La dysménorrhée: un problème pour le pédiatre [Dysmenorrhea: a problem for the pediatrician?].

Dysmenorrhea is common in adolescent years, especially after the onset of ovulatory cycles, usually 2 to 3 years after menarche. Pain and symptoms are responsible for school absenteeism and interruption of sports and social activities. OBJECTIVES: This study aims to measure the prevalence of severe dysmenorrhea and its consequences on adolescent girls in Switzerland. Treatment of dysmenorrhea is discussed and recommendations for clinical practice are given. STUDY DESIGN: Cross sectional survey (SMASH 02) on a nationally representative sample of adolescents (n=7548; 3340 females), aged 16 to 20 years who attended post-mandatory education. A self-administered questionnaire was used to assess the severity of dysmenorrhea and its consequences on daily life pursuit of medical help and medications used. RESULTS: Among 3340 girls, 86.6% suffered from dysmenorrhea-related symptoms: 12.4% described having severe dysmenorrhea and 74.2% moderate dysmenorrhea. Girls with severe dysmenorrhea described heavier consequences on daily activities compared with girls without dysmenorrhea: 47.8% of girls with severe dysmenorrhea reported staying at home and 66.5% declared reducing their sportive activities. Yet, fewer than half have consulted a physician for this complaint and even fewer were treated properly. RECOMMENDATION: The pediatrician has a pivotal role in screening young patients for dysmenorrhea, as well as, educating and effectively treating adolescent girls with menstruation-associated symptoms. Non-steroidal anti-inflammatory drugs are considered the first-line of treatment for dysmenorrhea, and adolescents with symptoms that do not respond to this treatment for 3 menstrual periods should be offered combined oestroprogestative contraception and must be followed up, as non-responders may have an underlying organic pathology. CONCLUSION: Dysmenorrhea is a frequent health problem in adolescent years and adolescent care providers should be able to care for these patients in an efficient way.

Distortion control for delay-sensitive sources

We investigate the problem of finding minimum-distortion policies for streaming delay-sensitive but distortion-tolerant data. We consider cross-layer approaches which exploit the coupling between presentation and transport layers. We make the natural assumption that the distortion function is convex and decreasing. We focus on a single source-destination pair and analytically find the optimum transmission policy when the transmission is done over an error-free channel. This optimum policy turns out to be independent of the exact form of the convex and decreasing distortion function. Then, for a packet-erasure channel, we analytically find the optimum open-loop transmission policy, which is also independent of the form of the convex distortion function. We then find computationally efficient closed-loop heuristic policies and show, through numerical evaluation, that they outperform the open-loop policy and have near optimal performance.

Heritage Sporting Event : An Old Recipe for a New Problem

In the last decades, the globalized competition among cities and regions made them develop new strategies for branding and promoting their territory to attract tourists, investors, companies and residents. Major sports events - such as the Olympic Games, the FIFA World Cup or World and Continental Championships - have played an integral part in these strategies. Believing, with or without evidence, in the capacity of those events to improve the visibility and the economy of the host destination, many cities, regions and even countries have engaged in establishing sports events hosting strategies. The problem of the globalized competition in the sports events "market" is that many cities and regions do not have the resources - either financial, human or in terms of infrastructure - to compete in hosting major sports events. Consequently, many cities or regions have to turn to second-tier sports events. To organise those smaller events means less media coverage and more difficulty in finding sponsors, while the costs - both financial and in terms of services - stay high for the community. This paper analyses how Heritage Sporting Events (HSE) might be an opportunity for cities and regions engaged in sports events hosting strategies. HSE is an emerging concept that to date has been under-researched in the academic literature. Therefore, this paper aims to define the concept of HSE through an exploratory research study. A multidisciplinary literature review reveals two major characteristics of HSEs: the sustainability in the territory and the authenticity of the event constructed through a differentiation process. These characteristics, defined through multiple variables, give us the opportunity to observe the construction process of a sports event into a heritage object. This paper argues that HSEs can be seen as territorial resources that can represent a competitive advantage for host destinations. In conclusion, academics are invited to further research HSEs to better understand their construction process and their impacts on the territory, while local authorities are invited to consider HSEs for the branding and the promotion of their territory.

Injuries Resulted From Breastfeeding: A New Approach To A Known Problem

This study aimed at analyzing nipple trauma resulted from breastfeeding based on dermatological approach. Two integrative reviews of literature were conducted, the first related to definitions, classification and evaluation methods of nipple trauma and another about validation studies related to this theme. In the first part were included 20 studies and only one third defined nipple trauma, more than half did not defined the nipple’s injuries reported, and each author showed a particular way to assess the injuries, without consensus. In the second integrative review, no validation study or algorithm related to nipple trauma resulted from breastfeeding was found. This fact demonstrated that the nipple’s injuries mentioned in the first review did not go through validation studies, justifying the lack of consensus identified as far as definition, classification and assessment methods of nipple trauma.


Importância da Programação Linear na Determinação de Informações de Gestão - Caso Moave, Sa

A Investigação Operacional vem demonstrando ser uma valiosa ferramenta de gestão nos dias de hoje em que se vive num mercado cada vez mais competitivo. Através da Programação Linear pode-se reproduzir matematicamente um problema de maximização dos resultados ou minimização dos custos de produção com o propósito de auxiliar os gestores na tomada de decisão. A Programação Linear é um método matemático em que a função objectivo e as restrições assumem características lineares, com diversas aplicações no controlo de gestão, envolvendo normalmente problemas de utilização dos recursos disponíveis sujeitos a limitações impostas pelo processo produtivo ou pelo mercado. O objectivo geral deste trabalho é o de propor um modelo de Programação Linear para a programação ou produção e alocação de recursos necessários. Optimizar uma quantidade física designada função objectivo, tendo em conta um conjunto de condicionalismos endógenas às actividades em gestão. O objectivo crucial é dispor um modelo de apoio à gestão contribuindo assim para afectação eficiente de recursos escassos à disposição da unidade económica. Com o trabalho desenvolvido ficou patente a importância da abordagem quantitativa como recurso imprescindível de apoio ao processo de decisão. The operational research has proven to be a valuable management tool today we live in an increasingly competitive market. Through Linear Programming can be mathematically reproduce a problem of maximizing performance or minimizing production costs in order to assist managers in decision making. The Linear Programming is a mathematical method in which the objective function and constraints are linear features, with several applications in the control of management, usually involving problems of resource use are available subject to limitations imposed by the production process or the market. The overall objective of this work is to propose a Linear Programming model for scheduling or production and allocation of necessary resources. Optimizing a physical quantity called the objective function, given a set of endogenous constraints on management thus contributing to efficient allocation of scarce resources available to the economic unit. With the work has demonstrated the importance of the quantitative approach as essential resource to support the decision process.

Lack of Discipline in Cape Verdean Secondary Schools: The Need to Better Define the Problem and Develop Strategies to Prevent or Manage the Situation

This research paper has been written with the intention to discuss the problem of discipline in Cape Verdean secondary schools. While many of us discuss the effects that student misbehavior has on the student misbehavior has on the student, school and society as a whole, very few of us seek solutions which would impact on the prevention and management of this problem that each day becomes more complicated and harder to handle. This paper will discuss the need to better define discipline at the school level; identify the causes and factors that aggravate the problem, in addition, to provide what I hope to be useful strategies to better manage the problem as we make the effort to reclaim our schools and better educate our students. My research included surveys completed by teachers and student alike as they baffled over the question: what is discipline and how can we better manage discipline problems at our schools?

A mathematical excursion: From the three-door problem to a Cantor-type perfect set

We start with a generalization of the well-known three-door problem:the n-door problem. The solution of this new problem leads us toa beautiful representation system for real numbers in (0,1] as alternated series, known in the literature as Pierce expansions. A closer look to Pierce expansions will take us to some metrical properties of sets defined through the Pierce expansions of its elements. Finally, these metrical properties will enable us to present 'strange' sets, similar to the classical Cantor set.

Locating emergency services with priority rules: The priority queuing covering location problem

One of the assumptions of the Capacitated Facility Location Problem (CFLP) is thatdemand is known and fixed. Most often, this is not the case when managers take somestrategic decisions such as locating facilities and assigning demand points to thosefacilities. In this paper we consider demand as stochastic and we model each of thefacilities as an independent queue. Stochastic models of manufacturing systems anddeterministic location models are put together in order to obtain a formula for thebacklogging probability at a potential facility location.Several solution techniques have been proposed to solve the CFLP. One of the mostrecently proposed heuristics, a Reactive Greedy Adaptive Search Procedure, isimplemented in order to solve the model formulated. We present some computationalexperiments in order to evaluate the heuristics performance and to illustrate the use ofthis new formulation for the CFLP. The paper finishes with a simple simulationexercise.

A multi-objective model for a multi-period distribution management problem

The problems arising in commercial distribution are complex and involve several players and decision levels. One important decision is relatedwith the design of the routes to distribute the products, in an efficient and inexpensive way.This article deals with a complex vehicle routing problem that can beseen as a new extension of the basic vehicle routing problem. The proposed model is a multi-objective combinatorial optimization problemthat considers three objectives and multiple periods, which models in a closer way the real distribution problems. The first objective is costminimization, the second is balancing work levels and the third is amarketing objective. An application of the model on a small example, with5 clients and 3 days, is presented. The results of the model show the complexity of solving multi-objective combinatorial optimization problems and the contradiction between the several distribution management objective.

Minimax lower bounds for the two-armed bandit problem

We obtain minimax lower bounds on the regret for the classicaltwo--armed bandit problem. We provide a finite--sample minimax version of the well--known log $n$ asymptotic lower bound of Lai and Robbins. Also, in contrast to the log $n$ asymptotic results on the regret, we show that the minimax regret is achieved by mere random guessing under fairly mild conditions on the set of allowable configurations of the two arms. That is, we show that for {\sl every} allocation rule and for {\sl every} $n$, there is a configuration such that the regret at time $n$ is at least 1 -- $\epsilon$ times the regret of random guessing, where $\epsilon$ is any small positive constant.

Modeling the forensic two-trace problem with Bayesian networks

The forensic two-trace problem is a perplexing inference problem introduced by Evett (J Forensic Sci Soc 27:375-381, 1987). Different possible ways of wording the competing pair of propositions (i.e., one proposition advanced by the prosecution and one proposition advanced by the defence) led to different quantifications of the value of the evidence (Meester and Sjerps in Biometrics 59:727-732, 2003). Here, we re-examine this scenario with the aim of clarifying the interrelationships that exist between the different solutions, and in this way, produce a global vision of the problem. We propose to investigate the different expressions for evaluating the value of the evidence by using a graphical approach, i.e. Bayesian networks, to model the rationale behind each of the proposed solutions and the assumptions made on the unknown parameters in this problem.