The rock carvings of Bouça da Cova da Moura (Ardegães, Maia, Northern Portugal) in the context of Late Prehistory in the Leça basin

Este texto pretende dar a conhecer o conjunto de gravuras rupestres da Bouça da Cova da Moura. A análise efetuada ao conjunto de signos permitiu denotar, a presença de composições gráficas pertencentes à tradição artística que se convencionou denominar de arte atlântica, representações de cariz mais esquemático e motivos de época histórica. Na envolvência dos afloramentos gravados descobriram-se monumentos megalíticos, áreas de dispersão de materiais cerâmicos datáveis do Calcolítico, uma ocupação da Idade do Bronze, além de materiais dispersos deste período genérico, relevantes para a análise da biografia deste lugar numa pequena escala de análise. A inserção deste locus numa escala mais ampla de análise, ou seja, os Montes do Leandro, pequeno contraforte da serra do Bougado, permite admitir que este complexo de gravuras rupestres faria parte de um vasto território de ampla significação simbólica durante a Pré-história Recente. Neste sentido as diferentes materialidades seriam, resultado de um processo aditivo que resulta da frequência do planalto, da sua da reutilização e reinterpretação, num templo cíclico.The aim of this paper is to offer an overview of the rock art assemblage at Bouça da Cova da Moura in its local and regional contexts. The site is located in Ardegães, parish of Águas Santas, municipality of Maia, district of Porto, in north-western Portugal. Fieldwork carried out in the end of the 20th century and the beginning of the 21st century, resulted in the discovery of new carved surfaces in the place where the well-known ‘pedra partida de Ardegães’ had been found; it was not only possible to unveil aspects related to its topographical context but also to discover other materialities which are spatially related to the rock carvings. Stylistic analysis undertaken to the set of carvings allow us to consider that we are beyond an assemblage which is partly constituted of rock art compositions belonging to the prehistoric art tradition conventionally called atlantic art, there is one schematic human figure and other motifs that belong to historical periods. In the vicinities of the carved outcrops there are megalithic monuments dated to the Neolithic, scatters of pottery fragments probably dated to the Copper Age, evidence for a Bronze Age occupation site, as well as clusters of surface finds from the same period. Overall, the field data recovered so far is extremely relevant for the analysis of the biography of this place at a small scale of analysis. The integration of this locus in a wider spatial scale, i.e. in the plateau that cuts across the territory in the north-south direction linking it to the Bougado hills, allow us to admit that this rock art complex would be part of a vast territory of symbolic significance in Late Prehistory. Thus, the distinct archaeological remains may be the materialisation of the importance of this geomorphological unit in the cognitive map and ideological universe of the prehistoric communities who dwelled, over a long period of time, along the middle basin of the River Neiva. These different materialities would result from a process of addition in the occupation of the plateau, of its reuse and reinterpretation in a cyclical time.Este texto insere-se no projeto Bronze Age Landscapes in the west of Iberian Peninsula / Paisagens da Idade do Bronze no ocidente peninsular (SFRH/BSAB/ 986/10) apoiado e financiado pela FCT no âmbito de uma Bolsa de Licença Sabática.info:eu-repo/semantics/publishedVersio

What is the effect of size on the use of the EFQM excellence model?

Purpose By contrasting a contingency with a universal approach to business excellence models (BEMs), the purpose of this paper is to investigate the effect of size on the use of the European Foundation for Quality Management (EFQM) model by organizations that were officially “Recognized for Excellence” in Spain. It considers the potential differences between large organizations and SMEs on the level of adoption of EFQM criteria and on the impact that enablers-criteria may have on key performance measures. Design/methodology/approach This study uses actual sub-criteria and criteria scores attained by organizations in their assessment for EFQM recognition. Scores of a population of 216 organizations are analyzed via analysis of variance, factor and structural equations models. Findings Although there are some criteria in the EFQM model that appear to be universally adopted irrespective of size, the empirical analyses indicate that size may shape the adoption of other criteria and the impact that enablers can have on results, thus supporting a contingency perspective. Moreover, the findings call for the revision of the relationships embedded in the EFQM model. Originality/value In contrast to most previous research, which relied on surveys of managers’ perceptions, this study uses the actual scores achieved by organizations in their assessment for EFQM recognition. It addresses the effect of size on the whole model, which so far has been neglected in the literature. All in all this study contributes to the literature on contingency approaches to best practices, and more specifically to BEMs. To the practitioner, it provides guidelines for addressing perceived performance gaps in their pursuit of recognition for excellence

Prevalência de atividade física em adolescentes e fatores associados

OBJECTIVE: To estimate the prevalence and identify correlates of physical activity among adolescents. METHODS: Cross-sectional study nested within a cohort of 4,325 subjects from the city of Pelotas, Southern Brazil, aged 14-15 years in 2008. Physical activity was analyzed using three different approaches: (1) prevalence of any leisure-time physical activity; (2) prevalence of any active commuting to school; and (3) prevalence of engaging in at least 300 minutes per week of both (1) and (2) combined. Independent variables included sociodemographic, behavioral, social, and biological characteristics, and number of different leisure-time physical activites practiced. Statistical analyses were carried out using Poisson regression. RESULTS: The proportion of adolescents involved in any type of leisure-time physical activity was 75.6%, while 73.4% displayed some form of active commuting to school. Prevalence of total physical activity score (>; 300 min/week) was 48.2%, being greater among boys (62.6%) than among girls (34.5%). Furthermore, prevalence increased along with the number of physical activity modalities practiced (pOBJETIVO: Estimar la prevalencia de actividad física entre adolescentes y identificar los factores asociados. MÉTODOS: Estudio transversal anidado en una cohorte con 4.325 individuos de 14-15 años en Pelota, Sur de Brasil, en 2008. La actividad física fue analizada por medio de tres diferentes abordajes: 1) prevalencia de alguna actividad física de ocio; 2) prevalencia de algún traslado activo para la escuela; 3) prevalencia de compromiso de por lo menos 300 minutos por semana en la combinación de ambos (1 y 2). Variables independientes incluyeron características demográficas, socioeconómicas, comportamentales, sociales y biológicas y número de actividades físicas practicadas en el tiempo de ocio. Los análisis estadísticos fueron hechos por la regresión de Poisson. RESULTADOS: La proporción de adolescentes envueltos en alguna actividad física de ocio fue 75,6% mientras que 73,4% presentaron alguna forma de traslado activo para la escuela. La prevalencia de actividad física total (escore ³ 300 min/sem) fue 48,2% siendo mayor para los niños (62,6%) que para las niñas (34,5%). Además, la prevalencia aumentó de acuerdo con el número de actividades físicas practicadas (pOBJETIVO: Estimar a prevalência de atividade física entre adolescentes e identificar fatores associados. MÉTODOS: Estudo transversal aninhado em uma coorte com 4.325 indivíduos de 14-15 anos em Pelotas, RS, em 2008. A atividade física foi analisada por meio de três diferentes abordagens: 1) prevalência de alguma atividade física de lazer; 2) prevalência de algum deslocamento ativo para a escola; 3) prevalência de engajamento em pelo menos 300 minutos por semana da combinação de ambos (1 e 2). Variáveis independentes incluíram características demográficas, socioeconômicas, comportamentais, sociais e biológicas e número de atividades físicas praticadas no tempo de lazer. As análises estatísticas foram feitas pela regressão de Poisson. RESULTADOS: A proporção de adolescentes envolvidos em alguma atividade física de lazer foi 75,6%, enquanto 73,4% apresentou alguma forma de deslocamento ativo para a escola. A prevalência de atividade física total (escore >; 300 min/sem) foi 48,2%, sendo maior para os meninos (62,6%) do que para as meninas (34,5%). Além disso, a prevalência aumentou de acordo com o número de atividades físicas praticadas (p < 0,001). Os fatores associados à maior prática de atividade física (lazer + deslocamento) nos níveis recomendados foram: cor de pele não-branca, ter repetido de ano na escola e jogar videogame. As variáveis menor nível socioeconômico, maior tempo de uso de computador e atividade física dos pais estiveram associadas ao desfecho apenas entre as meninas. CONCLUSÕES: Menos da metade dos adolescentes atingiu as recomendações para a prática de atividade física, e essa proporção tende a diminuir entre os sujeitos de maior nível socioeconômico. Os fatores associados diferiram entre lazer e deslocamento. Engajamento em uma ampla variedade de atividades físicas deve ser encorajado desde a infância

Ronco habitual e apnéia obstrutiva observada em adultos: estudo de base populacional, Pelotas, RS

OBJECTIVE: To estimate the prevalence of habitual snoring and obstructive sleep apnea and their factors associated. METHODS: Cross-sectional study with a representative sample comprising 3,136 adults (>;20 years) living in the city of Pelotas, Southern Brazil, in 2005. A questionnaire was used to collect information on demographic, socioeconomic, behavioral and anthropometric variables and outcomes. Crude and adjusted statistical analysis using Fisher exact test and chi-square test for linear trend and a multivariate analysis through Poisson regression model were carried out, respectively. RESULTS: The prevalence of habitual snoring was 50.5% (95% CI: 48.1;52.8) and obstructive sleep apnea was 9.9% (95% CI: 8.7;11.2). After adjustment, the risk of habitual snoring was greater in males (prevalence ratio [PR]=1.25, 95% CI: 1.16;1.34), elderly people (PR=1.62, 95% CI: 1.46;1.80), current smokers (PR=1.15, 95% CI: 1.07;1.25), alcohol users (PR=1.17, 95% CI: 1.03;1.31) and obese people (PR=1.71, 95% CI: 1.55;1.88). The risk of obstructive sleep apnea was greater in males (PR=2.05, 95% CI: 1.67;2.52), elderly people (PR=2.23, 95% CI: 1.64;3.03), current smokers (PR=1.60, 95% CI: 1.25;2.05) and obese people (PR=2.61, 95% CI: 1.97;3.47). CONCLUSIONS: In the studied population, habitual snoring and obstructive sleep apnea were common symptoms. Well-known risk factors such as male gender and age between 40 and 60 years are not modifiable. However, smoking, alcohol use and obesity need to be identified and treated in general population.OBJETIVO: Estimar a prevalência de ronco habitual e apnéia obstrutiva observada e fatores associados. MÉTODOS: Estudo transversal com amostra representativa de 3.136 adultos, com 20 anos ou mais, residentes em Pelotas, Rio Grande do Sul, em 2005. Informações sobre os desfechos e variáveis demográficas, socioeconômicas, comportamentais e antropométricas foram coletadas por meio de questionário. A análise estatística bruta e ajustada foi realizada utilizando-se teste exato de Fisher ou qui-quadrado de tendência linear e regressão de Poisson, respectivamente. RESULTADOS: A prevalência encontrada de ronco habitual foi de 50,5% (IC 95%: 48,1;52,8) e de apnéia obstrutiva de 9,9% (IC 95%: 8,7;11,2). Na análise ajustada, o relato de ronco foi maior nos homens (Razão de Prevalências - RP=1,25; IC 95%: 1,16;1,34), nos idosos (RP=1,62; IC 95%: 1,46;1,80), nos tabagistas (RP=1,15; IC 95%: 1,07;1,25), nos alcoolistas (RP=1,17; IC 95%: 1,03;1,31) e nos obesos (RP 1,71, IC95% 1,55;1,88). O relato de apnéia obstrutiva foi maior nos homens (RP=2,05; IC 95%: 1,67;2,52), nos idosos (RP=2,23; IC 95%: 1,64;3,03), nos tabagistas (RP=1,60; IC 95%: 1,25;2,05) e nos obesos (RP=2,61; IC 95%: 1,97;3,47). CONCLUSÕES: Ronco habitual e apnéia obstrutiva foram sintomas comuns na população estudada. Fatores de risco conhecidos como sexo masculino e idade entre quarta e quinta décadas de vida não são modificáveis. Entretanto, tabagismo, alcoolismo e obesidade também associados aos desfechos, devem ser identificados e tratados na população geral

Respiratory symptoms (COPD Assessment Test and modified Medical Research Council dyspnea scores) and GOLD-ABCD COPD classification: the LASSYC study

Chronic obstructive pulmonary disease; Symptoms; COPDEnfermedad pulmonar obstructiva crónica; Síntomas; EPOCMalaltia pulmonar obstructiva crònica; Símptomes; MPOCObjective To assess the frequency and severity of 24-hour respiratory symptoms according to COPD GOLD-ABCD classification (2017-version), the distribution of the patients with COPD into GOLD categories using mMRC (≥2) or CAT (≥10) scores, and agreement between these cut-off points. Methods In this cross-sectional study (LASSYC study), 24-hour day respiratory symptoms were assessed by the Evaluating Respiratory Symptoms in COPD (E-RS) questionnaire, Nighttime Symptoms of COPD Instrument (NiSCI), Early Morning Symptoms of COPD Instrument (EMSCI), CAT and mMRC scores. Results Among the 734 patients with COPD, 61% were male, age 69.6±8.7 years, FEV1% post-BD 49.1±17.5%, mMRC 1.8±1.0 and CAT 15.3±.8.1. By mMRC 33.7% were group-A, 29.2% group-B, 10.2% group-C and 26.9% group-D. By CAT 22.3% were group-A, 41% group-B, 4.8% group-C and 31.9% group-D. Using the mMRC the severity of E-RS, NiSCI and EMSCI scores increased from group A to D. Using the CAT, the groups B and D had the higher scores. Agreement between mMRC and CAT was 89.5% (Kappa statistics=75.7%). For mMRC score of 2, CAT score of ≥11 showed the maximum Youden’s index (1.34). For mMRC score of 1, CAT score of ≥9 and ≥10 showed the maximum Youden’s index (1.48). Conclusion GOLD COPD classification by CAT seems to better discriminate 24-hour symptoms. Results do not support the equivalent use of CAT≥10 and mMRC≥2 for assessing symptoms.This observational study was funded by AstraZeneca Latin America. The funder had no input into the study design, analysis, or interpretation of the results

Adverse childhood experiences:Prevalence and related factors in adolescents of a Brazilian birth cohort

AbstractAdverse childhood experiences (ACEs) can affect people's health and wellbeing not only at the time the ACE is experienced, but also later in life. The majority of studies on ACEs are carried out in high-income countries and little is known about its prevalence in low and middle-income countries. Thus, the aim of this study was to assess the prevalence of ACEs, associations between ACEs and sociodemographic factors, and the interrelationship between types of ACEs in adolescents of a Brazilian birth cohort. Data from 3,951 adolescents (78.4% of the original cohort) from the 1993 Pelotas Cohort were analyzed. Seven types of ACEs were assessed in those up to 18 years old: physical abuse, sexual abuse, physical neglect, emotional neglect, domestic violence, parental separation and parental death. The most common ACE was parental separation (42%), followed by emotional neglect (19.7%) and domestic violence (10.3%). Approximately 85% of the adolescents experienced at least one ACE, and females reported a higher number of adversities. Several socioeconomic, demographic and family-related characteristics were associated with the occurrence of ACEs, e.g. non-white skin color, low family income, low maternal schooling, absence of mother's partner, maternal smoking, and poor maternal mental health. A strong interrelationship was observed among the ACEs, indicating clustering of risk. These aspects should be considered by health and social care professionals in the prevention and identification of childhood adversities

Especificidade e sensibilidade de rastreamento para lesões cutâneas pré-malignas e malignas

OBJECTIVE: The incidence of melanoma is increasing worldwide, prevalence of malignant epithelial tumors is high and early diagnosis reduces significantly the morbi-mortality of these diseases. The purpose of the study is to estimate the prevalence of pre-malignant and malignant skin lesions and to determine the sensitivity and specificity of screening tests. METHODS: A cross-sectional population-based study was carried out using 48 census tracts randomly selected from urban zone of southern, Brazil. A total of 2,112 dwellings were visited and 1,292 individuals aged 50 years or more were interviewed. The questionnaire consisted of specific questions about new skin lesions in the last six months and/or the presence of lesions on exposed areas. Those who answered affirmatively were referred to the university's outpatient clinic for medical skin examination (gold standard). For assessing specificity the same doctors investigated a sub-sample of those who replied negatively to the questionnaire. RESULTS: The prevalence of pre-malignant and malignant skin lesions was 20.7%. The screening sensitivity was 20.1%, specificity 86.9%, positive predictive value 29%, negative predictive value 80.4%, and accuracy 72.9%. Using different cut-off points, the maximum sensitivity value was 38.8% and specificity remained almost the same. CONCLUSIONS: The study showed a high prevalence of skin lesions both pre-malignant and malignant in adults. Skin lesion screening revealed low sensitivity and unsatisfactory specificity, regardless the cut-off points set.OBJETIVO: O melanoma tem incidência crescente, sendo que a prevalência dos tumores malignos epiteliais é alta, e o diagnóstico precoce contribui significativamente para a redução da morbimortalidade dessas doenças. O objetivo da pesquisa é medir a prevalência das lesões cutâneas pré-malignas e malignas e determinar a sensibilidade e a especificidade de um rastreamento para essas lesões. MÉTODOS: Foi realizado um estudo transversal de base populacional com escolha aleatória de 48 setores censitários da zona urbana de Pelotas, RS, Brasil. Um total de 2.112 domicílios foram visitados, sendo entrevistadas 1.292 pessoas de 50 anos de idade ou mais. O rastreamento possuía questões específicas sobre o surgimento de lesões de pele nos últimos seis meses e/ou a presença de lesões em áreas expostas. Os que responderam afirmativamente foram encaminhados ao exame médico. Também foi examinada uma subamostra daqueles que haviam respondido negativamente às questões do rastreamento. RESULTADOS: A prevalência corrigida das lesões cutâneas pré-malignas e malignas foi de 20,7%. A sensibilidade do rastreamento foi de 20,1%, a especificidade, de 86,9%, o valor preditivo positivo, de 29%, o valor preditivo negativo, de 80,4%, e acurácia, de 72,9%. Com diferentes pontos de corte, o valor máximo da sensibilidade atingiu 38,8%, e a especificidade não se alterou significativamente. CONCLUSÕES: O estudo demonstrou alta prevalência de lesões cutâneas pré-malignas e malignas em adultos. O rastreamento para essas lesões mostrou baixa sensibilidade e especificidade inferior ao desejado, independentemente dos pontos de corte

Fatores de risco para mortalidade perinatal em Pelotas, RS, 1993

INTRODUCTION: Although there was a considerable reduction in infant mortality in Pelotas, Rio Grande do Sul in the last decade, its perinatal causes were reduced only by 28%. The associated factors of these causes were analised. MATERIAL AND METHOD: All hospital births and perinatal deaths were assessed by daily visits to all the maternity hospitals in the city, throughout 1993 and including the first week of 1994. RESULTS: The perinatal mortality rate was 22.1 per thousand births. The multivariate analysis showed the following risk factors: low socioeconomic level, male sex and maternal age above 35 years . Among multigravidae women, the fetal mortality rate was significantly increased for mothers with a previously low birthweight and a previous stillbirth. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight. CONCLUSIONS: Main risk factors for perinatal mortality: low socioeconomic level, maternal age above 35 years and male sex. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight.INTRODUÇÃO: Apesar de importante redução da mortalidade infantil em Pelotas, RS, na última década, as causas perinatais foram reduzidas em apenas 28%. Analisou-se os principais fatores associados a essas causas. MATERIAL E MÉTODO: Todos os nascimentos hospitalares e óbitos perinatais, em Pelotas, foram acompanhados através de visitas diárias aos hospitais, durante 1993 até a primeira semana de 1994. RESULTADOS: O coeficiente de mortalidade perinatal foi 22,1/1.000 nascimentos. A análise multivariada apontou os seguintes fatores de risco: baixo nível socioeconômico, sexo masculino e idade materna acima de 35 anos. Nas multíparas, encontrou-se maior risco para a mortalidade fetal naquelas que relatavam baixo peso prévio e natimorto prévio. A mortalidade neonatal precoce esteve associada com número de consultas pré-natais inferior a 5 e baixo peso ao nascer. CONCLUSÕES: Principais fatores de risco para mortalidade perinatal: baixo nível socioeconômico, idade materna elevada e sexo masculino. Para mortalidade neonatal precoce, o risco maior foi para consultas pré-natai

Tuberculosis and airflow obstruction: evidence from the PLATINO study in Latin America

The aim of the present study was to evaluate the association between history of tuberculosis and airflow obstruction.A population-based, multicentre study was carried out and included 5,571 subjects aged >= 40 yrs living in one of five Latin American metropolitan areas: São Paulo (Brazil); Montevideo (Uruguay); Mexico City (Mexico); Santiago (Chile); and Caracas (Venezuela). Subjects performed pre- and post-bronchodilator spirometry and were asked whether they had ever been diagnosed with tuberculosis by a physician.The overall prevalence of airflow obstruction (forced expiratory volume in one second/forced vital capacity post-bronchodilator < 0.7) was 30.7% among those with a history of tuberculosis, compared with 13.9% among those without a history. Males with a medical history of tuberculosis were 4.1 times more likely to present airflow obstruction than those without such a diagnosis. This remained unchanged after adjustment for confounding by age, sex, schooling, ethnicity, smoking, exposure to dust and smoke, respiratory morbidity in childhood and current morbidity. Among females, the unadjusted and adjusted odds ratios were 2.3 and 1.7, respectively.In conclusion, history of tuberculosis is associated with airflow obstruction in Latin American middle-aged and older adults.Univ Fed Pelotas, BR-96020220 Pelotas, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilNatl Inst Resp Dis, Mexico City, DF, MexicoUniv Republica, Montevideo, UruguayCatholic Univ Chile, Santiago, ChileCent Univ Venezuela, Caracas, VenezuelaUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc