Mudanças no âmbito da testagem anti-HIV no Brasil entre 1998 e 2005

OBJETIVO: Analisar mudanças na realização de teste anti-HIV, as razões alegadas entre as pessoas que foram ou não testadas e o recebimento de aconselhamento. MÉTODOS: Estudos transversais conduzidos com homens e mulheres de 16 a 65 anos, com amostras representativas do Brasil urbano em 1998 (n=3.600) e 2005 (n=5.040). Características sociodemográficas, sexuais, reprodutivas e de experiências de vida e saúde foram consideradas na análise. A avaliação das possíveis diferenças nas distribuições das variáveis baseou-se nos testes qui-quadrado de Pearson e F design-based (±<5%). RESULTADOS: Em 1998, 20,2% dos entrevistados haviam realizado o teste e 33,6% em 2005. Foram testadas 60% das mulheres na faixa 25-34 anos, mas as que iniciaram a vida sexual antes dos 16 anos e reportaram quatro ou mais parceiros sexuais nos cinco anos anteriores à entrevista foram menos testadas. Não se observou aumento significativo da testagem entre homens, exceto para os de 55-65 anos, renda per capita entre 1-3 e 5-10 salários mínimos, aposentados, protestantes históricos e adeptos de cultos afro-brasileiros, moradores da região Norte/Nordeste e os que declararam parceria homo/bissexual ou não tiveram relações sexuais nos cinco anos anteriores à entrevista. Não aumentou a freqüência de testagem entre pessoas auto-avaliadas como sob alto risco para o HIV. Entre as mulheres, a freqüência de testagem pré-natal aumentou e a testagem por trabalho diminuiu entre os homens. Em 2005, metade dos testados não recebeu orientação antes ou após o teste. CONCLUSÕES: Houve expansão desigual na testagem, atingindo principalmente mulheres em idade reprodutiva, adultas e pessoas com melhores condições sociais. A testagem parece estar aumentando no País sem a devida atenção à decisão autônoma das pessoas e sem o provimento de maior e melhor oferta de aconselhamento

The Borg Scale as an Important Tool of Self-Monitoring and Self-Regulation of Exercise Prescription in Heart Failure Patients During Hydrotherapy - A Randomized Blinded Controlled Trial

Background: The Borg Scale may be a useful tool for heart failure patients to self-monitor and self-regulate exercise on land or in water (hydrotherapy) by maintaining the heart rate (HR) between the anaerobic threshold and respiratory compensation point. Methods and Results: Patients performed a cardiopulmonary exercise test to determine their anaerobic threshold/respiratory compensation points. The percentage of the mean HR during the exercise session in relation to the anaerobic threshold HR (%EHR-AT), in relation to the respiratory compensation point (%EHR-RCP), in relation to the peak HR by the exercise test (%EHR-Peak) and in relation to the maximum predicted HR (%EHR-Predicted) was calculated. Next, patients were randomized into the land or water exercise group. One blinded investigator instructed the patients in each group to exercise at a level between ""relatively easy and slightly tiring"". The mean HR throughout the 30-min exercise session was recorded. The %EHR-AT and %EHR-Predicted did not differ between the land and water exercisegroups, but they differed in the %EHR-RCP (95 +/- 7 to 86 +/- 7. P<0.001) and in the %EHR-Peak (85 +/- 8 to 78 +/- 9, P=0.007). Conclusions: Exercise guided by the Borg scale maintains the patient's HR between the anaerobic threshold and respiratory compensation point (ie, in the exercise training zone). (Circ J 2009; 73: 1871-1876)

Simultaneous preconcentration of copper, zinc, cadmium, and nickel in water samples by cloud point extraction using 4-(2-pyridylazo)-resorcinol and their determination by inductively coupled plasma optic emission spectrometry

A procedure for simultaneous separation/preconcentration of copper. zinc, cadmium, and nickel in water samples, based on cloud point extraction (CPE) as a prior step to their determination by inductively coupled plasma optic emission spectrometry (ICP-OES), has been developed. The analytes reacted with 4-(2-pyridylazo)-resorcinol (PAR) at pH 5 to form hydrophobic chelates, which were separated and preconcentrated in a surfactant-rich phase of octylphenoxypolyethoxyethanol (Triton X-I 14). The parameters affecting the extraction efficiency of the proposed method, such as sample pH, complexing agent concentration, buffer amount, surfactant concentration, temperature, kinetics of complexation reaction, and incubation time were optimized and their respective values were 5, 0.6 mmol L(-1). 0.3 mL, 0.15% (w/v), 50 degrees C, 40 min, and 10 min for 15 mL of preconcentrated solution. The method presented precision (R.S.D.) between 1.3% and 2.6% (n = 9). The concentration factors with and without dilution of the surfactant-rich phase for the analytes ranged from 9.4 to 10.1 and from 94.0 to 100.1, respectively. The limits of detection (L.O.D.) obtained for copper, zinc, cadmium, and nickel were 1.2, 1.1, 1.0. and 6.3 mu g L(-1), respectively. The accuracy of the procedure was evaluated through recovery experiments on aqueous samples. (C) 2009 Published by Elsevier B.V.

Enantioselective determination of chloroquine and its n-dealkylated metabolites in plasma using liquid-phase microextraction and LC-MS

A selective method using three-phase liquid-phase microextraction (LPME) in conjunction with LC-MS-MS was devised for the enantioselective determination of chloroquine and its n-dealkylated metabolites in plasma samples. After alkalinization of the samples, the analytes were extracted into n-octanol immobilized in the pores of a polypropylene hollow fiber membrane and back extracted into the acidic acceptor phase (0.1 M TFA) filled into the lumen of the hollow fiber. Following LPME, the analytes were resolved on a Chirobiotic V column using methanol/ACN/glacial aceti acid/diethylamine (90:10:0.5:0.5 by volume) as the mobile phase. The MS detection was carried out using multiple reaction monitoring with ESI in the positive ion mode. The optimized LPME method yielded extraction recoveries ranging from 28 to 66%. The method was linear over 5 - 500 ng/mL and precision (RSD) and accuracy (relative error) values were below 15% for all analytes. The developed method was applied to the determination of the analytes in rat plasma samples after oral administration of the racemic drug.

Elite athletes: Why does the 'fire' burn so brightly?

Background and Purpose: What drives some athletes to achieve at the highest level whilst other athletes fail to achieve their physical potential? Why does the ‘fire’ burn so brightly for some elite athletes and not for others? A good understanding of an athlete’s motivation is critical to a coach designing an appropriate motivational climate to realize an athlete’s physical talent. This paper examines the motivational processes of elite athletes within the framework of three major social-cognitive theories of motivation. Method: Participants were five male and five female elite track and field athletes from Australia who had finished in the top ten at either the Olympic Games and/or the World Championships in the last six years. Qualitative data were collected using semi-structured interviews. Results and Discussion: Inductive analyses revealed several major themes associated with the motivational processes of elite athletes: (a) they were highly driven by personal goals and achievement, (b) they had strong self-belief, and (c) track and field was central to their lives. The findings are discussed in light of recent social-cognitive theories of motivation, namely, self-determination theory, the hierarchical model of motivation, and achievement goal theory. Self-determined forms of motivation characterised the elite athletes in this study and, consistent with social-cognitive theories of motivation, it is suggested that goal accomplishment enhances perceptions of competence and consequently promotes self-determined forms of motivation.

Attributions for the performance of self and other: It matters who the "other" is

This study tested hypotheses that locus of causality attributions for the academic performance of others are influenced by whether the other is a specific individual, or a typical other, and whether the other is similar or dissimilar to self. The research was carried out in two studies. Study 1 entailed development of two scales to measure perceptions of interpersonal similarity: 254 Australian undergraduates rated their similarity to either a specific other or to typical other students. In Study 2, 332 subjects completed one of the 16-item scales developed in Study 1, along with Rosenberg's self-esteem scale, and self-attribution and other-attribution versions of the Multidimensional Multi-attribution Causation Scale (MMCS). Results showed that attributions for the academic performance of others were strongly affected by whether the other was perceived to be similar or dissimilar to self, especially when the other was a specific individual. In particular, causal attributions for similar specific others were more favourable than attributions for self.

The effect of imposed and self-selected computer monitor height on posture and gaze angle

Objective: The objectives were to determine the postural consequences of varying computer monitor height and to describe self-selected monitor heights and postures. Design: The design involved experimental manipulation of computer monitor height, description of self-selected heights, and measurement of posture and gaze angles. Background. Disagreement exists with regard to the appropriate height of computer monitors. It is known that users alter both head orientation and gaze angle in response to changes in monitor height; however the relative contribution of atlanto-occipital and cervical flexion to the change in head rotation is unknown. No information is available with regard to self-selected monitor heights. Methods. Twelve students performed a tracking task with the monitor placed at three different heights. The subjects then completed eight trials in which monitor height was first self-selected. Sagittal postural and gaze angle data were determined by digitizing markers defining a two-dimensional three-link model of the trunk, cervical spine and head. Results. The 27 degrees change in monitor height imposed was, on average, accommodated by 18 degrees of head inclination and a 9 degrees change in gaze angle relative to the head. The change in head inclination was achieved by a 6 degrees change in trunk inclination, a 4 degrees change in cervical flexion, and a 7 degrees change in atlanto-occipital flexion. The self-selected height varied depending on the initial monitor height and inclination. Conclusions. Self-selected monitor heights were lower than current 'eye-level' recommendations. Lower monitor heights are likely to reduce both visual and musculoskeletal discomfort. Relevance Musculoskeletal and visual discomfort may be reduced by placing computer monitors lower than currently recommended. (C) 1998 Elsevier Science Ltd. All rights reserved.

A medial to lateral shift in premovement cortical activity in hemi-Parkinson's disease: Studies of event-related potentials and whole-scalp magneto encephalography

Cortical activity associated with voluntary movement is shifted from medial to lateral premotor areas in Parkinson's disease. This occurs bilaterally, even for unilateral movements. We have used both EEG and MEG to further investigate medial and lateral premotor activity in patients with hemi-Parkinson's disease, in whom basal ganglia impairment is most pronounced in one hemisphere. The CNV, recorded from 21 scalp positions in a Go/NoGo task, was maximal over central medial regions in control subjects. For hemi-Parkinson's disease subjects, activity was shifted more frontally, reduced in the midline and lateralised towards the side of greatest basal ganglia impairment. With 143 channel whole-scalp magneto encephalography (MEG) we are further examining asymmetries in supplementary motor/premotor cortical activity prior to self-paced voluntary movement. In preliminary results, one hemi-Parkinson's disease patient with predominantly left-side symptoms showed strong medial activity consistent with a dominant source in the left supplementary motor area (SMA). Three patients showed little medial activity, but early bilateral sources within lateral premotor cortex. Results suggest greater involvement of lateral premotor rather than the SMA prior to movement in Parkinson's disease and provide evidence for asymmetric function of the SMA in hemi- Parkinson's disease, with reduced activity on the side of greatest basal ganglia deficit.

Defective NF-kappaB Activation in Response to LPS in Type 1 Diabetes Dendritic Cells

Dendritic cells (DC) are the potent antigen presenting cells which modulate T cell responses to self or non-self antigens. DC play a significant role in the pathogenesis of autoimmune diseases, inflammation and infection, but also in the maintenance of tolerance. NF-kappaB, particularly RelB is a crucial pathway for myeloid DC differentiation and functional maturation. While the current paradigm is that mature, nuclear RelB+ DC prime T cells for immunity/autoimmunity and immature DC for tolerance, RelB-deficient mice paradoxically develop generalised systemic autoimmune inflammatory disease with myelopoiesis and splenomegaly. Previous studies suggested abnormal DC differentiation in healthy relatives of type 1 diabetes (t1dm) patients. Therefore, we compared NF- kB activation in monocyte-derived DC from t1dm and non-t1dm controls in response to LPS. While resting DC appeared normal, DC from 6 out of 7 t1dm patients but no t2dm or rheumatoid arthritis patients failed to translocate NF- kB subunits to the nucleus in response to LPS, along with a failure to up-regulate expression of cell surface CD40 and MHC class I. NF- kB subunit mRNA increased normally in t1dm DC after LPS. Both the classical or non-canonical NF- kB pathways were affected as both TNF-a and CD40 stimulation led to a similarly abnormal NF- kB response. In contrast, expression of phosphorylated p38 MAPK and pro-inflammatory cytokine production was intact. These abnormalities in NF- kB activation appear to be generally and specifically applicable at a post-translational level in t1dm, and have the capacity to profoundly influence immunoregulation in affected individuals.

Periurethral Suspension Stitch During Robot-Assisted Laparoscopic Radical Prostatectomy: Description of the Technique and Continence Outcomes

Background: Several studies have shown that robot-assisted laparoscopic radical prostatectomy (RALP) is feasible, with favorable complication rates and short hospital times. However, the early recovery of urinary continence remains a challenge to be overcome. Objective: We describe our technique of periurethral retropubic suspension stitch during RALP and report its impact on early recovery of urinary continence. Design, setting, and participants: We analyze prospectively 331 consecutive patients who underwent RALP, 94 without the placement of suspension stitch (group 1) and 237 with the application of the suspension stitch (group 2). Surgical procedure: The only difference between the groups was the placement of the puboperiurethral stitch after the ligation of the dorsal venous complex (DVC). The periurethral retropubic stitch was placed using a 12-in monofilament polyglytone suture on a CTI needle. The stitch was passed from right to left between the urethra and DVC, and then through the periostium on the pubic bone. The stitch was passed again through the DVC, and then through the pubic bone in a figure eight, and then tied. Measurements: Continence rates were assessed with a self-administered validated questionnaire (Expanded Prostate Cancer Index Composite [EPIC] at 1, 3, 6, and 12 mo after the procedure. Continence was defined as the use of no absorbent pads or no leakage of urine. Results and limitations: In group 1, the continence rate at 1, 3, 6, and 12 mo postoperatively was 33%, 83%, 94.7%, and 95.7%, respectively; in group 2, the continence rate was 40%, 92.8%, 97.9%, and 97.9%, respectively. The suspension technique resulted in significantly greater continence rates at 3 mo after RALP (p = 0.013). The median/mean interval to recovery of continence was also statistically significantly shorter in the suspension group (median: 6 wk; mean: 7.338 wk: 95% confidence interval [CI]: 6.387-8.288) compared to the non-suspension group (median: 7 wk; mean: 9.585 wk: 95% CI: 7.558-11.612; log rank test, p = 0.02). Conclusions: The suspension stitch during RALP resulted in a statistically significantly shorter interval to recovery of continence and higher continence rates at 3 mo after the procedure. (C) 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Analytical validation for a series of marker compounds used to assess renal drug elimination processes

Renal drug elimination is determined by glomerular filtration, tubular secretion, and tubular reabsorption. Changes in the integrity of these processes influence renal drug clearance, and these changes may not be detected by conventional measures of renal function such as creatinine clearance. The aim of the current study was to examine the analytic issues needed to develop a cocktail of marker drugs (fluconazole, rac-pindolol, para-aminohippuric acid, sinistrin) to measure simultaneously the mechanisms contributing to renal clearance. High-performance liquid chromatographic methods of analysis for fluconazole, pindolol, para-aminohippuric acid, and creatinine and an enzymatic assay for sinistrin were developed or modified and then validated to allow determination of each of the compounds in both plasma and urine in the presence of all other marker drugs. A pilot clinical study in one volunteer was conducted to ensure that the assays were suitable for quantitating all the marker drugs to the sensitivity and specificity needed to allow accurate determination of individual renal clearances. The performance of all assays (plasma and urine) complied with published validation criteria. All standard curves displayed linearity over the concentration ranges required, with coefficients of correlation greater than 0.99. The precision of the interday and intraday variabilities of quality controls for each marker in plasma and urine were all less than 11.9% for each marker. Recoveries of markers (and internal standards) in plasma and urine were all at least 90%. All markers investigated were shown to be stable when plasma or urine was frozen and thawed. For all the assays developed, there were no interferences from other markers or endogenous substances. In a pilot clinical study, concentrations of all markers could be accurately and reproducibly determined for a sufficient duration of time after administration to calculate accurate renal clearance for each marker. This article presents details of the analytic techniques developed for measuring concentrations of marker drugs for different renal elimination processes administered as a single dose to define the processes contributing to renal drug elimination.

Confirmatory Factor Analysis of the Behavioural Regulation in Exercise Questionnaire – Portuguese Version

Exercise constitutes one of the pillars of a healthy lifestyle (USDHHS, 1996). Paradoxically, more than 40% of Europeans are sedentary (Eurobarometer 213, 2004), although some interventions, at both community and individual levels, have been established to improve this situation. Some of these interventions are based on Self-Determination Theory (SDT: Deci & Ryan, 1985), which state that more internalized types of behaviour regulation lead to feelings of selfdetermination in one’s chosen activities and, consequently, to greater likelihood of behavioural adherence. Today, SDT is one of the most popular approaches to the study of exercise, thus the cross-cultural validation of instruments that can measure its constructs is a necessary step to further advance in the study of exercise motivation.

O papel da Organização das Nações Unidas em Angola

RESUMO: Angola tem sido ao longo dos tempos objecto de cobiça por parte de países estrangeiros por motivações diversas, que foram desde interesses coloniais – como aconteceu com Portugal, que durante séculos a colonizou, e da Holanda, que dominou Luanda entre 1641 e 1648 – ou por interesses hegemónicos, ideológicos e políticos – como sucedeu com os EUA e a URSS, mas também com a Republica Popular da China e Cuba – e até por interesses regionais – como foram os casos da África do Sul e dos contíguos Congo Belga, hoje Republica Democrática do Congo, e Zâmbia. No entanto, a todos estes interesses diversos não se pode excluir um que lhes é transversal: o interesse económico. De facto, os 1246700 km² de que Angola dispõe, aliados à sua excelente localização geográfica com uma extensa costa atlântica e a sua extraordinária riqueza em recursos naturais podem explicar este envolvimento estrangeiro na História de Angola. No que diz respeito ao objecto da Dissertação, o envolvimento da ONU nas questões relacionadas com Angola remonta à década de 50, ou seja, ao período colonial e muito antes da independência do país em 1975, devido à política descolonizadora saída da II Guerra Mundial. Além disso, a dinâmica que emergiu da II Guerra Mundial, rapidamente, reconfigurou o panorama político internacional em dois blocos: o ocidental liderado pelos EUA e o de Leste liderado pela URSS, que se envolveram numa Guerra Fria, polarização cujos efeitos se ligam de forma trágica à guerra em Angola, primeiro para a autodeterminação, e, depois, já num contexto de independência, num conflito armado que ultrapassou o plano interno. Os interesses dos EUA e da URSS, que começaram por ser antagónicos, deram lugar em 1989 com o fim da bipolaridade a uma cooperação mais aberta e uma abertura política em Angola rumo à paz e ao início da construção da democracia. Neste trabalho estuda-se o papel da ONU em Angola, quer no período de luta pela independência, quer depois, na busca da paz no sangrento conflito – nem sempre civil – que mesmo antes da data da independência, a 11 de Novembro de 1975, e até Fevereiro de 2002, dilacerou o país. Procura-se, igualmente, analisar o contributo da ONU na consolidação das instituições e na construção de um regime democrático em Angola. ABSTRACT: Angola has been along time subject to the greed of several foreign countries for many reasons and motivations which go from colonial interests - that is the cases of, Portugal which for centuries colonized it, and Netherlands under whose administration had been Luanda between 1641 and 1648 - or for hegemonic, ideological and political interests - as it happened in regard to USA and USSR, but also People‟s Republic of China, Cuba, - and even for regional interests - regarding South Africa Republic, and the neighbouring countries, Democratic Republic of Congo (ancient Republic of the Congo “Leopoldville”), and the Republic of Zambia. On the other hand to these interests we may join another which is transversal to all of them: economic interest. Effectively, Angola‟s 481,351 square miles (1,246,700 Km2) estimated area, combined with its excellent geographical location with a lengthy Atlantic coast, its extraordinary richness in natural resources may well explain this foreign participation in its Political History. Concerning the objective of this work, the UN has been involved in matters regarding Angola since the decade of 50 of the last century, during the colonial period, long before the independence of the country in 1975, due to the decolonization policy emerged from the Second World War. Furthermore, after the Second World War, international environment has changed, transforming quickly the world into two main blocs, the West with the leadership of the USA and the East with the leadership of USSR which went into a Cold War. The effects of this polarization reached tragically Angola, early in the fight for self-determination, and went on later after independence in an armed conflict, which has overcome the internal dimension. The USA and USSR interests, at the beginning being antagonistic had become by 1989, with the end of bipolarity, more cooperative, leading Angola to a political reform towards peace and beginning the construction of democracy. In this academic work it‟s studied the UNO role in Angola since the fight for self-determination early in the sixties of last century, and later in the search for peace during the bloody - and not always civil – war conflict which very before independence date in 11th November 1975, and as long as 2002, divided the country. Additionally, this work aims to understand the UNO contribution to consolidate institutions and to promote democracy in Angola.

Comparing a current-carrying circular wire with polygons of equal perimeter: Magnetic field versus magnetic flux

We compare the magnetic field at the centre and the self-magnetic flux through a current-carrying circular loop, with those obtained for current-carrying polygons with the same perimeter. As the magnetic field diverges at the position of the wires, we compare the self-fluxes utilizing several regularization procedures. The calculation is best performed utilizing the vector potential, thus highlighting its usefulness in practical applications. Our analysis answers some of the intuition challenges students face when they encounter a related simple textbook example. These results can be applied directly to the determination of mutual inductances in a variety of situations.

Auto-determinação e inclusão social das pessoas com deficiência mental - uma intervenção centrada no sujeito

Dotar as pessoas com deficiência mental com competências para se autodeterminarem e terem a oportunidade de concretizar a sua plena inclusão social, é um desafio colocado à sociedade actual. Torna-se importante colocar em prática o que diferentes autores e organizações como a American Association of Mental Retardation defendem, criando condições para que os profissionais, famílias e comunidade possam ser os facilitadores deste processo. Neste sentido foi implementado no Centro de Reabilitação de Ponte de Lima um modelo de intervenção específico baseado na promoção e desenvolvimento da autonomia pessoal, social e de realização da pessoa com deficiência mental e criado um instrumento de observação e registo que reflecte essa forma de intervenção designado por Protocolo de Registo e Avaliação de Competências - PRAC. Neste estudo realizou-se uma análise ao instrumento em causa, pretendendo dar um contributo para a sua posterior validação. Nesse sentido, utilizou-se uma metodologia qualitativa e quantitativa para analisar se o instrumento pode ou não ser considerado representativo da capacidade de autodeterminação; se é estável quando utilizado por mais que um utilizador; se descrimina os indivíduos com maior ou menor autonomia e se os itens quando sujeitos à análise factorial, evidenciam os constructos teóricos previamente traçados. Muito embora o PRAC tenha sido pensado e estruturado para pessoas com deficiência mental, neste estudo foi utilizado por um grupo diversificado de profissionais oriundos de áreas distintas o que veio comprovar que o instrumento pode ser utilizado em diferentes contextos e com público-alvo mais alargado. Os resultados evidenciados são consistentes, permitindo respostas positivas às questões elaboradas, é de referir contudo que necessitam de um maior aprofundamento de forma a estabelecer outro tipo de generalizações.