Aplicação de recursos de acessibilidade em informática para alunos com baixa visão

The aim of this study was to verify the use of the accessibility options provided by the Windows-XP system with 12 students with low vision who attend an informatics course, with different diagnosis and visual impairments. The data collection was done by the assessment of visual acuity, visual field, sensitivity contrast and by observation of the performance in computer tasks. The results showed that for visual acuity equal or better of 0.2, the accessibility options accessed by the Accessibility Assistant were satisfactory. For visual acuity better than 0.1 and less of 0.2 it was necessary to increase the number of pixels for count. For visual acuity equal or less of 0.1, it was also necessary to be closer to the screen. It was concluded that the choice of accessibility resources for low vision is an individual task because of the diversity of visual impairments and that, the accessibility options of the Windows XP provided visibility in the proposed tasks.http://dx.doi.org/10.5902/1984686X3031O objetivo deste estudo foi verificar a aplicabilidade dos recursos de acessibilidade do sistema Windows-XP em 12 alunos com baixa visão de um curso de informática, que apresentavam diferentes diagnósticos e níveis de comprometimento da percepção visual. Os dados foram coletados através da aplicação de instrumentos de avaliação da acuidade visual (AV), campo visual, sensibilidade aos contrastes, e da observação do desempenho em tarefas no computador. Os resultados mostraram que para AV até 0,2 os recursos oferecidos pelo Assistente de Acessibilidade foram suficientes. Para AV menor que 0,2 e maior que 0,1 foi necessário aumentar o número de pixels por polegada da tela, e para AV igual ou menor a 0.1, somou-se uma maior aproximação da tela. Concluiu-se que, a escolha dos recursos de acessibilidade para baixa visão frente à diversidade da deficiência visual, é uma tarefa individualizada e que estes recursos presentes no Windows-XP proporcionaram visibilidade nas tarefas propostas

Mastectomia versus tratamento cirúrgico conservador: impacto na qualidade de vida de mulheres com câncer mamário

OBJECTIVES: to compare the impact of mastectomy and conservative surgery on the quality of life of patients with breast cancer. METHODS: an assessment was made of the quality of life of patients undergoing mastectomy or segmentary mastectomy, at the Pouso Alegre Clinical Hospital, in the Brazilian State of Minas Gerais, using SF-36. The patients were grouped by age (50 years) and years of schooling (8 years). The Mann-Whitney test was used to compare the groups with regard to the age and schooling domains of SF-36. RESULTS: a significant difference between the two groups was found in the domains of physical functioning (p=0.04) and pain (p=0.01): with the patients undergoing a mastectomy registering the worst scores. Young patients who had undergone a mastectomy displayed the worst quality of life in terms of physical functioning (p=0.03), pain (p=0.01) and social functioning (p=0.01); those undergoing conservative surgery aged over 50 years scored worst on role emotional (p=0.05). Patients undergoing a mastectomy with lower levels of schooling scored lower in physical functioning (p=0.01), role physical (p=0.05) and pain (p=0.05). Among those who had attended school for more than eight years, those having undergone a mastectomy scored less in the pain domain (p=0.04). CONCLUSIONS: patients who had undergone a mastectomy had worse results in the physical component of the evaluation of quality of life and this negative impact was more strongly felt among younger patients and those with lower levels of schooling.OBJETIVOS: comparar o impacto da mastectomia e da cirurgia conservadora na qualidade de vida de pacientes com câncer mamário. MÉTODOS: avaliou-se qualidade de vida de pacientes submetidas à mastectomia ou à mastectomia segmentar, no Hospital das Clínicas de Pouso Alegre, Minas Gerais, Brasil, utilizando-se o SF-36. As pacientes foram estratificadas quanto à idade (50 anos) e escolaridade (8 anos). Aplicou-se o teste de Mann-Whitney para comparar os grupos quanto aos domínios do SF-36, idade e escolaridade. RESULTADOS: observou-se diferença significante entre os grupos nos domínios capacidade funcional (p=0,04) e dor (p=0,01): as pacientes mastectomizadas com piores resultados. Pacientes mastectomizadas mais jovens apresentaram pior qualidade de vida em capacidade funcional (p=0,03), dor (p=0,01) e aspectos sociais (p=0,01); as submetidas à cirurgia conservadora, com mais de 50 anos, resultado pior em aspectos emocionais (p=0,05). Pacientes mastectomizadas com menor escolaridade apresentaram escores menores em capacidade funcional (p=0,01), aspectos físicos (p=0,05) e dor (p=0,05). Entre as que frequentaram a escola por mais de oito anos, as mastectomizadas pontuaram menos no domínio dor (p=0,04). CONCLUSÕES: pacientes mastectomizadas apresentaram piores resultados no componente físico da qualidade de vida, e este impacto negativo foi mais acentuado entre pacientes mais jovens e com menor escolaridade.Universidade do Vale do SapucaíUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Abordagem oncoplástica no tratamento conservador do câncer mamário: análise de custos

PURPOSE: To analyze the direct costs of conservative surgical treatment of breast cancer, performed in a university hospital, to the Brazilian National Health Care Public System (SUS), checking the impact of the oncoplastic approach on these costs. METHODS: One hundred thirty eight breast cancer patients who had undergone conservative treatment with oncoplastic approach (n=36) or not (control group, n=102), in the period from 2005 to 2010, were enrolled. Sociodemographic and clinical data were recorded. The direct costs of the surgical procedure were obtained and analyzed. RESULTS: Groups did not differ in regard to age (p=0.963), and patients in oncoplastic group had a longer time of hospital stay (p=0.000). The median direct cost for the oncoplastic group was R$461.00 and for the control group was R$229.00 (p=0.000). CONCLUSION: The oncoplastic approach has generated higher direct costs in conservative surgical treatment of breast cancer to SUS.OBJETIVO: Analisar os custos diretos do tratamento cirúrgico conservador do câncer mamário, realizado pelo Sistema Único de Saúde (SUS) em um hospital universitário, verificando o impacto da abordagem oncoplástica sobre estes custos. MÉTODOS: Foram incluídas 138 pacientes submetidas ao tratamento conservador do câncer mamário pelo SUS, com abordagem oncoplástica (n=36) ou não (grupo controle, n=102), no período de 2005 a 2010. Foram registrados dados sócio-demográficos e da operação. Os custos diretos do procedimento cirúrgico foram obtidos e analisados. RESULTADOS: Não houve diferença entre os grupos quanto à idade (p=0.963), e o tempo de internação hospitalar foi maior no grupo oncoplástica (p=0,000). A mediana dos custos diretos do grupo oncoplástica foi de R$461,00 e do grupo controle foi de R$229,00 (p=0,000). CONCLUSÃO: A abordagem oncoplástica gerou custos diretos maiores para o tratamento cirúrgico conservador do câncer mamário pelo SUS.UNIVÁS Plastic Surgery DivisionUNIVÁS Mastology DivisionUNIVÁS Hospital das Clínicas Samuel Libânio Plastic Surgery DivisionUNIVÁS School of AdministrationUNIVÁS Bioestatistics DivisionUNIFESP Plastic Surgery DivisionUNIFESP Head of Plastic Surgery DivisionUNIFESP, Plastic Surgery DivisionUNIFESP, Head of Plastic Surgery DivisionSciEL

Risk levels for suffering a traffic injury in primary health care. The LESIONAT* project

Background: Literature shows that not only are traffic injuries due to accidents, but that there is also a correlation between different chronic conditions, the consumption of certain types of drugs, the intake of psychoactive substances and the self perception of risk (Health Belief Model) and the impact/incidence of traffic accidents. There are few studies on these aspects in primary health care. The objectives of our study are: Main aim: To outline the distribution of risk factors associated with Road Traffic Injuries (RTI) in a driving population assigned to a group of primary health care centres in Barcelona province. Secondly, we aim to study the distribution of diverse risk factors related to the possibility of suffering an RTI according to age, sex and population groups, to assess the relationship between these same risk factors and self risk perception for suffering an RTI, and to outline the association between the number of risk factors and the history of reported collisions. Methods/Design: Design: Cross-sectional, multicentre study. Setting: 25 urban health care centres. Study population: Randomly selected sample of Spanish/Catalan speakers age 16 or above with a medical register in any of the 25 participating primary health care centres. N = 1540. Unit of study: Basic unit of care, consisting of a general practitioner and a nurse, both of whom caring for the same population (1,500 to 2,000 people per unit). Instruments of measurement: Data collection will be performed using a survey carried out by health professionals, who will use the clinical registers and the information reported by the patient during the visit to collect the baseline data: illnesses, medication intake, alcohol and psychoactive consumption, and self perception of risk. Discussion: We expect to obtain a risk profile of the subjects in relation to RTI in the primary health care field, and to create a group for a prospective follow-up. Trial Registration: Clinical Trials.gov Identifier: NCT00778440. </p

Evaluation of blood biomarkers in rats submitted to nanotextured and polyurethane foam-coated silicone implants

Introduction: In recent decades, there has been a great evolution in breast implants' lining surface, which has resulted in decreased complications. In the postoperative period, the inflammation is constant and can be evaluated by the blood count, as it is a fast, inexpensive, and highly available examination. The present study evaluates blood biomarkers in rats submitted to the placement of nanotextured silicone implants and implants coated with polyurethane foam. Methods: 60 Wistar rats were used divided into two groups for nanotextured mini-implants and others mini-implants coated with polyurethane foam, subdivided into subgroups according to the animals' euthanasia in the 30, 60, and 90 days. At the time of euthanasia, blood samples were obtained by cardiac puncture and the blood count was analyzed. Results: Hemoglobin, hematocrit, mean corpuscular hemoglobin, leukocytes, neutrophils, lymphocytes, and platelets had very similar results in all subgroups evaluated (30, 60, and 90 days). However, when the different subgroups were compared within each group, statistically significant results were obtained in the mean corpuscular hemoglobin (nanotextured p=0.032 and polyurethane p=0.007) and leukocytes (nanotextured p=0.038 and polyurethane p=0.034). Changes in postoperative blood biomarkers were hypochromic anemia, normal leukocyte count, neutrophilia, lymphopenia, and thrombocytopenia. Conclusion: After the placement of mini-silicone implants, the rats of both groups evolved with hypochromic anemia, normal leukocyte count at the expense of neutrophilia and lymphopenia, and thrombocytopenia

Fixation of the short-term central venous catheter. A comparison of two techniques

Purpose: To compare the fixation of the central venous catheter (CVC) using two suture techniques. Methods: A clinical, analytical, interventional, longitudinal, prospective, controlled, single-blind and randomized study in adult, intensive care unit (ICU) patients. After admission and indication of CVC use, the patients were allocated to the Wing group (n = 35, catheter fixation with clamping wings and retainers) or Shoelace group (n = 35, catheter fixation using shoelace cross- tied sutures around the device). Displacement, kinking, fixation failure, hyperemia at the insertion site, purulent secretion, loss of the device, psychomotor agitation, mental confusion, and bacterial growth at the insertion site were evaluated. Results: Compared with the Wing group, the Shoelace group had a lower occurrence of catheter displacement (n = 0 versus n = 4p = 0.04), kinking (n = 0 versus n = 8p = 0.001), and fixation failure (n = 2 versus n = 8p = 0.018). No significant difference was found in bacterial growth (n = 20 versus n = 14p = 0.267) between groups. Conclusion: The Shoelace fixation technique presented fewer adverse events than the Wing fixation technique.Univ Vale Sapucai UNIVAS, Profess Masters Program Appl Hlth Sci, Pouso Alegre, MG, BrazilUniv Vale Sapucai, Profess Masters Program Appl Hlth Sci, Pouso Alegre, MG, BrazilUniv Vale Sapucai, Hosp Clin Samuel Libanio, Dept Cardiac Surg, Pouso Alegre, MG, BrazilUniv Vale Sapucai, Dept Biostat, Pouso Alegre, MG, BrazilUniv Vale Sapucai, Res Lab, Pouso Alegre, MG, BrazilUniv Vale Sapucai, Hosp Clin Samuel Libanio, Pouso Alegre, MG, BrazilUniv Vale Sapucai, Hosp Clin Samuel Libanio, Intens Care Dept, Pouso Alegre, MG, BrazilUniv Vale Sapucai, Pouso Alegre, MG, BrazilUniv Fed São Paulo UNIFESP, Div Plast Surg, São Paulo, BrazilUniv Fed São Paulo UNIFESP, Div Plast Surg, Dept Surg, São Paulo, BrazilUniv Fed São Paulo UNIFESP, Div Plast Surg, São Paulo, BrazilUniv Fed São Paulo UNIFESP, Div Plast Surg, Dept Surg, São Paulo, BrazilWeb of Scienc

GESTAÇÃO NA ADOLESCÊNCIA: DESCRIÇÃO E ANÁLISE DA ASSISTÊNCIA RECEBIDA

Objetiva-se descrever e analisar a assistência pré-natal às adolescentes, em relação ao Programa de Humanização noPré-natal e Nascimento (PHPN), através de um estudo descritivo, transversal e quantitativo realizado entre março ejulho de 2009, a partir de formulário e entrevista com 200 adolescentes, em maternidade de referência em obstetríciado SUS. As jovens realizaram pré-natal em serviço público (96,4%), o iniciaram no primeiro trimestre (47,4%), nãoobtiveram o mínimo de consultas (52,6%), receberam suplemento de ferro (96,9%), imunização antitetânica (80,5%) e foram pouco orientadas (46,0%). Quanto aos exames laboratoriais, foram realizados na primeira consulta (80,0%), sendo apenas um terço deles repetidos no terceiro trimestre gestacional. Conclui-se que o PHPN não está sendo realizadointegralmente, conforme o Ministério da Saúde preconiza, e a assistência pré-natal deve ser melhorada, principalmentena captação precoce, continuidade da assistência, solicitação da segunda amostra dos exames e oferta de orientações

Taking the strain? Impact of glaucoma on patients' informal caregivers

Purpose: To estimate informal caregiver (ICG) strain in people from a glaucoma clinic. Methods: Patients with glaucoma were consecutively identified from a single clinic in England for a cross-sectional postal survey. The sample was deliberately enriched with a number of patients designated as having advanced glaucoma (visual field [VF] mean deviation worse than -12 dB in both eyes). Patients were asked to identify an ICG who recorded a Modified Caregiver Strain Index (MCSI), a validated 13 item instrument scored on a scale of 0-26. Previous research has indicated mean MCSI to be >10 in Multiple Sclerosis and Parkinson’s disease. All participants gave a self-reported measure of general health (EQ5D). Results: Responses from 105 patients (43% of those invited) were analysed; only 38 of the 105 named an ICG. Mean (95% confidence interval [CI]) MCSI was 2.4 (1.3, 3.6) and only three ICGs recorded a MCSI > 7. The percentage of patients with an ICG was much higher in patients with advanced VF loss (82%; 9/11) when compared to those with non-advanced VF loss (31%; 29/94; p=0.001). Mean (standard deviation) MCSI was considerably inflated in the advanced patients (5.6 [4.9] vs 1.5 [2.2] for non-advanced; p=0.040). Worsening VF and poorer self-reported general health (EQ5D) of the patient were associated with worsening MCSI. Conclusion: ICG strain, as measured by MCSI, for patients with non-advanced glaucoma is negligible, compared to other chronic disease. ICG strain increases moderately with worsening VFs but this could be partly explained by worse general health in our sample of patients