Dor pós-operatória em crianças: uma abordagem de gênero

O objetivo do estudo foi verificar e descrever, sob o enfoque de gênero, as associações entre o sexo e as variáveis específicas da dor pós-operatória em pediatria. Corte transversal com 77 crianças, com idades entre seis e 13 anos (M=9 anos; dp=2,2 anos), ASA I e II, 77,9% pertencentes às classes socioeconômicas C e D, 68,8% meninos e 32,8% meninas. Os dados foram coletados no primeiro dia pós-operatório, por meio de entrevista semi-estruturada e quatro escalas de medida. As principais doenças de base foram adenoamigdalite e fraturas. A prevalência de dor foi de 91,7% para meninas e 75,5% para meninos (p>0,05). Não houve associação entre intensidade de dor e sexo; as palavras mais utilizadas para descrever a dor foram corta e aperta. A escala preferida foi a Escala de Faces do Cebolinha e da Mônica. O manejo da dor em pediatria ainda é inadequado e o gênero pode influenciar na resposta dor.

Investigating Gaze of Children with ASD in Naturalistic Settings.

BACKGROUND: Visual behavior is known to be atypical in Autism Spectrum Disorders (ASD). Monitor-based eye-tracking studies have measured several of these atypicalities in individuals with Autism. While atypical behaviors are known to be accentuated during natural interactions, few studies have been made on gaze behavior in natural interactions. In this study we focused on i) whether the findings done in laboratory settings are also visible in a naturalistic interaction; ii) whether new atypical elements appear when studying visual behavior across the whole field of view. METHODOLOGY/PRINCIPAL FINDINGS: Ten children with ASD and ten typically developing children participated in a dyadic interaction with an experimenter administering items from the Early Social Communication Scale (ESCS). The children wore a novel head-mounted eye-tracker, measuring gaze direction and presence of faces across the child's field of view. The analysis of gaze episodes to faces revealed that children with ASD looked significantly less and for shorter lapses of time at the experimenter. The analysis of gaze patterns across the child's field of view revealed that children with ASD looked downwards and made more extensive use of their lateral field of view when exploring the environment. CONCLUSIONS/SIGNIFICANCE: The data gathered in naturalistic settings confirm findings previously obtained only in monitor-based studies. Moreover, the study allowed to observe a generalized strategy of lateral gaze in children with ASD when they were looking at the objects in their environment.

Epidémiologie des cancers épithéliaux de la peau [Epidemiology of epithelial skin cancers]

With no less than 15,000 estimated new cases diagnosed per year, non melanomatous carcinomas are the commonest cutaneous cancers in the Swiss population. About 1 in 3 new cancer case is a basal (BCC) or a squamous cell carcinoma (SCC). Incidence rates are steadily increasing, faster for BCC than SCC. Rates are higher for men than women and increase exponentially with age. Systematic population-based registration of non melanomatous skin cancers faces many challenges that few cancer registries can meet. Rates of these cancers in Switzerland are among the highest in Europe. Primary and secondary nationwide prevention campaigns have been carried out for nearly 20 years with a focus on the deadliest cutaneous cancer: melanoma. However, detection of non melanomatous skin cancers benefits from these campaigns since prevention messages and means of early detection are similar for melanomas and other skin cancers.

Women survivors of intimate partner violence: the difficult transition to independence

Objective To understand the trajectories that women go through from entering into to leaving relationships involving intimate partner violence (IPV), and identify the stages of the transition process. Method We utilized a constructivist paradigm based on grounded theory. We ensured that the ethical guidelines of the World Health Organization for research on domestic violence were followed. The analysis focused on narratives of 28 women survivors of IPV, obtained from in-depth interviews. Results The results showed that the trajectories experienced by women were marked by gender issues, (self) silencing, hope and suffering, which continued after the end of the IPV. Conclusion The transition process consists of four stages: entry - falls in love and becomes trapped; maintenance - silences own self, consents and remains in the relationship; decides to leave - faces the problems and struggles to be rescued; (re) balance - (re) finds herself with a new life. This (long) process was developed by wanting (and being able to have) self-determination.

Emotional modulation of the ability to inhibit a prepotent response during childhood.

The present study examined the bottom-up influence of emotional context on response inhibition, an issue that remains largely unstudied in children. Thus, 62 participants, aged from 6 to 13 years old, were assessed with three stop signal tasks: one with circles, one with neutral faces, and one with emotional faces (happy and sad). Results showed that emotional context altered response inhibition ability in childhood. However, no interaction between age and emotional influence on response inhibition was found. Positive emotions were recognized faster than negative emotions, but the valence did not have a significant influence on response inhibition abilities.

Assessing risks of multiple sclerosis therapies.

Over the last two decades, thanks to the discovery of several pharmaceutical agents, multiple sclerosis (MS) has been transformed into a treatable disorder although the degree of therapeutic response may vary considerably. As more medications find their entry into the MS market, a clinician faces a mounting challenge of comparing risk and benefit profiles of various agents in an attempt to find the best treatment approach for each individual patient. In this review, we aim to summarize the available data on safety profiles of available MS therapies while focusing mostly on serious medication specific potential adverse events without discussing the teratogenic potential of each agent (unless there is a black box warning) or hypersensitivity reactions. Our goal is to provide a clinician with guidance on assuring the appropriate safety monitoring for patients treated with one of the agents discussed. We also comment on the future of risk management in MS and discuss possible enhancements to the current model of drug approval process and general strategies to improve the patient safety.

Aging effects on selective attention-related electroencephalographic patterns during face encoding.

Previous electrophysiological studies revealed that human faces elicit an early visual event-related potential (ERP) within the occipito-temporal cortex, the N170 component. Although face perception has been proposed to rely on automatic processing, the impact of selective attention on N170 remains controversial both in young and elderly individuals. Using early visual ERP and alpha power analysis, we assessed the influence of aging on selective attention to faces during delayed-recognition tasks for face and letter stimuli, examining 36 elderly and 20 young adults with preserved cognition. Face recognition performance worsened with age. Aging induced a latency delay of the N1 component for faces and letters, as well as of the face N170 component. Contrasting with letters, ignored faces elicited larger N1 and N170 components than attended faces in both age groups. This counterintuitive attention effect on face processing persisted when scenes replaced letters. In contrast with young, elderly subjects failed to suppress irrelevant letters when attending faces. Whereas attended stimuli induced a parietal alpha band desynchronization within 300-1000 ms post-stimulus with bilateral-to-right distribution for faces and left lateralization for letters, ignored and passively viewed stimuli elicited a central alpha synchronization larger on the right hemisphere. Aging delayed the latency of this alpha synchronization for both face and letter stimuli, and reduced its amplitude for ignored letters. These results suggest that due to their social relevance, human faces may cause paradoxical attention effects on early visual ERP components, but they still undergo classical top-down control as a function of endogenous selective attention. Aging does not affect the face bottom-up alerting mechanism but reduces the top-down suppression of distracting letters, possibly impinging upon face recognition, and more generally delays the top-down suppression of task-irrelevant information.

Does Prison Substance Abuse Treatment Reduce Recidivism?Performance Audit Report Iowa Department of Corrections Licensed Substance Abuse Programs, May 25, 2007

The Iowa Department of Corrections faces a growing prison population expected to quickly exceed current capacities. Additionally, nine out of every ten offenders have a history of alcohol or drug problems often both. Research suggests that alcohol and drugs lead to criminal behavior, which lead offenders right back to prison creating a vicious circle and placing a financial and societal burden on the state. However, research also shows that substance abuse treatment can minimize criminal behavior, and offers a way to shut the revolving prison door. Substance abuse programming attempts to change offender thinking patterns and behavior in order to facilitate re-entry back into the community, lessen substance abuse relapse and reduce recidivism. Yet nearly 60% of offenders with identified needs are not treated, and many lacking treatment are high risk. Additionally, the percentage of offenders returning to prison varies significantly from program to program and some programs can not show they have reduced recidivism when compared to offender groups with substance abuse problems and receiving no treatment at all. All of which minimize the effect substance Abuse programming has in curbing prison population growth and reducing crime.

Bundling and competition for slots: Sequential pricing

In this paper we study, as in Jeon-Menicucci (2009), competition between sellerswhen each of them sells a portfolio of distinct products to a buyer having limitedslots. This paper considers sequential pricing and complements our main paper (Jeon-Menicucci, 2009) that considers simultaneous pricing.First, Jeon-Menicucci (2009) find that under simultaneous individual pricing, equilibriumoften does not exist and hence the outcome is often inefficient. By contrast,equilibrium always exists under sequential individual pricing and we characterize it inthis paper. We find that each seller faces a trade-off between the number of slots heoccupies and surplus extraction per product, and there is no particular reason thatthis leads to an efficient allocation of slots.Second, Jeon-Menicucci (2009) find that when bundling is allowed, there alwaysexists an efficient equilibrium but inefficient equilibria can also exist due to purebundling (for physical products) or slotting contracts. Under sequential pricing,we find that all equilibria are efficient regardless of whether firms can use slottingcontracts, and both for digital goods and for physical goods. Therefore, sequentialpricing presents an even stronger case for laissez-faire in the matter of bundling thansimultaneous pricing.

Strong minimax lower bounds for learning

Minimax lower bounds for concept learning state, for example, thatfor each sample size $n$ and learning rule $g_n$, there exists a distributionof the observation $X$ and a concept $C$ to be learnt such that the expectederror of $g_n$ is at least a constant times $V/n$, where $V$ is the VC dimensionof the concept class. However, these bounds do not tell anything about therate of decrease of the error for a {\sl fixed} distribution--concept pair.\\In this paper we investigate minimax lower bounds in such a--stronger--sense.We show that for several natural $k$--parameter concept classes, includingthe class of linear halfspaces, the class of balls, the class of polyhedrawith a certain number of faces, and a class of neural networks, for any{\sl sequence} of learning rules $\{g_n\}$, there exists a fixed distributionof $X$ and a fixed concept $C$ such that the expected error is larger thana constant times $k/n$ for {\sl infinitely many n}. We also obtain suchstrong minimax lower bounds for the tail distribution of the probabilityof error, which extend the corresponding minimax lower bounds.

A simple permutation test for clusteredness

Hierarchical clustering is a popular method for finding structure in multivariate data,resulting in a binary tree constructed on the particular objects of the study, usually samplingunits. The user faces the decision where to cut the binary tree in order to determine the numberof clusters to interpret and there are various ad hoc rules for arriving at a decision. A simplepermutation test is presented that diagnoses whether non-random levels of clustering are presentin the set of objects and, if so, indicates the specific level at which the tree can be cut. The test isvalidated against random matrices to verify the type I error probability and a power study isperformed on data sets with known clusteredness to study the type II error.

Consultoria em Gestão de Recursos Naturais – Áreas Protegidas São Nicolau

São Nicolau apresenta uma configuração da qual ressaltam duas situações distintas: - um corpo principal, cujo contorno se assemelha ao do continente africano e um prolongamento oriental de 22.5 km, localmente designado por Ponta Norte. O corpo principal estende-se no sentido N-S e em 22.5 km, desde a Ponta Espechim à Ponta da Vermelharia e no sentido W-E desde a Ponta Bronco até à base N (alt. 138 m) no Campo da Preguiça, ao longo de 15.3 km. A extensão oriental vai desde o Campo da Preguiça até à Ponta à Ponta Pélam, no extremo leste. Na morfologia geral de S. Nicolau, com realce para as formações salientes de relevo, destacam-se: as plataformas costeiras de cotas baixas que contornam quase toda a ilha e que se relacionam com os derrames basálticos da última fase lávica, em parte recobertos por materiais piroclásticos ou depósitos de materiais de escorrimento; as formas de relevo acidentado que se erguem continuamente da superfície costeira e a crista montanhosa central, de relevos majestosos e miudamente talhados pela erosão e que são mais influenciados pelos ventos húmidos que sopram de Nordeste. O clima da ilha tem, em grande parte, características de extrema aridez, aridez acentuada e semi-aridez. Toda plataforma circundante, de baixo relevo, exceptuando a correspondente à fachada exposta a nordeste, apresenta características de extrema aridez. As faces viradas a E, S e W, plataformas de colinas salientes, formas residuais de relevo e vertentes escarpadas, demarcam-se pela sua acentuada aridez, enquanto que a fachada montanhosa exposta a NE apresenta características de região semi-árida. A fachada montanhosa exposta a NE, apresenta, características, de zonas sub-húmidas, a partir de 200/300 m até 600/700 m e de zonas húmidas, nas zonas do ponto culminante da ilha ou seja, Monte Gordo. Monte Gordo, Monte do Alto das Cabaças, considerados os centros de maior concentração de espécies da flora autóctone e da vegetação natural da ilha, e Fajã de Cima e Lombo Pelado, zonas de maior concentração do dragoeiro (Dracaena draco), são as áreas propostas para protecção.

Insider Trading and Real Investment

In this paper I analyze the effects of insider trading on real investmentand the insurance role of financial markets. There is a single entrepreneurwho, at a first stage, chooses the level of investment in a risky business.At the second stage, an asset with random payoff is issued and then the entrepreneurreceives some privileged information on the likely realization of productionreturn. At the third stage, trading occurs on the asset market, where theentrepreneur faces the aggregate demand coming from a continuum of rationaluniformed traders and some noise traders. I compare the equilibrium withinsider trading (when the entrepreneur trades on her inside information in theasset market) with the equilibrium in the same market without insider trading. Ifind that permitting insider trading tends to decrease the level of realinvestment. Moreover, the asset market is thinner and the entrepreneur's netsupply of the asset and the hedge ratio are lower, although the asset priceis more informative and volatile.

Regulating financial conglomerates

We investigate the optimal regulation of financial conglomerates which combinea bank and a non-bank financial institution. The conglomerate s risk-taking incentivesdepend upon the level of market discipline it faces, which in turn isdetermined by the conglomerate s liability strucure. We examine optimal capitalrequirements for standalone institutions, for integrated financial conglomerates,and for financial conglomerates that are structured as holding companies.For a given risk profile, integrated conglomerates have a lower probability offailure than either their standalone or decentralised equivalent. However, whenrisk profiles are endogenously selected conglomeration may extend the reachof the deposit insurance safety net and hence provide incentives for increasedrisk-taking. As a result, integrated conglomerates may optimally attract highercapital requirements. In contrast, decentralised conglomerates are able to holdassets in the socially most efficient place. Their optimal capital requirementsencourage this. Hence, the practice of regulatory arbitrage , or of transferingassets from one balance sheet to another, is welfare-increasing. We discuss thepolicy implications of our finding in the context not only of the present debateon the regulation of financial conglomerates but also in the light of existingUS bank holding company regulation.

Dinâmica populacional de ácaros fitófagos (Acari, Eriophyidae, Tenuipalpidae) em seis clones de seringueira no sul do Estado de Mato Grosso

Foi estudada a dinâmica populacional de Calacarus heveae Feres, 1992, Phyllocoptruta seringueirae Feres, 1998 (Eriophyidae) e Tenuipalpus heveae Baker, 1945 (Tenuipalpidae) em seis clones de seringueira (Hevea brasiliensis Muell. Arg.), com o intuito de conhecer a sazonalidade e as possíveis diferenças nos níveis de infestação dessas espécies sobre os diferentes clones, em seringal localizado no sul do Estado de Mato Grosso. Para isso, no período de março de 2004 a março de 2005, foram realizadas coletas num intervalo médio de catorze dias em seis parcelas clonais. Em cada amostragem, foram analisados 100 folíolos de cada parcela, registrando-se o número total de ácaros encontrados em ambas as faces. Os níveis de infestação das espécies variaram entre os diferentes clones. O clone RRIM 600 apresentou maior abundância de T. heveae, enquanto que PB 235 e PB 260 de P. seringueira e C. heveae, respectivamente. Por outro lado, esse último clone apresentou menor número de indivíduos de T. heveae e P. seringueirae, e PB 235 de C. heveae. O primeiro semestre foi o período crítico de infestação, porém a duração da ocorrência e o pico de abundância dos fitófagos variaram nos diferentes clones.