A importância do suporte emocional aos pais de bebês internados num CTI pediátrico: aspectos teóricos e práticos de um trabalho com grupos

Este trabalho, realizado num hospital, apresenta a prática de Grupo com pais de bebês internados em Centro de Tratamento Intensivo. Tal prática visa basicamente o atendimento aos pais no sentida de lhes oferecer as condições necesárias para a manutenção e preservação do vínculo afetivo bebê-pais, e consequentemente aceitação deste bebê doente, tanto durante o período de internação como também após sua alta. Visa, portanto, revelar a importância de um suporte emocional aos pais de tais bebês, sem o que, acredita-se, dificilmente ais pais teriam condições de superar a situação de crise emocional por que passam diante ao nascimento de um filho doente ou que adoece logo ao nascer. o trabalho com os Grupos realiza-se uma vez por s~ mana. tendo a duração de 1DJla hora. A coordenação destes grupos é feita em co~terap:ta por UltlJllédico peaiatra e um psicõl~ go. Baseia-se na livre expressão dos participantes. e tanto o médico quanto o psicólogo. oferecem informações sobre o estado de saúde do bebê ao mesmo tempo em que buscam compreen -der na fala dos pais os aspectos emocionais nela subentendi -dos. .' Essencialmente, tornaram-se temas centrais deste trabalho os que dizem respeito a ligação afetiva dos pais com o bebê, aos sentimentos de culpa pela doença do mesmo e os relativos i preocupação dos pais com o desenvolvimento futuro de seu filho. Os referidos temas foram denominados com os seguintes títulos: Vínculos e Separações, Sentimentos de Culpa e O Espaço da Criança, e neles foram abordados os aspectos teóricos de cada questão, visando uma melhor compreensão das ansiedades dos pais e na esperança de fornecer suporte emocional aos mesmos, a fim de que possam melhor amparar seus filhos.

Intervenções no sistema adenosinérgico : avaliação de aspectos neuroquímicos, locomotores e nociceptivos

A adenosina está presente em todos os tipos celulares exercendo um papel homeostático. Em sistema nervoso central e periférico seu papel neuromodulador é observado. A presença de adenosina no meio extracelular permite a ativação de receptores adenosinérgicos específicos, classificados em: A1, A2A, A2B e A3. A ativação dos receptores A1 e A2A, receptores de alta afinidade, está diretamente envolvida com o papel neuromodulador, visto que a sua ativação produz inibição e facilitação da liberação de neurotransmissores, respectivamente. A seleção de qual receptor será ativado, visto que exibem co-expressão em muitas regiões neurais, pode ser feita de acordo com os sítios de liberação ou produção de adenosina extracelular. Desta forma, receptores A1 seriam preferencialmente ativados pela adenosina liberada através dos transportadores bidirecionais de nucleosídeos e os receptores A2A preferencialmente ativados pela adenosina proveniente da degradação do ATP realizada por uma cascata enzimática. A hidrólise de ATP a adenosina é realizada pelas enzimas ectonucleosídeo trifosfato difosfoidrolases e ecto-5’-nucleotidase. Em ratos, a ativação do sistema adenosinérgico exerce seus efeitos neuromoduladores desde fases iniciais de desenvolvimento embrionário, alcançando o padrão adulto mesmo antes do nascimento. A ativação de receptores de adenosina na fase fetal e neonatal foi demonstrada ter como conseqüência o retardo no desenvolvimento global dos animais, bem como, ventriculomegalia e perda de massa cerebral branca. Esta informação levanta a questão da suscetibilidade do cérebro imaturo a certas drogas, tais como a cafeína. A cafeína é uma metilxantina com efeitos estimulantes, a qual exibe como base para seus efeitos o bloqueio inespecífico dos receptores de adenosina. No presente estudo, avaliou-se o efeito da administração de cafeína em diversos parâmetros. A administração aguda de cafeína, mas não a crônica, em ratos adultos foi capaz de alterar significativamente as atividades de hidrólise de ATP no hipocampo e de ADP no estriado. Este resultado poderia estar relacionado com a capacidade plástica do sistema adenosinérgico em restabelecer seu tônus em ratos adultos tratados cronicamente com cafeína. Além disto, verificou-se que a ação direta da cafeína afetou a produção de adenosina. A administração crônica de cafeína na água de beber de ratas mães durante a fase gestacional e lactacional alterou o padrão de hiperlocomoção induzido por MK-801, um antagonista de receptores NMDA glutamatérgicos, nos ratos filhotes aos 21 dias de vida, mesmo quando o acesso a cafeína foi retirado sete dias antes do teste. Além disto, o mesmo tratamento não alterou o limiar de dor de filhotes aos 14 e 50 dias de vida, bem como a analgesia induzida nestes animais aos 50 dias. Entretanto, quando os animais ainda recebiam cafeína no dia do teste, foi observado efeito analgésico somente nos ratos de 14 dias. A análise dos efeitos do tratamento sobre a degradação de acetilcolina e sobre a degradação de nucleotídeos em hipocampo de ratos jovens demonstrou que ambas as atividades foram alteradas. O conjunto de resultados desta tese indica que a intervenção no sistema adenosinérgico durante as fases gestacional e neonatal é capaz de desenvolver adaptações, provavelmente relacionadas ao aumento da expressão de receptores para adenosina, na tentativa de restabelecer o controle modulador adenosinérgico, considerada a importância dos sistemas avaliados para a manutenção do organismo.

Brand image co-creation and individual identity extension in online environments: a Facebook investigation

In this thesis I investigate the extent to which companies can build a more communal environment out of their fan pages while also evaluating the corresponding brand value that may come from having such a communal environment. My research is comprised in three articles: in the first article, I describe how the brand image is created or augmented in the fan page environment, therefore providing demonstrable evidence of value creation. In the second article, I describe how individuals use fan page semiotic elements to communicate their identities. Finally, in the third article, I describe the possible communal characteristics of a fan page and the conditions that enable it to evolve to the virtual brand community concept. As a result, I will contribute to the marketing literature on the use of Facebook for communicating brand identity, on the co-creation of the brand image in social media context, and on the conceptual definition of fan pages as a communal environment.

Co-creation in hospitality industry: a case study on the drivers of traveler-generated content

User-generated content in travel industry is the phenomenon studied in this research, which aims to fill the literature gap on the drivers to write reviews on TripAdvisor. The object of study is relevant from a managerial standpoint since the motivators that drive users to co-create can shape strategies and be turned into external leverages that generate value for brands through content production. From an academic perspective, the goal is to enhance literature on the field, and fill a gap on adherence of local culture to UGC given industry structure specificities. The business’ impact of UGC is supported by the fact that it increases e-commerce conversion rates since research undertaken by Ye, Law, Gu and Chen (2009) states each 10% in traveler review ratings boosts online booking in more than 5%. The literature review builds a theoretical framework on required concepts to support the TripAdvisor case study methodology. Quantitative and qualitative data compound the methodological approach through literature review, desk research, executive interview, and user survey which are analyzed under factor and cluster analysis to group users with similar drivers towards UGC. Additionally, cultural and country-specific aspects impact user behavior. Since hospitality industry in Brazil is concentrated on long tail – 92% of hotels in Brazil are independent ones (Jones Lang LaSalle, 2015, p. 7) – and lesser known hotels take better advantage of reviews – according to Luca (2011) each one Yelp-star increase in rating, increases in 9% independent restaurant revenue whereas in chain restaurants the reviews have no effect – , this dissertation sought to understand UGC in the context of travelers from São Paulo (Brazil) and adopted the case of TripAdvisor to describe what are the incentives that drives user’s co-creation among targeted travelers. It has an outcome of 4 different clusters with different drivers for UGC that enables to design marketing strategies, and it also concludes there’s a big potential to convert current content consumers into producers, the remaining importance of friends and family referrals and the role played by incentives. Among the conclusions, this study lead us to an exploration of positive feedback and network effect concepts, a reinforcement of the UGC relevance for long tail hotels, the interdependence across content production, consumption and participation; and the role played by technology allied with behavioral analysis to take effective decisions. The adherence of UGC to hospitality industry, also outlines the formulation of the concept present in the dissertation title of “Traveler-Generated Content”.

Aspectos sociais e de saúde de portadores da coinfecção hiv/tuberculose

Objetivou-se avaliar os aspectos sociais e de saúde e a percepção diante do diagnóstico de indivíduos com a coinfecção HIV/tuberculose. Estudo descritivo, com abordagem quantiqualitativa, realizado em hospital de referência em Fortaleza, Ceará, de janeiro a abril de 2009, utilizando-se entrevista semiestruturada em ambiente privativo. Os dados foram analisados de modo descritivo e por análise de conteúdo. Participaram 16 pacientes com coinfecção HIV/tuberculose, 56,25% do sexo masculino, com faixa etária predominante entre 31 a 39 anos (43,75%), com pouca escolaridade e renda familiar mensal de aproximadamente um salário mínimo. A forma predominante da apresentação da tuberculose foi a pulmonar (62,50%). A percepção sobre a descoberta da coinfecção foi demonstrada por duas categorias: Medo e angústia face ao diagnóstico e Mudanças nos hábitos de saúde e no estilo de vida. Urge, diante dos achados, a promoção do bem-estar psicológico e físico desses pacientes, por meio de ações políticas e de saúde

Micropartículas de poli (ácido lático-co-ácido glicólico) obtidas por spray drying para a liberação prolongada de metotrexato

Methotrexate (MTX) is a drug used in the chemotherapy of some kind of cancers, autoimmune diseases and non inflammatory resistant to corticosteroids uveits. However, the rapid plasmatic elimination limits its therapeutic success, which leads to administration of high doses to maintain the therapeutic levels in the target tissues, occurring potential side effects. The aim of this study was to obtain spray dried biodegradable poly-lactic acid co-glycolic acid (PLGA) microparticles containing MTX. Thus, suitable amounts of MTX and PLGA were dissolved in appropriate solvent system to obtain solutions at different ratios drug/polymer (10, 20, 30 and 50% m/m). The physicochemical characterizing included the quantitative analysis of the drug using a validate UV-VIS spectrophotometry method, scanning electron microscopy (SEM), infrared spectrophotometry (IR), thermal analyses and X-ray diffraction analysis. The in vitro release studies were carried out in a thermostatized phosphate buffer pH 7.4 (0.05 M KH2PO4) medium at 37°C ± 0.2 °C. The in vitro release date was subjected to different kinetics release models. The MTX-loaded PLGA microparticles showed a spherical shape with smooth surface and high level of entrapped drug. The encapsulation efficiency was greater then 80%. IR spectroscopy showed that there was no chemical bond between the compounds, suggesting just the possible occurrence of hydrogen bound interactions. The thermal analyses and X-ray diffraction analysis shown that MTX is homogeneously dispersed inside polymeric matrix, with a prevalent amorphous state or in a stable molecular dispersion. The in vitro release studies confirmed the sustained release for distinct MTX-loaded PLGA microparticles. The involved drug release mechanism was non Fickian diffusion, which was confirmed by Kornmeyer-Peppas kinetic model. The experimental results demonstrated that the MTX-loaded PLGA microparticles were successfully obtained by spray drying and its potential as prolonged drug release system.

Calçadas invisíveis: aspectos do passeio público, em Natal-RN, como projeção de uma cidadania ausente

This study has as a goal to establish a relationship between public sidewalk characteristics of Lagoa Nova District (neighborhood), in Natal and the kind of citizens whose constructions and maintenance layouts reflects. It‟s understood here as public sidewalk, specifically, the place reserved for passers-by traffic, located between public lots and vehicles pavements. It‟s a concern to make a brief survey about the occupation of this particular region and a detailed description over physical characteristic of its sidewalks that shows several obstacles for passers-by accessibility, trying to find possible factors that explain the problematic format , once, at the first sight, most of accessibility of passers-by is compromised. It‟ also, searched, local population thoughts regarding occupation notions about this environment, just like as cultural, political and economical aspects that might influence upon snatching these hybrid places located between private and public border line. It‟s confirmed that the nowadays sidewalks‟ shapes is not only citizenship reflection or a lack of it but shows it as an active agent related with the construction of this set of fundamental rights and duties vital for harmonical co-living local citizens

Aspectos clínicos e radiográficos da osteodistrofia hipertróica em cães: estudo retrospectivo de 16 casos

Descrevem-se 16 casos de osteodistrofia hipertrófica (OH) entre 13.483 casos levantados nos arquivos do Setor de radiologia do Hospital Veterinário Governador Laudo Natel da FCAVJ-UNESP, entre 1° de janeiro de 1977 a 31 de dezembro de 1995. A enfermidade mostrou-se de baixa manifestação clínica, atingindo cães jovens em fase de crescimento, pertencentes às raças de grande porte e supernutridos. Destaca-se ainda, a importância do exame radiográfico seriado no diagnóstico da enfermidade e principalmente como método de avaliação da reversão clínica do processo, mormente quando ocorre bacteremia associada.

Aspectos clínico e cirúrgicos do tumor mamário canino: clinical and surgical evolution

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Aspectos biológicos de Cycloneda sanguínea (Coleóptera: Coccinellidae) alimentadas con pulgones criados en algodón transgénico Bollgard I

Cycloneda sanguinea is an important biological control agent of aphid cotton. The objective of this study was to evaluate the biological aspects of C. sanguinea fed with nymphs and adults of Aphis gossypii reared in DeltaOPAL and NuOPAL cultivars (Bollgard I). The experiment was conducted in the laboratory under controlled temperature (25 +/- 1 degrees C), humidity (70 +/- 10%) and photophase (12 hours). The experimental design was completely randomized, and treatments aphids fed on the two cultivars, and replicates 40 individuals. Each larva was individually until adult emergence of the predator in Petri dishes of 9 cm in diameter with moistened filter paper. For evaluation of individual adults were five couples newly emerged in plastic pots 12 cm in diameter and 9 cm tall, with filter paper for oviposition. The parameters evaluated were: duration and viability of the larval stage, pupal stage duration and survival, adult longevity, reproductive period, post-reproductive and total number of eggs per female. The duration of the larval stage of C. sanguinea was lower when fed aphids reared on the cultivar NuOPAL, while adult longevity and the reproductive period were higher. The female fertility and egg viability were also lower.

Detection of hemoplasma and Bartonella species and co-infection with retroviruses in cats subjected to a spaying/neutering program in Jaboticabal, SP, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Qualidade de vida de pessoas com úlcera venosa: associação dos aspectos sociodemográficos, de saúde, assistência e clínicos da lesão

Venous ulcer (VU) is a lower limbs injury resulting from inadequate return of venous blood in feet or legs. Although it is not a deadly disease, it causes chronic wounds, which seriously undermine patients´ quality of life (QOL) and sometimes leads to drastic family, social, economic and psychological changes. In this sense, there are several aspects that may influence the venous ulcers patients´ QOL. The study´s objective aimed on the association of socio-demographic and health, health care and clinical injury on UV patients‟ QOL. Analytical studies, which consider the complexity of factors involved in changes in UV patients‟ QOL has a cross-sectional and quantitative approach. The HUOL Ethics Committee approved this project (n.279/09). The collection of data lasted a period of 3 months in 2010 and it took place at the clinic of Angiology at Hospital Universitário Onofre Lopes (HUOL). The data sample consisted of 60 patients treated by UV angiologists in the HUOL Surgical Clinic. The results were analyzed with SPSS 15.0 by descriptive and inferential statistics. The study was based on UV patients that were predominantly female, average age of 61.4 years, that had low education level and low family income, with occupations requiring long periods of standing or sitting, but mostly retired, unemployed or laid off due to the disease and/or due to chronic diseases associated with the UV. The study took also into consideration patients that used inappropriate products, that were improperly treated by a professional caregiver, that lacked of adequate guidance and compression therapy, that performed no lifting of the lower limbs and regular exercise, that the time of injury were greater than or equal to six months, that were missing specific laboratory tests. The study‟s reference were on recurrent lesions, medium to large lesions area, bed of the lesion (injuries) with fibrin and/or necrosis, with amount of exudate with medium to large, odorless and no signs of infection, with tissue loss between 1st and 2nd degree, without collecting swab or biopsy and with pain. In general, QOL of researched individuals were considered low, the maximum score was 69 points, which the areas that were mostly influenced were the total scores of QOL functional capacity (0.021), emotional (0.000) and social functioning (0.080). Of the 60 individuals, 53.3% had scores between 40 and 69 points in SF-36, and they had the best scores in sociodemographic and health variables (ρ = 0.049). In respect to the assistance and injury characteristics, patients who scored between 40 and 69 points in SF-36 had better scores on these characteristics. By combining the socio-demographic variables, health, and handling characteristics of the injury, we observed a significant difference (ρ = 0.032) when linking them with the QOL total scores. When analyzing separately the domains of the SF-36 scores on the quality of life, we find that the areas that showed statistical significance were functional ability (ρ = 0.035), appearance (ρ = 0.019), emotional (ρ = 0.000), and mental health (ρ = 0.050). Among the socio-demographic characteristics studied, gender and marital status contributed more to the reduction of QOL and among the variables of assistance and the injury, orientation, reference and area of UV contributed the most. By analyzing these five variables all together in accordance with the overall score obtained in the quality of life, we found a significant correlation (ρ = 0.002); with 6.23 times more chances of patients have better QOL in the presence of these five positive factors. By conducting the Mann Whitney U test between all the five demographic variables, health, and clinical care, we found that this combination also proved to be significant (ρ = 0.006). Therefore, patients with these five variables positive tend to have a better QOL. Based on these results, we reject the null hypothesis (H0) and accept the alternative hypothesis (H1) proposed in this study because we noted that the QOL of patients with UV is associated with sociodemographic and health, health care and clinical aspects of the injury

Doenças sem doentes: Ocorrência de Distúrbios Osteomusculares Relacionados ao Trabalho DORT nos operadores de caixa de um banco

The changes incurred in the financial system with the introduction of new technologies and new forms of administration of banks has caused impact on the health of workers. These changes, which passed in the process of work, generate a combined share of the risk factors that result in numerous injuries and illnesses among banks, notably between the operators of banks tellers. The Work-Related Musculoskeletal Disordes - WRMD represent a group of occupational diseases always present among these workers. Because of its high incidence and the amount of financial resour envolved to manage the problem has been the object of constant study. This paper aims to analyze the bank teller activity; search the occurrence of WRMD in the activity, identifying the factors determining the occurrence of WRMD in the activity and determine the real number of touchs on a keyboard made by the operator and propose solutions that influence the reduction of illness in the workplace of the bank teller. Methodological tools of ergonomics are used to provide a broad knowledge of aspects of work that have been studied and influential in the generation of occupational diseases studied. It was found that activity put workers to serious risk of occupational diseases. As the main contributory factors and determinants for this illness: the requirements and control the numbers daily endorsements; evaluation system based on performance targets for productivity; management system at time of service to customers; work with stressful factors (broken box); excess of time worked; furniture of workstations with ergonomic inadequacies and policy for the prevention of occupational diseases inefficient. They have also noted cases of illness for DORT workers without fulfilling the legal requirement of the issuance of the communication of labour accident and without the removal of the employee of the workplace

Efeitos da estimulação ambiental sobre os aspectos motores, cognitivos e neuronais em um modelo farmacológico progressivo da doença de Parkinson

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Beta-bloqueadores em anestesiologia: aspectos farmacológicos e clínicos

JUSTIFICATIVA E OBJETIVOS: Informações experimentais e clínicas têm sugerido que os b-bloqueadores apresentam efeitos hemodinâmicos importantes e protetores durante o ato anestésico-cirúrgico. O objetivo deste trabalho é revisar as informações farmacológicas e clínicas dos b-bloqueadores para sua utilização adequada na medicina per-operatória. CONTEÚDO: Os b-bloqueadores seletivos inibem preferencialmente os b1-receptores reduzindo a freqüência e inotropismo cardíacos e determinando redução no consumo de oxigênio do miocárdio. Os b-bloqueadores não seletivos inibem também os b2-receptores, aumentando a resistência bronquiolar e vascular periférica. Alguns b-bloqueadores são, também, vasodilatadores. O tratamento prolongado com os b-bloqueadores aumenta a densidade dos b-receptores na membrana celular, o que pode explicar a hiperatividade simpática que pode ocorrer durante a parada do tratamento desses medicamentos. em cirurgia não cardíaca, os efeitos benéficos do b-bloqueadores em pacientes hipertensos ou nos que apresentam doença coronariana têm sido demonstrados, com redução da incidência de isquemia miocárdica no pós-operatório e da mortalidade durante o período de dois anos que se segue à operação. CONCLUSÕES: O tratamento com b-bloqueadores deve ser mantido até o período da manhã da operação, exceto nos pacientes com sinais de intolerância à droga, como hipotensão ou bradicardia importante. Os b-bloqueadores exercem efeito benéfico na recuperação pós-operatória de pacientes com doenças cardiovasculares ou nos que apresentam fatores de risco. Por isso, o emprego desses medicamentos é importante na medicina per-operatória e deve ser ampliado.