924 resultados para Sick person
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En el present estudi s’han analitzat quines són les fonts energètiques utilitzades a les llars de Haër, així com les repercussions que aquestes tenen sobre el medi natural i socioeconòmic de les famílies. Per tal de poder identificar quines són aquestes fonts i els seus efectes, s’ha realitzat un inventari i una diagnosi energètica. S’ha estudiat l’ús de l’energia en dos àmbits domèstics principals: la il·luminació i el cuinat, analitzant la freqüència d’ús i quantificant el consum energètic familiar. Les fonts energètiques detectades són: llenya, carbó, gas, querosè, piles i espelmes, de les quals, la llenya, el querosè i el carbó són les majoritàriament utilitzades. El consum energètic per càpita és de 2.100 kWh/any. Per altra banda, l’obtenció d’algunes d’aquestes fonts energètiques, suposen un cost econòmic molt elevat per les economies familiars, arribant a suposar un 60% dels ingressos. A partir de les dades obtingudes a la diagnosi, s’ha aplicat un indicador per tal de quantificar la magnitud de l’impacte sobre el medi produït pel model energètic seguit dins de les llars. L’indicador estudiat ha estat la petjada energètica, amb la qual s’ha traduït aquest consum en unitats de superfície biològicament productiva, requerida per absorbir el CO2 emès. El resultat ha estat que una persona produeix anualment 2,09·10-2 tCO2, que requereix de 7,53·10-3 gha/persona de superfície forestal per ser absorbides. S’ha comparat aquest resultat amb la petjada energètica domèstica calculada pel poble d’Araós, el qual, amb un model energètic totalment diferent, té una petjada energètica de 1,53 gha/persona. Un cop detectats els problemes o impactes causats pel model energètic actual, es proposa una alternativa energètica per tal de reemplaçar algunes fonts convencionals, principalment el querosè dels quinqués. Així doncs, mitjançant l’aprofitament de l’energia solar, es plantegen dos models fotovoltaics adaptats a dues tipologies de llars diferents, amb l’objectiu de minimitzar el cost i optimitzar els recursos energètics. Finalment es planteja una solució financera per abordar el cost inicial de la instal·lació solar.
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BACKGROUND: Sudden cardiac death (SCD) among the young is a rare and devastating event, but its exact incidence in many countries remains unknown. An autopsy is recommended in every case because some of the cardiac pathologies may have a genetic origin, which can have an impact on the living family members. The aims of this retrospective study completed in the canton of Vaud, Switzerland were to determine both the incidence of SCD and the autopsy rate for individuals from 5 to 39 years of age. METHODS: The study was conducted from 2000 to 2007 on the basis of official statistics and analysis of the International Classification of Diseases codes for potential SCDs and other deaths that might have been due to cardiac disease. RESULTS: During the 8 year study period there was an average of 292'546 persons aged 5-39 and there were a total of 1122 deaths, certified as potential SCDs in 3.6% of cases. The calculated incidence is 1.71/100'000 person-years (2.73 for men and 0.69 for women). If all possible cases of SCD (unexplained deaths, drowning, traffic accidents, etc.) are included, the incidence increases to 13.67/100'000 person-years. However, the quality of the officially available data was insufficient to provide an accurate incidence of SCD as well as autopsy rates. The presumed autopsy rate of sudden deaths classified as diseases of the circulatory system is 47.5%. For deaths of unknown cause (11.1% of the deaths), the autopsy was conducted in 13.7% of the cases according to codified data. CONCLUSIONS: The incidence of presumed SCD in the canton of Vaud, Switzerland, is comparable to the data published in the literature for other geographic regions but may be underestimated as it does not take into account other potential SCDs, as unexplained deaths. Increasing the autopsy rate of SCD in the young, better management of information obtained from autopsies as well developing of structured registry could improve the reliability of the statistical data, optimize the diagnostic procedures, and the preventive measures for the family members.
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La reconnaissance des troubles musculo-squelettiques (TMS) comme maladies professionnelles : controverses sociales et trajectoires personnelles¦Les TMS sont actuellement considérés comme des problèmes majeurs de santé au travail, mais leur reconnaissance comme maladies professionnelles reste controversée. L'objectif central de cette thèse est de comprendre, dans une perspective de psychologie socio-culturelle intégrant certains apports de la sociologie interactionniste, les conséquences que cette situation peut avoir pour des travailleuses et travailleurs souffrant de ces affections. Au préalable, il s'agira de saisir comment se constituent les controverses sur les TMS et pourquoi ces derniers sont si rarement reconnus comme maladies professionnelles en Suisse. Les principales données sont constituées de documents institutionnels et d'entretiens avec des ouvrières et ouvriers atteints de TMS.¦Les résultats montrent que les enjeux de la reconnaissance des maladies professionnelles ne se limitent pas aux prestations d'assurance et à la prise en charge des coûts engendrés par les maladies. En effet, leur non-reconnaissance contribue à définir les TMS comme des problèmes personnels plutôt que professionnels, ce qui peut entraver les capacités des ouvrières et ouvriers à agir sur leurs conditions de travail. En outre, les explications qui circulent sur les TMS par le biais de discours institutionnels ou informels ont des conséquences sur la manière dont une personne appréhende sa propre maladie. Ces explications de la maladie peuvent être des outils de compréhension, mais aussi contribuer à définir l'identité de la personne malade. Dans ce cas, la reconnaissance du caractère professionnel de la maladie touche aussi à des questions de reconnaissance sociale.¦MSDs are currently considered major occupational health problems, but their recognition as occupational illnesses remains controversial. The central objective of the thesis is to grasp, from a socio-cultural psychology perspective that integrates certain contributions of interactionist sociology, the consequences that these circumstances can have for workers suffering from such ailments. Further, the thesis first aims to understand how controversies about MSDs emerge and why these disorders are so rarely recognized as occupational illnesses in Switzerland. Most of the data used stems from institutional documents and from interviews with workers suffering from MSDs.¦The results show that the stakes of recognizing occupational illnesses are not limited to issues of insurance benefits and the coverage of costs generated by the disorders. In fact, the non-recognition of MSDs contributes to their characterization as personal rather than professional problems, which can in turn impede workers' ability to act to change their working conditions. Furthermore, accounts of and explanations about MSDs circulating by means of institutional or informal discourse have consequences on the way a person may perceive his or her own illness. Such explanations of the illness can be tools for understanding it, but they may also contribute to defining the identity of the affected person. In this case, the recognition of the occupational nature of the illness is also closely related to questions of social recognition.
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GREC CLÀSSIC. Curs d’autoaprenentatge introductori. Dos anys. El curs consta de tretze lliçons i d’una gramàtica estructurada en quatre blocs: 1. Alfabet i diacrítics, fenòmens fonètics. 2. Morfologia nominal. 3. Morfologia verbal. 4. Infinitius i participis. Sintaxi de les oracions. L’estructura de les lliçons, excepte la primera que inclou l’alfabet, combina qüestions de morfologia nominal i verbal o de morfologia i sintaxi, tal com acostumen a fer els mètodes d’aprenentatge de les llengües modernes. Cada lliçó formula els seus objectius específics, desenvolupa la seva part de continguts i conclou amb uns exercicis pràctics d’autocorrecció. La Gramàtica, per la seva banda, està organitzada com un manual elemental de llengua grega on la persona que segueixi el curs pot ampliar la seva formació i consultar els dubtes. Parts complementàries: presentació on es formulen els objectius, la metodologia i les instruccions concretes per a seguir el curs; terminologia on s’ordenen alfabèticament els conceptes gramaticals emprats en el curs; avaluació final per tal que, més enllà dels exercicis de cada lliçó, hom pugui comprovar si ha assolit els coneixements previstos o si, en cas de no arribar-hi, ha de reforçar algunes lliçons o parts de les mateixes abans de tornar a fer l’avaluació; lèxic, ordenat alfabèticament per tal que hom pugui conèixer el significat dels mots emprats en el curs sense necessitat de consultar un diccionari. A la part d’avaluació hi ha també una enquesta per tal que les persones que segueixin el curs en facin una valoració i ens permetin corregir els seus dèficits o mancances. El projecte 2007MQD00178 ha continuat ampliant els dossiers electrònics, els exercicis autoavaluatius del seu web www.ub.edu/filologiagrega/electra i ha dedicat una part important de la seva tasca a elaborar els continguts i els programes de les assignatures dels dos primers cursos del nou grau de Filologia Clàssica.
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Menorca és una illa del Mediterrani occidental i una important destinació turística. El turisme estival és un pilar de l’economia de l’illa i té implicacions en tots els aspectes d’aquesta. Una bona part dels turistes es concentren en nuclis turístics costaners dedicats a una única activitat (l’allotjament de turistes). En aquest projecte s’estudien els consums i els potencials de captació d’aigua i energia de cinc nuclis turístics menorquins i alguns dels seus establiments turístics i se n’avalua el potencial d’autosuficiència. També es fa un estudi de mobilitat dels turistes, a partir del qual es quantifica el cost energètic de la mobilitat i les emissions de CO2 que se’n deriven. Les eines utilitzades han estat enquestes i Sistemes d’Informació Geogràfica. Els resultats mostren que el consum hídric per persona és molt variable (de 98 a 466 litres diaris). El consum elèctric per persona és més homogeni que el d’aigua (entre 5 i 10 kWh·persona-1·dia-1 a nivell de nucli turístic) i presenta valors superiors en allotjaments del tipus hotel que del tipus apartaments. Els trajectes d’anada i tornada a l’illa amb avió o vaixell representen més del 80% del cost energètic total de les vacances a Menorca (aprox. 1 MWh per estada) i de les emissions de CO2 associades. Els turistes espanyols recorren un 180% més de distància en desplaçaments a l’interior de l’illa que els d’altres nacionalitats. L’aprofitament d’aigües pluvials podria cobrir menys del 25% de les necessitats hídriques de la majoria d’allotjaments turístics i entre el 28 i el 36% de les necessitats hídriques totals dels nuclis turístics, mantenint-se els nivells actuals de consum. La captació d’energia solar fotovoltaica in situ podria arribar a suplir entre el 50 i el 90% del consum d’energia elèctrica en els nuclis turístics i fins al 100% del mateix en alguns allotjaments turístics.
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Specialisation in medicine requires multidisciplinary approaches, and hence coordination in collaborations of the different partners involved. These integrated approaches, sometimes called "disease management", fit particularly well to chronic diseases. Our institution introduced an integrated approach for taking care of the acute somatic hospitalisation of patients suffering from anorexia nervosa. Interfaces with the different partners were defined, specifying tasks, rights, and duties of each person, care givers or patients. This initiative allows now to identify any deviation occurring in the process of care or hole in the care system, so that it can be corrected and recurrence prevented. This model will be extended to other complex and multidisciplinary care processes and other services in our institution.
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PURPOSE: In Burkina Faso, gold ore is one of the main sources of income for an important part of the active population. Artisan gold miners use mercury in the extraction, a toxic metal whose human health risks are well known. The aim of the present study was to assess mercury exposure as well as to understand the exposure determinants of gold miners in Burkinabe small-scale mines.METHODS: The examined gold miners' population on the different selected gold mining sites was composed by persons who were directly and indirectly related to gold mining activities. But measurement of urinary mercury was performed on workers most susceptible to be exposed to mercury. Thus, occupational exposure to mercury was evaluated among ninety-three workers belonging to eight different gold mining sites spread in six regions of Burkina Faso. Among others, work-related exposure determinants were taken into account for each person during urine sampling as for example amalgamating or heating mercury. All participants were medically examined by a local medical team in order to identify possible symptoms related to the toxic effect of mercury.RESULTS: Mercury levels were high, showing that 69% of the measurements exceeded the ACGIH (American Conference of Industrial Hygienists) biological exposure indice (BEI) of 35 µg per g of creatinine (µg/g-Cr) (prior to shift) while 16% even exceeded 350 µg/g-Cr. Basically, unspecific but also specific symptoms related to mercury toxicity could be underlined among the persons who were directly related to gold mining activities. Only one-third among the studied subpopulation reported about less than three symptoms possibly associated to mercury exposure and nearly half of them suffered from at least five of these symptoms. Ore washers were more involved in the direct handling of mercury while gold dealers in the final gold recovery activities. These differences may explain the overexposure observed in gold dealers and indicate that the refining process is the major source of exposure.CONCLUSIONS: This study attests that mercury exposure still is an issue of concern. North-South collaborations should encourage knowledge exchange between developing and developed countries, for a cleaner artisanal gold mining process and thus for reducing human health and environmental hazards due to mercury use.
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We propose and analyze a new solution concept, the R solution, for three-person, transferable utility, cooperative games. In the spirit of the Nash Bargaining Solution, our concept is founded on the predicted outcomes of simultaneous, two-party negotiations that would be the alternative to the grand coalition. These possibly probabilistic predictions are based on consistent beliefs. We analyze the properties of the R solution and compare it with the Shapley value and other concepts. The R solution exists and is unique. It belongs to the bargaining set and to the core whenever the latter is not empty. In fact, when the grand coalition can simply execute one of the three possible bilateral trades, the R solution is the most egalitarian selection of the bargaining set. Finally, we discuss how the R solution changes important conclusions of several well known Industrial Organization models.
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Meta-analysis of prospective studies shows that quantitative ultrasound of the heel using validated devices predicts risk of different types of fracture with similar performance across different devices and in elderly men and women. These predictions are independent of the risk estimates from hip DXA measures.Introduction Clinical utilisation of heel quantitative ultrasound (QUS) depends on its power to predict clinical fractures. This is particularly important in settings that have no access to DXA-derived bone density measurements. We aimed to assess the predictive power of heel QUS for fractures using a meta-analysis approach.Methods We conducted an inverse variance random effects meta-analysis of prospective studies with heel QUS measures at baseline and fracture outcomes in their follow-up. Relative risks (RR) per standard deviation (SD) of different QUS parameters (broadband ultrasound attenuation [BUA], speed of sound [SOS], stiffness index [SI], and quantitative ultrasound index [QUI]) for various fracture outcomes (hip, vertebral, any clinical, any osteoporotic and major osteoporotic fractures) were reported based on study questions.Results Twenty-one studies including 55,164 women and 13,742 men were included in the meta-analysis with a total follow-up of 279,124 person-years. All four QUS parameters were associated with risk of different fracture. For instance, RR of hip fracture for 1 SD decrease of BUA was 1.69 (95% CI 1.43-2.00), SOS was 1.96 (95% CI 1.64-2.34), SI was 2.26 (95%CI 1.71-2.99) and QUI was 1.99 (95% CI 1.49-2.67). There was marked heterogeneity among studies on hip and any clinical fractures but no evidence of publication bias amongst them. Validated devices from different manufacturers predicted fracture risks with similar performance (meta-regression p values > 0.05 for difference of devices). QUS measures predicted fracture with a similar performance in men and women. Meta-analysis of studies with QUS measures adjusted for hip BMD showed a significant and independent association with fracture risk (RR/SD for BUA = 1.34 [95%CI 1.22-1.49]).Conclusions This study confirms that heel QUS, using validated devices, predicts risk of different fracture outcomes in elderly men and women. Further research is needed for more widespread utilisation of the heel QUS in clinical settings across the world.
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OBJECTIVE: To collect data on the consultation frequency and demographic profile of victims of violence attending an emergency department (ED) in Switzerland. METHODS: We undertook screening of all admitted adult patients (>16 years) in the ED of the CHUV, Lausanne, Switzerland, over a 1 month period, using a modified version of the Partner Violence Screen questionnaire. Exclusionary criteria were: life threatening injury (National Advisory Committee on Aeronautics score > or =4), or inability to understand or speak French, to give oral informed consent, or to be questioned without a family member or accompanying person being present. Data were collected on history of physical and/or psychological violence during the previous 12 months, the type of violence experienced by the patient, and if violence was the reason for the current consultation. Sociodemographic data were obtained from the registration documents. RESULTS: The final sample consisted of 1602 patients (participation rate of 77.2%), with a refusal rate of 1.1%. Violence during the past 12 months was reported by 11.4% of patients. Of the total sample, 25% stated that violence was the reason for the current consultation; of these, 95% of patients were confirmed as victims of violence by the ED physicians. Patients reporting violence were more likely to be young and separated from their partner. Men were more likely to be victims of public violence and women more commonly victims of domestic violence. CONCLUSIONS: Based on this monthly prevalence rate, we estimate that over 3000 adults affected by violence consult our ED per annum. This underlines the importance of the problem and the need to address it. Health services organisations should establish measures to improve quality of care for victims. Guidelines and educational programmes for nurses and physicians should be developed in order to enhance providers' skills and basic knowledge of all types of violence, how to recognise and interact appropriately with victims, and where to refer these patients for follow up care in their local networks.
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Aquest treball de recerca tracta de la relació existent entre pedagogia, traducció, llengües estrangeres i intel•ligències múltiples. El debat sobre si la traducció és una eina útil a la classe de llengües estrangeres és un tema actual sobre el qual molts investigadors encara indaguen. Estudis recents, però, han demostrat que qualsevol tasca de traducció -en la qual s’hi poden incloure treballs amb les diferents habilitats- és profitosa si la considerem un mitjà, no una finalitat en ella mateixa. Evidentment, l’ús de la traducció dins l’aula és avantatjosa, però també hem de tenir presents certs desavantatges d’aquesta aplicació. Un possible desavantatge podria ser la creença que, al principi, molta gent té referent a l’equivalència, paraula per paraula, d’una llengua vers una altra. Però després de presentar vàries tasques de traducció als estudiants, aquests poden arribar a controlar, fins i tot, les traduccions inconscients i poden assolir un cert nivell de precisió i flexibilitat que val la pena mencionar. Però l’avantatge principal és que s’enfronten a una activitat molt estesa dins la societat actual que combina dues llengües, la llengua materna i la llengua objecte d’estudi, per exemple. De tot això en podem deduir que utilitzar la llengua materna a la classe no s’ha de considerar un crim, com fins ara, sinó una virtut, evidentment si és emprada correctament. En aquest treball de recerca s’hi pot trobar una síntesi tant de les principals teories d’adquisició i aprenentatge de llengües com de les teories de traducció. A la pregunta de si les teories, tant de traducció com de llengües estrangeres, s’haurien d’ensenyar implícita o explícitament, es pot inferir que segons el nivell d’estudis on estiguin els aprenents els convindrà aprendre les teories explícitament o les aprendran, de totes maneres, implícitament. Com que qualsevol grup d’estudiants és heterogeni -és a dir que cada individu té un ritme i un nivell d’aprenentatge concret i sobretot cadascú té diferents estils de percepció (visual, auditiu, gustatiu, olfactiu, de moviment) i per tant diferents intel•ligències-, els professors ho han de tenir en compte a l’hora de planificar qualsevol programa d’actuació vers els alumnes. Per tant, podem concloure que les tasques o projectes de traducció poden ajudar als alumnes a aprendre millor, més eficaçment i a aconseguir un aprenentatge més significatiu.
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National malaria control programmes have the responsibility to develop a policy for malaria disease management based on a set of defined criteria as efficacy, side effects, costs and compliance. These will fluctuate over time and national guidelines will require periodic re-assessment and revision. Changing a drug policy is a major undertaking that can take several years before being fully operational. The standard methods on which a decision can be taken are the in vivo and the in vitro tests. The latter allow a quantitative measurement of the drug response and the assessment of several drugs at once. However, in terms of drug policy change its results might be difficult to interpret although they may be used as an early warning system for 2nd or 3rd line drugs. The new WHO 14-days in vivo test addresses mainly the problem of treatment failure and of haematological parameters changes in sick children. It gives valuable information on whether a drug still `works'. None of these methods are well suited for large-scale studies. Molecular methods based on detection of mutations in parasite molecules targeted by antimalarial drugs could be attractive tools for surveillance. However, their relationship with in vivo test results needs to be established
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A mathematical model is proposed to analyze the effects of acquired immunity on the transmission of schistosomiasis in the human host. From this model the prevalence curve dependent on four parameters can be obtained. These parameters were estimated fitting the data by the maximum likelihood method. The model showed a good retrieving capacity of real data from two endemic areas of schistosomiasis: Touros, Brazil (Schistosoma mansoni) and Misungwi, Tanzania (S. haematobium). Also, the average worm burden per person and the dispersion of parasite per person in the community can be obtained from the model. In this paper, the stabilizing effects of the acquired immunity assumption in the model are assessed in terms of the epidemiological variables as follows. Regarded to the prevalence curve, we calculate the confidence interval, and related to the average worm burden and the worm dispersion in the community, the sensitivity analysis (the range of the variation) of both variables with respect to their parameters is performed.
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BACKGROUND: Pulse wave velocity (PWV), an index of arterial wall stiffness, is modulated by blood pressure (BP). Whether heart rate (HR) is also a modulator of PWV is controversial. Recent research involving mainly patients with high aortic PWV have found either no change or a positive correlation between the two. Given that PWV is increasingly being measured in cardiovascular studies, the relationship between HR and PWV should be known in patients with preserved arterial wall elasticity. OBJECTIVE: The aim of this study was to evaluate the importance of HR as a determinant of the variability in PWV in patients with a low degree of atherosclerosis. DESIGN AND METHODS: Fourteen patients (five female, nine male; aged 68 +/- 8 years) were evaluated post pacemaker implantation due to sick sinus or carotid hypersensitivity syndromes. Carotid-femoral PWV was measured at rest and during atrial pacing at 80, 90 and 100 bpm (paced HR). Arterial femoral blood flow (AFBF) was measured by echodoppler. RESULTS: PWV increased from 6.2 +/- 1.5 m/s (mean +/- SD) during resting sinus rhythm (HR 62 +/- 8 bpm; mean +/- SD) to 6.8 +/- 1.0, 7.0 +/- 0.9, and 7.6 +/- 1.1 m/s at pacing rates of 80, 90 and 100 bpm, respectively (P < 0.0001). Systolic (SBP) and mean blood pressure (MBP) remained constant at all HR levels, whereas AFBF increased in a linear fashion. CONCLUSIONS: These results demonstrate that even in patients with a low degree of atherosclerosis, HR is a potential modulator of carotid-femoral PWV.
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The incidence of invasive meningococcal disease (IMD) before (1984-1988) and after (1989-1994), a nationwide intervention with VA-MENGOC-BC vaccination started in 1989, was compared. The prevaccination period incidence density (ID> 8.8/ 105 year-person) was higher than the postvaccination ID (ID< 6.5/ 105 year-person). The percentage proportional differences from the start to the end of each period of ID in the vaccinal period was higher (87%) than the prevaccinal (37%) with significant differences among vaccinated groups (< 25 years old). A break-point (Chow test) was confirmed by the decrease in the ID between 1989 and 1990 in children under 1 year old, 5-9, 10-14, 15-19 and 50-54 years. Comparison of ID using maps showed a decrease in IMD in all municipalities during the postvaccination period. These findings support the epidemiological impact of VA-MENGOC-BC vaccination in the reduction of IMD morbidity.