What does the vibration therapy add?: a quasi-experimental, pilot study on the short term effects of whole-body vibration as mode of exercise for nursing home residents aged 80+

Aims: To compare the responses of nursing home residents aged 80+ to an 8 weeks exercise program performed on a vibratory device and to the same exercise program preformed without vibration on lower limb performance, functional dependence and quality of life. Methods:Lower limb performance was evaluated using the 30 seconds Chair Sit to Stand test. Functional mobility was assessed using the timed up and go test. Postural stability was measured using a force platform. The Barthel Index was used to assess functional dependence and the EuroQol was used to evaluate Health-Related Quality of Life. 44 participants were allocated to the whole-body vibration group (n= 15), non-vibration group (n= 15) or to the control group (n= 14). Results:Significant differences were detected in favour of the whole-body vibration group in lower limb muscle performance (p= 0.001), mobility (p= 0.001), functional independence (p= 0.009) and quality of life (p <0.001) as compared to the control and non-vibration groups. Conclusions: Whole body vibration based interventions may add additional benefits to conventional exercise programs in terms of lower limb muscle performance, functional dependence and quality of life among nursing home residents over 80 years

Tracing a strategy map for a public institution

In such competitive times, where performance levels determine the survival of companies and where efficiency is key to any business, it is mandatory to bring forward an analysis that enables organizations to accurately construct a solid strategy based on specific objectives. This applies both to the private sector and to the public sector. Public administration institutions play a very specific role, not only in user satisfaction, but also as guarantee of their services, as legally stated, and within the limits of their budget. This thesis focuses on the importance and usefulness of tracing a Strategy Map for a Portuguese public institution – the Central Services of the Rectory of the University of Lisbon. Through the analysis of the information provided by the University and the collection of theoretical information, it was possible to frame the importance of strategy for any organization and to determine how, using the Balanced Scorecard, it is possible to best analyze a company and determine a suitable strategy, monitor it, evaluate it and, eventually, reformulate it as an instrument of adaptation to its environment. Each organization should be analyzed individually, taking into account the multiple factors that influence its existence. Preventive measures should be taken and corrective actions should be applied when necessary. This only works if an organization is aligned at all its levels. The representation of the BSC in a Strategy Map enables the necessary understanding throughout the organization while establishing strategic objectives by which it should be guided.Numa era tão competitiva, em que os níveis de desempenho determinam a sobrevivência das empresas e em que a eficiência é fundamental para qualquer área de negócio, é essencial construir uma análise que permita às organizações delinear corretamente uma estratégia sólida baseada em objetivos específicos. Isto é válido, não só para o setor privado, mas também para o setor público. As instituições públicas desempenham um papel muito específico, não só na satisfação dos seus utentes, mas também garantindo a prestação de serviços a que estão obrigadas por lei e observando os limites orçamentais que lhes são impostos. Esta tese centra-se na importância e na utilidade de traçar um Mapa Estratégico de uma instituição pública – os Serviços Centrais da Reitoria da Universidade de Lisboa. Através da análise da informação disponível pela Universidade e da recolha de informação teórica, foi possível enquadrar a importância da estratégia de qualquer organização e determinar como, através da utilização do Balanced Scorecard, é possível analisar uma empresa, determinar uma estratégia adequada, monitorizá-la, avaliá-la e, eventualmente, reformulá-la como instrumento de adaptação ao seu ambiente. Cada organização deve ser analisada individualmente, tendo em conta os vários fatores que influenciam a sua existência. Devem ser tomadas medidas preventivas e devem ser aplicadas, quando necessário, ações corretivas. Isto apenas funciona quando uma organização está alinhada a todos os seus níveis. A representação do BSC num mapa estratégico permite a compreensão necessária em toda a organização ao estabelecer objetivos estratégicos através dos quais esta deve ser guiada

Mirror Images of Invisibility-the Hispanic Journalist: How Does the Disproportionate Ratio of Local Hispanic News Anchors and Reporters Impact San Antonio Hispanics?

The U.S. 2000 Census reveals San Antonio\u27s 671,394 Hispanic or Latino population is 58.7 percent of the city\u27s 1.14 million people. This statistic contrasts nationwide to 12.5 percent or 35.3 million Hispanic or Latino people. San Antonio, ninth-largest U.S. city in total population, compares to two other Texas cities, Houston ranking fourth-largest and Dallas eighth-largest. San Antonio, fifth-largest city in Hispanic population on the U.S. Census chart of Ten Largest Places in Total Population and in Hispanic Population, outnumbers Dallas, listed eighth-largest in Hispanic population. Only Houston, remaining the fourth-largest Texas city, outranks San Antonio in Hispanic population. San Antonio Hispanics, who watch the mainstream local newscasts, will notice the ratio of Hispanic news anchors and reporters appears disproportionate to the area demographics, giving the above facts extreme importance. When a city, ranked ninth in the nation and nearly 60 percent Hispanic, lacks comparable representation on its local news, the situation cries for a response because of the seemingly inequitable situation. The question of whether or not the ratio of Hispanic news anchors and reporters represents the Hispanic population becomes an interesting one to explore because of the multifaceted social and cultural issues presented in this circumstance. This study explores some of the impacts that result from these social and cultural issues

No dejarse engañar por las estadísticas.

Calidad de análisis -- Ventaja competitiva -- Riesgos estadísticos -- Simulación -- Distribuciones de probabilidades -- Cisne negro

Entwicklung einer neuen Echtzeit-Methode zur Untersuchung des erytrozytärer Lebenszyklus von Plasmodium falciparum mit Schwingquarzbiosensoren

Previous studies carried out by the Biosensor Research Group of the Institute of Clinical and Experimental Transfusion Medicine at the Tübingen University had successfully demonstrated determination of various blood types through the interaction of erythrocytes with immobilised antibodies on a QCM. These studies have opened the possibility to test new applications of this technique for the study of infectious diseases. In our case, studies of the erythrocyte life cycle of P. falciparum, particularly during the last six hours preceding the merozoite release and studies related to reinfection of erythrocytes by merozoites were the focus of our investigation. Release of malaria parasites of P. falciparum from infected erythrocyte at the end of their asexual erythrocyte cycle occurs approximately every 48 hours, asynchronously in parasite culture and synchronously in vivo. This process is poorly studied due to: (I) merozoite release is a very short event (<60 s), (II) schizont stages have high sensitivity for culture conditions like pH, medium, osmotic pressure, gas atmosphere and temperature. (III) Schizont conditions are not easy to maintain under the miscrocope, making miscroscopical real time observation of the release difficult. The aim of the presented project was to study the release of Plasmodium falciparum merozoites from erythrocytes with the QCM sensor technique. In this way, the frequency shift due to the change of mass associated to the merozoite release and, on a second QCM, the reinfection of healthy erythrocytes are monitored in real time. Our QCM experiments included the following stages: (I) Adaptation and optimisation of the immobilisation of biological layers to capture the erythrocytes on the quartz. (II) Optimisation of parasite culture conditions in a QCM chamber. (III) Observation of the frequency signal both for infected and non-infected erythrocytes samples and correlation of the signal with the release of merozoites. (IV) Reinfection of healthy erythrocytes on a second quartz within one QCM system. (V) Test of inhibition of merozoite release and reinfection by antimalarial compounds. The results showed that there was significant increase of ~1000 Hz for QCM with infected erythrocyte compared to QCM with healthy erythrocytes, where the frequency remained stable. Microscopical observation of the quartz surface at different times during the experiment (TEM and optical) demonstrated a correlation between the increase in frequency and merozoite release. At this point, approximately more than 80% of the infected erythrocytes on the quartz are involved in the release. Reinfection of new erythrocytes was observed on a second QCM. pH of the system (7.2), Temperature (37°C+/-0.1), flow of the medium (9 µL/min), sterility of the process (BactAlert), gas atmosphere (O2 5%, residual N2) were established to ensure parasite development and survival. External controls using flow cytometry 24 hours after the reinfection showed a parasitemia percentage of >1% in the erythrocytes infected in situ. Our results show, that the QCM technique is an appropriate and important new tool to elucidate the biology of the re-invasion process of Plasmodia.Frühere Studien, ausgeführt durch die Biosensor-Forschungsgruppe des Instituts für Klinische und Experimentelle Transfusionsmedizin an der Universität Tübingen, hatten die Blutgruppenbestimmung durch die Wechselwirkung von Erythrozyten mit immobilisierten Antikörpern auf einem Schwingquarzbiosensor (SQ) erfolgreich demonstriert. Diese Studien haben die Möglichkeit eröffnet, neue Anwendungen dieser Technik für die Untersuchung von Infektionskrankheiten zu evaluieren. In unserem Fall waren Studien des erythrozytären Lebenszyklus von P. falciparum, besonders die letzten sechs Stunden, die der Merozoiten-Freisetzung vorangehen, und Studien verbunden mit der Reinfektion durch Merozoiten der Schwerpunkt unserer Forschung. Die Freisetzung von Malaria-Parasiten von P. falciparum aus infizierten Erythrozyten am Ende ihres asexuellen erythrozytären Lebenzyklus erfolgt alle 48 Stunden und ist asynchron in Parasiten-Kultur und ist synchron in vivo. Dieser Prozess ist wenig untersucht worden. Die Hindernisse sind: (I) Freisetzung der Merozoiten findet in einer kurzen Zeit statt (<60 s) (II) Das Schizonten-Stadium der Parasiten hat eine hohe Empfindlichkeit gegenüber den Labor Bedingungen: pH-Wert und Zusammensetzung des Mediums, osmotischer Druck, Gas-Atmosphäre und Temperatur. (III) Die Erhaltung des Schizonten-Stadiums unter dem Mikroskop ist problematisch, so dass die Freisetzung der Merozoiten schwierig in Echtzeit zu beobachten ist. Das Ziel des Projektes war, die Freisetzung von Merozoiten von Plasmodium falciparum aus Erythrozyten mit der Schwingquarzbiosensor-Technik zu studieren. Dabei wurde die Änderung der Frequenz, aufgrund der Massenänderung bei der Freisetzung von Merozoiten, und auf einem zweiten Quarz die Reinfektion der nicht infizierten Erythrozyten durch die freigesetzten Merozoiten in Echtzeit beobachtet. Unsere SQ-Experimente beinhalten die folgenden Schritte: (I) Anpassung und Optimierung der Immobilisierung von biologischen Schichten, um Erythrozyten auf dem Quarz zu binden. (II) Optimierung von Bedingungen der Parasiten-Kultur in einer Schwingquarz-Messzelle. (III) Beobachtung des Frequenzsignals für infizierte und nicht-infizierte Erythrozyten und die Korrelation des Signals mit der Freisetzung von Merozoiten. (IV) Reinfektion gesunder Erythrozyten auf einem zweiten Quarz innerhalb eines SQ-System. (V) Test der Hemmung der Freisetzung der Merozoiten und der Reinfektion durch Merozoiten unter Einwirkung von Malariamedikamenten. Die Ergebnisse zeigten einen signifikanten Anstieg von ~ 1000 Hz am SQ für infizierte Erythrozyten, im Vergleich zu einem SQ mit gesunden Erythrozyten, wo das Frequenzsignal stabil geblieben ist. Mikroskopische Beobachtung der Oberfläche des Quarzes zu unterschiedlichen Zeitpunkten während des Experiments (REM und optisch) zeigte eine Korrelation zwischen dem Anstieg der Frequenz und der Freisetzung von Merozoiten. An diesem Punkt sind etwas mehr als 80% der infizierten Erythrozyten auf dem Quarz an dem Release beteiligt. Reinfektion neuer Erythrozyten wurde auf einem zweiten Quarz beobachtet. pH-Wert des Systems (7.2), Temperatur (37 ° C + / -0,1), Durchfluss des Mediums (9 uL / min), Sterilität des Prozesses (BactAlert), Gas-Atmosphäre (5% O2, Rest N2) wurden eingerichtet, um die Entwicklung der Parasiten und ihr Überleben sicher zu stellen. Externe Kontrollen mitttels Durchflusszytometrie 24 Stunden nach der Reinfektion zeigten einen Prozentsatz von Parasitämie von >1% in den in situ infizierten Erythrozyten. Unsere Ergebnisse zeigen, dass die Schwingquarz-Technologie ein geeignetes und wichtiges neues Instrument ist, um die Biologie des Re-Invasions-Prozesses der Plasmodien aufzuklären

Do democratic governments provide more goods and services?

This thesis studies the relationship between democracy and government consumption, through the lenses of the median voter model of democratic redistribution developed by Meltzer and Richard. Taking a large sample covering countries across all regions of the world for the 1960-2017 period, I estimate a positive effect of democratization on government consumption, controlling for country and year fixed effects. However, these results are not robust, as high levels of significance are not retained once I take the dynamics of government consumption and the Nickel bias into account. Given potential issues of endogeneity, I also carry out a two-stage least squares (2SLS) strategy, by using regional levels of democracy as an instrument, and my results do not change substantively. The lack of definitive conclusions arising from my empirical analysis suggests the relationship between democracies and government consumption may be more ambiguous than the median voter model of redistribution implies. If, for instance, democracy is “captured” by the elites, levels of redistribution might not be determined by the newly enfranchised segments of the population. Thus, I also discuss some of the reasons why recently democratized nations should not necessarily be expected to increase their levels of government consumption.Nesta tese, estuda-se a relação entre democracia e consumo público, tendo em conta o modelo do eleitor mediano num contexto de redistribuição democrática, desenvolvido por Meltzer and Richard. Considerando uma amostra alargada de países de todas as regiões do mundo para o período 1960-2017, estimo um impacto positivo da democratização no consumo público, controlando os efeitos fixos ao nível do país e ano. Contudo, estes resultados não são robustos, já que os elevados níveis de significância não se mantêm uma vez considerados as dinâmicas do consumo público e o problema do enviesamento de Nickel. Dada a potencial existência de endogeneidade, levo também a cabo uma estratégia de mínimos quadrados em dois estágios (2SLS), usando níveis regionais de democracia como variáveis instrumentais e os meus resultados não se alteram substancialmente. A falta de conclusões definitivas da minha análise empírica sugere que a relação entre democracias e consumo público poderá ser mais ambígua do que o modelo do eleitor mediano presume. Se, por exemplo, uma democracia for “controlada” pela elites, os níveis de redistribuição poderão não ser determinados pelos segmentos da população que acabaram de conquistar poder politico. Assim, discuto também algumas das razões pelas quais não se deverão necessariamente verificar aumentos do consumo público em nações recentemente democratizadas

Population Level Impact of Self-Immolation on Burn Unit Resources: A Retrospective Case-Matched Study

Background: This investigator sought to enhance medical knowledge and clinical care by distinguishing the population level characteristics of patients who attempted self-immolation within the burn population and determine the impact these patients have on health-care related resource utilization. Methods: Patients who met the inclusion criteria and were admitted for a documented attempt of self-immolation were case-matched based on age, gender, total body surface area burn, inhalation injury, and burn mechanism to individuals who experienced accidental burn injuries and were admitted to the burn unit during the same time-period. To compare patients, this investigator matched patient groups using a propensity score method. Results: Seventy-two total patients, including matched pairs, were selected after propensity scoring. Self-immolation patients had a significant difference in preexisting history of depression (p = .008), psychiatric disease (p = .028) and previous psychiatric treatment (p \u3c .001) as compared to accidental burn injury patients. They were also more likely to present with a history of anxiety (OR = 1.8), drug abuse (OR = 2.5) and alcohol abuse (OR = 2.8). Longer length of stay and the need for more specialty consult services visits (p = .002), and higher rates of complications (p = .013) were also found among self-immolation patients. Self-immolation patients were twice as likely to experience greater burn depth with differences in full thickness burn admissions (OR = 2.2). Self-immolation patients required more concomitant surgical procedures than accidental burn injury patients (p = .024) and were nearly three times as likely to be readmitted (OR = 2.82) to the hospital with longer hospital stays during readmission in comparison with accidental burn patients (15 days vs. 9 days). Conclusion: Self-immolation patients had distinguishable differences in patient levelcharacteristics and utilized more burn unit health-related resources as compared to matched accidental burn injury patients