O processo psicoterápico com autistas: produções subjetivas de duas psicólogas clínicas

A presente pesquisa tem como objetivo geral propiciar reflexões em relação ao papel do psicoterapeuta frente à condição do autismo, a partir da compreensão das produções subjetivas de duas profissionais em atuação clínica, tendo como referencial teórico a Teoria da Subjetividade em uma perspectiva cultural-histórica. A metodologia aqui empregada teve como fundamento o método construtivo-interpretativo, baseado na Epistemologia Qualitativa, que compreende o conhecimento como o processo de construção de campos da realidade, produzidos por uma inter-relação entre a prática do pesquisador e a realidade concreta estudada. As participantes da pesquisa são psicólogas clínicas que experienciaram a atuação psicoterápica com indivíduos autistas. A pesquisa foi realizada por meio de dinâmicas conversacionais e complemento de frases, e buscou trazer um diferente enfoque para a condição do autismo, levando em consideração o processo de transformação histórica desse diagnóstico, abordando supostos prejuízos e possibilidades no tratamento desses indivíduos, atendo-se as possibilidades de expressão autêntica e singular que o espaço clínico facilita. Ademais, o estudo visou gerar inteligibilidade sobre a atuação clínica com indivíduos autistas, num esforço metapsicológico, a fim de propiciar futuras reflexões e estudos nessa temática

Trabajar lo conocido para saltar hacia lo desconocido: un ámbito para la especulación, la experimentación y el análisis

Con la reciente aprobación en el Consejo de Ministros del día 14 de diciembre pasado de la Orden Ministerial que desarrolla las directrices propias del título de Grado de Arquitecto, en breve nos veremos obligados plantear el nuevo marco en el que queremos que se desarrolle el proceso de formación de los futuros arquitectos, y para ello habremos de acometer la reforma de los planes de estudios adaptándolos a las exigencias que plantea el Espacio Europeo de Educación Superior. Nuestro objetivo en la presente comunicación es el de suscitar algunas reflexiones que nos permitan abordar esta reforma desde un punto de vista amplio, crítico y de futuro, y eludir la comodidad de lo sancionado por la tradición

Zonificación climática para su aplicación al diseño bioclimático. Aplicación en Galicia (España)

The current Spanish legislation for energy efficiency establishes the climatic zones for compliance with the limitation of energy demand and consumption. These established zones do not have the function of being the basis for the design of buildings with bioclimatic strategies. We propose a methodology to develop a cartography based on Givoni’s design strategies, establishing a general zoning between geographic areas of similar behaviour. The cartography thus obtained provides the designer with information on the strategies that can be used to achieve comfort, without having to perform complex information searches. It validates the operation of the methodology used in its application to the Autonomous Community of Galicia (Spain). Within the process, a comparison is established between the two cartographies so that the similarities and divergences can be verified between them, concluding the concrete and differential applications for each of them.La normativa española actual para la eficiencia energética establece las zonas climáticas para el cumplimiento de la limitación de la demanda y consumo energéticos. Estas zonas establecidas no tienen la función de ser base para el diseño de edificios con estrategias bioclimáticas. Se propone una metodología para elaborar una cartografía basada en las estrategias de diseño de Givoni, estableciendo una zonificación general entre áreas geográficas de comportamiento similar. La cartografía así obtenida aporta al diseñador información sobre las estrategias que puede utilizar para alcanzar el confort, sin tener que realizar búsquedas de información complejas. Se valida el funcionamiento de la metodología utilizada en su aplicación a la Comunidad Autónoma de Galicia (España). Dentro del proceso se establece complementariamente una comparativa entre ambas cartografías de modo que se pueden comprobar las similitudes y divergencias entre las mismas, concluyendo las aplicaciones concretas y diferenciales para cada una de ellas

Methodology for a regional cartography for the application of the bioclimatic strategies of the Givoni Charter

The aim of the research is the feasibility of a methodology to map a specific territory, implementing the bioclimatic strategies necessary to achieve comfort, according to the Givoni diagram, as a very useful tool for building design.The methodology used is developed in four phases: I, obtaining the climatic information; II, analysis of climatological data; III, selection of stations and monthly data, application of Givoni letter and start of the mapping process; IV, establishment of zoning, and mapping, on a monthly basis. As a result of the application of the methodology, a set of maps is obtained that indicate the appropriate bioclimatic strategies for each territory, on a monthly basis, in order to achieve comfort in the buildings. The methodology has been validated in a specific territory in Spain, used as a case study. The original contribution of the research is said methodology that allows to elaborate the cartography for a territory, that becomes a powerful tool for the bioclimatic design, and that is capable of being applied to any territory.Se plantea como objetivo de la investigación expuesta la viabilidad de una metodología para cartografiar un territorio concreto, implementando las estrategias bioclimáticas necesarias para alcanzar el confort, según el diagrama de Givoni; herramienta muy útil para el diseño de edificios. Tal metodología se desarrolla en cuatro fases: I, obtención de la información climática; II, análisis de los datos climatológicos; III, selección de estaciones y datos mensuales, aplicación de la carta de Givoni e inicio del proceso de cartografiado; IV, establecimiento de la zonificación, y elaboración de mapas, con carácter mensual. Como resultado del trabajo, se obtiene un conjunto de mapas que indican las estrategias bioclimáticas adecuadas a cada territorio, en periodicidad mensual, para alcanzar el confort en los edificios. La metodología fue validada en un territorio concreto en España, utilizado como caso de estudio. En definitiva, la aportación original de la investigación es precisamente el desarrollo de la mencionada metodología, que permite elaborar una cartografía para un territorio determinado -mapa que convierte en una potente herramienta para el diseño bioclimático- y que, además, es susceptible de ser aplicada a cualquier territorio

PERFIS HEMATOLÓGICOS, BIOQUÍMICOS E PROTEÍNA PLASMÁTICA TOTAL DE GATOS INFECTADOS COM O VÍRUS DA LEUCEMIA FELINA

A leucemia viral felina (FeLV) é causada por um retrovírus E pode provocar várias alterações no organismo, como distúrbios de proliferação celular (linfoma ou doenças mieloproliferativas) e de supressão celular (imunodeficiência e mielosupressão). Considerando a importância dos resultados laboratoriais no diagnóstico, avaliação clínica e determinação do prognóstico de gatos infectados, os objetivos do estudo foram descrever as alterações hematológicas, bioquímicas e de proteína plasmática total de gatos infectados com o vírus da leucemia. Foram coletadas amostras de sangue de 48 gatos infectados com FeLV e avaliados os valores de hematócrito, hemoglobina, contagem de hemácias, leucócitos, plaquetas, análise citomorfológica e contagem diferencial de leucócitos e proteína plasmática total. Os valores de alanina aminotransferase (ALT), gama-glutamiltransferase (GGT), ureia e creatinina também foram avaliados. A linfopenia foi a alteração hematológica mais comum, em 31,25% dos gatos, seguida pela presença de linfócitos reativos ou atípicos (27,1%). Houve  anemia em 16,66% dos gatos; leucocitose em 16,66%; leucopenia em 14,58%; linfocitose em 8,33%, monocitose em 14,58%, eosinofilia em 4,17%, neutrofilia em 16,66%, neutropenia em 16,66%, desvio nuclear de neutrófilos à esquerda em 14,58% e presença de neutrófilos tóxicos em 16,66%. No perfil bioquímico, em 3,16% dos animais verificou-se azotemia; no perfil hepático, as alterações foram: aumento da GGT em 18,52%, aumento da ALT em 33,33% e aumento de ambas em 7,40%. No presente estudo, constatou-se que em 78,95% dos animais houve alguma alteração no hemograma. O estudo ressalta a importância do hemograma no diagnóstico, monitoramento e determinação do prognóstico de gatos infectados com FeLV

Evaluating the potential for the environmentally sustainable control of foot and mouth disease in Sub-Saharan Africa

Strategies to control transboundary diseases have in the past generated unintended negative consequences for both the environment and local human populations. Integrating perspectives from across disciplines, including livestock, veterinary and conservation sectors, is necessary for identifying disease control strategies that optimise environmental goods and services at the wildlife-livestock interface. Prompted by the recent development of a global strategy for the control and elimination of foot-and-mouth disease (FMD), this paper seeks insight into the consequences of, and rational options for potential FMD control measures in relation to environmental, conservation and human poverty considerations in Africa. We suggest a more environmentally nuanced process of FMD control that safe-guards the integrity of wild populations and the ecosystem dynamics on which human livelihoods depend while simultaneously improving socio-economic conditions of rural people. In particular, we outline five major issues that need to be considered: 1) improved understanding of the different FMD viral strains and how they circulate between domestic and wildlife populations; 2) an appreciation for the economic value of wildlife for many African countries whose presence might preclude the country from ever achieving an FMD-free status; 3) exploring ways in which livestock production can be improved without compromising wildlife such as implementing commodity-based trading schemes; 4) introducing a participatory approach involving local farmers and the national veterinary services in the control of FMD; and 5) finally the possibility that transfrontier conservation might offer new hope of integrating decision-making at the wildlife-livestock interface

High energy emission from microquasars

The microquasar phenomenon is associated with the production of jets by X-ray binaries and, as such, may be associated with the majority of such systems. In this chapter we briefly outline the associations, definite, probable, possible, and speculative, between such jets and X-ray, gamma-ray and particle emission.Comment: Contributing chapter to the book Cosmic Gamma-Ray Sources, K.S. Cheng and G.E. Romero (eds.), to be published by Kluwer Academic Publishers, Dordrecht, 2004. (19 pages

The example of CaPSURE: lessons learned from a national disease registry

IntroductionAlthough randomized controlled trials (RCTs) remain the gold standard for determining evidence-based clinical practices, large disease registries that enroll large numbers of patients have become paramount as a relatively cost-effective additional tool.MethodsWe highlight the advantages of disease registries focusing on the example of prostate cancer and the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE™) registry.ResultsCaPSURE collects approximately 1,000 clinical and patient-reported variables, in over 13,000 men that are enrolled. Thus far, CaPSURE has yielded over 130 peer-reviewed publications, with several others in press, in key areas of risk migration, practice patterns, outcome prediction, and quality of life outcomes.ConclusionsDisease registries, like CaPSURE complement RCTs and CaPSURE, have provided a means to better understand many aspects of prostate cancer epidemiology, practice patterns, oncologic and HRQOL outcomes, and costs of care across populations. Specialized observational disease registries such as CaPSURE provide insight and have broad implications for disease management and policy

Cost-effectiveness of non-invasive methods for assessment and monitoring of liver fibrosis and cirrhosis in patients with chronic liver disease: systematic review and economic evaluation

BACKGROUND: Liver biopsy is the reference standard for diagnosing the extent of fibrosis in chronic liver disease; however, it is invasive, with the potential for serious complications. Alternatives to biopsy include non-invasive liver tests (NILTs); however, the cost-effectiveness of these needs to be established. OBJECTIVE: To assess the diagnostic accuracy and cost-effectiveness of NILTs in patients with chronic liver disease. DATA SOURCES: We searched various databases from 1998 to April 2012, recent conference proceedings and reference lists. METHODS: We included studies that assessed the diagnostic accuracy of NILTs using liver biopsy as the reference standard. Diagnostic studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Meta-analysis was conducted using the bivariate random-effects model with correlation between sensitivity and specificity (whenever possible). Decision models were used to evaluate the cost-effectiveness of the NILTs. Expected costs were estimated using a NHS perspective and health outcomes were measured as quality-adjusted life-years (QALYs). Markov models were developed to estimate long-term costs and QALYs following testing, and antiviral treatment where indicated, for chronic hepatitis B (HBV) and chronic hepatitis C (HCV). NILTs were compared with each other, sequential testing strategies, biopsy and strategies including no testing. For alcoholic liver disease (ALD), we assessed the cost-effectiveness of NILTs in the context of potentially increasing abstinence from alcohol. Owing to a lack of data and treatments specifically for fibrosis in patients with non-alcoholic fatty liver disease (NAFLD), the analysis was limited to an incremental cost per correct diagnosis. An analysis of NILTs to identify patients with cirrhosis for increased monitoring was also conducted. RESULTS: Given a cost-effectiveness threshold of £20,000 per QALY, treating everyone with HCV without prior testing was cost-effective with an incremental cost-effectiveness ratio (ICER) of £9204. This was robust in most sensitivity analyses but sensitive to the extent of treatment benefit for patients with mild fibrosis. For HBV [hepatitis B e antigen (HBeAg)-negative)] this strategy had an ICER of £28,137, which was cost-effective only if the upper bound of the standard UK cost-effectiveness threshold range (£30,000) is acceptable. For HBeAg-positive disease, two NILTs applied sequentially (hyaluronic acid and magnetic resonance elastography) were cost-effective at a £20,000 threshold (ICER: £19,612); however, the results were highly uncertain, with several test strategies having similar expected outcomes and costs. For patients with ALD, liver biopsy was the cost-effective strategy, with an ICER of £822. LIMITATIONS: A substantial number of tests had only one study from which diagnostic accuracy was derived; therefore, there is a high risk of bias. Most NILTs did not have validated cut-offs for diagnosis of specific fibrosis stages. The findings of the ALD model were dependent on assuptions about abstinence rates assumptions and the modelling approach for NAFLD was hindered by the lack of evidence on clinically effective treatments. CONCLUSIONS: Treating everyone without NILTs is cost-effective for patients with HCV, but only for HBeAg-negative if the higher cost-effectiveness threshold is appropriate. For HBeAg-positive, two NILTs applied sequentially were cost-effective but highly uncertain. Further evidence for treatment effectiveness is required for ALD and NAFLD. STUDY REGISTRATION: This study is registered as PROSPERO CRD42011001561. FUNDING: The National Institute for Health Research Health Technology Assessment programme

Measurement of the cross-section and charge asymmetry of WW bosons produced in proton-proton collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

This paper presents measurements of the $W^+ \rightarrow \mu^+\nu$ and $W^- \rightarrow \mu^-\nu$ cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data were collected in proton--proton collisions at a centre-of-mass energy of 8 TeV with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of 20.2~\mbox{fb^{-1}}. The precision of the cross-section measurements varies between 0.8% to 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.Comment: 38 pages in total, author list starting page 22, 5 figures, 4 tables, submitted to EPJC. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-13