A hitchhikers' guide to the terminology of accreditation processes for health professionals and institutions.

Accreditation processes for health care professions are designed to ensure that individuals and programs in these fields meet established standards of quality and effectiveness. The accelerating pace of globalization in the health care professions has increased the need for a shared understanding of the vocabulary of evaluation, assessment, and accreditation. The psychometric principles of valid and reliable assessment are commonly accepted, but the terminology is confusing. We believe that all stakeholders - evaluators, faculty, students but also the community - will benefit from a shared language and common set of definitions. We recognize that not all readers will agree with the definitions we propose, but we hope that this guide will help to ensure clarity, consistency, transparency, and fairness, and that it will promote through the stimulation of a debate greater collaboration across national and international boundaries.

Goat performance on pure Andropogon gayanus pastures or associated with legumes.

The objective of this study was to evaluate the grazing of goats in a grass monoculture system and in intercropping systems of grass + legumes. A randomized block design was adopted, with the treatments arranged in a split-plots scheme. The plots consisted of three cropping systems: monoculture-Andropogon gayanus cv. Planaltina; mixture I-A. gayanus cv. Planaltina + Stylosanthes cv. Campo Grande; and mixture II-A. gayanus cv. Planaltina + Calopogonium mucunoides. The subplots consisted of two grazing cycles. The highest (P = 0.04) total forage mass (TFM) was recorded in the mixture I (A. gayanus cv. Planaltina + Stylosanthes. cv. Campo Grande), which was 2.6 ± 0.1 tons DM/ha. The crude protein (CP) was lower in the monoculture which also showed the highest content of neutral detergent fiber (NDF). The grazing time in the monoculture was the longest (8.23 ± 1.14 h). The goats used a longer time for rumination (P < 0.01) in the mixture I. The lowest (P < 0.01) bite rate was found in mixture II in comparison to the other cropping systems. The bite rate was higher (P < 0.01) in grazing cycle II than in all the other cropping systems. In mixture I, the Stylosanthes cv. Campo Grande, and in mixture II, the C. mucunoides presented the lowest (P < 0.01) δ13C value in the forage. The highest forage intake occurred in the mixture systems (P < 0.01) in comparison to the monoculture. The mixture pastures presented better results for forage mass, nutritive value, and intake in comparison to the monoculture.

Principais aspectos considerados por consumidores na aquisição e consumo de carne suína em colônia do Piauí-PI / Key aspects considered by consumers in the purchase and consumption of pork in colônia do Piauí-PI / Principales aspectos considerados por consumidores en la adquisición y consumo de carne porcina en la ciudad de colonia del Piauí-PI

Objetivou-se avaliar o perfil do consumidor, da carne suína, quanto aos aspectos importantes considerados para o consumo, na cidade de Colônia do Piauí-PI. A pesquisa foi feita em forma de questionários com perguntas objetivas, sendo abordados nas residências da cidade, no interior e também nos estabelecimentos comerciais. As informações coletadas foram processadas pelo programa computacional Excel®. Foram entrevistadas 100 pessoas, sendo 38% homens e 62% mulheres. Constatou-se que 95% dos entrevistados consomem a carne suína, dando preferência a carne bovina citada por 42%. A maior frequência de consumo da carne suína foi considerada mensalmente por 36% dos entrevistados. Na região, 77% dos entrevistados consomem a carne suína mais sobre a forma in natura apresentando maior preferência pelo corte cárneo, costela com 35,8% dos consumidores e dentre os industrializados a linguiça liderou em consumo (48%). Possibilitou-se verificar que 86% afirmaram nunca ter visualizado propaganda de incentivo ao consumo de carne suína. Os entrevistados acreditam que os animais que passam menor desconforto na produção e no abate são as aves e peixes, ambos com 37% das opiniões. Percebe-se que o principal entrave para consumo da carne suína em Colônia do Piauí-PI pode estar atrelado à falta de esclarecimento sobre os benefícios de que a carne suína pode trazer, e de investimentos em marketing que desmistifiquem os problemas relacionados às questões sanitárias e ao teor de gordura. A frequência de consumo pode ser aumentada, já que o preço não foi o fator limitante para o consumo.(AU)

The purpose of this study was to assess the profile of pork consumers regarding key aspects considered for the consumption in Colônia do Piauí ­ PI. The survey was developed through questionnaires containing closed-end questions applied to residents at their homes and also at stores in the city. The data were processed using Microsoft Excel®. A total of 100 people were interviewed, being 38% men and 62% women. The results showed that 95% of the respondents consume pork, although 42% preferred beef. The highest frequency of pork consumption was considered on a monthly basis by 36% of the respondents. In the region, 77% of the respondents consume pork mostly in natura, expressing preference for pork rib cuts, with 35.8% of consumers; sausage was the most frequently consumed item among industrialized goods, with 48%. The main reason for not consuming pork more often was the idea that the meat had high cholesterol levels, answer provided by 55.8% of the respondents. It was also possible to verify that 86% said they had never viewed any advertising encouraging the consumption of pork. Respondents believe that animals that provide the lowest levels of discomfort in the production and slaughter are birds and fish, both with 37% of the answers. It can be concluded that the main obstacle to the consumption of pork in Colônia do Piauí ­ PI may be linked to a lack of awareness about the benefits pork can bring, and of marketing investments to clarify the sanitary and fat content issues. The consumption frequency can be increased, since price was not the limiting factor for consumption.(AU)

Se ha buscado evaluar el perfil del consumidor de la carne porcina, en cuanto a los aspectos importantes considerados para el consumo, en la ciudad de Colonia del Piauí - Piauí. La investigación se hizo en forma de cuestionarios con preguntas objetivas, siendo abordados en las residencias de la ciudad, en el interior y también en los establecimientos comerciales. Las informaciones recopiladas fueron procesadas por el programa computacional Excel®. Se entrevistó a 100 personas, siendo 38% hombres y 62% mujeres. Se constató que el 95% de los entrevistados consumen la carne porcina, dando preferencia a la carne bovina citada por el 42%. La mayor frecuencia de consumo de la carne de cerdo fue considerada mensualmente por el 36% de los entrevistados. En la región, el 77% de los entrevistados consumen la carne porcina más sobre la forma in natura presentando mayor preferencia por el corte cárneo, costilla con 35,8% de los consumidores y entre los industrializados la longaniza lideró en consumo (48%). Se pudo verificar que el 86% afirmaron nunca haber visto propaganda de incentivo al consumo de carne porcina. Los entrevistados creen que los animales que pasan menos molestias en la producción y en el sacrificio son las aves y los peces, ambos con el 37% de las opiniones. Se percibe que el principal obstáculo para el consumo de carne de cerdo en Colonia del Piauí-PI puede estar vinculado a la falta de aclaración sobre los beneficios de que la carne de cerdo puede traer, y de inversiones en marketing que desmistifiquen los problemas relacionados con las cuestiones sanitarias y al contenido de grasa. La frecuencia de consumo puede ser aumentada, ya que el precio no fue el factor limitante para el consumo.(AU)

Qualidade da carne de bovinos terminados em pastejo / Quality of bovine meat finished in grazing / Calidad de la carne de bovinos terminados en pastaje

A carne bovina é uma importante fonte de proteína para alimentação humana, e as exportações de carne contribuem significativamente com a balança comercial brasileira. Entretanto, a conquista e consolidação de novos mercados depende da compreensão que o consumidor tem da qualidade da carne. Com o consumidor mais consciente, o foco da qualidade da carne vem passando do produtor e da indústria (peso da carcaça, rendimento de carcaça, etc.) para o consumidor, com avaliação das características organolépticas e valor nutricional. Apesar do confinamento de bovinos ter crescido nos últimos anos, a terminação a pasto é predominante no país e o rebanho é composto basicamente por animais zebuínos. Esta modalidade de terminação garante a carne características qualitativas particulares, e embora animais terminados em pastejo apresentem carne menos macia e com menos marmoreio, tais características podem ser melhoradas por meio do manejo nutricional e cruzamentos. Já o valor nutritivo da carne tende a ser melhor em animais terminados em pastejo, apresentando menor teor de gordura, e com melhor perfil lipídico, com maior concentração de ácidos graxos insaturados, ácido linoleico conjugado (CLA) e menor relação Ω6:Ω3. Tais características tornam a carne de animais produzidos em pastejo um alimento funcional, podendo ser trabalhado para agregar valor à carne brasileira, que poderá atender a nichos específicos de mercado.

Beef is an important source of protein for human consumption, and meat exports significantly contribute to the Brazilian trade balance. However, the conquest and consolidation of new markets depend on the understanding the consumer has of the quality of meat. With consumers being more aware, the focus of quality meat is shifting from the producer and the industry (carcass weight, carcass yield, etc.) to the consumer, with the evaluation of organoleptic characteristics and nutritional value. Despite the growth in cattle confinement in recent years, the termination in grazing is prevalent in the country and the flock is basically composed of zebu animals. This form of termination ensures the meat presents particular quality characteristics, and although animals finished on grazing have less soft flesh and less marbling, such characteristics can be improved through nutrition management and cross-breeding. The nutritional value of the meat, on the other hand, tends to be better in animals finished on grazing, with less fat, and better lipid profile with higher concentration of unsaturated fatty acids, conjugated linoleic acid (CLA) and lower Ω6:Ω3 relationship. These characteristics make the meat produced from animals in grazing in a functional food, and can bring added value to the Brazilian beef, which can cater to specific niche markets.

La carne bovina es una importante fuente de proteína para la alimentación humana, y las exportaciones de carne contribuyen significativamente con la balanza comercial brasileña. Sin embargo, la conquista y consolidación de nuevos mercados depende de la comprensión que el consumidor tiene de la calidad de la carne. Con el consumidor más consciente, el foco de la calidad de la carne viene pasando del productor y de la industria (peso de caparazón, rendimiento de caparazón, etc.) para el consumidor, con evaluación de las características organolépticas y valor nutricional. A pesar del confinamiento de bovinos haber crecido en los últimos años, la terminación a pasto es predominante en el país y el rebaño es compuesto básicamente por animales cebús. Esta modalidad de terminación garantiza a la carne características cualitativas particulares, y aunque los animales terminados en pastaje presenten carne menos blanda y con menos marmoleo, tales características pueden ser mejoradas a través del manejo nutricional y cruzamientos. Ya el valor nutritivo de la carne tiende a ser mejor en animales terminados en pastaje, presentando menor tenor de grasa, y con mejor perfil lipidio, con mayor concentración de ácidos grasos insaturados, ácido linoleico conjugado (CLA) y menor relación Ω6:Ω3. Tales características hacen la carne de animales producidos en pastaje un alimento funcional, pudiendo ser trabajado para agregar valor a la carne brasileña, que podrá atender a nichos específicos de mercado.

Lipopolysaccharide as an Antigen Target for the Formulation of a Universal Vaccine against Escherichia coli O111 Strains

A promising approach to developing a vaccine against O111 strains of diarrheagenic Escherichia coli thatexhibit different mechanisms of virulence is to target either the core or the polysaccharide chain (O antigen)of their lipopolysaccharide (LPS). However, due to structural variations found in both these LPS components,to use them as antigen targets for vaccination, it is necessary to formulate a vaccine able to induce a humoralimmune response that can recognize all different variants found in E. coli O111 strains. In this study, it was demonstrated that, despite differences in composition of oligosaccharide repeat units between O111ab and O111ac LPS subtypes, antibodies against one O111 subtype can recognize and inhibit the adhesion to human epithelial cells of all categories of O111 E. coli(enteropathogenic E. coli [EPEC], enterohemorrhagic E. coli [EHEC], and enteroaggregative E. coli [EAEC]) strains regardless of the nature of their flagellar antigens, mechanisms of virulence, or O111 polysaccharide subtypes. These antibodies were also able to increase the clearance of different strains of O111 E. coli by macrophages. PCR analyses of the pathways involved in O111 LPS core biosynthesis showed that all EAEC strains have core type R2, whereas typical EPEC and EHEC havecore type R3. In contrast, atypical EPEC strains have core types R2 and R3. In summary, the results presentedherein indicate that the O111 polysaccharide and LPS core types R2 and R3 are antigen targets for panspecific immunotherapy against all categories of O111 E. coli.

Lipopolysaccharide as an antigen target for the formulation of a universal vaccine against Escherichia coli O111 strains.

A promising approach to developing a vaccine against O111 strains of diarrheagenic Escherichia coli that exhibit different mechanisms of virulence is to target either the core or the polysaccharide chain (O antigen) of their lipopolysaccharide (LPS). However, due to structural variations found in both these LPS components, to use them as antigen targets for vaccination, it is necessary to formulate a vaccine able to induce a humoral immune response that can recognize all different variants found in E. coli O111 strains. In this study, it was demonstrated that, despite differences in composition of oligosaccharide repeat units between O111ab and O111ac LPS subtypes, antibodies against one O111 subtype can recognize and inhibit the adhesion to human epithelial cells of all categories of O111 E. coli (enteropathogenic E. coli [EPEC], enterohemorrhagic E. coli [EHEC], and enteroaggregative E. coli [EAEC]) strains regardless of the nature of their flagellar antigens, mechanisms of virulence, or O111 polysaccharide subtypes. These antibodies were also able to increase the clearance of different strains of O111 E. coli by macrophages. PCR analyses of the pathways involved in O111 LPS core biosynthesis showed that all EAEC strains have core type R2, whereas typical EPEC and EHEC have core type R3. In contrast, atypical EPEC strains have core types R2 and R3. In summary, the results presented herein indicate that the O111 polysaccharide and LPS core types R2 and R3 are antigen targets for panspecific immunotherapy against all categories of O111 E. coli.

Detection of diarrheagenic Escherichia coli from children with and without diarrhea in Salvador, Bahia, Brazil.

We identified different diarrheagenic (DEC) Escherichia coli pathotypes isolated from 1,207 children with and without acute endemic diarrhea in Salvador, Bahia, Brazil collected as part of a case-control study. Since the identification of DEC cannot be based on only biochemical and culture criteria, we used a multiplex polymerase chain reaction developed by combining five specific primer pairs for Enteropathogenic Escherichia coli (EPEC), Shiga toxin-producing E. coli/ Enterohaemorrhagic E. coli (STEC/EHEC), Enterotoxigenic E. coli (ETEC) and Enteroaggregative E. coli (EAEC) to detect these pathotypes simultaneously in a single-step reaction. In order to distinguish typical and atypical EPEC strains, these were tested for the presence of EAF plasmid. The prevalence of diarrheagenic E. coli in this sample of a global case-control study was 25.4% (259 patients) and 18.7% (35 patients) in the diarrhea group (1,020 patients) and the control group (187 patients), respectively. The most frequently isolated pathotype was EAEC (10.7%), followed by atypical EPEC (9.4%), ETEC (3.7%), and STEC (0.6%). Typical EPEC was detected only in one sample. The prevalence of the pathotypes studied in children with diarrhea was not significantly different from that in children without diarrhea.

Detection of diarrheagenic Escherichia coli from children with and without diarrhea in Salvador, Bahia, Brazil

We identified different diarrheagenic (DEC) Escherichia coli pathotypes isolated from 1,207 children with and without acute endemic diarrhea in Salvador, Bahia, Brazil collected as part of a case-control study. Since the identification of DEC cannot be based on only biochemical and culture criteria, we used a multiplex polymerase chain reaction developed by combining five specific primer pairs for Enteropathogenic Escherichia coli (EPEC), Shiga toxin-producing E. coli/ Enterohaemorrhagic E. coli (STEC/EHEC), Enterotoxigenic E. coli (ETEC) and Enteroaggregative E. coli (EAEC) to detect these pathotypes simultaneously in a single-step reaction. In order to distinguish typical and atypical EPEC strains, these were tested for the presence of EAF plasmid. The prevalence of diarrheagenic E. coli in this sample of a global case-control study was 25.4 percent (259 patients) and 18.7 percent (35 patients) in the diarrhea group (1,020 patients) and the control group (187 patients), respectively. The most frequently isolated pathotype was EAEC (10.7 percent), followed by atypical EPEC (9.4 percent), ETEC (3.7 percent), and STEC (0.6 percent). Typical EPEC was detected only in one sample. The prevalence of the pathotypes studied in children with diarrhea was not significantly different from that in children without diarrhea.

Efeitos do prebiótico (oligossacarídeo) em leite em pó modificado na flora intestinal: comparação com leite em pó modificado sem prebiótico em estudo duplo-cego / Effects of the prebiotic (ologasaccharide) in modified milk powder on the intestinal flora: comparison with modified milk pwder without prebiotic in a double-blind study

Objetivo: estudar a influência de um prebiótico (oligossacarídeo) acrescido ao leite em pó modificado sobre a flora intestinal de crianças. Métodos: estudo duplo-cego de crianças eutróficas com mais de 1 e menos de 4 anos de idade randomizadas por sorteio em computador a duas dietas: ingestão de leite em pó modificado com adição de prebiótico )n = 14) e leite em pó sem essa adição (n = 14). A oferta de 500 ml/dia dos leites foi feita por 21 dias, de tal maneira que a equipe de pesquisa e a família desconheciam a presença ou não do prebiótico. A análise microbiológica da flora fecal foi realizada antes e após 21 dias de tratamento pelo Laboratório Especial de microbiologia do instituto Butantan. Para a comparação estatística, empregaram-se testes não paramétricos, considerando-se significante p < 0,005. Resultados: ao início do estudo, os dois grupos foram homogêneos em relação ao número de colônias de lacto e bífidos bacilos. Aos 21 dias, o grupo com prebiótico apresentou aumento do número de colônias de lactobacilos muito próximo de significância estatística (p = 0,065) e crescimento altamente significante do número de colônias de bífidos (p = 0,0033). Na comparação entre os grupos após 21 dias de tratamento, constatou-se que o número de colônias de bífidos foi maior no grupo com prebiótico (p = 0,0212).