118 resultados para Obstructed defaecation


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The frequencies of atmospheric blocking in both winter and summer and the changes in them from the 20th to the 21st centuries as simulated in twelve CMIP5 models is analysed. The RCP 8.5 high emission scenario runs are used to represent the 21st century. The analysis is based on the wave-breaking methodology of Pelly and Hoskins (2003a). It differs from the Tibaldi and Molteni (1990) index in viewing equatorward cut-off lows and poleward blocking highs in equal manner as indicating a disruption to the westerlies. 1-dimensional and 2-dimensional diagnostics are applied to identify blocking of the mid-latitude storm-track and also at higher latitudes. Winter blocking frequency is found to be generally underestimated. The models give a decrease in the European blocking maximum in the 21st century, consistent with the results in other studies. There is a mean 21st century winter poleward shift of high- latitude blocking, but little agreement between the models on the details. In summer, Eurasian blocking is also underestimated in the models, whereas it is now too large over the high-latitude ocean basins. A decrease in European blocking frequency in the 21st century model runs is again found. However in summer there is a clear eastward shift of blocking over Eastern Europe and Western Russia, in a region close to the blocking that dominated the Russian summer of 2010. While summer blocking decreases in general, the poleward shift of the storm track into the region of frequent high latitude blocking may mean that the incidence of storms being obstructed by blocks may actually increase.

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Pedagogues in the borderland of their social task: dealing with family law proceedings, threats and violence Drawing upon an explorative study of family law proceedings from a school perspective, the aim of this paper is to examine the school staff’s strategies for solving or coping with problematic situations in this context. Gendered conflicts between adults and violence are extreme cases for pedagogues in school and preschool. How do the staff cope with their own and the children’s vulnerability? Based upon interviews with 22 informants, the staff’s strategies are outlined and discussed in relation to organizational and professional circumstances and intersecting social relations of power. An analytical construction of six types of proactive and reactive strategies, ranging from distance keeping to normalization of own exposure, is utilized in the analysis. Findings suggest that the staff’s strategies to handle challenging events in this context vary with the parent’s gender, class position and ethnicity. Further, it is argued that creating a sense of safety and promoting learning among the children may be obstructed by lack of support from the school’s organization, demands on staff to perform customer oriented attitudes towards parents and lack of clarity concerning the limits of the social task. Conflicts between the organization and profession on the one hand and the educational and the social task on the other hand, are thus illuminated. In conclusion, a further aim of this article is to contribute to broader discussions on men’s violence against women and children – in families as well as in workplaces and in the intersection between these two areas. 

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Poor mobility has been associated with age-related deterioration in muscle strength. While previous work has examined the effects of improved strength on level walking, we have quantified the effects of a resistance-training program on obstructed gait tasks using biomechanical-dependent measures. Forty-five community-dwelling participants aged 62 years or older were randomised to either a control (n=16) or experimental group (n=29). The experimental subjects exercised for 24 weeks on a progressive resistance-training program designed to improve lower body strength. Dynamic strength was assessed at weeks 0 and 24 as well as specific laboratory gait kinetics and kinematics during stepping over an obstacle and negotiation of a raised surface set at 10, 20 and 30% of each subject's leg length.

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Community locomotion is threatened when older individuals are required to negotiate obstacles, which place considerable stress on the musculoskeletal system. The vulnerability of older adults during challenging locomotor tasks is further compromised by age-related strength decline and muscle atrophy. The first study in this investigation determined the relationship between the major muscle groups of the lower body and challenging locomotor tasks commonly found in the community environment of older adults. Twenty-nine females and sixteen males aged between 62 and 88 years old (68.2 ±6.5) were tested for the maximal voluntary contraction (MVC) strength of the knee extensors and 1-RM for the hip extensors, flexors, adductors, abductors, knee extensors and flexors and ankle plantar flexors. Temporal measurements of an obstacle course comprising four gait tasks set at three challenging levels were taken. The relationship between strength and the obstacle course dependent measures was explored using linear regression models. Significant associations (p≤0.05) between all the strength measures and the gait performances were found. The correlation values between strength and obstructed gait (r = 0.356-0.554) and the percentage of the variance explained by strength (R2 = 13%-31%), increased as a function of the challenging levels, especially for the stepping over and on and off conditions. While the difficulty of community older adults to negotiate obstacles cannot be attributed to a single causal pathway, the findings of the first study showed that strength is a critical requirement. That the magnitude of the association increased as a function of the challenging levels, suggests that interventions aimed at improving strength would potentially be effective in helping community older adults to negotiate environmental gait challenges. In view of the findings of the first study, a second investigation determined the effectiveness of a progressive resistance-training program on obstructed gait tasks measured under specific laboratory conditions and on an obstacle course mimicking a number of environmental challenges. The time courses of strength gains and neuromuscular mechanisms underpinning the exercise-induced strength improvements in community-dwelling older adults were also investigated. The obstructed gait conditions included stepping over an obstacle, on and off a raised surface, across an obstacle and foot targeting. Forty-three community-living adults with a mean age of 68 years (control =14 and experimental=29) completed a 24-week progressive resistance training program designed to improve strength and induce hypertrophy in the major muscles of the lower body. Specific laboratory gait kinetics and kinematics and temporal measures taken on the obstacle course were measured. Lean tissue mass and muscle activation of the lower body muscle groups were assessed. The MVC strength of the knee extensors and 1-RM of the hip extension, hip flexion, knee extension, knee flexion and ankle plantar flexion were measured. A 25% increase on the MVC of the knee extensors (p≤0.05) was reported in the training group. Gains ranging between 197% and 285% were recorded for the 1-RM exercises in the trained subjects with significant improvements found throughout the study (p≤0.05). The exercise-induced strength gains were mediated by hypertrophic and neural factors as shown by 8.7% and 27.7% increases (p≤0.05) in lean tissue mass and integrated electromyographic activity, respectively. Strength gains were accompanied by increases in crossing velocity, stride length and reductions in stride duration, stance and swing time for all gait tasks except for the foot targeting condition. Specific kinematic variables associated with safe obstacle traverse such as vertical obstacle heel clearance, limb flexion, horizontal foot placements prior to and at post obstacle crossing and landing velocities resulted in an improved crossing strategy in the experimental subjects. Significant increases in the vertical and anterior-posterior ground reaction forces accompanied the changes in the gait variables. While further long-term prospective studies of falls rates would be needed to confirm the benefits of lower limb enhanced strength, the findings of the present study provide conclusive evidence of significant improvements to gait efficiency associated with a systematic resistance-training program. It appears, however, that enhanced lower body strength has limited effects on gait tasks involving a dynamic balance component. In addition, due to the larger strength-induced increases in voluntary activation of the leg muscle compared to relatively smaller gains in lean tissue mass, neural adaptations appear to play a greater contributing role in explaining strength gains during the current resistance training protocol.

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1. Waterbirds are considered to import large quantities of nutrients to freshwater bodies but quantification of these loadings remains problematic. We developed two general models to calculate such allochthonous nutrient inputs considering food intake, foraging behaviour and digestive performance of waterbirds feeding in terrestrial habitats: an intake model (IM), mainly based on an allometric relationship for energy requirements and a dropping model (DM), based on allometric relationships for defaecation.

2. Reviewed data of nitrogen (N) and phosphorus (P) content of herbivorous food varied according to diet type (foliage, seeds and roots), season and fertilization. For model parameterization average foliage diet contained 38.20 mg N g−1 and 3.21 mg P g−1 (dry weight), whereas mean faeces composition was 45.02 mg N g−1 and 6.18 mg P g−1.

3. Daily allochthonous nutrient input increased with body mass ranging from 0.29 g N and 0.03 g P in teals Anas crecca to 5.69 g N and 0.57 g P in mute swans Cygnus olor. Results from IM differed from those of DM from ducks to swans by 63–108% for N and by −4 to 23% for P. Model uncertainty was lowest for the IM and mainly caused by variation in estimates of food retention time (RT). In DM food RT and dropping mass determined model uncertainty in similar extent.

4. Exemplarily applying the models to Dutch wetlands resulted in mean annual contribution of herbivorous waterbirds to allochthonous nutrient loading of 382.8 ± 167.1 tonnes N a−1and 34.7 ± 2.3 tonnes P a−1, respectively, which corresponds to annual surface-water loadings of 1.07 kg N ha−1 and 0.10 kg P ha−1.

5. There was a distinct seasonal pattern with peak loadings in January, when bird abundances were highest. Lowest inputs were in August, when bird abundance and nutrient content in food was low and birds foraged less in terrestrial habitats. Three-quarters of all nutrient input was contributed by greater white-fronted goose Anser albifrons, greylag goose Anser anser, wigeon Anas penelope and barnacle goose Branta leucopsis alone.

6. We provide general, easy to use calculation methods for the estimation of allochthonous nutrient inputs by waterbirds, which are applicable to a range of waterbird species, a variety of potential diets and feeding behaviours, and across spatial scales. Such tools may greatly assist in the planning and execution of management actions for wetland nutrient budgets.

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Background: Much of the quantitative research on maternal mortality in developing countries focuses on the need for health service interventions such as skilled attendants at birth and emergency obstetric and newborn care. A growing number of studies document the need for a more comprehensive perspective and include the macrostructural, that is, the social, cultural, economic and political determinants of health.
Objectives: To examine the salient aspects of birth at home and variables that influence decision making around transfer to a health facility during prolonged/obstructed labor.
Methods: Ethnography using participant observation and semi-structured interviews was conducted in 2007. A total of 56 mothers in Kafa Zone were selected: 20 in-depth interviews with women who gave birth at home; four who gave birth in a health facility; and 32 during antenatal care. Interviews were also conducted with health staff from Bonga Hospital and 15 health centers or health posts. Analysis followed a process of data reduction, data display and conclusion drawing/verification with the data organized around key themes.
Results: Most women gave birth at home assisted by their neighbor, mother, mother-in-law, or husband. It is likely women who gave birth at home feel ‘safe’ because that is where birth normally takes place and where they feel supported by close relatives and neighbors. Prolonged labor or ‘waiting-to-see’ if the baby would come was somewhat normalized and resulted in considerable delays to seeking assistance. Women felt it was ‘unsafe’ to go to a health facility because of the very real possibility that they would die on the way.
Conclusion: The findings highlight the importance of educating the local communities to recognize pregnancy related risks and to develop and implement appropriate responses, especially early referral, as communities play an important mobilizing role to health services.

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O conhecimento da organização, Sistema Nacional de Centrais de Abastecimento - SINAC, e de sua ambiência, constituem- se nos elementos fu1crais do presente trabalho. Empreende-se uma análise fundamentada na abordagem institucional e orientada pela assertiva que a modernização social pode ser alcançada através de organizações promotoras do desenvolvimento. Objetiva-se evidenciar os fluxos das diferentes es pécies de transações da organização, as variáveis e elos institucionais preponderantes e as disfunções existentes no âmbito organizacional. Constata-se que, a despeito de um apoio formalmente alocado à organização, é apenas sofrível seu envolvimento institucional, tendo em vista a ambiguidade de algumas variáveis e a incoerência entre elas.Conclui-se que a inexistência de elementos p1inadores, catalizadores e integradores, das variáveis cionais e ambientais, consubstanciados numa política para o setor de hortigranjeiros vêm de apresentar mazelas 12 disciinstiturealista administrativo- operacionais e obstaculizar o processo de instituciona 1ização do SINAC. Sugere-se a reformu1ação organizacional, no sentido de se redefinir objetivos, proposições e condições de implementação, com base no concreto e real apoio dos elos capacitadores. Ao mesmo tempo recomenda-se investir em recursos humanos e pesquisas na área de comercialização agrícola, adotando-se, porém, um enfoque mais pragmático e menos academicista.

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

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Objectives: To assess cardiac morphology and function by means of echocardiograms of children with obstructad breathing while asleep.Methods: the study enrolled 40 children of both sexes, aged from 3 to 11 years; 30 of them had obstructed breathing during sleep (group I) and 10 children were healthy controls (group II). The two groups were similar in terms of sex, age, weight and height. The 40 children underwent echocardiogram, viewing all four chambers during systole and diastole, paying special attention to the right ventricle (RV). These data were compared by means of Student's t test (p < 0.05).Results: In group I, increased diameter and area of the right ventricle were observed during both systole and diastole. There was less variation in RV area between systole and diastole. Reduced left ventricle (LV) diastolic diameter was also observed, together with reduced ejection fraction and reduced contraction.Conclusions: the morphological and functional cardiac abnormalities observed in the RV and LV suggest that, in children, obstructed breathing during sleep can lead to cardiovascular repercussions. These abnormalities may expose these children to increased anesthetic and surgical risks.

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This study aims at understanding how sociocultural adjustment occurs in the case of managers, and their spouses, expatriated to Brazil by private and public Spanish organizations. To do so, it adopts as main theoretical frame the expatriate adaptation model proponed by Parker & McEvoy (1993), based on Black, Mendenhall & Oddou s model (1991), which establishes three dimensions of adaptation: adjustment to work; adjustment to general environment and adjustment to interaction with host country nationals. This work, of exploratory and descriptive nature, used field research to gather primary data subsequently analyzed with a qualitative approach. Data collection came from individual in-depth interviews with three Spanish managers expatriated in Brazil and two of their spouses. Resulting data were analyzed through one of content analysis procedures, thematic analysis. This research shows that adjustment is obstructed by cultural distance or cultural novelty rather than by work role characteristics, being more successful in expatriates that carry previous solid sociocultural knowledge about host country. It also verifies that the degree of expatriate adjustment is enhanced by the comprehension of cultural differences that originate values and behaviors different from those of the expatriate. It points out that individual factors such as perception and relation skills, flexibility, empathy and self-efficacy are positively linked to the three dimensions of adjustment: work, general adjustment and interaction adjustment. It finds expatriate adjustment to be lowered by spouse unsuccessful adjustment and shows that location in an environment perceived as short in key infrastructures is negatively linked to adjustment in expatriates coming from strongly urban environments. It concludes that expatriate adjustment occurs through progressive understanding of host country environment and through comprehension of the sociocultural context that explains differences between host country behaviors and values and those from the country of origin, a process which is favored by expatriate individual characteristics not directly linked to his/her technical qualification, such as perception and relation skills, flexibility and empathy, together with solid sociocultural knowledge about the host country. This research propones, therefore, that organizations involved in expatriation processes should include in their selection criteria the degree to which candidates possess personal characteristics and sociocultural knowledge that may facilitate adaptation

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A leishmaniose pode destruir os tecidos nasais resultando em alterações da via lacrimal excretora. OBJETIVO: Avaliar a ocorrência de alterações do sistema lacrimal excretor em portadores de leishmaniose na fase de pós-tratamento. MÉTODOS: Foi realizada a avaliação da via lacrimal excretora em 45 portadores de leishmaniose tratada (90 vias lacrimais) pelo teste de Jones I. Treze pacientes (26 ductos nasolacrimais) tiveram o teste de Jones I alterado, tendo sido submetidos a dacriocistografia e endoscopia nasal. RESULTADOS: A maioria dos indivíduos avaliados apresentava a leishmaniose na forma cutânea (64,4%). Entretanto, 69,23% dos indivíduos com alteração do sistema lacrimal excretor apresentavam a forma mucocutânea antes do tratamento. A alteração mais freqüentemente detectada foi ducto nasolacrimal permeável e dilatado (92,30%). Apenas 3,84% (1/26) das vias lacrimais estavam obstruídas. A endoscopia nasal mostrou hipertrofia de corneto (53,84%), desvio de septo (53,84%) e perfuração do septo nasal (23,07%). CONCLUSÃO: em portadores de leishmaniose tratada encontra-se como seqüela mais freqüente no sistema excretor lacrimal as vias lacrimais permeáveis e dilatadas.

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

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

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Sialolithiasis of the salivary gland is a benign pathology that occurs most frequently in the submandibular gland because of its anatomic features. Depending on the sialolith size and calcification degree, it can be visible in radiographic examinations. Commonly, patients may experience pain and/or edema, when the ducts are obstructed. The authors report the case of sialolithiasis of the submandibular gland in a 42-year-old, female, white-skinned patient, noticed during routine dental examination. Following diagnosis confirmed by clinical and radiographic examinations, the treatment plan consisted of surgery for removal of the calcified mass. The prognosis is often good, and generally there is no recurrence.

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