Miracle-dz/UniFAR-FTUs huggingface dataset:
Variabilidade genética e biomarcadores associados ao diabetes gestacional

Gestational diabetes mellitus (gestational diabetes, GDM) is defined as glucose intolerance diagnosed in pregnancy and that is not overt diabetes. The frequency of GDM in the Brazilian population is between 4-7% of pregnancies. The objective of this study, was to associate the genetic variability of polymorphic sites A3243G of mtDNA, rs10885122 of ADRA2A gene, rs2237892 of KCNQ1 gene, rs1801282 of PPARg gene, rs5393 of SLC2A2 gene and rs3758947 of ABCC8 gene with gestational diabetes and investigate for association between laboratorial parameters and the disease. The sample consisted of 814 women (89,7% Euro-Brazilian), classified as healthy (control group, n = 506) and patients with gestational diabetes (GDM group, n = 308). The project was approved by the Ethics in Human Research of the HC-UFPR (CEP / SD: 927.052.10.05 and CAAE: 1924.0.000.091-10). Women in the GDM group had a median age higher than the controls (32 vs 26 years, P<0,001) and higher body mass index (BMI) (32 vs 24 kg/m). Fasting glucose was different between GDM and control group (93 vs 82 mg/dL, P<0,001) and mean HbA1C concentration (5,6%) in GDM group suggests a group with a good glycemic control. Only HDL-C was not different between the groups (P=0,596). The genotyping was performed with fluorescent probes (TaqMan system) or with PCR-RFLP (mtDNA). The studied variants were in the Hardy-Weinberg equilibrium and were not associated with gestational diabetes mellitus in the South Brazilian population. An association between pregnant women with GDM and BMI were found. Carriers of T allele (GT+TT) of ADRA2A gene have higher BMI (2,03kg/m2) than those carriers of G allele. Health pregnant women carrier of G allele (CG+GG; Pro/Ala+Ala/Ala) of PPARg gene have higher BMI (2,2kg/m2) than those women carrier of C allele (CC; Pro/Pro; P=0,003). For the same SNP, pregnant women with GDM and carrying G (CG+GG; Pro/Ala+Ala/Ala) allele have higher HDL-C levels than those carrying C allele (CC; Pro/Pro). For the ABCC8 gene, pregnant women with GDM have higher concentration of 1,5 anhydroglucitol when carrying T allele (CT+TT) than those carrying C allele (CC). This fact suggests that these women have better glycemic control. Serum concentration of advanced glycation end products (AGEs), carboxymethyllysine and pentosidina, quantified by LC-MS/MS, are higher in GDM group (P<0,05) when compared with health pregnant women. The atherogenic index of plasma (AIP), calculated as Log(TG/HDL-C), is a valuable index to identify pregnant women with low risk of gestational diabetes before the 24th week of pregnancy. Pregnant women with AIP bellow 0,454 have low probability of gestational diabetes mellitus in early pregnancy (before 24th week of pregnancy). This index could help the screening for GDM. Key-words: gestational diabetes, mtDNA, ADRA2A, KCNQ1, PPARg, SLC2A2, ABBC8, CML, MG-H1, pentosidine, Log(TG/HDl-C), SNP, genetic variations.
Measuring NHS output growth

We report estimates of output growth for the National Health Service in England over the period 2003/4 to 2006/7. Our output index is virtually comprehensive, capturing as far as possible all the activities undertaken for NHS patients by both NHS and non-NHS providers across all care settings. We assess the quality of output by measuring the waiting times and survival status of every single patient treated in hospital, and we allow for improved disease management in primary care. We propose and apply a method that avoids the traditional requirement for consistent definition of output categories over time in construction of output indices. Use of our approach is critical: it would be not otherwise be possible to calculate output growth for the NHS over the years we consider in any meaningful way. After correcting for significant improvements in data collection in the early period, output growth for the NHS between 2003/4 to 2006/7 averages 5.1% per year, of which 1% is due to improvements in the quality of care.
Development of composite index and ranking the districts using nutrition survey data in Madhya Pradesh, India

Introduction: Level of development in health and nutrition at district level is useful for planning intervention in less developed districts. Aims & Objectives : to develop composite index based on 12 variables to compare development within districts in the state of Madhya Pradesh. Material & Methods : Data collected by National Institute of Nutrition, Hyderabad during 2010-11 on nutritional status of rural children at district level in Madhya Pradesh was used. A total of 22,895 children (Boys: 12379, Girls: 10516), were covered. Results: It was observed that Indore district rank 1 st as per composite index and Singrauli rank last in the district ranking. Three categories of districts were done based on percentile of composite index i.e less developed, developing and developed districts. It was observed that there was significant (p<0.01) trend in the prevalence of undernutrition among three set of districts. Similarly, significant (p<0.01) trend was observed in proportion of children participating regularly in ICDS supplementary feeding programme, use of sanitary latrine and iodized cooking salt among three sets of districts. C onclusions : Widespread disparity in health and nutrition was observed among the districts. It is quite important to examine the extent of improvements needed in different developmental indicators for enhancing the level of development of low developed districts. This will help the planners and administrators to readjust the resources for bringing about uniform development in the state.
The effectiveness of structured food pattern advice for achievement of macronutrient targets in nutrition intervention

Dietary advice to individuals in Medical Nutrition Therapy for the prevention and treatment of disease should be based on the best available evidence. A review of the evidence identifies appropriate nutrients on which to base advice. However, evidence to support the application of advice for the achievement of nutrient targets in free-living individuals has not been adequately determined. In this doctoral program the hypothesis tested was that structured advice based on the pattern of intake from food group sources of required nutrients will result in better achievement of dietary targets and thereby clinical outcomes than advice based on existing core food guides. In developing a more comprehensive food guidance system, nutritional therapy for diabetes treatment provides an appropriate example in which individual macronutrients and the type of fat are targets of advice. A cross-sectional survey of the food habits of a sample of women with Gestational Diabetes Mellitus was conducted to confirm the relevance of food patterns to specific clinical outcomes, in this case, glucose tolerance. Secondly, foods commonly consumed by these women enabled the identification of food groups likely to impact on macronutrient and fat profiles within the diet. Subsequent determination of a total diet model demonstrated that a structured approach to dietary advice relating to nine food groups (vegetables, starch, fruit, milk, soymilk, meat, oily fish/soybeans, monounsaturated and polyunsaturated fats) for the identification of sources of saturated and unsaturated fats would achieve nutritional adequacy and targets for
The Effectiveness of Bilingual Schools: The State of Kuwait

The study aimed at identifying the effectiveness of bilingual schools in the State of Kuwait from principals' and teachers' perceptions due to some variables: gender, qualification and experience. To achieve the purpose of this study, a questionnaire of (60) five-likert scale items in five domains: (behavior of teachers, behavior of directors, outcomes of students, school climate, and the school’s relationship with the local society) was distributed. The questionnaire was applied on a random sample of (316) principals and teachers in bilingual schools. The study came out with a number of outcomes, above which were: The level of effectiveness of bilingual schools from principals' and teachers' perceptions was high in all domains of effectiveness, and it was at its highest in the domain of students' achievement, whereas it was at its lowest in the domains of school environment and the school’s relationship with the local society. The study also found differences with statistical significances among the average of degrees at 0.05 due to: gender, job, nationality and qualification. However, there were no statistical differences between the individuals of the sample in terms of their evaluation of the school’s effectiveness due to experience.
The effect of pedagogic formation training on vocational attitudes of mathematics teacher candidates

Bu arastirma, pedagojik formasyon egitimi sertifika programina devam eden ogretmen adaylarinin meslege iliskin tutumlarindaki degisimlerini belirlemek ve bu degisimin cinsiyet ve mezun olunan lise turu degiskenlerine olan etkisini irdelemek amaciyla yapilmistir. Calisma boylamsal panel arastirma modeline gore desenlenmistir. Arastirmanin orneklemini bir devlet universitesinin pedagojik formasyon egitimi sertifika programina devam eden 114 matematik ogretmen adayi olusturmustur. Arastirmanin sonunda pedagojik formasyon egitimi sertifika programinin ilk asamasindan baslayarak surec icerisinde ogretmen adaylarinin meslege iliskin tutumlarinda olumlu bir degisim gozlemlenmis; ayrica, cinsiyet ve mezun olunan lise turu degiskenlerinin ogretmen adaylarinin meslege yonelik tutum puanlari uzerinde herhangi bir etkisinin olmadigi bulgusuna ulasilmistir.
Health professionals' views of the effectiveness of nutrition care in general practice setting

Aim: The current qualitative study aimed to explore the perceptions of key health professionals relating to the effectiveness of nutrition care provided in the general practice setting. Methods: Twenty-eight health professionals across a range of disciplines (general practitioners (n = 11), practice nurses (n = 3), dieticians (n = 5), naturopaths (n = 5) and exercise physiologists (n = 4)) individually participated in a semistructured telephone interview, guided by an inquiry logic informed by the literature. Interviews were transcribed verbatim and analysed thematically using a constant comparison approach. Results: Health professionals, including general practitioners, perceived that nutrition care provided in the general practice setting was mostly ineffective at improving patient nutrition behaviour. This was reported to be due to nutrition care competency deficits among general practitioners, a general practice reimbursement system that encourages practices inconsistent with quality nutrition care, and a low prioritisation of nutrition care in general practice. Tensions were apparent between health professional groups, which may be hindering the successful implementation of interdisciplinary nutrition care for patients with chronic disease in this setting. Conclusion: Without systematic changes to Australian primary health care model, the demand on general practitioners as primary providers of nutrition care will continue, therefore mandating support for general practitioners providing care in this context. Further research is required to identify strategies to improve nutrition care and opportunities to facilitate integrated health care provided to the general public within the general practice setting.
The profile analysis of attempted-suicide patients referred to Pelonomi Hospital for psychological evaluation and treatment from 1 May 2005 to 30 April 2006

Background. Suicide is an increasing phenomenon worldwide. A suicide occurs every 40 seconds, and there is 1 attempt every 1 to 3 seconds. By 2020, these figures may have doubled. No accurate statistics regarding the occurrence of attempted suicide (or non-fatal suicidal behaviour) in South Africa exist, because there has been no systematic data collection. Aim . The aim of the study was to determine the profile of patients who had attempted suicide and were referred to Pelonomi Hospital, Bloemfontein, for psychological evaluation and treatment during the period 1 May 2005 to 30 April 2006. Method. A descriptive, retrospective study was conducted. The study population comprised 258 attempted-suicide patients referred to Pelonomi Hospital for psychological evaluation and treatment. A data form was compiled to transfer the relevant information from patients’ clinical files. Results . The majority of patients were female (68.9%). The median age was 22 years. The most common method used in suicide attempts was drug overdose (66%) – mostly antidepressants (19.7%)) and analgesics (8.2%). More females than males overdosed on drugs ( p =0.0103). The main precipitating factors included problematic relationships (55.4%), financial problems (22.9%), psychiatric problems (22.1%), arguments (19.8%), abuse (emotional, sexual, physical – 18.2%), low self-esteem/ worthlessness/hopelessness/humiliation (16.7%), and recent life changes (13.2%). Conclusion. The aim of the study was to determine the profile of patients who had attempted suicide. Possible factors associated with suicide attempts in our sample were identified and summarised in the form of a screening checklist. The value of the checklist is that it can be used as a screening method to identify possible suicide risk in patients.
Nivolumab (Nivolumab BMS®) for the second-line therapy of metastatic squamous non-small cell lung cancer

Nivolumab is the first immunotherapy medicine licensed in the European Union for the treatment of squamous-cell non-small cell lung cancer (NSCLC). Based on the findings of the CheckMate 017 trial, nivolumab received market authorisation for previously treated patients with squamous NSCLC in July 2015. This open-label phase III study compared nivolumab with docetaxel in a total of 272 patients with squamous-cell NSCLC who had previously been treated with one platinum-containing regimen Median. Overall survival (the primary outcome of this phase III trial) was increased by 3.2 months in the nivolumab group in comparison to the docetaxel group, resulting in a reduction of risk of death by 41%. With 38%, the risk of progression or death was also statistically lower, leading to a gain in median progression-free survival by 0.7 months. Duration of response was not yet reached in the nivolumab group and was 8.4 months in the docetaxel group. Response rates also favoured the PD-L1 inhibitor (20% vs 9%), with the majority being partial responses (19% vs 9%). In terms of safety outcomes, treatment-related adverse events (AEs) were less frequent in the nivolumab group than in the chemotherapy group. Any-grade AEs occurred in 58% in the nivolumab group in comparison to 86% in the docetaxel group, and grade 3 or 4 AEs in 7% and 55% respectively. Overall, improved outcomes in all assessed endpoints were demonstrated in the CheckMate 017 trial, with fewer AEs in comparison to standard second-line chemotherapy. Nonetheless, high costs are incurred, data for patient-reported outcomes have not been published yet and long-term adverse effects of immune therapies are unknown.
Pharmacology for Nursing Care

Introduction: orientation to pharmacology application of pharmacology in nursing practice pharmacology and the nursing process drug legislation, development, names, and information. Part 1 Basic principles of pharmacology: pharmacokinetics pharmacodynamics drug-drug and drug-food interactions adverse drug reactions individual variation in drug responses. Part 2 Drug therapy across the life span: drug therapy pregnancy and breast feeding drug therapy in paediatric patients drug therapy in geriatric patients. Part 3 Peripheral nervous system drugs: introduction - basic principles of neuropharmacology, physiology of the peripheral nervous system cholinergic drugs - muscarinic agonists and antagonists, cholinesterase inhibitors, neuromuscular blocking agents and ganglionic blocking agents adrenergic drugs - adrenergic agonists, adrenergic antagonists, indirect-acting antiadrenergic agents. Part 4 Central nervous system drugs: introduction - introduction to central nervous system pharmacology neurologic drugs - drugs for Parkinson's disease, drugs for epilepsy, drug therapy of muscle spasm and spasticity analgesics and anaesthetic - opioid (narcotic) analgesics, local anaesthetics, general anaesthetics, drugs for headache psychotherapeutic drugs - antipsychotic agents, antidepressants, drugs for bipolar disorder, benzodiazepines and other drugs for anxiety and insomnia, central nervous system stimulants and their use in attention-deficit/hyperactivity disorder, other psychologic disorders, drug abuse - considerations, alcohol, opioids, depressants, stimulants, marijuana, psychedelics, inhalants, and nicotine. Part 5 Drugs that affect fluid and electrolyte balance: diuretics agents affecting the volume and ion content of body fluids. Part 6 Cardiovascular drugs: review of haemodynamics drugs acting on the renin-angiotensin system calcium channel blockers vasodilators drugs for hypertension drugs for angina pectoris drugs for heart failure management of myocardial infarction antidysrthymic drugs prophylaxis of coronary artery disease - drugs used to lower cholesterol levels. Part 7 Drugs that affect the blood: drugs that affect coagulation - anticoagulants, antiplatelet drugs, and thrombolytics drugs for deficiency anaemias haematopoietic growth factors. Part 8 Endocrine drugs: drugs for diabetes mellitus drugs for thyroid diseases drugs related to hypothalamic and pituitary functions drugs for disorders of the adrenal cortex oestrogens and progestins birth control drugs for infertility uterine stimulants and relaxants androgens. (Part contents).
Factors Predicting Intention for Cervical Cancer Screening among Women Aged 30 to 60 Years in Ratchaburi Province, Thailand: Population-based Study

Cervical cancer is the second most common cancer among women worldwide. Cervical cancer screening can help to detect cancer at an early stage for early treatment. Objective: This descriptive study was conducted in order to predict an intention to receive cervical cancer screening among women aged 30 to 60 years in Ratchaburi province, Thailand. Four hundred and fi fty healthy urban women in this province were recruited by the multi-stage random sampling method. Materials and Methods: The questionnaires were comprised of demographic data, attitude toward cervical cancer screening, subjective norm, perceived behavioral control, and intention to receive cervical cancer screening. Data were analyzed by using stepwise multiple regression analysis. Results: This results of the study revealed that the subjective norm (SN) and perceived behavioral control (PBC) of factors were contributing signifi cantly to the variance accounted for 28.10 percent (R2 = 0.281, p < 0.01) in the intention to receive cervical cancer screening. Recommendations from individual spouse and nearby medical stuff are specific reasons for the intention to receive cervical cancer screening. Conclusion: SN and PBC had important roles for intention to obtain cervical cancer screening. Campaigns for cervical cancer screening promotion should be also carried out in her spout. Key words: cervical cancer screening, intention
Perfil sociodemográfico e condição bucal de usuários de drogas em dois municípios do Estado do Paraná, Brasil

IntroductionEpidemiological survey of the oral conditions of drug users is an important strategy to know this population, whose growth is increasing in Brazil, so that preventive goals and adequate treatment can be proposed.AimThe aim of this study was to identify the sociodemographic profile and oral health condition of drug users in rehab of two municipalities of the State of Parana.Material and methodOne hundred individuals participated in the study, which data were collected by questionnaire and physical exam. The following values were obtained: DMFT index (decay-missing-filled index), probing depth (PD), clinical attachment level (CAL), gingival index (GI), plaque index (PI), and bleeding on probing (BOP). Data analyses were performed by Student t test and one-way ANOVA.ResultThe mean age of participants was 29.12 years. The major frequencies were: male (95.5%), single (69.0%), lower schooling (41%) and higher consumption of licit drugs tobacco (90.9%) and alcohol (84.5%), followed by crack (80.9%), and marijuana (77.3%). The mean DMFT index was 15.21 (SD=5.84), and the longer the dependence time, the greater this index (p<0.05). Mean PD was 3.55 and mean CAL was 3.59. BOP occurred in 82.7% and 79.5% showed moderate inflammation. Detectable plaque and moderate plaque accumulation were observed in 39.5% and 35.3%, respectively.ConclusionPrevalence was observed in young and single males with low schooling, and with consumption of licit and illicit drugs. Poor oral health condition was identified, which deserves more attention from health professional and policymakers for this population.
How Doctors Think: Clinical Judgment and the Practice of Medicine

Introduction: rationality in an uncertain practice PART 1: MEDICINE AS A PRACTICE 1. Medicine and the limits of knowledge 2. The misdescription of medicine 3. Clinical judgement and the interpretation of case PART 2: CLINICAL JUDGEMENT AND THE IDEA OF CAUSE 4. "What brings you here today? ": the idea of cause in medical practice 5. The simplification of clinical cause 6. Clinical judgement and the problem of particularizing PART 3: THE FORMATION OF CLINICAL JUDGEMENT 7. Aphorisms, maxims, and old saws: some rules of clinical reasoning 8. "Don't think zebras": a theory of clinical knowing 9. Knowing one's place: the evaluation of clinical judgement PART 4: CLINICAL JUDGEMENT AND THE NATURE OF MEDICINE 10. The self in medicine: the use and misuse of the science claim 11. A medicine of neighbours 12. Uncertainty and the ethics of practice
A brief antenatal and postnatal preventive intervention programme to enhance the quality of parent-infant interaction in at risk families (abstract)

parents have recently gained more and more attention (Barlow et al., 2003, 2009). Infants in at-risk families (in which parents have severe problems them-selves) often stay invisible to care for a long time, and referrals to professional care generally take place too late. Patterns of negative interactions between parents and infant have already occurred or have even become set, which increases the risk of an adverse socio-emotional development of the child. It is for this reason that the Project “Baby Extra” was initiated. “Baby Extra” functions as an intermediary between at-risk parents and health care providers and closely cooperates with several mental health care organizations, hospitals and youth (health) care centres. During one antenatal and one postpartum two-sessions-module the contact between (expectant) parents and their infant is promoted in an attempt to enhance the quality of parentinfant interaction and to prevent the infant from developing attachment problems. Preventive intervention programmes for vulnerable infants of high-risk parents have recently gained more and more attention (Barlow et al., 2003, 2009). Infants in at-risk families (in which parents have severe problems them-selves) often stay invisible to care for a long time, and referrals to professional care generally take place too late. Patterns of negative interactions between parents and infant have already occurred or have even become set, which increases the risk of an adverse socio-emotional development of the child. It is for this reason that the Project “Baby Extra” was initiated. “Baby Extra” functions as an intermediary between at-risk parents and health care providers and closely cooperates with several mental health care organizations, hospitals and youth (health) care centres. During one antenatal and one postpartum two-sessions-module the contact between (expectant) parents and their infant is promoted in an attempt to enhance the quality of parentinfant interaction and to prevent the infant from developing attachment problems. INTRODUCTION