Impacto da variabilidade de peso no controle matebólico de pacientes transplantados cardíacos

Heart transplantation (HT) represents one of the greatest advances in medicine over the last decades. It is indicated for patients with severe heart disease unresponsive to clinical treatment and conventional surgery, poor short-term prognosis and a 1- year mortality rate over 40%. HT has improved survival worldwide (80% in the first year, 70% in five years and 60% in ten years). However, the procedure has been associated with weight change and increased risk of secondary conditions such as diabetes, hypertension, dyslipidemia and obesity due to immunosuppressive therapy following transplantation. The objective of this study was to determine the impact of weight change on the metabolic stability of HT patients. The study was retrospective with data collected from the records of 82 adult patients (83% male; average age 45.06±12.04 years) submitted to HT between October 1997 and December 2005 at a transplantation service in Ceará (Brazil). The selected outcome variables (biopathological profile, weight and body mass index―BMI) were related to biochemical and metabolic change. The results were expressed in terms of frequency, measures of central tendency, Student s t test and Pearson s correlation coefficients. The analysis showed that following HT the average global BMI increased from 23.77±3.68kg/m2 to 25.48±3.92kg/m2 in the first year and to 28.38±4.97kg/m2 in the fifth. Overweight/obese patients (BMI ≥ 25 kg/m2) had higher average levels of glucose, total cholesterol, low-density lipoprotein and triglycerides than patients with eutrophy/malnutrition (BMI < 25 kg/m2). In conclusion, overweight/obese patients were likely to present higher average levels of glucose, triglycerides, total cholesterol and fractions than patients with eutrophy/malnutrition, indicating a direct and significant relation between nutritional status and weight change in the metabolic profile of HT patients

Rastreamento populacional para Doença de Gaucher em Tabuleiro do Norte-CE

Background. Gaucher Disease (GD) is a hereditary lysosomal storage disorder characterized by the accumulation of glucosylceramide, mainly in the cells of the reticuloendothelial system, due to a deficiency of the enzyme acid β-glucosidase (GBA). Diagnosis is usually based on measurement of GBA activity in peripheral leukocytes. The purpose of this study was to evaluate the ability of screening for GBA and chitotriosidase activity using Dried Blood Spots on Filter Paper (DBS-FP) to identify individuals at high risk for GD in high-risk populations such as that of Tabuleiro do Norte, a small town in Northeastern Brazil. Methods. Between June 1, 2007 and May 31, 2008, 740 consented residents and descendants of traditional families from Tabuleiro do Norte were submitted to screening with DBS-FP. Subjects with GBA activity <2.19 nmol/h/mL were referred to analysis of GBA and chitotriosidase activity in peripheral leukocytes and in plasma, respectively. Subjects at highest risk for GD (GBA activity in peripheral leukocytes <5.6 nmol/h/mg protein) were submitted to molecular analysis to confirm diagnosis. Results. Screening with DBS-FP identified 135 subjects (18.2%) with GBA activity <2.19 nmol/h/mL, 131 of whom remained in the study. In 10 of these (7.6%), GBA activity in leukocytes was 2.6 5.5 nmol/h/mg protein. Subsequent molecular analysis confirmed 6 cases of heterozygosity and 4 normals for GD. Conclusion. DBS-FP assay was shown to be an effective initial GD screening strategy for high-prevalence populations in developing regions. Diagnosis could not be established from GBA activity in leukocytes alone, but required confirmation with molecular analysis

Os trabalhos de amor e outras mandingas: A experiência mágico-religiosa em terreiros de umbanda

The following text addresses the magical-religious experience carried on by many individuals when they seek to solve their love, financial and health problems by means of white magic spells done by pais-de-santo e mães-de-santo (saint s father and saint s mother) from umbanda. The rites through which this seek can be detected are free love spells, troublesolving spells, and healing spell. The concept of experience, here understood as the thing which gives sense to the sense, has been the main guiding idea of the reflections here enclosed. People who seek the umbandista spells as a way of solving their daily afflictions have the opportunity of living a rich magical-religious experience in which several dimensions intersect. Among these dimensions I decided to study the performance, the knowhow and the subjetivity. Each one gave rise to the opportunity of studying a range of other themes, such as the corporeity, the gestuality, vocality, the world knowledge, the science, the secret, the emotions and the moral. The ethnographic research was carried on in the yards which are named after Dona Luiza, Pai Gledson, Pai Salviano and Dona Terezinha umbanda, all of them situated in the town of Limoeiro do Norte, Ceará

O discurso religioso no processo migratório para o caldeirão do beato José Lourenço

The Caldeirão is a site located in the city of Crato, in the south of Ceará, belonged to priest Cícero Romão Batista. There, was created a religious community led by blessed José Lourenço, who marked the life of thousands of Northeast country people in 1930s, for represent to them a space of religious conviviality, work and devotion. The Caldeirão s population was about three thousand of people, originated from states of Pernambuco, Alagoas, Paraíba, Maranhão, Piauí, Ceará and Rio Grande do Norte, who share the community s daily activities. The misery caused by the dryness and exploration of these country people by the landlords are indicated as the motivator elements of this migratory flux by the greater number of works published about the Caldeirão, turning the community into a primitive experience of class struggles. This present study proposes other comprehension of this migratory movement by the religious speech of salvation taken to country people by the counselor Severino Tavares. Was used as analysis camp the remaining norte-rio-grandenses that migrated to the Caldeirão, and as theoretical and methodological references the understanding model of investigation, the cultural history and the remaining memorial speech analysis. The work follows that pointing the phenomenon of Caldeirão as an campestral revolt is try to impose to this people the aspirations or wishes of others, besides of deny to them the right and the dignity of act by their believes and their own dreams.

Trabalho, pobreza e caridade: as ações do Padre Ibiapina nos sertões do Nordeste

This work started from an investigation concerning the process of education, moralization and disciplining of the poor in the backlands of the Brazilian Northeast region, in the second half of the 19th century, through the incorporation of the values of productive work. In order to do so, we took as our field of investigation the missions of Father José Antônio Pereira Ibiapina (1806-1883), in which an extensive work was developed, including the construction of twenty two (22) charity houses in the States of Rio Grande do Norte, Paraíba, Pernambuco, Ceará e Piauí, but also of weirs, churches, graveyards, hospitals and so forth. Given the socio-historical character of the research, we adopted qualitative methods of analysis and the following procedures: survey and analysis of documents, statute and internal rules that ordered the workings of the charity houses; biographies on Father Ibiapina and the missions‟ reports, as well as various sorts of publications on the missionary. Our study comprises his 27 year-period of missionary-religious activity (1856-1883), and undertakes an analysis on the topic of poverty, since the medieval Christian take on it until modernity, when it stops representing a value and becomes a problem to be solved through work. The socio-political context in which Ibiapina lived in the Northeast was marked by the consequence of droughts and economic crises in the region. The analysis of the documents indicates that, in the circumstances of political weakness and lack of interest for regional demands by the national political agenda, his missionary actions produced strong effects. Starting from an ethics of valorization of work, which combined modern and traditional elements, his actions set up disciplinary, moralizing and civil educational practices of the poor, founding, simultaneously, a pragmatic religious experience directed at the resolution of the problems caused by poverty. In that sense, we observe that such actions are connected to the broader process of moralization and education of the poor, but the analysis also suggests that their inscription into the social order articulated both forward as well as conservative aspects of the established system

A etnopoética de Iracema: diálogo, ciência e literatura

Literary works are thought provokers that make it possible to access several forms to view the world and reality. They provide diversified points of view and infinite connections. In a particular way, among all the other forms of art expression literature is considered to be the closest to life, once it is able to reconnect all human dimensions emotional, rational, mystic, personal, universal, corporal, historic, mythical. This thesis aims at offering some reflections about the frontiers and bridges between science and literature aiming at understanding the complexity that guides them. It presents a new reading of Iracema novel: Ceará tale of José de Alencar from a meticulous incursion through new ways and natural spaces interwoven by Alencar. It tries to hear the echoes of this indianist novel in the university students today. In a broader context, it creates arguments that question the multiple threadsthat join science and literature so that a science of complexity arises distinguishing but not separating the innumerous narratives about the world. For this purpose, this thesis has as interlocutors: Antonio Candido, Charles P. Snow, Edgar Morin, Emilio Ciurana, Fritjof Capra, George Steiner, Ilya Prigogine, Isabelle Stengers, Roger Chartier, Roland Barthes. The plot presented here does not limit the novel to science, but makes it a rereading of the word, of life, once this is the raw material of books. As a methodological strategy, we rebuilt Iracema´s character trips in a way to update the novel, resulting in the video documentary Iracema ways: the arid and remote interior, the plateau, the sea. Iracema novel and character enhancing dialogs that allow the dichotomy rupture between two cultures (Charles P. Snow), recognizing they are not incommunicable and revealing the core argument of the thesis: Iracema belongs to a complex category. It is a hybrid novel that is far, far away from that bluish plateau in the horizon

Estado desenvolvimentista e o Nordeste :o BNB na busca de um modelo de desenvolvimento regional

This research tried to follow up with the way of intervention that a developing State promotes it regional development, once its action departs from a quantitative conception until its acting focused in maintenance, like the strategy of local development input in the Northeastern of Brazil in the 90 s. particularly, the attention was focused onto Banco do Nordeste which, between 1995 and 2002, achieved a organization changing process to get fit itself to the new conception of development and State, that advocates the maintenance and the participation of the society in its accomplishment, becoming itself the main agent of the Federal Government in the Region. By taking over the strategy of local development, Banco do Nordeste starts, at least in speech, to be less of a bank to become more of a development agent , representing some development and hope to overcome the social and economical inequalities of the Region. The hypothesis that surrounds this essay is that this reorientation experienced at Banco do Nordeste is related to three factors: timing; the Institution of a project of international technical cooperation with PNUD; the unrest of an employees group, who used to fight for the acting increase of the Bank to beyond the credit acting; and, above all, the juncture created in Ceara from the second half of the 80 s, expressed, mainly, for the political rise of a group of businessmen, who took over and modernized the standards of public management in the State, transforming the cearense experience into reference in Brazil and the world. The research was developed from information got through the use of semi-structured interviews and documental research and, as complementary resource, field observation. The interviews were done with BNB managers between 1995 and 2003, some of them current administrators (2003-2006), plus one of CAPEF directors and the present president of AFBNB. The research revealed that strategic place taken by BNB in the period studied did not come to represent a rupture in its organizational culture, being strongly attached to factors that allows its operation. When some of these elements stopped existing, it was observed a retracing in the pattern of state intervention in the Region. This conclusion restates the vision of State that guided this thesis, identified as relationships field, of different interests; space where social conflicts are established; incarnated through the institutions

Estimativas de mortalidade para a região nordeste do Brasil em 2010: uma associação do método demográfico equação geral de balanceamento, com o estimador bayesiano empírico

One of the greatest challenges of demography, nowadays, is to obtain estimates of mortality, in a consistent manner, mainly in small areas. The lack of this information, hinders public health actions and leads to impairment of quality of classification of deaths, generating concern on the part of demographers and epidemiologists in obtaining reliable statistics of mortality in the country. In this context, the objective of this work is to obtain estimates of deaths adjustment factors for correction of adult mortality, by States, meso-regions and age groups in the northeastern region, in 2010. The proposal is based on two lines of observation: a demographic one and a statistical one, considering also two areas of coverage in the States of the Northeast region, the meso-regions, as larger areas and counties, as small areas. The methodological principle is to use the General Equation and Balancing demographic method or General Growth Balance to correct the observed deaths, in larger areas (meso-regions) of the states, since they are less prone to breakage of methodological assumptions. In the sequence, it will be applied the statistical empirical Bayesian estimator method, considering as sum of deaths in the meso-regions, the death value corrected by the demographic method, and as reference of observation of smaller area, the observed deaths in small areas (counties). As results of this combination, a smoothing effect on the degree of coverage of deaths is obtained, due to the association with the empirical Bayesian Estimator, and the possibility of evaluating the degree of coverage of deaths by age groups at counties, meso-regions and states levels, with the advantage of estimete adjustment factors, according to the desired level of aggregation. The results grouped by State, point to a significant improvement of the degree of coverage of deaths, according to the combination of the methods with values above 80%. Alagoas (0.88), Bahia (0.90), Ceará (0.90), Maranhão (0.84), Paraíba (0.88), Pernambuco (0.93), Piauí (0.85), Rio Grande do Norte (0.89) and Sergipe (0.92). Advances in the control of the registry information in the health system, linked to improvements in socioeconomic conditions and urbanization of the counties, in the last decade, provided a better quality of information registry of deaths in small areas

Análise da resiliência sócio-ecológica em unidades de conservação de uso sustentável: subsídios para o manejo da pesca artesanal no Brasil

O uso da biodiversidade pelo homem leva a alterações no funcionamento dos ecossistemas, podendo ainda levar a perda de resiliência. Pode-se definir resiliência como a capacidade de um sistema absorver um distúrbio e reorganizar-se, enquanto submetido a mudanças, mantendo a mesma estrutura e funcionamento. Em um sistema social, entende-se como a capacidade dos usuários de recursos naturais de enfrentar e adaptar-se as mudanças nas regras que regem o uso e acesso a estes. Alterações na resiliência, tanto ecológica quanto social, podem ser resultantes das ações de exploração e manejo destes recursos. Assim, torna-se essencial compreender como funcionam as estratégias de manejo e sua interação com a resiliência sócio-ecológica, permitindo a auto-avaliação das ações e possíveis modificações das mesmas. Neste projeto, propõe-se comparar a resiliência sócio-ecológica de três Unidades de Conservação (UCs) de uso sustentável: Reserva de Desenvolvimento Sustentável (RDS) Ponta do Tubarão, localizada no estado do Rio Grande do Norte; e as Reservas Extrativistas do Batoque e Prainha do Canto Verde, ambas localizadas no estado do Ceará. Em cada área de estudo serão escolhidas comunidades pesqueiras, permitindo a comparação entre elas. A partir destas comunidades, alguns aspectos relacionados ao uso dos recursos serão analisados, como atividade pesqueira, dieta e modo de vida. Os dados serão coletados através de questionários semi-estruturados, contendo questões baseadas em aspectos sociais, econômicos e ecológicos. Os resultados obtidos servirão de indicadores para a resiliência ecológica (informações obtidas com base na atividade pesqueira) e social (informações obtidas com base no acompanhamento da dieta e análise do modo de vida). Apesar da similaridade ecológica entre as áreas de estudo, algumas estratégias de manejo distintas em função da categoria da UC podem apresentar diferentes resultados sobre a resiliência sócio-ecológica. Desta forma, compreender como a resiliência sócio-ecológica se comporta, dentro dos sistemas de manejo estudados, permitirá avaliar a influência destes dois tipos de UCs (RDS e RESEX) na promoção da sustentabilidade ecológica e/ou social

Geração de renda e ocupações na cadeia agroindustrial de castanha de caju no Rio Grande do Norte: o caso do sertão de Apodi

This work is part of the research group studying agribusiness chains, by characterizing agroindustrial chain of cashew nuts in Rio Grande do Norte, with special emphasis on Sertão de Apodi Citizenship Territory, showing their different flows and linkages and analyzes generating jobs and income in the production of this good, from the experience of COOPAPI, using as a methodology for analyzing the input-output matrix. And this is justified by the fact that Brazil is in the context as the world's fifth largest producer of cashew nuts and the production of this product focus in the Northeast, especially the Rio Grande do Norte, which is the second largest producer of region, behind only the state of Ceará, which is the largest producer in the country. Moreover, in recent years the state has increased its insertion in international markets this product, particularly the Mossoró-Assu Territory, which constitutes the largest producer in the state, particularly the municipality of Serra do Mel, which has an arrangement different yield, based on the model of integrated rural development, embodied in family farming. Nevertheless, the Sertão de Apodi Citizenship appear as the fourth among the Citizenship territories of Rio Grande do Norte in the ranking of the production of cashew nuts, but the prevailing model of Cooperatives in the Territory, based on the Solidarity Economy, i,e, different from the old cooperative, which is based on the precepts as patronage, with cooperative owners, favor, etc.., encourages scientific research. In this, after a careful analysis of data from field research, it was noticed that among the links in the chain, the production link is what generates the most jobs, while the processing link commands to generate income, but a portion meaningful occupations and income are generated outside the territory, especially out of state RN, denouncing the gap in supply of some specific demands within the chain

Industrialização e emprego formal: uma análise para os municípios da região metropolitana do Cariri nos anos de 1990 e 2000

The Northeast has a record of fighting to reduce disparities. In late 1950, the state intervened through SUDENE, organizing and planning the promotion of development through industrialization. This study aims to identify the characteristics of the industrialization of the Northeast and evolution of formal employment in the metropolitan area of Cariri, located in the southern state of Ceará, in the case of the municipalities of Crato, Juazeiro do Norte and Barbalha (CRAJUBAR) in decades of 1990 and 2000. The assumption permeates the SUDENE with public policies to encourage the industry, causing profound changes in the cities studied. The results indicate that the Cariri since the 1960 has been benefiting the programs implemented by SUDENE. With the implementation of these programs, with in a set of circumstances based on local vocations and state policies, there was a spatial distribution industry, triggering a growth and development on the provision of formal jobs in the industrial sector

O Cariri cearense: da ocupação do território à institucionalização da região metropolitana do Cariri

Urbanization in their mearing simpler, the agglomeration of people, occurred from the time that the productive activities have to be based on trade. The first cities arose when the evolution of agriculture allowed the production and storage of surpluses. However, with industrialization was that urbanization becomes intense, according to Singer (1987), the industrial revolution was to stage, from the beginning, the urban area. It requires, in its proximity, the presence of a large number of workers. With respect to the Cariri cearense, the occupation of its territory is associated with the movement of agricultural surpluses produced and reproduced under the hegemony of merchant capital and due to the development of extensive cattle that promoted the territorial occupation of Ceará. From the 1960s, the region has undergone changes in its productive structure due to industrial planning policies of the government of Ceará. However it was in the 1990s that the region itself as economic and urban polo because policies to attract investments from the state government of Ceará. This policy led to boosting trade and services marking the predominance of tertiary activities in the region, especially the retail, wholesale , medical services and education. Investments also consolidated the industrial park area making it diverse, especially the footwear industries, mining, non-metallic minerals, transport equipment, pharmaceutical chemical, food and beverages, rubber and leather and construction. Thus, the aim of this study was to review the region of Cariri cearense occupation of its territory institutionalizing its metropolitan region, to understand what factors influenced the Cariri cearense become an important area in urban and economic terms in the interior of Ceará. In order to develop this research in that refers to the methodological perspective, research is guided by bibliographic studies and also makes use of secondary data analysis (population, GDP, urbanization rate, employment) of the main databases the country, as IBGE, IPEADATA and RAIS - MTE

Habitus, representações sociais e construção identitária dos professores de Maracanaú

In the last three decades, the subject of the teacher's social identity has been discussed under various theoretical focuses, not only in Brazil, but also beyond our borders. In this thesis, the theme is approached starting from the theoretical proposal that has been developed by Domingos Sobrinho (1994), which is strongly based in the epistemological approach between Pierre Bourdieu’s praxiology and the Theory of the Social Representations formulated by Serge Moscovici. It presupposes that this would make it easier to apprehend the process of construction of social identity of the investigated social group. The universe of the research is constituted by teachers of the fundamental teaching of the municipal district of Maracanaú, state of Ceará, that were active in class-room work there during at least three years, and were registered or had concluded the Course of Educational Formation promoted by UECE in that municipal district. Taking into account that the teacher's social identity is a process in permanent construction, resulting of their daily experiences and of the interferences originated from of the social context, the investigative tasks were implemented in two different stages, although they complement each other. Initially, with the objective of putting in evidence the genesis of the formation of that group’s habitus, an analysis of the family and school lives of eleven teachers who participated in the course was made, using as main sources of data: thematic memorials, semi-structured interviews and observations - inside and out of the class-room – during four school semesters. In the second stage a test of free association of words was applied to 426 teachers, seeking to apprehend the structure of the social representations of family and school – a methodological strategy considered necessary to enhance and identify certain outlines of the habitus in study, besides being in agreement with the theoretical model followed. It became evident from the results that the identity of Maracanaú’s teachers is molded and transformed into a multifaceted dynamic unit that shows successes and mistakes, certainties and doubts. For instance, besides an innovative speech seeking to reassure that teaching is a profession and not a simple vocation or mission, some discourse and attitudes are identified that point to the opposite direction, extolling the school as extension of the family, defending a parental relationship with the students, and looking at certain aspects of daily school life as “sacramental”. However, in the light of science such ambiguities and incoherences are inherent to common sense discourse, where the influences of the patterns and cultural references are present in the process of identity construction of the group, which was confirmed by the research of their social representations of family and school

Avaliação da aprendizagem no no contexto dos ciclos: sentidos da prática avaliativa docente

The present paper analyses matters about the assessment in the context of the school organization in cycles. The complexity that involves the assessment turns it into a difficult subject, since the evidence that the model supported by the traditional approach contributes to foil the fulfillment of new continuous and wide-ranging assessment practices, that are coherent with a view of learning as a process established in the student-teacher-knowledge interaction. This paper has as guidance the following questions: How did the introduction of the teaching organization in cycles happen in Fortaleza/ CE? How far are the teachers prepared to the introduction of the cycles system, specially in the way of thinking and practicing the assessment? What are the teacher s involvements with this project and with the continuous assessment in the cycles? What meanings do the teachers give to the assessment in this project? Therefore, were determined as objectives: to comprehend the meanings attributed to the learning assessment by the teachers in contact with the cycles in Fortaleza/CE; to identify assessment practices that are closer to a less qualifying perspective, more related to the students learning and to the educational intervention in order to improve this process. The methodological orientation chosen was based on the presuppositions of the comprehensible interview, with reference to the studies of the French sociologist Jean Claude Kaufmann, developed with 15 (fifteen) teachers of 15 (fifteen) schools of the state teaching system of Fortaleza/CE. It was considered, in the methodology, the word as a central fact in the consolidation of the object of study, what allows to conceive the teachers as active participants of this research and of the discussions about assessment. The analysis about the speeches in the interviews made possible to glimpse the meanings attributed to the learning assessment that are not related to the traditional paragon, in spite of the dilemma in which the participants of the research faced at the time of the introduction of the cycles in Fortaleza/CE. These meanings were created between the presence and the absence of the teachers knowledge that, in their way, interact with the changes caused by the obligation of the teaching organization in cycles, seeking a strategy of self-organization as a consequence of the search for new knowledge connected with the teaching

Agir, aprender, formar, intervir, agir uma experiência dos consultores internos na gestão do conhecimento da Petrobrás UN-RNCE

This research aims at studying the formation of internal consultants in organizational setting in the joint resolution of problems, around the conversion of knowledge. The objective of research is to understand and explain the meanings attributed by Petrobras internal consultants to their practice and training for the conversion process of tacit knowledge into explicit, around the joint resolution of their problems with their collaborators. It has directed the next question: what the meanings assigned by the consultants of Unidade de Negócios Rio Grande do Norte e Ceara (UN-RNCE) in Knowledge Management (KM), for their interventionist and formative practices in problem solving, as well as conversion of tacit knowledge in explicit? This paper has assumed that there is a dual logic integrated into its daily practices: solving troubles and converting knowledge. The thesis has considered the daily practices of these consultants are characterized as epistemic spaces and permanent education through the conversion of knowledge. It has adopted the principles of multi-referential approach as foundations, regarding the translation of a variety of angles, perspectives and prospects which allow the interpretation and understanding of complex issues that are part of conversion of knowledge. The understanding and explanation of the senses are based on the methodology of the comprehensive interview; taking ownership is the sensitive listening for comprehensive interpretation of oral discourses of ten consultants, in addition to the autoscopy that putting into practice, thus, the stance of the researcher as an intellectual craftsman. Furthermore, it has assessed that the limits and possibilities for training and learning in the conversion of knowledge arise, on one hand from a predominantly driven training culture by the paradigm of technical rationality and one the other hand, from a set of relationship to knowledge and relation to know , revealed in the search for training in other dimensions. There are tensions between the local and global demands located in a situation marked by a systemic organization of knowledge. However, the context is perceived by researchers as impregnated by the discontinuity, unpredictability and uncertainty; mobilizing a number of elements necessary for the mediation in training practices of these consultants. Finally, it has set an instrumental and technological support, restricting the formation and undermining the position of the consultancy as nuclear function in Knowledge Management