Development of an integrative cessation program for co-smokers of cigarettes and cannabis: demand analysis, program description, and acceptability

Abstract Background Tobacco and cannabis use are strongly interrelated, but current national and international cessation programs typically focus on one substance, and address the other substance either only marginally or not at all. This study aimed to identify the demand for, and describe the development and content of, the first integrative group cessation program for co-smokers of cigarettes and cannabis. Methods First, a preliminary study using expert interviews, user focus groups with (ex-)smokers, and an online survey was conducted to investigate the demand for, and potential content of, an integrative smoking cessation program (ISCP) for tobacco and cannabis co-smokers. This study revealed that both experts and co-smokers considered an ISCP to be useful but expected only modest levels of readiness for participation.Based on the findings of the preliminary study, an interdisciplinary expert team developed a course concept and a recruitment strategy. The developed group cessation program is based on current treatment techniques (such as motivational interviewing, cognitive behavioural therapy, and self-control training) and structured into six course sessions.The program was evaluated regarding its acceptability among participants and course instructors. Results Both the participants and course instructors evaluated the course positively. Participants and instructors especially appreciated the group discussions and the modules that were aimed at developing personal strategies that could be applied during simultaneous cessation of tobacco and cannabis, such as dealing with craving, withdrawal, and high-risk situations. Conclusions There is a clear demand for a double cessation program for co-users of cigarettes and cannabis, and the first group cessation program tailored for these users has been developed and evaluated for acceptability. In the near future, the feasibility of the program will be evaluated. Trial registration Current Controlled Trials ISRCTN15248397

DIGITAL LIBRARIES AND LEARNING OBJECTS REPOSITORIES

Discusses the technological changes that affects learning organizations as well as the human, technical, legal and sustainable aspects regarding learning objects repositories creation, maintenance and use. It presents concepts of information objects and learning objects, the functional requirements needed to their storage at Learning Management Systems. The role of Metadata is reviewed concerning learning objects creation and retrieval, followed by considerations about learning object repositories models, community participation/collaborative strategies and potential derived metrics/indicators. As a result of this desktop research, it can be said that not only technical competencies are critical to any learning objects repository implementation, but it urges that an engaged community of interest be establish as a key to support a learning object repository project. On that matter, researchers are applying Activity Theory (Vygostky, Luria y Leontiev) in order to seek joint perceptions and actions involving learning objects repository users, curators and managers, perceived as critical assets to a successful proposal.

Variations in Management of Mild Prenatal Hydronephrosis Among Maternal-Fetal Medicine Obstetricians, and Pediatric Urologists and Radiologists

Purpose: There are no current guidelines for diagnosing and managing mild prenatal hydronephrosis. Variations in physician approach make it difficult to analyze outcomes and establish optimal management. We determined the variability of diagnostic approach and management regarding prenatal hydronephrosis among maternal-fetal medicine obstetricians, pediatric urologists and pediatric radiologists. Materials and Methods: Online surveys were sent to mailing lists for national societies for each specialty. Participants were surveyed regarding criteria for diagnosing mild prenatal hydronephrosis and recommendations for postnatal management, including use of antibiotic prophylaxis, followup scheduling and type of followup imaging. Results: A total of 308 maternal-fetal medicine obstetricians, 126 pediatric urologists and 112 pediatric radiologists responded. Pediatric urologists and radiologists were divided between Society for Fetal Urology criteria and use of anteroposterior pelvic diameter for diagnosis, while maternal-fetal medicine obstetricians preferred using the latter. For postnatal evaluation radiologists preferred using personal criteria, while urologists preferred using anteroposterior pelvic diameter or Society for Fetal Urology grading system. There was wide variation in the use of antibiotic prophylaxis among pediatric urologists. Regarding the use of voiding cystourethrography/radionuclide cystography in patients with prenatal hydronephrosis, neither urologists nor radiologists were consistent in their recommendations. Finally, there was no agreement on length of followup for mild prenatal hydronephrosis. Conclusions: We observed a lack of uniformity regarding grading criteria in diagnosing hydronephrosis prenatally and postnatally among maternal-fetal medicine obstetricians, pediatric urologists and pediatric radiologists. There was also a lack of agreement on the management of mild intermittent prenatal hydronephrosis, resulting in these cases being managed inconsistently. A unified set of guidelines for diagnosis, evaluation and management of mild intermittent prenatal hydronephrosis would allow more effective evaluation of outcomes.

Pediatric pain: prevalence, assessment, and management in a teaching hospital

The goal of this study was to examine the prevalence, assessment and management of pediatric pain in a public teaching hospital. The study sample consisted of 121 inpatients (70 infants, 36 children, and 15 adolescents), their families, 40 physicians, and 43 nurses. All participants were interviewed except infants and children who could not communicate due to their clinical status. The interview included open-ended questions concerning the inpatients’ pain symptoms during the 24 h preceding data collection, as well as pain assessment and pharmacological/non-pharmacological management of pain. The data were obtained from 100% of the eligible inpatients. Thirty-four children/adolescents (28%) answered the questionnaire and for the other 72% (unable to communicate), the family/health professional caregivers reported pain. Among these 34 persons, 20 children/adolescents reported pain, 68% of whom reported that they received pharmacological intervention for pain relief. Eighty-two family caregivers were available on the day of data collection. Of these, 40 family caregivers (49%) had observed their child’s pain response. In addition, 74% reported that the inpatients received pharmacological management. Physicians reported that only 38% of the inpatients exhibited pain signs, which were predominantly acute pain detected during clinical procedures. They reported that 66% of patients received pharmacological intervention. The nurses reported pain signs in 50% of the inpatients, which were detected during clinical procedures. The nurses reported that pain was managed in 78% of inpatients by using pharmacological and/or non-pharmacological interventions. The findings provide evidence of the high prevalence of pain in pediatric inpatients and the under-recognition of pain by health professionals.

PLANEJAMENTO, OBJETIVOS E DEFINIÇÃO DE PADRÕES NA DESCRIÇÃO DOS METADADOS DA COLEÇÃO DA BIBLIOTECA BRASILIANA DIGITAL

O projeto „Por uma Biblioteca Brasiliana Digital‟ é parte integrante do projeto BRASILIANA USP, uma iniciativa da Reitoria da Universidade de São Paulo (USP), que tem por objetivo facultar para a pesquisa a maior Brasiliana custodiada por uma universidade, tornando-a disponível na internet. O trabalho que ora apresentamos é resultado da implantação de um modelo de biblioteca digital que atende aos padrões de interoperabilidade e compartilhamento de informações. Especificamente, apresentaremos os procedimentos e processos de descrição de conteúdos das diversas tipologias documentais (livros, periódicos, mapas, gravuras etc.) e formatos digitais (pdf, mp3, jpeg entre outros), bem como a consolidação de um esquema de metadados gerenciais e administrativos que contemplam as informações e dados produzidos pelo Projeto da Brasiliana Digital.

USO DO DUBLIN CORE NA DESCRIÇÃO DE OBRAS RARAS NA WEB: A COLEÇÃO DA BIBLIOTECA BRASILIANA DIGITAL

Acessível ao público desde junho de 2009, a Biblioteca Brasiliana Digital, da Universidade de São Paulo tem por objetivo facultar para a pesquisa, a maior Brasiliana custodiada por uma universidade. Sua intenção é disponibilizar virtualmente parte do acervo da Universidade oferecendo-se como um instrumento útil e funcional para a pesquisa e o estudo dos temas e cultura brasileiros, além de oferecer um modelo tecnológico de gestão que possa ser difundido a outras coleções, acervos e instituições. Este trabalho apresenta os resultado da implantação de um esquema de metadados baseado no formato Dublin Core, para a descrição de obras raras e especiais na web. Especificamente, apresenta os procedimentos e processos de descrição de conteúdos das diversas tipologias documentais (livros, periódicos, gravuras etc.) e formatos digitais (pdf, jpeg entre outros). Palavras-Chave: Bibliotecas digitais; Metadados; Dublin Core.

Web Scale Discovery Systems – How to assess the best solution

The University of São Paulo has been experiencing the increase in contents in electronic and digital formats, distributed by different suppliers and hosted remotely or in clouds, and is faced with the also increasing difficulties related to facilitating access to this digital collection by its users besides coexisting with the traditional world of physical collections. A possible solution was identified in the new generation of systems called Web Scale Discovery, which allow better management, data integration and agility of search. Aiming to identify if and how such a system would meet the USP demand and expectation and, in case it does, to identify what the analysis criteria of such a tool would be, an analytical study with an essentially documental base was structured, as from a revision of the literature and from data available in official websites and of libraries using this kind of resources. The conceptual base of the study was defined after the identification of software assessment methods already available, generating a standard with 40 analysis criteria, from details on the unique access interface to information contents, web 2.0 characteristics, intuitive interface, facet navigation, among others. The details of the studies conducted into four of the major systems currently available in this software category are presented, providing subsidies for the decision-making of other libraries interested in such systems.

Management of Port Solid Waste Framework

One of contemporary environmental issues refers to progressive and diverse generation of solid waste in urban areas or specific, and requires solutions because the traditional methods of treatment and disposal are becoming unviable over the years and, consequently, a significant contingent of these wastes presents final destination inappropriate. The diversity of solid waste generated as a result of human activities must have the appropriate allocation to specific legislation in force, such as landfill, incineration, among other procedures established by the competent bodies. Thus, also the waste generated in port activities or proceeding vessels require classification and segregation for proper disposal later. This article aims at presenting a methodology for the collection, transportation, treatment and disposal of solid waste port and also application of automation technology that makes possible the implementation of the same.