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Search Results: 1 - 10 of 411743 matches for " Valdinar S; Arag?o "
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Infant mortality: comparison between two birth cohorts from Southeast and Northeast, Brazil
Ribeiro,Valdinar S; Silva,Ant?nio A M; Barbieri,Marco A; Bettiol,Heloisa; Arago,Vania M F; Coimbra,Liberata C; Alves,Maria T S S B;
Revista de Saúde Pública , 2004, DOI: 10.1590/S0034-89102004000600004
Abstract: objective: to obtain population estimates and profile risk factors for infant mortality in two birth cohorts and compare them among cities of different regions in brazil. methods: in ribeir?o preto, southeast brazil, infant mortality was determined in a third of hospital live births (2,846 singleton deliveries) in 1994. in s?o luís, northeast brazil, data were obtained using systematic sampling of births stratified by maternity unit (2,443 singleton deliveries) in 1997-1998. mothers answered standardized questionnaires shortly after delivery and information on infant deaths was retrieved from hospitals, registries and the states health secretarys' office. the relative risk (rr) was estimated by poisson regression. results: in s?o luís, the infant mortality rate was 26.6/1,000 live births, the neonatal mortality rate was 18.4/1,000 and the post-neonatal mortality rate was 8.2/1,000, all higher than those observed in ribeir?o preto (16.9, 10.9 and 6.0 per 1,000, respectively). adjusted analysis revealed that previous stillbirths (rr=3.67 vs 4.13) and maternal age <18 years (rr=2.62 vs 2.59) were risk factors for infant mortality in the two cities. inadequate prenatal care (rr=2.00) and male sex (rr=1.79) were risk factors in s?o luís only, and a dwelling with 5 or more residents was a protective factor (rr=0.53). in ribeir?o preto, maternal smoking was associated with infant mortality (rr=2.64). conclusions: in addition to socioeconomic inequalities, differences in access to and quality of medical care between cities had an impact on infant mortality rates.
Fatores associados à inadequa??o do uso da assistência pré-natal
Coimbra,Liberata C; Silva,Ant?nio A M; Mochel,Elba G; Alves,Maria T S S B; Ribeiro,Valdinar S; Arago,Vania M F; Bettiol,Heloisa;
Revista de Saúde Pública , 2003, DOI: 10.1590/S0034-89102003000400010
Abstract: objective: to identify factors associated with inadequacy of prenatal care utilization in urban community. methods: a cross-sectional study of a systematic sample stratified by maternity hospital, consisting of hospital births in the municipality of s?o luís, brazil, was carried out from march 1997 to february 1998. socioeconomic and demographic factors, reproductive health, morbidity during pregnancy, and utilization of prenatal care services were studied. mothers answered a standardized questionnaire before hospital discharge. the adequacy of prenatal care utilization was analyzed by means of two indexes: apncu (adequacy of prenatal care utilization) and a new index based on the recommendations of the brazilian ministry of health. results: there were interviewed 2,831 women who delivered at 10 public and private maternity hospitals. the inadequacy of prenatal care utilization was 49.2% according to the apncu index and 24.5% when determined by the brazilian index. prenatal care at public services, low maternal schooling, low income, having no partner, and absence of maternal diseases during pregnancy were associated with inadequacy of prenatal care use according to both indexes. high parity and maternal age of 35 years or more were also associated with inadequacy, whereas primiparity, morbidity, and young maternal age (<20 years) seemed to protect from inadequacy when the brazilian index was used. conclusions: prenatal care showed low coverage in the municipality of s?o luís. the inadequacy of prenatal care utilization was associated with several factors linked to social inequality.
Perinatal health and mother-child health care in the municipality of S?o Luís, Maranh?o State, Brazil
Silva, Ant?nio Augusto M. da;Coimbra, Liberata Campos;Silva, Raimundo Ant?nio da;Alves, Maria Teresa S. S. de B. e;Lamy Filho, Fernando;Lamy, Zeni Carvalho;Mochel, Elba Gomide;Arago, Vania Maria de F.;Ribeiro, Valdinar Sousa;Tonial, Sueli Rosina;Barbieri, Marco Ant?nio;
Cadernos de Saúde Pública , 2001, DOI: 10.1590/S0102-311X2001000600025
Abstract: the purpose of this article was to evaluate socioeconomic and demographic indicators, reproductive health, use of prenatal, childbirth, and neonatal services, and anthropometric data for mothers and infants. the authors performed a cross-sectional analysis of a systematic sample of 2,831 hospital births in s?o luís, maranh?o state, from march 1997 to february 1998 at ten public and private maternity hospitals. the sample was stratified proportionally according to the number of births in each maternity hospital. mothers answered a standard questionnaire. of the total, 97.9% were live births and 98% were singletons. prenatal coverage was 89.5%, and prevalence of cesarean sections was 33.8%. a physician provided prenatal care in 75.7% of cases and performed 73.8% of the deliveries. the unified health system covered the costs of 76.4% of the prenatal visits and 89.7% of the deliveries. a pediatrician was present in the delivery room in 50.2% of cases. the low birth weight rate was 9.6% and the preterm birth rate 13.9%. reasons for concern included a high percentage of adolescent mothers, single mothers (or without partners), the high cesarean rate, and the high percentage of births attended by unqualified personnel.
Which factors could explain the low birth weight paradox?
Silva,Ant?nio Augusto Moura da; Bettiol,Heloisa; Barbieri,Marco Antonio; Brito,Luiz Gustavo Oliveira; Pereira,Márcio Mendes; Arago,Vania Maria Farias de; Ribeiro,Valdinar Sousa;
Revista de Saúde Pública , 2006, DOI: 10.1590/S0034-89102006000500014
Abstract: objective: low birth weight children are unusual among well-off families. however, in brazil, low birth weight rate was higher in a more developed city than in a less developed one. the study objective was to find out the reasons to explain this paradox. methods: a study was carried out in two municipalities, ribeir?o preto (southeastern brazil) and s?o luís (northeastern brazil), which low birth weight rates were 10.7% and 7.6% respectively. data from two birth cohorts were analyzed: 2,839 newborns in ribeir?o preto in 1994 and 2,439 births in s?o luís in 1997-1998. multiple logistic regression analysis was performed, adjusted for confounders. results: low birth weight risk factors in s?o luís were primiparity, maternal smoking and maternal age less than 18 years. in ribeir?o preto, the associated variables were family income between one and three minimum wages, maternal age less than 18 and equal to or more than 35 years, maternal smoking and cesarean section. in a combined model including both cohorts, ribeir?o preto presented a 45% higher risk of low birth weight than s?o luís. when adjusted for maternal smoking habit, the excess risk for low birth weight in ribeir?o preto compared to s?o luís was reduced by 49%, but the confidence interval was marginally significant. differences in cesarean section rates between both cities contributed to partially explain the paradox. conclusions: maternal smoking was the most important risk factor for explaining the difference in low birth weight between both cities. the other factors contributed little to explain the difference in low birth weight rates.
Risk factors for preterm births in S?o Luís, Maranh?o, Brazil
Arago, Vania Maria de Farias;Silva, Ant?nio Augusto Moura da;Arago, Lívia Farias de;Barbieri, Marco Ant?nio;Bettiol, Heloísa;Coimbra, Liberata Campos;Ribeiro, Valdinar Sousa;
Cadernos de Saúde Pública , 2004, DOI: 10.1590/S0102-311X2004000100019
Abstract: preterm birth continues to be one of the main causes of neonatal morbidity and mortality. the objective of the present study was to identify risk factors for preterm birth in s?o luís, maranh?o, brazil. the sample consisted of hospital births at 10 public and private hospitals from march 1, 1997 to february 28, 1998. a total of 2,443 live births were randomly selected, excluding multiple deliveries and stillbirths. preterm birth rate in s?o luís was 12.7%. risk factors for preterm delivery were maternal age below 18 years, family income equal to or less than one minimum wage/ month, primiparity, vaginal delivery at a public hospital, single mothers (or living without a partner), and absence of prenatal care. the following factors remained associated with preterm birth after multivariate analysis to control for confounding: maternal age below 18 years (or = 1.9), primiparity (or = 1.5), and failure to appear for scheduled prenatal care visits (or = 1.5).
Concentrated terms and varying domains in elliptic equations: Lipschitz case
G. S. Arago,S. M Bruschi
Mathematics , 2014,
Abstract: In this paper, we analyze the behavior of a family of solutions of a nonlinear elliptic equation with nonlinear boundary conditions, when the boundary of the domain presents a highly oscillatory behavior which is uniformly Lipschitz and nonlinear terms are concentrated in a region which neighbors the boundary domain. We prove that this family of solutions converges to the solutions of a limit problem in H^1 , an elliptic equation with nonlinear boundary conditions which captures the oscillatory behavior of the boundary and whose nonlinear terms are transformed into a flux condition on the boundary. Indeed, we show the upper semicontinuity of this family of solutions.
Infant mortality and low birth weight in cities of Northeastern and Southeastern Brazil
Silva,Ant?nio Augusto Moura da; Bettiol,Heloísa; Barbieri,Marco Ant?nio; Ribeiro,Valdinar Sousa; Arago,Vania Maria de Farias; Brito,Luiz Gustavo Oliveira; Pereira,Márcio Mendes;
Revista de Saúde Pública , 2003, DOI: 10.1590/S0034-89102003000600002
Abstract: objective: to compare estimates of low birth weight (lbw), preterm birth, small for gestational age (sga), and infant mortality in two birth cohorts in brazil. methods: the two cohorts were performed during the 1990s, in s?o luís, located in a less developed area in northeastern brazil, and ribeir?o preto, situated in a more developed region in southeastern brazil. data from one-third of all live births in ribeir?o preto in 1994 were collected (2,839 single deliveries). in s?o luís, systematic sampling of deliveries stratified by maternity hospital was performed from 1997 to 1998 (2,439 single deliveries). the chi-squared (for categories and trends) and student t tests were used in the statistical analyses. results: the lbw rate was lower in s?o luís, thus presenting an epidemiological paradox. the preterm birth rates were similar, although expected to be higher in ribeir?o preto because of the direct relationship between preterm birth and lbw. dissociation between lbw and infant mortality was observed, since s?o luís showed a lower lbw rate and higher infant mortality, while the opposite occurred in ribeir?o preto. conclusions: higher prevalence of maternal smoking and better access to and quality of perinatal care, thereby leading to earlier medical interventions (cesarean section and induced preterm births) that resulted in more low weight live births than stillbirths in ribeir?o preto, may explain these paradoxes. the ecological dissociation observed between lbw and infant mortality indicates that the lbw rate should no longer be systematically considered as an indicator of social development.
Fluxos de nutrientes em larvas de peixes: aplica??o de técnicas com marcadores isotópicos e de modela??o
Concei??o, Luís;Morais, Sofia;Arago, Cláudia;
Revista Brasileira de Zootecnia , 2007, DOI: 10.1590/S1516-35982007001000002
Abstract: a mechanistic simulation model of fish larval growth should contribute to a better understanding of growth and metabolism of fish larvae. it should also assist in studying the nutritional requirements and developing feeding strategies. a model was developed that simulates growth and biochemical composition in time. the model is driven by feed intake, with absorbed nutrients being used for energy production and biosynthesis, based on the stoicheometry of intermediary metabolism. model simulations suggest that imbalanced dietary amino acid (aa) profiles and dietary lipid excess may lead to suboptimal growth in fish larvae culture. tracer studies have therefore been used to study aa and lipid metabolism in fish larvae. in addition, modeling techniques have been also used in these studies, to better interpret results obtained. digestive capacity, as well as utilization of different aa, fatty acids and lipid classes, has been studied using radiolabeled nutrients (normally with 14c) using a tube-feeding technique. this method allows quantification of the tracer that is present in faeces, retained in tissues and catabolised. another method, combining the use of live food in which proteins are labeled with a stable isotope and a spectroscopic/spectrometric technique that allows determination of the isotopic enrichment in individual aa, can be used to estimate ideal dietary indispensable aa profiles. together these two types of techniques that allow the study of nutrient fluxes have lead to important advances in the understanding of fish larvae nutritional physiology and growth.
Cost-Effectiveness of the Third-Agent Class in Treatment-Naive Human Immunodeficiency Virus-Infected Patients in Portugal
Filipa Arago, José Vera, Inês Vaz Pinto
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0044774
Abstract: Introduction Current Portuguese HIV treatment guidelines recommend initiating antiretroviral therapy with a regimen composed of two Nucleoside Reverse Transcriptase Inhibitors plus one Non-nucleoside Reverse Transcriptase Inhibitor (2NRTI+NNRTI) or two Nucleoside Reverse Transcriptase Inhibitors plus one boosted protease inhibitor (2NRTI+PI/r). Given the lower daily cost of NNRTI as the third agent when compared to the average daily costs of PI/r, it is relevant to estimate the long term impact of each treatment option in the Portuguese context. Methods We developed a microsimulation discrete events model for cost-effectiveness analysis of HIV treatment, simulating individual paths from ART initiation to death. Four driving forces determine the course of events: CD4+ cell count, viral load, resistance and adherence. Distributions of time to event are conditional to individuals’ characteristics and past history. Time to event was modeled using parametric survival analysis using Stata 11?. Disease progression was structured according to therapy lines and the model was parameterized with cohort Portuguese observational data. All resources were valued at 2009 prices. The National Health Service’s perspective was assumed considering a lifetime horizon and a 5% annual discount rate. Results In this analysis, initiating therapy with two Nucleoside Reverse Transcriptase Inhibitors plus one Non-nucleoside Reverse Transcriptase Inhibitor reduces the average number of switches by 17%, saves 19.573€ per individual and increases life expectancy by 1.7 months showing to be a dominant strategy in 57% of the simulations when compared to two Nucleoside Reverse Transcriptase Inhibitors plus one boosted protease inhibitor. Conclusion This study suggests that, when clinically valid, initiating therapy with two Nucleoside Reverse Transcriptase Inhibitors plus one Non-nucleoside Reverse Transcriptase Inhibitor is a cost-saving strategy and equally effective when compared to two Nucleoside Reverse Transcriptase Inhibitors plus one boosted protease inhibitor as the first regimen.
Condicionamento osmótico de sementes de mel?o: absor??o de água e germina??o em diferentes temperaturas
Nascimento, Warley Marcos;Arago, Fernando A.S;
Revista Brasileira de Sementes , 2002, DOI: 10.1590/S0101-31222002000100022
Abstract: low temperatures (below 17°c) may inhibit muskmelon seed germination. seed priming may overcome the inhibitory effect of low temperatures and increase germination and seedling establishment in the field. muskmelon seeds were primed in kno3 (0.35m) aerated solution for six days at 25°c. water imbibition during seed priming and germination was determined. higher germination in both temperatures was observed in primed seeds. primed seeds absorbed more water and germinated faster than unprimed seeds.
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