Fatores associados à obesidade global e à obesidade abdominal em mulheres na pós-menopausa

OBJETIVOS: avaliar a prevalência de obesidade global e obesidade abdominal, em mulheres pós-menopausa, segundo o grau de instrução, nível de atividade física, uso de terapia hormonal na menopausa (THM) e paridade. MÉTODOS: foram entrevistadas 157 mulheres na pós-menopausa, atendidas em dois ambulatórios públicos da cidade de São Paulo, São Paulo, Brasil. A obesidade foi determinada segundo o índice de massa corporal (IMC > 30,0) e segundo o percentual de gordura corporal (%GC > 37%). A obesidade abdominal foi determinada pela relação cintura-quadril (RCQ > 0,85). RESULTADOS: a prevalência de obesidade global foi 34,4% (segundo o IMC) e de 40,1% (segundo o %GC). A prevalência de obesidade abdominal foi de 73,8%. Grande parte das entrevistadas referiu até sete anos de instrução formal (47,8%), foi considerada sedentária ou insuficientemente ativa (52,3%) e nunca tinha utilizado THM oral ou tinha utilizado por menos de 12 meses (72,0%). Foi constatada maior prevalência de obesidade global no grupo de mulheres sedentárias ou insuficientemente ativas e no grupo de não usuárias de THM (p<0,05). Quanto à obesidade abdominal, fator de risco para doenças cardiovasculares (DCV), apenas o grau de instrução mostrou-se associado à RCQ (p<0,05). CONCLUSÕES: mulheres após a menopausa, fisicamente ativas e usuárias de THM exibiram menor prevalência de obesidade global, porém a prevalência de obesidade abdominal foi alta e ainda maior nas mulheres com menor grau de instrução

Inspeção sanitária em creches: uma proposta de roteiro de inspeção

O trabalho apresenta um projeto de intervenção na realidade concreta das ações de Vigilância Sanitária, através da proposição de um roteiro para inspeção destinado a creches. Os objetivos específicos foram identificar os fundamentos jurídicos, técnico-científicos e sanitários que possam nortear a prática de inspeções sanitárias em creches; elaborar uma proposta de roteiro que permita um processo de análise mais explícito, objetivo e homogêneo e discutir a contribuição do instrumento proposto para a atividade de Vigilância Sanitária, com base na literatura científica pesquisada. Para a realização do trabalho foi feita uma revisão fundamentada em textos didáticos e normativos das áreas de educação e saúde, legislação sobre Vigilância Sanitária e Educação Infantil, outros roteiros já existentes e artigos da literatura científica sobre agravos à saúde em crianças que frequentam creches. O trabalho focaliza o conteúdo da legislação específica vigente e sua aplicabilidade na prática da inspeção sanitária em creches e baseia-se na Portaria - MS n. 321 de 26.05.1988. Este estudo apresenta um instrumento para avaliar a qualidade do atendimento nas creches sob o aspecto da promoção da saúde e sugere estudos posteriores de validação para o contexto, com a possível inclusão de um sistema de classificação para os padrões de conformidade, por meio de uma metodologia estatística

The effectiveness of educational practice in diabetic foot: a view from Brazil

Background: The aim of the present study was to evaluate the prevention and self-inspection behavior of diabetic subjects with foot at ulcer risk, no previous episode, who participated in the routine visits and standardized education provided by the service and who received prescribed footwear. This evaluation was carried out using a questionnaire scoring from 0-10 (high scores reflect worse practice compliance). Results: 60 patients were studied (30 of each sex); mean age was 62 years, mean duration of the disease was 17 years. As for compliance, 90% showed a total score <= 5, only 8.7% regularly wore the footwear supplied; self foot inspection 65%, 28,3% with additional familiar inspection; creaming 77%; proper washing and drying 88%; proper cutting of toe nails 83%; no cuticle cutting 83%; routine shoe inspection 77%; no use of pumice stones or similar abrasive 70%; no barefoot walking 95%. Conclusion: the planned and multidisciplinary educational approach enabled high compliance of the ulcer prevention care needed in diabetic patients at risk for complications. In contrast, compliance observed for the use of footwear provided was extremely low, demonstrating that the issue of its acceptability should be further and carefully addressed. In countries of such vast dimensions as Brazil multidisciplinary educational approaches can and should be performed by the services providing care for patients with foot at risk for complications according to the reality of local scenarios. Furthermore, every educational program should assess the learning, results obtained and efficacy in the target population by use of an adequate evaluation system.

The accuracy of the Clock Drawing Test compared to that of standard screening tests for Alzheimer`s disease: results from a study of Brazilian elderly with heterogeneous educational backgrounds

Background: Although the Clock Drawing Test (CDT) is the second most used test in the world for the screening of dementia, there is still debate over its sensitivity specificity, application and interpretation in dementia diagnosis. This study has three main aims: to evaluate the sensitivity and specificity of the CDT in a sample composed of older adults with Alzheimer`s disease (AD) and normal controls; to compare CDT accuracy to the that of the Mini-mental State Examination (MMSE) and the Cambridge Cognitive Examination (CAMCOG), and to test whether the association of the MMSE with the CDT leads to higher or comparable accuracy as that reported for the CAMCOG. Methods: Cross-sectional assessment was carried out for 121 AD and 99 elderly controls with heterogeneous educational levels from a geriatric outpatient clinic who completed the Cambridge Examination for Mental Disorder of the Elderly (CAMDEX). The CDT was evaluated according to the Shulman, Mendez and Sunderland scales. Results: The CDT showed high sensitivity and specificity. There were significant correlations between the CDT and the MMSE (0.700-0.730; p < 0.001) and between the CDT and the CAMCOG (0.753-0.779; p < 0.001). The combination of the CDT with the MMSE improved sensitivity and specificity (SE = 89.2-90%; SP = 71.7-79.8%). Subgroup analysis indicated that for elderly people with lower education, sensitivity and specificity were both adequate and high. Conclusions: The CDT is a robust screening test when compared with the MMSE or the CAMCOG, independent of the scale used for its interpretation. The combination with the MMSE improves its performance significantly, becoming equivalent to the CAMCOG.

Analysis of coaches objectives in artistic gymnastics

The present study is a piece of the main project entitled ""Diagnosis of the Artistic Gymnastics Developing Program in Brazil"". Among many issues included in the main study, we analyzed and discussed the coach`s objectives who are coaching incoming gymnasts who are potential to be representative at the national teams. We interviewed 46 coaches from 29 sports institutions in Brazil. As data collection we used a semi-structured interview, and as data treatment we used the content analysis proposed by Bardin ( 2004). We could evidence that many coaches` objectives is focused on the competition and the highest level, and that the institutions` emphasis on the results in all levels of categories.

A geometrical approach of 3-D FEA for educational purposes applied to electrostatic fields

A geometrical approach of the finite-element analysis applied to electrostatic fields is presented. This approach is particularly well adapted to teaching Finite Elements in Electrical Engineering courses at undergraduate level. The procedure leads to the same system of algebraic equations as that derived by classical approaches, such as variational principle or weighted residuals for nodal elements with plane symmetry. It is shown that the extension of the original procedure to three dimensions is straightforward, provided the domain be meshed in first-order tetrahedral elements. The element matrices are derived by applying Maxwell`s equations in integral form to suitably chosen surfaces in the finite-element mesh.

Adult language input in the early childhood educational setting

Age-related changes in the adult language addressed to children aged 2;0-4;0 years in polyadic conditions were investigated in Australian childcare centres. The language that 21 staff members addressed to these children was coded for multiple variables in the broad social categories of prosody, context, speech act and gesture. The linguistic components were coded within the categories of phonology, lexicon, morphology, syntax and referential deixis. Minimal age-related differences were found. Explanations for the similarity of the adult language input across the age groups within the early childhood educational environment, will be discussed

Learning for fun: The unique contribution of educational leisure experiences

What do visitors want or expect from an educational leisure activity such as a visit to a museum, zoo, aquarium or other such experience? Is it to learn something or to experience learning? This paper uses the term 'learning for fun' to refer to the phenomenon in which visitors engage in a learning experience because they value and enjoy the process of learning itself. Five propositions regarding the nature of learning for fun are discussed, drawing on quantitative and qualitative data from visitors to a range of educational leisure activities. The commonalities between learning for fun and other theoretical constructs such as 'experience,' 'flow', 'intrinsic motivation', and 'curiosity' are explored. It is concluded that learning for fun is a unique and distinctive offering of educational leisure experiences, with implications for future research and experience design.

Triple objective team mentoring: achieving learning objectives with chemical engineering students

A sophisticated style of mentoring has been found to be essential to support engineering student teams undertaking technically demanding, real-world problems as part of a Project-Centred Curriculum (PCC) at The University of Queensland. The term ‘triple-objective’ mentoring was coined to define mentoring that addresses not only the student’s technical goal achievement but also their time and team management. This is achieved through a number of formal mentor meetings that are informed by a confidential instrument which requires students to individually reflect on team processes prior to the meeting, and a checklist of technical requirements against which the interim student team progress and achievements are assessed. Triple-objective mentoring requires significant time input and coordination by the academic but has been shown to ensure effective student team work and learning undiminished by team dysfunction. Student feedback shows they value the process and agree that the tools developed to support the process are effective in developing and assessing team work and skills with average scores mostly above 3 on a four point scale.

Modeling control objectives for business process compliance

Business process design is primarily driven by process improvement objectives. However, the role of control objectives stemming from regulations and standards is becoming increasingly important for businesses in light of recent events that led to some of the largest scandals in corporate history. As organizations strive to meet compliance agendas, there is an evident need to provide systematic approaches that assist in the understanding of the interplay between (often conflicting) business and control objectives during business process design. In this paper, our objective is twofold. We will firstly present a research agenda in the space of business process compliance, identifying major technical and organizational challenges. We then tackle a part of the overall problem space, which deals with the effective modeling of control objectives and subsequently their propagation onto business process models. Control objective modeling is proposed through a specialized modal logic based on normative systems theory, and the visualization of control objectives on business process models is achieved procedurally. The proposed approach is demonstrated in the context of a purchase-to-pay scenario.

Economic , Educational and Conservation Benefits of Sea Turtle Based Ecotourism: A Study Focused on Mon Repos

The study examines the economic, educational and conservation values of sea turtle-based ecotourism in Australia. The centre-piece of this research is a case study undertaken at the Mon Repos Conservation Park located near the town of Bundaberg, Queensland. Each year from mid-November to end of March, thousands of visitors visit Mon Repos Conservation Park to view sea turtles either nesting on the one km stretch of beach or to see hatchlings emerge from their nests and march on to the sea or both. As a result of this activity there are considerable economic benefits to the Bundaberg region during the sea turtle season. The study examines the economic impact of sea turtle viewing at Mon Repos to the region. The study assesses the recreational value of sea turtle viewing. Furthermore, sea turtle-based ecotourism also provides educational and conservation benefits that are important for the protection and conservation of sea turtles, especially in Australia. The study specifies the extent of the educational impact and conservation appreciation of sea turtle viewing at Mon Repos Conservation Park. As a background to the study, Mon Repos visitors’ profile and socio-economic data of visitors are provided. In order to conduct this study, 1,200 survey forms were distributed, out of which 519 usable responses were obtained.

Educational characteristics of students with high or low self-concept

In response to methodological concerns associated with previous research into the educational characteristics of students with high or low self-concept, the topic was re-examined using a significantly more representative sample and a contemporary self-concept measure. From an initial screening of 515 preadolescent, coeducational students in 18 schools, students significantly high or low in self-concept were compared using standardized tests in reading, spelling, and mathematics, and teacher interviews to determine students' academic and nonacademic characteristics. The teachers were not informed of the self-concept status of the students. Compared to students with low self-concept, students with high self-concept were rated by teachers as being more popular, cooperative, and persistent in class, showed greater leadership, were lower in anxiety, had more supportive families, and had higher teacher expectations for their future success. Teachers observed that students with low self-concept were quiet and withdrawn, while peers with high self-concept were talkative and more dominating with peers. Students with lower self-concepts were also lower than their peers in reading, spelling, and mathematical abilities. The findings support the notion that there is an interactive relationship between self-concept and achievement. (C) 1998 John Wiley & Sons, Inc.