Reduced face preference in infancy: a developmental precursor to callous-unemotional traits?

Background Children with callous-unemotional (CU) traits, a proposed precursor to adult psychopathy, are characterized by impaired emotion recognition, reduced responsiveness to others’ distress, and a lack of guilt or empathy. Reduced attention to faces, and more specifically to the eye region, has been proposed to underlie these difficulties, although this has never been tested longitudinally from infancy. Attention to faces occurs within the context of dyadic caregiver interactions, and early environment including parenting characteristics has been associated with CU traits. The present study tested whether infants’ preferential tracking of a face with direct gaze and levels of maternal sensitivity predict later CU traits. Methods Data were analyzed from a stratified random sample of 213 participants drawn from a population-based sample of 1233 first-time mothers. Infants’ preferential face tracking at 5 weeks and maternal sensitivity at 29 weeks were entered into a weighted linear regression as predictors of CU traits at 2.5 years. Results Controlling for a range of confounders (e.g., deprivation), lower preferential face tracking predicted higher CU traits (p = .001). Higher maternal sensitivity predicted lower CU traits in girls (p = .009), but not boys. No significant interaction between face tracking and maternal sensitivity was found. Conclusions This is the first study to show that attention to social features during infancy as well as early sensitive parenting predict the subsequent development of CU traits. Identifying such early atypicalities offers the potential for developing parent-mediated interventions in children at risk for developing CU traits.

Impact of chronic disease on quality of life among the elderly in the state of Sao Paulo, Brazil: a population-based study

Objectives. To assess the impact of chronic disease and the number of diseases on the various aspects of health-related quality of life (HRQOL) among the elderly in Sao Paulo, Brazil. Methods. The SF-36 (R) Health Survey was used to assess the impact of the most prevalent chronic diseases on HRQOL. A cross-sectional and population-based study was carried out with two-stage stratified cluster sampling. Data were obtained from a multicenter health survey administered through household interviews in several municipalities in the state of Sao Paulo. The study evaluated seven diseases-arthritis, back-pain, depression/anxiety, diabetes, hypertension, osteoporosis, and stroke-and their effects on quality of life. Results. Among the 1958 elderly individuals (60 years of age or older), 13.6% reported not having any of the illnesses, whereas 45.7% presented three or more chronic conditions. The presence of any of the seven chronic illnesses studied had a significant effect on the scores Of nearly all the SF-36 (R) scales. HRQOL achieved lower scores when related to depression/anxiety, osteoporosis, and stroke. The higher the number of diseases, the greater the negative effect on the SF-36 (R) dimensions. The presence of three or more diseases significantly affected HRQOL in all areas. The bodily pain, general health, and vitality scales were the most affected by diseases. Conclusions. The study detected a high prevalence of chronic diseases among the elderly population and found that the degree of impact on HRQOL depends on the type of disease. The results highlight the importance of preventing and controlling chronic diseases in order to reduce the number of comorbidities and lessen their impact on HRQOL among the elderly.

Acesso a atendimento médico continuado : uma estratégia para reduzir a utilização de consultas não urgentes em serviços de emergência

A utilização de uma emergência por pacientes com problemas médicos eletivos contribui para a demanda excessiva e impede de acesso a pacientes com emergência verdadeira. O presente estudo se propôs: (1) investigar as características do usuário da emergência em relação a aspectos demográficos, local de moradia e tempo que apresenta os sintomas que o levaram a consultar; (2) identificar as diferenças da demanda entre o final de semana e durante a semana; (3) investigar a prevalência de saúde mental, alcoolismo, doença coronariana e hipertensão; (4) avaliar como é a utilização e o acesso a serviços de saúde para pacientes que referem ter um médico definido em comparação com quem refere não ter; (5) avaliar a satisfação dos pacientes com o atendimento na emergência e (6) verificar se o atendimento através de um médico definido ou em serviço de atenção primária em saúde diminui o afluxo de casos não urgentes aos serviços de emergência. Foi realizado um estudo transversal na Emergência do Hospital N.S. da Conceição de Porto Alegre (RS) no período de 6 de janeiro a 25 de junho de 1996, tendo sido incluídos 20 dias escolhidos entre o meio-dia de sábado e o meio-dia de domingo, para caracterizar a demanda do final de semana, e o meio-dia de segunda-feira e meio-dia de terça-feira, para a dos outros dias. Fizeram parte da amostra 553 pacientes selecionados através de amostragem aleatória sistemática, com uma taxa de resposta de 88%. A coleta de dados consistiu de questionário de 156 questões aplicado aos pacientes. O registro e análise dos dados foram realizados utilizando-se os programas Epi-Info, EGRET e SPSS. As análises incluíram tabulações simples para determinação de prevalência das condições investigadas e regressão logística para avaliar o efeito conjunto das variáveis independentes sobre cada uma das variáveis dependentes. A população que freqüenta a emergência do HNSC é composta de jovens, predominantemente do sexo feminino, mora em Porto Alegre (especialmente, no bairro Sarandi) e na Grande Porto Alegre (especialmente, Alvorada), desloca-se preferencialmente de ônibus até o serviço de emergência, vem acompanhada, na maioria das vezes, de algum familiar, e a maioria decide consultar por iniciativa própria ou por indicação de algum familiar. Os homens internam com maior freqüência. Os serviços de atenção primária representaram 23% do atendimento habitual dos pacientes. As consultas foram definidas pelos emergencistas como de emergência em 15% dos casos, de urgência em 46%, e programáveis em 39% poderiam ser programadas. A prevalência de hipertensão foi 19%; de angina, 13%; de alcoolismo, 16%; de problema psiquiátrico menor, 32% entre os homens e 51% entre as mulheres (p< 0,0001). Como desfecho da consulta, 73% dos pacientes foram encaminhados para o domicílio ou para um serviço especializado, 10% foram para sala de observação e para apenas 5% foi indicada a internação. A maioria dos pacientes referiram estar satisfeitos com o atendimento. Os que consultaram no final de semana apresentaram, em média, um tempo menor de sintomas até decidir consultar, um menor tempo de deslocamento até o serviço de emergência, maior satisfação, média de idade maior, maior proporção de moradores de Porto Alegre e foram levados de carro até a emergência mais do que aqueles que consultaram durante a semana. O modelo de regressão logística identificou as variáveis independentes determinantes de ter um médico definido: consulta habitual em atenção primária em saúde (RC=3,22 IC95%=2,04-5,09), consulta definida como emergência ou urgência (RC=2,46 IC95%=1,55-3,92) e afastamento do trabalho (RC=1,59 IC95%= 1,03-2,45). Este resultado demonstra que o paciente que habitualmente consulta em serviços de atenção primária tem mais probabilidade para ter a continuidade no atendimento. A consulta ser de emergência ou de urgência apresentou associação significativa com as seguintes variáveis independentes, após ser colocada num modelo de regressão logística: pacientes internados ou em observação (RC=5,80 IC95%=3,33-10,17), costume de consultar com o mesmo médico (RC=2,98 IC95%=1,84-4,80) e ida de carro até a emergência (RC=2,67 IC95%=1,75-4,05). A variável hábito de consultar em serviço de atenção primária deixou de ficar estatisticamente significativa ao ser colocada no modelo de regressão logística. Este resultado revela que pacientes com médico definido têm três vezes mais chances de consultar por um problema de emergência no serviço de emergência do que aqueles que não têm um médico definido. Assim, uma estratégia para reduzir a ocorrência de consultas não urgentes em serviços de emergência é o paciente ter tal vínculo. No entanto, aqueles pacientes que referiram o posto de saúde como local onde habitualmente consultam não evitam, necessariamente, a utilização de um serviço de emergência por motivo considerado como programável. É necessário otimizar o atendimento de pacientes com problemas não urgentes que chegam à emergência através de estratégias no nível de atenção primária – especialmente possibilitando o atendimento médico continuado -, onde uma abordagem integral com ênfase na prevenção garanta um atendimento de melhor qualidade e custo menor.

O significado da distribuição para os grandes bancos verejistas: análise e consequências sob o ponto de vista de marketing

Trata da revolução em curso nos canais de distribuição dos grandes bancos varejistas em função dos impactos provocados pela tecnologia, pela globalização, pelas parcerias e pela formação de um novo ambiente de distribuição eletrônico, remoto e virtual denominado como marketspace. Esse novo ambiente, até o ano de 2007, deverá canalizar 2/3 dos negócios bancários que envolvam efetiva intermediação financeira. A revolução é tão importante que pode significar o início de um novo ciclo no negócio dos grandes bancos varejistas. Os impactos sobre marketing são igualmente poderosos, exigindo dos bancos uma completa revisão de sua estratégia mercadológica. Evidências foram colhidas de extensiva revisão bibliográfica, através de entrevistas em profundidade e de pesquisa amostrai com clientes bancários. Cursos de ação são sugeridos.

A confiança interorganizacional nas compras

This research is part of the field of organizational studies, focusing on organizational purchase behavior and, specifically, trust interorganizational at the purchases. This topic is current and relevant by addressing the development of good relations between buyer-supplier that increases the exchange of information, increases the length of relationship, reduces the hierarchical controls and improves performance. Furthermore, although there is a vast literature on trust, the scientific work that deal specifically at the trust interorganizational still need further research to synthesize and validate the variables that generate this phenomenon. In this sense, this investigation is to explain the antecedents of trust interorganizational by the relationship between the variable operational performance, organizational characteristics, shared values and interpersonal relationships on purchases by manufacturing industries, in order to develop a robust literature, most consensual, that includes the current sociological and economic, considering the effect of interpersonal relationships in this phenomenon. This proposal is configured in a new vision of the antecedents of interorganizational trust, described as significant quantitative from models Morgan and Hunt (1994), Doney and Cannon (1997), Zhao and Cavusgil (2006) and Nyaga, Whipple, Lynch (2011), as well as qualitative analysis of Tacconi et al. (2011). With regard to methodological aspects, the study assumes the form of a descriptive, survey type, and causal trace theoretical and empirical. As for his nature, the investigation, explicative character, has developed a quantitative approach with the use of exploratory factor analysis and structural equation modeling SEM, with the use of IBM software SPSS Amos 18.0, using the method of maximum verisimilitude, and supported by technical bootstraping. The unit of analysis was the buyer-supplier relationship, in which the object under investigation was the supplier organization in view of the purchasing company. 237 valid questionnaires were collected among key informants, using a simple random sampling developed in manufacturing industries (SIC 10-33), located in the city of Natal and in the region of Natal. The first results of descriptive analysis demonstrate the phenomenon of interorganizational trust, in which purchasing firms believe, feel secure about the supplier. This demonstration showed high levels of intensity, predominantly among the vendors that supply the company with materials that are used directly in the production process. The exploratory and confirmatory factor analysis, performed on each variable alone, generated a set of observable and unobservable variables more consistent, giving rise to a model, that needed to be further specified. This again specify model consists of trajectories was positive, with a good fit, with a composite reliability and variance extracted satisfactory, and demonstrates convergent and discriminant validity, in which the factor loadings are significant and strong explanatory power. Given the findings that reinforce the model again specify data, suggesting a high probability that this model may be more suited for the study population, the results support the explanation that interorganizational trust depends on purchases directly from interpersonal relationships, sharing value and operating performance and indirectly of personal relationships, social networks, organizational characteristics, physical and relational aspect of performance. It is concluded that this trust can be explained by a set of interactions between these three determinants, where the focus is on interpersonal relationships, with the largest path coefficient for the factor under study

Semiparametric modeling of the spatial distribution of occupational accident risk in the casual labor market, Piracicaba, southeast Brazil

The objective of this study was to estimate the spatial distribution of work accident risk in the informal work market in the urban zone of an industrialized city in southeast Brazil and to examine concomitant effects of age, gender, and type of occupation after controlling for spatial risk variation. The basic methodology adopted was that of a population-based case-control study with particular interest focused on the spatial location of work. Cases were all casual workers in the city suffering work accidents during a one-year period; controls were selected from the source population of casual laborers by systematic random sampling of urban homes. The spatial distribution of work accidents was estimated via a semiparametric generalized additive model with a nonparametric bidimensional spline of the geographical coordinates of cases and controls as the nonlinear spatial component, and including age, gender, and occupation as linear predictive variables in the parametric component. We analyzed 1,918 cases and 2,245 controls between 1/11/2003 and 31/10/2004 in Piracicaba, Brazil. Areas of significantly high and low accident risk were identified in relation to mean risk in the study region (p < 0.01). Work accident risk for informal workers varied significantly in the study area. Significant age, gender, and occupational group effects on accident risk were identified after correcting for this spatial variation. A good understanding of high-risk groups and high-risk regions underpins the formulation of hypotheses concerning accident causality and the development of effective public accident prevention policies.

Comparison of selective genotyping strategies for prediction of breeding values in a population undergoing selection

Genomewide marker information can improve the reliability of breeding value predictions for young selection candidates in genomic selection. However, the cost of genotyping limits its use to elite animals, and how such selective genotyping affects predictive ability of genomic selection models is an open question. We performed a simulation study to evaluate the quality of breeding value predictions for selection candidates based on different selective genotyping strategies in a population undergoing selection. The genome consisted of 10 chromosomes of 100 cM each. After 5,000 generations of random mating with a population size of 100 (50 males and 50 females), generation G(0) (reference population) was produced via a full factorial mating between the 50 males and 50 females from generation 5,000. Different levels of selection intensities (animals with the largest yield deviation value) in G(0) or random sampling (no selection) were used to produce offspring of G(0) generation (G(1)). Five genotyping strategies were used to choose 500 animals in G(0) to be genotyped: 1) Random: randomly selected animals, 2) Top: animals with largest yield deviation values, 3) Bottom: animals with lowest yield deviations values, 4) Extreme: animals with the 250 largest and the 250 lowest yield deviations values, and 5) Less Related: less genetically related animals. The number of individuals in G(0) and G(1) was fixed at 2,500 each, and different levels of heritability were considered (0.10, 0.25, and 0.50). Additionally, all 5 selective genotyping strategies (Random, Top, Bottom, Extreme, and Less Related) were applied to an indicator trait in generation G(0), and the results were evaluated for the target trait in generation G(1), with the genetic correlation between the 2 traits set to 0.50. The 5 genotyping strategies applied to individuals in G(0) (reference population) were compared in terms of their ability to predict the genetic values of the animals in G(1) (selection candidates). Lower correlations between genomic-based estimates of breeding values (GEBV) and true breeding values (TBV) were obtained when using the Bottom strategy. For Random, Extreme, and Less Related strategies, the correlation between GEBV and TBV became slightly larger as selection intensity decreased and was largest when no selection occurred. These 3 strategies were better than the Top approach. In addition, the Extreme, Random, and Less Related strategies had smaller predictive mean squared errors (PMSE) followed by the Top and Bottom methods. Overall, the Extreme genotyping strategy led to the best predictive ability of breeding values, indicating that animals with extreme yield deviations values in a reference population are the most informative when training genomic selection models.

Estratégia ambiental e agências de viagens e turismo :um estudo sobre a importância de práticas ambientais na escolha de um pacote turístico

The objective of the work was to investigate, from the vision of travel agents, the importance of environmental practices as a decision factor in the purchase of a tourist package. For in such a way, it was established as target population, the travel agencies and tourism linked to he Brazilian Association of Travel agencies ABAV, hearing the Brazilian travel agents that exerted the function in Natal, city in 2005. The election of the sample was accomplished using the simple random sampling technique. The amount of agents effectively searched was of 150 agents being distributed 150 questionnaires, with closed and opened questions, applied during the month of November in 2005. Results showed great variability of interviewed answers in that if it relates for sale of package tourist where the customer demonstrates enviromental concern with the environmental quality. Through multiple regression analyses, it was environmental concern with the environmental quality of the place and the perception of the practical importance of the existence environmental practices in the place as important factor in the decision of tourist package purchase

Modelagem de equações estruturais na análise de dados de serviços em comunicações móveis

In recent decades, changes have been occurring in the telecommunications industry, allied to competition driven by the policies of privatization and concessions, have fomented the world market irrefutably causing the emergence of a new reality. The reflections in Brazil have become evident due to the appearance of significant growth rates, getting in 2012 to provide a net operating income of 128 billion dollars, placing the country among the five major powers in the world in mobile communications. In this context, an issue of increasing importance to the financial health of companies is their ability to retain their customers, as well as turn them into loyal customers. The appearance of infidelity from customer operators has been generating monthly rates shutdowns about two to four percent per month accounting for business management one of its biggest challenges, since capturing a new customer has meant an expenditure greater than five times to retention. For this purpose, models have been developed by means of structural equation modeling to identify the relationships between the various determinants of customer loyalty in the context of services. The original contribution of this thesis is to develop a model for loyalty from the identification of relationships between determinants of satisfaction (latent variables) and the inclusion of attributes that determine the perceptions of service quality for the mobile communications industry, such as quality, satisfaction, value, trust, expectation and loyalty. It is a qualitative research which will be conducted with customers of operators through simple random sampling technique, using structured questionnaires. As a result, the proposed model and statistical evaluations should enable operators to conclude that customer loyalty is directly influenced by technical and operational quality of the services offered, as well as provide a satisfaction index for the mobile communication segment

Ephemeroptera, Plecoptera and Trichoptera assemblages in two Atlantic Rainforest streams, Southeastern Brazil

Comunidades de Ephemeroptera, Plecoptera e Trichoptera (EPT) em substrato rochoso foram estudadas em dois riachos do Parque Estadual Intervales. Coletas com um amostrador de Surber (10 subamostras aleatórias, 1 m²) foram feitas mensalmente de setembro de 1999 a setembro de 2000 e trimestralmente de dezembro de 2000 a setembro de 2001 nos Ribeirões Bocaina e Água Comprida. A fauna de EPT do Ribeirão Bocaina foi mais diversificada e mais abundante do que a do Ribeirão Água Comprida. A fauna de EPT foi bastante diferente entre os dois riachos, tanto do ponto de vista da composição faunística quanto do ponto de vista funcional. Os resultados indicaram que não houve um padrão sazonal claro da variação temporal da densidade.

Medidas da dinâmica respiratória em crianças de quatro a dez anos

TEMA: medidas da dinâmica respiratória são freqüentemente utilizadas na clínica fonoaudiológica, mas poucos são os dados científicos destas na população infantil. OBJETIVO: estudar a dinâmica respiratória entre crianças que respiram pelo modo nasal. MÉTODO: o estudo foi realizado com uma amostra aleatória estratificada de 106 crianças respiradoras nasais de escolas da cidade de Marília / SP, entre quatro e dez anos de ambos os sexos. Foram realizadas as medidas de capacidade vital (CV), nas posições em pé e sentada, com e sem oclusão nasal; de tempo máximo de fonação (TMF) de vogais e consoantes sustentadas, além de fala em seqüência com a contagem de números. RESULTADOS: a medida média da CV na posição em pé com e sem oclusão nasal foi 1515,56 ml e 1538,67 ml respectivamente e na posição sentada, 1524 ml e 1539,15 ml respectivamente; o TMF das vogais em segundos foi: /a/ = 8,32 , /i/ = 8,61 e /u/ 8,42; o de consoantes foi: /s/ = 6,64 e /z/ = 7,65 e o de seqüência de números foi de 7,76 segundos. Resultados: observou-se que o tempo médio destas medidas aumentou progressivamente conforme as faixas etárias. Tanto para o TMF das vogais como, para o das consoantes, houve diferença estatística significante (p < 0,05) nas idades mais distantes, ou seja, entre quatro e dez anos, quatro e nove, e quatro e oito anos. em faixas etárias consecutivas não houve diferença estatística significante nos valores de CV. Houve forte associação entre a CV e o crescimento físico da criança. CONCLUSÃO: esse estudo mostrou medidas de dinâmica respiratória em crianças que podem ser úteis no diagnóstico e terapia fonoaudiológica. Outras pesquisas deveriam ser desenvolvidas para adicionais informações sobre o assunto.

Análise da relação causal entre imagem de destinos, qualidade, satisfação e fidelidade: um estudo de acordo com a percepção do turista nacional no destino turístico Natal

This dissertation aims to analyze the causal relationship between the quality of tourist services, satisfaction with the attributes and globally, fidelity and image of tourist destinations. Therefore, it was conducted an exploratory, descriptive research with quantitative analytical approach. Data collection was performed by a questionnaire addressed to tourists at the Augusto Severo International Airport and Bus station of Natal, the main points of entry and exit of tourists. The composition was simple random sampling by reaching the final number of 400 tourists interviewed. Among the main results, is an assessment of the quality of the components of the destination. It was noted that nine are the dimensions of perceived quality of tourism products and services of ―Sun and Sand‖ segment, that is, Beaches and Facilities, Public Equipment, Catering Services, Transportation, Hotel Equipment, Hotel Services, Entertainment & Attractions, Access to the Hotel and Hospitality. Moreover, it was concluded that the Preview Tourism Destination Image has little direct influence in the Consumer Satisfaction, and only indirectly in the Post-Purchase Behavior. While the Complex Tourism Destination Image exerts strong and direct influence on both factors, in the Customer Satisfaction Process and Loyalty, the dimensions of quality also claimed to be strongly influences both factors

Gestão Sustentável da água: um estudo da conscientização ambiental em atividades residenciais urbanas

The search for sustainable solutions through an appropriate environmental administration of the available natural resources, that comes from encounter to the aspirations of preservation of the environment and of the human being, in way to diagnose and to solve the environmental and social problems with the smallest possible impact to the nature and the man, it is the great challenge, so much for that generation, as for the future generations. The study of the environmental problems of the water and the participation and the social actors' environmental understanding as a whole, interferes in the field of the thematic environmental international, contemplating the strategic need of an appropriate administration of that very natural one, through a program returned to the diagnosis of the problems and in the search of compatible maintainable solutions, in a social and environmental politics of planning and environmental education, centered above all in the citizen's voice , user of that system. The present thesis she seeks to study the problem of the maintainable administration of the water, focusing the participation and the citizen's environmental understanding in the use of that very natural one for urban residential activities, in what concerns the approach and analyses of variables that treat of the measurement of general knowledge and you adapt, sense of community of the access to the means of information and of the attitudes and environmental behaviors, besides the variables of partner-demographic characterization or personal identification of the interviewed ones of an exploratory research of the type " survey ", accomplished through a stratified aleatory sampling, being the strata each one of the 4 (four) Political-Administrative Areas of the Natal city, having happened the collection of the data in the period of february to april/2002. The methodology used in this work it constitutes in the application of questionnaires with scales of the type Likert to measure the echo-varied of the study, besides a partner-demographic scale for the characterization of the studied sample. For the analysis of the results, it was made an exploratory descriptive study initially, followed by the use of techniques statistical multivariate s, such as, factorial analysis through the application of main components, besides the accomplishment of studies of multiple lineal regression. To complement this study, the accomplishment of Tests of Independence was proceeded through the Qui-square of Pearson, in way to verify the dependence of the associations between the partner-demographic variables and the principal selected variables and presents in the resulting factors of the factorial analysis. The results appear for a low level of environmental knowledge, of access to the information and community's sense, besides the verification that the principal factors resultants send for the need of feeling emphasis in the programs and administration actions addressed for the environmental understanding, the behaviors and attitudes that approach the information and the environmental education, besides the reuse of the water

As praças públicas de Natal/RN no âmbito dos problemas socioambientais urbanos

This paper presents the public square as a subsystem of the city for the potential integration of elements 'natural' and built environment. But sometimes the suitability of projects and the social processes involved are not compatible and favorable to their real functions in urban space. The city of Natal, with a population of 803,739 inhabitants has 253 public parks not uniformly distributed in the urban area, but mostly in central areas and their absence in some peripheral neighborhoods. In this sense, the objective of this paper is to analyze the quality and spatiality of the city's public squares within the urban socio-environmental problems. For this, use of simple random sampling to define the sample and the proportional allocation of districts, totaling 168 squares to be raised. We prepared a form to collect data on the field that includes aspects of leisure, infrastructure and environment. For each square sampled was calculated Square Quality Index (PQI), then calculating the average per IQP neighborhood. The rates found were crossed with census data and Municipal Public Administration by neighborhood, using multivariate analysis. We generated maps, charts and tables, considered appropriate to each question format, focused comparison. The public square appears as an indicator of environmental challenges present in intra-urban spaces of the city. Their spatial distribution is not consistent demand population, both by disposition and by how much. In terms of quality are characterized by different levels of inadequacy and degradation aspects of leisure, environmental and infrastructure, often causing disfigurement, abandonment and improper occupation in such spaces. Multivariate analysis point to a central concentration and their problems in certain administrative units, not only as regards the public squares, but also to aspects of education, income, and other violence, perpetuating the problem. The various levels of inadequacy and degradation of public squares have been more blatant in the poorest neighborhoods of the city, pointing to a structural pattern associated with the intrinsic characteristics of the neighborhood and the socioeconomic profile of the local population. These are problems of social and environmental dimensions, threaded in and influenced the political, economic and broader social process of transformation of the city and the urban. Based on an uneven process in which space necessarily reflect the contradictions inherent in the active forces and interests. Thus evidencing the importance of managing the necessary public effectively engaged with the problems that are present there, in order to equate them, without being prioritized certain areas of the city at the expense of others

Histopathological placental lesions in mild gestational hyperglycemic and diabetic women

Objective: To investigate and compare the incidence of histopathological placental lesions in mild gestational hyperglycemia, gestational diabetes and overt diabetes at term and preterm gestation.Research design and methods: One-hundred-and-thirty-one placental samples were collected from Diabetes mellitus (DM) positive screened patients. Two diagnostic tests, glycemic profile and 100 g oral glucose tolerance test (OGTT) in parallel identified 4 groups normoglycemic, mild gestational hyperglycemia (MGH), gestational DM (GDM) or overt DM (DM). Placental tissue specimens and sections from 4 groups were obtained by uniform random sampling and stained with hematoxylin-eosin.Results: Placentas from MGH group presented 17 types of histopathological change and higher rates of syncytial nodes and endarteritis. GDM placentas presented only nine types of histopathological change, high rates of dysmaturity, low rates of calcification and no syncytial nodes. Overt DM placentas showed 22 types of histopathological change, 21 of which were present in the preterm period. There were histopathological similarities between MGH and DM placentas, but the former exhibited a higher incidence of endarteritis, which has been described as a post-mortem phenomenon.Conclusion: Our results confirmed that the distinct placental changes associated with DM and MGH depend on gestational period during which the diabetic insult occurs. It may reasonably be inferred that subclinical maternal hyperglycemia during pregnancy, as showed in MGH group, is responsible for increased placental endarteritis, a postmortem lesion in the live fetus.