Reflexões sobre normalidade e desvio social

O texto expõe como se instituiu uma das oposições fundamentais na organização de nossa sociedade. A partir da reconstrução histórica do processo de normalização chegamos ao movimento sócio-científico da Eugenia e a poderosa teoria da hereditariedade sob o qual ela se assentava. A categoria social dos anormais é analisada como produto de discursos e práticas sociais, portanto, historicamente. Por fim, apresentamos algumas considerações sobre a polaridade normalidade e patologia na sociedade contemporânea e a persistência de teorias que visam naturalizar diferenças individuais e desigualdades sociais.

Critical adsorption of polyelectrolytes onto charged Janus nanospheres

Based on extensive Monte Carlo simulations and analytical considerations we study the electrostatically driven adsorption of flexible polyelectrolyte chains onto charged Janus nanospheres. These net-neutral colloids are composed of two equally but oppositely charged hemispheres. The critical binding conditions for polyelectrolyte chains are analysed as function of the radius of the Janus particle and its surface charge density, as well as the salt concentration in the ambient solution. Specifically for the adsorption of finite-length polyelectrolyte chains onto Janus nanoparticles, we demonstrate that the critical adsorption conditions drastically differ when the size of the Janus particle or the screening length of the electrolyte are varied. We compare the scaling laws obtained for the adsorption-desorption threshold to the known results for uniformly charged spherical particles, observing significant disparities. We also contrast the changes to the polyelectrolyte chain conformations close to the surface of the Janus nanoparticles as compared to those for simple spherical particles. Finally, we discuss experimentally relevant physicochemical systems for which our simulations results may become important. In particular, we observe similar trends with polyelectrolyte complexation with oppositely but heterogeneously charged proteins.

Immunohistochemical localization of nicotinic acetylcholine-receptor subunits in the mesencephalon and diencephalon of the chick (Gallus-gallus)

Monoclonal antibodies against two alpha-bungarotoxin-binding subunits (alpha-7 and alpha-8) of the nicotinic acetylcholine receptors (nAChRs) were used as immunohistochemical probes to map their distribution in the chick diencephalon and mesencephalon. The distribution of the alpha-7 and alpha-8 nAChR subunits was compared to the distribution of immunoreactivity produced by a monoclonal antibody against the beta-2 structural subunit of the nAChRs.Structures that contained high numbers of alpha-7-like immunoreactive (LI) somata included the intergeniculate leaflet, nucleus intercalatus thalami, nucleus ovoidalis, organum paraventricularis, nucleus rotundus, isthmic nuclei, nucleus trochlearis, oculomotor complex, nucleus interstitio-pretecto-subpretectalis, stratum griseum centrale of the optic tectum, and nucleus semilunaris. Neuropil staining for alpha-7-LI was intense in the nucleus dorsomedialis hypothalami, nucleus geniculatus lateralis ventralis, griseum tecti, isthmic nuclei, nucleus lentiformis mesencephali, nucleus of the basal optic root, and stratum griseum et fibrosum superficiale of the tectum. High numbers of alpha-8-LI somata were found in the stratum griseum et fibrosum superficiale of the tectum and the nucleus interstitio-pretecto-subpretectalis, and intense neuropil staining for alpha-8-LI was found in the dorsal thalamus, nucleus geniculatus lateralis ventralis, lateral hypothalamus, griseum tecti, nucleus lentiformis mesencephali, nucleus interpeduncularis, and stratum griseum et fibrosum superficiale of the tectum. High numbers of beta-2-LI somata were found only in the nucleus spiriformis lateralis, whereas neuropil staining for beta-2-LI was intense in the nucleus geniculatus lateralis ventralis, nucleus suprachiasmaticus, nucleus lateralis anterior, nucleus habenularis lateralis, area pretectalis, griseum tecti, nucleus lentiformis mesencephali, nucleus externus, and nucleus interpeduncularis, and in the stratum griseum centrale, stratum griseum et fibrosum superficiale, and stratum opticum of the tectum.These results indicate that there are major disparities in the localization of the alpha-bungarotoxin-binding alpha-7 and alpha-8 nAChR subunits and the beta-2 structural nAChR subunit in the chick diencephalon and mesencephalon. These nAChR subunits appear, however, to coexist in several regions of the chick brain.

Condição periodontal, perda dentária e diferenças socioeconômicas em adultos e idosos brasileiros

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Economia da educação, inovação tecnológica e o conceito de capital humano

The paper shows the basic economic theories that support the rationality behind the financial and technological dominance in present social relations, and try to demonstrate the paradoxes and contradictions of the theoretical system, having as background elements from the Frankfurt School. From the field of theoretical economics of education, authors discuss the concept of human capital with its economical dimensions, presenting their affinities and disparities with Keynesians, neoclassical economics and the evolutionary economics of Schumpeter.

Relationship between race and clinical characteristics, extent of disease, and response to chemotherapy in patients with low-risk gestational trophoblastic neoplasia

Objective. To evaluate the potential effects of race on clinical characteristics, extent of disease, and response to chemotherapy in women with postmolar low-risk gestational trophoblastic neoplasia (GTN).Methods. This non-concurrent cohort study was undertaken including patients with FIGO-defined postmolar low-risk GTN treated with comparable doses and schedules of chemotherapy at the New England Trophoblastic Disease Center (NETDC) between 1973 and 2012. Racial groups investigated included whites, African American and Asians. Information on patient characteristics and response to chemotherapy (need for second line chemotherapy, reason for changing to an alternative chemotherapy, number of cycles/regimens, need for combination chemotherapy, and time to hCG remission) was obtained.Results. Of 316 women, 274 (86.7%) were white, 19 (6%) African American, and 23 (7.3%) Asian. African Americans were significantly younger than white and Asian women (p = 0.008). Disease presentation, and extent of disease, including antecedent molar histology, median time to persistence, median hCG level at persistence, rate of D&C at persistence, presence of metastatic disease, and FIGO stage and risk score were similar among races. Need for second line chemotherapy (p = 0.023), and median number of regimens (p = 0.035) were greater in Asian women than in other races.Conclusions. Low-risk GTN was more aggressive in Asian women, who were significantly more likely to need second line chemotherapy and a higher number of chemotherapy regimens to achieve complete remission than women of African American and Asian descent. Further studies involving racial differences related to clinical, biological and environmental characteristics are needed. (C) 2015 Published by Elsevier Inc.

Politicas públicas para agricultura familiar: o caso do Programa de Aquisição de Alimentos (PAA) no estado de São Paulo, Brasil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Regulatory issues on pharmacovigilance in Latin American countries

Pharmacovigilance is responsible for monitoring the safety of medicines in normal clinical use andduring clinical trials. Legal requirements for pharmacovigilance in some Latin American countries (Argentina, Brazil, Chile, Paraguay and Uruguay) were reviewed. Disparities in the legal framework among the countries are observed being those for marketing authorization holders one of the most evident. Theactive rol of the universities and drug information centers for/of pharmacovilance seems to be a positivecommon point. Legal requirements regarding pharmacovigilance of biosimilar medicines, is still a pointto be developed.

Mortalidade Materna: uma abordagem atualizada

Purpose: to review literature, highlighting current aspects of maternal mortality.  Method: research initiated through electronic data base PubMed [http:// www.ncbi.nlm.nih.gov/pubmed], limited to the last 10 years. The selected cases which related to pre-defined aspects of interest to the study, such as vulnerable population, risk factors, causes, difficulties in obtaining data, preventive measures e new approaches to the problem, among them, ‘near misses’ and severe maternal morbidity.  Results: maternal death is directly related to the quality of life of the population, with relevant disparities among the different social economic areas. Although maternal mortality is the proper indicator to the female population health, its numbers are presented in unrealistic manners due to the difficulties in identifying the cases through death certificates. Preventive measures associated to early and adequate diagnose and treatment are benefic factors in decreasing those maternal deaths. Apart from these, identification and classification of ‘near misses’ and maternal morbidity are featured in the contemporary approach to the issue.  Final considerations: In spite of advanced technology and recognition of preventive measures, a large number of women die daily due to complications in the pregnancy and puerperal cycle. To decrease such tragedy political, social and economical commitment to Health is necessary, in order to promote the needed reforms in the assistance of such cycle.

Educational Investment, Family Context, and Children’s Math and Reading Growth from Kindergarten through the Third Grade

Drawing on longitudinal data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998–1999, this study used IRT modeling to operationalize a measure of parental educational investments based on Lareau’s notion of concerted cultivation. It used multilevel piecewise growth models regressing children’s math and reading achievement from entry into kindergarten through the third grade on concerted cultivation and family context variables. The results indicate that educational investments are an important mediator of socioeconomic and racial/ethnic disparities, completely explaining the black-white reading gap at kindergarten entry and consistently explaining 20 percent to 60 percent and 30 percent to 50 percent of the black-white and Hispanic-white disparities in the growth parameters, respectively, and approximately 20 percent of the socioeconomic gradients. Notably, concerted cultivation played a more significant role in explaining racial/ethnic gaps in achievement than expected from Lareau’s discussion, which suggests that after socioeconomic background is controlled, concerted cultivation should not be implicated in racial/ethnic disparities in learning.

Laser Optical Plankton Counter and Zooscan intercomparison in tropical and subtropical marine ecosystems

Two recently developed instruments, the Laser Optical Plankton Counter (LOPC) and the Zooscan, have been applied to study zooplankton biomass size spectra in tropical and subtropical marine ecosystems off Brazil. Both technologies rely on optical measurements of particles and may potentially be used in zooplankton monitoring programs. Vertical profiles of the LOPC installed in a 200 mu m ring net have been obtained from diverse environmental settings ranging from turbid and nearshore waters to oligotrophic open ocean conditions. Net samples were analyzed on the Zooscan and counted under a microscope. Particle biovolume in the study area estimated with the LOPC correlated with plankton displacement volume from the net samples, but there was no significant relationship between total areal zooplankton biomass determined with LOPC and the Zooscan. Apparently, normalized biomass size spectra (NBSS) of LOPC and Zooscan overlapped for particles in the size range of 500 to 1500 mu m in equivalent spherical diameter (ESD), especially at open ocean stations. However, the distribution of particles into five size classes was statistically different between both instruments at 24 of 28 stations. The disparities arise from unequal flow estimates, from different sampling efficiencies of LOPC tunnel and net for large and small particles, and possibly from the interference of non-zooplankton material in the LOPC signal. Ecosystem properties and technical differences therefore limit the direct comparability of the NBSS slopes obtained with both instruments during this study, and their results should be regarded as complementary.

Effects of age and optical blur on real depth stereoacuity

Stereoscopic depth perception utilizes the disparity cues between the images that fall on the retinae of the two eyes. The purpose of this study was to determine what role aging and optical blur play in stereoscopic disparity sensitivity for real depth stimuli. Forty-six volunteers were tested ranging in age from 15 to 60 years. Crossed and uncrossed disparity thresholds were measured using white light under conditions of best optical correction. The uncrossed disparity thresholds were also measured with optical blur (from +1.0D to +5.0D added to the best correction). Stereothresholds were measured using the Frisby Stereo Test, which utilizes a four-alternative forced-choice staircase procedure. The threshold disparities measured for young adults were frequently lower than 10 arcsec, a value considerably lower than the clinical estimates commonly obtained using Random Dot Stereograms (20 arcsec) or Titmus Fly Test (40 arcsec) tests. Contrary to previous reports, disparity thresholds increased between the ages of 31 and 45 years. This finding should be taken into account in clinical evaluation of visual function of older patients. Optical blur degrades visual acuity and stereoacuity similarly under white-light conditions, indicating that both functions are affected proportionally by optical defocus.

Do established prognostic factors explain the different mortality rates in ICU septic patients around the world?

Background. The aim of this paper was to clarify if previously established prognostic factors explain the different mortality, rates observed in ICU septic patients around the world. Methods. This is a sub-study from the PROGRESS study, which was an international, prospective, observational registry of ICU patients with severe sepsis. For this study we included 10930 patients from 24 countries that enrolled more than 100 patients in the PROGRESS. The effect of potential prognostic factors on in-hospital mortality was examined using univariate and multivariate logistic regression. The complete set of data was available for 7022 patients, who were considered in the multivariate analysis. Countries were classified according to country, income, development status, and in-hospital mortality terciles. The relationship between countries' characteristics and hospital mortality mortality was evaluated using linear regression. Results. Mean in-hospital mortality was 49.2%. Severe sepsis in-hospital mortality varied widely in different countries, ranging from 30.6% in New Zealand to 80.4% in Algeria. Classification as developed or developing country was not associated with in-hospital mortality (P=0.16), nor were levels of gross national product per capita (P=0.15). Patients in the group of countries with higher in-hospital mortality, had a crude OR for in-hospital death of 2.8 (95% CI 2.5-3.1) in comparison to those in the lower risk group. After adjustments were made for all other independent variables, the OR changed to 2.9 (95% CI 2.5-3.3). Conclusion. Severe sepsis mortality varies widely, in different countries. All known markers of disease severity and prognosis do not fully, explain the international differences in mortality,. Country, income does not explain this disparity, either. Further studies should be developed to verify if other organizational or structural factors account for disparities in patient care and outcomes. (Minerva Anestesiol 2012;78:1215-25)

Parental reports of the oral health-related quality of life of children with cerebral palsy

Background: The severity of physical and mental impairments and oral problems, as well as socioeconomic factors, may have an impact on quality of life of children with cerebral palsy (CP). The aim of this research was to assess the impact of impairments and oral health conditions, adjusted by socioeconomic factors, on the Oral Health-Related Quality of Life (OHRQoL) of children with CP using their parents as proxies. Methods: Sixty children, between 6-14 years of age were selected. Their parents answered a children's OHRQoL instrument (5 domains) which combines the Parental-Caregivers Perception Questionnaire (P-CPQ) and Family Impact Scale (FIS). The severity of dental caries, type of CP, communication ability, gross motor function, seizures and socioeconomic conditions were assessed. Results: Considering the total score of the OHRQoL instrument, only the reduction of communication ability and dental caries severity had a negative impact on the OHRQoL (p < 0.05). Considering each domain of the instrument, the severity of the type of CP and its reduction of communication ability showed a negative impact on oral symptoms and functional limitations domains (p < 0.05). Seizures have a negative impact on oral symptoms domain (p = 0.006). The multivariate fitted model showed that the severity of dental caries, communication ability and low family income were negatively associated with the impact on OHRQoL (p = 0.001). Conclusions: The severity of dental caries, communication ability, and family income are conditions strongly associated with a negative impact on OHRQoL of children with CP.

Equity and women's health services for contraception, abortion and childbirth in Brazil

This paper addresses equity in health and health care in Brazil, examining unjust disparities between women and men, and between women from different social strata, with a focus on services for contraception, abortion and pregnancy. In 2010 women's life expectancy was 77.6 years, men's was 69.7 years. Women are two-thirds of public hospital services users and assess their health status less positively than men. The total fertility rate was 1.8 in 2011, and contraceptive prevalence has been high among women at all income levels. The proportion of sterilizations has decreased; lower-income women are more frequently sterilized. Abortions are mostly illegal; women with more money have better access to safe abortions in private clinics. Poorer women generally self-induce abortion with misoprostol, seeking treatment of complications from public clinics. Institutional violence on the part of health professionals is reported by half of women receiving abortion care and a quarter of women during childbirth. Maternity care is virtually universal. The public sector has fewer caesarean sections, fewer low birth weight babies, and more rooming-in, but excessive episiotomies and inductions. Privacy, continuity of care and companionship during birth are more common in the private sector. To achieve equity, the health system must go beyond universal, unregulated access to technology, and move towards safe, effective and transparent care. (C) 2012 Reproductive Health Matters