Introduction [to Food Safety in the Seafood Industry: A practical guide for ISO 22000 and FSSC 22000 implementation]

The prelims comprise: * Half-Title Page * Dedication Page * Title Page * Copyright Page * Table of Contents * Foreword * Acknowledgements * Disclaimer * Introduction

Safety and efficacy of angioplasty with intracoronary stenting in patients with unstable coronary syndromes. Comparison with stable coronary syndromes

OBJECTIVE: To assess safety and efficacy of coronary angioplasty with stent implantation in unstable coronary syndromes. METHODS: Retrospective analysis of in-hospital and late evolution of 74 patients with unstable coronary syndromes (unstable angina or infarction without elevation of the ST segment) undergoing coronary angioplasty with stent placement. These 74 patients were compared with 31 patients with stable coronary syndromes (stable angina or stable silent ischemia) undergoing the same procedure. RESULTS: No death and no need for revascularization of the culprit artery occurred in the in-hospital phase. The incidences of acute non-Q-wave myocardial infarction were 1.4% and 3.2% (p=0.6) in the unstable and stable coronary syndrome groups, respectively. In the late follow-up (11.2±7.5 months), the incidences of these events combined were 5.7% in the unstable coronary syndrome group and 6.9% (p=0.8) in the stable coronary syndrome group. In the multivariate analysis, the only variable with a tendency to significance as an event predictor was diabetes mellitus (p=0.07; OR=5.2; 95% CI=0.9-29.9). CONCLUSION: The in-hospital and late evolutions of patients with unstable coronary syndrome undergoing angioplasty with intracoronary stent implantation are similar to those of the stable coronary syndrome group, suggesting that this procedure is safe and efficacious when performed in unstable coronary syndrome patients.

“Safety and health” as a criterion in the choice of tunneling method

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.

A multicenter, open-label study of the efficacy and safety of telmisartan in mild to moderate hypertensive patients

OBJECTIVE: To evaluate the efficacy and tolerability of telmisartan, given once a day to patients with mild to moderate hypertension, as well as to assess the 24-hour blood pressure profile with ABPM. METHODS: Initially, 163 patients over 18 were selected, regardless of sex, with blood pressure levels >140/90mmHg at visit 1, which was confirmed at visit 2. One hundred thirty-four patients completed the study. After a 4-week placebo run-in phase, telmisartan 40mg/daily was given for 6 weeks. In those patients whose blood pressure (BP) levels were lower than 140/90mmHg, the same dosage was kept for an additional period of 6 weeks. For those who had BP higher than 140/90mmHg, the dosage was increased to 80mg/daily. Sixty-two patients were included in a subgroup that underwent ABPM 3 different times during the study. RESULTS: In the overall group, blood pressure reduction ranged from 162.3±14.5/101.3±5.75 mmHg (baseline) to 147.3±20.1/90.8±10.9 mmHg (week 12) (p<0.05). Mean blood pressure decreases were 14.4mmHg for systolic BP and 10.3mmHg for diastolic BP, after 12 weeks of active treatment. A subanalysis showed that 47 (35%) patients took telmisartan 40mg throughout the study and 81 (65%) had the dosage increased to 80mg daily. Using ABPM, an 8-mmHg reduction in systolic BP as well as a 5-mmHg reduction in diastolic BP were observed, when compared with baseline values in the final 6 hours (18-24 hours after the last dose of study medication). CONCLUSION: Our results confirm that telmisartan given once a day is effective in reducing blood pressure levels in mild to moderate hypertensive patients. This reduction occurs in a sustained and gradual manner during a 24-hour period confirmed by ABPM.

Benefits of exercise training in the treatment of heart failure: study with a control group

OBJECTIVE: Exercise training programs have been proposed as adjuncts to treatment of heart failure. The effects of a 3-month-exercise-training-program with 3 exercise sessions per week were assessed in patients with stable systolic chronic heart failure. METHODS: We studied 24 patients with final left ventricle diastolic diameter of 70±10mm and left ventricular ejection fraction of 37±4%. Mean age was 52±16 years. Twelve patients were assigned to an exercise training group (G1), and 12 patients were assigned to a control group (G2). Patients underwent treadmill testing, before and after exercise training, to assess distance walked, heart rate, systolic blood pressure, and double product. RESULTS: In G2 group, before and after 3 months, we observed, respectively distance walked, 623±553 and 561± 460m (ns); peak heart rate, 142±23 and 146± 33b/min (ns); systolic blood pressure, 154±36 and 164±26 mmHg (ns); and double product, 22211± 6454 and 24293±7373 (ns). In G1 group, before and after exercise, we observed: distance walked, 615±394 and 970± 537m (p<0.003) peak heart rate, 143±24 and 143±29b/min (ns); systolic blood pressure, 136±33 and 133±24 mmHg (ns); and double product, 19907± 7323 and 19115±5776, respectively. Comparing the groups, a significant difference existed regarding the variation in the double product, and in distance walked. CONCLUSION: Exercise training programs in patients with heart failure can bring about an improvement in physical capacity.

Safety, feasibility, and results of exercise testing for stratifying patients with chest pain in the emergency room

OBJECTIVE: To assess safety, feasibility, and the results of early exercise testing in patients with chest pain admitted to the emergency room of the chest pain unit, in whom acute myocardial infarction and high-risk unstable angina had been ruled out. METHODS: A study including 1060 consecutive patients with chest pain admitted to the emergency room of the chest pain unit was carried out. Of them, 677 (64%) patients were eligible for exercise testing, but only 268 (40%) underwent the test. RESULTS: The mean age of the patients studied was 51.7±12.1 years, and 188 (70%) were males. Twenty-eight (10%) patients had a previous history of coronary artery disease, 244 (91%) had a normal or unspecific electrocardiogram, and 150 (56%) underwent exercise testing within a 12-hour interval. The results of the exercise test in the latter group were as follows: 34 (13%) were positive, 191 (71%) were negative, and 43 (16%) were inconclusive. In the group of patients with a positive exercise test, 21 (62%) underwent coronary angiography, 11 underwent angioplasty, and 2 underwent myocardial revascularization. In a univariate analysis, type A/B chest pain (definitely/probably anginal) (p<0.0001), previous coronary artery disease (p<0.0001), and route 2 (patients at higher risk) correlated with a positive or inconclusive test (p<0.0001). CONCLUSION: In patients with chest pain and in whom acute myocardial infarction and high-risk unstable angina had been ruled out, the exercise test proved to be feasible, safe, and well tolerated.

Initial experience in Brazil with the Helex septal occluder for percutaneous occlusion of atrial septal defects

OBJECTIVE: To evaluate the initial clinical experience with the Helex septal occluder for percutaneous closure of atrial septal defects. METHODS: Ten patients underwent the procedure, 7 patients with ostium secundum atrial septal defects (ASD) with hemodynamic repercussions and 3 patients with pervious foramen ovale (PFO) and a history of stroke. Mean age was 33.8 years and mean weight was 55.4 kg. Mean diameter by transesophageal echocardiography and mean stretched ASD diameter were 11.33 ± 3.3mm, and 15.2 ± 3.8mm, respectively. The Qp/Qs ratio was 1.9 ± 0.3 in patients with ASD. RESULTS: Eleven occluders were placed because a patient with 2 holes needed 2 devices. It was necessary to retrieve and replace 4 devices in 3 patients. We observed immediate residual shunt (< 2mm) in 4 patients with ASD, and in those with patent foramen ovale total occlusion of the defect occurred. No complications were noted, and all patients were discharged on the following day. After 1 month, 2 patients with ASD experienced trivial residual shunts (1mm). In 1 patient, we observed mild prolapse in the proximal disk in the right atrium, without consequences. CONCLUSION: The Helex septal occluder was safe and effective for occluding small to moderate atrial septal defects. Because the implantation technique is demanding, it requires specific training of the operator. Even so, small technical failures may occur in the beginning of the learning curve, but they do not involve patient safety.

Immune cell changes in swimmers : response to acute exercise and training

O treino competitivo envolve exercício intenso e prolongado, capaz de modular o número e actividade das células imunitárias. Quando demasiado exigente poderá induzir fadiga e aumentar a susceptibilidade a doenças. Esta dissertação apresenta três estudos desenvolvidos no âmbito da Imunologia do Exercício, considerando a análise da resposta celular imunitária sistémica aguda e crónica ao exercício aplicada em situações reais do treino competitivo de natação, controlando factores passíveis de influenciar esta resposta. Pretendeu-se avaliar a resposta imunitária a uma sessão de treino prolongada e intensa, durante as 24h de recuperação (Estudo 1) e a uma época de treino com sete meses (Estudo 2), e estudar a influência de um macrociclo de treino de quatro meses sobre a resposta imunitária à mesma sessão de treino e período de recuperação (Estudo 3), controlando sexo, fases do ciclo menstrual, maturidade, escalão, especialidade, performance, cargas de treino e sintomas respiratórios superiores (URS). A sessão de treino induziu a diminuição da vigilância imunitária adquirida imediatamente e, pelo menos nas 2h seguintes. Juvenis e seniores recuperaram totalmente 24h depois, mas não os juniores, reforçando a ideia da existência de uma janela aberta para a infecção após exercícios prolongados e intensos e sugerindo uma recuperação menos eficiente para os juniores. No período de treino mais intenso da época observou-se uma imunodepressão e maior prevalência de URS. No final da época, a imunidade inata diminuiu aparentando maior sensibilidade aos efeitos cumulativos da carga de treino, enquanto a imunidade adquirida parece ter recuperado após o taper. O macrociclo de treino atenuou a resposta imunitária à sessão de treino e aumentou o período de janela aberta às infecções (efeitos mais acentuados nos adolescentes). Os resultados evidenciam a importância de controlar alterações imunitárias durante a época competitiva, especialmente em períodos de treino intenso e quando se realizam sessões de treino intensas consecutivas com recuperações inferiores a 24h.

REVISANDO LOS CONTENIDOS EN LENGUA: Hacia una semántica integradora. Transferencia y capacitación. REVIEWING CONTENTS IN LANGUAGE: Toward an integrative semantics. Transference and training.

En el trabajo se sistematiza la información semántica a fin de que ella sea la articuladora y eje de otros contenidos abordados en la enseñanza de la lengua materna. Así, en primer lugar se sistematizarán conceptos y perspectivas semánticas, para luego establecer relaciones con otros niveles lingüísticos, como lo son la Morfología y la Sintaxis, sin descuidar los aportes de la semántica a los procesos de producción y comprensión textuales. Realizaremos estudios para sistematizar y asignar al contenido un lugar dominante e integrador en el proceso de enseñanza-aprendizaje de la lengua materna, sin pretender desdibujar otras temáticas. Planteamos tareas cuyo punto culminante es la capacitación de docentes y experimentación de las propuestas didácticas en tres cursos de lengua en una institución educativa de la ciudad de Córdoba, cuyo examen, de ser positivo, permitirá la replicación y transferencia de esas prácticas a otras instituciones. Como objetivos generales, destacamos colaborar con la integración de los contenidos que se dictan en Lengua Materna, tomando como eje la naturaleza semántica del lenguaje; contribuir con la formación de los estudiantes en las dimensiones de la comprensión y producción textuales; promover la reflexión y el incremento del caudal léxico -y del lenguaje en general-, por parte de los estudiantes; contribuir con la capacitación y formación de los docentes en las temáticas abordadas, a través de acciones concretas; corroborar que la formación de los alumnos podrá tornarse más significativa en la medida en que se trabajen 'formas' lingüísticas atravesadas por contenidos. El marco teórico está constituido por los aportes de diferentes líneas, los que, compatibilizados, permitirán acceder a un abordaje integral del 'contenido' lingüístico. Más precisamente, consideramos las conceptualizaciones de autores tales como Coseriu (1986) para la delimitación semántica, sus conceptos y operaciones, al que completamos con la perspectiva de Lyons (1986, 1997); para las relaciones entre Morfología, seguimos a Ramírez Sáinz (2008) ; el vínculo sintaxis- semántica será abordado desde la perspectiva de la Gramática Generativa (Demonte,V. 1991; D'Introno, 2001; Fernández Lagunilla, M y Anula Rebollo,A, 1995; los aportes de la comprensión serán considerados desde De Beaugrande-Dresller (1997). Otros autores de referencia son Lakoff y Jhonsson (1998).

Análisis crítico de la formación y capacitación del profesional de la seguridad en la Provincia de Córdoba en los últimos diez años. A critical analysis of the formation and training of the professional in the area of security in the province of Córdoba in the last 10 years.

El problema que abordaremos es la transformación y la toma de decisiones en los procesos de formación y capacitación de las instituciones de seguridad, específicamente, los motivos y fundamentos de los cambios en los planes de estudios, en relación a los contenidos curriculares de los institutos de formación de los profesionales en seguridad. Esto sobre la hipótesis de que las organizaciones educativas policiales y penitenciarias han llevado a cabo transformaciones en su organización y gestión curricular para adecuarse a las nuevas demandas sociales y políticas. El objetivo del presente proyecto es analizar críticamente los contenidos curriculares de los institutos de formación y capacitación de la Policía y Servicio Penitenciario de la Provincia de Córdoba. Abordaremos el análisis de los planes de dichas instituciones en los últimos 10 años, sus modificaciones y criterios utilizados para responder a los nuevos escenarios sociales. Se hará una exploración de la información y la documentación existente en los ámbitos oficiales. Asimismo, la investigación contará con la realización de entrevistas y encuestas a directivos, docentes, alumnos y demás actores claves, con la finalidad de recabar la opinión de los mismos respecto de las transformaciones en la educación policial y penitenciaria. A partir del proyecto de investigación se pretende construir conocimiento acerca de las políticas educativas en el área de seguridad especialmente sobre la formación y capacitación de recursos profesionales específicos, dentro del ámbito local. De tal modo, se pretende aportar elementos teóricos de análisis al modo en que se han instituido la oferta educativa y las transformaciones en los planes de estudios en las instituciones de formación profesional de la seguridad y cómo éstos han sido implementados a la luz de los nuevos escenarios políticos y sociales. Esto nos permitirá aportar al incipiente campo de los estudios sobre la seguridad, específicamente sobre la formación de los profesionales en seguridad, poniendo a diposición de los responsables gubernamentales e institucionales un estudio que explora y sistematiza las transformaciones y fundamentos de la politica de educación en el campo de la seguridad provincial. Este desarrollo investigativo nos permitirá inagurar la actividad de producción de conocimiento dentro del ámbito académico de la Licenciatura en Seguridad de la Universidad Nacional de Villa María a través del presente proyecto que describirá el proceso de formación y capacitación policial y penitenciaria y los cambios que con el transcurso del tiempo se han verificado.

Training and development in Irish technology companies

The sustained economic growth that has been experienced in the Irish economy in recent years has relied, to a large extent, on the contribution and performance of those industry sectors that possess the ability to provide high-value-added products and services to domestic and international markets. One such contributor has been the Technology sector. However, the performance of this sector relies upon the availability of the necessary capabilities and competencies for Technology companies to remain competitive. The Expert Group on Future Skills Needs have forecasted future skills shortages in this sector. The purpose of this research has been to examine the extent to which Irish Technology companies are taking measures to meet changing skills requirements, through training and development interventions. Survey research methods (in the form of a mail questionnaire, supported by a Web-based questionnaire) have been used to collect information on the expenditure on, and approach to, training and development in these companies, in addition to the methods, techniques and tools/aids that are used to support the delivery of these activities. The contribution of Government intervention has also been examined. The conclusions have been varied. When the activities of the responding companies are considered in isolation, the picture to emerge is primarily positive. Although the expenditure on training and development is slightly lower than that indicated in previous studies, the results vary by company size. Technical employees are clearly the key focus of training provision, while Senior Managers and Directors, Clerical and Administrative staff and Manual workers are a great deal more neglected in training provision. Expenditure on, and use of, computer-based training methods is high, as is the use of most of the specified techniques for facilitating learning. However, when one considers the extent to which external support (in the form of Government interventions and cooperation with other companies and with education and training providers) is integrated into the overall training practices of these companies, significant gaps in practice are identified. The thesis concludes by providing a framework to guide future training and development practices in the Technology sector.

Ultrasound Blocks for the Anterior Abdominal Wall - Adult and Pediatric Surgery

Somatic post-surgical pain is invalidating and distressing to patients and carries the risk of important complications. The anterior abdominal wall is involved in most surgical procedures in general, gynecologic, obstetric, urological, vascular and pediatric surgery. Combined multimodal strategies involving nerve blocks, opiates, and non-steroidal anti-inflammatory drugs for systemic analgesia are necessary for optimal pain modulation. Anterior abdominal wall blocks, transverse abdominal plexus block, iliohypogastric and ilioinguinal nerveblock, genitofemoral nerve block and rectus sheath block have an important role as components of multimodal analgesia for somatic intraoperative and postoperative pain control. Ultrasound visualization has improved the efficacy and safety of abdominal blocks and implemented the application in the clinical setting. For this reason, they are a very important tool for all anesthesiologists who aim to treat effectively patients’ pain. This guide provides an evidence based comprehensive and necessary overview of anatomical, anesthesiological and technical information needed to safely perform these blocks.

Qualitative and quantitative formal model-based safety analysis : push the safety button

Magdeburg, Univ., Fak. für Informatik, Diss., 2011

"Differential metabolic recruitment of cognitive, emotional and modulatory brain regions in infant and adolescent rats undergoing two-way active avoidance training"

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2011

Evaluation of Sexual Dimorphism in the Efficacy and Safety of Simvastatin/Atorvastatin Therapy in a Southern Brazilian Cohort

Background: Dyslipidemia is the primary risk factor for cardiovascular disease, and statins have been effective in controlling lipid levels. Sex differences in the pharmacokinetics and pharmacodynamics of statins contribute to interindividual variations in drug efficacy and toxicity. Objective: To evaluate the presence of sexual dimorphism in the efficacy and safety of simvastatin/atorvastatin treatment. Methods: Lipid levels of 495 patients (331 women and 164 men) were measured at baseline and after 6 ± 3 months of simvastatin/atorvastatin treatment to assess the efficacy and safety profiles of both drugs. Results: Women had higher baseline levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) compared with men (p < 0.0001). After treatment, women exhibited a greater decrease in plasma TC and LDL-C levels compared with men. After adjustment for covariates, baseline levels of TC and LDL-C influenced more than 30% of the efficacy of lipid-lowering therapy (p < 0.001), regardless of sex. Myalgia [with or without changes in creatine phosphokinase (CPK) levels] occurred more frequently in women (25.9%; p = 0.002), whereas an increase in CPK and/or abnormal liver function was more frequent in in men (17.9%; p = 0.017). Conclusions: Our results show that baseline TC and LDL-C levels are the main predictors of simvastatin/atorvastatin therapy efficacy, regardless of sex. In addition, they suggest the presence of sexual dimorphism in the safety of simvastatin/atorvastatin. The effect of sex differences on receptors, transporter proteins, and gene expression pathways needs to be better evaluated and characterized to confirm these observations.