Aspectos de patogenicidade e relacionamento genético de isolados clínicos vaginas e anais de Candida albicans oriundos de pacientes com candidíase vulvovaginal

Vulvovaginal candidiasis (VVC) is one of the most common causes of vaginitis and affects about 75% of women of reproductive age. The majority of cases (80 to 90%) are due to C. albicans, the most virulent species of the genus Candida. Virulence attributes are scarcely investigated and the source of infection remains uncertain. Objective: This study aimed to evaluate the virulence factors and genotypes of clinical isolates of C. albicans sequentially obtained from the anus and vagina of patients with sporadic and recurrent VVC. Materials and methods: We analyzed 62 clinical isolates of C. albicans (36 vaginal and 26 anal strains). Direct examination of vaginal and anal samples and colony forming units (CFU) counts were performed. Yeasts were identified using the chromogenic media CHROMagar Candida® and by classical methodology, and phenotypically characterized regarding to virulence factors, including the ability to adhere to epithelial cells, proteinase activity, morphogenesis and biofilm formation. The genotypes of the strains were investigated with ABC genotyping, microsatellite genotyping with primer M13 and RAPD. Results: We found 100% agreement between direct examination and culture of vaginal samples. Filamentous forms were present in most of the samples of vaginal secretion, which presented CFU counts significantly higher than the samples of anal secretion. There was no statistically significant difference between virulence factors of infecting vaginal isolates and those presented by colonizing anal isolates; as well as for the comparison of the vaginal isolates from patients with different clinical conditions (sporadic or recurrent VVC). There was a decrease in the ability to adhere to HBEC, morphogenesis and biofilm formation of the vaginal isolates during the progress of infection. There was an association between the ability to express different virulence factors and the clinical manifestations presented by the patients. Genotype A was the most prevalent (93.6%), followed by genotype C (6.4%). We found maintenance of the same ABC genotype and greater prevalence of microevolution for the vaginal strains of C. albicans sequentially obtained. Vaginal and anal isolates of C. albicans obtained simultaneously from the same patient presented the same ABC genotype and high genetic relatedness. Conclusion: It is noteworthy that the proliferation of yeast and bud-to-hypha transition are important for the establishment of CVV. The expression of virulence factors is important for the pathogenesis of VVC, although it does not seem to be determinant in the transition from colonization to infection or to the installation of recurrent condition. Genotype A seems to be dominant over the others in both vaginal and anal isolates of patients with VVC. The most common scenario was microevolution of the strains of C. albicans in the vaginal environment. It is suggested that the anal reservoir constituted a possible source of vaginal infection, in most cases assessed

Imagens do medo na mídia: uma análise das representações da violência em Natal-RN

Social violence is one of the phenomena of human life that produce effects on the social imaginary as it is in it that are designed conflicting values concerning what is most vital to humans, such as respect for the strength and the fear of death, pleasure trespass for injury and pain, the rejection of injustice and anger that is born of revolt. The variability of feelings and reasons that constitute violence has required academic knowledge increasingly sensitive reflections that encompass the complexity of its manifestations. The feeling of fear and insecurity which constitute the collective social imagination has caused large changes in the behavior of both individuals and the society as a whole. This study aims to reflect on media representations the social violence in Natal-RN. Through a thematic survey and documentary analysis of three newspapers of Rio Grande do Norte - Tribuna do Norte, Novo Jornal and Jornal Metropolitano - was possible to list events and trace different discursive strategies that lead to receptors ideological interests of class, constitute social and spatial segregations and maximize violations of rights and of the human dignity, with important implications in the construction of social representations concerning the reality of violence

Efeitos de peixes zooplanctívoros e onívoros sobre a resposta de comunidades planctônicas à fertilização por nutrientes

The food chain theory predict that presence of omnivory prevent the trophic cascade and could be a strong stabilizing factor over resource and consumer community dynamics, and that the nutrient enrichment destabilize populations dynamics. Most of the freshwater tropical reservoirs are eutrophic, and strategies that seek improve the water quality through the control of phytoplankton biomass and nutrient input, become essential for the improvement and preservation of water quality. The aim of this study was test the zooplanktivory (when larvae) and omnivory (when young and adult) effects of Nile Tilapia over the structure and dynamics of plankton communities, in addition or absence of nutrients enrichment. For this, one field experiment was performed with a factorial design 2x3 resulting in six treatments: control, without fish and nutrient (C); with omnivorous fish (O); with zooplanktivorous fish (Z); without fish and with enrichment of nutrients (NP); with omnivorous fish and nutrients (ONP); and, with zooplanktivorous fish and nutrients (ZNP). The two planktivory types reduced the zooplankton biomass and increased the phytoplankton biomass, but the omnivory of filter-feeding fish attenuated the trophic cascade magnitude. The fertilization by nutrients increases the nutrient concentrations in water and the phytoplankton biomass, but the effect on zooplankton is dependent of the trophic structure. In a general way, the effects of the fish and nutrient addition were addictive, but significant interactions among those factors were observed in the answer of some zooplankton groups. The effects of omnivorous fish over the temporal variability of phytoplankton and zooplankton biomass were very variable, the increase or reduce in variability of the plankton depending of the level of nutrients and of the analyzed variable. With base in this study, we conclude that the planktivory type exercised by the fish and the concentrations of nutrients in the water affects the force of pelagic trophic cascades and probably the success of biomanipulation programs for the handling of water quality in lakes and tropical reservoirs

Influência das mudanças climáticas na estrutura funcional da comunidade fitoplanctônica em um reservatório da região do semiárido

The Brazilian Northeast is the most vulnerable region to climatic variability risks. For the Brazilian semi-arid is expected a reduction in the overall rates of precipitation and an increase in the number of dry days. These changes predicted by the IPCC (2007) will intensify the rainfall and droughts period that could promote the dominance of cyanobacteria, thus affecting the water quality of reservoirs, that are most used for water supply, in the semi-arid. The aim of this study was to evaluate the effects of increasing temperature combined with nutrient enrichment on the functional structure of the phytoplankton community of a mesotrophic reservoir in the semi-arid, in the worst case scenario of climate change predicted by the IPCC (2007). Two experiments were performed, one in a rainy season and another in the dry season. In the water sampled, nutrients (nitrate and orthophosphate) were added in different concentrations. The microcosms were submitted to two different temperatures, five-year average of air temperature in the reservoir (control) and 4°C above the control temperature (warming). The results of this study showed that warming and nutrient enrichment benefited mainly the functional groups of cyanobacteria. During the rainy season it was verified the increasing biomass of small functional groups of unicellular and opportunists algae such as F (colonial green algae with mucilage) and X1 (nanoplanktonic algae of eutrophic lake systems). It was also observed an increasing in total biomass, in the richness and diversity of the community. In the dry season experiment there was a greater contribution in the relative biomass of filamentous algae, with a replacement of the group S1 (non-filamentous cyanobacteria with heterocytes) for H1 (filamentous cyanobacteria with heterocytes) in nutrient- enriched treatments. Moreover, there was also loss in total biomass, species richness and diversity of the community. The effects of temperature and nutrients manipulation on phytoplankton community of reservoir Ministro João Alves provoked changes in species richness, the diversity of the community and its functional composition, being the dry period which showed the highest susceptibility to the increase in the contribution of potentially toxic cyanobacteria with heterocytes

Desenpenho aeróbio e controle autonômico cardíaco em idosas praticantes de tai chi chuan e sedentárias

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Sensibilidade interoceptiva e respostas psicofisiológicas ao exercício submaximo

The complex human behavior related to exercise involves cognitive, physical and emotional processing. The recent theories about exercise s intensity regulation have highlighted the role played by psychophysics aspects in controlling exercise s intensity. In this regard, recent evidences have shown that there is variability in human capacity in perceiving interoceptives clues. Thus, subjects more sensitive show higher physiological arousal to physical and/or emotional stress, and sensations with higher intensity. In fact, studies have evidenced that interoceptive feedback modifies behavior in exercise with free load. However, exercise recommendations are based in a constant load standard. Therefore, we aimed to analyze the influence of interoceptive sensibility on psychophysics responses during dynamic exercise performed with constant load. Twenty-four adult males were allocated into two groups accordingly with their interoceptive sensibility: high sensibility (n=11) and low sensibility (13). They underwent to an incremental test (IT) and then randomly to two sections of moderate and severe exercise intensity for 20 minutes. Heart rate (HR), rating of perceived exertion (RPE), affective feelings (AF), alert state (AS), and percentage of associative thoughts were collect during exercise. A two-way ANOVA with repeated measures was used to assess differences between psychophysics responses. There were differences between group in RPE, AF, and AS in moderate intensity. There was no difference in any measure in severe intensity. We conclude that subjects with high interoceptive sensibility feel dynamic moderate exercise more intense than the subjecs with low interoceptive sensibility

Efeito do treinamento resistido na função autônomica cardíaca, nos parâmetros bioquímicos e antropométricos de pessoas vivendo com HIV/AIDS

Introduction: The emergence of High Active Antiretroviral Therapy (HAART) increase the life expectancy of the persons living with HIV/AIDS (PLHIV), therefore the prolonged use cause metabolic implications and influences on body fat distribution and increase the cardiovascular diseases prevalence. Aims: Evaluate the effect of resistance training on heart rate variability, biochemical parameters and somatotype on PLHIV. Methods: Participated this study seven sedentary men, with age above 25 years old, living with HIV/AIDS, under HAART use. Were submitted a 16 week intervention with resistance training. Evaluated the heart rate variability, biochemical parameters and somatotype, before, after 8 weeks and 16 weeks, all in paired form. It was found the data normality by Shapiro-Wilk test and conducted the Anova one way combined with Tukey post hoc to samples in each evaluate moment, adopting significance level p<0,05. Also were calculated percentage change deltas. For somatotype was used the somatotype spatial distance (DES), obeying the significance value DES≥1. Results: Was found significance differences only in variable final heart rate delta 60s (p=0,01), however, is not showed changes on heart rate variability, biochemical parameters and somatotype components. Conclusion: 16 weeks of resistance training showed improvement on heart rate recovery after submaximal effort and, despite is not enough to produce significance differences on biochemical parameters and somatotype components, could be realize improvement on average value of fasting glucose and lipid profile, as well as reducing the endomorphic component

Carga de trabalho de enfermagem e infecções relacionadas à assistência à saúde na unidade de terapia intensiva

In recent decades, the search for quality care has been widely discussed by the institutions and health professionals. In this context, it is the nurse coordinator of the process of providing nursing staff, reflecting the commitment to quality of care. In this process, it is the appearance of Infections Related to health care and its potential association with the workload in nursing as a valuable indicator of quality of care. Thus, this research contributes to studies to characterize the demand of nursing work to promote a safe healthcare practice. This study aimed to identify the association of nursing workload with the number of cases of Ventilator-Associated Pneumonia, urinary tract infection and central venous catheter infection in the intensive care unit. This is a quantitative research approach, descriptive, cross-sectional and prospective, held at Unimed Hospital in Natal-RN. The study population consisted of all patients treated in the Intensive Care Unit, Hospital for a period of 90 consecutive days in 2011. The convenience sample was compostapelos patients admitted to the ICU during the period of data collection, a total sample of 286 patients. To perform the data analysis software were used: Statistica 6.0, SPPS (Statistical Package for Social Sciences) version 17.0 (2004) and Excel 2007. In the descriptive analysis, we used Measures of Central Tendency and Measures of Dispersion or Variability and the use of nonparametric tests. Of the 286 patients, 88 were from the ICU and 198 ICU II II. Males predominated in the ICU I (51.1%) and female ICU II (57.6%) patients in the ICU I were aged 61-80 years (39.8%) followed by greater than 80 years (39.8%). In the ICU II, most of the patients were aged 61-80 years (38.9%) and then from 41 to 60 years (24.2%). In relation to the class of TISS inlet predominant class II in the two ICUs (59.1%), followed by Class III also in the two units (34.6%). Most patients (70.6%) out of the ICUs belonging to class II TISS. In the ICU I, the average number of forms of the TISS 28 was 6, has in ICU II this value drops to 3.2 forms. The overall mean was 19.9 TISS points in ICU patients I and ICU II.the 17 points in the average hours required to provide adequate nursing care to patients in the ICU I found that is 10 , 7 hours, and the ICU II 9.2 hours. It was found that the time provided by the nursing staff were higher in ICU II, with an average of 19 hours available for nurses in this sector. In the ICU I, which showed higher need of available hours, it was found that the mean value of 12.7 available hours. It was found that only 2.4% of patients had these units Ventilator-Associated Pneumonia, 1.0% were infected central venous catheter and 1.4% of patients had urinary tract infection. Infection associated with health care occurs, on average, on the tenth day of hospitalization. In the ICU II, this average value extends to the twelfth day with an excess of 2.7 hours of nursing care while in ICU I value decays to the ninth day of hospitalization with a deficiency of 12-hour assistance. It is concluded that patients generally showed a need for classification of semi-intensive care and has been assisted in their need to load. As for his association with the Related Infections Health will assist this analysis could not be performed due to the small number of notifications in this period. It is suggested further study how other factors related to infections me a longer period of analysis

Atendimento Pré-hospitalar Móvel. Mapeando Riscos e Prevenindo Erros

The attention with safety of the patients is important in the quality of the nursing and health care. In the pre-hospital care, such care is essential on site with the purpose of avoiding possible consequences to the individual, ensuring a fast and appropriate care, with improvement of the morbidity and reduction of the mortality. This medical attention is equally associated with the significant risks of adverse events and serious mistakes, which can be reduced with the awareness of the professionals, organization and quality management. It is a descriptive, transversal research, of quantitative approach, with the objective of identifying the risks for the safety of the patient during the mobile pre-hospital care under the view of the nurses, in a city of the Brazilian Northeast. The sample was formed by 23 nurses. The inclusion criteria: to have at least two years of experience and accept to participate on the research. The data collection was done in two steps, first photo collection, through the adapted method of photographic analysis, and the second with the application of questionnaire, divide in two parts: socio-professional data and digital photo punctuation instrument of the patient s safety. The majority of the nurses had an average working time in the mobile pre-hospital care of six years and six months, in the age group of 38 to 53 years old (69,56%) and with Lato sensu specialization (73,91%), being (29,41%) emergency and (29,41%) in intensive care. The (74%) have the Advance Cardiac Life Support (ACLS) and (100%) have the Pre-Hospital Trauma Life Support (PHTLS); (91, 30%) know the thematic safety of the patient. On the pictures it was observed a bigger variability of the categories (risks) where 44% of variance emerged on the first picture of the research. The pictures 4 and 9 with the average below 5 were classified as very insecure, while pictures 7 and 3 with an average above 7, very secure. On the results of risks observed for the patient s safety in the mobile pre-hospital care five categories emerged: organization and packaging of the equipment and materials, routines and specificities in the mobile pre-hospital care, risks on the management of medications, for traumas and infections. Starting from the analysis of these risks, it was proposed ten steps for the safety in the mobile pre-hospital care: 1- Identify the patient; 2- Safety related to prevention of infection; 3- Safety in the management of medications; 4- Safety and standardization of the packaging of equipment and materials; 5- Attention to the specificities of the mobile pre-hospital care; 6- Incentive and value the participation of the patient and family; 7- Promote the communication with the central of regulation; 8- Prevention of traumas and falls; 9- Protect the skin from additional injuries; 10- Understand the benefit of all the equipment in the ambulance. The multiple risks and their emerged combinations on the research indicate a variety of actions to be developed and stimulated, like the use of steps for the patient s safety in the mobile pre-hospital care which contributes with the aid and management of risks, reduction of mistakes, disabilities and death

Metodologia de implantação da construção enxuta: estudo de caso em construtora de porte médio

In recent years, the Brazilian construction industry has gone by changes like currency stability, increasing competition, shortage of skilled labor and increasing quality importance required by the customer, who made the sector companies seek solutions through new management practices in order to become more efficient. A alternative to these management practices is known as Lean Construction which is derived from the Toyota System Production. Lean Construction main goals are to reduce parts of activities that do not add value, increase product value by considering customer needs, reduce variability and production cycle time, simplify process by reducing the number of parts or steps, increase the flexibility in the product execution and transparency process, focus the control on overall process, introduce continuous improvement process, maintain a balance between improvements in flows and conversions and seek to learn from practices adopted by competitors. However, the construction industry is characterized by having nomadic activity, which undertakes an unique product with high cost of production and big inertia for behavioral change, making it difficult to implement the philosophy of lean construction in companies. In this sense, the main objective of this study is to develop a methodology for implementation of the principles of Lean Construction. The method of implementing the proposed management system was designed with the aid of 5W2H tool, and the implementation process is divided into three phases. The first one aims to know in a macro way the current operation of construction, identify who is its target audience and what are the products and services offered to the Market. The second phase aims to describe what actions should be taken and which documents are needed to be created or modified; finally, the third step goal consists in how to control and monitor established processes, where through Strategic Planning the company goals would be set along with their respective targets and indicators in order to keep the system working, aiming for continuous improvement with focus on the customer. This methodology was conceived as a case study analyzing a medium size construction with more than 18 years of activity and certified for almost 10 years with ISO9001 and level A in PBQP-H. We also conclude that this implementation process can be used in any developer and / or builder

Utilização do controle estatístico do processo para monitoramento do peso médio de cápsulas de Tuberculostáticos: estudo de caso no NUPLAM- RN

This Master Thesis presents a case study on the use of Statistical Process Control (SPC) at the Núcleo de Pesquisas em Alimentos e Medicamentos (NUPLAM). The SPC basic tools have been applied in the process of the tuberculostáticos drugs encapsulation, primarily concerning the objective to choose, between two speeds, which one is the best one to perform the tuberculostatics encapsulation. Later on, with the company effectively operating, the SPC was applied intending to know the variability of the process and, through the tracking of the process itself, to arrive at an estimated limit for the control of future lots of tuberculostatics of equal dosage. As special causes were detected acting in the process, a cause-and-effect diagram was built in order to try to discover, in each factor that composes the productive process, the possible causes of variation of the capsules average weight. The hypotheses raised will be able to serve as a base for deepened the study to eliminate or reduce these interferences in the process. Also a study on the capacity of the process to attend the specifications was carried out, and this study has shown the process´s inaptitude to take care of them. However, on the side of NUPLAM exists a real yearning to implant the SPC and consequently to improve the existing quality already present on its medicines

Aplicação da metodologia seis sigma em uma empresa de médio porte do setor têxtil

The Six Sigma methodology has received considerable attention in the last two decades. This is due to its great potencial to reduce processes variability, through the use of accurate data, facts and statistical techniques. The methodology seeks to improve the quality of products and services, maximizing the company s financial performance. Specifically, its implementation and results in medium-sized textile enterprises is unknow, although there are signs that the methodology can be applied with success. Considering this scenario, the goal of this research is to describe the application of the Six Sigma methodology in a médium-sized textile company specialized in the production of male shirts in the satate of Rio Grande do Norte, Brazil. First, we present a literature review, seeking to highlight the themes of quality, Six Sigma and its methodology for improvement. Then, we show the implementation of the project selected, depicting the steps and procedures that must be performed. The results confirm the efficiency of Six Sigma in providing significant gains to companies. It is observed substantial improvements in the speed of product development and the flexibility of the parts produced, reducing the process lead time from 12.5 to 6.2 days, which means a performance improvement of over 50%. This leads also to cultural and behaviour change, creating motivation for implementation of new projects and a continuous search for knowledge

Gestão dos resíduos sólidos das contruções prediais na cidade do Natal-RN

The present work has the objective of presenting an investigation about the quantification, classification and destination of the waste of construction and demolition (RCD) in the city of Natal - RN, focusing the aspects of the environmental impacts and the strategic importance of the environmental administration in the earnings of productivity of the companies. Of the environmental point of view the research intends to identify and to quantify the monthly and annual production of RCD in the city, as well as to know the places of deposition of those residues. To reach the objectives of the study, an exploratory and descriptive research was accomplished, using a questionnaire with closed subjects and an open one, applied in 25 entrepreneurs of the branch of the building site, being 21 builders and 4 entrepreneurs of collection companies and removal dumps. As form of analysis of the data, the descriptive analysis was used and of crossing. The production engineering considers important the insert of best production practices and administration of the product in the companies, with views to the increase of your competitiveness, productivity earnings and improvement of the environmental aspects with views to the consumer's satisfaction, in that case the buyer of immobile. The principal results of the investigation demonstrate that there was not great variability of answers with relationship to the interviewees opinion in what he refers to the environmental practices. In your majority the building site interviewees entrepreneurs evidenced the absence of the public power, particularly the city hall of Natal, in the control, fiscalization and creation of mechanisms for a correct destination of RCD, as well as for your reuse and recycle. On the other hand also it was evident that the recycle or the reuse of RCD on the part of the companies is a rare practice and a lot of times inexistent, although the entrepreneurs' of the building site section great majority recognizes that would have won of productivity with the correct and intensive use of such measures

Gestão de satisfação e fidelidade do cliente na hotelaria :um estudo sobre os fatores que influenciam a satisfação e a fidelidade do turista internacional no Brasil

The objective of this thesis was studying the factors which contribute to customer s satisfaction and loyalty, focusing the Norwegian model of satisfaction and loyalty of the consumer, applied in the sector of hotel services in Natal/RN, Brazil. The theoretical research was led through the concepts of service quality, customer satisfaction and loyalty, models of quality management systems, national index of customer s satisfaction and methods which evaluate the customer s satisfaction. The field research was carried through from December 1st of 2004 to 24 st, among 381 international tourists who had been housed in the hotels of Natal. The analyses of the data had been made through the descriptive statistics and analysis of multiple regression. The results had evidenced that the main precedents variables of satisfaction had been: hotel s room, staff friendliness, hotel restaurant food and price paid; these are factors which explained, in 56,0% the variation of satisfaction with hotels. In relation to the constructs which had influenced the tourist s loyalty, were founds: tourist s satisfaction, hotel image and affective commitment, which had explained 53.0% of the data variability. The complaint management resulted as a basic factor for the tourist s satisfaction and loyalty

Estratégia ambiental e agências de viagens e turismo :um estudo sobre a importância de práticas ambientais na escolha de um pacote turístico

The objective of the work was to investigate, from the vision of travel agents, the importance of environmental practices as a decision factor in the purchase of a tourist package. For in such a way, it was established as target population, the travel agencies and tourism linked to he Brazilian Association of Travel agencies ABAV, hearing the Brazilian travel agents that exerted the function in Natal, city in 2005. The election of the sample was accomplished using the simple random sampling technique. The amount of agents effectively searched was of 150 agents being distributed 150 questionnaires, with closed and opened questions, applied during the month of November in 2005. Results showed great variability of interviewed answers in that if it relates for sale of package tourist where the customer demonstrates enviromental concern with the environmental quality. Through multiple regression analyses, it was environmental concern with the environmental quality of the place and the perception of the practical importance of the existence environmental practices in the place as important factor in the decision of tourist package purchase