Discursos e produção de sentidos: experiência da transferência da política do tratamento diretamente observado de curta duração para o controle da tuberculose em Moçambique - África

A estratégia do Tratamento Diretamente Observado de Curta Duração para o controle da tuberculose (DOTS) tem sido usada por vários países do mundo especificamente pelos 22 mais afetados pela doença, que contribuem com cerca de 80% de casos, porém, apesar da estratégia demonstrar a redução de casos e aumentar a adesão dos pacientes ao tratamento, e ter sido implementada em Moçambique desde a década de 1980, a doença continua a ser um problema grave de saúde pública no país. Este estudo tem como objetivo central: analisar a transferência da política do DOTS a partir da visão dos gestores centrais, provinciais e distritais, e profissionais de saúde da província de Nampula. Trata-se de um estudo qualitativo que usa a Análise de Discurso de matriz francesa como seu referencial teórico metodológico que busca a compreensão dos sentidos a partir das condições da produção. Participaram deste estudo 15 profissionais de saúde que ocupavam as posições de gestores, médicos e profissionais de enfermagem e/ou técnicos, e atuavam no Programa nacional de controle de Tuberculose em Moçambique com o mínimo de um ano de experiência, nos meses de maio a agosto de 2014, nos níveis central, provincial (Nampula), e distrital (em oito distritos da província de Nampula). Para a coleta de dados usou-se um roteiro de entrevista semi-estruturado que permitiu explorar os sentidos produzidos. O corpus em análise foi constituído a partir das entrevistas transcritas. Para o auxílio da organização dos dados usou-se o sofware Atlis.ti versão 6. Este estudo teve a aprovação da Comissão Nacional de Bioética e da autorização do Ministro da Saúde de Moçambique. Para a análise dos dados foram identificados quatro blocos discursivos: experiências adotadas na implementação e manutenção do DOTS; estratégias adotadas na implementação e manutenção de DOTS; potencialidades, fragilidades de DOTS no controle da tuberculose e; discursos não buscados pelo roteiro: possíveis soluções. Os sentidos produzidos enfatizam dizeres inscritos em formações discursivas que desconsideram a subjetividade do enfermo; de fragilidades do sistema de saúde, falta de recursos humanos, falta de transporte, baixos salários, insuficiência de laboratórios, distâncias longas entre a moradia do paciente e a unidade sanitária. Ainda os entrevistados entendem como potencialidade a participação dos agentes comunitários e da família no tratamento da doença. Conclui-se que para o controle da tuberculose usando a estratégia DOTS o compromisso do governo deve ser pragmático traduzindo-se em ações concretas como o aumento do financiamento das ações de controle de tuberculose, incluindo as pesquisas, formação dos recursos humanos e, sobretudo, atuar sobre os determinantes socias da saúde

Elaboração e validação de um instrumento de avaliação da transferência do Tratamento Diretamente Observado da tuberculose segundo a perspectiva de profissionais de saúde de nível médio e superior (ATP-IINFOC-TB)

Compreendendo a tuberculose enquanto problema de saúde pública, desde meados dos anos 1990 a Organização Mundial da Saúde recomenda ações de controle da doença, dentre estas a Directly Observed Treatment Short-Course (DOTS) que, junto às demais recomendações, é transferida e executada em diferentes cenários, sendo essa transferência merecedora de atenção e aprofundamento, o que deve ocorrer por meio da utilização de métodos válidos e confiáveis. Trata-se de um estudo metodológico, cujo objetivo é elaborar e validar um instrumento voltado à avaliação da transferência da política do Tratamento Diretamente Observado, segundo a perspectiva de profissionais de saúde, por meio das dimensões \"Informação\", \"Conhecimento\" e \"Inovação\". O estudo foi realizado em três fases, a saber: validação semântica, primeira fase do estudo de campo e segunda fase do estudo de campo. A validação semântica contou com 24 profissionais; a primeira fase do estudo de campo, com 101 profissionais; e a segunda fase do estudo de campo, com 401 profissionais. Na validação semântica, o instrumento foi ajustado segundo as sugestões dos entrevistados, tendo ocorrido também a retirada de dois itens dos 49 inicialmente propostos. Na primeira fase do estudo de campo, o instrumento não apresentou efeito floor and ceiling e foram retirados 8 itens com carga fatorial < 0,30 na Análise Fatorial Exploratória. O instrumento apresentou um bom alfa de Cronbach (?=0,87), e a dimensão \"Conhecimento\" apresentou alfa baixo (?=0,645). Na segunda fase do estudo de campo, o efeito floor and ceiling manteve- se ausente, com baixo coeficiente de correlação linear de Pearson (r), baixo ajuste (55%) e baixo alfa de Cronbach (?=0,61) para a dimensão \"Conhecimento\", tendo as dimensões \"Informação\" e \"Inovação\" atingido valores aceitáveis. Para o instrumento como um todo, o Alfa de Cronbach foi de 0,872. O KMO e o Teste de Esfericidade de Bartlett foram satisfatórios, permitindo a Análise Fatorial Confirmatória. Entretanto, identificou-se baixo valor de ajuste do modelo no CFI e RMSEA (0,576 e 0,088, respectivamente), com uma baixa correlação entre as dimensões propostas. Conclui-se que o instrumento elaborado é capaz de avaliar a transferência do TDO segundo a perspectiva de profissionais de saúde de nível médio e superior de forma unidimensional, sem a utilização das três dimensões inicialmente propostas

Coherent transport in graphene nanoconstrictions

We study the effect of a structural nanoconstriction on the coherent transport properties of otherwise ideal zigzag-edged infinitely long graphene ribbons. The electronic structure is calculated with the standard one-orbital tight-binding model and the linear conductance is obtained using the Landauer formula. We find that, since the zero-bias current is carried in the bulk of the ribbon, this is very robust with respect to a variety of constriction geometries and edge defects. In contrast, the curve of zero-bias conductance versus gate voltage departs from the (2n+1)e2∕h staircase of the ideal case as soon as a single atom is removed from the sample. We also find that wedge-shaped constrictions can present nonconducting states fully localized in the constriction close to the Fermi energy. The interest of these localized states in regards to the formation of quantum dots in graphene is discussed.

Optical initialization, readout, and dynamics of a Mn spin in a quantum dot

We have investigated the spin preparation efficiency by optical pumping of individual Mn atoms embedded in CdTe/ZnTe quantum dots. Monitoring the time dependence of the intensity of the fluorescence during the resonant optical pumping process in individual quantum dots allows to directly probe the dynamics of the initialization of the Mn spin. This technique presents the convenience of including preparation and readout of the Mn spin in the same step. Our measurements demonstrate that Mn spin initialization, at zero magnetic field, can reach an efficiency of 75% and occurs in the tens of nanoseconds range when a laser resonantly drives at saturation one of the quantum-dot transition. We observe that the efficiency of optical pumping changes from dot-to-dot and is affected by a magnetic field of a few tens of millitesla applied in Voigt or Faraday configuration. This is attributed to the local strain distribution at the Mn location which predominantly determines the dynamics of the Mn spin under weak magnetic field. The spectral distribution of the spin-flip-scattered photons from quantum dots presenting a weak optical pumping efficiency reveals a significant spin relaxation for the exciton split in the exchange field of the Mn spin.

Optical control of the spin state of two Mn atoms in a quantum dot

We report on the optical spectroscopy of the spin of two magnetic atoms (Mn) embedded in an individual quantum dot interacting with a single electron, a single exciton, or a single trion. As a result of their interaction to a common entity, the Mn spins become correlated. The dynamics of this process is probed by time-resolved spectroscopy, which permits us to determine an optical orientation time in the range of a few tens of nanoseconds. In addition, we show that the energy of the collective spin states of the two Mn atoms can be tuned through the optical Stark effect induced by a resonant laser field.

Ferromagnetism mediated by few electrons in a semimagnetic quantum dot

A (II,Mn)VI diluted magnetic semiconductor quantum dot with an integer number of electrons controlled with a gate voltage is considered. We show that a single electron is able to induce a collective spontaneous magnetization of the Mn spins, overcoming the short range antiferromagnetic interactions, at a temperature order of 1 K, 2 orders of magnitude above the ordering temperature in bulk. The magnetic behavior of the dot depends dramatically on the parity of the number of electrons in the dot.

Electrical control of a single Mn atom in a quantum dot

We report on the reversible electrical control of the magnetic properties of a single Mn atom in an individual quantum dot. Our device permits us to prepare the dot in states with three different electric charges, 0, +1e, and -1e which result in dramatically different spin properties, as revealed by photoluminescence. Whereas in the neutral configuration the quantum dot is paramagnetic, the electron-doped dot spin states are spin rotationally invariant and the hole-doped dot spins states are quantized along the growth direction.

Single-electron transport in electrically tunable nanomagnets

We study a single-electron transistor (SET) based upon a II–VI semiconductor quantum dot doped with a single-Mn ion. We present evidence that this system behaves like a quantum nanomagnet whose total spin and magnetic anisotropy depend dramatically both on the number of carriers and their orbital nature. Thereby, the magnetic properties of the nanomagnet can be controlled electrically. Conversely, the electrical properties of this SET depend on the quantum state of the Mn spin, giving rise to spin-dependent charging energies and hysteresis in the Coulomb blockade oscillations of the linear conductance.

Graphene single-electron transistor as a spin sensor for magnetic adsorbates

We study single-electron transport through a graphene quantum dot with magnetic adsorbates. We focus on the relation between the spin order of the adsorbates and the linear conductance of the device. The electronic structure of the graphene dot with magnetic adsorbates is modeled through numerical diagonalization of a tight-binding model with an exchange potential. We consider several mechanisms by which the adsorbate magnetic state can influence transport in a single-electron transistor: tuning the addition energy, changing the tunneling rate, and in the case of spin-polarized electrodes, through magnetoresistive effects. Whereas the first mechanism is always present, the others require that the electrode has to have either an energy- or spin-dependent density of states. We find that graphene dots are optimal systems to detect the spin state of a few magnetic centers.

Colour morphotypes of Elysia timida (Sacoglossa, Gastropoda) are determined by light acclimation in food algae

Elysia timida (Risso, 1818) colonizing the shallow waters of the Mar Menor Lagoon (Spain) exhibit a brown and a green morph. It was hypothesised that these morphs were the result of feeding preferentially on brown and green algae, respectively. E. timida and its potential food sources, Acetabularia acetabulum (Chlorophyta) and Halopteris filicina (Heterokontophyta) were collected by snorkelling during April 2010. Photosynthetic pigments were analysed by HPLC, photo-physiological parameters were estimated by PAM fluorometry and body colour was characterized by spectral reflectance. Digital photography was used to count the number and area of red spots (small red dots on the slug’s surface) on the parapodia of the 2 morphs. In the laboratory, green E. timida was fed with A. acetabulum cultured under 2 light treatments (high light, 600 µmol E m−2 s−1 and low light, 40 µmol E m−2 s−1), and digital photography was used to monitor colour alterations in E. timida. Spectral reflectance confirmed the colour differences, but both morphs showed a pigment composition similar to the green alga A. acetabulum and showed none of the pigments present in the brown alga H. filicina, neither immediately after collection of the slugs in situ, nor after the feeding experiment. A. acetabulum grown under high light intensity changed from green to brown colour and E. timida changed to brown colour when fed with high-light acclimated A. acetabulum. Thus, E. timida colour differences could not be attributed to feeding on different algae groups but was likely the result of feeding on A. acetabulum growing under different light intensities.

Quantum Dot-Sensitized Solar Cells Based on Directly Adsorbed Zinc Copper Indium Sulfide Colloids

Heavy metal-based quantum dots (QDs) have demonstrated to behave as efficient sensitizers in QD-sensitized solar cells (QDSSCs), as attested by the countless works and encouraging efficiencies reported so far. However, their intrinsic toxicity has arisen as a major issue for the prospects of commercialization. Here, we examine the potential of environmentally friendly zinc copper indium sulfide (ZCIS) QDs for the fabrication of liquid-junction QDSSCs by means of photoelectrochemical measurements. A straightforward approach to directly adsorb ZCIS QDs on TiO2 from a colloidal dispersion is presented. Incident photon-to-current efficiency (IPCE) spectra of sensitized photoanodes show a marked dependence on the adsorption time, with longer times leading to poorer performances. Cyclic voltammograms point to a blockage of the channels of the mesoporous TiO2 film by the agglomeration of QDs as the main reason for the decrease in efficiency. Photoanodes were also submitted to the ZnS treatment. Its effects on electron recombination with the electrolyte are analyzed through electrochemical impedance spectroscopy and photopotential measurements. The corresponding results bring out the role of the ZnS coating as a barrier layer preventing electron leakage toward the electrolyte, as argued in other QD-sensitized systems. The beneficial effect of the ZnS coating is ultimately reflected on the power conversion efficiency of complete devices, reaching values of 2 %. In a more general vein, through these findings, we aim to call the attention to the potentiality of this quaternary alloy, virtually unexplored as a light harvester for sensitized devices.

Interplay Between Structure, Stoichiometry, and Electron Transfer Dynamics in SILAR-based Quantum Dot-Sensitized Oxides

We quantify the rate and efficiency of picosecond electron transfer (ET) from PbS nanocrystals, grown by successive ionic layer adsorption and reaction (SILAR), into a mesoporous SnO2 support. Successive SILAR deposition steps allow for stoichiometry- and size-variation of the QDs, characterized using transmission electron microscopy. Whereas for sulfur-rich (p-type) QD surfaces substantial electron trapping at the QD surface occurs, for lead-rich (n-type) QD surfaces, the QD trapping channel is suppressed and the ET efficiency is boosted. The ET efficiency increase achieved by lead-rich QD surfaces is found to be QD-size dependent, increasing linearly with QD surface area. On the other hand, ET rates are found to be independent of both QD size and surface stoichiometry, suggesting that the donor–acceptor energetics (constituting the driving force for ET) are fixed due to Fermi level pinning at the QD/oxide interface. Implications of our results for QD-sensitized solar cell design are discussed.

Long time remodeling during retinal degeneration evaluated by optical coherence tomography, immunocytochemistry and fundus autofluorescence

Purpose: To characterize the relationship between fundus autofluorescence (FAF), Optical Coherence Tomography (OCT) and immunohistochemistry (IHC) over the course of chronic retinal degeneration in the P23H rat. Methods: Homozygous albino P23H rats, Sprague–Dawley (SD) rats as controls and pigmented Long Evans (LE) rats were used. A Spectralis HRA OCT system was used for scanning laser ophthalmoscopy (SLO) imaging OCT and angiography. To determine FAF, fluorescence was excited using diode laser at 488 nm. A fast retina map OCT was performed using the optic nerve as a landmark. IHC was performed to correlate with the findings of OCT and FAF changes. Results: During the course of retinal degeneration, the FAF pattern evolved from some spotting at 2 months old to a mosaic of hyperfluorescent dots in rats 6 months and older. Retinal thicknesses progressively diminished over the course of the disease. At later stages of degeneration, OCT documented changes in the retinal layers, however, IHC better identified the cell loss and remodeling changes. Angiography revealed attenuation of the retinal vascular plexus with time. Conclusion: We provide for the first time a detailed long-term analysis of the course of retinal degeneration in P23H rats using a combination of SLO and OCT imaging, angiography, FAF and IHC. Although, the application of noninvasive methods enables longitudinal studies and will decrease the number of animals needed for a study, IHC is still an essential tool to identify retinal changes at the cellular level.

Correlation between SD-OCT, immunocytochemistry and functional findings in an animal model of retinal degeneration

Purpose: The P23H rhodopsin mutation is an autosomal dominant cause of retinitis pigmentosa (RP). The degeneration can be tracked using different anatomical and functional methods. In our case, we evaluated the anatomical changes using Spectral-Domain Optical Coherence Tomography (SD-OCT) and correlated the findings with retinal thickness values determined by immunocytochemistry.Methods: Pigmented rats heterozygous for the P23H mutation, with ages between P18 and P180 were studied. Function was assessed by means of optomotor testing and ERGs. Retinal thicknesses measurements, autofluorescence and fluorescein angiography were performed using Spectralis OCT. Retinas were studied by means of immunohistochemistry. Results: Between P30 and P180, visual acuity decreased from 0.500 to 0.182 cycles per degree (cyc/deg) and contrast sensitivity decreased from 54.56 to 2.98 for a spatial frequency of 0.089 cyc/deg. Only cone-driven b-wave responses reached developmental maturity. Flicker fusions were also comparable at P29 (42 Hz). Double flash-isolated rod-driven responses were already affected at P29. Photopic responses revealed deterioration after P29.A reduction in retinal thicknesses and morphological modifications were seen in OCT sections. Statistically significant differences were found in all evaluated thicknesses. Autofluorescence was seen in P23H rats as sparse dots. Immunocytochemistry showed a progressive decrease in the outer nuclear layer (ONL), and morphological changes. Although anatomical thickness measures were significantly lower than OCT values, there was a very strong correlation between the values measured by both techniques.Conclusions: In pigmented P23H rats, a progressive deterioration occurs in both retinal function and anatomy. Anatomical changes can be effectively evaluated using SD-OCT and immunocytochemistry, with a good correlation between their values, thus making SD-OCT an important tool for research in retinal degeneration.

Zafer-nâme / li-Karaçelebizade Abdülaziz Efendi : manuscript, 1723 or 4

A historical account of the Yerevan and Baghdad campaigns of Murād IV (r. 1623-1640). Composed in eight chapters. Book begins in 1044 AH [1635 AD] with the army setting out from Üsküdar and ends in 1049 AH [1640 AD] with the sultna's return to Istanbul after conclusion of Kasrışirin Treaty.