58 resultados para Corrective measures


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Poor posture control has been associated with an increased risk of falls and mobility disability among older adults. This study was conducted to assess the test-retest reliability and sensitivity to group differences regarding the time-limit (TLimit) of one-leg standing and selected balance parameters obtained with a force platform in older and young adults. A secondary purpose was to assess the relationship between TLimit and these balance parameters. Twenty-eight healthy older adults (age: 69±5years) and thirty young adults (age: 21±4years) participated in this study. Two one-leg stance tasks were performed: (1) three trials of 30s maximum and (2) one TLimit trial. The following balance parameters were computed: center of pressure area, RMS sway amplitude, and mean velocity and mean frequency in both the anterio-posterior and medio-lateral directions. All balance parameters obtained with the force platform as well as the TLimit variable were sensitive to differences in balance performance between older and young adults. The test-retest reliability of these measures was found to be acceptable (ICC: 0.40-0.85), with better ICC scores observed for mean velocity and mean frequency in the older group. Pearson correlations coefficients (r) between balance parameters and TLimit ranged from -0.16 to -0.54. These results add to the current literature that can be used in the development of measurement tools for evaluating balance in older and young adults. © 2013 Elsevier Ltd.

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The influenza virus has been a challenge to science due to its ability to withstand new environmental conditions. Taking into account the development of virus sequence databases, computational approaches can be helpful to understand virus behavior over time. Furthermore, they can suggest new directions to deal with influenza. This work presents triplet entropy analysis as a potential phylodynamic tool to quantify nucleotide organization of viral sequences. The application of this measure to segments of hemagglutinin (HA) and neuraminidase (NA) of H1N1 and H3N2 virus subtypes has shown some variability effects along timeline, inferring about virus evolution. Sequences were divided by year and compared for virus subtype (H1N1 and H3N2). The nonparametric Mann-Whitney test was used for comparison between groups. Results show that differentiation in entropy precedes differentiation in GC content for both groups. Considering the HA fragment, both triplet entropy as well as GC concentration show intersection in 2009, year of the recent pandemic. Some conclusions about possible flu evolutionary lines were drawn. © 2013 Elsevier B.V.

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Vascular access is the major risk factor for bacteremia, hospitalization, and mortality among hemodialysis (HD) patients. The type of vascular access most associated with bloodstream infection is central venous catheter (CVC). The incidence of catheter-related bacteremia ranges between 0.6 and 6.5 episodes per 1000 catheter days and increases linearly with the duration of catheter use. Given the high prevalence of CVC use and its direct association with catheter-related bacteremia, which adversely impacts morbidity and mortality rates and costs among HD patients, several prevention measures aimed at reducing the rates of CVC-related infections have been proposed and implemented. As a result, a large number of clinical trials, systematic reviews, and meta-analyses have been conducted in order to assess the effectiveness, clinical applicability, and long-term adverse effects of such measures. In the following article, prophylactic measures against CVC-related infections in HD patients and their possible advantages and limitations will be discussed, and the more recent literature on clinical experience with prophylactic antimicrobial lock therapy in HD CVCs will be reviewed.

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The efficacy of sulfadoxine + trimethoprim in comparison to management measures for the control of Eimeria parasitism was studied in naturally infected sheep that were raised in a feedlot and were clinically asymptomatic for eimeriosis. Weight gain was also evaluated in these animals. The following groups were formed with 15 animals/group: TO!, control animals that received saline solution and maintenance of the same management measures that were performed before the study; T02, animals that received two intramuscular doses of sulfadoxine (20 mg/kg) + trimethoprim (4 mg/kg) with a 14-day interval; T03, sheep that received two intramuscular doses of sulfadoxine (20 mg/kg) + trimethoprim (4 mg/kg) with a 14-day interval plus management measures (wood shaving bedding was changed every Monday, and 30g of ammonium sulfate were applied to the bedding and other facilities were performed every Thursday, 10 mL/20 L of water); and T04, animals that received only the management measures described for the previous group. The highest efficacy rates (arithmetic mean) for the T02 group (sulfadoxine + trimethoprim at days 0 and 14) were 21.04% and 21.98% on the 14th and 28th days after the first treatment (DAFT), respectively. However, the treatment showed efficacy rates below 17% and was totally ineffective from the 70th DAFT to the end of the study. In both the T03 (chemical treatment+ management) and T04 (management only) groups, a significant (P <= 0.05) reduction of oocyst shedding per gram of feces was observed in the animals from the 14th DAFT in comparison to the control group; however, an efficacy rate above 90% was observed from the 28th DAFT. Animals belonging to the T02, T03 and T04 groups presented with alterations in weight gain of 0.57 kg, 4.30 kg and 4.53 kg, respectively, in comparison with the control animals (T01) throughout the 91-day study period. Thus, it is possible to conclude that the two-dose sulfadoxine + trimethoprim treatment, given with a 14-day interval, had little no effect on the oocyst shedding. Moreover, the adopted management measures were enough to cause a significant decrease in the animal parasite loads. (C) 2013 Published by Elsevier B.V.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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The development of the sugar and alcohol sector and its sugar cane cultivation has been given in an accelerated way in Pontal do Paranapanema, mainly from the last decade, and with this has taken quick changes in the dynamic socio-economic and environmental of the region, further accentuating some conflicts and dilemmas social and environmental legacy. This work was done in order that these issues are further explored, that of moving towards a greater theoretical-scientific maturity, and even has a better apparatus to support measures (corrective or preventive) that show required anti such conflicts. For this purpose, we used the environmental licensing as a means of doing this analysis, since it is one of the main instruments of control/ regulation of the State against the development of activities of the sugar and alcohol sector. We also used a little of the vast potential of information that is contained in the environmental agencies. In this case, we used six Environmental Impact Study / Environmental Impact Report (EIS /EIR), six Preliminary Environmental Reports(PER), five Characterization of Enterprise Memorials (CEM), among other documents /studies present there. Some of the information, organized and made available in this work, has even greater potential to be exploited. It was also made an essential literature survey and of the laws related to licensing and alcohol and sugar sector

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Solid-organ transplant recipients present a high rate of non-adherence to drug treatment. Few interventional studies have included approaches aimed at increasing adherence. The objective of this study was to evaluate the impact of an educational and behavioral strategy on treatment adherence of kidney transplant recipients. In a randomized prospective study, incident renal transplant patients (n = 111) were divided into two groups: control group (received usual transplant patient education) and treatment group (usual transplant patient education plus ten additional weekly 30-min education/counseling sessions about immunosuppressive drugs and behavioral changes). Treatment adherence was assessed using ITAS adherence questionnaire after 3 months. Renal function at 3, 6, and 12 months, and the incidence of transplant rejection were evaluated. The non-adherence rates were 46.4 and 14.5 % in the control and treatment groups (p = 0.001), respectively. The relative risk for non-adherence was 2.59 times (CI 1.38-4.88) higher in the control group. Multivariate analysis demonstrated a 5.84 times (CI 1.8-18.8, p = 0.003) higher risk of non-adherence in the control group. There were no differences in renal function and rejection rates between groups. A behavioral and educational strategy addressing the patient's perceptions and knowledge about the anti-rejection drugs significantly improved the short-term adherence to immunosuppressive therapy.

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To assess knowledge of nursing undergraduate students about the use of contact precautions. Methodology. There were 106 nursing undergraduate students from three universities within the state of Sao Paulo. The data collection was done between April and May 2012. A questionnaire was elaborated with questions assessing knowledge regarding contact precautions. The data were submitted to statistical procedures in the package MINITAB version 16. The knowledge were rated as adequate, partially adequate and inadequate. Results. There was a predominance of females (86%) and age group between 20 and 29 years (70%). Regarding the definition of contact precaution of diseases in which these measures are used, undergraduate’s knowledge was partially adequate (92% and 44%, respectively). The knowledge was considered adequate for the preventive measures used during assistance (86%). As difficulties mentioned in the use of these measures were discomfort, lack of material, personnel and time. Conclusion. Although undergraduate students know what measures to be used in contact precaution, they do not have adequate knowledge about which diseases they should use them. The three participating universities should reflect on the quality of training for nursing students regarding biosecurity and contact precautions.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)