Interdisciplinary approach to the management of Ewing sarcoma: A case report

Ewing sarcoma is a common primary bone malignancy occurring in childhood and adolescence. This case report describes a 4-year-old female patient who had Ewing sarcoma in the left clavicular region. The patient underwent total excision of the left clavicle and subsequently developed periodontitis and multiple carious lesions after chemotherapy. Caries risk and salivary flow rate tests were performed, followed by periodontal treatment, topical fluoride application, restoration of caries, and oral hygiene instruction. The care of this patient demonstrates that an interdisciplinary approach is essential to eliminate all foci of infection, minimize morbidity, and improve the patient's general health before, during, and after oncological treatment. © 2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

Dental students' familiarity with the medical management of dental patients at Brazilian dental schools

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The Rights of Indigenous Children

While children in general are overrepresented among those living in poverty, a long history of discrimination and exclusion has ensured that indigenous children in Latin America and the Caribbean are in an even worse position. In the general population 63% of children aged under 18 years live in poverty, as measured by privation of the basic rights to well-being; however, that figure is as high as 88% among indigenous children in the same age group. This is a violation of these children's rights —including their rights to survival and development— and entails high costs for society in terms of productive capacity and social inclusion. That is the thrust of the argument in the central article of this issue of Challenges, which focuses on poverty among indigenous children. The data show a pattern of inequality that is highly detrimental to indigenous children: they make up a disproportionate number of those living in extreme poverty and are three times more likely to lack access to education, safe drinking water and housing than other children. It is a matter of particular concern that in the countries of the Andean Community 5 of every 10 indigenous children under the age of 5 years suffer from chronic malnutrition.This edition includes brief testimonies by indigenous children as to what their life is like; an interview with Marta Maurás, Vice-Chairperson of the United Nations Committee on the Rights of the Child, on the international mechanisms in place to safeguard the rights of indigenous children; and, lastly, an article on the Uantakua programme in Mexico, which uses information and communication technologies in bilingual schools with large indigenous populations.

Before dividing we have to add: inter-viewing the foregrounds of indigenous students

Students' cultural diversity is an important factor to consider in a mathematics education concerned with equity. We argue that the significance of mathematics education is not only given by the understanding of mathematical concepts but also by students' foreground, that is, the students' perception of their future possibilities in life as made apparent to the individual by his/her social-political context. For students in a cultural borderline position, different reasons and intentions for engaging in mathematics learning may be related to the construction of meaning in mathematics. Through inter-viewing Brazilian Indian students' foreground, we illuminate the different types of significance given to mathematics education in their particular situation.

Talent Management in Higher Education: Developing Emerging Leaders Within the Administration at Private Colleges and Universities

This research focused on identifying a series of successful practices relating to administrative talent management within the higher education setting. The field study included a thorough examination of seven small to mid-size private colleges and universities that have incorporated employee development strategies. These strategies were aimed at growing future leaders from within the organization in order to achieve continuity and support institutional priorities. Specifically, several focus areas were investigated including presidential vision, leadership commitment, talent management’s place among institutional priorities, program characteristics, and program evaluation. Among the commonalities that were gathered included support at the senior officer level who serve as advocates, mentors, and program facilitators, a strong connection between talent management and the institutions’ strategic plans, and a holistic approach to developing talent at all levels of the organizations. In addition, both coaching and opportunities for growth in the work environment were evident within several of the institutions. Also, academic leadership development was considered to be a part of the talent management strategy within three of the colleges and universities. The key differentiators included the incorporation of organizational and leadership competencies to provide focus toward the performance development process at two institutions, the implementation of a succession planning model at another institution, and the location of human resource generalists in departments across two of the institutions to identify learning opportunities for both individuals and work teams. Based on both the findings from the field study and the literature review, a comprehensive procedural model is introduced that serves to support human resource departments and higher education professionals, in general, who are looking to either begin or broaden their own talent management approach. However, despite the progress that has been made across several institutions noted throughout the research study, much more must be learned in terms of how the time and resources invested in talent management translates to institutional success. Advisor: James O‘Hanlon

Use of policy, education, and enforcement to reduce binge drinking among university students: The NU Directions project

This paper describes a program, conducted over a 5-year period, that effectively reduced heavy drinking and alcohol-related harms among university students. The program was organized around strategies to change the environment in which binge drinking occurred and involved input and cooperation from officials and students of the university, representatives from the city and the neighborhood near the university, law enforcement, as well as public health and medical officials. In 1997, 62.5% of the university’s approximately 16,000 undergraduate student population reported binge drinking. This rate had dropped to 47% in 2003. Similar reductions were found in both self-reported primary and secondary harms related to alcohol consumption.

Advancing the management of primary immunodeficiency diseases in Latin America: Latin American Society for Immunodeficiencies (LASID) Initiatives

Primary immunodeficiency diseases (PIDD) are associated with significant morbidity and mortality and result in a significant public health burden. This is in part due to the lack of appropriate diagnosis and treatment of these patients. It is critical that governments become aware of this problem and provide necessary resources to reduce this impact on health care systems. Leading physicians in their respective countries must be supported by their own governments in order to implement tools and provide education and thus improve the diagnosis and treatment of PIDD. The Latin American Society of Primary Immunodeficiencies (LASID) has initiated a large number of activities aimed at achieving these goals, including the establishment of a PIDD registry, development of educational programmes and guidelines, and the introduction of a PIDD fellowship programme. These initiatives are positively impacting the identification and appropriate treatment of patients with PIDD in Latin America. Nevertheless, much remains to be done to ensure that every person with PIDD receives proper therapy. (C) 2011 SEICAP. Published by Elsevier Espana, S.L. All rights reserved.

Effect of a video on developing skills in undergraduate nursing students for the management of totally implantable central venous access ports

Background: Handling Totally Implantable Access Ports (TIAP) is a nursing procedure that requires skill and knowledge to avoid adverse events. No studies addressing this procedure with undergraduate students were identified prior to this study. Communication technologies, such as videos, have been increasingly adopted in the teaching of nursing and have contributed to the acquisition of competencies for clinical performance. Objective: To evaluate the effect of a video on the puncture and heparinization of TIAP in the development of cognitive and technical competencies of undergraduate nursing students. Method: Quasi-experimental study with a pretest-posttest design. Results: 24 individuals participated in the study. Anxiety scores were kept at levels 1 and 2 in the pretest and posttest. In relation to cognitive knowledge concerning the procedure, the proportion of correct answers in the pretest was 0.14 (SD=0.12) and 0.90 in the posttest (SD=0.05). After watching the video, the average score obtained by the participants in the mock session was 27.20. Conclusion: The use of an educational video with a simulation of puncture and heparinization of TIAP proved to be a strategy that increased both cognitive and technical knowledge. This strategy is viable in the teaching-learning process and is useful as a support tool for professors and for the development of undergraduate nursing students. (C) 2011 Elsevier Ltd. All rights reserved.

Current practices in the management of patients with ureteral calculi in the emergency room of a university hospital

OBJECTIVE: Urinary lithiasis is a common disease. The aim of the present study is to assess the knowledge regarding the diagnosis, treatment and recommendations given to patients with ureteral colic by professionals of an academic hospital. MATERIALS AND METHODS: Sixty-five physicians were interviewed about previous experience with guidelines regarding ureteral colic and how they manage patients with ureteral colic in regards to diagnosis, treatment and the information provided to the patients. RESULTS: Thirty-six percent of the interviewed physicians were surgeons, and 64% were clinicians. Forty-one percent of the physicians reported experience with ureterolithiasis guidelines. Seventy-two percent indicated that they use noncontrast CT scans for the diagnosis of lithiasis. All of the respondents prescribe hydration, primarily for the improvement of stone elimination (39.3%). The average number of drugs used was 3.5. The combination of nonsteroidal anti-inflammatory drugs and opioids was reported by 54% of the physicians (i. e., 59% of surgeons and 25.6% of clinicians used this combination of drugs) (p = 0.014). Only 21.3% prescribe alpha blockers. CONCLUSION: Reported experience with guidelines had little impact on several habitual practices. For example, only 21.3% of the respondents indicated that they prescribed alpha blockers; however, alpha blockers may increase stone elimination by up to 54%. Furthermore, although a meta-analysis demonstrated that hydration had no effect on the transit time of the stone or on the pain, the majority of the physicians reported that they prescribed more than 500 ml of fluid. Dipyrone, hyoscine, nonsteroidal anti-inflammatory drugs, and opioids were identified as the most frequently prescribed drug combination. The information regarding the time for the passage of urinary stones was inconsistent. The development of continuing education programs regarding ureteral colic in the emergency room is necessary.

Teaching of the Integrated Management of Childhood Illness strategy in undergraduate nursing programs

Objective: To describe and analyze the teaching of the Integrated Management of hildhood Illness (IMCI) strategy on Brazilian undergraduate nursing programs. Method: Integrating an international multicentric study, a cross-sectional online survey was conducted between May and October 2010 with 571 undergraduate nursing programs in Brazil Results: Responses were received from 142 programs, 75% private and 25% public. 64% of them included the IMCI strategy in the theoretical content, and 50% of the programs included IMCI as part of the students’ practical experience. The locations most used for practical teaching were primary health care units. The ‘treatment’ module was taught by the fewest number of programs, and few programs had access to the IMCI instructional manuals. All programs used exams for evaluation, and private institutions were more likely to include class participation as part of the evaluation. Teaching staff in public institutions were more likely to have received training in teaching IMCI. Conclusion: In spite of the relevance of the IMCI strategy in care of the child, its content is not addressed in all undergraduate programs in Brazil, and many programs do not have access to the IMCI teaching manuals and have not provide training in IMCI to their teaching staff.

A resource management scenario for traditional and scientific management of pink shrimp (Farfantepenaeus paulensis) in the Patos Lagoon estuary (RS), Brazil

Abstract Background This article aims to discuss the incorporation of traditional time in the construction of a management scenario for pink shrimp in the Patos Lagoon estuary (RS), Brazil. To meet this objective, two procedures have been adopted; one at a conceptual level and another at a methodological level. At the conceptual level, the concept of traditional time as a form of traditional ecological knowledge (TEK) was adopted. Method At the methodological level, we conduct a wide literature review of the scientific knowledge (SK) that guides recommendations for pink shrimp management by restricting the fishing season in the Patos Lagoon estuary; in addition, we review the ethno-scientific literature which describes traditional calendars as a management base for artisanal fishers in the Patos Lagoon estuary. Results Results demonstrate that TEK and SK describe similar estuarine biological processes, but are incommensurable at a resource management level. On the other hand, the construction of a “management scenario” for pink shrimp is possible through the development of “criteria for hierarchies of validity” which arise from a productive dialog between SK and TEK. Conclusions The commensurable and the incommensurable levels reveal different basis of time-space perceptions between traditional ecological knowledge and scientific knowledge. Despite incommensurability at the management level, it is possible to establish guidelines for the construction of “management scenarios” and to support a co-management process.

Acknowledging linguistic diversity in a multicultural society: the issue of indigenous languages in Colombia.

Nowadays, modern society is gradually becoming multicultural. However, only in the last few years awareness on its importance has been raised. In the case of Colombia, multiculturalism has existed since the pre-Columbian period and today there are more than 80 ethnic groups and 65 indigenous languages in the country. The aim of this work is to illustrate the status of indigenous languages in Colombia and to enlighten about the importance of recognizing, protecting and strengthening the use of these native languages. Subsequent to this, it will be point out that linguistic diversity should be considered a resource and not a barrier to achieve unity in diversity. Finally, ethno-education will be presented as an adequate educational program that may guarantee an equal linguistic representation in the country.

Pre- and posttransplant management of solid organ transplant recipients: risk-adjusted follow-up

Solid organ transplant recipients (SOTR) have an increased risk of skin cancer due to their long-term immunosuppressive state. As the number of these patients is increasing, as well as their life expectancy, it is important to discuss the screening and management of skin cancer in this group of patients. The role of the dermatologist, in collaboration with the transplant team, is important both before transplantation, where patients are screened for skin lesions and the individual risk for skin cancer development is assessed, and after transplantation. Posttransplant management consists of regular dermatological consultations (the frequency depends on different factors discussed below), where early skin cancer screening and management, as well as patient education on sun protective behavior is taught and enforced. Indeed, SOTR are very sensitive to sun damage due to their immunosuppressive state, leading to cumulative sun damage which results in field cancerization with numerous lesions such as in situ squamous cell carcinoma, actinic keratosis and Bowen's disease. These lesions should be recognized and treated as early as possible. Therapeutic options discussed will involve topical therapy, surgical management, adjustment of the patient's immunosuppressive therapy (i.e. reduction of immunosuppression and/or switch to mammalian target of rapamycin inhibitors) and chemoprevention with the retinoid acitretin, which reduces the recurrence rate of squamous cell carcinoma. The dermatological follow-up of SOTR should be integrated into the comprehensive posttransplant care.

Ethnosciences - A step towards the integration of scientific and non-scientific forms of knowledge in the management of natural resources for the future

Integration of indigenous knowledge and ethnoscientific approaches into contemporary frameworks for conservation and sustainable management of natural resources will become increasingly important in policies on an international and national level. We set the scene on how this can be done by exploring the key conditions and dimensions of a dialogue between ‘ontologies’ and the roles, which ethnosciences could play in this process. First, the roles which ethnosciences in the context of sustainable development were analysed, placing emphasis on the implications arising when western sciences aspire to relate to indigenous forms of knowledge. Secondly, the contributions of ethnosciences to such an ‘inter-ontological dialogue’ were explored, based on an ethnoecological study of the encounter of sciences and indigenous knowledge in the Andes of Bolivia, and reviewed experiences from mangrove systems in Kenya, India and Sri Lanka, and from case-studies in other ecosystems world-wide.