Occurrence of pathogenic environmental mycobacteria on surfaces in health institutions

The presence of environmental mycobacteria on surfaces in two public health institutions, namely a health center and a hospital in upstate São Paulo (Brazil), was identified by polymerase chain reaction-restriction enzyme analysis (PRA). The possible sources of contamination by these microorganisms were evaluated, contributing to epidemiology studies. Methods: From June 2005 to June 2006, a total of 632 samples were collected from exposed surfaces, such as washbasins, drinking fountains, and other accessible sites, and the mycobacteria present in the samples were isolated and cultured. Results: Sixty-five mycobacteria were isolated from the 632 samples; 47 of which were detected in samples from the health center and 18 in samples collected from the hospital. The isolates were identified by DNA restriction patterns obtained by PRA, and potentially pathogenic species were found to be prevalent among the identified mycobacteria. This study shows that the PRA technique can be employed as a fast and easy method for identification of nontuberculous mycobacteria in public areas. Conclusions: The isolation of environmental mycobacteria from the two health institutions demonstrates that these surfaces are reservoirs of potentially pathogenic mycobacteria and indicates the need for continuous maintenance and monitoring. These data will add to the study of the epidemiology of these microorganisms.

The role of the state in health public policies: an overview of the debate on the concept of State and the Brazilian case

This article is the result of a narrative literature review. The objective is to show the development of an overview on the ideological debate on the design of state health policies. We argue that the role of the state in the development of health policy, even under the pressure of the global market, may create alternatives to promote and drive economic and social development, meaning they are not subject to economic constraints imposed by the liberal ideal of market. Here is a part of a theoretical discussion about the construction and presence of the State in Latin America, particularly in Brazil. We take the approaches of the Marxist tradition and liberal to the issue as reference. This discussion allows us to understand the historical role of the state in the maintenance of social policies, specifically health, is an alternative to public control eases the intense capital mobility promoted by economic globalization. In this sense, the theme makes the Brazilian health an important issue of social sciences, why is the historicity of the construction of the Brazilian health system, as a public policy that can mirror the actual reconstruction of the institutional framework of the Brazilian state with the establishment instances of negotiation between the various spheres of power that strengthen the state in this process of democratization of Brazilian society.

Effects of resistance training in older women with knee osteoarthritis and total knee arthroplasty

OBJECTIVES: This study sought to analyze the effects of resistance training on functional performance, lower-limb loading distribution and balance in older women with total knee arthroplasty (TKA) and osteoarthritis (OA) in the contralateral knee. In addition, this older knee OA and TKA group (OKG) was compared to older (OG) and young women (YG) without musculoskeletal diseases who underwent the same resistance training program.METHODS: Twenty-three women divided into OKG (N = 7), OG (N = 8) and YG (N = 8) had their functional performance, lower-limb loading distribution and balance compared before and after 13 weeks of a twice-weekly progressive resistance training program.RESULTS: At baseline, the OKG showed lower functional performance and unilateral balance, and impaired lower-limb loading distribution compared to the OG and the YG (p<0.05). After resistance training, the OKG showed improvements in functional performance (similar to 13% in sit-to-stand and rising from the floor, similar to 16% in stair-climbing and similar to 23% in 6-minute walking (6 MW)), unilateral balance (similar to 72% and,78% in TKA and OA leg, respectively) and lower-limb loading distribution, which were greater than those observed in the OG and the YG. The OKG showed post-training 6 MW performance similar to that of the OG at baseline. Sit-to-stand performance and unilateral stand balance were further restored to post-training levels of the OG and to baseline levels of the YG.CONCLUSIONS: Resistance training partially restored functional, balance and lower-limb loading deficits in older women with TKA and OA in the contralateral knee. These results suggest that resistance training may be an important tool to counteract mobility impairments commonly found in this population.

Can geometric indices of heart rate variability predict improvement in autonomic modulation after resistance training in chronic obstructive pulmonary disease?

Chronic obstructive pulmonary disease (COPD) is associated with autonomic dysfunctions that can be evaluated through heart rate variability (HRV). Resistance training promotes improvement in autonomic modulation; however, studies that evaluate this scenario using geometric indices, which include nonlinear evaluation, thus providing more accurate information for physiological interpretation of HRV, are unknown. This study aimed to investigate the influence of resistance training on autonomic modulation, using geometric indices of HRV, and peripheral muscle strength in individuals with COPD. Fourteen volunteers with COPD were submitted to resistance training consisting of 24 sessions lasting 60 min each, with a frequency of three times a week. The intensity was determined as 60% of one maximum repetition and was progressively increased until 80% for the upper and lower limbs. The HRV and dynamometry were performed at two moments, the beginning and the end of the experimental protocol. Significant increases were observed in the RRtri (4·81 ± 1·60 versus 6·55 ± 2·69, P = 0·033), TINN (65·36 ± 35·49 versus 101·07 ± 63·34, P = 0·028), SD1 (7·48 ± 3·17 versus 11·04 ± 6·45, P = 0·038) and SD2 (22·30 ± 8·56 versus 32·92 ± 18·78, P = 0·022) indices after the resistance training. Visual analysis of the Poincare plot demonstrated greater dispersion beat-to-beat and in the long-term interval between consecutive heart beats. Regarding muscle strength, there was a significant increase in the shoulder abduction and knee flexion. In conclusion, geometric indices of HRV can predict improvement in autonomic modulation after resistance training in individuals with COPD; improvement in peripheral muscle strength in patients with COPD was also observed.

Low-carbon operations and production: putting training in perspective

The purpose of this paper is mainly to show how training may support low-carbon operations and production management in a more sustainable organizational context. Design/methodology/approach – A conceptual framework to facilitate the integration between training and low-carbon operations and production is presented. Findings – To accomplish better training in a low-carbon organization, some steps should be followed. Challenges may occur, including the necessity of collaboration across the supply chain. Research limitations/implications – The proposed framework should be applied and improved based on the actual conditions in organizations.

School activities in health education and their impact on parents

There is little empirical evidence establishing the value of schoolhouse education of children and the repercussions on their families; a quantitative analysis of instructional intervention in health and its reflection on the family permits quantification of its effectiveness outside of the school setting. To this end, we utilized instruction on head lice in schoolchildren was conducted. A randomized sample of those responsible for students enrolled from the third to fifth grade, from two public schools who had taken an instructional module on pediculosis, were invited to respond to a questionnaire that aimed to ascertain their opinions on the instruction and what its impact was on their family. The variables were assessed by univariat analysis. Of 155 total respondents, 89.9% were the parents of the students. The students that had infestation, in turn, had greater capacity to influence the family on measures against lice. The majority of those responsible supported the instruction and reported being satisfied with the school for having addressed the theme. When the subject pertains to the reality of the students, the school-family link is strengthened. Instruction on pediculosis in school helps bridge the gap between the theoretical and the practical, a harmonization required in health education.

Improvement of heart rate variability after exercise training and its predictors in COPD

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effects of physical training with different intensities of effort on lipid metabolism in rats submitted to the neonatal application of alloxan

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Responses of blood lactate concentration in aerobic and anaerobic training protocols at different swimming exercise intensities in rats

A swimming periodized experimental training model in rats in which different training protocols (TP) were classified in aerobic (A) and anaerobic (AN) intensity levels. The purpose of the present study was to verify if the classification of the TP used in the periodized training experimental model presented the blood lactate concentration [La] response adequate to the aerobic and anaerobic intensities levels. Twenty three male Wistar rats were divided into three groups. Two groups of swimming training (continuous, CT, n = 7, and periodized training, PET, n = 7) rats were evaluated during 5 weeks in eight different TP (TP-1 to TP-8) through the analysis of the [La] response. The third group was the sedentary control (SC, n = 9). The TP were classified in five intensity levels, three aerobic (A-1, A-2, A-3) and two anaerobic (AN-1, AN-2). Analysis of variance (ANOVA one-way, P<0.05) indicated significant differences in the [La] among the TP and among the five intensity levels. All TP of the A-2 and A-3 intensity levels differed from the A-1 and AN-1. The A-1 and AN-1 also differed among them. These findings demonstrate that the TP were classified properly at different levels of aerobic and anaerobic intensities, as based on the [La] response in a way similar to that of high performance swimming with humans. The results offer new perspectives for the study of exercise training in swimming rats at different levels intensity for performance or for health.

Moderate physical activity from childhood contributes to metabolic health and reduces hepatic fat accumulation in adult rats

Background: Obesity, oxidative stress and inflammation, by triggering insulin resistance, may contribute to the accumulation of hepatic fat, and this accumulation by lipotoxicity can lead the organ to fail. Because obesity is growing at an alarming rate and, worryingly, in a precocious way, the present study aimed to investigate the effects of moderate physical training performed from childhood to adulthood on liver fat metabolism in rats. Methods. Twenty rats that were 28days old were divided into two groups: control (C) and trained (T). The C Group was kept in cages without exercise, and the T group was submitted to swimming exercise for 1hour/day, 5days/week from 28 to 90days of age (8weeks) at 80% of the anaerobic threshold determined by the lactate minimum test. At the end of the experiment, the body weight gain, insulin sensitivity (glucose disappearance rate during the insulin tolerance test), concentrations of free fatty acids (FFA) and triglycerides (TG) and hepatic lipogenic rate were analyzed. For the statistical analysis, the Student t-test was used with the level of significance preset at 5%. Results: The T group showed lower body weight gain, FFA concentrations, fat accumulation, hepatic lipogenic rate and insulin resistance. Conclusion: The regular practice of moderate physical exercise from childhood can contribute to the reduction of obesity and insulin resistance and help prevent the development of accumulation of hepatic fat in adulthood. © 2013de Moura et al; licensee BioMed Central Ltd.

Prevalence of health promotion programs in primary health care units in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)