108 research outputs found
Mortalidade infantil e acesso geográfico ao parto nos municÃpios brasileiros
OBJETIVO: Analisar o acesso geográfico ao parto hospitalar nos municÃpios brasileiros. MÉTODOS: Foram analisadas informações de óbitos e nascimentos quanto à sua adequação para o cálculo do coeficiente de mortalidade infantil no perÃodo de 2005 a 2007 para os 5.564 municÃpios brasileiros. O acesso geográfico foi expresso por indicadores de deslocamento, oferta e acesso aos serviços de saúde. A associação entre o acesso geográfico ao parto e o coeficiente de mortalidade infantil em municÃpios com adequação de suas informações vitais foi avaliada por meio de regressão múltipla. RESULTADOS: Dentre os municÃpios analisados, 56% apresentaram adequação das informações vitais, correspondendo a 72% da população brasileira. O deslocamento geográfico ao parto mostrou-se inversamente associado ao porte populacional, à renda per capita, e à mortalidade infantil, mesmo controlado por fatores demográficos e socioeconômicos. CONCLUSÕES: Embora tenham sido desenvolvidas estratégias importantes para a melhoria da qualidade do atendimento à s gestantes no Brasil, as ações para garantir o acesso igualitário à assistência ao parto ainda são insuficientes. O maior deslocamento intermunicipal para o parto se mostrou como um fator de risco para a mortalidade infantil, aliado à desigualdade de oferta de serviços qualificados e à falta de integração com a atenção básica de saúde
Prefrontal dopamine and the dynamic control of human long-term memory
Dopaminergic projections to the prefrontal cortex support higher-order cognitive functions, and are critically involved in many psychiatric disorders that involve memory deficits, including schizophrenia. The role of prefrontal dopamine in long-term memory, however, is still unclear. We used an imaging genetics approach to examine the hypothesis that dopamine availability in the prefrontal cortex selectively affects the ability to suppress interfering memories. Human participants were scanned via functional magnetic resonance imaging while practicing retrieval of previously studied target information in the face of interference from previously studied non-target information. This retrieval practice (RP) rendered the non-target information less retrievable on a later final test—a phenomenon known as retrieval-induced forgetting (RIF). In total, 54 participants were genotyped for the catechol-O-methyltransferase (COMT) Val108/158Met polymorphism. The COMT Val108/158Met genotype showed a selective and linear gene-dose effect on RIF, with the Met allele, which leads to higher prefrontal dopamine availability, being associated with greater RIF. Mirroring the behavioral pattern, the functional magnetic resonance imaging data revealed that Met allele carriers, compared with Val allele carriers, showed a greater response reduction in inhibitory control areas of the right inferior frontal cortex during RP, suggesting that they more efficiently reduced interference. These data support the hypothesis that the cortical dopaminergic system is centrally involved in the dynamic control of human long-term memory, supporting efficient remembering via the adaptive suppression of interfering memories
Five views of a secret: does cognition change during middle adulthood?
This study examined five aspects of change (or
stability) in cognitive abilities in middle adulthood across a
12-year period. Data come from the Interdisciplinary Study
on Adult Development. The sample consisted of N = 346
adults (43.8 years on average, 48.6% female). In total, 11
cognitive tests were administered to assess fluid and crystallized
intelligence, memory, and processing speed. In a
first series of analyses, strong measurement invariance was
established. Subsequently, structural stability, differential
stability, stability of divergence, absolute stability, and the
generality of changes were examined. Factor covariances
were shown to be equal across time, implying structural
stability. Stability coefficients were around .90 for fluid and
crystallized intelligence, and speed, indicating high, yet not
perfect differential stability. The coefficient for memory
was .58. Only in processing speed the variance increased
across time, indicating heterogeneity in interindividual
development. Significant mean-level changes emerged,
with an increase in crystallized intelligence and decline in
the other three abilities. A number of correlations among
changes in cognitive abilities were significant, implying
that cognitive change
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