Oral health in transition: the case of Indigenous peoples from Brazil

The objective of this paper is to summarise epidemiological information about the distribution of dental caries among Indigenous peoples in Brazil. The authors also present a case study of a specific group of Xavante Indians, one of the most numerous of Brazil`s Indigenous peoples, describing how their oral health has deteriorated over recent decades, and showing how an oral health programme is attempting to reverse the present trend of increase in caries. The programme at Etenheritipa Xavante village incorporated three principal components: educational, preventive, and clinical. From the beginning, the programme included epidemiological record keeping for monitoring the level of caries in the population. Transversal studies of the condition of oral health among the Xavante of Etenheritipa were undertaken in 1999, 2004, and 2007. In the period from 2004 to 2007 the DMFS values in the 11-15 age cohort had a significant reduction in caries experience. The mean DMFS score fell from 4.95 in 2004 to 2.39 in 2007 (p<0.01). An increase in the percent of individuals who were free from caries was also noted: in 1999, 20% of adolescents 11-15 had no caries; in 2007, the proportion had risen to 47%. The Xavante case is a prime example of the transition in oral health that is taking place among the Indigenous peoples of the Americas, and it highlights the importance of oral health promotion through preventive measures such as access to fluoridation and basic care in reducing the inequality between Indians and non-Indians.

Characteristics of Acute Kidney Injury in Patients Infected with the 2009 Influenza A (H1N1) Virus

Background and objectives: There have been few studies investigating acute kidney injury (AKI) in patients infected with the 2009 pandemic influenza A (H1N1) virus. Therefore, the objective of this study was to identify the factors associated with AKI in H1N1-infected patients. Design, setting, participants, & measurements: This was a study of 47 consecutive critically ill adult patients with reverse transcriptase-PCR-confirmed H1N1 infection in Brazil. Outcome measures were AKI (as defined by the Risk, Injury, Failure, Loss, and End-stage renal failure [RIFLE] criteria) and in-hospital death. Results: AKI was identified in 25 (53%) of the 47 H1N1-infected patients. AKI was associated with vasopressor use, mechanical ventilation, high Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, and severe acidosis as well as with higher levels of C-reactive protein and lactic dehydrogenase upon intensive care unit (ICU) admission. A nephrology consultation was requested for 16 patients (64%), and 8 (50%) required dialysis. At ICU admission, 7 (15%) of the 25 AKI patients had not yet progressed to AKI. However, by 72 hours after ICU admission, no difference in RIFLE score was found between AKI survivors and nonsurvivors. Of the 47 patients, 9 (19%) died, all with AKI. Mortality was associated with mechanical ventilation, vasopressor use, dialysis, high APACHE II score, high bilirubin levels, and a low RIFLE score at ICU admission. Conclusions: Among critically ill H1N1-infected patients, the incidence of AKI is high. In such patients, AKI is mainly attributable to shock. Clin J Am Soc Nephrol 5: 1916-1921, 2010. doi: 10.2215/CJN.00840110

Coup Coup Land : A Comparative Study of the Coups of Fiji

A thesis presented on the political history of Fiji from cession to Britain in 1874 compares and analyses the country’s four political coups. A military coup occurred in 1987 by Lt. Col Sitiveni Rabuka. Six months later he staged a self-coup. In 2000 George Speight staged an armed civilian coup or putsch, and in 2006 Commodore Frank Bainimarama, head of Fiji’s military forces, overthrew the government of Laisenia Qarase. This paper is an internal comparison of the four coups of which the aim is to examine why coups occur in Fiji. The conclusion is that the level of influence of the country’s traditional paramount chiefs is a strong causal factor in events leading to the political overthrows. Issues such as ethnicity, constitutionalism, democracy, traditionalism, and modernity make the study of the Fiji coups complex. All of the major actors involved have been present or have been somehow linked to each coup. Questions of leadership arise as do issues regarding pluralism and multiculturalism. These issues are discussed in this paper. The end result is that if the question of traditional leadership is not addressed within a democratic framework then Fiji will continue to have coups.

Approach to culture through value orientations

What existential premises, what artifacts are walked through to make it possible for a person to step assuredly in reality? What scope exists for the frame shape? Are there doorways all peoples have to frame, and is there a limited stock to choose from? These were questions motivating the research which this paper reports.

American Indian Blankets

Raid the Icebox 1 with Andy Warhol exhibition installation negative of a blanket chest containing American Indian blankets. The top lid and front drawer are open.

Gasto energético de pacientes em ventilação mecânica: estudo comparativo das modalidades controlada e assistida através da calorimetria indireta

A necessidade de estimar com precisão o gasto energético dos pacientes gravemente doentes é cada vez mais importante para que se possa planejar uma nutrição adequada. Está bem estabelecido que tanto a desnutrição quanto o excesso alimentar prejudicam a evolução favorável destes doentes, especialmente quando estão sob ventilação mecânica. O objetivo do presente estudo foi comparar o Gasto Energético Total (GET) dos pacientes ventilados mecanicamente nos modos controlado e assistido, através da calorimetria indireta, medidos pelos monitores de gases TEEM-100 e DATEX-OHMEDA, verificando a necessidade de ajuste no aporte calórico em cada modo, correlacionando-os com a equação de Harris-Benedict (H-B). Foram estudados 100 pacientes em que os gases exalados (CO2 e O2) foram medidos durante 20 minutos em cada modo ventilatório (controlado e assistido) e o gasto energético calculado pela fórmula de “Weir”, determinando o GET, em 24 horas e comparado com o GET estimado pela equação de H-B. A média do escore APACHE II foi 21,1± 8,3. A média dos valores estimados pela equação de H-B foi de 1853,87±488,67 Kcal/24 h, considerando os fatores de atividade e estresse. Os valores médios obtidos pela calorimetria indireta (CI) foram de 1712,76 ±491,95 Kcal/24 h para a modalidade controlada e de 1867,33±542,67 Kcal/24 h para a assistida. A média do GET na modalidade assistida foi de 10,71% maior do que na controlada (p<0,001). A comparação das médias do GET, obtidos por CI com a equação de H-B ajustada para fatores de atividade e estresse demonstraram que a equação superestimou em 141,10 Kcal/24 h (8,2%) (p=0,012), quando na modalidade controlada. Retirando-se os fatores de atividade, observou-se uma tendência não significativa a subestimar em 44,28 Kcal/24 h (2,6%) (p=0,399). Quando na modalidade assistida, a comparação com H-B sem o fator de atividade, a medida por CI subestima em 198,84 Kcal/24 h, (10,71%), (p=0,001), enquanto que com o fator de atividade também subestimam, mas em 13,46 Kcal/24 h (0,75%) sem significância estatística (p=0,829). As diferenças observadas com o uso ou não de vasopressor, presença ou não de infecção e sepse como causa de internação na UTI, o tipo de dieta parenteral ou enteral ou sem dieta, e as faixas etárias não tiveram significância estatística, portanto não tiveram influência no gasto energético entre os modos ventilatórios. Os homens quando ventilando no modo controlado gastaram mais energia em relação às mulheres (1838,08 vs. 1577,01; p=0,007). Concluindo-se, os dados sugerem que devemos considerar o fator de atividade de 10%, somente quando em VM assistida, uma vez que este fator de atividade determina hiperalimentação, quando no modo controlado.

Valor prognóstico das cinéticas da procalcitonina e da proteína C reativa na pneumonia associada à ventilação mecânica

Introdução A pneumonia hospitalar é a principal causa de morte dentre as infecções hospitalares. A prevalência de pneumonia hospitalar em Unidades de Tratamento Intensivo (UTI) varia de 10 a 65%, com taxas de mortalidade que podem variar de 24 a 76%. A pneumonia associada à ventilação mecânica (PAV) é um determinante de mortalidade independente em pacientes submetidos à ventilação mecânica. A adequação do tratamento empírico precoce parece ser fundamental no prognóstico. Os critérios atualmente estabelecidos para avaliar adequação do tratamento empírico utilizam parâmetros clínicos, escores de gravidade e, principalmente, a sensibilidade do germe causador da infecção aos antibióticos administrados. Estes resultados balizam a necessidade de possíveis modificações no esquema antimicrobiano. A possibilidade de utilizar a Procalcitonina (PCT), a Proteína-C Reativa (CRP) e o escore SOFA (Avaliação de Falência de Órgãos Relacionada a Sepse), como indicadores de resposta do paciente, comparando seu status no dia do início do tratamento antimicrobiano (D0) com a evolução destes indicadores no quarto dia de tratamento (D4) abre a possibilidade de comparar o paciente com ele próprio, independente da exuberância da expressão da resposta inflamatória que ele possa desenvolver. Os resultados desta cinética entre D0 e D4 podem ser preditivos de gravidade de infecção, de eficiência antimicrobiana, e possivelmente de sobrevivência ou mortalidade hospitalar nos pacientes com suspeita de PAV. Objetivos Determinar e comparar o valor prognóstico de sobrevivência da cinética da PCT, da CRP, dos escores clínicos CPIS (Escore Clínico de Infecção Pulmonar) e SOFA, e do APACHE II (Avaliação da Fisiologia Aguda e da Saúde Crônica) na PAV entre o diagnóstico e o quarto dia de tratamento, quando a adequação do tratamento é avaliada. Pacientes e Métodos Realizamos um estudo de coorte prospectivo observacional que avaliou 75 pacientes internados no Centro de Tratamento Intensivo clínico-cirúrgico de adultos do Hospital de Clínicas de Porto Alegre que desenvolveram PAV no período de outubro de 2003 a agosto de 2005. Os pacientes com suspeita clínica de PAV que se adequaram aos critérios de inclusão e exclusão do estudo foram os candidatos a participar. Os familiares ou representantes dos pacientes receberam esclarecimentos por escrito acerca dos exames a serem realizados, bem como dos objetivos gerais da pesquisa. Os que aceitaram participar do estudo assinaram o termo de Consentimento Informado. O projeto foi aprovado pelo Comitê de Ética em Pesquisa do Hospital de Clínicas de Porto Alegre. No dia do diagnóstico de PAV foram coletados aspirado traqueal quantitativo, hemoculturas e sangue para a realização de dosagens de PCT, CRP, hemograma, plaquetas, creatinina, bilirrubinas, gasometria arterial e radiografia de tórax, com o objetivo de calcular o CPIS e o escore SOFA. No terceiro dia de tratamento foram novamente coletados aspirados traqueais quantitativos e os demais exames para o cálculo do CPIS. No quarto dia foi coletado sangue para dosagens de PCT, CRP e para os demais exames necessários para o cálculo do SOFA. Os pacientes foram acompanhados por 28 dias após o diagnóstico de PAV, quando foram considerados sobreviventes. Todos os pacientes que morreram antes do vigésimo oitavo dia foram considerados não-sobreviventes. Resultados Os níveis de PCT foram mais baixos nos sobreviventes em D0 (p=0.003) e em D4 (p=0.001). Os níveis de CRP não foram diferentes em sobreviventes e nãosobreviventes em D0 (p=0.77) e em D4 (p=0.14). O CPIS não pode diferenciar sobreviventes de não-sobrevientes em D0 (p=0.32) e em D3 (p=0.45). ΔCPIS decrescente não foi correlacionado a sobrevivência (p=0.59), o mesmo ocorrendo com CPIS <6 em D3 (p=0.79). Pacientes que morreram antes de D4 não puderam ter sua cinética calculada e foram considerados casos perdidos. Variáveis incluídas no modelo de regressão logística univariável para sobrevivência foram idade, APACHE II, ΔSOFA decrescente, ΔPCT decrescente e ΔCRP decrescente. Sobrevivência foi diretamente correlacionada a ΔPCT decrescente com RC = 5.67 (1.78;18.03) p = 0.003, ΔCRP com RC = 3.78 (1.24;11.50) p = 0.02, ΔSOFA decrescente com RC = 3.08 (1.02;9.26) p = 0.05 e escore APACHE II com RC = 0.92 (0.86;0.99) p = 0.02. O modelo de regressão logística multivariável para sobrevivência incluiu todas as variáveis participantes da análise univariável. Somente ΔPCT decrescente com RC = 4.43 (1.08;18.18) p = 0.04 e ΔCRP com RC = 7.40 (1.58;34.73) p = 0.01 permaneceram significativos. A avaliação da cinética dos marcadores inflamatórios e a associação com sobrevida no estudo mostraram que: - Em 95,1% dos sobreviventes houve queda dos níveis de PCT ou de CRP. - Em 61% dos sobreviventes ambos os níveis de PCT e de CRP caíram. Apenas 4,9% dos sobreviventes tiveram níveis de PCT e CRP crescentes. Com relação aos não-sobreviventes, 78.9% tiveram pelo menos um dos dois marcadores ou ambos com níveis crescentes. Conclusão As cinéticas da PCT e da CRP, obtidas pelas dosagens de seus níveis no dia do diagnóstico e no 4º dia de tratamento, podem predizer sobrevivência em pacientes com PAV. A queda dos níveis de pelo menos um destes marcadores ou de ambos indica maior chance de sobrevivência.

...Em busca da realidade... : a experiência da etnicidade dos Eleotérios (Catu/RN)

The south region of the Rio Grande do Norte has been historically recognized as a place of old indian villages. Inhabitants of the edges of the Catu River, border between the cities of Canguaretama and Goianinha, the Eleotérios in the threshold of 21st century had passed to be seen and self recognized as "remaining indians" of the RN. Their ethnic mobilizations, when becoming public had placed to the intellectual and political fields an old question to be reflected on: the asseverations concerning the "indian disappearing" in the State. This item brings with it other implications. Accessed by a para-oficial indigenism, the Eleotérios had started to establish political relations with the Potiguara indians of the Baía da Traição/PB and the Indian Movement, feeling stimulated to produce and to reproduce forms of social differentiation. In this context, this research is worried about elucidating the process of construction of the ethnicity among the Eleotérios, percepted from the social relations and politics kept with the amplest society, into a particular historical situation involving sugar cane fields owners, proprietaries, militants, researchers, ambiental agencies. The effects of these political and social relations had been extended, making Eleotérios appear to the society as susceptible social actors to the specific policies for the aboriginal populations

kàjré: a vida social de uma machadinha krahô

This paper proposes to analyse a situation of social drama involving the Krahô Indians (classified in ethnology as belonging to Jê-Timbira group) and the Museu Paulista of the Universidade de São Paulo, which we can classify as two distinct social fields. The understanding of the drama is conveyed through an examination of each of these fields and the coming together of both on the basis of the positions taken up, within the network of relationships established during the social process, by actors representing both the Krahô field and what we may call here the academic-administrative field. A multi-sited ethnographic approach is adopted, seeking the complexity of the drama and the positions in the aforementioned network, taking into consideration institutional political projects, personal projects and personal trajectories within a historical perspective. The aim is to encourage discussion of the relationship between the formation of the historical-scientific and ethnographic museums and the practices of the anthropological discipline, as well as the social role of these institutions and the processes of signification of objects belonging to the indigenous material culture

A cultura de índio, seu menino, vem de longe aqui : formação histórica e territorialização dos Tremembé/CE

This dissertation is based on the ethnography of a strategic selection of three Tremembé ethnic situations, which are situated in the backlands of Acaraú and Itarema, municipalities located in Ceará State (Northeast Brazil). My main aims are the following. Firstly, I reconstitute the historical and social formation of three localities, called Lagoa dos Negros, Telhas, and Queimadas, related to a particular origin myth which refers to Almofala, an extinct colonial Aldeamento in the seashore, where the Tremembé indians and other native populations were converted and gathered under missionary administration. According to the origin myth, these three localities were set up after a strong drought which happened in 1888 (the so called three eights) when a group of Tremembé families moved to the countryside and established close to the Lagoa dos Negros and, later on, they were segmented into smaller groups which started to live in other areas and places not far from the former location. Notably, I develop an anthropological approach to understand the historical formation of these three localities. Secondly, I analyze some processes of territorialization, which were emerged from the 1980s and had important consequences to these indigenous families throughout the next two decades. This historical dimension is re-appropriated and ressignified in ethnic terms. A third point of my work is the analysis of the construction of territorialities and also the cultural and symbolic dimensions which are formulated by the Tremembé Indians who live in these localities. Therefore, I investigate some cultural traditions and rituals, such as the Torém dance, but I also examine their multiple semantics, which constitute a transversal direction throughout the history understood by the Tremembé of the different social situations I researched. To sum up, there is a process of cultural actualization, which is still going on and presents itself through the ludic sphere as well as their political and religions dimensions, which are usually associated to the ritual presentation of the Torém

A questão do petróleo em terras indígenas: uma análise constitucional à luz do desenvolvimento sustentável

Recognizing the need to preserve a national ethnic minority, the Constitution, inspired by the pluralistic values of the Constitutional Law State, stipulated a series of rights and guarantees for the conservation of indigenous cultural singularity, disciplining in article 231 the Indians right to maintain their social organization, customs, languages, beliefs and traditions, as well as safeguarding the rights to the lands they traditionally occupy, and the exclusive use of the wealth existing in them, premise of ensuring their physical and cultural continuity, breaking decisively with the paradigm the assimilation of the Indian national civilization. However, despite the Indian policy of ethnic and cultural preservation, the Constitution allowed the exploitation of minerals in aboriginal territory, incorporated herein hydrocarbons, provided they meet certain predetermined requirements, leaving it to the legislature the discipline of ordinary matter. However, this law has not yet been published, with some projects in the National Congress, leaving thus precluding the indigenous subsurface oil exploration until the enactment of enabling legislation. Meanwhile, this paper carries out an integrated analysis of the constitutional protection of ethnic and cultural uniqueness of indigenous peoples, Convention Nº 169 of the International Labour Organization and the bill presented by Deputy Eduardo Valverde, in an attempt to consolidate sustainable development practices in the sector, through developing a system of social and environmental responsible oil exploration, aligning with national energy needs to maintain a balanced environment and preservation of socio-cultural organization of a minority so weakened and beaten over five centuries of domination

A formação da força de trabalho marítima no Brasil: cultura e cotidiano, tradição e resistência (1808-1850)

A partir du XVIe siècle, le Brésil surgit comme l'un des éléments centraux du surgissement d'un ordre économique et social dans lequel le navire apparaît comme un espace de luttes et de contradictions entre gouvernements, commandants et marins. Nous examinerons ici le processus de prolétarisation, au Brésil au cours de la premier moitié du XIXe siècle, qui a transformé en main d' uvre de travail maritime des indiens, des petits agriculteurs, des noirs libres et des esclaves.

Ocidentalização, territórios e populações indígenas no sertão da Capitania do Rio Grande

The objective of this work is to understand some of the modifications caused for the phenomenon of the westernization in the hinterland of the Capitania do Rio Grande e in the life of the indians populations that inhabited there during the Colonial Period. We break of the quarrel of Serge Gruzinski concerning the westernization, understood while immersed phenomenon in the context of the expansion of the commercial capitalism and that, for the imposition of the culture occidental person to the alteridades of the New World, emprende the conquest of its territories, bodies and souls. The space clipping has covered the hinterland of the Capitania do Rio Grande, specifically the colonial territory of the Freguesia da Gloriosa Senhora Santa Ana do Seridó. The chosen chronological limit for the research corresponds to the Colonial Period and part of the Imperial one. However, the emphasis falls again on the period that it initiates in 1670, year of the oldest concession of would sesmaria known until the moment in the hinterland of the Rio Grande, extending itself until the decade of 1840. Sources of written by hand nature, cartographic printed and compose the used document roll: official correspondence and legislation, petitions of would sesmaria, inventories post-mortem, justifications of debt, registers of parish, maps, action civil court jurisdiction, notes of notary's office, land landmarks. We take the method, analyzed for Carlo Ginzburg, to cross these sources between itself and to detect its implied particularitities and ideas in the space between lineses, but, attributing it status to they of a colonial speech, fruit of the bureaucracy of where it was originated and of the social place of who produced it. We look for to demonstrate, throughout the work, that the phenomenon of the westernization desestruturou the aboriginal societies and its habitat, constructing, over its rubbles, a colonial territory that found in the cartography of the Freguesia de Santa Ana an efficient instrument of control of the space and the population. On the other hand, if the imposition of the culture occidental person exterminou great part of the native population that inhabited the hinterland of the Rio Grande, the remainders of these indians and the mestizos of descending them had survived in diverse ways in the freguesia: in the condition of captives of war or in regimen of servile work, as living or assistants in the farms, populations and village; rambling without route in the fields and the population spots; as mediating agents between the world occidental person and the native, exerting military or civil positions and still appealing to Justice in search of its rights of inheritance. Experiences of slavery, servitude, errância and mediation, but, also of resistance, adaptation, mestization in the Freguesia de Santa Ana

Vicus Judæorum: os judeus e o espaço urbano no Recife neerlandês

This work broaches the participation of the Jewish community in the urban expansion of Recife, Brazil, during the Dutch period (1630-1654). With the arrival of the Dutch, the village of Olinda, former capital of Pernambuco, was destroyed and Recife received the juridical statute of city (stad), becoming the capital of Dutch Brazil or New Holland. It became the main West Indians Company s entrepot in South Atlantic, serving as naval base, port of call for ships, and point of export of the sugar production of Pernambuco, and import of European goods and African slaves. In order to such administrative, military and economic functions be carried out, the sand isthmus where Recife used to stay, and the fluvial island of Antônio Vaz, received improvements of many sort. The Dutch hydraulic technology was put in practice, with a posture of opposition between civilization and nature. Among military works and production of urban equipments, the rivers shores were land-filled, canals were built, bridges were lifted, and hundreds of buildings were erected. The civil Dutch population of Recife engaged in the process of production of physical space, which brought a sense of collective action towards the formation of the urban, or burgher, community. From the physical to the social space, there was an effort towards Dutch cultural standards in the urban environment. The Zur Israel Jewish community, formed by private civilians, it is, nonemployees of the WIC, engaged in those processes. It produced physical space through the land-filling and improvement of non healthy areas, and was also responsible for the construction of a significant section of the town s buildings and some of urban equipments, such as stores, markets and slave-warehouses, making more dynamic their economical activities. But their social traffic was due to the adaptation of their behavior to the standards of Dutch sociability. Thus, the community body made itself part of the social body. Disposing of internal selfregulation, it produced spaces with their cultural references cemetery, synagogue, texts enjoying benefits of the government. Zur Israel inscribed itself in the universal history of the Jews as the first community of Americas, and had a fundamental part on the emancipation of Jews within Western society