A rövidített házastársi stressz skála pszichometriai jellemzői = Psychometric characteristics of the shortened marital stress scale

Célkitűzés: A Gottsegen György Országos Kardiológiai Intézet Kockázat Vizsgálatának célja elsősorban a nyitott szívműtéten átesett betegek pszichoszociális kockázati tényezőinek vizsgálata és követése. Módszer: 137, nyitott szívműtéten átesett betegnél (87 férfi és 50 nő) a 17 tételes Házastársi Stressz Skála magyar változata a műtét után két évvel került felvételre, majd a kérdőív Varimax rotációval történő faktoranalízisét követően teszteltük a kérdőív rövidített változatát is. Eredmények: A 17 tételes Házastársi Stressz Skála (Cronbach-alfa 0,77) a faktoranalízis során öt különálló dimenziót eredményezett: a szeretet-bizalom, a problémák, a szexuális kapcsolat, a szívbetegség hatása a szexualitásra, valamint a személyes identitás faktorokat. A tételek az egyes dimenziókban jól elkülönültek, mindössze két tételt találtunk, melyek nem egyértelműen tartoztak egy faktorhoz, ezeket a rövidítés során kihagytuk. A kiválasztott Rövidített Házastársi Stressz Skála öt tételének (három kérdés az első faktorból, egy a másodikból, egy az ötödikből) skálaösszege korrelált a 17 tétel skálaösszegével (r = 0,902, p<0,001), belső konzisztenciája megfelelő (Cronbach-alfa 0,69). Konklúzió: A Rövidített Házastársi Stressz Skála pszichometriai jellemzői megfele­lőek

Parenteral amino acids v. dextrose infusion: an anabolic strategy to minimise the catabolic response to surgery while maintaining normoglycaemia in diabetes mellitus type 2 patients

Loss of body protein and hyperglycaemia represent typical features of the stress response to surgery and anaesthesia. This appears to be particularly pronounced in patients with diabetes mellitus type 2. The aim of the present study was to highlight the greater benefit of amino acids (AA) as represented by positive protein balance and maintenance of blood glucose homoeostasis compared with dextrose (DEX) in diabetic patients after colorectal surgery. A total of thirteen patients underwent a 5h stable isotope infusion study (2h fasted, 3h fed with an infusion of AA (n 6) or DEX (n 7)) on the second post-operative day. Glucose and protein kinetics were assessed by using the stable isotopes l-[1-13C]leucine and [6,6-2H2]glucose. The transition from fasted to fed state decreased endogenous glucose production (P<0·001) in both groups, with a more profound effect in the DEX group (P=0·031). In contrast, total glucose production was increased by the provision of DEX while being lowered by AA (P=0·021). Feeding decreased protein oxidation (P=0·009) and protein synthesis in the AA group, whereas DEX infusion did not affect oxidation and even decreased protein synthesis. Therefore, only AA shifted protein balance to a positive value, while patients in the DEX group remained in a catabolic state (P<0·001). Parenteral nutritional support with AA rather than with DEX is an effective strategy to achieve a positive protein balance while maintaining normoglycaemia in diabetic patients after colorectal surger

There is a need to request cervical spine routine radiographs for patients with Down s syndrome before carrying out otorhinolaryngologic surgery?

INTRODUCTION: The Down's Syndrome (DS) is a genetic syndrome characterized by several changes and the Atlanto-axial Instability is critical for the otorhinolaryngologist. OBJECTIVE: Check the prevalence of atlanto-axial instability in patients with Down's Syndrome who undergo service follow-up in the Clinical Hospital of the UFPR [Federal University of Paraná] and review the need to carry out routine cervical radiography in the patients with prescription to otorhinolaryngologic surgery. METHOD: Prospective study of patients with the syndrome who undergo CH/UFPR's follow up, through questionnaire and cervical X-ray. RESULTS: No case of IAA was found in the population studied. Discussion: we consider there's a high frequency of AAI in patients with DS, and for all patients who will take part in sports activities that involve motion of the region, or who are submitted to surgeries, an investigation with clinical and radiological exam is recommended. However, as the incidence has many variable findings we question the real validity of this research for all patients, even the asymptomatic ones. CONCLUSION: In spite of a DS's peculiar change, there are no evidences of the need to research the AAI as a routine in asymptomatic patients and the symptomatology should guide the investigation. But more studies are required to evaluate the importance of the radiological exams in such cases.INTRODUÇÃO: A Síndrome de Down é uma síndrome genética caracterizada por varias alterações, sendo que a Instabilidade Atlanto-axial é de grande importância para o Otorrinolaringologista. OBJETIVO: Verificar a prevalência de instabilidade atlanto-axial em pacientes portadores de Síndrome de Down que fazem acompanhamento ambulatorial no Hospital de Clínicas da UFPR e analisar se há necessidade de se realizar de rotina radiografia cervical nos pacientes com indicação de realizar cirurgia otorrinolaringológica. MÉTODO: Estudo prospectivo com paciente portadores da síndrome que tem acompanhamento no HC/UFPR, através de questionário e raios-X cervical. RESULTADOS: Não foi encontrado nenhum caso de IAA na população estudada. DISCUSSÃO: Considera-se que há uma alta frequência de IAA em pacientes com Síndrome de Down, sendo recomendado para todos os pacientes que vão participar de atividades esportivas que envolvam movimentação da região ou que sejam submetidos a cirurgias uma investigação com exame clinico e radiológico. No entanto, devido à incidência ter achados muito variados questiona-se a real validade desta investigação para todos os pacientes, mesmo que assintomáticos. CONCLUSÃO: Apesar de ser uma alteração peculiar da Síndrome de Down, não ha evidencias da necessidade de investigar a IAA rotineiramente em pacientes assintomáticos, sendo que a sintomatologia deve guiar a investigação. Porém, mais estudos são necessários para avaliar a importância dos exames radiológicos nesses casos.UFPR HC Faculdade Evangelica do ParanáEscola Paulista de MedicinaUniversidade Federal do ParanáSBORLHospital Infantil Pequeno PríncipePontifícia Universidade Católica do ParanáUNIFESP, EPMSciEL

Mentoring als zukunftsweisendes Instrument der Personal-, Unterrichts- und Schulentwicklung in der Berufseinstiegsphase von Lehrpersonen im österreichischen Bildungssystem

Mit der Einführung der neuen Pädagoginnen- und Pädagogenbildung in Österreich gehen Änderungen des Lehrer/ innendienstrechts einher. Eine Neuerung stellt die Umsetzung einer verpflichtenden Berufseinstiegsphase für alle Lehrerinnen und Lehrer dar. Dieser Artikel präsentiert am Beispiel eines Modellprojekts im Bundesland Steiermark, das in drei Schulbezirken von 2012 bis 2014 durchgeführt worden ist, Vorbereitungs- und Implementierungsstrategien von Mentoring im begleiteten Berufseinstieg. Am Beispiel der Primarstufe werden Gelingensbedingungenund relevante Faktoren von Mentoring und begleitenden Fortbildungsangeboten für Schulleiter/ innen, Mentorinnen und Mentoren sowie Berufseinsteiger/ innen diskutiert. (Autorenreferat)Due to the development of a new teacher training program in Austria, changes in service law come now into effect. These include obligatory support for all teachers during their first steps into the new profession. This article exemplarily outlines a model project in Styria (2012–2014) that considers strategies for preparing and implementing mentoring. Furthermore, circumstances and factors for a successful application of mentoring are discussed for teachers at the beginning of their careers in primary schools. (author's abstract

Lipopolysaccharide regulated protein expression is only partly impaired in monocytes from patients with type I diabetes

BACKGROUND: Monocytes play an important role in innate immunity and atherosclerosis. A disturbed secretion of cytokines in lipopolysaccharide (LPS) activated monocytes from type 1 diabetes (T1D) patients has been described and may contribute to the impaired inflammatory response in these individuals. In the present study the influence of LPS on five different proteins with a function in immunity and atherosclerosis was analyzed in monocytes from controls and T1D patients. METHODS: Monocytes were isolated from controls and T1D patients and the LPS-stimulated increase of IL-6, CXCL8, monocyte chemotactic protein 1 (CCL2, MCP-1) and superoxide dismutase (SOD 2), as well as the LPS-mediated decrease of apolipoprotein E (Apo E) in primary human monocytes from controls and T1D patients was determined. RESULTS: CCL2 and IL-6 secretion in response to LPS was found significantly reduced in monocytes from T1D patients when compared to controls whereas basal CCL2 release was similar in control and T1D cells. In contrast, CXCL8 and apolipoprotein E secretion and SOD 2 expression upon LPS stimulation is similar from T1D and control monocytes. CONCLUSION: These data indicate that LPS-mediated protein expression is only partly disturbed in monocytes from T1D patients. Reduced secretion of IL-6 and CCL2 in activated monocytes of these patients may contribute to an impaired inflammatory response and vascular disease

Magas vérnyomás vagy depresszió? Rossz házasságban másképp betegek a férfiak és másképp a nők = Hypertension or depression? In bad marriages, men may react differently than women

E tanulmány célja a házastársi stressz kapcsolatának vizsgálata a magasvérnyomás-betegséggel és a depresszióval – 65 évnél fiatalabb, házasságban/élettársi kapcsolatban élő, gazdaságilag aktív személyek körében; országos reprezentatív mintán (Hungarostudy 2002). A házastársi stresszt a Rövidített Stockholmi Házastársi Stressz Skálával, a depressziós tüneteket a Rövidített Beck Depresszió Kérdőívvel mértük. Azok a férfiak és nők alkották a „magasvérnyomás-beteg”, illetve „depressziós” csoportokat, akiket az elmúlt évben kezeltek is betegségük miatt. Hierarchikus logisztikus regresszió-elemzéssel vizsgáltuk a házastársi stressz hatását a magasvérnyomás-beteg, illetve a depressziós páciensek körében, valamint egészséges férfiak és nők körében. Adatainkat kontrolláltuk életkorra, iskolai végzettségre, szocioökonómiai státuszra, testtömeg-indexre, valamint az életmódra (dohányzás, alkoholfogyasztás és fizikai aktivitás). Míg a férfiaknál a házastársi stressz a magasvérnyomás-betegség hagyományos rizikótényezőktől független kockázati tényezőjének bizonyult, addig a nőkre ez nem állt fenn. Egy rossz házasságban élő férfinak majdnem kétszer nagyobb az esélye arra, hogy magasvérnyomás-betegség miatt kezeljék, mint a jó házasságban élő férfitársának. Ugyanakkor nőknél a házastársi stressz a depresszió miatti kezelés valószínűségét növelte szignifikáns mértékben, ez pedig a férfiakra nem volt jellemző. Egy rossz házasságban élő nőnek több mint kétszer nagyobb az esélye arra, hogy depresszió miatt kezelésben részesüljön, mint a jó házasságban élő nőtársának. Elemezéseink tehát azt mutatták, hogy férfiaknál a házastársi stressz a magasvérnyomás-betegség független kockázati tényezője, viszont nőknél a házastársi stressz a klinikai depresszió kockázati tényezője. | The aim of this study was to clarify the association of marital distress with hypertension and depression, based on a representative health survey, the Hungarostudy 2002. We analyzed data on all men and women younger than age 65, who were married or cohabitating and economically active at the time of examination. Marital distress (shortened Stockholm Marital Stress Scale) and depressive symptoms (shortened Beck Depression Inventory) were included in the survey. All subjects who during the past year had been diagnosed by a physician as suffering from hypertension or depression, and had been treated accordingly (self-report), were classified as “hypertensive” or ”depressed”. Hierarchical logistic regression analyses evaluated the effects of marital distress on hypertensive or depressed subjects, compared to controls who did not report health complaints. Analyses were adjusted for age, education, SES, BMI, and lifestyle (smoking, alcohol use and physical activity). Odds ratios (OR) with 95% confidence intervals were calculated. In men, but not in women, marital distress was independently associated with current treatment for hypertension. A man having a bad marriage runs a double risk of being treated for hypertension, compared to having a good marriage. In women, but not in men, marital distress was associated with elevated risk of treatment for depression. A woman having a bad marriage runs more than a double risk of being treated for depression, compared to living a good marriage. Based on these data, in men, marital distress was independently associated with elevated risk for hypertension treatment, whereas in women, marital distress was independently associated with risk for depression treatment

Quantum Interference of Coulomb Interaction and Disorder: Phase Shift of Friedel Oscillations and an Instability of the Fermi Sea

We investigate the influence of interference between Coulomb interaction and impurity scattering on the static electronic response $\chi (0,q)$ in disordered metals to leading order in the effective Coulomb interaction. When the transport relaxation time $\tau _{tr}$ is much shorter than the quasiparticle life time, we find a \mbox{sgn}(2p_F-q)/\sqrt{|2p_F-q|} divergence of the polarization function at the Fermi surface ($q=2p_F$). It causes a phase shift of the Friedel oscillations as well as an enhancement of their amplitude. Our results are consistent with experiments and may be relevant for understanding the stability of the amorphous state of certain alloys against crystallization.Comment: 11 pages, 4 PostScript figures appended as a self-extracting tar archive; includes output instruction

Platelet receptor gain-of-function single nucleotide polymorphisms in carotid and vertebral stenosis patients

The role of platelet receptor gain-of-function single nucleotide polymorphisms (SNP) in cardiovascular disease is controversial. We hypothesised that certain SNPs may accelerate the development of carotid artery stenosis. The intronic PAR-1 receptor intervening sequence-14 A/T (IVSn-14 A/T) polymorphism and three additional platelet receptor polymorphisms, i.e. GPIa (807C/T), GPIbα (5T/C) and HPA-1a/HPA-1b (Pl (A1/A2)) of GPIIIa were studied. The interaction of SNPs with conventional risk factors including male gender, hypertension, high cholesterol, diabetes, advanced age and smoking were investigated. The hypothesis was tested in 114 well-characterised patients with symptomatic carotid or vertebral stenosis from the British CAVATAS population and compared the results with 97 unrelated controls. The allele frequency of the platelet gain-of-function SNP was not significantly different in the CAVATAS population as compared to controls (PAR-1A/T (P=0.13), GPIa C/T (P=0.25), GPIIIa HPA-1a/HPA-1b (PlA1/A2) (P=0.66) and GPIb T/C (P=0.20)). In the subgroup of smokers, however, the prothrombotic GPIbα C mutated allele was found in a significantly higher frequency in the patient as compared to the control group (P=0.04). Contrary to the primary hypothesis, the PAR-1A/T SNP as well as the other SNPs tested were not over- or underrepresented in the CAVATAS population. However, a significantly increased prevalence of GPIb-α (5C/T) was found in the subgroup of smokers and may represent an important cofactor in this patient group of our hypothesis-generating stud