Comparative study on free-running locomotor activity circadian rhythms in Brazilian subterranean fishes with different degrees of specialization to the hypogean life (Teleostei: Siluriformes; Characiformes)

In this paper we report findings on the presence of circadian rhythms in six species of cave-dwelling fishes from Brazil. Locomotor activity of islolated individuals was automatically recorded for 10 consecutive days under constant darkness. The species tested show varied degrees of specialization to subterranean life and we found varying degrees of the circadian components of locomotor activity as measured by the periodogram algorhythm of Lomb-Scargle. Both the presence and robustness of the circadian components seem to vary according to the degree of specialization to subterranean life, the more specialized, the less circadian rhythmicity was detected.

Gender Differences in Life Expectancy and Disability-Free Life Expectancy Among Older Adults in Sao Paulo, Brazil

Background: Research on life expectancy has demonstrated the negative impact of disability on the health of older adults and its differential effects on women as evidenced by their higher disabled life expectancy (DLE). The goal of the present study was to investigate gender differences in total life expectancy (TLE), disability-free life expectancy (DFLE), and DLE; examine gender differences on personal care assistance among older adults in Sao Paulo, Brazil; and discuss the implications for public policies. Methods: The sample was drawn from two waves (2000, 2006) of the dataset of Salud, Bienestar, y Envejecimiento, a large longitudinal study conducted in Sao Paulo (n = 2,143). The study assessed disability using the activities of daily living (ADL). The interpolation of Markov Chain method was used to estimate gender differences in TLE, DLE, and DFLE. Findings: TLE at age 60 years was approximately 5 years longer for women than men. Women aged 60 years were expected to live 28% of their remaining lives twice the percentage for men with at least one ADL disability. These women also lived more years (M = 0.71, SE = 0.42) with three or more ADL disabilities than men (M = 0.82, SE = 0.16). In terms of personal care assistance, women received more years of assistance than men. Conclusion: Among older adults in Sao Paulo, women lived longer lives but experienced a higher and more severe disability burden than men. In addition, although women received more years of personal assistance than men, women experienced more unmet care assistance needs. Copyright (C) 2011 by the Jacobs Institute of Women`s Health. Published by Elsevier. Inc.

Dignified death: Concept development involving nurses and doctors in Pediatric Intensive Care Units

The aim of this study was to develop the concept of the dignified death of children in Brazilian pediatric intensive care units (PICUs). The Hybrid Model for Concept Development was used to develop a conceptual structure of dignified death in PICUs in an attempt to define the concept. The fieldwork study was carried out by means of in-depth interviews with nine nurses and seven physicians working in PICUs. Not unexpectedly, the concept of dignified death was found to be a complex phenomenon involving aspects related to decisions made by the multidisciplinary team as well as those related to care of the child and the family. Knowledge of the concept`s dimensions can promote reflection on the part of healthcare professionals regarding the values and beliefs underlying their conduct in end-of-life situations. Our hope is that this study may contribute to theoretic and methodological development in the area of end-of-life care.

Sexuality and quality of life of breast cancer patients post mastectomy

Aim: To evaluate the sexual functioning of breast cancer patients post mastectomy and its association with their quality of life, the personal characteristics of women and their partners, breast reconstruction, cancer staging and adjuvant therapies. Methods: A cross-sectional study was carried out in a University hospital located in the SouthEast of Brazil. A total of 100 women were included in the study. The parameters evaluated were sexual functioning, which was assessed based on the Sexual Quotient Female Version (SQ-F), quality of life (QoL), evaluated by the Medical Outcomes Study 36-item Short Form (SF-36), cancer staging, breast reconstruction, adjuvant therapies and the personal characteristics of patients (age, years of study and years of marriage) and their partners (age, years of study). Results: The majority (40.48%) of women had an unfavorable to regular SQ-F score. A significant positive correlation (p < 0.05) was found between the SQ-F score and years of education (p = 0.03), and the following SF-36 domains: functional capacity (p = 0.03), vitality (p = 0.06), emotional limitations (p = 0.00) and mental health (p = 0.03). A significant negative correlation was found between SQ-F score and the age of the partners (p = 0.03). SQ-F mean value was significantly higher (p = 0.04) among women who underwent breast reconstruction. Conclusions: Women with low educational level, who have older partners, and who did not have a breast reconstruction should receive special attention with respect to their sexuality, and the effects of mastectomy on the sexuality of patients should be assessed. Oncology nurses are best qualified to recognize issues related to sexuality and quality of life, and can offer specific and meaningful support for breast cancer patients. (C) 2010 Elsevier Ltd. All rights reserved.

Understanding Pain and Quality of Life for Patients With Chronic Venous Ulcers

Aim. To identify the impact of pain on quality of life (QOL) of patients with chronic venous ulcers. Methods. A cross-sectional study was performed on 40 outpatients with chronic venous ulcers who were recruited at one outpatient care center in Sao Paulo, Brazil. WHOQOL-Bref was used to assess QOL, the McGill Pain Questionnarie-Short Form (MPQ) to identify pain characteristics, and an 11-point numerical pain rating scale to measure pain intensity. Kruskall-Wallis or ANOVA test, with post-hoc correction (Tukey test) was applied to compare groups. Multiple linear regression models were used. Results. The mean age of the patients was 67 +/- 11 years (range, 39-95 years), and 26 (65%) were women. The prevalence of pain was 90%, with worst pain mean intensity of 6.2 +/- 3.5. Severe pain was the most prevalent (21 patients, 52.5%). Pain most frequently reported was sensory-discriminative and evaluate in quality. Pain was significantly and negatively correlated with physical (PY), environmental (EV), and overall QOL. Compared to a no-pain group, those with pain had lower overall QOL. On multiple analyses, pain remained as a predictor of overall QOL (beta = -0.73, P = 0.03) and was also predictive of social QOL, whereas pain did not have any impact on physical, emotional, or social relationships QOL (beta = -3.85, P = 0.00) when adjusted for age, number, duration and frequency of wounds, pain dimension (MPQ), partnership, and economic status. Conclusion. To improve QOL of out-patients with chronic venous ulcers, the qualities and the intensity of pain must be considered differently.

Impact of cancer-related symptom synergisms on health-related quality of life and performance status

To identify the impact of multiple symptoms and their co-occurrence on health-related quality of life (HRQOL) dimensions and performance status (PS), 115 outpatients with cancer, who were not receiving active cancer treatment and were recruited from, a university hospital in Sao Paulo, Brazil completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, the Beck Depression Inventory, and the Brief Pain Inventory. Karnofsky Performance Status scores also were completed. Application of TwoStep Cluster analysis resulted in two distinct patient subgroups based on 113 patient experiences with pain, depression, fatigue, insomnia, constipation, lack of appetite, dyspnea, nausea, vomiting, and diarrhea. One group had multiple and severe symptom subgroup and another had Less symptoms and with lower severity. Multiple and severe symptoms had worse PS, role functioning, and physical, emotional, cognitive, social, and overall HRQOL. Multiple and severe symptom subgroup was also six times as likely as lower severity to have poor role functioning;five times more likely to have poor emotional;four times more likely to have poor PS, physical, and overall HRQOL, and three times as likely to have poor cognitive and social HRQOL, independent of gender, age, level of education, and economic condition. Classification and Regression Tree analyses were undertaken to identify which co-occurring symptoms would best determine reduction in HRQOL and PS. Pain and fatigue were identified as indicators of reduction on physical HRQOL and PS. Fatigue and insomnia were associated with reduction in cognitive; depression and pain in social; and fatigue and constipation in role functioning. Only depression was associated with reduction in overall HRQOL. These data demonstrate that there is a synergic effect among distinct cancer symptoms that result in reduction in HRQOL dimensions and PS.

Adaptations in autonomic function during exercise training in heart failure

Although neurohumoral excitation is the hallmark of heart failure (HF), the mechanisms underlying this alteration are not entirely known. Abnormalities in several systems contribute to neurohumoral excitation in HF, including arterial and cardiopulmonary baroreceptors, central and peripheral chemoreceptors, cardiac chemoreceptors, and central nervous system abnormalities. Exercise intolerance is characteristic of chronic HF, and growing evidence strongly suggests that exercise limitation in patients with chronic HF is not due to elevated filling pressures or inadequate cardiac output during exercise, but instead due to skeletal myopathy. Several lines of evidence suggest that sympathetic excitation contributes to the skeletal myopathy of HF, since sympathetic activity mediates vasoconstriction at rest and during exercise likely restrains muscle blood flow, arteriolar dilatation, and capillary recruitment, leading to underperfused areas of working muscle, and areas of muscle ischemia, release of reactive oxygen species (ROS), and inflammation. Although controversial, either unmyelinated, metabolite-sensitive afferent fibers, and/or myelinated, mechanosensitive afferent fibers in skeletal muscle underlie the exaggerated sympathetic activity in HF. Exercise training has emerged as a unique non-pharmacological strategy for the treatment of HF. Regular exercise improves functional capacity and quality of life, and perhaps prognosis in chronic HF patients. Recent studies have provided convincing evidence that these benefits in chronic HF patients are mediated by significant reduction in central sympathetic outflow as a consequence of improvement in arterial and chemoreflex controls, and correction of central nervous system abnormalities, and increase in peripheral blood flow with reduction in cytokines and increase in mass muscle.

Quality of life after coronary artery bypass surgery

This study assessed the quality of life (QoL) of 124 people with coronary artery disease who had coronary artery bypass surgery in a hospital in Brazil, by using the Modified Flanagan`s QoL instrument as the outcome measure. In addition, we studied the association between QoL and demographic, clinical, and perceived health status (using SF-36 Health Survey) measures. The mean for the Modified Flanagan`s QoL was high (M = 84.8, SD = 13.6) when compared to similar studies in the United States. In a linear regression analysis, the SF-36 subscales of vitality, and general and mental health were statistically significant (p < .01 for all), after adjusting for other demographic and clinical variables. Increasing values of those SF-36 subscales corresponded to increasing Modified Flanagan`s QoL. Despite the limitations of the study, this result suggests that future clinical interventions aimed to improve QoL in this population could focus on the patient`s psychological conditions after the surgery.

The Outcomes of Visualization and Acupuncture on the Quality of Life of Adult Cancer Patients Receiving Chemotherapy

Background: The use of complementary and alternative medicine (CAM) to treat cancer patients has increased around the world, and its benefits have been described. These therapies represent an important theme in oncology and have been used in parallel with conventional therapies. Objective: This study aimed to assess the outcomes of using relaxation with visualization and acupuncture on the quality of life of cancer patients undergoing chemotherapy treatment and to compare these outcomes with patients who did not choose to receive the intervention. Methods: Participants chose to be in either the intervention group (IG) or control group (CG). They completed the Quality of Life Questionnaire-Core 30 at the start and end of chemotherapy. The IG was chosen by 38 patients with different types of cancer who completed weekly relaxation with visualization and acupuncture sessions, whereas the CG was composed of 37 patients who did not receive the intervention. Results: Statistically significant results evidenced an increase in global health and emotional and social functions and a decrease in fatigue and loss of appetite for the IG, and an increase in global health for the CG (P <= .05). A highly significant difference was found when comparing the post-chemotherapy scores of the Quality of Life Questionnaire-Core 30 in the global health domain between the CG and the IG (P <= .001), indicating positive outcomes of the CAM intervention. Conclusion: Adults with cancer are able to choose between involvement or not with this kind of CAM intervention. Global health could be improved by participating in this type of intervention. Implications for Practice: Choosing whether to be involved may be assisted by knowing the positive outcomes for some patients.

The life impact of burns: the perspective from burn persons in Brazil during their rehabilitation phase

Method. Participants were 18 years of age or older, who had been discharged from hospitalisation between 6 months and 1 year before the interview, or who underwent reconstructive surgery during the previous year, or who were under outpatient follow-up awaiting reconstructive surgery. Data were collected by means of semi-structured interviews. Results. Thirty-eight of the 44 participants (86.4%) reported some type of changes associated with the burn injury, the treatment, or both, regarding the following aspects: work, leisure, relationships, religious ties, educational activities and habits (smoking, using alcohol and drugs and dressing style). The data showed a statistically significant association between burns on at least one of the upper limbs (with or without hands) and changes in work. Conclusions. Some of the aspects mentioned by the participants, such as work and leisure activities, need to be further researched in order to improve our understanding of the impact that these changes causes in the person`s life.

Cultural meaning of quality of life: perspectives of Brazilian burn patients

Purpose. This study was designed to explore the cultural meaning and dimensions of quality of life from the perspective of Brazilian burn patients. Method. A qualitative research approach was used. Nineteen burn patients and their close relatives participated in this ethnographic study. Data were collected by means of direct observation and semi-structured interviews, conducted in a hospital outpatient clinic and during visits to patients` homes. The following inter-related phases guided the analysis process: reading of the material and data reduction, data display, conclusion outlining and verification. Results. Participants reported that the quality of life is related to autonomy and the ability to work. The dimensions of quality of life included: resuming work and functional ability, body image, having leisure and interpersonal relationships. Their descriptions revealed their feelings and attitudes about resuming their previous activities and social lives, particularly concerning the work. Conclusion. For burn patients, quality of life is associated with the concept of normality, the satisfactory performance of social roles in the context of family life and the social world. The results showed the importance of the sociocultural dimension in the concept of quality of life for persons undergoing burn rehabilitation.

Coupled reliability and boundary element model for probabilistic fatigue life assessment in mixed mode crack propagation

Fatigue and crack propagation are phenomena affected by high uncertainties, where deterministic methods fail to predict accurately the structural life. The present work aims at coupling reliability analysis with boundary element method. The latter has been recognized as an accurate and efficient numerical technique to deal with mixed mode propagation, which is very interesting for reliability analysis. The coupled procedure allows us to consider uncertainties during the crack growth process. In addition, it computes the probability of fatigue failure for complex structural geometry and loading. Two coupling procedures are considered: direct coupling of reliability and mechanical solvers and indirect coupling by the response surface method. Numerical applications show the performance of the proposed models in lifetime assessment under uncertainties, where the direct method has shown faster convergence than response surface method. (C) 2010 Elsevier Ltd. All rights reserved.

Atmospheric impacts of the life cycle emissions of fuel ethanol in Brazil: based on chemical exergy

An assessment is made of the atmospheric emissions from the life cycle of fuel ethanol coupled with the cogeneration of electricity from sugarcane in Brazil. The total exergy loss from the most quantitative relevant atmospheric emission substances produced by the life cycle of fuel ethanol is 3.26E+05 kJ/t of C(2)H(5)OH, Compared with the chemical exergy of 1 t of ethanol (calculated as 34.56E + 06 kJ). the exergy loss from the life cycle`s atmospheric emission represents 1.11% of the product`s exergy. The activity that most contributes to atmospheric emission chemical exergy losses is the harvesting of sugarcane through the methane emitted in burning. Suggestions for improved environmental quality and greater efficiency of the life cycle of fuel ethanol with cogenerated energy are: harvesting the sugarcane without burning, renewable fuels should be used in tractors, trucks and buses instead of fossil fuel and the transportation of products and input should be logistically optimized. (C) 2009 Elsevier Ltd. All rights reserved.

Failure analysis of belt/roll tribological pair used for the production of eucalypt fiber panels

The premature failure of a large agglomeration machine used for the annual production of 360,000 m(3) of eucalypt fiber panels was investigated to identify the nucleation and growth mechanisms of cracking in PH stainless steel belts (126 m x 2.9 m x 3.0 mm). These belts are used to compress a cushion composed of eucalyptus fibers and glue, being the pressure transmitted from the pistons by the action of numerous case-hardening steel rolls. Examination of the belt working interfaces (belt/rolls and belt/eucalypt fibers) indicated that the main cracking was nucleated on the belt/roll interface and that there is a clear relationship between the crack nucleation and the presence of superficial irregularities, which were observed on the belt/roll working surface. Used rolls showed the presence of perimetric wear marks and 2 mu m silicon-rich encrusted particles (identified as silicon carbide). Lubricant residues contained the presence of helicoidal wires, which were originated by the release of the stainless steel cleaning brush bristles, and 15 mu m diameter metallic particles, which were generated by material detachment of the belt. The presence of foreign particles on the tribological interface contributed to an increase of the shear stresses at the surfaces and, consequently, the number of the contact fatigue crack nucleation sites in the belt/roll tribo-interface. The cracking was originated on the belt/roll interface of the stainless steel belt by a mixed rolling/slip contact fatigue mechanism, which promoted spalling and further nucleation and growth of conventional fatigue cracks. Finally, the system lubrication efficiency and the cleaning procedure should be optimised in order to increase the life expectancy of the belt. (c) 2006 Elsevier Ltd. All rights reserved.

Life cycle assessment and life cycle cost of sugar plants evaporators

The evaporators of sugar plants in Brazil have used carbon steel intensively because of it is, a low priced material, which possesses inferior corrosion resistance. The materials more indicated for the substitution of carbon steel are stainless steels, however they are considered expensive. The environmental and financial performances of evaporator pipes constructed with carbon steel and with types AISI 304 444 and 439 stainless steel were evaluated. For the environmental evaluation, the Life Cycle Assessment (LCA) methodology Was used and it, revealed that stainless steel is more environmentally efficient than carbon steel. The life cycle costing (LCC) technique was the tool chosen for the financial evaluation and it showed that stainless steel is a better investment option compared to carbon steel. The results also indicate that LCA and LCC methodologies must be used together Therefore, it can he seen that safer environmental products can come to be the most profitable investment options.