73 resultados para Qualidade de vida Aspectos sociais
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Em 1996 com a introduo no Brasil da Highly Active Antiretroviral Therapy (HAART) melhorando a sobrevida e diminuindo o nmero de bitos entre os portadores do HIV/Aids, surgem relatos de alteraes metablicas e morfolgicas - Sndrome Lipodistrfica (SLD). Portanto, este estudo busca avaliar a partir da autopercepo esttica de pessoas que vivem com HIV/AIDS (PVHA) em uso de terapia antirretroviral (TARV) o impacto da SLD na qualidade de vida. Pesquisa exploratria observacional com dados quantitativos e qualitativos, que contou com a multidisciplinaridade, a partir dos critrios de incluso os voluntrios eram captados pelo mdico infectologista assistente. Foi realizada com base nos princpios da Resoluo 196/96-CNP. A amostra foi composta por 48 PVHA, com idade entre 32 a 66 anos. 89,6% demonstraram interesse em mudar partes do corpo que perceberam enquanto alteradas ou comprometidas pela SLD, dado reforado quando estes afirmam que se percebem (35,4%) e sentem (35,4%) que as outras pessoas os vem de forma diferente. Quanto a qualidade de vida o domnio da espiritualidade, religio e crenas pessoais alcanou maior mdia (14,7) com DP 4,0 neste estudo. A pesquisa permitiu uma publicao internacional (Journal of Public Health and Epidemiology-JPHE) e vrias participaes com publicao em eventos (nacionais e internacionais). O estudo sugere que a infeco por HIV e a presena da SLD a partir da autopercepo dos sujeitos entrevistados pode afetar a qualidade de vida. E destaca a importncia de aes que ressaltem o suporte social como motivador para o autocuidado
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Conselho Nacional de Desenvolvimento Cientfico e Tecnolgico
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A sobrevida das pessoas com AIDS tem aumentado com o uso das terapias com antiretrovirais (TARV), esses, entretanto, possuem efeitos colaterais que interferem no padro morfofuncional e hematolgico, o que pode levar a alteraes na qualidade de vida (QV). Este estudo quase-experimental objetivou avaliar parmetros antropomtricos, funcionais, hematolgicos e de QV em pessoas com HIV/AIDS submetidas a um programa de exerccios de 16 semanas. Os participantes tinham idade entre 35 e 51 anos (n=15), eram registrados no Ncleo de atendimento do Hospital Giselda Trigueiro em Natal/Rio Grande do Norte e apresentaram CD4350cel/mm3, lipodistrofia e estavam em TARV. Foram avaliados o ndice de massa corprea (IMC), a relao cintura-quadril (RCQ), o percentual de gordura (%G), a fora escapular e manual, a contagem de CD4, carga viral e QV, antes e aps a interveno. Essa foi realizada com exerccios de aquecimento e utilizou como base os exerccios resistidos, realizados 3x/semana, com 1h e intensidade de 60 a 75% de 1RM. Observaram-se modificaes significativas no %G (p=0,031), fora escapular (p=0,007) e preenso manual (p=0,039). Houve aumento no CD4 e a carga viral manteve-se indetectvel. Nos domnios da QV, houve mudana significativa no do meio ambiente (p=0,021), espiritualidade, religiosidade e crenas pessoais (p=0,032) e na percepo da qualidade de vida e sade geral (p=0,005). Os resultados sugerem que os exerccios resistidos para essa populao constituem agente teraputico coadjuvante no controle dos efeitos colaterais advindos da TARV, promovendo modificaes na composio corporal, aumento da capacidade funcional e dos nveis de CD4, mantendo estvel a carga viral e melhorando a QV. Sugerimos novos estudos com maior tempo de interveno e com o acompanhamento de equipes multidisciplinares, o que poder promover melhorias mais significativas na qualidade de vida e efetuar maior controle nas variveis intervenientes
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Descriptive study aimed to analyze the quality of life (QOL) of patients with venous ulcers (UV) outpatient clinic of a university hospital in Natal / RN. The aim of the study population was composed of 50 patients with UV treated at the cardiology clinic of a university teaching hospital at the tertiary level. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol 279/09). Data collection was performed over a period of two months by the very a masters degree and an academic nursing through the application of a form concerning the socio-demographic, clinical, and health care, and the instruments WHOQOL and WHOQOL - old. The data were analyzed with SPSS 15.0, using descriptive and inferential statistics presented in the form of tables, charts and graphs. Of the surveyed, female predominance, age range 59 years, Catholic, low education, married, with up to 03 children, not working, retired, or with occupations requiring long periods in one position, wage income of up to 02 minimum wages, inadequate sleep, patients with chronic venous insufficiency and other chronic diseases such as diabetes and hypertension, were taking medications for treatment, being a minority to IVC. In patients with predominant only one injury, time of injury up to five years, inadequate rest, pain, edema and lesions colonized. The assistance the UV patients began treatment of the injury until four months after the onset of the ulcer, and services primary health care most wanted, access to angiologist by reference form, commuted by public transportation, received support regarding the treatment of injuries. The topical product most used in the lesion was healing, and few were using compression therapy. respondents suffer discrimination in society, showed changes in quality of life after the occurrence of ulcer in relation to leisure, pain, restriction of social / school / transportation; barring employment / financial / social ladder; Physical appearance / discrimination and restriction of domestic activity. These changes were related to the time of injury and found that the more chronic injury is the most negative changes occur in their QV (ρ = 0.000). Analyzing the characteristics of QV measured by the WHOQOL-bref, we found for the two general questions they are dissatisfied with their health (ρ = 0.023) and all areas have significant difference compared with the worst QV have the injury of more than 5 years (ρ = 0.000). The QV measured by the WHOQOL-old, we found that these patients had no changes from the time of injury. We conclude that the QV of patients with UV was considered unsatisfactory when compared to the time of injury on more than 5 years which shows that the quality of life worsens with time the chronic UV.
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Introduction: Radical prostatectomy surgery is the best treatment currently adopted by detecting prostate cancer. The urinary incontinence is one more common and difficult to treat postoperative complications, which causes a negative impact on quality of life of the individual prostatectomy . The surface electrical nerve stimulation involves the transmission of electrical impulses from an external stimulator for peripheral nerve through surface electrodes attached to skin. It is an easy and efficient technique, widely used for pain relief, rehabilitation and muscle strengthening. Objective: To analyze the effect of T10-L2 percutaneous electrical stimulation, in individuals with urinary incontinence who underwent radical prostatectomy by the laparoscopic technique. Methods: Six patients had previously undergone radical prostatectomy were submitted to 20 sections of surface electrical stimulation with frequency of 4 Hz, pulse width of 1ms during 20 minutes. All subjects fillid a quality of life - International Consultation on Incontinence Questionnaire- Short FormI - ICIQ-SF questionnaire evaluating. Results: Results showed reduction in the use of the number of pads, number of leaks before and after treatment, and reduced voiding frequency and consequent improvement in quality of life. No side effects were reported. Conclusion: Percutanous electrical stimulation in T10-L2 may be an effective technique to treat urinary incontinence (UI) after radical prostatectomy video laparoscopy
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Diabetes Mellitus (DM) affected approximately 171 million people in the world in the year 2000 as described by the World Health Organization (WHO). Because DM is a multisystem disease it can cause several complications especially those related to the cardiovascular system. The Peripheral Arterial Disease (PAD) of the lower limbs and the Diabetic Distal Symmetric Polyneuropathy (DDSP) can affect the DM patient causing consequences as the diabetic foot and eventually amputations. The main objective of this study was to determine the prevalence of PAD and sensorial impairment in 73 type 2 DM (DM2) patients and also assess the impact of PAD on quality of life, level of physical activity and body composition. For clinical assessment it was used: the ankle-brachial index (ABI); quantitative sensorial test for tactile sensibility (ST), pain (SD), vibration (SV); Achilles tendon reflex (RA); quality of life questionnaire (SF-36); modified Baecke physical activity questionnaire and bioelectric impedance. Prevalence of PAD in the studied population was 13.7%. ABI was inversely correlated to age (p=0,03; rh= -0,26), diabetes duration (p=0,02; rh= -0,28) and blood pressure (p= 0,0007; rh= -0,33). There were lower scores for physical health summary on the SF-36 in DM2 patients; however, the presence of PAD predominantly mild did not significantly impact quality of life, body composition or physical activity level assessed by questionnaire. Fourteen patients (19.2%) present bilateral and symmetrical alterations in two or more sensorial tests compatible to DPN diagnosis. Abnormalities in ST, SD and SV were present in 27.3%, 24.6% and 8.2%; respectively. There was association of results from ST abnormalities with RA and mainly with SD, suggesting the importance of 10g monofilament use in DM2 routine assessment. In conclusion, the prevalence of PAD in subclinical DM2 was slightly higher compared to the general population and in agreement to previously published data in DM patients. The PAD severity was predominantly mild and still without repercussion on quality of life and body composition. Our study demonstrated a significant prevalence of both PAD and DPN in DM2 without previous diagnosis of these complications and indicates the necessity of early preventive and therapeutic interventions for this population
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The cerebral vascular accident is a neurological dysfunction of vascular origin that leds to development of motor sensibility, cognitive, perceptive and language deficits. Despite the fact that the main sleep disorders in stroke patients are well known, it is still necessary to analyze which mechanisms of regulation of sleep and wakefulness are affected. The objective of this study was to evaluate the changes in the circadian and homeostatic control of sleep-wakefulness in stroke patients and the correlations with quality of life and level of physical activity. The study analyzed 22 stroke patients (55 12 years old) and 24 healthy subjects (57 11 years old). The instruments used in this study were questionnaires on sleep quality, daytime sleepiness, quality of life, physical activity level and the actigraphy. The data were analyzed using the Student `t test, Mann-Whitney test, ANOVA and Spearman's correlation tests. The results showed stability in the sleep-wake circadian expression with changes in the amplitude of the rhythm. However, significant changes were found related to the homeostatic component characterized by increased sleep duration, increased latency, fragmented sleep and lower sleep efficiency. Additional data showed decreased quality of sleep and increased daytime sleepiness, as well as decreased quality of life and level of physical activity. The results indicate that the interaction of circadian and homeostatic control of sleep-wake is compromised and the main reason might be because of the homeostatic component and the lower activity level resulting from the brain damage. Thus, further studies may be developed to evaluate whether behavioral interventions such as increased daytime activity and restriction of sleep during the day can influence the homeostatic process and its relation to circadian component, resulting in improved quality of nocturnal sleep in stroke patients
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Even nowadays there is in Brasil a large number of edentulous and a precarious financial condition of most of the population. In addition, World Health Organization aims for oral health, which consists on the maintenance of a natural dentition, functional and aesthetic composed of at least 20 teeth, without need of prosthetic intervention throughout life. From this and considering the lack of researches about the permanence of edentulous spaces in the oral cavity, and also avoiding overtreatment, this research has been proposed. Thus, the aim was to evaluate the effect of different lengths of the shortened lower dental arch in the presence or absence of a removable partial denture (RPD) on masticatory function, quality of life and occurrence of temporomandibular dysfunction. To achieve this goal, we compared the masticatory efficiency (colorimetric test), the oral comfort through the analysis of the impact of oral health in quality of life (OHIP-14), the presence of temporomandibular dysfunction (RDC/TMD) and the general quality of life (WHOQOL) of patients with shortened dental arches (SDA) (n=60), which is an arch with a reduction of teeth starting posteriorly, and patients with complete dental arch (Complete DA) (n = 34). The group of patients whit SDA was divided among PPR wears (PPD + SDA) (n = 17) and non-wears (n = 43). The population of this study consisted on patients who received or looked for treatment at the clinics of the Department of Dentistry of UFRN, from clinical analysis and records. The sample was chosen by convenience. For statistical analysis, it was a database in SPSS 17.0, followed by descriptive analysis with frequencies, absolute values, tests of central tendency and variability. The statistical tests used were chi-squared and analysis of variance as well as Tukey s post test, when applicable, all with a 95% confidence level. The results shown a prevalence of TMD of 47,1% among patients using PRP and 69,8% among those who didn t, but this result wasn t statistically significant. The mean of the results of masticatory efficiency, WHOQOL and OHIP didn t show association to the presence or absence of PPR and to the lower number of occlusal units of the patients (0, 1, 2 or more occlusal). The association only occurred among the different groups of SDA and the patients with complete dental arch. Taking into account the results, it could be observed that studied patients with low posterior support using lower PRP didn t have better masticatory efficiency, general quality of life, less impacts of their oral conditions in quality of life or not even less temporomandibular dysfunction or better masticatory efficiency when compared to those who didn t use the prosthesis
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Nas ltimas dcadas, com a significativa reduo da crie dentria em crianas e adolescentes, uma maior ateno tem sido dada a outros problemas bucais como as oclusopatias. Em termos epidemiolgicos no Brasil, esta tem ocupado o terceiro lugar dentre os problemas de sade oral na populao e, portanto, a incluso destas como um problema de sade pblica se deve no apenas sua alta prevalncia, mas tambm ao impacto social, que interfere diretamente na qualidade de vida das pessoas. Diante do exposto que este estudo objetiva buscar o impacto da presena e severidade das oclusopatias e suas respectivas necessidades de tratamento na qualidade de vida de adolescentes escolares de um municpio. Sendo assim, foram examinados 356 escolares na faixa etria de 15 -19 anos e determinadas a prevalncia, severidade e necessidade de tratamento de oclusopatias atravs dos ndices DAI, IOTN e ICON. O impacto scio dentrio das oclusopatias na qualidade de vida dos adolescentes foi analisado atravs do ndice CS-OIDP. A fim de se verificar possveis influncias de variveis estudadas na determinaao do impacto na qualidade de vida das oclusopatias, estas sero coletadas atravs do estatus scio-econmico, gnero, idade e tipo escola. Nos resultados parciais, relacionado a 50% da amostra, se observou uma maior prevalncia do escolares de escola pblica(68,1%), idade entre 15-16 anos(74,7%), gnero feminino(52,7%) e maior prevalncia do SES baixo(77,5%). A anlise estatstica usando o teste qui-quadrado mostrou uma associao significativa do impacto da oclusopatia na qualidade de vida apenas quando avaliada com o ndice ICON e o A-IOTN do examinado, comprovando uma associao da necessidade de tratamento com a presena do impacto na qualidade de vida. Com isso, busca-se comprovar e enfatizar a necessidade de se estabelecer polticas pblicas que trabalhem na preveno e interceptao dessas oclusopatias na populao, melhorando, portanto, a qualidade de vida e sade oral dos adolescentes.
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Nas ltimas dcadas, com a significativa reduo da crie dentria em crianas e adolescentes, uma maior ateno tem sido dada a outros problemas bucais como as oclusopatias. Em termos epidemiolgicos no Brasil, esta tem ocupado o terceiro lugar dentre os problemas de sade oral na populao e, portanto, a incluso destas como um problema de sade pblica se deve no apenas sua alta prevalncia, mas tambm ao impacto social, que interfere diretamente na qualidade de vida das pessoas. Diante do exposto que este estudo objetiva buscar o impacto da presena e severidade das oclusopatias e suas respectivas necessidades de tratamento na qualidade de vida de adolescentes escolares de um municpio. Sendo assim, foram examinados 356 escolares na faixa etria de 15 -19 anos e determinadas a prevalncia, severidade e necessidade de tratamento de oclusopatias atravs dos ndices DAI, IOTN e ICON. O impacto scio dentrio das oclusopatias na qualidade de vida dos adolescentes foi analisado atravs do ndice CS-OIDP. A fim de se verificar possveis influncias de variveis estudadas na determinaao do impacto na qualidade de vida das oclusopatias, estas sero coletadas atravs do estatus scio-econmico, gnero, idade e tipo escola. Nos resultados parciais, relacionado a 50% da amostra, se observou uma maior prevalncia do escolares de escola pblica(68,1%), idade entre 15-16 anos(74,7%), gnero feminino(52,7%) e maior prevalncia do SES baixo(77,5%). A anlise estatstica usando o teste qui-quadrado mostrou uma associao significativa do impacto da oclusopatia na qualidade de vida apenas quando avaliada com o ndice ICON e o A-IOTN do examinado, comprovando uma associao da necessidade de tratamento com a presena do impacto na qualidade de vida. Com isso, busca-se comprovar e enfatizar a necessidade de se estabelecer polticas pblicas que trabalhem na preveno e interceptao dessas oclusopatias na populao, melhorando, portanto, a qualidade de vida e sade oral dos adolescentes.
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One of the largest problems of the present time resulting from the economic globalization and the modern technology, of the point of view of the biological rhytms of our organism, it is offering services and production of goods available in 24 o'clock, that it demands organized workers in several work schedules besides the hours of the day. Those schedules cause a series of biopsychosocial consequences in the worker's health, in function of circadian, homeostatic and psychosocial alterations. Accordingly, the aim of this study was to accomplish an evaluation of the effects of several works schedules in the pattern of the sleep wake cycle, anxiety, stress and in the health. We counted with a sample of 274 workers subdivided in 49 daytime worker groups and 225 workers in different shift work schedules with different speeds (rotating shift group, slower day shift group, faster day shift group). From the results analysis it is verified irregularities of the daily activities, stress and alterations in the workers' health in all schedules. It was also verified thata the workers thata presented irregularities in the daily activities were the mroe stressed. On the other hand, the shift works were considered more ansious and associated with bad sleep quality. It was verified that the workers with bad sleep quality were those presented larger levels of dispocional anxiety. There was no statistically significant correlation between bad sleep quality and irregular daily lifestyle. However, it can be affirmed thata shift work schendules doesn't are the main determinant for the circadian alterations, but the answers of the individuals to the shifts work; and that the inadequate behavioural strategies to work with the effects of the shift schedules. In conclusion, individual strategies related to the coping of the work in shift (adaptation and tolerance) should be extolled as indispensable tool in the ergonomic evaluation of the work
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The increase in survival time and cure requires more extensive care about the quality of life of cancer patients, which begins soon after diagnosis. Thus, it seems reasonable to the emphasis on development of studies covering the psychosocial variables, such as stigma, treatment of childhood cancer aiming thereby to the attention of the overall needs of the child. Thus, this research aims to investigate the perception of stigma and quality of life in children with cancer. This is a cross-sectional research and understanding of the descriptive type, the type specimen being adopted for convenience. This consisted of thirty children with cancer and thirty children without chronic disease. The instruments used were the Quality of Life Questionnaire, the Perceived Stigma Scale and Technical Drawing Story with a Theme. The results indicate that the chronic condition, no interfered significantly in satisfaction with the quality of life in children with cancer and identified that the quality of life is not related to the stigma. Comparison with children with no chronic disease with infants with cancer, no significant differences were observed. However, the group mean contrast was lower, suggesting a greater impairment in quality of life of children with cancer compared to those without chronic disease. It is worth noting that the psychosocial effects and the limitations imposed by disease and treatment are presented as important factors in the design mode of subjective manifestations of children with cancer. Therefore, it is expected that knowledge elucidated by this study will assist, greatly to the promotion of improved emotional, biological and social development itself and the involvement of children with cancer treatment
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Early childhood caries, especially in its severe form, which is characterized by an acute and aggressive nature, can have negative impacts on thequality of life of a child, due to effects such as difficulty in chewing, decreased appetite, weight loss, insomnia, changes in behavior and a decreased performance in school, among others. Moreover, the quality of life of the child`s family can also be affected, as the pain and discomfort caused by this type of caries result in loss of working days of parents, spending on dental treatments, changes in sleep patterns and stress. The aim of this study was to evaluate the impact of severe early childhood caries in the Oral Health-Related Quality of Life (OHRQoL) of public daycares`s preschool children through the Escala de Impacto da Sade Bucal na Primeira Infncia, a Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). A single calibrated examiner (kappa=1.0) evaluated, through the dmfs index, the oral health of 116 children aged between 3 and 5, which were included in one of three study groups: "caries-free", "not-severe early childhood caries" and "severe early childhood caries". The parents responded to ECOHIS, to assess their perception regarding the OHRQoL of their children, and a questionnaire on socioeconomic conditions. The OHRQoL was measured through the total scores and domains of ECOHIS. Descriptive analysis, Mann-Whitney test, Kruskal-Wallis test, chi-square test and Poisson multiple regression with robust variance were used. Among the children observed, 38.8% were caries-free, 27.6% showed not-severe early childhood caries and 33.6% showed severe early childhood caries. Regarding the total score of ECOHIS, severe early childhood caries had a greater negative impact on OHRQoL, compared to caries-free and not-severe early childhood caries groups (p <0.001). Regarding the child subscale, there was significant difference between the "severe early childhood caries" group and the other groups in all domains, except for theone of self-image / social interaction. In the family subscale domains, there was statistical significance between the severe early childhood caries and the caries-free groups in all domains (p <0.001), whereas between the "severe early childhood caries and not-severe early childhood caries groups there was a statistically significant difference only in the domain of parental anguish (p <0.001). Multivariate analysis showed that early childhood caries and the parent`s age were significantly associated to OHRQoL (p <0.05), independently of the other variables in the model. The presence of severe early childhood caries resulted in greater negative impact on OHRQoL (AdjPR= 6.016; 95%CI = 3.12 11.56; p<0.001), while older parents reported better OHRQoL (AdjPR = 0.603; 95%CI = 0.428 - 0.850; p = 0.004). The presence of severe early childhood caries had a negative impact on OHRQoL of preschool children and their families.
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Edentulous patients with complaint about mandibular conventional denture might experience poor masticatory function and negative impact of oral health on quality of life. The aim of this controlled clinical trial was to evaluate the effect of mandibular overdenture on oral health-related quality of life and masticatory efficacy in patients wearing mandibular complete dentures. The edentulous patients (n=16) were rehabilitated with new maxillary and mandibular complete dentures and, after 3 months, mandibular overdentures retained by 2 implants (bar-clip system) were fabricated. The Brazilian version of OHIP-Edent questionnaire was used to assess the oral healthrelated quality of life. Masticatory efficacy was evaluated through a colorimetric method with chewing capsules. The mean OHIP-Edent score was 8.5 with conventional dentures and 2.0 with mandibular overdenture, which means a positive impact of oral health on quality of life with overdentures (p=0.001). The mean absorbance for masticatory efficacy was 0.025 for conventional dentures and 0.073 for overdentures. There was statistically significant difference for masticatory efficacy before and after implants rehabilitation (p=0.003). However, there was no correlation between masticatory efficacy and OHIP (p>0.05). So, mandibular overdenture retained by 2 implants improved the quality of life and masticatory efficacy of edentulous patients with complaint about mandibular conventional complete dentures
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OBJETIVO: analisar o impacto da fibromialgia sobre os sinais e sintomas climatricos, qualidade de vida, funo sexual em mulheres na fase do climatrio. MTODOS: Foi realizado estudo observacional analtico de corte transversal, envolvendo 161 mulheres na fase do climatrio. As participantes foram divididas em dois grupos: grupo sem fibromialgia (83) e grupo com fibromialgia (78). As variveis investigadas foram: Qualidade de vida medida atravs do questionrio UQOL (Utian Quality of Life), Funo sexual analisada atravs do questionrio Quociente Sexual - verso feminina (QS-F) e sinais e sintomas climatricos avaliados pelo ndice menopausal de Blatt & Kupperman (IMBK). No estudo estatstico, foi realizada anlise inferencial atravs do mtodo de modelos lineares generalizados. Para anlise do UQOL e seus domnios assim como o QS-F e IMBK, foi utilizado uma funo de ligao linear de Log Poisson com exposio de contrastes para os nveis dos fatores de exposio. O nvel de significncia adotado foi de 5%. RESULTADOS: No grupo fibromialgia foram observados escores significativamente inferiores para o domnio ocupacional UQOL (p 0,01) e UQOL total (p = 0,02), em comparao ao grupo sem fibromialgia. O grupo de mulheres com fibromialgia apresentou escores superiores em relao intensidade dos sinais e sintomas climatricos (p 0,01) e escores inferiores na avaliao da funo sexual pelo QS-F (p = 0,01), quando comparado ao grupo sem fibromialgia. As mulheres mais jovens, com trabalhos extra domiclio, maior renda e maior grau de escolaridade apresentaram melhores escores na qualidade de vida em todos os domnios. Quanto aos sinais e sintomas climatricos, a renda mais alta e maior tempo de escolaridade exerceram associao direta com sinais e sintomas mais leves, entretanto, quanto mais jovens, maior relao com sintomatologia mais intensa. Em relao funo sexual, melhores escores estiveram associados com idade entre 45 a 49 anos e trabalho extra domiclio. CONCLUSO: Os resultados obtidos no presente estudo permitem concluir que o diagnstico de fibromialgia na fase do climatrio apresentase como influncia negativa no domnio ocupao da qualidade de vida, sinais e sintomas climatricos e funo sexual, sendo esta associao influenciada significativamente por diversos fatores scio demogrficos
