Ethnomedical uses, biocompounds and biological properties of Cereus Jamacaru DC. (Cactaceae): a comprehensive review.

Cereus jamacaru, popularly known as mandacaru, is a Cacactacea native to the Caatinga of Brazil, but it is distributed in arid and semiarid regions worldwide. This plant is used for various purposes, such as food, animal fodder, civil construction, and as an ornamental and medicinal plant. Traditional medicine uses the cladodes, roots, and seeds of C. jamacaru to treat various diseases. This review discusses the ethnobotanical uses, phytochemical composition, and biological properties of C. jamacaru. The data demonstrate that C. jamacaru produces a wide range of secondary metabolites involved in the defense mechanism against biotic agents and abiotic stresses. Carbohydrate polymers, phenolic compounds, terpenes, and bioactive nitrogen compounds, have been identified and linked to this plant's biological properties. The present review will support future scientific research in identifying new bioproducts and demonstrating the potential of C. jamacaru as a food and medicinal plant.

Association between the intensity of obstructive sleep apnea and skeletal alterations in the face and hyoid bone / Relação entre a influência da gravidade da apneia obstrutiva do sono e alterações craniofaciais e do posicionamento do osso hioide

Abstract Introduction The association between the intensity of obstructive sleep apnea and skeletal alterations in the face and hyoid bone is still scarcely addressed in the literature. Objective To evaluate whether the intensity of obstructive sleep apnea is associated with craniofacial alterations and the position of the hyoid bone in children with mixed dentition. Methods 76 children aged 7 to 10 years old were examined by otorhinolaryngological evaluation, polysomnography, and orthodontic assessment, including cephalometry. The participants were divided in 3 groups: primary snoring, mild obstructive sleep apnea and moderate to severe obstructive sleep apnea. Cephalometric measures of the face and hyoid bone were assessed. These measures were compared among the different groups by unpaired Student's t test. Moreover, these measures were correlated with the patient's obstructive apnea and hypopnea index variable using Pearson's correlation test. Results Of the 76 children, 14 belonged to group 1, with primary snoring; 46 to group 2, with mild obstructive sleep apnea; and 16 to group 3, with moderate-severe obstructive sleep apnea. There was no difference between the groups regarding the craniofacial variables. Children with obstructive sleep apnea showed a longer distance from the hyoid bone to the mandibular plane when compared to the primary snoring group (p < 0.05). Between the two obstructive sleep apnea subgroups, patients with moderate or severe disease showed significantly shorter horizontal distance between the hyoid bone and the posterior pharyngeal wall (p < 0.05), when compared to the groups with mild obstructive sleep apnea. We also observed a significant positive correlation between obstructive apnea and hypopnea index and the distance from the hyoid to the mandibular plane (p < 0.05) as well as a significant negative association between obstructive apnea and hypopnea index and the horizontal distance from the hyoid to the posterior pharyngeal wall (p < 0.01). Conclusion We did not observe any association between obstructive sleep apnea and linear lateral alterations of the face. In contrast, there is a direct association between obstructive sleep apnea severity and the inferior and posterior position of the hyoid bone in children aged 7 to 10 years old.

Resumo Introdução A relação entre a intensidade da apneia obstrutiva do sono e alterações esqueléticas da face e do hioide em crianças é pouco explorada na literatura. Objetivo Avaliar se a intensidade da apneia obstrutiva do sono correlaciona-se às alterações craniofaciais e ao posicionamento do osso hioide em crianças em fase de dentição mista. Método Foram submetidas 76 crianças entre 7 e 10 anos à avaliação otorrinolaringológica, polissonografia e avaliação ortodôntica, inclusive cefalometria. Os participantes foram divididos em 3 grupos: grupo 1 com ronco primário, grupo 2 com apneia obstrutiva do sono leve e grupo 3 com apneia obstrutiva do sono moderada/grave. Foram analisadas medidas cefalométricas da face e do osso hioide. Essas medidas foram comparadas entre si dentro dos diferentes grupos por teste t de Student não pareado. Além disso, essas medidas foram correlacionadas com a variável índice de apneias obstrutivas e hipopneias do paciente através do teste de correlação de Pearson. Resultados Das 76 crianças, 14 constituíram o grupo 1, ronco primário; 46 o grupo 2, apneia obstrutiva do sono leve; e 16 o grupo 3, apneia obstrutiva do sono moderada/grave. Não se observou diferença significante entre os grupos para as variáveis craniofaciais. Observou-se maior distância do osso hioide ao plano mandibular nos dois grupos com apneia obstrutiva do sono quando comparado ao ronco primário (p < 0,05). Entre os dois subgrupos da apneia obstrutiva do sono, os pacientes com doença moderada ou grave apresentaram distância horizontal entre o hioide e a parede posterior da faringe significantemente menor (p < 0,05), quando comparados aos grupos com apneia obstrutiva do sono leve. Observamos ainda correlação significantemente positiva entre índice de apneias obstrutivas e hipopneias e a distância do hioide ao plano mandibular (p < 0,05) e significantemente negativa entre índice de apneias obstrutivas e hipopneias e distância horizontal do hioide com a parede posterior da faringe (p < 0,01). Conclusão Não observamos relação da apneia obstrutiva do sono com alterações lineares laterais da face. Em contraste, existe relação direta entre a gravidade da apneia obstrutiva do sono e a posição inferior e posterior do osso hioide em crianças entre 7 e 10 anos.

Can drug-induced sleep endoscopy (DISE) predict compliance with positive airway pressure therapy? A pilot study.

PURPOSE: Drug-induced sleep endoscopy (DISE) has been poorly explored as an examination to assess positive airway pressure (PAP) therapy in patients with obstructive sleep apnea (OSA). The present study aimed to identify by DISE possible characteristics related to low compliance with PAP therapy due to respiratory complaints. METHODS: Patients using PAP for OSA underwent DISE in two conditions: (1) baseline (without PAP) and (2) PAP (with the same mask and airway pressure used at home). We compared patients reporting low compliance to PAP due to respiratory complaints to those well-adapted to therapy. VOTE classification (assessment of velopharynx, oropharynx, tongue base, and epiglottis) and TOTAL VOTE score (the sum of VOTE scores at each anatomical site) were assessed. ROC curve analyzed the accuracy of TOTAL VOTE to predict low compliance due to persistent pharyngeal obstruction in both conditions. RESULTS: Of 19 patients enrolled, all presented multilevel pharyngeal obstruction at baseline condition, with no difference between groups at this study point. When PAP was added, the median VOTE value was higher in the epiglottis (P value=0.02) and tended to be higher at the velum and tongue base in the poorly adapted group; TOTAL VOTE score was also significantly increased in patients with low compliance (P value<0.001). ROC curve demonstrated that patients with TOTAL VOTE scored 2.5 or more during DISE with PAP presented a 4.6-fold higher risk for low compliance with PAP therapy due to pharyngeal obstruction (AUC: 0.88±0.07; P value<0.01; sensitivity: 77%; specificity: 83%). CONCLUSIONS: Adding PAP during a DISE examination may help to predict persistent pharyngeal obstruction during PAP therapy.

Association between the intensity of obstructive sleep apnea and skeletal alterations in the face and hyoid bone.

INTRODUCTION: The association between the intensity of obstructive sleep apnea and skeletal alterations in the face and hyoid bone is still scarcely addressed in the literature. OBJECTIVE: To evaluate whether the intensity of obstructive sleep apnea is associated with craniofacial alterations and the position of the hyoid bone in children with mixed dentition. METHODS: 76 children aged 7 to 10 years old were examined by otorhinolaryngological evaluation, polysomnography, and orthodontic assessment, including cephalometry. The participants were divided in 3 groups: primary snoring, mild obstructive sleep apnea and moderate to severe obstructive sleep apnea. Cephalometric measures of the face and hyoid bone were assessed. These measures were compared among the different groups by unpaired Student's t test. Moreover, these measures were correlated with the patient's obstructive apnea and hypopnea index variable using Pearson's correlation test. RESULTS: Of the 76 children, 14 belonged to group 1, with primary snoring; 46 to group 2, with mild obstructive sleep apnea; and 16 to group 3, with moderate-severe obstructive sleep apnea. There was no difference between the groups regarding the craniofacial variables. Children with obstructive sleep apnea showed a longer distance from the hyoid bone to the mandibular plane when compared to the primary snoring group (p<0.05). Between the two obstructive sleep apnea subgroups, patients with moderate or severe disease showed significantly shorter horizontal distance between the hyoid bone and the posterior pharyngeal wall (p<0.05), when compared to the groups with mild obstructive sleep apnea. We also observed a significant positive correlation between obstructive apnea and hypopnea index and the distance from the hyoid to the mandibular plane (p<0.05) as well as a significant negative association between obstructive apnea and hypopnea index and the horizontal distance from the hyoid to the posterior pharyngeal wall (p<0.01). CONCLUSION: We did not observe any association between obstructive sleep apnea and linear lateral alterations of the face. In contrast, there is a direct association between obstructive sleep apnea severity and the inferior and posterior position of the hyoid bone in children aged 7 to 10 years old.

Swallowing evaluation after surgery for obstructive sleep apnea syndrome: uvulopalatopharyngoplasty vs. expansion pharyngoplasty.

PURPOSE: To evaluate the effect of pharyngeal surgery on swallowing pattern in patients with obstructive sleep apnea syndrome (OSAS), and to compare two surgical techniques: uvulopalatopharyngoplasty (UPPP) and expansion pharyngoplasty (EP), through videofluoroscopy. METHODS: Longitudinal prospective cohort, in a tertiary referral center. 17 adult patients were enrolled this study, divided into two groups: patients who underwent UPPP (n = 10) or EP (n = 7). Swallowing videofluoroscopy (for both liquid and pasty consistences) was assessed at three different periods: before surgery, and at 14 and 28 days following surgery. Comparisons were performed between pre- and post-operative (PO) swallowing conditions in the same patient, and between surgical techniques. RESULTS: Asymptomatic OSAS patients already presented altered swallowing pattern before surgery. Both surgical procedures led to an increased hyoid movement time and an increased frequency of laryngeal penetration in early PO during liquid ingestion. For pasty consistency, both techniques reduced velum movement time and increased pharyngeal transit time and the rate of stasis in hypopharynx. All these parameters reached or tended to reach the pre-operative indices at day PO 28. CONCLUSIONS: OSAS patients show sub-clinical changes in swallowing pattern before surgery. Both surgical techniques are related to transitory changes in swallowing biomechanics. Complete or partial reversal to pre-operative swallowing parameters occurs 1 month after both surgery techniques.

The importance of clinical monitoring for compliance with Continuous Positive Airway Pressure / A importância do seguimento clínico para adesão ao CPAP

Abstract Introduction: Obstructive sleep apnea syndrome is currently a public health problem of great importance. When misdiagnosed or improperly treated, it can lead to serious consequences on patients' quality of life. The gold standard treatment for cases of obstructive sleep apnea syndrome, especially in mild to severe and symptomatic cases, is continuous positive airway pressure therapy. Compliance with continuous positive airway pressure therapy is directly dependent on the active participation of the patient, which can be influenced by several factors. Objective: The objective of this study is to describe the factors related to compliance with continuous positive airway pressure therapy, and to analyze which associated factors directly influence the efficiency of the treatment. Methods: Patients who received continuous positive airway pressure therapy through the Municipal Health Department of the city of Ribeirão Preto were recruited. A structured questionnaire was administered to the patients. Compliance with continuous positive airway pressure therapy was assessed by average hours of continuous positive airway pressure therapy usage per night. Patients with good compliance (patients using continuous positive airway pressure therapy ≥4 h/night) were compared to those with poor compliance (patients using <4 h/night). Results: 138 patients were analyzed: 77 (55.8%) were considered compliant while 61 (44.2%) were non-compliant. The comparison between the two groups showed that regular monitoring by a specialist considerably improved compliance with continuous positive airway pressure therapy (odds ratio, OR = 2.62). Conclusion: Compliance with continuous positive airway pressure therapy is related to educational components, which can be enhanced with continuous and individualized care to patients with obstructive sleep apnea syndrome.

Resumo Introdução: Síndrome da apneia obstrutiva do sono (SAOS) é, atualmente, um problema de saúde pública de suma importância. Quando mal diagnosticada ou tratada inadequadamente, pode levar a sérias consequências na qualidade de vida do paciente. O tratamento padrão-ouro para casos de SAOS, principalmente nos casos moderados a grave e sintomáticos, é o CPAP (Continuous Positive Airway Pressure). A adesão ao CPAP depende diretamente da participação ativa do paciente, que pode ser influenciada por vários fatores. Objetivo: O objetivo deste estudo é descrever os fatores relacionados à adesão ao CPAP e analisar quais fatores associados influenciam diretamente na eficiência do tratamento. Método: Foram recrutados pacientes que receberam CPAP pela Secretaria Municipal de Saúde de Ribeirão Preto. Um questionário estruturado foi aplicado ao paciente. A adesão ao CPAP foi avaliada pela média de horas de uso do CPAP por noite. Pacientes com boa adesão (pacientes em uso de CPAP ≥4 horas/noite) foram comparados aos com má adesão (pacientes em uso < 4 horas/noite). Resultados: No estudo, 138 pacientes foram analisados: 77 (55,8%) foram considerados aderentes e 61 (44,2%) foram não aderentes. A comparação entre os dois grupos demonstrou que o seguimento regular com especialista melhorou consideravelmente a adesão ao CPAP (odds ratio, OR = 2,62). Conclusão: A adesão ao CPAP está relacionada a componentes educacionais, que podem ser aprimorados com assistência contínua e individualizada ao paciente com SAOS.

Prevalence and associated factors for early interruption of exclusive breastfeeding: meta-analysis on Brazilian epidemiological studies / Prevalência e fatores associados à interrupção precoce do aleitamento materno exclusivo: metanálise de estudos epidemiológicos brasileiros

Abstract Objectives: to summarize Brazilian studies that analyzed the risk factors for Exclusive Breastfeeding (EBF) interruption before the child's six months of life. Methods: systematic review and meta-analysis indexed articles from Bireme, Scielo and Pubmed databases published in the period of January 2000 to December 2015. Results: 22 articles were included in the meta-analysis. The factors related to newborns were observed, such as birth weight (OR= 1.17; CI 95%: 1.05-1.29), female gender (OR= 1,09; CI 95%: 1.04-1.13) and the use of pacifier (OR= 2.29; CI 95%: 1.68-2.91) were the main factors responsible for the increase in the occurrence of EBF interruption. The factors were related to the mother, maternal age below twenty years old (OR= 1.22; CI 95%: 1.12-1.33) low schooling level (OR=1.28; CI 95%: 1.11-1.45), primiparity (OR= 1.17; CI 95%: 1.02-1.32) maternal employment during the postpartum period (OR= 1.26; CI 95%: 1.11-1.41), and low family income (OR= 1.22; CI 95%: 1.08-1.37) contributed significantly to the EBF interruption . Conclusions: the meta-analysis of Brazilian epidemiological studies demonstrated evidences to conclude that below the age of twenty, low schooling, primiparity, maternal employment in the postpartum period and low family income are associated to the interruption of exclusive breastfeeding until 6 months of age. Children with low birth weight, female gender and used a pacifier had greater vulnerability to not be exclusively breastfed. In conclusion, most of these factors can be modified through appropriate public policies throughout the adequate prenatal period to promote exclusive breastfeeding.

Resumo Objetivos: sumarizar estudos brasileiros que analisaram os fatores de risco para interrupção do aleitamento materno exclusivo (AME) antes dos seis meses de vida da criança. Métodos: revisão sistemática e metanálise de artigos indexados na base de dados Bireme, Scielo e Pubmed, publicados no período de janeiro 2000 a dezembro de 2015. Resultados: 22 artigos foram incluídos na metanálise. Observou-se que os fatores relacionados ao recém-nascido como o baixo peso ao nascer (OR= 1,17; IC95%: 1,05-1,29), sexo feminino (OR= 1,09; IC95%: 1,04-1,13) e uso de chupeta (OR= 2,29; IC95%: 1,68- 2,91) foram os principais fatores de exposição responsável pelo aumento da ocorrência de interrupção do AME. No que se refere aos fatores de exposição relacionados à mãe, a idade materna inferior a vinte anos (OR= 1,22; IC95%: 1,12-1,33), a baixa escolaridade (OR=1.28; CI 95%: 1,11-1,45), a primiparidade (OR= 1,17; IC95%: 1,02-1,32), o trabalho materno no puerpério (OR= 1,26; IC95%: 1,11-1,41) e a baixa renda familiar (OR= 1,22; IC95%: 1,08-1,37) contribuíram significativamente para ocorrência de interrupção do AME. Conclusões: a metanálise de estudos epidemiológicos brasileiros registrou evidências para concluir que a idade inferior a vinte anos, baixa escolaridade, primiparidade, trabalho materno no puerpério e a baixa renda familiar estão associados com a interrupção do aleitamento materno exclusivo até os seis meses de idade. Crianças com baixo peso ao nascer, do sexo feminino e que usaram chupeta tiveram maior vulnerabilidade de não serem amamentadas exclusivamente. Conclui-se, que a maioria deste fatores podem ser modificados por meio de políticas públicas de acompanhamento adequado durante todo o pré-natal,com ações de promoção do aleitamento materno exclusivo.

The importance of clinical monitoring for compliance with Continuous Positive Airway Pressure.

INTRODUCTION: Obstructive sleep apnea syndrome is currently a public health problem of great importance. When misdiagnosed or improperly treated, it can lead to serious consequences on patients' quality of life. The gold standard treatment for cases of obstructive sleep apnea syndrome, especially in mild to severe and symptomatic cases, is continuous positive airway pressure therapy. Compliance with continuous positive airway pressure therapy is directly dependent on the active participation of the patient, which can be influenced by several factors. OBJECTIVE: The objective of this study is to describe the factors related to compliance with continuous positive airway pressure therapy, and to analyze which associated factors directly influence the efficiency of the treatment. METHODS: Patients who received continuous positive airway pressure therapy through the Municipal Health Department of the city of Ribeirão Preto were recruited. A structured questionnaire was administered to the patients. Compliance with continuous positive airway pressure therapy was assessed by average hours of continuous positive airway pressure therapy usage per night. Patients with good compliance (patients using continuous positive airway pressure therapy ≥4h/night) were compared to those with poor compliance (patients using <4h/night). RESULTS: 138 patients were analyzed: 77 (55.8%) were considered compliant while 61 (44.2%) were non-compliant. The comparison between the two groups showed that regular monitoring by a specialist considerably improved compliance with continuous positive airway pressure therapy (odds ratio, OR=2.62). CONCLUSION: Compliance with continuous positive airway pressure therapy is related to educational components, which can be enhanced with continuous and individualized care to patients with obstructive sleep apnea syndrome.

Biotecnologias, subjetivação e psicologias: mercado de células-tronco do cordão umbilical / Biotecnologías, subjetividad y psicologías: mercado de células madre del cordón umbilical / Biotechnology, subjectivity and psychologies: umbilical cord stem cell market

Resumo Esse artigo visa a analisar as práticas de produção da subjetividade engendradas pelo mercado de células-tronco do cordão umbilical, que se constitui por meio da gestão de riscos e precauções do futuro biopolítico, no âmbito da família e da relação pais e filhos. O interesse da psicologia pela inovação biotecnológica pode ser visualizado tanto na problematização crítica realizada pelo campo científico sobre os modos de subjetivações que emergem do acoplamento entre biotécnicas e corpo quanto em seu campo de atuação profissional, por meio de psicoterapias de aconselhamento genético. Nas estratégias biopolíticas de controle e de manipulação das células-tronco do cordão umbilical, evidenciam-se subjetivações que emergem em uma rede complexa de produção tecnobiológica.

Resumen Este artículo tiene como objetivo analizar las prácticas de producción de bio-social subjetividad a través del mercado de células madre realizado a través de medidas de gestión de riesgos y la biopolítica futuras, dentro de la familia y la relación padre-hijo. El interés de la psicología de la innovación biotecnológica se puede ver tanto en cuestionamiento crítico efectuado por campo científico sobre las formas de subjetividades que emergen del acoplamiento entre la biotecnología y el cuerpo, y en su campo profesional, a través de la psicoterapia asesoramiento genético. En las estrategias biopolíticas de control y la manipulación de las células madre del cordón umbilical, mostrará subjetividades que emergen en una compleja red de tecnobiológica producción.

Abstract This article aims to analyze production practices of bio-social subjectivity through the stem cell market made through risk management and biopolitics future precautions, within the family and the parent-child relationship. The interest of psychology from biotechnological innovation can be viewed both in critical questioning conducted by scientific field on ways of subjectivities that emerge from the coupling between biotech and body, and in your professional field, through genetic counseling psychotherapy. In biopolitical strategies of control and manipulation of umbilical cord stem cells show up subjectivities that emerge in a complex network of tecnobiológica production.

Orofacial motor functions in pediatric obstructive sleep apnea and implications for myofunctional therapy.

OBJECTIVES: The purposes of this study were (1) to identify possible differences in muscular and orofacial functions between children with obstructive sleep apnea (OSA) and with primary snoring (PS); (2) to examine the standardized difference between normal values of myofunctional scores and those of subjects with OSA or PS; and (3) to identify the features associated with OSA. METHODS: Participants were 39 children (mean age 8 ± 1.2 years) of which, 27 had a diagnosis of OSA and 12 had PS. All participants were examined by an otorhinolaryngologist and underwent overnight polysomnography. Orofacial characteristics were determined through a validated protocol of orofacial myofunctional evaluation with scores (OMES), surface electromyography of masticatory muscles, and measurements of maximal lip and tongue strength. Reference values in the OMES were included to quantify the standardized difference (effect size = ES) relative to the groups studied and in the regression analysis. RESULTS: The OSA group had lower scores in breathing and deglutition, more unbalanced masticatory muscle activities than PS group (P < 0.05), but both groups had similar reductions in orofacial strength. OSA had a large ES (Cohen's d > 0.8) in all analysed OMES scores, while PS group showed small and medium differences in breathing and mastication scores, respectively. The mobility of the stomatognathic components score was the most important to contribute for group status (57%, P < 0.0001) in the regression analysis. CONCLUSION: Children with tonsillar hypertrophy and OSA had relevant impairments in orofacial functions and lesser muscular coordination than children with PS.

Pesquisa documental com relatórios da UNESCO, de 1990 a 2010, sobre os direitos ao esporte, ao lazer e à cultura de crianças e adolescentes, no Brasil / Desk research with reports of UNESCO from 1990 to 2010, on the rights to sport, leisure and culture of children and adolescents in Brazil / La investigación documental con informes de la UNESCO desde 1990 hasta 2010, sobre los derechos a deporte, el ocio y la cultura de los niños y adolescentes en Brasil

Este artigo busca analisar as práticas de esporte, lazer e cultura que têm tido visibilidade, no Brasil, de diversas formas, especialmente voltadas para crianças e adolescentes, no âmbito dos direitos e das atuações de organizações mundiais. Considerando a incidência e a legitimidade internacional da Organização das Nações Unidas para Educação, Ciência e Cultura (UNESCO), no país, este trabalho, uma pesquisa histórica e documental, objetiva descrever e analisar, através do método histórico-genealógico baseado em Michel Foucault, as práticas da UNESCO, no Brasil, de 1990 a 2010, a respeito do direito ao esporte, lazer e cultura de crianças e adolescentes. Os resultados apresentam o levantamento de literatura das temáticas do estudo: história e direitos da criança e do adolescente; cultura, esporte e lazer; sociedade contemporânea e mecanismos de segurança; políticas públicas frente à UNESCO e ECA, relacionando-as com as propostas de práticas da UNESCO por meio da descrição e análise de relatórios elaborados por esse órgão. É relevante problematizar as práticas, no Brasil, para realizar questionamentos como contribuição para a sociedade, sem cristalizar verdades. (AU)

This paper analyzes the practices of sport, leisure and culture have had visibility in Brazil in various ways, especially aimed at children and adolescents in the context of the rights and actions of organizations worldwide. Whereas the incidence and the international legitimacy of the United Nations Educational, Scientific and Cultural Organization (UNESCO) in the country, this work, a historical and documentary research, aims to describe and analyze through the historical-genealogical method, based on Michel Foucault, the practices of UNESCO in Brazil, 1990-2010, concerning the right to sport, leisure and culture of children and adolescents. The results present a survey of literature on themes of study: History and rights of children and adolescents; culture, sport and recreation; contemporary society and security mechanisms; public policy front UNESCO and ECA, relating them to the proposed practices of UNESCO through the description and analysis of reports made by that body. It is relevant to question the practices in Brazil to make inquiries as a contribution to society without crystallizing truths. (AU)

Este trabajo analiza las prácticas del deporte, el ocio y la cultura han tenido visibilidad en Brasil en varias formas, especialmente dirigido a los niños y adolescentes en el contexto de los derechos y acciones de las organizaciones de todo el mundo. Mientras que la incidencia y la legitimidad internacional de las Naciones Unidas para la Educación, la Ciencia y la Cultura (UNESCO) en el país, este trabajo, una investigación histórica y documental, tiene como objetivo describir y analizar a través del método histórico-genealógico, basado en Michel Foucault, el prácticas de la UNESCO en Brasil, 1990-2010, en relación con el derecho al deporte, el ocio y la cultura de los niños y adolescentes. Los resultados presentan un estudio de la literatura sobre temas de estudio: Historia y derechos de los niños y adolescentes; la cultura, el deporte y la recreación; la sociedad contemporánea y los mecanismos de seguridad; frente de la política pública de la UNESCO y la CEPA, relacionándolos con las prácticas propuestas por la UNESCO a través de la descripción y análisis de los informes realizados por este organismo. Es pertinente para cuestionar las prácticas en Brasil para hacer consultas como una contribución a la sociedad sin cristalizar verdades. (AU)

Pesquisa documental com relatórios da UNESCO, de 1990 a 2010, sobre os direitos ao esporte, ao lazer e à cultura de crianças e adolescentes, no Brasil / Desk research with reports of UNESCO from 1990 to 2010, on the rights to sport, leisure and culture of children and adolescents in Brazil / La investigación documental con informes de la UNESCO desde 1990 hasta 2010, sobre los derechos a deporte, el ocio y la cultura de los niños y adolescentes en Brasil

Este artigo busca analisar as práticas de esporte, lazer e cultura que têm tido visibilidade, no Brasil, de diversas formas, especialmente voltadas para crianças e adolescentes, no âmbito dos direitos e das atuações de organizações mundiais. Considerando a incidência e a legitimidade internacional da Organização das Nações Unidas para Educação, Ciência e Cultura (UNESCO), no país, este trabalho, uma pesquisa histórica e documental, objetiva descrever e analisar, através do método histórico-genealógico baseado em Michel Foucault, as práticas da UNESCO, no Brasil, de 1990 a 2010, a respeito do direito ao esporte, lazer e cultura de crianças e adolescentes. Os resultados apresentam o levantamento de literatura das temáticas do estudo: história e direitos da criança e do adolescente; cultura, esporte e lazer; sociedade contemporânea e mecanismos de segurança; políticas públicas frente à UNESCO e ECA, relacionando-as com as propostas de práticas da UNESCO por meio da descrição e análise de relatórios elaborados por esse órgão. É relevante problematizar as práticas, no Brasil, para realizar questionamentos como contribuição para a sociedade, sem cristalizar verdades.

This paper analyzes the practices of sport, leisure and culture have had visibility in Brazil in various ways, especially aimed at children and adolescents in the context of the rights and actions of organizations worldwide. Whereas the incidence and the international legitimacy of the United Nations Educational, Scientific and Cultural Organization (UNESCO) in the country, this work, a historical and documentary research, aims to describe and analyze through the historical-genealogical method, based on Michel Foucault, the practices of UNESCO in Brazil, 1990-2010, concerning the right to sport, leisure and culture of children and adolescents. The results present a survey of literature on themes of study: History and rights of children and adolescents; culture, sport and recreation; contemporary society and security mechanisms; public policy front UNESCO and ECA, relating them to the proposed practices of UNESCO through the description and analysis of reports made by that body. It is relevant to question the practices in Brazil to make inquiries as a contribution to society without crystallizing truths.

Este trabajo analiza las prácticas del deporte, el ocio y la cultura han tenido visibilidad en Brasil en varias formas, especialmente dirigido a los niños y adolescentes en el contexto de los derechos y acciones de las organizaciones de todo el mundo. Mientras que la incidencia y la legitimidad internacional de las Naciones Unidas para la Educación, la Ciencia y la Cultura (UNESCO) en el país, este trabajo, una investigación histórica y documental, tiene como objetivo describir y analizar a través del método histórico-genealógico, basado en Michel Foucault, el prácticas de la UNESCO en Brasil, 1990-2010, en relación con el derecho al deporte, el ocio y la cultura de los niños y adolescentes. Los resultados presentan un estudio de la literatura sobre temas de estudio: Historia y derechos de los niños y adolescentes; la cultura, el deporte y la recreación; la sociedad contemporánea y los mecanismos de seguridad; frente de la política pública de la UNESCO y la CEPA, relacionándolos con las prácticas propuestas por la UNESCO a través de la descripción y análisis de los informes realizados por este organismo. Es pertinente para cuestionar las prácticas en Brasil para hacer consultas como una contribución a la sociedad sin cristalizar verdades.

Posicionamentos de homens em uma relação de coabitação / Men's positioning in cohabiting relationship

As transformações culturais, sociais e econômicas contemporâneas se refletem nas relações conjugais, em suas representações e práticas. Conseqüentemente, grande parte das expectativas e demandas dirigidas aos parceiros nas relações conjugais também mudaram. Este estudo de casos, baseado nas teorias de González Rey e da Rede de Significações, teve como objetivo compreender o discurso de quatro homens (25-40 anos) que coabitam com suas parceiras sobre as posições que ocupam e que lhes são atribuídas na relação conjugal. A análise de conteúdo das entrevistas realizadas mostrou que todos consideraram que cabe ao homem, na relação conjugal, ser o provedor. É permitido à mulher trabalhar, mas a contribuição financeira masculina deve ser decisiva. A representação do homem como provedor continua fortemente associada à subjetividade masculina, provavelmente pelo poder que concede aos homens na relação. A coabitação significa o aprofundamento da relação, sem a solidez do casamento. É um espaço de experimentação.(AU)

Nowadays, cultural, social and economical changes are reflected in conjugal relationships, in their practices, and representations. Consequently, a significant part of the expectations and demands directed to the partners involved in those conjugal relations have also changed. The purpose of this case study, based on Gonzalez Rey's and Network of Meanings theories, was to understand the discourse of four men (25-40 years old), who cohabit with their partners, about the positions they occupy and the ones assigned to them in the relationship. The content analysis of the interviews showed that the participants considered that it is the man's role to be the provider. Women are allowed to work. However, men's financial contribution has to be decisive. Man's representation as the provider is still strongly related to his subjectivity, possibly because of the power granted to him by this position. As to cohabitation, it means the intensification of a relationship without the solidity of marriage. It is, initially, a time for experimentation.(AU)

Posicionamentos de homens em uma relação de coabitação / Men’s positioning in cohabiting relationship

As transformações culturais, sociais e econômicas contemporâneas se refletem nas relações conjugais, em suas representações e práticas. Conseqüentemente, grande parte das expectativas e demandas dirigidas aos parceiros nas relações conjugais também mudaram. Este estudo de casos, baseado nas teorias de González Rey e da Rede de Significações, teve como objetivo compreender o discurso de quatro homens (25-40 anos)que coabitam com suas parceiras sobre as posições que ocupam e que lhes são atribuídas na relação conjugal. A análise de conteúdo das entrevistas realizadas mostrou que todos consideraram que cabe ao homem, na relação conjugal, ser o provedor. É permitido à mulher trabalhar, mas a contribuição financeira masculina deve ser decisiva. A representação do homem como provedor continua fortemente associada à subjetividade masculina, provavelmente pelo poder que concede aos homens na relação. A coabitação significa o aprofundamento da relação, sem a solidez do casamento. É um espaço de experimentação. (AU)

Nowadays, cultural, social and economical changes are reflected in conjugal relationships, in their practices, and representations. Consequently, a significant part ofthe expectations and demands directed to the partners involved in those conjugal relations have also changed. The purpose of this case study, based on Gonzalez Rey’s and Network of Meanings theories, was to understand the discourse of four men (25-40 years old), who cohabit with their partners, about the positions they occupy and the ones assigned to them in the relationship. The content analysis of the interviews showed that the participants considered that it is the man’s role to be the provider. Women are allowed to work. However, men’s financial contribution has to be decisive. Man’s representation as the provider is still strongly related to his subjectivity, possibly because of the power granted to him by this position. As to cohabitation, it means the intensification of a relationship without the solidity of marriage. It is, initially, a time for experimentation. (AU)

Association of MTHFR and PICALM polymorphisms with Alzheimer's disease.

Alzheimer's disease (AD) is a complex neurodegenerative disorder and the primary cause of dementia in the elderly and causes a decrease in cognition, functionality, and behaviour. Genetic risk factors play an important role in the pathogenesis of AD. In this case-control study, we aimed to investigate whether single nucleotide polymorphisms in MTHFR (rs1801133), PICALM (3851719), CLU (rs11136000), and CR1 (rs6701713) are associated with AD. Genotype frequencies were evaluated in 82 late-onset AD patients and 161 elderly healthy controls matched by age and gender. We detected a significant association of the MTHFR rs1801133 and PICALM rs3851179 polymorphisms with AD. The results of this study support the hypothesis that several genes are involved in the aetiology of AD.

A experiência do Primeira Infância Melhor (PIM) no Rio Grande do Sul / The experience of the Better Early Childhood (PIM) in Rio Grande do Sul

Política pública pioneira no Brasil, o "Primeira Infância Melhor" (PIM) é uma ação transversal de promoção do desenvolvimento integral da primeira infância. Suas Modalidades de Atenção compreendem visitas domiciliares e atividades grupais realizadas semanalmente com famílias em situação de risco e vulnerabilidade social, cujo objetivo é orientá-las, a partir de sua cultura e experiências, para que promovam o desenvolvimento integral de suas crianças, desde a gestação até os 5 anos de idade.

Adherence of obstructive sleep apnea syndrome patients to continuous positive airway pressure in a public service.

INTRODUCTION: The standard therapy for obstructive sleep apnea syndrome (OSAS) is continuous positive airway pressure (CPAP), but its correct and frequent use is essential to control the disease. PURPOSE: To analyze adherence to CPAP among patients with OSAS treated in a multidisciplinary outpatient clinic of a public tertiary hospital. METHODS: This was a retrospective study evaluating 156 patients with OSAS who underwent polysomnography for CPAP titration from 2008 to 2011. The patients were divided into two groups, those with good adherence to CPAP (a mean use of four or more hours per night) and those with poor adherence. The groups were compared regarding the following data: gender, age, body mass index, associated diseases, AHI at diagnostic polysomnography, and pressure (cmH2O) suggested by titration polysomnography. RESULTS: 125 patients were analyzed, and it was observed that 82 of the patients (65%) had good adherence, whereas 43 (35%) showed poor adherence. Comparison between groups revealed that patients with a higher apnea-hypopnea index (AHI) were those who better adhered to treatment with CPAP. CONCLUSIONS: the rate of adherence to CPAP among OSAS patients undergoing clinical monitoring at a public service was 65%. Patients with a higher AHI were those who adhered better to treatment with CPAP.

Adesão de pacientes com síndrome da apneia obstrutiva do sono à pressão positiva contínua em via aérea em um serviço público / Adherence of obstructive sleep apnea syndrome patients to continuous positive airway pressure in a public service

Introdução: A terapia padrão para tratamento da síndrome da apneia obstrutiva do sono (SAOS) é o aparelho de pressão positiva contínua em via aérea (CPAP); todavia, seu uso correto e frequente é determinante para o controle da doença. Objetivo: Analisar a adesão ao CPAP entre pacientes com SAOS tratados em um ambulatório multidisciplinar em um hospital público. Métodos: Estudo retrospectivo avaliando 156 pacientes com SAOS que foram submetidos à polissonografia para titulação de CPAP de 2008 a 2011. Os pacientes foram divididos em dois grupos: os com boa e os com má adesão. Os grupos foram comparados entre si em relação aos seus dados: sexo, idade, IMC, doenças associadas, IAH à polissonografia diagnóstica e pressão em (cmH20) sugerida à polissonografia de titulação. Resultados: Foram analisados 125 pacientes, demonstrando que 82 dels (65%) tinham boa adesão, enquanto 43 (35%) eram maus usuários. A comparação entre os grupos mostrou que os pacientes com maior índice de apneia e hipopneias (IAH) eram os com melhor adesão ao tratamento com CPAP. Conclusões: A taxa de adesão ao CPAP entre os pacientes com SAOS monitorizados regularmente em um serviço público foi de 65%. Os pacientes com pior IAH foram os mais aderentes ao tratamento com CPAP. .

Introduction: The standard therapy for obstructive sleep apnea syndrome (OSAS) is continuous positive airway pressure (CPAP), but its correct and frequent use is essential to control the disease. Purpose: To analyze adherence to CPAP among patients with OSAS treated in a multidisciplinary outpatient clinic of a public tertiary hospital. Methods: This was a retrospective study evaluating 156 patients with OSAS who underwent polysomnography for CPAP titration from 2008 to 2011. The patients were divided into two groups, those with good adherence to CPAP (a mean use of four or more hours per night) and those with poor adherence. The groups were compared regarding the following data: gender, age, body mass index, associated diseases, AHI at diagnostic polysomnography, and pressure (cmH2O) suggested by titration polysomnography. Results: 125 patients were analyzed, and it was observed that 82 of the patients (65%) had good adherence, whereas 43 (35%) showed poor adherence. Comparison between groups revealed that patients with a higher apnea-hypopnea index (AHI) were those who better adhered to treatment with CPAP. Conclusions: the rate of adherence to CPAP among OSAS patients undergoing clinical monitoring at a public service was 65%. Patients with a higher AHI were those who adhered better to treatment with CPAP. .

Facial features and hyoid bone position in preschool children with obstructive sleep apnea syndrome.

The aim of the study was to evaluate facial features and hyoid bone position in children with obstructive sleep apnea syndrome (OSAS) by cephalometric radiography. A prospective cross-sectional study was conducted in a tertiary referral hospital. Twenty-nine children in the 3-6 year age bracket were evaluated: 14 children with OSAS and 15 nasal-breathing children. All children underwent otorhinolaryngologic examination, and those with OSAS also underwent in-laboratory polysomnography for diagnostic confirmation. The children were then submitted to orthodontic evaluation and cephalometry. Lateral cephalometric radiographs from children with OSAS were compared to those of nasal-breathing children. We found no differences between the two groups regarding the linear and angular measurements of the face. However, the children with OSAS presented, already at the preschool age, with an inferiorly positioned hyoid bone, thus increasing the pharyngeal area. In children with OSAS, the hyoid bone appears to be in a significantly inferior position at an early age. Our findings provide evidence that there is a relationship between the position of the hyoid bone and OSAS in children, which could contribute to the persistence of OSAS into adulthood.

Working Mothers and their Multivoiced Self / Las Madres Trabajadoras y la Polifonía de su Self / As Mães Trabalhadoras e a Polifonia de Seu Self

Since the 1960's, work has been a goal for Brazilian middle class women. In contrast, mothers of lower-income groups have always needed to work. This qualitative study investigated the meaning of motherhood, child care and work among 28 working mothers of different social classes. In order to do so, interviews and focus groups were conducted. Results show that women attribute exclusively to mothers the child care function. In addition, being a working woman has different meanings for each of those two social classes. There are voices in the self that represent the positions of mother and worker. They act on the meaning systems and they can lead to contradictory attitudes in a similar context.

El trabajo femenino se convirtió en un objetivo para las mujeres brasileñas de clase media, especialmente a partir de 1960, pero las madres de clase baja siempre necesitaron trabajar. Por medio de entrevistas y grupos focales, el presente estudio cualitativo investigó el significado de la maternidad, de los cuidados infantiles y del trabajo, con 28 madres trabajadoras de diferentes clases sociales. En general, las mujeres atribuyeron la función de cuidar a los hijos únicamente a las madres. Adicionalmente, ser mujer trabajadora tuvo un significado diferente en cada clase social. Existen voces del "self" que representan las posiciones de madre y de trabajadora, que actúan en los sistemas de significación y pueden llevar a actitudes contradictorias para una misma situación.

O trabalho feminino se converteu em um objetivo para as mulheres brasileiras de classe média, especialmente a partir de 1960; no entanto, as mães de classe baixa sempre precisaram trabalhar. Por meio de entrevistas e grupos focais, o presente estudo qualitativo pesquisou o significado da maternidade, dos cuidados infantis e do trabalho, com 28 mães trabalhadoras de diferentes classes sociais. Em geral, as mulheres atribuíram a função de cuidar dos filhos unicamente às mães. Adicionalmente, ser mulher trabalhadora teve um significado diferente em cada classe social. Existem vozes do "self" que representam as posições de mãe e de trabalhadora que atuam nos sistemas de significação e podem levar a atitudes contraditórias para uma mesma situação.