Development of guidelines for adults on how to communicate with adolescents about mental health problems and other sensitive topics: a Delphi study

There is little evidence-based information available to guide adults in the general community on communicating effectively with adolescents about mental health problems or other sensitive topics. The Delphi methodology was used to develop guidelines to fill this evidence gap. An online questionnaire containing potential guideline statements was developed following a literature search and input from two focus groups. Two expert panels (Youth Mental Health First Aid instructors and young consumer advocates) rated the questionnaire over three rounds, according to whether or not they believed that the statements should be included in the guidelines. Results were analyzed by comparing endorsement rates between the panels. Of the 175 statements presented, 80 were rated as essential or important by ≥90% of both panels and were included in the guidelines. The Delphi process has offered an effective way to achieve consensus between expert panels on useful tips to help adults communicate with adolescents.

Spinal immobilisaton in pre-hospital and emergency care: A systematic review of the literature

Background: Spinal immobilisation has been a mainstay of trauma care for decades and is based on the premise that immobilisation will prevent further neurological compromise in patients with a spinal column injury. The aim of this systematic review was to examine the evidence related to spinal immobilisation in pre-hospital and emergency care settings. Methods: In February 2015, we performed a systematic literature review of English language publications from 1966 to January 2015 indexed in MEDLINE and Cochrane library using the following search terms: 'spinal injuries' OR 'spinal cord injuries' AND 'emergency treatment' OR 'emergency care' OR 'first aid' AND immobilisation. EMBASE was searched for keywords 'spinal injury OR 'spinal cord injury' OR 'spine fracture AND 'emergency care' OR 'prehospital care'. Results: There were 47 studies meeting inclusion criteria for further review. Ten studies were case series (level of evidence IV) and there were 37 studies from which data were extrapolated from healthy volunteers, cadavers or multiple trauma patients. There were 15 studies that were supportive, 13 studies that were neutral, and 19 studies opposing spinal immobilisation. Conclusion: There are no published high-level studies that assess the efficacy of spinal immobilisation in pre-hospital and emergency care settings. Almost all of the current evidence is related to spinal immobilisation is extrapolated data, mostly from healthy volunteers.

Exclusão social: gestão estratégica de pessoas em duas subsidiárias de uma empresa multinacional

The present study of case empirically investigates the existence of indicators that suggest the social exclusion preoccupation from the organizations with a strategic management of human resources focus. The objects of study are two subsidiaries of a multinational enterprise in emergency and first-aid services area. One of them is Portuguese and the other is a Brazilian one. This exploratory research has used a sectional way with a longitudinal perspective, since it has considered a specific verified data referring to 2004 and 2005 years, beyond the deeper interviews with actual managers to an evaluation of these studied perception and its authentication. Our indicators identification sources were principally the individual and social rights and duties broaching and the fundamental guarantees disposed in the Brazilian and Portuguese Constitutions as such as the European Constitution project. The results appoint to great differences of management between both subsidiaries, being the Brazilian one closer to our research proposes, as such as suggest us that the human resource areas, still acting in an instrumentalist way, establish a great barrier to better practices in social inclusion and they would be unprepared for a management with the focus in the employees. Although our study has been realized in a specific activity enterprise, we believe that our results can stimulate the realization of other investigations with the same objectives. In this way, we contribute to a better comprehension of the social exclusion causes and the organizations participations in this process.

Caracterização do ritmo de atividade/repouso do Mocó (Kerodon Rupestris) em fotoperíodo artificial

Kerodon rupestris (rock cavy, mocó) is an endemic caviidae of Brazilian northeast that inhabits rocky places in the semi arid region. The aim of this study was to characterize the activity/rest rhythm of the rock cavy under 12:12 h LD cycle and continuous light. In the first stage, seven animals were submitted to two light intensities (LD; 250:0 lux and 400:0 lux; 40 days each intensity). In the second stage four males were kept for 40 days in LD (470:<1 lux), for 18 days in LL 470 lux (LL470) and for 23 days in red dim light below 1 lux (LL<1). In the third stage three males were initially kept in LD 12:12 h (450:<1 lux) and after that in LL with gradual increase in light intensity each 21 days (<1 lux LL<1; 10 lux-LL10; 160 lux LL160; 450 lux LL450). In the fourth stage it was analyzed the motor activity of 16 animals in the first 10 days in LD. Motor activity was continuously recorded by passive infrared movement sensors connected to a computer and totaled in 5 min bins. The activity showed circadian and ultradian rhythms and activity peaks at phase transitions. The activity and the rest occurred in the light as well as in the dark phase, with activity mean greater in the light phase for most of the animals. The light intensity influenced the activity/rest rhythm in the first three stages and in the first stage the activity in 400 lux increased in four animals and decreases in two. In the second stage, the tau for 3 animals in LL470 was greater than 24 h; in LL<1 it was greater than 24 h for one and lower for two. In the third stage the tau decreased with the light intensity increase for animal 8. During the first days in the experimental room, the animals did not synchronize to the LD cycle with activity and rest occurring in both phases. The results indicate that the activity/rest rhythm of Kerodon rupestris can be affected by light intensity and that the synchronization to the LD cycle results from entrainment as well as masking probably as a consequence of the action of two or more oscillators with low coupling strength

Comportamento alimentar do camarão marinho farfantenaeus subtilis em condições laboratoriais

Shrimp culture represents an important activity to brazilian economy. The northeastern region has presented high levels of production because of its climatic conditions. An important factor for the activity´s major development is related to the introduction of the species Litopenaeus vannamei. The use of an exotic species can disturb the ecosystem. In the last decades, L. vannamei has been the only species cultivated in Brazilian farms, there not being an alternative species for shrimp culture. So, there is an urgent need to developing new studies with the native species, which might represent an alternative concerning shrimp production, with emphasis on Farfantepenaeus subtilis. Another important aspect related to the activity is feeding management, once it is quite usual that feed offer on the pond does not take into account either the species´ physiology and behavior or the influence of environmental variables, such as light cycle and substrate. That knowledge may optimize management and so reduce the impact of effluents in the environment. This study´s objective was characterizing feeding behavior of F. subtilis in laboratory. For that, an ethogram was developed, using 20 wild animals which were observed through ad libitum and all occurrences methods. Two experiments were developed in order to register feeding behavior on different substrates, along 15 days, each. In the first experiment, 40 animals were distributed in eight aquaria, half being observed during the light phase of the 24 hour cycle and the other half in the dark phase, both in halimeda substrate. In the second experiment, 20 animals were distributed in four aquaria, under similar conditions as the previous ones, but in sand substrate. In both experiments, animals were observed respectively one, four, seven and ten hours after the beginning of the phase, for light phase, for the dark phase, in ten minute observation windows, before and immediately after feed offer. The following behaviors were registered: feed ingestion, ingestion of other items, inactivity, exploration, vertical exploration, swimming, crawling, digging, burrowing, and moving by the animals. Observation windows after feed offer also included latency to reach the tray and to ingest feed. Nineteen behaviors were described for the species. F. subtilis presented more behavioral activities in halimeda substrate even in the light phase, while burrowing was predominant in sand substrate. In both substrates, moving, crawling and exploration were more frequent after feed offer, but inactivity and burrowing were more frequent before that. Feed ingestion was more frequent in halimeda, both in light and dark phases. Weight gain was also more prominent in that substrate. In sand substrtate, ingestion was more frequent in the dark phase, which suggests that higher granulometry facilitates feed ingestion in F. subtilis juveniles. Our results demonstrate the importance of studies for the better knowledge of the species, specially its response to environmental stimuli, in order to improve animal management

Efeitos do substrato e da densidade populacional sobre as atividades comportamentais e níveis de homócitos em relação à densidade em Litopenaeus vannamei (BOONE, 1931)

Carciniculture in Brazil occupies world-wide prominence due to shrimp culture, and the state of Rio Grande do Norte has presented the best results in the culture of the Litopenaeus vannamei in the last decade. This species has been shown to adapt easily to different environments and is between the five most cultivated penaeids of the world. The ponds are usually constructed in areas close to water courses and estuaries. Stock density and substrate ponds can pollute environment, causing losses in the growth and survival of the shrimps, being considered stress factors. Shrimps in inadequate densities and substrates can result reduced productivity of the farm; and favor diseases. So, it is important to verify how these variables influence the development of the animals in the culture farms. Our objective was to study the influence of the type of substrate and the stock density on the behavior and haemocyte count of the L. vannamei. Individually marked juvenile shrimps were kept in aquaria with 30 L of seawater and continuous aeration, in 12L-12D photoperiod. They were observed through Ad libitum and focal sampling instantaneous methods during thirty days, five times per week, six times per day (8:00 to 18:00) in windows of 15 minutes every two hours. The marking of carapace permitted quantifying molting and the feeding was supplied three times a day. Two experiments were carried out: the first one tested animals in the three different substrates (fine sand, smaller rocks-SPP and biggest rocks-SGR) with 33 shrimp/m2. In the second one, the animals were tested in three stock densities (26, 52 and 66 shrimp/m2) in fine sand substrate. At the end of experiment, biometry (first and second ones) and haemocyte count (second one) were made. The behavior of the L. vannamei seems to have been influenced by substrate and stocking density. In low granulometry of the substrate; the exploratory behavior became more frequent and inactivity of the shrimps was reduced. Burrowing was registered in sand substrate, specially in the initial period of the day. Cleaning was gradually higher along the day, presenting the biggest levels as the dark phase approached. The ingestion of feeding was more frequent in low density, and the animals were bigger and heavier at the end of the experiment. In the fine sand condition, the animals presented better growth, probably associated with the burrowing. The molting was equivalent in all types of substrate, but it was more frequent in high densities. Mortality of the shrimps was more frequent in high densities, and cannibalism and diseases were also registered in that condition. The clinical signals were similar to the ones of infectious mionecrosis (IMNV), generally associated with environment and physical stress. The haemocyte count was low for the hematologic standards of the penaeid, which we attributed for greater dilution of haemolymph in the postmolting phase. Smaller shrimps presented lower levels of haemocytes in relation to the bigger animals, count was also low in 26 shrimp/m2 density. The study demonstrates that stocking density and the granulometry of the substrate can affect the welfare, the health and the behavior of the L. vannamei. The sand substrate and low stocking density can be important tools in the management systems of shrimp production

Eletromanometria do esfíncter superior do esôfago antes e após perfusão esofágica com ácido clorídrico 0,1N: estudo experimental no cão

Racional — A resposta do esfíncter esofágico superior ao refluxo gastroesofágico é controvertida. A perfusão esofágica com ácido clorídrico é modelo de estudo da ação do ácido o componente mais agressivo do refluxo sobre o esfíncter. Objetivos - Estudar o efeito da acidificação esofágica sobre o esfíncter esofágico superior através da eletromanometria esofágica. - Material e Métodos - em 30 cães adultos de ambos os sexos foram registrados estudos eletromanométricos do esôfago. A técnica utilizada foi a de puxada intermitente da sonda e perfusão contínua dos cateteres com água destilada. Estes exames permitiram as medidas da amplitude da pressão (mm Hg) e do comprimento (cm) do esfíncter superior do esôfago em condições basais (momento 1). Após esta fase, os animais foram submetidos a perfusão esofágica e divididos em 3 grupos de 10, na dependência da solução utilizada na perfusão e do momento do estudo: Grupo 1: perfusão esofágica com água destilada e estudos eletromanométricos realizados aos 15 minutos (momento 2) e 30 minutos (momento 3) do término da perfusão; Grupo 2: perfusão esofágica com HCl 0,1 N e estudos eletromanométricos realizados 15 minutos após o término da perfusão (momento 2); Grupo 3: perfusão esofágica com HCl 0,1 N e estudos eletromanométricos realizados 30 minutos após o término da perfusão (momento 3). Resultados/Conclusão - Os resultados observados permitiram concluir que a acidificação do esôfago não provocou alterações significativas sobre a amplitude de pressão e comprimento do esfíncter superior do esôfago.

Africanized honeybee stings: how to treat them

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

Armadilhas cognitivas: o caso das omissões na gênese dos acidentes de trabalho

Neste artigo discute-se o tema das omissões na gênese de acidentes do trabalho, tendo como referência contribuições de James Reason. Os autores descrevem três acidentes de trabalho ocorridos em atividades de manutenção, e nos quais a omissão de passos na execução da atividade foi apontada como causa nas análises efetuadas pelas empresas, acarretando atribuição de culpa aos acidentados. Nos três casos, a análise efetuada pelos autores revelou que, na seqüência de passos da atividade havia presença simultânea de pelo menos quatro das características apontadas por Reason como geradoras de omissões, caracterizando as denominadas armadilhas cognitivas.

Stable isotopes for determining carbon turnover in sheep feces and blood

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

Effects of cyclosporin, phenytoin, and nifedipine on the synthesis and degradation of gingival collagen in tufted capuchin monkeys (Cebus apella): Histochemical and MMP-1 and -2 and collagen I gene expression analyses

Background: The purpose of this experimental study was to evaluate the collagen fiber distribution histologically after phenytoin, cyclosporin, or nifedipine therapy and to correlate it with collagen I and matrix metalloproteinase (MMP)-1 and -2 gene expression levels.Methods: Gingival samples from the canine area were obtained from 12 male monkeys (Cebus apella). The mesial part of each sample was assessed by reverse transcription-polymerase chain reaction, whereas the distal part was processed histologically for picrosirius red and hematoxylin and eosin stainings, as well as for collagen IV immunostaining. One week after the first biopsy, the animals were assigned to three groups that received daily oral dosages of cyclosporin, phenytoin, or nifedipine for 120 days. Additional gingival samples were obtained on days 52 and 120 of treatment from two animals from each group on the opposite sides from the first biopsies.Results: Picrosirius red staining showed a predominance of mature collagen fibers in the control group. Conversely, there was an enlargement of areas occupied by immature collagen fibers in all groups at days 52 and 120, which was not uniform over each section. There was a general trend to lower levels of MMP-1 gene expression on day 52 and increased levels on day 120. Phenytoin led to increased levels of MMP-2 and collagen I gene expression on day 120, whereas the opposite was observed in the nifedipine group.Conclusion: Cyclosporin, phenytoin, and nifedipine led to phased and drug-related gene expression patterns, resulting in impaired collagen metabolism, despite the lack of prominent clinical signs.

Knowledge of firefighters with special paramedic training of the emergency management of avulsed teeth

Immediate replantation into the socket is the ideal procedure in cases of accidental avulsion of permanent teeth. In Brazil, firefighters with special paramedic training are in charge of providing first-aid care to victims of road accidents and might have to deal with tooth avulsions. This study assessed the knowledge of firefighters regarding the emergency management of avulsed teeth. Information was collected from a questionnaire submitted to 110 volunteer firefighters in seven cities in the São Paulo State (Brazil). The results revealed that 70.9% of the respondents did not know what tooth avulsion was; 53.6% did not know what tooth replantation was or defined it incorrectly; 60% would not act properly in tooth avulsion cases; 20.9% did not consider replantation of the avulsed tooth into the socket as a treatment option; the ideal time interval for tooth replantation was unknown to 40% of the interviewees; 90% of the participants answered that they would not be able to perform tooth replantation. Among those who considered themselves unable to perform tooth replantation, 47.3% chose saline as the best storage medium for an avulsed tooth, 21.8% chose milk, 3.6% chose the patient's mouth and 20% reported not knowing where to store the tooth; 81.8% of the firefighters reported not to have ever received any specific directions on tooth replantation and 100% of them considered this knowledge a requirement for first-aid care to accident victims. In conclusion, the knowledge of the surveyed firefighters regarding emergency management after tooth avulsion was unsatisfactory in several aspects that are important for the success of replantation procedures. Firefighters with special paramedic training should be educated on how to proceed in cases of dentoalveolar traumas and tooth avulsions in order to improve treatment prognosis and increase the survival rate of replanted teeth.

Determinação de zinco da sola do casco de bovinos leiteiros com ou sem lesões podais, suplementados ou não com levedura seca de cana-de-açúcar

Com o objetivo de estudar as concentrações de zinco da sola do casco de bovinos com e sem lesões podais, suplementados ou não com levedura seca, foram selecionadas e examinadas 60 vacas, escolhidas aleatoriamente, de um rebanho de 150 animais. Formaram-se quatro grupos de 15 animais, sendo o primeiro com animais com lesões podais e suplementados com levedura, o segundo com animais com lesões podais e sem suplementação de levedura, o terceiro com animais sem lesões podais e suplementados com levedura e o quarto com animais sem lesões podais e sem a suplementação de levedura. As concentrações de zinco da sola do casco foram determinadas por espectrometria de absorção atômica com chama (AAS). A comparação estatística das concentrações de zinco nas amostras foram submetidos à análise de variância, seguida pelo teste de Tukey, para comparação de médias. As médias das concentrações de zinco da sola do casco dos animais dos quatro grupos, quando comparadas estatisticamente, apresentaram diferença estatística significativa, somente nos animais com lesões podais e suplementados com levedura.

Efeito da associação de furosemida e fenilbutazona sobre variáveis hidroeletrolíticas de cavalos antes e após a corrida

The objective of this study was to verify the effects of furosemide and phenylbutazone association on fluid and electrolyte balance characteristics of horses before and after a race. Nineteen horses were divided into three groups according to treatment protocols. The first group (five animals - control) was not medicated. A second group (seven animals) was treated with furosemide (1mg/kg, intramuscular up to four hours before the race). A third group (seven animals) received furosemide (1mg/kg) and phenylbutazone (4.4 mg/kg), both intramuscular, up to four hours before race. Blood samples were collected before, immediately after and two hours after a race to evaluate the plasma osmolality and sodium, potassium and chloride concentrations. The use of furosemide and furosemide plus phenylbutazone up to four hours before the race altered (P<0.05) the plasma osmolality but did not change (P>0.05) the sodium, potassium and chloride concentrations. It was not possible to determine an antagonist effect of phenylbutazone on furosemide, based on fluid and electrolyte balance. Due to the high intensity exercise, the increase in plasma osmolality and potassium concentration was attributed to the race effect.