Contribuição da reabilitação na saúde e na qualidade de vida do idoso no Brasil: reflexões para a assistência multidisciplinar

Resumo: O progressivo crescimento da população no Brasil tem causado, no âmbito sócio-econômico principalmente, preocupação aos sistemas de saúde, os quais ainda não estão preparados para atender as diversificadas demandas deste seguimento etário. Cuidar do idoso como uma pessoa integral e não apenas como um organismo biológico, protegendo-o e integrando-o dentro do contexto psicossocial do momento, deve ser o maior objetivo dos profissionais da saúde. Devemos estar tão preparados para lidar com especificidades do processo de envelhecimento quanto para tratar seus distúrbios. Há profunda inter-relação entre a qualidade de vida percebida e a saúde física e mental. Esta reflexão analisa a importância da reabilitação preventiva na promoção da qualidade de vida do idoso e de seus familiares conduzindo à conseqüente prevenção e postergação da manifestação de sintomas e de doenças crônicas. Palavras-chave: Envelhecimento. Reabilitação. Ensino. Abstract: The progressive populational growth in Brazil has caused, in the social-demographical scope mainly, much worry to the health systems, wich are not prepared to attend the different demands of this age segment. Caring for the elderly people as an integral person and not only as a biological organism, protecting them and integrating them into the psychosocial context of the moment should be the main objective of the health field professionals. We must be as well prepared to deal with the specificities of the aging process as to treat their disturbances. There is a deep inter-relation between the perceived quality of life and the mental and physical health. This reflexion analyzes the importance of the preventive rehabilitation in the elderly’s and their family’s life quality promotion, leading to the consequent prevention and postponement of the symptoms and chronical diceases manifestation. Keywords: Elderly. Rehabilitation. Teaching

Comparison between calcium hydroxide mixtures and mineral trioxide aggregate in primary teeth pulpotomy: a randomized controlled trial

Objectives: To evaluate the effect of calcium hydroxide (CH) associated with two different vehicles as a capping material for pulp tissue in primary molars, compared with mineral trioxide aggregate (MTA). Methodology: Forty-five primary mandibular molars with dental caries were treated by conventional pulpotomy using one of the following materials: MTA only (MTA group), CH with saline (CH+saline group) and CH with polyethylene glycol (CH+PEG group) (15 teeth/group). Clinical and periapical radiographic examinations of the pulpotomized teeth were performed 3, 6, and 12 months after treatment. Data were tested by chi-squared analysis and a multiple comparison post-test. Results: The MTA group showed both clinical and radiographic treatment success in 14/14 teeth (100%), at all followup appointments. By clinical evaluation, no teeth in the CH+saline and CH+PEG groups had signs of mobility, fistula, swelling or inflammation of the surrounding gingival tissue. However, in the CH+saline group, radiographic analysis detected internal resorption in up to 9/15 teeth (67%), and interradicular bone resorption and furcation radiolucency in up to 5/15 teeth (36%), from 3 to 12 months of follow-up. In the CH+PEG group, 2/11 teeth (18%) had internal resorption and 1/11 teeth (9%) presented bone resorption and furcation radiolucency at all follow-up appointments. Conclusion: CH with PEG performed better than CH with saline as capping material for pulpotomy of primary teeth. However, both combinations yielded clinical and radiographic results inferior to those of MTA alone

Molecular evolution of the three short PGRPs of the malaria vectors <em>Anopheles gambiae</em> and <em>Anopheles arabiensis</em> in East Africa

BACKGROUND: Immune responses to parasites, which start with pathogen recognition, play a decisive role in the control of the infection in mosquitoes. Peptidoglycan recognition proteins (PGRPs) are an important family of pattern recognition receptors that are involved in the activation of these immune reactions. Pathogen pressure can exert adaptive changes in host genes that are crucial components of the vector's defence. The aim of this study was to determine the molecular evolution of the three short PGRPs (PGRP-S1, PGRP-S2 and PGRP-S3) in the two main African malaria vectors - Anopheles gambiae and Anopheles arabiensis. RESULTS: Genetic diversity of An. gambiae and An. arabiensis PGRP-S1, PGRP-S2 and PGRP-S3 was investigated in samples collected from Mozambique and Tanzania. PGRP-S1 diversity was lower than for PGRP-S2 and PGRP-S3. PGRP-S1 was the only gene differentiated between the two species. All the comparisons made for PGRP-S1 showed significant P-values for Fst estimates and AMOVA confirming a clear separation between species. For PGRP-S2 and PGRP-S3 genes it was not possible to group populations either by species or by geographic region. Phylogenetic networks reinforced the results obtained by the AMOVA and Fst values. The ratio of nonsynonymous substitutions (Ka)/synonymous substitutions (Ks) for the duplicate pair PGRP-S2 and PGRP-S3 was very similar and lower than 1. The 3D model of the different proteins coded by these genes showed that amino acid substitutions were concentrated at the periphery of the protein rather than at the peptidoglycan recognition site. CONCLUSIONS: PGRP-S1 is less diverse and showed higher divergence between An. gambiae and An. arabiensis regardless of geographic location. This probably relates to its location in the chromosome-X, while PGRP-S2 and PGRP-S3, located in chromosome-2L, showed signs of autosomal introgression. The two short PGRP genes located in the chromosome-2L were under purifying selection, which suggests functional constraints. Different types of selection acting on PGRP-S1 and PGRP-S2 and S3 might be related to their different function and catalytic activity

Classification of gasoline as with or without dispersant and detergent additives using infrared spectroscopy and multivariate classification

AbstractGasoline may contain additives which can minimize the amount of pollutants emitted to the atmosphere. Detergents and dispersants added to gasoline can reduce gas emissions towards atmosphere and the formation of deposits in engines. The Brazilian Agency of Petroleum, Natural Gas and Biofuel (ANP) has established that Brazilian commercial gasoline must contain detergent and dispersant additives, thus requiring the development of methods for their identification in commercial gasoline. This work proposes a methodology which uses infrared spectra in the medium and near region (MIR and NIR) of the residue of distillation for classification of gasoline samples into two groups: with or without detergent/dispersant additives. The performances of three types of classification methods were compared: linear discriminant analysis (LDA), partial least squares discriminant analysis (PLS-DA) and Support Vector Machines (SVM). Different algorithms for selection of spectral variables for LDA were evaluated: stepwise (SW), genetic algorithm (GA) and successive projections algorithm (SPA). The best results were obtained using LDA/GA or SPA/LDA for MIR region

ATIVIDADE FÍSICA, MANUTENÇÃO DA CAPACIDADE FUNCIONAL E DA AUTONOMIA EM IDOSOS: REVISÃO DE LITERATURA E INTERFACES DO CUIDADO

A capacidade funcional dos sistemas do organismo diminui gradualmente desde a juventude favorecendo a ocorrência de doenças crônicas, quedas e diminuição da capacidade funcional. O sedentarismo contribui significativamente na aceleração do ritmo do declínio, de modo que a eficácia da prática de atividade física na prevenção e controle dessas condições vem sendo progressivamente estudada. O objetivo deste estudo foi conhecer a produção do conhecimento, na forma de artigo, voltada para a manutenção da capacidade funcional e da autonomia em idosos por meio da atividade física, discutindo sobre as abordagens propostas para essa finalidade. Através de estudo exploratório, foi realizada uma revisão no período entre 2004 e 2008, das bases de dados Medline, Pubmed, Lilacs, Cinahal e Scielo, de onde foram selecionados artigos que verificaram as varia  das abordagens propostas em programas de atividade física. Os artigos demonstraram, em sua maioria, os benefícios da atividade física regular e adaptada aos diversos momentos e condições do idoso, na manutenção da capacidade funcional e da autonomia em idosos, confirmando inclusive a importância do incentivo à prática de atividade física em qualquer idade e principalmente ao idoso, dentro de suas amplas possibilidades e contextos.   PHYSICAL ACTIVITY, MAINTENANCE OF FUNCTIONAL CAPACITY AND AUTONOMY: LITERATURE REVIEW AND INTERFACES  OF CARE abstract The functional capacity of the body systems gradually decreases since the youth, favoring the occurrence of chronic diseases, falls and decreased functional capacity. The sedentary lifestyle contributes significantly in accelerating the pace of decline, so that the effectiveness of physical activity in the prevention and control of these conditions has been increasingly studied. The aim of this study was to know about the production of knowledge, in the form of articles, devoted to the maintenance of functional capacity and autonomy in older people through physical activity, discussing on the approaches proposed for this purpose. Through a exploratory study, a review was conducted in the period between 2004 and 2008, on the databases Medline, Pubmed, Lilacs, and Scielo Cinahal, from where were selected articles that were found in the various approaches proposed programs of physical activity. Most of the articles demonstrated the benefits of regular physical activity and adapted to different times and conditions of the elderly, the maintenance of functional capa  city and autonomy in the elderly, inclusively confirming the impor  tance of fostering physical activity at any age and especially for the elderly, within their broad scope and contexts. 

Qualidade de vida de pessoas com hanseníase atendidas em um hospital de referência, Paraíba-Brasil

Objective: Evaluate the degree of impairment of the quality of life of people with Hansen’s disease, according to social demographic and clinical variablesMethod: Descriptive, transversal, quantitative study, involving 45 patients from a reference hospital located in João Pessoa, Paraíba, Brazil. For obtaining data, interviews were performed based on a semi-structured questionnaire, including social demographic and clinic variables of the participants; to evaluate their life quality the instrument Dermatology Life Quality Index, was used, after approval in the Committee of Ethics in Research of the Federal University of Paraíba. In the data analysis, the non-parametric Test of the Chi-square of Pearson was used with level of significance of 5% (p&lt;0,05), being used the Yates correction continuity, when necessary.Results: It is highlighted a prevalence of male, brown, single, aged 18 to 40 individuals, with family income lower than three minimum salaries and low schooling. From this total, 88,9% presented the clinical multibacillary form of the Hansen’s disease and 60% of them, with level of impairment of quality of life varying between moderate and very serious, according to scores of the instrument used.Conclusion: It is reassured the important impact of the Hansen’s disease in the quality of life of their carriers, as indicated by the high scores obtained in the application of the DLQI.Objetivo: Evaluar el grado de deterioro de la calidad de vida de las personas con enfermedad de Hansen, de acuerdo con las variables sociodemográficas y clínicasMétodo: Estudio descriptivo, transversal, cuantitativo, que involucró a 45 pacientes de un hospital de referencia en João Pessoa, Paraíba, Brasil. Para la obtención de datos, las entrevistas se realizaron a partir de un cuestionario semiestructurado que incluyó las variables sociodemográficas y clínicas de los participantes; para evaluar su calidad de vida se utilizó el instrumento Dermatology Life Quality Index, luego de su aprobación en el Comité de Ética en Investigación de la Universidad Federal de Paraíba. En el análisis de los datos, se utilizó la Prueba no paramétrica del Qui-cuadrado de Pearson con un nivel de significación del 5% (p &lt;0,05), usándose la continuidad de corrección de Yates, cuando fue necesario.Resultados: Se destaca la prevalencia de individuos varones, pardos, solteros, de entre 18 y 40 años, con ingresos familiares inferiores a tres salarios mínimos y baja escolaridad. De este total, el 88,9% presentó la forma clínica multibacilar de la enfermedad de Hansen y el 60% de ellos, con un nivel de deterioro de la calidad de vida que varía entre moderado y muy grave, según los puntajes del instrumento utilizado.Conclusión: Se confirma el importante impacto de la enfermedad de Hansen en la calidad de vida de sus portadores, como lo indican los altos puntajes obtenidos en la aplicación del DLQI.Objetivo: Avaliar o grau de comprometimento da qualidade de vida de pessoas com hanseníase, segundo variáveis sociodemográficas e clínicas. Método: Estudo descritivo, transversal, quantitativo, envolvendo 45 pacientes de um hospital de referência, localizado em João Pessoa, Paraíba, Brasil. Para obtenção dos dados, realizou-se entrevistas a partir de questionário semiestruturado, contemplando variáveis sociodemográficas e clínicas dos participantes; para avaliar sua qualidade de vida foi utilizado o instrumento Dermatology Life Quality Index, após aprovação do Comitê de Ética em Pesquisa da Universidade Federal da Paraíba. Na análise dos dados, utilizou-se o Teste não-paramétrico do Qui-quadrado de Pearson com nível de significância de 5% (p&lt;0,05), sendo utilizado a Correção de Continuidade de Yates, quando necessário.Resultados: Evidencia-se uma prevalência dos indivíduos do sexo masculino, pardos, solteiros, com idade entre 18 e 40 anos, com renda familiar inferior a três salários mínimos e baixa escolaridade. Desse total, 88,9% apresentavam a forma clínica multibacilar da hanseníase e 60% deles, com grau de comprometimento da qualidade de vida vaiando de moderado a muito grave, segundo escores do instrumento utilizado.Conclusão: Reafirma-se o importante impacto da hanseníase na qualidade de vida de seus portadores, tal como indicado pelos altos escores obtidos na aplicação do DLQI

Percepção Ambiental de Trabalhadores em Empresa Certificada ISO 14001: práticas e comportamentos

ISO 14001 Environmental Management Systems certified companies develop programs to control their environmental aspects by means of procedures and practices such as segregated waste collection, reduction of consumption of energy and water, among others. The implementation of environmental practices within the company can influence the environmental attitude of the worker in the outer side. This work aims to study the environmental practices applied by the worker within a company, its correlation with everyday life and whether these practices are related to the attitude of the worker outside the professional environment. A total of 147 responses were obtained for a questionnaire specifically developed for this research with employees of a metal surface treatment company. The results were treated by analyzing the bivariate correlations between responses. In addition to the questionnaire, operational and environmental management information was obtained from the company. The analysis of the results triangulated both information. It should be emphasized that among the assertions linked to the company’s stance those in which the leadership attitude serves as a stimulus to environmentally responsible behavior correlated with the greater number of assertions about employee behavior. As a result of the research carried out, it was concluded that the development training actions of workers can be revised in order to present practical approaches to professional and daily life and so as to awaken in the worker the environmental perception about the relation of their internal and external impacts on the environment

MÉTODOS DE OBTENÇÃO DE VALORES DE ÂNGULO DE ATRITO E COESÃO: COMPARAÇÃO ENTRE O ENSAIO DE CISALHAMENTO DIRETO E CÁLCULO BASEADO NO SPT

 A elaboração de mapas de suscetibilidade é um meio de avaliar previamente áreas que podem sofrer escorregamentos e, para tanto, é necessário conhecer alguns índices físicos do solo como os valores de coesão e o ângulo de atrito. O método mais utilizado para obtenção destes índices físicos é o de cisalhamento direto. Outro método para obtenção de valores de ângulo de atrito e coesão dá-se através de cálculos baseados na resistência do solo à penetração. O presente trabalho utilizou dados obtidos de sondagens Standart Penetration Test (SPT), realizados previamente ao longo da rodovia BR 376 entre os municípios de Curitiba-PR e Garuva-SC, os dados obtidos por meio das sondagens foram base para os cálculos de obtenção dos valores de coesão e ângulo de atrito bem como amostras indeformadas para obtenção dos mesmos parâmetros. Os pontos de coleta de amostra indeformada foram escolhidos próximos aos locais de onde foram realizadas as sondagens, priorizando os mesmos tipos de solo para possibilitar posterior comparação de resultados. Os valores obtidos por meio do cálculo baseado no SPT mostraram-se menores que os valores obtidos por meio do ensaio de cisalhamento direto, o que resultará em mapas de suscetibilidade mais confiáveis.

Surgical techniques for the treatment of ankyloglossia in children: a case series

This paper reports a series of clinical cases of ankyloglossia in children, which were approached by different techniques: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser. Information on the indications, contraindications, advantages and disadvantages of the techniques was also presented. Children diagnosed with ankyloglossia were subjected to different surgical procedures. The choice of the techniques was based on the age of the patient, length of the frenulum and availability of the instruments and equipment. All the techniques presented are successful for the treatment of ankyloglossia and require a skilled professional. Laser may be considered a simple and safe alternative for children while reducing the amount of local anesthetics needed, the bleeding and the chances of infection, swelling and discomfort

Validação da Versão Brasileira da Escala ISMI Adaptada para Dependentes de Substâncias.

The aim of this study was to validate the Internalized Stigma of Mental Illness scale ”“ ISMI adapted forsubstance dependents in Brazil. The research was conducted with a sample of 299 substance dependents. In this sample, thescale had a reliability coefficient alpha of .83 and a coefficient Spearman-Brown of .76. The construct validity, estimatedby Exploratory Maximum Likelihood Factor Analysis, showed a statistically significant correlation (p&lt;0.01) between ISMIand CES-D (r=.47), Herth Hope Scale (r=-.19), and Rosenberg Self-Esteem Scale (r=-0.48). The Brazilian version of ISMIshowed satisfactory psychometric properties in the studied sample and promises to be a useful tool to measure internalizedstigma among substance dependents.Esse estudo teve como objetivo validar a escala Internalized Stigma of Mental Illness ”“ ISMI adaptada para dependentes de substâncias psicoativas, no Brasil. Método: a pesquisa foi conduzida com uma amostra de 299 dependentes de substâncias. Resultados: O valor do alfa de Cronbach do escore total foi de 0,83 e o Coeficiente Spearman-Brown de 0,76. A validade de constructo, estimada pela Análise Fatorial Exploratória de Máxima Verossimilhança, demonstrou correlação estatisticamente significativa (p&lt;0,01) entre a ISMI e as escalas CES-D (r=0,47), Escala de Esperança de Herth (r=-0,19) e Escala de Auto-estima de Rosenberg (r=-0,48). Discussão: A versão brasileira da ISMI demonstrou propriedades psicométricas satisfatórias e promete ser um instrumento útil para mensurar estigma internalizado entre dependentes de substâncias