Pathomechanics of posterior ankle impingement syndrome in female ballet dancers

A dança é uma actividade de grande exigência atlética, que pode conduzir a um elevado número de lesões, particularmente na região do tornozelo, possivelmente devido à amplitude extrema do movimento articular de flexão plantar do mesmo, que os bailarinos, especialmente do sexo feminino possuem, para realizar a ponta e meia ponta tão características do ballet clássico (Kadel, 2006; Motta-Valencia, 2006; Russel, Kruse, Koutedakis, McEwan, Wyon, 2010). Estas posições de flexão plantar extrema produzem força excessiva na região posterior do tornozelo, o que muitas vezes pode resultar em conflito, dor e incapacidade, representando na maioria das vezes um desafio de diagnóstico. O síndrome do conflito posterior do tornozelo refere-se a um grupo de entidades patológicas que resultam da flexão plantar forçada do tornozelo, de forma repetitiva ou traumática, causando um conflito das estruturas ósseas e/ou de tecidos moles (Hamilton, Geppert, Thompson, 1996; Hamilton, 2008) . Os objectivos deste projecto são compreender os quais os factores de risco, mecânicos e funcionais que contribuem para a mecânica patológica da lesão descritos na literatura, e proceder a uma avaliação biomecânica do movimento de flexão plantar do tornozelo. Método. Realizar uma revisão sistemática de literatura dirigida á mecânica patológica do síndrome do conflito posterior do tornozelo em bailarinas e conduzir um estudo caso-controlo, cujo objectivo é avaliar, comparar e descrever o movimento da flexão plantar do tornozelo realizado ao efectuar os movimentos de ponta e meia-ponta, em bailarinas pré-profissionais com e sem lesão recorrente resultante do conflito posterior do tornozelo. Resultados. Não foram encontrados estudos relacionados especificamente com a mecânica patológica do tornozelo, no entanto vários estudos foram encontrados considerando as características clínicas e anatómicas assim como os procedimentos de tratamento, indicando que os principais factores de risco relacionados com a lesão se dividem em factores mecânicos e funcionais que quando combinados entre si e associados ao sobre-uso podem resultar no conflito posterior do tornozelo. Na avaliação do movimento foram observadas diferenças na actividade muscular entre os sujeitos com lesão e controlos, tendo sido possível a observação de um padrão na sequência de activação para um dos movimentos testados. Na oscilação postural e na rigidez do tornozelo foram também observadas diferenças entre os sujeitos bem como entre as posições realizadas. Conclusão. Concluiu-se que não sendo possível alterar a anatomia do bailarino, por vezes é possível intervir a nível funcional melhorando a capacidade técnica de forma obter um melhor desempenho e a actuar preventivamente em relação às lesões, uma vez que estas podem apresentar padrões cinéticos próprios, relacionados com a função muscular, a estabilidade postural e a rigidez articular.

Auto-relato da frequência de consumo de álcool numa amostra representativa da população adulta portuguesa : associações com a obesidade e o perímetro da cintura

São vários, e ainda mal compreendidos, os factores que contribuem para a obesidade. Em Portugal, há simultaneamente uma elevada prevalência de obesidade e um elevado consumo de bebidas alcoólicas. A associação entre consumo de álcool e obesidade não é clara. Este artigo analisa a associação entre a frequência auto-relatada de consumo de bebidas alcoólicas (vinho, cerveja e bebidas brancas/espirituosas) e a prevalência de pré-obesidade e/ou obesidade na população adulta (entre os 18 e os 64 anos) em Portugal. Trata-se de um estudo observacional e transversal, representativo a nível de Portugal continental. No total, recolheram-se dados relativamente a 8116 portugueses. As frequências de consumo das várias bebidas estão fortemente correlacionadas entre si. Foi encontrada uma associação significativa entre as frequências auto-relatadas de consumo de álcool e o excesso de peso, a obesidade e as medidas do perímetro da cintura. A frequência auto-relatada de consumo para todas as bebidas aumenta com as categorias de índice de massa corporal. As categorias de perímetro da cintura associadas a risco cardiovascular estão associadas a maior frequência auto-relatada de consumo de todas as bebidas alcoólicas em estudo, à excepção das bebidas brancas/espirituosas. Embora a associação entre álcool e obesidade ainda esteja por clarificar, vários estudos revelaram associações positivas entre o consumo de álcool e a obesidade. Esta descoberta é apoiada pelos dados aqui descritos, recolhidos em Portugal continental, que sugerem um efeito sinergético do consumo (auto-relatado) do vinho e da cerveja tanto no IMC como no perímetro da cintura. Os resultados sugerem uma ligação importante entre a frequência autorelatada de consumo de álcool e o peso excessivo e a obesidade abdominal na população adulta portuguesa.

Dispositivos de iluminação natural: a sua evolução na arquitectura

Este estudo apresenta uma perspectiva da ‘janela’, como o dispositivo mais frequente de iluminação, na sua evolução e significado na arquitectura. A sua capacidade de caracterizar tendências e estilos arquitectónicos, permanece desde as primeiras referências históricas até aos elementos desenvolvidos e associados à iluminação natural dos dias de hoje. O interesse por este tema surgiu, principalmente, por ser o elemento arquitectónico que desde sempre permitiu a entrada de luz natural nas construções. Foi sempre um dos pontos de ligação e relação do interior com o exterior. Em determinadas situações tornou-se num elemento tão discreto, que nos passou despercebido, além de ter sido ocasionalmente desvalorizado. A janela ou dispositivo de iluminação natural, quando utilizado correctamente pode trazer muitos benefícios à arquitectura, assim como proporcionar conforto térmico sem necessidade de gastos energéticos excessivos.

A actuação do enfermeiro como gestor na unidade de terapia intensiva do Hospital Regional do Baixo Amazonas-Santarém-Pará-Brasil : um estudo de caso

Estudo descritivo que teve como objetivo avaliar a atuação do enfermeiro como gestor da Unidade de Terapia Intensiva do Hospital Regional do Baixo Amazonas Dr. Waldemar Pena – HRBA, o qual obteve o selo de Acreditado em Nível 1 em 2012. Para a obtenção dos dados utilizou-se um questionário elaborado com 10 perguntas subjetivas e aplicado aos enfermeiros gerentes que atuam nas Unidades de Terapia Intensiva e CTI do HRBA. Verificou-se nesse estudo que são indivíduos na faixa etária de 25 a 45 anos, com predominância do gênero feminino, com especialização em áreas diversas da enfermagem. Na atuação no setor de gerência, os enfermeiros estabelecem prioridades, direcionando sua equipe para os atendimentos assistenciais complexos aos pacientes, ficando o trabalho burocrático para ser realizado por último. Os entraves relatados são a insatisfação e o desgaste no exercício da função de gerente da unidade devido ao excesso de funcionários sem experiência em UTI, falta de autonomia, dupla jornada de trabalho, excesso de burocracia entre outras situações que se tornam motivos de estresse. Concluiu-se que a atuação do enfermeiro como gerente se respalda na função assistencial ao paciente através de cuidados diretos e indiretos e na organização dos trabalhos burocráticos na Unidade de Terapia Intensiva.

Scar formation in the inner ear followig acoustical injury: sequence of changes from early signs of damage to healed lesion

This paper is a review of a study to investigate the effects of excessive noise exposure to the organ of Corti using chinchillas.

Student musicians' perception of loudness and how it correlates to the measured level

The purpose of this project was to evaluate student musicians’ perception of loudness and see how it relates to the measured sound level when playing an instrument alone and when playing in an orchestra. Perhaps by examining this relationship, strategies can be developed to educate musicians on the risk of excessive noise exposure and hearing protection options.

El viaje a Camelot de Bartolomé de las Casas (Estudios)

La autora lee la Brevísima, de Bartolomé de las Casas, en el contexto del auge del imaginario caballeresco en el siglo XVI español, propiciado por las empresas de la Conquista y la Colonia, y que alcanzó igualmente a las gestas religiosas. Estudia este reflejo caballeresco –ensombrecido tal vez por el dramatismo y la violencia de lo narrado, entre otras razones–, empezando por la promesa lascasiana de ennoblecer a campesinos pacíficos a cambio de que colonizaran con justicia, resalta el carácter cortés y pacífico de los indios, así como de sus valores de tinte caballeresco («lo mismo los varones que las mujeres, muertas antes que entregar su honra o faltar a sus esposos», destaca su respeto a la jerarquía, natural o adquirida, y a las responsabilidades de cada cual, incluidas las del buen rey, que protege a sus vasallos y defiende los límites de su territorio), incluso distingue su delicadeza corporal como signo de nobleza. El patrón narrativo de la Brevísima es similar al de muchas obras de la tradición caballeresca. Utiliza todos estos elementos en un retrato civilizado de los indios, presentados viviendo en sociedad y según las virtudes cristianas antes de la llegada de los españoles, en un equilibrio que sería amenazado por los afanes desmedidos de los conquistadores.

La revolución tecnológica en los medios de comunicación y los desafíos del derecho y la democracia (Tema Central)

El presente artículo aborda el impacto de la transformación tecnológica y los nuevos instrumentos de la teleinformática en los medios de comunicación masiva. La forma como se han estructurado las transnacionales mediáticas a partir del uso de instrumentos como la web, el software o el podcasting y los riesgos que su exceso conlleva respecto de la democracia al imponer sus intereses económicos y culturales por encima del interés del individuo, el interés público, la intimidad y el honor. Todo lo cual plantea nuevos desafíos al derecho y la protección de los derechos del individuo.

The simple macroeconomics of North and South in EMU. Bruegel Working Paper 2012/12, 30 July 2012

The euro area today consists of a competitive, moderately leveraged North and an uncompetitive, over-indebted South. Its main macroeconomic challenge is to carry out the adjustment required to restore the competitiveness of its southern part and eliminate its excessive public and private debt burden. This paper investigates the relationship between fiscal and competitiveness adjustment in a stylised model with two countries in a monetary union, North and South. To restore competitiveness, South implements a more restrictive fiscal policy than North. We consider two scenarios. In the first, monetary policy aims at keeping inflation constant in the North. The South therefore needs to deflate to regain competitiveness, which worsens the debt dynamics. In the second, monetary policy aims at keeping inflation constant in the monetary union as a whole. This results in more monetary stimulus, inflation in the North is higher, and this in turn helps the debt dynamics in the South. Our main findings are: •The differential fiscal stance between North and South is what determines real exchange rate changes. South therefore needs to tighten more. There is no escape from relative austerity. •If monetary policy aims at keeping inflation stable in the North and the initial debt is above a certain threshold, debt dynamics are perverse: fiscal retrenchment is self-defeating; •If monetary policy targets average inflation instead, which implies higher inflation in the North, the initial debt threshold above which the debt dynamics become perverse is higher. Accepting more inflation at home is therefore a way for the North to contribute to restoring debt sustainability in the South. •Structural reforms in the South improve the debt dynamics if the initial debt is not too high. Again, targeting average inflation rather than inflation in the North helps strengthen the favourable effects of structural reforms.

The ERA-40 re-analysis

ERA-40 is a re-analysis of meteorological observations from September 1957 to August 2002 produced by the European Centre for Medium-Range Weather Forecasts (ECMWF) in collaboration with many institutions. The observing system changed considerably over this re-analysis period, with assimilable data provided by a succession of satellite-borne instruments from the 1970s onwards, supplemented by increasing numbers of observations from aircraft, ocean-buoys and other surface platforms, but with a declining number of radiosonde ascents since the late 1980s. The observations used in ERA-40 were accumulated from many sources. The first part of this paper describes the data acquisition and the principal changes in data type and coverage over the period. It also describes the data assimilation system used for ERA-40. This benefited from many of the changes introduced into operational forecasting since the mid-1990s, when the systems used for the 15-year ECMWF re-analysis (ERA-15) and the National Centers for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR) re-analysis were implemented. Several of the improvements are discussed. General aspects of the production of the analyses are also summarized. A number of results indicative of the overall performance of the data assimilation system, and implicitly of the observing system, are presented and discussed. The comparison of background (short-range) forecasts and analyses with observations, the consistency of the global mass budget, the magnitude of differences between analysis and background fields and the accuracy of medium-range forecasts run from the ERA-40 analyses are illustrated. Several results demonstrate the marked improvement that was made to the observing system for the southern hemisphere in the 1970s, particularly towards the end of the decade. In contrast, the synoptic quality of the analysis for the northern hemisphere is sufficient to provide forecasts that remain skilful well into the medium range for all years. Two particular problems are also examined: excessive precipitation over tropical oceans and a too strong Brewer-Dobson circulation, both of which are pronounced in later years. Several other aspects of the quality of the re-analyses revealed by monitoring and validation studies are summarized. Expectations that the second-generation ERA-40 re-analysis would provide products that are better than those from the firstgeneration ERA-15 and NCEP/NCAR re-analyses are found to have been met in most cases. © Royal Meteorological Society, 2005. The contributions of N. A. Rayner and R. W. Saunders are Crown copyright.

Differences in phosphorus retention and release in soils amended with animal manures and sewage sludge

Excessive levels of P in agricultural soils pose a threat to local water quality. This study evaluated (i) time-dependent changes in soil P sorption (expressed as a phosphorus sorption index, PSI) and P availability (as resin P) during incubation (100 d) with poultry litter, cattle slurry, sewage sludge, or KH2PO4, added on a P-equivalent basis (100 mg P kg(-1)), and (ii) the subsequent kinetics of P release, measured by repeated extractions with a mixed cation-anion exchange resin. Soil exchangeable Ca and ammonium oxalate-extractable Fe and Al were also determined at 100 d of incubation. The small decrease in P sorption in the litter and sludge treatments (25%), compared with that in the slurry and KH2PO4 treatments (52%) between 20 and 100 d of incubation was attributed partly to the formation of new adsorption sites for P. Subsequent P release was described by a power equation: Resin P = a(extraction number)(b), where the constants a and b represent resin P obtained with a single extraction and the rate of P release per resin extraction, respectively. On average, the rate of P release decreased in the order: KH2PO4 and slurry > litter > sludge, and was inversely related to exchangeable Ca content of the incubated soils (R-2 = 0.57). The slower rates of P release in the litter and sludge treatments (P < 0.001) are attributed to the large values for exchangeable Ca (1050-2640 and 1070-2710 mg kg(-1), respectively) in these amended soils. Future research concerned with short-term declines in environmentally harmful levels of P in recently amended soils should consider the differential effects of the amendments on soil P dynamics.

Nutrient Imbalances in Agricultural Development

Nutrient cycles link agricultural systems to their societies and surroundings; inputs of nitrogen and phosphorus in particular are essential for high crop yields, but downstream and downwind losses of these same nutrients diminish environmental quality and human well-being. Agricultural nutrient balances differ substantially with economic development, from inputs that are inadequate to maintain soil fertility in parts of many developing countries, particularly those of sub-Saharan Africa, to excessive and environmentally damaging surpluses in many developed and rapidly growing economies. National and/or regional policies contribute to patterns of nutrient use and their environmental consequences in all of these situations. Solutions to the nutrient challenges that face global agriculture can be informed by analyses of trajectories of change within, as well as across, agricultural systems.

The impact of market and supply configurations on the costs of tendering in the construction industry

The cost of tendering in the construction industry is widely suspected to be excessive, but there is little robust empirical evidence to demonstrate this. It also seems that innovative working practices may reduce the costs of undertaking construction projects and the consequent improvement in relationships should increase overall value for money. The aim of this proposed research project is to develop mechanisms for measuring the true costs of tendering based upon extensive in-house data collection undertaken in a range of different construction firms. The output from this research will enable all participants in the construction process to make better decisions about how to select members of the team and identify the price and scope of their obligations.

The ASSET intercomparison of ozone analyses: method and first results

This paper aims to summarise the current performance of ozone data assimilation (DA) systems, to show where they can be improved, and to quantify their errors. It examines 11 sets of ozone analyses from 7 different DA systems. Two are numerical weather prediction (NWP) systems based on general circulation models (GCMs); the other five use chemistry transport models (CTMs). The systems examined contain either linearised or detailed ozone chemistry, or no chemistry at all. In most analyses, MIPAS (Michelson Interferometer for Passive Atmospheric Sounding) ozone data are assimilated; two assimilate SCIAMACHY (Scanning Imaging Absorption Spectrometer for Atmospheric Chartography) observations instead. Analyses are compared to independent ozone observations covering the troposphere, stratosphere and lower mesosphere during the period July to November 2003. Biases and standard deviations are largest, and show the largest divergence between systems, in the troposphere, in the upper-troposphere/lower-stratosphere, in the upper-stratosphere and mesosphere, and the Antarctic ozone hole region. However, in any particular area, apart from the troposphere, at least one system can be found that agrees well with independent data. In general, none of the differences can be linked to the assimilation technique (Kalman filter, three or four dimensional variational methods, direct inversion) or the system (CTM or NWP system). Where results diverge, a main explanation is the way ozone is modelled. It is important to correctly model transport at the tropical tropopause, to avoid positive biases and excessive structure in the ozone field. In the southern hemisphere ozone hole, only the analyses which correctly model heterogeneous ozone depletion are able to reproduce the near-complete ozone destruction over the pole. In the upper-stratosphere and mesosphere (above 5 hPa), some ozone photochemistry schemes caused large but easily remedied biases. The diurnal cycle of ozone in the mesosphere is not captured, except by the one system that includes a detailed treatment of mesospheric chemistry. These results indicate that when good observations are available for assimilation, the first priority for improving ozone DA systems is to improve the models. The analyses benefit strongly from the good quality of the MIPAS ozone observations. Using the analyses as a transfer standard, it is seen that MIPAS is similar to 5% higher than HALOE (Halogen Occultation Experiment) in the mid and upper stratosphere and mesosphere (above 30 hPa), and of order 10% higher than ozonesonde and HALOE in the lower stratosphere (100 hPa to 30 hPa). Analyses based on SCIAMACHY total column are almost as good as the MIPAS analyses; analyses based on SCIAMACHY limb profiles are worse in some areas, due to problems in the SCIAMACHY retrievals.

Assimilation of stratospheric ozone from MIPAS into a global general-circulation model: The September 2002 vortex split

Ozone and temperature profiles from the Michelson Interferometer for Passive Atmospheric Sounding (MIPAS) have been assimilated, using three-dimensional variational assimilation, into a stratosphere troposphere version of the Met Office numerical weather-prediction system. Analyses are made for the month of September 2002, when there was an unprecedented split in the southern hemisphere polar vortex. The analyses are validated against independent ozone observations from sondes, limb-occultation and total column ozone satellite instruments. Through most of the stratosphere, precision varies from 5 to 15%, and biases are 15% or less of the analysed field. Problems remain in the vortex and below the 60 hPa. level, especially at the tropopause where the analyses have too much ozone and poor agreement with independent data. Analysis problems are largely a result of the model rather than the data, giving confidence in the MIPAS ozone retrievals, though there may be a small high bias in MIPAS ozone in the lower stratosphere. Model issues include an excessive Brewer-Dobson circulation, which results both from known problems with the tracer transport scheme and from the data assimilation of dynamical variables. The extreme conditions of the vortex split reveal large differences between existing linear ozone photochemistry schemes. Despite these issues, the ozone analyses are able to successfully describe the ozone hole split and compare well to other studies of this event. Recommendations are made for the further development of the ozone assimilation system.