951 resultados para Regulation of private health insurance plans in Brazil
Resumo:
The specific Ca2+ binding site that triggers contraction of molluscan muscle requires the presence of an essential light chain (ELC) from a Ca2+ binding myosin. Of the four EF hand-like domains in molluscan ELCs, only domain III has an amino acid sequence predicted to be capable of binding Ca2+. In this report, we have used mutant ELCs to locate the Ca2+ binding site in scallop myosin and to probe the role of the ELC in regulation. Point mutations in domain III of scallop ELC have no effect on Ca2+ binding. Interestingly, scallop and rat cardiac ELC chimeras support Ca2+ binding only if domain I is scallop. These results are nevertheless in agreement with structural studies on a proteolytic fragment of scallop myosin, the regulatory domain. Furthermore, Ca2+ sensitivity of the scallop myosin ATPase requires scallop ELC domain I: ELCs containing cardiac domain I convert scallop myosin to an unregulated molecule whose activity is no longer repressed in the absence of Ca2+. Despite its unusual EF hand domain sequence, our data indicate that the unique and required contribution of molluscan ELCs to Ca2+ binding and regulation of molluscan myosins resides exclusively in domain I.
Resumo:
Issues addressed: The study was designed to gain an understanding of health promotion from the perspective of oral health professionals employed in the public sector during a transition in the focus of services. Methods: A cross sectional survey of oral health professionals employed by Queensland Health was conducted between March and April 2001. Staff were randomly sampled from employment records. A proportionate random sample, stratified across professional groups and geographical zones, was selected. Results: While the majority of the health professionals surveyed perceived oral health promotion to be part of their role, they felt ill equipped to adopt it. Professional groups differed in their confidence and perception of how to promote health in their clinical setting, existing barriers they encountered and their participation in health promotion programs. Conclusions: Strategies to improve the adoption of the oral health promotion role within Queensland public oral health services include: regular in- service and education for all staff regarding health promotion issues; increased cohesion of the oral health team; intersectorial collaboration; supportive district management; and a refocus to primary health care and public health concepts
Resumo:
The thesis examines the system of occupational health and safety in France. It analyses the use of expert manpower in the field with a view to establishing the possibility of a profession in health and safety. An input-output model is developed to bring together the necessary elements of prevention of accidents and occupational diseases. The role of institutions concerned with health and safety is analysed with reference to this model. The research establishes the need for a health and safety specialist role. The recognition and status of this role are found to be subject to other criteria including the acceptance by institutions of such a specialist role. The model is also used to define the role of this specialist as expected by the various institutions intervening in the field.
Resumo:
The principal aim of this paper is to examine the criteria assisting in the selection of biomass for energy generation in Brazil. To reach the aim, this paper adopts case study and survey research methods to collect information from four biomass energy case companies and solicits opinions from experts. The data gathered are analysed in line with a wide range of related data, including selection criteria for biomass and its importance, energy policies in Brazil, availability of biomass feedstock in Brazil and its characteristics, as well as status quo of biomass-based energy in Brazil. The findings of the paper demonstrate that there are ten main criteria in biomass selection for energy generation in Brazil. They comprise geographical conditions, availability of biomass feedstock, demand satisfaction, feedstock costs and oil prices, energy content of biomass feedstock, business and economic growth, CO2 emissions of biomass end-products, effects on soil, water and biodiversity, job creation and local community support, as well as conversion technologies. Furthermore, the research also found that these main criteria cannot be grouped on the basis of sustainability criteria, nor ranked by their importance as there is correlation between each criterion such as a cause and effect relationship, as well as some overlapping areas. Consequently, this means that when selecting biomass more comprehensive consideration is advisable.
Resumo:
Background: Despite a number of programs aimed at the transfer of reproductive health information, adolescents in Zimbabwe still face unprecedented reproductive challenges. Objectives: The study sought to explore adolescent girls’ knowledge of their sexual and reproductive health; the factors that influence their sexual behaviors and to determine the extent to which adolescents had access to sexual and reproductive health information. Methods: The case study methodology was used for the study. The interpretive paradigm was used as the methodological theory and Grunig’s model of excellence in communication was used as the substantive theory. Data was obtained through the use of focus group discussions and indepth interviews. Results: Although adolescents knew the different types of sexually transmitted diseases and were aware of the consequences of engaging in risky sexual behaviors, they engaged in health behaviors which had potential for serious consequences. The study established that adolescents did not have adequate access to sexual and reproductive health information. Sexual issues were not adequately addressed both at school and at home. Conclusion: Adolescents lack adequate access to reproductive health information and there is need for effective communication programs that contribute towards the understanding of communicated messages by audiences and the understanding of audiences by communicators.
Resumo:
Abstract Presently, Hop stunt viroid(HSVd) and Citrus exocortis viroid (CEVd) are the only viroids reported to infect grapevines (Vitis spp.) in Brazil, among the seven viroid species already reported infecting this host in other countries. All grapevine viroid diseases are graft-transmissible and can induce losses especiallywhenassociatedwithviruses.Theaimofthisworkwas to confirm infection by Grapevine yellow speckle viroid 1(GYSVd-1) in grapevine samples exhibiting yellow speckle symptoms in the leaves and in asymptomatic samples sequenced by next generation sequencing (NGS). The occurrence of this viroid in Brazil was further investigated in a second study. Total RNAs and dsRNAs were extracted from five symptomatic plants and 16 asymptomatic samples, respectively. Specific primers were used for RT-PCR and amplified DNA fragments were cloned and sequenced by the Sanger method. Eleven complete nucleotide sequences of GYSVd-1 isolates (366 ?367 nt) were obtained from NGS and from RT-PCR amplicons. Comparisons showed high identities (95.9 ?100 %) among ten isolates and an identity of 87.2 ?90.4 % with a divergent isolate (RM-BR). Phylogenetic analyses placed GYSVd-1 isolates in four clusters (types 1, 2, 3 and 4). All GYSVd-1 infections were confirmed by conventional RT-PCR and RT-qPCR using specific oligonucleo-tides and a labeled probe. This is the first report and molecular characterization of GYSVd-1 infecting grapevines in Brazil, and our survey indicates that this viroid could be widespread in the major grape producing regions of Brazil. Keywords GYSVd-1 . Incidence . Next generation sequencing. Secondary structure. Vine.
Resumo:
The phenolic compounds content and antioxidant activity of pomace from the vinification of grape varieties widely produced in Brazil (Cabernet Sauvignon, Merlot, Bordeaux and Isabel) were investigated with a view to their exploitation as a potential source of natural antioxidants. Cabernet Sauvignon grape pomace was found to have the highest content of total phenolic compounds (74.75 mg gallic acid equivalent (GAE)/g), the highest antioxidant activity (determined using the 2,2`-azino-bis(3-ethylbenzothiazoline-6-sulfonate) (ABTS) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging methods; 485.42 and 505.52 mu Mol Trolox equivalent antioxidant capacity (TEAC)/g, respectively), and the highest reducing power (determined using the FRAP method; 249.46 mu Mol TEAC/g). The Bordeaux variety showed the highest oxidation inhibition power (41.13%), determined using the beta-carotene/linoleic acid method and the highest content of total anthocyanins (HPLC; 29.17 mg/g). Catechin was the most abundant non-anthocyanic compound identified in the grape pomace (150.16 mg/100 g) for all varieties. In this study, pomaces of the red wine vinification of Cabernet Sauvignon and Bordeaux varieties showed the highest potential as a source of antioxidant compounds and natural colourants, respectively. (C) 2011 Elsevier Ltd. All rights reserved.
Resumo:
Objective: To examine the extent to which suicidal ideation and suicide attempts are predictive of service use. Design and setting: The National Survey of Mental Health and Wellbeing considered service utilisation in relation to self-reported mental health problems. Service utilisation was inquired of in relation to hospital-based care (including both specialist mental health and general care settings), as well as consultations with a range of health professionals (both specialist and non-specialist mental health professionals, including psychiatrists, psychologists and general practitioners) on an outpatient basis. Participants: Secondary analysis of self-report data from 10 641 randomly selected Australian adults who participated in the National Survey of Mental Health and Wellbeing in 1997. The key predictor variables were reported suicidal ideation and suicide attempts over the past 12 months. Main outcome measures: Use of services for mental health problems (past 12 months). Results: When considered in isolation, individuals reporting suicidal ideation were more likely to make use of at least one type of service for mental health problems than non-suicidal individuals (OR, 17.3; 95% Cl, 13.2-22.6), and individuals reporting suicide attempts were even more likely to do so (OR, 32.3; 95% CI, 9.0-115.4). In the case of suicidal ideation, this effect remained significant after controlling for a range of potential confounders. For suicide attempts, the effect of mental health service use was no longer significant after other variables were taken into account. Conclusions: Suicidal individuals are likely to make use of services, and a high proportion of suicides may be preventable through appropriate healthcare system responses.
Resumo:
Objectives The aim was to test the potential use of an extract of Mikania laevigata (popularly known in Brazil as guaco), made from leaves harvested in different months of the year, oil neutrophil migration after all inflammatory Stimulus and investigate the underlying molecular mechanisms. Methods We examined the effect of guaco on vascular permeability and leucocyte function in carrageenan-induced peritonitis in mice. Key findings Our results demonstrated that guaco extract administered subcutaneously (3 mg/kg) decreased the vascular permeability and also leucocyte rolling and adhesion to the inflamed tissues by a mechanism dependent on nitric oxide. Specifically, inhibitors of nitric oxide synthase remarkably abrogated the guaco extract-mediated suppression of neutrophil migration to the inflammatory site. In addition, guaco extract-mediated suppression of neutrophil migration appeared to be dependent on the production of the cytokines interleukin-1 beta and tumour necrosis factor-alpha. One of the major constituents of the guaco extract, coumarin, was able to inhibit the neutrophil migration towards the inflammatory focus. Conclusions In conclusion the anti-inflammatory effect induced by guaco extract may be by inhibition of pro-inflammatory cytokine production at the inflammatory site.
Resumo:
This research sought to investigate the self-perceived competence of mental health occupational therapists in Queensland. The research is a post-hoc analysis of survey results that formed part of the 1995 Professional Development Strategy for Adult Mental Health Services for the Queensland Health Mental Health Unit. A sample of 55 occupational therapists was compared with other professionals in relation to both general self-efficacy and efficacy in specific competencies. The devised scale for measuring self-efficacy was found to have a high level of internal reliability. The results indicated that the general self-perceived competence of occupational therapists for the whole sample was comparable to that of other professional groups, but that in the community-based sample it was significantly higher than that of social workers or nurses. In addition, occupational therapists in community settings had significantly higher general self-perceived competence than occupational therapists in hospital locations. Greater length of experience in mental health was strongly predictive of higher levels of competence for occupational therapists than for other professionals. The results suggest that occupational therapists have adapted well to the demands of multidisciplinary community practice. The possible reasons for these results, and the implications for competency-based recruitment and training, are presented.
Resumo:
Mass vaccination campaigns against influenza in the elderly have been conducted in Brazil since 1999. A search of the literature on influenza in Brazil indicated that data on disease burden are still scarce and inaccurate. Published data seem to indicate that vaccination has produced some impact in the southern and southeastern regions but not in other regions of Brazil. A discussion of the technical and scientific rationale for mass immunization against influenza is presented and it is argued that the current strategy has not taken into account potential differences in disease occurrence in different areas. It is suggested some epidemiological surveillance actions needed to address major concerns regarding mass influenza vaccination and its impact in Brazil.
Resumo:
OBJECTIVE: To assess a new impunity index and variables that have been found to predict variation in homicide rates in other geographical levels as predictive of state-level homicide rates in Brazil. METHODS: This was a cross-sectional ecological study. Data from the mortality information system relating to the 27 Brazilian states for the years 1996 to 2005 were analyzed. The outcome variables were taken to be homicide victim rates in 2005, for the entire population and for men aged 20-29 years. Measurements of economic and social development, economic inequality, demographic structure and life expectancy were analyzed as predictors. An "impunity index", calculated as the total number of homicides between 1996 and 2005 divided by the number of individuals in prison in 2007, was constructed. The data were analyzed by means of simple linear regression and negative binomial regression. RESULTS: In 2005, state-level crude total homicide rates ranged from 11 to 51 per 100,000; for young men, they ranged from 39 to 241. The impunity index ranged from 0.4 to 3.5 and was the most important predictor of this variability. From negative binomial regression, it was estimated that the homicide victim rate among young males increased by 50% for every increase of one point in this ratio. CONCLUSIONS: Classic predictive factors were not associated with homicides in this analysis of state-level variation in Brazil. However, the impunity index indicated that the greater the impunity, the higher the homicide rate.
Resumo:
OBJECTIVE To evaluate the validity and reliability of an instrument that evaluates the structure of primary health care units for the treatment of tuberculosis.METHODS This cross-sectional study used simple random sampling and evaluated 1,037 health care professionals from five Brazilian municipalities (Natal, state of Rio Grande do Norte; Cabedelo, state of Paraíba; Foz do Iguaçu, state of Parana; Sao José do Rio Preto, state of Sao Paulo, and Uberaba, state of Minas Gerais) in 2011. Structural indicators were identified and validated, considering different methods of organization of the health care system in the municipalities of different population sizes. Each structure represented the organization of health care services and contained the resources available for the execution of health care services: physical resources (equipment, consumables, and facilities); human resources (number and qualification); and resources for maintenance of the existing infrastructure and technology (deemed as the organization of health care services). The statistical analyses used in the validation process included reliability analysis, exploratory factor analysis, and confirmatory factor analysis.RESULTS The validation process indicated the retention of five factors, with 85.9% of the total variance explained, internal consistency between 0.6460 and 0.7802, and quality of fit of the confirmatory factor analysis of 0.995 using the goodness-of-fit index. The retained factors comprised five structural indicators: professionals involved in the care of tuberculosis patients, training, access to recording instruments, availability of supplies, and coordination of health care services with other levels of care. Availability of supplies had the best performance and the lowest coefficient of variation among the services evaluated. The indicators of assessment of human resources and coordination with other levels of care had satisfactory performance, but the latter showed the highest coefficient of variation. The performance of the indicators “training” and “access to recording instruments” was inferior to that of other indicators.CONCLUSIONS The instrument showed feasibility of application and potential to assess the structure of primary health care units for the treatment of tuberculosis.
Resumo:
RESUMO - Assiste-se a um crescimento exponencial das despesas em saúde, quer na Europa como nos Estados Unidos. Em Portugal, os gastos totais com a saúde ascenderam a 10,2% do PIB, em 2006, contra os 8,8% registados no início da década anterior. É importante perceber o que motiva este crescimento quer em termos globais, quer no que diz respeito ao consumo de recursos, bem como até em termos da despesa pública. Este projecto tem dois objectivos fundamentais: em primeiro lugar, contribuir para o estudo dos factores determinantes da procura de cuidados de saúde em Portugal e, consequentemente, determinar as elasticidades procura – preço para diferentes tipos de cuidados de saúde. Metodologia: Estudo observacional baseado na análise empírica de dados administrativos (claims) respeitantes à utilização dos cuidados de saúde por parte de 12.230 indivíduos detentores de um plano de seguro de saúde individual, numa seguradora privada em Portugal. As elasticidades procura – preço para os diferentes tipos de cuidados de saúde obtiveram-se utilizando as variações percentuais das quantidades dos diferentes cuidados de saúde, antes e depois da variação do preço pago pelo indivíduo, para cada tipo de cuidado de saúde. Resultados: De acordo com a teoria económica tradicional o aumento do preço a pagar reduz o consumo de cuidados de saúde, e a procura é elástica, ou seja, os valores da elasticidade procura – preço obtidos são superiores a 1, em valor absoluto, logo o aumento do preço levou a uma redução mais do que proporcional das quantidades procuradas. A procura de cuidados de saúde em ambulatório é mais sensível à variação do preço do que a procura de cuidados de internamento. ------- ABSTRACT - We are witnessing an exponential growth of health care expenditures around the world. In Portugal, the total expenditure on health amounted to 10.2% of GDP in 2006, against 8.8% at the beginning of previous decade. It is important to understand what motivates this growth both in overall terms, with respect to resource consumption, and even in terms of public spending. This study was designed two achieve two objectives: first, to contribute to the study of demand for health care and, more specifically, to analyze the effect of price changes on the utilization of health care services; and secondly, to estimate the demand elasticity for different types of heath care. Methodology: Observational study based on empirical analysis of administrative data (claims) from a private health insurance Company in Portugal. The sample used had information regarding 12.230 individuals. Demand elasticity for the different types of health care services was obtained by the quotient between the percentage changes in the quantity of health care services, before and after the change in the price paid by the corresponding percentage change in the price. Results: This study showed that, for all medical services, price increases were associated with reductions in the quantity of care consumed as predicted by neoclassical demand theory, and we are in the presence of an elastic demand. This means that price elasticity is greater than 1 in absolute value so the increase in the price led to a more than proportional reduction in the quantity demanded. Demand elasticity was more responsive to changes in the price of specialist and emergency care than to changes in the price of inpatient care.
Resumo:
Dissertation presented to obtain a Ph.D degree in Cellular Biology