Resilience and religiosity have received attention as an important process in the experience and management of chronic comorbidities; however, there is no study evaluating resilience in hemodialysis patients and its association with other psychological dimensions or with treatment adherence. This observational prospective study assessed resilience (25 item Wagnild and Young Resilience Scale), religiosity under three dimensions (organizational, non-organizational and intrinsic) using DUREL scale, depressive symptoms (Patient Health Questionnaire-9) and health-related quality of life (Short Form-36 questionnaire). The main outcomes were medication adherence using the Morisky Medication Adherence Scale-8 (MMAR-8) and the missing/shortened dialysis sessions in the following six months. Of 208 patients approached, 202 (97.1%) agreed to participate. One hundred twenty-three patients (60.9%) were males and mean age was 52.8 ± 14.8 years-old. The median time on hemodialysis was 36 months (IQR, 12, 84). 82 (40.6%) patients obtained a MMAS-8 score <6 and were considered as having 'poor adherence'. Overall, the mean score of medication adherence was low (5.7 ± 2.1). About adherence to hemodialysis sessions, patients missed a total of 234 (1.6%) hemodialysis sessions. Forty-eight patients (23.7%) missed an average of at least three sessions in six months. Regarding adherence to medication, there was no association in the uni- or multivariate analysis between religiosity dimensions and MMAS-8 score. After adjustment, resilience was positively associated with MMAS-8 score (standardized β coefficient .239, p = .016). Organized and intrinsic religiosity were associated with adherence to dialysis sessions (standardized β coefficient .258, p = .004 and .231, p = .026, respectively). Interestingly, opposite to medication adherence, more resilient patients were associated with less adherence to hemodialysis sessions (standardized β coefficient -.296, p = .001). Religiosity was associated with dialysis adherence but not with medication adherence. Resilience was associated with higher medication adherence but lower adherence to dialysis sessions.
Antiretroviral therapy has increased the survival of patients with HIV/AIDS, thus necessitating health promotion practice with immunization. Vaccines are critical components for protecting people living with HIV/AIDS (PLWHA). The purpose of study was to analyze the vaccination status of PLWHA in outpatient care in Fortaleza, Ceará, Brazil. Cross-sectional study performed from June 2014 to June 2015. The screening was done with patients in antiretroviral therapy, 420 patients underwent screening, but only 99 met the inclusion criteria. Data were collected for interviews using forms to characterize sociodemographic, clinical and vaccination situations. Only 14 patients had complete vaccination schedules. The most used vaccines were hepatitis B, influenza vaccine and 23-valent pneumococcal. There was no difference between men and women regarding the proportion of PLWHA with full vaccination schedule or between sex, skin color, marital status, sexual orientation, religion or occupational status. There was no difference between having or not having a complete vaccination schedule and age, years of education, family income or number of hospitalizations. CD4+ T-cells count of patients with incomplete immunization was lower than patients with complete immunization. Health education strategies can be done individually or in groups to explain the importance of vaccination and to remind about doses to be administered. Most patients did not have proper adherence to vaccination schedules, especially due to lack of guidance. Results implied that education in health is important for vaccination adhesion, knowledge of adverse events and continuation of schemes.
RESUMO Objetivo Identificar se existe correlação entre o Índice de Triagem para Distúrbio de Voz e as condições de trabalho de professores das escolas públicas e privadas e compará-las entre os professores das duas redes de ensino. Métodos Participaram 183 professores, sendo 122 de escolas públicas e 61 de uma escola privada, que responderam ao questionário Condição de Produção Vocal do Professor, composto por 81 questões. Destas, entretanto, foram analisadas as questões referentes à identificação pessoal, funcional, condições vocais e de trabalho. Foi realizada análise estatística descritiva e inferencial. Resultados Quando analisados em relação às condições vocais, a maioria dos professores das escolas públicas relatou queixa vocal. O Índice de Triagem para Distúrbio de Voz dos professores das escolas públicas correspondeu a mais sintomas vocais do que os da escola privada. Além disso, os docentes das escolas públicas relataram piores condições de trabalho, em relação aos docentes da escola privada. Conclusão Existe uma correlação negativa entre o Índice de Triagem para Distúrbio de Voz e as condições de trabalho dos professores de escola pública e particular. Os professores das escolas públicas relataram piores condições de trabalho do que os da escola privada, bem como referiram maior ocorrência de distúrbio da voz e apresentaram maior pontuação no Índice de Triagem para Distúrbio de Voz.
RESUMO Embora seja considerado um município completamente urbano, Natal possui ilhas de ruralidade em seu território, caracterizadas pela produção agrícola e por um modo de vida que remete ao campo. Exemplo disto é o Gramorezinho, comunidade localizada no bairro Lagoa Azul. Tendo em vista a crescente discussão sobre a agricultura urbana e a sua importância para a construção de cidades sustentáveis, o artigo objetiva refletir sobre o papel do Gramorezinho para a sustentabilidade socioambiental em Natal. A metodologia adotada consistiu na revisão bibliográfica sobre os conceitos de sustentabilidade e agricultura urbanas, visitas de campo, reuniões com os moradores e coleta de dados secundários sobre o Gramorezinho. Na pesquisa, foi verificado que a área possui grande potencial paisagístico, ambiental, cultural e aspectos sociais e econômicos relevantes, sendo um exemplo de como atividades econômicas podem se desenvolver em consonância com a proteção ambiental. No entanto, foram constatadas demandas por serviços e melhorias de infraestrutura na comunidade, bem como a urgência de regulamentação da Zona de Proteção Ambiental em que ela se insere e do próprio Gramorezinho como Área Especial de Interesse Social voltada para a Segurança Alimentar. A regulamentação permitirá o reconhecimento legal da área e facilitará a provisão de infraestrutura para a mesma, garantindo a permanência de seus moradores e a continuidade da atividade agrícola no local.
Objective: to conduct an integrative literature review on the effect of group speech-language pathology actions related to teachers’ vocal health, and to identify, evaluate and discuss therapeutic approaches, assessment instruments, duration of actions, number of meetings, and their effectiveness, from articles published between 2007 and 2017. Methods: this research was conducted using the “voice”, “faculty”, “psychotherapy group” and “voice training” descriptors, and their corresponding descriptors in Portuguese, using the databases: LILACS, SciELO and PubMed. Results: the search resulted in 1,944 papers. After the selection, 9 studies fulfilled the inclusion and exclusion criteria. Conclusion: the group speech-language pathology actions related to teachers’ vocal health have an effect on the voice-related quality of life, reducing the vocal and emotional symptoms caused by work-related factors. The eclectic therapeutic approach was the most used one, and there were variations in the duration of actions and number of meetings among the studies. In terms of assessment instruments, the self-assessment of voice and the auditory-perceptual analysis were the most highlighted ones. Furthermore, most studies considered the results of their actions as effective.
Abstract. This meta-paper proposes a RPG-liked (Role Playing Game)
Bacteria from genus Bradyrhizobium can establish symbiosis with soybean and supply the plant nitrogen demands via biological nitrogen fixation (BNF). This study aimed to characterize genes related to BNF efficiency in B. japonicum strains contrasting in BNF efficiency. These gene sequences were previously identified in B. japonicum (strain S370) as probably related to the BNF efficiency in soybean using a DNA subtractive technique. These genes were amplified with primers based on B. japonicum USDA110 genome. The PCR products were digested with restriction endonucleases and the RFLP products were analyzed by horizontal electrophoresis. Among the four genes, only blr3208 and blr4511 amplified for most of the strains. Neither polymorphism of the restriction profile of blr3208 and blr4511 genes nor with endonuclease for PCR-RFLP was observed. The contrasting strains had blr3208 and blr4511 genes sequenced and the multiple alignment analysis of nucleotide sequences showed the presence of preserved internal regions, confirming the analysis with PCR-RFLP. The blr3208 and blr4511 genes are highly conserved among B. japonicum strains, which may be related to adaptive function during the evolutionary process of Bradyrhizobium genus.
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