Grau de procura da acupunctura como opção terapêutica numa amostra da população de Lisboa

Este é um estudo exploratório e correlacional, com um número inicial de 150 participantes, utilizando uma amostra de conveniência constituída por cinco clínicas médicas e cinco casas de medicina tradicional chinesa, em Lisboa, onde os indivíduos foram autorizados a responder voluntariamente a questionários. Apresenta uma taxa de resposta de 74% (N=111). A adesão à acupunctura é maior no sexo feminino e na faixa etária de 31 a 50 anos (40% homens e 48% mulheres). A procura de tratamento de problemas musculares e articulares e para problemas do foro psicológico são as mais descritas, apesar de ser referida como eficaz noutro tipo de queixas, e não ser o primeiro tipo de tratamento que a população procura. É reconhecido que os resultados podem ocorrer a médio e longo prazo, após várias sessões terapêuticas, o que não parece afetar a perceção da população em estudo que se diz satisfeita (53%) com uma muita boa e / ou boa relação benefício-custo. Em geral, a maioria da população (93%) confia na terapia pelo resultado bom ou muito bom (79%) ou razoável (16%) obtido, e deposita confiança (88%) nas competências do profissional de saúde que executa a acupunctura.

El multilateralismo ante el entredicho y la encrucijada (Tema Central)

El artículo plantea cómo la decisión tomada por Estados Unidos de atacar a Iraq se contrapone a la naturaleza del multilateralismo y atenta contra la normatividad jurídica vigente -Derecho Internacional-. El autor presenta a la ""acción preventiva"" y a la ""confrontación entre el bien el mal"" como los pilares de la visión internacional norteamericana guiada actualmente por los neoconservadores, propone la necesidad de que el multilateralismo se renueve para que no pierda vigencia.

"Ella", de Juan Carlos Onetti. Necrofilia y ficción (Homenaje)

La autora reflexiona sobre el relato “Ella”, del uruguayo Juan Carlos Onetti, y sobre otras representaciones de la muerte de Eva Perón, escritas por Jorge Luis Borges, David Viñas y Néstor Perlongher. Afirma que en la Argentina de Perón ya confluían realidad y ficción, y que las múltiples biografías de Eva serían “un duelo de versiones narrativas entre la ficción y la historia o, si se prefiere, una metáfora de la historia”. Rosano plantea que, en los textos revisados, es la realidad la que adopta contornos fantasmagóricos, disparados por motivos diversos: la descomposición y el tópico del mal olor, la impostura del cuerpo embalsamado y del mandatario, el entrelazamiento entre lo político y lo sexual en la escena del velorio, la imagen de Eva, “una diosa que muestra sus encajes de novia de suburbio” pero también una siniestra y doliente “zombi escarlata”. Señala, finalmente, que los textos muestran a los fieles, esos “miles de necrófilos murmurantes y enlutados”, sometidos a la potencia del mito.

Multivariable cluster analysis for high-speed industrial machinery

The overall operation and internal complexity of a particular production machinery can be depicted in terms of clusters of multidimensional points which describe the process states, the value in each point dimension representing a measured variable from the machinery. The paper describes a new cluster analysis technique for use with manufacturing processes, to illustrate how machine behaviour can be categorised and how regions of good and poor machine behaviour can be identified. The cluster algorithm presented is the novel mean-tracking algorithm, capable of locating N-dimensional clusters in a large data space in which a considerable amount of noise is present. Implementation of the algorithm on a real-world high-speed machinery application is described, with clusters being formed from machinery data to indicate machinery error regions and error-free regions. This analysis is seen to provide a promising step ahead in the field of multivariable control of manufacturing systems.

Does increased hydrochemical model complexity decrease robustness?

The aim of this study was, within a sensitivity analysis framework, to determine if additional model complexity gives a better capability to model the hydrology and nitrogen dynamics of a small Mediterranean forested catchment or if the additional parameters cause over-fitting. Three nitrogen-models of varying hydrological complexity were considered. For each model, general sensitivity analysis (GSA) and Generalized Likelihood Uncertainty Estimation (GLUE) were applied, each based on 100,000 Monte Carlo simulations. The results highlighted the most complex structure as the most appropriate, providing the best representation of the non-linear patterns observed in the flow and streamwater nitrate concentrations between 1999 and 2002. Its 5% and 95% GLUE bounds, obtained considering a multi-objective approach, provide the narrowest band for streamwater nitrogen, which suggests increased model robustness, though all models exhibit periods of inconsistent good and poor fits between simulated outcomes and observed data. The results confirm the importance of the riparian zone in controlling the short-term (daily) streamwater nitrogen dynamics in this catchment but not the overall flux of nitrogen from the catchment. It was also shown that as the complexity of a hydrological model increases over-parameterisation occurs, but the converse is true for a water quality model where additional process representation leads to additional acceptable model simulations. Water quality data help constrain the hydrological representation in process-based models. Increased complexity was justifiable for modelling river-system hydrochemistry. Increased complexity was justifiable for modelling river-system hydrochemistry.

Multimodel projections of stratospheric ozone in the 21st century

Simulations from eleven coupled chemistry-climate models (CCMs) employing nearly identical forcings have been used to project the evolution of stratospheric ozone throughout the 21st century. The model-to-model agreement in projected temperature trends is good, and all CCMs predict continued, global mean cooling of the stratosphere over the next 5 decades, increasing from around 0.25 K/decade at 50 hPa to around 1 K/ decade at 1 hPa under the Intergovernmental Panel on Climate Change (IPCC) Special Report on Emissions Scenarios (SRES) A1B scenario. In general, the simulated ozone evolution is mainly determined by decreases in halogen concentrations and continued cooling of the global stratosphere due to increases in greenhouse gases (GHGs). Column ozone is projected to increase as stratospheric halogen concentrations return to 1980s levels. Because of ozone increases in the middle and upper stratosphere due to GHGinduced cooling, total ozone averaged over midlatitudes, outside the polar regions, and globally, is projected to increase to 1980 values between 2035 and 2050 and before lower stratospheric halogen amounts decrease to 1980 values. In the polar regions the CCMs simulate small temperature trends in the first and second half of the 21st century in midwinter. Differences in stratospheric inorganic chlorine (Cly) among the CCMs are key to diagnosing the intermodel differences in simulated ozone recovery, in particular in the Antarctic. It is found that there are substantial quantitative differences in the simulated Cly, with the October mean Antarctic Cly peak value varying from less than 2 ppb to over 3.5 ppb in the CCMs, and the date at which the Cly returns to 1980 values varying from before 2030 to after 2050. There is a similar variation in the timing of recovery of Antarctic springtime column ozone back to 1980 values. As most models underestimate peak Cly near 2000, ozone recovery in the Antarctic could occur even later, between 2060 and 2070. In the Arctic the column ozone increase in spring does not follow halogen decreases as closely as in the Antarctic, reaching 1980 values before Arctic halogen amounts decrease to 1980 values and before the Antarctic. None of the CCMs predict future large decreases in the Arctic column ozone. By 2100, total column ozone is projected to be substantially above 1980 values in all regions except in the tropics.

Discovery of novel GPVI receptor antagonists by structure-based repurposing.

Inappropriate platelet aggregation creates a cardiovascular risk that is largely managed with thienopyridines and aspirin. Although effective, these drugs carry risks of increased bleeding and drug 'resistance', underpinning a drive for new antiplatelet agents. To discover such drugs, one strategy is to identify a suitable druggable target and then find small molecules that modulate it. A good and unexploited target is the platelet collagen receptor, GPVI, which promotes thrombus formation. To identify inhibitors of GPVI that are safe and bioavailable, we docked a FDA-approved drug library into the GPVI collagen-binding site in silico. We now report that losartan and cinanserin inhibit GPVI-mediated platelet activation in a selective, competitive and dose-dependent manner. This mechanism of action likely underpins the cardioprotective effects of losartan that could not be ascribed to its antihypertensive effects. We have, therefore, identified small molecule inhibitors of GPVI-mediated platelet activation, and also demonstrated the utility of structure-based repurposing.

Regulation of Bcl-xL expression by H2O2 in cardiac myocytes.

Oxidative stress promotes cardiac myocyte apoptosis through the mitochondrial death pathway. Since Bcl-2 family proteins are key regulators of apoptosis, we examined the effects of H2O2 on the expression of principal Bcl-2 family proteins (Bcl-2, Bcl-xL, Bax, Bad) in neonatal rat cardiac myocytes. Protein expression was assessed by immunoblotting. Bcl-2, Bax, and Bad were all down-regulated in myocytes exposed to 0.2 mm H2O2, a concentration that induces apoptosis. In contrast, although Bcl-xL levels initially declined, the protein was re-expressed from 4-6 h. Bcl-xL mRNA was up-regulated from 2 to 4 h in neonatal rat or mouse cardiac myocytes exposed to H2O2, consistent with the re-expression of protein. Four different untranslated first exons have been identified for the Bcl-x gene (exons 1, 1B, 1C, and 1D, where exon 1 is the most proximal and exon 1D the most distal to the coding region). All were detected in mouse or rat neonatal cardiac myocytes, but exon 1D was not expressed in adult mouse hearts. In neonatal mouse or rat cardiac myocytes, H2O2 induced the expression of exons 1B, 1C, and 1D, but not exon 1. These data demonstrate that the Bcl-x gene is selectively responsive to oxidative stress, and the response is mediated through distal promoter regions.

Upplevelser av stöd från diabetessjuksköterskan hos personer med diabetes typ 1 : – Sekundäranalys av en kvalitativ intervjustudie

Introduction: Type 1 diabetes is a chronic disease that affects the individual in everyday life. The diabetes team sets the treatment goals together with the patient aiming for a good quality of life and to prevent complications. The diabetes nurse should include in-depth knowledge of the daily life of people with diabetes, and have respect for the individual's choices and life situation. Aim: To describe how people with type 1 diabetes experience the support from the diabetes nurse. Method: A qualitative content analysis with an inductive approach has been used. A secondary analysis including semi-structured interviews with 15 adults (> 18 years) with type 1 diabetes was conducted. Result: The result was summarized with an overall theme "At the clinic - experience of the support offered" describes how people experience the support from their diabetes nurse. The theme constituted three categories "Access to the diabetes nurse", "The diabetes nurse - a source of information and knowledge that might need to be complemented with the support from other professionals" and,"Mutual trust - the patient's experience of the district nurse as a discussion partner and support". Conclusion: The results showed that the accessibility to diabetes nurses was experienced as good. It was simple and easy to make contact. The diabetes nurses were experienced to be engaged and provide good support to the patients. A good dialogue with the diabetes nurse and commitment from the diabetes nurse were mentioned as important factors that made the visits to be experienced as good and important. There were requests for greater access and expanded opportunities for help from counselors, as well as an increased focus on how the person is feeling.

Sjuksköterskors upplevelser av att vårda patienter med smärta En litteraturöversikt

Bakgrund: Smärta är en individuell upplevelse och smärta är en stor orsak till att befolkningen söker vård. För att ge säker och god vård krävs det att sjuksköterskor ska kunna bedöma och utvärdera patienternas smärta. Sjuksköterskors upplevelser kan orsaka ett flertal hinder som kan göra att en god och säker vård inte kan uppnås. Syfte: Att beskriva sjuksköterskors upplevelser av att vårda patienter med smärta. Metod: Litteraturöversikt som är baserad på 15 vetenskapliga artiklar med både kvalitativ- och kvantitativansats. Resultat: Denna litteraturstudies resultat visade att sjuksköterskor upplever kunskapsbrist när det gäller att vårda patienter med smärta. Sjuksköterskor upplever sig otillräckliga och frustrerade över att inte kunna ge en optimal smärtlindring samt en stor rädsla att starta ett missbruk hos patienterna. Slutsats: Det är viktigt att fortsätta forska på sjuksköterskors upplevelser för att kunna tydliggöra eventuella hinder som försvårar arbetet med att ge god och säker vård till patienter med smärta.

Omvårdnadsåtgärder till patienter med diagnosen KOL : En litteraturstudie

Bakgrund: Kronisk obstruktiv lungsjukdom(KOL) är en långsiktig sjukdom som tar tid innan den visar symtom. När patienten kommer och vill ha information och åtgärder för sina symtom har sjukdomsförloppet redan pågått ett tag. Eftersom den är långdragen är omvårdnadsåtgärderna olika beroende på vart i tiden man ligger i sjukdomen. År 2020 kommer denna patientgrupp vara den tredje största i världen, finns det omvårdnadsåtgärder som ökar livskvalitén för denna patientgrupp? Syfte: Syftet med litteraturstudien var att sammanställa resultat avseende forskning om omvårdnad vid kronisk obstruktiv lungsjukdom som leder till förbättrad livskvalité. Metod: Litteratur studie. Resultat: Kunskapsutbytet mellan patient och sjuksköterska: Hur viktigt det är med en klar och tydlig information vid möte mellan sjuksköterska och patient. Att ge stöd och trygghet: Viktigt att sjuksköterskan finns tillgänglig för patienten, underlätta för patienten: Sjuksköterskan har en viktig roll hos patienter med KOL för att förbättra deras förutsättningar för god livskvalité. Slutsats: Viktigt att skapa en tillit mellan sjuksköterskan och patienten, detta skapar trygghet och resulterar till en god fysisk omvårdnad. När trygghet och tillit har byggts upp mellan sjuksköterskan och patienten blir kommunikationen god och man kan tillsammans komma fram till den bästa lösningen för varje enskild patient.

Perspective: LaGuardia Community College Newsletter (Fall 1981)

Vol. 10 No, 1 Fall 1981; Perspective is a quarterly publication of LaGuardia Community College / CUNY which is designed and edited by the Office of Communications, Bill Freeland, director. Information on news and features stories should be addressed to the office In room M194. Faculty and staff news items should be sent to Dr. Roberta Matthews, Associate Dean of Faculty, room SB65.

Perspective: LaGuardia Community College Newsletter (Spring 1981)

Vol.9 No.1 Spring 1981; Perspective is a quarterly publication of LaGuardia Community College / CUNY which is designed and edited by the Office of Communications, Bill Freeland, director. Information on news and features stories should be addressed to the office In room M194. Faculty and staff news items should be sent to Dr. Roberta Matthews, Associate Dean of Faculty, room SB65.

Perspective: LaGuardia Community College Newsletter (Fall 1982)

Vol. 11 No. 1; Perspective is a quarterly publication of LaGuardia Community College / CUNY which is designed and edited by the Office of Communications, Bill Freeland, director. Information on news and features stories should be addressed to the office In room M194. Faculty and staff news items should be sent to Dr. Roberta Matthews, Associate Dean of Faculty, room SB65.