Comportamento alimentar e imagem corporal entre estudantes de medicina

Transtornos do comportamento alimentar (TCA) tendem a ocorrer entre mulheres jovens, colocando universitárias como grupo de risco. Este estudo visa identificar comportamentos alimentares e imagem corporal como fatores de risco para TCA em estudantes de Medicina. É um estudo transversal com amostra aleatória representativa,que utilizou o índice de massa corporal (IMC) autorreferido; o BodyShapeQuestionnaire (BSQ) ; o BulimicInvestigatory Test Edinburgh (Bite) ;e o EatingAttitudes Test (EAT-26) . A estatística foi descritiva,com teste do qui-quadrado e Anova,e nível de significância p<0,05. Asmédias(DP) de idade e IMC foram20,8 (2,2) anos e 21,5 (2,6) kg/m². As prevalências foram: 27,7% apresentaram distorção da imagem corporal pelo BSQ; 31,7% expressaram comportamento alimentar anormal e 6,3% com risco para bulimia pelo Bite, sendo que 7,9% apresentaram sintomas com gravidade moderada/intensa; 19% tiveram risco de desenvolver distúrbios alimentares pelo EAT-26. Houve associação significativa entre IMC, imagem corporal e risco para TCA. Alunas de Medicina apresentaram risco subclínico ou estágio inicial de TCA e precisam de atenção para que estes distúrbios não prejudiquem sua saúde e prática profissionais.

Targeting of caries prevention at preschool children, a practice based study

Aim and design: To evaluate an oral health program directed to expecting families and their children. The intervention was carried out in one of the four health care areas of the city of Turku. Another area acted as a control. Subjects and methods: Children (n = 1217), born between January 1, 1998 and June 30, 1999, in the respective health care areas were screened for mutans streptococci bacteria (MS), and their caretakers were interviewed when the child was 18 months old. MScolonization was used as the child’s risk indicator. Intensified health education and the use of xylitol lozenges targeted at the children at risk were the main elements of the program. Controls and the non-MS-colonized children received routine prevention –examination and education at the ages of three and five years. Altogether 794 subjects were followed for 42 months after receiving consent from their caretakers. Associations of oral-health-related factors with MS colonization and caries increment were studied inside the control group. Results: MS colonization associated with the occupation of the caretaker and ethnicity. The program was effective in white-collar families; prevented fraction being 67 %. In blue-collar families no effect was achieved. At the age of five years, caries increment was strongly related to the occupation of the caretaker, MS at 18 months, child’s sugar use, night feeding, use of thirst quencher at the age of 18 months, and father’s reported oral health. Conclusions: Programs targeted at MS-colonized children can reduce caries in whitecollar families. A program mainly based on activity at home seems to favor white-collar families, whereas different kind of support is needed for the blue-collar families.

Composição corporal na desnutrição causada por câncer e doenças benignas do aparelho digestivo

A perda de peso é comum em uma grande variedade de doenças, particularmente entre as neoplasias. O objetivo deste estudo foi o de comparar a composição corporal de pacientes desnutridos portadores de câncer ou doenças benignas do aparelho digestivo, através da impedância bioelétrica. Foram avaliados 35 pacientes desnutridos (Indice de massa corporal < 18,5), de 22 a 70 anos, 26 (74,3%) do sexo masculino e nove (25,7%) do sexo feminino, sendo 17 (48,6%) portadores de neoplasias e 18 (51,4%) com doenças benignas. O grupo com neoplasia apresentou idade superior ao de doenças benignas (55,5±10,4 vs 39,8±9,9; p<0,05). O percentual de perda de peso e os valores de albumina sérica não foram diferentes entre os grupos. O percentual de gordura corporal, de massa magra e de água corporal também não diferiu significantemente. Conclui-se que a variação da composição corporal não é diferente em pacientes desnutridos portadores de doença neoplásica ou benigna do aparelho digestivo, quando eliminada a interferência causada por diferentes graus de perda ponderal.

Creating possibilities for collective creativity : Brokerage Functions in Practice-Based Innovation

In the network era, creative achievements like innovations are more and more often created in interaction among different actors. The complexity of today‘s problems transcends the individual human mind, requiring not only individual but also collective creativity. In collective creativity, it is impossible to trace the source of new ideas to an individual. Instead, creative activity emerges from the collaboration and contribution of many individuals, thereby blurring the contribution of specific individuals in creating ideas. Collective creativity is often associated with diversity of knowledge, skills, experiences and perspectives. Collaboration between diverse actors thus triggers creativity and gives possibilities for collective creativity. This dissertation investigates collective creativity in the context of practice-based innovation. Practice-based innovation processes are triggered by problem setting in a practical context and conducted in non-linear processes utilising scientific and practical knowledge production and creation in cross-disciplinary innovation networks. In these networks diversity or distances between innovation actors are essential. Innovation potential may be found in exploiting different kinds of distances. This dissertation presents different kinds of distances, such as cognitive, functional and organisational which could be considered as sources of creativity and thus innovation. However, formation and functioning of these kinds of innovation networks can be problematic. Distances between innovating actors may be so great that a special interpretation function is needed – that is, brokerage. This dissertation defines factors that enhance collective creativity in practice-based innovation and especially in the fuzzy front end phase of innovation processes. The first objective of this dissertation is to study individual and collective creativity at the employee level and identify those factors that support individual and collective creativity in the organisation. The second objective is to study how organisations use external knowledge to support collective creativity in their innovation processes in open multi-actor innovation. The third objective is to define how brokerage functions create possibilities for collective creativity especially in the context of practice-based innovation. The research objectives have been studied through five substudies using a case-study strategy. Each substudy highlights various aspects of creativity and collective creativity. The empirical data consist of materials from innovation projects arranged in the Lahti region, Finland, or materials from the development of innovation methods in the Lahti region. The Lahti region has been chosen as the research context because the innovation policy of the region emphasises especially the promotion of practice-based innovations. The results of this dissertation indicate that all possibilities of collective creativity are not utilised in internal operations of organisations. The dissertation introduces several factors that could support collective creativity in organisations. However, creativity as a social construct is understood and experienced differently in different organisations, and these differences should be taken into account when supporting creativity in organisations. The increasing complexity of most potential innovations requires collaborative creative efforts that often exceed the boundaries of the organisation and call for the involvement of external expertise. In practice-based innovation different distances are considered as sources of creativity. This dissertation gives practical implications on how it is possible to exploit different kinds of distances knowingly. It underlines especially the importance of brokerage functions in open, practice-based innovation in order to create possibilities for collective creativity. As a contribution of this dissertation, a model of brokerage functions in practice-based innovation is formulated. According to the model, the results and success of brokerage functions are based on the context of brokerage as well as the roles, tasks, skills and capabilities of brokers. The brokerage functions in practice-based innovation are also possible to divide into social and cognitive brokerage.

MASTER DATA MANAGEMENT MATURITY AND TECHNOLOGY ASSESSMENT - From theory to practice, case Ineo Oy

After decades of mergers and acquisitions and successive technology trends such as CRM, ERP and DW, the data in enterprise systems is scattered and inconsistent. Global organizations face the challenge of addressing local uses of shared business entities, such as customer and material, and at the same time have a consistent, unique, and consolidate view of financial indicators. In addition, current enterprise systems do not accommodate the pace of organizational changes and immense efforts are required to maintain data. When it comes to systems integration, ERPs are considered “closed” and expensive. Data structures are complex and the “out-of-the-box” integration options offered are not based on industry standards. Therefore expensive and time-consuming projects are undertaken in order to have required data flowing according to business processes needs. Master Data Management (MDM) emerges as one discipline focused on ensuring long-term data consistency. Presented as a technology-enabled business discipline, it emphasizes business process and governance to model and maintain the data related to key business entities. There are immense technical and organizational challenges to accomplish the “single version of the truth” MDM mantra. Adding one central repository of master data might prove unfeasible in a few scenarios, thus an incremental approach is recommended, starting from areas most critically affected by data issues. This research aims at understanding the current literature on MDM and contrasting it with views from professionals. The data collected from interviews revealed details on the complexities of data structures and data management practices in global organizations, reinforcing the call for more in-depth research on organizational aspects of MDM. The most difficult piece of master data to manage is the “local” part, the attributes related to the sourcing and storing of materials in one particular warehouse in The Netherlands or a complex set of pricing rules for a subsidiary of a customer in Brazil. From a practical perspective, this research evaluates one MDM solution under development at a Finnish IT solution-provider. By means of applying an existing assessment method, the research attempts at providing the company with one possible tool to evaluate its product from a vendor-agnostics perspective.

Exclusão gastroduodenal e vagotomia troncular: repercussão no peso corporal e gastrinemia- estudo experimental em ratos

OBJETIVO: A obesidade mórbida é uma doença crônica que se acompanha de várias complicações médicas e de uma menor esperança de vida, prejudicando o aspecto físico, emocional, econômico e social. As pesquisas clínicas e experimentais são amplamente justificadas nesta doença, considerando-se que a opção de tratamento operatório é recente. As gastroplastias e as derivações gástricas são algumas das modalidades terapêuticas propostas e produzem uma grande câmara gástrica remanescente, que em algumas técnicas fica totalmente excluída do trânsito alimentar. As possíveis alterações deste segmento, transformado em apêndice do sistema digestório, representam um vasto campo para pesquisa. Tivemos como objetivo avaliar o peso e as alterações da dosagem de gastrina sérica do rato, após denervação vagal troncular subdiafragmática, com exclusão da câmara gástrica e duodeno do trânsito alimentar do animal. MÉTODO: Foi realizada vagotomia troncular e exclusão gastroduodenal em cem ratos, dos quais trinta puderam ser estudados. Eram ratos machos adultos (Rattus Norvegicus Albinus), da linhagem Wistar, com peso médio de 378,67 g. Este estudo foi complementado pela dosagem sérica de gastrina por radioimunoensaio com I125 e duplo anticorpo para gastrina. RESULTADOS: O peso de todos os ratos estudados diminuiu em média de 378,67 g para 285,83 g. Os trinta animais perderam em média 92,83 g (-24,52%). Houve diferenças significativas entre o peso inicial dos animais e o peso final (p< 0,001). A gastrina sérica também diminuiu em vinte e um dos trinta ratos operados, caindo de 59,68 pg/ml para 46,77 pg/ml em média, correspondendo a uma diminuição de 12,91 pg (-19,73%) entre as duas médias (p< 0,001). A análise estatística teve como objetivo avaliar se houve diminuição nas médias das variáveis: peso e gastrina, medidas antes e depois da operação proposta. Para avaliar as diferenças entre as médias, utilizou-se o teste estatístico do T-Student. CONCLUSÕES: Houve uma diminuição significativa do peso e da dosagem de gastrina sérica do animal.

Exploring the role and transformative potential of human rights in development practice and food security : case study from Malawi

Avhandlingen är en analys av den roll som mänskliga rättigheter spelar i utvecklingssamarbete i allmänhet och tre matsäkerhetsprojekt i Malawi i synnerhet. Författaren undersöker huruvida mänskliga rättigheter kan bidra till samhälleliga förändringsprocesser. Undersökningen har en diskursiv syn på mänskliga rättigheter; rättigheter ses som sociala konstruktioner skapade av människor, konstruktioner som förändras i takt med att aktörerna ger dem ny mening. Människorättsbaserade utvecklingsstrategier riktar uppmärksamheten mot olika aktörers skyldigheter samt vikten av att mänskliga rättigheter inte kränks genom utvecklingspolitiska beslut. En analys som utgår från mänskliga rättigheter kan leda till att nya frågor lyfts fram: vem har skyldigheter, vem har rättigheter, och varför förverkligas inte dessa? Fokus flyttas till hur politiska, ekonomiska och juridiska strukturer kan förändras så att de främjar mänskliga rättigheter. Författaren använder empiriskt material från Malawi för att visa vilken roll mänskliga rättigheter och så kallade människorättsprinciper spelar inom tre projekt: (1) ett mathjälpsprojekt; (2) ett rättighetsbaserat projekt med fokus på att stärka strategier för livsuppehälle; (3) ett juridiskt projekt inom ramen för vilket man skapat ett lagförslag om rätten till föda. Analysen visar att det rättighetsbaserade projektet strävade efter den mest djupgående samhälleliga förändringen. Människorättsprinciperna ansvarighet och deltagande handlade inte endast om verksamheten inom projektet utan man strävade även efter att stärka dessa principer mellan medborgare och myndigheter. Rättigheter, som ett sätt att tala, tänka och handla, inte som abstrakta juridiska normer, påverkade de lokala aktörernas sätt att kräva bl.a. tjänster av lokala myndigheter. Teoretiskt kan man säga att det rättighetsbaserade projektet representerar ett aktörsperspektiv på mänskliga rättigheter där aktörernas egna uppfattningar om vad de är berättigade till samt krav på myndigheters ansvar formade vilken mening rättigheterna kom att få.

Reflexive model of research-based theatre – processing innovation at the crossroads of theatre, reflection and practice-based innovation activities

Contemporary organisations have to embrace the notion of doing ‘more with less’. This challenges knowledge production within companies and public organisations, forcing them to reorganise their structures and rethink what knowledge production actually means in the context of innovation and how knowledge is actually produced among various professional groups within the organisation in their everyday actions. Innovations are vital for organisational survival, and ‘ordinary’ employees and customers are central but too-often ignored producers of knowledge for contemporary organisations. Broader levels of participation and reflexive practices are needed. This dissertation discusses the missing links between innovation research conducted in the context of industrial management, arts, and culture; applied drama and theatre practices (specifically post-Boalian approaches); and learning – especially organising reflection – in organisational settings. This dissertation (1) explores and extends the role of research-based theatre to organising reflection and reflexive practices in the context of practice-based innovation, (2) develops a reflexive model of RBT for investigating and developing practice-based organisational process innovations in order to contribute to the development of a tool for innovation management and analysis, and (3) operationalises this model within private- and publicsector organisations. The proposed novel reflexive model of research-based theatre for investigating and developing practice-based organisational process innovations extends existing methods and offers a different way of organising reflection and reflexive practices in the context of general innovation management. The model was developed through five participatory action research processes conducted in four different organisations. The results provide learning steps – a reflection path – for understanding complex organisational life, people, and relations amid renewal and change actions. The proposed model provides a new approach to organising and cultivating reflexivity in practice-based innovation activities via research-based theatre. The results can be utilised as a guideline when processing practice-based innovation within private or public organisations. The model helps innovation managers to construct, together with their employees, temporary communities where they can learn together through reflecting on their own and each others’ experiences and to break down assumptions related to their own perspectives. The results include recommendations for practical development steps applicable in various organisations with regard to (i) application of research-based theatre and (ii) related general innovation management. The dissertation thus contributes to the development of novel learning approaches in knowledge production. Keywords: practice-based innovation, research-based theatre, learning, reflection, mode 2b knowledge production

Variação no Índice de Massa Corporal em Usuárias de Terapia de Reposição Hormonal

Objetivo: avaliar os efeitos da terapia de reposição hormonal sobre o índice de massa corporal de mulheres na pós-menopausa. Casuística e Métodos: foram avaliadas retrospectivamente, por um período de três anos, 166 usuárias e 136 não-usuárias de reposição hormonal, acompanhadas no Ambulatório de Menopausa do Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas, avaliando-se a variação desse parâmetro ao final de cada ano em relação ao inicial. A análise dos dados foi realizada usando-se o testechi², o teste t de Student e o teste de Mann-Whitney para amostras independentes. Resultados: não foram observadas variações significativas no índice de massa corporal, quando se compararam as usuárias e não-usuárias durante os três anos de observação. Conclusão: a terapia de reposição hormonal não produziu alterações no índice de massa corporal em mulheres adequadamente acompanhadas durante o seu uso.

Fatores Associados à Obesidade e ao Padrão Andróide de Distribuição da Gordura Corporal em Mulheres Climatéricas

Objetivos: descrever as características de um grupo de mulheres climatéricas, conhecer a freqüência e os fatores associados à obesidade e ao padrão andróide de distribuição da gordura corporal. Métodos: estudo observacional com 518 pacientes com idade entre 45 e 65 anos em um ambulatório de climatério. Foram considerados a idade, cor, status menopausal, tempo de menopausa, atividade física, tabagismo, dieta, etilismo, antecedentes pessoais e familiares de hipertensão, diabetes, doença cardiovascular, dislipidemia e obesidade. O índice de massa corpórea e a relação das medidas cintura/quadril foram variáveis dependentes. Na análise estatística utilizaram-se os testes de Wilcoxon, c² de Pearson, com nível de significância de 5%, e análise múltipla por regressão logística. Resultados: mais de dois terços das participantes eram não-obesas com perfil andróide e menopausadas. Aproximadamente um quarto tinha atividade física adequada, era tabagista, metade referiu dieta inadequada e um quinto era etilista. Pacientes com perfil andróide apresentaram média etária maior que mulheres com padrão ginecóide. Antecedentes pessoais de obesidade, hipertensão, diabetes e história familiar de diabetes relacionaram-se com obesidade e padrão andróide. O status pós-menopausa associou-se significativamente ao perfil andróide. Conclusões: a maioria das mulheres foram não-obesas com perfil andróide, brancas, pós-menopáusicas, sedentárias, não-tabagistas nem etilistas. Os principais fatores associados à obesidade e padrão andróide foram os antecedentes pessoais de obesidade, hipertensão arterial, diabetes, história familiar de diabetes e, particularmente, o status pós-menopausa com o perfil andróide.