Prevalência de sintomas do climatério em mulheres dos meios rural e urbano no Rio Grande do Norte, Brasil

OBJETIVO: avaliar a sintomatologia climatérica e fatores relacionados entre mulheres dos meios urbano e rural do Rio Grande do Norte. MÉTODOS: estudo transversal, descritivo, envolvendo casuística de 261 mulheres climatéricas residentes em Natal e Mossoró (grupo urbano; n=130) e Uruaçu, em São Gonçalo do Amarante (grupo rural; n=131). A sintomatologia climatérica foi avaliada pelo Índice Menopausal de Blatt-Kupperman (IMBK) e Escala Climatérica de Greene (ECG). A análise estatística constou de comparações das medianas dos escores entre os grupos e regressão logística. Definiram-se como "muito sintomáticas" as pacientes com escores >20, para ambos instrumentos (variável dependente). As variáveis independentes foram: idade, procedência, alfabetização, obesidade e prática de atividade física. RESULTADOS: o grupo urbano apresentou escores significativamente superiores ao grupo rural, tanto para o IMBK (medianas de 26,0 e 17,0, respectivamente; p<0,0001), quanto para a ECG (medianas de 27,0 e 16,0, respectivamente; p<0,0001). Na amostra total, evidenciou-se que 56,3% (n=147) das mulheres foram classificadas como "muito sintomáticas". Na comparação intergrupos, essa prevalência foi significativamente mais elevada nas mulheres urbanas em relação às rurais (79,2 e 33,6%, respectivamente; p<0,05). Pela análise de regressão logística, evidenciou-se que a chance de pertencer ao grupo definido como "muito sintomáticas" foi maior para mulheres do meio urbano [odds ratio ajustado (OR)=7,1; 95% intervalo de confiança a 95% (IC95%)=3,69-13,66] e alfabetizadas (OR=2,19; IC95%=1,16-4,13). A idade superior a 60 anos associou-se com menor chance de ocorrência de sintomas significativos (OR=0,38; IC95%=0,17-0,87). CONCLUSÕES: a prevalência de sintomas climatéricos significativos é menor em mulheres do meio rural, demonstrando que fatores socioculturais e ambientais estão fortemente relacionados ao surgimento dos sintomas climatéricos em nossa população.

Avaliação nutricional de gestantes sob acompanhamento em serviços de pré-natal distintos: a região metropolitana e o ambiente rural

Objetivo Verificar diferenças em alguns aspectos nutricionais de gestantes acompanhadas em serviço de atenção pré-natal em uma cidade do interior e na região metropolitana. Métodos Foram avaliadas gestantes em atendimento pré-natal na cidade de Belo Horizonte (BH), região metropolitana, e Paula Cândido (PC), interior de MG. Aplicou-se um Questionário de Frequência Alimentar (QFA) contendo informações socioeconômicas e sobre o hábito alimentar, além disso, foramaferidos peso e altura nomomento do atendimento e questionado o peso pré-gestacional, para posterior cálculo do IMC (índice de massa corpórea). A análise dos dados foi dividida por região e trimestre gestacional, utilizando o software SPSS versão 15.0, teste t para comparação de médias e qui-quadrado de independência, com 5% de significância. Resultados Foram incluídas 240 gestantes, sendo 90 do interior e 150 da região metropolitana. Destas, a maioria são casadas (BH = 56,6%; PC = 46,6%), não trabalham fora de casa (BH = 54,6%; PC = 84,4%), predominantemente se alimentam 3 a 4 vezes ao dia no 1° e 2° trimestre (BH = 54,0 e 46,0%; PC = 66,7 e 63,3%, respectivamente) e fazem 5 a 6 refeições ao dia no 3° trimestre em BH (44%). Houve ganho de peso significativo somente no 1° trimestre (BH: 58,0%; PC: 53,33%). Ganho de peso versus hábito alimentar foi significativo para as variáveis "almoça ou janta fora de casa," no 1° trimestre BH (p = 0,006); "quantas vezes consome leite," no 1° trimestre PC (p = 0,03); "quantas vezes consome fastfood," no 3° trimestre BH (p = 0,009). Conclusões As gestantes emambas regiões se alimentam de forma adequada, apesar da prevalência de sobrepeso pré-gestacional em BH e baixo nível de escolaridade e renda, principalmente no interior, indicador que pode ser pouco favorável à nutrição das gestantes neste período. Estudos de associação entre hábito alimentar e saúde do recém-nascido irão contribuir para maiores informações sobre a nutrição no período gestacional.

Evidence of hantavirus infection in wild rodents captured in a rural area of the state of São Paulo, Brazil

Hantaviruses are the etiological agents of the Hantavirus Cardio-Pulmonary Syndrome, a serious rodent-borne disease in Brazil. In order to investigate the occurrence of hantavirus infection in wild rodents, a survey was conducted in three different suburban areas of the municipality of Pedreira, State of São Paulo, Brazil. Of the 145 wild animals captured belonging to 12 different species identified by morphology and karyological analysis, 107 were rodents of the following species: Akodon montensis, Bolomys lasiurus, Calomys tener, Oligoryzomys nigripes, Oligoryzomys flavescens, and Myocastor coypus. Blood samples from these rodents were assayed for the presence of antibodies against hantavirus by IgG ELISA using Andes recombinant nucleocapsid antigen. Antibody reactive to Andes virus was found in two different species, O. nigripes and O. flavescens. These results indicate a potential risk for hantavirus transmission to humans in this area, where reservoir rodents are present in peridomestic settings.

Soroprevalência da infecção por Trypanosoma cruzi em cães de uma área rural do Estado de Mato Grosso do Sul

Doença de Chagas é uma antropozoonose causada por Trypanosoma cruzi que tem os cães como importante reservatório da doença na América do Sul. Este trabalho teve como objetivo avaliar a ocorrência da infecção natural pelo T. cruzi em cães de uma área rural do estado de Mato Grosso do Sul, Brasil. Foram utilizados os testes de imunofluorescência indireta (IFI) e ensaio imunossorvente ligado a enzima (ELISA) em 75 cães residentes na área. Foram detectados anticorpos em 45,3% (n=34) e 24,0% (n=18) nos testes de IFI e ELISA, respectivamente. A real prevalência da infecção foi confirmada como 22,7% (n=17) pelo critério de positividade em ambos os testes. Os resultados obtidos confirmam a infecção chagásica nos cães dessa região.

Organisational learning and knowledge acquisition. A case study of internationalising manufacturers of wood-based prefabricated buildings

The study investigates organisational learning and knowledge acquisition of wood-based prefabricated building manufacturers. This certain group of case companies was chosen, because their management and their employees generally have a strong manufacturing and engineering background, while the housing sector is characterised by national norms, regulations, as well as local building styles. Considering this setting, it was investigated, how the case companies develop organisational learning capabilities, acquire and transfer knowledge for their internationalisation. The theoretical framework of this study constitutes the knowledge-based conceptualisation of internationalisation, which combines the traditional internationalisation process, as well as the international new venture perspective based on their commonalities in the knowledge-based view of the firm. Different theories of internationalisation, including the network-perspective, were outlined and a framework on organisational learning and knowledge acquisition was established. The empirical research followed a qualitative approach, deploying a multiple-case study with five case companies from Austria, Finland and Germany. In the study, the development of the wood-based prefabricated building industry and of the case companies are described, and the motives, facilitators and challenges for foreign expansion, as well as the companies’ internationalisation approaches are compared. Different methods of how companies facilitate the knowledge-exchange or learn about new markets are also outlined. Experience, market knowledge and personal contacts are considered essential for the internationalisation process. The major finding of the study is that it is not necessary to acquire the market knowledge internally in a slow process as proposed by the Uppsala model. In four cases companies engaged knowledge in symbiotic relations with local business partners. Thereby, the building manufacturers contribute their design and production capabilities, and in return, their local partners provide them with knowledge about the market and local regulations; while they manage the sales and construction operations. Thus, the study provides strong evidence for the propositions of network perspective. One case company developed the knowledge internally in a gradual process: it entered the market sequentially with several business lines, showing an increasing level of complexity. In both of the observed strategies, single-loop and double-loop learning processes occurred.

Exploring Customer-Oriented Service Offerings in Public Health: Developing Integrated Health Care Services for Rural Areas

Väestön ikääntyminen pakottaa yhteiskunnan ja julkisen terveydenhuollon muutoksiin. Jotta ikääntyvien ihmisten kotona asuminen voidaan mahdollistaa, palvelujärjestelmän pitää mukautua muuttuvaan tilanteeseen. Tämän diplomityön tarkoituksena on tunnistaa asiakaslähtöisiä lähellä asiakasta tarjottavia palvelukokonaisuuksia. Tutkimuksen teoreettinen viitekehys muodostuu asiakasarvon luomisesta ja palvelutarjoamista. Tarkasteluryhmänä on Etelä-Karjalan alueen 60–90-vuotiaat ja käytetty aineisto on kerätty vastaajilta postitse lähetetyllä kyselyllä. Tutkimus on eksploratiivinen ja tulosten tulkinnassa on hyödynnetty määrällisen tutkimuksen ja verkostoanalyysin menetelmiä. Työn keskeisimmät tulokset ovat tunnistetut asiakassegmentit ja heidän tarpeidensa pohjalta muodostetut palvelupaketit. Tulokset indikoivat asiakkaiden tarpeita ja tuloksia on analysoitu myös tuottajan näkökulmasta. Empiiristen tulosten lisäksi teoriaviitekehystä on kehitetty eteenpäin, jotta palvelukeskeiset teoriat voidaan ymmärtää yritysten näkökulman lisäksi asiakkaan näkökulmasta.

Petri Net approach for modelling system integration in intelligent buildings

In this paper, a Petri Net approach is introduced for modelling and simulation of control strategies in Intelligent Building. In this context, it is claimed that integration with other building systems can be achieved in a more systematic way considering a mechatronic approach (i.e. multidisciplinary concepts applied to the development of systems). The case study is the Ambulatory Building of Medical School Hospital of University of São Paulo. Particularly, the developed methodology is applied to the elevator system and to the HVAC (Heating, Ventilation and Air Conditioning) system. It is shown that using this approach, the control systems could be integrated, improving performance.

Mobile clinics in public health care: Integrated service offerings for rural elderly

This research is an analysis of the value and content of local service offerings that enable longer periods of living at home for elderly people. Mobile health care and new distribution services have provided an interesting solution in this context. The research aim to shed light on the research question, ‘How do we bundle services based on different customer needs?’ A research process consisting of three main phases was applied for this purpose. During this process, elderly customers were segmented, the importance of services was rated and service offerings were defined. Value creation and service offering provides theoretical framework for the research. The target group is South Karelia’s 60 to 90-year old individuals and the data has been acquired via a postal questionnaire. Research has been conducted as exploratory research utilizing the methods of quantitative and social network analysis. The main results of the report are identified customer segments and service packages that fits to the segments’ needs. The results indicate the needs of customers and the results are additionally analysed from the producer’s point of view. In addition to the empirical results, the used theory framework has been developed further in order for the service-related theories to be seen from the customer’s point of view and not just from the producer’s point of view.

Long-term efficacy of a rural community-based integrated intervention for prevention and management of chronic obstructive pulmonary disease: a cluster randomized controlled trial in China's rural areas

This study aimed to assess the efficacy of a rural community-based integrated intervention for early prevention and management of chronic obstructive pulmonary disease (COPD) in China. This 18-year cluster-randomized controlled trial encompassing 15 villages included 1008 patients (454 men and 40 women in the intervention group [mean age, 54 ± 10 years]; 482 men and 32 women in the control group [mean age, 53 ± 10 years]) with confirmed COPD or at risk for COPD. Villages were randomly assigned to the intervention or the control group, and study participants residing within the villages received treatment accordingly. Intervention group patients took part in a program that included systematic health education, smoking cessation counseling, and education on management of COPD. Control group patients received usual care. The groups were compared after 18 years regarding the incidence of COPD, decline in lung function, and mortality of COPD. COPD incidence was lower in the intervention group than in the control group (10% vs 16%, <0.05). A decline in lung function was also significantly delayed in the intervention group compared to the control group of COPD and high-risk patients. The intervention group showed significant improvement in smoking cessation compared with the control group, and smokers in the intervention group had lower smoking indices than in the control group (350 vs 450, <0.05). The intervention group also had a significantly lower cumulative COPD-related death rate than the control group (37% vs 47%, <0.05). A rural community-based integrated intervention is effective in reducing the incidence of COPD among those at risk, delaying a decline in lung function in COPD patients and those at risk, and reducing mortality of COPD.

Identificação de antocianidinas em acerolas do Banco Ativo de Germoplasma da Universidade Federal Rural de Pernambuco

As antocianinas, pigmentos responsáveis pela cor vermelha da acerola madura, foram extraídas e purificadas de 12 genótipos cultivados no Banco Ativo de Germoplasma da Universidade Federal Rural de Pernambuco, com o objetivo de determinar a sua composição. As antocianinas e suas respectivas agliconas, obtidas pela hidrólise ácida, foram separadas por cromatografia líquida de alta eficiência (CLAE) usando uma coluna de fase reversa (C18). A identificação foi realizada pela ordem de eluição e pelos tempos de retenção dos padrões de referência e das antocianidinas obtidas por hidrólise ácida de uvas Isabel, Patrícia e Red Globe, ameixa, cebola roxa, morango e da casca de manga Tommy Atkins. Os cromatogramas obtidos demonstraram que o perfil antociânico dos genótipos de acerola é relativamente simples, apresentando de três a cinco picos comuns entre eles. Após hidrólise ácida foram obtidas somente duas agliconas identificadas como cianidina e pelargonidina. Comparando os cromatogramas das antocianinas e das antocianidinas e, avaliando os tempos de retenção, foi constatada a presença de antocianinas com diferentes graus de glicosilação e ausência de ácidos acilados em suas moléculas e que as agliconas identificadas, cianidina e pelargonidina, encontravam-se em diferentes proporções nos genótipos estudados.

Food access and consumption in a rural settlement in Castanhal, PA, Brazil

Abstract The study aimed to assess the food accessibility and consumption among families in the Cupiúba rural settlement, in the city of Castanhal, Pará, Brazil. It was found that the access to food is worrying and indicated that most families are in food insecurity conditions. Moreover, income and food safety level were associated. The consumption of the settler families comprises mainly high-energy, low-nutrient content foods, characterized by the low intake of fruits and vegetables and the introduction of processed foods with high energy density and sugar-added beverages, although the traditional dietary habits (rice and beans) are still present. This configures a diet at risk for important nutritional deficits, obesity, and many non-communicable chronic diseases.