Mães de crianças com deficiência visual: percepções, conduta e constribuição do atendimento em grupo

A presente pesquisa teve quatro objetivos: 1) identificar reações de mães em relação ao diagnóstico da deficiência visual; 2) identificar o responsável pela detecção da deficiência; 3) verificar dificuldades da criança no processo de escolarização, e 4) verificar possíveis contribuições de atividades terapêuticas direcionadas ao grupo de mães. Foi realizado um "survey" descritivo com as mães de crianças com deficiência visual, atendidas no CEPRE-FCM-Unicamp. Para a coleta de dados foi utilizado um questionário aplicado por entrevista, desenvolvido após estudo exploratório. Compôs-se uma amostra não probabilística, constituída por 14 mães. Entre os resultados obtidos, com relação aos sentimentos apontados pelas mães em relação ao diagnóstico, destacaram-se: a tristeza (71,0 por cento); o medo (64,0 por cento) e a decepção (42,0 por cento). O problema visual foi percebido por mães em 53,0 por cento dos casos, por pediatras em 26,0 por cento e por familiares em 21,0 por cento. Entre as dificuldades da criança no processo de escolarização foram apontadas: medo de não conseguirem acompanhar as exigências escolares (75,0 por cento) e discriminação (63,0 por cento). A maioria das mães (78,0 por cento) acredita que as atividades do grupo contribuem para o esclarecimento de dúvidas, e as atividades terapêuticas contribuíram para que aprendessem a lidar com as dificuldades de seus filhos (78,0 por cento). Os resultados obtidos contribuíram para concluir: que os sentimentos de tristeza, medo e decepção mostraram-se mais evidentes; que, na maioria dos casos, a deficiência visual foi detectada pela mãe; que na opinião das mães, as crianças teriam dificuldades em acompanhar as atividades escolares e que o grupo contribuiu para esclarecer dúvidas e favorecer troca de experiências

A Survey for Diclofop-Methyl Resistance in Italian Ryegrass from Tennessee and How To Manage Resistance in Wheat

Italian ryegrass resistance to diclofop has been documented in several countries, including the United States. The purpose of this research was to screen selected putative resistant populations of Italian ryegrass for resistance to the acetyl-CoA carboxylase (ACCase)-inhibiting herbicides diclofop and pinoxaden and the acetolactate synthase (ALS)-inhibiting herbicides imazamox, pyroxsulam, and mesosulfuron in the greenhouse and to use field experiments to develop herbicide programs for Italian ryegrass control. Resistance to diclofop was confirmed in eight populations from Tennessee. These eight populations did not show cross-resistance to pinoxaden. One additional population (R1) from Union County, North Carolina, was found to be resistant to both diclofop and pinoxaden. The level of resistance to pinoxaden of the R1 population was 15 times that of the susceptible population. No resistance was confirmed to any of the ALS-inhibiting herbicides examined in this research. Field experiments demonstrated PRE Italian ryegrass control with chlorsulfuron (71 to 94%) and flufenacet + metribuzin (84 to 96%). Italian ryegrass control with pendimethalin applied PRE or delayed preemergence (DPRE) was variable (0 to 85%). POST control of Italian ryegrass was acceptable with pinoxaden, mesosulfuron, flufenacet + metribuzin, and chlorsulfuron + flucarbazone (> 80%). Application timing and herbicide treatment had no effect on wheat yield, except for diclofop and pendimethalin treatments, in which uncontrolled Italian ryegrass reduced wheat yield.

How to unravel and solve soil fertility problems

This book provides a way for farmers in developing countries to benefit from scientific knowledge on plant nutrition and soil fertility. Specifically, it will help farmers recognise and deal with shortages or excesses of chemical elements.

Refining the risk-benefit equation for thrombolysis: How to identity the low risk patient before administering thrombolytic therapy

In view of the relative risk of intracranial haemorrhage and major bleeding with thrombolytic therapy, it is important ro identify as early as possible the low risk patient who may not have a net clinical benefit from thrombolysis in the setting of acute myocardial infarction. An analysis of 5434 hospital-treated patients with myocardial infarction in the Perth MONICA study showed that age below 60 and absence of previous infarction or diabetes, shock, pulmonary oedema, cardiac arrest and Q-wave or left bundle branch block on the initial ECG identified a large group of patients with a 28 day mortality of only 1%, and one year mortality of only 2%. Identification of baseline risk in this way helps refine the risk-benefit equation for thrombolytic therapy, and may help avoid unnecessary use of thrombolysis in those unlikely to benefit.

How to do safe sternal reentry and the risk factors of redo cardiac surgery: A 21-year review with zero major cardiac injury

Objectives: Resternotomy is a common part of cardiac surgical practice. Associated with resternotomy are the risks of cardiac injury and catastrophic hemorrhage and the subsequent elevated morbidity and mortality in the operating room or during the postoperative period. The technique of direct vision resternotomy is safe and has fewer, if any, serious cardiac injuries. The technique, the reduced need for groin cannulation and the overall low operative mortality and morbidity are the focus of this restrospective analysis. Methods: The records of 495 patients undergoing 546 resternotomies over a 21-year period to January 2000 were reviewed. All consecutive reoperations by the one surgeon comprised patients over the age of 20 at first resternotomy: M:F 343:203, mean age 57 years (range 20 to 85, median age 60). The mean NYHA grade was 2.3 [with 67 patients (1), 273 (11),159 (111), 43 (IV), and 4 (V classification)] with elective reoperation in 94.6%. Cardiac injury was graded into five groups and the incidence and reasons for groin cannulation estimated. The morbidity and mortality as a result of the reoperation and resternotomy were assessed. Results: The hospital/30 day mortality was 2.9% (95% Cl: 1.6%-4.4%) (16 deaths) over the 21 years. First (481), second (53), and third (12) resternotomies produced 307 uncomplicated technical reopenings, 203 slower but uncomplicated procedures, 9 minor superficial cardiac lacerations, and no moderate or severe cardiac injuries. Direct vision resternotomy is crystalized into the principle that only adhesions that are visualized from below are divided and only sternal bone that is freed of adhesions is sewn. Groin exposure was never performed prophylactically for resternotomy. Fourteen patients (2.6%) had such cannulation for aortic dissection/aneurysm (9 patients), excessive sternal adherence of cardiac structures (3 patients), presurgery cardiac arrest (1 patient), and high aortic cannulation desired and not possible (1 patient). The average postop blood loss was 594 mL (95% CI:558-631) in the first 12 hours. The need to return to the operating room for control of excessive bleeding was 2% (11 patients). Blood transfusion was given in 65% of the resternotomy procedures over the 21 years (mean 854 mL 95% Cl 765-945 mL) and 41% over the last 5 years. Conclusions: The technique of direct vision resternotomy has been associated with zero moderate or major cardiac injury/catastrophic hemorrhage at reoperation. Few patients have required groin cannulation. In the postoperative period, there was acceptable blood loss, transfusion rates, reduced morbidity, and moderate low mortality for this potentially high risk group.

How to be a chaste species pluralist-realist: the origins of species modes and the synapomorphic species concept

The biological species (biospecies) concept applies only to sexually reproducing species, which means that until sexual reproduction evolved, there were no biospecies. On the universal tree of life, biospecies concepts therefore apply only to a relatively small number of clades, notably plants and animals. I argue that it is useful to treat the various ways of being a species (species modes) as traits of clades. By extension from biospecies to the other concepts intended to capture the natural realities of what keeps taxa distinct, we can treat other modes as traits also, and so come to understand that the plurality of species concepts reflects the biological realities of monophyletic groups. We should expect that specialists in different organisms will tend to favour those concepts that best represent the intrinsic mechanisms that keep taxa distinct in their clades. I will address the question whether modes of reproduction such as asexual and sexual reproduction are natural classes, given that they are paraphyletic in most clades.