Loneliness in Middle and Old Age

Purpose of the research: (a) To identify the degree of much loneliness reported in the Portuguese population over 50 years of age and (b) test whether loneliness can be predicted by socio-demographic, health related or social characteristic of the sample other than age. Materials and methods: 1174 late middle age and older adults were interviewed face to face by different interviewers across the country; after the informed consent was signed, we asked the participants several socio-demographic and health-related questions; finally we asked ‘‘How often do you feel lonely?’’ and participants responded according to a five point Likert scale. Principal results: The results showed that 12% of participants reporting feeling lonely often or always, whereas 40% reporting never feeling lonely. The remaining 48% self-reported they felt lonely seldom or sometimes. Additionally, results show that, when taken together, variables such as marital status, type of housing, residence settings, health conditions, social satisfaction, social isolation, lack of interest, transportation, and age were predictors of loneliness. Major conclusions: (1) The association of loneliness with advanced age has been greatly exaggerated by mass media and common sense; (2) But although our findings did not confirm the most alarmist views, the 12% of older adults reporting that they are feeling lonely always or often should be cause for attention and concern. It is necessary to understand the meaning, reasons and level of suffering implied on those feelings of loneliness. (3) Our findings suggest that it makes no sense to construe age as a singular feature or cause for feelings of loneliness. Instead, age and also a number of other features combine to predict feelings of loneliness. But even with our predictor variables there was a substantial of variance left unexplained. Therefore it is necessary to continue exploring how feelings of loneliness arise from the experience of living and how they can be changed.

How middle managers contribute to strategy formation process: connection of strategy processes and strategy practices

The role of middle management is essential when managing integrative and emergent strategy formation processes. We stand out the importance of its role connecting micro and macro organizational level offering a very important contribution when examining the strategy-as-practice perspective and integrative strategy formation process. The main goal of this research is to analyse the relationship between the integrative strategy formation process and the roles of middle management under the strategy-as-practice perspective. To check it out we adopted a qualitative methodology droving a case analysis in a Spanish University. Data was collected by means of personal interviews with members of different levels of the Institution, documents analysis and direct observation. In advance of some results we find out that the University develops an integrative strategy formation process and confers to middle management an important role extended all over the organization.

ANTECEDENTS AND CONSEQUENCES OF HOUSEHOLD FINANCIAL MANAGEMENT IN BRAZILIAN LOWER-MIDDLE-CLASS

Through two complementary and exploratory studies – one qualitative and one quantitative – this research aims to understand the ways in which lower-middle-class families in Brazil manage their household finances. The study proposes an integrated framework that brings together various previously disconnected theoretical fragments. Based on a survey with a sample of 165 lower-middle-class female consumers of a retail company in São Paulo, we explored and tested, via a quantitative study, how antecedents such as personal characteristics affect the financial management process, as well as its consequences, either negatively as defaults or positively as savings. The model calibration and analysis were derived from a series of regression analyses. The results revealed the mediator role that financial management plays in the relationship between personal characteristics and defaults and savings. Compared to previous studies with consumers of more affluent countries, we identified peculiar findings among Brazilian lower-middle-class consumers: inadequate attention to control, weak or no focus on short- or long-range planning, widespread absence of budget surplus, and influence of critical events on episodes of default.

Factors affecting nutrition behavior among middle-class adolescents in urban area of Northern region of Brazil

INTRODUCTION: Brazil has been called a nation in nutrition transitional because of recent increases in the prevalence of obesity and related chronic diseases. With overweight conditions already prevalent among middle-income populations, there exists a need to identify factors that influence nutrition behavior within this group. OBJECTIVE: To address this subject, a research study was implemented among middle-class adolescents attending a large private secondary school in Manaus, Amazonas, Brazil. The study determined the availability and accessibility of snack foods as well as subjects’ attitudes and preferences towards, and the influence of family and friends on healthy (high-nutrient density) snack choices. METHODS: The 4-stage process included: (a) a nutrition expert focus group discussion that reported local nutrition problems in general and factors related to adolescent nutrition, (b) an adolescent pilot survey (n=63) that solicited information about snacking preferences and habits as well as resources for nutrition information and snack money; (c) a survey of various area food market sources to determine the availability and accessibility of high nutrient density snacks; and (d) a follow-up adolescent survey (n=55) that measured snack food preferences and perceptions about their cost and availability. RESULTS: Results included the finding that, although affordable high nutrient density snacks were available, preferences for low nutrient density snacks prevailed. The adolescents were reportedly more likely to be influenced by and obtain nutrition information from family members than friends. CONCLUSION: From study results it is apparent that a focus on food availability will not automatically result in proper nutritional practices among adolescents. This fact and the parental influence detected are evidence of a need to involve adolescents and their parents in nutrition education campaigns to improve adolescent snack food choices.

Occupational accidents among middle and high school students of the state of São Paulo, Brazil

OBJECTIVES: To estimate the prevalence of occupational injuries and identify their risk factors among students in two municipalities. METHODS: A cross-sectional survey was conducted in public schools of the municipalities of Santo Antonio do Pinhal and Monteiro Lobato, Brazil. A stratified probabilistic sample was drawn from public middle and high schools of the study municipalities. A total of 781 students aged 11 to 19 years participated in the study. Students attending middle and high school answered a comprehensive questionnaire on living and working conditions, as well as aspects of work injuries, and health conditions. Multiple logistic regression models were fitted to estimate risk factors of previous and present occupational injuries. RESULTS: Of 781 students, 604 previously had or currently have jobs and 47% reported previous injuries. Among current workers (n=555), 38% reported injuries on their current job. Risk factors for work injuries with statistically significant odds ratio >2.0 included attending evening school, working as a housekeeper, waiter or brickmaker, and with potentially dangerous machines. CONCLUSIONS: The study results reinforce the need of restricting adolescent work and support communities to implement social promotion programs.

Reliability of nasal auscultation and their relation to middle ear condition – a clinical interest to pediatrics respiratory physiotherapy

Background: Acute respiratory infections are usual in children under three years old occurring in upper respiratory tract, having an impact on child and caregiver’s quality of life predisposing to otitis media or bronchiolitis. There are few valid and reliable measures to determine the child’s respiratory condition and to guide the physiotherapy intervention. Aim: To assess the intra and inter rater reliability of nasal auscultation, to analyze the relation between sounds’ classification and middle ear’s pressure and compliance as well as with the Clinical Severity Score. Methods: A cross-sectional observational study was composed by 125 nursery children aged up to three years old. Tympanometry, pulmonary and nasal auscultation and application of Clinical Severity Score were performed to each child. Nasal auscultation sounds’ were recorded and sent to 3 blinded experts, that classified, as “obstructed” and “unobstructed”, with a 48 hours interval, in order to analyze inter and intra rater reliability. Results: Nasal auscultation revealed a substantial inter and intra rater reliability (=0,749 and evaluator A - K= 0,691; evaluator B - K= 0,605 and evaluator C - K= 0,724, respectively). Both ears’ pressure was significantly lower in children with an "unobstructed" nasal sound when compared with an “obstructed” nasal sound (t=-3,599, p<0,001 in left ear; t=-2,258, p=0,026 in right ear). Compliance in both ears was significantly lower in children with an "obstructed" nasal sound when compared with “unobstructed” nasal sound (t=-2,728, p=0,007 in left ear; t=-3,830, p<0,001 in right ear). There was a statistically significant association between sounds’ classification and tympanograms types in both ear’s (=11,437, p=0,003 in left ear; =13,535, p=0,001 in right ear). There was a trend to children with an "unobstructed" nasal sound that had a lower clinical severity score when compared with “obstructed” children. Conclusion: It was observed a good intra and substantial inter reliability for nasal auscultation. Nasal auscultation sounds’ classification was related to middle ears’ pressure and compliance.

Socioeconomic inequities in the health and nutrition of children in low/middle income countries

OBJECTIVE: To describe the effects of social inequities on the health and nutrition of children in low and middle income countries. METHODS: We reviewed existing data on socioeconomic disparities within-countries relative to the use of services, nutritional status, morbidity, and mortality. A conceptual framework including five major hierarchical categories affecting inequities was adopted: socioeconomic context and position, differential exposure, differential vulnerability, differential health outcomes, and differential consequences. The search of the PubMed database since 1990 identified 244 articles related to the theme. Results were also analyzed from almost 100 recent national surveys, including Demographic Health Surveys and the UNICEF Multiple Indicator Cluster Surveys. RESULTS: Children from poor families are more likely, relative to those from better-off families, to be exposed to pathogenic agents; once they are exposed, they are more likely to become ill because of their lower resistance and lower coverage with preventive interventions. Once they become ill, they are less likely to have access to health services and the quality of these services is likely to be lower, with less access to life-saving treatments. As a consequence, children from poor family have higher mortality rates and are more likely to be undernourished. CONCLUSIONS: Except for child obesity and inadequate breastfeeding practices, all the other adverse conditions analyzed were more prevalent in children from less well-off families. Careful documentation of the multiple levels of determination of socioeconomic inequities in child health is essential for understanding the nature of this problem and for establishing interventions that can reduce these differences.

How many low birthweight babies in low- and middle-income countries are preterm?

OBJECTIVE: To assess the prevalence of preterm birth among low birthweight babies in low and middle-income countries. METHODS: Major databases (PubMed, LILACS, Google Scholar) were searched for studies on the prevalence of term and preterm LBW babies with field work carried out after 1990 in low- and middle-income countries. Regression methods were used to model this proportion according to LBW prevalence levels. RESULTS: According to 47 studies from 27 low- and middle-income countries, approximately half of all LBW babies are preterm rather than one in three as assumed in studies previous to the 1990s. CONCLUSIONS: The estimate of a substantially higher number of LBW preterm babies has important policy implications in view of special health care needs of these infants. As for earlier projections, our findings are limited by the relative lack of population-based studies.

Distributed active traction control system applied to the RoboCup middle size league

This work addresses the problem of traction control in mobile wheeled robots in the particular case of the RoboCup Middle Size League (MSL). The slip control problem is formulated using simple friction models for ISePorto Team robots with a differential wheel configuration. Traction was also characterized experimentally in the MSL scenario for relevant game events. This work proposes a hierarchical traction control architecture which relies in local slip detection and control at each wheel, with relevant information being relayed to a higher level responsible for global robot motion control. A dedicated one axis control embedded hardware subsystem allowing complex local control, high frequency current sensing and odometric information procession was developed. This local axis control board is integrated in a distributed system using CAN bus communications. The slipping observer was implemented in the axis control hardware nodes integrated in the ISePorto robots and was used to control and detect loss of for traction. %and to detect the ball in the kicking device. An external vision system was used to perform a qualitative analysis of the slip detection and observer performance results are presented.

Access to medicines for acute illness in middle income countries in Central America

OBJECTIVE : To analyze the main predictors of access to medicines for persons who experienced acute health conditions. METHODS : This was a cross-sectional analytic study, based on data from household surveys. We examined the predictors of: (1) seeking care for acute illness in the formal health care system and (2) obtaining all medicines sought for the acute condition. RESULTS : The significant predictors of seeking health care for acute illnesses were urban geographic location, head of household with secondary school education or above, age under 15, severity of illness perceived by the respondent, and having health insurance. The most important predictor of obtaining full access to medicines was seeking care in the formal health care system. People who sought care in the formal system were three times more likely to receive all the medicines sought (OR 3.0, 95%CI 2.3;4.0). For those who sought care in the formal health system, the strongest predictors of full access to medicines were seeking care in the private sector, having secondary school education or above, and positive perceptions of quality of health care and medicines in public sector health facilities. For patients who did not seek care in the formal health system, full access to medicines was more likely in Honduras or Nicaragua than in Guatemala. Urban geographic location, higher economic status, and male gender were also significant predictors. CONCLUSIONS : A substantial part of the population in these three countries sought and obtained medicines outside of the formal health care system, which may compromise quality of care and pose a risk to patients. Determinants of full access to medicines inside and outside the formal health care system differ, and thus may require different strategies to improve access to medicines. 

Biogeographic and palaeoclimatic relationships of the Middle Pliocene ichthyofauna of the Samoggia Torrent (Bologna, Italy)

New Middle Pliocene ichthyofauna (2.4-2.2 Ma) from central-eastern Italy (Samoggia Torrent, Bologna) are described. These ichthyolites were found in a rather thin laminated layer that was deposited after the 2.4 Ma climatic crisis. The origin of this deposit, in which 31 taxa have been classified, is to be related to anoxic events on a regional and, probably, supraregional scale. This ichthyofaunistic association, which consists of living genera, is characterized by a clearcut predominance of mesopelagic species. The palaeoclimatic characters of these ichthyofauna indicate subtropical-type waters, while from a palaeobiogeographic point of view there is a close relationship with the present-day Atlantic-Mediterranean bioprovince. The Samoggia deposit has yielded six taxa that are absent or only occasionally present in the Mediterranean: one of these, Spratelloides gracilis, is exclusive of the Indo-Pacific bioprovince.

Ecological aspects of American cutaneous leishmaniasis: 6. Man-biting sandfly fauna of a patch of residual forest in the middle and north-eastern region of the São Paulo State, Brazil

This report shows the phlebotomine vectorial role in the endemic cutaneous leishmaniasis situated in the middle and north-eastern region of the São Paulo, Brazil. Analysis of information encloses a sandfly man-biting fauna of four different patches of residual forest. So, using the human-bait and Shannon trap for a period of one year we have caught 16,869 sandflies. The predominance of Lutzomyia intermedia (85,6%) was clear. Moreover, the low density of Lutzomyia whitmani and Lutzomyia pessoai and their epidemiological implications at present and in the past are discussed. Information about the daily activity of some species is given and we emphasize for the first time, the diurnal activity of Lutzomyia firmatoi in the São Paulo State.

Biogeographic and palaeoclimatic relationships of the Middle Pliocene ichthyofauna of the Samoggia Torrent (Bologna, Italy)*

New Middle Pliocene ichthyofauna (2.4-2.2 Ma) from central-eastern Italy (Samoggia Torrent, Bologna) are described. These ichthyolites were found in a rather thin laminated layer that was deposited after the 2.4 Ma climatic crisis. The origin of this deposit, in which 31 taxa have been classified, is to be related to anoxic events on a regional and, probably, supraregional scale. This ichthyofaunistic association, which consists of living genera, is characterized by a clearcut predominance of mesopelagic species. The palaeoclimatic characters of these ichthyofauna indicate subtropical-type waters, while from a palaeobiogeographic point of view there is a close relationship with the present-day Atlantic-Mediterranean bioprovince. The Samoggia deposit has yielded six taxa that are absent or only occasionally present in the Mediterranean: one of these, Spratelloides gracilis, is exclusive of the Indo-Pacific bioprovince.

Nouvelles données sur le Miocène moyen marin ("Sallomacien") de Gironde (Bassin d'Aquitaine-France) Approche des paléoenvironnements New data about the maine Middle Miocene ("Sallomacian") of Gironde (Aquitaine Basin); paleoecological outline

The Mid Miocene marine formations of Salles area (former "Sallomacian" stage) have been studied again from numerous outcrops and cores. The deep structural framework influences notably of the characteristics and distribution of the deposits, which are neritic. The stratigraphy is stated precisely thanks to the planktonic fauna and floradetailed examination (probably Serravallian zones NN6 - N12). Several paleobiofacies are reconstituted from the rich invertebrate faunas, which give also paleoclimatic data.