Health and mood among HIV‐positive outpatients attending an ART Clinic of a University Hospital

To evaluate how individuals at different stages of infection with HIV perceive their health status and its association with mood states. With the introduction of Highly Active Antiretroviral Therapy in 1996, the quality of life of people living with HIV has improved. However, the literature emphasises the negative effects of the disease on the mental health of individuals suffering from this condition and the high incidence of depression among infected individuals. Although people diagnosed and living with HIV are overwhelmed by emotions, we found that various emotional manifestations are understudied within this group of patients. A cross-sectional study was conducted in an outpatient unit of a University Hospital (antiretroviral therapy clinic), with a consecutive sample composed of 152 patients. Data were collected through a questionnaire used to assess the sociodemographic and clinical characteristics, the Short Form (36) Health Survey, and the Profile of Mood States scale. The health status negatively affects the role at the emotional and mental health dimensions. The participants showing a worse health condition than in the previous year had higher levels of tension/anxiety, depression/dejection, fatigue/inertia and confusion/bewilderment. The stage of disease and the profile of mood state emerged as independent phenomena. The results of this study indicate that nurses worldwide should be aware of the emotional aspects (negative emotions strongly impact health) related to the subjective perception of a worsening health status, regardless of the stage of the disease.

Between Bacchus and Dionysus: European Union policies on rural development: the cases of Nemea and Basto wine regions

A actividade vitivinícola possui um conjunto diverso de características presentes no solo, território e comunidade que fazem parte do património cultural de uma determinada região. Quando a tradição se traduz num conceito como terroir que é formado por características territoriais, sociais e culturais de uma região rural, o vinho apresenta uma “assinatura” que se escreve “naturalmente” no paladar regionalmente identificado. Os vinhos da Região de Nemea, na Grécia e de Basto (Região dos Vinhos Verdes) em Portugal, estão ambos sob a proteção dos regulamentos das Denominações de Origem. No entanto, apesar de ambos serem regulados por sistemas institucionais de certificação e controlo de qualidade, afigura-se a necessidade de questionar se o património cultural e a identidade territorial específica, “impressa” em ambos os terroirs, pode ser protegida num sentido mais abrangente do que apenas origem e qualidade. Em Nemea, a discussão entre os produtores diz respeito ao estabelecimento de sub-zonas, isto é incluir na regulação PDO uma diferente categorização territorial com base no terroir. Ou seja, para além de estar presente no rótulo a designação PDO, as garrafas incluirão ainda informação certificada sobre a área específica (dentro do mesmo terroir) onde o vinho foi produzido. A acontecer resultaria em diferentes status de qualidade de acordo com as diferentes aldeias de Nemea onde as vinhas estão localizadas. O que teria possíveis impactos no valor das propriedades e no uso dos solos. Para além disso, a não participação da Cooperativa de Nemea na SON (a associação local de produtores de vinho) e como tal na discussão principal sobre as mudanças e os desafios sobre o terroir de Nemea constitui um problema no sector vitivinícola de Nemea. Em primeiro lugar estabelece uma relação de não-comunicação entre os dois mais importantes agentes desse sector – as companhias vinícolas e a Cooperativa. Em segundo lugar porque constituiu uma possibilidade real, não só para os viticultores ficarem arredados dessa discussão, como também (porque não representados pela cooperativa) ficar impossibilitado um consenso sobre as mudanças discutidas. Isto poderá criar um ‘clima’ de desconfiança levando a discussão para ‘arenas’ deslocalizadas e como tal para decisões ‘desterritorializadas’ Em Basto, há vários produtores que começaram a vender a sua produção para distribuidoras localizadas externamente à sub-região de Basto, mas dentro da Região dos Vinhos Verdes, uma vez que essas companhias tem um melhor estatuto nacional e internacional e uma melhor rede de exportações. Isto está ainda relacionado com uma competição por uma melhor rede de contactos e status mais forte, tornando as discussões sobre estratégias comuns para o desenvolvimento rural e regional de Basto mais difícil de acontecer (sobre isto a palavra impossível foi constantemente usada durante as entrevistas com os produtores de vinho). A relação predominante entre produtores é caracterizada por relações individualistas. Contudo foi observado que essas posições são ainda caracterizadas por uma desconfiança no interior da rede interprofissional local: conflitos para conseguir os mesmos potenciais clientes; comprar uvas a viticultores com melhor rácio qualidade/preço; estratégias individuais para conseguir um melhor status político na relação com a Comissão dos Vinhos Verdes. Para além disso a inexistência de uma activa intermediação institucional (autoridades municipais e a Comissão de Vinho Verde), a inexistência entre os produtores de Basto de uma associação ou mesmo a inexistência de uma cooperativa local tem levado a região de Basto a uma posição de subpromoção nas estratégias de promoção do Vinho Verde em comparação com outras sub-regiões. É também evidente pelos resultados que as mudanças no sector vitivinícolas na região de Basto têm sido estimuladas de fora da região (em resposta também às necessidades dos mercados internacionais) e raramente de dentro – mais uma vez, ‘arenas’ não localizadas e como tal decisões desterritorializadas. Nesse sentido, toda essa discussão e planeamento estratégico, terão um papel vital na preservação da identidade localizada do terroir perante os riscos de descaracterização e desterritorialização. Em suma, para ambos os casos, um dos maiores desafios parece ser como preservar o terroir vitivinícola e como tal o seu carácter e identidade local, quando a rede interprofissional em ambas as regiões se caracteriza, tanto por relações não-consensuais em Nemea como pelo modus operandi de isolamento sem comunicação em Basto. Como tal há uma necessidade de envolvimento entre os diversos agentes e as autoridades locais no sentido de uma rede localizada de governança. Assim sendo, em ambas as regiões, a existência dessa rede é essencial para prevenir os efeitos negativos na identidade do produto e na sua produção. Uma estratégia de planeamento integrado para o sector será vital para preservar essa identidade, prevenindo a sua desterritorialização através de uma restruturação do conhecimento tradicional em simultâneo com a democratização do acesso ao conhecimento das técnicas modernas de produção vitivinícola.

Sense-making in theory and practice: a metatheoretical foundation and application for health information seeking

This thesis attempts to provide deeper historical and theoretical grounding for sense-making, thereby illustrating its applicability to practical information seeking research. In Chapter One I trace the philosophical origins of Brenda Dervin’s theory known as “sense making,” reaching beyond current scholarship that locates the origins of sense-making in twentieth-century Phenomenology and Communication theory and find its rich ontological, epistemological, and etymological heritage that dates back to the Pre-Socratics. After exploring sense-making’s Greek roots, I examine sense-making’s philosophical undercurrents found in Hegel’s Phenomenology of Spirit (1807), where he also returns to the simplicity of the Greeks for his concept of sense. With Chapter Two I explore sense-making methodology and find, in light of the Greek and Hegelian dialectic, a dialogical bridge connecting sense-making’s theory with pragmatic uses. This bridge between Dervin’s situation and use occupies a distinct position in sense-making theory. Moreover, building upon Brenda Dervin’s model of sense-making, I use her metaphors of gap and bridge analogy to discuss the dialectic and dialogic components of sense making. The purpose of Chapter Three is pragmatic – to gain insight into the online information-seeking needs, experiences, and motivation of first-degree relatives (FDRs) of breast cancer survivors through the lens of sense-making. This research analyses four questions: 1) information-seeking behavior among FDRs of cancer survivors compared to survivors and to undiagnosed, non-related online cancer information seekers in the general population, 2) types of and places where information is sought, 3) barriers or gaps and satisfaction rates FDRs face in their cancer information quest, and 4) types and degrees of cancer information and resources FDRs want and use in their information search for themselves and other family members. An online survey instrument designed to investigate these questions was developed and pilot tested. Via an email communication, the Susan Love Breast Cancer Research Foundation distributed 322,000 invitations to its membership to complete the survey, and from March 24th to April 5th 10,692 women agreed to take the survey with 8,804 volunteers actually completing survey responses. Of the 8,804 surveys, 95% of FDRs have searched for cancer information online, and 84% of FDRs use the Internet as a sense-making tool for additional information they have received from doctors or nurses. FDRs report needing much more information than either survivors or family/friends in ten out of fifteen categories related to breast and ovarian cancer. When searching for cancer information online, FDRs also rank highest in several of sense-making’s emotional levels: uncertainty, confusion, frustration, doubt, and disappointment than do either survivors or friends and family. The sense-making process has existed in theory and praxis since the early Greeks. In applying sense–making’s theory to a contemporary problem, the survey reveals unaddressed situations and gaps of FDRs’ information search process. FDRs are a highly motivated group of online information seekers whose needs are largely unaddressed as a result of gaps in available online information targeted to address their specific needs. Since FDRs represent a quarter of the population, further research addressing their specific online information needs and experiences is necessary.

Use of Poppers (Amyl Nitrite): Unpleasant Side Effects in a Brothel

Introduction: Various agents can lead to an acquired methaemoglobinaemia (MHB) with potentially fatal consequences. There is a lack of literature on the formation of methaemoglobin (MH) in the blood after the intake of poppers (amyl nitrite). Poppers are a popular aphrodisiac agent. Case description: A 56-year-old diabetic called an ambulance after using poppers in a brothel with subsequent associated acrocyanosis, confusion and headache. The paramedics reported tachycardia and blood glucose of 3.8 mmol/l. The arterial blood gas analysis in the Emergency Department (ED) revealed a MHB of 23.1%. MH levels decreased rapidly without antidotal therapy. The patient was discharged the next day free of symptoms. Discussion: This case illustrates the potential risks of taking poppers. A wide spectrum of symptoms were present in our patient. For the differential diagnosis of acquired MHB, poppers should be considered.

Hashimoto’s Encephalopathy: An Unusual Cause of Autoimmune Encephalopathy in a Clinically and Biochemically Euthyroid Patient

Objectives: To highlight the occurrence of Hashimoto’s encephalopathy – a steroid-responsive encephalopathy associated with elevated antithyroid antibodies. Material and methods: We describe a clinically and biochemically euthyroid patient with an encephalopathy presenting with headache, mild confusion and personality changes for 6 weeks and tonic–clonic seizures upon admission Results: There was no obvious infective or metabolic cause. The patient had a high titre of antithyroid antibodies and responded to steroid therapy. Conclusion: This uncommon disease needs to be considered in patients presenting with neurological symptoms that remain unexplained after routine standard investigations, even when the patient is euthyroid. Early diagnosis is important, as this is a treatable condition.

Vulnerabilidad de las consumidoras adolescentes: un estudio en un entorno virtual

El principal objetivo de este estudio fue investigar lo que produce la vulnerabilidad de las consumidoras adolescentes en un ambiente virtual. Se eligió un enfoque cualitativo, utilizando como método la investigación documental. Los datos fueron recolectados en el entorno virtual de la Revista Capricho, específicamente en las secciones de Moda y Belleza entre enero de 2013 y junio de 2014. Los resultados de la investigación identificaron como factores agravantes de la vulnerabilidad de las consumidoras adolescentes: el género; autoconcepto; condición socioeconómica; la falta de conocimiento y la poca experiencia en el consumo; motivación; el estigma y la discriminación; las normas de la subcultura adolescente; el exceso de información; y el uso excesivo de internet. Las características de vulnerabilidad más relevantes fueron: no tienen confianza en términos de autoimagen; materialismo; inseguridad; perdida de bienestar; incapacidad de resistir a las presiones de grupo; estado de confusión y vicio en internet

Usos político-partidistas en cuentas de Twitter de administraciones públicas

Introducción: La comunicación institucional y la comunicación política deberían tener cauces de difusión separados pero, adoptando la hipótesis de la normalización, en las redes sociales también se refleja la tendencia al indebido uso partidista de los canales institucionales. Metodología: Este estudio analiza las publicaciones en Twitter de 40 cuentas institucionales españolas distribuidas equitativamente entre cuatro niveles territoriales (estatal, autonómico, provincial y local). Se trata de una investigación cualitativa con un método exploratorio en el que se ha empleado fundamentalmente el análisis de contenido. Resultados y conclusiones: Los resultados verifican la hipótesis de que se están dando usos propagandísticos y partidistas desde estas cuentas institucionales con una decena de tendencias que reflejan una gran preocupación por la proyección de los políticos en tanto que agentes de un partido. Por tanto, se consolida en este nuevo canal la confusión de estos dos planos, ya advertida en investigaciones previas con respecto a las salas de prensa online de una institución (García Orosa y Vázquez Sande, 2012).

Hypoglyceamia in a Patient with a Solitary Fibrous Tumour

Objective: To illustrate an unusual mechanism causing hypoglycaemia. Material and methods: A 76-year-old man presented with episodes of agitation and confusion and was resuscitated with oral glucose gel when found to be hypoglycaemic. Results: A CT scan for an abdominal mass confirmed a solitary fibrous tumour (SFT). The sarcoma multidisciplinary team suggested conservative management. The patient's episodic hypoglycaemia was managed with diet modification including corn-based starch, scheduled snacks and dexamethasone. Glucose levels were within normal range at discharge from hospital. The patient was referred to the palliative care team for follow-up. Conclusion: SFTs causing non-islet cell tumour hypoglycaemia are difficult to treat. KEYWORDS

Computational Foundations for Safe and Efficient Human-Robot Collaboration in Assembly Cells

Human and robots have complementary strengths in performing assembly operations. Humans are very good at perception tasks in unstructured environments. They are able to recognize and locate a part from a box of miscellaneous parts. They are also very good at complex manipulation in tight spaces. The sensory characteristics of the humans, motor abilities, knowledge and skills give the humans the ability to react to unexpected situations and resolve problems quickly. In contrast, robots are very good at pick and place operations and highly repeatable in placement tasks. Robots can perform tasks at high speeds and still maintain precision in their operations. Robots can also operate for long periods of times. Robots are also very good at applying high forces and torques. Typically, robots are used in mass production. Small batch and custom production operations predominantly use manual labor. The high labor cost is making it difficult for small and medium manufacturers to remain cost competitive in high wage markets. These manufactures are mainly involved in small batch and custom production. They need to find a way to reduce the labor cost in assembly operations. Purely robotic cells will not be able to provide them the necessary flexibility. Creating hybrid cells where humans and robots can collaborate in close physical proximities is a potential solution. The underlying idea behind such cells is to decompose assembly operations into tasks such that humans and robots can collaborate by performing sub-tasks that are suitable for them. Realizing hybrid cells that enable effective human and robot collaboration is challenging. This dissertation addresses the following three computational issues involved in developing and utilizing hybrid assembly cells: - We should be able to automatically generate plans to operate hybrid assembly cells to ensure efficient cell operation. This requires generating feasible assembly sequences and instructions for robots and human operators, respectively. Automated planning poses the following two challenges. First, generating operation plans for complex assemblies is challenging. The complexity can come due to the combinatorial explosion caused by the size of the assembly or the complex paths needed to perform the assembly. Second, generating feasible plans requires accounting for robot and human motion constraints. The first objective of the dissertation is to develop the underlying computational foundations for automatically generating plans for the operation of hybrid cells. It addresses both assembly complexity and motion constraints issues. - The collaboration between humans and robots in the assembly cell will only be practical if human safety can be ensured during the assembly tasks that require collaboration between humans and robots. The second objective of the dissertation is to evaluate different options for real-time monitoring of the state of human operator with respect to the robot and develop strategies for taking appropriate measures to ensure human safety when the planned move by the robot may compromise the safety of the human operator. In order to be competitive in the market, the developed solution will have to include considerations about cost without significantly compromising quality. - In the envisioned hybrid cell, we will be relying on human operators to bring the part into the cell. If the human operator makes an error in selecting the part or fails to place it correctly, the robot will be unable to correctly perform the task assigned to it. If the error goes undetected, it can lead to a defective product and inefficiencies in the cell operation. The reason for human error can be either confusion due to poor quality instructions or human operator not paying adequate attention to the instructions. In order to ensure smooth and error-free operation of the cell, we will need to monitor the state of the assembly operations in the cell. The third objective of the dissertation is to identify and track parts in the cell and automatically generate instructions for taking corrective actions if a human operator deviates from the selected plan. Potential corrective actions may involve re-planning if it is possible to continue assembly from the current state. Corrective actions may also involve issuing warning and generating instructions to undo the current task.

Ad hoc procedure for optimising agreement between observational records

Observational studies in the field of sport are complicated by the added difficulty of having to analyse multiple, complex events or behaviours that may last just a fraction of a second. In this study, we analyse three aspects related to the reliability of data collected in such a study. The first aim was to analyse and compare the reliability of data sets assessed quantitatively (calculation of kappa statistic) and qualitatively (consensus agreement method). The second aim was to describe how, by ensuring the alignment of events, we calculated the kappa statistic for the order parameter using SDIS-GSEQ software (version 5.1) for data sets containing different numbers of sequences. The third objective was to describe a new consultative procedure designed to remove the confusion generated by discordant data sets and improve the reliability of the data. The procedure is called "consultative" because it involves the participation of a new observer who is responsible for consulting the existing observations and deciding on the definitive result.

L'insaisissable catégorie sociale d'enfants orphelins d'Afrique: de quoi parle-t-on?

There is no definition of orphans that would allow to know without confusion who is an orphan child. This article analyses the challenges and difficulties in defining and targeting the social category of orphans. It is based on a number of works, as well as the field research on the social actor's logics regarding the family support to orphans among the Mossi people in Ouagadougou (Burkina Faso), for my Ph.D. in sociology at Laval University (Canada). In fact, international charity organisations use orphans as a vulnerable and universal category. This has been done through the propagation of information on HIV. From the social sciences perspective, the category of orphans covers a variety of realities, and making the choice to see it otherwise would hide the diversity of those realities.

Les armes de jet d’Argilos : catalogue typologique

Quelques sites archéologiques comme Olympie, Stymphalos et Olynthe possèdent respectivement un répertoire faisant l’étude des armes de jet retrouvées durant une série de campagnes de fouilles archéologiques. Parmi ces indexes, figurent fréquemment des pointes de flèche, des balles de fronde et des saurotères (contrepoids de lance ou de javelot) provenant de différentes périodes historiques gréco-romaines. À travers les 20e et 21e siècle de notre ère, des spécialistes comme D. Robinson (1931), A. Snodgrass (1964), H. Baitinger (2001), C. Hagerman (2014) dédièrent une partie de leur expertise pour produire des synthèses sur ces objets jadis négligés. Ainsi, ils parvinrent à créer de grandes encyclopédies commentées composées de projectiles retrouvés en sol grec. À l’aide de ces bases de données, les archéologues militaires sont en mesure d’établir des datations et l’origine prétendue de certains types de projectiles. Jusqu’en 2015, les artéfacts militaires trouvés sur le site archéologique d’Argilos n’avaient jamais fait l’objet d’une étude de synthèse. D’abord, inspiré par de publications semblables, ces projectiles furent soumis à un inventaire sous forme de catalogue. Au total, deux types de balles de fronde en plomb, onze types de pointes de flèche et un type de saurotère furent identifiés. Finalement, ce nouveau contenu fut assujetti à des analyses comparatives avec d’autres sites archéologiques possédant des données similaires. Les conclusions découlant de ces analogies donnèrent naissance à la première typologie des armes de jet argilienne. Certes, les analyses se heurtèrent à certains obstacles, notamment à une compréhension de la quasi-inexistence d'une pointe de flèche typiquement "grecque" et à la confusion systématique quant à la distinction entre un saurotère et une pointe de javelot, voire possiblement un carreau de gastraphétès (une sorte d’arbalète imposante utilisée lors de sièges durant le 4e siècle av. J.-C.). En partie, ceci découle de l'historique d'échanges entre la Grèce et les autres peuples méditerranéens, balkaniques et orientaux. En outre, de nombreuses réformes militaires des périodes archaïque et classique provoquèrent une évolution constante sur les aspects stratégiques et les tactiques militaires. Considérant ces facteurs parmi tant d'autres et le fait qu'Argilos ait été une fondation grecque en territoire thraco-macédonien, la possibilité d'influence "étrangère" devient alors prépondérante sur la typologie des projectiles argiliens publiée dans le présent mémoire. Avec beaucoup d’espoir, nous croyons sans équivoque que ce travail de recherche contribuera grandement non seulement à l’histoire d’Argilos, mais aussi à l’étude des projectiles en Grèce du nord.

Can we predict agitation in patients with suicide attempts in the emergency department?

Background: The agitation in patients presenting to the emergency department (ED) after suicide attempts is common and an important problem. Objective: To establish whether we can predict agitated patients among suicide attempt patients in ED. Methods: This is a cross-sectional observational study of adult suicide attempt events in ED. Information was collected prospectively on a specially designed data-collection form. Patients aged 16 years old and above who presented to the ED for care due to suicide attempts were included in the study. Suicide attempts were grouped as aggressive and non-aggressive attempts. Results: A total of 533 patients were included. Forty-three of these patients had agitation in ED (8%). Non-aggressive suicide attempts were referred to psychiatry services more than aggressive ones (73.6%, n=345 vs 32.8%, n=21, P<0.0001). Agitation in ED and being male increased aggressive suicide attempt risk 3.5 (95% CI:1.6-7.6) and 3.2 times (95% CI:1.8-5.5), respectively. Agitation was statistically more frequent among these patients: those on antidepressant overdose, with previous suicide attempt; with aggressive suicide attempt; and those with confusion; and unconsciousness (P<0.05). Conclusion: Patients who attempted suicide and whose risk of harm to others included those with: antidepressant overdose, aggressive suicide attempt and the unconscious. Response teams should be prepared for these subgroups.

Traumas psicosociales que generan los centros de internamiento para extranjeros

[ES]La población inmigrante se expone a problemas relacionados con la salud mental de manera más violenta que otras personas. Estos problemas se ven pronunciados según las condiciones en las que inician su “nueva vida”, por lo que son varias las incertidumbres que surgen sobre si el paso de los extranjeros por un Centros de Internamiento para Extranjeros1 fomenta los traumas psicosociales que padecen en base a las condiciones de vida que hay dentro de ellos, y si son estos una solución efectiva. Los centros de internamiento para extranjeros son actualmente un tema de interés y desconcierto para la ciudadanía, por el impacto sociocultural y político que suponen. Analizando los estudios y las situaciones de los inmigrantes podremos llegar a conclusiones sobre si son adecuadas las medidas que se llevan a cabo.

MEN WRITING WOMEN: “THE WOMAN QUESTION” AND MALE DISCOURSE OF IRANIAN MODERNITY"

In this dissertation I explore “The Woman Question” in the discourse of Iranian male authors. A pro-modernity group, they placed women’s issues at the heart of their discourse. This dissertation follows the trajectory of the representation of “The Woman Question” as it is reflected in the male discourse over the course of a century. It discusses the production of a literature that was anchored in the idea of reform and concerned itself with issues pertaining to women. These men challenged lifelong patriarchal notions such as veiling, polygamy, gender segregation, and arranged marriages, as well as traditional roles of women and gender relations. This study is defined under the rubrics of “The Woman Question” and “The New Woman,” which I have borrowed from the Victorian and Edwardian debates of similar issues as they provide clearer delineations. Drawing upon debates on sexuality, and gender, this dissertation illustrates the way these men championed women was both progressive and regressive. This study argues that the desire for women’s liberation was couched in male ideology of gender relations. It further illustrates that the advancement of “The Woman Question,” due to its continuous and yet gradual shifting concurrent with each author’s nuanced perception of women’s issues, went through discernible stages that I refer to as observation, causation, remedy, and confusion. The analytical framework for this project is anchored in the “why” and the “how” of the Iranian male authors’ writings on women in addition to “what” was written. This dissertation examines four narrative texts—two in prose and two in poetry—entitled: “Lankaran’s Vizier,” “The Black Shroud,” “‘Arefnameh,” and “Fetneh” written respectively by Akhundzadeh, ‘Eshqi, Iraj Mirza, and Dashti. Chapter one outlines the historical background, methodology, theoretical framework, and literature review. The following chapters examine, the advocacy for companionate marriage and romantic love, women and nationalistic cause, veiling and unveiling, and the emerging figure of the New Iranian Woman as morally depraved.