Development of the Initial Surveys for the All of Us Research Program.

BACKGROUND: The All of Us Research Program is building a national longitudinal cohort and collecting data from multiple information sources (e.g., biospecimens, electronic health records, and mobile/wearable technologies) to advance precision medicine. Participant-provided information, collected via surveys, will complement and augment these information sources. We report the process used to develop and refine the initial three surveys for this program. METHODS: The All of Us survey development process included: (1) prioritization of domains for scientific needs, (2) examination of existing validated instruments, (3) content creation, (4) evaluation and refinement via cognitive interviews and online testing, (5) content review by key stakeholders, and (6) launch in the All of Us electronic participant portal. All content was translated into Spanish. RESULTS: We conducted cognitive interviews in English and Spanish with 169 participants, and 573 individuals completed online testing. Feedback led to over 40 item content changes. Lessons learned included: (1) validated survey instruments performed well in diverse populations reflective of All of Us; (2) parallel evaluation of multiple languages can ensure optimal survey deployment; (3) recruitment challenges in diverse populations required multiple strategies; and (4) key stakeholders improved integration of surveys into larger Program context. CONCLUSIONS: This efficient, iterative process led to successful testing, refinement, and launch of three All of Us surveys. Reuse of All of Us surveys, available at http://researchallofus.org, may facilitate large consortia targeting diverse populations in English and Spanish to capture participant-provided information to supplement other data, such as genetic, physical measurements, or data from electronic health records.

Yoga Research and Spirituality: A Case Study Discussion.

There is growing evidence that yoga can be beneficial as an aspect of self-care for people with arthritis. However, yoga may be less acceptable to those from different cultures, socioeconomic backgrounds, and racial/ethnic identities. While implementing a feasibility/acceptability pilot study of yoga as self-care in minority communities, the subject of spirituality surfaced. This commentary shares the experience of the researchers and yoga teachers collaborating on the study and the larger conversation that ensued following the withdrawal of one of the study participants. It is an attempt to start a relevant and needed dialogue around yoga research as an integrative health modality, and why the underlying body-mind-spirit approach to yoga may sometimes serve as a barrier to participation for diverse populations suffering from arthritis.

Projetos Vidas Paralelas Migrantes: mosaicos de cenários, perspectivas e produção de conhecimento no Brasil e na França - 2017/2020 / Project Migrant Parallel Lives: mosaics of scenarios, perspectives and knowledge production in Brazil and France - 2017/2020 / Proyecto Vidas Paralelas de Migrantes: mosaicos de escenarios, perspectivas y producción de conocimiento en Brasil y Francia - 2017/2020

Este artigo aborda a experiência do Projeto Vidas Paralelas Migrantes Brasil-Franca, implantado entre 2017 e 2020 em Brasília, Rio de Janeiro, Paris e Montpellier. Trata-se de uma pesquisa-ação realizada por meio de cooperação internacional entre Universidade de Brasília, Universidade do Estado do Rio de Janeiro, Université Paris 5, Université Paris 13 e Université Montpellier 3, financiada por edital CAPES-COFECUB. O artigo constitui um recorte de pesquisa do trabalho desenvolvido em Brasília com estudantes migrantes vinculados ao Programa de Estudantes-Convênio de Graduação (PEC-G) da Universidade de Brasília e com o Mouvement Sans-Papiers em Paris, bem como as experiências realizadas junto aos centros de acolhimento de migrantes da Cáritas, situado no Rio de Janeiro e em Paris. Aborda-se também trabalho de pesquisa sobre o processo de socialização de migrantes e refugiados vinculados a diversas organizações sediadas em Paris. A partir do resgate das experiências, busca-se refletir sobre os diferentes cenários, perspectivas teóricas e os caminhos percorridos na produção do conhecimento acerca do cotidiano de vida, cultura, saúde e trabalho dos migrantes, assinalando os avanços e desafios que caracterizam o desenvolvimento de um trabalho de cooperação.

Precocious puberty: an endocrine manifestation in congenital toxoplasmosis.

We reviewed retrospectively seven children with congenital toxoplasmosis and precocious puberty. All seven showed very high levels of LH (25.2-155.0 IU/ml) and FSH (7.1-38.2) upon stimulation with GnRH. Three of them showed low GH response to an insulin tolerance test. All the children had severe mental retardation. We emphasize that children with congenital toxoplasmosis should have their hypothalamopituitary function evaluated even in subclinical situations that could be responsible for endocrinological disturbances such as precocious puberty.

Social support: a key variable for health promotion and chronic disease management in Hispanic patients with rheumatic diseases.

Chronic diseases, including rheumatic diseases, can cause immense physical and psychosocial burden for patients. Many Hispanics suffering with arthritis face activity limitations. Social support, or the functional content of relationships, may be important to consider when examining treatment and outcomes for Hispanic individuals. Participants were recruited from an urban community health center (CHC) as part of a larger health behavior study. A cross-sectional, descriptive, mixed methods analysis was conducted to explore the role of social support in the sample. Only Hispanic/Latino patients (n = 46) were included in this analysis. Interviews were conducted in both English and Spanish. The majority of the sample (87%) perceived some presence of social support in their lives. The two most commonly cited types of social support were emotional and instrumental. The two most common sources of social support were family members other than spouses (52.2%) and spouses (32.6%). Body mass index (BMI) was significantly correlated with the number of perceived sources of support. The presence or absence and the role of social support in supporting optimal health outcomes should be considered for Hispanics with chronic rheumatic diseases. Involving family members and spouses in the plan of care for this population could facilitate health promotion and chronic disease management.

Uma visão contemporânea do mal-estar das juventudes brasileiras segregadas: indissociabilidade entre crítica cultural e clínica social nas atuais práticas psi / A contemporary view of the malaise of segregated Brazilian youth: indissociability of cultural critique and social praxis in current psy practices / Una visión contemporánea del malestar de las juventud brasileña segregada: insociabilidad entre crítica cultural y clínica social en las actuales prácticas psi

Este artigo visa problematizar as mudanças geradas pelos avanços das ciências médicas sobre os meios de controle da natalidade, destacando a proposta de uma prática clínica e crítica voltada para jovens brasileiras segregadas do sexo feminino. Pretendemos promover um debate sobre a escuta do mal-estar contemporâneo dessas jovens mães-adolescentes e seus bebês no cenário da Cidade do Rio de Janeiro no Século XXI(AU)

This article aims to discuss the changes generated by the advances of medical science on birth control means, highlighting the proposal for a clinical practice and critique of female segregated Brazilian youths. We intend to promote a debate on listening to the contemporary malaise of these young adolescent mothers and their babies in the scene of Rio de Janeiro in the XXI century(AU)

Este artículo visa problematizar los cambios generados por los avances de las ciencias médicas sobre los medios de control de la natalidad, destacando la propuesta de una práctica clínica y crítica devotada para jóvenes brasileñas segregadas del sexo femenino. Pretendemos promover un debate sobre la escucha del malestar contemporáneo de esas jóvenes manos-adolescentes y sus bebés en el escenario de la Ciudad de Rio de Janeiro en el Siglo XXI(AU)

Description of the complexity of prescribed medication regimens in primary health care of Ribeirão Preto - SP

Introduction: Pharmacotherapy is the main therapeutic resource for the management of diseases. However, the number of drugs prescribed, dose frequency, and mode of administration can make the treatment more complex and influence treatment outcomes. The aim of this study was to measure the complexity of prescribed medication regimens in primary health care (PHC) services in Ribeirão Preto, Brazil. Methods: This cross-sectional study included 1,009 participants: 889 from primary health units and 120 from family health units in Ribeirão Preto, Brazil. Treatment complexity was assessed using the Medication Regimen Complexity Index (MRCI). Results: MRCI mean scores were 12.5 points (SD = 9.3) and dose frequency was the major contributor to increase the score. The complexity of pharmacotherapy showed a significant correlation with the number of prescribed medications (r = 0.93, p < 0.01), but not with patients' age (r = 0.28, p < 0.01). There is also no difference in complexity between the sexes (p = 0.83) and the types of primary health care service (p = 0.31). An analysis of variance revealed that patients with lower levels of education receive more complex prescriptions (p < 0.01). Conclusions: The pharmacotherapy prescribed in PHC services from Ribeirão Preto, Brazil is complex, and there is a need to concentrate efforts and adopt strategies to simplify drug prescription without compromising patient's clinical status.

Adequação da prescrição de medicamentos na Atenção Primária à Saúde de Ribeirão Preto-SP: estudo transversal / Adequacy of drug prescriptions in the Primary Health Care of Ribeirão Preto-SP: a cross-sectional study / Adecuación de las prescripciones de medicamentos en la Atención Primaria de Salud de Ribeirão Preto-SP: estudio transversal

Objetivo: Este estudo transversal visa analisar comparativamente as prescrições de medicamentos provenientes da atenção básica tradicional (Unidades Básicas de Saúde - UBS) com as da Estratégia de Saúde da Família (ESF). Métodos: Foram incluídas 1053 prescrições, alocadas em dois grupos: 932 provenientes de UBS e 121 da ESF. Tais prescrições foram analisadas de acordo com a adequação aos itens legalmente exigidos e aos indicadores de qualidade (presença de antimicrobianos, presença de injetáveis, uso da denominação oficial, uso da relação de medicamentos essenciais, média de medicamentos prescritos). Resultados: As prescrições da ESF se mostraram estatisticamente mais completas quanto à presença do endereço do prescritor (82,6% UBS, 96,7% ESF), à ausência de rasuras (90,3% UBS, 96,7% ESF) e ao cumprimento dos aspectos legais exigidos referentes ao uso do medicamento, sendo eles: forma farmacêutica (70,7% UBS, 80,2% ESF), dose (70,9% UBS, 79,3% ESF), posologia (63,0% UBS, 75,2% ESF), via de administração (58,3% UBS, 83,5% ESF) e duração do tratamento (76,9% UBS, 92,6% ESF). Os resultados dos indicadores de qualidade da prescrição se aproximaram nos dois modelos de atenção básica e estão de acordo com os valores recomendados, com exceção da média de medicamentos prescritos, a qual evidenciou uma tendência à polifarmácia no município (3,9 medicamentos por prescrição na UBS e 3,5 na ESF). Conclusão: Apesar dos resultados revelarem práticas inapropriadas na prescrição de medicamentos na Atenção Primária como um todo, há evidências de que as prescrições da ESF estão mais próximas ao padrão ideal, o que pode favorecer o Uso Racional de Medicamentos.

Objective: This cross-sectional study aims to comparatively analyze drug prescriptions from the traditional basic health care service (Basic Health Units - BHU) with those from Family Health Strategy (FHS). Methods: A total of 1053 prescriptions were included, allocated in two groups: 932 from BHU and 121 from FHS. These prescriptions were analyzed according with compliance to legally required items and quality indicators (presence of antimicrobials, presence of injectable, use of the official name, use of the list of essential drugs, average of drugs prescribed). Results: The ESF prescriptions were more complete regarding the presence of the prescriber's address (82.6% BHU, 96.7% FHS), the absence of erasures and overwritten words (90.3% BHU, 96.7% FHS) and with compliance to legally required items related to use of drugs, being: pharmaceutical form (70.7% BHU, 80.2% FHS), dose (70.9% BHU, 79.3% FHS), posology (63.0% BHU, 75.2% FHS), administration route (58.3% BHU, 83.5% FHS) and time of therapy (76.9% BHU, 92.6% FHS). The results of the indicators of quality of prescription are approximated in both models of basic attention and according to the recommended values, with the exception of the average of drugs prescribed, which showed a tendency to polypharmacy at county (3.9 drugs per prescription at the BHU and 3.5 at the FHS). Conclusion: although the results reveal inappropriate practices in drug prescription at Primary Health Care services as a whole, there are evidence that prescriptions from FHS are closer to the ideal pattern, which may favor the Rational Use of Drugs.

Objetivo: Este estudio transversal tuvo como objetivo comparar prescripciones médicas de la atención primaria tradicional (Unidades Básicas de Salud - UBS) con las de la Estrategia de Salud Familiar (ESF). Métodos: Se incluyeron 1053 prescripciones, divididas en dos grupos: 932 de la UBS y 121 de la ESF. Estas prescripciones se analizaron de acuerdo con la adecuación de los ítems legalmente requeridos y a los indicadores de calidad (presencia de antimicrobianos, presencia de inyectables, uso de la denominación oficial, uso de la relación de medicamentos esenciales, número medio de los medicamentos prescritos). Resultados: Las prescripciones de la ESF eran estadísticamente más completas debido a la presencia de la dirección del prescriptor (82,6% UBS, 96,7% ESF), en la ausencia de tachaduras (90,3% UBS, 96,7% ESF) y en el cumplimiento de los aspectos legales requeridos referentes al uso del medicamento, siendo ellos: forma farmacéutica (70,7% UBS, 80,2% ESF), dosis (70,9% UBS, 79,3% ESF), posología (63,0% UBS, 75,2% ESF), vía de administración (58,3% UBS, 83,5% ESF) y duración del tratamiento (76,9% UBS, 92,6% ESF). Los resultados de los indicadores de calidad de la prescripción fueron similares en los dos modelos de atención primaria y están de acuerdo con los valores recomendados, excepto el número medio de los medicamentos prescriptos, que mostró una tendencia a la polifarmacia en el municipio (3,9 medicamentos por prescripción en la UBS y 3,5 en la ESF). Conclusión: Aunque los resultados indican prácticas inadecuadas en la prescripción de medicamentos en atención primaria en general, existen evidencias de que las prescripciones de la ESF son más cercanas a los estándares, lo que puede favorecer el Uso Racional de Medicamentos.

Prevalence of the metabolic syndrome using two proposed definitions in a Japanese-Brazilians community.

Metabolic Syndrome (MetS) is associated with increased risk of morbi-mortality, thus the characterization of the population magnitude of this syndrome is critical for allocating health care. However, prevalence estimates of MetS in the same population could differ depending on the definition used. Therefore, we compared the prevalence of the MetS using definitions proposed by: National Cholesterol Education Panel Revised (NCEP) and International Diabetes Federation (IDF) 2009 in a Japanese-Brazilians community (131 individuals, age 57 ± 16 years, 1st and 2nd generation). All individuals went through a clinical and laboratorial evaluation for assessment of weigh, height, waist circumference, blood pressure, triglycerides, HDL-cholesterol and fasting plasma glucose. The prevalence of MetS was 26.7% (n = 35) and 37.4% (n = 49) under the NCEP and IDF definitions, respectively. Despite higher blood pressure measurements, waist circumference and serum triglyceride levels and lower HDL cholesterol levels (p < 0.01), individuals identified with MetS did not show increased blood glucose levels. IDF definition classified 14 individuals (10.7%) with MetS that were not classified under the NCEP and 35 individuals were identified with MetS by both criteria. We observed, in this group, more severe lipid disorders, compared to individuals identified only under the IDF definition, and the BMI and waist circumference (p = 0.01; p = 0.006, respectively) were lower. In conclusion, the IDF revised criteria, probably because of the ethnic specific values of waist circumference, was able to identify a larger number of individuals with MetS. However, our data suggesting that additional studies are necessary to define best MetS diagnostic criteria in this population.

Cardiovascular risk in Japanese-Brazilian subjects.

OBJECTIVE: To evaluate the prevalence of risk factors for cardiovascular disease in Japanese-Brazilian subjects. SUBJECTS AND METHODS: One hundred thirty-one residents of the Mombuca community were studied. Statistical analysis was based on the X² test, Fisher's Exact test, Student's t test, and ANOVA, at a 5% significance level. RESULTS: The average age was 56.7 years-old; 76.3% had dyslipidemia, 24.4% pre-diabetes (PDM), 10.7% type 2 diabetes mellitus (T2DM), 46.6% hypertension, 52.7% abdominal obesity, and 35.8% metabolic syndrome (MS). There were significant correlations between HOMA-IR and MS diagnosis and obesity, while HOMA-ß levels were decreased in T2DM and PDM. The ankle-brachial index was positive for peripheral artery disease in 22.3% of the individuals. Electrocardiograms did not show increased evidence of myocardial ischemia. CONCLUSION: Subjects of this community are exposed to major cardiovascular risk factors, namely high prevalence of MS diagnoses and increased HOMA-IR.

Ancestralidade Africana da Cultura e da Identidade do Samba / African Ancestry of Samba Culture and Identity / Ancestralidad Africana de la Cultura y de la Identidad de la Samba / Culture D'ascendance Africaine et L'identité de la Samba

O artigo aborda o processo de configuração das identidades negras dos povos da diáspora africana no Brasil, frisando os lugares e os contextos de emergência e o desenvolvimento da negritude como conceito. A partir dessa perspectiva sócio-histórica, faz referência à construção da identidade nacional brasileira apontando para a hibridação como fenômeno cultural tangível nas tradições musicais. Nessa linha de preservação das tradições, o texto finalmente apresenta a forma como o samba carioca foi registrado como patrimônio cultural imaterial do Brasil sob a liderança do Centro Cultural Cartola, hoje Museu do Samba.

The article deals with the process of configuring the black identities of the peoples of the African diaspora in Brazil, highlighting the places and contexts of emergence and the development of blackness as a concept. From this socio historical perspective, it makes reference to the construction of the Brazilian national identity pointing to the hybridization as tangible cultural phenomenon in the musical traditions. In this line of preservation of traditions, the text finally shows how samba in Rio was registered as intangible cultural heritage of Brazil, under the leadership of the Cartola Cultural Center, today the Samba Museum.

Este trabajo aborda el proceso de configuración de las identidades negras de los pueblos de la diáspora africana en Brasil, subrayando los lugares y los contextos de emergencia y el desarrollo del concepto de negritud. Partiendo de esta perspectiva socio-histórica, haz referencia a la construcción de la identidad nacional brasileña indicando para la hibridación como fenómeno cultural tangible en las tradiciones musicales. En este rumbo de preservación de las tradiciones, el texto finalmente presenta la forma como la samba carioca fue registrada como patrimonio cultural inmaterial del Brasil, bajo liderazgo del Centro Cultural Carlota, hoy Museo de la Samba.

L'article décrit le processus de création des identités noires du peuple de la diaspora africaine au Brésil, en mettant en relief les lieux et les situations d'urgence et le développement de la négritude comme un concept. De ce point de vue socio-historique, il fait référence à la construction de l'identité nationale brésilienne montrant l'hybridation en tant que phénomène culturel tangible dans les traditions musicales. Dans cette ligne de préservation des traditions, le texte montre, enfin, comment la samba a été enregistré en tant que patrimoine culturel immatériel du Brésil, sous la direction du Centre Culturel Cartola, aujourd'hui, le Musée de la Samba.

Escala de preferências por objetos ocupacionais: correlações com o Questionário de Busca Autodirigida / Object scale of occupational preferences: correlations with the self-directed search questionnaire / Escala de objetos de preferencias ocupacionales: correlaciones con el cuestionario de búsqueda autodirigida

Testes psicológicos podem clarificar a escolha profissional. Esta pesquisa objetivou ampliar as análises acerca das características psicométricas da Escala de Preferências por Objetos Ocupacionais, por meio da comparação com o Questionário de Busca Autodirigida. Participaram 496 estudantes do Ensino Médio, com idade média de 17 anos (DP = 20,4). As correlações mostraram-se significativas entre os fatores Artes e Comunicação e o tipo Artístico, Ciências Biológicas e da Saúde e o Investigativo, Entretenimento e o Social. Encontraram-se diferenças na média entre sexos nas tipologias Realista, Social e Empreendedor, e nos fatores Ciências Biológicas e da Saúde e Ciências Exatas e Agrárias. Tais resultados apontam comunalidade entre construtos, validade da EPOOc e evidenciam contribuições para a área da Avaliação Psicológica e da Orientação Profissional.

Psychological tests can clarify the professional choice. This research aimed to expand the analysis of OSOP - Object Scale of Occupational Preference, through comparison with SDS - Self Directed Search. A number of 496 high school students with an average age of 17 years took part in the study. (SD = 20.4). The correlations were significant between the Arts and Communication; Artistic, Biological and Health Sciences and Research, Entertainment and Social factors. Differences were found in gender of the realistic, social and entrepreneur dimensions, in the factors biological sciences and in health and exact sciences and agricultural sciences. These results show commonality among constructs, validity of OSOP and evidence contributions to the field of Psychological Assessment and Professional Orientation.

Las pruebas psicológicas pueden contribuir a dilucidar la elección profesional. Esta investigación tuvo como objetivo ampliar análisis sobre las características psicométricas de la EPOOc - Escala de Objetos de Preferencias Ocupacionales, a través de comparación con SDS - Self Directed Search. Participaron 496 estudiantes de escuela secundaria, con edad promedio de 17 años (DP = 20,4). Las correlaciones fueron significativas entre los factores Artes y Comunicación y el tipo Artístico, Ciencias Biológicas y de Salud e Investigación, Entretenimiento y Social. Se encontraron diferencias en la media entre sexos en las dimensiones Realistas, Social y Emprendedor, y en los factores Ciencias Biológicas y de Salud y Ciencias Exactas y Agrícolas. Estos resultados apuntan comunalidad entre constructos, validez del EPOOc y evidencian contribuciones al campo de la Evaluación Psicológica y Orientación Profesional.

Prevalence of diabetes mellitus in the Japanese-Brazilian community of Mombuca, Guatapará, SP.

OBJECTIVE: To estimate the prevalence of type 2 diabetes mellitus (DM2) and impaired glucose tolerance (IGT) in the Japanese-Brazilian community of Mombuca in relation to risk factors (FR) for diabetes and cardiovascular disease. SUBJECTS AND METHODS: Cross-sectional study with 131 individuals of Japanese ancestry (69% first generation), aged 20 years or more, submitted to socio-cultural, anthropometric, and biochemistry evaluation. RESULTS: Of the individuals studied (n = 131, age = 55.1 ± 15.9 years), 58.8% were women. The prevalence of DM2 and IGT were 13.7% and 14.5%, respectively. Regarding RF, 76.3% presented dyslipidemia, 52.7% abdominal obesity, 48.1% arterial hypertension, and 42.3% whole body obesity. CONCLUSIONS: The prevalence of DM2, IGT, and RF in this Japanese-Brazilian community was higher than in the adult population of the city of Ribeirão Preto-SP, Brazil, suggesting an increase in risk conditions for these morbidities.

Mangueira: a cultura comunitária e o centro cultural cartola / Mangueira: a community Culture and "Cartola" Cultural Center / Mangueira: la cultura comunitaria y el Centro Cultural Cartola

O presente trabalho analisa as relações entre os processos de investigação e de intervenção no campo comunitário, enfatizando duas questões centrais: a) se a investigação (pesquisa) deve conduzir a ações que também sejam comprometidas com a realidade e a transformação social; e b) se o processo de intervenção em comunidade gera conhecimentos socialmente relevantes. Para isso procede-se a uma reflexão sobre os dilemas e desafios éticos que estão presentes nas práticas comunitárias: a) relacionados às exigências metodológicas e de produção de conhecimento; b) ligados à "sensibilidade cotidiana e histórica". Indaga-se se a intervenção psicossocial capta os processos de participação e conscientização. Finaliza-se com uma exposição de aspectos importantes para a congruência metodológica e política entre intervenção e investigação psicossocial em comunidade, na perspectiva da Psicologia Social Comunitária Latino-Americana.

This paper analyzes the relationships between the processes of investigation and intervention in the community field, emphasizing two central questions: (a) if the investigation (research) should lead to actions that are also committed to reality and social change; and (b) if the community intervention process generates socially relevant knowledge. For it the paper proceeds to a reflection on the dilemmas and ethical challenges that are present in community practices: (a) related to methodological requirements and to the production of knowledge; (b) linked to "daily and historical sensibility". It asks if psychosocial intervention captures the processes of participation and awareness. It ends up with an exposure of significant aspects to the methodological and political congruence between intervention and psychosocial research in community from the perspective of Latin American Social Community Psychology.

Este trabajo analiza las relaciones entre los procesos de investigación e intervención en el ámbito de la comunidad, haciendo hincapié en dos cuestiones centrales: (a) si la investigación (pesquisa) debe conducir a acciones que también están comprometidos con la realidad y el cambio social; y (b) si el proceso de intervención comunitaria genera conocimiento socialmente relevante. Para tanto el documento procede a una reflexión sobre los dilemas y desafíos éticos que están presentes en las prácticas en la comunidad: (a) en relación con los requisitos metodológicos y de la producción de conocimiento; (b) ligados a "la sensibilidad cotidiana y histórica". Se pregunta si la intervención psicosocial captura los procesos de participación y toma de conciencia. Se termina con una exposición de los aspectos importantes de la congruencia metodológica y política entre la intervención y la investigación psicosocial en la comunidad desde la perspectiva de la Psicología Social Comunitaria Latinoamericana.

Breastfeeding pattern in the first month of life in women submitted to breast reduction and augmentation.

OBJECTIVE: To describe the breastfeeding pattern in the first month of life in women submitted to two types of surgery - breast reduction and augmentation - and to compare it with the pattern exhibited by women who had no surgery. METHODS: Controlled prospective cohort with 25 women submitted to reduction surgery, 24 submitted to augmentation surgery and 25 with no breast surgery, who gave birth at Hospital Israelita Albert Einstein, São Paulo, Brazil. The data were obtained from assessments carried out 48 to 72 hours, between the 5th and 7th days, and 30 days after delivery. The following tests were used for data analysis: chi-square test, Fisher's exact test, Kaplan-Meier curve and Cox regression. RESULTS: The probability of an infant being on exclusive breastfeeding at the end of the first month of life was 29% in women with reduction surgery, 54% in those with augmentation surgery, and 80% in women who had no surgery. The probability of mixed breastfeeding being adopted during this same period amounted to 68% among women with reduction surgery, 32% in those with augmentation surgery, and only 16% among those without any breast surgery. The risk of an infant being on non-exclusive breastfeeding was five times greater in women submitted to reduction surgery when compared to those women with no surgery (p = 0.002). Among women with augmentation surgery, the risk of an infant being on non-exclusive breastfeeding was 2.6 times greater than that observed in infants whose mothers had no breast surgery (p = 0.075). CONCLUSION: Breast reduction and augmentation surgeries led to lower rates of exclusive breastfeeding in the first month of life.

Comparison of venous plasma glycemia and capillary glycemia for the screening of type 2 diabetes mellitus in the Japanese-Brazilian community of Mombuca (Guatapará-SP).

BACKGROUND: To identify the most appropriate cut-off points of fasting glycemia for the screening of diabetes mellitus type 2 (DM2) with the comparison of the properties of capillary glycemia (CG) and venous blood plasma glycemia (PG) in a population of Japanese origin from the community of Mombuca, Guatapará-SP, Brazil. METHODS: This was a population-based descriptive cross-sectional study conducted on a sample of 131 individuals of both genders aged 20 years or more (66.8% of the target population). CG was measured with a glucometer in a blood sample obtained from the fingertip and PG was determined by an enzymatic method (hexokinase) in venous blood plasma, after a 10-14 hour fast in both cases. Data were analyzed by the receiver operating characteristic (ROC) curve in order to identify the best cut-off point for fasting glycemia (CG and PG) for the diagnosis of DM, using the 2-hour plasma glycemia > 200 mg/dl as gold - standard. RESULTS: The ROC curve revealed that the best cut-off point for the screening of DM was 110 mg/dl for CG and 105 mg/dl for PG, values that would optimize the relation between individuals with positive and false-positive results. The area under the ROC curve was 0.814 for CG (p < 0.01) and 0.836 for PG (p < 0.01). CONCLUSIONS: The cut-off points of 105 mg/dl(5.8 mmol/l) for PG and of 110 mg/dl(6.1 mmol/l) for CG appear to be the most appropriate for the screening of DM2 in the population under study, with emphasis on the fact that the value recommended for CG is 5 mg/dl higher than that for PG, in contrast to WHO recommendations.

Motivos de um indivíduo para praticar atividades físico-esportivas / Reasons for an individual to practice physical sports activities / Motivos de un individuo para la práctica de actividades físico-deportivas

Este estudo objetiva investigar os motivos de um indivíduo para aderir à prática regular de atividades físico-esportivas. É um estudo de caso qualitativo que emerge do interesse pelos aspectos intrínsecos de um caso particular. O instrumento utilizado para coleta de dados foi a entrevista. Tendo em vista a análise e a interpretação dos dados coletados, concluímos que: (1) a prática de atividades físico-esportivas pode estar associada a motivos que não são representados, isto é, a impulsos que permanecem obscuros; (2) o sujeito pratica regularmente atividades físico-esportivas porque com ela se sente mais consciente dos seus limites, de sua potência e de sua estética; (3) sua prática regular está associada à identificação com atividades físico-esportivas variadas; (4) o sujeito pratica-as regularmente, porque associa essa prática a um remédio saudável, porque mexer com o corpo é brincar com o corpo; (5) o sujeito pratica regularmente atividades físico-esportivas porque as qualidades da imaginação o confortam e a ilusão o acolhe e o move...

This study aims to investigate the reasons why an individual joins regular physical sports activities. This is a qualitative case study which rises from the interest in inherent aspects of a specific situation. The instrument used for data collection was an interview. Considering the analysis and interpretation of the collected data, we have concluded that: (1) the practice of physical sports activities may be associated with reasons which are not shown, that is, with impulses which remain unclear; (2) the individual practices physical sports activities regularly, because by doing so they feel more aware of their limits, their power, their aesthetics; (3) the regular practice of such activities is associated with the identification with varied physical sports activities; (4) the subject practices such activities regularly, as this practice is associated with a healthy medication, since moving the body means playing with the body; (5) the individual practices physical sports activities regularly because the qualities of the imagination are comforting to them, the illusion shelters him and makes him move forward...

Este estudio tiene el objetivo de investigar los motivos de la adhesión de un individuo a la práctica regular de actividades físico-deportivas. Se trata de un estudio de caso cualitativo que emerge del interés por aspectos intrínsecos de un caso particular. El instrumento utilizado para la recolección de datos fue la entrevista. Teniendo en cuenta el análisis y la interpretación de los datos recogidos, concluimos que: (1) la práctica de actividades físico-deportivas puede estar asociada a motivos que no son representados, esto es, a impulsos que permanecen oscuros; (2) el sujeto practica regularmente actividades físico-deportivas, porque, así, se siente más consciente de sus límites, de su potencia, de su estética; (3) su práctica regular está asociada a la identificación con actividades físico-deportivas variadas; (4) el sujeto las practica regularmente, porque asocia esa práctica a un remedio saludable, porque moverse con el cuerpo es jugar con el cuerpo; (5) el sujeto practica regularmente actividades físico-deportivas porque las cualidades de la imaginación lo confortan, la ilusión lo acoge y lo mueve...

Motivos de um indivíduo para praticar atividades físico-esportivas / Reasons for an individual to practice physical sports activities / Motivos de un individuo para la práctica de actividades físico-deportivas

Este estudo objetiva investigar os motivos de um indivíduo para aderir à prática regular de atividades físico-esportivas. É um estudo de caso qualitativo que emerge do interesse pelos aspectos intrínsecos de um caso particular. O instrumento utilizado para coleta de dados foi a entrevista. Tendo em vista a análise e a interpretação dos dados coletados, concluímos que: (1) a prática de atividades físico-esportivas pode estar associada a motivos que não são representados, isto é, a impulsos que permanecem obscuros; (2) o sujeito pratica regularmente atividades físico-esportivas porque com ela se sente mais consciente dos seus limites, de sua potência e de sua estética; (3) sua prática regular está associada à identificação com atividades físico-esportivas variadas; (4) o sujeito pratica-as regularmente, porque associa essa prática a um remédio saudável, porque mexer com o corpo é brincar com o corpo; (5) o sujeito pratica regularmente atividades físico-esportivas porque as qualidades da imaginação o confortam e a ilusão o acolhe e o move.(AU)

This study aims to investigate the reasons why an individual joins regular physical sports activities. This is a qualitative case study which rises from the interest in inherent aspects of a specific situation. The instrument used for data collection was an interview. Considering the analysis and interpretation of the collected data, we have concluded that: (1) the practice of physical sports activities may be associated with reasons which are not shown, that is, with impulses which remain unclear; (2) the individual practices physical sports activities regularly, because by doing so they feel more aware of their limits, their power, their aesthetics; (3) the regular practice of such activities is associated with the identification with varied physical sports activities; (4) the subject practices such activities regularly, as this practice is associated with a healthy medication, since moving the body means playing with the body; (5) the individual practices physical sports activities regularly because the qualities of the imagination are comforting to them, the illusion shelters him and makes him move forward.(AU)

Este estudio tiene el objetivo de investigar los motivos de la adhesión de un individuo a la práctica regular de actividades físico-deportivas. Se trata de un estudio de caso cualitativo que emerge del interés por aspectos intrínsecos de un caso particular. El instrumento utilizado para la recolección de datos fue la entrevista. Teniendo en cuenta el análisis y la interpretación de los datos recogidos, concluimos que: (1) la práctica de actividades físico-deportivas puede estar asociada a motivos que no son representados, esto es, a impulsos que permanecen oscuros; (2) el sujeto practica regularmente actividades físico-deportivas, porque, así, se siente más consciente de sus límites, de su potencia, de su estética; (3) su práctica regular está asociada a la identificación con actividades físico-deportivas variadas; (4) el sujeto las practica regularmente, porque asocia esa práctica a un remedio saludable, porque moverse con el cuerpo es jugar con el cuerpo; (5) el sujeto practica regularmente actividades físico-deportivas porque las cualidades de la imaginación lo confortan, la ilusión lo acoge y lo mueve.(AU)

Escala de prefeêências por objetos ocupacionais relações com a escala de aconsselhamento profissiona (eap) / Scale of Objects for Occupational Preferences: relations with Scale of Professional Counseling (EAP) / Escala de los objetos de preferencias ocupacionales: relaciones con la escala de Orientación Profesional (EAP)

O processo de orientarlo profissionai implica conhecimento do individuo e do mercado de traballio, de modo que facilite a tomada de decisào. Um dos desafios para os especialistas da área é o desenvolvimiento de instrumentos que congreguem a Avaliacào Psicológica e a Orientarlo Profissional. A quantidade de instrumentos brasileiros que se propóem avaliar os interesses nos padróes científicos considerados adequados é escassa. O objetivo deste estudo foi verificar as relagoes entre os instrumentos Escala de Preferencias por Objetos Ocupacionais (EPOOc) e Escala de Aconselhamento Profissional (eap). A amostra foi composta por 553 participantes, com idades entre 19 a 52 anos, de diversos cursos de uma universidade particular do interior do estado de Sao Paulo. Os resultados indicaram, no geral, que as atividades desenvolvidas nos cursos estao associadas com a preferencia pela utilizarlo de objetos nas profissóes relacionadas. Sugere-se novos estudos com amostras diversificadas e a utilizarlo de outros instrumentos em pesquisas futuras.

The process of career guidance implies knowledge of the individual and the labor market in order to facilitate decision making. The one of the challenges for specialists in the field is the development of tools which bring together the Psychological Assessment and Vocational Guidance. The amount of Brazilian instruments that propose to assess the interest in scientific standards considered adequate is scarce. The goal of this study was to examine relationships between the instruments Scale Preferences Objects for Occupational (EPOOc) and Professional Counseling Scale (eap). The sample consisted of 553 participants, aged 19 to 52 years, several courses at a private university in the state of Sao Paulo. The results showed, in general, that the activities in courses associated with the preference for using objects in related professions. It is suggested that further studies with diverse samples and the use of other instruments further research.

[Obesity and its relationship with cardiovascular risk factors in a Japanese-Brazilian population]. / Obesidade e sua relação com fatores de risco para doenças cardiovasculares em uma população nipo-brasileira.

OBJECTIVE: To describe associations of weight excess and abdominal obesity with cardiovascular risk factors in a Japanese-Brazilian population from Mombuca, Guatapará, SP. METHODS: Cross-sectional study with 131 individuals of Japanese ancestry (69.2% first and 30.8% second generation), aged 20 years or more, corresponding to 66.8% of the resident population from this age group. Data were collected through standardized questionnaires and laboratory and physical examinations were performed. RESULTS: Prevalence of overweight and obesity was 29.6% and 46.3% in men and 25.6% and 39.0% in women, respectively. The prevalence of abdominal obesity was 55.6% in men and 20.8% in women. Body mass index was independently associated with triglycerides, waist circumference and age; systolic blood pressure with waist circumference. CONCLUSIONS: Data from the present survey highlight the necessity of interventions to prevent obesity in the Japanese-Brazilian population from Mombuca.