[Training simulation during the announcement of fetal malformation discovered on screening ultrasound: Results of a pilot study]. / Formation par simulation à l'annonce d'une malformation fœtale découverte en échographie de dépistage : résultats d'une étude pilote.

OBJECTIVES: Breaking bad news (BBN) to a pregnant woman with fetal abnormalities (FA) on ultrasound (US) examination is a challenge. Announcement technique influences patient reaction. Physicians receive little training in BBN. The simulation and using a BBN protocol as the English SPIKES protocol which guides the announcement consultation according to 6 steps (Setting Up, Perception, Invitation, Knowledge, Emotions and Empathy, Strategy and Summary) can be used for this teaching. The objective was to assess feasibility simulation scenarii of BBN for FA discovered during US and to evaluate the usefulness of SPIKES protocol in this situation. METHODS: Two scenarios have been created combining US simulator (US Mentor, Symbionix®) with simulated patient (SP). Scenarii objectives were to diagnose FA and break it to SP. Checklist derived from SPIKES was fulfilled by two investigators thanks to video recording, the SP and every participant (residents, physicians, fetal medicine specialists [FMS]). Participants filled out survey about the usefulness of this exercise too. RESULTS: Nine physicians (3 residents, 4 physicians, 2 FMS) produced 18 scenarii. Seventy-eight percent of physicians thought simulation was like real situation of BBN during US examination. Majority of participant (88%) found that this simulation training could help them to increase their ability to BBN and that it can be used to teach residents (89%) or physicians (100%). FMS had better SPIKES checklist than physicians (P<0,05). CONCLUSION: Simulation scenario of BBN for FA discovered during US is feasible by combining US simulator and SP. SPIKES protocol can be useful but a validated checklist should be created.

Evidence of higher photosynthetic plasticity in the early successional Guazuma ulmifolia Lam. compared to the late successional Hymenaea courbaril L. grown in contrasting light environments.

The present study investigated changes in photosynthetic characteristics of Guazuma ulmifolia Lam. (early successional species) and Hymenaea courbaril L. (late successional species) grown in contrasting light conditions as a way of assessing photosynthetic plasticity. Early successional species typically inhabit gap environments being exposed to variability in multiple resources, hence it is expected that these species would show higher photosynthetic plasticity than late successional ones. In order to test this hypothesis, light and CO2 response curves and chlorophyll content (Chl) were measured in plants grown in high and low light environments. G. ulmifolia presented the highest amounts of both Chl a and b, especially in the low light, and both species presented higher Chl a than b in both light conditions. The Chl a/b ratio was higher in high light leaves of both species and greater in G. ulmifolia. Taken together, these results evidence the acclimation potential of both species, reflecting the capacity to modulate light harvesting complexes according to the light environment. However, G. ulmifolia showed evidence of higher photosynthetic plasticity, as indicated by the greater amplitude of variation on photosynthetic characteristics between environments shown by more significant shade adjusted parameters (SAC) and principal component analysis (PCA). Thus, the results obtained were coherent with the hypothesis that the early successional species G. ulmifolia exhibits higher photosynthetic plasticity than the late successional species H. courbaril.

[Natural features of oviposition of Culex (Melanoconion) Group Pilosus (Diptera: Culicidae)]. / Observação sobre característica natural de oviposição de Culex (Melanoconion) Grupo Pilosus (Diptera: Culicidae).

Eggs of Culex (Melanoconion) Grupo Pilosus were found in three oviposition traps set in the toilet of a Bus Station in Joinville city, State of Santa Catarina, Brazil, during a surveillance study of Aedes aegypti. The intrinsic characteristic of group oviposition not directly on the water was confirmed.

Working with Dominican youth.

PIP: Milqueya Portes, vice president of the Family Planning Association of the Dominican Republic (PROFAMILIA), and president of the Dominican Pharmaceutical Industry Association (INFADOMI), was interviewed by JOICFP News on April 11, 1995, concerning the work of PROFAMILIA. Her remarks included the following: 1) the need to orient young people on sexual life, reproduction, and male responsibility; 2) the importance of avoiding sexual activity and pregnancy at too early an age because of interference with reproductive health and educational status; 3) the need to educate young people concerning the care of their health, their bodies, life, and the importance of good health and education; and 4) her association's programs for young people, which provide education and cover acquired immunodeficiency syndrome (AIDS) prevention. She mentioned that the PROFAMILIA Council has members from different professions, which allows discussion and analysis of issues from different viewpoints. The organization has an active group of volunteers and holds workshops on various issues, including sexual health and reproduction. It recently added a clinic for men to its two clinics for women belonging to PROFAMILIA. It has agreements with more than 100 private clinics that deal with different clinical contraceptive methods (especially the IUD), and with companies that allow it to sell the contraceptive pill and condoms at lower than retail prices. It is engaged in social marketing.^ieng

[The pharmacist should play an active role in family planning]. / El farmaceutico debe jugar un papel activo en la planificacion familiar.

PIP: Although pharmacies now dispense primarily modern products originating in large multinational corporations, the community pharmacist has not been replaced by any ultramodern technological advance. Many thousand persons acquire family planning products in pharmacies. The pharmacist works many hours a day, is always available, and provides free advice to his clients. Pharmacists are consulted daily on numerous topics, especially on family planning. Many prsons in rural areas are without the services of a physician and rely on pharmacists all the more. Pharmacists could orient the public on family planning in general, help in choosing the most appropriate of available methods, and refer patients to physicians in case of problems. Participants at the recent International Conference on the Role of Retail Pharmacists in Family Planning, held in Alexandria, Egypt, concluded that pharmacists should cooperate with physicians and other health professionals to provide family planning services and should participate in elaboration of laws regulating the manufacture, storage, prices, and distribution of contraceptives. The prices of contraceptive supplies to the consumer could be reduced if taxes and import duties were removed, if supplies were produced locally, or if supplies were subsidized by some donor organization.^ieng