ABSTRACT: Knowledge of the distribution of total phosphorus (P) content in native soils provides information on the management of ecosystem, land capability for agriculture, environmental quality, and biodiversity conservation. We mapped the spatial distribution of total P concentrations in topsoils (0-30 cm) of uncultivated (native) areas in Brazil. We obtained data on native total P of the southern, south-eastern, and north-eastern regions from reports of exploratory projects developed between 1960s and 1970s by EMBRAPA and by the RADAM Brazil Project. We estimated data from the central-western and northern regions from the relationship between total P and soil properties (Fe, Al, C and clay content), based on the RADAM Brazil Project. Soil total P varied widely (< 25 to > 500 mg kg–1) in all regions in Brazil. Higher concentrations (> 500 mg kg–1) were observed in southern region compared to most of the rest of the country (< 200 mg kg–1), while the Cerrado (Central), Amazon (North) and Caatinga (Northeast) biomes are very poor in total P. This first national native soil total P map provides a valuable baseline for understanding the historical patterns of agriculture expansion in Brazil. It allows quantifying the effect of agriculture expansion and future cropping systems on soil available P content and legacy P, targeting regional soil-crop specific strategies for optimization of ecosystem services, and mitigating potential environmental risk due to P transference to water bodies.

ABSTRACT Objective: To determine physical activity levels of community dwelling persons with spinal cord injury (SCI) who received inpatient rehabilitation at the Sir John Golding Rehabilitation Centre (SJGRC). This study also explored the perceived barriers to exercise and the development of secondary health complications. Methods: A non-experimental cross-sectional analysis of relationships was done. Participants were recruited from the SJGRC discharge files. Three questionnaires (The Physical Activity and Disability Scale, Spinal Cord Injury Secondary Conditions Scale and the Barriers to Exercise and Disability Scale) were administered via a telephone interview. Results: Only 58.3% of patients were engaged in some form of exercise and of that amount only 6% engaged in vigorous exercise. The main secondary conditions affecting both persons with paraplegia and quadriplegia were spasticity, chronic, muscle and joint pain. There were no significant differences between persons having paraplegia and quadriplegia in relation to physical activity levels, development of secondary conditions or barriers to exercise. Most persons were interested in an exercise programme but the most common barriers to exercise were cost and not knowing where they could go to exercise. Conclusion: Regardless of injury level, persons with spinal cord injury living in their communities in Jamaica are not engaged in adequate levels of exercise to confer health benefits and aid with healthy ageing. Barriers like cost, availability and accessibility of facilities must be addressed if this situation is to improve.

RESUMEN Objetivo: Determinar los niveles de actividad física de las personas con lesión de la médula espinal (LME) que viven en sus comunidades –es decir, en sus casas en vez de asilos o instituciones asistenciales–y que recibieron rehabilitación hospitalaria en el Centro de Rehabilitación Sir John Golding (SJGRC, en inglés). Este estudio también exploró las barreras percibidas para hacer ejercicios, y el desarrollo de complicaciones secundarias de salud. Métodos: Se realizó un análisis transversal no experimental de las relaciones. Los participantes fueron reclutados a partir de los archivos de altas del Centro SJGRC. Se aplicaron tres cuestionarios mediante entrevista telefónica (Escala de Actividad Física y Discapacidad, Escala de Condiciones Secundarias de la Lesión Medular, y Escala de Discapacidad y Barreras al Ejercicio). Resultados: Sólo el 58.3% de los pacientes se hallaban participando en alguna forma de ejercicio, y de este número sólo el 6% practicaba ejercicios fuertes. Las condiciones secundarias principales que afectaban a ambas personas con paraplejia y cuadriplejia eran la espasticidad, y el dolor muscular y articular crónico. No había diferencias significativas entre las personas que tenían paraplejia y cuadriplejia en lo referente a los niveles de actividad física, el desarrollo de condiciones secundarias o las barreras al ejercicio. La mayoría de las personas estaban interesadas en un programa de ejercicios, pero las barreras más comunes eran el costo y el no saber dónde ir a hacerlos. Conclusión: Independientemente del nivel de la lesión, las personas con lesión medular que viven en sus comunidades en Jamaica no participan en niveles adecuados de ejercicio que brinden beneficios de salud y ayuden a un envejecimiento saludable. Las barreras como el costo, la disponibilidad y la accesibilidad de las instalaciones deben ser abordadas, si se quiere mejorar esta situación.

Objetivo: Describir la forma y distribución de las rugas palatinas en una población de estudio y determinar si existen variaciones entre hombres y mujeres. Metodología: Modelo descriptivo en el que se estudió la morfología y distribución de las rugosidades palatinas con el modelo de Trobo hermosa en 94 pacientes adultos que asistieron a consulta de la clínica odontológica de la Corporación Universitaria Rafael Núñez, se excluyeron los sujetos con asimetría palatina y con antecedentes de cirugía en el paladar. Resultados: De los 94 sujetos de estudio 58 fueron mujeres y 36 hombres, el promedio de edad fue 35,1 ± 9,5, en cuanto a la procedencia el 38,3% eran de Cartagena, la morfología de ruga palatina más prevalente fue sinuosa 258, seguida de recta 238 y punto 104, en el sexo femenino la forma más frecuente fue sinuosa 156 y círculo no se encontró en el estudio de modelos, mientras que en los hombres sinuosa se presentó con mayor prevalencia 92 y círculo la que presentó menor frecuencia en 4, no se evidenció dimorfismo sexual. Conclusión: Las rugas palatinas de mayor frecuencia son sinuosa y recta; referente a la frecuencia, forma y distribución, no se evidenció dimorfismo sexual, ni patrones y disposición de rugas iguales. El patrón individualizado de las rugas palatinas es una herramienta de guía confiable para la identificación forense ya que no se observó ninguna fórmula palatóscopica igual.

Objective: To describe the shape and distribution of the palatal rugae in a study population and determine if there are variations between men and women. Methodology: Descriptive Model in which the morphology and distribution of the palatal ridges with Trobo Hermosa in 94 adult patients attending the dental clinic consultation of the corporacion Universitaria Rafael Nuñez was studied, subjects were excluded with palatal asymmetry and with a history of surgery on the palate. Results: Of the 94 study subjects were 58 women and 36 men, average age was 35.1 years (SD=9.5), regarding the origin 38.3% were of Cartagena, the morphology of palatal ruga was more prevalent sinuous 258, line by 238 and point 104, female sexual gender in the most frequent form was sinuous 156 and circle was not found in the study of models, while the sinuous men presented with higher prevalence 92 and circle the less frequently than 4, no sexual dimorphism was evident. Conclusion: The most frequent palatal rugae are sinuous and line; concerning the frequency, shape and distribution, no sexual dimorphism, or patterns and provision of equal rugae evidenced. The individual pattern of palatal rugae is a reliable tool for the forensic identification guide I like that no palatóscopica formula was observed.

Sea \SL(2,q) el grupo de las matrices 2\times 2 con determinante uno sobre un campo finito F de tamaño q. Se prueba que si q es par, entonces el producto de cualesquiera dos clases conjugadas no centrales de \SL(2,q) es la unión de al menos q-1 distintas clases conjugadas de \SL(2,q). Por otro lado, si q>3 es impar, entonces el producto de cualesquiera dos clases conjugadas no centrales de \SL(2,q) es la unión de al menos \fracq+32 distintas clases conjugadas de \SL(2,q).

Let \SL(2,q) be the group of 2\times 2 matrices with determinant one over a finite field F of size q. We prove that if q is even, then the product of any two noncentral conjugacy classes of \SL(2,q) is the union of at least q-1 distinct conjugacy classes of \SL(2,q). On the other hand, if q>3 is odd, then the product of any two noncentral conjugacy classes of \SL(2,q) is the union of at least \fracq+32 distinct conjugacy classes of \SL(2,q).

Colonic infection with Clostridium difficile, leading to pseudomembranous colitis, is a common complication of antibiotic therapy, especially in elderly patients. It has been suggested that non-pathogenic probiotic bacteria might prevent the development and recurrence of C. difficile infection. This double-blind, placebo-controlled study examines the role of probiotic administration in the prevention of C. difficile-associated diarrhoea (CDAD) in elderly patients receiving antibiotic therapy. Consecutive patients (150) receiving antibiotic therapy were randomised to receive either a probiotic containing both Lactobacillus and Bifidobacterium or placebo for 20 days. Upon admission to hospital, bowel habit was recorded and a faecal sample taken. Trial probiotic or placebo was taken within 72 h of prescription of antibiotics, and a second stool sample was taken in the event of development of diarrhoea during hospitalisation or after discharge. Of the randomised patients, 138 completed the study, 69 with probiotics in conjunction with antibiotics and 69 with antibiotics alone. On the basis of development of diarrhoea, the incidence of samples positive for C. difficile-associated toxins was 2.9% in the probiotic group compared with 7.25% in the placebo-control group. When samples from all patients were tested (rather than just those developing diarrhoea) 46% of probiotic patients were toxin-positive compared with 78% of the placebo group.

A infecção do cólon por Clostridium difficile, derivando em colite pseudomembranosa, é uma complicação comum nas terapias com antibióticos, especialmente em pacientes na terceira idade. Tem sido sugerido que as bactérias probióticas não patógenas poderiam ter um efeito preventivo sobre o desenvolvimento da infecção por C.difficile. Este estudo, duplamente cego, com controle mediante placebos, examina a influência da administração de probióticos sobre a prevenção de diarréia associada a C. difficile (CDAD) em pacientes da terceira idade submetidos à terapia com antibióticos. Foram escolhidos 150 pacientes submetidos à terapia com antibióticos e se administrou, aleatoriamente, durante 20 dias um probiótico que continha Lactobacillus e Bifidobacterium ou um placebo. Na admissão hospitalar foram anotados o regime intestinal do paciente e foram colhidas amostra fecal. Durante as primeiras 72 horas do tratamento com antibióticos foram administrados conjuntamente probiótico ou placebo e foi tomada uma segunda amostra de fezes, caso o paciente desenvolvesse diarréia durante ou após a alta médica. Dos pacientes escolhidos, 138 completaram o estudo, 69 tratados com antibióticos e probióticos e 69 somente com antibióticos. Dentre os pacientes que desenvolveram diarréia, foram encontradas 2,9% de amostras positivas para a toxina associada a C. difficile no grupo tratado com probióticos, em comparação com 7,25% detectado no grupo controle tratado com placebo. Quando foram analisadas as amostras de todos os pacientes (não somente os que desenvolveram diarréia), 46% dos pacientes tratados com probióticos apresentaram positividade para a toxina em comparação com 78% do grupo tratado com placebo.

La infección de colon por Clostridium difficile, que produce colitis pseudomembranosa, es una complicación frecuente en las terapias con antibióticos, especialmente en pacientes de la tercera edad. Se ha sugerido que las bacterias probióticas no patógenas podrían prevenir el desarrollo de la infección por C. difficile. Este estudio de doble ciego con control mediante placebos examina la influencia de la administración de probióticos en la prevención de diarrea asociada a C. difficile (CDAD) en pacientes de la tercera edad sometidos a terapia con antibióticos. Se escogieron al azar 150 pacientes consecutivos sometidos a terapia con antibióticos y se les administró aleatoriamente durante 20 días un probiótico que contenía Lactobacillus y Bifidobacterium o un placebo. Tras su ingreso hospitalario, se anotó su régimen intestinal y se tomó una muestra fecal. El probiótico o el placebo se administró durante las 72 h primeras del tratamiento con antibióticos, y se tomó una segunda muestra de heces en el caso de aparecer diarrea durante la hospitalización o tras el alta médica. De los pacientes escogidos, 138 completaron el estudio, 69 tratados con antibióticos y probióticos y 69 solamente con antibióticos. Entre los pacientes que tuvieron diarrea, se encontró un 2,9% de muestras positivas para la toxina asociada a C. difficile en el grupo tratado con probióticos, en comparación con el 7,25% detectado en el grupo control tratado con placebo. Cuando se analizaron muestras de todos los pacientes (no solamente los que tuvieron diarrea), un 46% de los pacientes tratados con probióticos dieron positivo para la toxina, en comparación con el 78% del grupo tratado con placebo.

Nesse artigo, discuto a aplicação dos princípios de ética médica e da pesquisa médica ao caso de crianças e outros cujo consentimento a tratamento e pesquisa é problemático. A saúde pública depende substancialmente da possibilidade da continuidade de pesquisas dirigidas a todas as condições que afetam a saúde da população. Restrições nessas pesquisas são, portanto, uma questão de saúde pública. Além disso, e mais importante, testagens preditivas e, especialmente, screening para condições relevantes (para) à saúde constituem-se em valiosos instrumentos de saúde pública. Limitações no uso desses instrumentos são da maior significância à medicina ligada à saúde pública. Levando em consideração os problemas particulares criados pela pesquisa e testagem preditiva para crianças no que se refere a condições que se manifestam tardiamente, prossigo discutindo investigações naqueles cujo consentimento é problemático em termos mais gerais. Concluo com recomendações radicais para a reforma da Declaração de Helsinki e das Orientações Éticas Internacionais para Pesquisa Biomédica Envolvendo Sujeitos Humanos, preparadas pelo Council for International Organizations of Medical Sciences (CIOMS).

In this paper I discuss the application of the principles of medical ethics and of medical research to the case of children and others whose consent to treatment and to research is problematic. Public health depends substantially on the possibility of ongoing research into all conditions which affect the health of the people. Constraints on this research are therefore a public health issue. Moreover and more importantly the possibility of predictive testing and indeed of screening for health-relevant conditions is an important public health tool, and limitations on the use of this tool are of great significance to public health medicine. Having considered the particular problems created by research and predictive testing on children for late-onset conditions I go on to discuss research on those whose consent is problematic more generally. I conclude with radical recommendations for the reform of The Declaration of Helsinki and of the International Ethics Guidelines for Biomedical Research Involving Human Subjects, prepared by the Council for International Organizations of Medical Sciences (CIOMS).

Nesse artigo, discuto a aplicação dos princípios de ética médica e da pesquisa médica ao caso de crianças e outros cujo consentimento a tratamento e pesquisa é problemático. A saúde pública depende substancialmente da possibilidade da continuidade de pesquisas dirigidas a todas as condições que afetam a saúde da população. Restrições nessas pesquisas são, portanto, uma questão de saúde pública. Além disso, e mais importante, testagens preditivas e, especialmente, screening para condições relevantes (para) à saúde constituem-se em valiosos instrumentos de saúde pública. Limitações no uso desses instrumentos são da maior significância à medicina ligada à saúde pública. Levando em consideração os problemas particulares criados pela pesquisa e testagem preditiva para crianças no que se refere a condições que se manifestam tardiamente, prossigo discutindo investigações naqueles cujo consentimento é problemático em termos mais gerais. Concluo com recomendações radicais para a reforma da Declaração de Helsinki e das Orientações Éticas Internacionais para Pesquisa Biomédica Envolvendo Sujeitos Humanos, preparadas pelo Council for International Organizations of Medical Sciences (CIOMS).

In this paper I discuss the application of the principles of medical ethics and of medical research to the case of children and others whose consent to treatment and to research is problematic. Public health depends substantially on the possibility of ongoing research into all conditions which affect the health of the people. Constraints on this research are therefore a public health issue. Moreover and more importantly the possibility of predictive testing and indeed of screening for health-relevant conditions is an important public health tool, and limitations on the use of this tool are of great significance to public health medicine. Having considered the particular problems created by research and predictive testing on children for late-onset conditions I go on to discuss research on those whose consent is problematic more generally. I conclude with radical recommendations for the reform of The Declaration of Helsinki and of the International Ethics Guidelines for Biomedical Research Involving Human Subjects, prepared by the Council for International Organizations of Medical Sciences (CIOMS).