759 resultados para 1104


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This study aimed to analyze how the families of cancer patients perceived the treatment provided at a specialist public outpatient clinic, using Bardin's method of Content Analysis. Seven families consisting of fourteen family members were interviewed. They underlined doctor-patient relationship, judging it to be impersonal and superficial, resulting in a lack of security and trust. Families try to to participate but feel undervalued and excluded from the care. Necessary information that they are not given is sought in the media, while comfort is achieved through religious or spiritual practices. Health care training must encourage professionals to view the family as a unit of care, aligning training to different modes of health care.

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The elderly are the object of policies of protection against risks and diseases. According to the liberal premise, the idea is ensure the individual's independence, which actually serves to isolating and weakening the elderly. We propose the paradigm of recognition and social bonds that support the life of individuals who exercise recognition and are recognized. Intersubjective autonomy is guaranteed through relations of affection/friendship, social esteem, recognition of rights and responsibilities and threatened by de-valuing attitudes, disrespect and violence. This contributes to the health of the elderly, by understanding exclusion, slander and trauma and supporting the care institution with a view to integrity and social justice.

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

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The Family Health Strategy facilitates user access to mental health actions. This study aimed to verify the community health agents’ perceptions of the Family Health Strategy about mental disorder. A qualitative study was conducted with 26 randomly selected community health agents, among the professionals of 13 units, which constitute the Family Health Strategy of Itapeva (SP). The community health agents responded to a personal information questionnaire and a semi-structured interview. Data were checked through content analysis. Stigmatizing perception of the mentally disturbed persons, lack of knowledge about the process of falling ill and the mental disorder evolution, and the unpreparedness to act in this population were observed. Capacitating agents enable them to contribute in a positive way to the effective functioning of a care net in mental health in the city.

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In the light of the collective health and of the mental health, the concept of territory is present in multiple dimensions and meanings. It appears in documents that express principles and guidelines of the health policies and in the planning of local actions, and it is a central element to organize the care network in psychosocial attentiveness. This present essay aims to discuss the concept of territory and its uses in the practices of psychosocial care, developing a dialogue with the geographer Milton Santos and the philosophers Gilles Deleuze and Félix Guattari who, from different fields and perspectives, work with this concept. This dialogue made it possible to think the territory in its complexity, as space, process and composition, in order to optimize the relationship between service, culture, production of care and production of subjectivity.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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This study aimed to evaluate the efficacy of chemical agents to increase the bleaching effectiveness of 10% carbamide peroxide. Two hundred and ninety enamel-dentin discs were prepared from bovine incisors. The color measurement was performed by a spectrophotometer using the CIE L*a*b*system. The groups were divided according to the bleaching treatment: negative control group (NC): without bleaching; positive control group (PC): bleached with 10% carbamide peroxide gel without any chemical activator; Manganese gluconate (MG); Manganese chloride (MC); Ferrous gluconate (FG); Ferric chloride (FC); and Ferrous sulphate (FS). Three different concentrations (MG, MC, FG, FC: 0.01, 0.02 and 0.03% w/w; FS: 0.001, 0.002 and 0.003% w/w) for each agent were tested. The bleaching gel was applied on the specimens for 8 h, after which they were immersed in artificial saliva for 16 h, during 14 days. Color assessments were made after 7 and 14 days. The data were analyzed by repeated measures analysis of variance and Tukey's test (5%). Generally, the test groups were unable to increase the bleaching effect (ΔE) significantly compared to the PC group. Only for ΔL, significant higher values compared to the PC group could be seen after 7 days in groups MG (0.02%), and FS (0.002 and 0.003%). The NC group showed significantly lower values than all tested groups. It was concluded that for home bleaching procedures, the addition of chemical activators did not produce a bleaching result significantly higher than the use of 10% carbamide peroxide without activation, and that the concentration of chemical activators used did not significantly influence the effectiveness of treatment.

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Solid-organ transplant recipients present a high rate of non-adherence to drug treatment. Few interventional studies have included approaches aimed at increasing adherence. The objective of this study was to evaluate the impact of an educational and behavioral strategy on treatment adherence of kidney transplant recipients. In a randomized prospective study, incident renal transplant patients (n = 111) were divided into two groups: control group (received usual transplant patient education) and treatment group (usual transplant patient education plus ten additional weekly 30-min education/counseling sessions about immunosuppressive drugs and behavioral changes). Treatment adherence was assessed using ITAS adherence questionnaire after 3 months. Renal function at 3, 6, and 12 months, and the incidence of transplant rejection were evaluated. The non-adherence rates were 46.4 and 14.5 % in the control and treatment groups (p = 0.001), respectively. The relative risk for non-adherence was 2.59 times (CI 1.38-4.88) higher in the control group. Multivariate analysis demonstrated a 5.84 times (CI 1.8-18.8, p = 0.003) higher risk of non-adherence in the control group. There were no differences in renal function and rejection rates between groups. A behavioral and educational strategy addressing the patient's perceptions and knowledge about the anti-rejection drugs significantly improved the short-term adherence to immunosuppressive therapy.

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Despite having a very low incidence of disease, reindeer (Rangifer tarandus) are subject to tuberculosis (TB) testing requirements for interstate shipment and herd accreditation in the United States. Improved TB tests are desperately needed, as many reindeer are falsely classified as reactors by current testing procedures. Sera collected sequentially from 11 (experimentally) Mycobacterium bovis-infected reindeer and 4 noninfected reindeer were evaluated by enzyme-linked immunosorbent assay (ELISA), immunoblotting, and multiantigen print immunoassay (MAPIA) for antibody specific to M. bovis antigens. Specific antibody was detected as early as 4 weeks after challenge with M. bovis. By MAPIA, sera were tested with 12 native and recombinant antigens, which were used to coat nitrocellulose. All M. bovis-infected reindeer developed responses to MPB83 and a fusion protein, Acr1/MPB83, and 9/11 had responses to MPB70. Other antigens less commonly recognized included MPB59, ESAT-6, and CFP10. Administration of purified protein derivatives for skin testing boosted serum antibody responses, as detected by each of the assays. Of the noninfected reindeer, 2/4 had responses that were detectable immediately following skin testing, which correlated with pathological findings (i.e., presence of granulomatous lesions yet the absence of acid-fast bacteria). The levels of specific antibody produced by infected reindeer appeared to be associated with disease progression but not with cell-mediated immunity. These findings indicate that M. bovis infection of reindeer elicits an antibody response to multiple antigens that can be boosted by skin testing. Serological tests using carefully selected specific antigens have potential for early detection of infections in reindeer.

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Order Cetacea, Suborder Odontoceti, Superfamily Delphinoidea, Family Phocoenidae. Four species are included in the genus. No subspecies are recognized in P. sinus.

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Landowners and agencies have expressed difficulty finding hunters willing to harvest the female portion of the ungulate populations, and likewise, hunters have expressed difficulty achieving access to private lands. Since 2003, the Montana “DoeCowHunt” website (www.doecowhunt.montana.edu) has provided an avenue to improve hunter-landowner contact and wild ungulate population management. A product of Montana State University Extension Wildlife Program, this website provides a means for hunters and landowners in Montana to contact each other by listing contact information (email address, physical address, and telephone number) for the purpose of harvesting antlerless ungulates. In the first year over 10,000 users visited the site. Of those who actually registered, 11 were landowners and 1334 were hunters. An evaluation survey resulted in a 40% response rate. The survey indicated the average registered landowner had 20 hunter contacts. Many landowners contacted hunters through use of the website but did not register or list their contact information on the site.

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Purpose--The paper theoretically and empirically investigates the impact on human capital investment decisions and income growth of lowered life expectancy as a result of HIV/AIDS and other diseases. Design/methodology/approach--The theoretical model is a three-period overlapping generations model where individuals go through three stages in their life, namely, young, adult and old. The model extends existing theoretical models by allowing the probability of premature death to differ for individuals at different life stage, and by allowing for stochastic technological advances. The empirical investigation focuses on the effect of HIV/AIDS on life expectancy and on the role of health on educational investments and growth. We address potential endogeneity by using various strategies, such as controlling for country specific time-invariant unobservables and by using the male circumcision rate as an instrumental variable for HIV/AIDS prevalence. Findings--We show theoretically that an increased probability of premature death leads to less investment in human capital, and consequently slower growth. Empirically we show that HIV/AIDS has resulted in a substantial decline in life expectancy in African countries and these falling life expectancies are indeed associated with lower educational attainment and slower economic growth world wide. Originality/value--The theoretical and empirical findings reveal a causal link flowing from health to growth, which has been largely overlooked by the existing literature. The main implication is that health investments, that decrease the incidence of diseases like HIV/AIDS resulting on increases in life expectancy, through its complementarity with human capital investments lead to long run growth..

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Genotypic, developmental, and environmental factors converge to determine the degree of Crassulacean acid metabolism (CAM) expression. To characterize the signaling events controlling CAM expression in young pineapple (Ananas comosus) plants, this photosynthetic pathway was modulated through manipulations in water availability. Rapid, intense, and completely reversible up-regulation in CAM expression was triggered by water deficit, as indicated by the rise in nocturnal malate accumulation and in the expression and activity of important CAM enzymes. During both up-and down-regulation of CAM, the degree of CAM expression was positively and negatively correlated with the endogenous levels of abscisic acid (ABA) and cytokinins, respectively. When exogenously applied, ABA stimulated and cytokinins repressed the expression of CAM. However, inhibition of water deficit-induced ABA accumulation did not block the up-regulation of CAM, suggesting that a parallel, non-ABA-dependent signaling route was also operating. Moreover, strong evidence revealed that nitric oxide (NO) may fulfill an important role during CAM signaling. Up-regulation of CAM was clearly observed in NO-treated plants, and a conspicuous temporal and spatial correlation was also evident between NO production and CAM expression. Removal of NO from the tissues either by adding NO scavenger or by inhibiting NO production significantly impaired ABA-induced up-regulation of CAM, indicating that NO likely acts as a key downstream component in the ABA-dependent signaling pathway. Finally, tungstate or glutamine inhibition of the NO-generating enzyme nitrate reductase completely blocked NO production during ABA-induced up-regulation of CAM, characterizing this enzyme as responsible for NO synthesis during CAM signaling in pineapple plants.

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The incidence of obesity is increasing rapidly all over the world and results in numerous health detriments, including disruptions in reproduction. However, the mechanisms by which excess body fat interferes with reproductive functions are still not fully understood. After weaning, female rats were treated with a cafeteria diet or a chow diet (control group). Biometric and metabolic parameters were evaluated in adulthood. Reproductive parameters, including estradiol, progesterone, LH and prolactin during the proestrus afternoon, sexual behavior, ovulation rates and histological analysis of ovaries were also evaluated. Cafeteria diet was able to induce obesity in female rats by increasing body and fat pad weight, which resulted in increased levels of triglycerides, total cholesterol, LDL and induced insulin resistance. The cafeteria diet also negatively affected female reproduction by reducing the number of oocytes and preantral follicles, as well as the thickness of the follicular layer. Obese females did not show preovulatory progesterone and LH surges, though plasma estradiol and prolactin showed preovulatory surges similar to control rats. Nevertheless, sexual receptiveness was not altered by cafeteria diet. Taken together, our results suggest that the cafeteria diet administered from weaning age was able to induce obesity and reduce the reproductive capability in adult female rats, indicating that this obesity model can be used to better understand the mechanisms underlying reproductive dysfunction in obese subjects. (C) 2012 Elsevier Inc. All rights reserved.