Aborto inseguro: determinantes sociais e iniquidades em saúde em uma população vulnerável, São Paulo, Brasil

This cross-sectional population-based study in a peripheral low-income community in São Paulo, Brazil, aimed to estimate the prevalence of unsafe abortion and identify the socio-demographic characteristics associated with it and its morbidity. The article discusses the study's results, based on univariate and multiple multinomial logistic regression analyses. The final regression models included: age at first intercourse 2 sex partners in the previous year (OR = 3.63); more live born children than the woman's self-reported ideal number (OR = 3.09); acceptance of the abortion due to insufficient economic conditions (OR = 4.07); black ethnicity/color (OR = 2.67); and low schooling (OR = 2.46), all with p 2 (OR = 3,63); número de filhos nascidos vivos > ideal (OR = 3,09); aceitação do aborto por falta de condições econômicas (OR = 4,07); etnia negra/cor preta (OR = 2,67); e escolaridade baixa (OR = 2,46), todos com p < 0,05. Foi utilizada na discussão uma abordagem voltada aos determinantes sociais da saúde, segundo conceito e modelo adotados pela WHO, e às iniquidades em saúde por esses geradas na ocorrência do aborto inseguro. Verificou-se que o aborto inseguro e características sociodemográficas são influenciados pelos determinantes sociais da saúde descritos, gerando nessa população iniquidades em saúde de proporções diversas.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Epidemiology of unsafe abortion in a poverty stricken environment Favela Inajar de Souza, São Paulo, Brazil

This article compares the results of a survey carried out recently in a poverty stricken environment in São Paulo, Brazil - a country where abortion is illegal in most circumstances- to data from Cuba - where abortion is safe and legal, and data registries are reliable. A cross-sectional survey was conducted in a community in the north side of the city, called Favela Inajar de Souza, with the purpose of estimating the frequency of unsafe, clandestine abortions and identifying socio-demographic characteristics and morbidity related to abortion in a poor population. All women aged 15 to 54 years that lived in this community (Census) were interviewed for this survey. The Chi-Square Test and the Fisher exact test were used for categorical variables, and analysis of variance was used for numeric variables. Throughout the analysis, the statistical significance level of 5% (p<0.05) was adopted. A high number of unsafe abortions and a high rate of post-abortion complications were detected in the studied population - the community of Favela Inajar. With regard to induced abortions, the only common features between the two populations were age and civil status. As opposed to what happens in Cuba, the analysis of the data from Favela Inajar shows that there were statistically significant associations between unsafe abortion and: income, educational level, internal migration and ethnicity. These findings indicate that this population is particularly vulnerable to unsafe abortion in face of the several forms of structural violence present in Brazil, which produce social inequity. The performance of safe and legal abortion, as is the case in Cuba, would change this scenario. Legalization of abortion in Brazil would mostly benefit poor women.Procurou-se, neste trabalho, comparar os Resultados de Pesquisa recente, realizada em São Paulo, Brasil, país em que o aborto é ilegal em quase todas as circunstâncias, com dados referentes a Cuba, país onde o aborto é legal e seguro, dispondo de registros confiáveis. Essa pesquisa foi sediada em uma comunidade da Zona Norte da cidade de São Paulo, Favela Inajar de Souza: um estudo transversal que teve por objetivo estimar a freqüência de Abortos Inseguros, bem como determinar as características sociodemográficas e a morbidade associadas a tal ocorrência, em uma população em situação de pobreza. Foram entrevistadas todas as mulheres entre 15 e 54 anos residentes na comunidade (Censo). Na análise dos dados foram empregados o teste exato de Fisher e o teste qui-quadrado para as variáveis categóricas, e a análise de variância (ANOVA) para as variáveis numéricas. Em toda a análise adotou-se um nível de significância de 5%, com p < 0,05. Encontrou-se, na população estudada, Favela Inajar, um alto número de abortos inseguros e alta porcentagem de complicações pós-aborto. Em comum com Cuba, quanto ao Aborto Induzido foi observada semelhança de perfil somente em relação à Idade e ao Estado Civil. Nos Resultados foram constatadas também - contrariamente ao que ocorre em Cuba - associações estatisticamente significativas entre Aborto Inseguro e Renda/Escolaridade (baixas), Aborto Inseguro e Etnia/Cor, Aborto Inseguro e Não Apoio do Parceiro, e Aborto Inseguro e Migração Interna - o que torna essa população especialmente vulnerável ao aborto inseguro frente às violências estruturais, geradoras de iniqüidade, vigentes no Brasil. O aborto legal e seguro, tal como em Cuba, transformaria essa realidade. A legalização do aborto beneficiaria, sobretudo, as mulheres pobres.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Medicina PreventivaUNIFESP, EPM, Depto. de Medicina PreventivaSciEL

SUSCEPTIBILITY MAPPING OF SHALLOW LANDSLIDES INDUCING DEBRIS FLOWS: A COMPARISON OF PHYSICS-BASED APPROACHES

The assessment of timing and potential locations of rainfallinduced shallow landslides through mathematical models represents a challenge for the assessment of landslide hazard, especially in cases with limited or not available data. In fact, modeling slope hydrological response and stability requires accurate estimates of unsaturated/saturated hydraulic and geotechnical properties of materials involved in landsliding, as well as climate and topography. Such aspect is relevant for the prediction of location and timing of landslide events, which is greatly needed to reduce their catastrophic effects in terms of economic losses and casualties. To such a scope, we present the comparison of results of two physics-based models applied to the assessment of susceptibility to shallow rainfall-induced landslides in Valtellina region (northern Italy). The analyses were carried out considering effects of availability, resolution and type of data concerning spatial distribution, thickness and properties of soils coverings. For such a scope, the Transient Rainfall Infiltration and Grid-Based Regional Slope-Stability (TRIGRS) and the Climatic Rainfall Hydrogeological Modeling Experiment (CHRyME) models were considered. The study emphasizes issues in performing distributed numerical slope stability modeling depending on the availability of spatially distributed soil properties which hamper the quality of physic-based models. Further analyses aimed at the probabilistic assessment of landslide spatial distribution, related to a specific value of rainfall threshold, can be considered as potentially applicable to multi-scale landslide hazard mapping and extendable to other similar mountainous frameworks

Prevalência e características sociodemográficas de mulheres com aborto provocado em uma amostra da população da cidade de São Paulo, Brasil

Objectives:This study aims at estimating the prevalence of women with induced abortion among women of childbearing age (15-49 years) who had any previous pregnancy, in the city of São Paulo, Brazil, in the last quarter of 2008, and identifying the sociodemographic characteristics (SC) associated with it. Methods:A cross-sectional survey was carried out. The dependent variable was dichotomized as: no abortion and induced abortion. The independent variables were: age, paid work/activity, familial monthly income, schooling, marital status, contraceptive use and number of live births. Statistical analysis was performed using log-binomial regression models with approximation of Poisson to estimate the prevalance ratios (PR). Results:Of all women with any previous pregnancy (n = 683), 4.5% (n = 31) reported induced abortion. The final multivariate model showed that having now between 40 and 44 years (PR = 2.76, p = 0.0043), being single (PR = 2.79, p = 0.0159), having 5 or more live births (PR = 3.97, p = 0.0013), current oral contraception or IUD use (PR = 2.70, p = 0.454) and using a non effective (or of low efficacy) contraceptive method (PR = 4.18, p = 0.0009) were sociodemographic characteristics associated with induced abortion in this population. Conclusions:Induced abortion seems to be used to limit fertility, more precisely after having reached the desired number of children. The inadequate use or non-use of effective contraceptive methods, and / or the use of contraceptivenon effective, exposed also the women to the risk of unintended pregnancies and, therefore, induced abortions. In addition, when faced with a pregnancy, single women were more likely to have an abortion than married women.Objetivos:O presente estudo busca estimar a prevalência de mulheres com aborto provocado dentre as mulheres em idade fértil (15 a 49 anos de idade) que apresentaram alguma gestação prévia, residentes na cidade de São Paulo, Brasil, no último trimestre de 2008, bem como identificar essa ocorrência em função de algumas características sociodemográficas (CSD).Métodos:Trata-se de um estudo transversal. A variável dependente aborto foi dicotomizada em: aborto provocado (AP) e nenhum aborto (NA). As variáveis independentes utilizadas foram: idade, atividade remunerada, renda mensal familiar, escolaridade, estado conjugal, uso de método(s) contraceptivo(s) e número de filhos nascidos vivos. A análise estatística foi realizada por meio de modelos de regressão log-binomial com aproximação de Poisson para avaliar as razões de prevalência (RP).Resultados:Dentre o total de mulheres com alguma gestação prévia (n = 683), 4,5% (n = 31) declararam algum AP. O modelo log-binomial final mostrou que idade atual entre 40 e 44 anos de idade (RP = 2,76; p = 0,0043), estado conjugal solteira (RP = 2,79; p = 0,0159), número de filhos nascidos vivos igual ou maior que 5 (RP = 3,97; p = 0,0013, uso de contraceptivo não eficaz ou de baixa eficácia (RP = 4,18; p = 0,0009) e uso atual de contraceptivo oral ou dispositivo intrauterino (RP = 2,70; p = 0,454) foram as características que se apresentaram mais fortemente associadas à ocorrência de AP entre as mulheres dessa população.Conclusões:O aborto provocado é utilizado para limitar a fecundidade, mais precisamente após atingir-se o número desejado de filhos. O uso inadequado, ou o não-uso, de contraceptivos eficazes e/ou a utilização de contraceptivos não eficazes, ou de baixa eficácia, também promovem a resolução pelo aborto, assim como o fato de as mulheres solteiras enfrentarem uma gestação sozinhas.Universidade Federal de São Paulo (UNIFESP) Department of Preventive MedicineCentro Universitário de GuaxupéUNIFESP, Department of Preventive MedicineSciEL

Concerning synthesis of new biobased polycarbonates with curcumin in replacement of bisphenol a and recycled diphenyl carbonate as example of circular economy

Curcumin (CM) is a natural polyphenol well-known for its antioxidant and pharmaceutical properties, that can represent a renewable alternative to bisphenol A (BPA) for the synthesis of biobased polycarbonates (PC). In the presented strategy, preparation of the CM-based PC was coupled with chemical recycling of the fossil-based BPA polycarbonate (BPA-PC) conducting a two-steps trans-polymerization that replaces BPA monomer with CM or its tetrahydrogenated colorless product (THCM). In the first step of synthetic strategy, depolymerization of commercial BPA-PC was carried out with phenol as nucleophile, according to our previous procedure based on zinc derivatives and ionic liquids as catalysts, thus producing quantitatively diphenyl carbonate (DPC) e BPA. In the second step, DPC underwent a melt transesterification with CM or THCM monomers affording the corresponding bio-based polycarbonates, CM-PC and THCM-PC, respectively. THCM was prepared by reducing natural bis-phenol with cyclohexene as a hydrogen donor and characterized by 1H-NMR and MS techniques. Polymerization reactions were monitored by infrared spectroscopy and average molecular weights and dispersity of the two biobased polymers THCM-PC and CM-PC were determined by means of gel permeation chromatography (GPC). Optical properties of the prepared polymers were also measured

Impact of Circadian Desynchrony on Spermatogenesis: A Mini Review

The purpose of this mini review is to provide data about pre-clinical and clinical evidence exploring the impact of circadian desynchrony on spermatogenesis. Several lines of evidence exist demonstrating that disruption of circadian rhythms may interfere with male fertility. Experimental knock-out or knock-down of clock genes, physiologically involved in the regulation of circadian rhythms, are associated with impairments of fertility pathways in both animal and human models. Moreover, disruption of circadian rhythms, due to reduction of sleep duration and/or alteration of its architecture can negatively interfere in humans with circulating levels of male sexual hormones as well as with semen parameters. Unfortunately, current evidence remains low due to study heterogeneity

Photoreduction of Carbon Dioxide to Formic Acid in Aqueous Suspension: A Comparison between Phthalocyanine/TiO2 and Porphyrin/TiO2 Catalysed Processes

Composite materials prepared by loading polycrystalline TiO2 powders with lipophilic highly branched Cu(II)- and metal-free phthalocyanines or porphyrins, which have been used in the past as photocatalysts for photodegradative processes, have been successfully tested for the efficient photoreduction of carbon dioxide in aqueous suspension affording significant amounts of formic acid. The results indicated that the presence of the sensitizers is beneficial for the photoactivity, confirming the important role of Cu(II) co-ordinated in the middle of the macrocycles. A comparison between Cu(II) phthalocyanines and Cu(II) porphyrins indicated that the Cu(II)- phthalocyanine sensitizer was more efficient in the photoreduction of CO2 to formic acid, probably due to its favorable reduction potential

Integrating Biological Advances Into the Clinical Management of Breast Cancer Related Lymphedema

Breast cancer-related lymphedema (BCRL) occurs in a significant number of breast cancer survivors as a consequence of the axillary lymphatics' impairment after therapy (mainly axillary surgery and irradiation). Despite the recent achievements in the clinical management of these patients, BCRL is often diagnosed at its occurrence. In most cases, it remains a progressive and irreversible condition, with dramatic consequences in terms of quality of life and on sanitary costs. There are still no validated pre-surgical strategies to identify individuals that harbor an increased risk of BCRL. However, clinical, therapeutic, and tumor-specific traits are recurrent in these patients. Over the past few years, many studies have unraveled the complexity of the molecular and transcriptional events leading to the lymphatic system ontogenesis. Additionally, molecular insights are coming from the study of the germline alterations involved at variable levels in BCRL models. Regrettably, there is a substantial lack of predictive biomarkers for BCRL, given that our knowledge of its molecular milieu remains extremely puzzled. The purposes of this review were (i) to outline the biology underpinning the ontogenesis of the lymphatic system; (ii) to assess the current state of knowledge of the molecular alterations that can be involved in BCRL pathogenesis and progression; (iii) to discuss the present and short-term future perspectives in biomarker-based patients' risk stratification; and (iv) to provide practical information that can be employed to improve the quality of life of these patients

Hard X-ray and radio observations of Abell 754

We present a long BeppoSAX observation of Abell 754 that reports a nonthermal excess with respect to the thermal emission at energies greater than ~45 keV. A VLA radio observation at 1.4 GHz definitely confirms the existence of diffuse radio emission in the central region of the cluster, previously suggested by images at 74 and 330 MHz (Kassim et al 2001), and reports additional features. Besides, our observation determines a steeper radio halo spectrum in the 330-1400 MHz frequency range with respect to the spectrum detected at lower frequencies, indicating the presence of a spectral cutoff. The presence of a radio halo in A754, considered the prototype of a merging cluster, reinforces the link between formation of Mpc-scale radio regions and very recent or current merger processes. The radio results combined with the hard X-ray excess detected by BeppoSAX give information on the origin of the electron population responsible for nonthermal phenomena in galaxy clusters. We discuss also the possibility that 26W20, a tailed radio galaxy with BL Lac characteristics located in the field of view of the PDS, could be responsible for the observed nonthermal hard X-ray emission.Comment: 7 pages, 3 figures; Astronomy & Astrophysics, in pres