Effect of a lifestyle intervention to prevent weight gain at initiation of insulin pump therapy in type 2 diabetes: A randomized, controlled, multicentre trial.

Insulin pump therapy improves glycaemic control in individuals with type 2 diabetes. However, it may be associated with weight gain. AIM: To test the effectiveness of a six-month dietary and physical activity intervention, compared to usual care, on weight gain prevention after initiation of insulin pump. METHODS: Multicentre randomized, controlled trial of 54 individuals. Primary endpoint was between group difference in weight gain at six-months. RESULTS: Weight gain after 6 months of insulin pump treatment did not differ between groups: mean 3.2 (3.9) kg in the control group and 3.9 (3.8) kg in the intervention group, (p = 0.56). HbA1c improved without difference between groups. Post-hoc multivariate analysis of all participants found that weight gain was independently associated with younger age, active smoking, and the magnitude of HbA1c reduction. A 1 % decrease in HbA1c was associated with an increase of 0.94 kg [95 % Confidence Interval 0.47; 1.41], p < 0.001. CONCLUSIONS: Treatment intensification by insulin pump therapy in patients with type 2 diabetes is effective to improve glycaemic control. A gain of about 1 kg per 1 % drop in HbA1c can be expected after insulin treatment intensification. This weight gain was not prevented by a home-base, individualized, 6-months lifestyle intervention program.

Effect of cigarette smoke on aesthetic brackets: an in vitro study.

OBJECTIVE: The objective of this study was to evaluate the effect of cigarette smoke (CS) on physical and mechanical properties of ceramic, polycarbonate and alumina ceramic brackets. The null hypothesis tested was that aesthetic brackets would not be influenced by CS. METHODS: Ninety aesthetic brackets were allocated to three groups (n = 30): ceramic (GCE), polycarbonate (GCO) and alumina ceramic (GPS). Ten samples of each group were assigned to color and surface roughness analysis, performed before (T0) and after (T1) exposure to CS; and twenty samples were allocated into control and experimental groups (n = 10) (not exposed and exposed to CS, respectively) for shear bond strength test (SBS). Exposure to CS followed an adaptation of the method described by Le Mesurier. Colorimetric reading, surface morphology and roughness, SBS and adhesive remnant index (ARI) were assessed. Statistical analysis comprised independent and paired t-tests, ANOVA/Tukey and Fisher's exact tests (α = 0.05). RESULTS: Changes were observed in brackets' color (NBS: GCE = 2.4; GCO = 1.9; GPS = 2.1), surface roughness (ΔRa: GCE = 1.1 ± 0.8 µm; GCO = 1.9 ± 1.5µm; GPS = -0.3 ± 0.1 µm / ΔRz: GCE = 1.4 ± 1.0 nm; GPS = -0.5 ± 0.1 nm); and SBS (GPS - experimental = 221.8 ± 48.6 N) after exposure to CS (p< 0.05). CONCLUSIONS: Exposure, in vitro, of aesthetic brackets to CS resulted in changes of color to darker and more opaque shades, surface roughness alterations, and higher SBS values. ARI scores were not associated with exposure to CS.

The STEP Program-A Qualitative Study of the Supportive Therapeutic Excursion Program and Its Effect on Enabling Parental Self-Efficacy and Connectedness after the Stress-Experience of the NICU.

As a child is born, so are the parents with new roles assumed. Attachment is secured, and parents quickly become the experts in their child. With preterm birth, however, this quiet and essential period of discovery is interrupted. It is described as a traumatic and stressful experience. Programs that aim to address this focus on education and support. This qualitative study explores the effect on parents and staff of a novel and simple intervention of parents walking their baby in a stroller (Supportive Therapeutic Excursion Program, STEP). This study used a qualitative methodology that included 20 semi-structured interviews for content saturation to explore the experiences of parents and staff participating in the STEP program. We found an overall positive experience reported by both parents and nursing staff with STEP. Analysis revealed that as autonomy is fostered with parent education around transition to home, STEP brought a normalcy that was reported to bolster participating parents' self-efficacy and connectedness, two important elements for recovery from stressful situations. The potential impact of STEP can be far reaching because, although future research is needed, these data suggest that inexpensive programs that promote normalcy may enable self-efficacy and connectedness prior to hospital discharge.

Effect of cigarette smoke on aesthetic brackets: an in vitro study

ABSTRACT Objective: The objective of this study was to evaluate the effect of cigarette smoke (CS) on physical and mechanical properties of ceramic, polycarbonate and alumina ceramic brackets. The null hypothesis tested was that aesthetic brackets would not be influenced by CS. Methods: Ninety aesthetic brackets were allocated to three groups (n = 30): ceramic (GCE), polycarbonate (GCO) and alumina ceramic (GPS). Ten samples of each group were assigned to color and surface roughness analysis, performed before (T0) and after (T1) exposure to CS; and twenty samples were allocated into control and experimental groups (n = 10) (not exposed and exposed to CS, respectively) for shear bond strength test (SBS). Exposure to CS followed an adaptation of the method described by Le Mesurier. Colorimetric reading, surface morphology and roughness, SBS and adhesive remnant index (ARI) were assessed. Statistical analysis comprised independent and paired t-tests, ANOVA/Tukey and Fisher's exact tests (α = 0.05). Results: Changes were observed in brackets' color (NBS: GCE = 2.4; GCO = 1.9; GPS = 2.1), surface roughness (ΔRa: GCE = 1.1 ± 0.8 µm; GCO = 1.9 ± 1.5µm; GPS = -0.3 ± 0.1 µm / ΔRz: GCE = 1.4 ± 1.0 nm; GPS = -0.5 ± 0.1 nm); and SBS (GPS - experimental = 221.8 ± 48.6 N) after exposure to CS (p< 0.05). Conclusions: Exposure, in vitro, of aesthetic brackets to CS resulted in changes of color to darker and more opaque shades, surface roughness alterations, and higher SBS values. ARI scores were not associated with exposure to CS.

RESUMO Objetivo: O objetivo do presente estudo foi avaliar os efeitos da fumaça do cigarro (FC) nas propriedades físicas e mecânicas de braquetes cerâmicos, de policarbonato e de cerâmica de alumina. A hipótese nula testada foi de que os braquetes estéticos não seriam influenciados pela FC. Métodos: Noventa braquetes estéticos foram alocados em três grupos (n = 30): cerâmica (GCE), policarbonato (GCO) e cerâmica de alumina (GPS). Dez amostras de cada grupo foram designadas para análise de cor e rugosidade superficial, realizada antes (T0) e após (T1) exposição à FC, e vinte amostras foram alocadas nos grupos controle e experimental (n = 10) (não expostos e expostos à FC, respectivamente) para o teste de resistência ao cisalhamento (RC). A exposição à FC foi realizada de acordo com o método descrito por Le Mesurier. Leitura colorimétrica, morfologia e rugosidade de superfície, RC e índice de adesivo remanescente (ARI) foram avaliados. A análise estatística foi realizada por meio dos testes t independente e para amostras pareadas, ANOVA/Tukey e teste exato de Fisher (α = 0,05). Resultados: Foram observadas alterações na cor (NBS: GCE = 2,4; GCO = 1,9; GPS = 2,1), rugosidade superficial (ΔRa: GCE = 1,1 ± 0,8 µm; GCO = 1,9 ± 1,5 µm; GPS = -0,3 ± 0,1 µm / ΔRz: GCE = 1,4 ± 1,0 nm; GPS = -0,5 ± 0,1 nm) e RC (GPS - experimental = 221,8 ± 48,6 N) dos braquetes após exposição à FC (p< 0,05). Conclusões: A exposição in vitro de braquetes estéticos à FC resultou em mudanças na cor, para tons mais escuros e mais opacos; alterações na rugosidade superficial e maiores valores de RC. Os resultados do ARI não foram associados à exposição à FC.

Callitetrarhynchus gracilis (Rudolphi, 1819) Pintner, 1931 (Cestoda: Trypanorhyncha) parasitizing the musculature of Sardinella brasiliensis (Steindachner, 1879) (Actinopterygii) off the coast of the state of Rio de Janeiro, Brazil.

Cestodes of the order Trypanorhyncha can frequently be found infecting the muscles of several marine fish species, and lead to a repugnant aspect of the fish and rejection by consumers. The Brazilian sardinella, Sardinella brasiliensis, occurs from the Gulf of Mexico and the Caribbean to northern Uruguay. In southeastern Brazil, fishing for the species is very intensive since it generates significant revenue as one of the most commonly consumed fish and an important element of the canned fish industry. The aims of the present study were to identify and report the occurrence of tiny cestodes (3 mm-6.6 mm) in the musculature of Brazilian sardinella that were purchased in the São Pedro fish market in the municipality of Niterói, state of Rio de Janeiro, Brazil. From October 2013 to November 2016, 75 specimens of S. brasiliensis were investigated. The trypanorhynch cestodes encountered were identified as plerocerci of Callitetrarhynchus gracilis using morphological, morphometric and molecular data. Parasitic indices were calculated, and the cestodes infection of the musculature of Brazilian sardinella had the following values: prevalence, 40%; mean intensity, 3.47; mean abundance, 1.39; and range of infection, 1-18, specimens. The presence of this trypanorhynch cestode in the musculature of Brazilian sardinella is an important indicator of fish hygiene.

Fatores determinantes ao ingresso de alunos com deficiência no ensino médio / Determinants for the Entry of Students with Disabilities in High School / Factores que Determinan la Admisión de Estudiantes con Discapacidad en la Escuela Secundaria

Este estudo visou identificar os aspectos positivos e negativos da escolarização de alunos com deficiência antes de seu ingresso no ensino médio e fatores determinantes ao ingresso no ensino médio, segundo os mesmos e seus familiares. Participaram sete alunos com deficiência matriculados no primeiro ano do ensino médio de escolas públicas regulares, e seus respectivos responsáveis (cinco mães e um pai, com idades entre 37 e 57 anos). Os participantes foram entrevistados, respondendo a questões sobre a escolarização antes do ingresso no ensino médio e a transição para esta etapa de ensino. O roteiro de entrevista foi submetido à apreciação de quatro juízes, a fim de verificar a compatibilidade do instrumento com os objetivos propostos e com a população alvo. Foi possível considerar que apesar da escola ser protagonista dos acontecimentos positivos e negativos da escolarização do aluno, exerceu pouca influência na decisão e motivação ao ingresso no ensino médio.

This study aimed to identify the positive and negative aspects of the education of students with disabilities before their entry into high school and determinants for enrollment in high school, according to them and their parents. The participants were seven students with disabilities enrolled in the first year of public high schools, and their respective parents (five mothers and one father, aged 37-57). The participants were interviewed with questions about their schooling before entering high school and the transition to this stage of education. The interview script was submitted to four judges in order to verify the compatibility of the instrument with the proposed objectives and with the target population.It was possible to consider that, although the school is a protagonist in the positive and negative schooling events of the student, it exercised little influence on the decision and motivation to enroll in high school.

Este trabajo tiene como objetivo identificar los aspectos positivos y negativos de la educación de estudiantes con discapacidades antes de su entrada en la enseñanza media y los factores determinantes para inscribirse en la enseñanza media, de acuerdo con ellos y sus familias. Los participantes fueron siete estudiantes con discapacidad matriculados en el primer año de la enseñanza media de las escuelas públicas ordinarias, y sus respectivos tutores (Cinco madres y un padre, con edades entre 37 y 57 años). El guión de la entrevista fue sometido a la consideración de cuatro jueces, a fin de verificar la compatibilidad del instrumento con los objetivos propuestos y con la población. Los participantes fueron entrevistados, respondiendo a preguntas sobre la escuela antes de entrar en la enseñanza media y en la transición a esta etapa de la educación. Fue posible identificar que aunque la escuela sea la protagonista de los acontecimientos positivos y negativos de la escolarización del estudiante, exerció poca influencia en la decisión y motivación para inscribirse en la enseñanza media.

O uso da comunicação suplementar e alternativa como recurso para a interpretação de livros de literatura infantil / The use of Augmentative and Alternative Communication as a resource for the children literature books interpretation

RESUMO: Objetivo: analisar o uso da Comunicação Suplementar e Alternativa como recurso de interpretação de livros de literatura infantil por uma criança com paralisia cerebral e necessidades complexas de comunicação. Métodos: para isso, realizou-se um estudo por meio do delineamento de sujeito único com um participante de sete anos com diagnóstico de paralisia cerebral e com necessidades complexas de comunicação. A variável dependente constituiu-se nas habilidades de comunicação e interpretação e a variável independente constituiu-se nas atividades de interpretação de histórias infantis, utilizando livros e figuras adaptadas por meio da Comunicação Suplementar e Alternativa. As atividades realizadas foram conduzidas em três etapas, sendo: Linha de Base, Intervenção e Manutenção. As sessões foram filmadas e anotadas em folhas de registro, e, posteriormente, os dados obtidos foram analisados quantitativamente. Resultados: os resultados obtidos permitiram identificar notável avanço no número de êxitos alcançados pelo participante durante as sessões realizadas, respondendo de forma autônoma, independente e assertiva às indagações, por meio das figuras e algumas verbalizações. Conclusão: foi possível constatar a eficácia da Comunicação Suplementar e Alternativa como recurso pedagógico e de apoio nas atividades de compreensão e interpretação de histórias na sala de aula por alunos com necessidades complexas de comunicação.

ABSTRACT: Purpose: to analyze the use of augmentative and alternative communication as resource interpretation of children's literature books for a participant with cerebral palsy and with complex communication needs. Methods: to this end, it used single subject design with a seven year old child diagnosed with cerebral palsy and with complex communication needs. The dependent variable was constituted in communication and interpretation skills and the independent variable was constituted in the interpretation of children's stories activities, using books and pictures adapted by augmentative and alternative communication. The activities were conducted in three stages, as follows: Baseline, Intervention and Maintenance. The sessions were filmed and recorded in record sheet, and then the data were analyzed quantitatively. Results: the results showed remarkable advance in the number of successes achieved by the participant during the sessions correctly answering questions with autonomy and independence using the figures and some utterances. Conclusion: it was possible to verify the effectiveness of the augmentative and alternative communication as an educational resource and support in comprehension and interpretation activities of stories in the classroom for students with complex communication needs.

Morphoquantitative description of bovine digital cushion / Descrição morfoquantitativa do tórus digital de bovinos

The digital cushion is characterized as a modified subcutaneous tissue that absorbs the shock during gait, assists venous return of the hoof and supports a considerable part of body weight. Digital cushions have particular importance in the pathogenesis of the hoof, since they need to properly work in order to prevent compression and traumas in soft tissues. This study aimed to measure and determine how is the arrangement of these structures, and for this it was established the proportions of connective, adipose, vascular tissues and collagen fibers and collagen types found in palmar and plantar digital cushion of bovine using fore and hindlimbs of twelve adult zebu cattle of both sexes, 11 male and one female, with 269kg average carcass weight and without limb disorders. Fragments of cushions were subjected to conventional histology, cut to a thickness of 4µm and stained with Red Picrosirius. With digital optical microscope, the quantification of the connective tissue and differentiation of types of collagen used the Image Pro Plus® software, and of adipose and vascular tissue, the test point system. The mean and standard error were estimated with the GraphPad Prism 5.0 software, and then data were subjected to Kolmogorov-Smirnov normality test and Student's t-test with significance level set at 5% for determining the amount of different tissues between fore and hindlimbs of studied animals. In forelimbs the mean and standard error of the connective tissue proportion was 50.10%+1.54, of the adipose tissue was 21.34%+1.44, and of vascular tissue was 3.43%+0.28. Hindlimbs presented a proportion of connective tissue of 61.61%+1.47, 20.66%+1.53 of adipose tissue, and 3.06%+0.20 of vascular tissue. A significant difference (p<0.001) was detected in the connective tissue proportion between fore and hindlimbs. Types I and II collagen fibers have presented, respectively, a proportion of 31.89% and 3.9% in forelimbs and 34.05% and 1.78% in hindlimbs...

O tórus digital é caracterizado como um tecido subcutâneo modificado que atua na absorção do impacto durante a locomoção, auxilia o retorno venoso do casco e mantêm o suporte de uma considerável parte do peso corporal. Os tórus possuem particular importância nas patogêneses de casco, já que eles precisam trabalhar corretamente para prevenir compressões e traumas nos tecidos moles. Assim, o objetivo deste estudo foi quantificar e com isso determinar, como se arranjam estas estruturas, para tanto, foram estabelecidas as proporções dos tecidos conjuntivo, adiposo, vascular e ainda das fibras colágenas e dos tipos de colágenos encontrados nos tórus digitais palmares e plantares de bovinos. Foram utilizados membros torácicos e pélvicos de doze bovinos zebuínos adultos, de ambos os sexos, sendo onze machos e uma fêmea, com peso médio de carcaça com 269kg e sem afecções nos membros. Os fragmentos dos tórus foram submetidos à técnica histológica convencional, cortados em espessura de 4µm e corados com Picrosirius Red. Com o uso de microscópio óptico digital, o tecido conjuntivo e a diferenciação dos tipos de colágeno foram quantificados empregando-se o programa de análise de imagem Image Pro Plus® e para a quantificação dos tecidos adiposo e vascular foi utilizada o sistema teste de pontos. Através do programa GraphPad Prism 5.0 foram obtidas por meio de uma analise descritiva a media e o erro padrão da media, em seguida os dados foram submetidos à aplicação do teste de normalidade de Kolmogorov-Smirnov e ao teste "T" Student com nível de significância de 5% para a determinação da quantidade encontrada dos diferentes tecidos entre os membros torácicos e pélvicos dos animais estudados. Nos membros torácicos a média e o erro padrão da proporção de tecido conjuntivo foi de 50,10%+1,54, a de tecido adiposo foi de 21,34%+1,44 e a de tecido vascular foi de 3,43%+0,28. Os membros pélvicos...