Workloads and strain process in Community Health Agents

ABSTRACT OBJECTIVE To identify the workloads present in the work activities of community health agents (CHAs) and the resulting strain processes. METHOD A descriptive, exploratory, cross-sectional and quantitative study conducted with 137 CHAs. Data were collected through a questionnaire and interview guided by the health surveillance software called SIMOSTE (Health Monitoring System of Nursing Workers), following the ethical codes of the current law. RESULTS In total, were identified 140 workloads involved in 122 strain processes, represented by the occurrence of health problems of the CHAs. The mechanical (55.00%) and biological (16.43%) loads stood out. The most common strain processes were the external causes of morbidity and mortality (62.31%) and diseases of the musculoskeletal system and connective tissue (10.66%). CONCLUSION From the identified overloads, it became evident that all workloads are present in the work process of CHAs, highlighting the mechanical load, represented mainly by external causes of morbidity and mortality that are related to occupational accidents

T Helper 1–Inducing Adjuvant Protects against Experimental Paracoccidioidomycosis

Immunostimulatory therapy is a promising approach to improving the treatment of systemic fungal infections such as paracoccidioidomycosis (PCM), whose drug therapy is usually prolonged and associated with toxic side effects and relapses. The current study was undertaken to determine if the injection of a T helper (Th) 1–stimulating adjuvant in P. brasiliensis–infected mice could have a beneficial effect on the course of experimental PCM. For this purpose, mice were infected and treated with complete Freund's adjuvant (CFA), a well-established Th1 experimental inductor, or incomplete Freund's adjuvant (IFA - control group) on day 20 postinfection. Four weeks after treatment, the CFA-treated mice presented a mild infection in the lungs characterized by absence of epithelioid cell granulomas and yeast cells, whereas the control mice presented multiple sites of focal epithelioid granulomas with lymphomonocytic halos circumscribing a high number of viable and nonviable yeast cells. In addition, CFA administration induced a 2.4 log reduction (>99%) in the fungal burden when compared to the control group, and led to an improvement of immune response, reversing the immunosuppression observed in the control group. The immunotherapy with Th1-inducing adjuvant, approved to be used in humans, might be a valuable tool in the treatment of PCM and potentially useful to improve the clinical cure rate in humans

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Identificaçao de propiedades mecanicas de materiais compósitos utilizando técnicas de optimizaçao

É apresentado um modelo numérico para a identificaçáo de propriedades mecanicas de placas de materiais compósitos que associa técnicas de optimizaçáo com um método experimental de determinaçáo de frequencias próprias. A análise dinamica e o cálculo das sensibilidades com respeito a perturbacoes nos parametros adimensionais do material sáo obtidas com um modelo discreto de elementos finitos formulado segundo a teoria das deformaçoes de corte lineares de Mindlin. A optimizaçao de um funcional de erro que exprime a diferença entre as frequencias obtidas experimentalmente e as que lhes correspondem no modelo numérico é levada a cabo com o programa ADS (Automated Design Synthesis). Apresentam-se vários exemplos de identificaçáo.Peer Reviewe

Identificaçao de propiedades mecanicas de materiais compósitos utilizando técnicas de optimizaçao

É apresentado um modelo numérico para a identificaçáo de propriedades mecanicas de placas de materiais compósitos que associa técnicas de optimizaçáo com um método experimental de determinaçáo de frequencias próprias. A análise dinamica e o cálculo das sensibilidades com respeito a perturbacoes nos parametros adimensionais do material sáo obtidas com um modelo discreto de elementos finitos formulado segundo a teoria das deformaçoes de corte lineares de Mindlin. A optimizaçao de um funcional de erro que exprime a diferença entre as frequencias obtidas experimentalmente e as que lhes correspondem no modelo numérico é levada a cabo com o programa ADS (Automated Design Synthesis). Apresentam-se vários exemplos de identificaçáo.Peer Reviewe

Identificaçao de propiedades mecanicas de materiais compósitos utilizando técnicas de optimizaçao

É apresentado um modelo numérico para a identificaçáo de propriedades mecanicas de placas de materiais compósitos que associa técnicas de optimizaçáo com um método experimental de determinaçáo de frequencias próprias. A análise dinamica e o cálculo das sensibilidades com respeito a perturbacoes nos parametros adimensionais do material sáo obtidas com um modelo discreto de elementos finitos formulado segundo a teoria das deformaçoes de corte lineares de Mindlin. A optimizaçao de um funcional de erro que exprime a diferença entre as frequencias obtidas experimentalmente e as que lhes correspondem no modelo numérico é levada a cabo com o programa ADS (Automated Design Synthesis). Apresentam-se vários exemplos de identificaçáo.Peer Reviewe

Long term follow up of rheumatic fever and predictors of severe rheumatic valvar disease in Brazilian children and adolescents

Objectives: To investigate the progress of rheumatic fever (RF) and the predictors of severe chronic valvar disease. Design: Patients prospectively followed up since their first attack of acute RF (ARF). Setting: Universidade Federal de Minas Gerais, Brazil. Patients: 258 children and adolescents who met the revised Jones criteria for RF. The follow up period ranged from 2–15 years. Main outcome measures: The presence and severity of mitral or aortic valvar disease were determined by both clinical and Doppler echocardiographic examinations. The variables associated with severe chronic valvar disease were initially identified by the Kaplan-Meier method and, later, by multivariate analysis. Results: Doppler echocardiography of 258 patients studied showed that 186 (72.1%) developed chronic valvar disease and 41 (15.9%) progressed to severe chronic mitral or aortic lesions. Of 146 patients who developed carditis, 49 (33.6%) had a normal clinical examination in the chronic phase but only nine (6.2%) had normal Doppler echocardiographic findings—that is, 40 (27.4%) patients progressed to chronic subclinical valvar disease. Moderate or severe carditis, recurrences of ARF, and mother’s low educational level were risk factors in predicting severe chronic valvar diseases. Conclusion: The increased risk of progressing to severe chronic valvar disease was associated with moderate or severe carditis, recurrences of ARF, and mother’s low educational level. Hence, in a country such as Brazil, the options available for disease control are mainly primary and secondary prophylaxis