19 resultados para advanced practice, extended practice, scope of practice, performance level, competency standards

em Scielo Saúde Pública - SP


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OBJECTIVE: To evaluate the discriminative and diagnostic values of neuropsychological tests for identifying schizophrenia patients. METHODS: A cross-sectional study with 36 male schizophrenia outpatients and 72 healthy matched volunteers was carried out. Participants underwent the following neuropsychological tests: Wisconsin Card Sorting test, Verbal Fluency, Stroop test, Mini Mental State Examination, and Spatial Recognition Span. Sensitivity and specificity estimated the diagnostic value of tests with cutoffs obtained using Receiver Operating Characteristic curves. The latent class model (diagnosis of schizophrenia) was used as gold standard. RESULTS: Although patients presented lower scores in most tests, the highest canonical function for the discriminant analysis was 0.57 (Verbal Fluency M). The best sensitivity and specificity were obtained in the Verbal Fluency M test (75 and 65, respectively). CONCLUSIONS: The neuropsychological tests showed moderate diagnostic value for the identification of schizophrenia patients. These findings suggested that the cognitive impairment measured by these tests might not be homogeneous among schizophrenia patients.

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INTRODUCTION: Human cytomegalovirus (HCMV) is often reactive in latently infected immunosuppressed patients. Accordingly, HCMV remains one of the most common infections following solid organ and hemopoietic stem cell transplantations, resulting in significant morbidity, graft loss and occasional mortality. The early diagnosis of HCMV disease is important in immunosuppressed patients, since in these individuals, preemptive treatment is useful. The objective of this study was to compare the performance of the in-house qualitative polymerase chain reaction (PCR) and pp65 antigenemia to HCMV infection in immunosuppressed patients in the Hospital de Clínicas of Porto Alegre (HCPA). METHODS: A total of 216 blood samples collected between August 2006 and January 2007 were investigated. RESULTS: Among the samples analyzed, 81 (37.5%) were HCMV-positive by PCR, while 48 (22.2%) were positive for antigenemia. Considering antigenemia as the gold standard, sensitivity, specificity, positive predictive values and negative predictive values for PCR were 87.5%, 76.8%, 51.8% and 95.5% respectively. CONCLUSIONS: These results demonstrated that qualitative PCR has high sensitivity and negative predictive value (NPV). Consequently PCR is especially indicated for the initial diagnosis of HCMV infection. In the case of preemptive treatment strategy, identification of patients at high-risk for HCMV disease is fundamental and PCR can be useful tool.

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Multiple locus sequence typing (MLST) was undertaken to extend the genetic characterization of 29 isolates of Bacillus cereus and Bacillus thuringiensis previously characterized in terms of presence/absence of sequences encoding virulence factors and via variable number tandem repeat (VNTR). Additional analysis involved polymerase chain reaction for the presence of sequences (be, cytK, inA, pag, lef, cya and cap), encoding putative virulence factors, not investigated in the earlier study. MLST analysis ascribed novel and unique sequence types to each of the isolates. A phylogenetic tree was constructed from a single sequence of 2,838 bp of concatenated loci sequences. The strains were not monophyletic by analysis of any specific housekeeping gene or virulence characteristic. No clear association in relation to source of isolation or to genotypic profile based on the presence or absence of putative virulence genes could be identified. Comparison of VNTR profiling with MLST data suggested a correlation between these two methods of genetic analysis. In common with the majority of previous studies, MLST was unable to provide clarification of the basis for pathogenicity among members of the B. cereus complex. Nevertheless, our application of MLST served to reinforce the notion that B. cereus and B. thuringiensis should be considered as the same species.

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The objective of this work was to evaluate, through a polymorphism in the ND5 gene of the bovine mitochondrial DNA, the frequency of Bos taurus indicus mtDNA individuals in a sample of Nellore purebred origin animals (n = 69) and crossbred animals originated from crosses of European sires and Nellore purebred origin females (n = 275). Only 2.26% (8/354) of the animals presented Bos taurus indicus mtDNA. The high frequency of Bos taurus taurus mtDNA in these animals can be a consequence of selection, once the animals studied are originated from selected lineages of high performance for meat production.

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The present paper constitutes a synthesis of the results gotten during the five campaigns of air quality measurement in the years of 2003 and 2004 carried out in the Portuguese city of Viana do Castelo to characterise the reference situation and to accompany the Polis Programme, an urban re-qualification and environmental valorisation plan. The main objective of the monitoring programme consisted of the evaluation of atmospheric pollutants whose levels were susceptible of enhancement in the course of the urbanistic public works. The presented results refer to measurements performed in two distinct places of this city, comprising various consecutive days of acquisition that include, at least, one day of weekend.

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A study was made to evaluate the effect of a castor oil-based detergent on strawberry crops treated with different classes of pesticides, namely deltamethrin, folpet, tebuconazole, abamectin and mancozeb, in a controlled environment. Experimental crops of greenhouse strawberries were cultivated in five different ways with control groups using pesticides and castor oil-based detergent. The results showed that the group 2, which was treated with castor oil-based detergent, presented the lowest amount of pesticide residues and the highest quality of fruit produced.

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The bioassay, first order derivative UV spectrophotometry and chromatographic methods for assaying fluconazole capsules were compared. They have shown great advantages over the earlier published methods. Using the first order derivative, the UV spectrophotometry method does not suffer interference of excipients. Validation parameters such as linearity, precision, accuracy, limit of detection and limit of quantitation were determined. All methods were linear and reliable within acceptable limits for antibiotic pharmaceutical preparations being accurate, precise and reproducible. The application of each method as a routine analysis should be investigated considering cost, simplicity, equipment, solvents, speed, and application to large or small workloads.

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A study of the different hydrocarbon reactions over Ni doped WO3-ZrO2 catalysts was performed. Ni was found as NiO at low Ni concentration while at high Ni concentrations a small fraction was present as a metal. For both cases, Ni strongly modified total acidity and concentration of strong acid sites. In the cyclohexane dehydrogenation reaction, Ni addition promotes both benzene and methyl cyclopentane production. The hydroconversion activity (n-butane and n-octane) increases with the augment of total acidity produced by Ni. The selectivity to reaction products is modified according to the acid strength distribution changes produced by Ni addition.

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The present work aimed to evaluate the tractive performance of four agricultural tractors with auxiliary front traction in function of six lateral inclinations in a lateral track of trials, which belongs to the Agronomic Sciences Faculty from the São Paulo State University, Campus of Botucatu. The lateral inclinations were 0; 5; 10; 15; 20 and 25 degrees. In all of these situations, the tractors operated with predetermined load of an imposed traction to the pulled tractor of 40 kN in the inclination of 0 degrees. Hence a delineation in random blocks was used, considering six inclinations and four tractors, and with three repetitions for each treatment. The analyzed variables were slippage, tractive force, hourly fuel consumption, and speed. It was concluded that the pneumatic tire configurations influenced in the tractive performance of the tractors, as they increased the lateral inclinations of the terrain.

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The aim of this study was to perform an experimental study to evaluate the proper operation distance between the nodes of a wireless sensor network available on the market for different agricultural crops (maize, physic nut, eucalyptus). The experimental data of the network performance offers to farmers and researchers information that might be useful to the sizing and project of the wireless sensor networks in similar situations to those studied. The evaluation showed that the separation of the nodes depends on the type of culture and it is a critical factor to ensure the feasibility of using WSN. In the configuration used, sending packets every 2 seconds, the battery life was about four days. Therefore, the autonomy may be increased with a longer interval of time between sending packets.

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The present research aimed to develop a modeling capable of identifying the ideal profile of swine finishing producers using the interactive performance optimization, which began by verifying qualitative the criteria considered most relevant to the decision-making, generating a closed structured diagnosis that covers the socioeconomic aspects about the activity, until the design of a mathematical model able to translate the data obtained in quantitative information. For the verification, it was proposed a practical study for a universe of 120 members of a cooperative in the state of Rio Grande do Sul, Brazil. The results showed that, from the application and the definition of the ideal profile, it was possible to verify that 82 producers are in the group of those who have obtained a "Good" performance, and to 44 the result is in the range between 86% to 90% from the ideal, which means that most have short or medium-term conditions to evolve their status for the considered "Very Good", where only 12.5% of the producers are currently.

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ABSTRACT Given the need to obtain systems to better control broiler production environment, we performed an experiment with broilers from 1 to 21 days, which were submitted to different intensities and air temperature durations in conditioned wind tunnels and the results were used for validation of afuzzy model. The model was developed using as input variables: duration of heat stress (days), dry bulb air temperature (°C) and as output variable: feed intake (g) weight gain (g) and feed conversion (g.g-1). The inference method used was Mamdani, 20 rules have been prepared and the defuzzification technique used was the Center of Gravity. A satisfactory efficiency in determining productive responses is evidenced in the results obtained in the model simulation, when compared with the experimental data, where R2 values ​​calculated for feed intake, weight gain and feed conversion were 0.998, 0.981 and 0.980, respectively.

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To test the hypothesis that the low socioeconomic population living is shanty towns in Porto Alegre presents different levels of poverty which are reflected on its health status, a cross-sectional study was designed involving 477 families living in Vila Grande Cruzeiro, Porto Alegre, Brazil. The poverty level of the families was measured by using an instrument specifically designed for poor urban populations. Children from families living in extreme poverty (poorest quartile) were found to have higher infant mortality rate, lower birth weights, more hospitalizations, and higher malnutrition rates, in addition to belonging to more numerous families. Thus, the shanty town population of Porto Alegre is not homogeneous, and priority should be given to the more vulnerable subgroups.

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OBJECTIVE: A cross-sectional population-based study was conducted to assess, in active smokers, the relationship of number of cigarettes smoked and other characteristics to salivary cotinine concentrations. METHODS: A random sample of active smokers aged 15 years or older was selected using a stepwise cluster sample strategy, in the year 2000 in Rio de Janeiro, Brazil. The study included 401 subjects. Salivary cotinine concentration was determined using gas chromatography with nitrogen-phosphorus detection. A standard questionnaire was used to collect demographic and smoking behavioral data. The relation between the number of cigarettes smoked in the last 24h and cotinine level was examined by means of a nonparametric fitting technique of robust locally weighted regression. RESULTS: Significantly (p<0.05) higher adjusted mean cotinine levels were found in subjects smoking their first cigarette within five minutes after waking up, and in those smoking 1-20 cigarettes in the last 24h who reported inhaling more than ½ the time. In those smoking 1-20 cigarettes, the slope was significantly higher for those subjects waiting for more than five minutes before smoking their first cigarette after waking up, and those smoking "light" cigarettes when compared with their counterparts. These heterogeneities became negligible and non-significant when subjects with cotinine >40 ng/mL per cigarette were excluded. CONCLUSIONS: There was found a positive association between self-reporting smoking five minutes after waking up, and inhaling more than ½ the time are consistent and higher cotinine levels. These can be markers of dependence and higher nicotine intake. Salivary cotinine proved to be a useful biomarker of recent smoking and can be used in epidemiological studies and smoking cessation programs.