Child sexual abuse in southern Brazil and associated factors: a population-based study

<p>Abstract</p> <p>Background</p> <p>The prevalence of child sexual abuse (CSA) in the population has been poorly described in developing countries. Population data on child sexual abuse in Brazil is very limited. This paper aims to estimate lifetime prevalence of child sexual abuse and associated factors in a representative sample of the population aged 14 and over in a city of southern Brazil.</p> <p>Methods</p> <p>A two-stage sampling strategy was used and individuals were invited to respond to a confidential questionnaire in their households. CSA was defined as non-consensual oral-genital, genital-genital, genital-rectal, hand-genital, hand-rectal, or hand-breast contact/intercourse between ages 0 and 18. Associations between socio-demographic variables and CSA, before and after age 12, were estimated through multinomial regression.</p> <p>Results</p> <p>Complete data were available for 1936 respondents from 1040 households. Prevalence of CSA among girls (5.6% 95%CI [4.8;7.5]) was higher than among boys (1.6% 95%CI [0.9;2.6]). Boys experienced CSA at younger ages than girls and 60% of all reported CSA happened before age 12. Physical abuse was frequently associated with CSA at younger (OR 5.6 95%CI [2.5;12.3]) and older (OR 9.4 95%CI [4.5;18.7]) ages. CSA after age 12 was associated with an increased number of sexual partners in the last 2 months.</p> <p>Conclusion</p> <p>Results suggest that CSA takes place at young ages and is associated with physical violence, making it more likely to have serious health and developmental consequences. Except for gender, no other socio-demographic characteristic identified high-risk sub-populations.</p

Quantification of methylmercury and geochemistry of mercury in sediments from a contaminated area of Descoberto (MG), Brazil.

In 2002, metallic Hg was found buried in a rural area of Descoberto city, Brazil. The origin of the Hg was a gold mining explotation plant established nearly one century ago. Although a number of studies have been conducted in order to assess the contamination of the area, none of them investigated the presence of methylated Hg in the hydric system. In this work methylmercury (CH3Hg?) was determined using gas chromatography-pyrolysis-atomic fluorescence detection (CG-pyro-AFS) in material from rain sedimentation boxes and stream sediments near the contaminated area. Total Hg concentration (HgT) along with the chemical speciation by thermo-desorption were performed. HgT in material from the sedimentation boxes was found to be very high, up to 41,580 mg kg 1, even in the rainy season, when in general HgT were much lower than in dry season. The samples from the Grama and Rico streams show a range of HgT from 5.8 to 266 mg kg 1. The thermo-desorption analysis showed predominance of Hg2?, possibly linked to organic sulfur, suggested by a good positive correlation between Hg2?, HgT, organic mater (OM) and total S. The CH3Hg? concentration in stream sediment samples ranged from <0.07 to 1.87 mg kg 1 and in the samples of sedimentation boxes the concentrations were 1.33 and 8.0 mg kg 1 during dry season. The sample with the highest percentage of HgT as Hg2? (98%) presented also the highest percentage of CH3Hg? (0.7%). These are high values, showing that care should be taken to avoid the transport of this material to the hydrological system. Further studies on the transfer through the food chain would be very important

52-week efficacy and safety of telbivudine with conditional tenofovir intensification at week 24 in HBeAg-positive chronic Hepatitis B

Background and Aims: The Roadmap concept is a therapeutic framework in chronic hepatitis B for the intensification of nucleoside analogue monotherapy based on early virologic response. The efficacy and safety of this approach applied to telbivudine treatment has not been investigated. Methods: A multinational, phase IV, single-arm open-label study (ClinicalTrials.gov ID NCT00651209) was undertaken in HBeAg-positive, nucleoside-naive adult patients with chronic hepatitis B. Patients received telbivudine (600 mg once-daily) for 24 weeks, after which those with undetectable serum HBV DNA (<300 copies/mL) continued to receive telbivudine alone while those with detectable DNA received telbivudine plus tenofovir (300 mg once-daily). Outcomes were assessed at Week 52. Results: 105 patients commenced telbivudine monotherapy, of whom 100 were included in the efficacy analysis. Fifty-five (55%) had undetectable HBV DNA at Week 24 and continued telbivudine monotherapy; 45 (45%) received tenofovir intensification. At Week 52, the overall proportion of undetectable HBV DNA was 93% (93/100) by last-observation-carried-forward analysis (100% monotherapy group, 84% intensification group) and no virologic breakthroughs had occurred. ALT normalization occurred in 77% (87% monotherapy, 64% intensification), HBeAg clearance in 43% (65% monotherapy, 16% intensification), and HBeAg seroconversion in 39% (62% monotherapy, 11% intensification). Six patients had HBsAg clearance. Myalgia was more common in the monotherapy group (19% versus 7%). No decrease in the mean glomerular filtration rate occurred in either treatment group at Week 52. Conclusions: Telbivudine therapy with tenofovir intensification at Week 24, where indicated by the Roadmap strategy, appears effective and well tolerated for the treatment of chronic hepatitis B. Trial Registration: ClinicalTrials.gov NCT0065120

Critical teacher education : on socially responsible language teaching.

Neste trabalho, objetivamos apresentar resultados de pesquisas e propostas de atua??o de integrantes do N?cleo Parceiro de Belo Horizonte e Regi?o, filiado ao Projeto Nacional de Forma??o de Professores nas Teorias dos Novos Letramentos e Multiletramentos, coordenado pela Profa. Dra. Walkyria Monte M?r e pelo Prof. Dr. Lynn Mario Trindade Menezes de Souza. Primeiramente faremos uma r?pida retrospectiva da ?rea de forma??o de professores e discutiremos quest?es voltadas para o ensino cr?tico de l?nguas, j? que este tem sido o foco das pesquisas realizadas pelo n?cleo. Depois, ser?o discutidos trabalhos realizados por membros do n?cleo envolvendo a forma??o inicial de professores, a forma??o continuada e o ensino de l?nguas dentro da perspectiva da educa??o para as rela??es ?tnico-raciais, buscando desenvolver um senso de responsabilidade em rela??o a quest?es cr?ticas em nossa sociedade atual. Nos tr?s casos, as pesquisas e propostas foram sempre realizadas dentro da perspectiva cr?tica para o ensino de l?nguas, perspectiva essa adotada pelo Projeto Nacional. Por fim, conclu?mos o texto argumentando que os programas de forma??o de professores precisam criar espa?os para os professores repensarem suas pr?ticas e desenvolverem novas atitudes e perspectivas que lhes permitam atuar criticamente pela constru??o de sociedades menos injustas e menos desiguais.In this paper, we aim to present research results and proposals for practice put forward by members of the Partner Nucleus of Belo Horizonte and Region, affiliated to the National Project for Teacher Development in the Theories of New Literacies and Multiliteracies, coordinated by Prof. Walkyria Monte M?r and Prof. Lynn Mario Trindade Menezes de Souza. First, we will do a quick retrospective of the area of teacher education and discuss issues related to critical language teaching, since these have been the focus of the research carried out by the nucleus. Then we will discuss research and practices carried out by core members involving pre-service teacher education, inservice teacher education and language teaching from the perspective of education for ethnic-racial relations, seeking to develop a sense of responsibility for critical issues in our society. In all three cases, research and proposals were always carried out within the critical perspective for language teaching, a perspective adopted by the National Project. Finally, we conclude the text by arguing that teacher development programs need to create spaces for teachers to rethink their practices and develop new attitudes and perspectives that enable them to act critically by building less unjust and less unequal societies

Effects of type and level of training on variation in physician knowledge in the use and acquisition of blood cultures: a cross sectional survey

BACKGROUND: Blood culture (BCX) use is often sub-optimal, and is a user-dependent diagnostic test. Little is known about physician training and BCX-related knowledge. We sought to assess variations in caregiver BCX-related knowledge, and their relation to medical training. METHODS: We developed and piloted a self-administered BCX-related knowledge survey instrument. Expert opinion, literature review, focus groups, and mini-pilots reduced > 100 questions in multiple formats to a final questionnaire with 15 scored content items and 4 covariate identifiers. This questionnaire was used in a cross-sectional survey of physicians, fellows, residents and medical students at a large urban public teaching hospital. The responses were stratified by years/level of training, type of specialty training, self-reported practical and theoretical BCX-related instruction. Summary scores were derived from participant responses compared to a 95% consensus opinion of infectious diseases specialists that matched an evidence based reference standard. RESULTS: There were 291 respondents (Attendings = 72, Post-Graduate Year (PGY) = 3 = 84, PGY2 = 42, PGY1 = 41, medical students = 52). Mean scores differed by training level (Attending = 85.0, PGY3 = 81.1, PGY2 = 78.4, PGY1 = 75.4, students = 67.7) [p ≤ 0.001], and training type (Infectious Diseases = 96.1, Medicine = 81.7, Emergency Medicine = 79.6, Surgery = 78.5, Family Practice = 76.5, Obstetrics-Gynecology = 74.4, Pediatrics = 74.0) [p ≤ 0.001]. Higher summary scores were associated with self-reported theoretical [p ≤ 0.001] and practical [p = 0.001] BCX-related training. Linear regression showed level and type of training accounted for most of the score variation. CONCLUSION: Higher mean scores were associated with advancing level of training and greater subject-related training. Notably, house staff and medical students, who are most likely to order and/or obtain BCXs, lack key BCX-related knowledge. Targeted education may improve utilization of this important diagnostic tool

Loss of interleukin-12 modifies the pro-inflammatory response but does not prevent duct obstruction in experimental biliary atresia

BACKGROUND: Livers of infants with biliary atresia and of neonatal mice infected with rotavirus (RRV) have increased expression of interferon-gamma (IFNγ) and interleukin (IL)-12. While the expression of IFNγ regulates the obstruction of extrahepatic bile ducts by lymphocytes, the role of IL-12 in the pathogenesis of biliary obstruction is unknown. Based on the role of IL-12 as a key proinflammatory cytokine, we hypothesized that loss of IL-12 prevents the obstruction of extrahepatic bile ducts. METHODS: IL12-knockout (IL-12KO) and wild type mice were injected with RRV or saline at day 1 of age and monitored for the development of symptoms. The cellular and molecular phenotypes were determined at days 3, 7, and 14 by real-time PCR and flow cytometry. RESULTS: RRV infection of IL-12KO mice resulted in growth failure, jaundice/acholic stools, and decreased survival similar to wild-type mice. IL-12KO mice had a remarkable neutrophil-rich portal inflammation and epithelial sloughing of extrahepatic bile ducts. Loss of IL-12 decreased but did not abolish the hepatic expression of IFNγ, displayed a remarkable increase in expression of TNFα, IFNα, IFNβ and decreased expression of IL-4 and IL-5. CONCLUSION: Loss of IL-12 did not modify the progression of bile duct obstruction in experimental biliary atresia. However, the inflammatory response was predominantly neutrophil-based and displayed a Th1 response in the absence of IL-12