Electron Beam Melting (EBM) technology applied to the titanium alloy Ti6Al4V is attracting interest in the biomedical industry since it allows producing surgical implants requiring a reduced number ...of subsequent machining steps. Even if the microstructural features of the EBM Ti6Al4V induce higher tool wear than the wrought Ti6Al4V, no evidences can be found in literature concerning the tool wear analysis when machining the EBM alloy, especially under dry and cryogenic cutting conditions, which are of particular interest for the biomedical industry allowing the reduction of the parts cleaning steps.
The aim of the paper is to evaluate the tool wear mechanisms arising when semi-finishing turning the EBM Ti6Al4V under dry and cryogenic conditions using a coated tungsten carbide insert at varying cutting speed and feed rate. The tool wear behaviour was investigated at fixed turning times using different analysis techniques. Scanning electron microscopy analyses were performed to measure the flank wear at the nose region, and energy dispersive X-ray spectroscopy was employed to investigate the workpiece material elements adhered on the cutting edge and rake face of the tool. 3-D optical profilometer analysis of the rake face was carried out to evaluate the abrasive and adhesive wear; the width of the adhered layer was measured by removing through chemical etching the workpiece material from the insert, allowing the quantification of the adhesive wear in comparison to the abrasive one.
The obtained results demonstrate that the higher cutting speed and feed rate the higher the tool wear; nevertheless, it was found the cryogenic cooling allowed reducing the adhesive wear mechanism of the workpiece material on the tool cutting surfaces in comparison with dry cutting, proving the feasibility of utilizing the cryogenic cooling to reduce the tool wear when machining the EBM Ti6Al4V.
Worldwide, a minority of disordered children/adolescents receives mental health assistance. In order to improve service access, it is important to investigate factors that influence the process ...leading to receiving care. Data on frequency and barriers for mental health service use (MHSU) among Brazilian children/adolescents are extremely scarce and are needed to guide public policy.
To establish the frequency of MHSU among 6-to-16-year-old with psychiatric disorders from four Brazilian regions; and to identify structural/psychosocial/demographic barriers associated with child/adolescent MHSU.
Multicenter cross-sectional-study involving four towns from four out of five Brazilian regions. In each town, a representative sample of elementary public school students was randomly selected (sample: 1,721). Child/adolescent MHSU was defined as being seen by a psychologist/psychiatrist/neurologist in the previous 12 months. Standardized instruments measured: (1) children/adolescent characteristics (1.1) Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL)-psychiatric disorders; (1.2) Ten Questions Screen-neurodevelopment problems; (1.3) two subtests of WISC-III-estimated IQ; (1.4) Academic Performance Test-school performance), (2) factors related to mothers/main caregivers (Self-Reporting Questionnaire-anxiety/depression), (3) family (Brazilian Research-Companies-Association's Questionnaire-SES).
Only 19.8% of children/adolescents with psychiatric disorder have used mental health services in the previous 12 months. Multiple logistic regression modeling identified five factors associated with lower rates of MHSU (female gender, adequate school performance, mother/main caregiver living with a partner, lower SES, residing in deprived Brazilian regions) regardless of the presence of any psychiatric disorders/neurodevelopmental problems.
Only a small proportion of children/adolescents with psychiatric disorders had been seen by a mental health specialist in the previous 12 months. Structural/psychosocial/demographic factors were associated with uneven access to service for certain groups of children/adolescents. These results call attention to the urgent need to implement programs to help reduce this large unmet mental health need; inequalities must be considered by policy makers when planning strategies to address barriers for care.
Adolescents may seek help for many reasons beyond health needs, such as personal stress due to violence exposure.
To investigate factors associated with receiving professional assistance and informal ...help due to violence exposure in the community and at school.
This study was conducted in Itaboraí, a low-income medium-size city in the State of Rio de Janeiro, Southeast Brazil, characterized by poverty, inequality and violence. It analyses data reported by 669 in-school adolescents (11–15-years, 51.7% girls).
This is a cross-sectional study nested in a longitudinal study (Itaboraí Youth Study). The Itaboraí Youth Study involved a probabilistic community-based sample of 1409 6-to-15-year-olds based on a 3-stage probabilistic sampling plan that included a random selection of census units, eligible households and the target child.
Professional assistance was mainly received from psychologists (the Brazilian population has free access to health services). Family members were the main source of informal help. Correlates of professional assistance were having clinical emotional problems and not counting on an adult (if needing help) for community violence victims, and absent father for community and school violence victims. Correlates of informal help were female sex, maternal anxiety/depression and absent father for community violence victims, and younger age and higher maternal education for school violence victims.
The mental health needs of violence victims, and maternal difficulties to deal with the adolescent distress resulting from violence exposure (maternal increased burden due to father absence and/or having anxiety/depression) are important influences on the help-seeking process.
•The majority of adolescents exposed to violence did not receive any professional assistance (PA) or informal help (IH)•Emotional problems, lack of social support and father’s absence favored PA among victims of school violence•Younger age and maternal schooling > 7 years favored IH among victims of school violence•The father's absence increased the odds of receiving PA among victims of community violence•Female gender, maternal anxiety/depression and father's absence favored IH among victims of community violence
To efficiently target capacity-building efforts for child mental health services in low- and middle-income countries (LMICs), it is critical to define how care is structured across sectors and ...individual-level factors.
In a community-based sample of 1,408 children and adolescents (ages 6-15 years) from Itaboraí, Brazil, the authors assessed need and service use across four care systems (mental health specialty, health, welfare, and informal). Individual-level factors included child gender and age, maternal perception of child mental health need, paternal absence, maternal education, and maternal anxiety and depression.
The mental health treatment gap was 88%, with only 12% of children with psychiatric problems using mental health services. Children with mental health problems were more likely than those without these problems to use health and other sectors of care and to use services in more than one sector of care. Overall, 46% of the children with any clinical mental health problems and 31% of those with only internalizing problems were identified by their mothers as having a mental health need. Among those with clinical mental health problems, factors associated with mental health service use were being a boy and paternal absence but not mental health problem type or maternal awareness.
Closing the child mental health treatment gap in urban settings in LMICs where resources are scarce will likely require system-level changes, such as engagement of diverse service sectors of care. Interventions need to target increased maternal awareness about mental health problems and encourage provision of mental health services to girls.
Although the history of recognition of child abuse in Europe and North America extends over 40 years, recognition and data are lacking in other parts of the world. Cultural differences in ...child-rearing complicate cross-cultural studies of abuse.
To ascertain rates of harsh and less-harsh parenting behavior in population-based samples.
We used parallel surveys of parental discipline of children in samples of mothers in Brazil, Chile, Egypt, India, Philippines, and the United States. Data were collected between 1998 and 2003. The instrument used was a modification of the Parent-Child Conflict Tactics Scale, along with a study-developed survey of demographic characteristics and other parent and child variables. Women (N=14 239) from 19 communities in 6 countries were surveyed. We interviewed mothers aged 15 to 49 years (18-49 years in the United States) who had a child younger than 18 years in her home. Sample selection involved either random sampling or systematic sampling within randomly selected blocks or neighborhoods.
Nearly all parents used nonviolent discipline and verbal or psychological punishment. Physical punishment was used in at least 55% of the families. Spanking rates (with open hand on buttocks) ranged from a low of 15% in an educated community in India to a high of 76% in a Philippine community. Similarly, there was a wide range in the rates of children who were hit with objects (9%-74% median: 39%) or beaten by their parents (0.1%-28.5%). Extremely harsh methods of physical punishment, such as burning or smothering, were rare in all countries. It is concerning that >or=20% of parents in 9 communities admitted shaking children younger than 2 years.
Physical and verbal punishments of children are common in high-, middle-, and low-income communities around the world. The forms and rates of punishment vary among countries and among communities within countries. A median of 16% of children experienced harsh or potentially abusive physical discipline in the previous year.
The Achenbach System of Empirically Based Assessment (ASEBA) for school-age children includes three instruments for assessing emotional and/or behavioral problems: Child Behavior Checklist (CBCL), ...completed by parents, Youth Self-Report (YSR), completed by adolescents and Teacher's Report Form (TRF), completed by teachers. This review article gives detailed information on the development of these forms in the United States and Brazil, describing the main changes to the items, scales and score cut-off points in original versions between 1991 and 2001, as well as the process involved in the translation, back-translation and cultural adaptation of the original questionnaires to develop the current official Brazilian versions of the CBCL, YSR and TRF. The utility of these tools for research and clinical practice is highlighted, mentioning epidemiological studies and evaluation of interventions conducted in Brazil. Researchers' and clinicians' doubts regarding the correct use of the current official Brazilian versions are answered, giving examples of frequently asked questions relevant to the Brazilian context.
Cancer-associated fibroblast (CAFs) are the most abundant cells in the tumor microenvironment, able to secrete growth factors and act on tumor progression. Melatonin is associated with several ...mechanisms of action with oncostatics and oncoprotectors effects, and also participate in the reduction of synthesis of surrounding fibroblasts and endothelial cells in breast cancer.
The objectives of this study were to determine the effectiveness of melatonin in cell viability and expression of proteins involved in angiogenesis and inflammation in triplenegative mammary tumor cell line (MDA-MB-231) and in co-culture with CAFs.
Cell viability was measured by MTT assay and the protein expression was evaluated by Membrane Antibody Array after melatonin treatment.
Melatonin treatment (1 mM) for 48 hours reduced the cell viability of MDA-MB-231, CAFs and co-culture (p < 0.05). The semi-quantitative protein analysis showed that when monoculture of tumor cells were compared with co-culture of CAFs, there was a regulation of angiogenic and inflammatory proteins (p < 0.05). Melatonin treatment also leads a differential expression of angiogenic and inflammatory proteins in both monoculture and co-culture of tumor cells and CAFs (p < 0.05).
The influence of CAFs under the tumor microenvironment was confirmed, increasing the malignancy of the tumor. In addition, melatonin is effective in both monoculture and co-culture, regulating angiogenic and inflammatory proteins that contribute to tumor progression. This study show an overview of melatonin ability in regulating angiogenic and inflammatory proteins, and opens the way for exploration of each individual protein in further studies.
Objectives
To demonstrate a study design that could be useful in low‐resource and violent urban settings and to estimate the prevalence of child violence exposure (at home, community, and school) and ...child mental health problems in a low‐income medium‐size city.
Methods
The Itaboraí Youth Study is a Norway–Brazil collaborative longitudinal study conducted in Itaboraí city (n = 1409, 6–15 year olds). A 3‐stage probabilistic sampling plan (random selection of census units, eligible households, and target child) generated sampling weights that were used to obtain estimates of population prevalence rates.
Results
Study strengths include previous pilot study and focus groups (testing procedures and comprehension of questionnaire items), longitudinal design (2 assessment periods with a mean interval of 12.9 months), high response rate (>80%), use of standardized instruments, different informants (mother and adolescent), face‐to‐face interviews to avoid errors due to the high frequency of low‐educated respondents, and information gathered on a variety of potential predictors and protective factors. Children and adolescents presented relevant levels of violence exposure and clinical mental health problems.
Conclusions
Prevalence estimates are probably valid to other Brazilian low‐income medium‐size cities due to similarities in terms of precarious living conditions. Described study methods could be useful in other poor and violent world regions.
Different diagnostic interviews in child and adolescent psychiatry have been developed in English but valid translations of instruments to other languages are still scarce especially in developing ...countries, limiting the comparison of child mental health data across different cultures. The present study aims to examine the convergent validity of the Brazilian version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version (K-SADS-PL) by comparison with the Child Behavior Checklist (CBCL), a parental screening measure for child/adolescent emotional/behavior problems.
An experienced child psychiatrist blind to CBCL results applied the K-SADS-PL to a consecutive sample of 78 children (6-14 years) referred to a public child mental health outpatient clinic (response rate = 75%). Three K-SADS-PL parameters were considered regarding current disorders: parent screen interview rates, clinician summary screen interview rates, and final DSM-IV diagnoses. Subjects were classified according to the presence/absence of any affective/anxiety disorder, any disruptive disorder, and any psychiatric disorder based on K-SADS-PL results. All subjects obtained T-scores on CBCL scales (internalizing, externalizing, total problems).
Significant differences in CBCL mean T-scores were observed between disordered and non-disordered children. Compared to children who screened negative, children positive for any affective/anxiety disorder, any disruptive disorder, and any psychiatric disorder had a higher internalizing, externalizing and total problem T-score mean, respectively. Highly significant differences in T-score means were also found when examining final diagnoses, except for any affective/anxiety disorder.
Evidence of convergent validity was found when comparing K-SADS-PL results with CBCL data.
To examine the relationship between specific types of child mental health problems and severe physical punishment, in combination with other important known risk factors.
We conducted a ...cross-sectional study in Embu, São Paulo, Brazil, as the Brazilian component of a multicountry survey on abuse in the family environment. From a probabilistic sample of clusters that included all eligible households (women aged 15-49 years with a son or daughter < 18 years of age), we randomly selected one mother-child pair per household (n = 813; attrition rate: 17.6%). This study focused on children aged 6-17 years (n = 480). Child Behaviour Checklist CBCL/6-18 was used to identify children with internalizing problems only, externalizing problems only, and both internalizing and externalizing problems (comorbidity). Severe physical punishment was defined as being hit with an object, being kicked, choked, smothered, burnt, scalded, branded, beaten or threatened with a weapon. We examined other potential correlates from four domains: child (gender, age, ever witnessing marital violence); mother (education, unemployment, anxiety or depression, marital violence); father (absence, drunkenness); and family (socioeconomic status). The WHO Self-Reporting Questionnaire (SRQ-20) was used to identify maternal anxiety or depression (score > 7). Backward logistic regression analysis identified independent correlates and significant interactions.
Multivariate modelling showed that severe punishment was an independent correlate of comorbid internalizing and externalizing problems but was not associated with internalizing problems only. It increased the risk of externalizing problems alone only for children and adolescents not exposed to maternal anxiety or depression. Maternal anxiety or depression increased the risk only for children or adolescents not exposed to severe punishment.
Severe punishment may be related to child mental health problems, with the mechanism depending on the type of problem. Its influence persists in the presence of family stressors such as the father's absence and maternal anxiety or depression.
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