Análise dos efeitos de um treino parental sobre comportamentos de crianças com TDAH: comparação entre setting terapêutico e ambiente domiciliar

Esse estudo foi realizado com o objetivo de contribuir com a avaliação dos efeitos de uma intervenção comportamental direcionada a pais/responsáveis de crianças com Transtorno do Déficit de Atenção e Hiperatividade-TDAH, investigando os efeitos desse modelo de treino parental em duas condições, setting terapêutico (Condição 1) e ambiente domiciliar (Condição 2), sobre a ocorrência de comportamentos de hiperatividade versus autocontrole. Os participantes foram pais de quatro crianças, na faixa etária entre cinco e nove anos. Utilizaram-se como instrumentos: Termo de Consentimento Livre e Esclarecido-TCLE, Inventário de Estilos Parentais-IEP, Lista de Verificação Comportamental para Crianças e Adolescentes-CBCL/TRF, Escala do TDAH versão para professor, Roteiro de Entrevista Inicial, Roteiro de Entrevista de Avaliação, Roteiro de Entrevista Final, Critério de Classificação Econômica Brasil-CCEB. O procedimento de pesquisa consistiu em: (a) contato com neuropediatra; (b) triagem e convite aos participantes; (c) distribuição de dois participantes para cada condição de intervenção; (d) avaliação inicial, incluindo entrevista com os responsáveis, aplicações do TCLE, IEP e CBCL; (e) visita à escola e aplicações do TCLE, da Escala do TDAH e do TRF, versões para professor; (f) realização de cinco sessões de intervenção, gravadas em áudio e vídeo, duas de linha de base, uma de habituação às regras e duas de manutenção das regras e instalação de comportamento de auto-observação, que envolveram situações de interação em jogos de regras, com participação da terapeuta-pesquisadora, da mãe e da criança; (g) realização de entrevista de avaliação da primeira fase; (h) reversão de contextos para os participantes e (i) avaliação final, realizada por meio de entrevista com os responsáveis e re-aplicação dos instrumentais padronizados com pais e professores, utilizados anteriormente, mais o CCEB. Os dados obtidos por meio dos instrumentos padronizados receberam o tratamento indicado nos manuais. Dois sistemas de categorias de análise do comportamento foram utilizados, um para descrever os comportamentos das mães e outro para comportamentos observados nas crianças. Os principais resultados sugerem que as crianças em ambiente de consultório tiveram maior ocorrência de emissão de comportamentos de autocontrole do que as em ambiente de domicílio, as quais, por sua vez, tiveram prevalência de comportamentos de hiperatividade/impulsividade. Do mesmo modo, as mães em ambiente de consultório obtiveram maiores escores em práticas educativas positivas e menos em negativas, comparadas às mães do grupo de domicílio. Houve aumento de práticas educativas positivas para a maioria das mães. Discute-se o contexto de consultório enquanto um ambiente eficaz de intervenção, embora se reconheça que as dificuldades de controle de comportamentos inadequados são maiores para os pais em ambiente domiciliar, por isso, intervenções em ambiente natural devem ser consideradas no processo terapêutico. Por outro lado, o treino parental demonstrou ser efetivo na aquisição, fortalecimento e manutenção de práticas educativas positivas em todas as mães, o que pode influenciar beneficamente os comportamentos das crianças com TDAH.

Setting boundaries: Environmental and spatial effects on Odonata larvae distribution (Insecta)

Características ambientais e distâncias espaciais entre os locais foram utilizadas para explicar a distribuição das espécies no ambiente, através das predições da teoria Neutra (espaço) e teoria do Nicho (ambiente). Foram avaliados os efeitos de fatores geográficos e ambientais sobre a distribuição de larvas de Odonata ao longo da Bacia do Rio Suiá-Missu, no estado de Mato Grosso. Nós testamos a hipótese de que (1) o ambiente é o principal fator de estruturação da comunidade devido às suas exigências ecofisiológicas; e (2) o padrão, se presente, é mais expressivo para Zygoptera. As amostras foram feitas em 12 locais na Bacia do Rio Suiá-Missu, em três campanhas (2007/2008), com um total de 1.382 larvas de Odonata, composta por 10 famílias, 51 gêneros e 100 morfoespécies. Os Anisoptera foram mais abundantes que Zygoptera, que compreende 81% de todas as amostras. O ambiente afetou Zygoptera (R = 0,291; p = 0,007) e foi o principal fator de estruturação da assembléia. Assim, a teoria do nicho foi confirmada. A ausência deste efeito sobre Anisoptera pode ser devido às adaptações ecofisiológicos que lhes permitem ocupar diferentes habitats. Larvas de Zygoptera são indicadores de mudanças na estrutura do habitat. Os efeitos das variáveis ambientais sobre a ecologia das larvas enfatizam a forte relação entre esses organismos e integridade ambiental.

Non-destructive thermal wave method applied to study thermal properties of fast setting time endodontic cement

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Compressive strength and setting time of MTA and portland cement associated with different radiopacifying agents

The aim of this study was to evaluate the compressive strength and setting time of MTA and Portland cement (PC) associated with bismuth oxide (BO), zirconium oxide (ZO), calcium tungstate (CT), and strontium carbonate (SC). Methods. For the compressive strength test, specimens were evaluated in an EMIC DL 2000 apparatus at 0.5 mm/min speed. For evaluation of setting time, each material was analyzed using Gilmore-type needles. The statistical analysis was performed with ANOVA and the Tukey tests, at 5% significance. Results. After 24 hours, the highest values were found for PC and PC + ZO. At 21 days, PC + BO showed the lowest compressive strength among all the groups. The initial setting time was greater for PC. The final setting time was greater for PC and PC + CT, and MTA had the lowest among the evaluated materials (< 0.05). Conclusion. The results showed that all radiopacifying agents tested may potentially be used in association with PC to replace BO.

Reflexões psicanalíticas winnicottianas sobre o sentido do silêncio no setting

We tried to analyze in this paper the meaning of silence into the analytical setting, based in Winnicott’s proposal of psychoanalysis and from clinical experience fragments of one the authors. Therefore, we surveyed the meaning of silence in the setting for some psychoanalysts and, afterwards, we made reference mainly to the concepts related to Winnicott’s Theory of the Emotional Maturity, such as holding, handling, the presentation of objects, and those concerning hesitation and transitionality. We further availed ourselves of the concepts of transference and count transference to ponder on the therapeutic dyad into the analytical setting. Our final considerations point to the need to consider silence as an important communication in certain circumstances of the therapeutic work, as well as suggesting that the setting, in this case study, requested hopeful non-invasive approach of the therapist, to allow the appearance of transitional space through which the emotional maturity can be resumed in this patient.

Double-setting alpha-tricalcium phosphate cement provided with interconection channels in rabbits after enucleation: a potential implant for the anophthalmic socket

The purpose of this study was to evaluate the macroscopy and microstructure of a double setting alpha-tricalcium phosphate bone cement sphere provided with interconnection channels (alpha-TCP-i), as well as the integration of the implant with the rabbits' orbital tissue, through macroscopic analysis and histopathology. The external and internal surfaces of the alpha-TCP-i were evaluated macroscopically and by electron microscopy. Twelve New Zealand rabbits received 12mm implants of alpha-TCP-i following enucleation of the left eye. The clinical assessment was undertaken daily during the first 15 days, followed by fortnightly assessment until the end of the study period. For the morphological analysis, exenteration was performed in 3 animals per experimental period (15, 45, 90 and 180 days). The external and internal surfaces of the implant appeared solid, smooth and compact, with six channels which interconnected centrally. The micro-architecture was characterized by the formation of columns of hexagonal crystals. No signs of infection, exposure, dehiscence of sutures or extrusion of the implant were noted in any of the animals during the entire period of the study. The morphological evaluation demonstrated the presence of a thin capsule around the implant, from whence appeared fibro-vascular projections, which penetrated it through the interconnecting channels. In the first days after the insertion of the implant, an intense inflammatory reaction was noted. At 180 days, however, there were no signs of inflammation. The alpha-tricalcium phosphate cement implant was well tolerated in this rabbit model and appeared to be relatively inert with some fibrovascular ingrowth through the large channels.

Mycobacterium tuberculosis population structure shift in a 5-year molecular epidemiology surveillance follow-up study in a low endemic agro-industrial setting in São Paulo, Brazil

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

CC98-414 Money 2000+ Setting a Goal

Money 2000+ provides you with opportunities to acquire skills and information to help you reach your money goal(s). The first step with Money 2000+ is setting your goal(s). Then, by taking more control of your spending and where your money goes, you may be surprised at what you can actually accomplish as you progress with Money 2000+ Maybe you already know what you want to accomplish. Even so, take some time to read the rest of this booklet and to think about all parts of your life to make sure you don't miss something important.

Hydrogeologic Setting and Ground-Water Flow Simulations of the Eastern High Plains Regional Study Area, Nebraska

The transport of anthropogenic and natural contaminants to public-supply wells was evaluated in a part of the High Plains aquifer near York, Nebraska, as part of the U.S. Geological Survey National Water-Quality Assessment Program. The aquifer in the Eastern High Plains regional study area is composed of Quaternary alluvial deposits typical of the High Plains aquifer in eastern Nebraska and Kansas, is an important water source for agricultural irrigation and public water supply, and is susceptible and vulnerable to contamination. A six-layer, steady-state ground-water flow model of the High Plains aquifer near York, Nebraska, was constructed and calibrated to average conditions for the time period from 1997 to 2001. The calibrated model and advective particle-tracking simulations were used to compute areas contributing recharge and travel times from recharge areas to selected public-supply wells. Model results indicate recharge from agricultural irrigation return flow and precipitation (about 89 percent of inflow) provides most of the ground-water inflow, whereas the majority of ground-water discharge is to pumping wells (about 78 percent of outflow). Particle-tracking results indicate areas contributing recharge to public-supply wells extend northwest because of the natural ground-water gradient from the northwest to the southeast across the study area. Particle-tracking simulations indicate most ground-water travel times from areas contributing recharge range from 20 to more than 100 years but that some ground water, especially that in the lower confined unit, originates at the upgradient model boundary instead of at the water table in the study area and has travel times of thousands of years.

SETTING UP AN EFFECTIVE URBAN BLACKBIRD ROOST CONTROL PROGRAM

The City of Denton is situated 35 miles north of north-central Texas. This area is within one of the major N-S corridors for migratory birds. It is also far enough south so that winters are generally mild and open. The average rainfall of 30 inches sustains good stands of pecan and several species of oak, which serve as excellent roost sites for blackbirds. For the past several years, summering flocks of blackbirds have chosen Denton as a roosting site. Interviews with oldtimers here indicate that flocks of birds have always been around. It is only in recent years that their numbers seem much greater and the resulting mess deeper. They also say that "in the old days" if flocks appeared and started creating a problem, they were simply shot with little fuss resulting. This method is not generally acceptable today.

Do established prognostic factors explain the different mortality rates in ICU septic patients around the world?

Background. The aim of this paper was to clarify if previously established prognostic factors explain the different mortality, rates observed in ICU septic patients around the world. Methods. This is a sub-study from the PROGRESS study, which was an international, prospective, observational registry of ICU patients with severe sepsis. For this study we included 10930 patients from 24 countries that enrolled more than 100 patients in the PROGRESS. The effect of potential prognostic factors on in-hospital mortality was examined using univariate and multivariate logistic regression. The complete set of data was available for 7022 patients, who were considered in the multivariate analysis. Countries were classified according to country, income, development status, and in-hospital mortality terciles. The relationship between countries' characteristics and hospital mortality mortality was evaluated using linear regression. Results. Mean in-hospital mortality was 49.2%. Severe sepsis in-hospital mortality varied widely in different countries, ranging from 30.6% in New Zealand to 80.4% in Algeria. Classification as developed or developing country was not associated with in-hospital mortality (P=0.16), nor were levels of gross national product per capita (P=0.15). Patients in the group of countries with higher in-hospital mortality, had a crude OR for in-hospital death of 2.8 (95% CI 2.5-3.1) in comparison to those in the lower risk group. After adjustments were made for all other independent variables, the OR changed to 2.9 (95% CI 2.5-3.3). Conclusion. Severe sepsis mortality varies widely, in different countries. All known markers of disease severity and prognosis do not fully, explain the international differences in mortality,. Country, income does not explain this disparity, either. Further studies should be developed to verify if other organizational or structural factors account for disparities in patient care and outcomes. (Minerva Anestesiol 2012;78:1215-25)

Association between education in EOL care and variability in EOL practice: a survey of ICU physicians

This study investigated the association between physician education in EOL and variability in EOL practice, as well as the differences between beliefs and practices regarding EOL in the ICU. Physicians from 11 ICUs at a university hospital completed a survey presenting a patient in a vegetative state with no family or advance directives. Questions addressed approaches to EOL care, as well physicians' personal, professional and EOL educational characteristics. The response rate was 89%, with 105 questionnaires analyzed. Mean age was 38 +/- A 8 years, with a mean of 14 +/- A 7 years since graduation. Physicians who did not apply do-not-resuscitate (DNR) orders were less likely to have attended EOL classes than those who applied written DNR orders [0/7 vs. 31/47, OR = 0.549 (0.356-0.848), P = 0.001]. Physicians who involved nurses in the decision-making process were more likely to be ICU specialists [17/22 vs. 46/83, OR = 4.1959 (1.271-13.845), P = 0.013] than physicians who made such decisions among themselves or referred to ethical or judicial committees. Physicians who would apply "full code" had less often read about EOL [3/22 vs. 11/20, OR = 0.0939 (0.012-0.710), P = 0.012] and had less interest in discussing EOL [17/22 vs. 20/20, OR = 0.210 (0.122-0.361), P < 0.001], than physicians who would withdraw life-sustaining therapies. Forty-four percent of respondents would not do what they believed was best for their patient, with 98% of them believing a less aggressive attitude preferable. Legal concerns were the leading cause for this dichotomy. Physician education about EOL is associated with variability in EOL decisions in the ICU. Moreover, actual practice may differ from what physicians believe is best for the patient.

Local symmetries in gauge theories in a finite-dimensional setting

It is shown that the correct mathematical implementation of symmetry in the geometric formulation of classical field theory leads naturally beyond the concept of Lie groups and their actions on manifolds, out into the realm of Lie group bundles and, more generally, of Lie groupoids and their actions on fiber bundles. This applies not only to local symmetries, which lie at the heart of gauge theories, but is already true even for global symmetries when one allows for fields that are sections of bundles with (possibly) non-trivial topology or, even when these are topologically trivial, in the absence of a preferred trivialization. (C) 2012 Elsevier B.V. All rights reserved.