Turismo cultural na ZEPH-Ribeira: possibilidades e limitações

Considering that urban interventions, planned and executed recently at Natal, RN, should put Ribeira - one of the town centers - in the new limits of the expanded center of the city, this work examines the use of this new accessibility for the benefit of the development of an infrastructure to support a type of tourism currently seen as an alternative to diversification into areas dominated by entertainment tourism (the case of Natal). A local with city's traditional cultural facilities and holder of a set built that is a synthesis of the images of the neighborhood, it fears that this increase in the potential for movement and flows of use stimulate speculation and deployment of a bulk type of activity incompatible with the preservation the architectural heritage. Important economy for the city, tourism has been showing a factor propellant processing urban related changes in accessibility. It is argued that cultural tourism, often used in plans and projects of revitalization across the country, may be factor for sustainable development and conserve the assets, and contributes to the process of revitalization of the historic cultural center as Ribeira. Intended to illustrate the need to consider other information that might help in the revitalization of the neighborhood, this research presents the offer cultural tourism of Ribeira and identifies and maps certain physical attributes that, combined with functional attributes, can stimulate or inhibit the diversity and vitality in the region

Vitalidade no centro antigo Teresina, Piauí Praça Marechal Deodoro: uma intervenção contemporânea em área de valor patrimonial

This study deals with the discussions of contemporary interventions in public spaces in areas of heritage value. The product of this dissertation is an Intervention Project to Marechal Deodoro Square located in Teresina/PI center. The starting point for understanding the theme of this study is to investigate the accessibility and vitality of a public space - through relationship between form and uses. The spatial properties of accessibility and visibility as well as the distribution of land use - factors were associated with distinct patterns of vitality - and compared to usage patterns observed in situ and statements from users obtained through the results of the questionnaires. In attention to questions about the building constructed, particularly in historical centers, considers the guidelines to define intervention strategies in the square, consisted in the development of simulations that after evaluation of results of redesign, was chosen the best option to meet the necessary requirements to the performance, considering the spatial properties of integration and visibility that meet these requirements. Therefore, the "Intervention Project" carried out for the Marechal Deodoro Square characterization proposed items are discussed: spatial structure, vegetation, road network, pavements, street furniture and lighting

Repercussões psico-sociais da síndrome dos ovários policísticos: estudo quali-quantitativo

BACKGROUND: Polycystic ovary syndrame (PCOS) has been shown to cause a reduction in quality of life. Little is known on the psychosocial aspects associated with PCOS, especially on women s own experiences regarding the syndrome. Therefore, the aim of this study was to analyze the psychosocial impact of PCOS by measuring the health-related quality of life and exploring the women s own experiences of PCOS. METHODS: A two-phase model of combination of quantitative and qualitative research approaches was conducted, a crass-sectional survey to pravide quantitative data on the quality of life and a qualitative approach to understand the women s experience in relation to the PC OS sympt?ms. For the first phase, 109 women with PC OS and 104 healthy contrais were evaluated with the 36-item short-form health survey (SF-36). Additionally, semi-structured interviews (n=30) were conducted to facilitate in-depth exploration of PC OS women s experience. RESUL TS: PCOS patients showed significant reductions in almost ali SF-36 domains of quality of life when compared with healthy contrais (physical function 76.5:!:20.5 and 84.6:!:15.9, respectively; physical rale function 56.4:!:43.3 and 72.6:!:33.3; general health 55.2:!:21.0 and 62.5:!:17.2; vitality 49.6:!:21.3 and 55.3:!:21.3; social function 55.3:!:32.4 and 66.2:!:26.7; emotional rale function 34.2:!:39.7 and 52.9:!:38.2; mental health 50.6:!:22.8 and 59.2:!:20.2). Thematic analysis revealed reports of feeling abnormal , sadness, afraid and anxiety. These feelings were related to four symptoms commonly experienced by women with PCOS: excess hair grawth; irregular or absent menstruation, infertility and obesity. CONCLUSIONS: Polycystic ovary syndrame impacts women both physically and psychosocially. Owing to this, women with PCOS need not only medical treatment for. the reproductive, esthetic and metabolic repercussions, but also the care of a multidisciplinary team, since PCOS is not just a physical condition, but also an important psychosocial problem that affects various aspects of a woman s life

Qualidade de vida do servidor da Universidade Federal do Rio Grande do Norte em condição crônica de saúde

The study aimed to analyze the influence of chronic health conditions (CHC) on quality of life (QOL) of UFRN servers assaulted by CHC. It is a descriptive and cross-sectional study with prospective data and quantitative approach, accomplished in the ambulatory clinic of the Department of Server Assistance (DSA) of the Pro-Rectory of Human Resources, during three months. The sample was composed by accessibility, totaling 215 people, being 153 active and 62 inactive servers, in chronic health condition. The data were collected through the application of the sociodemographic characterization, health, environmental and laboral form, the Medical Outcome Study 36-Item Short Form (SF-36). The study was evaluated by the HUOL Ethics Committee (CAAE no. 0046.0.294.000.10), obtaining assent. The results were analyzed in the SPSS 15.0 program through the descriptive and inferential statistics. It was identified servants predominantly male (59,1%), under 60 years old, married or in stable union, Catholics, brown color, living in the capital and residents in own home. Regarding labor issues, there was a predominance of active servers technical-administrative with intermediate and medium level positions and small proportion of docents. Among the CHC, the non-communicable diseases - NCDs (95.8%) had a higher frequency, followed by persistent mental disorders - PMDs (18.6%) and, finally, the continuous and structural physical deficiency - CSPD (16.9 %). The QOL of servers was considered good, with a mean score of 72.5 points in the total score, with the most affected domains: physical (59.1), general health (66.2), bodily pain (66.3) and functional aspects (72.0). The mental health dimension (76.5) had a better average than the physical dimension (68.0 points). It was found that the decrease in QOL scores is significant statistically related to higher number of CHC (ρ <0.001), with no statistical significance regarding the functional situation (p = 0.259). The administrative technicians of elementary, primary, secondary levels and docents had the worst QOL scores. After the correlation analysis of CHC with the domains and dimensions of the SF-36, there was statistically significant, negative and weak correlation of the domains: functional aspect (ρ = 0.002, r = -0.207), physical aspects (ρ = 0.007; r = -0.183), vitality (ρ = 0.002, r = -0.213), social function (ρ = 0.000, r = -0.313), emotional aspects (ρ = 0.000, r = -0.293), mental health (ρ = 0.000 , r = -0.238), physical health dimension (ρ = 0.002, r = -0.210) and mental health dimension (ρ = 0.000, r = -0.298). The presence of PMD isolated or together, contributed to a lower SF-36 scores, being the domains variation of mean significant, except for bodily pain, general health and physical aspects. By correlating the categories of CHC and QOL, there was a weak correlation (r ≤ -0.376) and significant (ρ ≤ 0.011), mainly related to the NCD, PMDs and NCD + PMD, affecting the mental health, social function, emotional aspects, vitality and functional aspect domains. Front of the results, it was concludes that the servers quality of life is influenced by the CHC. Thus, it was inferred that the presence of CHC causes a negative effect on quality of life, leading the active and inactive servers to exposure their overall life activities and work over the years, due to the morbidity affected, mainly related to NCDs and PMDs. Descriptors: Quality of life. Chronic disease. Occupational Health. Nursing

Autoestima e qualidade de vida de pessoas com úlcera venosa atendidas na atenção primária

Venous ulcers (VU) is a chronic injury of the lower extremities and because of its high incidence and recurrence implies long and complex treatments, damaging the quality of life (QOL) and self-esteem (SE) of the people. This study aimed to analyze the association between self-esteem with the quality of life of people with venous ulcers treated in primary care. Cross sectional analytical study with a quantitative approach conducted with 44 people met with VU at 13 primary care units 2 and Mixed units in Natal/RN. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte (UFRN), CAAE: 07556312.0.0000.5537. Held data collection from February to April 2014 and used three instruments: a structured form covering sociodemographic, health care and clinical variables, the Rosenberg Self-Esteem Scale and the SF-36. The collected data were entered into a database and processed on computerized software for descriptive and inferential analyzes. The results showed a predominance of people with UV females (65,9%), with more than 60 years (59,1%), married or in a stable relationship (52,3%), low education (86,4%) without occupation (68,2%) and less than one minimum wage income (81,8%). Regarding assistance characteristics was observed that most patients performed the dressing with appropriate material (72,7%), professional or trained caregiver (61,4%) did not use compression therapy (81,8%), treating the injury for more than 6 months (77,3%), lack of guidelines for the use of compression therapy, elevation of legs, and regular exercise (77,3%) and consulting the angiologist last year (52,3% ). Regarding clinical features of the lesion was found that most of the recurrent lesions are (77,3%), over one year of current lesion (52,3%) medium to large lesions (54,8%), without signs of infection (61,3%) and pain (79,5%). The mean SE of respondents was 9,3 (± 5,1). The relations between the SE and the sociodemographic variables, health care and clinics showed that individuals without a partner (a) (p = 0,01), who did not wear compression therapy (p = 0,04), with more 6 months of treatment (p = 0,01) and larger lesions (p = 0,01) had a lower SE. The mean domain and the dimensions of the SF-36 were lower emphasizing the functional capacity 36.5 (± 27,6) and the physical aspects of 15.3 (± 30,6). There were significant correlations between AE people with VU and the domains and dimensions of the SF-36: physical functioning (r = -0,432), general health (r = -0,415), vitality (r = -0,573), aspects social (r = -0,517), mental health (r = -0,612) and mental health dimensions (r = -0,612) and physical health (r = -0,473). Based on these results it is concluded by rejecting the null hypothesis and accept the alternative proposed in the study in which it was found that there is a negative correlation between the SE and the QOL of people with venous ulcers

Subtle Cognitive Deficits in Adults With a Previous History of Sydenham's Chorea During Childhood

Objective. To evaluate the neuropsychological profile and health-related quality of life (HRQOL) of adults who had rheumatic fever (RF) during childhood with and without Sydenham's chorea (SC).Methods. Three groups of patients were assessed: adults who had RF with SC during childhood (SC group), adults who had RF without SC during childhood (RF group), and controls (CT group). A range of neuropsychological tests looked at several cognitive domains. HRQOL was measured through a Brazilian version of the Short Form 36 (SF-36) health survey.Results. Twenty patients were included in the SC group, 23 patients in the RF group, and 19 patients in the CT group. The 3 groups were homogeneous regarding sex (P = 0.078), age (P = 0.799), schooling (P = 0.600), socioeconomic status (P = 0.138), intelligence quotient (P = 0.329), and scores for anxiety (P = 0.156) and depression (P = 0.076). The SC group demonstrated inferior performance in tests that assessed attention (Digit Span Forward [ P = 0.005], Corsi Block Forward [ P = 0.014]), speeded information processing (Trail Making A [ P = 0.009], Symbol Search [ P = 0.042]), and executive functions and working memory (Corsi Block Backward [ P = 0.028]), and higher scores for attention deficit scale (P = 0.030) when compared with the RF and CT groups. They also showed a tendency toward lower scores in the physical aspects, vitality, emotional aspects, and mental health domains of the SF-36. The RF group had a lower score for the general health domain than the CT group (P = 0.030).Conclusion. Patients who had SC during childhood can exhibit inferior performance in tasks that evaluate attention, speeded information processing, executive functions, and working memory in adult life. Therefore, there is indirect evidence of the persistence of dysfunction in cerebral circuits involved with the basal ganglia. They also presented a worse self-evaluation in HRQOL that was not related to cognitive impairments.

Avaliação da qualidade de vida relacionada à saúde de cortadores de cana-de-açúcar nos períodos de entressafra e safra

OBJETIVO: Avaliar a qualidade de vida relacionada à saúde de cortadores de cana-de-açúcar. MÉTODOS: Estudo longitudinal em uma usina sucroalcooleira no Oeste do estado de São Paulo de abril (final da entressafra) a outubro (final da safra) de 2010. Foram avaliados 44 cortadores de cana-de-açúcar tabagistas e não tabagistas em três períodos: ao final da entressafra, no fim do terceiro mês de safra e no final da safra. A qualidade de vida relacionada à saúde foi avaliada pelo questionário Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Foram realizados análise de variância para medidas repetidas e teste de Friedman para comparar a qualidade de vida entre os períodos. Utilizou-se o teste de Goodman para identificar a frequência dos trabalhadores cujo escore aumentou nos períodos de safra em comparação com a entressafra (respondedores positivos), considerando-se as variáveis qualitativas dos domínios do SF-36. RESULTADOS: Ao final da entressafra, 23% dos trabalhadores desistiram do trabalho; 27% eram tabagistas. Houve decréscimo significativo no domínio vitalidade no final da safra em comparação com a entressafra. Os desistentes apresentaram maior escore no domínio aspecto social em relação ao grupo que permaneceu no trabalho. Não houve diferença na qualidade de vida relacionada à saúde entre tabagistas e não tabagistas. No entanto, observou-se maior percentual de respondedores positivos entre não tabagistas nos domínios aspecto físico, social e emocional nos três meses de safra e nos domínios estado geral de saúde e aspecto social nos seis meses de safra, quando comparados aos tabagistas. CONCLUSÕES: A qualidade de vida relacionada à saúde em cortadores de cana-de-açúcar mostrou-se diminuída após o período de safra no domínio vitalidade. Os trabalhadores que permaneceram na safra são os que apresentaram piores aspectos sociais, o que mostra a necessidade de promoção de políticas assistencialistas de saúde a essa população específica, principalmente durante a safra canavieira.

Força muscular respiratória, qualidade de vida e modulação autonômica da frequência cardíaca na distrofia miotônica

Background: The myotonic dystrophy (MD) is a multisystem neuromuscular disease that can affect the respiratory muscles and heart function, and cause impairment in quality of life. Objectives: Investigate the changes in respiratory muscle strength, health-related quality of life (HRQoL) and autonomic modulation heart rate (HR) in patients with MD. Methods: Twenty-three patients performed assessment of pulmonary function, sniff nasal inspiratory pressure (SNIP), the maximal inspiratory (MIP) and expiratory (MEP) pressure, and of HRQoL (SF-36 questionnaire). Of these patients, 17 underwent assessment of heart rate variability (HRV) at rest, in the supine and seated positions. Results: The values of respiratory muscle strength were 64, 70 and 80% of predicted for MEP, MIP, and SNIP, respectively. Significant differences were found in the SF-36 domains of physical functioning (58.7 ± 31,4 vs. 84.5 ± 23, p<0.01) and physical problems (43.4 ± 35.2 vs. 81.2 ± 34, p<0.001) when patients were compared with the reference values. Single linear regression analysis demonstrated that MIP explains 29% of the variance in physical functioning, 18% of physical problems and 20% of vitality. The HRV showed that from supine position to seated, HF decreased (0.43 x 0.30), and LF (0.57 x 0.70) and the LF/HF ratio (1.28 x 2.22) increased (p< 0.05). Compared to healthy persons, LF was lower in both male patients (2.68 x 2.99) and women (2.31 x 2.79) (p< 0.05). LF / HF ratio and LF were higher in men (5.52 x 1.5 and 0.8 x 0.6, p <0.05) and AF in women (0.43 x 0.21) (p< 0.05). There was positive correlation between the time of diagnosis and LF / HF ratio (r = 0.7, p <0.01). Conclusions: The expiratory muscle strength was reduced. The HRQoL was more impaired on the physical aspects and partly influenced by changes in inspiratory muscle strength. The HRV showed that may be sympathetic dysfunction in autonomic modulation of HR, although with normal adjustment of autonomic modulation during the change of posture. The parasympathetic modulation is higher in female patients and sympathetic tends to increase in patients with longer diagnosis

O bem-estar subjetivo e os valores humanos em músicos e advogados da cidade de João Pessoa

Are there values that predict health? Moreover, would the absence of health motivate deterioration in the subjective well-being? This research has attempted to find answers to these questions by verifying in which proportion human values explain the subjective well-being experienced by people in different contexts of value reference. Both musicians and lawyers have been studied. In a preliminary study, composed of two researches, it was attempted to overcome the lack of bibliography in order to make known the current context of these professions in João Pessoa, Paraíba, through newspaper articles from the Correio da Paraíba and interviews with privileged informers. The technique of content analysis was then used identifying the main dilemmas of the professions as well as their socio-occupational contexts. In the second and main study, the aim was to verify the existing relations among the variables of subjective well-being and the human values for these professionals adopting the socioeconomical panorama of the occupations to support the analysis. 387 professionals took part in this study: 148 musicians (31.8% instrumentalists) and 239 lawyers (36.8% civil), with ages varying from 18 up to 77 years old (M=35.9; SD=12.35), and from 22 up to 79 years (M =38.6; SD=12.31), respectively, answered the Basic Human Values (BHV); Positive and Negative Affect Scale; Vitality Scale; General Health Questionnaire GHQ-12; Satisfaction with Life Scale and the socio-demographic questions. The SPSS Statistical Package for the Social Sciences was used and it could be observed that, for the musicians, the importance of the type of existence/bio-social value stands out just as an indicator of vitality. The type of value Accomplishment/Power, showed itself important for the positive affection and for vitality, while the types Accomplishment/Self-direction and Normative haven t had any influence in the subjective well-being. Only the relation between the Existence/Bio- Social type and vitality was mediated by the sex and marital status variables. As for the lawyers, the type of predictor value of the subjective well-being was the normative [F(1,219) = 11,8, p ≤ 0,001; Rmultiple = 0,23, R2adjusted = 0,05]. On the other hand, the type Existence/Bio social presented a direct relation with vitality but inverse with depression. It was then concluded that the congruency of personal values with those promoted in the social context of reference may be an indicator of subjective well-being, given the existence of a social value context well demarcated

Bem-estar psicológico de servidores e funcionários técnico-administrativos das Instituições de Ensino Superior Públicas e Privadas : indicadores e antecedentes

The elaboration of this thesis aimed at getting to know the structure of the psychological well-being (PWB) at work and analysing the differences in the PWB levels among technical-administrative servants in public and private Institutions of Higher Education (IES) in the municipality of João Pessoa. Two hundred and thirty-three public and private IES male and female servants of João Pessoa participated in the research, replying to an instrument composed of questionnaires referring to the elaborated model. Factorial and regression analyses were accomplished in order to test the hypotheses in respect of the proposed model. The results showed that the PWB related with the work is composed of indicators such as affection, vitality, anxiety, depression, satisfaction at work and aspiration for accomplishment and reduction of the self-efficiency. The observed PWB predictors at work were the IES type, presence of children, age and the escape and back-out facing strategy. These predictors possess relationship of moderation among them in the explanation of PWB. On comparing the PWB experienced by the technical-administrative servants, it was observed that those linked to private IES showed higher PWB rates. Furthermore, there are differences among PWB predictors in accordance with the IES type. The applicability of the results of this thesis is wide as regards social interventions in the search of health improvement under a psycho-sociological perspective. Eventually, the thematic of this thesis intends to reinforce the studies on the worker s health, since by knowing what would lead him into a feeling of accomplishment and well-being will result in more chances of promoting him, while creating opportunities of a sounder life for these people in psychological terms

Efeitos de um programa de orientação para adultos com lombalgia

OBJETIVO: Implantar um programa de Escola da Postura para pacientes com lombalgia crônica. MÉTODOS: Foram avaliados 41 sujeitos (46,81 ± 13,35 anos), de ambos os gêneros, com idade entre 25-65 anos que possuíam dor lombar há mais de 6 meses. Inicialmente, foi realizado a avaliação da qualidade de vida (Medical Outcomes Study 36- Item Short-Form Health Survey- SF-36) e capacidade funcional (Oswestry Low Back Pain Disability Questionnaire - ODQ). em seguida, todos os sujeitos participaram de cinco encontros semanais de 60 minutos, nos quais foram desenvolvidos as capacitações teórico-práticas. Após uma semana, os sujeitos foram reavaliados. Os dados obtidos nas avaliações foram analisados utilizando o teste estatístico não-paramétrico de Wilcoxon, com nível de significância de 5% (p<0,05). RESULTADOS: Foi observada melhora significativa na capacidade funcional (ODQ, p<0,0001). em relação à qualidade de vida observou-se melhora significativa nos domínios capacidade funcional (p=0,0016), dor (p=0,0035), estado geral de saúde (p<0,0001), vitalidade (p<0,0001), aspectos sociais (p<0,0001) e saúde mental (p=0,0007). Nos itens aspectos físicos e aspectos emocionais não foi observada diferença significativa. CONCLUSÃO: O programa Escola da Postura elaborado foi capaz de melhorar a qualidade de vida e capacidade funcional dos participantes.

Interação entre a analgesia de parto e o seu resultado: avaliação pelo peso e índice de Apgar do recém-nascido

JUSTIFICATIVA E OBJETIVOS: Existem controvérsias quanto à possibilidade de a analgesia de parto interferir no andamento do trabalho de parto e na vitalidade do recém-nascido. O objetivo deste estudo foi a interação entre analgesia do parto pelas técnicas peridural contínua e duplo bloqueio, com pequena dose de anestésico local, e o tipo de parto ocorrido, pela análise do peso e índice de Apgar do recém-nascido. MÉTODO: Analisaram-se, prospectivamente, os resultados de 168 analgesias de parto (janeiro de 2002 a janeiro de 2003), divididas em quatro grupos: G1 (n = 58) peridural contínua e evolução para parto vaginal; G2 (n = 69) duplo bloqueio e evolução para parto vaginal; G3 (n = 25) peridural contínua e evolução para cesariana; G4 (n = 16) duplo bloqueio e evolução para cesariana. Para G1 foi administrada ropivacaína a 0,125% (12 a 15 mL), para G2, bupivacaína a 0,5% (0,5 a 1 mL), sufentanil (10 mg), por via subaracnóidea. Administrou-se ropivacaína a 0,5%, por via peridural, para o parto vaginal (8 mL) e para cesariana (20 mL). Avaliaram-se idade, peso, altura, índice de massa corpórea (IMC), idade gestacional (IG), paridade e complicações (hipotensão arterial, bradicardia e hipóxia), e, do recém-nascido, peso e índice de Apgar (1º, 5º e 10º min). RESULTADOS: A maioria das parturientes era primigesta, com gestação de termo (uma IG de 28 semanas e nenhum pós-datismo), com peso, G2 < G4, e, IMC, G2 £ G4. Para o peso do RN, G1 < G3 e G2 < G4, e o Apgar do 1º min, G1 > G3. CONCLUSÕES: As técnicas de analgesia, peridural contínua e duplo bloqueio, com pequenas doses de anestésico local, não apresentaram interação com o resultado do parto, se a análise estiver focalizada no peso e no índice de Apgar do recém-nascido.

Qualidade de vida de mulheres com baixa massa óssea na pós-menopausa

OBJETIVO: avaliar a qualidade de vida de pacientes com osteoporose e osteopenia, acompanhadas em ambulatórios especializados em osteoporose e climatério, comparando-as com pacientes com densidade mineral óssea (DMO) normal. MÉTODOS: estudo de série de casos transversal, observacional, que se propôs a analisar, por meio do questionário Medical Outcomes Study 36 Short-Form Health Survey (SF-36), a qualidade de vida de mulheres com osteopenia e osteoporose. Foram avaliadas 124 mulheres na pós-menopausa divididas em três grupos: 55 pacientes com diagnóstico densitométrico de osteoporose, 35 com o de osteopenia e 34 que apresentavam DMO normal. Os três grupos foram comparados com relação aos dados demográficos, características clínicas e de estilo de vida e aos diferentes domínios do SF-36. RESULTADOS: as pacientes dos grupos osteopenia e DMO normal apresentaram menor idade média (56,7±7,1 e 52,9±5,4 anos), maior índice de massa corpórea (IMC) (28,6±3,7 e 30,9±5,1 kg/m²) e menor tempo de menopausa (8,4±5,9 e 5,8±4,5 anos) quando comparadas ao grupo osteoporose (61,8±10,1 anos, IMC de 25,7±5,3 kg/m², 15,5±7,5 anos, respectivamente; p<0,05). de acordo com o SF-36, não houve diferença significativa entre os grupos com relação aos domínios, à exceção do domínio vitalidade, que se mostrou superior no grupo osteoporose. Com relação à impressão pessoal sobre seu estado de saúde, das pacientes que o consideraram bom, um maior percentual pertencia ao grupo osteoporose, e entre aquelas que o consideraram ruim, um percentual menor pertencia ao grupo osteopenia. CONCLUSÃO: a qualidade de vida foi similar em mulheres com osteoporose e osteopenia, em relação às com DMO normal, à exceção do domínio vitalidade, que foi superior, paradoxalmente, nas pacientes com osteoporose.

Perinatal factors associated with early deaths of preterm infants born in Brazilian Network on Neonatal Research centers

Objective: To evaluate perinatal factors associated with early neonatal death in preterm infants with birth weights (BW) of 400-1,500 g.Methods: A multicenter prospective cohort study of all infants with BW of 400-1,500 g and 23-33 weeks of gestational age (GA), without malformations, who were born alive at eight public university tertiary hospitals in Brazil between June of 2004 and May of 2005. Infants who died within their first 6 days of life were compared with those who did not regarding maternal and neonatal characteristics and morbidity during the first 72 hours of life. Variables associated with the early deaths were identified by stepwise logistic regression.Results: A total of 579 live births met the inclusion criteria. Early deaths occurred in 92 (16%) cases, varying between centers from 5 to 31%, and these differences persisted after controlling for newborn illness severity and mortality risk score (SNAPPE-II). According to the multivariate analysis, the following factors were associated with early intrahospital neonatal deaths: gestational age of 23-27 weeks (odds ratio - OR = 5.0; 95%CI 2.7-9.4), absence of maternal hypertension (OR = 1.9; 95%CI 1.0-3.7), 5th minute Apgar 0-6 (OR = 2.8; 95%CI 1.4-5.4), presence of respiratory distress syndrome (OR = 3.1; 95%CI 1.4-6.6), and network center of birth.Conclusion: Important perinatal factors that are associated with early neonatal deaths in very low birth weight preterm infants can be modified by interventions such as improving fetal vitality at birth and reducing the incidence and severity of respiratory distress syndrome. The heterogeneity of early neonatal rates across the different centers studied indicates that best clinical practices should be identified and disseminated throughout the country.

Health related quality of life among the elderly: a population-based study using SF-36 survey

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)