Made available in DSpace on 2015-09-25T12:23:25Z (GMT). No. of bitstreams: 1 PDF - Anne Aluska da Silva Pequeno.pdf: 776856 bytes, checksum: f944e884ca72defc62ec6631d955f5ed (MD5) Previous issue date: 2012-05-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / INTRODUCTION: The Northeastearn states of Brazil have higher frequencies of consanguineous marriages, which contribute to increase the risk of children affected by different genetic diseases. OBJECTIVES: The aim of this study was to estimate the prevalence of disabled people and to characterize their etiological factors and demands for rehabilitation services and assistive technology. MATERIALS AND METHODS: Crosssectional epidemiological study using the method of the informant, involving eight communities with high rates of inbreeding in the state of Paraíba, Brazil. 338 individuals were indicated and 256 selected to perform clinical genetics evaluation. Descriptive and correlation statistical analysis was performed using SPSS 17 with significance level of 5%. RESULTS: The frequency of individuals with physical disabilities in the population was 0.3% and 48.5% had genetic etiology. The estimated prevalence of inherited neuromuscular disease was 1/1.732 inhabitants, having been identified three clusters of these neuromuscular diseases: Spoan syndrome, girdle muscular dystrophy type IIB (disferlinopatia) and progressive spinal amyotrophy. CONCLUSION: These findings can show the existence of clusters, resulting from the combination of founder effect, genetic drift and inbreeding. Public policies for these communities should include access to specialized services such as medical genetics community and assistive technology. / INTRODUÇÃO: Os estados do nordeste brasileiro apresentam elevadas frequências de casamentos consanguíneos, os quais contribuem para aumentar o risco de nascimento de crianças afetadas por diferentes doenças genéticas. OBJETIVOS: O objetivo deste estudo foi estimar a prevalência de pessoas com deficiência, caracterizar os fatores etiológicos determinantes e as demandas por serviços de reabilitação e tecnologia assistiva. MATERIAL E MÉTODOS: Estudo epidemiológico transversal com uso do método do informante, realizado em oito municípios com elevadas taxas de endogamia, no estado da Paraíba, Brasil. Foram indicados 338 indivíduos para triagem e selecionados 256 deficientes para avaliação clínica-genética. A análise estatística descritiva e de correlação foi feita com SPSS 17. RESULTADOS: A frequência de indivíduos com deficiência física na população foi de 0,3% e 48,5% dessas deficiências tinham etiologia genética. A prevalência estimada de doenças neuromusculares hereditárias foi de 1/1.732 habitantes, tendo sido identificadas três clusters dessas doenças neuromusculares: síndrome Spoan, distrofia muscular de cinturas tipo II B (disferlinopatia) e amiotrofia espinal progressiva. CONCLUSÃO: Os achados podem evidenciar a existência de clusters, fruto da combinação de efeito de fundador, deriva genética e endogamia. Políticas públicas específicas para essas comunidades devem incluir o acesso aos serviços especializados, como genética médica comunitária e tecnologia assistiva.

Submitted by Erika Demachki (erikademachki@gmail.com) on 2017-01-10T16:57:36Z No. of bitstreams: 3 Tese - Adriana Marques Faria - 2016 - Parte 01.pdf: 5478875 bytes, checksum: ae9c08d62c1ad44305030954fe0b0a5e (MD5) Tese - Adriana Marques Faria - 2016 - Parte 02.pdf: 16834328 bytes, checksum: 2faf307ee33c6a223a00b491091a66f2 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-01-11T09:54:12Z (GMT) No. of bitstreams: 3 Tese - Adriana Marques Faria - 2016 - Parte 01.pdf: 5478875 bytes, checksum: ae9c08d62c1ad44305030954fe0b0a5e (MD5) Tese - Adriana Marques Faria - 2016 - Parte 02.pdf: 16834328 bytes, checksum: 2faf307ee33c6a223a00b491091a66f2 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-01-11T09:54:12Z (GMT). No. of bitstreams: 3 Tese - Adriana Marques Faria - 2016 - Parte 01.pdf: 5478875 bytes, checksum: ae9c08d62c1ad44305030954fe0b0a5e (MD5) Tese - Adriana Marques Faria - 2016 - Parte 02.pdf: 16834328 bytes, checksum: 2faf307ee33c6a223a00b491091a66f2 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-12-06 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The closeness beteween wild and domestic animals with humans may result in common diseases involving these three groups, including zoonotic and antropozoonotic diseases. The study of bacteria and disease that affects animals is an important way to approach epidemiologic control and sanitary vigilance, as we do not understand the roll of wild animals in transmitting diseases among wild, exotic and domestic animals. The main objective of the present study was to search the presence of Escherichia coli and Salmonella sp. from rectal swabs of non-domesticated Suiformes in Commercial herds in Goiás State. It was collected rectal swabs of 100 Sus scrofa scrofa, 60 T. pecari and 30 P. tajacu, from different ages. The samples were used in order to obtain the isolation, antimicrobial profile, hemolisin test for E. coli and virulence and resistance gene presences in both bacteria. The serotyping was performed with polyvalent anti-O serum and the virulence and resistance gene deteccion by PCR technique. The results shown high rates of antimicrobial resistance and virulence and resistance genes in analyzed groups of E. coli. The isolation of Salmonella sp. occurred in one sample of S. scrofa, with high rates of antimicrobial resistance also, but no resistance and virulence genes were detected in this isolate. We must pay attention to the possibility of horizontal gene transference of virulence factors and resistance trough contaminated water and food, that may transform commensal bacteria in possible pathogenic agents. It is conclude: that Salmonella sp. is not commonly isolated from T. pecari and P. tajacu, showing low frequency of isolation in S. scrofa in these conditions; and E. coli with multidrug resistance patterns is isolated from S. scrofa, T. pecari and P. tajacu in commercial herds from Goiás State. / A proximidade de animais silvestres com animais domésticos e seres humanos pode resultar no aparecimento de doenças comuns a estes três grupos, incluindo doenças zoonóticas. O estudo de bactérias e doenças que acometem animais silvestres é importante para atuar na forma de controle epidemiológico e vigilância sanitária, visto que não se compreende o papel destes animais na transmissão de doenças entre outros animais silvestres, exóticos e domésticos. O presente estudo foi desenvolvido com o objetivo de pesquisara presença das bactérias Escherichia coli e Salmonella sp. em suabes retais provenientes de Suiformes não domesticados em criações comerciais no Estado de Goiás. Foram colhidos suabes retais de 100 Sus scrofa scrofa, 60 de Tayassu pecari e 30 de Pecari tajacu, de diferentes faixas etárias. À partir do material colhido fez-se o isolamento, perfil antimicrobiano, teste de hemólise para E. coli e detecção de genes de virulência e de resistência das bactérias. Para a detecção dos agentes, foi realizado exame bacteriológico convencional e ensaios de suscetibilidade a antimicrobianos. Foi realizadas a tipificação sorológica por teste sorológico com soro polivalente anti-O para a bactéria Salmonella e detecção de genes virulência e de resistência pela técnica de PCR nos isolados. Os resultados obtidos demonstraram altas taxas de resistência aos antimicrobianos e presença de genes de virulência em amostras de E. coli em todos os grupos testados. O isolamento de Salmonella sp. foi possível em uma amostra de S. scrofa, que apresentou também altas taxas de resistência à antimicrobianos, mas não houve detecção de genes de virulência ou de resistência neste isolado. Conclui-se que: nesta condição de criação Salmonella sp. não é isolada comumente de T. pecari e P. tajacu, sendo isolada em baixa frequência de S. scrofa; e que E. coli é isolada de S. scrofa, T. pecari e P. tajacu em rebanhos comerciais do Estado de Goiás, com múltiplos padrões de resistência antimicrobiana.

Made available in DSpace on 2016-04-28T20:19:28Z (GMT). No. of bitstreams: 1 2008 - Jocelio de Souza Maciel.pdf: 540920 bytes, checksum: 59313a3c8b27e9ddb1b998574d525703 (MD5) Previous issue date: 2008-08-28 / The quality concept was developed throughout the years for studious as Juran, Ishikawa, Feigenbaum, Crosby, Deming, amongst others. Respected the had partner-cultural contexts in which the cited theoreticians met inserted, all had been unanimous in choosing the emphasis in the customer as the main component of the theory of the quality. Although the concepts and techniques directed to the quality if have initiated in the industrial context, later, by means of complex and personalized adaptations, was transferred to also use it such concepts in the area of the health. The objective of the present dissertation consists of evaluating the quality of the services given for the Clinic of Physiotherapy and Rehabilitation of the University Center of Barra Mansa - RJ. The study it was developed next to 347 patients. In the development of the research an adaptation of the Servqual scale was used, instrument consecrated in studies on evaluation of quality in health services. Amongst the evaluated dimensions, the users had indicated "Reliability" as the most important parameter to evaluate the services given for the clinic. The dimension "Tangibles", that it says respect to the aspects of physical structure and equipment received the lesser indices from satisfaction amongst the other evaluated dimensions. / O conceito de qualidade foi desenvolvido ao longo dos anos por estudiosos como Juran, Ishikawa, Feigenbaum, Crosby, Deming, dentre outros. Respeitados os devidos contextos s?cio-culturais nos quais os te?ricos citados encontravam-se inseridos, todos foram un?nimes em eleger a ?nfase no cliente como o principal componente da teoria da qualidade. Embora os conceitos e t?cnicas voltados ? qualidade tenham se iniciado no contexto industrial, posteriormente, por meio de adapta??es complexas e personalizadas, passou-se a utilizar tais conceitos tamb?m na ?rea da sa?de. O objetivo da presente disserta??o consiste em avaliar a qualidade dos servi?os prestados pela Cl?nica de Fisioterapia e Reabilita??o do Centro Universit?rio de Barra Mansa - RJ. O estudo foi desenvolvido junto a 347 pacientes. No desenvolvimento da pesquisa foi utilizada uma adapta??o da escala Servqual, instrumento consagrado em estudos sobre avalia??o de qualidade em servi?os de sa?de. Dentre as dimens?es avaliadas, os usu?rios indicaram a "Confiabilidade" como o mais importante par?metro para se avaliar os servi?os prestados pela cl?nica. A dimens?o "Tangibilidade", que diz respeito aos aspectos de estrutura f?sica e equipamentos recebeu os menores ?ndices de satisfa??o dentre as outras dimens?es avaliadas.

Este estudo delimita a concepção dos gestores sobre os pressupostos e diretrizes do Sistema Único de Saúde (SUS), contextualizando-a no processo de estruturação deste Órgão nos municípios de Bagé e Dom Pedrito (RS). A partir de uma abordagem sobre a realidade da Região da Campanha (RS), que abrange a 7ª Coordenadoria Regional de Saúde (7ª CRS-RS), reflete sobre a importância do tema gestão para efetivar a saúde como uma prática social com um enfoque profissional. Neste sentido, identifica as concepções dos gestores dos SUS dos municípios de Bagé e de Dom Pedrito (RS) quanto aos pressupostos e diretrizes do SUS; caracteriza o processo de estruturação do SUS nestes municípios; enumera os elementos da prática administrativa, considerados restritores ou facilitadores pelos gestores no seu processo de estruturação, sistematiza as concepções futuras quanto ao processo de consolidação do SUS na região em estudo. O retorno de informações e reflexões, aqui delineadas, poderão subsidiar novos estudos, discussões e ações entre os atores sociais envolvidos no processo de efetivação do SUS, numa tentativa de uma aproximação mais adequada da realidade loco-regional com as políticas de saúde e políticas sociais.

A reforma sanitária, ocorrida após a constituição de 1988, criou o Sistema Único de Saúde (SUS), descentralizando a gestão em saúde pública no Brasil e delegando mais autonomia e responsabilidade aos municípios. Esta descentralização traz inúmeros benefícios, pois aproxima a gestão das realidades locais. Os municípios são peculiares e podem apresentar dificuldades em atingir os mesmos padrões de serviços de saúde dos demais entes federados e, eventualmente, incorrer na desigualdade em saúde. Para garantir a integralidade no atendimento, as Redes Regionais de Atenção à Saúde (RRAS) articulam o sistema de maneira a satisfazer os diferentes níveis de complexidade. Procurou-se nesta pesquisa encontrar padrões espaciais destoantes na distribuição de recursos de saúde no estado de São Paulo, de maneira a caracterizar eventuais desigualdades em saúde. Os dados foram analisados por RRAS e por aglomerados de munícipios de atributos similares. Os resultados indicam diferenças regionais nos vários aspectos pesquisados, sobretudo na cobertura por equipes de saúde da família, no acesso aos serviços de saúde e na oferta e ocupação de leitos. Estas diferenças variam conforme se dista da capital do estado e estão associadas à renda e à presença da saúde suplementar. / The health care reformulation, which started after the constitution of 1988, created the Unified Health Care System (SUS), decentralizing the management of public health care in Brazil and delegating more autonomy and responsibility to counties.This decentralization brings numerous benefits because it approaches the county management to local area realities. Counties have different features and may have difficulties achieving the same health care standards of other federative entities and possibly create health care inequalities. To ensure comprehensiveness in health care, the Regional Health Care Networks (RRAS) articulate the system in order to provide the different levels of complexity. It is aimed in this research to find dissonant spatial patterns in health care resources distribution in the state of São Paulo, in order to characterize any inequalities. The data was analyzed by the RRAS and clusters of counties of similar attributes. Results indicate regional differences in several aspects of the research, mostly in family health care teams coverage, access to health care services and availability and bed occupancy rate. These differences vary according to how distant from the state capital the county is and are associated with income and health insurance attendance.

Current knowledge about processes that generate long-distance dispersal of plants is still limited despite its importance for persistence of populations and colonization of new potential habitats. Today wild large mammals are presumed to be important vectors for long-distance transport of diaspores within and between European temperate forest patches, and in particular wild boars recently came into focus. Here we use a specific habit of wild boar, i.e. wallowing in mud and subsequent rubbing against trees, to evaluate epizoic dispersal of vascular plant diaspores. We present soil seed bank data from 27 rubbing trees versus 27 control trees from seven forest areas in Germany. The mean number of viable seeds and the plant species number were higher in soil samples near rubbing trees compared with control trees. Ten of the 20 most frequent species were more frequent, and many species exclusively appeared in the soil samples near rubbing trees. The large number of plant species and seeds – approximated > 1000 per tree – in the soils near rubbing trees is difficult to explain unless the majority were dispersed by wild boar. Hooked and bristly diaspores, i.e. those adapted to epizoochory, were more frequent, above that many species with unspecialised diaspores occurred exclusively near rubbing trees. Different to plant species closely tied to forest species which occur both in forest and open vegetation, and non-forest species were more frequent near rubbing trees compared with controls. These findings are consistent with previous studies on diaspore loads in the coats and hooves of shot wild boars. However, our method allows to identify the transport of diaspores from the open landscape into forest stands where they might especially emerge after disturbance, and a clustered distribution of epizoochorically dispersed seeds. Moreover, accumulation of seeds of wetness indicators near rubbing trees demonstrates directed dispersal of plant species inhabiting wet places between remote wallows. / Das aktuelle Wissen über Prozesse, die zur Fernausbreitung von Pflanzen führen, ist trotz ihrer Bedeutung für das Überleben von Populationen und die Besiedlung neuer potenzieller Habitate noch immer sehr begrenzt. Wildlebende Großsäuger sind heutzutage vermutlich wichtige Vektoren für den Ferntransport von Diasporen innerhalb und zwischen den einzelnen Waldflächen in Mitteleuropa, und speziell das Wildschwein (Sus scrofa L.) spielt dabei offenbar eine herausragende Rolle. Wir nutzen hier ein spezifisches Verhalten des Wildschweins – Suhlen im Schlamm und nachfolgendes Scheuern an sogenannten Malbäumen – um die epizoochore Ausbreitung von Gefäßpflanzen-Diasporen einzuschätzen. Dargestellt werden die Ergebnisse von Samenbank-Untersuchungen von 27 Malbäumen im Vergleich zu 27 Kontrollbäumen aus sieben Waldgebieten in Deutschland. Sowohl die mittlere Zahl lebensfähiger Samen als auch die Artenzahl waren höher in Bodenproben neben Malbäumen. Zehn der 20 in der Samenbank verbreitetsten Pflanzenarten hatten hier ihren Schwerpunkt, und viele Arten kamen ausschließlich in den neben Malbäumen gewonnenen Proben vor. Die große Zahl von Pflanzenarten und Samen – zumindest > 1000 pro Baum – im Boden an Malbäumen lässt sich nur durch die Aktivität der Wildschweine erklären. Mit Haken oder Borsten ausgestattete, d.h. an Epizoochorie angepasste Diasporen waren häufiger, aber auch viele Arten mit unspezialisierten Diasporen kamen ausschließlich in der Samenbank bei Malbäumen vor. Anders als weitgehend an Wald gebundene Pflanzenarten waren solche, die sowohl im Wald und im Offenland vorkommen, sowie nicht im Wald vorkommende Arten häufiger neben Malbäumen als neben Kontrollbäumen. Diese Befunde stimmen mit denen früherer Untersuchungen von Diasporenladungen im Fell und in den Hufen geschossener Wildschweine überein. Unsere Methode erlaubt darüber hinaus aber die Identifizierung des Diasporentransports aus dem Offenland in die Waldbestände, wo sie insbesondere nach Störungen keimen dürften, sowie einer ungleichmäßigen Verteilung epizoochor ausgebreiteter Diasporen. Außerdem zeigt die Akkumulation von Samen von Nässezeigern neben den Malbäumen eine gezielte Ausbreitung nasse Standorte bewohnender Pflanzenarten zwischen entfernt gelegenen Suhlen.

This dissertation examines the role of religion, political parties, and strategic alliances in three contemporary health policy debates in the United States and Brazil.

Glutathione transferases (GSTs, EC 2.5.1.18) possess multiple functions and have potential applications in biotechnology. This thesis contributes to knowledge about glutathione transferases from Sus scrofa (pig). The study is needed for better understanding of biochemical processes in this species and is desirable for drug development, for food industry research and in medicine. A primary role of GSTs is detoxication of electrophilic compounds. Our study presents porcine GST A1-1 as a detoxication enzyme expressed in many tissues, in particular adipose tissue, liver and pituitary gland. Based on comparison of activity and expression profiles, this enzyme can be expected to function in vivo similarly to human GST A2-2 (Paper II). In addition to its protective function, human GST A3-3 is an efficient steroid isomerase and contributes to the biosynthesis of steroid hormones in vivo. We characterized a porcine enzyme, pGST A2-2, displaying high steroid-isomerase activity and resembling hGST A3-3 in other properties as well. High levels of pGST A2-2 expression were found in ovary, testis and liver. The properties of porcine enzyme strengthen the notion that particular GSTs play an important role in steroidogenesis (Paper I). Combination of time-dependent and enzyme concentration-dependent losses of activity as well as the choice of the organic solvent for substrates were found to cause irreproducibility of activity measurements of GSTs. Enzyme adsorption to surfaces was found to be the main explanation of high variability of activity values of porcine GST A2-2 and human Alpha-class GSTs reported in the literature. Several approaches to improved functional comparison of highly active GSTs were proposed (Paper III). / Felaktigt tryckt som Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and Technology 733

Mestre -- Escola Nacional de Saude Publica, Rio de Janeiro, 1999.

Doutor -- Escola Nacional de Saude Publica, Rio de Janeiro, 1999.