Qualidade de vida em idosos

Introdução: Esta tese de doutorado é mais uma contribuição do Grupo de Qualidade de Vida (Centro Brasileiro) do Programa de Pós-Graduação em Ciências Médicas: Psiquiatria, da UFRGS. Esse grupo têm trabalhado em projetos transculturais de elaboração de instrumentos de qualidade de vida (QV) sob a coordenação da Organização Mundial de Saúde. Entre os instrumentos genéricos de QV já desenvolvidos estão o WHOQOL-100 e o WHOQOL-Bref e entre os instrumentos específicos, para populações especiais, estão o WHOQOL-HIV, o WHOQOL-SRPB e, mais recentemente, o WHOQOL-OLD. O desenvolvimento de uma escala de QV para idosos é especialmente importante tendo em vista especificidades deste grupo etário, bem como o aumento da proporção de idosos na população mundial. Objetivos: O objetivo maior deste estudo é desenvolver uma escala de QV para idosos (WHOQOL-OLD). Entretanto, como trata-se de um processo com longa duração de tempo, foram gerados objetivos específicos a partir da revisão da literatura e coleta de dados, que deram origem a 5 artigos, cada um com sua proposta, a saber: artigo 1. Apresentar a metodologia utilizada e os resultados dos grupos focais para avaliação de QV do idoso, artigo 2. Identificar variáveis relevantes na QV de pessoas idosas, artigo 3. Investigar a relação da percepção de QV do idoso com a percepção de QV do idoso na opinião de seu cuidador, artigo 4. Investigar variáveis associadas com percepção subjetiva de saúde em idosos internados e artigo 5. Pesquisar um possível viés nas respostas de idosos no Inventário de Depressão de Beck (BDI). Métodos: O primeiro estudo teve um desenho qualitativo enquanto os demais foram quantitativos. As amostras variaram para cada estudo. Em todos os estudos idosos(as) acima de 60 anos foram entrevistados. Para os estudos 1 e 2, a amostra contou com profissionais da área da saúde (1) e cuidadores (1 e 2). E, para o estudo 5, adultos acima de 18 anos também foram pesquisados. A coleta dos dados foi realizada em hospitais, lares e grupos comunitários, residências e recrutamento utilizando a técnica de "snow-ball" (bola de neve) em que cada sujeito indicava um outro sujeito. Todos os entrevistados preencheram o Termo de Consentimento Informado e, a partir daí, foram convidados a responder acerca de informações sociodemográficas, QV percebida (WHOQOL-100) e sintomatologia depressiva (BDI), com pequena variação para os cuidadores. O último estudo contou apenas com os dados sociodemográficos e com as respostas ao BDI. Resultados: De forma abreviada, os resultados dos 5 artigos confirmam as especificidades do idoso e portanto a necessidade de desenvolvimento de instrumentos específicos para esta população. O artigo 1 teve como resultado a sugestão de novos itens para idosos, a partir das respostas espontâneas e análise dos domínios e facetas do WHOQOL-100. O artigo 2, por sua vez, mostrou associações da percepção de QV geral com níveis de depressão, percepção subjetiva de saúde e sexo. No artigo 3, foi possível verificar uma tendência, em todos os domínios e na medida QV geral, de o cuidador responder pior percepção de QV do idoso do que o próprio idoso cuidado, apesar de algumas concordâncias (domínios físico, nível de independência, meio ambiente e espiritualidade/religião). Também observou-se que a intensidade de depressão do idoso exerceu forte influência tanto na sua própria percepção de QV quanto na percepção do cuidador sobre o idoso. O artigo 4 mostrou uma prevalência alta e não esperada de idosos internados que se percebiam como saudáveis. Foi possível observar, ainda, uma associação significativa entre percepção saudável e menor intensidade de sintomas depressivos, bem como melhor percepção de QV no domínio nível de independência. E por último, o artigo 5 discute o viés da subescala somático e de desempenho nas respostas do idoso ao BDI. Conclusões: Idosos constituem um grupo particular e, como tal, apresentam especificidades relevantes. A avaliação dos idosos em relação às suas percepções de QV está associada a sexo, idade, estado civil, classe social, percepção de saúde e mais fortemente associada a níveis de sintomas depressivos. Explorando o cuidador como avaliador da QV do idoso observou-se uma tendência de o cuidador perceber a QV do idoso pior do que a própria percepção do idoso, apesar de fortes correlações para todos os domínios e na medida QV geral na percepção do par idoso-cuidador. Já na avaliação de percepção de saúde em idosos foi verificada a influência da intensidade dos sintomas depressivos bem como da dimensão independência: quanto menor a intensidade de depressão e quanto maior o nível de independência, maior associação com percepção de saúde entre idosos. Além desses, características próprias da população idosa podem interferir nos resultados do BDI fazendo com que seus achados sejam maximizados por questões somáticas e de desempenho sugerindo pontos de corte especiais para os idosos. Novos estudos são sugeridos a fim de atender a demanda específica do idoso.

Insatisfacción corporal y actitudes alimentarias anómalas en bailarines y bailarinas

[ES] El riesgo de desarrollar trastornos de conducta alimentaria (TCA) es mayor en mujeres que en hombres de muestras comunitarias. Sin embargo, no existen datos suficientes que reflejen que esta diferencia también se mantenga en poblaciones especiales como por ejemplo, los bailarines/as. En este estudio se comparan estudiantes de población general y bailarines de ambos sexos para conocer si existen diferencias entre ellos respecto a sus actitudes alimentarias einsatisfacción con la imagen corporal.

Evidence for a perception memory continuum: an EEG study in a healthy population

In line with current memory theories of a perception-memory continuum along the ventral visual pathway, there is evidence that the specific profile of enhanced memory in special populations (e.g. synaesthesia) is based on increased perceptual sensitivity. The main goal of this study was to test in a more general population, if increased perceptual sensitivity is indeed associated with enhanced memory performance. We measured ERPs in response to simple perceptual stimuli biasing either the ventral or the dorsal route and established if perceptual sensitivity in response to ventrally (but not dorsally) processed stimuli is associated with visual short term memory performance in a change detection task. Preliminary results confirm the hypothesis and strengthen the assumption of a perceptual-memory-continuum.

Family Preservation Journal, 2003, Volume 7. (Entire issue)

Entire issue (large pdf file) Articles include: Social Workers' Perceptions of Family Preservation Programs. Elaine M Maccio, David Skiba, Howard J Doueck, Karen A. Randolph, Elisabeth A. Weston, and Lorie E. Anderson Targeting Special Populations for Family Preservation: The Influence of Worker Competence and Organizational Culture. Ramona W: Denby, Keith A. Alford, and Carla M Curtis Understanding and Fostering Family Resilience. Robert G. Blair Walking Our Talk in the Neighborhoods: Building Professional/Natural Helper Partnerships. Jill Kinney and Margaret Trent Intersystem Collaboration: A Statewide Initiative to Support Families. Elizabeth M Tracy, David E. Biegel, Ann C. Rebeck, and Jeffrey A. Johnsen

Sensory thresholds obtained from MEG data:cortical psychometric functions

Sensory sensitivity is typically measured using behavioural techniques (psychophysics), which rely on observers responding to very large numbers of stimulus presentations. Psychophysics can be problematic when working with special populations, such as children or clinical patients, because they may lack the compliance or cognitive skills to perform the behavioural tasks. We used an auditory gap-detection paradigm to develop an accurate measure of sensory threshold derived from passively-recorded MEG data. Auditory evoked responses were elicited by silent gaps of varying durations in an on-going noise stimulus. Source modelling was used to spatially filter the MEG data and sigmoidal ‘cortical psychometric functions’ relating response amplitude to gap duration were obtained for each individual participant. Fitting the functions with a curve and estimating the gap duration at which the evoked response exceeded one standard deviation of the prestimulus brain activity provided an excellent prediction of psychophysical threshold. Thus we have demonstrated that accurate sensory thresholds can be reliably extracted from MEG data recorded while participants listen passively to a stimulus. Because we required no behavioural task, the method is suitable for studies of populations where variations in cognitive skills or vigilance make traditional psychophysics unsuitable.

Class in Classrooms: The Challenges Public Librarians Face as Border Crossing Educators

In border crossing pedagogy, educators help students negotiate identity and cultural issues. Public librarians help special populations of patrons improve on class issues through education. This study explored the issues public librarians face when they teach and border cross across social classes.

Perfil epidemiológico y análisis de la formulación antibiótica en pacientes con infección urinaria nosocomial en la Fundación Cardioinfantil en el año 2014

Introducción: La IVU es muy frecuenten en la (FCI - IC), Alrededor el 60% de los pacientes con diagnóstico de IVU nosocomial corresponden a gérmenes resistente, Desde el año 2010 el CLSI disminuyó los puntos de corte de sensibilidad en las enterobacteriaceae y removió la necesidad de tamizaje y confirmación de (BLEE), en el presente trabajo se pretende determinar el perfil epidemiológico de la formulación antibiótica en pacientes con IVU nosocomial. Diseño: Se realizó un estudio observacional analítico de corte transversal. Métodos: Se realizó un análisis univariado, bivariado y multivariado. El análisis bivariado y multivariado se realizó para determinar la medida de asociación teniendo en cuenta la formulación de Carbapenemico la variable dependiente, evaluándose mediante chi cuadrado. Resultados: Se revisaron 131 urocultivos, se incluyeron 116. Los aislamientos microbiológicos más frecuentemente encontrados fueron E. Coli y K. Pneumoniae, el 43.4% de los aislamientos, presentaron expresión de BLEE, 90% de los aislamientos fueron sensibles a Cefepime. La mayoría de los modelos obtenidos mostraron una fuerte asociación entre el reporte de BLEE en antibiograma con la formulación de carbapenémicos como terapia final OR 33,12 IC 95% (2,90 – 337,4). Conclusión: La epidemiologia de la IVU nosocomial en la FCI-IC no difiere de las referencias internacionales, no hay adherencia a las guías de manejo intrahospitalario y el reporte de la palabra BLEE en el antibiograma predice la formulación de antibiótico carbapenémico por el médico que lee el urocultivo

Genetic diversity among horse populations with a special focus on the Franches-Montagnes breed

Genetic characterization helps to assure breed integrity and to assign individuals to defined populations. The objective of this study was to characterize genetic diversity in six horse breeds and to analyse the population structure of the Franches-Montagnes breed, especially with regard to the degree of introgression with Warmblood. A total of 402 alleles from 50 microsatellite loci were used. The average number of alleles per locus was significantly lower in Thoroughbreds and Arabians. Average heterozygosities between breeds ranged from 0.61 to 0.72. The overall average of the coefficient of gene differentiation because of breed differences was 0.100, with a range of 0.036-0.263. No significant correlation was found between this parameter and the number of alleles per locus. An increase in the number of homozygous loci with increasing inbreeding could not be shown for the Franches-Montagnes horses. The proportion of shared alleles, combined with the neighbour-joining method, defined clusters for Icelandic Horse, Comtois, Arabians and Franches-Montagnes. A more disparate clustering could be seen for European Warmbloods and Thoroughbreds, presumably from frequent grading-up of Warmbloods with Thoroughbreds. Grading-up effects were also observed when Bayesian and Monte Carlo resampling approaches were used for individual assignment to a given population. Individual breed assignments to defined reference populations will be very difficult when introgression has occurred. The Bayesian approach within the Franches-Montagnes breed differentiated individuals with varied proportions of Warmblood.

Assessment of vehicle safety problems for special driving populations. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Library services to special needs populations in Wisconsin : 1975-1984 /

Mode of access: Internet.

mtDNA and Y‐chromosome diversity in Aymaras and Quechuas from Bolivia: Different stories and special genetic traits of the Andean Altiplano populations

Two Bolivian samples belonging to the two main Andean linguistic groups (Aymaras and Quechuas) were studied for mtDNA and Y-chromosome uniparental markers to evaluate sex-specific differences and give new insights into the demographic processes of the Andean region. mtDNA-coding polymorphisms, HVI-HVII control regions, 17 Y-STRs, and three SNPs were typed in two well-defined populations with adequate size samples. The two Bolivian samples showed more genetic differences for the mtDNA than for the Y-chromosome. For the mtDNA, 81% of Aymaras and 61% of Quechuas presented haplogroup B2. Native American Y-chromosomes were found in 97% of Aymaras (89% hg Q1a3a and 11% hg Q1a3*) and 78% of Quechuas (100% hg Q1a3a). Our data revealed high diversity values in the two populations, in agreement with other Andean studies. The comparisons with the available literature for both sets of markers indicated that the central Andean area is relatively homogeneous. For mtDNA, the Aymaras seemed to have been more isolated throughout time, maintaining their genetic characteristics, while the Quechuas have been more permeable to the incorporation of female foreigners and Peruvian influences. On the other hand, male mobility would have been widespread across the Andean region according to the homogeneity found in the area. Particular genetic characteristics presented by both samples support a past common origin of the Altiplano populations in the ancient Aymara territory, with independent, although related histories, with Peruvian (Quechuas) populations.

Geographic and Phenotypic Variation in Heartwood and Essential-Oil Characters in Natural Populations of Santalum austrocaledonicum in Vanuatu.

Phenotypic variation in heartwood and essential-oil characters of Santalum austrocaledonicum was assessed across eleven populations on seven islands of Vanuatu Trees differed significantly in their percentage heartwood cross-sectional area and this varied independently of stem diameter The concentrations of the four major essential-oil constituents (alpha-santalol, beta-santalol. (Z)-beta-curcumen-12-ol, and cis-nuciferol) of alcohol-extracted heartwood exhibited at least tenfold and continuous tree-to-tree variation Commercially important components alpha- and beta-santalol found in individual trees ranged from 0 8-47% and 0-24 1%, respectively, across all populations, and significant (P < 0 05) differences for each were found between Individual populations. The Erromango population was unique in that the mean concentrations of its monocyclic ((Z)-beta-curcumen-12-ol and cis-nuciferol) sesquiterpenes exceeded those of Its bi- and tricyclic (alpha- and beta-santalol) sesquiterpenes Heartwood colour varied between trees and spanned 65 colour categories, but no identifiable relationships were found between heartwood colour and alpha- and beta-santalol, although a weak relationship was evident between colour saturation and total oil concentration These results indicate that the heartwood colour is not a reliable predictive trait for oil quality The results of this study highlight the knowledge gaps in fundamental understanding of heartwood biology in Santalum genus The intraspecific variation in heartwood cross-sectional area. oil concentration. and oil quality traits is of considerable importance to the domestication of sandalwood and present opportunities for the development of highly superior S austrocaledonicum cultivars that conform to the industry's International Standards used for S album.

Recrudescent Infection Supports Hendra Virus Persistence in Australian Flying-Fox Populations

Zoonoses from wildlife threaten global public health. Hendra virus is one of several zoonotic viral diseases that have recently emerged from Pteropus species fruit-bats (flying-foxes). Most hypotheses regarding persistence of Hendra virus within flying-fox populations emphasize horizontal transmission within local populations (colonies) via urine and other secretions, and transmission among colonies via migration. As an alternative hypothesis, we explore the role of recrudescence in persistence of Hendra virus in flying-fox populations via computer simulation using a model that integrates published information on the ecology of flying-foxes, and the ecology and epidemiology of Hendra virus. Simulated infection patterns agree with infection patterns observed in the field and suggest that Hendra virus could be maintained in an isolated flying-fox population indefinitely via periodic recrudescence in a manner indistinguishable from maintenance via periodic immigration of infected individuals. Further, post-recrudescence pulses of infectious flying-foxes provide a plausible basis for the observed seasonal clustering of equine cases. Correct understanding of the infection dynamics of Hendra virus in flying-foxes is fundamental to effectively managing risk of infection in horses and humans. Given the lack of clear empirical evidence on how the virus is maintained within populations, the role of recrudescence merits increased attention.

Gene flow from transgenic plant populations: models and applications for risk assessment

The future use of genetically modified (GM) plants in food, feed and biomass production requires a careful consideration of possible risks related to the unintended spread of trangenes into new habitats. This may occur via introgression of the transgene to conventional genotypes, due to cross-pollination, and via the invasion of GM plants to new habitats. Assessment of possible environmental impacts of GM plants requires estimation of the level of gene flow from a GM population. Furthermore, management measures for reducing gene flow from GM populations are needed in order to prevent possible unwanted effects of transgenes on ecosystems. This work develops modeling tools for estimating gene flow from GM plant populations in boreal environments and for investigating the mechanisms of the gene flow process. To describe spatial dimensions of the gene flow, dispersal models are developed for the local and regional scale spread of pollen grains and seeds, with special emphasis on wind dispersal. This study provides tools for describing cross-pollination between GM and conventional populations and for estimating the levels of transgenic contamination of the conventional crops. For perennial populations, a modeling framework describing the dynamics of plants and genotypes is developed, in order to estimate the gene flow process over a sequence of years. The dispersal of airborne pollen and seeds cannot be easily controlled, and small amounts of these particles are likely to disperse over long distances. Wind dispersal processes are highly stochastic due to variation in atmospheric conditions, so that there may be considerable variation between individual dispersal patterns. This, in turn, is reflected to the large amount of variation in annual levels of cross-pollination between GM and conventional populations. Even though land-use practices have effects on the average levels of cross-pollination between GM and conventional fields, the level of transgenic contamination of a conventional crop remains highly stochastic. The demographic effects of a transgene have impacts on the establishment of trangenic plants amongst conventional genotypes of the same species. If the transgene gives a plant a considerable fitness advantage in comparison to conventional genotypes, the spread of transgenes to conventional population can be strongly increased. In such cases, dominance of the transgene considerably increases gene flow from GM to conventional populations, due to the enhanced fitness of heterozygous hybrids. The fitness of GM plants in conventional populations can be reduced by linking the selectively favoured primary transgene to a disfavoured mitigation transgene. Recombination between these transgenes is a major risk related to this technique, especially because it tends to take place amongst the conventional genotypes and thus promotes the establishment of invasive transgenic plants in conventional populations.

Phylogeography and Adaptive Divergence of Three-spined Stickleback Populations

Genetic studies on phylogeography and adaptive divergence in Northern Hemisphere fish species such as three-spined stickleback (Gasterosteus aculeatus) provide an excellent opportunity to investigate genetic mechanisms underlying population differentiation. According to the theory, the process of population differentiation results from a complex interplay between random and deterministic processes as well historical factors. The main scope in this thesis was to study how historical factors like the Pleistocene ice ages have shaped the patterns molecular diversity in three-spined stickleback populations in Europe and how this information could be utilized in the conservation genetic context. Furthermore, identifying footprints of natural selection at the DNA level might be used in identifying genes involved in evolutionary change. Overall, the results from phylogeographic studies indicate that the three-spined stickleback has colonized the Atlantic basin relatively recently but constitutes three major evolutionary lineages in Europe. In addition, the colonization of freshwater appears to result from multiple and independent invasions by the marine conspecifics. Molecular data together with morphology suggest that the most divergent freshwater populations are located in the Balkan Peninsula and these populations deserve a special conservation genetic status without warranting further taxonomical classification. In order to investigate the adaptive divergence in Fennoscandian three-spined stickleback populations several approaches were used. First, sequence variability in the Eda-gene, coding for the number of lateral plates, was concordant with the previously observed global pattern. Full plated allele is in high frequencies among marine populations whereas low plated allele dominates in the freshwater populations. Second, a microsatellite based genome scan identified both indications of balancing and directional selection in the three-spined stickleback genome, i.e. loci with unusually similar or unusually different allele frequencies over populations. The directionally selected loci were mainly associated with the adaptation to freshwater. A follow up study conducting a more detailed analysis in a chromosome region containing a putatively selected gene locus identified a fairly large genomic region affected by natural selection. However, this region contained several gene predictions, all of which might be the actual target of natural selection. All in all, the phylogeographic and adaptive divergence studies indicate that most of the genetic divergence has occurred in the freshwater populations whereas the marine populations have remained relatively uniform.