Contribución de la fuerza y el dolor en la función del paciente con artrosis trapecio metacarpiana. Estudio transversal

Objetivo Establecer una posible relación entre la fuerza (Jamar), el dolor (EVA) y la capacidad funcional referida por el paciente (DASH) determinando en qué grado influyen unas en otras. Estudio observacional transversal analítico. Participantes Muestra de 72 pacientes que presentaban una artrosis trapecio metacarpiana grado 2-3 de Eaton. Los pacientes fueron reclutados cuando acudían a la Unidad de Cirugía de mano. Método Se realizaron mediciones de fuerza de agarre, pinza, valoración del dolor y funcionalidad, y se establecieron las correlaciones entre cada una de ellas. Resultados El modelo más significativo para la función (R2 =0.83) incluye la variable dolor y la fuerza. Pero es la fuerza punta contra punta la que presenta una mayor correlación con el cuestionario DASH (B-estandarizado: –57). Respecto al dolor, influye en todas las mediciones de fuerza realizadas con el dinamómetro, siendo también la fuerza de la pinza punta contra punta la que presenta una mayor correlación. Conclusiones Los hallazgos corroboran que existe una correlación significativa entre la función referida por el paciente y variables que podemos medir en consulta, como la fuerza del puño y la pinza. Pero también esta correlación es significativa entre las variables función y dolor entre sí, pero es la pinza punta contra punta la que presenta una mayor asociación con el cuestionario DASH. Abstract in English Objective To assess the relationship between muscle strength (Jama), and pain (VAS) levels with hand function (DASH) in patients with trapeziometarcapal osteoarthritis. Cross-sectional study. Participants Sample of 72 patients with osteoarthritis stage 2-3 (Eaton) and trapeziometacarpal osteoarthritis. Patients were recruited when they came to the Hand Surgery Unit. Method Grip strength, pinch, pain and hand function were measured, and correlation and regression coefficients between them were obtained. Results For function, the most significant model (R2 = 0.83) included pain and strength. But it is tip to tip pinch force which has a stronger relationship with DASH (Standardized B: –57) questionnaire. Pain also influenced strength measured with the dynamometer but it was tip to tip pinch force that was the most affected. Conclusions Findings confirm that there is a significant correlation between function referred by the patient and variables that can be measured in the clinic such as grip strength and pinch. The correlation between pain intensity and function was also significant, but tip to tip pinch strength had the greatest impact on the function.

El Aprendizaje Informado

Welcome to Informed Learning. If you have opened this book, it is probably because you are interested in how people learn. It may also be because you are interested in how learners interact with their information environment and would like to help them do so in ways that help them learn better. What should we teach and how, so that our students will use information successfully, creatively and responsibly in their journey as lifelong learners? Informed learning provides a unique perspective on helping students become successful learners in our rapidly evolving information environments. It presents a new framework for informed learning, that will enable teachers, librarians, researchers and teacher-researchers to work together as they continue to respond to the need to help students use information to learn. Do you want to help your students engage with the information practices of their discipline or chosen profession? Are you looking for ideas to invigorate and refresh your curriculum? Are you looking for ways to help your students write better essays or search the internet more successfully? Are you looking for strategies to enhance your research supervision? Are you trying to discover how information literacy and information literacy education can contribute to academic curriculum? Informed Learning can help you. Informed learning is using information, creatively and reflectively, in order to learn. It is learning that draws on the different ways in which we use information in academic, professional and community life; and it is learning that draws on emerging understanding of our varied experiences of using information to learn. Indeed, we cannot learn without using information. It is problemetising the interdependence between information use and learning that is the foundation of this book. Most of the time we take for granted that aspect of learning which we call information use. What might happen to the learning experience if we attend to it? Informed Learning examines research into the experience of using information to learn in academic, workplace and community contexts, that can be used to inform learning and learning design at many levels. It draws on contemporary higher education teaching and learning theory to suggest ways forward for a learning agenda that values the need for engaging with the wider world of information. In doing so, it offers a new and unified framework for implementing curriculum that recognises the importance of successful, creative and reflective information use as a strategy for learning as well as a learning outcome; and proposes a research agenda that will continue to inform learning. Informed Learning reconceptualises information literacy as being about engaging in information practices in order to learn; engaging with the different ways of using information to learn. Based on the author’s work in developing the seven faces of information literacy, it proposes the need for teaching and learning to 1) bring about new ways of experiencing and using information, and 2) engage students with those information practices relevant to their discipline or profession. This book is written for a diverse audience of educators from many disciplines, curriculum designers, researchers, and administrators. While this book both establishes a new approach to learning design and an associated research agenda, it is also intended to be practical. I have sought to ground the ideas in practice through: • using Steve and Jane as academics from different disciplines on a journey; experiencing the implementation of informed learning; • using examples from the literature and personal experience; • using reflective questions towards the end of each chapter. In this book you will find many examples of how people experience information use as they go about learning in different contexts. The research reported here shows that as people go about learning they interact with information in different ways. They may be learning about a content area in a formal context, they may be engaged in informal learning as they go about their everyday work, or they may be learning through doing original research. The emphasis on experience and ways of seeing comes from the work of researchers into student learning such as Ference Marton, Paul Ramsden, Shirley Booth, Michael Prosser, Keith Trigwell and others who have shown that, if we are to help students learn, we must first be aware of how they experience those aspects of the world about which they are learning. Different ways of reading this book The first three chapters of this book establish the broad theoretical framework for informed learning; and the remaining chapters consider the out workings of this in a range of contexts. If you want to browse the general directions of this book, read the narratives at the start of each chapter. If you want to see how the book might influence your practice, read the narratives and the reflective questions at the end of each chapter. If you want to help your students become informed learners in their discipline or profession, focus on chapters one, two, three and five. If you are looking for help with students engaged in information practices such as internet searching or essay writing, focus on chapters one, three and four. If you are interested in informed learning in the community or workplace, focus on chapters one, two, three and six. If you want to help your research students become informed learners, focus on chapters one, two, three, seven and eight. If you are working with colleagues to promote information literacy education and are looking for ideas, read chapter nine. If you are interested in researching informed learning read chapter ten

Huellas de Eros y Thánatos en la narrativa de Diamela Eltit : La palabra en movimiento en el juego entre tropos, metáforas y deconstrucciones lingüísticas

Väitöskirja analysoi espanjan kielen dekonstruktioita ruumiin metaforista ja troopeista koostuvassa aineistossa chileläisen kirjailijan Diamela Eltitin (1949 -) neljässä romaanissa: Lumpérica (1983), Vaca sagrada (1991), El infarto del alma (1994) ja Los trabajadores de la muerte (1998). Näkökulma on kielen muutoksessa Eltitin proosassa 1980- ja 1990-luvuilla alkaen kokeellisesta huippuvaiheesta 1983, jolloin hän julkaisi esikoisromaaninsa Lumpérica. Tutkimus korostaa Eltitin romaanien historiallista arvoa, kirjallisuuden tapaa murtaa kielen rakenteita ja sitä miten tämä murros kytkeytyy taideteoreettiseen muutokseen kulttuuridiskursseissa. Tutkimus tarkastelee Eltitin kehityskaarta kenraali Augusto Pinochetin sotilasvallankaappauksesta 1973 halki sotilashallituksen kauden (1973-1990) aina kansalaisyhteiskunnan vahvistumiseen ja vuoteen 1998. Tutkimus analysoi ruumiin troopeista ja metaforista koostuvaa tutkimusaineistoa lingvistiikan, kirjallisuustieteen, historian ja sukupuolen tutkimuksen monitieteisessä viitekehyksessä. Sen vuoksi väitöskirja liittyy espanjalaisen filologian, yleisen kirjallisuustieteen, Latinalaisen Amerikan tutkimuksen ja naistutkimuksen oppiaineisiin. Kolme tärkeintä oppiteoreettista runkoa ovat lingvistinen strukturalismi, dekonstruktio ja feministiset kirjallisuusteoriat. Dekonstruktiivinen lähestymistapa tekstiin korostaa kielen merkityksen muodostumisen filosofista perustaa. Se pyrkii selvittämään, miten merkitys muodostuu kirjoittajan, tekstin ja lukijan välillä. Tekstikritiikki koostuu semanttisesta ja dekonstruktiivisesta tekstianalyysistä, jonka metodologisen mallin perusta on tanskalaisen kielitieteilijän Louis Hjelmslevin (1899-1965) kielitieteellinen malli. Väitös ei käytä mallia suoraan, vaan soveltaa sitä kaunokirjallisuuden tutkimukseen. Oppiteoreettisen viitekehyksen osalta tutkimus sijoittuu strukturalismin ja poststrukturalismin murrokseen. Tutkimus korostaa Eltitin radikaalia muotokieltä ja teatraalisuutta, hänen kielensä visuaalisuutta ja ruumiin metaforien eroottista jännitettä, mikä ilmenee mm. falloksen metaforaksi tulkitun hehkuvan valon kuvissa romaanissa Lumpérica. Vanhat kreikkalaiset myytit Éros ja Thánatos kasvavat esille länsimaisen taidehistorian perinteestä ja kontekstualisoituvat uusiksi kielikuviksi Chilen kirjallisessa maaperässä. Ne muodostavat Eltitin taiteellisen tuotannon pysyvän aihepiirin ja luovat teoksiin synkkää ja karua virettä sekä tummia ja eroottisia sävyjä. Tutkimus osoittaa, että Eltit dekonstruoi kieltä, mutta dekonstruktiot eivät ole jatkuvia eivätkä samanlaisia kaikissa romaaneissa. Kielellisten dekonstruktioiden variaatio on laaja eikä Eltit murra kielen syntaktisia ja morfologisia rakenteita kaikissa teksteissään. Tutkimuksen perusteella väitän, että Eltitin kirjoituksesta puhuttaessa useat tutkijat käyttävät epämääräisesti dekonstruktio-termiä. Useiden tutkijoiden toteamus dekonstruktiosta Diamela Eltitin kirjallisessa tuotannossa pysyvänä piirteenä on epätäsmällinen. Sen sijaan dekonstruktiivinen kirjoitus tarkoittaa Eltitillä laajasti vaihtelevaa lähestymistapaa kieleen, mikä ilmenee kehityslinjana hänen tuotannossaan ja eri tavoin jokaisessa teoksessa.

"Do Not Celebrate Your Feast without Your Neighbours" : A Study of References to Feasts and Festivals in Non-Literary Documents from Ramesside Period Deir el-Medina

This dissertation is a study of the forms and functions of feasts and feasting in the ancient Egyptian village of Deir el-Medina in Thebes (modern Luxor). This particular village, during the New Kingdom (c. 1550 1069 BC), was inhabited by the men (and their families) who constructed the Royal Tombs in the Valley of the Kings and the Valley of the Queens. The royal artisans were probably more literate than the average Egyptians and the numerous Ramesside Period (c. 1295 1069 BC) non-literary texts found in the excavations of the village and its surroundings form the source material for this study. In this study, the methods used are mainly Egyptological and the references to feasts and feasting are considered in view of what is known of New Kingdom Egypt, Thebes, and Deir el-Medina. Nevertheless, it is the use of the methodological concept local vernacular religion that has resulted in the division of the research findings into two sections, i.e., references to feasts celebrated both in and outside the community and other references to feasts and feasting in the village. When considering the function of the feasts celebrated at Deir el-Medina, a functional approach to feasts introduced by anthropologists and archaeologists is utilized. The Deir el-Medina feasts which were associated with the official religion form a festival calendar of feasts celebrated annually on the same civil calendar day. The reconstructed festival calendar of Deir el-Medina reflects the feasts celebrated around Thebes or, at least, in Western Thebes. The function of the nationally and regionally observed feasts (which, at least at Deir el-Medina, resulted in a work-free day) may have been to keep people content so that they would continue to work which was to the advantage of the king and the elite surrounding him. Local feasts appear to have been observed more irregularly at Deir el-Medina or perhaps according to the lunar calendar. Feasts celebrated by the community as a whole served to maintain the unity of the group. In addition to feasts celebrated by the entire community, the inhabitants of Deir el-Medina could mark their own personal feasts and organize small gatherings during public feasts. Through such feasts, an individual man might form alliances and advance his chances of a favourable marriage or of acquiring a position on the work crew.

Estudio diacrónico comparativo de los usos y la semántica de la preposición DE en dos novelas españolas: Libro del caballero Zifar y El ingenioso hidalgo don Quijote de la Mancha

Prepositioner är välkända för sin polysemi eller betydelsemångfald, och utgångspunkten för den här uppsatsen har varit ett intresse av att undersöka om det är möjligt att för en av de mest mångtydiga spanska prepositionerna, DE, finna en sammanhängande semantisk struktur, eller om det är nödvändigt att se de olika betydelserna som inbördes orelaterade. För att utreda den här frågan och ge den ett diakroniskt perspektiv undersöker jag i den här uppsatsen användningen av den spanska prepositionen DE i två romaner ur den spanska litteraturhistorien, Libro del caballero Zifar och El ingenioso hidalgo don Quijote de la Mancha, del I. Uppsatsen består av tre delar. I kapitel två ger jag en teoretisk översikt över spanskans prepositionssystem och prepositionerna beskrivs både ur syntaktisk och semantisk synvinkel. Dessutom presenteras den kognitiva grammatiken och dess synsätt på prepositioner. Huvuddelen av arbetet koncentrerar sig på att presentera prepositionen DE på två sätt och enligt två skilda metoder. I kapitel tre presenteras de olika kontextuella användningarna av DE enligt den traditionella, historisk-komparativa metoden. Med utgångspunkt i dessa kontextuella användningar ställer jag i kapitel fyra med stöd av den kognitiva grammatikens begreppssystem upp en semantisk nätverksmodell av de olika betydelser som jag fastställt för DE i den funktionella analysen. För den semantiska beskrivningen har jag använt mig av den kognitiva grammatiken, eftersom denna grammatikuppfattning i motsats till den traditionella grammatiken ser polysemin som regel och utgångspunkt i den semantiska strukturen. Analysdelen av uppsatsen inleds med den funktionella presentationen av användningarna av DE av två grundläggande skäl: För det första anser jag det ändamålsenligt att för den semantiska beskrivningen ha en solid bas av exempel där användningen av DE analyserats med hänsyn till kontexten. Kapitel tre är därför indelat i fyra huvuddelar, enligt vilken ordklass DEs huvudord tillhör, t.ex.: substantiv, adjektiv, verb. I exemplen i den fjärde gruppen fungerar prepositionsfrasen som inleds av DE som en mer fristående bestämning på frasnivå, där huvudordets ordklasstillhörighet inte är av avgörande betydelse. För det andra utgår jag från att en viss utveckling av DE har skett under de 300 år som tidsmässigt skiljer de båda romanerna åt, både vad gäller dess användning och dess semantik. För att komma underfund med och beskriva utsträckningen hos denna utveckling är det nödvändigt att den komparativa delen presenteras innan den semantiska beskrivningen kan inledas. Resultaten av den komparativa analysen är att ett antal smärre skillnader i användningen förekommer, men detta till trots har ingen betydande semantisk utveckling kunnat iakttas. Detta innebär att den semantiska beskrivningen av DE kan göras utifrån ett relativt enhetligt material. Jag har följaktligen också kunnat ställa upp en enhetlig semantisk nätverksmodell av tolv olika, relaterade betydelser hos DE. Utgående från mitt material är det sålunda möjligt att se DEs polysemi som ett sammanhängande nätverk, trots att vissa av betydelserna kan verka sinsemellan motstridiga och att 300 år skiljer åt de två böckerna. Nyckelord: prepositioner, DE: semantik och användning, polysemi, kognitiv grammatik, diakroni

Rainfall and streamflow response to El Niño Southern Oscillation: a case study in a semiarid catchment, Australia.

This paper aims to compare the shift in frequency distribution and skill of seasonal climate forecasting of both streamflow and rainfall in eastern Australia based on the Southern Oscillation Index (SOI) Phase system. Recent advances in seasonal forecasting of climate variables have highlighted opportunities for improving decision making in natural resources management. Forecasting of rainfall probabilities for different regions in Australia is available, but the use of similar forecasts for water resource supply has not been developed. The use of streamflow forecasts may provide better information for decision-making in irrigation supply and flow management for improved ecological outcomes. To examine the relative efficacy of seasonal forecasting of streamflow and rainfall, the shift in probability distributions and the forecast skill were evaluated using the Wilcoxon rank-sum test and the linear error in probability space (LEPS) skill score, respectively, at three river gauging stations in the Border Rivers Catchment of the Murray-Darling Basin in eastern Australia. A comparison of rainfall and streamflow distributions confirms higher statistical significance in the shift of streamflow distribution than that in rainfall distribution. Moreover, streamflow distribution showed greater skill of forecasting with 0-3 month lead time, compared to rainfall distribution.

Impacts of El Niño southern oscillation and Indian Ocean dipole on dengue incidence in Bangladesh

Dengue dynamics are driven by complex interactions between hosts, vectors and viruses that are influenced by environmental and climatic factors. Several studies examined the role of El Niño Southern Oscillation (ENSO) in dengue incidence. However, the role of Indian Ocean Dipole (IOD), a coupled ocean atmosphere phenomenon in the Indian Ocean, which controls the summer monsoon rainfall in the Indian region, remains unexplored. Here, we examined the effects of ENSO and IOD on dengue incidence in Bangladesh. According to the wavelet coherence analysis, there was a very weak association between ENSO, IOD and dengue incidence, but a highly significant coherence between dengue incidence and local climate variables (temperature and rainfall). However, a distributed lag nonlinear model (DLNM) revealed that the association between dengue incidence and ENSO or IOD were comparatively stronger after adjustment for local climate variables, seasonality and trend. The estimated effects were nonlinear for both ENSO and IOD with higher relative risks at higher ENSO and IOD. The weak association between ENSO, IOD and dengue incidence might be driven by the stronger effects of local climate variables such as temperature and rainfall. Further research is required to disentangle these effects.

Temple Beth El (Helena, Ark.) records, undated, 1875-2006.

The records of Temple Beth El offer a valuable insight into a small town Southern Jewish community. The community members, composed mainly of German Jews devoted to Reform movement, participated actively in charity work and mutual benefit societies, and maintained a close relationship with Jewish communities throughout the South. Contributors to the Southern economy, their synagogue activities often reflect their business interests; a bale of cotton was once used in a fundraising auction. The strength of their Jewish commitment is reflected in their efforts to keep the synagogue active, despite difficulties in hiring and maintaining Rabbis for the pulpit.

Temple Beth El Providence, Rhode Island collection, 1940-1969

In 1916, the Jewish community of Boston established Beth Israel Temple Beth-El, located on the East Side of Providence, dates back to 1849, with the creation of the group "Sons of Israel." On September 10, 1849, Solomon Pareira, Leonard Gavitts and Morris Steinberg were granted an acre of land along the New London Turnpike (now Reservoir Avenue) to establish a cemetery. In 1854, the Congregation of the Sons of Israel and David was established, leading to president Solomon Pareira's deeding of the cemetery land in 1857 for the sole utilization of the congregation. This collection contains programs, sermons and newsletters. Although the congregation was originally Orthodox, it affiliated with the Union of American Hebrew Congregations (Union for Reform Judaism) in 1877.

Temperatura vozdukha v Krymu v 1925-1926 s.kh.g. v gradisokh T︠S︡elʹt︠s︡ii︠a︡

Digital image

Shift of peak in summer monsoon rainfall over Korea and its association with El Nino-Southern Oscillation

The annual cycle of rainfall over the Korean Peninsula is marked by two peaks: one during July and the other during August. Since the mid-1970s, the maximum rainfall over the Korean Peninsula has shifted from July to August. This shift in rainfall peak was caused by a significant increase of August rainfall after the mid-1970s. The basic reason for this shift has been traced to a change in teleconnection between El Nino-Southern Oscillation (ENSO) and August rainfall. The relationship between August rainfall over Korea and ENSO changed from 1954-1975 (PI) to 1976-2002 (PII). The variability of August rainfall was significantly associated with sea surface temperature (SST) variation over the eastern equatorial Pacific during PI, but this relationship is absent during the PII period. In El Nino years during PI, low-level westerly and southerly wind anomalies are dominant around the East China Sea, which relates to strong August rainfall. In La Nina years during PI, easterly and northerly wind anomalies are dominant. During the PII period, however, westerly and southerly wind anomalies around the East China Sea were responsible for the high August rainfall over the East Asian region, even though La Nina SST conditions were in effect over the eastern Pacific.