Hydroxyurea in the sickle cell anemia: toxicity and effectiveness

Objective: to evaluate the use of hydroxyurea with regard to effectiveness and toxicity in people with sickle cell anemia. Method: this is a retrospective descriptive study, developed with 57 medical records of patients with sickle cell anemia, treated at the University Hospital Center of Campo Grande (Mato Grosso do Sul, Brazil), from 1993 to 2005. Inclusion criteria: electrophoresis of hemoglobin in medical record; regular use of drugs, for an average of 196 weeks; dosage; and hematological analyses before starting treatment. Exclusion criteria: living with other hemoglobinopathies. The variables evaluated were: neutrophils count; platelets; leukocytes; hemoglobin; time using hydroxyurea; drug response to the optimal dosage; and number and type of episodes of hospitalization. The research protocol was approved by the Ethics Committee of Universidade Federal de Mato Grosso do Sul, under the Protocol 645. Results: of the 57 medical records, 3 cases were evaluated. Comparing the hematological values, according to Portaria 872, enacted on 11/12/2002, it was found that: cases A, B, and C present an use of hydroxyurea (500 mg/day) for four years, with an average of 196 weeks. Case A, female, decreased painful episodes and frequency of hospitalization, keeping hematological values with no toxicity. In Case B, female, there was one hospitalization due to pain crises and important hemolysis. It stood out, in case C, male, neutropenia with hematological values < 2,000/mm3 . Conclusion: in the cases analyzed, we observed a drop in the number of hospitalizations with the decrease in painful crises from three to one a year, and there was no toxicity with regard to the dosage and time using hydroxyurea, in all three cases. For more comprehensive results, one suggests further study on this therapy with significant samples of this clientele.

Transtornos alimentares

Over the last decades of the 20th century, our society started an endless search for an ideal of beauty, advertised intensely by mass communication media. The concept of beauty pursued is being young, beautiful and thin. Thus, teenagers eventually die in the search for an ideal of body dominated by fat-fearing ideas. This article is a report about the field experience, during the collection of data for elaborating our Master’s Degree Dissertation on anorexia and adolescence. We went through an internship in an Eating Disease Program of a Mental Health Ambulatory from a Public University in the State of Sao Paulo, where we were able to experience the service organization, attention to users and the experience of anorexia, by the users in treatment. As the main result from this experience, it is possible to indicate the clientele profile, comprised predominantly by teenage girls, obsessed with the incessant pursuit of being thinner.

Bovine Tb Eradication Project – Recognizing Hot Button Issues

The Michigan Departments of Agriculture, Community Health, and Natural Resources, US Department of Agriculture (USDA) and Michigan State University work cooperatively together as the bovine TB eradication project partners. The interagency group combines expertise in epidemiology, veterinary and human medicine, pathology, wildlife biology, animal husbandry, regulatory law and policy and risk communications. The stakeholders, those impacted by the disease, include agriculture and tourism industry representatives, “Mom-and-Pop” businesses, hunters, wildlife enthusiasts, farmers, Local Health Departments and legislators. The regulatory agencies are the above mentioned project partners, excluding MSU and USDA Wildlife Services, both of which offer services to agencies and stakeholders. Eradicating bovine TB would not be difficult if there were no social issues surrounding it. The economy, hunting traditions, animal management, tourism and human health are all impacted by regulatory response to the disease. Often the social issues play a large role in decision making, therefore it is important to understand your clientele and anticipate public reaction to policy changes and requirements.

URBAN WILDLIFE: CAN WE LIVE WITH THEM?

ABSTRACT: A survey of Extension Wildlife Specialists in the U.S. provided a basis for estimating the magnitude of urban wildlife damage and control in this country. Response to the 9-question mail questionnaire was good (76 percent) following the single mailing to all Extension Wildlife Specialists or people in similar positions listed in the national directory. The majority of questions were answered based upon the experiences and best estimates of these specialists for the interval October 1986-September 1987. Specialists had difficulty providing estimates of damage and costs of prevention and control; 57 percent were not able to provide any data on these topics. Several of the questions dealt with attitudes of people requesting urban wildlife information and/or assistance and wide ranges of responses were received to most of these questions. Most people (78 percent) appeared willing to implement prevention/control measures recommended by these specialists, more than half (61 percent) wanted the animal handled/removed by someone else, and only about 40 percent wanted the damage stopped regardless of cost. Also, slightly over half (55 percent) of clientele represented did not want the offending animal harmed in any way. These results were highly variable from state to state. Several differences were noted in overall responses regarding urban wildlife species. Requests for information were received most frequently for bats and snakes, but both of these groups of animals ranked very low in terms of actual damage reported. The most frequently mentioned groups of animals causing damage in urban areas were roosting birds (including pigeons, starlings, and sparrows), woodpeckers (especially flickers), tree squirrels, bats, and moles. In terms of actual dollar values of damage done, white-tailed deer and pocket gophers apparently caused the most estimated damage. Due to these differences, it is necessary to know which criteria are being used to make an assessment of the relative importance of animal damage control problems. Techniques for controlling urban wildlife damage, such as exclusion, live-trapping, repellents, and poisons, are compared and discussed in some detail in this paper. As urbanization occurs across the nation, concerns about urban wildlife damage will continue; in most cases, we can and will live among these creatures.

BIRD CONTROL METHODS AND DEVICES--COMMENTS OF THE NATIONAL PEST CONTROL ASSOCIATION

It may be useful to review some of the considerations that go into recommendations concerning bird management. Later I will make some comments concerning specific methods and devices being used in or promoted for bird control work regardless of whether or not they are new. Members of the National Pest Control Association provide a variety of services, such as fumigation, termite control and general pest control which includes rodent control. There are eight such categories listed in our roster, but only one member in five provides every service listed. Bird control is a rather recent development and is the newest category of service to be listed in the NPCA roster where it appeared for the first time in 1959. As of September 1, 1966, 45% of our members' offices indicated that they were prepared to offer bird control service. Less than 40% did so in 1964. Why is it that more of our members do not declare themselves as ready to do bird control work? I believe the most common answer you would find is that bird control is not yet sufficiently established that they can provide a service comparable in quality to that which is provided against termites or cockroaches or rats. Our members simply do not want to jeopardize their reputation on methods that are not certain or are too complex. Others recognize the emotional reaction evidenced by much of the population concerning control of birds and do not want to become involved in work that might offend some of their clientele. Still others simply do not agree that birds are their responsibility.

WHAT THE STUDIES CONDUCTED IN BRAZIL REGARDING DIVIDEND POLICY REVEAL

This paper consists of a review of the literature about dividend policy in Brazil, focusing on the empirical studies conducted from 1990 to 2010 that were published in major Brazilian administration, accounting and finance journals and major conference proceedings on this subject. The analyzed sample comprised 39 studies using various methods and conducted in various periods. Based on the model of Harris and Raviv (1991), this paper grouped studies according to model type, and it found five main categories. We were able to find some tendencies, such as: dividend policy relevance in the Brazilian market; confirmation of existence of agency problems; conflicting findings regarding the clientele hypothesis; tax signaling in, and tax impact on, defining dividend policy; non-conflicting findings regarding key factors of dividend policy..

I think of my family, therefore I am: perceptions of daily occupations of some Albanians in Switzerland

The purpose of this qualitative study was to increase the understanding of the relationship between culture and occupation by exploring the perceptions of current daily occupations of some immigrants living in Switzerland. Semi-structured interviews with eight healthy Muslim Albanian men doing blue-collar work were analysed in a comparative manner followed by an interpretation. Three themes were identified: "Everything I do I do for my family"; "Where do I belong?"; and "Doing something for myself". These themes reflect the occupational perceptions of the participants. The findings are discussed in relation to the ongoing discourses on individualism and collectivism. To offer occupational therapy appropriately to a multicultural clientele the findings indicate the necessity to be conscious of the differences between one's own and the client's attitudes regarding individualism and collectivism.

Social Work, Mobility and Membership

Social work is more involved in the collective life of its clientele than are other human service activities, because it is directly concerned with the bonds and conflicts between individuals, and the co-operative and competitive aspects of groups and communities. Hence it relies on being sited in organisations relevant to service users' lives, and on being able to influence these collectivities. This article argues that the 'organisational landscape' is being transformed, as commercial enterprises (more mobile and adaptable than either state or non-government organisations) take over important aspects of collective provision. The implications of this transformation for practice are analysed, by reference to examples from the United Kingdom in particular.

Veterinary Medical Libraries in the 21st Century

The purpose of this volume is to present a picture of information access and delivery by United States and Canadian academic veterinary medical libraries (VMLs) to the veterinary community and others with interests in the profession. This is done by discussing the resources that are available, as well as methods of delivery of that information. Our discussion of these topics will not only point out the unique aspects of these collections and services, but will also illustrate much that is in common with all medical collections and library services. As with all libraries, the goal of VMLs is to provide high quality service while looking after the information needs of their clientele through selection, acquisition, cataloging, and dissemination of materials and familiarizing their users with these resources. In the past decade, new challenges and opportunities for information specialists stem from the impact of technology on VMLs. Our goal with this volume is to be concise, but thorough about all of these topics.

A descriptive analysis of the consumers at farm stands outside WIC clinics

Because fruit and vegetable intake remains low in low-income populations, the attention of public health researchers has focused on different strategies to reach this population. One possible method of reaching low income populations is through government food assistance programs like the WIC's Farmers Market Nutrition Program (FMNP). This program provides vouchers to WIC recipients that are redeemable only at farmers' markets. In the summer of 2010, two farm stands near WIC clinics in Austin were surveyed in order to establish socio-demographic characteristics of the clientele of the markets. The overall purpose of this pilot study was to describe the clientele of the markets and to examine associations between food insecurity, acculturation, socio-demographic factors, and farmers' market participants' fruit and vegetable intake. The sample was a convenience sample of farmers' market customers. One hundred study participants completed self-administered surveys. Independent t-tests were used to explore the differences in means of fruit and vegetable intake according to acculturation and food insecurity levels. The overall mean (SD) of daily fruit and vegetable intake was 4.20±2.69 for customers of both markets. Significant differences were reported between the two markets in overall fruit and vegetable intake and specifically in the following: 100% juice (P=.023), fruit consumption (P=.028), green salad (P=.003), and salsa (P=.044). The differences showed that customers at the market in a more busy location were on average reporting eating more fruits and vegetables than customers at another market that was located in a more secluded location. When examined by level of food security, individuals who were more food secure consumed more fruit (P=.016). When examined by level of acculturation, the overall fruit and vegetable intake was not significantly different between levels of acculturation. The overall findings in this report suggest that the population at these markets consists of individuals who are food insecure and on government assistance programs. While there were no significant differences between fruit and vegetable intake, acculturation and food insecurity, this report suggests the need for culturally tailored interventions that serve the Hispanic population and would assist this population to become more food secure.^

A Case Study of an Agency's Three Family Preservation Contracts

This article presents a case study of a nonprofit child welfare agency that delivered family preservation services under three different purchase-of-service (POS) contracts. The research specifically focuses on how certain POS contract provisions and reimbursement rates influence the delivery of family preservation services. The three contacts examined differed on criteria, such as reimbursement mechanism, service volume, definition of clientele, and reimbursement rate. The study found that as reimbursement rates decline and as administrative costs increase, the service provider struggled with cash flow, staffing, fundraising, and service provision, among other things. It is concluded that contract-related resources, policies, and procedures impact provider agencies in multiple, significant ways that are critical to the provision of services and the accomplishment of positive client outcomes.

El régimen señorial castellano. Estudio del proceso de acumulación patrimonial y político llevado adelante por la Casa de los Velasco en los territorios pertenecientes a la Merindad de Castilla Vieja, entre los siglos XIV y XVI

Estudio sobre el proceso de acumulación patrimonial y político llevado adelante por la Casa de los Velasco en los territorios septentrionales de Castilla la Vieja en los siglos XIV y XVI.

Pulperos y pulperías rurales bonaerenses : Su influencia en la campaña y los pueblos, 1780-1820

En las últimas décadas se ha construido una nueva imagen del mundo rural pampeano que ha complejizado el análisis con nuevos temas, métodos y fuentes. En estos estudios si bien los pulperos y pulperías están presentes siempre figuran de manera lateral o complementaria. En este trabajo me propuse profundizar el estudio de pulperos y pulperías rurales una vez reconocida su influencia en materia económica, política y social tanto en la campaña en su conjunto como hacia el interior de los pueblos. El tema elegido entonces responde a la necesidad de un estudio exclusivo y exhaustivo sobre un grupo que entendemos ha cumplido una función muy relevante como elemento central en la expansión, ocupación y estructuración de la sociedad rural bonaerense al igual que lo fueron las estancias, los fuertes y las parroquias. La expansión y consolidación de la campaña bonaerense ha sido acompañada por el despliegue comercial en las últimas décadas del siglo XVIII. Podemos hablar de un fenómeno de retroalimentación entre comerciantes y explotaciones ganaderas protagonizado con frecuencia por las mismas personas. En este sentido las pulperías contribuyeron a la formación de pueblos, la ocupación de nuevas tierras y el desarrollo de relaciones pacíficas con los pueblos originarios, aunque a veces fueron agentes disruptores. Nos queda claro que las pulperías eran engranajes importantes dentro de la economía local y ubicaban a sus propietarios por encima de la mayoría de los productores. Sin embargo muchos pulperos también eran productores o viceversa y esa diversificación les permitía disminuir los riesgos y las posibilidades de "naufragio". Creemos haber matizado y en algunos casos rechazado algunas de las imágenes literarias que en general configuraron una visión muy negativa de los pulperos y sus negocios. El pulpero no era muy distinto a su clientela y formaba parte de las costumbres predominantes de la campaña más allá de tener, en muchos casos, una posición económica más holgada. En este sentido, muchos pulperos fueron vecinos referentes en sus pueblos cumpliendo distintas funciones más allá de la fundamental que era el abastecimiento de bienes básicos, ocuparon cargos en el andamiaje institucional y se erigieron en la "voz del pueblo". La posición privilegiada de algunos pulperos les permitía evadir el peso de la justicia y cuando ocupaban cargos sacar provecho de ellos. Esto refuerza la idea de connivencia entre comercializadores locales y el aparato institucional local en torno al usufructo del tráfico de cueros que cada vez se hacía más rentable.

El régimen señorial castellano. Estudio del proceso de acumulación patrimonial y político llevado adelante por la Casa de los Velasco en los territorios pertenecientes a la Merindad de Castilla Vieja, entre los siglos XIV y XVI

Estudio sobre el proceso de acumulación patrimonial y político llevado adelante por la Casa de los Velasco en los territorios septentrionales de Castilla la Vieja en los siglos XIV y XVI.

Pulperos y pulperías rurales bonaerenses : Su influencia en la campaña y los pueblos, 1780-1820

En las últimas décadas se ha construido una nueva imagen del mundo rural pampeano que ha complejizado el análisis con nuevos temas, métodos y fuentes. En estos estudios si bien los pulperos y pulperías están presentes siempre figuran de manera lateral o complementaria. En este trabajo me propuse profundizar el estudio de pulperos y pulperías rurales una vez reconocida su influencia en materia económica, política y social tanto en la campaña en su conjunto como hacia el interior de los pueblos. El tema elegido entonces responde a la necesidad de un estudio exclusivo y exhaustivo sobre un grupo que entendemos ha cumplido una función muy relevante como elemento central en la expansión, ocupación y estructuración de la sociedad rural bonaerense al igual que lo fueron las estancias, los fuertes y las parroquias. La expansión y consolidación de la campaña bonaerense ha sido acompañada por el despliegue comercial en las últimas décadas del siglo XVIII. Podemos hablar de un fenómeno de retroalimentación entre comerciantes y explotaciones ganaderas protagonizado con frecuencia por las mismas personas. En este sentido las pulperías contribuyeron a la formación de pueblos, la ocupación de nuevas tierras y el desarrollo de relaciones pacíficas con los pueblos originarios, aunque a veces fueron agentes disruptores. Nos queda claro que las pulperías eran engranajes importantes dentro de la economía local y ubicaban a sus propietarios por encima de la mayoría de los productores. Sin embargo muchos pulperos también eran productores o viceversa y esa diversificación les permitía disminuir los riesgos y las posibilidades de "naufragio". Creemos haber matizado y en algunos casos rechazado algunas de las imágenes literarias que en general configuraron una visión muy negativa de los pulperos y sus negocios. El pulpero no era muy distinto a su clientela y formaba parte de las costumbres predominantes de la campaña más allá de tener, en muchos casos, una posición económica más holgada. En este sentido, muchos pulperos fueron vecinos referentes en sus pueblos cumpliendo distintas funciones más allá de la fundamental que era el abastecimiento de bienes básicos, ocuparon cargos en el andamiaje institucional y se erigieron en la "voz del pueblo". La posición privilegiada de algunos pulperos les permitía evadir el peso de la justicia y cuando ocupaban cargos sacar provecho de ellos. Esto refuerza la idea de connivencia entre comercializadores locales y el aparato institucional local en torno al usufructo del tráfico de cueros que cada vez se hacía más rentable.