Repositório RCAAP

Introduction As a result to the population aging, changes in demographic and epidemiological profile is public health problem, entailing the need to develop health policies and practices for the population. Fortaleza is a city of two and a half million inhabitants, of which 7.48% are elderly. The assessment of how the care for the elderly occurs in health assistance networks in Fortaleza produces information that can support the decision taken by the municipal government. Purpose Understanding how the way of caring for the elderly takes place in five health care networks in Fortaleza, in the perception of managers acting in this scenario. Methodology A qualitative study with descriptive approach and focus group technique. The Discourse of the Collective Subject was used to organize the findings (LEFÉVRE, LEFÉVRE, 2006). Results In the Family Health assistance network (so called Estratégia Saúde da Família), the actions of health promotion and introduction of the recording book of the elderly as a working tool are highlighted. A significant unmet demand was observed due to the lack of specialized services in caring for the elderly in the Specialized assistance network. Specific care for the elderly was not observed in the Hospital assistance network, as he is seen as common user. In the Emergency assistance network, the removal is included as a priority, and in the hospital, the service applied is according to severity. In Mental Health assistance network, there is a psychosocial approach to community involvement and intersectorial coordination. Final considerations Among the main findings of this study is that the way of care for the elderly in the city of Fortaleza is still weak, where some strands are misaligned, or broken, compromising the continuity of service. Given the state of demographic transition and the demographic and epidemiological profile, there is a need for better integration of health care, anchored in the Family Health Strategy as well as the structuring of new specialized services, aiming to improve care for the elderly population of Fortaleza.

Esta dissertação se propõe a mostrar um outro olhar ao estudo da Carcinicultura, ao realizar uma investigação geográfica, selecionando um jornal local, a partir de sua produção discursiva. O estudo investiga de que maneira o discurso jornalístico opera na construção de representações sobre essa atividade. Para isso, é necessário percebê-lo como um constituidor de significados, onde se exercem e travam lutas para produzir uma suposta verdade/realidade. Ao analisar as matérias jornalísticas, como discursos construídos culturalmente, percebe-se o modo como as representações estão sendo elaboradas. As ferramentas teóricas norteadoras desta pesquisa foram fornecidas pela Geografia Cultural, as quais possibilitaram uma nova leitura sobre o assunto. A pesquisa busca compreender as representações elaboradas pelo jornal O POVO, um dos mais importantes veículos da mídia impressa do Ceará, sobre a Carcinicultura em três períodos: de 1978-1984; 1990-1994 e de 2000-2004. A divisão desses períodos está alicerçada nos critérios estabelecidos pelo IBAMA e SEMACE em seus estudos sobre a questão. O cultivo de camarão começa a ser veiculado pelo jornal na década de 1970, mas somente na década de 1990 que conquista uma maior notoriedade na agenda pública. A metodologia utilizada consiste em um levantamento de reportagens que tratam, de alguma forma, a temática da Carcinicultura. Considero como campo da pesquisa as edições diárias do jornal O POVO desses períodos. O jornal, ao ser pensado como artefato cultural, está sendo visto como um local de produção de saberes sobre a atividade camaroneira, auxiliando na formação da opinião pública. O estudo, ao estar pautado na análise da construção discursiva, teve que se direcionar a examinar as estratégias acionadas para elaborar os ditos sobre a Carcinicultura. Neste sentido, descrevo e problematizo o funcionamento dos discursos jornalísticos. No primeiro período, 1978-1984, em Ao encontro do Eldorado, observo dizeres que apontam a Carcinicultura como algo benéfico, uma importante saída para a crise do sal, uma atividade para inserir o Ceará e o Nordeste no circuito nacional de produção. À medida que avança para os períodos seguintes, o discurso do referido jornal desloca-se para outros significados. Assim, a atividade camaroneira é, por um longo período, apontada pelo jornal como a única saída viável para o Nordeste. Isso passa a ser questionado. A expansão da Carcinicultura no Brasil é bastante expressiva nas últimas décadas. Esse progresso está relacionado à introdução e ao cultivo da espécie Litopenaeus vannamei, ao uso de técnicas de melhoramento, tanto voltadas para o aumento da produção como da reprodução do camarão, incentivos governamentais e à utilização indiscriminada de certas áreas litorâneas No segundo período, 1990-1994, A promessa da redenção econômica ainda permanece. O discurso da atividade, como uma coisa muito promissora, no início está presente, para, posteriormente, a atividade passar a ser vista não mais como algo tão benéfico. Para o terceiro período, dede 2000-2004, O sonho acabou, embora o cultivo do camarão, naquele momento, já fosse uma das mais importantes atividades do setor primário nordestino, ocupando lugar de destaque na pauta de exportação do estado do Ceará. Os enunciados dos discursos jornalísticos passam a registrar essa prática como uma atividade preocupante pela forma como é realizada, isto é, sendo a causa de inúmeros problemas socioambientais. A prática do cultivo de camarão, em áreas de mangues e suas adjacências, vêm provocando uma série de danos, tanto para o ambiente, como para inúmeras comunidades que dependem do ecossistema manguezal para sobreviverem. Nesse sentido, o discurso do jornal, ao deslocar esses dizeres sobre a Carcinicultura, mostra como atua estrategicamente para a naturalização dos significados. Com isso, deve ser entendido não apenas como um informador dos acontecimentos, dos fatos, mas como um instrumento que estabelece verdades, as suas.

The Aedes albopictus mosquito is a vector of several different arboviruses and uses natural breeding sites for its reproduction. The objective of this study was to describe the determinants of Ae. albopictus infestation in verdant areas of Fortaleza, Ceará (Brazil). It is a descriptive, exploratory study conducted in four areas of the city with a high density of vegetation and the presence of natural breeding sites. The environmental, populational and physical aspects of these areas were detailed as well as the possibility that they serve as a source of protection for viable eggs in the dry season. The study was composed of two parts conducted throughout 2007. The first was undertaken during the rainy season with water samples taken from natural and artificial breeding sites. The second took place in the dry season and samples were collected only from within the natural breeding sites. These areas were classified in accordance with the literature and correlated with the presence of immature forms of Ae. albopictus. During the rainy period, of the 62 breeding areas in existence, 49 (79%) were natural and of these, 25 (51%) were infested with Ae. albopictus. Among the trees that tested positively in these areas, the genera Terminalia, Acacia, Bambusa and Magnifera stood out, while in the artificial breeding sites tires, opened coconuts and small plastic containers were most common. Ae. albopictus was the lone inhabitant of 24 (96%) of the natural breeding sites and the greatest density of larvae was found in areas of lesser vegetation and closer to the soil, whereas tires held the higher density within the artificial areas. Nine (37.5%) natural breeding sites continued to be infested in the two seasons and five others only in the rainy season (14; 30.4%; CI 95%: 16.62 – 44.25). In general terms, there was infestation of 51.0% of natural breeding only in the rainy season, 30.4% in only the dry season and 63.8% if considered in totality. One can conclude that trees of several genera in natural breeding areas offer adequate conditions for the development of immature forms of Ae. albopictus at several stages. In this sense, there may be expanded propagation in the next rainy season in the urban areas of Fortaleza. This scenario amplifies the challenges inherent in the control of dengue fever and other infectious diseases transmitted by this vector.

The research Veraneio Marítimo e Expansão Metropolitana no Ceará: Fortaleza em Aquiraz (Maritime Summering and Metropolis expansion: Fortaleza in Aquiraz), has, as a general goal, to understand the relation between the valorization of coast spaces and the expansion of the metropolis of Ceará. The doing of modern maritime activities (sea baths, tourism, summering), especially summering, represent new possibilities of approximation of society with the sea, detaching the coast space as the main place that populations of big cities have to have fun and to live. This way, the urbanization becomes a process related to the dissemination of the modern maritime life. The modern maritime life is spread out for the society of Fortaleza for the whole state of Ceara from the 70’s, and first reaches the small citys of Aquiraz and Caucaia, members since 1973 of the initial formation of the metropolitan region of Fortaleza. To understand this process, the case of the expansion of the maritime summering thru the cost of Aquiraz was analized. When you understand the influence of the metropolis in the spreading of maritime summering, you see how the coast space is reached by the urban tissue of Fortaleza. The summering people, real estate entrepreneurs, the people who live in local beaches, the public power of small cities and States are social subjects involved in the process of the making of un urban discontinous morphology, characterized by urban divisions and accumulations of second residences. The household-electric, the car traffic, the tv, the habits, the differentiated standard of accessing the land generates indicative unfoldings of the arrival of the urban one in the littoral space of Aquiraz. The buildings of summering represent new trends related to the desire of isolation, associated to the people who live in Fortaleza. The analysis of the nuclei of Iguape, Prainha, Porto das Dunas and Plug demonstrates that the summering in Aquiraz constitutes territories, in which the metropolis and its society exist. Analyzing the Managing Plan of Urban Development of Aquiraz, concluded in the year of 2001, it was understood that the small city public power, based on the plans of government of the state public power, legitimizes the process of valuation of the littoral space and assigns, through laws and zonings, preferential areas for the expansion of the process of littoral valuation. It is proven valuation of the littoral spaces as a necessary process for the expansion of the metropolis for the metropolitans small cities pertaining to the state of Ceará.

The current modifications observed in Performance‘s Model of the State of Ceará at Public Politics for the regional- urban development, since from middles of the eighties, especially in Solid of Baturité-CE, causes the present researche. It also points the process of (re)production in area, , coming of competitive integration in the cities ‗ market in search os global surplus value and of ―incomes monopolists‖ of the Tourist activity, mainly in the highland sub-area of the Solid area. It understands itself that studying the process of production at Urban Space-regional, of study‘s area, it can be understood the spaces practices on present and in matter stimulated them by the State. It realizes this process as a need of the Capitalism for its development and maintenance with the continuous production of the space transformed in merchandise. For the performance‘s analysis , were taken it reference some programs and regional development plans done by the State in different administration scales. For us to arrive to the objectives of the research , we will use this return to the pas, proposed in the method , but being evidenced that the study seeks the present, being the necessary historical study for understanding of the process, for us we won‘t fall in the trap of a simple historical analysis. The research starts about the qualitative and quantitative data analysis, doing a little use of statistical techniques , it was analyzes the phenomena described in the documental collection, by the bibliographical research , and confronted them with the direct observation of the atmosphere, stage of the research – municipal districts of the sub-highland area of the Solid of Baturité. So, get difficult with the mentioned problems, we locate a positive performance or solid with concretes results of the planning, because all of the areas mentioned as priority at programs and development projects for the area, pass for structural problems. It stands out, like this, the lack of a larger performance in public politics as the ones that works with the offer services and equipments of buses consumption buses, that in a touristic region, before they serve tourists , are indispensable for the local population.

Through a geoenvironmental analysis, this work is related to the study of a hidrographic basin as a geographical analysis category. The hydrographic basin of the Apodi-Mossoró river represents 27% of the territory of the state of Rio Grande do Norte, covering a total area of 14.271 km2, having a spatial cutting for this study, the lower course of the mentioned river, which covers 973 km2. Regarding the geodiversity, it is characterized as an area with a presence of a plateau, coastal tablelands, fluviomarine plain, of coastal band with beaches, cliffs and dunes. In this context, the work had the objective to do an analysis of the environmental framework considering the dynamics of the use and occupation, through a study of a multitemporal scale from 1989 to 2009, basically identifying and putting on a spatial scale the geoenvironmental units, the pressure of use, using remote sensoring, the geographical information system for the handling and information crossing, qualitative quantitative research, obtaining as a final result a set of seven maps. The result also indicated, in hectares, a percentage of economic activities in 1989 as: 16,4% of cyclical cultures, 19,2% of perennial culture, 0,04% of petroliferous areas, 64,4 % of salt-mines (craft and industrial). In 2009, the perennial cultures represented 32,7% , the petroliferous activities 33,4%, saltmines 34% (craft and industrial) and the breeding of crabs and other crustaceous 2%. Therefore, it was observed a growth of 126% for perennial cultures, 1.847% for petroliferous activities and 28,50% for alt-mine activities. We can understand that the different forms of use alters the environmental dynamics of the studied area, contributing to the intensification of fluvial processes, to the deposition of sediments, to the silting up process, to the erosion, to the destruction of cilliary woods and to the ecosystem´s mangal. The changes in the low course of Apodi-Mossoró river, correspond to the very significant modifications of the original morphology and in the dynamics of geomorphological processes, in the rate of average annual fluvial discharge and in the rate of transportation of the sediments. Those facts, associated with the environments of inadequate occupation foster the emergence of areas with high exposure of environmental quality.

This study refers to an investigation about the relations between labour market and gender in Fortaleza (CE), focusing on occupational areas aiming at understanding how women are positioned, especially in 2001 and 2005. It is pertinent due to helping to show that positioning and circulating places addressed to women are still very much related to gender division. Its theoretical field is Cultural Geography, particularly a branch that has discussed, problematised and made use of a theoretical articulation’s fruitfulness in the poststructuralist perspectives, as it helps to understand that these relations are constructed in the cultural practices to position women and men in different occupational fields. We have sought to understand gender relations from the cultural practices. In this sense, gender relations are understood as those which bring into play (fe)male representations and symbols whose powers are directed to social practices to stay alive in the society’s value set. Therefore, gender use as the analysis focus lies at deconstructing, displacing meanings that were culturally constructed, and showing that when they are marked around gender difference, they can and should be issued, questioned and problematised. To understand these issues we have sought for the research data at the Censos do Instituto Brasileiro de Geografia e Estatística (IBGE), Anuários Estatísticos do Sistema Nacional de Empregos, and Instituto de Desenvolvimento do Trabalho (SINE/IDT-CE) and da Relação Anual das Informações Sociais (RAIS) in 2001 and 2005, as they provided accessibility and updating. From the collection, some variables that allow us to understand the studied problematic, were observed: occupational field, age, instruction degree, salary, and working hours of the workers in Fortaleza. With the crossing of variables, we have constructed the theme thread for the research: local labour occupation and distribution, which provided discussions of the studied problematic. This has allowed us to reflect about and understand the configuration of the women in the labour market as cultural practices.

Tuberculosis (TB) is a disease that has challenged mankind since antiquity. It was believed that with the new technology, infectious diseases would be easily tracked and banned. The reality has been presented differently, despite advances in knowledge of tuberculosis and technology available for its control, the current picture is far from the targets set by governments. It is essential to the study of factors associated with pulmonary tuberculosis, since they are present in the prime-infeccção in relapse and multi-drug resistant pulmonary TB. Knowledge of data related to TB in the general population and specific groups at risk for TB are crucial to assess the epidemiological reality of our environment allowing proper organization of prevention and care activities. OBJECTIVE: To investigate factors associated with the diagnosis of TB, the frequency and characteristics of pulmonary tuberculosis with respiratory symptoms in three routine health services in Fortaleza. Cross-sectional study of quantitative accomplished through the application of a questionnaire in patients from three health units of Fortaleza. Respondents were divided on outcome of patients with tuberculosis and non tuberculosis outcome. We studied the influence of sociodemographic factors, housing conditions, behavioral factors, antecedents related to TB infection and clinical outcome for tuberculosis. RESULTS: The rate of pulmonary TB patients with respiratory symptoms among the study sample was 41.2%, but this data can not be extrapolated, the socio demographic and clinical outcome independently associated with TB were cough, fever and weight loss considering the level of six percent of significance. The main method used to assist diagnosis of TB in patients suspected of units studied in Fortaleza was the chest radiograph. The susceptibility profile of Mycobacterium tuberculosis showed 8.82 percent of MDR strains and sensitivity to isoniazid, rifampin, ethambutol and streptomycin from 88.23 percent in the samples taken and can not be extrapolated. If all TSA excluded from the hospital and found only Messejana TSA health posts, the resistance value reduces to a case of MDR 28 to TSA made, representing 3.6% of the sample, most patients with pulmonary TB had AFB positive only a cross, which may mean duration of disease not so long.

The aim of this study was to identify the socioeconomic and environmental factors related to Hansen’s disease in the State of Ceará. A descriptive study was carried out in three municipalities in the State of Ceará with a high finding and prevalence rate of Hansen’s disease in the last ten years in Senator Pompeu, Iguatu and Juazeiro do Norte. The areas where the cases took place were described, and it was also observed if there were water bodies frequently used by the population in the surroundings. The possibility of other factors is speculated, not only the person-person transmission, just like the water, to participate as an infection source for the Mycobacterium leprae. A case-control study in the municipalities of Fortaleza, Juazeiro do Norte, Sobral, and Morada Nova was accomplished in 2001, starting from this pilot descriptive study, showed that the proximity to natural water bodies, and the frequent contact with them emerged as a significant risk factor for Hansen’s disease in Ceará. A determination model of the Hansen’s disease was idealized based on the disease epidemiology. A univaried analysis was accomplished in each block to know which variables would be analyzed through a logistic regression. After that analysis, considering the idealized model, a multivaried hierarchical analysis was used where each explanatory block was analyzed separately, on a discending scale, and the following blocks were adjusted by the significant variables of the ascending block(s). The results found reinforce previous discoveries, in other studies, of the association of Hansen’s disease with low educational levels, extreme poverty, and the lack of hygiene was also shown to be associated with Hansen’s disease. As well as the people who usually take frequent baths in dams, swamps or rivers had a larger risk of developing Hansen’s disease. Having a vaccine scar was shown as an important protection factor against Hansen’s disease.

The river basin committees - CBH were established in Brazil by Law 9433/97, the National Policy of Water Resources, with the goal of enabling social participation in conducting the process of water management, through the representation of various sectors of society, to discuss and define paths for a given river basin where they live and work. In this context, We made an analysis of the trajectory of the Watershed Committee of the Metropolitan Region of Fortaleza - CBH-RMF, the state of Ceara, in order to understand whether the activities of that committee has been successful in addressing the problems environmental Metropolitan Watershed, and what limitations on the articulation of policies and in the effectiveness of participatory water management. As a basis for the studies we were performed literature searches, analysis of documents, records, interviews and observation of committee meetings. The research concluded that the CBH-RMF has taken relevant steps, especially in making diagnoses and conducting some procedures. However, this policy has limitations in its implementation because it is poorly distributed and discussed with the company. It is necessary to greater institutional coordination and social participation to reflect the views and interests of the community in relation to water management.

Após o surgimento da terapia anti-retroviral (TARV), tem sido observado o desenvolvimento de um perfil crônico-degenerativo caracterizado pela presença de diversos distúrbios endócrino-metabólicos, como síndrome metabólica, diabetes mellitus tipo 2 (DM2), dislipidemia e lipodistrofia, condições reconhecidamente associadas a aumento do risco cardiovascular. Além disso, reconhece-se que o próprio HIV desempenha papel significativo no surgimento destas alterações. No entanto, até o momento, dispõe-se de dados limitados sobre a epidemiologia das complicações metabólicas associadas ao HIV no Brasil e em especial no estado do Ceará. O objetivo deste estudo foi determinar a prevalência de distúrbios metabólicos em pacientes portadores de infecção pelo HIV/Aids acompanhados no Hospital São José de Doenças Infecciosas, considerado centro de referência para o atendimento desta condição no estado. Foi realizado um estudo transversal, onde foram incluídos 144 pacientes atendidos no ambulatório de HIV/Aids entre os meses de janeiro a maio de 2010, selecionados de forma sequencial. Para o grupo controle, foram selecionados aleatoriamente 95 pacientes sem infecção pelo HIV. Os pacientes foram submetidos à avaliação médica, exame físico e coleta de amostras de sangue pela manhã em jejum, para determinações de glicose, insulina, colesterol total, lipoproteína de alta densidade (HDL), triglicerídeos, contagem de linfócitos T CD4+ e carga viral do HIV. Foi calculado o HOMA-IR para inferir a resistência à insulina e foi estimado o risco cardiovascular pelo Escore de Risco Framingham (ERF). Os dados foram submetidos à análise estatística, sendo utilizado para esse fim, o programa StataTM, versão 9.1. Na análise dos dados, foram utilizados o teste t de Student, teste de Mann-Whitney, correlação linear de Spearman, qui-quadrado, teste exato de Fisher e teste de X2 Mantel-Haenszel, com nível de significância estatística de 5% (p<0,05). Foi observada uma elevada prevalência de DM2 (7,3% vs. 1,1%; p<0,05), HDL baixo (70,3% vs. 46,1%; p<0,05) e hipertrigliceridemia (54,3% vs. 32,6%; p<0,05) nos pacientes com infecção pelo HIV/Aids em comparação ao grupo controle. DM2 (9,5% vs. 2,5%; p<0,05) e hipertrigliceridemia (68,4% vs. 41,0%; p<0,05) foram mais freqüentes entre os pacientes em uso de TARV vs. sem TARV, ao passo que HDL baixo foi encontrado na mesma proporção entre indivíduos expostos e não-expostos à TARV (68,4% vs. 75,0%; p>0,05). Houve uma menor proporção de pacientes com medida de CA aumentada no grupo com infecção pelo HIV em uso de TARV versus controle (18,6% vs. 42,1%; p<0,05). Foi observado aumento da proporção de indivíduos com risco maior que 20% em 10 anos (alto risco) no grupo de pacientes com infecção pelo HIV/Aids usuários da TARV versus controle (16,7% vs. 3,2%; p<0,05). Não houve diferença na prevalência de síndrome metabólica entre os grupos com e sem infecção pelo HIV (26,4% vs. 31,9%; p>0,05). Lipoatrofia de tecido subcutâneo foi observada em 28,8% dos pacientes infectados pelo HIV, exclusivamente entre aqueles em tratamento. Lipohipertrofia foi detectada em 14,6% dos indivíduos em TARV. Lipodistrofia associada ao HIV (ou seja, presença de lipoatrofia ou de lipohipertrofia) foi observada em 39,4% dos pacientes com infecção pelo HIV em uso da TARV. Em conclusão, estes dados indicam a elevada prevalência de alterações metabólicas entre os pacientes com infecção pelo HIV no nosso meio e orientam que, no âmbito da saúde pública, é preciso considerar a necessidade de desenvolvimento de estratégias que favoreçam a redução das complicações metabólicas e das doenças cardiovasculares neste grupo susceptível.

Introduction – The study of the risk factors of death among young children under one year of age makes it possible the elucidation of the net of determinant events, identification of exposed groups as well as the necessities of the health of population subgroups permitting the programming of interventions aimed at the reduction of infant deaths. The interest in relating records in different data bases has been increasing progressively according to the increasing possibility of large computerized data bases in the health area. The present study shows the results of the linkage of information of the Information System on Live Births (SINASC) and Mortality Information System (SIM) in the determination of infant deaths in the town of Maracanaú, Ceará. Objective – To analyze risk factors for the death of young children under one year of age, in the town of Maracanaú, in the state of Ceará, between the years 2000 and 2002, through the linkage of the information from SINASC and SIM. Methodology – Study of the retrospective cohort of live births. The population constituted of 11,127 live births with certificate of born alive (DN) filled out, between January 1, 2000 and December 31, 2002, children of mothers residing in Maracanaú and 119 infant deaths connected with this cohort of live births, with death certificates (DO) or instrument of investigation of infant death filled out occurred, between January 1, 2000 and December 31, 2003. The risk factors for the infant death were estimated through the logistic regression. Results and Discussion –The model of the multi-variable analyses for the infant death showed that the underweight born-alive when coming to life presented risks of death 3 times bigger before reaching the first year of age when compared with the ones with weights the same as or bigger than 2,500g (OR = 3.16; IC95% 1.58-6.35), the premature born-alive had the death risk 2.7 higher than those of the term (OR = 2.70; IC95% 1.25-5.86), born-alive from mothers with pre-natal appointment the same as or lower than 6 (OR = 2.05; IC95% 1.15-3.64) and born-alive whose Apgar score in the first (OR = 4.40; IC95% 2.48-7.81) and fifth (OR = 5.5; IC95% 2.75-11.20) minutes of life were lower than seven. The low birth weight, values of Apgar score lower than seven in the first and fifth minute of life, the pre-maturity and the number of pre-natal appointments lower than six presented in the cohort in study strong association with death before reaching the first year of life, reinforcing the studies described in the literature that they are variables strongly predictors of infant mortality. This study made it possible the use of data bases of birth and death, through of use of linkage procedure, suggesting its use by the city level of attention to health as well as the continuous vigilance and offer of adequate and technologically advanced assistance in each one of the levels of complexity of the local health system to the subgroup of newly-born with higher risk of death in the first year of age besides the guarantee of proper and conducted pre-natal assistance of good quality and the organization of the assistance in hierarchy and regional systems.

The relationship between maternal blood glucose and macrossomia has being an issue of controversy among different studies. In spite of the evidences that a linear and statistical significant association between maternal blood glucose and macrossomia do exists, no threshold glucose value has being identified as a major risk of this endpoint when using the 75g-OGTT in pregnancy. There are a lack of studies of statistical significance that clarify about the relationship between this test results and fetal growth. The aims of this study is to investigate the characteristics of maternal blood glucose on 75g – OGTT following the WHO criteria and an increased risk of large for gestational age infants in a cohort of 3942 woman from the Brazilian Study for Gestational Diabetes (EBDG,1991-1995). It has being the larger study about gestational diabetes that has being done in our Country and had validated the diagnostic of gestational Diabetes with the WHO criteria in relation to the endpoints such as macrosomia (SCHMIDT et al, 2001). A receiver-Operator characteristic (ROC) curve for the prediction of macrossomia were constructed for the feasting, one and two hours of 75-g glucose load values to determine the plasma glucose threshold value that yielded the highest combined sensitivity and specificity for the prediction of abnormal neonatal birth weight. An investigation about the proprieties of sensitivity and specificity of the cut points of glucose values on the test, distributed in terms of percentil was performed, and also these proprieties if having et least 1, et least two or the three values above certain percentil of the glucose values distribution. The results of these analyses had shown a statistical significant correlation between glucose values and macrossomia on the 75-g load ( p=0,000 ).The analyses of the TOTG-75g load values on ROC curve, with macrossomia as the end point , has shown no inflection point that discriminate a major risk of macrossomia. The discriminative power of the curve in fasting state, 1 hour and two hours is week , as shown by the area under the curve of 0,557 for fasting (CI: 527-588); 0,587 for 1hour values,( CI: 557-617): and 0,574 ( CI: 544-604) for 2 hours. Using the linear tendency test of Fleiss, (Fleiss, 1981) a constant increment on the incidence of macrossomia was observed, as the cut point of glycemia goes up on the range of the percentiles of distribution of glucose values, in such a way that do not exist a threshold level of glycemia that discriminate between an infant with macrossomia from other with adequate weight for gestational age. This study intends to contribute with its data for the discussions about sensible and specific criteria that define predictor’s end points in pregnancy.

Knowledge about the oral health status and the use of dental services for people living with HIV / AIDS (PLWHA) is a factor important to plan actions in order to provide a focus Quality dental care to this population. This study aimed to identify the main factors related to utilization of dental services and oral health status of PLWHA in Fortaleza - Ceará. To this end, A transversal study with a quantitative approach, developed August to December 2009 with PLWHA who were accompanying us infectious disease clinics of a university hospital (HUWC) and Medical Specialties Center José de Alencar (CEMJA). We collected Data on the clinical and laboratory such persons, on conditions sociodemographic, utilization of dental services and the conditions of oral health of this population. The study included 173 patients; 72.3% male and 27.7% female, with a mean age of 36.4 years. Of these, 50.9% (88/173) said they had not yet consulted with a dentist after HIV infection and 52.6% (91/173) of participants said not disclose their HIV status to the dentist before a treatment dentistry. The study also showed that searching for dental care public services (PR: 2.39, 95% CI 1.23 to 4.16, p <0.001) and reveal the condition serology for the dentist (PR: 2.11, 95% CI: 1.03 - 4.31, p <0.001) were significantly associated with having difficulty in accessing these services. There was a high prevalence (61.3%), periodontal disease (87.3%) and changes in oral mucosa (12.7%) in this population. It was evident that there is no statistically significant association between caries and immunological conditions of seropositive patients (p> 0.05). However, the presence of changes in oral mucosa was associated statistically significant with low CD4 count (PR: 4.20; 95% CI: 1.74 to 10.13, p <0.001) and high levels of plasma viral load (PR: 4.74; 95% CI: 2.11 to 10.67, p <0.001). This study concluded that there is at investigated population a high prevalence of oral diseases, showing therefore, great need for dental treatment. However, also observed that there are limitations on access to these people oral health services.

We review in this work the principal properties of single polyacetylene chain from a theoretical field formalism. Then, we study a coupled polyacetylene chain using the same formalism and verify that this system presents a gap in its electronic band structure. This energy gap is calculated in terms of a quantized effective mass that depends on the coupling between the polyacetylene chains. As the coupling decreases the gap vanishes and we restore the previous results of one single polyacetylene chain not dimerized. We show that there is a chiral broken symmetry. We study also the behavior of coupled polyacetilene in presence of solitons. A formalism is developed to show that there is an oscillatory phenomenon of quantum character analogous to Bloch oscillations. The conductivity of the system is also calculated.

This dissertation presents the results of Raman scattering in crystals of DL-aspartic acid under various temperature conditions. The DL-aspartic acid (C4H7NO4) crystallizes in space group C2h 6 with eight molecules per unit cell, so there are 128 atoms in the unit cell that give rise to 384 normal modes of vibration. Of these modes a total of 192 modes are Raman active, which could be observed in not polarized spectra, but by various factors only some of these modes are observed. We did an attempt identification of all normal modes of vibration that appears in the spectral range between 50 and 3200cm-1 and a study with variation in temperature between 10 and 433 K. The interval between 0 and 150 cm-1 is extremely important for detection of phase transitions because it contains the structural modes of vibration of the lattice. In the case of DL-aspartic acid there was a reversal of intensity for the modes at 82 and 87 cm-1, in considering the extremes of temperature interval measured. This reversal was interpreted as a small conformational change, not associated with a phase transition. With exception of this reversal there were not anomalies, not appearance or disappearance of modes in this region, which pointed to the stability of the material. Another event occurred in this region: the bands at 116 and 132 cm-1, very different at very low temperatures (< 150 K) become indistinguishable at 200 K. This fact can not be associated with a phase transition because the broadening of bands, arising from increasing temperatures, implies the superposition of modes. Added to this there is the fact that the torsional vibrations of the NH3 + and rocking of CO2 - (modes associated with hydrogen bonds) behaved linearly in frequency-temperature curves. Finally we did a study of differential scanning calorimetry, which confirmed what had been observed by Raman spectroscopy - the stability of the structure throughout the temperature range investigated.

A simple mechanism is used in some universities in Brazil to select students at entry and allocate them into various majors. Students rst choose a major and then take exams that either select them in the chosen major or select them out. The matching literature analyzing the student placement issue, points out that this mechanism is not fair and is strategic. Pairs of major & students can be made better o¤ and students tend to disguise their preferences. We build up a dynamic model of choice of major and of grading as well as e¤ort exerted to be successful where preferences are carefully modelled. We estimate this model by simulated using cross-section data about entry exams at Universidade Federal do Ceara in Brazil in 2004. Using the empirical results of the model estimation, we then evaluate changes in the way choices are given to the prospective students. Ex-ante expected utilitarian social welfare indeed increases but it hides very strong distributive e¤ects among students. Strategic e¤ects are found to be very strong.

A pesca de lagostas foi avaliada quanto aos ciclos históricos de produção, produtividade do substrato de algas calcárias como habitat das lagostas Lanulirus argus e Panulirus laevicauda, e sua capacidade de carga e produção instantânea. O material de análise consistiu da série histórica de dados sobre produção, esforço de pesca e CPUE, no Estado do Ceará, de 1974 a 1995. A atividade pesqueira passou por quatro fases: Desenvolvimento, Aceleração, Estabilização e Depleção e, atualmente, se encontra nesta última, caracterizada por (a) tendência de decréscimo da produção, elevadas taxas positivas de crescimento do esforço (b= 1.814 e G=4,1%/ano) e taxas negativas de crescimento da CPUE (b= -0,0387 e G= -3,7%/ano). O Estado do Ceará constitui-se no maior produtor e exportador de lagostas do Brasil, em função de características ambientais muito favoráveis ao crescimento e sobrevivência das lagostas. A plataforma continental, com 48,1% de cobertura pelo substrato de algas calcárias com uma área superficial de 23.088 Km2 (27,6% do total), contém 43,5% da capacidade de carga (7,301.335 kg) e 42,9% da produção instantânea de bimassa (7.398.883 kg), com densidade de 316,3kg/km2. As espécies P. argus e P. laevicauda participam da capacidade de carga com 68,9% e 31,1%, sendo a primeira mais abundante em áreas mais afastadas da costa, a partir da isóbata de 30 m. A capturabilidade é de 55,6% e a intensidade de pesca e densidade ótimas são 5,1 covos/ha e 9,1 ind./ha.

The fluids displacement in porous media has been subject in researches with great scientific and technologic interesting due to its close connection to industry applications, like oil recovery problem, groundwater studies etc. In this thesis, we have investigated through numerical simulations three two-phase flow problems. The first one, is about the secondary oil recovery method, which consist to push the oil using the injection of water; the second case, treats of the tertiary oil recovery method, where the oil viscosity is decreased by the increasing of the temperature; and the last one, is an interfacial hardness model to simulate the glue penetration in porous media. In the first part, we study the behavior of the oil production rate in an isothermal and two-dimensional reservoir field. Water is pushed from an injection to a production well, separated by a distance r. This corresponds to the secondary recovery method in oil reservoirs. We then investigate through direct numerical calculation using the commercial reservoir field simulator STARS of CMG (Computer Modelling Group) the influence of the viscosity ratio (m = moil/mwater) on the oil production (C(t)) when m ≥ 1. We keep m constant through simulation. We first consider a macroscopically disordered and homogeneous reservoir. In this case, all the geometry is accessible to the fluids, but the porosity varies randomly in space. The results show two power law regimes in the oil production curves, with exponent -1/3 and -5/2. We also study the behavior of inhomogeneous system with a percolation-like reservoir geometry. We see in this case a power law behavior with exponent -0.8 in C(t) curves. We verify that the breakthrough time carries units of r 1.8 m1/4 in the homogeneous case and r m1/5 in the inhomogeneous one. When the kind of oil is heavy, tertiaries methods are necessary to improve the recovery. One of the most used techniques is the Steam Injection, where a hot fluid (usually, water or steam) is injected into the reservoir to decrease the oil viscosity. In order to make those studies we consider a microscopic approximation of the medium. The oil viscosity is dependent on temperature according the following function, exp(B/T), where B is a physico-chemical parameter which define the kind of oil, and T is the temperature. A gradient of temperature, ∆T, is applied crossing the medium in the same direction of the injection. Initially, the porous medium is saturated with oil and, then, another fluid is injected. We have considered two cases of injection. The first one, the viscosity of the invading fluid is constant (the viscosity ratio is, then, finite) and the second one, the invading fluid is inviscid (infinite viscosity ratio). Our results show that the recovery efficiency of the oil can increase substantially with the ∆T. We show, also, that the percentage of the oil recovery decreases with B for the finite viscosity ratio case, but the opposite behavior for the other case. In the last part, we propose an Invasion Percolation modified model to simulate the penetration of a fluid into another with hardening interface. Initially, the capillary pressure of each site in the lattice is randomly chosen between 0 and 1, and then, the hardness effect by contact with the defending phase is obtained by increasing the pressure of those sites at interface. The most time exposition a site has the greatest is its pressure value. During this exposition, if a site has pressure greater or equal to 1, that site becomes a pine and cannot be invaded anymore. That represents a glue penetrating into a porous medium where it becomes hard due to exposition with the air. We also consider three different regimes of the displacement according the Bond number, Bo > 0, Bo = 0 and Bo < 0. We have analyzed the influence of that hardness effect in those regimes. We see that, besides the patterns change with this effect, the average behavior do not affect much.

Poucos são os estudos taxonômicos ou morfológicos dos ossos tímpano-perióticos, que constituem o ouvido médio e interno dos cetáces. O presente trabalho tem como objetivo identificar e descrever, numa análise comparativa, as estruturas que formam os osso tímpano-perióticos de seis espécies de pequenos cetáceos que ocorrem na costa no Estado do Ceará, Brasil. Durante o período de janeiro de 1992 a julho de 1996, foram estudados 22 ossos tímpano-perióticos de seis espécies: 15 de Sotalia fluviatilis, 2 de Steno bredanensis, 1 de Stenella clymene, 2 de Tursiops truncatus, 1 de Peponocephala electra e 1 de Ziphius cavirostris. As bulas auditivas foram codificadas e medidas com precisão de 0,05 mm, observando-se 22 características. Também realizou-se, em S. fluviatilis, estudo de simetria bilateral através da comparação das medidas das bulas direita e esquerda, utilizando-se o teste multivariado Hotelling's T2. Não foi observada variação significativa na simetria dos ossos tímpano-perióticos para S. fluviatilis. As relações filogenéticas obtidas pela análise de agrupamento realizada com base nas medidas dos ossos tímpano-perióticos das seis espécies estudadas estão de acordo com árvores filogenéticas obtidas através de análises estatísticas baseadas em seqüências do DNA mitocondrial.