A psicologia económica associada ao cumprimento fiscal em IVA

Mestrado em Contabilidade, Fiscalidade e Finanças Empresariais

Influência do zinco suplementar na maturação biológica e no crescimento de jovens atletas de futebol do sexo masculino

Introdução O zinco é um importante elemento traço que auxilia na capacidade antioxidante, além de participar da maturação biológica. Em atletas, a suplementação de zinco tem efeito positivo nos parâmetros hematológicos e pode melhorar o rendimento esportivo. Sua deficiência é comumente observada nesses grupo e pode estar associada à diminuição da força física assim como da massa corporal, além de ter efeito significativo no crescimento. Assim os objetivos do presente estudo foram: comparar os métodos de avaliação da maturidade biológica e suas relações com variáveis antropométricas e de rendimento físico de acordo com o estado de zinco em jovens jogadores de futebol; comparar diferentes métodos de avaliação da composição corporal em jovens jogadores de futebol esratificados de acordo com os níveis plasmáticos de zinco e investigar o efeito do zinco suplementar na maturação biológica, no crescimento, na composição corporal e na força muscular de jogadores de futebol púberes do sexo masculino. Materiais e métodos Foram avaliados em dois momentos 48 jovens do sexo masculino (13±1 anos, massa corporal de 48±10kg, estatura de 160±10cm e zinco plasmático de 12,1±2,2 μmol/L). Todos eram jogadores de futebol de um tradicional clube do Rio de Janeiro e foram divididos aleatoriamente em dois grupos. Durante 12 semanas o grupo placebo (n=28) recebeu cápsulas de amido de milho e o grupo suplementado (n=20) recebeu cápsulas de gluconato de Zn (22mg/dia). O valor de 11,0 μmol/L foi considerado como ponto de corte para classificação dos jovens em normozincêmicos ou hipozincêmicos. No início da manhã, após jejum noturno, foram coletados sangue e urina para determinação da concentração de zinco. A massa corporal, alturas (do vértex, acromial, dactiloidal, iliocristal, trocantérica e sentado), composição corporal, força e maturidade esquelética (TW3) também foram determinadas por metodologias validadas. Resultados As comparações entre as categorias maturacionais definidas por cada método de avaliação mostraram que a idade óssea foi o único método que permitiu a identificação de diferenças entre as três categorias, em ao menos duas variáeis relacionadas ao rendimento (massa livre de gordura (MLG) e força na mão dominante (FMD) – p<0,0001). O método da pilosidade axilar foi capaz de discriminar apenas para a FMD (p<0,0001). Embora tenha fornecido quatro categorias maturacionais, o método por dosagem da testosterona não possibilitou a identificação de diferenças entre as categorias relativas a MLG, a FMD e as dobras cutâneas(DC). Quando observamos os métodos de avaliação da composição corporal não foram identificadas diferenças sigificativas entre os grupos hipozincêmico e normozincêmico no percentagem de gordura(PG) nem na MLG obtidas através dos métodos da absortometria de dupla energia (DXA) (p=0,06076 e p=0,5638 respectivamente), das DC (p=0,6840 and 0,5087) e através da bioimpedância elétrica (BIA) (p=0,3475 and p=0,3475). Entre os diferentes métodos também não foi encontrada diferenças significativas (PG: p=0,1272 e p=0,3231 - MLG: p=0,9229 and p=0,8933 para os grupos hipozincêmico e normozincêmico, respectivamente). As correlações entre os métodos foram significativas (PG: r= 0,3414 a 0,9765 e p<0,0001 a 0,0133 - MLG: r=0,9533 a 0,9998 e p<0,0001). Fortes coeficientes de determinação foram obtidos nas regressões múltiplas dos valores do DXA com a equação de Slaughter na estimativa da PG (r=0,86; r2=0,928 e SEE=2,37%) e ainda maiores para MLG (r=0,98; r2=0,990 e SEE=1,18kg). Valores menores foram encontrados para as outras equações com DC e para BIA. Ao analisar os efeitos da suplementação de zinco sobre o crescimento, a maturação, a composição corporal e a força, observou-se que somente as alterações ocorridas nos indicadores de crescimento foram significativas (p=0,0312), sendo que todas as demais não foram significativas - idade óssea (p=0,1391), massa livre de gordura (p=0,0593), percentual de massa gorda (p=0,2212) e força na mão dominante (p=0,6569). Conclusões Observando diferentes métodos de avaliação da maturidade biológica e as categorias por eles definidas, o método da idade óssea (IO) mostrou ser melhor, visto que ele permitiu identificar diferenças entre as três categorias possíveis, nas variáveis MLG e FMD, ao contrário dos outros métodos. Para a avaliação da composição corporal, os métodos baseados nas DC foram melhores que BIA, quando DXA não estiver disponível. A comparação entre os métodos baseados nas DC mostrou que a melhor associação foi obtida com a equação de Slaughter, seguida pela equação de Lohman com a utilização da IO ao invés da idade cronológica. Os níveis de zinco plasmático parecem não serem influenciados pela composição corporal, o que certamente justifica mais estudos. Os resultados da análise dos efeitos da suplementação de zinco no crescimento, na maturação, na composição corporal e na força, nos levam a concluir que o crescimento teve alteração positiva significativa e que os valores das demais variáveis estudadas (maturação, composição corporal e força muscular) não sofreram alterações significativas relacionadas à suplementação de zinco nos jovens jogadores de futebol do sexo masculino, na faixa etária dos 12 aos 14 anos.

Caracterização clínica, metabólica e hormonal de portadores de lipodistrofia parcial familiar

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, 2015.

Hazard Mitigation Element Quality in Coastal Comprehensive Plans in a State with Strong Requirements for Hazard Mitigation Plan Elements

This dissertation examines the quality of hazard mitigation elements in a coastal, hazard prone state. I answer two questions. First, in a state with a strong mandate for hazard mitigation elements in comprehensive plans, does plan quality differ among county governments? Second, if such variation exists, what drives this variation? My research focuses primarily on Florida’s 35 coastal counties, which are all at risk for hurricane and flood hazards, and all fall under Florida’s mandate to have a comprehensive plan that includes a hazard mitigation element. Research methods included document review to rate the hazard mitigation elements of all 35 coastal county plans and subsequent analysis against demographic and hazard history factors. Following this, I conducted an electronic, nationwide survey of planning professionals and academics, informed by interviews of planning leaders in Florida counties. I found that hazard mitigation element quality varied widely among the 35 Florida coastal counties, but were close to a normal distribution. No plans were of exceptionally high quality. Overall, historical hazard effects did not correlate with hazard mitigation element quality, but some demographic variables that are associated with urban populations did. The variance in hazard mitigation element quality indicates that while state law may mandate, and even prescribe, hazard mitigation in local comprehensive plans, not all plans will result in equal, or even adequate, protection for people. Furthermore, the mixed correlations with demographic variables representing social and disaster vulnerability shows that, at least at the county level, vulnerability to hazards does not have a strong effect on hazard mitigation element quality. From a theory perspective, my research is significant because it compares assumptions about vulnerability based on hazard history and demographics to plan quality. The only vulnerability-related variables that appeared to correlate, and at that mildly so, with hazard mitigation element quality, were those typically representing more urban areas. In terms of the theory of Neo-Institutionalism and theories related to learning organizations, my research shows that planning departments appear to have set norms and rules of operating that preclude both significant public involvement and learning from prior hazard events.

The Performance and Service Life Prediction of High Performance Concrete in Sulfate and Acidic Environments

Concrete substructures are often subjected to environmental deterioration, such as sulfate and acid attack, which leads to severe damage and causes structure degradation or even failure. In order to improve the durability of concrete, the High Performance Concrete (HPC) has become widely used by partially replacing cement with pozzolanic materials. However, HPC degradation mechanisms in sulfate and acidic environments are not completely understood. It is therefore important to evaluate the performance of the HPC in such conditions and predict concrete service life by establishing degradation models. This study began with a review of available environmental data in the State of Florida. A total of seven bridges have been inspected. Concrete cores were taken from these bridge piles and were subjected for microstructural analysis using Scanning Electron Microscope (SEM). Ettringite is found to be the products of sulfate attack in sulfate and acidic condition. In order to quantitatively analyze concrete deterioration level, an image processing program is designed using Matlab to obtain quantitative data. Crack percentage (Acrack/Asurface) is used to evaluate concrete deterioration. Thereafter, correlation analysis was performed to find the correlation between five related variables and concrete deterioration. Environmental sulfate concentration and bridge age were found to be positively correlated, while environmental pH level was found to be negatively correlated. Besides environmental conditions, concrete property factor was also included in the equation. It was derived from laboratory testing data. Experimental tests were carried out implementing accelerated expansion test under controlled environment. Specimens of eight different mix designs were prepared. The effect of pozzolanic replacement rate was taken into consideration in the empirical equation. And the empirical equation was validated with existing bridges. Results show that the proposed equations compared well with field test results with a maximum deviation of ± 20%. Two examples showing how to use the proposed equations are provided to guide the practical implementation. In conclusion, the proposed approach of relating microcracks to deterioration is a better method than existing diffusion and sorption models since sulfate attack cause cracking in concrete. Imaging technique provided in this study can also be used to quantitatively analyze concrete samples.

Health profile of centenarians in Portugal: a census-based approach

Background: The number of centenarians is rapidly increasing in Europe. In Portugal, it has almost tripled over the last 10 years and constitutes one of the fastest-growing segments of the population. This paper aims to describe the health and sociodemographic characteristics of Portuguese centenarians as given in the 2011 census and to identify sex differences. Methods: All persons living in Portugal mainland and Madeira and Azores islands aged 100 years old at the time of the 2011 census (N = 1,526) were considered. Measures include sociodemographic characteristics and perceived difficulties in six functional domains of basic actions (seeing, hearing, walking, cognition, self-care, and communication) as assessed by the Portuguese census official questionnaires. Results: Most centenarians are women (82.1 %), widowed (82 %), never attended school (51 %), and live in private households (71 %). The majority show major constraints in seeing (67.4 %), hearing (72.3 %), and particularly in their mobility (83.7 % cannot/have great difficulties in walking/climbing stairs and 80.7 % in bathing/dressing). In general, a better outcome was found for reported memory/concentration and understanding, with 39.1 % and 42.5 % presenting no or mild difficulty, respectively. Top-level functioning (no/mild difficulties in all dimensions concurrently) was observed in a minority of cases (5.96 %). Women outnumber men by a ratio of 4.6, and statistically significant differences were found between men and women for all health-related variables, with women presenting a higher percentage of difficulties. Conclusion: Portuguese centenarians experience great difficulties in sensory domains and basic daily living activities, and to a lesser extent in cognition and communication. The obtained profile, though self-reported, is important in considering the potential of social and family participation of this population regardless of their functional and sensory limitations. Based on the observed differences between men and women, gender-specific and gender-sensitive interventions are recommended in order to acknowledge women’s worse overall condition.

Concurrent validity of the Swedish version of the life-space assessment questionnaire

BACKGROUND: The Life-Space Assessment (LSA), developed in the USA, is an instrument focusing on mobility with respect to reaching different areas defined as life-spaces, extending from the room where the person sleeps to mobility outside one's hometown. A newly translated Swedish version of the LSA (LSA-S) has been tested for test-retest reliability, but the validity remains to be tested. The purpose of the present study was to examine the concurrent validity of the LSA-S, by comparing and correlating the LSA scores to other measures of mobility. METHOD: The LSA was included in a population-based study of health, functioning and mobility among older persons in Sweden, and the present analysis comprised 312 community-dwelling participants. To test the concurrent validity, the LSA scores were compared to a number of other mobility-related variables, including the Short Physical Performance Battery (SPPB) as well as "stair climbing", "transfers", "transportation", "food shopping", "travel for pleasure" and "community activities". The LSA total mean scores for different levels of the other mobility-related variables, and measures of correlation were calculated. RESULTS: Higher LSA total mean scores were observed with higher levels of all the other mobility related variables. Most of the correlations between the LSA and the other mobility variables were large (r = 0.5-1.0) and significant at the 0.01 level. The LSA total score, as well as independent life-space and assistive life-space correlated with transportation (0.63, 0.66, 0.64) and food shopping (0.55, 0.58, 0.55). Assistive life-space also correlated with SPPB (0.47). With respect to maximal life-space, the correlations with the mobility-related variables were generally lower (below 0.5), probably since this aspect of life-space mobility is highly influenced by social support and is not so dependent on the individual's own physical function. CONCLUSION: LSA was shown to be a valid measure of mobility when using the LSA total, independent LS or assistive LSA.

Do health care providers use online patient ratings to improve the quality of care?

Background: Physician-rating websites have become a popular tool to create more transparency about the quality of health care providers. So far, it remains unknown whether online-based rating websites have the potential to contribute to a better standard of care. Objective: Our goal was to examine which health care providers use online rating websites and for what purposes, and whether health care providers use online patient ratings to improve patient care. Methods: We conducted an online-based cross-sectional study by surveying 2360 physicians and other health care providers (September 2015). In addition to descriptive statistics, we performed multilevel logistic regression models to ascertain the effects of providers' demographics as well as report card-related variables on the likelihood that providers implement measures to improve patient care. Results: Overall, more than half of the responding providers surveyed (54.66%, 1290/2360) used online ratings to derive measures to improve patient care (implemented measures: mean 3.06, SD 2.29). Ophthalmologists (68%, 40/59) and gynecologists (65.4%, 123/188) were most likely to implement any measures. The most widely implemented quality measures were related to communication with patients (28.77%, 679/2360), the appointment scheduling process (23.60%, 557/2360), and office workflow (21.23%, 501/2360). Scaled-survey results had a greater impact on deriving measures than narrative comments. Multilevel logistic regression models revealed medical specialty, the frequency of report card use, and the appraisal of the trustworthiness of scaled-survey ratings to be significantly associated predictors for implementing measures to improve patient care because of online ratings. Conclusions: Our results suggest that online ratings displayed on physician-rating websites have an impact on patient care. Despite the limitations of our study and unintended consequences of physician-rating websites, they still may have the potential to improve patient care.

Depresión en pacientes con epilepsia: Revisión sistemática de la literatura

Esta revisión sistemática de la literatura tuvo como objetivo investigar sobre la depresión en personas con epilepsia en la última década (2005-2015), enfocándose en identificar en el paciente con epilepsia: características sociodemográficas, prevalencia de la depresión, tipos de intervención para el manejo de la depresión, factores asociados con la aparición y el mantenimiento de la depresión y por último, identificar las tendencias en investigación en el estudio de la depresión en pacientes con epilepsia. Se revisaron 103 artículos publicados entre 2005 y 2015 en bases de datos especializadas. Los resultados revelaron que la prevalencia de depresión en pacientes con epilepsia es diversa y oscila en un rango amplio entre 3 y 70 %, por otro lado, que las principales características sociodemográficas asociadas a la depresión está el ser mujer, tener un estado civil soltero y tener una edad comprendida entre los 25 y los 45 años. A esto se añade, que los tratamientos conformados por terapia psicológica y fármacos, son la mejor opción para garantizar la eficacia en los resultados del manejo de la depresión en los pacientes con epilepsia. Con respecto a los factores asociados a la aparición de la depresión en pacientes con epilepsia, se identificaron causas tanto neurobiológicas como psicosociales, asimismo los factores principales asociados al mantenimiento fueron una percepción de baja calidad de vida y una baja auto-eficacia. Y finalmente los tipos de investigación más comunes son de tipo aplicado, de carácter descriptivo, transversales y de medición cuantitativa.

Effects of an emotional intelligence program in variables related to the prevention of violence

In recent decades, numerous studies have shown a significant increase in violence during childhood and adolescence. These data suggest the importance of implementing programs to prevent and reduce violent behavior. The study aimed to design a program of emotional intelligence (El) for adolescents and to assess its effects on variables related to violence prevention. The possible differential effect of the program on both genders was also examined. The sample comprised 148 adolescents aged from 13 to 16 years. The study used an experimental design with repeated pretest-posttest measures and control groups. To measure the variables, four assessment instruments were administered before and after the program, as well as in the follow-up phase (1 year after the conclusion of the intervention). The program consisted of 20 one-hour sessions. The pretest-posttest ANCOVAs showed that the program significantly increased: (1) El (attention, clarity, emotional repair); (2) assertive cognitive social interaction strategies; (3) internal control of anger; and (4) the cognitive ability to analyze negative feelings. In the follow-up phase, the positive effects of the intervention were generally maintained and, moreover, the use of aggressive strategies as an interpersonal conflict-resolution technique was significantly reduced. Regarding the effect of the program on both genders, the change was very similar, but the boys increased assertive social interaction strategies, attention, and emotional clarity significantly more than the girls. The importance of implementing programs to promote socio-emotional development and prevent violence is discussed.

Characterization and optimization of experimental variables within a reproducible bladder encrustation model and in vitro evaluation of the efficacy of urease inhibitors for the prevention of medical device-related encrustation

This study presents a reproducible, cost-effective in vitro encrustation model and, furthermore, describes the effects of components of the artificial urine and the presence of agents that modify the action of urease on encrustation on commercially available ureteral stents. The encrustation model involved the use of small-volume reactors (700 mL) containing artificial urine and employing an orbital incubator (at 37 degrees C) to ensure controlled stirring. The artificial urine contained sources of calcium and magnesium (both as chlorides), albumin and urease. Alteration of the ratio (% w/w) of calcium salt to magnesium salt affected the mass of encrustation, with the greatest encrustation noted whenever magnesium was excluded from the artificial urine. Increasing the concentration of albumin, designed to mimic the presence of protein in urine, significantly decreased the mass of both calcium and magnesium encrustation until a plateau was observed. Finally, exclusion of urease from the artificial urine significantly reduced encrustation due to the indirect effects of this enzyme on pH. Inclusion of the urease inhibitor, acetohydroxamic acid, or urease substrates (methylurea or ethylurea) into the artificial medium markedly reduced encrustation on ureteral stents. In conclusion, this study has described the design of a reproducible, cost-effective in vitro encrustation model. Encrustation was markedly reduced on biomaterials by the inclusion of agents that modify the action of urease. These agents may, therefore, offer a novel clinical approach to the control of encrustation on urological medical devices. (c) 2005 Wiley Periodicals, Inc.

Differentiating between tuberculosis-related and lymphoma-related lymphocytic pleural effusions by measuring clinical and laboratory variables: Is it possible?

Objective: To describe clinical and laboratory characteristics in patients with tuberculosis-related or lymphoma-related lymphocytic pleural effusions, in order to identify the variables that might contribute to differentiating between these diseases. Methods: This was a retrospective study involving 159 adult HIV-negative patients with tuberculosis-related or lymphoma-related lymphocytic effusions (130 and 29 patients, respectively), treated between October of 2008 and March of 2010 at the Pleural Diseases Outpatient Clinic of the University of Sao Paulo School of Medicine Hospital das Clinicas Heart Institute, in the city of Sao Paulo, Brazil. Results: Mean age and the mean duration of symptoms were lower in the tuberculosis group than in the lymphoma group. The levels of proteins, albumin, cholesterol, amylase, and adenosine deaminase (ADA) in pleural fluid, as well as the serum levels of proteins, albumin, and amylase, were higher in the tuberculosis group, whereas serum cholesterol and triglycerides were higher in the lymphoma group. Pleural fluid leukocyte and lymphocyte counts were higher in the tuberculosis group. Of the tuberculosis group patients, none showed malignant cells; however, 4 showed atypical lymphocytes. Among the lymphoma group patients, cytology for neoplastic cells was positive, suspicious, and negative in 51.8%, 24.1%, and 24.1%, respectively. Immunophenotyping of pleural fluid was conclusive in most of the lymphoma patients. Conclusions: Our results demonstrate clinical and laboratory similarities among the patients with tuberculosis or lymphoma. Although protein and ADA levels in pleural fluid tended to be higher in the tuberculosis group than in the lymphoma group, even these variables showed an overlap. However, none of the tuberculosis group patients had pleural fluid ADA levels below the 40-U/L cut-off point.