Types of Epiglottic Collapse in Breathing Sleep Disorder and Their Impact in Clinical Practice

Abstract Introduction Obstructive sleep apnea (OSA) is a severe form of sleep-disordered breathing (SDB) that is strongly correlated with comorbidities, in which epiglottic collapse (EC) and other contributing factors are involved. Objectives To evaluate the occurrence of EC in OSA patients through drug-induced sleep endoscopy (DISE) and to determine the factors contributing to EC. Methods A retrospective study of 37 adult patients using medical history. Patients were assessed for laryngopharyngeal reflux (LPR) and lingual tonsil hypertrophy (LTH) using reflux symptom index and reflux finding score (RFS); for OSA using polysomnography, and for airway collapse through DISE. An independent t-test was performed to evaluate risk factors, including the involvement of three other airway structures. Results Most EC patients exhibited trap door epiglottic collapse (TDEC) (56.8%) or pushed epiglottic collapse (PEC) (29.7%). Lingual tonsil hypertrophy, RFS, and respiratory effort-related arousal (RERA) were associated with epiglottic subtypes. Laryngopharyngeal reflux patients confirmed by RFS (t(25) = −1.32, p = 0.197) tended to suffer PEC; LTH was significantly associated (X2(1) = 2.5, p = 0.012) with PEC (odds ratio [OR] value = 44) in grades II and III LTH patients; 11 of 16 TDEC patients had grade I LTH. Pushed epiglottic collapse was more prevalent among multilevel airway obstruction patients. A single additional collapse site was found only in TDEC patients. Conclusion Laryngopharyngeal reflux causes repetitive acid stress toward lingual tonsils causing LTH, resulting in PEC with grade II or III LTH. Trap door epiglottic collapse requires one additional structural collapse, while at least two additional collapse sites were necessary to develop PEC. Respiratory effort-related arousal values may indicate EC.

Evaluation of thermal environment and human thermal comfort in 8 types of public places from 2019 to 2021 / 中华劳动卫生职业病杂志

Objective: To evaluate the thermal environment of different types of public places and the thermal comfort of employees, so as to provide scientific basis for the establishment of microclimate standards and health supervision requirements. Methods: From June 2019 to December 2021, 50 public places (178 times) of 8 categories in Wuxi were selected, including hotels, swimming pools (gymnasiums), bathing places, shopping malls (supermarkets), barber shops, beauty shops, waiting rooms (bus station) and gyms. In summer and winter, microclimate indicators such as temperature and wind speed were measured in all kinds of places, combined with the work attire and physical activity of employees in the places. Fanger thermal comfort equation and center for the built environment (CBE) thermal comfort calculation tool were used to evaluate the predicted mean vote (PMV), predicted percent dissatisfied (PPD) and standard effective temperature (SET) according to the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) 55-2020. The modification effects of seasonal and temperature control conditions on thermal comfort were analyzed. The consistency of GB 37488-2019 "Hygienic Indicators and Limits in Public Places" and ASHRAE 55-2020 evaluation results on thermal environment was compared. Results: The thermal sensation of hotel, barber shop staff and the gym front-desk staff were moderate, while the thermal sensation of swimming place lifeguard, bathing place cleaning staff and gym trainer were slightly warm in summer and winter. Waiting room (bus station) cleaning and working staff, shopping mall staff felt slightly warm in summer and moderate in winter. Service staff in bathing places felt slightly warm in winter, while staff in beauty salons felt slightly cool in winter. The thermal comfort compliance of hotel cleaning staff and shopping mall staff in summer was lower than that in winter (χ(2)=7.01, 7.22, P=0.008, 0.007). The thermal comfort compliance of shopping mall staff in the condition of air conditioning off was higher than that in the condition of air conditioning on (χ(2)=7.01, P=0.008). The SET values of front-desk staff in hotels with different health supervision levels were significantly different (F=3.30, P=0.024). The PPD value and SET value of the front-desk staff, and the PPD value of cleaning staff of hotels above three stars were lower than those of hotels below three stars (P<0.05). The thermal comfort compliance of front-desk staff and cleaning staff in hotels above three stars was higher than that in hotels below three stars (χ(2)=8.33, 8.09, P=0.016, 0.018). The consistency of the two criteria was highest among waiting room (bus station) staff (100.0%, 1/1) and lowest among gym front-desk staff (0%, 0/2) and waiting room (bus station) cleaning staff (0%, 0/1) . Conclusion: There are different degrees of thermal discomfort in different seasons, under the condition of air conditioning and health supervision, and the microclimate indicators can not fully reflect the thermal comfort of human body. The health supervision of microclimate should be strengthened, the applicability of health standard limit value should be evaluated in many aspects, and the thermal comfort of occupational group should be improved.

Politics, pandemics, and support: the role of political actors in Dutch state aid during COVID-19 / Políticas, pandemias e auxílio do estado: o papel dos atores políticos no auxílio governamental oferecido pelos Países Baixos durante a pandemia da COVID-19 / Políticas, pandemias y apoyo del estado: el papel de los actores políticos en la ayuda gubernamental ofrecida por los Países Bajos durante la pandemia de COVID-19

Abstract How do governments distribute resources across economic sectors during a crisis? And why do some sectors receive more than others? The recent COVID-19 pandemic has highlighted the urgency of these questions. In this paper, we explore the extent to which a political economy perspective can help explain the characteristics of sector-specific state aid in the Netherlands, a traditionally corporatist country. While KLM, the biggest player in the Dutch aviation sector, was promised loans worth €3.4 billion, the horeca (hospitality) sector was denied a similar deal. Limited cross-case analysis eliminates purely economic accounts. We employed process-tracing and analyzed hundreds of national media articles to understand the influence of elected leaders, interest groups, and experts. We find that, against the backdrop of economic concerns, vote-seeking behavior by elected leaders as well as the strength and organization of interest groups influenced how much each sector could expect. Meanwhile, policy-seeking behavior helps explain the form that aid took. Our findings highlight the need to consider fiscal support in political economy terms, even during crises, and to explore the composition of state aid, not just its presence or amount.

Resumo Como são distribuídos os recursos de auxílio governamental entre os vários setores econômicos durante uma crise? E por que alguns sectores recebem mais do que outros? A recente pandemia da COVID-19 sublinhou a urgência destas questões. Neste artigo, discutimos como uma perspectiva de economia política pode ajudar a explicar as caraterísticas do auxílio estatal setorial nos Países Baixos, uma nação tradicionalmente corporativista. Enquanto o governo prometeu à KLM, o maior ator no setor da aviação holandês, empréstimos no valor de 3,4 mil milhões de euros, o horeca (sector da hotelaria) não recebeu um pacote de auxílio semelhante. A análise de casos elimina explicações puramente técnicas para esse fenômeno. Utilizamos process-tracing e fizemos uma análise de centenas de artigos publicados na mídia do país para compreender a influência dos líderes políticos, lobbies e peritos. Descobrimos que, num contexto de crise econômica, o comportamento eleitoreiro dos líderes políticos e a força e organização dos lobbies, determinaram a quantia que cada setor poderia esperar receber. Entretanto, os interesses no campo das políticas públicas ajudam a explicar a forma específica do auzílio. Nossas conclusões sublinham a necessidade de considerar o apoio fiscal em termos de economia política, mesmo durante crises, e de explorar não somente a existência ou o montante dos auxílios oferecidos pelo estado, mas também sua composição.

Resumen ¿Cómo se distribuyen los recursos de ayuda gubernamental entre los diferentes sectores económicos durante una crisis? ¿Y por qué algunos sectores reciben más que otros? La reciente pandemia de COVID-19 puso de relieve la importancia de estas cuestiones. En este artículo, exploramos cómo una perspectiva de economía política puede ayudar a entender la distribución del apoyo estatal en diferentes sectores en los Países Bajos, un país de tradición corporativista. Mientras que a KLM ‒el actor más importante del sector de aviación holandés‒ el gobierno le prometió préstamos de alrededor de 3.400 millones de euros, al sector HORECA (que congrega hoteles, restaurantes y cafeterías) se le denegó una ayuda similar. A través de un análisis cruzado de casos eliminamos razones puramente técnicas para este fenómeno. A continuación, utilizamos la metodología process-tracing y analizamos cientos de artículos de medios de comunicación holandeses para entender la influencia de líderes políticos, lobbies y expertos. Descubrimos que, en un contexto de crisis económica, el comportamiento electorero de los líderes políticos y el poder y organización de los lobbies determinaron la suma que cada sector podría esperar. Por otro lado, la estructura de dichas ayudas se explica a través del alineamiento político de los decisores políticos. Nuestros resultados subrayan la necesidad de estudiar el apoyo gubernamental en términos de economía política, inclusive durante crisis, y de explorar no solo la existencia o la cuantía de dichas ayudas sino también su composición.

Reflections on the Reform of "Two-vote System" for Drug Purchase Based on Financial Perspective / 中国药房

OBJECTIVE: To provide reference for China to comprehensively promote and perfect the "two-vote system" for drug purchase. METHODS: The effects of "two-vote system" on interested parties, the existing problems of drug purchase and its financial reasons were analyzed; the finance strategies were put forward to deal with the existing problems of drug purchase. RESULTS & CONCLUSIONS: "Two-vote system" has certain impact on drug production enterprises, drug circulation enterprises, public medical institutions and government drug supervision departments. At present, the existing problems of drug purchase mainly include that the mechanism of "drug to support hospital" has promoted the virtual-high price of drugs; drug enterprises pull drug sales by the way of rebate; hidden rules disrupt the circulation of drugs as "be subordinate to" "amateur performance". Financial reasons mainly include that the mode of "drug to support hospital" pursuit the maximization of its own interests unilaterally and ignore the drug cost burden of patients; some enterprises have poor investment, lack of R&D investment, have weak internal financial control measures, lack of social responsibility consciousness, rely on "be subordinate to" "amateur performance" profit, underestimate financial risk, etc. The drug production enterprises should adjust marketing model and reduce cost; drug circulation enterprises should predict positioning scientifically and expand profit space; public medical institutions should reform financial supply and reduce drug cost; government drug supervision departments should reduce the supervision cost and improve the comprehensive efficiency. Only by deepening the reform of the medical and health care system, improving the supporting measures for the "two-vote system" in drug purchase can the problems existing in the circulation of drugs be solved gradually.

A importância do crescimento econômico local na escolha do chefe do Executivo no Brasil / La importancia del crecimiento económico local en la elección del jefe del Ejecutivo en Brasil / The importance of local economic growth on the elections of Brazilian chief executives of governments

Resumo A investigação dos fatores que influenciam a escolha do chefe do Executivo no Brasil é uma questão de vital importância. Neste artigo, apresentam-se evidências de que o crescimento econômico local no último ano de governo possui impacto positivo na porcentagem de votos obtidos pelo incumbente em uma amostra da população dos municípios brasileiros, com dados das eleições presidenciais e municipais de 2000 a 2010. Usamos a expansão real do PIB municipal como medida do crescimento econômico local e testamos a hipótese de que os eleitores em um município premiam os incumbentes, ou seus respectivos candidatos, que tiveram bom desempenho econômico no último ano de mandato. A hipótese se baseia na teoria econômica do voto que sugere que os incumbentes têm mais chances de vencer uma reeleição, ou eleger seu sucessor, quando a economia está em um bom momento. Na análise utilizamos as abordagens para dados em painel, além de análise multinível, de modo a melhor explorar a heterogeneidade existente no fenômeno do voto econômico e com isso inferir a existência de efeitos do crescimento econômico na proporção de votos obtidos pelo incumbente e como esses efeitos podem variar em relação a partidos, unidades da federação, circunscrição eleitoral e outras variáveis.

Resumen La investigación de los factores que influyen en la elección del jefe del Ejecutivo en Brasil es un asunto de vital importancia en la literatura. En este artículo, presentamos evidencia de que el crecimiento económico local en el último año del gobierno tiene un impacto positivo en el porcentaje de votos obtenidos por el incumbente en una muestra de los municipios brasileños, con datos relativos a las elecciones presidenciales y municipales de 2000 a 2010. Utilizamos el crecimiento real del PIB municipal como medida de crecimiento económico local para poner a prueba la hipótesis de que los votantes en una ciudad tienden a recompensar el titular y sus candidatos que tuvieron un buen desempeño económico en el último año de mandato. La hipótesis se base en la teoría económica de la votación que sugiere que los titulares tienen más probabilidades de ganar la reelección, o elegir a su sucesor, cuando la economía está en un buen momento. En el análisis se utiliza los métodos de datos de panel y el análisis multinivel con el fin de aprovechar mejor la heterogeneidad existente en el fenómeno del voto económico y con ello inferir la existencia de efectos del crecimiento económico sobre la proporción de votos obtenidos por el incumbente y cómo estos efectos pueden variar en relación a partidos, las unidades de la federación, circunscripción electoral y otras variables.

Abstract The motives for choosing the government's chief executive are of vital importance in a democratic society. In this article, evidence is presented of how local economic growth in the last year of government has a positive impact on the percentage of votes obtained by the incumbent in a population sample of Brazilian municipalities, with data of the presidential and municipal elections of 2000 to 2010. Real GDP growth of the city is used as a measure of local economic growth to test the hypothesis that voters in a municipality tend to reward incumbents and their candidates, if they had good economic performance in the last year of their mandate. The hypothesis is based on the economic theory of voting, suggesting that incumbents are more likely to win re-election, or elect their successor, when the economy is good. Panel and Multilevel models are used to detail the effects and the impact of economic growth in the proportion of votes obtained by the incumbent. The multilevel analysis was used in order to better explore existing heterogeneity in the economic voting phenomenon and thereby infer how economic growth effects may vary among parties, the federation units, constituency and other variables.

Comparison of drug-induced sleep endoscopy and Müller's maneuver in diagnosing obstructive sleep apnea using the VOTE classification system / Comparação entre endoscopia com sono induzido por fármacos e manobra de Müller no diagnóstico de apneia obstrutiva do sono usando o sistema de classificação VOTE

Abstract Introduction: Knowledge of the site of obstruction and the pattern of airway collapse is essential for determining correct surgical and medical management of patients with Obstructive Sleep Apnea Syndrome (OSAS). To this end, several diagnostic tests and procedures have been developed. Objective: To determine whether drug-induced sleep endoscopy (DISE) or Müller's maneuver (MM) would be more successful at identifying the site of obstruction and the pattern of upper airway collapse in patients with OSAS. Methods: The study included 63 patients (52 male and 11 female) who were diagnosed with OSAS at our clinic. Ages ranged from 30 to 66 years old and the average age was 48.5 years. All patients underwent DISE and MM and the results of these examinations were characterized according to the region/degree of obstruction as well as the VOTE classification. The results of each test were analyzed per upper airway level and compared using statistical analysis (Cohen's kappa statistic test). Results: There was statistically significant concordance between the results from DISE and MM for procedures involving the anteroposterior (73%), lateral (92.1%), and concentric (74.6%) configuration of the velum. Results from the lateral part of the oropharynx were also in concordance between the tests (58.7%). Results from the lateral configuration of the epiglottis were in concordance between the tests (87.3%). There was no statistically significant concordance between the two examinations for procedures involving the anteroposterior of the tongue (23.8%) and epiglottis (42.9%). Conclusion: We suggest that DISE has several advantages including safety, ease of use, and reliability, which outweigh MM in terms of the ability to diagnose sites of obstruction and the pattern of upper airway collapse. Also, MM can provide some knowledge of the pattern of pharyngeal collapse. Furthermore, we also recommend using the VOTE classification in combination with DISE.

Resumo Introdução: O conhecimento do local da obstrução e do padrão de colapso das vias respiratórias é essencial para determinar o tratamento cirúrgico e clínico corretos de pacientes com Síndrome de Apneia Obstrutiva do Sono (SAOS). Para este fim, vários testes e procedimentos de diagnóstico foram desenvolvidos. Objetivo: Determinar se a Endoscopia de Sono Induzido por Fármacos (DISE) ou Manobra de Müller (MM) seria mais bem-sucedida na identificação do local de obstrução e do padrão de colapso das vias respiratórias superiores em pacientes com SAOS. Método: O estudo incluiu 63 pacientes (52 do sexo masculino e 11 do sexo feminino) que foram diagnosticados com SAOS em nossa clínica. As idades variaram de 30 a 66 anos e a idade média foi de 48,5 anos. Todos os pacientes foram submetidos a DISE e MM e os resultados destes exames foram caracterizados de acordo com a região/grau de obstrução, bem como a classificação VOTE. Os resultados de cada teste foram analisados de acordo com o nível das vias respiratórias superiores e comparados por análise estatística (teste estatístico kappa de Cohen). Resultados: Houve concordância estatisticamente significativa entre os resultados da DISE e MM para os procedimentos que envolvem configuração anteroposterior (73%), lateral (92,1%) e concêntrica (74,6%) do véu palatino. Os resultados da parte lateral da orofaringe também estavam em concordância entre os testes (58,7%). Os resultados da configuração lateral da epiglote estavam em concordância entre os testes (87,3%). Não houve concordância estatisticamente significativa entre os dois exames para os procedimentos que envolvem a parte anteroposterior da língua (23,8%) e epiglote (42,9%). Conclusão: Sugere-se que a DISE apresenta várias vantagens, como segurança, facilidade de uso e confiabilidade, que superam a MM em termos da capacidade de diagnosticar locais de obstrução e o padrão de colapso da via respiratória superior. O MM pode também fornecer algum conhecimento sobre o padrão de colapso da faringe. Além disso, recomendamos o uso da classificação VOTE em combinação com DISE.

Cultura política en un escenario electoral de polarización en Argentina

Este artículo aborda la cultura política de ciudadanos/as de Córdoba en un escenario de polarización. El objetivo principal es conocer las características de la ciudadanía en función variables del ámbito psico-político y sus diferencias en función de la preferencia electoral. Se examinaron dos grupos de ciudadanos: aquellos que votaron por el actual presidente argentino, Mauricio Macri y quienes lo hicieron por su opositor, Daniel Scioli. La muestra estuvo compuesta por 455 cordobeses/ as entre 18 y 70 años (M=37,3). Se midieron variables vinculadas a la confianza política (confianza en actores políticos; percepción de corrupción, cinismo político y justicia); percepción del contexto sociopolítico (clima socioemocional, percepción de anomia) variables ideológicas (RWA, SDO, creencia en un mundo justo, tolerancia política, autoposicionamiento ideológico), valores psicosociales, aspectos cognitivos (interés, conocimiento y eficacia política), capital social (confianza social y participación) y actitudes hacia la democracia. Los resultados dieron cuenta de diferencias significativas entre estos grupos: los votantes de Macri manifestaron ideologías más conservadoras, mayor cinismo, desconfianza y actitudes más negativas hacia actores tradicionales de la política; mientras que valoraron positivamente el contexto social y el gobierno actual.

This paper assesses the political culture of citizens from Córdoba in a political polarization scenario. The main objective isto explore its characteristics in terms of a set of psycho-political variables and their differences depending on the electoral option. Two groups of citizens were examined: those who voted for the current Argentinian president, Mauricio Macri, and those who voted for his opponent, Daniel Scioli. The sample consisted of 455 citizens from Córdoba, between 18 and 70 years old (M = 37.3). We measured variables related to political trust (trust in political actors, corruption perception, political cynicism and justice), perception of the socio-political context (socio-emotional climate, anomie perception) ideological variables (RWA, SDO, belief in ajustworld, political tolerance, ideological selfpositioning), psycho-social values, cognitive aspects (political interest, knowledge and efficacy), social capital (social trust and participation) and attitudes towards democracy. The results showed significant differences between these groups. Macri's voters showed more conservative ideologies, greater cynicism, distrust and more negative attitudes towards politics' traditional actors; while they positively valued the social context and the current government.

Este artigo estuda a cultura política dos cidadãos de Córdoba em um cenário de polarização. Assim, seu principal objetivo é conhecer as características da cidadania através de variáveis da esfera psico-política e suas diferenças, dependendo da opção eleitoral na segunda rodada. Foram examinados dois grupos de cidadãos: aqueles que votaram no atual presidente argentino, Mauricio Macri e aqueles que votaram em seu oponente, Daniel Scioli. A amostra consistiu de 455 cidadãos cordobesos entre 18 e 70 anos (M = 37,3). Nós medimos variáveis de confiança política (confiança nos atores políticos, percepção de corrupçãom, cinismo político ejustiça), percepção do contexto sócio-político (clima socio-emocional, percepção de anomia) variáveis ideológicas (RWA, SDO, crença em um mundo justo, tolerância política, autoposicionamento ideológicos), valores psicossociais, aspectos cognitivos (interesse e conhecimento e eficácia política), capital social (confiança social e participação) e atitudes em relação à democracia. Os resultados mostraram diferenças significativas entre esses grupos. Os eleitores de Macri manifestaram ideologias mais conservadoras, maior cinismo, desconfiança e atitudes mais negativas em relação aos atores tradicionais da política; enquanto valorizaram positivamente o contexto social e o atual governo.

Efecto de la capacitación y el diseño del tarjetón sobre la comprensión y la validez del voto / Effect of Capacitation and the Ballot Design on Understanding and Validity of the Vote

Son limitadas las investigaciones acerca del impacto del diseño del tarjetón en las elecciones multipartidistas y el voto nulo, como también las que evalúan de manera general los efectos de la información o capacitación sobre los errores en el voto. El presente estudio buscó establecer el efecto de la capacitación y del diseño de tarjetón sobre el porcentaje de voto nulo y la compresión del mecanismo de voto. Se realizaron tres estudios específicos con diferentes muestras, el primer cuasiexperimento (60 participantes) constó de un diseño posprueba y un grupo control donde se rechazó la hipótesis de que la capacitación disminuye el porcentaje de voto nulo. En el segundo cuasiexperimento (172 participantes) con un diseño posprueba, un grupo control y dos grupos con diferentes tratamientos experimentales se rechazó la hipótesis de que la elaboración del encabezado del tarjetón disminuye la probabilidad de voto nulo. El tercer cuasiexperimento (60 participantes) con un diseño factorial 2x2, demostró que el priming obtenido a través del diseño didáctico de las instrucciones en cuartilla separada y gran tamaño disminuyó el porcentaje de voto nulo, aun en aquellos casos donde los electores no tuvieran experiencia con el sistema electoral. Se discute la importancia del diseño pedagógico del tarjetón y otras piezas que forman parte del sistema de voto a la luz de la psicología del consumidor y de la economía conductual.

There has been limited research about the impact of ballot paper design in multiparty elections and effects of information or training over the invalid vote and the vote mistakes. This study was to measure the effect of training and ballot paper design on the probability of invalid vote and vote mechanism compression. There has been applied three quasi-experimental designs with different samples, the first experiment (60 volunteers) to design a post test and control group were the hypothesis was rejected because the training doesn't reduces the likelihood of invalid ballots. The second experiment (172 volunteers) with a post-test design, a control group and two experimental treatments with different groups where the hypothesis of ballot paper decrease the likelihood of invalid ballots was also rejected. The third experiment (60 participants) with a 2x2 factorial design showed that the priming obtained through the instructional design of the on separate large sheet decreased the percentage of null vote even in cases where voters had no experience with the electoral system. The importance of the pedagogical ballot paper design and other items that are part of the voting system in the light of consumer psychology and behavioral economics are discussed.

DIMENSIONES CULTURALES, AFECTIVAS Y COGNITIVAS DEL COMPORTAMIENTO DE VOTO AL KIRCHNERISMO / DIMENSÕES CULTURAIS, AFETIVAS E COGNITIVAS DO COMPORTAMENTO DE VOTO AO KIRCHNERISMO / CULTURAL, EMOTIONAL AND COGNITIVE DIMENSIONS OF KIRCHNERIST ELECTORAL OPTION

El objetivo del trabajo fue estudiar el comportamiento del voto kirchnerista de la elección presidencial argentina del 2011 y contribuir desde la perspectiva psico-política al análisis del comportamiento electoral. Para ello, se analizó cómo el clima socio-político, el cinismo político, la ideología política y las emociones hacia el sistema político inciden sobre la sofisticación política y la eficacia política interna y externa. Además, qué porcentaje de la varianza de la intención de voto hacia Cristina Fernández de Kirchner (dimensión conductual y afectiva) estaría determinada por estas variables. Se trabajó con una muestra cuotificada de 350 ciudadanos de 18 a 65 años de Córdoba/Argentina, relevada en los cinco días anteriores a la elección del 23 de octubre de 2011. Los resultados discuten el rol mediador de variables sociocognitivas en relación a la elección de un candidato presidencial. Se enfatiza la importancia de considerar variables afectivas y situacionales asociadas al contexto socio-político...

O objetivo do trabalho foi estudar o comportamento do voto kirchnerista na eleição presidencial de 2011 e contribuir, a partir da perspectiva psicopolítica, à análise do comportamento eleitoral. Para isso, foi analisado como o clima eleitoral sociopolítico, o cinismo político, a ideologia política e as emoções em relação ao sistema político afetam a sofisticação política e eficácia política interna e externa. Além disso, qual é a percentagem da variação na intenção de votar em Cristina Fernandez de Kirchner (dimensão comportamental e afetiva) seria determinado por estas variáveis. Nós trabalhamos com uma amostra de 350 cidadãos de 18-65 anos, de Córdoba / Argentina, entrevistados nos cinco dias antes da eleição de 23 de outubro de 2011. Os resultados discutem o papel mediador das variáveis sócio-cognitivas em relação à escolha de um candidato presidencial. É enfatizada a importância de considerar variáveis afetivas e situacionais associadas com o contexto sociopolítico...

This study aimed to analyze the election of Cristina Fernández de Kirchner in 2011's Argentine presidential election and contribute from a psycho-political perspective to voter behavior analysis. We discuss how the socio-political climate, political cynicism, political ideology and emotions around political system affect the sophistication and internal / external efficacy of politics. Also, we analyzed which percentage of variance in the intention to vote for Cristina Fernández de Kirchner (behavioral and affective dimensions) would be determined by these variables. We used data from a non-probabilistic sample of 350 Cordoba's citizens between 18-65 years; quota by gender, age and socio-economic status and surveyed in the last five days previous to election (October 23th, 2011). Results show the mediating role of social-cognitive variables relative to the election of a presidential candidate. In turn, we emphasize the relevance of considering affective and situational variables related to socio-political context...

Eleições e comportamento político de adolescentes escolares: um estudo dasrepresentações sociais / Elections and political behavior of adolescent students: a study of socialrepresentations

Socialmente relevante, o comportamento político é assunto de interesse da Psicologia Social, mas ainda é pouco estudado no contexto de adolescentes e suas experiências subjetivas. Este artigo aborda as representações sociais elaboradas por adolescentes escolares acerca daseleições e os aspectos políticos que a envolvem. Participaram do estudo 129 adolescentes com idades entre 16 e 18 anos incompletos, os quais responderam à associação livre de palavras (política, político, eleições, voto), cuja análise fatorial de correspondência foi realizada pelo TriDeux-Mots. O saber compartilhado pelos adolescentes foi organizado em função do tipo de escola, nível de interesse político, sexo e opinião dos estudantes quanto ao voto facultativo. As evocações evidenciaram consensos e dissensos sobre o objeto social, destacando ambiguidades que revelam a dinâmica política da realidade social...

Socially relevant, the political behavior is a subject of interest of Social Psychology, but has been little studied in the context of teenagers and their subjective experiences. This article approaches the social representations elaborated by teenagers students about the elections and related subjects. Study participants were 129 teenagers with ages between 16 and 18 years old, who completed the free word association (political, politician, elections, vote) whose factorial analysis was performed by Tri-Deux-Mots. The knowledge shared by the teens were organized according to the type of school, level of political interest, sex and the students’opinion about the optional voting. Evocations showed consensus and dissent on the social object, highlighting ambiguities that reveal political dynamics and social reality...

Psicología política del comportamiento de voto: la elección presidencial 2011 en Argentina / Psicologia política do comportamento Eleitoral: a eleição presidencial de 2011 na Argentina / Political psychology of voting behavior: 2011 presidential election in Argentina / Psychologie politique du comportement électoral: l'élection présidentielle de 2011 en Argentine

Con el interés de analizar la intención de voto de los ciudadanos de Córdoba, Argentina, la presente investigación tuvo como objetivo principal la comparación de las variables: ideología política, autoritarismo, clima socio emocional, confianza institucional, intensidad afectiva, eficacia política, interés y conocimiento político en grupos de ciudadanos definidos según su intención de voto a los candidatos presidenciales, en las elecciones realizadas en Octubre del 2011. El estudio se realizó con una muestra cuotificada de 350 ciudadanos entre 18 y 65 años de edad. Los resultados mostraron diferencias significativas en relación con las distintas variables estudiadas, en los grupos identificados de acuerdo a su opción electoral...

With the interest of analyze the voting intentions of citizens of Cordoba, Argentina, the present study aimed to compare the main variables: political ideology, authoritarianism, social-emotional climate, institutional trust, affective intensity, political efficacy, political interest and political knowledge of citizens groups defined according to their intention to vote for presidential candidates in the elections held in October 2011. This study was conducted with a sample of 350 people between 18 and 65 years old. The results showed significant differences in relation to the different variables studied in the groups identified according to their electoral choice...

O presente trabalho tem por objetivo analisar a intenção de voto dos cidadãos de Córdoba, Argentina, focalizando na comparação das variáveis: ideologia política, autoritarismo, clima socioemocional, confiança institucional, intensidade afetiva, eficácia política, interesse e conhecimento político em grupos de cidadãos definidos segundo a sua intenção de voto aos candidatos presidenciais, nas eleições do Outubro de 2011. A pesquisa foi feita com uma amostra quantificada de 350 pessoas de 18 a 65 anos de idade. Os resultados mostraram diferenças significativas na relação com as distintas variáveis estudadas, nos grupos identificados de acordo com a sua opção eleitoral...

Avec l'intérêt de l'analyse des intentions de vote des citoyens de Cordoba, en Argentine, la présente étude visait à comparer les principales variables : l'idéologie politique, l'autoritarisme, le climat socio-affectif, la confiance institutionnelle, l'intensité affective, l'efficacité politique, l'intérêt politique et la connaissance politique de des groupes de citoyens définis en fonction de leur intention de voter pour les candidats à l'élection présidentielle tenue en Octobre 2011. Cette étude a été menée auprès d'un échantillon de 350 personnes entre 18 et 65 ans. Les résultats ont montré des différences significatives par rapport aux différentes variables étudiées dans les groupes identifiés en fonction de leur choix électoral...

Importancia de la distinción entre la antijuridicidad y la culpabilidad en juicios por presunta mal praxis médica / The importance of distinguishing illegality from guilt in trials for alleged medical malpractice

Un correcto análisis de los elementos esenciales del tipo penal que sanciona la llamada negligencia médica es fundamental para resolver en justicia los casos de presunta mal praxis, en el sentido de distinguir con propiedad, para cada caso concreto, la diferencia entre los reproches de antijuridicidad y de culpabilidad. Las redacciones legales abiertas y normativas de este tipo de ilícitos dan un gran margen de decisión a los jueces para determinar qué conducta se ajusta o no a los deberes de cuidado exigidos. Esta facultad les obliga a fundar sus fallos de condena en infracciones objetivas a estos deberes y no en criterios particulares de exigibilidad de una determinada conducta, basados en características individuales del agente.

A proper analysis of the essential elements that comprise a criminal offense that falls under the purview of medical negligence is fundamental in order to rule, in justice, cases of alleged malpractice. It is necessary to properly distinguish between accusations of illegality and those of guilt. Open legal essays and precedents about such illicit acts provide judges with great latitude in determining when acts are consistent or not with standard care. This power mandates that judges should ground their convictions on objective infringements of the law rather than subjective criteria.

Physicochemical transfer functions to predict zone of precipitation between calcium and phosphate in simplified parenteral nutrition.

We use committee-vote via empirical transfer functions obtained from various regression models of actual physicochemical data for describing possible zone of hazardous precipitation of calcium and phosphate for particular amino acid brand name, i.e., Moripron-F® or Aminovenos-N-Paed®. The logistic regression with modified Hosmer-Lemeshow method is also presented. We use a slack variable for grouping data space near each original data point for calculating odd ratio of precipitation event and then extrapolate back to zero value of the slack variable in order to obtain the intrinsic odd ratio function that is independent from the slack variable. Committee-vote could reveal a nonlinear pattern with high accuracy and low health hazardous prediction for Moripron-F®. However, applying such algorithm with Aminovenos-NPaed ® was unsuccessful due to violation of the committee-voting rule, i.e., empirical transfer function has too weak prediction power.

Brasil: liberalismo, café, escola e voto (1878-1881) / Brazil: liberalism, coffee, school and vote (1878-1881)

O trabalho mostra como, num país agrário, latifundiário e escravocrata, em pleno ciclo do café, com uma população predominantemente rural e absolutamente des provida de escolas, as elites brasileiras, agora representadas maciçamente por liberais na Câmara dos Deputados, conseguem, por meio da Lei Saraiva (1881), unir, num casamen to que duraria mais de um século, duas coisas aparentemente inconciliáveis na perspec tiva liberal: de um lado, o voto direto; de outro, a exclusão da grande massa do povo, os analfabetos (80 por cento da população), do direito de voto. O estudo mostra ainda quão dife rente foi o caminho seguido pela vizinha Argentina, por meio da Lei de Educação Comum (1884). Conclui lembrando as palavras de José Bonifácio o Moço, para quem, com a exclusão dos analfabetos do direito de voto, o projeto liberal de eleição direta em discus são na Câmara não era a bandeira da reforma, mas sim a reforma da bandeira liberal.

The paper shows how, in an agrarian country like Brazil, dominated by large land owners and slave holders, in the middle of the so-called coffee cycle, with a pre dominantly rural population that had absolutely no access to school education, the Brazilian elites, at that time massively represented by liberals at the Chamber of Deputies, managed to unite through the Saraiva Act (1881), in a partnership that lasted more than one century, two things apparently incompatible from a liberal perspective: the direct vote and the exclusion of the great mass of the people, viz, the illiterate (80 percent of the population), from the right to vote. It also shows the different path adopted in Argentina through the Law of Common Education (1884). It concludes by recalling a statement by José Bonifácio, the Young: according to him, because of the exclusion of the illiterate from the right to vote, the liberal draft bill on direct election was not the ban ner of reform, but the reform of the [liberal] banner.

O conteúdo da produção legislativa brasileira: leis nacionais ou políticas paroquiais? / The content of Brazilian legislative output: national laws or pork barrel politics?

This article analyzes whether the pork barrel political approach really exists in the context of legislative output by the Brazilian Congress. According to the author's argument, in the case of medium-large districts, multi-member districts (MMDs) increase the costs of investment in pork barrel bills of law. In addition, members of the Brazilian Congress face high legislative output costs that increase the incentives to avoid pork barrel strategies. The author investigates hypotheses on bills that were either approved or rejected by Congress, as well as those vetoed by the Executive, from 1991 to 2002. The results provide significant evidence for the author's theoretical argument. The study concludes that: (1) pork barrel bills are quantitatively insignificant in Brazil; (2) members of the Brazilian Congress invest much of their time and effort in pursuit of broader interests; and (3) seniority and internal law-making procedures can explain approved versus rejected distributive bills.

Dans cet article, on cherche à savoir si le pork barrel existe effectivement dans le cadre de la production législative du Congrès National brésilien. On part de la supposition que les MMDs (multi-member districts) districts d'importance moyenne et élevée surévaluent les coûts d'investissement dans les projets de pork barrel. En outre, les parlementaires brésiliens sont face à des coûts de production législative qui découragent les stratégies à esprit de clocher. On examine ces hypothèses sur la base de la législation approuvée et rejetée par le Congrès, y compris celles que le Président a rejetées pendant la période 1991-2002. D'où on peut conclure que: 1) les projets de pork sont insignifiants du point de vue quantitatif; 2) le parlementaire passe la plupart de son temps et gaspille ses efforts sur des questions qui visent à satisfaire des intérêts vagues; 3) la carrière du parlementaire et des facteurs internes propres au processus de décision peuvent expliquer le rejet ou l'approbation des projets de distribution.

Partidos fracos na arena eleitoral e partidos fortes na arena legislativa: a conexão eleitoral no Brasil / Weak parties in the electoral arena, strong parties in the legislative arena: the electoral connection in Brazil

This article analyzes the determinants of voting positions in the Brazilian House of Representatives (Chamber of Deputies) in relation to the preferences of the Executive Branch, focusing on the reasons leading Deputies to cooperate with or resist the President's interests on votes. The article examines the role played by political parties in the Deputies' behavior both inside and outside Congress, as well as the main instruments used by the Executive to encourage cooperative legislative behavior, applying a multivariate econometric model to estimate the determinants of Deputies' votes. The authors conclude that Deputies, especially those belonging to parties in the government coalition, cooperate with the President, following the orientation provided by their party leaders, as a strategy to access political and financial benefits controlled by the Executive, which in turn can be used in the electoral arena in order to maximize their odds of political survival, and that these same Deputies are the ones with the greatest odds of being reelected.

Dans cet article, on cherche à examiner ce qui détermine le vote à la Chambre des Députés par rapport aux préférences du Pouvoir Exécutif, en montrant surtout les raisons qui mènent les députés à voter dans le sens des intérêts du Président. On y examine - à l'aide de l'application d'un modèle économétrique multivarié qui évalue les déterminants du vote - le rôle joué par les partis politiques sur le comportement des parlementaires à l'intérieur et en dehors du Congrès, ainsi que les principaux outils employés par le Pouvoir Exécutif pour attirer leur coopération. On conclut que les parlementaires, surtout ceux qui se trouvent dans les partis de coalition gouvernementale, coopèrent avec le Président, suivant les directives de leurs chefs politiques, en vue d'obtenir du Pouvoir Exécutif des avantages politiques et financiers qui pourront leur servir dans la lutte électorale, dans l'optique de leur réélection, et que les parlementaires sont ceux qui possèdent les plus fortes chances d'être réélus.

Impacto das instituições estaduais na unidade das coalizões parlamentares no Brasil / State-level institutional effects on legislative coalition unity in Brazil

Research on political institutions suggests that sub-national factors affect the proclivity of legislators from the same party or coalition to vote together. We estimate the effects of such forces operating at the State-level - intra-list electoral competition, and alliance with governors. We propose that larger cohorts, in which the imperative for legislators to distinguish themselves from the group is stronger, should be less unified than smaller cohorts. We also derive from theoretical hypotheses that cohorts allied with governors may be either more or less unified than other cohorts. We analyze unity among coalition cohorts on recorded floor votes in the Brazilian Chamber of Deputies. We find support for the hypothesis that larger cohorts are less unified, but detect no net effect of alliance with governors on cohort voting unity. Governors are not dominant brokers of legislative coalitions, suggesting that the net gubernatorial effect is contingent on factors that shape their influence relative to national-level legislative actors.

Les recherches sur les institutions politiques indiquent que les facteurs sous-nationaux influencent la propension des législateurs d'un même parti ou coalition à voter unis. On analyse, dans cet article, les effets des forces institutionnelles agissant à l'échelon fédéral - la compétition électorale entre candidats d'une même liste et l'alliance avec des gouverneurs. On voit que les grandes cohortes, où le législateur éprouve le besoin de se démarquer du groupe, sont moins unies que les petites. En accord avec l'approche théorique, on voit aussi que les cohortes ayant une alliance avec les gouverneurs peuvent être plus ou moins unies que les autres cohortes. Cette analyse de l'unité entre des cohortes de coalition a pour base les votations dans la Chambre des députés brésilienne. On y voit donc confirmée l'hypothèse selon laquelle les grandes cohortes sont moins unies, mais on ne trouve aucun effet net de l'alliance avec des gouverneurs sur le vote uni des cohortes. Les gouverneurs ne sont pas des déclencheurs de coalitions parlementaires, ce qui laisse supposer que leur influence dépend de facteurs contingents façonnant leur pouvoir sur des acteurs politiques au niveau fédéral.

Evaluation of Cost-Effectiveness of Medical Nutrition Therapy: Meta-Analysis

OBJECTIVES: A meta-analysis of the literatures was conducted to evaluate the cost-effectiveness of medical nutrition therapy by dietitians. METHODS: The 30 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and the PQD database until May, 2002 and a review of reference lists. The main search terms were "dietitian", "dietary intervention", "nutrition intervention", "cost", "cost-effectiveness" and "cost-benefit analysis". The subgroup analysis was performed by publication year, study design, intervention provider, type of patient (in/out-patient) and type of cost (total cost/direct cost). Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. RESULTS: The 30 studies were identified using the electric database search and bibliographies. The 17 trials were eligible for inclusion criteria, then the systematic review and a meta-analysis were conducted on effectiveness and cost-effectiveness of medical nutrition therapy. The quality of the studies was evaluated using the quality assessment tool for observational studies. The quality score was 0.515+/-0.121 (range : 0.279-0.711, median : 0.466). The meta-analysis of 17 studies based on the random effect model showed that medical nutrition therapy was highly effective in treating the diseases (effect size 0.3092 : 95% confidence interval 0.2282-0.3303). The vote-counting method, one of meta-analysis methods, was applied to evaluate the cost-effectiveness of medical nutrition therapy conducted by dietitians. Two criteria (method 1, method 2) for voting were used. The calculated p-values for method 1 (more conservative method) and method 2 (less conservative method) were 0.1250 and 0.0106, respectively. Medical nutrition therapy by dietitians was significantly cost-effective in the method 2. CONCLUSION: This meta-analysis showed that the effectiveness of medical nutrition therapy was statistically significant in treating disease (effect size 0.3092), and that the cost-effectiveness of medical nutrition therapy was statistically significant in the method 2 (less conservative method) of vote counting.