Avaliação adrenocortical, tireoideana e do estresse oxidativo de cães naturalmente infectados por Ehrlichia canis

Pós-graduação em Medicina Veterinária - FCAV

Invisibilidade social e saúde do trabalhador: dinâmica territorial do trabalho na coleta de lixo domiciliar urbano em Presidente Prudente/SP

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A saúde mental do trabalhador: estudo sobre os afastamentos por transtornos mentais

Pós-graduação em Planejamento e Análise de Políticas Públicas - FCHS

Approach to Food and Nutrition issues in Teaching Materials in Elementary School: interface with food and nutritional security and national curriculum parameters

Food and Nutrition Security (FNS) must be ensured to everybody. The school environment is favorable to the formation of healthy habits and citizenship. The National Curriculum Parameters (PCNs) guide the promotion of health concepts in a transversal way in the school curriculum. This study aimed to identify and analyze the approach used for food and nutrition themes in Fundamental Education's teaching material and its interface with the concept of FNS and the PCNs. Documental research was conducted on the teaching material from 5th to 8th grades of Fundamental Education in Public School of the state of Sao Paulo. The diffuse presence of food and nutrition themes was found in most disciplines in all bimesters in the four series, which shows the interdisciplinarity in health. It was found that the PCNs are related to the concept of SAN in its various aspects and that most subjects include topics that approach this relationship. In the correlation between themes, there is emphasis to health promotion and food production. The methodology used in the teaching material presents the theme, but not the correspondent content, what made the analysis of its suitability impossible. We conclude that there is the approach of the issues related to food and nutrition in the teaching material, some of them in an inconsistent way; it is the educators' task to select the contents and the appropriate strategy, doing an effort of constant update. This isbeing proposed by the State, however it is not accessible to all professionals and therefore still depends on the initiative of each teacher.

Educación física y su relación con la salud en la formación integral. Experiencia desde el contexto educativo en Venezuela

[ES] El presente artículo describe la problemática poblacional venezolana en relación con sus patrones de comportamiento (hábitos), que vienen causando un deterioro gradual de la salud. Refiere la reseña histórica de la Educación física partiendo de su incorporación en el currículo educativo, transitando por sus cambios y transformaciones hasta la actualidad. Aborda la educación física en Venezuela en correspondencia con las políticas educativas y de la actividad física para la salud. Presenta los programas que viene direccionando y desarrollando el Estado con la intencionalidad de crear conciencia hacia la importancia de la actividad física para contribuir, con disminución del sedentarismo, uno de los factores causantes de la obesidad a escala pandémica. Resalta las prácticas actuales asociadas con programas educacionales relacionados con la educación física y la salud. Por último describe programas innovadores, implementados en las instituciones educativas y en las comunidades para la adquisición de hábitos y patrones de conducta saludables.

Development discourse in Romania: from Socialism to EU Membership

With their accession to the European Union, twelve new countries - Romania among them - (re)entered the international community of international donors. In the history of development aid this can be seen as a unique event: it is for the first time in history that such a large number of countries become international donors, with such short notice and in such a particular context that sees some scholars announcing the ‘death’ of development. But in spite of what might be claimed regarding the ‘end’ of the development era, development discourse seems to be rather vigorous and in good health: it is able to extert an undeniable force of attraction over the twelve countries that, in a matter of years, have already convinced themselves of its validity and adhered to its main tenets. This thesis collects evidence for improving our understanding of this process that sees the co-optation of twelve new countries to the dominant theory and practice of development cooperation. The evidence collected seems to show that one of the tools employed by the promoters of this co-optation process is that of constructing the ‘new’ Member States as ‘new’, inexpert donors that need to learn from the ‘old’ ones. By taking a case-study approach, this thesis gathers data that suggests that conceiving of the ‘twelve’ as ‘new’ donors is both historically inaccurate and value-ladden. On one hand, Romania’s case-study illustrates how in the (socialist) past at least one in the group of the twelve was particularly conversant in the discourse of international development. On the other hand, the process of co-optation, while being presented as a knowledgeproducing process, can also be seen as an ignorance-producing procedure: Romania, along with its fellow new Member States, takes the opportunity of ‘building its capacity’ and ‘raising its awareness’ of development cooperation along the line drawn by the European Union, but at the same time it seems to un-learn and ‘lower’ its awareness of development experience in the (socialist) past. This is one possible reading of this thesis. At a different level, this thesis can also be seen as an attempt to account of almost five decades of international development discourse in one specific country – Romania – in three different socio-political contexts: the socialist years (up to the year 1989), the ‘transition years’ (from 1989 to the pre-accession years) and the membership to the European Union. In this second reading, the thesis seeks to illustrate how – contrary to widespread beliefs – before 1989 Romania’s international development discourse was particularly vivid: in the most varied national and international settings President Ceausescu unfolded an extensive discursive activity on issues pertaining to international development; generous media coverage of affairs concerning the developing countries and their fight for development was the rule rather than the exception; the political leadership wanted the Romanians not only to be familiarized with (or ‘aware of’ to use current terminology) matters of underdevelopment, but also to prove a sense of solidarity with these countries, as well as a sense of pride for the relations of ‘mutual help’ that were being built with them; finally, international development was object of academic attention and the Romanian scholars were able not only to reflect on major developments, but could also formulate critical positions towards the practices of development aid. Very little remains of all this during the transition years, while in the present those who are engaged in matters pertaining to international development do so with a view of building Romania as an EU-compliant donor.

“What Happens When Pollinators Get Sick? Behavioral Impacts of Honeybee Viruses”

Like all organisms on the planet, honeybees (Apis mellifera) are susceptible to infection with a wide variety of viruses. These viruses may produce infections with no visible symptoms or may have devastating consequences on both the individual bee and the entire hive. Deformed Wing Virus, a member of the Iflavirus group of viruses, has an RNA genome and has had a particularly important impact on bee health. It can be spread between bees in a several ways – bees can infect each other during feeding or grooming activities, drones can pass the virus to the queen during mating and queens can lay infected eggs. The primary and most devastating way that these viruses are transmitted within and between hives involves a parasitic mite, an animal known ominously as Varroa destructor. The talk will discuss the effect that viruses have on the health and behavior of honeybees and will outline the collaborative research activities of Drs. Evans and Pizzorno over the last 7 years.

A study to demonstrate freedom of Trichinella spp. in domestic pigs in Switzerland

Trichinellosis is a food-borne zoonotic disease caused by the nematode Trichinella spp. Many omnivorous and carnivorous animal species can act as host for this parasite, including domestic pigs. To protect public health, it should be ensured that pork should not contain infective Trichinella larvae. Surveillance for Trichinella spp. can be done using direct (larval detection) and indirect (antibody detection) diagnostic techniques. The aim of this study was to demonstrate the absence of infection in Swiss domestic pigs. An ELISA was used as the initial screening test, and sera reacting in ELISA were further investigated using both a Western blot for serology and an artificial digestion test with 20 g of diaphragm tissue for larval detection. A total of 7412 adult pigs, 9973 finishing pigs and 2779 free-ranging pigs were tested. Samples from 17 (0.23%) adult pigs, 16 (0.16%) finishing pigs and nine (0.32%) free-ranging pigs were ELISA-positive, but all of these sera were subsequently negative by Western blot and by the artificial digestion method. Based on these findings, an absence of Trichinella infections in adult pigs (target prevalence 0.04%) and finishing pigs (target prevalence 0.03%) can be concluded. The results also demonstrated that the prevalence of Trichinella infections does not exceed 0.11% in free-ranging pigs, the group with the highest risk of exposure.

Plasminogen activator inhibitor-1, monocyte chemoattractant protein-1, e-selectin and C-reactive protein levels in response to 4-week very-high-fructose or -glucose diets.

BACKGROUND/OBJECTIVES High intake of added sweeteners is considered to have a causal role in the pathogenesis of cardiometabolic disorders. Especially, high-fructose intake is regarded as potentially harmful to cardiometabolic health. It may cause not only weight gain but also low-grade inflammation, which represents an independent risk factor for developing type 2 diabetes and cardiovascular disease. In particular, fructose has been suggested to induce plasminogen activator inhibitor-1 (PAI-1) expression in the liver and to increase circulating inflammatory cytokines. We therefore aimed to investigate, whether high-fructose diet has an impact on PAI-1, monocyte chemoattractant protein-1 (MCP-1), e-selectin and C-reactive protein (CRP) concentrations in healthy humans. SUBJECTS/METHODS We studied 20 participants (12 males and 8 females) of the TUebingen FRuctose Or Glucose study. This is an exploratory, parallel, prospective, randomized, single-blinded, outpatient, hypercaloric, intervention study. The participants had a mean age of 30.9 ± 2.1 years and a mean body mass index of 26.0 ± 0.5 kg/m(2) and they received 150 g of either fructose or glucose per day for 4 weeks.Results:There were neither significant changes of PAI-1, MCP-1, e-selectin and CRP after fructose (n=10) and glucose (n=10) intervention nor treatment effects (all P>0.2). Moreover, we did not observe longitudinal associations of the inflammatory parameters with triglycerides, liver fat, visceral fat and body weight in the fructose group. CONCLUSIONS Temporary high-fructose intake does not seem to cause inflammation in apparently healthy people in this secondary analysis of a small feeding trial.

A costing exercise of provision of prevention of HIV transmission from mother to child services in Vietnam

Objectives. This dissertation focuses on estimating the cost of providing a minimum package of prevention of mother-to-child HIV transmission (PMTCT) in Vietnam from a societal perspective and discussing the issues of scaling-up the minimum package nationwide. ^ Methods. Through collection of cost-related data of PMTCT services at 22 PMTCT sites in 5 provinces (Hanoi, Quang Ninh, Thai Nguyen, Hochiminh City, and An Giang) in Vietnam, the research investigates the item cost of each service in minimum PMTCT packages and the actual cost per PMTCT site at different organizational levels including central, provincial, and district. Next, the actual cost per site at each organizational level is standardized by adjusting for HIV prevalence rate to arrive at standardized costs per site. This study then uses the standardized costs per site to project, by different scenarios, the total cost to scale-up the PMTCT program in Vietnam. ^ Results. The cost for HIV tests, infant formula, and salary of health workers are consistently found to be the biggest expenditures in the PMTCT minimum package program across all organizational levels. Annual cost for drugs for prophylaxis treatment, operating and capital, and training costs are not substantial (less than 5% of total costs at all levels). The actual annual estimated cost for a PMTCT site at the central level is nearly VND 1.9 billion or US$ 107,650 (exchange rate US$ 1 = VND 17,500) while the annual cost for a provincial site is VND 375 million or US$ 21,400. The annual cost for a district site is VND 139 million (∼US$ 8,000). ^ The estimated total annual cost to roll out the PMTCT minimum package to the 5 studied provinces is approximately US$ 1.1 million. If the PMTCT program is to be scaled-up to 14 provinces until 2008 and up to 40 provinces through the end of 2010 as planned by the Ministry of Health, it would cost the health system an approximate annual amount of US$ 2.1 million and US$ 5.04 million, respectively. The annual cost for scaling-up the PMTCT minimum package nationwide is around US$ 7.6 million. Meanwhile, the total annual cost to implement PMTCT minimum packages to achieve PMTCT national targets in 2010 (providing counseling service to 90% of all pregnant women; 60% of them will receive HIV tests and 100% of HIV (+) mother and their newborn will receive prophylaxis treatment) would be US$ 6.1 million. ^ Recommendations. This study recommends: (1) the Ministry of Health of Vietnam should adjust its short-term national targets to a more feasible and achievable level given the current level of available resources; (2) a detailed budget for scaling-up the PMTCT program should be developed together with the national PMTCT action plan; (3) the PMTCT scaling-up plan developed by the Ministry of Health should focus on coverage of high prevalence population and quality of services provided rather than number of physical provinces reached; (4) exclusive breastfeeding strategy should be promoted as part of the PMTCT program; and (5) for a smooth and effective rolling out of PMTCT services nationwide, development of a national training plan and execution of this plan must precede any other initiations of the PMTCT scaling-up plan. ^

Doctor-patient communication in the medical interaction: Context, implications, and practice

Effective communication; whether from an interpersonal, mass media, or global perspective, is a critical component in public health. It is an essential conduit in increasing public awareness of available health resources, potential health hazards and related disease prevention strategies, and in delivering better health care. Within this context, available literature asserts doctor-patient communication as central to healthcare delivery. It has been shown to affect patient health outcomes, satisfaction with care, adherence to treatment recommendations, and even understanding of medical information. While research supports the essential imperative of interventions aimed at teaching doctors and patients the communication skills necessary for a successful and meaningful medical interaction, most interventions to date, focus on teaching these communication skills to doctors and seem to rely, largely, on mass media for providing patients with the information needed to increase communication efficacy. This study sought to fill a significant gap in the doctor-patient communication literature by reviewing the context of the doctor-patient exchange in the medical interaction, the implications of this exchange in resulting care of the patient, and the potential improvements to practice through interventions aimed at improving the communication exchange. Closing with an evaluation of a patient-centered communication intervention, the “How to Talk to Your Doctor” (HTTTYD) program that combines previously identified optimal strategies for improving communication between doctors and patients, this study examined the patients’ perspective of their potential as better communicators in the medical interaction. ^ Specific Aims, Hypotheses or Questions (Aim I) To examine the context of health communication within a public health framework and its relation to health care delivery. (Aim II) To review doctor-patient communication as a central focus within health care delivery and the resulting implications to patient care. (Aim III) To assess the utility of interventions to improve doctor-patient communication. Specifically, to evaluate the effectiveness of a patient-centered community education intervention, the “How to Talk to Your Doctor” (HTTTYD) program, aimed at improving patient communication efficacy.^

Identification of genes associated with quantitative traits involved in cardiovascular disease and lipoprotein metabolism

Cardiovascular disease (CVD) is a threat to public health. It has been reported to be the leading cause of death in United States. The invention of next generation sequencing (NGS) technology has revolutionized the biomedical research. To investigate NGS data of CVD related quantitative traits would contribute to address the unknown etiology and disease mechanism of CVD. NHLBI's Exome Sequencing Project (ESP) contains CVD related phenotypes and their associated NGS exomes sequence data. Initially, a subset of next generation sequencing data consisting of 13 CVD-related quantitative traits was investigated. Only 6 traits, systolic blood pressure (SBP), diastolic blood pressure (DBP), height, platelet counts, waist circumference, and weight, were analyzed by functional linear model (FLM) and 7 currently existing methods. FLM outperformed all currently existing methods by identifying the highest number of significant genes and had identified 96, 139, 756, 1162, 1106, and 298 genes associated with SBP, DBP, Height, Platelet, Waist, and Weight respectively. ^

A study of nutrition promotion in and consumer nutrition environments of hospitals

Dietary intake is a complex, health-related behavior, and although individual-level theoretical models explain some variation in dietary intake, comprehensive theoretical models such as the ecological framework describe the multiple levels which influence diet-related behaviors. Thus, the ecological framework is a preferred model for designing comprehensive nutrition interventions. While ecological-based nutrition interventions have been described, little work has focused on interventions in the hospital setting. Because hospitals are considered the hallmarks of health, it might seem that hospitals would regularly engage in worksite nutrition promotion; however, recent publications and other anecdotal evidence have indicated otherwise. The first paper of this dissertation systematically reviewed the scientific literature between 1996 and 2012 and identified 13 outcome evaluation trials for hospital-based worksite nutrition interventions. Of these 13 interventions, only one intervention targeted three of the four levels of the ecological framework and no intervention targeted all four levels. Only half of the interventions targeted the physical environment of hospitals, thus warranting more investigation into this specific level of the ecological framework in this setting. ^ A critical type of nutrition-related physical environments is the consumer nutrition environment. Although other tools measure the consumer nutrition environments of stores and restaurants, no tool specifically measured the consumer nutrition environments of hospitals until the CDC developed the Healthy Hospital Environment Scan for Cafeterias, Vending Machines, and Gift Shops (HHES-CVG). The HHES-CVG, a tool which measures the consumer nutrition environments of hospital cafeterias, vending machines, and gifts shops, was released in November 2011, and in the second paper of this dissertation, the reliability of this tool was investigated. Two trained raters visited 39 hospitals across Southern California between February and May 2012, and based on analyses of the raters' findings, the HHES-CVG exhibited strong reliability metrics (inter-observer agreement between 74 and 100%, and an intraclass correlation coefficient of 0.961 for the overall nutrition composite score). Because the HHES-CVG was found to be a reliable tool, the third paper of this dissertation presented HHES-CVG results from the 39 hospitals. Overall, hospitals only scored about one-fourth of the total possible points for the nutrition composite score, indicating that most facilities do not have acceptable consumer nutrition environments. Some of the best practices observed in cafeterias were significantly associated with having a large facility and with having a contracted foodservice operation, but overall nutrition composite score was not associated with any specific facility or operation type. ^ The dissertation concluded that much work is needed in order to improve the consumer nutrition environments of hospitals. Practitioners and healthcare administrators should consider starting with ecological-based interventions addressing all levels including the physical environment.^

Tratamiento periodontal en un paciente con bulimia y anorexia

En el caso clínico se trató periodontalmente a la paciente C. J., con diagnóstico de bulimia y anorexia nerviosa purgativa. Se destacó el importante trabajo de motivación, que dio como resultado una respuesta excelente en su salud bucal. Se contó con la posibilidad de colocar implantes dentales con buen resultado postoperatorio, lo cual es promisorio en cuanto a lograr rehabilitarla con una solución fija, que no sufrirán de patologías como la caries, pero sí pueden afectarlos las secuelas de una enfermedad periodontal, por lo que se remarca la importancia de los mantenimientos periodontales para lograr un muy buen pronóstico en su futura salud y rehabilitación oral.

(Supplement) Groundwater quality in Lahore Pakistan: emphasis on Arsenic and Fluoride levels

The dataset provides detailed information on the study that was conducted in Lahore's 7 major towns. The sample was taken from 472 tubewells and analyzed for major cations and anions using APHA 2012 techniques as explained herein. Besides, E.coli determination was done to check for microbial contamination. The data includes results from PHREEQC modeling of As(III)/ As(V) species and saturation indices as well as Aquachem's computed hydrochemical water facies. The WHO (2011) and EPA standards included in Aquachem identified the parameters that where in violation. Bicarbonates dominated the groundwater types with 50.21% of the samples exceeding the EPA maximum permissible limit of 250 mg/L in drinking water. Similarly, 30.51% of the samples had TDS values greater than 500 mg/L while 85.38 % of the samples exceed 10 µg/L threshold limit value of arsenic. Also, instances of high magnesium hazard values were observed which requires constant assessment if the groundwater is used for irrigation. Higher than 50% MH values are detrimental to crops which may reduce the expected yields. The membrane filtration technique using m-Endo Agar indicated that 3.59% samples had TNC (too numerous to count) values for E.coli while 5.06% showed values higher than 0 cfu/ 100 ml acceptable value in drinking water. Any traces of E-coli in a groundwater sample indicate recent fecal contamination. Such outcomes signify presence of enteric pathogens. If the groundwater is not properly dosed with disinfectants it may cause harm to human health. It is concluded that more studies are needed and proper groundwater management implement to safeguard the lives of communities that depend solely on groundwater in the city.