Satisfaction of quality of care in a Pediatric Emergency Room

Objective: To evaluate the satisfaction index of pediatric patients' companions in relation to the quality of care provided in an emergency service. Methods: Cross-sectional and descriptive study conducted in a Pediatric Emergency Room of a teaching hospital with participation of 300 companions of pediatric patients. A validated instrument was offered to family members for their evaluation of the emergency service quality. Results: Pediatric patients' companions demonstrated satisfaction with the quality of care provided at the Pediatric Emergency Room. There was a significant statistical difference (p<0.05) in the satisfaction index of family members of children diagnosed with dermatological diseases and who received medications administered via rectal route, and those who sought the service because they considered it a reference or because they did not have health insurance. Conclusion: The family members surveyed are satisfied with the quality of care provided to their children in the emergency room service.Objetivo: Avaliar o índice de satisfação do acompanhante do paciente pediátrico com relação à qualidade do atendimento prestado em um serviço de emergência. Métodos: Pesquisa transversal e descritiva desenvolvida em um Pronto-Socorro Infantil de um hospital universitário, com a participação de 300 acompanhantes dos pacientes pediátricos. Utilizou-se um instrumento validado oferecido aos familiares para avaliar a qualidade do serviço de emergência. Resultados: Os acompanhantes dos pacientes pediátricos demonstraram satisfação com a qualidade de atendimento prestado pelo Pronto-Socorro Infantil. Registrou-se diferença estatística significativa (p<0,05) quanto ao índice de satisfação manifestado pelos familiares das crianças diagnosticadas com doenças dermatológicas, que receberam medicações administradas pela via retal e que procuraram o serviço por considerarem-no como referência ou por não possuírem plano de saúde. Conclusão: Os familiares pesquisados encontram-se satisfeitos no que se refere à qualidade de atendimento prestado às suas crianças no serviço de pronto-socorro.Univ Fed Sao Paulo, Escola Paulista Enfermagem, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Escola Paulista Enfermagem, Sao Paulo, SP, BrazilWeb of Scienc

The Uninvited Host: Goa and the Parties not Meant for its People

Despite its history as a favored destination for hippies from the West in the 1960s and 1970s, present-day party tourism in Goa largely attracts Indian travelers. This is a product of the post-1990s liberalization of the Indian economy, coupled with the exoticization of Goa, which has rendered it a pleasure periphery to the subcontinent. Such difference, and attraction, occurs because, unlike most of the rest of the India that annexed Goa, the region was a Portuguese colony until 1961. Goa’s Lusitanization suggests a more liberal milieu, social gatherings with music and dancing being commonplace culturally, for example. While tourism has become an economic mainstay in Goa, the party economy pays little heed to Goans and their culture, treating the land as a place where fun is paramount and local concerns, including environmental ones, are sidelined

GESTÃO ESTRATÉGICA APLICADA AO COOPERATIVISMO SOLIDÁRIO: UMA ALTERNATIVA DE FORTALECIMENTO PARA OS AGRICULTORES FAMILIARES.

Este estudo teve como objetivo investigar, sob a ótica da administração, a Gestão Estratégica aplicada ao cooperativismo solidário como alternativa de fortalecimento organizacional. A intenção é conhecer as controvérsias a respeito da aplicação de ferramentas de gestão estratégica nos empreendimentos dessa natureza, mantendo suas características essenciais de cooperação, solidariedade e auto-gestão. Para isto buscou-se identificar um modelo de gestão capaz de facilitar o ganho de competitividade ao mesmo tempo em que mantenha as características de solidariedade e cooperação nos empreendimentos solidários. Utilizou-se o estudo de caso como método de pesquisa, tendo como objeto de análise uma pequena cooperativa de agricultores familiares. Onde se fez uma análise de como estão sendo aplicados na prática os princípios e valores dos Empreendimentos de Economia Solidária (EES) na Cooperativa de Agricultores Familiares de Itapuranga – COOPERAFI, bem como de seu modelo de gestão e estrutura organizacional. Analisou-se a aplicabilidade de instrumentos de gestão estratégica nas pequenas cooperativas, concluindo que os mesmos ajudam no desenvolvimento dos cooperados e da organização, sem necessariamente descaracterizar a cooperativa como empreendimento solidário.----------------------------------------------This study it had as objective to investigate, under the optics of the administration, the applied Strategical Management to the solidary cooperativism as an alternative to strengthen organizational. The intention is to know the controversies regarding the application of tools of strategical management in the enterprises of this nature, keeping its essential characteristics of cooperation, solidarity and self management. For this one searched to identify a model of management capable to facilitate the competitiveness profit at the same time where it keeps the characteristics of solidarity and cooperation in the solidary enterprises. The case study was used as research method, having as analysis object a small cooperative of familiar agriculturists. Where if it made an analysis of as they are being applied in practical the principles and values of the Enterprises of Economia Solidária (EES) in the Cooperative of Familiar Agriculturists of Itapuranga - COOPERAFI, as well as of its model of management and organizacional structure. It was analyzed applicability of instruments of strategical management in the small cooperatives, concluding that the same ones help in thedevelopment of the cooperated ones and the organization, without necessarily depriving of characteristics the cooperative as solidary enterprise.Gestão Estratégica, Solidariedade, Agronegócio, Cooperativismo, trategic Management, Solidarity, Agribusiness, Cooperativism, Agribusiness, Industrial Organization,

Nova ocorrência de Corchorus hirtus L. para o Piauí, Brasil

Corchorus hirtus L. belongs to the Malvaceae family, it is commonly found in humid and ruderal environments. The occurrence of this species is recorded in all states of Northeast Brazil, except Piauí. Therefore, the aim of this work is to record the occurrence of the species in an area of Piauí, collected in the county of Oeiras, Riacho Mocha, a region of ​​ecological tension. To portray the geographic distribution of the plant, there were made a morphological characterization with pictures of relevant aspects of the plant's morphology.Corchorus hirtus L. pertence à família Malvaceae, é comumente encontrado em ambientes úmidos e ruderais. A ocorrência desta espécie é registrada em todos os estados do Nordeste do Brasil, exceto Piauí. Portanto, o objetivo deste trabalho é registrar a ocorrência da espécie em uma área do Piauí, coletada no município de Oeiras, Riacho Mocha, uma região de tensão ecológica. Para retratar a distribuição geográfica da planta, foi feita uma caracterização morfológica com fotos de aspectos relevantes da morfologia da planta

Regulamentação do registro de agrotoxicos : abordagem da avaliação da exposição e do risco toxicologico ocupacional

Orientador : Flavio Ailton Duque ZambroneDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: A avaliação da exposição é parte integrante do processo da avaliação do risco à saúde humana requerido para a regulamentação de produtos praguicidas em muitos países. A avaliação do risco toxicológico ocupacional de trabalhadores agrícolas expostos aos praguicidas durante seu manuseio é realizada através de uma abordagem em 3 etapas (tier approach), proposta pela OECD. Através dela, a segurança ocupacional ao produto é quantificada associando-se a avaliação da exposição com os dos dados toxicológicos do produto em consideração. A realização deste processo, na pré- comercialização de praguicidas, é uma primeira medida na prevenção de possíveis danos à saúde humana. A exposição, ou seja, a quantificação do contato do trabalhador com o praguicida, pode ser estimada através de modelos preditivos ou medida através de estudos empíricos. Os modelos preditivos (estimativa da exposição por meio de dados substitutos) são utilizados nas primeiras etapas do processo da avaliação do risco. Durante a avaliação, se o risco calculado for aceitável ¿ for demonstrado existir uma margem de segurança para a exposição -, não é necessário prosseguir na investigação. Porém, se não o for, é requerida pelas autoridades competentes a quantificação da exposição através de estudos empíricos. No Brasil, a legislação dos praguicidas e afins exige apenas uma revisão de sua periculosidade através da avaliação toxicológica, não abordando, portanto, de forma sistemática, o processo da avaliação do risco. As ferramentas e informações para a realização da avaliação do risco toxicológico ocupacional com praguicidas estão disponíveis e seria desejável que fossem discutidas, visando sua realização, para melhorar as condições de segurança no trabalho com praguicidas no país, e a capacitação técnica necessáriaAbstract: The exposure assessment is part of the assessment process of health risk for the regulation of pesticides products in many countries. The toxicological evaluation risk of agricultural workers exposed to pesticides during its use is done through 3 stages (tier approach) proposed by the OECD. It is through this evaluation that the security of the product is verified associated with the evaluation of the exposure with its toxicological information. The realization of this process in the pre-commercialization of pesticides is the first stage in the prevention of possible health risk. The exposure, or better the quantity and quality relation of the workers contact with the pesticide, can be estimated through predictable models or through empirical studies. The predictable models (estimate exposure through surrogate data) are used in the first stage of the evaluation process of the risk. During this assessment, if the risk calculated is acceptable, with a good safety margin for the exposure, no further investigation takes place. But on the other hand if the risk calculated is not accepted than the authority requires an empirical study to be made as to the exposure of the product. In Brazil, the legislation of the pesticides and derivates requires only a revision of its hazards through a toxicological evaluation and not its risk assessment. The tools and information for the execution of the process are available and it would be good if they were discussed towards its realization and capabilitiesMestradoSaude ColetivaMestre em Saude Coletiv

Ghrelin and growth hormone secretagogues (GHS): modulation of growth hormone secretion and therapeutic applications

Growth hormone-releasing hormone (GHRH) and somatostatin modulate growth hormone (GH) secretion. A third mechanism was discovered in the last decade, involving the action of growth hormone secretagogues (GHS). Ghrelin, the endogenous ligand of the GHS-receptor, is an acylated peptide mainly produced by the stomach, but also synthesized in the hypothalamus. This compound increases both GH release and food intake. Endogenous ghrelin might amplify the basic pattern of GH secretion, optimizing somatotroph responsiveness to GHRH, activating multiple interdependent intracellular pathways. However, its main site of action is the hypothalamus. In the current paper it is reviewed the available data on the discovery of this peptide, the mechanisms of action and possible physiological roles of the GHS and ghrelin on GH secretion, and finally, the possible therapeutic applications of these compounds.A secreção do hormônio de crescimento (GH) é modulada pelo hormônio liberador de hormônio de crescimento (GHRH) e pela somatostatina. Na última década foi descoberto um terceiro mecanismo de controle, envolvendo os secretagogos de GH (GHS). A ghrelina, o ligante endógeno do receptor dos GHS, é um peptídeo acilado produzido no estômago, que também é sintetizado no hipotálamo. Este peptídeo é capaz de liberar GH, além de aumentar a ingesta alimentar. A ghrelina endógena parece amplificar o padrão básico de secreção de GH, ampliando a resposta do somatotrofo ao GHRH, estimulando múltiplas vias intracelulares interdependentes. Entretanto, seu local de atuação predominante é o hipotálamo. Neste trabalho, será apresentada revisão sobre a descoberta da ghrelina, os mecanismos de ação e o possível papel fisiológico dos GHS e da ghrelina na secreção de GH e, finalmente, as possíveis aplicações terapêuticas destes compostos.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL

Soroprevalência da Hepatite C e fatores associados em usuários de crack

OBJETIVO: investigar la seroprevalencia de la Hepatitis C en usuarios de crack del estado de Piauí. Método: se trata de una investigación seroepidemiológico, desarrollado en los Centros de Atención Psicosocial Alcohol y Drogas de Piauí entre diciembre del 2011 y mayo del 2012. Fue aplicado formulario y colectada muestra sanguínea para investigación serológica. Fue utilizado el test exacto de Fisher y de Mann-Whitney con nivel de significancia (pOBJETIVO: investigar a soroprevalência da Hepatite C em usuários de crack do Estado do Piauí. MÉTODO: trata-se de um inquérito soroepidemiológico, desenvolvido nos Centro de Atenção Psicossocial Álcool e Drogas do Piauí, nos meses de dezembro de 2011 a maio de 2012. Aplicou-se formulário e coletou-se amostra sanguínea para pesquisa sorológica. Utilizou-se o teste exato de Fisher e de Mann-Whitney com nível de significância pOBJECTIVE: to investigate the seroprevalence of hepatitis C in crack users in Piauí. METHOD: seroepidemiological survey, undertaken in the Psycho-Social Care Centers for Drugs and Alcohol (CAPS AD) in Piauí in the period December 2011 to May 2012. A questionnaire was administered and blood samples were collected for serological research. Fisher's exact test and the Mann-Whitney test were used, with a level of significance of (

Increased Frequency of CD4 and CD8 Regulatory T Cells in Individuals under 15 Years with Multibacillary Leprosy

Background: Leprosy is a chronic disease, caused by Mycobacterium leprae, which poses a serious public health problem worldwide. Its high incidence in people under 15 years old in Ceara state, Brazil, reflects the difficulty of its control. the spectrum of clinical manifestations is associated with the immune response developed, with the Th1 and Th2 responses being related to the paucibacillary and multibacillary forms, respectively. Regulatory T cells (Treg), which can suppress Th1 and Th2 response, have received special attention in the literature and have been associated with development of chronic infections. However, their role in leprosy in individuals under 15 years old has not yet been elucidated. We evaluated the frequency of CD4(+)/CD8(+)CD25(high)FOXP3(+) and CD4(+)/CD8(+)CD25(high)FOXP3(high) cells in leprosy patients and household contacts, in both cases under 15 years old.Methodology/Principal Findings: PBMC from 12 patients and 17 contacts were cultured for 72 hours with anti-CD3 and anti-CD28 (activators) or with activators associated with total sonicated fraction of M. leprae. After culture, the frequency of CD4(+)/CD8(+) Treg was identified by flow cytometry. Cells stimulated by activators and antigen from multibacillary patients showed Treg frequencies almost two times that of the contacts: CD4(+)FOXP3(+) (21.93 +/- 8.43 vs. 13.79 +/- 8.19%, p = 0.0500), CD4(+)FOXP3(high) (10.33 +/- 5.69 vs. 5.57 +/- 4.03%, p = 0.0362), CD8(+)FOXP3(+) (13.88 +/- 9.19 vs. 6.18 +/- 5.56%, p = 0.0230) and CD8(+)FOXP3(high) (5.36 +/- 4.17 vs. 2.23 +/- 2.68%, p = 0.0461). Furthermore, the mean fluorescence intensity of FOXP3 in Treg was higher in multibacillary patients than in the contacts. Interestingly, there was a positive correlation of the bacillary index and number of lesions with the frequency of all Treg evaluated in patients.Conclusions/Significance: We have demonstrated for the first time that multibacillary leprosy patients under 15 years old have greater CD4(+) and CD8(+) Treg frequencies and these correlate with clinical and laboratorial aspects of disease. These findings suggest the involvement of these cells in the perpetuation of M. leprae infection.Fundacao Cearense de Apoio ao Desenvolvimento Cientifico e TecnologicoPost-Graduation Program in Medical MicrobiologyUniv Fed Ceara, Dept Pathol & Legal Med, Med Lab Immunol, Fortaleza, Ceara, BrazilDermatol Ctr Dona Libania, Fortaleza, Ceara, BrazilWalter Cantidio Univ Hosp, Fortaleza, Ceara, BrazilUniv Fortaleza, Fortaleza, Ceara, BrazilUniversidade Federal de São Paulo, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, São Paulo, BrazilWeb of Scienc

Identification and evaluation of new reference genes in Gossypium hirsutum for accurate normalization of real-time quantitative RT-PCR data

<p>Abstract</p> <p>Background</p> <p>Normalizing through reference genes, or housekeeping genes, can make more accurate and reliable results from reverse transcription real-time quantitative polymerase chain reaction (qPCR). Recent studies have shown that no single housekeeping gene is universal for all experiments. Thus, suitable reference genes should be the first step of any qPCR analysis. Only a few studies on the identification of housekeeping gene have been carried on plants. Therefore qPCR studies on important crops such as cotton has been hampered by the lack of suitable reference genes.</p> <p>Results</p> <p>By the use of two distinct algorithms, implemented by <it>geNorm </it>and <it>NormFinder</it>, we have assessed the gene expression of nine candidate reference genes in cotton: <it>GhACT4, GhEF1α5, GhFBX6, GhPP2A1, GhMZA, GhPTB, GhGAPC2, GhβTUB3 </it>and <it>GhUBQ14</it>. The candidate reference genes were evaluated in 23 experimental samples consisting of six distinct plant organs, eight stages of flower development, four stages of fruit development and in flower verticils. The expression of <it>GhPP2A1 </it>and <it>GhUBQ14 </it>genes were the most stable across all samples and also when distinct plants organs are examined. <it>GhACT4 </it>and <it>GhUBQ14 </it>present more stable expression during flower development, <it>GhACT4 </it>and <it>GhFBX6 </it>in the floral verticils and <it>GhMZA </it>and <it>GhPTB </it>during fruit development. Our analysis provided the most suitable combination of reference genes for each experimental set tested as internal control for reliable qPCR data normalization. In addition, to illustrate the use of cotton reference genes we checked the expression of two cotton MADS-box genes in distinct plant and floral organs and also during flower development.</p> <p>Conclusion</p> <p>We have tested the expression stabilities of nine candidate genes in a set of 23 tissue samples from cotton plants divided into five different experimental sets. As a result of this evaluation, we recommend the use of <it>GhUBQ14 </it>and <it>GhPP2A1 </it>housekeeping genes as superior references for normalization of gene expression measures in different cotton plant organs; <it>GhACT4 </it>and <it>GhUBQ14 </it>for flower development, <it>GhACT4 </it>and <it>GhFBX6 </it>for the floral organs and <it>GhMZA </it>and <it>GhPTB </it>for fruit development. We also provide the primer sequences whose performance in qPCR experiments is demonstrated. These genes will enable more accurate and reliable normalization of qPCR results for gene expression studies in this important crop, the major source of natural fiber and also an important source of edible oil. The use of bona fide reference genes allowed a detailed and accurate characterization of the temporal and spatial expression pattern of two MADS-box genes in cotton.</p