This study assessed excessive weight gain in the second and third trimesters of pregnancy and the influence of biological, socio-demographic, behavioral, and reproductive factors and co-morbidity. The cross-sectional sample included 240 pregnant women at low risk of obstetric complications, followed from May 2000 to July 2001. There were 347 patient records in the original database, but 107 were excluded because of age (42 patients were younger than 18 years) or lack of data on weight (65 women). Excessive weight gain was common in all categories of baseline nutritional status, but was more frequent in the second trimester among women who were already overweight or obese upon entering pregnancy. In the third trimester, variables associated with excessive weekly weight gain were schooling and marital status.
The aim of this study was to investigate the effects of malnutrition, induced by a regional basic diet (RBD), on motor development. RBD is a 7.87%-protein diet based on aliments typical of Northeastern Brazil, elaborated after nutritional investigation by Teodosio et al. (1979). Female rats were treated with RBD during lactation. The reflex ontogenesis and the development of locomotor activity in their offspring were assessed. Malnourished (MN) rats showed a delay in reflex maturation and in locomotor activity evolution. The decreased locomotor activity may be related to the reduced movement experiences induced by the delay in the reflex maturation. Occurring during the critical period of brain development, this fact could jeopardize all the steps in future locomotion evolution. The present results confirm deleterious effects of RDB-induced malnutrition on the somatic development and maturation of the nervous system (NS).
Objectives:The aim of the current article was to conduct a systematic review of the performance of perineal exercises during pregnancy and their utility in the prevention of urinary incontinence. Methods: Randomized controlled studies (RCT) of a low-risk obstetric population (primiparas or nulliparas) who had done perineal exercises only during pregnancy met the inclusion criteria. Articles published between 1966 and 2007 from periodicals indexed in the LILACS, SCIELO, PubMed/MEDLINE, SCIRUS and Cochrane Library databases were selected , using the following keywords: 'urinary incontinence', 'pregnancy', 'pelvic floor' and 'exercise'. The Jadad scale was applied to assess the internal validity of the RCT and two meta-analysis: one of fixed effects and the other of random effects were carried out with data extracted from the RCT, using the Stata 9.2 statistical software and adopting a significance level of 0.05. Results: Four RCTs with high methodological quality, involving a total of 675 women were included. They indicated that perineal muscle exercise significantly reduced the development of urinary incontinence from 6 weeks to 3 months after delivery (odds ratio = 0.45; confidence interval: 0.3 to 0.66). However, when evaluating this effect during the 34th and 35th gestational week, a meta-analysis showed that the results were not significant (odds ratio = 0.13; confidence interval: 0.00 to 3.77). Conclusion: Pelvic floor muscle exercises may be effective at reducing the development of postpartum urinary incontinence, despite clinical heterogeneity among the RCT.
-Background: There is evidence that schooling can influence performance in cognitive assessement tests. In developing countries, formal education is limited for most people. The use of tests such as Mini-Mental State Examination (MMSE), could have an adverse effect on the evaluation of illiterate and low education individuals. Objective: To propose a new version of MMSE as a screening test to assess Illiterate and low education people. Method: A study was carried out enrolling 232 individuals, aged 60 or more of low and middle socio-economic classes. Three groups were studied: Illiterate;1-4 schooling years; 5-8 schooling years. The new version (MMSE-mo) consisted of modifications in copy and calculation items of the adapted MMSE (MMSE-ad) to Portuguese language.The maximum possible score was the same in the two versions: total, 30; copy, 1 and calculation, 5. Results: In the total test score ANOVA detected main effects for education and test, as well as an interaction between these factors: higher schooling individuals performed better than lower schooling ones in both test versions; scores in MMSE-mo were higher than in MMSE-ad in every schooling group. Conclusion. Higher schooling levels improve the perfomance in both test versions, the copy and calculation items contributing to this improvement. This might depend on cultural factors. The use of MMSE-mo in illiterate and low school individuals could prevent false positive and false negative cognitive evaluations.KEY WORDS: mini-mental state examination, cognition, education, cognitive assessement.O papel da educação no mini exame do estado mental: um estudo no Nordeste do Brasil RESUMO -Contexto: Existem evidências de que a escolaridade pode influenciar o desempenho em testes de avaliação cognitiva. Já que em paises subdesenvolvidos o nível educacional da maioria da população é baixo, isso poderia prejudicar resultados de avaliação por meio de testes.Assim é oportuno adequar o mini exame do estado mental (MEEM) a populações de baixa escolaridade. Objetivo: Propor nova versão do MEEM como um teste geral para avaliar indivíduos analfabetos e com baixa escolaridade. Método: Foram estudadas 232 pessoas de ambos os gêneros com 60 ou mais anos de idade, de classes socio-econômicas média e baixa. Foram considerados 3 grupos: analfabetos; 1-4 anos e 5-8 anos de escolaridade. A nova versão (MEEM-mo) consistiu de modificações nos itens cópia e cálculo do MEEM adaptado para a língua portuguesa (MEEM-ad). O escore máximo possível foi o mesmo nas duas versões: total 30 pontos; cópia, 1; cálculo, 5 pontos. Resultados: No escore total, o teste de ANOVA detectou efeitos principais para teste e escolaridade, assim como interação entre estes fatores: indivíduos com escolaridade mais alta realizaram melhor ambos os testes do que aqueles com mais baixa escolaridade. Os escores do MEEM-mo foram mais elevados do que os do MEEM-ad, em cada grupo de escolaridade. Conclusão: Indivíduos com maior escolaridade apresentam melhor performance em ambas as versões dos testes; os it...
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