Abordaje en las heridas de difícil cicatrización

Los conocimientos sobre la cicatrización han evolucionado de forma importante en las últimas dos décadas. Gracias a ello, actualmente es posible predecir la secuencia probable de acontecimientos que tendrán lugar a lo largo de la cicatrización y pronosticar el tiempo aproximado que tardará una herida, pero a menudo, durante la práctica clínica, y a pesar del mayor conocimiento y desarrollo de intervenciones, muchos profesionales de enfermería se enfrentan a diario ante heridas de difícil cicatrización, es decir, la cicatrización se prolonga en el tiempo o no se llega a alcanzar. Estos esfuerzos pueden provocar al profesional un aumento del estrés psicosocial y ansiedad, convirtiéndose en una carga financiera importante para el sistema de salud, ya de por sí, tan necesitado en los tiempos actuales. Estas heridas complejas siguen siendo en la actualidad un problema prevalente y de especial atención en salud, que afecta a pacientes en todos los niveles asistenciales y de todas las clases sociales. Requieren un compromiso de todos los profesionales de salud respecto a la prevención y atención de las mismas hasta el punto final de la cicatrización, por lo que los profesionales sanitarios, deben potenciar avances y conocimientos que permitan un cambio radical en la atención de estas lesiones.

In vivo brain macromolecule signals in healthy and glioblastoma mouse models: (1) H magnetic resonance spectroscopy, post-processing and metabolite quantification at 14.1 T.

In (1) H magnetic resonance spectroscopy, macromolecule signals underlay metabolite signals, and knowing their contribution is necessary for reliable metabolite quantification. When macromolecule signals are measured using an inversion-recovery pulse sequence, special care needs to be taken to correctly remove residual metabolite signals to obtain a pure macromolecule spectrum. Furthermore, since a single spectrum is commonly used for quantification in multiple experiments, the impact of potential macromolecule signal variability, because of regional differences or pathologies, on metabolite quantification has to be assessed. In this study, we introduced a novel method to post-process measured macromolecule signals that offers a flexible and robust way of removing residual metabolite signals. This method was applied to investigate regional differences in the mouse brain macromolecule signals that may affect metabolite quantification when not taken into account. However, since no significant differences in metabolite quantification were detected, it was concluded that a single macromolecule spectrum can be generally used for the quantification of healthy mouse brain spectra. Alternatively, the study of a mouse model of human glioma showed several alterations of the macromolecule spectrum, including, but not limited to, increased mobile lipid signals, which had to be taken into account to avoid significant metabolite quantification errors.

Uncertainty of combined activity estimations

This paper discusses basic theoretical strategies used to deal with measurement uncertainties arising from different experimental situations. It attempts to indicate the most appropriate method of obtaining a reliable estimate of the quantity to be evaluated depending on the characteristics of the data available. The theoretical strategies discussed are supported by experimental detail, and the conditions and results have been taken from examples in the field of radionuclide metrology. Special care regarding the correct treatment of covariances is emphasized because of the unreliability of the results obtained if these are neglected

Vertailuanalyysin käyttö termohydraulisten koelaitteistojen tulosten laitosmittakaavaan skaalautumisen tutkimisessa

Työn tavoitteena oli tarkastella termohydraulisten koelaitteistojen skaalauksessa käytettäviä periaatteita ja menettelyjä sekä vertailla Apros-simulaattoriohjelmalla laskettuja kanden koelaitteistomallin ja EPR-mallin tuloksia. Tarkoituksena oli saada käsitys siitä, miten hyvin tarkastellut koelaitteistot kuvaavat EPR-Iaitostyypin käyttäytymistä onnettomuustilanteessa. Malleilla tutkittiin jäähdytteen määrän vaikutusta primääripiirin käyttäytymiseen. Koelaitteistomallien tuloksissa toistuvat samat ilmiöt kuin EPR-mallin tuloksissa. Laskettuja PKL-koelaitteistomallin tuloksia vertailtiin myös koelaitteistolla suoritettuun kokeeseen. PKL-mallin todettiin toistavan hyvin kokeen tulokset. Koelaitteistojen tuloksien perusteella kelpoistetaan laskentaohjelmia, joita käytetään ydinvoimalaitosten turvallisuustutkimuksessa. Erityistä harkintaa tulee käyttää koelaitteistojen tulosten hyödyntämisessä, sillä mittakaava vaikuttaa ilmiöiden esiintymiseen.

Resultados científicos do cruzeiro do "Baependi" e do "Vega" à Ilha da Trindade: o gênero Firoloida, Prosobranchia Heteropoda

From the Jaseur Bank, off the Brazilian coast at 20º 30' S - 35º 50' W, were collected a few specimens of one of the less known species of the Heteropoda: Firoloida lesueuri (d'Orbigny). A detailed anatomical description follows aiming at the elucidation of some obscure points in the litterature on the subject and at showing the identity of most of the previously described "species" of the genus Firoloida. Special care was taken with the study of the nervous system of which most of the descriptions found were discordant. The author arrived at the conclusion that the pleural ganglia are either missing of fused to the cerebral ganglia, that the supraintestinal ganglion (left parietal ganglion) is present in the posterior region and is close to the subintestinal or right parietal ganglion, being both located near the rear end of the body. The innervations are described and discussed as well as the fusion of extensive tracts of the connectives. The present material is shown to be identical to F. kowalewskyi, well described by Vayssière and Tesch; F. desmaresti (Lesueur 1817) is shown to be undistinguishable from F. blainvilleana and F. gracilis. F. aculeata and F. gaimardi are here considered as "nomina nuda". F. liguriae Issel 1907 is admitted as separate species in spite of its insufficient description and, finally, F. vigilans (Troschel 1855), unsatisfactorily described from only one specimen is perhaps a valid species. A table is presented to show the slight differences between the 4 species which are undoubtedly very similar. F. desmaresti is found only in the Atlantic north of the line and a few points south and close to it as well as in dependent seas, while F. lesueuri is common to the south Atlantic, south Indie and south Pacific oceans, extending north only up to the Azores Islands. F. liguriae is from the south western Atlantic. ?F. vigilans would be an endemic species from Messina (Mediterranean).

SOFTWARE TO ASSESS BEEF CATTLE BODY MASS THROUGH THE FUZZY BODY MASS INDEX

ABSTRACT The Body Mass Index (BMI) can be used by farmers to help determine the time of evaluation of the body mass gain of the animal. However, the calculation of this index does not reveal immediately whether the animal is ready for slaughter or if it needs special care fattening. The aim of this study was to develop a software using the Fuzzy Logic to compare the bovine body mass among themselves and identify the groups for slaughter and those that requires more intensive feeding, using "mass" and "height" variables, and the output Fuzzy BMI. For the development of the software, it was used a fuzzy system with applications in a herd of 147 Nellore cows, located in a city of Santa Rita do Pardo city – Mato Grosso do Sul (MS) state, in Brazil, and a database generated by Matlab software.

Electrocardiographic changes during low-dose, short-term therapy of cutaneous leishmaniasis with the pentavalent antimonial meglumine

The pentavalent antimonial (Sb5+) meglumine is the drug of choice for the treatment of cutaneous leishmaniasis (CL) in Brazil. Although the cardiotoxicity of high-dose, long-term Sb5+ therapy is well known, the use of low-dose, short-term meglumine has been considered to be safe and relatively free from significant cardiac effects. In order to investigate the cardiotoxicity of low-dose, short-term therapy with meglumine in cutaneous leishmaniasis, 62 CL patients treated with meglumine were studied. A standard ECG was obtained before and immediately after the first cycle of treatment (15 mg Sb5+ kg-1 day-1). The electrocardiographic interpretation was carried out blindly by two investigators using the Minnesota Code. There were no significant differences in qualitative ECG variables before and after meglumine treatment. However, the corrected QT interval was clearly prolonged after antimonial therapy (420.0 vs 429.3 ms, P<10-6). QTc augmentation exceeded 40 ms in 12 patients, 7 of whom developed marked QTc interval enlargement (500 ms) after meglumine therapy. This previously unrecognized cardiac toxicity induced by short-term, low-dose antimonial therapy has potentially important clinical implications. Since sudden death has been related to QTc prolongation over 500 ms induced by high-dose antimonial therapy, routine electrocardiographic monitoring is probably indicated even in CL patients treated with short-term, low-dose meglumine schedules. Until further studies are conducted to establish the interactions between pentavalent antimonials and other drugs, special care is recommended when using meglumine in combination with other medications, in particular with drugs that also increase the QTc interval.

Social Justice and Weaker Sections: Role of the Judiciary

The Constitution of India. which has been described by an eminent writer as a "Corner stone of a nation". Has bestowed sufficient thought on the underprivileged. A number of provisions incorporated in it for their benefit tell the tale of statesmanship of the framers of the Constitution. for the vitality of a Constitution depends on the extent to which it affords protection to the under—priveleged. One such laudable provision in the Constitution relates to "weaker sections of the people", which has directed the State to promote with special care the educational and economic interests of such people. Besides. the Constitution has laid great stress on social justice. No comprehensive analysis in a single work seems to have been made so far of the connotations of social justice and the scope of the constitutional safeguards provided in favour of the weaker sections of the people. This thesis is the result of an attempt to analyse the connotations of social justice and the scope of the constitutional provisions made for the benefit of the weaker sections and the role played by the judiciary in this field The weaker sections, which are sought to be covered in this work, are "Backward C1asses". socially and educationally Backward Classes", "Scheduled Castes and Scheduled Tribes" and women. The first two categories of weaker sections have not been defined in the Constitution. So, their meaning and the criteria to determine them have to be gathered from the reports submitted by various Backward Class Commissions and judicial decisions rendered in a number of cases. The main thrust in this work is to understand the meaning and contents of social justice, identify the relevant weaker sections and to examine the extent to which the social justice has been rendered to the said weaker sections. The scope of this thesis is confined to the examination of the role of the judiciary in this field. So, the enquiry has been focussed mainly on the decisions of the judiciary bearing on the subject with a view to assessing the role of the judiciary in rendering social justice meaningful to the weaker sections in particular and to the Indian Society in general.

Echtzeitsimulation großer Grafikmodelle

Die vorliegende Arbeit entstand während meiner Zeit als wissenschaftlicher Mitarbeiter im Fachgebiet Technische Informatik an der Universität Kassel. Im Rahmen dieser Arbeit werden der Entwurf und die Implementierung eines Cluster-basierten verteilten Szenengraphen gezeigt. Bei der Implementierung des verteilten Szenengraphen wurde von der Entwicklung eines eigenen Szenengraphen abgesehen. Stattdessen wurde ein bereits vorhandener Szenengraph namens OpenSceneGraph als Basis für die Entwicklung des verteilten Szenengraphen verwendet. Im Rahmen dieser Arbeit wurde eine Clusterunterstützung in den vorliegenden OpenSceneGraph integriert. Bei der Erweiterung des OpenSceneGraphs wurde besonders darauf geachtet den vorliegenden Szenengraphen möglichst nicht zu verändern. Zusätzlich wurde nach Möglichkeit auf die Verwendung und Integration externer Clusterbasierten Softwarepakete verzichtet. Für die Verteilung des OpenSceneGraphs wurde auf Basis von Sockets eine eigene Kommunikationsschicht entwickelt und in den OpenSceneGraph integriert. Diese Kommunikationsschicht wurde verwendet um Sort-First- und Sort-Last-basierte Visualisierung dem OpenSceneGraph zur Verfügung zu stellen. Durch die Erweiterung des OpenScenGraphs um die Cluster-Unterstützung wurde eine Ansteuerung beliebiger Projektionssysteme wie z.B. einer CAVE ermöglicht. Für die Ansteuerung einer CAVE wurden mittels VRPN diverse Eingabegeräte sowie das Tracking in den OpenSceneGraph integriert. Durch die Anbindung der Geräte über VRPN können diese Eingabegeräte auch bei den anderen Cluster-Betriebsarten wie z.B. einer segmentierten Anzeige verwendet werden. Die Verteilung der Daten auf den Cluster wurde von dem Kern des OpenSceneGraphs separat gehalten. Damit kann eine beliebige OpenSceneGraph-basierte Anwendung jederzeit und ohne aufwendige Modifikationen auf einem Cluster ausgeführt werden. Dadurch ist der Anwender in seiner Applikationsentwicklung nicht behindert worden und muss nicht zwischen Cluster-basierten und Standalone-Anwendungen unterscheiden.

Propuesta de mejoramiento de la política de inventarios de la empresa Wholesale and Retail Place LLC

Wholesale and Retail place LLC, es una empresa que nace en el año 2012 en la ciudad de Carteret, Nueva Jersey dedicada a la comercialización y distribución de ropa para mujer colombiana en Estados Unidos. De esta manera, la problemática abordada en este proyecto será la influencia de la política de inventarios en el desempeño de la empresa. A partir de esto, se plantea realizar un mejoramiento de la política de gestión de inventarios, recurso que procure cambiar el modelo operativo de negocio mediante un enfoque a la transición, desde una pequeña hasta una mediana empresa, con énfasis en la perdurabilidad y sostenibilidad de la compañía.

Alunos com autismo : grau de aceitação por parte dos pares

As crianças com perturbações do Espectro do Autismo revelam acentuadas limitações ao nível das interacções sociais, tanto pela ausência de iniciação interativa com os seus pares, como pela falta de resposta às atitudes afetivas dos mesmos. Esta incapacidade para estabelecer relações sociais dificulta o convívio, mesmo quando os seus pares demonstram interesse em brincar. Ao longo da realização deste trabalho, através das leituras, vários autores referiram a importância da promoção das competências sociais nestas crianças. Com este estudo procura-se saber como são aceites os alunos com perturbações do Espectro do Autismo pelos seus pares sem Necessidades Educativas Especiais em contexto escolar. Propõe-se, assim, recolher as opiniões de vários alunos que frequentam o mesmo centro escolar face à presença de um colega com perturbações do Espectro do Autismo, de modo a fazer uma análise dos dados obtidos, bem como a elaboração de um plano de intervenção para uma melhoria da situação problema. Com base na análise das entrevistas realizadas no âmbito do estudo pode-se afirmar que os resultados da investigação revelam um contexto escolar positivo e empenhado no apoio aos alunos com perturbações do Espectro do Autismo. De acordo com os inquiridos e com os investigadores estudados na revisão da literatura é possível afirmar que o desenvolvimento das atividades lúdicas e um acompanhamento personalizado por um professor especializado, bem como a integração na turma, são fatores fundamentais para um melhor desenvolvimento global dos alunos em questão e para a prevenção de atitudes discriminatórias entre pares.

Unidades de Cuidados Continuados Integrados: uma resposta ao envelhecimento e à dependência em Portugal

A população portuguesa encontra-se num processo de envelhecimento, e tem de enfrentar esta nova realidade demográfica. Vários determinantes nomeadamente biológicos, psicológicos e sociais, foram já identificados. O aumento da prevalência de doenças crónicas e incapacitantes, como consequência directa do envelhecimento humano, tem aumentado a procura de respostas na área da saúde e ao nível social. A Rede Nacional de Cuidados Continuados Integrados (REDE) surge como resposta a esta nova problemática. Através da implementação de Unidades de Cuidados Continuados Integrados (UCCI), a REDE é uma alternativa aos internamentos nos hospitais de pessoas em situação de dependência e com necessidade de cuidados diferenciados mas sem necessidade de cuidados típicos de uma unidade de agudos. As UCCI apresentam um modelo de intervenção multidisciplinar que contempla as vertentes da saúde, social e económica dos utentes, composta por equipas multidisciplinares. Devido às especificidades da população idosa e/ou dependente, a intervenção especializada dos profissionais das UCCI, deve ser cuidadosamente preparada com base no treino e especialização, aspectos centrais do sucesso da REDE.

Key drivers of frontline employee generation of ideas for customer service improvement

Anchored in the service-dominant logic and service innovation literature, this study investigates the drivers of employee generation of ideas for service improvement (GISI). Employee GISI focuses on customer needs and providing the exact service wanted by customers. GISI should enhance competitive advantage and organizational success (cf. Berry et al. 2006; Wang and Netemeyer 2004). Despite its importance, there is little research on the idea generation stage of the service development process (Chai, Zhang, and Tan 2005). This study contributes to the service field by providing the first empirical evaluation of the drivers of GISI. It also investigates a new explanatory determinant of reading of customer needs, namely, perceived organizational support (POS), and an outcome of POS, in the form of emotional exhaustion. Results show that the major driver of GISI is reading of customer needs by employees followed by affective organizational commitment and job satisfaction. This research provides several new and important insights for service management practice by suggesting that special care should be put into selecting and recruiting employees who have the ability to read customer needs. Additionally, organizations should invest in creating work environments that encourage and reward the flow of ideas for service improvement

Messages about antibiotic resistance in different newspaper genres

Poorer people are more likely to use antibiotics; inappropriate antibiotic use causes resistance, and health campaigns attempt to change behaviour through education. However, fuelled by the media, the public think antibiotic resistance is outside their control. Differences in the attribution of blame for antibiotic resistance in two genres of UK newspapers, targeting distinct socioeconomic groups, were examined using a mixed methods approach. Firstly, depiction of blame was categorised as either external to the lay public (outside their control) or internal (lay person accountable) and subjected to a chi-square test. Secondly, using critical discourse analysis, we examined the portrayal of the main agents through newspaper language. Data from 597 articles (307 broadsheets) analysed revealed a significant association between newspaper genre and attribution of blame for antibiotic resistance. While both newspaper types blamed antibiotic resistance predominantly on factors external to the lay public, broadsheets were more likely to acknowledge internal factors than tabloids. Tabloids provided a more skewed representation, exposing readers to inaccurate explanations about antibiotic resistance. They highlighted ineptitude in health professionals, victimising patients and blaming others, while broadsheets used less emotive language. Pharmacists should take special care to communicate the importance of appropriate antibiotic use against this backdrop of distortion.

The importance of hormone receptor analysis in osteosarcoma cells growth submitted to treatment with estrogen in association with thyroid hormone

Bone tumor incidence in women peaks at age 50-60, coinciding with the menopause. That estrogen (E2) and triiodothyronine (T3) interact in bone metabolism has been well established. However, few data on the action of these hormones are available. Our purpose was to determine the role of E2 and T3 in the expression of bone activity markers, namely alkaline phosphatase (AP) and receptor activator of nuclear factor kappa B ligand (RANKL). Two osteosarcoma cell lines: MG-63 (which has both estrogen (ER) and thyroid hormone (TR) receptors) and SaOs-29 (ER receptors only) were treated with infraphysiological E2 associated with T3 at infraphysiological, physiological, and supraphysiological concentrations. Real-time RT-PCR was used for expression analysis. Our results show that, in MG-63 cells, infraphysiological E2 associated with supraphysiological T3 increases AP expression and decreases RANKL expression, while infraphysiological E2 associated with either physiological or supraphysiological T3 decreases both AP and RANKL expression. On the other hand, in SaOs-2 cells, the same hormone combinations had no significant effect on the markers` expression. Thus, the analysis of hormone receptors was shown to be crucial for the assessment of tumor potential growth in the face of hormonal changes. Special care should be provided to patients with T3 and E2 hormone receptors that may increase tumor growth. Copyright (C) 2007 John Wiley & Sons, Ltd.