Redes de empresas e seus efeitos sobre o turismo

O presente artigo tem como objetivo propor um modelo de alinhamento competitivo para a rede de atores do turismo, visando aumentar sua coesão e facilitar a busca de objetivos comuns. Tal proposta foi definida com base na expertise dos autores na análise de redes de turismo, aliada a resultados obtidos na pesquisa em Ouro Preto (MG). Dessa forma, foi possível perceber o peso dos atores envolvidos em função dos critérios de escolha utilizados pelos visitantes para configurar seu caminho dentro da região turística analisada e, assim, reforçar os relacionamentos existentes.

Health education: the role and functions of the specialist and the generalist

Education for health is a process in which all public health and medical care personnel are involved. People learn both formally (planned learning experiences) and informally (unplanned learning experiences). Since the patient, the client, the consummer and the community expect public health and medical care personnel to assist them with health and disease issues and problems, the response of the professional "educates" the customer whether the professional intends to educate or not. Therefore, it is incumbent on all public health and medical care professionals to understand their educational functions and their role in health education. It is also important that the role of the specialist in education be clear. The specialist, as to all other specialists, has an in-depth knowledge of his area of expertise, i.e., the teaching/learning process; s/he may function as a consultant to others to enhance the educational potential of their role or s/he may work with a team or with communities or groups of patients. Specific competencies and knowledge are required of the health education specialist; and there is a body of learning and social change theory which provides a frame of reference for planning, implementing and evaluating educational programs. Working with others to enhance their potential to learn and to make informed decisions about health/disease issues is the hallmark of the health education specialist.

SIMPLIFIED DIAGNOSIS OF MALARIA INFECTION: GFM/PCR/ELISA A SIMPLIFIED NUCLEIC ACID AMPLIFICATION TECHNIQUE BY PCR/ELISA

We report an adaptation of a technique for the blood sample collection (GFM) as well as for the extraction and amplification of Plasmodium DNA for the diagnosis of malaria infection by the PCR/ELISA. The method of blood sample collection requires less expertise and saves both time and money, thus reducing the cost by more than half. The material is also suitable for genetic analysis in either fresh or stored specimens prepared by this method.

Clinical and serological outcomes with different surgical approaches for human hepatic hydatidosis

ABSTRACTINTRODUCTION:Hydatidosis is the result of infection with the larval stages of some species of the genus Echinococcus. Treatment approaches for hydatid cysts include the use of albendazole, surgery, and/or medico-surgical procedures. The choice of the therapeutic surgical approach depends on the cyst number and localization, surgeon expertise, and presence of complications. The present study aimed to compare the outcomes of the following therapeutic approaches for the treatment of hepatic hydatid cysts: pericystectomy; the puncture, aspiration, injection, and reaspiration (PAIR) technique; and the PAIR technique followed by deroofing, evacuation of cysts, and omentoplasty.METHODS:The 54 patients were divided into 3 groups: Group I (14 patients) who underwent pericystectomy, Group II (23 patients) who underwent the PAIR technique, and Group III (17 patients) who underwent the PAIR technique followed by deroofing and omentoplasty. The diagnosis of hydatid cysts was based on serological testing using enzyme-linked immunosorbent assay, abdominal ultrasound, and parasitological examination of the cyst contents. Morbidity, mortality, length of hospital stay, recurrence, and postoperative complications were evaluated.RESULTS:Postoperative bleeding, infection, and recurrence were reported in Groups I and II; Group III did not experience postoperative infection and had shorter hospital stays. Recurrence and postoperative complications did not occur in Group III.CONCLUSIONS:The partial surgical procedure with deroofing, evacuation of the cysts, and omentoplasty, as performed in the present study, is recommended as a safe and effective method for elimination of the entire parasite with minimal possibility for intra-peritoneal spillage.

A inclusão do escore de risco na tomada de decisão em cardiopatia valvar

Fatos clínicos e dados numéricos sustentam interpretações sobre qualidade de vida e sobrevida no portador de cardiopatia valvar. Tais dados são úteis na tomada de decisão sobre interrupção da história natural e substituição por uma história pós-correção hemodinâmica. Competência e expertise interdisciplinar são exigidas para maximizar o resultado necessário e possível. Contudo, o ideal das recomendações para a obtenção do mais alto grau de satisfação terapêutica pelo portador de cardiopatia valvar sofre a influência de um conjunto de variáveis, parte ligadas a especificações do paciente, parte decorrentes de limitações dos métodos. O racional do escore de risco validado para marcadores múltiplos é o acréscimo de acurácia quantitativa à avaliação clínica prognóstica baseada na heterogeneidade da experiência individual e na intuição. Nesse contexto, o uso dos escores de riscos com função de predizer mortalidade pós-operatória são ferramentas úteis, de fácil aplicabilidade e que nos oferece dados objetivos sobre a situação do paciente. Das ferramentas disponíveis (EuroSCORE, STS score e Ambler Score) e utilizadas de forma assistencial, nenhuma apresenta validação em nossa população.

Femoral versus Radial Access in Primary Angioplasty. Analysis of the ACCEPT Registry

Background:The radial access provides a lower risk of bleeding and vascular complications related to the puncture site in comparison to the femoral access. Recent studies have suggested a reduction in mortality associated with the radial access in patients with acute myocardial infarction undergoing percutaneous coronary intervention.Objective:To compare the occurrence of adverse cardiovascular ischemic and hemorrhagic events in patients undergoing primary angioplasty according to the type of arterial access route.Methods:From August 2010 to December 2011, 588 patients undergoing primary percutaneous coronary intervention during acute ST-segment elevation myocardial infarction were assessed; they were recruited from 47 centers participating in the ACCEPT registry. Patients were grouped and compared according to the arterial access used for the procedure.Results:The mean age was 61.8 years; 75% were males and 24% had diabetes mellitus. There was no difference between groups as regards the procedure success rate, as well as regards the occurrence of death, reinfarction, or stroke at six months of follow-up. Severe bleeding was reported in 1.1% of the sample analyzed, with no statistical difference related to the access used.Conclusions:The femoral and radial accesses are equally safe and effective for the performance of primary percutaneous coronary intervention. The low rate of cardiovascular events and of hemorrhagic complications reflects the quality of the participating centers and the operators expertise with the use of both techniques.