A EVOLUÇÃO DA CENTRAIS DE MATERIAL E ESTERILIZAÇAO: HISTÓRIA, ATUALIDADES E PERSPECTIVAS PARA A ENFERMAGEM

This study is a theoretical reflection about some aspects of the evolution of the work process at the material sterilization unit that involves the activities of nurses that participate in infection control of the hospital. It was verified that, when making a future projection of the activities in this sector at Brazilian health institutions, the technological and scientific advances for reprocessing medical devices should be considered: The ethical and legal questions, environment preservation and development of protocols adequate to the institutions’ reality, guaranteeing for health systems’ users a riskless and quality assistance.Este estudio es una reflexión teórica que aborda algunos aspectos relacionados con la evolución del proceso de trabajo en centrales de esterilización de material, donde actúan enfermeros que participan del control de las infecciones hospitalarias. Se verificó que al hacer una proyección de las actividades en este sector en el futuro en las instituciones de salud brasileñas, tomando en consideración los avances técnico-científicos en el sector de procesamiento de materiales médico-hospitalarios, deben ser considerados: los aspectos ético-legales, la no agresión al medio ambiente y el desarrollo de protocolos adecuados a la realidad de las instituciones que aseguren a los usuarios de los servicios de salud una asistencia de calidad y libre de riesgos.O estudo trata de uma reflexão teórica que aborda alguns aspectos relacionados à evolução do processo de trabalho em Centrais de Material e Esterilização que perpassa pelas atividades dos enfermeiros no controle de infecções hospitalares. Verificou-se que, ao se fazer uma projeção das atividades neste setor no futuro nas instituições de saúde brasileiras, em vista dos avanços técnico-científicos já alcançados para o reprocessamento de materiais médico-hospitalares, deve-se considerar: as questões éticas e legais, a não-agressão ao meio ambiente e o desenvolvimento de protocolos que sejam adequados à realidade das instituições, mas que assegurem aos usuários dos serviços de saúde uma assistência de qualidade e livre de riscos

Implication of the overlap representation for modelling generalized parton distributions

Based on a field theoretically inspired model of light-cone wave functions, we derive valence-like generalized parton distributions and their double distributions from the wave function overlap in the parton number conserved s-channel. The parton number changing contributions in the t-channel are restored from duality. In our construction constraints of positivity and polynomiality are simultaneously satisfied and it also implies a model dependent relation between generalized parton distributions and transverse momentum dependent parton distribution functions. The model predicts that the t-behavior of resulting hadronic amplitudes depends on the Bjorken variable x_Bj. We also propose an improved ansatz for double distributions that embeds this property.Comment: 15 pages, 8 eps figure

CYP2C19 and ABCB1 gene polymorphisms are differently distributed according to ethnicity in the Brazilian general population

<p>Abstract</p> <p>Background</p> <p>Recent studies have reported the clinical importance of <it>CYP2C19 </it>and <it>ABCB1 </it>polymorphisms in an individualized approach to clopidogrel treatment. The aims of this study were to evaluate the frequencies of <it>CYP2C19 </it>and <it>ABCB1 </it>polymorphisms and to identify the clopidogrel-predicted metabolic phenotypes according to ethnic groups in a sample of individuals representative of a highly admixtured population.</p> <p>Methods</p> <p>One hundred and eighty-three Amerindians and 1,029 subjects of the general population of 4 regions of the country were included. Genotypes for the <it>ABCB1</it>c.C3435T (rs1045642), <it>CYP2C19*2 </it>(rs4244285), <it>CYP2C19*3 </it>(rs4986893), <it>CYP2C19*4 </it>(rs28399504), <it>CYP2C19*5 </it>(rs56337013), and <it>CYP2C19*17 </it>(rs12248560) polymorphisms were detected by polymerase chain reaction followed by high resolution melting analysis. The <it>CYP2C19*3</it>, <it>CYP2C19*4 </it>and <it>CYP2C19*5 </it>variants were genotyped in a subsample of subjects (300 samples randomly selected).</p> <p>Results</p> <p>The <it>CYP2C19*3 </it>and <it>CYP2C19*5 </it>variant alleles were not detected and the <it>CYP2C19*4 </it>variant allele presented a frequency of 0.3%. The allelic frequencies for the <it>ABCB1</it>c.C3435T, <it>CYP2C19*2 </it>and <it>CYP2C19*17 </it>polymorphisms were differently distributed according to ethnicity: Amerindian (51.4%, 10.4%, 15.8%); Caucasian descent (43.2%, 16.9%, 18.0%); Mulatto (35.9%, 16.5%, 21.3%); and African descent (32.8%, 20.2%, 26.3%) individuals, respectively. As a result, self-referred ethnicity was able to predict significantly different clopidogrel-predicted metabolic phenotypes prevalence even for a highly admixtured population.</p> <p>Conclusion</p> <p>Our findings indicate the existence of inter-ethnic differences in the <it>ABCB1 </it>and <it>CYP2C19 </it>variant allele frequencies in the Brazilian general population plus Amerindians. This information could help in stratifying individuals from this population regarding clopidogrel-predicted metabolic phenotypes and design more cost-effective programs towards individualization of clopidogrel therapy.</p

A global classification of coastal flood hazard climates associated with large-scale oceanographic forcing

Coastal communities throughout the world are exposed to numerous and increasing threats, such as coastal flooding and erosion, saltwater intrusion and wetland degradation. Here, we present the first global-scale analysis of the main drivers of coastal flooding due to large-scale oceanographic factors. Given the large dimensionality of the problem (e.g. spatiotemporal variability in flood magnitude and the relative influence of waves, tides and surge levels), we have performed a computer-based classification to identify geographical areas with homogeneous climates. Results show that 75% of coastal regions around the globe have the potential for very large flooding events with low probabilities (unbounded tails), 82% are tide-dominated, and almost 49% are highly susceptible to increases in flooding frequency due to sea-level rise.A.R., F.J.M. and P.C. acknowledge the support of the Spanish ‘Ministerio de Economia y Competitividad’ under Grants BIA2014-59643-R and BIA2015-70644-R. This work was critically supported by the US Geological Survey under Grant/Cooperative Agreement G15AC00426 and from the US DOD Strategic Environmental Research and Development Program (SERDP Project RC-2644) through the NOAA National Centers for Environmental Information (NCEI). Dynamic atmospheric corrections (storm surge) are produced by CLS Space Oceanography Division using the Mog2D model from Legos and distributed by Aviso, with support from CNES (http://www.aviso.altimetry.fr/). Marine data from global reanalysis are provided by IHCantabria and are available for research purposes upon request at [email protected]

Integração de métodos multicritério na busca da sustentabilidade agrícola para a produção de tomates no município de São José de Ubá-RJ.

Este estudo discute alternativas para os sistemas produtivos da terra no plantio de tomates em São José de Ubá-RJ e as relações de trabalho passíveis de serem colocadas em pratica de forma a promover uma agricultura sustentavel na região, priorizando os aspectos economicos, ambientais e culturais do problema. A introdução da questão cultural aumenta a complexidade da questão, sendo necessário o uso de uma metodologia capaz de lidar com toda a subjetividade envolvida nesse processo de tomada de decisão. O estudo visa contribuir para a conquista de um processo sustentavel na região, estabelecendo um processo de tomada de decisão pautado nas opinioes do agricultor, respeitando principalmente as questões culturais do problema. As características do ambiente de tomada de decisão indicaram o uso de uma combinação de métodos de apoio a decisão multicritério - MACBETH e VIP Analysis - para a seleção da melhor alternativa capaz de possibilitar o alcance dos objetivos propostos

The HIV-1 Subtype C Epidemic in South America Is Linked to the United Kingdom

Background: The global spread of HIV-1 has been accompanied by the emergence of genetically distinct viral strains. Over the past two decades subtype C viruses, which predominate in Southern and Eastern Africa, have spread rapidly throughout parts of South America. Phylogenetic studies indicate that subtype C viruses were introduced to South America through a single founder event that occurred in Southern Brazil. However, the external route via which subtype C viruses spread to the South American continent has remained unclear.Methodology/Principal Findings: We used automated genotyping to screen 8,309 HIV-1 subtype C pol gene sequences sampled within the UK for isolates genetically linked to the subtype C epidemic in South America. Maximum likelihood and Bayesian approaches were used to explore the phylogenetic relationships between 54 sequences identified in this screen, and a set of globally sampled subtype C reference sequences. Phylogenetic trees disclosed a robustly supported relationship between sequences from Brazil, the UK and East Africa. A monophyletic cluster comprised exclusively of sequences from the UK and Brazil was identified and dated to approximately the early 1980s using a Bayesian coalescent-based method. A sub-cluster of 27 sequences isolated from homosexual men of UK origin was also identified and dated to the early 1990s.Conclusions: Phylogenetic, demographic and temporal data support the conclusion that the UK was a crucial staging post in the spread of subtype C from East Africa to South America. This unexpected finding demonstrates the role of diffuse international networks in the global spread of HIV-1 infection, and the utility of globally sampled viral sequence data in revealing these networks. Additionally, we show that subtype C viruses are spreading within the UK amongst men who have sex with men

Viral Etiology of Influenza-Like Illnesses in Antananarivo, Madagascar, July 2008 to June 2009

In Madagascar, despite an influenza surveillance established since 1978, little is known about the etiology and prevalence of viruses other than influenza causing influenza-like illnesses (ILIs).From July 2008 to June 2009, we collected respiratory specimens from patients who presented ILIs symptoms in public and private clinics in Antananarivo (the capital city of Madagascar). ILIs were defined as body temperature ≥38°C and cough and at least two of the following symptoms: sore throat, rhinorrhea, headache and muscular pain, for a maximum duration of 3 days. We screened these specimens using five multiplex real time Reverse Transcription and/or Polymerase Chain Reaction assays for detection of 14 respiratory viruses. We detected respiratory viruses in 235/313 (75.1%) samples. Overall influenza virus A (27.3%) was the most common virus followed by rhinovirus (24.8%), RSV (21.2%), adenovirus (6.1%), coronavirus OC43 (6.1%), influenza virus B (3.9%), parainfluenza virus-3 (2.9%), and parainfluenza virus-1 (2.3%). Co-infections occurred in 29.4% (69/235) of infected patients and rhinovirus was the most detected virus (27.5%). Children under 5 years were more likely to have one or more detectable virus associated with their ILI. In this age group, compared to those ≥5 years, the risk of detecting more than one virus was higher (OR = 1.9), as was the risk of detecting of RSV (OR = 10.1) and adenovirus (OR = 4.7). While rhinovirus and adenovirus infections occurred year round, RSV, influenza virus A and coronavirus OC43 had defined period of circulation.In our study, we found that respiratory viruses play an important role in ILIs in the Malagasy community, particularly in children under 5 years old. These data provide a better understanding of the viral etiology of outpatients with ILI and describe for the first time importance of these viruses in different age group and their period of circulation

Perfectionism and eating disorder symptoms in female university students: The central role of perfectionistic self-presentation

Purpose: Numerous studies have found perfectionism to show positive relations with eating disorder symptoms, but so far no study has examined whether perfectionistic self-presentation can explain these relations or whether the relations are the same for different eating disorder symptom groups. Methods: A sample of 393 female university students completed self-report measures of perfectionism (self-oriented perfectionism, socially prescribed perfectionism), perfectionistic self-presentation (perfectionistic self-promotion, nondisplay of imperfection, nondisclosure of imperfection), and three eating disorder symptom groups (dieting, bulimia, oral control). In addition, students reported their weight and height so their body mass index (BMI) could be computed. Results: Results of multiple regression analyses controlling for BMI indicated that socially prescribed perfectionism positively predicted all three symptom groups, whereas self-oriented perfectionism positively predicted dieting only. Moreover, perfectionistic self-presentation explained the positive relations that perfectionism showed with dieting and oral control, but not with bulimia. Further analyses indicated that all three aspects of perfectionistic self-presentation positively predicted dieting, whereas only nondisclosure of imperfection positively predicted bulimia and oral control. Overall, perfectionistic self-presentation explained 10.4-23.5% of variance in eating disorder symptoms, whereas perfectionism explained 7.9-12.1%. Conclusions: The findings suggest that perfectionistic self-presentation explains why perfectionistic women show higher levels of eating disorder symptoms, particularly dieting. Thus perfectionistic self-presentation appears to play a central role in the relations of perfectionism and disordered eating and may warrant closer attention in theory, research, and treatment of eating and weight disorders