Tendência e diferenciais socioeconômicos da mortalidade por câncer de colo de útero no Estado do Paraná (Brasil), 1980-2000

O objetivo deste artigo é discutir a evolução da mortalidade por câncer de colo de útero no Estado do Paraná entre 1980 e 2000 e analisar seus diferenciais socioeconômicos em cada região. Taxas de mortalidade ajustadas por idade foram calculadas para as 22 regionais de saúde do Estado a cada ano. Análises comparativas avaliaram indicadores socioeconômicos associados com regiões que apresentaram tendência estacionária e crescente de mortalidade. A mortalidade por câncer de colo uterino cresceu no Estado como um todo a uma taxa de 1,68% (IC 1,20-2,17) ao ano. A maior parte das regiões apresentou tendência estacionária de mortalidade por câncer de colo de útero. As regionais com tendência de aumento na mortalidade apresentaram proporção significativamente mais elevada de analfabetismo (p<0,001) e de adultos (15 anos ou mais) com menos de 4 anos de estudo (p=0,001), e renda per capita (p=0,025) e IDH (p=0,023) inferiores. Houve tendência de aumento na mortalidade em todo o Estado; as regiões que contribuíram para o aumento experimentaram piores indicadores socioeconômicos.

Hanseníase no Estado do Espírito Santo, Brasil: uma endemia em ascensão?

Descrição do comportamento e análise da tendência da hanseníase entre pacientes residentes no Estado do Espírito Santo, Brasil, de 1980 a 2003. Utilizando modelos estatísticos para séries temporais, identificou-se tendência crescente para todo o período da taxa de detecção global (p < 0,05) com aparente estabilização no final do período, verificamos também tendência crescente para os períodos: (i) 1980-1987 nos grupos etários de < 15 anos e 50 anos e mais e para formas paucibacilares; (ii) 1988-1995 para as faixas de 15-19 anos, 20-29 e 50 anos e mais e para formas multibacilares; (iii) 1996-2003 no grupo de 20-29 anos e formas paucibacilares. Os indicadores de avaliação da endemia apontaram patamares estáveis do grau de incapacidade 2 (em média 6%); a proporção de casos entre < 15 anos situou-se abaixo de 10% e a de abandono de tratamento em torno de 6%. A prevalência apresentou forte declínio. A tendência crescente pode ser explicada, em parte pela maior sensibilidade da vigilância, mas a elevada proporção entre < 15 anos aponta a necessidade de estudos visando ao melhor conhecimento dos resíduos de fontes de infecção especialmente no domicílio.

O direito das minorias e as nações indígenas no Brasil

O presente artigo trata de questões da história, do direito, da economia, da antropologia, da sociologia, da política, no que tange a minorias, salientando alguns marcos significativos da política indigenista brasileira na década de 1980. No que tange aos direitos humanos aplicados às minorias, se anteriormente o fulcro era a proteção desses direitos, hoje se demanda a sua regulação e a garantia jurídica, fomentando uma reordenação dessas relações. Essa foi uma grande contribuição da Constituição de 1988 no que diz respeito às comunidades indígenas que habitam o território nacional.

Malária autóctone notificada no Estado de São Paulo: aspectos clínicos e epidemiológicos de 1980 a 2007

INTRODUÇÃO: A malária autóctone no Estado de São Paulo caracteriza-se por surtos esporádicos na região oeste e transmissão persistente na região leste onde ocorrem casos oligossintomáticos com baixa parasitemia pelo Plasmodium vivax. Os objetivos deste estudo foram: analisar a completitude das fichas de notificação de malária autóctone; estimar a tendência da incidência de casos autóctones no ESP de 1980 a 2007; analisar o comportamento clínico e epidemiológico dos casos em duas regiões de autoctonia neste período. MÉTODOS: Foi realizado um estudo descritivo com 18 variáveis das FIN de malária do ESP, analisadas em duas regiões e em dois períodos (1980-1993 e 1994-2007). Fontes de dados: SUCEN/SES/SP, SINAN/CVE/SES/SP e DATASUS. RESULTADOS: A completitude foi superior a 85% em 11 variáveis. A tendência da incidência foi decrescente. Foram notificados 821 casos autóctones, 91,6% na região leste, predominando Plasmodium vivax. A infecção assintomática teve maior porcentagem no segundo período (p<0,001). CONCLUSÕES: A completitude das informações foi considerada satisfatória. As diferenças clínicas encontradas merecem atenção da vigilância epidemiológica que deve lidar com o desafio da infecção assintomática por Plasmodium.

Incidence of dementia and cause of death in elderly Japanese emigrants to Brazil before World War II

In 1997 we examined the prevalence of dementia among the Japanese elderly immigrants living in the Sao Paulo metropolitan area (n = 166). Herein, we followed up on these subjects for causes of death and dementia incidence. We were able to contact 108 subjects: 54 were already dead. The most common cause of death was cardiac disease. For dementia, 31.6% of the dead subjects were found to have developed dementia before they died, and 20.8% of the living subjects were demented. As for the baseline the clinical dementia rating (CDR), 20.8% of CDR 0 and 50.0% of CDR 0.5 subjects developed dementia in the dead group; whereas in the living group, 23.9% of CDR 0 and 52.6% of CDR 0.5 developed dementia. As a whole, the incidence was 34.2% per 1000 person-years. Cardiac disease as the most common cause of death was probably due to the higher prevalence of diabetes mellitus. Compared with the previous study, the lower incidence of dementia from the CDR 0.5 group may have been due to a higher mortality rate. This is the first study on the incidence of dementia in elderly Japanese immigrants in Brazil. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Knowledges and practices of successful literacy teachers (Brazil, 1950-1980)

Significant changes have marked Brazilian education in the period focused on by this research. Aiming to understand the configurations of the teaching profession in that period, this work focuses on the issue of the school success in the area of literacy by means of an analysis of the practices of literacy teachers who were at work between the 1950s and 1980s. The research is based on life-history accounts. The study aimed at describing the various experiences of these teachers identifying the knowledges and practices that sustained their successful literacy work as well as the various factors of a social, religious, political, familiar or other nature that, in the history of each of these teachers, favoured the development of a pedagogical style of literacy particular to each one of them. Despite the peculiarities and originality of each history, the success in the literacy process, as the defining feature of the profile of the four teachers, results from two main aspects: first, the autonomy that each one managed to keep in the development of his/her teaching work, particularly in the organisation of the teaching practices that indicated greater chances of a pupil`s learning to read and write; second, their trust in the capacity of every child for learning, independently of his/her social, economic and cultural conditions. Based on this evidence it is argued that the success of the pedagogical work, particularly during the early years of schooling, lies in an ethics of the teaching work with a double implication: first, it requires the teachers` dedication to their pupils, and second, it requires respect for the work of the teacher, so that she/he can maintain her/his autonomy and inventiveness. These aspects indicate the need for reflection on teaching work and a review of current teacher education policies, particularly the policies targeted at teachers working with literacy practices.

Something moves: a philosophical and ethical praise to the combat practicing as art and education

In this work we tried to produce a philosophic-ethic praise to the Martial Arts` combat practice, based in our years of Martial Arts training accompanied with studies of oriental and occidental Philosophy. Tracing a critical history of the changes happened to the Martial Arts we brought the concept of combat as a martial practice of life empowerment. Opposing this, we presented the notion of fight as a result of the capture that the war arts suffered because of the despotic empires. Besides, we demonstrated that the combat practice is simultaneously an artistic and educational activity, because it aims at the production of an immanence field witch is loyal to the event.

Political Parties and Governors as Determinants of Legislative Behavior in Brazil`s Chamber of Deputies, 1988-2006

This article examines the relative importance of regional and national forces in shaping the behavior of Brazilian legislators at the national level. A widely held view is that national legislators respond to state pressures in making decisions, rather than pressures from the national government. Governors not only can influence national debates but also can determine outcomes by exerting control over their states` legislative delegations. This article examines a dataset of all roll-call votes in the Chamber of Deputies between 1989 and 2006 to isolate and evaluate the impact of local pressures on legislative voting. Spanning the terms of five presidents and five different congresses, the data show that the local influence is weaker than the national on the voting decisions of individual legislators and the voting cohesion of state delegations. Alternative institutional resources allow the central government to counteract the centrifugal pressures of federalism and other institutional influences.

Functional characterization of the hypothalamic-pituitary-adrenal axis of the Wistar Audiogenic Rat (WAR) strain

The Wistar Audiogenic Rat (WAR) strain is a genetic model of sound-induced reflex epilepsy which was selected starting from audiogenic seizures susceptible Wistar rats. Wistar resistant rats were used as WAR`s control in this study. In the acute situation, audiogenic seizures (AS) in WARs mimic tonic-clonic seizures and, in the chronic protocol, mimic temporal lobe epilepsy. AS have been shown to evoke neuroendocrine responses; however, the hypothalamic-pituitary-adrenal activity in the WAR has not been established. The aim of this study was to evaluate the hypothalamic-pituitary-adrenal axis (HPA) responses to exogenous ACTH stimulation (8 ng/rat), fifteen minute restraint stress and circadian variation (8 am and 8 pm) under rest conditions in these animals through plasma measurements of ACTH and corticosterone concentrations. We also measured the body weight from birth to the 9th week of life and determined adrenal gland weight. We found that WARs are smaller than Wistar and presented a higher adrenal gland weight with a higher level of corticosterone release after intravenous ACTH injection. They also showed altered HPA axis circadian rhythms and responses to restraint stress. Our data indicate that, despite the lower body weight, WARs have increased adrenal gland weight associated with enhanced pituitary and adrenal responsiveness after HPA axis stimulation. Thus, we propose WARs as a model to study stress-epilepsy interactions and epilepsy-neuropsychiatry comorbidities. (C) 2011 Elsevier B.V. All rights reserved.

Sexual differentiation of cortical spreading depression propagation after acute and kindled audiogenic seizures in the Wistar audiogenic rat (WAR)

Brain excitability diseases like epilepsy constitute one factor that influences brain electrophysiological features. Cortical spreading depression (CSD) is a phenomenon that can be altered by changes in brain excitability. CSD propagation was presently characterized in adult mate and female rats from a normal Wistar strain and from a genetically audiogenic seizure-prone strain, the Wistar audiogenic rat (WAR), both previously submitted (RAS(+)), or not (RAS(-)), to repetitive acoustic stimulation, to provoke audiogenic kindling in the WAR-strain. A gender-specific change in CSD-propagation was found. Compared to seizure-resistant animals, in the RAS- condition, mate and female WARs, respectively, presented CSD-propagation impairment and facilitation, characterized, respectively, by lower and higher propagation velocities (P<0.05). In contraposition, in the RAS(+) condition, mate and female WARs displayed, respectively, higher and tower CSD-propagation rates, as compared to the corresponding controls. In some Wistar and WAR females, we determined estrous cycle status on the day of the CSD-recording as being either estrous or diestrous; no cycle-phase-related differences in CSD-propagation velocities were detected. In contrast to other epilepsy models, such as Status Epilepticus induced by pilocarpine, despite the CSD-velocity reduction, in no case was CSD propagation blocked in WARs. The results suggest a gender-related, estrous cycle-phase-independent modification in the CSD-susceptibility of WAR rats, both in the RAS(+) and RAS(-) situation. (C) 2008 Elsevier B.V. All rights reserved.