Proactive management of extreme prematurity: disagreement between obstetricians and neonatologists

Objective: To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death. Study Design: Prospective cohort of 484 infants with 23(0/7) to 26(6/7) weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of >= 1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life. Result: Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions. Conclusion: In infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day. Journal of Perinatology (2012) 32, 913-919; doi:10.1038/jp.2012.28; published online 29 March 2012

Kinematics and Energetics of Nut-Cracking in Wild Capuchin Monkeys (Cebus libidinosus) in Piaui, Brazil

Wild bearded capuchins (Cebus libidinosus, quadrupedal, medium-sized monkeys) crack nuts using large stones. We examined the kinematics and energetics of the nut-cracking action of two adult males and two adult females. From a bipedal stance, the monkeys raised a heavy hammer stone (1.46 and 1.32 kg, from 33 to 77% of their body weight) to an average height of 0.33 m, 60% of body length. Then, they rapidly lowered the stone by flexing the lower extremities and the trunk until the stone contacted the nut. A hit consisting of an upward phase and a downward phase averaged 0.74 s in duration. The upward phase lasted 69% of hit duration. All subjects added discernable energy to the stone in the downward phase. The monkeys exhibited individualized kinematic strategies, similar to those of human weight lifters. Capuchins illustrate that human-like bipedal stance and large body size are unnecessary to break tough objects from a bipedal position. The phenomenon of bipedal nut-cracking by capuchins provides a new comparative reference point for discussions of percussive tool use and bipedality in primates. Am J Phys Anthropol 138:210-220, 2009. (C) 2008 Wiley-Liss, Inc.

Two new species and a review of the inseminating freshwater fish genus Monotocheirodon (Characiformes: Characidae) from Peru and Bolivia

Two new species of inseminating freshwater fishes of the genus Monotocheirodon, family Characidae, are described from Peru. Males and females of both new species have an external, visually obvious urogenital papilla that was not detected in the females in previous studies, with this longer in males, which use it as an inseminating organ. A third inseminating species from Bolivia, Monotocheirodon pearsoni, unstudied in any detail since its original description in 1924, is redescribed. This latter species lacks an inseminating organ. Monotocheirodon is redescribed, its phylogenetic relationships are briefly discussed and it is suggested that it is possibly related to the stevardiin genera Ceratobranchia, Othonocheirodus, and Odontostoechus.

A idéia de corpo e a configuração do ambiente da improvisação musical

O objetivo deste texto é evidenciar a importância da ideia de corpo para a reflexão sobre o ambiente da improvisação musical. Este tipo de prática em tempo real que parte de uma relação direta dos músicos com os seus instrumentos sem a mediação de uma partitura tem como ponto de partida inevitável o corpo dos improvisadores envolvidos. O corpo funciona tanto como um fator de reprodução de possíveis – refletindo os limites do próprio corpo (repetição) - quanto como um potencializador de produção de virtualidades – fundamentados numa expansão destes limites (diferença). Trata-se então de examinar, no agenciamento da improvisação, como o corpo pode ser entendido como detentor deste duplo dinamismo e, neste contexto, que tipo de relacionamento pode estabelecer com a matéria sonora. Procuraremos também estabelecer o papel das ideias de desejo e prazer na configuração deste dinamismo e relacionar esta reflexão com as propostas de improvisação livre e idiomática. Para esta discussão serão utilizados alguns conceitos formulados por Gilles Deleuze como território e linha de fuga, as reflexões de Paul Zumthor sobre corpo, oralidade e performance e as discussões epistemológicas de Edgar Morin sobre o conhecimento e a cultura

Gestão Social: notícias sobre o campo de estudos e práticas a partir das interações e debates do VI Enapegs

Este texto busca relatar a realização do evento Encontro Nacional da Rede de Pesquisadores em Gestão Social (Enapegs), que teve sua última edição em maio de 2012, em São Paulo. Para tanto, busca delimitar o que vem a ser o campo de estudos sobre Gestão Social, a constituição da Rede de Pesquisadores em Gestão Social (RGS), bem como a dinâmica de construção e realização do Enapegs e suas principais discussões e resultados, que no último encontro teve como temática: Gestão Social: mobilizações e conexões.

A snapshot of suspended sediment and fluid mud occurrence in a mixed-energy embayment, Tijucas Bay, Brazil

Along the southern Brazilian coast, Tijucas Bay is known for its unique muddy tidal flats associated with chenier plains. Previous field observations pointed to very high suspended sediment concentrations (SSCs) in the inner parts of the bay, and in the estuary of the Tijucas River, suggesting the presence of fluid mud. In this study, the occurrences of suspended sediments and fluid mud were examined during a larger-scale, high-resolution 2-day field campaign on 1-2 May 2007, encompassing survey lines spanning nearly 80 km, 75 water sampling stations for near-bottom density estimates, and ten sediment sampling stations. Wave refraction modeling provided qualitative wave energy estimates as a function of different incidence directions. The results show that SSC increases toward the inner bay near the water surface, but seaward near the bottom. This suggests that suspended sediment is supplied by the local rivers, in particular the Tijucas. Near-surface SSCs were of the order of 50 mg l(-1) close to the shore, but exceeded 100 mg l(-1) near the bottom in the deeper parts of the bay. Fluid mud thickness and location given by densimetry and echo-sounding agreed in some places, although being mostly discordant. The best agreement was observed where wave energy was high during the campaign. The discrepancy between the two methods may be an indication for the existence of fluid mud, which is recorded by one method but not the other. Agreement is considered to be an indication of fluidization, whereas disagreement indicates more consolidation. Wave modeling suggests that waves from the ENE and SE are the most effective in supplying energy to the inner bay, which may induce the liquefaction of mud deposits to form fluid mud. Nearshore mud resuspension and weak horizontal currents result in sediment-laden offshore flow, which explains the higher SSCs measured in the deeper parts of the bay, besides providing a mechanism for fine-sediment export to the inner shelf.

Playing to Create New Ways of Playing: A Child with Prader-Willi Syndrome

This investigation evaluates the possibility of constructing new ways of playing for a child with Prader-Willi syndrome, by means of occupational therapy. It is a qualitative study which makes use of the case study methodology, whose starting point is the clinical intervention as data collect field. It also presents a short revision of the literature to subside discussions and reflections. It was observed that through the playing experience the occupational therapist led the child to know his own limitations and possibilities, by making him discover new ways of doing activities. Observing the therapist and learning with her, the patient experienced different situations throughout the therapeutic relationship, what enabled him to experiment them in his everyday life. Finally, this study aims at showing the clinical reasoning of an occupational therapist with a view to demonstrate Brazilian therapeutical conduct.

Equation of Motion Governing the Dynamics of Vertically Collapsing Buildings

The present paper aims at contributing to a discussion, opened by several authors, on the proper equation of motion that governs the vertical collapse of buildings. The most striking and tragic example is that of the World Trade Center Twin Towers, in New York City, about 10 years ago. This is a very complex problem and, besides dynamics, the analysis involves several areas of knowledge in mechanics, such as structural engineering, materials sciences, and thermodynamics, among others. Therefore, the goal of this work is far from claiming to deal with the problem in its completeness, leaving aside discussions about the modeling of the resistive load to collapse, for example. However, the following analysis, restricted to the study of motion, shows that the problem in question holds great similarity to the classic falling-chain problem, very much addressed in a number of different versions as the pioneering one, by von Buquoy or the one by Cayley. Following previous works, a simple single-degree-of-freedom model was readdressed and conceptually discussed. The form of Lagrange's equation, which leads to a proper equation of motion for the collapsing building, is a general and extended dissipative form, which is proper for systems with mass varying explicitly with position. The additional dissipative generalized force term, which was present in the extended form of the Lagrange equation, was shown to be derivable from a Rayleigh-like energy function. DOI: 10.1061/(ASCE)EM.1943-7889.0000453. (C) 2012 American Society of Civil Engineers.

A Bayesian analysis of the Conway-Maxwell-Poisson cure rate model

The purpose of this paper is to develop a Bayesian analysis for the right-censored survival data when immune or cured individuals may be present in the population from which the data is taken. In our approach the number of competing causes of the event of interest follows the Conway-Maxwell-Poisson distribution which generalizes the Poisson distribution. Markov chain Monte Carlo (MCMC) methods are used to develop a Bayesian procedure for the proposed model. Also, some discussions on the model selection and an illustration with a real data set are considered.

The production of critical-reflexive narratives and their effect on nursing students' portfolios

The objective of this study is to analyze the process of producing reflexive narratives on nursing students' portfolios. This qualitative study performed an analysis of the portfolios of the class discipline Health Promotion in Primary Education, taught in the fourth semester of the Nursing Licensure Course. Results showed an initial predominance of descriptive records, with the incipient approach of theoretical aspects associated with the aspects regarding their experience. Further, in the group and experience discussions, there were narratives containing more critical and reflexive elements, with justifications for the described actions and the relationships with the theoretical-practical aspects studied in the class and in the course. In conclusion, there is a process of producing critical-reflexive narratives in portfolios that could include a summarized description, using common sense and idealization which allows for including the differences and the theoretical review.