Prevalência de sintomas depressivos em uma população de idosos usuários de serviços públicos

Esta dissertação pretende estimar a prevalência de sintomas depressivos em idosos segundo três níveis de complexidade de atenção à saúde e estudar a co-ocorrência de sintomas depressivos e incapacidade funcional. No Brasil, a transição demográfica ocorreu de forma rápida e explosiva. À medida que o número de idosos cresce ocorre o aumento da prevalência de doenças crônicas e suas complicações. A habilidade funcional pode ser vista como uma medida de resumo do impacto geral das condições médicas no contexto do ambiente e do sistema de apoio social do indivíduo, e deve ser uma consideração importante em qualquer planejamento de saúde. Uma enfermidade associada a elevado grau de incapacidade funcional é a depressão. Entre os agravos de saúde mental, a depressão é um dos mais comuns e importantes problemas psiquiátricos entre indivíduos idosos. Trata-se de estudo transversal com tamanho amostral de 643 idosos com idade de 65 ou mais anos selecionados aleatoriamente e usuários de três serviços públicos de saúde com níveis crescentes de complexidade (primário, secundário e terciário). A prevalência de sintomas depressivos foi estimada a partir da EDG-15, já traduzida e validada para uso no Brasil. O nível de estado funcional foi definido conforme os escores dos instrumentos SF-36 e HAQ. A prevalência de sintomas depressivos na amostra total foi de 45,2% (IC=41,1 49,3). Estratificando por unidade, a prevalência foi de 35,3% no nível primário, 47,6% no nível secundário e 51,7% no nível terciário (p=0,004). As prevalências encontradas foram altas nos três níveis de complexidade de atendimento, inclusive na população de idosos da unidade básica de saúde, apesar de serem idosos mais independentes e mais saudáveis. A prevalência geral de sintomas depressivos aumentou à medida que o grau de incapacidade funcional também aumentou. A busca ativa por idosos com sintomas depressivos é importante em todos os níveis de complexidade de atendimento do sistema de saúde.

Diagnóstico de um grupo de familiares em risco para o câncer de mama: contribuição para a assistência de enfermagem

Devido a sua alta incidência, mortalidade e custos elevados, o câncer de mama feminino é considerado um problema de saúde pública no Brasil. Sua etiologia envolve uma interação de diversos fatores denominados de risco os quais podem ser ambientais e genéticos. A história familiar positiva para câncer de mama é um importante fator de risco para o desenvolvimento dessa patologia. Conhecer esses fatores e as medidas de proteção permite que mulheres com risco elevado possam criar estratégias pessoais que venham minimizar os danos causados pela doença. Diante do exposto, o presente estudo tem como objetivos avaliar o nível de conhecimento de mulheres acerca do risco de desenvolverem câncer de mama em decorrência do vínculo familiar com a população portadora desta neoplasia matriculada no Hospital do Câncer III, unidade do Instituto Nacional de Câncer (INCA) especializada no tratamento e controle do câncer de mama, localizada no município do Rio de Janeiro, Brasil; descrever as características sociodemográficas das mulheres familiares de pacientes portadoras de câncer de mama e descrever a história reprodutiva e hormonal, bem como seus hábitos de cuidado com a saúde. Metodologia: trata-se de um estudo exploratório sob a perspectiva quantitativa, transversal e descritiva com 52 mulheres que acompanhavam suas familiares internadas em unidade clínica e cirúrgica do Hospital do Câncer III. A coleta de dados ocorreu no período entre julho e agosto de 2011. A técnica de amostragem adotada foi a não probabilística, intencional Para o cálculo amostral aplicou-se a fórmula de população infinita. Foram selecionadas as seguintes variáveis para compor o estudo: aspectos sociodemográficos, aspectos da vida reprodutiva e hormonal, aspectos de cuidados com a saúde e aspectos de esclarecimento relacionados à patologia/doença. Realizou-se entrevista estruturada com utilização de um formulário composto por 63 questões. A descrição das variáveis foi feita através de frequência simples e porcentagem. Resultados: 61,5% eram filhas, 34,6% eram irmãs e 3,8% eram mães, 40,4% moram no município do Rio de Janeiro, 86,4% encontram-se na faixa etária entre 29 e acima de 51 anos de idade, 32% são pardas, 46,1% apresentavam 2 grau completo, 46,2% são do lar, 15,4% tiveram menarca precoce, 7,7 % tiveram na menopausa tardia, 7,7% fizeram Terapia de Reposição Hormonal, 38,5% nunca engravidaram, 3,8% engravidaram após 30 anos, 3,8% não amamentaram, 42,4% usam anticoncepcional hormonal por mais de 5 anos e 40,4% nunca fizeram descanso ou faz por tempo inferior a 6 meses, 7,7% e 7,6% nunca fizeram e apresenta mais de 24 meses que fizeram exame ginecológico. Quanto ao grau de esclarecimento 34% concordaram com as afirmativas sobre fatores de risco, 65% concordaram com medidas preventivas e os profissionais de saúde foram os que mais transmitiram informação sobre o câncer de mama. Conclusão: ser familiar de primeiro grau associado à falta de esclarecimento sobre a doença torna essas mulheres mais vulneráveis em relação à população geral feminina. Torna-se oportuno para a enfermagem estratégias educativas que visem à promoção da saúde e que contribuam para a modificação do panorama da doença, em razão da detecção mais precoce.

Association between CASP8-652 6N Del Polymorphism (rs3834129) and Colorectal Cancer Risk: Results from a Multi-Centric Study

The common 2652 6N del variant in the CASP8 promoter (rs3834129) has been described as a putative low-penetrance risk factor for different cancer types. In particular, some studies suggested that the deleted allele (del) was inversely associated with CRC risk while other analyses failed to confirm this. Hence, to better understand the role of this variant in the risk of developing CRC, we performed a multi-centric case-control study. In the study, the variant 2652 6N del was genotyped in a total of 6,733 CRC cases and 7,576 controls recruited by six different centers located in Spain, Italy, USA, England, Czech Republic and the Netherlands collaborating to the international consortium COGENT (COlorectal cancer GENeTics). Our analysis indicated that rs3834129 was not associated with CRC risk in the full data set. However, the del allele was under-represented in one set of cases with a family history of CRC (per allele model OR = 0.79, 95% CI = 0.69-0.90) suggesting this allele might be a protective factor versus familial CRC. Since this multi-centric case-control study was performed on a very large sample size, it provided robust clarification of the effect of rs3834129 on the risk of developing CRC in Caucasians.

Genetic variation between outer-coastal and fjord populations of Pacific herring (Clupea pallasii) in the eastern Gulf of Alaska

Pacific herring (Clupea pallasii) from the Gulf of Alaska were screened for temporal and spatial genetic variation with 15 microsatellite loci. Thirteen collections were examined in this study: 11 from Southeast Alaska and 2 from Prince William Sound, Alaska. Although FST values were low, a neighbor-joining tree based on genetic distance, homogeneity, and FST values revealed that collectively, the Berners Bay and Lynn Canal (interior) collections were genetically distinct from Sitka Sound and Prince of Wales Island (outer-coastal) collections. Temporal genetic variation within regions (among three years of Berners Bay spawners and between the two Sitka Sound spawners) was zero, whereas 0.05% was attributable to genetic variation between Berners Bay and Sitka Sound. This divergence may be attributable to environmental differences between interior archipelago waters and outer-coast habitats, such as differences in temperature and salinity. Early spring collections of nonspawning Lynn Canal herring were nearly genetically identical to collections of spawning herring in Berners Bay two months later—an indication that Berners Bay spawners over-winter in Lynn Canal. Southeast Alaskan herring (collectively) were significantly different from those in Prince William Sound. This study illustrates that adequate sample size is needed to detect variation in pelagic fish species with a large effective population size, and microsatellite markers may be useful in detecting low-level genetic divergence in Pacific herring in the Gulf of Alaska.

Use of SARIMA models to assess data-poor fisheries: a case study with a sciaenid fishery off Portugal

Research on assessment and monitoring methods has primarily focused on fisheries with long multivariate data sets. Less research exists on methods applicable to data-poor fisheries with univariate data sets with a small sample size. In this study, we examine the capabilities of seasonal autoregressive integrated moving average (SARIMA) models to fit, forecast, and monitor the landings of such data-poor fisheries. We use a European fishery on meagre (Sciaenidae: Argyrosomus regius), where only a short time series of landings was available to model (n=60 months), as our case-study. We show that despite the limited sample size, a SARIMA model could be found that adequately fitted and forecasted the time series of meagre landings (12-month forecasts; mean error: 3.5 tons (t); annual absolute percentage error: 15.4%). We derive model-based prediction intervals and show how they can be used to detect problematic situations in the fishery. Our results indicate that over the course of one year the meagre landings remained within the prediction limits of the model and therefore indicated no need for urgent management intervention. We discuss the information that SARIMA model structure conveys on the meagre lifecycle and fishery, the methodological requirements of SARIMA forecasting of data-poor fisheries landings, and the capabilities SARIMA models present within current efforts to monitor the world’s data-poorest resources.

Age validation of great hammerhead shark (Sphyrna mokarran), determined by bomb radiocarbon analysis

Preliminary validation of annual growth band deposition in vertebrae of great hammerhead shark (Sphyrna mokarran) was conducted by using bomb radiocarbon analysis. Adult specimens (n=2) were collected and thin sections of vertebral centra were removed for visual aging and use in radiocarbon assays. Vertebral band counts were used to estimate age, and year of formation was assigned to each growth band by subtracting estimated age from the year of capture. A total of 10 samples were extracted from growth bands and analyzed for Δ14C. Calculated Δ14C values from dated bands were compared to known-age reference chronologies, and the resulting patterns indicated annual periodicity of growth bands up to a minimum age of 42 years. Trends in Δ14C across time in individual specimens indicated that vertebral radiocarbon is conserved through time but that habitat and diet may inf luence Δ14C levels in elasmobranchs. Although the age validation reported here must be considered preliminary because of the small sample size and narrow age range of individuals sampled, it represents the first confirmation of age in S. mokarran, further illustrating the usefulness of bomb radiocarbon analysis as a tool for life history studies in elasmobranchs.

Bothrops aff. Leucurus (Wagler, 1824) populazio irlatar baten deskribapen morfologikoa: suge populazio irlatar baten morfologia

[EUS] Atrox konplexuko espezieen barruan, Bothrops leucurus (Wagler, 1824) Bahia estatuko oihan atlantikoko sugegorri espezie arruntena da. Polimorfikoa da eta ezaugarri geografikoekin, ontogenikoekin eta sexuarekin erlazionatutako kolore aldakortasuna aurkezten du. Jadanik hainbat ikerketa burutu dira kontinenteko populazioei buruz, baina, oraindik ez da lanik egin BTS badiako populazio uhartetarrekin. Lan honen xedea Bothrops aff. leucurus populazio uhartetarraren deskribapena burutzea izan da, orbanen ereduetan, folidosian eta gorputz tamainan oinarriturik. Lagin tamaina erlatiboki txikia izanik (n=20), Student t testeko emaitzak type II erroreen menpe daude eta kontinenteko eta uharteko populazioen arteko ezberdintasunak estatistikoki ikertu izan ez diren arren, gure datuak garrantzia dute. Izan ere, ikerketa sakonagoetan oinarri bezala erabili ahal izango dira. Biometriari dagokionez, gure populazio uhartetarrean batazbesteko MKL txikiagoa ikusi dugu eta balioen tarteak murritzagoak dira. Ez da sexuen arteko ezberdintasun esangarririk topatu gorputzeko neurrientzat. Folidosian (ezkata zenbateka) lortutako datuak, beste autoreek Bothrops leucurus-entzat deskribatutako parametroekin bat datozen arren, gure laginak ezkata tarte mugatuagoak ageri ditu. Orban ereduak ale guztietan behatu eta irudikatu ostean, oro har bi eredu ezberdindu eta deskribatzea posible izan da. Behatuak izan diren ezberdintasunak, uhartetako baliagai-hornidura mugatuen ondorio gisa uler daitezke, izan ere, halako baldintzetan ale txikiagoak positiboki hautatuak izango liratekeelako.

Length-weight relationship of marine fishes from southern Brazil

The relationship between length (L) and weight (W) was estimated for 80 species belonging to 50 families of marine fishes from the shelf and upper slope of southern Brazil (lat. 28°S - 34°S). Sample sizes (n) for different species ranged from 11 to 14 741 specimens collected from commercial landings and research surveys. The fit of the equations (W=aLb) with a and b parameters estimated from regular and functional regression (of log-transformed weight and length data) as well as from a non-linear iterative process using the quasi-Newton algorithm were compared. The non-linear method gave the most accurate estimates in terms of residual sum of squares. Differences were less than 2.3% for n>500 compared with predictive regressions and 1.5% compared with functional regressions. No difference was observed between both predictive and functional regressions. Determination coefficients (r2) increased with sample size, and the highest r2 were obtained for 50samples due to seasonal changes in the condition of the fishes.

Using poststratification to improve abundance estimates from multispecies surveys: a study of juvenile flatfishes

Population assessments seldom incorporate habitat information or use previously observed distributions of fish density. Because habitat affects the spatial distribution of fish density and overall abundance, the use of habitat information and previous estimates of fish density can produce more precise and less biased population estimates. In this study, we describe how poststratification can be applied as an unbiased estimator to data sets that were collected under a probability sampling design, typical of many multispecies trawl surveys. With data from a multispecies survey of juvenile flatfish, we show how poststratification can be applied to a data set that was not collected under a probability sampling design, where both the precision and the bias are unknown. For each of four species, three estimates of total abundance were compared: 1) unstratified; 2) poststratified by habitat; and 3) poststratified by habitat and fish density (high fish density and low fish density) in nearby years. Poststratification by habitat gave more precise and (or) less design-biased estimates than an unstratified estimator for all species in all years. Poststratification by habitat and fish density produced the most precise and representative estimates when the sample size in the high fish-density and low fish-density strata were sufficient (in this study, n≥20 in the high fish-density stratum, n≥9 in the low fish-density stratum). Because of the complexities of statistically testing the annual stratified data, we compared three indices of abundance for determining statistically significant changes in annual abundance. Each of the indices closely approximated the annual differences of the poststratified estimates. Selection of the most appropriate index was dependent upon the species’ density distribution within habitat and the sample size in the different habitat areas. The methods used in this study are particularly useful for estimating individual species abundance from multispecies surveys and for retrospective st

Abordagens estereológica e imunohistoquímica no câncer de próstata: uma reavaliação diagnóstica e possível terapêutica

Os esforços para melhorar o diagnóstico, o prognóstico e a vigilância do câncer de próstata (CaP) são relevantes. A superestimação do Escore de Gleason (GSC) pode submeter os indivíduos a um tratamento agressivo desnecessário. Foi tido como objetivo utilizar a estereologia em avaliações do CaP e investigar se o volume nuclear médio (VNM) correlaciona-se com o padrão primário de Gleason (Gpp), a fim de buscar um método alternativo devido à subjetividade do Escore de Gleason, que seja aquele, um método confiável e objetivo, sem discordância interobservador. Para isso, identificamos 74 amostras de prostatectomia radical, que foram divididos em seis grupos com base no Gpp, de 3 a 5. Controles (C) foram adquiridos em regiões não tumorais pareadas das mesmas amostras. O VNM foi estimado utilizando o método de "intersecção dos pontos amostrados". Diferenças estatísticas do VNM entre os grupos C e os grupos Gpp foram testadas utilizando o teste de Kruskall-Wallis e pós- teste de Dunn. As diferenças entre cada grupo Gpp e seus homólogos foram testados com o teste de Wilcoxon. As correlações foram avaliadas com a correlação de Spearman (R [Spearman]). As correlações entre o antígeno prostático específico (PSA) e o GSC (R [Spearman] de 0,76) e entre o PSA e o VNM (R [Spearman] de 0,78) foram moderadamente forte e altamente significativa, e a correlação entre o VNM e o Gpp (R [Spearman] de 0,53) foi moderada e altamente significativa. O VNM foi significativamente maior em regiões cancerígenas em comparação as regiões de controle-pareado. O planejamento adequado de um estudo, bem como a disponibilidade de equipamentos e softwares para a quantificação morfológica, pode proporcionar incentivo para rapidez e precisão para estimar o VNM como parâmetro auxiliar na avaliação do câncer de próstata. A reprodutibilidade falha interobservador do GSC tem mostrado possíveis conduções equivocadas dos pacientes portadores de CaP. O VNM representa um método reprodutível de classificação objetiva para o câncer de próstata. Portanto, os dados atuais favorecem o uso de VNM associado com GSC e o PSA na avaliação do câncer de próstata.

Temporal trends in reef fish assemblages inside Virgin Islands National Park and around St. John, U.S. Virgin Islands, 1988-2006

This report is a result of long-term fish monitoring studies supported by the National Park Service (NPS) at the Virgin Islands National Park since 1988 and is now a joint NPS and NOAA collaboration. Reef fish monitoring data collected from 1988 to 2006 within Virgin Islands National Park (VINP) and adjacent reefs around St. John, U.S. Virgin Islands (USVI) were analyzed to provide information on the status of reef fishes during the monitoring period. Monitoring projects were initiated by the National Park Service (NPS) in the 1980s to provide useful data for evaluation of resources and for development of a long-term monitoring program. Monthly monitoring was conducted at two reef sites (Yawzi Point and Cocoloba Cay) starting in November 1988 for 2.5 years to document the monthly/seasonal variability in reef fish assemblages. Hurricane Hugo (a powerful Category 4 storm) struck the USVI in September 1989 resulting in considerable damage to the reefs around St. John. Abundance of fishes was lower at both sites following the storm, however, a greater effect was observed at Yawzi Point, which experienced a more direct impact from the hurricane. The storm affected species differently, with some showing only small, short-term declines in abundance, and others, such as the numerically abundant blue chromis (Chromis cyanea), a planktivorous damselfish, exhibiting a larger and longer recovery period. This report provides: 1) an evaluation of sampling methods, sample size, and methods used during the sampling period, 2) an evaluation of the spatial and temporal variability in reef fish assemblages at selected reef sites inside and outside of VINP, and 3) an evaluation of trends over 17 years of monitoring at the four reference sites. Comparisons of methods were conducted to standardize assessments among years. Several methods were used to evaluate sample size requirements for reef fish monitoring and the results provided a statistically robust justification for sample allocation.

Demersal groundfish densities in trawlable and untrawlable habitats off Washington: implications for the estimation of habitat bias in trawl surveys

Demersal groundfish densities were estimated by conducting a visual strip-transect survey via manned submersible on the continental shelf off Cape Flattery, Washington. The purpose of this study was to evaluate the statistical sampling power of the submersible survey as a tool to discriminate density differences between trawlable and untrawlable habitats. A geophysical map of the study area was prepared with side-scan sonar imagery, multibeam bathymetry data, and known locations of historical NMFS trawl survey events. Submersible transects were completed at randomly selected dive sites located in each habitat type. Significant differences in density between habitats were observed for lingcod (Ophiodon elongatus), yelloweye rockfish (Sebastes ruberrimus), and tiger rockfish (S. nigrocinctus) individually, and for “all rockfish” and “all flatfish” in the aggregate. Flatfish were more than ten times as abundant in the trawlable habitat samples than in the untrawlable samples, whereas rockfish as a group were over three times as abundant in the untrawlable habitat samples. Guidelines for sample sizes and implications for the estimation of the continental shelf trawl-survey habitat-bias are considered. We demonstrate an approach that can be used to establish sample size guidelines for future work by illustrating the interplay between statistical sampling power and 1) habitat specific-density differences, 2) variance of density differences, and 3) the proportion of untrawlable area in a habitat.

Assessing the precision of frequency distributions estimated from trawl-survey samples

In trawl surveys a cluster of fish are caught at each station, and fish caught together tend to have more similar characteristics, such as length, age, stomach contents etc., than those in the entire population. When this is the case, the effective sample size for estimates of the frequency distribution of a population characteristic can, therefore, be much smaller than the number of fish sampled during a survey. As examples, it is shown that the effective sample size for estimates of length-frequency distributions generated by trawl surveys conducted in the Barents Sea, off Namibia, and off South Africa is on average approximately one fish per tow. Thus many more fish than necessary are measured at each station (location). One way to increase the effective sample size for these surveys and, hence, increase the precision of the length-frequency estimates, is to reduce tow duration and use the time saved to collect samples at more stations.

Intraspecific variation of isozymes in Arenicola marina (Polychaeta: Annelida)

Six enzyme systems, namely acid phosphatase, leucine aminopeptidase, phosphoglucose isomerase, tetrazolium oxidase, esterases and malate dehydrogenase were studied electrophoretically in Arenicola marina from various localities in United Kingdom. Out of 13 presumed loci, ten were found monomorphic. The three loci which appeared to be polymorphic are LAP-1, EST-2 and TO-1. Due to small sample size allele frequencies and genetic identity were not calculated. However, results indicate genetic difference among the population of A. marina.

Economic analysis of carp based culture technologies in selected areas of Bangladesh

Six carp based culture technologies such as, carp-pangas, carp polyculture, carp-golda, pangas monoculture, golda monoculture and nursery have been selected to determine the cost and returns of respective technologies in Bangladesh. The sample farmers selected for these technologies were 55, 100, 65, 50, 51 and 55 respectively and thus the total sample size stood at 376. The study covered 7 districts of Bangladesh, namely, Mymensingh, Bogra, Noakhali, Comilla, Jessore, Khulna and Bagerhat. Both primary and secondary data were used for this study. It was found that farmers used a good number of feeds for the selected technologies and they maintained no standard doses for them. Remarkable differences were found among the prices of different feeds and other inputs used for different technologies in different locations. Prices of all inputs were found to be increasing and this increase was more in recent years compared to previous years. Though all the technologies were found to be profitable, the feed situation was not satisfactory. Except rice polish all the local feeds showed deficit in supply to meet the national demand for the country. If this situation persists and no proper measures are taken to secure the local feed supply, the present development of supplementary feed-based aquaculture would be fully dependent on imported feeds and would not be sustainable in future. This study strongly suggests the corresponding authority to handle the matter with proper attention considering its significant livelihood impact on the economy of the country.