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Toxoplasma gondii is able to infect a wide range of vertebrates, including humans. Studies show that cyclooxygenase-2 (COX-2) is a modulator of immune response in multiple types of infection, such as Trypanosoma cruzi. However, the role of COX-2 during T. gondii infection is still unclear. The aim of this study was to investigate the role of COX-2 during infection by moderately or highly virulent strains of T. gondii in Calomys callosus rodents and human THP-1 cells. C. callosus were infected with 50 cysts of T. gondii (ME49), treated with COX-2 inhibitors (meloxicam or celecoxib) and evaluated to check body weight and morbidity. After 40 days, brain and serum were collected for detection of T. gondii by real-time PCR and immunohistochemistry or cytokines by CBA. Furthermore, peritoneal macrophages or THP-1 cells, infected with RH strain or uninfected, were treated with meloxicam or celecoxib to evaluate the parasite proliferation by colorimetric assay and cytokine production by ELISA. Finally, in order to verify the role of prostaglandin E2 in COX-2 mechanism, THP-1 cells were infected, treated with meloxicam or celecoxib plus PGE2, and analyzed to parasite proliferation and cytokine production. The data showed that body weight and morbidity of the animals changed after infection by T. gondii, under both treatments. Immunohistochemistry and real-time PCR showed a reduction of T. gondii in brains of animals treated with both COX-2 inhibitors. Additionally, it was observed that both COX-2 inhibitors controlled the T. gondii proliferation in peritoneal macrophages and THP-1 cells, and the treatment with PGE2 restored the parasite growth in THP-1 cells blocked to COX-2. In the serum of Calomys, upregulation of pro-inflammatory cytokines was detected, while the supernatants of peritoneal macrophages and THP-1 cells demonstrated significant production of TNF and nitrite, or TNF, nitrite and MIF, respectively, under both COX-2 inhibitors. Finally, PGE2 treatment in THP-1 cells triggered downmodulation of pro-inflammatory mediators and upregulation of IL-8 and IL-10. Thus, COX-2 is an immune mediator involved in the susceptibility to T. gondii regardless of strain or cell types, since inhibition of this enzyme induced control of infection by upregulating important pro-inflammatory mediators against Toxoplasma.

Made available in DSpace on 2019-10-06T16:51:31Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-12-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) This study evaluated the effects of photodynamic inactivation (PDI) on single and multi-species biofilms, compounds by Candida albicans and Streptococcus sanguinis. Biofilms were formed, on microplate of 96 wells, by suspensions of C. albicans (ATCC 18804) and S. sanguinis (ATCC 7073) adjusted in 10 7 cells/mL, followed by incubation of 48 h (with 5% CO 2 ). The effects of the photosensitizer erythrosine (ER) at 400 μM for 5 min and green light-emitting diode (LED - 532 ± 10 nm) for 3 min, alone and conjugated, were evaluated. After normality test, results was analysed by Tukey´s test (P < 0.05). PDI group promoted reductions of 1.07 and 0.39 log 10 , respectively, in biofilms of C. albicans alone and in association with S. sanguinis. Biofilms of S. sanguinis alone were more sensitive, with reduction of 4.48 log 10 . When in association with the yeast, S. sanguinis have a decrease of 2.67 log 10 . SEM analysis revealed a decrease in bacterial and fungal structures of biofilms treated with PDI. In conclusion PDI promoted significant microbial reductions in both species of microorganisms grown on mixed biofilms. This study is one of the pioneers to evaluate the antimicrobial action of PDI on biofilms of S. sanguinis and C. albicans, demonstrating a way to control these microorganisms of clinical importance. São Paulo State University (Unesp) Department of Biosciences and Oral Diagnosis Institute of Science and Technology São Paulo State University (Unesp) Department of Biosciences and Oral Diagnosis Institute of Science and Technology

This paper primarily deals with the design of an Information and Control Technology (ICT) network for an advanced metering infrastructure (AMI) on the IEEE 34 node radial distribution network. The application is comprised of 330 smart meters deployed in the low voltage system and 33 data concentrators in the medium voltage system. A power line carrier (PLC) communication system design is developed and simulated in Network Simulator 3 (NS-3). The simulation result is validated by comparing the communication network performance with the minimum performance requirements for AMI. The network delay of a single data frame is calculated and compared with the simulation delay. The design methodology proposed in this article may be used for other smart grid applications. The secondary goal is to provide AMI network traffic based on the IEC Std. 61968 and a discussion on whether or not AMI could possibly be a source of big data on the future power grid.

This paper demonstrates a case study on the design of an Information and Control Technology (ICT) network for an advanced metering infrastructure (AMI) on the IEEE 34 node radial distribution network. The AMI application is comprised of 330 smart meters deployed in the low voltage system of the feeder and 33 data concentrators in the medium voltage system. A power line carrier (PLC) communication design was developed and simulated in Network Simulator 3 (NS-3). The result was validated by comparing the communication network performance with the minimum requirements from the IEC Std. 61968. The average global end-to-end delay is 216 ms and the maximum delay is 459 ms. All the measurement delays and the availability are according to the IEC Std. 61968.

Currently, given the widespread of computers through society, the task of recognizing visual patterns is being more and more automated, in particular to treat the large and growing amount of digital images available. Two well-referenced shape descriptors are BAS (Beam Angle Statistics) and MFD (Multiscale Fractal Dimension). Results obtained by these shape descriptors on public image databases have shown high accuracy levels, better than many other traditional shape descriptors proposed in the literature. As scale is a key parameter in Computer Vision and approaches based on this concept can be quite successful, in this paper we explore the possibilities of a scale-space representation of BAS and MFD and propose two new shape descriptors SBAS (Scale-Space BAS) and SMFD (Scale-Space MFD). Both new scale-space based descriptors were evaluated on two public shape databases and their performances were compared with main shape descriptors found in the literature, showing better accuracy results in most of the comparisons.

Programa de Pós-Graduação em Educação. Departamento de Educação, Instituto de Ciências Humanas e Sociais, Universidade Federal de Ouro Preto. Objetivo: Analisar a concordância e qual a relevância que acadêmicos de Pedagogia apresentam quanto ao contexto tecnológico atual, às percepções educacionais e tecnológicas e aos aspectos neurocientíficos atrelados às tecnologias. Métodos: Estudo descritivo e análises de associação de um Survey aplicado a acadêmicos de Pedagogia de duas instituições de ensino de Belo Horizonte – MG, sendo respondidos 200 questionários. Resultados: A maioria dos entrevistados possui até 29 anos e é do gênero feminino. Todos consideram importante o uso das tecnologias nas práticas educacionais (100%). Concordam com o perfil dos nativos digitais e seus comportamentos, entretanto, a relevância atribuída para tais comportamentos apresentou a menor média (4,18). Ao mesmo tempo, fatores como falta de incentivo na profissão, capacitação e ausência de recursos tecnológicos para as futuras práticas são entraves que impossibilitam uma aprendizagem contextualizada. Levou-se em conta que as conexões entre o uso das tecnologias e estimulações sensoriais e cognitivas ainda são pouco percebidas pelos acadêmicos, de todas as áreas, foi a que teve maior número de respostas com média menor que 4,00. Conclusão: Estamos diante de uma geração de alunos com novos comportamentos associados aos contextos tecnológicos que ainda são incompreendidos, e de, nas Neurociências, possíveis respostas que podem auxiliar na compreensão do contexto, no papel do professor e do aluno na educação e nas diferentes formas de estímulos presentes no uso adequado das tecnologias. Objective: To analyze the concordance and the relevance that Pedagogical scholars present regarding the current technological context, the educational and technological perceptions and the neuroscientific aspects linked to the technologies. Methods: Descriptive study and analysis of the association of a Survey applied to Pedagogy students from two educational institutions of Belo Horizonte - MG, with 200 questionnaires answered. Results: Most interviewees are 29 years old and are female. All consider the use of technologies in educational practices as important (100%). They agree with the profile of digital natives and their behaviors, however, the relevance attributed to such behaviors presented the lowest mean (4.18). At the same time, factors such as lack of incentive in the profession, training and lack of technological resources for future practices, are obstacles that make contextualized learning impossible. It has been realized that the connections between the use of technologies and sensorial and cognitive stimulation are still little perceived by the academics. Of all the areas it was the one that had the highest number of answers with an average of less than 4.00. Conclusion: We are facing a generation of students with new behaviors associated with the technological contexts that are still incomprehensible, and in the Neurosciences possible answers that can help in understanding the context, the role of the teacher and the student in the education and in the different forms of stimuli present in the use technologies.

Despite public health campaigns and epidemiological surveillance activities, Chagas disease remains a major health problem in Latin America. According to data from the World Health Organization, there are approximately 7-8 million people infected with Trypanosoma cruzi worldwide, a large percentage of which in Latin America. This study aims to examine the serological profile of blood donors in blood banks of Hemominas hematology center, in the town of Ituiutaba, Minas Gerais State, Brazil. The study sample consisted of 53,941 blood donors, which were grouped according to gender and age. Sample collections were performed from January 1991 to December 2011, and 277 donors (0.5%) were considered serologically ineligible due to Chagas disease. Analysis of data showed no significant difference between genders. As for age, the highest proportion of ineligible donors was from 40 to 49 years (30%), and there was a positive correlation between increasing age and the percentage of patients seropositive for Chagas disease. Therefore, adopting strategies that allow the safe identification of donors with positive serology for Chagas disease is essential to reduce or eliminate indeterminate serological results. A doença de Chagas, apesar das campanhas de saúde pública e das ações de vigilância epidemiológica, ainda constitui-se um sério problema de saúde na América Latina. De acordo com dados divulgados pela Organização Mundial de Saúde, existem cerca de 7 a 8 milhões de pessoas infectadas com Trypanosoma cruzi em todo o mundo, principalmente na América Latina. Este estudo tem por objetivo analisar o perfil sorológico de doadores de sangue dos bancos de sangue do Hemominas de Ituiutaba, Minas Gerais. Os doadores também foram separados de acordo com o sexo e a idade. A amostra do estudo foi composta por 53.941 doadores de sangue durante o período de janeiro de 2001 a dezembro de 2011. Duzentos e setenta e sete doações (0,5%) foram considerados sorologicamente inaptas para a doença de Chagas. Quanto à idade, a maior proporção de doadores impróprios foi de 40 a 49 anos (30%). Os dados não revelaram diferença significativa entre os sexos (p < 0,05). Houve correlação positiva entre o aumento da idade e o percentual de pacientes soropositivos para doença de Chagas. É imprescindível a adoção de estratégias que permitam a identificação segura de um doador com sorologia positiva para doença de Chagas, tentando assim minimizar ou eliminar resultados sorológicos indeterminados.

Neospora caninum is an intracellular protozoan parasite that has drawn increasing interest due to its association with worldwide repetitive bovine abortions, which cause billionaire losses to the meat and dairy industries annually. Innate immunity plays an important role in infection control, and N. caninum activates the production of inflammatory mediators through Toll-like Receptors (TLR), Nod-Like Receptors (NLR) and Mitogen Activated Protein Kinase (MAPK) signaling pathways. Advances in the knowledge of initial host-parasite interactions are desirable for the design of control measures against the infection, obliterating its pathogenesis. In that sense, we here aimed to describe the role of the innate C-type lectin receptor (CLR) Dectin-1 during the infection by N. caninum. With that intent, we observed that the absence of Dectin-1, observed in genetically depleted (Dectin-1-/-) mice or competitively inhibited by an inert agonist (Laminarin, LAM), rescued 50% of the mice infected with lethal doses of N. caninum. Dectin-1-/- and LAM-treated mice also presented a reduction in the parasite load during acute and chronic phases, associated to decreased inflammatory scores in the central nervous system. Amongst all the cell phenotypes that migrated to the initial site of infection, dendritic cells and macrophages gained subpopulations with high Dectin-1 surface expression. The impairment of the receptor in these cells led to a decreased parasite burden, as well as augmented production of IL-12p40. We also found that Dectin-1+ cells produced less reactive oxygen species (ROS) at the initial site of the infection, while mice deficient in NAPDH oxidase isoform 2 (NOX2-/-) were not able to control parasite replication and produce IL-12p40, even upon LAM treatment. Interestingly, the absence of functional Dectin-1 did not alter the susceptibility of mice against closely related T. gondii. In conclusion, the gathered data suggests that Dectin-1 is involved in the parasite-induced downmodulation of ROS and other key molecules triggered for the control of N. caninum infection, and is a promising target for future development of protocols intended for intervention against neosporosis.

The focus of this study is the use of an anaerobic fluidized bed reactor (AFBR) to continuously produce hydrogen under thermophilic conditions (55 °C) using a range of cheese whey (CW) concentrations and hydraulic retention times (HRTs). The following combinations of tests parameters were evaluated: a fixed concentration of 4900 ± 200 mg lactose L−1 and HRTs of 8, 6, 4, 2, 1 and 0.5 h in AFBR1 and a fixed HRT of 6 h and influent CW concentrations of 2800 ± 100, 4900 ± 200, 6800 ± 300, 9800 ± 300 and 14,600 ± 300 mg lactose L−1 in AFBR2. For AFBR1, the maximum hydrogen production rate (HPR) obtained was 4.1 ± 0.2 L H2 h−1 L−1 in the HRT of 0.5 h, and maximum hydrogen yield (HY) of 3.67 ± 0.59 mol H2 mol lactose−1 in the HRT of 4 h. For AFBR2, the maximum HPR was 0.85 ± 0.12 L H2 h−1 L−1 at a concentration of 6800 ± 300 mg lactose L−1, and the maximum HY was 2.64 mol H2 mol lactose−1 at a concentration of 2800 ± 100 mg lactose L−1. In both reactors, the main metabolic products were acetic acid and butyric acid. Based on 16S rRNA clone analysis of the bacterial community, the identified sequences were affiliated with relative abundances of 48.42% (Thermoanaerobacterium and Thermohydrogenium kirishiense) and 75.53% (Thermoanaerobacterium thermosaccharolyticuum and T. kirishiense) in AFBR1 and AFBR2, respectively.

Neospora caninum infection is an important cause of neuromuscular disease in dogs and abortion in cattle, leading to significant economic losses in beef and dairy industries. The protective immunity against apicomplexan parasites, specifically Toxoplasma gondii and N. caninum, is typically achieved by inducing an IL-12-driven Th1 immune response. IL-12 stimulates IFN-γ production, which activates Inducible Nitric Oxide Synthase (iNOS) and promotes consequent Nitric Oxide (NO) synthesis, classically described as one of the main effector mechanisms for parasite elimination. Here, we aimed to evaluate the role played by iNOS during N. caninum infection. Our results show that N. caninum infection in C57BL/6 wild type (WT) mice induce NO production in vivo and in vitro. In agreement, iNOS deficient mice, as well as WT mice treated with iNOS inhibitor aminoguanidine, succumbed during acute infection with a dose lethal to 50 % of the WT mice, and presented significant increase in parasite load when submitted to sub-lethal infection protocols. Interestingly, the lack of control of parasite proliferation observed in iNOS-/- mice was associated with notable CNS inflammation and increased production of the main systemic proinflammatory cytokines (IL-12, IFN-γ, IL-6, TNF and IL-17A). Taken together, our findings show that iNOS plays an important role in restricting N. caninum replication, while also modulates the inflammatory process induced by the infection.

Background and Objectives: Several factors can compromise patient safety, such as ineffective teamwork, failed organizational processes, and the physical and psychological overload of health professionals. Studies about associations between burn out and patient safety have shown different outcomes. Objective: To analyze the relationship between burnout and patient safety. Materials and Methods: A systematic review with a meta-analysis performed using PubMed and Web of Science databases during January 2018. Two searches were conducted with the following descriptors: (i) patient safety AND burnout professional safety AND organizational culture, and (ii) patient safety AND burnout professional safety AND safety management. Results: Twenty-one studies were analyzed, most of them demonstrating an association between the existence of burnout and the worsening of patient safety. High levels of burnout is more common among physicians and nurses, and it is associated with external factors such as: high workload, long journeys, and ineffective interpersonal relationships. Good patient safety practices are influenced by organized workflows that generate autonomy for health professionals. Through meta-analysis, we found a relationship between the development of burnout and patient safety actions with a probability of superiority of 66.4%. Conclusion: There is a relationship between high levels of burnout and worsening patient safety.

Neospora caninum is an intracellular protozoan parasite that has drawn increasing interest due to its association with worldwide repetitive bovine abortions, which cause billionaire losses to the meat and dairy industries annually. Innate immunity plays an important role in infection control, and N. caninum activates the production of inflammatory mediators through toll-like receptors, NOD-like receptors, and mitogen-activated protein kinase signaling pathways. Advances in the knowledge of initial host–parasite interactions are desirable for the design of control measures against the infection, obliterating its pathogenesis. In that sense, we here aimed to describe the role of the innate C-type lectin receptor Dectin-1 during the infection by N. caninum. With that intent, we observed that the absence of Dectin-1, observed in genetically depleted (Dectin-1−/−) mice or competitively inhibited by an inert agonist [laminarin (LAM)], rescued 50% of the mice infected with lethal doses of N. caninum. Dectin-1−/− and LAM-treated mice also presented a reduction in the parasite load during acute and chronic phases, associated with decreased inflammatory scores in the central nervous system. Among all the cell phenotypes that migrated to the initial site of infection, dendritic cells and macrophages gained subpopulations with high Dectin-1 surface expression. The impairment of the receptor in these cells led to a decreased parasite burden, as well as augmented production of IL-12p40. We also found that Dectin-1+ cells produced less reactive oxygen species (ROS) at the initial site of the infection, while mice deficient in NADPH oxidase isoform 2 (NOX2−/−) were not able to control parasite replication and produce IL-12p40, even upon LAM treatment. Interestingly, the absence of functional Dectin-1 did not alter the susceptibility of mice against closely related Toxoplasma gondii. In conclusion, the gathered data suggest that Dectin-1 is involved in the parasite-induced downmodulation of ROS, and other key molecules triggered for the control of N. caninum infection and are a promising target for future development of protocols intended for intervention against neosporosis.

Infection by Toxoplasma gondii affects around one-third of world population and the treatment for patients presenting toxoplasmosis clinically manifested disease is mainly based by a combination of sulfadiazine, pyrimethamine, and folinic acid. However, this therapeutic protocol is significantly toxic, causing relevant dose-related bone marrow damage. Thus, it is necessary to improve new approaches to investigate the usefulness of more effective and non-toxic agents for treatment of patients with toxoplasmosis. It has been described that lectins from plants can control parasite infections, when used as immunological adjuvants in vaccination procedures. This type of lectins, such as ArtinM and ScLL is able to induce immunostimulatory activities, including efficient immune response against parasites. The present study aimed to evaluate the potential immunostimulatory effect of ScLL and ArtinM for treatment of T. gondii infection during acute phase, considering that there is no study in the literature accomplishing this issue. For this purpose, bone marrow-derived macrophages (BMDMs) were treated with different concentrations from each lectin to determine the maximum concentration without or with lowest cytotoxic effect. After, it was also measured the cytokine levels produced by these cells when stimulated by the selected concentrations of lectins. We found that ScLL showed high capacity to induce of pro-inflammatory cytokine production, while ArtinM was able to induce especially an anti-inflammatory cytokines production. Furthermore, both lectins were able to increase NO levels. Next, we evaluated the treatment effect of ScLL and ArtinM in C57BL/6 mice infected by ME49 strain from T. gondii. The animals were infected and treated with ScLL, ArtinM, ArtinM plus ScLL, or sulfadiazine, and the following parameters analyzed: Cytokines production, brain parasite burden and survival rates. Our results demonstrated that the ScLL or ScLL plus ArtinM treatment induced production of pro-inflammatory and anti-inflammatory cytokines, showing differential but complementary profiles. Moreover, when compared with non-treated mice, the parasite burden was significantly lower and survival rates higher in mice treated with ScLL or ScLL plus ArtinM, similarly with sulfadiazine treatment. In conclusion, the results demonstrated the suitable potential immunotherapeutic effect of ScLL and ArtinM lectins to control acute toxoplasmosis in this experimental murine model.

O nutricionista e um profissional importante na realizacao de acoes de promocao, tratamento e reabilitacao da saude. No entanto, sua contribuicao na Atencao Basica e limitada. O presente estudo objetivou compreender a atuacao dos nutricionistas nas equipes de saude sob a perspectiva dos profissionais da Atencao Primaria. Estudo descritivo de abordagem qualitativa realizado com tecnicos em enfermagem, enfermeiros e agentes comunitarios de saude. O instrumento utilizado foi um roteiro semiestruturado e para a analise dos dados, utilizou-se a tecnica segundo o agrupamento de estrategias para a analise do conteudo de acordo com Bardin, a partir da qual foram formados os discursos-sinteses. O referente estudo tem como base as instrucoes da Resolucao no 466/12, do Conselho Nacional de Saude. Foram entrevistados 15 (quinze) profissionais, todos pertencentes ao municipio de Juazeiro do Norte-CE. Com relacao ao genero, houve predominância do sexo feminino, correspondendo a 93,3% (n = 14) dos participantes entrevistados. Os resultados mostraram que os profissionais que atuam na UBS acham-se preparados para orientar quanto a nutricao, embora nao se sintam capacitados para isso, mas tambem relataram sobre o quanto e importante ter um nutricionista inserido na UBS para orientar os usuarios especificamente sobre alimentacao e atribuiram a ausencia do nutricionista na UBS a problemas de gestao politica. Como foi visto os profissionais da saude se sentem um tanto capazes para abordar a nutricao, mas nao com a mesma habilidade que o nutricionista tem, pois seus conhecimentos sao limitados, constatando uma falta de informacao quanto ao papel do nutricionista.

Background and Objectives: Depression is a public health problem that affects approximately 154 million people worldwide and its incidence has increased in recent years. Regarding this problem, elderly individuals show a percentage of 15% prevalence for some depressive symptoms, which requires special attention and prevention and care actions for this population. Thus, this study aimed to understand about depression in the elderly, the profile and the process of prevention and treatment of signs and symptoms in national and international literature. Method: This is a systematic review of the literature carried out in the following databases: Latin American and Caribbean Health Sciences (LILACS); Medical Literature Analysis and Retrieval System Online (MEDLINE) and Scientific Electronic Library Online (SciELO). Studies considered for the review were: scientific articles, dissertations and theses in English, Portuguese or Spanish, published between 2010 and 2015, using the key words: depression, elderly and geriatrics. Data collection was carried out using Ursi tool, which includes the evaluation of the study title, main results and conclusions. Results: After searching the databases, 261 studies were identified and, after applying the inclusion criteria, 44 of them were selected; after implementing the abovementioned tool, the final sample comprised 17 articles. The results showed the profile of the elderly affected by depression, types of treatment, arrival at the healthcare service and associated comorbidities. The study also showed the importance of encouraging self-care, encouragement and engagement of elderly individuals and family members into educational activities, training of health professionals and improvement of the health care system as important factors in the care of these individuals. Conclusion: Health professionals who deal with the elderly population should be aware of the signs and symptoms of depression, as well as receive continuing education to meet the demands through effective and high-quality care and encourage non-pharmacological methods of symptom relief and identify in the profile of these elderly individuals, which comorbidities associated with depression are the most common.

Toxoplasmosis is a zoonosis distributed all over the world, which the etiologic agent is an intracellular protozoan parasite, Toxoplasma gondii. This disease may cause abortions and severe diseases in many warm-blood hosts, including humans, particularly the immunocompromised patients. The parasite specialized secretory organelles, as micronemes, rhoptries and dense granules, are critical for the successful parasitism. The dense granule protein 2 (GRA2) is a parasite immunogenic protein secreted during infections and previous studies have been shown that this parasite component is crucial for the formation of intravacuolar membranous nanotubular network (MNN), as well as for secretion into the vacuole and spatial organization of the parasites within the vacuole. In the present study, we produced a monoclonal antibody to GRA2 (C3C5 mAb, isotype IgG2b), mapped the immunodominant epitope of the protein by phage display and built GRA2 synthetic epitopes to evaluate their ability to protect mice in a model of experimental infection. Our results showed that synthetic peptides for B- and T-cell epitopes are able to improve survival of immunized animals. In contrast with non-immunized animals, the immunized mice with both B- and T-cell epitopes had a better balance of cytokines and demonstrated higher levels of IL-10, IL-4 and IL-17 production, though similar levels of TNF-alpha and IL-6 were observed. The immunization with both B- and T-cell epitopes resulted in survival rate higher than 85% of the challenged mice. Overall, these results demonstrate that immunization with synthetic epitopes for both B- and T-cells from GRA2 protein can be more effective to protect against infection by T. gondii.

O numero de pacientes com Doenca Renal Cronica aumentam, ocorrendo por diversos fatores: patologias de base descompensadas, falta de cuidados, estilo de vida erroneos, acompanhamento renal ausentes, dentre outros. Assim evoluindo para dialise que pode ser: hemodialise ou dialise peritoneal. A hemodialise e um dos tratamentos de substituicao renal mais utilizado. Quando o paciente chega a fase dialitica muitas restricoes alimentares ocorrem, dentre elas: fosforo, potassio, proteina. Diante do exposto, este trabalho permite um maior conhecimento aos profissionais de saude, voltado principalmente aos da nutricao, para que estes possam desenvolver estrategias voltadas ao paciente hiperfosfatemico, assim diminuindo os indices de morbidade e mortalidade como tambem maior eficiencia ao tratamento. O objetivo deste estudo e conhecer as consequencias da hiperfosfatemia serica em pacientes renais em tratamento hemodialitico. O presente estudo define-se como uma revisao integrativa de abordagem qualitativa. A partir dos descritores de saude e dos criterios de inclusao e exclusao, obteve-se vinte artigos cientificos sendo utilizados dez artigos, estes discorrem sobre complicacoes da hiperfosfatemia em pacientes renais em tratamento hemodialitico. A partir dos artigos selecionados, foi elaborada duas tabelas uma contendo dados dos artigos como: nome dos autores, ano das publicacoes, titulo entre outros. E outra: dividindo os artigos divididos em categorias.Apesar das consequencias da hiperfosfatemia serem bastante prejudiciais, o controle deste ocorre de maneira simples: com utilizacao de quelantes, alimentacao adequada e sessoes de dialise. Porem o tratamento depende essencialmente do paciente.

A hanseniase e uma doenca que a comete em especial nervos e extremidades do corpo provocando incapacidades fisicas, de grande impacto para saude publica. Objetivou-se revisar a literatura sobre a importância do enfermeiro no controle da hanseniase na estrategia saude da familia. Trata-se de uma revisao integrativa de abordagem qualitativa. Realizada nos meses de setembro e outubro de 2015. Buscou-se publicacoes cientificas brasileiras, na biblioteca virtual em saude (BVS), indexadas na base LILACS e SCIELO. Obteve-se 20 artigos, dos quais 13 foram selecionados para a pesquisa. Nos resultados, identificou-se o papel primordial do Enfermeiro no controle nos casos de hanseniase (vigilância a saude, epidemiologia, na implementacao de politicas de saude, na assistencia (consulta), apoio na luta contra o estigma/preconceito e na educacao em saude) e, identificada as dificuldades enfrentadas pelo enfermeiro na assistencia ao paciente com hanseniase (processo de adesao ao tratamento, limitada capacitacao de profissional tratamento, adocao do modelo clinico assistencial hegemonico e equivoco na compreensao de atividades gerencias em detrimento ao cuidado integral). Portanto, compete ao enfermeiro o controle da hanseniase, sendo fundamental a qualificacao desse profissional e o seu compromisso para executar o cuidado integral ao paciente/familia.

Made available in DSpace on 2018-11-26T15:30:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-01-01. Added 1 bitstream(s) on 2019-10-09T18:24:55Z : No. of bitstreams: 1 S1806-83242016000100220.pdf: 238901 bytes, checksum: 52be972a60195803a9ffd08f0d2f6d44 (MD5) Faculdade de Medicina do ABC - FMABC Faculdade de Juazeiro do Norte - FJN Dental treatment promotes psychosomatic change that can influence the procedure and compromise the general well-being of the patient. In this context, it highlights the importance of evaluating the function of the autonomic nervous system in individuals undergoing endodontic treatment. Thus, this manuscript aimed to analyse cardiac autonomic modulation, through non-linear indices of heart rate variability (HRV) during endodontic treatment. Analysis of 50 subjects of either sex aged between 18 and 40 years diagnosed with irreversible pulp necrosis of lower molars undergoing endodontic treatment was undertaken. We carried out fractal and symbolic analysis of HRV, which was recorded in the first session of the endodontic treatment at four intervals: T1: 0-10 min before the onset of the treatment session; T2: 0-10 min after the application of anaesthesia; T3: throughout the period of treatment; and T4: 0-30 min after the end of the treatment session. There was reduction of alpha 1 in T2 compared to T1 and T4 (p < 0.0001). The alpha 2 index also reduced in T2 compared to T3 (p = 0.0035). There was an increase in the alpha 1/alpha 2 ratio in T4 compared to T2 and T3 (p = 0.0003). It was found that 0V% was significantly lower in T2 (p = 0.002), while 2UV% was significantly higher (p < 0.0001) when compared to other points in time. In conclusion, HRV is reduced during endodontic treatment, and after applying local anaesthetic the parasympathetic component of HRV increases. These data indicate that endodontic treatment acutely overcharges the heart, supporting the stress involved in this situation. Fac Med ABC FMABC, Lab Delineamento Estudos & Escrita Cient, Santo Andre, SP, Brazil Fac Juazeiro Norte FJN, Fac Odontol, Dept Saude, Juazeiro Do Norte, CE, Brazil Oxford Brookes Univ, Fac Hlth & Life Sci, Dept Biol & Med Sci, Oxford OX3 0BP, England Univ Estadual Paulista UNESP, Fac Filosofia & Ciencias, Ctr Estudos Sistema Nervoso Autonomo, Marilia, SP, Brazil Univ Estadual Paulista UNESP, Fac Filosofia & Ciencias, Ctr Estudos Sistema Nervoso Autonomo, Marilia, SP, Brazil

INTRODUCTION: There are positive influences of religious and spiritual beliefs in the face of diseases such as cancer. OBJECTIVE: To analyse the influence of spirituality and religiosity in cancer in the perspective of cancer patients. METHODS: It is a qualitative, descriptive and exploratory research, carried out with 10 patients in cancer treatment, aged between 37 and 75 years. Data were collected through interviews, containing guiding questions about the theme and treated according to the Content Analysis. RESULTS: The results are summarized into three categories: (1) perceptions / conceptions of patients in the discovery of cancer; (2) vision and experience of spirituality / religiosity of cancer patients and (3) the influence of spirituality / religiosity in the treatment of cancer. They were discussed in the light of the relevant literature to the subject. CONCLUSION: Cancer brings a new life meaning for patients. Religion and spirituality have a strong relationship between the disease and faith in the possibilities of healing, which makes the religious coping a stress reduction strategy and improves quality of life of people.

Objective: Relate the process of managerial work performed by nurses-managers between a public and private hospital. METHODS: It is a descriptive and comparative research of qualitative approach, having as participants nurses that assume managerial functions in these organizations, totaling ten nurses-managers, five in each hospital. Semi-structured interviews were conducted based on the managerial process and to identify the hierarchical organization of each institution. RESULTS: For organization of results, according to the technique of thematic analysis, speeches were separated into three categories: (i) hospital Management: hierarchical flow and the active participation of those involved in the process; (ii) obstacles management in nursing and their positive reflections: faults and support for management training and (iii) manage hospital attention: administrative reflections and the process studied. The public hospital nurses reported a lack of organization charts, professionals and the little logistical support for realization of management practice. In the private hospital, the management process is organized and respects the proposed hierarchical flow, however, features mostly low-skill professionals due to rotation of jobs. FINAL CONSIDERATIONS: The study showed that the private hospital managers were more involved and with greater affinity to administrative matters, to the alignment of objectives for the organization, with a focus on efficiency. In this regard, the public hospital, the absence of these features, so these are difficult to trace and achieve goals, targets and implement their action plans. Therefore, the form of work of these nurses is based on demand management.

Introduction: Innovation in education should be done from the context and the factors that interfere in the construction and understanding of the curriculum. In the scope of nursing, teaching has undergone great changes in educational activities due to the demands of the capitalist world. Objective: To analyze the curriculum advances, which are announced as innovative educational projects aiming vocational training in nursing in Brazil. Methods: This is a systematic review of literature on curricular innovations and training of nursing students. The bibliographic survey was performed in the databases of Lilacs and Medline/PubMed using the following keywords: higher education, degree programs in Nursing and curriculum. Results: We found seven articles that addressed on the profile and training of professional nurses and curriculum changes in the undergraduate course. It became evident that the curricular changes of course still happen gradually, and reflect political moments which often doesn’t being in line with the current health model conjecture. Conclusion: Despite the curricular changes in nursing that happened due to socio-political movements, have not yet produced changes in teaching that are sufficiently in line with the requirements of the job market and are able to prepare focused professionals in humanized and contextualized care and involved in the transformation of reality.

Este trabalho considera as alianças estratégicas como forma de obtenção de vantagem competitiva no cenário logístico globalizado. Por meio de um estudo de caso particular de parceria e aliança estratégica entre empresas nacionais (Rapidão Cometa, Expresso Araçatuba e Transportadora Americana) e uma internacional (FedEx Express), pode-se entender a influência proporcionada à Rapidão Cometa no que tange ao aumento de participação no mercado logístico, bem como a sua consolidação entre os principais operadores logísticos nacionais. A logística, que possui uma função estratégica, funciona como apoio no gerenciamento eficiente do fluxo de materiais/produtos, informações e recursos, tanto dentro da empresa, como entre as diferentes organizações que participam do ciclo completo de criação de valor. No Brasil, a visão da logística como um processo integrador, tanto quanto uma ferramenta estratégica, começou a ganhar relevância a partir da década de 1990, marcada pela explosão do comércio internacional, pela estabilização econômica e pela privatização da infraestrutura (Fleury, Wanke & Figueiredo, 2000). O ambiente em que as empresas operam atualmente é muito complexo e fortemente competitivo. Portanto elas estão buscando a diferenciação e o estabelecimento de vantagens competitivas em relação a seus concorrentes. Para alcançar esses objetivos, cada uma tenta encontrar o próprio caminho; porém, entre muitas delas, um ponto comum pode ser observado: a opção pela aplicação da logística (Ferraes Neto, 2001).

This paper considers strategic alliances as a means of obtaining advantage in the globalized logistics scenario. Through a particular case study of partnership and strategic alliance between national companies (Rapidão Cometa, Expresso Araçatuba and Transportadora Americana) and an international one (FedEx Express), one may comprehend the impact on Rapidão Cometa, in as much as the increase in market share within the logistics market, as well as the subsequent consolidation before major national logistics operators, is concerned.Logistics - a field that holds a strategic function - supports the efficient management of the flow of materials / products, information and resources, both within the company and between the different organizations that participate in the entire value creation cycle.In Brazil, the perception of logistics as an integrating process and as a strategic tool came to light as of the 90´s, a decade mile stoned by rampant growth of international trade, by economic stabilization and by the privatization of infrastructure (Fleury, 2000).The environment in which companies currently operate is very complex and highly competitive. Therefore, they are seeking differentiation and the setting of competitive advantages over competitors. To achieve these goals, each tries to find its own path, however, amongst many a point in common might be perceived: the choice to apply logistics. (Ferraes Neto, 2001). Este trabalho considera as alianças estratégicas como forma de obtenção de vantagem competitiva no cenário logístico globalizado. Por meio de um estudo de caso particular de parceria e aliança estratégica entre empresas nacionais (Rapidão Cometa, Expresso Araçatuba e Transportadora Americana) e uma internacional (FedEx Express), pode-se entender a influência proporcionada à Rapidão Cometa no que tange ao aumento de participação no mercado logístico, bem como a sua consolidação entre os principais operadores logísticos nacionais. A logística, que possui uma função estratégica, funciona como apoio no gerenciamento eficiente do fluxo de materiais/produtos, informações e recursos, tanto dentro da empresa, como entre as diferentes organizações que participam do ciclo completo de criação de valor. No Brasil, a visão da logística como um processo integrador, tanto quanto uma ferramenta estratégica, começou a ganhar relevância a partir da década de 1990, marcada pela explosão do comércio internacional, pela estabilização econômica e pela privatização da infraestrutura (Fleury, Wanke & Figueiredo, 2000). O ambiente em que as empresas operam atualmente é muito complexo e fortemente competitivo. Portanto elas estão buscando a diferenciação e o estabelecimento de vantagens competitivas em relação a seus concorrentes. Para alcançar esses objetivos, cada uma tenta encontrar o próprio caminho; porém, entre muitas delas, um ponto comum pode ser observado: a opção pela aplicação da logística (Ferraes Neto, 2001).

This paper considers strategic alliances in order to obtain competitive advantage in the global logistics scene. Through a particular case study of partnership and strategic alliance between national companies (Rapidao Cometa, Expresso Aracatuba and Transportadora Americana) and one international (FedEx Express), we can understand the influence afforded to the company Rapidao Cometa, one of the national companies focused on this aim, regarding to the increase of participation in the logistics market as well as consolidation among the major national logistic Operators. Logistics has a strategic role, working to support the efficient management of the flow of materials / products, information and resources, both within the company, as between the different organizations that participate in the full cycle of value creation. In Brazil, the view of logistics as an integrative process, as well as a strategic tool, began to heat up from the nineties, which was marked by the explosion of international trade for economic stabilization and privatization of infrastructure (Fleury, 2000). The environment in which companies operate nowadays is very complex and highly competitive. Therefore, they are seeking differentiation and the establishment of competitive advantages over its competitors. To achieve these goals, each one tries to find his own way, but among many of them, a common point can be seen: an option for the application of logistics. (Ferraes Neto, 2001). Key-words: Strategic alliance. Competitive advantage. Case study. PROFUTURO: PROGRAMA DE ESTUDOS DO FUTURO Editor cientifico: James Terence Coulter Wright Avaliacao: Double Blind Review pelo SEER/OJS Revisao: Gramatical, normativa e de formatacao Future Studies Research Journal ISSN 2175-5825 Sao Paulo, v. 3, n. 2, pp. 171 – 192, Jul./Dez. 2011 173 1 INTRODUCAO E OBJETIVO Dentre as diversas definicoes de logistica, pode-se entender que ela constitui-se no gerenciamento estrategico do fluxo de material e de informacoes correlatas para levar, de forma eficiente e eficaz, os produtos da origem a um destino. Nessa definicao, o gerenciamento estrategico desses fluxos e o elemento critico de inovacao. Deve-se ressaltar, no entanto, que as vantagens e diferenciais competitivos sao pouco duradouros. Por isso, rapidez e flexibilidade da gestao e operacionalizacao do fluxo logistico deixam de ser apenas um discurso e tornam-se obrigatorias. O objetivo deste artigo foi entender de que forma a alianca estrategica estabelecida entre a empresa americana FedEx e a brasileira Rapidao Cometa influenciou a formacao de outras parcerias. 2 PRECEDENTES TEORICOS 2.1 POSICIONAMENTO ESTRATEGICO Porter (1996) define estrategia como um conjunto de atividades que proporciona um composto de valor unico no mercado. Seu objetivo e estabelecer uma posicao lucrativa e sustentavel contra as forcas que determinam a concorrencia na industria. Para Mintzberg, Ahlstrand e Lampel (2000), estrategia e planejar e executar, de forma consistente, um plano de acao que permita que a empresa atinja e mantenha, ao longo do tempo, um desempenho superior ao dos concorrentes. Posicionamento estrategico, segundo Branski (2008), e determinado pelas escolhas da empresa quanto a quais clientes focar e quais produtos oferecer. A partir do posicionamento estrategico, a empresa estabelece as atividades que serao realizadas e a forma de execucao. Porter (1999) identifica tres tipos de posicionamento, nao excludentes e geralmente entremeados: PROFUTURO: PROGRAMA DE ESTUDOS DO FUTURO Editor cientifico: James Terence Coulter Wright Avaliacao: Double Blind Review pelo SEER/OJS Revisao: Gramatical, normativa e de formatacao Future Studies Research Journal ISSN 2175-5825 Sao Paulo, v. 3, n. 2, pp. 171 – 192, Jul./Dez. 2011 174  posicionamento baseado na variedade: define um subconjunto de produtos ou servicos de um setor para produzir. E adequado quando a empresa e capaz de realizar as atividades de forma diferenciada;  posicionamento baseado nas necessidades: atende a maioria das necessidades de um determinado grupo de compradores. E adequado quando existe um grupo de clientes com necessidades diferenciadas e que necessitam de atividades executadas sob medida;  posicionamento baseado no acesso: atende compradores com necessidades semelhantes, mas que exigem diferentes formas de acesso. As atividades necessarias para atender compradores rurais e urbanos, por exemplo. O posicionamento estrategico resulta em vantagens competitivas quando as atividades sao executadas e combinadas para obter um produto ou servico diferenciado. Diferenciacao exige que a empresa execute novas atividades nao realizadas pelos concorrentes, ou as mesmas, porem de novas formas (Branski, 2008). Para estabelecer e manter um posicionamento estrategico unico, a empresa precisa seguir seis principios fundamentais (Markides, 1999):  ter como meta de longo prazo obter retorno superior do investimento. a estrategia deve estar fundamentada na sustentacao da lucratividade e gerar valor economico real;  ter como objetivo proporcionar valor ou conjunto de beneficios diferente dos concorrentes; nao e, portanto, a universalizacao das melhores praticas nem um esforco para oferecer tudo para todos. Deve definir uma forma de competir que gere valor unico para um conjunto especifico de clientes;  realizar de forma diferente suas atividades ou realizar atividades diferentes das realizadas pelos concorrentes. As atividades devem estar adequadas a sua proposicao unica de valor;  abandonar algumas caracteristicas dos produtos, servico ou atividades para ser unica em outras, o que envolve escolhas; PROFUTURO: PROGRAMA DE ESTUDOS DO FUTURO Editor cientifico: James Terence Coulter Wright Avaliacao: Double Blind Review pelo SEER/OJS Revisao: Gramatical, normativa e de formatacao Future Studies Research Journal ISSN 2175-5825 Sao Paulo, v. 3, n. 2, pp. 171 – 192, Jul./Dez. 2011 175  definir como irao operar todos os elementos de uma empresa. A estrategia envolve escolhas interdependentes, portanto todas as atividades devem ser reforcadas mutuamente;  definir uma proposicao de valor unico para seguir, mesmo que isso implique perda de oportunidades. Assim, para que as vantagens competitivas se mantenham ao longo do tempo, as atividades devem ser compativeis entre si e com o posicionamento estrategico da empresa (Porter, 1996). 2.2 VANTAGEM COMPETITIVA Para Porter e Millar (1985), uma empresa tera vantagens competitivas, que acarretam rentabilidade superior a media da industria, quando for capaz de produzir com custos menores ou vender com preco superior aos concorrentes. As vantagens competitivas podem ser classificadas, segundo Porter e Millar (1985) em:  lideranca em custo: produzir produto ou servico semelhante aos da concorrencia, mas com custo inferior – podendo, entao, obter um lucro maior;  diferenciacao: proporcionar um valor maior ao cliente podendo, neste caso, vender seu produto ou servico a um preco superior ao do concorrente. Custo e diferenciacao sao unidades basicas de vantagem competitiva e refletem a forma como sao desempenhadas todas as atividades que a empresa realiza para criar, produzir, vender e entregar produtos ou servicos. Segundo Branski (2008), as duas unidades basicas de vantagem competitiva devem ser associadas ao escopo, ou seja, a amplitude das atividades. O escopo competitivo pode assumir quatro dimensoes:  escopo de segmento: variedade dos produtos produzidos e clientes atendidos; PROFUTURO: PROGRAMA DE ESTUDOS DO FUTURO Editor cientifico: James Terence Coulter Wright Avaliacao: Double Blind Review pelo SEER/OJS Revisao: Gramatical, normativa e de formatacao Future Studies Research Journal ISSN 2175-5825 Sao Paulo, v. 3, n. 2, pp. 171 – 192, Jul./Dez. 2011 176  escopo geografico: localidades de atuacao;  escopo setorial: variedade de industria onde atua;  escopo vertical: definicao das atividades realizadas internamente e por parceiros. A adocao de um escopo amplo permite que a empresa explore as relacoes existentes entre diferentes segmentos, areas geograficas ou setores afins. Porter (1985) cita o caso de unidades de negocios que podem compartilhar vendedores, coordenar compras de componentes comuns ou explorar os beneficios decorrentes da execucao de mais atividades proprias, prescindindo de fornecedores. Ja na adocao de um escopo estreito, Branski (2008) argumenta que essa opcao permite atender a segmentos especificos, areas geograficas ou uma industria em particular, oferecendo custos mais baixos ou diferenciacao. A empresa e capaz de atender a particularidades dos compradores ou mercados que seus concorrentes com escopo amplo nao conseguem. As vantagens competitivas decorrem da forma como as atividades sao executadas e combinadas (Markides, 1999). Vantagens de custo resultam das atividades de forma mais eficaz que os concorrentes. Diferenciacao do posicionamento estrategico, ou seja, da escolha das atividades e de sua forma de execucao.

A religiosidade e a espiritualidade criam impacto na vida das pessoas fazendo com que as mesmas se sintam mais amparadas e esperançosas, tendo dessa forma, um meio que corrobore para uma melhor saúde física e mental. Como o profissional de enfermagem busca suprir e auxiliar os pacientes em suas necessidades, em que se faz através do cuidado, deve-se então, abordar também a religiosidade e a espiritualidade no plano da assistência.

A palmeira Butia capitata var capitata produz o coquinho-azedo, fruto de odor agradável e penetrante, cuja polpa é aproveitada para a produção de um suco saboroso na região norte de Minas Gerais. As sementes apresentam uma amêndoa cuja exploração ainda é bastante limitada. O objetivo deste trabalho foi determinar a composição da amêndoa do coquinho-azedo, visando a avaliar suas possibilidades de uso. Na amêndoa, a composição química (umidade, proteínas, lipídios, cinzas e fibras) foi determinada por métodos gravimétricos. Os teores dos principais minerais foram avaliados por espectrofotometria de emissão atômica com fonte de plasma indutivo, e a composição dos ácidos graxos presentes na gordura da semente foi determinada por cromatografia a gás. A amêndoa do coquinho-azedo apresentou 9,9 % de umidade e 57,8 % de lipídios totais, 25,8 % de fibra detergente neutro, 17,6 % de fibra detergente ácido e 1,6 % de cinzas em base seca. A gordura extraída da amêndoa de coquinho-azedo apresentou elevados teores de ácido láurico (42,1 %), que foi seguido pelo ácido oléico (16,9 %). Predominaram os ácidos graxos saturados (78,9 %), principalmente os de cadeia média (C6-C12). The Butia capitata palm tree produce a very aromatic fruit named "coquinho-azedo", which freeze pulp is frequently used to produce agreeable juice in north of Minas Gerais, Brazil. "Coquinho-azedo" kernel contains a nut that is not frequently explored. The purpose of the present study was the chemical characterization of "coquinho-azedo" nut to evaluate the possibilities of its use. The moisture, lipids, ash and fiber contents were determined by gravimetric methods. The mineral profile was characterized by inductively coupled plasma spectrophotometer and the fatty acids profile was characterized by gas chromatography. The coquinho-azedo nut presented 9,9 % of moisture, 57,8 % of total lipid, 25,8 % of neutral detergent fiber, 17,6 % of acid detergent fiber and 1,6 % of ash. The fat from coquinho-azedo nut presented high content of lauric acid (42,1 %), followed by oleic acid (16,9 %). The saturated fatty acids predominated (78,9 %), mainly the medium chain length fatty acids (58,3 %).

The National Healthcare Safety Network/Center for Disease Control and Prevention (NHSN/CDC) published in 2013 a new surveillance protocol in order to standardize the ventilator-associated pneumonia (VAP) confirmation criteria and, consequently, to increase the reliability of indicators in different institutions.

Introducao: Sabe-se que a populacao idosa tem crescido de forma substancial, refletindo consequentemente no aumento da perspectiva de vida. Para tanto, e necessario que seja garantida uma saude de qualidade atraves da prevencao de patologias. Dentre as que mais acometem idosos, esta o diabetes mellitus (DM), que muitas vezes e assintomatica, dificultando entao, na adesao ao tratamento, portanto, tem-se a necessidade de analisar quais os entraves diante desta problematica, visto que e um problema recorrente nos servicos de saude. Objetivo: Compreender a atuacao do profissional enfermeiro frente a adesao do idoso ao tratamento de diabetes mellitus. Metodo: Estudo qualitativo de carater descritivo, realizado nas Estrategias de Saude da Familia do municipio de Juazeiro do Norte, com idosos portadores de DM, sob a analise tematica de Minayo, utilizando-se como instrumento de coleta, um questionario semi-estruturado. Resultados: Foram selecionados 12 idosos diabeticos, considerando os que mantinham acesso continuo ao servico de saude e que mantinham o tratamento da doenca ha mais de seis meses. Foram definidas duas categorias analiticas, a saber: Acucar no sangue: percepcao acerca do diabetes, que mostra o baixo conhecimento do publico idoso frente a sintomatologia e as principais condutas que devem ser tomadas no tratamento da doenca; A adesao do idoso ao tratamento do diabetes: o que fazem os enfermeiros, categoria esta, que exemplifica o deficit nas acoes de educacao em saude, onde estes profissionais, desempenham atividades curativistas, sem visar a promocao da saude. Consideracoes finais: Nota-se um deficit quanto as acoes de promocao a saude voltadas para a orientacao acerca do diabetes mellitus para o publico idoso, o que resula diretamente na nao adesao ao tratamento medicamentoso. Para tanto, devem ser implementadas acoes que visem a melhoria da qualidade de vida do idoso frente ao tratamento da patologia, afim de alcancar a adesao, atraves de acoes de educacao em saude, realizadas pelos profissionais de saude.

Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2015 Made available in DSpace on 2017-03-07T10:17:43Z (GMT). No. of bitstreams: 3 MICF_Ines_Lucas.pdf: 1269161 bytes, checksum: 5e9f27efbfed934544897d94d09dd592 (MD5) license.txt: 1195 bytes, checksum: 25733b0b84e8845b1d09ead22e7c5a2c (MD5) MICF_Ines_Lucas.pdf: 1269161 bytes, checksum: 5e9f27efbfed934544897d94d09dd592 (MD5) Previous issue date: 2015

Objetivo:Avaliar a concordância entre um novo metodo de vigilância epidemiologica do Center for Disease Control and Prevention e o Clinical Pulmonary Infection Score para deteccao de pneumonia associada a ventilacao mecânica.Metodos:Coorte prospectiva que avaliou pacientes internados nas unidades de terapia intensiva de dois hospitais que permaneceram intubados por mais de 48 horas no periodo de agosto de 2013 a junho de 2014. Os pacientes foram avaliados diariamente pelos fisioterapeutas com o Clinical Pulmonary Infection Score. De forma independente, um enfermeiro aplicou o novo metodo de vigilância proposto pelo Center for Disease Control and Prevention. Avaliou-se a concordância diagnostica entre os metodos. Clinical Pulmonary Infection Score ≥ 7 foi considerado diagnostico clinico de pneumonia associada a ventilacao mecânica, considerando-se diagnostico definitivo a associacao de Clinical Pulmonary Infection Score ≥ 7 com germe isolado em cultura semiquantitativa ≥ 104 unidades formadoras de colonias.Resultados:De 801 pacientes admitidos nas unidades de terapia intensiva, 198 estiveram sob ventilacao mecânica. Destes, 168 permaneceram intubados por mais de 48 horas. Identificaram-se 18 (10,7%) condicoes infecciosas associadas a ventilacao mecânica e 14 (8,3%) pneumonias associadas a ventilacao mecânica possiveis ou provaveis, representando 35% (14/38) diagnosticos clinicos de pneumonia associada a ventilacao mecânica. O metodo do Center for Disease Control and Prevention identificou casos de pneumonia associada a ventilacao mecânica com sensibilidade de 0,37 e especificidade de 1,0, com valor preditivo positivo de 1,0 e negativo de 0,84. As diferencas implicaram em discrepâncias na densidade de incidencia de pneumonia associada a ventilacao mecânica (CDC: 5,2/1000 dias de ventilacao mecânica; Clinical Pulmonary Infection Score ≥ 7: 13,1/1000 dias de ventilacao mecânica).Conclusao:O metodo do Center for Disease Control and Prevention falhou na deteccao de casos de pneumonia associada a ventilacao mecânica e pode nao ser satisfatorio como metodo de vigilância.Objective: To evaluate the agreement between a new epidemiological surveillance method of the Center for Disease Control and Prevention and the clinical pulmonary infection score for mechanical ventilator-associated pneumonia detection.

Since its inception, the Web has undergone continuous evolution in order to improve itself as a means of global communication and information sharing. Open Government Data are increasingly being published on the Web, contributing to the transparency and the reusability of public data. At the same time, the use of Linked Data has been increasing in recent years, enabling the development of better and smarter applications. This chapter presents a case on the publication of Open Government Data using the Linked Data practices, by creating a data set of Brazilian politicians with information collected from different sources. This is the first dataset providing Brazilian linked data.

Background: There are many animal studies demonstrating increased neuroapoptose in the first periods of development, especially in stronger neural development regions. In young cobais neuroapoptose also noted, however, more localized area as the dentate nucleus and the olfactory bulb of the brain regions that show sinaptogense even in adulthood and is responsible for learning. Objective: To describe the current studies about learning disabilities and cognitive impairment related to exposure to general anesthetics in children. Method: This is a systematic review, performed from the search in the PubMed database using the keywords "general anesthetics," "neurotoxicity", "children", "young child" and "pediatric" with the criterion inclusion, published in the last five years, in English and related exposure to anesthetics in human children . Were excluded from the articles concerning the studies in experimental animals or that they focus on side effects of other substances on the central nervous system, such as alcohol. Results: So were found 108 articles. All were analyzed by two researchers individually. Only 27 met the inclusion criteria. Discussion: In recent years, several studies have been conducted addressing neurotoxicity triggered by general anesthetics. The vast majority using experimental animals or stem cells. Suggest that both inhaled anesthetics such as venous are able to trigger the activation neuroapoptose with release of caspase 3:09, especially in phases of high growth and neural development. There is a strong association between duration of anesthesia and multiple exposures with learning disabilities and behavior. Conclusion: Currently, you can not say that the damage caused by agents in animals can be replicated humans. However, the severity of outcomes, the FDA recommends avoiding anesthesia and surgery in children under three years, at least those that do not have an emergency basis.