A multidimensional program including standing exercises, health education, and telephone support to reduce sedentary behavior in frail older adults:Randomized clinical trial

Objectives: The primary aim of this study was to evaluate the effect of a multidimensional program including home-based standing exercises, health education, and telephone support for the reduction of sedentary behavior in community-dwelling frail older adults. The secondary aim of this study was to evaluate the safety and adherence of the program. Study design: A single-blind, randomized controlled trial. Methods: A total of 43 frail older adults were randomly assigned to the intervention and control groups. The intervention consisted of combined strategies including home-based standing exercises, health education, and telephone support for 16 weeks for frail older adults. The control group received orientation regarding the harmful effects of a sedentary lifestyle. Sedentary behavior was evaluated by total sedentary time, accumulated sedentary time in bouts of at least 10 min, and by the break in sedentary time, measured by an accelerometer used for at least 600 min/day for 4 days. Safety was assessed by self-reporting of possible adverse events. Adherence was assessed based on the number of days in which standing exercises were performed by the participants. Repeated measures ANOVA and Tukeys post hoc test were used to analyze the collected data. Results: The intervention group reduced the sedentary time by 30 min/day (p= 0.048), but without significant maintenance after 30 days of the program. Of the total number of participants, 82% (n = 14) of the intervention group participants showed more than 70% adherence to the program. The main adverse effects faced by the intervention group participants were tiredness (53%; n = 9) and lower limb pain (47%; n = 8). Conclusions: The multidimensional program reduced sedentary behavior, was safe, and showed satisfactory adherence in frail older adults

The Oldest Case of Decapitation in the New World (Lapa do Santo, East-Central Brazil)

We present here evidence for an early Holocene case of decapitation in the New World (Burial 26), found in the rock shelter of Lapa do Santo in 2007. Lapa do Santo is an archaeological site located in the Lagoa Santa karst in east-central Brazil with evidence of human occupation dating as far back as 11.7-12.7 cal kyBP (95.4% interval). An ultra-filtered AMS age determination on a fragment of the sphenoid provided an age range of 9.1-9.4 cal kyBP (95.4% interval) for Burial 26. The interment was composed of an articulated cranium, mandible and first six cervical vertebrae. Cut marks with a v-shaped profile were observed in the mandible and sixth cervical vertebra. The right hand was amputated and laid over the left side of the face with distal phalanges pointing to the chin and the left hand was amputated and laid over the right side of the face with distal phalanges pointing to the forehead. Strontium analysis comparing Burial 26's isotopic signature to other specimens from Lapa do Santo suggests this was a local member of the group. Therefore, we suggest a ritualized decapitation instead of trophy-taking, testifying for the sophistication of mortuary rituals among hunter-gatherers in the Americas during the early Archaic period. In the apparent absence of wealth goods or elaborated architecture, Lapa do Santo's inhabitants seemed to use the human body to express their cosmological principles regarding death

Por que o mineral sofre? Teorias mestiças fronteriças e ontologias do real com relação ao extrativismo minerador em San Juan, Argentina

Objetivo/contexto: este artículo tiene como objetivo presentar aspectos de un trabajo etnográfico referido a las teorías mestizas fronterizas que circulan en comunidades del norte de San Juan, Argentina, con relación al extractivismo minero, poniendo el acento en la comprensión de las ontologías de lo real que las constituyen a partir de experiencias históricas y modos de relacionalidad local. Metodología: el trabajo se apoya en el estudio etnográfico de las relaciones conflictivas existentes entre las praxis cotidianas y las narrativas pluriversales locales en comunidades del norte de San Juan, al expresar otras ontologías de “lo real” disidentes a los proyectos políticos de incorporación-exclusión estatal y de mercado en estas comunidades, conformadas tanto por seres humanos, como por seres no humanos, que cohabitan estos lugares y agencian territorios en su actuar político. Conclusiones: se plantea que la discusión política pública, en torno a la presencia de los proyectos mega-mineros en las nacientes de agua cordillerana (glaciares) en San Juan, excluye a la ontología política y relacional expresada en las teorías mestizas fronterizas locales. Originalidad: el artículo propone reflexiones sobre las ontologías de los conflictos neoextractivistas en Argentina, abriendo cuestionamientos con derivaciones teóricas y metodológicas no exploradas en la bibliografía referida al caso de la provincia de San Juan.Objective/context: The purpose of this article is to present aspects of an 76 ethnographic work concerning the borderlands mestizo theories that circulate in communities in the north of San Juan, Argentina, related to mineral extractivism, emphasizing the understanding of ontologies of the real that are constituted from historical experiences and modes of local relationality. Methodology: The work is based on the ethnographic study of the existing conflictive relations between the daily praxis and the local pluriverse narratives in communities of the north of San Juan, when expressing other ontologies of “the real” that disagree with the political projects of state and market incorporation-exclusion in these communities, conformed by humans, as much as by nonhumans, that cohabit these places and manage territories in their political act. Conclusions: It is proposed that the public political discussion, around the presence of mega-mining projects in the mountain water springs (glaciers) in San Juan, excludes the political and relational ontology expressed in the local borderlands mestizo theories. Originality: T he article proposes reflections on the ontologies of neo-extractivist conflicts in Argentina, by opening questions with theoretical and methodological derivations not explored in the bibliography referring to the case of the province of San Juan.Objetivo/contexto: este artigo tem como objetivo apresentar aspectos de um trabalho etnográfico referente às teorias mestiças fronteiriças que circulam em comunidades no norte de San Juan, Argentina, relacionadas com o extrativismo minerador, com ênfase na compreensão das ontologias do real que são constituídas a partir de experiências históricas e dos modos de relacionamento local. Metodologia: este trabalho está apoiado no estudo etnográfico das relações conflitivas existentes entre as práticas cotidianas e as narrativas pluriversais locais em comunidades do norte de San Juan, ao expressar outras ontologias do “real” dissidentes dos projetos políticos de incorporação-exclusão estatal e de mercado nessas comunidades conformadas tanto por seres humanos quanto por não humanos, que coabitam esses lugares e agenciam territórios em seu agir político. Conclusões: propõe-se que a discussão política pública sobre a presença dos projetos megamineradores nas nascentes de água da Cordilheira (glaciares) em San Juan exclui a ontologia política e relacional expressa nas teorias mestiças fronteiriças locais. Originalidade: este artigo reflete acerca das ontologias dos conflitos neoextrativistas na Argentina ao abrir questionamentos com derivações teóricas e metodológicas não exploradas na literatura referida ao caso da província de San Juan.Fil: Jofre, Ivana Carina. Universidad Nacional de San Juan; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; Argentin

Quality of paediatric epilepsy care and rates of death and hospital admission among children & young people with epilepsy in England: national longitudinal data-linkage study

Background Concerns have been raised about variation in care quality and outcomes among children and young people with epilepsies in England. We aimed to investigate the relationship between quality of paediatric care, hospital admissions and epilepsy-related deaths (both before and after transition to adult services). Methods We accessed unit-level data from Round 1 (2009-11) and Round 2 (2013-14) of the Epilepsy12 national clinical audit, and data on death registrations and unplanned hospital admissions. We investigated the association between unit-level performance in involving a paediatrician with epilepsy expertise, Epilepsy Specialist Nurse (ESN), and Paediatric Neurologist (PN) in Round 1 and the proportion of adolescents with epilepsy admitted to each unit who subsequently died during the study period (2009-15). We also investigated whether change in Epilepsy12 performance between the audit rounds was associated with change in the standardised ratio of observed:expected unplanned epilepsy admissions. Findings 79/1164(7%) of patients included in the PN analyses died; 54/1164(5%) deaths occurred post-transition. Regression models estimated an absolute reduction of 6%(95% CI 1-13%) in total mortality risk and 6%(1-11%) post-transition mortality risk between units where all versus no eligible patients were seen by a PN. In dichotomised analyses, units where all eligible patients were seen by a PN were estimated to have 5%(0-9%) absolute mortality reduction and 5%(1-8%) reduction in post transition deaths compared to other units. There was no significant association between performance on other audit measures and mortality. In units where access to an ESN deteriorated, the standardised ratio of epilepsy admissions increased by a mean of 0·21 (95% CI 0·01-0·42). Interpretation Among adolescents with epilepsy, greater involvement of tertiary specialists in paediatric care predicts lower mortality in the period after transition to adult services. Reduced access to an ESN was associated with an increase in paediatric epilepsy admissions

Association of quality of paediatric epilepsy care with mortality and unplanned hospital admissions among children and young people with epilepsy in England: a national longitudinal data linkage study

Background Concerns have been raised about variation in care quality and outcomes among children and young people with epilepsies in England. We aimed to investigate the relationship between quality of paediatric care, hospital admissions and epilepsy-related deaths (both before and after transition to adult services). Methods We accessed unit-level data from Round 1 (2009-11) and Round 2 (2013-14) of the Epilepsy12 national clinical audit, and data on death registrations and unplanned hospital admissions. We investigated the association between unit-level performance in involving a paediatrician with epilepsy expertise, Epilepsy Specialist Nurse (ESN), and Paediatric Neurologist (PN) in Round 1 and the proportion of adolescents with epilepsy admitted to each unit who subsequently died during the study period (2009-15). We also investigated whether change in Epilepsy12 performance between the audit rounds was associated with change in the standardised ratio of observed:expected unplanned epilepsy admissions. Findings 79/1164(7%) of patients included in the PN analyses died; 54/1164(5%) deaths occurred post-transition. Regression models estimated an absolute reduction of 6%(95% CI 1-13%) in total mortality risk and 6%(1-11%) post-transition mortality risk between units where all versus no eligible patients were seen by a PN. In dichotomised analyses, units where all eligible patients were seen by a PN were estimated to have 5%(0-9%) absolute mortality reduction and 5%(1-8%) reduction in post transition deaths compared to other units. There was no significant association between performance on other audit measures and mortality. In units where access to an ESN deteriorated, the standardised ratio of epilepsy admissions increased by a mean of 0·21 (95% CI 0·01-0·42). Interpretation Among adolescents with epilepsy, greater involvement of tertiary specialists in paediatric care predicts lower mortality in the period after transition to adult services. Reduced access to an ESN was associated with an increase in paediatric epilepsy admissions

A ambientalização dos currículos de Educação Física no ensino superior The environmentalization of physical education curricula in higher education

Os debates em torno das questões ambientais se expandem por vários campos, promovendo diferentes modos de se relacionar com o tema e suas problemáticas. A multiplicidade de significações consequentes desses encontros deve ser considerada nos processos de disputa simbólica em que são formuladas, dentre eles, a ambientalização curricular da educação superior. Assim, o objetivo central desse artigo, sustentado por pesquisa teórica, é analisar como a inserção da dimensão ambiental está sendo estruturada na educação física no ensino superior brasileiro. Para tanto, o artigo foi dividido em quatro partes, apresentando: a) elementos da ambientalização curricular no ensino superior; b) algumas particularidades da educação física enquanto área de conhecimento; c) o papel das atividades na natureza na ambientalização curricular da educação física; d) as considerações finais, buscando compreender os caminhos da ambientalização curricular da educação física no ensino superior brasileiro.<br>Discussions surrounding environmental issues span multiple fields, promoting different ways to relate to the theme. The multiplicity of meanings resulting from these encounters should be analyzed regarding the processes of symbolic dispute in which they are formulated, among them, the environmentalization of curricula in higher education. This article, sustained by theoretical research, aims to analyze how the insertion of the environmental dimension is being structured in physical education in Brazilian higher education settings. To this end, the article was divided into four parts, showing: a) elements of curricular environmentalization in higher education; b) some particularities of physical education as area of knowledge construction; c) the role of nature (outdoor) activities in the environmentalization of physical education curricula; d) the final considerations, seeking to understand the processes of environmentalization of physical education curricula in Brazilian higher education