937 resultados para Socially prescribed perfectionism


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The selective serotonin reuptake inhibitor fluoxetine (FLX) is widely prescribed for depression and anxiety-related disorders. On the other hand, enhanced serotonergic transmission is known to be classically related to anxiety. In this study, the effects of acute (5.0 mg/kg) and chronic (5.0 mg/kg, 22 days) FLX were investigated in both food-deprived and non-deprived rats tested in the elevated plus-maze. Significant main effects of the three factors (drug, food condition and administration regimen) were observed, but no interaction between them. The administration of either acute or chronic FLX resulted in an anxiogenic effect, as detected by a significant reduction in the percentage of time spent in the open arms and in the percentage of open arm entries. Food deprivation yielded an anxiolytic-like profile, probably related to changes in locomotor activity. The administration regimen resulted in an anxiolytic profile in chronically treated rats, as would be expected after 22 days of regular handling. The anxiogenic action of acute FLX is consistent with both its neurochemical and clinical profile. The discrepancy between the anxiogenic profile of chronic FLX and its therapeutic uses is discussed in terms of possible differences between the type of anxiety that is measured in the plus-maze and the types of human anxiety that are alleviated by fluoxetine.

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R,S-sotalol, a ß-blocker drug with class III antiarrhythmic properties, is prescribed to patients with ventricular, atrial and supraventricular arrhythmias. A simple and sensitive method based on HPLC-fluorescence is described for the quantification of R,S-sotalol racemate in 500 µl of plasma. R,S-sotalol and its internal standard (atenolol) were eluted after 5.9 and 8.5 min, respectively, from a 4-micron C18 reverse-phase column using a mobile phase consisting of 80 mM KH2PO4, pH 4.6, and acetonitrile (95:5, v/v) at a flow rate of 0.5 ml/min with detection at lex = 235 nm and lem = 310 nm, respectively. This method, validated on the basis of R,S-sotalol measurements in spiked blank plasma, presented 20 ng/ml sensitivity, 20-10,000 ng/ml linearity, and 2.9 and 4.8% intra- and interassay precision, respectively. Plasma sotalol concentrations were determined by applying this method to investigate five high-risk patients with atrial fibrillation admitted to the Emergency Service of the Medical School Hospital, who received sotalol, 160 mg po, as loading dose. Blood samples were collected from a peripheral vein at zero, 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 6.0, 8.0, 12.0 and 24.0 h after drug administration. A two-compartment open model was applied. Data obtained, expressed as mean, were: CMAX = 1230 ng/ml, TMAX = 1.8 h, AUCT = 10645 ng h-1 ml-1, Kab = 1.23 h-1, a = 0.95 h-1, ß = 0.09 h-1, t(1/2)ß = 7.8 h, ClT/F = 3.94 ml min-1 kg-1, and Vd/F = 2.53 l/kg. A good systemic availability and a fast absorption were obtained. Drug distribution was reduced to the same extent in terms of total body clearance when patients and healthy volunteers were compared, and consequently elimination half-life remained unchanged. Thus, the method described in the present study is useful for therapeutic drug monitoring purposes, pharmacokinetic investigation and pharmacokinetic-pharmacodynamic sotalol studies in patients with tachyarrhythmias.

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Suurpetojen kannanhoitoon, ja etenkin suden kannanhoitoon liittyvä monitahoinen konfl ikti esiintyy jännitteinä paikallisyhteisöjen ja keskushallinnon, maaseudun ja kaupunkien sekä maallikoiden ja tutkijoiden välillä. Suurpetopolitiikan legitimiteettikriisi näkyy kansallisen kannanhoidon tavoitteiden ja toimenpiteiden kiistämisenä passiivisin ja aktiivisin toimin. Tällä ajankohtaisella ongelmalla on mittavat historialliset juuret. Luonnon ja ihmisen välinen suhde on ollut jatkuvaa tasapainottelua konfl iktien ja niiden hallinnan kanssa, ja suurpedot ovat väistämättä olleet konfl iktin keskiössä lajityypillisten piirteidensä vuoksi. Tämän tutkimuksen tavoitteena on osoittaa ympäristöhistoriallisen tutkimusotteen kautta suomalaisen vahinkoeläinhistorian keskeiset toimet ja toimijat, sekä ymmärtää vahinkoeläinten kannanhoidon tavoite- ja toimenpideasettelun vaikutukset eläinpopulaatioihin historiallisessa ja ekologisessa kontekstissa. Tutkimuksen toinen tavoite on tuottaa synteesi nykypäivän suurpetojen kannanhoidon tavoite- ja toimenpiteiden tarkoituksenmukaisuudesta ja vaikuttavuudesta historiallisessa kontekstissa ja esittää uudenlainen lähestymismalli sosiaalisesti kestävämmälle suurpetopolitiikalle. Vahinkoeläinhistoriaa käsitellään deduktiivisella ja rekonstruktiivisella tutkimusotteella käyttäen aineistona lakitekstejä, maksettuja tapporahoja, sanomalehtikirjoituksia, sidosryhmien kirjoituksia sekä eläintieteellisiä julkaisuja. Etenkin laeissa ja asetuksissa eri eläimistä asetetut tapporahat ja toisaalta saalistilastojen perusteella maksetut palkkiot on nostettu tässä tutkimuksessa merkittävään rooliin asenteiden tulkinnan välineenä. Tarkastelu ulotetaan nisäkkäiden lisäksi myös lintuihin, jotka ovat edellä mainitun aineiston valossa olleet merkittävä vainottu eläinryhmä. Nykypäivän petokonfl iktin tarkastelussa keskiöön nostetaan suurpetoasenteet, niiden muodostuminen ja vaikutus suurpetopolitiikan tavoitteiden ja toimenpiteiden kiistämisessä. Suurpetopolitiikan legitimiteettikriisiä tarkastellaan paikallisten uhmakkuutena hallintoa kohtaan ja tulkinta keinoista puuttua sosiopoliittiseen rikokseen rakennetaan tätä ajatusta vasten. Suurpetojen salakaatajat toimivat yhteisönsä puolesta ja saavat tukensa toimilleen yhteisöltään. Sosiopoliittinen rikos ei siten ole ainoastaan salakaatajien vaan sen sijaan yhteisön yhteinen. Salakaatajat ja paikallisyhteisö pyrkivät häivyttämään yhteiskunnassa viranomaisten ja sidosryhmien taholta toimintaan liittämää stigmaa ja siten oikeuttamaan tekonsa vallitsevissa olosuhteissa. Arvoristiriitoihin perustuvat konfl iktit ovat haasteellisia hallita ja lähtökohtana on oltava ymmärrys siitä, että etenkin suteen liittyvät jännitteet ja ristiriidat ihmisten välisissä suhteissa ovat väistämättömiä. Tunnistamalla historiallisen aineiston merkittävyys nykypäivän ongelmakeskeisen kannanhoidon ratkaisun tietopohjana on mahdollista rakentaa sosiaalisesti kestävämpää suurpetojen kannanhoitoa. Tässä väitöskirjatyössä painotetaan suurpetoihin liittyen ajatusta, jonka mukaan paikallisilta suurpetoalueilla eläviltä ihmisiltä tai sidosryhmien edustajilta ei edellytetä arvomaailman muuttumista, vaan hyväksytään heidän käsityksensä suurpetojen roolista vahingontekijöinä. Sen sijaan vahvistetaan suurpetojen välineellistä roolia paikallisyhteisöjen resurssina ja oleellisten sidosryhmien roolia yhteisön toimijoina psykologisen omistajuuden rakentamisen kautta. Suurpetojen kestävä kannanhoito vaatii siten riistahallinnon toimintakulttuurin muutosta ja uudenlaista suhdetta yhteiskunnan eri toimijoihin.

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The dissertation proposes two control strategies, which include the trajectory planning and vibration suppression, for a kinematic redundant serial-parallel robot machine, with the aim of attaining the satisfactory machining performance. For a given prescribed trajectory of the robot's end-effector in the Cartesian space, a set of trajectories in the robot's joint space are generated based on the best stiffness performance of the robot along the prescribed trajectory. To construct the required system-wide analytical stiffness model for the serial-parallel robot machine, a variant of the virtual joint method (VJM) is proposed in the dissertation. The modified method is an evolution of Gosselin's lumped model that can account for the deformations of a flexible link in more directions. The effectiveness of this VJM variant is validated by comparing the computed stiffness results of a flexible link with the those of a matrix structural analysis (MSA) method. The comparison shows that the numerical results from both methods on an individual flexible beam are almost identical, which, in some sense, provides mutual validation. The most prominent advantage of the presented VJM variant compared with the MSA method is that it can be applied in a flexible structure system with complicated kinematics formed in terms of flexible serial links and joints. Moreover, by combining the VJM variant and the virtual work principle, a systemwide analytical stiffness model can be easily obtained for mechanisms with both serial kinematics and parallel kinematics. In the dissertation, a system-wide stiffness model of a kinematic redundant serial-parallel robot machine is constructed based on integration of the VJM variant and the virtual work principle. Numerical results of its stiffness performance are reported. For a kinematic redundant robot, to generate a set of feasible joints' trajectories for a prescribed trajectory of its end-effector, its system-wide stiffness performance is taken as the constraint in the joints trajectory planning in the dissertation. For a prescribed location of the end-effector, the robot permits an infinite number of inverse solutions, which consequently yields infinite kinds of stiffness performance. Therefore, a differential evolution (DE) algorithm in which the positions of redundant joints in the kinematics are taken as input variables was employed to search for the best stiffness performance of the robot. Numerical results of the generated joint trajectories are given for a kinematic redundant serial-parallel robot machine, IWR (Intersector Welding/Cutting Robot), when a particular trajectory of its end-effector has been prescribed. The numerical results show that the joint trajectories generated based on the stiffness optimization are feasible for realization in the control system since they are acceptably smooth. The results imply that the stiffness performance of the robot machine deviates smoothly with respect to the kinematic configuration in the adjacent domain of its best stiffness performance. To suppress the vibration of the robot machine due to varying cutting force during the machining process, this dissertation proposed a feedforward control strategy, which is constructed based on the derived inverse dynamics model of target system. The effectiveness of applying such a feedforward control in the vibration suppression has been validated in a parallel manipulator in the software environment. The experimental study of such a feedforward control has also been included in the dissertation. The difficulties of modelling the actual system due to the unknown components in its dynamics is noticed. As a solution, a back propagation (BP) neural network is proposed for identification of the unknown components of the dynamics model of the target system. To train such a BP neural network, a modified Levenberg-Marquardt algorithm that can utilize an experimental input-output data set of the entire dynamic system is introduced in the dissertation. Validation of the BP neural network and the modified Levenberg- Marquardt algorithm is done, respectively, by a sinusoidal output approximation, a second order system parameters estimation, and a friction model estimation of a parallel manipulator, which represent three different application aspects of this method.

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If cytotoxin-associated gene A (CagA) status affects the response rates of therapy, then it may be possible to predict Helicobacter pylori eradication rates. We aimed to evaluate the response to eradication treatment of H. pylori infection in CagA-positive and CagA-negative patients. A total of 184 patients (93 males, 91 females, mean age 42.6 ± 12.8 years) with H. pylori-positive chronic gastritis were studied. Subjects underwent a gastroscopy and biopsy specimens were taken from the gastric antrum, body, and fundus. Before the eradication therapy was given all patients were tested for CagA, TNF-alpha and gastrin levels. They were then prescribed lansoprazole (30 mg bid), clarithromycin (500 mg bid), and amoxicillin (1.0 mg bid) for one week. On the 8th week a second endoscopy was performed and further biopsy specimens were obtained from the same sites as in the initial endoscopy. One hundred and twenty-seven patients (69.1%) were found to be CagA positive and 57 patients (30.9%) were CagA negative. The total eradication rate was 82.6%. In the CagA-positive group this rate was 87.4%, and in the CagA-negative group it was 71.9% (P = 0.019). TNF-alpha levels were higher in the CagA-positive than in the CagA-negative group (P = 0.001). However, gastrin levels were not different between groups (P = 0.421). Our findings revealed that CagA-negative status might be a risk factor for failure of H. pylori triple therapies. The CagA pathogenicity island gives a growth advantage to H. pylori strains and has been associated with an increase in the inflammatory response at the gastric mucosal level. These properties could make CagA-positive H. pylori strains more susceptible to antibiotics.

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A cross-sectional study was conducted on HIV-infected adults being treated with antiretroviral drugs at a reference service in Southern Brazil. Participants answered a sociodemographic questionnaire and were tested by scales assessing sociocognitive variables. Adherence to treatment was assessed by a self-report inventory developed for the study. Clinical information was obtained from the patients' records. Significance tests were conducted using univariate logistic regressions followed by multivariate logistic regression analysis. A total of 195 patients participated in the study and 56.9% of them reported > or = 95% adherence on the previous two days. In univariate analysis, the odds of adherence increased with self-efficacy (a person's conviction that he/she can successfully execute the behavior required to produce a certain desired outcome) in taking medications as prescribed (OR = 3.50, 95% CI 1.90-6.55), and decreased with perception of negative affect and physical concerns (OR = 0.71, 95% CI 0.53-0.95). The odds were lower for taking antiretroviral medications >4 times a day (OR = 0.44, 95% CI 0.20-0.94) and higher for patients with 8 years of schooling (OR = 2.28, 95% CI 1.12-4.66). In the multivariate analysis, self-efficacy (OR = 3.33, 95% CI 1.69-6.56) and taking medication >4 times a day (OR = 0.34, 95% CI 0.14-0.80) were independently associated with adherence. Self-efficacy was the most important predictor of adherence, followed by number of times antiretroviral medication was taken per day. Among sociodemographic and clinical variables, only the number of years of schooling was associated with adherence. Motivational interventions based on self-efficacy may be useful for increasing treatment adherence.

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The present prospective study was carried out to determine dietary fiber and energy intake and nutritional status of children during the treatment of chronic constipation. Twenty-five patients aged 2 to 12 years with chronic constipation were submitted to clinical evaluation, assessment of dietary patterns, and anthropometry before and after 45 and 90 days of treatment. The treatment of chronic constipation included rectal disimpaction, ingestion of mineral oil and diet therapy. The standardized diet prescribed consisted of regular food without a fiber supplement and met the nutrient requirements according to the recommended daily allowance. The fiber content was 9.0 to 11.9 g for patients aged less than 6 years and 12.0 to 18.0 g for patients older than 6 years. Sixteen patients completed the 90-day follow-up and all presented clinical improvement. The anthropometric variables did not change, except midarm circumference and triceps skinfold thickness which were significantly increased. Statistically significant increases were also found in percent calorie intake adequacy in terms of recommended daily allowance (55.5 to 76.5% on day 45 and to 68.5% on day 90; P = 0.047). Percent adequacy of minimum recommended daily intake of dietary fiber (age + 5 g) increased during treatment (from 46.8 to 52.8% on day 45 and to 56.3% on day 90; P = 0.009). Food and dietary fiber intake and triceps skinfold thickness increased during follow-up. We conclude that the therapeutic program provided a good clinical outcome.