984 resultados para Issues p


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A prescrição abusiva de medicamentos na odontologia constitui um desafio aos programas de saúde pública que visam corrigir a prescrição inadequada de fármacos. Os anti-inflamatórios não esteróides (AINE) podem alteram a eficácia dos anti-hipertensivos, elevando a pressão arterial, sobretudo em pacientes idosos e/ou com hipertensão arterial sistêmica (HAS). O objetivo foi avaliar o nível de conhecimentos dos cirurgiões-dentistas (CD) da rede pública da saúde da Prefeitura Municipal de São José dos Campos (PMSJC) sobre a prescrição de AINE a pacientes com HAS. Trata-se de estudo descritivo, realizado por meio de questionário aplicado aos 92 CD da PMSJC. Os resultados foram analisados estatisticamente utilizando-se os testes de Wald e de Fisher. A associação entre as variáveis foi estudada por meio da razão de chances (OR) com p-valor<0,05. Os resultados mostraram que o nível de conhecimento para a prescrição de AINE para pacientes com HAS foi insuficiente e as interações medicamentosas entre AINE e anti-hipertensivos são desconhecidas pela quase totalidade da amostra. Concluiu-se que os cursos de atualização em odontologia não estão suprindo as necessidades dos CD no âmbito da farmacoterapia.

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Gastroschisis is a birth defect in which an opening in the abdominal wall allows herniation of the viscera. Prenatal counseling regarding gastroschisis typically discusses that, although these infants often endure a difficult neonatal course, they experience few long-term complications. However, information regarding long-term outcomes is based on limited studies that lack specificity. Therefore, we aimed to study the long-term morbidity and quality of life in children born with gastroschisis in a large and diverse population drawn from the Texas Birth Defects Registry (TBDR). Study packets with informed consent, a questionnaire, and the Pediatric Quality of Life Inventory Generic Core Scale 4.0 (PedsQL 4.0) in English and Spanish were mailed to 1,112 parents of children born with isolated gastroschisis in Texas between 1999 and 2008 via the TBDR. Information was abstracted from the TBDR for 58 mothers of children with gastroschisis who returned study materials. Three hundred fifty five packets were returned to sender, giving a response rate of 7.7%. Children born with gastroschisis had quality of life scores that were not significantly different than expected (p = 0.981). However, factors such as having a learning disability (p = 0.001) and missing school due to gastrointestinal issues (p = 0.020) were found to significantly decrease quality of life. Overall, children with gastroschisis had a significantly increased risk for learning disabilities regardless of whether they were preterm (p = 0.021) or full term (p = 0.021). Additionally, there appeared to be an increased risk for auditory impairment in Caucasian children (p < 0.0005). Therefore, while overall long-term quality of life is not significantly altered for children born with gastroschisis, the previously unreported increased risk for learning disabilities and possible association with hearing impairment are important findings that should be conveyed to prospective parents.

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A avaliação vocal é realizada predominantemente por meio da avaliação perceptivoauditiva, sendo dependente de conhecimentos teóricos prévios e de treinamento prático e dinâmico. Entretanto, ainda são escassas as iniciativas educacionais que se utilizam das novas tecnologias para o ensino da avaliação perceptivoauditiva da voz. A utilização de estratégias com novas tecnologias de informação e comunicação, hoje tão presentes e familiarizadas no meio universitário, apresentam o intuito de facilitar e otimizar o processo de ensino e aprendizagem. Desta forma, este estudo teve o propósito de elaborar e avaliar um curso a distância em um ambiente virtual de aprendizagem sobre essa temática. Elaborou-se um curso a distância sobre a avaliação perceptivoauditiva da voz organizado em quatro módulos principais: 1. Noções básicas de anatomia e fisiologia da fonação; 2. Ouvindo vozes; 3. Avaliação perceptivoauditiva da voz e 4. Aplicabilidade da avaliação perceptivoauditiva da voz, além de um adicional com vídeos sobre curiosidades e sugestão de material complementar para estudo. O ambiente virtual de aprendizagem (AVA) também apresentou diversas ferramentas educacionais como textos, imagens ilustrativas, videoaulas, vídeos, arquivos de áudio, atividades práticas individuais, fóruns, além de recursos de interatividade entre alunos e tutora. Este material foi antecipadamente avaliado por três especialistas que avaliaram o material positivamente como uma inovadora e importante ferramenta educacional que poderá ser utilizada na formação de estudantes na área de voz. Foram convidados a participar do curso a distância, 133 alunos do 1o ao 4o ano de um curso de graduação em Fonoaudiologia de uma Universidade do interior paulista. Concordaram em participar 33 estudantes e desses, nove concluíram o curso. Os alunos responderam a avaliações de conteúdo nos momentos pré e pós-curso, de forma presencial e a avaliações de cada módulo, realizadas por meio de questões específicas e atividades práticas, no pprio site. Ao término do curso os alunos também responderam a uma avaliação motivacional do AVA. Observou-se diferença estatisticamente significante na média de acertos nas provas pré e pós-curso dos alunos, nas questões teóricas (p= 0,031), nas práticas (p=0,000) e no total (p=0,002), demonstrando que o material elaborado foi capaz de aumentar o conhecimento dos estudantes a respeito de seu tema. O AVA apresentou alto índice de satisfação motivacional e foi avaliado por todos os participantes como um curso impressionante, de acordo com o instrumento de avaliação motivacional utilizado. Conclui-se que foi possível elaborar um ambiente virtual de aprendizagem (AVA), em formato de curso a distância, sobre a temática da avaliação perceptivoauditiva da voz e que o material elaborado apresenta um importante potencial de ensino e aprendizagem sobre esse tema.

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Wild animals have been kept as pets for centuries, in Brazil companionship is one of the main reasons why wild species are legally bred and traded. This paper is an attempt to call the attention for problems concerning the welfare of wild pets involved in the trading system in Brazil. Some issues presented are: a) the significant increase in the number of wildlife breeders and traders and the difficulties faced by of the Brazilian government in controlling this activity; b) the main welfare issues faced by breeders and owners of wild pets; and c) the destination of wild pets no longer wanted. Finally, some recommendations are made having the welfare of the animals as a priority.

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12 Suppl 1

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Some recent results regarding the global dynamical behaviour of the wake of circular cylinders and airfoils with massive separation are reviewed in this paper. In order to investigate the effect of interference, the three-dimensional instability modes are analysed for the flow around two circular cylinders in tandem. In the same way, the flow around a stalled airfoil is investigated in order to provide a better understanding of the three-dimensional characteristics of wakes forming downstream of a lifting body with massive separation. These results are compared with those found for an isolated cylinder. Some fundamental differences among these flows are discussed. (C) 2011 Elsevier Ltd. All rights reserved.

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The Cluster Variation Method (CVM), introduced over 50 years ago by Prof. Dr. Ryoichi Kikuchi, is applied to the thermodynamic modeling of the BCC Cr-Fe system in the irregular tetrahedron approximation, using experimental thermochemical data as initial input for accessing the model parameters. The results are checked against independent data on the low-temperature miscibility gap, using increasingly accurate thermodynamic models, first by the inclusion of the magnetic degrees of freedom of iron and then also by the inclusion of the magnetic degrees of freedom of chromium. It is shown that a reasonably accurate description of the phase diagram at the iron-rich side (i.e. the miscibility gap borders and the Curie line) is obtained, but only at expense of the agreement with the above mentioned thermochemical data. Reasons for these inconsistencies are discussed, especially with regard to the need of introducing vibrational degrees of freedom in the CVM model. (C) 2008 Elsevier Ltd. All rights reserved.

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This study focuses on the floral development of Copaifera langsdorffii to elucidate uncertain features in its floral morphology, such as the tetramerous calyx, lack of petals, blackened anthers and their supposed sterility, as well as polyembryony. Buds and flowers were dissected and prepared for examination under scanning electron and light microscopes. The floral apex initiates two bracteoles, five sepals, five petals, five outer stamens, five inner stamens, and one carpel. Order is helical for sepals, reversed unidirectional for the petals, and unidirectional for two whorls of stamens. The tetramerous calyx results from the union of two adaxial sepal primordia, which forms one large sepal and three other smaller sepals. Although the flower lacks petals, the petal primordia are initiated but do not elongate like the other floral organs, remaining as petal rudiments. Ten stamens are formed in two distinct whorls. Formation within each whorl is almost simultaneous, and the inner whorl is formed shortly after the outer. During organ elongation, the inner stamen primordia bases are reoriented outward, resulting in a single whorl of stamens. The darkened anthers have viable pollen grains. Thus, there is no relation between sterility and the dark coloration of the anthers. No signs of extranumerary embryos are observed; therefore, polyembryony is not confirmed. Although studies on floral development of Detarieae have been reported, few Neotropical genera of the tribe (such as Copaifera) have been studied.

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In this text we proceed through a brief review of Naomi Lee`s (2009) article, highlighting her significant contributions to social and cultural psychology. In our dialogue with her text we inquire about some arguments and methodological procedures she presents. We raise some specific questions related to how the issue of beauty is framed, and we ponder on how a broadening of the scope to include history-of ideas, of relations-would bring some important elements to her approach. As Lee relates beauty and class, we examine the nuanced meanings of lack and deficiency in her analytical work. We also discuss her assumptions and position concerning discourse and dialogue which mark her ways of proceeding through the analysis of the interviews. We speculate that the depersonalized answer appointed in the interviewees` discourse can be related to a way of considering beauty as disembodied.

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This article aims to analyse the introduction of environmental issues in the context of the production function, which has been referred to as the organisational area to lead corporate environmental management. With that purpose, the theoretical references for corporate environmental management and the necessary alterations in production function have been organised to include environmental aspects, especially in terms of product and process development, quality management, and logistics. Considering that this research field still lacks empirical evidence for Brazilian companies, four case studies were conducted using companies located in the country. The environmental management maturity level of those companies tends to follow the rate with which the environmental issue is introduced in production sub-areas, especially in the product development process. However, in most cases we found that the companies had difficulties in structuring the insertion of the environmental dimension in logistics. The final notes point out the distance observed between what is recommended by international literature and the reality of Brazilian companies in the challenge of making the production function environmentally friendly.