Zugl.: Giessen, Universiẗat, Diss., 2008.

Resumo: A humanização é vista como um conjunto complexo de atitudes e ações motivadas por pensamentos éticos, humanísticos, sociais e holísticos. Hoje, a proposta de humanização em UTI tem um horizonte mais amplo, englobando desde o ambiente físico até as relações entre as equipes de saúde. Dessa forma, valorizar a presença de acompanhantes na instituição hospitalar e apreender sua percepção é um processo fundamental para o alcance de uma prática assistencial realmente humanizada. Assim, esse estudo tem o objetivo de analisar a percepção do acompanhante de pacientes que estão em processo de hospitalização, na busca da assistência humanizada em Unidade de Terapia Intensiva. É uma pesquisa de abordagem qualitativa, sendo entrevistados os acompanhantes nas UTIs pediátrica e coronariana do HC da Faculdade de Medicina de Botucatu - UNESP. Os depoimentos foram analisados através da Técnica de Análise de Conteúdo proposta por Bardin (96). As categorias identificadas foram: acolhimento e ambiente da UTI: estrutura física e profissionais de saúde. As percepções dos familiares em ser acompanhante refletem uma não diferenciação em ser acompanhante e ser visitante, porém enfatizam que a presença da família, mesmo nos horários de visitas, auxilia na recuperação do paciente, como também os tranqüilizam. Os acompanhantes consideram as informações fornecidas pelos profissionais de saúde, adequadas e verdadeiras. O atendimento das unidades é percebido como satisfatório, porém revelam ser necessário um repensar sobre as normas e rotinas das unidades, principalmente em relação aos horários de visitas. A percepção sobre acomodação reflete a possibilidade de estar próximo ao paciente, porém revelam a dificuldade por não ter um local apropriado para se acomodar que se localize próximo a UTI. Percebem ainda... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Humanization is viewed as a set of complex attitudes and actions motivated by ethical, humanistic, social and holistic thoughts. Today, the proposal of humanization at ICUs has a broader horizon which includes the physical environment as well as relations between health care teams. Hence, valuing the presence of companions in hospitals and apprehending their perceptions is a fundamental process for accomplishing an actually humanized care provision practice. Therefore, this study aimed at analyzing the perceptions of companions of patients undergoing the hospitalization process in the search for humanized care at an Intensive Care Unit. It is a qualitative study in which companions of patients hospitalized at the pediatric and coronary ICUs of the Botucatu School of Medicine University Hospital - UNESP were interviewed. The reports were analyzed through the Content Analysis Technique proposed by Bardin (96). The identified categories were: patient reception and the ICU enviroment - physical structure and health care professionals. Family members' perceptions of being companions reflected a non-differentiation between being a companion and being a visitor; however, they emphasized that the presence of relatives, even if only at visiting hours, helped patients' recovery as well as made them calm. Companions considered the information provided by health care professionals to be adequate and truthful. The care given at the units was perceived as satisfactory although the respondents reported the need to reconsider the units' rules and routine, especially as concerns visiting hours. The perception concerning acommodation reflected the possibility of being close to the patient; however, they revealed the difficulty of not having an appropriate accomodation area near the ICU. They also perceived that the University Hospital... (Complete abstract click electronic access below) / Orientador: Maria de Lourdes da Silva Marques Ferreira / Coorientador: Ione Correa / Banca: Ilda de Godoy / Banca: Maria José Sanches Marin / Mestre

Infection & Immunity / Currently, there are 38 million people living with human immunodeficiency virus (HIV-1) worldwide and there were 680,000 HIV-related deaths in 2020 alone. The greatest cause of mortality in people living with HIV (PLHIV) is infection with opportunistic pathogens such as tuberculosis (TB), which accounts for one third of HIV-related deaths. PLHIV are 20 times more susceptible to TB and co-infection leads to significantly worsened outcomes in terms of both diseases. Humanized mouse (hu-mouse) models, which possess human immune cells for HIV to infect, have been useful for HIV research. Our aim is to create hu- mouse models of HIV, TB and co-infection to investigate disease progression, immune responses, therapeutics, prevention and vaccination. NOD-Rag1null-IL2rgnull (NRG) mice are highly immunocompromised mice that are traditionally used to generate hu-mouse models. We are also developing NRG mice that are transgenic for human HLA-DR4 and HLA-A2 (DRAG-A2) and similar mice have been reported to have improved immune responses. NRG and DRAG-A2 mice were humanized with hematopoietic stem cells obtained from human umbilical cord blood. DRAG-A2 mice had significantly higher engraftment success rates (defined as the percentage of mice with >10% hCD45+) as well as higher overall CD45+ leukocyte, CD4+ T cell, CD19+ B cell and CD14+ monocyte reconstitution in the blood compared to huNRGs. huNRG mice were permissive to infection with JR-CSF or NL4.3-Bal-Env HIV-1 intravaginally or systemically. huDRAG-A2 mice were also infected intravaginally with NL4.3-Bal-Env HIV-1. huDRAG-A2 mice, but not huNRGs, produced HIV-specific IgG, indicating improved immune responses. huNRG mice were infected intranasally with mCherry-Erdman, YFP-H37Rv or H37Rv Mtb. huDRAG-A2 mice were also infected with H37Rv. Human immune cell involvement and human-like granuloma formation was observed using flow cytometry and immunohistopathology. These findings show that the DRAG-A2 model may be optimal for investigating HIV, TB and co-infection, which continue to be serious global health concerns. / Thesis / Master of Science (MSc) / Human immunodeficiency virus (HIV) and tuberculosis (TB) are infectious diseases that affect millions of people worldwide every year. The greatest cause of death in people living with HIV is co-infection with TB and HIV-positive individuals are much more likely to get TB. Humanized mouse (hu-mouse) models possess human immune cells for HIV to infect and are useful for studying HIV. Our goal is to create hu-mouse models of HIV, TB and HIV/TB co-infection that will allow us to study how these diseases interact. We are currently developing a traditional hu-mouse model (known as NRG), as well as an improved next-generation model (known as DRAG-A2) with a more functional immune system. Both models have been successfully infected with HIV or TB. Only DRAG-A2 mice were able to make antibodies against HIV. The improved DRAG-A2 model will enable future studies on HIV, TB and co-infection, which continue to be understudied global problems.

HIV and TB are endemic in many regions around the world but disproportionately affect low-income countries. HIV/TB co-infections significantly worsen disease outcome with TB being the leading cause of death in people living with HIV (PLWH). Currently, the only vaccine for TB is the BCG vaccine which is not protective against adult pulmonary TB and not recommended for PLWH. Antiretroviral therapy (ART) can suppress viral loads and improve the life span in PLWH but is ultimately unable to eliminate the virus. Therefore, better therapeutic options are needed to improve outcomes for both HIV and TB infections. IL-17 is a proinflammatory cytokine characteristically produced by Th17 cells. Utilizing a humanized mouse model, we aimed to investigate the role of IL-17 and Th17 cells in HIV and TB. HIV infection preferentially depleted Th17 cells in the blood and tissues of humanized mice. In TB infection, significantly increased numbers of Th17 cells were observed at 2 weeks post infection (p.i) in the lungs of M.tb infected mice compared to control and 4 weeks p.i. IL-17 levels trended higher in the lungs at 4 weeks p.i compared to control and 2 weeks. IL-17 depletion in acute TB infection showed slight decrease in bacterial load in the lungs of the treated mice compared to the control. This could suggest a potential pathological role of IL-17 in TB infection where IL-17 promotes M.tb replication. When exogenous IL-17 was administered to the lungs prior to TB infection, significantly higher numbers of CD4+ and CD8+ T cells in the lungs of treated mice were seen compared to the control but this did not affect bacterial load. Our current experiment administers exogenous IL-17 to HIV infected mice to assess how it would affect disease progression. Further investigation is needed to explore how IL-17 affects HIV and TB disease pathogenesis. / Thesis / Master of Science (MSc) / HIV and TB are diseases that place a huge burden on healthcare systems globally. Co-infections with HIV and TB worsen a patient’s prognosis significantly. Currently, antiretroviral therapy is used to treat HIV which can control infection but cannot eliminate the virus. The current vaccine for TB, the BCG vaccine is not completely efficacious for adults with TB, highlighting the urgent need for better vaccines and treatments for HIV and TB. IL-17 is a signalling molecule that has many effects on the immune system. Using mouse models that mimic human immune responses, we aimed to assess how IL-17 is involved in HIV and TB infections and if it can be used to develop new therapeutics for HIV and TB. We found adding IL-17 to TB infected mice led to increased immune cell recruitment suggesting a beneficial role of IL-17. Further investigation is needed to fully assess IL-17’s role in infectious diseases.

This investigation determines students' attitudes toward a "humanized" work climate. The possibility that attitudes developed before entering the labor force contribute to the lack of such environments is the basis of the research design. A review of motivation theories, relevant research and experiences of some "humanized" firms precedes the development of a model for a humanized climate. The three main elements of the model--team activity, the product, and the self-concept--are interconnected by elements such as self-control, job performance, autonomy, goal definition, and learning. The research questionnaire, a thirty-onestatement, Likert-type instrument, elicits attitudes about the time-task aspect of Kahn's "Work-Module." A Cronbach Alpha Coefficient of 0.74 indicates an acceptable reliability. The subjects, all male, were seventy senior business students at North Texas State University, fifty-six high school senior academic students from the Richardson, Texas ISD, thirty-two high school vocational students from the Garland, Texas ISD, and twenty-nine college vocational students from the El Centro Branch of the Dallas County Community College System. A 2 x 2 analysis of variance revealed a significant difference (P = 0.0038) between attitudes of vocational and non-vocational students. Vocational students apparently value an autonomous work situation. They prefer a job which permits them to develop and use four or five work skills, because that type of job appeals to their self-concept and promises economic and vocational security. However, students in academic programs consider their economic and job security best protected by structured and specialized jobs. Individuals who aspire to own their own business also prefer the structured climate; others prefer the autonomous environment. The difference in attitude between the two education levels was significant at P < 0.20. The education process appears to be associated with preference for a more structured work climate, in the case of both academic and vocational students. Education also appears to reduce the difference of opinion between academic and vocational students. The study concludes that the two major elements of the human resource begin their work lives with perceptual differences learned from experiences outside the work environment. Organization-change activities are impeded, and to some extent controlled, by these differences. The relationship of the attitudes, given the traditional manager-employee relationship, can contribute to the scarcity of "humanized" firms.

Ciberativismo em defesa do parto humanizado e da descriminalização do aborto: as diferenças na defesa dos direitos reprodutivos Parto e aborto fazem parte do escopo dos direitos reprodutivos e existem diversas organizações que trabalham estas questões, seja entendendo-os como uma questão de saúde e direitos humanos, seja focada em uma ou outra pauta especificamente. A defesa destes dois direitos possuem inúmeras similaridades em sua forma de articulação, rede de apoio e discursos, mas em alguns momentos se afastam. Este trabalho tem o objetivo analisar exclusivamente as diferenças no ciberativismo de movimentos organizados da sociedade civil em defesa do parto humanizado e pela descriminalização do aborto. Através das informações publicadas nos sites e utilizando análise de conteúdo, foram analisadas as categorias religião, classe social, mortalidade e consumo. Avaliando o conteúdo dos nove sites analisados concluímos que religião e classe social são pouco mencionadas quando relacionadas ao parto, mas frequentemente mencionadas na discussão pela descriminalização do aborto. A mortalidade materna é uma preocupação nas duas causas e a questão do / Childbirth and abortion fall under the scope of reproductive rights, and a number of organizations address these issues, by understanding them both as a public health and human rights issues, or by focusing on one or the other specifically. The defense of these two rights has numerous similarities: similarities in terms of how they are articulated, their support networks, and discourse. However, on some occasions they drift apart. This study aims to analyze not the similarities but the differences of the cyberactivism in defense of humanized childbirth and decriminalization of abortion practiced by a number of organized groups in society privileging one of these issues. Through the information published on websites and using content analysis, this study focuses on the following categories: religion, social class, maternal mortality, and consumption. Evaluating the content of nine websites this study found that religion and social class are mentioned little when related to childbirth, but often mentioned in discussions for the decriminalization of abortion. Maternal mortality is a concern expressed in both causes and the issue of

Ciberativismo em defesa do parto humanizado e da descriminalização do aborto: as diferenças na defesa dos direitos reprodutivos Parto e aborto fazem parte do escopo dos direitos reprodutivos e existem diversas organizações que trabalham estas questões, seja entendendo-os como uma questão de saúde e direitos humanos, seja focada em uma ou outra pauta especificamente. A defesa destes dois direitos possuem inúmeras similaridades em sua forma de articulação, rede de apoio e discursos, mas em alguns momentos se afastam. Este trabalho tem o objetivo analisar exclusivamente as diferenças no ciberativismo de movimentos organizados da sociedade civil em defesa do parto humanizado e pela descriminalização do aborto. Através das informações publicadas nos sites e utilizando análise de conteúdo, foram analisadas as categorias religião, classe social, mortalidade e consumo. Avaliando o conteúdo dos nove sites analisados concluímos que religião e classe social são pouco mencionadas quando relacionadas ao parto, mas frequentemente mencionadas na discussão pela descriminalização do aborto. A mortalidade materna é uma preocupação nas duas causas e a questão do / Childbirth and abortion fall under the scope of reproductive rights, and a number of organizations address these issues, by understanding them both as a public health and human rights issues, or by focusing on one or the other specifically. The defense of these two rights has numerous similarities: similarities in terms of how they are articulated, their support networks, and discourse. However, on some occasions they drift apart. This study aims to analyze not the similarities but the differences of the cyberactivism in defense of humanized childbirth and decriminalization of abortion practiced by a number of organized groups in society privileging one of these issues. Through the information published on websites and using content analysis, this study focuses on the following categories: religion, social class, maternal mortality, and consumption. Evaluating the content of nine websites this study found that religion and social class are mentioned little when related to childbirth, but often mentioned in discussions for the decriminalization of abortion. Maternal mortality is a concern expressed in both causes and the issue of

Detrimental immune and inflammatory responses contribute to the pathogenesis of various conditions, including Crohn’s disease, Lupus, and sepsis.1,2,3 Unfortunately, novel treatments for detrimental immune and inflammatory responses have been met with little success. Mesenchymal stromal cells (MSCs) represent a promising cellular therapy to treat immune and inflammatory disorders due to their ability to suppress the immune system. However, despite their promise, clinical trials that have employed MSC cellular therapies have produced varying and sometimes conflicting results. These discrepancies have been partially attributed to the cellular heterogeneity within MSC populations. To address these discrepancies, I performed transcriptomic and proteomic analysis of MSCs with varying immunomodulatory capacity to identify robust immunomodulatory biomarkers and gain better mechanistic insights into MSC immunomodulatory function. In this study, MSCs with differing immunomodulatory function were identified and the effect of in vitro passaging and proinflammatory induction on immunomodulatory ability was characterized. To characterize MSC immunomodulatory control mechanisms, RNA sequencing and proteomic analyses were performed on MSCs with different immunomodulatory capabilities. These analyses enabled the identification of potential immunomodulatory biomarkers and regulatory mechanisms. Finally, to test the therapeutic efficacy of immunomodulatory MSC subpopulations, I developed a humanize mouse model for sepsis. Overall, this work contributes to our understanding of MSC immunomodulation and to the development of a robust MSC cellular therapeutics.

No âmbito do Cuidado em Saúde, a Arte tem sido vista como potencial meio para a sensibilização de estudantes e profissionais implicados na prática de cuidado. O presente trabalho teve como objetivo principal investigar e analisar a percepção de estudantes de fonoaudiologia a respeito das relações entre cuidado em saúde e arte. O estudo ocorreu de forma interdisciplinar e intersetorial, a partir da proposta de experiência da Sala de Arte durante o Programa de Fonoterapia Intensiva (PFI) para correção de alterações de fala relacionadas à fissura labiopalatina e disfunção velofaríngea. Para tanto foram traçados os seguintes objetivos específicos: 1- Descrever as atividades realizadas na Sala de Arte no PFI e 2 Identificar registros que emergiram da experiência proposta pela Sala de Arte que abordem concepções e reflexões a respeito dos seguintes aspectos (analisadores): a) cuidado em saúde; b) arte; c) arte como cuidado; d) cuidado como arte. O estudo de características qualitativas valeu-se da cartografia associada à análise documental, tendo como objeto de pesquisa os registros produzidos por estudantes o curso de graduação em fonoaudiologia durante a ocorrência da Sala de Arte. Sustentados por princípios da arte-educação, os dados produzidos foram organizados considerando os analisadores propostos para este estudo e em seguida categorizados e confrontados com bibliografia pertinente. De acordo com os resultados, a percepção dos estudantes indica que há em sua formação, predomínio do caráter hegemônico, centrado em produção de procedimentos. Os resultados também indicam haver carência de espaços voltados para o diálogo, para a reflexão sobre sua prática de cuidado, assim como, espaços de escuta e interpretação, no âmbito da integralidade. Conclui-se assim, que a proposta de experiência da Sala de Arte, oportunizou espaço aos estudantes para reflexão a respeito de cuidado em saúde e arte, dessa forma contribuindo para sua percepção e prática de saúde de forma integral e sensível. / When considering Healthcare, Art has been proposed as a tool to prepare students and professional to implement more effective and sustainable actions in health. The present study had the objectives of investigating and analyzing the perception of Speech-Language Pathology Students regarding to the relationship between healthcare and art. This proposal was conducted in an interdisciplinary and intersectoral way within the Arts Room experience, during the Intensive Speech Therapy Program (ISTP) for correction of speech disorders related to cleft lip and palate and velopharyngeal dysfunction. The following specific objectives were addressed: 1- To describe the activities conducted in the Arts Room at the ISTP and 2- To identify the written records registered by the students while experiencing the Arts Room, that addressed the following aspects (analysers): a) healthcare; b) arts; c) arts as healthcare; d) healthcare as art. The qualitative feature study was based in cartography associated to documental analysis, using as research subject records of Speech-Language Pathology students within the Arts Room. Supported by the principle of art-education, the produced data has being organized considering proposed analyzers for this study and then categorized and confronted with pertinent literature. The findings indicate that the students are prepared within a hegemonic model with emphasis in procedures. There is a lack of spaces focused on the dialogical interaction, to reflect on their care practice, as well as listening and interpretation spaces, at comprehensive health scope. The Arts Room experience, therefore, provided opportunities to the students to think about healthcare and art, contributing for their health perception and practice in a whole, sensitive manner.

Made available in DSpace on 2016-08-10T10:54:09Z (GMT). No. of bitstreams: 1 PAULA CRISTINA ALVES DA SILVA.pdf: 1476609 bytes, checksum: 322179b99686c367765f728990e3883e (MD5) Previous issue date: 2013-04-29 / O Ministério da Saúde afirma que a gravidez é um evento social que marca definitivamente a vida reprodutiva da mulher. Para respaldar e garantir à gestante assistência qualificada, entram em cena as políticas de saúde relacionadas ao momento de gestação e parto, especificamente com o Programa Nacional de Humanização no Pré-Natal e Nascimento, que implementa as políticas do Programa de Atenção Integral à Saúde da Mulher, e visa resgatar a atenção obstétrica integrada, eficaz e humana, envolvendo estados, municípios e unidades de saúde. Um dos locais protagonistas deste percurso é a sala de pré-parto; local destinado ao trabalho de parto. A assistência de enfermagem prestada nesse setor interfere e determina diretamente as condições de parturição. Neste contexto, optou-se por desenvolver uma pesquisa qualitativa com o objetivo: de conhecer a percepção das parturientes atendidas no pré-parto do Hospital Regional Materno Infantil de Imperatriz-MA quanto à assistência de enfermagem, além de conhecer a assistência de enfermagem prestada às parturientes na sala de pré-parto; caracterizar a estrutura física, organizacional e profissional do pré-parto e analisar a assistência e os procedimentos realizados dentro do pré-parto à luz do PHPN. Os dados foram coletados por meio de observação direta e entrevistas por saturação de informações junto a 9 (nove) mulheres com mais de 18 anos, todas no puerpério imediato, independentemente do número de paridade; residentes no município de Imperatriz do Maranhão e que tinham realizado o parto no centro obstétrico do Hospital Regional Materno Infantil de Imperatriz-MA. Elas tiveram permanência mínima de sessenta minutos na sala de pré-parto e consentiram em participar do estudo mediante informação, esclarecimento e assinatura do Termo de Consentimento Livre e Esclarecido. A partir da análise dos dados, constatou-se que a média de idade foi de 24 anos, com ensino médio, em união estável e parto vaginal. As percepções das participantes demonstraram que o pré-parto tornou-se um lugar marcante em decorrência das emoções conflituosas que ali foram vivenciadas; que as mesmas não se sentem acolhidas pela equipe profissional que ali atua, mas que o conforto do espaço físico que elas ocupam e a presença da (o) acompanhante ajudaram a amenizar a ausência de acolhimento das (o) profissionais; quanto ao cuidado, observou-se a superficialidade da assistência de enfermagem, que destinou sua atenção a procedimentos e rotinas técnicas em detrimento da assistência humanizada, além da descaracterização da figura da (o) enfermeira (o), pois se tornou invisível aos olhos das entrevistadas, não conseguindo estas identificar e/ou caracterizar a figura e a função da (o) enfermeira (o) na sala de pré-parto. Os resultados sugerem que a sala de pré-parto é um local marcante pelas emoções conflituosas ali vivenciadas; o acolhimento não é realizado, passando a ser atribuído ao espaço físico e aos acompanhantes; foram encontradas falhas na assistência humanizada preconizada pelo PHPN em decorrência da superficialidade na assistência de enfermagem e a descaracterização da figura da (o) enfermeira (o). Assim, ainda são muitos os desafios das equipes de enfermagem para o acolhimento e a humanização no cuidar de pessoas no ambiente de parturição.