O estudo realizado compreendeu a avaliação pré-clínica e clínica de uma forma farmacêutica de liberação sustentada contendo extrato padronizado de própolis EPP-AF para o tratamento de queimaduras. Utilizamos um polímero com características termorreversíveis que possibilitaram a obtenção de um produto que se mantém na forma líquida quando a baixas temperaturas e geleifica in situ. A forma farmacêutica proposta visa maior comodidade e adesão do paciente, obtenção de um tecido epitelial organizado e menor tempo para a cicatrização da área. Neste trabalho, foi avaliada a atividade antimicrobiana in vitro, do extrato de própolis e dos géis obtidos, através da técnica de difusão em agar e também através do método de microdiluição em microplacas contendo caldo de enriquecimento e o revelador trifeniltetrazólio, frente aos microrganismos S. aureus, M. luteus e P. aeruginosa. O potencial mutagênico foi estudado em modelo experimental utilizando micronúcleos de sangue periférico de ratos wistar. A histologia do tecido formado em lesão induzida com a utilização de um punch para biópsia e a eficácia do produto em pacientes queimados também foram objeto deste estudo. As áreas doadoras foram utilizadas como modelos experimentais. Os resultados demonstraram que o extrato de própolis apresentou atividade frente aos microrganismos pesquisados sendo que os géis não se difundiram em disco. Em microdiluição, o modelo utilizado para estudo da atividade antimicrobiana não foi adequado ao microrganismo M. luteus, mas foi possível a obtenção do CIM para S. aureus e P. aeruginosa, que foram respectivamente, 50 ug/mL e 200 ug/mL. O produto não apresentou potencial genotóxico nos tratamentos agudo, sub-agudo e crônico. A pesquisa clínica demonstrou que o gel termorreversível contendo extrato padronizado de própolis 3,6%p/v apresentou tempo de cicatrização semelhante à pomada contendo nitrofurazona (furacin®), tratamento referência utilizado na Unidade de Queimados do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. / The present paper examines the pre-clinical and clinical evaluation of a pharmaceutical form that provides sustained delivery of a formulation containing standardized propolis extract EPP AF to the treatment of burn wounds. There has been used a polymer with thermoreversible characteristics which made possible the obtaintion of a product that maintains its liquid state in low temperatures and provides in situ gelling property. The proposed pharmaceutical form intends to enhance patients comfort and acceptance, to obtain a histological well-organized skin tissue and to reduce wound healing time. This study evaluated in vitro the antimicrobial activity of propolis extract and obtained gels using the agar-diffusion method and also a broth microdilution method with microdillution in microplates containing serially diluted antimicrobial and triphenilthetrazolium agent, against microorganisms S. aureus, M. luteus e P. aeruginosa, the mutagenic potential using micronuclei of peripheral blood Wistar rats experimental models, the histology of neo-formed tissue induced by lesions done with a punch and the effectiveness of the products in burn patients, using skin-grafting donnor sites like experimental models. The results show that propolis extract has activity against the listed microorganisms and that the gels did not spread into agar medium plate. In the microdilution method, the used model for the antimicrobial activity study is not adequate to the microorganism M. luteus, but it was possible for the obtention of CIM to S. aureus e P. aeruginosa, which were, respectively, 50 ug/mL e 200 ug/mL. The product did not show genotoxic potential to acute, subacute and chronic treatments. The clinical research show that the thermoreversible gel formulation containing standardized propolis extract 3,6%p/v presented wound healing time similar to the reference treatment used in the Burn Victims Unity witch is nitrofurazone cream (furacin®).

A presente pesquisa interessa-se em fazer uma análise aprofundada do Direito nascido com o advento da Modernidade, partindo da hipótese de que o Direito Pós-Moderno, embora se auto-proclame como defensor da diversidade, por ainda estar atrelado àquele modelo de legalidade calcado principalmente no positivismo jurídico, passa por uma grave crise, uma vez que, ao excluir regras costumeiras, elimina na prática muitas das possibilidades de aceitação e inclusão do heterogêneo. A exclusão do diferente, do heterogêneo, do \"outro\" contrário à lógica capitalista se torna ainda mais evidente quando normas jurídicas embebidas de conhecimentos científicos ao serem orientadas a regular comportamentos de grupos sociais regulados por regras costumeiras, acabam por invalidá-las, tornando igualmente inexistentes os saberes tradicionais nelas contidos. A fim de melhor compreender esta problemática, entre os diversos direitos que compõem o espectro da Pós- Modernidade, foi escolhido o direito socioambiental como ícone que integra a tutela da diversidade social, cultural e natural. Para tanto, esta pesquisa pretende, através de um Estudo de Caso, verificar as conseqüências relacionadas à possibilidade da Comunidade Remanescente de Quilombo de Ivaporunduva, cuja diferença é tutelada juridicamente como patrimônio cultural brasileiro, continuar a cultivar seus alimentos de forma tradicional, diante da imposição, em caráter universal e geral, de normas jurídicas ambientais infraconstitucionais, em específico, o Código Florestal e a Lei da Mata Atlântica, ainda portadoras de estudos científicos realizados aos moldes racionalidade moderna. Os procedimentos metodológicos se basearam na obra de Boaventura de Souza Santos. Já as técnicas de coleta de dados que foram aplicadas são: observação e roteiro de entrevista semi-estruturado. A análise dos resultados foi feita por meio da técnica de triangulação de dados. Dos resultados obtidos, constata-se 1) a sustentabilidade da roça de coivara; 2) a diminuição da prática da coivara pela comunidade de Ivaporunduva que contribuiu para a) compra de seus alimentos no supermercado, b) aumento de obesidade e desnutrição nesta população, c) intensificação da agricultura e perda da sustentabilidade do sistema, d) ineficácia jurídica e social das normas jurídicas analisadas. A presente pesquisa não propõe uma conclusão fechada desta temática, mas sugere a necessidade de diálogo de saberes para permissão ou não da prática da agricultura de corte e queima, para que se consiga a partir de uma justiça cognitiva, alcançar a almejada justiça social. / This research aims at developing a thorough analysis of the Right that arose with modernity. Based on the hypothesis that even though Post-Modern Right autodenominates itself the advocate of diversity, it is still tied to the legality model of judicial positivism. The Right is ongoing an important crises, and at the time that eliminates customary rules, eliminates several possibilities of acceptance and inclusion of heterogeneity. The exclusion of \"difference/diversity\", of the \"heterogeneous\", of the \"otherness\", is completely opposite to the capitalist logic. This is even more evident when judicial rules embedded in scientific knowledge are targeted to regulate social groups\' behaviors, and end-up invalidating them and eliminating the traditional knowledge embedded in those customary rules. In order to better understand this issue, this research analyzed the tutelage of social, cultural and natural diversity, by means of socio-environmental right, chosen from several rights that compound post-modernity. In order to do so, this case study verifies the consequences related to the possibility of remnants of Quilombola Community, which \"difference/diversity\" is trusted as a Brazilian Cultural Patrimony, continue cultivating their food in a traditional way, facing the universal and general imposition of infraconstitutional environmental legislation, namely, The Brazilian Forestry Code (Código Florestal Brasileiro) and The Atlantic Rain Forest Law (Lei da Mata Atlântica), constituted from scientific studies based on modern rationality thoughts. The methodology and foundation of this study were Boaventura de Sousa Santos\' theoretical work. The data collection was carried out by means of several techniques, like: observation, and semi-structured interviews. The data analysis was carried out by means of data triangulation. From the results obtained in this study it is possible to verify: 1) the sustainability of slash and burn agriculture according to traditional knowledge; 2) the decrease of slash and burn agriculture practice in Ivaporunduva Community leading to a) purchase of food from local supermarkets, b) increase of obesity and malnutrition in community members, c) agriculture intensification and loss of their system\'s sustainability, d) judicial and social inefficiency of the legislation analyzed in this study. The intention of this research is not to propose a final conclusion of this issue, but to suggest the need of an active dialog between traditional and scientific knowledge in order to determine if slash and burn agriculture will be allowed or prohibited as a practice for this community, looking to achieve by means of a cognitive justice, the long expected social justice.

Com o objetivo de estabelecer as possíveis correlações entre os ácidos orgânicos na precipitação e as alterações no uso do solo, amostras de água da chuva e aerossol foram coletadas nos Parques Estaduais de Intervales (PEI) e Morro do Diabo (PEMD), no Estado de São Paulo, cuja vegetação é formada por florestas pertencentes ao domínio Mata Atlântica. Entre julho de 2002 a julho de 2004 foram coletadas 232 amostras de água de chuva em PEI e 96 amostras em PEMD, determinando-se os teores de formato, acetato, metanosulfonato, piruvato, oxalato, maleato, valerato, citrato, butirato, tartarato, cloreto, nitrato, sulfato, sódio, amônio, potássio, cálcio e magnésio por cromatografia iônica (CI). Também foram determinadas as concentrações de carbono orgânico dissolvido (COD), carbono inorgânico dissolvido (CID) e o pH das amostras. Entre julho de 2002 a maio de 2003, amostras de aerossol inalável (PM10), subdividido nas frações fina (dp < 2,5 µm) e grossa (2,5 < dp < 10 µm), foram coletadas separadamente, totalizando 60 amostras para cada fração no PEMD e 90 amostras para cada fração no PEI, determinando-se as concentrações em massa por gravimetria e a composição química do material solúvel em água por CI. Eventos de chuva ácida ocorreram nos dois locais ao longo do período de amostragem. Os ácidos orgânicos contribuíram com até 16% da somatória iônica (µeq.L-1) no PEI e até 12% no PEMD, com predominância do ácido acético no PEI e com predominância de ácido fórmico no PEMD. A emissão direta da vegetação foi a principal fonte de ácidos orgânicos no PEI, uma vez que a razão entre o ácido fórmico e ácido acético < 1,0. No PEMD, a razão entre ácido fórmico e acético > 1,0 indicou como as principais fontes as reações secundárias de oxidação fotoquímicas no local e a emissão direta biogênica da vegetação. A contribuição dos ácidos orgânicos para a acidez da água da chuva foi de até 40% no PEI e até 30% no PEMD. Adicionalmente, as correlações significantes entre H+ e COD (p < 0,05) sugerem contribuições de compostos orgânicos para acidez da água da chuva. A influência de fontes regionais de queima de biomassa e das condições meteorológicas na composição química da atmosfera no PEMD é evidenciada pela concentração média de PM10 (22 ug.m-3); pela concentração de \"black carbon\" (40 ?g.m-3), superiores às verificadas no PEI, pela maior contribuição da fração fina do aerossol para a concentração de COD da fração solúvel em água. Por outro lado, no PEI, a fração grossa relacionada à compostos biogênicos, aerossol marinho e partículas de solo foi a maior contribuinte para o COD. Dos ácidos orgânicos detectados no aerossol solúvel em água, o ácido oxálico foi o mais abundante. / In order to establish the possible correlations among organic acids in the precipitation and land use changes, rain water and aerosol samples were collected in the State Parks of Intervales (PEI) and Morro do Diabo (PEMD), in the State of São Paulo. The vegetation there is formed by Mata Atlântica forests (Atlantic forest). Between July, 2002 and July, 2004, 232 samples of rainwater were collected in PEI and 96 samples in PEMD, for the analysis of formate, acetate, methanesulfonate, pyruvate, oxalate, malate, valerate, citrate, butyrate, tartarate, chloride, nitrate, sulfate, sodium, ammonium, potassium, calcium, magnesium for ionic chromatography (CI). The concentrations of dissolved organic carbon (COD), dissolved inorganic carbon (CID) and pH of the samples were also determined. Between July, 2002 and May, 2003, samples of inhalable aerosol (PM10), subdivided in fine fraction (dp <2.5 µm) and coarse fraction (2.5 <dp <10 µm), were collected separately, in a total of 60 samples for each fraction in PEMD and 90 samples for each fraction in PEI, submitted to the analyses of concentration in mass through gravimeter and the chemical composition of the water soluble aerosol for CI. Events of acid rain were verified along the sampling period in both places and the organic acids contributed up to 16% of the ionic sum (µeq.L-1) in PEI and up to 12% in PEMD, with predominance of acetic acid in PEI and with predominance of formic acid in PEMD. The direct emission from vegetation was the main source of organic acids in PEI, once the ratio between the formic acid and acetic acid was <1.0 and that the effects of biomass burns are not verified. In PEMD, the ratio among formic and acetic acid >1.0 indicated the secondary reactions of photo-chemical oxidation ?in situ? and biogenic direct emission from the vegetation as the main source. The contribution of the organic acids for the acidity of the rainwater was up to 40% in PEI and up to 30% in PEMD. In addition to the strong correlations between H+ and COD (p <0.05) they suggest contributions of organic compositions for the acidity of the rainwater. The influence of regional sources of biomass burning and of the meteorological conditions in the chemical composition of the atmosphere in PEMD is also observed by the medium concentration of PM10 (22 µg.m-3) and concentration of \"black carbon\" (40 ?g.m-3), both higher than the ones observed in PEI, and for the highest contribution of fine fraction of aerosol for the concentration of COD analyzed from the water soluble fraction. In PEI, the coarse fraction related to biogenic compounds, marine aerosol and soil particles were the greatest responsible agents for COD. Oxalic acid was the most abundant organic acid detected.

"May 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 362-387). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / The objective was to assess the changes promoted in the stocks and flows of C and N from the soil by farming systems agroforestry (agrosilvipasture - AGP and silvipasture - SILV) and traditional (TR), compared to natural vegetation of Caatinga (VN), after 13 years, the experiment was installed on a typical Ortic Chromic Luvisol, the city of Sobral, CearÃ. Soil samples were collected at depths 0-6, 6-12, 12-20, 20-40 and 40-60 cm, relief in four replicates per. Was determined by the total carbon carbon (TOC); total nitrogen (NT) and bulk density. The gas flow was measured using an analyzer in the field of O2, CO2, NO / NO x and SO 2 (UNIGAS Eurotron 3000). To this end, were used for still cameras based on galvanized steel and PVC cover installed in the field. The sampling was done in three replicates, considering the relief plan, convex and concave in each study situation. For each determination were performed triplicate, totaling nine chambers for relief. Soil samples were collected for determination of soil bulk density (Ds) and particle (Dp) and gravimetric moisture (Ug), which allowed the calculation of total porosity (Pt) and the pore space filled with water (EPPA). Among the agroforestry systems studied, the silvipasture, long-term, promoted greater reductions in C stocks and N, the system promoted agrossilvipastroil lower losses and represents a sustainable alternative to sequestration of soil C and N in the Brazilian semi-arid conditions. The traditional cropping system provided a reduction of 58.87 and 9.57 (Mg ha-1), which meant, a reduction of 6.5 and 1.06 (Mg ha-1), for those of TOC and TN, respectively. These results demonstrate the inadequacy of this system for the Brazilian semi-arid conditions. The concave topography (AGP) and flat (SILV) showed the highest values of TOC. For NT the concave shape (VN, AGP, and SILV) showed the highest values. Flows of C-CO2 varied with the time, AGP and SILV being similar to NV in the wet season, while in the dry season are higher. The TR has a different behavior, being higher during the wet season and similar to AGP and SILV in the dry. The flow behavior of NO present without a tendency similar to C-CO2: AGP and SILV presents similar to each other in the wet season, but smaller than VN. During the dry SILV and VN are larger than AGP. In TR NO was not detected in the two periods. The convex shape of relief TR system showed the highest values of C-CO2 fluxes in the wet season. In the dry season were found higher values of C-CO2 flows in AGP, SILV and RT, compared to NV flat terrain. Soil moisture was the variable most correlated with the fluxes of NO, what might be observed in systems SILV and AGP and VN convex reliefs. / Objetivou-se avaliar as alteraÃÃes promovidas nos estoques e fluxos de C e N do solo por sistemas agrÃcolas agroflorestais (Agrossilvipastoril â AGP e Silvipastoril â SILV) e tradicional (TR), comparativamente à vegetaÃÃo natural de Caatinga (VN), apÃs 13 anos, em experimento instalado sobre um Luvissolo CrÃmico Ãrtico tÃpico, no municÃpio de Sobral, CearÃ. Amostras de solo foram coletadas nas profundidades de 0-6, 6-12, 12-20, 20-40 e 40-60 cm, em quatro repetiÃÃes, considerando os relevos plano, convexo e cÃncavo em cada situaÃÃo de estudo. Nestas amostras foram determinados o carbono orgÃnico total do solo (COT), nitrogÃnio total (NT), densidades do solo (Ds) e de partÃcula (Dp) e a umidade gravimÃtrica (Ug), o que possibilitou o cÃlculo da porosidade total (Pt) e o espaÃo poroso preenchido por Ãgua (EPPA). O fluxo dos gases foi quantificado no campo utilizando um analisador de O2, CO2, NO/NOX e SO2 (UnigÃs Eurotron 3000). Para tanto, foram utilizadas cÃmaras estÃticas com base de aÃo galvanizado e tampa de PVC instaladas no campo em triplicatas, totalizando nove cÃmaras por relevo. Entre os sistemas agroflorestais estudados, o silvipastoril, em longo prazo, promoveu maiores reduÃÃes nos estoques de C e N, enquanto que agrossilvipastoril promoveu menores perdas, representando uma alternativa sustentÃvel para o sequestro de C e N do solo nas condiÃÃes semiÃridas brasileira. O sistema de cultivo tradicional (TR) apresentou reduÃÃo no perÃodo 13 anos de 58,87 e 9,57 Mg ha-1 (6,5 e 1,06 Mg ha-1 ano-1) dos estoques de COT e NT, respectivamente, o que comprova a nÃo adequaÃÃo deste sistema para as condiÃÃes semiÃridas brasileiras. Os relevos cÃncavo (AGP) e plano (SILV) apresentaram os maiores valores de estoques de COT, enquanto que para o NT, a forma cÃncava apresentou os maiores valores, no caso VN, AGP e SILV. Os fluxos de C-CO2 variaram com a Ãpoca, sendo AGP e SILV semelhantes à VN no perÃodo Ãmido, enquanto no perÃodo seco estes mesmos sistemas foram maiores. O TR apresenta comportamento diferenciado, sendo maior no perÃodo Ãmido e semelhante ao AGP e SILV no seco. Os fluxos de NO apresentaram comportamento com tendÃncia diferente do C-CO2: AGP e SILV apresentaram-se semelhantes entre si no perÃodo Ãmido, porÃm menores que VN. No perÃodo seco, SILV e VN foram maiores que AGP. No TR, o NO nÃo foi detectado nos dois perÃodos. O relevo convexo no TR apresentou os maiores valores de fluxos de C-CO2 no perÃodo Ãmido. No perÃodo seco foram encontrados maiores valores de fluxos de C-CO2 em AGP, SILV e TR em relaÃÃo à VN no relevo plano. A umidade do solo foi a variÃvel que mais se correlacionou com os fluxos de NO, o que pÃde ser observado nos sistemas SILV e AGP e na VN relevos convexos.

Com o objetivo de estabelecer as possíveis correlações entre os ácidos orgânicos na precipitação e as alterações no uso do solo, amostras de água da chuva e aerossol foram coletadas nos Parques Estaduais de Intervales (PEI) e Morro do Diabo (PEMD), no Estado de São Paulo, cuja vegetação é formada por florestas pertencentes ao domínio Mata Atlântica. Entre julho de 2002 a julho de 2004 foram coletadas 232 amostras de água de chuva em PEI e 96 amostras em PEMD, determinando-se os teores de formato, acetato, metanosulfonato, piruvato, oxalato, maleato, valerato, citrato, butirato, tartarato, cloreto, nitrato, sulfato, sódio, amônio, potássio, cálcio e magnésio por cromatografia iônica (CI). Também foram determinadas as concentrações de carbono orgânico dissolvido (COD), carbono inorgânico dissolvido (CID) e o pH das amostras. Entre julho de 2002 a maio de 2003, amostras de aerossol inalável (PM10), subdividido nas frações fina (dp < 2,5 µm) e grossa (2,5 < dp < 10 µm), foram coletadas separadamente, totalizando 60 amostras para cada fração no PEMD e 90 amostras para cada fração no PEI, determinando-se as concentrações em massa por gravimetria e a composição química do material solúvel em água por CI. Eventos de chuva ácida ocorreram nos dois locais ao longo do período de amostragem. Os ácidos orgânicos contribuíram com até 16% da somatória iônica (µeq.L-1) no PEI e até 12% no PEMD, com predominância do ácido acético no PEI e com predominância de ácido fórmico no PEMD. A emissão direta da vegetação foi a principal fonte de ácidos orgânicos no PEI, uma vez que a razão entre o ácido fórmico e ácido acético < 1,0. No PEMD, a razão entre ácido fórmico e acético > 1,0 indicou como as principais fontes as reações secundárias de oxidação fotoquímicas no local e a emissão direta biogênica da vegetação. A contribuição dos ácidos orgânicos para a acidez da água da chuva foi de até 40% no PEI e até 30% no PEMD. Adicionalmente, as correlações significantes entre H+ e COD (p < 0,05) sugerem contribuições de compostos orgânicos para acidez da água da chuva. A influência de fontes regionais de queima de biomassa e das condições meteorológicas na composição química da atmosfera no PEMD é evidenciada pela concentração média de PM10 (22 ug.m-3); pela concentração de \"black carbon\" (40 ?g.m-3), superiores às verificadas no PEI, pela maior contribuição da fração fina do aerossol para a concentração de COD da fração solúvel em água. Por outro lado, no PEI, a fração grossa relacionada à compostos biogênicos, aerossol marinho e partículas de solo foi a maior contribuinte para o COD. Dos ácidos orgânicos detectados no aerossol solúvel em água, o ácido oxálico foi o mais abundante. / In order to establish the possible correlations among organic acids in the precipitation and land use changes, rain water and aerosol samples were collected in the State Parks of Intervales (PEI) and Morro do Diabo (PEMD), in the State of São Paulo. The vegetation there is formed by Mata Atlântica forests (Atlantic forest). Between July, 2002 and July, 2004, 232 samples of rainwater were collected in PEI and 96 samples in PEMD, for the analysis of formate, acetate, methanesulfonate, pyruvate, oxalate, malate, valerate, citrate, butyrate, tartarate, chloride, nitrate, sulfate, sodium, ammonium, potassium, calcium, magnesium for ionic chromatography (CI). The concentrations of dissolved organic carbon (COD), dissolved inorganic carbon (CID) and pH of the samples were also determined. Between July, 2002 and May, 2003, samples of inhalable aerosol (PM10), subdivided in fine fraction (dp <2.5 µm) and coarse fraction (2.5 <dp <10 µm), were collected separately, in a total of 60 samples for each fraction in PEMD and 90 samples for each fraction in PEI, submitted to the analyses of concentration in mass through gravimeter and the chemical composition of the water soluble aerosol for CI. Events of acid rain were verified along the sampling period in both places and the organic acids contributed up to 16% of the ionic sum (µeq.L-1) in PEI and up to 12% in PEMD, with predominance of acetic acid in PEI and with predominance of formic acid in PEMD. The direct emission from vegetation was the main source of organic acids in PEI, once the ratio between the formic acid and acetic acid was <1.0 and that the effects of biomass burns are not verified. In PEMD, the ratio among formic and acetic acid >1.0 indicated the secondary reactions of photo-chemical oxidation ?in situ? and biogenic direct emission from the vegetation as the main source. The contribution of the organic acids for the acidity of the rainwater was up to 40% in PEI and up to 30% in PEMD. In addition to the strong correlations between H+ and COD (p <0.05) they suggest contributions of organic compositions for the acidity of the rainwater. The influence of regional sources of biomass burning and of the meteorological conditions in the chemical composition of the atmosphere in PEMD is also observed by the medium concentration of PM10 (22 µg.m-3) and concentration of \"black carbon\" (40 ?g.m-3), both higher than the ones observed in PEI, and for the highest contribution of fine fraction of aerosol for the concentration of COD analyzed from the water soluble fraction. In PEI, the coarse fraction related to biogenic compounds, marine aerosol and soil particles were the greatest responsible agents for COD. Oxalic acid was the most abundant organic acid detected.

O paciente grande queimado está entre os de maior risco de contrair infecção hospitalar, sendo que, aproximadamente 80% dos óbitos nestes pacientes são decorrentes de infecção. Devido à prevalência de S. aureus meticilina resistente (MRSA) nas unidades de queimados prescreve-se a vancomicina como fármaco de 1ª linha. Entretanto como a farmacocinética se encontra profundamente alterada geralmente ocorre a falência terapêutica e surgimento de resistência antimicrobiana. O objetivo do presente estudo foi monitorar as concentrações plasmáticas através da análise em CLAE-UV e realizar a modelagem farmacocinética da vancomicina, administrada nestes pacientes. Para tanto, validou-se método analítico que se mostrou linear, preciso, exato e suficientemente sensível para o monitoramento das concentrações plasmáticas da vancomicina nos pacientes. Investigaram-se 9 pacientes adultos grandes queimados após cirurgia de debridamento; os pacientes foram informados em detalhes sobre o estudo e assinaram o TCLE, e incluídos no protocolo. Coletaram amostras sangüíneas seriadas para a farmacocinética (PK solutions 2.0). A estatística descritiva (Microsoft Excell, Office for Windows, versão 2000) forneceu os resultados expressos através da média +/- DP: 16 mg/L±11, para o pico (referência 20-40mg/L) e 2,6 mg/L±1,5 para o vale (referência,5-10mg/L), abaixo da CME nestes pacientes. Os parâmetros farmacocinéticos foram o volume aparente de distribuição que se mostrou aumentado em cerca de 3,5 vezes, (1,4 L/Kg ± 0,8 versus 0,33-0,45L/kg, referência, a depuração plasmática mostrou-se aumentada em cerca de 2,5 vezes (3,2±1,65 mL/min.kg versus 1,3 - 1,5mL/min.kg, referência, enquanto a constate de eliminação e a meia-vida biológica se mantiveram inalteradas. Este estudo indica que o regime posológico e tipo de infusão endovosa devam ser revistos, utilizando a farmacocinética como ferramenta importante. Recomenda-se ainda que a terapia dose ajustada seja baseada no controle terapêutico destes pacientes em todas as fases da internação, principalmente após cada cirurgia de debridamento. / Nosocomial infections shows high incidence in burn patient, and approximately 80% of mortality of them is due to severe infections and sepse. High prevalence of methycilin resistant S. aureus (MRSA) occurs in the intensive care units for burn patients and vancomycin is largely prescribed as first choice drug for severe infections and sepse. In general occurs therapeutic fail, since the pharmacokinetics is altered in these patients and arise the antimicrobial resistance. The main of the present study was to perform therapeutic plasma vancomycin monitoring by HPLC-UV and also PK- modelling after 1g every 12 hours, 1 hour infusion. Bioanalitical method was validated showing good linearity, precision, accuracy, good stability and robustness. Additionally method required 200&#181;L of plasma and showed sensitivity enough for vancomycin plasma monitoring. Nine large burn patients were included in the study after they signed the informed written consent term to participate of the protocol. The follow up was done after debridment surgery. Blood samples were collected from venous catheter at time dose interval to investigate the pharmacokinetics (PK solutions 2.0) and also to determine the peak and trough. Descriptive statistics was performed applying Microsoft Excell, Office for Windows, versão 2000. Data obtained were 16 mg/L±11 peak (reference 20-40mg/L) and 2.6 mg/L±1.5 trough that was lower than MEC since the reference ranges from 5 to 10mg/L). Pharmacokinetic parameters were volume apparent of distribution, that was increased by 3.5 times (1.4 L/Kg ± 0,8 against the reference values 0.33-0.45L/kg), plasma clearance was also increased by 2.5 times (3.2±1.7mL/min.kg versus 1.3 - 1.5mL/min.kg, reference values), while elimination rate constant and biological half-life remained unchanged in those patients. Based on data obtained in the study, author recommends a revision on dose schedule and also concerning intravenous drug infusion using the pharmacokinetics as a powerful tool and the therapeutic plasma vancomycin monitoring for dose adjustments in all phases of the follow up of burn patient, mainly after each surgery debridement.

Public child welfare agencies experience front line worker turnover rates as high as 25% a year. Worker turnover has significant financial costs to agencies, and has been linked to negative outcomes for children in care. Prior research has linked organizational factors, such as organizational climate, culture, and supervisor satisfaction, to turnover intent in child welfare populations. This research uses an empowerment framework to turn to workers directly to answer the question, "What are the organizational factors that lead frontline child welfare workers to stay or leave the agency, and what, then, are the implications for agency administrators?" This study relies upon secondary data of a workforce study conducted by the Child Welfare Partnership at Portland State University's School of Social Work. The data was collected via a pilot internet survey of approximately 400 State-employed Oregon child welfare case workers across all geographic regions in the state, and focuses on workers who plan to leave for preventable reasons. This study explored links between organizational factors and turnover in a sample of Oregon public child welfare workers. This research finds that climate, culture, supervision, and knowledge of the job prior to hire are all significantly correlated with intent to leave. Climate is most significantly correlated to Intent to Leave, and explains 25% of the variance in intent to leave in a regression model. These research findings suggest that agency administrators who are interested in improving worker retention can monitor and address local culture and climate as one tool for increasing workforce stability. Retention may be improved by maintaining an organizational culture and climate that is empowering to workers and that encourages workers to be a part of the change process. Additional implications for the child welfare workforce, social work research, and social work education are discussed.

<p>Being severely burned is a traumatic life event that affects the victim both physically and psychologically. Recovery can be a long process that is dependent in part upon psychological factors, but research in this area is still quite limited. The main aim of the thesis was to explore coping, personality and cognitive processes in long-term and short-term adaptation. The participants were recruited from three separate samples of former and consecutive adult burn patients. </p><p>A questionnaire, the Coping with Burns Questionnaire (CBQ), was developed to retrospectively assess coping. It consisted of six coping factors related in different ways to self-reported health status. Regarding personality, the former patients displayed slightly more Neuroticism than people in general, suggesting an overrepresentation of premorbid neurotic personality traits. Avoidant coping was related to poorer perceived health status, more maladaptive personality traits, and was a strong predictor of psychological symptoms at three months post-burn. Regarding cognitive processes, a moderate attentional bias towards burn-related information was found in the former patients when using the emotional Stroop task. This indicates that the burn may still be an important issue years after the event. Finally, former patients’ reactions to participating in a trauma-related postal survey were investigated. A majority felt that participation was positive or even beneficial, while a small subgroup felt that participation was cumbersome or negative. </p><p>To summarise, although many burn patients adapt well in the long run, the burn may still be a significant theme and the subgroup of Avoidant copers are especially vulnerable. The CBQ seems to be an adequate tool for discerning individuals at risk for poor adjustment. Trauma-related postal questionnaires are well accepted by a majority of former burn patients. Although long-term prospective follow-ups are needed to further validate the results, it is suggested that early screening of psychological factors could be of value in burn care.</p>

Gegenstand der Arbeit ist die Beanspruchungssituation des Pflegepersonals im Krankenhausbereich. Es wird der Frage nachgegangen, mit welchem Verhaltens- und Erlebensmuster Pflegepersonen ihren Anforderungen gegenübertreten und wie sie über die Art und Weise der persönlichen Auseinandersetzung mit den Anforderungen ihre Beanspruchungsverhältnisse mitgestalten.<br><br>Den theoretischen Ausgangspunkt der Arbeit bilden salutogenetisch orientierte Ressourcenmodelle, insbesondere Beckers Modell der seelischen Gesundheit (Becker, 1982, 1986). Nach ihm hängt der Gesundheitszustand einer Person davon ab, wie gut es ihr gelingt, externe und interne Anforderungen mithilfe externer und interner Ressourcen zu bewältigen. Hier knüpft das in der Arbeit im Mittelpunkt stehende diagnostische Instrument AVEM (Arbeitsbezogenes Verhaltens- und Erlebensmuster; Schaarschmidt & Fischer, 1996, 2001) an, das die Erfassung interner Anforderungen und Ressourcen der Person sowie deren Zuordnung zu 4 Verhaltens- und Erlebensmustern gegenüber der Arbeit unter Gesundheits- und Motivationsbezug ermöglicht.<br><br>Mit den Hypothesen wird angenommen, dass in Anbetracht der problematischen Arbeitsbedingungen in der Pflege eine Zurücknahme im Engagement bzw. eine Schutzhaltung vor nicht gewollten und als unangemessen empfundenen Anforderungen sowie wenig beeinflussbaren Bedingungen im Vordergrund stehen. Dort, wo zumindest partiell gesundheitsförderliche und als herausfordernd erlebte Arbeitsbedingungen anzutreffen sind, sollten günstigere Musterkonstellationen auftreten. Wir vermuteten, dass sich die ungünstigen Tendenzen bereits in der Berufsausbildung und in frühen Berufsjahren zeigen. Musterveränderungen in gesundheits- und persönlichkeitsförderlicher Hinsicht sollten durch gezielte Intervention herbeigeführt werden können. Schließlich nahmen wir an, dass die Tätigkeit und die mit ihr verbundenen Anforderungen und Ausführungsbedingungen musterspezifisch wahrgenommen werden.<br><br>Zur Beantwortung der Fragen werden Ergebnisse aus verschiedenen Quer- und Längsschnittuntersuchungen herangezogen, die in Wiener Spitälern und Krankenpflegeschulen, aber auch in deutschen Krankenhäusern durchgeführt wurden. Zu Vergleichszwecken werden Befunde anderer Berufsgruppen dargestellt. Neben dem AVEM wurden weitere Fragebögen zu folgenden Inhalten eingesetzt: Arbeitsbezogene Werte, Erleben von Ressourcen in der Pflegetätigkeit, Belastungserleben und Objektive Merkmale der Arbeitstätigkeit.<br><br>Die Ergebnisse bestätigen die Hypothesen in allen wesentlichen Punkten. Im Vergleich mit anderen Berufsgruppen fallen für die Pflegekräfte deutliche Einschränkungen im Arbeitsengagement auf. In Bezug auf die gesundheitlichen Risikomuster nimmt das Pflegepersonal eine Mittelstellung ein. Die Musterdifferenzierung in der Pflegepopulation lässt die stärksten Unterschiede in Abhängigkeit von der Position erkennen: Je höher die Position, desto größer ist der Anteil des Gesundheitsmusters und desto geringer ist die Resignationstendenz. Die meisten Risikomuster zeigen sich bei den Pflegekräften mit der niedrigsten Qualifikation. Für Pflegeschüler ist ein zeitweiliges starkes Auftreten von resignativen Verhaltens- und Erlebensweisen sowie eine kontinuierliche Abnahme des Engagements kennzeichnend. Dieser Trend setzt sich nach Aufnahme der Berufstätigkeit fort. Nur gezielte intensive personenorientierte Interventionen erwiesen sich als geeignet, Musterveränderungen in gesundheits- und persönlichkeitsförderlicher Hinsicht zu erreichen. Die Tätigkeit und die mit ihr verbundenen Anforderungen und Ausführungsbedingungen werden musterspezifisch wahrgenommen, wobei Personen mit eingeschränktem Engagement bzw. mit einer Resignationstendenz wesentliche Tätigkeitsmerkmale, denen persönlichkeits- und gesundheitsförderliche Wirkung zugesprochen wird, für sich als wenig wichtig beurteilen und sich mehr Defizite im Verhalten gegenüber Patienten bescheinigen.<br><br>Die Ergebnisse verweisen darauf, dass im Pflegeberuf vor allem die Zurückhaltung im Engagement Anlass für eine kritische Betrachtung sein muss. Das Problem "Burnout" stellt sich in seiner Bedeutung relativiert dar. Günstigere Voraussetzungen für die Aufrechterhaltung und Förderung der Gesundheit bestehen dort, wo im konkreten Arbeitsfeld ein erweiterter Tätigkeits- und Handlungsspielraum sowie mehr Verantwortung vorliegen. Diese Befunde stehen in Einklang mit arbeitspsychologischen Ressourcenmodellen. Die Befunde zu den Pflegeschülern verweisen auf teilweise ungünstige Eignungsvoraussetzungen der Auszubildenden und legen nahe, die Angemessenheit der Anforderungen in den Krankenpflegeschulen zu hinterfragen. Hinsichtlich der Möglichkeiten der Veränderung der Muster in gesundheits- und motivationsdienlicher Weise brachten die Ergebnisse zum Ausdruck, dass verhaltensbezogenen Maßnahmen ohne gleichzeitige bedingungsbezogene Interventionen wenig Erfolg beschieden ist. Mit Blick auf die musterspezifische Wahrnehmung der Tätigkeit und der mit ihr verbundenen Anforderungen und Ausführungsbedingungen ist schließlich grundsätzlich festzuhalten, dass arbeitspsychologische Konzepte, die hohen bzw. komplexen Anforderungen und umfangreichen Freiheitsgraden in der Arbeit grundsätzlich persönlichkeits- und gesundheitsförderliche Wirkungen zuschreiben, einer Relativierung durch eine differentielle Perspektive bedürfen. Die vorgefundene Interaktion von Persönlichkeit und Arbeitsbedingungen hat zur Konsequenz, dass Verhaltens- und Verhältnisprävention in untrennbarem Zusammenhang gesehen werden sollten. / The object of this essay is the strain situation of nursing personnel in the hospital sector. We will take a look at the coping capacity of the nursing personnel, the behaviour and experience patterns with which they meet their challenges and how they co-design their present and future strain situations by means of their personal approach to these challenges.<br><br>The theoretic starting points of this work are salutogenetic-oriented resource models, especially Becker's model of mental health (Becker, 1982, 1986). According to him, a person's state of health depends on how well he or she manages to cope with external and internal demands with the help of external and internal resources. The model uses the lack of satisfaction of personal requirements as a source of extraordinary strain. This is where the diagnostic instrument AVEM (Arbeitsbezogenes Verhaltens- und Erlebensmuster [work-related behaviour and experience patterns]; Schaarschmidt & Fischer, 1996, 2001) comes into the picture, which is at the center of work and helps to determine the internal requirements and resources of the person as well as the classification into 4 behaviour and experience patterns compared to working under health and motivation aspects.<br><br>These hypotheses assume that reduced engagement as well as guarding against demands deemed unwanted and inappropriate together with hard to influence conditions are in the foreground when considering the problematic working conditions in the nursing profession.<br><br>More favourable model constellations should occur in areas with partially health-promoting and challenging working conditions. We furthermore assume that the expected unfavourable trends already become apparent during vocational training and the early working years. It should be possible to induce pattern changes from a health and personality promotion point of view by means of targeted intervention. And finally, we assumed that the profession and its related challenges and performance conditions are perceived as patterns.<br><br>In order to answer these questions, we will refer to results from various cross-section and panel studies performed in hospitals and nursing colleges in Vienna but also in German hospitals. The results obtained in other profession groups will be presented for comparison. Besides the AVEM, we applied additional questionnaires dealing with the following contents: work-related values, experiencing resources in the nursing profession, experiencing strain and objective professional features.<br><br>The results confirm the hypothesis in all essential points. Compared to other profession groups in Austria, the nursing profession shows clear restrictions when it comes to work engagement. With respect to the health risk patterns, the nursing profession takes a medial position. The pattern differentiation in the nursing population shows the strongest differences depending on the position: the higher the position, the larger the share of the health pattern and the lower the resignation tendency. Most risk patterns become evident among nursing staff with the lowest qualifications. Nursing students temporarily show strong occurrences of resignation and experience patterns as well as a continuous decline in engagement. This trend continues once the vocational training is completed. Only direct, intensive and person-oriented intervention turned out to be suitable in order to achieve pattern changes with respect to promoting health and personality. In the end it turned out that the profession and its related demands and performance conditions is perceived in a pattern-specific way, whereby especially persons with restricted engagement or a trend towards resignation rate essential work features that are said to promote health and personality as less important for themselves and attribute themselves more deficits in their behaviour towards patients.<br><br>The results indicate that above all restrained engagement must be critically examined in the nursing profession. The "burnout" problem, which is often seen as a central problem, is therefore relative. More favourable prerequisites for maintaining and promoting health are especially given wherever there is extended activity and action scope in the actual working environment together with more responsibility. These results coincide with the recognised work psychology models, which emphasise the effect of resources. The results obtained for nursing students indicate that part of the trainees lacks qualification. However, one also has to question the appropriateness of the demands made in nursing schools. With respect to changing the patterns in a way that suits health and motivation, the results showed that behaviour-related measures are not very successful if there are no condition-related interventions at the same time. Concerning the pattern-specific perception of the profession and its related demands and performance conditions, we conclusively have to ascertain that work psychology concepts, which generally attribute personality and health-promoting effects to high or complex demands and extensive degrees of liberty at work, require relativisation through a differential perspective. As a consequence of the encountered interaction of personality and work conditions, behaviour and condition prevention should be seen in an inseparable context.