Self-management programs in stage 1-4 chronic kidney disease : a literature review.

Background Chronic kidney disease (CKD) is a complex health problem, which requires individuals to invest considerable time and energy in managing their health and adhering to multifaceted treatment regimens. Objectives To review studies delivering self-management interventions to people with CKD (Stages 1–4) and assess whether these interventions improve patient outcomes. Design: Systematic review. Methods Nine electronic databases (MedLine, CINAHL, EMBASE, ProQuest Health & Medical Complete, ProQuest Nursing & Allied Health, The Cochrane Library, The Joanna Briggs Institute EBP Database, Web of Science and PsycINFO) were searched using relevant terms for papers published between January 2003 and February 2013. Results The search strategy identified 2,051 papers, of which 34 were retrieved in full with only 5 studies involving 274 patients meeting the inclusion criteria. Three studies were randomised controlled trials, a variety of methods were used to measure outcomes, and four studies included a nurse on the self-management intervention team. There was little consistency in the delivery, intensity, duration and format of the self-management programmes. There is some evidence that knowledge- and health-related quality of life improved. Generally, small effects were observed for levels of adherence and progression of CKD according to physiologic measures. Conclusion The effectiveness of self-management programmes in CKD (Stages 1–4) cannot be conclusively ascertained, and further research is required. It is desirable that individuals with CKD are supported to effectively self-manage day-to-day aspects of their health.

Appendiceal sonography in children: A retrospective analysis as a platform for potential implementation of diagnostic categories

- Background Sonography is an important diagnostic tool in children with suspected appendicitis. Reported accuracy and appendiceal visualisation rates vary significantly, as does the management of equivocal ultrasound findings. The aim of this study was to audit appendiceal sonography at a tertiary children's hospital, and provide baseline data for a future prospective study. - Summary of work Records of children who underwent ultrasound studies for possible appendicitis between January 2008 and December 2010 were reviewed. Variables included patient demographics, sonographic appendix characteristics, and secondary signs. Descriptive statistics and analysis using ANOVA, Mann-Whitney U test, and ROC curves were performed. Mater Human Research Ethic Committee approval was granted. - Summary of results There were 457 eligible children. Using a dichotomous diagnostic model (including equivocal results), sensitivity was 89.6%, specificity 91.6%, and diagnostic yield of 40.7%. ROC curve analysis of a 6mm diameter cut-off was 0.88 AUC (95% CI 0.80 to 0.95). - Discussion and conclusions Sonography is an accurate test for acute appendicitis in children, with a high sensitivity and negative predictive value. A diameter of 6mm as an absolute cut-off in a binary model can lead to false findings. Results were compared with available literature. Recent publications propose categorising diameter1 and integrating secondary signs2 to improve accuracy and provide more meaningful results to clinicians. This study will be a benchmark for future studies with multiple diagnostic categorisation.

Cartas enviadas por Marcelo Baillet a Justo Garate entre 1970 y 1971

2 cartas y 2 tarjetas postales (mecanografiadas y manuscritas) ; entre 210x280mm y 150x105mm

Simple method for estimating minimum bend radii of SOI single mode curved rib waveguides

A simple method based on the effective index method was used to estimate the minimum bend radii of curved SOI waveguides. An analytical formula was obtained to estimate the minimum radius of curvature at which the mode becomes cut off due to the side radiative loss.

Macroprudential Ideas and Contested Social Purpose: A Response to Terrence Casey

In response to Terrence Casey's argument that the emergence of macroprudential regulation since the financial crash can and should save neoliberalism we raise five objections. 1). The Debt-Driven Growth Hypothesis (DDG) and the Financial Instability Hypothesis (FIH), as Casey terms them, are just as likely to be complementary as they are oppositional and they are by no means incompatible. 2) Casey's empirics are too thin and static, drawn from the 1980s and 1990s, while Anglo Liberal Financialised Capitalism (ALFC) is a complex adaptive system that has continued to evolve throughout the 2000s. 3) Casey overlooks the dynamic relationship between potentially excessive financialisation and the performance of the wider economy, which is becoming a growing concern for many policy makers using the macroprudential frame. 4) Macroprudential as a series of ideas about the economy are often incompatible with neoliberal premises and their ontological foundations. 5) Many of the policy makers who have acted as the biggest champions of macroprudential regulation have also been highly critical of ALFC and view the macroprudential turn as making a contribution to a much needed deeper financial reformation that would over time transform some of the constituent economic and social relations of the existing political economy. We conclude that what we call the social purpose of macroprudential regulation (the question of whether it is intended to patch up or transform the existing system) is contested, and that macroprudential regulation has much potential beyond saving ‘neoliberalism’.

Estudio para el mejoramiento de seis centrales de climatización de la sala de tejedura de 4161.62 m2, que cuenta con 76 telares para tejido plano, de la fábrica textil "La Internacional"

En el área textil, sea esta tejeduría, hilandería, tintorería, o acabados de tela intervienen una infinidad de factores externos, relacionados con el tipo de material a procesar, se necesita tener un control riguroso de los factores externos tales como humedad relativa (HR) y temperatura, por lo que en el diseño de un área específica de cualquier planta textil, en este caso tejeduría, se invierte mucho dinero para garantizar condiciones estables de climatización tanto para el proceso como para el recurso humano.

L'Écho de Paris

1917/08/21 (Numéro 12058).

Biblioteca de predicadores ó sermonario escogido de las obras predicables de Cochin, Chevassu, Eguileta, Flechier, García, González, Massillon, Sánchez Sobrino, Santander, Treto, Troncoso y otros

UANL

Overexpression of catalase prevents gentamicin – induced apoptosis of renal proximal tubular cells in transgenic mice.

Introduction : La néphrotoxicité est une complication majeure de la gentamicine, qui est largement utilisée dans le traitement des infections bactériennes, en particulier celles provoquées par des bactéries à Gram-négatif. La gentamicine induit l'apoptose tubulaire, mais les mécanismes moléculaires impliqués demeurent mal compris. Dans l’étude présente, nous avons examiné le rôle des espèces réactives de l'oxygène (ROS) , des proteins Bax, Bmf et Caspase-12 (Csp-12) dans le mécanisme d’action de la gentamicine sur l'apoptose des tubules proximaux rénaux (RPT) et les dommages rénaux induits par ce médicament chez la souris. Méthode: Des souris adultes (âgées 18-19 semaines) mâles non-Tg et des souris transgéniques (CAT-Tg) qui surexpriment la catalase spécifiquement dans leurs cellules des RPT ont été traitées par injections intra-péritonéales de gentamicine (20 mg/kg/jour) pour 5 jours consécutifs, puis euthanasiés. Les reins ont été examinés et analysés par histologie, immunohistochimie pour presansance de la stress oxidative, expression des proteins Bax, Bmf et Csp-12 et essai TUNEL pour étudier de l’apoptose . Nous avons aussi examiné l'effet de la gentamicine sur génération des ROS et l’apoptose dans les cellules RPTC immortalisées de rat (IRPTC) in vitro. Résultats: In vivo, chez les souris non-Tg, la gentamicine induit une tubulopathie et l'apoptose des RPT , stimule la production de ROS et induit une augmentation de Bax et Bmf détectée par immunohistochimie et augmont activité du caspase-12. Ces changements sont atténués chez les souris Cat-Tg. In vitro, la gentamicine induit l’apoptos des cellulles. Le co-traitement avec la catalase normalise ces effets dans les IRPTC. Conclusion : Ces données démontrent que l'apoptose des RPTC induite par la gentamicine s’effectue, au moins en partie, par l'intermédiaire de la génération des ROS.

Actuación de UNAMID (operación híbrida de la Unión Africana y las Naciones Unidas en Darfur) en la defensa de los Derechos Humanos de las mujeres en el conflicto en Darfur (2008 – 2012)

El interés de esta monografía es analizar los alcances y las limitaciones de la actuación de UNAMID en la defensa de los Derechos Humanos de las mujeres en el conflicto en Darfur (2008-2012). Lo anterior, para dar cuenta de que si bien UNAMID ha tenido avances significativos en el aumento de denuncias por violación sexual, en la educación y en la inclusión de la mujer en Darfur, la intervención tardía, la falta de personal cualificado y el lento despliegue ha limitado su actuación para erradicar la violencia sexual como arma de guerra. Sin embargo, la baja internalización de la norma por parte del Estado de Sudán ha sido el mayor limitante para la Misión de Paz. Este análisis se realiza mediante el concepto de Responsabilidad de proteger y el enfoque de Alexander Wendt y Nicholas Onuf.

La educaci??n sexual en lo cotidiano de la escuela

Resumen tomado de la publicaci??n