925 resultados para Major cardiovascular events


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In rural Ethiopia, parents play an important role in the major life events of their daughters such as education and marriage. However, parents’ roles have been evolving, likely due to the rapid expansion of educational opportunities for girls and the growing need of cash income among rural households. Currently, encouraging their daughters to take up further education and jobs in the formal sector contrasts with rural Ethiopian women’s conventional life course events in the past, which are characterized by early marriage and low educational profiles. An interview analysis with parents of young women indicated that under the continuing de-agrarianization among rural households, women are expected to have their own cash income generating activities to qualify as marriage partners.

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O HDL-c é um fator de risco cardiovascular negativo e sua concentração plasmática apresenta relação inversa com a incidência de eventos cardiovasculares. Entretanto, as evidências relativas ao grupo de indivíduos com níveis de HDL-c acima do percentil 95 da população geral ainda são escassas e o impacto da hiperalfalipoproteinemia (HALP) sobre o risco cardiovascular continua representando motivo de controvérsia na literatura médica. Alguns estudos em populações específicas associam a HALP a aumento do risco cardiovascular. Ao mesmo tempo, outros estudos identificaram populações de indivíduos hipoalfalipoproteinêmicos com marcada longevidade. Assim, demonstrou-se aparente dissociação entre níveis de HDL-c e risco cardiovascular em determinadas populações, reconduzível a aspectos disfuncionais da HDL. O objetivo do presente estudo foi verificar o papel da HALP na determinação do risco cardiovascular; comparar a prevalência de doença cardiovascular subclínica, avaliada por meio da quantificação ultrassonográfica da Espessura Íntimo-Medial Carotídea (EIMC), entre portadores de HDL-c >= 90mg/dL (grupo HALP) e portadores de concentrações de HDL-c atualmente consideradas normais (entre 40 e 50mg/dL para os homens e entre 50 e 60mg/dL para as mulheres); e avaliar características e função da HDL em portadores de HALP por meio do estudo de sua composição, de sua capacidade de efluxo de colesterol, e de sua atividade anti-inflamatória e antioxidante, correlacionando estas características com a presença de doença cardiovascular subclínica avaliada por meio da determinação da EIMC, da Velocidade de Onda de Pulso (VOP) e da presença de Calcificação Arterial Coronariana (CAC) avaliada pela TCMD. Para responder estas perguntas, o presente estudo foi articulado em dois braços: Braço 1: Análise da coorte do estudo ELSA com o objetivo de determinar a prevalência de HALP em uma população geral; definir o perfil demográfico, antropométrico e metabólico dos portadores de HALP; e comparar a prevalência de doença vascular subclínica deste grupo com controles da mesma coorte com níveis normais de HDL-colesterol. Braço 2: Recrutamento de 80 voluntários hígidos e portadores de HALP para avaliação da correlação entre presença de doença vascular subclínica, e aspectos estruturais e funcionais da HDL. Em seus dois braços, o estudo levou a quatro conclusões principais: 1) Níveis marcadamente elevados de HDL-c estão associados a menor espessura íntimo-medial carotídea quando comparados a níveis de HDL-c considerados normais pelas diretrizes vigentes. Embora portadores do fenótipo HALP apresentem, como grupo, um perfil metabólico mais favorável que o encontrado em indivíduos com HDL-c normal, a associação entre EIMC e HALP foi independente dos fatores de risco tradicionais, indicando que a menor prevalência destes últimos em portadores de HDL-c marcadamente elevado justifica apenas parcialmente a menor prevalência de doença vascular subclínica neste grupo; 2) Embora a HALP se apresente como um fenótipo ateroprotetor, há indivíduos com níveis marcadamente elevados de HDL-c que evoluem com doença cardiovascular, clínica ou subclínica. Neste contexto, nossos resultados indicam correlação entre os três métodos avaliados para estudar doença vascular subclínica em portadores de HALP: EIMC, VOP e CAC; 3) Os fatores de risco tradicionais continuam exercendo seu peso na determinação do risco cardiovascular em portadores de HALP. Idade, tabagismo, hipertensão arterial, hipertrigliceridemia e altos níveis de LDL-c apresentaram associação estatisticamente significativa com a presença de doença vascular subclínica no grupo estudado; 4) A avaliação da composição e da função da HDL em portadores de HALP pode permitir identificar indivíduos especificamente mais suscetíveis à aterosclerose. Nossos resultados indicam que, em particular, a atividade anti-inflamatória da HDL, avaliada pela capacidade de inibição da produção de IL-6; o efluxo de colesterol e a capacidade de transferência de triglicérides apresentaram associação independente com menor espessura íntimo-medial carotídea em portadores de HALP, enquanto níveis mais altos de Apo A-IV se associaram a maior grau de doença cardiovascular subclínica

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A Educação para a Conservação é um campo de pesquisa que se dedica ao estudo das reflexões éticas e das atitudes humanas direcionadas para com o respeito que se deve ter com o ambiente, principalmente pelo estabelecimento de ações conservacionistas pautadas em interações educativas. Os Zoos, de modo geral, estão inseridos nessa perspectiva, uma vez que se apresentam como instituições de cunho educativo voltadas para a conservação da biodiversidade. No entanto, o discurso expositivo apresentado por esses aparatos culturais no Brasil, muitas vezes, não contempla tais elementos em suas exposições. Por este motivo, buscou-se a análise de exposições zoológicas também no exterior, que contemplassem discursos sobre a conservação da biodiversidade em suas exposições, tendo sido escolhida a exposição do Zoo de Barcelona, Espanha, para a realização desta investigação. A pesquisa teve por objetivos compreender como a conservação da biodiversidade é abordada na exposição deste zoológico catalão, com base na formulação de saberes de referência constituídos a partir de diferentes áreas: os Movimentos Ambientalistas, a Filosofia da Conservação e as Éticas Ambientais. Igualmente, buscou-se compreender como o discurso expositivo sobre conservação encontra-se apresentado nos aparatos expográficos distribuídos ao longo da exposição, bem como em livros e documentos. Compreendendo a investigação como um Estudo de Caso, foram acessados documentos institucionais de acesso público encontrados no site da instituição e textos presentes nos painéis expositivos. As análises foram realizadas com base no referencial teórico da Transposição Didática/Museográfica, que permite o estudo da exposição por ao menos três lógicas: a lógica do discurso; a lógica do espaço; e a lógica do gesto. Além disso, o mesmo referencial prevê o estabelecimento de um saber de referência ou saber sábio pautado no conhecimento epistemológico sobre a conservação da biodiversidade e, nesta pesquisa, no discurso de pesquisadores da área, que foram entrevistados sobre este assunto. Este saber de referência ou saber sábio possibilitou a criação de um conjunto de categorias de análise que pautou a análise do discurso expositivo apresentado pelo Zoo de Barcelona. As categorias criadas foram classificadas em duas dimensões: a dos Valores e a das Ações. Duas categorias, a Antropocêntrica e a Não antropocêntrica constituíram a Dimensão dos Valores e quatro categorias, a Desenvolvimentista, a Sustentabilista, a Sócio-humanística e a Técnico-científica constituíram a Dimensão das Ações. Os resultados apontaram que o discurso expositivo é composto predominantemente por informações Técnico-científicas e Sustentabilistas, ambas as categorias contextualizadas por uma visão não antropocêntrica de valorização da natureza. A forma como o discurso expositivo encontra-se apresentado na parte textual da exposição corrobora a linha conceitual de assuntos abordados nos grandes eventos globais promovidos pela ONU ao longo dos últimos 40 anos, sobre a conservação do meio ambiente. Categorias como a Sócio-humanística, a Antropocêntrica e a Dimensão dos Valores foram pouco abordadas. A categoria Desenvolvimentista não foi encontrada na exposição. Pelas evidências levantadas durante a análise dos dados pode-se concluir que o Zoo de Barcelona apresenta um discurso expositivo conservacionista e que há elementos suficientes na exposição para se apontar o desenvolvimento de uma Educação para a Conservação.

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The Australian southern continental margin is the world’s largest site of cool-water carbonate deposition, and the Great Australian Bight is its largest sector. The Eyre Peninsula is fringed by coastal beaches with aeolianites and marks the eastern edge of the Great Australian Bight. Five shoreline transects of varying lengths spanned a 150km longitudinal distance and at each the intertidal, beach, dune and secondary dune environments were sampled, for a total of 18 samples. Sediments are a mixture of modern, relict, and Cenozoic carbonates, and quartz grains. Carbonate aeolianites on the western Eyre Peninsula are mostly composed of modern carbonate grains: predominantly molluscs (23-33%) and benthic foraminifera (10-26%), locally abundant coralline algae (3-28%), echinoids (2-22%), and bryozoans (2-14%). Cenozoic grain abundance ranges from 1-6% whereas relict grain abundance ranges from 0-17%. A southward increase in bryozoan particles correlates with a nutrient element abundance and decrease in temperature due to a large seasonal coastal upwelling system that drives 2-3 major upwelling events per year, bringing cold, nutrient rich, Sub-Antarctic Surface Water (<12°C) onto the shelf. In southern, mostly wind protected locations, the beach and dune sediment compositions are similar, indicating that wind energy has successfully carried all sediment components of the beach into the adjacent dunes. In northern, exposed locations, the composition is not the same everywhere, and trends indicate that relative wind energy has the ability to impact grain composition through preferential wind transport. Aeolianite composition is therefore a function of both upwelling and the degree of coastal exposure.

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Pressurised slurries of fine-grained sediment expelled from the base of the active layer have been observed in recent years in the High Arctic. Such mud ejections, however, are poorly understood in terms of how exactly climate and landscape factors determine when and where they occur. Mud ejections at the Cape Bounty Arctic Watershed Observatory, Melville Island, Nunavut, were systematically mapped in 2012 and 2013, and this was combined with observations of mud ejection activity and climatic measurements carried out since 2003. The mud ejections occur late in the melt season during warm years and closely following major rainfall events. High-resolution satellite imagery demonstrates that mud ejections are associated with polar semi-desert vegetative settings, flat or low-sloping terrain and south-facing slopes. The localised occurrence of mud ejections appears to be related to differential soil moisture retention.

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The financial crisis of 1997-1998 in Southeast Asia and the European Union’s financial crisis of 2008 followed by the sovereign debt crisis represented major policy events in the regions and beyond. The crises triggered policy adjustments with implications on economic and other policies. This paper aims at evaluating the perception of university students in the European Union (EU) and Southeast Asia on the management of these crises. It strives to confirm several ex ante assumptions about the relationship between students’ background, their policy orientation and their knowledge of the European Union and ASEAN policies. It also provides an analysis of the students’ evaluation of the geopolitical importance of the global regions and the EU and ASEAN policies. The paper is based on opinion surveys conducted during the first part of 2012 at four universities, two in the EU and two in ASEAN countries. In the eyes of EU and ASEAN students, the EU crisis is not being managed appropriately. The citizens of the EU surveyed were even significantly more critical of the EU’s anti-crisis measures than any other surveyed group. Their ASEAN counterparts were generally more positive in their evaluations.

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Three major geopolitical events are putting the stability of the Eastern Mediterranean at risk. Most of the region is in a deep monetary and economic crisis. The Arab Spring is causing turmoil in the Levant and the Maghreb. Gas and oil discoveries, if not well managed, could further destabilise the region. At the same time, Russia and Turkey are staging a comeback. In the face of these challenges, the EU approaches the Greek sovereign debt crisis nearly exclusively from a financial and economic viewpoint. This brief argues that the EU has to develop a comprehensive strategy for the region, complementing its existing multilateral regional framework with bilateral agreements in order to secure its interests in the Eastern Mediterranean.

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Three major geopolitical events are putting the stability of the Eastern Mediterranean at risk. Most of the region is in a deep monetary and economic crisis. The Arab Spring is causing turmoil in the Levant and the Maghreb. Gas and oil discoveries, if not well managed, could further destabilise the region. At the same time, Russia and Turkey are staging a comeback. In the face of these challenges, the EU approaches the Greek sovereign debt crisis nearly exclusively from a financial and economic viewpoint. This brief argues that the EU has to develop a comprehensive strategy for the region, complementing its existing multilateral regional framework with bilateral agreements in order to secure its interests in the Eastern Mediterranean.

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Calcareous nannofossils are abundant in the Paleogene sediments recovered during Ocean Drilling Program Leg 120. Although no continuous Paleogene section was obtained, Sites 747 through 751 complemented each other so as to provide a virtually complete composite stratigraphic section. The calcareous nannofossil biostratigraphy at Sites 747, 748, and 749 is discussed. Correlation of calcareous nannofossil biozones and magnetozones at these sites suggests some diachrony with low-latitude areas, as well as on a regional basis. Changes in calcareous nannofossil diversity throughout the Paleogene are analyzed and interpreted as reflecting major paleoclimatic events.

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We generated preliminary downcore records of total organic carbon content, calcium carbonate, long-chain n-alkane concentration, total alkenone concentration, and alkenone-based sea-surface temperature for samples from the easternmost flank of Nazca Ridge (Site 1237) and the eastern crest of Carnegie Ridge (Site 1239). Total organic carbon and long-chain n-alkane concentrations will be used to evaluate terrestrial sediment sources. Downcore records of alkenone sea-surface temperature will benefit studies of paleoceanography of the southeastern Pacific. Since these sites are located under the influence of major tectonic events, such as the uplift of the Andes Mountains and the closure of the Isthmus of Panama, the records will help us to examine the effects of the tectonic events on the oceanic environment.

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Upper Quaternary sediment sequences east of the Great Barrier Reef are characterized by alternating siliciclastic- and carbonate-rich horizons caused by changes in the input of various sedimentary components and reflected in cores by variations in bulk carbonate content. A total of 153 measurements of bulk carbonate content were determined using the carbonate-bomb technique for late Pleistocene sediments between 0 and 23.69 meters below sea floor (mbsf) in Ocean Drilling Program Hole 1198A. Average sample resolution was 15 cm and multiple analyses were performed on each sample. Bulk carbonate content ranges from a maximum of 94 wt% at 13.63 mbsf to a minimum of 73 wt% at 14.54 mbsf. Five cyclic trends are observed that may relate to five major glacial events during the last 500 k.y. of the Quaternary.

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Projected air and ground temperatures are expected to be higher in Arctic and sub-Arcticlatitudes and with temperatures already close to the limit where permafrost can exist,resistance against degradation is low. With thawing permafrost, the landscape is modifiedwith depression in which thermokarst lakes emerge. In permafrost soils a considerableamount of soil organic carbon is stored, with the potential of altering climate even furtherif expansion and formation of new thermokarst lakes emerge, as decay releasesgreenhouse gases (C02 and CH4) to the atmosphere. Analyzing the spatial distribution andmorphometry over time of thermokarst lakes and other water bodies, is of importance inaccurately predict carbon budget and feedback mechanisms, as well as to assess futurelandscape layout and these features interaction. Different types of high-spatial resolutionaerial and satellite imageries from 1963, 1975, 2003, 2010 and 2015, were used in bothpre- and post-classification change detection analyses. Using object oriented segmentationin eCognition combined with manual adjustments, resulted in digitalized water bodies>28m2 from which direction of change and morphometric values were extracted. Thequantity of thermokarst lakes and other water bodies was in 1963 n=92, with succeedingyears as a trend decreased in numbers, until 2010-2015 when eleven water bodies wereadded in 2015 (n=74 to n=85). In 1963-2003, area of these water bodies decreased with50 651m2 (189 446-138 795m2) and continued to decrease in 2003-2015 ending at 129337m2. Limnicity decreased from 19.9% in 1963 to 14.6% in 2003 (-5.3%). In 2010 and2015 13.7-13.6%. The late increase in water bodies differs from an earlier hypothesis thatsporadic permafrost regions experience decrease in both area and quantity of thermokarstlakes and water bodies. During 1963-2015, land gain has been in dominance of the ratiobetween the two competing processes of expansion and drainage. In 1963-1975, 55/45%,followed by 90/10% in 1975-2003. After major drainage events, land loss increased to62/38% in 2010-2015. Drainage and infilling rates, calculated for 15 shorelines werevaried across both landscape and parts of shorelines, with in average 0.17/0.15/0.14m/yr.Except for 1963-1975 when rate of change in average was in opposite direction (-0.09m/yr.), likely due to evident expansion of a large thermokarst lake. Using a squaregrid, distribution of water bodies was determined, with an indistinct cluster located in NEand central parts. Especially for water bodies <250m2, which is the dominant area classthroughout 1963-2015 ranging from n=39-51. With a heterogeneous composition of bothsmall and large thermokarst lakes, and with both expansion and drainage altering thelandscape in Tavvavuoma, both positive and negative climate feedback mechanisms are inplay - given that sporadic permafrost still exist.

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Hyperhomocysteinemia is a potential risk factor for vascular disease and is associated with endothelial dysfunction, a predictor of adverse cardiovascular events. Renal patients (end-stage renal failure (ESRF) and transplant recipients (RTR)) exhibit both hyperhomocysteinemia and endothelial dysfunction with increasing evidence of a causative link between the 2 conditions. The elevated homocysteine appears to be due to altered metabolism in the kidney (intrarenal) and in the uremic circulation ( extrarenal). This review will discuss 18 supplementation studies conducted in ESRF and 6 in RTR investigating the effects of nutritional therapy to lower homocysteine. The clinical significance of lowering homocysteine in renal patients will be discussed with data on the effects of B vitamin supplementation on cardiovascular outcomes such as endothelial function presented. Folic acid is the most effective nutritional therapy to lower homocysteine. In ESRF patients, supplementation with folic acid over a wide dose range ( 2 - 20 mg/day) either individually or in combination with other B vitamins will decrease but not normalize homocysteine. In contrast, in RTR similar doses of folic acid normalizes homocysteine. Folic acid improves endothelial function in ESRF patients, however this has yet to be investigated in RTR. Homocysteine-lowering therapy is more effective in ESRF patients than RTR.

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Background-Elevated serum inflammatory marker levels are associated with a greater long-term risk of cardiovascular events. Because 3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitors (statins) may have an antiinflammatory action, it has been suggested that patients with elevated inflammatory marker levels may have a greater reduction in cardiovascular risk with statin treatment. Methods and Results-We evaluated the association between the white blood cell count (WBC) and coronary heart disease mortality during a mean follow-up of 6.0 years in the Long-Term Intervention With Pravastatin in Ischemic Disease (LIPID) Study, a clinical trial comparing pravastatin (40 mg/d) with a placebo in 9014 stable patients with previous myocardial infarction or unstable angina. An increase in baseline WBC was associated with greater coronary heart disease mortality in patients randomized to placebo (hazard ratio for 1 X 10(9)/L increase in WBC, 1.18; 95% CI, 1.12 to 1.25; P<0.001) but not pravastatin (hazard ratio, 1.02; 95% CI, 0.96 to 1.09; P=0.56; P for interaction=0.004). The numbers of coronary heart disease deaths prevented per 1000 patients treated with pravastatin were 0, 9, 30, and 38 for baseline WBC quartiles of <5.9, 6.0 to 6.9, 7.0 to 8.1, and >8.2X10(9)/L, respectively. WBC was a stronger predictor of this treatment benefit than the ratio of total to high-density lipoprotein cholesterol and a global measure of cardiac risk. There was also a greater reduction (P=0.052) in the combined incidence of cardiovascular mortality, nonfatal myocardial infarction, and stroke with pravastatin as baseline WBC increased ( by quartile: 3, 41, 61, and 60 events prevented per 1000 patients treated, respectively). Conclusions-These data support the hypothesis that individuals with evidence of inflammation may obtain a greater benefit from statin therapy.