Acesso aos tratamentos de infertilidade no Centro Hospitalar do Alto Ave

Dissertação de mestrado em Economia e Política da SaúdeA infertilidade é considerada pela Organização Mundial de Saúde (OMS) como um problema grave de saúde pública. Estima-se que entre 60 a 80 milhões de casais em todo o mundo tenham problemas de fertilidade e que a incidência tenda a aumentar. Em paralelo crescem as soluções tecnológicas de tratamento. O acesso à tecnologia é, em geral, no entanto, difícil e desigual, fortemente limitado pela disponibilidade de serviços especializados, pela capacidade financeira e, ainda, por barreiras socioculturais. Somam-se, em alguns países, as barreiras legais ao acesso. Em Portugal, apesar da evolução favorável nos últimos anos, em particular a inclusão da comparticipação dos medicamentos em regime mais favorável, a oferta do Serviço Nacional de Saúde concentra-se num número reduzido de serviços e é claramente insuficiente. Do mesmo modo, os cuidados privados estão concentrados geograficamente em grandes cidades, seguindo o padrão do Serviço Nacional de Saúde, e são muito dispendiosos. Neste contexto, o objetivo da presente investigação é o de identificar as principais barreiras no acesso aos tratamentos de infertilidade, nas suas várias dimensões e para o caso específico da população abrangida pelo Centro Hospitalar do Alto Ave. Foi aplicado, entre os meses de julho e agosto de 2013, um inquérito por questionário, às mulheres inscritas na Unidade de Medicina de Reprodução do Centro Hospitalar do Alto Ave em Guimarães. A aplicação do inquérito foi presencial. Através da sua aplicação e posterior análise dos dados usando o programa estatístico Statistical Package for the Social Sciences foi possível conhecer as principais dificuldades com as quais os casais inférteis se deparam no acesso aos tratamentos de infertilidade, bem como sugerir algumas medidas suscetíveis de resultarem numa melhoria do acesso a esta vertente da saúde sexual e reprodutiva.Infertility is considered by the World Health Organization (WHO) as a serious public health problem. It is estimated that 60 to 80 million couples worldwide have fertility problems and this incidence tends to increase. In parallel, the technological treatments available are also increasing. Access to the technologies is, in generally, difficult and uneven, and highly it is limited by the scarce availability of specialized services, as well as by financial capacity, and sociocultural barriers. Additionally, some countries have legal barriers to access. Despite the favorable trend in recent years, in particular a more favorable reimbursement of medicines the National Health Service supply it is insufficient and geographical unequal in Portugal. Further, private care is also geographically concentrated in large cities, following the pattern of the National Health Service distribution, and it is very costly. In this context, the objective of this research is to identify the main barriers to access of infertility treatments in its various dimensions and for the specific case of the population served by the Hospital Center of Alto Ave. A questionnaire was applied between the months of July and August of 2013, to women enrolled in the Reproductive Medicine Unit of the Hospital Center of Alto Ave in Guimarães. The implementation of the questionnaire was face to face. Through its application and subsequent analysis of the data using the Statistical Package for the Social Sciences software, it was possible to identify the main difficulties that infertile couples face in access to infertility treatments, and suggest measures which could result in an improvement to the access to this crucial part of sexual and reproductive health

ANÁLISE DA ESPECIALIZAÇÃO E DO FLUXO DE COMÉRCIO EXTERIOR DO ESTADO DE MINAS GERAIS

O presente trabalho analisa a especialização e o fluxo do comércio exterior de Minas Gerais no período de 1997 a 2014. Para análise, foram utilizados os índices de vantagem comparativa revelada (Balassa), índice de vantagem comparativa revelada simétrica (Laursen) e o índice de comércio intraindústria (Grubbel e Lloyd). Quanto aos resultados, constatou-se que o estado, apesar de certa diversificação, concentra-se em poucos produtos, sobretudo, agrícolas, minerais e metais. Nesse sentido, os produtos que apresentaram vantagem comparativa foram os setores relativamente menos intensivos em capital, especialmente, produtos básicos, como os setores de “café, chá, mate e especiarias” e “Minérios, escórias e cinzas”, bem como, alguns semimanufaturados do setor de “Ferro fundido, ferro e aço”. Desta forma, conclui-se que, o comércio de Minas Gerais possui vantagem comparativa revelada em produtos de baixo valor agregado, e seu comércio é do tipo interindústria.

Alternativas comunicacionais como metodologia para ensino da língua de sinais

Podeu consultar el llibre complet a: http://hdl.handle.net/2445/164579[por] Com intuito de conhecer alternativas comunicacionais para o ensino da língua de sinais, esta investigação objetivou analisar o uso de dinâmicas no ensino da Língua Brasileira de Sinais (Libras). É uma pesquisa com metodologia qualitativa cujos resultados explicitaram que o uso de dinâmicas com abordagem comunicacional nas aulas de ensino da Libras pode despertar o interesse dos alunos e aumentar sua disposição para realização de exercícios. Essa abordagem promoveu a interação entre os alunos e melhorou a relação entre eles e o professor, aumentando o envolvimento do grupo. Esses momentos de interação permitiram aos alunos experimentarem um ambiente natural de fala que possibilitou o surgimento de discussões relativas à cultura surda ratificando que aprendizagem e cultura são processos imbricados. Conclui-se que o uso de dinâmicas com abordagem comunicacional é uma alternativa para o ensino da língua de sinais uma vez que possibilita contextos reais de aprendizagem.[eng] In order to know the communicational alternatives for the teaching of sign language, this research aimed to analyze the use of practice activities in the teaching of Brazilian Sign Language (Libras). This is a qualitative methodology reseach whose results made it clear that the use of communicational practice activities in sign language teaching classes arouse students’ interest and increased their willingness in carrying out exercises. This approach promoted interaction among students and improved the relationship between them and the teacher, increasing the connection of the group. Those moments of interaction allowed students to experience a natural speech environment which enabled the emergence of discussions related to deaf culture, ratifying that learning and culture are intertwined processes. It is concluded that the use of practice activities with a communicational approach is a favorable alternative for the teaching of sign language since it enables real learning contexts

Contaminação de trabalhadores da saúde pelo Vírus HIV / Workers health contamination by HIV Virus

O Vírus da imunodeficiência humana (HIV) representa um risco ocupacional elevado aos profissionais da saúde. O objetivo do estudo foi realizar uma revisão sistemática para identificar quais os profissionais de saúde são mais acometidos por infecção pelo HIV, no local de trabalho, e a forma mais comum de contaminação. Realizou-se uma revisão sistemática nas bases de dados Pubmed, Scielo, e Science Direct, selecionando nove artigos. O profissional da saúde mais acometido pela exposição ao HIV foi o enfermeiro e a forma mais frequente de exposição foi por manuseio de agulha. Medidas de biossegurança são necessárias durante a prática profissional para prevenir a contaminação pelo vírus HIV

School Psychology and Childhood – a public school experience

This work reports an activity performed as part of coursework in Psychology class during a school semester which aimed to provide students an effective experience of what public school psychologists do, based on the critical presumptions about Psychology and also aimed to present reflections on the performance of this professional together with children. The proposal involved encounters with teachers and children and the undergraduates were responsible for the preparation and execution of activities under the supervision of professors. The Psychology students highlighted the importance of this practice for their professional training, which provided discussions on key questions such as childhood, education and the impact of School Psychology in the Brazilian educational scope

Access to infertility consultations: what women tell us about it?

The main objective of the present paper is to evaluate the perception of women concerning the barriers and access to infertility consultations. Socio cultural and economic access to infertility consultations is detached and three municipalities of the northwest of Portugal were chosen as an example of a peripheral country. A quantitative/qualitative study was done with 60 women. Three dimensions were evaluated: geographic and structural and functional access; economic access; and sociocultural access. The main barriers were mainly identified in the last two dimensions. The economic access was the less well evaluated by women being the cost of treatment (medication, and concentration of costs in a short period) difficult to bear. This can justify a greater involvement of the Portuguese Government, by developing policies for the reimbursement of part of the costs. Also, some changes in structural and functional access must be done with special regard to the separation of the infertility consultations from the reproductive medicine section. The setting of the teams, with a follow-up by the same team of health professionals is also needed

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost