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‣ Functionalization of dendrimers for improved gene delivery to mesenchymal stem cell

Santos, José Luís da Silva
Fonte: Universidade da Madeira Publicador: Universidade da Madeira
Tipo: Tese de Doutorado
Publicado em //2009 Português
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Disease, injury, and age problems compromise human quality of life and continuously motivate the search for new and more efficacious therapeutic approaches. The field of Tissue Regeneration and Engineering has greatly evolved over the last years, mainly due to the combination of the important advances verified in Biomaterials Science and Engineering with those of Cell and Molecular Biology. In particular, a new and promising area arose – Nanomedicine – that takes advantage of the extremely small size and especial chemical and physical properties of Nanomaterials, offering powerful tools for health improvement. Research on Stem Cells, the self-renewing progenitors of body tissues, is also challenging to the medical and scientific communities, being expectable the appearance of new and exciting stem cell-based therapies in the next years. The control of cell behavior (namely, of cell proliferation and differentiation) is of key importance in devising strategies for Tissue Regeneration and Engineering. Cytokines, growth factors, transcription factors and other signaling molecules, most of them proteins, have been identified and found to regulate and support tissue development and regeneration. However, the application of these molecules in long-term regenerative processes requires their continuous presence at high concentrations as they usually present short half-lives at physiological conditions and may be rapidly cleared from the body. Alternatively...

‣ Drug carriers for oral delivery of peptides and proteins: accomplishments and future perspectives

Reis, CP; Silva, C; Martinho, N; Rosado, C
Fonte: Therapeutic Delivery Publicador: Therapeutic Delivery
Tipo: Artigo de Revista Científica
Português
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Effective formulation for peptide and protein delivery through the oral route has always been the critical effort with the advent of biotechnology. Stability, enzymatic degradation and ineffective absorption are common difficulties found for conventional dosage forms. As a result, new drug-delivery approaches are used to circumvent these limitations and enhance effective oral drug delivery. Some of these technologies have reached late stages of clinical trials and promising results will be available in the near future. This review covers, in general, the recent carriers reported in literature.

‣ Atenção qualificada ao parto: a realidade da assistência de enfermagem em Rio Branco - AC; Qualified attention to delivery: the reality of nursing assistance in Rio Branco - AC

Dotto, Leila Maria Geromel
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 22/09/2006 Português
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Tem havido consenso de que a atenção qualificada ao parto e nascimento é uma intervenção fundamental para tornar as gestações e partos mais seguros, visto que apenas 53% das mulheres em países em desenvolvimento são atendidas no parto por pessoal qualificado. As evidências epidemiológicas mostram que existe uma relação entre a atenção qualificada ao parto e o declínio da mortalidade materna. Este estudo buscou conhecer a realidade do atendimento a parturientes, realizado pela enfermagem nas maternidades do município de Rio Branco-AC. Objetivos: identificar e descrever o perfil dos profissionais de enfermagem que atuam na atenção ao trabalho de parto e parto normal, e analisar as competências essenciais desenvolvidas por eles nesta prática. Metodologia: estudo descritivo, com abordagem quantitativa, realizado em duas maternidades. A população estudada foi composta por 30 profissionais de enfermagem (02 enfermeiras, 07 enfermeiras obstétricas, 08 técnicas de enfermagem e 13 auxiliares de enfermagem). A coleta de dados foi realizada por meio de entrevistas e observações sistemáticas das competências essenciais em obstetrícia. Foram observados 14 admissões, 34 evoluções de trabalho de parto, 11 partos normais e 11 pósparto. A estatística descritiva e o teste exato de Fisher foram usados para análise dos dados. Resultados: perfil dos profissionais: a média de idade dos profissionais foi de 41 anos...

‣ Avaliação do efeito do tipo de parto sobre a força muscular do assoalho pélvico de primíparas; Evaluation of the effect of the kind of delivery on the muscular strength of the pelvic floor of primiparous

Oliveira, Janaina Mayer de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 05/11/2007 Português
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A força dos músculos do assoalho pélvico e as estruturas de sustentação dos órgãos pélvicos são afetadas por vários acontecimentos durante toda a vida da mulher. A gravidez e o parto são situações que influenciam a anatomia e fisiologia materna causando efeito sobre o assoalho pélvico e suas estruturas. A literatura que trata da avaliação da função da musculatura do assoalho pélvico no ciclo gravídico-puerperal é escassa. Este trabalho teve como finalidade analisar o efeito do tipo de parto sobre a força muscular do assoalho pélvico de primíparas com os seguintes objetivos específicos: identificar a presença de alterações na força muscular do assoalho pélvico após o parto; verificar a existência de correlação entre alterações na força muscular do assoalho pélvico após o parto de acordo com o tipo de parto; identificar a presença de fatores que contribuem para a diminuição da força muscular do assoalho pélvico pós-parto correlacionando-os com o tipo de parto. Metodologia: Trata-se de um estudo de coorte prospectivo em que participaram 43 mulheres primíparas, em sua maioria jovens com menos de 25 anos de idade, as quais foram avaliadas por meio da perineometria em dois momentos distintos: antes do parto (a partir da 32ª semana gestacional) e entre 45 e 75 dias após o parto. Foram utilizados formulários de avaliação como instrumentos de coleta de dados os quais foram complementados com dados de prontuários. Resultados: houve redução da força do assoalho pélvico após o parto...

‣ Necessidade de cuidado e de participação no parto: a voz de um grupo de gestantes de Londrina - PR; Care and participation needs during delivery: the voices of a group of pregnant women from Londrina - PR

Sodré, Thelma Malagutti
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 05/03/2010 Português
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No contexto da assistência ao parto em Londrina-PR, a passividade das parturientes, diante da atitude desrespeitosa de muitos profissionais que não atendem a suas necessidades, e o uso excessivo e rotineiro de intervenções geraram alguns questionamentos que nortearam o presente estudo: as mulheres desejam participar das decisões relacionadas ao seu parto? Elas desejam planejar seu parto? As mulheres participam do parto? O acesso às informações favorece a participação ativa das mulheres no parto? Como as mulheres desejam ser atendidas durante o parto? Quais são as suas necessidades durante esta experiência? Com quem elas desejam compartilhar esta experiência? Diante de tais questionamentos, estabeleceram-se os seguintes objetivos: Conhecer e compreender as necessidades de cuidado e de participação nas decisões sobre o parto de um grupo de gestantes de Londrina-PR. Apreender o típico da ação de um grupo de gestantes de Londrina-PR diante do parto. Para tanto, realizou-se uma pesquisa qualitativa, fundamentada na Sociologia Fenomenológica de Alfred Schütz, com base nas questões norteadoras: Qual a sua expectativa em relação ao seu parto? Como você gostaria de ser cuidada durante o seu parto? Você deseja tomar alguma decisão em relação ao seu parto? Qual decisão? Dos depoimentos de quatorze gestantes...

‣ Dosagens de melatonina e de citocinas de acordo com a via de parto; Melatonin and cytokines concentrations in accordance with the mode of delivery

Beirigo, Priscila Fabiane dos Santos
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 15/12/2011 Português
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Objetivo: Avaliar o perfil de citocinas pró-inflamatórias e de melatonina no cordão umbilical e no sangue materno de gestantes hígidas de acordo com a via de parto. Métodos: Entre março e setembro de 2010, foi realizado estudo observacional prospectivo no Hospital Universitário da Universidade de São Paulo. Foram dosadas citocinas (IL-1, IL-6, TNF) e melatonina em pacientes sem doenças clínicas ou complicações obstétricas que entraram em trabalho de parto espontâneo. As concentrações de citocinas e de melatonina foram comparadas de acordo com a via de parto, além do período do dia e do local de coleta. O sangue retirado da veia do cordão umbilical (VCU) era obtido imediatamente após o parto, sendo que após uma hora era colhido o sangue da veia braquial materna (VB). Foram excluídas pacientes com infecção, parto prematuro e sofrimento fetal. Resultados: Foram estudadas 50 parturientes, das quais 25 evoluíram para parto vaginal e 25 para cesárea. A idade materna foi em média 26,0 ± 6,7 anos. A idade gestacional no parto foi em média 39,5 ± 1,7 semanas. O peso médio dos recém-nascidos foi 3366,5 ± 340,2 gramas. Todos os casos receberam analgesia durante o parto (analgesia combinada: peridural e raquianestesia). A maioria das pacientes era de nulíparas (31/50 - 62...

‣ Liposomes and micro/nanoparticles as colloidal carriers for nasal drug delivery

Mainardes, Rubiana Mara; Cocenza Urban, Maria Cristina; Cinto, Priscila Oliveira; Chaud, Marco Vinícius; Evangelista, Raul Cesar; Daflon Gremião, Maria Palmira
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Revisão Formato: 275-285
Português
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The use of the nasal route for drug delivery has attracted much interest in recent years in the pharmaceutical field. Local and principally systemic drug delivery can be achieved by this route of administration. But the nasal route of delivery is not applicable to all drugs. Polar drugs and some macromolecules are not absorbed in sufficient concentration due to poor membrane permeability, rapid clearance and enzymatic degradation into the nasal cavity. Thus, alternative means that help overcome these nasal barriers are currently in development. Absorption enhancers such as phospholipids and surfactants are constantly used, but care must be taken in relation to their concentration. Drug delivery systems including liposomes, cyclodextrins, micro- and nanoparticles are being investigated to increase the bioavailability of drugs delivered intranasally. This review article discusses recent progress and specific development issues relating to colloidal drug delivery systems in nasal drug delivery. © 2006 Bentham Science Publishers Ltd.

‣ Improving the Delivery of Health Services : A Guide to Choosing Strategies

Berman, Peter; Pallas, Sarah; Smith, Amy L.; Curry, Leslie; Bradley, Elizabeth H.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
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Sufficient funding and efficacious technology may be necessary conditions for achieving health gains, but experience in many countries confirms that they are not sufficient. Effective and efficient service delivery is the point at which the potential of the health system to improve lives meets the opportunity to realize health gains. Health service delivery performance means access and use by those in need; adequate quality of care to produce health benefits; efficient use of scarce resources; and organizations that can learn, adapt, and improve for the future. All too often, potential benefits are not realized because service delivery underperforms. Organizations must combine financial, physical, and human resources to deliver health services. However, organizations can be complex, and this complexity must be considered in developing strategies for change. This guide will help planners and policy makers navigate the complexity and make better decisions to improve health services. Users of this Guide will find practical advice about what performance means in service delivery as well as how to measure the performance of service delivery organizations. The Guide discusses reforms to service delivery organizations at the system level and at the individual facility level. It emphasizes the internal workings of the organization as well as the external environment in which an organization functions...

‣ Local Service Delivery in Nepal

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Português
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The effectiveness of public service delivery depends in large part on the capability, resources and inputs, and the motivation of frontline service providers at the local level. In Nepal a combination of de-concentrated line agencies and local bodies at the district, municipal, and village level provides inputs which are translated into delivery of service outputs and outcomes. Yet the relationships between line agencies and local bodies in service delivery are not well understood. The purpose of this report is to examine in detail the current dynamics of frontline service delivery to identify institutional limitations and present approaches to addressing them. This study seeks to map out the dynamics of service delivery at the local level through analysis of the institutional framework and actual practices in service delivery in 14 jurisdictions in the two districts of Dhankuta and Dhanusa. The study includes a detailed review of the provision of local roads networks and primary and lower secondary education. In this context...

‣ Evaluating the Appropriateness of Project Delivery Systems for Different Trenchless Methods

Mostafavi, Ali; Iseley, Tom; Abraham, Dulcy
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
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Trenchless methods have been considered to be a viable solution for pipeline projects in urban areas. Their applicability in pipeline projects is expected to increase with the rapid advancements in technology and emerging concerns regarding social costs related to trenching methods. Selecting appropriate project delivery system (PDS) is a key to the success of trenchless projects. To ensure success of the project, the selected project delivery should be tailored to trenchless project specific characteristics and owner needs, since the effectiveness of project delivery systems differs based on different project characteristics and owners requirements. Since different trenchless methods have specific characteristics such rate of installation, lengths of installation, and accuracy, the same project delivery systems may not be equally effective for different methods. The intent of this paper is to evaluate the appropriateness of different PDS for different trenchless methods. PDS are examined through a structured decision-making process called Fuzzy Delivery System Selection Model (FDSSM). The process of incorporating the impacts of: (a) the characteristics of trenchless projects and (b) owners’ needs in the FDSSM is performed by collecting data using questionnaires deployed to professionals involved in the trenchless industry in order to determine the importance of delivery systems selection attributes for different trenchless methods...

‣ The Relationship Between Socioeconomic Status, Course Delivery Method, and Student Success at a State College: A Single Institution Analysis

Garcia, Rolando
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
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In an effort to improve instruction and better accommodate the needs of students, community colleges are offering courses delivered in a variety of delivery formats that require students to have some level of technology fluency to be successful in the course. This study was conducted to investigate the relationship between student socioeconomic status (SES), course delivery method, and course type on enrollment, final course grades, course completion status, and course passing status at a state college. A dataset for 20,456 students of low and not low SES enrolled in science, technology, engineering, and mathematics (STEM) course types delivered using traditional, online, blended, and web enhanced course delivery formats at Miami Dade College, a large open access 4-year state college located in Miami-Dade County, Florida, was analyzed. A factorial ANOVA using course type, course delivery method, and student SES found no significant differences in final course grades when used to determine if course delivery methods were equally effective for students of low and not low SES taking STEM course types. Additionally, three chi-square goodness-of-fit tests were used to investigate for differences in enrollment, course completion and course passing status by SES...

‣ Silica materials in drug delivery applications

Simovic, S.; Ghouchi-Eskandar, N.; Sinn, A.; Losic, D.; Prestidge, C.
Fonte: Bentham Science Publishers Publicador: Bentham Science Publishers
Tipo: Artigo de Revista Científica
Publicado em //2011 Português
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In this review article we collect and analyse preparation, chemistry and properties of silica materials relevant for drug delivery applications. We review some of the most relevant milestones in the research of silica materials for implantable, oral, intravenous and dermal drug delivery systems. Preparation, chemistry and drug delivery characteristics of fumed silica nanoparticles (oral and dermal delivery route), silica xerogels (implant delivery), mesoporous silica materials (implant and oral delivery) and mesoporous silica spheres (intravenous delivery) with particular emphasis on their role in anticancer therapy and the design of stimuli responsive drug delivery systems are analysed. Recent progress in the research of silica materials for controlled drug delivery, namely, biocompatibility aspects, research on hybrid materials, anticancer and stimuli-responsive mesoporous silica materials are particularly emphasized.; Spomenka Simovic, Nasrin Ghouchi-Eskandar, Aw Moom Sinn, Dusan Losic and Clive A. Prestidge

‣ Evaluation von Normwerten des sonographischen Endometriums- und Flüssigkeitsreflexes des Cavum uteri post partum; Evaluation of normal data of sonographic endometrium and fluid reflex of cavum uteri after delivery

Geissl-de Both, Judith
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
Português
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Zielsetzung der Studie war es, anhand einer grossen Fallzahl Frauen postpartal - unabhängig ihres Geburtsmodus - sonographisch zu untersuchen, um Normwerte des sagittalen bzw. transversalen Endometriums- und Flüssigkeitsreflexes zu definieren. 6 bis 12 Monate postpartal wurde von den Patientinnen ein zusätzlicher Fragebogen zu dieser Studie beantwortet. Ein weiteres Ziel dieser Arbeit bestand darin, das Lochialsekret zu quantifizieren und herauszufinden, ob und ab wann sonographisch ein Rückstau oder eine beginnende Endomyometritis erfassbar und somit rechtzeitig therapierbar sind. Von Juni 2003 bis Juli 2004 wurden 508 Frauen postpartal untersucht. Die erhobenen Werte des Endometriumsreflexes zeigten in den sagittalen und transversalen Schnittebenen eine enorme Variationsbreite (zwischen 1.7mm und 48.5mm). Beim Vergleich der Werte der unterschiedlichen Entbindungsmodi ergab sich, dass die sagittalen Mediane signifikant divergieren (Gesamtmedian: 10.2mm; vaginal: 12.5mm; VE: 11.8mm; Forceps: 22.9mm; primäre Sectio: 6.6mm; sekundäre Sectio: 6.7mm; Notsectio: 5.8mm). Bei 50% lies sich ein nach den Kriterien von Hertzberg (1991) und Carlan (1997) normal definierter Endometriumsreflex nachweisen. 2% dieser Frauen erhielten postpartal eine Abrasio. In keinem Fall war ein Lochialstau aufgetreten Die einzige Endomyometritis kam in dieser Gruppe vor. In 38% war ein inhomogener Reflex nachweisbar (postpartale Abrasio: 2.7%; Lochialstau: 4.8%). Ein echoreicher Reflex war in 10% nachweisbar (postpartale Abrasio: 2%; Lochialstau: 15%). In 3% war ein echoarmer Reflex nachweisbar (postpartale Abrasio: 7%; Lochialstau 0%) Schlussfolgerung: Der als normal definierte Endometriumsreflex ist somit der häufigste postpartale Sonographiebefund. Der Endometriums- und Flüssigkeitsreflex post partum weist messtechnisch nur sehr bedingt eindeutige Unterschiede bei postpartalen Komplikationen auf. Daher sind sonographischen Messwerte als alleinige prognostische Faktoren für das Auftreten von postpartalen Komplikationen wie Lochialstau...

‣ Use and influence of Delivery and Birth Plans in the humanizing delivery process

Suárez-Cortés,María; Armero-Barranco,David; Canteras-Jordana,Manuel; Martínez-Roche,María Emilia
Fonte: Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Publicador: Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2015 Português
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OBJECTIVES: get to know, analyze and describe the current situation of the Delivery and Birth Plans in our context, comparing the delivery and birth process between women who presented a Delivery and Birth Plan and those who did not.METHOD: quantitative and cross-sectional, observational, descriptive and comparative cohort study, carried out over two years. All women who gave birth during the study period were selected, including 9303 women in the study.RESULTS: 132 Delivery and Birth Plans were presented during the first year of study and 108 during the second. Among the variables analyzed, a significant difference was found in "skin to skin contact", "choice of dilation and delivery posture", "use of enema", "intake of foods or fluids", "eutocic deliveries", "late clamping of the umbilical cord" and "perineal shaving".CONCLUSIONS: the Delivery and Birth Plans positively influence the delivery process and its outcome. Health policies are needed to increase the number of Delivery and Birth Plans in our hospitals.

‣ The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery

MacLennan, A.; Taylor, A.; Wilson, D.; Wilson, D.
Fonte: British Journal of Obstetrics and Gynaecology Publicador: British Journal of Obstetrics and Gynaecology
Tipo: Artigo de Revista Científica
Publicado em //2000 Português
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OBJECTIVE: To define the prevalence of pelvic floor disorders in a non-institutionalised community and to determine the relationship to gender, age, parity and mode of delivery. DESIGN: A representative population survey using the 1998 South Australian Health Omnibus Survey. SAMPLE: Random selection of 4400 households; 3010 interviews were conducted in the respondents' homes by trained female interviewers. This cross sectional survey included men and women aged 15-97 years. RESULTS: The prevalence of all types of self-reported urinary incontinence in men was 4.4% and in women was 35.3% (P<0.001). Urinary incontinence was more commonly reported in nulliparous women than men and increased after pregnancy according to parity and age. The highest prevalence (51.9%) was reported in women aged 70-74 years. The prevalence of flatus and faecal incontinence was 6.8% and 2.3% in men and 10.9% and 3.5% in women, respectively. Pregnancy (> 20 weeks), regardless of the mode of delivery, greatly increased the prevalence of major pelvic floor dysfunction, defined as any type of incontinence, symptoms of prolapse or previous pelvic floor surgery. Multivariate logistic regression showed that, compared with nulliparity, pelvic floor dysfunction was significantly associated with caesarean section (OR 2.5...

‣ Expectant parents' preferences for mode of delivery and trade-offs of outcomes for breech presentation

Kok, M.; Gravendeel, L.; Opmeer, B.; van der Post, J.; Mol, B.
Fonte: Elsevier Ireland Publicador: Elsevier Ireland
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
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OBJECTIVE: To assess patients' preferences and trade-offs for mode of delivery in case of breech presentation at term. METHODS: Eighty women (40 with a foetus in breech presentation and 40 with a foetus in cephalic presentation) with a gestational age from 36 weeks onwards were offered scenarios of vaginal and caesarean breech delivery in which 1-month and 2-year neonatal and maternal complication rates were varied; expectant fathers (when present) were interviewed separately. Thresholds for complication rates where patients switch preferences were visualised graphically in trade-off curves. Differences in preference thresholds were tested using the Wilcoxon signed ranks test. RESULTS: Caesarean delivery was the preferred mode of delivery for breech presentation in 65% of the patients interviewed. The trade-off questions showed that the 2-year neonatal outcome after breech delivery was the most important outcome for the mothers, whereas the fathers were more influenced by the maternal outcome. CONCLUSION: When realistic assumptions for complications are made, most women prefer a caesarean delivery over vaginal delivery for at term breech presentation. In the balance of pros and cons, 2-year neonatal outcome is the most important factor in the decision between caesarean and vaginal delivery. PRACTICE IMPLICATIONS: The results of this study can be used by the clinician to help patients weigh risk...

‣ Republic of India - eGovernance in the North East : Reducing Public Administration Constraints to Improve Service Delivery

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Other Public Sector Study
Português
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The Government of Assam (GoA) is engaged in a process of improving services to citizens. The focus on better services to citizens is in line with the National e-Government Plan (NeGP), with a number of existing and anticipated Union Acts, and with recently passed acts in Assam, especially the Assam Right to Public Services Act of 2012. The GoA is fully aware that progress on service delivery will require attention to both vertical and horizontal connectivity, and it intends to develop a Strategic Action Plan which focuses on these critical elements. The policy dialogue with the Government of Assam and review of relevant documents reveal general agreement on main public administration constraints (PAC's) to service delivery. The current report proposes a gradual reform approach, with a focus on searching for improvements that can be accomplished with a reasonable effort. The present report is structured as follows. Chapter two, 'Public Administration Constraints (PAC's)', provides a detailed diagnostic of constraints identified in Assam...

‣ A humanização do cuidado na assitencia hospitalar ao parto : uma avaliação da qualidade; Humanizing the hospital attendance care to delivery : evaluating the quality

Elizabeth Eriko Ishida Nagahama
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 11/05/2007 Português
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Esta pesquisa objetivou avaliar a qualidade da atenção ao parto nos dois hospitais de referência para atendimento ao parto SUS no município de Maringá-Paraná, com enfoque na humanização do cuidado. Realizou-se estudo avaliativo transversal, misto e formativo, por meio de pesquisa em prontuário hospitalar e entrevista estruturada com 569 puérperas atendidas nos dois hospitais, no período de março/2005 a fevereiro/2006. Foram utilizados sete indicadores de processo da qualidade na assistência ao parto humanizado. Os indicadores relacionados ao trabalho de parto foram: fornecimento às mulheres de todas as informações e explicações que desejassem, presença do acompanhante, uso de métodos não-invasivos e não-farmacológicos de alívio da dor e oferecimento de líquidos por via oral. A presença do acompanhante na sala de parto, o fornecimento às mulheres de todas as informações e explicações que desejassem, e o contato pele a pele entre mãe e filho em sala de parto qualificaram o atendimento na sala de parto. Por meio do estabelecimento de escores para cada um dos indicadores e da somatória obtida em cada um deles, a assistência hospitalar foi qualificada em quatro níveis: insatisfatória, regular, boa e excelente. Considerou-se a taxa de cesárea o indicador de resultado...

‣ Transport Phenomena in Anti-HIV Microbicide Delivery Vehicles

Geonnotti, III, Anthony Robert
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Dissertação Formato: 5694810 bytes; application/pdf
Publicado em 21/04/2008 Português
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There were 2.5 million people newly infected with HIV in 2007, clearly motivating the need for additional novel prevention methods. In response, topical vaginal antimicrobials, or microbicides, are being developed. These products aim to stop HIV transmission through local, vaginal delivery of antiviral compounds. To succeed, microbicides require a potent active compound within a well-engineered delivery vehicle.

A well-engineered delivery vehicle provides an antiviral compound with the greatest opportunity to interact with HIV and/or infected cells, thereby increasing overall microbicide effectiveness. The theoretical and experimental investigations within this dissertation are concerned with the study of HIV and active compound transport within microbicide delivery vehicles and with the mechanisms by which these transport processes can be affected to maximize viral neutralization. To initially investigate the factors contributing to microbicide effectiveness, a combined pharmacokinetic and pharmacodynamic model of HIV transport and neutralization within a microbicide product was created. Model results suggested that thin (~100µm) layers of microbicide product may protect against HIV infection. Model results also indicated that a specific and engineerable property of delivery vehicles - the ability to restrict viral transport - may increase the overall effectiveness of a microbicide. Two new experimental assays were developed to test the hypothesis that delivery vehicles can slow viral transport. First...

‣ Drug Delivery and Anti-Vascular Effects of Temperature Sensitive Liposomal Doxorubicin

Manzoor, Ashley Anne
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Dissertação
Publicado em //2010 Português
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Traditionally, the goal of nanoparticle-based chemotherapy has been to decrease normal tissue toxicity by improving drug specificity to tumor. Relying on the EPR effect (Enhanced Permeability and Retention), a host of nanoparticles (from micelles and dendrimers to liposomes and lipidic nanoparticles) have been developed and tested for passive accumulation into tumor interstitium. Unfortunately, most nanoparticles achieve only suboptimal drug delivery to tumors, due to heterogeneity of tumor vessel permeability, limited nanoparticle penetration, and relatively slow drug release. However, recent developments in nanoparticle technology have occurred with the design and testing of a fast drug-releasing liposome triggered by local heat. This temperature-sensitive liposome formulation loaded with doxorubicin (Dox-TSL) has already shown substantial anti-tumor efficacy and is currently in clinical trials.

Previous pre-clinical work to understand the mechanism of efficacy has illustrated increases in overall drug concentration in the tumor, and an anti-vascular effect not observed with heat alone. These initial studies have also suggested that these liposomes may be the most efficacious when they are injected into a pre-heated tumor...