779 resultados para Family physicians (or general practitioners)
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There is no information whatsoever of a society in which there are no demands among private people and companies, among individuals and institutions, varying only the tenor and the intensity of the issues. It would be ideal if conflicts could be solved in common aggreement. The selfcomposition, yet, does not often occurr; leaving the remaining issues for a third part, i.e., the State. Up to the English and French Revolutions, political power was exercised by limitless governors and the State did not submit to the law. After those revolutions, rules are agregated to curb Absolutism and organize the State, which starts to acccomplish its duties under the law, i.e., a Law State. As a result, today, the individual can sue the State to make the State perform or not any undesirable action. In this dissertation, one traces back from the very beginning the role of the institutions in charge of defending the State in courts of law. The judicial defense of the Brazilian State in a court of law, since 1608 to the 1988 Constitution, was a role of the Public Ministry, along with other institutional functions, including prosecution. As a consequence of this ambivalence, the results of the State defense came even to be contradictory. The promulgation of the 1988 Federal Constitution adjusted this historical dualism. The 1988 Constituent embodied significant change to the concept and operationalization of a State Advocacy, confering to a new institution , which was called 'Advocacia Geral da União' or 'General Advocacy of the Union' (article 131), the judicial and extrajudicial representation of the Union. The final object of the reflections of this study is centred on the analysis of the activities of the 'General Advocacy of the Union', in its first years of functioning, in other words, from 1993 to 1999
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O presente trabalho investiga os esforços orientados à geração interna de novos negócios em subsidiárias de empresas multinacionais atuantes no Brasil. Para tanto, realiza uma pesquisa exploratória, na forma de um estudo de casos múltiplos, com quatro projetos de três diferentes empresas. A pesquisa agrega evidências empíricas que poderão ser utilizadas posteriormente pela academia no desenvolvimento de teorias, ou também nas empresas, através da referência de práticas já experimentadas. Os casos são analisados com base nos conceitos da literatura produzida em torno do conceito de corporate venturing, tido como uma das manifestações do empreendedorismo corporativo. O estudo observa, entre as empresas analisadas, consideráveis diferenças em suas abordagens. Verifica, em termos de organização, desde a ausência de separação das funções de desenvolvimento de novos negócios para o negócio tradicional, até indícios de ambidestria organizacional. Constata a existência de processos estruturados, que incluem fases como a prospecção de iniciativas e a incubação, em contraste com outros mais simplificados, desenvolvidos ad-hoc para a condução de projetos específicos. Identifica manifestações de lógicas estratégicas orientadas tanto ao exploration como ao exploitation. Por fim, aponta algumas das particularidades observadas pelo fato do desenvolvimento ter sido realizado em ambiente brasileiro.
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One of the greatest challenges of demography, nowadays, is to obtain estimates of mortality, in a consistent manner, mainly in small areas. The lack of this information, hinders public health actions and leads to impairment of quality of classification of deaths, generating concern on the part of demographers and epidemiologists in obtaining reliable statistics of mortality in the country. In this context, the objective of this work is to obtain estimates of deaths adjustment factors for correction of adult mortality, by States, meso-regions and age groups in the northeastern region, in 2010. The proposal is based on two lines of observation: a demographic one and a statistical one, considering also two areas of coverage in the States of the Northeast region, the meso-regions, as larger areas and counties, as small areas. The methodological principle is to use the General Equation and Balancing demographic method or General Growth Balance to correct the observed deaths, in larger areas (meso-regions) of the states, since they are less prone to breakage of methodological assumptions. In the sequence, it will be applied the statistical empirical Bayesian estimator method, considering as sum of deaths in the meso-regions, the death value corrected by the demographic method, and as reference of observation of smaller area, the observed deaths in small areas (counties). As results of this combination, a smoothing effect on the degree of coverage of deaths is obtained, due to the association with the empirical Bayesian Estimator, and the possibility of evaluating the degree of coverage of deaths by age groups at counties, meso-regions and states levels, with the advantage of estimete adjustment factors, according to the desired level of aggregation. The results grouped by State, point to a significant improvement of the degree of coverage of deaths, according to the combination of the methods with values above 80%. Alagoas (0.88), Bahia (0.90), Ceará (0.90), Maranhão (0.84), Paraíba (0.88), Pernambuco (0.93), Piauí (0.85), Rio Grande do Norte (0.89) and Sergipe (0.92). Advances in the control of the registry information in the health system, linked to improvements in socioeconomic conditions and urbanization of the counties, in the last decade, provided a better quality of information registry of deaths in small areas
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Fungi of the family Nidulariaceae or bird s nest fungi present a vase-shaped basidiomata with the wall surface smooth or striated lengthwise and internal structures resembling small bird eggs in a nest, the peridioles. Among the five genera that comprise the group, the more representative is Cyathus Haller: Pers. The Brazilian Northeast region shows major importance for the world s diversity by containing a Brazilian unique and exclusively phytoecological domain, the Caatinga, which lacks particular attention regarding macrofungi. Although the gradual growth of knowledge in recent years, studies are still insipient in the Caatinga domain. Between their various vegetal formations are the Brejos de Altitude , described as islands with moist perennial vegetation, low soil fertility and annual precipitation of 900 1.300 mm. This study aimed to evaluate the taxonomic richness of Nidulariaceae fungi in Caatinga s areas of Northeastern Brazil, describing and identifying species, as well as expanding the collection of Herbarium UFRN Fungos. For description of Nidulariaceae fungi was followed the proposed by specialized literature in the group. We have found and described 10 species of the genus Cyathus, namely: C. earlei Lloyd, C. gayanus Tul. & C. Tul., C. gracilis H.J. Brodie, C. intermedius (Mont.) Tul. & C. Tul., C. limbatus Tul. & C. Tul., C. montagnei Tul. & C. Tul., C. pallidus Berk. & M.A. Curtis, C. poeppigii Tul. & C. Tul., C. striatus (Huds.) Willd. and C. tríplex Lloyd. Beyond these have been described four new species to science: Cyathus calvescens R. Cruz & Baseia sp. nov., C. hortum R. Cruz & Baseia sp. nov., C. magnomuralis R. Cruz & Baseia sp. nov. and C. parvocinereus R. Cruz & Baseia sp. nov. Two samples were identified only to genus level. No member of Mycocalia J.T. Palmer, Nidula V.S. White, Nidularia Fr. and Crucibulum Tul. & C. Tul. has been found, however the results were extremely valuable for being an unprecedented work in Caatinga, and importante tool for implementation of conservation projects and sustainable utilization of this domain
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Trata-se de um estudo qualitativo, utilizando-se, como referencial teórico, o Interacionismo Simbólico e, como referencial metodológico, a Grounded Theory, visando: compreender a experiência interacional de familiares visitantes e acompanhantes de adultos e idosos hospitalizados, há mais de sete dias, em um Hospital Universitário de grande porte do Estado de São Paulo, e desenvolver um modelo teórico representativo dessa experiência. As estratégias para obtenção dos dados foram a observação e a entrevista. Dos resultados, emergiram dois fenômenos: vivendo a expectativa pela internação no Hospital Universitário e assumindo o papel de familiar visitante ou de familiar acompanhante. A compreensão da experiência nos permitiu ampliar o conhecimento, referente ao movimento que eles empreenderam na vivência denominada como movendo-se perante a sinalização do enfermeiro entre os papéis de familiar visitante e familiar acompanhante: compartilhando uma experiência de poucos prazeres em solidariedade ao adulto e ao idoso hospitalizados.
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There is an urgent need to find consensus on screening, diagnosing and treating all degrees of DYSGLYCEMIA that may occur during pregnancies in Brazil, considering that many cases of DYSGLYCEMIA in pregnant women are currently not diagnosed, leading to maternal and fetal complications. For this reason the Brazilian Diabetes Society (SBD) and the Brazilian Federation of Gynecology and Obstetrics Societies (FEBRASGO), got together to introduce this proposal. We present here a joint consensus regarding the standardization of clinical management for pregnant women with any degree of Dysglycemia, on the basis of current information, to improve medical assistance and to avoid related complications of Dysglycemia in pregnancy to the mother and the fetus. This consensus aims to standardize the diagnosis among general practitioners, endocrinologists and obstetricians allowing the dissemination of information in basic health units, public and private services, that are responsible for screening, diagnosing and treating disglycemic pregnant patients.
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Purpose: This study evaluated the assumption that there are morphological differences between the natural anterior dentition of men and women. The goal of the study was to determine the gender of patients based on the appearance of the anterior teeth in photographs. Materials and Methods: Laymen and observers from different specialties were asked to determine the gender of individuals based on the shape and arrangement of anterior teeth. Forty anterior dentition photographs of dental students of both genders (20 women, 20 men) between 18 and 26 years old were selected, coded, and randomly arranged in an album. The albums were delivered to five groups of observers: general practitioners (recently graduated dentists), prosthodontists, orthodontists, restorative dentists (specialists in cosmetic and restorative dentistry), and laymen (control group). The observers evaluated the photographs twice at 1-week intervals. Results: The average correctly identified values in women and men were 57.6% and 58.8%, respectively. There was no statistical difference between observers and between each group of professionals and the laymen group (p > 0.05). An intraobserver agreement was not observed between the evaluations (kappa =-0.01). Conclusion: The results of this limited study indicated that it was not possible to differentiate gender by viewing photographs of anterior teeth.
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By generalizing the Hodge dual operator to the case of soldered bundles, and working in the context of the teleparallel equivalent of general relativity, an analysis of the duality symmetry in gravitation is performed. Although the basic conclusion is that, at least in the general-case, gravitation is not dual symmetric, there is a particular theory in which this symmetry shows up. It is a self dual (or anti-self dual) teleparallel gravity in which, due to the fact that it does not contribute to the interaction of fermions with gravitation, the purely tensor part of torsion is assumed to vanish. The ensuing fermionic gravitational interaction is found to be chiral. Since duality is intimately related to renormalizability, this theory may eventually be more amenable to renormalization than telepaxallel gravity or general relativity.
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OBJETIVOS: Identificar e medir a magnitude do risco de desnutrição associada a fatores determinantes da capacidade materna de cuidado infantil: estrutura familiar, escolaridade, trabalho, saúde física e saúde mental maternas. MÉTODOS: Delineou-se um estudo de casos e controles. Foram selecionados 101 casos (crianças com peso/idade abaixo do percentil 5) e 200 controles (crianças com peso/idade acima do percentil 25) mediante inquéritos antropométricos realizados durante três Dias Nacionais de Vacinação, em 1996 e 1997. Os dados foram obtidos em entrevistas realizadas nos domicílios com as mães das crianças. Para detectar o efeito-líquido de cada fator em estudo, realizou-se análise de regressão logística multivariada e hierarquizada. Tais fatores e as possíveis variáveis de controle foram agrupados em blocos, ordenados segundo a precedência com que influiriam sobre o estado nutricional infantil. Adotaram-se p<0,20 para seleção das variáveis de controle (mediante análise univariada) e p<0,05 para identificação de associação estatisticamente significativa entre fatores de estudo e desnutrição infantil. RESULTADOS: Foram identificados como fatores de risco de desnutrição: (a) estrutura familiar adversa indicada pela ausência de companheiro (odds ratio [OR] = 2,2; IC95%, 1,1-4,5); (b) internação materna durante a gravidez (OR=3,5; IC95%, 1,6-7,7); (c) precária saúde mental materna expressa pela presença de três a quatro sintomas de depressão (OR=3,1; IC95%, 0,9-10,3); (d) fatores de estresse familiar, no caso, indícios de alcoolismo em pelo menos um membro da família (OR=2,1; IC95%, 1,2-3,9). A idade da criança no início/retorno da mãe ao trabalho também se associou de modo independente à presença de desnutrição, porém os efeitos variaram: retorno precoce (criança com menos de quatro meses) não significou risco ou proteção; volta da mãe ao trabalho quando a criança tinha entre quatro meses e 12 meses constituiu fator de proteção. CONCLUSÕES: Evidenciou-se que fatores potencialmente definidores da capacidade materna de cuidado exercem efeito independente sobre o estado nutricional infantil.
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Estimou-se a prevalência e a incidência de parasitas intestinais em crianças e funcionários de 5 creches municipais em Botucatu/SP. Foram realizados dois estudos seccionais em 2002 (N=379) e 2003 (N=397) e um estudo longitudinal observacional, onde as crianças de 2002 e 2003 foram seguidas por um ano. Foram aplicados questionários nos funcionários e nos pais das crianças, onde foram coletadas as seguintes variáveis: nível sócio-econômico, hábitos sanitários, moradia, idade, sexo e presença de animais domésticos. Foram realizados exames coproparasitológicos nas crianças das creches. A prevalência de enteroparasitas em 2002 foi de 76,74% e 34% em 2003. As variáveis associadas à presença de enteroparasitas no ano de 2002 foram: localização das creches (OR=0,27 IC=0,15-0,47), renda familiar (OR=4,38 IC=1,91-10,04), sexo (OR=0,52 IC=0,32-0,85), faixa etária (OR=2,08 IC=1,06-4,08) e presença de animais domésticos na casa (OR=1,85 IC=1,10-3,11); em 2003, as variáveis foram: creche localizada em bairro periférico (OR=0,49 IC=0,31-0,78), renda familiar (OR=3,69 IC=2,19-6,24), nível educacional da mãe (OR=6,19 IC=1,81-21,21), sexo (OR=0,36 IC=0,36-0,93) e presença de animais domésticos (OR=1,68 IC=1,01-2,79). A coorte foi integrada por 253 crianças apresentando incidência de 23,22%. Os dados deste estudo evidenciam situações de risco em populações específicas (creches) e poderiam ser utilizados por Instituições que promovem o cuidado com as crianças.
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Two new genera and five new species of feather mites of the family Proctophyllodidae are described from passerine birds from Brazil: Tyranniphyllodes pitangi gen. n., sp. n. from Pitangus sulphuratus (Tyrannidae); Atrichophyllodes delalandi gen. n., sp. n. from Corythopis delalandi (Tyrannidae); A. mentalis gen. n., sp. n. from Dysithamnus mentalis (Thamnophilidae); Anisophyllodes candango sp. n. from Elaenia chiriquensis (Tyrannidae); and Platyacarus sittasomi sp. n. from Sittasomus griseicapillus (Dendrocolaptidae). The discovery of these taxa might give data for a better understanding of the evolution of the family Proctophyllodidae in general and the dispersion of these mites on passerines in South America in paricular.
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Potentiostatic and potentiodynamic studies were carried out to establish the inhibiting effects of citric acid on the pitting corrosion of tin. The critical potential (E-crit), which leads to pitting or general corrosion, was determined in sodium perchlorate solution in the pH range 1.0 to 4.0. Pit nucleation and growth, at pH 4.0, can be described by instantaneous nucleation followed by progressive nucleation. The results show that the minimum acid concentration needed to inhibit pitting of tin is 10(-2) M. Pitting occurrence by direct interaction between metal and perchlorate anions was observed.
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Usually referral letters are the only means of communication between general practitioners and specialists in the health area. However, they are inadequate if important basic data are omitted. The aim of this study was to compare the content of standard and non-standard letters. A total of 1956 files from the Oral Medicine Service were consecutively evaluated (March 1996 to September 2000). Key items were considered for analysis and the results were stored in a database using the Epinfo 6.04 program. The X-2 test (a=0.05) was applied to the results. of the 1956 files examined, 34% (662) had a referral letter, 31% of them being standard letters and 69% non-standard letters. Most standard letters (87%) were from professionals of public health institutions. Most percent discrepancies between standard and non-standard letters were observed for patient address (14.90 vs 1.32%), patient age (54.81 vs 9.47%), chief complaint (32.21 vs 8.37%), fundamental lesion (29.33 vs 13.66%), and symptoms (27.81 vs 15.42%,,). Statistically significant differences were observed for patient age, professional referring the patient, chief complaint, and site of the lesion. The quality and quantity of the information differed significantly between the two types of letters. The standard letters were more complete and contained information commonly absent in the non-standard letters. We suggest the use of standard letters for improving the quality of communication among professionals.
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This qualitative study intends to understand the meaning of pregnancy for diabetic women. Semi-structured interviews were carried out and data were analyzed by means of the Collective Subject Discourse, identifying the following central ideas: happiness about a desired pregnancy, preoccupation with pregnancy and renouncement, my pregnancy was planned, I had other plans, I feel what pregnant women feel, I had many problems during pregnancy, a child was everything that he wanted, he didn't feel the same emotions as a woman, I am controlling, doing everything the doctor says, I am trying to follow a diet, but it is hard. These central ideas demonstrate that, among the diabetic pregnant women, planning and wanting the pregnancy and counting on the support of the family and/or companion were also essential for the treatment to be faced naturally and for the pregnancy to be experienced in a pleasant way.
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Includes bibliography