As transformações históricas e a dinâmica atual da paisagem nas microbacias dos ribeirões: Santo Antônio - SP, São Francisco - PR e Três Barras - MS

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

Políticas públicas de educação para assentados da Reforma Agrária: o caso do PRONERA Saúde na Transamazônica

As ações dos Agentes Comunitários de Saúde são reconhecidas em sua relevância nas legislações brasileira que se concretiza em 2002 com a Lei nº 10.507 de 10 de Julho de 2002 que cria a Profissão do Agente Comunitário de Saúde e dá outras providências, posteriormente substituída pela Lei 11.350, de 05 de outubro de 2006. Contudo a história dos ACS‟s remonta períodos bem anteriores como à criação do Programa dos Agentes Comunitários de Saúde (PACS) em 1991, considerado começo da profissionalização do ACS‟s. Diante disso, o Programa Nacional de Educação na Reforma Agrária (PRONERA) vem para dar sua contribuição na formação de Técnicos Agentes Comunitários de Saúde (TACS‟s). De maneira concisa o PRONERA emerge como Política Pública Educacional em 2009, quando o mesmo se consolida no artigo 33 da Lei nº 11.947/09 e no final de 2010 onde é assinado o Decreto nº 7.352/10, que trata da educação do campo e institui formalmente o PRONERA no Ministério do Desenvolvimento Agrário (MDA). Assim, o PRONERA compõe a Política de Educação do Campo, ao mesmo tempo se caracteriza como Política Pública de Educação vinculada à Reforma Agrária. O PRONERA é um Programa do Governo Federal, através do Ministério de Desenvolvimento Agrário, coordenado pelo Instituto Nacional de Colonização e Reforma Agrária (INCRA) em convênio com as Universidades Públicas, em parceria com Movimentos Sociais e agentes governamentais estaduais e municipais. Oferece cursos de educação básica, técnica e tecnológica, ensino superior e pós graduação. Nosso objeto aqui está na análise do projeto “Saúde em movimento na Transamazônica: Curso de Formação Integrada em Técnico Agente Comunitário de Saúde (TACS) e Ensino Médio”, portanto no PRONERA Saúde que é apenas um dos projetos do PRONERA no Pará. Este abrange os municípios de Altamira, Senador José Porfírio, Medicilândia, Anapú e Pacajá, o curso foi projetado e aprovado em 2005 e começou em 2006 e finalizado em julho de 2011. Iniciou com 90 discentes todos ACS‟s das prefeituras parceiras (Altamira, Anapú, Medicilândia, Pacajá, Sen. José Porfírio). Esses discentes foram selecionados por uma equipe técnica do PRONERA, a partir das indicações dos Movimentos Sociais locais, principalmente dos Sindicatos dos Trabalhadores Rurais. Para o desenvolvimento dessa pesquisa utilizamos os Relatórios de Atividades do PRONERA Saúde e as entrevistas com os discentes (ACS‟s). A perspectiva teórico metodológica de análise das fontes para construção dissertativa se deu com base na teoria crítica marxista e nas leituras e contribuições da Educação Ambiental crítica, a relação saúde, meio ambiente e políticas públicas permeia a pesquisa e possibilita uma interação fundamental para busca de melhoria de vida desses agentes sociais.

NGAL como marcador precoce de lesão renal em ratos submetidos à isquemia renal sob anestesia venosa total

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Ocorrência de tabagismo e dependência nicotínica em universitários

In Brazil, smoking incidence varies between 9.5% and 21.2% and it is more common among men. In college students incidence can reach 14% depending on the region, which is quite disturbing. Joining college is a crucial period for the commencement or maintenance of smoking. The Knowledge among college students about tobacco use is critical to devise strategies for intervention in this population. The objectives were to establish the occurrence of smoking and risk factors, nicotine dependence in college students and college goers. We interviewed students, teachers and administrative personnel from the Philosophy and Science School at UNESP at Marilia, from both sexes, regardless their age, which visited the First Week Against Tobacco event. The sociodemographic data, smoking status, time as a smoker, cigarettes smoked, date when they started smoking, history of smoking in the family, friends or associates were questioned. We also assessed the degree of motivation to quit smoking and the degree of nicotine dependence. Data were presented using descriptive statistics. Comparisons between categorical variables were made using the chi-square test (p <0.05). A total of 432 people, 180 men and 252 women, average aged 22.6 ± 6.9 years were researched. From the volunteers studied, 267 (61.8) had tried cigarettes and 171 of them (64%) reported that they were offered by friends. As a whole, 79 (18.3%) of these people were smokers, 52 (65.8%) reported intending to quit smoking and in 37 of them (46.8%), the degree of nicotine dependence was very low. Of all the smokers, 63 had smokers in the family and all of them had friends who smoked. 28.9% of all men were smokers and 10.7%of all women. The occurrence of smoking was 18.3% and the risk factor associated to smoking habit is related to friendship and family, and very low nicotine dependence.

Usuários de serviço de saúde mental: o que conhecem sobre os direitos de cidadania

This is an exploratory descriptive study with a qualitative approach. It aimed at apprehending what users undergoing treatment at a mental health service know about their rights. A semistructured interview was used as a data collection strategy. Five users were interviewed. Thematic content analysis was used for data analysis, and three categories emerged: process of falling ill, experiences of treatment and users’ rights. The users reported voluntary and involuntary hospitalization experiences and that, after treatment commencement at the psychosocial care center, they perceived significant changes in mental health care. They reported that they did not know the mental health legislation, but they knew about the rights stemming from experiencing mental disorder. For users to be able to recognize and take advantage of their citizens’ rights, awareness must be developed by health care professionals, which also includes their academic education

Short-term efficacy of physical interventions in osteoarthritic knee pain. A systematic review and meta-analysis of randomised placebo-controlled trials

Abstract Background Treatment efficacy of physical agents in osteoarthritis of the knee (OAK) pain has been largely unknown, and this systematic review was aimed at assessing their short-term efficacies for pain relief. Methods Systematic review with meta-analysis of efficacy within 1–4 weeks and at follow up at 1–12 weeks after the end of treament. Results 36 randomised placebo-controlled trials (RCTs) were identified with 2434 patients where 1391 patients received active treatment. 33 trials satisfied three or more out of five methodological criteria (Jadad scale). The patient sample had a mean age of 65.1 years and mean baseline pain of 62.9 mm on a 100 mm visual analogue scale (VAS). Within 4 weeks of the commencement of treatment manual acupuncture, static magnets and ultrasound therapies did not offer statistically significant short-term pain relief over placebo. Pulsed electromagnetic fields offered a small reduction in pain of 6.9 mm [95% CI: 2.2 to 11.6] (n = 487). Transcutaneous electrical nerve stimulation (TENS, including interferential currents), electro-acupuncture (EA) and low level laser therapy (LLLT) offered clinically relevant pain relieving effects of 18.8 mm [95% CI: 9.6 to 28.1] (n = 414), 21.9 mm [95% CI: 17.3 to 26.5] (n = 73) and 17.7 mm [95% CI: 8.1 to 27.3] (n = 343) on VAS respectively versus placebo control. In a subgroup analysis of trials with assumed optimal doses, short-term efficacy increased to 22.2 mm [95% CI: 18.1 to 26.3] for TENS, and 24.2 mm [95% CI: 17.3 to 31.3] for LLLT on VAS. Follow-up data up to 12 weeks were sparse, but positive effects seemed to persist for at least 4 weeks after the course of LLLT, EA and TENS treatment was stopped. Conclusion TENS, EA and LLLT administered with optimal doses in an intensive 2–4 week treatment regimen, seem to offer clinically relevant short-term pain relief for OAK.

Definition, realization and evaluation of a software reference architecture for use in space applications

A recent initiative of the European Space Agency (ESA) aims at the definition and adoption of a software reference architecture for use in on-board software of future space missions. Our PhD project placed in the context of that effort. At the outset of our work we gathered all the industrial needs relevant to ESA and all the main European space stakeholders and we were able to consolidate a set of technical high-level requirements for the fulfillment of them. The conclusion we reached from that phase confirmed that the adoption of a software reference architecture was indeed the best solution for the fulfillment of the high-level requirements. The software reference architecture we set on building rests on four constituents: (i) a component model, to design the software as a composition of individually verifiable and reusable software units; (ii) a computational model, to ensure that the architectural description of the software is statically analyzable; (iii) a programming model, to ensure that the implementation of the design entities conforms with the semantics, the assumptions and the constraints of the computational model; (iv) a conforming execution platform, to actively preserve at run time the properties asserted by static analysis. The nature, feasibility and fitness of constituents (ii), (iii) and (iv), were already proved by the author in an international project that preceded the commencement of the PhD work. The core of the PhD project was therefore centered on the design and prototype implementation of constituent (i), a component model. Our proposed component model is centered on: (i) rigorous separation of concerns, achieved with the support for design views and by careful allocation of concerns to the dedicated software entities; (ii) the support for specification and model-based analysis of extra-functional properties; (iii) the inclusion space-specific concerns.

Growth response to antiretroviral treatment in HIV-infected children: a cohort study from Lilongwe, Malawi

Objective  Malnutrition is common in HIV-infected children in Africa and an indication for antiretroviral treatment (ART). We examined anthropometric status and response to ART in children treated at a large public-sector clinic in Malawi. Methods  All children aged <15 years who started ART between January 2001 and December 2006 were included and followed until March 2008. Weight and height were measured at regular intervals from 1 year before to 2 years after the start of ART. Sex- and age-standardized z-scores were calculated for weight-for-age (WAZ) and height-for-age (HAZ). Predictors of growth were identified in multivariable mixed-effect models. Results  A total of 497 children started ART and were followed for 972 person-years. Median age (interquartile range; IQR) was 8 years (4–11 years). Most children were underweight (52% of children), stunted (69%), in advanced clinical stages (94% in WHO stages 3 or 4) and had severe immunodeficiency (77%). After starting ART, median (IQR) WAZ and HAZ increased from −2.1 (−2.7 to −1.3) and −2.6 (−3.6 to −1.8) to −1.4 (−2.1 to −0.8) and −1.8 (−2.4 to −1.1) at 24 months, respectively (P < 0.001). In multivariable models, baseline WAZ and HAZ scores were the most important determinants of growth trajectories on ART. Conclusions  Despite a sustained growth response to ART among children remaining on therapy, normal values were not reached. Interventions leading to earlier HIV diagnosis and initiation of treatment could improve growth response.

Sudden death among young people with first-episode psychosis: An 8-10 year follow-up study

Individuals with first episode psychosis (FEP) experience high rates of premature mortality, in particular due to suicide. The study aims were to: a) Estimate the rate of sudden death among young people with FEP during an 8-10 year period following commencement of treatment; b) Examine and describe the socio-demographic and clinical characteristics associated with sudden death; and c) Examine the timing of death in relation to psychiatric treatment.This was a cohort study. The sample comprised 661 patients accepted into treatment at the Early Psychosis Prevention and Intervention Centre between 1/1/1998 and 31/12/2000. Demographic and clinical data were collected by examination of the medical files. Mortality data were collected via a search of the National Coroners Information System; the Victorian State Coroner's office and clinical files. Nineteen patients died and just over two thirds of deaths were classified as intentional self-harm or suicide. Death was associated with male gender, previous suicide attempt and greater symptom severity at last contact. People with FEP are at increased risk of premature death, in particular suicide. A previous suicide attempt was very common amongst those who died, suggesting that future research could focus upon the development of interventions for young people with FEP who engage in suicidal behaviour.

The near babylonian speech confusion in early detection of psychosis

It is barely 15 years since, in 1996, the issue theme of Schizophrenia Bulletin (Vol 22, 2) “Early Detection, and Intervention in Schizophrenia” signified the commencement of this field of research. Since that time the field of early detection research has developed rapidly and it may be translated into clinical practice by the introduction of an Attenuated Psychosis Syndrome in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-5) (www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=412#). Attenuated psychotic symptoms (APS) had first been suggested as a clinical predictor of first-episode psychosis by the Personal Assessment and Crisis Evaluation (PACE) Clinic group as part of the ultrahigh risk (UHR) criteria.1 The term ultrahigh risk became broadly accepted for this set of criteria for imminent risk of developing psychosis in the late 1990s. The use of the term “prodrome” for a state characterized by at-risk (AR) criteria was criticized as a retrospective concept inevitably followed by the full-blown disorder.1 Although alternative terms have been suggested, prodrome is still used in prospective studies (eg, prodromally symptomatic, potentially or putatively prodromal, prodrome-like state/symptoms). Some alternative suggestions such as prepsychotic state/symptoms, subthreshold psychotic symptoms, early psychosis, subsyndromal psychosis, hypopsychosis, or subpsychosis were short-lived. Other terms still in use include UHR, at-risk mental state (ARMS), AR, high risk, clinical high risk (CHR), or early and late AR state. Further, the term psychotic-like experiences (PLEs) has recently (re-)entered early detection research. …

Webinar Training: an acceptable, feasible and effective approach for multi-site medical record abstraction: the BOWII experience

Background Abstractor training is a key element in creating valid and reliable data collection procedures. The choice between in-person vs. remote or simultaneous vs. sequential abstractor training has considerable consequences for time and resource utilization. We conducted a web-based (webinar) abstractor training session to standardize training across six individual Cancer Research Network (CRN) sites for a study of breast cancer treatment effects in older women (BOWII). The goals of this manuscript are to describe the training session, its participants and participants' evaluation of webinar technology for abstraction training. Findings A webinar was held for all six sites with the primary purpose of simultaneously training staff and ensuring consistent abstraction across sites. The training session involved sequential review of over 600 data elements outlined in the coding manual in conjunction with the display of data entry fields in the study's electronic data collection system. Post-training evaluation was conducted via Survey Monkey©. Inter-rater reliability measures for abstractors within each site were conducted three months after the commencement of data collection. Ten of the 16 people who participated in the training completed the online survey. Almost all (90%) of the 10 trainees had previous medical record abstraction experience and nearly two-thirds reported over 10 years of experience. Half of the respondents had previously participated in a webinar, among which three had participated in a webinar for training purposes. All rated the knowledge and information delivered through the webinar as useful and reported it adequately prepared them for data collection. Moreover, all participants would recommend this platform for multi-site abstraction training. Consistent with participant-reported training effectiveness, results of data collection inter-rater agreement within sites ranged from 89 to 98%, with a weighted average of 95% agreement across sites. Conclusions Conducting training via web-based technology was an acceptable and effective approach to standardizing medical record review across multiple sites for this group of experienced abstractors. Given the substantial time and cost savings achieved with the webinar, coupled with participants' positive evaluation of the training session, researchers should consider this instructional method as part of training efforts to ensure high quality data collection in multi-site studies.

Central Europeans towards Integration with the European Union: A Study of Public Opinion, Social Attitudes and National Identities

Since the turbulence of 1989, the countries of Central and Eastern Europe have striven to "return to Europe". Agreements have been signed with ten post-communist countries, beginning in 1991 with Czechoslovakia (before its division), Hungary and Poland. Since that time several countries have expressed a desire to become members of the EU. In 1997 the European Commission announced its opinion on the applications for EU membership of the Czech Republic, Hungary, Poland, Slovakia, and seven other applicant countries. The Commission recommended the commencement of negotiations on accession with the Czech Republic, Estonia, Hungary, Poland, and Slovenia. Mr. Kucia's report, presented in the form of a series of manuscripts totalling 91 pages, written in English and Polish and including many pages of tables and graphs, presents the results of a study of public opinion on European integration in four countries of Central Europe (CE): the Czech Republic (CZ), Hungary (H), Poland (PL), and Slovakia (SK). The research results are primarily based on a public-opinion survey known as the Central and Eastern Eurobarometer (CEEB). CEEB has been conducted on behalf of the European Commission in the Central and Eastern European countries each year in autumn since 1990. Below is a very small selection of Mr. Kucia's research findings. Throughout the 90s people in the four countries increasingly saw their countries' future tied up with the EU, since economic and political connections to the EU were growing and prospects for EU membership were increasing. Regional co-operation within CE did not gain much popular recognition. However, initially high levels of enthusiasm for the EU were gradually superseded by a more realistic approach or even scepticism. Poland was the exception in this respect; its population was more positive about the EU in 1996 than ever before. Mr. Kucia concludes that, since the political "elites" in CE are more positive about the EU than the people they serve, they should do their best to bring people round to their beliefs, lest the project of European integration become purely the business of the elites, as Mr. Kucia claims it has been in the EU up till now. He accuses the governments of the region, the EU authorities and the media of failing to provide appropriate information, especially about the two subjects which most affect them, association with the EU and the PHARE assistance programme. Respondents were asked to rank in order the countries or regions they saw their country's future most closely tied up with. In the period 92-96 the EU received the highest ratings in all of CE. The ratings were highest in CZ in 92 and 93 (46%) and in Poland in 96 (46%). They were the lowest in Hungary (22% in 94). After the EU came "Other Western European countries (non EU)", that is Austria, Sweden and Finland (before they joined the EU in 1995), Switzerland and Norway. Mr. Kucia puts the high ratings of these countries down to historical connections and geographical proximity, particularly in the case of Austria. The USA always came second in Poland, and in Hungary too its standing has always been higher than in CZ or SK. Indeed Mr. Kucia suggests that the USA's standing is disproportionately low in especially the CZ. Germany was nominated frequently by Hungarians, though in the CZ and SK, figures have been consistently low (1-2%). "Other CE/EE countries" increased their ratings in all of CE except Poland between 92 and 96. With regard to these last figures, Mr. Kucia makes an interesting note. Assuming that for the respondents in the four countries this category covered the Visegrad 4, least support was found in Poland, whose government was the most in favour of close political co-operation within the V4, while most support was in evidence in CZ and SK, for whose governments V4 was simply not a priority. Again, there is evidence of a divide between the political elites and the people. Russia has occupied a consistently modest rank. It was the highest in PL, fairly low in H and SK and the lowest in CZ. The Slovak government's policy of closer ties with Russia is reflected in a growth in the figures from 2% in 93 to 6% in 95. Every year the spontaneous answer "we should depend on ourselves" appeared, which Mr. Kucia interprets as either a sign of isolationism and disillusionment or as a call for self-reliance. Unfortunately he regards both these tendencies as unfeasible in the uniting Europe. Moving to more general conclusions, Mr. Kucia finds that the concept "Central Europe" does not have much meaning for Central Europeans. He believes that this is probably due to the failure to establish a viable regional co-operation network. Group discussions also revealed that people thought themselves European as a consequence of being Czech or Polish etc. Thus European identity is based on national identities. Generally within the surveyed period, the numbers of those who said they often think themselves European decreased, while the numbers of those who said they never think themselves European increased from 41% in PL, 36% in CZ, and 30% in H in 1990, to 67% in CZ, 58% in PL, and 51% in H in 1995.

The Acropolitan - v. 1, no. 6

In this issue...commencement, Butte, Montana, W. B. Daly, Anaconda Copper Mining Company, Masonic Hall, white-washing the M, Rocky Mountain Garden Club

The Acropolitan - v. 2, no. 7

In this issue...Big Butte, "M" Days, Hotel Finlen, Congo region, Butte Business College, Miles City, Butte, Montana, Dr. Hult, commencement, Oratorical Contest

The Acropolitan - v. 8, no. 4

In this issue...School of Mines Librarian, Margery Bedinger, Kiwanis, Medlin's Pharmacy, Commencement, Poser-Badger case, Mr. Chester Steele, Map Interpretation class