Dedicated severe asthma services improve health-care use and quality of life

Background: Systematic assessment of severe asthma can be used to confirm the diagnosis, identify comorbidities, and address adherence to therapy. However, the prospective usefulness of this approach is yet to be established. The objective of this study was to determine whether the systematic assessment of severe asthma is associated with improved quality of life (QoL) and health-care use and, using prospective data collection, to compare relevant outcomes in patients referred with severe asthma to specialist centers across the United Kingdom. Methods: Data from the National Registry for dedicated UK Difficult Asthma Services were used to compare patient demographics, disease characteristics, and health-care use between initial assessment and a median follow-up of 286 days. Results: The study population consisted of 346 patients with severe asthma. At follow-up, there were significant reductions in health-care use in terms of primary care or ED visits (66.4% vs 87.8%, P < .0001) and hospital admissions (38% vs 48%, P = .0004). Although no difference was noted in terms of those requiring maintenance oral corticosteroids, there was a reduction in steroid dose (10 mg [8-20 mg] vs 15 mg [10-20 mg], P = .003), and fewer subjects required short-burst steroids (77.4% vs 90.8%, P = .01). Significant improvements were seen in QoL and control using the Asthma Quality of Life Questionnaire and the Asthma Control Questionnaire. Conclusions: To our knowledge, this is the first time that a prospective study has shown that a systematic assessment at a dedicated severe asthma center is associated with improved QoL and asthma control and a reduction in health-care use and oral steroid burden.

A closer look at Carver and White's BIS/BAS scales: Factor analysis and age group differences

The Behavioural Inhibition and Behavioural Activation System (BIS/BAS) scales were developed by Carver and White (1994) and comprise four scales which measure individual differences in personality (Gray 1982, 1991). More recent modifications, namely the five-factor model derived from Gray and McNaughton's (2000) revised Reward Sensitivity Theory (RST) suggests that Anxiety and Fear are separable components of inhibition. This study employed exploratory and confirmatory factor analyses on the scales in order to test whether the four or five-factor model was the better fit in a sample of 994 participants aged 11–30 years. Consistent with RST, superior model fit was shown for the five-factor model with all variables correlated. Significant age effects were observed for BIS Fear and BIS Anxiety, with scores peaking in middle and late adolescence respectively. The BAS subscales showed differential effects of age group. Significantly increasing scores from early to mid and from mid to late adolescence were found for Drive, but the effect of age on Fun Seeking and Reward Responsiveness was not significant.

Reply (Correspondence)

We appreciate the interest of Galvis and associates in our work.1 It has been suggested that undercorrection of children's refractive error might retard myopia progression. Previous studies,2,3 limited by size, have generally not been consistent with this. We performed a post hoc analysis on data from our large trial of spectacle provision in China and found no evidence of worsening visual acuity (VA) among children randomized to receive glasses compared to controls. In fact, the final uncorrected VA of Treatment Group children was significantly better than that of controls.

Stated preference methods and landscape ecology indicators: an example of transdisciplinarity in landscape economic valuation

This paper addresses the representation of landscape complexity in stated preferences research. It integrates landscape ecology and landscape economics and conducts the landscape analysis in a three-dimensional space to provide ecologically meaningful quantitative landscape indicators that are used as variables for the monetary valuation of landscape in a stated preferences study. Expected heterogeneity in taste intensity across respondents is addressed with a mixed logit model in Willingness to Pay space. Our methodology is applied to value, in monetary terms, the landscape of the Sorrento Peninsula in Italy, an area that has faced increasing pressure from urbanization affecting its traditional horticultural, herbaceous, and arboreal structure, with loss of biodiversity, and an increasing risk of landslides. We find that residents of the Sorrento Peninsula would prefer landscapes characterized by large open views and natural features. Residents also appear to dislike heterogeneous landscapes and the presence of lemon orchards and farmers' stewardship, which are associated with the current failure of protecting the traditional landscape. The outcomes suggest that the use of landscape ecology metrics in a stated preferences model may be an effective way to move forward integrated methodologies to better understand and represent landscape and its complexity.

Systematically retrieving research in the digital age: Case study on the topic of social networking sites and young people’s mental health

Online information seeking has become normative practice among both academics and the general population. This study appraised the performance of eight databases to retrieve research pertaining to the influence of social networking sites on the mental health of young people. A total of 43 empirical studies on young people’s use of social networking sites and the mental health implications were retrieved. Scopus and SSCI had the highest sensitivity with PsycINFO having the highest precision. Effective searching requires large
generic databases, supplemented by subject-specific catalogues. The methodology developed here may provide inexperienced searchers, such as undergraduate students, with a framework to define a realistic scale of searching to undertake for a particular literature review or similar project.

Melt processing and properties of linear low density polyethylene-graphene nanoplatelet composites

Composites of Linear Low Density Polyethylene (LLDPE) and Graphene Nanoplatelets (GNPs) were processed using a twin screw extruder under different extrusion conditions. The effects of screw speed, feeder speed and GNP content on the electrical, thermal and mechanical properties of composites were investigated. The inclusion of GNPs in the matrix improved the thermal stability and conductivity by 2.7% and 43%, respectively. The electrical conductivity improved from 10−11 to 10−5 S/m at 150 rpm due to the high thermal stability of the GNPs and the formation of phonon and charge carrier networks in the polymer matrix. Higher extruder speeds result in a better distribution of the GNPs in the matrix and a significant increase in thermal stability and thermal conductivity. However, this effect is not significant for the electrical conductivity and tensile strength. The addition of GNPs increased the viscosity of the polymer, which will lead to higher processing power requirements. Increasing the extruder speed led to a reduction in viscosity, which is due to thermal degradation and/or chain scission. Thus, while high speeds result in better dispersions, the speed needs to be optimized to prevent detrimental impacts on the properties.

Development of the Consumer Refrigerator Safety Questionnaire (CRSQ): A Measure of Consumer Perceptions and Practices

Food preparation and storage behaviors in the home deviating from the ‘best practice’ food safety recommendations may result in food borne illnesses. Currently, there are limited tools available to fully evaluate the consumer knowledge, perceptions and behavior in the area of refrigerator safety. The current study aimed to develop a valid and reliable tool in the form of a questionnaire (CFSQCRSQ) for assessing systematically all these aspects. Items relating to refrigerator safety knowledge (n=17), perceptions (n=46), reported behavior (n=30) were developed and pilot tested by an expert reference group and various consumer groups to assess face and content validity (n=20), item difficulty and item consistency (n=55) and construct validity (n=23). The findings showed that the CFSQCRSQ has acceptable face and content validity with acceptable levels of item difficulty. Item consistency was observed for 12 out of 15 refrigerator safety knowledge. Further, all five of the subscales of consumer perceptions of refrigerator safety practices relating to risk of developing foodborne disease food poisoning showed acceptable internal consistency (Cronbach’s α value > 0.8). Construct validity of the CFSQCRSQ was shown to be very good (p=0.022). The CFSQCRSQ exhibited acceptable test-retest reliability at 14 days with majority of knowledge items (93.3%) and reported behavior items (96.4%) having correlation coefficients of greater than 0.70. Overall, the CFSQCRSQ was deemed valid and reliable in assessing refrigerator safety knowledge and behavior and therefore has the potential for future use in identifying groups of individuals at increased risk of deviating from recommended refrigerator safety practices as well as the assessment of refrigerator safety knowledge, behavior for use before and after an intervention.

La síntesis fenomeno-lógica. Aspectos metódicos de la apropiación heideggeriana de la fenomenología de Husserl

Sabemos que la relación filosófica entre la obra de Edmund Husserl y Martin Heidegger no es un asunto sencillo de abordar. Con facilidad se inclina la balanza hacia uno u otro autor.1 Eso por sí no sería grave, excepto por el hecho de que múltiples interpretaciones de entrada impiden cualquier posibilidad de acercamiento.2 De esa forma uno estaría obligado a tomar posición a favor de uno y en contra del otro. Ese camino evidentemente empobrece la discusión filosófica. Sin embargo, al intentar abordar una posible relación nos encontramos con ciertas interpretaciones de Heidegger que parecen colocar algo en donde todavía no había tal propuesta en su momento. Ante este panorama quisiera intentar destacar algunos aspectos que den luz sobre la relación fenomenológica entre Husserl y Heidegger tomando como hilo conductor las aseveraciones enfáticas de Heidegger en torno al papel que desempeñaron las Investigaciones lógicas (IL) de Husserl en la conformación de su pensar. Evidentemente con este retorno a las IL buscamos poner a prueba la propia interpretación de Heidegger. De esta forma se verá al final si los señalamientos de Heidegger proporcionan el espacio para llevar a cabo un diálogo fructífero que supere posiciones cerradas.

Analysis of genetic diversity in Portuguese Ceratonia siliqua L. cultivars using RAPD and AFLP markers

Although carob (Ceratonia siliqua L.) is of great economic importance little is still known about the pattern of genetic variation within this species. Morphological characteristics based on 31 fruit and seeds of continuous characters determinant for agro-industrial uses, were compared with RAPD and AFLP markers for assessing genetic distances in 68 accessions of carob trees, from different cultivars, varieties and eco-geographic regions of Algarve. Eighteen selected RAPD primers applied to the 68 accessions produced a total of 235 fragments ranging from 200 to 2000 bp, of which 93 (40%) were polymorphic. Four AFLP selective primer combinations generated a total of 346 amplification fragments of which 110 were polymorphic. The average level of polymorphism based on four primer combinations was 31.8%. The phenetic trees based on RAPD and AFLP analyses gave high co-phenetic correlation values, and were found to be consistent in general with the analysis of morphological data, carried out on the same accessions. A number of RAPD and AFLP markers were found to be diagnostic for ‘Canela’ cultivar and 13 wild ungrafted trees.

O impacto da experiência de estágio no desenvolvimento vocacional de alunos dos cursos tecnològicos e profissionais do ensino secundário

Tese de dout., Psicologia (Psicologia da Educação), Faculdade de Ciências Humanas e Sociais, Univ. do Algarve, 2011

Património rural construído do Baixo Guadiana

O património rural mediterrânico encerra um quadro de manifestações passadas e presentes com uma riqueza específica e uma diversidade de significados. No quadro de uma ampla parceria dialogante, com uma estrutura técnica entusiasta, dinâmica e crente no desenvolvimento do território do espaço do Mediterrâneo e Baixo Guadiana, foram feitas trocas de experiências, discutidos conceitos e metodologias de intervenção e analisados impactos de onde resultou para cada território um conjunto de acções- piloto de carácter transnacional que consubstanciassem as temáticas do projecto Rural Med, onde se enquadra o presente estudo do Baixo Guadiana.

Metal speciation dynamics in colloidal ligand dispersions. Part 2: electrochemical lability

We investigate the dynamic nature of metal speciation in colloidal dispersions using a recently proposed theory [J.P. Pinheiro, M. Minor, H.P. Van Leeuwen, Langmuir, 21 (2005) 8635] for complexing ligands that are situated on the surface of the particles. The new approach effectively modifies the finite rates of association/dissociation of the colloidal metal complexes, thus invoking consideration of the two basic dynamic criteria: the association/dissociation kinetics of the volume complexation reaction (the ‘‘dynamic’’ criterion), and the interfacial flux of free metal to a macroscopic surface due to dissociation of complex species (the ‘‘lability’’ criterion). We demonstrate that the conventional approach for homogeneous systems that assume a smeared-out ligand distribution, overestimates both the dynamics and the lability of metal complexes when applied to colloidal ligands. It is also shown that the increase of lability with increasing particle radius, as expected for a homogeneous solution, is moderated for spherical microelectrodes and practically eliminated for planar electrodes.

Biologia pesqueira e dinâmica populacional de Diplodus vulgaris (geoffr.) e Spondyliosoma cantharus (L.) (pisces, sparidae) na costa sudoeste de Portugal

As espécies da família Sparidae ocupam um lugar de destaque na actividade pesqueira da Costa Sudoeste de Portugal, sendo das principais subsidiárias da pesca artesanal nesta região. Com o presente trabalho pretendeu-se clarificar aspectos básicos da biologia de dois esparídeos, Diplodus vulgaris (safia) e Spondyliosoma cantharus (choupa), nas áreas da ecologia alimentar, reprodução, idade, crescimento e mortalidade; estimar os parâmetros de selectividade das artes de pesca mais importantes sobre estas espécies e avaliar preliminarmente o estado da pescaria destes dois esparídeos. Para atingir estes objectivos cumpriu-se um plano de amostragem de frequências de comprimento nas lotas de Sagres e Sines, de Julho de 1992 a Março de 1994; estudos laboratoriais com amostras recolhidas em Sagres de Dezembro de 1992 a Março de 1994 e um estudo de selectividade de aparelho de anzol e redes de emalhar realizado em 1997/98. Os hábitos alimentares foram estudados a partir da análise de conteúdos estomacais, utilizando-se 3 métodos de avaliação da composição da dieta, 5 índices combinados da bibliografia e 3 propostos. Da análise comparativa entre os vários índices concluiu-se que o índice de importância relativa (IRI) e o índice de alimentação ponderado (IPO2) serão os mais adequados para descrever as dietas destas espécies. Registaram-se elevados coeficientes de vacuidade, motivados em grande parte pela natureza da arte de pesca. A dieta de D. vulgaris é composta essencialmente por ofiurídeos, poliquetas, anfípodes e equinóides, enquanto que S. cantharus consome principalmente poliquetas, anfípodes e hidrozoários. As duas dietas são significativamente diferentes, principalmente pelo maior consumo de equinodermes no caso de D. vulgaris. A estrutura e dimensões da boca nestes esparídeos são distintas, podendo influenciar o seu comportamento trófico. À semelhança de grande parte dos esparídeos, D. vulgaris e S. cantharus são espécies bentívoras, que adoptam uma estratégia alimentar generalista, com fortes afinidades com o alimento disponível no meio. Da análise do ciclo reprodutivo verificou-se que as épocas de postura são extensas: D. vulgaris: Dezembro a Março com maior intensidade em Janeiro/Fevereiro; S. cantharus: Fevereiro a Abril, com máxima intensidade em Março. Não existiram diferenças significativas na proporção entre os sexos (M:F = 1.01) ao longo do ano e por tamanho em D. vulgaris, enquanto que em S. cantharus as fêmeas foram mais abundantes ao longo do ano (M:F=0.57) e nas classes de comprimento inferiores. Os tamanhos de 1ª maturação (L50%) para o conjunto dos sexos e indivíduos indeterminados foram de: D. vulgaris, 18.33 cm, não existindo diferenças significativas entre machos e fêmeas; S. cantharus, 20.10 cm, existindo diferenças significativas entre machos (22.41 cm, TL) e fêmeas (19.98 cm, TL). Os tamanhos de 1ª maturação estimados foram consideravelmente superiores aos tamanhos mínimo legais de desembarque (TML) em Portugal, para D. vulgaris (TML=15.0 cm) e ligeiramente inferiores no caso de S. cantharus (TML=23 cm). A fecundidade média absoluta (Fa) e a fecundidade relativa (Fr) foram de: D. vulgaris - Fa = 131127 ovos; Fr = 526 ovos/g; S. cantharus - Fa = 61396 ovos; Fr = 346 ovos/g. As relações entre a fecundidade absoluta e o comprimento total (TL) e o peso somático (SW) foram as seguintes: D. vulgaris: Fa = 0.1853TL4.1903; Fa = 57.715SW1.4067; S. cantharus: Fa = 436.27TL1.5747; Fa = 2979.7SW0.585. A estratégia reprodutiva destas espécies é caracterizada por hermafroditismo, rudimentar com eventual protândria parcial em D. vulgaris e protogínia em S. cantharus. A determinação da idade foi efectuada pela análise de estruturas duras, otólitos para D. vulgaris e otólitos e escamas para S. cantharus. As estimações do comprimento à idade ajustaram-se bem ao modelo de Von Bertalanffy. De entre os métodos de estimação dos parâmetros de crescimento, escolheu-se o ajuste não linear aplicado a todos os pares de comprimentos à idade, sendo esta corrigida pela data de captura. Para além do maior rigor desta análise, os resultados produzidos foram considerados os mais aproximados da realidade: D. vulgaris (otólitos): L=28.1 cm K=0.30 ano-1 e t0= -1.618 anos (validade: 12.5-30.5 cm; 1-10 anos); S. cantharus (escamas): L=35 cm, K=0.32 ano-1 e t0=-0.481 anos (validade: 14.3-33.5 cm; 1-9 anos). A análise de distribuição de frequências de comprimento, apresentou um L mais próximo da realidade: L=39.6 cm, K=0.32 ano-1 e t0=-0.481 anos (D. vulgaris); L=40.0 cm, K=0.24 ano-1 e t0=-0.646 anos (S. cantharus). As relações peso-comprimento de D. vulgaris e S. cantharus para a Costa Sudoeste foram do tipo potencial W=a Lb, sendo definidas pelos seguintes parâmetros: a=0.0223 e b= 2.895, r2=0.89 (D. vulgaris); a=0.0106 e b= 3.085, r2= 0.89 (S. cantharus). Os valores de mortalidade natural (M), estimados por métodos indirectos, para D. vulgaris e S. cantharus foram de 0.39 e 0.30 ano-1, respectivamente. O valor de M de esparídeos pode ser estimado preliminarmente mediante a utilização de uma regressão multilinear que integra as três variáveis (M, K e L): M = -0.162 + 1.714K + 0.00273L (r2=0.77). A análise das curvas de captura permitiu obter os seguintes valores de mortalidade total (Z): D. vulgaris: Z=0.642 (otólitos) e 0.727 ano-1 (frequências de comprimento); S. cantharus: Z=0.676 (escamas) e 0.576 ano-1 (frequências de comprimento). As artes de pesca mais importantes para D vulgaris e S. cantharus e para a região considerada são, por ordem de grandeza, o aparelho de anzol e redes de emalhar, e em menor escala a arte do cerco. Os esparídeos diversos e dentro destes a choupa, que deveria ser discriminada nas estatísticas oficiais, constituíram os únicos esparídeos que apresentaram uma evolução com tendência negativa de 1987 a 1998. A estrutura demográfica de desembarques de safia é caracterizada por cerca de 86.9 % indivíduos entre 20.5 a 27.5 cm (2 a 6 anos), enquanto que para a choupa, 85.0% dos indivíduos desembarcados estão compreendidos entre 21.5 e 27.5 cm (2 a 6 anos). No estudo de selectividade foram realizadas 40 pescas experimentais em que se testaram 4 tamanhos de anzol (nº11, 12, 13 e 15) e de malha (80, 70, 60 e 50mm). D. vulgaris e S. cantharus são das espécies mais abundantes na pescaria com aparelho de anzol, tendo uma representação inferior quer em termos relativos, quer absolutos nas capturas das redes de emalhar. Existiu um decréscimo geral das taxas de captura com o tamanho do anzol e uma maior eficiência para os tamanhos intermédios da malha nas redes de emalhar. Paralelamente, existiu para ambas as espécies uma sobreposição de comprimentos médios com o tamanho dos anzóis e uma separação clara de comprimentos médios de ambas as espécies com a malhagem. Adoptaram-se, com bom ajuste, uma curva de selectividade do tipo logística para o aparelho de anzol e normal para as redes de emalhar, para ambas as espécies. Atendendo a uma eventual revisão dos tamanhos mínimos legais de desembarque, em função dos tamanhos de primeira maturação e à estrutura das capturas, as malhas de 70 e 80mm são as mais adequadas na pescaria de D. vulgaris e S. cantharus, respectivamente. O anzol número 13 será o mais apropriado a D. vulgaris, dada a pouca praticabilidade do anzol 15. Em relação a S. cantharus o anzol nº 11 apresenta a menor proporção de indivíduos com tamanho ilegal, sendo então o mais indicado à pescaria desta espécie. Para o aparelho de anzol e de acordo com os modelos de rendimento por recruta a pescaria de safia processa-se de forma moderada, a níveis inferiores a uma taxa de exploração máxima (Emax) suportável pelo "stock". A pescaria de choupa apresenta indícios de uma exploração intensa, próxima dos valores máximos comportados pelo "stock". Uma alteração nos valores actuais da taxa de exploração e/ou de comprimento de 1ª captura terá de ter em consideração o carácter multiespecifico desta pescaria. Visando a gestão destes recursos pesqueiros, dever-se-á controlar principalmente o nível do esforço de pesca praticado e rever os tamanhos mínimos de desembarque, de modo a evitar que esta pescaria entre numa fase de sobreexploração. O estabelecimento de reservas marinhas e de recifes artificiais poderá ser um contributo para uma exploração pesqueira sustentada e para a conservação da biodiversidade.

Estimating the size of the population of persons who inject drugs in the island of Montréal, Canada, using a six-source capture-recapture model

BACKGROUND: To plan and implement services to persons who inject drugs (PWID), knowing their number is essential. For the island of Montréal, Canada, the only estimate, of 11,700 PWID, was obtained in 1996 through a capture-recapture method. Thirteen years later, this study was undertaken to produce a new estimate. METHODS: PWID were defined as individuals aged 14-65 years, having injected recently and living on the island of Montréal. The study period was 07/01/2009 to 06/30/2010. An estimate was produced using a six-source capture-recapture log-linear regression method. The data sources were two epidemiological studies and four drug dependence treatment centres. Model selection was conducted in two steps, the first focusing on interactions between sources and the second, on age group and gender as covariates and as modulators of interactions. RESULTS: A total of 1480 PWID were identified in the six capture sources. They corresponded to 1132 different individuals. Based on the best-fitting model, which included age group and sex as covariates and six two-source interactions (some modulated by age), the estimated population was 3910 PWID (95% confidence intervals (CI): 3180-4900) which represents a prevalence of 2.8 (95% CI: 2.3-3.5) PWID per 1000 persons aged 14-65 years. CONCLUSIONS: The 2009-2010 estimate represents a two-third reduction compared to the one for 1996. The multisource capture-recapture method is useful to produce estimates of the size of the PWID population. It is of particular interest when conducted at regular intervals thus allowing for close monitoring of the injection phenomenon.