Complicações perinatais no Hospital Universitário Cassiano Antonio de Moraes: uma questão de idade?

A população brasileira vem passando por uma transição demográfica e epidemiológica, caracterizadas por aumento na expectativa de vida, diminuições nas taxas de mortalidade, natalidade e fecundidade, aumento da escolaridade, diminuição do desemprego, aumento das enfermidades crônico-degenerativas e diminuição das enfermidades infectocontagiosas. Tais transições vêm afetando também a perinatologia, com aumento proporcional e absoluto das gestações tardias tanto no Espírito Santo quanto no Brasil. Este estudo realizou uma análise retrospectiva das gestações tardias no HUCAM, comparando as mesmas com as gestações de mulheres adolescentes e adultas jovens quanto aos seguintes desfechos perinatais: anomalia fetal, hipóxia no primeiro e quinto minuto de vida, duração da gestação, peso ao nascer e tipo de parto. As variáveis foram analisadas categoricamente, e comparadas através de análise bivariada, utilizando-se o Teste Exato de Fisher, e através de regressão logística. Na análise bivariada, foi encontrada apenas associação entre a idade materna e o tipo de parto, mas esta associação não foi confirmada na regressão logística. Analisando outros fatores relativos à gestação, restou evidenciado uma associação positiva entre um menor número de consultas pré-natais e uma maior frequência de hipóxia no recém-nascido e de prematuridade (odds ratio de 2,9 e 5,7, respectivamente). Ao final deste trabalho são elaboradas propostas para aprimoramento da coleta e do armazenamento de dados acerca da gestação no HUCAM, e para otimização da assistência pré-natal das gestantes atendidas pelo hospital, visando melhorar os desfechos perinatais encontrados.

Consumo de álcool e adiposidade abdominal : resultados do estudo longitudinal de saúde do adulto – ELSA Brasil

A acumulação de tecido adiposo abdominal apresenta associação positiva com eventos cardiovasculares, pressão arterial e alterações metabólicas. Dentre os fatores de risco para o aumento da obesidade abdominal está o alto consumo de bebidas alcoólicas, particularmente a cerveja. O objetivo deste estudo foi identificar associação entre consumo de bebidas alcoólicas (CBA) e adiposidade abdominal. Trata-se de uma investigação de corte transversal conduzida a partir da linha de base do Estudo Longitudinal de Saúde do Adulto – ELSA-Brasil, composta por 15.105 indivíduos (35 a 74 anos). Foram analisadas variáveis antropométricas, socioeconômicas e consumo de bebidas alcoólicas e utilizados, para diagnóstico de obesidade abdominal, os pontos de corte da circunferência da cintura (CC) e relação cintura/quadril (RCQ) preconizados pela Organização Mundial de Saúde. O CBA foi categorizado em quintis. Teste de Kolmogorov-Smirnov foi utilizado para avaliar a normalidade das variáveis. A associação entre variáveis antropométricas e o CBA foi avaliada utilizando-se teste Mann-Whitney, Kruskal-Wallis e teste qui-quadrado. Foram testados modelos de regressão linear e Poisson, ajustados por idade, sexo, IMC, tabagismo, atividade física, renda e escolaridade. A CC inadequada foi associada a maior CBA em toda amostra (1,03, IC95% 1,01-1,05) e em homens (1,05, IC95% 1,03-1,08). A RCQ inadequada foi associada a maior CBA tanto para o total da amostra (1,04, IC95% 1,01-1,06) como para mulheres (1,07, IC95% 1,03-1,12). Homens no quinto quintil de consumo de cerveja apresentaram chance 1,05 maior (IC95% 1,02-1,08) de ter a CC inadequada quando comparados aos que se encontravam no primeiro quintil. Já entre as mulheres a chance foi 1,16 (IC95% 1,13-1,20). Homens e mulheres no quinto quintil de consumo de cerveja tinham, respectivamente, 1,03 (IC95% 1,00-1,07) e 1,10 (IC95%1,04-1,15) vezes mais chance de apresentar RCQ inadequada. O consumo de vinho só foi associado a maior chance de ter CC aumentada entre mulheres (β=0,026, p<0,027). Neste estudo, o consumo de álcool foi associado positivamente com obesidade abdominal, sendo mais importante a contribuição da cerveja para aumento da CC e da RCQ.

Indirect effect of neem oil on Podisus nigrispinus (Hemiptera, Pentatomidae): biology and predatory capacity

This study evaluated the effects on the development and predatory capacity of Podisus nigrispinus fed on Spodoptera frugiperda that have ingested different concentrations of neem oil. The predatory capacity of Podisus nigrispinus was assessed, separating nymphs (fourth instar) and adults (males and females). The treatments consisted of S. frugiperda larvae reared in neem oil aqueous solutions (0.077, 0.359 and 0.599%), deltamethrin EC 25 (0.100%) and control arranged in a completely randomized design, with ten replicates. Insects were offered three larval densities (one, three and six), in the third or fourth instars. The predated larvae were examined at 24 and 48 hours after the beginning of the experiment. Biological parameters of Podisus nigrispinus were evaluated in groups of ten second-instar nymphs transferred to pots, in five replicates. Insects were offered 2-6 third and/or fourth-instar larvae reared in the same neem oil concentrations in a completely randomized design. The following parameters were evaluated: duration of each nymph stage (days), nymph mortality (%), weight of fifth-instar nymphs (mg), sex ratio, weight of males and females (mg) and longevity of unfed adults (days). The predatory capacity of nymphs and adults of Podisus nigrispinus was influenced by the neem oil at the concentrations of 0.359% and 0.599% in the highest density. The concentration of 0.359% lengthened the nymphal stage and the concentration of 0.599% reduced the weight of males.

Report about the scope and distribution of large urban distressed areas in European cities

LUDA is a research project of Key Action 4 "City of Tomorrow & Cultural Heritage" of the programme "Energy, Environment and Sustainable Development" within the Fifth Framework Programme of the European Commission.

Building the Directorate General for Urban Affairs in European Union

LUDA is a research project of Key Action 4 "City of Tomorrow & Cultural Heritage" of the programme "Energy, Environment and Sustainable Development" within the Fifth Framework Programme of the European Commission

Appraisal of urban rehabilitation literature and projects, including a glossary of terms and a preliminary set of indicators characterising LUDA

LUDA is a research project of Key Action 4 "City of Tomorrow & Cultural Heritage" of the programme "Energy, Environment and Sustainable Development" within the Fifth Framework Programme of the European Commission

Appraisal of planning regulations regarding large urban distressed areas in European countries

LUDA is a research project of Key Action 4 "City of Tomorrow & Cultural Heritage" of the programme "Energy, Environment and Sustainable Development" within the Fifth Framework Programme of the European Commission

Preliminary Overview over Requirements Regarding Tools and Methods Derived from LUDA Cases

LUDA is a research project of Key Action 4 "City of Tomorrow & Cultural Heritage" of the programme "Energy, Environment and Sustainable Development" within the Fifth Framework Programme of the European Commission

Methodology for the Comparative Analysis of Sustainable Evaluation of LUDA

LUDA is a research project of Key Action 4 "City of Tomorrow & Cultural Heritage" of the programme "Energy, Environment and Sustainable Development" within the Fifth Framework Programme of the European Commission

Large Urban Distressed Areas: a difficult challenge for European cities

LUDA is a research project of Key Action 4 "City of Tomorrow & Cultural Heritage" of the programme "Energy, Environment and Sustainable Development" within the Fifth Framework Programme of the European Commission

The undergraduate level (1st study cycle) as a fundamental platform/standard for the development of Urban and Regional Planning in higher education programs

LUDA is a research project of Key Action 4 "City of Tomorrow & Cultural Heritage" of the programme "Energy, Environment and Sustainable Development" within the Fifth Framework Programme of the European Commission

Metamorfoses em espelho de água : identidade, perfil, contextos e mudança nas (auto)representações dos professores

RESUMO: Nos últimos trinta anos, em Portugal, ocorreram processos de democratização política e de modernização da sociedade e das instituições, tendo como impulso as vontades nacionais e as mudanças ocorridas no Mundo em globalização, lideradas, no campo da educação, por agentes como a OCDE ou o Banco Mundial, e pela integração de Portugal na União Europeia. À implementação da(s) reforma(s), correspondeu uma mudança de paradigma educativo e organizacional, a criação de uma escola para todos, a emergência de novos alunos e de novos mandatos à Escola, a contingência de novas respostas educativas. Tais reformas constituiram instrumentos de mudança das organizações escolares e do sistema educativo, mas também do que significa ser professor, reformulando o desempenho e a “performatividade” docente (Ball, 2002), induzindo uma nova “identidade social” (Bernstein, 1996 e Dubar, 2006), produzindo novos modos de “fabricação da alma dos professores” (Foucault, 1996). Neste sentido, a autora procurou analisar, numa perspectiva crítica, as representações de professores do Ensino Básico, sobre os mecanismos de (re)configuração das suas identidades/perfis profissionais, recorrendo a uma investigação qualitativa descritiva, que privilegia a análise de conteúdo dos seus discursos sobre o tema, recolhidos segundo a técnica focus group. O estudo indiciou que os alunos são factor de realização, de risco e de mudança do perfil docente, actuando como uma quinta dimensão da (re)construção identitária dos Professores, a par da formação, do associativismo, do Estado e do Mercado, constituindo factor importante a ter em conta nos estudos sobre identidade docente. ABSTRACT: In the past thirty years, in Portugal, radical changes on politics and policies have been occurring, to achive the society and its institutions democratization and modernization, led by national wills and the changes occured in the World, stimulated, in the Education area, by global agencies like OECD, or the World Bank, and the integration of Portugal in the European Union. These reforms are connected to a new educational and organizational paradigm, the creation of a school for all, the emergence of new pupils, new demands to School and teachers, the imperative of new pedagogical solutions for educational problems, and are not only changing instruments in schools and in the educational system, but are also a powerful way to change “what to be a teacher” means, to re-formulate the teaching performance and “performativity” (Ball, 2002), to recompose his/her “social identity” (Bernstein, 1996; Dubar, 2006), or, in Michel Foucault (1996) words, to produce “new ways to manufacture teachers soul”. In this sense, the author intended to analyze, on a critical perspective, the representations of portuguese teachers of basic education (K12), on the mechanisms of (re)configuration of their professional identities/profiles, appealing to a qualitative descriptive research, which privileges the analysis of content of their speeches on the subject, collected according to the focus group technique, what, in its development, was brought near a circle of culture (in the sense of Paulo Freire‟s pedagogy). At least, pupils are the most important references and motivation to teachers changes, reflecting professional satisfaction and well done, but also risk, acting like a fifth dimension of teachers identity (re)construction, together with training, associative involvement, State and Market, and they must be considered on teatching identity studies.

The population of Brazil

In 1970 the population of Brazil with 94,508,554 inhabitants was extreme youth, since 42.67% was composed of children under 14 years old. In that year the proportion of female was 50.2%. The population density increased from 1.17 inhabitants /km² in 1872 to 11.18 in 1970, and in this last year the range was 1.03 in the North region and 43.90 in the South-East region. The urban population increased from 31.24% in 1940 to 55.98% in 1970 and for the first time the rural population was smaller than the urban population. In 1950 concerning with marital status 39% of the population 15 years old and over was single and 54% married. In 1970 this rate was respectively 35.4% and 56.6%. The population economically inactive increased from 49.17% in 1940 to 52.24% in 1970. The literacy ratio increased from 43% in 1940, to 48% in 1950 and 68.04% in 1970. The crude birth rate was 43/1000 live births in 1950 and fell to 37.7/1000 in 1970. The fertility rate decreased from 179.3/1000 women (15-49 years old} to 156.7/1000 in 1960/70. The crude death rate decreased from 20.60/1000 inhabitants in 1940/50 to 9.4/1000 in 1960/70. The infant mortality rate still remains high: 171/1000 live births in 1940/50 and 170/1000 in 1971. Concerning with the size of the cities, 8 in 1940 had 100,000 or more inhabitants and in 1970 this number increased to 94 cities. The population growth increased from 2.38% in 1940/50, to 2.99% in 1950/60 and 2.83% in 1960./70. Brazil is the first country in population size in Latin America and the eighth in the world. Concerning his area, Brazil is the fifth country in size.

Possible consequences of increasing life expectancy in Brazil: the perspective of a European historical demographer

Those over sixty years of age accounted for 6.6% of the total population of Brazil in 1985, in the Federal Republic of Germany this proportion was 20.3% in 1984. As early as 1950 it had been 14.5%. This proportion will not even be reached in Brazil in the year 2000 when persons aged sixty years and older are only projected to make up 8.8% of the total population. Similarly, in 1982/84 life expectancy at birth in the Federal Republic was 70.8 years for men and 77.5 for women; in Brazil the figures for 1980/85 were, by contrast, "only" 61.0 and 66.0. Against this background it is easy to understand why the discussion concerning an ageing society with its many related medical, economic, individual and social problems has been so slow in coming into its own in Brazil. As important as a more intensive consideration of these aspects may be in Brazil at present, they are, nevertheless, only one side of the story. For a European historical demographer with a long-term perspective of three of four hundred years, the other side of the story is just as important. The life expectancy which is almost ten years lower in Brazil is not a result of the fact that no one in Brazil lives to old age. In 1981 people sixty-five years and older accounted for 34.4% of all deaths! At the same time infants accounted for only 22.1% of total mortality. They are responsible, along with the "premature" deaths among youths and adults, for the low, "average" life expectancy figure. In Europe, by contrast, these "premature" deaths no longer play much of a role. In 1982/84 more than half of the women (52.8%) in the Federal Republic of Germany lived to see their eightieth birthdays and almost half of the men (47.3%) lived to see their seventy-fifth. Our biological existence is guaranteed to an extent today that would have been unthinkable a few generations ago. Then, the classic troika of "plague, hunger and war" threatened our forefathers all the time and everywhere. The radical transition from the formerly uncertain to a present-day certain lifetime, which is the result of the repression of "plague, hunger and war", led to unexpected consequences for our living together. Our forefathers were forced to live in closely knit Gemeinschaften in the interest of physical survival and to subordinate their egoistic goals to a common value, but now these pressures have, for the most part, fallen away. Correspondingly, this much more certain EGO has taken center stage. An ever greater number of us chooses to live life as single beings: the number of marriages is lower every year; the number of divorces is on the increase; in Berlin (West) more than half (sic! 52.3%) of all households are already composed on only one person. For the last dozen years the annual number of births in the Federal Republic has been insufficient to ensure population replacement. Not a population explosion but rather the opposite, a population implosion, is our problem. Human beings do not appear to be "social animals", as was axiomatically assumed for so long. They were only forced to behave as such for as long as "plague, hunger and war" forced them to do so. When these life endangering conditions no longer exist and life becomes certain even without their being integrated into a Gemeinschaft then humans suddenly show themselves more and more to be independent single beings. It is not the percentage of the population that is over sixty or sixty-five that is decisive in this context but rather how certain adults perceive their biological lives to be, since they are the ones who organize their lives, who build communities or who are ever more often willing only to enter into means-to-an-end personal unions without lasting or close ties and mutual responsibilities. There are many signs which seem to point to a development in this direction in Brazil as well. More and more adults in Brazil are caught up in the deep-seated transition from an uncertain to a certain lifetime. A third of them die after having reached their sixty-fifth birthday. It therefore seems to me to be high time that one began to give more consideration to the other side of the story in Brazil as well. And who is more suited intensively to consider the long-term perspectives than those engaged in the public health sector in whose competence, after all, such aspects, as "life certainty", "life expectancy" and "age at death" belong?

Relatório de estágio em terapia manual

Objectivo: descrever a intervenção em fisioterapia numa paciente com diagnóstico de epicondilalgia. Participantes e Métodos: estudo de caso de uma paciente que desenvolveu um quadro doloroso no cotovelo esquerdo no início de Janeiro de 2010 e em que a intervenção de fisioterapia teve início no princípio de Fevereiro de 2010. Foi utilizada uma variedade de técnicas articulares, nomeadamente a mobilização com movimento de Mulligan, aplicação de tape e manipulação cervical. O tratamento foi realizado em dias alternados e teve a duração total de duas semanas. Resultados: logo no final da primeira sessão a paciente referiu melhoria na dor à preensão. Na segunda sessão a paciente demonstrou capacidade de realizar auto-mobilização com movimento em casa. A regressão dos sintomas foi muito rápida durante as duas primeiras sessões, passou por uma fase de estabilização da terceira à quinta sessão, até à completa remissão no fim da sexta sessão. Conclusão: o processo de raciocínio clínico desenvolvido pelo fisioterapeuta durante as seis sessões de tratamento foi salientado. Após a recolha dos dados relativos à história e sua interpretação levantaram-se as primeiras hipóteses: epicondilalgia, disfunção cervical ou sindroma do túnel radial. No exame objectivo foram realizados testes para permitir a obtenção do diagnóstico diferencial – epicondilalgia; elaborou-se então um plano de intervenção em colaboração a paciente, que se mostrou eficaz, com resultados acima das expectativas.