Efeitos da perda de peso induzida pela cirurgia bariátrica sobre a função respiratória

Background: Obesity leads to alteration of lung volumes and capacities due to accumulation of fat in the chest wall and abdomen. Few studies have shown that weight loss induced by surgery improves lung function. Our objective was to evaluate the anthropometric development, pulmonary function, respiratory muscle, strength and endurance after weight loss induced by bariatric surgery. Methods: We evaluated in pre and post operative period variables of weight, BMI, NC, WHR and spirometric and respiratory pressure. Results: 39 subjects were evaluated, with age mean 35.9 ± 10.9 years, predominantly by women (76.3%). The weight mean decreased from 124.8 ± 17.5 kg to 88.8 ± 14.28 kg in post operative. The mean BMI ranged from 47,9 ± 5,6 Kg/m² to 34,3 ± 4,75 Kg/m². There was a significant increase in FVC from 3,63 ± 0,94 to 4,01±1,03, FEV1 from 3,03 ± 0,72 to 3,39 ± 0,85, FEF 25-75% from 3,41 ± 0,72 to 3,82 ± 0,94, PEF from 6,56 ± 1,47 to 7,81 ± 1,69, ERV from 0,35 ± 0,39 to 0,66 ± 0,38, MVV ranged from 103,43 ± 22,21 to 137,27 ± 29,84, all of them to p<0,01. The MIP and MEP showed no significant difference in pre and post operative. It was noted that for every centimeter reduced in neck circumference, an increase of 0.06 in FVC and 5.98 in MVV is observed. This is also observed in weight and BMI. Conclusion: We conclude that weight loss induced by bariatric surgery in obese provides a significant improvement in lung function and reduction of fat around the neck is more important in the generation of lung volume than the reduction of BMI

Compreensão da experiência do sofrimento de mulheres na relação amorosa

Our professional everyday life, as a psychologist, we often come across the narrative made by women of a permanent suffering experience in loving and sexual relation. This checking created questions which indicated to the questioned experience singularity, taking into account the historic and cultural aspects (genre and romantic love) that seemed to permeate such an experience. The conduction given to this research was guided by the following question: how is to the woman the experience of going on suffering on loving and sexual relation? Therefore, the objective was to understand that experience. Were carried out with six women that were living the experience which intend to investigate. The narrative, in according to the purposal by Walter Benjamin was the access tool to the experience. The narrative analysis shows the singularity of constant suffering experience on loving relation as well as common aspects. It is remarkable the presence of relative questions to the genre and romantic loving dimension, influencing the way as the interviewed women perceive themselves on the existence and realize the loving suffering which experience. Women reveal several ways of expressing and perceiving to the loving suffering which is common the manifestation of several physical and psychic symptoms. The most participants had experiences of protected familiar contact of feeling development of low self-esteem, disability, unstableness and fear. We realize that the suffering of interviewed women, on loving relation, it revels, above all, a way of being in the world, perveiving themselves, marked by solitude fear, lovelessness, leading the life itself giving origin to the lifestyle and of really new loving. Thus, we emphasize the importance of greater engagement of professionals and institutions which deal with the thematic this research in order to develop actions that consider its complexity. We also emphasize new reflections about the loving suffering so that different sense possibilities can emerge propitiating a greater comprehension of human subjectivity

GESTÃO AMBIENTAL E COMPETITIVIDADE EM DESTINOS TURÍSTICOS: percepção dos gestores de pequenos meios de hospedagem de Natal/RN sobre o uso de práticas ambientais como fator de competitividade

The present work aimed at investigating the small hotel managers perceptions from Natal/RN concerning the environmental practice uses as a competitive factor. This study is characterized as a descriptive exploratory research that used an aleatory probabilistic sample followed by the application of collect data instrument (questionnaire). The small hotels located in Natal/RN were the study participants and the specific location where 35 questionnaires were answered. Based on the data and on the mangers point of view, it is possible to comprehend that, among the presented indicators, the development of environmental programs in the hotel enterprise is showed as the least important for the client s choice. As the main conclusion it is relevant to argue that, according to the small hotel managers, the guests do not still search for hotels that implement environmental practices. On the other side, the interviewed managers believe that the use of these practices can generate a great competitive advantage in relation to their competitors. The information obtained by this present research will be able to contribute to establish a contemporary panorama in relation to the importance attributed by the managers concerning the use of environmental practices in small hotel enterprises in Natal/RN. In addition the correct use of this information can generate possibilities of major competitiveness in this segment

Análise da atividade turística desenvolvida na área de proteção ambiental dos Recifes de Corais RN

The protected areas are created for conservation to nature. The way they associate with the communities and visitors are essential to its objectives are achieved. This study aims to analyze how tourism is developed in the. The Recifes dos Corais Protected Area (APARC) through the identification of the image that tourists and residents have with respect to Parracho of Maracajaú and knowledge of the factors that contribute to a satisfactory visit of tourists. For this was an exploratorydescriptive study with quali-quantitative approach, with 236 tourists and 70 residents of the district of Maracajaú, using questionnaires and interviews. Data analysis techniques were used and percentage of arithmetic, factor analysis and content analysis. The results showed that the importance and significance attributed by residents to Parracho related to economic gains. Information on the APARC and on their standards are not done efficiently and contribute to negatively impact the site. The profile of tourists is not the most appropriate for a protected area. The dimensions of satisfaction to the tourists demonstrated the need for actions to be undertaken by the administration of APARC. Conclude that the image that the residents and tourists have of APARC is not conducive to the image of a protected areas. The tourists are satisfied with the tour in APARC, however, the dimensions of satisfaction are not consistent with the conservation of the site

Estratégias de enfrentamento da incontinência urinária por mulheres

Este artigo é parte de uma pesquisa qualitativa mais abrangente que utilizou como referencial teórico-metodológico a Grounded Theory e o Interacionismo Simbólico, resultando no modelo teórico denominado Entre o sofrimento e a esperança: a reabilitação da incontinência urinária como componente interveniente. Com a intenção de comunicar todo o conhecimento produzido, apresenta-se parte desse modelo, referente ao processo de enfrentamento da incontinência urinária por mulheres sem perspectivas de acesso ao tratamento cirúrgico, após falha dos procedimentos conservadores. Ao inter-relacionar os componentes (categorias e subcategorias) relativos à experiência dessas mulheres, buscando compará-los e analisá-los para compreender a interação entre eles, notou-se vulnerabilidade moral e psicossocial no movimento da experiência do grupo, suscetibilizando-o a riscos à saúde e ao comprometimento da qualidade de vida. Pesquisas são necessárias para aprofundar a compreensão de experiências em que haja barreira ao tratamento cirúrgico por descrédito do profissional médico sobre sua efetividade.

Patterns of alcohol use between genders: A cross-cultural evaluation

Introduction: Alcohol use by men and women is very much influenced by social habits and customs. Cultural peculiarities and biological differences between the sexes require more focused and standardized studies. The objective was to systematize information on patterns of alcohol use between the sexes.Method: A literary review (1972-2004) identified 96 publications (Lilacs, Scielo, Medline) and some related books.Results and conclusions: Men drank more and presented more problems (legal, family, social, clinical, traumas and mortality) associated with alcohol use; the consequences of alcohol use in developing countries with low death rates is even higher. Women can face more discrimination by using alcohol as well as worse health problems when they abuse drinking (liver, pancreas, and central and peripheral nervous system problems, psychiatric comorbidity, etc.); sexual abuse is more commonly associated with women than discussing the different responses to treatment. As for social roles/responsibilities exercised by women, there are indications that marriage, employment, and children have a good influence, discouraging alcohol use, while divorce, unemployment, and no children contribute to higher consumption. For both sexes, religion was a protective factor for alcohol use; acculturation was a strong influence in the pattern of alcohol use, and alcohol worsened the evolution of existing psychiatric disorders. (c) 2006 Elsevier B.V. All rights reserved.

Oral cleft prevention program (OCPP)

Background: Oral clefts are one of the most common birth defects with significant medical, psychosocial, and economic ramifications. Oral clefts have a complex etiology with genetic and environmental risk factors. There are suggestive results for decreased risks of cleft occurrence and recurrence with folic acid supplements taken at preconception and during pregnancy with a stronger evidence for higher than lower doses in preventing recurrence. Yet previous studies have suffered from considerable design limitations particularly non-randomization into treatment. There is also well-documented effectiveness for folic acid in preventing neural tube defect occurrence at 0.4 mg and recurrence with 4 mg. Given the substantial burden of clefting on the individual and the family and the supportive data for the effectiveness of folic acid supplementation as well as its low cost, a randomized clinical trial of the effectiveness of high versus low dose folic acid for prevention of cleft recurrence is warranted.Methods/design: This study will assess the effect of 4 mg and 0.4 mg doses of folic acid, taken on a daily basis during preconception and up to 3 months of pregnancy by women who are at risk of having a child with nonsyndromic cleft lip with/without palate (NSCL/P), on the recurrence of NSCL/P. The total sample will include about 6,000 women (that either have NSCL/P or that have at least one child with NSCL/P) randomly assigned to the 4 mg and the 0.4 mg folic acid study groups. The study will also compare the recurrence rates of NSCL/P in the total sample of subjects, as well as the two study groups (4mg, 0.4 mg) to that of a historical control group. The study has been approved by IRBs (ethics committees) of all involved sites. Results will be disseminated through publications and presentations at scientific meetings.Discussion: The costs related to oral clefts are high, including long term psychological and socio-economic effects. This study provides an opportunity for huge savings in not only money but the overall quality of life. This may help establish more specific clinical guidelines for oral cleft prevention so that the intervention can be better tailored for at-risk women.

Vidas errantes e alcoolismo: uma questão social

O fenômeno da errância, impulsionado por motivos sócio-econômicos ou mesmo por razões pessoais, traz consigo profundas transformações no plano psicossocial. A presente pesquisa se propôs a investigar as razões que levam os trecheiros à ruptura com a vida sedentária e o papel que o alcoolismo exerce nesse processo de deserção. Foram entrevistados doze sujeitos que fazem uso de bebidas alcoólicas, albergados numa Instituição Assistencial da cidade de Assis, SP, sendo as entrevistas submetidas, posteriormente, a uma análise de conteúdo. Os resultados mostraram que a morte dos pais, os conflitos familiares e o desemprego têm sido um dos principais motivos para a ruptura com o sedentarismo. O uso do álcool, no trecho, é atribuído pelos próprios sujeitos à necessidade de esquecer problema, maior encorajamento e apaziguar conflitos remanescentes, em geral, conflitos afetivos que possuem como epicentro a infidelidade conjugal.

Experiências afetivo-familiares de mulheres com alopecia areata

Este estudo consistiu na análise da dinâmica emocional das experiências afetivas de mulheres com alopecia areata, tendo como eixo as relações de afeto mantidas com os pais e em suas relações conjugais. Foram entrevistadas cinco pacientes, atendidas no Instituto Lauro de Souza Lima, com idade entre 22 e 53 anos. O estudo baseou-se no método clínico de investigação e os dados foram obtidos mediante entrevistas semi-estruturadas. Nos depoimentos foram apontadas experiências dolorosas da relação conjugal e do adoecimento, que foram associadas a vivências traumáticas na infância. As associações realizadas pelas mulheres entre suas experiências passadas, relações conjugais, adoecimento e o impacto da doença na vida atual confirmaram os achados da literatura, e os dados encontrados puderam ser interpretados à luz das contribuições psicanalíticas. Os resultados obtidos podem contribuir para o esclarecimento de aspectos dinâmicos relacionados à alopecia areata e a outras psicodermatoses, bem como favorecer intervenções interdisciplinares e psicoterápicas mais efetivas com pacientes dermatológicos crônicos.

Utilização das recomendações de nutrientes para estimar prevalência de consumo insuficiente das vitaminas C e E em gestantes

Na gestação ocorrem adaptações que conduzem a um aumento da taxa metabólica basal, caracterizando um estado de alto nível de estresse oxidativo, tornando relevante a avaliação do consumo de nutrientes antioxidantes por mulheres grávidas. Este estudo teve como objetivo estimar a prevalência de consumo insuficiente das vitaminas C e E em gestantes assistidas em serviços públicos de saúde. Estudou-se amostra (n=107) representativa das mulheres no segundo trimestre gestacional atendidas durante o pré-natal nas unidades de atenção básica do município de Botucatu/SP. O consumo foi investigado mediante dois inquéritos recordatórios de 24 horas. Para estimar a prevalência de inadequação de consumo na população, foi utilizado o método EAR como ponto de corte. Diferenças de consumo (em tercis) em relação a fatores socioeconômicos, obstétricos e hábitos de vida foram pesquisadas mediante análise estratificada, adotando-se p<0.05 como nível de significância. As prevalências estimadas de consumo insuficiente das vitaminas C e E foram 60% e 91,5%, respectivamente. Houve associação inversa entre o consumo de vitamina E com paridade e o consumo de vitamina C foi menor nas adolescentes em relação às adultas. Estes resultados indicam a necessidade de intervenções individuais e coletivas de promoção e apoio ao consumo de alimentação saudável por mulheres em idade fértil. Conclui-se que a prevalência de inadequação do consumo das vitaminas C e E é elevada e sem contrastes socioeconômicos.

Low-level laser therapy for pain relief after episiotomy: a double-blind randomised clinical trial

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

A review of antifertility folkloric plants tested in laboratory animals

The use of natural active principals is widespread among a great proportion of the rural population, or by people who do not have easy access to medical assistance. These active principles are used as food or medicines, and even for purposes of contraception. It becomes necessary to establish a relationship between the folklore habits and current information on the nature of anti-fertility substances, and knowledge of their mechanisms. Anti-fertility agents may exert their actions in a number of areas, (hypothalamus, anterior pituitary, oviduct, uterus, and vagina), inhibiting synthesis and/or liberation of hormones (follicle-stimulating, luteinizing, and steroid hormones), ovulation, ovum transportation, and implantation process. Therefore, a review of literature was carried out, including of several plants used by women as abortifacient and anti-fertility agents to compare their effects with those obtained among laboratory animals.

Adaptação para o Português do questionário de auto-avaliação de percepção de saúde física e mental da mulher de meia-idade - Questionário da Saúde da Mulher

The objective of this study is to translate to Brazilian Portuguese, and validate (criterion) it to the Brazilian population, the Women's Health Questionnaire (WHQ), questionnaire was developed by Hunter (1992) in order to evaluate physical and mental symptoms, which were experienced by women, along their climacteric transition. A sample of 63 women, from 45 to 65 years old, was selected from the HC-UNESP staff and HC-Community Health School Center users. The WHQ and the General Health Questionnaire - GHQ (Goldberg-1972 - 60 items) were answered by all of them. The GHQ was used as reference. Pearson correlation coefficient, sensitivity and specificity were calculated for assessing the validity of the questionnaire. Cut-off points were determined in the WHQ by linear regressions (the reference was GHQ's cut-off points - higher than 2). Outcomes highlighted a general index of sensitivity of 0.83, specificity of 0.87, and correlation of - 0.82 and reliability of 0.89. The study sample does not portray the general population because the persons interviewed had high level of education. As the WHQ is easy to be applied and analyzed, it could be used in general, gynecologic, oncology and psychiatric practice.

Social Panorama of Latin America 2002-2003

Includes bibliography

Social Panorama of Latin America 2006

Includes bibliography