844 resultados para Difficulties in the intervention
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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This article aims to analyse the introduction of environmental issues in the context of the production function, which has been referred to as the organisational area to lead corporate environmental management. With that purpose, the theoretical references for corporate environmental management and the necessary alterations in production function have been organised to include environmental aspects, especially in terms of product and process development, quality management, and logistics. Considering that this research field still lacks empirical evidence for Brazilian companies, four case studies were conducted using companies located in the country. The environmental management maturity level of those companies tends to follow the rate with which the environmental issue is introduced in production sub-areas, especially in the product development process. However, in most cases we found that the companies had difficulties in structuring the insertion of the environmental dimension in logistics. The final notes point out the distance observed between what is recommended by international literature and the reality of Brazilian companies in the challenge of making the production function environmentally friendly.
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Among the difficulties found in the implementation of ISO 14001 systems, resistance to change can always be found. It is mainly a consequence of the hurry to change, loss of focus, concentration of decision making at the level of top management, arbitrary imposition of objectives and results, faulty communication, and the absence of motivational and financial incentive for change.Therefore, the main objective of this paper is to present best practices with respect to the management of organizational change due to the implementation of ISO 14001 norms in two industrial companies in the Midwest region of the State of São Paulo - Brazil. (C) 2008 Elsevier Ltd. All rights reserved.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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The results of dynamic instrumentation in two construction sites that used steel rails as pile foundation are presented in this paper. The first dynamic load tests were executed in piles made by single steel rails of the type TR32 and TR37. In the second group of dynamic tests, the piles were made by a composition of two and three steel rails of the same type TR37. The difficulties in placing the sensors, the effect of hammer blow eccentricity and the influence of the non-uniform welding along the pile length are presented in detail and discussed.
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The concept of information is analyzed starting from Adams' hypothesis in The Informational Turn in Philosophy, according to which there has been a far-reaching turn in Philosophy following the publication of Turing's article "Computing Machinery and Intelligence". Adams maintains that new guidelines are being indicated in philosophical research, having the concept of "information" as the basis for treatment of classical problems, such as the relationships between mind-body, perception-action, and the nature of knowledge, amongst others. Partially agreeing with Adams, we believe, however, that his hypothesis faces difficulties, the most fundamental of which concerns the different meanings given to the concept of information. We argue that even though the concept of information underlying the mechanicist proposal of Turing, according to which "to think is to compute", is indeed being employed in Philosophy, this is not because of its mechanistic nature, but mainly due to the representationist presupposition dominant in this area. From this point of view, the informational turn in philosophy would not provide any great novelty, given that since the earliest days philosophical approaches to the nature of mind have always been mainly representationist. The novelty would not lie specifically in the Turing thesis, but in reflections on the nature of information, especially ecological information, and its relation to action.
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BackgroundDetection and quantification of hepatitis C virus (HCV) RNA is integral to diagnostic and therapeutic regimens. All molecular assays target the viral 5'-noncoding region (59-NCR), and all show genotype-dependent variation of sensitivities and viral load results. Non-western HCV genotypes have been under-represented in evaluation studies. An alternative diagnostic target region within the HCV genome could facilitate a new generation of assays.Methods and FindingsIn this study we determined by de novo sequencing that the 3'-X-tail element, characterized significantly later than the rest of the genome, is highly conserved across genotypes. To prove its clinical utility as a molecular diagnostic target, a prototype qualitative and quantitative test was developed and evaluated multicentrically on a large and complete panel of 725 clinical plasma samples, covering HCV genotypes 1-6, from four continents (Germany, UK, Brazil, South Africa, Singapore). To our knowledge, this is the most diversified and comprehensive panel of clinical and genotype specimens used in HCV nucleic acid testing (NAT) validation to date. The lower limit of detection (LOD) was 18.4 IU/ml (95% confidence interval, 15.3-24.1 IU/ml), suggesting applicability in donor blood screening. The upper LOD exceeded 10(-9) IU/ml, facilitating viral load monitoring within a wide dynamic range. In 598 genotyped samples, quantified by Bayer VERSANT 3.0 branched DNA (bDNA), X-tail-based viral loads were highly concordant with bDNA for all genotypes. Correlation coefficients between bDNA and X-tail NAT, for genotypes 1-6, were: 0.92, 0.85, 0.95, 0.91, 0.95, and 0.96, respectively; X-tail-based viral loads deviated by more than 0.5 log10 from 5'-NCR-based viral loads in only 12% of samples (maximum deviation, 0.85 log10). The successful introduction of X-tail NAT in a Brazilian laboratory confirmed the practical stability and robustness of the X-tail-based protocol. The assay was implemented at low reaction costs (US$8.70 per sample), short turnover times (2.5 h for up to 96 samples), and without technical difficulties.ConclusionThis study indicates a way to fundamentally improve HCV viral load monitoring and infection screening. Our prototype assay can serve as a template for a new generation of viral load assays. Additionally, to our knowledge this study provides the first open protocol to permit industry-grade HCV detection and quantification in resource-limited settings.
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Myelodysplastic syndromes (MDS) and juvenile myelomonocytic leukemia (JMML) are rare hematopoietic stem cell diseases affecting children. Cytogenetics plays an important role in the diagnosis of these diseases. We report here the experience of the Cytogenetic Subcommittee of the Brazilian Cooperative Group on Pediatric Myelodysplastic Syndromes (BCG-MDS-PED). We analyzed 168 cytogenetic studies performed in 23 different cytogenetic centers; 84 of these studies were performed in patients with confirmed MDS (primary MDS, secondary MDS, JMML, and acute myeloid leukemia/MDS+Down syndrome). Clonal abnormalities were found in 36.9% of the MDS cases and cytogenetic studies were important for the detection of constitutional diseases and for differential diagnosis with other myeloid neoplasms. These data show the importance of the Cooperative Group for continuing education in order to avoid a late or wrong diagnosis.
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CONTEXTO: O retardo do crescimento intra-uterino (RCIU) continua sendo importante problema em perinatologia neste final de século. A natureza do agente etiológico, o período da gestação em que ocorreu o insulto e a sua duração influenciam o tipo de RCIU. OBJETIVO: Estudar a fisiopatologia do retardo de crescimento intrauterino (RCIU) em ratas, decorrente da restrição protéico-calórica materna, em relação à evolução do pâncreas fetal e placenta entre o 18o e 21o dias de prenhez. TIPO DE ESTUDO: Ensaio clínico randomizado em animal de laboratório. PARTICIPANTES: 41 ratas prenhes, normoglicêmicas, da raça Wistar. INTERVENÇÃO: Constituíram-se seis grupos experimentais: controle, com dieta ad libitum e cesárea, respectivamente, no 18º e 21º dias; grupos dieta restritiva a 25% introduzida no 1o dia da prenhez e cesárea no 18o e 21o dias; grupos com a mesma restrição, porém iniciada no 3o dia, com cesárea no 18o e 21o dias. VARIÁVEIS ESTUDADAS: Os recém-nascidos foram classificados, em relação à média mais ou menos um desvio padrão do grupo controle, em peso pequeno (PIP), adequado (AIP) e grande (GIP) para a idade de prenhez; as placentas foram pesadas e processadas para estudo histopatológico, incluindo morfologia e histoquímica, e os pâncreas fetais, para estudo morfológico. RESULTADOS: A desnutrição protéico-calórica materna causou RCIU após o 18o dia da prenhez. Antes desse período não ocorreu RCIU, porque a desnutrição materna diminuiu o número da prole e a placenta tornou-se vicariante. A restrição alimentar não interferiu com a morfologia do pâncreas fetal, e o estudo imunohistoquímico da placenta mostrou que, quando a restrição é introduzida no 1o dia de prenhez, os estoques de glicogênio também não sofrem alterações, diminuindo entre o 18o e 21o dias, como na prenhez normal. A restrição no 3o dia cursou com baixas concentrações de glicogênio placentário no 18o dia e desaparecimento no 21o dia. CONCLUSÃO: A fisiopatologia do RCIU, decorrente da restrição protéico-calórica materna em ratas, está relacionada com menor peso placentário e baixos estoques de glicogênio placentário.
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Uma técnica para restituir a anatomia acetabular com aprofundamento da cavidade acetabular e reconstrução do ligamento da cabeça do fêmur e da cápsula articular, foi testada em nove cães, de raças de grande porte, portadores de displasia coxofemoral grave com subluxação acentuada ou luxação. O procedimento cirúrgico foi constituído de duas fases. Inicialmente, foi realizada a pectineotomia bilateral em todos os cães. A segunda intervenção nos mesmos cães incluiu abordagem e aprofundamento do acetábulo, reconstrução do ligamento da cabeça do fêmur e da cápsula. em geral, 30 dias após a cirurgia, os cães apoiavam o membro operado para se locomover. Com exceção de dois cães, todos os outros recuperaram a função locomotora do membro pélvico dentro de 60-90 dias. É concluído que a técnica de acetabuloplastia é uma boa alternativa para o tratamento da displasia coxofemoral grave.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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OBJECTIVE: To analyze the effects of motor intervention on the neuropsychiatric symptoms of Alzheimer's disease and on the caregivers' burden. DESIGN: This is a controlled trial evaluating the effects of a motor intervention program on the neuropsychiatric symptoms. SETTING: The intervention was performed on community patients from two university centers specializing in physical exercise for the elderly. SUBJECTS: Patients with Alzheimer's disease were divided into two groups: sixteen received the motor intervention and sixteen controls (five controls were excluded because of clinical intercurrences). INTERVENTIONS: Aerobic exercises (flexibility, strength, and agility) and functional balance exercises were conducted over six months for 60 minutes three times per week. MAIN MEASURES: Psychopathological features of patients were evaluated with the Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia. Caregivers were evaluated using the Neuropsychiatric Inventory-Distress and Burden Interview. A two-way analysis of variance (ANOVA) was applied to observe interactions (pre- vs. post-intervention; participants vs. controls). RESULTS: Patients from the intervention presented a significant reduction in neuropsychiatric conditions when compared to controls (Neuropsychiatric Inventory: F: 11.12; p = 0.01; Cornell Depression scale: F: 11.97; p = 0.01). The burden and stress of caregivers responsible for patients who participated in the intervention significantly decreased when compared to caregivers responsible for controls (Neuropsychiatric Inventory-Distress: F: 9.37; p = 0.01; Burden Interview: F: 11.28; p = 0.01). CONCLUSIONS: Aerobic exercise was associated with a reduction in the neuropsychiatric symptoms and contributed to attenuate the caregivers' burden. However, the researchers were not blinded to the patient's intervention status, which constitutes an important limitation of this study.
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Background: Ageing is characterized by a number of physical changes that contribute to a decline in the ability to perform daily tasks. Stretching has been proposed to reduce hip flexion contracture and increase hip and pelvis range of motion, thus improving gait performance. Objective: The purpose of this study was to determine whether a supervised stretching program designed to improve the range of motion of the lower limbs alters gait kinematics in older adults. Methods: Twenty healthy older adult women (65.9 +/- 4.2 years old and BMI 24.9 +/- 3.5) were divided into 2 groups. The experimental group undertook 12 sessions of stretching exercises, whereas the control group did not engage in any physical activity. Gait performance was assessed at the beginning of the experiment and after the 4-week intervention period. Results: Those in the experimental group showed increased step length, higher velocity and reduced double support time after training. In addition, participants involved in the stretching program showed greater anterior and lateral pelvis tilt and also greater rotation (p < 0.05). Conclusions: Based on our results, we can suggest that a supervised stretching program is effective to alter a number of gait variables. Moreover, after the stretching protocol, aged participants displayed gait parameters which were similar to those reported in young healthy adults. Therefore, stretching can be used as an effective means to improve range of motion and reverse some age-related changes that influence gait performance. Copyright (C) 2009 S. Karger AG, Basel
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)