Manobra de Epley repetida em uma mesma sessão na vertigem posicional paroxística benigna Epley’s maneuver in the same session in benign positional paroxysmal vertigo

OBJETIVO: Avaliar se a repetição de manobras de Epley em uma mesma sessão resulta em um menor número de sessões para abolir o nistagmo de posicionamento do que uma única manobra por sessão. MÉTODO: A manobra de Epley foi realizada em 123 pacientes com VPPB unilateral por ductolitíase do canal posterior. O grupo I foi composto por 75 pacientes submetidos a uma única manobra de Epley por sessão semanal e o grupo II foi constituído por 48 pacientes submetidos a quatro manobras na primeira sessão. RESULTADOS: O grupo II apresentou latência e duração do nistagmo maiores do que o grupo I (p<0,05). A média e o desvio-padrão do número de sessões apresentados pelo grupo I foram maiores do que no grupo II (p=0,008). Observou-se associação significante entre a distribuição do número de sessões e o grupo (p=0,039). O grupo II apresentou 21,4% a mais de pacientes que necessitaram apenas de uma sessão (IC 95% [7,7% - 35,1%]). CONCLUSÃO: A repetição de manobras de Epley em uma mesma sessão resulta em um menor número de sessões para abolir o nistagmo de posicionamento do que uma única manobra por sessão.<br>AIM: To assess whether more than one Epley’s maneuver in the same session, compared to a single one, decreases the number of sessions necessary to suppress positional nystagmus. METHOS: Epley’s maneuver was done in 123 patients with BPPV due to unilateral posterior semicircular canal canalolithiasis. The number of sessions for positional nystagmus suppression was compared in two groups of patients. Group I consisted of 75 patients submitted to a single Epley’s maneuver on weekly sessions and group II consisted of 48 patients that were submitted to four Epley’s maneuvers during the first session. RESULTS: Group II showed greater nystagmus latency and duration than group I (p<0.05). The number of sessions and standard deviation showed by group I was greater than in group II (p=0.008). We observed a significant association between number of sessions and group (p=0.039) studied. Group II had 21.4% more nystagmus-free patients following only one session (CI95% [7.7% - 35.1%]). CONCLUSION: Repeated Epley’s maneuvers in less sessions rendered more positional nystagmus-free patients when compared to those submitted to more sessions of single maneuvers

HRM professionals and their perceptions of HRM and firm performance in the Philippines

This paper reports the findings of a study conducted in the Philippines that examines the extent of adoption of human capital-enhancing human resource (HR) and industrial relations (IR) practices. Differences between locally owned and other organizations in these practices and their relationship to firm performance were also investigated. Questionnaire responses were obtained from managers and union representatives from 128 organizations located in the Philippines. The results indicated that there was, on average, a fairly high level of adoption of practices consistent with a strategic approach to human resource management (HRM), with foreign-owned firms tending to show a slightly higher level of adoption of such practices. A scale representing the adoption of a more conciliatory and union-friendly IR approach was found to be a significant predictor of perceived firm performance. Surprisingly, the level of strategic integration between HRM and business planning and most human capital-enhancing HR practices were not significant predictors of perceived firm performance. Research and practical implications in relation to the role of HRM in enhancing firm performance are discussed

Trabalho feminino e saúde na terceira idade Women's work and health among Brazilian elderly

O objetivo deste estudo é estimar e caracterizar a participação de idosas no mercado de trabalho e investigar diferenciais de saúde, segundo sua inserção nesse mercado, após considerar a influência de fatores sociodemográficos. O estudo incluiu 4.607 com 65 anos e mais, residentes em dez regiões metropolitanas brasileiras e participantes da PNAD/98. Foram definidas as categorias: trabalhando, aposentada e outra. A análise incluiu o qui-quadrado e o odds ratio estimado através de regressão logística multinomial. Quase 10% das mulheres trabalhavam, 42% eram aposentadas e 48% não trabalhavam nem eram aposentadas. As idosas ocupadas eram mais jovens, tinham maior renda, e de 4 a 7 anos de escolaridade. O fato de estar trabalhando esteve associado à melhor percepção da própria saúde, menor relato de doenças crônicas, plano privado de saúde, menor relato de consulta e internação hospitalar, melhores indicadores de autonomia e mobilidade física e maior freqüência de consulta odontológica. A permanência das idosas na vida ativa é inferior à dos homens brasileiros no mesmo período. Os diferenciais de saúde relacionados ao trabalho são mais acentuados entre as mulheres. É fundamental determinar se os diferenciais de saúde observados entre idosas, também são encontrados nas mulheres em idade ativa.<br>The objective of this study is to estimate and describe the participation of aged women in the labour market, and to investigate health differentials according to their working position, after considering the influence of social and demographic factors. This study comprises 4.607 females aged 65 or more, residents in 10 Brazilian metropolitan regions and participants of PNAD conducted in 1998. The following working categories have been defined: working, retired and other. The analysis was based on qui-square tests and odds ratios were obtained by multinomial logistic regression. Almost 10% of the aged women worked, 42% were retired, and 48% did not work nor were retired. Working women were younger, had higher income and schooling level between 4 and 7 years. Working was associated with better self-perceived health, less report of chronic diseases, having private health plan, less medical visits and hospitalisations, better indicators of autonomy and physical mobility and more dentist visits. Our results show that the proportion of women who remain in the active life in older ages is much lower than that found among Brazilian males in the same period. It is important to determine if the observed differentials in health among aged women are also found among women in active age

Benign Paroxysmal Positional Vertigo and Migraine

Benign paroxysmal positional vertigo (BPPV) is the most frequent cause of vertigo in adults and migraine is the most frequent cause of headache in humans. Females are more commonly affected than males in both diseases. Over the last 15 years, interesting, important relationships between the two disorders have been studied and proposed. Here we review the pathophysiology and diagnosis of BPPV both in its simple and linear presentations and in its more complex forms in which the patterns of nystagmus are less easily understood. We also mention the main therapeutic options for treating posterior and lateral canal BPPV. Possible correlations between BPPV and migraine are described. Finally, since migraine can cause vestibular symptoms, including positional vertigo, suggestions are given for differential diagnosis between the two diseases