Substance misuse among physicians: a still neglected problem

OBJECTIVE: To evaluate the opinions and attitudes about substance use among clinical physicians. METHOD: A hundred physicians of clinical areas were selected in a public hospital of São Paulo. All of them were asked to answer a questionnaire with some questions about drug use. 83% completed the research protocol properly. RESULTS: 60.2% of the interviewed clinicians think that physicians are more likely to develop substance use disorders than general population. 67.5% of them stated they knew a colleague presenting a substance use disorder and in that in 41.0% of the cases the abused substance was a psychotropic available on the surgery facilities. However, 96.4% of the participants denied they could have a substance use problem, although 16.9% declared they had already used non prescribed psychotropics. Benzodiazepines were the most frequently used substances. In addition, 88.0% of them consider it was difficult to search for medical help. They added that a service exclusive for physicians would make this search easier. Nevertheless, 56.6% are not aware of the existence of such a service. CONCLUSION: Non-prescribed psychotropic use was high. However, most part of the clinicians does not consider this a problem. Most of the professionals do not know programs on substance use disorders specific for physicians, what would be a very positive initiative according to great part of them.OBJETIVO: Avaliar as impressões e as opiniões de médicos de áreas clínicas acerca do uso de drogas entre médicos e, mais especificamente, em ambiente cirúrgico. MÉTODOS: Foram sorteados 100 médicos não-residentes de áreas clínicas, selecionados ao acaso entre os profissionais com vínculo em um hospital público de São Paulo. Destes, 83 concluíram o estudo, respondendo perguntas sobre o uso de drogas entre médicos. RESULTADOS: Declararam conhecer algum colega com problemas relacionados ao uso de substâncias 67,5% dos médicos. Esse índice foi de 41,0% quando a pergunta era acerca de drogas disponíveis em ambiente cirúrgico, visto que 68,6% julgam ser fácil o desvio de psicotrópicos desse local. Além disso, 60,2% acreditam que os médicos são mais suscetíveis ao uso abusivo de psicotrópicos quando comparados à população geral. No entanto, 88,0% do total consideram difícil a procura por ajuda especializada. A porcentagem é de 56,6% dos que não conhecem serviço de atendimento direcionado exclusivamente para esses profissionais, algo que, na opinião de 83,1%, facilitaria a busca por tratamento. Dos participantes, 96,4% declararam não apresentar problemas relacionados ao uso de substâncias, ainda que 16,9% admita já ter feito uso de psicotrópicos sem prescrição. CONCLUSÃO: A freqüência de uso de psicotrópicos sem prescrição foi elevada. No entanto, parcela considerável não considera isso problema. A maioria dos profissionais não conhece serviços de atendimento específico para médicos.Universidade Federal de São Paulo (UNIFESP) Departamento de Psiquiatria Programa de Orientação e Atendimento a DependentesUNIFESP, Depto. de Psiquiatria Programa de Orientação e Atendimento a DependentesSciEL

Different Responses in Geographic Range Shifts and Increase of Niche Overlap in Future Climate Scenario of the Subspecies of Melipona quadrifasciata Lepeletier

Climate change is suggested to be one of the possible drivers of decline in pollinators. In this paper, we applied an ecological niche model to modeling distributional responses in face of climate changes for the subspecies of Melipona quadrifasciata Lepeletier. This species is divided into two subspecies based on difference in the yellow tergal stripes, which are continuous in M. q. quadrifasciata and interrupted in M. q. anthidioides. The geographic distribution of each subspecies is also distinct. M. q. quadrifasciata is found in colder regions in the Southern states of Brazil, whereas M. q. anthidioides is found in habitats with higher temperatures, suggesting that ecological features, such as adaption to distinct climatic conditions may take place. Thus, the possibility of having diff erent responses in geographic range shifts to future climate scenario would be expected. This study aimed to investigate the eff ects of climate changes on the distribution of the two M. quadrifasciata subspecies in Brazil, using an ecological niche model by the MaxEnt algorithm. Our results indicate that the subspecies showed clear diff erences in geographic shift patterns and increased climate niche overlap in the future scenarios. M. q. anthidioides will have the potential for an increase of suitable climatic conditinos in the Atlantic Forest, and towards the Pampa biome, while M. q. quadrifasciata will suffer a reduction of adequate habitats in almost all of its current geographic distribution. Given the potential adverse eff ects of climate changes for this subspecies, conservation actions are urgently needed to avoid that it goes extinct

Translation and validation of the Brown attention-deficit disorder scale for use in Brazil: identifying cases of attention-deficit/hyperactivity disorder among samples of substance users and non-users. Cross-cultural validation study

BACKGROUND: The Brown Attention-Deficit Disorder Scale (BADDS) was developed as a self-report assessment that was designed to screen for presence of symptoms of attention deficit hyperactivity disorder (ADHD). The objective here was to translate and validate the adult self-report BADDS for use in Brazil. DESIGN AND SETTING: Cross-cultural validation study conducted in an addiction unit at a public university hospital. METHODS: This study included a control group (n = 100) and a drug-user group (n = 100). Both groups included subjects aged 18 to 60 years old. The control group had no prior diagnosis of drug addiction and the drug-user group included participants with a diagnosis of addiction. Each participant answered Brazilian Portuguese translations of both the BADDS and the Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS) guestionnaires, in paper-and-pencil format. RESULTS: The drug-user group scored higher than the control group on both scales. The mean scores on ASRS were 27.26 (standard deviation, SD 11.99) and 25.85 (SD:8.65) respectively (P > 0.05). The mean scores on BADDS were 79.56 (SD:29.61) and 79.31 (SD:18.09), respectively (P > 0.05) Cronbach's alpha for BADDS was 0.95. BADDS presented fair sensitivity (72% accuracy) and fair specificity (88% accuracy). CONCLUSION: This study provides discriminative validity evidence for use of BADDS among Brazilian adults with substance-use disorders.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Univ Fed Sao Paulo, UNIFESP, Av Prof Ascendino Reis 763, BR-04027000 Sao Paulo, SP, BrazilColumbia Univ, Mailman Sch Publ Hlth, New York, NY USAUniv Fed Sao Paulo, Dept Psychiat, UNIFESP, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, UNIFESP, Av Prof Ascendino Reis 763, BR-04027000 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Psychiat, UNIFESP, Sao Paulo, SP, BrazilCNPq: 122507/2014-2Web of Scienc

Leaching columns with sandy and clay texture soils and application of biosolids

The objective of this research was to evaluate the contaminant potential of the leachate from soils treated with increasing doses of biosolids. The experiment was carried out in protected cultivation in clayey (Eutrophic RED LATOSOL) and sandy texture (Dystrophic YELLOW RED LATOSOL) soils. The experimental design was completely randomized with five treatments, six repetitions and two soil types: T1 - absence of biosolids, T2-T6, respectively 0, 15, 30, 45 and 60 ton ha-1 of biosolids. The vessels (leaching column) were made by PVC tubes 0.50 m high and 0.10 m in diameter at its base is adapted a perforated PVC cap for collecting the leached material. Each column was filled with 3,141.6 cm3 soil (sandy or clayey), of which the amounts of biosolid. After this stage, the plots were taken to 70% of the field capacity incubated for 60 days and after that period the leachate was collected and evaluated as: pH, electrical conductivity and contents of K, Ca and Mg. The results indicated that increased doses of biosolids lead to elevated pH. It was concluded that the clay soil supported higher doses of biosolids in relation to the sandy soil, presenting leachates with lower pollutant potential

Efetivação Dos Direitos Sociais Aos Adolescentes Acolhidos Institucionalmente Prestes A Completar A Maioridade / Implementation of Social Rights for Adolescents Institutionally Sheltered About to Complete Age

O Estatuto da Criança e do Adolescente preceitua que toda criança e adolescente devem ser criados no seio da família biológica e, ocorrendo situações adversas o mesmo irá conviver na família extensa ou substituta. Contudo, ocorrem situações em que criança e adolescente são institucionalizados judicialmente para salvaguardar as mínimas condições para um desenvolvimento psicossocial sadio. Ocorre que, com a chegada da maioridade, o adolescente é notificado que deverá deixar a instituição de acolhimento. A controvérsia está, no que efetivamente vem sendo feito para garantir que estes adolescentes possuam os direitos sociais básicos, visto a impossibilidade de reinserção na família, o histórico de abandono familiar, a baixa escolaridade, a falta de experiência profissional e a falta de recursos para seu próprio sustento, ficam desamparados pela família e pelo Estado

Caracterización mecánica del hormigón producido con residuos de construcción y demolición

The construction industry is responsible for the generation of large volumes of waste, known as construction and demolition waste (CDW). Around the world, millions of tons of these wastes are generated annually, which often become important environmental liabilities. The situation gets worse as the sector develops. In Europe, only 15 of the 27 countries in the European Union annually produce around 180 million tonnes of CDW, in Brazil, the data about this indicates that in 2014 the municipalities collected about 45 million tons of CDW, quantity 4.1% higher than in 2013. In this scenario, the present study aims to evaluate the partial replacement of natural aggregates by CDW (aggregates of concrete waste) in the production of concretes. In this sense, the effects of this substitution on the workability and mechanical characteristics of the concretes produced, as well as the influence of the mixing method and the percentage of superplasticizer additive on the same characteristics were evaluated. The methodology basically consists in the production of seven different traits, which are references and different combinations of mixing method, aggregate substitutions and superplasticizer percentages. Specimens of these traces were molded for mechanical characterization. Workability parameters were also evaluated. It is concluded that the workability is strongly affected by the addition of CDW, but a good workability can be obtained with the use of superplasticizer additives. The mixing method did not change the results obtained for this property. The results also indicate that the compressive and tensile strengths are not negatively affected by the substitution of aggregates, as well as being not significantly affected by the presence of the percentages of superplasticizer used, nor by the mixing methods.O setor da construção civil é responsável pela geração de grande volume de resíduos, conhecidos como resíduos de construção e demolição (RCD). Em todo o mundo são geradas anualmente milhões de toneladas desses resíduos, que muitas vezes se tornam passivos ambientais importantes. A situação se agrava à medida que o setor se desenvolve, na Europa apenas 15 dos 27 países da União Europeia produzem anualmente cerca de 180 milhões de toneladas de RCD, já no Brasil, dados indicam que, em 2014, os municípios coletaram cerca de 45 milhões de toneladas de RCD, número 4,1% maior que em 2013. Diante desse cenário, o presente estudo tem como objetivo avaliar a substituição parcial de agregados naturais por RCD (agregados de resíduo de concreto) na produção de concretos. Nesse sentido buscou se avaliar os efeitos dessa substituição na trabalhabilidade e nas características mecânicas dos concretos produzidos, bem como a influência do método de mistura e do percentual de aditivo superplastificante sobre as mesmas características. A metodologia consiste basicamente na produção de sete traços diferentes, que são referências e diferentes combinações de método de mistura, substituições de agregados e percentuais de superplastificante. Foram moldados corpos de prova dos referidos traços para caracterização mecânica. Também foram avaliados parâmetos de trabalhabilidade.  Conclui-se que a trabalhabilidade é fortemente afetada pela adição de resíduos de construção e demolição, contudo uma boa trabalhabilidade pode ser obtida com o uso de aditivos superplastificantes. O método de mistura não alterou os resultados obtidos quanto a essa propriedade. Os resultados obtidos indicam também que as resistências à compressão e tração não são afetadas negativamente pela substituição de agregados, assim como não sofrem efeito significativo pela presença dos percentuais utilizados de superplastificante, nem pelos métodos de mistura.El sector de la construcción es responsable de la generación de grandes volúmenes de residuos, conocidos como residuos de construcción y demolición (RCD). Millones de toneladas de estos desechos se generan anualmente en todo el mundo, lo que a menudo se convierte en importantes pasivos ambientales. La situación empeora a medida que el sector se desarrolla, en Europa solo 15 de los 27 países de la Unión Europea producen anualmente alrededor de 180 millones de toneladas de RCD, mientras que en Brasil, los datos indican que en 2014, los municipios recolectaron alrededor de 45 millones de toneladas de RCD, 4.1% más que en 2013. Dado este escenario, el presente estudio tiene como objetivo evaluar el reemplazo parcial de agregados naturales por RCD (agregados de residuos de concreto) en la producción de concreto. En este sentido, se evaluaron los efectos de esta sustitución sobre la trabajabilidad y las características mecánicas de los hormigones producidos, así como la influencia del método de mezcla y el porcentaje de aditivo superplastificante en las mismas características. La metodología consiste básicamente en la producción de siete rasgos diferentes, que son referencias y diferentes combinaciones de métodos de mezcla, sustituciones de agregados y porcentajes de superplastificantes. Las muestras de estos rastros fueron moldeadas para caracterización mecánica. Los parámetros de viabilidad también fueron evaluados. Se concluye que la trabajabilidad se ve fuertemente afectada por la adición de residuos de construcción y demolición, sin embargo, se puede obtener una buena trabajabilidad con el uso de aditivos superplastificantes. El método de mezcla no cambió los resultados obtenidos para esta propiedad. Los resultados obtenidos también indican que las resistencias a la compresión y a la tracción no se ven afectadas negativamente por la sustitución de agregados, así como tampoco sufren un efecto significativo por la presencia de los porcentajes de superplastificantes utilizados, ni por los métodos de mezcla

Two-step continuous cooling heat treatment applied in a low carbon bainitic steel

Thermo-mechanical treatments using continuous cooling after forging are an established method for producing bainitic steels, mainly because of the elimination of energy intensive additional heat treatment processes. The cooling is usually employed in an uncontrolled manner in the industrial sector, which can be detrimental to the resulting microstructural morphology and, consequently, to the final product properties. In this study, a new controlled two-step cooling route based on the principles of bainitic displacive growth was designed and applied in a 0.18C (wt-%) steel. Inverse finite element method was used on the cooling data to obtain the evolution of temperatures for the samples during cooling, allowing to assess point to point cooling rates. Investigations via X-ray diffraction, optical microscopy analysis and hardness testing revealed a variation of bainitic morphology, namely, the transition from granular bainite to lath-like bainite with relatively high hardness and constituents/phase boundaries than the pre-treated microstructure

Assessing Alcohol Dependence in Hospitalized Patients

Alcohol misuse is generally not detected in hospital settings. the goal of this study was to estimate the prevalence of alcohol abuse and dependence in hospitalized patients in a university hospital in São Paulo (Brazil). Patients were randomly selected from all hospital admissions. the final sample consisted of 169 adult inpatients. Two screening tools were used: the Short Alcohol Dependence Data (SADD) and the CAGE questionnaires. in this sample, 25.4% of patients could be considered alcohol dependent according to the CAGE questionnaire, whereas 32.9% of patients fulfilled the criteria according to the SADD. the only predictor of alcohol dependence was gender; male inpatients were 3.2 times more prone to alcohol dependence with female inpatients. All inpatients should be systematically screened for alcohol use disorders. the choice of the screening tool will depend on whether the goal is to identify inpatients with hazardous drinking behaviors or with established alcohol-related problems. To maximize proper case identification, the CAGE questionnaire should be used as a first-step screening tool, and patients who screen positive on this scale should be subsequently administered the SADD questionnaire to assess the severity of the condition.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, São Paulo Sch Med, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo Sch Med, Dept Psychiat, São Paulo, BrazilWeb of Scienc