Care arrangements for people with dementia in developing countries

Background: Rapid demographic ageing will soon lead to large increases in the numbers of persons with dementia in developing countries. This study is the first comprehensive assessment of care arrangements for people with dementia in those regions. Methods: A descriptive and comparative study of dementia care; caregiver characteristics, the nature of care provided, and the practical, psychological (Zarit Burden Interview, General Health Questionnaire) and economic impact upon the caregiver in 24 centres in India, China and South East Asia, Latin America and the Caribbean and Africa. Results: We interviewed 706 persons with dementia, and their caregivers. Most caregivers were women, living with the person with dementia in extended family households. One-quarter to one-half of households included a child. Larger households were associated with lower caregiver strain, where the caregiver was co-resident. However, despite the traditional apparatus of family care, levels of caregiver strain were at least as high as in the developed world. Many had cutback on work to care and faced the additional expense of paid carers and health services. Families from the poorest countries were particularly likely to have used expensive private medical services, and to be spending more than 10% of the per capita GNP on health care. Conclusions: Older people in developing countries are indivisible from their younger family members. The high levels of family strain identified in this study feed into the cycle of disadvantage and should thus be a concern for policymakers in the developing world. Copyright © 2004 John Wiley & Sons, Ltd.

Avaliação de sintomas neuropsiquiátricos na demência: Para melhorar a precisão

The issue of this article concerned the discussion about tools frequently used tools for assessing neuropsychiatric symptoms of patients with dementia, particularly Alzheimer's disease. The aims were to discuss the main tools for evaluating behavioral disturbances, and particularly the accuracy of the Neuropsychiatric Inventory - Clinician Rating Scale (NPI-C). The clinical approach to and diagnosis of neuropsychiatric syndromes in dementia require suitable accuracy. Advances in the recognition and early accurate diagnosis of psychopathological symptoms help guide appropriate pharmacological and non-pharmacological interventions. In addition, recommended standardized and validated measurements contribute to both scientific research and clinical practice. Emotional distress, caregiver burden, and cognitive impairment often experienced by elderly caregivers, may affect the quality of caregiver reports. The clinician rating approach helps attenuate these misinterpretations. In this scenario, the NPI-C is a promising and versatile tool for assessing neuropsychiatric syndromes in dementia, offering good accuracy and high reliability, mainly based on the diagnostic impression of the clinician. This tool can provide both strategies: a comprehensive assessment of neuropsychiatric symptoms in dementia or the investigation of specific psychopathological syndromes such as agitation, depression, anxiety, apathy, sleep disorders, and aberrant motor disorders, among others.

Machine vision to identify broiler breeder behavior

Animal behavioral parameters can be used to assess welfare status in commercial broiler breeders. Behavioral parameters can be monitored with a variety of sensing devices, for instance, the use of video cameras allows comprehensive assessment of animal behavioral expressions. Nevertheless, the development of efficient methods and algorithms to continuously identify and differentiate animal behavior patterns is needed. The objective this study was to provide a methodology to identify hen white broiler breeder behavior using combined techniques of image processing and computer vision. These techniques were applied to differentiate body shapes from a sequence of frames as the birds expressed their behaviors. The method was comprised of four stages: (1) identification of body positions and their relationship with typical behaviors. For this stage, the number of frames required to identify each behavior was determined; (2) collection of image samples, with the isolation of the birds that expressed a behavior of interest; (3) image processing and analysis using a filter developed to separate white birds from the dark background; and finally (4) construction and validation of a behavioral classification tree, using the software tool Weka (model 148). The constructed tree was structured in 8 levels and 27 leaves, and it was validated using two modes: the set training mode with an overall rate of success of 96.7%, and the cross validation mode with an overall rate of success of 70.3%. The results presented here confirmed the feasibility of the method developed to identify white broiler breeder behavior for a particular group of study. Nevertheless, more improvements in the method can be made in order to increase the validation overall rate of success. (C) 2013 Elsevier B.V. All rights reserved.

In vitro conservation of Dendrobium germplasm

Dendrobium is a large genus in the family Orchidaceae that exhibits vast diversity in floral characteristics, which is of considerable importance to orchid breeders, biotechnologists and collectors. Native species have high value as a result of their medicinal properties, while their hybrids are important as ornamental commodities, either as cut flowers or potted plants and are thus veritable industrial crops. Thus, preservation of Dendrobium germplasm is valuable for species conservation, breeding programs and the floriculture industry. Cryopreservation represents the only safe, efficient and cost-effective long-term storage option to facilitate the conservation of genetic resources of plant species. This review highlights 16 years of literature related to the preservation of Dendrobium germplasm and comprises the most comprehensive assessment of thorough studies performed to date, which shows reliable and reproducible results. Air-drying, encapsulation-dehydration, encapsulation-vitrification, vitrification and droplet-vitrification are the current cryopreservation methodologies that have been used to cryopreserve Dendrobium germplasm. Mature seeds, pollen, protoplasts, shoot primordia, protocorms and somatic embryos or protocorm-like bodies (PLBs) have been cryopreserved with different levels of success. Encapsulation-vitrification and encapsulation-dehydration are the most used protocol, while PLBs represent the main explant explored.

Presupuestos participativos (PPs) e instituciones participativas (IPs) en Brasil: criterios (y marco) para la evaluación de experiencias y casos

This paper identifies relevant criteria for evaluation of participatory budgeting and participatory institutions that are currently adopted by governments of both Brazil and elsewhere, highlighting the importance of a comprehensive assessment that integrates all these criteria. Finally, it is recommended to pay special attention to assessing the desirability of these institutions, which are not always positively for theories on democracy

Assessment of Ergonomic Aspects in Dental Clinic Rooms

This study aimed to describe how to evaluate and quantify the ergonomic satisfaction level of dental clinics rooms. Requirements for design, production and selection of dental equipment as described in ISO/TC-106/SC-6-N-411, support more comprehensive studies for an ergonomic evaluation and ergo design of the dental workstations. It was created a checklist of ergonomics requirements which is supported by Standards ISO/FDI and acquired by mean of a literature review. According to information exposed at the document of the Ergonomics Society of Dental Ergonomics - ESDE we can consider that the elaboration of an ergonomic evaluation protocol regard to the dental workstation is an important demand for the ergonomics, particularly in relation to the performance of the ergonomic design which presents qualified to assist to dental equipment manufactures. By this means, the identification of the evaluation factors pointed in ISO/TC 106/SC 6 N 411 offers the basic information to the process of elaboration of this protocol addressed by the described general guidelines.

The Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders: recruitment, assessment instruments, methods for the development of multicenter collaborative studies and preliminary results

OBJETIVO: Descrever o recrutamento de pacientes, instrumentos de avaliação, métodos para o desenvolvimento de estudos colaborativos multicêntricos e os resultados preliminares do Consórcio Brasileiro de Pesquisa em Transtornos do Espectro Obsessivo-Compulsivo, que inclui sete centros universitários. MÉTODO: Este estudo transversal incluiu entrevistas semi-estruturadas (dados sociodemográficos, histórico médico e psiquiátrico, curso da doença e diagnósticos psiquiátricos comórbidos) e instrumentos que avaliam os sintomas do transtorno obsessivo-compulsivo (Escala para Sintomas Obsessivo-Compulsivos de Yale-Brown e Escala Dimensional para Sintomas Obsessivo-Compulsivos de Yale-Brown), sintomas depressivos (Inventário de Depressão de Beck), sintomas ansiosos (Inventário de Ansiedade de Beck), fenômenos sensoriais (Escala de Fenômenos Sensoriais da Universidade de São Paulo), juízo crítico (Escala de Avaliação de Crenças de Brown), tiques (Escala de Gravidade Global de Tiques de Yale) e qualidade de vida (questionário genérico de avaliação de qualidade de vida, Medical Outcome Quality of Life Scale Short-form-36 e Escala de Avaliação Social). O treinamento dos avaliadores consistiu em assistir cinco entrevistas filmadas e entrevistar cinco pacientes junto com um pesquisador mais experiente, antes de entrevistar pacientes sozinhos. A confiabilidade entre todos os líderes de grupo para os instrumentos mais importantes (Structured Clinical Interview for DSM-IV, Dimensional Yale-Brown Obsessive-Compulsive Scale, Universidade de São Paulo Sensory Phenomena Scale ) foi medida após seis entrevistas completas. RESULTADOS: A confiabilidade entre avaliadores foi de 96%. Até março de 2008, 630 pacientes com transtorno obsessivo-compulsivo tinham sido sistematicamente avaliados. A média de idade (±SE) foi de 34,7 (±0,51), 56,3% eram do sexo feminino e 84,6% caucasianos. Os sintomas obsessivo-compulsivos mais prevalentes foram os de simetria e os de contaminação. As comorbidades psiquiátricas mais comuns foram depressão maior, ansiedade generalizada e transtorno de ansiedade social. O transtorno de controle de impulsos mais comum foi escoriação neurótica. CONCLUSÃO: Este consórcio de pesquisa, pioneiro no Brasil, permitiu delinear o perfil sociodemográfico, clínico e terapêutico do paciente com transtorno obsessivo-compulsivo em uma grande amostra clínica de pacientes. O Consórcio Brasileiro de Pesquisa em Transtornos do Espectro Obsessivo-Compulsivo estabeleceu uma importante rede de colaboração de investigação clínica padronizada sobre o transtorno obsessivo-compulsivo e pode abrir o caminho para projetos semelhantes destinados a integrar outros grupos de pesquisa no Brasil e em todo o mundo.

Brazilian consensus on gastroesophageal reflux disease: Proposals for assessment, classification, and management

The Brazilian Consensus on Gastroesophageal Reflux Disease considers gastroesophageal reflux disease to be a chronic disorder related to the retrograde flow of gastroduodenal contents into the esophagus and/or adjacent organs, resulting in a variable spectrum of symptoms, with or without tissue damage. Considering the limitations of classifications currently in use, a new classification is proposed that combines three criteria - clinical, endoscopic, and pH-metric - providing a comprehensive and more complete characterization of the disease. The diagnosis begins with the presence of heartburn, acid regurgitation, and alarm manifestations (dysphagia, odynophagia, weight loss, GI bleeding, nausea and/or vomiting, and family history of cancer). Also, atypical esophageal, pulmonary, otorhinolaryngological, and oral symptoms may occur. Endoscopy is the first approach, particularly in patients over 40 yr of age and in those with alarm symptoms. Other exams are considered in particular cases, such as contrast radiological examination, scyntigraphy, manometry, and prolonged pH measurement. The clinical treatment encompasses behavioral modifications in lifestyle and pharmacological measures. Proton pump inhibitors in manufacturers' recommended doses are indicated, with doubling of the dose in more severe cases of esophagitis. The minimum time of administration is 6 wk. Patients who do not respond to medical treatment, including those with atypical manifestations, should be considered for surgical treatment. Of the complications of gastroesophageal reflux disease, Barrett's esophagus presents a potential development of adenocarcinoma; biopsies should be performed, independent of Barrett's esophagus extent or location. In this regard the designation short Barrett's is not important in terms of management and prognosis. © 2002 by Am. Coll. of Gastroenterology.

Performance of race instrumentation system in curved root canals: a comprehensive analysis by three study methods

In this study, curved maxillary molar root canals were instrumented with RaCe rotary system to evaluate: 1. the occurrence of canal transportation using a radiographic platform; 2. the action of the instruments on the dentin walls, centering ability and canal enlargement by analysis of digital images; and the percentage of regular dentin surfaces and debris within the canal by histological analysis. Ten mesiobuccal roots of extracted human maxillary molars were embedded in acrylic resin and sectioned at the middle and apical thirds. Root canal shaping was performed using the RaCe rotary system at 250 rpm and 1 Ncm torque. Each instrument set was used five times according to a crowndown technique in the following sequence: 40/0.10, 35/0.08, 25/0.06, 25/0.04, 25/0.02 (working length - WL), 30/0.02 (WL) and 35/0.02 (WL). Each instrument was inserted until resistance was felt and then pulled back, followed by brushing movements towards all canal walls. Each specimen was assessed by three study methods: radiographic platform, digitized image assessment and histological analysis. The radiographic platform showed lack of apical transportation. No statistically significant difference (Wilcoxon test, p>0.05) was found between the middle and apical thirds regarding instrument action on dentin walls, centering ability, area of root canal enlargement, percentage of regular dentin surfaces and debris within the root canal. It may be concluded that RaCe system is a suitable method for the preparation of curved root canals, regarding the maintenance of root canal original path, action on dentin walls, canal enlargement and removal of debris from the root canal lumen.

Integrated analysis environment for the Movement Assessment Battery for Children

Developmental Coordination Disorder (DCD), a chronic and usually permanent condition found in children, is characterized by motor impairment that interferes with a child's activities of daily living and with academic achievement. One of the most popular tests for the quantitative diagnosis of DCD is the Movement Assessment Battery for Children (MABC). Based on the Battery's standardized scores, it is possible to identify children with typical development, children at risk of developing DCD, and children with DCD. This article describes a computational system we developed to assist with the analysis of results obtained in the MABC test. The tool was developed for the web environment and its database provides integration of MABC data. Thus, researchers around the world can share data and develop collaborative work in the DCD field. In order to help analysis processes, our system provides services for filtering data to show more specific sets of information and present the results in textual, table, and graphic formats, allowing easier and more comprehensive evaluation of the results.

A comprehensive study on the phenolic profile of widely used culinary herbs and spices: Rosemary, thyme, oregano, cinnamon, cumin and bay

Herbs and spices have long been used to improve the flavour of food without being considered as nutritionally significant ingredients. However, the bioactive phenolic content of these plant-based products is currently attracting interest.In the present work, liquid chromatography coupled to high-resolution/accurate mass measurement LTQ-Orbitrap mass spectrometry was applied for the comprehensive identification of phenolic constituents of six of the most widely used culinary herbs (rosemary, thyme, oregano and bay) and spices (cinnamon and cumin). In this way, up to 52 compounds were identified in these culinary ingredients, some of them, as far as we know, for the first time. In order to establish the phenolic profiles of the different herbs and spices, accurate quantification of the major phenolics was performed by multiple reaction monitoring in a triple quadrupole mass spectrometer. Multivariate statistical treatment of the results allowed the assessment of distinctive features among the studied herbs and spices. (C) 2014 Elsevier Ltd. All rights reserved.

Modelagem do transporte de sedimentos na alta Bacia do Córrego Cachoeirinha (Rio Claro, SP) através do software Soil and Water Assessment Tool (SWAT)

This study aimed to simulate and evaluate the sediment transport in Upper Basin Stream Cachoeirinha in Rio Claro, SP, and compare the results with previous studies performed in the same basin. The modeling software used in this study was Soil and Water Assessment Tool (SWAT), which is a very comprehensive tool that discusses many physical processes. In this work, the hydrosedimentological processes were treated, aiming to understand the sediment production and transport. The Basin Stream Cachoeirinha has an area with predominantly agricultural use, especially sugar cane. The database for inclusion in software was constructed from the following elements: climatic, topographical, soil type and use and land cover of the area, also including the parameters of Modified Universal Soil Loss Equation (MUSLE). The analysis was conducted for a period of 16 years (1994-2010), which is the range of data available from CEAPLA. The results were analyzed in terms of annual runoff and sediment yield. The average sediment delivery in the simulation was 0.94 t/ha/year, while the maximum annual contribution was 7.28 t/ha/year