Rola Centralnej Kartoteki Haseł Wzorcowych

Background People with intellectual disabilities (ID) have lower levels of physical activity than the general population. The aim of this study was to understand the motivational factors of participation in physical activity for people with ID from the perspectives of the family members and staff. Method An abductive qualitative design was used. Social Cognitive Theory constituted the theoretical frame of reference of the study. Two focus group interviews with health care workers and family members and two individual interviews with health care workers were conducted at their workplace. A thematic analysis was performed. Results Three main themes were identified. According to support persons, motivation could be promoted at the individual level by fun, mastery, social setting, technology and knowledge about health behaviours. At a contextual level, physical activity was mediated by engagement with support individuals and available resources. At an interactional level, individuals were more motivated if the interaction was featured by joint activities, predictability and the use of rewards. Conclusions Motivation for participation in physical activity might be promoted at the individual, contextual and interactional levels. The interactions between individuals with ID and their support persons should work in a supportive way and strengthen mastery experiences. Support and engagement in the context could serve as a prerequisite for motivation and participation in physical activity and should be considered when developing interventions for physical activity for individuals with ID

Schistosomal portal hypertension: influence of the portal blood flow in serum levels of hepatic enzymes

Objetivo – Avaliar a relação entre o fluxo sangüíneo portal e o perfil laboratorial hepático em pacientes com hipertensão portal esquistossomótica. Pacientes e Métodos – Estudaram-se 64 pacientes com hipertensão portal esquistossomótica, sendo 19 não-operados, 23 submetidos a desconexão ázigo-portal com esplenectomia e 22 submetidos a derivação esplenorrenal distal. Avaliou-se o perfil laboratorial hepático através da dosagem sérica de albumina, transaminases glutâmico-oxalacética e glutâmico-pirúvica, bilirrubinas direta e indireta, fosfatase alcalina, gama-glutamil transferase e avaliação do tempo de protrombina. O fluxo portal foi avaliado por Doppler. Os resultados foram analisados através de regressão linear, coeficiente de correlação de Pearson, teste do Qui-quadrado e análise de variância de um via com pós-teste de Tukey. Resultados – Evidenciou-se que somente a gama-glutamil transferase teve correlação significativa com o fluxo portal. No cotejo dos quartis, também, somente a gama-glutamil transferase mostrou resultado significativo, em que se constatou que o quarto quartil, de maior fluxo portal e formado em sua maioria por pacientes não operados, também foi o de maior valor médio de gama-glutamil transferase e significativamente maior que o primeiro e terceiro quartis. Conclusões – Estes dados sugerem que: quanto maior o fluxo sangüíneo portal, maior o nível sérico de gama-glutamil transferase; a gama-glutamil transferase é a variável da avaliação do perfil hepático mais representativa da influência do fluxo portal na atividade funcional hepática nos pacientes com esquistossomose hepatoesplênica, e é possível que as cirurgias, através de suas modificações hemodinâmicas (diminuição da congestão), sejam também benéficas por diminuírem o grau de colestase presente ou em regredirem a indução microssomal. _________________________________________________________________________________________ ABSTRACT: Aim – To evaluate relation between the portal blood flow and the laboratory hepatic screening in patients with schistosomal portal hypertension. Patients and Methods – Sixty-four patients with schistosomal portal hypertension had studied, being 19 not operated, 23 submitted to esophagogastric devascularization with splenectomy and 22 submitted to distal splenorenal shunt. Evaluated the laboratory hepatic screening through the dosage of albumin, aspartate aminotransferase, alanine aminotransferase, direct bilirubin and indirect bilirubin, alkaline phosphatase, gamma-glutamil transferase and prothrombin time. The portal flow was evaluated for Doppler. The results have been analyzed through linear regression, Pearson correlation coefficient, chi-square and one-way analysis of variance with Tukey's test. Results – It was proven that only gamma-glutamil transferase had significant correlation with the portal flow. In compare of the quartiles, also only gamma-glutamil transferase showed resulted significant, it was evidenced that the fourth quartile, that is bigger portal flow and formed in its majority for patients not operated, also was bigger average of gamma-glutamil transferase and significantly bigger value than first and the third quartiles. Conclusions – 1. The portal blood flow was bigger in patients that the serum level of GGT was bigger; 2. the gamma-glutamil transferase is the variable of the hepatic screening evaluation more representative of the portal flow influence in hepatic functional activity in patients with hepatosplenic schistosomiasis, and 3. probably, the different surgeries through hemodynamics modifications, are beneficial in to diminish the degree of cholestasis or in decrease the microssomal induction