Terapia de aceptación y compromiso en un caso de tras¬torno mixto de ansiedad y depresión en una paciente con cáncer

This paper introduces the case of a woman with breast cancer who had developed a mixed depressive-anxiety disorder with avoidance behaviors. The patient presented depressive symptoms like listlessness, insomnia, weeping, food disorders and hopelessness though. Also, she exhibited physiological arousal and restlessness feelings. Additionally, the patient had an avoidance patron behavior in relation with all stimulus she believed could hurt her. Based on the Acceptance and Commitment Therapy (ACT) the intervention planted the following objectives: the patient will learn to accept her illness and the emotional distress that she was experiencing, also, the patient will recover the other areas of her life that she had abandoned. The treatment was developed in 14 sessions. The therapist used these techniques: creative hopelessness, disabling verbal functions, values clarification and loss of control over private events. In the results, it was observed a positive change in the behavior of the patient as well as a decrease in emotional distress that was his reason for initial consultation

Uppföljning och utvärdering av det balanserade styrkortet : Är balanserat styrkort ett värdeskapande och strategiskt instrument inom den kommunala verksamheten?

The need to steer economic development has always been great and as management model has the balanced scorecard has been popular since the mid- 1990s, mainly in the private sector but also in the municipal sector. The introduction of the balanced scorecard has been primarily to organizations to see more than economic dimensions. The Balanced Scorecard was originally a measurement system, and today it works more as a strategic instrument. In our study is a case study to evaluate a municipality and how they make use of the balanced scorecard as a tool for strategic and value-adding work in municipal activities. In the local business is it important that the organization adapts the balanced scorecard, so it fits on the basis that it is a politically driven organization, with mandates, committees and administrations. In our study, we used a qualitative method with a deductive approach. In the study, we have gathered information through a case study where we interviewed 7 people in leading positions. In our analysis and results section, we came to the conclusion that the municipality does not use the balanced scorecard correctly. We also found that the balanced scorecard as a tool for value creation and strategic planning does not work in a favorable way. In our study, we see difficulties with the implementation of the balanced scorecard. If the municipality has invested in implementing the balanced scorecard at all levels of the business so the municipality would be able to use it on one of the activities more adequately. When the municipality is a politically driven organization, it is important that vision alive and changing based on the conditions that reflect the outside world and the municipality in general. Looking at a vivid vision, goals and business ideas, it's balanced scorecard in line with how a balanced scorecard should look like. The municipality has a strategic plan in terms of staff and employees at large. In the study, we have seen that the strategic plan is not followed up in a good way and for the business favorably, the municipality chooses the easy way out for evaluation. Employee participation to changes and ongoing human resources management feels nonexistent. However, as has been the vision of creating empowered and motivated employees. In our conclusion, we describe how we in our study look at the use of the balanced scorecard in municipal operations. We can also discern that a balanced scorecard as a tool for value creation and strategic work is good if it is used properly. In the study, we have concluded that the municipality we have chosen to study should not use the balanced scorecard when you have not created the tools and platforms required for employees, civil servants and politicians to evaluate, monitor and create a living scorecard change over time. The study reveals major shortcomings in the implementation, evaluation and follow-up possibilities, and the consequence of this is that the balanced scorecard is not - 4 - preferable in municipal operations as a strategic instrument for value creation and long-term planning.

Dealing with flood damages: will prevention, mitigation, and ex post compensation provide for a resilient triangle?

There is a wealth of literature on the design of ex post compensation mechanisms for natural disasters. However, more research needs to be done on the manner in which these mechanisms could steer citizens toward adopting individual-level preventive and protection measures in the face of flood risks. We have provided a comparative legal analysis of the financial compensation mechanisms following floods, be it through insurance, public funds, or a combination of both, with an empirical focus on Belgium, the Netherlands, England, and France. Similarities and differences between the methods in which these compensation mechanisms for flood damages enhance resilience were analyzed. The comparative analysis especially focused on the link between the recovery strategy on the one hand and prevention and mitigation strategies on the other. There is great potential within the recovery strategy for promoting preventive action, for example in terms of discouraging citizens from living in high-risk areas, or encouraging the uptake of mitigation measures, such as adaptive building. However, this large potential has yet to be realized, in part because of insufficient consideration and promotion of these connections within existing legal frameworks. We have made recommendations about how the linkages between strategies can be further improved. These recommendations relate to, among others, the promotion of resilient reinstatement through recovery mechanisms and the removal of legal barriers preventing the establishment of link-inducing measures.

Professionalizing school governance: the disciplinary effects of school autonomy and inspection on the changing role of school governors

Since the 1980s, state schools in England have been required to ensure transparency and accountability through the use of indicators and templates derived from the private sector and, more recently, globally circulating discourses of ‘good governance’ (an appeal to professional standards, technical expertise, and performance evaluation as mechanisms for improving public service delivery). The rise of academies and free schools (‘state-funded independent schools’) has increased demand for good governance, notably as a means by which to discipline schools, in particular school governors – those tasked with the legal responsibility of holding senior leadership to account for the financial and educational performance of schools. A condition and effect of school autonomy, therefore, is increased monitoring and surveillance of all school governing bodies. In this paper, I demonstrate how these twin processes combine to produce a new modality of state power and intervention; a dominant or organizing principle by which government steer the performance of governors through disciplinary tools of professionalization and inspection, with the aim of achieving the ‘control of control’. To explain these trends, I explore how various established and emerging school governing bodies are (re)constituting themselves to meet demands for good governance.

The role of dietary breadth in national bumblebee (Bombus) declines: Simple correlation?

Bumblebee species declines have been reported in Europe, North America and Asia. Loss of suitable habitat to agricultural intensification is considered to be the main cause of declines in Europe. Differential impacts on species have been recorded but insufficient knowledge of species ecology means that effective conservation management prescriptions cannot be put into place with certainty. Dietary specialisation, specifically on flowers of Fabaceae, has been hypothesised as driving differential declines but the reliability of previous studies has been questioned. Here we present a three-year study of the foraging behaviour of two UK Biodiversity Action Plan bumblebee species. For the first time, analysis of nectar and pollen foraging was performed on sites where nationally rare UK bumblebees were as abundant as more nationally ubiquitous species. Results indicated that the nationally rare Bombus sylvarum collected the majority of its pollen from flowers of Odontites verna and had a significantly narrower mean nectar dietary breadth than ecologically similar species Bombus humilis and Bombus pascuorum (p = 0.004 and 0.008 respectively). In contrast, the dietary breadth of the nationally rare B. humilis was similar to the more nationally ubiquitous species B. pascuorum and Bombus lapidarius. Moreover, B. lapidarius was recorded as having the narrowest pollen dietary breadth, collected pollen from the least number of floral taxa and was the most specialised of the Bombus species on pollen of Fabaceae. Patterns of dietary specialization were inconsistent with national declines and results highlighted a need for further detailed investigation into the factors contributing to differential declines.

Saúde Mental em adolescentes portugueses: contributos do +Contigo

INTRODUÇÂO A prevalência de doença mental é uma das mais altas do mundo (Caldas de Almeida & Xavier, 2013) em adultos, desconhecendo-se os dados epidemiológicos para os adolescentes. O + Contigo é um projecto que visa promover a saúde mental e prevenir comportamentos suicidários na comunidade educativa (Santos et al 2013). OBJETIVOS Os objectivos deste estudos são caracterizar o bem-estar, autoconceito, coping e depressão numa amostra de 3500 adolescentes portugueses, estudantes do 7º ao 10 ano. Comparar os diversos indicadores tendo em conta o género. Comparar os diversos indicadores tendo em conta o ano de escolaridade. METODOLOGIA A recolha de dados foi feita através de questionário, preenchido em sala de aula, autorizado pela DSPE (inquérito n.º 0224900002). Do questionário faziam parte os seguintes instrumentos: Índice de Bem-estar da Organização Mundial de Saúde (1998), Escala Toulosiana de Coping elaborada por (Esparbés et 1993 e validada para Portugal, por Tap, Costa & Alves (2005), Inventário de Depressão de Beck criado por Beck & Steer (1987) e validado por Martins, (2000), Escala de auto-conceito de Piers (Piers-Harris Children's Self-Concept Scale 2, Piers & Hertzberg, 2002, validada por Veiga (2006 ) RESULTADOS Foram considerados válidos 3150 questionários, com 50,1% de raparigas, com média etária de 13,56 anos, distribuídos pelo 7º ano (43%); 8ºano (24,6%); 9º ano (15,1%); 10º ano (17,3%). Os resultados indicam níveis elevados de depressão 26,7%, com 14,4% com depressão moderada ou severa. O índice de bem-estar apresenta uma média de 18,75, o autoconceito uma média de 42,03 e o coping de 153,46. Nas variáveis protetoras de comportamentos suicidários as raparigas apresentam scores inferiores relativamente aos rapazes, apresentando níveis superiores na sintomatologia depressiva, considerado fator de risco para os comportamentos suicidários.Considerando o ano de escolaridade verificou-se, de forma consistente, um agravamento das variáveis estudadas ao longo dos anos, mas com uma diferença estatisticamente significativa entre os alunos do 10º ano e os restantes. CONCLUSÕES Cerca de um quarto dos adolescentes apresentam níveis de sintomatologia depressiva, em que 14,4% apresentam níveis moderados ou severos, mais evidentes nas raparigas e agravando-se ao longo da sua progressão académica, entre o 7º e o 10º ano. As adolescentes apresentam maiores vulnerabilidades em saúde mental. Estes achados reforçam a necessidade de privilegiar a promoção da saúde mental junto da comunidade educativa e, particularmente, junto dos adolescentes. Tendo em conta os dados recolhidos, a supervisão, monitorização e acompanhamento de comportamentos de risco assume particular importância na promoção de saúde mental, evidenciando assim a relevância do projecto + Contigo. BIBLIOGRAFIA- Caldas de Almeida, J., & Xavier, M. (2013). Estudo Epidemiológico Nacional de Saúde Mental (Vol. 1). Lisboa. Faculdade de Ciências Médicas, da Universidade Nova de Lisboa. Santos, José; Erse, Maria; Simões, Rosa; Façanha, Jorge; Marques, Lucia; (2013) "+ Contigo na promoção da saúde mental e prevenção de comportamentos suicidários em meio escolar" - Revista de Enfermagem Referência, Número: 10, Série: III série, 1ª Edição, UICISA-E, Coimbra, p203 - 207.

Cardiorespiratory fitness and aerobic performance adaptations to a 4-week sprint interval training in young healthy untrained females

Purpose The aim of this study was to test the effects of sprint interval training (SIT) on cardiorespiratory fitness and aerobic performance measures in young females. Methods Eight healthy, untrained females (age 21 ± 1 years; height 165 ± 5 cm; body mass 63 ± 6 kg) completed cycling peak oxygen uptake ( V˙O2V˙O2 peak), 10-km cycling time trial (TT) and critical power (CP) tests pre- and post-SIT. SIT protocol included 4 × 30-s “all-out” cycling efforts against 7 % body mass interspersed with 4 min of active recovery performed twice per week for 4 weeks (eight sessions in total). Results There was no significant difference in V˙O2V˙O2 peak following SIT compared to the control period (control period: 31.7 ± 3.0 ml kg−1 min−1; post-SIT: 30.9 ± 4.5 ml kg−1 min−1; p > 0.05), but SIT significantly improved time to exhaustion (TTE) (control period: 710 ± 101 s; post-SIT: 798 ± 127 s; p = 0.00), 10-km cycling TT (control period: 1055 ± 129 s; post-SIT: 997 ± 110 s; p = 0.004) and CP (control period: 1.8 ± 0.3 W kg−1; post-SIT: 2.3 ± 0.6 W kg−1; p = 0.01). Conclusions These results demonstrate that young untrained females are responsive to SIT as measured by TTE, 10-km cycling TT and CP tests. However, eight sessions of SIT over 4 weeks are not enough to provide sufficient training stimulus to increase V˙O2V˙O2 peak.

Responses to various protein and energy supplements by steers fed low-quality tropical hay. 1. Comparison of response surfaces for young steers

Response curves were established for different supplements, offered at intakes ranging from 0 to 20 g/kg liveweight (W).day to young Bos indicus crossbred steers fed low-quality Rhodes grass (Chloris gayana) hay ad libitum in two pen experiments. Supplements included protein meals of varying rumen-degradability (cottonseed meal (CSM) or fishmeal), as well as ‘energy sources’ comprising grains of high and low ruminal starch degradability (barley and sorghum) and a highly fermentable sugar source (molasses), with all diets adjusted for rumen-degradable nitrogen and mineral content. Unsupplemented steers gained 0.08 and 0.15 kg/day, in Experiments 1 and 2, respectively. Growth of steers increased linearly with intake of ‘energy source’ supplements in increasing order of molasses, sorghum and barley (all differences P < 0.05). Steer growth rate also increased linearly with fishmeal, albeit over a narrow intake range (0–4.1 g/kg W.day), whereas the response with CSM was asymptotic, showing a steep response at low intake before levelling at ~1.2 kg/day. All supplement types were associated with a linear reduction in hay intake by the steers (energy substitution) where the reduction was greater (P < 0.05) for barley and molasses (not different) than for sorghum (P < 0.05), and for fishmeal compared with CSM (P < 0.05). In concurrent metabolism studies with the same rations, organic matter digestibility of the total ration (561–578 g/kg DM, unsupplemented) was increased linearly by barley and molasses (both P < 0.05) but was unaffected by CSM and sorghum supplements. The efficiency of microbial protein synthesis in steers increased linearly, from 91 g microbial crude protein/kg digestible organic matter (unsupplemented), in both molasses and CSM-supplemented steers, with the trend for a higher response to molasses (P = 0.05), and appeared most closely related to digestible organic matter intake. The response curves from these studies provide the practical framework upon which to formulate rations for cattle grazing low-quality forages.

Responses to various protein and energy supplements by steers fed low-quality tropical hay. 2. Effect of stage of maturity of steers

Dose response curves to various supplements were established in two pen-feeding experiments (Exp1 and Exp2) with Bos indicus crossbred steers of two age groups (Young, 10–12 months; Old, 33–36 months) fed low-quality tropical grass hays ad libitum. Diets included supplements based on (Exp1) cottonseed meal (CSM; intake (as fed) 0–10 g/kg liveweight (W).day) and a barley mix (Bar; 0–20 g/kg W.day) and (Exp2) a molasses mix (MUP) and a Bar mix, both fed at 0–20 g/kg W.day. Urea was provided with the Bar mixes and urea/copra meal with the MUP mix. Growth rates of Young steers increased linearly with Bar and MUP supplements but asymptotically with CSM whereas those of Old steers increased asymptotically with all supplement types. With supplement intake expressed on a liveweight basis (g/kg W.day), responses were greater for both steer age groups with CSM compared with Bar (Young, P < 0.001; Old, P < 0.01) and Bar compared with MUP treatments (Young, P < 0.01; Old, P < 0.05). Furthermore, Old steers outperformed their Young counterparts with both CSM (P < 0.05) and Bar (P < 0.001) supplements fed in Exp1 and with Bar and MUP supplements (P < 0.01) fed in Exp2. When supplement intake was expressed in absolute terms (kg/day), growth responses were not different between age groups for different supplements except that Old steers had a higher daily W gain on Bar than their Young counterparts (P < 0.05). Intake of hay (W-corrected) was higher for Young compared with Old steers without supplement but was variably reduced for both steer groups with increasing supplement intake. The results of these experiments have implications for supplement formulation for steers at different stages of maturity grazing low-quality forages.

Validation of single photon absorptiometry for on-farm measurement of density and mineral content of tail bone in cattle

A validation study examined the accuracy of a purpose-built single photon absorptiometry (SPA) instrument for making on-farm in vivo measurements of bone mineral density (BMD) in tail bones of cattle. In vivo measurements were made at the proximal end of the ninth coccygeal vertebra (Cy9) in steers of two age groups (each n = 10) in adequate or low phosphorus status. The tails of the steers were then resected and the BMD of the Cy9 bone was measured in the laboratory with SPA on the resected tails and then with established laboratory procedures on defleshed bone. Specific gravity and ash density were measured on the isolated Cy9 vertebrae and on 5-mm2 dorso-ventral cores of bone cut from each defleshed Cy9. Calculated BMD determined by SPA required a measure of tail bone thickness and this was estimated as a fraction of total tail thickness. Actual tail bone thickness was also measured on the isolated Cy9 vertebrae. The accuracy of measurement of BMD by SPA was evaluated by comparison with the ash density of the bone cores measured in the laboratory. In vivo SPA measurements of BMD were closely correlated with laboratory measurements of core ash density (r = 0.92). Ash density and specific gravity of cores, and all SPA measures of BMD, were affected by phosphorus status of the steers, but the effect of steer age was only significant (P < 0.05) for steers in adequate phosphorus status. The accuracy of SPA to determine BMD of tail bone may be improved by reducing error associated with in vivo estimation of tail bone thickness, and also by adjusting for displacement of soft tissue by bone mineral. In conclusion a purpose-built SPA instrument could be used to make on-farm sequential non-invasive in vivo measurements of the BMD of tailbone in cattle with accuracy acceptable for many animal studies.

An evaluation of carbon offset supplementation options for beef production systems on coastal speargrass in central Queensland, Australia

In 2014, the Australian Government implemented the Emissions Reduction Fund to offer incentives for businesses to reduce greenhouse gas (GHG) emissions by following approved methods. Beef cattle businesses in northern Australia can participate by applying the 'reducing GHG emissions by feeding nitrates to beef cattle' methodology and the 'beef cattle herd management' methods. The nitrate (NO3) method requires that each baseline area must demonstrate a history of urea use. Projects earn Australian carbon credit units (ACCU) for reducing enteric methane emissions by substituting NO3 for urea at the same amount of fed nitrogen. NO3 must be fed in the form of a lick block because most operations do not have labour or equipment to manage daily supplementation. NO3 concentrations, after a 2-week adaptation period, must not exceed 50 g NO3/adult animal equivalent per day or 7 g NO3/kg dry matter intake per day to reduce the risk of NO3 toxicity. There is also a 'beef cattle herd management' method, approved in 2015, that covers activities that improve the herd emission intensity (emissions per unit of product sold) through change in the diet or management. The present study was conducted to compare the required ACCU or supplement prices for a 2% return on capital when feeding a low or high supplement concentration to breeding stock of either (1) urea, (2) three different forms of NO3 or (3) cottonseed meal (CSM), at N concentrations equivalent to 25 or 50 g urea/animal equivalent, to fasten steer entry to a feedlot (backgrounding), in a typical breeder herd on the coastal speargrass land types in central Queensland. Monte Carlo simulations were run using the software @risk, with probability functions used for (1) urea, NO3 and CSM prices, (2) GHG mitigation, (3) livestock prices and (4) carbon price. Increasing the weight of steers at a set turnoff month by feeding CSM was found to be the most cost-effective option, with or without including the offset income. The required ACCU prices for a 2% return on capital were an order of magnitude higher than were indicative carbon prices in 2015 for the three forms of NO3. The likely costs of participating in ERF projects would reduce the return on capital for all mitigation options. © CSIRO 2016.

Influence of climate variability and stocking strategies on greenhouse gas emissions (GHGE), production and profit of a northern Queensland beef cattle herd

Previous studies of greenhouse gas emissions (GHGE) from beef production systems in northern Australia have been based on models of ‘steady-state’ herd structures that do not take into account the considerable inter-annual variation in liveweight gain, reproduction and mortality rates that occurs due to seasonal conditions. Nor do they consider the implications of flexible stocking strategies designed to adapt these production systems to the highly variable climate. The aim of the present study was to quantify the variation in total GHGE (t CO2e) and GHGE intensity (t CO2e/t liveweight sold) for the beef industry in northern Australia when variability in these factors was considered. A combined GRASP–Enterprise modelling platform was used to simulate a breeding–finishing beef cattle property in the Burdekin River region of northern Queensland, using historical climate data from 1982–2011. GHGE was calculated using the method of Australian National Greenhouse Gas Inventory. Five different stocking-rate strategies were simulated with fixed stocking strategies at moderate and high rates, and three flexible stocking strategies where the stocking rate was adjusted annually by up to 5%, 10% or 20%, according to pasture available at the end of the growing season. Variation in total annual GHGE was lowest in the ‘fixed moderate’ (~9.5 ha/adult equivalent (AE)) stocking strategy, ranging from 3799 to 4471 t CO2e, and highest in the ‘fixed high’ strategy (~5.9 ha/AE), which ranged from 3771 to 7636 t CO2e. The ‘fixed moderate’ strategy had the least variation in GHGE intensity (15.7–19.4 t CO2e/t liveweight sold), while the ‘flexible 20’ strategy (up to 20% annual change in AE) had the largest range (10.5–40.8 t CO2e/t liveweight sold). Across the five stocking strategies, the ‘fixed moderate’ stocking-rate strategy had the highest simulated perennial grass percentage and pasture growth, highest average rate of liveweight gain (121 kg/steer), highest average branding percentage (74%) and lowest average breeding-cow mortality rate (3.9%), resulting in the lowest average GHGE intensity (16.9 t CO2e/t liveweight sold). The ‘fixed high’ stocking rate strategy (~5.9 ha/AE) performed the poorest in each of these measures, while the three flexible stocking strategies were intermediate. The ‘fixed moderate’ stocking strategy also yielded the highest average gross margin per AE carried and per hectare. These results highlight the importance of considering the influence of climate variability on stocking-rate management strategies and herd performance when estimating GHGE. The results also support a body of previous work that has recommended the adoption of moderate stocking strategies to enhance the profitability and ecological stability of beef production systems in northern Australia.

Implications of retaining woody regrowth for carbon sequestration for an extensive grazing beef business: a bio-economic modelling case study

A bio-economic modelling framework (GRASP-ENTERPRISE) was used to assess the implications of retaining woody regrowth for carbon sequestration on a case study beef grazing property in northern Australia. Five carbon farming scenarios, ranging from 0% to 100% of the property regrowth retained for carbon sequestration, were simulated over a 20-year period (1993–2012). Dedicating regrowth on the property for carbon sequestration reduced pasture (up to 40%) and herd productivity (up to 20%), and resulted in financial losses (up to 24% reduction in total gross margin). A net carbon income (income after grazing management expenses are removed) of $2–4 per t CO2-e was required to offset economic losses of retaining regrowth on a moderately productive (~8 ha adult equivalent–1) property where income was from the sale of weaners. A higher opportunity cost ($ t–1 CO2-e) of retaining woody regrowth is likely for feeder steer or finishing operations, with improved cattle prices, and where the substantial transaction and reporting costs are included. Although uncertainty remains around the price received for carbon farming activities, this study demonstrated that a conservatively stocked breeding operation can achieve positive production, environmental and economic outcomes, including net carbon stock. This study was based on a beef enterprise in central Queensland’s grazing lands, however, the approach and learnings are expected to be applicable across northern Australia where regrowth is present.

Experiências adversas na infância e depressão em adultos com obesidade

Dissertação de Mestrado apresentada no Instituto Superior de Psicologia Aplicada para obtenção do grau de Mestre na especialidade de Psicologia Clínica

GeoGebraTUTOR : développement d’un système tutoriel autonome pour l’accompagnement d’élèves en situation de résolution de problèmes de démonstration en géométrie plane et genèse d’un espace de travail géométrique idoine

Travaux d'études doctorales réalisées conjointement avec les travaux de recherches doctorales de Nicolas Leduc, étudiant au doctorat en génie informatique à l'École Polytechnique de Montréal.