Qualidade de Vida em Crianças Nascidas Prematuras: Fatores de Risco e Proteção

Given the significant increase in survival rates of prematurely born children, this study assessed their quality of life at school age and identified potential risk and protective factors. We included 57 children with premature birth aged 5 to 8 years. Participants completed a cognitive test, and their parents assessed their behavior and quality of life. Most children presented an average or high intellectual level. Despite the mildly compromised quality of life, we observed a high prevalence of behavioral problems in older children. Male participants and behavioral problems were identified as risk factors for lower quality of life; this finding indicates the need to implement systematic monitoring services to facilitate adaptation of premature born children when entering in the school.Ante el aumento significativo en las tasas de supervivencia de los recién nacidos prematuros, este estudio tuvo el objetivo de evaluar la calidad de vida de estos niños en edad escolar e identificar posibles factores de riesgo y protección. Cincuenta y siete niños de 5-8 años de edad, nacidos prematuros, contestaron una prueba cognitiva y los padres calificaron su comportamiento y calidad de vida. La mayoría de los niños presentó nivel intelectual promedio o superior. A pesar de pocos daños en la calidad de vida, fue encontrada alta prevalencia de problemas de conducta en los niños mayores. El sexo masculino y problemas conductuales se presentaron como factores de riesgo para la calidad de vida, lo que indica que son necesarios servicios de seguimiento para los niños nascidos prematuros antes que empiecen la escuela, para facilitar su adaptación.Considerando-se o aumento significativo nos índices de sobrevida de crianças nascidas prematuras, objetivou-se avaliar sua qualidade de vida em idade escolar e identificar possíveis fatores de risco e proteção. 57 crianças de 5 a 8 anos, nascidas prematuras, responderam a um teste cognitivo e os pais avaliaram seu comportamento e qualidade de vida. A maioria das crianças apresentou nível intelectual médio ou superior. Apesar do leve prejuízo na qualidade de vida, observou-se alta prevalência de problemas de comportamento nas crianças maiores. Identificou-se sexo masculino e problemas comportamentais como fatores de risco para qualidade de vida, sinalizando para a necessidade de serviços de acompanhamento antes do ingresso da criança nascida prematura na escola, visando facilitar sua adaptação

Indivíduos fisicamente ativos submetidos ao tratamento com Tribulus terrestris versus placebo

The purpose of the present study is to evaluate anthropometric, biochemical, hormonal and performance differences among physically active individuals who utilize (or not) Tribulus terrestris (TT) supplementation.  The cohort is composed of 32 subjects divided into two groups: 1) 8 males and 8 females individuals who are physically active and utilize Tribulus terrestres; 2) 8 males and 8 females individuals who are physically active and utilize placebo. Inclusion criteria for all subjects consisted of age requirement within the range of 18 and 40 years old, a history of at least 6 months of physical activity and absence of any drug treatment/consumption. Analysis of body composition, physical performance test and blood collection for subsequent hormonal and biochemical tests were collected. Data were processed and analyzed based on descriptive statistical tests and one-way-ANOVA. Results were considered statistically significant when p<0.05. Results show significant increase in testosterone levels for both females and males treated with TT, decreased levels of body fat among the treated women, increased libido for treated individuals and enhanced strength among treated women. Biochemical parameters among all groups were within normal limits.O objetivo do presente estudo é avaliar as diferenças antropométricas, bioquímicas, hormonais ede desempenho entre indivíduos fisicamente ativos que utilizam (ou não) a suplementação comTribulus terrestris (TT). A coorte é composta por 32 indivíduos divididos em dois grupos: 1) 8indivíduos do sexo masculino e 8 do sexo feminino, fisicamente ativos e que utilizam Tribulusterrestres; 2) 8 indivíduos do sexo masculino e 8 do sexo feminino que são fisicamente ativos eutilizam placebo. Os critérios de inclusão para todos os sujeitos consistiram na exigência de idadeentre 18 e 40 anos, histórico de pelo menos 6 meses de atividade física e ausência de qualquertratamento / consumo de drogas. Análise da composição corporal, teste de desempenho físico ecoleta de sangue para testes hormonais e bioquímicos subsequentes foram coletados. Os dadosforam processados e analisados com base em testes estatísticos descritivos e ANOVA one-way. Osresultados foram considerados estatisticamente significantes quando p <0,05. Os resultadosmostram aumento significativo nos níveis de testosterona para mulheres e homens tratados comTT, diminuição dos níveis de gordura corporal entre as mulheres tratadas, aumento da libido paraindivíduos tratados e aumento da força entre mulheres tratadas. Parâmetros bioquímicos entretodos os grupos estavam dentro dos limites normais

Práticas Educomunicativas

Esta publicação pretende divulgar as práticas educomunicativas realizadas em diferentes regiões do país e que estão sendo implantadas por nossos associados. O e-book Práticas Educomunicativas, que visa oferecer um material de uso prático que possa servir de apoio pedagógico em diferentes contextos, escolar ou de ações junto a instituições, apresenta 20 artigos de profissionais e pesquisadores que implementam ações que inter-relacionam comunicação e educação no contexto da educação apontando as experiências e processos de educomunicação e valorizando desta forma, o trabalho realizado por cada educomunicador oferecendo, ao leitor, um material de uso prático que possa servir de apoio pedagógico em diferentes contextos

Educomunicação e suas áreas de intervenção: Novos paradigmas para o diálogo intercultural

oai:omp.abpeducom.org.br:publicationFormat/1O material aqui divulgado representa, em essência, a contribuição do VII Encontro Brasileiro de Educomunicação ao V Global MIL Week, da UNESCO, ocorrido na ECA/USP, entre 3 e 5 de novembro de 2016. Estamos diante de um conjunto de 104 papers executivos, com uma média de entre 7 e 10 páginas, cada um. Com este rico e abundante material, chegamos ao sétimo e-book publicado pela ABPEducom, em seus seis primeiros anos de existência. A especificidade desta obra é a de trazer as “Áreas de Intervenção” do campo da Educomunicação, colocando-as a serviço de uma meta essencial ao agir educomunicativo: o diálogo intercultural, trabalhado na linha do tema geral do evento internacional: Media and Information Literacy: New Paradigms for Intercultural Dialogue

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Qualidade de vida, avaliação cognitiva e comportamental de prematuros de muito baixo peso com idade entre cinco e oito anos

Como conseqüência dos avanços recentes na área de Obstetrícia e Perinatologia, houve uma redução significativa nos índices nacionais de mortalidade infantil e altas taxas de sobrevida de crianças nascidas prematuras. No entanto, não se verificou o mesmo impacto na redução das sequelas durante o desenvolvimento e na qualidade de vida da criança, tanto na infância, como na adolescência e idade adulta. Há relatos na literatura que associam prematuridade com sequelas físicas e psicossociais, aumentando-se a chance de problemas comportamentais e cognitivos, especialmente na idade escolar. Entretanto, os resultados não são conclusivos e poucos estudos associam esses déficits com qualidade de vida, geralmente avaliada segundo percepção dos pais. O presente estudo teve por objetivo avaliar a qualidade de vida de crianças nascidas prematuras, em idade pré-escolar e escolar, sua associação com condições de nascimento, variáveis socioeconômicas, desempenho cognitivo e comportamental; e levantar possíveis preditores de risco e proteção. Para tanto, foram utilizados os seguintes instrumentos: AUQEI (Autoquestionnaire Qualité de Vie Enfant Imagé), HUI 3 (Health Utility Index 3), CBCL (Child Behavior Checklist), WISC e WPPSI (Wechsler Intelligence Scale). Dos 57 participantes com idade variando de 5 a 8 anos, 33,3% eram extremo baixo peso e 75,4% prematuras extremas. Na avaliação cognitiva, 56,1% das crianças tiveram desempenho cognitivo de regular a superior, 22,8% foram consideradas limítrofes e 8,8% intelectualmente deficientes. Com relação ao comportamento, 36,8% apresentavam problemas em nível clínico, especialmente hiperatividade e déficit de atenção (21,1%) e ansiedade (19,5%). Houve relação significativa entre escolaridade materna, reinternação no primeiro ano de vida e problemas comportamentais...As an outcome of the recent advancement in the fields of Obstetrics and Perinatology, a significant reduction in the national rates of child mortality and high survival rates of children born preterm have been observed. However, there has not been a similar impact on reducing sequelae during children’s development or on the quality of life of children in both childhood and adolescence or in adulthood. There are reports in the literature that associate prematurity with physical and psychosocial sequelae that increase the chances for behavioral and cognitive problems, particularly at school age. However, results are not conclusive, and few studies associate such deficit with quality of life, generally evaluated according to parents’ perception. This study aimed at evaluating the quality of life of children born preterm that are now at preand school age, its association with birth conditions, socioeconomic variables, cognitive and behavioral performance as well as at assessing possible risk and protection predictors. To that end, the following instruments were used: AUQEI (Autoquestionnaire Qualité de Vie Enfant Imagé), HUI 3 (Health Utility Index 3), CBCL (Child Behavior Checklist), WISC and WPPSI (Wechsler Intelligence Scale). Of the 57 participants at ages ranging from 5 to 8 years, 33.3% were extremely low weight, and 75.4% were extremely preterm. In the cognitive assessment, 56.1% of the children showed cognitive performance from fair to superior, 22.8% were considered to be borderline, and 8.8 were intellectually impaired. As regards behavior, 36.8% showed problems at the clinical level, especially hyperactivity and attention deficit (21.1%) and anxiety (19.5%). There was a significant relation between maternal education, re-hospitalization in the first year of life and behavioral problems with cognitive performance. Concerning quality... (Complete abstract click electronic access below)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Quality of Life of Preterm Children: Risk and Protective Factors

Abstract Given the significant increase in survival rates of prematurely born children, this study assessed their quality of life at school age and identified potential risk and protective factors. We included 57 children with premature birth aged 5 to 8 years. Participants completed a cognitive test, and their parents assessed their behavior and quality of life. Most children presented an average or high intellectual level. Despite the mildly compromised quality of life, we observed a high prevalence of behavioral problems in older children. Male participants and behavioral problems were identified as risk factors for lower quality of life; this finding indicates the need to implement systematic monitoring services to facilitate adaptation of premature born children when entering in the school

Assessment of impairment in activities of daily living in mild cognitive impairment using an individualized scale

ABSTRACT Mild impairment in activities of daily living (ADL) can occur in Mild Cognitive Impairment (MCI), but the nature and extent of these difficulties need to be further explored. The Canadian occupational performance measure (COPM) is one of the few individualized scales designed to identify self-perceived difficulties in ADL. The present study investigated impairments in ADL using the COPM in elderly with MCI. A total of 58 MCI patients were submitted to the COPM for studies of its validity and reliability. The COPM proved a valid and consistent instrument for evaluating ADL in elderly MCI patients. A total of 74.6% of the MCI patients reported difficulties in ADL. Of these problems, 41.2% involved self-care, 31.4% productivity and 27.4% leisure. This data further corroborates recent reports of possible functional impairment in complex ADL in MCI