Is asenapine or aripiprazole more effective than a placebo for reducing episodes of mania in children with bipolar I disorder?

Objective: The objective of this selective EBM review is to determine whether or not asenapine or aripiprazole are more effective than a placebo for reducing episodes of mania in children with bipolar I disorder. Study Design: Review of two randomized control trials (RCTs) published in 2013 and 2015, and a flexible-dose, open-label, extension study published in 2016. Data Sources: Each article used was published in English and found using PubMed database. All articles were published in peer-reviewed journals. Outcomes Measured: The clinical superiority of asenapine and aripiprazole were measured by a change in baseline in the Young Mania Rating Scale (YMRS) total score. A decrease in YMRS score indicates improved mania symptoms. Results: Findling, et al. (2015) found that all studied doses of asenapine were more effective than a placebo at reducing the baseline score of the Young Mania Rating Scale (YMRS) [for 2.5 mg: -12.8 vs -9.6, p=0.008; for 5mg -14.9 vs -9.6, p \u3c0.001; for 10mg: - 15.8 vs -9.6, p \u3c0.001]. Findling, et al. (2013) found that all doses of aripiprazole were more effective than a placebo using the same YMRS change from baseline [for 10mg: - 14.1 vs -8.2, p \u3c0.001; for 30 mg: -14.9 vs -8.2, p \u3c0.001]. This article also examined the average time to withdrawal [for 10 mg 15.6 weeks vs 5.3, p \u3c0.001; for 30 mg 9.5 vs 5.3, p \u3c0.05]. The Findling, et al. (2016) open-label, extension study found that there was a greater mean change in baseline YMRS total scores in the placebo/asenapine population (-13.0 at 26 weeks and -15.2 at 50 weeks), a 79.2% total population of patients that were YMRS 50% responders, and 68.5% of all patients achieved YMRS remission. Conclusions: Though each study reported an improvement of symptoms, the efficacy of asenapine and aripiprazole over a placebo for the treatment of mania episodes in children with bipolar I disorder cannot be determined due to the limitations in experimental design and validity

The Role of Self-efficacy and Social Support in Emerging Adults\u27 Physical Activity

Emerging adulthood is a time where emerging adults develop health behaviors that persist throughout the life span (Barnett et al., 2014). However, only 55.4% of emerging adults engage in the recommended amount of physical activity each week (U.S. Department for Health and Human Services, 2013). The current study examined two factors that are associated with physical activity, specifically self-efficacy and social support, in 403 (M age = 19.25, SD = 1.12) emerging adults. Linear regressions indicated that emerging adults who reported higher levels of general self-efficacy (beta = .13, p \u3c .05), domain self-efficacy (beta = .33, p \u3c .05), and support from the entire social network (beta = .50, p \u3c .001) engaged in more physical activity. Support from the entire social network still accounted for a significant portion of the variance in physical activity when accounting for general or domain self-efficacy (beta for support = .48, p \u3c .001 and .30, p \u3c .05, respectively). The differential effects of source of support (i.e., family and friends) and type of support (i.e., esteem support, informational support, and companionship support) were also examined. Emerging adults who reported higher levels of support from family (beta = .22, p \u3c .001) and friends (beta = .33, p \u3c .001) engaged in more physical activity. Although emerging adults reported receiving more esteem support from family (M = 2.95, SD = 1.23) compared to friends (M = 2.74, SD = 1.15), esteem support from friends (beta = .33, p \u3c .001) had a larger effect on physical activity than esteem support from family (beta = .21, p \u3c .05)

A Human Rights Approach to Emergency Response? The Advocacy of Canada's Human Rights Commissions during the COVID-19 Crisis

Emergencies can undermine human rights by disrupting societies, increasing vulnerabilities, and prompting extraordinary responses from governments and other actors. During the COVID-19 public health emergency, Canada’s federal, provincial and territorial human rights commissions (HRCs) have mobilized to advocate for upholding human rights. Based on an original dataset and content analysis of HRCs’ official statements in response to COVID-19, this research note examines the points of consistency and variation in HRCs’ advocacy for human rights during the COVID-19 crisis. It shows how HRCs have highlighted core human rights issues and obligations, and advocated for various policies and practices that promote respect for human rights during the COVID-19 crisis. In an emergency typically framed in terms of public health and safety, aggregating and comparatively analyzing these Canadian human rights authorities’ advocacy provides a foundation for deliberating whether and how a human rights approach to COVID-19 response should be pursued

Speech and language therapy, stuttering and social activism

Introdução: A gaguez é uma perturbação da fluência do discurso, com impacto a vários níveis, mais concretamente a nível pessoal e social, tornando-se num problema de comunicação. Há várias técnicas de intervenção terapêutica na área da gaguez, mas atendendo ao impacto que a mesma tem na relação do sujeito com a sociedade pode perspetivar-se a possibilidade de ação terapêutica enquanto processo de ativismo social. Como tal, o presente estudo propõe-se explorar e divulgar a visão dos TFs Portugueses sobre a intervenção terapêutica na gaguez enquanto processo de ativismo social. Métodos: Este estudo tem um caráter exploratório e transversal, com características descritivas. Foi utilizado um questionário construído e validado por Gomes (2018), composto por questões de resposta aberta e fechada, que foi divulgado online através das redes sociais (LinkedIn, Facebook, Instagram). Os dados foram analisados através de estatística descritiva, apresentando-se em forma de Percentil 25, Mediana e Percentil 75. Para a análise dos diferentes grupos foram utilizados o teste U de Mann-Whitney e o teste de Kruskal-Wallis. Para as questões de resposta aberta, foi realizada análise de conteúdo (análise temática). Resultados: Foram obtidas 115 respostas totais (das quais apenas 32 são respostas completas). Estas foram divididas em diferentes grupos (grupos com diferentes graus académicos, grupos com diferente tempo de experiência profissional e grupos com diferente tempo de experiência profissional na área da gaguez). Da análise realizada foi possível encontrar duas visões terapêuticas distintas para o conceito de gaguez, nomeadamente: a gaguez caracterizada como uma perturbação da fala; e a gaguez caracterizada como uma perturbação da fala com impacto na fluência e na comunicação. Relativamente ao ativismo social, foi claro em algumas das respostas a identificação de ações individuais e/ou de grupo e os objetivos da luta social. Sobre a intervenção como processo de ativismo social, foi possível identificar ações ativistas centradas em torno da prevenção e da sensibilização sobre o tema. Foi igualmente abordado o conceito de empowerment e a promoção do associativismo. Conclusão: Os resultados obtidos apontam para a existência de intervenção terapêutica como processo de ativismo social, em Portugal, como por exemplo: colaborar com a Associação Portuguesa de Gagos, promovendo o associativismo, realizando ações de sensibilização, divulgação e consciencialização sobre o tema juntamente com pessoas que gaguejam promovendo o empowerment. No entanto, foi possível observar que a visão de intervenção na gaguez como processo de ativismo social encontra-se apenas relacionada com o conhecimento acerca da gaguez e do ativismo social, uma vez que, de um modo geral, os inquiridos que definiram a gaguez com a tónica na fala, apresentaram fracos conhecimentos sobre ativismo e consequentemente, uma intervenção terapêutica centrada na fala. Por outro lado, os TFs que caracterizaram a gaguez como uma perturbação da fala com impacto na fluência e na comunicação, aparentam ter conceitos de ativismo social mais marcados e, consequentemente, uma intervenção terapêutica na área da gaguez mais voltada para o processo de ativismo social. Futuros estudos poderão verificar se as PQG consideram que os TFs intervêm como ativistas sociais e, quais as formas de intervenção utilizadas, identificadas pelas PQG.Introduction: Stuttering is a speech fluency disorder and mainly impacts personal and social levels, becoming a communication problem. There are several therapeutic intervention techniques in the area of stuttering, but given the impact, it has on the subject's relationship with society, the possibility of therapeutic action as a process of social activism can be put into perspective. As such, the present study aims to explore and disclose the vision of Portuguese SLTs regarding the therapeutic intervention in stuttering as a process of social activism. Methods: This is an exploratory and cross-sectional study, with descriptive characteristics. A questionnaire constructed and validated by Gomes (2018) was used, composed of open and closed-ended questions, which were shared online through social networks (LinkedIn, Facebook, Instagram). The data was analysed using descriptive statistics, in the form of the 25th percentile, median, and 75th percentile. For the analysis of the different groups, the Mann-Whitney U test as well as the Kruskal-Wallis test. For the open-ended questions, content analysis (thematic analysis) was performed. Results: 115 total responses were obtained (from each only 32 are complete answers), these were divided into different groups (groups with different academic degrees, groups with different lengths of professional experience, and groups with different lengths of professional experience in the area of stuttering). From the analysis, it was possible to find two distinct visions for the concept of stuttering: stuttering characterized as a speech disorder; and stuttering characterized as a speech disorder with an impact on fluency and communication. Regarding social activism, it was clear in some answers the identification of individual and/or group actions and the objectives of the social struggle. Regarding intervention as a process of social activism, it was possible to identify activist actions focused on prevention and raising awareness about the topic. As well as the concept of empowerment and the promotion of associativism. Conclusion: The results obtained point to the existence of therapeutic intervention as a process of social activism in Portugal, such as: collaborating with “Associação Portuguesa de Gagos”, promoting associativism, performing awareness-raising, dissemination, and awareness-raising actions on the topic together with people who stutter (PWS), promoting empowerment. However, it was possible to observe that the vision of stuttering intervention as a process of social activism is only related to the knowledge about stuttering and social activism, since, in general, the respondents who defined stuttering with emphasis on speech showed little knowledge about activism and consequently, a therapeutic intervention focused on speech. On the other hand, the SLTs who characterized stuttering as a speech disorder with an impact on fluency and communication seemed to have more marked concepts of social activism and consequently therapeutic intervention in the area of stuttering was more focused on the process of social activism. Future studies could verify if the PWS consider SLTs to intervene as social activists and, what forms of intervention are used, as identified by the PQG

Gender in portuguese legislative and education systems: recognition and inclusivity of LGBTQI+ people in schools

This Master thesis argues that the Portuguese state should be the principal regulator and promoter of an improved concept of gender in the legislative and education systems, in order to foster the social inclusion of the LGBTQI+ community, particularly transgender people. To this end, first, it correlates Human Rights and Human Capital concepts that belong to the Human and Social Development frame, in order to bring forward two perspectives in education, one focused on rights and the other on economic development. Since these concepts are used by international organizations with the purpose of improving livelihoods globally, by using Roger Dale’s education governance framework, the aim is to demonstrate that the Portuguese state, as a member of the international community, is not the sole actor in the context of global governance. Rather, the state must also comply with policies and standards issued by the OECD and the European Union, which are integrated into the domestic legislation while regulating and dividing efforts with other coordination institutions. On this basis, the thesis associates feminist development with queer theory to contextualize gender and Nancy Fraser’s politics of recognition in legal and educational institutions, at the same time identifying contradictions in the Portuguese gender legislation and exploring ways of improving the inclusion of trans people in the education system.Esta dissertação de mestrado argumenta que o Estado Português deve ser o principal regulador e promotor de um aperfeiçoado conceito de género nos sistemas legislativo e educativo, de forma a promover a inclusão social da comunidade LGBTQI +, em particular dos transexuais. Com esta finalidade, em primeiro lugar, correlaciona os conceitos de Direitos Humanos e Capital Humano pertencentes ao quadro do Desenvolvimento Humano e Social, a fim de trazer duas perspectivas de educação, uma voltada para os direitos e outra para o desenvolvimento econômico. Uma vez que estes conceitos são utilizados por organizações internacionais com o propósito de melhorar os meios de subsistência a nível global, ao utilizar a estrutura de governação da educação de Roger Dale, pretende-se demonstrar que o Estado Português, enquanto membro da comunidade internacional, não é o único ator neste contexto de governança global. Em vez disso, o estado também deve cumprir as políticas e normas emitidas pela OCDE e pela União Europeia, que são integradas na legislação doméstica, ao mesmo tempo que regula e divide esforços com outras instituições de coordenação. A partir disto, a tese associa o desenvolvimento feminista à teoria queer para contextualizar o género e a política de reconhecimento de Nancy Fraser nas instituições legais e educativas, ao mesmo tempo que identifica contradições na legislação portuguesa relativamente ao conceito género e explora formas de melhorar a inclusão das pessoas trans no sistema de educação

A new millennium for women and kidney disease

Introduction: Taking advantage of this year’s synergy, as World Kidney Day (WKD) and International Women’s Day fall on the same day, the theme chosen for WKD 2018 was “Kidneys and Women’s health”, drawing the attention of the nephrology community to the special features of diseases of the kidney as they affect women. When focusing on this subject, we come to see the major gaps in this area of knowledge. On one hand, it is now comprehensively accepted that there are unique biological and behavioral differences resulting in sex/gender variances, albeit mostly in favour of women. However, on the other, despite mounting evidence in multiple medical disciplines, these disparities have not been so well explored in nephrology, and so we try, in this editorial, to review current knowledge n this field.info:eu-repo/semantics/publishedVersio

LESIÓN RENAL AGUDA OBSTRUCTIVA CON MANTENIMIENTO DE LA DIURESIS: UN CASO DE BIFIDEZ URETERAL

Percutaneous kidney biopsy in transplanted kidneys remains an essential and commonly performed procedure required for diagnostic and prognostic information. Hemorrhage is the main complication of renal graft biopsy. We report a case of a 47-year-old caucasian woman admitted to perform an ultrasound (US)-guided biopsy of the renal graft. Six hours later, she presented with macroscopic hematuria which improved after urethral catheterization and intravenous hydration. However the hematuria reappeared associated with anemia and worsening of the serum creatinine value. Te US study, revealed hydronephrosis with high Doppler derived renal resistive index compatible with clot obstruction. Despite the vesical lavage nd intravenous hydration. However the hematuria reappeared associated with anemia and worsening of the serum creatinine value. Te US study, revealed hydronephrosis with high Doppler derived renal resistive index compatible with clot obstruction. Despite the vesical lavage with drainage of several clots, the patient rapidly progressed to hemorrhagic shock with worsening of renal function. Pelvic computed tomography (CT) revealed calyx and pelvis duplicity and ureter bifdity which merged into a single ureter and inserted into the right anterolateral wall of the bladder. Te inferior ureter was enlarged due to an obstructive clot. Most acute obstructive uropathies are associated with signifcant pain or the abrupt diminution of urine fow. Te presence of ureter bifdity in the CT study explained the maintenance of signifcant diuresis despite obstruction, located only to the lower ureter but with sufcient functional impact to condition acute kidney injury (AKI).La biopsia renal percutánea en riñones trasplantados sigue siendo un procedimiento esencial y común, necesario para obtener información diagnóstica y pronóstica. La hemorragia es la principal complicación de la biopsia de injerto renal. Presentamos un caso de una mujer caucásica de 47 años, quien fue hospitalizada para la realización de una biopsia de injerto renal guiada por ultrasonido (US). Seis horas después, presentó hematuria macroscópica que mejoró después de la cateterización uretral e hidratación intravenosa. Sin embargo, la hematuria reapareció asociada con anemia y empeoramiento del valor sérico de creatinina. El estudio de US reveló, mediante Doppler, una hidronefrosis con alto índice de resistencia renal, compatible con obstrucción por un coágulo. A pesar del lavado vesical con drenaje de varios coágulos, la paciente progresó rápidamente a choque hemorrágico con empeoramiento de la función renal. La tomografía computarizada (TC) pélvica reveló la duplicidad del cáliz y la pelvis y la bifdez ureteral, que se fusionó en un solo uréter y se insertó en la pared anterolateral derecha de la vejiga. El uréter inferior se agrandó debido a un coágulo obstructivo.La mayoría de las uropatías obstructivas agudas están asociadas con dolor signifcativo o la disminución abrupta del fujo de orina. La presencia de la bifdez del uréter en el estudio de TC explicó el mantenimiento de una diuresis signifcativa a pesar de la obstrucción, localizada solo en el uréter inferior, pero con sufciente impacto funcional como para provocar insufciencia renal aguda (IRA).info:eu-repo/semantics/publishedVersio

Comparación de la capacidad predictiva entre escalas Rockall preendoscópica y Glasgow Blatchford para la necesidad de terapia endoscópica en pacientes con hemorragia digestiva alta no variceal

Determinar que la escala Rockall Preendoscópica tiene mayor capacidad predictiva para la necesidad de terapia endoscópica que la escala Glasgow Blatchford en pacientes con hemorragia digestiva alta no variceal. Materiales y métodos: Estudio retrospectivo, observacional de tipo prueba diagnóstica realizado en el servicio de gastroenterología del Hospital Víctor Lazarte Echegaray que incluyó un total de 92 pacientes con diagnóstico de hemorragia digestiva alta no variceal. Se calculó la sensibilidad, especificidad, VPP, VPN de cada escala y se compararon los índices de validez y la razón de verosimilitud positivo y negativo. Resultados: La escala Rockall preendoscópica presentó una sensibilidad del 90%, especificidad del 19%, valor predictivo positivo del 23% y valor predictivo negativo del 87.5%. La escala Glasgow presentó una sensibilidad 85 %, especificidad del 11%, valor predictivo positivo del 20.9% y valor predictivo negativo del 72.7%. Al comparar ambas escalas, la escala Rockall tuvo un índice de validez de 34.8%, una razón de verosimilitud positiva de 1.12 y una razón de verosimilitud negativa de 0.51 mientras que la escala Glasgow Blatchford tuvo un índice de validez del 27.2%, razón de verosimilitud positivo de 0.97 y valor de verosimilitud negativo de 1.35. Conclusiones: La escala Rockall Preendoscópica tiene mayor capacidad predictiva para la necesidad de terapia endoscópica en pacientes con hemorragia digestiva alta no variceal.To determine the Rockall Preendoscopic scale has greater predictive capacity for the need for endoscopic therapy than the Glasgow Blatchford scale in patients with non-variceal upper gastrointestinal bleeding. Materials and methods: A retrospective, observational diagnostic test study conducted in the gastroenterology service of the Víctor Lazarte Echegaray Hospital with 92 patients with a diagnosis of non-variceal upper gastrointestinal bleeding. The sensitivity, specificity, PPV, NPV of each scale were calculated and the validity indexes and the positive and negative likelihood ratio were compared. Results: The preendoscopic Rockall scale has a sensitivity of 90%, a specificity of 19%, a positive predictive value of 23% and a negative predictive value of 87.5% The Glasgow scale has a sensitivity of 85%, a specificity of 11%, a value positive predictive of 20.9% and a negative predictive value of 72.7%. When comparing both scales, the Rockall scale had a validity index of 34.8%, a positive likelihood ratio of 1.12 and a negative likelihood ratio of 0.51 while the Glasgow Blatchford scale had a validity index of 27.2%, likelihood ratio positive of 0.97 and negative likelihood value of 1.35. Conclusions: The Rockall Preendoscopic scale has greater predictive capacity for the need for endoscopic therapy in patients with non-variceal upper gastrointestinal bleeding.Tesi

Evaluation of screencasts settings applied to CAD online teaching

Screencasts are video recording techniques that capture dynamic images of the computer screen. Besides that, the screen recordings are combined with audio or subtitles instructions. Originally, screencasts were developed to produce videos that aim to teach instructional content. The most frequent applications of screencasts are in videos about software tutorials. Due to these features, screencasts present potential to be employed in online classes of technical drawing, especially ones that apply Computer-Aided Design (CAD) software. However, it is fundamental to optimize the screencast settings that adjust to the teaching-learning process. This article aims to evaluate different screencasts settings, directed to technical drawing online teaching with AutoCAD. Three participants evaluated four different screencasts settings to find which settings are adequated for capturing the attention and the student video comprehension. As a result, the participants exposed their preference for screencasts with audio instructions due to the facility of assimilating the audio with the images simultaneously. Additionally, there were inconclusive aspects related to the instructor’s webcam application in screencasts. Thus, it is recommended deep investigation in the future.The authors are glad to Prorectorate for Outreach and Extension (PROEX) of Universidade Federal de Santa Catarina (UFSC), Brazil, which become available financial resources to the Group of Innovative Communication Technologies for Education in Technical Drawing for Engineering Courses (NTICEGEng). NTICEGEng organized the course Introduction to AutoCAD Screencasts to train professors in online teaching for CAD. Juliane Silva de Almeida is a Junior Lecturer of the Graphic Communication Department at UFSC, Brazil, since 2015 and the head of the NTICEGEng. She lectures technical drawing with CAD and descriptive geometry for engineering undergrads. NTICEGEng activities are focused on promoting outreach training courses about online teaching tools and techniques. Nicole Santini Baratto is a student of Civil Engineering undergrad at UFSC, Brazil, since 2018 and a junior researcher at NTICEGEng. 64