Experiencias positivas de la aplicación de un método didáctico para estudiantes del programa de Fisioterapia en la práctica de promoción y prevención

El Objetivo fue aplicar un método didáctico diseñado para estudiantes de Promoción y Prevención del programa de Fisioterapia de la Universidad del Rosario, en Colombia, con el fin de facilitar sus acciones de educación en salud con la comunidad. Metodología: el proyecto incluyó tres fases: la revisión teórica de las competencias del docente en la práctica y los diferentes métodos empleados para desarrollar acciones de promoción y prevención en el trabajo comunitario, el diseño del método y su aplicación con los estudiantes y, finalmente, la evaluación y el respectivo análisis de resultados. Resultados: se evidenció que frente al desarrollo de otras experiencias docentes, la aplicación de un método didáctico con los estudiantes les permitía desarrollar hábilmente sus competencias para el trabajo con grupos poblacionales. Conclusiones: la aplicación de un método didáctico en práctica favorece la adquisición de herramientas pedagógicas por los estudiantes y mejora su desempeño en el desarrollo de las actividades programadas.

Informal access to urban land. Housing policies devoted to vulnerable sectors implemented in Cordoba-Argentina

The urban growth in Latino American cities, in a neoliberal context, has led to several population groups to having no possibilities to the access to urban land. Informal and irregular urban settlements increase, requiring attention from local governments, with actions and strategies in order to achieve both the regularization of such situation and further prevention. In the city of Córdoba different informal and irregular operations have taken place promoted by different actors. Furthermore, policies focused on regularization which have been promoted, have few intervention mechanisms, a fact that becomes critical, especially for the urban problems it causes. The main aim of this article is to present a classification over different modes of urban land acquirement taking place out of both urban and civil legislations. Afterwards, different informal settlement typologies are described, as well as the policies focused on them, together with their respective effects and impacts.

Búsqueda de selección en el polimorfismo 677C>T (c.665C>T) del gen de la metilentetrahidrofolato reductasa (MTHFR) en una población Colombiana

Se realizó un estudio genético – poblacional en dos grupos etarios de población colombiana con la finalidad de evaluar las diferencias genéticas relacionadas con el polimorfismo MTHFR 677CT en busca de eventos genéticos que soporten la persistencia de este polimorfismo en la especie humana debido que este ha sido asociado con múltiples enfermedades. De esta manera se genotipificaron los individuos, se analizaron los genotipos, frecuencias alélicas y se realizaron diferentes pruebas genéticas-poblacionales. Contrario a lo observado en poblaciones Colombianas revisadas se identificó la ausencia del Equilibrio Hardy-Weinberg en el grupo de los niños y estructuras poblacionales entre los adultos lo que sugiere diferentes historias demográficas y culturales entre estos dos grupos poblacionales al tiempo, lo que soporta la hipótesis de un evento de selección sobre el polimorfismo en nuestra población. De igual manera nuestros datos fueron analizados junto con estudios previos a nivel nacional y mundial lo cual sustenta que el posible evento selectivo es debido a que el aporte de ácido fólico se ha incrementado durante las últimas dos décadas como consecuencia de las campañas de fortificación de las harinas y suplementación a las embarazadas con ácido fólico, por lo tanto aquí se propone un modelo de selección que se ajusta a los datos encontrados en este trabajo se establece una relación entre los patrones nutricionales de la especie humana a través de la historia que explica las diferencias en frecuencias de este polimorfismo a nivel espacial y temporal.  

Do Colombian students underestimate higher education returns?

We analyze the determinants of subjective returns of higher education in Colombia. The information on expectations has been collected in categories, motivating the use of interval regression and an ordered probit approaches for modeling the relationship between beliefs and measures of ability, conditioning on individual, school and regional covariates. The results suggest that there are considerable differences in the size of the expected returns according to some population groups and a strong dominance of college against technical education. Gender gaps disappear in college education but it is found that girls tend to believe that professional wages are more concentrated into higher income categories than boys. Finally, it seems that Colombian students overestimate the pecuniary returns to education.

Filogeografia de la truita comuna (Salmo trutta) basada en la diversitat molecular del DNA mitocondrial

Les anàlisis realitzades en cent deu poblacions de truita comuna (Salmo trutta) que abarquen el seu rang natural de distribució indiquen que el patró filogenètic es relaciona amb les tres grans vessants on es troba distribuïda l'espècie: ponto-càspia, atlàntica i mediterrània. Aquesta diferenciació estaria associada a l'aïllament de les vessants durant el Quaternari. L'origen de l'espècie es relaciona amb la vessant ponto-càspia, d'acord amb els models biogeogràfics que postulen l'origen asiàtic de la ictiofauna europea. S'ha detectat també un segon nivell de divergència dins de cada vessant que dóna com a resultat l'existència de sis llinatges evolutius: Atlàntic i Duero a la vessant atlàntica, els llinatges Adriàtic, Mediterrani i Marmoratus als rius mediterranis, i el llinatge Danubi a la zona ponto-càspia. Les glaciacions del Pleistocè han modificat profundament el rang de distribució de la truita comuna, especialment a la vessant atlàntica, on s'han proposat quatre grans refugis glacials: a l'est de la capa de gel, a Europa central, a l'entorn del canal de la Mànega i a l'entorn del golf de Biscaia; tot i que només els tres primers haurien participat en la recolonització del nord d'Europa al final de l'última glaciació. El quart refugi, que inclou el sud de França i el Cantàbric hauria estat l'origen de l'expansió cap al sud durant el Pleistocè Superior d'un grup de poblacions distribuïdes actualment a la vessant atlàntica ibèrica, i també hauria servit de base per a l'expansió cap al nord d'altres grups de truita durant interglacials anteriors. A la vessant atlàntica de la peninsula Ibèrica, l'estructura poblacional es troba associada a la xarxa hidrogràfica i es determinen fins a cinc unitats poblacionals: les truites dels rius Cantàbrics, les del Miño, les del Duero, les del Tajo i les del Guadalquivir. Les poblacions del Guadalquivir pertanyerien a un grup d'influència mediterrània. Els marcadors d'al·lozims i de DNA mitocondrial es troben fortament correlacionats en aquesta vessant, on apunten cap als mateixos grups de poblacions. Per contra, els rius de la vessant mediterrània haurien estat colonitzats pels llinatges Adriàtic i Mediterrani i s'hauria produït una intensa intergradació secundària entre aquests llinatges durant els períodes glacials a partir de l'expansió de les poblacions retingudes a les capçaleres durant els interglacials. Els grups de hibridació, l'aïllament i la deriva en el període interglacial fa que els grups de poblacions identificats pels marcadors d'al·lozims i de DNA mitocondrial no coincideixin.

Prebiotic interventions for the improvement of gut health

The increasing awareness of the role that the colonic microflora plays in maintaining host health within the gastrointestinal tract and systemically through the absorption of metabolites, has attracted a lot of interest, within the nutritional sciences, in developing dietary tools for controlling the colonic microflora. Among those dietary tools, prebiotics aim to improve health by stimulating numbers and/or activities of the beneficial bacteria in the gut, mainly bifidobacteria and lactobacilli. The ability of incorporating prebiotics in various food processes together with recent developments in understanding how prebiotics are metabolised by health promoting bacteria, allow us to specifically aim such dietary interventions towards selected population groups, such as infants and elderly, and disease states, such as colon cancer and irritable bowel disease.

Molecular mechanisms by which dietary isoflavones potentially prevent atherosclerosis

Dietary isoflavones are currently receiving much attention because of their potential role in preventing coronary artery disease and other chronic diseases. Accumulating evidence from cell culture and laboratory animal experiments indicates that isoflavones have the potential to prevent or delay atherogenesis. Suggested mechanisms of action include: a reduction in low-density lipoprotein (LDL) cholesterol and a potential reduction in the susceptibility of the LDL particle to oxidation; (2) an improvement in vascular reactivity; (3) an inhibition of pro-inflammatory cytokines, cell adhesion proteins and nitric oxide (NO) production; and (4) an inhibition of platelet aggregation. These mechanisms are consistent with the epidemiological evidence that a high consumption of isoflavone-rich soy products is associated with a reduced incidence of coronary artery disease. Biological effects of isoflavones are dependent on many factors, including dose consumed, duration of use, protein-binding affinity, and an individual's metabolism or intrinsic oestrogenic state. Further clinical studies are necessary to determine the potential health effects of isoflavones in specific population groups as we currently know little about age-related differences in exposure to these compounds and there are few guidelines on optimal dose for cardiovascular health benefits.

Revised QUICKI provides a strong surrogate estimate of insulin sensitivity when compared with the minimal model

OBJECTIVE: To compare insulin sensitivity (Si) from a frequently sampled intravenous glucose tolerance test (FSIGT) and subsequent minimal model analyses with surrogate measures of insulin sensitivity and resistance and to compare features of the metabolic syndrome between Caucasians and Indian Asians living in the UK. SUBJECTS: In all, 27 healthy male volunteers (14 UK Caucasians and 13 UK Indian Asians), with a mean age of 51.2 +/- 1.5 y, BMI of 25.8 +/- 0.6 kg/m(2) and Si of 2.85 +/- 0.37. MEASUREMENTS: Si was determined from an FSIGT with subsequent minimal model analysis. The concentrations of insulin, glucose and nonesterified fatty acids (NEFA) were analysed in fasting plasma and used to calculate surrogate measure of insulin sensitivity (quantitative insulin sensitivity check index (QUICKI), revised QUICKI) and resistance (homeostasis for insulin resistance (HOMA IR), fasting insulin resistance index (FIRI), Bennetts index, fasting insulin, insulin-to-glucose ratio). Plasma concentrations of triacylglycerol (TAG), total cholesterol, high density cholesterol, (HDL-C) and low density cholesterol, (LDL-C) were also measured in the fasted state. Anthropometric measurements were conducted to determine body-fat distribution. RESULTS: Correlation analysis identified the strongest relationship between Si and the revised QUICKI (r = 0.67; P = 0.000). Significant associations were also observed between Si and QUICKI (r = 0.51; P = 0.007), HOMA IR (r = -0.50; P = 0.009), FIRI and fasting insulin. The Indian Asian group had lower HDL-C (P = 0.001), a higher waist-hip ratio (P = 0.01) and were significantly less insulin sensitive (Si) than the Caucasian group (P = 0.02). CONCLUSION: The revised QUICKI demonstrated a statistically strong relationship with the minimal model. However, it was unable to differentiate between insulin-sensitive and -resistant groups in this study. Future larger studies in population groups with varying degrees of insulin sensitivity are recommended to investigate the general applicability of the revised QUICKI surrogate technique.

Obesity and health in Europeans aged 50 years and older

Background: Obesity is increasing globally across all population groups. Limited data are available on how obesity patterns differ across countries. Objective: To document the prevalence of obesity and related health conditions for Europeans aged 50 years and older, and to estimate the association between obesity and health outcomes across 10 European countries. Methods: Data were obtained from the 2004 Survey of Health, Ageing and Retirement in Europe, a cross-national survey of 22 777 Continental Europeans over the age of 50 years. The health outcomes included self-reported health, disability, doctor-diagnosed chronic health conditions and depression. Multivariate regression analysis was used to predict health outcomes across weight classes (defined by body mass index [BMI] from self-reported weight and height) in the pooled sample and individually in each country. Results: The prevalence of obesity (BMI >= 30) ranged from 12.8% in Sweden to 20.2% in Spain for men and from 12.3% in Switzerland to 25.6% in Spain for women. Adjusting for compositional differences across countries changed little in the observed large heterogeneity in obesity rates throughout Europe. Compared with normal weight individuals, men and women with greater BMI had significantly higher risks for all chronic health conditions examined except heart disease in overweight men. Depression was linked to obesity in women only. Particularly pronounced risks of impaired health and chronic health conditions were found among severely obese people. The effects of obesity on health did not vary significantly across countries. Conclusions: Cross-country differences in the prevalence of obesity in older Europeans are substantial and exceed socio-demographic differentials in excessive body weight. Obesity is associated with significantly poorer health outcomes among Europeans aged 50 years and over, with effects similar across countries. Large heterogeneity in obesity throughout Europe should be investigated further to identify areas for effective public policy. (C) 2007 Published by Elsevier Ltd on behalf of The Royal Institute of Public Health.

Psychometric evaluation of the Disordered Eating Attitude Scale (DEAS). English version

Eating attitudes are defined as beliefs, thoughts, feelings, behaviors and relationship with food They could influence people`s food choices and their health status Objective This study aimed to adapt from Portuguese to English the Disordered Eating Attitude Scale (DEAS) and evaluate its validity and reliability. The original scale in Portuguese was translated and adapted into English and was applied to female university students of University of Minnesota USA (n = 224). Internal consistency was determined (Cronbach`s Alpha). Convergent validity was assessed by correlations between Eating Attitude Test-26 (EAT-26) and Restrain Scale (RS). Reliability was evaluated applying twice the scale to a sub-sample (n = 30). The scale was back translated into Portuguese and compared with the original version and discrepancies were not found. The internal consistency was .76 The DEAS total score was significantly associated with EAT-26 (r = 0.65) and RS (r = 0 69) scores The correlation between test-retest was r = 09 The English version of DEAS showed appropriate internal consistency, convergent validity and test-retest reliability and will be useful to assess eating attitudes in different population groups in English spoken countries. (C) 2010 Elsevier Ltd. All rights reserved

DEVELOPMENT AND VALIDITY OF THE DISORDERED EATING ATTITUDE SCALE (DEAS)

The aim of this study was to develop and validate the Disordered Eating Attitude Scale to measure disordered eating attitudes, defined as abnormal beliefs, thoughts, feelings, behaviors, and relationship regarding food. Exploratory factor analysis was performed and internal consistency assessed in a sample of female university students (N=196). Convergent validity was acceptable based on statistically significant correlations with the Eating Attitude Test-26 and Restraint Scale. Known-groups validity was determined by comparing the student sample`s mean scores against scores of an eating disorder group (N=51). The Disordered Eating Attitude Scale comprises 25 questions and five subscales explaining 54.3% of total variance. The total scores differentiated student, bulimia, and anorexia groups. The scale should prove useful for evaluating eating attitudes in various population groups and eating disordered patients.

Estado e terceiro setor na prestação de serviços públicos: o programa Nacionmal de DST e Aids: 1994-2005

O presente trabalho busca analisar os motivos pelos quais o Estado realiza parceria com organizações da sociedade civil na prestação de serviços públicos. Para tanto, tomamos como exemplo a política pública nacional de combate ao HIV/Aids, capitaneada pelo Programa Nacional de DST/Aids do Ministério da Saúde, tido como referência na realização de parcerias com estas organizações. A análise é conduzida tentando responder três questões básicas: os motivos da parceria, as áreas ou as modalidades de serviço onde esta parceria ocorre e como se dão os mecanismos de contratualização. O trabalho mostra a construção de uma política de parcerias a partir da constatação das dificuldades do Estado em prestar diversos serviços dentro desta política, serviços estes que já eram executados com sucesso por muitas organizações não-governamentais. A partir disso se estabelece uma espécie de divisão de trabalho, na qual as ONGs desempenharão diversas atividades no campo da prevenção, assistência e direitos humanos, notadamente com as chamadas populações mais vulneráveis à epidemia. Após vários anos centralizada no governo federal, esta política passa por um processo de descentralização, inserindo de forma mais definitiva os níveis estadual e municipal de governo. No bojo deste processo, percebe-se um conflito ainda não resolvido a respeito da ¿titularidade¿ destes serviços: se serão incorporados pelo Estado ou se continuarão sendo executados pelas ONGs. Apesar disso, a política de descentralização foi pactuada de forma a se garantir que um percentual mínimo de recursos destinadas a cada unidade da federação seja destinado ao apoio de projetos destas organizações, representando uma institucionalização desta política de parcerias.

Caracterização morfofisiológica de isolados do gênero Cylindrocladium

Com o objetivo de caracterizar o complexo gênero anamórfico Cylindrocladium, dezoito isolados foram cultivados em meios de cultura distintos, mantidos sob diferentes temperaturas, além de ter conídios e vesículas terminais analisados morfologicamente para identificação correta das culturas. Inoculações em diferentes hospedeiros foram, também, realizadas para avaliação do comportamento patogênico dos isolados estudados. Com relação aos caracteres morfológicos, pôde-se observar que ocorrem alterações nas dimensões de conídios e na morfologia da vesícula terminal devido, provavelmente, à mudança do substrato de cultivo. Porém, a variabilidade natural nas características dessas estruturas é tão elevada que dificulta a identificação correta dos isolados. em uma mesma cultura, por exemplo, foram observadas vesículas terminais de diferentes morfologias. Pôde-se constatar que existem diferenças patogênicas e fisiológicas entre os isolados, uma vez que houve a formação de grupos distintos quando tais características foram consideradas. Estas diferenças, provavelmente, sejam devidas à constituição genética distinta existente entre os isolados.

Estrutura genética de Chromis multilineata (Guichenot, 1853) (Perciformes Pomacentridae) na costa NE do Brasil e ilhas oceânicas: evidências de um passado evolutivo instável.

The fauna of Brazilian reef fishes comprises approximately 320 species distributed along the coast of the mainland and islands ocean. Little is known about the levels of connectivity between their populations, but has been given the interest in the relations between the offshore and the islands of the Brazil, in a biogeographical perspective. The oceanic islands Brazilian hosting a considerable number of endemic species, which are locally abundant, and divide a substantial portion of its reef fish fauna with the Western Atlantic. Among the richest families of reef fish in species are Pomacentridae. This study analyzed through analysis of sequences of the mitochondrial DNA control region (D-loop), the standards-breeding population of C. Multilineata in different areas of the NE coast of Brazil, involving both oceanic islands (Fernando de Noronha Archipelago and of St. Peter and St. Paul) and continental shelf (RN and BA). To this aim, partial sequences were used in the region HVR1 of mtDNA (312pb). The population structure and parameters for the estimates of genetic variability, molecular variance (AMOVA), estimation of the index for fixing (FST) and number of migrants were determined. The phylogenetic relationships between the populations were estimated using neighbor-joining (NJ) method. A group of Bayesian analysis was used to verify population structure, according to haplotype frequency of each individual. The genetic variability of populations was extremely high. The populations sampled show moderate genetic structure, with a higher degree of genetic divergence being observed for the sample of the Archipelago of St. Peter and St. Paul. At smaller geographical scale, the sample of Rio Grande do Norte and the Archipelago of Fernando de Noronha do not have genetic differentiation. Three moderately differentiated population groups were identified: a population group (I), formed by the Rio Grande do Norte (I') and the archipelago of Fernando de Noronha (I''), and two other different groups formed by the island population of the archipelago of Saint Peter and St. Paul (II) and Bahia (III). The genetic patterns found suggest that the species has suffered a relatively recent radiation favoring the absence of shared haplotypes. C. multilineata seems to constitute a relatively homogenous population along the West Atlantic coast, with evidence of a moderate population genetic structure in relation to the Archipelago of St. Peter and St. Paul. These data supports the importance of the dispersal larvae by marine current and the interpopulation similarity this species.

Percepção das condições de saúde bucal por gestantes atendidas em uma unidade de saúde no município de Araraquara, São Paulo, Brasil

OBJETIVOS: avaliar a percepção das condições de saúde bucal de um grupo de gestantes, através da aplicação do índice General Oral Health Assessment Index (GOHAI). MÉTODOS: participaram do estudo 53 gestantes que freqüentavam uma Unidade Básica de Saúde em Araraquara, São Paulo. Foi aplicado um questionário contendo questões do índice GOHAI, questões sobre a autopercepção das condições bucais e sobre as características sócio-demográficas. Por meio dos testes não-paramétricos Mann-Whitney e Kruskall-Wallis, foram determinados a associação das variáveis sociais e de autopercepção com o índice GOHAI. RESULTADOS: a percepção das condições bucais, medida pelo índice GOHAI, foi positiva e apresentou um valor médio de 31,6. Os dados subjetivos mostram que apenas 12,0% das gestantes classificaram sua condição bucal como ruim, a maioria declarou nenhum problema dentário, embora 58,7% tenha relatado distúrbios gengivais. As questões como dor e/ou desconforto foram as mais percebidas pelas gestantes. CONCLUSÕES: as gestantes fizeram uma avaliação positiva de sua condição bucal, estando o índice GOHAI associado a variáveis relacionadas à autopercepção. Tal índice pode ser aplicado em grupos populacionais como as gestantes, possibilitando medidas educativas e/ou preventivas direcionadas às suas reais necessidades.