Mortes por Asfixias com Alimentos em Crianças: Aspectos Médico Legais da Sufocação Direta por Engasgamento

The asphyxia by suffocation (choking) with foreign bodies are dramatic. Among these, the choking with food are responsible for most of these deaths. Children under four years old are particularly vulnerable due to not having a well-developed posterior dentition. The paper presents the report of two cases of suffocation with food and discusses some legal medical concepts, warning of the further prevention of such cases.

Australian Clinical Psychology Training Program Directors Survey

A survey of clinical psychology program directors was conducted to provide an illustrative snapshot of clinical training in Australia. Postgraduate clinical psychology program directors from 27 universities in all States in Australia and the Australian Capital Territory offering postgraduate clinical training programs were emailed the survey; 19 surveys were returned. The present paper reports on a range of issues of relevance to clinical training programs, including numbers of students, types and content of courses, staff workload, relationship with professional bodies, practical training and university-based clinics, and concerns raised by directors. The information is intended to assist those responsible for training in clinical psychology in Australia in their work of increasing the quality of postgraduate training by being informed of the practices of other programs.

Expressão geofísica-estrutural do lineamento transbrasiliano na porção central da Bacia do Parnaíba (Maranhão-Piauí)

The objective of this study was to characterize the structural-geophysical expression of the Transbrasiliano Lineament (TBL) in the east-central portion of the Parnaíba Basin. The TBL corresponds to a major Neoproterozoic NE-trending shear zone related to the Brasiliano orogenic cycle, with dextral strike-slip kinematics, underlying (but also laterally exposed in the NE and SW basin edges) the sedimentary section of the Parnaíba Basin. In this study, the interpretation of gravity and magnetic anomaly maps is consistent with the TBL kinematics, the signature of the geophysical anomalies corresponding to the high (plastic behaviour) and subsequent declining temperature (ductile to brittle behaviour) stages during Brasiliano and late Brasiliano times. The pattern of residual gravity anomalies is compatible with an S-C dextral pair shaping the geological bodies of an heterogeneous basement, such as slices of gneisses and granulites (positive anomalies), granitic and low-medium grade metasedimentary rocks (negative anomalies). Such anomalies curvilinear trends, ranging from NNE (interpreted as S surfaces) to NE (C surfaces), correspond to flattening surfaces (S), while the NE rectilinear trend must represent a C band. The narrower magnetic anomalies also display NNE to NE (S surfaces) trends and should correspond to similar (although narrower and more discontinuous) sources in the equivalent anomaly patterns. Pre-Silurian pull-apart style grabens may contribute to the NE negative gravimetric anomalies, although this interpretation demands control by seismic data analysis. On the other hand, the curvilinear anomalies associated to contractional trends are incompatible with their interpretation as pre-Silurian graben, in both maps. In the (reduced to the pole) magnetic anomalies map, most of these are again associated to low-temperature shear zones (C planes) and faults, juxtaposing distinct blocks in terms of magnetic properties, or eventually filled with basic bodies. It is also possible that some isolated magnetic anomalies correspond to igneous bodies of late-Brasiliano or Mesozoic age. The basement late discontinuities pattern can be interpreted in analogy to the Riedel fractures model, with steep dipping surfaces and a sub-horizontal movement section. This study also explored 2D gravity modeling controlled by the interpretation of a dip seismic line as regards to the Transbrasiliano Lineament. The rock section equivalent to the Jaibaras Group occupying a graben structure (as identified in the seismic line) corresponds to a discrete negative anomaly superimposed to a gravimetric high, once again indicating a stronger influence of older crystalline basement rocks as gravimetric sources, mainly reflecting the heterogeneities and anisotropies generated at high temperature conditions and their subsequent cooling along the TBL, during the Brasiliano cycle.

Expressão geofísica-estrutural do lineamento transbrasiliano na porção central da Bacia do Parnaíba (Maranhão-Piauí)

The objective of this study was to characterize the structural-geophysical expression of the Transbrasiliano Lineament (TBL) in the east-central portion of the Parnaíba Basin. The TBL corresponds to a major Neoproterozoic NE-trending shear zone related to the Brasiliano orogenic cycle, with dextral strike-slip kinematics, underlying (but also laterally exposed in the NE and SW basin edges) the sedimentary section of the Parnaíba Basin. In this study, the interpretation of gravity and magnetic anomaly maps is consistent with the TBL kinematics, the signature of the geophysical anomalies corresponding to the high (plastic behaviour) and subsequent declining temperature (ductile to brittle behaviour) stages during Brasiliano and late Brasiliano times. The pattern of residual gravity anomalies is compatible with an S-C dextral pair shaping the geological bodies of an heterogeneous basement, such as slices of gneisses and granulites (positive anomalies), granitic and low-medium grade metasedimentary rocks (negative anomalies). Such anomalies curvilinear trends, ranging from NNE (interpreted as S surfaces) to NE (C surfaces), correspond to flattening surfaces (S), while the NE rectilinear trend must represent a C band. The narrower magnetic anomalies also display NNE to NE (S surfaces) trends and should correspond to similar (although narrower and more discontinuous) sources in the equivalent anomaly patterns. Pre-Silurian pull-apart style grabens may contribute to the NE negative gravimetric anomalies, although this interpretation demands control by seismic data analysis. On the other hand, the curvilinear anomalies associated to contractional trends are incompatible with their interpretation as pre-Silurian graben, in both maps. In the (reduced to the pole) magnetic anomalies map, most of these are again associated to low-temperature shear zones (C planes) and faults, juxtaposing distinct blocks in terms of magnetic properties, or eventually filled with basic bodies. It is also possible that some isolated magnetic anomalies correspond to igneous bodies of late-Brasiliano or Mesozoic age. The basement late discontinuities pattern can be interpreted in analogy to the Riedel fractures model, with steep dipping surfaces and a sub-horizontal movement section. This study also explored 2D gravity modeling controlled by the interpretation of a dip seismic line as regards to the Transbrasiliano Lineament. The rock section equivalent to the Jaibaras Group occupying a graben structure (as identified in the seismic line) corresponds to a discrete negative anomaly superimposed to a gravimetric high, once again indicating a stronger influence of older crystalline basement rocks as gravimetric sources, mainly reflecting the heterogeneities and anisotropies generated at high temperature conditions and their subsequent cooling along the TBL, during the Brasiliano cycle.

Desistance from Sexual Offending: Do the Mainstream Theories Apply?

The literature on desistance from crime has become well established in recent years with strong bodies of evidence supporting the role of factors such as employment, relationships and identity change in this process. However, the relevance of this literature to individuals convicted of sexual crimes is not known as such individuals are almost always excluded from this research. This article presents the results from one of the first empirical studies on desistance from sexual offending based on 32 in-depth life story interviews with adult males previously convicted of child sex offences. In this analysis we explore the significance of work, the role of relationships, and changes in imagined selves in the self-identities of individuals successfully desisting from sexual offending. The findings provide support for all three factors in helping to sustain desistance from sex offending, but also suggest clear differences between desistance from sex offending and other types of crime in these regards.

Trust, confidence, and equity affect the legitimacy of natural resource governance

Social-ecological systems are often highly complex, making effective governance a considerable challenge. In large, heterogeneous systems, hierarchical institutional regimes may be efficient, but effective management outcomes are dependent on stakeholder support. This support is shaped by perceptions of legitimacy, which risks being undermined where resource users are not engaged in decision-making. Although legitimacy is demonstrably critical for effective governance, less is known about the factors contributing to stakeholders’ perceptions of legitimacy or how these perceptions are socially differentiated. We quantitatively assessed stakeholder perceptions of legitimacy (indicated by support for rules) and their contributory factors among 307 commercial fishers and tourism operators in Australia’s Great Barrier Reef Marine Park. Legitimacy was most strongly associated with trust in information from governing bodies, followed by confidence in institutional performance and the equity of management outcomes. Legitimacy differed both within and among resource user groups, which emphasizes the heterogeneous nature of commonly defined stakeholder groups. Overall, tourism operators perceived higher legitimacy than did commercial fishers, which was associated with higher trust in information from management agencies. For fishers, higher levels of trust were associated with: (1) engagement in fisheries that had high subsector cohesion and positive previous experiences of interactions with governing bodies; (2) location in areas with greater proximity to sources of knowledge, resources, and decision-making; and (3) engagement in a Reef Guardian program. These findings highlight the necessity of strategies and processes to build trust among all user groups in large social-ecological systems such as the Great Barrier Reef Marine Park. Furthermore, the social differentiation of perceptions that were observed within user groups underscores the importance of targeted strategies to engage groups that may not be heard through traditional governance channels.

Exploring the Impact of a Difficult Breastfeeding Experience on Maternal Identity: A Narrative Analysis

Introduction: Due to the implied health benefits for mother and baby, breastfeeding has become a key public health issue. Literature reviewed highlighted the ‘medical’ and ‘natural’ mother discourse which surrounds motherhood and impacts on women’s decisions to breastfeed. Whilst the emotional and physical strains of a difficult experience have been explored, it is unclear how these experiences impact on women’s identities as mothers and in what ways women are able to narrate and share their embodied experiences. Methods: Seven first time mothers who described themselves as having had a difficult breastfeeding experience were interviewed to gather data pertaining to how mothers construct narratives of breastfeeding and the impact of these narratives on their identity as mothers. An interest in both socio-political discourse and embodiment theory derived from the literature review led to the use of visual methods in eliciting narratives and the employment of a critical narrative analysis in exploring the data gathered. Findings: The participants’ narratives drew from ‘medical’ and ‘natural’ mother discourses and were found to constrain subjective experience and leave participants with feelings of guilt, frustration and loss. A prevailing assumption that unruly, excessive bodies must be controlled by a rational ‘mind’ led to the body becoming a site for control and resistance for participants as they attempted to conform to norms of motherhood and breastfeeding. Discussion: Results identified the ways in which women as mothers can see their subjective experiences diminished and their voices silenced due to a lack of available discourse and entrenched ideologies surrounding the ‘good’ mother. It is suggested that adopting a social justice agenda within therapeutic practice might prevent the internalisation of oppressive discourse which can lead to mothers’ psychological distress. Moreover, it is suggested that exploring the body in therapy might resist a mind/body dualism and lead to increasingly compassionate and accepting relationships with our bodies; in turn increasing awareness of subjective experience.

Développement et expérimentation d'algorithmes de réorientation pour un robot sériel en chute libre

Ce mémoire présente 2 types de méthodes pour effectuer la réorientation d’un robot sériel en chute libre en utilisant les mouvements internes de celui-ci. Ces mouvements sont prescrits à partir d’algorithmes de planification de trajectoire basés sur le modèle dynamique du robot. La première méthode tente de réorienter le robot en appliquant une technique d’optimisation locale fonctionnant avec une fonction potentielle décrivant l’orientation du système, et la deuxième méthode applique des fonctions sinusoïdales aux articulations pour réorienter le robot. Pour tester les performances des méthodes en simulation, on tente de réorienter le robot pour une configuration initiale et finale identiques où toutes les membrures sont alignées mais avec le robot ayant complété une rotation de 180 degrés sur lui-même. Afin de comparer les résultats obtenus avec la réalité, un prototype de robot sériel plan flottant possédant trois membrures et deux liaisons rotoïdes est construit. Les expérimentations effectuées montrent que le prototype est capable d’atteindre les réorientations prescrites si peu de perturbations extérieures sont présentes et ce, même si le contrôle de l’orientation est effectué en boucle ouverte.

Processo de transição da pessoa estomizada da depêndencia de cuidado ao autocuidado: subsídios à enfermagem

Objetivou-se conhecer como a pessoa com estomia vivência o processo de transição da dependência de cuidados ao autocuidado à luz da Teoria das Transições de Meleis. Pesquisa exploratória, descritiva com abordagem qualitativa no Serviço de Estomaterapia do Hospital Universitário Dr Miguel Riet Corrêa Jr do Rio Grande/ RS/ Brasil com 27 pessoas com estomias definitivas por câncer. Os dados foram coletados nos mês de janeiro e fevereiro de 2014 por meio de entrevista com roteiro semiestruturado e submetidos à Análise de Conteúdo apoiada nas ideias da Teoria das Transições de Afaf I. Meleis. Constatou-se que a natureza da transição situou-se no processo tipo saúde/doença. A entrada no processo de transição deu-se a partir da consciência desencadeada pelo diagnóstico de câncer, reforçado pela cirurgia de estomização. O empenhamento surge ao dedicarem-se a construção do conhecimento para o autocuidado frente às mudanças na sua vida e na sua nova relação com seu corpo, mudando a visão de si, do mundo e dos outros. Destacou-se o espaço temporal como algo dinâmico e variavelmente indeterminável, sendo fundamental para que se organizem e reflitam acerca do seu novo viver, fortalecendo-se para que a transição progrida. Verificaram-se como fatores facilitadores do autocuidado a construção de um significado positivo à estomização, o preparo dessa experiência ainda no pré-operatório, a estabilidade emocional, a fé e a religiosidade e a sensação de normalidade adquirida a partir de uma imagem próxima da anterior. Referiram-se, ainda, ao fornecimento de forma gratuita pelo governo das bolsas coletoras, adjuvantes e acessórios e ao atendimento da equipe multiprofissional. Como fatores inibidores do processo de transição encontraram-se a visão distorcida de seu corpo, o despreparo para viver com a estomia, a instabilidade emocional, a desmotivação com afastamento de atividades prazerosas, o cuidado excessivo e/ou estendido e até mesmo a superproteção da família, as complicações como hérnias e prolapsos, a falta de atitudes positivas quanto à vida, a negação da bolsa coletora, as tentativas frustradas de omitir o uso da bolsa coletora, a falta do domínio do manuseio dos equipamentos, o afastamento do trabalho e as dificuldades financeiras. Além destas, o abandono do parceiro, atitudes negativas e estigmatizantes por parte da família e a baixa qualidade dos materiais fornecidos pelo governo. Como indicadores de resultados identificaram-se a confiança para realizar atividades anteriores, aceitação de sua situação, uma visão positiva de sua vida e da capacidade de compartilhar o seu cuidado com sua família. Considera-se a saída da transição quando este for capaz de dominar novas competências tanto para o cuidado físico ao realizar a troca da bolsa coletora quanto readequando sua imagem e autoconceito. Concluiu-se que o processo de transição da dependência de cuidados ao autocuidado da pessoa com estomia é complexo e carregado de subjetividades. É necessário que o enfermeiro estabeleça ações terapêuticas de enfermagem eficazes e eficientes, contribuindo para a promoção e reabilitação da saúde deste, auxiliando-o na aquisição de sua autonomia e independência, subsidiando seu autocuidado e bem-estar.

Erosão dentária associada a distúrbios alimentares

Os distúrbios alimentares traduzem-se em comportamentos, quer pela falta, quer pelo excesso da ingestão de alimentos, sendo a anorexia nervosa e a bulimia as que mais frequentemente se verificam na população. O crescente aumento destes distúrbios, nomeadamente a obsessão pelos corpos magros, está relacionada com o impacto que os media têm na sociedade, uma vez que a magreza é vista como mecanismo de atracção sexual e de integração social. O diagnóstico das desordens alimentares não é fácil de ser efectuado, dado que os sinais são muitas vezes omitidos/ocultados pelos indivíduos. Os médicos dentistas podem ter um papel importante na sua detecção, dadas as manifestações precoces das alterações alimentares na cavidade oral. Há diversos sintomas comuns aos dois distúrbios alimentares como a erosão dentária, a hipersensibilidade dentinária, a hipertrofia das glândulas salivares e consequente hipossalivação, a cárie dentária, a doença periodontal, as mucosites, a candidíase oral e a queilite angular. Resultante do vómito induzido, há o aporte de ácido proveniente do conteúdo gástrico que induz alterações estruturais do esmalte e dentina, facilitando o processo de desgaste erosivo. Os fenómenos erosivos são uma das manifestações orais mais evidentes dos distúrbios alimentares. O conhecimento dos sinais, sintomas e da forma de evolução da erosão dentária, é imprescindível, e acaba por diferenciar a atuação profissional que possibilita um diagnóstico eficaz e o tratamento correto. A elaboração desta dissertação tem como objectivo reforçar a informação sobre estes fenómenos para que possam ser mais eficazmente prevenidos, diagnosticados e controlados/tratados. Para tal efectuou-se uma pesquisa na B-On, Medline/PubMed, sciELO, RCAAP e em livros, de informação válida sobre o tema. Interpôs-se limitação temporal e usaram-se as seguintes palavras-chave na seleção de artigos: “Dental erosion”, “Erosive wear”, “Anorexia”, “Bulimia”, “Eating disorders”.

Corpos diferenciados e o processo de criação da performance Kahlo em Mim Eu E(m) Kahlo

The dissertation intends to develop an investigation on the artistic existence in human beings with different bodies in society at different historical moments. In this regard and based on this scenario, the study develops a description of the stigmas production and how they are established, spread and interfere with the sociability among human beings regarded as normal and those with different bodies. Regarding the scenic arts, the text describes about the participation of artists with different bodies in the scene, specifically the freak show and postdramatic theater. The text also investigates aspects of the biography and the work of mexican artist Frida Kahlo, which underpin methodological proceedings and produce contribution to the creative process of performance Kahlo em mim Eu e(m) Kahlo , which is to investigate the practice of the scene in this dissertation

O encontro no teatro: Em redor das noções de “momento presente” e “momento de encontro”

Este trabalho tem como objectivo explorar a metodologia de preparação do actor, centrada nas teorias teatrais do teatro de encontro/contacto, à luz da teoria do momento presente e do momento de encontro. A investigação consiste num estudo exploratório de caso que pretende compreender e aprofundar as proximidades existentes entre as teorias teatrais e psicológicas do encontro. Partindo de uma reflexão teórica pretendeu-se responder a algumas das questões levantadas, através de uma pesquisa junto de um grupo de actores. Para isso procurou-se perceber a possibilidade de identificar e caracterizar “momentos de encontro” durante o treino e desempenho dos actores. Em paralelo procurou-se indagar, sobre o eventual efeito de facilitação do crescimento pessoal das técnicas de preparação de actor identificadas. As temáticas desta investigação foram exploradas através de uma entrevista semi-dirigida Este estudo de caso contou com a participação de três actores de teatro universitário, do dISPArteatro, com pelo menos 2 anos de frequência do grupo. Na prática do grupo foram encontradas as aproximações sugeridas entre as concepções de uma preparação do actor através do contacto e as características do momento presente/momento de encontro. Todos os actores experienciaram mudanças na sua vida pessoal, nas áreas investigadas (relação com o corpo, relação consigo mesmos e relação com os outros). O processo foi sentido pelos actores como um crescimento pessoal e no global mencionam que se sentem mais capazes de viver o momento, o aqui-e-agora e que procuram mais relacionamentos com maior nível de intimidade e partilha.

Corpos diferenciados e o processo de criação da performance Kahlo em Mim Eu E(m) Kahlo

The dissertation intends to develop an investigation on the artistic existence in human beings with different bodies in society at different historical moments. In this regard and based on this scenario, the study develops a description of the stigmas production and how they are established, spread and interfere with the sociability among human beings regarded as normal and those with different bodies. Regarding the scenic arts, the text describes about the participation of artists with different bodies in the scene, specifically the freak show and postdramatic theater. The text also investigates aspects of the biography and the work of mexican artist Frida Kahlo, which underpin methodological proceedings and produce contribution to the creative process of performance Kahlo em mim Eu e(m) Kahlo , which is to investigate the practice of the scene in this dissertation

Role of nuclear redox control, intra-population heterogeneity and oxygen tension in human amniotic fluid stem cells aging

Amniotic fluid stem cells (hAFSC) are emerging as a potential therapeutic approach for various disorders. The low number of available hAFSC requires their ex vivo expansion prior to clinical use, however, during their in vitro culture, hAFSC quickly reach replicative senescence. The principal aim of this study was to investigate the aging process occurring during in vitro expansion of hAFSC, focusing on the redox control that has been reported to be affected in premature and physiological aging. My results show that a strong heterogeneity is present among samples that reflects their different behaviour in culture. I identified three proteins, namely Nox4, prelamin A and PML, which expression increases during hAFSC aging process and could be used as new biomarkers to screen the samples. Furthermore, I found that Nox4 degradation is regulated by sumoylation via proteasome and involves interactions with PML bodies and prelamin A. Since various studies revealed that donor-dependent differences could be explained by cell-to-cell variation within each patient, I studied in deep this phenomenon. I showed that the heterogeneity among samples is also accompanied by a strong intra-population heterogeneity. Separation of hAFSC subpopulations from the same donor, using Celector® technology, showed that an enrichment in the last eluted fraction could improve hAFSC application in regenerative medicine. One of the other problems is that nowadays hAFSC are expanded under atmospheric O2 concentration, which is higher than the O2 tension in their natural niches. This higher O2 concentration might cause environmental stress to the in vitro cultured hAFSCs and accelerate their aging process. Here, I showed that prolonged low oxygen tension exposure preserves different hAFSC stemness properties. In conclusion, my study pointed different approaches to improve in vitro hAFSC expansion and manipulation with the purpose to land at stem cell therapy.

The development of professional guidelines for the eye examination of people with dementia

Recently published guidelines��in the UK��relating to sight tests among people with dementia go some of the way to addressing the specific needs of this group. However, there is still a long way to go in terms of improving the provision of eye care services and optimising the visual health of this group.A��study, published by the Thomas Pocklington Trust,��which examines this subject - The development of professional guidelines for the eye examination of people with dementia - was presented at the first ever national “Dementia and Sight Loss conference” in London (1st December) - a forum where 100 dementia and sight loss professionals met to discuss ways to tackle the challenge of concurrent dementia and sight loss. The study, by researchers at the University of Bradford Schools of Optometry and Health Studies, reviewed procedures for sight tests and eye examinations among those with dementia. It found that policy and practice were hampered by a serious lack of basic research into concurrent dementia and sight loss and prompted recommendations which could lead to improved procedures, tools and techniques.Recommendations prompted by the study outline seven steps towards improving policy and practice:Conduct a systematic study of the availability and uptake of sight tests among people with dementia. Set up a website for people with dementia and their carers with information on how dementia affects eye health, and the importance of eye examinations. Develop education and training for optometrists and care home staff. Compile a list of optometrists experienced in providing eye care for people with dementia. Develop a template for recording the results of eye examinations in people with dementia – something which can be endorsed by professional bodies and made available to care homes. Measure the effectiveness of eye care, such as sight tests and cataract removals, on the quality of life of people with dementia. Research clinical testing methods so that guidelines can be strengthened. Measuring contrast sensitivity, for example, in someone with dementia could be vital as an inability to judge contrasts can make daily tasks impossible.To access the discussion paper please follow this link: The development of professional guidelines for the eye examination of people with dementia ��