Modelos explicativos em saúde coletiva: abordagem biopsicossocial e auto-organização

A complexidade do processo saúde-doença tem ensejado a proposição de uma diversidade de modelos explicativos. Fazemos uma breve revisão dessas propostas, confrontando três perspectivas: o modelo oriundo da Medicina do século XIX, a lógica da História Natural da Doença e o debate epidemiológico no contexto da Medicina Social latino-americana. Tomando-se como referência teórica a ideia de causalidade circular presente na teoria da auto-organização, propomos que os fatores causais privilegiados em cada um dos modelos explicativos acima não seriam conflitantes. Uma noção-chave para se pensar o processo de autoorganização biopsicossocial é o efeito baldwiniano, que descreve uma relação dialética ou coevolutiva entre processos naturais e socioculturais.

Auto-percepção de aluna de enfermagem ao desenvolver relação de ajuda a familiares de criança em fase terminal

O presente estudo visa relatar e analisar o processo de relacionamento terapêutico entre aluna de enfermagem e mãe de criança internada em UTI pediátrica, em fase terminal. As interações desenvolvidas neste processo foram gravadas e analisadas no enfoque do Relacionamento Terapêutico. Utilizando técnicas de comunicação terapêutica e medidas terapêuticas de enfermagem, a aluna envolveu-se empaticamente com a mãe da criança e com os demais familiares, propondo-se a ajudá-los a superar suas dificuldades diante da criança em fase terminal. Neste estudo a aluna analisa a sua própria ansiedade diante da situação e as dificuldades que teve devido aos seus conflitos diante da terminalidade do seu paciente.

A proposta de reabilitação psicossocial de Saraceno: um modelo de auto-organização?

Discute-se a teoria da Reabilitação Psicossocial, proposta por Benedetto Saraceno, tomando como referencial a teoria de Sistemas Auto-Organizados, elaborada, entre outros, por Michel Debrun. Observa-se que a proposta de Saraceno satisfaz diversos aspectos do processo de auto-organização, porém não chega a se constituir plenamente como tal. A partir dessa reflexão, pode-se entender melhor algumas das dificuldades da prática de reabilitação na área de Saúde Mental.

Residual signal auto-correlation to evaluate speech in Parkinson's disease patients

Objective: To evaluate the maximum residual signal auto-correlation also known as pitch amplitude (PA) values in patients with Parkinson's disease (PD) patients. Method. The signals of 21 Parkinson's patients were compared with 15 healthy individuals, divided according age and gender. Results: Statistical difference was seen between groups for PA, 0.39 for controls and 0.25 for PD. Normal value threshold was set as 0.3; (p <= 0.001). In the Parkinson's group 80.77%, and in the control group only 12.28%, had a PA < 0.3 demonstrating an association between these variables. The dispersion diagram for age and PA for PD individuals showed p=0.01 and r=0.54. There was no significant difference in relation to gender and PA between groups: Conclusion: the significant differences in pitch's amplitude between PD patients and healthy individuals demonstrate the methods specificity.-The results showed the need of prospective controlled studies,to improve the use and indications of residual signal auto-correlation to evaluate speech in PD patients.

Adaptação para o Português do questionário de auto-avaliação de percepção de saúde física e mental da mulher de meia-idade - Questionário da Saúde da Mulher

The objective of this study is to translate to Brazilian Portuguese, and validate (criterion) it to the Brazilian population, the Women's Health Questionnaire (WHQ), questionnaire was developed by Hunter (1992) in order to evaluate physical and mental symptoms, which were experienced by women, along their climacteric transition. A sample of 63 women, from 45 to 65 years old, was selected from the HC-UNESP staff and HC-Community Health School Center users. The WHQ and the General Health Questionnaire - GHQ (Goldberg-1972 - 60 items) were answered by all of them. The GHQ was used as reference. Pearson correlation coefficient, sensitivity and specificity were calculated for assessing the validity of the questionnaire. Cut-off points were determined in the WHQ by linear regressions (the reference was GHQ's cut-off points - higher than 2). Outcomes highlighted a general index of sensitivity of 0.83, specificity of 0.87, and correlation of - 0.82 and reliability of 0.89. The study sample does not portray the general population because the persons interviewed had high level of education. As the WHQ is easy to be applied and analyzed, it could be used in general, gynecologic, oncology and psychiatric practice.

Comparação entre o sistema Autoścan-4 e métodos convencionais na identificação de bacilos Gram-negativos não fermentadores, isolados de materiais clínicos de pacientes em Presidente Prudente - SP

Ninety eight strains of glucose-nonfermenting Gram-negative bacilli were analyzed and isolated from several clinical materials of 95 patients admitted at the Dr. Domingos Leonardo Cerávolo University Hospital and three from outpatients. All of them were assisted in the Laboratory of Clinical Analysis of Unoeste University, Presidente Prudente, SP, from the period of October of 1999 to April of 2001. In this work, the level of agreement between the semi-automated commercial system AutoScan-4 and the conventional system for the identification of those bacteria were studied comparatively. There was agreement in 81 (82.7%), showing that both methodologies are useful for identification; partial agreement in six strains (6.1%) and disagreement in 11 (11.2%). The comercial system did not identify nine (9.2%) of the strains and reported them as very rare biotypes.

Immunization of Balb/c mice with modified auto-antigens for induction of autoimmune sialoadenitis

Sjögren's syndrome is an autoimmune disease characterized by sialoadenitis and elevated titers of autoantibodies. To assess whether it is possible to induce inflammatory changes in salivary gland tissues, a series of immunizations in Balb/c mice have been undertaken, using salivary gland extract, modified or not, added to several adjuvants. Mice's humoral immune response to salivary gland antigens was monitored by ELISA. Inflammatory cells infiltrating gland tissue were seen 3 months after immunization with salivary gland extract modified with pepsin (AgGp) and metaperiodate (AgGMp). Although pathological progression was not observed, the histopathological picture was similar to the initial phase of Sjögren's syndrome. In addition, a monoclonal antibody reactive with 3 gland polypeptides and anhydrase carbonic II was rescued among B cells from immunized mice. Thus, immunizations with modified autoantigens were able to initiate pathological damage to glandular tissue and stimulate the proliferation of auto-reactive B cells.

Incompatibilidade distributiva e desenvolvimento auto-sustentado

Incluye Bibliografía

Dermatoses bolhosas auto-imunes

Autoimmune bullous dermatoses are diseases in which blisters and vesicles are the primary and fundamental types of skin lesion. Their classification is based on the location of the blister: intraepidermal and subepidermal. Patients produce autoantibodies against self-specific structures of the skin detectable by immunofluorescence techniques, immunoblotting and ELISA. Recent advances in molecular and cellular biology have brought to knowledge these self-antigens, against which patients are sensitized, and which are found in epidermis or in the dermo-epidermal junction. These are low incidence, but high morbidity diseases that may be fatal. The aim of this article is to review and describe the progress of four autoimmune vesiculobullous disorders: endemic pemphigus foliaceous (wild fire), pemphigus vulgaris, bullous pemphigoid and dermatitis herpetiformis. ©2009 by Anais Brasileiros de Dermatologia.

Educação em saúde: Efeito de um método de auto-instruçáo sobre os níveis de higiene oral em escolares

Objective: To identify the effect of a self-instructive method (comic strip), applied with distinct approaches and evaluated over two periods, on the oral health of schoolchildren. Method: The sample comprised 2nd year elementary schoolchildren chosen randomly and divided into four groups: a control group (G1) which received no material, a reading group (G2), which was given the comic strip and read it in the classroom, a discussion group (G3), who received the comic strip, which was read out loud in the classroom and discussed, and a complete group (G4), which received the comic strip and which, after reading it, was asked to rewrite the story. O'Leary's plaque index was used as an evaluation instrument, measured immediately prior to application of the program and again 30 days later. The plaque index measured after and 30 days was compared, in each group, using the Wilcoxon test. The plaque index of the diferents groups was compared using the Kruskal-Walis test, in two moments diferents. The significance level was 5%. Results: The results of the evaluation revealed a statistically significant reduction (p<0.05) of the plaque index presented between the two periods in the four groups studied here. However, this reduction was considerably greater in the discussion and complete groups. Conclusion: The use of the self-instruction method associated with work on its content, as occurred in the discussion and complete groups, led to a better understanding of the subject matter, resulting in a higher reduction of plaque indices.

Generalization of Wye and Delta auto-connections: Analysis of voltages and currents

Multipulse rectifier topologies based on autoconnections, or differential connections, are more and more applied as interface stages between the mains and power converters. These topologies mitigate many low-order current harmonics in the utility, reducing the THD (total harmonic distortion) and increasing the power factor. This paper presents a mathematical model based on phasor diagrams, that results in a single expression able to unify all differential topologies connections (Delta and Wye), for both step-up or step-down autotransformers, for 12 and 18-pulse AC-DC converters. The proposed family of converters can be designed for any relationship between the input voltage and the load voltage. An immediate application would be the retrofit, i.e. to replace a conventional rectifier with poor quality of the processed energy by the 12 or 18 pulses rectifier with Wye or Delta-differential connection. The design procedure, simple and fast, is developed and tested for a prototype rating 6 kW and 250 V on the DC load © 2010 IEEE.

Analysis of inventory management in small business auto parts

The objective of this study was to analyze the production process and supply control in order to identify possible gaps and develop a method for managing supplies. The relevance of this research is on the benefits that can obtain by identifying the problems of supply control. The research method used was the case study, which was grounded on tripod semi-structured interviews, on-site observation, and document analysis. This methodology was very suitable because it can be analyzed and cross checked. The possibility of implementation of the proposal obtained from the theoretical framework, that together with the complementary actions suggested here, offers the opportunity to make the process more productive and profitable. This work allowed one to observe the weaknesses in managing the supply chain and at what points to work should be improved. It allowed to use some scientific models in the company object of study in order to improve supply management. © 2011 IEEE.

Auto-avaliação dos Discentes do Curso de Ciências Biológicas da Unemat, Campus de Nova Xavantina: um modelo para avaliação das disciplinas curriculares, segundo a percepção do corpo discente e docente

This paper presents an evaluation of the curriculum subjects of the Biological Sciences course in the University of the State of Mato Grosso (UNEMAT), Nova Xavantina campus, Brazil. The research was carried out by means of a self-assessment instrument, aimed at searching learners' and educators' points of view. The questionnaires were given in the first, third and seventh semesters, in which students were asked to assess pedagogical aspects regarding professors and their didacticism, as well as the subject matters being taught; in addition, they were invited to evaluate themselves as learners. The data was analyzed using statistical parameters, in order to measure teaching performance, and, subsequently, professors were given the opportunity to express their concepts about the students' assessment. The average value of the overall Cronbach's alpha coefficient was 0.923±0.001, a significant value considering that alpha varies between 0 and 1, which proves the questionnaire to be reliable. The hierarchical cluster analysis (HCA) does not permit teaching performance to be associated with professors' qualification or workload.

A new design methodology for multipulse rectifiers with Delta auto-connected transformers and a retrofit application in Adjustable Speed Drives (ASDs)

Multipulse rectifiers can replace a conventional six pulse three-phase rectifier (diode bridge) providing a DC voltage with low ripple, low Total Harmonic Distortion of current (THDi) and a high Power Factor (PF). In this context is presented a multipulse rectifier with generalized Delta-differential autotransformer topology, which can provide any level of DC output voltage for any level of three-phase AC input voltage. This paper presents all the possible configurations for Delta topology in order to choose, through graphics, one configuration that presents reduced weight and volume. The average voltage on the DC bus must be compatible with the DC voltage in the six pulse rectifier used in commercial ASDs. Therefore, it is possible to apply the retrofit technique to replace the conventional bridge rectifier by the proposed multipulse rectifier. Based on mathematic models and simulation results, an 18-pulse rectifier with Delta topology, 220 V of line voltage, 315 V of DC output, and rating 2.5 kW of power was designed, implemented and applied for three different commercial ASDs. Experimental results as voltage and current waveforms and results about PF and THDi will be presented. © 2012 IEEE.

Avaliação da qualidade de vida em pacientes portadores de câncer de esôfago submetidos à inserção de stent esofágico auto-expansível

Pós-graduação em Bases Gerais da Cirurgia - FMB