Acupuncture with manual and electrical stimulation for labour pain : a longitudinal randomised controlled trial

Background: Acupuncture is commonly used to reduce pain during labour despite contradictory results. The aim of this study is to evaluate the effectiveness of acupuncture with manual stimulation and acupuncture with combined manual and electrical stimulation (electro-acupuncture) compared with standard care in reducing labour pain. Our hypothesis was that both acupuncture stimulation techniques were more effective than standard care, and that electro-acupuncture was most effective.  Methods: A longitudinal randomised controlled trial. The recruitment of participants took place at the admission to the labour ward between November 2008 and October 2011 at two Swedish hospitals. 303 nulliparous women with normal pregnancies were randomised to: 40 minutes of manual acupuncture (MA), electro-acupuncture (EA), or standard care without acupuncture (SC). Primary outcome: labour pain, assessed by Visual Analogue Scale (VAS). Secondary outcomes: relaxation, use of obstetric pain relief during labour and post-partum assessments of labour pain. The sample size calculation was based on the primary outcome and a difference of 15 mm on VAS was regarded as clinically relevant, this gave 101 in each group, including a total of 303 women.  Results: Mean estimated pain scores on VAS (SC: 69.0, MA: 66.4 and EA: 68.5), adjusted for: treatment, age, education, and time from baseline, with no interactions did not differ between the groups (SC vs MA: mean difference 2.6, 95% confidence interval [CI] -1.7-6.9 and SC vs EA: mean difference 0.6 [95% CI] -3.6-4.8). Fewer number of women in the EA group used epidural analgesia (46%) than women in the MA group (61%) and SC group (70%) (EA vs SC: odds ratio [OR] 0.35; [95% CI] 0.19-0.67).  Conclusions: Acupuncture does not reduce women's experience of labour pain, neither with manual stimulation nor with combined manual and electrical stimulation. However, fewer women in the EA group used epidural analgesia thus indicating that the effect of acupuncture with electrical stimulation may be underestimated. These findings were obtained in a context with free access to other forms of pain relief.

Monitoring vegetation on railway embankments : supporting maintenance decisions

The national railway administrations in Scandinavia, Germany, and Austria mainly resort to manual inspections to control vegetation growth along railway embankments. Manually inspecting railways is slow and time consuming. A more worrying aspect concerns the fact that human observers are often unable to estimate the true cover of vegetation on railway embankments. Further human observers often tend to disagree with each other when more than one observer is engaged for inspection. Lack of proper techniques to identify the true cover of vegetation even result in the excess usage of herbicides; seriously harming the environment and threating the ecology. Hence work in this study has investigated aspects relevant to human variationand agreement to be able to report better inspection routines. This was studied by mainly carrying out two separate yet relevant investigations.First, thirteen observers were separately asked to estimate the vegetation cover in nine imagesacquired (in nadir view) over the railway tracks. All such estimates were compared relatively and an analysis of variance resulted in a significant difference on the observers’ cover estimates (p<0.05). Bearing in difference between the observers, a second follow-up field-study on the railway tracks was initiated and properly investigated. Two railway segments (strata) representingdifferent levels of vegetationwere carefully selected. Five sample plots (each covering an area of one-by-one meter) were randomizedfrom each stratumalong the rails from the aforementioned segments and ten images were acquired in nadir view. Further three observers (with knowledge in the railway maintenance domain) were separately asked to estimate the plant cover by visually examining theplots. Again an analysis of variance resulted in a significant difference on the observers’ cover estimates (p<0.05) confirming the result from the first investigation.The differences in observations are compared against a computer vision algorithm which detects the "true" cover of vegetation in a given image. The true cover is defined as the amount of greenish pixels in each image as detected by the computer vision algorithm. Results achieved through comparison strongly indicate that inconsistency is prevalent among the estimates reported by the observers. Hence, an automated approach reporting the use of computer vision is suggested, thus transferring the manual inspections into objective monitored inspections

Differences in muscle activity during hand dexterity tasks between women with arthritis and a healthy reference group

Background. Impaired hand function is common in patients with arthritis and it affects performance of daily activities; thus, hand exercises are recommended. There is little information on the extent to which the disease affects activation of the flexor and extensor muscles during these hand-dexterity tasks. The purpose of this study was to compare muscle activation during such tasks in subjects with arthritis and in a healthy reference group. Methods. Muscle activation was measured in m. extensor digitorium communis (EDC) and in m. flexor carpi radialis (FCR) with surface electromyography (EMG) in women with rheumatoid arthritis (RA, n = 20), hand osteoarthritis (HOA, n = 16) and in a healthy reference group (n = 20) during the performance of four daily activity tasks and four hand exercises. Maximal voluntary isometric contraction (MVIC) was measured to enable intermuscular comparisons, and muscle activation is presented as %MVIC. Results. The arthritis group used a higher %MVIC than the reference group in both FCR and EDC when cutting with a pair of scissors, pulling up a zipper and—for the EDC—also when writing with a pen and using a key (p < 0.02). The exercise “rolling dough with flat hands” required the lowest %MVIC and may be less effective in improving muscle strength. Conclusions. Women with arthritis tend to use higher levels of muscle activation in daily tasks than healthy women, and wrist extensors and flexors appear to be equally affected. It is important that hand training programs reflect real-life situations and focus also on extensor strength.

Lessons learned from stakeholders in a facilitation intervention targeting neonatal health in Quang Ninh province, Vietnam

BACKGROUND: In northern Vietnam the Neonatal health - Knowledge Into Practice (NeoKIP, Current Controlled Trials ISRCTN44599712) trial has evaluated facilitation as a knowledge translation intervention to improve neonatal survival. The results demonstrated that intervention sites, each having an assigned group including local stakeholders supported by a facilitator, lowered the neonatal mortality rate by 50% during the last intervention year compared with control sites. This process evaluation was conducted to identify and describe mechanisms of the NeoKIP intervention based on experiences of facilitators and intervention group members. METHODS: Four focus group discussions (FGDs) were conducted with all facilitators at different occasions and 12 FGDs with 6 intervention groups at 2 occasions. Fifteen FGDs were audio recorded, transcribed verbatim, translated into English, and analysed using thematic analysis. RESULTS: Four themes and 17 sub-themes emerged from the 3 FGDs with facilitators, and 5 themes and 18 sub-themes were identified from the 12 FGDs with the intervention groups mirroring the process of, and the barriers to, the intervention. Facilitators and intervention group members concurred that having groups representing various organisations was beneficial. Facilitators were considered important in assembling the groups. The facilitators functioned best if coming from the same geographical area as the groups and if they were able to come to terms with the chair of the groups. However, the facilitators' lack of health knowledge was regarded as a deficit for assisting the groups' assignments. FGD participants experienced the NeoKIP intervention to have impact on the knowledge and behaviour of both intervention group members and the general public, however, they found that the intervention was a slow and time-consuming process. Perceived facilitation barriers were lack of money, inadequate support, and the function of the intervention groups. CONCLUSIONS: This qualitative process evaluation contributes to explain the improved neonatal survival and why this occurred after a latent period in the NeoKIP project. The used knowledge translation intervention, where facilitators supported multi-stakeholder coalitions with the mandate to impact upon attitudes and behaviour in the communes, has low costs and potential for being scaled-up within existing healthcare systems.

Como tomadores de decisão experts percebem cenários complexos?

In this thesis, the basic research of Chase and Simon (1973) is questioned, and we seek new results by analyzing the errors of experts and beginners chess players in experiments to reproduce chess positions. Chess players with different levels of expertise participated in the study. The results were analyzed by a Brazilian grandmaster, and quantitative analysis was performed with the use of statistical methods data mining. The results challenge significantly, the current theories of expertise, memory and decision making in this area, because the present theory predicts piece on square encoding, in which players can recognize the strategic situation reproducing it faithfully, but commit several errors that the theory can¿t explain. The current theory can¿t fully explain the encoding used by players to register a board. The errors of intermediary players preserved fragments of the strategic situation, although they have committed a series of errors in the reconstruction of the positions. The encoding of chunks therefore includes more information than that predicted by current theories. Currently, research on perception, trial and decision is heavily concentrated on the idea of pattern recognition". Based on the results of this research, we explore a change of perspective. The idea of "pattern recognition" presupposes that the processing of relevant information is on "patterns" (or data) that exist independently of any interpretation. We propose that the theory suggests the vision of decision-making via the recognition of experience.

Autodeterminação local e desenvolvimento: uma análise da dinâmica social no município de São Roque de Minas

In this thesis, the basic research of Chase and Simon (1973) is questioned, and we seek new results by analyzing the errors of experts and beginners chess players in experiments to reproduce chess positions. Chess players with different levels of expertise participated in the study. The results were analyzed by a Brazilian grandmaster, and quantitative analysis was performed with the use of statistical methods data mining. The results challenge significantly, the current theories of expertise, memory and decision making in this area, because the present theory predicts piece on square encoding, in which players can recognize the strategic situation reproducing it faithfully, but commit several errors that the theory can¿t explain. The current theory can¿t fully explain the encoding used by players to register a board. The errors of intermediary players preserved fragments of the strategic situation, although they have committed a series of errors in the reconstruction of the positions. The encoding of chunks therefore includes more information than that predicted by current theories. Currently, research on perception, trial and decision is heavily concentrated on the idea of 'pattern recognition'. Based on the results of this research, we explore a change of perspective. The idea of 'pattern recognition' presupposes that the processing of relevant information is on 'patterns' (or data) that exist independently of any interpretation. We propose that the theory suggests the vision of decision-making via the recognition of experience.

Brasil em lições: a história do ensino de história do Brasil no Império através dos manuais de Joaquim Manuel de Macedo

Esta dissertação trata daqueles que são considerados os principais compêndios didáticos de História do Brasil do século XIX. A construção do Estado Imperial provocou significativas mudanças nas vidas de muitos componentes da "boa sociedade", dentre eles os próprios dirigentes imperiais. Uma destas vidas foi a de Joaquim Manuel de Macedo - professor do principal colégio do Império, autor dos mais importantes compêndios de História do Brasil do século XIX e divulgador de um método de ensino adotado por inúmeras gerações de professores. Lições de História do Brasil para uso dos alunos do Imperial Colégio de Pedro 11 e Lições de História do Brasil para uso das escolas de Instrução Primária - obras de perfil conservador, elas fixaram para sucessivas gerações de "boa sociedade" imperial conteúdos, métodos, valores e imagens de uma História do Brasil que cumpria o papel de não apenas legitimar a ordem imperial, mas também e sobretudo de pôr em destaque o lugar do Império do Brasil no conjunto das "Nações Civilizadas" e o lugar da "boa sociedade" no conjunto da sociedade imperial, permitindo, assim, a construção de uma identidade.

O entre do carvão ao corpo - em - arte de ator-brincante

I propose with this paper a reflection on the experiences contained in the creation of the body- in-art (FERRACINI, 2006a, b) that originated the show Rosmaninhos... This process was developed within the coletivo UZUME teatro from João Pessoa PB, through recreations and resignifications of the corporeity and physicality contained in the steps, loas, aboios, songs and choreography observed in the manners that Mestre Zequinha plays in his group of Cavalo Marinho (Sea Horse), resident in the city of Bayeux - PB, and starting from the appropriation of the text Hamlet of William Shakespeare. The body-in-art is understood in this work as a vectorial body that dilates its daily functionality, recognizing a potential learning area capable to generate creative escape lines that destabilize the "subject centered in an individuality and identity" (FOUCAULT apud FERRACINI, 2006b, p.14), being open to the differentiation of itself, indicating the possible existence of an itself-other and of the exchange-in-art space. This process of construction of the body-in-art based on Master Zequinha s ways of playing the Cavalo Marinho was methodically guided by the appropriation of the coletivo UZUME teatro of the stages of Observation, Codification and Theatricalization contained in the technique of corporal mimeses proposed by the LUME Teatro (Campinas - SP). That use resulted in two phases: Active Observation and Composition of the body-in-art. Through the repetition of these aesthetic matrixes of the Cavalo Marinho, the actors discovered actions that when, codified and organized, can configure their body-in-art, which created a vectorial exchange-in-art space to what was found in the Cavalo Marinho party. This search proposed the means of potentiating the actors' work when it comes to a preparation that allowed to dilate the scenic presence and stimulated the production of actions, which culminated in the mounting of the show Rosmaninhos...

A prática de atividade física de crianças e adolescentes com e sem epilepsia

The epilepsy is one of the neurological disorders more common in the pediatric period, and which interferes significantly in the psycho and social life of children and teenagers. The objective of this study was analyzing the practice of sedentary practices, physicals, traditional infant fun and games of children and teenagers with and without epilepsy. The study was prospective, transversal descriptive, done with 60 children and teenagers with epilepsy (Epileptic Group - EG) patients from Pediatric Neurology Clinic of the Centre Integrated Health Lineu Araújo and 60 children and teenagers without epilepsy (Control Group - CG) students from municipal public school, both of the two groups paired with the same age (age group 7 to 14 years) of both the genders (female = 25/41,6% and male = 35/58,3%) of the Teresina city Piauí. It was done two pattern questionnaires, one applied to children and teenagers of the EG and CG to identify the sedentary activities, physical and traditional infant games and other to the parents/responsible of the EG about the clinical and demographic information. The results permitted the elaboration of two manuscripts: a) the first one titled The Practice of Sedentary and Physical Activities of Children and Teenagers with Epilepsy which showed significant difference in the sedentary activities of playing with car toy (p=0,021) to the EG and reading to the CG (p=0,001); in the physical activities the school physical education (p=0,001) and riding a bike (p=0,014) to the CG; b) the second one The Practice of Infant Games and Fun the children and teenagers with and without Epilepsy in this one the playing with marble presented significant difference (p=0,016) to the CG, despite the girls of the two groups don t do this activity. Observing the distribution of frequencies, it was verified that in the play catch-up and hide-and-seek and burn the EG plays more than the CG both in female and male gender. The girls of the EG play less skip, 60 while the boys of the two groups don t play. Elastic jump the girls of the two groups play in a same frequency and the boys don t participate of this fun. The seizures were found to occur during: soccer (23,3%); hide-and-seek (6,6%) and running (3,3%). In the sedentary activities, seizures were reported to occur: resting and watching TV (18,3%), sleeping (36,0%); sitting (13,3%) and lying down (11,7%). Our results showed that the epileptic group and the controls group engage in the same activities, although the epileptic group participates less than the controls. Although the EG had presented a bigger percentage of generalized attacks, they don t occur during the practice of formal physical activities. The research was developed by a multidisciplinary team, and this contributed a lot to the realization of this study

Quando as professoras se encontram para estudar matemática: saberes em movimento

This text results of a research in an Education Doctorate about teachers, professional background, formation, teaching knowledge and abilities. In this text, it s described the history of a study group in mathematics education composed by teachers who teach mathematics in the 2nd cycle of Ensino Fundamental (5th year of schooling), all belonging to the same school of the municipal public schools network. It presents the trajectory of the collaborative group, in all particularities, singularities, and the constant search to become collaborative. This trajectory was marked by the stories of it s participants in the ceaseless path to constitute teachers, by the sharing of knowledge, by the process of collaboration, by the thinking about the teaching practice, and by the personal and professional improvement of the teachers that form the group. The interpretative and qualitative research had as its investigation field the study group. The data supplied by the collect instruments indicate us that the collaboration between the teachers, the access to specific knowledge of mathematics area, the reflections about the teaching practice in a given context, are paths that lead to and make possible the re-elaboration of the teaching skills by teachers that teach mathematics to the first years

A linguagem da reflexão de uma professora de Língua Inglesa: um estudo de caso sob a perspectiva do sistema de avaliatividade

Research about teacher education, carried out in the area of Applied Linguistics (AL), reveals the importance of reflective practices in the professional development of teachers. With the aim of contributing to this area, we present this case study conducted at a technical school in Natal, RN. The corpus of the study is formed mainly from the teacher‟s discourse, generated during a stimulated recall session and the instruments used to collect the data: an initial questionnaire, a video recording of a class and the text transcript of the stimulated recall session. The central objective is to understand the way in which the reflection-on-action (SCHÖN, 1983, 1987) can contribute to raise the awareness of an English as a Foreign Language teacher (EFL) about her actions in the classroom. With this proposal, we begin our discussion presenting the origins, the presuppositions and characteristics of the concept of reflection according to Schön (1983, 1987), and supported by other authors (PERRENOUD, 2002; GÓMEZ, 1995; IMBERNÓN, 2009, among others); of critical reflection (LISTON e ZEICHNER, 1993; PIMENTA, 2002; DUTRA e MELLO, 2004, among others); and of the process of critical reflection (SMYTH, 1992). To evidence the reflections that emerge in the teacher‟s discourse, we found support in the theories and methods of Systemic Functional Grammar (SFG), which was initially proposed by Halliday (1985, 1994), Halliday and Hasan (1989), Halliday and Matthiessen (2004) and followers, such as, Eggins (1994), Thompson (1996), among others. We focus mainly on the subsystem of Attitude, an integral component of the system of discourse resources, Appraisal, presented by Martin (2000), Martin and Rose (2003, 2007), Martin and White (2005). The results reveal that the actions of the teacher in the classroom reflect not only her professional experiences, but also her values and concepts about teaching/learning languages. The results also show the teacher‟s awareness of the need for changes in her practices. Faced with these findings, we believe that this study reveals important concepts that can direct teacher educators to rethink new ways of approaching teacher training courses. In addition, it also reveals the importance of discourse analysis based on a systemic functional approach.

Análise dos fatores responsáveis pela alta salinidade do aqüífero fissural da microbacia da Riacho do Feijão - Pedro Avelino/RN

The fissures aquifer northeast semi-arid Brazilian, present high text frequently of leave, with of low a hídric availability. The research has as objective main to analyze the components that inside influence in the salinity of the waterbearing fissures of an evaluation physicist-chemistry of the water, leading in consideration the physical interventions of the environment. One used techniques of interpretation of image of Landsat satellite -1999 and delimitation of the micro basin through the topographical map SUDENE. One identified waters of the NaCl type with Ca++ and Mg++ in secondary concentrations. The analyzed wells (15), had presented an average salinity of 5.147 mg/L of STD and a well only supplies drinking waters with 319 mg/L of STD. The recharge of the aquifer one if carries through for infiltration in the open fracture of ortognaisse it migmatization. The type and directions of the fracture do not control the STD. Relations between salinity and out let do not exist. The quality of the well of low salinity is identical the superficial waters (aquifer dam and alluvial). The studies of the meteoric erosion processes had evidenced that in the transformations of the rock in ground, the Ca++ and Na+ are taken for superficial waters. The treatment of the data chemical showed that the grade of Na+, Ca++, Mg++ and Cl-are controlled for the evaporation process, from only water that would have the qualities of superficial waters or the well of low salinity. Already the HCO3-grade is controlled for the precipitation of the dolomite. The STD of this aquifer one would be consequence of the high tax of evaporation of dams constructed in regions of plain topography. You leave them precipitated in deep argillaceous ones dry dams are led for the aquifer in first rains. The research suggests some recommendations for the use and exploitation of the water salinity in piscicultura, carcinicultura, culture of the grass-salt (Atriplex sp), among others

Programa de remediação fonológica em escolares com dificuldades de aprendizagem

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Níveis críticos de fósforo no solo e nas folhas para a implantação de Eucalyptus grandis Hill ex Maiden, em quatro tipos de solos

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

A produção textual escrita de alunos de 8. série do ensino fundamental

Pós-graduação em Educação - IBRC