPR. Additionally we searched yet reference lists of articles and conference proceedings. All searches were done without language restriction. Date of the most recent searches: 14 January 2014. Selection criteria: We considered randomized or quasi-randomized controlled trials that compared traditional surgery with minimally invasive surgery for treating pectus excavatum. Data collection and analysis: Two review authors independently assessed the eligibility of the trials identified and agreed trial eligibility after a consensus meeting. The authors also assessed the risk of bias of the eligible trials. Main results: Initially we located 4111 trials from the electronic searches and two further trials from other resources. All trials were added into reference management software and the duplicates were excluded, leaving 2517 studies. The titles and abstracts of these 2517 studies were independently analyzed by two authors and finally eight trials were selected for full text analysis, after which they were all excluded, as they did not fulfil the inclusion criteria. Authors' conclusions: There is no evidence from randomized controlled trials to conclude what is the best surgical option to treat people with pectus excavatum.

Differentiation in Male and Female Speech Styles

From the moment of their birth, a person's life is determined by their sex. Ms. Goroshko wants to know why this difference is so striking, why society is so concerned to sustain it, and how it is able to persist even when certain national or behavioural stereotypes are erased between people. She is convinced of the existence of not only social, but biological differences between men and women, and set herself the task, in a manuscript totalling 126 pages, written in Ukrainian and including extensive illustrations, of analysing these distinctions as they are manifested in language. She points out that, even before 1900, certain stylistic differences between the ways that men and women speak had been noted. Since then it has become possible, for instance in the case of Japanese, to point to examples of male and female sub-languages. In general, one can single out the following characteristics. Males tend to write with less fluency, to refer to events in a verb-phrase, to be time-oriented, to involve themselves more in their references to events, to locate events in their personal sphere of activity, and to refer less to others. Therefore, concludes Ms Goroshko, the male is shown to be more active, more ego-involved in what he does, and less concerned about others. Women, in contrast, were more fluent, referred to events in a noun-phrase, were less time-oriented, tended to be less involved in their event-references, locate events within their interactive community and refer more to others. They spent much more time discussing personal and domestic subjects, relationship problems, family, health and reproductive matters, weight, food and clothing, men, and other women. As regards discourse strategies, Ms Goroshko notes the following. Men more often begin a conversation, they make more utterances, these utterances are longer, they make more assertions, speak less carefully, generally determine the topic of conversation, speak more impersonally, use more vulgar expressions, and use fewer diminutives and more imperatives. Women's speech strategies, apart from being the opposite of those enumerated above, also contain more euphemisms, polite forms, apologies, laughter and crying. All of the above leads Ms. Goroshko to conclude that the differences between male and female speech forms are more striking than the similarities. Furthermore she is convinced that the biological divergence between the sexes is what generates the verbal divergence, and that social factors can only intensify or diminish the differentiation in verbal behaviour established by the sex of a person. Bearing all this in mind, Ms Goroshko set out to construct a grammar of male and female styles of speaking within Russian. One of her most important research tools was a certain type of free association test. She took a list comprising twelve stimuli (to love, to have, to speak, to fuck, a man, a woman, a child, the sky, a prayer, green, beautiful) and gave it to a group of participants specially selected, according to a preliminary psychological testing, for the high levels of masculinity or femininity they displayed. Preliminary responses revealed that the female reactions were more diverse than the male ones, there were more sentences and word combinations in the female reactions, men gave more negative responses to the stimulus and sometimes didn't want to react at all, women reacted more to adjectives and men to nouns, and that, surprisingly, women coloured more negatively their reactions to the words man, to love and a child (Ms. Goroshko is inclined to attribute this to the present economic situation in Russia). Another test performed by Ms. Goroshko was the so-called "defective text" developed by A.A. Brudny. All participants were distributed with packets of complete sentences, which had been taken from a text and then mixed at random. The task was to reconstruct the original text. There were three types of test, the first descriptive, the second narrative, and the third logical. Ms. Goroshko created computer programmes to analyse the results. She found that none of the reconstructed texts was coincident with the original, differing both from the original text and amongst themselves and that there were many more disparities in the male than the female texts. In the descriptive and logical texts the differences manifested themselves more clearly in the male texts, and in the narrative texts in the female texts. The widest dispersal of values was observed at the outset, while the female text ending was practically coincident with the original (in contrast to the male ending). The greatest differences in text reconstruction for both males and females were registered in the middle of the texts. Women, Ms. Goroshko claims, were more sensitive to the semantic structure of the texts, since they assembled the narrative text much more accurately than the other two, while the men assembled more accurately the logical text. Texts written by women were assembled more accurately by women and texts by men by men. On the basis of computer analysis, Ms. Goroshko found that female speech was substantially more emotional. It was expressed by various means, hyperbole, metaphor, comparisons, epithets, ways of enumeration, and with the aid of interjections, rhetorical questions, exclamations. The level of literacy was higher for female speech, and there were fewer mistakes in grammar and spelling in female texts. The last stage of Ms Goroshko's research concerned the social stereotypes of beliefs about men and women in Russian society today. A large number of respondents were asked questions such as "What merits must a woman possess?", "What are male vices and virtues?", etc. After statistical manipulation, an image of modern man and woman, as it exists in the minds of modern Russian men and women, emerged. Ms. Goroshko believes that her findings are significant not only within the field of linguistics. She has already successfully worked on anonymous texts and been able to decide on the sex of the author and consequently believes that in the future her research may even be of benefit to forensic science.

¿Confiar en los criollos? Apreciaciones sobre la condición de los españoles americanos en el siglo XVIII

Este trabajo realiza una reflexión sobre el recelo que el sector criollo ocasionaba en las altas magistraturas de la monarquía hispánica, de la que emana, obviamente, la política selectiva de cargos y honores tanto en el ámbito de la administración como en el de la Iglesia. El talento y la calidad moral de este segmento de la población estuvo, más que en ninguna otra época, en tela de juicio a lo largo de todo el siglo XVIII. El trabajo traza una panorámica sustentada en obras y documentos del setecientos donde se realizan apologías o críticas de los españoles americanos. La hipótesis que sostiene esta investigación plantea que si la desconfianza hacia la población hispánica de América no hubiera calado tan profundamente, la política borbónica podría haber tenido otra orientación, y por tanto la memoria histórica de los criollos, posterior a la Independencia, podría haber sido menos negativa con respecto a su pasado virreinal

¿Confiar en los criollos? Apreciaciones sobre la condición de los españoles americanos en el siglo XVIII

Este trabajo realiza una reflexión sobre el recelo que el sector criollo ocasionaba en las altas magistraturas de la monarquía hispánica, de la que emana, obviamente, la política selectiva de cargos y honores tanto en el ámbito de la administración como en el de la Iglesia. El talento y la calidad moral de este segmento de la población estuvo, más que en ninguna otra época, en tela de juicio a lo largo de todo el siglo XVIII. El trabajo traza una panorámica sustentada en obras y documentos del setecientos donde se realizan apologías o críticas de los españoles americanos. La hipótesis que sostiene esta investigación plantea que si la desconfianza hacia la población hispánica de América no hubiera calado tan profundamente, la política borbónica podría haber tenido otra orientación, y por tanto la memoria histórica de los criollos, posterior a la Independencia, podría haber sido menos negativa con respecto a su pasado virreinal

¿Confiar en los criollos? Apreciaciones sobre la condición de los españoles americanos en el siglo XVIII

Este trabajo realiza una reflexión sobre el recelo que el sector criollo ocasionaba en las altas magistraturas de la monarquía hispánica, de la que emana, obviamente, la política selectiva de cargos y honores tanto en el ámbito de la administración como en el de la Iglesia. El talento y la calidad moral de este segmento de la población estuvo, más que en ninguna otra época, en tela de juicio a lo largo de todo el siglo XVIII. El trabajo traza una panorámica sustentada en obras y documentos del setecientos donde se realizan apologías o críticas de los españoles americanos. La hipótesis que sostiene esta investigación plantea que si la desconfianza hacia la población hispánica de América no hubiera calado tan profundamente, la política borbónica podría haber tenido otra orientación, y por tanto la memoria histórica de los criollos, posterior a la Independencia, podría haber sido menos negativa con respecto a su pasado virreinal

The negative effects of failed service recoveries

Research has shown that more than half of attempted recovery efforts fail, producing a ‘double deviation’ effect. Surprisingly, these double deviation effects have received little attention in marketing literature. This paper examines what happens after these critical encounters, which behavior or set of behaviors the customers are prone to follow and how customers’ perceptions of the firm’s recovery efforts influence these behaviors. For the analysis of choice of the type of response (complaining, exit, complaining and exit, and no-switching), we estimate multinomial Logit models with random coefficients (RCL). The results of our study show that magnitude of service failure, explanations, apologies, perceived justice, angry and frustration felt by the customer, and satisfaction with service recovery have a significant effect on customers’ choice of the type of response. Implications from the findings are offered.

Ouvrages apologétiques /

Three 'Apologies' composed somewhere in the third century A.D., once attributed to Justin Martyr, and erroneously included in the 'Corpus Iustini.'

Nineteenth century teachers and other essays,

Samuel Taylor Coleridge.--Frederick Denison Maurice.--Thomas Erskine of Linlathen.--Life of Charles Kingsley.--Arthur Penrhyn Stanley.--The Cambridge apostles of 1830.--Richard Holt Hutton.--A study of Carlyle.--The majority.--James Fitzjames Stephen.--The moral influence of George Eliot.--John Ruskin.--Laurence Oliphant.--Count Leo Tolstoi.--Morals and politics.--Ethics and science.--Biography.--The relation of memory to will.--The vanity of men of letters.--Invalids.--Apologies.--Henry Thomas Buckle.--The unfaithful steward.--Brothers, an address to female students.--De senectute.--The drawbacks of the intellectual life.

Thalidomide and birth defects

Apologies to the many papers we were unable to cite, due to space constraints. We thank Lynda Erskine, Shaunna Beedie and Chris Mahony for helpful discussions. Lucas Rosa Fraga is funded by a PhD scholarship from the Science without Borders program - CNPq Brazil - INAGEMP/ Grant CNPq 573993/2008-4. Alex J. Diamond is funded by a BBSRC DTP PhD Scholarship.

Thalidomide and birth defects

Apologies to the many papers we were unable to cite, due to space constraints. We thank Lynda Erskine, Shaunna Beedie and Chris Mahony for helpful discussions. Lucas Rosa Fraga is funded by a PhD scholarship from the Science without Borders program - CNPq Brazil - INAGEMP/ Grant CNPq 573993/2008-4. Alex J. Diamond is funded by a BBSRC DTP PhD Scholarship.

Crisis communication in politics: forgiveness as image restoration tool

Crisis communication is a widely treated field. There are lot of works and guides which provide helpful information in order to face crisis situations successfully (Alcat, 2005, Benoit, 1997) and articles about case studies (Nespereira, 2014, Blaney y Benoit 2001). Nonetheless, most of times, these guides are focused on business or corporations (Abeler, 2010) and there are not such information about crisis communications in politics (Gaspar e Ibeas, 2015). The field is smaller if we speak about forgiveness as restoration image tool in politics (Harris 2006). Despite all, we live in “forgiveness era” as Krauze said (1998) where people demand to politicians to apologize when they have mistakes (Harris et al. 2006:716). So, we will try to make an approach to forgiveness in politics as a image restoration tool and analyze its capabilities in order to face crisis management.

Egyptian Pagans through Christian Eyes

Construction of Christian identity in Egypt proceeded in pace with construction of the Egyptian pagan “Other” between the second and sixth centuries. Apologies, martyrdoms, apocalypses, histories, sermons, hagiographies, and magical texts provide several different vantage points from which to view the Christian construction of the Egyptian pagan “Other”: as the agent of anti-Christian violence, as an intellectual rival, as an object of anti-pagan violence, as an obstacle to salvation, and—perhaps most dangerously—as but another participant in a shared religious experience. The recent work of social scientists on identity, deviance, violence, social/cultural memory, and religiosity provides insight into the strategies by which construction of the “Other” was part of a larger project of fashioning a “proper” Christian religious domain.