Caracterización de pacientes adultos mayores con epilepsia en dos hospitales de Bogotá (Colombia)

La prevalencia global de la epilepsia en Colombia es del 1,13% y en pacientes mayores de 65 años puede estar cercana al 1,5%. El objetivo de este trabajo ha sido el de describir las características demográficasy clínicas de la población mayor de 65 años que presenta epilepsia. Materiales y métodos: estudio descriptivo, de corte transversal en dos hospitales en Bogotá (Colombia), durante los años 2005-2008. Se revisaron las bases de datos y se seleccionaron las historias clínicas de los pacientes mayores de 65 años con epilepsia. Resultados: se revisaron 211 historias clínicas y se seleccionaron 179. La edad media fue de 75 años (65-98) y el inicio de la epilepsia fue a los 67,5 (7-93); el 64,4% inició la enfermedad después de los 65 años. El 84% de las crisis fueron clasificadas como focales. El diagnóstico más frecuente fue epilepsia focal sintomática (94,4%). 61 pacientes tuvieron como etiología una enfermedad cerebro-vascular. Los antiepilépticos de primera generación, especialmente fenitoína, fueron los más utilizados (99%), aunque 81 de 104 pacientes tratados no estaban libres de crisis. Conclusiones: la mayoría de las crisis son resultado de una epilepsia focal sintomática como consecuencia de una lesión vascular, por lo que se debe considerar el tratamiento farmacológico desde la primera crisis. Es recomendable iniciar el tratamiento con antiepilépticos de segunda generación como lamotrigina, gabapentin, levetiracetam, para minimizar efectos secundarios, y mantener el principio de inicio con dosis bajas y mantenimiento con dosis bajas. Si las condiciones económicas no lo permiten, se puede usar fenitoína o carbamacepina con precaución.

Calidad de la educación básica y media en Colombia: diagnóstico y propuestas

Este trabajo hace una propuesta de política educativa para Colombia que permita mejorar la calidad de la educación básica, secundaria y media y así convertirla en una herramienta efectiva de movilidad social. Se muestra que Colombia ha tenido avances importantes en cobertura. Sin embargo, las mejoras en términos de calidad han sido marginales e inequitativas. Las propuestas de política son: i) fortalecimiento de la evaluación de la calidad de la educación; ii) fortalecimiento de la capacidad institucional de los colegios públicos; iii) implementación de la jornada escolar completa; iv) implementación de una política de docentes que permita atraer mejores profesionales y mejorar los instrumentos de evaluación de los docentes; v) participación del sector privado en la provisión de educación.

El papel de los principios en las fallas de los regímenes internacionales: el Fondo Monetario Internacional en la crisis económica argentina de 2001

Este trabajo de grado busca analizar el papel que juegan los principios en las fallas del Régimen Internacional de Pagos a la hora de responder a situaciones de crisis, específicamente, en la actuación del Fondo Monetario Internacional durante la crisis económica argentina de 2001. El Régimen, atado al cumplimiento de sus principios, actuó de manera tal que produjo unas fallas que terminaron exacerbando la crisis. Mediante el análisis de fuentes primarias y secundarias, y con métodos tanto cualitativos como cuantitativos se busca demostrar que efectivamente, los principios en los que se fundamentan las actuaciones de los regímenes, que son creencias, tienden a tornarse dogmáticos, por lo tanto, se hacen resistentes al cambio y no permiten a las instituciones obrar de manera que se ajuste a la realidad. Es así que los principios llegan agravar las crisis que debían solucionar, tal y como sucedió en Argentina en 2001.

Molecular genetics of cork formation

La peridermis és una estructura complexa que protegeix els òrgans vegetals madurs (secundaris) i les zones que han sofert ferides de la pèrdua d'aigua i dels patògens. Aquesta funció barrera és deguda al fel·lema o súber, un teixit format per cèl·lules suberificades. Tant el fel·lema com la suberina són crucials per la vida de les plantes terrestres, però pràcticament no es coneix res dels processos moleculars que regulen la seva formació, probablement degut a la manca de models adequats. En aquesta tesi s'han identificat i caracteritzat gens induïts al fel·lema mitjançant la combinació de dues plantes models. L'escorça d'alzina surera (Quercus suber) s'ha utilitzat per aïllar gens candidats de la formació del fel·lema i per investigar el comportament d'alguns d'aquests gens durant l'estació de creixement, mentre que la pela de la patata (Solanum tuberosum) s'ha utilitzat en estudis de genètica reversa per demostrar la funció d'alguns gens reguladors al fel·lema.

Paper del nucli hidrofòbic principal de la RNasa A en el plegament i desplegament induïts per pressió i temperatura

Utilitzant temperatura i pressió com a agents desnaturalitzants s'ha explorat la contribució a l'estabilitat de diferents residus del principal nucli hidrofòbic de la RNasa A. Aquests resutats suggereixen que el principal nucli hidrofòbic d'aquest enzim, està fortament empaquetat i ha revelat l'existència de reordenacions en l'interior de la proteïna. El mètode dels valors , han permès estudiar el paper de les interaccions hidrofòbiques establertes pels residus del principal nucli hidrofòbic de la RNasa A en el seu estat de transició induït per pressió. En conjunt, aquests resultats suggereixen que l'estat de transició de la RNasa A, s'assemblaria a un glòbul col·lapsat amb una cadena estructurada però amb un debilitat nucli hidrofòbic. S'ha explorat també, el paisatge energètic del plegament/desplegament proteic de la variant Y115W de la RNasa A. L'estat de transició sembla interaccionar fortament amb la capa d'hidratació d'aquest estat, tal i com indiquen els resultats en presència de glicerol.

O impacto do contrato de autonomia através das percepções dos actores educativos : o caso da Escola-Piloto ES/3 João G. Zarco

Este trabalho pretende identificar as alterações introduzidas pela atribuição de competências resultantes da celebração do Contrato de Autonomia numa escola secundária com 3ºciclo e reflectir sobre o reforço da autonomia e da capacidade de intervenção dos órgãos de direcção para melhorar a eficácia da execução das medidas de política educativa e da prestação do serviço público de educação. Para isso realizamos entrevistas para conhecer as percepções e as atitudes de alguns intervenientes directos, nomeadamente dos elementos da comissão de acompanhamento local, director da escola e alguns docentes envolvidos nos diferentes órgãos de gestão. A atribuição de autonomia à escola visa dotá-la de uma capacidade de decisão e organização interna de forma a ser capaz de responder em tempo útil aos desafios que a comunidade local coloca. Não parece que tenha sido isso que aconteceu, pelo menos na perspectiva dos entrevistados. Para que um contrato de autonomia produza os seus verdadeiros efeitos, ele não pode ser imposto. Sendo certo que cada escola tem as suas particularidades, pode-se todavia estabelecer um conjunto de condições consideradas essenciais entre as quais: projecto educativo eficaz e eficiente, internalizado pela comunidade escolar, um corpo docente estável, lideranças assertivas e partilhadas.

os museus escolares nas escolas secundárias portuguesas

O trabalho de investigação cujos resultados aqui se apresentam, foi realizado como objectivo de caracterizar as escolas secundarias portuguesas relativamente ao seu envolvimento, real ou potencial, em actividades do domínio da museologia. A populacao-alvo inicial era constituída por 472 escolas, das quais foram seleccionadas 86, após contactos telefónicos especificamente estruturados. Esta populacao-alvo final foi então objecto de visitas programadas, acompanhadas por entrevistas a que serviu de orientação um modelo de inquérito especificamente elaborado. O tratamento dos dados assim obtidos conduziu a distribuição dos 86 perfis analisados por 16 categorias. Procedeu-se então a análise comparativa das escolas incluídas em cada categoria, dando ênfase a identificação dos principais factores que condicionam, actualmente, o desenvolvimento da museologia em meio escolar em Portugal.

Uptake of a free coronary heart disease risk screening programme in community pharmacy: the Healthy Heart Assessment service

Introduction Health promotion (HP) aims to enhance good health while preventing ill-health at three levels of activity; primary (preventative), secondary (diagnostic) and tertiary (management).1 It can range from simple provision of health education to ongoing support, but the effectiveness of HP is ultimately dependent on its ability to influence change. HP as part of the Community Pharmacy Contract (CPC) aims to increase public knowledge and target ‘hard-to-reach’ individuals by focusing mainly on primary and tertiary HP. The CPC does not include screening programmes (secondary HP) as a service. Coronary heart disease (CHD) is a significant cause of morbidity and mortality in the UK. While there is evidence to support the effectiveness of some community pharmacy HP strategies in CHD, there is paucity of research in relation to screening services.2 Against this background, Alliance Pharmacy introduced a free CHD risk screening programme to provide tailored HP advice as part of a participant–pharmacist consultation. The aim of this study is to report on the CHD risk levels of participants and to provide a qualitative indication of consultation outcomes. Methods Case records for 12 733 people who accessed a free CHD risk screening service between August 2004 and April 2006 offered at 217 community pharmacies were obtained. The service involved initial self-completion of the Healthy Heart Assessment (HHA) form and measurement of height, weight, body mass index, blood pressure, total cholesterol and highdensity lipoprotein levels by pharmacists to calculate CHD risk.3 Action taken by pharmacists (lifestyle advice, statin recommendation or general practitioner (GP) referral) and qualitative statements of advice were recorded, and a copy provided to the participants. The service did not include follow-up of participants. All participants consented to taking part in evaluations of the service. Ethical committee scrutiny was not required for this service development evaluation. Results Case records for 10 035 participants (3658 male) were evaluable; 5730 (57%) were at low CHD risk (<15%); 3636 (36%) at moderate-to-high CHD risk (≥15%); and 669 (7%) had existing heart disease. A significantly higher proportion of male (48% versus 30% female) participants were at moderate- to-high risk of CHD (chi-square test; P < 0.005). A range of outcomes resulted from consultations. Lifestyle advice was provided irrespective of participants’ CHD risk or existing disease. In the moderate-to-high-risk group, of which 52% received prescribed medication, lifestyle advice was recorded for 62%, 16% were referred and 34% were advised to have a re-assessment. Statin recommendations were made in 1% of all cases. There was evidence of supportive and motivational statements in the advice recorded. Discussion Pharmacists were able to identify individuals’ level of CHD risk and provide them with bespoke advice. Identification of at-risk participants did not automatically result in referrals or statin recommendation. One-third of those accessing the screening service had moderate-to-high risk of CHD, a significantly higher proportion of whom were men. It is not known whether these individuals had been previously exposed to HP but presumably by accessing this service they may have contemplated change. As effectiveness of HP advice will depend among other factors on ability to influence change, future consultations may need to explore patients’ attitude towards change in relation to the Trans Theoretical Model4 to better tailor HP advice. The high uptake of the service by those at moderate-to-high CHD risk indicates a need for this type of screening programme in community pharmacy, perhaps specifically to reach men who access medical services less.

The Mannich reaction of hydrazones: improved reactivity under solvent-free conditions

The Mannich reaction of hydrazones can be performed without solvent by simply mixing the hydrazone with two to three equivalents of a secondary amine and formaldehyde. Best yields and conditions are obtained with p-nitro substituted arylhydrazones. These conditions allow the efficient coupling of simple hydrazones that failed to react in toluene or ethanol solutions.

Manipulating resource allocation in plants

The distribution of nutrients and assimilates in different organs and tissues is in a constant state of flux throughout the growth and development of a plant. At key stages during the life cycle profound changes occur, and perhaps one of the most critical of these is during seed filling. By restricting the competition for reserves in Arabidopsis plants, the ability to manipulate seed size, seed weight, or seed content has been explored. Removal of secondary inflorescences and lateral branches resulted in a stimulation of elongation of the primary inflorescence and an increase in the distance between siliques. The pruning treatment also led to the development of longer and larger siliques that contained fewer, bigger seeds. This seems to be a consequence of a reduction in the number of ovules that develop and an increase in the fatty acid content of the seeds that mature. The data show that shoot architecture could have a substantial impact on the partitioning of reserves between vegetative and reproductive tissues and could be an important trait for selection in rapid phenotyping screens to optimize crop performance.

Improvement of the GenTHREADER method for genomic fold recognition

Motivation: In order to enhance genome annotation, the fully automatic fold recognition method GenTHREADER has been improved and benchmarked. The previous version of GenTHREADER consisted of a simple neural network which was trained to combine sequence alignment score, length information and energy potentials derived from threading into a single score representing the relationship between two proteins, as designated by CATH. The improved version incorporates PSI-BLAST searches, which have been jumpstarted with structural alignment profiles from FSSP, and now also makes use of PSIPRED predicted secondary structure and bi-directional scoring in order to calculate the final alignment score. Pairwise potentials and solvation potentials are calculated from the given sequence alignment which are then used as inputs to a multi-layer, feed-forward neural network, along with the alignment score, alignment length and sequence length. The neural network has also been expanded to accommodate the secondary structure element alignment (SSEA) score as an extra input and it is now trained to learn the FSSP Z-score as a measurement of similarity between two proteins. Results: The improvements made to GenTHREADER increase the number of remote homologues that can be detected with a low error rate, implying higher reliability of score, whilst also increasing the quality of the models produced. We find that up to five times as many true positives can be detected with low error rate per query. Total MaxSub score is doubled at low false positive rates using the improved method.

First Results with the RISING active stopper

This paper outlines some of the physics opportunities available with the GSI RISING active stopper and presents preliminary results from an experiment aimed at performing beta-delayed gamma-ray spectroscopic studies in heavy-neutron-rich nuclei produced following the projectile fragmentation of a 1 GeV per nucleon 208Pb primary beam. The energy response of the silicon active stopping detector for both heavy secondary fragments and beta-particles is demonstrated and preliminary results on the decays of neutron-rich Tantalum (Ta) to Tungsten (W) isotopes are presented as examples of the potential of this technique to allow new structural studies in hitherto experimentally unreachable heavy, neutron-rich nuclei. The resulting spectral information inferred from excited states in the tungsten daughter nuclei are compared with results from axially symmetric Hartree–Fock calculations of the nuclear shape and suggest a change in ground state structure for the N = 116 isotone 190W compared to the lighter isotopes of this element.

New insights into the structure of exotic nuclei using the RISING active stopper

This conference paper outlines the operation and some of the preliminary physics results using the GSI RISING active stopper. Data are presented from an experiment using combined isomer and beta‐delayed gamma‐ray spectroscopy to study low‐lying spectral and decay properties of heavy‐neutron‐rich nuclei around A∼190 produced following the relativistic projectile fragmentation of 208Pb primary beam. The response of the RISING active stopper detector is demonstrated for both the implantation of heavy secondary fragments and in‐situ decay of beta‐particles. Beta‐delayed gamma‐ray spectroscopy following decays of the neutron‐rich nucleus 194Re is presented to demonstrate the experimental performance of the set‐up. The resulting information inferred from excited states in the W and Os daughter nuclei is compared with results from Skyrme Hartree‐Fock predictions of the evolution of nuclear shape.