Dinâmica da população do concelho de Tarrafal entre 1990 e 2000 e o seu impacto socio-económico

O presente trabalho, cujo o tema é «Dinâmica da população do concelho de Tarrafal entre 1990 e 2000 e o seu impacto socio-económico», vem na sequência de investigação para apresentação de um trabalho científico de fim do curso como requisito parcial para a obtenção do grau de licenciatura em Geografia. Este trabalho surgiu, igualmente, da verificação de vários problemas que afectam o concelho, tanto de ordem demográfico, económico, social como ambiental. Não obstante os problemas, que se arrastam desde há muito tempo e que levou na, actualidade, ao posicionamento do concelho de entre os mais pobres do arquipélago de Cabo Verde. O concelho tem vindo a aumentar consideravelmente o seu efectivo populacional ao longo dos tempos. Ao longo da elaboração deste trabalho enfrentamos algumas dificuldades, sobretudo na aquisição de dados, devido à criação do concelho de São Miguel em 1997, que veio separar a freguesia de São Miguel Arcanjo da freguesia da de Santo Amaro Abade, dando assim origem a dois concelhos autónomos. Por isso no segundo capítulo, onde analisamos dinâmica/estado e evolução demográfica enfrentamos algumas dificuldades, dado à ausência de séries estatísticas específicas sobre o actual concelho em estudo. Neste contexto optamos pela análise conjunta (Tarrafal e São Miguel) de alguns indicadores. Como sabemos, a dinâmica de uma população tem implicações directas nas condições sócio-económicas, podendo arrastar consigo alguns problemas que podem influir nas condições de vida das populações. Sendo assim, com estes propósitos procurámos fazer uma abordagem geral sobre a dinâmica da população no concelho do Tarrafal e o seu impacto sócio-económico, em vários ângulos, nomeadamente: os aspectos sócio-culturais, económicos e demográficos. Além da introdução onde procurámos fazer o enquadramento do trabalho, com os objectivos preconizados, a metodologia seguida, a justificação da importância do tema, este trabalho se encontra estruturado em quatro capítulos, mais as conclusões, recomendações, bibliografias e anexos.

Prediction of myocardial infarction size using the SYNTAX score in patients treated with primary percutaneous coronary intervention for acute ST- segment elevation myocardial infarction

Objectives The relevance of the SYNTAX score for the particular case of patients with acute ST- segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI)  has previously only been studied in the setting of post hoc analysis of large prospective randomized clinical trials. A "real-life" population approach has never been explored before. The aim of this study was to evaluate the impact of the SYNTAX score for the prediction of the myocardial infarction size, estimated by the creatin-kinase (CK) peak value, using the SYNTAX score in patients treated with primary coronary intervention for acute ST-segment elevation myocardial infarction. Methods The primary endpoint of the study was myocardial infarction size as measured by the CK peak value. The SYNTAX score was calculated retrospectively in 253 consecutive patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) in a large tertiary referral center in Switzerland, between January 2009 and June 2010. Linear regression analysis was performed to compare myocardial infarction size with the SYNTAX score. This same endpoint was then stratified according to SYNTAX score tertiles: low <22 (n=178), intermediate [22-32] (n=60), and high >=33 (n=15). Results There were no significant differences in terms of clinical characteristics between the three groups. When stratified according to the SYNTAX score tertiles, average CK peak values of 1985 (low<22), 3336 (intermediate [22-32]) and 3684 (high>=33) were obtained with a p-value <0.0001. Bartlett's test for equal variances between the three groups was 9.999 (p-value <0.0067). A moderate Pearson product-moment correlation coefficient (r=0.4074) with a high statistical significance level (p-value <0.0001) was found. The coefficient of determination (R^2=0.1660) showed that approximately 17% of the variation of CK peak value (myocardial infarction size) could be explained by the SYNTAX score, i.e. by the coronary disease complexity. Conclusion In an all-comers population, the SYNTAX score is an additional tool in predicting myocardial infarction size in patients treated with primary percutaneous coronary intervention (PPCI). The stratification of patients in different risk groups according to SYNTAX enables to identify a high-risk population that may warrant particular patient care.

Efficacy of brief motivational intervention at army conscription to address alcohol use and related problems: a randomized controlled trial

Objectives: The aim of this study was to evaluate the efficacy of brief motivational intervention (BMI) in reducing alcohol use and related problems among binge drinkers randomly selected from a census of 20 year-old French speaking Swiss men and to test the hypothesis that BMI contributes to maintain low-risk drinking among non-bingers. Methods: Randomized controlled trial comparing the impact of BMI on weekly alcohol use, frequency of binge drinking and occurrence of alcohol-related problems. Setting: Army recruitment center. Participants: A random sample of 622 men were asked to participate, 178 either refused, or missed appointment, or had to follow military assessment procedures instead, resulting in 418 men randomized into BMI or control conditions, 88.7% completing the 6-month follow-up assessment. Intervention: A single face-to-face BMI session exploring alcohol use and related problems in order to stimulate behaviour change perspective in a non-judgmental, empathic manner based on the principles of motivational interviewing (MI). Main outcome measures: Weekly alcohol use, binge drinking frequency and the occurrence of 12 alcohol-related consequences. Results: Among binge drinkers, we observed a 20% change in drinking induced by BMI, with a reduction in weekly drinking of 1.5 drink in the BMI group, compared to an increase of 0.8 drink per week in the control group (incidence rate ratio 0.8, 95% confidence interval 0,66 to 0,98, p = 0.03). BMI did not influence the frequency of binge drinking and the occurrence of 12 possible alcohol-related consequences. However, BMI induced a reduction in the alcohol use of participants who, after drinking over the past 12 months, experienced alcohol-related consequences, i.e., hangover (-20%), missed a class (-53%), got behind at school (-54%), argued with friends (-38%), engaged in unplanned sex (-45%) or did not use protection when having sex (-64%). BMI did not reduce weekly drinking in those who experienced the six other problems screened. Among non-bingers, BMI did not contribute to maintain low-risk drinking. Conclusions: At army conscription, BMI reduced alcohol use in binge drinkers, particularly in those who recently experienced alcohol-related adverse consequences. No preventive effect of BMI was observed among non-bingers. BMI is an interesting preventive option in young binge drinkers, particularly in countries with mandatory army recruitment.