Prevalência e fatores associados à morbidade materna: inquérito populacional em Natal/RN

INTRODUCTION: Severe maternal morbidity , also known as maternal near miss , has been used as an alternative to the study of maternal mortality , since being more frequent shares the same determinants and enables the implementati on of epidem iological surveillance of cases . Since then, hospital audits ha ve been carried out to determine the rates of maternal near miss, its mai n causes and associated factors . More recently, population surveys based on self - reported morbidity have als o been presented as vi able in identifying these cases . OBJECTIVE: The aim of this study was to determine the prevalence and associated factors of maternal near miss and complications during pregnancy and puerperal period in Natal/RN. METHODS: A cross - secti onal population - based study was conducted in Natal /RN , Brazil, which has as its target population women aged 15 to 49 years who were pregnant in the last five years. It was carried out a probabilistic sam pling design based on a multi - stage complex sample , in which 60 census tracts were selected from three strata (north , south - east and west). Afterwards, domiciles were visited in order to obtain a sample of the 908 eligible women in whom a questionnaire was applied. The descriptive analyzes and bivariate ass ociations were performed using the Chi - square test and the estimate of the prevalence ratio (PR ) with 95% confidence interval (CI) and considering the weights and design effects . The Poisson regression analysis , also with 5% significance and 95% CI, was us ed for analyzes of associated factors. RESULTS: 848 women were identified and interviewed after visits in 8.227 households corresponding to a response rate of 93 . 4 %. The prevalence of maternal near miss was 41 . 1 /1 000NV, being the Intensive Care Unity stay i ng (19 . 1 /1 000 LB ) and eclampsia (13 . 5/1000LB) the most important marker s . The prevalence of complications in the puerperal peri od was 21 . 2 %, and hemorrhage (10 . 7%) and urinary tract infection (10 . 7%) the most frequently reported clinical conditions and rema in ing in the hospital for over a week after delivery the mo st frequent intervention (5.4%) . Regarding associated factors , the bivariate analysis showed an association between the increased number of complications in women of black/brown race ( PR= 1 . 23; CI95 % : 1 . 04 - 1 . 46) and lower socioeconomic status ( PR= 1 . 33; CI95%: 1 . 12 - 1 . 58) in women who had pre natal care in public service ( PR= 1 . 42; CI95%: 1 . 16 to 1 . 72 ) and that were not advised during prenatal about where they should do the d elivery (PR= 1 . 24; CI95%: 1 . 05 - 1 . 46), made the del ivery in the public service (PR= 1 . 63; CI95%: 1 . 30 - 2 . 03), had to search for more than one hospital for delivery (PR=1 . 22; CI95%: 1 . 03 - 1 . 45) and had no companion during childbirth ( PR =1 . 19; CI95%: 1 . 01 - 1 . 41) or at all times of childbirth c are - before, during and after childbirth - ( PR= 1 . 25, CI95%: 1 . 05 - 1 . 48) . Moreover, the number of days postpartum hospitalization was higher in women who had more complications (P R= 1 . 59 ; CI95%: 1 . 36 - 1 . 86). In the final regression model for both birth place (P R= 1 . 21 ; CI 95% : 1 . 02 to 1 . 44 ) and socioeconomic status (PR = 1.54 ; CI95%: 1 . 25 - 1 . 90 ) the association remained. CONCLUSION : Conducting population surveys using the pragmatic definition of near miss is feasible and may add importa nt information about this ev ent . It was possible to find the expression of health inequalities related to maternal health in the analysis of both socioeconomic conditions and on the utilization of health services.

Modelagem dos efeitos da irradiação luminosa no cérebro de camundongos e rastreamento de neurônios durante experimentos de microscopia de fluorescência

The fluorescent proteins are an essential tool in many fields of biology, since they allow us to watch the development of structures and dynamic processes of cells in living tissue, with the aid of fluorescence microscopy. Optogenectics is another technique that is currently widely used in Neuroscience. In general, this technique allows to activate/deactivate neurons with the radiation of certain wavelengths on the cells that have ion channels sensitive to light, at the same time that can be used with fluorescent proteins. This dissertation has two main objectives. Initially, we study the interaction of light radiation and mice brain tissue to be applied in optogenetic experiments. In this step, we model absorption and scattering effects using mice brain tissue characteristics and Kubelka-Munk theory, for specific wavelengths, as a function of light penetration depth (distance) within the tissue. Furthermore, we model temperature variations using the finite element method to solve Pennes’ bioheat equation, with the aid of COMSOL Multiphysics Modeling Software 4.4, where we simulate protocols of light stimulation tipically used in optogenetics. Subsequently, we develop some computational algorithms to reduce the exposure of neuron cells to the light radiation necessary for the visualization of their emitted fluorescence. At this stage, we describe the image processing techniques developed to be used in fluorescence microscopy to reduce the exposure of the brain samples to continuous light, which is responsible for fluorochrome excitation. The developed techniques are able to track, in real time, a region of interest (ROI) and replace the fluorescence emitted by the cells by a virtual mask, as a result of the overlay of the tracked ROI and the fluorescence information previously stored, preserving cell location, independently of the time exposure to fluorescent light. In summary, this dissertation intends to investigate and describe the effects of light radiation in brain tissue, within the context of Optogenetics, in addition to providing a computational tool to be used in fluorescence microscopy experiments to reduce image bleaching and photodamage due to the intense exposure of fluorescent cells to light radiation.

Prevalência e fatores associados à síndrome da fragilidade em idosos: inquérito populacional em Campina Grande-PB

The frailty syndrome is a geriatric medical condition of vulnerability resulting in the decline of physiological reserves, characterized by high-risk consequences as falls, disability, hospitalization, institutionalization and death. Although the presence of comorbidities is not always accompanied by fragility, this presence could also indicate an increased risk of adverse health events, taking the elderly to a greater likelihood of becoming brittle due to the physical limitations that may occur with emergence of diseases, which are strongly predictive of Fragility Syndrome. This study aimed to assess the prevalence of frailty syndrome in the elderly and associated factors. The specific objectives were to identify the prevalence of frailty syndrome in the elderly and their associations with demographic, economic, health, functional and psychological; identify the reasons for the prevalence of frailty syndrome with the demographic profile, health problems, use of legal drugs and problems with sleep of older people. The study was cross-sectional and composed of 385 elderly aged 65 or more. Multivariate Poisson regression models were used to check conditions associated with fragility and determine the prevalence ratio (α = 0.05). The prevalence of fragility was 8.7% and pre-fragility of 50.4%. Fragile and pre-frail elderly presented, bigger and increasing prevalence ratio for marital status, difficulty in performing instrumental activities of daily living, old age, involuntary loss of stool, depression and negative affect. Elderly people who do not work have a higher prevalence of fragility, as well as those who reported having had a stroke / stroke / ischemia, those who suffered falls in the last 12 months and those with sleep problems. It is considered that the results, together with other available in the literature, can contribute to the understanding of the fragility epidemiology and also in the implementation of specific programs aimed at reducing the prevalence of frailty, optimizing the quality of life. It is suggested that future programs have special attention to the profiles of elderly people who have not yet developed fragility, i.e., pre-fragile. This could prevent the elderly from becoming frail.

Prevalência e fatores associados ao Near Miss Materno: inquérito populacional em uma capital do Nordeste Brasileiro

The scope of this study was to determine the prevalence of near misses and complications during pregnancy and the puerperal period, identifying the main clinical and intervention markers and socioeconomic and demographic factors associated with near misses. It involved a cross-sectional, population-based and probabilistic study with multi-stage complex sampling design conducted in Natal, State of Rio Grande do Norte, Brazil. A validated questionnaire was given to 848 women aged 15 to 49 identified in 8,227 households in 60 census sectors. In theanalysis of associations, the Chi-square test applied and calculated the prevalence ratio (PR) with Confidence Interval (CI) of 95% and 5% significance. The prevalence of maternal near misses was 41.1/1000LB, with hospitalization in an Intensive Care Unit (19.1/1000LB) and eclampsia (13.5/1000LB) being the most important markers. The prevalence of complications during pregnancy and the puerperal period was 21.2%. The highest prevalence of near misses was observed in older women, of black/brown race and low socioeconomic status. Conducting population surveys is feasible and may add important information to the study of near misses and the markers highlight the need for enhancing maternal care to reduce health inequality.

Prevalência e fatores associados ao Near Miss Materno: inquérito populacional em uma capital do Nordeste Brasileiro

The scope of this study was to determine the prevalence of near misses and complications during pregnancy and the puerperal period, identifying the main clinical and intervention markers and socioeconomic and demographic factors associated with near misses. It involved a cross-sectional, population-based and probabilistic study with multi-stage complex sampling design conducted in Natal, State of Rio Grande do Norte, Brazil. A validated questionnaire was given to 848 women aged 15 to 49 identified in 8,227 households in 60 census sectors. In theanalysis of associations, the Chi-square test applied and calculated the prevalence ratio (PR) with Confidence Interval (CI) of 95% and 5% significance. The prevalence of maternal near misses was 41.1/1000LB, with hospitalization in an Intensive Care Unit (19.1/1000LB) and eclampsia (13.5/1000LB) being the most important markers. The prevalence of complications during pregnancy and the puerperal period was 21.2%. The highest prevalence of near misses was observed in older women, of black/brown race and low socioeconomic status. Conducting population surveys is feasible and may add important information to the study of near misses and the markers highlight the need for enhancing maternal care to reduce health inequality.

Perfil sociodemográfico dos idosos nas capitais do Nordeste e a mortalidade por doenças crônico-degenerativas desse segmento populacional em Natal (RN)

Population aging is a global demographic trend. This process is a reality that merits attention and importance in recent years, and cause considerable impact in terms of greater demands on the health sector, social security and special care and attention from families and society as a whole. Thus, in the context of addressing the consequences of demographic transition, population aging is characterized as a major challenge for Brazilian society. Therefore, this study was conducted in two main objectives. In the first article, variables of socioeconomic and demographic contexts were employed to identify multidimensional profiles of elderly residents in the Northeast capitals, from specific indicators from the 2010 Census information Therefore, we used the Grade of Membership Method (GoM), whose design profiles admits that an individual belongs to different degrees of relevance to multiple profiles in order to identify socioeconomic and demographic factors associated with living conditions of the elderly in the Northeastern capitals. The second article examined the possible relationship between mortality from chronic diseases and socio-economic indicators in the elderly population, of the 137 districts in Natal, broken down by ten-year age groups (60 to 69 years, 70-79 years and 80 and over. The microdata from the Mortality Information System (SIM), was used, provided by the Health Secretariat of Christmas, and population information came from the Population Census 2010. The method refers to the Global and Local Index neighborhood logic (LISA) Moran, whose spatial distribution from the choropleth maps allowed us to analyze the mortality of the elderly by neighborhoods, according to socioeconomic and demographic indicators, according to the presence of special significance. In the first article, the results show the identification of three extreme profiles. The Profile 1 which is characterized by median socioeconomic status and contributes 35.5% of elderly residents in the area considered. The profile 2 which brings together seniors with low socioeconomic status characteristics, with a percentage of 24.8% of cases. And the Profile 3 composing elderly with features that reveal better socioeconomic conditions, about 29.7% of the elderly. Overall, the results point to poor living conditions represented by the definition of these profiles, mainly expressed by the results observed in more than half of the northeastern elderly experience a situation of social vulnerability given the large percentage that makes up the Profile 1 and Profile 2, adding 60% of the elderly. In the second article, the results show a higher proportion of elderly concentrated in the neighborhoods of higher socioeconomic status, such as Petrópolis and LagoaSeca. Mortality rates, according to the causes of death and standardized by the empirical Bayesian method were distributed locally as follows: Neoplasms (Reis Santos, New Discovery, New Town, Grass Soft and Ponta Negra); Hypertensive diseases (Blue Lagoon, Potengi, Redinha, Reis Santos, Riverside, Lagoa Nova, Grass Soft, Neópolis and Ponta Negra); Acute Myocardial Infarction (Northeast, Guarapes and grass Soft); Cerebrovascular diseases (Petrópolis and Mother Luiza); Pneumonia (Ribeira, Praia do Meio, New Discovery, Grass Soft and Ponta Negra); Chronic Diseases of the Lower Way Airlines (Igapó, Northeast and Thursdays). The present findings at work may contribute to other studies on the subject and development of specific policies for the elderly.

Perfil sociodemográfico dos idosos nas capitais do Nordeste e a mortalidade por doenças crônico-degenerativas desse segmento populacional em Natal (RN)

Population aging is a global demographic trend. This process is a reality that merits attention and importance in recent years, and cause considerable impact in terms of greater demands on the health sector, social security and special care and attention from families and society as a whole. Thus, in the context of addressing the consequences of demographic transition, population aging is characterized as a major challenge for Brazilian society. Therefore, this study was conducted in two main objectives. In the first article, variables of socioeconomic and demographic contexts were employed to identify multidimensional profiles of elderly residents in the Northeast capitals, from specific indicators from the 2010 Census information Therefore, we used the Grade of Membership Method (GoM), whose design profiles admits that an individual belongs to different degrees of relevance to multiple profiles in order to identify socioeconomic and demographic factors associated with living conditions of the elderly in the Northeastern capitals. The second article examined the possible relationship between mortality from chronic diseases and socio-economic indicators in the elderly population, of the 137 districts in Natal, broken down by ten-year age groups (60 to 69 years, 70-79 years and 80 and over. The microdata from the Mortality Information System (SIM), was used, provided by the Health Secretariat of Christmas, and population information came from the Population Census 2010. The method refers to the Global and Local Index neighborhood logic (LISA) Moran, whose spatial distribution from the choropleth maps allowed us to analyze the mortality of the elderly by neighborhoods, according to socioeconomic and demographic indicators, according to the presence of special significance. In the first article, the results show the identification of three extreme profiles. The Profile 1 which is characterized by median socioeconomic status and contributes 35.5% of elderly residents in the area considered. The profile 2 which brings together seniors with low socioeconomic status characteristics, with a percentage of 24.8% of cases. And the Profile 3 composing elderly with features that reveal better socioeconomic conditions, about 29.7% of the elderly. Overall, the results point to poor living conditions represented by the definition of these profiles, mainly expressed by the results observed in more than half of the northeastern elderly experience a situation of social vulnerability given the large percentage that makes up the Profile 1 and Profile 2, adding 60% of the elderly. In the second article, the results show a higher proportion of elderly concentrated in the neighborhoods of higher socioeconomic status, such as Petrópolis and LagoaSeca. Mortality rates, according to the causes of death and standardized by the empirical Bayesian method were distributed locally as follows: Neoplasms (Reis Santos, New Discovery, New Town, Grass Soft and Ponta Negra); Hypertensive diseases (Blue Lagoon, Potengi, Redinha, Reis Santos, Riverside, Lagoa Nova, Grass Soft, Neópolis and Ponta Negra); Acute Myocardial Infarction (Northeast, Guarapes and grass Soft); Cerebrovascular diseases (Petrópolis and Mother Luiza); Pneumonia (Ribeira, Praia do Meio, New Discovery, Grass Soft and Ponta Negra); Chronic Diseases of the Lower Way Airlines (Igapó, Northeast and Thursdays). The present findings at work may contribute to other studies on the subject and development of specific policies for the elderly.

Estudo comparativo de dois conversores Boost quadrático com comutação suave monochaveados para aplicação de rastreamento de máxima potência em sistemas fotovoltaicos

This paper makes a comparative study of two Soft Single Switched Quadratic Boost Converters (SSS1 and SSS2) focused on Maximum Power Point Tracking (MPPT) of a PV array using Perturb and Observe (P&O) algorithm. The proposed converters maintain the static gain characteristics and dynamics of the original converter with the advantage of considerably reducing the switching losses and Electromagnetic Interference (EMI). It is displayed the input voltage Quadratic Boost converter modeling; qualitative and quantitative analysis of soft switching converters, defining the operation principles, main waveforms, time intervals and the state variables in each operation steps, phase planes of resonant elements, static voltage gain expressions, analysis of voltage and current efforts in semiconductors and the operational curves at 200 W to 800 W. There are presented project of PI, PID and PID + Notch compensators for MPPT closed-loop system and resonant elements design. In order to analyze the operation of a complete photovoltaic system connected to the grid, it was chosen to simulate a three-phase inverter using the P-Q control theory of three-phase instantaneous power. Finally, the simulation results and experimental with the necessary comparative analysis of the proposed converters will be presented.

El autocuidado y apoyo social de mujeres de un proyecto de seguimiento mamográfico en Porto Alegre/Brasil

Objective: Identify preventive self-care practices and analyze the configurations of the network support for women with and without breast cancer registered in a mammography-monitoring project from Porto Alegre/Brazil.Method: a mixed sequential delimitation was performed, which expanded the results of the quantitative step (cross and correlation section) in a qualitative step (narrative interviews). 37 women diagnosed with breast cancer (group 1) and 72 without this diagnosis (group 2 – monitoring) participated. The following instruments were used: Assessment Questionnaire Self-care Ability (ASA-A) and Assessment Questionnaire Perceived Social Support and Community. There were performed descriptive analysis and comparison of means (t test and ANOVA) between the two groups. To deepen the understanding of the data, we selected four women with breast cancer with extreme levels on the scale of Social Support to participate in the biographical narrative interviews.Results: the analysis indicate that women who had breast cancer have better self-care practices than the women from the monitoring project (t = 1.791, P = 0.027). As for the analysis of social support, there were no statistically significant differences between the two groups. All participants have an average level of perceived social and community support. It was highlighted by the qualitative data that it was after the diagnosis of breast cancer that women lived self-care aspects they had not previously experienced.Conclusions: the self-care was significantly bigger in the group of women with breast cancer, where the cancer diagnosis was a trigger to increase self-care.

Envelhecimento populacional, mercado de trabalho e políticas públicas de emprego nos países da OCDE

O objetivo deste trabalho é apresentar e analisar sucintamente as consequências do processo de envelhecimento populacional no mercado de trabalho e nas políticas públicas de emprego nos países da Organização de Cooperação para Desenvolvimento Econômico (OCDE). Uma pesquisa bibliográfica composta por seleção, análise, resumo, complementação e confrontação das referências bibliográficas é adotada. As estatísticas disponibilizadas pela Organização das Nações Unidas (ONU) e Organização de Cooperação para Desenvolvimento Econômico (OCDE) são as fontes de dados empíricos e sempre que possível os dados referente ao Brasil são inseridos. O impacto econômico do envelhecimento populacional são evidenciados por meio dos efeitos diretos e indiretos. Os efeitos diretos estão associados à quantidade e à qualidade do emprego e os efeitos indiretos correspondem à redução dos recursos econômicos necessários para lidar com o envelhecimento, à interferência nas decisões dos indivíduos e, ainda, à pressão sobre os sistemas de educação, de seguro social e de saúde. As políticas públicas de emprego podem resolver ou amenizar os efeitos considerados negativos do processo de envelhecimento populacional sobre o mercado de trabalho e, consequentemente, sobre o crescimento econômico dos países. Destaca-se que os países membros da OCDE investigados neste trabalho estão incentivando o retorno dos trabalhadores mais velhos e idosos ao mercado de trabalho, por meio das políticas públicas de emprego, em especial, as políticas ativas, tais como: reciclagem, treinamento, orientação e realocação.

Envelhecimento populacional, mercado de trabalho e políticas públicas de emprego no Brasil

O objetivo principal deste trabalho é caracterizar o processo de envelhecimento populacional no Brasil e analisar suas consequências para o mercado de trabalho e a política pública de emprego. Para tanto, é realizada revisão crítica da literatura e são apresentados dados quantitativos descritivos e estatísticos de fontes secundárias. A taxa de participação dos idosos no mercado de trabalho no Brasil é 44%. É uma taxa elevada para os padrões de países desenvolvidos. No entanto, o maior desafio para a política pública de emprego para idosos no Brasil é sua baixa escolaridade. No país, não existe política pública de emprego específica para os idosos. Fora do campo previdenciário, praticamente não há ação governamental com o objetivo de alterar o nível de emprego entre os idosos. A implantação de política pública de emprego específica para idosos pode amenizar os efeitos negativos do envelhecimento populacional sobre o mercado de trabalho, a exemplo do que já ocorre nos países da OCDE.

MATCHMOVING, TECNOLOGIAS PARA O RASTREAMENTO, CALIBRAÇÃO DE CÂMERA COM USABILIDADES EM PRODUÇÕES AUDIOVISUAIS.

Os efeitos especiais estão presentes na maioria das exibições que a mídia oferece, como nos programas de televisão, filmes e jogos, mesmo que passe sem a observação de telespectador. A crescente demanda mundial em adotar novas tecnologias em diversas áreas, como na tecnologia da informação, e o alto nível das produções audiovisuais, tem levado ao desenvolvimento de técnicas e soluções avançadas, tornando possível criar grande parte das produções em audiovisual. Atualmente trabalha-se com o Matchmoving (casamento de movimento, não existe palavra equivalente em português), onde se desenvolve a técnica e a arte para alterar uma imagem, retirando ou acrescentando elementos a ela. Dentre as principais características estão o uso de câmeras digitais e soluções computacionais desenvolvidas especificamente para este fim.  Este estudo pretende trabalhar o processo técnico em Matchmoving sendo auxiliado pelos softwares Autodesk 3ds Max 2016 e o Autodesk Machmover 2016. Neste contexto será desenvolvido os fundamentos da calibração da câmera descobrindo sua matriz essencial e o motivo para o uso deste processo, sendo que o mesmo será aplicado na técnica descrita. O modelo a ser desenvolvido será a inserção de elementos 3d (Turbinas Eólicas Virtuais), em vídeo real de aproximadamente 10 segundos. Palavras-chave. Matchmoving. Calibração. Efeitos Especiais. Câmera. Vídeo.

PREVALENCE AND FACTORS ASSOCIATED WITH THE PERFORMANCE OF MAMMOGRAPHY AND PAP SMEAR TEST

Objective: To estimate the prevalence and factors associated with the performance of mammography and pap smear test in women from the city of Maringá, Paraná. Methods: Population-based cross-sectional study conducted with 345 women aged over 20 years in the period from March 2011 to April 2012. An interview was carried out using a questionnaire proposed by the Ministry of Health, which addressed sociodemographic characteristics, risk factors for chronic noncommunicable diseases and issues related to mammographic and pap screening. Data were analyzed using bivariate analysis, crude analysis with odds ratio (OR) and chi-squared test using Epi Info 3.5.1 program; multivariate analysis using logistic regression was performed using the software Statistica 7.1, with a significance level of 5% and a confidence interval of 95%. Results: The mean age of the women was 52.19 (±5.27) years. The majority (56.5%) had from 0 to 8 years of education. Additionally, 84.6% (n=266) of the women underwent pap smear and 74.3% (n=169) underwent mammography. The lower performance of pap smear test was associated with women with 9-11 years of education (p=0.01), and the lower performance of mammography was associated with women without private health insurance (p<0.01). Conclusion: The coverage of mammography and pap smear test was satisfactory among the women from Maringá, Paraná. Low education level and women who depended on the public health system presented lower performance of mammography.

Estrutura genética populacional de Lutjanus analis cioba e Lutjanus jocu dentão (Lutjanidae) ao longo do litoral brasileiro

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Estrutura populacional e potencial para o manejo de Bertholletia excelsa (Bonpl.) em castanhais nativos do Acre e Amapá.

Este estudo discute a estrutura populacional e o potencial para o manejo de castanhais em duas regiõesextremas da Amazônia (Acre e Amapá), avaliando a densidade de castanheiras, a distribuição diamétrica,e variáveis de copa. O diâmetro a 1,3 m do solo (DAP), a forma e posição da copa, presença de cipós nacopa estatusreprodutivo foram avaliados para cada árvore mapeada (DAP ≥ 10 cm) em parcelas perma-nentes de 9 ha. Foram inventariadas seis parcelas em cada Estado, totalizando 108 ha de amostragem. Adensidade e distribuição de indivíduos em classes de diâmetro foram determinadas por região (Alto Acreou Alto Cajari) e dentro de cada região. No total, foram mapeadas 610 castanheiras, sendo 124 no AltoAcre e 486 no Alto Cajari. A densidade de castanheiras nos castanhais do Alto Cajari foi quatro vezes maiorque no Alto Acre. Os castanhais do Alto Cajari apresentaram árvores com melhores características paraa produção, como forma e posição da copa, bem como menor ocorrência de cipós na copa das árvores.Em termos de estrutura populacional, o castanhal do Sororoca apresentou problemas recentes com a re-generação ou alteração na dinâmica da regeneração natural ao longo do tempo, talvez por ser uma áreade transição cerrado-floresta. Ambas regiões apresentaram castanhais com potencial para o manejo, comnecessidades específicas de tratos silviculturais que favoreçam o recrutamento de jovens no Sororoca(AP) e corte de cipós no Filipinas (AC).