Evidências de necessidades de autocuidado de militares com hipertensão arterial sistêmica da Marinha do Brasil: contribuição da Enfermagem

Este estudo refere-se às evidências de necessidades de autocuidado de militares com hipertensão sistêmica da Marinha do Brasil. A hipertensão arterial é uma das doenças crônicas mais frequentes, de maior prevalência no mundo e a sua evolução leva a complicações que comprometem todos os sistemas orgânicos. Neste sentido o problema apresentado é: como se caracterizam as necessidades de autocuidado de militares hipertensos da Marinha do Brasil. Para tanto, o objetivo geral da pesquisa foi: Discutir as necessidades de cuidado no processo saúde/adoecimento do militar da Marinha do Brasil e os objetivos específicos: Descrever as características sociodemográficas e de autocuidado dos militares atendidos no ambulatório de cardiologia do HNMD; Identificar através dos depoimentos dos militares, as necessidades de autocuidado e; Propor estratégias de autocuidado em saúde aos militares. O referencial teórico utilizado foi o Modelo de Promoção de Saúde de Nola J Pender. Trata-se de um estudo misto de caráter exploratório e descritivo, realizado no ambulatório de Cardiologia do Hospital Naval Marcilio Dias, no município do Rio de Janeiro, no período de julho a agosto de 2014. Os sujeitos do estudo foram 20 militares hipertensos da Marinha do Brasil com idade acima dos 25 anos. Os dados foram coletados por meio de entrevista semiestruturada, em seguida, submetidos à análise de conteúdo de Bardin, emergindo três categorias e subcategorias assim denominadas: Primeira: Evidências de necessidades de autocuidado. Segunda: Identificação situacional da saúde dos militares com a subcategoria: A experiência do autocuidado para o militar com HAS. Terceira: Interesse pelo autocuidado com duas subcategorias: Interesse pelo aprendizado e Estratégias para o aprendizado do autocuidado. O perfil dos participantes caracterizou-se da seguinte maneira: Dos 20 militares, 19 são homens e 1 mulher, sendo 3 da ativa e 17 da reserva, a maioria são casados, idosos, de etnia parda e crença religiosa cristã, possuem ensino médio completo, com remuneração acima de 4 salários mínimos, residindo em local com saneamento básico. Quanto ao autocuidado referido pelos participantes: a maioria controla o uso de sal, ingesta hídrica adequada, utilizam alimentação balanceada, praticam algum tipo de exercício diário, a maioria referiu uso regular de anti-hipertensivos, e procura pelos serviços de saúde, quando necessário. Conclui-se que apesar do autocuidado referido, estes estão aquém às necessidades de saúde e não atendem às demandas de autocuidado necessária à manutenção da vida. Apesar de diversos fatores contribuírem para desmotivar os militares em relação ao autocuidado, eles apresentam interesse em aprender novas tecnologias de cuidar para adequação de sua saúde atual e melhora da qualidade de vida. Para atender às necessidades de autocuidado identificadas, sugere-se planejamento das ações estratégicas de promoção à saúde conjunta, com a equipe multiprofissional, instituindo a consulta de enfermagem, avaliação do autocuidado, prevenção dos fatores de risco e acompanhamento regular para análise das mudanças efetivas dos hábitos de vida saudáveis.

Identidades na Roda: diálogos com a Capoeira Angola e com as narrativas de suas/seus praticantes

Este trabalho tem como proposta pensar os processos identitários da afrodiáspora, a partir dos diálogos com a Capoeira Angola e as narrativas de suas/seus praticantes. Apresentamos a Capoeira Angola como prática cultural de matriz africana, significada por um processo histórico de luta e resistência das populações negras na diáspora. Procuramos discutir quais identidades são reivindicadas, tecidas e enunciadas nessa prática, com especial atenção às identidades angoleiras, às identidades negras e ao pertencimento etnicorracial enunciado por suas/seus praticantes. O processo histórico de escravização das populações negras no Brasil resultou na discriminação racial de mulheres e homens negras/os e na visibilização estereotipada das suas práticas e epistemologias, produzindo diferenciações hierárquicas. A cultura como enunciação e diferença permite através do ato enunciativo, a produção de novos sentidos e significados para as populações negras, que ressignificam suas identidades e tensionam às lógicas e racionalidades hegemônicas. As identidades são compreendidas como processos de identificação, permitidos pelo dinamismo da cultura e pelas práticas discursivas. O agenciamento coletivo reivindica outras identificações, de modo que o ato enunciativo pode produzir novos sentidos para às significações atribuídas às populações negras, sendo a linguagem um importante mecanismo de circulação da palavra e o indicador mais sensível de transformações sociais.

Distribution patterns of infection with multiple types of human papillomaviruses and their association with risk factors

Background: Infection with multiple types of human papillomavirus (HPV) is one of the main risk factors associated with the development of cervical lesions. In this study, cervical samples collected from 1, 810 women with diverse sociocultural backgrounds, who attended to their cervical screening program in different geographical regions of Colombia, were examined for the presence of cervical lesions and HPV by Papanicolau testing and DNA PCR detection, respectively. Principal Findings: The negative binomial distribution model used in this study showed differences between the observed and expected values within some risk factor categories analyzed. Particularly in the case of single infection and coinfection with more than 4 HPV types, observed frequencies were smaller than expected, while the number of women infected with 2 to 4 viral types were higher than expected. Data analysis according to a negative binomial regression showed an increase in the risk of acquiring more HPV types in women who were of indigenous ethnicity (+37.8%), while this risk decreased in women who had given birth more than 4 times (-31.1%), or were of mestizo (-24.6%) or black (-40.9%) ethnicity. Conclusions: According to a theoretical probability distribution, the observed number of women having either a single infection or more than 4 viral types was smaller than expected, while for those infected with 2-4 HPV types it was larger than expected. Taking into account that this study showed a higher HPV coinfection rate in the indigenous ethnicity, the role of underlying factors should be assessed in detail in future studies.

Reversal of impairment losses, firm performance and reporting incentives: Evidence from Malaysia

Malaysian Financial Reporting Standard (FRS) No. 136, Impairment of Assets, was issued in 2005. The standard requires public listed companies to report their non-current assets at no more than their recoverable amount. When the value of impaired assets is recovered, or partly recovered, FRS 136 requires the impairment charges to be reversed to its new recoverable amount. This study tests whether the reversal of impairment losses by Malaysian firms is more closely associated with economic reasons or reporting incentives. The sample of this study consists of 182 public companies listed on Bursa Malaysia (formerly known as the Kuala Lumpur Stock Exchange) that reported reversals of their impairment charges during the period 2006-2009. These firms are matched with firms which do not reverse impairment on the basis of industrial classification and size. In the year of reversal, this study finds that the reversal firms are more profitable (before reversals) than their matched firms. On average, the Malaysian stock market values the reversals of impairment losses positively. These results suggest that the reversals generally reflect increases in the value of the previously impaired assets. After partitioning firms that are likely to manage earnings and those that are not, this study finds that there are some Malaysian firms which reverse the impairment charges to manage earnings. Their reversals are not value-relevant, and are negatively associated with future firm performance. On the other hand, the reversals of firms which are deemed not to be earnings managers are positively associated with both future firm performance and current stock price performance, and this is the dominant motivation for the reversal of impairment charges in Malaysia. In further analysis, this study provides evidence that the opportunistic reversals are also associated with other earnings management manifestations, namely abnormal working capital accruals and the motivation to avoid earnings declines. In general, the findings suggest that the fair value measurement in impairment standard provides useful information to the users of financial statements.

Electrochemical biosensor based on microfabricated electrode arrays for life sciences applications

In developing a biosensor, the utmost important aspects that need to be emphasized are the specificity and selectivity of the transducer. These two vital prerequisites are of paramount in ensuring a robust and reliable biosensor. Improvements in electrochemical sensors can be achieved by using microelectrodes and to modify the electrode surface (using chemical or biological recognition layers to improve the sensitivity and selectivity). The fabrication and characterisations of silicon-based and glass-based gold microelectrode arrays with various geometries (band and disc) and dimension (ranging from 10 μm-100 nm) were reported. It was found that silicon-based transducers of 10 μm gold microelectrode array exhibited the most stable and reproducible electrochemical measurements hence this dimension was selected for further study. Chemical electrodeposition on both 10 μm microband and microdisc were found viable by electro-assisted self-assembled sol-gel silica film and nanoporous-gold electrodeposition respectively. The fabrication and characterisations of on-chip electrochemical cell was also reported with a fixed diameter/width dimension and interspacing variation. With this regard, the 10 μm microelectrode array with interspacing distance of 100 μm exhibited the best electrochemical response. Surface functionalisations on single chip of planar gold macroelectrodes were also studied for the immobilisation of histidine-tagged protein and antibody. Imaging techniques such as atomic force microscopy, fluorescent microscopy or scanning electron microscope were employed to complement the electrochemical characterisations. The long-chain thiol of self-assembled monolayer with NTA-metal ligand coordination was selected for the histidine-tagged protein while silanisation technique was selected for the antibody immobilisation. The final part of the thesis described the development of a T-2 labelless immunosensor using impedimetric approach. Good antibody calibration curve was obtained for both 10 μm microband and 10 μm microdisc array. For the establishment of the T-2/HT-2 toxin calibration curve, it was found that larger microdisc array dimension was required to produce better calibration curve. The calibration curves established in buffer solution show that the microelectrode arrays were sensitive and able to detect levels of T-2/HT-2 toxin as low as 25 ppb (25 μg kg-1) with a limit of quantitation of 4.89 ppb for a 10 μm microband array and 1.53 ppb for the 40 μm microdisc array.

Remembrance of the ancestors in contemporary paganism: Lineage, identity, and cultural belonging in the Irish context

This article explores some of the ways of remembering and honouring the ancestors in contemporary Pagan religious traditions, with a focus on the Irish context. An overview is provided of how the "ancestors" are conceptualised within Paganism, as well as where they are believed to be located in the afterlife or Otherworld. Veneration of ancestral peoples is a significant part of many Pagan rituals. Some methods of honouring the dead, and contacting the dead, through ritual practices are described. Remembering and honouring the dead, whether distant forebears or more recent relatives, is particularly important during the Pagan celebration of the festival of Samhain, feast of the dead, on October 31. Issues around ancestors, lineages and ethnicity are significant in many Pagan traditions, and attention is paid to these factors in terms of the Irish Pagan community's sense of cultural belonging as well as their sense of place in a physical respect in relation to the landscape, proximity of sacred sites, and other features of their geographical location.

Variability in frontotemporal brain structure: the importance of recruitment of African Americans in neuroscience research.

BACKGROUND: Variation in brain structure is both genetically and environmentally influenced. The question about potential differences in brain anatomy across populations of differing race and ethnicity remains a controversial issue. There are few studies specifically examining racial or ethnic differences and also few studies that test for race-related differences in context of other neuropsychiatric research, possibly due to the underrepresentation of ethnic minorities in clinical research. It is within this context that we conducted a secondary data analysis examining volumetric MRI data from healthy participants and compared the volumes of the amygdala, hippocampus, lateral ventricles, caudate nucleus, orbitofrontal cortex (OFC) and total cerebral volume between Caucasian and African-American participants. We discuss the importance of this finding in context of neuroimaging methodology, but also the need for improved recruitment of African Americans in clinical research and its broader implications for a better understanding of the neural basis of neuropsychiatric disorders. METHODOLOGY/PRINCIPAL FINDINGS: This was a case control study in the setting of an academic medical center outpatient service. Participants consisted of 44 Caucasians and 33 ethnic minorities. The following volumetric data were obtained: amygdala, hippocampus, lateral ventricles, caudate nucleus, orbitofrontal cortex (OFC) and total cerebrum. Each participant completed a 1.5 T magnetic resonance imaging (MRI). Our primary finding in analyses of brain subregions was that when compared to Caucasians, African Americans exhibited larger left OFC volumes (F (1,68) = 7.50, p = 0.008). CONCLUSIONS: The biological implications of our findings are unclear as we do not know what factors may be contributing to these observed differences. However, this study raises several questions that have important implications for the future of neuropsychiatric research.

Patterns in blood pressure medication use in US incident dialysis patients over the first 6 months.

BACKGROUND: Several observational studies have evaluated the effect of a single exposure window with blood pressure (BP) medications on outcomes in incident dialysis patients, but whether BP medication prescription patterns remain stable or a single exposure window design is adequate to evaluate effect on outcomes is unclear. METHODS: We described patterns of BP medication prescription over 6 months after dialysis initiation in hemodialysis and peritoneal dialysis patients, stratified by cardiovascular comorbidity, diabetes, and other patient characteristics. The cohort included 13,072 adult patients (12,159 hemodialysis, 913 peritoneal dialysis) who initiated dialysis in Dialysis Clinic, Inc., facilities January 1, 2003-June 30, 2008, and remained on the original modality for at least 6 months. We evaluated monthly patterns in BP medication prescription over 6 months and at 12 and 24 months after initiation. RESULTS: Prescription patterns varied by dialysis modality over the first 6 months; substantial proportions of patients with prescriptions for beta-blockers, renin angiotensin system agents, and dihydropyridine calcium channel blockers in month 6 no longer had prescriptions for these medications by month 24. Prescription of specific medication classes varied by comorbidity, race/ethnicity, and age, but little by sex. The mean number of medications was 2.5 at month 6 in hemodialysis and peritoneal dialysis cohorts. CONCLUSIONS: This study evaluates BP medication patterns in both hemodialysis and peritoneal dialysis patients over the first 6 months of dialysis. Our findings highlight the challenges of assessing comparative effectiveness of a single BP medication class in dialysis patients. Longitudinal designs should be used to account for changes in BP medication management over time, and designs that incorporate common combinations should be considered.

Polymorphisms at the microRNA binding-site of the stem cell marker gene CD133 modify susceptibility to and survival of gastric cancer.

CD133 is one of the most common stem cell markers, and functional single nucleotide polymorphisms (SNPs) of CD133 may modulate its gene functions and thus cancer risk and patient survival. We hypothesized that potentially functional CD133 SNPs are associated with gastric cancer (GC) risk and survival. To test this hypothesis, we conducted a case-control study of 371 GC patients and 313 cancer-free controls frequency-matched by age, sex, and ethnicity. We genotyped four selected, potentially functional CD133 SNPs (rs2240688A>C, rs7686732C>G, rs10022537T>A, and rs3130C>T) and used logistic regression analysis for associations of these SNPs with GC risk and Cox hazards regression analysis for survival. We found that compared with the miRNA binding site rs2240688 AA genotype, AC + CC genotypes were associated with significantly increased GC risk (adjusted OR = 1.52, 95% CI = 1.09-2.13); for another miRNA binding site rs3130C>T SNP, the TT genotype was associated with significantly reduced GC risk (adjusted OR = 0.68, 95% CI = 0.48-0.97), compared with CC + CT genotypes. In all patients, the risk rs3130 TT variant genotype was significantly associated with overall survival (OS) (adjusted P(trend) = 0.016 and 0.007 under additive and recessive models, respectively). These findings suggest that these two CD133 miRNA binding site variants, rs2240688 and rs3130, may be potential biomarkers for genetic susceptibility to GC and possible predictors for survival in GC patients but require further validation by larger studies.

No association between TGFB1 polymorphisms and late radiotherapy toxicity: a meta-analysis.

BACKGROUND: Transforming growth factor-beta 1 (TGF-β1) protein may be multifunctional and related to the development of fibrosis, induction of apoptosis, extracellular signaling and inhibition of proliferation in response to radiation-induced DNA damage. Several studies have investigated associations between single nucleotide polymorphisms (SNPs) in the TGFB1 gene and risk of late radiation-induced injury of normal tissue, but the conclusions remain controversial. METHODS: We searched three electronic databases (i.e., MEDLINE, EMBASE and EBSCO) for eligible publications and performed a meta-analysis assessing the association of three commonly studied SNPs in TGFB1 (i.e., rs1800469, rs1800470 and rs1800471) with risk of late radiation-induced injury of normal tissue. RESULTS: We finally included 28 case-only studies from 16 publications on aforementioned SNPs in TGFB1. However, we did not find statistical evidence of any significant association with overall risk of late radiotherapy toxicity in the pooled analysis or in further stratified analysis by cancer type, endpoint, ethnicity and sample size. CONCLUSIONS: This meta-analysis did not find statistical evidence for an association between SNPs in TGFB1 and risk of late radiation-induced injury of normal tissue, but this finding needs further confirmation by a single large study.

Physical Activity, Central Adiposity, and Functional Limitations in Community-Dwelling Older Adults.

BACKGROUND AND PURPOSE: Obesity and physical inactivity are independently associated with physical and functional limitations in older adults. The current study examines the impact of physical activity on odds of physical and functional limitations in older adults with central and general obesity. METHODS: Data from 6279 community-dwelling adults aged 60 years or more from the Health and Retirement Study 2006 and 2008 waves were used to calculate prevalence and odds of physical and functional limitation among obese older adults with high waist circumference (waist circumference ≥88 cm in females and ≥102 cm in males) who were physically active versus inactive (engaging in moderate/vigorous activity less than once per week). Logistic regression models were adjusted for age, sex, race/ethnicity, education, smoking status, body mass index, and number of comorbidities. RESULTS: Physical activity was associated with lower odds of physical and functional limitations among older adults with high waist circumference (odds ratio [OR], 0.59; confidence interval [CI], 0.52-0.68, for physical limitations; OR, 0.52; CI, 0.44-0.62, for activities of daily living; and OR, 0.44; CI, 0.39-0.50, for instrumental activities of daily living). CONCLUSIONS: Physical activity is associated with significantly lower odds of physical and functional limitations in obese older adults regardless of how obesity is classified. Additional research is needed to determine whether physical activity moderates long-term physical and functional limitations.

‘The Pinocchio Effect’ – when managing the brand creation process, across cultures

In global marketing and international management, the fields of Branding and Culture are well discussed as separate disciplines; within both academia and industry. However, there appears to be limited supporting literature, examining brands and culture as a collective discipline. In addition, environmental factors such as ethnicity, nationality and religion are also seen to play a significant role. This in itself adds to the challenges encountered, by those looking to critically apply learning and frameworks, to any information gathered. In the first instance, this paper tries to bring aspects together from Branding and Culture and in doing so, aims to find linkages between the two. The main purpose of this paper is to distil current brand thinking and explore what impact cross-cultural, cross-national, and ethnic interactions have on a brand’s creation. The position of the authors is that without further understanding in this field, a brand will experience what has been termed by them as the ‘Pinocchio Effect’. Pinocchio was a puppet who longed to become a real human being; but sadly encountered difficulties. The conclusion presented is that the critical long-term success of a brand lies in three areas: how it is created; the subsequent associated perceptions; and more specifically in the reality of the relationships that it enjoys. Collectively these processes necessitate an appraisal of connecting strategic management procedures and thinking. Finally, this paper looks into proposing future methods for brand evaluation and strategic management. The aim is to stimulate further thinking in a field; which transcends national, ethnic and cultural boundaries - in the interests of developing new insight, and to provide a platform for marketers to develop more effective communications.