Variáveis associadas a não adesão à terapia medicamentosa em idosos hipertensos e com comorbidades de uma unidade pública de saúde de Ribeirão Preto-SP

A adesão ao tratamento ocorre quando o conselho médico ou de saúde coincide com o comportamento do indivíduo, ao uso de medicamentos, cumprimento da dieta e mudanças no estilo de vida, não sendo, portanto, um ato não passivo do paciente. Em pacientes com hipertensão arterial sistêmica a adesão ao tratamento pode ser definida como o grau de cumprimento das medidas terapêuticas indicadas, sejam elas medicamentosas ou não, com o objetivo de manter a pressão arterial em níveis pressóricos normais. A não adesão em pacientes com doenças crônicas em tratamento a longo prazo em países desenvolvidos é em média de 50%, revelando a importância de serem avaliados os motivos que levam a esse comportamento. O estudo teve como objetivo avaliar a não adesão em idosos hipertensos de uma unidade pública de saúde de Ribeirão Preto - SP. Trata-se de um estudo de corte transversal, desenvolvido com uma amostra de 196 pessoas. A coleta de dados ocorreu entre agosto de 2014 até junho de 2015, após aprovação do Comitê de Ética em Pesquisa. Para essa etapa foram utilizados os instrumentos Brief Medication Questionnaire, Medical Outcomes Studies 36-item Short Form Survey, Escore de Risco Global e Escore de Risco pelo Tempo de Vida. Após a coleta dos dados, as entrevistas foram codificadas, os dados foram tabulados e foi realizada a análise estatística descritiva e de correlação. Como resultado, constatou-se que houve predomínio de mulheres, com idade média de 69,4 anos, casados/união estável, não moravam sozinhos, com 1,85 pessoas na casa em média, de cor branca, com ensino fundamental incompleto, renda de até dois salários mínimos e aposentados/pensionistas, atendidos pelo SUS. Apresentaram hábitos de vida razoáveis, sem predomínio de consumo de bebidas alcoólicas, tabagismo, uso excessivo de sal e sedentarismo. A mais frequente comorbidade associada à HAS foi a dislipidemia. Foi observado elevado predomínio de fatores de risco cardiovasculares como obesidade abdominal, obesidade geral, comorbidades, razão de lipídeos e fatores agravantes como proteína c reativa ultrassensível, microalbuminúria e síndrome metabólica. A maioria da amostra foi classificada como sendo portador de risco cardiovascular alto após estratificação do risco. A percepção da qualidade de vida relacionada à saúde foi considerada baixa na maioria principalmente devido a limitações emocionais. A não adesão esteve presente em quase metade dos idosos, relacionada principalmente à complexidade da farmacoterapia e dificuldade em lembrar sobre o uso de seus medicamentos. Não foi observada correlação entre a não adesão e as variáveis estudadas. Conclui-se que o comportamento de não adesão observado não esteve relacionada às variáveis estudadas nessa amostra e que são necessárias intervenções urgentes para reduzir o risco cardiovascular e prevenir doenças cardiovasculares e mortalidade, bem como melhora da percepção da qualidade de vida relacionada à saúde.

Discursive constructions of social and environmental accounting in Brazil: the case of Petrobras.

In the 29 years following \"Our Common Future\" by the United Nations, there is considerable debate among governments, civil society, interest groups and business organisations about what constitutes sustainable development, which constitutes evidence for a contested discourse concerning sustainability. The purpose of this study is to understand this debate in the developing economic context of Brazil, and in particular, to understand and critique the social and environmental accounting [SEA] discursive constructions relating to the State-owned, Petrobras as well as to understand the Brazilian literature on SEA. The discourse theory [DT]-based analysis employs rhetorical redescription to analyse twenty-two reports from Petrobras from 2004-2013. I investigate the political notions by employing the methodological framework of the Logics of Critical Explanation [LCE]. LCE engenders five methodological steps: problematisation, retroduction, logics (social, political and fantasmatic), articulation and critique. The empirical discussion suggests that the hegemony of economic development operates to obfuscate, rhetorically, the development of sustainability, so as to maintain the core business of Petrobras conceived as capital accumulation. Equally, these articulations also illustrate how the constructions of SEA operate to serve the company\'s purpose with few (none) profound changes in integration of sustainability. The Brazilian literature on SEA sustains the status quo of neo-liberal market policies that operate to protect the dominant business case approach to maintain an agenda of wealth-creation in relation to social and environmental needs. The articulations of the case manifested in policies regarding, for example, corruption, which involved over-payments for contracts and unsustainable practices relating to the use of fossil fuels and demonstrated that there was antagonism between action and disclosure. The corruption scandal that emerged after SEA disclosures highlighted the rhetorical nature of disclosure when financial resources were subtracted from the company for political parties and engineering contractors hid facts through incomplete disclosures. The articulations of SEA misrepresent a broader context of the meanings associated with sustainability, which restricted the constructions of SEA to principally serve and represent the intention of the most powerful groups. The significance of SEA, then is narrowed to represent particular interests. The study argues for more critical studies as limited Brazilian literature concerning SEA kept a \'safe distance\' from substantively critiquing the constructions of SEA and its articulations in the Brazilian context. The literature review and the Petrobras\' case illustrate a variety of naming, instituting and articulatory practices that endeavour to maintain the current hegemony of development in an emerging economy, which allows Petrobras to continue to exercise significant profit at the expense of the social and environmental. The constructed idea of development in Petrobras\' discourses emphasises a rhetoric of wider development, but, in reality, these discourses were the antithesis of political, social and ethical developmental issues. These constructions aim to hide struggles between social inequalities and exploitation of natural resources and constitute excuses about a fanciful notion of rhetorical and hegemonic neo-liberal development. In summary, this thesis contributes to the prior literature in five ways: (i) the addition of DT to the analysis of SEA enhances the discussion of political elements such as hegemony, antagonism, logic of equivalence/difference, ideology and articulation; (ii) the analysis of an emerging economy such as Brazil incorporates a new perspective of the discussion of the discourses of SEA and development; (iii) this thesis includes a focus on rhetoric to discuss the maintenance of the status quo; (iv) the holistic structure of the LCE approach enlarges the understanding of the social, political and fantasmatic logics of SEA studies and; (v) this thesis combines an analysis of the literature and the case of Petrobras to characterise and critique the state of the Brazilian academy and its impacts and reflections on the significance of SEA. This thesis, therefore, argues for more critical studies in the Brazilian academy due to the persistence of idea of SEA and development that takes-for-granted deep exclusions and contradictions and provide little space for critiques.

El Programa de Educación en Alimentación y Nutrición (1961-1982) y la capacitación de las amas de casa como responsables del bienestar familiar

El objetivo de este trabajo es analizar desde una perspectiva de género, a través del ejemplo del Programa de Educación en Alimentación y Nutrición (EDALNU) que se desarrolló en España en las décadas finales del siglo XX, los mensajes y estrategias de educación alimentaria nutricional que iban dirigidos a mejorar la capacitación de las amas de casa como garantes del bienestar familiar y como expertas en la gestión de los diversos aspectos del hogar. Su acción específica sobre las amas de casa y los argumentos sobre los que se sostenía dicha intervención afianzaron el modelo social de género en el que los hombres eran los únicos responsables de los recursos económicos del hogar y las mujeres las proveedoras de cuidados familiares y en concreto los relacionados con la alimentación y la nutrición.

Visual Manifestations of Primary Metaphors Through Mise-en-scène Techniques

Grady distinguishes two main types of metaphor in order to provide a solution in the controversies stemming from the conceptual theory of metaphor: correlation-based metaphors and resemblance metaphors. In “correlation-based metaphors”, the source domain is sensory-motor, while the target domain is not. On the contrary, “resemblance metaphors” are originated by a physical or conceptual perception which is common in both domains, by the association of concepts with common features. Primary metaphors are the minimal units of correlation-based metaphors; they are inherent in human nature and the result of the nature of our brain, our body and the world that we inhabit. We acquire them automatically and we cannot avoid them. Furthermore, as corporal experiences are universal, so are primary metaphors. In this paper, I will argue that primary metaphors manifest themselves visually through scene-setting techniques such as composition, framing, camera movement or lighting. Film-makers can use the different aspects of mise-en-scène metaphorically in order to express abstract notions like evil, importance, control, relationship or confusion. Such visual manifestations, as also occurs with their verbal equivalents, frequently go unnoticed or have been used so often that they have become clichés. But the important thing to bear in mind is that their origin lies in a primary metaphor and due to this origin these kinds of film-making strategies have been so expressively successful.

Defying the Treaty: The Influence of the Polish and Lithuanian Council Presidencies on the Development of the Eastern Partnership. EU Diplomacy Paper No. 6, October 2014

Many scholars now argue that the Treaty of Lisbon has removed the role and influence of the rotating Council Presidency in the domain of the European Union’s foreign affairs. This paper will, however, go beyond a superficial, treaty-based analysis of the influence of the post-Lisbon rotating Council Presidency and instead look at two primary, residual, informal Presidential roles, namely agenda-shaping and brokering. It will examine the extent to which these informal roles allowed the Polish and Lithuanian Council Presidencies of July to December 2011 and 2013 respectively to influence the development of the bilateral, multilateral and internal tracks of the Eastern Partnership. The paper will argue that the considerable influence of these rotating Presidencies defied the logic of the Lisbon Treaty, suggesting that the ‘golden age’ of this six-month position, whereby individual Member States pursue foreign policy issues of significant domestic interest at the European level, has not yet passed.

Banks and the political economy of the sovereign debt crisis in Italy and Spain. CES Papers - Open Forum #18, 2013-2014

This paper sets out to explain why Spain experienced a full-fledged sovereign debt crisis and had to resort to euroarea financial assistance for its banks, whereas Italy did not. It undertakes a structured comparison, dissecting the sovereign debt crisis into a banking crisis and a balance of payments crisis. It argues that the distinctive features of bank business models and of national banking systems in Italy and Spain have considerable analytical leverage in explaining the different scenarios of the crises in each country. This ‘bank-based’ analysis contributes to the flourishing literature that examines changes in banking with a view to account for the differentiated impact of the global banking crisis first and the sovereign debt crisis in the euroarea later.

Modelled spatial and seasonal distribution of Blue Whiting (Micromesistius poutassou) larvae in the North-East Atlantic (1951 to 2005)

Blue whiting (Micromesistius poutassou, http://www.marinespecies.org/aphia.php?p=taxdetails&id=126439) is a small mesopelagic planktivorous gadoid found throughout the North-East Atlantic. This data contains the results of a model-based analysis of larvae captured by the Continuous Plankton Recorder (CPR) during the period 1951-2005. The observations are analysed using Generalised Additive Models (GAMs) of the the spatial, seasonal and interannual variation in the occurrence of larvae. The best fitting model is chosen using the Aikaike Information Criteria (AIC). The probability of occurrence in the continous plankton recorder is then normalised and converted to a probability distribution function in space (UTM projection Zone 28) and season (day of year). The best fitting model splits the distribution into two separate spawning grounds north and south of a dividing line at 53 N. The probability distribution is therefore normalised in these two regions (ie the space-time integral over each of the two regions is 1). The modelled outputs are on a UTM Zone 28 grid: however, for convenience, the latitude ("lat") and longitude ("lon") of each of these grid points are also included as a variable in the NetCDF file. The assignment of each grid point to either the Northern or Southern component (defined here as north/south of 53 N), is also included as a further variable ("component"). Finally, the day of year ("doy") is stored as the number of days elapsed from and included January 1 (ie doy=1 on January 1) - the year is thereafter divided into 180 grid points.

Document re-ranking by generality in bio-medical information retrieval

Document ranking is an important process in information retrieval (IR). It presents retrieved documents in an order of their estimated degrees of relevance to query. Traditional document ranking methods are mostly based on the similarity computations between documents and query. In this paper we argue that the similarity-based document ranking is insufficient in some cases. There are two reasons. Firstly it is about the increased information variety. There are far too many different types documents available now for user to search. The second is about the users variety. In many cases user may want to retrieve documents that are not only similar but also general or broad regarding a certain topic. This is particularly the case in some domains such as bio-medical IR. In this paper we propose a novel approach to re-rank the retrieved documents by incorporating the similarity with their generality. By an ontology-based analysis on the semantic cohesion of text, document generality can be quantified. The retrieved documents are then re-ranked by their combined scores of similarity and the closeness of documents’ generality to the query’s. Our experiments have shown an encouraging performance on a large bio-medical document collection, OHSUMED, containing 348,566 medical journal references and 101 test queries.

ANTROPOLOGIA TRANSCENDENTAL E CORRELAÇÃO : KARL RAHNER E PAUL TILLICH EM DIALOGO - UMA LEITURA INTERCONFESSIONAL DE MÉTODOS TEOLÓGICOS A PARTIR DA ONTOLOGIA EXISTENCIAL DE MARTIN HEIDEGGER

Esta tese de Doutorado procura estudar os métodos teológicos em diálogo, antropologiatranscendental de Karl Rahner e correlação de Paul Tillich, a partir da sistematização da ontologia existencial elaborada pelo jovem Heidegger em Sein und Zeit. Tanto num, como noutro método, o que se discute é a profundidade do ser, na sua possibilidade de aproximação em superação ao que não pode ser dito. Nesse caso, tanto a metafísica tomista, resgatada por Rahner, quanto a secularização protestante e o abismo do ser, enfatizado por Tillich, assumem a impossibilidade de se dizer o conteúdo do sagrado, exatamente por se situarem ou no inconceito da raiz ontológica (Rahner), ou no excesso de sentido do Ultimate Concern (Tillich). Dessas impossibilades, independente se um antes e depois (Rahner), ou se um depois e um antes em profundidade (Tillich), o que se tem é a pergunta ontológica como possibilidade da abertura do ser, nos dois casos sem conteúdo, para que a resposta , que também não responde, seja dada como (im)possibilidade do deslocamento do ser. No resgate da metafísica tomista, em Rahner, há um deslocamento a partir de um sentido, de certo modo linear , daí antropologia-transcendental. Já na leitura protestante de Tillich, o deslocamento se dá por uma dialética , o ser ameaçado pelo não-ser, como uma unidade rompida, daí correlação. A tese é apresentada em quatro capítulos. No primeiro há uma leitura de Heidegger, pela perspectiva da hermenêutica da compreensão. Já no segundo a reflexão se dá em busca da possibilidade da compreensão pela racionalidade ontológica na correlação, Paul Tillich, pela mediação do simbólico. No terceiro, seguindo as mesmas preocupações, se faz a leitura da epistemologia na racionalidade ontológica na antropologia -transcendental, Karl Rahner, pela mediação da pré-apreensão. O quarto capítulo apresenta temas decorrentes, e tradicionais da teologia, em diálogo a partir dos métodos.(AU)

CRÍTICOS & CRITICADOS A CRÍTICA CINEMATOGRÁFICA E SUA RELAÇÃO COM OS CINEASTAS DA RETOMADA

O objetivo deste estudo é analisar a crítica cinematográfica durante o período chamado de Retomada do cinema nacional. Foram escolhidos os maiores veículos de circulação da região Sudeste do País, os jornais O Globo (Rio de Janeiro), Folha de S.Paulo e O Estado de S.Paulo (São Paulo) e a revista Veja para fazer uma análise de conteúdo das críticas das seis maiores bilheterias da Retomada para, em seguida, conferir a recepção das mesmas pelos diretores desses filmes, por meio de entrevistas semi-estruturadas. A intenção é analisar quais conflitos permeiam a relação entre os críticos de cinema e os cineastas, a fim de contribuir para o melhor entendimento do trabalho de dois elementos dos mais importantes da área de cinema. O confronto do material da análise com as entrevistas confirmou a hipótese da existência de conflitos de valores e opiniões entre os dois lados e permitiu identificar pré-julgamentos, simpatias e antipatias, análises emotivas e não-fundamentadas de alguns críticos e cineastas, mas também opiniões e valores fundamentados de outros, demonstrando uma rica diversidade que não se encaixa em uma única definição.(AU)

A PRESENÇA DE DEPRESSÃO EM PACIENTES DURANTE O PERÍODO DE REABILITAÇÃO FÍSICA E O IMPACTO NA QUALIDADE DE VIDA DOS MESMOS

A depressão é um termo que descreve uma série de comportamentos complexos e tem sido empregada para designar tanto um estado afetivo normal, quanto um sintoma, uma síndrome e uma ou várias doenças. É caracterizada por um conjunto de sintomas relacionados a uma dada situação, ou ainda pelo aparecimento destes, de forma repetida e/ou sem nenhuma causa aparente. Os principais sintomas para o diagnóstico da depressão são alteração do apetite, agitação ou retardo psicomotor, diminuição da energia ou cansaço excessivo, sensação de culpa, dificuldade de concentração e pensamentos recorrentes de morte ou suicídio. A qualidade de vida está relacionada ao completo bem-estar físico, psíquico e social do indivíduo. Este estudo tem como objetivo investigar a presença de depressão em pacientes portadores de doenças reumatológicas e neurológicas, que estão em tratamento fisioterapêutico na Clínica Escola de Fisioterapia da Universidade Metodista de São Paulo e analisar o impacto da depressão sobre a qualidade de vida dos mesmos. Foram selecionados indivíduos nos setores de neurologia e reumatologia, em atendimento no período de junho a agosto de 2003, os quais responderam a dois questionários, Inventário de Beck para investigar a presença de depressão e, o SF-36 para avaliar a qualidade de vida. Os resultados obtidos foram analisados pelo teste T-Student, de correlação de Pearson, análise de Cluster, e Lambda de Wilks. Os dados foram analisados no programa STATISTICA, foi adotado um nível de significância de 5% (p≤ 0,05). Concluiu-se que durante o período de reabilitação física dos indivíduos participantes deste estudo, um número significativo de pacientes apresentou depressão em diferentes níveis, com provável incidência no grupo reumatológico e este mesmo grupo, apresentou qualidade de vida inferior a dos indivíduos do grupo neurológico avaliados neste estudo

Statistical mechanics of low-density parity-check codes

We review recent theoretical progress on the statistical mechanics of error correcting codes, focusing on low-density parity-check (LDPC) codes in general, and on Gallager and MacKay-Neal codes in particular. By exploiting the relation between LDPC codes and Ising spin systems with multispin interactions, one can carry out a statistical mechanics based analysis that determines the practical and theoretical limitations of various code constructions, corresponding to dynamical and thermodynamical transitions, respectively, as well as the behaviour of error-exponents averaged over the corresponding code ensemble as a function of channel noise. We also contrast the results obtained using methods of statistical mechanics with those derived in the information theory literature, and show how these methods can be generalized to include other channel types and related communication problems.

Statistical mechanics of broadcast channels using low-density parity-check codes

We investigate the use of Gallager's low-density parity-check (LDPC) codes in a degraded broadcast channel, one of the fundamental models in network information theory. Combining linear codes is a standard technique in practical network communication schemes and is known to provide better performance than simple time sharing methods when algebraic codes are used. The statistical physics based analysis shows that the practical performance of the suggested method, achieved by employing the belief propagation algorithm, is superior to that of LDPC based time sharing codes while the best performance, when received transmissions are optimally decoded, is bounded by the time sharing limit.

Inventory parameter management and focused continuous improvement for repetitive batch manufacturers

What this thesis proposes is a methodology to assist repetitive batch manufacturers in the adoption of certain aspects of the Lean Production principles. The methodology concentrates on the reduction of inventory through the setting of appropriate batch sizes, taking account of the effect of sequence dependent set-ups and the identification and elimination of bottlenecks. It uses a simple Pareto and modified EBQ based analysis technique to allocate items to period order day classes based on a combination of each item's annual usage value and set-up cost. The period order day classes the items are allocated to are determined by the constraints limits in the three measured dimensions, capacity, administration and finance. The methodology overcomes the limitations associated with MRP in the area of sequence dependent set-ups, and provides a simple way of setting planning parameters taking this effect into account by concentrating on the reduction of inventory through the systematic identification and elimination of bottlenecks through set-up reduction processes, so allowing batch sizes to reduce. It aims to help traditional repetitive batch manufacturers in a route to continual improvement by: Highlighting those areas where change would bring the greatest benefits. Modelling the effect of proposed changes. Quantifying the benefits that could be gained through implementing the proposed changes. Simplifying the effort required to perform the modelling process. It concentrates on increasing flexibility through managed inventory reduction through rationally decreasing batch sizes, taking account of sequence dependent set-ups and the identification and elimination of bottlenecks. This was achieved through the development of a software modelling tool, and validated through a case study approach.

Three-factor models versus time series models:quantifying time-dependencies of interactions between stimuli in cell biology and psychobiology for short longitudinal data

Signal integration determines cell fate on the cellular level, affects cognitive processes and affective responses on the behavioural level, and is likely to be involved in psychoneurobiological processes underlying mood disorders. Interactions between stimuli may subjected to time effects. Time-dependencies of interactions between stimuli typically lead to complex cell responses and complex responses on the behavioural level. We show that both three-factor models and time series models can be used to uncover such time-dependencies. However, we argue that for short longitudinal data the three factor modelling approach is more suitable. In order to illustrate both approaches, we re-analysed previously published short longitudinal data sets. We found that in human embryonic kidney 293 cells cells the interaction effect in the regulation of extracellular signal-regulated kinase (ERK) 1 signalling activation by insulin and epidermal growth factor is subjected to a time effect and dramatically decays at peak values of ERK activation. In contrast, we found that the interaction effect induced by hypoxia and tumour necrosis factor-alpha for the transcriptional activity of the human cyclo-oxygenase-2 promoter in HEK293 cells is time invariant at least in the first 12-h time window after stimulation. Furthermore, we applied the three-factor model to previously reported animal studies. In these studies, memory storage was found to be subjected to an interaction effect of the beta-adrenoceptor agonist clenbuterol and certain antagonists acting on the alpha-1-adrenoceptor / glucocorticoid-receptor system. Our model-based analysis suggests that only if the antagonist drug is administer in a critical time window, then the interaction effect is relevant.