Socio-political aspects of the implantation of the Transplant Center of Piauí

A qualitative study aiming at understanding the socio-political aspects that mediate the implantation of the Transplant Center of Piauí, identify the social topics involved in this implantation and analyze the participation of the organized civil society. Ten people directly related to the implantation of the transplant center were involved in the study, selected through the "snowball" technique. A loosely structured interview, taped, transcribed and submitted for thematic analysis was used. It was concluded that the implantation of the transplant center in Piauí was the fruit of a complex series of negotiations and interests among the State and organized civil society, as there was no political project for action in the area of transplants. This distancing from the responsibility of the public sector characterizes the importance that was given to this implantation.     

Can the science of communication inform the art of the medical humanities?

CONTEXT There is increasing interest in establishing the medical humanities as core integrated provision in undergraduate medicine curricula, but sceptics point to the lack of evidence for their impact upon patient care. Further, the medical humanities culture has often failed to provide a convincing theoretical rationale for the inclusion of the arts and humanities in medical education. DISCUSSION Poor communication with colleagues and patients is the main factor in creating the conditions for medical error; this is grounded in a historically determined refusal of democracy within medical work. The medical humanities may play a critical role in educating for democracy in medical culture generally, and in improving communication in medical students specifically, as both demand high levels of empathy. Studies in the science of communication can provide a valuable evidence base justifying the inclusion of the medical humanities in the core curriculum. A case is made for the potential of the medical humanities – as a form of ‘adult play’– to educate for collaboration and tolerance of ambiguity or uncertainty, providing a key element of the longer‐term democratising force necessary to change medical culture and promote safer practice. CONCLUSION The arts and humanities can provide important contextual media through which the lessons learned from the science of communication in medicine can be translated and promoted as forms of medical education.     

Estimation of the prevalence of epilepsy in the Benin region of Zinvié using the capture-recapture method

BACKGROUND: The prevalence of epilepsy was estimated in two villages of 3134 inhabitants, in Benin, in April and May 1997 using the capture-recapture method. METHODS: Information was obtained from (i) a door-to-door cross-sectional study, (ii) a non-medical source consisting of key informants (traditional practitioners, teachers, village leaders, and religious representatives) and (iii) a medical source through evaluation of medical records in health centres. In all the three situations, the diagnosis of epilepsy was confirmed by a neurologist. RESULTS: The door-to-door survey found 50 epileptics, i.e. a prevalence of 15.9 per 1000. The non-medical source found 26 patients. The medical source found only four patients. In total, 66 epileptics were found by combining the three sources, giving a prevalence of 21.1 per 1000. After application of the capture-recapture method, the estimated number of cases from the door-to-door survey and non-medical source was 105, and 110 cases when the medical source was considered as well. The respective prevalences were 33.5 per 1000, and 35.1 per 1000. CONCLUSIONS: The door-to-door survey has been usefully improved by using key informants. The epilepsy prevalence estimate found by capture-recapture is clearly higher than that found by traditional cross-sectional methods, and could better depict the frequency of epilepsy in Africa.     

South-East Asian ovalocytosis among the population of the Highlands of Madagascar: a vestigé of the island's settlement

In the Madagascar Highlands, 0.76% of children from 168 random primary schools, and 19 of 150 families from 3 villages, had oval-shaped erythrocytes. Most harboured the deletion in the band 3 gene characteristic of South-East Asian ovalocytosis. This genetic trait supports the Indonesian origin of the Madagascar settlement.     

Wading for food the driving force of the evolution of bipedalism?

Evidence is accumulating that suggests that the large human brain is most likely to have evolved in littoral and estuarine habitats rich in naturally occurring essential fatty acids. This paper adds further weight to this view, suggesting that another key human trait, our bipedality might also be best explained as an adaptation to a water-side niche. Evidence is provided here that extant apes, although preferring to keep dry, go into water when driven to do so by hunger. The anecdotal evidence has suggested that they tend to do this bipedally. Here, a new empirical study of captive bonobos found them to exhibit 2% or less bipedality on the ground or in trees but over 90% when wading in water to collect food. The skeletal morphology of AL 288-1 ("Lucy") is shown to indicate a strong ability to abduct and adduct the femur. These traits, together with a remarkably platypelloid pelvis, have not yet been adequately explained by terrestrial or arboreal models for early bipedalism but are consistent with those expected in an ape that adopted a specialist side-to-side 'ice-skating' or sideways wading mode. It is argued that this explanation of A. afarensis locomotor morphology is more parsimonious than others which have plainly failed to produce a consensus. Microwear evidence of Australopithecus dentition is also presented as evidence that the drive for such a wading form of locomotion might well have been waterside foods. This model obtains further support from the paleo-habitats of the earliest known bipeds, which are consistent with the hypothesis that wading contributed to the adaptive pressure towards bipedality.     

Influence of the porosity on the ²²²Rn exhalation rate of concrete

The composition of 23 concrete mixtures was varied in five separate series to evaluate the influence of porosity on the 222Rn exhalation rate. In each series, a range in porosities is obtained by varying (1) the amount of cement, (2) type of cement (Portland or blast furnace slag cement), (3) the amount of water at a fixed cement level, (4) addition of an air entraining agent, or (5) the amount of recycled aggregates. The porosities ranged from 1% to 16%. The 222Rn exhalation rate is normalized to the 22?Ra activity concentration and expressed as the 222Rn release factor to eliminate the effect of differences in 22?Ra activity concentrations among the various concrete mixtures. Since most 222Rn originates from the cement, a 222Rn release factor based on the amount of 22?Ra introduced by the cements appeared to be more adequate. Although the methods to attain the porosities in the concrete mixtures differ widely, this cement-related factor corresponds well with the capillary porosity of the mixtures. Since the water-to-cement ratio of the fresh paste is a good indicator of the capillary porosity, this is the guiding factor in the fabrication of concretes low in 222Rn exhalation. The lower the water-to-cement ratio, the less capillary pore area will be available from which 222Rn can emanate from the mineral matrix into the pore system. The good correlation between the cement-based 222Rn release factor and literature data on the internal capillary pore area support the results of this study.