“Enjoy your baby” Internet-based CBT for mothers with babies: a feasibility randomised control trial

Background: Postnatal depression is a global health problem with lasting effects on the family. Government policy is focussed on early intervention and increasing access to psychological therapies. There is a growing evidence base for the use of computerised CBT packages and this study investigated the feasibility of a CBT-based self-help internet intervention for new mothers. Objective: To assess the ability to recruit mothers, deliver an internet course, obtain follow-up data and evaluate what mothers think of the course. Design: A feasibility randomised control design was used to compare a waiting list control group (delayed access= DA) to the Enjoy Your Baby course (immediate access= IA). Measures were administered at baseline and 8 week follow-up. Methods: Adverts were placed in the Metro freesheet, on charity web pages, on social media, posters were put up in the community, and leaflets were handed out at mother and baby groups. Participants had to be 18 years old or over with a child less than 18 months old. The IA arm was given access to the course straight away. After 8 weeks all participants were asked to recomplete the original measures and those in the IA arm also gave feedback on the course. Participants in the DA arm were given access after recompleting the questionnaires. Due to a lack of follow-up data a small discussion group was conducted. Intervention: The course contains 4 core modules including helping mothers understand why they feel the way they do and helping them build closeness to their babies. Additional modules, worksheets and homework tasks were available. The DA group were given a list of additional support resources and services, and encouraged to seek additional help if required. All participants received weekly automated emails for 12 weeks as they worked through the course. It was not possible to deliver individualised support. 34 Results: Despite using a number of recruitment strategies, recruitment was lower and slower than anticipated, and attrition was high. 41 women, primarily recruited via the internet, were randomised (IA n=21, DA n=20). No significant differences were observed between participants in either arm at baseline and no statistically significant differences were identified when the demographics and baseline measures of participants who logged-on to the course were compared to those who did not, or when participants who completed follow-up measures were compared to those who did not. Pre and post intervention scores on the EPDS approached statistical significance (P=.059, r=.444) favouring the intervention arm. The discussion group suggested strengths of the course and recommended areas for improvement, including making the course more mobile friendly. Conclusion: Internet interventions show promise; however it is difficult to recruit mothers, engagement is low and attrition high. A number of recommendations are made and a further pilot or an internal pilot of a larger substantive study should be conducted to confirm recruitment and retention. Trial ID: ISRCTN90927910.

The real effects of banking supervision:evidence from enforcement actions

We present a novel way to examine macro-financial linkages by focusing on the real effects of bank supervisors’ enforcement actions. Exploiting plausibly exogenous variation in supervisory monitoring intensity, we show that enforcement actions in single-market banks trigger temporarily large adverse effects for the macroeconomy by reducing personal income growth, the number of establishments, and increasing unemployment. These effects are related to contractions in bank lending and liquidity creation, and are more pronounced when we consider enforcement actions on both single-market and multi-market banks, and in counties with fewer banks and greater external financial dependence.

L'apprentissage d'être soi en intervention : l'intégration du développement de l'authenticité au processus de supervision.

L'objectif de cet essai est de proposer une manière de favoriser la formation d'intervenantes et intervenants efficaces en relation d'aide. Plus précisément, il vise à expliquer de manière concrète un moyen de favoriser la formation d'intervenantes et d'intervenants efficaces en orientation, par le biais des supervisions suivies dans le cadre du baccalauréat en orientation de l'Université de Sherbrooke.

Control and Supervision of Wind Energy Conversion Systems

This paper is about a PhD thesis and includes the study and analysis of the performance of an onshore wind energy conversion system. First, mathematical models of a variable speed wind turbine with pitch control are studied, followed by the study of different controller types such as integer-order controllers, fractional-order controllers, fuzzy logic controllers, adaptive controllers and predictive controllers and the study of a supervisor based on finite state machines is also studied. The controllers are included in the lower level of a hierarchical structure composed by two levels whose objective is to control the electric output power around the rated power. The supervisor included at the higher level is based on finite state machines whose objective is to analyze the operational states according to the wind speed. The studied mathematical models are integrated into computer simulations for the wind energy conversion system and the obtained numerical results allow for the performance assessment of the system connected to the electric grid. The wind energy conversion system is composed by a variable speed wind turbine, a mechanical transmission system described by a two mass drive train, a gearbox, a doubly fed induction generator rotor and by a two level converter.

[recommendations For Physical Exercise Practice During Pregnancy: A Critical Review].

Physical exercise is recommended for all healthy pregnant women. Regular practice of exercises during pregnancy can provide many physical and psychological benefits, with no evidence of adverse outcomes for the fetus or the newborn when exercise is performed at mild to moderate intensity. However, few pregnant women engage in this practice and many still have fears and doubts about the safety of exercise. The objective of the present study was to inform the professionals who provide care for Brazilian pregnant women about the current recommendations regarding physical exercise during pregnancy based on the best scientific evidence available. In view of the perception that few systematic models are available about this topic and after performing several studies in this specific area, we assembled practical information of interest to both the professionals and the pregnant women. We also provide recommendations about the indications, contraindications, modalities (aerobics, resistance training, stretching and pelvic floor training), frequency, intensity and duration indicated for each gestational trimester. The review addresses physical exercise recommendation both for low risk pregnant women and for special populations, such as athletes and obese, hypertensive and diabetic subjects. The advantages of an active and healthy lifestyle should be always reinforced during and after gestation since pregnancy is an appropriate period to introduce new habits because pregnant women are usually more motivated to adhere to recommendations. Thus, routine exams, frequent returns and supervision are recommended in order to provide new guidelines that will have long-term beneficial effects for both mother and child.

Equipamento microprocessado para geração de sinal de correção diferencial, em tempo real, para GPS

This work presents the development of low cost microprocessor-based equipment for generation of differential GPS correction signal, in real time, and configuration and supervision of the GPS base. The developed equipment contains a dedicated microcontroller connected to the GPS receiver, alphanumeric display and multifunction keyboard for configuration and operation of the system and communication interfaces. The electronic circuit has the function of receiving the information from GPS base; interpret them, converting the sentence in the RTCM SC-104 protocol. The microcontroller software makes the conversion of the signal received by the GPS base from the specific format to RTCM SC-104 protocol. The processing main board has two serials RS-232C standard interfaces. One of them is used for configuration and receiving the information generated by the GPS base. The other operates as output, sending the differential correction signal for the transmission system. The development of microprocessor-based equipment showed that it is possible the construction of a low cost private station for real time generation of differential GPS correction signal.

Da preparação preliminar ao nivel olimpico : um estudo de caso no remo brasileiro feminino

Universidade Estadual de Campinas . Faculdade de Educação Física

Relações entre aptidão fisica, sexo, idade, nivel de atividade fisica e supervisão dos exercicios em individuos fisicamente ativos de 50 a 79 anos de idade

Universidade Estadual de Campinas . Faculdade de Educação Física

A familia, o adolescente e suas relações com a pratica de atividades fisicas em região metropolitana e interiorana do Estado de São Paulo

Universidade Estadual de Campinas . Faculdade de Educação Física

Lei n.º 11.889/2008: avanço ou retrocesso nas competências do técnico em saúde bucal?

O objetivo deste estudo foi analisar as competências que, desde a aprovação da lei n.º 11.889/08, incumbem ao técnico em saúde bucal (TSB) no Brasil, incluindo os termos definidos para sua supervisão. Foi realizada análise documental, comparando-se as competências definidas no referido instrumento legal com as previstas no parecer n.º 460/75 do Conselho Federal de Educação e na resolução n.º 63/2005 do Conselho Federal de Odontologia. Foram empregadas técnicas de análise temática considerando-se as habilidades em termos de ações diretas e indiretas distribuídas em quatro áreas de competência: planejamento e administração em saúde, promoção da saúde, prevenção de doenças e de assistência individual. Embora as competências aprovadas na lei tenham sido distribuídas em um número menor de itens, comparado aos dois outros documentos, do ponto de vista qualitativo, os resultados da análise permitiram concluir que vários avanços foram obtidos com a regulamentação da profissão, nos termos aprovados, em todas as áreas de competência. Houve impacto positivo para o processo de trabalho em saúde, tanto com relação à cooperação interprofissional quanto à supervisão técnica das atividades, representando uma conquista relevante dos trabalhadores da área e também uma contribuição significativa para avançar na ampliação do acesso aos serviços odontológicos

A qualidade das refeições de empresas cadastradas no Programa de Alimentação do Trabalhador na cidade de São Paulo

OBJETIVO: Avaliar a qualidade global das refeições oferecidas por Unidades de Alimentação e Nutrição de empresas beneficiárias do Programa de Alimentação do Trabalhador, na cidade de São Paulo. MÉTODOS: Estudo transversal realizado com 72 empresas cadastradas no programa. Foram coletadas informações de três dias consecutivos das refeições oferecidas no almoço, no jantar e na ceia. A qualidade das refeições oferecidas foi avalia pelo Índice de Qualidade da Refeição, e sua análise foi feita de forma estratificada segundo o perfil da empresa obtido pela análise de cluster. RESULTADOS: A média do Índice de Qualidade da Refeição para as grandes refeições foi de 66,25. Foram obtidos dois grupos de empresas na análise de cluster. As empresas do primeiro, composto em sua maioria por empresas do setor de comércio de micro e pequeno porte, cadastradas na modalidade de autogestão e sem supervisão de nutricionista, obtiveram pior qualidade da refeição (Índice=56,23). As empresas do segundo cluster, constituído principalmente por empresas de médio e grande porte do setor industrial, com gestão terceirizada e supervisão de nutricionista, obtiveram pontuação média do Índice de 82,95. CONCLUSÃO: As refeições oferecidas pelas empresas participantes do Programa de Alimentação do Trabalhador não estavam adequadas, segundo o Índice de Qualidade da Refeição. As empresas de menor porte e estrutura tiveram refeições de pior qualidade quando comparadas com as demais, demonstrando que empresas deste perfil são prioritárias para intervenções dentro do Programa de Alimentação do Trabalhador.

Efetividade de programa de agentes comunitários na promoção da saúde bucal

OBJETIVO:Avaliar mudanças em conhecimentos, atitudes e acesso/utilização de serviços odontológicos decorrentes de um programa de promoção da saúde bucal com agentes comunitários de saúde. MÉTODOS:Um projeto de capacitação combinando ensino-aprendizagem, apoio e supervisão, foi desenvolvido entre os meses de julho de 2003 a agosto de 2004. As mudanças foram avaliadas por meio de entrevistas estruturadas em que participaram 36 agentes comunitários de saúde e uma amostra de 91 mulheres e mães, representativa de donas de casa com 25 a 39 anos de idade, alfabetizadas e residentes em domicílios de três a seis cômodos no município de Rio Grande da Serra (SP). Foram colhidos dados sobre conhecimentos de saúde-doença bucal, práticas e capacidades auto-referidas em relação ao auto-exame, higiene bucal, número de residentes e de escovas dentais individuais e coletivas em cada domicílio e acesso e uso de serviços odontológicos. Por meio do teste t de Student pareado, foram comparadas as médias dos valores obtidos antes e depois do programa para cada um dos grupos estudados. As respostas foram analisadas adotando-se um nível de significância de 5%. RESULTADOS: Foram observadas diferenças estatisticamente significativas para questões relativas ao conhecimento de saúde bucal entre os agentes e entre as mulheres antes e depois da capacitação (p<0,05). Desequilíbrio entre o número de escovas e de indivíduos em cada família diminuiu. A freqüência da escovação e do uso do fio dental se elevou depois da atuação dos agentes. Os valores de auto-avaliação da higiene bucal aumentaram. Modificação nas práticas e capacidades auto-referidas mostrou significativa elevação da auto-confiança. O acesso ao serviço foi mais fácil (p<0,000) e seu uso mais regular (p<0,000) entre mulheres. CONCLUSÕES: Houve mudanças positivas na percepção em relação a aspectos de saúde bucal, na auto-confiança e no acesso e uso de serviços odontológicos. Tais mudanças po

Radial variation of anatomical features, wood density and decay resistance in teak (Tectona grandis) from two qualities of growing sites and two climatic regions of Costa Rica

The objective of this study was to show the radial variation of some anatomic characteristics, wood density and natural durability of teak (Tectona grandis L.F.) growing in Costa Rica. Samples of trees 13 years old were obtained from two growing sites (high and low growing) of plantations established in a humid tropical climate (CHT) and dry tropical climate (CST). The variables measured of the fibers as well as for the rays were not affected by the climate or the type of growing site, except for the length of the fibers. The fibers of teak wood from the best growing site were significantly larger. Vessels were found with a greater frequency for the CST but mostly solitary in comparison with the CBT. Average density, maximum density and the variation within the ring presented a light higher magnitude for the CST. The quality of the growing site did not affect these variables. The resistance of fungus attack was similar in the area of heartwood near the pith compared to the heartwood near the sapwood for all the conditions evaluated. Nevertheless, it was observed in some trees a similar resistance of fungus attack for areas of sapwood compared to similar areas of heartwood.

Evaluation of the Incidence of Bladder Perforation After Transurethral Bladder Tumor Resection in a Residency Setting

Purpose: To evaluate prospectively the actual bladder perforation incidence during transurethral resection of bladder tumor (TURB) performed by residents and to identify possible predisposing factors to such condition. Patients and Methods: Thirty-four patients with bladder tumor were submitted to TURB in our academic institution in April 2006, and were prospectively studied. Procedures were all done by senior residents under an attending direct supervision. All patients had a cystograms performed after the procedure by the injection of 400 mL of saline-diluted contrast solution with low-pressure infusion through the Foley catheter. The cystograms were evaluated blindly by a single radiologist. All patients were examined by cystoscopy and/or CT every 3 months for the first 2 years postoperatively. Results: The cystogram showed contrast leaking compatible with bladder perforation in 17 (50%) cases. None of the perforations were recognized intraoperatively by the surgeon. All perforations were extraperitoneal and managed conservatively. There was no significant correlation between the incidence of bladder perforation and the patient age (p = 0.508), the tumor stage (p = 0.998), the tumor grade (p = 0.833), the number of lesions (p = 0.394), and the tumor size (p = 0.651). The only factor that had impact on the development of bladder perforation was tumor localization at the bottom of the bladder (p = 0.035; OR, 6750; 95% CI, 1.14, 39.8). Conclusion: Asymptomatic perforations of the bladder wall occur very frequently after a TURB procedure performed by residents in training and, most of the time, are not noticed by the surgeon. Localization of the tumor at bladder dome was the only factor that negatively influenced perforation rates.

Remote control of CNC machines using the CyberOPC communication system over public networks

During the last few years, the evolution of fieldbus and computers networks allowed the integration of different communication systems involving both production single cells and production cells, as well as other systems for business intelligence, supervision and control. Several well-adopted communication technologies exist today for public and non-public networks. Since most of the industrial applications are time-critical, the requirements of communication systems for remote control differ from common applications for computer networks accessing the Internet, such as Web, e-mail and file transfer. The solution proposed and outlined in this work is called CyberOPC. It includes the study and the implementation of a new open communication system for remote control of industrial CNC machines, making the transmission delay for time-critical control data shorter than other OPC-based solutions, and fulfilling cyber security requirements.