intervals thereafter, where increase represents normal response. Age-and sex-adjusted regression models were used to examine trends in mean number of components across quartiles of area under the curve (AUC) salivary cortisol. Patterns of mean cortisol response were assessed by MetSyn status using repeatedmeasures analysis of covariance. Results The study included 373 officers (74.0% men) with a mean age of 41.0 years. Prevalence of MetSyn was 25.7%. The mean count of MetSyn components decreased (1.89, 1.75, 1.55, 1.37; P < 0.01) across increasing quartiles of AUC salivary cortisol. The pattern of mean salivary cortisol decreased from baseline (5.55, 4.58, 4.47, 4.79, 4.75 nmol/L) in officers with MetSyn and increased (5.08, 5.82, 5.92, 5.82, 5.60 nmol/L) in their counterparts. The test for interaction between MetSyn status and sample timing was statistically significant (P < 0.001). Conclusions A reduced cortisol response to a high-protein challenge may be associated with MetSyn. Future longitudinal studies could provide useful evidence for planning intervention studies on cardiovascular risk among police officers. Objectives A cross-section study design aimed to explain the characteristics of traffic accident cases in northern of Thailand. Method A cross-section study design aimed to explain the characteristics of traffic accident cases in northern of Thailand. The subjects were recruited from 8 hospitals and 7 police stations in the highest case accident areas from hospitals and police stations during 2009-2012. All medical records and police statements were used as the sources of data collection. All research procedures were approved by the committee for the protection of human subjects of Mae Fah Luang University. Results Totally 35 925 cases had been recruited into the study from 8 hospitals during 2009-2011. 66.58% were female, 28.01% aged 16-25 years old, and main vehicle was motorcycle (78.85%). 29.31% of subjects had been admitted at the hospital, 77.06% had a length of admission ≤31 days, 2.39% diability found, 84.81% had medical cost ≥5000 baht. Univariate analysis found alcohol used, types of vehicle, medical cost, and medical surgery were statistical different between sex.In 7 police stationts, 2339 cases had been recruited into the analysis. 71.43% were females, 27.61% were aged 16-25 years old, 60.96% were married, 92.02% were Buddhism. The main type of vehicle was the cars (56.60%), 67.29% had their accident on the highways, and 60.66% had accidents on the day time (06.00 am.-06.00pm.), and those 13.12% drank alcohol. Conclusions Thailand needs the specific study for improving driving safety behaviours and also an effective regulation to control for traffic accident. Objectives The objectives of this study were to assess the importance of the mental suffering of employees in the service sector of a city in western Algeria and to identify risk factors and moderators of this suffering in order to develop a effective prevention. Method Standardised questionnaires were subjected to 753 employees in ...

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Objective:To analyze the perception of pediatric guidelines by mothers at the time of consultation in private offices, in order to know how they assimilate, process and use the information received from the pediatricians.Methods:Data collection was carried out by a questionnaire sent to participants by a total of 200 mothers from a virtual community in social networks participated in the research. The answers were transcribed using the Discourse of the Collective Subject method. The analyses were supported by the research qualitative perspective, from the viewpoint of the social representation theory.Results:Three categories were obtained through data analysis: (1) assessing the pediatric guidelines, (2) confronting theory and practice and (3) developing a critical view of the pediatric guidelines. These categories have elucidated that the level of knowledge of pediatric issues by mothers and their ability to use them when making decisions about the care of their babies, have a direct association between following or not the pediatric guidelines.Conclusions:The mother's decision on following the pediatrician's recommendations depends on two main factors: (a) certification of the updated and proven recommendations, according to the official health agencies; (b) support and recognition by the pediatrician of the maternal empowerment during the follow-up process. The mothers' practice of accessing knowledge through social networks hinders the pediatric monitoring.

INTRODUÇÃONos últimos anos tem-se observado no Brasil um grande interesse pelo aleitamento materno, tanto de parte das autoridades, como dos profissionais na área da saúde. O interesse resulta de evidências que mostram as vantagens do leite materno para a saúde da criança 2,9 e dos resultados de diversas pesquisas que apontam um desmame cada vez mais precoce 8,12 , incluindo uma proporção de até 10 a 15% de mulheres que não amamentam seus filhos 13,17 . Essas observações fizeram com que diversos autores assinalassem a necessidade de desenvolver ações que levassem um número maior de mulheres a amamentar, e a um desmame mais tardio 14,15 . Com este objetivo, foi planejado um programa de estímulo ao aleitamento materno 5,7 , a ser desenvolvido no município de Paulínia, no Estado de São Paulo. Considerando a pouca experiência existente sobre o efeito das ações de estímulo e a necessidade de se utilizar os recursos disponíveis da maneira mais eficaz possível, optou-se por começar desenvol-

-Multi-minicore disease (MmD) is an infrequent congenital myopathy, defined by structural changes in optic and electron microscopy, namely, multiple small areas lacking oxidative enzyme activity and focal disorganization of contractile proteins involving at most a few sarcomeres. The classical form of the disease manifests as more or less severe hypotonia and generalized weakness with predominance in axial and proximal limb muscles. Clinical variants also exist. Usually MmD is inherited as an autosomal recessive trait. Genetic heterogeneity is recognized and up to now mutations in the genes of RYR1 and SEPN1 have been detected. We record three unrelated cases of MmD. Case 1, with the classical benign form, was followedup for 15 years. Case 2, presenting pharyngolaryngeal involvement and severe delay of head control, improved gradually, until independent gait was acquired at age of six years. A moderate restriction of daily life activities remains. Case 3, of antenatal-onset, was expressed by arthrogryposis of hands, predominance of scapular girdle deficit and a stable course after ten years on physiotherapy. All cases were selected by the characteristic morphological abnormalities in biceps brachii samples, including electron microscopy. Emphasis is given to case 2 due to type 1 fiber uniformity and mild endomysial fibrosis, posing a difficult differential diagnosis with congenital muscular dystrophy were it not for the significant number of multi-minicores.KEY WORDS: congenital myopathy, multi-minicore disease, phenotype, histochemistry, electron microscopy. Miopatia dos multi-minifocos revisitadaRESUMO -A miopatia dos múltiplos minifocos (MM) é doença congênita rara, definida por alterações estruturais observadas ao microscópio óptico e eletrônico: múltiplas e pequenas áreas sem atividade enzimática oxidativa e desorganização focal das proteínas contráteis envolvendo poucos sarcômeros. A forma clássi-ca da doença se manifesta com hipotonia mais ou menos grave e fraqueza generalizada, predominante em músculos axiais e proximais em membros. Entretanto, variantes clínicas existem. A MM é usualmente herdada como traço autossômico recessivo. Heterogeneidade genética tem sido reconhecida e até o momento mutações nos genes RYR1 e SEPN1 foram detectadas. Relatamos três casos de MM. Caso 1, que tem a forma clássica e benigna da doença, assim permaneceu ao longo de 15 anos. Caso 2 apresentou envolvimento faringo-laríngeo e grave atraso no controle cefálico que melhorou gradualmente, até que a deambulação plena foi adquirida aos seis anos; permanece com moderada limitação das atividades da vida diária. Caso 3 teve início pré-natal, expresso através de artrogripose das mãos. Havia predominância de déficit em cintura escapular e o curso tem sido estável, com fisioterapia, por 10 anos. Os casos foram selecionados pelas características morfológicas na biópsia do biceps braquial que incluiu microscopia eletrônica. Enfatizamos, no caso 2, a uniformidade das fibras do tipo 1 e a leve fibrose do endomísio, tendo sido ne...