bluuebunny/crossref_metadata_2025 huggingface dataset:
A regulação municipal ambulatorial de serviços do Sistema Único de Saúde no Rio de Janeiro: avanços, limites e desafios
Authors: Pinto Luiz Felipe , Soranz Daniel , Scardua Mariana Tomasi , Silva Iandara de Moura
Published: April 2017

Resumo O federalismo é o pilar da República, composta pela união dos Estados, dos Municípios e do Distrito Federal, tendo como princípio básico a descentralização político-administrativa, nas relações políticas, econômicas e sociais. Na saúde, o provedor de atenção primária deve ser capaz de integrar todo cuidado que o paciente recebe através da coordenação entre os serviços. Objetiva-se avaliar os resultados dos encaminhamentos de consultas e exames ambulatoriais da APS do município do Rio de Janeiro, demonstrando os avanços, limites e desafios para a gestão no nível local. Estudo quantitativo que utilizou as bases de dados administrativas do Cadastro Nacional de Estabelecimentos de Saúde (CNES) e o Sistema Nacional de Regulação (SISREG), além de uma “linkage” entre ambas as bases. Entre 2011 e 2015, o nº de procedimentos agendados teve um aumento de 86%, como reflexo da descentralização da regulação ambulatorial para os médicos de família. Pode-se inferir que não há falta de especialistas para atendimento ambulatorial no SUS carioca em quase todas as áreas. Existem gargalos artificiais pela ausência de regulação da maior parte da carga horária contratada na especialidade, ou seja, a oferta de vagas é menor do que a capacidade instalada das unidades municipal, estaduais, federais e conveniadas ao SUS.
O processo de regionalização do SUS: revisão sistemática
Authors: Mello Guilherme Arantes , Pereira Ana Paula Chancharulo de Morais , Uchimura Liza Yurie Teruya , Iozzi Fabíola Lana , Demarzo Marcelo Marcos Piva , Viana Ana Luiza d’Ávila
Published: April 2017

Resumo Nesta revisão foram incluídos apenas estudos específicos sobre o processo de regionalização do SUS, baseados em resultados empíricos e publicados a partir de 2006, já sob o referencial do Pacto pela Saúde. Foi evidenciado que o processo de regionalização é hoje uma realidade em todas as esferas de governo, sujeito a um conjunto de desafios comuns às diversas realidades do país. Entre os principais, os colegiados são valorizados com espaços de inovação, mas ainda em busca da superação da cultura política burocrática e clientelista. A governança regional é ainda prejudicada pela fragmentação do sistema e, em particular, pela histórica deficiência com planejamento, desde o nível local às políticas estratégicas de incorporação tecnológica. As análises permitiram implicar a cultura de amplo privilégio para negociação política em detrimento do planejamento como uma das principais responsáveis por um ciclo vicioso que sustenta a deficiência técnica da gestão.
Dificuldade de acesso a serviços de média complexidade em municípios de pequeno porte: um estudo de caso
Authors: Silva Camila Ribeiro , Carvalho Brigida Gimenez , Cordoni Júnior Luiz , Nunes Elisabete de Fátima Pólo de Almeida
Published: April 2017

Resumo O estudo visou analisar a oferta de consultas especializadas pelo SUS de maior dificuldade de acesso em municípios de pequeno porte na 18ª Regional de Saúde do Paraná, utilizando a metodologia de Estudo de Caso. Os dados foram coletados de janeiro a abril de 2015, por meio de entrevistas com gestores, membros das equipes gestoras e a diretoria do Consórcio Intermunicipal de Saúde. As 21 especialidades estudadas foram categorizadas em Cota Suficiente, Cota Insuficiente, Oferta Inexistente e Vazio Assistencial. As áreas de maior dificuldade de acesso na região são: Cirurgia Vascular, Proctologia, Geriatria, Endocrinologia e Neurologia, que foram consideradas oferta inexistente/vazio assistencial. Enquanto que Ortopedia, Neuro-pediatria, Urologia, Reumatologia, Oftalmologia e Otorrinolaringologia foram consideradas insuficientes. Contribuem para a magnitude do problema: carência de especialistas com consequente insuficiência de consultas, dependência do setor privado e redução da participação da União e do Estado na oferta de serviços e no financiamento. A situação da atenção especializada na região é complexa e de difícil solução a curto prazo, reforçando a tese de que a atenção neste nível é atualmente o gargalo do SUS.
Organização dos serviços farmacêuticos no Sistema Único de Saúde em regiões de saúde
Authors: Araújo Suetônio Queiroz , Costa Karen Sarmento , Luiza Vera Lucia , Lavras Carmen , Santana Eucilene Alves , Tavares Noemia Urruth Leão
Published: April 2017

Resumo O presente estudo teve o objetivo de caracterizar os serviços farmacêuticos prestados no Sistema Único de Saúde do Brasil sob a ótica das redes de atenção à saúde em regiões de saúde contempladas no Projeto QualiSUS-Rede. O estudo teve delineamento transversal, com coleta de dados de dezembro de 2013 a julho de 2015 em todos os estabelecimentos públicos de saúde que realizavam entrega/armazenamento de medicamentos (n = 4.938) de 465 municípios e Distrito Federal em 43 regiões de saúde. Os resultados mostram a existência de pelo menos um serviço gerencial de apoio à rede de saúde além do armazenamento de medicamentos em todas as regiões (> 90%). E de forma irregular entre as Regiões, há a oferta de pelo menos um serviço assistencial nos pontos de atenção pelos profissionais farmacêuticos, ocorrendo em maior proporção na Região Sudeste (74,3%) e menor na Nordeste (43,3%). Os resultados reforçam a necessidade da efetiva estruturação da assistência farmacêutica nas RAS superando uma visão restritiva das suas atividades, que valoriza quase que exclusivamente seu componente logístico de apoio a rede em detrimento da clínica. É igualmente importante ampliar e aprimorar o acesso da população aos medicamentos assim como e qualificar o cuidado em saúde ofertado aos usuários do sistema.
Regionalização em Saúde no Amazonas: avanços e desafios
Authors: Garnelo Luiza , Sousa Amandia Braga Lima , Silva Clayton de Oliveira da
Published: April 2017

Resumo O artigo analisa o processo de regionalização em saúde no estado do Amazonas por meio de estudo de caso da regional em Saúde Entorno de Manaus. Pesquisa qualitativa, descritivo-analítica, cujos dados foram coletados através de entrevistas, revisão de documentos e de páginas de internet, tomando como conceito guia a regionalização em saúde. Os achados do estudo mostram uma cena social onde predominam a assimetria, a verticalidade, a competitividade e a fragilidade das relações multilaterais entre municípios, associados a um perfil cartorial das instituições que atuam na região de saúde sob estudo. Os agentes políticos envolvidos no processo têm limitado reconhecimento das condições sociopolíticas e institucionais em que atuam. Tendem a atribuir os problemas de gestão e operacionalização das redes de assistência à configuração dos espaços naturais-geográficos amazônicos, mas seu financiamento, governança e capacidade técnica são insuficientes para superá-los.
Is reiki or prayer effective in relieving pain during hospitalization for cesarean? A systematic review and meta-analysis of randomized controlled trials
Authors: Ferraz Guilherme Augusto Rago , Rodrigues Meline Rosseto Kron , Lima Silvana Andrea Molina , Lima Marcelo Aparecido Ferraz , Maia Gabriela Lopes , Pilan Neto Carlos Alberto , Omodei Michelle Sako , Molina Ana Cláudia , El Dib Regina , Rudge Marilza Vieira Cunha
Published: April 2017

ABSTRACT CONTEXT AND OBJECTIVE: This systematic review compared reiki and prayer with drug use for relieving pain during hospitalization for cesarean, given that the popularity of integrative medicine and spiritual healing has been increasing. It had the aim of evaluating whether reiki or prayer is effective in relieving pain during cesarean section. DESIGN AND SETTING: Systematic review with meta-analysis conducted at Botucatu Medical School, UNESP, São Paulo, Brazil. METHODS: The following databases were searched up to March 2016: MEDLINE, Embase, LILACS and CENTRAL. Randomized controlled trials published in English or Portuguese were included in the review. Two reviewers independently screened eligible articles, extracted data and assessed the risk of bias. A GRADE table was produced to evaluate the risk of bias. RESULTS: There was evidence with a high risk of bias showing a statistically significant decrease in pain score through use of reiki and prayer, in relation to the protocol group: mean difference = -1.68; 95% confidence interval: -1.92 to -1.43; P < 0.00001; I2 = 92%. Furthermore, there was no statistically significant difference in heart rate or systolic or diastolic blood pressure. CONCLUSION: Evidence with a high risk of bias suggested that reiki and prayer meditation might be associated with pain reduction.
Risk assessment and incidence of falls in adult hospitalized patients
Authors: Pasa Thiana Sebben , Magnago Tânia Solange Bosi De Souza , Urbanetto Janete De Souza , Baratto Mari Angela Meneghetti , Morais Bruna Xavier , Carollo Jéssica Baldissera
Published: April 2017

Abstract Objectives: assess the risk of falls in adult hospitalized patients and verify the incidence of the event in this environment. Method: cohort study, with approval by the Research Ethics Committee, which monitored 831 patients hospitalized at a university hospital. The Morse Fall Scale (MFS) was used to assess the risk and patients with high risk (≥45 points) were considered exposed to falls. Results: the mean MFS score was 39.4 (±19.4) points. Between the first and the final assessment, the score increased by 4.6%. The first assessment score presented a strong and positive correlation with the final assessment score (r=0.810; p=0.000). Conclusion: the higher the risk score for falls when the patient is admitted, the higher the score at the end of the hospitalization period and vice-versa. The incidence rate corresponded to 1.68% with a higher percentage of patients classified at high risk of falls.
Adesão à terapêutica antirretroviral de pessoas vivendo com HIV/aids em um município do interior paulista
Authors: Foresto Jaqueline Scaramuza , Melo Elizabete Santos , Costa Christefany Régia Braz , Antonini Marcela , Gir Elucir , Reis Renata Karina
Published: April 2017

RESUMO Objetivo Avaliar a adesão aos antirretrovirais de pessoas vivendo com o HIV/AIDS e identificar sua associação com variáveis sociodemográficas e clínicas. Métodos Estudo analítico transversal que utilizou instrumento sociodemográfico e o CEAT-HIV, com dados coletados no período de 2014 a 2015. Resultados Identificou-se 75,0% com grau de adesão bom/adequado. Verificou-se que os indivíduos com idade entre 40 e 59 anos (p=0,029) e com mais de oito anos de estudo (p=0,043) obtiveram maior grau de adesão, assim como aqueles com diagnóstico de HIV/AIDS há mais de 10 anos (p=0,002), contagem de TCD4 >350 células/mm3 (p<0,001) e carga viral indetectável (p=0,025). Conclusão Nesse estudo, identificou-se uma boa adesão entre os sujeitos e observou-se que indivíduos de maior faixa etária, maior grau de escolaridade, maior tempo de diagnóstico, elevada contagem de células TCD4 e carga viral indetectável estiveram associados a uma maior adesão ao tratamento.
PHYSIOLOGICAL RESPONSES OF DWARF COCONUT PLANTS UNDER WATER DEFICIT IN SALT-AFFECTED SOILS
Authors: SILVA ALEXANDRE REUBER ALMEIDA DA , BEZERRA FRANCISCO MARCUS LIMA , LACERDA CLAUDIVAN FEITOSA DE , SOUSA CARLOS HENRIQUE CARVALHO DE , BEZERRA MARLOS ALVES
Published: April 2017

ABSTRACT The objective of this study was to characterize the physiological acclimation responses of young plants of the dwarf coconut cultivar Jiqui Green‘ associated with tolerance to conditions of multiple abiotic stresses (drought and soil salinity), acting either independently or in combination. The study was conducted under controlled conditions and evaluated the following parameters: leaf gas exchange, quantum yield of chlorophyll a fluorescence, and relative contents of total chlorophyll (SPAD index). The experiment was conducted under a randomized block experimental design, in a split plot arrangement. In the plots, plants were exposed to different levels of water stress, by imposing potential crop evapotranspiration replacement levels equivalent to 100%, 80%, 60%, 40%, and 20%, whereas in subplots, plants were exposed to different levels of soil salinity (1.72, 6.25, 25.80, and 40.70 dS m-1). Physiological mechanisms were effectively limited when water deficit and salinity acted separately and/or together. Compared with soil salinity, water stress was more effective in reducing the measured physiological parameters. The magnitudes of the responses of plants to water supply and salinity depended on the intensity of stress and evaluation period. The physiological acclimation responses of plants were mainly related to stomatal regulation. The coconut tree has a number of physiological adjustment mechanisms that give the species partial tolerance to drought stress and/or salt, thereby enabling it to revegetate salinated areas, provided that its water requirements are at least partially met.
APPLICATION OF ANTIOXIDANTS AND EDIBLE STARCH COATING TO REDUCE BROWNING OF MINIMALLY-PROCESSED CASSAVA
Authors: COELHO DANIEL GOMES , ANDRADE MOAB TORRES DE , MÉLO NETO DOMINGOS FERREIRA DE , FERREIRA-SILVA SÉRGIO LUIZ , SIMÕES ADRIANO DO NASCIMENTO
Published: April 2017

ABSTRACT This study aimed to evaluate the quality of minimally-processed cassava treated with antioxidants and a starch-based edible coating. Cassava roots were washed, cooled, immersed in cold water, peeled and then cut. Root pieces were then immersed in a chloride solution, centrifuged, and subsequently immersed in either a starch suspension (3%), a solution containing antioxidants (3% citric acid and 3% ascorbic acid), or in both the coating and antioxidant solutions. Coated root pieces were dried at 18 ± 2°C for 1 hour, then packaged into polypropylene bags (150 g per pack) and kept at 5 ± 2°C for 15 days, and assessed every 3 days. A completely randomized design was used in a 4 × 6 factorial consisting of the treatment (control, coating, antioxidant, or coating and antioxidant) and the storage period (0, 3 6, 9, 12 or 15 days), with three replicates in each group. The pH, blackened area and peroxidase and polyphenol oxidase activities of the cassava was reduced in treatments containing antioxidants and the scores of visual analysis and phenolic content were higher. Therefore, treatment with antioxidants was effective for reducing browning in minimally- processed cassava, retaining the quality of cassava pieces stored for 15 days at 5 ± 2°C. The combination of antioxidants and the edible coating showed no improvement compared to treatment with antioxidants alone.
GRAFT TAKES OF TOMATO ON OTHER SOLANACEOUS PLANTS
Authors: ZEIST ANDRÉ RICARDO , RESENDE JULIANO TADEU VILELA DE , GIACOBBO CLEVISON LUIZ , FARIA CACILDA MARIA DUARTE RIOS , DIAS DIEGO MUNHOZ
Published: April 2017

ABSTRACT This paper aimed to assess tomato grafting on different solanaceous species through two grafting methods. Scions were cut from cultivar Santa Cruz Kada seedlings. A fully randomized experimental design was carried out with treatments in a 9 x 2 factorial scheme. As rootstocks, four accessions of mini-tomatoes (0224-53, RVTC 57, RVTC 20 and 6889-50 - Solanum lycopersicum L); two species of wild tomato (Solanum habrochaites var hirsutum ‘PI-127826’ and Solanum pennellii ‘LA716’); other two tomato species [Solanum, cocona (Solanum sessiliflorum) and physalis (Physalis peruviana)] and a control with cultivar Santa Cruz Kada (auto-graft) rootstocks were used. In addition, two grafting methods were evaluated full cleft and approach graft. Fifteen days after grafting, plants were assessed for graft-take percentage; root length; plant height; leaf number; foliar area; root, stem and leaf dry matter; and ratio between shoot and root dry matter. Based on the results, we may state rootstock and grafting interaction had effect on both graft -take rate and plant development. Overall, the studied plants should be recommended as rootstock, except for 6889-50 mini-tomato (S. lycopersicum L.) and S. pennellii. Full cleft grafting was most suitable for cocona and physalis, while the approach method showed better results for the mini-tomato accessions 0224-53, RVTC 57 and RVTC 20, as well as for S. habrochaites.
Photoelastic analysis of stress generated by Connecticut Intrusion Arch (CIA)
Authors: Schwertner Alessandro , Almeida Renato Rodrigues de , Gonini Jr Alcides , Almeida Marcio Rodrigues de
Published: April 2017

ABSTRACT Objective: The present in vitro study evaluated, by means of the photoelastic technique, the effects generated by the Connecticut Intrusion Arch (CIA), with a 90o bend on the distal surface of molar tubes and using the 4 x 2 appliance on the anterior and posterior regions of the upper dental arch. Methods: Five models were manufactured, in which two different clinical situations were correlated: 1) use of intrusion arch not cinched back and transpalatal bar for anchorage (Group 1); 2) use of intrusion arch cinched back and transpalatal bar for anchorage (Group 2). Stress generated in the apical and middle regions of tooth roots of maxillary anterior teeth and maxillary first molars was evaluated. Results: Taking a reference value of 1.0 MPa = 100%, qualitative descriptive analysis was performed, which showed uniformity between stress values in the apical region of anterior teeth of both groups (G1 and G2). In the posterior region, for models with the arch cinched back (G2), stress remained within 100%. As for G1 models (with the arch not cinched back), variations in the mesial surface of first molars were observed, with an increase of 20% in the generated stress. The apical region did not undergo any changes, while in the distal region of molars there was a decrease of 20% in stress. Conclusion: Laboratory results revealed differences in stress between Groups 1 and 2 in the molar region, thereby indicating that there was a tendency towards mesial root tipping of first molars when the distal end of the CIA was not cinched back.
Simulation of land use scenarios in the Camboriú River Basin using the SWAT model
Authors: Blainski Éverton , Porras Eileen Andrea Acosta , Garbossa Luis Hamilton Pospissil , Pinheiro Adilson
Published: April 2017

ABSTRACT Changes in the Earth’s landscape have been the focus of much environmental research. In this context, hydrological models stand out as tools for several assessments. This study aimed to use the Soil and Water Assessment Tool (SWAT) hydrological model to simulate the impact of changes in land use in the Camboriú River Watershed in the years 1957, 1978, and 2012. The results indicated that the SWAT model was efficient in simulating water flow and sediment transport processes. Thus, it was possible to evaluate the impact of different land use scenarios on water and sediment yield in the catchment. The changes in land use caused significant changes in the hydro-sedimentological dynamic. Regarding flow, the effects of land use changes were more pronounced at both ends of the curve representing duration of flow. The worst scenario was identified for the year 2012, which saw the highest peak discharges during flood events and lowest flows during the dry season. Concerning soil erosion, the highest values were identified for sub-basins that were predominantly covered by rice paddies and pastures; this was attributed mainly to surface runoff and changes in land use (represented by C-USLE). Overall, the Camboriú River Basin did not experience severe soil erosion issues; however, it was found that changes in land use related to soil and climate characteristics may increase soil degradation, especially in years with high precipitation levels.
Trajetórias de mulheres privadas de liberdade: práticas de cuidado no reconhecimento do direito à saúde no Centro de Referência de Gestantes de Minas Gerais
Authors: Lopes Tatiana Coelho , Pinheiro Roseni
Published: April 2017

Resumo Objetivo: Analisar a trajetória de cuidado de mulheres de um Centro de Referência a Gestantes Privadas de Liberdade (CRGPL), no que concerne às práticas dos trabalhadores no reconhecimento do direito à saúde e integralidade do cuidado. Metodologia: Adotaram-se a fenomenologia sociológica e a teoria do reconhecimento proposta por Alex Honneth (2003). Entrevistaram-se mulheres, agentes penitenciárias, diretores do CRGPL e do Hospital Sofia Feldman e profissionais de saúde, sendo realizada observação direta. Resultados e discussão: Identificaram-se três planos de reconhecimento, sendo que a autoconfiança foi verificada nas relações de vínculo e acolhimento dessas mulheres por gestores e trabalhadores. O autorrespeito foi identificado no entendimento, de profissionais e gestores, de que essas mulheres perderam seus direitos civis, mas que a saúde como um direito deve ser garantida. Verificou-se a autoestima na rede de solidariedade e compromisso construída de forma que resolutividade, referência e contrarreferência dessas mulheres sejam capazes de garantir o direito e a integralidade do cuidado. Conclusões: O estudo busca dar visibilidade a formas de cuidado mais solidárias, em que a garantia à saúde e ao cuidado integral não sejam apenas o cumprimento de um direito individual, mas uma nova forma de tratar essa questão na sociedade.
A avaliação da educação superior diante de uma colonialidade do saber e do poder: a participação política discente
Authors: Campos Douglas Aparecido de
Published: April 2017

Resumo: Este artigo é o resultado de investigação em pós-doutorado que analisou e discutiu a participação política dos estudantes nos espaços democráticos de duas universidades públicas: no Brasil e Portugal. Sob o enfoque do colonialismo, ainda presente na atualidade, e da colonialidade do poder e do saber nas interações acadêmicas desenvolvemos as discussões, tendo como fundamentação o referencial teórico de Boaventura de Sousa Santos. Investigamos os fatores que provocam essa despolitização dentro da comunidade acadêmica, principalmente, os que afetam e criam culturalmente essa omissão do corpo discente nas deliberações próprias dos setores da universidade, instituição esta, que deveria garantir o direito de participação política em todas as suas instâncias. Temos como pontos principais: primeiro, o de que democracia e participação são entes distintos, mas, convergentes; segundo, que a participação exige pelo menos três condições: o caráter cultural, o caráter político e caráter epistemológico. Neste contexto desenvolveremos no primeiro momento a democracia como princípio e a estrutura organizacional como fundamento das universidades públicas, a partir das mudanças implementadas nos últimos anos nas universidades brasileiras com a Reestruturação e Expansão das Universidades Federais - REUNI; no segundo momento, o colonialismo, ainda, presente nas universidades, bem como a descaracterização de sua estrutura (fundamento), a partir das relações de poder entre suas bases, principalmente, no que diz respeito às relações entre corpo docente e discente. Os instrumentos metodológicos principais foram questionários e entrevistas. Os resultados demonstraram que em ambas as instituições não há formação política orientada ao corpo discente. Os alunos entram e saem da universidade despolitizados.
Civil liability of the ophthalmologist in the São Paulo Court of Appeals
Authors: Braga Isabel de Fátima Alvim , Vieira Kelly de Oliveira , Martins Thiago Gonçalves dos Santos
Published: April 2017

ABSTRACT Objective To conduct a data survey on the subject of medical claims involving civil liability in ophthalmology at the São Paulo Court of Appeals. Methods A case law research was carried out on the São Paulo Court of Appeals website searching for the keyword “ophthalmologist” for all years until 2016. Results Of the 65 cases found, 29 were selected. There has been an increase in the number of claims in ophthalmology, especially in surgical procedures on the anterior chamber of the eye. Most lower court judgments were for defendant. Conclusion The study suggested the need for specialists to exercise the required amount of care when treating the patients, so that they may understand the risks inherent to the procedure. Despite the increase in claims, most decisions were favorable for the physician.
Effects of zinc supplementation on fatigue and quality of life in patients with colorectal cancer
Authors: Ribeiro Sofia Miranda de Figueiredo , Braga Camila Bitu Moreno , Peria Fernanda Maris , Martinez Edson Zangiacomi , Rocha José Joaquim Ribeiro da , Cunha Selma Freire Carvalho
Published: April 2017

ABSTRACT Objective To investigate the effects of oral zinc supplementation on fatigue intensity and quality of life of patients during chemotherapy for colorectal cancer. Methods A prospective, randomized, double-blinded, placebo-controlled study was conducted with 24 patients on chemotherapy for colorectal adenocarcinoma in a tertiary care public hospital. The study patients received zinc capsules 35mg (Zinc Group, n=10) or placebo (Placebo Group, n=14) orally, twice daily (70mg/day), for 16 weeks, from the immediate postoperative period to the fourth chemotherapy cycle. Approximately 45 days after surgical resection of the tumor, all patients received a chemotherapeutic regimen. Before each of the four cycles of chemotherapy, the Functional Assessment of Chronic Illness Therapy-Fatigue scale was completed. We used a linear mixed model for longitudinal data for statistical analysis. Results The scores of quality of life and fatigue questionnaires were similar between the groups during the chemotherapy cycles. The Placebo Group presented worsening of quality of life and increased fatigue between the first and fourth cycles of chemotherapy, but there were no changes in the scores of quality of life or fatigue in the Zinc Group. Conclusion Zinc supplementation prevented fatigue and maintained quality of life of patients with colorectal cancer on chemotherapy.
Cement blocks with EVA waste for extensive modular green roof: contribution of the components for thermal insulation
Authors: MELO A. B. DE , MENDONÇA T. N. M.
Published: April 2017

Abstract Green roofs can contribute in many ways to the quality of the environment, being known for reducing the heat transfer to the interior of the buildings. Amongst the available techniques for the execution of this type of covering, the use of light cement blocks which are compatible with the system of extensive modular green roofs is proposed. For the light cement blocks, produced with EVA aggregates (waste from the footwear industry), an additional contribution in the capacity of thermal insulation of the proposed green roof is expected. In the present article, the demonstration of such contribution is intended through measurements carried out in prototypes in hot and humid climates. After characterizing the capacity of thermal insulation of the proposed green roof, with different types of conventional covering as a reference, an additional contribution of the component used in this green roof was identified by making comparisons with measurements collected from another green roof, executed with cement blocks without the presence of the EVA aggregates. In the experiments, external and internal surface temperatures were measured in each of the prototypes' coverings, as well as the air temperatures in the internal and external environments. From the analysis of the data for a typical summer day, it was possible to prove that the proposed green roof presented the lowest temperature ranges, considering the internal air and surface temperatures. The presence of the EVA aggregates in the proposed blocks contributed to the decrease of the internal temperatures.
Cidadãos e cidadãs na cidade grega clássica. Onde atua o gênero?
Authors: Cuchet Violaine Sebillotte
Published: April 2017

Resumo O gênero, enquanto categoria analítica, combinado aos trabalhos pioneiros dos anos 1980 sobre o caráter misto da maioria das práticas cívicas e do léxico da cidadania, convidam-nos a traçar um quadro da cidadania grega clássica (nomeadamente ateniense) bastante afastado da definição dada por Aristóteles no livro III das Politika (1275b17-20). O presente artigo busca distinguir, por um lado, o que diz respeito ao regime democrático, propriamente dito - e, de forma mais geral, à abordagem que visa descrever regimes políticos (na Grécia antiga ou alhures) -, do que diz respeito, por outro lado, às práticas cívicas dos politai - práticas “políticas”, em termos gregos -, nas quais, embora diferenciados em suas funções, mulheres e homens são solidários.
A corrupção na Época Moderna - conceitos e desafios metodológicos
Authors: Romeiro Adriana
Published: April 2017

Resumo Este artigo aborda o conceito da corrupção nas sociedades da Época Moderna,indagando sobre a sua pertinência naquele contexto histórico. A partir de uma investigação sobre os significados da palavra corrupção nos textos coevos,propõe-se a refletir sobre as noções que estruturavam o imaginário do mau governo. Considerada um vício,a ambição desmedida dos governantes era objeto de condenação nos textos políticos e morais da época,sendo apontada como uma das causas da corrupção do corpo da República.
A monarquia papal (1000-1300): a fundação de um conceito
Authors: Rust Leandro Duarte
Published: April 2017

Resumo A vinculação do papado à história medieval sofreu profunda alteração após 1850. Até então habituais, as referências intelectuais sobre as características medievais do poder temporal dos papas tornaram-se genéricas e insuficientes. Um novo modelo interpretativo ganhou contornos, sobrepujando as explicações existentes. Ancorado na aplicação do método de crítica documental e reivindicando credenciais científicas, esse modelo fixou os séculos seguintes ao ano 1000 como período da institucionalização da Igreja romana, isto é, de sua transformação em uma monarquia papal. Com esse trabalho, buscamos esclarecer como se deu essa fundação historiográfica, analisando a importância do trabalho do erudito francês Paul Fabre e a publicação da edição moderna do Liber Censuum. Toda argumentação é orientada por uma hipótese: esse deslocamento epistemológico naturalizou certas categorias políticas oitocentistas na escrita da história medieval.
Kaposi Sarcoma Inflammatory Cytokine Syndrome (KICS): A Rare but Potentially Treatable Condition
Authors: Karass Michael , Grossniklaus Emily , Seoud Talal , Jain Sanjay , Goldstein Daniel A.
Published: April 2017

Kaposi sarcoma inflammatory cytokine syndrome (KICS) is a newly-described condition affecting individuals who are HIV-positive and are infected with human herpesvirus 8 (HHV-8). This is a syndrome that in some ways mimics severe sepsis with associated acute respiratory distress syndrome, possibly requiring a ventilator and vasopressor support. However, unlike severe sepsis, antibiotics provide no benefit. Management of KICS has not been fully elucidated because of its high mortality rate. However, the syndrome has been successfully treated in some cases with immunomodulatory therapy. It is crucial for oncologists to be able to recognize this syndrome and to institute the appropriate therapy.
FDA Approval Summary: Atezolizumab for the Treatment of Patients with Progressive Advanced Urothelial Carcinoma after Platinum-Containing Chemotherapy
Authors: Ning Yang-Min , Suzman Daniel , Maher V. Ellen , Zhang Lijun , Tang Shenghui , Ricks Tiffany , Palmby Todd , Fu Wentao , Liu Qi , Goldberg Kirsten B. , Kim Geoffrey , Pazdur Richard
Published: April 2017

Until recently in the United States, no products were approved for second-line treatment of advanced urothelial carcinoma. On May 18, 2016, the U.S. Food and Drug Administration approved atezolizumab for the treatment of patients with locally advanced or metastatic urothelial carcinoma whose disease progressed during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy. Atezolizumab is a programmed death-ligand 1 (PD-L1) blocking antibody and represents the first approved product directed against PD-L1. This accelerated approval was based on results of a single-arm trial in 310 patients with locally advanced or metastatic urothelial carcinoma who had disease progression after prior platinum-containing chemotherapy. Patients received atezolizumab 1,200 mg intravenously every 3 weeks until disease progression or unacceptable toxicity. Key efficacy measures were objective response rate (ORR), as assessed by Independent Review per RECIST 1.1, and duration of response (DoR). With a median follow-up of 14.4 months, confirmed ORR was 14.8% (95% CI: 11.1, 19.3) in all treated patients. Median DoR was not reached and response durations ranged from 2.1+ to 13.8+ months. Of the 46 responders, 37 patients had an ongoing response for ≥ 6 months. The most common adverse reactions (≥20%) were fatigue, decreased appetite, nausea, urinary tract infection, pyrexia, and constipation. Infection and immune-related adverse events also occurred, including pneumonitis, hepatitis, colitis, endocrine disorders, and rashes. Overall, the benefit-risk assessment was favorable to support accelerated approval. The observed clinical benefits need to be verified in confirmatory trial(s).
The Role of Anti-vascular Endothelial Growth Factor Agents in the Management of Retinopathy of Prematurity
Authors: Conrady Christopher D ,   Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah, Utah, US, Hartnett M Elizabeth ,   Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah, Utah, US
Published: April 2017

Retinopathy of prematurity is a vasoproliferative disease of preterm infants and has effects on infant vision and overall development. It is increasing worldwide with advances in perinatal care. In the following manuscript, we review the pathophysiology and possible treatments. We focused on anti-vascular endothelial growth factor (VEGF) agents and a few select other candidates.
Systemic inflammation and Viral Exposure among Young Mexican American Women: Nativity-Related Differences
Authors: Rosenberg Natalya , Daviglus Martha L. , DeVon Holli A. , Park Chang Gi , Eldeirawi Kamal
Published: April 2017

Background: Factors contributing to el­evated inflammation in racial/ethnic minor­ity populations are not well understood. We examined the association of viral exposure with C-reactive protein (CRP) in young Mexican American women.

Methods and Results: Participants (N=1,141) were currently non-pregnant women of Mexican background, aged 18- 39 years, from the cross-sectional National Health and Nutrition Examination Survey (NHANES) 1999-2010. Viral exposure was defined as seropositive status for hepatitis B, and herpes simplex types 1 and 2, and classified as seronegative, seropositive for any one agent, and seropositive for 2 or 3 agents. The association of viral exposure with elevated CRP (3.01-10.00 mg/L) varied by country of birth (P=.001). Among Mexico-born women, those seropositive for 2 or 3 agents had 3.79 times (95% CI: 1.28- 11.27) and those seropositive for any one agent 2.56 times (95% CI: 1.12-5.86) the odds of elevated CRP compared with sero­negative women, after adjustment for age, country of birth, household density, waist circumference, glycated hemoglobin, and total cholesterol. Among US-born women, the corresponding odds were OR: .32, 95% CI: .12-.86 and OR: .71, 95% CI .43-1.17.

Conclusions: In Mexico-born Mexican American women, viral exposure is associ­ated with higher odds of elevated CRP.

Ethn Dis. 2017;27(2):133-142; doi:10.18865/ed.27.2.133.
Impact of Distress Reduction on Behavioral Correlates and A1C in African American Women with Uncontrolled Type 2 Diabetes: Results from EMPOWER
Authors: Cummings Doyle M. , Lutes Lesley D. , Littlewood Kerry , Solar Chelsey , Hambidge Bertha , Gatlin Peggy
Published: April 2017

Objective: Symptoms of emotional distress related to diabetes have been associated with inadequate self-care behaviors, medication non-adherence, and poor glycemic control that may predispose patients to premature death. African American women, in whom diabetes is more common and social support is often insufficient, may be at particularly high risk. The objective of this study was to examine the impact of lowering diabetes-re­lated emotional distress on glycemic control and associated behavioral correlates in rural African American women with uncontrolled type 2 diabetes (T2D).

Design: Post-hoc analysis of prospective, randomized, controlled trial.

Setting: Rural communities in the southeast­ern United States.

Patients: 129 rural middle-aged African American women with uncontrolled type 2 diabetes (T2D)(A1C ≥ 7.0).

Primary Independent Variable: Diabetes-related distress.

Main Outcome Measures: Changes from baseline to 12-month follow-up in diabetes-related distress, and associated changes in medication adherence, self-care activities, self-efficacy, and glycemic control (A1C).

Results: Patients with a reduction in diabe­tes-related distress (n=79) had significantly greater improvement in A1C, medication adherence, self-care activities, and self-effi­cacy compared with those in whom diabetes distress worsened or was unchanged (n=50). Changes in distress were also significantly and inversely correlated with improvements in medication adherence, self-care activities, and self-efficacy.

Conclusions: Among rural African Ameri­can women, reductions in diabetes-related distress may be associated with lower A1C and improvements in self-efficacy, self-care behaviors, and medication adherence.

Ethn Dis. 2017;27(2):155-160; doi:10.18865/ed.27.2.155.
Racial and Ethnic Differences in a Linkage With the National Death Index
Authors: Miller Eric A. , McCarty Frances A. , Parker Jennifer D.
Published: April 2017

Objectives: Differences in the availability of a Social Security Number (SSN) by race/ ethnicity could affect the ability to link with death certificate data in passive follow-up studies and possibly bias mortality dispari­ties reported with linked data. Using 1989- 2009 National Health Interview Survey (NHIS) data linked with the National Death Index (NDI) through 2011, we compared the availability of a SSN by race/ethnicity, estimated the percent of links likely missed due to lack of SSNs, and assessed if these estimated missed links affect race/ethnic­ity disparities reported in the NHIS-linked mortality data.

Methods: We used preventive fraction methods based on race/ethnicity-specific Cox proportional hazards models of the relationship between availability of SSN and mortality based on observed links, adjusted for survey year, sex, age, respondent-rated health, education, and US nativity.

Results: Availability of a SSN and observed percent linked were significantly lower for Hispanic and Asian/Pacific Islander (PI) participants compared with White non-His­panic participants. We estimated that more than 18% of expected links were missed due to lack of SSNs among Hispanic and Asian/PI participants compared with about 10% among White non-Hispanic partici­pants. However, correcting the observed links for expected missed links appeared to only have a modest impact on mortality disparities by race/ethnicity.

Conclusions: Researchers conducting analyses of mortality disparities using the NDI or other linked death records, need to be cognizant of the potential for differential linkage to contribute to their results.

Ethn Dis. 2017;27(2):77-84; doi:10.18865/ ed.27.2.77
A Review of Constitutional Principles Regarding Taxation: Ethiopian and Turkish Perspective
Authors: Adimassu Yonas Girma , Ustun Suleyman
Published: April 2017

Constitutions as supreme legal authorities enshrine the principles of taxation which are often used as the guidance to the legislations related to fiscal aspect, requires to be explored critically so as to provide clear understanding on taxation. This article has explored the tax provisions in the constitutions of Ethiopia and Turkey from comparative perspective through the method of doctrinal legal analysis. Both the latest constitution of Turkey and Ethiopia comprise relatively related principles regarding taxation in spite of the disparities of taxation system in these two countries due to the fact that Turkey is a unitary state whereas Ethiopia is federal. In-fact, there are some disparities within these constitutions. For instance, the 1982 Constitution of Turkey specifies the citizens' duties to pay tax and the adjudication system of tax in different way than the Ethiopian 1995 constitution. The Ethiopian constitution enshrines the taxation power in detail among other things in line with the federal system of government.
Micronutrient Fortified Carbohydrate Supplementation and Speed, Agility and Power in Indian Adolescent Athletes
Authors: Morris Tessa E. , Bhoite Rachana , Karwal Ritu , Verma , , Bhavna , , Khadilkar , , Anuradha ,
Published: April 2017

The positive performance impact of exogenous carbohydrate intake on prolonged endurance is well established. The effect on shorter duration activities has been less documented, in particular with adolescents. In this randomized, cross over study, thirty adolescent athletes (24 male and 6 female; age: 13.5 ± 1.0 yrs; height: 161.4 ± 8.1cm; weight: 50.4 ± 9.3 kg) performed the same sequence of procedures; baseline assessments, a treatment drink before and after a 45 min intermittent exercise protocol followed by post-baseline assessments. Participants were randomised to one of three blinded treatment drinks; micronutrient fortified carbohydrate (CHO), calorie-matched control (PRO) or water (WAT). The assessments involved repeated sprint and repeated agility tests (6 repetitions; 65 sec. provided to complete the repetition and recover prior to the next effort) and a repeated Wingate anaerobic test (3 x 30 sec) on a cycle ergometer. The Fatigue Index (FI) was calculated from the sprint and agility results and Mean Power Output (MPO) from the repeated Wingate results. The difference between the baseline and post-baseline results was then calculated and CHO, PRO and WAT treatment groups compared using Analysis of variance (ANOVA). No significant differences were found between speed, agility and power change from baseline results when CHO, PRO and WAT treatment groups were compared (p ≥ 0.05). Supplementation with a micronutrient fortified carbohydrate beverage does not increase repeated speed, agility or power in Indian adolescent team sport athletes.
Hypoglycemic and Hypocholesterolemic Potential of Wheat Grass Juice Extract and Powder on Diabetics
Authors: Lekha L. , Kalpana C. A.
Published: April 2017

The study was designed to evaluate the hypoglycemic and hypocholesterolemic potential of wheat grass juice, extract and powder on diabetics. Two hundred male employees (35-50 y) of Tamil Nadu Electricity Board (TNEB) from Usilampatti, a town in Madurai district, Tamil Nadu were selected for the study. After screening, 60 employees whose fasting blood glucose level was ≥ 145mg/dl and not taking oral hypoglycemic drugs or insulin were considered for the study. Fifty grams of fresh wheat grass, made into a fine paste using a stone grinder was mixed in 100ml of water. Two to three drops of lemon juice was added to enhance the flavour and palatability of the juice. Wheat grass extract obtained was then squeezed and the fiber separated. Fresh wheat grass was harvested and shade dried for 2-3 days. It was then made into fine powder with a stone grinder. Five grams of wheat grass powder was added in 100ml of water and mixed thoroughly. The selected diabetic employees (60) were divided into three experimental groups and one control group of 15 members each. Experimental group I was supplemented with 100ml of wheat grass juice, group II was supplemented with 100ml of wheat grass extract and group III was supplemented with 5g of wheat grass powder mixed in 100ml of water and for a period of four months. No supplementation was given to control group. Anthropometric parameters like height, weight, Body Mass Index (BMI), waist / hip ratio, skin fold thickness and biochemical parameters namely fasting blood glucose level, post prandial blood glucose level, total cholesterol, LDL, VLDL, HDL, HbA1C and blood pressure were measured before and after supplementation. Group II supplemented with wheat grass extract showed a slight difference in weight when compared to groups I and III. The mean skin fold thickness of all the three groups decreased after supplementation. The mean initial blood glucose level of the experimental groups (I, II and III) and control group were above the normal range . The mean decrease of fasting blood glucose level in experimental group I, II, III and control group were 37.4, 32.9, 27.6 and 1.4 mg /dl respectively. The mean decrease of post prandial blood glucose level in experimental groups I, II, III and control group were 63, 60.3, 39 and 1.8 mg/dl respectively. High fibre supplement lowered total cholesterol by about 19.2 % and reduced LDL cholesterol by 13.2 % with maximum reduction in groups II and III. HDL cholesterol level was highly increased in experimental group II. The decrease in HbA1C level was higher in experimental group I (2.5%) and blood pressure was highly decreased in experimental group I compared to other experimental groups and control group.
Effect of Replacement of Refined Wheat Flour with Germinated Fenugreek Seed Flour on Quality Characteristics of Cookies
Authors: Agrawal R. S. , Syed H. M. , Satwadhar P. N.
Published: April 2017

The effect of partial replacement of wheat flour by different levels (5, 10 and 15%) of Germinated Fenugreek Seed Flour (GFSF) on the physical, chemical and sensory characteristics of cookies were studied. Also, these cookies were evaluated for textural parameters in terms of hardness and compared to control cookies (100% wheat flour). Results revealed that cookies processed from wheat flour supplemented by 10% of GFSF had higher acceptance scores for all sensory attributes than other blend cookies. Replacement of wheat flour with germinated fenugreek seed flour increased the protein, fiber and ash content proportionately to the level of substitution.
Infant and Young Child Feeding Indicators in Children <2 Yrs of Age in a Tertiary Care Centre
Authors: Maurya Manisha , Maurya Arun Kumar , Pandey Poonam
Published: April 2017

Adequate infant and young child feeding practices in children <2years is the most important determinant of under-five mortality and morbidity. According to World Health Organization1 (WHO) under nutrition is associated with 47 % of child deaths and about 800,000 lives can be saved if optimal feeding practices are followed world wide1. Study done by Kushwaha et al showed significant improvement in IYCF practices after counseling of mothers by mother support groups in Lalitpur.
Novelties in Diabetes-Endocrine Development - Vol. 31
Authors: Jeyanthi G. P.
Published: April 2017

The field of diabetes mellitus research is currently characterized by rapid and remarkable growth that has led to the development of significant diagnostic and therapeutic advances. The frequency of the disease continues to increase at alarming rates worldwide. This volume is a comprehensive overview of the contemporary state of the art in the field. Renowned experts in the field provide a comprehensive balanced overview of the most important related topics. Starting with a chapter on the individualization of treatment goals describing short and long term therapeutic targets in Type 1 and 2 diabetes the book then provides an overview of potential means to achieve this target. This encompasses chapters weighing the role of well known as opposed to novel therapeutic approaches, the latter including not only technical achievements like artificial pancreas, but also the state of the art in beta cell replacement. A focus is set on diabetic complications and the recently debated association between diabetes and cancer. Treatment strategies for blood pressure and weight control are discussed.