ABSTRACT Purpose To investigate if the narrative score of the ProNOH protocol allows for discriminating age groups, as well as its relation with the global coherence level of the story. The performance of preschool and schoolchildren on the macrostructure aspects. Methods Participants were 97 preschoolers and schoolchildren with typical language development, aged between five and 12 years old, and both sexes who attended public schools. The “Protocolo de Avaliação da Narrativa Oral de História (ProNOH)” (Protocol for the Evaluation of Oral Storytelling) was applied and the narrative score in the macrostructure dimension was calculated with story grammar elements. These same story elements were used to obtain the global coherence level of the story, as proposed by Spinillo and Martins (1997). Results A statistically significant difference was found between age groups, mainly between the borderline ages of 5-6 years, 7-8 years, 9-10 years, and 11-12 years. Positive and statistically significant correlations were found between the narrative score and global coherence and age, as well as between the narrative score and global coherence. Conclusion The protocol proved to be useful for identifying the repertoire of typical story grammar elements as an objective measure that differs in oral narrative across age groups. The results also indicate that the narrative score can provide an idea about the global coherence of the story, although this value does not replace a specific analysis.

RESUMO Objetivo Investigar se o escore narrativo obtido por meio da aplicação do “Protocolo de Avaliação da Narrativa Oral de História (ProNOH)” permite discriminar os grupos etários estudados, bem como sua relação com o nível de coerência global da história. Método Participaram 97 pré-escolares e escolares com desenvolvimento típico de linguagem, entre 5 e 12 anos, ambos os sexos que frequentavam escola pública. Foi aplicado o “Protocolo de Avaliação da Narrativa Oral de História (ProNOH)” e calculado o escore narrativo na dimensão macroestrutural a partir dos elementos estruturais previstos no modelo da gramática de história. Esses mesmos elementos foram usados para obter o nível de coerência global da história, segundo proposta de análise de Spinillo e Martins (1997). Resultados Diferença estatisticamente significante foi encontrada entre os grupos etários, principalmente entre as idades fronteiriças de 5-6 anos, 7-8 anos, 9-10 anos e 11-12 anos. Correlação positiva e estatisticamente significante foi encontrada com a idade e o escore narrativo e a coerência global, bem como entre o escore narrativo e o nível de coerência global. Conclusão O protocolo mostrou ser útil para identificar o repertório de elementos típicos da gramática de história na narrativa oral como uma medida objetiva que diferenciou a narrativa oral de grupos etários. Os resultados indicaram ainda que o escore narrativo pode ser uma medida norteadora do nível de coerência da história, apesar deste valor não substituir uma análise específica.

Resumo Este estudo objetivou avaliar o uso dos dados provenientes do Climatic Research Unit (CRU) e do 5th Generation of European ReAnalysis (ERA5) para o monitoramento da seca no estado de São Paulo por meio do índice de Precipitação Padronizado (SPI) e do índice de Precipitação e Evapotranspiração Padronizado (SPEI). Foram utilizados dados de precipitação mensal (P) para o cálculo do SPI e de temperatura do ar para estimar a evapotranspiração potencial (ETp) para o SPEI nas escalas de 1, 6 e 12 meses. Utilizou-se análises de ajuste paramétricos e concordância para avaliação e comparação com dados de estações de superfície. Os resultados indicam que os dados do CRU (P e ETp) apresentam baixa correlação com os dados das estações. Os dados do SPI e SPEI obtidos por meio do CRU e ERA5 apresentaram correlação ligeiramente maior no inverno na escala de tempo mensal. Um estudo de caso da crise hídrica de 2014 mostrou que os índices calculados a partir dos dados da CRU subestimaram o episódio da seca. Por outro lado, os índices calculados a partir dos dados ERA5 superestimaram a seca. Dessa forma, conclui-se que os dados de reanálise não podem ser utilizados diretamente para o monitoramento da seca.

Abstract The aim of this study was to evaluate the suitability of the Climatic Research Unit (CRU) and the 5th Generation of European ReAnalysis (ERA5) for calculating both SPI and SPEI and, hence, for drought monitoring in the state of São Paulo. Monthly precipitation (P) and air temperature data were used to calculate the SPI and the SPEI at time scales of 1, 6 and 12 months. Goodness-of-fit tests and indices of agreement were used in this study. It was observed low agreement between data provided by the CRU (P and P- ETP) and data from the surface stations. However, the SPI and SPEI estimates presented a slightly higher agreement, especially in the winter months at the monthly time scale. Equivalent results were found for the ERA5 data. A case study on the water crisis of 2014 showed that the drought indices calculated from the CRU data underestimated the drought episode. On the other hand, the indices calculated from ERA5 data overestimated the drought. Therefore, we concluded that the reanalysis data cannot be directly used for drought monitoring in the state of São Paulo.

ABSTRACT The selection of an appropriate nonstationary Generalized Extreme Value (GEV) distribution is frequently based on methods, such as Akaike information criterion (AIC), second-order Akaike information criterion (AICc), Bayesian information criterion (BIC) and likelihood ratio test (LRT). Since these methods compare all GEV-models considered within a selection process, the hypothesis that the number of candidate GEV-models considered in such process affects its own outcomehas been proposed. Thus, this study evaluated the performance of these four selection criteria as function of sample sizes, GEV-shape parameters and different numbers candidate GEV-models. Synthetic series generated from Monte Carlo experiments and annual maximum daily rainfall amounts generated by the climate model MIROC5 (2006-2099; State of São Paulo-Brazil) were subjected to three distinct fitting processes, which considered different numbers of increasingly complex GEV-models. The AIC, AICc, BIC and LRT were used to select “the most appropriate” model for each series within each fitting process.BIC outperformed all other criteria when the synthetic series were generated from stationary GEV-models or from GEV-models allowing changes only in the location parameter (linear or quadratic). However, this latter method performed poorly when the variance of the series varied over time. In such cases, AIC and AICc should be preferred over BIC and LRT. The performance of all selection criteria varied with the different number of GEV-models considered in each fitting processes. In general, the higher the number of GEV-models considered within aselection process, the worse the performance of the selection criteria. In conclusion, the number of GEV-models to be used within a selection process should be set with parsimony.

ABSTRACT Thyroglobulin (Tg) is the major glycoprotein produced by the thyroid gland, where it serves as a template for thyroid hormone synthesis and as an intraglandular store of iodine. Measurement of Tg levels in serum is of great practical importance in the follow-up of differentiated thyroid carcinoma (DTC), a setting in which elevated levels after total thyroidectomy are indicative of residual or recurrent disease. The most recent methods for serum Tg measurement are monoclonal antibody-based and are highly sensitive. However, major challenges remain regarding the interpretation of the results obtained with these immunometric methods, particularly in patients with endogenous antithyroglobulin antibodies or in the presence of heterophile antibodies, which may produce falsely low or high Tg values, respectively. The increased prevalence of antithyroglobulin antibodies in patients with DTC, as compared with the general population, raises the very pertinent possibility that tumor Tg may be more immunogenic. This inference makes sense, as the tumor microenvironment (tumor cells plus normal host cells) is characterized by several changes that could induce posttranslational modification of many proteins, including Tg. Attempts to understand the structure of Tg have been made for several decades, but findings have generally been incomplete due to technical hindrances to analysis of such a large protein (660 kDa). This review article will explore the complex structure of Tg and the potential role of its marked heterogeneity in our understanding of normal thyroid biology and neoplastic processes.

OBJETIVO: Determinar a época do diagnóstico de fendas orofaciais típicas em diferentes regiões brasileiras e sua influência na idade da correção cirúrgica. MÉTODO: Estudo prospectivo, descritivo e transversal realizado em centros médicos do Sudeste, Sul e Nordeste do Brasil. Fonoaudiólogos e geneticistas treinados realizaram entrevista, previamente validada, com pais de crianças afetadas. Utilizaram-se os programas Epi-Info e SPSS. Adotou-se nível de significância de 5% (p < 0,05). RESULTADOS: A amostra contou com 215 entrevistas para análise: 21,9% (47) aplicadas no Sudeste, 51,1% (110) no Sul e 27% (58) no Nordeste. A renda mensal no Sudeste foi maior (p < 0,05). A fenda labiopalatal foi encontrada em 61,4% (132) dos casos, a palatal, em 20,9% (45), e a labial, em 17,7% (38). Em 75,3% (162) dos casos, o diagnóstico ocorreu na maternidade, em 14% (30), no pré-natal e, em 10,2% (22), após a alta da maternidade. O Sudeste apresentou maior frequência de diagnóstico pré-natal (27,7%), possivelmente relacionada ao maior poder aquisitivo e a oportunidades de investigação. Dos diagnósticos em maternidades, 74,4% ocorreram no Nordeste. Entretanto, não houve diferença na comparação entre época de diagnóstico, região e idade da primeira cirurgia. CONCLUSÃO: Considerando que o diagnóstico é mais frequente em maternidades, sugere-se o treinamento das equipes de saúde desses locais, visando efetiva coordenação do atendimento inicial. Apesar da época do diagnóstico não influenciar a idade das cirurgias, ela favorece o planejamento dos cuidados neonatais e terapêuticos dos afetados.

OBJECTIVE: To determine the time of diagnosis of typical orofacial clefts in different Brazilian regions and its influence on age at surgical correction. METHOD: This was a prospective, descriptive, cross-sectional study conducted in medical centers in the Southeast, South, and Northeast of Brazil. Trained speech therapists and geneticists interviewed the parents of affected children using a previously validated questionnaire. Epi-Info and SPSS were used for data analysis. Significance level was set at 5% (p < 0.05). RESULTS: The sample consisted of 215 interviews conducted in the following regions: 21.9% (47) in the Southeast, 51.1% (110) in the South, and 27% (58) in the Northeast. Monthly family income was higher in the Southeast (p < 0.05). Cleft lip and palate were found in 61.4% (132) of cases, cleft palate in 20.9% (45), and cleft lip in 17.7% (38). Diagnosis occurred in the maternity ward in 75.3% (162) of cases, during the prenatal period in 14% (30), and after hospital discharge in 10.2% (22). The Southeast had a higher frequency of prenatal diagnosis (27.7%), possibly related to greater purchasing power in this region and greater availability of prenatal investigation. Of all cases diagnosed in the maternity ward, 74.4% occurred in the Northeast. However, no significant difference was found when comparing time of diagnosis, region, and age at first surgery. CONCLUSION: Considering that diagnosis is more common in the maternity ward, local health care teams should be trained in order to effectively improve the initial care of these patients. Although time of diagnosis did not affect age at surgery, it favors the planning of neonatal care and treatment of affected infants.

Este artigo objetiva analisar a magnitude e algumas características do fenômeno do assédio moral no trabalho no setor saúde do Rio de Janeiro. Foram analisados dados de pesquisa desenvolvida em 2001 como parte do programa "Violência no Trabalho no Setor Saúde", resultantes de um inquérito anônimo. Para constituir o banco para análise, foram selecionados todos os casos (1.569) e as variáveis relacionadas ao assédio moral. O grupo profissional que teve maior proporção de vítimas de assédio moral foi o de auxiliar de enfermagem (22,7%). Colegas, supervisores ou administradores compuseram o mais importante grupo de agressores (48,7%). A reação psicológica mais prevalente foi "permanecer supervigilante". Embora 38,5% das vítimas tenham relatado a violência a superiores, 20% relataram ter sido tomada alguma providência. Os autores concluem que mais pesquisas e medidas de vigilância devem ser realizadas no Brasil para assegurar a visibilidade desse tipo de violência. Além disso, ressaltam a necessidade de implementar medidas institucionais de controle da violência no trabalho e de estimular estudos que enfatizem o manejo institucional desse tipo de violência.

This article aims at analyzing the magnitude and some characteristics of the workplace moral harassment phenomenon in Rio de Janeiro health sector. Data from a randomized anonymous survey research developed in 2001 as part of the Program "Workplace Violence in the Health Sector" was analyzed. All cases (1569) and their variables related to moral harassment were selected for the bank analysis. The professional group of nurses' aides presented the highest proportion of moral harassment victims (22.7%) and the most frequent perpetrators were co-workers, supervisors and managers (48.7%). The victims' most frequent psychological reaction was "becoming super-alert". Although part of them (38.5%) reported to their bosses they had been morally harrassed, only 20% of them had an action taken. In order to evidence this kind of violence in Brazil, the authors suggest increasing research and surveillance. They also emphasize the need to implement institutional measures to control violence at work and studies that will stimulate the institutional management of this kind of violence.