Comparative Study of Informal Health Care Networks and Elderly Health Status in Argentina and Cuba

The objective of this study is to evaluate the impact of informal care support networks on the health status, life satisfaction, happiness and anxiety of elderly individuals in Argentina and Cuba. Recent economic changes, demographic changes, the structure of families and changes in women?s labor participation have affected the availability of informal care. Additionally, the growing number of elderly as a percentage of total population has significant implications for both formal and informal care in Argentina and Cuba. Methods: The SABE - Survey on Health, Well-Being, and Aging in Latin America and the Caribbean, 2000 was used as the data source. The survey has a sample of 10,656 individuals aged 60 years and older residing in private households occupied by permanent dwellers in 7 cities in the Latin American and Caribbean region. My study will focus on the Buenos Aires and Havana samples in which there were 1043 individuals and 1905 individuals respectively. General sampling design was used to establish comparability between countries. Individuals requiring assistance are surveyed on their source of help and the relative impact of informal versus paid help is measured for this group. Other measures of social support (number of living children, companionship and number of individuals living in the same dwelling) are used to measure networks for the full sample. Multivariate probit regression analyses were run separately for Cuba and for Argentina to evaluate the marginal impacts of the types of social support on health status, life satisfaction, happiness and anxiety. Results: For Argentina, almost all of the family help variables positively impact good health. Getting help from most other members of the family negatively impacts satisfaction with life. Happiness is affected differently by each of the family help variables but community support increases the likelihood of being happy. Although none of the family or community help variables show statistical significance, most negatively affect anxiety levels. In Cuba, all of the social support variables have a positive marginal impact on the health status of the elderly. In this case, some of the family and community help variables have a negative marginal impact on life satisfaction; however, it appears that having those closest to the elderly, children, spouse, or other family, positively impacts life satisfaction. Most of the support variables negatively impact happiness. Receiving help from a child, spouse or parent is associated with a marginal increase in anxiety, whereas receiving help from a grandchild, another family member or a friend actually reduces anxiety. Discussion: The study highlights the necessity for enhancing the coordination of various care networks in order to provide adequate care and reduce the burdens of old age on the individual, family and society and the need for consistent support for the caregivers. More qualitative work should be done to identify how support is given and what comprises the support. The constant change and advancement of the world, and the growth of the Latin American and Caribbean region, suggests that more updates studies need to be done.

Antinociceptive effects, metabolism and disposition of ketamine in ponies under target-controlled drug infusion

Ketamine is widely used as an anesthetic in a variety of drug combinations in human and veterinary medicine. Recently, it gained new interest for use in long-term pain therapy administered in sub-anesthetic doses in humans and animals. The purpose of this study was to develop a physiologically based pharmacokinetic (PBPk) model for ketamine in ponies and to investigate the effect of low-dose ketamine infusion on the amplitude and the duration of the nociceptive withdrawal reflex (NWR). A target-controlled infusion (TCI) of ketamine with a target plasma level of 1 microg/ml S-ketamine over 120 min under isoflurane anesthesia was performed in Shetland ponies. A quantitative electromyographic assessment of the NWR was done before, during and after the TCI. Plasma levels of R-/S-ketamine and R-/S-norketamine were determined by enantioselective capillary electrophoresis. These data and two additional data sets from bolus studies were used to build a PBPk model for ketamine in ponies. The peak-to-peak amplitude and the duration of the NWR decreased significantly during TCI and returned slowly toward baseline values after the end of TCI. The PBPk model provides reliable prediction of plasma and tissue levels of R- and S-ketamine and R- and S-norketamine. Furthermore, biotransformation of ketamine takes place in the liver and in the lung via first-pass metabolism. Plasma concentrations of S-norketamine were higher compared to R-norketamine during TCI at all time points. Analysis of the data suggested identical biotransformation rates from the parent compounds to the principle metabolites (R- and S-norketamine) but different downstream metabolism to further metabolites. The PBPk model can provide predictions of R- and S-ketamine and norketamine concentrations in other clinical settings (e.g. horses).

An analysis of variance type method to describe and compare steady states in clinical data

Identifying and comparing different steady states is an important task for clinical decision making. Data from unequal sources, comprising diverse patient status information, have to be interpreted. In order to compare results an expressive representation is the key. In this contribution we suggest a criterion to calculate a context-sensitive value based on variance analysis and discuss its advantages and limitations referring to a clinical data example obtained during anesthesia. Different drug plasma target levels of the anesthetic propofol were preset to reach and maintain clinically desirable steady state conditions with target controlled infusion (TCI). At the same time systolic blood pressure was monitored, depth of anesthesia was recorded using the bispectral index (BIS) and propofol plasma concentrations were determined in venous blood samples. The presented analysis of variance (ANOVA) is used to quantify how accurately steady states can be monitored and compared using the three methods of measurement.

Towards the introduction of the 'Immunoscore' in the classification of malignant tumours.

The American Joint Committee on Cancer/Union Internationale Contre le Cancer (AJCC/UICC) TNM staging system provides the most reliable guidelines for the routine prognostication and treatment of colorectal carcinoma. This traditional tumour staging summarizes data on tumour burden (T), the presence of cancer cells in draining and regional lymph nodes (N) and evidence for distant metastases (M). However, it is now recognized that the clinical outcome can vary significantly among patients within the same stage. The current classification provides limited prognostic information and does not predict response to therapy. Multiple ways to classify cancer and to distinguish different subtypes of colorectal cancer have been proposed, including morphology, cell origin, molecular pathways, mutation status and gene expression-based stratification. These parameters rely on tumour-cell characteristics. Extensive literature has investigated the host immune response against cancer and demonstrated the prognostic impact of the in situ immune cell infiltrate in tumours. A methodology named 'Immunoscore' has been defined to quantify the in situ immune infiltrate. In colorectal cancer, the Immunoscore may add to the significance of the current AJCC/UICC TNM classification, since it has been demonstrated to be a prognostic factor superior to the AJCC/UICC TNM classification. An international consortium has been initiated to validate and promote the Immunoscore in routine clinical settings. The results of this international consortium may result in the implementation of the Immunoscore as a new component for the classification of cancer, designated TNM-I (TNM-Immune).

Baclofen facilitates sleep, neuroplasticity, and recovery after stroke in rats.

OBJECTIVE Sleep disruption in the acute phase after stroke has detrimental effects on recovery in both humans and animals. Conversely, the effect of sleep promotion remains unclear. Baclofen (Bac) is a known non-rapid eye movement (NREM) sleep-promoting drug in both humans and animals. The aim of this study was to investigate the effect of Bac on stroke recovery in a rat model of focal cerebral ischemia (isch). METHODS Rats, assigned to three experimental groups (Bac/isch, saline/isch, or Bac/sham), were injected twice daily for 10 consecutive days with Bac or saline, starting 24 h after induction of stroke. The sleep-wake cycle was assessed by EEG recordings and functional motor recovery by single pellet reaching test (SPR). In order to identify potential neuroplasticity mechanisms, axonal sprouting and neurogenesis were evaluated. Brain damage was assessed by Nissl staining. RESULTS Repeated Bac treatment after ischemia affected sleep, motor function, and neuroplasticity, but not the size of brain damage. NREM sleep amount was increased significantly during the dark phase in Bac/isch compared to the saline/isch group. SPR performance dropped to 0 immediately after stroke and was recovered slowly thereafter in both ischemic groups. However, Bac-treated ischemic rats performed significantly better than saline-treated animals. Axonal sprouting in the ipsilesional motor cortex and striatum, and neurogenesis in the peri-infarct region were significantly increased in Bac/isch group. CONCLUSION Delayed repeated Bac treatment after stroke increased NREM sleep and promoted both neuroplasticity and functional outcome. These data support the hypothesis of the role of sleep as a modulator of poststroke recovery.

Evaluation of the success of medical management for presumptive thoracolumbar intervertebral disk herniation in dogs.

OBJECTIVE To determine the success of medical management of presumptive thoracolumbar disk herniation in dogs and the variables associated with treatment outcome. STUDY DESIGN Retrospective case series. ANIMALS Dogs (n=223) with presumptive thoracolumbar disk herniation. METHODS Medical records from 2 clinics were used to identify affected dogs, and owners were mailed a questionnaire about success of therapy, recurrence of clinical signs, and quality of life (QOL) as interpreted by the owner. Signalment, duration and degree of neurologic dysfunction, and medication administration were determined from medical records. RESULTS Eighty-three percent of dogs (185/223) were ambulatory at initial evaluation. Successful treatment was reported for 54.7% of dogs, with 30.9% having recurrence of clinical signs and 14.4% classified as therapeutic failures. From bivariable logistic regression, glucocorticoid administration was negatively associated with success (P=.008; odds ratio [OR]=.48) and QOL scores (P=.004; OR=.48). The duration of cage rest was not significantly associated with success or QOL. Nonambulatory dogs were more likely to have lower QOL scores (P=.01; OR=2.34). CONCLUSIONS Medical management can lead to an acceptable outcome in many dogs with presumptive thoracolumbar disk herniation. Cage rest duration does not seem to affect outcome and glucocorticoids may negatively impact success and QOL. The conclusions in this report should be interpreted cautiously because of the retrospective data collection and the use of client self-administered questionnaire follow-up. CLINICAL RELEVANCE These results provide an insight into the success of medical management for presumptive thoracolumbar disk herniation in dogs and may allow for refinement of treatment protocols.

La penalidad de la ebriedad en el código penal y en la praxis judicial bonaerense 1878-1888

La sanción del código penal en la provincia de Buenos Aires en el año 1877, fijó en el homicidio la penalidad y determinó las circunstancias del delito mediante la enumeración de los atenuantes y agravantes. El objetivo era contemplar todas las posibilidades del delito para reducir el "arbitrio judicial". Sin embargo, deteniéndonos en los cambios operados en cuanto a la ebriedad en la normativa legal y en la práctica judicial, se puede observar que la función del juez no se redujo únicamente a computar la pena según el delito. A su cargo quedó la apreciación de las pruebas y la interpretación legal. En este sentido, la ley dejó márgenes para considerar a la ebriedad como atenuante o no de la penalidad. Sin embargo, los jueces le negaron tal beneficio al imputado, lo cual marcó una ruptura con respecto al período anterior. Interpretación que estuvo determinada no por un cambio en la percepción sobre el efecto del alcohol como perturbador de la conciencia, sino por ciertos prejuicios que otorgaron una jerarquía y un valor a los motivos que pudieran cegar al trasgresor. Considerada aun como un vicio y no una patología, revelaron la condena a esta práctica social determinando que hechos ya no quedaban comprendidos como circunstancias atenuantes. En definitiva, la ebriedad posibilita apreciar el complejo proceso de codificación que consistió no únicamente en la aplicación literal de la ley sino también en la interpretación que de ella se hiciera.

La penalidad de la ebriedad en el código penal y en la praxis judicial bonaerense 1878-1888

La sanción del código penal en la provincia de Buenos Aires en el año 1877, fijó en el homicidio la penalidad y determinó las circunstancias del delito mediante la enumeración de los atenuantes y agravantes. El objetivo era contemplar todas las posibilidades del delito para reducir el "arbitrio judicial". Sin embargo, deteniéndonos en los cambios operados en cuanto a la ebriedad en la normativa legal y en la práctica judicial, se puede observar que la función del juez no se redujo únicamente a computar la pena según el delito. A su cargo quedó la apreciación de las pruebas y la interpretación legal. En este sentido, la ley dejó márgenes para considerar a la ebriedad como atenuante o no de la penalidad. Sin embargo, los jueces le negaron tal beneficio al imputado, lo cual marcó una ruptura con respecto al período anterior. Interpretación que estuvo determinada no por un cambio en la percepción sobre el efecto del alcohol como perturbador de la conciencia, sino por ciertos prejuicios que otorgaron una jerarquía y un valor a los motivos que pudieran cegar al trasgresor. Considerada aun como un vicio y no una patología, revelaron la condena a esta práctica social determinando que hechos ya no quedaban comprendidos como circunstancias atenuantes. En definitiva, la ebriedad posibilita apreciar el complejo proceso de codificación que consistió no únicamente en la aplicación literal de la ley sino también en la interpretación que de ella se hiciera.

La penalidad de la ebriedad en el código penal y en la praxis judicial bonaerense 1878-1888

La sanción del código penal en la provincia de Buenos Aires en el año 1877, fijó en el homicidio la penalidad y determinó las circunstancias del delito mediante la enumeración de los atenuantes y agravantes. El objetivo era contemplar todas las posibilidades del delito para reducir el "arbitrio judicial". Sin embargo, deteniéndonos en los cambios operados en cuanto a la ebriedad en la normativa legal y en la práctica judicial, se puede observar que la función del juez no se redujo únicamente a computar la pena según el delito. A su cargo quedó la apreciación de las pruebas y la interpretación legal. En este sentido, la ley dejó márgenes para considerar a la ebriedad como atenuante o no de la penalidad. Sin embargo, los jueces le negaron tal beneficio al imputado, lo cual marcó una ruptura con respecto al período anterior. Interpretación que estuvo determinada no por un cambio en la percepción sobre el efecto del alcohol como perturbador de la conciencia, sino por ciertos prejuicios que otorgaron una jerarquía y un valor a los motivos que pudieran cegar al trasgresor. Considerada aun como un vicio y no una patología, revelaron la condena a esta práctica social determinando que hechos ya no quedaban comprendidos como circunstancias atenuantes. En definitiva, la ebriedad posibilita apreciar el complejo proceso de codificación que consistió no únicamente en la aplicación literal de la ley sino también en la interpretación que de ella se hiciera.

Distribution and abundance of nannofossils in DSDP Site 89-585

Late Aptian through middle Eocene nannofossil assemblages were recovered from a continuously cored section at Site 585. Poorly preserved assemblages of low diversity were observed in samples taken throughout both upper Aptian and/or lower Albian sandstone and mudstone and middle Cenomanian to lower Turonian claystone at the base of this section. A 70-m interval barren of nannofossils separates these poorly preserved assemblages from those recovered from an upper Campanian chalk farther uphole. This chalk marks the most significant change in carbonate deposition at this site, and deposition of interbedded zeolitic claystone and sediment of varied nannofossil content proceeded without major interruption until the early Paleocene (Fasciculithus tympaniformis Zone, CP4). A middle Eocene chalk (dated by nannofossils) unconformably overlies lower Paleocene sediment in both Holes 585 and 585A. Only a few interbeds of zeolitic claystone are present within 100 m of nannofossil-rich sediment above this unconformity. This entire interval is cautiously assigned to the Discoaster sublodoensis Zone (CP 12), which indicates a sedimentation rate almost an order of magnitude higher than expected from normal pelagic sedimentation. The most obvious feature of the assemblages examined from these cores is the amount of reworked material. Rare Nannoconus elongatus and Braarudosphaera sp. in several upper Campanian to middle Eocene samples demonstrate the contribution of pelagic material from upslope and, along with other reworked species throughout the Upper Cretaceous samples examined, provide evidence contradictory to an excursion of the calcium compensation depth to deep basinal settings in the western Pacific during the Campanian-Maestrichtian time (Thierstein, 1979). The overwhelming dominance of reworked species in all middle Eocene samples examined and the persistence of these assemblages throughout such a large thickness of sediment suggest that currents that redeposited material intensified at this time and may be associated with the formation of the lower Paleocene/middle Eocene unconformity at this site. A single surface core of calcareous ooze taken from Hole 585A dated as early Pleistocene contains abundant and well-preserved late Miocene and Pliocene species.

Comparison of natural and forced amplification regimes in plasma-based soft-x-ray lasers seeded by high-order harmonic

The amplification of high-order harmonics (HOH) in a plasma-based amplifier is a multiscale, temporal phenomenon that couples plasma hydrodynamics, atomic processes, and HOH electromagnetic fields. We use a one-dimensional, time-dependent Maxwell-Bloch code to compare the natural amplification regime and another regime where plasma polarization is constantly forced by the HOH. In this regime, a 10-MW (i.e., 100 times higher than current seeded soft x-ray laser power), 1.5-μJ, 140-fs pulse free from the parasitic temporal structures appearing on the natural amplification regime can be obtained.

Activity based costing, time-driven activity based costing and lean accounting: differences among three accounting systems' approach to manufacturing

Choosing an appropriate accounting system for manufacturing has always been a challenge for managers. In this article we try to compare three accounting systems designed since 1980 to address problems of traditional accounting system. In the first place we are going to present a short overview on background and definition of three accounting systems: Activity Based costing, Time-Driven Activity Based Costing and Lean Accounting. Comparisons are made based on the three basic roles of information generated by accounting systems: financial reporting, decision making, and operational control and improvement. The analysis in this paper reveals how decisions are made over the value stream in the companies using Lean Accounting while decisions under the ABC Accounting system are taken at individual product level, and finally we will show how TD-ABC covers both product and process levels for decision making. In addition, this paper shows the importance of nonfinancial measures for operational control and improvement under the Lean Accounting and TD-ABC methods whereas ABC relies mostly on financial measures in this context.

Methodology for developing an advanced communications system for the Deaf in a new domain

A methodology for developing an advanced communications system for the Deaf in a new domain is presented in this paper. This methodology is a user-centred design approach consisting of four main steps: requirement analysis, parallel corpus generation, technology adaptation to the new domain, and finally, system evaluation. During the requirement analysis, both the user and technical requirements are evaluated and defined. For generating the parallel corpus, it is necessary to collect Spanish sentences in the new domain and translate them into LSE (Lengua de Signos Española: Spanish Sign Language). LSE is represented by glosses and using video recordings. This corpus is used for training the two main modules of the advanced communications system to the new domain: the spoken Spanish into the LSE translation module and the Spanish generation from the LSE module. The main aspects to be generated are the vocabularies for both languages (Spanish words and signs), and the knowledge for translating in both directions. Finally, the field evaluation is carried out with deaf people using the advanced communications system to interact with hearing people in several scenarios. In this evaluation, the paper proposes several objective and subjective measurements for evaluating the performance. In this paper, the new considered domain is about dialogues in a hotel reception. Using this methodology, the system was developed in several months, obtaining very good performance: good translation rates (10% Sign Error Rate) with small processing times, allowing face-to-face dialogues.

A proposal for enhancing the motivation in students of computer programming

Computer programming is known to be one of the most difficult courses for students in the first year of engineering. They are faced with the challenge of abstract thinking and gaining programming skills for the first time. These skills are acquired by continuous practicing from the start of the course. In order to enhance the motivation and dynamism of the learning and assessment processes, we have proposed the use of three educational resources namely screencasts, self-assessment questionnaires and automated grading of assignments. These resources have been made available in Moodle which is a Learning Management System widely used in education environments and adopted by the Telecommunications Engineering School at the Universidad Politécnica de Madrid (UPM). Both teachers and students can enhance the learning and assessment processes through the use of new educational activities such as self-assessment questionnaires and automated grading of assignments. On the other hand, multimedia resources such as screencasts can guide students in complex topics. The resources proposed allow teachers to improve their tutorial actions since they provide immediate feedback and comments to students without the enormous effort of manual correction and evaluation by teachers specially taking into account the large number of students enrolled in the course. In this paper we present the case study where three proposed educational resources were applied. We describe the special features of the course and explain why the use of these resources can both enhance the students? motivation and improve the teaching and learning processes. Our research work was carried out on students attending the "Computer programming" course offered in the first year of a Telecommunications Engineering degree at UPM. This course is mandatory and has more than 450 enrolled students. Our purpose is to encourage the motivation and dynamism of the learning and assessment processes.