Estudo de validação da versão portuguesa da Alarm Distress Baby Scale (ADBB)

Contexto. O comportamento de retraimento social prolongado da criança é um importante sinal de alarme, quer tenha origem orgânica, psicológica e/ou social. A. Guédeney construiu a Alarm Distress Baby Scale (ADBB), para identificar este comportamento no contexto da consulta pediátrica ou da observação psicológica. Objectivos. Validação da versão portuguesa da ADBB destinada a avaliar o comportamento de retraimento social de crianças com idades compreendidas entre 2 e 24 meses. Metodologia A ADBB e as Bayley Scales of Infant Development (BSID) foram administradas a uma amostra de 130 lactentes com 3 meses de idade, cujas mães preencheram a versão portuguesa da Edinburgh Postnatal Depression Scale (EPDS); 51 bebés foram novamente avaliados aos 12 meses de idade. Resultados. Os itens da ADBB organizam-se satisfatoriamente em duas sub-escalas. A consistência interna do instrumento é razoável (alpha de Cronbach = .587). A validade externa é elevada: a correlação entre os resultados na ADBB e nas BSID é muito significativa - os bebés que aos 3 meses apresentam um resultado igual ou superior a 5 na ADBB evidenciam menor desenvolvimento nas BSID. Os resultados testemunham ainda que bebés de mães deprimidas (EPDS ≥ 12) mostram mais sinais de retraimento social do que os bebés das mães não deprimidas. Conclusão. A escala permite detectar crianças a necessitar de ajuda no sentido de contrariar o retraimento social que encetaram em relação ao meio. Desenhada para sinalizar tão precocemente quanto possível o retraimento social do lactente, e na medida em que este é um comprovado sinal da perturbação do desenvolvimento, a ADBB pode estimular os clínicos na procura das suas causas e na intervenção junto das mesmas. Estudos em amostras de crianças com mais idade são necessários. No entanto, os resultados obtidos apontam que a Versão portuguesa da ADBB é robusta e válida.

Combustion of alternative biomass fuels in a domestic boiler and in a large-scale furnace

Programa Doutoral em Engenharia Mecânica.

Estudos sôbre alimentação mineral do cafeeiro: VIII. Estudo da absorção e da translocação do radiozinco no cafeeiro (Coffea arabica L.)

WATER-CULTURE EXPERIMENTS. Two water-culture experiments were carried out to study the absorption and the translocation of radiozinc in young coffee plants as influenced by two factors, namely, concentration of heavy metals (iron, man ganese, copper and molybdenum) and method of application. Inert zinc was supplied at an uniform rate of 0. 05 p. p. m.; the levels of iron supply were 0, 1.0, and 10.0 p. p.m.; manganese was supplied in three doses 0, 0.5, and 5.0 p. p.m.; copper- 0, 0. 02, and 0. 2 p. p. m.; molybdenum- 0, 0. 01, and 0. 1 p. p. m. When applied to the nutrient solution the activity os the radiozinc (as zinc chloride) was 0. 15 microcuries per plant. In the study of the leaf absorption, Zn65 was supplied at the level of 0. 10 microcuries per plant; in this case the radioative material was brushed either on the lower or on the upper surface or both two pairs of mature leaves. The absorption period was 8 weeks. The radioactivity assay showed the following results: 1 - Among the heavy metals herein investigated the iron concentration did not affect the uptake of the radiozinc; by raising the level of Mn, Cu and Mo ten times, the absorption dropped to 50 per cent and even more when compared with the control plants; when, however, these micronutrients were omitted from the nutrient solution, an increase in the uptake of zinc was registered in the minus Cu treatment only. The effects of high levels of Mn, Cu and Mo probably indicate an interionic competition for a same site on a common binding substance in the cell surface. 2 - The absorption of the radiozinc directly applied to the leaf surface reached levels as high as 8 times that registered when the root uptake took place. Among the three methods of application which have been tried, brushing the lower surface of the leaves proved to be the most effective; this result is easily understood since the stomatal openings of the coffee leaves an preferentially located in the lower surface - in this treatment, about 40 per cent of the activity was absorved and around 12 per cent were translocated either to the old or to the newer organs. Chemical analyses for heavy metals, were carried out only in the plants received Zn65Cl2 in the nutrient solution; the results were as follows; 1 - Control plants had, per 1,000 gm, of dry weight the following amounts in mg.: Zn- 48 in the roots and 29 in the tops; Fe- 165 in the roots and 9 in the tops; Mn- 58 in the roots and 15 in the tops, Cu- 15 in the roots and 1. 2 in the tops; Mo- 2. 8 in the roots and 0. 45 in the tops. 2 - The effect of different levels of micronutrients in the composition of the plants can be summarized as follows: Fe and Zn- when omitted from the nutrient solution, the iron and zinc contents in the roots decreased, no variation being noted in the tops; the higher dosis caused an accumulation in the roots but no apparent effect in the tops; Mn- by omitting this micronutrient a decrease in its content in the roots was noted, where as the concentration in the tops was the same; Mo- no variation in roots and tops contents when molybdenum was omitted; higher dosis of manganese and molybdenum increased the amounts formed both in the roots and in the tops. 3 - The influence of the different concentrations of micronutrients heavy metals on the zinc content of the coffee plants can be described by saying that: Fe and Mo- no marked variation; Mn- no effect when omitted, reduced amount when the high dosis was supplied; Mn- when the plants did not receive manganese the zinc content in roots and tops was the same as in the control plants; a decrease in the zinc content of the total plant occurred when the high dosis was employed; Cu -the situation is similar to that described for manganese. Hence, results showed by the chemical analyses roughly correspond to those of the radioactivity assay; the use of the tracer technique, however, gave best informations along this line. SOIL-POTS EXPERIMENTS. The two types of soils which when selected support the most extensive coffee plantations in the State of São Paulo, Brazil: "arenito de Bauru", a light sandy soil and "terra roxa legitima", a red soil derived from basalt. Besides NPK containing salts, the coffee plants were given two doses of inert zinc (65 and 130 mg ZnCl2 per pot) and radiozinc at a total activity of 10(6) counts/minute. The results of the countings can be summarized as follows: 1 - When plants were grown in "arenito de Bauru" the activity absorbed as per cent of the total activity supplied was not affected by the dosis of inert zinc. The highest value found was around 0. 1 per cent. 2 - For the "terra roxa" plants, the situation is almost the same; there was, however, a slight increase in the absorption of the radiozinc when 130 mgm of ZnClg2 was given: a little above 0. 2 per cent of the activity supplied was absorbed. The results clearly show that the young coffee plants practically did not absorb none of the zinc supplied; two reasons at least could be pointed out to explain such a fact: 1 - Zinc fixation by an exchange with magnesium or by filling holes in the octahedral layer of aluminosilicates, probably kaolinite; 2 - No need for fertilizer zinc in the particular stage of life cycle under which the experiment was set up. The data from chemical analysis are roughly parallel to the above mentioned. When one attempts to compare - by taking data herein reported zinc uptake from nutrient solution, leaf brushing or from fertilizers in the soil, a practical conclusion can be drawn: the control of zinc deficiency in coffee plants should not be done by adding the zinc salts to the soil; in other words: the soil applications used so extensively in other countries seem not to be suitable for our conditions; hence zinc sprays should be used wherever necessary.

Thrombolysis in ischemic stroke without arterial occlusion at presentation.

BACKGROUND AND PURPOSE: None of the randomized trials of intravenous tissue-type plasminogen activator reported vascular imaging acquired before thrombolysis. Efficacy of tissue-type plasminogen activator in stroke without arterial occlusion on vascular imaging remains unknown and speculative. METHODS: We performed a retrospective, multicenter study to collect data of patients who presented to participating centers during a 5-year period with ischemic stroke diagnosed by clinical examination and MRI and with imaging evidence of no vascular occlusion. These patients were divided into 2 groups: those who received thrombolytic therapy and those who did not. Primary outcome measure of the study was excellent clinical outcome defined as modified Rankin Scale of 0 to 1 at 90 days from stroke onset. Secondary outcome measures were good clinical outcome (modified Rankin Scale, 0-2) and perfect outcome (modified Rankin Scale, 0). Safety outcome measures were incidence of symptomatic intracerebral hemorrhage and poor outcome (modified Rankin Scale, 4-6). RESULTS: A total of 256 patients met study criteria, 103 with thrombolysis and 153 without. Logistic regression analysis showed that patients who received thrombolysis had more frequent excellent outcomes with odds ratio of 3.79 (P<0.01). Symptomatic intracerebral hemorrhage was more frequent in thrombolysis group (4.9 versus 0.7%; P=0.04). Thrombolysis led to more frequent excellent outcome in nonlacunar group with odds ratio 4.90 (P<0.01) and more frequent perfect outcome in lacunar group with odds ratio 8.25 (P<0.01). CONCLUSIONS: This study provides crucial data that patients with ischemic stroke who do not have visible arterial occlusion at presentation may benefit from thrombolysis.

Adolescent Drug Abuse Diagnosis (ADAD) vs. Health of Nation Outcome Scale for Children and Adolescents (HoNOSCA) in clinical outcome measurement.

BACKGROUND: The Adolescent Drug Abuse Diagnosis (ADAD) and Health of Nation Outcome Scales for Children and Adolescents (HoNOSCA) are both measures of outcome for adolescent mental health services. AIMS: To compare the ADAD with HoNOSCA; to examine their clinical usefulness. METHODS: Comparison of the ADAD and HoNOSCA outcome measures of 20 adolescents attending a psychiatric day care unit. RESULTS: ADAD change was positively correlated with HoNOSCA change. HoNOSCA assesses the clinic's day-care programme more positively than the ADAD. The ADAD detects a group for which the mean score remains unchanged whereas HoNOSCA does not. CONCLUSIONS: A good convergent validity emerges between the two assessment tools. The ADAD allows an evidence-based assessment and generally enables a better subject discrimination than HoNOSCA. HoNOSCA gives a less refined evaluation but is more economic in time and possibly more sensitive to change. Both assessment tools give useful information and enabled the Day-care Unit for Adolescents to rethink the process of care and of outcome, which benefited both the institution and the patients.

A multi-purpose grammar generating a multi-scale integrated analysis of Laos

In this study we propose an application of the MuSIASEM approach which is used to provide an integrated analysis of Laos across different scales. With the term “integrated analysis across scales” we mean the generation of a series of packages of quantitative indicators, characterizing the performance of the socioeconomic activities performed in Laos when considering: (i) different hierarchical levels of organization (farming systems described at the level of household, rural villages, regions of Laos, the whole country level); and (ii) different dimensions of analysis (economic dimension, social dimension, ecological dimension, technical dimension). What is relevant in this application is that the information carried out by these different packages of indicators is integrated in a system of accounting which establishes interlinkages across these indicators. This is a essential feature to study sustainability trade-offs and to build more robust scenarios of possible changes. The multi-scale integrated representation presented in this study is based on secondary data (gathered in a three year EU project – SEAtrans and integrated by other available statistical sources) and it is integrated in GIS, when dealing with the spatial representation of Laos. However, even if we use data referring to Laos, the goal of this study is not that of providing useful information about a practical policy issue of Laos, but rather, to illustrate the possibility of using a multipurpose grammar to produce an integrated set of sustainability indicators at three different levels: (i) local; (ii) meso; (iii) macro level. The technical issue addressed is the simultaneous adoption of two multi-level matrices – one referring to a characterization of human activity over a set of different categories, and another referring to a characterization of land uses over the same set of categories. In this way, it becomes possible to explain the characteristics of Laos (an integrated set of indicators defining the performance of the whole country) in relation to the characteristics of the rural Laos and urban Laos. The characteristics of rural Laos, can be explained using the characteristics of three regions defined within Laos (Northern Laos, Central Laos and Southern Laos), which in turn can be defined (using an analogous package of indicators), starting from the characteristics of three main typologies of farming systems found in the regions.

Spatial and seasonal trends of a natural population of Biomphalaria occidentalis in northeastern Argentina

This study aims to analyze the age of a population of Biomphalaria occidentalis on a pound of Riachuelo river basin, wich is one of the three most important Middle Paraná river affluents in Corrientes province. Samples were drawn from three stations, were spatial and temporal numerical variations of the snail, as well as its relation with different environmental parameters, mainly temperature, rainfall, pH and conductivity, were analyzed. Snail abundance is given in number of individuals/hour. The differences between the three sampling stations, estimated by nonparametric tests, was nonsignificant. A relative scale to the greatest shell diameter was employed to build the age pyramids. Temporal fluctuations of snail abundance correlated negatively with the highest monthly accumulated temperatures (P < 0.05). Although different floristic compositions were observed at the three stations, no significant numerical variations were detected in B. occidentalis spatial distribution. Reproductive activity took place between March-April and November with overlapping cohort system. During summer (December-Febuary) mortality increased along with temperature and reproductive activity was not evident.

Mean platelet volume in the early phase of acute ischemic stroke is not associated with severity or functional outcome.

Background: Previous studies reported an increase of mean platelet volume (MPV) in patients with acute ischemic stroke. However, its correlation with stroke severity has not been investigated. Moreover, studies on the association of MPV with functional outcome yielded inconsistent results. Methods: We included all consecutive ischemic stroke patients admitted to CHUV (Centre Hospitalier Universitaire Vaudois) Neurology Service within 24 h after stroke onset who had MPV measured on admission. The association of MPV with stroke severity (NIHSS score at admission and at 24 h) and outcome (Rankin Scale score at 3 and 12 months) was analyzed in univariate analysis. The chi(2) test was performed to compare the frequency of minor strokes (NIHSS score </=4) and good functional outcome (Rankin Scale score </=2) across MPV quartiles. The ANOVA test was used to compare MPV between stroke subtypes according to the TOAST classification. Student's two-tailed unpaired t test was performed to compare MPV between lacunar and nonlacunar strokes. MPV was generated at admission by the Sysmex XE-2100 automated cell counter (Sysmex Corporation, Kobe, Japan) from EDTA blood samples. Results: There was no significant difference in the frequency of minor strokes (p = 0.46) and good functional outcome (p = 0.06) across MPV quartiles. MPV was not associated with stroke severity or outcome in univariate analysis. There was no significant difference in MPV between stroke subtypes according to the TOAST classification (p = 0.173) or between lacunar and nonlacunar strokes (10.50 +/- 0.91 vs. 10.40 +/- 0.81 fl, p = 0.322). Conclusions: MPV, assessed within 24 h after ischemic stroke onset, is not associated with stroke severity or functional outcome.

Validation of the German version of the Career Adapt-Abilities Scale and its relation to orientations to happiness and work stress

Career adapt-ability has recently gained momentum as a psychosocial construct that not only has much to offer the field of career development, but also contributes to positive coping, adjustment and self-regulation through the four dimensions of concern, control, curiosity and confidence. The positive psychology movement, with concepts such as the orientations to happiness, explores the factors that contribute to human flourishing and optimum functioning. This research has two main contributions; 1) to validate a German version of the Career Adapt-Abilities Scale (CAAS), and 2) to extend the contribution of adapt-abilities to the field of work stress and explore its mediating capacity in the relation between orientations to happiness and work stress. We used a representative sample of the German-speaking Swiss working population including 1204 participants (49.8% women), aged between 26 and 56 (Mage = 42.04). Results indicated that the German version of the CAAS is valid, with overall high levels of model fit suggesting that the conceptual structure of career adapt-ability replicates well in this cultural context. Adapt-abilities showed a negative relationship to work stress, and a positive one with orientations to happiness. The engagement and pleasure scales of orientations to happiness also correlated negatively with work stress. Moreover, career adapt-ability mediates the relationship between orientations to happiness and work stress. In depth analysis of the mediating effect revealed that control is the only significant mediator. Thus control may be acting as a mechanism through which individuals attain their desired life at work subsequently contributing to reduced stress levels.

The Visual Dysphagia Questionnaire: Piloting a New Tool for Assessing Food Consistency-Dependent Dysphagia in Eosinophilic Esophagitis

Background and Aims: The international EEsAI study group is currently developing the first activity index specific for Eosinophilic Esophagitis (EoE). None of the existing dysphagia questionnaires takes into account the consistency of the ingested food that considerably impacts the symptom presentation. Goal: To develop an EoE-specific questionnaire assessing dysphagia associated with different food consistencies. Methods: Based on patient chart reviews, an expert panel (EEsAI study group) identified internationally standardized food prototypes typically associated with EoE-related dysphagia. Food consistencies were correlated with EoE-related dysphagia, also considering potential food avoidance. This Visual Dysphagia Questionnaire (VDQ) was then tested, as a pilot, in 10 EoE patients. Results: The following 9 food consistency prototypes were identified: water, soft foods (pudding, jelly), grits, toast bread, French fries, dry rice, ground meat, raw fibrous foods (eg. apple, carrot), solid meat. Dysphagia was ranked on a 5-point Likert scale (0=no difficulties, 5=very severe difficulties, food will not pass). Severity of dysphagia in the 10 EoE patients was related to the eosinophil load and presence of esophageal strictures. Conclusions: The VDQ will be the first EoE-specific tool for assessing dysphagia related to internationally defined food consistencies. It performed well in a pilot study and will now be further evaluated in a cohort study including 100 adult and 100 pediatric EoE patients.

Rockfall hazard and risk assessments along roads at a regional scale: Example in Swiss Alps

Unlike fragmental rockfall runout assessments, there are only few robust methods to quantify rock-mass-failure susceptibilities at regional scale. A detailed slope angle analysis of recent Digital Elevation Models (DEM) can be used to detect potential rockfall source areas, thanks to the Slope Angle Distribution procedure. However, this method does not provide any information on block-release frequencies inside identified areas. The present paper adds to the Slope Angle Distribution of cliffs unit its normalized cumulative distribution function. This improvement is assimilated to a quantitative weighting of slope angles, introducing rock-mass-failure susceptibilities inside rockfall source areas previously detected. Then rockfall runout assessment is performed using the GIS- and process-based software Flow-R, providing relative frequencies for runout. Thus, taking into consideration both susceptibility results, this approach can be used to establish, after calibration, hazard and risk maps at regional scale. As an example, a risk analysis of vehicle traffic exposed to rockfalls is performed along the main roads of the Swiss alpine valley of Bagnes.

Control of schistosomiasis in Brazil: perspectives and proposals

Attempts to control schistosomiasis have hitherto involved the use of one or more of the following methods, either in isolation or in combination: (1) control of the intermediate host using molluscicides or biological methods; (2) basic sanitation and clean water supply; (3) health education; (4) individual or mass treatment; (5) protection of individuals in such a way as to prevent cercariae from penetrating the skin; (6) vaccine-based strategies against schistosomiasis. None of these methods is capable, on its own, of bringing about effective control of schistosomiasis, except in populations of a very limited size or under very special conditions. Molluscicides, besides expensive and toxic, have only a temporary effect. As for biological control, there is no effective method yet. Basic sanitation and clean water supply combined with health education potentially constitute the most effective approach, but only in the mid-to-long term. Mass treatment reduces morbidity, but does not control transmission. Protection of individuals has proved to be impracticable on a large scale. Vaccine-based strategies against schistosomiasis are still in the experimental stage. Experiments carried out in Brazil in the last 20 years have shown that mass treatment with single doses of oxamniquine or praziquantel can rapidly reduce levels of Shistosoma mansoni infection and morbidity in endemic areas. They have also shown that subsequent transmission and reinfection frequently occur in defined foci or "clusters", due to human contact with water, and in inverse proportion to the number and frequency of treatments carried out. On the basis of these experiments, the author suggests a multidisciplinary strategy for schistosomiasis control.

Présentation de l'adaptation française de « l'échelle de coparentage » de McHale pour familles avec jeunes enfants [Presentation of the french adaptation of McHale's coparenting scale for families with young children.]

The aim of this paper is to present McHale's coparenting scale,a self-administered questionnaire enabling assessment of the quality of coparenting, and first steps in structural and construct validation of the French version. A total of 41 French speaking Swiss families and 84 US families completed this questionnaire and the Dyadic Adjustment Scale, a measure of marital satisfaction. The results of the Swiss families correspond to those of US families: first, items distributed into four factors (family integrity, conflict, affection and disparagement) and second, a partial link was found between quality of coparenting and marital adjustment. This finding supports the construct validity of the questionnaire, reflecting the established link between these two family sub-systems. Given that coparenting quality has a major influence on children's socio-affective development, the questionnaire will find great use in assessing not just negative features of coparenting, such as conflicts and disparagement, but also positive components such as warmth and support. This will be an important asset for research as well as clinical purposes.

Poor value of pulsed-field gel electrophoresis to investigate long-term scale epidemiology of methicillin-resistant Staphylococcus aureus.

Pulsed-field gel electrophoresis (PFGE) is widely used for epidemic investigations of methicillin-resistant Staphylococcus aureus (MRSA). In the present study, we evaluated its use in a long-term epidemiological setting (years to few decades, country to continent level). The clustering obtained from PFGE patterns after SmaI digestion of the DNA of 20 strains was compared to that obtained using a phylogenetic typing method (multiprimer RAPD). The results showed that the analysis of small PFGE bands (10-85kb) correlates better with multiprimer RAPD than the analysis of large PFGE bands (>85-700kb), suggesting that the analysis of small bands would be more suitable for the investigation of long-term epidemiological setting. However, given the technical difficulties to obtain a good resolution of these bands and the putative presence of plasmids among them, PFGE does not appear to be a method of choice for the long-term epidemiology analysis of MRSA.

Revisiting the size-R&D productivity relation: introducing the mediating role of decision-making style on the scale and quality of innovative output

We develop a mediation model in which firm size is proposed to affect the scale and quality of innovative output through the adoption of different decision styles during the R&D process. The aim of this study is to understand how the internal changes that firms undergo as they evolve from small to larger organizations affect R&D productivity. In so doing, we illuminate the underlying theoretical mechanism affecting two different dimensions of R&D productivity, namely the scale and quality of innovative output which have not received much attention in previous literature. Using longitudinal data of Spanish manufacturing firms we explore the validity of this mediation model. Our results show that as firms evolve in size, they increasingly emphasize analytical decision making, and consequently, large-sized firms aim for higher-quality innovations while small firms aim for a larger scale of innovative output.