Teaching the Rational Use of Medicines to medical students: a qualitative research

Background: Prescribing is a complex and challenging task that must be part of a logical deductive process based on accurate and objective information and not an automated action, without critical thinking or a response to commercial pressure. The objectives of this study were 1) develop and implement a discipline based on the WHO's Guide to Good Prescribing; 2) evaluate the course acceptance by students; 3) assess the impact that the Rational Use of Medicines (RUM) knowledge had on the students habits of prescribing medication in the University Hospital.Methods: In 2003, the RUM principal, based in the WHO's Guide to Good Prescribing, was included in the official curriculum of the Botucatu School of Medicine, Brazil, to be taught over a total of 24 hours to students in the 4th year. We analyzed the students' feedback forms about content and teaching methodology filled out immediately after the end of the discipline from 2003 to 2010. In 2010, the use of RUM by past students in their medical practice was assessed through a qualitative approach by a questionnaire with closed-ended rank scaling questions distributed at random and a single semistructured interview for content analysis.Results: The discipline teaches future prescribers to use a logical deductive process, based on accurate and objective information, to adopt strict criteria (efficacy, safety, convenience and cost) on selecting drugs and to write a complete prescription. At the end of it, most students considered the discipline very good due to the opportunity to reflect on different actions involved in the prescribing process and liked the teaching methodology. However, former students report that although they are aware of the RUM concepts they cannot regularly use this knowledge in their daily practice because they are not stimulated or even allowed to do so by neither older residents nor senior medical staff.Conclusions: This discipline is useful to teach RUM to medical students who become aware of the importance of this subject, but the assimilation of the RUM principles in the institution seems to be a long-term process which requires the involvement of a greater number of the academic members.

Postural control in Down syndrome: the use of somatosensory and visual information to attenuate body sway

The purpose of this study was to examine the effects of visual and somatosensory information on body sway in individuals with Down syndrome (DS). Nine adults with DS (19-29 years old) and nine control subjects (CS) (19-29 years old) stood in the upright stance in four experimental conditions: no vision and no touch; vision and no touch; no vision and touch; and vision and touch. In the vision condition, participants looked at a target placed in front of them; in the no vision condition, participants wore a black cotton mask. In the touch condition, participants touched a stationary surface with their right index finger; in the no touch condition, participants kept their arms hanging alongside their bodies. A force plate was used to estimate center of pressure excursion for both anterior-posterior and medial-lateral directions. MANOVA revealed that both the individuals with DS and the control subjects used vision and touch to reduce overall body sway, although individuals with DS still oscillated more than did the CS. These results indicate that adults with DS are able to use sensory information to reduce body sway, and they demonstrate that there is no difference in sensory integration between the individuals with DS and the CS.

Antimicrobial activity of Calendula officinalis, Camellia sinensis and chlorhexidine against the adherence of microorganisms to sutures after extraction of unerupted third molars

Objective: The objective of this study was to compare the antimicrobial effect of mouthwashes containing Calendula officinalis L., Camellia sinensis (L.) Kuntze and 0.12% chlorhexidine digluconate on the adherence of microorganisms to suture materials after extraction of unerupted third molars. Material and Methods: Eighteen patients with unerupted maxillary third molars indicated for extraction were selected (n=6 per mouthwash). First, the patients were subjected to extraction of the left tooth and instructed not to use any type of antiseptic solution at the site of surgery (control group). After 15 days, the right tooth was extracted and the patients were instructed to use the Calendula officinalis, Camellia sinensis or chlorhexidine mouthwash during 1 week (experimental group). For each surgery, the sutures were removed on postoperative day 7 and placed in sterile phosphate-buffered saline. Next, serial dilutions were prepared and seeded onto different culture media for the growth of the following microorganisms: blood agar for total microorganism growth; Mitis Salivarius bacitracin sucrose agar for mutans group streptococci; mannitol agar for Staphylococcus spp.; MacConkey agar for enterobacteria and Pseudomonas spp., and Sabouraud dextrose agar containing chloramphenicol for Candida spp. The plates were incubated during 24-48 h at 37 degrees C for microorganism count (CFU/nnL). Results: The three mouthwashes tested reduced the number of microorganisms adhered to the sutures compared to the control group. However, significant differences between the control and experimental groups were only observed for the mouthwash containing 0.12% chlorhexidine digluconate. Conclusions: Calendula officinalis L. and Camellia sinensis (L.) Kuntze presented antimicrobial activity against the adherence of microorganisms to sutures but were not as efficient as chlorhexidine digluconate.

Structural analyzes of the use of residues of tires in reinforced concrete

The search for an adequate destination to the tires without use is a problem for many countries. The use of tire rubber in concrete through the partial substitution of the small aggregate has for objective the withdrawal of this material of the environment besides serving as alternative material in places that present sand scarcity. However, to use this type of concrete in civil construction it's necessary to verify its structural behavior. The behavior of the adherence enters the bar of armor and the concrete surrounding it has decisive importance with relation to the load capacity of the structures of reinforced concrete. In this context, this work presents, argues and evaluates the results of the experimental studies for determination of the adherence tension according to pulling up assays pull-out normalized for CEB RC6 and also related in the ASTM C-234 in concrete with and without rubber residues. Armors of nominal diameter of 10,0; 12,5 and 16 mm had been used and concrete contend 10% of rubber fibres in substitution to the sand in volume.

Use of cooled bull semen as a strategy to increase the pregnancy rate in fixed-time artificial insemination programs-case report

Semen cryopreservation is still considered suboptimal due to lower fertility when compared to fresh semen. The reasons for the loss of fertility are various and related to irreversible damage caused to the cells during the freeze-thaw process. An alternative to conventional cryopreservation represents the use of chilled bull semen, preventing the damage associated with freezing, thereby guaranteeing greater sperm viability. The aim of this study was to describe the use of cooled bull semen as a strategy to increase the pregnancy for Fixed-Time Artificial Insemination (FTAI) of Nellore (Bos indicus) cows. One ejaculate of a select Nellore bull obtained by electroejaculation was used; the semen sample was fractioned into two aliquots: one diluted in Botu-Bov® extender containing 6.4% glycerol for cryopreservation (BB-F, frozen group) and one diluted in the same extender, free from cryoprotectants and used for cooling (BB-C, cooled semen group). The samples in the BB-C group were chilled to 5°C using an isothermic box and maintained for 24 h prior to use. A total of 349 lactating Nellore cows (70-90 days after birth) were synchronized by the insertion of a progesterone releasing device (1.0 g) and estradiol benzoate (2.0 mg i.m.) on a random day of the estrous cycle (Day 0); FTAI was performed 44-48 h after the removal of the device. The pregnancy rates were 45.71 and 61.49% (P<0.05), respectively, for the cryopreserved or chilled bovine semen groups. In conclusion, the use of bull semen cooled for 24 h represents an alternative to conventionally cryopreserved semen, as determined by the increase the pregnancy per artificial insemination in bovine herds. © 2012 Science Publication.

Use of hemoglobin as alternative to peroxidases in cholesterol amperometric biosensors

Sophisticated molecular architectures can be produced with the layer-by-layer (LbL) method, which may combine distinct materials on the same film. In this study, we take advantage of this capability to produce cholesterol amperometric biosensors from LbL films containing hemoglobin (Hb) and cholesterol oxidase in addition to the polyelectrolytes poly(allylamine hydrochloride) (PAH) and poly(ethylene imine) (PEI). Following an optimization procedure, we found that an LbL film deposited onto ITO substrates, with the architecture ITO(PEI/Hb)5(PEI/COx)10, yielded a sensitivity of 93.4 μA μmol L-1 cm-2 for cholesterol incorporated into phospholipid liposomes, comparable to state-of-the-art biosensors. Hb acted as efficient electron mediator and did not suffer interference from phospholipids. Significantly, cholesterol could also be detected in real samples from chicken egg yolk, with no effects from potential interferents, including phospholipids. Taken together these results demonstrate the possible fabrication of low cost, easy-to-use cholesterol amperometric biosensors, whose sensitivity can be enhanced by further optimizing the molecular architectures of the LbL films. © 2012 Elsevier B.V.

Optical properties of the MoO3-TiO2 particulate system and its use as a ceramic pigment

Mo-doped TiO2 powders were prepared using a dry mixture of TiO2 and MoO3 oxides with several compositions, followed by a calcination step at several temperatures. The resulting oxide system develops yellow and green tones. The XRD patterns showed only traces of MoO 3; however, EDS results, combined with TG/DTA data, confirmed the presence of molybdenum ions, suggesting that the changes in optical properties of the oxide system is due to the incorporation of Mo ions into the TiO 2 matrix, substituting Ti+4 with Mo+6 ions. The band gap decreased with increasing of MoO3 content; on the other hand, the band gap reached a maximum value at about 850°C to 910°C when plotted as a function of the calcination temperature. The glazes produced showed that the oxide system under study is a potential material for use as abinary ceramic pigment. Copyright © 2013 Taylor & Francis Group, LLC.

Evaluation report of the training workshop on the use of the module to analyse growth of international commerce (Magic Plus) and the competitive analysis of nations (TRADECAN 2009) software

The aim of the workshop was to provide a functional overview of the software package, to enable participants to use the software in order to inform more evidence-based trade strategies, and build capacity for researchers and trade negotiators to provide more rigorous, analytical policy research to inform future trade negotiations. Participants came from the ministries of trade of the following CDCC member countries: Dominica, Grenada, Jamaica, Saint Lucia, Saint Kitts and Nevis, Saint Vincent and the Grenadines, and Trinidad and Tobago. Representatives of the following regional institutions were represented: the Caribbean Community/Caribbean Regional Negotiating Mechanism (CARICOM/CRNM); the Organisation of Eastern Caribbean States (OECS); the University of Guyana, University of Suriname and the University of the West Indies (UWI). It was hoped the workshop would be a stepping stone towards more advanced trade analysis training. The list of participants appears as Annex I.

Otimização e caracterização microestrutural de cerâmicas de carbeto de silício obtidas com material nacional para uso em blindagem balística

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Resistência mecânica do material compósito: madeira de eucalipto-lâmina de bambu

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Perfil epidemiológico de acidentes com material biológico entre estudantes de medicina em um pronto-socorro cirúrgico

OBJECTIVE: To evaluate the accidents with biological material among medical students interning in a trauma emergency room and identify key related situations, attributed causes and prevention. METHODS: we conducted a study with a quantitative approach. Data were collected through a questionnaire applied via internet, with closed, multiple-choice questions regarding accidents with biological material. The sample comprised 100 students. RESULTS: thirty-two had accidents with biological material. Higher-risk activities were local anesthesia (39.47%), suture (18.42%) and needle recapping (15.79%). The main routes of exposure to biological material were the eyes or mucosa, with 34%, and syringe needle puncture, with 45%. After contamination, only 52% reported the accident to the responsible department. CONCLUSION: The main causes of accidents and routes of exposure found may be attributed to several factors, such as lack of training and failure to use personal protective equipment. Educational and preventive actions are extremely important to reduce the incidence of accidents with biological materials and improve the conduct of post-exposure. It is important to understand the main causes attributed and situations related, so as general and effective measures can be applied.

Análise microbiológica e físico-química de material proteico comestível derivado do processamento da gordura oriunda do abate de bovinos

Background: The use of all by-products of bovine slaughter is of high economic importance for the industries of products of animal origin. Among these products, fat has an important role, once fat rendering may generate several different products, such as protein material that may be used in the manufacture of meat products. However, in spite of the importance that the use of all by-products has for the economic balance of the industry, there are no reports on their use in Brazil, or studies that supply data on microbiological and physical-chemical local standards for this protein. Thus, the objective of this study was to evaluate microbiological and physical-chemical characteristics of protein material obtained from fat rendering, as well as to provide support for companies to use fat rendering to generate protein material, adding value to industrialized meat products.Materials, Methods & Results: The experimental production of edible protein obtained of fat rendering was conducted in slaughterhouse with supervision of the Brazilian Ministry of Agriculture, Livestock and Food Supply. Protein material was obtained in a continuous, humid heat system at high temperatures. Fat scraps containing protein were ground and cooked at high temperature (85 degrees C), and placed in a three phase decanter centrifuge. After centrifugation, protein material was ground again and packed. Samples were collected from 15 batches of protein material, and the following microbiological analyses were carried out: counts of aerobic mesophilic and psychrotrophic microorganisms, coliforms at 35 degrees C, Escherichia coli, sulfite-reducing Clostridium, and Staphylococcus aureus, besides presence or absence of Salmonella and Listeria monocytogens. The following physical-chemical analyses were also carried out: protein, total lipid, moisture, ash, carbohydrate, and energy content. Mean counts of mesophiles, psychrotrophs, and coliforms at 35 degrees C were 4.17; 3.69 and 1.87 (log CFU/g), respectively. Levels of protein, total lipids, moisture, ashes and carbohydrates were 27.50; 7.83; 63.88%; 0.24%; and 0.55%, respectively, and energy content was 182.63 kcal/100g.Discussion: Results of microbiological analyses demonstrated that, although low, the final product showed to be contaminated. Contamination that occurred during the second grinding procedure may be an explanation for these bacterial counts. Also, the temperature used for fat fusion was not enough to eliminate thermoduric microorganisms. However, even with the presence of indicator microorganisms in the samples, none was contaminated by E. coli, sulfite-reducing Clostridium, S. aureus, Salmonella or L. monocytogenes. Physical-chemical analyses showed that the product had adequate nutritional quality. Based on these results, it was possible to conclude that protein material obtained in fat rendering showed characteristics that enable the use of this product as raw material for processed meat products. Besides, the present study was the first one to present scientific results in relation to edible by-products obtained in fat rendering, supplying important information for slaughterhouses and meat-processing plants. The study also produced relevant data on the innocuousness of the product, which may be used to guide decision-making of health inspectors.

Adhesive bonding of resin composite to various titanium surfaces using diferente metal conditioners and a surface modification system

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

Ability of Salmonella spp. to Produce Biofilm Is Dependent on Temperature and Surface Material

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

Risk factors that may signify a propensity to the use of drugs in students at a public university

Introduction: We sought to evaluate the risk factors that may increase the propensity to use licit and illicit drugs among students at a public university. Methods: The project involved students (n = 268) enrolled in the first and fourth years of courses in the areas of the social and biological sciences at a public university. Data collection was conducted by means of self-administered, semistructured questionnaires, based on such standardized assessment instruments as Audit, Assist, Cage and Duse. Collected data were analyzed quantitatively by calculating the percentages and evaluating the data in terms of categories of risk, classifying them by age, gender, religion, schooling, use (before or after entering university) and contexts of use. By means of this survey the researchers were able to correlate the use of drugs to the risk factors that might increase the students’ propensity to use these substances. Results: The results revealed a high proportion of current drug-using students, but showed no significant differences between the first and fourth year students as regards contexts of use. However, 67% of students regarded the university environment as encouraging the use of drugs. Students pointed to such major risk factors as friends’ and fellow-students’ influence, university parties, excessive curiosity and desire to experiment. Conclusion: Due to the high rate of drug use among university students, by the determination of the risk factors related to the university environment and also knowing that the process of addiction is one of growing chemical dependence, the importance of the development and implementation of public health policies at all levels, especially in terms of approaches and specific interventions addressing this population, should be noted.