Estimated dietary intakes and sources of flavanols in the German population (German National Nutrition Survey II)

Background/Objectives Data from intervention studies suggest a beneficial effect of flavanols on vascular health. However, insufficient data on their intake have delayed the assessment of their health benefits. The aim of this study was to estimate intake of flavanols and their main sources among people living in Germany. Subjects/Methods Data from diet history interviews of the German National Nutrition Survey II for 15,371 people across Germany aged 14–80 years were analyzed. The FLAVIOLA Flavanol Food Composition Database was compiled using the latest US Department of Agriculture and Phenol-Explorer Databases and expanded to include recipes and retention factors. Results Mean intake of total flavanols, flavan-3-ol monomers, proanthocyanidins (PA), and theaflavins in Germany was 386, 120, 196, and 70 mg/day, respectively. Women had higher intakes of total flavanols (399 mg/day) than men (372 mg/day) in all age groups, with the exception of the elderly. Similar results were observed for monomers (108 mg/day for men, 131 mg/day for women) and PA (190 mg/day; 203 mg/day), although intake of theaflavins was higher in men (74 mg/day; 66 mg/day). There was an age gradient with an increase in total flavanols, monomers, and theaflavins across the age groups. The major contributor of total flavanols in all subjects was pome fruits (27 %) followed by black tea (25 %). Conclusions This study demonstrated age- and sex-related variations in the intake and sources of dietary flavanols in Germany. The current analysis will provide a valuable tool in clarifying and confirming the potential health benefits of flavanols.

Recovering lost lives: researching women in legal history

Drawing on the research I undertook into the life of Gwyneth Bebb, who in 1913 challenged the Law Society of England and Wales for their refusal to admit women to the solicitors’ profession, this article focuses on the range of sources one might use to explore the lives of women in law, about whom there might be a few public records but little else, and on the ways in which sources, even official ones, might be imaginatively used. It traces the research process from the case that inspired the research (Bebb v The Law Society [1914] 1 Ch 286) through to the creation of an entry in the Oxford Dictionary of National Biography and what this means for women’s history, emphasising the importance of asking the ‘woman question’ and seeking out the broader significance of a woman’s life in the context of her times.

Glädje i vårdandets värld

Föreliggande vårdvetenskapliga studie har som syfte att avtäcka och synliggöra glädjesom idé i vårdandets värld. Glädje sammanbinds med vårdandet genom kärleken somden tongivande kraften hos glädje. Vårdandets sak har genom historien alltid varit attlindra lidande och att tjäna liv och hälsa i en anda av kärlek och barmhärtighet. Dennastudie om glädje i vårdandet har en övergripande idéhistorisk inriktning och resultatetsammanställs i form av ett idémönster. Tolkningen sker genom en hermeneutisk ansatsmed fokus på förståelse av själva vårdandet. För att djupare förstå glädje, dessursprungsidé, väsen och uttrycksformer granskas begreppet ’glädje’ och de näraliggandebegreppen ’glad’ och ’ljus’ i etymologiska ordböcker samt i svenska, engelska ochlatinska ordböcker. Som stöd för tolkningen används klassiska texter innehållandefilosofers tankar om glädje. Glädje som idé glimtar fram i form av ett sjufaldigtmönster. Detta mönster innehåller särdrag hos glädje och det hjärtas natur somrespektive särdrag förverkligas i. I andlig mening utgör hjärtat livets medelpunkt ochkänslornas hemvist. Mönstret bildar bakgrund och blir vägledande vid den hermeneutiska läsningen omglädje, så som den framträder i berättelser om vårdande under åren 1900–1933. Dehistoriska källorna utgörs av facktidskriften Svensk sjukskötersketidning, böcker medberättelser om vårdande, arkivmaterial samt läroböcker om vårdarbete. Resultatetmynnar ut i ett idémönster, där idéer om det som gör glädje verksamt som vårdandeframträder. Dessa är det sanna hjärtats rena glädje – kärlek, glädje är ett kärleksbevis.Det brinnande hjärtats djupa glädje – livsglädje, glädje inspirerar och genererar kraft.Det bärande hjärtats glansfulla glädje – generositet, glädje är en gåva till den andra medlöfte om hjälp. Det inbjudande hjärtats glittrande glädje – gemenskap, glädje inbjudertill gemenskap. Det upprymda hjärtats uppsluppna glädje – integration, glädje gör attmänniskan kan glömma sitt lidande och närma sig den hon önskar vara. Detstämningsfulla hjärtats högtidliga glädje – bevärdigande, glädje skapar en anda ochatmosfär där människan upplever sig hedrad. Det fridfulla hjärtats stora glädje –räddning, en glädje visar sig när människan har erhållit det som kan begäras av gott ochundsluppet ont och är förnöjd med sin levnads lott. Förhoppningen är att dennagrundforskning ska öppna för ett nytt seende som kan leda till att glädjeuppmärksammas i vårdandets värld och artikuleras där.

Políticas públicas de educação para assentados da Reforma Agrária: o caso do PRONERA Saúde na Transamazônica

As ações dos Agentes Comunitários de Saúde são reconhecidas em sua relevância nas legislações brasileira que se concretiza em 2002 com a Lei nº 10.507 de 10 de Julho de 2002 que cria a Profissão do Agente Comunitário de Saúde e dá outras providências, posteriormente substituída pela Lei 11.350, de 05 de outubro de 2006. Contudo a história dos ACS‟s remonta períodos bem anteriores como à criação do Programa dos Agentes Comunitários de Saúde (PACS) em 1991, considerado começo da profissionalização do ACS‟s. Diante disso, o Programa Nacional de Educação na Reforma Agrária (PRONERA) vem para dar sua contribuição na formação de Técnicos Agentes Comunitários de Saúde (TACS‟s). De maneira concisa o PRONERA emerge como Política Pública Educacional em 2009, quando o mesmo se consolida no artigo 33 da Lei nº 11.947/09 e no final de 2010 onde é assinado o Decreto nº 7.352/10, que trata da educação do campo e institui formalmente o PRONERA no Ministério do Desenvolvimento Agrário (MDA). Assim, o PRONERA compõe a Política de Educação do Campo, ao mesmo tempo se caracteriza como Política Pública de Educação vinculada à Reforma Agrária. O PRONERA é um Programa do Governo Federal, através do Ministério de Desenvolvimento Agrário, coordenado pelo Instituto Nacional de Colonização e Reforma Agrária (INCRA) em convênio com as Universidades Públicas, em parceria com Movimentos Sociais e agentes governamentais estaduais e municipais. Oferece cursos de educação básica, técnica e tecnológica, ensino superior e pós graduação. Nosso objeto aqui está na análise do projeto “Saúde em movimento na Transamazônica: Curso de Formação Integrada em Técnico Agente Comunitário de Saúde (TACS) e Ensino Médio”, portanto no PRONERA Saúde que é apenas um dos projetos do PRONERA no Pará. Este abrange os municípios de Altamira, Senador José Porfírio, Medicilândia, Anapú e Pacajá, o curso foi projetado e aprovado em 2005 e começou em 2006 e finalizado em julho de 2011. Iniciou com 90 discentes todos ACS‟s das prefeituras parceiras (Altamira, Anapú, Medicilândia, Pacajá, Sen. José Porfírio). Esses discentes foram selecionados por uma equipe técnica do PRONERA, a partir das indicações dos Movimentos Sociais locais, principalmente dos Sindicatos dos Trabalhadores Rurais. Para o desenvolvimento dessa pesquisa utilizamos os Relatórios de Atividades do PRONERA Saúde e as entrevistas com os discentes (ACS‟s). A perspectiva teórico metodológica de análise das fontes para construção dissertativa se deu com base na teoria crítica marxista e nas leituras e contribuições da Educação Ambiental crítica, a relação saúde, meio ambiente e políticas públicas permeia a pesquisa e possibilita uma interação fundamental para busca de melhoria de vida desses agentes sociais.

O golpe de 1964 e a instauração da ditadura civil-militar no Pará: apoios e resistências

Este artigo, inserido nos debates historiográficos sobre a ditadura civil-militar no Brasil (1964-1985), pretende contribuir para o conhecimento da história política do estado do Pará antes, durante e após o golpe de estado de 1964. Examinamos preferencialmente a participação dos militares e o apoio de setores da sociedade civil ao golpe militar, e a repressão que sofreram os estudantes e organizações de esquerda e políticos "populistas". Na perspectiva metodológica dos estudos de história local e regional, as principais fontes utilizadas foram os jornais de Belém, livros de memórias, trabalhos acadêmicos e fontes orais.

Trends in Brazilian academic production in the History of Mathematics Education: directions from EBRAPEM

The number of papers on History of Mathematics Education presented at EBRAPEM (Brazilian Meeting of Graduate Students in Mathematics Education) has increased significantly between 2003 and 2008. This article presents a study with the aim of identifying themes, periods in focus, and sources and theoretical and methodological references used by the authors of the papers on History of Mathematics Education published in the proceedings of VII, VIII, IX, X, XI and XII EBRAPEM. The study indicates that the approach of ongoing research in History of Mathematics Education in Brazil has been similar to the approach of research in History of Education in general. However, the institutional separation between these two areas of investigation is noted as a factor rendering communication between both groups of researchers difficult.

A família e o indivíduo no curso vital: compreensão trigeracional sobre a morte e o morrer

The death has been considered a forbidden issue. To develop studies that promote reflections about it allows the enlargement of the understanding as regarding the death as about life in that both are related during the human existence. This research aimed to understand the death’s conceptions and family meanings to three different generations. For this goal, through phenomenological methodology, were achieved individual interviews with adolescents, both his parents and the grandfather, all belonging to the same family. After to understand the participant’s experiences, six thematic categories were created: a) Death’s meanings; b) The death of himself; c) The death of another and/or its possibility; d) Sources of support; e) The family in the death’s presence; f) The life in the death’s inevitability presence. From these categories, the dates were phenomenologically. The participants showed similar reports in several times, confirming the literature that says that the daily life experiences among the family members take the family to form a peculiar way to understand and an interpret their experiences. This identity family, however, did not prevent each participant to develop his particular history based in idiosyncratic elements and associated with the stage of life cycle that it is. The reports showed that the prohibition of death in society is still very present, which prevents that discussions about the issue are present in daily life. This study provided for participants to reflect on their experiences around the phenomenon of death and, consequently, about the inseparable relationship between living and dying. It has also reiterated the literature, showing the similarity of views among the family members of three generations face a vital phenomenon potentially impacting the life cycle of individual and family.

The construction of the African perspective: a history of the General History of Africa project (Unesco)

This article analyzes the construction of the African perspective in the General History of Africa project (GHA), focusing on the period between 1965 and 1979. With the participation of over two hundred international experts under the auspices of Unesco, this was one of the greatest intellectual projects of the twentieth century. Based on primary sources, this analysis emphasizes the internal conflicts involved in the construction of the African perspective as a hegemonic line of thought in the GHA. Two critical moments of the project were found in the investigation: the controversial years (1972-78), and the pragmatic years (1978-82). As a result of these disputes, theoretical and methodological parameters were constructed, in addition to eight volumes of material published in the 1980s, and recently republished in Brazil.

Predictors of the risk of falls among elderly with chronic atrial fibrillation

OBJECTIVES: Though elderly persons with chronic atrial fibrillation have more comorbidities that could limit indications for the chronic use of anticoagulants, few studies have focused on the risk of falls within this particular group. To evaluate the predictors of the risk of falls among elderly with chronic atrial fibrillation, a cross-sectional, observational study was performed. METHODS: From 295 consecutive patients aged 60 years or older with a history of atrial fibrillation who were enrolled within the last 2 years in the cardiogeriatrics outpatient clinic of the Instituto do Coracao do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, 107 took part in this study. Their age was 77.9 +/- 6.4 years, and 62 were female. They were divided into two groups: a) no history of falls in the previous year and b) a history of one or more falls in the previous year. Data regarding the history of falls and social, demographic, anthropometric, and clinical information were collected. Multidimensional assessment instruments and questionnaires were applied. RESULTS: At least one fall was reported in 55 patients (51.4%). Among them, 27 (49.1%) presented recurrent falls, with body lesions in 90.4% and fractures in 9.1% of the cases. Multivariate logistic regression showed that self-reported difficulty maintaining balance, use of amiodarone, and diabetes were independent variables associated with the risk of falls, with a sensitivity of 92.9% and a specificity of 44.9%. CONCLUSION: In a group of elderly patients with chronic atrial fibrillation who were relatively independent and able to attend an outpatient clinic, the occurrence of falls with recurrence and clinical consequences was high. Difficulty maintaining balance, the use of amiodarone and a diagnosis of diabetes mellitus were independent predictors of the risk for falls. Thus, simple clinical data predicted falls better than objective functional tests.

Postnatal longitudinal evaluation of children diagnosed with prenatal hydronephrosis: insights in natural history and referral pattern

Objectives Clinical significance and management of prenatal hydronephrosis (PNH) are sources of debate. Existing studies are flawed with biased cohorts or inconsistent follow-up. We aimed to evaluate the incidence of pathology in a large cohort of PNH and assess the biases and outcomes of this population. Methods We reviewed 1034 charts of fetuses with PNH. Records of delivered offspring were reviewed at a pediatric center and analyzed with respect to prenatal and postnatal pathology and management. Results Prenatal resolution of hydronephrosis occurred in 24.7% of pregnancies. On first postnatal ultrasound, some degree of dilatation was present in 80%, 88% and 95% of mild, moderate and severe PNH cases, respectively. At the end of follow-up, hydronephrosis persisted in 10%, 25% and 72% of children, respectively. Incidence of vesicoureteral reflux did not correlate with severity of PNH. Children with postnatal workup had more severe PNH than those without. Conclusions Despite prenatal resolution totalizing 25%, pelvic dilatation persisted on first postnatal imaging in most cases, thus justifying postnatal ultrasound evaluation. Whereas most mild cases resolved spontaneously, a quarter of moderate and more than half of severe cases required surgery. Patients with postnatal imaging and referral had more severe PNH, which could result in overestimation of pathology. (c) 2012 John Wiley & Sons, Ltd.

Accuracy of Timed Up and Go Test for screening risk of falls among community-dwelling elderly

Objective: To determine the accuracy of the Timed Up and Go Test (TUGT) for screening the risk of falls among community-dwelling elderly individuals. Method: This is a prospective cohort study with a randomly by lots without reposition sample stratified by proportional partition in relation to gender involving 63 community-dwelling elderly individuals. Elderly individuals who reported having Parkinson's disease, a history of transitory ischemic attack, stroke and with a Mini Mental State Exam lower than the expected for the education level, were on a wheelchair and that reported a single fall in the previous six months were excluded. The TUGT, a mobility test, was the measure of interested and the occurrence of falls was the outcome. The performance of basic activities of daily living (ADL) and instrumental activities of daily living (IADL) was determined through the Older American Resources and Services, and the socio-demographic and clinical data were determined through the use of additional questionnaires. Receiver Operating Characteristic Curves were used to analyze the sensitivity and specificity of the TUGT. Results: Elderly individuals who fell had greater difficulties in ADL and IADL (p<0.01) and a slower performance on the TUGT (p=0.02). No differences were found in socio-demographic and clinical characteristics between fallers and non- fallers. Considering the different sensitivity and specificity, the best predictive value for discriminating elderly individuals who fell was 12.47 seconds [(RR= 3.2) 95% CI: 1.3- 7.7]. Conclusions: The TUGT proved to be an accurate measure for screening the risk of falls among elderly individuals. Although different from that reported in the international literature, the 12.47 second cutoff point seems to be a better predictive value for Brazilian elderly individuals.

Risk factors for geriatric patient falls in rehabilitation hospital settings: a systematic review

Objective: To review the literature to identify and synthesize the evidence on risk factors for patient falls in geriatric rehabilitation hospital settings. Data sources: Eligible studies were systematically searched on 16 databases from inception to December 2010. Review methods: The search strategies used a combination of terms for rehabilitation hospital patients, falls, risk factors and older adults. Cross-sectional, cohort, case-control studies and randomized clinical trials (RCTs) published in English that investigated risks for falls among patients ≥65 years of age in rehabilitation hospital settings were included. Studies that investigated fall risk assessment tools, but did not investigate risk factors themselves or did not report a measure of risk (e.g. odds ratio, relative risk) were excluded. Results: A total of 2,824 references were identified; only eight articles concerning six studies met the inclusion criteria. In these, 1,924 geriatric rehabilitation patients were followed. The average age of the patients ranged from 77 to 83 years, the percentage of women ranged from 56% to 81%, and the percentage of fallers ranged from 15% to 54%. Two were case-control studies, two were RCTs and four were prospective cohort studies. Several intrinsic and extrinsic risk factors for falls were identified. Conclusion: Carpet flooring, vertigo, being an amputee, confusion, cognitive impairment, stroke, sleep disturbance, anticonvulsants, tranquilizers and antihypertensive medications, age between 71 and 80, previous falls, and need for transfer assistance are risk factors for geriatric patient falls in rehabilitation hospital settings.

Falls and fractures in the elderly with sinus node disease: the impact of pacemaker implantation

Background. Falls and fractures in the elderly are among the leading causes of disability. We investigated whether pacemaker implantation prevents falls in patients with SND in a large cohort of patients. Methods. Patient demographics and medical history were collected prospectively. Fall history was retrospectively reconstituted from available medical records. The 10-year probability for major osteoporotic fractures was calculated retrospectively from available medical records using the Swiss fracture risk assessment tool FRAX-Switzerland. Results. During a mean observation period of 2.3 years after implantation, the rates of fallers and injured fallers with fracture were reduced to 15% and 6%, respectively. This corresponds to a relative reduction in the number of fallers of 75% (P < 0.001) and of injured fallers of 63% (P = 0.014) after pacemaker implantation. Similarly, the number of falls was reduced from 60 (48%) before pacemaker implantation to 22 (18%) thereafter (relative reduction 63%, P = 0.035) and the number of falls with injury from 22 (18%) to 7 (6%), which corresponds to a relative reduction of 67%, P = 0.013. Conclusion. In patients with SND, pacemaker implantation significantly reduces the number of patients experiencing falls, the total number of falls, and the risk for osteoporotic fractures.

The Gandhi Story: An Official Indian Comic Book History of the Mahatma

In 1966, the Publications Division of the Government of India’s Ministry of Information and Broadcasting released a 47-page hardbound comic book entitled The Gandhi Story. Written and illustrated by S.D. Sawant and S.D. Badalkar, it opens with a foreword by independent India’s first prime minister, Jawaharlal Nehru, and presents a state sanctioned narrative of Gandhi’s life and role in the Indian struggle for independence. This articles examines how the creators of The Gandhi Story drew upon both textual and visual sources as reference material during its creation, and investigates the relationship between "official" and "unofficial" nationalisms of twentieth-century Indian history.

Latin Sources of Inspiration for 15th and 16th Century Orthodox Prints

The project studied the history of Orthodox graphic art in the context of artistic links between the Eastern and Western worlds, tracing the routes by which iconographic models from western Europe penetrated into eastern Europe and underscoring the role of central European countries in the shaping of the culture of the modern Orthodox church. One important element was the identification of graphic prototypes and export routes for woodcutting blocks which travelled from Germany via Prague, Cracow and Vilnius to Moscow and Kiev, revealing the artistic ties between followers of different religions. Another major element was a study of the appearance of copper engraving in the second half of the 17th century.