Valores hematológicos em Geochelone carbonária (Jabuti)

Hematology has a great importance in assessing the health of all animals, including reptiles, since it aids in the diagnosis of certain diseases and help to monitor patient's clinical evolution, although studies and articles in this area are rare, even with the increasing number of calls of these animals in veterinary clinics. Moreover, there are a lot of environmental and individual factors, which influence the hematological values of this group, such as age, sex, stress levels, nutrient levels and season which the exam was made, among others. For these reasons studies that aimed to evaluate the reference values of some specie, are essential to increase the knowledge in the field and to assist on the clinical approach. This paper aim’s to study the patterns of Hematology of Tortoise (Geochelone carbonaria) seeking the greater knowledge of clinical pathology of this species and increasing the possibilities for diagnosis, monitoring clinical outcome, and assessment of the general state and treatment

In situ remineralizing effect of fluoride varnishes containing sodium trimetaphosphate

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação e monitoramento da obesidade em adultos residentes do município de Rio Claro - SP

Obesity is characterized by an excess of fat on the body and can results several problems on the individual health. As an epidemic of modern times, the prevalence started to increase at an accelerated rate from the 90's in worldwide. Data on the epidemic in Brazil and medium-sized cities are scarce, and the monitoring of obesity is essential for development public policy. So, the objective was to analyze the individual factors associated with obesity such as age, gender, education, marital status, economic class and level of physical activity and make a monitoring of obesity in adults in the city of Rio Claro - SP. To do this, the survey was conducted longitudinally, consists of two times at an interval of seven years. At first (2008) were interviewed 1588 adults in the city of Rio Claro distributed throughout the city. At the second phase (2014/2015) was conducted a new interview with the same subject in 1588. In 2008, personal information collected and applied some questionnaires with the physical activity level, food intake and quality of life. To assess obesity in adults was calculated the body mass index (BMI) proposed by the World Health Organization (WHO) from the high reported weight and height. For older people it used a specific BMI. The prevalence was used percentages and their respective confidence intervals of 95%. For the incidence, was calculated by the formula of cumulative incidence, both stratified by personal characteristics (gender, economic class, education, marital status and age). Thus it was observed that there was an increase in the prevalence of obesity in 2008 (19.0%), increasing to 26.7% in 2015. The cumulative incidence was 14.4% in the range of 7 years. As for the groups, we observed a significant difference between economic class and obesity being less prevalent among people of class D / E. Regarding marital status, it was observed that married / cohabiting have a higher prevalence. Therefore, we can conclude...

Late entry into HIV care: lessons from Brazil, 2003 to 2006

Background: To ascertain the population rates and proportion of late entry into HIV care, as well as to determine whether such late entry correlates with individual and contextual factors. Methods: Data for the 2003-2006 period in Brazil were obtained from public health records. A case of late entry into HIV care was defined as one in which HIV infection was diagnosed at death, one in which HIV infection was diagnosed after the condition of the patient had already been aggravated by AIDS-related diseases, or one in which the CD4(+) T-cell count was <= 200 cells/mm(3) at the time of diagnosis. We also considered extended and stricter sets of criteria (in which the final criterion was <= 350 cells/mm(3) and <= 100 cells/mm(3), respectively). The estimated risk ratio was used in assessing the effects of correlates, and the population rates (per 100,000 population) were calculated on an annual basis. Results: Records of 115,369 HIV-infected adults were retrieved, and 43.6% (50,358) met the standard criteria for late entry into care. Diagnosis at death accounted for 29% (14,457) of these cases. Late entry into HIV care (standard criterion) was associated with certain individual factors (sex, age, and transmission category) and contextual factors (region with less economic development/increasing incidence of AIDS, lower local HIV testing rate, and smaller municipal population). Use of the extended criteria increased the proportion of late entry by 34% but did not substantially alter the correlations analyzed. The overall population rate of late entry was 9.9/100,000 population, specific rates being highest for individuals in the 30-59 year age bracket, for men, and for individuals living in regions with greater economic development/higher HIV testing rates, collectively accounting for more than half of the cases observed. Conclusions: Although the high proportion of late entry might contribute to spreading the AIDS epidemic in less developed regions, most cases occurred in large cities, with broader availability of HIV testing, and in economically developed regions.

Sviluppo di tecniche di analisi ifenate per la quantificazione di biomarcatori di esposizione a tossici ambientali: gli acidi mercapturici

Human biomonitoring (HBM) is an ideal tool for evaluating toxicant exposure in health risk assessment. Chemical substances or their metabolites related to environmental pollutants can be detected as biomarkers of exposure using a wide variety of biological fluids. Individual exposure to aromatic hydrocarbon compounds (benzene, toluene, and o-xylene –“BTX”) were analysed with a liquid chromatography coupled to electrospray ionisation-mass spectrometry (μHPLC-ESI-MS/MS) method for the simultaneous quantitative detection of the BTX exposure biomarker SPMA, SBMA and o-MBMA in human urine. Urinary S-phenylmercapturic acid (SPMA) is a biomarker proposed by the American Conference of Governmental Industrial Hygienists (ACGIH) for assessing occupational exposure to benzene (Biological Exposure Index of 25 microg/g creatinine). Urinary S-benzylmercapturic (SBMA) and o-methyl S-benzyl mercapturic acid (o-MBMA) are specific toluene and o-xylene metabolites of glutathione detoxicant pathways, proposed as reliable biomarkers of exposure. To this aim a pre-treatment of the urine with solid phase extraction (SPE) and an evaporation step were necessary to concentrate the mercapturic acids before instrumental analysis. A liquid chromatography separation was carried out with a reversed phase capillary column (Synergi 4u Max-RP) using a binary gradient composed of an acquous solution of formic acid 0.07% v/v and methanol. The mercapturic acids were determinated by negative-ion-mass spectrometry and the data were corrected using isotope-labelled analogs as internal standards. The analytical method follows U.S. Food and Drug Administration guidance and was applied to assess exposure to BTX in a group of 396 traffic wardens. The association between biomarker results and individual factors, such as age, sex and tobacco smoke were also investigated. The present work also included improvements in the methods used by modifying various chromatographic parameters and experimental procedures. A partial validation was conducted to evaluate LOD, precision, accuracy, recovery as well as matrix effects. Higher sensitivity will be possible in future biological monitoring programmes, allowing evaluation of very low level of BTX human exposure. Keywords: Human biomonitoring, aromatic hydrocarbons, biomarker of exposure, HPLC-MS/MS.

An interdisciplinary analysis of obesity: theory and empirical evidence

The dissertation is structured in three parts. The first part compares US and EU agricultural policies since the end of WWII. There is not enough evidence for claiming that agricultural support has a negative impact on obesity trends. I discuss the possibility of an exchange in best practices to fight obesity. There are relevant economic, societal and legal differences between the US and the EU. However, partnerships against obesity are welcomed. The second part presents a socio-ecological model of the determinants of obesity. I employ an interdisciplinary model because it captures the simultaneous influence of several variables. Obesity is an interaction of pre-birth, primary and secondary socialization factors. To test the significance of each factor, I use data from the National Longitudinal Survey of Adolescent Health. I compare the average body mass index across different populations. Differences in means are statistically significant. In the last part I use the National Survey of Children Health. I analyze the effect that family characteristics, built environment, cultural norms and individual factors have on the body mass index (BMI). I use Ordered Probit models and I calculate the marginal effects. I use State and ethnicity fixed effects to control for unobserved heterogeneity. I find that southern US States tend have on average a higher probability of being obese. On the ethnicity side, White Americans have a lower BMI respect to Black Americans, Hispanics and American Indians Native Islanders; being Asian is associated with a lower probability of being obese. In neighborhoods where trust level and safety perception are higher, children are less overweight and obese. Similar results are shown for higher level of parental income and education. Breastfeeding has a negative impact. Higher values of measures of behavioral disorders have a positive and significant impact on obesity, as predicted by the theory.

Altersabhängige Besonderheiten in der Entwicklung des Bedeutungsfeldes der binären Opposition von „Möglichkeit“ vs. „Unmöglichkeit“

Die vorliegende Arbeit zum kindlichen Erwerb der binären Opposition von „Möglichkeit“ und „Unmöglichkeit“ und ihrer modalen Ausdrucksweisen im Russischen ist in ihrem praktischen Teil eine Einzelfall- und Langzeitstudie, die eine Ergänzung zu den bisher veröffentlichten, durchgehend eher experimentell und statistisch orientierten Forschungsarbeiten darstellen soll.rnÜber dreieinhalb Jahre hinweg wurde kontinuierlich Sprachmaterial eines Kindes sowie einiger ungefährer Altersgenossen und Spielkameraden aufgezeichnet, geordnet und ausgewertet. Zu Beginn des Untersuchungszeitraums war die Hauptprobandin dreieinhalb Jahre alt, zum Schluß sieben Jahre. Dieses Verfahren wurde bisher für das Russische noch nicht angewandt und wird im theoretischen Teil sorgfältig begründet.rnDas Sammeln für die Fragestellung relevanten sprachlichen Materials erfordert naturgemäß einen hohen Zeit- und Arbeitsaufwand, liefert dafür aber Daten, die eine Beeinflussung durch einen vorgegebenen Versuchsaufbau ausschließen, der natürlichen, spontanen Kommunikation entspringende Äußerungen festhalten und es ermöglichen, unprovozierte Interaktion, situationsbedingte Einflüsse, das Diskursverhalten der Probanden und ähnliche, individuelle Faktoren bei der Interpretation des Sprachmaterials in angemessener Weise zu berücksichtigen.rnUm die Fülle modaler Ausdrucksweisen sinnvoll zu strukturieren, konzentriert sich die Analyse auf die kindliche Verwendung von Modalverben und Prädikative als zentrale Mittel innerhalb des „Möglichkeitsfeldes“ und richtet den Fokus dabei auf das Verb moč’. Aus diesem Grunde wurde das theoretische Fundament, das der Arbeit zugrunde liegt, zu einem nicht geringen Teil aus dem Ansatz I.V. Šatunovskijs entwickelt, der die differenzierteste Analyse der zahlreichen Bedeutungsschattierungen des Verbs moč’ vorgelegt hat. Für besonders bedeutungsvoll für die vorliegende Arbeit erweist sich die Unterscheidung von kontrollierbarer und unkontrollierbarer Möglichkeit.rnIm Rahmen der Untersuchung ließen sich die grundlegenden Entwicklungstendenzen verfolgen. Dabei wurde nicht nur versucht nachzuvollziehen, in welcher Weise sich bei einem Kind das Fundament des Sprachgebrauchs in Gestalt eines allgemeinen „Zitatenschatzes“ formiert, sondern es gelang mitunter sogar, erste Fälle der Verwendung des einen oder anderen kommunikativen Fragments mit der Bedeutung von „Möglichkeit“ / „Unmöglichkeit“ oder erste Fälle der Konfrontation des Kindes mit einer neuen Situation, die eine solche Bedeutung verlangte, und sein Sprachverhalten in diesem Moment zu fixieren.

Untersuchung der Auswirkungen verschiedener Variationsbereiche des differenziellen Lernens und Lehrens im weiten Sinn auf ausgewählte technische Grundfertigkeiten im Hallenhockey

Die Frage wie großmotorische Bewegungen gelernt werden beschäftigt nicht nur Sportler, Trainer und Sportlehrer sondern auch Ärzte und Physiotherapeuten. Die sportwissenschaftlichen Teildisziplinen Bewegungs- und Trainingswissenschaft versuchen diese Frage sowohl im Sinne der Grundlagenforschung (Wie funktioniert Bewegungslernen?) als auch hinsichtlich der praktischen Konsequenzen (Wie lehrt man Bewegungen?) zu beantworten. Innerhalb dieser Themenfelder existieren Modelle, die Bewegungslernen als gezielte und extern unterstützte Ausbildung zentralnervöser Bewegungsprogramme verstehen und solche, die Lernen als Selbstorganisationsprozess interpretieren. Letzteren ist das Differenzielle Lernen und Lehren (Schöllhorn, 1999) zuzuordnen, das die Notwendigkeit betont, Bewegungen durch die Steigerung der Variationen während der Aneignungsphase zu lernen und zu lehren. Durch eine Vielzahl an Variationen, so die Modellannahme, findet der Lernende ohne externe Vorgaben selbstorganisiert ein individuelles situatives Optimum. Die vorliegende Arbeit untersucht, welchen Einfluss Variationen verschiedener Art und Größe auf die Lern- und Aneignungsleistung großmotorischer Bewegungen haben und in wie fern personenübergreifende Optima existieren. In zwei Experimenten wird der Einfluss von räumlichen (Bewegungsausführung, Bewegungsergebnis) und zeitlichen Variationen (zeitliche Verteilung der Trainingsreize) auf die Aneignungs- und Lernleistung großmotorischer sportlicher Bewegungen am Beispiel zweier technischer Grundfertigkeiten des Hallenhockeys untersucht. Die Ergebnisse der Experimente stützen die bisherige Befundlage zum Differenziellen Lernen und Lehren, wonach eine Zunahme an Variation in der Aneignungsphase zu größeren Aneignungs- und Lernleistungen führt. Zusätzlich wird die Annahme bestätigt, dass ein Zusammenhang von Variationsbereich und Lernrate in Form eines Optimaltrends vorliegt. Neu sind die Hinweise auf die Dynamik von motorischen Lernprozessen (Experiment 1). Hier scheinen individuelle Faktoren (z. B. die Lernbiografie) als auch die Phase im Lernprozess (Aneignung, Lernen) Einfluss zu haben auf den Umfang und die Struktur eines für die optimale Adaptation notwendigen Variationsbereichs. Darüber hinaus weisen die Befunde auf verschiedene Aneignungs- und Lerneffekte aufgrund alleiniger Variation der zeitlichen Verteilung bei ansonsten gleichen Trainingsreizen hin (Experiment 2). Für zukünftige Forschungsarbeiten zum Erlernen großmotorischer Bewegungen und für die sportliche Praxis dürfte es daher erkenntnisreich sein, die Historie der intrinsischen Dynamik der lernenden Systeme stärker zu berücksichtigen. Neben Fragestellungen für die Grundlagenforschung zum (Bewegungs-)Lernen ließen sich hieraus unmittelbar praxisrelevante Erkenntnisse darüber ableiten, wie Bewegungslernprozesse mittels verschiedener Variationsbereiche strukturiert und gesteuert werden könnten.

Exploring Assistance in Sweden and the United States

Few international comparisons of health services are performed using microlevel data. Using such data, this paper compares the need for and receipt of assistance with activities of daily living (ADLs) in comparable samples in the United States and Sweden, a country with a universal system of community-based services.Design and Methods: Data from national surveys of community residents completed at approximately the same time in each nation are used to create comparable measures of need and assistance. Descriptive and logistic regression analyses compare need and assistance patterns across the nations and identify individual factors that explain receipt of assistance and unmet needs.Results:Our results indicate that a simple story of greater use of paid formal services in Sweden and more unpaid informal use in the United States masks a more complex relationship. Assistance with ADLs seems to be more targeted in Sweden; narrow differences in assistance widen considerably when the analysis is limited to those reporting need. Implications:Although these two different health systems result in similar levels of overall ADL assistance, a detailed microlevel comparison reveals key distinctions. Further microlevel comparisons of access, cost, and quality in cross-national data can further aid our understanding of the consequences of health policy.

Study of Staphylococcus aureus pathogenic genes by transfer and expression in the less virulent organism Streptococcus gordonii

Because Staphylococcus aureus strains contain multiple virulence factors, studying their pathogenic role by single-gene inactivation generated equivocal results. To circumvent this problem, we have expressed specific S. aureus genes in the less virulent organism Streptococcus gordonii and tested the recombinants for a gain of function both in vitro and in vivo. Clumping factor A (ClfA) and coagulase were investigated. Both gene products were expressed functionally and with similar kinetics during growth by streptococci and staphylococci. ClfA-positive S. gordonii was more adherent to platelet-fibrin clots mimicking cardiac vegetations in vitro and more infective in rats with experimental endocarditis (P < 0.05). Moreover, deleting clfA from clfA-positive streptococcal transformants restored both the low in vitro adherence and the low in vivo infectivity of the parent. Coagulase-positive transformants, on the other hand, were neither more adherent nor more infective than the parent. Furthermore, coagulase did not increase the pathogenicity of clfA-positive streptococci when both clfA and coa genes were simultaneously expressed in an artificial minioperon in streptococci. These results definitively attribute a role for ClfA, but not coagulase, in S. aureus endovascular infections. This gain-of-function strategy might help solve the role of individual factors in the complex the S. aureus-host relationship.

Community managed rural water supply systems in the Dominican Republic : assessment of sustainability of systems built by the National Institute of Potable Water and Peace Corps, Dominican Republic

In the Dominican Republic economic growth in the past twenty years has not yielded sufficient improvement in access to drinking water services, especially in rural areas where 1.5 million people do not have access to an improved water source (WHO, 2006). Worldwide, strategic development planning in the rural water sector has focused on participatory processes and the use of demand filters to ensure that service levels match community commitment to post-project operation and maintenance. However studies have concluded that an alarmingly high percentage of drinking water systems (20-50%) do not provide service at the design levels and/or fail altogether (up to 90%): BNWP (2009), Annis (2006), and Reents (2003). World Bank, USAID, NGOs, and private consultants have invested significant resources in an effort to determine what components make up an “enabling environment” for sustainable community management of rural water systems (RWS). Research has identified an array of critical factors, internal and external to the community, which affect long term sustainability of water services. Different frameworks have been proposed in order to better understand the linkages between individual factors and sustainability of service. This research proposes a Sustainability Analysis Tool to evaluate the sustainability of RWS, adapted from previous relevant work in the field to reflect the realities in the Dominican Republic. It can be used as a diagnostic tool for government entities and development organizations to characterize the needs of specific communities and identify weaknesses in existing training regimes or support mechanisms. The framework utilizes eight indicators in three categories (Organization/Management, Financial Administration, and Technical Service). Nineteen independent variables are measured resulting in a score of sustainability likely (SL), possible (SP), or unlikely (SU) for each of the eight indicators. Thresholds are based upon benchmarks from the DR and around the world, primary data collected during the research, and the author’s 32 months of field experience. A final sustainability score is calculated using weighting factors for each indicator, derived from Lockwood (2003). The framework was tested using a statistically representative geographically stratified random sample of 61 water systems built in the DR by initiatives of the National Institute of Potable Water (INAPA) and Peace Corps. The results concluded that 23% of sample systems are likely to be sustainable in the long term, 59% are possibly sustainable, and for 18% it is unlikely that the community will be able to overcome any significant challenge. Communities that were scored as unlikely sustainable perform poorly in participation, financial durability, and governance while the highest scores were for system function and repair service. The Sustainability Analysis Tool results are verified by INAPA and PC reports, evaluations, and database information, as well as, field observations and primary data collected during the surveys. Future research will analyze the nature and magnitude of relationships between key factors and the sustainability score defined by the tool. Factors include: gender participation, legal status of water committees, plumber/operator remuneration, demand responsiveness, post construction support methodologies, and project design criteria.

Differences between dual X-ray absorptiometry using pencil beam and fan beam modes and their determinants in vivo and in vitro

The aim of this study was to determine the influence of individual factors on differences in bone mineral density (BMD) using dual X-ray absorptiometry pencil beam (PB) and fan beam (FB) modes in vivo and in vitro. PB.BMD and FB.BMD of 63 normal Caucasian females ages 21-80 yr were measured at the lumbar spine and hip. Residuals of the FB/PB regression were used to assess the impact of height, weight, adiposity index (AI) (= weight/height(3/2)), back tissue thickness, and PB.BMD, respectively, on FB/PB difference. The Hologic Anthropomorphic Spine Phantom (ASP) was measured using the PB and FB modes at two different levels to assess the impact of scanning mode and focus distance. The European Spine Phantom (ESP) prototype, a geometrically well-defined phantom with known vertebral densities, was measured using PB and FB modes and analyzed manually to determine the impact of bone density on FB/PB difference and automatically to determine the impact of edge detection on FB/PB difference. Population BMD results were perfectly correlated, but significantly overestimated by 1.5% at the lumbar spine and underestimated by 0.7% at the neck, 1.8% at the trochanter, and 2.0% at the total hip, respectively, when using the FB compared with PB mode. At the lumbar spine, the FB/PB residual correlated negatively with height (r = 0.34, p < 0.01) and PB.BMD (r = 0.48, p <: 0. 0001) and positively with AI (r = 0.26, p < 0.05). At the hip, residual of trochanter correlated positively with weight (r = 0.36, p < 0.01) and AI (r = 0.36, p < 0.01). The FB mode significantly increased ASP BMD by 0.7% compared with PB. Using the FB mode, increasing focus distance significantly (p < 0.001) decreased area and bone mineral content, but not BMD. By contrast, increasing focus distance significantly decreased PB.BMD by 0.7%. With the ESP, the PB mode supplied accurate projected are of the bone (AREA) results but significant underestimation of specified BMD in the manual analysis. The FB mode significantly underestimated PB. AREA by 2.9% but fitted specified BMD quite well. FB/PB overestimation was larger for the low-density (+8.7%) than for the high-density vertebra (+4. 9%). The automated analysis resulted in more than 14% underestimation of PB. AREA (low-density vertebra) and an almost 13% overestimation of PB.BMD (high-density vertebra) using FB. In conclusion, FB and PB measurements are highly correlated at the lumbar spine and hip with small but significant BMD differences related to height, adiposity, and BMD. In clinical practice, it can be erroneous to switch from one method to another, especially in women with low bone density.

Development of Values after Compulsory School: Work comes first, then family

During school-to-work transition, adolescents develop values and prioritize what is im-portant in their life. Values are concepts or beliefs about desirable states or behaviors that guide the selection or evaluation of behavior and events, and are ordered by their relative importance (Schwartz & Bilsky, 1987). Stressing the important role of values, career re-search has intensively studied the effect of values on educational decisions and early career development (e.g. Eccles, 2005; Hirschi, 2010; Rimann, Udris, & Weiss, 2000). Few re-searchers, however, have investigated so far how values develop in the early career phase and how value trajectories are influenced by individual characteristics. Values can be oriented towards specific life domains, such as work or family. Work values include intrinsic and extrinsic aspects of work (e.g., self-development, cooperation with others, income) (George & Jones, 1997). Family values include the importance of partner-ship, the creation of an own family and having children (Mayer, Kuramschew, & Trommsdroff, 2009). Research indicates that work values change considerably during early career development (Johnson, 2001; Lindsay & Knox, 1984). Individual differences in work values and value trajectories are found e.g., in relation to gender (Duffy & Sedlacek, 2007), parental background (Loughlin & Barling, 2001), personality (Lowry et al., 2012), educa-tion (Battle, 2003), and the anticipated timing of school-to-work transition (Porfeli, 2007). In contrast to work values, research on family value trajectories is rare and knowledge about the development during the school-to-work transition and early career development is lack-ing. This paper aims at filling this research gap. Focusing on family values and intrinsic work values and we expect a) family and work val-ues to change between ages 16 and 25, and b) that initial levels of family and work values as well as value change to be predicted by gender, reading literacy, ambition, and expected du-ration of education. Method. Using data from 2620 young adults (59.5% females), who participated in the Swiss longitudinal study TREE, latent growth modeling was employed to estimate the initial level and growth rate per year for work and family values. Analyses are based on TREE-waves 1 (year 2001, first year after compulsory school) to 8 (year 2010). Variables in the models included family values and intrinsic work values, gender, reading literacy, ambition and ex-pected duration of education. Language region was included as control variable. Results. Family values did not change significantly over the first four years after leaving compulsory school (mean slope = -.03, p =.36). They increased, however, significantly five years after compulsory school (mean slope = .13, p >.001). Intercept (.23, p < .001), first slope (.02, p < .001), and second slope (.01, p < .001) showed significant variance. Initial levels were higher for men and those with higher ambitions. Increases were found to be steeper for males as well as for participants with lower educational duration expectations and reading skills. Intrinsic work values increased over the first four years (mean slope =.03, p <.05) and showed a tendency to decrease in the years five to ten (mean slope = -.01, p < .10). Intercept (.21, p < .001), first slope (.01, p < .001), and second slope (.01, p < .001) showed signifi-cant variance, meaning that there are individual differences in initial levels and growth rates. Initial levels were higher for females, and those with higher ambitions, expecting longer educational pathways, and having lower reading skills. Growth rates were lower for the first phase and steeper for the second phase for males compared to females. Discussion. In general, results showed different patterns of work and family value trajecto-ries, and different individual factors related to initial levels and development after compul-sory school. Developments seem to fit to major life and career roles: in the first years after compulsory school young adults may be engaged to become established in one's job; later on, raising a family becomes more important. That we found significant gender differences in work and family trajectories may reflect attempts to overcome traditional roles, as over-all, women increase in work values and men increase in family values, resulting in an over-all trend to converge.

Survey of safety climate in public hospitals in Costa Rica in 1997

In response to growing concern for occupational health and safety in the public hospital system in Costa Rica, a research program was initiated in 1995 to evaluate and improve the safety climate in the national healthcare system through regional training programs, and to develop the capacity of the occupational health commissions in these settings to improve the identification and mitigation of workplace risks. A cross-sectional survey of 1000 hospital-based healthcare workers was conducted in 1997 to collect baseline data that will be used to develop appropriate worker training programs in occupational health. The objectives of this survey were to: (1) describe the safety climate within the national hospital system, (2) identify factors associated with safety climate focusing on individual and organizational variables, and (3) to evaluate the relationship between safety climate and workplace injuries and safety practices of employees. Individual factors evaluated included the demographic variables of age, gender, education and profession. Organizational factors evaluated included training, psychosocial work environment, job-task demands, availability of protective equipment and administrative controls. Work-related injuries and safety practices of employees included the type and frequency of injuries experienced and reported, and compliance with established safety practices. Multivariate regression analyses demonstrated that training and administrative controls were the two most significant predictors of safety climate. None of the demographic variables were significant predictors of safety climate. Safety climate was inversely and significantly associated with workplace injuries and positively and significantly associated with safety practices. These results suggest that training and administrative controls should be included in future training efforts and that improving safety climate will decrease workplace injuries and increase safety practices. ^

Improving children’s cognitive performance – Effect of a memory strategy training in children born very preterm

Aims: To examine the effect of memory strategy training on different aspects of memory in children born very preterm and to determine whether there is a generalization of the training effect to non-trained functions. The influence of individual factors such as age and performance level on the training success will be determined. Methods: In a randomized, controlled and blinded clinical trial, 46 children born very preterm (aged 7-12 years) were allocated to a memory strategy training (MEMO-Training, n=23) or a control group (n=23). Neuropsychological assessment was performed before, immediately after the training and at a 6-month follow-up. In the MEMO-Training, five different memory strategies were introduced and practiced in a one-to-one setting (4 hour-long training sessions over 4 weeks, 20 homework sessions). Results: A significant training-related improvement occurred in trained aspects of memory (verbal and visual learning and recall, verbal working memory) and in non-trained functions (inhibition, mental arithmetic). No performance increase was observed in the control group. At six months follow-up, there was a significant training-related improvement of visual working memory. Age and performance level before the training predicted the training success significantly. Conclusion: Teaching memory strategies is an effective way to improve different aspects of memory but also non-trained functions such as inhibition and mental arithmetic in children born very preterm. Age and performance level influence the success of memory strategy training. These results highlight the importance of teaching children memory strategies to reduce scholastic problems.