Análise dos resultados dos cursos de especialização promovidos pelo PNBU face aos objetivos propostos

Analisa os relatórios dos cinco cursos de especialização para bibliotecários de instituições de ensino superior promovidos pelo Plano Nacional de Bibliotecas Universitárias, confrontando seus objetivos e resultados. Destaca as avaliações feitas pelos alunos e professores participantes dos cursos. Conclui que este tipo de curso constitui uma das melhores formas de educação continuada objetivando melhorar o desempenho dos bibliotecários universitários.Analyses the reports of five specialízation courses sponsored by the National Plan of University Libraries comparing their objectives and results. Points out the comments made by teachers and students and concludes that such a course represents an important effort to improve continuing education in order to achieve the best performance of academic librarians

Análise dos resultados dos cursos de especialização promovidos pelo PNBU face aos objetivos propostos

Analyses the reports of five specialization courses sponsored by the National Plan of University Libraries comparing their objectives and results. Points out the comments made by teachers and students and concludes that such a course represents an important effort to improve continuing education in order to achieve the best performance of academic librarians.Analisa os relatórios dos cinco cursos de especialização para bibliotecários de instituições de ensino superior promovidos pelo Plano Nacional de Bibliotecas Universitárias, confrontando seus objetivos e resultados. Destaca as avaliações feitas pelos alunos e professores participantes dos cursos. Conclui que este tipo de curso constitui uma das melhores formas de educação continuada objetivando melhorar o desempenho dos bibliotecários universitário

AGE-RELATED CEREBRAL VENTRICULAR VOLUME CHANGES IN HEALTHY ELDERLY HUMANS

Normal aging is associated with morphological alte-rations in brain. Ventricular system is located deep inside brain and reflect the overall process of parenchymal atrophy. Once neurode-generative disorders course with more prominent dilatation of brain ventricles, to establish normative volumetric parameters from Brazi-lian healthy old individuals is necessary, and it may be an additional tool on differentiation from the normal to pathological. Objective: To investigate brain ventricular volume changes in Brazilian healthy el-derly people. Methods: Transversal study using magnetic resonance imaging (1.5T) of the brain from 21 elderly healthy volunteers (67À6 years old). Data were assessed with manual segmentation techni-que. Regions of interest were the brain ventricles and intracranial volumes. Old (60-69 years old, 15 women) and Older (69 years old) groups were created for analysis. Results: Volume of all ventricular compartments significantly increased (p.001) with age, with excep-tion of the fourth ventricle. The third and lateral ventricles increased between groups 2.1- and 2.8-fold, respectively. Mean total ventricular volume was 1.2À.4% of intracranial volume in Old and 3.2À1.8% in Ol-der group (p.001), which represents 15À6ml and 40À24ml (p=.001), respectively. We observed a moderate to strong positive correlation between ventricular volume and age, with the best correlation in the third ventricle (r=.710). Total intracranial volume diminished with age, but without statistical significance. Conclusions: Brain ventricles vo-lume increased significantly with age in healthy old individuals, with exception of the fourth ventricle

Efeitos de um programa de intervenção de oito semanas de exercício físico na aptidão cardiorrespiratória e duração da dor em mulheres sedentárias com migrânea

Introdução: Os indivíduos com migrânea, habitualmente apresentam uma baixa aptidão cardiorrespiratória (ACR). O incremento na ACR atua como modulador da migrânea. A quantificação e controle da intensidade do EF no tratamento da migrânea devem ser monitorados. Objetivo: Associar alterações na aptidão cardiorrespiratória na redução da intensidade da dor em mulheres sedentárias com migrânea. Métodos: O estudo é do tipo quase-experimental. Seis mulheres eutróficas (idade: 26±10,2anos; Vo2pico: 28,1±3,7 mL.kg-1.min-1) realizaram um teste incremental em esteira para determinação do Vo2pico, na condição basal e ao final da quarta semana. As sessões foram realizadas três vezes por semana, com a duração de 40 minutos, durante oito semanas. Resultados: Ao final das 08 semanas, houve aumento do Vo2pico (p=0,011), e redução na duração da dor (p=0,039), enquanto a intensidade (p=0,217) e frequência da dor de cabeça (p=0,056) não tiveram redução significativa. Conclusão: O exercício aeróbico com duração de 08 semanas, aumentou a aptidão cardiorrespiratória. Também se verificou a redução na duração das crises de enxaqueca

Investigation of stress, anxiety and depression in women with fibromyalgia: a comparative study

Introduction:Depression has emerged as the most prevalent mental disorder in patients with fibromyalgia. Stress, whose stages are alarm, resistance, near-exhaustion and exhaustion, constitutes a physical reaction to a threatening situation.Objective:To investigate the levels of stress, anxiety and depression in women with fibromyalgia, comparing them with those of healthy women.Patients and methods:Participants were 50 women, 25 with a diagnosis of fibromyalgia according to the criteria of the American College of Rheumatology, and 25 without this diagnosis, matched for age. Instruments used: Lipp Inventory of Stress Symptoms for Adults (LISS), State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI).Results:The mean age was 49.36 years for the group with fibromyalgia (FM) and 49.20 years for the group without fibromyalgia (non-FM). FM showed a higher incidence of stress (96%) compared with non-FM (5%). The resistance phase was predominant in both groups, FM (42%) and non-FM (100%). In FM there was distribution of the four stages (alarm, resistance, near-exhaustion and exhaustion). The differences between phases in the analyzed groups were significant (p < 0.001). FM showed predominance of psychological symptoms (54%); non-FM did show the same frequency of psychological and physical/psychological (40%) symptoms. Symptoms of state and trait anxiety and of depression in FM were significantly higher, when compared with non-FM (p < 0.01).Conclusion:Stress index (96%), trait anxiety (over 50) and clinically relevant depression (greater than 20) in FM were relevant. The understanding of the emotional variables involved in fibromyalgia is important to define the therapeutic strategy.Introdução:A depressão tem se apresentado como o transtorno mental mais prevalente em pacientes com fibromialgia. O estresse, cujas fases são alarme, resistência, quase-exaustão e exaustão, constitui importante reação do organismo frente a uma situação ameaçadora.Objetivo:Investigar os índices de estresse, ansiedade e depressão em mulheres com fibromialgia, comparando-os com os de mulheres saudáveis.Pacientes e métodos:Participaram 50 mulheres, 25 com o diagnóstico de fibromialgia, segundo os critérios do American College of Rheumatology, e 25 sem o diagnóstico, pareadas por idade. Instrumentos utilizados: Inventário de Sintomas de Stress para Adultos de Lipp (ISSL), Inventário de Ansiedade Traço-Estado (IDATE) e Inventário de Depressão Beck (BDI).Resultados:Idade média de 49,36 anos para o grupo com fibromialgia (FM) e 49,20 anos para o grupo sem fibromialgia (não FM). O FM apresentou maior incidência de estresse (96%) quando comparado com o não FM (5%). A fase de resistência foi predominante nos dois grupos, FM (42%) e não FM (100%). No FM verificou-se distribuição nas quatro fases (alerta, resistência, quase-exaustão e exaustão). As diferenças entre as fases nos grupos analisados foram significativas (p<0,001). O FM apresentou predominância de sintomas psicológicos (54%), o não FM apresentou a mesma frequência de sintomas psicológico e físico/psicológico (40%). Os sintomas de ansiedade estado e traço e depressão do FM foram significativamente superiores, quando comparados com o não FM (p<0,01).Conclusão:Constatou-se índice de estresse (96%), traço de ansiedade (superior a 50) e depressão clinicamente (superior a 20) relevantes no FM. O entendimento das variáveis emocionais envolvidas na fibromialgia é importante na definição da terapêutica.Universidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo (UNIFESP) Departamento de Ciências do Movimento HumanoUniversidade Federal de São Paulo (UNIFESP) Departamento de BiociênciasUniversidade Metropolitana de SantosUniversidade Federal de São Paulo (UNIFESP) Departamento de Saúde, Educação e SociedadeUNIFESP, Depto. de Ciências do Movimento HumanoUNIFESP, Depto. de BiociênciasUNIFESP, Depto. de Saúde, Educação e SociedadeSciEL

Telemental health in Brazil: past, present and integration into primary care

Background Telemental Health Care has reported very good results and is included within mental health priorities by the World Health Organization. Objective To provide an overview of the current situation of the integration of Brazilian telemedicine activities into primary health care. Methods Critical review based on MEDLINE database, using the keywords “telemedicine”, “primary health care” “mental health” and “telemental health”, on websites of the Brazilian Ministry of Health and Brazilian Telehealth Network Program, and on personal communication. Results The Brazilian Telehealth Network Program is well positioned and connects primary health care with academic centers. Regulations standards allow a broader scope of activities for psychologists, however, are more restrictive for physicians. In Brazil most of telemental health activities are focused on education and second opinion consulting. A huge challenge must be overcome considering the regional differences and the telehealth implementation experience. Research initiatives have been initiated both in the implementation and evaluation of the mental health assistance into primary health care. Discussion Brazilian Telemental Health initiatives into Primary Care are aligned with other examples around the world, have a great potential for improving mental health care service delivery, and access to proper mental health care, especially if articulated in a national program and coordinated research

Quantitative genetics of extreme insular dwarfing: The case of red deer on Jersey

[Aim]: The Island Rule—that is, the tendency for body size to decrease in large mammals and increase in small mammals on islands has been commonly evaluated through mac-roecological or macroevolutionary, pattern-orientated approaches, which generally fail to model the microevolutionary processes driving either dwarfing or gigantism. Here, we seek to identify which microevolutionary process could have driven extreme insular dwarfism in the extinct dwarf red deer population on the island of Jersey.[Location]: Jersey, UK (Channel Islands).[Taxon]: Red deer (Cervus elaphus).[Methods]: We applied an individual-based quantitative genetics model parameterized with red deer life-history data to study the evolution of dwarfism in Jersey's deer, con-sidering variations in island area and isolation through time due to sea level changes.[Results]: The body size of red deer on Jersey decreased fast early on, due to pheno-typic plasticity, then kept decreasing almost linearly over time down to the actual body size of the Jersey deer (36kg on average). Only 1% of 10,000 replicates failed to reach that size in our simulations. The distribution of time to adaptation in these simulations was right skewed, with a median of 395 generations (equivalent to roughly 4kyr), with complete dwarfism effectively occurring in less than 6kyr 84.6% of times. About 72% of the variation in the time to adaptation between simulations was col-lectively explained by higher mutational variance, the number of immigrants from the continent after isolation, available genetic variance, heritability, and phenotypic plasticity.[Main Conclusions]: The extreme dwarfing of red deer on Jersey is an expected out-come of high mutational variance, high immigration rate, a wide adaptive landscape, low levels of inbreeding, and high phenotypic plasticity (in the early phase of dwarfing), all occurring within a time window of around 6kyr. Our model reveals how extreme dwarfism is a plausible outcome of common, well-known evolutionary processes.This study is a contribution of the INCT in Ecology, Evolution and Biodiversity Conservation founded by MCTIC/CNPq/FAPEG (grant 465610/2014-5), arising from the workshop “Fast Evolution on Islands”, organized by AMCS and JAFD-F. Authors EB, FN, WS, KSS, RSS, and ZASV are supported by CAPES MsC or Doctoral fellowships. JAFD-F, RT, TFR, and RD are supported by CNPq Productivity Fellowships and grants, and LJ and EB received CNPq/DTI-A Fellowships from INCT. JH was supported by the project ‘Predicting diversity variations across scales through process-based models linking community ecology and biogeography’ (CNPq PVE 314523/2014-6), and AMCS by a Spanish MICIU Juan de la Cierva-Incorporación (IJCI-2014-19502) fellowship.Peer reviewe

Estratégias para o cuidado da pessoa com doença crônica : diabetes mellitus

Telemedicin

Brazilian recommendations on the safety and effectiveness of the yellow fever vaccination in patients with chronic immune-mediated inflammatory diseases

Background: In Brazil, we are facing an alarming epidemic scenario of Yellow fever (YF), which is reaching the most populous areas of the country in unvaccinated people. Vaccination is the only effective tool to prevent YF. In special situations, such as patients with chronic immune-mediated inflammatory diseases (CIMID), undergoing immunosuppressive therapy, as a higher risk of severe adverse events may occur, assessment of the risk-benefit ratio of the yellow fever vaccine (YFV) should be performed on an individual level. Main body of the abstract: Faced with the scarcity of specific orientation on YFV for this special group of patients, the Brazilian Rheumatology Society (BRS) endorsed a project aiming the development of individualized YFV recommendations for patients with CIMID, guided by questions addressed by both medical professionals and patients, followed an internationally validated methodology (GIN-McMaster Guideline Development). Firstly, a systematic review was carried out and an expert panel formed to take part of the decision process, comprising BRS clinical practitioners, as well as individuals from the Brazilian Dermatology Society (BDS), Brazilian Inflammatory Bowel Diseases Study Group (GEDIIB), and specialists on infectious diseases and vaccination (from Tropical Medicine, Infectious Diseases and Immunizations National Societies); in addition, two representatives of patient groups were included as members of the panel. When the quality of the evidence was low or there was a lack of evidence to determine the recommendations, the decisions were based on the expert opinion panel and a Delphi approach was performed. A recommendation was accepted upon achieving ≥80% agreement among the panel, including the patient representatives. As a result, eight recommendations were developed regarding the safety of YFV in patients with CIMID, considering the immunosuppression degree conferred by the treatment used. It was not possible to establish recommendations on the effectiveness of YFV in these patients as there is no consistent evidence to support these recommendations. Conclusion: This paper approaches a real need, assessed by clinicians and patient care groups, to address specific questions on the management of YFV in patients with CIMID living or traveling to YF endemic areas, involving specialists from many areas together with patients, and might have global applicability, contributing to and supporting vaccination practices. We recommended a shared decision-making approach on taking or not the YFV