Análise de parâmetros da função reprodutiva masculina após perda ponderal induzida pela cirurgia bariátrica

Introdução: A obesidade e suas formas extremas como a forma mórbida, vem assumindo preocupação nos sistemas de saúde pública e é atualmente considerado um dos mais importantes agravos de saúde no mundo desenvolvido. Acarreta repercussões em várias partes do corpo, com potencial para interferir negativamente também na função reprodutiva, recentemente sendo mais estudado na população masculina. Objetivo: avaliar parâmetros hormonais e seminais da função reprodutiva em um grupo de homens obesos mórbidos, antes e após 6 meses da perda de peso induzida pela cirurgia bariátrica. Métodos: Inicialmente, de uma amostra de 36 pacientes com idade entre 18 e 40 anos e índice de massa corporal (IMC) ≥40 Kg/m2, apenas 1 caso foi excluído por ser portador de hiperprolactinoma e outros 24 pacientes não completaram todo o protocolo de avaliação laboratorial solicitada. Um total de apenas 11 pacientes completou o protocolo. Todos foram previamente avaliados por uma equipe multidisciplinar. O grupo selecionado foi submetido a avaliação seminal e dosagens hormonais de testosterona total(TT), FSH e LH. Os parâmetros foram reavaliados após 6 meses de realização da cirurgia pela técnica de Y-em-Roux, para análise dos efeitos da perda de peso sobre os parâmetros da função reprodutiva. Resultados: No grupo selecionado ao estudo, os exames pré-operatórios mostraram um grupo heterogêneo de resultados. Após seis meses do tratamento cirúrgico, a perda ponderal foi significativa no grupo analisado, com redução do IMC de mediana 46 Kg/m2para mediana de 36 Kg/m2(p=0,03). Em relação ao perfil hormonal, houve elevação significativa do nível sérico de TT com mediana de 187ng/ml no período pré-operatório para 457 ng/ml (p=0,02) no período pós-operatório. Entre os períodos pré e pós-operatório, não foram observadas alterações significantes do FSH (2,70 mIU/ml para 3,31 mIU/ml, p=0,79), LH (4,82 mIU/ml para 3,00mIU/ml, p=0,39), concentração espermática (38milhões/ml para 31milhões/ml, p=0,88) e motilidade A+B (50% para 50%, p=0,89).Conclusão: A redução ponderal decorrente da cirurgia em obesos mórbidos parece levar a uma elevação dos níveis de testosterona total, sem alterações nas demais provas de avaliação reprodutiva. Estudos adicionais com casuística maior e múltiplos parâmetros são necessários para esclarecimento definitivo do impacto da obesidade e da perda de peso induzida pela cirurgia sobre a função reprodutiva masculina

Ansiedade em indivíduos bruxômanos e suas principais implicações na vida social

Neste trabalho procuramos estudar o fenômeno do bruxismo, definido como o ato de apertar e/ou ranger os dentes, hábito prejudicial à região orofacial relacionado a varáveis psicossociais. O bruxismo é frequentemente associado aos aspectos emocionais, entre os mais ressaltados, a ansiedade e o estresse, podendo implicar em alterações das estruturas orofaciais, modificações funcionais e inclusive com repercussões sociais. Deste modo, torna-se relevante evidenciar que a pesquisa foi desenvolvida, visando o contexto multidisciplinar, abrangendo a Fonoaudiologia, Odontologia e Psicologia. Objetivo: verificar associação entre bruxismo, ansiedade e as principais queixas referentes à função mastigatória. Método: participaram oitenta voluntários, divididos entre grupo com bruxismo (N=40) e sem bruxismo (N=40), do sexo masculino e feminino. O diagnóstico do bruxismo foi realizado através do exame clínico. Para avaliar os níveis de ansiedade empregou-se o Inventário de Ansiedade Traço e Estado e para os aspectos psicossociais um questionário com questões estruturadas referentes às atividades diárias, focando a função mastigatória (para o grupo com bruxismo). Resultados:: Os resultados permitem evidenciar diferenças significativas entre os grupos analisados, a média e desvio padrão de ansiedade estado no grupo com bruxismo, 42,7±9,6 e sem bruxismo 38,6±8,2 (p ≤0,04) e de ansiedade traço respectivamente 44,5±11,0 e controle 40,7±9,5 (p ≤0,11). O relato dos participantes com bruxismo evidenciou como principais queixas durante a mastigação, dor na face ao mastigar, cansaço muscular na face, cefaleia ao mastigar e presença de ruídos articulares. Conclusões: Evidenciamos uma associação dos fatores emocionais como a ansiedade e o bruxismo, e como resultante os pacientes apontam que a função mastigatória encontra-se depreciada

Implementação da política de assistência social em Mossoró/RN : uma avaliação a partir dos centros de referência da assistência social

The current National Policy for Social Assistance (PNAS) is the instrument that regulates the organization and procedures of social-welfare actions. Developed and approved in 2004 since the Unified Social Assistance System (ITS) was crated in 2003, it reaffirms the democratic principles of the Social Assistance Organic Law (LOAS) focusing on the universalization of social rights and equality of rights when accessing the social-welfare system. In the SUAS point of view, the PNAS highlights the information, monitoring and evaluation fields for being the best way to assure the regulation, organization and control by the Federal Government paying attention to the principles of decentralization and participation. This political-institutional rearrangement occurs through the pact among all the three federal entities. The pact deals with the implementation of the task. It says that it has to be shared between the federal autonomous entities, established by dividing responsibilities. To the cities, considered as the smallest territorial unit of the federation and closer to the population, was given the primary responsibility, which is to feed and maintain the database of SUAS NETWORK and identify families living in situations of social vulnerability. In addition to these responsibilities, the cities that have full autonomy in the management of their actions, have the responsibility to organize the basic social protection and the special social protection, that using the Center of Social Assistance Reference (CRAS) and the Center of Specialized Social Assistance Reference (CREAS), are responsible for the provision of programs, projects and services that strengthen the family and community; that promote people who are able to enjoy the benefits of the Continuing benefit of Provisions (BPC) and transfer of incomes; that hold the infringed rights on its territory; that maximize the protective role of families and strengthen its users organization. In Mossoró/RN, city classified as autonomous in the social assistance management, has five units of CRAS that, for being public utilities, are considered the main units of basic social protection, since they are responsible for the connection between the other institutions that compose the network of local social protection. Also known as Family House, the CRAS, among other programs and services, offers the Integral Attention to Families Program (PAIF), Juvenile ProJovem Program, socio-educational coexistence services programs, as well as sending people to other public policies and social-welfare services network, provides information, among others. In this large field, social workers are highlighted as keys to implement the policy of social assistance within the city, followed by psychologists and educators. They should be effective public employees, as a solution to ensure that the provision of the services are to be continued, provided to the population living around the units. However, what we can find here is inattention to the standard rules of social assistance, which not only undermines the quality of programs and services, but also the consolidation of policy on welfare as public policy of social rights

A construção das representações sociais na relação da polícia militar e a sociedade Aracajuana

In recent years, issues involving public safety have gained more prominence in scientific debates, the media, and common sense, because undoubtedly the feeling of fear and insecurity caused by the increase in violence overall, has spread like construction element of social representations, both in individual levels, as well as collectively. Violence is a social phenomenon existing in human manifestations, from the older societies, ie it was present in all historical periods, but in different ways in the subjective and objective, having had the task of being the central element in modeling process for the formation of individual behavior, both in older societies as in modern society. However, it has a peculiar feature of acquiring new contours to the extent that the individual and collective behaviors are modified in relation individual-violence. In this sense, the institutions that establish the order from the control of violence, have their social representations in the context of social relationships permeated by elements of violence, fear and insecurity, that shift the subjective feeling of insecurity, or existential, for a concrete plan and goal, namely to the level of physical insecurity in daily life in the modern world. The objective of this study was to capture the construction of social representations of the population in Aracaju on the police institution and the figure of the policeman in the contemporary context. We focus our attention only to the institutions of order, which constitute the field of the apparatus of public security and social protection of our state

O corredor cultural: espaço de materialização da exclusão social em Mossoró-RN

In contemporary society, social exclusion is an actual and pertinent theme, because it presents itself as a challenge to management and planning of the public policies. In this perspective, the thesis entitled "The Cultural Corridor: space materialization of social exclusion in Mossoró-RN" is a moment of apprehension and analysis of the local reality from the urban policy implementation that emphasized an enterprising model, which has, as the concrete space to urban renovation manifestation, the cultural complex called cultural corridor. Because of the investigation and the directional hypothesis, it is possible to say that the urban development policy implemented in Mossoró, starting from the 1990 decade, based in the model of modernizing/enterprising management, has been causing an intensification of a society parcel exclusion from the city public space, since this public policy didn't prioritized job market increasing, as well as population incomes improving, poverty and social inequality reduction, at the same proportions it promoted geographic space reorganization with directional actions to build the "spectacle city"

Política de assistência social no Brasil: uma análise a partir das tipologias de políticas públicas

The study of public policy typologies is still a knowledge field which lacks more embracing and applicable studies to different sectors. On that perspective, this work, Social Assistance Policy in Brazil: an analysis from the typologies on public policy, pursues to add the relevant literature to social assistance what focus on the public policy ratings. Moreover, it concerns about a study on the the national policy of social assistance implemented by the Brazilian government from the theoretical referrence of the public policy typologies. For that reason, the referential framework of the public policies as well as the analisys of its fundamentals/principles that are indispensable for achieving a bigger goal, that is to tipify the social assistance policy based on the different public policy typologies and characterize it through the main elements which are intrinsec to the social political and economic reality of Brazil. Thus, the issue suggested for the work is: what is the profile and the political trajectory of the social assistance implemented by the Brazilian Government? How it presents, above all, the features of a distributive, focused and lawful policy, the work has been done througho the following hypothesis: the social assistance policy in Brazil has been of universal, assistance, and focusing aspects. For each of those features granted to the social assistance policy, there is a gathering of changes according to the social, political and economic moment of the country and that stands out due to the different institutions within every cyclical period. The work showed that besides the social policy has gone through meaningful changes during the last decades, even though the adoption of the Organic Law of Social Assistance and its rules, some of the mentioned characteristics still remain, as long as the State s primacy goes on being the economic policies over the dubbed social policies. Notwithstanding, the social assistance will build up itself from the materialization of the growing of the social rights related to the State, but also assuming an important role on the amplified reproducing process regarding the capitalist social relations

Uma análise sociodemográfica dos cuidadores formais de idosos institucionalizados no município de Natal/RN, 2012

The aging population and individual have been the subject of a multitude of studies nowadays. This is probably due to the impact of this phenomenon in various sectors of society, like social security, social assistance and public health. The process of aging of the individual imply the demand for specific services, considering the limitations and vulnerabilities of the individual at that stage of life cycle. The growth of the elderly contingent in the last decades raises challenges for policymakers, the family and also for the society at large. In this scenario, long-stay institutions for the elderly (LSIEs) appear as an option to aid and support the elderly and their family, assisting in all or part in the activities of daily living and self-care. Inside these LSIEs we find the professional responsible for the direct care of the elderly, the formal caregiver. In this context, this dissertation presents two main objectives: an analysis of the phenomenon of population aging in a given brazilian municipality Natal / RN, based on the Demographic Censuses of 2000 e 2010; and a social, demographic and economic characterization of the Formal caregiver for the institutionalized elderly in the municipality, evaluating aspects of his quality of life and also analyzing the institutions where they are inserted. Furthermore, we intend to identify demographic, socioeconomic and quality of life factors that are correlated with caregivers quitting the job. The data used in the second part of this work comes from the research project named Long-Stay Institutions for Elderly: abandonment or a family need? . This survey interviewed 92 caregivers in eleven LSIEs in Natal/RN. In the data treatment logistic regressions, cluster analysis and statistical tests were used. The survey revealed that aging in Natal is more pronounced in the older, more traditional districts: Petrópolis, Lagoa Seca and Tirol. It also allowed a broad characterization of the formal caregivers in LSIEs. Most of these professionals are female. The educational level is predominantly complete high school and more. Most caregivers reported being married or in union, or have ever been in a union. Family monthly income is under three times the minimum wage. The mean age is of 37.4 years. The mean time of work as a caregiver was 5.93 years. The associations showed that being woman, not being single, having caregiving training and physical limitations (regarding quality of life) are related to wanting to quit the caregiving job. As for the characterization of the LSIEs, it was found that the philanthropic ones are older and have most (62.5%) of the institutionalized elderly. The institutions managers gave social interaction and affinity with the elderly as the main criteria with which to evaluate and hire caregivers. It is intended with this study to contribute to improving the quality of life of the elderly and their caregiver, providing information on aspects of institutionalization of elderly both in the philanthropic and particular institutions, in Natal/RN; this dissertation may also be used as a starting point for later works

O direito social fundamental de acesso à energia elétrica e a atuação estatal

Electrical energy today is an essential element in the life of any human being. Through the access to electrical energy it is possible to enjoy dignified conditions of life, having in mind the possibility of making use of minimal material conditions of life. The lack of access to electricity is directly linked to poverty and degrading conditions of life, in which are some communities in Brazil, especially the more isolated from urban centers. Access to the electric service is a determining factor for the preservation of human dignity, constitutional principle inscribe in the art.1 of the Federal Constitution, and the promotion of development, being a right of everyone and a duty of the State to promote universal access. For that reason, focuses mainly on the analysis of their setting as a fundamental social right and its importance for national development. For this, the theoretical and descriptive method was used, with normative and literary analysis, in particular the Constitution of 1988. This study also discusses the form of action of the State in the energy sector, to give effect to the fundamental social right of access to electricity, the characteristics of public service and the principles that guide it, in addition to the role of public policies in universalization of access, in particular the analysis of the Program Luz para Todos, and the function of regulation in the implementation of these policies and the provision of adequate public services.

O princípio da vedação ao retrocesso social e o papel dos poderes públicos na efetivação dos direitos fundamentais sociais

The purpose of this dissertation is to analyze the role of Public Powers in the enforcement of fundamental social rights, according to the principle of prohibition to social regression. The Federal Constitution of Brazil, situated in a position normative hierarchical superior, disciplines the legal and political process of the country, determining how Public Powers (Legislative, Executive and Judiciary) should act to enforce fundamental rights (social). Thus, features a cast of fundamental rights that aim to ensure social justice, highlighting the concern to ensure social values aimed at reducing social inequalities. The will of the state should be prevented by controlling the constitutionality of measures which restrict fundamental social rights, assuming the principle of human dignity, pillar of Social and Democratic State of Right, a dual role in the brazilian legal system, acting as the presupposition of jurisdictional control of the constitutionality of restrictive acts and as supervisory of omission or insufficient action of the State in the fulfillment of their fundamental duties. The constitutional determinations remove from the legislator the option to create or not the law that prints effectiveness to the social rights, as well as from the Executive the option of to execute or not rules directed at realization of the constitutional parameters, and Judiciary to behave or not in accordance with the Constitution, being given to the Powers only the arbitrariness of "how" to do, so that all functions performed by public actors to use the Constitution as a repository of the foundational values of the collectivity. Any situation that does not conform the principle of proportionality in relation to the enforcement of fundamental rights, especially the social, represents an unacceptable social regression unconstitutional. The constitutional rules and principles postulated by the realization of the rights, freedoms and guarantees of the human person, acting the principle of prohibition to social regression to regulate a concrete situation, whenever it is intended to change, reducing or deleting, the content of a social right. This paper of limit of state action serves to provide to the society legal security and protection of trust, ensuring the core of every social right. This should be effected to be sheltered the existential minimum, as a guarantee of the inviolability of human life, respecting the constitutional will, not falling into social regression

A Livre expressão na alfabetização de jovens e adultos: vivências em salas de aula

Cette étude a été faite à partir d une expérience d alphabétisation chez des jeunes et des adultes dans deux groupes du "Projet Réduction de l analphabétisme" realisé par l Université Fédérale du Rio Grande do Norte, le bureau du Ministere de l Éducation et la Préfecture Municipale de Natal-RN. Nous avons choisi la méthode qualitative de recherche, en utilisant l observation de la dynamique en salle de classe, considérant les acteurs sociaux comme étant le sujet actif du processus historique, culturel et politique. Nous avons voulu colaborer dans ce theme en proposant un référenciel théorique et pratique, en visant le dynamisme de la salle de classe, à travers la vision de I alphabétisation centrée sur les utilisations sociales de la lecture et de l écrit; la conception dialogique de Paulo Freire, basée sur la propre culture de l élève et sur sa valorisation en tant que sujet actif de l apprentissage ; la proposition pédagogique de Célestin Freinet dans son aspect de la dynamisation de la salle de classe renforçant le principe de la libre expression, de la colaboration, de l activité et le respect du rytme individuel, pour le succes scolaire. Nous avons rappelé que Célestin Freinet e Paulo Freire ont contribué dans la conscientisation individuelle, sociale, culturelle, politique, de l éleve par le processus scolaire. Nous avons séparé l intérêt et la participation de celles qui alphabétisent et des élêves dans ce processus éducatif. Nous avons constaté tout au long du travail des changements dans la posture de celles qui alphabétisent, surpassant les pratiques centrées dans le formalisme, et le verbalisme fruits de l Éducation traditionnelle. A vançant dans le sens de l Abordage Constructiviste de la connaissance, garantissant un climat de sécurité, de dynamisme et de respect en salle de classe