Introdução: Comparados com pacientes bipolares com episódios maníacos/hipomaníacos e depressivos, os que apresentam estados mistos tendem a curso mais grave da doença, início mais precoce, ocorrência mais frequente de sintomas psicóticos, maior risco de suicídio, altas taxas de comorbidade e tempo maior para remissão. Portanto, medidas objetivas de avaliação desses estados são necessárias. Objetivo:Avaliar a concordância entre três pares formados por uma de três escalas de mania (Young Mania Rating Scale (YMRS), Bech-Rafaelsen Mania Scale (BRMS) ou Clinician-Administered Rating Scale for Mania (CARS-M)) e uma de depressão (21-item Hamilton Depression) na avaliação da resposta a estabilizadores do humor em pacientes mistos. Método:Sessenta e oito (n=68) consecutivos pacientes ambulatoriais bipolares Tipo I e II com sintomatologia mista pelo DSM-IV-TR e pelos critérios de Cincinatti foram incluídos nesse estudo aberto de 8 semanas entre 2010 e 2014 foram randomizados para receberem em monoterapia, ácido valproico, carbamazepina ou carbonato de lítio. Resultados: O padrão de resposta (diminuição de, pelo menos, 50% em uma das escalas de mania e na de depressão) foi muito semelhante: 21-HAM-D + YMRS = 22,1%, 21-HAM-D + BRMS = 20,6% e 21-HAM-D + CARS-M = 23,5%; p < 0,368). Os resultados referentes à concordância de resposta revelam valores de kappa bastante altos: 21-HAM-D + YMRS X 21-HAM-D + CARS-M , Kappa = 0,87; 21-HAM-D + YMRS X 21-HAM-D + BRMS, Kappa = 0,78 e 21-HAM-D + CARS-M X 21-HAM-D + BRMS, Kappa = 0,91 (p < 0,001). Conclusões:O presente estudo sugere que qualquer uma das três escalas de mania utilizadas (YMRS, BRMS, CARS-M) pode ser associada à 21-HAM-D na avaliação da resposta em bipolares mistos. / Background: Compared with patients with bipolar disorder who exhibit pure manic/hypomanic or depressive episodes, the presence of mixed mood states is associated with a more severe course of illness, younger age of onset, more frequent ocurrence of psychotic symptoms, major risk of suicide, higher rates of comorbidities and longer time to achieve remission. Therefore, objective avaliation of these states are necessary. Objective: To evaluate the concorccance amog three pairs of three scales (Young Mania Rating Scale (YMRS), Bech-Rafaelsen Mania Scale (BRMS) or Clinician-Administered Rating Scale for Mania (CARS-M)) and a depression scale (21-item Hamilton Depression) in the assessment of response to humor stabizator drugs in mix bipolar patients. Methods: Sixty eight (n=68) consecutive bipolar type I and II outpatients with mixed sitomatology accordint to DSM-IV-TR and Cincinatti Criteria were included in these 8 weeks open-trial, from 2010 through 2014, to, randomly, receive monotherapy valporic acid, carbamazepine or lithium carbonate. Results: The response answer (decrease of, at least 50 %, in one of the mania and depression scales) were very similar: 21-HAM-D + YMRS = 22.1%, 21-HAM-D + BRMS = 20.6% e 21-HAM-D + CARS-M = 23.5%; p < 0,368). The kappa values were : 21-HAM-D + YMRS X 21-HAM-D + CARS-M , Kappa = 0.87; 21-HAM-D + YMRS X 21-HAM-D + BRMS, Kappa = 0.78 e 21-HAM-D + CARS-M X 21-HAM-D + BRMS, Kappa = 0.91 (p < 0,001). Conclusions: The present study suggests that any of the three mania scales used (YMRS, BRMS, CARS-M) may be associated to 21-HAM-D in the assessment of the response o bipolar patients.

Different emotions and behaviors were examined in this study: Emotional Instability. Physicaland Verbal Aggression, and Prosocial Behavior. First of all, we analyzed the correlation betweenratings from different sources (children or teachers). Cultural differences were also discussedwith regards to a sample of 50 children and adolescents, 25 Peruvians and 25 Spanish.Data showed non-significan! differences in Aggressiveness between children and teachers' ratings.Nevertheless, the correlation is higher between Peruvian children and teachers than betweenSpanish ones. On the other hand, Peruvian teenagers showed higher levels of EmotionalInstability whereas the Spanish got higher average ratings in Prosocial Behavior and Aggressiveness.These data could be due to cultural differences. / En este trabajo se estudian distintas emociones y comportamientos: Inestabilidad Emocional, Agresividad Física y Verbal, y Conducta Prosocial. En primer lugar, se analizan las correlaciones entre las puntuaciones pertenecientes a las distintas fuentes informantes (jóvenes y profesores). Se comparan también las diferencias entre distintas culturas (española y peruana). La muestra está compuesta por 50 niños y adolescentes; 25 peruanos y 25 españoles. Los datos muestran que, en Agresividad, no hay diferencias significativas entre las puntuaciones de los jóvenes y los maestros. Sin embargo, aparece una mayor correlación entre jóvenes y profesores peruanos que entre jóvenes y profesores españoles. Por otro lado, los adolescentes peruanos tienen niveles más elevados en Inestabilidad Emocional, mientras que los españoles alcanzan puntuaciones medias más altas en Conducta Prosocial y Agresividad. Estas diferencias entre los grupos pueden estar motivadas por factores culturales.

Introdução: Comparados com pacientes bipolares com episódios maníacos/hipomaníacos e depressivos, os que apresentam estados mistos tendem a curso mais grave da doença, início mais precoce, ocorrência mais frequente de sintomas psicóticos, maior risco de suicídio, altas taxas de comorbidade e tempo maior para remissão. Portanto, medidas objetivas de avaliação desses estados são necessárias. Objetivo:Avaliar a concordância entre três pares formados por uma de três escalas de mania (Young Mania Rating Scale (YMRS), Bech-Rafaelsen Mania Scale (BRMS) ou Clinician-Administered Rating Scale for Mania (CARS-M)) e uma de depressão (21-item Hamilton Depression) na avaliação da resposta a estabilizadores do humor em pacientes mistos. Método:Sessenta e oito (n=68) consecutivos pacientes ambulatoriais bipolares Tipo I e II com sintomatologia mista pelo DSM-IV-TR e pelos critérios de Cincinatti foram incluídos nesse estudo aberto de 8 semanas entre 2010 e 2014 foram randomizados para receberem em monoterapia, ácido valproico, carbamazepina ou carbonato de lítio. Resultados: O padrão de resposta (diminuição de, pelo menos, 50% em uma das escalas de mania e na de depressão) foi muito semelhante: 21-HAM-D + YMRS = 22,1%, 21-HAM-D + BRMS = 20,6% e 21-HAM-D + CARS-M = 23,5%; p < 0,368). Os resultados referentes à concordância de resposta revelam valores de kappa bastante altos: 21-HAM-D + YMRS X 21-HAM-D + CARS-M , Kappa = 0,87; 21-HAM-D + YMRS X 21-HAM-D + BRMS, Kappa = 0,78 e 21-HAM-D + CARS-M X 21-HAM-D + BRMS, Kappa = 0,91 (p < 0,001). Conclusões:O presente estudo sugere que qualquer uma das três escalas de mania utilizadas (YMRS, BRMS, CARS-M) pode ser associada à 21-HAM-D na avaliação da resposta em bipolares mistos. / Background: Compared with patients with bipolar disorder who exhibit pure manic/hypomanic or depressive episodes, the presence of mixed mood states is associated with a more severe course of illness, younger age of onset, more frequent ocurrence of psychotic symptoms, major risk of suicide, higher rates of comorbidities and longer time to achieve remission. Therefore, objective avaliation of these states are necessary. Objective: To evaluate the concorccance amog three pairs of three scales (Young Mania Rating Scale (YMRS), Bech-Rafaelsen Mania Scale (BRMS) or Clinician-Administered Rating Scale for Mania (CARS-M)) and a depression scale (21-item Hamilton Depression) in the assessment of response to humor stabizator drugs in mix bipolar patients. Methods: Sixty eight (n=68) consecutive bipolar type I and II outpatients with mixed sitomatology accordint to DSM-IV-TR and Cincinatti Criteria were included in these 8 weeks open-trial, from 2010 through 2014, to, randomly, receive monotherapy valporic acid, carbamazepine or lithium carbonate. Results: The response answer (decrease of, at least 50 %, in one of the mania and depression scales) were very similar: 21-HAM-D + YMRS = 22.1%, 21-HAM-D + BRMS = 20.6% e 21-HAM-D + CARS-M = 23.5%; p < 0,368). The kappa values were : 21-HAM-D + YMRS X 21-HAM-D + CARS-M , Kappa = 0.87; 21-HAM-D + YMRS X 21-HAM-D + BRMS, Kappa = 0.78 e 21-HAM-D + CARS-M X 21-HAM-D + BRMS, Kappa = 0.91 (p < 0,001). Conclusions: The present study suggests that any of the three mania scales used (YMRS, BRMS, CARS-M) may be associated to 21-HAM-D in the assessment of the response o bipolar patients.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2016-04-18T12:47:22Z No. of bitstreams: 2 Tese - Leo Cartano Fernandes da Silva - 2013.pdf: 4204827 bytes, checksum: 32e2d37452b1a8310f2d6934fa94c0b5 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-04-18T12:49:04Z (GMT) No. of bitstreams: 2 Tese - Leo Cartano Fernandes da Silva - 2013.pdf: 4204827 bytes, checksum: 32e2d37452b1a8310f2d6934fa94c0b5 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2016-04-18T12:49:04Z (GMT). No. of bitstreams: 2 Tese - Leo Cartano Fernandes da Silva - 2013.pdf: 4204827 bytes, checksum: 32e2d37452b1a8310f2d6934fa94c0b5 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-07-31 / The objective of this work was explore the relationships between diet, morphology and taxonomy in 30 species from Serra da Mesa Reservoir. The relationships between diet and morphology, diet and taxonomy and morphology e taxonomy were examined using Mantel test. And we test the relationships between diet and morphology after retire the effect os taxonomy using Partial Mantel Test. We used RDA to explore relevant attributes to diet. Results show that, independently of Taxonomy, some of the trophic guilds could be grossly predicted from few relevant morphological attributes (i.e mouth width and mouth Height especially for piscivores and carnivores) and thus suggest a significant link between diet and morphology. In other words, species having similar diet tend to converge to some extent on some morphological attributes. / O objetivo deste trabalho foi explorar as relações entre dieta, morfologia e taxonomia de 30 espécies capturada no Reservatório de Serra da Mesa. As relações entre dieta e morfologia, dieta e taxonomia e morfologia e taxonomia foram testadas utilizando o teste de Mantel. E a relação entre dieta e morfologia, após retirado o efeito da taxonomia foi testada utilizando o teste de mantel parcial. Foi utilizada uma RDA para analisar quais características são importantes para as diferentes dietas apresentadas. Os resultados demonstraram que, independente da taxonomia, algumas guildas tróficas podem ser preditos a partir de alguns atributos morfológicos relevantes (i.e. altura e largura da boca para píscívoros e carnívoros) e sugere relação significativa entre dieta e morfologia. Ou seja, espécies que possuem dieta similar tendem a possuir características morfológicas semelhantes.

By linguistically examining 162 articles published during the summer of 2015 in two UK broadsheets: The Guardian (TG) and The Daily Telegraph (TDT), this essay aims to analyse the discursive representation of the ‘migrant crisis’. To do so, the representation of the social actors migrating (SAM) during the ‘crisis’ was focused on. A combined Corpus Linguistic (CL) and Critical Discourse Analysis (CDA) approach was implemented to investigate the most frequently used terms to refer to the SAM. Once the terms were found, their usage across the corpora was examined by looking at frequency distributions. Next, collocates of the terms referring to SAM were analysed by way of Van Leeuwen’s (2008) Social Actor Network. Collocate and concordance analyses helped to show how the SAM were represented in the articles and how the representation varied across the two newspapers. The results of the analyses indicated that the most frequent terms used to refer to the SAM were migrant, people and refugee. It also indicated differences in connotations of those three words, with refugee ‘sympathetically’ connoted, migrant negatively connoted and people connoted both negatively and positively. The overall conclusion was that the SAM’s representation was more ‘sympathetic’ in TG than in TDT.

Successful triage is the basis for sound emergency department (ED) care, whereas unsuccessful triage could result in adverse outcomes. ED triage is a rather unexplored area in the Swedish health care system. This thesis contributes to our understanding of this complex nursing task. The main focus of this study has been on the organisation, performance, and decision making in Swedish ED triage. Specific aims were to describe the Swedish ED triage context, describe and compare registered nurses’ (RNs) allocation of acuity ratings, use of thinking strategies and the way they structure the ED triage process. In this descriptive, comparative, and correlative research project quantitative and qualitative data were collected using telephone interviews, patient scenarios and think aloud method. Both convenience and purposeful sampling were used when identifying the participating 69 nurse managers and 423 RNs from various types of hospital-based EDs throughout the country. The results showed national variation, both in the way triage was organised and in the way it was conducted. From an organisational perspective, the variation emerged in several areas: the use of various triageurs, designated triage nurses, and triage scales. Variation was also noted in the accuracy and concordance of allocated acuity ratings. Statistical methods provided limited explanations for these variations, suggesting that RNs’ clinical experience might have some affect on the RNs’ triage accuracy. The project identified several thinking strategies used by the RNs, indicating that the RNs, amongst other things, searched for additional information, generated hypotheses about the fictitious patients and provided explanations for the interventions chosen. The RNs formed relationships between their interventions and the fictitious patients’ symptoms. The RNs structured the triage process in several ways, beginning the process by searching for information, generating hypotheses, or allocating acuity ratings. Comparison of RNs’ use of thinking strategies and the structure of the triage process based on triage accuracy revealed only slight differences. The findings in this dissertation indicate that the way a patient is triaged, and by whom, depends upon the particular organisation of the ED. Moreover, the large variation in RNs triage accuracy and the inter-rater agreement and concordance of the allocated acuity ratings suggest that the acuity rating allocated to a patient may vary considerably, depending on who does the allocation. That neither clinical experience nor the RNs’ decision-making processes alone can explain the variations in the RNs triage accuracy indicates that accuracy might be influenced by individual and contextual factors. Future studies investigating triage accuracy are recommended to be carried out in natural settings. In conclusion, Swedish ED triage is permeated by diversity, both in its organisation and in its performance. The reasons for these variations are not well understood.

Im Katalog des Südwestverbunds besitzen zahlreiche Publikationen sowohl SWD-Schlagwörter und -ketten als auch Notationen der Regensburger Verbundklassifikation (RVK). An der Universitätsbibliothek Mannheim wurden auf dieser Datenbasis automatische Korrelationen zwischen SWD und RVK generiert, die im Rahmen einer Bachelorarbeit an der Hochschule der Medien Stuttgart analysiert wurden. Im Vortrag werden die Ergebnisse der Analyse vorgestellt und Überlegungen zu möglichen praktischen Anwendungen solcher Korrelationen angestellt.

Bakgrund: Hypertoni är en folksjukdom och är en starkt bidragande orsak till sjukdomar som stroke, hjärtsvikt, kranskärlssjukdom och arterioskleros. En effektiv läkemedelsbehandling mot hypertoni reducerar kraftigt insjuknande och död i dessa sjukdomar. Mer än 50 % av patienterna som behandlas för hypertension, slutar helt sin behandling inom ett år från att diagnos har ställs. Bland de som fortsätter sin behandling är det endast hälften som är följsamma det vill säga tar 80 % av sitt förskrivna antihypertensiva läkemedel. Syfte: Syftet med denna litteraturstudie var att undersöka vilka faktorer som påverkar följsamheten till medicinering hos patienter med diagnosen hypertension. Metod: Metoden som användes var en litteraturstudie med en ansats till innehållsanalys. Tio artiklar från sju kvantitativa studier och tre kvalitativa studier, som svarade på syftet kvalitetsgranskades och inkluderades i litteraturstudien. Resultat: Resultatet visade att anledningen till att inte följa sin läkemedelsordination kan bero på många olika faktorer som grundar sig på patienters attityd till sin sjukdom och medicin, sociala och ekonomiska faktorer, mental påverkan samt vårdgivarens roll och agerande. Konklusion: Att se varje patient som unik och arbeta personcentrerat visade sig förbättra följsamheten till läkemedelsbehandlingen. Detta är ett område där mer forskning krävs. / Background: Hypertension is a common disease and is a major contributor to diseases such as stroke, heart failure, coronary artery disease and atherosclerosis. An effective drug treatment for hypertension greatly reduces illness and death from these diseases. More than 50% of patients being treated for hypertension, stops treatment within a year of the diagnosis. Among those who continue their treatment, only half are compliant i.e., taking 80% of their prescribed antihypertensive medications. Objective: The aim of this study was to investigate the factors that influence adherence to medication in patients with the diagnosis hypertension. Method: The method used was a literature review with an approach to content analysis. Ten articles from seven quantitative studies and three qualitative studies, answering the study aim were reviewed regarding scientific quality and were finally included in the literature review. Results: The results showed that the reason for not being adherent to medication could be caused by many different factors, based on patients' attitudes to their illness and medicine, social and economic factors, mental influence and the caregiver's role and actions. Conclusion: To see each patient as a unique person and give individualized care improved adherence to drug treatment. This is an area where more research is needed.

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