7 research outputs found
Avaliação da qualidade dos serviços de transporte público urbano em Cuiabá e Várzea Grande utilizando método servqual / Evaluation of the quality of urban public transport services in Cuiabá and Várzea Grande using servqual method
O transporte pĂşblico Ă© um dos meios de transporte mais utilizados, sendo responsável pela integração entre as diferentes áreas das cidades, transportando trabalhadores, estudantes e pessoas a passeio, portanto a qualidade neste modelo de serviço Ă© de suma importância, pois está diretamente ligada a vida dos usuários. Partindo deste cenário, esse artigo mostra a aplicação da ferramenta de avaliação de serviços Servqual, utilizando um mĂ©todo descritivo, contendo uma pesquisa bibliográfica e uma abordagem quantitativa, buscando mensurar a qualidade do transporte pĂşblico. Desta forma o objetivo desta pesquisa Ă© analisar a percepção dos usuários do transporte coletivo urbano em relação Ă qualidade dos serviços prestados oferecidos pelas empresas de Ă´nibus presentes nas cidadeslimĂtrofes de Cuiabá e Várzea Grande no Estado de Mato Grosso. A análise dos resultados mostrou que, a percepção dos usuários Ă© inferior as expectativas em todas as dimensões analisadas, dessa forma todas as dimensões apresentam oportunidades de melhorias
Surgical therapy in transsexual patients: a multi-disciplinary approach
A transsexual patient has the constant and persistent conviction that he or she belongs to the opposite sex, thus creating a deeply seated gender identity conflict. With psychotherapy being unsuccessful, it has been proven that in carefully selected patients, gender reassignment or adjusting the body to the mind (both with hormones and surgery) is the best way to normalize their lives. Optimal treatment of these patients requires the multidisciplinary approach of a gender team with the input of several specialties. Such a team consists of a nucleus of physicians who sees the patient more frequently : the psychiatrist, the endocrinologist, the plastic surgeon, the gynecologist and the urologist and a more peripheral group that sees the patients more incidentaly : the psychologist, the otorhinolaryngologist, the dermatologist, the speech therapist, the lawyer, the nurse and the social worker.
Between 1987 and 1999, a total of 71 male-to-female (MTF) and 54 female-to-male transsexuals have undergone gender confirming surgery in our hospital. This article gives a review and an update on the different surgical procedures as well as on the outcome in our patient population. The results in this series of patients clearly demonstrate that a close cooperation of the different surgical specialties, within our multidisciplinary gender team, is the key to success in treating transsexual patients
Protection of Hippocampal Neurogenesis from Toll-Like Receptor 4-Dependent Innate Immune Activation by Ablation of Prostaglandin E2 Receptor Subtype EP1 or EP2
Prostaglandin E2 is one of several eicosanoid products of the cyclooxygenase isozymes and is a key regulator of innate immune responses; it also possesses paracrine effects on mature neurons. The prostaglandin E2 receptor family consists of four subtypes of which EP1 and EP2 are known to be expressed by microglia. Lipopolysaccharide (LPS)-induced innate immune activation leads to the degeneration of intermediate progenitor cells (IPCs) that are destined for neuronal maturation in the hippocampal subgranular zone (SGZ); these cells can be identified by the expression of the transcription factor T-box brain gene 2 (Tbr2). Importantly, depletion of LPS-induced IPCs from the SGZ is suppressed by cyclooxygenase inhibitors. We therefore tested the hypothesis that either EP1 or EP2 is critical to LPS-induced depletion of Tbr2+ IPCs from the SGZ. Expression of either EP1 or EP2 was necessary for Toll-like receptor 4-dependent innate immune-mediated depletion of these Tbr2+ IPCs in mice. Moreover, EP1 activation was directly toxic to murine adult hippocampal progenitor cells; EP2 was not expressed by these cells. Finally, EP1 modulated the response of murine primary microglia cultures to LPS but in a manner distinct from EP2. These results indicate that prostaglandin E2 signaling via either EP1 or EP2 is largely to completely necessary for Toll-like receptor 4-dependent depletion of IPCs from the SGZ and suggest further pharmacological strategies to protect this important neurogenic niche