Obsessive Compulsive Treatment Efficacy Trial (OCTET) comparing the clinical and cost effectiveness of self-managed therapies: study protocol for a randomised controlled trial

Background: UK National Institute of Health and Clinical Excellence guidelines for obsessive compulsive disorder (OCD) specify recommendations for the treatment and management of OCD using a stepped care approach. Steps three to six of this model recommend treatment options for people with OCD that range from low-intensity guided self-help (GSH) to more intensive psychological and pharmacological interventions. Cognitive behavioural therapy (CBT), including exposure and response prevention, is the recommended psychological treatment. However, whilst there is some preliminary evidence that self-managed therapy packages for OCD can be effective, a more robust evidence base of their clinical and cost effectiveness and acceptability is required. Methods/Design: Our proposed study will test two different self-help treatments for OCD: 1) computerised CBT (cCBT) using OCFighter, an internet-delivered OCD treatment package; and 2) GSH using a book. Both treatments will be accompanied by email or telephone support from a mental health professional. We will evaluate the effectiveness, cost and patient and health professional acceptability of the treatments. Discussion: This study will provide more robust evidence of efficacy, cost effectiveness and acceptability of self-help treatments for OCD. If cCBT and/or GSH prove effective, it will provide additional, more accessible treatment options for people with OCD.

The impact of European legislative and technology measures to reduce air pollutants on air quality, human health and climate

European air quality legislation has reduced emissions of air pollutants across Europe since the 1970s, affecting air quality, human health and regional climate. We used a coupled composition-climate model to simulate the impacts of European air quality legislation and technology measures implemented between 1970 and 2010. We contrast simulations using two emission scenarios; one with actual emissions in 2010 and the other with emissions that would have occurred in 2010 in the absence of technological improvements and end-of-pipe treatment measures in the energy, industrial and road transport sectors. European emissions of sulphur dioxide, black carbon (BC) and organic carbon in 2010 are 53%, 59% and 32% lower respectively compared to emissions that would have occurred in 2010 in the absence of legislative and technology measures. These emission reductions decreased simulated European annual mean concentrations of fine particulate matter(PM2.5) by 35%, sulphate by 44%, BC by 56% and particulate organic matter by 23%. The reduction in PM2.5 concentrations is calculated to have prevented 80 000 (37 000–116 000, at 95% confidence intervals) premature deaths annually across the European Union, resulting in a perceived financial benefit to society of US$232 billion annually (1.4% of 2010 EU GDP). The reduction in aerosol concentrations due to legislative and technology measures caused a positive change in the aerosol radiative effect at the top of atmosphere, reduced atmospheric absorption and also increased the amount of solar radiation incident at the surface over Europe. We used an energy budget approximation to estimate that these changes in the radiative balance have increased European annual mean surface temperatures and precipitation by 0.45 ± 0.11 °C and by 13 ± 0.8 mm yr−1 respectively. Our results show that the implementation of European legislation and technological improvements to reduce the emission of air pollutants has improved air quality and human health over Europe, as well as having an unintended impact on the regional radiative balance and climate.

Participation of the liver gluconeogenesis in the glibenclamide-induced hypoglycaemia in rats

We previously demonstrated an increased liver gluconeogenesis (LG) during insulin-induced hypoglycaemia. Thus, an expected effect of sulphonylureas induced hypoglycaemia (SIH) could be the activation of LG. However, sulphonylureas infused directly in to the liver inhibits LG. Considering these opposite effects we investigated herein LG in rats submitted to SIH. For this purpose, 24 h fasted rats that received glibenclamide (10 mg kg(-1)) were used (SIH group). Control group received oral saline. Glycaemia at 30, 60, 90, 120 and 150 min after oral administration of glibenclamide were evaluated. Since the lowest glycaemia was obtained 120 min after glibenclamide administration, this time was chosen to investigate LG in situ perfused livers. The gluconeogenesis from precursors that enters in this metabolic pathway before the mitochondrial step, i.e. L-alanine (5 mM), L-lactate (2 mM), pyruvate (5 mM) and L-glutamine were decreased (p < 0.05). However, the gluconeogenic activity using glycerol (2 mM), which enters in the gluconeogenesis after the mitochondrial step was maintained. Taken together, the results suggest that the inhibition of LG promoted by SIH overcome the activation of this metabolic pathway promoted by IIH and could be attributed, at least in part, to its effect on mitochondrial function. Copyright (C) 2011 John Wiley & Sons, Ltd.

Deficiency of thrombospondin-1 reduces Th17 differentiation and attenuates experimental autoimmune encephalomyelitis

Transforming growth factor beta (TGF-beta) plays a role both in the induction of Treg and in the differentiation of the IL-17-secreting T cells (Th17) which drive inflammation in experimental autoimmune encephalomyelitis (EAE). We investigated the role that thrombospondin-1 (TSP-1) dependent activation of TGF-beta played in the generation of an encephalitic Th17 response in EAE. Upon immunization with myelin oligodendrocyte glycoprotein peptide (MOG(35-55)), TSP-1 deficient (TSP-1(null)) mice and MOG(35-55) TCR transgenic mice that lack of TSP-1 (2D2.TSP-1(null)) exhibited an attenuated form of EAE, and secreted lower levels of IL-17. Adoptive transfer of in vitro-activated 2D2.TSP-1(null) T cells induced a milder form of EAE, independent of TSP-1 expression in the recipient mice. Furthermore, in vitro studies demonstrated that anti-CD3/anti-CD28 pre-activated CD4+ T cells transiently upregulated latent TGF-beta in a TSP-1 dependent way, and such activation of latent TGF-beta was required for the differentiation of Th17 cells. These results demonstrate that TSP-1 participates in the differentiation of Th17 cells through its ability to activate latent TGF-beta, and enhances the inflammatory response in EAE. (C) 2009 Elsevier Ltd. All rights reserved.

Interaction of Mycoplasma genitalium with host cells: evidence for nuclear localization

Mycoplasma genitalium (Mg) is a mollicute that causes a range of human urogenital infections. A hallmark of these bacteria is their ability to establish chronic infections that can persist despite completion of appropriate antibiotic therapies and intact and functional immune systems. Intimate adherence and surface colonization of mycoplasmas to host cells are important pathogenic features. However, their facultative intracellular nature is poorly understood, partly due to difficulties in developing and standardizing cellular interaction model systems. Here, we characterize growth and invasion properties of two Mg strains (G37 and 1019V). Mg G37 is a high-passage laboratory strain, while Mg 1019V is a low-passage isolate recovered from the cervix. The two strains diverge partially in gene sequences for adherence-related proteins and exhibit subtle variations in their axenic growth. However, with both strains and consistent with our previous studies, a subset of adherent Mg organisms invade host cells and exhibit perinuclear targeting. Remarkably, intranuclear localization of Mg proteins is observed, which occurred as early as 30 min after infection. Mg strains deficient in adherence were markedly reduced in their ability to invade and associate with perinuclear and nuclear sites.

Comparative genomics of the neglected human malaria parasite Plasmodium vivax

The human malaria parasite Plasmodium vivax is responsible for 25 - 40% of the similar to 515 million annual cases of malaria worldwide. Although seldom fatal, the parasite elicits severe and incapacitating clinical symptoms and often causes relapses months after a primary infection has cleared. Despite its importance as a major human pathogen, P. vivax is little studied because it cannot be propagated continuously in the laboratory except in non- human primates. We sequenced the genome of P. vivax to shed light on its distinctive biological features, and as a means to drive development of new drugs and vaccines. Here we describe the synteny and isochore structure of P. vivax chromosomes, and show that the parasite resembles other malaria parasites in gene content and metabolic potential, but possesses novel gene families and potential alternative invasion pathways not recognized previously. Completion of the P. vivax genome provides the scientific community with a valuable resource that can be used to advance investigation into this neglected species.

Endurance training activates AMP-activated protein kinase, increases expression of uncoupling protein 2 and reduces insulin secretion from rat pancreatic islets

Endurance exercise is known to enhance peripheral insulin sensitivity and reduce insulin secretion. However, it is unknown whether the latter effect is due to the reduction in plasma substrate availability or alterations in beta-cell secretory machinery. Here, we tested the hypothesis that endurance exercise reduces insulin secretion by altering the intracellular energy-sensitive AMP-activated kinase (AMPK) signaling pathway. Male Wistar rats were submitted to endurance protocol training one, three, or five times per week, over 8 weeks. After that, pancreatic islets were isolated, and glucose-induced insulin secretion (GIIS), glucose transporter 2 (GLUT2) protein content, total and phosphorylated calmodulin kinase kinase (CaMKII), and AMPK levels as well as peroxisome proliferator-activated receptor-gamma coactivator-1-alpha (PGC-1 alpha) and uncoupling protein 2 (UCP2) content were measured. After 8 weeks, chronic endurance exercise reduced GIIS in a dose-response manner proportionally to weekly exercise frequency. Contrariwise, increases in GLUT2 protein content, CaMKII and AMPK phosphorylation levels were observed. These alterations were accompanied by an increase in UCP2 content, probably mediated by an enhancement in PGC-1 alpha protein expression. In conclusion, chronic endurance exercise induces adaptations in beta-cells leading to a reduction in GIIS, probably by activating the AMPK signaling pathway. Journal of Endocrinology (2011) 208, 257-264

Basic oxygen furnace slag as a treatment material for pathogens: Contribution of inactivation and attachment in virus attenuation

Basic oxygen furnace (BOF) slag media were studied as a potential treatment material in on-site sanitation systems. Batch and column studies were conducted to evaluate attenuation of the bacteriophage PR772 and 0.190 mu m diameter microspheres by BOF media, and to delineate the relative contributions of two principle processes of virus attenuation: inactivation and attachment. In the batch studies, conducted at 4 degrees C, substantial inactivation of PR772 did not occur in the pH 7.6 and 9.5 suspensions. At pH 11.4, bimodal inactivation of PR772 was observed, at an initial rate of 2.1 log C/C(0) day(-1) for the first two days, followed by a much slower rate of 0.124 log C/C(0) day(-1) over the following 10 days. Two column studies were conducted at 4 degrees C at a flow rate of 1 pore volume day(-1) using two slag sources (Stelco, Ontario; Tubarao, Brazil) combined with sand and pea gravel. In both column experiments, the effluent microsphere concentration approached input concentrations over time (reductions of 0.1-0.2 log C/C(0)), suggesting attachment processes for microspheres were negligible. Removal of PR772 virus was more pronounced both during the early stages of the experiments, but also after longer transport times (0.5-1.0 log C/C(0)). PR772 reduction appeared to be primarily as a result of virus inactivation in response to the elevated pH conditions generated by the BOF mixture (10.6-11.4). On-site sanitation systems using BOF media should be designed to maintain sufficient contact time between the BOF media and the wastewater to allow sufficient residence time of pathogens at elevated pH conditions. (C) 2009 Published by Elsevier Ltd.

Actions of octocoral and tobacco cembranoids on nicotinic receptors

Nicotinic acetylcholine receptors (AChRs) are pentameric proteins that form agonist-gated cation channels through the plasma membrane. AChR agonists and antagonists are potential candidates for the treatment of neurodegenerative diseases. Cembranoids are naturally occurring diterpenoids that contain a 14-carbon ring. These diterpenoids interact with AChRs in complex ways: as irreversible inhibitors at the agonist sites, as noncompetitive inhibitors, or as positive modulators, but no cembranoid was ever shown to have agonistic activity on AChRs. The cembranoid eupalmerin acetate displays positive modulation of agonist-induced currents in the muscle-type AChR and in the related gamma-aminobutyric acid (GABA) type A receptor. Moreover, cembranoids display important biological effects, many of them mediated by nicotinic receptors. Cembranoids from tobacco are neuroprotective through a nicotinic anti-apoptotic mechanism preventing excitotoxic neuronal death which in part could result from anti-inflammatory properties of cembranoids. Moreover, tobacco cembranoids also have anti-inflammatory properties which could enhance their neuroprotective properties. Cembranoids from tobacco affect nicotine-related behavior: they increase the transient initial ataxia caused by first nicotine injection into naive rats and inhibit the expression of locomotor sensitization to repeated injections of nicotine. In addition, cembranoids are known to act as anti-tumor compounds. In conclusion, cembranoids provide a promising source of lead drugs for many clinical areas, including neuroprotection, smoking-cessation, and anti-cancer therapies. (C) 2009 Elsevier Ltd. All rights reserved.

Museum Personalized : The impact of floor staff on an exhibition - A holistic approach

The current paper presents a study conducted at The National Museum of Science and Technology in Stockholm to investigate the exhibition “Antarctica – that’s cool” from its first concept to the first workshop that is held in the exhibition. The focus is on the influence of floor staff on an exhibition and workshops as learning facilities in museums. Findings, based on visitor observation and the exhibition building process, go into the characteristics of low-budget productions and discuss the importance of staff on the exhibition floor for museums as life-long learning facilities. The holistic approach of the study provides deep insights into the complex interplay of visitors, staff and exhibitions. The results can be used for future exhibition building processes and educational programs in museums and should strengthen the museum’s position as life-long learning facility in nowadays society.

Impacto da divulgação das notas no Enem na concorrência entre escolas

A partir 2006, o INEP (Instituto Nacional de Estudos e Pesquisa) passou a divulgar anualmente as notas das escolas no Exame Nacional do Ensino Médio (Enem). Tal divulgação já faz parte do calendário das escolas, professores, jornais e revistas que cobrem o setor educacional e até de pais de alunos. Este estudo visa analisar o impacto da divulgação dessas notas na competição entre as instituições de ensino médio e, mais especificamente, avaliar o efeito da nota média das escolas concorrentes na nota de uma dada escola, em relação aos anos anteriores à divulgação. A concorrência será analisada do ponto de vista espacial, de modo que, o peso atribuído à nota de uma instituição na estimação da nota de outra escola é inversamente proporcional à distâncias entre as mesmas. Essa análise empírica de instituições públicas e privadas foi realizada por meio da estimação em mínimos quadrados, utilizando-se variáveis de controle relacionadas às instituições e ao perfil socioeconômico dos alunos. Para tanto, foram utilizadas as bases de microdados do Censo Escolar e do Enem no período de 2004 à 2011. Os resultados indicam a existência de competição entre as escolas, com aumento no grupo de escolas públicas no período posterior à divulgação.

Fatores determinantes da ino vação no Instituto Nacional de Criminalística e na Diretoria Técnico-Científica da Polícia Federal

Poucos temas apresentam tanta concordância entre os pesquisadores organizacionais como a importância da inovação para o desempenho e a efetividade organizacional. O tema inovação é tão importante quanto é vasta e diversificada a sua literatura. Mas, se por um lado, se reconhece a importância do tema, por outro, se constata que o entendimento do comportamento inovador nas organizações permanece ainda relativamente pouco desenvolvido, sobretudo no setor público. Do ponto de vista da gestão da inovação, interessa saber quais são os fatores organizacionais que determinam a capacidade que a organização tem para inovar. Nesse aspecto, o objetivo deste estudo foi identificar as características e os fatores organizacionais indutores ou inibidores dos processos de inovação no Instituto Nacional de Criminalística e na Diretoria Técnico-Científica da Polícia Federal, na percepção dos sujeitos que se envolveram com o desenvolvimento de ideias inovadoras no ambiente pesquisado. Com esse propósito, foi realizado um levantamento a fim de avaliar a percepção dos sujeitos da pesquisa quanto a 15 fatores característicos relevantes para os processos de inovação, postulados pelos pesquisadores do Minnesota Innovation Research Program – MIRP, da Universidade de Minnesota. A amostra obtida foi composta de 62 atores organizacionais que retornaram o questionário, encaminhado para 79 peritos, que se envolveram no desenvolvimento ou implantação de 42 diferentes ideias inovadoras. Os resultados indicaram que dos 15 fatores analisados, dez fatores (67%) foram percebidos como indutores dos processos de inovação enquanto três fatores (20%) foram percebidos como inibidores desses processos. Dois fatores obtiveram pouca convergência das respostas, de forma que os dados obtidos não permitiram concluir se tais fatores atuavam favorecendo ou inibindo o desenvolvimento de inovações no ambiente pesquisado. Os resultados confirmaram o pressuposto levantado na pesquisa de que o ambiente organizacional pesquisado apresenta elementos característicos que favorecem o desenvolvimento de inovações.

Memória ferroviária : da mobilização social à política pública de patrimônio

Esta tese tem como objetivo o estudo do processo de construção e apropriação do passado ferroviário e da transformação da memória ferroviária como objeto de política pública, sobretudo após a edição da Lei no 11.483/2007. O estudo aborda os papeis desempenhados por agentes sociais diversos, como as associações de preservação ferroviárias (APF), a Rede Ferroviária Federal (RFFSA) e o Instituto do Patrimônio Histórico e Artístico Nacional (Iphan), e suas estratégias de ressignificação e objetificação do passado ferroviário, processo que teve início ainda na década de 1970. A pesquisa descreve a implantação da malha ferroviária brasileira, de maneira a contextualizar a extinção da RFFSA, em 2007; aborda o surgimento e evolução das APFs, e descreve a atuação da Rede na preservação e salvaguarda do passado da ferrovia por meio da análise do Programa de Preservação do Patrimônio Histórico Ferroviário (Preserfe). Por fim, a tese se debruça sobre a atuação do Iphan, recorrendo à análise dos processos de tombamentos de bens ferroviários e ao estudo dos desdobramentos da Lei no 11.483/2007 no interior do órgão. O movimento de valorização do passado ferroviário contribui para os debates acerca dos processos de apropriação e patrimonialização do passado.

Robótica e educação: uma possibilidade de inserção sócio-digital

This paper presents a reflection on the use of robotics in education technology and the fostering of social and digital inclusion, unveiling a new field that has been outlined today. Robotics constitutes a tool still little known and not regulated at national level in education, there is little experience involving the tool in the Northeast. This research aims to reveal one of the first experiments with educational level robotics in Rio Grande do Norte. We present a field research conducted in a public school chancellor for a major institute of science and technology education of the state from seeking review of the robotics course, understand how they work and show their use in school and shows that contributions were generated for digital inclusion category students, based on speeches by teachers, engineers, management and students. As part of gathering information, we used the focus group technique, applied in two stages, one with groups of students, teachers and other school administration, as well as comments directed to the times when the robotics course was being finalized. As a result, we found that the school, through the robotics course is a provider of social and digital inclusion, since it awakens in the sample of students in this research knowledge enabler of social change. And that despite the student category do not understand the depth of meaning of inclusion, the same report in daily actions that integrate technology into their social context in harmony, enjoying its cultural citizenship in full

Dentistry in Brazil: Its History and Current Trends

The objectives of this article are to provide a short history of dentistry and dental education in Brazil and to analyze the nature of its development to date. The databases consulted are those provided by the Brazilian Federal Council of Dentistry, Brazilian Ministry of Health, Brazilian Ministry of Education, National Institute of Studies and Educational Research Anisio Teixeira, and Brazilian Institute of Geography and Statistics. Formal dental education in Brazil started in the late nineteenth century with the creation of courses annexed to existing schools of medicine in Rio de Janeiro and Bahia. Today, there are 191 institutions of higher education nationwide granting degrees in dentistry (137 private [71.7 percent] and fifty-four public [28.3 percent]), with a total of 17,157 student positions offered annually. These schools graduate around 10,000 professionals per year-one of the highest rates in the world. Both the distribution of schools of dentistry and of dentists varies among the regions of the country, with the greatest concentrations in major metropolitan centers with high population density, resulting in limited coverage in the more deprived regions. A review of epidemiological data for oral health and distribution of dentists in Brazil indicates that there is a lack of systematic planning for the allocation of the dental workforce and a lack of consideration of regional needs in the development of dental training programs in Brazil today.