34 resultados para Local management


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The Brazilian public health system requires competent professionals sensitive to the needs of the population. The Foundation for Advancement of International Medical Education and Research (FAIMER) provides a two-year faculty development programme for health professions educators, aiming to build leadership in education to improve health. A partnership with governmental initiatives and FAIMER was established for meeting these needs. This paper describes the initial process evaluation results of the Brazilian FAIMER Institute Fellowship (FAIMER BR). Methods: Data were analysed for the classes 2007-2010 regarding: application processes; innovation project themes; retrospective post-pre self-ratings of knowledge acquisition; and professional development portfolios. Results: Seventeen of 26 Brazilian states were represented among 98 Fellows, predominantly from public medical schools (75.5%) and schools awarded Ministry of Health grants to align education with public health services (89.8%). One-third (n = 32) of Fellows' innovation projects were related to these grants. Significant increases occurred in all topic subscales on self-report of knowledge acquisition (eff ect sizes, 1.21-2.77). In the follow up questionnaire, 63% of Fellows reported that their projects were incorporated into the curriculum or institutional policies. The majority reported that the programme deepened their knowledge (98%), provided new ideas about medical education (90%) and provided skills for conflict management (63%). One-half of the Fellows reported sustained benefits from the programme listserv and other communications, including breadth of expertise, establishment of research collaboration and receiving emotional support. Conclusion: Contributors to initial programme success included alignment of curriculum with governmental initiatives, curriculum design merging educational technology, leadership and management skills and central role of an innovation educational project responding to local needs.

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Thrombophlebitis of the jugular vein is commonly observed in horses, particularly during intensive care, and leads to local and systemic inflammatory responses as well as head and neck circulatory impairment. Thrombolytic therapy is widely used in human practice with the aim of thrombus dissolution and recanalization of the injured vessels. There are similarities between human and horse coagulation and fibrinolytic processes. This review examines the fibrinolytic system, thrombus formation, and the clinical management of jugular thrombophlebitis, including thrombolytic therapy. There is evidence that early regional thrombolytic therapy for jugular thrombophlebitis in horses may be effective to achieve sustained recanalization.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Osteochondroma is one of the most common benign tumors of the skeleton. This tumor is rare in the craniofacial region, with the most common sites of occurrence being the coronoid process of the mandible and the mandibular condyle. Traditionally, the treatments of these lesions include total condylectomy or local resection of the lesion. Conservative condylectomy procedure with reshaping of the remaining condylar neck and repositioning of the articular disk has been suggested. This article aimed to describe a 35-year-old woman with osteochondroma in the left mandibular condyle who was treated by conservative condylectomy. The patient has been free of recurrence for 2 years, showing good aesthetic and functional stability. Copyright © 2013 by Mutaz B. Habal, MD.

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Soft tissue sarcomas (STSs) are a heterogeneous group of mesenchymal tumors of >50 subtypes. However, STSs represent <1% of types of cancer. Despite this low frequency, the disease is aggressive and treatment, when possible, is based on traditional chemotherapies. A number of cases of resistance to adjuvant therapies have been reported. Metastases are commonly identified in STS patients during diagnosis and the development of effective clinical parameters is crucial for correct management of the disease. The use of biological markers in cancer is a useful tool to determine patient prognosis. Ki--67 is a protein marker for proliferation of somatic cells and is widely used in prognostic studies of various types of tumor, including STSs. Cluster of differentiation 100 (CD100) is a member of the semaphorin family. The family was initially described as axon guidance molecules important for angiogenesis, organogenesis, apoptosis and neoplasia. CD100 was previously utilized as a prognostic factor in tumors and also in STSs. In the present study, protein expression of Ki--67 and CD100 was analyzed by immunohistochemistry in samples of STS patients of the Barretos Cancer Hospital (Barretos, Brazil) to establish prognostic criteria of the disease. Results demonstrate a correlation between CD100 expression and poor prognosis, consistent with a previous study. Moreover, the expression of Ki-67 was identified to correlate with presence of local or locoregional recurrence. To the best of our knowledge, no large casuistic study has revealed this correlation between Ki--67 and local recurrence in STSs. The use of Ki--67 and CD100 as markers in clinical pathological analysis may be suitable as a prognostic criterion in disease progression.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Pós-graduação em Serviço Social - FCHS

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Pós-graduação em Engenharia Elétrica - FEIS

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Osteochondroma is a hamartomatous proliferation of cartilaginous tissue, which is the most common benign tumor of the long bones, but is relatively rare in the maxillofacial region. Most cases of mandibular condylar osteochondroma manifest with facial asymmetry or malocclusion with limited temporomandibular joint movements. Several approaches for management of this lesion have been proposed, as conservative condylectomy technique. This procedure has been suggested a valid approach to minimize facial asymmetry, contributing to the recovery of occlusion associated with no local tumor recurrence, and without condylar reconstruction procedure. Therefore, this article aims to describe a clinical report of a true osteochondroma of the mandibular condyle in a 35-year-old patient who was successfully treated using conservative condylectomy procedure.

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Small-scale farmers in the Brazilian Amazon collectively hold tenure over more than 12 million ha of permanent forest reserves, as required by the Forest Code. The trade-off between forest conservation and other land uses entails opportunity costs for them and for the country, which have not been sufficiently studied. We assessed the potential income generated by multiple use forest management for farmers and compared it to the income potentially derived from six other agricultural land uses. Income from the forest was from (i) logging, carried out by a logging company in partnership with farmers' associations; and (ii) harvesting the seeds of Carapa guianensis (local name andiroba) for the production of oil. We then compared the income generated by multiple-use forest management with the income from different types of agrarian systems. According to our calculations in this study, the mean annual economic benefits from multiple forest use are the same as the least productive agrarian system, but only 25% of the annual income generated by the most productive system. Although the income generated by logging may be considered low when calculated on an annual basis and compared to incomes generated by agriculture, the one-time payment after logging is significant (US$5,800 to US$33,508) and could be used to implement more intensive and productive cropping systems such as planting black pepper. The income from forest management could also be used to establish permanent fields in deforested areas for highly productive annual crops using conservation agriculture techniques. These techniques are alternatives to the traditional land use based on periodic clearing of the forest. Nevertheless, the shift in current practices towards adoption of more sustainable conservation agriculture techniques will also require the technical and legal support of the State to help small farmers apply these alternatives, which aim to integrate forest management in sustainable agricultural production systems.

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The aims of this study are to determine how anuran calling males are spatially and temporally distributed in the Morro do Diabo State Park (MDSP), and to test for indicator species in different breeding habitats. We found high species turnover among breeding habitats of different hydroperiods. Our results indicate that spatial partitioning is more important than seasonal occurrence in permitting species coexistence at MDSP. Indicator Species Analysis identified one species associated with a local stream, one species associated with permanent ponds, two species associated with temporary ponds, and three species associated with a semipermanent pond. Guilds of species do not appear to stratify their distributions throughout the year, since most species occur during the rainy and warm months and are thus temporally overlapping. The main conservation implication of our work is the need to protect the different areas of the park where these unique breeding habitats, and their associated anuran assemblages, are found.