Nonoxynol-9 spermicide for prevention of vaginally acquired HIV and other sexually transmitted infections: systematic review and meta-analysis of randomised controlled trials including more than 5000 women

We aimed to determine the effectiveness of the vaginally administered spermicide nonoxynol-9 (N-9) among women for the prevention of HIV and other sexually transmitted infections (STIs), We did a systematic review of randomised controlled trials, Nine such trials including 5096 women, predominantly sex workers, comparing N-9 with placebo or no treatment, were included. Primary outcomes were new HIV infection, new episodes of various STIs, and genital lesions. Five trials included HIV and nine included STI outcomes, and all but one (2% of the data) contributed to the meta-analysis. Overall, relative risks of HIV infection (1.12, 95% confidence interval 0.88-1.42), gonorrhoea (0.91, 0.67-1.24), chlamyclia (0.88, 0.77-1.01), cervical infection (1.01, 0.84-1-22), trichomoniasis (0.84, 0.69-1.02), bacterial vaginosis (0.88, 0.74-1.04) and candidiasis (0.97, 0.84-1.12) were not significantly different in the N-9 and placebo or no treatment groups. Genital lesions were more common in the N-9 group (1.18, 1.02-1.36). Our review has found no statistically significant reduction in risk of HIV and STIs, and the confidence intervals indicate that any protection that may exist is likely to be very small. There is some evidence of harm through genital lesions. N-9 cannot be recommended for HIV and STI prevention.

Dating the dreaming? Creation of myths and rituals for mounds along the northern Australian coastline

Shell mounds ceased to be built in many parts of coastal northern Australia about 800-600 years ago. They are the subject of stories told by Aboriginal people and some have been incorporated in ritual and political activities during the last 150 ears. These understandings emerged only after termination of the economic and environmental system that created them, 800-600 years ago, in a number of widely separated coastal regions, Modern stories and treatments of these mounds by Aboriginal people concern modern or near-modern practices. Modern views of the mounds, their mythological and ritual associations, may be explained by reference to the socioeconomic transitions seen in the archaeological record; but the recent cultural, social and symbolic statements about these places cannot inform us of the process or ideology concerned with the formation of the mounds. Many Aboriginal communities over the last half a millennium actively,formed understandings of new landscapes and systems of land use. Attempts to impose historic ideologies and cosmologies on earlier times fail to acknowledge the magnitude and rate of economic and ideological change on the tropical coastline of Australia.

Ticagrelor vs. clopidogrel in patients with acute coronary syndromes and diabetes: a substudy from the PLATelet inhibition and patient Outcomes (PLATO) trial

Patients with diabetes mellitus (DM) have high platelet reactivity and are at increased risk of ischaemic events and bleeding post-acute coronary syndromes (ACS). In the PLATelet inhibition and patient Outcomes (PLATO) trial, ticagrelor reduced the primary composite endpoint of cardiovascular death, myocardial infarction, or stroke, but with similar rates of major bleeding compared with clopidogrel. We aimed to investigate the outcome with ticagrelor vs. clopidogrel in patients with DM or poor glycaemic control. We analysed patients with pre-existing DM (n = 4662), including 1036 patients on insulin, those without DM (n = 13 951), and subgroups based on admission levels of haemoglobin A1c (HbA1c; n = 15 150). In patients with DM, the reduction in the primary composite endpoint (HR: 0.88, 95% CI: 0.76-1.03), all-cause mortality (HR: 0.82, 95% CI: 0.66-1.01), and stent thrombosis (HR: 0.65, 95% CI: 0.36-1.17) with no increase in major bleeding (HR: 0.95, 95% CI: 0.81-1.12) with ticagrelor was consistent with the overall cohort and without significant diabetes status-by-treatment interactions. There was no heterogeneity between patients with or without ongoing insulin treatment. Ticagrelor reduced the primary endpoint, all-cause mortality, and stent thrombosis in patients with HbA1c above the median (HR: 0.80, 95% CI: 0.70-0.91; HR: 0.78, 95% CI: 0.65-0.93; and HR: 0.62, 95% CI: 0.39-1.00, respectively) with similar bleeding rates (HR: 0.98, 95% CI: 0.86-1.12). Ticagrelor, when compared with clopidogrel, reduced ischaemic events in ACS patients irrespective of diabetic status and glycaemic control, without an increase in major bleeding events.

The history and value of the elephant in Sri Lankan society

Reviews the literature to provide an overview of the historical significance of the elephant in Sri Lankan society, an association which dates back more than 4,000 years. The present status of this relationship assessed on the basis of the findings of a recent study undertaken on the total economic value of elephants in Sri Lanka. This paper, first briefly outlines the history, evolution, nature and their distribution of the Asian elephant while providing some insights on the status of the elephant (Elephas maxima maxima) in Sri Lanka. Next, it reviews the literature in order to assess the historical affiliation that the elephant has maintained with the Sri Lankan society, its culture, history, mythology and religion. The empirical evidence on the economic value of conservation of the remaining elephant population in Sri Lanka is reviewed and the Sri Lankan people’s attitudes towards conserving this species of wildlife. Literature reviewed and analysis undertaken indicates that the elephant in Sri Lanka, still, as in the past has a special place in Sri Lankan society, particularly, in its culture, religion and value system. Thus, there is a strong case for ensuring the survival of wild elephant population in Sri Lanka. Furthermore, it also suggests that the community as a whole will experience a net benefit from ensuring the survival of wild elephants in Sri Lanka.

Mitos, organizações e mudança

Como concebe James G. March, professor da Universidade de Stanford e considerado um dos maiores teóricos actuais das organizações,a mudança ou, pelo menos, as condições para a sua existência numa organização? Evocando os mitos da gestão, James G. March aborda o tema de um modo original.

Educación popular y nutrición infantil: experiencia de trabajo con mujeres en una zona rural de México

OBJETIVO: Se realizó una intervención comunitaria bajo la estrategia de promoción de la salud, con el objetivo de desarrollar un programa de educación para la salud con mujeres. MÉTODOS: Se analizó la metodología de educación popular; con la finalidad de generar procesos organizativos y de participación social que mejoren la nutrición y sobrevivencia infantil. RESULTADOS: Los principales resultados, se relacionan con la generación de procesos autogestivos, la conformación de un grupo de promotoras de salud que han impulsado la organización de las mujeres enfocando su trabajo a mejorar la nutrición infantil y la salud familiar. Las promotoras han tomado en sus manos el programa de vigilancia epidemiológica en nutrición infantil y en conjunto con las mujeres han emprendido una serie de acciones para mejorar la nutrición de los niños y los porcentajes de desnutrición en los niños que participan en el programa de nutrición infantil han iniciado un descenso (64% a 62%). CONCLUSIONES: Los programas de nutrición infantil tienen mayores posibilidades de éxito en la medida que logran involucrar a la población en la resolución de esta problemática, eso es posible cuando se utiliza una metodología que propicie la participación de los individuos y se generen espacios que les permitan realizar una práctica transformadora de su realidad. La metodología de la educación popular proporciona las pautas en ese sentido. Es necesario continuar ampliando las experiencias educativas en educación para la salud con este tipo de metodología.

Migración y ruralización del SIDA: relatos de vulnerabilidad en comunidades indígenas de México

OBJETIVO: Analizar la vulnerabilidad para ITS/VIH entre mujeres Purépechas y Zapotecas unidas en concubinato con varones que practican sexo sin protección. MÉTODOS: Estudio etnográfico realizado en febrero del 2004 y en diciembre del 2005 en localidades indígenas de Michoacán y Oaxaca, Mexico. Estos son entidades con niveles altos de expulsión migratoria, rezago comunitario y casos registrados de VIH/SIDA. Se entrevistaron en profundidad a 91 personas: migrantes temporales (24), mujeres indígenas (33), autoridades locales (20) y personal de salud (14). RESULTADOS: La ruralización del ITS/VIH puede relacionarse con las prácticas de iniciación sexual femeninas pero sobre todo con el miedo del migrante a que su concubina tenga relaciones extra-conyugales en su ausencia. El embarazo y la crianza son recursos masculinos de control de las esposas. CONCLUSIONES: La migración de retorno implica formas de vulnerabilidad para las mujeres indígenas en las localidades estudiadas, cuya sexualidad tiene un remarcado carácter reproductivo. Es necesario implementar políticas de prevención para ITS/VIH dirigidas a fortalecer derechos sexuales y reproductivos de las mujeres y que tomen en cuenta aspectos de identidad sexual masculina.

Sistema de animação de personagens virtuais para comunicação não verbal

O principal objectivo da animação de personagens virtuais é o de contar uma história através da utilização de personagens virtuais emocionalmente expressivos. Os personagens têm personalidades distintas, e transmitem as suas emoções e processos de pensamento através dos seus comportamentos (comunicação não verbal). As suas acções muitas das vezes constituem a geração de movimentos corporais complexos. Existem diversas questões a considerar quando se anima uma entidade complexa, tais como, a posição das zonas móveis e as suas velocidades. Os personagens virtuais são um exemplo de entidades complexas e estão entre os elementos mais utilizados em animação computacional. O foco desta dissertação consistiu na criação de uma proposta de sistema de animação de personagens virtuais, cujos movimentos e expressões faciais são capazes de transmitir emoções e estados de espírito. Os movimentos primários, ou seja os movimentos que definem o comportamento dos personagens, são provenientes da captura de movimentos humanos (Motion Capture). As animações secundárias, tais como as expressões faciais, são criadas em Autodesk Maya recorrendo à técnica BlendShapes. Os dados obtidos pela captura de movimentos, são organizados numa biblioteca de comportamentos através de um grafo de movimentos, conhecido por Move Tree. Esta estrutura permite o controlo em tempo real dos personagens através da gestão do estado dos personagens. O sistema possibilita também a transição eficaz entre movimentos semelhantes e entre diferentes velocidades de locomoção, minimizando o efeito de arrastamento de pés conhecido como footskate. Torna-se assim possível definir um trajecto que o personagem poderá seguir com movimentos suaves. Estão também disponíveis os resultados obtidos nas sessões de avaliação realizadas, que visaram a determinação da qualidade das transições entre animações. Propõem-se ainda o melhoramento do sistema através da implementação da construção automática do grafo de movimentos.

Malhas de polígonos para simulação de tecidos baseadas em regiões afins

Dissertação de Mestrado em Engenharia Informática

Death cabaret: porque os mortos viajam depressa

Projecto do Mestrado de Teatro especialização em Artes Performativas

Octopus Lipid and Vitamin E Composition: Interspecies, Interorigin, and Nutritional Variability

Octopus vulgaris, Octopus maya, and Eledone cirrhosa from distinct marine environments [Northeast Atlantic (NEA), Northwest Atlantic (NWA), Eastern Central Atlantic, Western Central Atlantic (WCA), Pacific Ocean, and Mediterranean Sea] were characterized regarding their lipid and vitamin E composition. These species are those commercially more relevant worldwide. Significant interspecies and interorigin differences were observed. Unsaturated fatty acids account for more than 65% of total fatty acids, mostly ω-3 PUFA due to docosahexaenoic (18.4−29.3%) and eicosapentanoic acid (11.4− 23.9%) contributions. The highest ω-3 PUFA amounts and ω-3/ω-6 ratios were quantified in the heaviest specimens, O. vulgaris from NWA, with high market price, and simultaneously in the lowest graded samples, E. cirrhosa from NEA, of reduced dimensions. Although having the highest cholesterol contents, E. cirrhosa from NEA and O. maya from WCA have also higher protective fatty acid indexes. Chemometric discrimination allowed clustering the selected species and several origins based on lipid and vitamin E profiles.

Intestinal microsporidiosis in HIV-positive patients with chronic unexplained diarrhea in Rio de Janeiro, Brazil: diagnosis, clinical presentation and follow-up

After the diagnosis of two cases of microsporidial intestinal infection in 1992, in Rio de Janeiro, we have started looking for this parasite in HIV-infected patients with chronic unexplained diarrhea. We have studied 13 patients from Hospital Evandro Chagas, IOC-FIOCRUZ. Fecal specimens from these patients were examined for the presence of Cryptosporidia and Microsporidia, in addition to routine examination. Spores of Microsporidia were found in the stools of 6 (46.1%) of the 13 patients studied, with 2 histological jejunal confirmations. The Microsporidia-infected patients presented chronic diarrhea with about 6 loose to watery bowel movements a day. Five infected patients were treated with Metronidazole (1.5 g/day). They initially showed a good clinical response, but they never stopped eliminating spores. After about the 4th week of therapy, their diarrhea returned. Two patients utilized Albendazole (400 mg/day-4 weeks) with a similar initial improvement and recurrence of the diarrhea. Intestinal Microsporidiosis seems to be a marker of advanced stages of AIDS, since 5 of our 6 infected patients were dead after a 6 month period of follow-up. The present study indicates that intestinal microsporidiosis may be a burgeoning problem in HIV-infected patients with chronic diarrhea in Brazil, which deserves further investigation.

Frequency of dermatophytes in the metropolitan area of Porto Alegre, RS, Brazil

In order to evaluate the distribution of dermatophytes in Porto Alegre, the capital of the state of Rio Grande do Sul, Brazil, they were isolated from the skin, hairs and nails samples and retrospectively analyzed from June 1981 to June 1995, in two different institutions in the city of Porto Alegre: (i) the Serviço de Micologia do Instituto de Pesquisas Biológicas Jandyr Maya Faillace, da Secretaria de Saúde e Meio Ambiente do Rio Grande do Sul which attends the low income population (low and middle classes) and, (ii) Laboratório Weinmann, a clinical pathology laboratory which attends predominantly the higher income population (middle and upper classes), both which attend in the metropolitan area of Porto Alegre. The dermatophyte predominance of Trichophyton rubrum was confirmed (55.33%) followed by T. mentagrophytes (21.46%). The data obtained were compared with the existing prevalence data which were collected in the interior of the state over a period of 32 years (1960-1992). T. verrucosum, T. simii, Microsporum persicolor, T. schöenleinii, M. nanum and M. cookei were isolated in the interior and have not been found in the capital so far. On the other side, T. violaceum was, isolated in the capital and has not been found in the interior so far.

Adult T-cell leukemia/lymphoma associated with HTLV-1 infection in a Brazilian adolescent

We present the case of a 15-year-old patient infected with HTLV-1 who developed a cutaneous T-cell lymphoma, confirmed by histopathological and immunohistochemical examination, as well as clinically and hematologically confirmed leukemia. The patient died 3 months after initial presentation of the disease. The rarity of the disease in this age group justifies the present report.

Haida Totem Poles: Reflections of a Society

The Haida were a First Nations group located on the Northwest Coast of Canada. They were exceptional wood carvers that produced various types of works, the most monumental of which were their totem poles. This dissertation analyses 26 of these open architectural structures, each of which belonged to one of the following five types: frontal, mortuary, memorial, house post, or corner post. Of the representations found on poles, 28 different figures were identified. However, individual poles were found to contain between one and fourteen different figures with frontal poles generally featuring the most. The predominant figures on the inventoried poles proved to be birds, humans, and bears. An iconographic structure of a tripartite character was detected that reflects the religious ideology of the Haida population with birds being featured at the top of the poles, humans in the middle, and bears at the lowest point. It also suggests the possible transition from a hunter-gatherer economy to a food producing economy.***********************************************************************************Os Haida foram um grupo das Primeiras Nações que habitaram a costa Noroeste do Canadá. Eram excepcionais escultores de madeira, tendo produzido variados tipos de artefactos, dos quais os totem poles eram os mais monumentais. Na presente dissertação são analisadas 26 dessas estruturas arquitectónicas de exterior, sendo que cada uma delas pertenceria a um dos seguintes cinco tipos: frontal, funerário, memorial, travemestra, ou postes de esquina. Das representações encontradas nos postes, foram individualizadas 28 figuras. No entanto, em postes isolados foi possível identificar entre uma e catorze figuras distintas, sendo os postes frontais os que apresentavam, geralmente, o maior número. A análise destes postes permitiu detectar uma estrutura iconográfica tripartida que reflectia a ideologia religiosa das populações Haida, representando-se as aves no topo, os humanos a meio, e os ursos na base dos postes. Por outro lado, foi possível sugerir, para estas populações, a transição de uma economia baseada na caça-recolecção para uma economia de produção alimentar.