Usual clinical practice for early supported discharge after stroke with continued rehabilitation at home : an observational comparative study

Introduction: Based on randomised controlled trials, evidence exists that early supported discharge (ESD) from the hospital with continued rehabilitation at home has beneficial effects after stroke; however, the effects of ESD service in regular clinical practice have not been investigated. The purpose of the current study was to compare ESD service with conventional rehabilitation in terms of patient outcomes, caregiver burden at 3 and 12 months and the use and costs of healthcare during the first year after stroke. Material and methods: This study was a subgroup analysis of a longitudinal observational study of patients who received care in the stroke unit at Karolinska University Hospital in Sweden. Patients who met the inclusion criteria for ESD in previous experimental studies were included. The patients were referred to available rehabilitation services at discharge, and comparisons between those who received ESD service (the ESD group, n = 40) and those who received conventional rehabilitation (the NoESD group, n = 110) were performed with regard to independence in activities of daily living (ADL), the frequency of social activities, life satisfaction, and caregiver burden and the use and costs of healthcare during the first year after stroke. Results: At 3 and 12 months, no differences were observed with regard to patient outcomes; however, ESD was associated with a lower caregiver burden (p = 0.01) at 12 months. The initial length of stay (LOS) at the hospital was 8 days for the ESD group and 15 days for the NoESD group (p = 0.02). The median number of outpatient rehabilitation contacts was 20.5 for the ESD group (81% constituting ESD service) and 3 for the NoESD group (p<0.001). There was no difference between the groups with regard to overall healthcare costs. Conclusions: ESD service in usual clinical practice renders similar health benefits as conventional rehabilitation but a different pattern of resource use and with released capacity in acute stroke care.

A relação entre desenvolvimento cognitivo e estimulação precoce em alunos da 4. serie do 1. grau

O presente estudo teve por objetivo uma verificação experimental da influência da estimulação precoce no desenvolvimento cognitivo. A ideias deste trabalho surgiu da importância que ora se atribui ao problema de um melhor aproveitamento do homem em suas potencialidades para a construção de uma humanidade melhor. Tal possibilidade reflete-se primordialmente no âmago do processo educativo, e em particular a escola. Fundamentou-se teoricamente em Gerome Bruner, tendo por central 2 de suas proposições: Qualquer assunto pode ser ensinado com eficiência, de forma honesta, a qualquer criança em qualquer estágio de desenvolvimento; É objetivo primordial da educação atingir a imaturidade, levando o homem a ser mais produtivo, mais ajustado à sua cultura, desenvolvendo suas potencialidades ou indo além delas para criar mais. Buscando um maior embasamento, a autora se valeu de estudos teóricos e experimentais de Piaget, Montessori, Okón, Poppovic, Oslon, Austin & Postethwaite, e outros, além de algumas pesquisas realizadas por autores ou instituições brasileiras. O estudo dirigiu-se, especificamente, a alunos da 4º série do 1º grau, para medir competência pedagógica e conhecer dados referentes à escolarização inicial. Os resultados obtidos confirmaram a hipótese fundamental de que quanto mais precocemente a criança for estimula da, maior será sua competência pedagógica posterior, o que se pressupõe ser decorrente da aceleração de seu desenvolvimento cognitivo. Entretanto, face às delimitações criadas e às limitações sofridas, a autora sugere a realização de pesquisas ulteriores sobre o tópico, a fim de que se possa, diante de dados experimentais cada vez mais consistentes e de maior amplitude, propor, de forma mais enfática, uma aplicação psicopedagógica adaptada à realidade social e tecnológica de nossa era.

Leader-organization fit: comparing the effectiveness of paternalistic and transformational leadership in different organizational cultures

Research on paternalistic leadership (PL) has been based exclusively on national cultures´ differences. However there are cues that other contextual variables can add to the explanation of this construct. Due to its capacity to influence expectations of individuals in organizations, organizational culture can contribute to fill this gap. To test if organizational culture influences the effectiveness of leadership style, we conducted two experimental studies using Amazon’s Mechanical Turk, comparing effects of paternalistic and transformational leadership on followers’ outcomes. Using video clips and vignettes, we found that PL is better related to followers´ outcomes in cultures oriented to people than outcome, and that TL has a better relationship in cultures oriented to innovation than stability. The results suggest that organizational culture helps in explaining PL endorsement, and that further analysis of the influence of this variable to PL can provide a better understanding of the expression of this leadership style in organizations.

On paternalistic leadership fit: exploring cross-cultural endorsement, leader-follower fit, and the boundary role of organizational culture

Although cross-cultural leadership research has thrived in international business literature, little attention has been devoted to understanding the effectiveness of non-western theories beyond their original contexts. The purpose of this study is to examine the cross-cultural endorsement of paternalistic leadership, an emerging non-western leadership theory, using data from GLOBE project. Using multigroup confirmatory factor analyses we found measurement equivalence of a scale derived from GLOBE’s data, which enabled us to compare the endorsement of paternalistic leadership dimensions across 10 cultural clusters and 55 societies. Our study revealed that there are significant differences in the importance societies give to each dimension, suggesting that paternalism as leadership style is not universally nor homogeneously endorsed. Furthermore, results suggest that different patterns of endorsement of each of these dimensions give rise to idiosyncratic shades of paternalistic leadership across societies. Implications for theory and future research on international business are discussed.

A infecção por Leishmania infantum chagasi altera o metabolismo lipídico do hospedeiro

American visceral leishmaniasis (AVL), caused by Leishmania infantum chagasi (L.i.chagasi), stands as a public health problem in Brazil, with human and canine cases related in all states..Lipid metabolism can be modified in several status of infection. For example, experimental studies show that the cholesterol is necessary to internalization and replication of L.i.chagasi in macrophages through caveolar domains. Patients with AVL present low levels of cholesterol and a visible triglycerides increase. This work aimed to evaluate the lipid metabolism in several post-infection status by L.i.chagasi, including individuals with symptomatic infection (AVL), and asymptomatic. The levels of cholesterol, triglycerides, HDL and reactive C protein, were measured. Individuals with AVL were compared with individuals with assymptomatic infection and presented low levels of total cholesterol (128 ± 6.180 mg/dL vs. 158 ±5.733 mg/dL, p=0.0001), HDL (29 ± 1.746 mg/dL vs. 37 ± 1.647 mg/dL, p=0.0001), increased levels of triglycerides (149.5 mg/dL ± 12.72 vs. 78.00 ± 10.43 mg/dL, p=0.0095) and higher levels of reactive C protein (1.750± 0.4939 mg/dL vs. 0.40 ± 0.1707 mg/dL; p=0.0001). The expression of genes related to lipid metabolism, such as LXR-a, LXR-b, PPAR-a, PPAR-d, PPAR-g and APOE was evaluated by real time PCR. A reduction in the expression of those genes was found in the group of AVL patients corroborating the serum levels of the metabolites earlier quantified. Our findings suggest a modulation of metabolism of lipids, in the chronic phase of AVL, this could facilitate the survival of leishmania, due to the known reduction on the ability of macrophages in presenting antigens efficiently to the T cells due to the reduction in the cholesterol available, it results in a subversion of the host immunity.

Adsorção de Pb(II) utilizando adsorvente composto por montmorilonita e dolomita

The destructive impact of improper disposal of heavy metals in the environment increases as a direct result of population explosion, urbanization and industrial expansion and technological developments. Argil are potential materials for adsorption of inorganic and the pelletization of it is required for use in adsorptive columns of fixed bed. The low cost and the possibility of regeneration makes these materials attractive for use in the purification process, capable of removing inorganic compounds in contaminated aquatic environments. In this work was made pellets of a mixture of dolomite and montmorillonite by wet agglomeration, in different percentages. The removal of Pb (II) was investigated through experimental studies, and was modeled by kinetic models and isotherms of adsorption. The materials were characterized using the techniques of XRD, TG / DTA, FT-IR, and surface area by BET method. The results showed the adsorption efficiency of the contaminant by the composite material studied in synthetic solution. The study found that the adsorption follows the Langmuir model, and the kinetics of adsorption follows the model of pseudosecond order

Pesquisa odontológica no Brasil: características da produção científica no início do século XXI

Dentistry, as a science and field of knowledge, has presented a substantial development in the last decades in the areas of research and education. The aim of this study was to evaluate the Brazilian scientific production in Dentistry, as from their methodological outlining, which characterizes the XXI Century. Five thousand two hundred and three study abstracts were evaluated, comprising works presented in the meetings of the Brazilian Society of Dentistry Research (SBPqO), during the period of 2001 to 2006. The main results identify that, as for the methodology used in the researches, there was a predominance of the studies of an individuate, interventionist and longitudinal nature; of the researches in the areas of Dentistry, Periodontology, Endodontics, Pedodontics and Collective Oral Health and experimental studies about clinical researches or with collective subjects. The inter and multidisciplinarity are pointed out in the outlining of this study, as the triad Education-Health-Research is discussed, so that they transcend in their fields of action, in the direction of the transdisciplinarity. It is concluded that, in the studied period, there was a reasonable and balanced production in Brazilian dental field

Fuzzy modeling to predict chicken egg hatchability in commercial hatchery

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

Ectoparasitos associados a aves de um fragmento de Floresta Estacional Decidual no Rio Grande do Norte, Brasil

This study to aimed investigate the community of ectoparasites associated with birds in the Mata do Olho D água, in the municipality of Macaíba, Rio Grande do Norte (RN), Brazil, its structure and the ambiental and hosts influential variables on it, and to verify microhabitats preferences by species of chewing lice and feather mites. We examined 172 individuals belonging to 38 species of Passeriformes and non-Passeriformes. 12 new geographic records are reported and 11 host-parasite associations not yet known for chewing lice and feather mites species. Significant relationship was found between the abundance of chewing lice and the variables total length (r = 0.29, p <0.05) and exposed culmen (r = 0.38, p <0.05) of the hosts. A principal component (PC1) accounted for 90.1% of the hosts morphological variation was significantly influential on the abundance of chewing lice (p <0.05), indicating that the morphological characteristics of the hosts may be positively influencing the abundance of these ectoparasites. Significantly higher frequency of individuals with high loads of chewing lice was detected during the dry period (x ² = 8.5, p <0.05), corroborating studies that propose that birds of arid environments suffer as much pressure as those of parasitic humid environments. Analyses of null models of co-occurrence and niche overlap showed a high degree of structure in the feather mites and chewing lice assemblies, when compared with other groups, and preferences in the use of microhabitats by taxa identified. These results corroborate ecological theories in host-parasite systems, contribute to the knowledge of ectoparasites associated with neotropical birds, and the need for experimental studies, as well as further deepening the biology of these arthropods

Orbital cellulitis associated with Toxocara canis in a dog

Reports of Toxocara canis ocular larva migrans are uncommon in animals, with only a few cases reported. Most reports involve larval migration into the retina and choroid, with parasitic invasion of the orbit reported only in experimental studies. This is the first clinical case of Toxocara canis infection in the retrobulbar region of a 10-year-old, cross-bred male dog presenting with unilateral orbital cellulitis. Ophthalmic signs included protrusion of the nictitating membrane, chemosis, exophthalmos and hypertropia. The parasite was diagnosed by histologic and parasitologic examination of orbital tissues, which were removed during enucleation.

Estudo da qualidade de serviço de uma aplicação VoIP em ambientes wireless com handoff

This work deals with experimental studies about VoIP conections into WiFi 802.11b networks with handoff. Indoor and outdoor network experiments are realised to take measurements for the QoS parameters delay, throughput, jitter and packt loss. The performance parameters are obtained through the use of software tools Ekiga, Iperf and Wimanager that assure, respectvely, VoIP conection simulation, trafic network generator and metric parameters acquisition for, throughput, jitter and packt loss. The avarage delay is obtained from the measured throughput and the concept of packt virtual transmition time. The experimental data are validated based on de QoS level for each metric parameter accepted as adequated by the specialized literature

A new method to quantify macroalgae and a practical sampler for experimentation in lotic habitats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Surface-enhanced raman scattering: metal nanostructures coated with langmuir-blodgett films

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

Atividade biológica de células-tronco da polpa de dentes decíduos humanos submetidas à criopreservação

Dental pulp stem cells have been widely investigated because of their ability to differentiate into both dental and non-dental cells, with potential use in therapies involving tissue engineering. The technique of cell cryopreservation represents a viable alternative for the conservation of these cells, since it stops reversibly, in a controlled manner, all of cell biological functions in an ultra low temperature. The present study aimed to evaluate, using in vitro experiments, the influence of a cryopreservation protocol on the biologic acti vity of stem cells from human exfoliated deciduous teeth (SHED). Cells obtained from the pulp of three deciduous teeth on end-stage exfoliation or with indicated extraction were expanded in α-MEM culture medium supplemented with antibiotics and 15% fetal bovine serum. At second subculture (P2), a group of cells were submitted to cryopreservation for 30 days in 10% DMSO diluted in fetal bovine serum, at -80º C, while the remind cells continued under normal conditions of cell culture. Cell proliferation was evaluated in both groups (not cryopreserved or cryopreserved) by Trypan blue stain essay at intervals of 24, 48 and 72h after plating. Cell cycle analysis of SHEDs submitted or not to the cryopreservation protocol was performed in the same intervals. Events related to cell death were studied by Annexyn V and PI expression under flow cytometry at the intervals of 24 and 72h. The presence of nuclear morphological changes was evaluated by DAPI staining at 72h interval. It was observed that both groups exhibited an upward cell proliferation curve, without considerable changes in cell viability throughout the experiment. The distribution of cell in the cell cycle phasis was consistent with cell proliferation in both groups. There were no nuclear morphological damages in the end range of the experiment. therefore, it is concluded that the proposed cryopreservation protocol is efficient for storing the studied cell type, allowing its use in future experimental studies

Uso de medicações por via subaracnóidea no tratamento da dor crônica

JUSTIFICATIVA E OBJETIVOS: A dor crônica é um desafio para a Medicina atual. Novos métodos e medicamentos têm sido propostos com o intuito de controlar os sintomas álgicos. A via de administração subaracnóidea tem se mostrado como uma alternativa viável e segura, embora necessite continuamente ser objeto de estudo de muitos pesquisadores. O objetivo deste trabalho é fazer uma revisão dos medicamentos disponíveis no arsenal terapêutico já consagrados pelo uso e os que se mostram promissores na atualidade para a prática clínica diária. CONTEÚDO: Nesta revisão são avaliados vários fármacos que apresentam ação analgésica quando utilizada via neuroeixo. Opióides, anestésicos locais, agonistas alfa2-adrenérgicos, antagonistas dos aminoácidos excitatórios e inibitórios, acetilcolina, inibidores da acetilcolinesterase, bloqueadores dos canais de cálcio, adenosina, serotonina, antidepressivos tricíclicos e inibidores da síntese de prostaglandinas são analisados no que concerne aos seus efeitos farmacológicos, incluindo os indesejáveis. CONCLUSÕES: Muitos avanços foram registrados no controle dos sintomas álgicos após a utilização das substâncias citadas por via raquidiana, onde certamente algumas serão aproveitadas e enriquecerão o arsenal terapêutico e outras relegadas temporária ou definitivamente. Entretanto, ainda serão necessários muitos estudos clínicos e experimentais para que estes conhecimentos possam ser incorporados e utilizados com segurança pelos profissionais que lidam com o tratamento da dor crônica.