967 resultados para everyday practice


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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Hypomineralized first molar often in combination with hypomineralized incisors (MIH - molar incisor hypomineralization) is a common finding in everyday practice. In this condition, hypomineralized dental enamel is fragile and soft, and it can break easily leading to an exposed dentin, and causing dental sensitivity and progression of caries lesions. The prevalence of MIH range from 3.6 to 25% in North of Europe that consider this condition a public health problem. No conclusive information was reported about the etiologic factors of MIH, however, systemic causes seem to be of importance. Several aetiological factors are mentioned as the cause of this condition and they are frequently associated with complications during pregnancy and childhood diseases during the first three years of life. MIH is frequently misinterpreted as fluorosis, hypoplasia or amelogénesis imperfect, however, this condition presents defined clinical aspects that can distinct it from the other defects.

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This research aimed to investigate, to describe and to reflect on the initial and continuous training playful preschool teachers and their applicability in daily practice. Through a literature search on the official documents and playfulness in the formation of the pedagogue, we see the importance of the uses of games and toys in kindergarten. Therefore, a retrospective of early childhood education and teacher training were conducted by analyzing the knowledge necessary to professor of playing in kindergarten. In order to collect data in the field were used as instruments to direct observation of everyday practice of the teacher and a questionnaire to see if the teachers' planning the use of toys and games, times and spaces intended for recreational actions are recorded and are ensured. With these investigative actions, from the descriptive and interpretative analysis of the data can be verified as occurred playful teacher education early childhood education and its importance in recreational use in the classroom every day

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Die protokollbasierte Medizin stellt einen interdisziplinären Brennpunkt der Informatik dar. Als besonderer Ausschnitt der medizinischen Teilgebiete erlaubt sie die relativ formale Spezifikation von Prozessen in den drei Bereichen der Prävention, Diagnose und Therapie.Letzterer wurde immer besonders fokussiert und gilt seit jeher im Rahmen klinischer Studien als Projektionsfläche für informationstechnologische Konzepte. Die Euphorie der frühen Jahre ernüchtert sich jedoch bei jeder Bilanz. Nur sehr wenige der unzählbaren Projekte haben ihre Routine in der alltäglichen Praxis gefunden. Die meisten Vorhaben sind an der Illusion der vollständigen Berechenbarkeit medizinischer Arbeitsabläufe gescheitert. Die traditionelle Sichtweise der klinischen Praxis beruht auf einer blockorientierten Vorstellung des Therapieausführungsprozesses. Sie entsteht durch seine Zerlegung in einzelne Therapiezweige, welche aus vordefinierten Blöcken zusammengesetzt sind. Diese können sequentiell oder parallel ausgeführt werden und sind selbst zusammengesetzt aus jeweils einer Menge von Elementen,welche die Aktivitäten der untersten Ebene darstellen. Das blockorientierte Aufbaumodell wird ergänzt durch ein regelorientiertes Ablaufmodell. Ein komplexes Regelwerk bestimmt Bedingungen für die zeitlichen und logischen Abhängigkeiten der Blöcke, deren Anordnung durch den Ausführungsprozeß gebildet wird. Die Modellierung der Therapieausführung steht zunächst vor der grundsätzlichen Frage, inwieweit die traditionelle Sichtweise für eine interne Repräsentation geeignet ist. Das übergeordnete Ziel besteht in der Integration der unterschiedlichen Ebenen der Therapiespezifikation. Dazu gehört nicht nur die strukturelle Komponente, sondern vorallem die Ablaufkomponente. Ein geeignetes Regelmodell ist erforderlich, welches den spezifischen Bedürfnissen der Therapieüberwachung gerecht wird. Die zentrale Aufgabe besteht darin, diese unterschiedlichen Ebenen zusammenzuführen. Eine sinnvolle Alternative zur traditionellen Sichtweise liefert das zustandsorientierte Modell des Therapieausführungsprozesses. Das zustandsorientierte Modell beruht auf der Sichtweise, daß der gesamte Therapieausführungsprozeß letztendlich eine lineare Folge von Zuständen beschreibt, wobei jeder Zustandsübergang durch ein Ereignis eingeleitet wird, an bestimmte Bedingungen geknüpft ist und bestimmte Aktionen auslösen kann. Die Parallelität des blockorientierten Modells tritt in den Hintergrund, denn die Menge der durchzuführenden Maßnahmen sind lediglich Eigenschaften der Zustände und keine strukturellen Elemente der Ablaufspezifikation. Zu jedem Zeitpunkt ist genau ein Zustand aktiv, und er repräsentiert eine von endlich vielen klinischen Situationen, mit all ihren spezifischen Aktivitäten und Ausführungsregeln. Die Vorteile des zustandsorientierten Modells liegen in der Integration. Die Grundstruktur verbindet die statische Darstellung der möglichen Phasenanordnungen mit der dynamischen Ausführung aktiver Regeln. Die ursprünglichen Inhalte des blockorientierten Modells werden als gewöhnliche Eigenschaften der Zustände reproduziert und stellen damit nur einen Spezialfall der zustandsbezogenen Sicht dar.Weitere Möglichkeiten für die Anreicherung der Zustände mit zusätzlichen Details sind denkbar wie sinnvoll. Die Grundstruktur bleibt bei jeder Erweiterung jedoch die gleiche. Es ergibt sich ein wiederverwendbares Grundgerüst,ein gemeinsamer Nenner für die Erfüllung der Überwachungsaufgabe.

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This thesis aims at investigating a new approach to document analysis based on the idea of structural patterns in XML vocabularies. My work is founded on the belief that authors do naturally converge to a reasonable use of markup languages and that extreme, yet valid instances are rare and limited. Actual documents, therefore, may be used to derive classes of elements (patterns) persisting across documents and distilling the conceptualization of the documents and their components, and may give ground for automatic tools and services that rely on no background information (such as schemas) at all. The central part of my work consists in introducing from the ground up a formal theory of eight structural patterns (with three sub-patterns) that are able to express the logical organization of any XML document, and verifying their identifiability in a number of different vocabularies. This model is characterized by and validated against three main dimensions: terseness (i.e. the ability to represent the structure of a document with a small number of objects and composition rules), coverage (i.e. the ability to capture any possible situation in any document) and expressiveness (i.e. the ability to make explicit the semantics of structures, relations and dependencies). An algorithm for the automatic recognition of structural patterns is then presented, together with an evaluation of the results of a test performed on a set of more than 1100 documents from eight very different vocabularies. This language-independent analysis confirms the ability of patterns to capture and summarize the guidelines used by the authors in their everyday practice. Finally, I present some systems that work directly on the pattern-based representation of documents. The ability of these tools to cover very different situations and contexts confirms the effectiveness of the model.

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Background: Chai hu (Bupleuri radix), one of the most frequently used herbs in Chinese herbal medicine, has 3 major functions, depending on dosage and combination with other herbs. The aim of this study was to investigate how chai hu is prescribed in everyday practice in Switzerland, and whether these prescription patterns reflect its various applications. Methods: A random sample of 1,053 prescriptions was drawn from the database of Lian Chinaherb AG, Wollerau, Switzerland, and analyzed regarding the most frequently used classical formulas containing chai hu, daily dosages and combinations with other herbs. Results: 29.0% of all prescriptions contained chai hu, and 98.0% of these were in granular form. The most frequently used classical formulas were xiao yao san (‘rambling powder’), jia wei xiao yao san (‘augmented rambling powder’) and chai hu shu gan san (‘Bupleurum powder to spread the liver’). In more than half of the prescriptions, chai hu was combined with bai shao (Paeoniae Radix Alba), dang gui (Angelicae sinensis radix) or fu ling (Poria). 51.8% of the prescriptions contained a low daily dosage of chai hu, 24.9% a medium and 15.1% a high dosage. Conclusion: Chai hu was generally prescribed in classic combinations with other herbs and in a medium dosage. Due to the addition of supplementary herbs to classical formulas, its daily dose was often diminished from a high or medium dose to a low dose. This raises the question if chai hu would then still exert its desired function of, e.g., moving liver-qi in these prescriptions

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The available literature consistently shows increased pain sensitivity after sensory stimulation of healthy tissues in patients who have various chronic pain conditions. This indicates a state of hypersensitivity of the CNS that amplifies the nociceptive input arising from damaged tissues. Experimental data indicate that central hypersensitivity is probably induced primarily by nociceptive input arising from a diseased tissue. In patients, imbalance of descending modulatory systems connected with psychologic distress may play a role. There is experimental support in animal studies for the persistence of central hypersensitivity after complete resolution of tissue damage. This is particularly true for neuropathic pain conditions, whereby potentially irreversible plasticity changes of the CNS have been documented in animal studies. Whether such changes are present in musculoskeletal pain states is at present uncertain. Despite the likely importance of central hypersensitivity in the pathophysiology of chronic pain, this mechanism should not be used to justify the lack of understanding on the anatomic origin of the pain complaints in several pain syndromes, which is mostly due to limitations of the available diagnostic tools. Treatment strategies for central hypersensitivity in patients have been investigated mostly in neuropathic pain states. Possible therapy modalities for central hypersensitivity in chronic pain of musculoskeletal origin are largely unexplored. The limited evidence available and everyday practice show, at best, modest efficacy of the available treatment modalities for central hypersensitivity. The gap between basic knowledge and clinical benefits remains large and should stimulate further intensive research.

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BACKGROUND: Conventionally, endosseous dental implants have required 3 to 6 months of uninterrupted healing based on observations for dental implants that were characterized by a relatively smooth machined surface. Many studies have since demonstrated that implants with a roughened surface resulted in greater bone apposition, earlier bone contact, and a stronger bond between the implant and the bone, suggesting that implants with roughened surfaces could be loaded earlier than 3 to 6 months. Formal clinical studies confirmed that implants with rough surfaces can have abutments placed and be loaded occlusally as early as 6 weeks postplacement. The purpose of this prospective, human clinical investigation was to evaluate a large number of implants with a specific rough surface (sand-blasted acid-etched [SLA]) placed in everyday practice under routine private-practice conditions. METHODS: A prospective, multicenter, human clinical observational study was initiated with the goal of recruiting a minimum of 500 patients and 800 implants. The implants were to be placed and restored in predominantly private-practice settings around the world. Ninety-two practitioners in 16 countries agreed to participate, and 86 followed the study design. Patients had to be in good health, have sufficient bone to encase the implant, and agree to return for recall appointments. Exclusion criteria included heavy smoking (>10 cigarettes a day) and bone augmentation procedures at the implant site. All implants were two-piece (an abutment was to be placed after 6 weeks of healing) and were characterized by the presence of a transmucosal polished collar. Each implant had an SLA surface. All implants were positioned using a non-submerged (single-stage) surgical technique. Survival and success rates were calculated by life-table analyses. RESULTS: A total of 706 patients were enrolled and 1,406 implants were placed. In the final analyses, 590 patients with 990 implants (70.4% of those enrolled) met all inclusion criteria, including placement of an abutment and provisional restoration within 63 days of surgical placement. The majority of implants were 10 and 12 mm long (78.7%) and were placed in type II and III bone (87%). Seventy-three percent of the implants were placed in the mandible, and 27% were placed in the maxilla. The cumulative survival rate was 99.56% at 3 years and 99.26% at 5 years. The overall success rate was 99.12% at 3 years and 97.38% after 5 years. CONCLUSIONS: Under private-practice conditions, implants with an SLA surface could be placed and restored predictably within 6 to 8 weeks. Data from this prospective, multicenter, human observational study reinforced the results of more formal clinical studies and demonstrated that implants with the SLA surface can be restored in patients in approximately half of the time of conventional healing periods.

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In this paper the author outlines the background to the history of the conflict in Northern Ireland which led to the current ‘Troubles’. In this discussion a range of key ideas are highlighted, including the nature of sectarianism and patterns of violence which have profoundly affected the society. The second part of the paper reviews a number of issues which face social workers when they try to deal with the effects of such violence as well as highlighting new challenges which have emerged as the society moves towards the resolution of conflict. It concludes with the argument that, wherever there is such conflict in the world, social workers need critically to understand the way in which political and social structures impinge upon their everyday practice.

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OBJECTIVE The purpose of this study was to investigate outcomes of patients treated with prasugrel or clopidogrel after percutaneous coronary intervention (PCI) in a nationwide acute coronary syndrome (ACS) registry. BACKGROUND Prasugrel was found to be superior to clopidogrel in a randomized trial of ACS patients undergoing PCI. However, little is known about its efficacy in everyday practice. METHODS All ACS patients enrolled in the Acute Myocardial Infarction in Switzerland (AMIS)-Plus registry undergoing PCI and being treated with a thienopyridine P2Y12 inhibitor between January 2010-December 2013 were included in this analysis. Patients were stratified according to treatment with prasugrel or clopidogrel and outcomes were compared using propensity score matching. The primary endpoint was a composite of death, recurrent infarction and stroke at hospital discharge. RESULTS Out of 7621 patients, 2891 received prasugrel (38%) and 4730 received clopidogrel (62%). Independent predictors of in-hospital mortality were age, Killip class >2, STEMI, Charlson comorbidity index >1, and resuscitation prior to admission. After propensity score matching (2301 patients per group), the primary endpoint was significantly lower in prasugrel-treated patients (3.0% vs 4.3%; p=0.022) while bleeding events were more frequent (4.1% vs 3.0%; p=0.048). In-hospital mortality was significantly reduced (1.8% vs 3.1%; p=0.004), but no significant differences were observed in rates of recurrent infarction (0.8% vs 0.7%; p=1.00) or stroke (0.5% vs 0.6%; p=0.85). In a predefined subset of matched patients with one-year follow-up (n=1226), mortality between discharge and one year was not significantly reduced in prasugrel-treated patients (1.3% vs 1.9%, p=0.38). CONCLUSIONS In everyday practice in Switzerland, prasugrel is predominantly used in younger patients with STEMI undergoing primary PCI. A propensity score-matched analysis suggests a mortality benefit from prasugrel compared with clopidogrel in these patients.

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Dealing with popular music in premodern times historical research usually focuses on so called “Volksmusik”. But already in the 18th century researchers were disappointed to find only few traces of imaginary “traditional” music in Switzerland. They unfortunately overlooked that common people kept on with their own stubborn musical culture: Beginning with the Reformation the authorities encouraged the communities to employ schoolmasters who were able to teach music. Their goal was that everybody should be able to participate in liturgical music actively. Over generations even people with no special musical talent adopted their own repertoire of psalms plus techniques of reading music and polyphonic singing. Spontaneous choral singing evolved into a common everyday practice. The most ambitious and brightest teachers even taught instrumental lessons at home on their proper pianos and chamber organs or encouraged the villagers to build new prestigious organs in their churches. The financial burden of such instruments weighted heavily on the communities. Some of them received financial support from the government, albeit unwillingly because it was obvious to the rulers that the villages just wanted to overtop each other. Homemade music was the most important issue in the cultural life of most parishes. Rich communes spent a lot of money to win the best voices on-site for their church choirs. Belonging to an elitists’ singer association paved the way to the farmer-village’s highlevel sociability.

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Bridge building is a highly uncertain endeavour that entails considerable risk, as attested to by the succession of construction-related incidents and accidents recently reported in Spain and elsewhere. While efforts are being made to improve on-site safety, many issues are still outstanding, such as the establishment of reliability requirements for the ancillary systems used. The problems that must be dealt with in everyday practice, however, are more elementary and often attributable to human error. The overall organisation of the use of bridge construction equipment is in need of improvement. Close cooperation between the bridge engineers responsible for construction planning and ancillary element suppliers is imperative, for flawed interaction between building equipment and the bridge under construction may generate structural vulnerability. External quality assurance should likewise be mandatory

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La presente tesis doctoral pretende ampliar conocimientos de los sistemas de producción y tecnología asociada del cerdo Ibérico. Los trabajos de campo fueron llevados a cabo en el CIA ‘El Dehesón del Encinar’ (Oropesa, Toledo, España) con cerdos Ibéricos de la estirpe Torbiscal. En los dos primeros experimentos, utilizando dos grupos de cerdos, se estudió el efecto de la restricción de la alimentación en premontanera sobre las características de la canal y sobre la composición de la grasa al sacrificio de los cerdos posteriormente cebados en montanera. Los animales restringidos en premontanera crecieron significativamente menos que los no restringidos durante dicho periodo, y manifestaron un crecimiento compensatorio durante la montanera. Este crecimiento compensatorio no fue suficiente, y los animales restringidos llegaron con pesos significativamente inferiores al sacrificio, aunque esto no supuso diferencias para las características de la canal entre ambos grupos de animales. También al sacrificio, los animales restringidos durante la premontanera tuvieron concentraciones significativamente diferentes de ácidos grasos, sobre todo en la capa interna de la grasa subcutánea y en la fracción de lípidos polares de la grasa intramuscular; asimismo, tuvieron mayores concentraciones de tocoferoles en el músculo Longissimus dorsi. En un tercer experimento, utilizando cuatro grupos de animales, se estudió el efecto del tiempo de estancia de los cerdos en montanera exclusiva sobre las características de la canal y de la grasa al sacrificio. La duración de la montanera afectó significativamente al crecimiento, a los pesos y porcentajes de los productos del despiece y al perfil de ácidos grasos de la grasa subcutánea. Los animales cebados con pienso en confinamiento tuvieron mayor crecimiento, mejor calidad de la canal, y peor calidad de grasa que los otros tres grupos de animales que se acabaron en montanera exclusiva durante 46, 83 y 111 días. En el último experimento se evaluó si la impedancia bioeléctrica es un método adecuado para realizar un estudio tisular de los jamones de cerdos Ibéricos, aspecto especialmente relevante para la industria. La impedancia bioeléctrica resultó ser un método no invasivo adecuado, que puede ser aplicado para predecir la composición tisular de los jamones, aunque se necesitan más ensayos antes de llevar este método a la práctica cotidiana de la industria. ABSTRACT This Thesis aims to expand knowledge on production systems and technology associated to Iberian pigs. Fieldwork was conducted in the CIA ‘El Dehesón del Encinar’ (Oropesa, Toledo, Spain) with Iberian pigs Torbiscal line. In first two experiments, using two groups of pigs, the effect of feed restriction during the period previous to free-range fattening on growth and carcass characteristics in Iberian pigs finished under free-range conditions was studied. The pigs fed low feeding levels during the period previous to free-range finishing period, had significantly lower growth than those feed with a high level during that period, and showed a compensatory growth during free-range period. However, this compensatory growth was not enough to reach the same weight than the animals fed with a high level, and the slaughter weights were significantly different, although no differences were observed for the carcass characteristics between both groups of pigs. At slaughter, animals fed low feeding levels during the period previous to free-range finishing period, had significantly different fatty acid proportions, especially in the inner backfat layer and in polar lipids fraction of the intramuscular fat; also, the tocopherol concentration found in Longissimus dorsi muscle from pigs fed low feeding levels was higher than those fed high feeding levels. In a third experiment, using four groups of animals, the effect of duration under freerange exclusive conditions on carcass and fat characteristics at slaughter was studied. The growth, weights and percentages of carcass cuts, and fatty acid profile of the backfat were significantly affected by the duration under free-range exclusively conditions. The animals fed in confinement with concentrate diets during the whole fattening period had high growth, better carcass quality and worse fat quality than the other three groups of animals fed under free-range exclusive conditions during 46, 83 and 111 days. In the last experiment, it assessed whether the bioelectrical impedance is a suitable method for perform a tissue study of Iberian pig hams, particularly important aspect for industry. The bioelectrical impedance has proved to be a non-invasive suitable method, which can be applied to predict the tissues composition of the hams, but more trials are needed before carrying this method to everyday practice in the industry.