Made available in DSpace on 2012-05-07T14:40:37Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 000009.pdf: 10930205 bytes, checksum: 4adfda0171bec85ac94d9251a429a8eb (MD5) Previous issue date: 2007 / A exacerbação da atividade pestosa no início dos anos 1960 e o desconhecimento de aspectos da epidemiologia levaram o Governo Brasileiro, através do Departamento Nacional de Endemias Rurais (DNERu), a convidar Marcel Baltazard, do Instituto Pasteur de Paris, para elaborar um projeto de pesquisa visando a elucidação da conservação, focalização, epizootização e epidemização da peste no Brasil, com vistas à implementação de atividades eficazes de controle. O projeto, denominado Plano Piloto de Peste em Exu, foi executado na Chapada do Araripe-PE de 1966 a 1974. Apesar de toda a sorte de óbices, dificultando o desempenho da equipe, composta basicamente por dois técnicos brasileiros, auxiliares semi-analfabetos e consultores dos Institutos Pasteur de Teerã e de Paris, foi desenvolvido um amplo programa de pesquisas elucidando a maioria das questões propostas. A compilação das atividades jamais foi publicada, mas registros isolados permitem listar os principais resultados obtidos: a) a comprovação da infecção natural de roedores silvestres e de outros pequenos mamíferos e suas pulgas; b) o papel do Bolomys lasiurus (Zygodontomys lasiurus pixuna) na epizootização; c) a capacidade vetora da Polygenis bolhsi jordani e o seu papel na transmissão da infecção ao homem, com um desempenho superior aos de Xenopsylla cheopis e Pulex irritans; d) a participação da P. irritans na epidemização; e) a sensibilidade dos sigmodontinos e equimídeos e a relativa resistência do Ratus rattus; f) a resistência dos cavídeos, decorrente da sua asparaginasemia; g) a resistência da X. cheopis e P. irritans aos inseticidas organoclorados; h) o descarte das pestes endógena e crônica como mecanismos responsáveis pela conservação; i) a redução dos prazos para confirmação diagnóstica; j) o isolamento de 719 cepas, que deram origem à maior coleção brasileira de culturas de Yersinia pestis; k) a definição de um programa de controle baseado na vigilância contínua e sistemática, privilegiando a participação comunitária e contemplando a pesquisa da Y. pestis nos roedores e suas pulgas e pesquisa de anticorpos contra o antígeno F1 em animais-sentinela, o que ensejou a estruturação de uma rede nacional de laboratórios, bem como a intervenção imediata nas ocorrências, com diagnóstico precoce, pronto tratamento, quimioprofilaxia e despulização

<p>The researcher has been working for CIAT, as a community development facilitator and research assistant for past five years (2001-2006). CIAT has been involved in testing tools and methods for promoting participation and tracking changes at community level under different pilot projects in Eastern and Central Africa in partnership with national research organizations of respective countries. One of CIAT&rsquo / s areas of research is developing participatory monitoring and evaluation systems that are appropriate for rural communities. The researcher has been involved in designing and setting up community-driven participatory monitoring and evaluation systems on a pilot basis with communities in Eastern and Southern Africa.</p>

<p>The researcher has been working for CIAT, as a community development facilitator and research assistant for past five years (2001-2006). CIAT has been involved in testing tools and methods for promoting participation and tracking changes at community level under different pilot projects in Eastern and Central Africa in partnership with national research organizations of respective countries. One of CIAT&rsquo / s areas of research is developing participatory monitoring and evaluation systems that are appropriate for rural communities. The researcher has been involved in designing and setting up community-driven participatory monitoring and evaluation systems on a pilot basis with communities in Eastern and Southern Africa.</p>

Magister Artium - MA / The researcher has been working for CIAT, as a community development facilitator and research assistant for past five years (2001-2006). CIAT has been involved in testing tools and methods for promoting participation and tracking changes at community level under different pilot projects in Eastern and Central Africa in partnership with national research organizations of respective countries. One of CIAT&rsquo;s areas of research is developing participatory monitoring and evaluation systems that are appropriate for rural communities. The researcher has been involved in designing and setting up community-driven participatory monitoring and evaluation systems on a pilot basis with communities in Eastern and Southern Africa. / South Africa

The purpose of this study was to provide an in-depth explanation of the development of coordinated services during the last four years at a selected number of Project Success pilot sites, and to identify critical factors that emerged which are associated in the literature with effective school-linked strategies. The research questions guiding this study were: (1) What common elements developed that crossed all selected sites, and what individual differences emerged among the sites? (2) What organizational structure emerged among the multi-agencies at the selected sites? (3) What collaborative processes emerged across selected sites that facilitated the project? (4) In what ways did parents become involved in the implementation of the project? (5) What barriers or support were encountered in establishing and operating the sites? The data collection for this study occurred in three parts: individual interviews with the Project Coordinators, focus group interviews with appropriate representatives of the pilot site projects, and notes from meetings of the Local Governing Board. A questionnaire that consisted of seven questions was used to collect data for this study. Materials gathered during in-depth interviews were transcribed and analyzed after the interviews were completed. First, the researcher read the transcribed interviews and hand coded the consistencies and emerging themes on a large chart. Second, a matrix was made of the hand coded data using a word processor. Third, the researcher used the Ethnograph Computer Software Program to organize and code the data. From this data, the researcher identified themes, common patterns, and important stories shared by the participants regarding their experiences with developing coordinated services to meet the needs of children and families during the last four years. A narrative summary was written for each selected pilot site. Recommendations for further research are provided at the conclusion of chapter five. / Ed. D.

Žemės konsolidacijos metu vyksta kompleksinis visos teritorijos pertvarkymas, atsižvelgiant į vietovės ypatumus, kaimo bendruomenės, žemės savininkų ekonominius interesus ir aplinkosaugos rekomendacijas. Šiuo metu teritorija, kurioje galėtų būti rengiami konsolidacijos projektai, yra daugiau nei 2500 tūkst. ha privačios žemės ūkio paskirties žemės, kuri priklauso apie 300 tūkst. žemės savininkų. 2000 – 2003 metais Lietuvoje vyko keturi bandomieji žemės konsolidacijos projektai, kurie leido įvertinti esamą padėtį Lietuvoje – išryškino šalies specifiką bei teisės aktų trūkumus. Šie bandomieji žemės konsolidacijos projektai buvo atlikti remiantis užsienio ekspertų patirtimi, kurie stengėsi savo šalių patirtį pritaikyti Lietuvos sąlygomis. Darbe išanalizuoti bandomųjų ir šiuo metu atliktų žemės konsolidacijos projektų rezultatai ir išryškinti jų privalumus bei trūkumus. Bandomuosiuose projektuose dalyvavo tik 28% žemės savininkų, iš galėjusių dalyvauti. Kaimo plėtros priemonės įgyvendintos tik dalinai Pabaisko ir Puskelnių projektų teritorijose, nors savininkai visuose projektuose pageidavo tokių plano sprendinių. Viena iš pagrindinių priežasčių, kodėl nebuvo įgyvendintos subalansuotos kaimo plėtros priemonės – atskiras finansavimas tik žemės konsolidacijos projektams. 2007 – 2008 metais Lietuvoje buvo įgyvendinta 14 žemės konsolidacijos projektų Telšių, Tauragės, Marijampolės ir Panevėžio apskrityse. Šie projektai skyrėsi ir savo dydžiu (nuo 133 iki 670 ha), ir pasiektais... [toliau žr. visą tekstą] / Land consolidation is a complex territory rearrangement taken into account local peculiarities, rural community and land owners economical and environmental recommendations. Today the area for available land consolidation projects is more than 2500 thousands ha of private agricultural land, which includes more than 300 thousands owners. Four pilot land consolidation projects were accomplished during 2000 – 2003. These projects estimated situation in Lithuania, showed specific features of country and required legal base for land consolidation. The article analyses the results of pilot projects. Only 28% of land owners took participation in pilot land consolidation projects. Means of rural development were implemented partly only in Pabaiskas and Puskelniai projects, although owners asked for these means in all projects. One of the main reasons for this is separate financing for land consolidation projects and rural development measures. 14 land consolidation projects were implemented during 2007 – 2008 in Telšių, Tauragės, Marijampolės and Panevėžio counties. These projects varied by size (from 133 to 670 ha) and results. First land consolidation projects were implemented in counties, where farm size is greater than average in Lithuania and dominate 10 – 50 ha farms. Accomplished regression analysis shows, that there is a strong relations between project area and implementation costs. Larger projects are more efficient and less costly. The costs of project implementation... [to full text]

Medicines management services provided by community pharmacists have been proposed as one means to ensure that patients receive all the medicines they may benefit from in the English National Health Service. These services may also offer ways of addressing the historic under-utilization of community pharmacists' clinical skills and expertise. Medicines management services differ significantly from the dispensing and medicines sales roles traditionally associated with community pharmacy, particularly in relation to the provision for pharmacists to make recommendations to both patients and doctors about pharmacological treatment and lifestyle management. This paper describes patients' experiences of a medicines management service provided by community pharmacists for people with coronary heart disease, delivered in England. It draws on findings from semistructured, face-to-face interviews with 49 patients recruited from pilot sites delivering the service. Findings suggest that although patients cautiously welcomed the opportunity to consult with a pharmacist about their medicines, they had reservations about them making recommendations about treatment, and many still regarded the doctor as the health professional 'in charge' of their medicines. The implications of these findings are discussed in light of the developing sociological literature on pharmacy and medicines usage.

Thesis (M.S.)--Medical University of Ohio, 2006. / "In partial fulfillment of the requirements for the degree of Master of Science in Occupational Health." Major advisor: Sheryl Milz. Includes abstract. Document formatted into pages: iv, 110 p. Title from title page of PDF document. Bibliography: pages 72-86.

OBJECTIVE: Because training in pediatric disaster medicine (PDM) is neither required nor standardized for pediatric residents, we designed and integrated a PDM course into the curriculum of a pediatric residency program and assessed if participation increased participants' knowledge of managing disaster victims. METHODS: We adapted and incorporated a previously studied PDM course into a small-sized pediatric residency program. The curriculum consisted of didactic lectures and experiential learning via simulation with structured debriefing. With IRB approval, the authors conducted a longitudinal series of pretests and posttests to assess knowledge and perceptions. RESULTS: Sixteen eligible residents completed the intervention. Before the course, none of the residents reported experience treating disaster victims. Pairwise comparison of scores revealed a 35% improvement in scores immediately after completing the course (95% confidence interval, 22.73%-47.26%; P < 0.001) and a 23.73% improvement 2 months later (95% confidence interval, 7.12%-40.34%; P < 0.01). CONCLUSIONS: Residents who completed this course increased their knowledge of PDM with moderate retention of knowledge gained. There was a significant increase in perceived ability to manage patients in a disaster situation after this educational intervention and the residents' confidence was preserved 2 months later. This PDM course may be used in future formulation of a standardized curriculum.

INTRODUÇÃO: O tratamento cirúrgico em pacientes com neoplasias de cabeça e pescoço envolve a abordagem de uma região de anatomia complexa. São procedimentos cirúrgicos prolongados e com grandes riscos de complicações pós-operatórias. Dentre os tipos de complicações, as de origem respiratória estão entre as mais descritas na literatura. A fisioterapia respiratória pré-operatória, além de identificar pacientes com função pulmonar comprometida, pode otimizar e tratar as disfunções respiratórias apresentadas. Este estudo teve por objetivo avaliar a viabilidade e os resultados da aplicação de duas abordagens de fisioterapia respiratória pré-operatória em pacientes candidatos à cirurgia de grande porte em pacientes com câncer de cabeça e pescoço, com presença de traqueostomia e esvaziamento cervical, bem como correlacionar aspectos nutricionais, cirúrgicos e do período pós-operatório com o desfecho das complicações respiratórias observadas no período pós-operatório. MÉTODOS: Os pacientes selecionados realizaram avaliação respiratória, por meio da espirometria e manuvacuometria, e avaliação nutricional. Os pacientes foram submetidos a fisioterapia pré-operatória, fases: 1) Estímulos para drive respiratório efetivo e umidificação das vias aéreas nos dois primeiros dias; 2) treinamento muscular respiratório com carga linear pressórica (Grupo A), ou casos em que foram realizados as fases 1 e 2 do Grupo (A); acrescido da fase 3) fortalecimento muscular de quadríceps (Grupo B). Um terceiro grupo, denominado observação, foi composto por pacientes que realizaram a cirurgia de grande porte, porém não preencheram os critérios de inclusão (Grupo C). Durante o período pós operatório, os pacientes receberam a terapia padrão da instituição. Dados como tempo cirúrgico, internamento em Unidade de Terapia Intensiva e enfermaria, e uso de ventilação mecânica no período pós-operatório foram coletados. Os pacientes foram monitorados por 30 dias quando ao surgimento de complicações respiratórias. RESULTADOS: Foram incluídos para análise 10 pacientes no Grupo (A), 10 no Grupo (B) e 12 no Grupo (C). Em relação a resposta à fisioterapia no Grupo (A), houve aumento de todas as médias dos valores de espirometria de CVF, VEF1, FEF25/75, VVM e PFE, e pequena queda dos valores de PImáx e PEmáx, mas os dados não foram considerados significativos (p > 0,05). Em relação à resposta a fisioterapia no Grupo (B), houve aumento das médias dos valores de CVF, VEF1 e VVM, e pequena queda dos valores de FEF25/75, PFE e dos valores de PImáx e PEmáx, mas os dados também não foram considerados significativos (p > 0,05). Dos 32 pacientes da amostra, somente 3 desenvolveram complicações respiratórias no período pós-operatório, totalizando uma taxa de complicação de 9,4%, sendo um paciente de cada um dos Grupos (A), (B) e (C). Todos os pacientes da amostra final (N=20) conseguiram realizar a série completa proposta neste trabalho. Em nenhum dos pacientes dos Grupos (A) e (B) foram observados efeitos adversos, como quadro álgico ou fadiga, ao término da realização da fisioterapia. CONCLUSÃO: As duas abordagens de fisioterapia pré-operatória utilizadas no estudo foram viáveis e seguras, no entanto o tamanho da amostra é pequeno. Conclusões definitivas podem ser obtidas em um estudo prospectivo randomizado / INTRODUCTION: Surgical treatment in patients with neoplasms of the head and neck involves an approach of a region of complex anatomy, the surgical procedures are lengthy and there is a great risk of postoperative complications. Among the types of complications, those of respiratory origin are among the most reported in the literature. Preoperative respiratory therapy can optimize and treat respiratory dysfunctions. This study aimed to evaluate the feasibility and results of the application of two approaches to preoperative respiratory physiotherapy for candidates to major surgery for head and neck cancer. The impact of presence tracheostomy and neck dissection, as well impact of nutritional aspects were analysed a risk for respiratory complications in the postoperative period. METHODS: Selected patients performed respiratory assessment, through the application of spirometry, manuvacuometry and nutrition. The patients were underwent preoperative physiotherapy phases: 1) Stimuli for effective respiratory drive and humidification airways in the first two days; 2) respiratory muscle training with linear load pressure, (Group A), patients were underwent phases 1 and 2 in Group (A) plus phase 3) strengthening of the quadriceps muscle (Group B), a third group was composed of patients who underwent major surgery, but did not fill the inclusion criteria (Group C). During the postoperative period, patients received the standard therapy of the institution. Data as surgical time, and hospitalization in the intensive care unit and ward, and mechanical ventilation in the postoperative period were collected. Patients were monitored for 30 days to detect respiratory complications. RESULTS: There were 10 patients for analysis Group (A), 10 Group (B) and 12 in Group (C). Regarding the response to physical therapy to Group A, an increase of all the mean values of spirometry for FVC, FEV1, FEF25 / 75, MVV e PEF, and small decreases in MIP and MEP but was not considered significant (p > 0.05). Regarding the response to physical therapy in Group (B), an increase of mean values of FVC, FEV1 and MVV, and small decreases in FEF25 / 75, PFE and MIP and MEP, but the data were not considered significant (p > 0,05). Of the 32 patients in the sample, only 3 developed respiratory complications in the postoperative period, a total complication rate of 9.4%, one patient of each Group (A), (B) and (C). All patients in the final sample (N = 20) were able to perform the full range proposed in this paper. In none of the patients in Groups (A) and (B) was observed adverse effects such as fatigue or pain status at the end of the preoperative physical therapy.CONCLUSION: The two approaches used in this study was safe and feasible. However, the sample size was small and definitive conclusions as only be taken by a randomized prospective study