Delirium in the elderly: Current problems with increasing geriatric age.

Delirium is an acute disorder of attention and cognition seen relatively commonly in people aged 65 yr or older. The prevalence is estimated to be between 11 and 42 per cent for elderly patients on medical wards. The prevalence is also high in nursing homes and long term care (LTC) facilities. The consequences of delirium could be significant such as an increase in mortality in the hospital, long-term cognitive decline, loss of autonomy and increased risk to be institutionalized. Despite being a common condition, it remains under-recognised, poorly understood and not adequately managed. Advanced age and dementia are the most important risk factors. Pain, dehydration, infections, stroke and metabolic disturbances, and surgery are the most common triggering factors. Delirium is preventable in a large proportion of cases and therefore, it is also important from a public health perspective for interventions to reduce further complications and the substantial costs associated with these. Since the aetiology is, in most cases, multfactorial, it is important to consider a multi-component approach to management, both pharmacological and non-pharmacological. Detection and treatment of triggering causes must have high priority in case of delirium. The aim of this review is to highlight the importance of delirium in the elderly population, given the increasing numbers of ageing people as well as increasing geriatric age.

Sedation palliative: aspects cliniques pratiques [Clinical and practical aspects of palliative sedation]

Un certain nombre de patients palliatifs en fin de vie présentent des symptômes qui ne peuvent pas être soulagés malgré la mise en oeuvre de tous les moyens traditionnels à disposition. Pour ces patients, lorsque des symptômes réfractaires induisent une souffrance intolérable, la sédation palliative est un moyen de dernier recours qui peut leur offrir un soulagement transitoire ou même définitif. Tout en présentant les enjeux éthiques, cet article explore les dimensions cliniques d'ordre pratique qui peuvent se présenter lors d'une sédation palliative chez un patient en fin de vie. Patients at the end-of-life may present with refractory symptoms which cannot be adequately relieved despite the use of all traditional means. When refractory symptoms lead to intolerable suffering, palliative sedation is a last recourse temporary or definitive treatment. While discussing ethical issues, clinical practice dimensions of palliative sedation are explored in this article

A practical guide for the formulation of propositions in the bayesian approach to DNA evidence interpretation in an adversarial environment

The interpretation of complex DNA profiles is facilitated by a Bayesian approach. This approach requires the development of a pair of propositions: one aligned to the prosecution case and one to the defense case. This note explores the issue of proposition setting in an adversarial environment by a series of examples. A set of guidelines generalize how to formulate propositions when there is a single person of interest and when there are multiple individuals of interest. Additional explanations cover how to handle multiple defense propositions, relatives, and the transition from subsource level to activity level propositions. The propositions depend on case information and the allegations of each of the parties. The prosecution proposition is usually known. The authors suggest that a sensible proposition is selected for the defense that is consistent with their stance, if available, and consistent with a realistic defense if their position is not known.

Latent Class Analysis of Gambling Activities in a Sample of Young Swiss Men : Association with Gambling Problems, Substance Use Outcomes, Personality Traits and Coping Strategies.

The study aimed to identify different patterns of gambling activities (PGAs) and to investigate how PGAs differed in gambling problems, substance use outcomes, personality traits and coping strategies. A representative sample of 4989 young Swiss males completed a questionnaire assessing seven distinct gambling activities, gambling problems, substance use outcomes, personality traits and coping strategies. PGAs were identified using latent class analysis (LCA). Differences between PGAs in gambling and substance use outcomes, personality traits and coping strategies were tested. LCA identified six different PGAs. With regard to gambling and substance use outcomes, the three most problematic PGAs were extensive gamblers, followed by private gamblers, and electronic lottery and casino gamblers, respectively. By contrast, the three least detrimental PGAs were rare or non-gamblers, lottery only gamblers and casino gamblers. With regard to personality traits, compared with rare or non-gamblers, private and casino gamblers reported higher levels of sensation seeking. Electronic lottery and casino gamblers, private gamblers and extensive gamblers had higher levels of aggression-hostility. Extensive and casino gamblers reported higher levels of sociability, whereas casino gamblers reported lower levels of anxiety-neuroticism. Extensive gamblers used more maladaptive and less adaptive coping strategies than other groups. Results suggest that gambling is not a homogeneous activity since different types of gamblers exist according to the PGA they are engaged in. Extensive gamblers, electronic and casino gamblers and private gamblers may have the most problematic PGAs. Personality traits and coping skills may predispose individuals to PGAs associated with more or less negative outcomes.

The First International Workshop on Warning Criteria for Active Slides: technical issues, problems and solutions for managing early warning systems

Early warning systems (EWSs) rely on the capacity to forecast a dangerous event with a certain amount of advance by defining warning criteria on which the safety of the population will depend. Monitoring of landslides is facilitated by new technologies, decreasing prices and easier data processing. At the same time, predicting the onset of a rapid failure or the sudden transition from slow to rapid failure and subsequent collapse, and its consequences is challenging for scientists that must deal with uncertainties and have limited tools to do so. Furthermore, EWS and warning criteria are becoming more and more a subject of concern between technical experts, researchers, stakeholders and decision makers responsible for the activation, enforcement and approval of civil protection actions. EWSs imply also a sharing of responsibilities which is often averted by technical staff, managers of technical offices and governing institutions. We organized the First International Workshop on Warning Criteria for Active Slides (IWWCAS) to promote sharing and networking among members from specialized institutions and relevant experts of EWS. In this paper, we summarize the event to stimulate discussion and collaboration between organizations dealing with the complex task of managing hazard and risk related to active slides.

Fingermark age determinations: legal considerations, review of the literature and practical propositions

The question of the age of fingermarks is often raised in investigations and trials when suspects admit that they have left their fingermarks at a crime scene but allege that the contact occurred at a different time than the crime and for legal reasons. In the first part of this review article, examples from American appellate court cases will be used to demonstrate that there is a lack of consensus among American courts regarding the admissibility and weight of testimony from expert witnesses who provide opinions about the age of fingermarks. Of course, these issues are not only encountered in America but have also been reported elsewhere, for example in Europe. The disparity in the way fingermark dating cases were managed in these examples is probably due to the fact that no methodology has been validated and accepted by the forensic science community so far. The second part of this review article summarizes the studies reported on fingermark dating in the literature and highlights the fact that most proposed methodologies still suffer from limitations preventing their use in practice. Nevertheless, several approaches based on the evolution of aging parameters detected in fingermark residue over time appear to show promise for the fingermark dating field. Based on these approaches, the definition of a formal methodological framework for fingermark dating cases is proposed in order to produce relevant temporal information. This framework identifies which type of information could and should be obtained about fingermark aging and what developments are still required to scientifically address dating issues.

The practical application of e-Portfolio at the Open University of Catalonia : assessment of competence based learning

The paper presents the results of the piloting or pilot test in a virtual classroom. This e-portfolio was carried out in the 2005-2006 academic year, with students of the Doctorate in Information Society, at the Open University of Catalonia. The electronic portfolio is a strategy for competence based assessment. This experience shows the types of e-portfolios, where students show their work without interactions, and apply the competence-based learning theories in an interactive portfolio system. The real process of learning is developed in the competency based system, the portfolio not only is a basic bio document, has become a real space for learning with competence model. The paper brings out new ideas and possibilities: the competence-based learning promotes closer relationships between universities and companies and redesigns the pedagogic act.

Evaluation of Implementation of BSc IT Curriculum at Tumaini University

In Tanzania computer knowledge is vital to supplement the pace fast growing economic and development activities, which demands high and reliable level of expertise in com- puting field. In 2006, a research carried out at Tumaini University with purpose to design and implement a contextualized curriculum that can supplement for such needs hence facilitate development in Tanzanian context. A contextualized curriculum took advantage of six principles namely curriculum contex- tualization, projects, practical, interdisciplinary orientation, international recognition and continuous research for the program’s formative and development. Implementation of the curriculum followed the CATI (Contextualize, Apply, Transfer, and Import) model with emphasis on students to identify societal expectations at the early stage in learning process, in which case the graduates will potentially cater for societal expertise needs on ICT. This study adopts an emergent exploratory cross-section research design, while employ- ing a qualitative approach. This study was conducted at Tumaini University in Iringa where by purposeful sampling was used to obtain participants such as students, teach- ers, administrators and employers who participated in several focus group discussions, in-depth interviews and participant observation. The study reveals that six principles are satisfactorily met,despite of bottlenecks such as incompatibility in pedagogical thinking and technology availability for e-learning, learning attitudes, insufficient experts with actual skills and experience,in academic field among the others. The study recommends that iterative longitudinal study should be car- ried out to design for proper intervention in response to these problems which will help in improving and stabilize the curriculum.

LVI- ja sähköurakoinnin raportoinnin kehittäminen IT-palveluyrityksessä

Työn tavoitteena oli kehittää LVI- ja sähköurakointitoimialan asiakkaille tarjottavaa raportointia IT-palveluyrityksessä. Raportoinnin tulisi soveltua paremmin yrityksen ohjaamiseen ja sen avulla yrityksen tulisi tietää kannattavuutensa, rahoitustilanteensa ja liiketoimintansa kehityssuunnat. Tarkoituksena oli suunnitella raportointimalli, joka soveltuu toimialan pienten ja keskisuurten yritysten käyttöön. Tutkimus toteutettiin konstruktiivisena eli tutkimuksen tavoitteena oli luoda uusi ratkaisumalli käytännön ongelmaan. Konstruktion rakentamiseksi työssä selvitettiin LVI- ja sähköurakoinnin erityispiirteitä, yrityksen ohjaukseen vaikuttavia tekijöitä ja menetelmiä sekä raportoinnin periaatteellista ja teknistä toteuttamista. Näiden osa-alueiden avulla luotiin raportointimallille vaatimukset, jotka sen tulisi täyttää. Tämän jälkeen kuvattiin raportoinnin nykyinen tekninen toteutustapa ja sen sisältämät osa-alueet. Selvitettyjen vaatimusten ja nykyisen raportoinnin ongelmien perusteella luotiin alustava raportointimalli, jonka käytännön merkitys selvitettiin haastattelemalla 11 LVI- ja sähköurakointiyrityksen vastuunalaista johtajaa. Haastatteluista saatiin selville, että kahdeksan johtajaa olisi ollut valmis käyttämään konstruktiota. Alustavan raportointimallin ja haastatteluista saadun palautteen perusteella luotiin ehdotus raportointimallista toimialalla. Lisäksi IT-palveluyrityksen nykyiselle raportointimallille luotiin kolmivaiheinen kehityssuunnitelma, jolla raportointia voidaan kehittää luodun raportointimallin mukaiseksi.

The grammar of psychosis

This thesis is concerned with the philosophical grammar of certain psychiatric concepts, which play a central role in delineating the field of psychiatric work. The concepts studied are ‘psychosis’, ‘delusion’, ‘person’, ‘understanding’ and ‘incomprehensibility’. The purpose of this conceptual analysis is to provide a more perspicuous view of the logic of these concepts, how psychiatric work is constituted in relation to them, and what this tells us about the relationships between the conceptual and the empirical in psychiatric concepts. The method used in the thesis is indebted primarily to Ludwig Wittgenstein’s conception of philosophy, where we are urged to look at language uses in relation to practices in order to obtain a clearer overview of practices of interest; this will enable us to resolve the conceptual problems related to these practices. This questioning takes as its starting point the concept of psychosis, a central psychiatric concept during the twentieth century. The conceptual analysis of ‘psychosis’ shows that the concept is logically dependent on the concepts of ‘understanding’ and ‘person’. Following the lead found in this analysis, the logic of person-concepts in psychiatric discourse is analysed by a detailed textual analysis of a psychiatric journal article. The main finding is the ambiguous uses of ‘person’, enabling a specifically psychiatric form of concern in human affairs. The grammar of ‘understanding’ is then tackled from the opposite end, by exploring the logic of the concept of ‘incomprehensibility’. First, by studying the DSM-IV definition of delusion it is shown that its ambiguities boil down to the question of whether psychiatric practice is better accounted for in terms of the grammar of ‘incorrectness’ or ‘incomprehensibility’. Second, the grammar of ‘incomprehensibility’ is further focused on by introducing the distinction between positive and negative conceptions of ‘incomprehensibility’. The main finding is that this distinction has wide-ranging implications for our understanding of psychiatric concepts. Finally, some of the findings gained in these studies are ‘put into practice’ in studying the more practical question of the conceptual and ethical problems associated with the concept of ‘prodromal symptom of schizophrenia’ and the agenda of early detection and intervention in schizophrenia more generally.

Eristekourujen ponttauslaitteen suunnittelu

Diplomityössä suunnitellaan eristekourujen ponttauslaite, jolla pystytään ponttaamaan eristekouruja. Pontattavien eristekourujen pituus ja halkaisija muuttuvat. Suunnittelun lähtökohtana on nykyisin käytössä olevien ponttauslaitteiden ergonomia- ja työturvallisuusongelmat. Työssä käydään läpi erilaisia mahdollisuuksia ponttauslaitteen toteutukseen ja kehitellään kaksi periaatteellista ratkaisua toimiviksi kokoonpanoiksi. Kokoonpanoista valitaan perustellusti parempi vaihtoehto jatkokehitykseen ja se kehitellään valmiiksi ponttauslaitteeksi. Työ käsittää laitteen mekaniikkasuunnittelun, automaatiosuunnittelu rajataan työn ulkopuolelle. Työn eteneminen seuraa järjestelmällisen koneensuunnitteluprosessin vaiheita. Lopputuloksena suunniteltiin laite, joka toteuttaa sille asetetut suoritusvaatimukset. Suunniteltu laite on turvallinen ja ergonomiset vaatimukset täyttävä. Lisäksi laitteen rungolle tehtiin värähtelytarkasteluja, joiden perusteella analysoitiin ominais- ja herätetaajuuksien suhteita sekä rungon jäykistämisen vaikutuksia.

Métodos analíticos ultrasensíveis: lente térmica e técnicas correlatas

Among the emergent laser based spectrometric methods, thermal lensing and other photothermal techniques present a great potential for solving a variety of problems in the fields of chemistry, physics and biology. Their main advantages are high concentration sensitivity, sensibility to physical-chemical properties of the medium, excellent spatial resolution and noninvasive characteristics. In this article, theoretical principles, main applications and practical hints as well as fundamental limitations of these techniques will be carefully described. It is hoped that this will give the reader a clear picture of this field of investigation as well as provide to the ones who are not specialists in the area, the necessary background to understand, implement and use photothermal techniques. In the final sections the development frontiers of photothermal spectrometry will be discussed.

The Pursuit of Efficient Copyright Licensing : How Some Rights Reserved Attempts to Solve the Problems of All Rights Reserved

This dissertation analyses the growing pool of copyrighted works, which are offered to the public using Creative Commons licensing. The study consist of analysis of the novel licensing system, the licensors, and the changes of the "all rights reserved" —paradigm of copyright law. Copyright law reserves all rights to the creator until seventy years have passed since her demise. Many claim that this endangers communal interests. Quite often the creators are willing to release some rights. This, however, is very difficult to do and needs help of specialized lawyers. The study finds that the innovative Creative Commons licensing scheme is well suited for low value - high volume licensing. It helps to reduce transaction costs on several le¬vels. However, CC licensing is not a "silver bullet". Privacy, moral rights, the problems of license interpretation and license compatibility with other open licenses and collecting societies remain unsolved. The study consists of seven chapters. The first chapter introduces the research topic and research questions. The second and third chapters inspect the Creative Commons licensing scheme's technical, economic and legal aspects. The fourth and fifth chapters examine the incentives of the licensors who use open licenses and describe certain open business models. The sixth chapter studies the role of collecting societies and whether two institutions, Creative Commons and collecting societies can coexist. The final chapter summarizes the findings. The dissertation contributes to the existing literature in several ways. There is a wide range of prior research on open source licensing. However, there is an urgent need for an extensive study of the Creative Commons licensing and its actual and potential impact on the creative ecosystem.

Processo químico industrial de extração de óleo vegetal: um experimento de química geral

In this study we describe an experimental procedure based on a chemical industrial process of soya-bean oil extraction applied in general chemistry for undergraduate students. The experiment was planned according to the Science, Technology and Society (STS) approach to teach basic chemical concepts and provide grounding in the management of environmental care. The use of real life chemistry problems seems to salient the relevance of chemistry to our students and enhances their motivation to learn both the practical and theoretical components of the discipline.