Pacifier : construção e aplicação de um programa para pais nos cuidados de saúde primários

Este trabalho teve como objetivo fundamental a construção, aplicação e avaliação dos efeitos de um programa de educação parental universal, numa vertente preventiva, designado como – Pacifier – visando a sua implementação nos Cuidados de Saúde Primários, a pais de crianças dos 0 aos 6 meses e com carácter domiciliário. Foi construído com base numa revisão da literatura e práticas baseadas em evidência sobre parentalidade positiva e programas de educação parental e posteriormente aplicado a quatro mães e dois pais – dois casais e duas mães –, sendo que os efeitos foram avaliados de acordo com um modelo de estudos de caso múltiplos, constituídos por quatro famílias. Neste sentido, de modo a medir os objetivos que definimos para o programa, realizámos uma avaliação inicial e final com os instrumentos adaptados Sentido de Competência Parental e Inventário sobre o Conhecimento de Desenvolvimento Infantil. Ainda incluímos um questionário final relativo à Satisfação dos Pais com o Programa. No que respeita aos resultados, nos quatro estudos de caso verificaram-se melhorias nos resultados de ambos os instrumentos aplicados, o que nos permite considerar que o programa foi eficaz e melhorou o sentido de competência parental assim como o conhecimento do desenvolvimento infantil nestes pais. Por último, os pais mostraram uma grande satisfação com o programa.This work had as main objective the construction, implementation and evaluation of the effects of a universal parenting program, a preventive arm, designated as - Pacifier - for its implementation in primary health care, to parents of children aged 0 to 6 months and home visiting character. It was built based on a review of literature and practices based on evidence of positive parenting and parental education programs and later applied to four mothers and two fathers - two couples and two mothers -, and the effects were evaluated according to a multiple case studies model, consisting of four families. In this regard, in order to measure the goals set for the program, we conducted an initial and final evaluation with the adequate instruments for Parental Sense of Competence and Knowledge of Infant Development Inventory. Also included a final questionnaire on the Parental Satisfaction with the Program. With regard to the results in the four case studies there have been improvements in the results of both instruments used, which allows us to consider that the program was effective and improved sense of parental competence as well as knowledge of child development in these parents. Finally, parents have shown great satisfaction with the program

Análise estatística dos fatores ante-mortem que podem influenciar a qualidade final da carne de suíno

Este estudo pretendeu analisar o efeito de diversos fatores pré-abate, na ocorrência de carnes de menor qualidade, como as PSE. Os parâmetros da qualidade estudados foram o pH final, percentagem de exsudação e a cor da carne. Os fatores estudados foram a exploração de origem, o género, o peso líquido da carcaça, a densidade animal no transporte e na abegoaria, o tempo de espera pré-abate e o tempo de jejum. A amostra foi composta por 180 animais, pertencentes a 7 explorações e 2 fornecedores distintos. Foram medidos valores de pH inicial (50 minutos post-mortem) e final (24 horas post-mortem) no matadouro, calculadas percentagens de exsudação (48 horas post-mortem) e medidos valores de luminosidade (L*) das carnes dos animais amostrados. Foi elaborada uma análise estatística (alfa=0,05), recorrendo ao teste de qui-quadrado para as variáveis categóricas, ao teste t-student para as variáveis com distribuições normais e homogéneas e ao teste de Mann-Whitney para as variáveis com distribuições não paramétricas. Além disso, foi feita uma Análise de Componentes Principais (PCA) e uma análise utilizando a Regressão por Mínimos Quadrados Parciais (PLS). A exploração de origem dos animais apresentou um efeito significativo, tanto no pH final (p=0,017), como na cor da carne (p=5,05E-4). Das explorações analisadas, a exploração 7 foi a que apresentou piores resultados relativos à qualidade final da carne. A densidade ani- mal no transporte apresentou-se como fator significativo na cor da carne (p=0,015). Os animais com menores áreas de descanso no veículo manifestaram carnes de cor mais clara, o que se poderá dever a uma dificuldade em descansar e maior propensão a lutas. O tempo de espera pré-abate foi um fator significativo no pH final (p=0,041). Os animais abatidos num tempo inferior a 1 hora exibiram maior qualidade, o que sugere que os suínos não descansam de uma forma eficaz na abegoaria. Finalmente, o tempo de jejum teve um efeito significativo na cor final da carne (p=5,15E-4). O facto dos animais com maior tempo de privação de comida re- velarem maior qualidade da carne, parece indicar que deverá existir uma especial atenção para o emparelhamento entre a antecedência do jejum, ao início do transporte, e a hora de abate. Para que seja reduzida a ocorrência de carnes de menor qualidade, como as PSE, deve- rão ser tidos em conta, com maior afinco, fatores da vida animal, como a densidade animal no transporte, tempo de espera pré-abate e o tempo de jejum.This study aimed to analyse the effect of several pre-slaughter factors on the occurrence of lower quality meats, such as PSE. The quality parameters studied were final pH, percentage of exudation and meat colour. The factors studied were the farm of origin, gender, net carcass weight, animal density during transport and at the slaughterhouse, pre-slaughter waiting time, and fasting time. The sample consisted of 180 animals from 7 farms and 2 different suppliers. Initial (50 minutes post-mortem) and final (24 hours post-mortem) pH values were measured in the slaugh- terhouse, exudation percentages were calculated (48 hours post-mortem) and brightness (L*) values of the meat of the sampled animals were measured. A statistical analysis was performed (alpha=0.05), using the chi-square test for categor- ical variables, the t-student test for variables with normal and homogeneous distributions and the Mann-Whitney test for variables with non-parametric distributions. In addition, a Principal Component Analysis (PCA) and a Partial Least Squares Regression (PLS) analysis were per- formed. The farm of origin of the animals showed a significant effect on both final pH (p=0.017) and meat colour (p=5.05E-4). Of the farms analysed, farm 7 was the one that presented the worst results regarding final meat quality. The animal density during transport was a signif- icant factor in meat colour (p=0.015). Animals with smaller resting areas in the transport ve- hicle showed lighter coloured meat, which may be due to difficulty in resting and greater propensity to fight. Pre-slaughter waiting time was a significant factor in final pH (p=0.041). Animals slaughtered in a time of less than 1 hour exhibited higher quality, suggesting that the animals do not rest effectively in the slaughterhouse. Finally, fasting time had a significant effect on final meat colour (p=5.15E-4). The fact that animals with longer feed privation times showed higher meat quality seems to indicate that special attention should be paid to the pairing between the time of fasting before the start of transport and the time of slaughter. In order to reduce the occurrence of lower quality meats such as PSE, animal life factors such as animal density during transport, pre-slaughter waiting time and fasting time should be taken more into account

ICD and overdentures: improving esthetics, mastication and quality of life

The teeth total loss is one of the worst clinical situations that can be found in Dentistry and it may cause masticatory ability reduction and consequent interference in food digestion. Besides, it may affect esthetics and phonation. This situation contributes to a decrease of life quality and self-esteem. The complete denture is the most used therapeutic modality in the rehabilitation of complete edentulous people. A problem that should be faced, when the total prosthesis is indicated, lays exactly on the fact that the patients resist being toothless, while they wait for the osseous and tissue repairs, used in the posterior prosthesis confection. Another problem is associated with much reabsorbed ridges, which are unable to present retention and stability conditions to a complete denture. The utilization of immediate complete dentures (ICD) and dental implants can solve these problems. The SUS doesn't offer these treatment modalities, neither in the basic attention, nor in the special. The curricular disciplines of FOUFMG don't offer the necessary information on how to rehabilitate edentulous people with few residual alveolar ridge using implants or those unsatisfied with the use of their complete denture. The the objective of the Immediate Total Prosthesis/Overdentures Project implantation was to fill the lack of that practice in the curriculum and in the patient treatment. The present work aims to present the PTI/Overdentures Project to the academic community, a project with assistance characteristics, practical/theoretical nature and that was developed for the FOUFMG graduation students and for the patients, who use complete denture or with indication to use it. The activity shows a huge utility, both to users and students, as it fulfills a gap in the health social service and of the curriculum. The impact in the improving patients' life quality is evaluated by applying the Oral Health Impact Profile - OHIP-14 questionary. The initial objectives selected by the project coordinators have satisfactorily been reached because a well defined attendance and a dynamic and interdisciplinary action were made. Also, the extension activity has provided an interaction between learning, research and knowledge production areas, giving a high impact in the academic formation of the participant students and consolidating the formation of a citizen professional, and a positive dialogic relationship with the assisted community. Besides, it resulted on a high improvement in the life quality of the patients. The conclusion is that the project has been satisfactorily achieved its objectives, benefiting students and patients.</p

ICD AND OVERDENTURES: IMPROVING ESTHETICS, MASTICATION AND QUALITY OF LIFE

A perda total dos dentes é uma das piores situações clínicas encontradas na Odontologia, acarretando diminuição da capacidade mastigatória e consequente interferência na digestão dos alimentos. Além disso, pode prejudicar a fonação e a estética, piorando a qualidade de vida e a autoestima do indivíduo. A Prótese Total Removível (PT) é a modalidade terapêutica mais utilizada na reabilitação de pacientes edêntulos. Um problema a ser enfrentado ocorre quando o paciente resiste em permanecer sem seus dentes, enquanto se aguarda a reparação tecidual e óssea, para posterior confecção da prótese. Outro problema está associado a rebordos muito reabsorvidos, incapazes de apresentar condições de retenção e estabilidade para uma PT. A utilização de PT imediata (PTI) e de implantes pode solucionar esses problemas. O SUS ainda não oferece estas modalidades de tratamento, nem na atenção básica, nem na especializada. As disciplinas curriculares da FOUFMG não ofertam o conteúdo necessário para o aprendizado do corpo discente de como reabilitar pacientes parcialmente dentados de forma imediata, com PT, e nem pacientes edêntulos com pouco rebordo residual, utilizando implantes. A implantação do Projeto Prótese Total Imediata/Overdentures veio tentar cobrir essas deficiências na grade curricular e no atendimento aos pacientes. Esse trabalho objetiva apresentar o Projeto PTI/Overdentures à comunidade acadêmica, projeto com características assistenciais, de natureza teórico/prática, voltado a alunos do curso de graduação da FOUFMG e pacientes portadores de PT ou com indicação para tal. A atividade tem-se mostrado de grande utilidade, tanto para usuários quanto para alunos, ao preencher uma lacuna no serviço social de saúde e na grade curricular. O impacto na melhoria da qualidade de vida dos pacientes atendidos tem sido avaliado por meio da aplicação do questionário Oral Health Impact Profile - OHIP-14. Os objetivos iniciais traçados pelos idealizadores do projeto têm sido satisfatoriamente alcançados, tendo em vista que, com um protocolo de atendimento bem definido e uma atuação dinâmica e interdisciplinar, a atividade de extensão tem proporcionado boa articulação entre as áreas de ensino, pesquisa e produção de conhecimento, gerando um alto impacto na formação acadêmica dos alunos participantes, consolidando a formação de um profissional cidadão, e uma relação dialógica positiva com a comunidade assistida, além da grande melhoria na qualidade de vida dos pacientes atendidos. Conclui-se, portanto, que o projeto vem cumprindo satisfatoriamente sua missão, seja pelos benefícios aos alunos, seja à comunidade.La pérdida total de los dientes es una de las peores situaciones clínicas encontradas en Odontología, causando disminución de la capacidad masticatoria y la consiguiente interferencia en la digestión de los alimentos, además de afectar la fonación y la estética, empeorando la calidad de vida y la autoestima del individuo. La prótesis total desprendible (PT) es la modalidad terapéutica más utilizada en la rehabilitación en pacientes edentulos. Un problema que debe ser enfrentado se produce cuando el paciente se resiste a quedarse sin sus dientes, en espera de la reparación de los tejidos y el hueso para la posterior elaboración de la prótesis. Otro problema se relaciona con los bordes muy reabsorbidos, incapaces de prestar condiciones de retención y estabilidad para un PT. El uso de Dentadura Completa inmediata (DCI) y los implantes pueden resolver estos problemas. El SUS no ofrece estas modalidades de tratamiento, ni en la atención primaria, ni los especializados. Las materias curriculares de FOUFMG no ofertan el contenido requerido para el aprendizado del cuerpo discente de como rehabilitar con PT, tampoco a pacientes parcialmente dentado inmediatamente, y ni a los pacientes edentulos con poco reborde residual, utilizando implantes. La ejecución del proyecto Prótese Total imediata/overdentures vino para tratar de cubrir estas debilidades en el programa curricular y em el atendimiento de pacientes. Ese trabajo se orienta a presentar el Proyecto PTI/Overdentures a comunidad académica, proyecto con características asistenciales de naturaleza teórico/práctico, direccionado a alumnos del curso de graduación de la FOUFMG y pacientes portadores de PT o con indicación de este. La actividad ha demostrado ser de gran utilidad, tanto para los usuarios como para los alumnos, para llenar um vacío em el servicio social, la salud y el plan de estudios. El impacto sobre el mejoramiento de la calidad de vida de los pacientes tratados han sido evaluados por medio de aplicación del cuestionario de Salud Oral Health Impact Profile – OHIP–14. Los objetivos iniciales elaborados por los proponentes del proyecto han sido alcanzados satisfactoriamente, teniendo en cuenta que, con un protocolo de tratamiento bien definido y un trabajo dinámico e interdisciplinar, la actividad de extensión ha proporcionado una buena interacción entre las áreas de enseñanza, encuesta y producción de conocimiento, generando un alto impacto en la información académica de los alumnos participantes, lo que refuerza la formación profesional de un ciudadano y una buena relación con la comunidad que asistieron, además de la gran mejoría en la calidad de vida de los pacientes tratados. Concluimos, pues, que el proyecto cumple de forma satisfactoria su misión, sea por los beneficios tanto a los alumnos, como a la comunidad.The teeth total loss is one of the worst clinical situations that can be found in Dentistry and it may cause masticatory ability reduction and consequent interference in food digestion. Besides, it may affect esthetics and phonation. This situation contributes to a decrease of life quality and self-esteem. The complete denture is the most used therapeutic modality in the rehabilitation of complete edentulous people. A problem that should be faced, when the total prosthesis is indicated, lays exactly on the fact that the patients resist being toothless, while they wait for the osseous and tissue repairs, used in the posterior prosthesis confection. Another problem is associated with much reabsorbed ridges, which are unable to present retention and stability conditions to a complete denture. The utilization of immediate complete dentures (ICD) and dental implants can solve these problems. The SUS doesn’t offer these treatment modalities, neither in the basic attention, nor in the special. The curricular disciplines of FOUFMG don’t offer the necessary information on how to rehabilitate edentulous people with few residual alveolar ridge using implants or those unsatisfied with the use of their complete denture. The the objective of the Immediate Total Prosthesis/Overdentures Project implantation was to fill the lack of that practice in the curriculum and in the patient treatment. The present work aims to present the PTI/Overdentures Project to the academic community, a project with assistance characteristics, practical/theoretical nature and that was developed for the FOUFMG graduation students and for the patients, who use complete denture or with indication to use it. The activity shows a huge utility, both to users and students, as it fulfills a gap in the health social service and of the curriculum. The impact in the improving patients’ life quality is evaluated by applying the Oral Health Impact Profile - OHIP-14 questionary. The initial objectives selected by the project coordinators have satisfactorily been reached because a well defined attendance and a dynamic and interdisciplinary action were made. Also, the extension activity has provided an interaction between learning, research and knowledge production areas, giving a high impact in the academic formation of the participant students and consolidating the formation of a citizen professional, and a positive dialogic relationship with the assisted community. Besides, it resulted on a high improvement in the life quality of the patients. The conclusion is that the project has been satisfactorily achieved its objectives, benefiting students and patients

Aggregation properties of probiotic strains under aerobic and anaerobic conditions

info:eu-repo/semantics/publishedVersio

Aggregation properties of probiotic strains under aerobic and anaerobic conditions

info:eu-repo/semantics/publishedVersio

Livro de Atas do XVI Colóquio Ibérico de Geografia: Península Ibérica no Mundo: problemas e desafios para uma intervenção ativa da Geografia

Realizou-se em Lisboa, nas instalações do IGOT, entre os dias 5 a 7 de novembro de 2018, o XVI Colóquio Ibérico de Geografia, aberto também a colegas de outros países que falam português ou espanhol, O tema escolhido para enquadrar todas as apresentações e intervenção dos conferencistas convidados foi "Península Ibérica: problemas e desafios para uma intervenção ativa da Geografia", com 15 temáticas distribuídas pelas sessões paralelas. Existiram também mesas redondas sobre os temas mais atuais e uma saída de campo. Foi um tempo de aprendizagem e de consolidação ou debate a propósito de investigação em curso, projetos futuros, ou reflexões mais teóricas. Além disso, para lá da dimensão científica (central, por certo), pretendeu-se que este encontro fosse também um tempo de festa da Geografia, de encontro e de troca de informação e conhecimentos.info:eu-repo/semantics/publishedVersio

Cardiovascular System of Agouti (Dasyprocta prymnolopha)

Background: The species Dasyprocta prymnolopha is a wild rodent with a geographic distribution that extends from Mexico to South America, including Brazil. Agouti has been the subject of morphophysiological research, but data on the cardiovascular system remains limited. Therefore, the objective was to describe the macroscopic and microscopic morphology, including the study of the cardiac and coronary system syntopy of the species D. prymnolopha. Materials, Methods &amp; Results: Twelve Dasyprocta primnolopha adults were used, 6 males and 6 females. Topographic analysis of the heart was evaluated in situ, with subsequent measurement, anatomovascular description and macroscopic study of cardiac and coronary vascularization. A microscopic investigation and identification of structural cardiac aspects were also carried out in adult agoutis, the biological samples of the heart were submitted to histological techniques and stained with Hematoxylin and Eosin and Masson's Trichrome. The heart is located between the end of the 2nd and the beginning of the 5th intercostal space, with the apex reaching the 6th space. It presents the presence of 2 ligaments: phrenopericardium and sternopericardium. The right atrioventricular valve is composed of 2 cusps, the parietal and the septal, with variations within the same species for 3 cusps. Projections that interconnect the papillary muscles with each other were observed. In the left ventricle there are variations in the number of papillary muscles (range 2 to 4). In the region of the aortic valve, 5 ostia were observed in the left aortic sinus in all animals. The coronary circulation has a predominantly left distribution. Histologically, the heart consists of 3 main layers: endocardium, myocardium, and epicardium. The cusp valves of the atrioventricular openings are composed of endocardial folds that contain a central plate of dense connective tissue, and inserted in this cardiac musculature was observed the cardiac skeleton, with its fibrous ring consisting of collagen and elastic fibers that surrounds the atrioventricular opening. Discussion: Cardiac assessment in wild animals is challenging, as in-depth knowledge of the morphology of the cardiovascular system is required for the use of diagnostic tools. In this first anatomical study of the heart, this organ presents syntopy with those of other rodents, but the topography may vary in individuals of the same species, which may be related to the accentuated vertebral curve. The phrenopericardial and sternopericardial ligaments were observed in this research, although there are no reports in other species of Dasyprocta sp. The arrangement of the arteries has, as a particularity, the larger left atrium in relation to the heart/atrium size ratio when compared to other domestic species, covering the left coronary sinus until it reaches the left atrial surface. In the agouti, it was observed that the vascularization is left, with the left coronary artery giving rise to both the paraconal and subsinuous interventricular branch, a fact found in animals such as ruminants, dogs. In the histological observations of the present study, the heart was similar to that of other mammals. Our data reveal morphological characteristics similar to those of other mammals, but with very expressive characteristics that differ even within the species. It is important to generate new information to elucidate cardiac and coronary diagnostic analyses, which can be extended to different species. Keywords: agouti, wild rodent, coronary arteries, cardiac, heart, histology, morphology

Comparative effectiveness and predictors of response to tumour necrosis factor inhibitor therapies in rheumatoid arthritis

Funding Information: positions on two Pfizer sponsored trials and has directed an educational course supported by Bristol Myers Squibb. He serves as an epidemiology consultant to CORRONA. J.A.P.S. has received honoraria as a speaker or consultant and benefited from research support from several pharmaceutical companies involved in the production of biologic agents (Abbott, Amgen, MSD, Pfizer and Roche), always at sums less than E10 000. All other authors have declared no conflicts of interest. Funding Information: Funding: This work was supported by a grant from Harvard-Portugal Program HMSP-ICS/SAU-ICT/0002/ 2010.Objectives: Adalimumab, etanercept and infliximab are effective TNF inhibitors (TNFis) in the treatment of RA, but no randomized clinical trials have compared the three agents. Prior observational data are not consistent. We compared their effectiveness over 1 year in a prospective cohort.Methods: Analyses were performed on subjects' first episode of TNFi use in the Rheumatic Diseases Portuguese Register, Reuma.pt. The primary outcome was the proportion of patients with European League Against Rheumatism good response sustained at two consecutive observations separated by 3 months during the first year of TNFi use. Comparisons were performed using conventional adjusted logistic regression, as well as matching subjects across the three agents using a propensity score. In addition, baseline predictors of treatment response to TNFi were identified.Results: The study cohort included 617 RA patients, 250 starting etanercept, 206 infliximab and 161 adalimumab. Good response was achieved by 59.6% for adalimumab, 59.2% for etanercept and 51.9% for infliximab (P = 0.21). The modelled probability of good response did not significantly differ across agents (etanercept vs adalimumab OR = 0.97, 95% CI 0.55, 1.71; etanercept vs infliximab OR = 1.25, 95% CI 0.74, 2.12; infliximab vs adalimumab OR = 0.80, 95% CI 0.47, 1.36). Matched propensity score analyses also showed no significant treatment response differences. Greater educational attainment was a predictor of better response, while smoking, presence of ACPA, glucocorticoid use and worse physician assessment of disease activity at baseline each predicted a reduced likelihood of treatment response.Conclusion: Over 1 year, we found no difference in effectiveness between adalimumab, etanercept and infliximab.publishersversionpublishe