998 resultados para traditional birth attendants


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An experiment was conducted to determine the chemical composition and apparent metabolizable energy (AME) and apparent metabolizable energy corrected for nitrogen balance (AMEn) values of corn, soybean meal (SBM), soybean oil (SO) and sugarcane yeast (SY) (Saccharomyces cerevisiae). A metabolism trial was performed with 120 Dekalb White laying hens at 65 weeks of age, using the method of total excreta collection. Birds were housed in metabolism cages and distributed according to a completely randomized design into five treatments with, six replicates of four birds each. The experimental period consisted of four days of adaptation and four days of excreta collection. The experimental diets included: a reference diet based on corn and SBM and four test diets containing 40% corn, 30% SBM, 10% SO or 30 % SY. The chemical compositions of the tested ingredients, expressed on "as-is" basis were: 86.9, 87.29, 87.32 and 99.5% dry matter; and 3.51, 2.08, 99.31 and 0.03 ether extract for corn, SBM, SO and SY, respectively. Corn, SBM, and SO presented 7.33, 43.61 and 24.64% crude protein, and 0.58, 5.07 and 6.77% ash, respectively; and crude fiber contents of corn and SBM were, respectively, 2.24% and 3.56%. The following AME and AMEn (kcal/kg dry matter) values were obtained: 3,801 and 3,760 kcal/kg for corn, 2,640 and 2,557 kcal/kg for SBM, 8,952 and 8,866 kcal/kg for SO, and 1,023 and 925 kcal/kg for sugarcane yeast, respectively.

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Background: Pectus excavatum is characterized by a depression of the anterior chest wall (sternum and lower costal cartilages) and is the most frequently occurring chest wall deformity. The prevalence ranges from 6.28 to 12 cases per 1000 around the world. Generally pectus excavatum is present at birth or is identified after a few weeks or months; however, sometimes it becomes evident only at puberty. The consequence of the condition on a individual's life is variable, some live a normal life and others have physical and psychological symptoms such as: precordial pain after exercises; impairments of pulmonary and cardiac function; shyness and social isolation. For many years, sub-perichondrial resection of the costal cartilages, with or without transverse cuneiform osteotomy of the sternum and placement of a substernal support, called conventional surgery, was the most accepted option for surgical repair of these patients. From 1997 a new surgical repair called, minimally invasive surgery, became available. This less invasive surgical option consists of the retrosternal placement of a curved metal bar, without resections of the costal cartilages or sternum osteotomy, and is performed by videothoracoscopy. However, many aspects that relate to the benefits and harms of both techniques have not been defined. Objectives: To evaluate the effectiveness and safety of the conventional surgery compared with minimally invasive surgery for treating people with pectus excavatum. Search methods: With the aim of increasing the sensitivity of the search strategy we used only terms related to the individual's condition (pectus excavatum); terms related to the interventions, outcomes and types of studies were not included. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, LILACS, and ICTPR. Additionally we searched yet reference lists of articles and conference proceedings. All searches were done without language restriction. Date of the most recent searches: 14 January 2014. Selection criteria: We considered randomized or quasi-randomized controlled trials that compared traditional surgery with minimally invasive surgery for treating pectus excavatum. Data collection and analysis: Two review authors independently assessed the eligibility of the trials identified and agreed trial eligibility after a consensus meeting. The authors also assessed the risk of bias of the eligible trials. Main results: Initially we located 4111 trials from the electronic searches and two further trials from other resources. All trials were added into reference management software and the duplicates were excluded, leaving 2517 studies. The titles and abstracts of these 2517 studies were independently analyzed by two authors and finally eight trials were selected for full text analysis, after which they were all excluded, as they did not fulfil the inclusion criteria. Authors' conclusions: There is no evidence from randomized controlled trials to conclude what is the best surgical option to treat people with pectus excavatum.

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Weight records of Brazilian Nelore cattle, from birth to 630 d of age, recorded every 3 mo, were analyzed using random regression models. Independent variables were Legendre polynomials of age at recording. The model of analysis included contemporary groups as fixed effects and age of dam as a linear and quadratic covariable. Mean trends were modeled through a cubic regression on orthogonal polynomials of age. Up to four sets of random regression coefficients were fitted for animals' direct and maternal, additive genetic, and permanent environmental effects. Changes in measurement error variances with age were modeled through a variance function. Orders of polynomial fit from three to six were considered, resulting in up to 77 parameters to be estimated. Models fitting random regressions modeled the pattern of variances in the data adequately, with estimates similar to those from corresponding univariate analysis. Direct heritability estimates decreased after birth and tended to be lowest at ages at which maternal effect estimates tended to be highest. Maternal heritability estimates increased after birth to a peak around 110 to 120 d of age and decreased thereafter. Additive genetic direct correlation estimates between weights at standard ages (birth, weaning, yearling, and final weight) were moderate to high and maternal genetic and environmental correlations were consistently high.

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Many adverse pregnancy outcomes (APOs), including spontaneous preterm birth (PTB), are associated with placental dysfunction. Recent clinical and experimental evidences suggest that premature aging of the placenta may be involved in these events. Although placental aging is a well-known concept, the mechanisms of aging during normal pregnancy and premature aging in APOs are still unclear. This review was conducted to assess the knowledge on placental aging related biochemical changes leading to placental dysfunction in PTB and/or preterm premature rupture of membranes (pPROM). We performed a systematic review of studies published over the last 50 years in two electronic databases (Pubmed and Embase) on placental aging and PTB or pPROM. The search yielded 554 citations, 30 relevant studies were selected for full-text review and three were included in the review. Only one study reported oxidative stress-related aging and degenerative changes in human placental membranes and telomere length reduction in fetal cells as part of PTB and/or pPROM mechanisms. Similarly, two animal studies reported findings of decidual senescence and referred to PTB mechanisms. Placental and fetal membrane oxidative damage and telomere reduction are linked to premature aging in PTB and pPROM but the risk factors and biomolecular pathways causing this phenomenon are not established in the literature. However, no biomarkers or clinical indicators of premature aging as a pathology of PTB and pPROM have been reported. We document major knowledge gaps and propose several areas for future research to improve our understanding of premature aging linked to placental dysfunction.

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Preterm infants in neonatal intensive care units frequently receive red blood cells (RBC) transfusions due to the anemia of prematurity. A number of variables related to gestational age, severity of illness and transfusion practices adopted in the neonatal unit where the neonate was born may contribute to the prescription of RBC transfusions. This study aimed to analyse the frequency and factors associated with RBC transfusions in very-low-birth-weight preterm infants. A prospective cohort of 4283 preterm infants (gestational age: 29.9 ± 2.9 weeks; birth weight: 1084 ± 275 g) carried out at 16 university hospitals in Brazil between January 2009 and December 2011 was analysed. Factors associated with RBC transfusions were evaluated using univariate and multiple logistic regression analysis. A total of 2208 (51.6%) infants received RBC transfusions (variation per neonatal unit: 34.1% to 66.4%). RBC transfusions were significantly associated with gestational age (OR: -1.098; 95%CI: -1.12 to -1.04), SNAPPE II score (1.01; 1.00-1.02), apnea (1.69; 1.34-2.14), pulmonary hemorrhage (2.65; 1.74-4.031), need for oxygen at 28 days of life (1.56; 1.17-2.08), clinical sepsis (3.22; 2.55-4.05), necrotising enterocolitis (3.80; 2.26-6.41), grades III/IV intraventricular hemorrhage (1.64; 1.05-2.58), mechanical ventilation (2.27; 1.74-2.97), use of umbilical catheter (1.86; 1.35-2.57), parenteral nutrition (2.06; 1.27-3.33), >60 days of hospitalization (5.29; 4.02-6.95) and the neonatal unit where the neonate was born. The frequency of RBC transfusions varied among neonatal intensive care units. Even after adjusting for adverse health conditions and therapeutic interventions, the neonatal unit continued to influence transfusion practices in very-low birth-weight infants.

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The contemporary world is characterized, among other factors, by the influence of the new computer information systems on the behavior of individuals. However, traditional information systems still have interaction problems with users. The aim of this study was to determine whether the interaction aspects between user versus traditional information systems (particularly the graphics) have been fully studied. To do so, the ergonomic aspects and usability of such systems were reviewed, with emphasis on the problems of visibility, legibility and readability. From that criteria, the evolution of ergonomic studies of information systems was reviewed (bibliometrics technique); and examples of ergonomic and usability problems in packaging were demonstrated (case study). The results confirm that traditional information systems still have problems of interaction between human X system, hindering the effective perception of information.

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Deficient antioxidant defenses in preterm infants have been implicated in diseases such as bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, periventricular leukomalacia, and intraventricular hemorrhage. The antioxidant properties of selenium, vitamin A, and vitamin E make these elements important in the nutrition of Very Low-Birth Weight (VLBW) infants. Selenium is a component of glutathione peroxidase, an enzyme that prevents the production of free radicals. The decrease in plasma selenium in VLBW infants in the first month after birth makes evident that preterm infants have low selenium store and require supplementation by parenteral and enteral nutrition. A meta-analysis, with only three trials, showed that selenium supplementation did not affect mortality, and the incidence of neonatal chronic lung disease or retinopathy of prematurity, but was associated with a reduction in lateonset sepsis. Most VLBW infants and extremely Low-Birth Weight Infants (ELBW) are born with low vitamin A stores and need vitamin A supplementation by intramuscular or enteral route. Low plasma retinol concentrations increase the risk of chronic lung disease/bronchopulmonary dysplasia and long-term respiratory disabilities in preterm infants. There is evidence that vitamin A supplementation decreases the mortality or oxygen requirement at one month of age, and oxygen requirement at 36 weeks’ postmenstrual age. Vitamin E blocks natural peroxidation of polyunsaturated fatty acids from lipid layers of cell membranes. VLBW infants have a decrease in plasma concentrations in the first month after birth suggesting the need of vitamin E supplementation. A meta-analysis on vitamin E supplementation concluded that vitamin E did not affect mortality, risk of bronchopulmonary dysplasia, and necrotizing enterocolitis but reduced the risk of intraventricular hemorrhage and increased the risk of sepsis. Serum vitamin E concentrations higher than 3.5 mg/dL are associated with a decrease in the risk of severe retinopathy of prematurity, and blindness, but also with an increase in neonatal sepsis. Caution is recommended with the supplementation of high doses of parenteral vitamin E and supplementation that increases serum levels above 3.5 mg/dL. In conclusion: although it is known that preterm infants are deficient in selenium, vitamin A and E, more studies are required to determine the best way to supplement and the impact of supplementation on neonatal outcome.

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Until 1990, beef cattle production in Brazil was recognized as an enterprise of low investment, low cost of production, as well as an extensive production system that used large land areas to be economically feasible. The situation changed for the Brazilian beef market when the economy stabilized in 1994 and all sectors involved in the beef supply chain were able to predict their associated costs and profits. During the same period, purchasing power of the Brazilian population grew, and as a consequence, consumers began to demand higher quality beef products. This new scenario in the late 1990s and early 2000s has led to more intensive beef production systems in Brazil as well as the need for a greater understanding of how technologies might be applied. As consequence of this evolution, in the last five years, a necessity to increase beef production has occurred. The quality of Brazilian beef has improved compared with beef produced 15 years ago, but continued improvements are needed to achieve excellence in terms of large-scale production of high quality beef, be sustainable over a long period of time, and increase our contribution to global food security.

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The aim of the work was to evaluate the productivity, leaf nutrient content and soil nutrient concentration in maize (Zea mays L.) grown in sequence with black oats (Avena strigosa Schreb.) under Leucaena diversifolia alley cropping agroforestry system (AFS) and traditional management system/sole crop (without trees-TS), after two years of cultivation following a randomized block design. The experiment was carried out in the Brazilian Association of Biodynamic Agriculture, in Botucatu—S?o Paulo, Brazil. Treatments were: control (C), chemical fertilizer application (F), biomass of L. diversifolia alley cropping application (B), biomass of L. diversifolia alley cropping + chemical fertilizer application (B + F). In the second year of management it was observed that black oat yield was higher in treatments B + F and F with significant difference in relation to the others treatments in both systems, followed by treatment B. Between systems, only treatment B showed significant difference, with higher yield value corresponding to AFS, reflecting the efficiency of AFS to promote soil fertility. Maize production presented the second year of cultivation an increasing trend in all treatments in both production systems. This result may be due to the cumulative effect of mineralization and maize straw and oats, along the experiment. How productivity was higher in the AFS system, could also be occurring effect of biological nitrogen fixation, water retention and reduction of extreme microclimate through the rows of L. diversifolia. Comparing the AFS and TS, it was observed that the concentration of N in leaf tissue was higher in the AFS treatments, probably due to nitrogen fixation performed through the rows of L. diversifolia, that is a nitrogen fixing tree species. After two years, carbon stocked in soil show higher values in the treatments biomass + fertilizer and biomass application, in both systems, AFS and TS.

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Pós-graduação em Bases Gerais da Cirurgia - FMB

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In this action research study of my classroom of seventh grade mathematics, I investigated the use of non-traditional activities to enhance mathematical connections. The types of nontraditional activities used were hands-on activities, written explanations, and oral communication that required students to apply a new mathematical concept to either prior knowledge or a realworld application. I discovered that the use of non-traditional activities helped me reach a variety of learners in my classroom. These activities also increased my students’ abilities to apply their mathematical knowledge to different applications. Having students explain their reasoning during non-traditional activities improved their communications skills, both orally and in writing. As a result of this research, I plan to incorporate more non-traditional activities into my curriculum. In doing so, I hope to continue to increase my students’ abilities to solve problems. I also plan to incorporate the use of written explanations of my students’ mathematical reasoning in order to continue to improve their communication of mathematics.

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A demographic model is developed based on interbirth intervals and is applied to estimate the population growth rate of humpback whales (Megaptera novaeangliae) in the Gulf of Maine. Fecundity rates in this model are based on the probabilities of giving birth at time t after a previous birth and on the probabilities of giving birth first at age x. Maximum likelihood methods are used to estimate these probabilities using sighting data collected for individually identified whales. Female survival rates are estimated from these same sighting data using a modified Jolly–Seber method. The youngest age at first parturition is 5 yr, the estimated mean birth interval is 2.38 yr (SE = 0.10 yr), the estimated noncalf survival rate is 0.960 (SE = 0.008), and the estimated calf survival rate is 0.875 (SE = 0.047). The population growth rate (l) is estimated to be 1.065; its standard error is estimated as 0.012 using a Monte Carlo approach, which simulated sampling from a hypothetical population of whales. The simulation is also used to investigate the bias in estimating birth intervals by previous methods. The approach developed here is applicable to studies of other populations for which individual interbirth intervals can be measured.

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During autumn 2003, several thousand European starlings (Sturnus vulgaris) began roosting on exposed I-beams in a newly constructed, decorative glass canopy that covered the passenger pick-up area at the terminal building for Cleveland Hopkins International Airport, Ohio. The use of lethal control or conventional dispersal techniques, such as pyrotechnics and fire hoses, were not feasible in the airport terminal area. The design and aesthetics of the structure precluded the use of netting and other exclusion materials. In January 2004, an attempt was made to disperse the birds using recorded predator and distress calls broadcast from speakers installed in the structure. This technique failed to disperse the birds. In February 2004, we developed a technique using compressed air to physically and audibly harass the birds. We used a trailer-mounted commercial air compressor producing 185 cubic feet per minute of air at 100 pounds per square inch pressure and a 20-foot long, 1-inch diameter PVC pipe attached to the outlet hose. One person slowly (< 5 mph) drove a pick-up truck through the airport terminal at dusk while the second person sat on a bench in the truck bed and directed the compressed air from the pipe into the canopy to harass starlings attempting to enter the roost site. After 5 consecutive nights of compressed-air harassment, virtually no starlings attempted to roost in the canopy. Once familiar with the physical effects of the compressed air, the birds dispersed at the sound of the air. Only occasional harassment at dusk was needed through the remainder of the winter to keep the canopy free of starlings. Similar harassment with the compressor was conducted successfully in autumn 2004 with the addition of a modified leaf blower, wooden clappers, and laser. In conclusion, we found compressed air to be a safe, unobtrusive, and effective method for dispersing starlings from an urban roost site. This technique would likely be applicable for other urban-roosting species such as crows, house sparrows, and blackbirds.

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Pós-graduação em Bases Gerais da Cirurgia - FMB