992 resultados para Circulació-Accidents,Medicaments-Ús


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Risk management is of paramount importance in the success of tunnelling works and is linked to the tunnelling method and to the constraints of the works. Sequencial Excavation Method (SEM) and Tun-nel Boring Machine (TBM) method have been competing for years. This article, part of a wider study on the influence of the â Safety and Healthâ criterion in the choice of method, reviews the existing literature about the criteria usually employed to choose the tunnelling method and on the criterion â Safety and Healthâ . This crite-rion is particularly important, due to the financial impacts of work accidents and occupational diseases. This article is especially useful to the scientific and technical community, since it synthesizes the relevance of each one of the choice criteria used and it shows why â Safety and Healthâ must be a criterion in the decision mak-ing process to choose the tunnelling method.

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Abstract Background: Truck driver sleepiness is a primary cause of vehicle accidents. Several causes are associated with sleepiness in truck drivers. Obesity and metabolic syndrome (MetS) are associated with sleep disorders and with primary risk factors for cardiovascular diseases (CVD). We analyzed the relationship between these conditions and prevalence of sleepiness in truck drivers. Methods: We analyzed the major risk factors for CVD, anthropometric data and sleep disorders in 2228 male truck drivers from 148 road stops made by the Federal Highway Police from 2006 to 2011. Alcohol consumption, illicit drugs and overtime working hours were also analyzed. Sleepiness was assessed using the Epworth Sleepiness Scale. Results: Mean age was 43.1 ± 10.8 years. From 2006 to 2011, an increase in neck (p = 0.011) and abdominal circumference (p < 0.001), total cholesterol (p < 0.001), triglyceride plasma levels (p = 0.014), and sleepiness was observed (p < 0.001). In addition, a reduction in hypertension (39.6% to 25.9%, p < 0.001), alcohol consumption (32% to 23%, p = 0.033) and overtime hours (52.2% to 42.8%, p < 0.001) was found. Linear regression analysis showed that sleepiness correlated closely with body mass index (β = 0.19, Raj2 = 0.659, p = 0.031), abdominal circumference (β = 0.24, Raj2 = 0.826, p = 0.021), hypertension (β = -0.62, Raj2 = 0.901, p = 0.002), and triglycerides (β = 0.34, Raj2 = 0.936, p = 0.022). Linear multiple regression indicated that hypertension (p = 0.008) and abdominal circumference (p = 0.025) are independent variables for sleepiness. Conclusions: Increased prevalence of sleepiness was associated with major components of the MetS.

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The general properties of POISSON distributions and their relations to the binomial distribuitions are discussed. Two methods of statistical analysis are dealt with in detail: X2-test. In order to carry out the X2-test, the mean frequency and the theoretical frequencies for all classes are calculated. Than the observed and the calculated frequencies are compared, using the well nown formula: f(obs) - f(esp) 2; i(esp). When the expected frequencies are small, one must not forget that the value of X2 may only be calculated, if the expected frequencies are biger than 5. If smaller values should occur, the frequencies of neighboroughing classes must ge pooled. As a second test reintroduced by BRIEGER, consists in comparing the observed and expected error standard of the series. The observed error is calculated by the general formula: δ + Σ f . VK n-1 where n represents the number of cases. The theoretical error of a POISSON series with mean frequency m is always ± Vm. These two values may be compared either by dividing the observed by the theoretical error and using BRIEGER's tables for # or by dividing the respective variances and using SNEDECOR's tables for F. The degree of freedom for the observed error is one less the number of cases studied, and that of the theoretical error is always infinite. In carrying out these tests, one important point must never be overlloked. The values for the first class, even if no concrete cases of the type were observed, must always be zero, an dthe value of the subsequent classes must be 1, 2, 3, etc.. This is easily seen in some of the classical experiments. For instance in BORKEWITZ example of accidents in Prussian armee corps, the classes are: no, one, two, etc., accidents. When counting the frequency of bacteria, these values are: no, one, two, etc., bacteria or cultures of bacteria. Ins studies of plant diseases equally the frequencies are : no, one, two, etc., plants deseased. Howewer more complicated cases may occur. For instance, when analising the degree of polyembriony, frequently the case of "no polyembryony" corresponds to the occurrence of one embryo per each seed. Thus the classes are not: no, one, etc., embryo per seed, but they are: no additional embryo, one additional embryo, etc., per seed with at least one embryo. Another interestin case was found by BRIEGER in genetic studies on the number os rows in maize. Here the minimum number is of course not: no rows, but: no additional beyond eight rows. The next class is not: nine rows, but: 10 rows, since the row number varies always in pairs of rows. Thus the value of successive classes are: no additional pair of rows beyond 8, one additional pair (or 10 rows), two additional pairs (or 12 rows) etc.. The application of the methods is finally shown on the hand of three examples : the number of seeds per fruit in the oranges M Natal" and "Coco" and in "Calamondin". As shown in the text and the tables, the agreement with a POISSON series is very satisfactory in the first two cases. In the third case BRIEGER's error test indicated a significant reduction of variability, and the X2 test showed that there were two many fruits with 4 or 5 seeds and too few with more or with less seeds. Howewer the fact that no fruit was found without seed, may be taken to indicate that in Calamondin fruits are not fully parthenocarpic and may develop only with one seed at the least. Thus a new analysis was carried out, on another class basis. As value for the first class the following value was accepted: no additional seed beyond the indispensable minimum number of one seed, and for the later classes the values were: one, two, etc., additional seeds. Using this new basis for all calculations, a complete agreement of the observed and expected frequencies, of the correspondig POISSON series was obtained, thus proving that our hypothesis of the impossibility of obtaining fruits without any seed was correct for Calamondin while the other two oranges were completely parthenocarpic and fruits without seeds did occur.

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Lutosa brasiliensis, an Orthopteran Tettigonioidean belonging to the family Stenopelmatidae is referred to in this paper The spermatogonia are provided with 15 chromosomes, that is, 7 pairs of autosomes and a single sex chromosome. One pair of autosomes is much larger than the rest, two pairs are of median sized elements, and four pairs are of small ones. The daughter sex chromosomes show at anaphase great difficulty in reaching the poles, being left for a long while in the region of the equator where they are seen stretched one after the other on the same line or lying side by side in different positions. When the spermatogonium divides each daughter cell gets passively its sex chromosome. Though slowly, the sex chromosome finishes by beins enclosed in the nucleus. Its behavior may be attributed to a very weak kinetic activity of the centromere. In view of se pronouced an inertness of the sex chromosomes, two things may be expected : primary spermatocyte nuclei with two sex chromosomes, and primary spermatocytes with the sex chromosome lying outside the nucleus. Both situations have been discovered. The latter, together with the delay of the spermatogonial sex chromosome in reaching the poles suggested to the anther the mechanism which might have given origin to the cases in which the sex chromosome normally does not enter the nucleus to rejoin the autosomes, remaning outside in its own nucleus. It may well be supposed that accidents like that found in the present individual have turned to be a normal event in the course of the evolution of some species. Trie primary spermatocytes are provided with chromatoid bodies which remain visible all over the whole history of the cells and pass to one of the resulting secondary spermatocytes, the larger of them being found later in the area occupied by the tails of the spermatozoa. No relation of these bodies to nucleoli con?d be established. Pachytene and diplotene nuclei are normal Metaphase nuclei show 7 autosomal tetrads, one of which being much larger than the rest. At this stage the chromosomes have a pronounced tendency to form clumps. Even when they are separated from each other they generally appear competed by chromosomal substance. The sex chromosome Hes always in one of the poles, being enclosed in the nucleus formed there. The stickness of the chromosomes can also be noted at anaphase. Telophase chromosomes distend them- selves for giving origin to secondary spermatocyte nuclei in a state comparable to a beginning prophase. As the secondary spermatocytes approach metaphase the autosomes appear entirely divided except at the kinetochore where the chromatids remain united. In the division of the secondary spermatocytes nothing else merits special reference.

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Bone diseases and tooth alterations in 47 specimens of Otaria byronia (Blainville, 1820), from southern Brazilian coast, were analized. Tooth wear and the associated bone pathologies were determined, as well as their percentuals. The main infection was osteomyelitis associated with tooth alterations, such as fractures and attrition, both of them exposing the pulp chamber. Tooth attrition increases with age, favoring fractures and their complications, including osteomyelitis, causing a high frequency of them in specimens presenting more pronounced tooth wear. In one specimen tuberculosis was found in the maxilla, perhaps primarily pulmonary. The high frequency of enamel hypoplasia might reflect cyclic food deficit. Infections and tooth fractures might be related to behaviour, such as fishermen interaction, territorial fighting, and accidents during food capture.

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Dans l'intoxication expérimentale du pigeon avec les venins de Crotalus terrificus, de Lachesis jararaca et de Naya tripudians, nous avons étudié l'action de 12 médicaments, possédant des affinités neurotropes plus ou moins accusées, arrivant aux conclusions suivantes: 1 - Quelques-uns des ces médicaments exercent une action protectrice spéciale contre ces venins, permettant, injectés une heure avant le vénin, d'eviter tout symptôme d'intoxication chez le pigeon. Certains n'agissent qu'injectés em même temps que le vénin. D'autres sont complètement inactifs. Aucun d'êntre eux ne possède de propriétés curatives. 2 - En plus de ce pouvoir protecteur, ou phylactique, un certain nombre d'entre eux possède sur les venins, une action neutralisante "in vitro", s'accentuant après une heure de contact. 3 - Les conditions dans lesquelles s'exercent ces deux actions, protectrice et neutralisante, sont très variables suivant les venins et les médicaments. Sur leur mécanisme très complexe, on ne peut actuellement formuler que des hypothèses. 4 - Au point de vue pratique, certains de ces médicaments, surtout la spartéine et l'adrénaline, peuvent être utilisés avec avantage comme complément du traitement sérotérapique spécifique dans les accidents déterminés par les animaux venimeux.

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L'aparició de les revistes en format digital posa de nou de manifest la necessitat de disposar de bons mecanismes de distribució i accés a les mateixes. Això encara esdevé més rellevant en els actuals moments de concentració en grans grups empresarials de l'edició i la distribució de les revistes de l'anomenat àmbit científic, tècnic i mèdic (STM: “scientific, technical and medical”). Davant d'aquest fenomen, encara ho tenen més complicat les publicacions amb una circulació més restringida per raons de llengua o d'especialització. És el cas de moltes revistes publicades a Catalunya, editades i distribuïdes per canals diferents als del sistema STM comercial internacional. Davant d’aquesta problemàtica, el Consorci de Biblioteques Universitàries de Catalunya (CBUC) ha encarregat el present informe. Un dels objectius fonamentals del CBUC és facilitar l'accés dels usuaris a la informació especialitzada; dins d'aquesta es vol prestar un suport especial als continguts creats a Catalunya per tal de facilitar-ne la seva utilització i contribuir al seu desenvolupament futur. Dins l’actual moment de canvi provocat per la irrupció de l’edició digital, es corre el risc de que els continguts catalans no tinguin la suficient presència i utilització en aquest nou suport, cosa que suposaria un evident endarreriment. Per tal d’evitar-ho, el CBUC vol explorar les implicacions i les possibilitats de crear plataformes o portals per a la difusió de les revistes erudites catalanes, en el cas que no ho puguin fer pels canals comercials internacionals. A nivell operatiu aquest informe intenta respondre a les següents preguntes: Què és un portal de revistes científiques?, Quins elements s’han de preveure en la seva constitució?, Quines alternatives de servei hi ha?, Quines problemàtiques tècniques es plantegen? i Existeixen iniciatives o inquietuds semblants a les plantejades pel CBUC?

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El context social i sanitari del nostre país mostra una resposta insuficient a les creixents necessitats i demandes sociosanitàries de les persones grans. La planificació d’ estratègies en els serveis sanitaris i socials dedicats a l atenció de les persones grans han de ser considerats a partir de criteris racionals i eficients. És un bon mètode la analitzar la situació amb una estratègia qualitativa ? La participació de la gent gran en la definició de problemes aporta alguna perspectiva novedosa?. Per a la gestió sanitària, manquen a la seu anàlisi i avaluació dissenys innovadors útils i de fàcil aplicació. Els objectius de l’ estudi són: 1.-Identificar , definir i prioritzar els problemes socials i sanitaris de les persones majors de 70 anys del municipi de Roda de Ter ( Barcelona), emprant la tècnica de Grup Nominal. 2.-Avaluar una dinàmica de participació ciutadana per la detecció de problemes i necessitats. Metodologia. S’organitza un grup nominal per a la identificació, definició i priorització dels problemes de salut. El grup està constituït per 11 persones clau, persones especialment implicades en el context social del municipi , entre els que hi ha els profesionals dels serveis socials i sanitaris. Resultats. Es varen identificar 15 problemes i es varen prioritzar en 3 grups, de major a menor importància. En el primer grup: la soledat, manca i dificultat d’ accés a l’ informació, problemes d’ ordre fisiològic: limitacions físiques,incontinència urinària y el dolor, les barreres rquitectòniques en el domicili, el soport als cuidadors, la manca de serveis d’ ajuda a domicili. El segon grup: diners, la qualitat de les relacions familiars, l’ automedicació, la manca de coneixement del que significa ser gran per part dels fills i barreres arquitectòniques al carrer. En el tercer grup: disposar d’ajudar de confiança per als tràmits i gestions econòmiques administratives, disposar de companyia per anar als llocs i manca de mitjans de transport per anar als llocs. Discussió. La anàlisi dels resultats suggereix seguir les següents línees d’ actuació: 1.Promoció de la qualitat de les relacions familiars i socials. 2.Elaborar programes específics per : atenció al dolor crònic, rehabilitació i manteniment físic, diagnòstic i tractament de la vista i oïda, reeducació de la presa de medicaments, programa de reeducació vesical. 3.Creació d’ estratègies de comunicació eficients dirigides a persones grans. 4.Allargar l’ estada en el domicili fomentant l’ autonomia individual mitjançant: serveis a domicili, ajudes tècniques,reeducació d’ activitats de la vida diària i adaptació de l’habitatge. 5.Atenció i suport al cuidador de persones dependents. 6.Creació de serveis d’assessoria legal, administrativa i financera. 7.Reivindicació de l’ acompliment de la llei de supressió de barreres arquitectòniques. La dinàmica interdisciplinar, la participació ciutadana y la utilització d’una estratègia d’investigació qualitativa com el grup nominal, s’ha valorat com unes eines útils per a la planificació en l’àmbit sociosanitari. Des de el punt de vista dels professionals dels serveis implicats, s’ha introduit canvis importants en la definicó dels conceptes sobre la salut i la qualitat de vida de les persones grans. En conjunt, hem contrastat les possibilitats d’ una altra forma d’analitzar els problemes de salut de les persones grans y ens ha permès pensar en accions futures d’una forma diferent a la realitzada fins al moment, basada principalment en estratègies quantitatives, per a l’ abordatge de la qualitat de vida.

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The aim of this paper is to analyse the effects of recent regulatory reforms that Spanish Health Authorities have implemented in the pharmaceutical market: the introduction of a reference price system together with the promotion of generic drugs. The main objectives of these two reforms are to increase price competition and, ultimately, reduce pharmaceutical costs. Before the introduction of reference prices, consumers had to pay a fixed copayment of the price of whatever drug purchased. With the introduction of such system, the situation differs in the following way: if (s)he buys the more expensive branded drug, then (s)he pays a sum of two elements: the copayment associated to the reference price plus the difference between the price of this good and the reference price. However, if the consumer decides to buy the generic alternative, with price lower than the reference price, then (s)he has to pay the same copayment as before. We show that the introduction of a reference price system together with the promotion of generic drugs increase price competition and lower pharmaceutical costs only if the reference price is set in a certain interval. Also profits for the duopolists might be reduced. These results are due to the opposing effects that reference prices have on branded and generic producers respectively.

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This paper studies price determination in pharmaceutical markets using data for 25 countries, six years and a comprehensive list of products from the MIDAS IMS database. We show that market power and the quality of the product has a significantly positive impact of prices. The nationality of the producer appears to have a small and often insignificant impact on prices, which suggests that countries which regulates prices have relatively little power to do it in a way that advances narrow national interest. We produce a theoretical explanation for this phenomenon based on the fact that low negotiated prices in a country would have a knock-on effect in other markets, and is thus strongly resisted by producers. Another key finding is that the U.S. has prices that are not significantly higher than those of countries with similar income levels. This, together with the former observation on the effect of the nationality of producers casts doubt on the ability of countries to purs

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El presente proyecto es un estudio epidemiológico transversal, con el propósito de describir la exposición a la contaminación petrolera y el estado de salud de una Comuna indígena de etnia shuar en la provincia de Sucumbíos, Región Amazónica Ecuatoriana.

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El protocol de transplants, especifica que l'òrgan a ser transplantat es conserva a una temperatura de 4ºC en el seu nucli, just després de ser extret del donant. Aquesta temperatura es manté durant el seu transport fins el destinatari. L'extracció es realitza mitjançant la isquèmia, en la qual es suspèn la circulació arterial. Un cop l'òrgan ha arribat a la destinació final i el pacient està a punt, es retira l'òrgan de la banyera de gel i es coseix en el lloc pertinent del receptor. En aquest estat, previ a la reperfusió (reactivació del rec sanguini) l'òrgan va guanyant temperatura a poc a poc per l'exposició a la temperatura ambient o del propi cos del receptor. En tot aquest procés, cal tenir controlada la temperatura de l'òrgan, ja que la isquèmia calenta el podria malmetre irreversiblement. Aquest projecte proporciona un producte per al mesurament remot de la temperatura. Està destinat a la monitorització de l'estat tèrmic dels òrgans dins el protocol de transplants explicat. El producte està format per un dispositiu transmissor, en contacte directe amb l'òrgan i un receptor connectat a un ordinador així com el seu software. La comunicació entre els aparells transmissor i receptor es realitza mitjançant radiofreqüència. L’aparell transmissor té característiques de baix cost, baix consum i petites dimensions. En el desenvolupament del projecte s'intenta en tot moment donar-hi dimensió de producte. Per això juntament amb la informació referent al producte en si, amb més caire tècnic, es mostra un breu estudi legislatiu en el capítol introductori i es realitza una valoració dels costs reals que comporta la seva fabricació.