The contribution of Portuguese nursing to universal health access and coverage

Objetivo: analisar a contribuição da enfermagem portuguesa para a melhoria do acesso e cobertura universal em saúde, através da identificação da distribuição dos enfermeiros no sistema de saúde; evolução de indicadores de saúde; e sistemas de promoção do acesso, em que os enfermeiros têm papel relevante. Método: pesquisa documental das publicações de organizações nacionais e internacionais sobre planejamento e resultados em saúde, consultadas bases de dados estatísticos e legislação sobre as reformas da saúde. Resultados: no serviço nacional de saúde os enfermeiros representam 30,18% dos recursos humanos; nos sistemas de promoção de acesso, realizados por enfermeiros, verificam-se bons níveis de eficácia (95,5%) e satisfação dos utentes (99% totalmente satisfeitos); nos cuidados de proximidade regista-se a criação de Unidades de Cuidados na Comunidade (185) e 85,80% das consultas domiciliárias realizadas por enfermeiros. Conclusões: estratégias políticas, serviço nacional de saúde e reforço dos recursos humanos em saúde são os principais determinantes. A enfermagem é o grupo profissional mais numeroso no serviço nacional de saúde, mas ainda deficitária nos cuidados de saúde primários. O aumento da qualificação acadêmica e autorregulação deste grupo profissional tem permitido melhores respostas ao desafio de melhoria da saúde para os portugueses.Objetivo: analizar la contribución de la enfermería portuguesa para la mejora del acceso y cobertura universal en salud, mediante la identificación de la distribución de los enfermeros en el sistema de salud, evolución de los indicadores de salud y sistemas de promoción del acceso en los que los enfermeros tienen un papel importante. Método: investigación documental de las publicaciones de organizaciones nacionales e internacionales sobre planificación y resultados en salud, basadas en datos estadísticos y la legislación sobre las reformas de salud. Resultados: en el servicio nacional de salud, los enfermeros representan 30.18% de los recursos humanos; en los sistemas de promoción de acceso realizados por enfermeros, se verifican buenos niveles de eficacia (95.5%) y satisfacción de los usuarios (99% totalmente satisfechos), y los cuidados de proximidad registran la creación de Unidades de Cuidados en la Comunidad (185) y 85.80% de las consultas domiciliarias realizadas por enfermeros. Conclusiones: las estrategias políticas, servicio nacional de salud y refuerzo de los recursos humanos en salud son los principales determinantes. La enfermería es el grupo profesional más numeroso en el servicio nacional de salud, pero es aún deficiente en cuanto a los cuidados primarios de salud. El aumento de la calificación académica y autorregulación de este grupo profesional ha permitido mejores respuestas ante el desafío de mejora de la salud para los portugueses.Objective: to analyze the contribution of Portuguese nursing to improving universal health access and coverage by means of the identification of nurses in the health system; evolution of health indicators; and access-promoting systems, in which nurses play a relevant role. Method: this was documentary research of publications fromnational and international organizations on planning and health outcomes. Statistical databases and legislation on health reforms were consulted. Results: nurses represent 30.18% of human resources in the national health service; the systems of access promotion performed by nurses have good levels of efficacy (95.5%) and user satisfaction (99% completely satisfied); in the local care the creation of Community Care Units (185) occurred, and 85.80% of home consultations were performed by nurses. Conclusion: political strategies, the National Health Service and strengthening of human resourcesin healthcareare the main determinants. Nursing is the most numerous professional group in the National Health Service, however numbers remaindeficient in primary health care. The improvement of academic qualification and self-regulation of this professional group has allowed for better answers inimproving health for the Portuguese

Estudo proteômico de marcadores da toxoplasmose ocular

O Toxoplasma gondii (T.gondii) é um dos principais agentes causadores de Uveíte posterior Presumidamente por T. gondii (UPAPT) em diferentes partes do mundo. A infecção predomina em jovens da segunda e terceira década de vida e é considerada a maior causa de perda da acuidade visual e cegueira. O diagnóstico da fase ativa da toxoplasmose ocular é difícil de ser realizado. Os exames sorológicos fornecem uma informação valiosa para realizar o diagnóstico etiológico desta doença, mas freqüentemente, não são conclusivos. O parasito causa a infecção latente. Algumas proteínas identificadas atualmente pela biologia molecular convencional e, utilizadas como marcadores no diagnóstico laboratorial, não conseguem discriminar entre toxoplasmose ativa e crônica, dificultando a intervenção terapêutica no momento adequado. Estudos prévios melhoraram o diagnóstico da toxoplasmose congênita usando immunoblotting bidimensional (2DIB). Nós desenvolvemos um método de 2DIB com o antígeno de taquizoítos da cepa RH do T. gondii para investigar as diferentes respostas dos anticorpos IgA e IgG ao parasito usando o soro de pacientes com e sem UPAPT. 68% das proteínas antigênicas foram reconhecidas especificamente pelos anticorpos IgA presentes no soro de pacientes com UPAPT. Nossos dados sugerem que estas proteínas antigênicas podem ser usadas como possíveis marcadores no diagnóstico da toxoplasmose ocular ativ

Quantifying mRNA and MicroRNA with qPCR in Cervical Carcinogenesis: A Validation of Reference Genes to Ensure Accurate Data

<div><p>A number of recent studies have catalogued global gene expression patterns in a panel of normal, tumoral cervical tissues so that potential biomarkers can be identified. The qPCR has been one of the most widely used technologies for detecting these potential biomarkers. However, few studies have investigated a correct strategy for the normalization of data in qPCR assays for cervical tissues. The aim of this study was to validate reference genes in cervical tissues to ensure accurate quantification of mRNA and miRNA levels in cervical carcinogenesis. For this purpose, some issues for obtaining reliable qPCR data were evaluated such as the following: geNorm analysis with a set of samples which meet all of the cervical tissue conditions (Normal + CIN1 + CIN2 + CIN3 + Cancer); the use of individual Ct values versus pooled Ct values; and the use of a single (or multiple) reference genes to quantify mRNA and miRNA expression levels. Two different data sets were put on the geNorm to assess the expression stability of the candidate reference genes: the first dataset comprised the quantities of the individual Ct values; and the second dataset comprised the quantities of the pooled Ct values. Moreover, in this study, all the candidate reference genes were analyzed as a single “normalizer”. The normalization strategies were assessed by measuring p16^INK4a and miR-203 transcripts in qPCR assays. We found that the use of pooled Ct values, can lead to a misinterpretation of the results, which suggests that the maintenance of inter-individual variability is a key factor in ensuring the reliability of the qPCR data. In addition, it should be stressed that a proper validation of the suitability of the reference genes is required for each experimental setting, since the indiscriminate use of a reference gene can also lead to discrepant results.</p></div

Effect of normalization options on miR-203 expression in cervical tissues.

<p>In a), it is shown that there is no significant effect on normalization between the use of the two most stable genes and the three genes. The differences in the expression levels of miR-203 were statistically significant with ANOVA when the use of the two and three most stable genes were compared with the use of each gene as a single normalizer. Graph b), shows the relative quantification of miR-203 in cervical tissues using a combination of <i>miR-191</i> and <i>miR-23a</i> (from an analysis involving individual Ct values) as the normalizer. The error bars indicate a 95% confidence interval; **, p<0.01; ****, p<0.0001.</p

Ct values of candidate npcRNA reference genes in cervical tissues.

<p>Boxplots shows interquartile range box, median and range whiskers, from the raw Ct values obtained from the amplification curves. All the npcRNA genes showed a normal distribution pattern across all the cervical tissue conditions as confirmed by the D′Agostino–Pearson normality test.</p

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Ct values of the candidate mRNA reference genes in cervical tissues.

<p>Boxplots shows interquartile range box, median and range whiskers, from the raw Ct values obtained from the amplification curves. All the genes showed a normal distribution pattern across all the cervical tissue conditions as confirmed by the D′Agostino–Pearson normality test.</p

Ranking and best combination of candidate genes determined from the analysis of pooled Ct values, by geNorm.

<p>Ranking and best combination of candidate genes determined from the analysis of pooled Ct values, by geNorm.</p

Effect on the p16^INK4a expression profile across cervical tissues using different normalizers.

<p>In this diagram: the normal tissue is represented by the blue bar; CIN1 is represented by the red bar; CIN2 is represented by the green bar; CIN3 is represented by the pink bar; and cancer (Ca) is represented by the purple bar. The graphs a) and c) show the p16^INK4a expression profile by means of the NFs obtained from the individual Ct analysis, as well as the NFs from the pooled Ct analysis, respectively. The graphs b) and d) show p16^INK4a expression normalized to individual Ct values and the pooled Ct values of each single candidate reference gene.</p