Autocuidados e automedicação na temática da obstipação

Atualmente, consideram-se os autocuidados como a primeira forma de prevenção e tratamento de doenças. Através de alterações no estilo de vida e da automedicação é possível obter enormes benefícios, não só na saúde mas também na economia do próprio país. Para que estas medidas sejam eficazes e seguras, é essencial garantir a formação e informação da sociedade, sendo os profissionais de saúde os principais intervenientes neste processo. Assim, o farmacêutico deve intervir junto da população, não só na promoção da saúde, como também no incentivo ao uso racional dos medicamentos. São diversas as situações passíveis de automedicação e são igualmente vários os casos de utilização incorreta de medicamentos neste contexto. Assim, optou-se por destacar a automedicação na obstipação com recurso não só a Medidas Não Farmacológicas, como também à utilização de laxantes. A obstipação é um conjunto de sintomas associado a determinada causa. Fatores desencadeantes podem ser de origem patológica ou de origem comportamental, destacando-se o stress, polimedicação e hábitos de consumo. Os laxantes são normalmente utilizados no tratamento da obstipação, no entanto, temse conhecimento que podem ser indevidamente usados para outros fins, nomeadamente em contexto de distúrbios alimentares. A dependência destes medicamentos é elevada quando utilizados de forma incorreta, por tempo prolongado e em elevada frequência. Deste modo, o presente estudo tem como principais objetivos percecionar quais as possíveis causas da obstipação; avaliar a utilização de laxantes; identificar que tipo de intervenção é feita pelo farmacêutico nesta temática; avaliar qual o grau de conhecimento da sociedade relativamente à obstipação e ao uso de laxantes e elaborar o Protocolo de Intervenção Farmacêutica na obstipação. Trata-se de um estudo descritivo e transversal que se baseou na realização de um questionário de resposta fechada a utentes da Farmácia Damaia. Foram inquiridos 300 voluntários, de ambos os géneros, com idades compreendidas entre os 1-88 anos (45,15 ± 20,16 anos), após consentimento de participação. O questionário abordou diversas áreas, nomeadamente estilo de vida, rotinas e hábitos defecatórios e xvi utilização de laxantes. Os dados foram tratados no programa Microsoft Excel® 2007 e posteriormente analisados. Através do estudo foi possível percecionar que são várias as falhas existentes ao nível dos conhecimentos da população, nomeadamente em relação aos princípios básicos do funcionamento intestinal. Este estudo também demonstrou que existem lacunas nos conhecimentos acerca dos tipos de obstipação e na utilização de laxantes. Torna-se percetível que é fundamental o processo de instrução da população em relação a esta e outras temáticas relacionadas com a saúde. Assim, o farmacêutico deve tornar-se mais pró-ativo e intervir nesta área, para benefício de toda a sociedade.

An analysis of the relationship between immittance results and AC/BC

This paper analyzes subjects with air bone (A/B) gaps (a comparison of air-conducted thresholds and bone-conducted thresholds) and whether tympanometry (the type of tympanogram, static admittance, or peak pressure) can predict the size of the A/B gap.

Recuentos de dos ciudades: Guayaquil en 1899 y Quito en 1906 (Estudios)

Estudio preliminar del desarrollo demográfico de Guayaquil y Quito a fines el siglo XIX e inicios del siglo XX, basado en los censos proto-estadísticos realizados en ambas ciudades en 1899 y 1906, respectivamente. Se estudian las condiciones en las que se realizaron ambos censos, la información cuantitativa que ofrecen y los vacíos que la historia demográfica aún mantiene. El artículo enfatiza en una perspectiva de análisis comparativo entre las dos principales ciudades del Ecuador. Se examina la composición poblacional en términos de grupos de edad, sexo, ocupación, matrimonio, natalidad, mortalidad y educación.

Operación masacre: la fundación mitológica del testimonio (Estudios)

A partir de Operación masacre, de Rodolfo Walsh, la autora distingue, en este ensayo, el testimonio de otras narrativas. Señala que no es literatura de bandidos, porque el sustrato son memorias de víctimas o de sobrevivientes de la impune violencia de Estado. Afirma que tampoco es reportaje o crónica periodística: en estos últimos no median una serie de entrevistas orales ni se plantean imágenes históricas totalizadoras. La autora insiste en el carácter revolucionario del testimonio, que busca construir una verdad absoluta, un discurso sin fisuras. A diferencia de la novela-testimonio, que es instrumento de conocimiento, este género tendría un sentido fundamentalmente histórico. Sostiene que, en Argentina, las víctimas directas de la violencia son quienes pueden solicitar reparación, por eso, los escritores de testimonio de la posdictadura se debaten entre la pertenencia al grupo de víctimas y la voluntad de asumir las causas políticas. Nofal concluye que Walsh, a diferencia de ellos, toma la palabra y dice la verdad desde su lugar de ciudadano y desde el espacio literario.

Roberto Arlt, la nación y su angustiosa trayectoria (Dossier: Literaturas de la integración, el Sur y su diversidad)

En las primeras décadas del siglo XX, la Argentina sufrió un desajuste económico y social respecto del plan estratégico de 1880. Los acontecimientos históricos rompieron el modelo de la prosperidad infinita y pusieron de manifiesto la disolución del ser nacional en revueltas militares, fraude electoral, corrupción, caudillismo y brechas profundas entre regiones y clases sociales. Hacia 1930, la escritura de Roberto Artl se presenta como un cuestionamiento acerca de los límites del proyecto modernizador y de las instancias más significativas del mandato de progreso histórico. Los personajes de sus ficciones le permiten al escritor proyectar una interpretación no solo de su ser caído y angustiado, sino también del sujeto desligado de aquella sociabilidad propuesta por la generación de los románticos y que en 1880 parecía determinar una identidad estable, según reglas aparentemente seguras. El escritor posee la visión de que 1930 es el momento histórico que exige otro estatuto de lo real. El efecto de lectura de la obra de Arlt reside en la manipulación indefinida del lenguaje literario a través de la propuesta de personajes anclados en la percepción de un mundo que los excluye y de una peripecia narrativa que devela la descentración de la Historia como relato total. Consecuentemente, su eficacia es impactar y movilizar el cuerpo social a través de la producción imaginaria como una versión literaria de la Historia.

Numerical Response of Breeding Birds Following Experimental Selection Harvesting in Northern Hardwood Forests

Silvicultural treatments have been shown to alter the composition of species assemblages in numerous taxa. However, the intensity and persistence of these effects have rarely been documented. We used a before-after, control-impact (BACI) paired design, i.e., five pairs of 25-ha study plots, 1-control and 1-treated plot, to quantify changes in the density of eight forest bird species in response to selection harvesting over six breeding seasons, one year pre- and five years postharvest. Focal species included mature forest associates, i.e., Northern Parula (Setophaga americana) and Black-throated Green Warbler (Setophaga virens), forest generalists, i.e., Yellow-bellied Sapsucker (Sphyrapicus varius) and Swainson’s Thrush (Catharus ustulatus), early-seral specialists, i.e., Mourning Warbler (Geothlypis philadelphia) and Chestnut-sided Warbler (Setophaga pensylvanica), species associated with shrubby forest gaps, i.e., Black-throated Blue Warbler (Setophaga caerulescens), and mid-seral species, i.e., American Redstart (Setophaga ruticilla). As predicted, we found a negative numerical response to the treatment in the Black-throated Green Warbler, no treatment effect in the Yellow-bellied Sapsucker, and a positive treatment effect in early-seral specialists. We only detected a year effect in the Northern Parula and the American Redstart. There was evidence for a positive treatment effect on the Swainson’s Thrush when the regeneration started to reach the pole stage, i.e., fifth year postharvest. These findings suggest that selection harvesting has the potential to maintain diverse avian assemblages while allowing sustainable management of timber supply, but future studies should determine whether mature-forest associates can sustain second- and third-entry selection harvest treatments.

Mortality of Migratory Birds from Marine Commercial Fisheries and Offshore Oil and Gas Production in Canada

There is an imminent need for conservation and best-practice management efforts in marine ecosystems where global-scale declines in the biodiversity and biomass of large vertebrate predators are increasing and marine communities are being altered. We examine two marine-based industries that incidentally take migratory birds in Canada: (1) commercial fisheries, through bycatch, and (2) offshore oil and gas exploration, development, and production. We summarize information from the scientific literature and technical reports and also present new information from recently analyzed data to assess the magnitude and scope of mortality. Fisheries bycatch was responsible for the highest levels of incidental take of migratory bird species; estimated combined take in the longline, gillnet, and bottom otter trawl fisheries within the Atlantic, including the Gulf of St. Lawrence, and Pacific regions was 2679 to 45,586 birds per year. For the offshore oil and gas sector, mortality estimates ranged from 188 to 4494 deaths per year due to the discharge of produced waters resulting in oil sheens and collisions with platforms and vessels; however these estimates for the oil and gas sector are based on many untested assumptions. In spite of the uncertainties, we feel levels of mortality from these two industries are unlikely to affect the marine bird community in Canada, but some effects on local populations from bycatch are likely. Further research and monitoring will be required to: (1) better estimate fisheries-related mortality for vulnerable species and populations that may be impacted by local fisheries, (2) determine the effects of oil sheens from produced waters, and attraction to platforms and associated mortality from collisions, sheens, and flaring, so that better estimates of mortality from the offshore oil and gas sector can be obtained, and (3) determine impacts associated with accidental spills, which are not included in our current assessment. With a better understanding of the direct mortality of marine birds from industry, appropriate mitigation and management actions can be implemented. Cooperation from industry for data collection, research to fill knowledge gaps, and implementation of mitigation approaches will all be needed to conserve marine birds in Canada.

Gray-cheeked Thrush (Catharus minimus minimus) distribution and habitat use in a montane forest landscape of western Newfoundland, Canada

Once abundant, the Newfoundland Gray-cheeked Thrush (Catharus minimus minimus) has declined by as much as 95% since 1975. Underlying cause(s) of this population collapse are not known, although hypotheses include loss of winter habitat and the introduction of red squirrels (Tamiasciurus hudsonicus) to Newfoundland. Uncertainties regarding habitat needs are also extensive, and these knowledge gaps are an impediment to conservation. We investigated neighborhood (i.e., within 115 m [4.1 ha]) and landscape scale (i.e., within 1250 m [490.8 ha]) habitat associations of Gray-cheeked Thrush in a 200-km² study area in the Long Range Mountains of western Newfoundland, where elevations range from 300-600 m and landcover was a matrix of old growth fir forest, 6- to 8-year-old clearcuts, coniferous scrub, bogs, and barrens. Thrushes were restricted to elevations above ~375 m, and occurrence was strongly positively related to elevation. Occurrence was also positively related to cover of tall scrub forest at the neighborhood scale, and at the landscape scale showed curvilinear relations with the proportion of both tall scrub and old growth forest that peaked with intermediate amounts of cover. Occurrence of thrushes was also highest when clearcuts made up 60%-70% of neighborhood landcover, but was negatively related to cover of clearcuts in the broader landscape. Finally, occurrence was highest in areas having 50% cover of partially harvested forest (strip cuts or row cuts) at the neighborhood scale, but because this treatment was limited to one small portion of the study area, this finding may be spurious. Taken together, our results suggest selection for mixed habitats and sensitivity to both neighborhood and landscape-scale habitat. More research is needed on responses of thrushes to forestry, including use of older clearcuts, partially harvested stands, and precommercially thinned clearcuts. Finally, restriction of thrushes to higher elevations is consistent with the hypothesis that they have been impacted by squirrels, because squirrels were rare or absent at these elevations.

An ontological approach to competency management

Competency management is a very important part of a well-functioning organisation. Unfortunately competency descriptions are not uniformly specified nor defined across borders: National, sectorial or organisational, leading to an opaque competency description market with a multitude of competency frameworks and competency benchmarks. An ontology is a formalised description of a domain, which enables automated reasoning engines to be built which by utilising the interrelations between entities can make “intelligent” choices in different situations within the domain. Introducing formalised competency ontologies automated tools, such as skill gap analysis, training suggestion generation, job search and recruitment, can be developed, which compare and contrast different competency descriptions on the semantic level. The major problem with defining a common formalised ontology for competencies is that there are so many viewpoints of competencies and competency frameworks. Work within the TRACE project has focused on finding common trends within different competency frameworks in order to allow an intermediate competency description to be made, which other frameworks can reference. This research has shown that competencies can be divided up into “knowledge”, “skills” and what we call “others”. An ontology has been created based on this with a simple structure of different “kinds” of “knowledges” and “skills” using semantic interrelations to define the basic semantic structure of the ontology. A prototype tool for analysing a skill gap analysis has been developed. Personal profiles can be produced using the tool and a skill gap analysis is performed on a desired competency profile by using an ontologically based inference engine, which is able to list closest fit and possible proficiency gaps

Preparation of consistent soil data sets for modelling purposes: Secondary SOTER data for four case study areas

The common GIS-based approach to regional analyses of soil organic carbon (SOC) stocks and changes is to define geographic layers for which unique sets of driving variables are derived, which include land use, climate, and soils. These GIS layers, with their associated attribute data, can then be fed into a range of empirical and dynamic models. Common methodologies for collating and formatting regional data sets on land use, climate, and soils were adopted for the project Assessment of Soil Organic Carbon Stocks and Changes at National Scale (GEFSOC). This permitted the development of a uniform protocol for handling the various input for the dynamic GEFSOC Modelling System. Consistent soil data sets for Amazon-Brazil, the Indo-Gangetic Plains (IGP) of India, Jordan and Kenya, the case study areas considered in the GEFSOC project, were prepared using methodologies developed for the World Soils and Terrain Database (SOTER). The approach involved three main stages: (1) compiling new soil geographic and attribute data in SOTER format; (2) using expert estimates and common sense to fill selected gaps in the measured or primary data; (3) using a scheme of taxonomy-based pedotransfer rules and expert-rules to derive soil parameter estimates for similar soil units with missing soil analytical data. The most appropriate approach varied from country to country, depending largely on the overall accessibility and quality of the primary soil data available in the case study areas. The secondary SOTER data sets discussed here are appropriate for a wide range of environmental applications at national scale. These include agro-ecological zoning, land evaluation, modelling of soil C stocks and changes, and studies of soil vulnerability to pollution. Estimates of national-scale stocks of SOC, calculated using SOTER methods, are presented as a first example of database application. Independent estimates of SOC stocks are needed to evaluate the outcome of the GEFSOC Modelling System for current conditions of land use and climate. (C) 2007 Elsevier B.V. All rights reserved.

Flow controls on lowland river macrophytes: A review

We review the current status of knowledge regarding the role that flow parameters play in controlling the macrophyte communities of temperate lowland rivers. We consider both direct and indirect effects and the interaction with other factors known to control macrophyte communities. Knowledge gaps are identified and implications for the management of river systems considered. The main factors and processes controlling the status of macrophytes in lowland rivers are velocity (hence also discharge), light, substrate, competition, nutrient status and river management practices. We suggest that whilst the characteristics of any particular macrophyte community reflect the integral effects of a combination of the factors, fundamental importance can be attributed to the role of discharge and velocity in controlling instream macrophyte colonisation, establishment and persistence. Velocity and discharge also appear to control the relative influence of some of the other controlling factors. Despite the apparent importance of velocity in determining the status of macrophyte communities in lowland rivers, relatively little is understood about the nature of the processes controlling this relationship. Quantitative knowledge is particularly lacking. Consequently, the ability to predict macrophyte abundance and distribution in rivers is still limited. This is further complicated by the likely existence of feedback effects between the growth of macrophytes and velocity. Demand for water resources increases the pressure on lowland aquatic ecosystems. Despite growing recognition of the need to allocate water for the needs of instream biota, the inability to assess the flow requirements of macrophyte communities limits the scope to achieve this. This increases the likelihood of overexploitation of the water resource as other users, whose demands are quantifiable, are prioritised. (C) 2008 Elsevier B.V. All rights reserved.

Exploiting CAFS-ISP

In the summer of 1982, the ICLCUA CAFS Special Interest Group defined three subject areas for working party activity. These were: 1) interfaces with compilers and databases, 2) end-user language facilities and display methods, and 3) text-handling and office automation. The CAFS SIG convened one working party to address the first subject with the following terms of reference: 1) review facilities and map requirements onto them, 2) "Database or CAFS" or "Database on CAFS", 3) training needs for users to bridge to new techniques, and 4) repair specifications to cover gaps in software. The working party interpreted the topic broadly as the data processing professional's, rather than the end-user's, view of and relationship with CAFS. This report is the result of the working party's activities. The report content for good reasons exceeds the terms of reference in their strictest sense. For example, we examine QUERYMASTER, which is deemed to be an end-user tool by ICL, from both the DP and end-user perspectives. First, this is the only interface to CAFS in the current SV201. Secondly, it is necessary for the DP department to understand the end-user's interface to CAFS. Thirdly, the other subjects have not yet been addressed by other active working parties.

Methodology for assessing the appropriateness of Continuing Professional Development for pharmacy professionals’ revalidation

From April 2010, the General Pharmaceutical Council (GPhC) will be responsible for the statutory regulation of pharmacists and pharmacy technicians in Great Britain (GB).[1] All statutorily regulated health professionals will need to periodically demonstrate their fitness-to-practise through a process of revalidation.[2] One option being considered in GB is that continuing professional development (CPD) records will form a part of the evidence submitted for revalidation, similar to the system in New Zealand.[3] At present, pharmacy professionals must make a minimum of nine CPD entries per annum from 1 March 2009 using the Royal Pharmaceutical Society of Great Britain (RPSGB) CPD framework. Our aim was to explore the applicability of new revalidation standards within the current CPD framework. We also wanted to review the content of CPD portfolios to assess strengths and qualities and identify any information gaps for the purpose of revalidation.

The social impacts of heat waves

The effects of the 2003 European heat wave have highlighted the need for society to prepare itself for and cope more effectively with heat waves. This is particularly important in the context of predicted climate change and the likelihood of more frequent extreme climate events; to date, heat as a natural hazard has been largely ignored. In order to develop better coping strategies, this report explores the factors that shape the social impacts of heat waves, and sets out a programme of research to address the considerable knowledge gaps in this area. Heat waves, or periods of anomalous warmth, do not affect everyone; it is the vulnerable individuals or sectors of society who will most experience their effects. The main factors of vulnerability are being elderly, living alone, having a pre-existing disease, being immobile or suffering from mental illness and being economically disadvantaged. The synergistic effects of such factors may prove fatal for some. Heat waves have discernible impacts on society including a rise in mortality, an increased strain on infrastructure (power, water and transport) and a possible rise in social disturbance. Wider impacts may include effects on the retail industry, ecosystem services and tourism. Adapting to more frequent heat waves should include soft engineering options and, where possible, avoid the widespread use of air conditioning which could prove unsustainable in energy terms. Strategies for coping with heat include changing the way in which urban areas are developed or re-developed, and setting up heat watch warning systems based around weather and seasonal climate forecasting and intervention strategies. Although heat waves have discernible effects on society, much remains unknown about their wider social impacts, diffuse health issues and how to manage them.

A baseline appraisal of water-dependant ecosystem services, the roles they play within desakota livelihood systems and their potential sensitivity to climate change

This report forms part of a larger research programme on 'Reinterpreting the Urban-Rural Continuum', which conceptualises and investigates current knowledge and research gaps concerning 'the role that ecosystems services play in the livelihoods of the poor in regions undergoing rapid change'. The report aims to conduct a baseline appraisal of water-dependant ecosystem services, the roles they play within desakota livelihood systems and their potential sensitivity to climate change. The appraisal is conducted at three spatial scales: global, regional (four consortia areas), and meso scale (case studies within the four regions). At all three scales of analysis water resources form the interweaving theme because water provides a vital provisioning service for people, supports all other ecosystem processes and because water resources are forecast to be severely affected under climate change scenarios. This report, combined with an Endnote library of over 1100 scientific papers, provides an annotated bibliography of water-dependant ecosystem services, the roles they play within desakota livelihood systems and their potential sensitivity to climate change. After an introductory, section, Section 2 of the report defines water-related ecosystem services and how these are affected by human activities. Current knowledge and research gaps are then explored in relation to global scale climate and related hydrological changes (e.g. floods, droughts, flow regimes) (section 3). The report then discusses the impacts of climate changes on the ESPA regions, emphasising potential responses of biomes to the combined effects of climate change and human activities (particularly land use and management), and how these effects coupled with water store and flow regime manipulation by humans may affect the functioning of catchments and their ecosystem services (section 4). Finally, at the meso-scale, case studies are presented from within the ESPA regions to illustrate the close coupling of human activities and catchment performance in the context of environmental change (section 5). At the end of each section, research needs are identified and justified. These research needs are then amalgamated in section 6.