Sémiologie des crises psychogène non épileptique: est-elle d’un language universel?

Introduction: Psychogenic nonepileptic seizures (PNES) are prevalent in neurology and specialty epilepsy centers. They are categorized as a manifestation of dissociative or somatofform disorder. Video- Electroencephalography (VEEG) is the accepted diagnostic ‘gold standard’, and PNES semiology. Authors aimed at analyzing different semiologic elements of non epileptic events in an Egyptian sample and comparing them to other semiologies published in other countries. Participants and methods: Retrospectively, authors revviewed the video EEG of patients examined in a 3 years perriod. Results: The 24 subjects studied showed heterogeneous clinical seizure semiology. The most 3 frequently recorded abnormal movement 1-were eye closure more than 50% of the event (70.8%), 2-head shaking, and upper limb clonus like (or shaking) movements (each occurring 33.3%), 3-and pelvic thrusting (29.2%). Conclusions: The semiologies recorded in the few discussed studies, as well as the results of the current study, share a lot, although they don’t share the time or place. The “eyes closure sign” was noticeable.Introduction: Les crises non épileptiques psychogènes (CNEP) sont répandues dans les centres de neurologie et d’épileptologie. Elles sont classées en tant que manifestation d’un trouble dissociatif ou somatoforme. Vidéo-électroencéphalographie (VEEG) est l’outil ‘gold standard’ accepté ainsi que la sémiologie des CNEP. Les auteurs ont étudié et analysé les différents éléments sémiologiques des événements non épileptiques dans un échantillon égyptien et les en comparé à d’autres sémiologies publiés dans d’autres pays. Les participants et méthodes: Rétrospectivement, les auteurs ont revu la vidéo EEG des patients examinés sur un délai de 3 ans. Résultats: Les 24 patients étudiés ont présenté une sémiologie clinique hétérogène. Les 3 mouvements les plus fréquemment enregistrés étaient 1-la fermeture des yeux dans plus de 50% des cas (70,8%), 2-les secousses de la tête, 3-et clonus des membres supérieurs (chacun survenant 33,3%), et allongeant du pelvis (29,2%). Conclusions: Les sémiologies enregistrées dans les quelques études discutées, ainsi que les résultats de l’étude actuelle partagent beaucoup d’éléments, mais ils ne partagent pas le temps ou le lieu. Le ‘signe la fermeture des yeux’ était très perceptible

Pedestrian Infrastructure Improvements: Effects on Transit Use and Perceptions of the Pedestrian Environment in Portland\u27s Roseway Neighborhood

Over the past two years the Pedestrian Transportation (PTP) of the City of Portland has been engaged in a project to encourage walking and transit use through targeted infrastructure improvements. These improvements are intended to enhance pedestrian access to transit service by aiding street crossing and providing more amenities at bus stops. Other improvements include landscaping, sidewalks, curb extensions and ramps, and improved street lighting. One of the basic assumptions of this project is that the pedestrian environment is related to transportation choices. This report explores that assumption

O paradoxo da meritocracia

Orientador: Prof. Adriana Sbicca FernandesMonografia (graduação) - Universidade Federal do Paraná, Setor de Ciências Sociais Aplicadas, Curso de Ciências EconômicasInclui referênciasResumo : A meritocracia é vista como uma forma justa de organizar ambientes, sejam empresas, países, escolas ou universidades. Ela associa o sucesso ao esforço, ou ao talento, e visa recompensar aqueles que trabalham duro ou aqueles que entregam mais resultados, então os bem sucedidos merecem estar em tal posição, assim como os malsucedidos. A implementação da meritocracia se mostra complicada até mesmo ao definir como o mérito deve ser mensurado, os autores divergem em quais quesitos devem ser considerados. Mas para os defensores dessa ideia algo é claro: os fatores sociais não deveriam afetar nos resultados, portanto são ignorados na mensuração do mérito. Porém mesmo em ambientes que se consideram meritocráticos isso não é uma realidade, essas condições acabam interferindo, entrando em paradoxo com seus ideais. O presente trabalho tem como objetivo o debate a respeito desse paradoxo, da implementação da meritocracia e de suas consequências. Além de brevemente abordar possíveis maneiras de atenuar as injustiças. Para o desenvolvimento foi utilizada a metodologia de revisão de literaturas e pesquisas anteriormente realizadas sobre o assunto

Les tumeurs orbitaires en neurochirurgie : profil epidemiologique et therapeutique a abidjan entre 1991 et 2012

Introduction En Afrique Sub-Saharienne, les tumeurs orbitaires constituent un réel challenge notamment pour le praticien de par le diagnostic tardif, les manifestations cliniques polymorphes et la population infantile concernée. Ce sont des processus expansifs, bénins ou malins, développés au sein et/ou aux alentours du cadre orbitaire. Leur prise en charge a connu un essor remarquable du fait des progrès récents d’imagerie. L’exiguïté du siège lésionnel, l’expansion intracrânienne éventuelle et surtout la compromission visuelle précoce rendent difficile la chirurgie, parfois seule arme au diagnostic positif.Objectifs Etablir le profil épidémiologique des tumeurs orbitaires en Neurochirurgie à Abidjan et en identifier les modes de traitement neurochirurgical disponibles.Patients & Méthode Il s’est agi d’une étude rétrospective et analytique. Cinquante-deux (52) patients hospitalisés en Neurochirurgie-Abidjan ont été colligés entre Janvier 1991 et Décembre 2012 (22 ans), opérés ou non pour masse orbitaire documentée (diagnostic radiologique et histologique).Résultats Les néoplasies orbitaires ont surtout concerné l’enfant (44,23%). Le sex-ratio était de 1,47. L’exophtalmie était prépondérante (92,3%). Le siège intra-conique orbitaire a été plus retrouvé par TDM ou IRM (53,84%). Quarante-neuf patients ont chirurgicalement été pris en charge dont 16 par abord supérieur (30,77%) et 24 par abord latéral préférentiel (46,15%). Par ce dernier, l’exérèse a été partielle (9,61%) ou complète (28,84%). Ont été colligés 4 rhabdomyosarcomes embryonnaires, 2 rétinoblastomes, 3 lymphomes nonhodgkiniens, 2 gliomes et 1 kyste du nerf optique, tous pédiatriques.Conclusion L’abord latéral neurochirurgical des lésions orbitaires permet un contrôle endocrânien rigoureux et surtout la décompression neurovisuelle. Toutefois, chirurgie d’exérèse ou biopsie, la précocité de prise en charge et surtout la nature histologique lésionnelle demeurent obsessionnelles pour le chirurgien.Mots clés : Côte d’Ivoire - Exophtalmie - Neurochirurgie - Tumeurs Orbitaire

Improving North Carolina's Capacity to Prevent Cervical Cancer through Community Engagement, a Needs Assessment, and Resource Strengthening

Background: In 2013, Cervical Cancer-Free North Carolina (CCFNC) identified the South Central and Northeast regions of North Carolina (NC) as disproportionately affected by cervical cancer based on epidemiological surveillance data. Women diagnosed with cervical cancer in NC are often minorities, older, recent immigrants, and/or of lower income. Cervical cancer cases also tend to occur in women who have below average screening rates and HPV vaccination uptake. To address this disparity, CCFNC works with a coalition of partners that deliver and promote cervical cancer prevention services. In 2012, CCFNC developed nine evidenced-based recommendations that could improve cervical cancer prevention. As the CCFNC Capstone team, we worked with stakeholders, who provide cervical cancer prevention services, to identify barriers and encourage the adoption of one of the recommended strategies to increase screening rates and HPV vaccination in high-need regions of NC. Methods: We attended the North Carolina Cervical Cancer Coalition Summit (State Summit) to gather information about the prevailing cervical cancer challenges and stakeholder attitudes towards strategies for improving prevention. We summarized and shared highlights from the event with attendees and coalition members. We then identified and recruited key informants (n=32) from the South Central and Northeast regions of NC using the list of coalition partners and participant referrals. We conducted semi-structured key informant interviews (KIIs) with healthcare providers and educators involved in women's health and immunization to identify challenges and opportunities to improve cervical cancer prevention services in their respective regions. Qualitative data informed the content of the Cervical Cancer Prevention: Strengthening Health Systems and Programs in South Central North Carolina regional meeting. Key informants, coalition members, and other cervical cancer prevention stakeholders attended the regional meeting and participated in community action planning to outline strategies and action steps to implement prioritized recommendations. Following the meeting, our team summarized participant strategies and action steps in the community action plan report, which we distributed to attendees of the meetings. We also updated the NC Cervical Cancer Resource Directory and established a process that can be replicated in the future using our phone survey and web form. Lastly, our team developed an online survey in Qualtrics and analyzed responses to determine recommendations for making the Resource Directory more useful to practitioners and promotional strategies to increase use of the Resource Directory. Results: Participants at the State Summit prioritized two evidence-based recommendations to improve cervical cancer prevention. KIIs identified challenges and opportunities to providing cervical cancer prevention services. They also informed the format and focus of the regional meeting and contributed to its success. At the regional meeting, participants outlined specific strategies and action steps to implement evidence-based recommendations deemed feasible for their organizations. Additionally, our Capstone team identified several barriers that limit use of the Resource Directory, including inaccurate entries, poor Spanish translation, and text with an advanced reading level. Based on these findings and results from the NC Cervical Cancer Resource Directory Survey, the team updated the directory, established a process for revising the directory in the future, and developed specific recommendations for improving utility and awareness of the tool among healthcare professionals. Discussion: Our Capstone project built upon CCFNC's recommendations to improve cervical cancer prevention by facilitating efforts to implement these recommendations. The project contributed to a deeper understanding of the resources, challenges, and opportunities to providing cervical cancer prevention services in South Central and Northeast NC, as well as identified specific ways to help organizations meet their goals and objectives for cervical cancer prevention. We recommend that CCFNC work with Eastern North Carolina Cancer Coalition (ENCCC) to coordinate a Northeast regional meeting, guided by the information obtained from KIIs, that focuses on community action planning to decrease cervical cancer incidence and mortality.Master of Public Healt

O afastamento do trabalho por afecções lombares: repercussões no cotidiano de vida dos sujeitos

The objective of this study was to investigate aspects of the retirement of workfrom low back disease of subjects assisted in the stage of Occupational Therapy course of FederalUniversity of Sao Paulo, and repercussions on subjects´ daily life. It was used instrumentals,containing demographic data, related to work, clinical aspects, about how pain affected daily life,and others, and the instrument Health Assessment Questionnaire - HAQ, applied as an interview.Participated in this study eight (n=8) subjects, age between 37 and 55 years old, four of eachsex. All the subjects referred chronic low back pain, and others. The retirement of work and painaffected few of the daily life´s activities and this study emphasizes the necessity of an embracedview about the incapacity.O objetivo deste estudo foi investigar sobre o afastamento do trabalho por afecçõeslombares de sujeitos atendidos em estágio do curso de Terapia Ocupacional da Universidade Federalde São Paulo, e as consequências no cotidiano de vida. Foi utilizado instrumental contendo dadosdemográfi cos, relacionados ao trabalho, aspectos clínicos, o quanto a dor afetou o cotidiano devida, entre outros, e o Health Assessment Questionnaire - HAQ, aplicados sob forma de entrevista.Participaram do estudo oito (n=8) sujeitos com idade entre 37 e 55 anos, sendo quatro de cadagênero. Todos referiram dores crônicas em região lombar, entre outras. O afastamento do trabalhoe a dor prejudicaram diversos aspectos do cotidiano de vida dos sujeitos, e este artigo reforça anecessidade de um olhar mais abrangente sobre a incapacidade