High fat diet has a prominent effect upon the course of chronic schistosomiasis mansoni in mice

This study investigated whether a long-term high-fat diet has an effect on the outcome of chronic murine schistosomiasis mansoni compared to a standard diet. Swiss Webster female mice (3 weeks old) were fed each diet for up to six months and were then infected with 50 Schistosoma mansoni cercariae. Their nutritional status was assessed by monitoring total serum cholesterol and body mass. Infected mice were examined 6-17 weeks post infection to estimate the number of eggs in faeces. Mice were euthanised the next day. Total serum cholesterol was lower in infected mice in comparison to uninfected controls (p = 0.0055). In contrast, body mass (p = 0.003), liver volume (p = 0.0405), spleen volume (p = 0.0124), lung volume (p = 0.0033) and faecal (p = 0.0064) and tissue egg density (p = 0.0002) were significantly higher for infected mice fed a high-fat diet. From these findings, it is suggested that a high-fat diet has a prominent effect on the course of chronic schistosomiasis mansoni in mice.

The effect of combined polymorphisms in chemokines and chemokine receptors on the clinical course of HIV-1 infection in a Brazilian population

Polymorphisms in genes that encode chemokines or their receptors can modulate susceptibility to human immunodeficiency virus (HIV) infection and disease progression. The objective of this study was to assess the frequency of polymorphisms CCR5-Δ32, CCR2-64I, CCR5-59029A and SDF1-3'A and their role in the course of HIV infection in a Southern Brazilian population. Clinical data were obtained from 249 patients for an average period of 6.4 years and genotypes were determined by standard polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism. Survival analyses were conducted for three outcomes: CD4+ T-cell counts below 200 cells/µL, acquired immune deficiency syndrome (AIDS) or death. The frequency of the polymorphisms CCR5-Δ32, CCR2-64I, CCR5-59029A and SDF1-3'A were 0.024, 0.113, 0.487 and 0.207, respectively. CCR5-Δ32 was associated with a reduction in the risk for CD4+ T-cell depletion and with an increased risk for death after AIDS diagnosis. CCR2-64I was associated with a reduction in the risk for developing AIDS. SDF1-3'A was also associated with decreased risk for AIDS, but its effect was only evident when CCR2-64I was present as well. These results highlight the possibility of using these markers as indicators for the prognosis of disease progression and provide evidence for the importance of analysing the effects of gene polymorphisms in a combined fashion.

Incidence of active mycobacterial infections in Brazilian patients with chronic inflammatory arthritis and negative evaluation for latent tuberculosis infection at baseline - A longitudinal analysis after using TNFa blockers

Several studies point to the increased risk of reactivation of latent tuberculosis infection (LTBI) in patients with chronic inflammatory arthritis (CIAs) after using tumour necrosis factor (TNF)a blockers. To study the incidence of active mycobacterial infections (aMI) in patients starting TNFa blockers, 262 patients were included in this study: 109 with rheumatoid arthritis (RA), 93 with ankylosing spondylitis (AS), 44 with juvenile idiopathic arthritis (JIA) and 16 with psoriatic arthritis (PsA). All patients had indication for anti-TNFa therapy. Epidemiologic and clinical data were evaluated and a simple X-ray and tuberculin skin test (TST) were performed. The control group included 215 healthy individuals. The follow-up was 48 months to identify cases of aMI. TST positivity was higher in patients with AS (37.6%) than in RA (12.8%), PsA (18.8%) and JIA (6.8%) (p < 0.001). In the control group, TST positivity was 32.7%. Nine (3.43%) patients were diagnosed with aMI. The overall incidence rate of aMI was 86.93/100,000 person-years [95% confidence interval (CI) 23.6-217.9] for patients and 35.79/100,000 person-years (95% CI 12.4-69.6) for control group (p < 0.001). All patients who developed aMI had no evidence of LTBI at the baseline evaluation. Patients with CIA starting TNFa blockers and no evidence of LTBI at baseline, particularly with nonreactive TST, may have higher risk of aMI.

Bonafide, type-specific human papillomavirus persistence among HIV-positive pregnant women: predictive value for cytological abnormalities, a longitudinal cohort study

This study investigated the rate of human papillomavirus (HPV) persistence, associated risk factors, and predictors of cytological alteration outcomes in a cohort of human immunodeficiency virus-infected pregnant women over an 18-month period. HPV was typed through L1 gene sequencing in cervical smears collected during gestation and at 12 months after delivery. Outcomes were defined as nonpersistence (clearance of the HPV in the 2nd sample), re-infection (detection of different types of HPV in the 2 samples), and type-specific HPV persistence (the same HPV type found in both samples). An unfavourable cytological outcome was considered when the second exam showed progression to squamous intraepithelial lesion or high squamous intraepithelial lesion. Ninety patients were studied. HPV DNA persistence occurred in 50% of the cases composed of type-specific persistence (30%) or re-infection (20%). A low CD4+T-cell count at entry was a risk factor for type-specific, re-infection, or HPV DNA persistence. The odds ratio (OR) was almost three times higher in the type-specific group when compared with the re-infection group (OR = 2.8; 95% confidence interval: 0.43-22.79). Our findings show that bonafide (type-specific) HPV persistence is a stronger predictor for the development of cytological abnormalities, highlighting the need for HPV typing as opposed to HPV DNA testing in the clinical setting.

Adherence to anti-hypertensive treatment within a chronic disease management program: A longitudinal, retrospective study

Objective This study assessed pharmacological treatment adherence using the Morisky-Green Test and identified related variables. Method A longitudinal and retrospective study examined 283 patients with hypertension (62.5% women, 73.4 [10.9] years old) who were being monitored by a chronic disease management program for 17 months between 2011 and 2012. Nurses performed all the actions of the program, which consisted of advice via telephone and periodic home visits based on the risk stratification of the patients. Results A significant increase in treatment adherence (25.1% vs. 85.5%) and a decrease in blood pressure were observed (p<0.05). Patients with hypertension and chronic renal failure as well as those treated using angiotensin-converting enzyme inhibitors were the most adherent (p<0.05). Patients with hypertension who received angiotensin receptor blockers were less adherent (p<0.05). Conclusions Strategies such as nurse-performed chronic disease management can increase adherence to anti-hypertensive treatment and therefore contribute to the control of blood pressure, minimizing the morbidity profiles of patients with hypertension.

Gerontology course in the nursing undergraduate curricula

Objective To explores nursing faculty members’ attitudes towards older people, their thoughts about gerontological nursing education. Method Five focus groups and a survey were used with nursing faculty members 132 at the three nursing schools to explore their attitudes towards the care of older people and the perceived status of gerontological nursing education. The survey was given to 132 faculty members, including 76 clinical instructors, 40 associate professors and 16 professors. The nursing faculty in general had a positive attitude toward older people (M=3.36, SD 0.25), and teachers’ attitudes were higher than those of their nursing students (M=3.18, SD0.29). Results This study results suggests that Saudi nursing curricula should include more extensive gerontology content and clinical experience with older people. Conclusion This is the first time in Saudi Arabia that research has listened to their voices and examined their commitments toward gerontology education.


The sign of the Cross of Andreas in the iris and Diabetes Mellitus: a longitudinal study

OBJECTIVETo compare the development of diabetes mellitus in subjects with and without the sign of the Cross of Andreas in the iris over a period of four years.METHODA prospective, descriptive study of quantitative approach. This cohort study had 91 patients without the disease, with and without the signal. The monitoring was conducted by means of the records in medical charts.RESULTSAt the end of the research, 28.2% of the group with the sign of the Cross of Andreas was diagnosed with diabetes and 56.5% had two or more episodes of impaired glucose tolerance. In the group without the sign, 4.4% was diagnosed with the disease and 24.5% had two or more episodes of glucose intolerance. There was a statistically significant difference between the groups regarding the development of the disease and glucose intolerance.CONCLUSIONThe group with the Cross of Andreas developed more glucose intolerance and diabetes than the group without the sign.

O poder da pré-escola: evidências de um estudo longitudinal na Inglaterra

No âmbito do debate de experiências de pesquisa sobre a qualidade dos serviços de educação infantil, este artigo documenta as duas primeiras fases de um estudo longitudinal financiado pelo Departamento de Educação do Reino Unido. O projeto Effective provision of pre-school and primary education, 1997-2008 é o maior estudo europeu sobre a eficácia da educação pré-escolar. Apresentam-se aqui objetivos, amostra, metodologia e os principais resultados da pesquisa sobre a educação pré-escolar, que destacam a importância da qualidade nas unidades de educação infantil e mostram como a boa qualidade é essencial e traz benefícios para as crianças da pré-escola aos 11 anos de idade

Educação infantil e políticas municipais: um estudo longitudinal

Este artigo analisa resultados da pesquisa interinstitucional Educação Infantil e formação de profissionais no Estado do Rio de Janeiro (1999-2009), realizada por meio de questionário. O primeiro item faz considerações metodológicas sobre o universo investigado; o segundo trata da organização da Educação Infantil nas Secretarias Municipais de Educação e da cobertura do atendimento educacional; o terceiro analisa a formação dos profissionais, ingresso e carreira, recursos financeiros e materiais. Ao final, destacam-se avanços observados no período e indicam-se aspectos que necessitam com urgência entrar na agenda das políticas públicas municipais.

The use of mini-projects in an undergraduate laboratory course in chemistry

This paper reports the results of a three-year study of the effectiveness of mini-projects in a first year laboratory course in chemistry at a Scottish university. A mini-project is a short, practical problem which requires for its solution the application of the knowledge and skills developed in previously completed set experiments. A number of recommendations have been made about the most appropriate ways of introducing mini-projects into undergraduate laboratory course. The main hypothesis of this survey was concerned with the value of mini-projects in laboratory courses formulated within the context of Information Processing Theory.

Designing an undergraduate laboratory course in general chemistry

From an analysis of a learning model based on the theory of information processing four hypothesis were developed for improving the design of laboratory courses. Three of these hypotheses concerned specific procedures to minimise the load on students' working memories (or working spaces) and the fourth hypothesis was concerned with the value of mini-projects in enhancing meaningful learning of the knowledge and skills underpinning the set experiments. A three-year study of a first year undergraduate chemistry laboratory course at a Scottish university has been carried out to test these four hypotheses. This paper reports the results of the study relevant to the three hypotheses about the burden on students' working spaces. It was predicted from the learning model that the load on students working space should be reduced by appropriate changes to the written instructions and the laboratory organisation and by the introduction of prelab-work and prelab-training in laboratory techniques. It was concluded from research conducted over the three years period that all these hypothesised changes were effective both in reducing the load on students' working spaces and in improving their attitudes to the laboratory course.

Laboratory projects using inquiry-based learning: an application to a practical inorganic course

This paper reports how laboratory projects (LP) coupled to inquiry-based learning (IBL) were implemented in a practical inorganic chemistry course. Several coordination compounds have been successfully synthesised by students according to the proposed topics by the LP-IBL junction, and the chemistry of a number of metals has been studied. Qualitative data were collected from written reports, oral presentations, lab-notebook reviews and personal discussions with the students through an experimental course with undergraduate second-year students at the Universidad Nacional de Colombia during the last 5 years. Positive skills production was observed by combining LP and IBL. Conceptual, practical, interpretational, constructional (questions, explanations, hypotheses), communicational, environmental and application abilities were revealed by the students throughout the experimental course.

Transtornos emocionais e a formação em Medicina: um estudo longitudinal

Transtornos emocionais como ansiedade, estresse e até mesmo burnout têm sido apontados em estudantes de Medicina durante o período de formação. Esta pesquisa investiga a ocorrência destes transtornos em 18 alunos ao longo dos seis anos de um curso de Medicina. Além de um questionário sociodemográfico, foram aplicados diversos instrumentos de avaliação (Idate, MBI, BAI e ISE), uma ou mais vezes em anos subsequentes. Os resultados evidenciaram que os transtornos foram mais intensos no terceiro e quarto anos. O sentimento de realização pessoal foi aumentando no transcorrer do curso, assim como as atitudes de desumanização. A exaustão emocional, por sua vez, apresentou decréscimo no final do curso. Sugere-se um estudo dos fatores de maior pressão, principalmente os relativos aos terceiro e quarto anos do curso, no sentido de modificá-los e/ou minimizar suas consequências nos estudantes. Por outro lado, disciplinas que promovam maior conhecimento do ser humano e, portanto, atitudes de humanização, devem ser implementadas e/ou receber mais destaque. A ênfase do curso deve ser pautada não só na capacitação técnica e desenvolvimento de habilidades, mas, especialmente, no conhecimento do ser humano e nas relações interpessoais e afetivas.

Indicadores da escolha de pediatria por graduandos da universidade de Brasília: estudo longitudinal em série histórica

Os autores analisaram a escolha de residência médica em Pediatria dentre 877 egressos do curso de Medicina da Universidade de Brasília, formados no período 1994-2007. Os dados abrangeram descritores demográficos e de aprendizagem, preferência inicial por carreira, monitoria, rendimento acadêmico, estágio seletivo no internato e inscrição para residência médica. Efetuaram-se análises de contingência e de regressão logística agrupando-se os egressos por escolha de Pediatria ou não. Do total, 9,7% escolheram Pediatria, dentre os quais 44,7% mostraram atração inicial e 45,9% expressaram interesse pela área já na fase clínica. No período 2002-2007, houve declínio significante da escolha, em conexão com menor procura por monitoria e estágio seletivo na área, mas sem tendência temporal na atração inicial. A regressão logística identificou cinco fatores preditivos, nesta ordem decrescente de magnitude de efeito na escolha: estágio seletivo, rendimento global, estilo de aprendizagem reflexivo, ordem de preferência inicial e época da graduação. Os efeitos independentes de sexo e monitoria não foram significantes. Concluindo, os fatores preditivos da escolha de Pediatria incluíram indicadores pessoais e curriculares em vertentes distintas de interesse e influência, num quadro de queda recente da opção pela área.

Internato Longitudinal

O internato médico tem gerado recorrente debate frente às transformações curriculares em andamento no País. A despeito das discussões, um modelo de internato consonante com essas mudanças ainda não foi consistentemente delineado. Neste ensaio, trazemos uma proposta de matriz estruturante para o internato médico. Propomos que o internato médico seja realizado durante os seis anos do curso, de forma longitudinal, tendo como eixo estruturante a clínica da Atenção Básica (AB). Esse modelo de "internato longitudinal" prevê a introdução progressiva na prática clínica, iniciando-se pela AB nos dois primeiros anos, acrescentando-se progressivamente os ambulatórios de especialidades, os estágios hospitalares e demais atividades práticas, alcançando-se, dessa forma, o rol de diversidade e complexidade previsto para o egresso da escola médica.