Does Obesity Affect Outcomes In Children Admitted From Trauma Centers?

Introduction and Research Objectives: Pediatric obesity has reached epidemic proportions in the United States. In the critical care setting, obesity has yet to be fully studied. We sought to evaluate the effects of obesity in children who are admitted to a hospital from trauma centers using Kid's Inpatient Database (KID) during 2009. Methods: The study examined inpatient admissions from pediatric trauma patients in 2009 using the Kids´ Inpatient Database (KID). Patients (n=27599) were selected from the KID based on Age (AGE>1) and Admission Type (ATYPE=5) and assessed on Race, Sex, Length of Stay (LOS), Number of Diagnoses and Procedures, Severity of Illness (SOI), Risk of Mortality (ROM), Co-morbidities, and Intubation by comparing obese and non-obese cohorts. Chi-square test and student t-test were used to analyze the data. All variables were weighted to get national estimates. Results:The overall prevalence of obesity (those coded as having obesity as co-morbidity) was 1.6% with significantly higher prevalence among Blacks (1.8%), Hispanics (2.3%), and Native Americans (4.1%; p Conclusion: Our study using KID national database found that obese children who are admitted from trauma centers have a higher morbidity and LOS but lower mortality. Racial and gender inequalities of obesity prevalence is consistent with previous reports.

Generosidade e cooperação de crianças monitoradas e não monitoradas: a interação entre a condição socioeconômica e o ambiente escolar

Studies have shown that a person's socioeconomic status (SES) and the environment in which they are inserted modulate their pro-sociality. While children studying in schools with a more affluent student body tend to be more generous, adults with high SES in both real and experimental situations tend to be more selfish, greedy and individualistic. Another factor that influences pro-sociality is monitoring. When we do something under the supervision of another person, we tend to be more generous and cooperative, compared to situations in which no one is watching, even if the "observer" is a drawing of eyes. This monitoring effect occurs in both adults and children. To date, no studies have investigated whether the SES and the environment influence the pro-sociality of the children. There have also been no studies on how the monitoring effect might be influenced by SES and the environment (in this case, whether the environment is a public or private school). Given this context, our main objective was to investigate whether the generosity and cooperation of monitored and unmonitored kids is modulated by these factors. To this end, we did eight matches of the public goods, under monitoring and control conditions, with 249 children from the ages of 7 to 10 years enrolled in public and private schools in Natal, state of Rio Grande do Norte (Brazil). The SES of each child's family was assessed according to the Economic Classification Criterion of Brazil (2013). Contrary to our predictions, SES, school environment and experimental conditions did not significantly influence cooperation and generosity behavior when analyzed separately. We discuss whether the influences of resource and experimental design adopted for the current study and the historical and economic conditions of Brazil might explain these observations. Interestingly, when SES and school environment were analyzed together, an effect of monitoring on generosity and cooperation was detected. More specifically, monitoring had the effect of decreasing generosity among children with greater SES in private schools; and increased cooperation among children with greater SES in public schools. These results suggest that there is an influence of monitoring on the pro-sociality of children in relation to their SES and acquaintanceship environments. We argue that these observations may be explained by different preoccupations with reputation, according to the environment in which a child is inserted.

Análise fitoquímica e avaliação das atividades anti-inflamatória, antipeçonhenta e citotóxica de extratos aquosos de Aspidosperma pyrifolium e Ipomoea asarifolia

Envenomation caused by venomous animals, mainly scorpions and snakes, are a serious matter of public health. Tityus serrulatus is considered the most venomous scorpion in South America because of the high level of toxicity of its venom. It is responsible for causing serious accidents, mainly with kids. The species Bothrops jararaca is a serpent that has in its venom a complex mixture of enzyme, peptides and other molecules. The toxins of the venom of B. jararaca induce local and systemic inflammatory responses. The treatment chosen to serious cases of envenomation is the intravenous administration of the specific antivenom. However, the treatment is not always accessible to those residents in rural areas, so that they use medicinal plant extracts as the treatment. In this context, aqueous extracts, fractions and isolated compounds of Aspidosperma pyrifolium (pereiro) and Ipomoea asarifolia (salsa, salsa-brava), used in popular medicine, were studied in this research to evaluate the anti-inflammatory activity in the peritonitis models induced by carrageenan and peritonitis induced by the venom of the T. serrulatus (VTs), and in the local oedema model and inflammatory infiltrate induced by the venom of the B. jararaca, administrated intravenously. The results of the assays of cytotoxicity, using the MTT, showed that the aqueous extracts from the plant species presented low toxicity to the cells that came from the fibroblast of the mouse embryo (3T3).The chemical analysis of the extracts by High Performance Liquid Chromatography revealed the presence of the rutin flavonoid, in A. pyrifoliu, and rutin, clorogenic acid and caffeic acid, in I. asarifolia. Concerning the pharmacological evaluation, the results showed that the pre-treatment using aqueous extracts and fractions reduced the total leukocyte migration to the abdominal cavity in the peritonitis model caused by the carrageenan and in the peritonitis model induced by the T. serulatus venom. Yet, these groups presented anti-oedematous activity, in the local oedema model caused by the venom of the B. jararaca, and reduced the inflammatory infiltrate to the muscle. The serum (anti-arachnid and anti-bothropic) specific to each venom acted inhibiting the inflammatory action of the venoms and were used as control. The compounds identified in the extracts were also tested and, similar to the plant extracts, showed meaningful anti-inflammatory effects, in the tested doses. Thus, these results are indicating the potential anti-inflammatory activity of the plants studied. This is the first research that evaluated the possible biological effects of the A. pyrifolium and I. asarifolia, showing the biological potential that these species have.

Lovepaper display Sistema espositivo per la linea di prodotti cartacei Lovepaper

Il progetto di tesi è stato sviluppato durante il tirocinio, in collaborazione con Tipolito Salvioli e Kina Studio. Si tratta di un sistema espositivo per la linea di prodotti cartacei LovePaper.

Análise da qualidade do serviço na satisfação do cliente no processo de compra online: estudo de caso Vertbaudet

Nos dias de hoje, uma empresa não pode desenvolver um negócio sustentável limitando-se à oferta de um produto, é necessário compreender que muitas vezes o cliente recorre ao consumo de determinado bem devido ao serviço ao cliente que este tem associado (Grönroos, 2007). As empresas atualmente deparam-se com uma concorrência no serviço ao cliente prestado, sendo que a difusão da informação tecnológica e o aumento do uso de internet oferece às empresas oportunidades de desenvolver a sua oferta de serviço ao cliente e de se diferenciar da concorrência (Grönroos, 2007). Com vista a aprofundar e melhorar o conhecimento sobre o serviço ao cliente e o seu impacto na sua satisfação online surgiu a presente investigação. O objetivo principal da investigação é retratar esse impacto numa empresa portuguesa. Para o efeito foi utilizada a metodologia de Estudo de Caso. Neste estudo é feita uma caracterização da empresa, apresentação e desenvolvimento do conceito de serviço ao cliente e o seu impacto na satisfação do cliente no contexto online. A metodologia usada permitiu aplicar as dimensões da qualidade do serviço em contexto real, analisando o desempenho da Vertbaudet comparativamente aos seus maiores concorrentes: Zippy e Zara Kids. Por fim é descrito o período de estágio que originou o presente relatório, apresentando os objetivos e as atividades desenvolvidas.

Understandings of transnational families in debates on Migration and development

International migration sets in motion a range of significant transnational processes that connect countries and people. How migration interacts with development and how policies might promote and enhance such interactions have, since the turn of the millennium, gained attention on the international agenda. The recognition that transnational practices connect migrants and their families across sending and receiving societies forms part of this debate. The ways in which policy debate employs and understands transnational family ties nevertheless remain underexplored. This article sets out to discern the understandings of the family in two (often intermingled) debates concerned with transnational interactions: The largely state and policydriven discourse on the potential benefits of migration on economic development, and the largely academic transnational family literature focusing on issues of care and the micro-politics of gender and generation. Emphasizing the relation between diverse migration-development dynamics and specific family positions, we ask whether an analytical point of departure in respective transnational motherhood, fatherhood or childhood is linked to emphasizing certain outcomes. We conclude by sketching important strands of inclusions and exclusions of family matters in policy discourse and suggest ways to better integrate a transnational family perspective in global migration-development policy.

The Electoral Rise of Populist Radical Right Parties in Europe: Ideological Parameters and Social Motivations

Populist radical right parties have become major political actors in Europe. This paper analyses the path and the different phases that have led them from the fringes of public debate to their present signifi cance, which is based on their capacity to attract electoral support and infl uence the political agendas in their respective countries. Besides, an analysis of the core ideological beliefs of these parties, and of the topics on which their mobilization capacity rests, is provided, as well as of the type of voters that are attracted by them. Finally, the authors discuss the meaning and impact of the growing popularity of the ideas and proposals put forward by the populist radical right parties.

O perfil sociodemográfico de pacientes em pós-operatório imediato de prostatectomia

Identificar o perfil sociodemográfico de pacientes submetidos à prostatectomia. Método: estudo quantitativo, transversal e descritivo, realizado na clínica cirúrgica de um Hospital Universitário na cidade de Natal/RN/Brasil, com 50 indivíduos em pós-operatório imediato de prostatectomia. A coleta de dados deu-se com um roteiro de anamnese e exame físico. Para a análise estatística dos dados foi utilizado o Programa Statistical Package for the Social Sciences, versão 16.0. O projeto de pesquisa foi aprovado pelo Comitê de Ética da Universidade Federal do Rio Grande do Norte, protocolo nº 130/10 CEP/UFRN. Resultados: os homens entrevistados tinham idade média de 67,78 anos, 80% tinham companheiros, com número de filhos variando de zero a quatro (56%). Conclusão: o conhecimento do perfil sociodemográfico dos pacientes prostatectomizados proporciona um direcionamento das ações de enfermagem frente à realidade de vida dessa clientela, uma vez que os pacientes estudados apresentaram perfil similar ao observado em outras cidades brasileiras

Evaluating a School Community Linked Physical Activity Intervention Programme: a Multi-level Analysis.

Previous research has highlighted the importance of positive physical activity (PA) behaviors during childhood to promote sustained active lifestyles throughout the lifespan (Telama et al. 2005; 2014). It is in this context that the role of schools and teachers in facilitating PA education is promoted. Research suggests that teachers play an important role in the attitudes of children towards PA (Figley 1985) and schools may be an efficient vehicle for PA provision and promotion (McGinnis, Kanner and DeGraw, 1991; Wechsler, Deveraux, Davis and Collins, 2000). Yet despite consensus that schools represent an ideal setting from which to ‘reach’ young people (Department of Health and Human Services, UK, 2012) there remains conceptual (e.g. multi-component intervention) and methodological (e.g. duration, intensity, family involvement) ambiguity regarding the mechanisms of change claimed by PA intervention programmes. This may, in part, contribute to research findings that suggest that PA interventions have had limited impact on children’s overall activity levels and thereby limited impact in reducing children’s metabolic health (Metcalf, Henley & Wilkin, 2012). A marked criticism of the health promotion field has been the focus on behavioural change while failing to acknowledge the impact of context in influencing health outcomes (Golden & Earp, 2011). For years, the trans-theoretical model of behaviour change has been ‘the dominant model for health behaviour change’ (Armitage, 2009); this model focusses primarily on the individual and the psychology of the change process. Arguably, this model is limited by the individual’s decision-making ability and degree of self-efficacy in order to achieve sustained behavioural change and does not take account of external factors that may hinder their ability to realise change. Similar to the trans-theoretical model, socio-ecological models identify the individual at the focal point of change but also emphasises the importance of connecting multiple impacting variables, in particular, the connections between the social environment, the physical environment and public policy in facilitating behavioural change (REF). In this research, a social-ecological framework was used to connect the ways a PA intervention programme had an impact (or not) on participants, and to make explicit the foundational features of the programme that facilitated positive change. In this study, we examined the evaluation of a multi-agency approach to a PA intervention programme which aimed to increase physical activity, and awareness of the importance of physical activity to key stage 2 (age 7-12) pupils in three UK primary schools. The agencies involved were the local health authority, a community based charitable organisation, a local health administrative agency, and the city school district. In examining the impact of the intervention, we adopted a process evaluation model in order to better understand the mechanisms and context that facilitated change. Therefore, the aim of this evaluation was to describe the provision, process and impact of the intervention by 1) assessing changes in physical activity levels 2) assessing changes in the student’s attitudes towards physical activity, 3) examining student’s perceptions of the child size fitness equipment in school and their likelihood of using the equipment outside of school and 4) exploring staff perceptions, specifically the challenges and benefits, of facilitating equipment based exercise sessions in the school environment. Methodology, Methods, Research Instruments or Sources Used Evaluation of the intervention was designed as a matched-control study and was undertaken over a seven-month period. The school-based intervention involved 3 intervention schools (n =436; 224 boys) and one control school (n=123; 70 boys) in a low socioeconomic and multicultural urban setting. The PA intervention was separated into two phases: a motivation DVD and 10 days of circuit based exercise sessions (Phase 1) followed by a maintenance phase (Phase 2) that incorporated a PA reward program and the use of specialist kid’s gym equipment located at each school for a period of 4 wk. Outcome measures were measured at baseline (January) and endpoint (July; end of academic school year) using reliable and valid self-report measures. The children’s attitudes towards PA were assessed using the Children’s Attitudes towards Physical Activity (CATPA) questionnaire. The Physical Activity Questionnaire for Children (PAQ-C), a 7-day recall questionnaire, was used to assess PA levels over a school week. A standardised test battery (Fitnessgram®) was used to assess cardiovascular fitness, body composition, muscular strength and endurance, and flexibility. After the 4 wk period, similar kid’s equipment was available for general access at local community facilities. The control school did not receive any of the interventions. All physical fitness tests and PA questionnaires were administered and collected prior to the start of the intervention (January) and following the intervention period (July) by an independent evaluation team. Evaluation testing took place at the individual schools over 2-3 consecutive days (depending on the number of children to be tested at the school). Staff (n=19) and student perceptions (n = 436) of the child sized fitness equipment were assessed via questionnaires post-intervention. Students completed a questionnaire to assess enjoyment, usage, ease of use and equipment assess and usage in the community. A questionnaire assessed staff perceptions on the delivery of the exercise sessions, classroom engagement and student perceptions. Conclusions, Expected Outcomes or Findings Findings showed that both the intervention (16.4%) and control groups increased their PAQ-C score by post-intervention (p < 0.05); with the intervention (17.8%) and control (21.3%) boys showing the greatest increase in physical activity levels. At post-intervention, there was a 5.5% decline in the intervention girls’ attitudes toward PA in the aesthetic subdomains (p = 0.009); whereas the control boys had an increase in positive attitudes in the health domain (p = 0.003). No significant differences in attitudes towards physical activity were observed in any other domain for either group at post-intervention (p > 0.05). The results of the equipment questionnaire, 96% of the children stated they enjoyed using the equipment and would like to use the equipment again in the future; however at post-intervention only 27% reported using the equipment outside of school in the last 7 days. Students identified the ski walker (34%) and cycle (32%) as their favorite pieces of equipment; with the single joint exercises such as leg extension and bicep/tricep machine (<3%) as their least favorite. Key themes from staff were that the equipment sessions were enjoyable, a novel activity, children felt very grown-up, and the activity was linked to a real fitness experience. They also expressed the need for more support to deliver the sessions and more time required for each session. Findings from this study suggest that a more integrated approach within the various agencies is required, particularly more support to increase teachers pedagogical content knowledge in physical activity instruction which is age appropriate. Future recommendations for successful implementation include sufficient time period for all students to access and engage with the equipment; increased access and marketing of facilities to parents within the local community, and professional teacher support strategies to facilitate the exercise sessions.

Möjlighet till delaktighet i meningsfulla aktiviteter under sjukhusvistelse. : En beskrivning av barns egna upplevelser

Tidigare forskning inom detta område har fokuserat på barns vård, däremot har barns upplevelser utifrån ett aktivitetsperspektiv under sjukhusvistelse inte uppmärksammats. Författarnas uppfattning var att aktiviteter som erbjuds på barn- och ungdomskliniker oftast passar yngre barn och därför ansågs det relevant att tillfråga äldre barn om deras upplevelser av att kunna vara delaktiga i aktiviteter på sjukhus. Syftet var att beskriva barns upplevelser av möjlighet till delaktighet i meningsfulla aktiviteter under sjukhusvistelse. Kvalitativ metod användes med semi-strukturerade intervjuer. Ett bekvämlighetsurval användes och respondenterna var 12 barn i åldrarna 8-15 som befann sig på två barn- och ungdomskliniker i södra Sverige. Datamaterialet bearbetades med en kvalitativ innehållsanalys. Tolkningen av datamaterialet resulterade i det övergripande temat “Upplevelse av möjlighet till delaktighet i meningsfulla aktiviteter”. Resultatet delades in i tre kategorier; delaktighet, meningsfull aktivitet och aktiviteter på sjukhus. Slutsatsen var att barnen upplevde både möjligheter och begränsningar i att kunna vara delaktiga i aktiviteter under sin sjukhusvistelse. Majoriteten av barnen upplevde sig ha goda möjligheter till att kunna vara delaktiga i meningsfulla aktiviteter såsom att vistas på lekterapi, spela tv-spel och umgås med familj och vänner. 

O recreio no Jardim de Infância: espaço e tempo para construção de culturas da Infância

O recreio no jardim-de-infância é um dos poucos espaços que resta para que as crianças se encontrem e façam aquilo em que verdadeiramente são especialistas: brincar! Este deve ser um espaço e um tempo valorizados, pois é aí que este grupo constrói as culturas que o identificam e o distinguem como grupo geracional, distinto dos demais. Esta construção de culturas faz-se através das interações inerentes ao ato de brincar. Nesta sociedade globalizada, a competição e o sucesso académico fazem parte cada vez mais cedo da vida das crianças. Assim, é importante devolver-lhes estes espaços e tempos que lhes permitam brincar e jogar, uma vez que estas ações se assumem como indispensáveis para o seu bem-estar e para o desenvolvimento saudável das suas habilidades físicas, cognitivas, emocionais e sociais.

A estrutura psicossocial na turma de uma criança portadora de autismo

Dissertação submetida para satisfação parcial dos requisitos do grau de Mestre em Ciências da Educação — Especialização em Educação Especial

A entreajuda e a cooperação de braços dados com a diferenciação pedagógica

Relatório de estágio apresentado à Escola Superior de Educação de Paula Frassinetti, para obtenção do grau de mestre em Pré-escolar

A Gestão da dualidade Afetos/Limites, numa sala de 4 anos

Relatório de estágio para a obtenção do grau Mestre em Educação Pré-Escolar