Association between Spirituality and Adherence to Management in Outpatients with Heart Failure

Abstract Background: Spirituality may influence how patients cope with their illness. Objectives: We assessed whether spirituality may influence adherence to management of outpatients with heart failure. Methods: Cross sectional study enrolling consecutive ambulatory heart failure patients in whom adherence to multidisciplinary treatment was evaluated. Patients were assessed for quality of life, depression, religiosity and spirituality utilizing validated questionnaires. Correlations between adherence and psychosocial variables of interest were obtained. Logistic regression models explored independent predictors of adherence. Results: One hundred and thirty patients (age 60 ± 13 years; 67% male) were interviewed. Adequate adherence score was observed in 38.5% of the patients. Neither depression nor religiosity was correlated to adherence, when assessed separately. Interestingly, spirituality, when assessed by both total score sum (r = 0.26; p = 0.003) and by all specific domains, was positively correlated to adherence. Finally, the combination of spirituality, religiosity and personal beliefs was an independent predictor of adherence when adjusted for demographics, clinical characteristics and psychosocial instruments. Conclusion: Spirituality, religiosity and personal beliefs were the only variables consistently associated with compliance to medication in a cohort of outpatients with heart failure. Our data suggest that adequately addressing these aspects on patient’s care may lead to an improvement in adherence patterns in the complex heart failure management.

Fads and fashions in management: the case of ERP

This article discusses the Enterprise Resource Planning (ERP) rage. ERP represents immense investments for companies around the globe and has been promoted as a management panacea. Not surprisingly, many implementations fail to match expectations. In this study, we propose a broader perspective to comprehend the substantive, institutional, and political factors involved in the ERP phenomenon, as an alternative to the "techno-reductionism" that has characterized the prevailing approach on the subject, and present an exploratory survey of 28 implementation experiences, concentrating on the process of adoption, chosen implementation approaches and outcome assessment.

Health and poverty: health management by the woman

The goal this follow-up study was to relate the mother's marital satisfaction to family health status in a low SES. The random sample was made up of 30 families with children under 7 years old: 15 considered as sick (Group A) and 15 as healthy (Group B). Both group had similar demographic characteristics (age of father and mother, persons per family group and age of children) and SES. Results showed that mothers were those mainly in charge of their family groups. Mothers of Group A were significantly less understanding and more dissatisfied than those of Group B ( p < .05 and p < .01). Mothers of Group A had significantly more arguments with their partners than those of Group B (p < .006). Health care was learned less from the child's own mother in group A than in B (p < .05). Health was considered by mothers of Group A as something that "must be taken care of" more than by those of Group B (p < .01). The behaviours of mothers in choosing one of the health systems was similar in both groups. Dissatisfied mothers were associated more with sick family members during the 6 month follow-up. It is suggested that the satisfaction of the mother is a factor that needs further investigation because health is managed by mothers is the large majority of families.

Detection of EBV-DNA in serum samples of an immunosuppressed child during a three years follow-up: association of clinical and PCR data with active infection

Twenty-four whole blood and serum samples were drawn from an eight year-old heart transplant child during a 36 months follow-up. EBV serology was positive for VCA-IgM and IgG, and negative for EBNA-IgG at the age of five years old when the child presented with signs and symptoms suggestive of acute infectious mononucleosis. After 14 months, serological parameters were: positive VCA-IgG, EBNA-IgG and negative VCA-IgM. This serological pattern has been maintained since then even during episodes suggestive of EBV reactivation. PCR amplified a specific DNA fragment from the EBV gp220 (detection limit of 100 viral copies). All twenty-four whole blood samples yielded positive results by PCR, while 12 out of 24 serum samples were positive. We aimed at analyzing whether detection of EBV-DNA in serum samples by PCR was associated with overt disease as stated by the need of antiviral treatment and hospitalization. Statistical analysis showed agreement between the two parameters evidenced by the Kappa test (value 0.750; p < 0.001). We concluded that detection of EBV-DNA in serum samples of immunosuppressed patients might be used as a laboratory marker of active EBV disease when a Real-Time PCR or another quantitative method is not available.

Premature thelarche: identification of clinical and laboratory data for the diagnosis of precocious puberty

PURPOSE: Two groups of girls with premature breast development were studied retrospectively. We tried to identify clinical, radiological, and hormonal parameters that could distinguish between a benign, nonprogressive premature thelarche and a true precocious puberty. METHODS: The clinical outcome of 88 girls with breast enlargement before 6.1 years of age was analyzed. Taking into account the progression of their sexual maturation, we allocated the children into 2 groups: "Isolated Premature Thelarche" (n = 63) and "Precocious Puberty" (n = 25) groups. Chronological and bone ages, height and growth velocity centiles, computerized tomography of hypothalamus-pituitary area, pelvic ultrasonography, gonadotropin response to luteinizing hormone-releasing hormone stimulation as well as basal levels of luteinizing hormone, follicle-stimulating hormone, estradiol, and prolactin were studied in both groups. Statistical analysis were performed using the Student t test to compare the sample means. Fisher's exact test and chi² test were used to analyze the nonparametric variables. RESULTS: Isolated premature thelarche most frequently affected girls younger than 2 years who presented exaggerated follicle-stimulating hormone response to luteinizing hormone-releasing hormone stimulation test. The precocious puberty group had higher initial stature, accelerated growth rate and bone age, increased uterine and ovarian volumes, high spontaneous luteinizing hormone levels by immunofluorimetric assay, as well as a high luteinizing hormone response and peak luteinizing hormone/follicle-stimulating hormone ratio after luteinizing hormone-releasing hormone stimulation. CONCLUSION: At initial presentation, girls who undergo true precocious puberty present advanced bone age, increased uterine and ovarian volumes in addition to breast enlargement, as well as an luteinizing hormone-predominant response after a luteinizing hormone-releasing hormone stimulation test.

New species of Bakeriella (Hymenoptera, Bethylidae) from the New World and new data on geographic distribution

Bakeriella lata sp. nov. (Brazil, Rondônia), Bakeriella aurata sp. nov. (Brazil, Amazonas) and Bakeriella sulcaticeps sp. nov. (Brazil, Amazonas) are described and illustrated. New geographic records and variation data for B. cristata Evans, 1964, B. floridana Evans, 1964, B. flavicornis Kieffer, 1910, B. incompleta Azevedo, 1994, B. mira Evans, 1997, B. montivaga (Kieffer, 1910), B. olmeca Evans, 1964 and B. subcarinata Evans, 1965 are provided. The male of B. incompleta is described for the first time.

Biogeographic analysis of Crocidiinae (Diptera, Bombyliidae): finding congruence among morphological, molecular, fossil and paleogeographical data

Biogeographic studies dealing with Bombyliidae are rare in the literature and no information is available on its origin and early diversification. In this study, we found evidence from molecular phylogeny and from fossil record supporting a Middle Jurassic origin of the Bombylioidea, taken as a starting point to discuss the biogeography and diversification of Crocidiinae. Based on a previously published phylogenetic hypothesis, we performed a Brooks Parsimony Analysis (BPA) to discuss the biogeographical history of Crocidiinae lineages. This subfamily is mostly distributed over arid areas of the early components of the Gondwanaland: Chile and southern Africa, but also in southwestern Palaearctic and southwestern Nearctic. The vicariant events affecting the Crocidiinae biogeography at the generic level seems to be related to the sequential separation of a Laurasian clade from a Gondwanan clade followed by the splitting of the latter into smaller components. This also leads to a hypothesis of origin of the Crocidiinae in the Middle Jurassic, the same period in which other bombyliid lineages are supposed to have arisen and irradiated.

Carbon balance and crop residue management in dynamic equilibrium under a no-till system in Campos Gerais

The adoption of no-tillage systems (NT) and the maintenance of crop residues on the soil surface result in the long-term increase of carbon (C) in the system, promoting C sequestration and reducing C-CO2 emissions to the atmosphere. The purpose of this study was to evaluate the C sequestration rate and the minimum amount of crop residues required to maintain the dynamic C equilibrium (dC/dt = 0) of two soils (Typic Hapludox) with different textural classes. The experiment was arranged in a 2 x 2 x 2 randomized block factorial design. The following factors were analyzed: (a) two soil types: Typic Hapludox (Oxisol) with medium texture (LVTM) and Oxisol with clay texture (LVTA), (b) two sampling layers (0-5 and 5-20 cm), and (c) two sampling periods (P1 - October 2007; P2 - September 2008). Samples were collected from fields under a long-term (20 years) NT system with the following crop rotations: wheat/soybean/black oat + vetch/maize (LVTM) and wheat/maize/black oat + vetch/soybean (LVTA). The annual C sequestration rates were 0.83 and 0.76 Mg ha-1 for LVTM and LVTA, respectively. The estimates of the minimum amount of crop residues required to maintain a dynamic equilibrium (dC/dt = 0) were 7.13 and 6.53 Mg ha-1 year-1 for LVTM and LVTA, respectively. The C conversion rate in both studied soils was lower than that reported in other studies in the region, resulting in a greater amount of crop residues left on the soil surface.

Cover crops and herbicide timing management on soybean yield under no-tillage system

The objective of this work was to evaluate the effect of cover crops and timing of pre-emergence herbicide applications on soybean yield under no-tillage system. The experiment consisted of four cover crops (Panicum maximum, Urochloa ruziziensis, U. brizantha, and pearl millet) and fallow, in addition to four herbicide timings (30, 20, 10, and 0 days before soybean sowing), under no-tillage system (NTS), and of two control treatments under conventional tillage system (CTS). The experimental design was a completely randomized block, in a split-plot arrangement, with three replicates. Soybean under fallow, P. maximum, U. ruziziensis, U. brizantha, and pearl millet in the NTS and soybean under U. brizantha in the CTS did not differ significantly regarding yield. Soybean under fallow in the CTS significantly reduced yield when compared to the other treatments. The amount of straw on soil surface did not significantly affect soybean yield. Chemical management of P. maximum and U. brizantha near the soybean sowing date causes significant damage in soybean yield. However, herbicide timing in fallow, U. ruziziensis, and pearl millet does not affect soybean yield.

Genetic diversity of irrigated barley based on molecular and quantitative data and on malting quality

The objective of this work was to quantify the genetic diversity of elite genotypes of irrigated barley in the Brazilian savanna. Thirty elite barley genotypes from Embrapa Cerrados' collection were evaluated using 160 RAPD markers, 12 agronomic traits related to yield components, and 10 malting quality parameters. The genetic dissimilarity matrices based on molecular markers, quantitative traits, and malting quality characters were calculated and a cluster analysis was performed using the unweighted pair-group method with arithmetic mean (UPGMA) as grouping criterion. High genetic diversity among accessions were observed. The estimated genetic dissimilarities were weakly correlated, showing the complementarity of the different character groups. Selection indices and graphical dispersion analysis allowed the selection of promising genotypes and the indication of suitable crosses for maximizing the heterotic effects in breeding programs for irrigated barley in the Brazilian savanna.

Genetic variability of hull-less barley accessions based on molecular and quantitative data

The objective of this work was to characterize and quantify the genetic, molecular, and agronomic variability of hull-less barley genotypes, for the selection of parents and identification of genotypes adapted to the irrigated production system in the Brazilian Cerrado. Eighteen hull-less barley accessions were evaluated, and three covered barley accessions served as reference. The characterization was based on 157 RAPD molecular markers and ten agronomic traits. Genetic distance matrices were obtained based on molecular markers and quantitative traits. Graphic grouping and dispersion analyses were performed. Genetic, molecular, and agronomic variability was high among genotypes. Ethiopian accessions were genetically more similar, and the Brazilian ones were genetically more distant. For agronomic traits, two more consistent groupings were obtained, one with the most two-rowed materials, and the other with six-rowed materials. The more diverging materials were the two-rowed CI 13453, CN Cerrado 5, CN Cerrado 1, and CN Cerrado 2. The PI 356466, CN Cerrado 1, PI 370799, and CI 13453 genotypes show agronomic traits of interest and, as genetically different genotypes, they are indicated for crossing, in breeding programs.

Combined experimental powder X-ray diffraction and DFT data to obtain the lowest energy molecular conformation of friedelin

Friedelin molecular conformers were obtained by Density Functional Theory (DFT) and by ab initio structure determination from powder X-ray diffraction. Their conformers with the five rings in chair-chair-chair-boat-boat, and with all rings in chair, are energy degenerated in gas-phase according to DFT results. The powder diffraction data reveals that rings A, B and C of friedelin are in chair, and rings D and E in boat-boat, conformation. The high correlation values among powder diffraction data, DFT and reported single-crystal data indicate that the use of conventional X-ray diffractometer can be applied in routine laboratory analysis in the absence of a single-crystal diffractometer.

Silicon and rice disease management

The element silicon (Si) is not considered an essential nutrient for plant function. Nevertheless, Si is absorbed from soil in large amounts that are several fold higher than those of other essential macronutrients in certain plant species. Its beneficial effects have been reported in various situations, especially under biotic and abiotic stress conditions. The most significant effect of Si on plants, besides improving their fitness in nature and increasing agricultural productivity, is the restriction of parasitism. There has been a considerable amount of research showing the positive effect of Si in controlling diseases in important crops. Rice (Oryza sativa), in particular, is affected by the presence of Si, with diseases such as blast, brown spot and sheath blight becoming more severe on rice plants grown in Si-depleted soils. The hypothesis underlying the control of some diseases in both mono- and di-cots by Si has been confined to that of a mechanical barrier resulting from its polymerization in planta. However, some studies show that Si-mediated resistance against pathogens is associated with the accumulation of phenolics and phytoalexins as well as with the activation of some PR-genes. These findings strongly suggest that Si plays an active role in the resistance of some plants to diseases rather than forming a physical barrier that impedes penetration by fungal pathogens.

Effects of irrigated rice sowing season and imazapyr + imazapic time of application on rice grain yield and red rice management

Irrigated rice sowing season and red rice competition are among the main factors affecting grain yield. The objective of this work was to evaluate the sowing date of irrigated rice and moments of application of the herbicide imazapyr + imazapic to control red rice management and irrigated rice grain yield. Eight experiments were performed at the following dates (09/30, 10/19, 11/08 and 12/01) for the 2010/2011 harvest season and (09/27, 10/17, 11/08 and 12/05) for the 2011/2012 harvest season. The treatments were: application of the herbicide imazapyr + imazapic at doses of 105+35 g ha-1 in pre-emergence (PRE); 52.5+17.5 g ha‑1 in pre-emergence and 52.5+17.5 g ha-1 in post-emergence (PRE + POST); and 105+35 g ha-1 in post- emergence (POST), and a control without application and no weeding. The cultivar Puitá Inta CL was used and a randomized block design with four replicates. A joint analysis of the experiments was carried out. There was less emergence of red rice and higher grain yield of the irrigated rice at the early periods (09/30/10 and 09/27/11), with 10,578 and 8,653 kg ha-1, respectively. At the end of the season (12/01/10 and 12/05/11), there was greater reduction of the red rice seed bank. Sowing at the beginning of the recommended period provided more irrigated rice grain yield. The application of imazapyr + imazapic at a dose of 52.5+17.5 g ha-1 in PRE + 52.5+17.5 g ha-1 POST, and 105+35 g ha-1 only in PRE and POST was effective in the control of red rice.