Prevalência de excesso de peso em pré-escolares na cidade do Natal

Obesity is currently considered a public health problem and there has been growing interest in the study of various aspects related to this infirmity such as: epidemiology, diagnosis, treatment, prevention and others. Thus, the purpose of this study was to determine the prevalence of weight excess and overweight in preschoolers in Natal, Brazil and relate them to variables such as gender, age, type of school (public or private) and zones of the city (east/south and north/west). This is a transversal study, carried out in Natal, Brazil between August and September 2004, in 20 public and 20 private schools/day care centers selected by the systematic sampling method. We measured the weight and height of 3721 students between the ages of 2 and 6 years. The children were stratified, according to age, into age group 1 (2 to 4 years) and age group 2 (5 and 6 years) and according to the region of the school, into north/west and east/south zones, the regions with the smallest and highest quality of life indices in the city, respectively. Children were considered to have weight excess when BMI ≥ 85th percentile, including those with BMI ≥ 95th percentile and overweight when BMI ≥ 95th percentile. The prevalence of weight excess was 26.5%, and of overweight 12.4%. There was greater prevalence of weight excess in the private schools and in the east/south zones. Overweight displayed the same epidemiologic profile, with a greater prevalence in private schools and in the east/south zones. The prevalence of weight excess in preschoolers in Natal, Brazil is high and is related, above all, to private schools and to those located in the highest quality of life areas. Therefore, prevention programs should be implanted in elementary schools in order to decrease weight excess and possible associated co-morbidities. This research project met the norms established by PPGCSa/UFRN and aimed at promoting the interrelation between different researchers and between different fields of knowledge, using multi and interdisciplinary concepts. This study was enriched by the interaction between the following professionals: pediatrician, pediatric gastroenterologist and physician nutrition specialist, pediatric endocrinologist, epidemiologist and biostatistician

Excesso de peso em região do nordeste brasileiro: contraste entre escolares de rede pública e privada de ensino

The prevalence of obesity has been increased in the last three decades. It is already considered as epidemic by the World Health Organization and reaches around 300 million people worldwide. The weight gain in all ages is related to a sedentary way of life and hyper caloric food ingestion at the modern society. Obesity is a chronic disease and leads to high blood pressure, diabetes, cardiovascular diseases and cancer. The aim of this study was to evaluate the prevalence of weight excess among student in Natal schools and to analyze its association with age, gender, school category and geographic localization in city zones. This was a transversal study which enrolled 1927 children. 1084 of these were between 6 and 8 years-old (group 1) and 843 were 9 to 10 years-old (group 2). 895 of the total children studied in private schools and 1032 studied in public schools. 33,6% of the students had body mass index equal or above the 85th percentile and were considered as having weight excess. There was no statistical difference in this prevalence considering neither gender nor age. The weight excess prevalence in private schools was 54,5% and in public ones was 15,6% (p<0,01; OR=6,49). Weight excess was also more prevalent in the south and east city zones (41,3%) which have better quality of life index than in the north and west zones (28,4%) (p<0,01). In conclusion, the weight excess prevalence among students is found to be high in Natal and programs of intervention and prevention of obesity are necessary. The higher prevalence in private schools as in the wealthier city zones reflects the link between obesity and high socioeconomic level found in countries in developing. This was an interdisciplinary work with participation of epidemiology, child nutrition and pediatric endocrinology following the recommendations and principles of the Post graduation Program in Health Sciences of the Federal University of Rio Grande do Norte

Síndrome metabólica e fatores de risco relacionados em crianças e adolescentes com excesso de peso na cidade do Natal

Nas últimas décadas, houve grande aumento da prevalência de obesidade, inclusive na faixa etária pediátrica. Com isso, aumentou o número de crianças e adolescentes afetados por síndrome metabólica (SM), diabetes tipo 2 (DM2) e doenças cardiovasculares (DCV), doenças anteriormente consideradas quase exclusivas de adultos. Os objetivos do estudo foram identificar e correlacionar marcadores antropométricos (IMC- índice de massa corpórea, CA- circunferência abdominal, RCQ- razão cintura/quadril, RCArazão cintura altura e PSE- prega subescapular), PAS e PAD- pressão arterial sistólica e diastólica, respectivamente, e laboratoriais (CT- colesterol total, HDL, LDL, TGL- triglicérides, I/G- razão insulina glicose, HOMA- homeostatic model assessment for insulin resistance) de risco para o desenvolvimento de SM e observar a sua prevalência em crianças e adolescentes com excesso de peso. Foi conduzido estudo transversal, em amostra aleatória, de conveniência, onde foram avaliadas 60 crianças e adolescentes com excesso de peso, atendidas no ambulatório de endocrinologia pediátrica do Hospital de Pediatria da Universidade Federal do Rio Grande do Norte (UFRN) com idade mínima e máxima de 7 e 15 anos, de maio de 2009 a abril de 2010. Foram admitidos os indivíduos que apresentavam sobrepeso (IMC P > 85 e < 95) ou obesidade (IMC P > 95) (CDC, 2000) e história familiar positiva para DM2 em parentes de primeiro ou segundo grau ou algum dos sinais de resistência insulínica (acantose, hipertensão arterial, dislipidemia, síndrome de ovários policísticos). 2 O componente individual para SM mais prevalente foi o percentil da CA ≥ 90 (58,3%), seguido de HDL ≤ 40 mg/dl (36,6%). Na regressão linear simples, observaram-se as variações para mais nos parâmetros laboratoriais e de PA para cada unidade de aumento de IMC, CA, RCA, RCQ e PSE, sendo significantes as seguintes correlações: CA com TGL, HOMA IR, I/G, PAS e PAD; RCQ com TGL, HOMA, I/G, LDL e glicemia; RCA com TGL; PSE com TGL, HOMA-IR, I/G e PAS; e IMC com HOMA IR, I/G, PAS e PAD. De acordo com os critérios da IDF (Federação Internacional de Diabetes International Diabetes Federation) 2007, o diagnóstico de SM foi encontrado em seis indivíduos (10%). Do total, oito (13,3%), estavam em situação de sobrepeso e 52 (86,6%), obesos. As evidências de correlação CA e RCQ, medidas de obesidade centrípeta, com vários marcadores como TGL e HOMA, já sabidamente relacionados à SM, chamam atenção para a necessidade de utilização dessas medidas de forma mais rotineira na prática pediátrica, por serem de fácil obtenção, baixo custo e método não invasivo. Os valores de CA, RCQ, RCA e PSE, quando elevados devem justificar maior detalhamento na avaliação laboratorial de possível resistência insulínica. É importante a identificação de crianças e adolescentes que preencham os requisitos para o diagnóstico da SM, pois são indivíduos de maior risco metabólico e devem ser adequadamente acompanhados.

Estilo de vida individual de universitários jovens com excesso de peso da Universidade Católica de Murcia-Espanha

Individual lifestyle includes health and risk behaviors that can altar health status. Excess weight is a public health problem of modern civilization and there is an estimated mean prevalence of 45% in European countries. In Spain, the Murcia Region is an area of high morbidity and mortality from cardiovascular disorders. In this study we assess the differences in health and risk behaviors in ove/weight and normal weight undergraduates at the Universidad Católica San Antonio de Murcia (UCAM). Methods: Transversal design of parallel groups (overweight - cases and normal weight - control) , formed using the anthropometric technique. A questionnaire applied to a sample of 471 undergraduates of either sex, between the ages of 18 and 29 years, enrolled in 4 bachelor degree courses (ADE, CA, PER, PUB) at UCAM. We performed a standardized measurement of body mass (weight in kg), height (in meters) using a Seca® scale with calibrated stadiometer, waist and hip circumferences (in cm) with an inelastic tape and skinfolds thickness (triceps and subscapular in mm) with a Holtain® caliper, to calculate body mass index (BMI), waist-to-hip ratio (WHR) and the sum of skinfolds (SSF). We applied a lifestyle questionnaire about alcohol and tobacco consumption, knowledge and behaviors related to health indicators (arterial pressure and cholesterol), diet and physical activity. The information was collected in April and May, 2001 at the UCAM laboratory of Applied Nutrition. Statistical analysis: analysis of independent groups, contingency tables that reveal which qualitativa variables show differences and associations between the groups, Pearson's chi-square,and a significance levei of p < 0.05 followed by a residual analysis (1.96). Descriptive statistics (mean and standard deviation) were used to establish the two groups: case and contrai with 65 men and 26 women each who had BMI < 25 kg/m2. Results: A total of 65 of the men assessed (14%) and 26 (6%) of the women were overweight. Mean body mass index of the case group was 27. 78 ±: 2.83 kg/m2 in the men and 26.26 ± 1.37 kg/m2 in the women, while contrai group men had mean BMI of 22.36 ± 1.72 kg/m2, while for the women it was 20.76 ±: 2.13 kg/m2. The self-declared values of weight and height were underestimated, but with high accuracy, sensitivity and specificity. Thus, these can be used to calculate the BMI of overweight Spanish undergraduates. Regular vigorous physical activity was observed only in normal weight men. The analysis showed the following significant differences for the qualitativa variables of the two groups. The contrai group was interested in arterial hypertension, believed that they were not overweight, that they had no abdominal fat, and had not considered controlling 'fatty food consumption. Those who thought of controlling it sometimes, did so without professional help. However, part of the overweight group believed that they were overweight and had abdominal fat between average and considerable, had often or always considered controlling fatty foods and had often or always tried to control consumption with the help of professionals. They had always thought of engaging in physical activities, unlike the normal weight individuals. Nearly all (95%) of the overweight undergraduates and most (75%) of the normal weight group reported that they sometimes or always controlled fatty food ingestion. Mean physical activity was nearly twice as high in the summer than in the winter. Conclusions: The overweight undergraduates in this sample displayed a lifestyle with a greater number of healthy behaviors when compared to normal weight individuals

Crescimento inicial e morfologia foliar em plantas de Enterolobium contortisiliquum (Vell.) Morong. E Erythrina velutina Mart. ex Benth, sob estresse hídrico

The Caatinga is the predominant vegetation type in semi-arid region of Brazil, where many inhabitants depend on hunting and gathering for survival, obtaining resources for: food and feed, folk medicine, timber production, etc. It‟s the dry ecosystem with highest population density in the world. The early stages of development are the most critical during the life cycle of a flowering plant and they‟re primordial to its establishment in environments exposed to water stress. Information about adjustments to the growth of the species, correlated with their studies of distribution in Seridó oriental potiguar, are an important ecological and economic standpoint, because they provide subsidies for the development of cultivation techniques, to programs of sustainable use and recovery of degraded areas. This thesis aimed to study the initial growth and foliar morphology in plants like Enterolobium contortisiliquum (Vell.) Morong. (tamboril) and Erythrina velutina Mart. ex Benth (mulungu), species of occurrence in the Caatinga, under water stress. After sowing and emergency, the seedlings were exposed to three water regimes: 450 (control), 225 (moderate stress) and 112.5 (severe stress) mm of water slide for 40 days. Seeding occurred in bags of 5 kg and after the establishment of seedlings thinning was carried out leaving a plantlet per bag. At the beginning the waterings occurred daily with distilled water, passing to be on alternate days after thinning. Twenty and forty days after the thinning seedlings collections were held to be done analysis of growth and biomass partition. When compared to the control group, the treatments with water stress showed reduction in the growth of the aerial part, growth of the greater root, number of leaves and leaflets, dry leaf area and total phytomass in both species, but in general, this effect was most marked for E. velutina. Regarding the partition of biomass, there were few changes throughout the experiment. Morphological changes in the leaves as a function of stress were not significant, however, there was a trend, in both species, to produce narrower leaves, that facilitate heat loss to the environment. It has not been possible to establish a positive relationship between inhibition of growth and distribution of species, whereas E. velutina is a species of most common occurrence in Seridó oriental potiguar. In this way, other aspects should be taken into account when studying the adaptation of species the dry environments, such as salinity, presence of heavy metals, wind speed, etc

A produção biopolítica do corpo saudável: mídia e subjetividade na cultura do excesso e da moderação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

A Produção biopolítica do corpo saudável: mídia e subjetividade na cultura do excesso e da moderação

Recognizing the plans left by Foucault as legitimate, for those that the struggle to fight against all forms of way of life subjection takes an important role on human being existence, this thesis questions the impacts of body planning on health specialized media on the production of the contemporary subjectivity. Having the Saúde! magazine as this thesis empirical field, it discusses the subjectivity processes centered on the realization of many bodily practices destined to a perfect body self-construction, finding suitable conditions for a narcissistic development of the new ways of social regulation on hypermodern societies. Our central argument, refering to a specific reflection about the body, media and subjectivity, is that the body promoting over the health specialized media makes possible the creation of new existential territories, configuring the healthy body bio-political production by a subjectivity process open to experimenting and to self-invention. Bodily subjectivity process centered on body self-construction, simultaneously generating human subjectivity singularization and massification, evidencing escape routes to build a body health existential perspective. In this thesis we seek to point not only the historically hegemonic forms of being healthy, but mainly the forces that nowadays question these forms, making possible the thought of other ways to live the health of the body, starting from the subjectivity singularization

Enfermagem na atenção primária em saúde no screening de adolescentes com excesso de peso

One of the Primary Health Care strategies for adolescent health is the growth and development follow-up and the early detection of overweight adolescents. Even though the School Health Program in Brazil proposes to evaluate the nutritional state of the school population in the corresponding community health units, not all cities have adhered to the Program and many nurses do not recognize overweight as a problem in their territory. The objective of the study was to identify the nurse´s participation in the screening of overweight adolescent students in their work territory. Cross sectional study conducted in eight state supported schools of the municipality of Natal/RN and in four Primary Health Units. The total student population was 27.277. A stratified sample was statistically calculated based on the student population of the four city geographical zones: 112 North , 74 West; 108 East; and 78 South, totalizing 372 adolescents. The students were selected by a probability process where eight schools were first selected, two per district, until the number per subsample in each district was reached. Four primary health nurses, responsible for the health units were included. Two instruments were used for data collection, a screening questionnaire and a semi-structured interview form for questioning of the nurses. The content of both instruments was validated. Anthropometric and health data were collected from the students and analyzed with descriptive and analytical statistics. Interview data were transcribed and submitted to content analysis. The nursing diagnosis of overweight was identified in 50 (13,5%) of the adolescents and its association with consumption of foods that have cardiovascular risk (canned foods, pasta and fried food). An association of the nursing diagnosis was identified with family history (diabetes, hypertension, obesity, and kidney disease). The nurses judged that care of overweight adolescents was important but noted difficulties because of the absence of this population in the health units, because of their work overload, and the lack of school articulation. The nurses do not have impacting actions with this population and delegate the responsibility to other professionals. It is concluded that overweight is a nutritional problem relevant to the adolescent school population in Natal/RN, with a 13,5% prevalence and that it is related to food consumption with cardiovascular risk and family health history. The nurses consider overweight as an important public health problem but do not envision ways to maintain linkage with adolescents and with the school to promote the needed care

Simulação numérica do fluxo hídrico subterrâneo na bacia hidrográfica do Rio Pitimbu RN

Urban centers in Pitimbu Watershed use significant groundwater sources for public supply. Therefore, studies in Dunas Barreiras aquifer are relevant to expand knowledge about it and help manage water resources in the region. An essential tool for this management is the numerical modeling of groundwater flow. In this work, we developed a groundwater flow model for Pitimbu Watershed, using the Visual Modflow, version 2.7.1., which uses finite difference method for solving the govern equation of the dynamics of groundwater flow. We carried out the numerical simulation of steady-state model for the entire region of the basin. The model was built in the geographical, geomorphological and hydrogeological study of the area, which defined the boundary conditions and the parameters required for the numerical calculation. Owing to unavailability of current data based on monitoring of the aquifer it was not possible to calibrate the model. However, the simulation results showed that the overall water balance approached zero, therefore satisfying the equation for the three-dimensional behavior of the head water in steady state. Variations in aquifer recharge data were made to verify the impact of this contribution on the water balance of the system, especially in the scenario in which recharge due to drains and sinks was removed. According to the results generated by Visual Modflow occurred significantly hydraulic head lowering, ranging from 16,4 to 82 feet of drawdown. With the results obtained, it can be said that modeling is performed as a valid tool for the management of water resources in Pitimbu River Basin, and to support new studies

Zoneamento agroclimático da palma forrageira (Opuntia sp.) para o estado da Paraíba

The cactus pear has become over the years an important forage alternative for brazilian semiarid region, especially during long periods of drought. Despite its importance for agriculture, its cultivation has dispensed basic crop practices and fundamentals technical-scientific basis about its climatic requirements. Thus, the main objective of this study was to elaborate the agroclimatic zoning of cactus pear (Opuntia sp.) for the state of Paraíba. The agroclimatic zoning of cactus pear was based on climatic indicators outlined in the literature and climatological data of precipitation and temperature (mean, maximum, and minimum) from 97 locations in the state of Paraíba. According to the results, the region of ‘Borborema’ is the most favorable for the cultivation of cactus pear. The regions of ‘Agreste’, ‘Sertão’, and coastal part of Litoral may be used but with restrictions. However, the cultivation of cactus pear is recommended throughout the state of Paraíba, except the coastal part of the Litoral and the region around Areia. In both cases, the inability is due to excessive precipitation.

Construção de bibliotecas de cDNAs subtraídos a partir das sementes de Mamona submetidas à estresse hídrico e análise in silico de transcritos potencialmente expressos sob condições de estresse: Metalotioneina, proteína reprimida por auxina de 12.5 kDa e Glutelina tipo-A3

Estresses ambientais abióticos são fatores que causam respostas ao nível molecular, fisiológico e morfológico em plantas, dependendo também de sua intensidade e duração. É visto que algumas espécies apresentam tolerância a condições estressantes e ao mesmo tempo são fontes naturais de matéria prima para indústria. Nesse contexto encontra-se a mamona (Ricinus comunnis L.), principal fonte de óleo de rícino valorizado por suas aplicações farmacêuticas e principalmente industriais, vem sendo usada como cultura em regiões onde a disponibilidade de água é reduzida, usada como fonte de renda para agricultura da região nordeste brasileira. Visto que pouco se sabe sobre as respostas moleculares que levam essa planta a tolerar regiões secas e como as sementes, principais foco de interesse, respondem a essa escassez, nesse trabalho foram construídas duas bibliotecas de cDNAs, onde a partir de uma abordagem subtrativa, continham RNAs diferencialmente expressos em sementes de plantas mamona submetidas ao estresse hídrico durante 5 dias (biblioteca L7), e a outra RNAs diferencialmente expressos em sementes controle (biblioteca L5). A biblioteca L7 apresentou a maior variedade de transcritos com um total de 182. A maior parte das funções estabelecidas pelo sistema Gene Ontology - GO, foram direcionadas aos “Processos Metabólicos” (526), em segundo “Respostas a estímulos” (57), o terceiro termo mais abundante foram referentes a “Desenvolvimento”(26). Já na biblioteca L5, foram encontrados 91 transcritos, com maior parte de suas funções referentes a “Processos Metabólicos”(413), em segundo “Respostas a estímulos” (8) e em terceiro Regulação (6). Alguns dos transcritos da biblioteca L7 foram escolhidos para análise por repetirem-se mais de 3x e não aparecerem na biblioteca L5, o que indica uma possível regulação positiva sobre estresse. As análises sobre Metalotioneína (4x), mostraram que a sequência de proteica apresentava os domínios conservados que a caracterizava como tipo II, onde são encontrados dois domínios funcionais ricos em cisteína com posições altamente conservadas, desempenhando a função de ligar-se a metais pesados, correlacionadas assim como a atividade de eliminação EROs e defesa contra o estresse oxidativo, além de apresentar homologia com a sequência de Bruguiera gymnorhiza, uma planta de mangue adaptada a ambientes salinos. Analisamos também os transcritos da referente a proteína AUXIN-REPRESSED 12.5 KDA (3x), apontada como sendo reprimida pelo hormônio auxina e associada ao processo de dormência da semente, é descrito em uma família gênica onde vários membros pertencem as vias de resposta ao estresse. Por último, analisamos a proteína GLUTELIN TYPE-A 3 (5x), uma importante proteína de armazenamento com caráter hidrofílico, possivelmente direcionada para o vacúolo. Em nosso trabalho foi possível observar um aumento de transcritos em relação a subtração controle, possivelmente reflexo do aumento do metabolismo da semente, tanto para resposta defensiva ao estresse hídrico quanto para o amadurecimento rápido da semente onde foram observados transcritos referentes a resposta oxidativa, controle hormonal, proteínas de reserva e produção de óleo.

Busca por excesso no infravermelho médio em estrelas evoluídas com fotometria WISE e 2MASS

Debris discs are commonly detected orbiting main-sequence stars, but little is known regarding their fate as stars evolve along subgiant and giant stages. Jones (2008) has found strong evidence on the presence of mid-IR excess in G and K stars of luminosity class III, using photometric data from the Two-Micron All-Sky Survey (2MASS) and GLIMPSE catalogues. While the origin of these excesses remains uncertain, it is plausible that they arise from debris discs around these stars. The present study brings an unprecedent survey in the search for mid-IR excess among single and binary F, G and K-type evolved stars of luminosity classes IV, III, II and Ib. For this study, we use WISE and 2MASS photometric data for a sample of 3000 evolved stars, complete up to visual magnitude of 6.5. As major results, we found that the frequency of evolved stars showing mid-IR WISE excess increases from the luminosity classes IV and III to luminosity classes II and Ib. In addition, there is no clear difference between the presence of IR excess in binary and single stars for all the analyzed luminosity classes.

Busca por excesso no infravermelho médio em estrelas evoluídas com fotometria WISE e 2MASS

Debris discs are commonly detected orbiting main-sequence stars, but little is known regarding their fate as stars evolve along subgiant and giant stages. Jones (2008) has found strong evidence on the presence of mid-IR excess in G and K stars of luminosity class III, using photometric data from the Two-Micron All-Sky Survey (2MASS) and GLIMPSE catalogues. While the origin of these excesses remains uncertain, it is plausible that they arise from debris discs around these stars. The present study brings an unprecedent survey in the search for mid-IR excess among single and binary F, G and K-type evolved stars of luminosity classes IV, III, II and Ib. For this study, we use WISE and 2MASS photometric data for a sample of 3000 evolved stars, complete up to visual magnitude of 6.5. As major results, we found that the frequency of evolved stars showing mid-IR WISE excess increases from the luminosity classes IV and III to luminosity classes II and Ib. In addition, there is no clear difference between the presence of IR excess in binary and single stars for all the analyzed luminosity classes.

Tatuagem: cultura de massas e afirmação subjetiva incorporadas

Como afirmar a própria subjetividade e pertenças identitárias num mundo em constante mudança pelo excesso de informação midiática e pela alternância de papéis sociais? Para jovens urbanos, o consumo cultural possibilita utilizar a imagem do próprio corpo como instância de incorporação de valores, símbolos midiáticos e expressão de subjetividade a partir de sua escolha por produtos simbólicos veiculados pela mídia da comunicação de massa e tatuados na pele. Com suporte principal em Hall, Canclíni, Morin e Le Breton, partimos do pressuposto de que não existe realidade sem representação da linguagem; assim, a opção por certos tipos de narradores midiáticos da cultura contemporânea põe em foco o simbolismo sobreposto à pele, que reproduz imagens icônicas de bandas, filmes e desenhos animados ou de quadrinhos. Essas imagens são resíduos de memórias individuais/coletivas ostentadas socialmente e que discursam sobre as relações de consumo dos sujeitos sociais e as novas sensibilidades originadas da convivência tecnologicamente midiatizada

Burocracia e comércio exterior: os desafios à exportação sob a ótica das micro e pequenas empresas exportadoras do rio grande do norte

As micro e pequenas empresas, ao mesmo tempo em que exercem um papel extremamente relevante na estrutura produtiva da economia brasileira pelo grande número de empreendedores existentes e expressivo volume de pessoal ocupado, perdem competitividade ao se deparar com entraves ao seu desenvolvimento, sejam eles em âmbito gerencial, financeiro, burocrático ou estrutural. Com base nesse contexto, o estudo procura identificar em que medida, na percepção das MPEs exportadoras do Rio Grande do Norte, as exigências burocráticas do processo exportador afetam o seu desempenho no comércio exterior. Como exigências burocráticas compreende-se o conjunto de normas, regras e procedimentos e documentos que disciplinam o processo exportador, enquanto desempenho é entendido como os resultados da atividade econômica medido através do crescimento das vendas para o mercado externo; das demandas de produtos exportados não atendidas e da ampliação do mercado internacional. A pesquisa realizada é de caráter censitário, desenvolvida junto a quatorze MPEs do estado, atuantes regularmente no comércio exterior nos últimos três anos (2009-2011), utilizando aplicação de questionário, assim como uma consulta a dados secundários disponíveis. A análise dos dados levantados revelou que, efetivamente, na percepção dos respondentes, fatores externos como o custo do processo de exportação, falta de incentivo do governo, excesso de controle dos órgãos públicos e a infraestrutura logística do estado exercem influência na pequena participação das MPEs nas exportações do Brasil e do Nordeste, enquanto o bom desempenho exportador destas relaciona-se a fatores gerenciais, com destaque para investimentos na estrutura organizacional da empresa, conhecimento do mercado internacional e bom relacionamento com clientes e mercados