Background: Between 1961-1971 vitamin D deficiency was recognized as a public health issue in the UK, because of the lack of effective sunlight and the population mix [1, 2]. In recent years, health care professionals have cited evidence suggesting a re-emergence of the vitamin D deficiency linked to a number of health consequences as a concern [3-6]. Evidence from observational studies has linked low vitamin D status with impairment in glucose homeostasis and immune dysfunction [7-9]. However, interventional studies, particularly those focused on paediatric populations, have been limited and inconsistent. There is a need for detailed studies, to clarify the therapeutic benefits of vitamin D in these important clinical areas. Objective: The aims of this PhD thesis were two-fold. Firstly, to perform preliminary work assessing the association between vitamin D deficiency and bone status, glucose homeostasis and immune function, and to explore any changes in these parameters following short term vitamin D3 replacement therapy. Secondly, to assess the effectiveness of an electronic surveillance system (ScotPSU) as a tool to determine the current incidence of hospital-based presentation of childhood vitamin D deficiency in Scotland. Methods: Active surveillance was performed for a period of two years as a part of an electronic web-based surveillance programme performed by the Scottish Paediatric Surveillance Unit (ScotPSU). The validity of the system was assessed by identifying cases with profound vitamin D deficiency (in Glasgow and Edinburgh) from the regional laboratory. All clinical details were checked against those identified using the surveillance system. Thirty-seven children aged 3 months to 10 years, who had been diagnosed with vitamin D deficiency, were recruited for the bone, glucose and immunity studies over a period of 24 months. Twenty-five samples were analysed for the glucose and bone studies; of these, 18 samples were further analysed for immune study. Treatment consisted of six weeks taking 5000 IU units cholecalciferol orally once a day. At baseline and after completion of treatment, 25 hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), alkaline phosphatase (ALP), collagen type 1 cross-linked C-telopeptide (CTX), osteocalcin (OCN), calcium, phosphate, insulin, glucose, homeostasis model assessment index, estimated insulin resistance (HOMA IR), glycated hemoglobin (HbA1c), sex hormone binding globulin (SHBG), lipids profiles, T helper 1 (Th1) cytokines (interleukin-2 ( IL-2), tumor necrosis factors-alpha (TNF-α), interferon-gamma (INF-γ)), T helper 2 (Th2) cytokines (interleukin-4 (IL-4), interleukin-5 (IL-5), interleukin-6 (IL-6)), T helper 17 (Th17) cytokine (interleukin-17 (IL-17)), Regulatory T (Treg) cytokine (interleukin-10 (IL-10)) and chemokines/cytokines, linked with Th1/Th2 subset balance and/or differentiation (interleukin-8 (IL-8), interleukin-12 (IL-12), eosinophil chemotactic protein ( EOTAXIN), macrophage inflammatory proteins-1beta (MIP-1β), interferon-gamma-induced protein-10 (IP-10), regulated on activation, normal T cell expressed and secreted (RANTES), monocyte chemoattractant protein-1(MCP-1)) were measured. Leukoocyte subset analysis was performed for T cells, B cells and T regulatory cells and a luminex assay was used to measure the cytokiens. Results: Between September 2009 and August 2011, 163 cases of vitamin D deficiency were brought to the attention of the ScotPSU, and the majority of cases (n = 82) were reported in Glasgow. The cross-validation checking in Glasgow and Edinburgh over a one-year period revealed only 3 (11%) cases of clearly symptomatic vitamin D deficiency, which had been missed by the ScotPSU survey in Glasgow. While 16 (67%) symptomatic cases had failed to be reported through the ScotPSU survey in Edinburgh. For the 23 children who are included in bone and glucose studies, 22 (96%) children had basal serum 25(OH)D in the deficiency range (< 50 nmol/l) and one (4%) child had serum 25(OH)D in the insufficiency range (51-75 nmol/l). Following vitamin D3 treatment, 2 (9%) children had final serum 25(OH)D lower than 50 nmol/l, 6 (26%) children had final serum 25(OH)D between >50-75 nmol/l, 12 (52%) children reached a final serum 25(OH)D >75-150 nmol/l and finally 3 (13%) exceeded the normal reference range with a final 25(OH)D >150 nmol/l. Markers for remodelling ALP and PTH had significantly decreased (p = 0.001 and <0.0001 for ALP and PTH respectively). In 17 patients for whom insulin and HOMA IR data were available and enrolled in glucose study, significant improvements in insulin resistance (p = 0.04) with a trend toward a reduction in serum insulin (p = 0.05) was observed. Of those 14 children who had their cytokines profile data analysed and enrolled in the immunity study, insulin and HOMA IR data were missed in one child. A significant increase in the main Th2 secreted cytokine IL-4 (p = 0.001) and a tendency for significant increases in other Th2 secreted cytokines IL-5 (p = 0.05) and IL-6 (p = 0.05) was observed following vitamin D3 supplementation. Conclusion: An electronic surveillance system can provide data for studying the epidemiology of vitamin D deficiency. However, it may underestimate the number of positive cases. Improving vitamin D status in vitamin D deficient otherwise healthy children significantly improved their vitamin D deficient status, and was associated with an improvement in bone profile, improvements in insulin resistance and an alteration in main Th2 secreting cytokines.

A high prevalence of malnutrition has been reported in paediatric inpatients both in developed and developing countries, using various methodology and criteria. According to national and international guidelines, all inpatients should be screened for risk of malnutrition on admission using a validated screening tool. However, because of the lack of universally accepted definition for malnutrition, there is no consensus on the measures and methods to use for nutritional screening. There is controversy concerning the validity, reliability and practicality of existing paediatric nutrition screening tools. Moreover, current paediatric screening tools have not been designed and validated for infants. The study aimed to: 1) Validate a novel malnutrition screening scheme for infants - the Infant Paediatric Yorkhill Malnutrition Score (iPYMS) and compare its utility in different hospital settings, in UK and Middle East, Iran. 2) Compare the usefulness of various anthropometric measures to predict malnutrition in infants. 3) Determine the factors that correlated with malnutrition in hospitalised infants. 4) Explore the use of body composition measures in sick infants. The Paediatric Yorkhill Malnutrition Score (PYMS) had already been developed in Glasgow for use in children admitted to hospital. It utilized four elements that were reported as recognized predictors of the past, present or future nutrition risk. An audit was carried out at the beginning of the PhD course and aimed to evaluate the effect of PYMS on collection of anthropometric measurements in the wards. Findings suggested that introduction of a screening tool improved the acquisition of anthropometry by nursing staff, but their utilization by medical staff remained poor. Method: The Infant Paediatric Yorkhill Malnutrition Score (iPYMS) was developed by the research team. The score encompasses 4 rated steps that similar to those used for older children: weight < 2nd and 9th centile was used as opposed to BMI, and 3 elements concerning the history of nutritional issues. A score of 1 classifies a patient at medium risk and ≥2 or ≥3 indicates high risk. Infants were studied at admission to two tertiary children's hospital, 210 (0-12 months) in Glasgow, UK and 187 (1-12 months) in Tabriz, Iran. Convenience sampling was used to recruit equal number of patients in each risk group. Four researchers recruited the samples for the UK cohort and one for the Iran cohort. The diagnostic accuracy and validity of iPYMS in both cohorts were assessed by comparing the iPYMS nutritional risk with the Paediatric Subjective Global Nutritional Assessment (SGNA) that determine malnutrition risk and mean skinfolds z-scores (triceps and subscapular) below <-2SD as the benchmark for low fat stores and acute/chronic malnutrition. Discriminant validity was assessed using body composition and anthropometry measurements, with the hypothesis that infants at high risk of malnutrition will have lower fat and possibly lean mass compared with those at low risk. Results: More infants in Iran (32%) were rated as high risk for undernutrition than UK (7%). The diagnostic performance of iPYMS improved with the cut-off ≥ 3, more so in Iran than the UK. In Iran, only, infants who were classified as being at high risk of malnutrition had longer hospital stay. Infants in the iPYMS moderate and high risk groups all had significantly lower mean SD-score for anthropometry. After excluding patients scored high risk based only on low weight z-score (≤-2 SD), the differences in weight and BMI z-scores remained significant. In Iran 76% infants with raised iPYMS had mean skinfolds <-2SD, but only 5% in the UK. The UK infants may thus not actually be malnourished. They may be ill and just at risk of malnutrition. The first step of iPYMS (weight below <9th or 2nd centile) was a strong predictor of malnutrition risk, more so in Iran; in the Iranian cohort, 91% and in the UK 70% of infants above the high risk threshold of ≥ 3 scored as high risk due to the weight below <9th or 2nd centile. ROC Analysis either with SGNA or sum skinfolds z-score as the main outcomes illustrated that admission weight and growth velocity had almost the same predictive value in predicting malnutrition risk. This suggests that weight velocity is no improvement on weight alone as a predictor of malnutrition. Current breast feeding was found to be an independent predictor of malnutrition in Iran. Socioeconomic factors were weak predictors of malnutrition in this population. There is a lack of validated and suitable methods to assess body composition in infants. To determine whether analysing bio-electrical impedance data is practical in our young age range population, this was compared to skinfolds thicknesses and how the two measures of body composition varied relative to SGNA. The WHO standard for skinfolds only starts at 3 months, excluding nearly one third of infants in the Iran cohort and half in the UK. An iPYMS skinfold reference was thus generated using the iPYMS dataset for the UK cohort, as this was a population with low rates of malnutrition risk who had skinfolds levels mainly within the WHO range beyond age 3 months. In Iran, most high SGNA risk infants (72%) had low skinfolds, but in UK there was no association. Iranian infants had much lower mean lean and fat than the UK infants. Fat measured by BIA varied by SGNA rating risk group with both cohorts, but lean differed between risk groups only for Iran cohort. Conclusion: Malnutrition was common in this tertiary children's hospital in Iran. iPYMS might perform well in this setting and could be used by health professionals to identify infants with malnutrition. In contrast, in the UK, iPYMS would mainly identify infants at risk of malnutrition, because of the low prevalence of under-nutrition. On the other hand, we found that weight alone (the first component of iPYMS) is a robust predictor of malnutrition risk. Therefore iPYMS may not add any advantage over the simple measurement of weight alone to identify infants at risk of malnutrition. This is essential where there are limited resources. Studies should be continued to explore a suitable and appropriate gold standard to test the validity of the tools particularly in low prevalence settings as well as the resources and cost of the introducing the tool in clinical practice. Any screening tool for malnutrition can only be considered effective if it results in early intervention and improved clinical outcomes, so the effectiveness of iPYMS needs to be explored in future intervention studies.

Background: The burden of childhood stunting and mortality remains huge in developing countries and in particular in the Sub-Saharan Africa region to which Nigeria is located. Despite the body of evidence supporting an association between neighbourhood contextual influences and health outcomes, few studies have examined the relationship between neighbourhood-level risk factors and childhood undernutrition (stunting) and mortality independent of the individual-level risk factors in a single analytical framework in Nigeria. Most studies to date have focused on individual-level factors overlooking the contribution of neighbourhood or area level factors. Beyond the effect of neighbourhood contextual influences, a child’s health will be influenced by the state, region and national policies and programs that in turn will affect the proximate determinants of his or her survival and health status. Aims: We described the variation that existed between the states in Nigeria using league table, control chart and spatial clustering of childhood stunting (Study I) and examined the contribution of community contextual factors at predicting childhood stunting beyond individual-level factors (Study II). We further identified and examined the predictors of childhood mortality in Nigeria (Study III) and developed prognostic model predicting differences in childhood mortality in Nigeria communities (Study IV). We also quantified the contribution of neighbourhood socioeconomic disadvantage alongside individual-level socioeconomic status to childhood mortality in Nigeria using multilevel analysis (Study V). Methods: We used the Nigeria Demographic and Health Survey (DHS) dataset which comprised of 28,647 and 31,482 under-five children nested within 888 and 896 communities for the 2008 and 2013 surveys respectively from 37 states including the Federal Capital Territory. We used league table, control chart and geospatial analysis to describe variations in childhood stunting that existed between the states in Nigeria (Study I). In study II, we applied multivariable multilevel logistic regression analysis to describe the independent contribution of community contextual influences (factors) alongside the individual level factors on childhood stunting in Nigeria. We applied multivariable logistic regression analysis that included Receiver Operating Characteristics (ROC) Curve to construct a model that examined the factors associated with childhood mortality (Study III). In study IV, we used mixed multivariable Poisson regression analysis to develop a prognostic model predicting differences in childhood mortality in Nigeria communities. In Study V, we applied multivariable multilevel logistic regression analysis and considered three measures of individual socioeconomic status i.e. maternal educational attainment, household wealth status, and employment status of the mothers. At the neighbourhood (level 2) and state (level 3), we included poverty rate, unemployment rate, and illiteracy rate. Results: There were statistically significant variations in the odds of childhood stunting and mortality across the neighbourhoods (Study II, IV & V) and states (I) in Nigeria. This confirmed the evidence of community and state level contextual phenomenon influencing childhood survival and stunting. Children residing in socioeconomically disadvantaged neighbourhoods had higher odds of childhood morbidity and mortality compared to their counterparts living in more socioeconomically advantageous neighbourhoods (Study II, IV & V). The odds of childhood morbidity and mortality were associated with neighbourhood and state socioecological conditions even after adjusting for individual’s household socioecological conditions (Study II, III, IV & V). There was moderate positive correlation between neighbourhood and individual variations in childhood mortality and morbidity (Study II & V). The odds of childhood stunting and mortality were higher in children residing in rural areas (Study II, III, IV & V) and in settings with poor sanitation (Study III & IV). Other factors that increased the odds of childhood mortality included low level of maternal health seeking behaviour, not breastfed for >18 months, being from a polygamous family setting, large family and high birth order, non-usage of contraceptive by mother, and mother having first marriage during their teenage years(Study III). Good household wealth status, adequate birth interval, being a female child and having normal birth weight, increasing maternal educational attainment were all associated with odds of not suffering from childhood stunting and surviving beyond five years of age (Study II & V). Conclusions: By adopting several modelling approaches including the multilevel modelling, we added to the growing body of evidence the effects of the neighbourhood contextual influences on childhood stunting and survival in Nigeria. Our study revealed that individual i.e. children and parental factors; neighbourhood and socioecological environment were associated with childhood stunting and mortality. Efforts at reducing the burden of childhood stunting and mortality should be directed at establishment of poverty alleviation programmes, effective publicly funded health care delivery, promotion of hygienic environmental practices and health education more importantly at the neighbourhood level. Lastly, given the importance of socioecological factors at influencing the lifestyles of neighbourhoods and individuals, interventions targeting structural make up of these two entities are vital in order to meet the MDGs 1 and 4 regarding childhood stunting and mortality in Nigeria and in particular developing countries in general.

The aim of this thesis is to discuss the issue of public legitimization of new medical technology, through a case of antenatal screening for Down's syndrome in Britain. It is based on ethnographic study of agents involved with the technology; inventors of the technology, medical practitioners, pregnant women, and people with disability and their families, especially parents. The thesis is interdisciplinary based on mainly two frames of reference; Science and Technology Studies and Disability Studies. The former equips the thesis with the basis to understand the process of invention and promotion of the technology, in the social context I will especially focus on transformation of rhetoric to legitimate the technology in its process. The latter provides the critical standpoint to observe the fundamental idea of antenatal screening that it is better to prevent life with disability. Today, provision of antenatal screening is commonly legitimated for its ability to enhance autonomous decision of women in the clinical setting. However it is questionable whether women can make reliable autonomous decisions, when they can only imagine the immediate consequences of their decision (Rapp and Ginsburg, 2001). Based on the idea of disability studies, I will argue that the key to the public legitimization of antenatal screening technology lies in the approach towards life with disability that society should take. I will show that an important problem in the process of social acceptance of antenatal screening for Down's syndrome in Britain is the lack of serious examination of alternatives to the preventive medical approach towards disability that this technology offers. I conclude that in order to generate the public legitimization of antenatal screening technology in the future, it is necessary for the public to consider a variety of possible approaches that society can take towards life with the targeted condition.

The aim of this thesis is to compare effects of respiratory distress syndrome (RDS) on the myocardial function of newborn preterm infants and the later effects of chronic lung disease of prematurity on pulmonary artery stiffness in school age children. The first study in this thesis compared global and regional myocardial function in preterm infants with respiratory distress syndrome (RDS) with preterm and term-born controls (30 with RDS, 30 preterm control ≤34 weeks, 60 term control) using conventional and tissue Doppler echocardiography at birth, at term, one month, and one year of age. The second study compared the pulmonary artery stiffness, an early preclinical marker of pulmonary hypertension, in children (aged 8-12 years) who had chronic lung disease of prematurity (CLD) with preterm and term-born controls. Pulmonary artery pulse wave velocity (PA PWV) was assessed in 59 children: 13 with CLD, 21 preterm (≤ 32 weeks gestation) and 25 term controls) using velocity encoded MRI technique while breathing room air and after 20 minutes of breathing 12% oxygen. At birth, infants with RDS had lower pulmonary artery AT:ET (p < 0.001), long axis shortening (p < 0.01), RV systolic velocity (p < 0.001) and higher TR (p < 0.01) compared to preterm and term control groups. The preterm groups was also noted to have diastolic dysfunction (lower mitral E:A) at birth (p < 0.001). At term corrected age, pulmonary artery AT:ET was still lower in the RDS group but no differences detected in TR between the groups. There were no differences in all parameters measured between the groups at one month and one year. 2 PA PWV was similar in all three groups at baseline when assessed at school age. However, following hypoxic challenge, PA PWV in children who had CLD increased significantly compared to preterm (p=0.025) and term controls (p=0.042). The findings in this thesis suggest that infants with RDS had mildly elevated pulmonary arterial pressure as a result of milder respiratory disease with improvement in antenatal and neonatal care. The RV global dysfunction in infants with RDS resolved with resolution of the respiratory condition. Both preterm groups underwent postnatal maturation of myocardial function and caught up with the term control group by one month corrected age. At school age, children who had CLD displayed increased pulmonary vascular reactivity to hypoxia and are at greater risk of developing pulmonary hypertension earlier.

Aims: Since 2008, in England, all sudden unexpected deaths in infancy (SUDI) must be investigated jointly by police, health and social care. This thesis aims to learn of parents’ and professionals’ experiences of this joint agency approach (JAA) and use this knowledge to improve these investigations. Methods: 1. Systematic literature review of bereaved parents’ experiences. 2. Systematic literature review of different models of SUDI investigation. 3. A mixed methods study of JAA investigation of SUDI cases; involving case note analysis, questionnaires and in-depth interviews with parents and professionals. 4. A descriptive study of outcomes of JAA SUDI investigation using Child Death Overview Panel (CDOP) data. Results: In the mixed methods study, 23/111 families were recruited giving theoretical saturation; the median time between death and parental study participation was 33 weeks. Parents felt that the JAA provided information about the death but offered minimal emotional support; they were often distressed by non-specialist police attending their home as part of the investigation. The joint home visit by police and paediatrician was shown to be a key investigative process. Social care were only involved in 13/23 JAA investigations. Some coroners were reluctant to share information with paediatricians preventing effective JAA investigations. In the CDOP study were obtained for 93% SUDI cases. Final case discussions were used to discuss risk factors but not to determine the cause of death; in nearly all cases the final cause of death relied on post-mortem examination alone and ignored death scene examination findings. Many deaths were labelled as unascertained despite fulfilling diagnostic criteria for SIDS. Conclusion: Ideally, SUDI investigations should be carried out only by specialist clinicians who do this work frequently and the JAA should be fully integrated with social care and coroners’ investigations. There needs to be a clearer system for classifying unexplained SUDI. Police should reconsider their immediate response to SUDI; parents would like more follow-up and bereavement support from professionals.

Impaired self-awareness is a common consequence following a brain injury in adults, particularly when the brain injury is moderate or severe. Impaired self-awareness affects engagement in rehabilitation and results in poor long term functional outcomes. There is a paucity of literature regarding self-awareness following a brain injury in childhood. Consequently, little is known about the differences between children and adults in the domain of self-awareness following brain injury. Children and young people are at different stages of development when their injury occurs and this study investigates the impact of the brain injury on the development of self-awareness. The aim of this research study is to gather quantitative and qualitative longitudinal data from children and young people who have experienced a moderate to severe traumatic brain injury in order to understand their level of self-awareness. This study used a longitudinal multiple case study design with mixed methodology. Fifteen children and young people with a moderate/severe traumatic brain injury were recruited and data were collected from the children and young people, their parents and their teacher over an eighteen month period. The results show that children and young people have an interruption to the development of self-awareness following a traumatic brain injury. Impaired self-awareness is not chronic in this group and they continue to make developmental gains in time. This study adds to our understanding of the interruption of self-awareness development following a brain injury in childhood. Occupational therapists have a particular role to play while engaging with children and young people in the everyday context of their lives, which is supportive of greater self-awareness. As children and young people become more able to assess their own performance, they may be in a better position to set realistic rehabilitation goals. Implications for future clinical and academic children’s neurorehabilitation are outlined.

Orientadores: Alessandro Batezelli, Emilson Pereira Leite / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Geociências / Made available in DSpace on 2018-08-27T22:53:56Z (GMT). No. of bitstreams: 1 Grou_TomasManuelLampreia_M.pdf: 5454230 bytes, checksum: 980d2f25cdbda923232bb18aae1a7b34 (MD5) Previous issue date: 2015 / Resumo: A interpretação de eletrofácies é uma ferramenta bastante utilizada no estudo de campos petrolíferos que se encontram numa fase inicial de exploração, e quando existe pouca informação geológica. A definição das eletrofácies resulta da interpretação dos perfis elétricos de poço, que por meio de diferentes ferramentas nos fornecem inúmeras informações de rocha. Esta metodologia foi aplicada à Formação Carapebus, que é descrita como sendo constituída por depósitos de águas profundas ¿ turbiditos, que se encontra localizada ao longo de toda a Bacia de Campos. Foi dada a informação para que o método não-supervisionado k-means subdividisse a informação dos perfis de poço em 4 clusters distintos. As 4 eletrofácies geradas ¿ reservatório, possível reservatório, cimentação e não reservatório, foram confrontadas com os perfis de porosidade, volume de argila, saturação em água e com os testemunhos de 3 dos 6 poços, permitindo validar a identificação das eletrofácies. A eletrofácies reservatório identificou as unidades arenosas; a eletrofácies possível reservatório identificou unidades arenosas com componente argilosa; a eletrofácies não reservatório identificou os intervalos com predominância de folhelhos na sua composição; e a eletrofácies cimentação identificou rochas carbonáticas e também intervalos de arenitos e folhelhos que se encontrassem com forte componente carbonática. A análise das associações de eletrofácies juntamente com as associações de fácies deste tipo de depósitos, permitiu enquadrar cada um dos 6 poços relativamente à sua posição no corpo turbidítico, aquando a deposição da Formação Carapebus. Os poços 4 e 6 apresenta uma associação de fácies com grandes pacotes de unidade mais arenosas sem intercalações de materiais mais finos, já os poços 1, 2, 3, e 5 apresentam associações de fácies com materiais finos intercalados com unidades mais arenosas. Assim, determinou-se a Formação Carapebus nos poços 4 e 6 se caracteriza por uma sedimentação mais proximal do corpo turbidítico ¿ transição de canal para lobo, e os poços 1, 2, 3, e 5 numa porção distal do corpo turbidítico ¿ fácies de lobos. A associação de fácies do poço 2 evidencia ainda a subsidência térmica que se iniciou durante o Eocêno, através da deposição de fácies de lobos em cima da associação de fácies de complexos de canais amalgamados, materializado a retrogradação sedimentar / Abstract: The interpretation of electrofacies are very useful during the initial phase of exploration of an oil field, which, normaly, have lack of geological information. Electrofacies result from the well log analysis, which provide a wide range of rock information due the existence of different tools. This methodology was applied at Carapebus Formation that is described in literature as a deep-water sedimentation ¿ turbidites, which can be found all along Campos Basin. The non-supervised method, k-means, received the input information to split the well log values in 4 different groups. This 4 electrofacies ¿ reservoir, possible reservoir, non-reservoir and cimentation was compared with the porosity, shale volume and water saturation logs and with the rock information from 3 of this 6 wells, allowing the validation of the electrofacies identification. Reservoir electrofacies identified sandstone bodies; possible reservoir identified the sandstone units with shale; Non-reservoir identified the shale rich units; and electrofacies cimentation identified the limestone rich units and sandstone and shale units with carbonatic influence. The interpretation of eletrofácies association with the facies association of this deposits lead to the position of the 6 wells inside the turbiditic body, during the deposition of Carapebus Formation. Well 4 and 6 have an facies association characterized by thick units of sandstone without shale intercalations, then wells 1 2, 3 and 5 present an facies association characterized by the intercalation of sand bodies with shale. With this information, Carapebus Formation at wells 4 and 6 it is represent by transictional deposits ¿ channel to lobe, and in wells 1, 2, 3 and 5 by lobe deposits. The facies association in well 2 provide an extra information, the evidence of thermal subsidence and consequent retrogradational sedimentation that started during the Eocene, and it is materialized by the deposition of lobe facies over the complex amalgamated channel facies / Mestrado / Mestre em Geociências

No Brasil, ainda são escassas pesquisas, políticas públicas e ações institucionais voltadas à população idosa em contexto de desastres. Os desastres relacionados às chuvas afetam cerca de 30% dos municípios brasileiros anualmente. Especificamente na região Sudeste, o Estado do Rio de Janeiro (RJ), recorrentemente é afetado por desastres, estando Teresópolis/RJ em segundo lugar entre os municípios com maior número de vítimas fatais, no período de 1991 a 2012. Devido ao contexto estrutural de desigualdade social que se desdobra em territorialidades também desiguais, alguns grupos sociais tornam-se mais suscetíveis do que outros quando expostos a fatores de ameaça associados a uma infra-estrutura precária, como o formado por idosos. Com o intuito de compreender o desastre sob a ótica da pessoa idosa em Teresópolis/RJ, este estudo se propôs a descrever e analisar, numa perspectiva de interface da sociologia e da gerontologia, dimensões objetivas e simbólicas de afetação das pessoas idosas e seus familiares, em contexto de desastre, bem como as estratégias de enfrentamento adotadas. Trata-se de um estudo exploratório e analítico, de natureza descritiva, com a utilização do método qualitativo de investigação. Foram utilizadas três técnicas integradas, a de pesquisa bibliográfica, análise documental e a de relatos orais, por meio de entrevistas semiestruturadas. Entrevistas com 19 idosos, seis familiares e cinco membros da comunidade são apresentadas. A partir das incursões realizadas, os resultados analisados nos discursos dos idosos, dos familiares, do meio oficial e da mídia são subdivididos nas dimensões (material, simbólica ou interpessoal) expressas. Os resultados evidenciam o desencontro de perspectivas e objetivos entre os atores oficiais, os midiáticos, os idosos afetados e seus familiares. Em relação à Teresópolis/RJ, este se constitui um campo emblemático, onde a afetação dos idosos e familiares caracteriza-se como contínua, complexa e multidimensional, marcada pelo descomprometimento do ente público para com os direitos da pessoa idosa. A presente pesquisa busca, portanto, estabelecer novos diálogos para o atendimento, de forma humanizada e multidimensional, das demandas emergentes da população em processo de envelhecimento no contexto de desastres. / In Brazil, still there is lack of research, public policy and institutional actions for the elderly population in disaster context. Disasters related to rains affect about 30% of Brazilian cities annually. Specifically in the Southeast, the State of Rio de Janeiro (RJ), is affected by recurrent disasters, being Teresópolis/RJ in second place among the cities with the highest number of fatal victims, from 1991 to 2012. Due to the structural context of social inequality that unfolds in territorialities also unequal, some social groups become more susceptible than others when exposed to threat factors associated with a poor infrastructure, as formed by the elderly. In order to understand the disaster from the perspective of the elderly in Teresópolis/RJ, this study aimed to describe and analyze, in a interface perspective of sociology and gerontology, objective and symbolic dimensions of affectation and coping strategies adopted by older people and their families in disaster context. This is an exploratory and analytical study of descriptive nature, using the qualitative research method. Three integrated techniques were used, the literature review, document analysis and oral reports, through semi-structured interviews. Interviews were conducted with 19 elderly people, six family members and five community members. Based on the incursions conducted in the field, the results analyzed were divided according to the dimensions (material, symbolic or interpersonal) expressed in the discourse of the elderly people and their families, the official actors and the media. The results show the mismatch of perspectives and goals between official actors, media, affected elderly people and their families. Teresópolis/RJ constitutes an emblematic field, where the affectation of elderly people and the family members is characterized as continuous, complex and multidimensional, marked with the disengagement of the public entity for the rights of the elderly people. The present research aims, therefore, to establish new dialogues for the care, in humanized and multidimensional way, of the emerging demands of aging process in the disaster context.

No Brasil, ainda são escassas pesquisas, políticas públicas e ações institucionais voltadas à população idosa em contexto de desastres. Os desastres relacionados às chuvas afetam cerca de 30% dos municípios brasileiros anualmente. Especificamente na região Sudeste, o Estado do Rio de Janeiro (RJ), recorrentemente é afetado por desastres, estando Teresópolis/RJ em segundo lugar entre os municípios com maior número de vítimas fatais, no período de 1991 a 2012. Devido ao contexto estrutural de desigualdade social que se desdobra em territorialidades também desiguais, alguns grupos sociais tornam-se mais suscetíveis do que outros quando expostos a fatores de ameaça associados a uma infra-estrutura precária, como o formado por idosos. Com o intuito de compreender o desastre sob a ótica da pessoa idosa em Teresópolis/RJ, este estudo se propôs a descrever e analisar, numa perspectiva de interface da sociologia e da gerontologia, dimensões objetivas e simbólicas de afetação das pessoas idosas e seus familiares, em contexto de desastre, bem como as estratégias de enfrentamento adotadas. Trata-se de um estudo exploratório e analítico, de natureza descritiva, com a utilização do método qualitativo de investigação. Foram utilizadas três técnicas integradas, a de pesquisa bibliográfica, análise documental e a de relatos orais, por meio de entrevistas semiestruturadas. Entrevistas com 19 idosos, seis familiares e cinco membros da comunidade são apresentadas. A partir das incursões realizadas, os resultados analisados nos discursos dos idosos, dos familiares, do meio oficial e da mídia são subdivididos nas dimensões (material, simbólica ou interpessoal) expressas. Os resultados evidenciam o desencontro de perspectivas e objetivos entre os atores oficiais, os midiáticos, os idosos afetados e seus familiares. Em relação à Teresópolis/RJ, este se constitui um campo emblemático, onde a afetação dos idosos e familiares caracteriza-se como contínua, complexa e multidimensional, marcada pelo descomprometimento do ente público para com os direitos da pessoa idosa. A presente pesquisa busca, portanto, estabelecer novos diálogos para o atendimento, de forma humanizada e multidimensional, das demandas emergentes da população em processo de envelhecimento no contexto de desastres. / In Brazil, still there is lack of research, public policy and institutional actions for the elderly population in disaster context. Disasters related to rains affect about 30% of Brazilian cities annually. Specifically in the Southeast, the State of Rio de Janeiro (RJ), is affected by recurrent disasters, being Teresópolis/RJ in second place among the cities with the highest number of fatal victims, from 1991 to 2012. Due to the structural context of social inequality that unfolds in territorialities also unequal, some social groups become more susceptible than others when exposed to threat factors associated with a poor infrastructure, as formed by the elderly. In order to understand the disaster from the perspective of the elderly in Teresópolis/RJ, this study aimed to describe and analyze, in a interface perspective of sociology and gerontology, objective and symbolic dimensions of affectation and coping strategies adopted by older people and their families in disaster context. This is an exploratory and analytical study of descriptive nature, using the qualitative research method. Three integrated techniques were used, the literature review, document analysis and oral reports, through semi-structured interviews. Interviews were conducted with 19 elderly people, six family members and five community members. Based on the incursions conducted in the field, the results analyzed were divided according to the dimensions (material, symbolic or interpersonal) expressed in the discourse of the elderly people and their families, the official actors and the media. The results show the mismatch of perspectives and goals between official actors, media, affected elderly people and their families. Teresópolis/RJ constitutes an emblematic field, where the affectation of elderly people and the family members is characterized as continuous, complex and multidimensional, marked with the disengagement of the public entity for the rights of the elderly people. The present research aims, therefore, to establish new dialogues for the care, in humanized and multidimensional way, of the emerging demands of aging process in the disaster context.