Quality measures for dental care: A systematic review

Objectives: This systematic review aimed to (a) provide an overview of existing quality measures in the field of oral health care, and to (b) evaluate the scientific soundness and applicability of these quality measures. Methods: A systematic search was conducted in three electronic databases MEDLINE (via PubMed), EMBASE (via OVID) and LILACS (via BIREME). The search was restricted to articles published between 2002 and 2018. Publications reporting on the development process or clinimetric properties of oral health care quality measures for outpatient oral health care in dental practices were included. The identified publications reporting on oral health care quality measures were critically appraised with the Appraisal of Indicators through Research and Evaluation 2.0 (AIRE 2.0) instrument to evaluate the soundness and applicability of the measures. Results: The search strategy resulted in 2541 unique and potentially relevant articles. In total, 24 publications were included yielding 215 quality measures. The critical appraisal showed a large variation in the quality of the included publications (AIRE scores ranging from 38 to 78 out of 80 possible points). The majority of measures (n = 71) referred to treatment and preventive services. Comparably, few measures referred to the domain patient safety (n = 3). The development process of measures often exhibited a lack of involvement of patients and dental professionals. Few projects reported on the validity (n = 2) and reliability (n = 3) of the measures. Four projects piloted the measures for implementation in practice. Conclusions: This systematic review provides an overview of the status quo with respect to existing quality measures in oral health care. Potential opportunities include the piloting and testing of quality measures and the establishment of suitable information systems that allow the provision of transparent routine feedback on the quality of oral health care

Uso eficiente da água: uma contribuição para o desenvolvimento sustentável da agropecuária

En la mayoria de las áreas agrícolas irrigadas, observamos que el volúmen de água utilizado és superior al necesário para la producción satisfactória de los alimentos. La utilización eficiente del agua podrá  contribuir para solucionar problemas de escasés , reduzir los conflictos entre los usuários y aumentar, estabilizar y garantir la producción.. este trabajo muestra alternativas posibles para el uso con eficiencia del agua en el sistema agropecuário, bseado en experiencias desarrolladas en Europa y Estados Unidos , que buscan establecer critérios adecuados a la realidad brasileña. Luego de estudios participativos  tanto en Europa cuanto en los Estados Unidos  fueron publicadas  Directrizes con orientaciones para  utilizar métodos  de irrigación con reducción del desperdício, indicando tecnologias y formas de gerenciamiento baseados en la medición, información y  el control, irrigación programada,  modernización de las técnicas de irrigación; adecuación de las técnicas de irrigación de acuerdo con el clima; técnicas de manejo del suelo y de las espécies cultivadas y utilización de plantas de cobertura. Existen soluciones tecnológicas y gerenciales que pueden contribuyir para el uso eficiente y la optimización del uso del agua en la agricultura irrigada del Brasil. Para aplicar las técnicas y los métodos propuestos es necesário que se haga un levantamiento de lapotencialidad del cambio y de las mejoras que esas soluciones proponen para nuestro território.In most of the irrigated agricultural areas the volume of water used is higher than actually necessary for the satisfactory production of food. The efficiency in water use can help in solving the problems of scarcity, reduce conflicts between users and increase, stabilize and ensure the production. This paper shows possible alternatives for the water use efficiency in agriculture, based on guidelines developed in Europe and the United States, seeking to establish criteria for appropriate use for Brazilian conditions. After a participatory process of consultation, both in Europe as the U.S. guidelines have been published with orientations for the use of irrigation methods with less waste. The guidelines indicate managements and technological solutions, such as: use of measurement systems, information and control, planning of irrigation, improved irrigation techniques, adequate management of irrigation according to the climate, soil management and the cultivated species, and use of plant coverage. There are technological and managements solutions that can contribute to the efficient use and optimization of water use in irrigated agriculture in Brazil. To implement these solutions it is needed to evaluate the potential for improvement and set targets for the coming years.Na maioria das áreas agrícolas irrigadas o volume de água utilizado é superior ao realmente necessário para a produção satisfatória de alimentos. A eficiência no uso da água pode auxiliar na resolução dos problemas de escassez, diminuir conflitos entre usuários e aumentar, estabilizar e garantir a produção. Este trabalho mostra possíveis alternativas para o uso eficiente da água na agropecuária baseado em diretrizes desenvolvidas na Europa e Estados Unidos, procurando estabelecer critérios de uso adequado para as condições brasileiras. Após um processo de consultas participativo, tanto na Europa quanto nos Estados Unidos foram publicadas diretrizes com orientações como a utilização de métodos de irrigação com menores desperdícios. As diretrizes indicam soluções tecnológicas e gerenciais como a utilização de sistemas de medição, informação e controle, programação da irrigação, aperfeiçoamento das técnicas de irrigação, adequação da gestão da rega de acordo com o clima, manejo do solo e das espécies cultivadas e a utilização de plantas de cobertura. Existem soluções tecnológicas e gerenciais que podem contribuir para o uso eficiente e a otimização da utilização da água na agricultura irrigada no Brasil. Para a aplicação dessas soluções há a necessidade de avaliar o potencial de melhoria e estabelecer metas para os próximos anos

Relatório Final de Estágio

Relatório Final de Estágio Supervisionado, agregando os resultados das disciplinas de ESI e ESII, apresentado como requisito à obtençao do titulo de licenciado em Letras - Espanhol, na modalidade a distância, da Universidade Federal de Santa Catarina (UFSC), realizado na Escola de Educação Básica Tiradentes

Síndrome de Stevens-Johnson. Apresentação de Caso Clínico

Introdução: A Síndrome de Stevens-Johnson (SSJ) é uma doença mucocutânea rara e potencialmente fatal, mais frequente no sexo masculino, cuja incidência aumenta com a idade e em determinados grupos de risco. A SSJ e a Necrólise Tóxica Epidérmica (NET) são duas entidades da mesma doença, com severidade diferente. A etiologia não é clara, mas pensa-se que se deva maioritariamente a reacções adversas a fármacos. Caso clínico: Um jovem de 17 anos de idade, sem antecedentes pessoais relevantes, foi observado no Serviço de Urgência por surgimento de lesões maculopapulares, com 3 dias de evolução, dispersas pela face, cavidade oral, tronco e extremidades, com prostração e taquicardia. Foi internado com o diagnóstico de SSJ. Discussão e Conclusões: O SSJ e a NET têm grande morbilidade e considerável mortalidade. O rápido reconhecimento desta identidade, com a remoção do fármaco desencadeador é essencial. A perda da função de barreira da pele, com a consequente alteração da homeostasia, implica muitas vezes a manutenção da terapêutica de suporte em Unidades de Cuidados Intensivos ou de Queimados.info:eu-repo/semantics/publishedVersio

Crystallographic studies on carp Fishelectin (FEL)

A few years ago we isolated and sequenced a novel glycoprotein present in the eggs of the carp (Cyprinus carpio) (1). The protein, that binds to a Sepharose 4B matrix column and can be eluted with 0.4 M N-acetyl glucosamine, behaves like a lectin of molecular mass 26686 Da. On the basis of DLS experiments the lectin is present in solution as a stable dimer. We have determined its 238 amino acid long sequence, the position of its 4 disulfide bridges and the structure of its single N-linked carbohydrate chain. The lectin shows a very low agglutinating activity for human A-type erythrocytes and interacts with both Gram positive and negative bacteria, these last interactions are inhibited by N-acetyl glucosamine. A data base search shows that its amino acid sequence is significantly similar to that of the members of an invertebrate lectin family that includes tachylectin-1, present in the amebocytes of the horseshoe crab Tachypleus tridentatus, and known to participate in the innate defense system of this species (2.3) and two other lectins, characterized in the plasmodium Physarum polycephalum, that are called Tectonins I and II and are located in the external surface of the plasma membrane (4). We have proposed the name fishelectins (by analogy with tachylectins) for this new vertebrate protein family. Homologous genes are present in other bony fish. The carp protein has 85 % identity with a gene expressed in the crucian carp (Carassius auratus gibelio) (5) and 78 % identity with a gene in the cDNA library of the zebrafish (Danio rerio). We have prepared three different crystal forms of the apo protein and two of co-crystals with N-acetyl glucosamine. The orthorhombic form of the apoprotein belongs to space group P212121 and was solved first using the MIR method. Our poster will present the data collection statistics of the best apo and holo forms of the lectin and the refinement statistics of the holo form and will discuss the structure and similarity of this newly identified family of vertebrate proteins to a well known invertebrate protein family

Crystallographic studies on carp Fishelectin (FEL)

A few years ago we isolated and sequenced a novel glycoprotein present in the eggs of the carp (Cyprinus carpio). The protein, that binds to a Sepharose 4B matrix column and can be eluted with 0.4 M N-acetyl glucosamine, behaves like a lectin of molecular mass 26686 Da. On the basis of DLS experiments the lectin is present in solution as a stable dimer. We have determined its 238 amino acid long sequence, the position of its 4 disulfide bridges and the structure of its single N-linked carbohydrate chain. The lectin shows a very low agglutinating activity for human A-type erythrocytes and interacts with both Gram positive and negative bacteria, these last interactions are inhibited by N-acetyl glucosamine. A data base search shows that its amino acid sequence is significantly similar to that of the members of an invertebrate lectin family that includes tachylectin-1, present in the amebocytes of the horseshoe crab Tachypleus tridentatus, and known to participate in the innate defense system of this species and two other lectins, characterized in the plasmodium Physarum polycephalum, that are called Tectonins I and II and are located in the external surface of the plasma membrane. We have proposed the name fishelectins (by analogy with tachylectins) for this new vertebrate protein family. Homologous genes are present in other bony fish. The carp protein has 85 % identity with a gene expressed in the crucian carp (Carassius auratus gibelio) and 78 % identity with a gene in the cDNA library of the zebrafish (Danio rerio). We have prepared three different crystal forms of the apo protein and two of co-crystals with N-acetyl glucosamine. The orthorhombic form of the apoprotein belongs to space group P212121 and was solved first using the MIR method. Our poster will present the data collection statistics of the best apo and holo forms of the lectin and the refinement statistics of the holo form and will discuss the structure and similarity of this newly identified family of vertebrate proteins to a well known invertebrate protein family

Advancing fish breeding in aquaculture through genome functional annotation

Genomics is increasingly applied in breeding programmes for farmed fish and shellfish species around the world. However, current applications do not include information on genome functional activity, which can enhance opportunities to predict relationships between genotypes and phenotypes and hence increase the accuracy of selection. Here, we review prospects for improving aquaculture breeding practises through the uptake of functional genomics data in light of the EU Horizon 2020 project AQUA-FAANG: ‘Advancing European Aquaculture by Genome Functional Annotation’. This consortium targeted the six major farmed fish species in European aquaculture, producing thousands of functional genomic datasets from samples representing embryos to mature adults of both sexes, and following immunological stimulation. This data was used to catalogue functional activity across the genome of each species, revealing transcribed regions, distinct chromatin states and regulatory elements impacting gene expression. These functional annotations were shared as open data through the Ensembl genome browser using the latest reference genomes for each species. AQUA-FAANG data offers novel opportunities to identify and prioritize causative genetic variants responsible for diverse traits including disease resistance, which can be exploited to enhance selective breeding. Such knowledge and associated resources have the potential to improve sustainability and boost production in aquaculture by accelerating genetic gain for health and robustness to infection, whilst reducing the requirement for animal testing. We further outline directions to advance and leverage genome functional annotation beyond the AQUA-FAANG project. Given the diversity of aquaculture sectors and businesses, the incorporation of functional genomic information into breeding decisions will depend on technological readiness level and scale of operation, with cost-benefit analysis necessary to determine the most profitable approach for each species and production system