Case-case-control study of risk factors for nasopharyngeal colonization with methicillin-resistant Staphylococcus aureus in a medical-surgical intensive care unit

Nasopharyngeal colonization with methicillin-resistant Staphylococcus aureus (MRSA) often precedes the development of nosocomial infections. In order to identify risk factors for MRSA colonization, we conducted a case-case-control study, enrolling 122 patients admitted to a medical-surgical intensive care unit (ICU). All patients had been screened for nasopharyngeal colonization with S. aureus upon admission and weekly thereafter. Two case-control studies were performed, using as cases patients who acquired colonization with MRSA and methicillin-susceptible S. aureus (MSSA), respectively. For both studies, patients in whom colonization was not detected during ICU stay were selected as control subjects. Several potential risk factors were assessed in univariate and multivariable (logistic regression) analysis. MRSA and MSSA were recovered from nasopharyngeal samples from 27 and 10 patients, respectively. Independent risk factors for MRSA colonization were: length-of-stay in the ICU (Odds Ratio [OR]=1.12, 95%Confidence Interval[CI]=1.06-1.19, p<0.001) and use of ciprofloxacin (OR=5.05, 95%CI=1.38-21.90, p=0.015). The use of levofloxacin had a protective effect (OR=0.08, 95%CI=0.01-0.55, p=0.01). Colonization with MSSA was positively associated with central nervous system disease (OR=7.45, 95%CI=1.33-41.74, p=0.02) and negatively associated with age (OR=0.94, 95%CI=0.90-0.99, p=0.01). In conclusion, our study suggests a role for both cross-transmission and selective pressure of antimicrobials in the spread of MRSA.

Auditory processing in children and adolescents in situations of risk and vulnerability

CONTEXTO E OBJETIVO: Crianças e adolescentes que vivem em situação de vulnerabilidade social apresentam uma série de problemas de saúde. Apesar disso, ainda é controversa a afirmação sobre a existência de alterações cognitivas e/ou sensoriais. O objetivo deste estudo foi investigar aspectos relacionados ao processamento auditivo, através da aplicação de testes de potencial evocado auditivo de tronco encefálico (PEATE) e avaliação comportamental do processamento auditivo em crianças em situação de rua, comparando a um grupo controle. TIPO DE ESTUDO E LOCAL: Estudo transversal no Laboratório de Processamento Auditivo, Faculdade de Medicina da Universidade de São Paulo. MÉTODOS: Os testes de processamento auditivo foram aplicados em um grupo de 27 indivíduos, subdivididos em grupos de 11 crianças (7 a 10 anos) e 16 adolescentes (11 a 16 anos) de ambos os sexos, em situação de vulnerabilidade social, e comparado a um grupo controle, formado por 21 crianças, subdivididas em grupos de 10 crianças e 11 adolescentes, pareados por idade, sem queixas. Também se aplicou os PEATE para investigação da integridade da via auditiva. RESULTADOS: Para ambas as faixas etárias, foram encontradas diferenças significantes entre grupos estudo e controle para a maioria dos testes aplicados, sendo que o grupo estudo apresentou desempenho estatisticamente pior do que o controle para todos os testes, exceto para o teste pediatric speech intelligibility. Apenas uma criança apresentou resultado alterado para os PEATE. CONCLUSÕES: Os resultados demonstraram pior desempenho do grupo estudo (crianças e adolescentes) para os testes comportamentais de processamento auditivo, apesar de estes apresentarem integridade da via auditiva em nível de tronco encefálico, demonstrada pela normalidade nos resultados do PEATE.

REFEREE PERSONAL MEANING: PERCEPTION of FOOTBALL OFFICIALS

The aim of this study was to evaluate the personal meaning of refereeing for Portuguese football referees. Participants were 47 football referees from the 1st Portuguese Professional Football League evaluated through an open question: "Write down what refereeing means to you". The analysis was made according to Miles & Huberman (1994) procedures. The 5 categories are: relation with the football; costs of the practice; emotion for the arbitration; social interaction and way of life. The results show that be connected to the world of the football, passion and the relationship with other referees are important motivational factors, with that the referees have a high grade of excitement and pleasure in his labor activity. on the other hand the task of refereeing is generating of stress and burnout.

Environmental diagnosis in areas with different use and occupation using the perception of diverse biological activity

In Brazil, the degradation of soil and landscape by urban and agricultural frontiers expansion leads to the need for comprehensive studies and consider the diverse biological activities generated from different interventions in the landscape, becoming an instrument for assessing the impacts and the decision for its environmental management. The objective of this study was to evaluate the influence of different forms of occupation of the landscape, considering ecological elements and their interactions. The work was carried out on the Instituto Agronômico in the county of Jundiai, in the state of Sao Paulo, Brazil. The area under study has been subjected to different use and occupancy for a period of about 40 years. During this period the landscape has been transformed, with the current scenario can be classified as a degraded area mining; grassy area; Araucaria forest and pasture. These areas were evaluated by means of a transect, from which ten sampling sites were selected for the description of diverse biological activities, which included: evaluation and description of ground cover, identifying the presence of fungus and insect species. Furthermore, we evaluated in these points the pH, fertility and porosity of the topsoil (0-0.10 m). The results showed a variation of the elements analyzed and a relationship between the use and occupation of land in the different scenarios of the current landscape. The biological activity was more diverse in the Araucaria forest, reflected by the abundance of litter, higher content of organic matter and soil nutrients, demonstrating the effectiveness of the technique for assessing the level of degradation of the landscape used, which is expeditious and inexpensive.

Influence of maxillary incisor edge asymmetries on the perception of smile esthetics among orthodontists and laypersons

Introduction: Our objective was to determine the perception of smile esthetics among orthodontists and laypeople with respect to asymmetries on the maxillary incisor edges in a frontal smile analysis. Methods: Two frontal close-up smile photos of 2 women, 1 white and 1 Afro-Brazilian, were selected for this study. Both smiles displayed healthy maxillary anterior dentitions. The images were digitally altered to create tooth wear on the maxillary left central and lateral incisors in 0.5-mm increments. The final images were randomly assembled into a photo album that was given to 120 judges, 60 orthodontists and 60 laypersons. Each rater was asked to evaluate the attractiveness of the images with visual analog scales. The data collected were statistically analyzed with 1-way analysis of variance with the Tukey post-hoc test and the unpaired Student t test. Results: The most attractive smiles in both types of smiles were those without asymmetries and the 0.5-mm wear in the lateral incisor. In general, tooth wear was considered unattractive by both groups of raters following a pattern: the more tooth wear, the more unattractive the smile; tooth wear in the central incisor was considered more unattractive than in the lateral incisor. For both group of raters, 0.5 mm of wear in the central incisor was considered unattractive, whereas the thresholds for lateral incisor discrepancies were 0.5 mm for orthodontists and 1.0 mm for laypersons. Conclusions: The result of this study corroborates the clinical assumption that symmetry between the maxillary central incisors is a paramount goal for esthetic treatments. Copyright © 2013 by the American Association of Orthodontists.

The perception of brazilian researchers concerning the factors that influence the citation of their articles: A study in the field of sustainability

With growing institutional pressure from the Brazilian government to increase the impact of research that it funds, Brazilian researchers are increasingly interested in discovering factors that affect the citation of their articles. The aim of the present article was to assess the perceptions of Brazilian sustainability researchers to identify factors that influence the impacts of their research. A survey was conducted with researchers in the field of sustainability and 89 questionnaires were completed. All of those researchers have articles or research projects in the field of sustainability (mixing environmental, social and/or economical) recorded in the Scielo or Lattes Curriculum Brazilian databases. Results suggest four factors that may explain the impact of article citations: (1) prestige of the author and the research network; (2) prestige of the means of publication and indexing; (3) accessibility and quality characteristics of the article; and (4) international nature of communication and scope of the study. Surprisingly, such factors were not statistically significant in explaining the citations of the participating researchers. These results show the need to consider other factors that can explain the impact of research, discovering the missing links. © 2013 Elsevier Inc.

Influence of risk behavior aggregation in different categories of physical activity on the occurrence of cardiovascular risk factors

Background: We aimed to verify the association of risk behavior aggregation in different categories of physical activity (PA) with the presence of cardiovascular risk factors (RF) employees at a public university. Method. We analyzed data of 376 employees, which were visited in their workplace for measurement of weight, height and questionnaires to identify the risk behaviors and risk factors. Chi-square test was used to analyze the association between the dependent and independent variables and binary logistic regression was used to construct a multivariate model for the observed associations. Results: Associations were found between the aggregation of following risk behaviors: smoking, alcohol consumption and physical inactivity, considered in different categories of PA, and the increase in RF, except for the presence of hypertriglyceridemia. Individuals with two or more risk behaviors in occupational PA category are more likely to be hypertensive (3.04 times) and diabetes (3.44 times). For the free time PA category, these individuals were 3.18 times more likely to have hypercholesterolemia and for locomotion PA, more likely to be hypertensive (2.42 times) and obese (2.51 times). Conclusion: There are association between the aggregation of two or more risk behaviors and the presence of cardiovascular RF. © 2013 Bernardo et al.; licensee BioMed Central Ltd.

Corporate governance in Brazil, Chile, Colombia, Mexico and Peru: The determinants of risk in corporate debt issuance

This study builds on the Corporate governance and development of capital markets in Latin America report published by the Development Bank of Latin America (CAF) and the Economic Commission for Latin America and the Caribbean (ECLAC), which looked at the regulatory framework related to the principles of corporate governance in the region and assessed its contribution to the development of capital markets. This book complements the previous study and is the result of a joint effort by CAF, the Inter- American Development Bank (IDB) and ECLAC to identify the key elements of corporate governance for determining debt instrument issuance risk in potential conflicts of interest arising from relationships among shareholders, executives and bondholders