Sociodemographic characteristics and clinical features of patients with adult polycystic kidney disease undergoing hemodialysis

Aims:To analyze the socio-demographic and clinical characteristics of patients with adult polycystic kidney disease admitted to hemodialysis services in Northwestern Paraná state,Brazil. Methods: This was an observational, descriptive and retrospective longitudinal study. Medical records of patients with polycystic kidneys who initiated hemodialysis between 1995 and 2012, in four centers that treat patients of the coverage area of the 15th Regional Health Region of Paraná state where analyzed. Results:We found that 10.3% of hemodialysis patients had polycystic kidney disease as a leading cause of stage 5 of chronic kidney disease. The mean age of patients was 54.9±9.4 years (ranging between 27 and 74 years), with equal gender distribution and Caucasian predominance (72.9%). The average age of dialysis initiation was 50±10.2 years. The most common comorbidity was systemic hypertension (66.7%). Liver cyst was the main extra-renal manifestation (10.4%). Twenty-five percent of the patients required renal transplantation, and (22.9%) undergone nephrectomy. The most widely used classes of antihypertensive drugs were β-blockers (41.7%) and drugs that act on the renin-angiotensin system (31.3%), while 56.3% of patients were treated with recombinant human erythropoietin. Conclusions:This is a pioneering epidemiological study in Northwestern Paraná state. We found in this population a sociodemographic and clinical profile of adult polycystic kidney disease similar to that of North America and Europe, probably because the ethnic constitution of the sample was predominantly of Euro-descendants.

The Totalizing and Silencing Features of Meta‐Narratives and Master Concepts

This paper is organized in the following way. First I deal with Hardt’s and Negri’s Empire; the second section of the paper focuses on Beck´s World Risk Society; the third main section of this paper tackles the functional differentiation argument posed by Buzan and Albert. By way of conclusion, the final section of this paper briefly discusses alternatives to grand-narratives and master concepts.

Experiences with sustainability indicators and stakeholder participation: A case study relating to a 'Blue Plan' project in Malta

The practical application of systemic sustainability analysis (SSA; Bell and Morse, 1999) as applied in-a project instigated and managed by 'Blue Plan', one of the regional activity centres of the Mediterranean Action Plan, is set out and explained in this paper. The context in which SSA was applied and adapted to SPSA (systemic and prospective sustainability analysis). is described in the Mediterranean, primarily in Malta. The SSA process is summarized, its extension and linkage to the prospective approach is described and the comments of stakeholders in the context are added. Some preliminary outcomes are suggested. The pauticular focus of the paper is on the lessons learned from doing SSA/SPSA within a classic blueprint project framework. It is-not assumed that SSA/SPSA is 'finished' or 'definitive'. Rather, we suggest that it is a developing and changing approach that practitioners can adapt and change to meet the specific needs of the circumstances that confront them. Copyright (C) 2004 John Wiley & Sons, Ltd and ERP Environment.

Holism and understanding sustainability

In work undertaken in both Malta and Lebanon we have been reflecting on the current means by which the international community apply concepts intended to achieve what is called "sustainable development." In an attempt to make means and ends conform to each other we have developed a holistic approach to what is essentially a timeless need for understanding, systemic planning, and compassionate stewardship. This essay indicates that we may be closer to holistic means with which to realize these goals than we know. It describes how some planning and analysis methods have their origins in ancient traditions. However, the milieu in which sustainability occurs is often unsympathetic to and sometimes incompatible with the ideals of holism. The essay assesses the current understanding of sustainability and points to the need for a wider and more inclusive base to contemporary sustainability as practiced in the community.