Search results for: Heloisa Pires
32 Economic Growth Relations to Domestic and International Air Passenger Transport in Brazil
Authors: Manoela Cabo da Silva, Elton Fernandes, Ricardo Pacheco, Heloisa Pires
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This study examined cointegration and causal relationships between economic growth and regular domestic and international passenger air transport in Brazil. Total passengers embarked and disembarked were used as a proxy for air transport activity and gross domestic product (GDP) as a proxy for economic development. The test spanned the period from 2000 to 2015 for domestic passenger traffic and from 1995 to 2015 for international traffic. The results confirm the hypothesis that there is cointegration between passenger traffic series and economic development, showing a bi-directional Granger causal relationship between domestic traffic and economic development and unidirectional influence by economic growth on international passenger air transport demand. Variance decomposition of the series showed that domestic air transport was far more important than international transport to promoting economic development in Brazil.Keywords: air passenger transport, cointegration, economic growth, GDP, Granger causality
Procedia PDF Downloads 23531 Social Support and Depressive Symptoms in Participants of a University of the Third Age: Evidences From a Cross-Sectional Study in Brazil
Authors: Ana Luiza Blanco, Juliana Cordeiro Carvalho, Tábatta Renata Pereira Brito, Ariene Angelini dos Santos Orlandi, Ligiana Pires Corona, Daniella Pires Nunes
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Depressive symptoms are recurrent in older adults and affect the quality of life and well-being of individuals. One of the strategies to reduce depression is social support, but studies are still needed to determine which types of social support are most effective in moderating this effect in certain populations. The objective was to identify the relationship between social support and depressive symptoms in participants of a University of the Third Age. This is a cross-sectional study. Participants were 82 individuals (≥ 50 years) who responded to the Geriatric Depression Scale - GDS and the Medical Outcomes Study - MOS. Data collection was carried out from November 2020 to May 2021. The Chi-Square and Mann Whitney tests were used, at a significance level of 5% for data analysis. Among the participants, 83.4% were female, 57.3% were age between 60 to 69 years, 83.1% studied 12 year or more and 48.1% receive from 4 to 10 minimum wages. The prevalence of depressive symptoms was 12.2%. The type of support with the highest median score was affective (100 points) and the lowest, or emotional (87.5 points). The results showed that participants without depressive symptoms had higher median scores for informational support when compared to those with depressive symptoms (p=0.029). The other types of social support were not statistically significant. The findings suggested that informational support is related to depressive symptoms in older adults. Promote informational support and educational actions in Universities of the Third Age may be an important strategy for preventing depressive symptoms and improve the quality of life of this population.Keywords: aged, depressive symptoms, social support, university of the third age
Procedia PDF Downloads 12230 Fields of Power, Visual Culture, and the Artistic Practice of Two 'Unseen' Women of Central Brazil
Authors: Carolina Brandão Piva
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In our visual culture, images play a newly significant role in the basis of a complex dialogue between imagination, creativity, and social practice. Insofar as imagination has broken out of the 'special expressive space of art' to become a part of the quotidian mental work of ordinary people, it is pertinent to recognize that visual representation can no longer be assumed as if in a domain detached from everyday life or exclusively 'centered' within the limited frame of 'art history.' The approach of Visual Culture as a field of study is, in this sense, indispensable to comprehend that not only 'the image,' but also 'the imagined' and 'the imaginary' are produced in the plurality of social interactions; crucial enough, this assertion directs us to something new in contemporary cultural processes, namely both imagination and image production constitute a social practice. This paper starts off with this approach and seeks to examine the artistic practice of two women from the State of Goiás, Brazil, who are ordinary citizens with their daily activities and narratives but also dedicated to visuality production. With no formal training from art schools, branded or otherwise, Maria Aparecida de Souza Pires deploys 'waste disposal' of daily life—from car tires to old work clothes—as a trampoline for art; also adept at sourcing raw materials collected from her surroundings, she manipulates raw hewn wood, tree trunks, plant life, and various other pieces she collects from nature giving them new meaning and possibility. Hilda Freire works with sculptures in clay using different scales and styles; her art focuses on representations of women and pays homage to unprivileged groups such as the practitioners of African-Brazilian religions, blue-collar workers, poor live-in housekeepers, and so forth. Although they have never been acknowledged by any mainstream art institution in Brazil, whose 'criterion of value' still favors formally trained artists, Maria Aparecida de Souza Pires, and Hilda Freire have produced visualities that instigate 'new ways of seeing,' meriting cultural significance in many ways. Their artworks neither descend from a 'traditional' medium nor depend on 'canonical viewing settings' of visual representation; rather, they consist in producing relationships with the world which do not result in 'seeing more,' but 'at least differently.' From this perspective, the paper finally demonstrates that grouping this kind of artistic production under the label of 'mere craft' has much more to do with who is privileged within the fields of power in art system, who we see and who we do not see, and whose imagination of what is fed by which visual images in Brazilian contemporary society.Keywords: visual culture, artistic practice, women's art in the Brazilian State of Goiás, Maria Aparecida de Souza Pires, Hilda Freire
Procedia PDF Downloads 15229 Cross-Disciplinary Perspectives on Climate-Induced Migration in Brazil: Legislation, Policies and Practice
Authors: Heloisa H. Miura, Luiza M. Pallone
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In Brazil, people forced to move due to environmental causes, called 'environmental migrants', have always been neglected by public policies and legislation. Meanwhile, the numbers of climate-induced migration within and to Brazil continues to increase. The operating Immigration Law, implemented in 1980 under the Brazilian military regime, is widely considered to be out of date, once it does not offer legal protection to migrants who do not fit the definition of a refugee and are not allowed to stay regularly in the country. Aiming to reformulate Brazil’s legislation and policies on the matter, a new Migration Bill (PL 2516/2015) is currently being discussed in the Senate and is expected to define a more humanized approach to migration. Although the present draft foresees an expansion of the legal protection to different types of migrants, it still hesitates to include climate-induced displacements in its premises and to establish a migration management strategy. By introducing a human rights-based approach, this paper aims to provide a new multidisciplinary perspective to the protection of environmental migrants in Brazil.Keywords: environmental migrants, human mobility, climate change, migration policy
Procedia PDF Downloads 40528 An Evaluation of the Effects of Special Safeguards in Meat upon International Trade and the Brazilian Economy
Authors: Cinthia C. Costa, Heloisa L. Burnquist, Joaquim J. M. Guilhoto
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This study identified the impact of special agricultural safeguards (SSG) for the global market of meat and for the Brazilian economy. The tariff lines subject to SSG were selected and the period of analysis was 1995 (when the rules about the SSGs were established) to 2015 (more recent period for which there are notifications). The value of additional tariff was calculated for each of the most important tariff lines. The import volume and the price elasticities for imports were used to estimate the impacts of each additional tariff estimated on imports. Finally, the effect of Brazilian exports of meat without SSG taxes was calculated as well as its impact in the country’s economy by using an input-output matrix. The most important markets that applied SSGs were the U.S. for beef and European Union for poultry. However, the additional tariffs could be estimated in only two of the sixteen years that the U.S. applied SSGs on beef imports, suggesting that its use has been enforced when the average annual price has been higher than the trigger price level. The results indicated that the value of the bovine and poultry meat that could not be exported by Brazil due to SSGs to both markets (EU and the U.S.) was equivalent to BRL 804 million. The impact of this loss in trade was about: BRL 3.7 billion of the economy’s production value (at 2015 prices) and almost BRL 2 billion of the Brazilian Gross Domestic Product (GDP).Keywords: beef, poultry meat, SSG tariff, input-output matrix, Brazil
Procedia PDF Downloads 12227 Naphtha Catalytic Reform: Modeling and Simulation of Unity
Authors: Leal Leonardo, Pires Carlos Augusto de Moraes, Casiraghi Magela
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In this work were realized the modeling and simulation of the catalytic reformer process, of ample form, considering all the equipment that influence the operation performance. Considered it a semi-regenerative reformer, with four reactors in series intercalated with four furnaces, two heat exchanges, one product separator and one recycle compressor. A simplified reactional system was considered, involving only ten chemical compounds related through five reactions. The considered process was the applied to aromatics production (benzene, toluene, and xylene). The models developed to diverse equipment were interconnecting in a simulator that consists of a computer program elaborate in FORTRAN 77. The simulation of the global model representative of reformer unity achieved results that are compatibles with the literature ones. It was then possible to study the effects of operational variables in the products concentration and in the performance of the unity equipment.Keywords: catalytic reforming, modeling, simulation, petrochemical engineering
Procedia PDF Downloads 51626 Uncertainty of the Brazilian Earth System Model for Solar Radiation
Authors: Elison Eduardo Jardim Bierhals, Claudineia Brazil, Deivid Pires, Rafael Haag, Elton Gimenez Rossini
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This study evaluated the uncertainties involved in the solar radiation projections generated by the Brazilian Earth System Model (BESM) of the Weather and Climate Prediction Center (CPTEC) belonging to Coupled Model Intercomparison Phase 5 (CMIP5), with the aim of identifying efficiency in the projections for solar radiation of said model and in this way establish the viability of its use. Two different scenarios elaborated by Intergovernmental Panel on Climate Change (IPCC) were evaluated: RCP 4.5 (with more optimistic contour conditions) and 8.5 (with more pessimistic initial conditions). The method used to verify the accuracy of the present model was the Nash coefficient and the Statistical bias, as it better represents these atmospheric patterns. The BESM showed a tendency to overestimate the data of solar radiation projections in most regions of the state of Rio Grande do Sul and through the validation methods adopted by this study, BESM did not present a satisfactory accuracy.Keywords: climate changes, projections, solar radiation, uncertainty
Procedia PDF Downloads 25225 The Duty of Application and Connection Providers Regarding the Supply of Internet Protocol by Court Order in Brazil to Determine Authorship of Acts Practiced on the Internet
Authors: João Pedro Albino, Ana Cláudia Pires Ferreira de Lima
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Humanity has undergone a transformation from the physical to the virtual world, generating an enormous amount of data on the world wide web, known as big data. Many facts that occur in the physical world or in the digital world are proven through records made on the internet, such as digital photographs, posts on social media, contract acceptances by digital platforms, email, banking, and messaging applications, among others. These data recorded on the internet have been used as evidence in judicial proceedings. The identification of internet users is essential for the security of legal relationships. This research was carried out on scientific articles and materials from courses and lectures, with an analysis of Brazilian legislation and some judicial decisions on the request of static data from logs and Internet Protocols (IPs) from application and connection providers. In this article, we will address the determination of authorship of data processing on the internet by obtaining the IP address and the appropriate judicial procedure for this purpose under Brazilian law.Keywords: IP address, digital forensics, big data, data analytics, information and communication technology
Procedia PDF Downloads 12424 Validation and Projections for Solar Radiation up to 2100: HadGEM2-AO Global Circulation Model
Authors: Elison Eduardo Jardim Bierhals, Claudineia Brazil, Deivid Pires, Rafael Haag, Elton Gimenez Rossini
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The objective of this work is to evaluate the results of solar radiation projections between 2006 and 2013 for the state of Rio Grande do Sul, Brazil. The projections are provided by the General Circulation Models (MCGs) belonging to the Coupled Model Intercomparison Phase 5 (CMIP5). In all, the results of the simulation of six models are evaluated, compared to monthly data, measured by a network of thirteen meteorological stations of the National Meteorological Institute (INMET). The performance of the models is evaluated by the Nash coefficient and the Bias. The results are presented in the form of tables, graphs and spatialization maps. The ACCESS1-0 RCP 4.5 model presented the best results for the solar radiation simulations, for the most optimistic scenario, in much of the state. The efficiency coefficients (CEF) were between 0.95 and 0.98. In the most pessimistic scenario, HADGen2-AO RCP 8.5 had the best accuracy among the analyzed models, presenting coefficients of efficiency between 0.94 and 0.98. From this validation, solar radiation projection maps were elaborated, indicating a seasonal increase of this climatic variable in some regions of the Brazilian territory, mainly in the spring.Keywords: climate change, projections, solar radiation, validation
Procedia PDF Downloads 20923 Investigation of Passive Solutions of Thermal Comfort in Housing Aiming to Reduce Energy Consumption
Authors: Josiane R. Pires, Marco A. S. González, Bruna L. Brenner, Luciana S. Roos
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The concern with sustainability brought the need for optimization of the buildings to reduce consumption of natural resources. Almost 1/3 of energy demanded by Brazilian housings is used to provide thermal solutions. AEC sector may contribute applying bioclimatic strategies on building design. The aim of this research is to investigate the viability of applying some alternative solutions in residential buildings. The research was developed with computational simulation on single family social housing, examining envelope type, absorptance, and insolation. The analysis of the thermal performance applied both Brazilian standard NBR 15575 and degree-hour method, in the scenery of Porto Alegre, a southern Brazilian city. We used BIM modeling through Revit/Autodesk and used Energy Plus to thermal simulation. The payback of the investment was calculated comparing energy savings and building costs, in a period of 50 years. The results shown that with the increment of envelope’s insulation there is thermal comfort improvement and energy economy, with a pay-back period of 24 to 36 years, in some cases.Keywords: civil construction, design, thermal performance, energy, economic analysis
Procedia PDF Downloads 55322 Intelligent Rainwater Reuse System for Irrigation
Authors: Maria M. S. Pires, Andre F. X. Gloria, Pedro J. A. Sebastiao
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The technological advances in the area of Internet of Things have been creating more and more solutions in the area of agriculture. These solutions are quite important for life, as they lead to the saving of the most precious resource, water, being this need to save water a concern worldwide. The paper proposes the creation of an Internet of Things system based on a network of sensors and interconnected actuators that automatically monitors the quality of the rainwater that is stored inside a tank in order to be used for irrigation. The main objective is to promote sustainability by reusing rainwater for irrigation systems instead of water that is usually available for other functions, such as other productions or even domestic tasks. A mobile application was developed for Android so that the user can control and monitor his system in real time. In the application, it is possible to visualize the data that translate the quality of the water inserted in the tank, as well as perform some actions on the implemented actuators, such as start/stop the irrigation system and pour the water in case of poor water quality. The implemented system translates a simple solution with a high level of efficiency and tests and results obtained within the possible environment.Keywords: internet of things, irrigation system, wireless sensor and actuator network, ESP32, sustainability, water reuse, water efficiency
Procedia PDF Downloads 15121 The Characteristics of the Chairman of Board of Directors That Are Associated with Better Levels of Performance
Authors: Abilio Pires Zacarias
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Analyzing company boards of directors is a relevant and timely topic. As the representative of shareholders, the board is the most senior management body of this type of company. Therefore, ascertaining the best kind of candidates to nominate, namely the most appropriate characteristics for leading the board to achieve better levels of performance, is certainly of great interest. The companies selected for this study were the 1,000 largest non-financial companies and the 100 largest financial companies in Portugal according to the Instituto Nacional de Estatística for 2010. The information stemmed from a questionnaire addressed to the person in charge of daily company management and then processed through STATA 17 with the multivariate analysis of variables - MANOVA. The study may correspondingly report that the vast majority of boards in the sample operate a dual leadership structure. By in terms of its prevalence, unitary leadership represents only a minority. Agency theory and stewardship theory postulate different characteristics for the ideal chairman but neither receive confirmation from our results. On the other hand, our findings do validate the behavioral theory of firms (BToF), concluding that experience is associated with organizational performance. This study is also relevant due to its analysis of companies not listed on the financial markets not only because of their weighting in the economy but also because they remain only very poorly studied in this field and thus also correspondingly contributing to deepening the literature.Keywords: agency theory, behavioral theory of the firm, board of directors, corporate governance, stewardship theory
Procedia PDF Downloads 18220 The Impact of Stigma on the Course of Mental Illness: A Brief Review
Authors: Mariana Mangas, Yaroslava Martins, Ana Matos Pires
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Introduction: Stigmatization is a common problem to overcome for people suffering from chronic diseases. It usually follows mental disorders and complicates the course of illness and reduces quality of life for people with mental illness. Objective: unsystematic review concerning stigma and mental illness, its impact on psychiatric disease and strategies to eradicate stigma. Methods: A search was conducted on PubMed, using keywords 'stigma' and 'mental illness'. Results and Discussion: Stigma is a psychosocial process that identifies individuals by the negative label of their differences. Stigma often brings a loss of occupational success and social support, reduced functioning and lower quality of life. The sense of stigma is common in individuals with mental illness and has considerable negative repercussions: delays treatment achievement, promotes social isolation, stress and maladaptive coping behaviors and it is associated with higher symptom levels, placing these individuals at higher risk for a poorer outcome and prognoses. Conclusion: Given the interrelation between stigma, symptoms, treatment seeking and disease management, stigma is a key construct in mental illness upon which anti-stigma initiatives may have considerable therapeutic potential. It will take multidisciplinary interventions to overcome mental illness stigma, including changes in social policy, attitudes and practices among mental health professionals, liaison between general public and people with a mental illness under conditions of equity and parity, family support, and easy access to evidence-based treatments.Keywords: discrimination, stigma, mental illness, quality of life
Procedia PDF Downloads 34119 Automated Monitoring System to Support Investigation of Contributing Factors of Work-Related Disorders and Accidents
Authors: Erika R. Chambriard, Sandro C. Izidoro, Davidson P. Mendes, Douglas E. V. Pires
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Work-related illnesses and disorders have been a constant aspect of work. Although their nature has changed over time, from musculoskeletal disorders to illnesses related to psychosocial aspects of work, its impact on the life of workers remains significant. Despite significant efforts worldwide to protect workers, the disparity between changes in work legislation and actual benefit for workers’ health has been creating a significant economic burden for social security and health systems around the world. In this context, this study aims to propose, test and validate a modular prototype that allows for work environmental aspects to be assessed, monitored and better controlled. The main focus is also to provide a historical record of working conditions and the means for workers to obtain comprehensible and useful information regarding their work environment and legal limits of occupational exposure to different types of environmental variables, as means to improve prevention of work-related accidents and disorders. We show the developed prototype provides useful and accurate information regarding the work environmental conditions, validating them with standard occupational hygiene equipment. We believe the proposed prototype is a cost-effective and adequate approach to work environment monitoring that could help elucidate the links between work and occupational illnesses, and that different industry sectors, as well as developing countries, could benefit from its capabilities.Keywords: Arduino prototyping, occupational health and hygiene, work environment, work-related disorders prevention
Procedia PDF Downloads 12618 Haematological Responses on Amateur Cycling Stages Race
Authors: Renato André S. Silva, Nana L. F. Sampaio, Carlos J. G. Cruz, Bruno Vianna, Flávio O. Pires
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multiple stage bicycle races require high physiological loads from professional cyclists. Such demands can lead to immunosuppression and health problems. However, in this type of competition, little is known about its physiological effects on amateur athletes, who generally receive less medical support. Thus, this study analyzes the hematological effects of a multiple stage bicycle race on amateur cyclists. Seven Brazilian national amateur cyclists (34 ± 4.21 years) underwent a laboratory test to evaluate VO2Max (69.89 ± 7.43 ml⋅kg-1⋅min-1). Six days later, these volunteers raced in the Tour of Goiás, participating in five races in four days (435 km) of competition. Arterial blood samples were collected one day before and one day after the competition. The Kolmogorov-Smirnov tests were used to evaluate the data distribution and Wilcoxon to compare the two moments (p <0.05) of data collection. The results show: Red cells ↓ 7.8% (5.1 ± 0.28 vs 4.7 ± 0.37 106 / mm 3, p = 0.01); Hemoglobin ↓ 7.9% (15.1 ± 0.31 vs 13.9 ± 0.27 g / dL, p = 0.01); Leukocytes ↑ 9.5% (4946 ± 553 versus 5416 ± 1075 / mm 3, p = 0.17); Platelets ↓ 7.0% (200.2 ± 51.5 vs 186.1 ± 39.5 / mm 3, p = 0.01); LDH ↑ 11% (164.4 ± 28.5 vs 182.5 ± 20.5 U / L, p = 0.17); CK ↑ 13.5% (290.7 ± 206.1 vs 330.1 ± 90.5 U / L, p = 0.39); CK-MB ↑ 2% (15.7 ± 3.9 vs. 20.1 ± 2.9 U / L, p = 0.06); Cortizol ↓ 13.5% (12.1 ± 2.4 vs 9.9 ± 1.9 μg / dL, p = 0.01); Total testosterone ↓ 7% (453.6 ± 120.1 vs 421.7 ± 74.3 ng / dL, p = 0.12); IGF-1 ↓ 15.1% (213.8 ± 18.8 vs 181.5 ± 34.7 ng / mL, p = 0.04). This means that there was significant reductions in O2 allocation / transport capacities, vascular injury disruption, and a fortuitous reduction of muscle skeletal anabolism along with maintenance and / or slight elevation of immune function, glucose and lipid energy and myocardial damage. Therefore, the results suggest that no abnormal health effect was identified among the athletes after participating in the Tour de Goiás.Keywords: cycling, health effects, cycling stages races, haematology
Procedia PDF Downloads 20117 The Importance of Mental Health Literacy: Interventions in a Psychiatry Service of Hospital José Joaquim Fernandes, Portugal
Authors: Mariana Mangas, Yaroslava Martins, Ana Charraz, Ana Matos Pires
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Introduction: Health literacy empowers people of knowledge, motivation and skills to access, understand, evaluate and mobilize information relating to health. Although the benefits of public knowledge of physical disease are widely accepted, knowledge about mental disorder has been compatibly neglected. Nowadays there is considerably evidence that literacy is of great importance for the promotion of health and prevention of mental illness. Objective: Disclosure the concept and importance of mental health literacy and introduce the literacy program of Psychiatry Service of Hospital José Joaquim Fernandes. Methodology: A search was conducted on PubMed, using keywords “literacy” and “mental health”. A description of mental health literacy interventions implemented on Psychiatry Service of Hospital José Joaquim Fernandes was performed, namely, psychoeducation programs for depression and bipolar disorder. Results and discussion: Health literacy enables patient to be able to actively participate in his treatment. The improving of mental health literacy can promote early identification of mental disorders, improve treatment results, increase the use of health services and allow the community to take action to achieve better mental health. Psychoeducation is very useful in improving the course of disease and in reducing the number of episodes and hospitalizations. Bipolar patients who received psychoeducation and pharmacotherapy have no relapses during the program and last year. Conclusion: Mental health literacy is not simply a matter of having knowledge, rather, it is knowledge linked to action which can benefit mental health.Keywords: mental health, literacy, psychoeducation, knowledge, empowerment
Procedia PDF Downloads 54916 Optimization of Smart Beta Allocation by Momentum Exposure
Authors: J. B. Frisch, D. Evandiloff, P. Martin, N. Ouizille, F. Pires
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Smart Beta strategies intend to be an asset management revolution with reference to classical cap-weighted indices. Indeed, these strategies allow a better control on portfolios risk factors and an optimized asset allocation by taking into account specific risks or wishes to generate alpha by outperforming indices called 'Beta'. Among many strategies independently used, this paper focuses on four of them: Minimum Variance Portfolio, Equal Risk Contribution Portfolio, Maximum Diversification Portfolio, and Equal-Weighted Portfolio. Their efficiency has been proven under constraints like momentum or market phenomenon, suggesting a reconsideration of cap-weighting. To further increase strategy return efficiency, it is proposed here to compare their strengths and weaknesses inside time intervals corresponding to specific identifiable market phases, in order to define adapted strategies depending on pre-specified situations. Results are presented as performance curves from different combinations compared to a benchmark. If a combination outperforms the applicable benchmark in well-defined actual market conditions, it will be preferred. It is mainly shown that such investment 'rules', based on both historical data and evolution of Smart Beta strategies, and implemented according to available specific market data, are providing very interesting optimal results with higher return performance and lower risk. Such combinations have not been fully exploited yet and justify present approach aimed at identifying relevant elements characterizing them.Keywords: smart beta, minimum variance portfolio, equal risk contribution portfolio, maximum diversification portfolio, equal weighted portfolio, combinations
Procedia PDF Downloads 34015 Overview of the 2017 Fire Season in Amazon
Authors: Ana C. V. Freitas, Luciana B. M. Pires, Joao P. Martins
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In recent years, fire dynamics in deforestation areas of tropical forests have received considerable attention because of their relationship to climate change. Climate models project great increases in the frequency and area of drought in the Amazon region, which may increase the occurrence of fires. This study analyzes the historical record number of fire outbreaks in 2017 using satellite-derived data sets of active fire detections, burned area, precipitation, and data of the Fire Program from the Center for Weather Forecasting and Climate Studies (CPTEC/INPE). A downward trend in the number of fire outbreaks occurred in the first half of 2017, in relation to the previous year. This decrease can be related to the fact that 2017 was not an El Niño year and, therefore, the observed rainfall and temperature in the Amazon region was close to normal conditions. Meanwhile, the worst period in history for fire outbreaks began with the subsequent arrival of the dry season. September of 2017 exceeded all monthly records for number of fire outbreaks per month in the entire series. This increase was mainly concentrated in Bolivia and in the states of Amazonas, northeastern Pará, northern Rondônia and Acre, regions with high densities of rural settlements, which strongly suggests that human action is the predominant factor, aggravated by the lack of precipitation during the dry season allowing the fires to spread and reach larger areas. Thus, deforestation in the Amazon is primarily a human-driven process: climate trends may be providing additional influences.Keywords: Amazon forest, climate change, deforestation, human-driven process, fire outbreaks
Procedia PDF Downloads 12914 Dental Education in Brazil: A Systematic Literature Review
Authors: Fabiane Alves Farias Guimarães, Rodrigo Otávio Moretti-Pires, Ana Lúcia Schaefer Ferreira de Mello
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Introduction: Considering the last changes in Brazilian Health and Higher Educational Systems, the production of scientific knowledge regarding dental education and training has been increasing. The National Curriculum Guidelines for undergraduate courses in Dentistry established in 2002 the principles and procedures to perform a more generalist dental professional profile. Objectives: To perform a systematic review of the Brazilian scientific literature about dental education and training. Methods: The systematic review was conducted considering the Lilacs - Latin American Literature in Health Sciences and SciELO - Scientific Electronic Library Online data bases, using the combination of key words dentistry, education, teaching or training. It was select original research articles, published between 2010 and 2013, in Portuguese. Results: Based on the selection criteria, it was found 23 articles. In order to organize the outcomes, the analysis was separated in three themes: Ethical aspects of education (3 articles), integrating dental service with training (10 articles) and Dental education and the Brazilian curriculum guidelines (10 articles). Most of the studies were published between 2011 and 2012 (35% each) and were held in public universities. The studied populations included dental students, teachers, universities directors, health managers and dentists. The qualitative methodological approach was predominant. Conclusion: It was possible to identify a transience time in Brazilian undergraduate courses in Dentistry after curricular changes. The produced literature shows some advances, as the incorporation of ethical values on dental education and the inclusion of new practices environments for students by integrating education and training in diversified dental services scenarios.Keywords: Teaching, Dental Students, Human resources in dentistry
Procedia PDF Downloads 53413 Relationship between Ageism, Health and Social Conditions: A Cross-Sectional Study Among Brazilian Older Adults
Authors: Ana Luiza Blanco, Luiza de Pádua Penteado, Daniella Pires Nunes
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Ageism is a widespread and prevalent phenomenon that affects older adults and directly affects healthy aging. Identifying the factors that contribute to ageism is important to discuss interventions that minimizes its social and emotional impact. To identify factors related with ageism in Brazilians older adults. Quantitative study, with a cross-sectional and analytical design. 134 older adults completed an online questionnaire about Sociodemographic and Health Characteristics, Discrimination (Ageism Survey), Depressive Symptoms (The Geriatric Depression Scale), Family Function (Family APGAR) and Loneliness. The Mann Whitney and Kruskal Wallis tests were used for data analysis, with a significance level of 5%. The mean age was 66.93 years (sd=0.50), mostly women (84.20%), married (52.60%) and with more than 12 years of schooling (75.93%). The results showed that older adults with a regular self-perception of health had higher median ageism scores when compared to individuals who rated their health as very good or good (p=0.006). The same occurred for individuals with depressive symptoms when compared to those without signs of depression (p=0.001). Regarding family function, it was observed that people with low family functionality tend to suffer more ageism than those with high functionality (p=0.017). Loneliness was also a factor related with the experience of ageism in this study. Lonely individuals had higher median ageism scores (p=0.002). There was relationship between ageism and self-perception of health, depressive symptoms, loneliness and dysfunctional family. Such findings demonstrate the importance of considering the psychosocial determinants of aging to reduce discrimination and promote healthy aging, focusing on social support and educational interventions.Keywords: ageism, age stereotypes, healthy aging, social conditions
Procedia PDF Downloads 9712 Driving and Hindering Forces for the Care of Older People: experiences of Brazilian Family Caregivers
Authors: Adriane Amend, Leidiene Ferreira Santos, Daniella Pires Nunes
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The experience of assuming or caring for older persons dependents by relatives is a complex task that encompasses or affective involvement, the demand for technical activities and or psychological support. It would be necessary to understand the situations related to the caregiver, the person and the environment, which help the family difficulty, as a caregiver to lead this role. Objective: To identify the forces that drive and restrict the care process of family caregivers of the older adults. Method: Descriptive and exploratory research, with a qualitative approach, which has as a reference the Force Field Theory. Five family caregivers of older adult’s dependents residing in the city of Palmas, Tocantins, Brazil will participate. The data were collected from December 2021 to February 2022, through a semi-structured individual interview, and submitted to content analysis. Results: As forces that drive or process of caring for family caregivers were: the account of compassionate attitudes and patience of the caregiver (I); to the collaboration of the other person to the care and to the body structure of the same (Other); and the supports of other people not cared for and structural, such as adaptations in the room, read and bathroom, as in the presence of air conditioners (Environment). Among the restrictive forces of care we mention difficulties in delegating care to another person, or stress of care and other personal demands (I); imposition of the older person about care and e a transfer from bed to hip (Other); e lack of accessibility of the house and absence of air conditioning and hospital bed (Environment). Conclusion: The results show that there are driving forces with the caregiver's attitude and feelings, a bond as an idol and support for the caregiver and the environment. On the other hand, conflicting ties, absence of physical structure and daily and continuous care shifts, can significantly compromise well-being or the cycle of older adult, caregiver and care.Keywords: caregivers, frail elderly, perception, geriatric nursing
Procedia PDF Downloads 9611 Species Selection for Phytoremediation of Barium Polluted Flooded Soils
Authors: Fabio R. Pires, Paulo R. C. C. Ribeiro, Douglas G. Viana, Robson Bonomo, Fernando B. Egreja Filho, Alberto Cargnelutti Filho, Luiz F. Martins, Leila B. S. Cruz, Mauro C. P. Nascimento
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The use of barite (BaSO₄) as a weighting agent in drilling fluids for oil and gas activities makes barium a potential contaminant in the case of spills onto flooded soils, where barium sulfate solubility is increased due to low redox conditions. In order to select plants able to remove barium in such scenarios, seven plant species were evaluated on barium phytoextraction capacity: Brachiaria arrecta; Cyperus cf. papyrus; Eleocharis acutangula; Eleocharis interstincta; Nephrolepsis cf. rivularis; Paspalum conspersum and Typha domingensis. Plants were grown in pots with 13 kg of soil each, and exposed to six barium concentrations (established with BaCl₂): 0; 2.5; 5.0; 10.0; 30.0; 65.0 mg kg-1. To simulate flooding conditions, every pot was manteined with a thin irrigation water depth over soil surface (~1.0 cm). Treatments were carried out in triplicate, and pots were distributed randomly inside the greenhouse. Biometric and chemical analyses were performed throughout the experiment, including Ba²⁺ accumulation in shoots and roots. The highest amount of barium was observed in T. domingensis biomass, followed by C. cf. papyrus. However, the latter exported most of the barium to shoot, especially in higher BaCl₂ doses, while the former accumulated barium preferentially in roots. Thus, barium removal with C. cf. papyrus could be achieved by simply harvesting aerial biomass. The amount of barium in C. cf. papyrus was a consequence of high biomass production rather than barium concentration in plant tissues, whereas T. domingensis showed high barium concentration in plant tissues and high biomass production as well. These results make T. domingensis and C. cf. papyrus potential candidates to be applied in phytoremediation schemes to remove barium from flooded soils.Keywords: barium sulfate, cyperus, drilling fluids, phytoextraction, Typha
Procedia PDF Downloads 27410 Liaison Psychiatry in Baixo Alentejo, Portugal: Reality and Perspectives
Authors: Mariana Mangas, Yaroslava Martins, M. Suárez, Célia Santos, Ana Matos Pires
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Baixo Alentejo is a region of Portugal characterized by an aging population, geographic isolation, social deprivation and a lack of medical staff. It is one of the most problematic regions in regards to mental health, particularly due to the factors mentioned. The aim of this study is a presentation of liaison psychiatry in Hospital José Joaquim Fernandes; a sample of the work done, the current situation and future perspectives. The aim is to present a retrospective study of internal psychiatric emergencies from January 1st, 2016 to August 31st, 2016. Liaison psychiatry of Department of Psychiatry and Mental Health (Psychiatry Service) of ULSBA includes the following activities: internal psychiatry emergencies, HIV consultation (comprised in the general consultation) and liaison psychology (oncology and pain), consisting of a total of 111 internal psychiatry emergencies during the identified period. Gender distribution was uniform. The most prevalent age group was 71-80 years, and 66,6% of patients were 60 years old and over. The majority of the emergency observations was requested by hospital services of medicine (56,8%) and surgery (24,3%). The most frequent reasons for admission were: respiratory disease (18,0%); tumors (15.3%); other surgical and orthopedic pathology (14,5%) and stroke (11,7%). The most frequent psychiatric diagnoses were: neurotic and organic depression (24,3%); delirium (26,1%) and adjustment reaction (14,5%). Major psychiatric pathology (schizophrenia and affective disorders) was found in 10,8%. Antidepressive medication was prescribed in 37,8% patients; antipsychotics in 34,2%. In 9.9% of the cases, no psychotropic drug was prescribed, and 5,4% of patients received psychologic support. Regarding hospital discharge, 42,4% of patients were referred to the general practitioner or to the medical specialist; 22,5% to outpatient gerontopsychiatry; 17,1% to psychiatric outpatient and 14,4% deceased. A future perspective is to start liaison in areas of HIV and psycho oncology in multidisciplinary approach and to improve collaboration with colleagues of other specialties for refining psychiatric referrals.Keywords: psychiatry, liaison, internal emergency, psychiatric referral
Procedia PDF Downloads 2539 Biomimetic Systems to Reveal the Action Mode of Epigallocatechin-3-Gallate in Lipid Membrane
Authors: F. Pires, V. Geraldo, O. N. Oliveira Jr., M. Raposo
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Catechins are powerful antioxidants which have attractive properties useful for tumor therapy. Considering their antioxidant activity, these molecules can act as a scavenger of the reactive oxygen species (ROS), alleviating the damage of cell membrane induced by oxidative stress. The complexity and dynamic nature of the cell membrane compromise the analysis of the biophysical interactions between drug and cell membrane and restricts the transport or uptake of the drug by intracellular targets. To avoid the cell membrane complexity, we used biomimetic systems as liposomes and Langmuir monolayers to study the interaction between catechin and membranes at the molecular level. Liposomes were formed after the dispersion of anionic 1,2-dipalmitoyl-sn-glycero-3-[phospho-rac-(1-glycerol)(sodium salt) (DPPG) phospholipids in an aqueous solution, which mimic the arrangement of lipids in natural cell membranes and allows the entrapment of catechins. Langmuir monolayers were formed after dropping amphiphilic molecules, DPPG phospholipids, dissolved in an organic solvent onto the water surface. In this work, we mixed epigallocatechin-3-gallate (EGCG) with DPPG liposomes and exposed them to ultra-violet radiation in order to evaluate the antioxidant potential of these molecules against oxidative stress induced by radiation. The presence of EGCG in the mixture decreased the rate of lipid peroxidation, proving that EGCG protects membranes through the quenching of the reactive oxygen species. Considering the high amount of hydroxyl groups (OH groups) on structure of EGCG, a possible mechanism to these molecules interact with membrane is through hydrogen bonding. We also investigated the effect of EGCG at various concentrations on DPPG Langmuir monolayers. The surface pressure isotherms and infrared reflection-absorption spectroscopy (PM-IRRAS) results corroborate with absorbance results preformed on liposome-model, showing that EGCG interacts with polar heads of the monolayers. This study elucidates the physiological action of EGCG which can be incorporated in lipid membrane. These results are also relevant for the improvement of the current protocols used to incorporate catechins in drug delivery systems.Keywords: catechins, lipid membrane, anticancer agent, molecular interactions
Procedia PDF Downloads 2338 Perspectives and Challenges a Functional Bread With Yeast Extract to Improve Human Diet
Authors: Cláudia Patrocínio, Beatriz Fernandes, Ana Filipa Pires
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Background: Mirror therapy (MT) is used to improve motor function after stroke. During MT, a mirror is placed between the two upper limbs (UL), thus reflecting movements of the non- affected side as if it were the affected side. Objectives: The aim of this review is to analyze the evidence on the effec.tiveness of MT in the recovery of UL function in population with post chronic stroke. Methods: The literature search was carried out in PubMed, ISI Web of Science, and PEDro database. Inclusion criteria: a) studies that include individuals diagnosed with stroke for at least 6 months; b) intervention with MT in UL or comparing it with other interventions; c) articles published until 2023; d) articles published in English or Portuguese; e) randomized controlled studies. Exclusion criteria: a) animal studies; b) studies that do not provide a detailed description of the intervention; c) Studies using central electrical stimulation. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Studies with < 4 on PEDro scale were excluded. Eighteen studies met all the inclusion criteria. Main results and conclusions: The quality of the studies varies between 5 and 8. One article compared muscular strength training (MST) with MT vs without MT and four articles compared the use of MT vs conventional therapy (CT), one study compared extracorporeal shock therapy (EST) with and without MT and another study compared functional electrical stimulation (FES), MT and biofeedback, three studies compared MT with Mesh Glove (MG) or Sham Therapy, five articles compared performing bimanual exercises with and without MT and three studies compared MT with virtual reality (VR) or robot training (RT). The assessment of changes in function and structure (International Classification of Functioning, Disability and Health parameter) was carried out, in each article, mainly using the Fugl Meyer Assessment-Upper Limb scale, activity and participation (International Classification of Functioning, Disability and Health parameter) were evaluated using different scales, in each study. The positive results were seen in these parameters, globally. Results suggest that MT is more effective than other therapies in motor recovery and function of the affected UL, than these techniques alone, although the results have been modest in most of the included studies. There is also a more significant improvement in the distal movements of the affected hand than in the rest of the UL.Keywords: physical therapy, mirror therapy, chronic stroke, upper limb, hemiplegia
Procedia PDF Downloads 557 Porcelain Paste Processing by Robocasting 3D: Parameters Tuning
Authors: A. S. V. Carvalho, J. Luis, L. S. O. Pires, J. M. Oliveira
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Additive manufacturing technologies (AM) experienced a remarkable growth in the latest years due to the development and diffusion of a wide range of three-dimensional (3D) printing techniques. Nowadays we can find techniques available for non-industrial users, like fused filament fabrication, but techniques like 3D printing, polyjet, selective laser sintering and stereolithography are mainly spread in the industry. Robocasting (R3D) shows a great potential due to its ability to shape materials with a wide range of viscosity. Industrial porcelain compositions showing different rheological behaviour can be prepared and used as candidate materials to be processed by R3D. The use of this AM technique in industry is very residual. In this work, a specific porcelain composition with suitable rheological properties will be processed by R3D, and a systematic study of the printing parameters tuning will be shown. The porcelain composition was formulated based on an industrial spray dried porcelain powder. The powder particle size and morphology was analysed. The powders were mixed with water and an organic binder on a ball mill at 200 rpm/min for 24 hours. The batch viscosity was adjusted by the addition of an acid solution and mixed again. The paste density, viscosity, zeta potential, particle size distribution and pH were determined. In a R3D system, different speed and pressure settings were studied to access their impact on the fabrication of porcelain models. These models were dried at 80 °C, during 24 hours and sintered in air at 1350 °C for 2 hours. The stability of the models, its walls and surface quality were studied and their physical properties were accessed. The microstructure and layer adhesion were observed by SEM. The studied processing parameters have a high impact on the models quality. Moreover, they have a high impact on the stacking of the filaments. The adequate tuning of the parameters has a huge influence on the final properties of the porcelain models. This work contributes to a better assimilation of AM technologies in ceramic industry. Acknowledgments: The RoboCer3D project – project of additive rapid manufacturing through 3D printing ceramic material (POCI-01-0247-FEDER-003350) financed by Compete 2020, PT 2020, European Regional Development Fund – FEDER through the International and Competitive Operational Program (POCI) under the PT2020 partnership agreement.Keywords: additive manufacturing, porcelain, robocasting, R3D
Procedia PDF Downloads 1636 Effect of Whey Proteins and Caffeic Acid Interactions on Antioxidant Activity and Protein Structure
Authors: Tassia Batista Pessato, Francielli Pires Ribeiro Morais, Fernanda Guimaraes Drummond Silva, Flavia Maria Netto
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Proteins and phenolic compounds can interact mainly by hydrophobic interactions. Those interactions may lead to structural changes in both molecules, which in turn could affect positively or negatively their functional and nutritional properties. Here, the structural changes of whey proteins (WPI) due to interaction with caffeic acid (CA) were investigated by intrinsic and extrinsic fluorescence. The effects of protein-phenolic compounds interactions on the total phenolic content and antioxidant activity were also assessed. The WPI-CA complexes were obtained by mixture of WPI and CA stock solutions in deionized water. The complexation was carried out at room temperature during 60 min, using 0.1 M NaOH to adjust pH at 7.0. The WPI concentration was fixed at 5 mg/mL, whereas the CA concentration varied in order to obtain four different WPI:CA molar relations (1:1; 2:1; 5:1; 10:1). WPI and phenolic solutions were used as controls. Intrinsic fluorescence spectra of the complexes (mainly due to Trp fluorescence emission) were obtained at λex = 280 nm and the emission intensities were measured from 290 to 500 nm. Extrinsic fluorescence was obtained as the measure of protein surface hydrophobicity (S0) using ANS as a fluorescence probe. Total phenolic content was determined by Folin-Ciocalteau and the antioxidant activity by FRAP and ORAC methods. Increasing concentrations of CA resulted in decreasing of WPI intrinsic fluorescence. The emission band of WPI red shifted from 332 to 354 nm as the phenolic concentration increased, which is related to the exposure of Trp residue to the more hydrophilic environment and unfolding of protein structure. In general, the complexes presented lower S0 values than WPI, suggesting that CA hindered ANS binding to hydrophobic sites of WPI. The total phenolic content in the complexes was lower than the sum of two compounds isolated. WPI showed negligible AA measured by FRAP. However, as the relative concentration of CA increased in the complexes, the FRAP values enhanced, indicating that AA measure by this technique comes mainly from CA. In contrast, the WPI ORAC value (82.3 ± 1.5 µM TE/g) suggest that its AA is related to the capacity of H+ transfer. The complexes exhibited no important improvement of AA measured by ORAC in relation to the isolated components, suggesting complexation partially suppressed AA of the compounds. The results hereby presented indicate that interaction of WPI and CA occurred, and this interaction caused a structural change in the proteins. The complexation can either hide or expose antioxidant sites of both components. In conclusion, although the CA can undergo an AA suppression due to the interaction with proteins, the AA of WPI could be enhanced due to protein unfolding and exposure of antioxidant sites.Keywords: bioactive properties, milk proteins, phenolic acids, protein-phenolic compounds complexation
Procedia PDF Downloads 5505 Analysis of the Relationship between Micro-Regional Human Development and Brazil's Greenhouse Gases Emission
Authors: Geanderson Eduardo Ambrósio, Dênis Antônio Da Cunha, Marcel Viana Pires
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Historically, human development has been based on economic gains associated with intensive energy activities, which often are exhaustive in the emission of Greenhouse Gases (GHGs). It requires the establishment of targets for mitigation of GHGs in order to disassociate the human development from emissions and prevent further climate change. Brazil presents itself as one of the most GHGs emitters and it is of critical importance to discuss such reductions in intra-national framework with the objective of distributional equity to explore its full mitigation potential without compromising the development of less developed societies. This research displays some incipient considerations about which Brazil’s micro-regions should reduce, when the reductions should be initiated and what its magnitude should be. We started with the methodological assumption that human development and GHGs emissions arise in the future as their behavior was observed in the past. Furthermore, we assume that once a micro-region became developed, it is able to maintain gains in human development without the need of keep growing GHGs emissions rates. The human development index and the carbon dioxide equivalent emissions (CO2e) were extrapolated to the year 2050, which allowed us to calculate when the micro-regions will become developed and the mass of GHG’s emitted. The results indicate that Brazil must throw 300 GT CO2e in the atmosphere between 2011 and 2050, of which only 50 GT will be issued by micro-regions before it’s develop and 250 GT will be released after development. We also determined national mitigation targets and structured reduction schemes where only the developed micro-regions would be required to reduce. The micro-region of São Paulo, the most developed of the country, should be also the one that reduces emissions at most, emitting, in 2050, 90% less than the value observed in 2010. On the other hand, less developed micro-regions will be responsible for less impactful reductions, i.e. Vale do Ipanema will issue in 2050 only 10% below the value observed in 2010. Such methodological assumption would lead the country to issue, in 2050, 56.5% lower than that observed in 2010, so that the cumulative emissions between 2011 and 2050 would reduce by 130 GT CO2e over the initial projection. The fact of associating the magnitude of the reductions to the level of human development of the micro-regions encourages the adoption of policies that favor both variables as the governmental planner will have to deal with both the increasing demand for higher standards of living and with the increasing magnitude of reducing emissions. However, if economic agents do not act proactively in local and national level, the country is closer to the scenario in which emits more than the one in which mitigates emissions. The research highlighted the importance of considering the heterogeneity in determining individual mitigation targets and also ratified the theoretical and methodological feasibility to allocate larger share of contribution for those who historically emitted more. It is understood that the proposals and discussions presented should be considered in mitigation policy formulation in Brazil regardless of the adopted reduction target.Keywords: greenhouse gases, human development, mitigation, intensive energy activities
Procedia PDF Downloads 3204 Chemical and Biological Studies of Kielmeyera coriacea Mart. (Calophyllaceae) Based on Ethnobotanical Survey of Rural Community from Brazil
Authors: Vanessa G. P. Severino, Eliangela Cristina Candida Costa, Nubia Alves Mariano Teixeira Pires Gomides, Lucilia Kato, Afif Felix Monteiro, Maria Anita Lemos Vasconcelos Ambrosio, Carlos Henrique Gomes Martins
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One of the biomes present in Brazil is known as Cerrado, which is a vast tropical savanna ecoregion, particularly in the states of Goiás, Mato Grosso do Sul, Mato Grosso, Tocantins and Minas Gerais. Many species of plants are characterized as endemic and they have therapeutic value for a large part of the population, especially to the rural communities. Given that, the southeastern region of the state of Goiás contains about 21 rural communities, which present a form of organization based on the use of natural resources available. One of these rural communities is named of Coqueiros, where the knowledge about the medicinal plants was very important to this research. Thus, this study focuses on the ethnobotanical survey of this community on the use of Kielmeyera coriacea to treat diseases. From the 37 members interviewed, 76% indicated this species for the treatment of intestinal infection, leukemia, anemia, gastritis, gum pain, toothache, cavity, arthritis, arthrosis, healing, vermifuge, rheumatism, antibiotic, skin problems, mycoses and all kinds of infections. The medicinal properties attributed during the interviews were framed in the body system (disease categories), adapted from ICD 10; thus, 20 indications of use were obtained, among five body systems. Therefore, the root of this species was select to chemical and biological (antioxidant and antimicrobial) studies. From the liquid-liquid extraction of ethanolic extract of root (EER), the hexane (FH), ethyl acetate (FAE), and hydro alcoholic (FHA) fractions were obtained. The chemical profile study of these fractions was performed by LC-MS, identifying major compounds such as δ-tocotrienol, prenylated acylphoroglucinol, 2-hydroxy-1-methoxyxanthone and quercitrin. EER, FH, FAE and FHA were submitted to biological tests. FHA presented the best antioxidant action (EC50 201.53 μg mL-1). EER inhibited the bacterial growth of Streptococcus pyogenes and Pseudomonas aeruginosa, microorganisms associated with rheumatism, at Minimum Inhibitory Concentration (MIC) of 6.25 μg mL-1. In addition, the FH-10 subfraction, obtained from FH fractionation, presented MIC of 1.56 μg mL-1 against S. pneumoniae; EER also inhibited the fungus Candida glabrata (MIC 7.81 μg mL- 1). The FAE-4.7.3 fraction, from the fractionation of FAE, presented MIC of 200 μg mL-1 against Lactobacillus casei, which is one of the causes of caries and oral infections. By the correlation of the chemical and biological data, it is possible to note that the FAE-4.7.3 and FH-10 are constituted 4-hydroxy-2,3-methylenedioxy xanthone, 3-hydroxy-1,2-dimethoxy xanthone, lupeol, prenylated acylphoroglucinol and quercitrin, which could be associated with the biological potential found. Therefore, this study provides an important basis for further investigations regarding the compounds present in the active fractions of K. coriacea, which will permit the establishment of a correlation between ethnobotanical survey and bioactivity.Keywords: biological activity, ethnobotanical survey, Kielmeyera coriacea Mart., LC-MS profile
Procedia PDF Downloads 1413 Osteosuture in Fixation of Displaced Lateral Third Clavicle Fractures: A Case Report
Authors: Patrícia Pires, Renata Vaz, Bárbara Teles, Marco Pato, Pedro Beckert
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Introduction: The management of lateral third clavicle fractures can be challenging due to difficulty in distinguishing subtle variations in the fracture pattern, which may be suggestive of potential fracture instability. They occur most often in men between 30 and 50 years of age, and in individuals over 70 years of age, its distribution is equal between both men and women. These fractures account for 10%–30% of all clavicle fractures and roughly 30%–45% of all clavicle nonunion fractures. Lateral third clavicle fractures may be treated conservatively or surgically, and there is no gold standard, although the risk of nonunion or pseudoarthrosis impacts the recommendation of surgical treatment when these fractures are unstable. There are many strategies for surgical treatment, including locking plates, hook plates fixation, coracoclavicular fixation using suture anchors, devices or screws, tension band fixation with suture or wire, transacromial Kirschner wire fixation and arthroscopically assisted techniques. Whenever taking the hardware into consideration, we must not disregard that obtaining adequate lateral fixation of small fragments is a difficult task, and plates are more associated to local irritation. The aim of the appropriate treatment is to ensure fracture healing and a rapid return to preinjury activities of daily living but, as explained, definitive treatment strategies have not been established and the variety of techniques avalilable add up to the discussion of this topic. Methods and Results: We present a clinical case of a 43-year-old man with the diagnosis of a lateral third clavicle fracture (Neer IIC) in the sequence of a fall on his right shoulder after a bicycle fall. He was operated three days after the injury, and through K-wire temporary fixation and indirect reduction using a ZipTight, he underwent osteosynthesis with an interfragmentary figure-of-eight tension band with polydioxanone suture (PDS). Two weeks later, there was a good aligment. He kept the sling until 6 weeks pos-op, avoiding efforts. At 7-weeks pos-op, there was still a good aligment, starting the physiotherapy exercises. After 10 months, he had no limitation in mobility or pain and returned to work with complete recovery in strength. Conclusion: Some distal clavicle fractures may be conservatively treated, but it is widely accepted that unstable fractures require surgical treatment to obtain superior clinical outcomes. In the clinical case presented, the authors chose an osteosuture technique due to the fracture pattern, its location. Since there isn´t a consensus on the prefered fixation method, it is important for surgeons to be skilled in various techniques and decide with their patient which approach is most appropriate for them, weighting the risk-benefit of each method. For instance, with the suture technique used, there is no wire migration or breakage, and it doesn´t require a reoperation for hardware removal; there is also less tissue exposure since it requires a smaller approach in comparison to the plate fixation and avoids cuff tears like the hook plate. The good clinical outcome on this case report serves the purpose of expanding the consideration of this method has a therapeutic option.Keywords: lateral third, clavicle, suture, fixation
Procedia PDF Downloads 79