Life course building epidemiology: An alternative approach to the collection and analysis of carbon emission data

Developing policy for the reduction of the carbon emissions due to buildings requires models for energy usage that incorporate social, behavioural, and environmental factors in addition to the physical properties and technical specifications of the buildings. Marked parallels exist with some of the more intractable public health issues, such as rising levels of obesity. Recently, health researchers have recognized the importance of taking a broader life-course approach to epidemiology in order to examine the degree that long-term health outcomes are set in early life and the extent that these may be mediated or mitigated by subsequent growth and development, as well as by intervention strategies. Life course epidemiology as applied in building science, where energy usage is treated as analogous to poor health outcomes, provides an alternative approach for the construction of causal models that allow for complex interactions between social and technical factors as well as long term effects. It can provide a useful framework for the successful management and analysis of longitudinal studies and may prove particularly effective in identifying the type, timing, and targeting of intervention strategies to produce optimal outcomes in terms of absolute reductions of carbon emissions and resilience of building performance to external stresses, such as those imposed by climate change. An example based on a study in Milton Keynes (London), which is currently in progress, is used to illustrate the way causal models may help elucidate the complex interactions between factors that influence energy usage

Projeto de desenvolvimento da rede dos Centros Locais de Aprendizagem da Universidade Aberta, 2016-2022

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The Support Role in Clinical Supervision of Nursing Students: Determinant in the Development of Emotional Skills

The problematic situation faced by clients, associated to the processes of health and disease, is expressed through emotions that nursing students have to deal with in the course of care and their formative experiences in clinical teaching. Students have learning needs not only to manage emotions in the context of customer care, but also in terms of their own internal world, emotional conflicts, emotional stress and burn-out. With the present literature review, we intend to explore existing evidence regarding the ways in which the nurse supervisor's support towards nursing students potentiates the development of their competences for the performance of emotional labour. These skills prove to be the key in the ability to manage the emotionally intense situations of care practice and the support function of the nursing supervisor contributes to the development of such competences

Social Comparison and Perceived Breach of Psychological Contract: Their Effects on Burnout in a Multigroup Analysis

This study focuses on the mediator role of social comparison in the relationship between perceived breach of psychological contract and burnout. A previous model showing the hypothesized effects of perceived breach on burnout, both direct and mediated, is proposed. The final model reached an optimal fit to the data and was confirmed through multigroup analysis using a sample of Spanish teachers (N = 401) belonging to preprimary, primary, and secondary schools. Multigroup analyses showed that the model fit all groups adequatelyEste estudio se centra en el papel de la comparación social en la relación entre la ruptura percibida del contrato psicológico y el burnout. Se propone un modelo previo mostrando los efectos hipotetizados, tanto directos como mediados, de la ruptura percibida sobre el burnout. El modelo final alcanzó un ajuste óptimo a los datos y se confirmó a través del análisis multigrupo usando una muestra de profesores españoles (N = 401) pertenecientes a escuelas infantiles, primarias y secundarias. Los análisis multigrupo mostraron que el modelo se ajusta adecuadamente a todos los grupos

Efficacy of Percutaneous Transluminal Angioplasty on Dysfunctional Fistulae Because of Inflow Stenosis

PURPOSE: Autogenous fistulas are the preferential vascular access for hemodialysis. The aim of this retrospective study was to determine the efficacy of angioplasty for dysfunctional fistulas because of inflow dysfunction. 
 METHODS: We reviewed all the angiographic procedures performed on our institution between April 2007 and April 2009. Procedures performed in dysfunctional fistulas because of inflow stenoses were analyzed. Fistulas with stenoses out of these areas were excluded. The following data were collected: patient age and sex, fistula age at the time of intervention, location of fistula, number and location of stenosis, angiography referral criteria, clinical findings (presence or absence of thrills, bruits and pulsatility) and date of reintervention or failure. 
 RESULTS: During the study period 215 fistulas were submitted to angiography of which, seventy-one presented inflow stenosis (33%). Mean follow-up was 21.72±9.26 months, and average age was 7.03 months. Two groups were considered: 31 fistulas comprising ≤6 months old, and 40 fistulas >6 months old. Primary patency rates±SE for older fistulas at 6, 12, 18 and 24 months, respectively, was 91.3%± 0.04%, 80.7%± 0.07%, 53.8% ±0.10% and 34.2±0.1% versus 91.7±0.08%, 57.1±0.14%, 23±0.14%, 11.4%± 0.1% for younger fistulas (P=0.04). Fistulas ≤6 months old and multiple stenosis were associated with a poorer primary patency rate (P=0.005).
 CONCLUSIONS: Inflow stenosis is frequently associated with fistula dysfunction. In this study we only analyzed AVF with inflow stenosis and we have shown that angioplasty can have great patency results, particularly for single lesions in matured fistulas.info:eu-repo/semantics/publishedVersio

Culture, longevity and social policies - Radar's Project from the Portuguese Institution Santa Casa da Misericórdia de Lisboa

Culture is intrinsically linked to the values of society. Politics dictates our evolution of society through choices and omissions. Older people and their perceived value to the world must be a global priority. Still, the West has not valued this age group wisely and fairly. The data indicate that the impact of social circumstances on the quality of life of the elderly has not been of paramount importance. Investment in the scientific biosocial approach has been deficient compared to the biomedical approach. However, it has had the most significant positive impact on living standards and longevity. We recognise that the funding of the biosocial approach is not considered as competitive as the biomedical approach, because the methodology of the social sciences is fundamentally different. Public policy lacks accuracy because science cannot overrule political power. Accordingly, from 2021 to 2030, the United Nations Organization has named the decade of healthy ageing. Healthcare, as a pillar of social governance and respect for the lives of the elderly, believes that it is vital to have the necessary social support to prosper. On the basis of these circumstances, this research paper outlines the importance of focusing on the social aspect of living and ageing in assessing this age group. Healthy ageing has reflected improved living standards, and increased longevity must become a political priority. This article highlights the concept of political longevity initiatives and how to observe them from an ethical point of view of social science results in a different picture of society. The different perspectives that we present are useful for the modern science of public health. Radar is a current Portuguese initiative as a political project involving public and social institutions. We analyse this project, focusing on the importance of making healthy global ageing a political option.info:eu-repo/semantics/publishedVersio

Environmental risk assessment in a contaminated estuary: an integrated weight of evidence approach as a decision support tool

Environmental risk assessment of complex ecosystems such as estuaries is a challenge, where innovative and integrated approaches are needed. The present work aimed at developing an innovative integrative methodology to evaluate in an impacted estuary (the Sado, in Portugal, was taken as case study), the adverse effects onto both ecosystem and human health. For the purpose, new standardized lines of evidence based on multiple quantitative data were integrated into a weight of evidence according to a best expert judgment approach. The best professional judgment for a weight of evidence approach in the present study was based on the following lines of evidence: i) human contamination pathways; ii) human health effects: chronic disease; iii) human health effects: reproductive health; iv) human health effects: health care; v) human exposure through consumption of local agriculture produce; vi) exposure to contaminated of water wells and agriculture soils; vii) contamination of the estuarine sedimentary environment (metal and organic contaminants); viii) effects on benthic organisms with commercial value; and ix) genotoxic potential of sediments. Each line of evidence was then ordinally ranked by levels of ecological or human health risk, according to a tabular decision matrix and expert judgment. Fifteen experts scored two fishing areas of the Sado estuary and a control estuarine area, in a scale of increasing environmental risk and management actions to be taken. The integrated assessment allowed concluding that the estuary should not be regarded as impacted by a specific toxicant, such as metals and organic compounds hitherto measured, but by the cumulative risk of a complex mixture of contaminants. The proven adverse effects on species with commercial value may be used to witness the environmental quality of the estuarine ecosystem. This method argues in favor of expert judgment and qualitative assessment as a decision support tool to the integrative management of estuaries. Namely it allows communicating environmental risk and proposing mitigation measures to local authorities and population under a holistic perspective as an alternative to narrow single line of evidence approaches, which is mandatory to understand cause and effect relationships in complex areas like estuaries.info:eu-repo/semantics/publishedVersio

European Islam Between Religious Traditions and Secular Formations

The workshop “European Islam between Religious Traditions and Secular Formations” was held in Slubice (Poland) from 7-10 February. It was jointly organized by ISIM, Casa Arabe and its International Institute of Arab and Muslim World Studies, Kompetenzzentrum Orient-Okzident Marinz, and Europa -Universitat Viadrina Frankfurt/Oder

Tuberculous Meningitis: an Endemic Cause of Intracranial Hypertension

Tuberculous meningitis (TBM) presents a complex clinical scenario, often marked by delayed recognition and high mortality. Our case involves a 27-year-old woman from Nepal with no significant medical history, presented with a two-week history of fatigue, altered consciousness, dizziness, vomiting, fever, holocranial headache, and photophobia. Initial examination revealed signs consistent with meningitis, including fever, hypertensive state, prostration, bilateral exophthalmos, sixth cranial nerve paresis, and positive Kernig/Brudzinski signs. Cerebrospinal fluid (CSF) exhibited characteristics typical of TBM: turbidity, lymphocytic-predominant pleocytosis, low glucose, and elevated protein. The patient was promptly started on meningeal doses of vancomycin, ceftriaxone, and acyclovir. However, persistent fever, neurological deterioration, and signs of increased intracranial pressure led to the decision to initiate conventional empiric treatment of tuberculosis (TB) with isoniazid, rifampicin, pyrazinamide, and ethambutol (HRZE) and dexamethasone 1 week before cultural positivity for Mycobacterium tuberculosis of CSF. The case underscores the importance of considering TBM in patients from endemic regions, interpreting CSF findings, and initiating empirical treatment in critical scenarios, contributing to a positive patient outcome despite the diagnostic challenges.info:eu-repo/semantics/publishedVersio

Functional kernel estimators of conditional extreme quantiles

We address the estimation of "extreme" conditional quantiles i.e. when their order converges to one as the sample size increases. Conditions on the rate of convergence of their order to one are provided to obtain asymptotically Gaussian distributed kernel estimators. A Weissman-type estimator and kernel estimators of the conditional tail-index are derived, permitting to estimate extreme conditional quantiles of arbitrary order.Comment: arXiv admin note: text overlap with arXiv:1107.226