Prodromal Parkinson's disease and its socio-demographic characteristics among people aged 55 and above in four provinces of China / 环境与职业医学

Background China is witnessing an accelerated aging process and an increasingly serious situation of Parkinson's disease. Research on the pre-disease stage and its related influencing factors has gained more and more attention. Objective To analyze the current situation of prodromal Parkinson's disease (pPD) of people aged 55 years and above in four provinces of China, and to explore its influencing demographic and socio-economic characteristics. Methods Using the data of Community-based Cohort Study on Nervous System Disease in 2020, a total of 10724 participants with complete data on demographic and socio-economic factors and risk factors on Parkinson's disease were selected. Based on the criteria recommended by the International Parkinson and Movement Disorder Society (MDS), we evaluated risk level (i.e., post-test probability) of pPd, prevalence of possible or probable pPD, and number of pPD-related risk/prodromal markers in the participants. Multiple linear regression and multiple logistic regression models were used to analyze the influencing socio-demographic factors of risk level of pPd and prevalence of possible or probable pPD, and Poisson regression and multinomial logit regression models were used to analyze the influencing socio-demographic factors of the number of pPD-related risk/prodromal markers in the total sample, men, and women, respectively. Results The median (P25, P75) of post-test probability of pPD in 2020 was 0.78% (0.42%, 1.66%), the prevalence rate of possible or probable pPD was 0.34%, and 69.03% of the participants reported 3-5 pPD-related risk/prodromal markers. The post-test probabilities of men, those with older age, lower education level, per capita monthly household income < 1000 yuan, urban residency, or without active employment were higher (P<0.05). Men and being aged ≥ 75 years had a higher prevalence of possible or probable pPD (P<0.05). The OR of possible or probable pPD was 8.404 (95%CI: 2.839−24.879) in subjects aged ≥ 75 years versus those aged 55−64 years. Males, those without active employment, being less educated, with older age, and urban residents were more likely to report pPD-related risk/prodromal markers than those of the opposite groups (P<0.05). Conclusion Men, subjects aged ≥75 years, those with lower education level, urban residents, and those without active employment have higher risk levels of pPD and are more likely to report pPD-related risk/prodromal markers among people aged 55 years and above in the four provinces of China, poor economic situation is also associated with higher risk levels of pPD.

Estratégias de participação social em leituras comunitárias de municípios brasileiros: aproximações da terapia ocupacional com a política urbana / Social participation strategies in the community reading of Brazilian municipalities: approximations of occupational therapy with urban policy

Resumo Introdução Há um abismo técnico e epistêmico sobre a produção de informações a respeito da gestão democrática no planejamento das cidades. Isso implica prejuízos na participação social, enquanto envolvimento ocupacional coletivo, na condução do Plano Diretor Participativo, em especial na etapa diagnóstica da leitura comunitária, como prevê o Estatuto da Cidade. Objetivo Identificar as abordagens metodológicas da leitura comunitária dos Planos Diretores Participativos de municípios brasileiros e aproximar as suas informações à área de terapia ocupacional. Método Foi conduzida uma pesquisa documental, hipotético-dedutiva, exploratória e de natureza quali-quantitativa. Elegeu-se como variáveis de análise o conjunto de estratégias metodológicas e categoria profissional. Resultados Foram levantados 42 documentos que compreendem cinco etapas na condução da leitura comunitária: Divulgação, Mobilização, Capacitação, Diagnóstico e Pactuações. Em cada etapa, estratégias são criadas ainda sob perspectivas tradicionais e hegemônicas, conduzidas, majoritariamente, por profissionais da Arquitetura, Geografia e Engenharia. Com isso, a ação interdisciplinar é insuficiente e a participação é tratada como um "ato de aderência populacional" na construção da política urbana. Conclusão Os municípios brasileiros encontram dificuldades para implementar a política urbana, sobretudo a etapa da leitura comunitária, a qual se considera fundamental para a participação social da população. Com isso, este estudo aproxima as questões do planejamento urbano da área de terapia ocupacional, em especial ao fornecer contribuições relativas às tecnologias de participação e ao direito à cidade, enquanto direitos humano e social intrínsecos à cotidianidade de diversas populações.

Abstract Introduction There is a technical and epistemic chasm about the production of information about democratic management in city planning. This implies losses in social participation, while collective occupational involvement, in the conduction of the Participative Master Plan, especially in the diagnostic stage of community reading, as provided for in the City Statute. Objective To identify methodological approaches to community reading of Participatory Master Plans in Brazilian municipalities and bring their information closer to the area of occupational therapy. Method A documentary, hypothetical-deductive, exploratory, and quali-quantitative research was conducted. The set of methodological strategies and professional categories were chosen as analysis variables. Results 42 documents were surveyed, which in summary comprises five stages in conducting community understanding: Dissemination, Mobilization, Training, Diagnosis, and Agreements. At each stage, strategies are still created under traditional and hegemonic perspectives, conducted mainly by professionals from Architecture, Geography, and Engineering. As a result, interdisciplinary action is insufficient, and participation is treated as an 'act of population adherence' in the construction of urban policy. Conclusion Brazilian municipalities find it difficult to implement urban policy, especially the stage of community reading, in which it is considered fundamental for the social participation of the population. With this, this study approaches the issues of urban planning in the area of occupational therapy, in particular by providing contributions related to the technologies of participation and the right to the city, as a human and social right involved in the daily lives of several populations.

Ornamental fishing in the region of Barcelos, Amazonas: socioeconomic description and scenario of activity in the view of piabeiros / A pesca ornamental na região de Barcelos, Amazonas: descrição socieconômica e cenário da atividade na visão dos piabeiros

Abstract The Negro river basin is considered the largest area of extractive of ornamental fish in Brazil. This area has fundamental importance for the populations from the Amazon. The present study aimed to describe socioeconomic profile of ornamental fishermen known as "piabeiros" in the Municipality of Barcelos, as well as the ornamental fishery, fisheries area, target species, environments, fishing techniques, equipment, capture techniques and main difficulties faced by the current activity. This study was carried out in municipality of Barcelos, through semi - structured interviews, with artisanal ornamental fishermen (N= 89). The main families of ornamental fish caught and traded were: Characidae, Lebiasinidae, Gasteropelecidae, Cichilidae, Anostomidae, Loricaridae, Potamotrygonidae and Gymnotidae. The main catchment areas were igarapés, lakes, flooded fields, beaches, river banks and igapó forest. Rapiché was the most used equipment in the fisheries both by the fishermen of the urban areas (43.81%) and rural (41.89%). Most of the fishermen are associated with the colony of fishermen of Barcelos (Z33). The data showed that the dynamics of ornamental fishing have changed in a short time and directly affected fishermen, in addition to the low age renewal with the participation of younger fishermen, threatening the transmission of ecological knowledge to future generations. As a result, the increase of the problems related to the productive chain and absence of public power to the activity, since ornamental fishing has already been treated as one of the main economic activities more important for the local communities and for the State of Amazonas.

Resumo A bacia do rio Negro é considerada a maior área de extrativismo de peixes ornamentais do Brasil. Esta área possui importância fundamental para as populações da Amazônia. O presente estudo objetivou descrever o perfil socioeconômico de pescadores conhecidos como "piabeiros" no município de Barcelos, bem como a pesca ornamental, área de pesca, espécies-alvo, ambientes, técnicas de pesca, equipamentos, técnicas de captura e dificuldades enfrentadas nesta atividade. O estudo foi realizado por meio de entrevistas semi - estruturadas, com pescadores artesanais ornamentais (N= 89). Os dados mostram que as famílias de peixes ornamentais capturados e comercializados foram: Characidae, Lebiasinidae, Gasteropelecidae, Cichilidae, Anostomidae, Loricaridae, Potamotrygonidae e Gymnotidae. As áreas de captura descritas foram igarapés, lagos, alagados, praias, margens de rios e floresta de igapó. O Rapiché foi o equipamento mais utilizado nas pescarias tanto pelos pescadores das áreas urbanas (43,81%) como rurais (41,89%). A maioria dos pescadores está associada à colônia de pescadores de Barcelos (Z33). Os dados coletados mostraram que a dinâmica da pesca ornamental mudou em pouco tempo e afetou diretamente os pescadores. Além da baixa taxa de renovação, com a participação de pescadores mais jovens, ameaçando a transmissão de conhecimento ecológico para as gerações futuras. Como resultado, notamos o aumento dos problemas relacionados à cadeia produtiva e a ausência de poder público na atividade. A pesca ornamental já foi tratada como uma das principais atividades econômicas para as comunidades locais e para o Estado do Amazonas.

Influence of sociodemographic and economic factors on physical activity among university students / Influência de fatores sociodemográficos e econômicos na atividade física entre estudantes universitários / La influencia de factores sociodemográficos y económicos para la actividad física de estudiantes universitarios

Objective: To estimate the influence of socioeconomic factors on the variation of time spent by university students on the practice of physical activity after the first academic year. Methods: Longitudinal quantitative study with 348 full-time university students, between 16 and 25 years old, from capital of Mato Grosso, Brazil. Change in time spent on the practice of moderate and vigorous physical activity was evaluated in minutes per week, through the short version of IPAQ - International Physical Activity Questionnaire. The following independent variables were analyzed: sex, age, race/skin color, economic class, students' housemates and field of study. Multinomial regression analysis was used to verify the association of physical activity time variation, in tertiles, with the independent variables. Results: The overall change in median physical activity time in one year was -90.0 minutes/week, the students of higher socioeconomic status maintained the same time of practice of physical activity, while those of other classes showed a decrease in this time after the first year at university. After adjustments, the lower economic class (OR=2.85; 95%CI= 1.26-6.43) and the fact that the student lives in a house shared by students (OR=2.84; 95%CI= 1.26-6.38) were associated with reduction in time spent on physical activity. Conclusion: There was a decrease in time spent on physical activity among students from the lower economic classes who lived in a share house after the first year at university.

Objetivo: Estimar a influência de fatores socioeconômicos na variação do tempo gasto por estudantes universitários na prática de atividade física após o primeiro ano letivo. Métodos: Estudo quantitativo longitudinal, realizado em 2015 e 2016, com 348 universitários em tempo integral, com idade entre 16 e 25 anos, da capital do Mato Grosso, Brasil. Avaliou-se a mudança no tempo gasto na prática de atividade física moderada e vigorosa em minutos por semana por meio da versão curta do International Physical Activity Questionnaire (IPAQ). As variáveis independentes do estudo são sexo, idade, raça/cor da pele, classe econômica, colegas de casa dos alunos e campo de estudo. Utilizou-se a análise de regressão multinomial para verificar a associação da variação do tempo de atividade física, em tercis, com as variáveis independentes. Resultados: A mudança geral no tempo mediano de atividade física em um ano é de 90,0 minutos/semana. Os estudantes de maior nível socioeconômico mantiveram o mesmo tempo de prática de atividade física, enquanto os de outras classes apresentaram uma diminuição nesse tempo após o primeiro ano na universidade. Após os ajustes, a classe econômica mais baixa (OR=2,85; IC95%=1,26-6,43) e o fato de o aluno morar em uma casa compartilhada pelos alunos (OR=2,84; IC95%=1,26-6,38) associaram-se à redução no tempo gasto em atividade física. Conclusão: Houve diminuição do tempo gasto em atividade física entre estudantes das classes econômicas mais baixas, que viviam em uma casa compartilhada, após o primeiro ano na universidade.

Objetivo: Estimar la influencia de factores socioeconómicos en la variación del tiempo gasto por estudiantes universitarios en la práctica de actividad física después del primer año académico. Métodos: Estudio cuantitativo y longitudinal realizado entre 2015 y 2016 con 348 universitarios a jornada completa entre 16 y 25 años de la capital Mato Grosso, Brasil. El cambio del tiempo gasto con la práctica de actividad física moderada y vigorosa ha sido evaluada en minutos por semana con la versión corta del IPAQ- International Physical Activity Questionnaire. Las variables independientes fueron el sexo, la edad, la raza/el color de la piel, la clase económica, los compañeros de piso y el campo de estudio. El análisis de regresión multinomial ha sido utilizado para verificar la asociación de la variación del tiempo de actividad física en terciles y las variables independientes. Resultados: El cambio total del tiempo mediano de la actividad física en un año ha sido de -90.0 minutos/semana, los estudiantes con estatus socioeconómico más alto mantuvieron el mismo tiempo de práctica de actividad física mientras aquellos de otras clases socioeconómicas presentaron una reducción en el tiempo de actividad física después del primer año en la universidad. Tras los ajustes, la clase económica más baja (OR=2,85; 95%CI= 1,26-6,43) y el hecho de vivir en casa compartida con estudiantes (OR=2,84; 95%CI= 1,26-6,38) se asoció con la reducción del tiempo gasto con la actividad física. Conclusión: Hubo una reducción del tiempo gasto con la actividad física entre los estudiantes de clases económicas más bajas que vivían en casa compartida después del primer año en la universidad.

Demographic and Socioeconomic Factors for Renouncing Further Active Therapy for Patients with Brain Metastasis of Non-Small Cell Lung Cancer

BACKGROUND: As patients with brain metastasis (BM) of non-small cell lung cancer (NSCLC) have dismal prognosis, some of them decide to discontinue further treatment for BM. The objective of this study was to determine factors for renouncing further active therapy in patients with BM of NSCLC, focusing on their demographic and socioeconomic status. METHODS: Medical records of 105 patients with radiological diagnosis of BM of NSCLC for the recent 11 years at authors' institution were retrospectively reviewed. Clinical features as well as demographic and socioeconomic characteristics such as marriage status, cohabiting family members, religious affiliations, educational background, and economic responsibility were reviewed. RESULTS: Median overall survival (OS) was 13.84 (95% CI: 10.26–17.42) years in 67 patients (group A) who underwent active treatment (radiotherapy and/or chemotherapy) and 4.76 (95% CI: 3.12–6.41) years in 38 patients (group B) who renounced active treatment. Less patients were unmarried (p=0.046), more cohabitating family members (p=0.008), and economically independent (p=0.014) in group A than those in group B. Similarly, the unmarried, and none cohabitating family members had short OS (5.17 and 7.38 years, respectively). In multivariate analysis for predisposing factors of OS in these patients, the following demographic and socioeconomic factors had independent significance: marriage status and cohabitating family members. CONCLUSION: This study suggests that demographic and socioeconomic status as well as clinical factors could influence the decision of further active treatment and prognosis of patients with BM of NSCLC.

An approach to risk isolation for relatively low-incidence conditions: An Australian national model of oral cellulitis

@#The purpose of this study was to develop a risk indicator applicable on a national level, to isolate at relatively highresolution, regions where oral cellulitis risk is high. The method used ten years of Western Australian (1999 to 2008) hospitalisation data, and applying the admission risks gleaned from this database (poverty, socioeconomics, age and Indigenous status) to model across Australia (at SA1 level) the risk profile. Five levels of oral cellulitis risk (low to very high) were mapped to each of the 54,000 SA1s that makeup Australia. Cumulative percentage analysis was used to study the effect of distance from capital city of each state on the number of population at high risk. Highest risk category (category 5) SA1s were not equally distributed amongst States, with the Northern Territory having 12.2% of its population (26011) belonging to category 5 (very high risk). The majority of that population (87.8%) live more than 100km away from the capital city, Darwin. A general trend amongst Australian capital cities was the low number of population at high risk within 5 km from General Post Office (GPO)

A economia de bens simbólicos e a criação de um ambiente favorável à doação: uma análise das campanhas de incentivo à doação de órgãos e tecidos / La economía de los bienes simbólicos y la creación de un ambiente propicio para la donación: un análisis de las campanas de incentivo de donación de órganos y tejidos / The economics of symbolic goods and the creation of a favorable environment for organ and tissue donation: an analysis of campaigns to promote organ and tissue donation

Resumo A partir da análise dos simbolismos presentes nos discursos publicitários das organizações que atuam com doação e transplantação de órgãos e tecidos no Brasil, o estudo tem como objetivo analisar quais são os símbolos que o Sistema Nacional de Transplantes (STN) produz para a construção de um ambiente favorável à doação. Para isso, parte-se de um plano teórico que discute os princípios que estruturam uma economia das trocas simbólicas no interior de uma lógica social, que estimula o comportamento altruísta e procura evitar o comportamento mercantil desses bens raros. No seu plano empírico, a partir da análise semiótica, observa-se que os atores públicos e privados intervenientes atuam na elaboração de símbolos capazes de estabelecer verdades subjetivas que estimulam a doação, em oposição ao comportamento mercantil.

Resumen A partir del análisis de la simbología presente en los discursos publicitarios de las organizaciones que trabajan con la donación y el trasplante de órganos y tejidos en Brasil, esta investigación tiene como objetivo analizar cuáles son los símbolos que el Sistema Nacional de Trasplantes (STN) se utiliza para la construcción de un entorno favorable a la donación. Para esto, fue construido un plan teórico que analiza los principios que sustentan una economía de intercambios simbólicos dentro de una lógica social, que estimula el comportamiento altruista y busca evitar el comportamiento comercial de estos productos raros. En su nivel empírico, a partir de un análisis semiótico, se observa que actores públicos y privados actúan en la elaboración de símbolos capaces de establecer verdades subjetivas que fomentan la donación a diferencia de comportamiento comercial

Abstract This article aims to analyze which are the symbols that the National Transplant System (STN) produces to build a favorable environment for organ and tissue donation. The study is based on the analysis of symbolism in advertising discourses of Brazilian organizations that promote organ and tissue donation. A theoretical plan is presented to discuss the principles at the base of the economy of symbolic exchanges within a social logic. The article argues that this process stimulates altruistic behavior and aims to avoid the mercantile behavior around organ and tissue donation. In the empirical plan, a semiotic analysis in organ donation advertise campaigns was conducted, observing that public and private actors use a set of symbols aiming to establish subjective truths that stimulate the donation in opposition to mercantile behavior.

Processed and ultra-processed food consumption among children aged 13 to 35 months and associated factors / Consumo de alimentos processados e ultraprocessados e fatores associados em crianças entre 13 e 35 meses de idade / Consumo de alimentos procesados y ultraprocesados y factores asociados en niños entre 13 y 35 meses de edad

Abstract: The aim of this study was to evaluate the consumption of processed and ultra-processed foods among children aged 13-35 months and its associated factors. We studied 1,185 children within the BRISA cohort in São Luís, Maranhão State, Brazil. The food consumption was investigated using a 24-hour recall, and the percentages of daily caloric intake and nutrients were estimated by food groups according to "NOVA" classification. We chose to categorize children belonging to the upper tertile of the distribution as having a high consumption of processed and ultra-processed food products. The Poisson regression model with robust variance estimation using a hierarchical modeling approach was used to calculate the prevalence ratios (PRs) of variables associated with high consumption of processed and ultra-processed food products. The mean energy intake was 1,226Kcal/day. After adjustments, there was a higher proportion of high consumption of processed and ultra-processed food products among children whose mothers had < 12 years of education and among children who were older than 16 months. Mothers with low schooling and children older than 16 months should be the targets of interventions aimed at reducing consumption of these food products and preventing adverse health outcomes in later life.

Resumo: O estudo teve como objetivo avaliar o consumo de alimentos processados e ultraprocessados por crianças entre 13 e 35 meses de idade e fatores associados. Estudamos 1.185 crianças da coorte BRISA em São Luís, Maranhão, Brasil. O consumo alimentar foi investigado com um recordatório de 24 horas, e os percentuais de ingestão diária de calorias e nutrientes foram estimados por grupos de alimentos de acordo com a classificação "NOVA". Optamos por categorizar as crianças pertencentes ao tercil superior da distribuição como tendo consumo elevado de produtos alimentícios processados e ultraprocessados. Foi utilizado um modelo de regressão Poisson com estimativa robusta de variância com modelagem hierárquica para calcular as razões de prevalência (RPs) das variáveis associadas ao consumo elevado de produtos alimentícios processados e ultraprocessados. A ingestão calórica média era 1.226Kcal/dia. Após os ajustes, houve uma proporção maior de consumo elevado de produtos alimentícios processados e ultraprocessados entre crianças cujas mães tinham menos de 12 anos de escola e entre crianças com mais de 16 meses de idade. As mães com baixa escolaridade e crianças acima de 16 meses devem ser alvos de intervenções para reduzir o consumo desses produtos alimentícios e prevenir os desfechos de saúde adversos na adolescência e idade adulta.

Resumen: El objetivo de este estudio fue evaluar el consumo de alimentos procesados y ultraprocesados por parte de niños entre 13 y 35 meses de edad y sus factores asociados. Estudiamos a 1.185 niños de la cohorte BRISA en São Luís, Maranhão, Brasil. El consumo alimentario fue investigado con un recordatorio de 24 horas, y los porcentajes de ingesta diaria de calorías y nutrientes fueron estimados por grupos de alimentos, de acuerdo con la clasificación "NOVA". Optamos por categorizar a los niños pertenecientes al tercil superior de la distribución como de consumo elevado de productos alimenticios procesados y ultraprocesados. Se utilizó un modelo de regresión Poisson de estimativa robusta de variancia con modelaje jerárquico para calcular las razones de prevalencia (RPs) de las variables asociadas al consumo elevado de productos alimenticios procesados y ultraprocesados. La ingesta calórica media era 1.226Kcal/día. Tras los ajustes, hubo una proporción mayor de consumo elevado de productos alimenticios procesados y ultraprocesados entre niños, cuyas madres contaban con menos de 12 años de escuela y entre niños con más de 16 meses de edad. Las madres con baja escolaridad y niños por encima de 16 meses deben ser objetivo de intervenciones para reducir el consumo de esos productos alimenticios y prevenir desenlaces de salud adversos en la adolescencia y edad adulta.

Pacientes ilegítimos: Acceso a la salud de los inmigrantes indocumentados en Chile / Illegitimate patients: Undocumented immigrants' access to health care in Chile

RESUMEN Chile se ha ido convirtiendo en un país de destino para las migraciones sudamericanas, las cuales generan un impacto en los servicios públicos, en particular en salud, a nivel económico, social y cultural. El objetivo de este artículo es aportar información documentada sobre los problemas de acceso a la salud de los inmigrantes indocumentados. Trabajamos desde una metodología cualitativa, basada principalmente en una etnografía del espacio clínico. Para el análisis de los resultados nos hemos basado en las teorías de las relaciones asimétricas de poder, así como en las de las relaciones interétnicas. En los resultados de la investigación, se destaca el incumplimiento de la normativa y el ejercicio del criterio personal discrecional como barreras en el acceso. Concluimos que, en Chile, los inmigrantes en general e indocumentados, en particular, son considerados pacientes ilegítimos.

ABSTRACT In recent decades, Chile has become a destination for immigrants from other South American countries, which has significantly impacted public services - particularly the public health system - at the economic, social, and cultural levels. The aim of this paper is to provide substantiated information on issues concerning undocumented immigrants' access to health care in Chile. A qualitative methodology, fundamentally an ethnography of the clinical setting, was used. Results were then analyzed in relation to theories of power asymmetries and interethnic relations. The research results highlight the lack of compliance with existing regulations and the exercise of discretionary personal judgment as barriers to access. It is concluded that in Chile immigrants in general, and undocumented immigrants in particular, are considered to be illegitimate patients.

Ornamental fishing in the region of Barcelos, Amazonas: socioeconomic description and scenario of activity in the view of piabeiros

Abstract The Negro river basin is considered the largest area of extractive of ornamental fish in Brazil. This area has fundamental importance for the populations from the Amazon. The present study aimed to describe socioeconomic profile of ornamental fishermen known as piabeiros in the Municipality of Barcelos, as well as the ornamental fishery, fisheries area, target species, environments, fishing techniques, equipment, capture techniques and main difficulties faced by the current activity. This study was carried out in municipality of Barcelos, through semi - structured interviews, with artisanal ornamental fishermen (N= 89). The main families of ornamental fish caught and traded were: Characidae, Lebiasinidae, Gasteropelecidae, Cichilidae, Anostomidae, Loricaridae, Potamotrygonidae and Gymnotidae. The main catchment areas were igarapés, lakes, flooded fields, beaches, river banks and igapó forest. Rapiché was the most used equipment in the fisheries both by the fishermen of the urban areas (43.81%) and rural (41.89%). Most of the fishermen are associated with the colony of fishermen of Barcelos (Z33). The data showed that the dynamics of ornamental fishing have changed in a short time and directly affected fishermen, in addition to the low age renewal with the participation of younger fishermen, threatening the transmission of ecological knowledge to future generations. As a result, the increase of the problems related to the productive chain and absence of public power to the activity, since ornamental fishing has already been treated as one of the main economic activities more important for the local communities and for the State of Amazonas.

Resumo A bacia do rio Negro é considerada a maior área de extrativismo de peixes ornamentais do Brasil. Esta área possui importância fundamental para as populações da Amazônia. O presente estudo objetivou descrever o perfil socioeconômico de pescadores conhecidos como piabeiros no município de Barcelos, bem como a pesca ornamental, área de pesca, espécies-alvo, ambientes, técnicas de pesca, equipamentos, técnicas de captura e dificuldades enfrentadas nesta atividade. O estudo foi realizado por meio de entrevistas semi - estruturadas, com pescadores artesanais ornamentais (N= 89). Os dados mostram que as famílias de peixes ornamentais capturados e comercializados foram: Characidae, Lebiasinidae, Gasteropelecidae, Cichilidae, Anostomidae, Loricaridae, Potamotrygonidae e Gymnotidae. As áreas de captura descritas foram igarapés, lagos, alagados, praias, margens de rios e floresta de igapó. O Rapiché foi o equipamento mais utilizado nas pescarias tanto pelos pescadores das áreas urbanas (43,81%) como rurais (41,89%). A maioria dos pescadores está associada à colônia de pescadores de Barcelos (Z33). Os dados coletados mostraram que a dinâmica da pesca ornamental mudou em pouco tempo e afetou diretamente os pescadores. Além da baixa taxa de renovação, com a participação de pescadores mais jovens, ameaçando a transmissão de conhecimento ecológico para as gerações futuras. Como resultado, notamos o aumento dos problemas relacionados à cadeia produtiva e a ausência de poder público na atividade. A pesca ornamental já foi tratada como uma das principais atividades econômicas para as comunidades locais e para o Estado do Amazonas.

Aspectos económicos y sociales relacionados con el comportamiento de la tuberculosis en Cuba. Década de los 90 / Economical and Social Aspects Related to the Behavior of Tuberculosis in Cuba. Decade of 90th

La tuberculosis es una enfermedad causada por el Micobacterium tuberculosis. En la actualidad existen diferentes patrones epidemiológicos de la enfermedad muy relacionados con los factores económicos y sociales. Su reemergencia se ha relacionado con situaciones de inequidad social, falta de prioridad de los programas de control. En Cuba se constató un aumento de las tasas de incidencia y prevalencia de la enfermedad a mediados de la década de los 90, coincidiendo con un período de profunda crisis económica. Este artículo tiene como objetivo mostrar la influencia de los factores económicos y sociales presentes en Cuba en este periodo y su relación con el aumento de las tasas de tuberculosis. Se presentó un incremento de la morbilidad y mortalidad a partir de 1992, las tasas de morbilidad aumentaron con la edad, y fueron más altas en los hombres que en las mujeres. El riesgo fue superior en el adulto mayor debido a factores biológicos, nutricionales y de condiciones de vida que explican esta vulnerabilidad; dificultades en los indicadores operacionales del programa, con demoras en la localización de casos favorecieron la transmisión en la comunidad.

Tuberculosis is a disease caused by Mycobacterium tuberculosis at present there are different epidemiological patterns of the disease closely related to economic and social factors. Its reemergence has also been associated with situations of social inequality, lack of priority control programs. In Cuba increased incidence and prevalence of the disease in the mid-1990s, coinciding with a period of deep economic crisis was found. The article aims to show the influence of economic and social factors in Cuba in the 1990s and its relationship with increased rates of tuberculosis. This logical historical method supported in the literature review was followed. Tuberculosis in Cuba showed an increase in morbidity and mortality from 1992 morbidity rates increased with age and were higher in men than in women. Result: increased risk of the disease at the expense of the elderly due to biological, nutritional and living conditions that explain this vulnerability factors; difficulties in operating indicators of the program, delays in locating cases favoring transmission in the community. Adverse economic situation that the country faced.

Associations of environmental factors with health and mortality among Chinese elderly:A sam-ple survey in 22 provinces in China / 中国卫生政策研究

We analyzed data from a nationally representative sample of 15,973 elderly residents from 866 coun-ties and cities in 2002 and followed up in 2005 with multilevel logistic regression models to investigate how social, eco-nomical environmental factors are associated with health outcomes and mortality risk. After control individual-level fac-tors, we found that air pollution increased the odds of disability in activities of daily living ( ADLs) , cognitive impair-ment, and health deficits index. More rainfall was protective, reducing the odds of ADL disability and cognitive impair-ment. Extremely low seasonal temperatures increased the odds of ADL disability and mortality. Extremely high seasonal temperatures increased the odds of cognitive impairment and health deficit index. Living in a mountain area decreased the odds of ADL disability and health deficits. The conclusion is that efforts to reduce pollution and improve socioeco-nomic conditions could significantly improve the health and survival of the elderly.

Endovascular therapy for selected (most non-surgical) intracranial aneurysms in a Brazilian University Hospital / Tratamento endovascular de aneurismas selecionados (maioria não cirúrgicos) em um hospital universitário brasileiro

OBJECTIVE: The objective of this study was to evaluate technical, clinical and angiographic results of a nonsurgical series of intracranial aneurysms treated by endovascular approach at Hospital das Clínicas of Medical School of Ribeirão Preto - University of São Paulo. METHOD: Between August 2005 and November 2008, 137 aneurysms in 106 patients were endovascularly treated. Of these, 101 were unruptured in 75 patients and 36 aneurysms in 31 patients were treated during the acute phase. The data were prospectively studied. RESULTS: Sixty three aneurysms (46 percent) were treated with coils alone, 52 (38 percent) with balloon remodeling, 15 (10.9 percent) with stent remodeling, and 7 (5.1 percent) with therapeutic occlusion of the internal carotid artery. Six clinical complications (5.7 percent) were related to the procedures, 3 (2.8 percent) transitory and 3 (2.8 percent) permanent. Angiographic follow-up was available for 97 aneurysms (70.8 percent), clinical monitoring for 77 patients (72.6 percent) and telephone contact for 97 (91.5 percent). CONCLUSION: The technical, clinical and angiographic results found in this study are similar to those reported in the literature.

OBJETIVO: Nosso objetivo foi avaliar os resultados técnicos, clínicos e angiográficos de uma série de aneurismas intracranianos não cirúrgicos tratados por via endovascular no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo e comparar com os dados disponíveis na literatura atualmente. MÉTODO: Entre agosto de 2005 e novembro de 2008, 137 aneurismas foram tratados por via endovascular em 106 pacientes. Destes, 101 eram não rotos em 75 pacientes e 36 aneurismas foram tratados em 31 pacientes durante a fase aguda de ruptura. Os dados foram incluídos de maneira prospectiva. RESULTADOS: Sessenta e três aneurismas (46 por cento) foram tratados com técnica simples, 52 (38 por cento) com remodelagem por balão, 15 (10,9 por cento) com remodelagem por stent e 7 (5,1 por cento) por oclusão terapêutica da carótida interna. Seis complicações clínicas ocorreram (5,7 por cento), 3 (2,8 por cento) transitórias e 3 (2,8 por cento) permanentes. Seguimento angiográfico foi realizado para 97 aneurismas (70,8 por cento), clínico para 77 pacientes (70,8 por cento) e contato telefônico para 97 pacientes (91,5 por cento). CONCLUSÃO: Os resultados encontrados nesta série, em termos técnicos, clínicos e angiográficos, são semelhantes aos encontrados na literatura.

Pobreza, inequidad y cáncer: [revisión] / Poverty, inequality and cancer: [review]

El gran desafío del control del cáncer en el siglo XXI, es reducir la morbilidad y la mortalidad por este mal en los países en desarrollo, en opinión de líderes e instituciones científicas del mundo porque no es cierto que el cáncer es problema de los países desarrollados, y las infecciones de los países pobres. Más de la mitad de los 11 millones de casos de cáncer registrados el 2 008, y dos terceras partes de los 7,6 millones de muertes por cáncer, ocurrieron en el llamado tercer mundo. El círculo vicioso de la inadecuada distribución de nuestros limitados recursos, con mayor inversión en tecnología de precios prohibitivos y resultados discutibles, en el tratamiento de cáncer avanzado, y poco o nada en programas de prevención, ha determinado que nuestras instituciones de nivel de excelencia, abrumadas por la demanda masiva de pacientes con cáncer avanzado y limitadas opciones de tratamiento, estén impedidas de dedicar tiempo y recursos para el desarrollo de planes integrales de control de cáncer de la población. Un país que tiene más de la mitad de la población urbana ubicada en los estratos socioeconómicos C y D, padeciendo la desigualdad en el acceso a los programas de control de cáncer, y que está invirtiendo su presupuesto en el tratamiento de una población con alta proporción de casos de cáncer avanzado, necesita un Plan Nacional realista de Cáncer que resuelva el dilema entre seguir invirtiendo sus limitados recursos en tratar cáncer avanzado o llevar programas de detección y prevención a los sectores mayoritarios que padecen la desigualdad en la atención.

The greatest challenge for cáncer control in the 21st century is to reduce morbidity and mortality in developing countries ,in opinion of a number of leading authorities and cáncer institutions, because cancer control in developing countries lags behind that in affluent countries. Cáncer is often considered to primarily affect people living in wealthy nations; this is a myth that needs to be corrected: six of the eleven million cases of cáncer registered in 2,008, and two thirds of the 7.6 million of cáncer related deaths occur in developing countries, and over the next 10 years, 70 per cent of cáncer cases will occur in the developing world.The vicious circle of the inefficacy in the use of our limited resources to treat advanced cáncer patients, and not implement the relatively inexpensive measures to the prevention and early detection of cáncer, ends with institutions with levels of excelency overwhelmed by the demand of attention for patients with advanced cáncer and for other side countries with a high proportion of poor uneducated, people with limited or none acces to the prevention and detection of curable precáncerous conditions. A well integrated primary care system that can offer prevention and detection of precáncerous conditions is the most efficient and cost-effective way of dealing with cáncer and to priorize when funding is limited.

Assistência ao parto em São Leopoldo (RS): um estudo de base populacional / Assistance to obstetrical deliveries in São Leopoldo, Rio Grande do Sul State: a population-based study

O objetivo foi descrever as condições estruturais de assistência ao parto, estabelecer o percentual de cesarianas, as características de atenção ao parto e verificar a associação do tipo e presença de pediatra no parto com variáveis socioeconômicas. Foi realizado um estudo transversal de base populacional, incluindo 840 mulheres de 20 a 49 anos residentes na zona urbana de São Leopoldo (RS). Entre as 840 mulheres entrevistadas na pesquisa, 36 (4,3 por cento) tiveram filho nos doze meses anteriores à realização da pesquisa. O percentual de mulheres que tiveram parto cesáreo foi de 52,8 por cento. Quanto à realização do parto, 97,2 por cento foram feitos por médico e 72,2 por cento das mulheres referiram a presença de pediatra no momento do parto. O financiamento do parto ocorreu em 68,6 por cento dos casos pelo SUS, 20 por cento foram financiados pelos planos privados de saúde e 11,4 por cento foram pagos de forma particular. O parto cesáreo foi menos frequente entre as mulheres de nível socioeconômico mais baixo (RP 0,42; IC95 por cento 0,20-0,86). Verificou-se que 30,4 por cento das mulheres que receberam cuidados pelo SUS não manifestaram presença de pediatra no momento do parto. Foram encontradas evidências mostrando a associação de tipo de parto e variáveis que expressam classe econômica, sendo possível afirmar que a remuneração interfere no tipo de parto.

The study was carried out to describe the deliveries structural conditions, characteristics of assistance to the deliveries, to establish the percentage of cesarean section, and to verify the association between the presence of the pediatrician and the type of childbirth with socioeconomic variables. A cross-sectional population-based study was carried out including 840 women from 20 to 49 years old resident in São Leopoldo, Rio Grande do Sul State. Among them, 36 (4.3 percent) had children within 12 months prior the research. The percentage of women who had caesarian delivery was 52.8 percent. Regarding the obstetric delivery, 97.2 percent had been assisted by a doctor and 72.2 percent of the women had reported the presence of pediatrician at the time of the labor. In 68.6 percent of the cases the delivery process was financed by the SUS, 20 percent were by private health care plans and 11.4 percent were privately paid. The caesarean delivery was less frequent among the women belonging to lower socioeconomic levels (prevalence rate 0.42; CI95 percent 0.20-0.86). It was verified that 30.4 percent of the women who had received maternal care by SUS did not report the presence of pediatrician in the labor. It was evidenced the association of the type of delivery and some variables related to economic class, making it possible to state that financial compensation intervenes with the type of obstetrical delivery.

Qualidade de vida e aspectos socioeconômicos em diabéticos tipo 1 / Quality of life and socio-economical aspects of diabetics type 1

OBJETIVOS: Avaliar a qualidade de vida (QV) em diabéticos tipo 1 assistidos na Associação dos Diabéticos de Itabuna, BA (ASDITA), e verificar suas relações com as variáveis clínicas e sociodemográficas (escolaridade, renda familiar e ocupação). MÉTODOS: Foram estudados 34 pacientes (γ = 88 por cento, ε = 5 por cento; 53 por cento mulheres, média de idade 20,4 ± 8,4 anos e média de tempo de diagnóstico 5,7 ± 4,9 anos), por meio de entrevista e antropometria (medidas de peso e altura). RESULTADOS: O perfil sociodemográfico da amostra revelou renda familiar per capita de 0,70 ± 0,56 salários mínimos, 53 por cento possuíam o ensino fundamental, 64,7 por cento eram estudantes. Em média, a qualidade de vida (QV) foi regular (58,8 por cento). Não interferiram na QV: escolaridade, ocupação, etnia, índice de massa corpórea, número de aplicações diárias de insulina e perfil de monitoração da glicemia capilar. Associaram-se a pior QV: sexo feminino, ser adulto, tempo de diagnóstico maior ou igual a dez anos e baixa renda familiar. CONCLUSÕES: A QV destes pacientes foi inferior ao descrito na literatura, entretanto, estudos adicionais são necessários para comparações com diabéticos em condições socioeconômicas e culturais semelhantes às observadas nesta pesquisa.

OBJECTIVES: This research has appraised the quality of life (QL) of diabetics type 1 member of Associação dos Diabéticos de Itabuna (ASDITA) and has verified their correlation between clinic variable and social-demographic situation of this group. RESEARCH DESIGN AND METHODS: Thirty-four patients (γ = 88 percent, ε = 5 percent; 53 percent female, age 20.4 ± 8.4 years, diagnostic time 5.7 ± 4.9 year) have participated in this research, data showed weight and height after the interview and measuring. RESULTS: The social-demographic profiles of this group revealed family income of 0.7 ± 0.56 of minimal salary, 53 percent had elementary school level and 64.7 percent were students. In avarage, the QL was regular (58.8 percent). QL has not been influenced by the level of education, ethnology, occupation, BMI, daily shot of insulin, or glicemic monitorization profile but woman, adult, diagnostic time more than ten years, little family income have had the worst QL. CONCLUSIONS: The QL of the searched patients has been less than what several publications have showed, but additional researches are necessary to have better comparisons between diabetics with socio-economical and cultural conditions similar to the ones observed in this research.