Consumo de álcool e risco para doença coronariana na região metropolitana de São Paulo: uma análise do Projeto GENACIS

OBJETIVOS: Examinar a associação entre consumo de álcool e risco para doença coronariana em amostra populacional. MÉTODOS: Estudo transversal, de base populacional, conduzido de janeiro/2006 a junho/2007, na região metropolitana de São Paulo, como parte do estudo internacional (Gender, Alcohol, and Culture: an International Study). Os sujeitos (1.501, sendo 609 homens e 892 mulheres) eram residentes da região metropolitana de São Paulo, tinham 30 anos ou mais de idade e foram selecionados aleatoriamente, a partir de amostragem complexa por conglomerados. Todos os indivíduos consentiram em participar da pesquisa. A variável dependente foi risco cardíaco avaliado através do WHO Rose Angina Questionnaire. A análise multivariada consistiu em regressão logística, tendo sido realizado ajuste para uso de tabaco e índice de massa corpórea. RESULTADOS: A taxa de resposta foi 75%. Ser mulher, ter mais idade, ser negro, fumante e ter um índice de massa corpórea elevado, foram associados a maior risco para doença coronariana. Indivíduos que nunca beberam na vida (OR = 2,22) e ex-bebedores (OR = 2,42) tiveram maior risco de doença cardíaca do que aqueles que informaram beber até 19 g de álcool por dia, sem episódios de beber excessivo. Entre os que tiveram episódios de embriaguês observou-se uma tendência a maior risco (OR = 3,95, p = 0,09). CONCLUSÕES: Nossos achados sugerem um menor risco para doença coronariana entre os bebedores moderados. Destaca-se que os estudos que avaliam o impacto do álcool sobre doença cardíaca precisam identificar o padrão de uso de álcool dos sujeitos, visto que este aspecto pode modificar o risco. Políticas públicas são necessárias para reduzir o uso nocivo de álcool e a morbidade a ele relacionada no país.

Análise dos fatores de risco para gagueira em crianças disfluentes sem recorrência familial

OBJETIVO: analisar os fatores gênero, idade, tipo de surgimento da gagueira, tempo de duração e tipologia das disfluências, fatores estressantes físicos e emocionais, e fatores comunicativos e qualitativos associados em crianças disfluentes sem recorrência familial do distúrbio. MÉTODO: participaram 43 crianças com alto risco para a gagueira de ambos os gêneros. A coleta de dados foi realizada por meio do Protocolo de Risco para a Gagueira do Desenvolvimento - PRGD. RESULTADOS: a razão masculino/feminino foi de 3,3:1. A única diferença estatisticamente significante dos fatores de risco analisados nos gêneros masculino e feminino foi a maior ocorrência de fatores comunicativos associados no gênero masculino (p=0,003). Houve uma semelhança dos achados entre os meninos e as meninas: quanto ao tempo de duração das disfluências a maioria apresentou mais de 12 meses de duração, a tipologia gaga foi a mais freqüente, a presença de fatores estressantes emocionais ocorreu na maior parte das crianças, e finalmente os fatores qualitativos associados, como taxa de elocução aumentada, tensão visível e incoordenação pneumo-fono-articulatória estiveram presentes em grande parte da amostra. CONCLUSÃO: os resultados desta investigação permitiram concluir que nos casos de crianças com alto risco para a gagueira isolada ocorreu a interação de inúmeros fatores, sugerindo que o distúrbio é multifatorial. Também foi possível concluir que a interação de alguns fatores como gênero masculino, tipologia gaga manifestada por mais de 12 meses, com início persistente, na presença de fatores qualitativos e comunicativos associados pode representar risco maior para o desenvolvimento da gagueira persistente.

Análise de risco aplicada ao manejo precaucionário das pescarias artesanais na região do reservatório da UHE-Tucuruí (Pará, Brasil)

As pescarias no reservatório da UHE-Tucuruí no rio Tocantins, Pará, envolvem cerca de 6.000 pescadores e movimentam cerca de R$ 4,2 milhões/ano. A atividade se concentra em três espécies principais: tucunaré Cichla monoculus (capturado com anzol), pescada Plagioscion squamosissimus (capturado com rede e/ou anzol) e mapará Hypophthalmus marginatus (capturado com rede). Com o objetivo de caracterizar os pescadores e as pescarias do reservatório, criar cenários de aumento do esforço pesqueiro e prever os momentos de conflito pela escassez de recursos, foram levantadas informações da literatura e realizadas duas campanhas de coleta de dados nos anos de 1999 e 2000, envolvendo entrevistas com líderes comunitários e pescadores. As seguintes variáveis foram consideradas: desembarque por espécie-alvo (de acordo com os registros fornecidos pelas colônias de pescadores), artes de pesca, estratégias dos pescadores, conflitos e formas de apropriação do espaço e rendimentos da atividade. Estas variáveis foram inseridas em um modelo dinâmico, simulado no software Vensim PLE para um período de 10 anos a partir de 1999. Os resultados indicam que a pesca de anzol é a estratégia mais rentável, e que possíveis momentos de conflito devido à escassez de recursos podem acontecer em curto prazo (2005). A metodologia utilizada para as simulações e análises de risco também se revelou adequada à realidade local e ao conjunto de dados disponíveis.

Conchostráceos com linhas de crescimento recurvadas junto à margem dorsal (famílias Palaeolimnadiopseidae e Perilimnadiidae) da formação rio do rasto, Permiano superior, bacia do Paraná, Brasil

Some Upper Permian conchostracans from the Rio do Rasto Formation (Parana Basin, South Brazil) have very characteristic recurved growth lines at the dorsal margin. All previously described specimens were classified as Palaeolimnadiopsis subalata (Reed) Raymond. However, a re-analysis of these fossils and of additional recently- collected specimens demonstrated that not all can be included in a single species, nor only in the Family Palaeolimnadiopseidae. According to their shape and the size of the umbo, they are classified into three species. The sub-elliptic carapaces with small anterior umbo are maintained in Palaeolimnadiopsis subalata (Reed, 1929) Raymond, 1946. The sub-circular carapaces with small sub-central umbo correspond to the new species Palaeolimnadiopsis riorastensis. The small size of the umbo is a character of the Family Palaeolimnadiopseidae. The small elliptic valves with large anterior umbo are assigned to the new species Falsisca brasiliensis of the Family Perilimnadiidae, which is characterized by large umbos. Palaeolimnadiopsis has a wide chronostratigraphic distribution, but Falsisca is restricted to the Upper Permian-Lower Triassic of Europe and Asia. This interval is in agreement with the probable Late Permian age of the respective strata of the Rio do Rasto formation. Falsisca was not previously recorded in Gondwana.

Lazer, aventura e risco: reflexões sobre atividades realizadas na natureza

This paper reflects on the conceptions of adventure and risk, revealed in activities in nature. The presented speeches are contained in a research, whose boarding works with a universe of reasons, aspirations, values, beliefs and attitudes, corresponding to a deeper space of the processes, relations and phenomena. It was possible to perceive that the adventure activities in nature are carrying of innumerable meanings, related with new discoveries, new challenges, search for the stranger, uncertainty, cooperation, friendship, among others. Such activities understand diverse forms of experimentation, pointing besides to physical risk, the symbolic and imaginary risk.

Disturbios da comunicacao em criancas de alto risco neonatal

Neonatal high risk children present high incidence for communication disorders and delay development of language. The present study aimed to evaluate the incidence of communication disorders and long term follow up of neonatal high risk children. Twenty-one children were followed up to age of four years old and were evaluated for the development of linguistics aspects. The main high risk neonatal factors were: prematurity, mechanical ventilation, long time in the incubator and severe hypoxia. In 47,62% of the cases, the following communication disorder were found: articulation disorders (9,52%), simple (9,52%) and small and (14,29%) with delay development of language. The incidence of these disorders was greater among male children (57,14%).

Variabilidade espacial de perdas de solo, do potencial natural e risco de erosão em áreas intensamente cultivadas

The objective of this work was to identify the spatial variability of the natural erosion potential, soil loss and erosion risk in two intensely cultivated areas, in order to assess the erosion occurrence patterns. The soil of the area located at Monte Alto, São Paulo state, was classified as Paleudalf (PVA) with moderately slope, with different managements. The soil of the area located at Jaboticabal, São Paulo state, was classified as Haplortox(LV) with gentle slope and cultivated with sugarcane. A irregular grid was imposed on the experimental areas. Soil samples were obtained from 0-0.2 m depth at each grid point: 88 samples in Monte Alto area (1465 ha) and 128 samples at Jaboticabal area (2597 ha). In order to obtain the values of the studied variables USLE was applied at each grid point. Descriptive statistics were calculated, and geoestatistical analyses were performed for defining semivariograms. Kriging techniques to develop map showing spatial patterns in variability of selected soil attributes were used. All variables showed spatial dependence. The PVA soil showed higher erosion risk due to the slope and atual management compared to the soil LV.

Formulário do perfil psicossocial do paciente anoftálmico com indicação de prótese ocular

The patient with anophthalmia may present feelings of inferiority and rejection. Knowing his/her needs and expectations contribute to a better technical intervention. Purpose: To elaborate a questionnaire of the psychosocial profile of the patient with anophthalmia with indication of ocular prosthesis. Methods: An exploratory research was used to elaborate the questionnaire, by means of a guided interview followed by writing down what was said by the interviewees, who were adult patients of the Bucco-Maxillo-Facial Prosthesis Center of FOSJC - UNESP. The guided interview was made up of 14 items directly related to the future outline of the profile. Each item of the interview resulted in questions of the questionnaire, which was pretested twice before reaching its final version. Results: The patients reported, in the exploratory research, unpleasant feelings with the loss of the eye; relationship shyness; expectations regarding surgery and prosthesis use; a wish to receive explanations and to hold their opinion about the treatment. The questionnaire of the psychosocial profile of the patient with anophthalmia with indication of ocular prosthesis is, therefore, made of 43 questions divided into 5 blocks in order to aid the comprehension of the inquired aspects and to facilitate both the computation of data and discussion, and also to improve the selection of questions according to the objective of the researcher or professional. Conclusions: It was concluded that the questionnaire was viable, can be used in full or by selecting blocks and provide a panorama of the patient's history related to the problem he/she faces, from the loss of the ocular globe to the confection of the prosthesis.

Avaliação de fatores de risco de cães sororreagentes à leptospira spp. e sua distribuição espacial, em área territorial urbana

We aimed to evaluate the risk factor of serum reactive dogs to antileptospire agglutinin and their spatial distribution in an urban area. We collected 1,000 blood samples from dogs at 20 immunization centers, homogeneously distributed in the urban area (32 km²) of Botucatu, Sao Paulo, Brazil. Diagnosis was made by microscopic serum agglutination using 24 serovars of Leptospira spp. Statistical analysis was performed by Goodman's test with 5% of significance. Spatial clusters were tested by spatial scan statistic using SaTScan. We found that 17.9% dogs reacted to Leptospira spp. (p<0.0001). Dogs with street access (22.14%) were more reactive (p<0.05) than those without (14.83%). The scan test indicated only one significant cluster influenced by age. Incorporating each one of the co-variables gender, breed, and street access to age, we found that street access was the most important. Street access and age were the most important risk factors in the large number of reactive animals in the cluster, with the castellonis serovar being the most reactive in urban dogs. The identification of a cluster with more reactive dogs than expected allows local preventive measures to be taken.

A reabilitação psicossocial no atendimento em saúde mental: Estratégias em construção

This study aims to identify the representations about Psychosocial Rehabilitation by Mental Health professionals working in open services, and also the difficulties they have met in the process of turning the care effective for the population. The study uses a qualitative methodology, collecting data by means of semistructured interviews with 15 subjects. The professionals identify the rehabilitation process as complex, meeting several obstacles and requiring their dedication and a flexible attitude to achieve the expected results.

Fatores de risco para doenças cardiovasculares em idosos com diabetes mellitus tipo 2

The aim of this study was to analyze the risk factors related to the cardiovascular diseases (CVRF) in elderly type 2 diabetics. A cross-sectional observational study was carried out on 100 elderly patients attending the Rehabilitation Center of Araraquara (CRRA), São Paulo State, Brazil, from March to December, 2004. The majority were married, female, white, with a low income and low educational level. Regarding habits and style of life, the subjects had an adequate diet, were sedentary, non-smoking and non-drinking. In the population of 100, 42% were overweight, 42% obese, 71% had above-normal waist measurements and 84% high waist-to-hip ratios. Concerning the CVRF, it was observed that more than half had hypertension, hypercholesterolaemia and hypertriglyceridaemia. 84% had high values of LDL-cholesterol and 59% HDL-cholesterol levels below the reference values, 78% high levels of fasting glycemia, 76% glycohemoglobin and 57% fibrinogen and thus subject to cardiovascular risk. The results showed a high frequency of cardiovascular risk factors, differing according to sex and the age.

Conchostráceos com linhas de crescimento recurvadas junto à margem dorsal (Famílias Palaeolimnadiopseidae e Perilimnadiidae) da Formação Rio do Rasto, permiano superior, Bacia do Paraná, Brasil

Some Upper Permian conchostracans from the Rio do Rasto Formation (Paraná Basin, South Brazil) have very characteristic recurved growth lines at the dorsal margin. All previously described specimens were classified as Palaeolimnadiopsis subalata (Reed) Raymond. However, a re-analysis of these fossils and of additional recently- collected specimens demonstrated that not all can be included in a single species, nor only in the Family Palaeolimnadiopseidae. According to their shape and the size of the umbo, they are classified into three species. The sub-elliptic carapaces with small anterior umbo are maintained in Palaeolimnadiopsis subalata (Reed, 1929) Raymond, 1946. The sub-circular carapaces with small sub-central umbo correspond to the new species Palaeolimnadiopsis riorastensis. The small size of the umbo is a character of the Family Palaeolimnadiopseidae. The small elliptic valves with large anterior umbo are assigned to the new species Falsisca brasiliensis of the Family Perilimnadiidae, which is characterized by large umbos. Palaeolimnadiopsis has a wide chronostratigraphic distribution, but Falsisca is restricted to the Upper Permian-Lower Triassic of Europe and Asia. This interval is in agreement with the probable Late Permian age of the respective strata of the Rio do Rasto Formation. Falsisca was not previously recorded in Gondwana.

Tipificação das famílias de oito assentamentos rurais da região de Andradina (SP), com base em diferentes estratégias de produção e comercialização

This article intends to provide a typology of the families that are settled in the region of Andradina (Sao Paulo state), according to the main production and commercialization systems and to the presence (or not) of agricultural income diversification. The empiric data used to form the groups originate from socioeconomic questionnaires that had been applied to 169 families of eight rural settlements and also from 80 interviews. The groups were compared with each other, starting from the family's profile; patrimony; credit and technical support; self-consumption production; and the lot's external income. The strategy to increase the production and the productivity (dairy cattle) is limited to less than a quarter of the producers, however different strategies had been used by families, such as the diversification of the agricultural income and the direct sale to the consumer or to the retail trade. The association of the production diversification with the use, in a regular way, of differentiated channels of commercialization demonstrated a strategy capable to approximate the indicators of this type of producer comparing with those that focused on increasing the production and the productivity. This verification is important because, even though there is no necessary contradiction among both strategies, a part of the families does not have resources, infrastructure and/or technical qualification to follow the way of the productive intensification and others do not have this project as a priority.

Análise multivariada na determinação do risco de erosão em solos sob irrigação

The objective of this work was to verify the application of cluster analysis to evaluate soil erosion risk for different soil classes, soil slopes and soil managements. The study was conducted in a 33 ha section of a large field located in Carmo do Rio Claro County, MG, Brazil. The field had been managed in a corn/bean rotation under conventional tillage and under coffee plantation for seven years, both under sprinkle irrigation. Soil samples were obtained at every 10 m at 0.20 m depth along a transect of 1050 m. Soil erosion risk (A), natural potential erosion (PN), and erosion expectation (EE) were determined and submitted to a cluster and principal component analysis. The application of clustering analysis showed high correlation between the clusters and soil types. With clustering analysis plus principal components analysis, it was possible to identify groups of high and low soil erosion expectation, showing that the areas with higher soil erosion expectation are correlated to the soil class, soil slope and soil management. Among the studied variables, the natural potential erosion (PN) showed to be the most important factor to identify different soil erosion groups. The cluster analysis showed that 98% of the variables were classified within each group, and that they should be managed differently due to the soil erosive potential of each group,.

Comparação entre hipertensão autoreferida e pressão arterial casual e presença de fatores de risco em funcionários da saúde Bauru e Jaú

Model: Prevalence study. Objectives: To evaluate the presence of self-reported hypertension to compare with blood pressure measurements. Besides, this work investigated health information level of workers and if the job position has any influence on blood pressure (BP). Methods: This study evaluated 349 health workers (44±10 years old) from Bauru and Jau cities, who answered some questions about history of health condition, use of medicines, past surgeries as well as social, scholar and physical conditions and had their blood pressure measured. Each subject selfreported as normotensive or hypertensive. Values of systolic ≥ 140 mmHg and/or diastolic PA ≥ 90 mmHg were considered elevated. Among the health workers evaluated, 198 were submitted to anthropometric and biochemical evaluations. Values are presented as means ± SD and frequency of distribution. It was used T-student test (p<0.05). Results: From all workers evaluated only 16% self-reported as hypertensive, which 56% presented high BP, however 91% used to take antihypertensive medicines. Among the 84% who self-reported as normotensive, 24% presented high BP and 8% used to take medicines. Although most of the employees of each section self-reported as normotensive, more than a half presented high BP and which was more common in the health's section (76.3%). Conclusion: These results suggest that besides the majority of the employees self-reported as normotensive, an elevated number of health workers presented high blood pressure and used to take medicines inappropriately, which indicates that they did not have enough knowledge about their health. Furthermore, it was observed that Health Section presented the higher blood pressure values.