Добірка наукової літератури з теми "EALTA"

This article is a validation study of two national large-scale tests that measure the language proficiency of 11/12 year-old English learners in Norway and Slovenia. Following the example of Alderson and Banerjee (2008), the authors of the article have employed the EALTA guidelines for good practice to validate the tests, and to formulate major recommendationsfor improvement of both assessment instruments, where feasible (Alderson & Banerjee, 2008). The results of the validation study show that both national tests in English seem to fulfil most of the EALTA guidelines for good practice, although a few issues related to the testconstruct and test design procedures need to be re-assessed, and some changes may be required.

ABSTRACT Introduction: We applied three-dimensional gait analysis to assess the effects of enhanced active contraction of the transversus abdominis (EACTA) during walking. We sought to evaluate the effect of EACTA during walking in order to improve walking quality. Methods: Thirty college students were recruited and trained to perform EACTA during walking. We examined gait parameters under different conditions, including EACTA and habitual ACTA (natural walking with mild contraction of the feedforward mechanism of ACTA, HACTA) during walking using three-dimensional gait analysis. We compared differences in gait parameters under the two walking conditions using SPSS 16.0 statistical software. Results: The following gait parameters were significantly lower under EACTA conditions than under HACTA conditions (P < 0.05): stance phase, 59.151% ± 1.903% vs. 59.825% ± 1.495%; stride time, 1.104 s ± 0.080 s vs. 1.134 s ± 0.073 s:; stance time, 0.656 s ± 0.057 s vs. 0.678 s ± 0.053 s; and swing time, 0.447 s ± 0.028 s vs. 0.454 s ± 0.031 s, respectively. Gait parameters single support phase and mean velocity were significantly higher for EACTA than for HACTA conditions (both P < 0.05). Conclusions: Overall, the results revealed that EACTA during walking can improve gait. This method is simple, and EACTA training during walking to improve gait quality in daily life could provide a positive basis for people to strengthen the transverse abdominal muscle. Level of evidence III; Retrospective comparative study .

ABSTRACT Enterotoxigenic Escherichia coli (ETEC) strains remain a formidable cause of diarrheal disease. To identify novel surface proteins of ETEC, we performed TnphoA mutagenesis of prototype ETEC strain H10407 and discovered a secreted protein not previously recognized in ETEC. DNA sequencing of the interrupted locus in mutant TnphoA.977 revealed a candidate 4,095-bp open reading frame without significant homology to commensal E. coli K-12 genomic DNA. Translation of this sequence revealed that it encoded a predicted peptide of 147.7 kDa that bears significant homology to members of the autotransporter family of bacterial virulence factors, particularly the serine protease autotransporters of the Enterobacteriaceae proteins. The gene identified in H10407, eatA (ETEC autotransporter A), encodes a potential serine protease motif (GDSGSP) in the secreted amino-terminal domain, and the predicted peptide shows more than 80% homology with SepA, a virulence protein secreted by Shigella flexneri. DNA hybridization and PCR demonstrated that eatA resides on the 92-kDa pCS1 virulence plasmid of H10407 and that it is present in multiple clinical ETEC strains. Immunoblots with antisera directed against a recombinant EatA passenger protein fragment identified a 110-kDa protein in supernatants purified from H10407 but not from the TnphoA.977 mutant or H10407-P, which lacks pCS1. EatA possesses serine protease activity that is abolished by mutations within a serine protease catalytic triad formed by residues H134, D162, and S267. Finally, interruption of the eatA gene retarded fluid accumulation in the rabbit ileal loop model, suggesting that this autotransporter contributes to the virulence of ETEC.

Health, Economics and health organization have the largest number of publications at all levels of government. However, direct measurement and dosed funding for each remains out of reach for the majority of the population. For them also remains unclear: what are the fundamental laws you need to follow to fulfill the doctor's orders. The movement towards monopoly narrows the health care market. Collective economic, social and urban projects do not reduce the pharmacy chain. The budget remains in surplus if mortality is not reduced. Medical statistics do not have the properties of a microscope. Therefore, for the population health is a social self-movement. Each industry has its own technology and economic costs, forming departmental lists of services and works at the expense of the state budget. The article on the Federal laws and regulations shows the relevance of updating health care to build a list of services and improve the methodology of budget planning on the basis of four health sectors R, N, Q and Z. It is established that the ratio of financing of the proposed industries (in multiplicities) is not : 10 : 100 : 1000 does not lead to the planned effects and possible efficiency evaluation. Conclusions and proposals of the article are necessary for the Concept of improving the efficiency of budget expenditures (adopted in January 2019).

Purpose A three-year research study, funded by Innovate UK, Consumer Models for Assisted Living (COMODAL) aimed to support the development of the consumer market for electronic assisted living technology (eALT) products and services, particularly for people aged 50-70, approaching older age and retirement themselves or with caring responsibilities for family or friends. The purpose of the COMODAL study was to gain a greater understanding of their needs and behaviours relating to the acquisition of eALT and develop sustainable consumer-led business models that might address these needs and support business development within a consumer market (Ward et al., 2016). The purpose of this paper is to present a follow up study to explore how the market may have changed since the publication of the research findings. Design/methodology/approach An online survey was used to collect both qualitative and quantitative data from individuals working in the supply and distribution of assisted living technologies in the UK regarding how their businesses had developed in the past two years. Findings The results showed that since the publication of the COMODAL research there have been changes in the way that the consumer market for eALT is being approached, not only with more direct marketing focused on consumer’s needs but also in direct partnerships with local authorities that offer greater choice with an improved range of products. Originality/value This is the first paper in the UK to follow up the impact of the original COMODAL research and explore its influence on the development of the consumer market for eALT.

Introdução: Informação qualificada no período pré-natal pode contribuir para o conhecimento das mulheres sobre práticas realizadas no parto, o que pode colaborar para melhores resultados maternos e perinatais, incluindo a integridade perineal. Objetivo: Avaliar se o programa de educação em saúde e apoio às mulheres (PRENACEL) contribui para a redução das lesões no períneo durante o parto de mulheres atendidas na rede pública de saúde de Ribeirão Preto, sudeste brasileiro. Métodos: Análise secundária do estudo PRENACEL, um ensaio aleatorizado por conglomerados implementado na cidade Ribeirão Preto. Participaram do estudo todas as mulheres com 18 anos ou mais que iniciaram acompanhamento pré-natal de risco habitual antes da 20ª semana gestacional, em uma das 20 unidades de saúde selecionadas. Para avaliar o desfecho perineal foram incluídas as mulheres que pariram por via vaginal em uma das quatro maternidades que oferecem atendimento público. A intervenção PRENACEL correspondeu ao oferecimento, via telefonia celular, de um pacote de mensagens curtas de texto (SMS) contendo informações essenciais ao acompanhamento do pré- natal e parto de baixo risco. Este programa de educação em saúde foi oferecido como um complemento ao cuidado pré-natal ofertado pelo Sistema Único de Saúde. A aleatorização dos conglomerados foi realizada em duas etapas através de sorteios aleatórios simples. A primeira etapa correspondeu à formação de dois grupos que, na segunda etapa, foram alocados em grupos intervenção ou controle. No grupo intervenção foi utilizada inscrição passiva para incluir as mulheres no programa. As participantes do grupo controle foram incluídas no momento da coleta de dados nas maternidades. Não foi adotada estratégia de mascaramento. O risco relativo e seu intervalo de confiança foram calculados, considerando um nível de significância de 5% para os testes. Resultados: Dez unidades de saúde participaram do grupo intervenção e dez do grupo controle. Para avaliar o desfecho principal foram consideradas 704 mulheres. A integridade perineal foi relatada por aproximadamente 30% das mulheres e a episiotomia foi um procedimento utilizado em aproximadamente 15% dos partos. Não foi encontrada diferença significativa relacionada ao desfecho perineal entre as participantes dos grupos. Conclusão: O uso de SMS, como uma proposta de educação em saúde oferecida no pré-natal, não foi associada à redução de traumas perineais durante o parto, apesar dos seus benefícios comprovados na atenção pré-natal. O estudo PRENACEL está catalogado no Registro Brasileiro de Ensaios Clínicos (ReBEC, RBR-54zf73).
Introduction: Qualified information in the antenatal period can contribute to women\'s knowledge about practices performed during childbirth, which may to improve maternal and perinatal outcomes, including perineal integrity. Objective: To evaluate whether the health education and support programme for women (PRENACEL) contributes to the reduction of perineal trauma of women attended in the public health system of Ribeirão Preto, Southeastern Brazil. Methods: Secondary analysis of the PRENACEL study, a cluster randomized trial implemented in the city of Ribeirão Preto. All women aged 18 years or more who started antenatal care at usual risk before the 20th gestational week, in one of the 20 selected health units participated in the study. To evaluate the perineal outcome, women who had a vaginal birth in one of the four participating maternity hospitals were included. The PRENACEL intervention corresponded to the offer, by mobile phones, of a package of short text messages (SMS) containing essential information about low-risk pregnancy and childbirth and related care. This health education programme was a complement to standard antenatal care offered in public health system (Sistema Único de Saúde). Cluster randomization was performed in two steps through simple random sweepstake. The first stage corresponded to the formation of two groups that, in the second stage, were allocated in intervention or control group. In the intervention group, passive enrollment was used to include women in the programme. Participants in the control group were included at the moment of data collection in the maternity hospitals. No masking strategy was adopted. The relative risk and the confidence interval were calculated, considering a level of significance of 5% for the tests. Results: Ten health units participated in the intervention group and ten in the control group. To evaluate the main outcome, 704 women were considered. Perineal integrity was reported by approximately 30% of women and episiotomy was a procedure used in approximately 15% of deliveries. No significant difference was found related to the perineal outcome between the participants of the groups. Conclusion: The use of SMS, as a proposed health education offered in antenatal care, was not associated with the reduction of perineal traumas during childbirth, despite its benefits in antenatal care. The PRENACEL study is included in the Brazilian Registry of Clinical Trials (ReBEC, RBR-54zf73).

The research had as general objective describe how the permanent education in health is developed by professionals in the multi-professional residence and as specific objectives: identify the perception of professional members of RMIS on EPS; learn how the EPS is developed in the everyday life of these professionals and understand how the EPS permeates the formation of residents. Was characterized by a qualitative approach of type case study which was carried out in a teaching hospital, a city in the interior of Rio Grande do Sul with seventeen members of Residence Multidisciplinary professionals incorporated into the public health system. The data were collected in the period from January to may 2012 through documentary analysis, systematic observation and semi-structured interview. Been complied with all ethical aspects of research with humans based on Resolution 196/96 of the National Health Council. The organization and the processing of data was carried out using the Atlas Software You 6.2. Data analysis occurred by means of thematic content analysis will Minayo that showed three categories: Professional members of RMS ' perception about the permanent education in health; RMIS as intercessor for the development of EPS and EPS as device of training professionals in health in RMIS. The results pointed to the understanding of the members of the multidisciplinary residency regarding permanent education in health beyond a strategic action. Also, evidence for the identification of multidisciplinary residency as a intersseçor space that permeates the formation of resident based on the concepts of permanent education in health which allows reflection of their practice articulating the attention and management spheres, as well as seeking the integration between theory and practice and multidisciplinary action as producers of health actions. It is concluded that there is a need for further research with greater depth and under other spaces of manifestation of EPS.
A pesquisa teve como objetivo geral descrever como a Educação Permanente em Saúde é desenvolvida pelos profissionais da residência multiprofissional e como objetivos específicos: identificar a percepção dos profissionais integrantes da RMIS sobre a EPS; apreender como a EPS é desenvolvida no cotidiano destes profissionais e compreender como a EPS permeia a formação dos residentes. Caracterizou-se pela abordagem qualitativa do tipo Estudo de Caso a qual foi realizada em um hospital de ensino de uma cidade do interior do Rio Grande do Sul com dezessete profissionais integrantes da Residência Multiprofissional Integrada em Sistema Público de Saúde. Os dados foram coletados no período de janeiro a maio de 2012 por meio de análise documental, observação sistemática e entrevista semiestruturada. Foram respeitados todos os aspectos éticos das pesquisas com seres humanos pautados na Resolução 196/96 do Conselho Nacional de Saúde. A organização e o processamento dos dados foram realizados com o uso do Software Atlas Ti 6.2. A análise dos dados ocorreu mediante á Análise de Conteúdo Temática de Minayo que evidenciou três categorias: percepção dos profissionais integrantes da RMS acerca da educação permanente em saúde; RMIS como espaço intersseçor para o desenvolvimento da EPS e EPS como dispositivo de formação de profissionais em saúde na RMIS. Os resultados apontaram para a compreensão dos integrantes da residência multidisciplinar acerca educação permanente em saúde para além de uma ação estratégica. Também, evidenciam para a identificação da residência multidisciplinar como um espaço intersseçor que permeia a formação do residente pautada nos conceitos da Educação Permanente em Saúde o qual possibilita reflexão das suas práticas articulando as esferas de atenção e gestão, bem como buscando a integração entre teoria e prática e do agir multiprofissional como produtores de ações de saúde. Conclui-se que há necessidade de novas pesquisas com maior aprofundamento e sob outros espaços da manifestação da EPS. OBSERVAÇÃO: Na página 13 da referida Dissertação está a explicação da palavra "intersseçor" estar escrita desta forma.

Dissertação(mestrado)-Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, 2005.
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Este trabalho teve como objetivo principal analisar o processo de trabalho da enfermagem na Rede Básica dos Serviços Públicos de Saúde, na ótica dos princípios da atenção primária ambiental e da promoção da saúde que estão presentes em suas práticas. Tendo como objetivos específicos conhecer o processo de trabalho da enfermagem da Rede Básica dos Serviços Públicos de Saúde; identificar os princípios da promoção da saúde que estão sendo desenvolvidos na Rede Básica dos Serviços Públicos de Saúde; conhecer os princípios da APA que estão sendo operacionalizados no trabalho da enfermagem. Para tanto, o método adotado foi o de um estudo de corte transversal, quanti-qualitativo de caráter exploratório, descritivo e analítico, no qual se buscou conhecer o trabalho desenvolvido pelas enfermeiras da Rede Básica de Saúde, a partir das Unidades de Saúde da Família (USF) e Unidades Básicas de Saúde, nos municípios de Rio Grande e São José do Norte que compõem a 3ª Coordenadoria Regional de Saúde. Conseqüentemente, foi construído um instrumento com 51 perguntas fechadas, de múltipla escolha, que utilizam uma escala de grau de importância com notas de 0 a 10, aplicado às enfermeiras da Rede Básica de Saúde. Ao término deste estudo destacam-se algumas considerações relevantes: a organização do trabalho na Rede Básica de Saúde ocorre em nível local através da participação da Secretaria Municipal de Saúde e das necessidades da população por meio da demanda programática, sendo que este dado foi mais expressivo pelas enfermeiras das USF do que pelas enfermeiras das UBS, entretanto não foi visualizada a participação em conjunto com o Conselho Municipal de Saúde; o trabalho na Rede Básica de Saúde desenvolvido pelas enfermeiras serve para promover a saúde e prevenir a doença; o entendimento sobre a expressão atenção primária ambiental é visualizado por meio das atividades de prevenção a doenças e agravos; o compromisso do profissional como cidadão, em assegurar que cada pessoa tenha acesso a um ambiente saudável é o princípio da atenção primária ambiental visualizado pelas enfermeiras através do trabalho que desenvolvem na Rede Básica de Saúde; a promoção da saúde influencia o trabalho sobre as condições clínicas (processo saúde-doença e seus condicionantes/determinantes); os elementos intrínsecos da promoção da saúde, utilizados pelas enfermeiras no trabalho que desenvolvem na Rede Básica de Saúde são os ambientes favoráveis à saúde, a participação social e o próprio sistema de saúde. Pode-se, então, concluir com esses fatos que o trabalho desenvolvido na Rede Básica de Saúde em âmbito da atenção primária ambiental e da promoção da saúde se aproximam das maneiras como as trabalhadoras desenvolvem suas atividades no processo de trabalho diário, tanto em USF quanto em UBS e constituem-se um caminho para a mudança do modelo assistencial hegemônico nos serviços de saúde.
This work had as a main objective analyze the process of work of the nursing in the Basic Net of Public Services of Health, in the look of the principles of the environment Primary Attention and the Promotion of Health that are present in their practices. Having as specific objectives to know the process of work of the nursing in the Basic Net of Public Services of Health; to identify the principles of the promotion of health that are being developed in the Basic Net of Public Services; to know the principles of APA that are being used in the nursing’s work. Then, the adopted method was a study of a transversal cut, quanti-qualitative with exploratory character, descriptive and analytical, in which we looked for to know the work developed by the nurses of the Basic Net of Health, starting from the Units of Health of Family (USF)and Basic Units of Health, in the municipals districts of Rio Grande and São José do Norte that compose the 3rd Regional Coordinator of Health. Consequently, an instrument was built up with 51 closed questions, multiple choice, that use a scale of degree of importance with grades from 0 to 10, applied to the nurses of the Basic Net Health. At the end of this study, stand out some relevant considerations: the work organization of the Basic Net Health happens in local level through participation of the Municipal General Health office and the needs of the population through the programmatic demand, and this is the detail more expressive for the nurses of the USF than the nurses of the UBS, however, it wasn’t visualized the participation with the Municipal Council Health office; the work in the Basic Net Health developed by the nurses is to promote health and to prevent the disease; the understanding of the expression environment primary attention is visualized through the prevention activities of disease and their offences; the professional’s commitment as a citizen, in assuring that each person has access to a healthy atmosphere is the principle of the environment primary attention visualized by the nurses through the work developed in the Basic Net Health; the promotion of health influences the work about the clinical conditions (health-disease process and its determinations); the intrinsic elements of the health promotion, used by the nurses in the work developed in the Basic Net Health are the favorable atmospheres to the health, the social participation and the own health system. We can say, then, conclude with these facts that the work developed in the Basic Net Health in extent of the environment primary attention and the health promotion approach to the ways that the workers develop their activities in the daily work process, as in the USF as in the UBS and they constituted a way to change the hegemonic assistance model in the health services.
Este estudio tuvo como objetivo principal analizar el proceso de trabajo d la enfermería en la Red Básica dos Servicios Públicos de Salud, en la óptica de los principios de la atención primaria ambiental y de la promoción de la salud los cuales están presentes en sus prácticas. Teniendo como objetivos específicos conocer el proceso de trabajo de la enfermería de la Red Básica dos Servicios Públicos de Salud; identificar los principios de la promoción de la salud que están siendo desarrollados en la Red Básica dos Servicios Públicos de Salud; conocer los principios de la APA que están siendo operacionalizados en el trabajo de la enfermería. Para esto, el método adoptado fue lo de un estudio de corte transversal, canti-cualitativo de carácter exploratorio, descriptivo y analítico, en lo cual se buscó conocer el trabajo desarrollado por las enfermeras de la Red Básica de Salud, a partir de las Unidades de Salud de la Familia (USF) y Unidades Básicas de Salud, en los municipios de Rio Grande y São José do Norte que componen la 3ª Coordinadoría Regional de Salud. Consecuentemente, fue construido un instrumento con 51 preguntas cerradas, de múltipla elección, que utilizaba una escala de grado de importancia con notas de 0 a 10, aplicado a las enfermeras de la Red Básica de Salud. Al término de este trabajo se destacan algunas consideraciones relevantes: la organización del trabajo en la Red Básica de Salud ocurre en nivel local a través de la participación de la Secretaría Municipal de Salud y de las necesidades de la población por medio de la demanda programática, siendo que este dato fue más expresivo por las evaluaciones de las enfermeras de las USF que por las enfermeras de las UBS, sin embargo no fue visualizada la participación en conjunto con el Consejo Municipal de Salud; el trabajo en la Red Básica de Salud desarrollado por las enfermeras sirve para promover la salud y prevenir la enfermedad; el entendimiento sobre la expresión atención primaria ambiental es visualizado por medio de las actividades de prevención a las enfermedades y agravios; el compromiso del profesional como ciudadano, en asegurar que cada persona tenga acceso a un ambiente saludable es el principio de la atención primaria ambiental visualizado por las enfermeras a través del trabajo que desarrollan en la Red Básica de Salud; la promoción de la salud influencia del trabajo sobre las condiciones clínicas (proceso salud-enfermedad y sus condicionantes/determinantes); los elementos intrínsecos de la promoción de la salud, utilizados por las enfermeras en el trabajo que desarrollan en la Red Básica de Salud son los ambientes favorables a la salud, la participación social y el propio sistema de salud. Es posible, entonces, concluir con esos hechos que el trabajo desarrollado en la Red Básica de Salud en ámbito de la atención primaria ambiental y de la promoción de la salud se acercan de las maneras como las trabajadoras desarrollan sus actividades en el proceso del trabajo diario, tanto en USF cuanto en UBS y constituyen un camino para el cambio del modelo asistencial hegemónico en los servicios de salud.

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior
Activities that have fuel subterranean storage system are considered potentially polluting fuels by CONAMA Resolution 273, due to the possibility of leak, outpouring and overflow of fuel into the ground. Being even more worrying when contaminate groundwater for public supply, as the case of Natal City. For this reason, the Public Ministry/RN, in partnership with UFRN, developed the project environmental suitability of Gas stations in Natal, of which 36% showed evidence of contamination. This paper describes the four stages of the management of contaminated areas: preliminary assessment of environmental liabilities, detailed confirmatory investigation of the contamination, risk analysis to human health (RBCA), as well as the remediation plan of degraded areas. Therefore it is presented a case study. For the area investigated has been proposed a mathematical method to estimate the volume of LNAPL by a free CAD software (ScketchUp) and compare it with the partition method for grid area. Were also performed 3D graphics designs of feathers contamination. Research results showed that passive benzene contamination in groundwater was 2791.77 ?g/L, when the maximum allowed by CONAMA Resolution 420 is 5 ?g/L which is the potability standards. The individual and cumulative risks were calculated from 4.4 x10-3, both above the limits of 1.0 x10-5 or by RBCA 1.0 x10-6 by the Public Ministry/RN. Corrective action points that remediation of dissolved phase benzene is expected to reach a concentration of 25 ?g/L, based on carcinogenic risk for ingestion of groundwater by residents residential, diverging legislation. According to the proposed model, the volume of LNAPL using the ScketchUp was 17.59 m3, while by the grid partitioning method was 14.02 m3. Because of the low recovery, the expected removal of LNAPL is 11 years, if the multiphase extraction system installed in the enterprise is not optimized
Atividades que possuem sistema de armazenamento subterr?neo de combust?veis s?o consideradas potencialmente poluidoras pela Resolu??o CONAMA 273/2000, devido ? possibilidade de vazamento, derramamento e transbordamento de combust?veis para o solo. Sendo ainda mais preocupante quando contaminam ?guas subterr?neas destinadas ao abastecimento p?blico, como o caso de Natal. Por este motivo, o Minist?rio P?blico/RN, em parceria com a UFRN, desenvolveu o projeto de adequa??o ambiental dos postos revendedores de combust?veis em Natal, dos quais 36% apresentaram ind?cios de contamina??o. Este trabalho descreve as quatro etapas do gerenciamento de ?reas contaminadas: avalia??o preliminar do passivo ambiental, investiga??o confirmat?ria detalhada da contamina??o, an?lise de risco a sa?de humana (RBCA), bem como o plano de remedia??o das ?reas degradadas. E apresenta um estudo de caso. Para a ?rea investigada ? proposto um m?todo matem?tico para estimar o volume de fase livre auxiliado por um software CAD livre (ScketchUp), este foi comparado com o m?todo de parti??o da ?rea por grid. Tamb?m s?o realizados os designs gr?ficos 3D das plumas de contamina??o. Os resultados da investiga??o de passivo mostraram que a contamina??o por benzeno na ?gua subterr?nea foi 2791,77 ?g/L, quando o m?ximo permitido pela Resolu??o CONAMA 420/2009 ? de 5 ?g/L que ? o padr?o de potabilidade. Os riscos individual e cumulativo calculados foram de 4,4x10-3, ambos acima dos limites aceit?veis pelo RBCA de 1,0x10-5 ou pelo Minist?rio P?blico/RN de 1,0x10-6. A a??o corretiva aponta que a remedia??o da fase dissolvida de benzeno dever? atingir uma concentra??o de 25 ?g/L, com base no risco carcinog?nico, para ingest?o de ?gua subterr?nea para moradores residenciais, divergindo da legisla??o. De acordo com o modelo proposto, o volume de fase livre utilizando o ScketchUp foi de ? de 17,59 m3, enquanto o m?todo de parti??o por grid foi de 14,02 m3. Devido ? baixa recupera??o, a previs?o de remo??o da fase livre ? de 11 anos, caso o sistema de extra??o multif?sica instalado no empreendimento n?o seja otimizado
2020-01-01

INTRODUÇÃO: A hanseníase é uma doença infecciosa crônica granulomatosa, cujo agente etiológico é uma bactéria de vida intracelular obrigatória, o Mycobacterium leprae, que tem no homem seu principal reservatório. A doença possui distribuição universal, predominando atualmente, em latitudes tropicais e tem sido enquadrada entre as enfermidades negligenciadas, atingindo desproporcionalmente populações pobres e marginalizadas. O bacilo é altamente contagioso, de baixa patogenicidade e acomete primordialmente pele e nervos, com grande potencial incapacitante. A doença grassou no Velho Mundo durante a Idade Média e praticamente desapareceu da Europa ainda no início do século XX, antes que qualquer recurso terapêutico eficaz estivesse disponível. Introduzida com os primeiros colonizadores europeus, a hanseníase é doença endêmica no Brasil e um problema de saúde pública. A hanseníase é hiperendêmica em muitos municípios, notadamente nos estados das regiões Norte e Centro-Oeste, que abrangem biomas de cerrado, pântano e floresta amazônica, em vastas áreas de baixa densidade demográfica; estas áreas vêm sofrendo enorme pressão antrópica relacionada ao incremento de atividades agropecuárias e extrativistas, gerando preocupações em relação ao impacto ambiental sobre a saúde humana, decorrente de transformações na dinâmica territorial. OBJETIVO: O propósito desta pesquisa foi conhecer o efeito ecológico de fatores sociodemográficos na delimitação de espaços endêmicos de hanseníase e gerar hipóteses sobre a relação entre a constituição do território e a exposição ambiental ao agente biológico da doença. MATERIAL E MÉTODOS: Supondo que a variação dos fatores de risco para contrair hanseníase pudesse ser maior entre grupos populacionais do que entre indivíduos, foi empreendido um estudo epidemiológico de delineamento ecológico do tipo grupo múltiplo, envolvendo 203 municípios dos estados do Mato Grosso e Mato Grosso do Sul, que estão localizados na região Centro-Oeste do Brasil. Foram constituídas variáveis sociodemográficas de exposição e a variável de efeito foi representada pela taxa de detecção média anual de hanseníase entre os anos de 2000 e 2006. Foram aproveitados dados secundários provenientes do Instituto Brasileiro de Geografia e Estatística e do Ministério da Saúde. Para compor um modelo multivariado, 14 variáveis foram analisadas por regressão linear simples e selecionadas sete variáveis com probabilidade de p < 0,2 para o coeficiente de inclinação da reta de regressão. As variáveis independentes selecionadas foram passo a passo testadas, simultaneamente e analisada a associação da variável dependente, visando o ajuste de um modelo singular da variabilidade da taxa de detecção de hanseníase. RESULTADOS: As variáveis que restaram no modelo após o processo de ajuste foram: Proporção da população moradora em domicílios com seis ou mais pessoas; Proporção da população não natural do estado; e, Cobertura populacional da estratégia de Atenção Saúde da Família. Estas variáveis juntas explicam 24,1% da variação nas taxas de detecção de hanseníase. CONCLUSÕES: Fatores sociodemográficos representam um importante domínio na epidemiologia da doença. A associação positiva do desfecho com a cobertura da estratégia de Atenção Saúde da Família indica que deve haver melhora no acesso ao diagnóstico mediante a implantação de modelos de Atenção Primária à Saúde baseados em racionalidades preventivas. Doentes poderiam ter sua contagiosidade interrompida mais precocemente, uma vez melhorada a capacidade diagnóstica dos serviços de saúde. Como recomendação para melhorar o acesso ao diagnóstico nas áreas endêmicas, a adoção da estratégia de Atenção Saúde da Família deve ser encorajada. Aglomeração domiciliar como variável ecológica foi interpretada como sendo um indicador socioeconômico indireto, mais do que propriamente relacionada às condições de contato. A qualidade da moradia, talvez seja mais importante para controle da endemia, tanto quanto possa vir acompanhada de melhorias gerais no padrão de vida. Reservatórios do M. leprae constituídos por indivíduos que eliminam bacilos cronicamente são os que perpetuam a endemia, embora possam, em tese, serem suplementados por fontes secundárias representadas por portadores transitórios. Fatores ligados à formação da fronteira agrícola e à urbanização brasileira podem ter fomentado a endemia de hanseníase, ao predisporem a renovação de susceptíveis pelas migrações, que modificam a composição populacional quanto à experiência de contato com o bacilo. Migrações poderiam romper os focos de hanseníase que estivessem saturados de indivíduos resistentes ao redistribuir espacialmente a população susceptível, levar infectantes para áreas indenes ou instalar as premissas biológicas e territoriais para tornar o contágio recorrente na população, mesmo que o contingente demográfico proveniente de imigrações não seja predominantemente mais vulnerável à doença. Tecnicização rural e constrições na esfera do trabalho têm movimentado populações que procuram refúgio nas periferias das cidades, caracterizadas por escassa infraestrutura urbana e rápido crescimento demográfico, supostamente continentes de grupos humanos dotados de diferentes perfis de resistência ao M. leprae. O circuito inferior da economia, uma resposta social à escassez de meios de vida e um traço da territorialização brasileira, tem oferecido os predicados espaciais para a persistência da endemia de hanseníase nos bolsões de pobreza urbana, ao gerar uma multiplicidade de contatos em proximidade e alimentar suas relações sociais de uma massa de recém-chegados do campo e da cidade, sua principal e mais abundante variável. Se a geografia estuda as condições de vida sobre a terra, estes resultados sugerem que a topografia médica, para além da descrição dos aspectos demográficos e socioeconômicos dos lugares de surgimento de doenças, pode contribuir em muito ao conhecimento em saúde, ao considerar analisar tais fatores enquanto potenciais condicionantes de endemias
BACKGROUND: Leprosy is a chronic granulomatous infectious disease whose causative agent is an obligate intracellular bacterium of life, Mycobacterium leprae, which has its main reservoir in man. The disease has a worldwide distribution, currently prevailing in tropical latitudes and has been framed between neglected diseases, disproportionately affecting poor and marginalized populations. The bacillus is highly contagious, and low pathogenic primarily affects the skin and nerves, with great potential crippling. The disease raged in the Old World during the Middle Ages and still practically disappeared from Europe in the early twentieth century, before any effective therapeutic resource was available. Introduced with the first European settlers, leprosy is endemic in Brazil and a public health problem. Leprosy is hyperendemic in many cities, especially in the states of North and Midwest, covering biomes savannah, swamp and rainforest, in vast areas of low population density; these areas have suffered huge human pressure related to increased activity agricultural and extractive, generating concerns about the environmental impact on human health, due to dynamic changes in territorial. OBJECTIVE: The purpose of this research was to understand the ecological effect of sociodemographic factors in the delimitation of leprosy-endemic areas and generating concerns about the relationship between the constitution of the territory and environmental exposure to the biological agent of the disease. MATERIAL AND METHODS: Assuming that the variation of the risk factors for contracting leprosy could be higher among population groups than between individuals, an epidemiological study was undertaken to design ecological type group multiple, involving 203 municipalities in the states of Mato Grosso and Mato Grosso do Sul, which are located in the Midwest region of Brazil. Sociodemographic variables were recorded for exposure and effect was variable represented by annual average detection rate of leprosy between 2000 and 2006. We utilized secondary data from the Brazilian Institute of Geography and Statistics and the Ministry of Health to compose a multivariate model, 14 variables were analyzed by linear regression and seven variables selected with probability p<0.2 for the slope coefficient of regression line. The independent variables were tested step by step, and simultaneously analyzed the association of the dependent variable in order to fit a model of the variability of the detection rate of leprosy. The variables that remained in the model after adjustment process were: \"Proportion of population living in households with six or more people,\" \"Proportion of population unnatural state,\" and \"Coverage of Population Health Care Strategy Family \". These variables together explain 24.1% of the variation in detection rates of leprosy. CONCLUSIONS: Sociodemographic factors represent an important area in the epidemiology of the disease. The positive association with the outcome of the strategic coverage of Family Health Care indicates that there must be improved access to diagnosis by implementing models of primary care-based preventive rationales. Patients could have their contagiousness interrupted earlier, once improved the diagnostic capacity of health services. As a recommendation to improve access to diagnosis in endemic areas, the adoption of the strategy of the Family Health Care should be encouraged. Household crowding as ecological variable was interpreted as an indirect socioeconomic indicator, rather than strictly related to contact conditions. The quality of housing, perhaps most important for disease control, as far as can be accompanied by general improvements in living standards. Reservoirs of M. leprae consist of individuals who are chronically eliminate bacilli that perpetuate endemic, although, in theory, be supplemented by secondary sources represented by transient carriers. Factors related to the formation of the agricultural frontier and the Brazilian urbanization may have fostered endemic leprosy, predispose to the renewal of the likely migration, which modify the composition of the population as to the experience of contact with the bacillus. Migration could break outbreaks of leprosy that were saturated with individuals resistant to spatially redistribute the population likely lead to infective areas unaffected or install the territorial and biological assumptions to make the recurring infection in the population, even though the population from immigration quota is not predominantly more vulnerable to disease. Technicisation rural and constrictions in the sphere of labor are busy people seeking refuge on the outskirts of cities, characterized by poor urban infrastructure and rapid population growth, supposedly continents groups of humans with different resistance profiles to M. leprae. The lower circuit of the economy, a social response to the scarcity of livelihood and a dash of Brazilian territorialization, has offered the spatial predicates for the persistence of endemic leprosy in pockets of urban poverty, to generate a plurality of contacts in proximity and feed their social relationships from a mass of newcomers from the countryside and the city, its main and most abundant variable. If geography studies the conditions of life on earth, these results suggest that medical topography, beyond the description of the demographic and socioeconomic aspects of the places outbreaks of diseases, can contribute greatly to health knowledge, to consider examining such factors as potential determinants of diseases

碩士
義守大學
管理學院管理碩士在職專班
101
Baking industry is a traditional industry, but baking industry is the people's livelihood industry, a ring, and the people's lives, so in Europe and other advanced countries, has still spent a lot of money to develop new products, materials and equipment, and personnel training, while investing the majority of the marketing communication resources, and consumers to establish good communication channels, making all kinds of baked goods with the brand image, habitual become people's daily food, so the baking industry is still in the traditional industries continue to improve to meet the trend of the world, ahead of the times front end. In addition, since joining the WTO domestic baking industry will face more and more competition with foreign intense, more and weak profits, the baking industry want sustainable only through enhanced product quality, features and attention to marketing strategies to sustainable development. However, changes in society, to enhance the standard of living after the consumer for the quality of bakery products, features plus more requirements, and baking industry In order to make the product more sophisticated the better it must rely on the development and production of raw materials to products.

Special and differential treatment (SDT) provisions in GATT were created to assist developing countries achieve economic progress while assimilating into the multilateral trading system. Despite these intentions, global trade imbalances still persist. Within this context, I focus on the region of East Asia which has experienced astounding growth in just several decades, propelling it far beyond other developing country regions. Although international trade continues to be the crucial factor driving growth in the region, reliance on SDT has in certain circumstances hindered development. As such, East Asia should seek alternatives to SDT. In that vein, I argue that sustainable growth and trade liberalization can be achieved by enhancing integration through a regional trade agreement. I further discuss various proposals for an East Asian trade agreement such as ASEAN+3, FTAAP, and EARTA. Finally, I highlight the importance of governance and identify several institutions essential for a successful regional arrangement.

The East African Community (EAC) was established in 1967, abolished ten years later, and re-established in 1999. In both cases, it included an international parliamentary institution, the East African Legislative Assembly (EALA). EALA is remarkable for its far-reaching legislative competencies. The EALA is best explained by a combination of diffusion and purpose. The chapter argues that the EAC builds on colonial institutions for the East African region, which were oriented towards establishing a federation and had always featured a legislative assembly. Member states followed this organizational template in both 1967 and 1999. Democratization, while not a cause of EALA itself, is shown to play a role in strengthening EALA in the 1999 treaty.

This chapter examines how opposition political parties have sought to overcome repressive practices in four of the six East African Community Member States: Kenya, Tanzania, Uganda, and South Sudan. Opposition political parties and politicians from these countries have prodded the East African Court of Justice (EACJ) to use a treaty remedy for violations of rules governing the elections of members to the East African Legislative Assembly (EALA) in each of these countries. They have done so by pursuing a judicial remedy in the EACJ to resolve a coordination problem that opposition parties face when their opportunity to participate in an above-board election is compromised. These cases show how challenging the electoral malpractices of dominant parties in the EACJ facilitate opposition mobilization in ways that are not always possible, or even anticipated, in their home country. The EACJ has facilitated this coordination by consistently affirming that above-board elections are the only permissible mode of electing members of the EALA. This has helped opposition political parties to know when they have a factual basis with a likelihood of success so they could bring cases against dominant political parties in the EACJ. By contrast, the lack of cases from Burundi and Rwanda shows that the clamp down on organizational rights in these countries have made it impossible for opposition parties and politicians to bring election cases before the EACJ.

En junio de 1914, a finales de su tercer año como estudiante en Oxford, Tolkien quedó fascinado al descubrir dos versos del poema anglosajón Crist, de Cynewulf: «Eala Earendel engla beorhtast / ofer middangeard monnum sended» (vv. 103-104), que se traducen como «Salve Earendel, el más brillante de los ángeles / enviado a los hombres sobre la media tierra». Con la palabra de Earendel algo despertó en Tolkien: se trataba de un nombre de bella dicción, designador de un ser magnánimo en misión, que no parecía inglés antiguo, pero que había sido guardado por su tradición; es decir, se trataba de algo remoto incluso para los mismos anglosajones, y que indicaba alguna relación con tierras de allende, pues Earendel había sido enviado.