Alcohol and other drug use disorders among older-aged people

In Australia people aged 65 years or older currently comprise 12.1% of the population. This has been estimated to rise to 24.2% by 2051. Until recently there has been relatively little research on alcohol and other drug use disorders among these individuals but, given the ageing population, this issue is likely to become of increasing importance and prominence. Epidemiological research shows a strong age-related decline in the prevalence of alcohol and other drug use disorders with age. Possible reasons for this include: age-related declines in the use and misuse of alcohol and other drugs; increased mortality among those with a lifetime history of alcohol and other drug use disorders; historical differences in exposure to and use of alcohol and other drugs. Despite the age-related decline in the prevalence of these disorders, they do still occur among those aged 65 years or older and, given historical changes in exposure to and use of illicit drugs, it likely that the prevalence of these disorders among older-aged individuals will rise. Specific issues faced by older-aged individuals with alcohol and other drug use problems are discussed. These include: interactions with prescribed medications, under-recognition and treatment of alcohol and drug problems, unintentional injury and social isolation. Finally, a brief discussion of treatment issues is provided.

Will chymase inhibitors be the next major development for the treatment of cardiovascular disorders?

Chymase is contained in the secretory granules of mast cells. In addition to the synthesis of angiotensin II, chymase is involved in transforming growth factor-beta activation and cleaves Type I procollagen to produce collagen. NK301 and BCEAB are orally-active inhibitors of chymase. NK301 was tested in a dog model of vascular intimal hyperplasia after balloon injury and shown to reduce the increased chymase activity in the injured arteries and prevent intimal thickening. In a hamster model of cardiac fibrosis associated with cardiomyopathy, BCEAB reduced the increased cardiac chymase activity in cardiomyopathy and reduced fibrosis. Chymase inhibitors may be an important development for the treatment of cardiovascular injury associated with mast cell degranulation.

Analysis of the return on preventive measures in musculoskeletal disorders through the benefitecost ratio: A case study in a hospital

Work-related musculoskeletal disorders (WMSDs) are among the most costly health problems that society is facing today. Prevention involves investments and it is important for organizations to make a cost ebenefit analysis of ergonomic projects. Return on prevention is a recent concern in the domain of occupational safety and health (OSH). There are many studies concerning the return on the prevention of WMSDs, in terms of the benefits for the organization in which the preventive measures are implemented. However, it is also important to perform an analysis of the impact of each measure on society (externalities). A model to perform a financial and economic costebenefit analysis related to OSH projects was developed and it was applied in the case of the prevention of WMSDs in a Portuguese hospital. An analysis of the accidents and corresponding costs has been made in six of the services of the hospital. Financial and an economic costebenefit analysis have been made and the benefitecost ratio (B/C) has been calculated. While the B/C financial ratio, considering only the benefits to the hospital, is around 2, the economic B/C ratio, taking into account all the external benefits that have been quantified, is higher than 14. Relevance to industry: Both the economic and the financial B/C ratio are important support tools for decision makers in public and private organizations, helping them to define which preventive measures should be implemented, taking into account the costs involved and the resulting quantified benefits, for the organization, for the workers and for the society.

As TIC e a Nova Metodologia de Análise Textual

Revista Lusófona de Línguas, Culturas e Tradução

Tecnologias de informação e comunicação (TIC) nas escolas : da idealização à realidade : estudos de casos múltiplos avaliativos realizado em escolas públicas do ensino médio do interior paraibano brasileiro

A escola parece ser um organismo impenetrável às transformações, resultantes do avanço científico e tecnológico, importantes para a formação do novo cidadão no contexto da atual sociedade. Esta dissertação analisa a realidade de três escolas públicas do Ensino Médio do interior do Estado da Paraíba-Brasil, relativamente à presença das Tecnologias de Informação e Comunicação (TIC) e sua utilização pelos professores. Na componente teórica abordamos sobre a inserção das TIC no cotidiano das escolas e as respectivas Políticas Educativas no Brasil sobre as TIC, com foco na proposta do Programa Nacional de Informática na Educação (ProInfo). A consecução dos objetivos conduziu a elaboração e análise de dois questionários, como instrumentos principais no processo de recolha de dados. O primeiro dirigido aos diretores das três escolas e o segundo direcionado aos professores dessas escolas. Os resultados evidenciam que o advento do computador e da Internet, apesar das suas potencialidades educativas, não modificou, de forma considerável, a prática dos professores. Verificou-se que estes, apesar de utilizarem as TIC a nível pessoal, pouco as exploram em contexto pedagógico dentro da sala de aula. Ao nível das escolas constatamos que as orientações do Programa Nacional não se efetivaram na prática, de forma a conduzir a definição de estratégias favoráveis à sua efetiva integração no contexto educativo. Verificamos também que as condições de funcionamento e quantidade de equipamentos disponíveis são dois importantes entraves à operacionalização das intenções constantes nos documentos do ProInfo.

A Rede Brasileira de Produção Pública de Medicamentos na perspectiva da gestão de cadeias de suprimentos: o papel das TIC

A indústria farmacêutica configura-se como um oligopólio, com produtos diferenciados em segmentos de classes terapêuticas específicas. As grandes farmacêuticas globais concentram seus esforços de pesquisa e de comercialização nas doenças degenerativas, que trazem maior retorno financeiro. No Brasil, destaca-se a presença de um conjunto de laboratórios públicos, os quais compõem a Rede Brasileira de Produção Pública de Medicamentos (RBPPM), voltados para as necessidades do Sistema Único de Saúde (SUS), em grande parte negligenciadas pelas Big Pharmas. O objetivo deste estudo é investigar o uso pelos laboratórios farmacêuticos oficiais brasileiros das contribuições derivadas das tecnologias da informação e comunicação (TIC), no sentido da integração da cadeia de suprimentos da RBPPM. Em sua primeira fase, a pesquisa de campo foi realizada por meio de uma abordagem quantitativa em todos os laboratórios oficiais afiliados à Associação de Laboratórios Farmacêuticos Oficiais Brasileiros (Alfob). Essa análise permitiu levantar questões que foram aprofundadas por meio da abordagem qualitativa em três laboratórios selecionados da fase anterior. As evidências coletadas permitem concluir que os objetivos descritos na criação da RBPPM, cujo alcance poderia ser facilitado pela adoção dos atributos da GCS pela rede capitaneada pelo Ministério da Saúde, ainda são incipientes e erráticos. O estudo demonstrou que, apesar das evidências teóricas e empíricas a respeito da capacidade das TIC de integrar processos, os laboratórios públicos brasileiros ainda fazem pouco uso das tecnologias estudadas na gestão de cadeias de suprimento (GCS), e o desempenho das poucas ferramentas encontradas revelou-se incipiente e insatisfatório. É bem provável que essa evidência seja uma decorrência natural do fato de que a RBPPM não utilizava uma abordagem de GCS na época em que esta pesquisa foi realizada.

Metodological issues in measuring the detection of emotional disorders by primary care physicians: a review of the literature

A series of studies in the field of Epidemiological Psychiatry have been performed over the last two decades, and these have focused on the ability of primary care physicians to detect emotional disorders in the patients that attend their practices. The scientific methodology utilized in these studies is the subject of this review, which contains a discussion concerning: a) interviewer awareness bias; b) accuracy of the instruments and c) medical and psychological concepts involved in defining minor emotional disorders. Suggestions for change in the methodology are made in each of the sections of the review.

Smoking, consumption of alcohol and sedentary life style in population grouping and their relationships with lipemic disorders

The study, part of the project "Atherosclerotic cardiovascular diseases, lipemic disorders, hypertension, obesity and diabetis mellitus in a population of the metropolitan area of the southeastern region of Brazil", had the following objectives: a) the characterization and distribution among typical human socio-economic groupings, of the prevalence of some particular habits which constitute aspects of life-style-the use of tobacco, the use of alcohol and sedentary activity; b) the establishment of the interrelation between the above-mentioned habits and some lipemic disorders. The prevalence of the habits cited behaved in the following manner: the use of tobacco predominated among men, distributed uniformly throughout the social strata; among the women the average percentage of smokers was 18,9%, a significant difference occurring among the highest socio-economic class, where the average was of 40.2%. The sedentary style of life presented high prevalence, among both men and women with exception of the women of the highest socio-economic level and of the skilled working class. The use of alcohol, as one would expect, is a habit basically practised by the men, without any statistically significant differences between classes. For the purpose of establishing associations between these risk fictors and lipemic conditions four situations were chosen, of the following characteristics: 1- total cholesterol > or = 220 mg/dl and triglycerides > or = 150 mg/dl; 2- HDL cholesterol <35 mg/dl for men and <45 mg/dl for women and triglycerides levels > or = 150 mg/dl; 3- HDL cholesterol <35 mg/dl for men and <45 mg/dl for women and triglycerides levels <150 mg/dl; 4- total cholesterol 220 mg/dl with triglycerides levels <150 mg/dl. Six models of multiple (backward) regression were established, with seven independent variables- age, sex, use of tobacco, consumption of alcohol, light physical activity, hypertension and obesity. Significant associations (P<0,05) were revealed with hypercholesterolemia, accompanied by triglyceride levels > or = 150 mg/dl, and the following independent variables: age, use of tobacco and the interactions between obesity and smoking, age and sedentary lifestyle, sex and obesity (R2=22%); the standardized B coefficient showed that the variables with the greatest weight in the forecasting of the variation in the levels of cholesterol were smoking and the interaction between obesity and smoking. The hypercholesterolemia accompanied by triglycerides levels <150 mg/dl showed a positive association between total cholesterol and sex and the interactions obesity/smoking and sex/obesity. As regards HDL cholesterol accompanied by triglyceride/ levels > or = 150 mg/dl was inversely associated with obesity and the interaction smoking/ age and directly with age (R=31%). The standardized B coeffients, indicated that the variables obesity and the interactions smoking/age possessed a weight three times greater than age alone in accounting for the variation in the serum levels of HDL cholesterol. When accompanied by triglycerides <150 mg/dl there was no association between and the independent variables and the set of them presented R equal to 22%. The sum of top, in the population stutied in this project, the component habits of life-style (smoking, alcohol consumption and sedentary activity) which constitute risk factors which determine morbidity from atherosclerotic cardiovascular diseases are be found distributed through all the typical social groupings of this particular form of social organization. On the other hand, the seven independent variables used in the multiple regression models for the explanation of the lipemic conditions considered presented multiple determination coefficients which varied, approximately, between 20% and 30%. Thus it is important that in the genetic epidemiology the study of the morbidities in question be emphasized.

O uso das TIC em salas de aula inclusivas : atitudes e práticas de professores do 1º ciclo

Numa escola para todos, o grande desafio, passa pela qualidade educativa, sendo necessária uma adaptação do ensino às características pessoais dos alunos, num ambiente o menos restritivo possível. Uma abordagem inclusiva do aluno com NEE assenta em soluções exequíveis, emergindo, entre outras a utilização de estratégias diversificadas e a rentabilização de recursos disponíveis, como práticas de diferenciação pedagógica positiva. Neste sentido, o problema central deste estudo prende-se com o tipo de uso que fazem das TIC os professores e alunos de salas de aula do 1º CEB, quando nessas salas de aula existem alunos com NEE que necessitam das tecnologias para aprender e para comunicar. Assim, o estudo visa conhecer as concepções e práticas dos professores do 1º CEB sobre o uso das TIC em salas de aula inclusivas, procurando saber: i) as percepções dos professores sobre as necessidades educativas especiais dos alunos em turmas inclusivas e as suas expectativas relativamente às aprendizagens destes alunos; ii) o papel atribuído pelos professores às TIC no processo de aprendizagem dos alunos em geral e dos alunos NEE em particular; assim como identificar: iii) o uso das TIC que os professores planeiam e desenvolvem efectivamente em sala de aula com a turma e, em particular com os alunos com NEE. O trabalho desenvolveu-se através de um estudo de caso de uma escola do 1º CEB, centrando-se em oito professores, responsáveis por turmas inclusivas. Como processo de recolha de dados utilizámos as técnicas da entrevista e da observação directa naturalista em sala de aula. Concluímos que os professores aceitam a inclusão, por razões diversas, mas sobretudo por a considerarem benéfica para o aluno com NEE. Consideram que os alunos com NEE têm necessidade de um bom clima sócio-emocional na sala de aula e assumem a necessidade de adequar actividades diferenciadas ao perfil de funcionalidade desses alunos, evidenciando a preocupação de fazer aprender estes alunos no sentido de os tornarem competentes. Quanto à abordagem curricular para os alunos com NEE, os professores revelam atenção à evolução dos alunos e diferenciam o currículo de forma a corresponder às suas necessidades. As inquietações dos professores vão, em parte, para factores de ordem estrutural e/ou ambiental, exteriores ao aluno, manifestando preocupações ligadas à falta de recursos humanos e materiais. A articulação com o professor de Educação Especial pressupõe uma díade cooperativa, que ao regular o percurso do aluno com NEE, promove também uma educação inclusiva. Quanto ao papel atribuído às TIC os professores, recorrem ao seu uso quando sentem necessidade de motivar os alunos, pois as mesmas permitem a obtenção de resultados mais positivos na aprendizagem, adaptando-se às exigências dos alunos em geral, assim como à especificidade dos alunos com NEE. Quanto à prática no uso das TIC, em dinâmicas de ensino e de aprendizagem, foi possível observar, que o recurso a equipamentos e programas adequados às necessidades dos alunos com NEE, não apenas promove a motivação e a aprendizagem destes alunos, como ajuda o professor a assegurar um clima de estabilidade e trabalho na sala de aula inclusiva.

Predicting the revolving door phenomenon among patients with schizophrenic, affective disorders and non-organic psychoses

OBJECTIVE: The aim of the study was to identify the variables that predict the revolving door phenomenon in psychiatric hospital at the moment of a second admission. METHODS: The sample consisted of 3,093 patients who have been followed during 5 to 24 years after their first hospital admission due to schizophrenia, and affective or psychotic disorders. Those who had had four or more admissions during the study period were considered as revolving door patients. Logistic regression analyses were used to assess the impact of gender, age, marital status, urban conditions, diagnosis, mean period of stay on the first admission, interval between the first and second admissions on the patterns of hospitalization. RESULTS: The variables with the highest predictive power for readmission were the interval between first and second admissions, and the length of stay in the first admission. CONCLUSIONS: These data may help public health planners in providing optimal care to a small group of patients with more effective utilization of the available services.

Clinical and functional aspects of work-related musculoskeletal disorders among active workers

OBJECTIVE: To evaluate musculoskeletal disorders among active industrial workers. METHODS: The study was carried out in São Carlos, Southeastern Brazil, in 2005. One hundred and thirty-four female workers were physically evaluated and answered questions about their physical symptoms, filled out a pain scale and gave responses in the Oswestry Disability Questionnaire, and the Work Ability Index questionnaire. The data were analyzed descriptively, and in correlation tests and through applying logistic regression. The outcome was evaluated in relation to the perceptions of pain, symptoms, physical assessment, ability to work and disability. RESULTS: Clinical evaluations and sick leave presented positive correlations with the subjective variables. The Work Ability Index presented a negative correlation with the physical disability index (r=-0.69). Symptoms reported at the time of the assessment presented a good correlation with the results from the pain scale and the clinical findings. Previous sick leave showed an association with disability (OR=1.13; 95% CI:1.08;1.18). CONCLUSION: Symptom reports and pain scales may be useful for assessing current conditions at the time of evaluating individuals with work-related musculoskeletal disorders, as they are easier to apply. In more severe cases of such injuries, clinical and functional evaluations and questionnaires such as those relating to ability to work and disability are preferable. Precise and specific evaluations of these disorders may contribute towards fairer legal and administrative decisions.

A relevância curricular no ensino de História : A importância das TIC

Fórum Internacional de Pedagogia (FIPED V): "À Descoberta da Investigação", Angra do Heroísmo, Universidade dos Açores, 17 e 18 de abril de 2015.

Survey of hearing disorders in an urban population in Rondonia, Northern Brazil

OBJECTIVE: To identify the prevalence of hearing loss for the population in the urban area. METHODS: A cross-sectional household survey based on the World Health Organization Ear and Hearing Disorders Survey Protocol was conducted in 298 households in the urban area of Monte Negro, Rondonia, Northern Brazil, from 2005 to 2007. Ear examinations, behavioral audiometry and pure tone audiometry were conducted on 577 individuals. RESULTS: The results showed that 3.8% (95%CI 2.17;5.45) of population were classified in the disabling hearing impairment category. The prevalence of moderate hearing impairment was 3.4%; severe impairment was 0.4%; and profound hearing impairment was not found. CONCLUSIONS: The impairing hearing loss prevalence found in this study is within of the international prevalence for this level of hearing loss and smaller than observed in a previous study in the South region of Brazil.