Diabète. Quels repères pour la prise en charge du diabète en 2010 [Diabetes. Perspectives on the management of diabetes in 2010.].

In the absence of works which would significantly change the perspective on the management of diabetes in the elapsed year, this article proposes a reflection on the integration of the evolving knowledge over the past decade into clinical practice. The major preventive impact of an approach targeting all the cardiovascular risk factors in diabetic patients will remain as the main lesson of this decade. The therapeutic goals need to be tailored to the individual patient's situation based on the evaluation of the benefit: inconvenience-ratio of the treatments. The process of their choice has to include the quest for a shared vision with the patient who is in charge of diabetes management in daily life.

La gestió dels llibres electrònics a la Biblioteca virtual de la UOC

El text que es presenta mostra com es du a terme la gestió dels llibres electrònics a la Biblioteca virtual (d'ara endavant BV) de la Universitat Oberta de Catalunya (d'ara endavant UOC). La BV posa un èmfasi especial en l'adquisició de llibres digitals per millorar l'accés als usuaris als recursos i col¿leccions d'una universitat que es caracteritza per la virtualitat. El document presenta, en primer lloc, l'entorn en què s'adquireixen i s'utilitzen els llibres electrònics: s'expliquen els diferents escenaris d'adquisició en els quals es pot trobar la biblioteca i es defineixen els circuits interns que en permeten la gestió i els processos tècnics dels documents. A continuació es mostren les diferents opcions d'accés i consulta de llibres electrònics que actualment s'ofereixen des de la biblioteca i s'expliquen les anàlisis d'usos d'aquests documents. Finalment es presenten les conclusions a les quals arriba la BV sobre el nou context de llibres electrònics.

Psychological distress in health sciences college students and its relationship with academic engagement

Objective: To determine the prevalence of psychological distress and its relationship with academic engagement (absorption, dedication and vigor), sex and degree among students from four public universities. Method: A non-experimental,comparative correlational, quantitative investigation without intervention. Study population: 1840 nursing and physical therapy students. The data collection tool used was a questionnaire. Results: A 32.2% prevalence of psychological distress was found in the subjects; a correlation between vigor and psychological distress was found for all of the subjects and also for women. High absorption and dedication scores and low psychological distress scores predicted higher vigor scores. Conclusion: The risk of psychological distress is high, especially for women. Women seem to have a higher level of psychological distress than men. Vigor, energy and mental resilience positively influence psychological distress and can be a vehicle for better results during the learning and studying process.







Perceived self-image in adolescent idiopathic scoliosis: an integrative review of the literature

Objective: To learn about the experiences of adolescents diagnosed with idiopathic scoliosis. Method: Integrative review of the literature published within a specified time frame. Results: For both sexes, the predominant clinical symptom of this condition appears to be the negative effect that the deformity exerts on perceived self-image. Quantitative studies used numerical scores to assess perceptions of body image but did not analyse emotional aspects. Patients treated surgically were found to have a better self-image than patients treated with a brace. Quality of life was improved by a reduction in the magnitude of the curve. Conclusion: Spinal deformity exerts a psychological effect on adolescent girls.


Viral-mediated overexpression of mutant huntingtin to model HD in various species.

Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder caused by an expansion of CAG repeats in the huntingtin (Htt) gene. Despite intensive efforts devoted to investigating the mechanisms of its pathogenesis, effective treatments for this devastating disease remain unavailable. The lack of suitable models recapitulating the entire spectrum of the degenerative process has severely hindered the identification and validation of therapeutic strategies. The discovery that the degeneration in HD is caused by a mutation in a single gene has offered new opportunities to develop experimental models of HD, ranging from in vitro models to transgenic primates. However, recent advances in viral-vector technology provide promising alternatives based on the direct transfer of genes to selected sub-regions of the brain. Rodent studies have shown that overexpression of mutant human Htt in the striatum using adeno-associated virus or lentivirus vectors induces progressive neurodegeneration, which resembles that seen in HD. This article highlights progress made in modeling HD using viral vector gene transfer. We describe data obtained with of this highly flexible approach for the targeted overexpression of a disease-causing gene. The ability to deliver mutant Htt to specific tissues has opened pathological processes to experimental analysis and allowed targeted therapeutic development in rodent and primate pre-clinical models.

Adolescent support networks in a health care context: the interface between health, family and education

AbstractOBJECTIVEAnalyze adolescents' perceptions about support networks and their health needs.METHODAnalytical and interpretive study using focus groups conducted in municipal state schools in Fortaleza, in the State of Ceará during the first semester of 2012. The sample comprised 36 male and female adolescents aged between 13 and 16 years attending the ninth grade of the second phase of elementary school.RESULTSThematic analysis revealed that the health care support network and interaction between health professionals, education professionals and family members was insufficient, constituting a lack of an integrated network to enable and provide support for health promotion.CONCLUSIONCoordination between education, health and family services has the potential to act as a support network to help meet adolescents' healthcare needs and demands.

Predictors of red blood cell transfusion after cardiac surgery: a prospective cohort study

Abstract OBJECTIVE To identify predictors of red blood cell transfusion (RBCT) after cardiac surgery. METHOD A prospective cohort study performed with 323 adults after cardiac surgery, from April to December of 2013. A data collection instrument was constructed by the researchers containing factors associated with excessive bleeding after cardiac surgery, as found in the literature, for investigation in the immediate postoperative period. The relationship between risk factors and the outcome was assessed by univariate analysis and logistic regression. RESULTS The factors associated with RBCT in the immediate postoperative period included lower height and weight, decreased platelet count, lower hemoglobin level, higher prevalence of platelet count <150x10 3/mm3, lower volume of protamine, longer duration of anesthesia, higher prevalence of intraoperative RBCT, lower body temperature, higher heart rate and higher positive end-expiratory pressure. The independent predictor was weight <66.5Kg. CONCLUSION Factors associated with RBCT in the immediate postoperative period of cardiac surgery were found. The independent predictor was weight.

Art i part :la figura del/la professional de l'educació social en processos de desenvolupament cultural comunitari

Anàlisi de la figura de l'educador/a social en processos de desenvolupament comunitari a partir d'experiències diverses a Catalunya

Impaired glutathione synthesis in schizophrenia: convergent genetic and functional evidence

Schizophrenia is a complex multifactorial brain disorder with a genetic component. Convergent evidence has implicated oxidative stress and glutathione (GSH) deficits in the pathogenesis of this disease. The aim of the present study was to test whether schizophrenia is associated with a deficit of GSH synthesis. Cultured skin fibroblasts from schizophrenia patients and control subjects were challenged with oxidative stress, and parameters of the rate-limiting enzyme for the GSH synthesis, the glutamate cysteine ligase (GCL), were measured. Stressed cells of patients had a 26% (P = 0.002) decreased GCL activity as compared with controls. This reduction correlated with a 29% (P < 0.001) decreased protein expression of the catalytic GCL subunit (GCLC). Genetic analysis of a trinucleotide repeat (TNR) polymorphism in the GCLC gene showed a significant association with schizophrenia in two independent case-control studies. The most common TNR genotype 7/7 was more frequent in controls [odds ratio (OR) = 0.6, P = 0.003], whereas the rarest TNR genotype 8/8 was three times more frequent in patients (OR = 3.0, P = 0.007). Moreover, subjects with disease-associated genotypes had lower GCLC protein expression (P = 0.017), GCL activity (P = 0.037), and GSH contents (P = 0.004) than subjects with genotypes that were more frequent in controls. Taken together, the study provides genetic and functional evidence that an impaired capacity to synthesize GSH under conditions of oxidative stress is a vulnerability factor for schizophrenia.

The investigation of deaths in custody: a qualitative analysis of problems and prospects.

The right to be treated humanely when detained is universally recognized. Deficiencies in detention conditions and violence, however, subvert this right. When this occurs, proper medico-legal investigations are critical irrespective of the nature of death. Unfortunately, the very context of custody raises serious concerns over the effectiveness and fairness of medico-legal examinations. The aim of this manuscript is to identify and discuss the practical and ethical difficulties encountered in the medico-legal investigation following deaths in custody. Data for this manuscript come from a larger project on Death in Custody that examined the causes of deaths in custody and the conditions under which these deaths should be investigated and prevented. A total of 33 stakeholders from forensic medicine, law, prison administration or national human rights administration were interviewed. Data obtained were analyzed qualitatively. Forensic experts are an essential part of the criminal justice process as they offer evidence for subsequent indictment and eventual punishment of perpetrators. Their independence when investigating a death in custody was deemed critical and lack thereof, problematic. When experts were not independent, concerns arose in relation to conflicts of interest, biased perspectives, and low-quality forensic reports. The solutions to ensure independent forensic investigations of deaths in custody must be structural and simple: setting binding standards of practice rather than detailed procedures and relying on preexisting national practices as opposed to encouraging new practices that are unattainable for countries with limited resources.

Cost of nursing turnover in a Teaching Hospital

Abstract OBJECTIVE To map the sub processes related to turnover of nursing staff and to investigate and measure the nursing turnover cost. METHOD This is a descriptive-exploratory study, classified as case study, conducted in a teaching hospital in the southeastern, Brazil, in the period from May to November 2013. The population was composed by the nursing staff, using Nursing Turnover Cost Calculation Methodology. RESULTS The total cost of turnover was R$314.605,62, and ranged from R$2.221,42 to R$3.073,23 per employee. The costs of pre-hire totaled R$101.004,60 (32,1%), and the hiring process consumed R$92.743,60 (91.8%) The costs of post-hire totaled R$213.601,02 (67,9%), for the sub process decreased productivity, R$199.982,40 (93.6%). CONCLUSION The study identified the importance of managing the cost of staff turnover and the financial impact of the cost of the employee termination, which represented three times the average salary of the nursing staff.

Bases de dades relacionals

Memòria descriptiva del projecte de creació d'un sistema de BD que dóna resposta a la necessitat dels jugadors de bàsquet a nivell mundial, que volen crear una nova plataforma centralitzada per tal d'unificar la informació de cadascun d'ells i permetre els equips i les federacions disposar d'aquesta informació a l'hora d'escollir els jugadors que integraran els diferents equips.

O gênero Anthidium Fabricius na América do Sul: chave para as espécies, notas descritivas e de distribuição geográfica (Hymenoptera, Megachilidae, Anthidiini)

The genus Anthidium Fabricius in the South America: key for the species, descriptive notes, and geographical distribution (Hymenoptera, Megachilidae, Anthidiini). The Anthidiini, in South America, is represented by a single genus Anthidium Fabricius, 1804 (type-species: Apis manicata Linnaeus, 1758). Thirty nine species are treated in this paper, as follows: Anthidium alsinai Urban, 2001; A. andinum Joergensen, 1912; A. anurospilum Moure, 1957 nom. reval. (formerly = A. espinosai Ruiz, 1938); A. atricaudum Cockerell, 1926; A. aymara Toro & Rodríguez, 1998; A. chilense Spinola, 1851; A. chubuti Cockerell, 1910; A. colliguayanum Toro & Rojas, 1970; A. cuzcoense Schrottky, 1910; A. danieli Urban, 2001; A. decaspilum Moure, 1957; A. deceptum Smith, 1879; A. edwini Ruiz, 1935; A. espinosai Ruiz, 1938; A. falsificum Moure, 1957; A. friesei Cockerell, 1911; A. funereum Schletterer, 1890; A. garleppi Schrottky, 1910 = A. matucanense Cockerell, 1914 syn. nov.; A. gayi Spinola, 1851; A. igori Urban, 2001; A. larocai Urban, 1997; A. latum Schrottky, 1902; A. luizae Urban, 2001; A. manicatum (Linnaeus, 1758); A. masunariae Urban, 2001; A. nigerrimum Schrottky, 1910; A. paitense Cockerell, 1926; A. penai Moure, 1957; A. peruvianum Schrottky, 1910; A. rafaeli Urban, 2001; A. rozeni Urban, 2001; A. rubripes Friese, 1908 = A. boliviense Friese, 1920 syn. nov. = A. adriani Ruiz, 1935 syn. nov. = A. kuscheli Moure, 1957 syn. nov.; A. sanguinicaudum Schwarz, 1933; A. sertanicola Moure & Urban, 1964; A. tarsoi Urban, 2001; A. toro Urban. 2001; A. vigintiduopunctatum Friese, 1904; A. vigintipunctatum Friese, 1908, and A. weyrauchi Schwarz, 1943. Some taxonomic comments are made for each species, and new data on geographic distribution are also given. The females of A. andinum, A. igori, A. rozeni and the male of A. anurospilum are described for the first time. Identification keys (for males and females), as well as illustrations for almost all species, are provided.

Neuropathies diabétiques: tableaux cliniques, détection précoce et appel au spécialiste [Diabetic neuropathies: clinical sub-types, early detection and asking help from the specialist].

In diabetes mellitus, it is expected to see a common, mainly sensitive, distal symmetrical polyneuropathy (DPN) involving a large proportion of diabetic patients according to known risk factors. Several other diabetic peripheral neuropathies are recognized, such as dysautonomia and multifocal neuropathies including lumbosacral radiculoplexus and oculomotor palsies. In this review, general aspects of diabetic neuropathies are examined, and it is discussed why and how the general practionner has to perform a yearly examination. At the present time, some consensuses emerge to ask help from the specialist when faced to other forms of peripheral neuropathies than distal symmetrical DPN.