Perspectivas da investigação sobre determinantes sociais em câncer

As diferenças socioeconômicas têm reflexos no perfil epidemiológico de câncer, no que diz respeito a incidência, mortalidade, sobrevida e qualidade de vida após o diagnóstico. Neste artigo examinam-se as disparidades da ocorrência de câncer na população brasileira e sintetizam-se evidências das investigações sobre determinantes sociais em câncer. Foram considerados os principais fatores que modulam a influência das condições socioeconômicas na ocorrência do câncer, como tabagismo, consumo de álcool, hábitos alimentares e obesidade, ocupação e acesso aos serviços de saúde. Modificações nas condições sociais dependem de mudanças estruturais na sociedade, a exemplo de melhorias do nível educacional; no entanto, investigações epidemiológicas bem conduzidas podem contribuir para o planejamento de intervenções visando a reduzir o impacto dos determinantes sociais em câncer. Esses estudos devem prover estratégias para promoção da qualidade das informações de incidência e mortalidade; realização periódica de inquéritos populacionais sobre prevalência de fatores de risco para câncer; desenvolver desenhos epidemiológicos mais eficientes para avaliar o efeito de fatores etiológicos em câncer e suas relações com o status social; análise de programas de rastreamento para tumores passíveis de detecção precoce; e avaliações do acesso da população ao diagnóstico e tratamento. Essas pesquisas devem contemplar populações em distintas regiões do mundo, em particular aquelas vivendo em regiões marginalizadas da dinâmica do atual sistema econômico global.

Disciplinas de Fundamentos de Matemática: uma discussão à luz dos significados da palavra “fundamentos”

Based on a survey of summaries of courses on the Foundations of Mathematics, from Mathematics Teacher Education programs in the southern part of Brazil, and some remarks on the legislation related to the course syllabuses, we discuss the meaning of the word ""Foundations"" in order to reflect on the proposals of these issues in the courses, which will be undergoing reformulation. The opinions of students in one of these courses regarding the meaning of the term ""foundations"", as well as the data obtained from the survey and the remarks regarding legislation, may lead to considerations about the possibilities for a better qualification of the initial education of Mathematics teachers.

The effectiveness of educational practice in diabetic foot: a view from Brazil

Background: The aim of the present study was to evaluate the prevention and self-inspection behavior of diabetic subjects with foot at ulcer risk, no previous episode, who participated in the routine visits and standardized education provided by the service and who received prescribed footwear. This evaluation was carried out using a questionnaire scoring from 0-10 (high scores reflect worse practice compliance). Results: 60 patients were studied (30 of each sex); mean age was 62 years, mean duration of the disease was 17 years. As for compliance, 90% showed a total score <= 5, only 8.7% regularly wore the footwear supplied; self foot inspection 65%, 28,3% with additional familiar inspection; creaming 77%; proper washing and drying 88%; proper cutting of toe nails 83%; no cuticle cutting 83%; routine shoe inspection 77%; no use of pumice stones or similar abrasive 70%; no barefoot walking 95%. Conclusion: the planned and multidisciplinary educational approach enabled high compliance of the ulcer prevention care needed in diabetic patients at risk for complications. In contrast, compliance observed for the use of footwear provided was extremely low, demonstrating that the issue of its acceptability should be further and carefully addressed. In countries of such vast dimensions as Brazil multidisciplinary educational approaches can and should be performed by the services providing care for patients with foot at risk for complications according to the reality of local scenarios. Furthermore, every educational program should assess the learning, results obtained and efficacy in the target population by use of an adequate evaluation system.

The accuracy of the Clock Drawing Test compared to that of standard screening tests for Alzheimer`s disease: results from a study of Brazilian elderly with heterogeneous educational backgrounds

Background: Although the Clock Drawing Test (CDT) is the second most used test in the world for the screening of dementia, there is still debate over its sensitivity specificity, application and interpretation in dementia diagnosis. This study has three main aims: to evaluate the sensitivity and specificity of the CDT in a sample composed of older adults with Alzheimer`s disease (AD) and normal controls; to compare CDT accuracy to the that of the Mini-mental State Examination (MMSE) and the Cambridge Cognitive Examination (CAMCOG), and to test whether the association of the MMSE with the CDT leads to higher or comparable accuracy as that reported for the CAMCOG. Methods: Cross-sectional assessment was carried out for 121 AD and 99 elderly controls with heterogeneous educational levels from a geriatric outpatient clinic who completed the Cambridge Examination for Mental Disorder of the Elderly (CAMDEX). The CDT was evaluated according to the Shulman, Mendez and Sunderland scales. Results: The CDT showed high sensitivity and specificity. There were significant correlations between the CDT and the MMSE (0.700-0.730; p < 0.001) and between the CDT and the CAMCOG (0.753-0.779; p < 0.001). The combination of the CDT with the MMSE improved sensitivity and specificity (SE = 89.2-90%; SP = 71.7-79.8%). Subgroup analysis indicated that for elderly people with lower education, sensitivity and specificity were both adequate and high. Conclusions: The CDT is a robust screening test when compared with the MMSE or the CAMCOG, independent of the scale used for its interpretation. The combination with the MMSE improves its performance significantly, becoming equivalent to the CAMCOG.

Enrollment in Physical Education Is Associated With Health-Related Behavior Among High School Students

METHODS: A total of 4210 students attending public high schools in Pernambuco (northeast of Brazil) were selected using random 2-stage cluster sampling. Data were collected by using the Global School-based Student Health Survey. The independent variable was the frequency of participation in PE classes, whereas physical activity, television viewing, smoking, and alcohol, fruit, vegetables and soda consumption were dependent variables. Logistic regressions were carried out to perform crude and adjusted analysis of the association between enrollment in PE classes and health-related behaviors. RESULTS: Sixty-five percent of students do not take part in PE classes, with a significantly higher proportion among females (67.8%). It was observed that enrollment in PE classes was positively associated with physical activity, TV viewing, and fruit consumption, but was negatively associated with soda drinking. The likelihood of reporting being active and eating fruit on a daily basis was 27% and 45% higher, respectively, among those who participate in at least 2 classes per week in comparison with those who do not. Students who participate in PE classes had 28-30% higher likelihood of reporting lower TV viewing during week days. CONCLUSIONS: Findings suggest that higher levels of enrollment in PE classes could play a role in the promotion of health-related behaviors among high school students.

Professional development and a discussion of the professional preparation provided by information and library science degree programs in public universities in Madrid, 2000-2005

A study was designed to determine how the degree programs in Information and library science available in 2000-2005 at the public universities of Madrid fit the tabour market needs of their students. The methodology used was the development of a questionnaire addressed to graduates. Although the number of surveys completed is not high (118), the authors believe that the results obtained permit a series of conclusions that may be extrapolated to the entire cohort.

Political Systems and the Perspective on Nursing Education during the Spanish Transition (from the Franco Regime to Democracy). A Contribution based on Nursing History

The aim of this study is to describe the changes in nursing education during the process prior to and after the establishment of democracy in Spain. It begins with the hypothesis that differences in social and political organization influenced the way the system of nursing education evolved, keeping it in line with neopositivistic schemes and exclusively technical approaches up until the advent of democracy. The evolution of a specific profile for nursing within the educational system has been shaped by the relationship between the systems of social and political organization in Spain. To examine the insertion of subjects such as the anthropology of healthcare into education programs for Spanish nursing, one must consider the cultural, intercultural and transcultural factors that are key to understanding the changes in nursing education that allowed for the adoption of a holistic approach in the curricula. Until the arrival of democracy in 1977, Spanish nursing education was solely technical in nature and the role of nurses was limited to the tasks and procedures defined by the bureaucratic thinking characteristic of the rational-technological paradigm. Consequently, during the long period prior to democracy, nursing in Spain was under the influence of neopositivistic and technical thinking, which had its effect on educational curricula. The addition of humanities and anthropology to the curricula, which facilitated a holistic approach, occurred once nursing became a field of study at the university level in 1977, a period that coincided with the beginnings of democracy in Spain.

Proposal of a High-Level Language for Writing Self Modifying Programs

This paper proposes a simple high-level programming language, endowed with resources that help encoding self-modifying programs. With this purpose, a conventional imperative language syntax (not explicitly stated in this paper) is incremented with special commands and statements forming an adaptive layer specially designed with focus on the dynamical changes to be applied to the code at run-time. The resulting language allows programmers to easily specify dynamic changes to their own program`s code. Such a language succeeds to allow programmers to effortless describe the dynamic logic of their adaptive applications. In this paper, we describe the most important aspects of the design and implementation of such a language. A small example is finally presented for illustration purposes.

A geometrical approach of 3-D FEA for educational purposes applied to electrostatic fields

A geometrical approach of the finite-element analysis applied to electrostatic fields is presented. This approach is particularly well adapted to teaching Finite Elements in Electrical Engineering courses at undergraduate level. The procedure leads to the same system of algebraic equations as that derived by classical approaches, such as variational principle or weighted residuals for nodal elements with plane symmetry. It is shown that the extension of the original procedure to three dimensions is straightforward, provided the domain be meshed in first-order tetrahedral elements. The element matrices are derived by applying Maxwell`s equations in integral form to suitably chosen surfaces in the finite-element mesh.

Prerequisite Programs at Schools: Diagnosis and Economic Evaluation

In this study, 20 Brazilian public schools have been assessed regarding good manufacturing practices and standard sanitation operating procedures implementation. We used a checklist comprised of 10 parts ( facilities and installations, water supply, equipments and tools, pest control, waste management, personal hygiene, sanitation, storage, documentation, and training), making a total of 69 questions. The implementing modification cost to the found nonconformities was also determined so that it could work with technical data as a based decision-making prioritization. The average nonconformity percentage at schools concerning to prerequisite program was 36%, from which 66% of them own inadequate installations, 65% waste management, 44% regarding documentation, and 35% water supply and sanitation. The initial estimated cost for changing has been U.S.$24,438 and monthly investments of 1.55% on the currently needed invested values. This would result in U.S.$0.015 increase on each served meal cost over the investment replacement within a year. Thus, we have concluded that such modifications are economically feasible and will be considered on technical requirements when prerequisite program implementation priorities are established.

Adult language input in the early childhood educational setting

Age-related changes in the adult language addressed to children aged 2;0-4;0 years in polyadic conditions were investigated in Australian childcare centres. The language that 21 staff members addressed to these children was coded for multiple variables in the broad social categories of prosody, context, speech act and gesture. The linguistic components were coded within the categories of phonology, lexicon, morphology, syntax and referential deixis. Minimal age-related differences were found. Explanations for the similarity of the adult language input across the age groups within the early childhood educational environment, will be discussed

Learning for fun: The unique contribution of educational leisure experiences

What do visitors want or expect from an educational leisure activity such as a visit to a museum, zoo, aquarium or other such experience? Is it to learn something or to experience learning? This paper uses the term 'learning for fun' to refer to the phenomenon in which visitors engage in a learning experience because they value and enjoy the process of learning itself. Five propositions regarding the nature of learning for fun are discussed, drawing on quantitative and qualitative data from visitors to a range of educational leisure activities. The commonalities between learning for fun and other theoretical constructs such as 'experience,' 'flow', 'intrinsic motivation', and 'curiosity' are explored. It is concluded that learning for fun is a unique and distinctive offering of educational leisure experiences, with implications for future research and experience design.

Print versus website physical activity programs: A randomized trial

Mediated physical activity interventions can reach large numbers of people at low cost. Programs delivered through the mail that target the stage of motivational readiness have been shown to increase activity. Communication technology (websites and e-mail) might provide a means for delivering similar programs. Randomized trial conducted between August and October 2001. Participants included staff at an Australian university (n=655; mean AGE=43, standard deviation, 10 years). Participants were randomized to either an 8-week, stage-targeted print program (Print) or 8-week, stage-targeted website (Web) program. The main outcome was change in self-reported physical activity.

Economic , Educational and Conservation Benefits of Sea Turtle Based Ecotourism: A Study Focused on Mon Repos

The study examines the economic, educational and conservation values of sea turtle-based ecotourism in Australia. The centre-piece of this research is a case study undertaken at the Mon Repos Conservation Park located near the town of Bundaberg, Queensland. Each year from mid-November to end of March, thousands of visitors visit Mon Repos Conservation Park to view sea turtles either nesting on the one km stretch of beach or to see hatchlings emerge from their nests and march on to the sea or both. As a result of this activity there are considerable economic benefits to the Bundaberg region during the sea turtle season. The study examines the economic impact of sea turtle viewing at Mon Repos to the region. The study assesses the recreational value of sea turtle viewing. Furthermore, sea turtle-based ecotourism also provides educational and conservation benefits that are important for the protection and conservation of sea turtles, especially in Australia. The study specifies the extent of the educational impact and conservation appreciation of sea turtle viewing at Mon Repos Conservation Park. As a background to the study, Mon Repos visitors’ profile and socio-economic data of visitors are provided. In order to conduct this study, 1,200 survey forms were distributed, out of which 519 usable responses were obtained.