Die älteren Ansiedelungsschichten /

"Aus den Abhandlungen der K. Bayer. Akademie der Wis. I. Kl., XXIV Bd., II. Abt."

Health service use and costs for infant behaviour problems and maternal stress

AIM: We aim to describe health service (HS) use in the first 6 months post-partum and to examine the associations between service costs, infant behaviour and maternal depressive symptoms. METHODS: Participants were 781 infants and mothers in Melbourne, Australia. Mothers reported infant feeding, sleeping and crying problems, depressive symptoms and health service use. Costs were valued in 2012 Australian dollars. RESULTS: The most common services used were maternal child health nurses, general practitioners (GP) and allied health. Infant feeding problems were associated with increased costs for services relevant to infant behaviour including maternal child health nurses (P = 0.007), GP (P = 0.008) and paediatricians (P = 0.03). Maternal depressive symptoms were associated with increased costs for services relevant to depressive symptoms including parenting centres (P = 0.04), GP (P = 0.004), psychiatrists (P = 0.02) and psychologists (P = 0.001). Mothers who completed high school had higher service costs for infant problems than those with lower education (P = 0.02). Single mothers had higher costs for services used for their depressive symptoms than partnered mothers (P < 0.001). Mothers with English as a second language had lower service costs for their depressive symptoms (P = 0.02). CONCLUSIONS: Infant feeding problems and maternal depressive symptoms are associated with higher costs for health services relevant to these conditions. Cost-effective strategies to manage these conditions are needed with accessibility being ensured for mothers who are experiencing social adversity.

Candida infective endocarditis: an observational cohort study with a focus on therapy

Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candida infective endocarditis. This prospective cohort study was based on 70 cases of Candida infective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candida infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis.

Influence of the timing of cardiac surgery on the outcome of patients with infective endocarditis and stroke

BACKGROUND: The timing of cardiac surgery after stroke in infective endocarditis (IE) remains controversial. We examined the relationship between the timing of surgery after stroke and the incidence of in-hospital and 1-year mortalities. METHODS: Data were obtained from the International Collaboration on Endocarditis-Prospective Cohort Study of 4794 patients with definite IE who were admitted to 64 centers from June 2000 through December 2006. Multivariate logistic regression and Cox regression analyses were performed to estimate the impact of early surgery on hospital and 1-year mortality after adjustments for other significant covariates. RESULTS: Of the 857 patients with IE complicated by ischemic stroke syndromes, 198 who underwent valve replacement surgery poststroke were available for analysis. Overall, 58 (29.3%) patients underwent early surgical treatment vs 140 (70.7%) patients who underwent late surgical treatment. After adjustment for other risk factors, early surgery was not significantly associated with increased in-hospital mortality rates (odds ratio, 2.308; 95% confidence interval [CI], .942-5.652). Overall, probability of death after 1-year follow-up did not differ between 2 treatment groups (27.1% in early surgery and 19.2% in late surgery group, P = .328; adjusted hazard ratio, 1.138; 95% CI, .802-1.650). CONCLUSIONS: There is no apparent survival benefit in delaying surgery when indicated in IE patients after ischemic stroke. Further observational analyses that include detailed pre- and postoperative clinical neurologic findings and advanced imaging data (eg, ischemic stroke size), may allow for more refined recommendations on the optimal timing of valvular surgery in patients with IE and recent stroke syndromes.

Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study.

BACKGROUND: We sought to provide a contemporary picture of the presentation, etiology, and outcome of infective endocarditis (IE) in a large patient cohort from multiple locations worldwide. METHODS: Prospective cohort study of 2781 adults with definite IE who were admitted to 58 hospitals in 25 countries from June 1, 2000, through September 1, 2005. RESULTS: The median age of the cohort was 57.9 (interquartile range, 43.2-71.8) years, and 72.1% had native valve IE. Most patients (77.0%) presented early in the disease (<30 days) with few of the classic clinical hallmarks of IE. Recent health care exposure was found in one-quarter of patients. Staphylococcus aureus was the most common pathogen (31.2%). The mitral (41.1%) and aortic (37.6%) valves were infected most commonly. The following complications were common: stroke (16.9%), embolization other than stroke (22.6%), heart failure (32.3%), and intracardiac abscess (14.4%). Surgical therapy was common (48.2%), and in-hospital mortality remained high (17.7%). Prosthetic valve involvement (odds ratio, 1.47; 95% confidence interval, 1.13-1.90), increasing age (1.30; 1.17-1.46 per 10-year interval), pulmonary edema (1.79; 1.39-2.30), S aureus infection (1.54; 1.14-2.08), coagulase-negative staphylococcal infection (1.50; 1.07-2.10), mitral valve vegetation (1.34; 1.06-1.68), and paravalvular complications (2.25; 1.64-3.09) were associated with an increased risk of in-hospital death, whereas viridans streptococcal infection (0.52; 0.33-0.81) and surgery (0.61; 0.44-0.83) were associated with a decreased risk. CONCLUSIONS: In the early 21st century, IE is more often an acute disease, characterized by a high rate of S aureus infection. Mortality remains relatively high.

Étude des phénomènes d'entartrage de la gibbsite sur les surfaces métalliques

Le procédé Bayer est cyclique et il permet d'extraire les hydrates d'alumine, contenu dans le minerai de bauxite. L'alumine est la matière première nécessaire pour la production de l'aluminium métallique par le procédé d'électrolyse. La solubilisation des hydrates d'alumine est effectuée dans une solution d'hydroxyde de sodium concentrée, liqueur Bayer, à haute température et pression. Il existe deux types de procédé : un procédé dit à basse température (150ÀC) et un procédé dit haute température (250ÀC). Selon la température utilisée, certaines impuretés présentes dans la bauxite vont être solubilisées comme par exemple la silice, le fer ou le titane. Comme le procédé est basé sur la solubilisation puis sur la précipitation des hydrates d'alumine, la solution est chauffée puis refroidie par une série d'échangeurs de chaleur. Ces changements de température impliquent des variations dans les conditions de saturation et sursaturation ce qui va conséquemment causer la formation de tartre dans le procédé. Selon la température du procédé utilisé, la composition chimique du tartre formé peut être différente. Dans le but d'inhiber partiellement ou totalement la cristallisation de la gibbsite, ou hydrate d'alumine, sur les surfaces métalliques, la compréhension des paramètres influençant sa formation est nécessaire. L'un des moyens de réduire ou d'inhiber la formation du tartre est de modifier les énergies de surface entre les surfaces métalliques et la solution de liqueur Bayer. Pour ce faire, des métaux ayant des propriétés différentes seront étudiés en entartrage et des composés organiques seront ajoutées à la solution d'hydroxyde de sodium afin de modifier l'interface entre ces métaux et la solution. L'influence des hydrates d'alumine et des différents composés organiques sur les métaux sera déterminer [i.e. déterminée] par des mesures d'isothermes d'adsorption, de potentiels zêta et d'angles de contact, dans le but d'établir une corrélation entre l'interface métal/solution et les temps de nucléation mesurés en entartrage. Un deuxième volet consiste en la fabrication d'un montage en laboratoire permettant d'effectuer la formation reproductible du tartre de freudenbergite. La freudenbergite est un tartre à base de titane qui se forme dans le procédé à haute température. Cette étude démontre que la formation du tartre dans le procédé Bayer est un phénomène de formation de cristaux de gibbsite en solution qui vont adhérer aux défauts de surfaces des surfaces métalliques. En ce sens, la rugosité de surface des métaux est le facteur déterminant pour la formation du tartre dans le procédé Bayer. Des tests d'entartrage réalisés au laboratoire sur cinq métaux différents démontrent une corrélation évidente entre la rugosité de surface, mesurée par microscope à force atomique, et les temps de nucléation obtenus en entartrage. Les mesures d'interactions interfaciales des aluminates de sodium sur les métaux étudiés, en présence ou non de composés organiques, ne permettent pas d'établir de corrélation avec les temps de nucléation obtenus en entartrage. Par contre, l'allongement de l'entartrage en présence de gluconate et de tartrate de sodium, des composés inhibiteurs de croissance des cristaux de gibbsite, confirme le phénomène de formation du tartre par des cristaux formés en solution. La croissance des cristaux de tartre étant partiellement inhibée, les temps de nucléation vont être allongés lors des tests d'entartrage. À l'inverse, l'EDTA favorise la formation de plusieurs cristaux en solution, ce qui diminue significativement la vitesse d'entartrage lorsqu'elle est ajoutée dans la liqueur Bayer. Afin de confirmer que la rugosité de surface est le facteur prédominant dans la formation du tartre dans le procédé Bayer, dans nos conditions de laboratoire, des tests d'entartrage sont effectués sur une surface d'or recouverte d'une monocouche d'alcane thiols. Ces tests démontrent que le changement de nature de la surface d'or ne permet pas de changer significativement le temps de nucléation de l'or dans nos conditions d'entartrage. Un montage expérimental comportant un four et quatre autoclaves, contrôlé par un système informatique a permis d'effectuer la formation de tartre de freudenbergite de façon reproductible au laboratoire.

Factores asociados a embarazo no deseado en mujeres en edad reproductiva en Colombia 2010

Objetivo: Identificar factores sociodemográficos y de fecundidad, asociados a ocurrencia de embarazo no deseado en mujeres colombianas en edad reproductiva en el año 2010. Métodos: Se realizó estudio retrospectivo de corte transversal, basado en los datos de la ENDS Colombia-2010, del total de mujeres en edad fértil (13-49 años) que al momento de la encuesta se encontraban en embarazo. La variable de interés fue embarazo no deseado, se describió la población a estudio y se evaluó la posible asociación con variables sociodemográficas y de fecundidad, a través de análisis bivariado y multivariado. Se realizaron los mismos análisis por grupo de edad (adolescentes vs adultas). Resultados: La prevalencia de embarazo no deseado en las mujeres colombianas en el 2010 fue de 61,4 %. De acuerdo al modelo de regresión logística, no estar en unión a una pareja (OR: 4,01 IC95%: 3,066-5,269), tener hijos (OR: 2,040 IC95%: 1,581 – 2,631), estar en el quintil de menor riqueza (OR: 2,137 IC95%: 1,328-3,440), y ser adolescente (OR: 1,599 IC95%: 1,183-2,162), son factores que aumentan la probabilidad de tener un embarazo no deseado. Se encontraron diferencias en los factores asociados al realizar segmentación por edad. Conclusiones: La prevalencia de embarazo no deseado permanece alta en Colombia respecto a años anteriores y a otros países. Los resultados pueden ser de utilidad para el desarrollo de políticas en salud sexual y reproductiva teniendo en cuenta los factores asociados identificados priorizando a la población adolescente y de menor estatus socioeconómico, para la prevención de embarazo no deseado en Colombia.

La semilla de la discordia: un estudio de la influencia del Régimen Alimentario Corporativo en la construcción de políticas públicas alimentarias en Colombia

El hambre es un tema fundamental dentro de la agenda política internacional en la actualidad. Diariamente, según la FAO, mueren alrededor de 24.000 personas a causa de no ingerir alimentos. Las estrategias planteadas por parte de las empresas y los gobiernos están enfocadas a generar una mayor producción de alimentos para disminuir el hambre y garantizar la seguridad alimentaria. Este artículo explica cómo el significado del alimento se transformó para ser entendido como mercancía, a partir del establecimiento del régimen alimentario corporativo. Las normas aquí creadas influyen en la construcción de las políticas públicas nacionales. Este estudio de caso evidencia la relación entre ambas en Colombia a partir del 2008 y el nivel de dependencia alimentaria y de insumos químicos del país hacia actores internacionales, analizado a partir de la importación y producción de alimentos. Finalmente, este trabajo investigativo permitirá determinar el estado de la soberanía alimentaria en Colombia.

Efluxo de metano (CH4) em dois solos do RS sob cultivo de arroz irrigado por alagamento.

O aumento da concentração de gases na atmosfera, decorrente da atividade humana, gera um aceleramento significativo do efeito estufa. Dentre os gases, o metano (CH4) é um dos que têm grande potencial em causar o efeito estufa, destacando-se como fonte geradora as áreas de várzea cultivadas com arroz irrigado por alagamento. Estima-se que estas áreas têm contribuído com até 45% da emissão de CH4 de origem antropogênica. O objetivo deste trabalho foi avaliar o efluxo de CH4 em dois solos, cultivados com arroz irrigado, no Estado do RS. O primeiro local avaliado foi uma lavoura na área experimental da Universidade Federal de Santa Maria (UFSM), Santa Maria - RS e o segundo na Estação Experimental do Arroz no Instituto Rio Grandense do Arroz (IRGA), Cachoeirinha - RS. Durante a safra do arroz realizaram-se coletas semanais de amostras de ar em câmaras coletoras com o auxílio de seringas plásticas de polipropileno aos 5, 10, 15, 20 e 25 minutos após o fechamento da câmara. Durante as coletas, foi registrada a temperatura do ar, da água de alagamento e do solo (0,05m de profundidade) para o cálculo das emissões. Os picos de emissão de CH4 em Santa Maria e Cachoeirinha ocorreram, respectivamente, aos 30 e 69 dias após o alagamento do solo, sendo que em Cachoeirinha os picos de emissão tiveram menor intensidade. O desencontro entre os picos de máxima emissão nas duas unidades de coleta e a menor intensidade de emissão na unidade de Cachoeirinha pode estar associado com as características dos solos, temperatura, como também, pelo uso de diferentes cultivares de arroz irrigado. Existe a necessidade de se conhecer melhor os fatores que influenciam as taxas de emissão de metano como também avaliar formas de manejo da cultura visando uma menor emissão deste gás, reduzindo os impactos da rizicultura sobre o efeito estufa.

Características físicas de frutos do pequizeiro (Caryocar coriaceum Wittm.) nativos da Chapada do Araripe - CE.

O pequizeiro, planta nativa explorada de forma extrativista, típica da região do cerrado, pertence ao gênero Caryocar e à família Caryocaraceae (LORENZI, 1992). Esta planta de grande importância socioeconômica, envolve as famílias de agricultores na atividade de catação do fruto, cuja venda in natura, gera emprego e renda para o município. São diversas as suas aplicações na culinária local, no preparo de arroz, feijão e galinha, na elaboração de bolos, biscoitos, doces e fabricação artesanal de licor, considerado o mais nobre subproduto da fruta. Seu óleo (da polpa ou da amêndoa) tem aplicações na indústria de cosméticos para fabricação de cremes e sabonetes e grande importância na farmacopéia popular no combate de bronquites, gripes, resfriados e tumores (BRAGA, 2001; ALMEIDA; SILVA, 1994). Sendo o pequizeiro uma planta nativa, é natural que apresente certa variabilidade em suas características gerais conforme evidenciado por pesquisas realizadas em frutos de pequizeiros de ocorrência natural no Estado de Goiás (VERA et al., 2005, 2007). Este achados motivaram a realização deste trabalho para determinar as características físicas dos frutos da espécie Caryocar coriaceum Wittm., presente na Chapada do Araripe CE, visando verificar possíveis diferenças entre os genótipos e identificar materiais de interesse agroindustrial e para estudos de melhoramento da espécie.

Variação diária da emissão de metano em solo cultivado com arroz irrigado no sul do Brasil.

O metano apresenta um potencial de aquecimento 23 a 32 vêzes maior que o do dióxido de C e a sua emissão diária em lavouras de arroz varia com a temperatura do solo e da água, e com o metabolismo das plantas.O objetivo deste estudo foi determinar o horário apropriado à coleta de amostras de ar para quantificar a emissão média diária de metano, informação fundamental para estudos visando a derivação de índices regionais de emissão desse gás. Com base nas curvas de emissão diária e considerando aspectos operacionais, o intervalo entre 9 e 12 horas é recomendado para a avaliação das emissões de metano em lavouras de arroz irrigado. Esse procedimento é válido para as sub-regiões produtoras de arroz no sul do Brasil. Sua adequação deve ser confirmada para outras regiões que apresentem condições ambientais diversas.

A new sward management strategy to mitigate the methane (CH4) emissions by grazing ruminants.

2016

Effect of acaricides on Calepitrimerus vitis (Napela, 1905) (Acari: Eriophyidae) and on the production os vineyards.

2016