Motivation and frustration in cardiology trial participation: The patient perspective

OBJECTIVE: The participation of humans in clinical cardiology trials remains essential, but little is known regarding participant perceptions of such studies. We examined the factors that motivated participation in such studies, as well as those that led to participant frustration.METHODS: Patients who had participated in hypertension and coronary arterial disease (phases II, III, and IV) clinical trials were invited to answer a questionnaire. They were divided into two groups: Group I, which included participants in placebo-controlled clinical trials after randomization, and Group II, which included participants in clinical trials in which the tested treatment was compared to another drug after randomization and in which a placebo was used in the washout period.RESULTS: Eighty patients (47 patients in Group I and 33 patients in Group II) with different socio-demographic characteristics were interviewed. Approximately 60% of the patients were motivated to participate in the trial with the expectation of personal benefit. Nine participants (11.2%) expressed the desire to withdraw, which was due to their perception of risk during the testing in the clinical trial (Group I) and to the necessity of repeated returns to the institution (Group II). However, the patients did not withdraw due to fear of termination of hospital treatment.CONCLUSIONS: Although this study had a small patient sample, the possibility of receiving a benefit from the new tested treatment was consistently reported as a motivation to participate in the trials.

Frustration and hydrophobicity interplay in protein folding and protein evolution

A lattice model is used to study mutations and compacting effects on protein folding rates and folding temperature. In the context of protein evolution, we address the question regarding the best scenario for a polypeptide chain to fold: either a fast nonspecific collapse followed by a slow rearrangement to form the native structure or a specific collapse from the unfolded state with the simultaneous formation of the native state. This question is investigated for optimized sequences, whose native state has no frustrated contacts between monomers, and also for mutated sequences, whose native state has some degree of frustration. It is found that the best scenario for folding may depend on the amount of frustration of the native structure. The implication of this result on protein evolution is discussed. (c) 2006 American Institute of Physics.

Analyzing the effect of homogeneous frustration in protein folding

The energy landscape theory has been an invaluable theoretical framework in the understanding of biological processes such as protein folding, oligomerization, and functional transitions. According to the theory, the energy landscape of protein folding is funneled toward the native state, a conformational state that is consistent with the principle of minimal frustration. It has been accepted that real proteins are selected through natural evolution, satisfying the minimum frustration criterion. However, there is evidence that a low degree of frustration accelerates folding. We examined the interplay between topological and energetic protein frustration. We employed a Cα structure-based model for simulations with a controlled nonspecific energetic frustration added to the potential energy function. Thermodynamics and kinetics of a group of 19 proteins are completely characterized as a function of increasing level of energetic frustration. We observed two well-separated groups of proteins: one group where a little frustration enhances folding rates to an optimal value and another where any energetic frustration slows down folding. Protein energetic frustration regimes and their mechanisms are explained by the role of non-native contact interactions in different folding scenarios. These findings strongly correlate with the protein free-energy folding barrier and the absolute contact order parameters. These computational results are corroborated by principal component analysis and partial least square techniques. One simple theoretical model is proposed as a useful tool for experimentalists to predict the limits of improvements in real proteins. © 2013 Wiley Periodicals, Inc.

Aggressive behavior in the genus Gallus sp

The intensification of the production system in the poultry industry and the vertical integration of the poultry agribusiness have brought profound changes in the physical and social environment of domestic fowls in comparison to their ancestors and have modified the expression of aggression and submission. The present review has covered the studies focusing on the different aspects linked to aggressiveness in the genus Gallus. The evaluated studies have shown that aggressiveness and subordination are complex behavioral expressions that involve genetic differences between breeds, strains and individuals, and differences in the cerebral development during growth, in the hormonal metabolism, in the rearing conditions of individuals, including feed restriction, density, housing type (litter or cage), influence of the opposite sex during the growth period, existence of hostile stimuli (pain and frustration), ability to recognize individuals and social learning. The utilization of fighting birds as experimental material in the study of mechanisms that have influence on the manifestation of aggressiveness in the genus Gallus might comparatively help to elucidate important biological aspects of such behavior.

Prevenção de conflitos médico-legais no exercício da medicina

Os conflitos médico-legais que ocorrem no exercício da Cirurgia e da Medicina são motivos de preocupação não só no meio médico, mas também na sociedade como um todo, pois se de um lado geram um maior desgaste emocional ao médico, por outro, os pacientes estão sendo rejeitados. As causas desses conflitos são muitas, envolvendo fatores não assistenciais, como o sistema de saúde distorcido e desorganizado, a falta de participação da sociedade e do médico na melhoria desse sistema, o aparelho formador que lança no mercado grande número de jovens médicos despreparados para o exercício dessa nobre profissão, além da falta do ensino continuado. A solução para esses conflitos não poderá ser por meio de simples criação de leis, e nem pela negativa da existência do erro médico, que ocorre numa freqüência até maior do que os próprios conflitos. Todavia, pode-se afirmar que é muito importante melhorar a relação médico-paciente. É necessário, ainda, que o médico conheça a fundo seus deveres de conduta e que, principalmente, se abstenha de praticar abusos do poder. A sociedade deve também entender que a saúde não é uma questão exclusiva dos médicos e que deve lutar pela melhoria das condições dos níveis de vida.

Entre o êxito e a frustração com a sistematização da assistência de enfermagem

Pesquisa qualitativa orientada pelos referenciais teórico-metodológicos: Interacionismo Simbólico e Grounded Theory para compreender o processo planejamento-implementação da Sistematização da Assistência de Enfermagem (SAE), segundo dois grupos amostrais: enfermeiros e auxiliares/técnicos de enfermagem de um hospital universitário, e desenvolver uma síntese dos modelos teóricos representativos dessas experiências. A saturação teórica configurou-se mediante a análise da 24ª entrevista não diretiva de 12 enfermeiros e de 12 técnicos de enfermagem, lotados em unidades de internação. da análise emergiram dois modelos teóricos, cuja síntese originou o terceiro, intitulado Entre o êxito e a frustração com a operacionalização da SAE: recursos humanos como componente determinante para a visibilidade do enfermeiro no processo de trabalho. Este modelo desvela o déficit de recursos humanos, impulsionando o enfermeiro a realizar uma SAE ilusória, e perpetuando um processo cíclico de sofrimento, por vivenciar a invisibilidade de sua práxis no processo de trabalho.

Estratégias de coping desenvolvidas por cuidadores de idosos portadores de doença crônica

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

The Origin of Nonmonotonic Complex Behavior and the Effects of Nonnative Interactions on the Diffusive Properties of Protein Folding

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

A gravidez na adolescência sob a perspectiva dos familiares: compartilhando projetos de vida e cuidado

Estudo qualitativo, que objetivou apreender o significado da gravidez da adolescente para seus familiares. Empregou-se a entrevista semi-estruturada e discurso do sujeito coletivo. A gravidez da adolescente é representada como problema a ser enfrentado com o suporte familiar. As famílias preocupam-se e se mobilizam para resolver as adversidades. Além do choque pela notícia, impotência quanto à prevenção da gravidez, conformismo, alegria e melhora no relacionamento familiar pela chegada do bebê, evidenciou-se a frustração devido à interrupção/mudança no projeto de vida familiar em relação à adolescente sem um relacionamento estável com o pai da criança. Considera-se que, ao se valorizar a perspectiva dos familiares sobre a gestação na adolescência, o cuidado profissional à adolescente grávida e à família pode se dar em parceria e sintonia com o contexto familiar e social, facilitando o enfrentamento de conflitos e reconhecendo a família como sujeito ativo nesse processo.

Feelings and Perceptions of Women in the Pregnancy-Puerperal Cycle Who Survived Severe Maternal Morbidity

Objetivou-se compreender a experiência relativa à morbidade materna grave, a partir de um grupo de mulheres que vivenciou esse problema. Adotaram-se os preceitos metodológicos da pesquisa qualitativa, sendo o Discurso do Sujeito Coletivo o referencial metodológico. Foram entrevistadas 16 mulheres que vivenciaram a morbidade materna grave. Os resultados foram discutidos a partir de quatro temas: descrevendo o desejo e o planejamento para ter um filho, percebendo seu problema de saúde, sua influência na gestação e para o concepto, passando pelo choque inicial no pós-parto e experienciando a situação de risco: desejos, frustrações e superação. Espera-se que este trabalho possa contribuir para qualificar a assistência de enfermagem, especialmente para reconhecer a diversidade e amplitude de necessidades que mulheres apresentam em situações de morbidade grave, durante o ciclo gravídico puerperal.

Les patients atteints d'hypertension artérielle: approche de leur vécu

The study aims at exploring the experience of the patients suffering from high blood pressure, analysing the difficulties they evoke and trying to generate similarities. It is a qualitative study, based on the phenomenological method. The interviews highlight the fact that the patients are preoccupied only by the symptoms of high blood pressure. They also show that all the patients live through the disease with a lot of emotions, with feelings of frustration, stress, anxiety and helplessness. A better understanding of the patients' experience must enable the nurses to have better targeted actions.

Temperature dependence of structural and electronic properties of the spin-liquid candidate κ-(BEDT-TTF) 2Cu 2(CN) 3

We investigate the effect that the temperature dependence of the crystal structure of a two-dimensional organic charge-transfer salt has on the low-energy Hamiltonian representation of the electronic structure. For that, we determine the crystal structure of κ-(BEDT-TTF) 2Cu 2(CN) 3 for a series of temperatures between T=5 and 300 K by single crystal X-ray diffraction and analyze the evolution of the electronic structure with temperature by using density functional theory and tight binding methods. We find a considerable temperature dependence of the corresponding triangular lattice Hubbard Hamiltonian parameters. We conclude that even in the absence of a change of symmetry, the temperature dependence of quantities like frustration and interaction strength can be significant and should be taken into account. © 2012 American Physical Society.

Multiferroicity in an organic charge-transfer salt that is suggestive of electric-dipole-driven magnetism

Multiferroics, showing simultaneous ordering of electrical and magnetic degrees of freedom, are remarkable materials as seen from both the academic and technological points of view. A prominent mechanism of multiferroicity is the spin-driven ferroelectricity, often found in frustrated antiferromagnets with helical spin order. There, as for conventional ferroelectrics, the electrical dipoles arise from an off-centre displacement of ions. However, recently a different mechanism, namely purely electronic ferroelectricity, where charge order breaks inversion symmetry, has attracted considerable interest. Here we provide evidence for ferroelectricity, accompanied by antiferromagnetic spin order, in a two-dimensional organic charge-transfer salt, thus representing a new class of multiferroics. We propose a charge-order-driven mechanism leading to electronic ferroelectricity in this material. Quite unexpectedly for electronic ferroelectrics, dipolar and spin order arise nearly simultaneously. This can be ascribed to the loss of spin frustration induced by the ferroelectric ordering. Hence, here the spin order is driven by the ferroelectricity, in marked contrast to the spin-driven ferroelectricity in helical magnets. © 2012 Macmillan Publishers Limited. All rights reserved.

Comportamento de poedeiras criadas a diferentes densidades e tamanhos de grupo em ambiente enriquecido

The objective of this work was to determine the behavioral differences among laying hens reared at different densities and group sizes, in an enriched environment. Isa Brownlaying hens with ages from 30 to 32-week-old, in small-sized and deformed pens, were used. Hens were raised during 28 days in bays with shavings bedding, perch and nest. Two group sizes were evaluated (6 and 12 fowls) and at two rearing densities (774 and 1,440 cm2 by fowl) in a factorial arrangement with three replicates. In fifteen-minute video footages, it was recorded the frequency and the expression period for the following behavior were recorded: feather scratching, sand bath, wing beating, drinking water, pecking, head scratching, earth scratching, eating, perching, leg stretching, pursuing, sitting, and nest visiting. The treatments and the interaction between them had significant effects. The six-hen group increased the frequency of behavior types that indicate fowl frustration, regardless of density. The group size is the most important factor for hen well-being.