Projetos de cuidado em Fisioterapia

As práticas de cuidado em fisioterapia, em muitas situações, resgatam a função do fisioterapeuta de executor de técnicas que lhe era atribuída nos primórdios da profissão. Ao exercer essa função meramente técnica, muitas vezes deixando-se substituir pelo equipamento nas suas ações, o profissional compromete o estabelecimento do vínculo terapeuta-paciente, contribuindo para o esvaziamento do encontro em saúde. Nessas situações, predomina o êxito técnico (a eficiência na realização do procedimento) sobre o sucesso prático (os benefícios trazidos para vida das pessoas). Para que o sucesso prático seja atingido, é fundamental que haja o questionamento sobre o que sonham as pessoas, profissionais e pacientes, para as suas vidas e para a saúde, quais são suas perspectivas e projetos de vida, seus projetos de felicidade. Nesse sentido, é imprescindível considerar, também, os projetos de felicidade dos profissionais da saúde enquanto sujeitos desse encontro. Afinal, é a partir deles que o profissional elabora o seu projeto de cuidado para cada paciente. Assim, esse trabalho buscou compreender os elementos que configuram a construção de projetos de cuidado em fisioterapia a partir da reflexão dos próprios fisioterapeutas. Para tanto, utilizou-se a metodologia qualitativa de pesquisa por meio de entrevistas semi-estruturadas para que fossem produzidas narrativas da história de vida do trabalho. Os discursos foram analisados integralmente e a categorização foi feita em três sub-temas: exercício profissional, relação com os pacientes e reflexões. Foi possível perceber que muitos dos arranjos de trabalho estabelecidos visam coibir o vínculo profissional-paciente, transformando-o em valor de troca e mercantilizando a relação terapêutica. Expropriada do vínculo, a prática se resume à realização de procedimentos independentes de sua finalidade, minando as possibilidades de sucesso prático. Nesse caso, não é a tecnologia que gera o afastamento e a mecanização, mas são as estratégias de mercantilização do cuidado fisioterápico. Essa situação só pode ocorrer por um processo de subordinação do profissional e seu saber, o que está fortemente associado a condições de trabalho exploratórias. Podemos dizer que a mercantilização do cuidado facilita a restrição sobre as condições de trabalho e também é fruto dela. O problema é que essa restrição é vista pelos profissionais como não definitiva, mas como um caminho para se alcançar reconhecimento na busca pelo exercício liberal da fisioterapia. A intenção desse estudo não foi traçar um plano normativo de conduta para a profissão, mas imaginamos que o equacionamento dessas questões passa necessariamente pelo reconhecimento, pelas inquietações e indignações com o problema. O que se espera, portanto, é facilitar esse processo de desconforto por meio da proximidade dessas questões trazidas pelas narrativas.

Correlação da resposta clínica à vardenafila em dois regimes terapêuticos com parâmetros vasculares e escore de risco cardiovascular em hipertensos com disfunção erétil vasculogênica

A disfunção erétil (DE) tem alta prevalência entre hipertensos e tem sido considerada marcador precoce de risco cardiovascular. A presença e gravidade da DE bem como a resposta clínica aos inibidores da fosfodiesterase tipo 5 (PDE5) parecem depender da biodisponibilidade do óxido nítrico (NO) endotelial e da extensão da doença aterosclerótica. O objetivo deste estudo foi avaliar a resposta clínica da vardenafila usada em dois regimes terapêuticos em hipertensos com DE vasculogênica e sem doença cardiovascular maior, correlacionando a gravidade da DE e a eficácia da vardenafila com dados antropométricos, laboratoriais, escore de risco cardiovascular e parâmetros vasculares funcionais e estruturais. A resposta clínica à vardenafila nos dois regimes foi avaliada conforme o percentual de respostas positivas à questão 3 do Perfil do Encontro Sexual (PES3). Os parâmetros vasculares considerados foram a espessura médio-intimal (EMI) da carótida comum, a dilatação mediada pelo fluxo (DMF) da artéria braquial e a dilatação nitrato-mediada (DNM). Foram incluídos 100 homens hipertensos com idade entre 50 e 70 anos, sendo 74 portadores de DE vasculogênica e 26 com função erétil normal que serviram de grupo controle. Nos pacientes com DE, o índice de massa corporal, relação cintura-quadril, EMI da carótida, níveis séricos de triglicerídeos, colesterol total e LDL foram significativamente maiores que no grupo controle. Após o uso de vardenafila on demand (fase 1), os pacientes com mais de 50% de respostas positivas ao PES3 ou 50% de respostas afirmativas e um incremento de 6 pontos ou mais em relação ao Índice Internacional de Função Erétil (IIEF-FE) basal e/ou resposta positiva a Questão de Avaliação Global (QAG), foram considerados respondedores. O escore do IIEF-FE basal se correlacionou negativamente com a EMI da carótida (r=-0,48, P<0,001) e com o escore de Framingham (r= -0,41, P<0,001) no grupo com DE. Houve forte correlação positiva entre a resposta clínica à vardenafila com a DMF (r= 0,70, P<0,001), que não se observou entre o sub-grupo de diabéticos. Os 35 pacientes considerados não-respondedores na fase 1 foram randomizados e, em desenho duplo-cego, receberam vardenafila ou placebo diariamente durante cinco semanas, podendo usar 10 mg de vardenafila uma hora antes da atividade sexual (fase2). Houve resposta clínica positiva em 38,8% dos que receberam a vardenafila na fase 2 e esta resposta se correlacionou com a frequência sexual (r= 0,68, P<0,01) e com o escore de Framingham (r= -0,65, P<0,01), com a EMI da carótida (r= -0,61, P=0,01) e com o LDL-colesterol (r= -0,64, P<0,01). A vardenafila foi bem tolerada em ambos os regimes terapêuticos. Concluímos que nessa amostra de hipertensos, a gravidade da DE foi relacionada a parâmetros vasculares estruturais (EMI), enquanto a resposta clínica à vardenafila on demand foi mais diretamente dependente da função vascular momentânea (DMF). Houve benefício na utilização de vardenafila diariamente com o objetivo de resgatar a eficácia do inibidor quanto à melhora do desempenho sexual. A falta de eficácia clínica ao inibidor da PDE5 em ambos os regimes terapêuticos pode servir como marcador clínico que identifica homens hipertensos com um risco cardiovascular aumentado.

A representação social da África e dos africanos

A África e os africanos são, sem dúvida, objetos especiais para a abordagem das Ciências Sociais e Humanas. O Brasil foi um dos países que receberam mais escravos negros oriundos da África. Houve momentos na história que a população negra e escrava suplantavam a população branca de origem européia, dona daqueles escravos. No início do século XIX, a capital do império, o Rio de Janeiro, era denominado por pequena África, tal o número da população negra existente. Devido a esta forte ligação, discursos foram criados para intermediar a relação destes dois povos. A teoria das representações sociais é convocada neste trabalho como instrumento teórico metodológico com os objetivos de investigar o processo de formação e a estrutura da representação social da África e dos africanos. Para alcançar tais finalidades foram realizados dois tipos de entrevistas: o primeiro foi uma entrevista fechada, realizada com 200 estudantes de graduação da UERJ, os sujeitos da presente pesquisa, com a finalidade de obter dados que pudessem ser analisados pela abordagem estrutural. Desses 200 entrevistados, 25 também responderam perguntas abertas, caracterizando uma entrevista semi-estruturada que visava abordar os aspectos processuais das representações. Na análise, verificou-se que a representação da África está muito ligada as mazelas, como pobreza, fome e miséria enquanto a representação social dos africanos está relacionada a aspectos mais positivos, como alegria, luta e cultura. A discrepância destes resultados gerou a necessidade de voltar a campo para investigar o porquê das gritantes diferenças entre estas duas representações. Destes 20 alunos entrevistados, 35% acreditam que as imagens negativas da África têm relação com as imagens veiculadas pela mídia e outros 30% crêem que isso é conseqüência da grande pobreza que existe lá. Já a imagem positiva dos africanos está relacionada a naturalização de aspectos positivos atribuídos aos africanos, como alegres e obstinados (30%) e uma identificação entre brasileiros e africanos(25%). A análise mostra que enquanto a representação social da África é muito veiculada ao discurso midiático, a representação social dos africanos relaciona-se fortemente aos discursos politicamente corretos como a democracia racial.

Spatial and seasonal relationships between Pacific harbor seals (Phoca vitulina richardii) and their prey, at multiple scales

Knowing where pinnipeds forage is vital to managing and protecting their populations, and for assessing potential interactions with fisheries. We assessed the spatial relationship between the seasonal distribution of Pacific harbor seals (Phoca vitulina richardii) outfitted with satellite transmitters and the seasonal distributions of potential harbor seal prey species in San Francisco Bay, California. Pearson’s correlation coefficients were calculated between the number of harbor seal locations in an area of the San Francisco Bay and the abundance of specific prey species in the same area. The influence of scale on the analyses was assessed by varying the scale of analysis from 1 to 10 km. There was consistency in the prey species targeted by harbor seals year-round, although there were seasonal differences between the most important prey species. The highest correlations between harbor seals and their prey were found for seasonally abundant benthic species, located within about 10 km of the primary haul-out site. Probable foraging habitat for harbor seals was identified, based on areas with high abundances of prey species that were strongly correlated with harbor seal distribution. With comparable local data inputs, this approach has potential application to pinniped management in other areas, and to decisions about the location of marine reserves designed to protect these species.

Changes in body composition and fatty acid profile during embryogenesis of quillback rockfish (Sebastes maliger)

We investigated developmental changes in the body compositions and fatty acid (FA) profiles of embryos and preparturition larvae of the quillback rockfish (Sebastes maliger). Comparisons of proximate composition data from early-stage embryos with data from hatched preparturition larvae taken from wild-caught gravid females indicated that embryos gain over one-third their weight in moisture while consuming 20% of their dry tissue mass for energy as they develop into larvae. Lipid contributed 60% of the energy consumed and was depleted more rapidly than protein, indicating a protein-sparing effect. Oil globule volume was strongly correlated with lipid levels, affirming its utility as an indicator of energetic status. FA profiles of early embryos differed significantly from those of hatched larvae. Differences in the relative abundances of FAs between early embryos and hatched larvae indicated different FA depletion rates during embryonic development. We conclude that some metabolically important FAs may prove useful in assessing the condition of embryos and preparturition larvae, particularly 20:4n-6, which cannot be synthesized by many marine fish and which is conserved during embryogenesis. Variability in body composition and energy use among rockfish species should be considered when interpreting any measures of condition.

Variation in yellowfin tuna (Thunnus albacares) catches related to El Niño-Southern Oscillation events at the entrance to the Gulf of California

Fishery catch data on yellowfin tuna (Thunnus albacares) were examined to study the effects of El Niño events between 1990 and 1999 for an area in the northeastern tropical Pacific (18−24°N, 112−104°W). The data were extracted from a database of logbook records from the Mexican tuna purse-seine f leet. Latitudinal distribution of the catches increased from south to north for the 10-year period. Highest catches and effort were concentrated between 22°N and 23°N. This area accumulated 48% of the total catch over the 10year period. It was strongly correlated with El Niño-Southern Oscillation (ENSO) events. At least two periods of exceptionally high catches occurred following El Niño events in 1991 and 1997. Peaks of catches were triggered by the arrival of positive anomalies of sea surface temperature (SST) to the area. A delay of two to four months was observed between the occurrence of maximum SST anomalies at the equator and peaks of catch. Prior to these two events, negative SST anomalies were the dominant feature in the study area and catch was extremely low. This trend of negative SST anomalies with low catches followed by positive SST anomalies and high catches may be attributed to northward yellowfin tuna migration patterns driven by El Niño forcing, a result that contrasts with the known behavior of decreasing relative abundance of these tuna after El Niño events in the eastern Pacific. However, this decrease in relative abundance may be the result of a local or subregional effect.

Reproductive biology of carpenter seabream (Argyrozona argyrozona) (Pisces: Sparidae) in a marine protected area

The carpenter seabream (Argyrozona argyrozona) is an endemic South African sparid that comprises an important part of the handline fishery. A three-year study (1998−2000) into its reproductive biology within the Tsitsikamma National Park revealed that these fishes are serial spawning late gonochorists. The size at 50% maturity (L50) was estimated at 292 and 297 mm FL for both females and males, respectively. A likelihood ratio test revealed that there was no significant difference between male and female L50 (P>0.5). Both monthly gonadosomatic indices and macroscopically determined ovarian stages strongly indicate that A. argyrozona within the Tsitsikamma National Park spawn in the astral summer between November and April. The presence of postovulatory follicles (POFs) confirmed a six-month spawning season, and monthly proportions of early (0−6 hour old) POFs showed that spawning frequency was highest (once every 1−2 days) from December to March. Although spawning season was more highly correlated to photoperiod (r = 0.859) than temperature (r = −0.161), the daily proportion of spawning fish was strongly correlated (r= 0.93) to ambient temperature over the range 9−22oC. These results indicate that short-term upwelling events, a strong feature in the Tsitsikamma National Park during summer, may negatively affect carpenter fecundity. Both spawning frequency and duration (i.e., length of spawning season) increased with fish length. As a result of the allometric relationship between annual fecundity and fish mass a 3-kg fish was calculated to produce fivefold more eggs per kilogram of body weight than a fish of 1 kg. In addition to producing more eggs per unit of weight each year, larger fish also produce significantly larger eggs.

Temporal and spatial dynamics of spawning, settlement, and growth of gray snapper (Lutjanus griseus) from the West Florida shelf as determined from otolith microstructures

The goal of our study was to understand the spatial and temporal variation in spawning and settlement of gray snapper (Lutjanus griseus) along the West Florida shelf (WFS). Juvenile gray snapper were collected over two consecutive years from seagrass meadows with a benthic scrape and otter trawl. Spawning, settlement, and growth patterns were compared across three sampling regions (Panhandle, Big bend, and Southwest) by using otolith microstructure. Histology of adult gonads was also used for an independent estimate of spawning time. Daily growth increments were visible in the lapilli of snapper 11–150 mm standard length; ages ranged from 38 to 229 days and estimated average planktonic larval duration was 25 days. Estimated growth rates ranged from 0.60 to 1.02 mm/d and did not differ among the three sampling regions, but did differ across sampling years. Back-calculated fertilization dates from otoliths indicated that juveniles in the Panhandle and Big Bend were mainly summer spawned fish, whereas Southwest juveniles had winter and summer fertilization dates. Settlement occurred during summer both years and in the winter of 1997 for the southern portion of the WFS. Moon phase did not appear to be strongly correlated with fertilization or settlement. Histological samples of gonads from adults collected near the juvenile sampling areas indicated a summer spawning period.

Modeling North Pacific temperature and pressure changes from coastal tree-ring chronologies

Climate modeling using coastal tree-ring chronologies has yielded the first summer temperature reconstructions for coastal stations along the Gulf of Alaska and the Pacific Northwest. These land temperature reconstructions are strongly correlated with nearby sea surface temperatures, indicating large-scale ocean-atmospheric influences. Significant progress has also been made in modeling winter land temperatures and sea surface temperatures from coastal and shipboard stations. In addition to temperature, the pressure variability center over the central North Pacific Ocean (PAC), which is related to the strength and location of the Aleutian Low pressure system, could be extended using coastal tree rings.

Decadal hydroclimatic variability in the western coastal United States: temporal and spatial variations in precipitation, streamflow, and lake level

EXTRACT (SEE PDF FOR FULL ABSTRACT): We have analyzed streamflow variations recorded at 15 USGS gauging stations in California during the past 90 years or so. The anomalies (departures from the 1960-1990 mean discharge) of streamflow on annual-to-decadal time scales are strongly correlated with precipitation anomalies in each drainage basin. ... Although causes of the decadal climate (precipitation) variability are not known with certainty, the use of streamflow records may help us understand the relative strengths of moisture sources and shift of the jet stream in atmospheric circulation.

Distribution of critical current density in large YBa2Cu3O7-δ grains fabricated using seeded peritectic solidification

High quality large grain high Tc superconducting ceramics offer enormous potential as 'permanent' magnets and in magnetic screening applications at 77K. This requires sample dimensions -cm with uniform high critical current densities of the order 105 A/cm2 in applied magnetic fields of IT. We report a study of the magnetic characterisation of a typical large YBa2Cu3O7-δ grain, prepared by seeded peritectic solidification, and correlate the magnetically determined critical current density, Jc, with microstuctural features from different regions of the bulk sample. From this data we extract the temperature, field and positional dependence of the critical current density of the samples and the irreversibility line. We find that whilst the bulk sample exhibits a good Jc of order 104 A/cm2 (77K, 1T), the local Jc is strongly correlated with the sample microstructure towards the edge of the sample and more severely at the centre of the sample by the presence of SmBa2Cu3O7-δ seed crystal. © 1997 IEEE.

High-frequency acousto-electric single-photon source

We propose a single optical photon source for quantum cryptography based on the acoustoelectric effect. Surface acoustic waves (SAWs) propagating through a quasi-one-dimensional channel have been shown to produce packets of electrons that reside in the SAW minima and travel at the velocity of sound. In our scheme, the electron packets are injected into a p-type region, resulting in photon emission. Since the number of electrons in each packet can be controlled down to a single electron, a stream of single- (or N-) photon states, with a creation time strongly correlated with the driving acoustic field, should be generated. ©2000 The American Physical Society.

Flame imaging of gas-turbine relight

High-altitude relight inside a lean-direct-injection gas-turbine combustor is investigated experimentally by highspeed imaging. Realistic operating conditions are simulated in a ground-based test facility, with two conditions being studied: one inside and one outside the combustor ignition loop. The motion of hot gases during the early stages of relight is recorded using a high-speed camera. An algorithm is developed to track the flame movement and breakup, revealing important characteristics of the flame development process, including stabilization timescales, spatial trajectories, and typical velocities of hot gas motion. Although the observed patterns of ignition failure are in broad agreement with results from laboratory-scale studies, other aspects of relight behavior are not reproduced in laboratory experiments employing simplified flow geometries and operating conditions. For example, when the spark discharge occurs, the air velocity below the igniter in a real combustor is much less strongly correlated to ignition outcome than laboratory studies would suggest. Nevertheless, later flame development and stabilization are largely controlled by the cold flowfield, implying that the location of the igniter may, in the first instance, be selected based on the combustor cold flow. Copyright © 2010.

Single UV excitation of Hoechst 33342 and propidium iodide for viability assessment of rhesus monkey spermatozoa using flow cytometry

Many fluorescent probes excited by visible light have been used to assess sperm quality by flow cytometry. Developing a viability evaluation method using UV excited stains would be useful for multiparameter analysis of sperm function. This investigation was conducted to determine the efficacy of Hoechst 33342 (H342) and propidium iodide (PI) dual staining for evaluating rhesus monkey sperm viability through use of flow cytometry and excited by a single UV laser. The results showed that the live cells stained only with H342 strongly correlated with expected sperm viability, and flow cytometric analyses were highly correlated with fluorescence microscopic observation. Using H342/PI/SYBR-14 triple staining method, it was found that the live/dead sperm distributions were completely concordant in both H342/PI and SYBR-14/PI assays. In addition, this dual staining was extended with fluorescein isothiocyanate-conjugated peanut agglutinin (FITC-PNA) to simultaneously analyze viability and acrosome integrity of sperm cryopreserved using two different extenders, TTE and TEST, and indicated that TTE offered better Preservation of plasma and acrosome integrity than TEST Therefore, the H342/PI dual staining provides an accurate technique for evaluating viability of rhesus monkey sperm and should be valuable for multiparameter flow cytometric analysis of sperm function.

Biogeochemical study of poly aromatic hydrocarbons (PAHs) and its physiological affection response in mudskipper (Boleophthalmus dussumieri) at coast of Khuzestan

Study on the biomarkers types to assess health status of marine ecosystems in environmental biomonitoring has an important value. Accordingly, accumulation of polycyclic aromatic hydrocarbons(PAHs) in sediment, water and tissues (liver and gill) of mudskipper(i.e. Boleophthalmus dussumieri) and some physiological responses like lysosomal membrane change performed on haemocytes, stability of red blood cell membrane and the Glutathione-S Transferase (GST) activity in the liver were measured in mudskipper. Samples were obtained from five sites along north western coast of the Persian Gulf (Khuzestan coast). Red blood cell membrane changes after different concentration of PAHs at different time was also studied to evaluate impact of PAHs compound on cell membrane. PAHs concentration was measured by HPLC method. The activity of GST enzyme was analysed by spectrophotometric method. Lysosomal membrane change was measured by NRR time method and stability of red blood cell membrane was evaluated by EOF test. Total PAH concentrations in the coastal sea water, the sediments, the liver and the gill tissues ranged between 0.80-18.34 μg/l, 113.50-3384.34 ng g-1 (dry weight), 3.99-46.64 ng g-1 dw and 3.11-17.76 ng g-1 dw, respectively. Highest PAHs pollution was found at Jafari while the lowest was detected at Bahrakan sampling sites. The lowest enzymatic activity was identified at Bahrakan (7.19 ± 1.541 nmol/mg protein/min), while the highest was recorded at Jafari (46.96 ± 7.877 nmol/mg protein/min). Comparative analysis of GST activity in the liver of mudskippers showed significant difference (p < 0.05) between the locations of Jafari and Bahrakan, and with other sites. Moreover, no significant difference was detected between the locations of Arvand, Zangi and Samayeli (p < 0.05). The mean RT was below 90 minutes in all sampling sites. Values of mean RT of the dye ranged from 34 (for the blood samples of mudskipper collected from Jafari site) to 78 minutes (for the blood samples of mudskipper collected from Bahrakan site). Spatial evaluation revealed the longest RT in fish from Bahrakan as compared with those from other sites. Preliminary results showed a significant difference (p < 0.05) among sampling sites except between Arvand and Zangi (p > 0.05). Osmotic fragility curves indicated that erythrocytes collected from mudskippers at Jafari were the most 009 fragile followed by Zangi> Arvand> Samayeli> and Bahrakan. The mean erythrocyte fragility was significantly higher at Jafari site (p < 0.05) when compared to other sites. Significant differences were found between the various sites (p < 0.05).The result indicated no significant differences between the control and treatments of mudskipper RBC exposed to field concentrations of PAHs (P>0.05). The results further indicated significant differences (P<0.05) between the control and treatments of mudskipper RBC exposed to acute. Potency Divisor concentrations. It is clear from the present result that chronic. Potency Divisor concentrations protect red cells against osmotic hemolysis. This study, however, showed that PAH concentrations in this region are not higher than the available standards. The findings showed that Lysosomal membrane destabilization, liver GST activities and fragility of red cell membrane are highly sensitive in the mudskipper, B. dussumieri. Thus, mudskipper perceived to be good sentinel organisms for PAH pollution monitoring. Sediment PAH concentrations were strongly correlated with biomarkers, indicating that PAH type pollutants were biologically available to fish. One of the possible risk assessment implications of this study is that biomarkers can be applied not only to characterize biological effects of pollution exposures, but also to determine the bioavailability of pollution in aquatic systems. The results also indicated that PAHs compound possess anti haemolytic property.