Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings

Objective: Fecal loading, cognitive impairment, loose stools, functional disability, comorbidity and anorectal incontinence are recognized as factors contributing to loss of fecal continence in older adults. The objective of this project was to assess the relative distribution of these factors in a variety of settings along with the outcome of usual management. Methods: One hundred and twenty adults aged 65 years and over with fecal incontinence recruited by convenience sampling from four different settings were studied. They were either living at home or in a nursing home or receiving care on an acute or rehabilitation elderly care ward. A structured questionnaire was used to elicit which factors associated with fecal incontinence were present from subjects who had given written informed consent or for whom assent for inclusion in the study had been obtained. Results: Fecal loading (Homes 6 [20%]; Acute care wards 17 [57%]; Rehabilitation wards 19 [63%]; Nursing homes 21 [70%]) and functional disability (Homes 5 [17%]; Acute care wards 25 [83%]; Rehabilitation wards 25 [83%]; Nursing homes 20 [67%]) were significantly more prevalent in the hospital and nursing home settings than in those living at home (P < 0.01). Loose stools were more prevalent in the hospital setting than in the other settings (Homes 11 [37%]; Acute care wards 20 [67%]; Rehabilitation wards 17 [57%]; Nursing homes 6 [20%]) (P < 0.01). Cognitive impairment was significantly more common in the nursing home than in the other settings (Nursing homes 26 [87%], Homes 5 [17%], Acute care wards 13 [43%], Rehabilitation wards 14 [47%]) (P < 0.01). Loose stools were the most prevalent factor present at baseline in 13 of the 19 (68%) subjects whose fecal incontinence had resolved at 3 months. Conclusion: The distribution of the factors contributing to fecal incontinence in older people living at home differs from those cared for in nursing home and hospital wards settings. These differences need to be borne in mind when assessing people in different settings. Management appears to result in a cure for those who are not significantly disabled with loose stools as a cause for their fecal incontinence, but this would need to be confirmed by further research.

A late Neoproterozoic paleomagnetic pole for the Congo craton: Tectonic setting, paleomagnetism and geochronology of the Nola dike swarm (Central African Republic)

New structural, geochronological and paleomagnetic data were obtained on dolerite dikes of the Nola region (Central African Republic) at the northern border of the Congo craton. In this region metavolcanic, successions were thrust southward onto the craton during the Panafrican orogenic events. Our structural data reveal at least two structural klippes south of the present-day limits of the Panafrican nappe suggesting that it has once covered the whole Nola region, promoting the pervasive hydrothermal green-schist metamorphism observed in the underlying cratonic basement and also in the intrusive dolerite dikes. Paleomagnetic measurements revealed a stable dual-polarity low-inclination magnetization component in nine dikes (47 samples), carried by pyrrhotite and magnetite. This component corresponds to a paleopole at 304.8 degrees E and 61.8 degrees S (dp = 5.4, dm = 10.7) graded at 2 = 6. Both metamorphism and magnetic resetting were dated by the Ar-40/Ar-39 method on amphibole grains separated from the dikes at 571 +/- 6 Ma. The Nola pole is the first well-dated paleomagnetic pole for the Congo craton between 580 and 550 Ma. It marks a sudden change in direction of the Congo craton apparent polar wander path at the waning stages of the Panafrican orogenic events. (c) 2008 Elsevier B.V. All rights reserved.

Lower and Upper Neoproterozoic magmatic records in Itaiacoca Belt (Parana-Brazil): Zircon ages and lithostratigraphy studies

The Itaiacoca Belt is a sequence of metavolcanic and metasedimentary rocks that crop out east of Parana and southeast of Sao Paulo states, in southern Brazil. This geologic-geochronologic study supports division of the Itaiacoca Belt into two major lithologic sequences. The older is a carbonate platform sequence (dolomitic meta-limestones/metamarls/calc-phyllites/ carbonate phyllites) with minimum deposition ages related to the end of the Mesoproterozoic/beginning of the Neoproterozoic (1030-908 Ma:U-Pb, zircon of metabasic rocks). The younger sequence contains mainly clastics deposits (meta-arkoses/metavolcanics/metaconglomerates/metapelites) with deposition ages related to the Neoproterozoic (645-628 Ma:U-Pb,zircon of metavolcanic rocks). These ages are quite close to K-Ar ages (fine fraction) of the 628-610 Ma interval, associated with metamorphism and cooling of the Itaiacoca Belt. The contact between the dolomitic meta-limestones and meta-arkoses is marked by intense stretching and high-angle foliation, suggesting that the discontinuity between these associations resulted from shearing. It is proposed here that the term Itaiacoca Sequence, should represent the dolomitic meta-limestones, and the term Abapa Sequence represents the meta-arkoses/metavolcanics/phyllites. in a major tectonic context, these periods are related to the break-up of Rodinia Supercontinent (1030-908 Ma) and the amalgamation of the Gondwana Supercontinent (645-628 Ma). (C) 2008 International Association for Gondwana Research. Published by Elsevier B.V. All rights reserved.

Dating coeval mafic magmatism and ultrahigh temperature metamorphism in the Anapolis-Itaucu Complex, Central Brazil

Dating granulites has always been of great interest because they represent one of the most extreme settings of an orogen. Owing to the resilience of zircon, even in such severe environments, the link between P-T conditions and geological time is possible. However, a challenge to geochronologists is to define whether the growth of new zircon is related to pre- or post-P-T peak conditions and which processes might affect the (re) crystallization. In this context, the Anapolis-Itaucu Complex, a high-grade complex in central Brazil with ultrahigh temperature (UHT) granulites, may provide valuable information within this topic. The Anapolis-Itaucu Complex (AIC) includes ortho- and paragranulites, locally presenting UHT mineral assemblages, with igneous zircon ages varying between 760 and 650 Ma and metamorphic overgrowths dated at around 650-640 Ma. Also common in the Anapolis-Itaucu Complex are layered mafic-ultramafic complexes metamorphosed under high-grade conditions. This article presents the first geological and geochronological constraints of three of these layered complexes within the AIC, the Damolandia, Taquaral and Goianira-Trindade complexes. U-Pb (LA-MC-ICPMS, SHRIMP and ID-TIMS) zircon analyses reveal a spread of concordant ages spanning within an age interval of similar to 80 Ma with an ""upper"" intercept age of similar to 670 Ma. Under cathodoluminescence imaging, these crystals show partially preserved primary sector zoning, as well as internal textures typical of alteration during high-grade metamorphism, such as inward-moving boundaries. Zircon grains reveal homogeneous initial (176)Hf/(177)Hf values in distinct crystal-scale domains in all samples. Moreover. Hf isotopic ratios show correlation neither with U-Pb ages nor with Th/U ratios, suggesting that zircon grains crystallized during a single growth event. It is suggested, therefore, that the observed spread of concordant U-Pb ages may be related to a memory effect due to coupled dissolution-reprecipitation process during high grade metamorphism. Therefore, understanding the emplacement and metamorphism of this voluminous mafic magmatism is crucial as it may represent an additional heat source for the development of the ultrahigh temperature paragenesis recorded in the paragranulites. (C) 2010 Elsevier B.V. All rights reserved.

Rhyacian (2.23-2.20 Ga) juvenile accretion in the southern Sao Francisco craton, Brazil: Geochemical and isotopic evidence from the Serrinha magmatic suite, Mineiro belt

The Serrinha magmatic suite (Mineiro belt) crops out in the southern edge of the Sao Francisco craton, comprising the Brito quartz-diorite, Brumado de Cima and Brumado de Baixo granodiorites, granophyres and felsic sub-volcanic and volcanic rocks, part of which intruded into the Nazareno greenstone belt. The suite rocks have petrographic features that are consistent with magma supercooling due to the low water content combined with volatile loss, leading to crystallization of quartz and alkaline feldspar at the rims of plagioclase phenocrysts (granophyric intergrowth). The investigated rocks are sub-alkaline, calc-alkaline and show low content in rare earth elements. The U-Pb zircon crystallization ages for the Brumado de Cima granodiorite [2227 +/- 22 (23) Ma] and a coeval granophyre [2211 +/- 22 (23) Ma], coupled with available single-zircon Pb evaporation ages for the Brito and Brumado de Baixo plutons, are significantly older than the ""Minas orogeny"" (ca. 2100-2050 Ga) of Quadrilatero Ferrifero area, eastward from the Serrinha suite. Our data establish an early Rhyacian event tectonically linked with the evolution of the Mineiro belt. The bulk Nd isotopic signature [low negative to positive epsilon(Nd(t)) values] of the Serrinha samples are consistent with the important role of Paleoproterozoic mantle components in the magma genesis. The integrated geologic, geochemical and isotopic information suggests that Paleoproterozoic evolution of the Mineiro belt initiated in a passive continental margin basin with deposition of the Minas Supergroup at ca. 2500 Ma. This stage was succeeded by outboard rupture of the oceanic lithosphere with development and coalescence of progressively younger magmatic arcs during Rhyacian time. One of the earliest arcs formed the Serrinha suite. The tectonic collage of the Serrinha and Ritapolis (2190-2120 Ma) arcs produced the NE-SW Lenheiro shear zone, resulting in mylonitization and recrystallization of both the granitoid intrusions and host rocks. As a matter of fact juxtaposition of distinct magmatic units in age and origin took place along the Lenheiros structure in this sector of the Mineiro belt. (C) 2009 Elsevier Ltd. All rights reserved.

Re-thinking bilingualism : challenges of multilingualism and communication in classroom settings

Editors’ preface to the special issue of the journal.

Non-challenging education and teacher control as factors for marginalization of students in diverse settings

This article discusses teachers’ attitudes towards immigrant students in poor settings and the effect these attitudes have on organization of education on classroom level. It draws on results from two ethnographic studies where some primary school classes in Sweden were followed with participant observation and interviews as main research methods. The article focuses on classroom activities and teachers’ attitudes towards immigrant students and students with low socio-economic status. In the article is argued for the importance of presenting students in poor settings with demanding tasks and challenging education. In these cases, intellectually undemanding tasks in combination with little room for students’ own initiatives resulted in low enthusiasm among students regarding schoolwork and accordingly low learning, while classroom work that demanded active involvement by students in combination with high level of students’ influence on what took place in classrooms resulted in high level of students’ engagement and high outcome.

Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings

Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

Are cutout handles used when available in real occupational settings? Description of grips and upper extremities movements during industrial box handling

In order to achieve better postures and decrease musculoskeletal risks adequate design of hand/box couplings for manual materials handling (MMH) are still needed. No studies evaluating upper limb movement thorough direct measurements during box handling in workplace were identified in the literature. In this study we describe the types of grip and movements adopted by ten workers when handling redesigned boxes with cutout handles between different heights on industrial pallets. The new handles were used by 90% of the workers through different types of grip. Electrogoniometric measurements showed relatively safe forearm and wrist movements, although elbow inadequate range of movement was recorded. Despite the good acceptance of the cutout by workers, the new design requires extra internal space in the boxes reducing applications for this alternative of box.

Evaluation of the thermoplasticity of gutta-percha and Resilon (R) using the Obtura II System at different temperature settings

Aim To analyse the thermoplasticity of several endodontic filling materials using the Obtura II System at different temperature settings.Methodology The following materials based on gutta-percha: Regular Obtura (OBT), Obtura Flow 150 (OBT F), Endo Flow (EDF), Odous (ODO) and the synthetic thermoplastic polymer material Resilon (RE) were heated using the Obtura II System at three temperature settings (140, 170 and 200 degrees C). Samples of the heated materials were placed on the sensor of a digital thermometer (THR-140; Instrutherm, São Paulo, Brazil) to determine their real temperature (RT) when the system was set at 140 degrees C (from 64.5 to 69 degrees C), 170 degrees C (from 73.8 to 77.5 degrees C) and 200 degrees C (from 83.6 degrees C for EDF and 100 degrees C for RE). Specimens (n = 30) were made by placing samples of each material in metallic ring moulds and compressing them between two glass slabs. After 24 h, specimens (n = 10) were heated at the different settings (RT) and submitted to compression under a 5-kg load. Plasticization was assessed by calculating the differences between the post-compression and initial diameters of each specimen. Data were submitted to ANOVA and Tukey's test at 5% significance.Results At 140 degrees C, Obtura Flow presented the highest thermoplasticity values and Regular Obtura, the lowest. At 170 degrees C, Obtura Flow and Resilon demonstrated greater plasticization. Resilon had the highest mean thermoplasticity values at 200 degrees C.Conclusions Thermoplasticity values were influenced both by the temperature settings on the Obtura II System and by the type of material analysed. Obtura Flow and Resilon had the highest mean thermoplasticity values.

Remote sensing analysis of depositional landforms in alluvial settings: Method development and application to the Taquari megafan, Pantanal (Brazil)

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

High-pressure granulites from Carire, Borborema Province, NE Brazil: Tectonic setting, metamorphic conditions and U-Pb, Lu-Hf and Sm-Nd geochronology

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Analysis of tectonic-controlled fluvial morphology and sedimentary processes of the western Amazon Basin: an approach using satellite images and digital elevation model

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)