Usual clinical practice for early supported discharge after stroke with continued rehabilitation at home : an observational comparative study

Introduction: Based on randomised controlled trials, evidence exists that early supported discharge (ESD) from the hospital with continued rehabilitation at home has beneficial effects after stroke; however, the effects of ESD service in regular clinical practice have not been investigated. The purpose of the current study was to compare ESD service with conventional rehabilitation in terms of patient outcomes, caregiver burden at 3 and 12 months and the use and costs of healthcare during the first year after stroke. Material and methods: This study was a subgroup analysis of a longitudinal observational study of patients who received care in the stroke unit at Karolinska University Hospital in Sweden. Patients who met the inclusion criteria for ESD in previous experimental studies were included. The patients were referred to available rehabilitation services at discharge, and comparisons between those who received ESD service (the ESD group, n = 40) and those who received conventional rehabilitation (the NoESD group, n = 110) were performed with regard to independence in activities of daily living (ADL), the frequency of social activities, life satisfaction, and caregiver burden and the use and costs of healthcare during the first year after stroke. Results: At 3 and 12 months, no differences were observed with regard to patient outcomes; however, ESD was associated with a lower caregiver burden (p = 0.01) at 12 months. The initial length of stay (LOS) at the hospital was 8 days for the ESD group and 15 days for the NoESD group (p = 0.02). The median number of outpatient rehabilitation contacts was 20.5 for the ESD group (81% constituting ESD service) and 3 for the NoESD group (p<0.001). There was no difference between the groups with regard to overall healthcare costs. Conclusions: ESD service in usual clinical practice renders similar health benefits as conventional rehabilitation but a different pattern of resource use and with released capacity in acute stroke care.

What is important for you? A qualitative interview study of living with diabetes and experiences of diabetes care to establish a basis for a tailored Patient-Reported Outcome Measure for the Swedish National Diabetes Register

OBJECTIVES: There is a growing emphasis on the perspective of individuals living with diabetes and the need for a more person-centred diabetes care. At present, the Swedish National Diabetes Register (NDR) lacks patient-reported outcome measures (PROMs) based on the perspective of the patient. As a basis for a new PROM, the aim of this study was to describe important aspects in life for adult individuals with diabetes. DESIGN: Semistructured qualitative interviews analysed using content analysis. SETTING: Hospital-based outpatient clinics and primary healthcare clinics in Sweden. PARTICIPANTS: 29 adults with type 1 diabetes mellitus (DM) (n=15) and type 2 DM (n=14). INCLUSION CRITERIA: Swedish adults (≥18 years) living with type 1 DM or type 2 DM (duration ≥5 years) able to describe their situation in Swedish. Purposive sampling generated heterogeneous characteristics. RESULTS: To live a good life with diabetes is demanding for the individual, but experienced barriers can be eased by support from others in the personal sphere, and by professional support from diabetes care. Diabetes care was a crucial resource to nurture the individual's ability and knowledge to manage diabetes, and to facilitate life with diabetes by supplying support, guidance, medical treatment and technical devices tailored to individual needs. The analysis resulted in the overarching theme 'To live a good life with diabetes' constituting the two main categories 'How I feel and how things are going with my diabetes' and 'Support from diabetes care in managing diabetes' including five different categories. CONCLUSIONS: Common aspects were identified including the experience of living with diabetes and support from diabetes care. These will be used to establish a basis for a tailored PROM for the NDR.

Making Energy Interventions more Effective : Situation, Interaction, and Precondition

A main purpose of this paper is to propose to policy makers, building professionals, and other non-social scientists a way to make energy interventions more culturally informed and, thereby, more effective. The case study on house purchasers gives an ample illustration of the richer results that can be achieved by paying attention to three aspects of energy efficiency initiatives: the contexts and situations of choice in each particular case, the interaction among relevant social actors, and the culture-specific preconditions for choice. Research on how purchasers of new pre-fabricated houses in Sweden choose their heating system show how such decisions tend to fall between two stools. Furthermore, the organizational structure of housing companies frames house purchasers' decision making. An important result is that energy saving or conversion measures must be promoted at an early stage amongst those who plan and construct buildings (rather than later amongst dwellers and energy end users).

Wind farm construction impacts reindeer migration and movement corridors

Over the last decade, we have seen a massive increase in the construction of wind farms in northern Fennoscandia. Wind farms comprising hundreds of wind turbines are being built, with little knowledge of the possible cumulative adverse effects on the habitat use and migration of semi-domesticated free-ranging reindeer. We assessed how reindeer responded to wind farm construction in an already fragmented landscape, with specific reference to the effects on use of movement corridors and reindeer habitat selection. We used GPS-data from reindeer during calving and post-calving in the MalAyen reindeer herding community in Sweden. We analysed data from the pre-development years compared to the construction years of two relatively small wind farms. During construction of the wind farms, use of original migration routes and movement corridors within 2 km of development declined by 76 %. This decline in use corresponded to an increase in activity of the reindeer measured by increased step lengths within 0-5 km. The step length was highest nearest the development and declining with distance, as animals moved towards migration corridors and turned around or were observed in holding patterns while not crossing. During construction, reindeer avoided the wind farms at both regional and landscape scale of selection. The combined construction activities associated with even a few wind turbines combined with power lines and roads in or close to central movement corridors caused a reduction in the use of such corridors and grazing habitat and increased the fragmentation of the reindeer calving ranges.

Beröringsbehandling hos patienter med cancer : En litteraturöversikt

Bakgrund: Varje år diagnostiseras cirka 64 000 personer med cancer och tumörsjukdomar är den näst vanligaste dödsorsaken i Sverige. Att få diagnosen cancer innebär en påfrestande tid både fysiskt och psykiskt. Sjuksköterskans arbetsuppgift är bland annat att lindra lidande och främja för god hälsa. Beröring är ett allmänmänskligt livslångt behov och blir extra tydligt när en dödlig sjukdom drabbar en människa. Syfte: Syftet är att belysa erfarenheter av beröringsbehandling hos sjuksköterskor och patienter med cancer. Metod: Studien har valt att genomföras som en litteraturöversikt, där 14 vetenskapliga artiklar användes varav 5 kvalitativa och 9 kvantitativa. Resultat: Resultatet delades in i två områden: Patienters erfarenheter av beröringsbehandling och sjuksköterskors erfarenheter av beröringsbehandling. Under området patienters erfarenheter framkom två kategorier: lindrande inverkan och främjande inverkan, samt underkategorierna: fysiskt obehag, psykiskt obehag, välbefinnande och närhet. Under området sjuksköterskors erfarenheter framkom en kategori: utbildning i beröringsbehandling samt underkategorin: upplevelser av beröringsbehandling. Slutsats: Beröringsbehandling har en kortvarig symtomlindrande inverkan på smärta, ångest, illamående samt ger ökat välbefinnande och livskvalitet. Därtill förbättrades kontakten mellan sjuksköterska och patient som bidrog till att den existentiella ensamheten minskades. Sjuksköterskorna såg patienten som en individ istället för en patient med en sjukdom.

Avaliação do concreto de cimento portland com resíduo da produção de scheelita em substituição ao agregado miúdo

From the 70`s, with the publication of the Manifesto for Environment UN Conference, held in Stockholm, in Sweden (1972), defend and improve the environment became part of our daily lives. Thus, several studies have emerged in several segments in order to reuse the waste. Some examples of waste incorporated in portland cement concrete are: rice husk ash, bagasse ash of cane sugar, powder-stone, microsilica, tire rubber, among others. This research used the residue of the mining industry Scheelite, to evaluate the incorporation of the residue composition of Portland cement concrete, replacing the natural sand. The percentage of residue were incorporated from 0% to 100%, with a variation of 10%, 11 being produced concrete mix in the ratio 1:2:3:0.60, by mass. We evaluated the following characteristics of concrete: slump test, compressive strength, tensile strength by diametral compression, water absorption, porosity and density, based on the ABNT, through tests performed in the Laboratory of Civil Construction, UFRN. The trace with the addition of 60% scheelite residue was obtained which better performance. Therefore, the use of the waste from the production of Scheelite is feasible due to the durability parameters (water absorption and porosity), sustainability, and the good results of the resistance of the concrete

Análise de necessidades de inglês para fins específicos em um curso de graduação em turismo

This study presents the results of a survey conducted in the area of English for Specific Purposes (ESP) in order to identify (1) the learning needs of students in a course in Tourism, their desires and lacks, at a federal university, with respect to use of English; (2) the needs of the present situation of teachers and the coordinator of that course as to the language; (3) the needs of the target situation of professionals (graduates) and companies with respect to this language. This research is a case study (STAKE, 1998; YIN, 2009) and was used for data collection, instruments such as questionnaires, semi-structured interviews, and document on the Tourism Course. To this end, it was adopted the theoretical basis for the constructs of English for Specific Purposes (ESP) Inglês para Fins Específicos (IFE) in Brazil, also known as Inglês Instrumental, whose foundation is based on the work by Hutchinson and Waters (1987), Robinson (1991), Dudley-Evans and St. John (1998), Celani, Deyes, Holmes, Scott (2006), among others, since this work is devoted to a specific area, Tourism. Results show that students opined the ability to prioritize reading and speaking into the classroom. Professionals reported that the latter is an indispensable tool for entering the labor market, yet they feel unprepared and need to attend English language courses in private language schools. The testimony of company executives also point to this deficiency. Finally, the present situation of teachers reveals that, while advocating the use of English in the classroom, this is not because students prefer their mother tongue. There is also an evident lack of needs analysis. Eventually, the coordinator said that there is some uncertainty as to the methodology, content and language skills worked, and the lack of interaction among teachers of English. It was concluded, therefore, it is important to conduct a needs analysis so that one can redesign a course that meets the different contextual needs: students, teachers, coordination, represented by the institutional needs, and the labor market

O imaginário da mediunidade no processo de escritura em Fernando Pessoa

The answer to creating a fictional world? Repulsion or form of reaction to an outside world? Mental illness, whose brand can be symbolic simulation or depersonalization? Hard to take a stand when the deed is a poet Fernando Pessoa as what is at stake. Notes Schlafman Léo (1998) who, at the age of 20 years, Fernando Pessoa wrote in English, in his diary, "One of my mental complications is the fear of madness, which in itself already is crazy." What rid of madness, notes Robert Bréchon (1986), was the taste of the game and was playing it for your writing. Even though it has rid the madness, the poet does not quit seeking explanations - or provide it - for the phenomena much bother him, or defined.'s where we come across the alignment of Fernando Pessoa within philosophical as occultism and reading about psychological and mental disorders treated. paths were pursued by him to explain the existence of his heteronyms and its entry process. This work therefore presents main objective: to analyze the personal papers of Fernando Pessoa, whose outstanding feature is the presence of occult and alleged mediumship demonstrations held in response to non-literary and heteronímicas. Therefore, I focused on specific goals, which are: a) to study the speech of Fernando Pessoa on his mediumship / occult b) analyzing specific texts that are, for the poet, psychic demonstrations, c) study of a series of excerpts personal letters in which Fernando Pessoa suggested to be a medium. Admittedly, this essay will touch many arguments already made by scholars and experts of Fernando Pessoa, but consider the possibility of developing issues and contribute to the critical fortune of the poet. We assume that announces the Portuguese scholar Jerome Pizarro (2006), one of the greatest scholars of the work Pessoan: those interested in Fernando Pessoa be lost in the maze created by him. It is the image of a person-Minotaur, devouring all but, holding us in its labyrinthine tessitura, as marked by mystery. Will draw on our analysis, a theory aligned themselves to objects of research, whose main authors are Sigmund Freud (1908) Carl Jung (1991.1996). Gaston Bachelard (1996), Helena Blavatsky (2008), among others

Narrativas de professores em formação sobre a didatização de podcasts para o ensino de inglês na floresta

Considering the following conditions: (1) the fluency demands of students in an undergraduate program in Languages and Literatures/English in the Amazon region; (2) the listening and speaking needs of pre-service teachers of English as a Foreign Language (EFL); (3) my continuing education as a professor of EFL and my academic literacy as a teacher-researcher and pre-service-teacher trainer, this study, which is based on Narrative Inquiry, reports on a teacher experience of working didactically with oral genres through podcasting an activity that emerged with the advent of Information and Communication Technology (ICT). Through this process, I engage with some theorists who promote teaching as a process that is driven by a concept of language as social practice. Subsequently, I make use of the notions of context of culture and context of situation, derived from Systemic Functional Linguistics, as well as the concept of genre and register derived from the perspective of this theory. Based on these principles and beliefs, the Amazon region constitutes the register (situation) of the genres used in this study. These principles also provide, opportunities for building learning strategies appropriate to this local context, and also to teach listening and speaking skills from a task-based approach. During the experience, based on the reflective teacher-education model, the participants produced narratives about the process, which I then analyzed according to Ely, Vinz, Downing and Anzul (2001), who propose possibilities of composing meanings in Narrative Inquiry. Based on this perspective, I discuss the following topics, which were highly emphasized in the participants narratives: the lack of didactic activities using oral genres; the relevance of context within teacher education; and collaborative work as a strategy to overcome gaps in digital literacy, language fluency and teaching skills. The meanings I thereby compose point to a paradigm shift in English language teaching within this context. I also argue for a pedagogical practice that is engaged with historical and socio-cultural issues, and with the development of language skills, also one that promotes the implementation of ICTs at the very start of teacher training programs, adopting teaching and learning strategies that correspond to the demands of fluency in this particular context, and deficiencies imposed by geographical isolation

Os leucócitos e a resposta inflamatória na lesão de isquemia-reperfusão

Os eventos de isquemia-reperfusão desencadeiam uma resposta inflamatória sistêmica que pode levar a lesões celulares e até falência de órgãos. Tais repercussões são notadas no pós-operatório de cirurgias, em especial, com o uso de circulação extracorpórea. Sabe-se, atualmente, que os leucócitos exercem importante papel neste processo. Assim, este estudo aborda o papel dos leucócitos na fisiopatologia das lesões de isquemia-reperfusão e a ativação das cascatas inflamatórias por esse processo e procura auxiliar na compreensão destes mecanismos assim como trazer contribuições acerca das abordagens terapêuticas que possam atenuá-los. Esta revisão bibliográfica retrospectiva foi realizada a partir de documentos científicos publicados nos últimos dez anos, em português e inglês, indexados em bases de dados internacionais Medline e SciELO e de textos clássicos relacionados. Os descritores pesquisados foram: isquemia-reperfusão, leucócitos, resposta inflamatória, circulação extracorpórea, efeitos adversos e apoptose.

A preparação de material terminológico em língua inglesa por meio de ferramentas linguístico-computacionais

O objetivo desse estudo é demonstrar, por meio de análise quantitativa e qualitativa, a eficácia de ferramentas linguístico-computacionais na seleção de terminologia para a produção de material terminológico. Serão apresentadas duas ferramentas linguístico-computacionais (WordSmith Tools e VocabProfile) e, também, sugestões para que o ensino de termos ofereça resultados práticos. A fundamentação teórico-metodológica recorreu a Barros (2004); Berber Sardinha (2000; 2005); Biderman (2001); Cabré (2007); Cobb (2007); Nation, (2003) e Sinclair (2004). O corpus da pesquisa foi constituído exclusivamente de material escrito na língua inglesa em diversas áreas de especialidade. Os procedimentos de preparação de material terminológico são exemplificados a partir de uma das áreas de especialidades utilizadas nos corpora de pesquisa, as Redes Neurais Artificiais. Os resultados obtidos indicam que a utilização do Wordsmith Tools juntamente com o VocabProfile pode fornecer dados importantes para a pesquisa linguistica.

Current conditions and outlook: Economic Survey of Latin America and the Caribbean 2001

Includes bibliography

As ambiguidades linguísticas no inglês e a tradução automática inglês-português: um estudo exploratório

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Uma análise da tradução de marcadores culturais em Sergeant Getulio e The Lizard's smile, à luz da linguística de corpus

Pós-graduação em Estudos Linguísticos - IBILCE

Tradução juramentada de contratos de compra e venda

Pós-graduação em Estudos Linguísticos - IBILCE