Quedas em idosos assistidos na estratégia saúde da família: frequência e fatores associados

The growth of the elderly population is a global phenomenon and, in Brazil, this transformation is happening in a very rapid rhythm. With the current population aging, this emerging age group will need more health care and attention. One of the characteristics of the population aging is the progressive accumulation of disabilities, which makes it more vulnerable to falls. This study was developed with the purpose of knowing the episode falls in the scope of an elderly population treated at a Family Health Unit. It is a research with cross-sectional nature, and its sample was composed by 121 elderly. The research was approved by the Ethics Committee of HUOL, with Opinion nº 816.022. We applied a questionnaire to the participants, and the results were statistically analyzed by using Chi-square test and Fisher’s exact test to verify the association between variables. In order to perform a multivariate analysis, we used the method of the Binomial Logistic Regression. For both tests, we accepted significance p<0,05 and CI of 95%. The results prove that the majority belongs to the female gender (76,9%); the age group of elderly reaches 88,4% and 11,6% is over-aged; regarding the marital status, 35,3% are married and 29,4% widowed; 92,1% with family income between one and two minimum wages; and 91,8% live with their partners and/or children. Regarding the frequency of falls, we found that 61,2% of the surveyed elderly suffered one or more falls in 2014. As associated factors, it became clear that 73,8% were due to extrinsic factors, 6,4% to intrinsic factors and 21,4% to both factors. As a consequence of the fall, we found that 89,2% have fear of falling again, 37,3% showed anxiety and 13,3% had their ambulation affected. Concerning the exposure to the risk factors, the most prevalent places were: street/avenue (31,0%), pavement (19,0%), living room (14,3%) and courtyard/backyard (10,7%). The study has proven a statistically significant association among female gender (p=0,001), rubble/objects in the backyard (p=0,015) and furniture that may cause accidents (p=0,005). It was evident among the elderly people surveyed, 72.7% receive little information about falls, being a risk factor for falls. We conclude that there is a high frequency of falls in the surveyed elderly, thereby constituting a worrisome data because this event in the elderly population is a serious matter, which raises the need to ensure them a safe environment in their homes and, above all, outside them. The information provided by the Family Health Strategy team are important to avoid these occurrences, which reinforces the need for developing health education activities together with the population as a way to prevent and reduce the occurrence of falls, thereby improving the quality of life of elderly.

An evaluation of home range models for marine fish tracking and fine scale habitat use and movement patterns of age 1 Greenland cod (Gadus macrocephalus ogac)

My thesis examines fine-scale habitat use and movement patterns of age 1 Greenland cod (Gadus macrocephalus ogac) tracked using acoustic telemetry. Recent advances in tracking technologies such as GPS and acoustic telemetry have led to increasingly large and detailed datasets that present new opportunities for researchers to address fine-scale ecological questions regarding animal movement and spatial distribution. There is a growing demand for home range models that will not only work with massive quantities of autocorrelated data, but that can also exploit the added detail inherent in these high-resolution datasets. Most published home range studies use radio-telemetry or satellite data from terrestrial mammals or avian species, and most studies that evaluate the relative performance of home range models use simulated data. In Chapter 2, I used actual field-collected data from age-1 Greenland cod tracked with acoustic telemetry to evaluate the accuracy and precision of six home range models: minimum convex polygons, kernel densities with plug-in bandwidth selection and the reference bandwidth, adaptive local convex hulls, Brownian bridges, and dynamic Brownian bridges. I then applied the most appropriate model to two years (2010-2012) of tracking data collected from 82 tagged Greenland cod tracked in Newman Sound, Newfoundland, Canada, to determine diel and seasonal differences in habitat use and movement patterns (Chapter 3). Little is known of juvenile cod ecology, so resolving these relationships will provide valuable insight into activity patterns, habitat use, and predator-prey dynamics, while filling a knowledge gap regarding the use of space by age 1 Greenland cod in a coastal nursery habitat. By doing so, my thesis demonstrates an appropriate technique for modelling the spatial use of fish from acoustic telemetry data that can be applied to high-resolution, high-frequency tracking datasets collected from mobile organisms in any environment.

IRAS 00183-7111: ALMA and X-ray view of an ultra luminous infrared galaxy

The aim of this Thesis work is to study the multi-frequency properties of the Ultra Luminous Infrared Galaxy (ULIRG) IRAS 00183-7111 (I00183) at z = 0.327, connecting ALMA sub-mm/mm observations with those at high energies in order to place constraints on the properties of its central power source and verify whether the gas traced by the CO may be responsible for the obscuration observed in X-rays. I00183 was selected from the so-called Spoon diagnostic diagram (Spoon et al. 2007) for mid-infrared spectra of infrared galaxies based on the equivalent width of the 6.2 μm Polycyclic Aromatic Hydrocarbon (PAH) emission feature versus the 9.7 μm silicate strength. Such features are a powerful tool to investigate the contribution of star formation and AGN activity in this class of objects. I00183 was selected from the top-left region of the plot where the most obscured sources, characterized by a strong Si absorption feature, are located. To link the sub-mm/mm to the X-ray properties of I00183, ALMA archival Cycle 0 data in Band 3 (87 GHz) and Band 6 (270 GHz) have been calibrated and analyzed, using CASA software. ALMA Cycle 0 was the Early Science program for which data reprocessing is strongly suggested. The main work of this Thesis consisted in reprocessing raw data to provide an improvement with respect to the available archival products and results, which were obtained using standard procedures. The high-energy data consists of Chandra, XMM-Newton and NuSTAR observations which provide a broad coverage of the spectrum in the energy range 0.5 − 30 keV. Chandra and XMM archival data were used, with an exposure time of 22 and 22.2 ks, respectively; their reduction was carried out using CIAO and SAS software. The 100 ks NuSTAR are still private and the spectra were obtained by courtesy of the PI (K. Iwasawa). A detailed spectral analysis was done using XSPEC software; the spectral shape was reproduced starting from simple phenomenological models, and then more physical models were introduced to account for the complex mechanisms that involve this source. In Chapter 1, an overview of the scientific background is discussed, with a focus on the target, I00183, and the Spoon diagnostic diagram, from which it was originally selected. In Chapter 2, the basic principles of interferometry are briefly introduced, with a description of the calibration theory applied to interferometric observations. In Chapter 3, ALMA and its capabilities, both current and future, are shown, explaining also the complex structure of the ALMA archive. In Chapter 4, the calibration of ALMA data is presented and discussed, showing also the obtained imaging products. In Chapter 5, the analysis and discussion of the main results obtained from ALMA data is presented. In Chapter 6, the X-ray observations, data reduction and spectral analysis are reported, with a brief introduction to the basic principle of X-ray astronomy and the instruments from which the observations were carried out. Finally, the overall work is summarized, with particular emphasis on the main obtained results and the possible future perspectives.

(Table 1) Age determination of composite sediment record LO09-14

A sediment core from Reykjanes Ridge has been studied at 10- to 50-year time resolution to document variability of Holocene surface water conditions in the western North Atlantic and to evaluate effects of Holocene ice-rafting episodes. Diatom assemblages are converted to quantitative sea surface temperatures (SST) using three different transfer functions. Spectral and scale-space methods are also applied on the records to explore variability at different timescales. Diatom assemblage and SST records clearly show that decaying remnants of the Laurentide ice sheet strongly influenced early Holocene climate in the western North Atlantic. This overrode the predominance of Milankovitch forcing, which played a key role in the development of Holocene climate in the eastern North Atlantic and Nordic Seas. Superimposed on general Holocene climate change is high-frequency SST variability on the order of 1°-3°C. The record also documents climatic oscillations with 600- to 1000-, ~1500-, and 2500-year periodicities, with a time-dependent dominance of different periodicities through the Holocene; a clear change in variability occurred about 5 ka BP. The SST record also provides evidence for Holocene cooling events (HCE) that, in some cases, correlate to documented southward intrusions of ice into the North Atlantic.

Morfometria dos forames mandibular, mentual e infraorbital de Lobo-guará Chrysocyon brachyurus, Illiger, 1815 aplicada a bloqueios anestésicos

CHAPTER II - The Chrysocyon brachyurus is the biggest South American canid which has a high frequency of dental injuries, both in wild and captivity. Thus, veterinary procedures are necessary to preserve the feeding capacity of hundreds of captive specimens worldwide. The aim of this study was to study the mandibular morphometry of maned wolf with emphasis on the establishment of anatomic references to the anesthetic blockage of the inferior alveolar and mental nerves. Therefore, 15 measurements in 22 hemimandibles of C. brachyurus adults were taken. For extra-oral technique of blockage of the inferior alveolar nerve at the level of the mandibular foramen, it is stated that the needle should be advanced, close to the medial surface of the mandibular ramus, by 11.4 mm perpendiculary from the palpable concavity. Alternatively, the needle can be introduced for 30.4 mm from the angular process at 20-25 degrees angle with the ventral margin. For blocking only the mentual nerve, it is recommended the introduction of needle for 10 mm, close to the lateral aspect of the mandibular body, at the level of the lower first premolar. The mandibular foramen showed similars position, size and symmetry in the maned wolfs specimens examined. The comparison of the data with those available for other carnivores reflects the necessity for determining these anatomical references specifically for each species.

Generation of harmonic oscillations in ring resonator with high Q-factor

We report on generation of harmonic oscillations with frequencies of hundreds of MHz and radio-frequency linewidth of 13 Hz in unidirectional ring laser oscillator. This high stability makes these oscillators a suitable substitute for existing quartz resonators used in high frequency optoelectronics applications.

Identifying the Structure and Fate of Wastewater Derived Organic Micropollutants by High-resolution Mass Spectrometry

Human activities represent a significant burden on the global water cycle, with large and increasing demands placed on limited water resources by manufacturing, energy production and domestic water use. In addition to changing the quantity of available water resources, human activities lead to changes in water quality by introducing a large and often poorly-characterized array of chemical pollutants, which may negatively impact biodiversity in aquatic ecosystems, leading to impairment of valuable ecosystem functions and services. Domestic and industrial wastewaters represent a significant source of pollution to the aquatic environment due to inadequate or incomplete removal of chemicals introduced into waters by human activities. Currently, incomplete chemical characterization of treated wastewaters limits comprehensive risk assessment of this ubiquitous impact to water. In particular, a significant fraction of the organic chemical composition of treated industrial and domestic wastewaters remains uncharacterized at the molecular level. Efforts aimed at reducing the impacts of water pollution on aquatic ecosystems critically require knowledge of the composition of wastewaters to develop interventions capable of protecting our precious natural water resources.

The goal of this dissertation was to develop a robust, extensible and high-throughput framework for the comprehensive characterization of organic micropollutants in wastewaters by high-resolution accurate-mass mass spectrometry. High-resolution mass spectrometry provides the most powerful analytical technique available for assessing the occurrence and fate of organic pollutants in the water cycle. However, significant limitations in data processing, analysis and interpretation have limited this technique in achieving comprehensive characterization of organic pollutants occurring in natural and built environments. My work aimed to address these challenges by development of automated workflows for the structural characterization of organic pollutants in wastewater and wastewater impacted environments by high-resolution mass spectrometry, and to apply these methods in combination with novel data handling routines to conduct detailed fate studies of wastewater-derived organic micropollutants in the aquatic environment.

In Chapter 2, chemoinformatic tools were implemented along with novel non-targeted mass spectrometric analytical methods to characterize, map, and explore an environmentally-relevant “chemical space” in municipal wastewater. This was accomplished by characterizing the molecular composition of known wastewater-derived organic pollutants and substances that are prioritized as potential wastewater contaminants, using these databases to evaluate the pollutant-likeness of structures postulated for unknown organic compounds that I detected in wastewater extracts using high-resolution mass spectrometry approaches. Results showed that application of multiple computational mass spectrometric tools to structural elucidation of unknown organic pollutants arising in wastewaters improved the efficiency and veracity of screening approaches based on high-resolution mass spectrometry. Furthermore, structural similarity searching was essential for prioritizing substances sharing structural features with known organic pollutants or industrial and consumer chemicals that could enter the environment through use or disposal.

I then applied this comprehensive methodological and computational non-targeted analysis workflow to micropollutant fate analysis in domestic wastewaters (Chapter 3), surface waters impacted by water reuse activities (Chapter 4) and effluents of wastewater treatment facilities receiving wastewater from oil and gas extraction activities (Chapter 5). In Chapter 3, I showed that application of chemometric tools aided in the prioritization of non-targeted compounds arising at various stages of conventional wastewater treatment by partitioning high dimensional data into rational chemical categories based on knowledge of organic chemical fate processes, resulting in the classification of organic micropollutants based on their occurrence and/or removal during treatment. Similarly, in Chapter 4, high-resolution sampling and broad-spectrum targeted and non-targeted chemical analysis were applied to assess the occurrence and fate of organic micropollutants in a water reuse application, wherein reclaimed wastewater was applied for irrigation of turf grass. Results showed that organic micropollutant composition of surface waters receiving runoff from wastewater irrigated areas appeared to be minimally impacted by wastewater-derived organic micropollutants. Finally, Chapter 5 presents results of the comprehensive organic chemical composition of oil and gas wastewaters treated for surface water discharge. Concurrent analysis of effluent samples by complementary, broad-spectrum analytical techniques, revealed that low-levels of hydrophobic organic contaminants, but elevated concentrations of polymeric surfactants, which may effect the fate and analysis of contaminants of concern in oil and gas wastewaters.

Taken together, my work represents significant progress in the characterization of polar organic chemical pollutants associated with wastewater-impacted environments by high-resolution mass spectrometry. Application of these comprehensive methods to examine micropollutant fate processes in wastewater treatment systems, water reuse environments, and water applications in oil/gas exploration yielded new insights into the factors that influence transport, transformation, and persistence of organic micropollutants in these systems across an unprecedented breadth of chemical space.

Quantitative Analysis of Kilohertz-Frequency Neurostimulation

Mainstream electrical stimulation therapies, e.g., spinal cord stimulation (SCS) and deep brain stimulation, use pulse trains that are delivered at rates no higher than 200 Hz. In recent years, stimulation of nerve fibers using kilohertz-frequency (KHF) signals has received increased attention due to the potential to penetrate deeper in the tissue and to the ability to block conduction of action potentials. As well, there are a growing number of clinical applications that use KHF waveforms, including transcutaneous electrical stimulation (TES) for overactive bladder and SCS for chronic pain. However, there is a lack of fundamental understanding of the mechanisms of action of KHF stimulation. The goal of this research was to analyze quantitatively KHF neurostimulation.

We implemented a multilayer volume conductor model of TES including dispersion and capacitive effects, and we validated the model with in vitro measurements in a phantom constructed from dispersive materials. We quantified the effects of frequency on the distribution of potentials and fiber excitation. We also quantified the effects of a novel transdermal amplitude modulated signal (TAMS) consisting of a non-zero offset sinusoidal carrier modulated by a square-pulse train. The model revealed that high-frequency signals generated larger potentials at depth than did low frequencies, but this did not translate into lower stimulation thresholds. Both TAMS and conventional rectangular pulses activated more superficial fibers in addition to the deeper, target fibers, and at no frequency did we observe an inversion of the strength-distance relationship. In addition, we performed in vivo experiments and applied direct stimulation to the sciatic nerve of cats and rats. We measured electromyogram and compound action potential activity evoked by pulses, TAMS and modified versions of TAMS in which we varied the amplitude of the carrier. Nerve fiber activation using TAMS showed no difference with respect to activation with conventional pulse for carrier frequencies of 20 kHz and higher, regardless the size of the carrier. Therefore, TAMS with carrier frequencies >20 kHz does not offer any advantage over conventional pulses, even with larger amplitudes of the carrier, and this has implications for design of waveforms for efficient and effective TES.

We developed a double cable model of a dorsal column (DC) fiber to quantify the responses of DC fibers to a novel KHF-SCS signal. We validated the model using in vivo recordings of the strength-duration relationship and the recovery cycle of single DC fibers. We coupled the fiber model to a model of SCS in human and applied the KHF-SCS signal to quantify thresholds for activation and conduction block for different fiber diameters at different locations in the DCs. Activation and block thresholds increased sharply as the fibers were placed deeper in the DCs, and decreased for larger diameter fibers. Activation thresholds were > 5 mA in all cases and up to five times higher than for conventional (~ 50 Hz) SCS. For fibers exhibiting persistent activation, the degree of synchronization of the firing activity to the KHF-SCS signal, as quantified using the vector strength, was low for a broad amplitude range, and the dissimilarity between the activities in pairs of fibers, as quantified using the spike time distance, was high and decreased for more closely positioned fibers. Conduction block thresholds were higher than 30 mA for all fiber diameters at any depth and well above the amplitudes used clinically (0.5 – 5 mA). KHF-SCS appears to activate few, large, superficial fibers, and the activated fibers fire asynchronously to the stimulation signal and to other activated fibers.

The outcomes of this work contribute to the understanding of KHF neurostimulation by establishing the importance of the tissue filtering properties on the distribution of potentials, assessing quantitatively the impact of KHF stimulation on nerve fiber excitation, and developing and validating a detailed model of a DC fiber to characterize the effects of KHF stimulation on DC axons. The results have implications for design of waveforms for efficient and effective nerve fiber stimulation in the peripheral and central nervous system.

Aerodynamic Testing of Variable Message Signs

The increasing nationwide interest in intelligent transportation systems (ITS) and the need for more efficient transportation have led to the expanding use of variable message sign (VMS) technology. VMS panels are substantially heavier than flat panel aluminum signs and have a larger depth (dimension parallel to the direction of traffic). The additional weight and depth can have a significant effect on the aerodynamic forces and inertial loads transmitted to the support structure. The wind induced drag forces and the response of VMS structures is not well understood. Minimum design requirements for VMS structures are contained in the American Association of State Highway Transportation Officials Standard Specification for Structural Support for Highway Signs, Luminaires, and Traffic Signals (AASHTO Specification). However the Specification does not take into account the prismatic geometry of VMS and the complex interaction of the applied aerodynamic forces to the support structure. In view of the lack of code guidance and the limited number research performed so far, targeted experimentation and large scale testing was conducted at the Florida International University (FIU) Wall of Wind (WOW) to provide reliable drag coefficients and investigate the aerodynamic instability of VMS. A comprehensive range of VMS geometries was tested in turbulence representative of the high frequency end of the spectrum in a simulated suburban atmospheric boundary layer. The mean normal, lateral and vertical lift force coefficients, in addition to the twisting moment coefficient and eccentricity ratio, were determined using the measured data for each model. Wind tunnel testing confirmed that drag on a prismatic VMS is smaller than the 1.7 suggested value in the current AASHTO Specification (2013). An alternative to the AASHTO Specification code value is presented in the form of a design matrix. Testing and analysis also indicated that vortex shedding oscillations and galloping instability could be significant for VMS signs with a large depth ratio attached to a structure with a low natural frequency. The effect of corner modification was investigated by testing models with chamfered and rounded corners. Results demonstrated an additional decrease in the drag coefficient but a possible Reynolds number dependency for the rounded corner configuration.

Near real time surface ocean velocity, Tyrrhenian Sea and Ligurian Sea in September 2016

The data set consists of maps of total velocity of the surface current in the North-Western Tyrrhenian Sea and Ligurian Sea averaged over a time interval of 1 hour around the cardinal hour. Surface ocean velocities estimated by HF Radar are representative of the upper 0.3-2.5 meters of the ocean. Total velocities are derived using least square fit that maps radial velocities measured from individual sites onto a cartesian grid. The final product is a map of the horizontal components of the ocean currents on a regular grid in the area of overlap of two or more radar stations.

(Table 1) Age determination of Chukchi Sea sediments

Dinocysts from cores collected in the Chukchi Sea from the shelf edge to the lower slope were used to reconstruct changes in sea surface conditions and sea ice cover using modern analogue techniques. Holocene sequences have been recovered in a down-slope core (B15: 2135 m, 75°44'N, sedimentation rate of ~1 cm/kyr) and in a shelf core (P1: 201 m, 73°41'N, sedimentation rate of ~22 cm/kyr). The shelf record spanning about 8000 years suggests high-frequency centennial oscillations of sea surface conditions and a significant reduction of the sea ice at circa 6000 and 2500 calendar (cal) years B.P. The condensed offshore record (B15) reveals an early postglacial optimum with minimum sea ice cover prior to 12,000 cal years B.P., which corresponds to a terrestrial climate optimum in Bering Sea area. Dinocyst data indicate extensive sea ice cover (>10 months/yr) from 12,000 to 6000 cal years B.P. followed by a general trend of decreasing sea ice and increasing sea surface salinity conditions, superimposed on large-amplitude millennial-scale oscillations. In contrast, d18O data in mesopelagic foraminifers (Neogloboquadrina pachyderma) and benthic foraminifers (Cibicides wuellerstorfi) reveal maximum subsurface temperature and thus maximum inflow of the North Atlantic water around 8000 cal years B.P., followed by a trend toward cooling of the subsurface to bottom water masses. Sea-surface to subsurface conditions estimated from dinocysts and d18O data in foraminifers thus suggest a decoupling between the surface water layer and the intermediate North Atlantic water mass with the existence of a sharp halocline and a reverse thermocline, especially before 6000 years B.P. The overall data and sea ice reconstructions from core B15 are consistent with strong sea ice convergence in the western Arctic during the early Holocene as suggested on the basis of climate model experiments including sea ice dynamics, matching a higher inflow rate of North Atlantic Water.

(Table 1) Stable oxygen and carbon isotopic ratios of tree rings, and tree ring width of white spruce (Picea glauca), Ennadai Lake

Stable isotope ratios from tree rings and peatland mosses have become important proxies of past climate variations. We here compare recent stable carbon and oxygen isotope ratios in cellulose of tree rings from white spruce (Picea glauca), growing near the arctic tree line; and cellulose of Sphagnum fuscum stems, growing in a hummock of a subarctic peatland, in west-central Canada. Results show that carbon isotopes in S. fuscum correlate significantly with July temperatures over the past ~20 yr. The oxygen isotopes correlate with both summer temperature and precipitation. Analyses of the tree-ring isotopes revealed summer temperatures to be the main controlling factor for carbon isotope variations, whereas tree-ring oxygen isotope ratios are controlled by a combination of spring temperatures and precipitation totals. We also explore the potential of combining high-frequency (annual) climate signals derived from long tree-ring series with low-frequency (decadal to centennial) climate signals derived from the moss remains in peat deposits. This cross-archive comparison revealed no association between the oxygen isotopes, which likely results from the varying sensitivity of the archives to different seasons. For the carbon isotopes, common variance could be achieved through adjustments of the Sphagnum age model within dating error.

Ocean acidification induces budding in larval sea urchins

Ocean acidification (OA), the reduction of ocean pH due to hydration of atmospheric CO2, is known to affect growth and survival of marine invertebrate larvae. Survival and transport of vulnerable planktonic larval stages play important roles in determining population dynamics and community structures in coastal ecosystems. Here, we show that larvae of the purple urchin, Strongylocentrotus purpuratus, underwent high-frequency budding (release of blastula-like particles) when exposed to elevated pCO2 level (>700 µatm). Budding was observed in >50 % of the population and was synchronized over short periods of time (~24 h), suggesting this phenomenon may be previously overlooked. Although budding can be a mechanism through which larval echinoids asexually reproduce, here, the released buds did not develop into viable clones. OA-induced budding and the associated reduction in larval size suggest new hypotheses regarding physiological and ecological tradeoffs between short-term benefits (e.g. metabolic savings and predation escape) and long-term costs (e.g. tissue loss and delayed development) in the face of climate change.