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Search Results: 1 - 10 of 360916 matches for " Ramalho de Oliveira D "
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Building a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study
Eton DT,Ramalho de Oliveira D,Egginton JS,Ridgeway JL
Patient Related Outcome Measures , 2012,
Abstract: David T Eton,1 Djenane Ramalho de Oliveira,2,3 Jason S Egginton,1 Jennifer L Ridgeway,1 Laura Odell,4 Carl R May,5 Victor M Montori1,61Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; 2College of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; 3Medication Therapy Management Program, Fairview Pharmacy Services LLC, Minneapolis, MN, USA; 4Pharmacy Services, Mayo Clinic, Rochester, MN, USA; 5Faculty of Health Sciences, University of Southampton, Southampton, UK; 6Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USABackground: Burden of treatment refers to the workload of health care as well as its impact on patient functioning and well-being. We set out to build a conceptual framework of issues descriptive of burden of treatment from the perspective of the complex patient, as a first step in the development of a new patient-reported measure.Methods: We conducted semistructured interviews with patients seeking medication therapy management services at a large, academic medical center. All patients had a complex regimen of self-care (including polypharmacy), and were coping with one or more chronic health conditions. We used framework analysis to identify and code themes and subthemes. A conceptual framework of burden of treatment was outlined from emergent themes and subthemes.Results: Thirty-two patients (20 female, 12 male, age 26–85 years) were interviewed. Three broad themes of burden of treatment emerged including: the work patients must do to care for their health; problem-focused strategies and tools to facilitate the work of self-care; and factors that exacerbate the burden felt. The latter theme encompasses six subthemes including challenges with taking medication, emotional problems with others, role and activity limitations, financial challenges, confusion about medical information, and health care delivery obstacles.Conclusion: We identified several key domains and issues of burden of treatment amenable to future measurement and organized them into a conceptual framework. Further development work on this conceptual framework will inform the derivation of a patient-reported measure of burden of treatment.Keywords: conceptual framework, patient-centered, medication therapy management, adherence, questionnaire, minimally disruptive medicine
Building a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study
Eton DT, Ramalho de Oliveira D, Egginton JS, Ridgeway JL, Odell L, May CR, Montori VM
Patient Related Outcome Measures , 2012, DOI: http://dx.doi.org/10.2147/PROM.S34681
Abstract: uilding a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study Original Research (1438) Total Article Views Authors: Eton DT, Ramalho de Oliveira D, Egginton JS, Ridgeway JL, Odell L, May CR, Montori VM Published Date August 2012 Volume 2012:3 Pages 39 - 49 DOI: http://dx.doi.org/10.2147/PROM.S34681 Received: 06 June 2012 Accepted: 26 June 2012 Published: 24 August 2012 David T Eton,1 Djenane Ramalho de Oliveira,2,3 Jason S Egginton,1 Jennifer L Ridgeway,1 Laura Odell,4 Carl R May,5 Victor M Montori1,6 1Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; 2College of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; 3Medication Therapy Management Program, Fairview Pharmacy Services LLC, Minneapolis, MN, USA; 4Pharmacy Services, Mayo Clinic, Rochester, MN, USA; 5Faculty of Health Sciences, University of Southampton, Southampton, UK; 6Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA Background: Burden of treatment refers to the workload of health care as well as its impact on patient functioning and well-being. We set out to build a conceptual framework of issues descriptive of burden of treatment from the perspective of the complex patient, as a first step in the development of a new patient-reported measure. Methods: We conducted semistructured interviews with patients seeking medication therapy management services at a large, academic medical center. All patients had a complex regimen of self-care (including polypharmacy), and were coping with one or more chronic health conditions. We used framework analysis to identify and code themes and subthemes. A conceptual framework of burden of treatment was outlined from emergent themes and subthemes. Results: Thirty-two patients (20 female, 12 male, age 26–85 years) were interviewed. Three broad themes of burden of treatment emerged including: the work patients must do to care for their health; problem-focused strategies and tools to facilitate the work of self-care; and factors that exacerbate the burden felt. The latter theme encompasses six subthemes including challenges with taking medication, emotional problems with others, role and activity limitations, financial challenges, confusion about medical information, and health care delivery obstacles. Conclusion: We identified several key domains and issues of burden of treatment amenable to future measurement and organized them into a conceptual framework. Further development work on this conceptual framework will inform the derivation of a patient-reported measure of burden of treatment.
Primary Care Providers’ experiences with Pharmaceutical Care-based Medication Therapy Management Services
Heather L. Maracle, Pharm.D.,Djenane Ramalho de Oliveira, Ph.D.,Amanda Brummel, Pharm.D
INNOVATIONS in Pharmacy , 2012,
Abstract: This study explored primary care providers’ (PCPs) experiences with the practice of pharmaceutical care-based medication therapy management (MTM). Qualitative, semi-structured interviews were conducted with six PCPs who have experiences working with MTM pharmacists for at least three years. The first author conducted the interviews that were audio-taped, transcribed, and coded independently. The codes were then harmonized via discussion and consensus with the other authors. Data were analyzed for themes using the hermeneutic-phenomenological method as proposed by Max van Manen. Three men and three women were interviewed. On average, the interviewees have worked with MTM pharmacists for seven years. The six (6) themes uncovered from the interviews included: (1) “MTM is just part of our team approach to the practice of medicine”: MTM as an integral part of PCPs’ practices; (2) “Frankly it’s education for the patient but it’s also education for me”: MTM services as a source of education; (3) “It’s not exactly just the pharmacist that passes out the medicines at the pharmacy”: The MTM practitioner is different from the dispensing pharmacist; (4) “So, less reactive, cleaning up the mess, and more proactive and catching things before they become so involved”: MTM services as preventative health care efforts; (5)“I think that time is the big thing”: MTM pharmacists spend more time with patients; (6) “There’s an access piece, there’s an availability piece, there’s a finance piece”: MTM services are underutilized at the clinics. In conclusion, PCPs value having MTM pharmacists as part of their team in ambulatory clinics. MTM pharmacists are considered an important source of education to patients as well as to providers as they are seen as having a unique body of knowledge –medication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients’ medications, and their capability to address patients’ medication experiences. MTM pharmacists are seen as being different from dispensing pharmacists, and PCPs usually highlight that difference to patients as they refer them to MTM services. Lastly, it is apparent that MTM pharmacists struggle to explain what their role is within the healthcare team and they need to find a more effective way to explain the unique value they add to the care of patients.
Alternative procedures for parent choice in a breeding program for the common bean (Phaseolus vulgaris L.)
Oliveira, L.B.;Ramalho, M.A.P.;Abreu, A. de F.B.;Ferreira, D.F.;
Brazilian Journal of Genetics , 1996, DOI: 10.1590/S0100-84551996000400014
Abstract: six common bean cultivars were crossed in diallel and the segregant populations were assessed in the f2 and f3 generations to compare methodologies for parental selection in a breeding program based on hybridization. the cultivars involved in the diallel were a 114, a 77, esal 686, milionário, carioca, and flor de mayo. the segregant f2 and f3 generations were assessed on the experimental campus of the universidade federal de larvas, in july 1994. it was found that the cultivars differed in their general combining ability (gca). flor de mayo, which belongs to the durango race, had the largest positive gca estimate for grain field, and the cultivars from the mesoamerican race, milionário and a 114, the smallest gca estimates. for flowering, the cultivar that most contributed to reduced plant cycle was esal 686. there was agreement among the results obtained from the diallel and the estimates of the parameter m + a of the populations. however, it was evident that the estimate of genetic variance of the populations should be considered as a condition to identify the hybrid population that will produce a line with high performance.
Laser phototherapy as a treatment for radiotherapy-induced oral mucositis
Lino, Maíra Dória Martinez da Costa;Carvalho, Fabíola Bastos de;Oliveira, Lara Ramalho de;Magalh?es, Edval Barreto;Pinheiro, Ant?nio Luiz Barbosa;Ramalho, Luciana Maria Pedreira;
Brazilian Dental Journal , 2011, DOI: 10.1590/S0103-64402011000200013
Abstract: oral mucositis is a harmful side effect of radiotherapy (rt) on the head and neck region. there are encouraging reports on the beneficial aspects of the use of laser light on the treatment of oral mucositis. this paper reports the efficacy of laser phototherapy (lpt) on the treatment of oral mucositis in a patient undergoing rt after surgical removal of a squamous cell carcinoma with osseous invasion of the maxilla. palatal and commissural lesions were treated with λ660 nm, 40 mw, ?=4 mm2, in contact mode, 5 x 2.4 j/cm2 per point, 14.4 j/cm2 per session. for treating the lesion on the patient's nasal mucosa, lpt (?=4 mm2, λ780 nm, 70 mw, 3 x 2.1 j/cm2 per point, 6.3 j/cm2 per session, contact mode) was used on the external area of the nose. a single dose (2.4 j/cm2) with the λ660 nm laser, as described before, was applied on the entrance of each nostril. lpt was used 3 times/week during 4 weeks. treatment results indicate that the use of lpt on oral mucositis was effective and allowed the patient to carry on the rt without interruption. however, long-term and controlled clinical trials are necessary to establish both preventive and curative protocols using lpt.
La investigación cualitativa en Farmacia: aplicación en la Atención Farmacéutica
Oliveira, Djenane Ramalho de;Varela, Niurka Dupotey;
Revista Brasileira de Ciências Farmacêuticas , 2008, DOI: 10.1590/S1516-93322008000400024
Abstract: se presenta desde una perspectiva teórica, el estado del arte de la metodología de investigación cualitativa en el campo de las ciencias farmacéuticas, haciendo especial énfasis en el área de la atención farmacéutica. se exponen los presupuestos teóricos e investigaciones cualitativas más importantes realizadas en el ámbito de las ciencias de la salud y en el sector asistencial farmacéutico internacional. a partir de la información expuesta, se considera que a pesar de que, la utilización de los métodos de investigación cualitativa se ha desarrollado considerablemente en el ámbito sanitario, su aplicación en el campo de la farmacia asistencial y de la atención farmacéutica, aún es insuficiente, lo que trasciende a latinoamérica, donde el ejercicio de esta nueva filosofía de práctica profesional no constituye actualmente una actividad globalmente establecida. la evaluación desde una perspectiva social del status de la profesión farmacéutica, a partir de la percepción de pacientes, farmacéuticos y otros profesionales sanitarios, así como la profundización desde el punto de vista cualitativo, de las principales barreras que limitan la generalización de la atención farmacéutica, pudieran contribuir fuertemente al mejoramiento de la actual actividad farmacéutica clínica, por un uso más racional de los medicamentos y calidad de vida superior en los pacientes.
Uma contribui??o da semiótica para a comunica??o visual na área da saúde
Oliveira, Sandra Regina Ramalho e;Gaspar, Débora da Rocha;Oliveira, Guilherme Augusto Ramalho e;
Interface - Comunica??o, Saúde, Educa??o , 2009, DOI: 10.1590/S1414-32832009000200013
Abstract: an analysis model proposed by jean-marie floch is presented as a possible tool for creating and evaluating visual communication within the field of healthcare, and in particular for educational campaigns. starting from introductory questions relating to semiotics, certain concepts common to discursive semiotics and esthetic semiotics are laid out, as postulated by floch. a model based on the semantic opposites of euphoria and dysphoria is then presented. the paper ends by demonstrating the application of the model to a poster from a preventive campaign against smoking-related diseases.
O uso de inibidores de apetite por mulheres: um olhar a partir da perspectiva de gênero
Melo,Cristiane Magalh?es de; Oliveira,Djenane Ramalho de;
Ciência & Saúde Coletiva , 2011, DOI: 10.1590/S1413-81232011000500022
Abstract: the scope of this study was to understand the motives that lead adult women to use appetite inhibitors and to establish, from a gender perspective, how these women relate to their own bodies. it was structured around the principles of qualitative research, and the methods of data collection were semi-structured interviews and direct observation. the informants were six women who used appetite inhibitors. the results indicated that images, publicity and social networks contribute significantly to the creation of new standards of physical appearance as well as lifestyles, which establish appearance (a slim body) and a happy marriage as the desired model. the slim body is represented as something able to alter the temperament of the individual, in other words a fat person is an unhappy person and a slim person is a happy person. the study shows that it is in the body per se that the social role destined for women is produced and reproduced.
Bone regeneration after demineralized bone matrix and castor oil (Ricinus communis) polyurethane implantation
Leite, Fábio Renato Manzolli;Ramalho, Lizeti Toledo de Oliveira;
Journal of Applied Oral Science , 2008, DOI: 10.1590/S1678-77572008000200008
Abstract: innocuous biocompatible materials have been searched to repair or reconstruct bone defects. their goal is to restore the function of live or dead tissues. this study compared connective tissue and bone reaction when exposed to demineralized bovine bone matrix and a polyurethane resin derived from castor bean (ricinus communis). forty-five rats were assigned to 3 groups of 15 animals (control, bovine bone and polyurethane). a cylindrical defect was created on mandible base and filled with bovine bone matrix and the polyurethane. control group received no treatment. analyses were performed after 15, 45 and 60 days (5 animals each). histological analysis revealed connective tissue tolerance to bovine bone with local inflammatory response similar to that of the control group. after 15 days, all groups demonstrated similar outcomes, with mild inflammatory reaction, probably due to the surgical procedure rather than to the material. in the polymer group, after 60 days, scarce multinucleated cells could still be observed. in general, all groups showed good stability and osteogenic connective tissue with blood vessels into the surgical area. the results suggest biocompatibility of both materials, seen by their integration into rat mandible. moreover, the polyurethane seems to be an alternative in bone reconstruction and it is an inexhaustible source of biomaterial.
EMPREGO DE INIBIDORES DE PROTEASE VEGETAIS COMO FERRAMENTA BIOTECNOLóGICA ALTERNATIVA NO CONTROLE DE PRAGAS
Caio Fernando Ramalho de Oliveira,Maria Lígia Rodrigues Macedo
Perspectivas Online : Biológicas e Saúde , 2011,
Abstract: Estatísticas d o-nos conta que em 2050 a popula o humana será de 9,1 bilh es de habitantes. Nestascircunstancias, recursos básicos como água e alimentos tornar-se- o escassos. Em especial, o fornecimentode alimento para a popula o em rápida expans o será um desafio para a humanidade. Há muito tempo ohomem busca maneiras de combater as perdas agrícolas. A introdu o dos inseticidas químicos nas lavourasfoi muito importante, no entanto, seus efeitos tóxicos s o indesejados. Por isso, a busca por agentesinseticidas que n o apresentem efeitos indesejáveis sobre a saúde e ao meio ambiente tornou-se necessária.Dentre as possibilidades existentes, a biotecnologia de plantas aparece como uma importante ferramenta parao controle de pragas, auxiliando no oferecimento de alimento com uma menor carga de produtos tóxicos. Osinibidores de proteases constituem uma interessante classe de proteínas vegetais bioinseticidas com potencialbiotecnológico. Durante décadas seu uso no combate a pragas agrícolas vem sendo estudado e plantastransformadas expressando diferentes inibidores apresentaram resultados satisfatórios, mostrandoperspectivas animadoras de sua aplica o como ferramenta biotecnológica para a prote o dos cultivares.Nesta revis o apresentamos algumas informa es sobre a biologia destas moléculas vegetais e sua história,relatos de trabalhos onde sua atividade inseticida foi estudada em plantas modificadas geneticamente e aindao futuro desta tecnologia, que poderá envolver a combina o de diferentes proteínas inseticidas e até mesmoa fus o de proteínas para a obten o de plantas mais eficientes.
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