Maintaining Tissue Perfusion in High-Risk Surgical Patients: A Systematic Review of Randomized Clinical Trials

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Percepção de riscos ambientais de populações vulneráveis a inundações e deslizamentos de dunas em Natal-RN

In urban, flooding and landslides are among the troubles that most bring human and material loss. Therefore, this study objected to perform an analysis on the risk perception on the population living in social environmental vulnerable places in order to understand what is the way this population realize the risks they are exposed to and what are the outbrave strategies the develop. The first analyzed area was Complexo Passo da Pátria for the flooding risk problematic and then the Cidade Nova neighborhood threatened by the dunes slides. The areas locate, respectively, in the West and East zones of Natal-RN. Using an interview screenplay adapted from risk perception researches from different brazilian cities, it was collected primarily data on the variables: perception, evaluation and choice, safety threshold, adjustment, decision and participation. Due to the studied areas characteristics the qualitative approach adjusted itself to the difficulties for accessing the areas. The studied places characterize for its insecure situation like selling/using drugs, robbery and murder among others. Due to this situation the interviewed individuals were the ones that could be found more accessibly and available in the moment and the interviews were made in the community leader presence of each area. Through the discourse of the respondents analysis it was able to conclude that the interviewed population is exposed to a high vulnerability grade and risks. However it was identified substantial differences between the perception and risks of Complexo Passo da Pátria and bairro Cidade Nova, because in the first area the intervied ones can recognize the high risk they are exposed to in a more emphatic way to the interviewed ones for the Cidade Nova neighborhood. Furthermore, there is a heavy dissatisfaction for the population of the two places about the city hall positions relating to the present problems in the studied areas. It was also identified the strategy development of acquaintanceship with the risk in the research places beyond a feeling of belonging and affection between the dwellers and the places, yet it was more evident for Complexo Passo da Pátria. Though this analysis it was possible to understand and perceptions and the behavior of the individuals or social groups facing the risks as acceptance and rejection of determined risks beyond adaptation measures of living together with the persistence presence of risks. Therefore, qualitative nature researches emphasizing the perception approach are in the fundamental importance in the studies about risks making it possible to offer aids to the urban planning and management in the implement of effective preventive measures and compatible with the population aims

A representação social de educação tecnológica de docentes da Rede Federal de Educação Profissional e Tecnológica: CEFETs do Rio Grande do Norte

The aim of this study was to investigate the social representation of technological education teachers at the Federal Technological Education Network. The survey was conducted from 2007 to 2010, and the respondents were 275 teachers, 135 of the Federal Center for Technological Education (CEFET in portuguese) in the state of Amazonas, in Manaus unit headquarters; 140 of the CEFET in the state of Rio Grande do Norte, a unit based in Natal. We adopt the concept of technological education as the top level of professional education, that is to say, the undergraduate programs of short duration called technological courses. The Federal Technological Education Network gathers hundreds of related institutions, coordinated and supervised by the Office of Vocational and Technological Education of the Ministry of Education. Although many of these institutions offer courses in technology education, no research addressing this subject from the perspective of Social Representations Theory (SRT) was found in the literature. We seek to unravel the social representation of technological education of the teachers by adopting the procedural approach of SRT. This is a qualitative approach, focusing on significant aspects of the representative activity and the formation mechanisms of the representation. Therefore, we search the socio-genesis of the representation in the articulations between discourses, social institutions and practices. We initiated the research through applying critical reading and an analytical perspective on the historical and regulatory documents of technological education in Brazil, from the early twentieth century to the present day. We adopt the Procedure for Multiple Classifications (PMC) from the Free Words Association Technique (FWAT) to access the elements of representational content. For the analysis of the data obtained with FWAT and selection of major words / phrases pertinent to the semantic field of education technology, we used Hamlet II software. For the data analysis of PMC and Free Classification (FC) we used the SPSS ® (Statistical Package for the Social Sciences) version 17.0 and used the method of multidimensional scaling - Multidimensional scaling - (MDS). The output from the central MDS takes the form of a set of scatterplots - "perceptual maps" - of which the points are the elements of the representational content. For the FC data analysis we used the Scalogram Multidimensional Analysis (SMA) - which makes use of the original data in its raw form and allows categorical data to be interpreted in the map as measures of (di)similarity. In order to help with the understanding of the settings of the perceptual maps of FC, we used the Content Analysis of the discourse fragments of the teachers interviewed. The results confirm our initial hypothesis regarding the presence of a single plot among the socio-cognitive study subjects, which is the basis for a social representation of technological education in line with the historic assumption of the dichotomy between mental and manual labor. In spite of the three merging representational elements of the representational content, the perceptual maps compiled from the MSA statistics corroborates the dichotomy, with the exception of the map relating to the subgroup of teachers belonging to the humanities

Predictors of first-year survival in patients with advanced COPD treated using long-term oxygen therapy

Little evidence-based guidance is available to aid clinicians in determining short-term prognoses in very severe COPD patients. Therefore, the present study was designed to provide a prospective assessment (1) of the mortality rates and (2) whether the baseline measurements may be determinants of 1-year mortality in hypoxemic COPD patients receiving long-term oxygen therapy (LTOT).Seventy-eight clinically stable patients with advanced COPD treated using LTOT were enrolled in a prospective cohort study. Outcome variable: first-year mortality. Baseline measurements: categorical variables: age (<60 or >= 60 years); gender; body mass index (<20 or >= 20 kg/m(2)); fat-free mass (FFM) index (<16 [men] and <15kg/m(2) [women]; baseline dyspnea index (BDI) (<= 3 or >3); and corticosteroid use. Continuous variables: smoking history; lung function; FFM; fat mass; hemoglobin; hematocrit; arterial blood gases; forearm muscle strength; St. George's Respiratory Questionnaire (SGRQ); and comorbidity score. By the end of 1-year of follow-up, 12 patients (15.4%) had died. Kaplan-Meier curves showed that BDI <= 3 was the only variable associated with higher mortality. Cox proportional hazards analysis revealed that tower PaO2 and SPO2, higher PaCO2 and SGRQ scores were associated with reduced survival. In the multivariate analysis, BDI remained predictive of mortality (hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.31-0.81), as did PaO2 (HR, 0.49; 95% CI, 0.26-0.95). These data suggest that readily available parameters as dyspnea intensity and hypoxemia severity may be useful in predicting first-year survival rates in advanced COPD patients receiving LTOT (C) 2007 Elsevier Ltd. All rights reserved.

Validade de histórias ocupacionais de informantes secundários

OBJETIVO: Embora sejam freqüentes os estudos epidemiológicos trazendo informações ocupacionais obtidas em entrevistas com familiares de trabalhadores, há poucos trabalhos analisando a validade dessas informações, sendo nenhum deles realizados em países em desenvolvimento. Objetivou-se estudar a validade do uso de informações ocupacionais obtidas de informantes secundários em estudos epidemiológicos, pela análise de concordância entre histórias ocupacionais obtidas em entrevistas independentes com os próprios trabalhadores e seus familiares. MÉTODOS: A história ocupacional de trabalhadores, residentes no Município de Botucatu, SP, em 1998, foi obtida por entrevistas com os próprios trabalhadores e com os familiares próximos. Calcularam-se a sensibilidade e a especificidade das informações ocupacionais dos familiares, considerando-se padrão-ouro a informação do trabalhador. Avaliou-se a concordância dos pares de informação pelo coeficiente Kappa. RESULTADOS: Foram entrevistados 2.163 pares trabalhador/familiar. A sensibilidade da informação ocupacional dos familiares variou entre 77,5% (IC95%; 64,6% -- 90,4%) e 98,9% (97,3% -- 100,0%), enquanto a especificidade variou entre 96,9% (96,0% -- 97,7%) e 99,9% (99,7% -- 100,0%). O coeficiente Kappa para a concordância da informação ocupação principal, segundo as duas fontes, foi de 0,86 (0,85 -- 0,88). CONCLUSÕES: A utilização de informações ocupacionais obtidas de informantes secundários, se tratadas como variáveis categóricas, tem validade. Utilizando-se informações relativas a tempos acumulados de trabalho, concluiu-se que informantes secundários subestimam os tempos de exposição quando comparados com os próprios trabalhadores.

Programa de extrações seriadas: variáveis relacionadas com a extração de pré-molares

OBJETIVO: verificar o percentual de pacientes que necessitaram extração de dentes permanentes, pré-molares, dentre aqueles tratados com extração de dentes decíduos para correção do apinhamento primário na dentição mista, bem como analisar as possíveis variáveis relacionadas. MÉTODOS: a amostra foi composta por documentações ortodônticas de 70 pacientes na dentição permanente, cujo tratamento iniciou-se na dentição mista com planejamento de um programa de extrações seriadas (PES). Todos os prontuários foram analisados por um único examinador, no intuito de verificar se o PES havia sido cumprido com a extração de dentes permanentes ou se havia sido realizada apenas extração de dentes decíduos. Verificou-se a associação entre a extração de dentes permanentes e as variáveis padrão facial; relação sagital entre as arcadas dentárias; IMPA; proporção tamanho do segundo molar permanente inferior/espaço retromolar; mecânica de controle de espaço e discrepância de modelo (teste exato de Fisher para as variáveis categóricas e modelo de regressão logística para as variáveis numéricas). Os resultados foram considerados para p<0,05. RESULTADOS: dos pacientes que haviam sido tratados com extração de dentes decíduos para a correção do apinhamento na dentição mista, 70% necessitaram de extração de dentes permanentes. A análise estatística não mostrou associação significativa entre as variáveis estudadas e a necessidade de extração de dentes permanentes, com exceção da variável discrepância de modelo. CONCLUSÃO: a discrepância de modelo representou a principal determinante de extração de pré-molares no PES.

Análise qualitativa do conteúdo ministrado na disciplina de bioética nas faculdades de odontologia brasileiras

The study consists on a qualitative analysis of content ministered by Bioethical discipline on Brazilian Dental Schools. Data collect occurred by semi-structured questioners send by e-mail and correspondence. It was used content analysis by categorical analysis technique, according to Bardin. Among 182 Schools, just 57 (31.3%) shows Bioethical Discipline. It was observed that the discipline is ministered on the first or last year of course generally. Principal subjects broached are bioethical dilemma (76.3%) with polemics questions and others actual like abortion, clone, organs transplant, attendance of patient porter of HIV and bioethical historic (65.8%), bioethical fundaments, principles and models (57.9%). 84.4% researched professors, said that bioethical discipline awake interesting on students because it actual and it's face to patient-professional relation too. It was possible to conclude that bioethical discipline treat in its content some actual and polemic themes that influence dental surgeon formation because promote him conscience and responsibility of him role front attention at oral health, and so, this discipline should be implanted, specifically in the first year of all Dentistry graduation courses.

Leprosy control: perspectives & epidemiological and operational aspects

OBJETIVOS: A partir de acervo de 200 textos acadêmicos e de documentos de organismos nacionais e internacionais voltados ao controle da hanseníase publicados no período de 1999 a 2008, procurou-se estudar respectivas possibilidades evolutivas futuras, empregando-se os subsídios do recurso de análise de cenários. MÉTODOS: A reconstrução metodológica adotada foi de natureza qualitativa, fulcrada nas técnicas de revisão bibliográfica e análise de conteúdo. Esta última foi empregada na tipificação documental categorial frequencial contigencial, de acordo com devida fundamentação pertinente. RESULTADOS: Recuperaram-se elementos atuais importantes de natureza epidemiológica e operacional, bem como de respectivas perspectivas. CONCLUSÕES: Projeta-se que a manutenção dos coeficientes de incidência da doença coloca reptos econômicos e sanitários a desafiar desde o modelo neoliberal de organização societária mundial até competências específicas das ações das equipes de saúde em campo.

Identification of Landslide Scars in the Region of the Serra do Mar, São Paulo State, Brazil, Using Digital Image Processing and Spatial Analysis Tools

The objective of the present study, developed in a mountainous region in Brazil where many landslides occur, is to present a method for detecting landslide scars that couples image processing techniques with spatial analysis tools. An IKONOS image was initially segmented, and then classified through a Batthacharrya classifier, with an acceptance limit of 99%, resulting in 216 polygons identified with a spectral response similar to landslide scars. After making use of some spatial analysis tools that took into account a susceptibility map, a map of local drainage channels and highways, and the maximum expected size of scars in the study area, some features misinterpreted as scars were excluded. The 43 resulting features were then compared with visually interpreted landslide scars and field observations. The proposed method can be reproduced and enhanced by adding filtering criteria and was able to find new scars on the image, with a final error rate of 2.3%.

Leaf heliotropism in Styrax camporum Pohl from the Brazilian cerrado: distinct gas exchange and leaf structure, but similar leaf temperature and water relations

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Colonização natural por espécies nativas e exóticas das encostas degradadas da Serra do Mar

Os deslizamentos são eventos inerentes à dinâmica da Serra do Mar, nos trechos mais declivosos. Contudo, devido a alguns fatores de intervenção, como a poluição atmosférica, ocupação da base dos morros e outros, a incidência desses eventos tem aumentado. Diante disso, este estudo objetivou avaliar a dinâmica de colonização de áreas de encosta degradadas, como forma de subsidiar ações de recuperação. Para tanto, foram adotadas duas áreas experimentais, localizadas em trechos da serra do Mar próximos à Baixada Santista, onde foram lançadas parcelas de 1 m² e obtidos dados fitossociológicos. em seguida, as áreas foram limpas e os mesmos parâmetros da avaliação inicial, registrados, mensalmente, ao longo de um ano. Foram encontradas 20 espécies, pertencentes a 14 famílias botânicas, em sua maioria espécies exóticas ou nativas não regionais.

Ordenação de constituintes em construções categorial, tética e apresentativa

A ordenação de constituintes oracionais nas variedades portuguesas é aqui tratada considerando-se três moldes de conteúdo, Tético, Apresentativo e Categorial. A linearização das estruturas oracionais refletem decisões assumidas na formulação do Nível Interpessoal e configuram predominantemente Molde de Conteúdo Categorial Tópico-orientado, com o constituinte Tópico ocupando a posição P I, a palavra verbal, a posição P M, e os outros constituintes, as posições à direita e à esquerda de P M. em Construções Téticas, a oração toda, por ser focal, ocupa o domínio de P F, já em Construções Apresentativas a cópula vazia assume a posição absoluta P M, e o sintagma nominal Tópico/Foco posiciona-se em P F.

Genetic evaluation of the probability of pregnancy at 14 months for Nellore heifers

To estimate the heritability for the probability that yearling heifers would become pregnant, we analyzed the records of 11,487 Nellore animals that participated in breeding seasons at three farms in the Brazilian states of São Paulo and Mato Grosso do Sul. All heifers were exposed to a bull at the age of about 14 mo. The probability of pregnancy was analyzed as a categorical trait, with a value of 1 (success) assigned to heifers that were diagnosed pregnant by rectal palpation about 60 d after the end of the breeding season of 90 d and a value of 0 (failure) assigned to those that were not pregnant at that time. The estimate of heritability, obtained by Method 9, was 0.57 with standard error of 0.01. The EPD was predicted using a maximum a posteriori threshold method and was expressed as deviations from 50% probability. The range in EPD was -24.50 to 24.55%, with a mean of 0.78% and a SD of 7.46%. We conclude that EPD for probability of pregnancy can be used to select heifers with a higher probability of being fertile. However, it is mainly recommended for the selection of bulls for the production of precocious daughters because the accuracy of prediction is higher for bulls, depending on their number of daughters.

Water waves generated by local disturbance: Serre's model validity

Water waves generated by landslides were long menace in certain localities and the study of this phenomenon were carried out at an accelerated rate in the last decades. Nevertheless, the phase of wave creation was found to be very complex. As such, a numerical model based on Boussinesq equations was used to describe water waves generated by local disturbance. This numerical model takes in account the vertical acceleration of the particles and considers higher orders derivate terms previously neglected by Boussinesq, so that in the generation zone, this model can support high relative amplitude of waves.

Analise da relação entre escorregamento e formas de vertentes no município de cubatão (SP) e seus arredores

The city of Cubatão is a densely populated area with high industrial activity. In the area there are also important linear works as roads, railways, pipelines, aqueducts and lines of transmission of energy. The geological and geomorphological features of the municipality, combined with the human activities, make the site an area heavily prone to the landslides, so a region at high risk. In this work, landslide scars were extracted in aerial photos from 1985 and 1994, years that recorded a high incidence of landslides. Quantitative analysis of the relationship between the occurrence of scars and the forms of tracks were conducted, based on an intensive survey of scars in the region, represented by 2595 extracted scars, with the aim of contributing to a better understanding of the slipping processes in the Serra do Mar paulista and thus to the reduction of risks in the region. Achievements have concluded that the greatest percentage of slides in the region is linked to the strands straitght, followed by convex, which confirms previous studies conducted in the region, in a qualitative way or with a much lower number of scars.