Medical conditions and body pain in patients presenting orofacial pain

OBJETIVO: Verificar a frequência de problemas médicos autorrelatados e a frequência de áreas de dor no corpo em pacientes com dor orofacial, comparando-os a pacientes submetidos a tratamento odontológico de rotina. MÉTODOS: Os dados foram coletados dos arquivos da Clínica de Dor Orofacial (Grupo A, n=319) e de clínicas de tratamento odontológico rotineiro (Grupo B, n=84) da Faculdade de Odontologia de Araraquara, São Paulo, Brasil. Os indivíduos responderam a questionários e preencheram um mapa corporal indicando os locais de dor. RESULTADOS: O teste de Mann-Whitney demonstrou que o Grupo A apresentou uma média de relatos de problemas médicos superior ao Grupo B (p=0,004). Para ambos os grupos, o teste de correlação de Pearson demonstrou correlação positiva entre os problemas médicos e a frequência de áreas dolorosas (respectivamente, 0,478, p=0,001 e 0,246, p=0,000). CONCLUSÕES: O Grupo A relatou maior número de problemas médicos e houve correlação positiva entre a frequência desses problemas e a de áreas de dor para ambos os grupos.

Is the environmental policies procedures a barrier to development of inland navigation and port management? A case of study in Brazil

The main objective of this article is to discuss the Brazilian environmental legislation and policies towards the development of navigation and port management. The research illustrated some difficulties faced by the country and make suggestions to overcome it. The construction of the environmental legal framework began in the early 1960s and resulted in a very complex system, as a consequence of policies adopted by the country. Nowadays Brazilian environmental policies are developed in democratic and participative way, although with elevated degree of bureaucracy and lack of integration among the several governmental agencies, which makes the approval of environmental certifications demand several years for new port projects or improvements, which delays the economic development of the country. Efforts have been made to simplify the licensing process. As result of this research two flowchart for environmental licenses of ports installation are shown: The first shows the process until 2009 and the second shows the process nowadays. This become an important issue due the fact that inland navigation is one of the less pollutant modes of transportation, and although, the process of environmental certification was simplified, if compare with 2009, it is still complex and time-consuming, delaying the development of the infrastructure. © 2012 Elsevier Ltd.

Acquisition of suture skills during medical graduation by instructor-directed training: A randomized controlled study comparing senior medical students and faculty surgeons

Due to shortage of time and limited availability of faculty surgeons to teach basic surgical skills during medical graduation, the search for alternative ways of simulated training with feedback is needed. The purpose of this study was to compare the simulated teaching of suture skills to novice medical students by senior medical students and by experienced faculty surgeons. Forty-eight novice medical students were randomly assigned to three practice conditions on bench model (n = 16): self-directed suture training (control), senior medical student-directed suture skills' training, or experienced faculty surgeon-directed suture skills' training. Pre- and post-tests were applied. Global Rating Scale with blinded evaluation and self-perceived confidence based on Likert scale were used to assess all suture performances in pre- and post-training. Effect size was also calculated. The analysis made after training showed that the students who received feedback from the instructors had better performance based on the Global Rating Scale (all p < 0.0000) and felt more confident to carry out sutures (all p < 0.0000) when compared to the control. There was no significant difference (all p > 0.05) between the student-directed teaching and faculty-directed teaching groups. The magnitude of the effect (instructor-directed training suture) was considered large (>0.80) in all measurements. The acquisition of suture skills after student-directed training was similar to the training supervised by faculty surgeon, and the increase in suture performances of trainees that received instructor administered training was superior to self-directed learning. © 2013 Springer-Verlag Italia.

Site Selection for Restoration Planning: A Protocol With Landscape and Legislation Based Alternatives

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Painful procedures and analgesia in the NICU: what has changed in the medical perception and practice in a ten-year period?

To compare the use of analgesia versus neonatologists' perception regarding analgesic use in painful procedures in the years 2001, 2006, and 2011. This was a prospective cohort study of all newborns admitted to four university neonatal intensive care units (NICUs) during one month in 2001, 2006, and 2011. The frequency of analgesic prescription for painful procedures was evaluated. Of the 202 neonatologists, 188 answered a questionnaire giving their opinion on the intensity of pain during lumbar puncture (LP), tracheal intubation, mechanical ventilation (MV), and postoperative period (PO) using a 10-cm visual analogic scale (VAS; pain >3cm). For LP, 12% (2001), 43% (2006), and 36% (2011) were performed using analgesia. Among the neonatologists, 40-50% reported VAS >3 for LP in all study periods. For intubation, 30% received analgesia in the study periods, and 35% (2001), 55% (2006), and 73% (2011) of the neonatologists reported VAS >3 and would prescribe analgesia for this procedure. As for MV, 45% (2001), 64% (2006), and 48% (2011) of patient-days were under analgesia; 56% (2001), 57% (2006), and 26% (2011) of neonatologists reported VAS >3 and said they would use analgesia during MV. For the first three PO days, 37% (2001), 78% (2006), and 89% (2011) of the patients received analgesia and more than 90% of neonatologists reported VAS >3 for major surgeries. Despite an increase in the medical perception of neonatal pain and in analgesic use during painful procedures, the gap between clinical practice and neonatologist perception of analgesia need did not change during the ten-year period.

An hydrochemical answer to a legislative demand involving health risk related to water quality

Effluents and surface waters around an area involved with the inking of tissues at Itatiba municipality, São Paulo State, Brazil, were chemically analyzed with the purpose of evaluating the influence on the water quality of the chemicals released, as well to provide answers to legislative requirements related to the São Paulo State Register 997 published on 31 May 1976.

Chronological Monte Carlo-based assessment of distribution system reliability

Regulatory authorities in many countries, in order to maintain an acceptable balance between appropriate customer service qualities and costs, are introducing a performance-based regulation. These regulations impose penalties, and in some cases rewards, which introduce a component of financial risk to an electric power utility due to the uncertainty associated with preserving a specific level of system reliability. In Brazil, for instance, one of the reliability indices receiving special attention by the utilities is the Maximum Continuous Interruption Duration per customer (MCID). This paper describes a chronological Monte Carlo simulation approach to evaluate probability distributions of reliability indices, including the MCID, and the corresponding penalties. In order to get the desired efficiency, modern computational techniques are used for modeling (UML -Unified Modeling Language) as well as for programming (Object- Oriented Programming). Case studies on a simple distribution network and on real Brazilian distribution systems are presented and discussed. © Copyright KTH 2006.

Qualidade da água utilizada para irrigação de hortaliças na região de Botucatu-SP

This work had as objective verifies the water quality used for irrigation by the vegetables producers of Botucatu-SP area. They were interviewed 27 producers that sell vegetables in the street markets of Botucatu. Among these producers, ten were selected, being one of each place. Three samples of water of each source were collected. The main standard to evaluate the obtained results were the CONAMA Resolution (National Environment Council) N° 357, March 17, 2005, that it establishes the standard for water classification. The Electric Conductivity was evaluated of agreement value suggested by CETESB and the color was verified according to OMS (Health World Organization), for potable water due to CONAMA Resolution not to stipulate a value for classification. For the public health, just the coliformes and nitrate are the preoccupying variables for they be related with the incidence of diseases, so, the analyzed waters, 40% of them (A, F, H and J producers) offer some risk for the health of Botucatu population, second established standard for CONAMA. We can to conclude that in a general way, those waters, are in conditions no alarming, because they don't present values very different from those established by the legislation.

Risk-assessment algorithm and recommendations for venous thromboembolism prophylaxis in medical patients

The risk for venous thromboembolism (VTE) in medical patients is high, but risk assessment is rarely performed because there is not yet a good method to identify candidates for prophylaxis. Purpose: To perform a systematic review about VTE risk factors (RFs) in hospitalized medical patients and generate recommendations (RECs) for prophylaxis that can be implemented into practice. Data sources: A multidisciplinary group of experts from 12 Brazilian Medical Societies searched MEDLINE, Cochrane, and LILACS. Study selection: Two experts independently classified the evidence for each RF by its scientific quality in a standardized manner. A risk-assessment algorithm was created based on the results of the review. Data synthesis: Several VTE RFs have enough evidence to support RECs for prophylaxis in hospitalized medical patients (eg, increasing age, heart failure, and stroke). Other factors are considered adjuncts of risk (eg, varices, obesity, and infections). According to the algorithm, hospitalized medical patients ≥40 years-old with decreased mobility, and ≥1 RFs should receive chemoprophylaxis with heparin, provided they don't have contraindications. High prophylactic doses of unfractionated heparin or low-molecular-weight-heparin must be administered and maintained for 6-14 days. Conclusions: A multidisciplinary group generated evidence-based RECs and an easy-to-use algorithm to facilitate VTE prophylaxis in medical patients. © 2007 Rocha et al, publisher and licensee Dove Medical Press Ltd.

Land parceling and neighborhood impacts in Brazil

The proposal and implementation of parceling real estate into smaller lots in Brazil is done according to legal and technical formalities. However, these instruments have proved inefficient in reducing the resulting environmental impacts. The ambiguities of the federal, state and municipal laws and regulations have limited the effectiveness of the actions of urban administrators. Law 10257/2001 emerged as an alternative to overcome these difficulties, proposing the adoption of neighborhood impact studies as an instrument to evaluate new proposals of urban occupation for purposes of environmental licensing. Thus, the purpose of this law is to provide the foundations for municipal public authorities to establish criteria for the assessment, mitigation and compensation of impacts resulting from new occupations. However, the very vagueness of the generic nature of this federal law and its incorrect application in the municipal sphere has posed the greatest obstacles to the good use of this instrument of urban environmental management. These deficiencies are classified herein in the categories of philosophical, technical and operational problems. The problems of a philosophical nature lead to technical difficulties, which in turn trigger operational deficiencies. This article discusses these deficiencies and points out ways to reduce them. © 2009 Journal of Urban and Environmental Engineering (JUEE). All rights reserved.

Pension legislation for federal public servants in Brazil

This paper addresses the creation of pension funds for federal civil servants in Brazil, analyzing the existing legislation and regulation on this issue. To this end, it takes off based on the genesis of the Brazilian private pension plans, logging the emergence of private funds as well as the existence of various laws and constitutional amendments prior to Law 12.618/2012, which provided for the pension funds system for Brazilian federal public servants. It also identifies proponents and opponents to the Foundation for Pension Funds of Federal Civil Servants (FUNPRESP), signaling the discursive construction of the pension fund schemes as central character in contemporary welfare capitalism. Finally, presents controversial aspects of the new pension fund law developments in Brazil.

Obsessive-compulsive symptoms in medical students: prevalence, severity, and correlates

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)