The poetical works of S.T. Coleridge : including the dramas of Wallenstein, Remorse, and Zapolya.

Printer's device (anchor & dolphin) on each t.p.

Analytical analysis of consumption in Brazil

This thesis is an analytical analysis of consumption in Brazil, based on data from the Consumer Expenditure Survey, years 2008 to 2009, collected by the Brazilian Institute of Geography and Statistics. The main aim of the thesis was to identify differences and similarities in consumption among Brazilian households, and estimate the importance of demographic and geographic characteristics. Initially, households belonging to different social classes and geographical regions were compared based on their consumption. For further insights, two cluster analyses were conducted. Firstly, households were grouped according to the absolute values of expenditures. Five clusters were discovered; cluster membership showed larger spending in all of the expense categories for households having higher income, and a substantial association with particular demographic variables, including as region, neighborhood, race and education. Secondly, cluster analysis was performed on proportionate distribution of total spending by every household. Five groups of households were revealed: Basic Consumers, the largest group that spends only on fundamental goods, Limited Spenders, which additionally purchase alcohol, tobacco, literature and telecommunication technologies, Mainstream Buyers, characterized by spending on clothing, personal care, entertainment and transport, Advanced Consumers, which have high relative expenses on financial and legal services, healthcare and education, and Exclusive Spenders, households distinguished by spending on vehicles, real estate and travelling.

When tomorrow finally comes: Imagining disability

The article focuses on scholars with disabilities reimagining communication. The trans disciplinary department of Communication, Cultural, and Media Studies in an Australasian university lies within a university that routinely asks what members of the university community need for functioning, and provides the communication facilitation, attendant and personal care, and other support, seeking to integrate these with community support, without seeking to place the financial burden of such support upon the individual or their family. Significant research projects are conducted with, and within, diverse communities, with which the university has equal and continuing relationships, as well as in the everyday interactions on campus, in the virtual communities fostered within the department, and with the wider community. Disability and deafness studies, have become an essential part of the teaching and learning as well as the research program. However, rather than some grand scenario being the epitome, it is in the day to day relationships of scholars and students drawn from communication, cultural, and media studies and people with disability.

Measuring mobility in frail older people: reliability and validity of the Physical Mobility Scale

Objectives: The study was designed to show the validity and reliability of scoring the Physical Mobility Scale (PMS). PMS was developed by physiotherapists working in residential aged care to specifically show resident functional mobility and to provide information regarding each resident's need for supervision or assistance from one or two staff members and equipment during position changes, transfers, mobilising and personal care. Methods: Nineteen physiotherapists of varying backgrounds and experience scored the performances of nine residents of care facilities from video recordings. The performances were compared to scores on two 'gold standard' assessment tools. Four of the physiotherapists repeated the evaluations. Results: The PAIS showed excellent content validity and reliability. Conclusions: The PAIS provides graded performance of physical mobility, including level of dependency on staff and equipment. This is a major advantage over existing functional assessment tools. There is no need for specific training for physiotherapists to use the tool.

Residents' rights and nurses' ethics in the Australian nursing home

Background: This article is derived from a more extensive review of literature for a qualitative study that explored the meaning of truth-telling within the care provider-aged resident dyad in high-level (nursing home) aged care. Aim: This paper describes through the literature, work practices and the culture of the nursing home as promoting instrumental care, therefore prioritizing doing-for over being-with. The nursing home, starved of time and staff, silences and isolates the aged care resident in an environment that is, arguably, rarely homelike. Conclusion: The appraisal of the nursing home offered here means that a number of residents' rights are at risk and care providers (notably registered nurses and the personal care assistants) risk contravening the Code of Ethics for Nurses in Australia.

Estudo comparativo entre antipsicóticos atípicos no tratamento da esquizofrenia e sua influência na qualidade de vida dos pacientes

Schizophrenia is a severe and persistent mental illness; diagnosis occurs mainly during adolescence. The pharmacological treatment is done with typical and atypical antipsychotics. Atypical have the advantage of reduced extrapyramidal effects, which make them promising for the treatment of schizophrenia, furthermore, they have shown significant metabolic and hormonal changes. The objective of this study was to evaluate the influence of atypical antipsychotics, olanzapine and risperidone on the quality of life and on their adverse effects in schizophrenic patients. For this we analyzed the quality of life of patients with implementation of EuroQol-5D-3L instrument and performing biochemical and hormonal tests, blood pressure measurement, and measurement of anthropometric indices, besides the application of Ugvalg scales for Kliniske Undersgelser (UKU) and Simpson-Angus, who evaluated the side effects caused by drugs. Data were analyzed using the Student t test and chi-square test, with 5% significance level. The results showed that the EuroQol the antipsychotic olanzapine causes significant losses associated with personal care (p <0.001). Comparing the two groups of antipsychotics, the average years of quality-adjusted life, known per QALY was favorable for the risperidone group (p <0.032). The results of olanzapine and risperidone groups were compared. In terms of socioeconomic, it was observed that men used, the prevalent form, olanzapine (p <0.008); this same group showed the following results significantly unfavorable, related to anthropometric variables: waist circumference (p <0.01), hip circumference (p <0.02), weight (p <0.02) and blood pressure (p <0.04). The biochemical and hormonal analyzes showed that olanzapine resulted in losses related to the following variables: triglycerides (p <0.04), HDL cholesterol in men (p < 0.02) and cortisol (p < 0.01). In risperidone users, the only negative value was prolactin (p < 0.04). Regarding the analysis of the Simpson-Angus scale, the group treated with olanzapine was handicapped because the average total scores for olanzapine was 0.38, while for risperidone was 0.11 (p < 0.02). In the UKU scale, the following results were obtained also unfavorable for the olanzapine group: fatigue (P <0.02), dystonia (p <0.01) and tremor (p <0.03). According to the UKU scale, the side effects present in the risperidone group included: gynecomastia (p <0.01), ejaculatory dysfunction (p <0.02) and erectile dysfunction (p <0.02). It was concluded that olanzapine users had the worst score of quality of life, higher metabolic risks associated with overweight and inadequate lipid profile and greater tendency to extrapyramidal manifestations. However, risperidone users were more likely to adverse reactions due to hormonal changes.

Leanin soveltaminen haavanhoitotuotteiden valmistuksen läpimenoaikojen lyhentämiseksi

Mölnlycke Health Care valmistaa kertakäyttöisiä leikkaussali- ja haavanhoitotuotteita. Yritys on saavuttanut arvostetun aseman markkinoilla ja pitääkseen asemansa sen tulee koko ajan kehittää toimintaansa. Keväällä 2016 yritys aloitti leanin implementoinnin, minkä vuoksi nykytilanteen kartoittaminen ja sen pohjalta tuotannon kehittäminen tuli ajankohtaiseksi. Diplomityössä selvitettiin Mölnlycke Health Care Oy:lle sopiva nykytilan kartoitusmenetelmä. Sopivaksi menetelmäksi osoittautui arvovirtakuvaus. Nykytilanteen kartoitus tehtiin yrityksen kannalta tärkeälle tuoteperheelle, joka tässä tapauksessa oli edistyksellinen haavanhoitotuote ja haavasidos Mepilex Border. Nykytilanteen kartoitus antoi tuotteen läpimenoajaksi 100 päivää varaston riitto huomioituna. Tästä ajasta kuitenkin suurin osa oli hukkaa, jota pystytään poistamaan. Nykytilanteesta tehtiin kuva, jonka pohjalta pystyttiin havainnoimaan kehittävät kohteet ja tekemään ehdotukset kohteiden parantamiseksi. Kehitysehdotusten tavoitteena oli tuoda yritystä lähemmäs Lean-filosofiaa ja auttaa pitämään yllä jatkuvan parantamisen kulttuuria.

Cyto- and Genotoxicity assessment of manufactured nano cerium dioxide in the A549 cell line

In the past decades the growing application of nanomaterials (NMs) in diverse consumer products has raised various concerns in the field of toxicology. They have been extensively used in a broad range of applications and cover most of the industrial sectors as well as the medicine and the environmental areas. The most common scenarios for human exposure to NMs are occupational, environmental and as consumers and inhalation is the most frequent route of exposure, especially in occupational settings. Cerium dioxide NMs (nano-CeO2) are widely used in a number of applications such as in cosmetics, outdoor paints, wood care products as well as fuel catalysts. For such reason, nano-CeO2 is one of the selected NMs for priority testing within the sponsorship program of the Working Party of Manufactured Nanomaterials of the OECD. In this context, the aim of this study is to assess the safety of nano-CeO2 (NM-212, Joint Research Center Repository) through the characterization of its cytotoxicity and genotoxicity in a human alveolar epithelial cell line. A dispersion of the NM in water plus 0.05% BSA was prepared and sonicated during 16 minutes, according to a standardized protocol. DLS analysis was used to characterize the quality of the NM dispersion in the culture medium. To evaluate the cytotoxicity of nano-CeO2 in the A549 cell line, the colorimetric MTT assay was performed; the capacity of cells to proliferate when exposed to CeO2 was also assessed with the Clonogenic assay. The genotoxicity of this NM was evaluated by the Comet Assay (3 and 24h of exposure) to quantify DNA breaks and the FPG-modified comet assay to assess oxidative DNA damage. The Cytokinesis-Block Micronucleus (CBMN) assay was used to further detect chromosome breaks or loss. The nano-CeO2 particles are spherical, displaying a diameter of 33 nm and 28 m2/g of surface area. The results of the MTT assay did not show any decreased in cells viability following treatment with a dose-range of nano-CeO2 during 24h. Nevertheless, the highest concentrations of this NM were able to significantly reduce the colony forming ability of A549 cells, suggesting that a prolonged exposure may be cytotoxic to these cells. Data from both genotoxicity assays revealed that nano-CeO2 was neither able to induce DNA breaks nor oxidative DNA damage. Likewise, no significant micronucleus induction was observed. Taken together, the present results indicate that this nano-CeO2 is not genotoxic in this alveolar cell line under the tested conditions, although further studies should be performed, e.g., gene mutation in somatic cells and in vivo chromosome damage (rodent micronucleus assay) to ensure its safety to human health.

Determinantes das perturbações musculoesqueléticas nos trabalhadores de cuidados pessoais em residências de apoio ao idoso

Introdução: O enfermeiro especialista em reabilitação é o profissional com competências e conhecimentos para, após o diagnóstico, implementar e monitorizar os resultados dos programas de redução do risco das perturbações musculosqueléticas relacionadas com o trabalho (PME), junto dos trabalhadores de cuidados pessoais em residências de apoio ao idoso, avaliando e introduzindo no processo de prestação de cuidados os necessários ajustamentos, promovendo assim, práticas mais seguras e eficazes. Assim, o presente estudo centrou-se em identificar os determinantes das PME nestes trabalhadores e suas repercussões na saúde. Métodos: Estudo de natureza quantitativa, de tipologia transversal e descritivocorrelacional, com recurso a uma amostra não probabilística por conveniência, constituída por 120 indivíduos, na sua maioria do género feminino (95,8%) e com uma média de idades de 43,21 anos (Dp=10,812 anos). Como instrumento de colheita de dados utilizou-se o inquérito de saúde e trabalho (INSAT), aferido para este domínio de investigação. Resultados: Estes cuidadores formais manifestam défices de saúde com principal relevância para os relacionados com a mobilidade física e dor, quer pela existência de constrangimentos de natureza física e biomecânica, organizacional e psicossocial, bem como de natureza individual. Os problemas de saúde identificados por estes trabalhadores, resultantes das condições e características do trabalho foram: dores de costas (90,8%), dores musculares e articulares (82,5%), varizes (64,2%), dores de cabeça (49,2%) e ansiedade ou irritabilidade (47,5%). Ser do género feminino, ter idade entre os 49-58 anos, ser viúvo ou divorciado, ter doenças crónicas, tomar medicação e efetuar horário diurno, revelaram-se como determinantes percursores das PME assim como, a nível laboral, as características e os constrangimentos organizacionais e relacionais relacionados com o esforço físico, a intensidade e tempo de trabalho, as exigências emocionais, a insuficiência de autonomia e a má qualidade das relações sociais. Conclusão: Estes resultados apontam para a necessidade de desenvolvimento de estratégias preventivas das PME neste grupo profissional, onde é fundamental a intervenção do enfermeiro de reabilitação na implementação de programas de promoção da saúde, gestão do stresse e riscos psicossociais e formação profissional. Palavras-chave: Doenças musculosqueléticas; Enfermagem de Reabilitação; Saúde Ocupacional.

Estágio realizado no Programa Comunitário PLE²NO

A OA é a doença reumática mais comum no ser humano e uma doença crónica com impacto elevado na sociedade. Tem repercussões na saúde, ao nível da funcionalidade, comprometendo a realização das atividades da vida diária e a qualidade de vida dos indivíduos. Uma das articulações mais afetada pela OA é a articulação do joelho. O tratamento eficaz requer a combinação de tratamentos farmacológicos e não farmacológicos. Os tratamentos não farmacológicos, principalmente o exercício e a educação do doente têm vindo a ganhar importância, no que se refere ao controlo dos sintomas. A realização do estágio curricular surge no programa comunitário PLE²NO. O programa é considerado uma opção não farmacológica no tratamento e controlo dos sintomas da Osteoartrose (OA) no joelho. Os principais objetivos do estágio no PLE²NO consistiram: aquisição de conhecimentos teóricos relacionados com OA e práticos com vista ao aperfeiçoamento da prescrição do exercício; aquisição de competências essenciais à ótima liderança e comunicação com as pessoas e instituições envolvidas; prescrição de exercício a indivíduos com OA no joelho; cativar e motivar as pessoas para a prática de exercício; e determinar a eficácia de um programa de 3 meses de educação e exercício nos sintomas, aptidão física e qualidade de vida dos idosos com OA no joelho. Na aptidão física verificaram-se diferenças significativas na capacidade aeróbia, flexibilidade e velocidade da marcha. Nos indicadores de saúde houve melhoria em praticamente todos os parâmetros avaliados: mobilidade, cuidados pessoais, dor/mal-estar e sintomas de ansiedade/depressão. Assim, esta intervenção revelou-se ser uma mais-valia para o tratamento não farmacológico da osteoartrose do joelho a médio prazo.

Protective effect of (-)-epigallocatechin gallate on ultraviolet b-induced skin damage in hairless mice

Purpose: To investigate the protective effect of green tea (-)-epigallocatechin gallate (EGCg) on ultraviolet B (UV-B)-induced skin damages in hairless mice in order to develop a natural sunscreen compound for use in skin care products and cosmetics. Methods: EGCg was dissolved in acetone at concentrations of 1.0, 10.0 and 50.0 mg/mL, and topically applied to the skin of hairless mice at doses of 0.2 mL/cm2, with acetone as control. The mice were then irradiatd m2 UV-B for 30 min daily. EGCg treatment and UV-B irradiation were carried out daily for 28 consecutive days. The mice were then sacrificed and their dorsal skin examined by transmission electron microscopy (TEM) on the 28th day. Results: UV-B irradiation induced severe macroscopic skin damage including chapping, cracking and abnormal desquamation in the treated hairless mice. EGCg showed dose-dependent protective effects against UV-B induced damage on the skin. Treatments with 10.0 and 50.0 mg/mL EGCg alleviated UVB-induced skin damage by suppressing both keratinocyte apoptosis and mitochondrial dysfunction, along with inhibiting the production of melanin pigment. Conclusion: Topical application of green tea EGCg shows dose-dependent protective effect against UV-B-induced damage on hairless mouse skin. Thus, the plant compound can potentially be used as an alternative agent for photoprotection against UV-B exposure.

Medicis: a personal health care assistant

The relation between patient and physician in most modern Health Care Systems is sparse, limited in time and very inflexible. On the other hand, and in contradiction with several recent studies, most physicians do not rely their patient diagnostics evaluations on intertwined psychological and social nature factors. Facing these problems and trying to improve the patient/physician relation we present a mobile health care solution to improve the interaction between the physician and his patients. The solution serves not only as a privileged mean of communication between physicians and patients but also as an evolutionary intelligent platform delivering a mobile rule based system.

Prediction of the economic cost of individual long-term care in the Spanish population

Pensions together with savings and investments during active life are key elements of retirement planning. Motivation for personal choices about the standard of living, bequest and the replacement ratio of pension with respect to last salary income must be considered. This research contributes to the financial planning by helping to quantify long-term care economic needs. We estimate life expectancy from retirement age onwards. The economic cost of care per unit of service is linked to the expected time of needed care and the intensity of required services. The expected individual cost of long-term care from an onset of dependence is estimated separately for men and women. Assumptions on the mortality of the dependent people compared to the general population are introduced. Parameters defining eligibility for various forms of coverage by the universal public social care of the welfare system are addressed. The impact of the intensity of social services on individual predictions is assessed, and a partial coverage by standard private insurance products is also explored. Data were collected by the Spanish Institute of Statistics in two surveys conducted on the general Spanish population in 1999 and in 2008. Official mortality records and life table trends were used to create realistic scenarios for longevity. We find empirical evidence that the public long-term care system in Spain effectively mitigates the risk of incurring huge lifetime costs. We also find that the most vulnerable categories are citizens with moderate disabilities that do not qualify to obtain public social care support. In the Spanish case, the trends between 1999 and 2008 need to be further explored.

Strategy for personal and public involvement in Health and Social Care research

This report outlines the strategic need for, and benefits of, personal and public involvement to all levels of Health and Social Care Research and Development Division activity.