A, B, C… Anorexia, bulimia y comedor compulsivo. Manual para docentes

Los trastornos relacionados con la alimentación se han convertido, en los úl- timos años, en un grave problema de salud pública, tanto por la gravedad que estas patologías adquieren con el tiempo, como por la alarma social que se ha despertado frente a la, cada vez más frecuente, aparición de estos trastornos. A este respecto baste señalar que, según los últimos datos, de la población de jóvenes escolarizados en la Comunidad de Madrid, con edades comprendidas entre los quince y dieciocho años, un 3.4% padecen un TCA y un 7,6% presen- tan riesgo de padecerlo, lo que, unido a la prevalencia actual, supone que este problema de salud afecta a un 11% de los adolescentes escolarizados en Madrid. Junto a los jóvenes que padecen un trastorno relacionado con la alimentación hay una cantidad considerable de menores que presentan conductas de riesgo relacionadas con la aparición de estos trastornos. Así, según los últimos estudios con adolescentes, un 7,1% de los chicos y un 34,1% de las chicas han iniciado una dieta para adelgazar en el último año, mientras que un 1,1% de los chicos y un 9,1% de las chicas se han provocado el vómito con la intención de adelgazar. Un joven que está empezando a desarrollar una anorexia o una bulimia puede pasar desapercibido para su entorno, la diferencia entre la salud y la enfer- medad es, en sus orígenes, muy sutil. Así, es difícil diferenciar al adolescente que se pone a dieta porque es la moda y acaba dejando la dieta pasadas unas semanas, del joven que, con idéntico inicio, acaba desarrollando un trastorno. El INUTCAM, consciente de la compleja situación a la que se enfrentan los docentes en cuanto a los TCA, publica este manual con la intención de brindar una ayuda más de cara a la prevención, detección y atención a los jóvenes con estas patologías.

Susan B. Anthony Poster at NOW conference in Washington, D.C.

General note: Title and date provided by Bettye Lane.

Susan B. Anthony poster at NOW conference in Washington, D.C.

General note: Title and date provided by Bettye Lane.

Experimentelle Untersuchung und Optimierung der Dekontamination von Verletzten bei einer C(B)RN-Gefahrenlage durch Organisationen der nichtpolizeilichen Gefahrenabwehr

Diese Bachelorarbeit zeigt durch eine gezielte experimentelle Untersuchung Verbesserungsmöglichkeiten zur Dekontamination Verletzter bei chemischen, biologischen, radiologischen und nuklearen Gefahrenlagen am Beispiel des Abrollbehälters-Verletztendekontamination (AB-V Dekon) der Feuerwehr Braunschweig auf. Zusätzlich zur Analyse der aktuellen Gefährdungslage in Deutschland und einem internationalen Vergleich der Dekontaminationsmethoden werden ausgewählte Konzepte vorgestellt und hinsichtlich ihrer praktischen Anwendbarkeit bewertet. Auf Basis des Rahmenkonzeptes zur Dekontamination Verletzter wurde ein Versuchsaufbau zur Verletztendekontamination entwickelt, in dem 24 Probanden mit einer fluoreszierenden Simulationssubstanz vorbereitet und anschließend durch Einsatzkräfte dekontaminiert wurden. Die Bestimmung der Kontaminationen erfolgte dabei digital mittels eines bildgebenden Verfahrens. Im Fokus des Experimentes liegt insbesondere die Untersuchung und Optimierung der Effektivität des Prozesses sowie eine kritische Auseinandersetzung mit der derzeit empfohlenen Wassertemperatur von 28°C. Hierzu wurde das persönliche Empfinden der Probanden mittels eines Fragebogens hinsichtlich einer Erhöhung auf 35°C analysiert und eine Aufzeichnung der Körpertemperatur vorgenommen. Aus den gewonnenen Ergebnissen werden Handlungsempfehlungen entwickelt, die für die Aus- und Fortbildung der Hilfsorganisationenverwendet werden können und zu einer ganzheitlichen Verbesserung der Verletzendekontamination beitragen sollen.

Hepatitis B and C prevalence in Portugal: disparity between the general population and high-risk groups

Background and aims: The prevalence of anti-HCV and HBsAg in Portugal has been shown to be elevated in high-risk groups, such as intravenous drug-users and incarcerated individuals. However, in the general population, prevalence remains largely unknown. The aims of this study were to estimate the prevalence of anti-HCV and HBsAg in the general Portuguese population and identify associated risk factors. Materials and methods: We carried out a nationwide, population-based cross-sectional study of adults resident in mainland Portugal. Serology for HBsAg, anti-HBc, anti-HBs, and anti-HCV was performed. Anti-HCV-positive individuals were tested for HCV RNA by PCR. Results: Of 1685 participants, 50.6% were men, mean age 50.2±18.3 years. In terms of hepatitis C, the prevalence of anti-HCV was 0.54% [95% confidence interval (CI): 0.2–0.9] and 0.12% (95% CI: 0.0–0.3) were viremic, with peak prevalence among individuals 35–64 years of age (0.8%), men (0.8%), and individuals from Lisbon and Tagus Valley region (1.9%). In terms of hepatitis B, the estimated prevalence of HBsAg was 1.45% (95% CI: 0.9–2.0). A higher prevalence was found in individuals who were 35–64 years old (2.2%), in men (2.5%), and in the Northern region (2.6%). The presence of positive serological markers of hepatitis C virus and hepatitis B virus infection did not correlate with elevated aminotransferases, race, place of birth, and alcohol consumption. Conclusion: These results suggest a low endemicity for both hepatitis B and hepatitis C in the general population, in contrast to a very high prevalence in risk groups, thus suggesting that targeted screening to high-risk groups may be more cost-effective than general population screening.

Macroalgas epífitas de Zostera marina L. en Bahía Concepción, B.C.S., México

Macroalgas epífitas de Zostera marina L. en Bahía Concepción, B. C. S. México.

As versões portuguesas da GMFM-66 B&C e da GMFM-66 IS

A Gross Motor Function Measure (GMFM) é a medida de ouro para avaliar alterações na função motora ao longo do tempo ou em resposta a uma intervenção em crianças com Paralisia Cerebral (PC) (Russell D. , Rosenbaum, Avery, & Lane, 2002). Uma das barreiras à utilização mais frequente da GMFM é o seu tempo de administração, que dura entre 40 a 60 minutos. Para responder à necessidade de versões mais reduzidas da GMFM mas sem perder o seu carácter discriminativo e altamente sensível à mudança, foram publicadas as versões Gross Motor Function Measure- Item Sets (GMFM-66 IS) e a Gross Motor Function Measure Basal and Ceiling (GMFM-66-B&C), tornando a avaliação da função motora menos morosa, e assim melhorando a sua aplicabilidade. A GMFM-66 IS baseia-se num algoritmo para determinar quais os itens a serem avaliados e a GMFM-66 B&C tem como abordagem os efeitos de chão e teto de acordo com as idades e níveis do Sistema de Classificação da Função Motora Grosseira (SCFMG) (Brutton & Bartlett, 2011). O objetivo deste estudo foi criar as versões portuguesas da GMFM-IS e GMFM-B&C. Tratou-se de um estudo de natureza metodológica, descritivo, longitudinal em crianças com PC, dividido em duas fases: 1. Tradução e adaptação cultural e linguística da GMFM-66 IS e da GMFM-66 B&C; 2. Estudo de validação com análise da fiabilidade (coerência interna, reprodutibilidade e fiabilidade inter-observador), validade e poder de resposta. A amostra em estudo foi constituída por 100 crianças com PC com idades compreendidas entre os 2 e os 12 anos, representativa de todos os 5 níveis do Sistema de Classificação da Função Motora Global. As versões portuguesas da GMFM-66-IS e da GMFM-66-B&C apresentam equivalência conceptual e semântica com as versões originais revelando fácil aplicabilidade. Demonstrou-se que as versões reduzidas portuguesas da GMFM apresentam muito boa consistência interna, com valores globais do Alfa de Cronbach de 0,998, muito boa concordância entre os avaliadores (ICC de 0,998 para a GMFM-66-B&C e de 0,999 para a GMFM-66-IS), e com valores de fiabilidade intra-observador excelentes (ICC de 0,999 para a GMFM-66-B&C e de 1,000 para a GMFM-66-IS). Quanto ao poder de resposta os resultados não foram tão expressivos, provavelmente comprometidos por uma amostra demasiado pequena. As versões portuguesas da GMFM-66-IS e da GMFM-66-B&C revelaram ter características psicométricas adequadas à sua aplicação em PC, necessitando, no entanto, de mais investigação relativamente à sua capacidade de detetar mudança como resultado de intervenções.

TRIBUNAL ARBITRAL DE NOARCO S.A., VIC. LIMITADA Y OBRAS ESPECIALES OBRESCA C.A. VS. EMPRESA DE ACUEDUCTO Y ALCANTARRILLADO DE BOGOTÁ (E.A.A.B. E.S.P.)

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A B C ou aleph ba’a ta’a : représentations du système d’écriture de l’enfant libanais

Cette recherche vise à décrire les liens entre les représentations des enfants dans deux systèmes d’écriture: alphabétique et consonantique. Cette étude transversale est déployée auprès de 60 enfants libanais âgés entre 4 et 6 ans. Les écritures des enfants autour de huit mots sont récoltées en français et en arabe. Les résultats ne montrent aucune différence significative entre les deux systèmes d’écriture aux âges de 4 et 5 ans. C’est à l’âge de 6 ans que des différences significatives se présentent entre les deux langues. Les résultats montrent une différence significative des écritures en fonction de l’âge. Ces résultats soutiennent l’hypothèse développementale d’une structuration unique inductive quant aux codes alphabétique français et consonantique arabe. Cette structuration se distingue pour chacune des langues lors de l’entrée formelle dans l’écrit. Descripteurs: 1- émergence, 2- littératie, 3- écriture provisoire, 4- français, 5- arabe

Landscape strategies in Bronze Age Southwestern Cyprus (2500-1100 B.C.)

This thesis concerns the analysis of the socio-economic transformation of communities in Bronze Age southwestern Cyprus. Through the adoption of a dialectical perspective of analysis, individuals and environment are considered part of the same unity: they are cooperating agents in shaping society and culture. The Bronze Age is a period of intense transformation in the organization of local communities, made of a continuous renegotiation of the socio-economic roles and interactions. The archaeological record from this portion of the island allows one to go beyond the investigation of the complex and articulated transition from the EBA-MBA agro-pastoral and self-sufficient communities to the LBA centralized and trade-oriented urban-centres. Through a shifting of analytical scales, the emerging picture suggests major transformations in the individual-community-territory dialectical relations. A profound change in the materials conditions of social life, as well as in the superstructural realm, was particularly entailed by the dissolution of the relation to the earth, due to the emergence of new forms of land exploitation/ownership and to the shift of the settlement pattern in previously unknown areas. One of the key points of this thesis is the methodological challenge of working with legacy survey data as I re-analysed a diverse archaeological legacy, which is the result of more than fifty years of survey projects, rescue and research-oriented excavations, as well as casual discoveries. Source critique and data evaluation are essential requirements in an integrative and cross-disciplinary regional perspective, in the comprehensive processing of heterogeneous archaeological and environmental datasets. Through the estimation of data precision and certainty, I developed an effective - but simple - method to critically evaluate existing datasets and to inter-correlate them without losing their original complexity. This powerful method for data integration can be applied to similar datasets belonging to other regions and other periods as it originates from the evaluation of larger methodological and theoretical issues that are not limited to my spatial and temporal focus. As I argue in this thesis, diverse archaeological legacies can be efficiently re-analysed through an integrative and regional methodology. The adoption of a regional scale of analysis can provide an excellent perspective on the complexity of transformations in ancient societies, thus creating a fundamental bridge between the local stories and grand landscape narratives.

Interferon-free therapy for hepatitis C, how prepared is Australia for biosimilars?

The Hepatitis C virus (HCV) affects some 150 million people worldwide. However, unlike hepatitis A and B there is no vaccination for HCV and approximately 75% of people exposed to HCV develop chronic hepatitis. In Australia, around 226,700 people live with chronic HCV infection costing the government approximately $252 million per year. Historically, the standard approved/licenced treatment for HCV is pegylated interferon with ribavirin. There are major drawbacks with interferon-based therapy including side effects, long duration of therapy, limited access and affordability. Our previous survey of an at-risk population reported HCV treatment coverage of only 5%. Since April 2013, a new class of interferon-free treatments for chronic HCV is subsidised under the Pharmaceutical Benefits Scheme: boceprevir and telaprevir - estimated to cost the Australian Government in excess of $220 million over five years. Other biologic interferon-free therapeutic agents are scheduled to enter the Australian market. Use of small molecule generic pharmaceuticals has been advocated as a means of public cost savings. However, with the new biologic agents, generics (biosimilars) may not be feasible or straightforward, due to long patent life; marketing exclusivity; and regulatory complexity for these newer products.