Análise de Maturidade em Gestão do Conhecimento na Secretaria Municipal de Saúde da Prefeitura do município de Contagem, Minas Gerais, Brasil / Analysis of Maturity in Knowledge Management at the Municipal Health Department of the Municipality of Contagem, Minas Gerais, Brazil

O objetivo desta pesquisa foi analisar o nível de maturidade de Gestão do Conhecimento na Secretaria Municipal de Saúde da Prefeitura do município de Contagem, Minas Gerais, Brasil, aliando teoria e prática. A maturidade em Gestão do Conhecimento é estabelecida em 13 dimensões, que devem ser consideradas concomitantemente. Os métodos utilizados consistem na aplicação de um instrumento de pesquisa constituído por 39 afirmativas, dispostas em escala likert de cinco pontos, seccionadas em 13 constructos, os quais são analisados sob a ótica positivista, por meio dos critérios de Kaiser-Meyer-Olkin para dimensionalidade, Alfa de Cronbach para confiabilidade e r de Pearson junto ao p-Valor para validade, sendo adotadas Médias, Desvio Padrão e Intervalo de Confiança de 95 porcent. Os resultados indicam que a instituição se encontra no nível três de cinco, denominado Incipiente, caracterizado por buscar gerenciar o conhecimento e suas áreas críticas para seu sucesso. Para elevação ao nível quatro de cinco de maturidade, são sugeridas três ações para as dimensões, Estratégia, Liderança e suporte da Alta Administração, Equipe de Gestão do Conhecimento, Recursos (financeiro, humano, material e tempo), Processos e Atividades, Gestão de Recursos Humanos, Treinamento e Educação, Motivação, Trabalho em Equipe, Cultura, Mensuração e Projeto Piloto e duas ações para a dimensão Tecnologia da Informação, totalizando 38 ações para promoção da maturidade. Esta pesquisa contribuiu na busca por estudos empíricos sobre nível de maturidade de Gestão do Conhecimento e instiga novos estudos em diferentes instituições públicas(AU)

El objetivo de esta investigación fue analizar el nivel de madurez de la Gestión del Conocimiento en la Secretaría Municipal de Salud del Municipio de Contagem, Minas Gerais, Brasil, combinando teoría y práctica. La madurez en Gestión del Conocimiento se establece en 13 dimensiones, las cuales deben ser consideradas concomitantemente. Los métodos utilizados consisten en la aplicación de un instrumento de investigación que consta de 39 enunciados, ordenados en una escala tipo Likert de cinco puntos, seccionados en 13 constructos, los cuales son analizados desde una perspectiva positivista, utilizando los criterios de dimensionalidad de Kaiser-Meyer-Olkin; Alfa de Cronbach para la confiabilidad y r de Pearson junto con el valor-p para validez; se adopta el análisis de la media, la desviación estándar y el intervalo de confianza del 95 por ciento. Los resultados indican que la institución se encuentra en el nivel tres de cinco, denominado incipiente, caracterizado por buscar gestionar el conocimiento y sus áreas críticas en función de su éxito. Para la elevación al nivel cuatro de cinco de madurez se sugieren tres acciones para las dimensiones: estrategia, liderazgo y apoyo a la alta dirección, equipo de gestión del conocimiento, recursos (económicos, humanos, materiales y de tiempo), procesos, actividades, recursos humanos, capacitación y educación, motivación, trabajo en equipo, cultura, medición y proyecto piloto; además dos acciones para la dimensión de Tecnologías de la Información. Se proponen 38 acciones en total para promover la madurez. Esta investigación contribuyó a la búsqueda de estudios empíricos sobre el nivel de madurez de la Gestión del Conocimiento y propone nuevos estudios en diferentes instituciones públicas(AU)

The objective of this research was to analyze the maturity level of Knowledge Management in the Municipal Health Department of the Municipality of Contagem, Minas Gerais, Brazil, combining theory and practice. Maturity in Knowledge Management is established in 13 dimensions, which must be considered concomitantly. The methods used consist of the application of a research instrument consisting of 39 statements, arranged on a five-point Likert scale, sectioned into 13 constructs, which are analyzed from a positivist perspective, using the Kaiser-Meyer-Olkin criteria for dimensionality. , Cronbach's Alpha for reliability and Pearson's r together with the p-Value for validity, adopting Means, Standard Deviation and Confidence Interval of 95percent. The results indicate that the institution is at level three out of five, called Incipient, characterized by seeking to manage knowledge and its critical areas for its success. For elevation to level four out of five of maturity, three actions are suggested for the dimensions, Strategy, Leadership and Senior Management support, Knowledge Management Team, Resources (financial, human, material and time), Processes and Activities, Human Resources, Training and Education, Motivation, Teamwork, Culture, Measurement and Pilot Project and two actions for the Information Technology dimension, totaling 38 actions to promote maturity. This research contributed to the search for empirical studies on the maturity level of Knowledge Management and instigates new studies in different public institutions(AU)

Single-base resolution methylomes of somatic embryogenesis in Theobroma cacao L. reveal epigenome modifications associated with somatic embryo abnormalities.

Propagation by somatic embryogenesis in Theobroma cacao has some issues to be solved, as many morphologically abnormal somatic embryos that do not germinate into plants are frequently observed, thus hampering plant production on a commercial scale. For the first time the methylome landscape of T. cacao somatic embryogenesis was examined, using whole-genome bisulfite sequencing technique, with the aim to understand the epigenetic basis of somatic embryo abnormalities. We identified 873 differentially methylated genes (DMGs) in the CpG context between zygotic embryos, normal and abnormal somatic embryos, with important roles in development, programmed cell death, oxidative stress, and hypoxia induction, which can help to explain the morphological abnormalities of somatic embryos. We also identified the role of ethylene and its precursor 1-aminocyclopropane-1-carboxylate in several biological processes, such as hypoxia induction, cell differentiation and cell polarity, that could be associated to the development of abnormal somatic embryos. The biological processes and the hypothesis of ethylene and its precursor involvement in the somatic embryo abnormalities in cacao are discussed.

Penicillin-resistant, ampicillin-susceptible Enterococcus faecalis isolates are uncommon in non-clinical sources.

This study aimed to investigate whether penicillin-resistant, ampicillin-susceptible E. faecalis (PRASEF) isolates are disseminated in non-clinical sources, and to compare the molecular characteristics and antimicrobial resistance (AMR) profile of clinical and non-clinical E. faecalis isolates. Non-clinical samples (n = 280) were collected and 101 E. faecalis isolates were recovered from food (n = 18), faeces of healthy animals (n = 24), water (n = 28) and sewage (n = 31). PRASEF (n = 68) and penicillin-susceptible, ampicillin-susceptible E. faecalis (n = 77) isolates of clinical origin were also evaluated. A significant variety of AMR profiles was observed among non-clinical isolates according to the source. No food isolate exhibited a multidrug resistance (MDR) phenotype different from those of isolates from animal faeces (50.0%) and sewage (38.7%). Overall, the MDR phenotype was more frequent among clinical (56.6%) than non-clinical isolates (22.8%) (p < 0.01). Non-clinical PRASEF isolates (n = 3) were only recovered from hospital sewage. Note that representative clinical and non-clinical PRASEF isolates were grouped in pulsotype A, and belonged to CC9 (clonal complex). In conclusion, E. faecalis isolates exhibiting the unusual penicillin-resistant but ampicillin-susceptible phenotype appeared to be restricted to the hospital environment. Our findings highlight the ability of PRASEF isolates to survive in sewage, which could enable these hospital-adapted lineages to spread to new ecological niches.

Mediação familiar e psicologia: articulações teórico-práticas na realidade brasileira / Mediación familiar y psicología: articulaciones teórico-prácticas en la realidade brasileña / Family mediation and psychology: theoretical-practical articulations in the brazilian reality

RESUMO. A Mediação Familiar é um método não-adversarial de resolução de conflitos, que pode ser realizada por diversos profissionais, em especial de Psicologia, de Direito e de Serviço Social. Neste trabalho, foi verificado como essa prática tem sido aplicada no Brasil em interlocução com o campo da Psicologia. Para tal, foi realizado levantamento bibliográfico de artigos publicados por psicólogos sobre Mediação Familiar nas bases de dados: SciElo, PePSIC, Periódicos Capes e Index-Psi, utilizando sete descritores: Mediação, Conflito Conjugal, Divórcio, Separação Conjugal, Psicologia Forense, Família e Psicologia Jurídica. Procedeu-se à análise temática de conteúdo em articulação com textos legais e outros marcos regulatórios da práxis no Brasil. As análises indicaram que os psicólogos têm atuado na mediação de conflitos, e que a Psicologia, enquanto área de conhecimento, tem contribuído e participado diretamente de sua construção. Deste modo, buscou-se estimular o debate e a reflexão, problematizando o posicionamento técnico e ético dos psicólogos nessa atividade, bem como a relação da Psicologia com tal campo, considerando as possíveis implicações com o movimento de judicialização das famílias.

RESUMEN. La Mediación Familiar es un método no adversarial de resolución de conflictos, que puede ser realizado por diversos profesionales, en especial, de Psicología, Derecho y Servicio Social. En este trabajo, se verifico cómo esta práctica se ha aplicado en Brasil em interlocución con el campo de la Psicología. Para ello, se realizo el levantamiento bibliográfico de artículos publicados por psicologos sobre mediación familiar em las bases de datos: SciElo, PePSIC, Periódicos Capes y Index-Psi, utilizando siete descriptores: Mediación, Conflicto Conjugal, Divorcio, Separación Conjugal, Psicología Forense, Familia y Psicología Jurídica. Se procedió el análisis temático de contenido en articulación con textos legales y otros marcos regulatorios de la práxis en Brasil. Los análisis indicaron que los psicólogos han actuado en la Mediación de Conflictos y que la Psicología, como área de conocimiento, ha contribuido y participado directamente de su construcción. De este modo, se buscó estimular el debate y la reflexión, problematizando el posicionamiento técnico y ético de los psicólogos en esta actividad, así como la relación de la Psicología con tal campo, considerando las posibles implicaciones con el movimiento de judicialización de las familias.

ABSTRACT. Family mediation is a non-adversarial conflict resolution method, which can be performed by several professionals, especially Psychology, Law and Social Services professionals. The objective of the present study was to analyze how this praxis has been applied in Brazil in dialogue with the field of Psychology. To this end, a literature survey of articles published by psychologists on Family Mediation was carried out in the following databases: SciElo, PePSIC, Periódicos Capes and Index-Psi, using seven descriptors: Mediation, Marital Conflict, Divorce, Marital Separation, Forensic Psychology, Family and Juridical Psychology.A thematic content analysis was carried out along with legal texts and other regulatory frameworks of praxis in Brazil. Psychologists have worked in the mediation of conflicts, and that Psychology, as an area of knowledge, has contributed and participated directly in its construction. In this way, we sought to stimulate debate and reflection, questioning the technical and ethical position of psychologists in this activity, as well as the relationship of Psychology with this field, considering the possible implications with the movement of judicialization of families.

QTL mapping and identification of SNP-haplotypes affecting yield components of Theobroma cacao L.

Cacao is a crop of global relevance that faces constant demands for improved bean yield. However, little is known about the genomic regions controlling the crop yield and genes involved in cacao bean filling. Hence, to identify the quantitative trait loci (QTL) associated with cacao yield and bean filling, we performed a QTL mapping in a segregating mapping population comprising 459 trees of a cross between 'TSH 1188' and 'CCN 51'. All variables showed considerable phenotypic variation and had moderate to high heritability values. We identified 24 QTLs using a genetic linkage map that contains 3526 single nucleotide polymorphism (SNP) markers. Haplotype analysis at the significant QTL region on chromosome IV pointed to the alleles from the maternal parent, 'TSH 1188', as the ones that affect the cacao yield components the most. The recombination events identified within these QTL regions allowed us to identify candidate genes that may take part in the different steps of pod growth and bean filling. Such candidate genes seem to play a significant role in the source-to-sink transport of sugars and amino acids, and lipid metabolism, such as fatty acid production. The SNP markers mapped in our study are now being used to select potential high-yielding cacao varieties through marker-assisted selection in our existing cacao-breeding experiments.

Reproductive biology, morphology, and morphometry of ovaries and oviducts of Trachemys scripta elegans in Brazilian Cerrado / Biologia reprodutiva, morfologia e morfometriade ovários e ovidutos de Trachemys scripta elegans no Cerrado Brasileiro

Although Trachemys scripta elegans is an exotic species popular as a pet in Brazil, studies on reproductive biology and capacity are non-existent in the Brazilian Cerrado. This study analyzed ovarian and oviduct characteristics and the egg production capacity of T. scripta elegans grown in this biome. The findings will associate with the size of the specimens and the sexual maturity, aiming at comparisons with native and exotic populations, as well as interspecific and contributing to the understanding of its impact on the invaded ecosystems and the establishment of eradication programs. Thus, 39 females had evaluated the body biometry and the morphology and morphometry of the ovaries and oviducts. G2 (N=20): with Class I (>5-10mm) follicles, with Class I and Class II (>10-fold) follicles, 25mm) and G3 (N=9) with Class I, Class II and Class III (>25mm) follicles. Analysis of variance, Scott-Knott's test, and Pearson's correlation analysis showed that there was no significant difference between the groups in body biometry; in the mean gonadosomatic index and gonadal morphometry, only the width of the oviducts in the right antimer and the mass and width in the left antimer were higher in G3, the only one that presented eggs. There was positive and harmonic development between body mass, carapace, and plastron, and gonadal growth occurred concomitantly with body growth, indicating a higher reproductive potential and a positive relationship between the size of the litter and the female litter. The gonadosomatic index proved to be an excellent reproductive indicator, and the ovarian evaluation was a better indicator of sexual maturity than the maximum carapace length. Ovaries were irregular structures, without delimitation between the cortical and medullary regions and filled with vitelogenic follicles of different diameters, atresic follicles, and corpora lutea, which reflected the ovarian complexity of the species and the presence of follicular hierarchy. In the scarce stroma, two germinative beds were observed per ovary and the presence of gaps very close to the follicles and associated with the blood vessels. Analysis of gonadal tissue revealed three types of oocytes according to cytoplasmic characteristics: homogeneous, vesicular or vesicular in the cortex with apparent granules. Oviducts were functional and separated, joining only in the final portion to form the cloaca and subdivided into infundibulum, tuba, isthmus, uterus, and vagina. The structure of the uterine tube was composed of serosa, muscular and mucous, which was full of glands. The presence of eggs in the oviducts indicated that the specimens can reproduce in the Brazilian Cerrado. This study provides necessary and relevant information on the reproductive biology and capacity of T. scripta elegans in the Brazilian Cerrado and can contribute to the understanding of its impact on the invaded ecosystems and the establishment of eradication programs. The extraction of females with capacity can reduce the annual reproductive yield of the species and decrease its effect on local biodiversity.(AU)

Embora Trachemys scripta elegans seja uma espécie exótica popular como animal de estimação no Brasil, estudos sobre biologia e capacidade reprodutivas são inexistentes no Cerrado brasileiro. Este estudo analisou características ovarianas e do oviduto e a capacidade de produção de ovos em T. scripta elegans criadas neste bioma, correlacionando estes achados ao tamanho dos espécimes e a maturidade sexual, visando comparações com populações nativas e exóticas, bem como interespecíficas e contribuir para a compreensão de seu impacto nos ecossistemas invadidos e com o estabelecimento de programas de erradicação. Assim, 39 fêmeas tiveram avaliadas a biometria corporal e a morfologia e morfometria dos ovários e ovidutos. De acordo com o tamanho dos folículos ovarianos as fêmeas foram separadas em G1 (N= 10): com folículos Classe I (>5-10 mm), G2 (N= 20): com folículos Classe I e Classe II (>10-25 mm) e G3 (N= 9) com folículos Classe I, Classe II e Classe III (>25 mm). À análise de variância, teste de Scott-Knott e à análise de correlação de Pearson verificou-se que não houve diferença significativa entre os grupos na biometria corporal; no índice gonadossomático médio e na morfometria gonadal, apenas a largura dos ovidutos no antímero direito e a massa e a largura no antímero esquerdo foram maiores no G3, o único que apresentou ovos. Houve desenvolvimento positivo e harmônico entre massa corporal, carapaça e plastrão e o crescimento gonadal ocorreu concomitante ao crescimento corporal, indicando maior potencial reprodutivo e relação positiva entre o tamanho da ninhada de ovos e o da fêmea. O índice gonadossomático mostrou-se um bom indicador reprodutivo e a avaliação ovariana um melhor indicador da maturidade sexual que o comprimento máximo da carapaça. Ovários foram estruturas irregulares, sem delimitação entre a região cortical e medular e repletos de folículos vitelogênicos de diferentes diâmetros, folículos atrésicos e corpos lúteos, que refletiram a complexidade ovariana da espécie e a presença de hierarquia folicular. No estroma escasso foram observados dois leitos germinativos por ovário e a presença de lacunas muito próximas aos folículos e associadas aos vasos sanguíneos. A análise do tecido gonadal revelou três tipos de oócitos de acordo com as características do citoplasma: homogêneo, vesicular ou vesicular no córtex com grânulos aparentes. Ovidutos eram funcionais e separados, unindo-se apenas na porção final para formar a cloaca e subdividiam-se em infundíbulo, tuba uterina, istmo, útero e vagina. A estrutura da tuba uterina era constituída de serosa, muscular e mucosa, a qual era repleta de glândulas. A presença de ovos nos ovidutos indicou que os espécimes podem se reproduzir no cerrado brasileiro. Este estudo fornece informações básicas e relevantes da biologia e capacidade reprodutivas de T. scripta elegans no Cerrado brasileiro e pode contribuir com a compreensão de seu impacto nos ecossistemas invadidos e com o estabelecimento de programas de erradicação, uma vez que a extração de fêmeas com capacidade reprodutiva pode contribuir com a diminuição do rendimento reprodutivo anual da espécie e diminuir seu efeito sobre a biodiversidade local.(AU)

Pensamento suicida entre a população transgênero: um estudo epidemiológico / Suicide thoughts among transgender population: an epidemiological study

RESUMO Objetivo Analisar a prevalência de pensamentos suicidas em pacientes de um ambulatório de transgêneros no Distrito Federal, bem como as variáveis associadas a esses eventos. Métodos Estudo epidemiológico de corte transversal, realizado a partir de uma revisão dos prontuários dos pacientes atendidos no ambulatório de transgêneros do Hospital Dia, no Distrito Federal, no período de agosto de 2017 a setembro de 2018. Os dados foram tabulados pelo programa Excel 2016 e depois analisados pelo Pacote Estatístico para as Ciências Sociais (SPSS). Resultados Neste estudo, observamos fatores intervenientes e variáveis que influenciam o desenvolvimento do comportamento suicida, com uma correlação entre fatores de risco modificáveis e não modificáveis. Os achados deste estudo corroboram a literatura internacional sobre comportamento suicida e as variáveis que podem estar relacionadas a esse fato. Conclusão Questões sociodemográficas, de habitação e psiquiátricas compõem esses fatores, demonstrando possíveis relações com a ideação suicida. Assim, é possível mostrar situações de intervenção e elaboração de estratégias e políticas que possam melhorar a qualidade de vida desses indivíduos e reduzir as taxas de comportamento suicida.

ABSTRACT Objective To analyze the prevalence of suicidal thoughts among patients from a transgender outpatient clinic in the Federal District, as well as the variables associated with these events. Methods A cross-sectional epidemiological study was carried out based on a review of the medical records of patients attending the transgender outpatient clinic of the Hospital Dia, in the Federal District, from August 2017 to September 2018. Data were then tabulated by the program Excel 2016 and then analyzed by the Statistical Package for the Social Sciences (SPSS). Results In this study, we observed intervening and variable factors influencing the development of suicidal behavior, with a correlation between modifiable and non-modifiable risk factors. The findings of this study corroborate with the international literature on suicidal behavior, and the variables that may be related to this fact. Conclusion Socio-demographic, housing, and psychiatric issues compose these factors, demonstrating possible relationships with suicidal ideation. Thus, it is possible to show situations of intervention and the elaboration of strategies and policies that can improve the quality of life of these individuals and reduce rates of suicidal behavior.

Methicillin-resistant Staphylococcus epidermidis isolates with reduced vancomycin susceptibility from bloodstream infections in a neonatal intensive care unit.

Introduction. Vancomycin has become the first-line therapy for most infections caused by methicillin-resistant staphylococci.Aim. To evaluate the vancomycin MIC, staphylococcal cassette chromosome mec (SCCmec) types and clonality of coagulase-negative staphylococci (CoNS) isolates recovered from neonates with true primary bloodstream infections (BSI).Methodology. CoNS isolates were prospectively recovered from blood cultures of non-repetitive patients admitted to a neonatal intensive care unit (NICU) in a tertiary-care hospital during a 3-year period. BSI was defined based on established criteria. Micro-organisms were identified phenotypically and by PCR. MIC-values for vancomycin and oxacillin were determined by broth dilution method and E-test. The SCCmec type conferring methicillin resistance was determined by multiplex PCR. The heterogeneous vancomycin (hV) resistance phenotype was screened on brain heart infusion agar containing 4 µg ml-1 of vancomycin. The clonality was investigated by PFGE.Results. Seventy-four CoNS isolates were recovered from blood cultures of neonates during the study period but only 40 (54 %) were associated with true primary BSI. Nine (22.5%) babies died. Staphylococcus epidermidis was the most prevalent species (95 %; 38/40). All S. epidermidis isolates were methicillin-resistant (MR). SCCmec type IV was predominant (55.3 %; 21/38). Most (80.0 %; 32/38) isolates exhibited vancomycin MIC-values of 2-4 µg ml-1 not associated with the SCCmec type or clonality. Sixteen (42.1%) isolates displayed hV resistance. All babies who died were harbouring MR-S. epidermidis exhibiting vancomycin MICs of 2-4 µg ml-1.Conclusion. The findings of this study demonstrated that blood invasive MR-S. epidermidis isolates recovered at NICU tend to show decreased vancomycin susceptibility making therapy of those fragile patients difficult.

A Gestão do Conhecimento holística: análise de aderência do modelo de Mutuwa e Maiga / The holistic Knowledge Management: adherence analysis of the Mutuwa and Maita model / La Gestión del Conocimiento holística: análisis de adherencia del modelo de Mutuwa y Maiga

Há sinalizações acadêmicas para o desenvolvimento de modelos de gerenciamento do conhecimento pautados no paradigma holístico. Mutuwa e Maiga afirmam que não há um modelo unificador para o setor de saúde, o que permite inferir que o modelo desses autores se propõe ao atingimento desse feito. Assim, esta pesquisa se justifica pelo objetivo de analisar a aderência do modelo de Mutuwa e Maiga à Gestão do Conhecimento holística, de modo a identificar se esse modelo supre a lacuna de uma estrutura unificadora para este setor. Essa análise é realizada por meio de procedimentos metodológicos mistos, contemplando a abordagem qualitativa-quantitativa e a Análise de Conteúdo. Por resultado, há uma adesão de somente 15,4% do modelo de Mutuwa e Maiga à Gestão do Conhecimento holística, conforme caracterização apresentada nessa pesquisa, permitindo inferir que a Gestão do Conhecimento não tem demonstrado direcionamento para uma abordagem orientada ao paradigma holístico. Assim, esta pesquisa contribui por fomentar o desenvolvimento de novos modelos de gerenciamento do conhecimento alicerçados no paradigma holístico, considerando os delineamentos aqui expostos.

There are academic signals for the development of knowledge management models based on the holistic paradigm. Mutuwa and Maiga affirm that there is no unifying model for the health sector, which allows to infer that the model of these authors is proposed to reach this achievement. Thus, this research is justified by the objective of analyzing the adherence of the model of Mutuwa and Maiga to Holistic Knowledge Management, in order to identify if this model bridged the gap of a unifying structure for this sector. This analysis is performed by means of mixed methodological procedures, including qualitative-quantitative approach and Content Analysis. As a result, the model of Mutuwa and Maiga adheres in 15.4% to the Holistic Knowledge Management, according to the characterization presented in this research, allowing to infer that Knowledge Management has not presented a direction towards a holistic paradigm-oriented approach. Thus, this research contributes to foster the development of new models of knowledge management based on the holistic paradigm, considering the designs presented here.

Hay señales académicas para el desarrollo de modelos de gestión del conocimiento pautados en el paradigma holístico. Mutuwa y Maiga afirman que no hay un modelo unificador para el sector de salud, lo que permite inferir que el modelo de esos autores se propone al logro de ese hecho. Así, esta investigación se justifica por el objetivo de analizar la adherencia del modelo de Mutuwa y Maiga a la Gestión del Conocimiento holístico, para identificar si ese modelo suplía la laguna de una estructura unificadora para este sector. Este análisis se realiza a través de procedimientos metodológicos mixtos, contemplando el abordaje cualitativocuantitativo y el Análisis de Contenido. Por lo tanto, el modelo de Mutuwa y Maiga se adhiere en un 15,4% puntos porcentuales a la Gestión del Conocimiento holístico, conforme caracterización presentada en esa investigación, permitiendo inferir que la Gestión del Conocimiento no ha presentado direccionamiento para un enfoque orientado al paradigma holística. Así, esta investigación contribuye por fomentar el desarrollo de nuevos modelos de gestión del conocimiento fundamentados en el paradigma holístico, considerando los delineamientos aquí expuestos.

High Prevalence of the aac(6')-Ie-aph(2'')-Ia Gene in Hospital Isolates of Enterococcus faecalis Co-Resistant to Gentamicin and Penicillin.

Objectives: This study aimed to characterize the molecular mechanism of resistance to gentamicin among penicillin-resistant, ampicillin-susceptible Enterococcus faecalis (PRASEF) isolates by investigating the presence of the aac(6')-Ie-aph(2'')-Ia gene. The co-resistance to antimicrobials of other classes was also evaluated. Results: Among the 151 isolates evaluated, 70 were PRASEF and 81 were penicillin-susceptible and ampicillin-susceptible E. faecalis (PSASEF). No ß-lactamase producing isolate was detected. Eighty-three (55.0%) and 35 (23.2%) out of the 151 E. faecalis isolates showed high-level gentamicin resistance (HLGR) and high-level streptomycin resistance (HLSR) phenotypes. However, a significantly higher rate of PRASEF (88.6%) showed HLGR phenotype in comparison with PSASEF (23.5%) (p < 0.01). Conversely, a significantly lower rate of PRASEF (14.3%) showing HLSR was observed in comparison with PSASEF (30.9%) (p = 0.02). The prevalence of isolates displaying multidrug resistance (MDR) phenotype was significantly higher (p < 0.01) in the group of PRASEF (81.4%) than in PSASEF (18.6%). The majority of PSASEF (61.9%) and PRASEF (90.3%) isolates showing HLGR phenotype was harboring the aac(6')-Ie-aph(2'')-Ia gene, which encodes a bifunctional enzyme that inactivates all aminoglycosides except streptomycin. Conclusion: The aac(6')-Ie-aph(2'')-Ia gene was prevalent among the Brazilian PRASEF isolates that usually exhibit co-resistance to gentamicin and to multiple other drugs.

A gestão do conhecimento holística: análise de aderência do modelo de Rojas, Bermúdez e Morales / La gestión del conocimiento holístico: análisis de adherencia del modelo de Rojas, Bermúdez y Morales / The holistic knowledge management: adherence analysis of the Rojas, Bermúdez and Morales model

O paradigma holístico é uma alternativa apontada há anos para o desenvolvimento de modelos de gestão do conhecimento. Esta abordagem, denominada gestão do conhecimento holística, visa abordar o gerenciamento do conhecimento em sua integralidade para que a gestão deste ativo seja atingida de forma abrangente. Neste contexto, esta pesquisa tem por objetivo analisar a aderência do modelo de Rojas, Bermúdez e Morales a GC holística. Por meio da análise de conteúdo qualitativa bem como quantificação da aderência á GC holística, o referido modelo foi analisado. Por resultado, o modelo de Rojas, Bermúdez e Morales, proposto para a área de saúde, se adere parcialmente a GC holística. Isto evidencia que um modelo de gerenciamento do conhecimento holístico para a área de saúde ainda é uma lacuna a ser superada, bem como aponta os quesitos a serem aprimorados. Todavia, este resultado não é conclusivo, pois advém da análise de um único modelo, sendo uma limitação desta pesquisa. Por esta limitação sugere-se, como pesquisas futuras, a análise de outros modelos de gestão do conhecimento propostos para a área de saúde, seguindo os métodos aplicados nesta pesquisa(AU)

El paradigma holístico es una alternativa apuntada desde hace años para el desarrollo de modelos de gestión del conocimiento. Este enfoque, denominado gestión del conocimiento holístico, pretende abordar la gestión del conocimiento en su totalidad para que la gestión de este activo sea alcanzada de forma integral. En este contexto, esta investigación tiene por objetivo analizar la adherencia del modelo de Rojas, Bermúdez y Morales a la gestión del conocimiento holística. Por medio del análisis de contenido cualitativo, así como la cuantificación de la adherencia a la gestión del conocimiento holística, el referido modelo fue analizado. Por consiguiente, el modelo de Rojas, Bermúdez y Morales, propuesto para el área de salud, se adhiere parcialmente a la gestión del conocimiento holística. Esto evidencia que un modelo de gestión del conocimiento holístico para el área de salud todavía es una laguna a ser superada, así como apunta a los requisitos a ser mejorados. Sin embargo, este resultado no es concluyente, pues viene del análisis de un solo modelo, que constituye una limitación de esta investigación. Por esta limitación se sugiere, como investigaciones futuras, el análisis de otros modelos de gestión del conocimiento propuestos para el área de salud, siguiendo los métodos aplicados en esta investigación(AU)

The holistic paradigm is an option for the development of knowledge management models pointed out years ago. This approach, called holistic knowledge management, aims to tackle the management of knowledge in its whole so enabling the full management of this asset. In this context, this research aims to analyze the adherence of the model of Rojas, Bermúdez and Morales to holistic GC. Through the qualitative Content Analysis and quantification of the adherence to the holistic knowledge management, this model was analyzed. As a result, the model of Rojas, Bermúdez and Morales, proposed for the health area, partially adheres to the holistic KM. This result shows that a holistic knowledge management model for the health area is still a gap to be overcome, as well as points out features to be addressed in a holistic knowledge management approach. However, this result is not conclusive, because it comes from the analysis of a single model, being a limitation of this research. This limitation suggests for future research, the analysis of other models of knowledge management proposed for the health area, following the methods applied in this research(AU)

Mapping of a Major QTL for Ceratocystis Wilt Disease in an F1 Population of Theobroma cacao.

Cacao is an important crop, its beans are key raw materials for the chocolate and cosmetic industries. Ceratocystis wilt of cacao (CWC) caused by Ceratocystis cacaofunesta is a lethal disease for the crop. Therefore, the selection of resistant cacao varieties is one of the viable ways to minimize losses in cacao production. In this paper, we described the identification of a major QTL associated with CWC in an F1 mapping population from a cross between a resistant, "TSH 1188," and a susceptible genotype, "CCN 51." A set of 266 trees were genotyped using 3,526 single nucleotide polymorphic markers and then multiple QTL mapping analyses were performed. Two QTLs were identified on chromosomes IV and VI. The major QTL was located at 20 cM from the top position of chromosome VI, accounting for more than 60% of the phenotypic variation. The favorable allele T1, with haplotype GTT, came from the "TSH 1188" parent. It was evident that the haplotype combination T1C2 on chromosome VI was the most significant for resistance, since 93% of resistant trees had this haplotype. The major QTL converged to a genomic region of 739.4 kb that harbored nine candidate genes, including two major classes of resistance genes, which would make them the primary candidates involved in the resistance to CWC. The haplotypes detected are now used to improve the efficiency and precision of the selection of resistant trees in cacao breeding.

Sexualidade na Adolescência e as Mídias Digitais: riscos, benefícios e desafios para a enfermagem no século XXI

O objetivo desta pesquisa foi realizar um levantamento bibliográfico sistemático das produções cientificas no país, acerca do desenvolvimento da sexualidade na adolescência e a utilização das mídias digitais, buscando apontar os riscos, benefícios e desafios para enfermagem no século XXI. Trata-se de uma pesquisa não-experimental, do tipo revisão sistemática de literatura. Dentre os resultados encontrados foram selecionados (10) artigos para discussão. Na qual, observou-se que apesar dos riscos da utilização das mídias digitais durante o desenvolvimento da sexualidade da adolescência, identifica-se também, seus benefícios tanto para os adolescentes quanto para os profissionais de enfermagem. Portanto, recomendações também são necessárias a esta faixa-etária, com o objetivo de transformar o uso das mídias digitais numa fonte mais segura, ética, educativa e saudável de conhecimentos.

Biometria corporal e parâmetros hematológicos de Trachemys scripta elegans e Trachemys dorbignyi (Testudines: Emydidae) criadas em cativeiro em Petrolina, Pernambuco / Body biometry and hematological parameters of Trachemys scripta elegans and Trachemys dorbignyi (Testudines: Emydidae) reared in captivity in Petrolina/PE, Brazil

Este estudo objetivou avaliar a biometria corporal e o perfil hematológico de Trachemys scripta elegans (N=28) e de Trachemys dorbignyi (N=22) criadas em cativeiro na região do submédio do Vale do São Francisco, semiárido nordestino brasileiro, visando estabelecer valores sanguíneos básicos de saúde e gerar dados úteis na fisiologia comparativa de Testudines. Após 120 dias de adaptação e jejum de 24 horas, 2,5 mL de sangue foram coletados do seio occipital dorsal e depositados em tubo com heparina sódica para a avaliação, na sequência, dos níveis hematologicos. A contagem total de eritrócitos (CTE) e global de leucócitos (CGL) foi realizada em câmara de Neubauer; a dosagem de hemoglobina (HGB) pelo método da método da cianometahemoglobina e o hematócrito (HCT) através da técnica do microhematócrito. A partir da CTE estabeleceram-se matematicamente os índices hematimétricos. A biometria corporal também foi avaliada: a) massa corporal (MC, g); b) dimensões máximas da carapaça [comprimento (CMC, cm) e largura (LMC, cm)];c) dimensões máximas do plastrão [comprimento (CMP, cm) e largura (LMP, cm)]; d) comprimento total da cauda (CTC, cm); e) comprimento linear da base da cauda ao orifício cloacal (CprC, cm); f) comprimento linear do orifício cloacal a extremidade da cauda(CpoC, cm). T. scripta elegans apresentaram valores maiores (P < 0,05) para a biometria corporal, enquanto que o CTC e CprC foram maiores (P<0,05) em T dorbignyi. Os níveis hematológicos não diferiram (P>0,05) entre as espécies. Os resultados demostram que a maior parte da variação observada entre T. scripta elegans e T. dorbignyi é explicada pelas variáveis biométricas e que algumas correlações hematológicas caracterizam diferenças interespecíficas. Conclui-se que os resultados lançam luz sobre valores de referência para estas espécies mantidas em cativeiro na região do semiárido e servem como um modelo para a fisiologia comparativa intra e interespécies.(AU)

This study aimed to evaluate the body biometry and hematological profile of Trachemys scripta elegans (N=28) and Trachemys dorbignyi (N=22) reared in captivity in the Brazilian submedium northeastern semi-arid region in the Valley of the São Francisco river. It aimed to establish basic health blood values and generate useful data on the comparative physiology of Testudines. After 120-day adaptation and 24-hour fasting, 2.5mL of blood were collected from the dorsal occipital sinus and deposited into a tube with sodium heparin for evaluation, following, of hematological levels. The red blood cell count (RBC) and GLC was conducted in a Neubauer chamber, the hemoglobin level (HGB) was supplied by the cyanmethemoglobin method and the hematocrit (HCT) was obtained by the microhematocrit technique. Based on the RBC, the hematimetric were mathematically established. Body biometry were also evaluated: a) body mass (BM, g); b) maximum dimensions of the carapace [length (MLC, cm) and width (MWC, cm)]; c) maximum dimensions of plastron [length (MLP, cm) and width (MWP, cm)]; d) total length of tail (TLT, cm); e) linear length from the base of the tail to the cloacal orifice (LPrC, cm); f) linear length from the cloacal orifice to the extremity of the tail (LPoC, cm). T. scripta elegans showed higher values (P<0.05) for biometrics, while TLT and LPrC were higher (P<0.05) in T. dorbignyi. The hematological values did not differ (P>0.05) among species. The results show that most of the variation found between T. scripta elegans and T. dorbignyi is explained by the biometric variables and that some hematologic correlations characterize interspecies differences. It was conclude that the results shed light on benchmarks for these species kept in captivity in the northeastern semi-arid region and serve as a model for intra and interspecies comparative physiology.(AU)

Human Social Behavior and Demography Drive Patterns of Fine-Scale Dengue Transmission in Endemic Areas of Colombia.

Dengue is known to transmit between humans and A. aegypti mosquitoes living in neighboring houses. Although transmission is thought to be highly heterogeneous in both space and time, little is known about the patterns and drivers of transmission in groups of houses in endemic settings. We carried out surveys of PCR positivity in children residing in 2-block patches of highly endemic cities of Colombia. We found high levels of heterogeneity in PCR positivity, varying from less than 30% in 8 of the 10 patches to 56 and 96%, with the latter patch containing 22 children simultaneously PCR positive (PCR22) for DEN2. We then used an agent-based model to assess the likely eco-epidemiological context of this observation. Our model, simulating daily dengue dynamics over a 20 year period in a single two block patch, suggests that the observed heterogeneity most likely derived from variation in the density of susceptible people. Two aspects of human adaptive behavior were critical to determining this density: external social relationships favoring viral introduction (by susceptible residents or infectious visitors) and immigration of households from non-endemic areas. External social relationships generating frequent viral introduction constituted a particularly strong constraint on susceptible densities, thereby limiting the potential for explosive outbreaks and dampening the impact of heightened vectorial capacity. Dengue transmission can be highly explosive locally, even in neighborhoods with significant immunity in the human population. Variation among neighborhoods in the density of local social networks and rural-to-urban migration is likely to produce significant fine-scale heterogeneity in dengue dynamics, constraining or amplifying the impacts of changes in mosquito populations and cross immunity between serotypes.

Identification of class 1 and 2 integrons from clinical and environmental Salmonella isolates.

INTRODUCTION: The indiscriminate use of antimicrobials has selected for the emergence of resistant strains. Many mechanisms contribute to the spread of antimicrobial-resistant genes, and integrons play a key role in this process. The aim of this study was to describe the serotypes and resistance profiles, and to characterize the presence of integrons in Salmonella strains isolated from Dourados, Mato Grosso do Sul, Brazil. METHODOLOGY: Thirty-six isolates from different sources were used. To evaluate the resistance profiles, the determination of minimum inhibitory concentrations together with polymerase chain reaction were used to screen for the presence of class 1 and class 2 integrons. RESULTS: The Infantis serotype of Salmonella was the most frequently isolated serotype. Minimum inhibitory concentrations showed that out of the 36 isolates, 11 (30.5%) were resistant to all the antimicrobials tested. These resistant isolates were separated into three groups: 4 clinical isolates (36.4%), 3 food isolates (36.4%), and 4 water isolates (27.2%). Class 1 integrons occurred in 31 (86.1%) isolates and were found in all 11 resistant isolates (35.5 %) and in 20 (64.5%) of the non-resistant isolates. Class 2 integrons were found in 3 (8.3%) isolates, which were all non-resistant. CONCLUSION: The presence of an integron did not necessarily confer resistance. Future studies will seek to identify the mechanism behind integron-mediated antimicrobial resistance.

Requirement of simultaneous assessment of crystal- and supernatant-related entomotoxic activities of Bacillus thuringiensis strains for biocontrol-product development.

Bioinsecticides with lower concentrations of endospores/crystals and without loss of efficiency are economically advantageous for pest biocontrol. In addition to Cry proteins, other Bacillus thuringiensis (Bt) toxins in culture supernatants (SN) have biocontrol potential (e.g., Vip3A, Cry1I, Sip1), whereas others are unwanted (ß-exotoxins), as they display widespread toxicity across taxa. A strain simultaneously providing distinct toxin activities in crystals and SN would be desirable for bioinsecticides development; however, strains secreting ß-exotoxins should be discarded, independently of other useful entomotoxins. Entomotoxicity of crystals and SN from a Brazilian Bt tolworthi strain (Btt01) was tested against Spodoptera frugiperda to assess the potential for biocontrol-product development based on more than one type of toxin/activity. Tests showed that 10(7) endospores mL(-1) caused >80% of larvae mortality, suggesting Btt01 may be used in similar concentrations as those of other Bt-based biopesticides. When it was applied to cornfields, a significant 60% reduction of larvae infestation was observed. However, bioassays with Btt01 SN revealed a thermostable toxic activity. Physicochemical characterization strongly suggests the presence of unwanted ß-exotoxins, with isolate-specific temporal variation in its secretion. Knowledge of the temporal pattern of secretion/activity in culture for all forms of toxins produced by a single strain is required to both detect useful activities and avoid the potential lack of identification of undesirable toxins. These findings are discussed in the contexts of commercial Bt product development, advantages of multiple-activity strains, and care and handling recommended for large-scale fermentation systems.

Síndrome de transfusão feto-fetal, diagnóstico e tratamento: relato de caso / Twin-twin transfusion syndrome, diagnosis and treatment: case report

Objetivo: relatar um caso de síndrome de transfusão feto-fetal (STFF), demonstrando a importância do correto eprecoce diagnóstico ultrassonográfico e quando necessário a indicação da fotocoagulação a laser fetoscópica(FCLF) como melhor conduta terapêutica. Relato do caso: mulher 18 anos, secundigesta, gestação gemelarmonocoriônica diamniótica com diagnóstico ultrassonográfico tardio de STFF, devido não realização de prénatal.Realizados dois procedimentos de amniodrenagem como medida paliativa, evoluindo para partoprematuro no oitavo dia de internação. Um dos gêmeos evoluiu a óbito na UTI neonatal. Considerações finais:percebe-se a necessidade de uma melhor assistência pré-natal, treinamento dos profissionais médicos para arealização do diagnóstico ultrassonográfico correto e de investimentos em centros de Medicina fetal no Parápara tratamento adequado

Objective: to report a case of twin-twin transfusion syndrome (TTTS), demonstrating the importance of correctand early ultrasound diagnosis and when necessary the indication of laser photocoagulation fetoscópica (FCLF)as the best therapeutic approach. Case report: 18 years woman, in her second, diamniótica monochorionic twinpregnancy with late diagnosis of TTTS, because failure to carry out prenatal care. Evolved into premature laborafter cesarean with indication of two procedures amniodrenagem. After a cesarean section withoutcomplications was death of the twins in the NICU. Final considerations: we perceive the need to support theadequacy of prenatal care, training of medical professionals to perform the correct ultrasound diagnosis andinvestments in fetal medicine centers in Pará.

An eco-physiological model of the impact of temperature on Aedes aegypti life history traits.

Physiological processes mediate the impact of ecological conditions on the life histories of insect vectors. For the dengue/chikungunya mosquito, Aedes aegypti, three life history traits that are critical to urban population dynamics and control are: size, development rate and starvation mortality. In this paper we make use of prior laboratory experiments on each of these traits at 2°C intervals between 20 and 30°C, in conjunction with eco-evolutionary theory and studies on A.aegypti physiology, in order to develop a conceptual and mathematical framework that can predict their thermal sensitivity. Our model of reserve dependent growth (RDG), which considers a potential tradeoff between the accumulation of reserves and structural biomass, was able to robustly predict laboratory observations, providing a qualitative improvement over the approach most commonly used in other A.aegypti models. RDG predictions of reduced size at higher temperatures, but increased reserves relative to size, are supported by the available evidence in Aedes spp. We offer the potentially general hypothesis that temperature-size patterns in mosquitoes are driven by a net benefit of finishing the growing stage with proportionally greater reserves relative to structure at warmer temperatures. By relating basic energy flows to three fundamental life history traits, we provide a mechanistic framework for A.aegypti development to which ecological complexity can be added. Ultimately, this could provide a framework for developing and field testing hypotheses on how processes such as climate variation, density dependent regulation, human behavior or control strategies may influence A.aegypti population dynamics and disease risk.

The interactive roles of Aedes aegypti super-production and human density in dengue transmission.

BACKGROUND: A. aegypti production and human density may vary considerably in dengue endemic areas. Understanding how interactions between these factors influence the risk of transmission could improve the effectiveness of the allocation of vector control resources. To evaluate the combined impacts of variation in A. aegypti production and human density we integrated field data with simulation modeling. METHODOLOGY/PRINCIPAL FINDINGS: Using data from seven censuses of A. aegypti pupae (2007-2009) and from demographic surveys, we developed an agent-based transmission model of the dengue transmission cycle across houses in 16 dengue-endemic urban 'patches' (1-3 city blocks each) of Armenia, Colombia. Our field data showed that 92% of pupae concentrated in only 5% of houses, defined as super-producers. Average secondary infections (R(0)) depended on infrequent, but highly explosive transmission events. These super-spreading events occurred almost exclusively when the introduced infectious person infected mosquitoes that were produced in super-productive containers. Increased human density favored R(0), and when the likelihood of human introduction of virus was incorporated into risk, a strong interaction arose between vector production and human density. Simulated intervention of super-productive containers was substantially more effective in reducing dengue risk at higher human densities. SIGNIFICANCE/CONCLUSIONS: These results show significant interactions between human population density and the natural regulatory pattern of A. aegypti in the dynamics of dengue transmission. The large epidemiological significance of super-productive containers suggests that they have the potential to influence dengue viral adaptation to mosquitoes. Human population density plays a major role in dengue transmission, due to its potential impact on human-A. aegypti contact, both within a person's home and when visiting others. The large variation in population density within typical dengue endemic cities suggests that it should be a major consideration in dengue control policy.