Influência de fatores biopsicossociais sobre a mortalidade de idosos no município de Santa Cruz/RN: um estudo prospectivo

The aging process if characterizes for a complex events network, from multidimensional nature, that encloses biological, social, psychic and functional aspects. The alteration of one or more aspects can speed up the aging process, anticipating limitations and until the death in the aged. For an adjusted confrontation of this question is necessary an interdisciplinary vision, in which the some areas of the knowledge can interact and with this to intervenes of the best possible form. Then, information derived from studies of aspects related to incidence, morbidity-mortality and transition patterns, involved in the health-illness process can more accurately identify risk groups thereby establishing links between social factors, illness, incapacity and death. Thus, this study aimed to identify, by a multidimensional vision, the risk factors of mortality in a coorth of elderly in a city in the interior of the state of Rio Grande do Norte (RN), Brazil. A prospective study carried out in Santa Cruz RN, where 310 elderly were randomly selected to form a baseline. The follow-up was 53 months. The predictive variables were divided into sociodemographic, physical health, neuropsychiatric and functional capacity. The statistical analysis carried out by bivariate analysis, survival analysis, followed by binary logistic regression and Cox regression, in the multivariate analysis, considering significant levels p < 0.05 and confidence interval (CI) of 95%. A total of 60 (19.3%) elderly died during the follow-up, where cardiovascular disease was the main cause. The survival was approximately 24.8 months. The study of general survival showed, at 12, 24, 36, and 48 months of observation, a survival rate of 97%, 54%, 31%, and 5% respectively, with a statistical difference in survival only observed for the variables of cognitive function and Basic Activities of Daily Living. In the logistic regression analysis, the risk factors identified were cognitive deficits (OR = 8.74), poor perception of health (OR = 3.89) and dependence for Basic Activities of Daily Living (OR = 3.96). In the Cox analysis, as well as dependence for Basic Activities of Daily Living (HR = 3.17), cognitive deficit (HR = 4.30) and stroke (CVA) (HR = 3.49) continued as independent risk factors for death. The risk factors found in the study can be interpreted as the primary predictors for death among elderly members of the community. Therefore, improvements in health conditions, with actions towards sustaining an autonomous life with special attention for elderly with cognitive impairment, could mean additional healthy quality of life, resulting in the reduction of premature mortality in this population

Periurbanização da leishmaniose visceral e emergência da coinfecção HIV/leishimania, no Rio Grande do Norte

Visceral leishmaniasis (VL) has undergone changes in terms of clinical and epidemiological presentation worldwide. Urbanization has been described in different regions of Brazil and the world, as well as in the state of Rio Grande do Norte. These changes have impacted in the clinical outcome of Leishmania infection. A new clinical entity called co-infection of HIV/Leishmania has been described as a consequence of overlapping areas of occurrence of VL and HIV / AIDS in different countries including Brazil. The aim of this study was to define the process of periurbanization of the LV and describe a case series of co-infection HIV / Leishmania in Rio Grande do Norte. A new demographic pattern of VL was detected, with an increase in the number VL adult male subjects. Analysis of spatial distribution of VL in the state of Rio Grande do Norte showed that in the past 20 years VL tends to occur in larger cities and therefore the highest risk disease is greater in the eastern and western regions. The first region included Natal, the state capital, where the process of suburbanization began in 1990, and more recently the city of Mossoró, the second largest state, where periurbanization began in the last five years. In 1990, the emergence of co-infection HIV/Leishmania in the state was observed. Case-control study revealed that the new clinical entity affects adult males, who acquired HIV through sexual intercourse, 40% of those with a preivous history of leishmania infection Relapse and death from LV is increased in HIV positive compared with HIV-negative patients matched by sex and age. This pattern is similar to the observed in Europe, except of the route of transmission, where in Europe occured concomitantly, by parenteral route in drug users. Analysis of spatial distribution identified overlapping new areas of occurrence of HIV / AIDS and LV potentially signaling to increased risk of this new clinical entity as described above. Therefore, epidemiological surveillance for co-infection HIV / Leishmania should be adopted in all areas of risk of VL. At the same time, it is necessary to evaluate drug resistance currently used in the treatment of VL, as well as parenteral transmission of L infantum/ chagasi in areas where drug dependence is a risk factor for HIV acquisition

O erotismo mítico da ninfeta

This dissertation establishes a viewpoint in the Social Cience Field of the Nymphs image in the romanesque construction of the twentieth century based in modern archaeology. Our literary corpus is constitututed by the book of the russian author callled Wladimir Nabokov entlited Lolita and the book Presença de Anita, from a brazilian author called Mario Donato. Both works had a singular repercussion involving an erotic conception wich was faced as pornographic and baffling. We appeal to Georges Bataille‟s and Foucault‟s discussion in order to observe it through an erotic viewpoint from an inner experience not submitted to normalizations. Such experiences provoke a feeling of something unknown and it reflects wild singularities proposed by Foucault and related with many misunderstanding things presented in institutions and cultures. Furthemore Bataille‟s conception about erotism will give us conditions to analyze nymphs‟ bodies in order to see themselves from their main characteristics, such as seduction and tempting and maligning forces. We still aim to focus the paradigm of mankind and nature in the direction presented by Edgar Morin. He analyzes some feelings that nymphs provoke and their relation between men and death. In adittion, we present in this issue some questions between culture and biology, focusing on the initial period of larva (wich means the beggining), bringing up what is ready to be born, a mythical and significant body shown in the media. Lolita in the cinema and A Presença de Anita in the TV was disturbing in society and it projected the possibility of a syntaxes of desire. It can has a symbolic purpose or it can be a kind of social and cultural phenomenon, wich is an object of representation. Our purpose is to immersion/emerge in the Nimphs‟s body with adventure and its risks at the same time in wich we are crossing frontiers

Ciência e espiritualidade: conversas com pacientes terminais

It has been reflected on Science and spirituality having as focus the relation between them and the process lived by terminal patients after the confirmation of the finitude of their lives. It has searched with this research to excite discussions that corroborate the tematization of a possible dialogue between science and spirituality, signaling perspectives of debates and formation of an understanding of the problematic that involves these human constructs in the development of alternatives for the understanding of the life finitude. We point out the moment of split between science and spirituality through the cartesian paradigm from a historical approach and after focusing the illness and death as foundation for our discussion. We use as methodological strategy, focal talks with terminal patients having as guidance a guideline with five punctuations: the singular citizen, diagnosis impacts, indicators of science, spirituality marks and death fear that served of base for analysis and data interpretation in according to selected theoretical foundations. Thus, it was possible to perceive that science, although not to keep an explicit dialogue with spirituality, it has pointed through is representation forms to the process indicatives that will culminate with the death. And these indicators had shown that in this direction it is efficient. We believe that the confrontation of the death can happen through of a new science that dialogues with the spirituality, where does not have separation between reason and emotion on the part of science; as well as it does not have reason disdain on the part of the spirituality

Folha de São Paulo: o diário oficial do grande irmão

This project wants to analyze the newspaper like a collective organic intellectual thing, and its action like a conservator integral journalism, it makes it looks like a politics block. In this case, the newspaper inserts itself in a process to support the dominated fundamental class. In the same time, it searches to disqualify politically, using the news and the opinion, the sprouting of against-hegemony even untimely and distant in the historical time. Facing this proposal we take as study object the FOLHA DE S. PAULO, nowadays the most representative agency of the great conservative press. Our theoretical reference takes as base the Gramsci organic intellectual formularizations, hegemony, position´s war, integral journalism and private device of hegemony. We allow ourselves, in a subsidiary way to the Gramsci basement, using the novel 1984 written by George Orwell, as a method to explicit, in a comparative way, the manipulation of the reality by the newspaper in its activity of collective organic intellectual. The ideology is the heuristic connection point to make convergence between reality and fiction. For the intended evidences we develop analysis of the daily covering about two great accidents occurred in 2007: The landslide of part of the workmanships of the tunnel of the Companhia do Metropolitano de São Paulo-Metrô (line yellow 4). And the flying disaster involving the airbus of Transportes Aéreos Meridionais-TAM, flight 3054, also in that state. In the first accident we find endorsement of the newspaper to the São Paulo´s government, in the person of the politician actor José Serra (PSDB), representative of the conservative forces and responsible for the workmanships of the Subway, to who it tried to distance politically of the fact. In the second event, the opposition to the politician actor Luis Inácio Luis Lula da Silva and his politics block, the PT, as a possibility against-hegemonic contested, being the mentioned actor appointed as responsible for the occurrence. However, the newspaper says that it is independent and direct, and this direct action comes from the environment. In this environment, the diversity of conceptions of world would guide the publishing work, making the FOLHA DE S. PAULO to take it as a reference for the intended objective, hiding the politics block militancy

Mortalidade infantil e condições socioeconômicas nas microrregiões do Nordeste Brasileiro

The study aims to answer the following question: what are the different profiles of infant mortality, according to demographic, socioeconomic, infrastructure and health care, for the micro-regions at the Northeast of Brazil? Thus, the main objective is to analyze the profiles or typologies associated mortality levels sociodemographic conditions of the micro-regions, in the year 2010. To this end, the databases of birth and death certificates of SIM and SINASC (DATASUS/MS), were taken from the 2010 population Census microdata and from SIDRA/IBGE. As a methodology, a weighted multiple linear regression model was used in the analysis in order to find the most significant variables in the explanation child mortality for the year 2010. Also a cluster analysis was performed, seeking evidence, initially, of homogeneous groups of micro-regions, from of the significant variables. The logit of the infant mortality rate was used as dependent variable, while variables such as demographic, socioeconomic, infrastructure and health care in the micro-regions were taken as the independent variables of the model. The Bayesian estimation technique was applied to the database of births and deaths, due to the inconvenient fact of underreporting and random fluctuations of small quantities in small areas. The techniques of Spatial Statistics were used to determine the spatial behavior of the distribution of rates from thematic maps. In conclusion, we used the method GoM (Grade of Membership), to find typologies of mortality, associated with the selected variables by micro-regions, in order to respond the main question of the study. The results points out to the formation of three profiles: Profile 1, high infant mortality and unfavorable social conditions; Profile 2, low infant mortality, with a median social conditions of life; and Profile 3, median and high infant mortality social conditions. With this classification, it was found that, out of 188 micro-regions, 20 (10%) fits the extreme profile 1, 59 (31.4%) was characterized in the extreme profile 2, 34 (18.1%) was characterized in the extreme profile 3 and only 9 (4.8%) was classified as amorphous profile. The other micro-regions framed up in the profiles mixed. Such profiles suggest the need for different interventions in terms of public policies aimed to reducing child mortality in the region

O discurso formativo do Biólogo sobre a morte: matizes e metáforas do saber que o sujeito não deseja saber

This study - Biologist s formative speech about death. Nuances and metaphors from knowing that the subject of do not want to know - shows a marginal cognitive construction in scientific education from biologist - death. It considered as obvious that death is a theme that covers both the scientific education from biologist and the division of the subject, and concerns the splitting of the double life-death and the principles of inclusion and exclusion of the subject. Part of sensitive question: What is the epistemological weave who supports biologist's speech about death? It is constituted an object of study of the biologist s speech on death. It is advocated the thesis that: Death is an epistemological obstacle announcing for something always aims to escape from the perspective of knowledge, especially of scientific knowledge because, since it is understood as cognitive learning about the disruption of biological phenomenon life which is involved on weave of imaginary and symbolic constructions about the finiteness of life; it has constituted a metaphorical knowing - encouraged by the noisy silence - which does not allow to know in full, mobilizing hence subject in searching for transitional truths that reduce the ontological being-mortal anguish centered in subjective dimension involved in the act of knowing. From this movement of search that the object mental life after death wins a symbolic value that requires a real-looking multi-referential for the study of biology - life - and its implications: the finiteness of life, especially by moving the omnipotence of scientific objectivity expressed by signs and symbols that seek say the completeness of scientific knowledge-, signaling thus the existence of the dynamics of incompleteness implicit in subjectivity that supports knowledge relating to the double, life and death, and to the temporality of the existence of Homo sapiens sapiens, with the axis guiding the desire of the subject, do not want to know about death, implicit in the mechanisms objective-subjective founded by non-said of death is the epistemology of the existence of objective-subjective subject, whose core is the negation of death. The theoretical methodological knowing web is anchored in the multi-reference which favors a transit by theoretical current, as the Psychoanalysis, bachelardian philosophy, the epistemology of complexity, the Thanatology, the Social Psychology, and Etnocenology, and Understanding Interview. The unveiling of the study object from the analysis of oral speech of eleven biologists who serve in high school, from three main guiding: Death in the history of life,Death in biologist s academic education and, Conceptions about concepts

A prática docente de Myriam Coeli na década de 1960

The present work has as objective to reconstitute the biographical profile and pedagogical practices of the teacher Myriam Coeli de Araújo Dantas da Silveira, in the Professionalizing scholl of the Federal Net of the Rio Grande do Norte, in the 60 s years. The choice of the period is justified by being this the time of important changes in the Education, as an example we have the implementation of the Law of Lines of direction and Bases of the National Education, the 4.024/1961. This teacher contributed for the formation of the potiguar s society scholar, acting in the press, the journalism and the teaching, activity that I analyzed in this study. How the pedagogical practices of her had happened in the 60 s years? This question guided the research and, in the search to answer it I used as source the Public Archive of the Rio grande do Norte, the Historical and Geographic Institute of the Rio grande do Norte, the periodicals of the time, photographs, sketch books of Myriam Coeli and interviews with familiar, former-pupils and contemporaries of this master. I verified that her performance always was based in the educational changes lived deeply for her, carrying through a series of activities in the school as: elaboration of the annual program of Portuguese Language, organization of literary competitions and an practice based on the effective norms without leaving to unite respect and the understanding for the pupils. Of this form, the analysis is not summarized only to the practices of a teacher, but the configuration, in part, of the Rio Grande do Norte educational history in a determined period, the 60 s years

Da informação ao conhecimento :o jornalismo científico na contemporaneidade

The purpose of this dissertation is to analyze the actual nature of the Scientific Journalism, studying the historical facts from these informations segment, their matters production and the news industries that work with these specific niche of the contemporary journalism. It is taken into account the educational potential of the specialized journalism and it is considered the communication as a transdiciplinary science. To get into this point it was elected as an analyze category the Reception it Mediation Studies specially the north-americans theories besides the utilization also of the reportage concept to identify how to establish the epistemological relations between Communication and Education. Among the objectives of this dissertation are the investigation of the scientific character of the journalism; the analysis of the theoretical currents of Pedagogy that are based on the theory of Social Communication, as for example the Total Language and the analysis of the industrial and technological characteristics of the most important scientific and cultural magazines of Brazil, Northeast and Natal

Atendimento Pré-hospitalar Móvel. Mapeando Riscos e Prevenindo Erros

The attention with safety of the patients is important in the quality of the nursing and health care. In the pre-hospital care, such care is essential on site with the purpose of avoiding possible consequences to the individual, ensuring a fast and appropriate care, with improvement of the morbidity and reduction of the mortality. This medical attention is equally associated with the significant risks of adverse events and serious mistakes, which can be reduced with the awareness of the professionals, organization and quality management. It is a descriptive, transversal research, of quantitative approach, with the objective of identifying the risks for the safety of the patient during the mobile pre-hospital care under the view of the nurses, in a city of the Brazilian Northeast. The sample was formed by 23 nurses. The inclusion criteria: to have at least two years of experience and accept to participate on the research. The data collection was done in two steps, first photo collection, through the adapted method of photographic analysis, and the second with the application of questionnaire, divide in two parts: socio-professional data and digital photo punctuation instrument of the patient s safety. The majority of the nurses had an average working time in the mobile pre-hospital care of six years and six months, in the age group of 38 to 53 years old (69,56%) and with Lato sensu specialization (73,91%), being (29,41%) emergency and (29,41%) in intensive care. The (74%) have the Advance Cardiac Life Support (ACLS) and (100%) have the Pre-Hospital Trauma Life Support (PHTLS); (91, 30%) know the thematic safety of the patient. On the pictures it was observed a bigger variability of the categories (risks) where 44% of variance emerged on the first picture of the research. The pictures 4 and 9 with the average below 5 were classified as very insecure, while pictures 7 and 3 with an average above 7, very secure. On the results of risks observed for the patient s safety in the mobile pre-hospital care five categories emerged: organization and packaging of the equipment and materials, routines and specificities in the mobile pre-hospital care, risks on the management of medications, for traumas and infections. Starting from the analysis of these risks, it was proposed ten steps for the safety in the mobile pre-hospital care: 1- Identify the patient; 2- Safety related to prevention of infection; 3- Safety in the management of medications; 4- Safety and standardization of the packaging of equipment and materials; 5- Attention to the specificities of the mobile pre-hospital care; 6- Incentive and value the participation of the patient and family; 7- Promote the communication with the central of regulation; 8- Prevention of traumas and falls; 9- Protect the skin from additional injuries; 10- Understand the benefit of all the equipment in the ambulance. The multiple risks and their emerged combinations on the research indicate a variety of actions to be developed and stimulated, like the use of steps for the patient s safety in the mobile pre-hospital care which contributes with the aid and management of risks, reduction of mistakes, disabilities and death

Imagens da morte: um estudo do gênero policial-fantástico em Poe, Wilde e Christie

The mirror has always been related to different symbols, usually connected to self-knowledge and truth. This is due to the fact that this object shows whoever looks oneself in it an image as close to reality as it is possible. On the other hand, the mirror is also associated to mysticism and to the supernatural for it can magically duplicate one who looks into it. This ambiguous characteristic turns the mirror into an element that is fantastic in itself and places it in the central position of our discussion. Therefore, in this study, we analyze the texts In a Glass Darkly, by Agatha Christie, The Oval Portrait, by Edgar Allan Poe, and The Picture of Dorian Gray, by Oscar Wilde, giving special attention to the study of the images and artificial representations of men: the mirror, as an ephemeral representation; and the portrait, as an attempt to eternize an ephemeral image. We also discuss themes such as jealousy, the double, and death in the several forms in which it appears in the texts: suicides, homicides, attempted murders, death in life (mourning, separation, and developmental phases) all of which are, somehow, related to the specular representations. The narrative resource of using a mirror to introduce the supernatural event, along with the theme of death in all the narratives we have studied, and the difficulty to place these texts within the pre-established genres led us to categorize them as being part of a hybrid genre that presents characteristics both of the fantastic and of the detective story which we have named fantastic-detective story

A paz tensa da chama fugaz: a configuração do amor no romance contemporâneo, Lygia Fagundes Telles e Lídia Jorge

This thesis A paz tensa da chama fugaz: a configuração do amor no romance contemporâneo, Lygia Fagundes Telles e Lídia Jorge aims to study the configuration of Love in contemporary novels. Their corpuses of study are the novels As horas nuas (1989), by the Brazilian writer Lygia Fagundes Telles; and O vento assobiando nas gruas (2002), by the Portuguese writer Lídia Jorge. The following research tries to understand how the characters from those texts deal with some love questions on the context of the contemporary narrative; it also tries to comprehend the love expression which is formed as a contradictorily fluid feeling and intensely wanted, which are important points concerning the love discourse at the present day. As a critic-comparative study, this research focuses on the problematic concerned love as a synonym of Eros, in other words, the relation between lovers, analyzed through social and philosophical perspective. Through that, this work broadens the study of two contemporary novels, and it also establish connections between the characters from those novels and the literary environment where they are placed, once it focuses on the human and social context presented in this books. The thesis ends calling attention to the dichotomy of love and death, to the image of love which grows through absence and through the longing of completeness of the human being; that is why this work sustains that the Lygia Fagundes Telles and Lídia Jorge update and materialized in their texts the plurality of contemporary love conception, which continues to be contradictory, fragmented and problematic

Saúde física e emocional de cuidadores da cidade de Santa Cruz-RN: perfil epidemiológico e fatores associados

Taking care for an impaired elderly is a hard and costly task that could affect directly the caregiver health. The purpose of this study was to evaluate the physical and mental health of elderly caregivers from the city of Santa Cruz-RN and analyze the potential correlated factors through an observational analytic design of a crosssectional. A multidimensional questionnaire was used to evaluation of the social demographics characteristics and those related to the care activity, as well as the caregivers´ physical and mental health. It was realized a descriptive analyze using frequency distribution and measures of the central tendency and dispersion to description of the caregivers. To verify the magnitude of the association between the variables was used the bivariate analysis through the Pearson and Spearman correlations and qui-square test. To evaluation of the association of the correlated factors to the adverse outcome with the caregivers´ physical and mental health was made a multivariate analysis by logistic binary regression and multiple linear regression models. The final sample was constituted by 304 persons, mostly women with a mean age of 50.3 ±16.8 years. The principal factors related to the physical health were age, stress and life satisfaction. Be a male caregiver, caring for a little while the elderly with cognitive deficit and not been spouse were related to worse mental health. Have worse physical health, high stress, depressive symptomatology, burden and low levels of satisfaction were also related to the mental health. After adjust through multiple linear regression was observed R2 values of R2=0,21 for Stress, R2 =0,17 for Depressive Symptomatology, R2 =0,21 for Burden and R2 =0,16 for Satisfaction. The attainment of the factors associated with caregiver´s health can help in the elaboration of specifics politics witch the goal is the integral attention to the elderly and his caregiver. The inability of continuous taking care could result in adverse outcomes such as institutionalization, impairment and death

Desventuras de Hypolita: luta contra a escravidão ilegal no sertão (Crato e Exu, século XIX)

This paper analyses the history of Hypolita Maria das Dores, mulatto woman, free born, was enslaved and, by an act of freedom, appealed to court to prove the illegitimacy of her captivity and regain their freedom and their children. The main scenarios of this social and legal struggle are Crato (Ceará) and Exu (Pernambuco), places where she lived in the 19th century. The main objective of this work is to understand how to set the tensions and alliances involving the struggle for freedom inside and outside justice, in differentiated provincial spaces. An approach that belongs to the field of the social history of slavery, we ll prioritize the narrative of life. In it, Hypolita is taken as the subject of her story, as she faces stately and patriarchal values in a slave society. The documentary corpus that allows such vertical investigative consists of parish registers, we examined the baptisms, marriages and death records; analyzed registry documents of postmortem inventories, petitions and crafts; reports of provincial presidents and, finally, the O Araripe s and O Cearense s journalistic information. The investigation of the case allowed the understanding of how, in space and time specific, freedom was understood, usurped and claimed by various social subjects in the frame of morals and justice institutionalized

Estudo da influência de linfócitos tcd-8 e das células nk em casos de carcinoma epidermóide de lábio inferior sem metástase e com metástase e sua relação com a progressão da lesão

The presence of inflammatory cells within the tumor microenvironment plays a dual role that may contribute both to the progression and for inhibition of tumor growth. Recent studies suggest that the quality, not the quantity, of the inflammatory infiltrate is the most important determinant for prognosis. Therefore, TCD8 cells and natural killer cells are the main effector cells in combating cancer. The aim of this study was to assess, through the immunohistochemical study, the expression of TCD8 lymphocytes and NK cells in epidermoid carcinoma (EC) of the lower lip. The sample consisted of 32 specimens of EC of the lower lip, of which 16 had regional lymph node metastasis, and the 16 remaining, free of metastases. The total number of positive cells at the front of invasion were evaluated quantitatively and the results were related to clinical TNM staging, histological grade of malignancy and prognostic factors. It was observed for the group with metastasis, prevalence of stages III and IV (p<0.0001). Most patients with metastasis, had a high grade of malignancy (p=0.006). Most cases classified as high grade of malignancy had stages III and IV (p=0.032). Of the total sample, there were three cases of recurrence and five with death, however these variables were not statistically significant when associated with clinicopathological parameters. The immunostaining of CD8 and CD57, respectively, showed no statistically significant association with any of the clinicopathological parameters studied, metastasis (p=0.346, p=0.622), TNM classification (p=0.146, p=0.576), histological grade of malignancy (p=0.936, p=936), recurrence (p=0.075, p=0.075) and death (p=0.897, p=0.856). Believing in the function of the immunological system against malignant cells, it is concluded that the TD8 lymphocytes and NK cells, would be acting in the control of the progression of malignant neoplasms, but not in isolated manner