Perspectivas de um programa de internação domiciliar neonatal no Sistema Único de Saúde

This study aimed to report aspects of how mothers undertake home care of their infants while the latter are kept in a neonatal home care program. It was based on a qualitative approach and institutional analysis related to the gender category was used as theoretical reference frameworks. Data collection was carried out through semistructured interviews with eleven mothers after discharge from the program. Discourse analysis showed that the mothers assessed this form of care as essential, innovative and positive. It is thus considered an effective intervention from a child-integrated-care perspective, since interference of the team in the everyday lives of these women and their children encompassed not only the clinical aspect but affected other dimensions of their lives. It established a partnership with them and helped the mothers to build greater autonomy in caring for their children. However, there is a need for interinstitutional space, which will create the potential for basic health care actions.Este estudio tiene por objetivo presentar aspecto del cuidado prestado en el domicilio relatado por las madres durante el periodo de internación en el Programa de Internacíon Domiciliar Neonatal. Se adoptó la aproximación cualitativa y se utilizó el análisis institucional articulado a la categoría género como referenciales teóricos. La recolecta de informaciones fue realizada por medio de encuestas semi-estructuradas con 11 madres, después de dar alta del programa. A partir de análisis del discurso, fue posible verificar que las madres evaluaron esa modalidad de atención como esencial, innovadora y positiva. Fue considerada efectiva, en la perspectiva de la integralidad de la atención al niño, una vez que la actuación del equipo en el cotidiano de esas mujeres incorporó no solamente los aspectos clínicos, pero también alcanzó otras dimensiones, estableciendo una relación de colaboración y fortalecimiento de las madres para la construcción de la autonomía en el cuidado de sus hijos. Entretanto, se observa la necesidad de espacios de articulación interinstitucionales que amplíen y potencialicen las acciones de salud en la atención básica.Com este estudo objetivou-se apresentar aspectos do cuidado prestado no domicílio, relatado pelas mães, durante o período de internação no Programa de Internação Domiciliar Neonatal. Adotou-se a abordagem qualitativa e utilizou-se a análise institucional articulada à categoria gênero como referenciais teóricos. A coleta de dados foi realizada por meio de entrevista semi-estruturada com 11 mães, depois da alta do programa. A partir da análise de discurso, foi possível verificar que as mães avaliaram essa modalidade de assistência como essencial, inovadora e positiva. Foi considerada efetiva, na perspectiva da integralidade da assistência à criança, uma vez que a atuação da equipe no cotidiano dessas mulheres e de seus filhos incorporou não somente os aspectos clínicos, mas atingiu outras dimensões, ao estabelecer relação de parceria e fortalecimento das mães para a construção da autonomia no cuidado dos seus filhos. Entretanto, observa-se a necessidade de espaços de articulação interinstitucionais que ampliem e potencializem as ações de saúde na atenção básica

Uma análise sobre o impacto do investimento direto estrangeiro no desenvolvimento da economia brasileira

O presente trabalho tem como objetivo explicar e analisar como o investimento direto estrangeiro contribui para o desenvolvimento da economia brasileira. Para tanto, em um primeiro momento são discutidos os determinantes teórico-analíticos do IDE e sua relação com o desenvolvimento econômico, fundamentando-se nas teorias tradicionais e nas teorias contemporâneas sobre o tema. Na sequência, descrevem-se, em perspectiva histórica, as principais características do processo de industrialização brasileiro, bem como o cenário atual do país e o comportamento dos fluxos de IDE visto a queda na confiança do investidor estrangeiro devido à falta de transparência e má gestão da principal empresa estatal nacional

Subjectivities of rural men with cardiovascular problems: care, threats, and masculinity affirmations

O artigo discute subjetividades cotidianas que podem fragilizar ou (re)afirmar a masculinidade e, por conseguinte, afastar os homens rurais do cuidado para com a saúde. Com abordagem qualitativa, a pesquisa foi aplicada em uma comunidade rural de município localizado no sul do Rio Grande do Sul com a participação de doze homens que vivenciaram adoecimento cardiovascular crônico. Os achados ilustram diferentes ações eleitas pelos entrevistados como ameaçadoras à masculinidade e que, portanto, devem ser evitadas ou negadas, redirecionando-se para um movimento de afirmação dos estereótipos de gênero. Evidenciou-se nas análises que determinadas prescrições associadas à masculinidade - como a crença na invulnerabilidade, o papel de provedor e a associação do cuidado com a feminilidade - podem acarretar prejuízos à saúde física, mental e social dos homens, em especial no envelhecimento, quando as fronteiras entre o que se deseja e o que se consegue atender se acentuam. Com o olhar para o rural, o estudo fornece aportes para pensar ações no campo da promoção da saúde masculina em sua pluralidade de contextos de vida, trazendo para a discussão o cenário de vida camponês e suas especificidades produtivas, que conformam e moldam situações de saúde.The article discusses daily subjectivities that may undermine or (re)affirm masculinity and thus alienate rural men from taking care of their health. Through a qualitative approach, the research was conducted within a rural community in a municipality in the south of Rio Grande do Sul (Brazil) and involved twelve male participants who experienced chronic heart disease. The findings illustrate different actions which were elected by the respondents as threats to their masculinity and that, therefore, should be avoided or denied, leading to an affirmation of gender stereotypes. The analyses made clear that certain prescriptions associated with masculinity, such as the belief in invulnerability, the role of the provider and the link between self care and femininity, may cause physical, mental, and social harm to men, especially during old age, when the boundaries between goals and possibilities become further apart. Focusing on the rural aspect, the study provides ideas for the development of actions towards men’s health promotion, taking into consideration their life context plurality and bringing the farmer’s life sphere and all its productive particularities, which shape health scenarios, to the discussion

4,4′-Di-tert-butyl-2,2′-bipyridine

In the title compound, C18H24N2, the mol­ecular unit adopts a trans conformation around the central C—C bond [N—C—C—N torsion angle of 179.2 (3)°], with the two aromatic rings almost coplanar [dihedral angle of only 0.70 (4)°]. The crystal packing is driven by co-operative contacts involving weak C—H⋯N and C—H⋯π inter­actions, and also the need to fill effectively the available space

Overexpression of Adenosine A2A receptors in rats: effects on depression, locomotion, and anxiety

Copyright: © 2014 Coelho, Alves, Canas, Valadas, Shmidt, Batalha, Ferreira, Ribeiro, Bader, Cunha, do Couto and Lopes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Adenosine A2A receptors (A2AR) are a sub-type of receptors enriched in basal ganglia, activated by the neuromodulator adenosine, which interact with dopamine D2 receptors. Although this reciprocal antagonistic interaction is well-established in motor function, the outcome in dopamine-related behaviors remains uncertain, in particular in depression and anxiety. We have demonstrated an upsurge of A2AR associated to aging and chronic stress. Furthermore, Alzheimer's disease patients present A2AR accumulation in cortical areas together with depressive signs. We now tested the impact of overexpressing A2AR in forebrain neurons on dopamine-related behavior, namely depression. Adult male rats overexpressing human A2AR under the control of CaMKII promoter [Tg(CaMKII-hA2AR)] and aged-matched wild-types (WT) of the same strain (Sprague-Dawley) were studied. The forced swimming test (FST), sucrose preference test (SPT), and the open-field test (OFT) were performed to evaluate behavioral despair, anhedonia, locomotion, and anxiety. Tg(CaMKII-hA2AR) animals spent more time floating and less time swimming in the FST and presented a decreased sucrose preference at 48 h in the SPT. They also covered higher distances in the OFT and spent more time in the central zone than the WT. The results indicate that Tg(CaMKII-hA2AR) rats exhibit depressive-like behavior, hyperlocomotion, and altered exploratory behavior. This A2AR overexpression may explain the depressive signs found in aging, chronic stress, and Alzheimer's disease.Joana E. Coelho, Vânia L. Batalha and Diana G. Ferreira were supported by a grant from Fundação para a Ciência e Tecnologia (FCT); Paula M. Canas and Rodrigo A. Cunha were supported by FCT (PTDC/SAU-NSC/122254/2010) and Defense Advanced Research Projects Agency (DARPA, grant 09-68-ESR- FP-010). Luísa V. Lopes is an Investigator FCT, funded by Fundação para a Ciência e Tecnologia (PTDC-099853/2009) and Bial.info:eu-repo/semantics/publishedVersio

Upper aerodigestive tract squamous cell carcinomas show distinct overall DNA methylation profiles and different molecular mechanisms behind WNT signaling disruption

SIMPLE SUMMARY: Squamous cell carcinomas of the upper aerodigestive tract are highly incident, lethal, and share the same epithelial lining of origin, risk factors and genetic alterations. However, their biological and clinical behaviors differ, having an impact on patient survival. This study aimed at identifying the main DNA methylation differences between these tumors, giving an overview of the main genomic regions affected, whether DNA methylation gains or losses are more common, the impact on gene expression and the signaling pathways affected. This knowledge will help identifying potential site-specific biomarkers as well as shedding light on whether epigenetic mechanisms explain, at least in part, the diverse behavior of upper aerodigestive tract tumors. ABSTRACT: Upper aerodigestive tract (UADT) tumors present different biological behavior and prognosis, suggesting specific molecular mechanisms underlying their development. However, they are rarely considered as single entities (particularly head and neck subsites) and share the most common genetic alterations. Therefore, there is a need for a better understanding of the global DNA methylation differences among UADT tumors. We performed a genome-wide DNA methylation analysis of esophageal (ESCC), laryngeal (LSCC), oral (OSCC) and oropharyngeal (OPSCC) squamous cell carcinomas, and their non-tumor counterparts. The unsupervised analysis showed that non-tumor tissues present markedly distinct DNA methylation profiles, while tumors are highly heterogeneous. Hypomethylation was more frequent in LSCC and OPSCC, while ESCC and OSCC presented mostly hypermethylation, with the latter showing a CpG island overrepresentation. Differentially methylated regions affected genes in 127 signaling pathways, with only 3.1% of these being common among different tumor subsites, but with different genes affected. The WNT signaling pathway, known to be dysregulated in different epithelial tumors, is a frequent hit for DNA methylation and gene expression alterations in ESCC and OPSCC, but mostly for genetic alterations in LSCC and OSCC. UADT tumor subsites present differences in genome-wide methylation regarding their profile, intensity, genomic regions and signaling pathways affected

Translation, Cross-Cultural Adaptation, and Validation of the Portuguese Version of the Rotterdam Elderly Pain Observation Scale

INTRODUCTION: This study reports on the translation, cultural adaptation, and validation of a Portuguese version of the Rotterdam Elderly Pain Observation Scale (REPOS), a Dutch scale to assess pain in patients who cannot communicate, with or without dementia. METHODS: This is a multicenter study in pain and neurological units involving Brazil (clinical phase) and the Netherlands (training phase). We performed a retrospective cross-sectional, 2-staged analysis, translating and culturally adapting the REPOS to a Portuguese version (REPOS-P) and evaluating its psychometric properties. Eight health professionals were trained to observe patients with low back pain. REPOS consists of 10 behavioral items scored as present or absent after a 2-min observation. The REPOS score of ≥3 in combination with the Numerical Rating Scale (NRS) of ≥4 indicated pain. The Content Validity Index (CVI) in all items and instructions showed CVI values at their maximum. According to the higher correlation coefficient found between NRS and REPOS-P, it may be suggested that there was an adequate convergent validity. RESULTS: The REPOS-P was administered to 80 patients with a mean age of 60 years (SD 11.5). Cronbach's alpha coefficient showed a moderate internal consistency of REPOS-P (α = 0.62), which is compatible with the original study of REPOS. All health professionals reached high levels of interrater agreement within a median of 10 weeks of training, assuring reproducibility. Cohen's kappa was 0.96 (SD 0.03), and the intraclass correlation coefficient was 0.98 (SD 0.02), showing high reliability of REPOS-P scores between the trainer (researcher) and the trainees (healthcare professionals). The Pearson correlation coefficient was 0.95 (95% confidence interval 0.94–0.97), showing a significant correlation between the total scores of REPOS-P and NRS. CONCLUSION: The REPOS-P was a valuable scale for assessing elderly patients with low back pain by different healthcare professionals. Short application time, ease of use, clear instructions, and the brief training required for application were essential characteristics of REPOS-P

Subtractive phage display selection from canine visceral leishmaniasis identifies novel epitopes that mimic leishmania infantum antigens with potential serodiagnosis applications

Visceral leishmaniasis (VL) is a zoonotic disease that is endemic to Brazil, where dogs are the main domestic parasite reservoirs, and the percentages of infected dogs living in regions where canine VL (CVL) is endemic have ranged from 10% to 62%. Despite technological advances, some problems have been reported with CVL serodiagnosis. The present study describes a sequential subtractive selection through phage display technology from polyclonal antibodies of negative and positive sera that resulted in the identification of potential bacteriophage-fused peptides that were highly sensitive and specific to antibodies of CVL. A negative selection was performed in which phage clones were adhered to purified IgGs from healthy and Trypanosoma cruzi-infected dogs to eliminate cross-reactive phages. The remaining supernatant nonadhered phages were submitted to positive selection against IgG from the blood serum of dogs that were infected with Leishmania infantum. Phage clones that adhered to purified IgGs from the CVL-infected serum samples were selected. Eighteen clones were identified and their reactivities tested by a phage enzyme-linked immunosorbent assay (phage-ELISA) against the serum samples from infected dogs (n 31) compared to those from vaccinated dogs (n 21), experimentally infected dogs with cross-reactive parasites (n 23), and healthy controls (n 17). Eight clones presented sensitivity, specificity, and positive and negative predictive values of 100%, and they showed no crossreactivity with T. cruzi- or Ehrlichia canis-infected dogs or with dogs vaccinated with two different commercial CVL vaccines in Brazil. Our study identified eight mimotopes of L. infantum antigens with 100% accuracy for CVL serodiagnosis. The use of these mimotopes by phage-ELISA proved to be an excellent assay that was reproducible, simple, fast, and inexpensive, and it can be applied in CVL-monitoring programsThis work was supported by grants from the Pró-Reitoria de Pesquisa of UFMG (supported 03/2013), the Instituto Nacional de Ciência e Tecnologia em Nano-Biofarmacêutica (INCT Nano-Biofar), Rede Nanobiotec/Brasil-UFU (CAPES), PRONEX-FAPEMIG (APQ-01019- 09), FAPEMIG (APQ-00496-11 and APQ-00819-12), and CNPq (APQ- 472090/2011-9 and APQ-482976/2012-8). E.A.F.C. and L.R.G. are recipients of grants from CNPq. M.A.C.-F. is the recipient of a grant from FAPEMIG/CAPE

Aves da Chapada dos Guimarães, Mato Grosso, Brasil: uma síntese histórica do conhecimento

Here we present a historical review of all known ornithological surveys carried out at Chapada dos Guimarães, central-western Brazil. We characterize the avifauna of the region following a critical review of all bird species listed by several generations of ornithologists. The final species account was produced based on extensive literature and museum consultation and on recent field work. Special attention is given to the series of papers by J.A. Allen, which was based on the monumental collecting work by H.H. Smith and his wife on the 19th century. The study area is predominantly characterized by a Cerrado bird assemblage and in a lesser extent, by Amazonian elements. A total of 393 bird species have confident records for the region. Other 52 species were cited for the region, but were judged unlikely to occur in the study area under our stringent criteria. Twenty four species collected by the Smiths are no longer recorded in the region. Six of these species are sensitive grassland specialists, and three are popular cagebirds. These species are probably extinct in the area. Seven species are waterbirds and two are Amazonian species, all of them have probably always been very rare in the region due to the lack of apropriate habitat. Six species are naturally rare, and could be overlooked. We report the first documented record of Caprimulgus longirostris for Mato Grosso and the second record of Pipraeidea melanonota for the state. We also comment on several apparently rare species on the region such as Ictinia mississipensis, Buteo melanoleucus, Harpia harpyja, Megascops usta, Asio flammeus, Berlepschia rikeri, Euscarthmus rufomarginatus, Xenopsaris albinucha, and Poospiza cinerea.É apresentada uma revisão histórica dos inventários ornitológicos conduzidos na Chapada dos Guimarães, centro-oeste do Brasil. A avifauna da região é caracterizada a partir de uma revisão crítica de todas as listas de espécies produzidas por várias gerações de ornitólogos, espécimes depositados em museus e meticulosos trabalhos de campo. Especial atenção foi dada às publicações de J.A. Allen, baseadas na monumental coleção preparada por H.H. Smith e sua esposa no final do século XIX. A avifauna da região é típica do Cerrado, abrigando também espécies amazônicas. Um total de 393 espécies de aves é listado para a região, sendo outras 52 espécies citadas pela literatura consideradas de ocorrência improvável baseado nos critérios restritivos adotados. Vinte e quatro espécies coletadas pelos Smith não foram mais registradas para a região. Seis destas espécies são campestres e bastante sensíveis a alterações antrópicas, enquanto que outras três são perseguidas pelo comércio ilegal de aves. Estas espécies provavelmente se encontram extintas na região. Sete outras espécies associadas a corpos hídricos, e duas de distribuição predominantemente Amazônica, eram provavelmente raras na região, mesmo em tempos históricos, principalmente devido à falta de hábitat adequado. Seis outras são normalmente raras, podendo ter passado despercebidas. São apresentados o primeiro registro documentado de Caprimulgus longirostris para o Mato Grosso e o segundo registro de Pipraeidea melanonota para o estado. Também são discutidos os registros de outras espécies raras na região, tais como Ictinia mississipensis, Buteo melanoleucus, Harpia harpyja, Megascops usta, Asio flammeus, Berlepschia rikeri, Euscarthmus rufomarginatus, Xenopsaris albinucha e Poospiza cinerea