Viabilidade do Strengthening Families Program para Famílias Brasileiras: Um Estudo com Métodos Mistos

The objective of this study was to examine the feasibility (limited effectiveness, acceptability and practicality) of the Strengthening Families Program, a universal preventive intervention, for Brazilian families. A pre-experimental study was carried out, with pre-test, post-test, 6- and 10-12-month follow-ups. 74 adolescents and their parents participated. Scales on academic, parenting, and health outcomes were applied to adolescents at the four assessment times. Direct observation of implementation fidelity and families engagement in the intervention and telephone interviews with facilitators were used to investigate acceptability and practicality. The results show significant increase in parental supervision and learning self-efficacy. High levels of fidelity and parent/guardian engagement as well as moderate levels of adolescent engagement were found. The facilitators found the intervention had acceptable goals, but procedures excessively structured and unsuitable for families with low educational level. Practical implications are discussed.Este estudo teve por objetivo examinar a viabilidade (efetividade limitada, aceitabilidade e praticidade) do Strengthening Families Program, uma intervenção preventiva universal, para famílias brasileiras. Conduziu-se um estudo pré-experimental, com pré-teste, pós-teste, 6 e 10-12 meses de follow-up. Participaram 74 adolescentes e seus pais. Escalas sobre desfechos acadêmicos, parentais e saúde foram aplicadas nos adolescentes nos quatro tempos de avaliação. Observação direta da fidelidade da implementação e do engajamento familiar na intervenção e entrevistas por telefone com facilitadores foram usadas para investigar aceitabilidade e praticidade. Identificou-se aumento significativo em supervisão parental e autoeficácia para a aprendizagem. Altos níveis de fidelidade e engajamento parental foram encontrados, bem como engajamento moderado dos adolescentes. Os facilitadores consideraram a intervenção aceitável em suas metas, mas com procedimentos excessivamente estruturados e inadequados para famílias com baixo grau de instrução. Implicações práticas são discutidas

Infection rate and Streptococcus agalactiae serotypes in samples of infected neonates in the city of Campinas (São Paulo), Brazil

PURPOSE: To describe the epidemiological cases and microbiological profile of Streptococcus agalactiae serotypes isolated from infected newborns of a Women's Health Reference Centre of Campinas, São Paulo, Brazil. METHODS: Cross-sectional laboratory survey conducted from January 2007 to December 2011. The newborns' strains, isolated from blood and cerebrospinal fluid samples, were screened by hemolysis on blood ágar plates, Gram stain, catalase test, CAMP test, hippurate hydrolysis or by microbiological automation: Vitek 2 BioMerieux®. They were typed by PCR, successively using specific primers for species and nine serotypes of S. agalactiae. RESULTS: Seven blood samples, one cerebrospinal fluid sample and an ocular sample, were isolated from nine newborns with infections caused by S. agalactiae, including seven cases of early onset and two of late onset. Only one of these cases was positive for paired mother-child samples. Considering that 13,749 deliveries were performed during the study period, the incidence was 0.5 cases of GBS infections of early onset per 1 thousand live births (or 0.6 per 1 thousand, including two cases of late onset) with 1, 3, 2, zero and 3 cases (one early and two late onset cases), respectively, for the years from 2007 to 2011. It was possible to apply PCR to seven of nine samples, two each of serotypes Ia and V and three of serotype III, one from a newborn and the other two from a paired mother-child sample. CONCLUSIONS: Although the sample was limited, the serotypes found are the most prevalent in the literature, but different from the other few Brazilian studies available, except for type Ia.OBJETIVO: Descrever os casos e o perfil microbiológico dos sorotipos de Streptococcus agalactiae provenientes de recém-nascidos em um Centro de Referência da Saúde da Mulher na cidade de Campinas, São Paulo, Brasil. MÉTODOS: Estudo transversal clínico-laboratorial realizado de janeiro de 2007 a dezembro de 2011. As cepas suspeitas, isoladas em amostras de sangue e líquor, foram identificadas a partir da hemólise em ágar sangue, coloração de Gram, provas de catalase, teste de CAMP, hidrólise do hipurato ou por automação microbiológica Vitek 2 BioMerieux®. A seguir, estas cepas foram tipadas por PCR utilizando sucessivamente primers específicos para espécie e para nove sorotipos de S. agalactiae. RESULTADOS: Foram isoladas sete amostras de sangue, uma de líquor e uma de secreção ocular provenientes de nove recém-nascidos com infecções causadas pelo S. agalactiae, sendo sete casos de infecção de início precoce e duas de início tardio. Apenas um destes casos foi positivo para amostras pareadas mãe-filho. Para um total de 13.749 partos no período, os 7 casos correspondem a 0,5 caso de infecção precoce por Streptococcus do Grupo B a cada 1 mil nascidos vivos (ou 0,6 casos por 1 mil, incluindo os 2 de infecção tardia), tendo ocorrido 1, 3, 2, nenhum e 3 casos (um precoce e dois tardios), respectivamente, nos anos de 2007 a 2011. Foi possível realizar o PCR para sete amostras, sendo duas de cada um dos sorotipos Ia e V e o sorotipo III em três amostras, uma delas em um recém-nascido e outras duas em amostra pareada mãe-filho. CONCLUSÕES: Embora com casuística limitada, os sorotipos encontrados coincidem com os mais prevalentes na literatura mundial, mas diferem dos estudos brasileiros, exceto para o sorotipo Ia.54454

Columellar reconstruction with chondrocutaneous graft after injury caused by CPAP

Introduction: Continuous positive pressure in the nasal airways (CPAP) is a non-invasive form of ventilation used in premature newborns in intensive care units. However, it can affect the nose of these patients, even evolving with ischemia and columellar necrosis. Several techniques are described to reconstruct the columella, such as skin grafts, composite grafts, local flaps, and free flaps, but the atrial chondrocutaneous graft has stood out. This study aims to describe a case of columella necrosis using CPAP with reconstruction using posterior atrial chondrocutaneous grafting. Case Report: A brown, female patient, with a history of prematurity and prolonged use of CPAP when she was born due to hyaline membrane syndrome, developed columella necrosis. The patient underwent posterior auricular chondrocutaneous grafting to reconstruct the columella. She presented a satisfactory surgical result, evolving with 100% graft vitality. Discussion: Columellar necrosis associated with the use of CPAP can be aesthetically and functionally debilitating, and represents a reconstructive challenge. The options for obtaining acceptable results are limited. However, the use of ear grafts is technically straightforward, uses structurally similar donor tissues, does not cause additional scarring on the nose, is performed in a surgical period, and generally has an excellent result. Posterior auricular composite grafting for columellar reconstruction proved safe, with satisfactory aesthetic and functional results and minimal morbidity in the donor area

Infection Rate And Streptococcus Agalactiae Serotypes In Samples Of Infected Neonates In The City Of Campinas (são Paulo), Brazil [taxa De Infecção E Sorotipos De Streptococcus Agalactiae Em Amostras De Recém-nascidos Infectados Na Cidade De Campinas (sp), Brasil]

PURPOSE: To describe the epidemiological cases and microbiological profile of Streptococcus agalactiae serotypes isolated from infected newborns of a Women's Health Reference Centre of Campinas, São Paulo, Brazil. METHODS: Cross-sectional laboratory survey conducted from January 2007 to December 2011. The newborns' strains, isolated from blood and cerebrospinal fluid samples, were screened by hemolysis on blood ágar plates, Gram stain, catalase test, CAMP test, hippurate hydrolysis or by microbiological automation: Vitek 2 BioMerieux®. They were typed by PCR, successively using specific primers for species and nine serotypes of S. agalactiae. RESULTS: Seven blood samples, one cerebrospinal fluid sample and an ocular sample, were isolated from nine newborns with infections caused by S. agalactiae, including seven cases of early onset and two of late onset. Only one of these cases was positive for paired mother-child samples. Considering that 13,749 deliveries were performed during the study period, the incidence was 0.5 cases of GBS infections of early onset per 1 thousand live births (or 0.6 per 1 thousand, including two cases of late onset) with 1, 3, 2, zero and 3 cases (one early and two late onset cases), respectively, for the years from 2007 to 2011. It was possible to apply PCR to seven of nine samples, two each of serotypes Ia and V and three of serotype III, one from a newborn and the other two from a paired mother-child sample. CONCLUSIONS: Although the sample was limited, the serotypes found are the most prevalent in the literature, but different from the other few Brazilian studies available, except for type Ia.3412544549Phares, C.R., Lynfield, R., Farley, M.M., Mohle-Boetani, J., Harrison, L.H., Petit, S., Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005 (2008) JAMA, 299 (17), pp. 2056-2065Farley, M.M., Group B streptococcal disease in nonpregnant adults (2001) Clin Infect Dis, 33 (4), pp. 556-561Campbell, J.R., Hillier, S.L., Krohn, M.A., Ferrieri, P., Zaleznik, D.F., Baker, C.J., Group B streptococcal colonization and serotype-specific immunity in pregnant women at delivery (2000) Obstet Gynecol, 96 (4), pp. 498-503Verani, J.R., McGee, L., Schrag, S.J., Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). 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Washington (DC): ASMTazi, A., Réglier-Poupet, H., Dautezac, F., Raymond, J., Poyart, C., Comparative evaluation of Strepto B ID chromogenic medium and Granada media for the detection of group B streptococcus from vaginal samples of pregnant women (2008) J Microbiol Methods, 73 (3), pp. 263-265Votava, M., Tejkalová, M., Drábková, M., Unzeitig, V., Braveny, I., Use of GBS media for rapid detection of group B streptococci in vaginal and rectal swabs from women in labor (2001) Eur J Clin Microbiol Infect Dis, 20 (2), pp. 120-122Peltroche-Llacsahuanga, H., Fiandaca, M.J., von Oy, S., Lütticken, R., Haase, G., Rapid detection of Streptococcus agalactiae from swabs by peptide nucleic acid fluorescence in situ hybridization (2010) J Med Microbiol, 59 (Pt 2), pp. 179-184Goodrich, J.S., Miller, M.B., Comparison of culture and 2 real-time polymerase chain reaction assays to detect group B Streptococcus during antepartum screening (2007) Diagn Microbiol Infect Dis, 59 (1), pp. 17-22Block, T., Munson, E., Culver, A., Vaughan, K., Hryciuk, J.E., Comparison of carrot broth - and selective Todd-Hewitt broth-enhanced PCR protocols for real-time detection of Streptococcus agalactiae in prenatal vaginal/anorectal specimens (2008) J Clin Microbiol, 46 (11), pp. 3615-3620Scicchitano, L.M., Bourbeau, P.P., Comparative evaluation of the AccuProbe group B Streptococcus culture test, the BD GeneOhm Strep B assay, and culture for detection of group B streptococci in pregnant women (2009) J Clin Microbiol, 47 (9), pp. 3021-3023Slotved, H.C., Kong, F., Lambertsen, L., Sauer, S., Gilbert, G.L., Serotype, I.X., A proposed new Streptococcus agalactiae serotype (2007) J Clin Microbiol, 45 (9), pp. 2929-2936Heath, P.T., Feldman, R.G., Vaccination against group B streptococcus (2005) Expert Rev Vaccines, 4 (2), pp. 207-218Edwards, M.S., Group B streptococcal conjugate vaccine: A timely concept for which the time has come (2008) Hum Vaccin, 4 (6), pp. 444-448Baker, C.J., Paoletti, L.C., Rench, M.A., Guttormsen, H.K., Carey, V.J., Hickman, M.E., Use of capsular polysaccharide-tetanus toxoid conjugate vaccine for type II group B Streptococcus in healthy women (2000) J Infect Dis, 182 (4), pp. 1129-1138Ausubel, F.M., Brent, R., Kingston, R.E., Moore, D.D., Seidman, J.G., Smith, J.A., (2003) Current Protocols In Molecular Biology, , 2nd ed. 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The climatic risk of Amazonian protected areas is driven by climate velocity until 2050

Changes in species distribution in response to climate change might challenge the territorial boundaries of protected areas. Amazonia is one of the global regions most at risk of developing long distances between current and future analogous climates and the emergence of climate conditions without analogs in the past. As a result, species present within the network of Protected Areas (PAs) of Amazonia may be threatened throughout the 21st century. In this study, we investigated climate velocity based on future and past climate-analogs using forward and backward directions in the network of PAs of Amazonia, in order to assess the climatic risk of these areas to climate change and verify their effectiveness in maintaining the current climate conditions. Using current (1970–2000) and future (2041–2060) average annual air temperature and precipitation data with a resolution of 10 km, climate velocities across the entire Amazon biome and average climate velocities of PAs and Indigenous Lands (ILs) were evaluated. The results show that the effects of backward velocity will be greater than that of forward velocity in the Amazon biome. However, the PA network will be less exposed to backward velocity impacts than unprotected areas (UAs)–emphasizing the importance of these areas as a conservation tool. In contrast, for the forward velocity impacts, the PA network will be slightly more exposed than UAs–indicating that the current spatial arrangement of the PA network is still not the most suitable to minimize impacts of a possible climate redistribution. In addition, a large extent of no-analog climates for backward velocities was found in central Amazonia, indicating that high temperatures and changes in precipitation patterns in this region will surpass the historical variability of the entire biome, making it a potentially isolated and unsuitable climatic envelope for species in the future. Most of the no-analog climates are in PAs, however the climate risks in ILs should also be highlighted since they presented higher climate velocities than PAs in both metrics. Our projections contrast with the median latitudinal migration rate of 2 km/year observed in most ecosystems and taxonomic groups studied so far and suggest the need for median migration rates of 7.6 km/year. Thus, despite the important role of PAs and ILs as conservation tools, they are not immune to the effects of climate change and new management strategies, specific to each area and that allow adaptation to global changes, will be necessary

[infection Rate And Streptococcus Agalactiae Serotypes In Samples Of Infected Neonates In The City Of Campinas (são Paulo), Brazil].

To describe the epidemiological cases and microbiological profile of Streptococcus agalactiae serotypes isolated from infected newborns of a Women's Health Reference Centre of Campinas, São Paulo, Brazil. Cross-sectional laboratory survey conducted from January 2007 to December 2011. The newborns' strains, isolated from blood and cerebrospinal fluid samples, were screened by hemolysis on blood ágar plates, Gram stain, catalase test, CAMP test, hippurate hydrolysis or by microbiological automation: Vitek 2 BioMerieux®. They were typed by PCR, successively using specific primers for species and nine serotypes of S. agalactiae. Seven blood samples, one cerebrospinal fluid sample and an ocular sample, were isolated from nine newborns with infections caused by S. agalactiae, including seven cases of early onset and two of late onset. Only one of these cases was positive for paired mother-child samples. Considering that 13,749 deliveries were performed during the study period, the incidence was 0.5 cases of GBS infections of early onset per 1 thousand live births (or 0.6 per 1 thousand, including two cases of late onset) with 1, 3, 2, zero and 3 cases (one early and two late onset cases), respectively, for the years from 2007 to 2011. It was possible to apply PCR to seven of nine samples, two each of serotypes Ia and V and three of serotype III, one from a newborn and the other two from a paired mother-child sample. Although the sample was limited, the serotypes found are the most prevalent in the literature, but different from the other few Brazilian studies available, except for type Ia.34544-