Resistência da artéria carótida e autônima funcional em mulheres idosas

High carotid artery resistance indices in the elderly arise mainly as a result of harmful daily lifestyle behavior and poor eating habits. The aim of this multidisciplinary study was to assess and correlate carotid artery resistance and functional autonomy in elderly women. A descriptive, exploratory cross-sectional study was conducted with a sample comprising 27 women, enrolled in pastoral programs in the city of Teresina, Brazil. Carotid artery resistance was assessed by a high-resolution Doppler ultrasound device and functional autonomy was evaluated through five protocol tests of the Latin American Development Group for the Elderly (GDLAM), simulating activities of daily life. The data were analyzed by the Shapiro-Wilk test and the correlation by Spearman s test, considering a p-value of <0.05. The sample consisted of women with mean age and standard deviation of (68.67 ± 4.52) years, respectively and carotid resistance index of (0.71 ± 0.07). The general index value of functional autonomy classified the elderly of the study group as weak in the performance of activities of daily living (30.46 ± 6.31). The general index of functional autonomy showed a high level of sedentary behavior in the group studied (p < 0.01). The sample was classified as weak in the performance of activities of daily life. The correlation coefficient between the carotid resistance index and the general GDLAM index was r = 0.998 and p = 0.000, showing a significant correlation. The elderly women assessed had a high carotid artery resistance index and low functional autonomy; a positive correlation was found between the dependent variables studied. To perform this study we formed a team composed of a nurse, who helped in organizing the sample and performing the examinations; a radiologist, who conducted the Doppler examinations; an angiologist, who collaborated in interpreting examination data; in addition to two physical education professors and two physical therapists, who applied the functional autonomy tests and conducted the 34 research along elderly health lines, contributing thus to the multidisciplinary character, fundamental for carrying out the study

Análise de qualidade da atenção à criança na estratégia saúde da família: o óbito infantil evitável como referência

Alma-Ata declaration bring the Primary Attention to the Health (PAH) as first level of health attention for individuals, family and community, which considers infant group as priority. Several initiatives that gave bases to integral attention to the children health formalized in the principles of Unique Health System. Family Health Strategy (FHS) comes to strengthen this attention, instituting new ways of work organization and professional practices that gave impact in their quality indicators. One of them is children mortality, showing decline in their values. Though, studies indicates persistence of avoidable infant deaths. In Natal RN, this reality is also perceptible leading to inquietudes, mainly at the space of services production, it means, which motivated the accomplishment of the present study intending to analyse the way that the organizational and structural processes as long as the professional practices in FHS interfered in the quality of children s health attention who died by avoidable death in the year of 2007 in municipal district of Natal-RN. It treats, therefore, to an exploratory and descriptive survey of cases study type, thar had as primary sources the oficial documents of MH, the family prontuary, pregnant card, child card and testimony obt ined from instrument of research elaborated based in investigation form of infant death by MH, applied to 10 mothers of children who had avoidable death. In analysis it was appealed silmultaneous triangulation of methods and sources, allowing a bigger aproximation from obtained informations. To elucidate the cases, the aspects studied were analyzed to the light of explicative model of Social Determinants of Health. Among individual and family aspects were highlighted the related to age, schooling, family habits and customs and mother s economic condition, besides of pregnancy age, newborn weight and associated diseases, which don t differ from literature about the theme. Reffering to the factors organizational and structural processes and professionals practice, highlihgted, the treatment given by the professionals, the territorialization and adscription of areas, the difficulty of having access to the services or sleepers and the reference and counterreference. But also, the ausence or few greet, the lack of communication, few assiduity and ponctuality by professionals in service, among others. In a general way mothers considers the attendance received in the hospital good and very good , opnions that in the Basic Attention weren t so favorable, in spite of many of predictible actions in this level have been performed in the studied cases. It is observed, therefore, that the social determinants of health has a strong influence in ocurrence of infant deaths, what implicates in a large actuation by Infant Mortality Committee from municipal district. This way, it becomes fundamental the reflection and evaluation about the effectiveness and execution by the processes of vigilance to health in FHUs; the rethink about the social determinants of health in a wide and articulate way to the services quality, to permanent education, to management in service, to the given attention and to the way how it is installed the popular participation and social control. To the professionals it is presented the great challenge to review their daily practice, their values, behaviors and commitment, which ones must be guided by logical of sharing, work in team, humanescence and alterity, not only by the accomplishment of a professional duty

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Condições dos treinamentos de ginastas brasileiras participantes de jogos olímpicos (1980-2004)

Este artigo tem como objetivo registrar e analisar as condições de infraestrutura dos treinamentos de ginastas brasileiras participantes de Jogos Olímpicos (1980-2004), na busca de reflexões para a modalidade de Ginástica Artística Feminina. Para tal, foi desenvolvida uma pesquisa qualitativa, que se utilizou do método de História Oral. A partir de uma análise cruzada dos depoimentos das dez ginastas colaboradoras desta pesquisa foi possível perceber que houve um aperfeiçoamento nas condições de infraestrutura a partir do início da década de 90. Este aperfeiçoamento é novamente impulsionado no final da década de 90, com a contratação de técnicos ucranianos, o estabelecimento de uma seleção brasileira permanente e investimentos nas condições de infraestrutura de equipamentos e ginásio. Porém mesmo com a transformação positiva da modalidade nos últimos anos, todas as ginastas do estudo relataram ter passado, em algum momento, por condições não adequadas de treinamento relativas às condições de infraestrutura.

Correlation between balance and the level of functional independence among elderly people

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The workload and plasma ion concentration in a training match session of high-goal (elite) polo ponies

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Functional and esthetic rehabilitation with In-Ceram alumina and zirconia system: A multidisciplinary approach

The development of all-ceramic systems following metalceramics restorations allowed simulation of natural dentition due to favorable esthetics and resistance. In-Ceram is an alternative when esthetics is primordial as well as resistance required in rehabilitation. However, an ideal smile is associated to not only shape, color, texture and translucency but also harmony with gingival tissue. So, the aim of this study is to report a clinical case based on periodontal and fixed partial dentures principles to perform periodontal plastic surgery followed by esthetic rehabilitation. A female patient, 40-year-old, presented complaint about dental esthetics. After clinical and radiographic exams, metal-ceramics crowns (teeth 11, 12, 13, 21, 22 and 23) were considered unsatisfactory due to marginal leakage, color change in gingival tissue associated to metallic margin, and gummy smile. So, a crown lengthening surgery of anterior teeth was performed followed by rehabilitation of superior teeth with In-Ceram single crowns. Clinical significance: The interaction between periodontics and fixed prosthodontic area is the key of an adequated treatment planning which involves gingival smile to provide function and an esthetic condition in association with an esthetic, resistant and predictable material.

Acute Phase Responses of Different Positions of High-Goal (Elite) Polo Ponies

The aim of this study was to investigate the acute phase response (APR) in 15 horses by quantifying physiological venous blood variables and serum acute phase proteins (APP) at 5 minutes and 6 and 12 hours after a training match of high-goal polo. The horses were divided into three experimental groups based on their team positions, including defense (n = 6), midfield (n = 5), and attack (n = 4). Serum proteinograms were obtained by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Data were evaluated using analysis of variance for repeated measures. The match represented a high-intensity stimulus for all positions. Defenders appeared to use the anaerobic pathway more than the other positions, as shown by their lower pH and greater lactatemia. Alterations in muscle membrane permeability were observed in all horses, as seen by the increase in serum creatine kinase activity without a correlation with APR. Significant elevations in total serum protein, albumin, ceruloplasmin, haptoglobin, alpha-1 antitrypsin, and 23-kDa protein were seen only during the course of the physical exertion of the match, although there were no differences in these values among positions of the team. After 6 hours of the match, the concentration of transferrin declined, whereas that of alpha-1 acid glycoprotein remained unaltered at all assessed times. These results demonstrated that the defenders required the most use of the anaerobic pathway during the match, and that equestrian polo exercise triggers an acute phase response of relatively short duration; this APR is characterized as noninflammatory, as APR appears to be a physiological alteration related to the stress inherent in physical exercise. © 2013 Elsevier Inc. All rights reserved.

Assessment of the damage caused by flood rains and landslides in association with hurricane Michelle, october 2001: implications for economic, social and environmental development

Preface This study was prepared for the Government of Jamaica following the significant physical damage and economic losses that the country sustained as a result of flood rains associated with the development of Hurricane Michelle. The Planning Institute of Jamaica (PIOJ) submitted a request for assistance in undertaking a social, environmental and economic impact assessment to the Economic Commission for Latin America and the Caribbean (ECLAC) on 14 November 2001. ECLAC responded with haste and modified its work plan to accommodate the request. A request for training in the use of the ECLAC Methodology to be delivered to personnel in Jamaica was deferred until the first quarter of 2002, as it was impossible to mount such an initiative at such short notice. This appraisal considers the consequences of the three instances of heavy rainfall that brought on the severe flooding and loss of property and livelihoods. The study was prepared by three members of the ECLAC Natural Disaster Damage Assessment Team over a period of one week in order to comply with the request that it be presented to the Prime Minister on 3 December 2001. The team has endeavoured to complete a workload that would take two weeks with a team of 15 members working assiduously with data already prepared in preliminary form by the national emergency stakeholders. There is need for training in disaster assessment as evidenced by the data collected by the Jamaican officials engaged in the exercise. Their efforts in the future will be more focused and productive after they have received training in the use of the ECLAC Methodology. This study undertakes a sectoral analysis leading to an overall assessment of the damage. It appraises the macroeconomic and social effects and proposes some guidelines for action including mitigating actions subsequent to the devastation caused by the weather system. The team is grateful for the efforts of the Office of Disaster Preparedness and Emergency Management (ODPEM), the associated government ministries and agencies, the Statistical Institute of Jamaica (STATIN), the Planning Institute of Jamaica and the Inter American Development Bank (IDB) for assistance rendered to the team. Indeed, it is the recommendation of the team that STATIN is poised to play a pivotal role in any disaster damage assessment and should be taken on board in that regard. The direct and indirect damages have been assessed in accordance with the methodology developed by ECLAC (1). The results presented are based on the mission's estimates. The study incorporates the information made available to the team and evidence collected in interviews and visits to affected locations. It is estimated that the magnitude of the losses exceeds the country's capacity to address reparations and mitigation without serious dislocation of its development trajectory. The government may wish to approach the international community for assistance in this regard. This appraisal is therefore designed to provide the government and the international community with guidelines for setting national and regional priorities in rehabilitation and reconstruction or resettlement programmes. A purely economic conception of the problem would be limited. A more integrated approach would have a human face and consider the alleviation of human suffering in the affected areas while attending to the economic and fiscal fallout of the disaster. Questions of improved physical planning, watershed management, early warning, emergency response and structural preparedness for evacuation and sheltering the vulnerable population are seen as important considerations for the post disaster phase. Special attention and priority should be placed on including sustainability and increased governance criteria in making social and productive investments, and on allocating resources to the reinforcing and retrofitting of vulnerable infrastructure, basic lifelines and services as part of the reconstruction and rehabilitation strategy. The Jamaican society and government face the opportunity of undertaking action with the benefit of revised paradigms, embarking on institutional, legal and structural reforms to reduce economic, social and environmental vulnerability. The history of flood devastation in the very areas of Portland and St. Mary shows a recurrence of flooding. Accounts of flooding from the earliest recorded accounts pertaining to 1837 are available. Recurrences in 1937, 1940, 1943 and 2001 indicate an ever-present probability of recurrence of similar events. The Government may wish to consider the probable consequences of a part of its population living in flood plains and address its position vis-à­¶is land use and the probability of yet another recurrence of flood rains. (1) ECLAC/IDNDR, Manual for estimating the Socio-Economic Effects of Natural Disasters, May,1999.

Instrumentação biomecânica aplicada à análise do desempenho do chute em jogadores de futebol de campo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Trabalho, códigos, gratidão e reciprocidade na prisão: um estudo de caso na Penitenciária Estadual de Parnamirim, no Estado do Rio Grande do Norte

O objetivo principal deste trabalho é analisar os sentidos que o trabalho assume no contexto prisional, tendo como referência a Penitenciária Estadual de Parnamirim, localizada no Estado do Rio Grande do Norte. Essa penitenciária foi criada para ser um modelo de ressocialização, nos moldes préfigurados na Lei de Execuções Penais. A PEP configura-se como um universo heterogêneo, marcado por contradições e conflitos intersubjetivos das mais variadas ordens, cuja resolução se dá com base nos códigos normativos informais que regem as relações constituídas entre os reclusos, e entre estes e a equipe dirigente. No seu cotidiano encontramos relações de poder, fundadas em uma racionalidade instrumental, mas também encontramos relações sentimentais, assentadas em laços de afetividade, gratidão e reciprocidade. Para abordar os sentidos que o trabalho assume na PEP, realizamos uma breve incursão no processo de constituição da penitenciária na sociedade moderna, sem maior aprofundamento sobre este ponto, pois nessa incursão o nosso objetivo é o de situar o leitor em relação às raízes, a concepção e aos propósitos almejados pela moderna penitenciária. No mesmo sentido elaboramos um retrato do colapso em que se encontra o sistema penitenciário brasileiro para, em seguida, enveredarmos pelo sistema penitenciário do Estado do Rio Grande do Norte para, enfim, aportarmos na PEP a fim de investigar a dinâmica da combinação que permite a instituição dos lugares sociais, a definição de identidades e a vivência dos valores relativos à normalidade e à transgressão do comportamento.

A implantação do plano de ações articuladas em São Sebastião da Boa Vista – PA: ações concretas ou pressupostos para o regime de colaboração?

O presente trabalho teve origem na realização de pesquisa desenvolvida pela equipe do Instituto de Ciências da Educação da Universidade Federal do Pará que analisou o processo de elaboração, implantação e implementação do Plano de Ações Articuladas (PAR) no estado do Pará, no período de 2008 a 2011. Esta Dissertação teve por objetivo analisar o PAR desenvolvido no Município de São Sebastião da Boa Vista e a sua configuração como instrumento para implementar o Regime de Colaboração entre os entes federados. Trata-se de um estudo de caso de caráter qualitativo que contou com trabalho de campo, com realização de entrevistas com os atores envolvidos em todo o processo de implantação do PAR. O estudo também contou com a análise das legislações (Constituição Federal 1988, LDB/9.394, Plano Nacional de Educação, PDE, Plano de Metas Compromisso Todos pela Educação, entre outras). A revisão bibliográfica realizada partiu das contribuições de estudiosos sobre a política educacional brasileira, como Carlos Roberto Jamil Cury, Luiz Fernandes Dourado, Fernando Haddad, José Carlos Libâneo e Demerval Saviani. A partir dos resultados encontrados, observamos que o PAR é um valioso instrumento para organização da gestão da educação municipal, que permite o ente federado conhecer a sua realidade, e também auxilia o Município ao sinalizar suas necessidades e propor ações e subações para mudar sua realidade. No entanto, a execução do Plano depende de fatores alheios para que o município atinja a execução total do que foi planejado, em muitas ações é necessário um aporte financeiro específico. Diante dos resultados dessa pesquisa também foi possível observar que o PAR desenvolvido no Município de São Sebastião da Boa Vista, representou uma inovação no planejamento do trabalho da Secretaria Municipal de Educação, se constituiu em um complexo desafio em termos de sua efetivação, pois revelou a fragilidade de articulação e de cumprimento das metas, e da efetividade de um legítimo regime de colaboração entre os entes federados.

Caracterização do perfil dos pacientes em oxigenoterapia domiciliar em uma cidade do interior do estado de São Paulo

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Structural and functional characterization of the chaperone Hsp70 from sugarcane. Insights into conformational changes during cycling from cross-linking/mass spectrometry assays

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)