928 resultados para Diagnoses-Related Groups (DRG)


Relevância:

30.00% 30.00%

Publicador:

Resumo:

Having into consideration that we live in a multicultural society, it is important to analyse how far people view and accept each other. Therefore, one should reflect upon concepts such as: representations and stereotypes, because they are interpersonal constructs which are (re)built during the interaction of different sociocultural groups. In this study, we focus our attention on the representations a sociocultural group – Portuguese teachers - has of intercultural education and the role of teachers and educators in the promotion of an intercultural approach at school. We believe that teachers have the responsibility to: find out the representations students have of the Other; reconfigure stereotyped representations; and create representations which favor dialogue and relationship with the Other flourish. Following a sociolinguistic approach (Müller, 1998; Vasseur, 2001; Vasseur & Hudelot, 1998), which is related to the construction and diffusion of representations in discourse, we analyse the discourse of teachers during a workshop called ‘The Other and Myself’, in which they build and discuss about a didactic mask that portrays their own vision of both themselves and their ideas of intercultural education.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

HIV-positive individuals engage in substance use at higher rates than the general population and are more likely to also suffer from concurrent psychiatric disorders and substance use disorders. Despite this, little is known about the unique clinical concerns of HIV-positive individuals entering substance use treatment. This study examined the clinical characteristics of clients (N=1712) entering residential substance use treatment as a function of self-reported HIV status (8.65% HIV-positive). Results showed higher levels of concurrent substance use and psychiatric disorders for HIV-positive individuals, who were also significantly more likely to meet criteria for bipolar disorder and borderline personality disorder. Past diagnoses of depression, posttraumatic stress disorder, and social phobia were also significantly more common. Study findings indicate a need to provide more intensive care for HIV-positive individuals, including resources targeted at concurrent psychiatric problems, to ensure positive treatment outcomes following residential substance use treatment discharge.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

Material suplementar está disponível em: http://journal.frontiersin.org/article/10.3389/fpsyg. 2016.01509

Relevância:

30.00% 30.00%

Publicador:

Resumo:

In the current economic situation very few business operations are static. In some cases, organizations feel that the most rational solution is not expanding but focusing on their core competencies or certain areas of business through corporate restructuring. The focus in this thesis is on corporate demerger, a process that involves a complete separation of units within a company. Despite the vast amount of research considering corporate demergers, there is still a lack of knowledge about how top managers experience these kinds of organizational rearrangements. In this qualitative case study, the aim is to bring forward the thoughts of executives in two companies that emerged from a single company through corporate demerger a few years ago. By conducting dyadic semi-structured interviews with the management group and board members in both the parent company and the demerger company, I pursue to understand the impressions that they had during the demerger process as well as during the change that followed afterwards. Additionally, their retrospective sense-making patterns are briefly examined. The findings suggest that the way operations are managed before plays an important role in the demerger process. In this case the pre-demerger organization was quite distinctly divided into two business areas, which allowed a somewhat natural allocation of resources. In addition, apart from the top management, every employee knew their future company and role, thus decreasing the amount of uncertainty in lower organizational levels. Consequently, the ambiguity and change faced by the top executives was evidently more powerful compared to the operational actors. The fragmented characteristics also enabled certain points of reference in the unfolding demerger process. Along with the information about future management groups, the pre-demerger re-grouping took place. This sparked up the mental division, where both groups started to act separately. On a personal level, the managers involved in the demerger planning have made retrospective sense of the repercussions related to the restructuring process. For them, it was an extremely demanding, ambiguous and burdensome project that provided them with managerial experiences they are likely not to have again.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

BACKGROUND:Tackling inequalities in overweight, obesity and related determinants has become a top priority for the European research and policy agendas. Although it has been established that such inequalities accumulate from early childhood onward, they have not been studied extensively in children. The current article discusses the results of an explorative analysis for the identification of inequalities in behaviours and their determinants between groups with high and low socio-economic status. METHODS: This study is part of the Epode for the Promotion of Health Equity (EPHE) evaluation study, the overall aim of which is to assess the impact and sustainability of EPODE methodology to diminish inequalities in childhood obesity and overweight. Seven community-based programmes from different European countries (Belgium, Bulgaria, France, Greece, Portugal, Romania, The Netherlands) participate in the EPHE study. In each of the communities, children aged 6-8 years participated, resulting in a total sample of 1266 children and their families. A parental self-administrated questionnaire was disseminated in order to assess the socio-economic status of the household, selected energy balance-related behaviours (1. fruit and vegetable consumption; 2. soft drink/ fruit juices and water consumption; 3. screen time and 4. sleep duration) of the children and associated family environmental determinants. The Mann-Whitney U test and Pearson's chi-square test were used to test differences between the low and high education groups. The country-specific median was chosen as the cut-off point to determine the educational level, given the different average educational level in every country. RESULTS: Children with mothers of relatively high educational level consumed fruits and vegetables more frequently than their peers of low socio-economic status. The latter group of children had a higher intake of fruit juices and/or soft drinks and had higher screen time. Parental rules and home availability were consistently different between the two socio-economic groups in our study in all countries. However we did not find a common pattern for all behaviours and the variability across the countries was large. CONCLUSIONS: Our findings are indicative of socio-economic inequalities in our samples, although the variability across the countries was large. The effectiveness of interventions aimed at chancing parental rules and behaviour on health inequalities should be studied.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

Standing dead biomass retention is considered one of the most relevant fuel structural traits to affect plant flammability. However, very little is known about the biological significance of this trait and its distribution between different functional groups. Our aim was to analyse how the proportion of dead biomass produced in Mediterranean species is related to the successional niche of species (early-, mid- and late-successional stages) and the regeneration strategy of species (seeders and resprouters). We evaluated biomass distribution by size classes and standing dead biomass retention in nine dominant species from the Mediterranean Basin in different development stages (5, 9, 14 and 26 years since the last fire). The results revealed significant differences in the standing dead biomass retention of species that presented a distinct successional niche or regeneration strategy. These differences were restricted to the oldest ages studied (>9 years). Tree and small tree resprouters, typical in late-successional stages, presented slight variations with age and a less marked trend to retain dead biomass, while seeder shrubs and dwarf shrubs, characteristic of early-successional stages, showed high dead biomass loads. Our results suggest that the species that tend to retain more dead branches are colonising species that may promote fire in early-successional stages.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

This is a redacted version of the the final thesis. Copyright material has been removed to comply with UK Copyright Law.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

Stem cell-based regenerative medicine is poised to revolutionize the way diseases are treated. In recent years, induced pluripotent stem (iPS) cells, a newly stem cell species, has attracted significant attention. This paper seeks to understand the pathways along which emerging clinical research efforts in the field of iPS cells is evolved. In particular, the empirical case of age-related macular degeneration (AMD) is used, which is the world-pioneering clinical application of iPS cells. In line with the literature, this study explores the interrelations between three different pathways, such as biomedical scientific understanding, development of medical technologies, and learning in clinical practice. For this, a techmining approach is used including co-term, co-citation, and direct citation methods. Scientific publications indexed in the Thomson Reuters' Web of Science and Elsevier's Scopus databases form the basis of the study. This research first explores the iPS cell research landscape through the construction of a co-term map, particularly stressing the location and intensity of disease-tackling efforts; then focus on the evolution of scientific knowledge on AMD through co-citation networks and the main path algorithm on direct citations. At the researcher level, the development of four different research groups working on cell therapies for AMD is evaluated through the software CitNetExplorer. By integrating these approaches, the result shows a wider picture of the complexities inherent in the translation of knowledge into revolutionary clinical methods.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

Myostatin (MSTN) and α-actinin-3 (ACTN3) genes are potentially associated with preservation of muscle mass and oxidative capacity, respectively. To explore the possible role of these genes in exceptional longevity (EL), the allele/genotype frequency distribution of two polymorphisms in MSTN (rs1805086, K153R) and ACTN3 (rs1815739, R577X) was studied in Japanese centenarians of both sexes (n = 742) and healthy controls (n = 814). The rs1805086 R-allele (theoretically associated with muscle mass preservation at the expense of oxidative capacity) was virtually absent in the two groups, where genotype distributions were virtually identical. Likewise, no differences in allele (p = 0.838 (women); p = 0.193 (men); p = 0.587 (both sexes)) or genotype distribution were found between groups for ACTN3 rs1815739 (p = 0.975 (women), p = 0.136 (men), p = 0.752 (both sexes)). Of note, however, the frequency of the rs1805086 R-allele observed here is the lowest been reported to date whereas that of the 'highly oxidative/efficient' rs1815739 XX genotype in Japanese male centenarians (33.3%) or supercentenarians of both sexes (≥110 years) are the highest (32.6%), for a non-American population. No definite conclusions can be inferred in relation to EL owing to its lack of association with both rs1815739 and rs1805086. However, it cannot be excluded that these gene variants could eventually be related to a "healthy" metabolic phenotype in the Japanese population. Further research might determine if such metabolic profile is among the factors that can potentially predispose these individuals to live longer than Caucasians and what genetic variants might be actually involved.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

Introducción: Las patologías del hombro suelen ser una de las causas de mayor solicitud de consulta en el ámbito laboral, con generación de incapacidad y pérdidas económicas, tanto para el afectado como para la empresa e incluso, la Entidad Promotora de Salud responsable de la atención y tratamiento. Entre las patologías de hombro más frecuentes se hallan el síndrome del manguito rotador, bursitis del hombro, síndrome de abducción dolorosa del hombro, tendinitis del bíceps, traumatismos del tendón del manguito rotador y tendinitis calcificante del hombro. Objetivo: Determinar y caracterizar las patologías del hombro de origen común y laboral, las prestaciones asistenciales y económicas que de estas se deriva en una EPS durante el periodo 2012 a 2014 en la ciudad de Bogotá. Metodología: Se realizó un estudio de corte transversal con datos secundarios procedentes de 657 afiliados del Régimen Contributivo en una EPS de la ciudad de Bogotá, con información de las patologías del hombro registradas de origen común y laboral, durante el periodo de 2012 a 2014. Las variables incluidas fueron las sociodemográficas, ocupacionales y clínicas. Se describieron las variables cualitativas en términos de proporción y las variables cuantitativas a través de medidas de tendencia central (medias/ medianas) y dispersión (rangos, desviación estándar, cuartiles). Para evaluar la asociación entre variables se utilizó la prueba de Chi cuadrado de Pearson usando nivel de significación α de 0,05. Resultados: Del total de afiliados se encontró que el 27,3% de las patologías fueron de origen laboral y el resto de origen común, predominando el género femenino (76.9%); el estado civil casado (34,4%), la escolaridad secundaria (60,4%). Un alto porcentaje de los pacientes se han desempeñado en la industria manufacturera (51%) y el diagnóstico más frecuente fue el síndrome de manguito rotatorio (89,2%). Al revisar los factores asociados con el origen de la patología en la calificación de estas, se encontró asociación con la edad (p = 0,000), la escolaridad (p = 0,013), la actividad económica (p = 0,0000), el factor ocupacional ergonómico (p = 0,0000) y con los diagnósticos de patologías del hombro (p = 0,025). Los días de incapacidad por las patologías del hombro reportaron una mediana de 111 días con rango de 0 a 1925 días. El tiempo de exposición al factor de riesgo ocupacional presento un rango de 6 a 470 meses, los costos por las patologías del hombro generadas correspondieron a un rango de $4000 a $68894438, con una mediana de $2287304. Es transcendental diagnosticar a tiempo e instaurar medidas terapéuticas, que permitan mejorar la sintomatología que ocasionan las patologías del hombro y la alteración en la funcionalidad del mismo, minimizando así los costos y días de incapacidad que a esto conlleva.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

In contrast to the definition of metabolic syndrome (MetS) in adults, there is no standard definition of MetS in pediatric populations. We aimed to assess the differences in the prevalence of MetS in children and adolescents aged 9–17 years in the city of Bogota (Colombia) using four different operational definitions for these age groups and to examine the associated variables. A total of 673 children and 1,247 adolescents attending public schools in Bogota (54.4% girls; age range 9–17.9 years) were included. The prevalence of MetS was determined by the definitions provided by the International Diabetes Federation (IDF) and three published studies by Cook et al., de Ferranti et al., and Ford et al. The prevalence of MetS was 0.3%, 6.3%, 7.8%, and 11.0% according to the IDF, Cook et al., Ford et al., and de Ferranti et al. definitions, respectively. The most prevalent components were low high-density lipoprotein cholesterol and high triglyceride levels, whereas the least prevalent components were abdominal obesity and hyperglycemia. Overall, the prevalence of MetS was higher in obese than in non-obese schoolchildren. In conclusion, MetS diagnoses in schoolchildren strongly depend on the definition chosen. These findings may be relevant to health promotion efforts for Colombian youth to develop prospective studies and to define which cut-offs are the best indicators of future morbidity.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

The aim of the study was to develop a culturally adapted translation of the 12-item smell identification test from Sniffin' Sticks (SS-12) for the Estonian population in order to help diagnose Parkinson's disease (PD). A standard translation of the SS-12 was created and 150 healthy Estonians were questioned about the smells used as response options in the test. Unfamiliar smells were replaced by culturally familiar options. The adapted SS-12 was applied to 70 controls in all age groups, and thereafter to 50 PD patients and 50 age- and sex-matched controls. 14 response options from 48 used in the SS-12 were replaced with familiar smells in an adapted version, in which the mean rate of correct response was 87% (range 73-99) compared to 83% with the literal translation (range 50-98). In PD patients, the average adapted SS-12 score (5.4/12) was significantly lower than in controls (average score 8.9/12), p < 0.0001. A multiple linear regression using the score in the SS-12 as the outcome measure showed that diagnosis and age independently influenced the result of the SS-12. A logistic regression using the SS-12 and age as covariates showed that the SS-12 (but not age) correctly classified 79.0% of subjects into the PD and control category, using a cut-off of <7 gave a sensitivity of 76% and specificity of 86% for the diagnosis of PD. The developed SS-12 cultural adaption is appropriate for testing olfaction in Estonia for the purpose of PD diagnosis.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Hypertensive patients exhibit higher cardiovascular risk and reduced lung function compared with the general population. Whether this association stems from the coexistence of two highly prevalent diseases or from direct or indirect links of pathophysiological mechanisms is presently unclear. This study investigated the association between lung function and carotid features in non-smoking hypertensive subjects with supposed normal lung function. Hypertensive patients (n = 67) were cross-sectionally evaluated by clinical, hemodynamic, laboratory, and carotid ultrasound analysis. Forced vital capacity, forced expired volume in 1 second and in 6 seconds, and lung age were estimated by spirometry. Subjects with ventilatory abnormalities according to current guidelines were excluded. Regression analysis adjusted for age and prior smoking history showed that lung age and the percentage of predicted spirometric parameters associated with common carotid intima-media thickness, diameter, and stiffness. Further analyses, adjusted for additional potential confounders, revealed that lung age was the spirometric parameter exhibiting the most significant regression coefficients with carotid features. Conversely, plasma C-reactive protein and matrix-metalloproteinases-2/9 levels did not influence this relationship. The present findings point toward lung age as a potential marker of vascular remodeling and indicate that lung and vascular remodeling might share common pathophysiological mechanisms in hypertensive subjects.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

To compare time and risk to biochemical recurrence (BR) after radical prostatectomy of two chronologically different groups of patients using the standard and the modified Gleason system (MGS). Cohort 1 comprised biopsies of 197 patients graded according to the standard Gleason system (SGS) in the period 1997/2004, and cohort 2, 176 biopsies graded according to the modified system in the period 2005/2011. Time to BR was analyzed with the Kaplan-Meier product-limit analysis and prediction of shorter time to recurrence using univariate and multivariate Cox proportional hazards model. Patients in cohort 2 reflected time-related changes: striking increase in clinical stage T1c, systematic use of extended biopsies, and lower percentage of total length of cancer in millimeter in all cores. The MGS used in cohort 2 showed fewer biopsies with Gleason score ≤ 6 and more biopsies of the intermediate Gleason score 7. Time to BR using the Kaplan-Meier curves showed statistical significance using the MGS in cohort 2, but not the SGS in cohort 1. Only the MGS predicted shorter time to BR on univariate analysis and on multivariate analysis was an independent predictor. The results favor that the 2005 International Society of Urological Pathology modified system is a refinement of the Gleason grading and valuable for contemporary clinical practice.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

The aim was to evaluate the relationship between orofacial function, dentofacial morphology, and bite force in young subjects. Three hundred and sixteen subjects were divided according to dentition stage (early, intermediate, and late mixed and permanent dentition). Orofacial function was screened using the Nordic Orofacial Test-Screening (NOT-S). Orthodontic treatment need, bite force, lateral and frontal craniofacial dimensions and presence of sleep bruxism were also assessed. The results were submitted to descriptive statistics, normality and correlation tests, analysis of variance, and multiple linear regression to test the relationship between NOT-S scores and the studied independent variables. The variance of NOT-S scores between groups was not significant. The evaluation of the variables that significantly contributed to NOT-S scores variation showed that age and presence of bruxism related to higher NOT-S total scores, while the increase in overbite measurement and presence of closed lip posture related to lower scores. Bite force did not show a significant relationship with scores of orofacial dysfunction. No significant correlations between craniofacial dimensions and NOT-S scores were observed. Age and sleep bruxism were related to higher NOT-S scores, while the increase in overbite measurement and closed lip posture contributed to lower scores of orofacial dysfunction.