Financial investment in human resources: an experience at a hospital

This study aimed to investigate the financial amount a large school hospital invested in training programs. Seven training programs for the hospital staff were analyzed by means of the absorption costing system, totaling 307 training sessions in 1999. Data analysis showed that, during that year, a total of R$ 225,493.84 was invested, that is, R$ 27.41 per worker. There are no data on other Brazilian hospitals to compare this figure. However, if this is compared with the annual worldwide average of US$ 252 per capita, the mean value is 9.2 times less than world average. This figure corresponds to 0.32% of the payment roll, while the world average is 2.7%. This study points towards the importance for Permanent Education Centers to understand the costs of training programs as well as for hospital organizations to create a formal policy for investment in these programs.     

Nursing and costs management

This work intend to broach structural elements that motivate institutions and health professionals to know and develop studies about hospital costs, emphasize the subject importance for the nursing professional.     

Conditioned antinociception and freezing using electrical stimulation of the dorsal periaqueductal gray or inferior colliculus as unconditioned stimulus are differentially regulated by 5-HT2A receptors in rats

RATIONALE: Electrical stimulation of the dorsal periaqueductal gray matter (dPAG) and the inferior colliculus (IC) has been used as an aversive unconditioned stimulus. However, studies on the behavioral, sensorial and autonomic components of the conditioned fear elaborated in the midbrain tectum are lacking. OBJECTIVES: This study was undertaken to investigate the nature of the aversiveness of stimulation of the dPAG and IC as well as the modulation by 5-HT mechanisms of the fear conditioned responses to these stimulations. METHODS: Animals chronically implanted with an electrode glued to a guide cannula into the dPAG or the IC were submitted to one, two or three sessions of conditioning. Each session consisted of ten pairings of the light in a distinctive chamber (CS) with the electrical stimulation of one of these regions at the escape threshold determined previously. Control groups were submitted to the same procedure, except for the conditioning sessions in which the conditioned stimuli were presented alone in one case and performed in a different context in the other. On the next day, each animal was exposed only to the CS (testing) and the duration of freezing, number of rearings, grooming, bouts of micturition and fecal boli were recorded for 5 min. Before and after the testing session, the animals were submitted to the tail-flick test. RESULTS: The data showed that the conditioning with electrical stimulation of the dPAG and the IC caused significant increases in the time of freezing, defecation and micturition, and significant reductions in the number of rearings and grooming. On the other hand, only the conditioning with electrical stimulation of the dPAG produced significant conditioned antinociception. Microinjections of methysergide, a non-specific antagonist of 5-HT receptors, or ketanserin, an antagonist of 5-HT2A receptors, into the dPAG before testing significantly inhibited the antinociception without affecting any of the behavioral or autonomic conditioned responses. CONCLUSIONS: 1) Conditioned freezing may be produced using the electrical stimulation of the dPAG or IC as unconditioned stimuli, 2) only the pairing of CS plus dPAG but not with IC stimulation, produces significant conditioned antinociception, 3) blockade of 5-HT2A receptors inhibits conditioned antinociception but not the conditioned defensive behavior using the electrical stimulation of the dPAG as unconditioned stimulus.     

Perception of vulnerability to HIV infection in a cohort of homosexual/bisexual men in Rio de Janeiro, Brazil. Oswaldo Cruz Foundation STD/HIV Prevention Group

The present study addresses sociodemographic characteristics, knowledge and attitudes regarding HIV/AIDS, as well as risk behaviour and perception of vulnerability to HIV infection, in the first 295 homosexual and bisexual volunteers (excluding male commercial sex workers and transvestites) taking part in a cohort study in Rio de Janeiro. The sample has a higher socio-economic level than the remainder of the cohort, and than comparable strata of the general population, and a sound knowledge about how to protect themselves against HIV infection. In addition, an association between perception of vulnerability to infection and the practice of unprotected anal sex was observed. An association was also observed between higher levels of formal education and perception of vulnerability; however no association was found with markers for past and recent exposure to sexually transmitted infections (hepatitis B, HbsAG and syphilis). The results of the present study suggest that knowledge and awareness of risk do not easily translate into behaviour change, since significant proportions of the cohort continue to practise unprotected sex with both principal and casual partners, despite their awareness of HIV infection risks as well as preventive measures.     

Influence of caloric restriction on the development of atherosclerosis in nonhuman primates: progress to date

Caloric restriction (CR) has been observed to retard aging processes and extend the maximum life span in rodents. In an effort to evaluate the effect of this nutritional intervention on physiologic variables in higher species, several nonhuman primate trials are ongoing. In particular, a study evaluating the independent effect of CR on the extent of atherosclerosis was initiated in 1993 in 32 adult cynomolgus monkeys. Therefore, the trial was designed to achieve identical cholesterol intake after animals were randomized to a control group or a calorie-restricted group (30% reduction from baseline caloric intake). The animals were routinely evaluated for glycated proteins, plasma insulin and glucose levels, insulin sensitivity, and specific measures for abdominal fat distribution by CT scans over a 4-year interval. The results from 4 years of intervention demonstrate that CR improves cardiovascular risk factors (such as visceral fat accumulation) and improves insulin sensitivity. In contrast to other primate studies with normolipidemic animals, CR had no independent effects on plasma lipid levels and composition in the presence of equivalent amounts of dietary cholesterol intake. Preliminary analysis of atherosclerotic lesion extent in the abdominal aorta has failed to demonstrate differences between control animals and CR animals. Follow- up studies are being conducted to determine the effect of CR on atherosclerosis extent in coronary and carotid arteries.      

选择性κ阿片激动剂K-Ⅱ与U-50488的药理作用比较

K-Ⅱ系k阿片激动剂U-50488的同类物。通过部分离体和整体实验比较了K-Ⅱ与U-50488的药理作用。实验发现,K-Ⅱ抑制电刺激兔输精管收缩的IC₅₀值为0.42 nmol/L,U-50488为26.5 nmol/L;K-Ⅱ抑制小鼠运动功能(横筛法)的ED₅₀值为1.7 mg/g,U-50488为15.3 mg/kg;K-Ⅱ的小鼠LD₅₀值为152.5 mg/kg,U-50488为118.4 mg/g;K-Ⅱ明显降低小鼠自发活动的作用比U-50488强5倍。结果表明,K-Ⅱ是一个药理作用较U-50488强的k受体激动剂。     

Perceptions of adolescents and young people regarding endemic dental fluorosis in a rural area of Brazil: psychosocial suffering

Severe dental fluorosis is endemic in some rural areas of Brazil. This paper describes the psychosocial consequences of this condition and how it has affected the self-esteem of adolescents and young people in a rural area in Brazil. Semi-structured, face-to-face interviews were carried out with 23 adolescents and young people affected by severe dental fluorosis and 14 of their teachers. The study revealed the affected individuals were embarrassed to smile at strangers due to a presumed association between fluorosis and a lack of dental hygiene. Further findings include conflicts between affected and non-affected students at school, problems in pursuing a romantic relationship and uncertainties regarding a professional future. Disbelief and scepticism were observed regarding the ethical position that science can offer a solution to the problems stemming from the disease. Lesions from severe dental fluorosis appear to be a stigmatising factor and have contributed toward suffering and self-exclusion among an entire generation of adolescents and young people.