Otorrinolaringologia pediátrica no Sistema Público de Saúde de Belo Horizonte

OBJETIVO: Analisar a adequação dos encaminhamentos da atenção primária para a secundária em otorrinolaringologia pediátrica. MÉTODOS: Estudo realizado em Belo Horizonte, estado de Minas Gerais, de março de 2004 a maio de 2005. Foram avaliadas 408 crianças pré-escolares encaminhadas da atenção primária para a secundária do setor de otorrinolaringologia com otite, faringoamigdalite, rinossinusite, rinite alérgica e hipertrofia de amígdala/adenóide. As variáveis analisadas foram: concordância dos diagnósticos na atenção primária e secundária, tempo de espera pela consulta, acompanhamento e especialista (médico de família ou pediatra) que examinou a criança na atenção primária. A concordância dos diagnósticos foi avaliada pela análise estatística de kappa. RESULTADOS: Os pacientes tinham em média cinco anos de idade, dos quais 214 (52,5%) eram meninos, o tempo médio de espera pela consulta foi de 3,7 meses. Os diagnósticos na atenção primária e secundária foram, respectivamente: otite (44%, 49%), hipertrofia de amígdala/adenóide (22%, 33%), faringoamigdalite (18%, 23%), rinossunusite (13%, 21%), rinite alérgica (3%, 33%). Análise de concordância kappa foi 0,15 para otite com efusão, 0,35 para otite recorrente, 0,04 para hipertrofia de amígdala/adenóide, 0,43 para faringoamigdalite, 0,05 para rinite alérgica; 0,2 para rinossinusite. Os diagnósticos na atenção primária para encaminhamento à secundária, definidos pelo médico de família ou pelo pediatra que avaliou a criança foram concordantes. CONCLUSÕES: A inadequação dos encaminhamentos da atenção primária para a secundária em otorrinolaringologia foi expressa pelo longo tempo de espera pela consulta e pela baixa concordância de diagnósticos firmados entre os níveis de atenção para os mesmos pacientes avaliados. A atenção primária poderia se tornar mais eficiente se os profissionais fossem mais bem capacitados em otorrinolaringologia.

A estrutura da narrativa na escrita dos alunos surdos

Dissertação apresentada à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ciências da Educação - Especialização em Educação Especial

Prevalence and determinants of child undernutrition and stunting in semiarid region of Brazil

OBJECTIVE : To analyze the evolution in the prevalence and determinants of malnutrition in children in the semiarid region of Brazil. METHODS : Data were collected from two cross-sectional population-based household surveys that used the same methodology. Clustering sampling was used to collect data from 8,000 families in Ceará, Northeastern Brazil, for the years 1987 and 2007. Acute undernutrition was calculated as weight/age < -2 standard deviation (SD); stunting as height/age < -2 SD; wasting as weight/height < -2 SD. Data on biological and sociodemographic determinants were analyzed using hierarchical multivariate analyses based on a theoretical model. RESULTS : A sample of 4,513 and 1,533 children under three years of age, in 1987 and 2007, respectively, were included in the analyses. The prevalence of acute malnutrition was reduced by 60.0%, from 12.6% in 1987 to 4.7% in 2007, while prevalence of stunting was reduced by 50.0%, from 27.0% in 1987 to 13.0% in 2007. Prevalence of wasting changed little in the period. In 1987, socioeconomic and biological characteristics (family income, mother’s education, toilet and tap water availability, children’s medical consultation and hospitalization, age, sex and birth weight) were significantly associated with undernutrition, stunting and wasting. In 2007, the determinants of malnutrition were restricted to biological characteristics (age, sex and birth weight). Only one socioeconomic characteristic, toilet availability, remained associated with stunting. CONCLUSIONS : Socioeconomic development, along with health interventions, may have contributed to improvements in children’s nutritional status. Birth weight, especially extremely low weight (< 1,500 g), appears as the most important risk factor for early childhood malnutrition.

Factors associated with dietary supplement use by people who exercise at gyms

OBJECTIVE To assess the factors associated with the use of dietary supplements by people who exercise at gyms.METHODS A cross-sectional study with a sample defined by convenience, considering the number of gyms registered in the Conselho Regional de Educação Física (Regional Council of Physical Education) of Sao Luis, MA, Northeastern Brazil, from July 2011 to July 2012. The final sample comprised 723 individuals who exercise at gyms. The dependent variable was supplement use, and the explanatory variables were length of time and motivation of the physical exercises, duration, goal and self-perception of training, weekly frequency of gym attendance, sex, age, educational attainment, self-perception of body weight, smoking and self-perception of diet. The association between variables was analysed by hierarchical Poisson regression based on a theoretical model.RESULTS Supplement use was reported by 64.7% of the participants. Most of the sample was male (52.6%). The most frequent age group was 20 to 39 years (74.4%). Most participants (46.1%) had been exercising for over a year. The following variables were associated with supplement use: self-perceiving body weight as below ideal (p < 0.001), smoking (p < 0.001), exercising for 7 to 12 months (p = 0.028) or more than one year (p < 0.001), spending more than two hours at the gym (p = 0.051), and perceiving training as moderate (p = 0.024) or intense (p = 0.001).CONCLUSIONS The use of supplements lacks proper professional guidance, being motivated by individuals unsatisfied with their low body weight and who perceive their workout as intense, which raises the need for monitoring this population.

Amebas de vida livre no intestino humano: evidências de parasitismo

Foram cultivadas fezes de 620 indivíduos para a pesquisa de amebas de vida livre, sendo 514 pacientes do Hospital Universitário Pedro Ernesto (UERJ) e 106 crianças e adultos de um orfanato. Foram positivas 70 amostras (11,2%) sendo 55 provenientes de pacientes do HU-UERJ e 15 de internos do orfanato. Foram isoladas 60 amostras de Acanthamoeba, 6 de Vahlkampfia, 5 de Hartmannella e 1 Echinamoeba. Alguns indivíduos tiveram cultura de fezes repetidamente positiva para Acanthamoeba durante dois meses de observação. Das amostras de Acanthamoeba isoladas, 28 foram inoculadas em camundongos por via intranasal, tendo sido reisoladas 16 (57,1%) amostras à partir de cérebro e (ou) pulmões dos animais. O estudo histopatológico demonstrou processo inflamatório agudo com presença de polimorfonucleares e amebas no cérebro e pulmões de alguns animais. O encontro de amostras patogênicas em fezes humanas reforça a hipótese do eventual desenvolvimento, em indivíduos portadores, de meningoencefalite amebiana granulomatosa, como infecção oportunística de origem endógena.

O diário de turma no 4º ano de escolaridade

Relatório de Estágio apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e 2.ºCiclo do Ensino Básico

Finge: relatório de estágio

Relatório de Estágio submetido à Escola Superior de Teatro e Cinema para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Teatro, especialização em Artes Performativas - interpretação.

Avaliação de uma metodologia de tratamento de desenhos a pastel

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para a obtenção do grau de Mestre em Conservação e Restauro Área de Documentos Gráficos

Estudo da conservação de uma obra em sabão de João Pedro Vale

Departamento de Conservação e Restauro Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa.Dissertação de Mestrado Conservação e Restauro, Arte Contemporânea

Phonological development in relation to native language and literacy: Variations on a theme in six alphabetic orthographies

Phonological development was assessed in six alphabetic orthographies (English, French, Greek, Icelandic, Portuguese and Spanish) at the beginning and end of the first year of reading instruction. The aim was to explore contrasting theoretical views regarding: the question of the availability of phonology at the outset of learning to read (Study 1); the influence of orthographic depth on the pace of phonological development during the transition to literacy (Study 2); and the impact of literacy instruction (Study 3). Results from 242 children did not reveal a consistent sequence of development as performance varied according to task demands and language. Phonics instruction appeared more influential than orthographic depth in the emergence of an early meta-phonological capacity to manipulate phonemes, and preliminary indications were that cross-linguistic variation was associated with speech rhythm more than factors such as syllable complexity. The implications of the outcome for current models of phonological development are discussed.

Microbicidal effect of medicinal plant extracts (Psidium guajava Linn. and Carica papaya Linn.) upon bacteria isolated from fish muscle and known to induce diarrhea in children

Out of the twenty-four samples of shrimp and fish muscle used for this study, twelve were collected near a large marine sewer for waste disposal, 3 km off the coast of Fortaleza (Brazil) and used for the isolation of E. coli. Other twelve were collected at the Mucuripe fresh fish market (Fortaleza, Brazil) and used for the isolation of Staphylococcus aureus. Ethanol, water and acetone-diluted extracts of guava and papaya leaf sprouts were tested on the bacteria in order to verify their microbicidal potential. The E. coli strains used in the trials were rated LT positive. The papaya leaf extracts (Carica papaya Linn) showed no microbicidal activity while the guava sprout extracts (Psidium guajava Linn) displayed halos exceeding 13 mm for both species, an effect considered to be inhibitory by the method employed. Guava sprout extracts by 50% diluted ethanol most effectively inhibited E. coli (EPEC), while those in 50% acetone were less effective. It may be concluded that guava sprout extracts constitute a feasible treatment option for diarrhea caused by E. coli or by S. aureus-produced toxins, due to their quick curative action, easy availability in tropical countries and low cost to the consumer.

Gramática generativa. Um projecto de investigação em linguística

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