Mortes maternas e mortes por causas maternas

Ao mensurar-se mortalidade materna, é necessário distinguir ' mortes por causas maternas' e 'mortes maternas' Para a Organização Mundial da Saúde-OMS-,mortes maternas são as que ocorrem na gestação, no parto e até 42 dias após o parto; e mortes por causas maternas englobam as causas classificadas no Capítulo XV da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde, Décima Revisão (CID-10), incluindo as ocorridas quando passados 42 dias do parto. Apresentam-se resultados da investigação de mortes femininas em idade fértil-10 a 49 anos- nas capitais de Estados e no Distrito Federal do Brasil, em 2002. Adotou-se a metodologia RAMOS, comparando-se as causas básicas das declarações de óbito originais com as das declarações preenchidas após o resgate de informações, obtidas em entrevistas domiciliares e prontuários. Entre as mortes por causas maternas originais, 15,9 por cento não eram mortes maternas, de acordo com a definição da OMS. Houve, concomitantemente, subenumeração de mortes maternas. Sugestões são feitas para melhorar o preenchimento das declarações de óbito e inclusão de novas categorias na CID-10, visando melhorar a informação das causas maternas

Prospectiva estrat??gica: instrumento para a constru????o do futuro e para a elabora????o de pol??ticas p??blicas

A prospectiva estrat??gica aparece como ferramenta que, apoiada nos instrumentos de an??lise econ??mica e social existentes e em t??cnicas espec??ficas, como o Delphi, a constru????o de cen??rios, a matriz de impactos cruzados e outras, possibilita ???vis??es de futuro???, que permitir??o a elabora????o de pol??ticas p??blicas que visem ?? constru????o de futuro desej??vel. Este trabalho pressup??e um Estado formulador de pol??ticas p??blicas e detentor de instrumentos de planejamento, o que nos remete a um vi??s ideol??gico: de que, no capitalismo contempor??neo, Estado e mercado coordenem os sistemas econ??micos, conforme explicitado no Plano Diretor da Reforma do Aparelho de Estado (Governo Federal, Brasil, 1995). S?? a aceita????o dessa hip??tese pode supor a exist??ncia e a necessidade de pol??ticas p??blicas, remetendo-nos o campo da ideologia e contrapondo-nos ao liberalismo.

Human risk assessment of benzene after a gasoline station fuel leak

OBJECTIVE: To assess the health risk of exposure to benzene for a community affected by a fuel leak. METHODS: Data regarding the fuel leak accident with, which occurred in the Brasilia, Federal District, were obtained from the Fuel Distributor reports provided to the environmental authority. Information about the affected population (22 individuals) was obtained from focal groups of eight individuals. Length of exposure and water benzene concentration were estimated through a groundwater flow model associated with a benzene propagation model. The risk assessment was conducted according to the Agency for Toxic Substances and Disease Registry methodology. RESULTS: A high risk perception related to the health consequences of the accident was evident in the affected community (22 individuals), probably due to the lack of assistance and a poor risk communication from government authorities and the polluting agent. The community had been exposed to unsafe levels of benzene (> 5 µg/L) since December 2001, five months before they reported the leak. The mean benzene level in drinking water (72.2 µg/L) was higher than that obtained by the Fuel Distributer using the Risk Based Corrective Action methodology (17.2 µg/L).The estimated benzene intake from the consumption of water and food reached a maximum of 0.0091 µg/kg bw/day (5 x 10-7 cancer risk per 106 individuals). The level of benzene in water vapor while showering reached 7.5 µg/m3 for children (1 per 104 cancer risk). Total cancer risk ranged from 110 to 200 per 106 individuals. CONCLUSIONS: The population affected by the fuel leak was exposed to benzene levels that might have represented a health risk. Local government authorities need to develop better strategies to respond rapidly to these types of accidents to protect the health of the affected population and the environment.

Determinants of using pacifier and bottle feeding

OBJECTIVE To analyze the factors associated with the use of pacifiers and/or bottle feeding in infants aged under one year.METHODS This is a cross-sectional study with 34,366 children and using data from the database of the 2nd Nationwide Survey of Breastfeeding Prevalence performed in the Brazilian capitals and Federal District in 2008. Cluster sampling was used. The questionnaire included questions about the use of artificial nipples in the last 24 hours. The analysis considered three outcomes: exclusive use of pacifier, exclusive use of bottle feeding, and use of artificial nipples (pacifier and bottle feeding). Prevalence ratios were obtained using Poisson regression with robust variance following a hierarchical model.RESULTS The following factors were associated with exclusive use of the pacifier: mother working outside the home, primiparity, child was not breastfed within the first hour, and child had consumed tea on the first day at home. The following factors were associated with exclusive use of bottle feeding: mother working outside the home, primiparity, low birth weight, child not breastfed within the first hour, and child had consumed milk formula and tea on the first day at home. The following factors were associated with use of artificial nipples (pacifier and bottle feeding): mother working outside the home, primiparity, cesarean delivery, the male gender, low birth weight, born in a hospital not accredited as “baby friendly”, required health baby monitoring in the Primary Health Care Unit (PR = 0.91), and child had consumed milk formula, water, or tea on the first day at home.CONCLUSIONS This study identified profiles of exclusive users of pacifiers, bottle feeding, and both. The provided information can guide preventive practices for child health.

Socioeconomic inequalities and changes in oral health behaviors among Brazilian adolescents from 2009 to 2012

OBJECTIVE To analyze oral health behaviors changes over time in Brazilian adolescents concerning maternal educational inequalities.METHODS Data from the Pesquisa Nacional de Saúde do Escolar(Brazilian National School Health Survey) were analyzed. The sample was composed of 60,973 and 61,145 students from 26 Brazilian state capitals and the Federal District in 2009 and 2012, respectively. The analyzed factors were oral health behaviors (toothbrushing frequency, sweets consumption, soft drink consumption, and cigarette experimentation) and sociodemographics (age, sex, race, type of school and maternal schooling). Oral health behaviors and sociodemographic factors in the two years were compared (Rao-Scott test) and relative and absolute measures of socioeconomic inequalities in health were estimated (slope index of inequality and relative concentration index), using maternal education as a socioeconomic indicator, expressed in number of years of study (> 11; 9-11; ≤ 8).RESULTS Results from 2012, when compared with those from 2009, for all maternal education categories, showed that the proportion of people with low toothbrushing frequency increased, and that consumption of sweets and soft drinks and cigarette experimentation decreased. In private schools, positive slope index of inequality and relative concentration index indicated higher soft drink consumption in 2012 and higher cigarette experimentation in both years among students who reported greater maternal schooling, with no significant change in inequalities. In public schools, negative slope index of inequality and relative concentration index indicated higher soft drink consumption among students who reported lower maternal schooling in both years, with no significant change overtime. The positive relative concentration index indicated inequality in 2009 for cigarette experimentation, with a higher prevalence among students who reported greater maternal schooling. There were no inequalities for toothbrushing frequency or sweets consumption.CONCLUSIONS There were changes in the prevalences of oral health behaviors during the analyzed period; however, these changes were not related to maternal education inequalities.

ERICA: prevalence of asthma in Brazilian adolescents

ABSTRACT OBJECTIVE To describe the prevalence of asthma and physician-diagnosed asthma in Brazilian adolescents. METHODS Cross-sectional, national, school-based study with adolescents from 12 to 17 years old, participants in the Study of Cardiovascular Risks in Adolescents (ERICA). The study stratified the sample by region and grouped according to schools and classes with representativeness to the set of cities with more than 100,000 inhabitants of the Country, macro-regions, capitals, and Federal District. A questionnaire collected data through a self-filled in method. We calculated the prevalences and their confidence intervals of 95% (95%CI) according to sex, age group, type of school and skin color. RESULTS Between 2013 and 2014, 74,589 adolescents were evaluated, 55.3% of the female sex. The total prevalence of active asthma was of 13.1% (95%CI 12.1-13.9), being higher in girls (14.8%; 95%CI 13.7-16.0) when compared to boys (11.2%; 95%CI 10.3-12.2) in all geographical strata examined. It was also higher between students of private schools (15.9%; 95%CI 14.2-17.7) when compared to public ones (12.4%; 95%CI 11.4-13.4). It was higher in the Southeast region (14.5%; 95%CI 12.9-16.1), and in the city of Sao Paulo (16.7%; 95%CI 14.7-18.7). The lowest prevalence was observed in North region (9.7%; 95%CI 9.7-10.5), and in Teresina (6.3%; 95%CI 4.9-7.7). The prevalence of physician-diagnosed asthma was of 8.7% (95%CI 8.2-9.1); higher in the North region (13.5%; 95%CI 12.7-14.2), and in Porto Alegre (19.8%; 95%CI 17.5-22.3). It was lower in the Midwest (6.9%; 95%CI 6.0-7.8), and in Cuiaba (4.8%; 95%CI 3.8-5.9). We found no significant difference in the expression of this rate between the sexes, as well as in other variables evaluated by the study. CONCLUSIONS The prevalence of asthma in Brazilian adolescents is high. Rates of active asthma and physician-diagnosed asthma vary widely in different regions and capitals evaluated by the ERICA. These results may assist in the preparation of preventive programs and policies on health and a better understanding of the factors associated with asthma in this age group.

Capital cities of federations. On the way to analysing the normative base of their asymmetrical status

Federal Capitals often have special statutes. Compared with member states, they often enjoy a lower degree of self-government and a lesser share in the governing of the federation. Why do actors choose such devices, and how can they be justified in a liberal democracy? Surprisingly, the burgeoning literature on asymmetric federalism (to which our research group has contributed significantly) has overlooked this important feature of a de iure asymmetry, perhaps because political theory up to now has concentrated on cases of multicultural and plurinational federations. However, comparative literature is also rare. This paper is the first step to filling in this gap by comparing some federal capitals. The Federal District model (Washington) is compared to capitals organized as member-states (Berlin and Brussels), and capitals that are cities belonging to a single member state (Ottawa in Ontario). The different features of de iure asymmetry will thereby be highlighted. Some light will be shed on the possible motives, reasons and justifications for the choice of each respective status. The paper opens the door to further research on such status questions by analysing public and parliamentary debates, for example. It paves the way for more thorough research. Sicne the author has been awarded a grant by the Institut d’Estudis Autonòmics, this research will be carried out soon.

Biogeographical aspects of drosophilids (Diptera, Drosophilidae) of the Brazilian savanna

Some species of drosophilids have been intensely studied, especially in the areas of genetics and molecular biology. However, little is known about their ecology and biogeography. Here, we revise the records of Drosophilidae species in the Cerrado domain, in order to organize the available information and to recognize patterns of geographic distribution and endemism. The 43 sampled sites in this domain reveal 100 species of drosophilids (10 of them exotic to the Neotropical region), distributed in eight genera. The collections were concentrated mainly in the States of Goiás (including the Federal District) and Minas Gerais. Serra do Cipó is the site with the highest richness of these insects. Of the 90 neotropical species found in the Cerrado, 77 also occur outside this domain, most of which are in the Atlantic Forest. Since extensive areas of this domain were poorly sampled for drosophilids and most studies used only baited traps to collect the flies, this absence of endemism should be carefully considered. It is recommended new inventories in poorly sampled regions, especially in the northeastern part of the domain. Also diversification of collection methods and improvement in the taxonomy of these flies are proposed. These directions should provide a significant increase in the list of species of drosophilids of the Cerrado; and thus, increase our knowledge about its biodiversity.

KIT COLORIMÉTRICO PARA DETECÇÃO DE METANOL EM ETANOL COMBUSTÍVEL PARA O MONITORAMENTO DA QUALIDADE DE COMBUSTÍVEIS

A colorimetric kit for methanol detection in ethanol-containing fuels and ease of use in the field was developed and tested. The analysis can detect the presence of methanol in fuels when exceeding specification (0.5% v/v) in about 20 min and its simple instrumentation does not require a specialist. The kit method was successfully validated at gas stations located in São Paulo State and the Federal District.

Nematode community, trophic structure and population fluctuation in soybean fields

Temporal (monthly in three fields for 12 months) and spatial (once in 23 fields during March-April) samplings were conducted in the major soybean (Glycine max)-growing region of the Brazilian Federal District. Fifty-three nematode genera were found in both samplings, but 13 were detected only by the temporal sampling, and one only by the spatial sampling. Fifty-three percent were plant-parasites, 35% were bacterivores, and about 12% were fungivores, predators and omnivores constituted the community that was dominated by the genera Helicotylenchus (40% of total abundance), Acrobeles (15%), Cephalobus (7.6%), Meloidogyne(5.6%) and Pratylenchus (4.9%). Heterodera glycines was not found in this study. There were no differences in ten ecological measurements [Ds, H', Es, T, FF/BF, (FF+BF)/PP, MI, PPI, mMI, and Dorylaimida (%)] between the two sampling types, but differences in indexes d and J'. Plant parasite populations dropped at the end of the crop cycle, remained at low levels during the dry season and the seedling period, then increased again in the crop-growing season. Fungivores maintained their low populations throughout the year, increasing only in June and July, the post-harvest period, when soil fungi decomposed root tissue. The population of bacterivores slightly declined during the dry season and the initial rainy season, but peaked in the middle of the rainy season, apparently associated with soil humidity. In the five most abundant nematodes, those of Acrobeles and Pratylenchus were more populous in wet soils, Cephalobus and Meloidogyne adapted well in dry soils, but Helicotylenchus survived abundantly in a wide range of soil moisture.

Diferentes padrões de políticas salariais nos estados brasileiros: uma análise a partir do diferencial de salários público-privado

Public servant wages represent a significant part of Brazilian state governments' current expenses. Based on the literature, this paper has tried to identify which states practice efficient, compensatory or appropriation wage politics through the estimation of public-private wage differentials. The differential of salaries was calculated between 1995 and 2004 following the Oaxaca's technique. The results show that the wage policy of an important number of states has had efficiency and a numerous part of the North and the Northeast states have developed compensatory politics. The Federal District and Roraima practiced a wage policy characterized by explicit appropriation.

Economia dos recursos naturais, desenvolvimento sustentável e teoria do crescimento econômico : uma aplicação para o Brasil

Este trabalho tem como meta uma exposição sucinta sobre as relações entre economia e meio ambiente, que foram, durante muito tempo, ignoradas ou relegadas a um plano secundário pela grande maioria dos economistas. Essas relações passaram a ser melhor investigadas após os choques do petróleo na década de 70, que mudaram radicalmente o enfoque sobre o binômio economia-meio ambiente, contribuindo também para essa mudança os efeitos cada vez mais visíveis causados pela poluição desenfreada do planeta. Discute-se também sobre o conceito de desenvolvimento sustentável, bem como sobre sua evolução ao longo do tempo e as duas visões concorrentes sobre essa questão, além de abordar, resumidamente, a qualidade ambiental e os recursos naturais de propriedade comum como bens públicos. O trabalho também traça um paralelo entre os modelos de crescimento neoclássicos e os modelos de crescimento endógeno, no que se refere à incorporação de variáveis ambientais, como poluição, energia e recursos naturais. Como contribuição empírica para a conexão entre capital natural e crescimento econômico, procuramos estimar a relação entre estoque de terras, empregado como proxy para o capital natural, e o crescimento da renda per capita para as unidades federativas brasileiras, a partir de 1970, por meio de uma relação cúbica empregando dados de painel. Verificamos que, quando se consideram, para o cálculo do índice de expansão agrícola, os dados referentes à área agrícola utilizada, que é a soma da área agrícola permanente mais a área agrícola temporária, o modelo empregado é significativo e bem especificado. Neste caso, constatamos um padrão de “explosão e quebra” do processo de crescimento econômico associado à expansão da lavoura agrícola das unidades federativas brasileiras.

O campo criminalística: uma abordagem da cultura organizacional à luz da filosofia da ação de Pierre Bourdieu

A cultura organizacional tem se revelado um excelente instrumento analítico em Administração. Sob seu prisma, as organizações têm sido estudadas com o intuito de estabelecer-se ou construir-se uma identidade como modo de alavancar as suas atuações. O presente trabalho, nessa seara, explora os conceitos de cultura e cultura organizacional para melhor amoldar-se aos seus objetivos. Optou-se, nesse contexto, por usar os conceitos firmados pela filosofia da ação de Pierre Bourdieu - Campo, Capitais e habitus -, uma vez que diferenciam-se das demais teorias da cultura por trazer uma concepção relacional entre estrutura e atores sociais, entre objetividade e subjetividade. Utilizando-se desse arcabouço teórico, delimitou-se o Campo Criminalística a partir dos Capitais que ali estão em jogo, sobretudo o Capital nomeado de Forense, diferenciando-o dos demais Campos que o tangenciam: Polícia, Jurídico e Científico. Diante dessa delimitação e a partir de um estudo de caso sobre o Instituto de Criminalística do Distrito Federal, foi possível, ainda, estabelecer os principais elementos cognitivos que compõem o habitus dos Peritos Criminais que ali atuam, cotejando-os, sobretudo, com o habitus do policial, traçando diferenças e possíveis similitudes e irrigações.

Monitoramento de recursos de transferências voluntárias na esfera municipal

Este trabalho tem por objetivo propor uma ferramenta de monitoramento de transferências voluntárias, entendidas como recursos financeiros repassados pela União aos Estados, Distrito Federal e Municípios em decorrência da celebração de convênios, acordos, ajustes ou outros instrumentos similares, cuja finalidade é a realização de obras e/ou serviços de interesse comum e coincidente às três esferas do Governo. Inicialmente são apresentados os conceitos que envolvem o tema com base no levantamento bibliográfico realizado. Em seguida, é apresentada a pesquisa de caráter qualitativo, realizada em 78 municípios do Estado do Rio de Janeiro, no período compreendido entre 2009 a 2013. A pesquisa identificou que os municípios têm dificuldades em: i) sistematizar as informações referentes aos convênios e, ii) acompanhar a sua execução. E, por fim, é proposta uma ferramenta de monitoramento de convênios dada a relevância destes recursos para o desenvolvimento dos municípios.

Alterações do fluxo sanguíneo em artéria umbilical na síndrome hipertensiva gestacional e suas implicações nos resultados neonatais

OBJETIVO: Avaliar as características antropométricas, a morbidade e mortalidade de recém-nascidos (RN) prematuros nascidos vivos de mães hipertensas em função da presença ou não de diástole zero (DZ) ou reversa (DR) na doplervelocimetria arterial umbilical. MÉTODOS: Estudo prospectivo, envolvendo RN prematuros nascidos vivos de gestantes hipertensas, com idade gestacional entre 25 e 33 semanas, submetidas à doplervelocimetria da artéria umbilical nos 5 dias que antecederam o parto, realizado no Hospital do Distrito Federal, entre 1º de novembro de 2009 e 31 de outubro de 2010. Os RN foram estratificados em dois grupos, conforme o resultado da doplervelocimetria da artéria umbilical: Gdz/dr=presença de diástole zero (DZ) ou diástole reversa (DR) e Gn=doplervelocimetria normal. Medidas antropométricas ao nascimento, morbidades e mortalidade neonatal foram comparadas entre os dois grupos. RESULTADOS: Foram incluídos 92 RN, assim distribuídos: Gdz/dr=52 RN e Gn=40 RN. No Gdz/dr a incidência de RN pequenos para idade gestacional foi significativamente maior, com risco relativo de 2,5 (IC95% 1,7‒3,7). No grupo Gdz/dr os RN permaneceram mais tempo em ventilação mecânica mediana 2 (0‒28) e no Gn mediana 0,5 (0‒25), p=0,03. A necessidade de oxigênio aos 28 dias de vida foi maior no Gdz/dr do que no Gn (33 versus10%; p=0,01). A mortalidade neonatal foi maior em Gdz/dr do que em Gn (36 versus 10%; p=0,03; com risco relativo de 1,6; IC95% 1,2 - 2,2). Nessa amostra a regressão logística mostrou que a cada 100 gramas a menos de peso ao nascer no Gdz/dr a chance de óbito aumentou 6,7 vezes (IC95% 2,0 - 11,3; p<0,01). CONCLUSÃO: em RN prematuros de mães hipertensas com alteração na doplervelocimetria da artéria umbilical a restrição do crescimento intrauterino é frequente e o prognóstico neonatal pior, sendo elevado o risco de óbito relacionado ao peso ao nascimento.