Humanitarian Logistics: a Clustering Methodology for Assisting Humanitarian Operations

In this paper, we propose a methodology to identify and classify regions by the type and frequency of disasters. The data on the clusters allow you to extract information that can be used in the preparedness phase as well as to identify the relief items needed to meet each cluster. Using this approach, the clusters are formed by using a computing tool that uses as the input the history data of the disasters in the Brazilian state of Santa Catarina, with a specific focus on: windstorms, hail, floods, droughts, landslides, and flash floods. The results show that the knowledge provided by the clustering analysis contributes to the decision making process in the response phase of Humanitarian Logistics (HL)

Long-term follow-up of a case of multicystic ameloblastoma treated with curettage: case report / Acompanhamento a longo prazo de um caso de ameloblastoma multi-cístico tratado com curetagem: relato de caso

The conventional or multicystic solid ameloblastoma is the most common type with the majority of cases affecting the posterior region of the mandible and occurring between the third and fourth decades of life. The present study aims to report a case of multicystic ameloblastoma in which treatment by means of curettage was chosen and no evidence of recurrence was noted over 7 years of follow-up. Although the literature indicates aggressive surgical therapy as the best form of treatment for multicystic ameloblastoma, factors such as the clinical, radiographic and histopathological aspects of the lesion, patient age, postoperative morbidity, possibilities for aesthetic and functional changes must be evaluated together during treatment planning. In some cases, as in the report presented, conservative therapies such as aggressive curettage of the lesion can be effective in the long term, with no recurrence of the lesion and providing quality of life to the patient

Sobrecarga e qualidade de vida de cuidadores de indivíduos com acidente vascular cerebral crônico

Objetivo: Analisar a sobrecarga e qualidade de vida percebida por cuidadores, correlacionando-as com o grau de deficiência dos indivíduos com acidente vascular cerebral crônico e seu comprometimento nas atividades de vida diária. Métodos: Estudo transversal e analítico desenvolvido no Centro Especializado em Reabilitação CER IV-IMIP (Recife – PE). Foram avaliados trinta e oito cuidadores primários informais, quanto à sobrecarga e qualidade de vida após a avaliação de seus respectivos pacientes, quanto a sua funcionalidade ou incapacidade. Foi considerado paciente pós Acidente Vascular Cerebral (AVC) crônico, com mais de 6 meses de lesão. Os seguintes instrumentos foram utilizados: CIF - classificação internacional da funcionalidade; QASCI - avaliação da sobrecarga do cuidador informal, e WHOQOL- bref - avaliação da qualidade de vida. As análises estatísticas foram feitas com o teste Shapiro-Wilk com p<0,05 (SPSS). Resultados: Foram avaliados 38 cuidadores primários informais, os quais, em sua maioria, relataram 'sobrecarga intensa' (média de 102,92). Em relação à qualidade de vida, a maioria encontra-se entre 'necessita melhorar' e 'regular'. Houve correlação positiva significativa, expressando relação direta entre a sobrecarga do cuidador e o item 'função do corpo'. Conclusão: cuidadores de pacientes vítimas de AVC que apresentam deficiências, relatam sobrecarga de trabalho e interferência na sua qualidade de vida

Active learning methodology, associated to formative assessment, improved cardiac physiology knowledge and decreased pre-test stress and anxiety

Stress and anxiety caused by assessments are often related to the student’s insecurity regarding the knowledge to be evaluated, while teaching strategies that increase effective learning can assist in reducing it. The aim of this study was to evaluate the hypothesis that the use of an active methodology, associated to formative assessment, could reduce students’ anxiety and stress, when compared to the traditional method, by promoting greater learning. New students enrolled in the same discipline of a Dentistry course were invited to participate in the study and were divided into two groups: traditional method and active methodology. The traditional method group received two lectures, delivered orally. The active methodology group received a lecture about cardiac cells and the autonomic control of cardiac function, with home study of the cardiac cycle using a textbook. In the second class, an individual formative assessment was applied. Afterwards, a group activity was performed with an educational game about the cardiac cycle, followed by a group formative assessment. After applying the traditional or active methodology, test 1 was carried out. Immediately before this test, saliva samples were collected for determination of the concentrations of the stress biomarkers cortisol and α-amylase. The students also answered the State-Trait Anxiety Inventory questionnaire, used for anxiety level determination. The score obtained in the test 1 was significantly higher for the active methodology group, compared to the traditional method group. No significant differences between the groups were observed for baseline cortisol and salivary α-amylase concentrations, or for anxiety scores. Before test 1, traditional method group presented higher concentrations of salivary cortisol and α-amylase, compared to the respective baseline values, while the active methodology group showed no difference between the baseline and test 1 levels. Before test 1, there were increases in anxiety levels, relative to the respective baseline values, regardless of the teaching methodology used, but this increase was greater for the traditional method group, compared to the active methodology group. These results showed that the active methodology, associated to formative assessment, decreased test stress and anxiety, with improved student performance in comparison to traditional lectures

Hyoscine butylbromide for colorectal polyp detection: prospective, randomized, placebo-controlled trial

OBJECTIVES: The removal of pre-malignant colorectal lesions prevents cancer. Hyoscine has been proposed as a means of improving diagnosis by reducing colonic movements. The aim of this study was to analyze whether this anti-spasmodic enhances the detection of pre-malignant colorectal lesions. METHODS: In a randomized, double-blinded fashion patients received hyoscine or a saline solution in all consecutive colonoscopies in which the cecum was reached. Lesions were analysed with respect to number, size, location, histology and capillary pattern. RESULTS: A total of 440 colonoscopies were randomized. The overall polyp detection rate (PDR) and the adenoma detection rate (ADR) were 65.2% and 49.3%, respectively. In the hyoscine group, non-polypoid lesions were detected significantly more often (p=0.01). In the placebo group 281 lesions were diagnosed (202 adenomas) and in the hyoscine group 282 lesions were detected (189 adenomas) (p=0.23). The PDR and ADR were similar between the placebo and hyoscine groups (64% vs 66% and 50% vs 47%, respectively). No differences were observed between the two groups in the advanced-ADR or advanced neoplasia detection rate, as well the mean numbers of polyps, adenomas, advanced adenomas and advanced neoplasias detected per patient. The administration of hyoscine also did not improve the diagnostic accuracy of digital chromoendoscopy. The presence of adenomatous polyps in the right colon was detected significantly more frequently in the hyoscine group (OR 5.41 95% CI 2.7 - 11;

Os sentidos das masculinidades juvenis num contexto de cuidado / The senses of the masculinities juveniles in a context of care

O presente estudo abordou a discussão acerca da sexualidade, juventude e masculinidade num cenário de epidemia de AIDS. O objetivo foi compreender como os homens jovens universitários se comportam sexualmente em tempos de AIDS. Resultado e Discussão este trabalho foi construído a partir das seguintes categorias: Identidade masculina sexual juvenil: armadilhas produzidas; Masculinidades e ausência do cuidado de si. Conclusão homens jovens apresentam comportamentos de risco no que diz respeito às práticas sexuais desprotegidas, uma vez que o tempo de namoro e confiança se apresentam de acordo com os depoimentos como fatores impeditivos para práticas sexuais mais segura

Eflorescência salina na igreja de Santo Alexandre, Belém - PA

Os monumentos históricos de Belém, PA, têm alvenarias estruturais constituídas de pedras e tijolos maciços assentados com argamassa de cal e podem apresentar diversas patologias, entre as quais se destacam a eflorescência salina e a ação da umidade. Alguns autores explicam que esses dois agentes ocasionam destacamento de camadas, pulverização de argamassa, surgimento de fissuras e aparência esbranquiçada. A pesquisa teve como principal objetivo identificar o processo de degradação atuante na alvenaria do transepto direito da Igreja de Santo Alexandre por meio da aplicação de técnicas instrumentais analíticas. Foram realizadas análises laboratoriais com o intuito de entender as condicionantes favoráveis ao processo de eflorescência salina, os danos provocados aos materiais e os tipos de sais mais atuantes. Primeiramente foi realizado o mapeamento da alvenaria e o mapeamento de danos, verificando a situação atual e as áreas mais degradadas. Posteriormente, foi realizada a caracterização física por meio de análise granulométrica, análise de traço e análise do teor de umidade da alvenaria, a caracterização química – teste qualitativo e quantitativo de sais – e a caracterização mineralógica por difração de raios X. Verificou-se que as técnicas aplicadas se mostraram eficientes e auxiliaram no diagnóstico correto, norteando quais intervenções devem ser utilizadas para amenizar a problemática

Aspectos clínicos e moleculares de tumor adrenocortical metacrônico pediátrico

The occurrence of metachronous adrenocortical carcinoma has rarely been described. We report a case of a child with virilizing adrenocortical metachronous tumors that, despite several metastases, presented long-term survival (15 years). We analyzed in this tumor IGF2, IGF1R and FGFR4 gene expression, and evaluated the presence of p.R337H germline p53 mutation and somatic CTNNB1 mutation. IGF2 gene was over-expressed in both left (Weiss score 5) and right (Weiss 7) adrenocortical tumors. IGF1R expression levels were higher in the right adrenocortical tumor. FGFR4 over-expression was also detected in the right adrenocortical tumor. In addition, this patient harbors the germline p.R337H p53 mutation and loss of heterozygosity (LOH) was detected in the tumors. No somatic CTNNB1 mutations were found in both tumors. In conclusion, we demonstrated in this unusual case the over-expression of growth signaling pathways, which are molecular mechanisms previously related to adrenocortical tumorigenesis. Furthermore, the absence of somatic CTNNB1 mutations, which is a molecular marker of poor prognosis in adults, might be related to the long-term survival of this patient.A ocorrência de carcinomas adrenocorticais metacrônicos é raramente relatada. Descrevemos o caso de uma criança portadora de tumor adrenocortical virilizante metacrônico que, apesar das inúmeras metástases, apresentou uma longa sobrevida (15 anos). Analisamos nesse tumor a expressão gênica de IGF2, IGF1R e FGFR4 e avaliamos a presença da mutação germinativa R337H no p53 e mutação somática no gene CTNNB1. O gene IGF2 foi hiperexpresso nos tumores adrenocorticais esquerdo (Weiss 5) e direito (Weiss 7). Os níveis de expressão de IGF1R foram maiores no tumor direito. Hiperexpressão do gene FGFR4 também foi observada no tumor adrenocortical direito. Esse paciente é portador da mutação germinativa R337H no p53, e perda de heterozigose (LOH) foi observada em ambos os tumores. Não foram encontradas mutações no gene CTNNB1 nos tumores. Em conclusão, demonstramos neste caso a hiperexpressão de vias moleculares de crescimento, que são mecanismos previamente relacionados à tumorigênese adrenocortical. Além disso, não encontramos mutações somáticas no gene CTNNB1, que é um marcador molecular de mau prognóstico em adultos e poderia estar relacionado à longa sobrevida desse paciente

Meningkatkan Hasil Belajar Siswa Kelas IV MIS Tompo Melalui Pemanfaatan Lingkungan Sekolah Sebagai Sumber Belajar IPA

Penelitian ini bertujuan untuk meningkatkan hasil belajar siswa pada mata IPA di Kelas IV MIS Tompo melalui Pemanfaatan Lingkungan Sekolah sebagai Sumber Belajar. Penelitian ini merupakan penelitian tindakan kelas (PTK), yang dilaksanakan sebanyak dua siklus, setiap siklus terdiri dari perencanaan, pelaksanaan tindakan, observasi dan refleksi yang mengacu pada model KemmisMc Taggart. Data yang diambil adalah data kualitatif dan kuantitatif. Data kualitatif diperoleh dari hasil aktifitas siswa dan guru, sedangkan data kuantitatif diperoleh dari hasil evaluasi disetiap siklus. Hasil siklus I menunjukkan bahwa aktifitas guru adalah: 82,85% dikategorikan baik sedang aktifitas siswa adalah, 71, 1% dikategorikan cukup, dengan ketuntasan belajar Klasikal 62,5%,. Hasil siklus II menunjukkan bahwa aktifitas guru 92,85%) dengan kategori sangat baik, sedang aktifitas siswa 82,2 % dikategorikan baik, dengan persentase daya serap klasikal sebesar 86,3%. Dengan demikian maka dapat dikatakan bahwa pemanfaatan lingkungan sekolah sebagai sumber belajar dapat meningkatkan hasil belajar IPA siswa Kelas IV MIS Tompo Kec. Taopa