772 resultados para 1464


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Background: Research suggests that patients presenting to hospital with self-cutting differ from those with intentional overdose in demographic and clinical characteristics. However, large-scale national studies comparing self-cutting patients with those using other self-harm methods are lacking. We aimed to compare hospital-treated self-cutting and intentional overdose, to examine the role of gender in moderating these differences, and examine the characteristics and outcomes of those patients presenting with combined self-cutting and overdose. Methods: Between 2003 and 2010, the Irish National Registry of Deliberate Self-Harm recorded 42,585 self-harm presentations to Irish hospital emergency departments meeting the study inclusion criteria. Data were obtained on demographic and clinical characteristics by independent data registration officers. Results: Compared with overdose only, involvement of self-cutting (with or without overdose) was significantly more common in males than females, with an overrepresentation of males aged <35 years. Independent of gender, involvement of self-cutting (with or without overdose) was significantly associated with younger age, city residence, repetition within 30 days and repetition within a year (females only). Factors associated with self-cutting as the sole method were no fixed abode/living in an institution, presenting outside 9 a.m. to 5 p.m., not consuming alcohol and repetition between 31 days and 1 year (males only). Conclusion: The demographic and clinical differences between self-harm patients underline the presence of different subgroups with implications for service provision and prevention of repeated self-harm. Given the relationship between self-cutting and subsequent repetition, service providers need to ensure that adequate follow-up arrangements and supports are in place for the patient.

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PURPOSE: There has been an increase in the number of natural disasters in recent history, and the rate of disability is increasing among survivors. The most recent major natural disaster was the earthquake(s) that occurred in Nepal on 25 April 2015 and 12 May 2015. In total, more than 8500 people were killed and over 18,500 people were left injured. This article aims to demonstrate the role of rehabilitation professionals in post-disaster relief and beyond in Nepal. METHOD: This is an experiential account of physiotherapists present during the earthquake and participating in the post-disaster relief. RESULTS: Rehabilitation professionals played an important role in the acute phase post-disaster by providing essential services and equipment. However, discharge planning emerged as an important role for rehabilitation providers in the early days of post-disaster and signaled a relatively new and innovative function that facilitated the heavy imbalance between little supply and tremendous demand for care. In the coming years, rehabilitation will need to support local initiatives that focus on minimizing the long-term effects among people with a newly acquired disability. CONCLUSIONS: Rehabilitation serves an important role across the continuum in post-disaster relief from the initial stages to the months and years following an event. IMPLICATIONS FOR REHABILITATION: Driven by medical advances in acute field medicine, the relative proportion of casualties following natural disasters is decreasing, while relative rates of disability are rising among survivors. In post-disaster settings, the growing number of people with newly acquired disabilities will be added to the existing proportion of the population who lived with disabilities, creating a significant growth in the total number of people with disabilities (PWDs) in communities that are often ill prepared to provide necessary services. Rehabilitation interventions in the initial stages of emergency humanitarian response can minimize the long-term effects among people with newly acquired disabilities through early activation and prevention of secondary effects. Rehabilitation providers thus appear to have an important mediating effect on outcomes of disabilities in the early stages, but must also be strong partners with PWDs to advocate for social and political change in the long term.

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The impact of widowhood on suicide and accident mortality in Ireland was investigated using Poisson regression analysis applied to routine data relating to all 10 561 suicidal and accidental deaths of married or widowed persons aged at least 35 years in Ireland during 1986–2005. Mortality rates were almost always higher among the widowed and often by a 2-fold, statistically significant difference. The excess mortality was equivalent to 2083 or 57.6% of all suicidal or accidental deaths of widowed persons in 1986–2005. Routine contact with recently widowed persons by public health professionals may be warranted with a view to reducing their excess mortality.

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Modeling Instruction (MI) has been successfully implemented in high school science classes. Moreover, MI curriculum for introductory physics has also been developed at a university level. Noticing the gap, the author will provide theoretical foundations to support the statement that MI curriculum should be developed for college biology courses.

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Improving the representation of the hydrological cycle in Atmospheric General Circulation Models (AGCMs) is one of the main challenges in modeling the Earth's climate system. One way to evaluate model performance is to simulate the transport of water isotopes. Among those available, tritium (HTO) is an extremely valuable tracer, because its content in the different reservoirs involved in the water cycle (stratosphere, troposphere, ocean) varies by order of magnitude. Previous work incorporated natural tritium into LMDZ-iso, a version of the LMDZ general circulation model enhanced by water isotope diagnostics. Here for the first time, the anthropogenic tritium injected by each of the atmospheric nuclear-bomb tests between 1945 and 1980 has been first estimated and further implemented in the model; it creates an opportunity to evaluate certain aspects of LDMZ over several decades by following the bomb-tritium transient signal through the hydrological cycle. Simulations of tritium in water vapor and precipitation for the period 1950-2008, with both natural and anthropogenic components, are presented in this study. LMDZ-iso satisfactorily reproduces the general shape of the temporal evolution of tritium. However, LMDZ-iso simulates too high a bomb-tritium peak followed by too strong a decrease of tritium in precipitation. The too diffusive vertical advection in AGCMs crucially affects the residence time of tritium in the stratosphere. This insight into model performance demonstrates that the implementation of tritium in an AGCM provides a new and valuable test of the modeled atmospheric transport, complementing water stable isotope modeling.

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Climate change and continuous urbanization contribute to an increased urban vulnerability towards flooding. Only relying on traditional flood control measures is recognized as inadequate, since the damage can be catastrophic if flood controls fail. The idea of a flood-resilient city – one which can withstand or adapt to a flood event without being harmed in its functionality – seems promising. But what does resilience actually mean when it is applied to urban environments exposed to flood risk, and how can resilience be achieved? This paper presents a heuristic framework for assessing the flood resilience of cities, for scientists and policy-makers alike. It enriches the current literature on flood resilience by clarifying the meaning of its three key characteristics – robustness, adaptability and transformability – and identifying important components to implement resilience strategies. The resilience discussion moves a step forward, from predominantly defining resilience to generating insight into “doing” resilience in practice. The framework is illustrated with two case studies from Hamburg, showing that resilience, and particularly the underlying notions of adaptability and transformability, first and foremost require further capacity-building among public as well as private stakeholders. The case studies suggest that flood resilience is currently not enough motivation to move from traditional to more resilient flood protection schemes in practice; rather, it needs to be integrated into a bigger urban agenda.

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El presente trabajo pretende analizar cuáles eran las características climáticas que se sucedían en Madrid y su Tierra a lo largo del año, fundamentalmente entre los siglos XIV y XVI. Se intentará comprobar, dentro de las limitaciones que impone la documentación de la época, si en aquel tiempo se daba también un clima mediterráneo, o no, y si este ha variado mucho desde entonces. Igualmente se podrá comprobar algo que tal vez podría, aunque no debería, sorprendernos: el hombre medieval tenía muy claros muchos conceptos meteorológicos y climatológicos, aunque siempre aprehendidos con una finalidad práctica, para aplicarlos en su vida cotidiana tan cercana y dependiente de la naturaleza.

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La ciudad ofrecía en la Baja Edad Media claras oportunidades para aquellos nobles que supieran situarse en el complejo juego de la política urbana y sus diversas instancias de poder. Para ello siempre se hace necesario contar con los apoyos sociales y físicos adecuados. La dinámica de enfrentamientos entre el Arzobispo de Santiago y el concello compostelano presenta un ejemplo inmejorable para valorar en su justa medida la inserción de la nobleza territorial en las relaciones de poder. Para abordar este caso se analizará la participación en la vida pública –también las revueltas urbanas– de la Casa de Moscoso tanto a través de su larga trayectoria de enfrentamientos con la Iglesia como mediante el estudio de su patrimonio urbano, incluyendo aquellos elementos relacionados con la creación de una memoria específica del linaje dentro de la ciudad.

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This article seeks to exemplify the extent to which oral life history research can enrich existing historiographies of English Religious Education (RE). Findings are reported from interviews undertaken with a sample of key informants involved in designing and/or implementing significant curriculum changes in RE in the 1960s and 1970s. The interviews provided insights into personal narratives and biographies that have been marginal to, or excluded from, the historical record. Thematic analysis of the oral life histories opened a window into the world of RE, specifically in relation to professional identity and practice, curriculum development, and professional organizations, thereby exposing the operational dynamics of RE at an (inter-)personal and organizational level. The findings are framed by a series of methodological reflections. Overall, oral life histories are shown to be capable of revealing that which was previously hidden and which can be confirmed and contrasted with knowledge gleaned from primary documentary sources.

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La berenjena (Solanum melongena L.) es una planta solanácea de múltiples variedades, cuyos ancestros salvajes se sitúan en Indochina y el este de África. Su cultivo fue muy temprano en zonas de China e India. Aun así, no se extendió al Occidente antiguo ni apenas se conoció, de ahí su ausencia en los textos clásicos de botánica y farmacología. Fueron los árabes quienes llevaron el cultivo de la planta por el Norte de África y Al-Andalus, de donde pasó ya a Europa. Los primeros testimonios occidentales de la berenjena aparecen en traducciones latinas de textos árabes, para incorporarse luego a la literatura farmacológica medieval y, más tarde ya, a la del Renacimiento, que empezó a tratar de ella por su posible parecido con una especie de mandrágora. Pese a que se le reconocían algunas virtudes medicinales, siempre se la tuvo bajo sospecha por ser de sabor poco agradable, indigesta y causante de algunas afecciones. Solo los botánicos de finales del Renacimiento describirían la planta y sus variedades con criterios más «científicos» y botánicos, ya sin apenas intereses farmacológicos.

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Understanding the evolution of sociality in humans and other species requires understanding how selection on social behaviour varies with group size. However, the effects of group size are frequently obscured in the theoretical literature, which often makes assumptions that are at odds with empirical findings. In particular, mechanisms are suggested as supporting large-scale cooperation when they would in fact rapidly become ineffective with increasing group size. Here we review the literature on the evolution of helping behaviours (cooperation and altruism), and frame it using a simple synthetic model that allows us to delineate how the three main components of the selection pressure on helping must vary with increasing group size. The first component is the marginal benefit of helping to group members, which determines both direct fitness benefits to the actor and indirect fitness benefits to recipients. While this is often assumed to be independent of group size, marginal benefits are in practice likely to be maximal at intermediate group sizes for many types of collective action problems, and will eventually become very small in large groups due to the law of decreasing returns. The second component is the response of social partners on the past play of an actor, which underlies conditional behaviour under repeated social interactions. We argue that under realistic conditions on the transmission of information in a population, this response on past play decreases rapidly with increasing group size so that reciprocity alone (whether direct, indirect, or generalised) cannot sustain cooperation in very large groups. The final component is the relatedness between actor and recipient, which, according to the rules of inheritance, again decreases rapidly with increasing group size. These results explain why helping behaviours in very large social groups are limited to cases where the number of reproducing individuals is small, as in social insects, or where there are social institutions that can promote (possibly through sanctioning) large-scale cooperation, as in human societies. Finally, we discuss how individually devised institutions can foster the transition from small-scale to large-scale cooperative groups in human evolution.

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Relatório de estágio apresentado à Escola Superior de Educação de Paula Frassinetti para obtenção de grau de Mestre em Ensino do 1º e do 2º Ciclo do Ensino Básico