Padrões de aborto provocado na Grande São Paulo, Brasil

OBJECTIVE: To assess the behavior of induced abortion as a function of certain demographic variables, for the population of fertile women (15 to 49 years old) residing in the Vila Madalena subdistrict S. Paulo (Brazil). MATERIAL AND METHOD: Two population samples were selected. One sample, with 996 women, investigated the incidence of induced abortions during 1987, using the RRT. In the other, involving 1,004 women, the same information was detected through a conventional approach. In both samples, the induced abortion occurring during the reproductive life was recorded in direct fashion. Though this analysis refers only to information about past abortions, that is by 2,000 women -, it should be noted that it is exactly the RRT that lends credibility to the found or results given results. CONCLUSION: The analysis furnishes evidence showing that single women, young women between the ages of 15 and 19, women who have not had live births, women who have a number of children below the expected ideal, women who use contraceptive methods (especially inefficient ones) and women who do not have any restrictions as to abortion constitute the categories most inclined to resort to induced abortion. This grouping suggests the existence of interrelationships between categories, that is, each of these categories is probably composed primarily of the same women, those who are at the beginning of their reproductive lives.OBJETIVO: Avaliar o comportamento do aborto provocado, segundo algumas variáveis sociodemográficas, para a população de mulheres em idade fértil (entre 15 e 49 anos de idade), residentes no subdistrito de Vila Madalena, São Paulo (Brasil). MATERIAL E MÉTODO: Foram selecionadas duas amostras populacionais. Uma delas, com 996 mulheres, foi destinada a investigar a incidência do aborto em 1987, recorrendo-se à TRA. Na outra, com 1.004 mulheres, a mesma informação foi coletada mediante abordagem direta. Em ambas as amostras foram coletadas as informações referentes à história genética das mulheres, apenas por abordagem direta. Embora a análise desenvolvida paute-se, unicamente, nesses eventos passados, é justamente a TRA que permite assegurar que as tendências detectadas são fidedignas. RESULTADOS E CONCLUSÕES: Foi possível se diagnosticar que as mulheres que mais recorrem à provocação de um aborto são as solteiras, as jovens entre 15 e 19 anos de idade, as que ainda não têm filhos, as que ainda não atingiram o número desejado de filhos, as que usam contraceptivos - sobretudo os não eficazes, e as que aceitam a prática do aborto provocado sem quaisquer restrições. Essas foram as que recorreram mais largamente a tal prática. Há fortes indícios de que os referidos grupos sejam, majoritariamente, constituído pelas mesmas mulheres: as que se encontram no início de suas vidas reprodutivas.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

O impacto do aborto ilegal na saúde reprodutiva: sugestões para melhorar a qualidade do dado básico e viabilizar essa análise

Trusworthy statistics on provoked abortion form countries where this practice is generalized allow for an adequate evaluation of the impact of abortion on Reprodutive Health. Paradoxically it is in these very countries that the less severe damage to Reproductive Health are observed. At the same time, even based on little or totally not trustworthy data the cost of clandestine practice is very high: its sequels are frequent and often lead to death. Evaluating how high these costs are, however, is a rather hard task that depending on the desired focus may even not be feasible. The best solution for such dilemma would be, according to the literature, the legalization of abortion. In this case the analysis of the duet Abortion/Health besides automatically reducing the costs on the clandestine practice would allow for the removal of the remaining costs. Nevertheless, while one has to live under a restrictive legislation the most sensible solution is optimizing the quality of analysis of that duet. One can in this sense adopt a statistical technique that removes the biggest obstacle to the determination of the dynamics of illegal abortion i.e. the under register/and/or under register of abortion frequency the RRT. One can also design population studies from a simplified sampling plan for they are very rare in comparison to hospital based analysis.Estatísticas fidedignas sobre o aborto provocado, provenientes de países em que essa prática é legalizada, permitem uma adequada avaliação do impacto do aborto na Saúde Reprodutiva. Paradoxalmente, é justamente nesses países que observam-se os menores danos à Saúde da Mulher enquanto que, mesmo pautando-se em dados pouco ou nada confiáveis, o custo da prática clandestina é altíssimo: suas sequelas são bastante frequentes e, não raras vezes, levam ao óbito. Avaliar-se o quão alto é este custo, contudo, é uma tarefa bastante árdua e, infelizmente, dependendo do enfoque desejado pode até ser inexequível. A solução mais acertada para a resolução desse dilema seria, a julgar pela literatura especializada, legalizar-se o aborto. Nessa eventualidade, além de se reduzir, automaticamente, os custos da prática clandestina, a análise do dueto Aborto/ Saúde, por si, permitiria remover os custos remanecentes.Mas, enquanto se convive com uma legislação restritiva, a solução mais sensata, é buscar otimizar a qualidade de análise daquele dueto. Nesse sentido, pode-se recorrer à adoção de uma técnica estatística que remove o maior dos entraves na determinação da dinâmica do aborto ilegal - a saber, a sub-declaração e/ou sub-registro da frequência de recorrência ao aborto -, a TRA; bem como elaborar-se estudos populacionais, a partir de um plano de amostragem simplificado, sobretudo por serem raríssimos frente aos estudos baseados em dados hospitalares, apesar de fornecerem informações bem mais amplas sobre a dinâmica do aborto.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

A paisagem cultural de Pitimbu, Paraíba / nordeste do Brasil

O Brasil é o país com a maior diversidade de embarcações tradicionais no planeta, que manifestam elementos e tradições de boa parte do patrimônio naval da humanidade. Se por um lado é contemplado com essa riqueza, por outro, a tem localizada em porções territoriais vulneráveis às mais diversas ameaças à sustentabilidade: a zona costeira. O município de Pitimbu-PB, por expressar uma tipologia de embarcação peculiar, a “jangada de duas velas”, foi selecionado dentre os principais contextos navais brasileiros como área prioritária com vistas a receber a chancela da Paisagem Cultural Brasileira pelo IPHAN. Por se tratar de um dos casos pioneiros de aplicação desse novo instrumento no Brasil, almejase compartilhar, neste artigo, alguns desafios da gestão do patrimônio cultural situado em contextos complexos, como os ambientes costeiros. As reflexões foram fundamentadas na análise da paisagem e em fontes documentais.Brasil es el país que tiene la mayor diversidad de embarcaciones tradicionales del planeta, exhibiendo elementos y tradiciones de gran parte del patrimonio naval de la humanidad. Sin embargo, las zonas costeras son las más vulnerables a factores que amenazan la sostenibilidad. Pitimbu-PB fue seleccionado entre los principales contextos navales brasileños como un lugar prioritario para ser nombrado Paisaje Cultural de Brasil por el IPHAN por su excepcional tipo de barco, la “balsa de dos velas principales “(y dos mástiles principales). Este artículo tiene como objetivo compartir retos de la gestión del patrimonio cultural asociado a ambientes complejos, como son las zonas costeras. La discusión se basa en el análisis del paisaje y las fuentes documentales.Brazil is the country that has the greatest diversity of traditional boats on the planet, exhibiting elements and traditions from much of the naval heritage of humanity. However, its wealth is located on areas that are vulnerable to several threats of sustainability: the coastal zone. Pitimbu-PB was selected among the main Brazilian naval contexts as a priority site to be nominated as Brazilian Cultural Landscape by IPHAN for its outstanding type of boat, the “raft of two main sails” (and two main masts). This article is aimed at sharing challenges of managing cultural heritage associated with complex enviroments such as coastal environments. The discussion is based on landscape analysis and documentary sources.Peer Reviewe

Lifestyle factors and neuroimaging metrics as predictors of cognitive performance in healthy aging

Despite all the advances made in health-related and psychological sciences, advancing age continues to be accompanied by cognitive decline. Aging is usually associated with major changes in the structure and functioning of the brain that lead to impairments in multiple cognitive functions. The trajectories of age-related effects on the brain and cognition exhibit considerable differences across cognitive domains and across individuals, and investigating approaches and factors that might prevent brain and cognitive decline during aging is considered a topic of great scientific and public health relevance. The overall goal of this thesis was to evaluate age-related differences in brain structure and functional connectivity to further our understanding of the neural mechanisms involved in age-related declines in cognition. This thesis also aimed to investigate the influence of lifestyle factors on age differences in cognition, and in that regard, I focused on the effects of sleep quality and physical activity on memory. In Study 1, I assessed the impact of aging on grey matter volume of the medial temporal lobe MTL and prefrontal cortex PFC and compared the relative contributions of MTL and PFC structures to age differences in associative memory. My findings emphasize the critical role of the frontal lobes, and the control processes they subserve, in determining the detrimental effects of age on memory. Additionally, I observed that the relationship between frontal grey matter volume and memory was not moderated by age or sex, suggesting that greater volume in PFC structures relates to better memory performance across the lifespan and in both sexes. In Study 2, I assessed the effects of age on functional brain networks. Given the essential role of the arousal system (ARAS) in cortical activation and previous findings of disrupted ARAS functioning with age, I investigated the hypothesis that age-related changes in ARAS-cortical functional connectivity may contribute to commonly observed age-related differences in cortical connectivity. The findings of this study showed that the arousal system is functionally connected to widespread cortical regions and suggest that age differences in functional connectivity within the cortex may be driven by age-related changes in the brainstem and these altered connectivity patterns have important implications for cognitive health. In Study 3, I investigated the relationship between sleep quality, physical activity, and memory in middle-age and older adults, in addition to assessing the impact of the COVID-19 pandemic on participants’ mood and sleep quality. Our results showed that people who were more active reported better sleep quality and showed better memory, and better sleep quality was associated with better memory. Moreover, our findings also showed that some of the beneficial effects of physical activity on cognition are partially mediated by improved sleep. Additionally, this study indicated that the COVID-19 pandemic had a deleterious effect on people’s sleep quality and overall well-being. Taken together, these studies suggest that aging is associated with disruptive effects on brain structure and function, and that these changes are associated with age-related cognitive decline. Additionally, our study supported the association between lifestyle factors, more specifically, sleep quality and physical activity, and cognitive performance during aging

Effect of CO2 laser in the enamel demineralization around orthodontic brackets

Orientador: Marines Nobre dos Santos UchoaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: A aplicação do laser de dióxido de carbono (CO2) à estrutura do esmalte modifica a composição química e/ou morfológica dessa superfície e inibe o desenvolvimento e a progressão de lesões cariosas. Porém, não foram realizadas pesquisas que tenham verificado se a irradiação do esmalte dental ao redor de braquetes ortodônticos com esse laser é efetiva em reduzir a desmineralização nessa região numa situação de alto desafio cariogênico. Assim, esta dissertação objetivou verificar, in vitro, se a irradiação do esmalte dental com laser de CO2 (?=10.6 µm e 10.0 J/cm2), associada ou não a liberação de fluoreto pelo material de colagem, seria capaz de reduzir a perda mineral do esmalte, ao redor de braquetes ortodônticos, quando submetido a uma situação de alto desafio cariogênico. Nesse estudo, 24 blocos de esmalte bovino foram divididos em 4 grupos, em triplicata: 1 ¿ resina composta não liberadora de fluoreto Transbond (T); 2 ¿ cimento de ionômero de vidro modificado por resina Fuji (F); 3 ¿ laser de CO2 + resina composta não liberadora de fluoreto (TL); 4 ¿ laser de CO2 + cimento de ionômero de vidro modificado por resina (FL). Um grupo contendo blocos de esmalte foi incluído apenas para análise de microdureza. Após a colagem dos braquetes, os espécimes foram suspensos em água destilada deionizada esterilizada e esterilizados com radiação gama. A seguir, foram transferidos para o meio de cultura esterilizado de caldo de cérebro-coração (BHI) contendo sacarose a 5% e os 4 grupos experimentais foram inoculados com uma cultura overnight de Streptococcus mutans. Diariamente, o meio BHI foi trocado e analisado quanto à contaminação microbiológica. Após 6 dias de incubação (37ºC - 10% CO2), o biofilme foi coletado e submetido as análises microbiológica (UFC/mg) e bioquímica. Além disso, microdureza do esmalte seccionado longitudinalmente foi determinada. Os dados foram analisados pelos testes ANOVA e Tukey, com alfa a 5%. As concentrações de polissacarídeo insolúvel em água (µg/mg) no biofilme foram: T ¿ 213,206(±421,746)a, F ¿ 111,208(±43,501)a, TL ¿ 124,626(±37,488)a e FL ¿ 138,83(±118,893)a. As concentrações de cálcio (µg/mg) foram: T ¿ 340,5(±27,01)a, F ¿ 329,5(±143,97)a, TL ¿ 412,3(±228,80)a e FL ¿ 411,8(±252,59)a. As concentrações de fluoreto (µg/mg) no biofilme foram: T ¿ 0,001(±0,005) a, F ¿ 0,010(±0,021) a, TL ¿ 0,0009(±0,002)a e FL ¿ 0,002(±0,007)a. As concentrações de fósforo (µg/mg) foram: T ¿ 0,162(±0,134)a, F ¿ 0,149(±0,066)a, TL ¿ 0,170(±0,104)a a e FL ¿ 0,148(±0,029)a. Os resultados (expressos 107 UFC/mg) obtidos da análise microbiológica foram: T ¿ 2,54(±2,58)a, F ¿ ,90(±3,08)a, TL ¿ 2,59(±3,13)a e FL ¿ 2,30(±4,04)a. A média numérica da microdureza knoop (kg/mm2) variou de 195,5(±87,3)c, 209,8(±75,0)bc, 218,2(±113,6)ab e 229,1(±82,7)a para os grupos T, F, TL e FL, respectivamente. Em conclusão, esse estudo demonstrou que o uso do laser de CO2 (?=10.6 µm e 10.0 J/cm2) sozinho ou combinado com o material de colagem liberador de fluoreto foi capaz de reduzir a perda mineral do esmalte ao redor de braquetes ortodônticos, quando submetidos a uma situação de alto desafio cariogênico com biofilme de Streptococcus mutans.Abstract: The application of carbon dioxide laser (CO2) on dental enamel structure modifies the chemical and/or morphologic composition of this surface and inhibits the development and progression of caries lesion. However, no research verified the if the irradiation of dental enamel around orthodontic brackets was able to reduce the enamel mineral loss in this region in a high cariogenic challenge. Thus, this dissertation aimed to verify in vitro, if the irradiation of the dental enamel with a laser of CO2 (? =10.6 µm and 10.0 J/cm2), associated or not with fluoride released from a bonding material, will be able to reduce the enamel mineral loss around orthodontic brackets, when submitted to a high cariogenic challenge situation. In this study, twenty four enamel slabs were divided into 4 groups in triplicate: 1. nonfluoride-releasing composite resin Transbond (T); 2. resinmodified glass ionomer cement Fuji (F); 3. CO2 laser + nonfluoride-releasing composite resin (TL); 4. CO2 laser + resin-modified glass ionomer cement (FL). One group with 6 specimens of sound enamel were used to determine the sound enamel microhardness. After brackets bonding, the specimens were immersed in sterile deionized distilled water and sterilized with gamma radiation. Following, the specimens were transferred to a sterile brain-heart infusion broth (BHI) with a 5% sucrose solution and the 4 experimental groups were inoculated with an overnight culture of Streptococcus mutans. The BHI medium was daily changed and analyzed to check for microbiological contamination. After 6 days of incubation (37ºC - 10% CO2), the biofilm was collected and submitted to microbiological (CFU/mg) and biochemical analyses. Additionally, microhardness assay of the enamel longitudinally sectioned was determine. The data were statistically analyzed by the ANOVA and Tukey¿ tests, with an alpha of 0.05. The concentrations of water-insoluvel polysaccharide (µg/mg) in biofilm were: T ¿ 213.206(±421.746)a, F ¿ 111.208(±43.501)a, TL ¿ 124.626(±37.488)a e FL ¿ 138.83(±118.893)a. The concentrations of calcium (µg/mg) were: T ¿ 340.5(±27.01)a, F ¿ 329.5(±143.97) a, TL ¿ 412.3(±228.80)a e FL ¿ 411.8(±252.59) a. The concentrations of fluoride (µg/mg) in biofilm were: T ¿ 0.001(±0.005) a, F ¿ 0.010(±0.021)a, TL ¿ 0.0009(±0.002)a e FL ¿ 0.002(±0.007)a. The concentrations of phosphorus (µg/mg) were: T ¿ 0.162(±0.134)a, F ¿ 0.149(±0.066)a, TL ¿ 0.170(±0.104)a e FL ¿ 0.148(±0.029)a. The results (expressed 107 CFU/mg) obtained of microbiological analysis were: T ¿ 2.54(±2.58)a, F ¿ 2.90(±3.08)a, TL ¿ 2.59(±3.13)a e FL ¿ 2.30(±4.04)a. The mean knoop microhardness number (kg/mm2) varied from 195.5(±87.3)c,209.8(±75.0)bc, 218.2(±113.6)ab and 229.1(±82.7)a for T, F, TL and FL respectively. In conclusion, the present study demonstrated that the use CO2 laser (?=10.6 µm and 10.0 J/cm2) alone or combined with the release of fluoride by bonding material was capable of reducing the enamel mineral loss around the orthodontic brackets, when submitted to a high microbiological cariogenic challenge with a Streptococcus mutans biofilm.MestradoOdontopediatriaMestre em Odontologi