Prevalence of and Factors Associated with School Bullying in Students with Autism Spectrum Disorder: A Cross-Cultural Meta-Analysis

Through this meta-analysis, we sought to examine the prevalence of, risks for, and factors associated with bullying involvement (victimization, perpetration, perpetration-victimization) among students with autism spectrum disorder (ASD). Additionally, we attempted to examine sources of variance in the prevalence and effect sizes of bullying in students with ASD across studies. Systematic database and literature review identified 34 relevant studies (31 for Western countries, three for Eastern countries). Pooled prevalence estimates for victimization, perpetration, and perpetration-victimization in general were 67%, 29%, and 14%, respectively.The risk of victimization in students with ASD was significantly higher than that in typically developing students and students with other disabilities. Further, deficits in social interaction and communication, externalizing symptoms, internalizing symptoms, and integrated inclusive school settings were related to higher victimization, and externalizing symptoms were related to higher perpetration. Finally, moderation analyses revealed significant variations in the pooled prevalences thereof depending on culture, age, school settings, and methodological quality and in the pooled effect sizes according to publication year and methodological quality. Our results highlight needs for bullying intervention for students with ASD, especially those who are younger, are in an inclusive school setting, and have higher social difficulties and externalizing/internalizing symptoms; for intensive research of bullying experiences among students with ASD in Eastern countries; and for efforts to improve the methodological quality of such research.

Sexual Dysfunction among Filipino breast cancer patients

INTRODUCTION: Sexual function is an important aspect of quality of life, and can be drastically affected in ill patients. Very few studies (and apparently none among Filipinas) looked into sexual dysfunction among females with breast cancer (BrCa); prevalence also is not well defined. This study evaluates the prevalence of sexual dysfunction among Filipino patients with BrCa, and assesses which treatment or if duration of illness, age, BMI, smoking history, diabetes, hypertension significantly contributed to the dysfunction.METHODS: A cross sectional study was conducted among BrCa patients consulting at the outpatient medical oncology clinic of a government tertiary hospital. Study population included those diagnosed and was with breast cancer over a 3-months period, with a calculated sample size of 60 (within 81±10% prevalence rate, Cl 95%). A validated translated version of the Female Sexual Function Index (FSFI) 19-item questionnaire that looked into 6 domains (arousal, lubrication, desire, pain, orgasm, and satisfaction) was used. Sexual dysfunction was defined as an FSFI score of RESULTS: Of the 97 respondents, mean age was 49.4 years old and mean BMI of 24.8. About 78% received chemotherapy, 26% hormonal therapy. 15% radiotherapy, 82% modified radical mastectomy (MRM), and 71% received both MRM and chemotherapy at the time of interview. Duration of cancer wasmonths in 72% of subjects. There were 97.9% who had sexual dysfunction which is similar to prevalence rates (64-98%) in other studies. Age, BMI, smoking history, hypertension, diabetes mellitus, chemotherapy, surgery, hormonal therapy, radiation therapy, and duration of illness were shown not to be significant predictors of sexual dysfunction among Filipinas with BrCa by bivariate analysis.CONCLUSION: Sexual dysfunction is highly prevalent among female Filipino BrCa patients. Knowing such high prevalence should prompt health care providers to include interventions to improve quality of life of BrCa patients, including their sexual life.

Outsourcing versus in-house maintenance of medical devices: a longitudinal, empirical study / Mantenimiento de los dispositivos médicos, interno o mediante contratación externa: un estudio longitudinal y empírico

OBJECTIVE: To determine what factors have a significant influence on the performance of medical device maintenance outsourcing, and to determine how the performance of external governance structures differs depending on whether a hospital is private or public. METHODS: This was a longitudinal study of 590 maintenance transactions at 20 hospitals in Bogotá, Colombia, involving 764 medical devices and 72 maintenance service providers. Maintenance performance data (i.e., turn-around time in hours; TAT) for the service providers (either in-house or outsourced) were primarily collected over a 20-month period, from December 2009-August 2011, by means of a monitoring procedure; then, a hazards model was run. RESULTS: The availability of specific repair parts, in-stock, in the city in which the medical devices were located, had a positive impact on the performance of both internal and external governance structures. Online service also had a positive impact on both, with a stronger positive impact on the performance of internal governance than on that of external governance. For transactions governed by external structures, better performance was seen in private hospitals than in public ones. In public health institutions, internal governance showed better performance than external governance. Both internal and external governance structures showed better performance in private healthcare institutions than in public ones. CONCLUSIONS: In public health institutions, internal governance shows better performance than external governance; this suggests that healthcare managers should reconsider the trend to eliminate in-house maintenance service staff in public healthcare institutions.

OBJETIVO: Establecer los factores que influyen significativamente en el desempeño del mantenimiento de los dispositivos médicos mediante contratación externa, y determinar cómo difiere el desempeño de las estructuras externas de gobernanza según un hospital sea privado o público. MÉTODOS: Se realizó un estudio longitudinal de 590 transacciones de mantenimiento en 20 hospitales de Bogotá (Colombia), que incluyeron 764 dispositivos médicos y 72 proveedores de servicio de mantenimiento. Por medio de un procedimiento de vigilancia, se recopilaron principalmente datos de desempeño del mantenimiento (es decir, el plazo de entrega en horas) por parte de los proveedores del servicio (ya fuera este interno o externalizado) durante un período de 20 meses, desde diciembre del 2009 a agosto del 2011; a continuación, se aplicó un modelo de riesgos. RESULTADOS: La disponibilidad de piezas de repuesto específicas en existencia en la misma ciudad en que se ubicaban los dispositivos médicos tuvo una repercusión positiva sobre el desempeño de ambas estructuras de gobernanza, la interna y la externa. El servicio en línea también tuvo una repercusión positiva en el desempeño de ambas estructuras; pero esta repercusión fue más intensa en el desempeño de la gobernanza interna que en el de la externa. En cuanto a las transacciones regidas por estructuras externas, se observó un mejor desempeño en los hospitales privados que en los públicos. En las instituciones de salud pública, la gobernanza interna mostró un mejor desempeño que la externa. Ambas estructuras de gobernanza mostraron un mejor desempeño en las instituciones de atención de salud privadas que en las públicas. CONCLUSIONES: En las instituciones de salud pública, la gobernanza interna muestra un mejor desempeño que la externa; ello indica que los gerentes de atención de salud deben reconsiderar la tendencia a eliminar al personal de los servicios de mantenimiento interno de las instituciones públicas de atención de salud.

Effect of different disinfecting procedures on the hardness and color stability of two maxillofacial elastomers over time

Objective Disinfection procedures often cause deterioration in a maxillofacial prosthesis. Color and hardness alterations could lead to a replacement of the prosthesis. Material and Methods An experimental chlorinated polyethylene (CPE) and a commercial polydimethyl siloxane (PDMS) sample were treated with four different disinfection procedures for a period which simulates 1 year of clinical service. The applied disinfection procedures included microwave exposure and immersion in three solutions, sodium hypochlorite, neutral soap and a commercial disinfecting soap. Shore A hardness (∆H) and color differences (∆E) were determined before and after each procedure. All data were analyzed by Two Way Analysis of Variance (ANOVA) and Tukey's post hoc tests at a level of α=0.05. Results The samples presented significant alterations in color and hardness after the different disinfection treatments. The color differences (∆E) were at least eye detectable in all cases and clinically unacceptable in most of the cases, with values ranging from 1.51 to 4.15 and from 1.54 to 5.92 for the PDMS and CPE material, respectively. Hardness was decreased after all the disinfection procedures in the PDMS, while for the CPE, a decrement was observed after disinfection with sodium hypochlorite and neutral soap and an increment after microwave exposure and the disinfection with a commercial antimicrobial agent. The PDMS samples presented greater alterations in color and hardness after disinfection with sodium hypochlorite solution, while the microwave exposure caused negligible effects. The CPE samples were affected most after disinfection when treated with neutral soap, and more slightly when disinfected with sodium hypochlorite solution. Conclusions The disinfection procedures caused alterations in color and hardness of the examined materials. The most suitable disinfection procedure for ...

Orquiepididimite em carneiro por Salmonella enterica sub-diarizonae: primeiro caso na América do Sul / Orchiepididymitis in ram by Salmonella enterica sub diarizonae: first case in South America

O objetivo deste artigo é relatar um caso de orquiepididimite associado com infecção por Salmonella enterica subespécie diarizonae em carneiro da raça Santa Inês de quatro anos de idade, vasectomizado. Ao exame clínico reprodutivo, o animal mostrou aumento severo do conteúdo escrotal, sendo o testículo direito maior do que o esquerdo e a cauda do epidídimo direita maior do que a esquerda. A consistência testicular, avaliada em escala de 1 a 5, foi 5 para o testículo direito e 2,5 para o esquerdo; o órgão apresentava-se muito sensível ao toque. Na ultrassonografia foram observadas estruturas anecoicas/hipoecoicas circulares na cauda do epidídimo, sugestivas de abscessos; alguns pontos hiperecogênicos no parênquima testicular, sugerindo lesões de calcificação; e todo o testículo direito rodeado por imagem hipoecoica, indicativa de edema. Uma das estruturas da cauda do epidídimo direita foi puncionada, encontrando-se exsudato purulento, o qual foi enviado para exame microbiológico, sendo isolada e identificada Salmonella enterica subespécie diarizonae. O carneiro foi submetido a orquiepididectomia, e o órgão foi caracterizado macroscopicamente por adesões fibrosas entre as camadas escrotais, coexistência de abscessos epididimários e degeneração testicular. A Salmonella enterica subespécie diarizonae deve ser considerada no diagnóstico diferencial de infecção genital em ovinos.

The objective of this manuscript was to report a case of orchiepididymitis associated with Salmonella enterica subespécie diarizonae infection in a vasectomized 4-year-old Santa Inês ram. In the clinical-reproductive examination, the animal showed a severe enlargement of the scrotal contents, being the right testicle larger than left, and the right epididymal cauda was higher than the left. The testicular consistency, evaluated in a scale from 1 to 5, was 5 to the right and 2.5 to the left, and the organ was very sensitive to the touch. In the ultrasound circular structures anechoic/hypoechoic in the epididymal cauda were observed, and in the parenchyma of testicles some points of hyperechogenic image, suggesting calcification lesions and the entire right testicle was surrounded by hypoechoic image, indicative of edema. One of those structures of the right epididymal cauda was aspirated and a purulent exsudate was found, which was sent to microbiological exam, was isolated and identified Salmonella enterica subespécie diarizonae. The ram was submitted to orchiepididectomy, and the organ was characterized macroscopically by fibrous adhesions between scrotum layers, coexistence of epididymal abscesses and testicular degeneration. The Salmonella enterica subspecie diarizonae must be taken into account in the differential diagnosis of ovine genital infections.

Pesquisa de anticorpos contra maedi visna em ovinos nas microregiões de Botucatu, Campinas, Piedade e São Paulo, Estado de São Paulo / Survey for antibodies against maedi-visna virus in sheep in the regions of Botucatu, Campinas, São Paulo and Piedade, State of São Paulo, Brazil

O objetivo deste estudo foi avaliar a ocorrência da infecção pelo vírus Maedi-Visna em ovinos criados nas microrregiões de Botucatu, Campinas, Piedade e São Paulo do Estado de São Paulo. As amostras de soro sanguíneo foram colhidas de 226 ovinos e foi realizada a técnica de imunodifusão em gel de ágar para a detecção de anticorpos antivírus Maedi-Visna e verificou-se que nenhuma das amostras testadas foi sororeagente. Dessa forma, faz-se necessário um estudo mais amplo no estado, a fim de se confirmar a baixa ocorrência e importância da enfermidade no estado.

Survey for antibodies against maedi-visna virus in sheep in the regions of Botucatu, Campinas, São Paulo and Piedade, state of São Paulo, Brazil. The purpose of the study was to evaluate the occurrence of infection with maedi-visna virus in sheep raised in the regions of Botucatu, Campinas, Piedade and São Paulo, state of São Paulo, Brazil, that showed symptoms of the disease. Blood serum samples collected from 226 sheep were submitted to the agar gel immunodiffusion technique for detection of antibodies against maedi-visna virus, and none of the samples tested was serum reactive. In conclusion, the maedi-visna virus has low frequency in animals raised in the regions studied.

Aspectos clínicos da artrite-encefalite dos caprinos / Clinical features of caprine arthritis-encephalitis infections

Caprinos de 14 plantéis localizados no estado de São Paulo, naturalmente infectados pelo vírus da artriteencefalite dos caprinos, foram clinicamente avaliados. Demonstrou-se que 17,1 % (64/374) dos caprinos sororreagentes apresentavam a forma clínica articular da enfermidade e que 6,6% (17/249) das cabras sororreagentes apresentavam a forma mamária.

Carotid Endarterectomy Using Patch Angioplasty without Routine Completion Duplex Scan

PURPOSE: Routine intraoperative duplex color-flow ultrasound carotid examination as a completion study has been welcomed by many vascular surgeons as the most recent, high proficiency tool to detect unsuspected remaining operative defects before the patient leaves the operating room, thereby improving operative outcome after Carotid Endarterectomy (CEA). However, after many years of experience gaining added knowledge about the clinical course and standardization of operative procedures of CEA for mainly occidental patients, the adherence to strict operative procedures using patch angioplasty and liberally added continuous-wave Doppler confirmation has been found to achieve well beyond acceptable operative results in our patients without routine intraoperative duplex scanning (IDS). METHODS: A retrospective review of 455 surgical patients who underwent patch angioplasty in a five year period, from January 1996, was performed to evaluated their operative outcome. Their perioperative morbidity, mortality, and follow up Duplex scan findings on restenosis for a mean of 20.8 months were observed for a comparison between our experience and recently reported results using routine IDS. RESULTS: We had a perioperative combined stroke-death rate of 2.0% (n=9), consisting of death in 0.9% (n=4) and stroke in 1.1% (n=5). Residual stenosis was confirmed by first follow up Duplex scanning in 13 patients a (4.2%), 6 of whom were resolved with time. Twenty-three (5.6%) recurrent stenoses, including 2 occlusions and 1 high grade stenotic internal carotid artery (ICA), and 1 occlusion with 2 severe stenoses in external carotid artery (ECA), appeared among 414 cases during follow up. Except for 2 patients who suffered perioperative stroke, one of whom died, all residual stenosis and recurrent stenosis patients stayed clinically symptom free. Among 5 immediate postoperative transient ischemic attacks (TIA) cases and 5 strokes, one residual stenosis accompanying stroke appeared during follow up. Of five cases that were re-explored in the operating room by continuous wave Doppler information with conversion of primary closure to patching (n=2) and revision of distal arteriotomy (n=2), all remained normal during follow up by duplex scan. CONCLUSION: Routine patch angioplasty, meticulous surgical technique and continuous-wave Doppler information were enough to achieve an acceptable clinical outcome in our patients. IDS might be necessary selectively for concerned cases only.

Carotid Endarterectomy Using Patch Angioplasty without Routine Completion Duplex Scan

PURPOSE: Routine intraoperative duplex color-flow ultrasound carotid examination as a completion study has been welcomed by many vascular surgeons as the most recent, high proficiency tool to detect unsuspected remaining operative defects before the patient leaves the operating room, thereby improving operative outcome after Carotid Endarterectomy (CEA). However, after many years of experience gaining added knowledge about the clinical course and standardization of operative procedures of CEA for mainly occidental patients, the adherence to strict operative procedures using patch angioplasty and liberally added continuous-wave Doppler confirmation has been found to achieve well beyond acceptable operative results in our patients without routine intraoperative duplex scanning (IDS). METHODS: A retrospective review of 455 surgical patients who underwent patch angioplasty in a five year period, from January 1996, was performed to evaluated their operative outcome. Their perioperative morbidity, mortality, and follow up Duplex scan findings on restenosis for a mean of 20.8 months were observed for a comparison between our experience and recently reported results using routine IDS. RESULTS: We had a perioperative combined stroke-death rate of 2.0% (n=9), consisting of death in 0.9% (n=4) and stroke in 1.1% (n=5). Residual stenosis was confirmed by first follow up Duplex scanning in 13 patients a (4.2%), 6 of whom were resolved with time. Twenty-three (5.6%) recurrent stenoses, including 2 occlusions and 1 high grade stenotic internal carotid artery (ICA), and 1 occlusion with 2 severe stenoses in external carotid artery (ECA), appeared among 414 cases during follow up. Except for 2 patients who suffered perioperative stroke, one of whom died, all residual stenosis and recurrent stenosis patients stayed clinically symptom free. Among 5 immediate postoperative transient ischemic attacks (TIA) cases and 5 strokes, one residual stenosis accompanying stroke appeared during follow up. Of five cases that were re-explored in the operating room by continuous wave Doppler information with conversion of primary closure to patching (n=2) and revision of distal arteriotomy (n=2), all remained normal during follow up by duplex scan. CONCLUSION: Routine patch angioplasty, meticulous surgical technique and continuous-wave Doppler information were enough to achieve an acceptable clinical outcome in our patients. IDS might be necessary selectively for concerned cases only.

Valores de referência da atividade enzimática da aspartato-aminotransferase e da gama-glutamiltransferase em bovinos da raça Jersey. Influência dos fatores etários, sexuais e da infecçäo pelo vírus da leucose dos bovinos / Reference values of the enzymatic activities of the aspartate aminotransferase and gamma glutamyltransferase of Jersey breed. The influence of age and sexual factors, and of the infection by the bovine leukosis virus

Com o objetivo de estabelecer os valores de referência de parâmetros bioquímicos que avaliem a funçäo hepática, por meio da determinaçäo da atividade enzimática da aspartato-aminotransferase (AST) e da gama-glutamiltransferase (GGT), de bovinos da raça Jersey, criados no Estado de Säo Paulo, bem como avaliar a influência dos fatores etários, sexuais e da infecçäo pelo vírus da leucose dos bovinos sobre os referidos parâmetros bioquímicos, foram colhidas e examinadas amostras de soro sangüíneo de 170 animais, sendo 106 fêmeas e 17 machos, considerados clinicamente sadios e näo reagentes ao antígeno glicoprotéico (gp51) da cápsula do vírus da leucose dos bovinos e 47 fêmeas soro-reagentes ao mencionado vírus. Os valores de referência obtidos para a AST foram iguais a 33,91ñ10,99U/l enquanto para a GGT obtiveram-se valores médios de 13,21ñ12,7U/l. A avaliaçäo dos resultados demonstrou que as transaminases sofreram influência dos fatores etários, pois comprovou-se os teores séricos da AST aumentaram significativamente com o evoluir da idade, sendo o valor mínimo observado nas bezerras com até 3 meses de idade (26,39ñ22,17U/l) e valor máximo em vacas com idade entre 48 e 72 meses de idade (38,60ñ11,24U/l). Para os níveis séricos da GGT observou-se que nas bezerras com até 3 meses de idade os níveis séricos (31,15ñ38,70U/l) foram maiores do que os observados nos animais mais velhos (entre 8,70ñ2,40U/l e 14,24ñ10,37U/l). Nesta pesquisa näo foram observadas influências dos fatores sexuais e da infecçäo pelo vírus da leucose dos bovinos sobre a atividade enzimática das transaminases