This paper describes the findings of the research conducted by the authors on the humanitarian logistic efforts after the cascading disasters that impacted the Tohoku region after the Great East Japan Earthquake of March 11 th , 2011. Using a combination of in depth interviews with participants in the relief efforts and meta analyses of news accounts, the authors identified lessons learned by the participants, and the corresponding policy implications and suggestions for improvement of future response efforts.

Soil-geosynthetic interface shear strength is an essential parameter for the design and stability analysis of geosynthetic-reinforced soil structures. Economic and environmental reasons have led to increasing use of locally available residual soils with a significant percentage of fines and lower draining capacity, when compared with the traditional good-quality backfill materials. This paper describes an extensive laboratory study carried out using a large-scale direct shear test device, in which the influence of soil moisture content, soil density and geosynthetic type on the direct shear behaviour of the soil-geosynthetic interface was evaluated. The study involved a locally available granite residual soil and four geosynthetics: two geogrids (one uniaxial and the other biaxial), one geocomposite reinforcement (high-strength geotextile) and one geotextile. Test results have revealed that the increase in soil moisture content can measurably reduce the soil-geosynthetic interface shear strength. Regardless of soil moisture content, soil density proved to have a remarkable influence on interface shear strength, particularly when geogrids were used. Among the different geosynthetics tested, the biaxial geogrid was found to be the most effective reinforcement for this particular type of soil, concerning the direct shear mechanism. For soil-geogrid interfaces, the coefficients of interaction ranged from 0.71 to 0.99. For soil-geotextile interfaces, the coefficients of interaction varied from 0.54 to 0.85.

Dental caries are a global health problem that affects all age groups and must be considered a public health priority due to its significant financial costs and impact on the quality of life. This study evaluated the association between oral health literacy (OHL), school factors, and untreated dental caries in 12-year-old Brazilian adolescents using a multilevel approach. A population-based cross-sectional study was carried out with 740 adolescents randomly selected from private and public schools in Campina Grande, Brazil. Two dentists were trained and calibrated to diagnose dental caries using the Nyvad index and OHL using the Brazilian Rapid Estimate of Literacy in Dentistry (BREALD-30). The caregivers of the adolescents reported demographic data (sex, skin color, and socioeconomic status). Data of school factors such as the type of school and the school grade retention rate were classified through a 2-step hierarchical cluster analysis to obtain the school environment. A robust multilevel log-linear negative binomial regression for complex samples was performed (p < 0.05). In the analysis, adjusted by individual determinants, nonwhite skin color (RR = 2.20; 95% CI 1.56–3.12), a low socioeconomic status (RR = 1.60; 95% CI 1.09–2.34), a low OHL score (RR = 0.94; 95% CI 0.91–0.98), and low satisfaction with the last dental appointment (RR = 2.25; 95% CI 1.67–3.04) were associated with untreated dental caries. The following factors remained associated with untreated dental caries in the final model: students from an unfavorable learning environment (RR = 2.20; 95% CI 1.27–3.80), nonwhite skin color (RR = 1.92; 95% CI 1.27–2.91), a low socioeconomic status (RR = 1.82; 95% CI 1.12–2.94), a low OHL score (RR = 0.95; 95% CI 0.91–0.98), and low satisfaction with the last dental appointment (RR = 2.07; 95% CI 1.47–2.91). Untreated dental caries in early adolescence were impacted by the school environment, the socioeconomic status, OHL, and the adolescent’s satisfaction with the last dental appointment.

Self-expanding metallic stents (SEMS) are the treatment of choice for incurable obstructive malignant esophageal strictures. Although the placement of SEMS is usually performed with fluoroscopic control (FC), recently several authors have shown the feasibility of placing SEMS under endoscopic control alone (EC). However, studies comparing the two techniques are lacking. The objective of this study was to compare the feasibility and safety of SEMS insertion under fluoroscopic control and endoscopic control. The study was performed through the retrospective analysis of patients who underwent SEMS insertion for malignant dysphagia between January 2005 and January 2010. Data concerning early and late complications and survival were retrieved. Early complications were defined as pain, vomiting, bleeding, malposition/migration, perforation, and/or dysphagia occurring until 30 days of SEMS insertion; and late complications as tumor ingrowth and overgrowth, migration, hemorrhage, fistulae, food impaction, and/or esophagitis occurring after 30 days. We placed 126 SEMS of which 87% for esophageal stricture, 8% for esophagus-respiratory fistula, and 5% for extrinsic compression. The mean age of the patients was 62 years, and 93 were male. SEMS insertion was performed with FC in 66 patients and EC in 60. Early complications occurred in 34 patients (52%) in the FC group and 28 (47%) in the EC group (P=0.71), including: pain in 22 patients of the FC group and 15 of the EC group (P=0.31); vomiting in 15 of the FC group and nine of the EC group (P=0.27); malposition/migration in three of the FC group and four of the EC group (P=0.60); hemorrhage in one of the FC group and two of the EC group (P=0.27); and dysphagia in two of the FC group and three of the EC group (P=0.57). Late complications occurred in 20 patients (30%) in the FC group and 22 (37%) in the EC group (P=0.44), including: tumor in/overgrowth in 13 patients of the FC group and 10 of the EC group (P=0.66); prostheses migration in five of the FC group and eight of the EC group (P=0.28); hemorrhage in two of the FC group and two of the EC group (P=0.54); appearance of esophageal fistulae in seven of the FC group and four of the EC group (P=0.43); food impaction in nine of the FC group and eight of the EC group (P=0.96); esophagitis in 12 of the FC group and 15 of the EC group (P=0.35). Median survival was 107 days (95% confidence interval [CI]=6-369 days) with no difference between the two groups. There were no statistical significant differences in the incidence of complications and in survival between patients undergoing SEMS placement under fluoroscopic control or endoscopic control.

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RESUMENEste es un estudio cualitativo realizado con mujeres infectadas con el VIH/SIDA atendidas por un servicio especializado en DST/SIDA y matriculadas por un equipo del Programa Salud de la Familia. Tuvo como objetivo identificar cuáles son las motivaciones de las mujeres seropositivas al VIH/SIDA para abrir la confidencialidad de sus informaciones al equipo del PSF. Se llevó a cabo por medio de entrevistas semiestructuradas, analizadas con el referencial teórico de la bioética. Se verificó que las mujeres revelan el diagnóstico al equipo del PSF cuando: el diagnóstico de seropositividad se realizó en la unidad; sienten que son mejor atendidas por ser seropositivas al VIH; tienen vínculo como si fuesen familiares; confían; y manifiestan que no sienten pena. Y no revelan cuando: la actitud del profesional generó miedo e inseguridad; consideran que el PSF cuida a personas enfermas; no confían por miedo a la quiebra del sigilo; y ya poseen toda la asistencia que necesitan en el SAE. DESCRIPTORES ABSTRACTThis qualitative study was carried out with women living with HIV/AIDS cared by a specialized STD/AIDS service and registered in a Family Health Program (FHP) unit. The purpose was to identify the motivations of women living with HIV/AIDS to provide private information to the FHP team. The study was performed using semi-structured interviews, analyzed with the bioethics theoretical framework. It was verified that women disclose the diagnosis to the FHP team when: the HIV/AIDS diagnosis was made in the unit; they feel there is better treatment for being HIV positive; they are bond as family members; there is trust; and women feel that they do not feel pity of them. Women so not disclose when: the professional's attitude produces fear and unreliability; they think that the FHP takes care of bedridden patients; they do not trust by fearing secret disclosure; and they already have all the care needed in the SCS. KEY WORDS

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In recent years, environmental concerns related to the overexploitation of natural resources and the need to manage large amounts of wastes arising from construction activities have intensified the pressure on the civil engineering industry to adopt sustainable waste recycling and valorisation measures. The use of recycled construction and demolition (C&D) wastes as alternative backfill for geosynthetic-reinforced structures may significantly contribute towards sustainable civil infrastructure development. This paper presents a laboratory study carried out to characterise the interaction between a fine-grained C&D material and two different geogrids (a polyester (PET) geogrid and an extruded uniaxial high-density polyethylene (HDPE) geogrid) through a series of large-scale pullout tests. The effects of the geogrid specimen size, displacement rate and vertical confining pressure on the pullout resistance of the geogrids are evaluated and discussed, aiming to assess whether they are in line with the current knowledge about the pullout resistance of geogrids embedded in soils. Test results have shown that the measured peak pullout resistance of the geogrid increases with the specimen size, imposed displacement rate and confining pressure. However, the pullout interaction coefficient has exhibited the opposite trend with the specimen size and confining pressure. The pullout interaction coefficients ranged from 0.79 and 1.57 and were generally greater than or equal to the values reported in the literature for soil-geogrid and recycled material-geogrid interfaces.