Adolescent salvia substance abuse

Background  Salvia divinorum is a non-water-soluble hallucinogen that is becoming increasingly popular among adolescents. Salvia is a highly selective full agonist of primate and cloned human cerebral kappa-opioid receptors, although its psychotomimetic effects are similar to serotonergic agonists and NMDA glutamate antagonists. Salvia has been associated with depersonalization, laughter, feelings of levitation and self-consciousness. These effects resolve within 30 minutes following use. Salvia has been banned in many countries, although it remains legal and easily assessable over the internet in the United States. Case description  A 15-year-old man with a history of salvia and marijuana use presented to psychiatric emergency services with acute onset of mental status changes characterized by paranoia, dÉjÀ vu, blunted affect, thought blocking and slow speech of 3 days' duration. Conclusion  There is limited literature discussing the clinical effects of salvia use. Based on this case presentation, salvia use may be associated with many undocumented long-term effects such as dÉjÀ vu. The ease of use and increasing popularity of salvia requires further investigation into the clinical effects of salvia use.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73578/1/j.1360-0443.2007.01810.x.pd

Memórias Quilombolas – A história de uma comunidade de remanescente de quilombo no Sul de Santa Catarina

TCC (graduação) - Universidade Federal de Santa Catarina. Centro de Comunicação e Expressão. Jornalismo.Este trabalho de conclusão de curso é um livro fotodocumental sobre a história de uma comunidade quilombola no Morro do Fortunato, em Garopaba, litoral Sul de Santa Catarina. Descendentes do ex-escravo Fortunato, cerca de 150 pessoas preservam ainda o legado da cultura africana. O quilombo existe há mais de 100 anos e foi certificado pela Fundação Palmares, braço do Ministério da Cultura, em 2007. A questão levantada é: como esta comunidade está organizada e como mantém culturalmente as raízes africanas em meio a uma cidade colonizada por europeus? O livro fotodocumental, com 34 fotos, propõe uma discussão sobre essa temática a partir de fotografias e legendas, cuja narrativa está organizada tendo como base três principais temas: (1) o dia a dia da comunidade, com base na agricultura e no lazer; (2) a rotina da comunidade quilombola e sua relação com a cultura africana; (3) a relação dessa comunidade com a cidade de Garopaba, município no qual ela está localizada

Primary care management for optimized antithrombotic treatment [PICANT]: study protocol for a cluster-randomized controlled trial

Background: Antithrombotic treatment is a continuous therapy that is often performed in general practice and requires careful safety management. The aim of this study is to investigate whether a best practice model that applies major elements of case management, including patient education, can improve antithrombotic management in primary health care in terms of reducing major thromboembolic and bleeding events. Methods: This 24-month cluster-randomized trial will be performed in 690 adult patients from 46 practices. The trial intervention will be a complex intervention involving general practitioners, health care assistants and patients with an indication for oral anticoagulation. To assess adherence to medication and symptoms in patients, as well as to detect complications early, health care assistants will be trained in case management and will use the Coagulation-Monitoring-List (Co-MoL) to regularly monitor patients. Patients will receive information (leaflets and a video), treatment monitoring via the Co-MoL and be motivated to perform self-management. Patients in the control group will continue to receive treatment-as-usual from their general practitioners. The primary endpoint is the combined endpoint of all thromboembolic events requiring hospitalization, and all major bleeding complications. Secondary endpoints are mortality, hospitalization, strokes, major bleeding and thromboembolic complications, severe treatment interactions, the number of adverse events, quality of anticoagulation, health-related quality of life and costs. Further secondary objectives will be investigated to explain the mechanism by which the intervention is effective: patients' assessment of chronic illness care, self-reported adherence to medication, general practitioners' and health care assistants' knowledge, patients' knowledge and satisfaction with shared decision making. Practice recruitment is expected to take place between July and December 2012. Recruitment of eligible patients will start in July 2012. Assessment will occur at three time points: baseline (T0), follow-up after 12 (T1) and after 24 months (T2). Discussion: The efficacy and effectiveness of individual elements of the intervention, such as antithrombotic interventions, self-management concepts in orally anticoagulated patients and the methodological tool, case-management, have already been extensively demonstrated. This project foresees the combination of several proven instruments, as a result of which we expect to profit from a reduction in the major complications associated with antithrombotic treatment

Hybrid Titanium/Biodegradable Polymer Implants with an Hierarchical Pore Structure as a Means to Control Selective Cell Movement

UNLABELLED: In order to improve implant success rate, it is important to enhance their responsiveness to the prevailing conditions following implantation. Uncontrolled movement of inflammatory cells and fibroblasts is one of these in vivo problems and the porosity properties of the implant have a strong effect on these. Here, we describe a hybrid system composed of a macroporous titanium structure filled with a microporous biodegradable polymer. This polymer matrix has a distinct porosity gradient to accommodate different cell types (fibroblasts and epithelial cells). The main clinical application of this system will be the prevention of restenosis due to excessive fibroblast migration and proliferation in the case of tracheal implants. METHODOLOGY/PRINCIPAL FINDINGS: A microbead-based titanium template was filled with a porous Poly (L-lactic acid) (PLLA) body by freeze-extraction method. A distinct porosity difference was obtained between the inner and outer surfaces of the implant as characterized by image analysis and Mercury porosimetry (9.8±2.2 µm vs. 36.7±11.4 µm, p≤0.05). On top, a thin PLLA film was added to optimize the growth of epithelial cells, which was confirmed by using human respiratory epithelial cells. To check the control of fibroblast movement, PKH26 labeled fibroblasts were seeded onto Titanium and Titanium/PLLA implants. The cell movement was quantified by confocal microscopy: in one week cells moved deeper in Ti samples compared to Ti/PLLA. CONCLUSIONS: In vitro experiments showed that this new implant is effective for guiding different kind of cells it will contact upon implantation. Overall, this system would enable spatial and temporal control over cell migration by a gradient ranging from macroporosity to nanoporosity within a tracheal implant. Moreover, mechanical properties will be dependent mainly on the titanium frame. This will make it possible to create a polymeric environment which is suitable for cells without the need to meet mechanical requirements with the polymeric structure

Le rôle des normes comptables dans la responsabilité civile des auditeurs de sociétés

En tant que professionnels de la comptabilité, les comptables appliquent dans le cadre de leur activité des normes professionnelles de nature technique : les normes comptables. Celles-ci sont adoptées par des organismes privés et indépendants émanant de la profession. Nous interrogeons le rôle qu’exercent aujourd’hui ces normes dans le contexte juridique canadien dans un domaine bien particulier qui est le droit de la responsabilité civile. Nous cherchons à déterminer dans quelle mesure elles peuvent être utilisées en tant que normes de comportement au stade de l’analyse de la faute qu’auraient pu commettre des auditeurs dans le cadre d’une vérification d’états financiers de sociétés.Suite à une analyse jurisprudentielle, nous remarquons que la violation ou le respect des normes comptables semble en pratique déterminant pour juger de la commission ou non d’une faute civile par un auditeur. Ce constat, qui semble à première vue être en contradiction avec l’état du droit canadien qui reconnaît un principe d’indépendance entre la faute civile (source de responsabilité) et la contravention à une norme externe, nous semble toutefois pouvoir être réconcilié avec ce concept dans le cadre d’un approfondissement de ses exceptions. Notre recherche nous conduit à proposer une extension de celles-ci au cas de la « norme de comportement utile et précise », une définition à laquelle nous semblent répondre les normes comptables.As accounting professionals, accountants apply specific professional and technical regulations in the course of their activities: accounting standards. These are adopted by private and independent bodies emanating from the profession. Our contribution questions the contemporary role of those standards in the Canadian legal context in a very specific area: civil liability. We seek to determine how accounting standards can be used in the context of negligence in order to ascertain the required standard of care of auditors while performing an audit of financial statements.Having performed a jurisprudential analysis, we notice that the violation of—or compliance with—accounting standards seems, in practice, instrumental in determining whether an auditor has been negligent. This conclusion seems at first sight inconsistent with the current state of Canadian law and the principle of independence between the notion of negligence, source of liability, and the breach of an external standard. In our opinion, however, it can be reconcilied through the recognition of an exception. We therefore propose to consider an additional special case: the “precise and adequate external standard”, a definition that we believe accounting standards meet