Evaluation of preventive measures for mother-to-child transmission of HIV in Aracaju, State of Sergipe, Brazil

INTRODUCTION: The main route of human immunodeficiency virus (HIV) infection in children is from mother to child. The preventive measures established for the Aids Clinical Trial Group protocol 076 (ACTG 076) significantly reduces HIV vertical transmission rates. This study aims to evaluate the implementation of the ACTG 076 protocol in the maternity units of State of Sergipe, Brazilian northeast. METHODS: This is a descriptive, retrospective study with a quantitative approach, with HIV positive women and children exposed, attending a Maternity reference for high-risk pregnancies. Data were obtained from patient records registered in the years 1994 to 2010. RESULTS: Amongst the 110 pregnant women and exposed newborns, the ACTG 076 protocol was fully utilized in only 31.8% of the participants. During the prenatal period, zidovudine (ZDV) was taken by 79.1% of the pregnant women. Only 49.1% of HIV seropositive patients used ZDV during delivery. Two (1.8%) children were considered infected and 50 (45.5%) do not have a conclusive diagnosis to date. CONCLUSIONS: There were significant deficiencies in the prevention of mother-to-child transmission of HIV, including lack of compliance with the three phases of the ACTG 076 protocol; inadequacies in prenatal care; inappropriate mode of delivery and lack of adequate follow up of exposed children.

Bone tuberculosis: a case report on child

The authors report a case of a 12-year-old child with a complaint of pain and deformity in the lower thoracic region that had lasted for two years. Clinical, epidemiological and laboratory characteristics associated with images of apparent damage in the T9-T10 and T11-T12 vertebrae taken by radiography of the thoracic spine and nuclear magnetic resonance in addition to the positivity of the molecular test based on the polymerase chain reaction, led to tuberculous spondylitis being diagnosed and specific therapy was started. Culture of vertebral biopsy was positive for Mycobacterium tuberculosis after thirty days.

Evaluation of outpatient child-adolescent mental health services (CAMHS) in Attica-Greece

ABSTRACT: Background: Childhood is a critical time for social and emotional development, educational progress and mental health prevention. Mental health for children and adolescents is defined by the achievement of expected developmental, cognitive, social and emotional skills. The development of child-adolescent mental health services (CAMHS) is a necessity for each country, not only as a prevention measure for the wellbeing of people, but also as an investment to the future of countries. Qualitative evaluation of services is the only way to ensure whether services function under quality standards and increase the possibility of better outcomes for their patients. This study examines the greek outpatient CAMHS against the British Standards of National Institute of Excellence for community CAMHS. The Standards assessed refer to the areas of Assessment, Care and Intervention. Objectives: The main objectives of the study are 1) to evaluate Greek outpatient CAMHS in the Attica region 2) to promote the evaluation process for mental health services in Greece. Methods: Due to the fact that Greek services are based on the British model, the tool used was the British self-review questionnaire of Quality Network for Community CAMHS(QNCC).The tool was translated, adapted and posted to services. Twelve out of twenty outpatient CAMHS of Attica (including Athens) responded. Data was collected and performed by the Statistical Package for Social Sciences SPSS. Results: The study resulted that the CAMHS examined, meet moderately the British Standards of 1) Referral and Access, 2) Assessment & Care planning, 3) Care & Intervention. Two out of twelve services examined, meet the standards of "Assessment and Care" in a higher percentage between 75% and 100%. Conclusions: The paper describes a satisfactory function of CAMHS in Attica prefecture taking into consideration the extremely difficult political situation of Greece at the time of the research. Strong and weak domains are identified. Also the translation and adaptation of British tools promote the evaluation process and quality assurance of Greek CAMHS.

Dystrophic calcinosis in a child with a thumb sucking habit: case report

We present an uncommon case of a 3-year-old boy with a finger sucking habit who developed dystrophic calcification in his left thumb. Two years after excision, there was no recurrence, and the thumb retained full range of motion. We also discuss its probable pathogenesis and present a brief review of the literature about orthopedic complications in the hand due to this habit.

Canada, a child's play

Science4you, a Portuguese developer, producer and seller of scientific and educational toys, leveraged the worldwide growth of this category to successfully expand its operations abroad. Following a recent entry into the United States market, the purpose of this report is to help the company define the next step in its international expansion. A customized scoring model, based on a set of relevant macro and micro-criteria was developed for Anglo-Saxon and Asian countries, yielding Canada as the market with the highest potential. The recommended entry mode is direct exporting via an independent distributor, being complemented with a financial and risk analysis.

Annoyance and welfare costs from the presence of renewable energy power plants: an application of the contingent valuation method

Sustainability is frequently defined by its three pillars: economically viable, socially equitable, and environmentally bearable. Consequently the evaluation of the sustainability of any decision, public or private, requires information on these three dimensions. This paper focuses on social sustainability. In the context of renewable energy sources, the examination of social sustainability requires the analysis of not only the efficiency but also the equity of its welfare impacts. The present paper proposes and applies a methodology to generate the information necessary to do a proper welfare analysis of the social sustainability of renewable energy production facilities. This information is key both for an equity and an efficiency analysis. The analysis focuses on the case of investments in renewable energy electricity production facilities, where the impacts on local residents��� welfare are often significantly different than the welfare effects on the general population. We apply the contingent valuation method to selected facilities across the different renewable energy power plants located in Portugal and conclude that local residents acknowledge differently the damage sustained by the type, location and operation of the plants. The results from these case studies attest to the need of acknowledging and quantifying the negative impacts on local communities when assessing the economic viability, social equity and environmental impact of renewable energy projects.

Child abuse monitor system model: a health care critical knowledge monitor system

The Childhood protection is a subject with high value for the society, but, the Child Abuse cases are difficult to identify. The process from suspicious to accusation is very difficult to achieve. It must configure very strong evidences. Typically, Health Care services deal with these cases from the beginning where there are evidences based on the diagnosis, but they aren���t enough to promote the accusation. Besides that, this subject it���s highly sensitive because there are legal aspects to deal with such as: the patient privacy, paternity issues, medical confidentiality, among others. We propose a Child Abuses critical knowledge monitor system model that addresses this problem. This decision support system is implemented with a multiple scientific domains: to capture of tokens from clinical documents from multiple sources; a topic model approach to identify the topics of the documents; knowledge management through the use of ontologies to support the critical knowledge sensibility concepts and relations such as: symptoms, behaviors, among other evidences in order to match with the topics inferred from the clinical documents and then alert and log when clinical evidences are present. Based on these alerts clinical personnel could analyze the situation and take the appropriate procedures.

Mothers' beliefs concerning severity and need for intervention in child maltreatment

Disserta����o de mestrado integrado em Psicologia Cl��nica e da Sa��de

Fine time scaling of purifying selection on human nonsynonymous mtDNA mutations based on the worldwide population tree and mother-child pairs

A high-resolution mtDNA phylogenetic tree allowed us to look backward in time to investigate purifying selection. Purifying selection was very strong in the last 2,500 years, continuously eliminating pathogenic mutations back until the end of the Younger Dryas (���11,000 years ago), when a large population expansion likely relaxed selection pressure. This was preceded by a phase of stable selection until another relaxation occurred in the out-of-Africa migration. Demography and selection are closely related: expansions led to relaxation of selection and higher pathogenicity mutations significantly decreased the growth of descendants. The only detectible positive selection was the recurrence of highly pathogenic nonsynonymous mutations (m.3394T>C-m.3397A>G-m.3398T>C) at interior branches of the tree, preventing the formation of a dinucleotide STR (TATATA) in the MT-ND1 gene. At the most recent time scale in 124 mother-children transmissions, purifying selection was detectable through the loss of mtDNA variants with high predicted pathogenicity. A few haplogroup-defining sites were also heteroplasmic, agreeing with a significant propensity in 349 positions in the phylogenetic tree to revert back to the ancestral variant. This nonrandom mutation property explains the observation of heteroplasmic mutations at some haplogroup-defining sites in sequencing datasets, which may not indicate poor quality as has been claimed.

The Portuguese programme ���one laptop per child��� and its impact on families: a study on parents��� and children���s perspectives

This paper intends to present and reflect upon some of the findings emerging from a research project entitled ���Navigating with ���Magalh��es���: Study on the Impact of Digital Media on Schoolchildren��� that was conducted at the Communication and Society Research Centre at the University of Minho, Braga, Portugal. The project focused on the politics of the governmental programme ���One Laptop per Child��� part of the Portuguese Technological Plan for Education, and the uses of the ���Magalh��es��� computer, and other media, by children aged 8-10 years. This paper analyses the impact of this particular public policy on digital literacy of young children based mostly on the perspectives of parents and their modes of mediation. It also debates parents��� and children���s perspectives on parental rules on computer and Internet usage. It ends by concluding that the impact of this programme occurred mainly at the level of access rather than the social and educational uses and practices. It also highlights the importance of family in the way children access and use ICT.

The Portuguese programme one laptop per child: political, educational and social impact

In 2008, the XVII Portuguese Constitutional Government launched the ���e.escolinha��� programme, within the Technological Plan for Education, which set out the distribution of a computer, called ���Magalh��es���, designed for chil-dren attending the 1st cycle of basic education. Suspended in 2011 by the XIX Government, this programme has allowed, however, almost 500 000 children to have access to a personal computer. It was expected that this political measure would ���revolutionise��� the national education system by bringing changes to the pedagogical practices of teachers and the learning processes of children and by achieving educational success, in general. Based on documental analysis and on a set of interviews with key decision-makers in conceiving, implementing and monitoring this governmental initiative, the ��� rst part of this chapter presents and analyses the ���e.escolinha��� initiative and the policies be-hind that governmental programme, seeking to disassemble those objectives and provide some insights into the relationship between discourses, rhetoric, and reality. After that, the chapter focuses on children���s uses and practices with the ���Magalh��es��� laptop, at school and at home. Based on the results of questionnaires ��� lled in by approximately 1500 children from 32 First Cycle public schools of the municipality of Braga (north of Portugal) and also from questionnaires applied to their parents and teachers, this chapter intends to analyse the real impact of this initiative for children, family and school. It also seeks to discuss the contribution of this educational policy to children���s digital literacy and also to their own and their families��� social and digital inclusion. To understand if it represented an added value to teachers��� pedagogical practice is another of its aims. The ��� ndings point out a major focus on technology and access rather than on uses and competences or even on social, educational and cultural change. In fact, a major conclusion is the existence of a strong gap between the policy and the practices, typical of a top-down policy design. This study is an integrant part of a research project titled ���Navigating with ���Magalh��es���: Study on the Impact of Digital Media in Schoolchildren��� conducted at the University of Minho, Portugal, ���nanced by the Portuguese Foundation for Science and Technology [PTDC/CCI-COM/101381/2008] and co-funded by the European Regional Development Fund [COMPETE: FCOMP-01-0124-FEDER-009056].

Constrictive pericarditis in a 19-month-old child

We report a case of chronic nonspecific constrictive pericarditis with myocardial involvement in a 19-month-old infant. The patient underwent total pericardiectomy and had irreversible hemodynamic instability. Constrictive pericarditis is rare in childhood. It may follow several processes, most frequently an infectious disease. The natural course of the disease consists of progressive myocardial dysfunction with atrioventricular valvular involvement. When diagnosis is established early in the course of the disease and treatment started immediately, the evolution is favorable in most instances.

A cumulative risk model of child physical maltreatment potential: findings from a community-based study

"Published online before print November 20, 2015"