Barriers in health care to breast cancer: perception of women

Identifying the barriers in the access to health care to breast cancer perceived by women undergoing chemotherapy.Method: An exploratory descriptive study. The sample consisted of 58 women with breast cancer receiving chemotherapy and registered in the public oncology ambulatory of Aracaju-Sergipe. Data collection was carried out between October 2011 and March 2012 by semistructured interviews, and data were processed using the SPSS, version 17.Results: Among the interviewed women, 37 (63.8%) reported at least a barrier in the trajectory of care for breast cancer. The organizational and health services barriers were the most reported in the periods of investigation and treatment of breast cancer.Conclusion: In face of these findings, the barriers should be considered in public health policies and programs for the control of breast cancer in Sergipe.



The influence of institutionalization on the perception of autonomy and quality of life in old people

Objective To evaluate the influence exercised by institutionalization on the autonomy and perception of quality of life among the institutionalized elderly. Method The study is quasi-experimental (interrupted time series) and longitudinal. The sample is composed for 104 elderly people who went into a three nursing home in Santander, Spain. To assess the quality of life and dependence two scales were used: the Barthel Index and Lawton Index. Results There was an important relationship between autonomy and independence and their deterioration due to their institutionalisation, such as the physical and social aspects. Conclusion It´s important to point out that the dependence of the elderly is a complex phenomenon, which admits many types of intervention, including the customary ones referring to more classic welfare actions which tend to supplant the absence of autonomy in everyday life by facilitating services and attention to make up for this need, without having to resort to institutionalization.

Violence as a research object and intervention in the health field: an analysis from the production of the Research Group on Gender, Health and Nursingi

The study aimed to describe how violence is revealed in the production of the Research Group on Gender, Health and Nursing. This is a historical research of qualitative approach, which evaluated the production of the Research Group, through content analysis. The results show gender as a central category in determining violence and health practices. This aspect determines limitations on professional practices of coping, such as the invisibility of the problem. The female autonomy, the use of alcohol and drugs and social vulnerability play an important relation with the phenomenon and the bond is revealed as potentiality of health practices to address the problem. Conclusion: The gender perspective in nursing research is an innovative field and counter-hegemonic, a possibility to assume a meaning of praxis by transforming potential of understanding and modes of intervention in the phenomenon of gender violence.

MEDICAL STUDENT IN THE FAMILY HEALTH STRATEGY ON THE FIRST YEARS OF COLLEGE: PERCEPTION OF GRADUATES

There is a lack of knowledge about the effective value of the experience gained by medical students who participate in the Family Health Strategy (Estratégia Saúde da Família (ESF)) during the early stages of their medical training. This teaching strategy is based on learning by experiencing the problems that exist in real life. This study proposed to understand the value of this teaching strategy from the viewpoint of the students who had participated, after their graduation. The method adopted was a qualitative study conducted through interviews with students who graduated in the years 2009, 2010 and 2011. The data analysis used the hermeneutic dialectic technique as its model. The graduates considered that this experience enabled them to understand the organization and functioning of the health service and the context of the daily life of the users. This experience facilitated the doctor patient relationship, the development of clinical reasoning and the bond with the user. However the students emphasized that a lack of maturity prevented them gaining a higher level of benefit from the experience. Therefore, although the structure of the course is permeated by advances and challenges, it was concluded that this experience contributed to the student's learning of certain essential elements of medical training.

Primary Health Care from the perception of women living in a rural area

AbstractOBJECTIVEUnderstanding the perception of women living in a rural area about the actions and services of Primary Health Care (PHC) in a municipality of southern Brazil, which is the only one regarded as predominantly rural.METHODA descriptive study of qualitative approach, carried out with women who lived in the countryside and required health services in the 15 days prior to collection.RESULTSThe results registered low fidelity to PHC attributes, focusing its functional axis on sickness, transforming the unit into small points of emergency care and a bureaucratic place where patients are referred to other types of services. The quality of service offered is compromised to offering quick, fragmented and unequal treatment in the rural context.CONCLUSIONThe findings of this study highlight the need for greater efforts in order to adequate the new care model in the development of appropriate actions as designated by PHC in the rural context studied.

Rostrum length, mandible serration, and food and salivary canals areas of selected species of stink bugs (Heteroptera, Pentatomidae)

Laboratory studies were conducted to compare rostrum length morphology of mandible serration and area of food and salivary canals of Dichelops melacanthus (Dallas) (Dm), Euschistus heros (F.) (Eh), Nezara viridula (L.) (Nv), and Piezodorus guildinii (Westwood) (Pg) (Heteroptera: Pentatomidae). Nv showed the longest (5.9 mm) and Pg the shortest (3.5 mm) rostrum length; Dm and Eh were intermediate. Length and width of mandible tip areas holding serration was bigger for Nv (106.0 and 30.2 µm, respectively) and smaller for Pg (71.1 and 23.7 µm), with all species having four central teeth and three pairs of lateral teeth. The inner mandible surface showed squamous texture. Cross-section of food and salivary canals (Fc and Sc) indicated greater area for Nv and Dm compared to Eh and Pg; however, the ratio Fc/Sc, yielded the highest relative area for Pg.

Genetic structure of populations of Pissodes castaneus (De Geer) (Coleoptera, Curculionidae) using amplified fragment length polymorphism

Genetic structure of populations of Pissodes castaneus (De Geer) (Coleoptera, Curculionidae) using amplified fragment length polymorphism. The objective of this study was to determine the genetic structure of populations of Pissodes castaneus from different areas and on different species of Pinus using the PCR-AFLP technique. Twenty samples were analyzed, representing 19 populations from Brazil and one from Florence, Italy, which is the region of origin of P. castaneus. The four combinations of primers generated a total of 367 fragments of DNA, and 100% of polymorphic loci, indicating high degree of molecular polymorphism. The dendrogram did not reveal trends for grouping the populations in relation to origin. The low genetic similarity (0.11 between the most distant groups) and genetic distances of 0.13 and 0.44 for 10 out of the 20 samples may indicate several founding events or multiple introductions of heterogeneous strains into Brazil. The allelic fixation index (Fst) was 0.3851, considered high, and the number of migrants (Nm) was 0.3991, indicating low gene flow among populations. The highest genetic distances were between the population from Irani, SC and Cambará do Sul, RS and Bituruna, PR, indicating an independent founding event or a particular allelic fixation in the former location. The high genetic diversity among populations points out that the populations are genetically heterogeneous with a diverse gene pool in the surveyed areas, what makes them to respond differently to control measures.

Graduating 4th year radiology residents' perception of optimal imaging modalities for neoplasm and trauma: a pilot study from four U.S. universities

OBJECTIVE: Our purpose was to assess 4th year radiology residents' perception of the optimal imaging modality to investigate neoplasm and trauma. MATERIALS AND METHODS: Twenty-seven 4th year radiology residents from four residency programs were surveyed. They were asked about the best imaging modality to evaluate the brain and spine, lungs, abdomen, and the musculoskeletal system. Imaging modalities available were MRI, CT, ultrasound, PET, and X-ray. All findings were compared to the ACR appropriateness criteria. RESULTS: MRI was chosen as the best imaging modality to evaluate brain, spine, abdominal, and musculoskeletal neoplasm in 96.3%, 100%, 70.4%, and 63% of residents, respectively. CT was chosen by 88.9% to evaluate neoplasm of the lung. Optimal imaging modality to evaluate trauma was CT for brain injuries (100%), spine (92.6%), lung (96.3%), abdomen (92.6%), and major musculoskeletal trauma (74.1%); MRI was chosen for sports injury (96.3%). There was agreement with ACR appropriateness criteria. CONCLUSION: Residents' perception of the best imaging modalities for neoplasm and trauma concurred with the appropriateness criteria by the ACR.

Hume, liberty and the object of moral evaluation

Hume's project concerning the conflict between liberty and necessity is ";reconciliatory";. But what is the nature of Hume's project? Does he solve a problem in metaphysics only? And when Hume says that the dispute between the doctrines of liberty and necessity is merely verbal, does he mean that there is no genuine metaphysical dispute between the doctrines? In the present essay I argue for: (1) there is room for liberty in Hume's philosophy, and not only because the position is pro forma compatibilist, even though this has importance for the recognition that Hume's main concern when discussing the matter is with practice; (2) the position does not involve a ";subjectivization"; of every form of necessity: it is not compatibilist because it creates a space for the claim that the operations of the will are non-problematically necessary through a weakning of the notion of necessity as it applies to external objects; (3) Hume holds that the ordinary phenomena of mental causation do not preempt the atribuition of moral responsibility, which combines perfectly with his identification of the object of moral evaluation: the whole of the character of a person, in relation to which there is, nonetheless, liberty. I intend to support my assertions by a close reading of what Hume states in section 8 of the first Enquiry.

A quasi-materialist, quasi-dualist solution to the mind-body problem

If the mental can affect, or be affected by, the physical, then the mental must itself be physical. Otherwise the physical world would not be explanatorily closed. But it is closed. There are reasons to hold that materialism (in both its reductive and non-reductive varieties) is false. So how are we to explain the apparent responsiveness of the physical to the mental and vice versa? The only possible solution seems to be this: physical objects are really projections or isomorphs of objects whose essential properties are mental. (A slightly less accurate way of putting this would be to say: the constitutive - i.e. the non-structural and non-phenomenal - properties of physical objects are mental, i.e. are such as we are used to encountering only in "introspection".) The chair, qua thing that I can know through sense perception, and through hypotheses based strictly thereupon, is a kind of shadow of an object that is exactly like it, except that this other objects essential properties are mental. This line of thought, though radically counterintuitive, explains the apparent responsiveness of the mental to the physical, and vice versa, without being open to any of the criticisms to which materialism, dualistic interaction ism, and epiphenomenalism are open.

Love and rationality: on some possible rational effects of love

In this paper I defend the idea that rather than disrupting rationality, as the common-sense conception has done it, love may actually help us to develop rational ways of thinking and acting. I make the case for romantic or erotic love, since this is the kind of love that is more frequently associated with irrationality in acting and thinking. I argue that this kind of love may make us develop epistemic and practical forms of rationality. Based on an analysis of its characteristic action tendencies, I argue that love may help us to develop an instrumental form of rationality in determining the best means to achieve the object of love. It may also narrow down the number of practical considerations that may help us to achieve our goals. Finally, love may generate rational ways of belief-formation by framing the parameters taken into account in perception and attention, and by bringing into light only a small portion of the epistemic information available. Love may make us perceive reality more acutely.

Digital surface area assessment of broiler chickens

Surface area (SA) of poultry is an important parameter for heat and mass transfer calculations. Optical approaches, such as the moiré technique (MT), are non-destructive, result in accuracy and speed gains, and preserve the object integrity. The objective of this research was to develop and validate a new protocol for estimating the surface area (SA) of broiler chickens based on the MT. Sixty-six Ross breed broiler chickens (twenty-seven male, thirty-nine female, ages spanning all growth phases) were used in this study. The dimensions (length, width and height) and body mass of randomly selected broiler chickens were evaluated in the laboratory. Chickens were illuminated by a light source, and grids were projected onto the chickens to allow their shape to be determined and recorded. Next, the skin and feathers of the chickens were removed to allow SA to be determined by conventional means. These measurements were then used for calibration and validation. The MT for image analysis was a reliable means of evaluating the three-dimensional shape and SA of broiler chickens. This technique, which is neither invasive nor destructive, is a good alternative to the conventional destructive methods.

Anaerobic reactors with biofilter and different diameter-length ratios in cassava starch industry wastewater treatment

The use of anaerobic reactors with media support in the treatment of wastewater from the cassava starch industry has emerged as a viable option because it allows the application of high organic loads and a significant reduction of the HDT needed for the treatment. This research aimed at studying the process of biodigestion in two anaerobic reactors with bamboo support, in the treatment of effluent of cassava starch, by evaluating their performance. The two reactors used present the following diameter: length ratio, 1:6 and 1:3. The organic loads applied to the systems were 0.519, 1.156, 1.471, 3.049, 4.347, 4.708 and 5.601g.L-1.d-1. Regarding the efficiency of removal of COD, TS and TVS, no statistically significant differences were obtained between the reactors. The two systems evaluated showed a stable behavior with respect to the VA/TA (volatile acidity/total alkalinity) for all submitted loads. The reactors tended to the maintenance of biogas production as a function of consumed COD for the last three organic loads applied, indicating an ability to withstand higher organic loads.

Self-perception of sexual life and associated factors: a population study conducted in women aged 50 or more years

PURPOSE: To evaluate the prevalence of women aged 50 years or more who are sexually active and their self-perception with respect to their sexual lives. Associated factors were also assessed. METHODS: A cross-sectional, population-based, self-reported household survey involving 622 Brazilian women aged 50 years or more. Sociodemographic, clinical, and behavioral factors were evaluated. The sexual life self-perception was classified as very good, good, fair, poor, or very poor. Data were analyzed using the χ² test, Fisher's exact test, and Poisson multiple regression analysis. Prevalence ratios and their 95% confidence intervals were also calculated. RESULTS: Of the women in this sample, 228 (36.7%) reported having a sexual life and, of these, 53.5% classified it as very good or good, while 46.5% considered it fair, poor, or very poor. The bivariate analysis indicated that being postmenopausal (p=0.025) and using natural remedies to treat the menopause (p=0.035) were factors associated with the woman classifying their sexual lives as fair, poor, or very poor. Multiple regression analysis showed that more women who had used or were currently using natural remedies for the menopause scored their sexual lives as fair, poor, or very poor. CONCLUSIONS: More than half the women aged 50 years or more in this study were not sexually active. A poorer sexual life self-perception was associated with the use of natural remedies to treat menopausal symptoms. This may indicate a need to improve the way in which these women are evaluated and treated. Women's assessment of their own sexual lives may prove a useful tool in clinical practice.

Farmers' perception about parasitic otitis in Gyr breed from three states of Brazil

This study aimed to know the perception of Gir cattle breeders and farm employees about parasitic otitis and practices regarding methods of treatment and control. A questionnaire was applied on specific topics about the disease. The results showed that the otitis occurred in 25 (89.3%) of the 28 farms studied, where the main etiologic agents were the nematodes Rhabditis spp. The majority of the farmers regarded the disease as a serious problem, mainly in cattle older than eight years of age. About half of the respondents did not observe a correlation between season and prevalence of the otitis; however, 30.8% reported an increase of its incidence during the rainy season. In addition to various methods and products for the rhabditiosis treatment, a lack of standardized preventive or curative protocols was found, suggesting insufficient knowledge about control of the disease.