42 resultados para Brasil, Região Centro-Oeste
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VANTI, Nadia; SILVA, Lailde da. Análise webométrica das Universidades Públicas Federais das Regiões Norte e Centro- oeste do Brasil.In: ENCONTRO NACIONAL DE ESTUDANTES DE BIBLIOTECONOMIA, DOCUMENTAÇÃO, GESTÃO, E CIÊNCIA DA INFORMAÇÃO,33 , 2010, Paraíba. Anais... Paraíba: ENEBD, 2010.
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VANTI, Nadia; SILVA, Lailde da. Análise webométrica das Universidades Públicas Federais das Regiões Norte e Centro- oeste do Brasil.In: ENCONTRO NACIONAL DE ESTUDANTES DE BIBLIOTECONOMIA, DOCUMENTAÇÃO, GESTÃO, E CIÊNCIA DA INFORMAÇÃO,33 , 2010, Paraíba. Anais... Paraíba: ENEBD, 2010.
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The deficit of water and sewerage services is a historic problem in Brazil. The introduction of a new regulatory framework, in 2007, presented ways intending to overcome these deficits, among them, the providers efficiency improvement. This thesis aims to analyze the regulators performance regarding its ability to induce the efficiency of the Brazilian water and sewerage services providers. To this end, an analytical approach based on a sequential explanatory strategy was used, and it consists of three steps. In the first step, the Data Envelopment Analysis ( DEA ) was used to measure the providers efficiency in 2006 and 2011. The results show that the average efficiency may be considered high; however significant inefficiencies among the 29 analyzed providers were detected. The ones in the Southeast region showed better performance level and Northeast had the lowest. The local and the private providers were more efficient on average. In 2006 and 2011 the average performance was higher among non-regulated providers. In 2006 the group regulated by local agencies had the best average performance, in 2011, the best performance was the group regulated by the consortium agencies. To analyse the second step was used the Malmquist Index, it pointed that the productivity between 2006 and 2011 dropped. The analysis through decomposing Malmquist Index showed a shift of technical efficiency frontier to a lower level, however was detected a small provider s advance towards the frontier. Only the Midwest region recorded progress in overall productivity. The deterioration in the total factor productivity was higher among regional providers but the local ones and the private agencies moved quickly to the frontier level. The providers regulated from 2007 showed less decrease on the total productivity and the results of the catch up effect were more meaningful. In the last step, the regulators standardization activity analyses noted that there are agencies that had not issued rules until 2011. The most standards topics discussed in the issued rules were the tariff adjustments and the setting of general conditions for the provision and use of services; in another hand, the least covered topics were new technologies incentive and the introduction of efficiency-inducing regulatory mechanisms and productivity gains for price reviews. Regulators created from 2007 were more active proportionately. Even with the advent of the regulatory framework and the creation of new regulatory bodies, the evidence points to a reality in which the actions of these agencies have not been ensuring that providers of water and sewage, regulated by them, has achieved better performance. The non- achievement of regulatory goals can be explained by the incipient level of performance of the Brazilian regulatory authorities, which should be strengthened because of its potential contribution to the Brazilian basic sanitation department
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
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Except the non-melanoma skin tumors, colorectal cancer is the second most common in the Southeastern Region of Brazil, the third most common in the Southern and Central Regions. It is also the forth most common in the Northern Region and it is the fifth one in the Northeastern. To assess pathological and clinical variables of colorectal Cancer is crucial to know the possible conclusions for the survival of patients and point out the characteristics in the progress of tumor, such as the profile of tumor invasion and its angiogenesis. This work focuses on analyzing clinically and pathologically some settings in colorectal cancer patients (CRC) in the city of Natal and its countryside through those variables as parameters of prognosis and determine the level of protein expression, for instance: E-cadherin (E-cad), beta- -catenin (β-cat), galectin-3 (gal-3), matrix metalloproteinases (MMP) 2 and 9 and vascular-endothelial growth factor alpha (α VEGF) in the tumor tissues. A retrospective study was done in colorectal cancer cases in the regions of Rio Grande do Norte state from 1995 to 2005, specifically in Natal city/RN/Brazil. The pathological and clinical variables, such as: age, gender, ethnicity, lifestyle, family history, the location of the primary tumor, level of differentiation, TDM staging, modified Dukes’, treatment and survival were analyzed. The pathological and clinical data were collected from medical records through a specific form and were filed on Excel. A total of 534 patients were selected from the Pathology Department file in this institution, however, 176 patients were excluded. 358 patients were included for Epidemiological analysis and its clinical and pathological correlations were selected. 180 patients were also selected for histological and immunohistochemical studies. The tumor progression of these selected proteins mentioned before were analyzed. The Paraffin blocks of these samples were treated by Microarray Tissue technique and its blades subjected to immunohistochemistry to test the intensity of these proteins in tumor tissues. The results of this analysis were correlated with clinicopathologic variables of patients. Statistical analysis using the chi-frame Pearson test and analysis of midlife by Kaplan-Meier curve was also utilized. P values < 0.05 were considered statistically significant. The average age of our sample was 58.8 years and 51.7 % were female. Alcohol consumption has increased by 1.71 time the risk of death by CCR (p = 0.034) and tobacco consumption increased 2.7 times the chance of developing tumors of high TNM stage (p = 0.001). Cancer patients had a family history of 3,833 times the chance of developing the CCR (p = 0.002). The expression of MMP-2 showed a significant association with tumors of high TNM stage (p <0.046) and mortality (p = 0.041). The α VEGF expression had statistically significant correlation with high TNM stage (p <0.009), degree of cell indifferentiation (p <0.025) and mortality (p <0.035). Expressions of E-cadherin and beta-catetina demonstrated tumor linked to high TNM stage (p = 0.0001) and Dukes› modified (p = 0.05), lesions in the rectum (p = 0.03 and p = 0.007, respectively), smoking (p = 0.05) and indifferentiation (p = 0.001). The expression of Gal-3 showed statistical significance with high TNM stage of patients (p = 0.01), smokers (p = 0.01), alcohol drinking (p = 0.03), indifferentiation (p = 0.0001) and mortality (p = 0.0001). Based on the results, therefore, we could realize that lifestyle and family history had correlation in the CCR prognosis, as well as MMP-2 expression, MMP-9, VEGF alpha, E-cadherin, Beta-catenin and Galectin-3 were important prognostic markers in tumor progression in colorectal cancer.
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Dos problemas de saúde existentes no ambiente de trabalho, 18% afetam o aparelho psíquico, a exemplo do estresse, atingindo cerca de 30% dos trabalhadores em geral. A persistência e intensidade do estresse, associada às sucessivas tentativas de lidar com os mesmos, tornam os indivíduos vulneráveis ao surgimento da Síndrome deBurnout. O objetivo deste trabalho foi identificar a relação dos aspectos socioeconômicos e demográficos com o estresse e a Síndrome de Burnout em fisioterapeutas do Brasil. Para isso, este estudo teve uma abordagem do tipo transversal, com 1040 fisioterapeutas do Brasil, através de uma amostragem do tipo snowbolle não probabilística. Utilizou-se um questionário socioeconômico, demográfico e profissional, a Escala de Estresse no Trabalho (EET) e a adaptação do Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo (CESQT). Na análise dos dados, foram utilizadas a estatística descritiva e inferencial. Dentre os principais resultados obtidos, percebeu-se uma maior representatividade da região Nordeste (48,7%), com idade média de 31anos, sexo feminino (75,7%), carga horária semanal de 35,4 horas, com 3-5 anos de atuação profissional. Observou-se que 37,0% apresentavam estresse relacionado estatisticamente com a idade (p=0,008),atividade física (p=0,039) e satisfação com a saúde (r=-0,322; p<0,001). Não foi observado nenhum caso de Burnout, porém houve uma média elevada nas dimensões, desgaste psíquico, indolência e culpa, totalizando 49,0% comtendência ao desenvolvimento da síndrome. Portanto, as variáveis, idade, prática da atividade física e satisfação com a saúde obtiveramrelação com o estresse. Para o Burnout, destacaram-se a região de moradia (centro-oeste), satisfação com a saúde, local de trabalho (clínicas e hospitais), além do maior número de locais de trabalho. Diante desse contexto, os estudos sobre o estresse e a Síndrome de Burnout se apresentam como elementos derelevância dentro do contexto da prevenção dos riscos laborais e da análise das condições de trabalho
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Studies on Brazilian biodiversity are still very few and can observe the difference of knowledge between the different regions of the country. This affirmation can be verified in the investigation to identify the rare species in Brazil and the key biodiversity areas (ACBs). In that study were identified for Brasil 2.256 rare species and 752 ACBs. The Rio Grande do Norte (RN) was the only Brazilian state that has not been identified any rare species and no ACBs, possibly due to the lack of floristic studies in this state. A particular area was selected for this study: an area of ecological tension with savanna physiognomy in Rio do Fogo, RN. This savanna community is represented in RN in a fragment and immersed in restinga and caatinga and was identified and described only through of radar imagens there are no studies to date in loco . We have prepared the following questions about this community savanna: 1) The region delimited and described by through of radar images by the RADAMBRASIL, 1976, can be associated of the Cerrado, in terms of floristic ?; 2) What is the floristic composition of this area? This area includes rare species, endemic or endangered? 3) What is the geographical and phytogeographical distribution of plant species registered in this area? 4) Those plant species registered are endemic or have affinity with other areas phytoecological Brazilian? To answer these questions we performed a floristic inventory of the August 2007 to September/2009. The results are presented in two chapters (manuscripts). The first chapter, titled "The Savannah Rio Grande do Norte: floristic links with other plant formations in the Northeast and Center-West Brazil" was submitted to the Revista Brasileira de Botância. Chapter 1 discusses the phytogeographical distribution of the species, by comparing floristic studies conducted in the Cerrado, Caatinga and Restinga in the Northeast and Cerrado of the Central Brazil. The analysis of data of this study and compilation with other studies indicated that: i) the record of 94 plant species; ii) of total species, about 64% are associated with the Cerrado, the second specialized bibliography, and about 78% as the List of Species of Flora of Brazil. However, about 73% of total species (94) are also distributed in the Caatinga, the Atlantic forest 64%, the Amazon forest 64%, the Pantanal 15% and the Pampa 12%. Floristically the data show that the community studied is influenced by other floras, has a structure where grasses dominate and also because of his appearance the same savanna then be classified as a Savana gramíneo-lenhosa do tabuleiro . Chapter 2, titled "Considerations on the flora of a savanna community in Rio Grande do Norte, northeastern Brazil: Subsidy key area for conservation" was submitted to the Revista Natureza e Conservação. This has the objective of improve the knowledge of flora of Rio Grande do Norte and to identify possible rare species and consequently increase the key areas of biodiversity in Brazil. The data indicated that: i) of 94 species registered in the study area, 40 were new records for the Rio Grande do Norte state; ii) These citations to unpublished state, Stylosanthes montevidensis Vogel (Fabaceae) and Aristida laevis (Nees) Kunth (Poaceae) are indicated for the first time to the Northeast of Brazil; iii) are registered in the area 24 species endemic to Brazil and 63 non-endemic; iv) Aspilia procumbens Baker (Asteraceae) registered in the area is considered a restricted species and micro endemic Rio Grande do Norte, ie rare species; v) Aspilia procumbens is also cited in the category of critically endangered species and Stilpnopappus cearensis Hubber (Asteraceae) a species vulnerable to extinction. This study shows a new area phytoecological in Rio Grande do Norte and indicates the area's potential to contribute with the sites of global significance for biodiversity conservation, either locally, regionally and nationally. This will certainly contribute to respond some targets set by the Global Strategy for Plant Conservation and the Convention on Biological Diversity such as the inventory of vegetal diversity in a region with little collection, which will provide data that contributes to questions and themes related to biodiversity.
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The study of mortality by various differentials has been an important tool to guide public health policies, due to better describing the events of deaths in a population. This research aims to seek disparities in mortality according to educational level, sex and adulthood in large Brazilian regions and consequently for Brazil as a whole. A vast literature has shown that people with more education tend to have lower risk of death. Studies on inequalities in mortality by level of education in Brazil are still very specific and has still known very little about Brazil about mortality according to educational level, due to lack of information about the well-filled school in the records of deaths arising from the Mortality Information System (MIS) of the Ministry of Health. This data source has shown improvement in the coverage of sub reports in the last decade, however, it has still perceived negligence in completing the question regarding schooling of death (about 30% of registered deaths in 2010 to Brazil, Given this scenario, this work contributes to the national literature on the behavior of adult mortality differentials having as proposed, using data from the new variable mortality of the 2010 Census (CD 2010), assuming the characteristics of education of the head the household for deaths occurring in the same. It is therefore considered that the probability of mortality is homogeneous within the household. Events of deaths were corrected only for the records come from households where the head possessed levels of schooling and Instruction Elementary Education No Incomplete and Primary Education and Secondary Education Complete Incomplete through the Generations Extinct Adjusted method. With deaths already corrected, probabilities of death were calculated between 15 and 60 years life, as well as tables by sex and level of education to all regions of Brazil. No que se refere às probabilidades de morte por idade, nas idades entre 15 e 60 anos as maiores probabilidades seguem um gradiente, maior probabilidade para os menos escolarizados. Results corroborate the literature, the more educated the population is, the greater the life expectancy. In all Brazilian regions, life expectancy of the female population is greater than that of men at all levels of schooling. With respect to probabilities of death by age between the ages of 15 and 60 years the most likely follow a gradient, most likely to the least educated. At older ages (from 70 years), this behavior has presented another pattern, the lowest level of education has the lowest odds in the regions, North, Northeast, South and Midwest, except in the Southeast region
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The interference of man in the middle atmosphere can be evidenced by the presence of carbon monoxide, gas associated with burning fossil fuels and carbon dioxide content, essential for respiration of plants and thermal balance of the Earth. In this thesis we initially evaluated the intensity of the spatial distribution of carbon monoxide in the Northeast of Brazil, and subsequently the behavior of temporal variations of the pollutants carbon monoxide and carbon dioxide in the atmospheric boundary layer Maxaranguape / RN. Research has shown that, driven by speculation and promoting the occupation of land for agriculture, cattle ranching and tourism in the Northeast of Brazil, the changes established by the man in the middle geomorphological affect the lower troposphere on a large scale, with a predominance of concentrations in central Pernambuco, Paraiba's south-central and central-west of Alagoas. However, the study of Maxaranguape / RN results showed little variation in carbon monoxide and carbon dioxide, with the speed of the wind persisting with values greater than 7.8 m / s, showing dispersion and diffusion of pollutants which resulted in faster renewal of local atmospheric air
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This thesis presents diagenetic and provenance studies of sandstones belonging to the Rift Tectonosequence of the Rio do Peixe and Araripe basins. These basins are located in the interior of Northeast Brazil aligned along the Trend-Cariri Potiguar. Their origin is related to the Early Cretaceous rifting event. In terms of lithostratigraphy, the studied section corresponds to the Antenor Navarro, Sousa and Rio Piranhas formations of the Rio do Peixe Basin, and the Missão Velha and Abaiara formations of the Araripe Basin, outcropping in the central-west Cariri Valley. A facies analysis was performed and identified nine distinct sedimentary facies for the Rio de Peixe Basin and ten sedimentary facies for the Araripe Basin, individualized according to the different rock types and their sedimentary structures. These facies associations to led paleoenvironments interpretations and their vertical succession allowed understanding the evolution of the depositional setting during the cronostratigraphic interval studied in these basins. Based on petrographic and diagenetic studies it was possible to characterize the texture and mineralogy of these sandstones, identifying their diagenetic stage and the grain framework provenance. The petrographic study allowed to classify the lithotypes studied in both basins as quartzarenites. Such quartzarenites, in general, are rich in quartz, feldspar and lithic fragment grains, and at accessory levels tourmaline, sphene, zircon, epidote and other mineralogy. The diagenetic history of the studied rocks proved to be very complex, being characterized by a variety mineral of phases that succeeded each other during the eo, meso and telodiagenetic stages. According to the studied formation and the textural and compositional aspects of the rocks, some processes were more or less active, while others were even absent. The eodiagenetic stage is marked by mechanical infiltration of clays and early mechanical compactional processes. The mesodiagenetic phase is characterized by continuity of the mechanical compaction and the beggining of chemical compaction, with quartz and feldspar overgrowths, precipitation of kaolinite, alteration of framework grains to chlorite and illite, and finally, precipitation of opaque minerals. The telodiagenetic stage is represented by the oxidation of some grains, matrix and cements. For the provenance analysis of the studied sandstones were used ternary diagrams whose vertices correspond to the percentage of quartz, feldspar and lithic fragments. This study allowed identifies the source area of these rocks as continental blocks. It was also possible, based on the chemical stability and mineralogical maturity of the rocks, recognize that the Antenor Navarro Formation of the Rio do Peixe Basin, and the upper section of the Missão Velha Formation of Araripe Basin have less maturity and stability when compared with the other studied formations
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The development of home refrigerators generally are compact and economic reasons for using simplified configuration. The thermodynamic coefficient of performance ( COP ) is limited mainly in the condenser design for reasons of size and arrangement ( layout ) of the project ( design ) and climatic characteristics of the region where it will operate. It is noteworthy that this latter limitation is very significant when it comes to a country of continental size like Brazil with diverse climatic conditions. The COP of the cycle depends crucially on the ability of heat dissipated in the condenser. So in hot climates like the northeast, north, and west-central dispel ability is highly attenuated compared to the south and southeast regions with tropical or subtropical climates when compared with other regions. The dissipation in compact capacitors for applications in domestic refrigeration has been the focus of several studies, that due to its impact on reducing costs and power consumption, and better use of the space occupied by the components of refrigeration systems. This space should be kept to a minimum to allow an increase in the useful storage volume of refrigerator without changing the external dimensions of the product. Due to its low cost manufacturing, wire on tube condensers continue to be the most advantageous option for domestic refrigeration. Traditionally, these heat exchangers are designed to operate under natural convection. Not always, the benefits of greater compactness of capacitors for forced outweigh the burden of pumping air through the external heat exchanger. In this work we propose an improvement in convective condenser changing it to a transfer mechanism combined in series with conductive pipes and wire to a moist convective porous medium and the porous medium to the environment. The porous media used in the coating was composed of a gypsum plaster impregnated fiber about a mesh of natural cellulosic molded tubular wire mesh about the original structure of the condenser , and then dried and calcined to greater adherence and increased porosity. The proposed configuration was installed in domestic refrigeration system ( trough ) and tested under the same conditions of the original configuration . Was also evaluated in the dry condition and humidified drip water under natural and forced with an electro - fan ( fan coil ) convection. Assays were performed for the same 134- refrigerant charge e under the same thermal cooling load. The performance was evaluated in various configurations, showing an improvement of about 72 % compared with the original configuration proposed in humidification and natural convection.
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The biomonitoring technique for water quality in water bodies has been incorporated increasingly in management of the natural resources, using mainly indices of its aquatic community characteristics. In Brazil the first efforts to use this technique was restricted to the South and the Midwest region of this country. Located in the northeast region, this study was conducted at Rio Grande do Norte state and had as main objective the assessment of water quality in the Piranhas-Açu river using benthic macroinvertebrates community as biological indicators. Thus, were applied two biotic indices, the BMWP (Biological Monitoring Working Party score system) and the IBF (Family Biotic Index). According the requirements of these indices, two periods of sampling were determined as basic methodology, in dry seasons of 2006 and 2007. The sampling sites were around the municipalities of Açu, Ipanguaçu, Alto do Rodrigues and Pendências. Physical-chemical measurements; a protocol of rapid assessment of diversity of habitats, and determination of the degree of tolerance of each taxon to organic pollution were also performed. The most abundant organisms found in the river were tolerant with the prevalence of Chironomidae (Diptera) and Melanoides tuberculata. This results, together with those ones got in indices application, showed a considerable organic pollution in the four sample places and the reaches were classified as modified to impacted. According to the used indices, this study suggest that this river have significant alteration in the biotic community and water quality on the organic pollution, and this fact, occurs in the reach of the river further downstream, where were expected a good water quality. Considering these results, measures aiming the conservation of this water body are needed regarding as it is inserted into a fragile ecosystem with dry season phenomenon, and the water of this river has extremely importance for the local economy
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This study aimed to analyze the social representations of Brazilian and Portuguese nurses on stress in the emergency service. A semi-structured interview and the free word association test, with "stress" as the inductive stimulus, were used as research instruments. Data were collected from 120 nurses, being 60 from an emergency hospital in the city of Natal, Brazil and 60 from an urgency hospital in the city of Aveiro, Portugal. Data from the word association test were analyzed with the EVOC 2002 program, after thematic categorical content analysis, enabling construction of a data bank. Data gathered from the interview were analyzed by ALCESTE 4.8 software. Nurse represent the stress in the urgency department as a generation of physical and mental detrition where adaptation is unsatisfactorily, resulting in the onset of fatigne, irritability, lack of concentration, lack of motivation, pessimism, impaired interpersonal relationship and low productivity. The solution is part of a complex whole, which demands an integrated way of acting that has demanded increasingly professional attitudes based on multidisciplinarity
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Study, a descriptive-like one, is guided by ethnographic principles which have analyzed the elderly within the familiar context in his/her process of health and aging, in the neighborhood called Felipe Camarão, located in the western administrative region of Natal, RN, a Northeastern city of Brazil. The participants are elders aging 61 to 84 years old, living in this referring neighborhood, whose majority is constituted of migrants from the rural region of the state of the RN, retired, including widows, widowers and married couples, with low school-educational degree. For the information gathering it was utilized a semi-structured interview, the participant observation and the field diary, being put into effect, in majority, in the houses and in the Family Health Unit, in a period between March and October of 2006. For the results discussion it was utilized an analysis of thematic content and the program ALCESTE (In Portuguese, Análise Léxica por Contexto de um Conjunto de Segmentos de Texto or Lexical Analysis by Context of a Set of Text Segments), which through have emerged two corpus: the corpus I, Family and the elderly, and corpus II, The elderly and the aging within society. The analysis of the results has permitted to conclude that the family, also used by the public policies as a strategy of their practices in health, it is a necessary base support for the elderly citizen in his/her process of aging and of health. The elders familiar contexts have allowed this study to identify the existence of minimal social conditions of life, of new rearrangements of the current families by means of the plurigenerational acquaintanceship and the active presence of the elderly woman as a maintainer of this family; also by means of conflicted relationships among one another but in a bearable level of acquaintanceship. Different conceptions about the aging and the elderly generate disagreement and divergency however the family support and help for the solving of these problems and the attention to health are proceeding from the family components. However, it is noticed that loneliness is something present in these elder s everyday lives. About the attention to health, in a basic level of it, it was noticed that there are still a lot of gaps, mainly concerning promotional and preventing actions, deserving a higher sensitization and effort by the local health institutions
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Leprosy is an ancient disease that still stands as a public health problem worldwide, especially in the considered developing countries. Of these, Brazil still has large areas of endemicity. The disease remains high among those younger than 15 years old. In this group, the national index achieves 0.6 every 10 000 inhabitants and reaches 2 in the North and Midwest of Brazil. Therefore, the plan of the Ministry of Health is to prioritize the fight against disease in critical areas, providing early diagnosis and timely treatment, especially for patients under 15 years old. This research aimed to: identify the knowledge of students from three schools of basic education in Parnamirim/RN about the risk of getting ill in leprosy; conduct them health education on this topic. An exploratory-descriptive study with quantitative and qualitative nature. Data collection consists of two steps: questionnaire and health education on leprosy. The study was approved by the Research Ethics Committee (REC) of UFRN through the opinion nº 204/2009. Quantitative data obtained were organized, categorized, typed and submitted to the Microsoft Office - Excel for quantitative analysis with simple percentage. Qualitative data were subjected to a content analysis according to Bardin. The sample consisted of 164 students of basic education, most of which is: 1st year of high school, from 11 to 15 years, in the afternoon shift, female gender, skin color white and residents in the municipality of Parnamirim/RN. Still, each student living with four people curiously did not respond in relation to occupation of the father. But the same answered their mother as a housewife and a family income of one to less than four minimum wages. There have been significant results compared the performance of health education in leprosy. Initially, students possessed little knowledge about leprosy. Subsequent to health education, most knew the answer about the disease, transmission, cause, where to get help in case of suspicion of leprosy and the need for the people who lives with leprosy patients to also seek for help, the understanding about if it is treatable or not. Content analysis has established the following themes: axis I, what I do not know about leprosy: cure, fear and prejudice. Axis II, what I know about leprosy, we identified: cure, effectiveness of health education and social exclusion in the past. It is considered the scope of the proposed objectives by matching the effectiveness of health education on leprosy in basic education in Parnamirim/RN; emphasizes, therefore, the importance of understanding the knowledge of public school students. It is expected of them to detect early cases of leprosy in their communities; encourage adherence to treatment as quickly as possible; prevent disability; reduce the stigma surrounding the disease.