Resistant hypertension: Prevalence and profile of patients followed in a university ambulatory.

BACKGROUND: Hypertension affects about 36 million Brazilians. It is estimated that 10%-20% of these have resistant hypertension. These patients are at an increased risk of early target organ damage, as well as cardiovascular and renal events. OBJECTIVE: To estimate the prevalence of resistant hypertension in a specialized outpatient clinic, to describe the sociodemographic and clinical characteristics of these patients, and to identify possible factors associated with resistant hypertension. METHODS: Data collection from medical records of hypertensive patients treated using oral antihypertensive drugs in optimized doses at a specialized university clinic from March 2014 to December 2014, after ethical approval statement. All patients were using appropriate antihypertensive drugs in optimized doses and assisted at a teaching-assistance clinic of internal medicine of the Bahiana School of Medicine and Public Health in Brazil. RESULTS: A total of 104 patients were enrolled and 31.7% (n = 33) had criteria for resistant hypertension. Of the total participants, 75.7% were female and 54.8% were black or brown. The average age was 61.7 years (SD ± 10.1). In the resistant hypertension group, 63.6% had diabetes, compared to 32.4% in the hypertension group. Among resistant hypertensive patients, 51.5% had dyslipidemia. Regarding drug treatment, 75.8% of the resistant hypertension group and 51.4% of the hypertension group used statins. Among patients with resistant hypertension, 90.9% used angiotensin II receptor blockers and 66.7%, dihydropyridine calcium channel blockers. In the resistant hypertension group, 75.8% used beta-blockers, against 25.4% in the hypertension group. CONCLUSION: The prevalence of hypertension was higher than that described in the global literature, which may be associated with the high percentage of black and brown ("pardos") patients in the population studied, and also because the study was performed in a specialized outpatient clinic.

Identificação de situações e condutas bioéticas na atuação profissional em saúde / Evidence of bioethical discourse and behaviors in health professions / Identificación de situaciones y conductas bioéticas en la práctica profesional en salud

Resumo O objetivo deste estudo foi identificar na literatura situações e condutas bioéticas na atuação profissional em saúde. Trata-se de revisão integrativa de artigos científicos indexados nas bases de dados da Biblioteca Virtual em Saúde e publicados entre 2014 e 2019. Utilizaram-se os descritores "pessoal de saúde", "prática profissional", "ética profissional", "discurso" e "bioética". Foram selecionados 21 estudos para a discussão, destacando-se cinco categorias de análise: bioética durante a formação profissional; bioética como forma de humanizar a saúde; relações interprofissionais, direitos e deveres de trabalhadores e pacientes; bioética nas decisões que permeiam o início e o fim da vida; e tomada de decisões na saúde. A autonomia do paciente foi o princípio bioético mais abordado em diversas circunstâncias clínicas, especialmente nos dilemas relativos ao fim da vida.

Abstract This study aimed to identify bioethical situations and behaviors in health professions reported in the literature. This integrative review of scientific articles indexed in the Virtual Health Library databases, published between 2014 and 2019, used the following keywords: "health personnel," "professional practice," "ethics, professional," "discourse," and "bioethics." Twenty-one studies were selected for discussion, with five categories identified in the analysis: bioethics during professional training; bioethics as a form of humanizing healthcare; interprofessional relationships, rights and duties of patients and professionals; bioethics in decisions in the beginning and end of life; and decision making in healthcare. Patient autonomy was the bioethical principle most often addressed in various clinical circumstances, especially in end-of-life dilemmas.

Resumen El objetivo de este estudio fue identificar en la literatura situaciones y conductas bioéticas de la práctica profesional en salud. Se trata de una revisión integradora de artículos científicos indexados en las bases de datos de la Biblioteca Virtual en Salud, publicados entre 2014 y 2019. Se utilizaron los descriptores "personal de salud", "práctica profesional", "ética profesional", "discurso" y "bioética". Se seleccionaron 21 estudios para discusión y, del análisis, surgieron cinco categorías: bioética durante la formación profesional; bioética como forma de humanizar la salud; relaciones interprofesionales, derechos y deberes de los trabajadores y pacientes; bioética en las decisiones que permean el inicio y el final de la vida; y toma de decisiones en salud. La autonomía del paciente fue el principio bioético más abordado en diversas circunstancias clínicas, especialmente en los dilemas al final de la vida.

Accuracy of surrogate methods to estimate skeletal muscle mass in non-dialysis dependent patients with chronic kidney disease and in kidney transplant recipients.

BACKGROUND & AIMS: Bioelectrical impedance analysis (BIA) and anthropometric predictive equations have been proposed to estimate whole-body (SMM) and appendicular skeletal muscle mass (ASM) as surrogate for dual energy X-ray absorptiometry (DXA) in distinct population groups. However, their accuracy in estimating body composition in non-dialysis dependent patients with chronic kidney disease (NDD-CKD) and kidney transplant recipients (KTR) is unknown. The aim of this study was to investigate the accuracy and reproducibility of BIA and anthropometric predictive equations in estimating SMM and ASM compared to DXA, in NDD-CKD patients and KTR. METHODS: A cross-sectional study including adult NDD-CKD patients and KTR, with body mass index (BMI) ≥18.5 kg/m2. ASM and estimated SMM were evaluated by DXA, BIA (Janssen, Kyle and MacDonald equations) and anthropometry (Lee and Baumgartner equations). Low muscle mass (LowMM) was defined according to cutoffs proposed by guidelines for ASM, ASM/height2 and ASM/BMI. The best performing equation as surrogate for DXA, considering both groups of studied patients, was defined based in the highest Lin's concordance correlation coefficient (CCC) value, the lowest Bland-Altman bias (<1.5 kg) combined with the narrowest upper and lower limits of agreement (LoA), and the highest Cohen's kappa values for the low muscle mass diagnosis. RESULTS: Studied groups comprised NDD-CKD patients (n = 321: males = 55.1%; 65.4 ± 13.1 years; eGFR = 28.8 ± 12.7 ml/min) and KTR (n = 200: males = 57.7%; 47.5 ± 11.3 years; eGFR = 54.7 ± 20.7 ml/min). In both groups, the predictive equations presenting the best accuracy compared to DXA were SMM-BIA-Janssen (NDD-CKD patients: CCC = 0.88, 95%CI = 0.83-0.92; bias = 0.0 kg; KTR: CCC = 0.89, 95%CI = 0.86-0.92, bias = -1.2 kg) and ASM-BIA-Kyle (NDD-CKD patients: CCC = 0.87, 95%CI = 0.82-0.90, bias = 0.7 kg; KTR: CCC = 0.89, 95%CI = 0.86-0.92, bias = -0.8 kg). In NDD-CKD patients and KTR, LowMM frequency was similar according to ASM-BIA-Kyle versus ASM-DXA. The reproducibility and inter-agreement to diagnose LowMM using ASM/height2 and ASM/BMI estimated by BIA-Kyle equation versus DXA was moderate (kappa: 0.41-0.60), in both groups. Whereas female patients showed higher inter-agreement (AUC>80%) when ASM/BMI index was used, male patients presented higher AUC (70-74%; slightly <80%) for ASM/height2 index. CONCLUSIONS: The predictive equations with best performance to assess muscle mass in both NDD-CKD patients and KTR was SMM-BIA by Janssen and ASM-BIA by Kyle. The reproducibility to diagnose low muscle mass, comparing BIA with DXA, was high using ASM/BMI in females and ASM/height2 in males in both groups.

Pharmacotherapy for hyperuricaemia in hypertensive patients.

BACKGROUND: This is the second update of this systematic review. High blood pressure represents a major public health problem. Worldwide, approximately one-fourth of the adult population has hypertension. Epidemiological and experimental studies suggest a link between hyperuricaemia and hypertension. Hyperuricaemia affects 25% to 40% of those with untreated hypertension; a much lower prevalence has been reported in those with normotension or in the general population. However, whether lowering serum uric acid (UA) might lower blood pressure (BP), is an unanswered question. OBJECTIVES: To determine whether UA-lowering agents reduce BP in people with primary hypertension or prehypertension, compared with placebo. SEARCH METHODS: The Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to May 2020: the Cochrane Hypertension Specialised Register, CENTRAL 2018, Issue 12, MEDLINE (from 1946), Embase (from 1974), the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also searched LILACS (1982 to May 2020), and contacted authors of relevant papers regarding further published and unpublished work. The searches had no language or date restrictions. SELECTION CRITERIA: To be included in this updated review, the studies had to meet the following criteria: 1) randomised or quasi-randomised, with a group assigned to receive a UA-lowering agent and another group assigned to receive placebo; 2) double-blind, single-blind, or open-label; 3) parallel or cross-over trial design; 4) cross-over trials had to have a washout period of at least two weeks; 5) minimum treatment duration of four weeks; 6) participants had to have a diagnosis of essential hypertension or prehypertension plus hyperuricaemia (serum UA greater than 6 mg/dL in women, 7 mg/dL in men, and 5.5 mg/dL in children or adolescents); 7) outcome measures included change in 24-hour ambulatory systolic or diastolic BP, or both; or clinic-measured systolic or diastolic BP, or both. DATA COLLECTION AND ANALYSIS: The two review authors independently collected the data using a data extraction form, and resolved any disagreements via discussion. We assessed risk of bias using the Cochrane 'Risk of bias' tool. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: In this review update, we screened 722 records, selected 26 full-text reports for evaluation. We identified no ongoing studies and did not add any new studies. We included three randomised controlled trials (RCTs), enrolling 211 people with hypertension or prehypertension, plus hyperuricaemia. Low-certainty evidence from three RCTs found inconclusive results between those who received UA-lowering drugs and placebo, in 24-hour ambulatory systolic (MD -6.2 mmHg, 95% CI -12.8 to 0.5) or diastolic BP (-3.9 mmHg, 95% CI -9.2 to 1.4). Low-certainty evidence from two RCTs found that UA-lowering drugs reduced clinic-measured systolic BP (-8.43 mmHg, 95% CI -15.24 to -1.62) but results for clinic-measured diastolic BP were inconclusive (-6.45 mmHg, 95% CI -13.60 to 0.70). High-certainty evidence from three RCTs found that serum UA levels were reduced by 3.1 mg/dL (95% CI 2.4 to 3.8) in the participants that received UA-lowering drugs. Low-certainty evidence from three RCTs found inconclusive results regarding the occurrence of adverse events between those who received UA-lowering drugs and placebo (RR 1.86, 95% CI 0.43 to 8.10). AUTHORS' CONCLUSIONS: In this updated Cochrane Review, the current RCT data are insufficient to know whether UA-lowering therapy lowers BP. More studies are needed.

Sarcopenia and its components in adult renal transplant recipients: prevalence and association with body adiposity.

Sarcopenia is a progressive and generalised skeletal muscle disorder associated with adverse outcomes. Ageing causes primary sarcopenia, while secondary causes include chronic kidney disease (CKD), long-term use of glucocorticoids and obesity. The aim of the present study was to evaluate the prevalence of sarcopenia using guidelines recommended by the European Working Group on Sarcopenia in Older People (EWGSOP, 2010; EWGSOP2, 2018) and the Foundation of the National Institutes of Health (FNIH) and analyse the relationship between sarcopenia and body adiposity in adult renal transplant recipients (RTR). This was a cross-sectional study of adult RTR (BMI ≥ 18·5 kg/m2). Body composition was evaluated by dual-energy X-ray absorptiometry (DXA) and anthropometry. Glomerular filtration rate was estimated (eGFR) by CKD-Epidemiology Collaboration equation. The prevalence of sarcopenia in adult RTR (n 185; 57 % men, 50 (se 0·82) years and eGFR 55·80 (se 1·52) ml/min) was 7 % (FNIH), 11 % (EWGSOP2) and 17 % (EWGSOP). Low muscle mass, muscle function and physical performance affected, respectively, up to 28, 46 and 10 % of the participants. According to EWGSOP and EWGSOP2, body adiposity evaluated by anthropometry and DXA (percentage trunk fat) was lower in participants with sarcopenia. Conversely, according to the FNIH criteria, RTR with sarcopenia presented higher waist:height ratio. The present study suggests that adult RTR sarcopenia prevalence varies according to the diagnostic criteria; low muscle mass, low muscle function and low physical performance are common conditions; the association of body adiposity and sarcopenia depends on the criteria used to define this syndrome; and the FNIH criteria detected higher adiposity in individuals with sarcopenia.

High abdominal adiposity and low phase angle in overweight renal transplant recipients.

Obesity is associated with increased risk of cardiovascular disease (CVD). Body mass index (BMI) is the most used parameter for obesity screening. However, the evaluation of CVD risk in overweight individuals should include the assessment of body fat distribution and body composition. Renal transplant recipients (RTR) have a high CVD risk and frequently present weight gain and loss of lean mass. The aim of this study was to evaluate body fat distribution and body composition in overweight RTR. This cross-sectional study was conducted with 86 RTR and 86 hypertensive individuals (comparison group, CG) presenting BMI 25-35 Kg/m2 and 45-70 years. Anthropometric evaluation included BMI, waist circumference, waist-to-height ratio, and a body shape index. Body composition was evaluated with bioelectrical impedance analysis (BIA). Glomerular filtration rate was estimated (eGFR) by CKD-EPI equation. RTR group (RTRG) and CG presented similar age and BMI. RTRG when compared to CG presented lower percentage of women and eGFR; higher central adiposity; and lower values of reactance, intracellular water, body cell mass and phase angle, more consistently observed in women. This study suggests that overweight RTR present higher abdominal adiposity and impairment in BIA parameters that are sensitive indicators of impaired membrane integrity, water distribution, and body cell mass.

Vitamin D status in renal transplant recipients living in a low-latitude city: association with body fat, cardiovascular risk factors, estimated glomerular filtration rate and proteinuria.

Recent evidence suggests that vitamin D deficiency is associated with CVD, impaired kidney function and proteinuria. To date, no study has evaluated these associations in renal transplant recipients (RTR) adjusting for body adiposity assessed by a 'gold standard' method. This study aimed to evaluate the vitamin D status and its association with body adiposity, CVD risk factors, estimated glomerular filtration rate (eGFR) and proteinuria in RTR, living in Rio de Janeiro, Brazil (a low-latitude city (22°54'10"S)), taking into account body adiposity evaluated by dual-energy X-ray absorptiometry (DXA). This cross-sectional study included 195 RTR (114 men) aged 47·6 (sd 11·2) years. Nutritional evaluation included anthropometry and DXA. Risk factors for CVD were hypertension, diabetes mellitus, dyslipidaemia and the metabolic syndrome. eGFR was evaluated using the Chronic Kidney Disease Epidemiology Collaboration equation. Serum 25-hydroxyvitamin D (25(OH)D) concentration was used to define vitamin D status as follows: 10 % (n 19) had vitamin D deficiency (30 ng/ml). Percentage of body fat (DXA) was significantly associated with vitamin D deficiency independently of age, sex and eGFR. Lower 25(OH)D was associated with higher odds of the metabolic syndrome and dyslipidaemia after adjustment for age, sex and eGFR, but not after additional adjustment for body fat. Hypertension and diabetes were not related to 25(OH)D. Lower serum 25(OH)D was associated with increasing proteinuria and decreasing eGFR even after adjustments for age, sex and percentage of body fat. This study suggests that in RTR of a low-latitude city hypovitaminosis D is common, and is associated with excessive body fat, decreased eGFR and increased proteinuria.

Birthplace and birthdate of Brazilian Olympic medalists / Local de nascimento e data de nascimento de medalhistas olímpicos brasileiros

Abstract The aim of the present study was to analyze the association between birthplace and relative age with winning Olympic medals in Brazilian athletes. he sample consisted of 186 Olympic medalist athletes born in Brazil. Data analysis was performed through descriptive (incidence and percentage) and inferential statistics (Chi-Square to binary logistic regression). The association between population contingents and Olympic champions presented a significant result (p <0.05); however, no significant associations were found with relative age. It was concluded that most Olympic medalists were born in places that present better living conditions, with intermediate MHDI, which appears only in cities with more than 100 thousand habitants, and relative age is not an important criterion in winning medals among athletes investigated.

Resumo O objetivo do presente estudo foi analisar a associação entre o local de nascimento e idade relativa com a obtenção de medalhas olímpicas em atletas brasileiros. A amostra foi constituída por 186 atletas medalhistas olímpicos nascidos em território brasileiro. A análise dos dados realizou-se por meio da estatística descritiva (incidência e percentual) e inferencial (Qui-Quadrado a regressão logística binária). A associação entre os contingentes populacionais e campeões olímpicos apresentou resultado significativo (p<0,05), porém, não foram encontradas associações significativas com a idade relativa. Concluiu-se que a maioria dos atletas medalhistas olímpicos nasceu em locais que apresentam melhores condições de vida, com o IDHM médio que aparece apenas nas cidades com mais de 100 mil habitantes, além de a idade relativa não ser um critério importante na obtenção de medalhas dos atletas investigados.

Pharmacotherapy for hyperuricemia in hypertensive patients.

BACKGROUND: High blood pressure represents a major public health problem. Worldwide, approximately one-fourth of the adult population has hypertension. Epidemiological and experimental studies suggest a link between hyperuricemia and hypertension. Hyperuricemia affects 25% to 40 % of individuals with untreated hypertension; a much lower prevalence has been reported in normotensives or in the general population. However, whether lowering serum uric acid (UA) might lower blood pressure (BP) is an unanswered question. OBJECTIVES: To determine whether UA-lowering agents reduce BP in patients with primary hypertension or prehypertension compared with placebo. SEARCH METHODS: The Cochrane Hypertension Information Specialist searched the following databases for randomized controlled trials up to February 2016: the Cochrane Hypertension Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 2), MEDLINE (from 1946), Embase (from 1974), the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also searched LILACS up to March 2016 and contacted authors of relevant papers regarding further published and unpublished work. SELECTION CRITERIA: To be included in this review, the studies had to meet the following criteria: 1) randomized or quasi-randomized, with a group assigned to receive a UA-lowering agent and another group assigned to receive placebo; 2) double-blind, single-blind or open-label; 3) parallel or cross-over trial; 4) cross-over trials had to have a washout period of at least two weeks; 5) minimum treatment duration of four weeks; 6) participants had to have a diagnosis of essential hypertension or prehypertension, and hyperuricemia (serum UA greater than 6 mg/dL in women, 7 mg/dL in men and 5.5 mg/dL in children/adolescents); 7) outcome measures assessed included change in clinic systolic, diastolic or 24-hour ambulatory BP. DATA COLLECTION AND ANALYSIS: The two review authors independently collected the data using a data extraction form, and resolved any disagreements via discussion. We assessed risk of bias using the Cochrane Collaboration' Risk of bias' tool. MAIN RESULTS: In this review update, we examined the abstracts of 349 identified papers and selected 21 for evaluation. We also identified three ongoing studies, the results of which are not yet available. Three other randomized controlled trials (RCTs) (two new), enrolling individuals with hypertension or prehypertension, and hyperuricemia, met the inclusion criteria for the review and were included in the meta-analysis. Low quality of evidence from three RCTs indicate no reduction in systolic (MD -6.2 mmHg, 95% CI -12.8 to 0.5) or diastolic (-3.9 mmHg, 95% CI -9.2 to 1.4) 24-hour ambulatory BP with UA-lowering drugs compared with placebo. Low quality of evidence from two RCTs reveal a reduction of systolic clinic BP (-8.43 mmHg, 95% CI -15.24 to -1.62) but not diastolic clinic BP (-6.45 mmHg, 95% CI -13.60 to 0.70). High quality of evidence from three RCTs indicates that serum UA levels were reduced by 3.1 mg/dL (95% CI 2.4 to 3.8) in the participants that received UA-lowering drugs. Very low quality of evidence from three RCTs suggests that withdrawals due to adverse effects were not increased with UA-lowering therapy (RR 1.86, 95% CI 0.43 to 8.10). AUTHORS' CONCLUSIONS: In this updated systematic review, the RCT data available at present are insufficient to know whether UA-lowering therapy also lowers BP. More studies are needed.

O atletismo como conteúdo vai à escola: olhares discentes sobre a experiência de ensino / Athletics becomes school content: students'perceptions on teaching experience / El atletismo como contenido va a la escuela: percepciones de los estudiantes sobre la práctica de enseñanza

O estudo trata das percepções dos alunos acerca do conteúdo Atletismo e sua relação com competências pessoais e sociais na Escola. Participaram do estudo 20 alunos de uma turma do ensino fundamental de uma escola pública. Foram ministradas 24 sessões nas aulas de Educa- ção Física, utilizando à técnica de grupo focal. Os alunos desconheciam o atletismo e apresen- tavam interpretações confusas sobre o tema. A prática do atletismo foi importante para seus aspectos pessoais contribuindo para ampliação das relações interpessoais. Concluiu-se que o conteúdo ensinado pode ser desenvolvido no ambiente escolar, desmistificando o olhar indi- vidual sobre a modalidade, causando entusiasmo quando oportunizado ludicamente e respei- tando as possibilidades de formação de cada indivíduo.

The study deals with the perceptions of students about the Athletics content and its relation to personal and social skills in school. The study included 20 students of an elementary educa- tion class in a public school. 24 sessions in Physical Education classes were held, using the focus group technique. Students were unaware of athletics and had confused interpretations of the theme. The practice of athletics was important for personal aspects contributing to the expansion of interpersonal relationships. It was concluded that the content taught can be de- veloped in the school environment, demystifying the individual look on the modality, causing enthusiasm when developed playfully and respecting each individual's educational possibili- ties.

El estudio se ocupa de las percepciones de los estudiantes sobre el contenido curricular del atletismo y su relación con las habilidades personales y sociales en la escuela. El estudio in- cluyó 20 estudiantes de una clase de educación primaria, de una escuela pública. Fueron da- das 24 clases de Educación Física, utilizando la técnica de grupo focal. Los estudiantes des- conocían el atletismo y tenían interpretaciones confusas sobre el tema. La práctica del atletis- mo fue importante para los estudiantes, pues contribuyó para que algunos aspectos personales contribuyan con la expansión de las relaciones interpersonales. Se concluyó que el contenido que se enseñó puede ser desarrollado en el entorno escolar, desmitificando las percepciones individuales sobre la modalidad y, causando entusiasmo cuando se ofrece de forma lúdica y respetando las oportunidades de formación de cada individuo.

Estrutura e finalidades do ambiente esportivo: estudo de caso em clube de basquetebol feminino / Structure and purposes of the sports environment: a case study in a female basketball club

O objetivo deste estudo foi investigar o percurso histórico, a estrutura e as finalidades de um clube esportivo com tradição no desenvolvimento de atletas de basquetebol feminino no estado de Santa Catarina. Participaram da pesquisa três treinadores e dois dirigentes. As informações obtidas nas entrevistas semi-estruturadas e nas fontes documentais foram analisadas por meio da técnica de análise de conteúdo. A investigação do ambiente de sucesso no desenvolvimento das atletas de basquetebol permitiu verificar a estreita relação entre os quatro níveis do contexto no paradigma bioecológico e a interferência do percurso histórico e social na sua constituição, estrutura e finalidades, influenciando consequentemente o processo de formação esportiva nele estabelecida. A estrutura organizativa do Clube é composta pela assembleia geral, pela diretoria, pelo conselho fiscal e pelos associados, sendo a diretoria e o conselho fiscal constituídos por membros familiares voluntários. Entre os associados, destaca-se a presença de atletas, pais de atletas e ex-atletas. A estrutura esportiva está organizada em escolinhas, equipes de base e adulta, as quais representam além do Clube, o município, as escolas e a universidade patrocinadora. As finalidades administrativas se baseiam na melhoria da gestão do Clube e na formação de um Centro de Excelência para o desenvolvimento de talentos da modalidade, enquanto as finalidades formativas envolvem objetivos educativos, recreativos e de rendimento, sendo esse último perspectivado a curto, médio e longo prazo e fortemente influenciado pelas forças dos exossistemas FME e patrocinadores, além das políticas públicas (macrossistema). Nessa perspectiva, evidenciou-se que a modalidade, apesar de ter iniciado suas atividades de forma voluntária, conseguiu por meio do auxílio do mesossistema Clubefamília e dos exossistemas Prefeitura Municipal, federações e patrocinadores se organizar melhor em prol de uma gestão mais profissionalizada, conseguindo gerir adequadamente seus recursos públicos e privados e alcançar maior autonomia em suas decisões e ações.(AU)

The aim of this study was to investigate the historical background, structure and goals of a sports club with tradition in the development of female basketball players in the state of Santa Catarina. Participants were three coaches and two managers. The information obtained in the semi-structured interviews and documentary sources were analyzed using content analysis technique. The investigation of the successful environment in the development of female basketball players demonstrated the close relationship between the four levels in the context of the bioecological paradigm and the interference of the historical and social path in its constitution, structure and purposes, thus influencing the sports training process. The organizational structure of the club is composed of general meeting, board of directors, audit board and members, and the board of directors an audit board consisted of volunteer family members. Among members, the presence of athletes, parents of athletes and former athletes stands out. The sports structure is organized in small schools, youth and adult teams, which represent beyond the club, the city, schools and the sponsoring university. Administrative purposes are based on improving the Club management and the formation of an Excellence Centre for the development of talents, while formative purposes involve educational, recreational and performance objectives, the latter based on short, medium and long term and strongly influenced by the forces of FME exosystems and sponsors, in addition to public policy (macrosystem). In this perspective, it became clear that basketball, despite having started its activities voluntarily, managed through Club-family mesosystem and City Hall, federations and sponsors exosystems, better organization towards a more professional management, properly managing its public and private resources and achieving greater autonomy in its decisions and actions.(AU)

Avaliação da função renal

Este material compõe o Curso de Especialização em Nefrologia Multidisciplinar (Módulo 5, Unidade 1), produzido pela UNA-SUS/UFMA. Trata-se de um recurso educacional interativo que apresenta o processo de avaliação da função renal, podendo assim identificar o doente através de estimativas da filtração glomerular.

Rastreamento populacional da doença renal crônica

Este material compõe o Curso de Especialização em Nefrologia Multidisciplinar (Módulo 5, Unidade 1), produzido pela UNA-SUS/UFMA. Trata-se de um recurso educacional interativo que apresenta a importância do rastreamento populacional da Doença Renal Crônica.

Estratégias de prevenção da doença renal crônica

Texto que compõe a unidade 1 do módulo 5, "Prevenção às doenças renais", do Curso de Especialização em Nefrologia Multidisciplinar, produzido pela UNA-SUS/UFMA. Aborda as principais estratégias para prevenção da Doença Renal Crônica, bem como os métodos de estimativa da filtração glomerular, o rastreio populacional da doença e a realização de campanhas para divulgação da DRC

Autoeficácia discente na formação inicial de estudantes universitários de educação física / Autoeficacia discente en la formación inicial de estudiantes universitarios de educación física / Students’ self-efficacy in initial university training in physical education

Analisaram-se as relações da autoeficácia (AE) discente com aspectos da formação inicial de 385 estudantes universitários de Educação Física. Foram aplicadas a Escala de Autoeficácia na Formação Superior e a Escala de Motivação Acadêmica aos estudantes, e os resultados revelaram diferenças significativas na AE discente, considerando-se as variáveis sexo, curso realizado, participação em atividades de pesquisa e extensão, Índice de Aproveitamento Acumulado e Índice de Autodeterminação. As evidências ressaltam a importância da investigação aprofundada da AE no ensino superior, que pode contribuir para o desenvolvimento acadêmico profissional do estudante e para a melhoria da qualidade dos cursos de graduação ofertados.

Students’ self-efficacy relations were analyzed, together with aspects of initial training of 385 Physical Education university students. The Higher Education Self-Efficacy Scale and the Academic Motivation Scale were applied to students, and results showed statistically significant differences between students’ self-efficacy, considering the variables of gender, major, participation in research and extension activities, Academic Achievement Index, and Self-Determination Index. Evidence shows the importance of thorough investigation of SE in Higher Education, which may contribute to students’ academic and professional development and to improving the quality of undergraduate courses offered.

Se analizaron las relaciones de la autoeficacia (AE) discente con aspectos de la formación inicial de 385 estudiantes universitarios de Educación Física. Se aplicaron la Escala de Autoeficacia en la Educación Superior y la Escala de Motivación Académica a los estudiantes, y los resultados revelaron diferencias significativas en la AE discente considerando sexo, curso, participación en actividades de investigación y extensión, Índice de Rendimiento Académico e Índice de Autodeterminación. Las evidencias demuestran la importancia de investigar la AE discente en la Educación Superior, que puede contribuir para el desarrollo académico profesional del estudiante y para mejorar la calidad de los cursos de graduación ofrecidos.

Africanized honeybees in urban areas: a public health concern.

INTRODUCTION: This study aimed to investigate the occurrence of Africanized honeybees in Botucatu, São Paulo, Brazil, and to implement a program to remove such swarms. METHODS: The occurrences of Africanized honeybee swarms between 2010 and 2012 were studied and strategies to prevent accidents were developed. RESULTS: We noted 1,164 cases of Africanized honeybee occurrences in the city, and 422 swarms were collected. The developed strategies to prevent accidents were disseminated to the population. CONCLUSIONS: We contributed to reducing the risks represented by Africanized honeybee swarms in urban areas, by collecting swarms and disseminating strategic information for preventing accidents.

[Fast reading of the KDIGO 2012: guidelines for evaluation and management of chronic kidney disease in clinical practice]. / Leitura rapida do KDIGO 2012: Diretrizes para avaliacao e manuseio da doenca renal cronica na pratica clinica.

The authors of this "fast reading" present the data they have considered as more relevant in the KDIGO 2012 as concerned to evaluation and management of chronic kidney disease. The text does not correspond to their opinion, it is a brief presentation of guidelines that could be useful in clinical practice.