Síndrome metabólica e fatores associados: estudo comparativo com mulheres que apresentaram pré-eclâmpsia e gravidez normal, acompanhadas cinco anos após o parto

Preeclampsia is defined as an extremely serious complication of the pregnancy-puerperium cycle with delayed emergence of cardiovascular risk factors, including metabolic syndrome. The research aimed estimate the prevalences of metabolic syndrome and associated factors in women with preeclampsia and normal pregnancy followed five years after childbirth. This is a cross-sectional observational study using a quantitative approach, conducted at a maternity school in the city of Natal in Rio Grande do Norte state. The sample was composed of 70 women with previous preeclampsia and 75 normal selected by simple random probability sampling. Subjects were analyzed for sociodemographic, obstetric, clinical, anthropometric and biochemical parameters. International Diabetes Federation criteria were adopted to diagnose metabol ic syndrome. The Kolmogorov-Smirnov, Mann-Whitney, Student s t, Pearson s chi-squared, and Fisher s exact tests, in addition to simple logistic regression, were used for data analysis, at a 5% significance level (p ≤ 0.05). Statistical tests demonstrated elevated body mass index (p = 0.001), predominance of family history of diabetes mellitus (p = 0.022) and significantly higher prevalence of metabolic syndrome in the preeclampsia group (37.1%) when compared to normal (22.7%) (p = 0.042). Intergroup comparison showed a high number of metabolic syndrome components in women with previous preeclampsia. Altered systolic and diastolic blood pressure (p < 0.001) was the most prevalent, followed by low concentrations of high-density lipoproteins (p = 0.049), and hyperglycemia (p=0.030). There was a predominance of the metabolic syndrome in women with schooling 0-9 years (42.4%) (p = 0.005), body mass index above 30Kg.m 2 (52.3%) (p < 0.001), uric acid high (62.5%) (p = 0.050 and family history of hypertension (38.5%) (p< 0.001). Multivariate analysis of the data showed that the body mass index above 30 kg.m2, education level less than 10 years of study (p < 0.001) and family history of hypertension (p = 0.002) remained associated with the metabolic syndrome after multivariate analysis of the data. It is considered Women with previous preeclampsia exhibited high prevalence of metabolic syndrome and their individual components in relation to normal, especially, altered systolic and diastolic blood pressure, low concentrations of high-density lipoproteins and hyperglycemia. The factors associated to this ou tcome were obesity, less than 10 years of schooling, and family history of hypertension. Overall, this study identified young women with a history of PE exposed to a higher cardiovascular risk than normal

Estado e sociedade civil no Acre (1970-1980)

The relation between State and civil society is not a very recent discussion, but it does not mean that debate is exhausted, since is in the historical context that the novelty is seized. Thinking like this, we may analyze how the relation between state and civil society happened in Acre during the decade of 1970. But, to understand how this relation is established in faraway Acre, we have available to the reader historical analyses, in a tireless attempt to clarify minimally aspects that characterize acreana society. To do this, we take on as a departure point, in general not differentiating of the given structure at national level, the conformation of this society was guided in a passive revolution, in another way, by high transformismo, relegating to the civil society, which is incipient, pífia a simple participation in the hegemonic policy direction. All this brings us to the thought that both state bureaucracy structure and the civil society organization, were influenced decisively for a traditional political elite. In addition, we begin the work with the lifting bibliographic reference searching and then we analyze the empirical reality, such as newspapers, official media publications and private, a few documents and last, interviews with political actors associated with the process consolidation of civil society in the 1970 decade. The interviewees were selected, firstly for their location in the region, and for their outstanding contribution to the consolidating process of recent Acre history. Thus, the interviews followed up on a semi-structured way, leading up, also, for the informations that the interviewees would have to pass on. The systematization and analysis of these surveys have shown us that, in the period before of the Acre Federal State lifting had, of course, a transformismo by high, but at 1970decade, the society with a more heterogeneous social formation, is not allowed, or at least, organize itself, to counter a systematic imposition. Thus, the hegemonic area of dispute between State and civil society occurs from the "reconciliation" with the adoption of public policies that amenizasse the dispute between both spheres, and to build up some bodies, settling a acreana civil society.

Ordem econômica e política nacional de recursos hídricos: hermenêutica constitucional para o desenvolvimento sustentável

This research proposes a study about the interpretative techniques application that are compatible with the national legal system under the principles for Sustainable Development characterized in Brazilian Constitution. It verifies the actual possibility of reconciliation between national development and environment protection, with reflections under the water legal protection. It was proposed, therefore, to point subsidies for jurisdictional decisions involving development and the environmental goods, protected as constitutionally guaranteed principles. It was assumed that, both development and environment protection represents basic rights that are eventually placed in conflict situations, considering the many legitimate economic activities within the Brazilian State. A representative case analysis was elected within the current national scene, detailing the judicial and political conflict involving the Transboundery water Project from the São Francisco River Basin to another Northeastern river basin in Brazil. The implementation of several constitutional principles with elements from legal hermeneutics provides subsidies for the legal analysis about the conflict between development and environmental protection. It was assumed that the main discussion item about rights due to development today is the institutions influence and their results, among them the rules, laws and interpretative elements for the constitutional text objectivity, as the institutions credibility and the Supreme Courts interpretations. The use of interpretative resources for specific conflict situations about constitutional principles by Superior Courts, on the search, would bring a contributory factor for decision safety, related to sustainable development principles, elimination of inequalities and regional protecting for the environment. Specific aspects of Law No. 9.433/97 that introduced the National Water Resources Policy were examined, with its instruments, in order to specifically contextualize aspects of the Brazilian water resources management politics

Contribuições de uma unidade de ensino potencialmente significativa UEPS para o ensino de ecologia em escola pública da educação básica

The research aims to evaluate the contributions of a teaching unit to enhance the learning contents ecological green areas in elementary school. The work was conducted with elementary students in a public school in Natal-RN. We sought to identify the students´ previous knowledge about the contents of ecology, develop and implement a Potentially Meaningful Teaching Units PMTU; assess learning of ecological concepts in Teaching Unit Potentially Significant; assess the contribution of interpretative trail as strategy teaching to learning content ecology. The survey of students´ previous knowledge through the pre-test was essential to identify the appropriate subsumers and partially correct, since they served as "anchor" for further expansion of scientific concepts contained in this research. The green areas of the school as an educational, contributed the motivational aspect, as students were protagonists throughout the entire process of teaching and learning. The method of stimulated memory was effective to evidence learning ecological concepts in interpretive trails. The use of diverse activities organized on a PMTU promoted intellectual autonomy of the students and facilitated the acquisition of new meanings through progressive differentiation, and integrative reconciliation consolidation of ecological content and concepts related to biotic and abiotic factors on the basis of the central ideas thematic Life and Environment. The development of procedural skills to capture and share meanings, observe, collect and record data, hypotheses, ability to explain, to apply knowledge to solve problem situations, argue, identify, compare, differentiate and relate concepts, negotiate meanings, reflecting Critically, systematize data was evidenced. Collaborative activities promoted the incorporation of attitudinal contents as developing respect for differences, learn to work in teams to plan, develop and implement actions together for citizenship and environmental responsibility. The application of the Potentially Meaningful Teaching Units PMTU showed evidence of Critical meaningful learning ecological concepts covered in elementary school.

O efeito da dessincronização circadiana sobre o metabolismo

The lost of phase relationship between rhythms and behaviour can, and often do, undesirable consequences. The purpose os study was to ascertain the effect of circadian desynchronization in T22 about metabolism of wistar rats. The subjects consisted of 24 animals separated in two groups: control (n=12) T24 with 8 weeks of aged and experimental group (n=12) T22, also with 8 weeks of aged. Both the groups were subject to register of locomotor actitivity, body temperature, body weight and food intake in all the experiment. And more, both the groups were subject to food deprivation, running in treadmill and forced swimming. The results show rhythm of locomotor activity and body temperature desynchronized. Dont exist diference in body weight between both the groups (T24 = 386,75±40,78g e T22 380,83±44,28g) . However, the food intake was different between the phases, light and dark, in intergroup and intragroup. The body temperature was not different in food deprivation. The same ocurred for running in treadmill and forced swimming. Since similar alterations occur in shift workers, it is proposed that the experimental paradigm presented in this manuscript is a useful model of shift work. That is, alterations in activity/rest cycles and consummatory behavior can affect the health of organism

Uma abordagem para evolução e reconciliação de linhas de produtos de software clonadas

Software product line engineering promotes large software reuse by developing a system family that shares a set of developed core features, and enables the selection and customization of a set of variabilities that distinguish each software product family from the others. In order to address the time-to-market, the software industry has been using the clone-and-own technique to create and manage new software products or product lines. Despite its advantages, the clone-and-own approach brings several difficulties for the evolution and reconciliation of the software product lines, especially because of the code conflicts generated by the simultaneous evolution of the original software product line, called Source, and its cloned products, called Target. This thesis proposes an approach to evolve and reconcile cloned products based on mining software repositories and code conflict analysis techniques. The approach provides support to the identification of different kinds of code conflicts – lexical, structural and semantics – that can occur during development task integration – bug correction, enhancements and new use cases – from the original evolved software product line to the cloned product line. We have also conducted an empirical study of characterization of the code conflicts produced during the evolution and merging of two large-scale web information system product lines. The results of our study demonstrate the approach potential to automatically or semi-automatically solve several existing code conflicts thus contributing to reduce the complexity and costs of the reconciliation of cloned software product lines.

Humanização do direito e da justiça: reconhecimento e efetividade dos direitos da criança e do adolescente

The crisis of the model of technical and formal rationality is discussed in light of a paradigmatic change of the Law that arises in the context of recent transformations of capitalism worldwide, proposing a humanization of Law and Justice with a new ethical-political foundation that promotes a reconciliation between the rules that governs the social order and the world of life, a process of society’s emancipation. As empirical cut it is taken the Right of Children and Youth and, in a practical perspective, the recognition and effectiveness of the Rights of Children and Adolescents in Brazil. It is proposed to analyze the process of democratization and legitimacy of the children and youth rights from the study and apprehension of knowledge that advocate a multidisciplinary view of knowledge and a dialogic praxis for construction of a thought able to contribute to the analysis of public policies and to develop strategies that allow a real change on the social thinking about the doctrine of integral protection of children and adolescents. The proposed methodological approach was developed from a dialectical view of science and as a research strategy for data collection of symbolic cartography or cartographic sociology of law and justice. It is shown that in the process of humanization of the Law and Justice there is a gap between the rights and the democratic participation of these rights.

A influência da relevância social no viés de grupo

Behaviors found in every culture, general human tendencies, are knew in Evolutionary Psychology as evolved psychological mechanisms. Those behaviors date back the Environment of Evolutionary Adaptedness, and a well know example of such behavior is the group bias (or intergroup bias). This bias consists of recognizing members of your own group and favor them, while disregarding or even harming outsiders. This behavior was and still is extensively studies, among the most important conclusions about this phenomenon is the Minimal Groups Paradigm, in which it was discovered that the group bias could trigger even when the groupings were done in following very arbitrary criteria. In the current study, our goal was to test if the participants, when playing an economic game, would behave in a similar fashion under a minimal group situation and real groups, with social meaning. With this in mind we made two experimental conditions, a Low Social Meaning one (LSM) where the groups were represented by letters (H, B, O and Y) in which participants would be ramdomly assorted to each group; and the High Social Meaning condition (HSM) in which religion was used as a group marker, containing the two most dominating religious groups in Brazil, catholic and evangelic, another group containing all the other affiliations e the fourth and last group representing atheists and agnostics. The ratio of donations in-group/out-group was roughly the same across both conditions. However, the amount of wafers donated to ingroup was significantly bigger in the HSM condition. By verifying which aspects of the individual best predicted the observed group bias, we discovered that the in-group Entitativity perception as well as the Group Identification were the most relevant variables, however, only in the HSM condition. Simultaneously, by verifying the generosity, biased or not, we observed that the agreeableness personality factor was the only variable able to predict it, and only in the LSM condition. We conclude that our generosity, or the lack of it, is for most part defined by our personality, the Agreeableness factor in particular. But this very generosity can be biased by the social meaning of the involved groups and that, if the social meaning is big enough, even people who, thanks to their personality, normally wouldn’t show generosity, are able to do so when the receiver is an in-group member.

Avaliação da efetividade do Programa de Alimentação do Trabalhador

This study analyzed the Worker’s Healthy Eating Program in Rio Grande do Norte state (RN) to assess its possible impact on the nutritional status of the workers benefitted. To that end, we conducted a cross-sectional observational prospective study based on a multistage stratified random sample comparing 26 small and medium-sized companies from the Manufacturing Sector (textiles, food and beverages, and nonmetallic minerals) of RN, divided into two equal groups (WFP and Non WFP). Interviews were conducted at each company by trained interviewers from Tuesday to Saturday between September and December 2014. Data were collected on the company (characterization and information regarding the program’s desired results) and workers (personal and professional information, anthropometrics, health, lifestyle and food consumed the previous day). Population estimates were calculated for RN on the characteristics of workers and the study variables. The main variable was BMI. The secondary variables were waist circumference (WC), nutritional diagnosis, calorie intake, blood pressure, metabolic variables and lifestyle indicators. The statistical method used was hierarchical mixed effects linear regression for interval variables and hierarchical mixed effects logistic regression for binary variables. The variables measured in ordinal scales were analyzed by ordinal logistic regression adjusted for correlated variables, adopting robust standard errors. The results for interval variables are presented as point estimates and their 95% confidence intervals; and as odds-ratios and their 95% confidence intervals for binary variables. The Fisher’s exact and Student’s t-tests were used for simple comparisons between proportions and means, respectively. Differences were considered statistically significant at p<0.05. A total of 1069 workers were interviewed, of which 541 were from the WFP group and 528 from the Non WFP group. Subjects were predominantly males and average age was 34.5 years. Significant intergroup differences were observed for schooling level, income above 1 MW (minimum wage) and specific training for their position at the company. The results indicated a significant difference between the BMI of workers benefitted, which was on average 0.989 kg/m2 higher than the BMI of workers from the Non WFP group (p=0.002); and between the WC, with the waist circumference of WFP group workers an average of 1.528 cm larger (p<0.05). Higher prevalence of overweight and obesity (p<0.001) and cardiovascular risk (p=0.038) were recorded in the WFP group. Tests on the possible effect of the WFP on health (blood pressure and metabolic indicators) and lifestyle indicators (smoking, alcohol consumption and exercise) were not significant. With respect to worker’s diets, differences were significant for consumption of saturated fat (lunch and daily intake), salt (lunch, other meals and daily intake) and proteins (other meals and daily intake), with higher consumption of these nutrients in the WFP group. The study showed a possible positive impact of the WFP on nutritional status (BMI and WC) among the workers benefitted. No possible effects of the program were observed for the lifestyle indicators studied. Workers benefitted consumed less salt, saturated fat and protein. The relevance of the WFP is recognized for this portion of society and it is understood that, if the program can reach and impact those involved, the development of educational initiatives aimed at nutritional and food safety may also exert a positive influence.

Avaliação sistemática de uma abordagem para integração de funcionalidades em sistemas web clonados

The software product line engineering brings advantages when compared with the traditional software development regarding the mass customization of the system components. However, there are scenarios that to maintain separated clones of a software system seems to be an easier and more flexible approach to manage their variabilities of a software product line. This dissertation evaluates qualitatively an approach that aims to support the reconciliation of functionalities between cloned systems. The analyzed approach is based on mining data about the issues and source code of evolved cloned web systems. The next step is to process the merge conflicts collected by the approach and not indicated by traditional control version systems to identify potential integration problems from the cloned software systems. The results of the study show the feasibility of the approach to perform a systematic characterization and analysis of merge conflicts for large-scale web-based systems.

Efeitos imediatos da plataforma vibratória no desempenho neuromuscular do quadríceps femoral, após reconstrução do LCA: ensaio controlado, randomizado e cego

Objective: to investigate the immediate effect of the vibrating platform on the neuromuscular performance of the quadriceps femoris and on the postural oscillation of subjects submitted to Anterior Cruciate Ligament (ACL) reconstruction. Materials and methods: this study is a randomized and blind clinical trial. Forty-four male volunteers (average age of 27,4 ±6,2 IMC of 26,85± 3,8 Kg/m² and post surgery timeframe of 17± 1,4 weeks) were randomized into two groups: OFF platform (n=22, protocol of exercise over the vibrating platform off) and ON platform (n=22 protocol of exercise over the vibrating platform on, 50Hz frequency and 4mm of amplitude). All volunteers were submitted to assessment the isokinetic evaluation of the quadriceps femoris (isometric and isokinetic at 60°/s) and of the electromyography activity of the muscles Vasto Lateralis (VL) and Vasto Medialis (VM), besides the postural oscillation (baropodometry) in two distinct moments: before and immediately after the intervention protocol. The data was analyzed through the SPSS 20.0 software, with a 5% significance level. To verify the homogeneity of the groups it was used an ANOVA one way, and a ANOVA mixed model to compare the intra and inter groups. Results: it was observed differences between the pre and the post, to latero lateral velocity, isometric torque peak and total work in comparison with intragroup. However, it wasn’t verified any difference in comparing the intergroup in the preevaluation and in the post-evaluation protocol over the vibrating platform. Conclusion: the use of the vibrating platform doesn’t change as an immediate manner the isokinetic performance of the quadriceps femoris, the electromyography activity of the VL and the VM, also doesn’t interfere with the postural oscillation of individuals that were submitted to the ACL reconstruction.

Resposta clínica periodontal e controle glicêmico em pacientes com e sem diabetes tipo II portadores de periodontite crônica ao tratamento periodontal “full mouth desinfection”

There is a bidirectional association between periodontal disease (PD) and diabetes mellitus, in which diabetes favors the development of PD and PD, if left untreated, can worsen the metabolic control of diabetes. Thus, periodontal disease should be treated to restore periodontal health and reduce the complications of diabetes. Therefore, the objective is assess the effect of full mouth periodontal therapy decontamination (Full Mouth Desinfection - FMD) in diabetic type II patients with chronic periodontitis during 12 months. Thirty-one patients in group one (G1) and 12 in group two (G2) were followed at baseline, 03, 06 09 and 12 months. There following clinical parameters were accessed: probing on bleeding (BOP), visible plaque index (PI), probing depth (PD), clinical attachment level (CAL) and gingival recession (GR). For diabetic patients, there were also made laboratory tests to evaluate blood parameters: fasting glucose and glycated hemoglobin. The results had been analyzed in two ways: all sites in the mouth and another with diseased sites. The Mann-Whitney, Friedman and Wilcoxon tests were used with 5% significance. Intergroup analysis of all sites it is clear that there was no significant difference over time concerning PD, BOP, PI, CAL and RG. However, when evaluating the diseased sites, we observed significant difference for CAL and PD, with higher values in G1. The intragroup analysis for all sites showed a statistically significant reduction at PD, PI and BOP in both groups. Intragroup analysis of periodontal affected sites showed a statistically significant reduction in PD, BOP and CAL in both groups. There was also a statistically significant increase in RG values. There was no significant change concerning glycated hemoglobin and fasting glucose in the G1. Therefore, it can be concluded that there were improvements in periodontal parameters over the 12 months of research, but without changes in glycemic levels of diabetic patients. Thus, periodontal therapy proved effective in maintaining oral health.

Efeitos do treino de marcha em esteira com adição de carga ao membro inferior não parético de indivíduos com acidente vascular cerebral: ensaio clínico controlado e randomizado

Introduction: Gait after stroke is characterized by a significant asymmetry between the lower limbs, with predominant use of the non-paretic lower limb (NPLL) over using the paretic lower limb. Accordingly, it has been suggested that adding load/weight to the NPLL as a form of restricting the movement of this limb may favor the use of the paretic limb, reducing interlimb asymmetry. However, few studies have been conducted up to this moment, which only investigated the immediate effects of this practice. Objectives: 1) Investigating whether there is an influence of adding load to the NPLL during treadmill training on cardiovascular parameters and on gait performance of individuals with stroke, compared to treadmill training without load addition; 2) Analyzing the effects of treadmill training with and without load added to the NPLL on kinematic parameters of each lower limb during gait; 3) Analyzing the effects of treadmill training with and without load added to the NPLL on measurements of functional mobility and postural balance of these patients. Materials and Methods: This is a randomized single blinded clinical trial involving 38 subjects, with a mean age of 56.5 years, at the subacute post-stroke phase (with mean time since stroke of 4.5 months). Participants were randomly assigned into an experimental group (EG) or control group (CG). EG (n= 19) was submitted to gait training on a treadmill with the addition of load to the NPLL by ankle weights equivalent to 5% of body weight. CG (n= 19) was only submitted to gait training on a treadmill. Behavioral strategies which included home exercises were also applied to both groups. The interventions occurred daily for two consecutive weeks (Day 1 to Day 9), being of 30 minutes duration each. Outcome measures: postural balance (Berg Functional Balance Scale – BBS), functional mobility (Timed Up and Go – TUG; kinematic variables of 180° turning) and kinematic gait variables were assessed at baseline (Day 0), after four training sessions (Day 4), after nine training sessions (Day 9), and 40 days after completion of training (Follow-up). Cardiovascular parameters (mean arterial pressure and heart rate) were evaluated at four moments within each training session. Analysis of variance (ANOVA) was used to compare outcomes between EG and CG in the course of the study (Day 0, Day 4, Day 9 and Follow-up). Unpaired t-tests allowed for intergroup comparison at each training session. 5% significance was used for all tests. Results: 1) Cardiovascular parameters (systemic arterial pressure, heart rate and derivated variables) did not change after the interventions and there were no differences between groups within each training session. There was an improvement in gait performance, with increased speed and distance covered, with no statistically significant difference between groups. 2) After the interventions, patients had increased paretic and non-paretic step lengths, in addition to exhibiting greater hip and knee joint excursion on both lower limbs. The gains were observed in the EG and CG, with no statistical difference between the groups and (mostly) maintained at follow-up. 3) After the interventions, patients showed better postural balance (higher scores on BBS) and functional mobility (reduced time spent on the TUG test and better performance on the 180° turning). All gains were observed in the EG and CG, with no statistically significant difference between groups and were maintained at follow-up. Conclusions: The addition of load to the NPLL did not affect cardiovascular parameters in patients with subacute stroke, similar to treadmill training without load, thus seemingly a safe training to be applied to these patients. However, the use of the load did not bring any additional benefits to gait training. The gait training program (nine training sessions on a treadmill + strategies and exercises for paretic limb stimulation) was useful for improving gait performance and kinematics, functional mobility and postural balance, and its use is suggested to promote the optimization of these outcomes in the subacute phase after stroke.