A feasibility trial to examine the social norms approach for the prevention and reduction of licit and illicit drug use in European University and college students.

Background: Incorrect perceptions of high rates of peer alcohol and tobacco use are predictive of increased personal use in student populations. Correcting misperceptions by providing feedback has been shown to be an effective intervention for reducing licit drug use. It is currently unknown if social norms interventions are effective in preventing and reducing illicit drug use in European students. The purpose of this paper is to describe the design of a multi-site cluster controlled trial of a web-based social norms intervention aimed at reducing licit and preventing illicit drug use in European university students. Methods/Design: An online questionnaire to assess rates of drug use will be developed and translated based on existing social norms surveys. Students from sixteen universities in seven participating European countries will be invited to complete the questionnaire. Both intervention and control sites will be chosen by convenience. In each country, the intervention site will be the university that the local principal investigator is affiliated with. We aim to recruit 1000 students per site (baseline assessment). All participants will complete the online questionnaire at baseline. Baseline data will be used to develop social norms messages that will be included in a web-based intervention. The intervention group will receive individualized social norms feedback. The website will remain online during the following 5 months. After five months, a second survey will be conducted and effects of the intervention on social norms and drug use will be measured in comparison to the control site. Discussion: This project is the first cross-national European collaboration to investigate the feasibility of a social norms intervention to reduce licit and prevent illicit drug use among European university students. Final trial registration number DRKS00004375 on the ‘German Clinical Trials Register’.This study is funded by the European Commission, Directorate General Justice, Freedom and Security (JLS/2009-2010/DPIP/AG

MATA-ATLÂNTICA: ECONOMIA, IGUALDADE, IDEIAS E PRESERVAÇÃO

A temática abordada neste estudo evidencia a concepção e a utilização de algumas espécies de frutas da mata atlântica em relação as suas propriedades medicinais, gastronômicas e comerciais do nosso município. O presente estudo tem como objetivo analisar a utilização econômica das frutas nativas da Mata Atlântica nas questões gastronômica, sustentabilidade e preservação. A investigação realizada caracterizou-se como um estudo exploratório, descritivo e experimental de natureza qualitativa e quantitativa. A base empírica desse estudo contou com uma amostra composta por quatrocentos e três alunos da Rede Estadual de Ensino de Santa Cecília (SC), os quais responderam um questionário de quatro questões sobre conhecimento do bioma Mata Atlântica. A coleta dos dados ocorreu através da pesquisa de descritiva, campo, revisão da literatura e experimentos em laboratório. Os dados coletados por meio da análise da literatura foram organizados visando identificar as onze espécies frutíferas, tais como pitanga, gabiroba, araticum, uvaia, araçá, jaracatiá, guabijú, cerejeira, amora, butiá e goiaba desconhecidos e não exploradas para atividades econômicas. A análise dos dados do questionário fechado nos possibilitou caracterizar que os alunos desconhecem o bioma; sendo, em sua maioria (79,65%); a árvore frutífera mais conhecida foi à goiaba com prevalência de (321) respostas; cerca de (60,30%) conhecem um alimento oriundo desse bioma; o desconhecimento sobre o restante da Mata Atlântica foi de (71,50%). O estudo evidenciou que a ausência de conhecimento do meio ambiente relacionado ao referido bioma, constitui um tipo de manifestação que demanda alerta por parte das instituições educativas. Apontou a necessidade de intervenção de aspectos referentes a orientação sobre meio ambiente, sustentabilidade; bem como a criação de um aplicativo tecnológico para monitoramento, objetivando colaborar na construção de alternativas para melhoria do quadro problema identificado na região foco desta pesquisa

CARACTERÍSTICAS SOCIODEMOGRÁFICAS Y MORTALIDAD MATERNA EN UN HOSPITAL DE REFERENCIA EN LA CIUDAD DE CURITIBA – PARANÁ

A mortalidade materna atrai inúmeras discussões e preocupações no Brasil visto que reflete a qualidade da assistência prestada nos serviços de saúde, bem como a operacionalização das políticas públicas voltadas à saúde da mulher. Esta pesquisa teve como objetivo identificar o perfil sociodemográfico e causal da mortalidade materna no período de 2004 a 2007, em um hospital de ensino da cidade de Curitiba, Estado do Paraná. Após análise das fichas hospitalares de investigação confidencial de óbitos e dos pareceres técnicos do Comitê Estadual de Prevenção de Mortalidade Materna encontrou-se um percentual de 80,6% de óbitos evitáveis, sendo que 45,16% destes ocorreram devido às causas diretas de óbito materno. Dentre essas causas, as que mais provocaram óbitos foram aquelas relacionadas a doenças do aparelho circulatório, embolias obstétricas e doenças renais. O estudo possibilitou concluir que há deficiência nos registros de informações nos prontuários quanto aos dados sociodemográficos, bem como a necessidade de discutir a melhoria de acesso aos serviços de saúde com vistas a reduzir as taxas de mortalidade materna.Maternal mortality is in the center of many discussions and is of concern in Brazil since it reflects the quality of care in health services, as well as the operationalization of public policies related to women’s health. This research aimed to identify the sociodemographic and causal profile of maternal mortality in the period 2004-2007 in a teaching hospital in Curitiba, Parana State. After analysis of the hospital records during confidential investigation of deaths and technical statements by experts of the State Committee for Prevention of Maternal Mortality, it was found a percentage of 80.6% of avoidable deaths, of which 45.16% of these were due to direct causes of mother deaths. Among these causes, the ones which caused more deaths were those related to circulatory diseases, obstetric embolism and kidney disease. We concluded that there’s some deficiency in the information registries in the medical record regarding socio demographic data, and there’s a need to discuss the health care acess improvement in order to decrease the maternal mortality rates.La mortalidad materna atrae innúmeras discusiones y preocupaciones en Brasil ya que refleja la cualidad de la asistencia prestada en los servicios de salud, así como operacionaliza las políticas públicas para la salud de la mujer. Esta investigación tuvo como objetivo identificar el perfil sociodemográfico y causal de la mortalidad materna en periodo de 2004 a 2007, en un hospital de enseñanza de la ciudad de Curitiba, estado de Paraná. Después del análisis de las fichas hospitalares de investigación confidencial de óbitos y de los pareceres técnicos del Comité Estadual de Prevención de Mortalidad Materna, fue encuentrado un percentual de 80,6% de óbitos evitables, siendo 45,16% de estes ocurridos por causas directas de óbito materno. Entre esas causas, las que más provocaron óbitos fueron aquellas referentes a enfermedades del aparato circulatorio, embolias obstétricas y enfermedades renales. Nosotros concluimos que existe deficiencia en los registros de informaciones en los prontuarios cuanto a los datos sociodemográficos, así como a la necesidad de discutir la mejoría de acceso a los servicios de salud para disminuir los índices de mortalidad matern

Primary resistance of HIV to antiretrovirals among individuals recently diagnosed at voluntary counselling and testing centres in the metropolitan region of Recife, Pernambuco

Determining the prevalence and type of antiretroviral (ARV) resistance among ARV-naïve individuals is important to assess the potential responses of these individuals to first-line regimens. The prevalence of primary resistance and the occurrence of recent infections among individuals with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) were identified among recently diagnosed patients at five sexually transmitted disease/AIDS testing and counselling centres in the metropolitan region of Recife (RMR), Pernambuco, Brazil, between 2007-2009. One-hundred and eight samples were analysed using the Calypte® BED assay. Males predominated (56%), as did patients aged 31-50 years. Twenty-three percent presented evidence of a recent HIV infection. The median CD4+ T lymphocyte count was 408 cells/mm³ and the median viral load was 3.683 copies/mL. The prevalence of primary resistance was 4.6% (confidence interval 95% = 1-8.2%) based on criteria that excluded common polymorphisms in accordance with the surveillance drug resistance mutation criteria. The prevalence of resistance to non-nucleoside reverse transcriptase, nucleoside/nucleotide reverse transcriptase and protease inhibitors were 3.8%, 1.5% and 0.8%, respectively. Fifty-seven percent of strains were from clade B, 37.7% were clade F and 3.1% were clade C; there were no statistically significant differences with respect to resistance between clades. Recent infection tended to be more common in men (p = 0.06) and in municipalities in the south of the RMR (Jaboatão dos Guararapes and Cabo de Santo Agostinho) (p = 0.046). The high prevalence of recent infection and the high prevalence of non-B strains in this poor Brazilian region merit further attention.Laboratório Central de Saúde Pública de Pernambuco Setor de VirologiaUniversidade Federal de Pernambuco Programa de Pós-Graduação em Medicina TropicalFiocruz Centro de Pesquisa Aggeu MagalhãesCentro de Testagem e Aconselhamento Herbert de SouzaUniversidade Federal de São Paulo (UNIFESP) Laboratório de RetrovirologiaUNIFESP, Laboratório de RetrovirologiaSciEL

Uncultivated Microbial Eukaryotic Diversity: A Method to Link ssu rRNA Gene Sequences with Morphology

Protists have traditionally been identified by cultivation and classified taxonomically based on their cellular morphologies and behavior. In the past decade, however, many novel protist taxa have been identified using cultivation independent ssu rRNA sequence surveys. New rRNA “phylotypes” from uncultivated eukaryotes have no connection to the wealth of prior morphological descriptions of protists. To link phylogenetically informative sequences with taxonomically informative morphological descriptions, we demonstrate several methods for combining whole cell rRNA-targeted fluorescent in situ hybridization (FISH) with cytoskeletal or organellar immunostaining. Either eukaryote or ciliate-specific ssu rRNA probes were combined with an anti-α-tubulin antibody or phalloidin, a common actin stain, to define cytoskeletal features of uncultivated protists in several environmental samples. The eukaryote ssu rRNA probe was also combined with Mitotracker® or a hydrogenosomal-specific anti-Hsp70 antibody to localize mitochondria and hydrogenosomes, respectively, in uncultivated protists from different environments. Using rRNA probes in combination with immunostaining, we linked ssu rRNA phylotypes with microtubule structure to describe flagellate and ciliate morphology in three diverse environments, and linked Naegleria spp. to their amoeboid morphology using actin staining in hay infusion samples. We also linked uncultivated ciliates to morphologically similar Colpoda-like ciliates using tubulin immunostaining with a ciliate-specific rRNA probe. Combining rRNA-targeted FISH with cytoskeletal immunostaining or stains targeting specific organelles provides a fast, efficient, high throughput method for linking genetic sequences with morphological features in uncultivated protists. When linked to phylotype, morphological descriptions of protists can both complement and vet the increasing number of sequences from uncultivated protists, including those of novel lineages, identified in diverse environments

Modern Subsurface Bacteria in Pristine 2.7 Ga-Old Fossil Stromatolite Drillcore Samples from the Fortescue Group, Western Australia

Several abiotic processes leading to the formation of life-like signatures or later contamination with actual biogenic traces can blur the interpretation of the earliest fossil record. In recent years, a large body of evidence showing the occurrence of diverse and active microbial communities in the terrestrial subsurface has accumulated. Considering the time elapsed since Archaean sedimentation, the contribution of subsurface microbial communities postdating the rock formation to the fossil biomarker pool and other biogenic remains in Archaean rocks may be far from negligible.In order to evaluate the degree of potential contamination of Archean rocks by modern microorganisms, we looked for the presence of living indigenous bacteria in fresh diamond drillcores through 2,724 Myr-old stromatolites (Tumbiana Formation, Fortescue Group, Western Australia) using molecular methods based on the amplification of small subunit ribosomal RNA genes (SSU rDNAs). We analyzed drillcore samples from 4.3 m and 66.2 m depth, showing signs of meteoritic alteration, and also from deeper "fresh" samples showing no apparent evidence for late stage alteration (68 m, 78.8 m, and 99.3 m). We also analyzed control samples from drilling and sawing fluids and a series of laboratory controls to establish a list of potential contaminants introduced during sample manipulation and PCR experiments. We identified in this way the presence of indigenous bacteria belonging to Firmicutes, Actinobacteria, and Alpha-, Beta-, and Gammaproteobacteria in aseptically-sawed inner parts of drillcores down to at least 78.8 m depth.The presence of modern bacterial communities in subsurface fossil stromatolite layers opens the possibility that a continuous microbial colonization had existed in the past and contributed to the accumulation of biogenic traces over geological timescales. This finding casts shadow on bulk analyses of early life remains and makes claims for morphological, chemical, isotopic, and biomarker traces syngenetic with the rock unreliable in the absence of detailed contextual analyses at microscale

Dealing with heterogeneity of treatment effects: is the literature up to the challenge?

<p>Abstract</p> <p>Background</p> <p>Some patients will experience more or less benefit from treatment than the averages reported from clinical trials; such variation in therapeutic outcome is termed heterogeneity of treatment effects (HTE). Identifying HTE is necessary to individualize treatment. The degree to which heterogeneity is sought and analyzed correctly in the general medical literature is unknown. We undertook this literature sample to track the use of HTE analyses over time, examine the appropriateness of the statistical methods used, and explore the predictors of such analyses.</p> <p>Methods</p> <p>Articles were selected through a probability sample of randomized controlled trials (RCTs) published in <it>Annals of Internal Medicine</it>, <it>BMJ</it>, <it>JAMA</it>, <it>The Lancet</it>, and <it>NEJM </it>during odd numbered months of 1994, 1999, and 2004. RCTs were independently reviewed and coded by two abstractors, with adjudication by a third. Studies were classified as reporting: (1) HTE analysis, utilizing a formal test for heterogeneity or treatment-by-covariate interaction, (2) subgroup analysis only, involving no formal test for heterogeneity or interaction; or (3) neither. Chi-square tests and multiple logistic regression were used to identify variables associated with HTE reporting.</p> <p>Results</p> <p>319 studies were included. Ninety-two (29%) reported HTE analysis; another 88 (28%) reported subgroup analysis only, without examining HTE formally. Major covariates examined included individual risk factors associated with prognosis, responsiveness to treatment, or vulnerability to adverse effects of treatment (56%); gender (30%); age (29%); study site or center (29%); and race/ethnicity (7%). Journal of publication and sample size were significant independent predictors of HTE analysis (p < 0.05 and p < 0.001, respectively).</p> <p>Conclusion</p> <p>HTE is frequently ignored or incorrectly analyzed. An iterative process of exploratory analysis followed by confirmatory HTE analysis will generate the data needed to facilitate an individualized approach to evidence-based medicine.</p

Sunlight-Exposed Biofilm Microbial Communities Are Naturally Resistant to Chernobyl Ionizing-Radiation Levels

BACKGROUND: The Chernobyl accident represents a long-term experiment on the effects of exposure to ionizing radiation at the ecosystem level. Though studies of these effects on plants and animals are abundant, the study of how Chernobyl radiation levels affect prokaryotic and eukaryotic microbial communities is practically non-existent, except for a few reports on human pathogens or soil microorganisms. Environments enduring extreme desiccation and UV radiation, such as sunlight exposed biofilms could in principle select for organisms highly resistant to ionizing radiation as well. METHODOLOGY/PRINCIPAL FINDINGS: To test this hypothesis, we explored the diversity of microorganisms belonging to the three domains of life by cultivation-independent approaches in biofilms developing on concrete walls or pillars in the Chernobyl area exposed to different levels of radiation, and we compared them with a similar biofilm from a non-irradiated site in Northern Ireland. Actinobacteria, Alphaproteobacteria, Bacteroidetes, Acidobacteria and Deinococcales were the most consistently detected bacterial groups, whereas green algae (Chlorophyta) and ascomycete fungi (Ascomycota) dominated within the eukaryotes. Close relatives to the most radio-resistant organisms known, including Rubrobacter species, Deinococcales and melanized ascomycete fungi were always detected. The diversity of bacteria and eukaryotes found in the most highly irradiated samples was comparable to that of less irradiated Chernobyl sites and Northern Ireland. However, the study of mutation frequencies in non-coding ITS regions versus SSU rRNA genes in members of a same actinobacterial operational taxonomic unit (OTU) present in Chernobyl samples and Northern Ireland showed a positive correlation between increased radiation and mutation rates. CONCLUSIONS/SIGNIFICANCE: Our results show that biofilm microbial communities in the most irradiated samples are comparable to non-irradiated samples in terms of general diversity patterns, despite increased mutation levels at the single-OTU level. Therefore, biofilm communities growing in sunlight exposed substrates are capable of coping with increased mutation rates and appear pre-adapted to levels of ionizing radiation in Chernobyl due to their natural adaptation to periodical desiccation and ambient UV radiation