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- ItemAcesso aberto (Open Access)Análise comparativa entre avaliação fonoaudiológica perceptivo-auditiva, análise acústica e laringoscopias indiretas para avaliação vocal em população com queixa vocal(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2005-02-01) Nemr, Kátia; Amar, Ali [UNIFESP]; Abrahão, Márcio [UNIFESP]; Leite, Grazielle Capatto De Almeida; Köhle, Juliana; Santos, Alexandra de O.; Correa, Luiz Artur Costa; Hospital Heliópolis Serviço de Fonoaudiologia; Hospital Heliópolis; Universidade Federal de São Paulo (UNIFESP); PUC/SP; CEFACAs a result of technology evolution and development, methods of voice evaluation have changed both in medical and speech and language pathology practice. AIM: To relate the results of perceptual evaluation, acoustic analysis and medical evaluation in the diagnosis of vocal and/or laryngeal affections of the population with vocal complaint. STUDY DESIGN: Clinical prospective. MATERIAL AND METHOD: 29 people that attended vocal health protection campaign were evaluated. They were submitted to perceptual evaluation (AFPA), acoustic analysis (AA), indirect laryngoscopy (LI) and telelaryngoscopy (TL). RESULTS: Correlations between medical and speech language pathology evaluation methods were established, verifying possible statistical signification with the application of Fischer Exact Test. There were statistically significant results in the correlation between AFPA and LI, AFPA and TL, LI and TL. CONCLUSION: This research study conducted in a vocal health protection campaign presented correlations between speech language pathology evaluation and perceptual evaluation and clinical evaluation, as well as between vocal affection and/or laryngeal medical exams.
- ItemSomente MetadadadosAssessment of scientific programs: a necessary procedure for Brazilian scientific policy - the young investigator program of the state of Sao Paulo research foundation(Acad Brasileira De Ciencias, 2007-09-01) Pian, Carlos Alberto de [UNIFESP]; Meneghini, Rogerio [UNIFESP]; FAPESP; BIREME; Universidade Federal de São Paulo (UNIFESP)Programs of Science and Technology research have grown significantly in Brazil over the last decades. Until the 1980s the so-called undirected programs, without specific goals and requiring only scientific merit, prevailed. The few programs with defined goals in this period were never objectively assessed. The same situation occurred in developed countries. In the early 1990s, the assessment of programs supported by public funding became mandatory in US and some European countries. In Brazil, program assessment has so far not been implemented yet. The Fundacao de Amparo a Pesquisa no Estado de Sao Paulo (FAPESP) ( Brazilian funding agency) Young Investigator (YI) Program is in its eleventh year, with approximately eight hundred projects awarded. Although it is free-demand based as concerns areas of knowledge, it has specific goals : (1) conceding grants to YI in view of the balance between funding, merit and real needs so as to enable satisfactory working conditions in the short term, (2) providing priority for institutions with a less extensive background in research, (3) granting a special fellowship to YI with no employment connection and ( 4) introduction of new research fronts in centers with a sound research background. This assessment provided evidence for the achievement of first three goals. The fourth one is still pending on additional data requiring survey assessment. Actions in this direction are recommended.
- ItemAcesso aberto (Open Access)Auditory processing in dysphonic children(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2011-06-01) Arnaut, Mirian Aratangy; Agostinho, Caroline Vieira; Pereira, Liliane Desgualdo [UNIFESP]; Weckx, Luc Louis Maurice [UNIFESP]; Ávila, Clara Regina Brandão de [UNIFESP]; University of São Paulo Speech and Hearing Department Graduate Program in Human Communication Disorders; Universidade Federal de São Paulo (UNIFESP)Contemporary cross-sectional cohort study. There is evidence of the auditory perception influence on the development of oral and written language, as well as on the self-perception of vocal conditions. The auditory system maturation can impact on this process. OBJECTIVE: To characterize the auditory skills of temporal ordering and localization in dysphonic children. MATERIALS AND METHODS: We assessed 42 children (4 to 8 years). Study group: 31 dysphonic children; Comparison group: 11 children without vocal change complaints. They all had normal auditory thresholds and also normal cochleo-eyelid reflexes. They were submitted to a Simplified assessment of the auditory process (Pereira, 1993). In order to compare the groups, we used the Mann-Whitney and Kruskal-Wallis statistical tests. Level of significance: 0.05 (5%). RESULTS: Upon simplified assessment, 100% of the Control Group and 61.29% of the Study Group had normal results. The groups were similar in the localization and verbal sequential memory tests. The nonverbal sequential memory showed worse results on dysphonic children. In this group, the performance was worse among the four to six years. CONCLUSION: The dysphonic children showed changes on the localization or temporal ordering skills, the skill of non-verbal temporal ordering differentiated the dysphonic group. In this group, the Sound Location improved with age.
- ItemAcesso aberto (Open Access)Avaliação da imagem corporal, qualidade de vida, sensibilidade tátil e dor em mulheres com câncer de mama submetidas a intervenção cirúrgica(Universidade Federal de São Paulo (UNIFESP), 2015-11-27) Bueno, Juliana Nishimura [UNIFESP]; Nazario, Afonso Celso Pinto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Make a comparison between the preoperative and the 30th, 60th and 90th day postoperatively the surgical treatment of breast cancer, the image changes body, quality of life, sensitivity and presence and level of women's pain pesquisadas.A body image of the evaluated patients changed after surgery treatment of breast cancer. There was a worsening of the results of postoperative 30, 60 and 90 days before the preoperative evaluation. The quality of life had changes in some aspects assessed by questionnaire EORTC QLQ C30, physical function in postoperative evaluation 60 days significantly improved compared to the preoperative period and the evaluation of the emotional function in the postoperative 30, 60 and 90 days compared the preoperative. The assessment of cognitive function also showed improvement in 30 days after surgery compared to preoperatively. There was a significant deterioration in social function and loss of appetite in the postoperative period of 30 days in relation to pre operative, and also the symptoms of nausea and vomiting and constipation in the postoperative period 90 days. Body image when assessed by questionnaire EORTC QLQ BR23, was significantly worse in the evaluation of postoperative 30 days, as well as breast symptoms in the postoperative 30 and 60 days, and symptoms arm in all evaluated postoperatively. As for the function and satisfaction sexual significant improvement in postoperative 30 days, as well as prospects have improved in all investigated postoperative. The sensitivity and pain was noticeable worsening on all postoperative when compared to the preoperative evaluation.
- ItemSomente MetadadadosBoys With Duchenne Muscular Dystrophy: 1-Year Locomotor Changes in Relation to a Control Group(Sage Publications Inc, 2018) Martini, Joyce; Caromano, Fatima Aparecida; Carvalho, Eduardo Vital; Goya, Priscila Albuquerque; Hayasaka, Rosana Massae [UNIFESP]; Nakazune, Silvia [UNIFESP]; Favero, Francis Meire [UNIFESP]; Voos, Mariana CallilWe compared the timed performance and compensatory movements of 32 boys (mean age = 10.0 years) with Duchenne muscular dystrophy (DMD) and 38 healthy boys (mean age = 9.2 years) on 10-meter walking and four-step stair work (climbing and descending). Dependent measures were digital scores on the Functional Evaluation Scale for DMD obtained by watching the boys on film. Groups were compared initially and after 6 and 12 months, using General Linear Models analysis (for two groups and three assessments). Results showed no significant timed performance differences between groups on 10-m walking at the initial assessment
- ItemSomente MetadadadosThe Brazilian version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ)(Clinical & Exper Rheumatology, 2001-07-01) Machado, CSM; Ruperto, N.; Silva, CHM; Ferriani, Virginia Paes Leme [UNIFESP]; Roscoe, I; Campos, LMA; Oliveira, SKF; Kiss, MHB; Bica, BERG; Sztajnbok, F.; Len, Claudio Arnaldo [UNIFESP]; Melo-Gomes, J. A.; Paediat Rheumatology Int Trials Or; Universidade de São Paulo (USP); IRCCS S Matteo; Universidade Federal de Uberlândia (UFU); Universidade Federal do Rio de Janeiro (UFRJ); Universidade Federal de São Paulo (UNIFESP); Inst Portugues ReumatolWe report the cross-cultural adaptation and validation into Brazilian-Portuguese of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability, in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children regardless the underlying disease, The Brazilian CHAQ was revalidated, while the CHQ has been derived from the Portuguese version. A total of 471 subjects were enrolled: 157 patients with JIA (27% systemic onset, 38% polyarticular onset, 9% extended oligoarticular subtype, and 26% persistent oligoarticular subtype) and 314 healthy children. The CHAQ discriminated clinically healthy subjects from JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and lower overall well-being scores when compared to their healthy peers. Also the CHQ discriminated clinically healthy, subjects from JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being score when compared to their healthy peers. In conclusion the Brazilian versions of the CHAQ-CHQ are reliable and valid tools for the combined physical and psychosocial assessment of children with JIA.
- ItemSomente MetadadadosEvaluation of a national evidence-based health care course via teleconference in a developing country(Wiley-Blackwell, 2013-08-01) Macedo, Cristiane Rufino de [UNIFESP]; Macedo, Elizeu Coutinho; Torloni, Maria Regina [UNIFESP]; Atallah, Álvaro Nagib [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Prebiteriana MackenzieRationale, aims and objectives Continuing health education is essential but challenged. in 2006, the Brazilian Cochrane Center, in collaboration with the Ministry of Health, launched a mass teaching initiative in evidence-based health care (EBH) for public-sector professionals via teleconferencing. This 152-hour, interactive EBH course has enrolled over 4500 professionals. This study aimed to assess the acquisition EBH knowledge and skills, as well as the attitudes and perceptions of a sample of students enrolled in the 2009 course via teleconferencing.Methods This prospective cohort study analyzed three aspects of this 152-hour EBH course that recruited 1040 volunteer participants, all public health sector employees working in 131 different hospitals or health agencies. Pre- and post-course tests using a modified version of the Berlin questionnaire with 20 multiple-choice questions were used to examine knowledge acquisition in a sample of 297 students. Tests were completed upon registration and at course completion. the research projects submitted by 872 participants were evaluated to assess skill acquisition. Answers to an anonymous survey assessed the attitudes and perceptions of 914 participants.Results There was a significant increase in knowledge from baseline to course completion (mean scores 8.2 +/- 3.3 versus 13.7 +/- 3.0, P < 0.001). Over 90% of the research projects were judged to be of adequate quality (appropriate rationale for the study, well-formulated research question and feasible execution); over 95% of the participants were satisfied with the course.Conclusion the Brazilian EBH course via teleconference improved the knowledge and skills of public-sector health professionals and was approved by the vast majority of students.
- ItemAcesso aberto (Open Access)Índices de confiabilidade da análise do ângulo poplíteo através da biofotogrametria(Sociedade Brasileira de Medicina do Exercício e do Esporte, 2014-12-01) Duarte, Ricardo B.; Romanatti, Sandro V.; Gongora, Hélcio; Antonietti, Leandro Stetner; Pires, Leonardo; Cohen, Moises [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction:The assessment and objective measurement of joint range of motion are of fundamental importance for the diagnosis, planning and monitoring treatment. With the advancement of technology, photogrammetry is beginning to be used with greater frequency in the physical therapy practice, measuring the amount of joint motion. The popliteal angle was chosen because it provides an indirect measure of flexibility of the hamstring muscles. The retraction of the hamstrings can result in significant postural problems and produce a continuous posterior tilt of the pelvis, affecting the gait and sports movements, as well as causing muscle or joint pain.Objectives:To confirm the reliability intra- and inter-examiner analysis of popliteal angle through computerized photogrammetry using the Postural Assessment Software (SAPO), to establish the repeatability and reproducibility of the method.Methods:Twenty-three patients (46 knees) were evaluated. Volunteers were positioned supine with hip and knee of the evaluated leg flexed at 90 degrees, keeping the contralateral limb in extension. Next, the knee of the tested limb was passively extended until the point at which the first resistance to stretching was perceived. At this point, the popliteal angle was recorded. Statistical analysis of inter- and intra-examiner reliability was determined by the results of the coefficient of intra-class correlation (ICC) of types 1.1 and 3.1 in the Pearson correlation test, considering a significance level of p<0.05.Results:The measurement of the popliteal angle by photogrammetry showed strong intra-examiner reliability (ICC=0.786) and very strong inter-examiner reliability (ICC=0.920).Conclusion:The photogrammetry is an appropriate method for the evaluation of the popliteal angle since the coefficient of intra-class correlation and intra and inter- examiners reached strong and very strong levels, respectively, confirming the reproducibility and repeatability of this assessment technique.
- ItemSomente MetadadadosInvasive cardiopulmonary exercise testing in the evaluation of unexplained dyspnea: Insights from a multidisciplinary dyspnea center(Sage Publications Ltd, 2017) Huang, Wei; Resch, Stephen; Oliveira, Rudolf K. F.; Cockrill, Barbara A.; Systrom, David M. [UNIFESP]; Waxman, Aaron B.Background: Unexplained dyspnea is a common diagnosis that often results in repeated diagnostic testing and even delayed treatments while a determination of the cause is being investigated. Through a retrospective study, we evaluated the diagnostic efficacy of a multidisciplinary dyspnea evaluation center (MDEC) using invasive cardiopulmonary exercise test to diagnose potential causes of unexplained dyspnea. Methods: We reviewed the medical records of all patients referred with unexplained dyspnea to the MDEC between March 2011 and October 2014. We assessed the diagnostic efficacy before and after presentation to the MDEC. Results: During the study period a total of 864 patients were referred to the MDEC and, of those, 530 patients underwent further investigation with invasive cardiopulmonary exercise test and constituted the study sample. The median age was 57 (44-68) years, 67.2% were women, and median body mass index was 26.22 (22.78-31.01). A diagnosis was made in 530 patients including: exercise pulmonary arterial hypertension of 88 (16.6%), heart failure with preserved ejection fraction of 94 (17.7%), dysautonomia 112 (21.1%), oxidative myopathy of 130 (24.5%), primary hyperventilation of 43 (8.1%), and other 58 (10.9%). The time from initial presentation to referral was significantly longer than time to diagnosis after referral for non-standardized conventional methods versus diagnosis through MDEC using invasive cardiopulmonary exercise test (511 days (292-1095 days) vs. 27 days (13-53 days), p<0.0001). In a subgroup analysis, we reviewed that patients referred from cardiovascular clinics were more likely to have a greater number of diagnostic tests performed and, conversely, patients referred from pulmonary clinics were more likely to have a greater number of treatments prescribed before referral to MDEC. Conclusions: As a result of this retrospective study, we have evaluated that a multidisciplinary approach that includes invasive cardiopulmonary exercise test dramatically reduces the time to diagnosis compared with traditional treatment and testing methods.
- ItemSomente MetadadadosInvestigar a contribuição da rede universitária de telemedicina no desenvolvimento de uma nova prática de saúde digital(Universidade Federal de São Paulo (UNIFESP), 2013-11-27) Lopes, Paulo Roberto de Lima [UNIFESP]; Sigulem, Daniel Sigulem [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: The practice of digital health is the set of techniques, practices, attitudes, ways of thinking and new values that develop as result of the digital space growing. The project: Brazilian Telemedicine University Network (RUTE) seeks to promote changes in digital health practice, providing a telecommunications network and telemedicine equipment to school hospitals in Brazil, focused research activities, teaching and health assistance. Objective: To investigate the contribution of RUTE project on the development of a new digital health practice in the axes of education, healthcare and research. Method: This is qualitative and quantitative exploratory study, based on electronic survey with 55 semi-structured questions, applied to the coordinators of 72 operational telemedicine units on the RUTE. The analysis clarifies the status of units and establish a measure of performance on digital health practice within the project RUTE. Results: With a membership of 75 % of the units of RUTE, 204 insights was collected from units and were classified by qualitative analysis on 14 categories. Five analysis axes were measured comparatively in the quantitative performance of the RUTE: (i) health education, (ii) remote collaborative healthcare practices, (iii) in the multicenter study and research, development and innovation of telemedicine, (iv) school hospitals management and (v) the social impact. Operating units have primary focus on the use of education, followed by remote assistance and then to research. Conclusion: Based on the assumptions set out in the project proposed by the RNP – National Education and Research Network, the results of operating units RUTE indicate that the network has led to the development of a new digital health practice in university hospitals, mainly through teaching and research.
- ItemSomente MetadadadosIsokinetic evaluation of the knee in patients with rheumatoid arthritis(Elsevier B.V., 2002-12-01) Meireles, S. M.; Oliveira, L. M.; Andrade, M. S.; Silva, A. C.; Natour, J.; Universidade Federal de São Paulo (UNIFESP)Objectives. Rheumatoid arthritis is a chronic inflammatory disease with a clinical picture of arthritis, muscle hypotrophy, loss of range of motion, loss of strength and disability. the objective of this study was to evaluate knees of patients with rheumatoid arthritis using an isokinetic dynamometer. Methods. Fifty patients with a diagnosis of rheumatoid arthritis and 50 control subjects were evaluated using an isokinetic dynamometer (Cybex 6.000) regarding the following parameters: peak torque, peak torque angle, power, total work, peak torque acceleration time, set total work, torque acceleration energy ('explosion') and endurance. Comparisons between rheumatoid arthritis and the control group, left side versus right side, flexors and extensors and the proportion between flexors and extensors were made. the subjects were also evaluated through the Health Assessment Questionnaire, visual and analogical scale of pain, EPM-ROM and goniometry of the knee. Results. the results showed that patients with rheumatoid arthritis have less strength than the control group (P < 0.05); the extensors are stronger than the flexors (P < 0.05); no significant differences between the right and the left knee for rheumatoid arthritis and the control group were observed and the proportion between flexors and extensors is the same in both groups. We concluded that regarding the isokinetic parameters, the knees of subjects with rheumatoid arthritis are different from normal knees with decreased strength parameters, maintaining the proportion between flexors and extensors with a global loss of strength in the segment, excluding the high speeds in some of the parameters. Joint Bone Spine 2002; 69 : 566-73. (C) 2002 Editions scientifiques et medicales Elsevier SAS.
- ItemSomente MetadadadosLessons from the English smoking treatment services(Wiley-Blackwell, 2005-04-01) Raw, M.; McNeill, A.; Coleman, T.; Univ London; Universidade Federal de São Paulo (UNIFESP); UCL; Univ Nottingham HospThis paper summarizes and discusses the key findings of the evaluation of the English smoking treatment services, which were established in 1999 as part of the English National Health Service. Within 4 years these services existed throughout the country and were working at full capacity, a total of 76 pound million having been spent on them over this period, excluding medication costs. in the fourth year almost 2 3 5 000 people attended treatment and set a quit date, and the total budget, including medications, was approximately 50 pound million. At the end of the fourth year the government allocated 13 pound 8 million for the services for the period April 2003-March 2006. the CO-validated 4-week abstinence rate was 5 3 %, the validated 5 2 -week abstinence rate was 15 %, and the relapse rate from 4 to 5 2 weeks was 7 5 %. There was no sex difference in cessation rates at long-term follow-up. the cessation results and relapse rate from weeks 4 to 52 are consistent with results from published studies, including clinical trials. the estimated cost per life-year saved was pound 684 and the figure is even lower if the potential future health care cost savings are taken into account at pound 43 8 per life-year saved. This compares with the benchmark of 20 pound 000 per life-year saved, which the National Institute for Clinical Excellence (NICE) is using to recommend new health care interventions in the National Health Service. the services were also succeeding in reaching disadvantaged smokers. However, there have been problems, and other health care systems considering an initiative of this kind should: set national training standards and increase training capacity before launching the services; standardize the provision of pharmaceutical treatments and make them as accessible as possible before launching the services; and give the services at least 5 years of central funding to allow them to become well established. Monitoring is extremely important but should not be so much of a burden that it detracts from developing a quality service and although cessation targets can be helpful, care needs to be taken that they are reasonable and do not promote throughput at the expense of quality.
- ItemAcesso aberto (Open Access)Padronização das técnicas de secção do nervo facial e de avaliação da mímica facial em ratos(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2006-06-01) Faria, Simone Damasceno De [UNIFESP]; Testa, Jose Ricardo Gurgel [UNIFESP]; Borin, Andrei [UNIFESP]; Toledo, Ronaldo N. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)AIM: standardization of the technique to section the extratemporal facial nerve in rats and creation of a scale to evaluate facial movements in these animals before and after surgery. STUDY DESIGN: Experimental. METHOD: twenty Wistar rats were anesthetized with ketamine xylazine and submitted to sectioning of the facial nerve near its emergence through the mastoid foramen. Eye closure and blinking reflex, vibrissae movement and positioning were observed in all animals and a scale to evaluate these parameters was then created. RESULTS: The facial nerve trunk was found between the tendinous margin of the clavotrapezius muscle and the auricular cartilage. The trunk was proximally sectioned as it exits the mastoid foramen and the stumps were sutured with a 9-0-nylon thread. An evaluation and graduation scale of facial movements, independent for eye and vibrissae, was elaborated, together with a sum of the parameters, as a means to evaluate facial palsy. Absence of eye blinking and closure scored 1; the presence of orbicular muscle contraction, without blinking reflex, scored 2; 50% of eye closure through blinking reflex, scored 3, 75% of closure scored 4. The presence of complete eye closure and blinking reflex scored 5. The absence of movement and posterior position of the vibrissae scored 1; slight shivering and posterior position scored 2; greater shivering and posterior position, scored 3 and normal movement with posterior position, scored 4; symmetrical movement of he vibrissae, with anterior position, scored 5. CONCLUSION: The rat anatomy allows easy access to the extratemporal facial nerve, allowing its sectioning and standardized suture. It was also possible to establish an evaluation and graduation scale of the rat facial movements with facial palsy based on the clinical observation of these animals.
- ItemAcesso aberto (Open Access)Performance of normal adults on Rey Auditory Learning Test: a pilot study(Academia Brasileira de Neurologia - ABNEURO, 2009-06-01) Teruya, Leila Cardoso [UNIFESP]; Ortiz, Karin Zazo [UNIFESP]; Minett, Thaís Soares Cianciarullo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The present study aimed to assess the performance of healthy Brazilian adults on the Rey Auditory Verbal Learning Test (RAVLT), a test devised for assessing memory, and to investigate the influence of the variables age, sex and education on the performance obtained, and finally to suggest scores which may be adopted for assessing memory with this instrument. The performance of 130 individuals, subdivided into groups according to age and education, was assessed. Overall performance decreased with age. Schooling presented a strong and positive relationship with scores on all subitems analyzed except learning, for which no influence was found. Mean scores of subitems analyzed did not differ significantly between men and women, except for the delayed recall subitem. This manuscript describes RAVLT scores according to age and education. In summary, this is a pilot study that presents a profile of Brazilian adults on A1, A7, recognition and LOT subitem.
- ItemAcesso aberto (Open Access)Programa nacional de reorientação da formação profissional em saúde pró-saúde como política norteadora do processo de reformulação curricular do curso de enfermagem da Universidade federal do acre(Universidade Federal de São Paulo (UNIFESP), 2013-02-27) Aguiar, Katiuscia Larsen de Abreu [UNIFESP]; Cury, Geraldo Cunha [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Training of human resources in health has been constituted national and international rich field of research. In Brazil, several programs aiming to improve workforce in health arose from the establishment of the Unified Health System - SUS and, among them there are the National Reorientation of Vocational Training in Health - Pro-Saúde. Similarly, an important movement between Health and Education took place with the advent of the National Curriculum Guidelines - DCN, enhancing current education for health professionals. The Universidade Federal do Acre, campus Rio Branco - UFAC/RB was established in 1974 with the Undergraduate Nursing course in order to meet the health care needs of the region. The importance of Political Pedagogical Project - PPP of the course was emphasized since it had only five revisions in thirty-eight years, being the privileged space for these interactions. General Objective: This study aimed to recognize the need to change the process of nursing education based on the National Reorientation of Vocational Training in Health – Pró-Saúde, as well as in accordance with the National Curriculum Guidelines- DCN for the Undergraduate Nursing Program at the UFAC/RB. Specific objectives: Identify the Pró-Saúde potential as an inducer of the teaching-service integration, improving the nursing course of the Universidade Federal do Acre / Rio Branco - UFAC/RB; to characterize the transformation process of the Nursing Course in relation to teaching/service integration; to investigate the mobilization and influence triggered by the Pró-Saúde in the Curriculum Committee of the Nursing Course ; apprehend managers´ perceptions about the process of curricular reorientation of the Nursing Course at the Universidade Federal do Acre / Rio Branco - UFAC/RB. Methodology: Using qualitative and quantitative approach with the following instruments: case study, documentary analysis on Pedagogical Political Projects - PPP of the Nursing Course of the UFAC/RB, the DCN and the Pró-Saúde program. A Likert-type attitudinal scale was used with four dimensions with 17 assertions in its contents and statistically validated by linear correlation, test reliability and homogeneity. Results: good perception regarding mobilization and influence triggered by Pro-Saúde in the curriculum committee of the Undergraduate Nursing Course UFAC/RB; the need for immediate changes and improvement related to the identification of Pró- Saúde potential as an inducer of improvement of the teaching-service integration in the Course of Nursing UFAC-RB; characterization of the transforming process of the Nursing Course UFAC-RB in relation to teaching-service integration and apprehension of managers' perceptions about the process of curricular reorientation of Nursing Course at UFAC-RB. Conclusion: Perception of an harmony between all actors in the Course of Nursing UFAC/RB based on the National Reorientation of Vocational Training in Health - Pró-Saúde, National Curriculum Guidelines - DCN Pedagogical Political Projects - PPP in relation to Human Resources training in Nursing; need of adjustments in the academic process operationalization; educational qualification of the academic staff, to improve practice, search for greater integration between the activities of teaching, research and extension, offering a curricular space for discussion of issues relating to ethics, citizenship, among others.
- ItemSomente MetadadadosRandomized Trial on the Effect of Sevoflurane on Polypropylene Membrane Oxygenator Performance(Elsevier B.V., 2013-10-01) Neto, Caetano Nigro; Arnoni, Renato; Rida, Bilal Smaili; Landoni, Giovanni; Tardelli, Maria Angela [UNIFESP]; Dante Pazzanese Inst Cardiol; Ist Sci San Raffaele; Maieut Fdn; Universidade Federal de São Paulo (UNIFESP)Objectives: Volatile anesthetics have cardioprotective properties that improve clinically relevant outcomes in cardiac surgery, and can be used during cardiopulmonary bypass (CPB) through adapted calibrated vaporizers together with air and oxygen (O-2). the effect of volatile agents on the membrane oxygenator is unknown. the aim of this study was to evaluate, for the first time, the performance of semiporous polypropylene membrane oxygenators after the use of sevoflurane vaporized during CPB in cardiac surgery.Design: A prospective, randomized, controlled trial.Setting: Teaching hospital.Participants: Thirty-two consecutive patients scheduled to undergo coronary artery bypass graft with CPB.Interventions: Patients were allocated randomly to receive either a volatile anesthetic (sevoflurane 1%-3%, 16 patients) or an intravenous hypnotic (midazolam, 16 patients) during CPB. After surgery, the membrane oxygenators used during CPB were tested with regard to O-2 transfer, carbon dioxide transfer, and pressure drop.Measurements and Main Results: the authors observed no protocol deviation or crossover. the performance of the membrane oxygenator was similar between the 2 groups, as documented by O-2 transfer (55 +/- 6.4 mL/min/L in the sevoflurane group versus 57 +/- 4.7 mL/min/L in the midazolam group, p = 0.4), carbon dioxide transfer, and pressure drop.Conclusions: the use of sevoflurane during CPB in cardiac surgery does not affect membrane oxygenator performance. (C) 2013 Elsevier Inc. All rights reserved.
- ItemAcesso aberto (Open Access)The relevance of trunk evaluation in Duchenne muscular dystrophy: the segmental assessment of trunk control(Assoc Arquivos Neuro- Psiquiatria, 2016) Sá, Cristina dos Santos Cardoso de [UNIFESP]; Fagundes, Iara Kristine [UNIFESP]; Araujo, Talita Bastos [UNIFESP]; Oliveira, Acary Souza Bulle [UNIFESP]; Favero, Francis Meire [UNIFESP]The aim was to describe trunk control in ambulant and non-ambulant patients with Duchenne muscular dystrophy (DMD). We conducted a cross-sectional analysis of a sample of 50 DMD patients, (M age = 16.7 years) who underwent the Segmental Assessment of Trunk Control (SATCo). A seven-level scale of trunk control was used (1: head control only
- ItemAcesso aberto (Open Access)Revisão sistemática das escalas utilizadas para avaliação funcional na doença de Pompe(Sociedade de Pediatria de São Paulo, 2012-06-01) Savegnago, Alana Karla [UNIFESP]; Silva, Rosangela Maria da [UNIFESP]; Jonhston, Cíntia [UNIFESP]; Martins, Ana Maria [UNIFESP]; Melo, Ana Paula L. de [UNIFESP]; Carvalho, Werther Brunow de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)OBJECTIVE: To identify functional assessment scales used in Pompe disease (PD) and to describe their levels of evidence and grades of recommendation. DATA SOURCE: Systematic review of the functional assessment scales used in PD. Review conducted in the databases Medline, Lilacs, Cochrane Central Register of Controlled Trials (CCTR), and SciELO including articles (except review articles) published between 2000 and 2010. The key-words used in Portuguese and English were: glycogen storage disease type II, activities of daily living, assessment. The articles were classified according to their level of evidence and grade of recommendations. DATA SYNTHESIS: 14 studies assessing patients ranging from newborns to adults were included in the present review (total sample=449). The scales found in the literature were: Pediatric Evaluation of Disability Inventory (PEDI) and its adapted version for PD (Pompe-PEDI), Alberta Infant Motor Scale (AIMS), Rotterdam Handicap Scale (RHS), Functional Independence Measure (FIM), Gross Motor Function Measure (GMFM), and Peabody Developmental Motor Scales (PDMS-II). Most studies had level of evidence III because they were non-randomized studies. The grades of recommendation of the scales were C for AIMS and Pompe-PEDI, D for GMFM and PDMS-II; and E for RHS and FIM. CONCLUSIONS: Most functional assessment scales used in PD show low level of evidence and grade of recommendation. The scales showing the highest grade of recommendation (C) were the AIMS and Pompe-PEDI used in Pediatrics.
- ItemAcesso aberto (Open Access)Temporomandibular disorder and generalized joint hypermobility: application of diagnostic criteria(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2011-07-01) Pasinato, Fernanda; Souza, Juliana Alves; Rodrigues Correa, Eliane Castilhos; Toniolo da Silva, Ana Maria [UNIFESP]; Universidade Federal de Sergipe (UFS); Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)Generalized joint hypermobility (GJH) has been considered a predisposing factor for the development of temporomandibular disorder (TMD).Aim: To evaluate clinical and psychosocial aspects in individuals diagnosed with TMD with or without GJH.Materials and methods: Clinical and experimental study, which enrolled 34 women, from 18 to 35 years of age with TMD diagnosed by RDC/TMD. The GJH was assessed by the Beighton score and volunteers were broken down into 2 groups: with GJH (n = 22) and without GJH (n = 12).Results: We found a high percentage of GJH (64.71%). All participants had myofascial pain; 79.41% had arthralgia and 41% had disk displacement. There was a correlation between higher GJH scores and higher passive mouth opening amplitude (p=0.0034), with pain (p=0.0029) and without pain (p=0.0081). Greater mandibular range of motion was observed in the group with GJH, except for protrusion. Painful mouth opening was statistically higher in the GJH group (p=0.0279).Conclusions: Individuals with TMD associated or not to GJH do not differ significantly regarding clinical and psychosocial aspects, except in the mandibular opening range of motion, which if kept at physiological levels can lead to a late diagnosis of TMD in these individuals.
- ItemAcesso aberto (Open Access)Tendências de mudanças em um grupo de escolas médicas brasileiras(Associação Brasileira de Educação Médica, 2009-01-01) Lampert, Jadete Barbosa; Costa, Nilce Maria da Silva Campos; Perim, Gianna Lepre; Abdalla, Ively Guimarães [UNIFESP]; Aguilar-da-Silva, Rinaldo Henrique; Stella, Regina Celes de Rosa [UNIFESP]; Universidade Federal de Santa Maria; Universidade Federal de Goiás; Universidade Estadual de Londrina; Ministério do Esporte Secretaria Nacional de Esporte Educacional; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de MaríliaThe purpose of this study of Caem/Abem conducted in a group of twenty-eight Brazilian medical schools was to show the trends in the changes made for meeting the National Curricular Guidelines and consolidating the Brazilian Health System and represents the first stage of the Project for evaluating the change trends in the undergraduate courses of the Brazilian medical schools. The schools answered the self-evaluation instrument according to the proposed methodology. The results show that the course is perceived as inter-relation of five main axes: the world of work, the pedagogical project, the pedagogical approach, sceneries of practice and qualification of teachers. In the perception of their social actors, the greater part of the schools of this group (75%) can be classified as advanced and innovative, strongly tending to the transformations commended for the health sector. The item Qualification of Teachers shows minor advances than the others, indicating in this moment of the process a disproportion in the dynamics of actions for consolidating the changes. It shows the need for deepening the study by developing evaluation processes and constructing qualitative and quantitative indicators that allow identifying and monitoring the changes.