Care in a birth center according to the recommendations of the World Health Organization

Birth centers are maternal care models that use appropriate technology when providing care to birthing women. This descriptive study aimed to characterize intrapartum care in a freestanding birth center, in light of the practices recommended by the World Health Organization (WHO), with 1,079 assisted births from 2006 to 2009 in the Sapopemba Birth Center, São Paulo, Brazil. Results included the use of intermittent auscultation (mean=7 controls); maternal positions during delivery: semi-sitting (82.3%), side-lying (16.0%), other positions (1.7%), oral intake (95.6%); companionship (93.3%); exposure to up to three vaginal examinations (85.4%), shower bathing (84.0%), walking (68.0%), massage (60.1%), exercising with a Swiss ball (51.7%); amniotomy (53.4%), oxytocin use during the first (31.0%) and second stages of labor (25.8%), bath immersion (29.3%) and episiotomy (14.1%). In this birth center, care providers used practices recommended by the WHO, although some practices might have been applied less frequently.

Adaptação transcultural e validação do World Health Organization Health and Work Performance Questionnaire para enfermeiros brasileiros

Estudo com objetivo de adaptar transculturalmente o instrumento Health and Work Performance Questionnaire (HPQ ) e avaliar as propriedades psicométricas da versão brasileira para enfermeiros. O processo de adaptação seguiu o Protocolo de Tradução da Organização Mundial da Saúde. Os dados para a avaliação das propriedades psicométricas foram coletados em um hospital público e de ensino de Ribeirão Preto em 2011. As propriedades psicométricas analisadas foram: validade de face e conteúdo (grupo de especialistas), confiabilidade pelo Alfa de Cronbach e estabilidade por teste-reteste. Na avaliação das propriedades psicométricas, a consistência interna da versão adaptada do HPQ, o alfa de cronbach foi de 0,94 para a seção A e 0,86 para a seção B do instrumento. Na análise das concordâncias da estabilidade teste-reteste, as concordâncias foram positivas e estatisticamente significativas. Dessa forma, a versão adaptada do HPQ mostrou-se válida e confiável na amostra estudada.

Organization of healthcare and assistance to the elderly indigenous population: synergies and particularities of the professional context

This study aimed to describe the effects of the organization of primary healthcare on the assistance provided to the elderly Kaingang population, according to the perception of health professionals that work in this area. It is a qualitative and descriptive study, supported by ethnography methodological references, and was conducted with ten healthcare professionals that work in Faxinal, an indigenous territory in the state of Paraná, in Brazil. Data was collected from November 2010 to February 2012 through participant observation and interviews. The results revealed that health professionals strive to meet the health needs of the elderly Kaingang people; however, there are negative effects that hinder the professional care, especially limited human resources, lack of training and material resources, heavy workload and high turnover rates. This study highlights the need to improve work conditions in order to provide better healthcare.

Pollinator guild organization and its consequences for reproduction in three synchronopatric species of Tibouchina (Melastomataceae)

Pollinator guild organization and its consequences for reproduction in three synchronopatric species of Tibouchina (Melastomataceae). In co-flowering plant species, pollinator sharing can result in interspecific pollen transfer and fecundity reduction. Competition will be relaxed whenever there is a large amount of initial pollen supply or if each plant species occupies different habitat patches. Reproduction in Tibouchina cerastifolia (Naudin) Cogn., T. clinopodifolia (DC.) Cogn. and T. gracilis (Bonpl.) Cogn. was studied in an area of Atlantic rainforest to examine whether synchronopatry induces time partitioning among pollinator species. Eleven bee species comprised the pollinator guild. Among pollinators, there were overlaps in bee species composition and in flower visitation time. Direct competition for pollen in Tibouchina Aubl. at the study site seems to lead to different activity periods among the bee species, in which Bombus pauloensis Friese,1913 was most active earlier, while the other species were active later in the day. Bombus pauloensis, the largest bee species recorded on Tibouchina flowers, was the most important and efficient pollinator. This species harvested pollen before the other species and had the shortest handling time. The plants reproduced sexually by selfing or outcrossing, and hybridization was not avoided by incompatibility reactions at the style. The avoidance of direct competition for pollen and no pollinator partitioning among the synchronopatric species of Tibouchina may reflect a facilitative interaction among these pioneer plants.

Local influence for spatial analysis of soil physical properties and soybean yield using student's t-distribution

The modeling and estimation of the parameters that define the spatial dependence structure of a regionalized variable by geostatistical methods are fundamental, since these parameters, underlying the kriging of unsampled points, allow the construction of thematic maps. One or more atypical observations in the sample data can affect the estimation of these parameters. Thus, the assessment of the combined influence of these observations by the analysis of Local Influence is essential. The purpose of this paper was to propose local influence analysis methods for the regionalized variable, given that it has n-variate Student's t-distribution, and compare it with the analysis of local influence when the same regionalized variable has n-variate normal distribution. These local influence analysis methods were applied to soil physical properties and soybean yield data of an experiment carried out in a 56.68 ha commercial field in western Paraná, Brazil. Results showed that influential values are efficiently determined with n-variate Student's t-distribution.

Gender Might Be Factor for Student Admission in Two Brazilian Medical Schools

This is a secondary data-based study conducted to investigate whether gender is related to acceptance. Two Brazilian Medical Schools, Universities A and B, were studied. Their entrance exams (EE) were analysed and the number of candidates who took the EE was compared to the number of students admitted to the MS according to gender, in the period between 1995 and 2009. The same data from MS in the United States in 2011 was also evaluated. There was an increase in the percentage of female applicants but it did not correspond to the percentage of admitted students of the same gender. There was a trend of selecting men. At A, 39.3% of the applicants and 47% of the admitted students were men (OR = 1.37; CI95% = 1.24 – 1.51). In B, men represented 39.3% of the applicants and 65.4% of the admitted students (OR = 2.93; CI 95% = 2.76 – 3.11). This was not seen in US MS. The analysis of the EE suggests that the greater selection of men could be a product of EE format.

Agricultural engineering at UNICAMP: undergraduate student dropout analysis

Nowadays, dropping out in B.Sc. courses practically occurs in all Universities of the contemporary world. Undergraduate student withdraw could means several losses as, to the student, not to graduate, to the teacher, for not accomplishing his goal as educator, to the university, for not attending its mission, to the society, economic and social losses and also to the family for unfulfilling the dreams. The objective of this research is to present a quantitative study on the dropping out rate in the Agricultural Engineering B.Sc. program (BSAGENG) at State University of Campinas (UNICAMP), seeking to contribute to the understanding of this issue. It has been determined the dropping out rate from 1995 to 2006 based on the university official data, by employing four different methods of calculation. Three of the methods revealed that dropping out rate is very close to the graduation index, i.e., close to 50%. Regardless of the adopted method for the dropping rate estimation and the statistics demonstrating that the agricultural engineering undergraduate course at UNICAMP figures falls within similar courses normality in Brazil, it should be recognized that a public institution of education should be concerned in presenting such figures. A detailed and deep analysis must be outlined in further studies seeking for specific actions aiming to reduce dropping out process.

Influência local em um modelo espacial linear da produtividade da soja utilizando distribuição t-Student

O uso das ferramentas da geoestatística, aliadas à agricultura de precisão permitem o acompanhamento das áreas agrícolas produtoras de soja, estabelecendo as relações de dependência espacial entre os pontos amostrados. A modelagem da estrutura de variabilidade espacial possibilita a construção de mapas temáticos dos atributos estudados, utilizando como método de interpolação a krigagem. Porém, a presença de valores atípicos entre os elementos amostrais pode influenciar na construção e interpretação desses mapas. A distribuição de probabilidades t-Student tem sido utilizada na tentativa de diminuir a influência dos valores atípicos durante a estimativa dos parâmetros de dependência espacial, por ter caudas mais pesadas que a distribuição normal. A detecção dos valores influentes na área em estudo, por meio da análise de diagnósticos de influência local, confere maior confiabilidade na utilização dos mapas gerados, corroborando a aplicação de insumos. Deste modo, o objetivo deste trabalho foi aplicar as técnicas de influência local em dados espacialmente referenciados, com os modelos de perturbação aditiva e utilizando a matriz escala, considerando a distribuição t-Student n-variada. Foi utilizado um modelo espacial linear para o estudo de dados da produtividade da soja em função da altura média de plantas e do número médio de vagens por planta. As técnicas de influência local foram eficientes para detectar pontos que influenciam na escolha do modelo geoestatístico, nas estimativas dos parâmetros e na construção do mapa temático.

Efeitos da reconstrução mamária imediata sobre a qualidade de vida de mulheres mastectomizadas

OBJETIVO: avaliar prospectivamente os efeitos da reconstrução mamária imediata sobre a qualidade de vida de mulheres mastectomizadas. MÉTODOS: foram incluídas 76 mulheres submetidas à mastectomia no Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas, em Campinas, São Paulo, Brasil, entre Agosto de 2007 a Dezembro de 2008. Dois grupos foram formados, 41 mulheres no grupo de mulheres submetidas à mastectomia associada à reconstrução imediata da mama (M+RI) e 35 no grupo de mulheres submetidas à mastectomia exclusiva (M). A avaliação da qualidade de vida foi feita com o uso do questionário World Health Organization - Quality of Life (WHOQOL-100). O questionário foi aplicado em três momentos: na data da internação, após um mês e novamente seis meses após a cirurgia. Os escores do WHOQOL-100 foram calculados conforme roteiro de análise fornecido pela Organização Mundial de Saúde. Para análise comparativa dos escores entre grupos, foram utilizados os testes t de Student, exato de Fisher, χ2 e Mann-Whitney, quando os dados eram paramétricos. Para análise das medidas repetidas, ao longo do tempo, foi utilizada a ANOVA e ANOVA para medidas repetidas. RESULTADOS: em todos os momentos, desde o pré-operatório, a pontuação média do Grupo M+RI foi maior que o Grupo M, principalmente nos domínios físico, psicológico, nível de independência e relações sociais. Dos seis domínios abrangidos no questionário, em três (físico, relações sociais, meio ambiente) não foram encontradas diferenças significativas. Houve melhor pontuação para o Grupo M+RI (15,5 a 14,9 no M+RI e 14,3 a 14,2 no M; p=0,04) no domínio psicológico. Observou-se redução significativa do nível de independência no primeiro mês pós-operatório em ambos os grupos, com recuperação significativa após seis meses. CONCLUSÕES: os presentes resultados sugerem que a reconstrução mamária imediata é benéfica para aspectos psicológicos da qualidade de vida, sem afetar a funcionalidade física da mulher.

Quality of life and menopausal symptoms in women with liver transplants

PURPOSE: To assess quality of life and climacteric symptoms in women with and without liver transplants. METHODS: This was a cross-sectional study of 52 women undergoing follow-up at a university hospital in southeastern Brazil from February 4th, 2009 to January 5th, 2011. Twenty-four of these women were 35 years old or older and had undergone liver transplantation at least one year before study entry. The remaining 28 women had no liver disease and were matched by age and menstrual patterns to the patients with transplants. The abbreviated version of the World Health Organization (WHOQOL-BREF) questionnaire was used to assess quality of life. Menopausal symptoms were assessed using the Menopause Rating Scale (MRS). Statistical analysis was carried out by Student's t-test, Mann-Whitney test and analysis of variance. Correlations between MRS and the WHOQOL-BREF were established by correlation coefficients. RESULTS: The mean age of the women included in the study was 52.2 (±10.4) years and the mean time since transplantation was 6.1 (±3.3) years. Women with liver transplants had better quality of life scores in the environment domain (p=0.01). No difference was noted between the two groups in any domain of the MRS. For women in the comparison group, there was a strongly negative correlation between somatic symptoms in the MRS and the physical domain of the WHOQOL-BREF (p<0.01; r=-0.8). In contrast, there was only a moderate association for women with liver transplants (p<0.01; r=-0.5). CONCLUSIONS: Women with liver transplants had better quality of life scores in the domain related to environment and did not exhibit more intense climacteric symptoms than did those with no liver disease. Climacteric symptoms negatively influenced quality of life in liver transplant recipients, although less intensely than in women without a history of liver disease.

Evolution of circadian organization in vertebrates

Circadian organization means the way in which the entire circadian system above the cellular level is put together physically and the principles and rules that determine the interactions among its component parts which produce overt rhythms of physiology and behavior. Understanding this organization and its evolution is of practical importance as well as of basic interest. The first major problem that we face is the difficulty of making sense of the apparently great diversity that we observe in circadian organization of diverse vertebrates. Some of this diversity falls neatly into place along phylogenetic lines leading to firm generalizations: i) in all vertebrates there is a "circadian axis" consisting of the retinas, the pineal gland and the suprachiasmatic nucleus (SCN), ii) in many non-mammalian vertebrates of all classes (but not in any mammals) the pineal gland is both a photoreceptor and a circadian oscillator, and iii) in all non-mammalian vertebrates (but not in any mammals) there are extraretinal (and extrapineal) circadian photoreceptors. An interesting explanation of some of these facts, especially the differences between mammals and other vertebrates, can be constructed on the assumption that early in their evolution mammals passed through a "nocturnal bottleneck". On the other hand, a good deal of the diversity among the circadian systems of vertebrates does not fall neatly into place along phylogenetic lines. In the present review we will consider how we might better understand such "phylogenetically incoherent" diversity and what sorts of new information may help to further our understanding of the evolution of circadian organization in vertebrates

Centromere domain organization and histone modifications

Centromere function requires the proper coordination of several subfunctions, such as kinetochore assembly, sister chromatid cohesion, binding of kinetochore microtubules, orientation of sister kinetochores to opposite spindle poles, and their movement towards the spindle poles. Centromere structure appears to be organized in different, separable domains in order to accomplish these functions. Despite the conserved nature of centromere functions, the molecular genetic definition of the DNA sequences that form a centromere in the yeasts Saccharomyces cerevisiae and Schizosaccharomyces pombe, in the fruit fly Drosophila melanogaster, and in humans has revealed little conservation at the level of centromere DNA sequences. Also at the protein level few centromere proteins are conserved in all of these four organisms and many are unique to the different organisms. The recent analysis of the centromere structure in the yeast S. pombe by electron microscopy and detailed immunofluorescence microscopy of Drosophila centromeres have brought to light striking similarities at the overall structural level between these centromeres and the human centromere. The structural organization of the centromere is generally multilayered with a heterochromatin domain and a central core/inner plate region, which harbors the outer plate structures of the kinetochore. It is becoming increasingly clear that the key factors for assembly and function of the centromere structure are the specialized histones and modified histones which are present in the centromeric heterochromatin and in the chromatin of the central core. Thus, despite the differences in the DNA sequences and the proteins that define a centromere, there is an overall structural similarity between centromeres in evolutionarily diverse eukaryotes.

Supraorganized collagen enhances Schwann cell reactivity and organization in vitro

We investigated the reactivity and expression of basal lamina collagen by Schwann cells (SCs) cultivated on a supraorganized bovine-derived collagen substrate. SC cultures were obtained from sciatic nerves of neonatal Sprague-Dawley rats and seeded on 24-well culture plates containing collagen substrate. The homogeneity of the cultures was evaluated with an SC marker antibody (anti-S-100). After 1 week, the cultures were fixed and processed for immunocytochemistry by using antibodies against type IV collagen, S-100 and p75NTR (pan neurotrophin receptor) and for scanning electron microscopy (SEM). Positive labeling with antibodies to the cited molecules was observed, indicating that the collagen substrate stimulates SC alignment and adhesion (collagen IV labeling - organized collagen substrate: 706.33 ± 370.86, non-organized collagen substrate: 744.00 ± 262.09; S-100 labeling - organized collagen: 3809.00 ± 120.28, non-organized collagen: 3026.00 ± 144.63, P < 0.05) and reactivity (p75NTR labeling - organized collagen: 2156.33 ± 561.78, non-organized collagen: 1424.00 ± 405.90, P < 0.05; means ± standard error of the mean in absorbance units). Cell alignment and adhesion to the substrate were confirmed by SEM analysis. The present results indicate that the collagen substrate with an aligned suprastructure, as seen by polarized light microscopy, provides an adequate scaffold for SCs, which in turn may increase the efficiency of the nerve regenerative process after in vivo repair.

Prevalence of child malnutrition at a university hospital using the World Health Organization criteria and bioelectrical impedance data

Malnutrition constitutes a major public health concern worldwide and serves as an indicator of hospitalized patients’ prognosis. Although various methods with which to conduct nutritional assessments exist, large hospitals seldom employ them to diagnose malnutrition. The aim of this study was to understand the prevalence of child malnutrition at the University Hospital of the Ribeirão Preto Medical School, University of São, Brazil. A cross-sectional descriptive study was conducted to compare the nutritional status of 292 hospitalized children with that of a healthy control group (n=234). Information regarding patients’ weight, height, and bioelectrical impedance (i.e., bioelectrical impedance vector analysis) was obtained, and the phase angle was calculated. Using the World Health Organization (WHO) criteria, 35.27% of the patients presented with malnutrition; specifically, 16.10% had undernutrition and 19.17% were overweight. Classification according to the bioelectrical impedance results of nutritional status was more sensitive than the WHO criteria: of the 55.45% of patients with malnutrition, 51.25% exhibited undernutrition and 4.20% were overweight. After applying the WHO criteria in the unpaired control group (n=234), we observed that 100.00% of the subjects were eutrophic; however, 23.34% of the controls were malnourished according to impedance analysis. The phase angle was significantly lower in the hospitalized group than in the control group (P<0.05). Therefore, this study suggests that a protocol to obtain patients’ weight and height must be followed, and bioimpedance data must be examined upon hospital admission of all children.