916 resultados para Parent-adolescent relationships
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This study aimed to compare foot plantar pressure distribution while jogging and running in highly trained adolescent runners. Eleven participants performed two constant-velocity running trials either at jogging (11.2 ± 0.9 km/h) or running (17.8 ± 1.4 km/h) pace on a treadmill. Contact area (CA in cm(2)), maximum force (F(max) in N), peak pressure (PP in kPa), contact time (CT in ms), and relative load (force time integral in each individual region divided by the force time integral for the total plantar foot surface, in %) were measured in nine regions of the right foot using an in-shoe plantar pressure device. Under the whole foot, CA, F(max) and PP were lower in jogging than in running (-1.2% [p<0.05], -12.3% [p<0.001] and -15.1% [p<0.01] respectively) whereas CT was higher (+20.1%; p<0.001). Interestingly, we found an increase in relative load under the medial and central forefoot regions while jogging (+6.7% and +3.7%, respectively; [p<0.05]), while the relative load under the lesser toes (-8.4%; p<0.05) was reduced. In order to prevent overloading of the metatarsals in adolescent runners, excessive mileage at jogging pace should be avoided.
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OBJECTIVE: To assess and compare the training needs in adolescent medicine of doctors within 6 specialties as a basis for the development of pre/postgraduate and continuing medical education (CME) training curricula. DESIGN: Cross-sectional postal survey. SETTING: Switzerland. PARTICIPANTS: National, representative, random sample of 1857 practising doctors in 6 disciplines (general practitioners, paediatricians, gynaecologists, internists, psychiatrists, child psychiatrists) registered with the Swiss Medical Association. MAIN OUTCOME MEASURES: Perceived importance of and training interest in 35 topics related to adolescent medicine listed in a self-administered, anonymous questionnaire. RESULTS: A total of 1367 questionnaires were returned, representing a response rate of 73.9%. Clear interest in adolescent medicine was reported by 62.1% of respondents. Topics perceived to be the most important in everyday practice were functional symptoms (71.4%), acne (67.1%), obesity (64.6%), depression-anxiety (68.1%) and communication with adolescents (61.7%). Differences between disciplines were especially marked for gynaecologists, who expressed interest almost exclusively in medical topics specific to their field. In contrast, other disciplines commonly reported a keen interest in psychosocial problems. Accordingly, interest in further training was expressed mostly for functional symptoms (62.4%), eating disorders (56.3%), depression-anxiety (53.7%) and obesity (52.6%). Issues related to injury prevention, chronic disease and confidentiality were rated as low priorities. CONCLUSIONS: Regardless of discipline, Swiss primary care doctors expressed a strong interest in adolescent medicine. Continuing medical education courses should include both interdisciplinary courses and discipline-specific sessions. Further training should address epidemiological and legal/ethical issues (e.g. injury prevention, confidentiality, impact of chronic conditions).
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The aims of this review were 1) to compile a large number of reliable literature data on the metabolic hydrolysis of medicinal carbamates and 2) to extract from such data a qualitative relation between molecular structure and lability to metabolic hydrolysis. The compounds were classified according to the nature of their substituents (R³OCONR&supl;R²), and a metabolic lability score was calculated for each class. A trend emerged, such that the metabolic lability of carbamates decreased (i.e., their metabolic stability increased), in the following series: Aryl-OCO-NHAlkyl >> Alkyl-OCO-NHAlkyl ~ Alkyl-OCO-N(Alkyl)? ? Alkyl-OCO-N(endocyclic) ? Aryl-OCO-N(Alkyl)? ~ Aryl-OCO-N(endocyclic) ? Alkyl-OCO-NHAryl ~ Alkyl-OCO-NHAcyl?>> Alkyl-OCO-NH? > Cyclic carbamates. This trend should prove useful in the design of carbamates as drugs or prodrugs.
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The osteoporosis of the child and the teenager is a pathological reality; its multifactorial pathogenesis often requires a collaborative approach and multidisciplinary. The osteoporosis characterized by a reduction in the bone mineral density is not a uniform pathology; it must be dealt with on all the levels by analyzing the factors of risks, by giving itself the diagnostic means and while insisting on the importance of a preventive approach as well as therapeutic.
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BACKGROUND: So far, none of the existing methods on Murray's law deal with the non-Newtonian behavior of blood flow although the non-Newtonian approach for blood flow modelling looks more accurate. MODELING: In the present paper, Murray's law which is applicable to an arterial bifurcation, is generalized to a non-Newtonian blood flow model (power-law model). When the vessel size reaches the capillary limitation, blood can be modeled using a non-Newtonian constitutive equation. It is assumed two different constraints in addition to the pumping power: the volume constraint or the surface constraint (related to the internal surface of the vessel). For a seek of generality, the relationships are given for an arbitrary number of daughter vessels. It is shown that for a cost function including the volume constraint, classical Murray's law remains valid (i.e. SigmaR(c) = cste with c = 3 is verified and is independent of n, the dimensionless index in the viscosity equation; R being the radius of the vessel). On the contrary, for a cost function including the surface constraint, different values of c may be calculated depending on the value of n. RESULTS: We find that c varies for blood from 2.42 to 3 depending on the constraint and the fluid properties. For the Newtonian model, the surface constraint leads to c = 2.5. The cost function (based on the surface constraint) can be related to entropy generation, by dividing it by the temperature. CONCLUSION: It is demonstrated that the entropy generated in all the daughter vessels is greater than the entropy generated in the parent vessel. Furthermore, it is shown that the difference of entropy generation between the parent and daughter vessels is smaller for a non-Newtonian fluid than for a Newtonian fluid.
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L’obesitat infantil, és un dels problemes de salut pública més greus del segle XXI, on la prevalença ha augmentat de manera alarmant a nivell mundial. Aquesta es defineix com una malaltia crònica i multifactorial, que sol iniciar-se en la infantesa i a l’adolescència. L’objectiu principal d’aquest estudi és conèixer la prevalença de sobrepès i obesitat en la població adolescent de Girona, i relacionar amb aquesta, els hàbits alimentaris, els hàbits d’activitat física, l’entitat de l’institut-escola, hores de son i nivell màxim d’estudis dels progenitors. Material i mètodes: Estudi descriptiu, observacional i transversal sobre una mostra de la població adolescent de Girona de 14 a 16 anys (n=185), els quals se’ls va administrar un qüestionari on es van recollir les variables relacionades amb l’estudi. L’obesitat i el sobrepès es van definir com valors de l’índex de massa corporal iguals o superiors als valors dels percentils 97 i 85, respectivament, de les taules de referencia de la OMS de 2007. Resultats: La prevalença de sobrepès i d’obesitat en la població adolescent de Girona és del 20% i del 3,78%, respectivament. El sobrepès i l’obesitat (23,78%) ha afectat més al sexe masculí (27,7%) respecte el femení (19,8%). S’ha establert relació significativa entre la prevalença de sobrepès i obesitat amb el nivell màxim d’estudis dels progenitors. Hi ha més prevalença de sobrepès i obesitat a l’institut públic en vers el privat amb un 26,7% respecte el 18,5%. Conclusions: Segons la bibliografia consultada, la població adolescent de Girona presenta més elevada la prevalença de sobrepès però no pel que fa la prevalença d’obesitat
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The aim of the present study was to determinate the cycle length of spermatogenesis in three species of shrew, Suncus murinus, Sorex coronatus and Sorex minutus, and to assess the relative influence of variation in basal metabolic rate (BMR) and mating system (level of sperm competition) on the observed rate of spermatogenesis, including data of shrew species studied before (Sorex araneus, Crocidura russula and Neomys fodiens). The dynamics of sperm production were determined by tracing 5-bromodeoxyuridine in the DNA of germ cells. As a continuous scaling of mating systems is not evident, the level of sperm competition was evaluated by the significantly correlated relative testis size (RTS). The cycle durations estimated by linear regression were 14.3 days (RTS 0.3%) in Suncus murinus, 9.0 days (RTS 0.5%) in Sorex coronatus and 8.5 days (RTS 2.8%) in Sorex minutus. In regression and multiple regression analyses including all six studied species of shrew, cycle length was significantly correlated with BMR (r2=0.73) and RTS (r2=0.77). Sperm competition as an ultimate factor obviously leads to a reduction in the time of spermatogenesis in order to increase sperm production. BMR may act in the same way, independently or as a proximate factor, revealed by the covariation, but other factors (related to testes size and thus to mating system) may also be involved.
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Tämän tutkimuksen tavoitteena oli tutkia ja selvittää monimutkaisia myyjän ja toimittajan välisiä liikesuhteita; miten ne kehittyvät ja millaisia prosesseja ne käyvät läpi, jos avainasiakassuhde on vaikeuksissa. Tavoitteena oli myös löytää syitä miksi ostokäyttäytyminen on muuttunut, onko se maailman- laajuinen ilmiö vai onko kyse vain yksittäisestä tapauksesta paperiteolli-suudessa. Lisäksi tavoitteena oli selvittää mitkä ovat alkusysäyksiä avain-asiakassuhteen murrostilaan. Tutkimuksen lähestymistapa on kvalitatiivinen tapaustutkimus. Tutkimuksen ensisijainen empiirinen aineisto on kerätty haastattelemalla UPM-Kymmenen johtoa, paperin osto-organisaation ostojohtajaa X ja asiakas Y:n entistä osto-johtajaa. Työ ei ole salainen. Tämän takia asiakkaiden nimiä ei voida julkaista, koska UPM-Kymmene vaati, että työ ei saa sisältää mitään informaatiota, josta lukija voi tunnistaa asiakas X:n tai Y:n. Johtopäätöksenä voidaan suosittaa toimittajan tarkkailevan ja ymmärtävän mahdollisia alkusysäyksiä ja varoitussignaaleja ehkäistäkseen tulevaisuuden murrostiloja liikesuhteissaan ja hallita paremmin avainasiakkaitaan.Pääasialliset alkusysäykset ovat vähentynyt avoin kommunikaatio, ostajan radikaalit säästöt, vähentynyt informaation vaihto ja ostajan johdon vaihtuminen, koska se luo epävarmuutta toimittajaan kuten myös ostajaan.
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Tämä tutkimuskeskittyy yritysten väliseen samanaikaiseen kilpailuun ja yhteistyöhön. Suurin mielenkiinto tässä tutkimuksessa kohdistuu yritysten väliseen tietämyksen siirtoon. Tietämyksen siirto samanaikaisissa kilpailu- ja yhteistyösuhteissa voi olla erityisen hyödyllistä samankaltaisten toimintalogiikoiden ja ymmärryksen takia. Toisaalta, mahdollinen kriittisen tiedon vuotaminen kilpailevalle yritykselle onriski, joka täytyy ottaa huomioon, kun yhteistyötä kilpailijan kanssa suunnitellaan. Tämän tutkimuksen tavoitteena on selvittää, kuinka tietämystä siirretään samanaikaisissa kilpailu- ja yhteistyösuhteissa välttäen kuitenkin tähän liittyvät riskit. Tutkimuksen empiirinen osa sisältää kolme erilaista case-esimerkkiä samanaikaisista kilpailu- ja yhteistyösuhteista. Empiirisessä osassa tehdyt havainnot tukevat pääasiassa teoriaosuudessa käsiteltyjä asioita. Tietämyksen siirron motiivit, suhdekohtaiset tietämyksen omaksumiskyvyt, tietojohtamiskäytännöt ja luottamus ovat tekijöitä, jotka vaikuttavat tietämyksen siirron tehokkuuteen. Pääasialliset keinot tietämyksen siirron riskin välttämiseksi samanaikaisissa kilpailu- ja yhteistyösuhteissa ovat hierarkkisen hallintomuodon käyttäminen tai horisontaalisesti ja vertikaalisesti rajattu yhteistyön laajuus.
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BACKGROUND: Propionic acidemia is an inherited disorder caused by deficiency of propionyl-CoA carboxylase. Although it is one of the most frequent organic acidurias, information on the outcome of affected individuals is still limited. STUDY DESIGN/METHODS: Clinical and outcome data of 55 patients with propionic acidemia from 16 European metabolic centers were evaluated retrospectively. 35 patients were diagnosed by selective metabolic screening while 20 patients were identified by newborn screening. Endocrine parameters and bone age were evaluated. In addition, IQ testing was performed and the patients' and their families' quality of life was assessed. RESULTS: The vast majority of patients (>85%) presented with metabolic decompensation in the neonatal period. Asymptomatic individuals were the exception. About three quarters of the study population was mentally retarded, median IQ was 55. Apart from neurologic symptoms, complications comprised hematologic abnormalities, cardiac diseases, feeding problems and impaired growth. Most patients considered their quality of life high. However, according to the parents' point of view psychic problems were four times more common in propionic acidemia patients than in healthy controls. CONCLUSION: Our data show that the outcome of propionic acidemia is still unfavourable, in spite of improved clinical management. Many patients develop long-term complications affecting different organ systems. Impairment of neurocognitive development is of special concern. Nevertheless, self-assessment of quality of life of the patients and their parents yielded rather positive results.
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Résumé Introduction: Les accidents sont la première cause de mortalité et de morbidité chez les enfants et les adolescents des deux sexes dès le premier mois de vie. Ils ne sont pas le fruit du hasard et ne devraient plus être considérés comme une fatalité. Leur nombre peut être réduit de façon substantielle par une bonne compréhension des processus accidentels et une information adéquate des intervenants. Cependant, les stratégies de prévention doivent se fonder sur une analyse locale de la situation. C'est pourquoi nous avons développé en 1990 un programme d'enregistrement prospectif des accidents d'enfants et d'adolescents. Le présent travail a pour but d'analyser l'épidémiologie de la traumatologie sportive de l'enfant et de l'adolescent. Matériel et méthode: Nous disposons d'un programme d'enregistrement prospectif des accidents d'enfants et d'adolescents de 0 à 16 ans survenus dans le canton de Vaud, Suisse. De 1990 à 2000, nous avons enregistré 24'900 traumatismes aux urgences du Service de chirurgie pédiatrique du CHUV de Lausanne, dont 6'890 (28%) étaient des traumatismes sportifs. Les informations collectées dans cette étude concernent la date de l'accident, l'âge du patient, le sport pratiqué, le type de lésion(s) et le type de suivi (traitement ambulatoire, hospitalisation, etc) et permettent une analyse de l'épidémiologie de la traumatologie sportive de l'enfant sur 11 ans. Résultats: Nette prédominance masculine (1.6 :1). Plus de 50% des enfants ont entre 12 et 15 ans. Vélo, gymnastique et football dominent, représentant à eux seuls 45% des cas. La fréquence des accidents obéit, selon le sport concerné, à un rythme saisonnier et dépendant des vacances. Certaines activités comme la trottinette ou le snowboard apparaissent soudain à la faveur d'une mode. Le ski occasionne 48% de lésions des membres inférieurs, le roller 56% de lésions des membres supérieurs, le basket-ball 57% de lésions de la main, la natation et le plongeon 53% de lésions de la tête ou de la colonne cervicale. Les contusions représentent 27% des consultations. La fracture la plus courante est celle de l'avant-bras, représentant 34% des fractures de membres. Les fractures de la main représentent 69% des fractures de membres au basket-ball, contre 3% dans l'équitation où les fractures de l'humérus prédominent (42%). 10% des patients sont hospitalisés, et 55% seront revus ambulatoirement. Discussion: Chaque sport occasionne des lésions dont le type et la localisation lui sont propres et qui permettent dans la plupart des cas de reconnaître le mécanisme lésionnel et de déterminer des stéréotypes. Conclusion: Une meilleure connaissance des lésions occasionnées par chaque sport devrait permettre le développement de programmes de prévention mieux adaptés. Ils doivent associer le plus grand nombre de partenaires possibles, issus de tous les milieux et passant par une information de ceux-ci.
Establishing intercompany relationships: Motives and methods for successful collaborative engagement
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This study explores the early phases of intercompany relationship building, which is a very important topic for purchasing and business development practitioners as well as for companies' upper management. There is a lot ofevidence that a proper engagement with markets increases a company's potential for achieving business success. Taking full advantage of the market possibilities requires, however, a holistic view of managing related decision-making chain. Most literature as well as the business processes of companies are lacking this holism. Typically they observe the process from the perspective of individual stages and thus lead to discontinuity and sub-optimization. This study contains a comprehensive introduction to and evaluation of literature related to various steps of the decision-making process. It is studied from a holistic perspective ofdetermining a company's vertical integration position within its demand/ supplynetwork context; translating the vertical integration objectives to feasible strategies and objectives; and operationalizing the decisions made through engagement with collaborative intercompany relationships. The empirical part of the research has been conducted in two sections. First the phenomenon of intercompany engagement is studied using two complementary case studies. Secondly a survey hasbeen conducted among the purchasing and business development managers of several electronics manufacturing companies, to analyze the processes, decision-makingcriteria and success factors of engagement for collaboration. The aim has been to identify the reasons why companies and their management act the way they do. As a combination of theoretical and empirical research an analysis has been produced of what would be an ideal way of engaging with markets. Based on the respective findings the study concludes by proposing a holistic framework for successful engagement. The evidence presented throughout the study demonstrates clear gaps, discontinuities and limitations in both current research and in practical purchasing decision-making chains. The most significant discontinuity is the identified disconnection between the supplier selection process and related criteria and the relationship success factors.