O lítio é freqüentemente utilizado no tratamento do Transtorno Bipolar, doença associada a um risco aumentado para demência. Evidências experimentais sugerem efeitos neuroproterores do lítio. O lítio inibe a amiloidogênese e a fosforilação da proteína tau tanto in vitro como in vivo. Estes são processos importantes na patogênese da doença de Alzheimer. O objetivo este estudo foi a investigação do efeito do lítio na prevalência de Transtorno Cognitivo Leve e doença de Alzheimer em 114 bipolares idosos eutímicos. Todos os sujeitos completaram uma avaliação catamnéstica, psicopatológica e cognitiva que incluía o mini-exame do estado mental (Mini-mental), o teste cognitivo de Cambridge (CAMCOG) e o questionário do informante sobre o declínio cognitivo do idoso (IQCODE). Foi feita uma comparação da prevalência de Transtorno Cognitivo Leve e doença de Alzheimer entre pacientes em uso de lítio e pacientes em uso de outros estabilizadores de humor. Os sujeitos que entraram na pesquisa tinham em média 68,2 ± 5,0 anos e preenchiam os critérios da Décima Revisão da Classificação Internacional de Doenças e Problemas de Saúde Relacionados (CID-10) para o transtorno bipolar. Durante a avaliação os bipolares estavam eutímicos. Eutimia foi definida como uma pontuação máxima de 7 pontos na escala de Hamilton de 21 pontos para Depressão e 4 na escala de Young para mania. 66 pacientes em uso contínuo do lítio por 6 anos em média foram comparados com 48 pacientes em tratamento com outros estabilizadores de humor. O diagnóstico de Transtorno Cognitivo Leve foi feito de acordo com os critérios de Petersen(1999) e de doença de Alzheimer de acordo com o critério do “National Institute for Communicative Disorders and Stroke - Alzheimer’s Disease and Related Disorders Association” (NINCDS/ADRDA). A prevalência de demência nesta amostra (19,4%) foi mais elevada do que o esperado para uma população comparável (7,1%). A prevalência de doença de Alzheimer entre aqueles com lítio foi 4,5% quando comparada com 33,3% entre aqueles sem lítio. Controlando idade e outras variáveis relacionadas ao curso da doença, o efeito do lítio na prevalência de doença de Alzheimer permaneceu significativo (OR = 0,079; p < 0,001). Nenhuma associação foi encontrada com Transtorno Cognitivo Leve. A alta da prevalência de doença de Alzheimer neste estudo está de acordo com as evidências de risco aumentado para demência em pacientes bipolares. Nesta amostra o tratamento com lítio reduziu a prevalência de Alzheimer aos níveis da população idosa em geral. Estes achados estão de acordo com os efeitos neuroprotetores do lítio em eventos cruciais para a patologia da doença de Alzheimer. Estudos prospectivos são necessários para avaliar se o lítio também pode ser efetivo na prevenção de doença de Alzheimer em outras populações. / Lithium is widely used in the treatment of bipolar disorder, a condition associated with an increased risk for dementia. Experimental evidence suggests that lithium has a neuroprotective effect. Both in vitro and in vivo, lithium inhibits amyloidogenesis and phosphorilation of tau protein, which are two crucial processes in the pathogenesis of Alzheimer’s disease. The objective of this study was to investigate the effect of lithium on the prevalence of Mild Cognitive Impairment and Alzheimer’s disease in 114 elderly euthymic bipolar patients. Subjects completed a thorough catamnestic, psychopathological and cognitive tests evaluation including the Mini-mental state evaluation, Cambridge cognitive test (CAMCOG) and the informant questionnaire on cognitive decline in the elderly (IQCODE). The prevalence of Mild Cognitive Impairment and Alzheimer’s disease between patients on lithium therapy and patients on treatment with other mood-stabilizing drugs was compared. Patients were 68.2 ± 5.0 years old and fulfilled of the International Classification of Diseases - 10th Revision (ICD-10) diagnosis for bipolar disorder. At the time of the evaluation patients were euthymic, as defined by a maximum score of 7 in the 21-item Hamilton Rating Scale for Depression, and 4 in the Young Mania Rating Scale. Sixty-six patients were continuously being treated with lithium for six years, on average, and 48 patients were receiving other mood-stabilizing drugs. Diagnosis of Mild Cognitive Impairment was made according to Petersen (1999) and of Alzheimer’s disease was made according to the National Institute for Communicative Disorders and Stroke - Alzheimer’s Disease and Related Disorders Association (NINCDS/ADRDA) criteria. The overall prevalence of dementia in our sample (19.4%) was higher than the prevalence expected in the age-comparable general population (7.1%). The prevalence of Alzheimer’s disease among lithium users was 4.5% as compared to 33.3% among non-users. After controlling for age and other variables related to the clinical course of the bipolar disorder, the effect of lithium on Alzheimer’s disease prevalence remained significant (OR = 0.079; p < 0.001). No association was found with Mild Cognitive Impairment. The higher prevalence of Alzheimer’s disease in our study supports the reports of increased risk for dementia in bipolar patients. In our sample, lithium treatment reduced the prevalence of Alzheimer’s disease to the levels of the general elderly population. This finding is in line with the neuroprotective effects of lithium on crucial events for the pathology of Alzheimer’s disease. Further prospective studies are needed to clarify whether lithium may also be effective in the prevention of Alzheimer’s disease in the general population.

Chung, Jennifer Siu Toye. / "June 2008." / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 145-157). / Abstracts in English and Chinese, some text in appendix also in Chinese. / Abstract of Thesis in English --- p.i / Abstract of Thesis in Chinese --- p.iii / Acknowledgments --- p.v / List of Tables --- p.xi / List of Figures --- p.xiii / List of Abbreviations --- p.xiv / List of Publications and Presentations related to Thesis --- p.xvi / Contributions related to Thesis --- p.xvii / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Introduction of the Thesis --- p.1 / Chapter 1.2 --- Review on Coronary Heart Disease --- p.3 / Chapter 1.2.1 --- Definition of Coronary Heart Disease --- p.3 / Chapter 1.2.2 --- Risk factors for the development of Coronary Heart Disease --- p.3 / Chapter 1.2.3 --- Worldwide Figures for Coronary Heart Disease --- p.9 / Chapter 1.2.4 --- Coronary Heart Disease in Asia Pacific --- p.10 / Chapter 1.2.5 --- Coronary Heart Disease in Hong Kong --- p.11 / Chapter 1.3 --- Dyslipidaemia --- p.14 / Chapter 1.3.1 --- Lipid Transport and Lipoprotein Metabolism --- p.14 / Chapter 1.3.2 --- Definition and Classification of Dyslipidaemia --- p.16 / Chapter 1.3.3 --- Coronary Heart Disease and Dyslipidaemia --- p.17 / Chapter 1.3.4 --- Lifestyle Modifications for the Management of Dyslipidaemia --- p.19 / Chapter 1.3.4.1 --- Dietary Measures --- p.20 / Chapter 1.3.4.2 --- Cigarette Smoking --- p.23 / Chapter 1.3.4.3 --- Physical Activity --- p.24 / Chapter 1.3.4.4 --- Weight Control --- p.25 / Chapter 1.3.5 --- Lipid-lowering Drug Therapy for Dyslipidaemia --- p.29 / Chapter 1.3.5.1 --- Statins --- p.31 / Chapter 1.3.5.2 --- Bile Acid Sequestrants --- p.35 / Chapter 1.3.5.3 --- Fibrates --- p.36 / Chapter 1.3.5.4 --- Ezetimibe --- p.37 / Chapter 1.3.5.5 --- Nicotinic Acid Group --- p.38 / Chapter 1.4 --- International Guidelines for Dyslipidaemic Management --- p.39 / Chapter 1.4.1 --- National Service Framework for Coronary Heart Disease (UK) --- p.39 / Chapter 1.4.1.1 --- National Service Framework Lipid-lowering Goals --- p.40 / Chapter 1.4.1.2 --- The Joint British Societies' Guidelines --- p.41 / Chapter 1.4.1.3 --- Achievement of the NSF Lipid Profile Targets --- p.42 / Chapter 1.4.2 --- National Cholesterol Education Program (United States) --- p.43 / Chapter 1.4.2.1 --- The Third Report of the National Cholesterol Education Program --- p.43 / Chapter 1.4.2.2 --- Review of Clinical Trials --- p.43 / Chapter 1.4.2.3 --- Low-Density Lipoprotein Cholesterol Goal Targets --- p.46 / Chapter 1.4.2.4 --- Compliance with the NCEP ATP III Guidelines --- p.48 / Chapter 1.4.3 --- Dyslipidaemic Guidelines for Study --- p.51 / Chapter 1.5 --- Clinical Pharmacy Services --- p.52 / Chapter 1.5.1 --- The Healthcare System in Hong Kong --- p.52 / Chapter 1.5.2 --- Clinical Pharmacy Services in Hong Kong --- p.54 / Chapter 1.5.3 --- Examples of successful Clinical Pharmacy Services --- p.55 / Chapter 1.5.3.1 --- Hypertension Clinic --- p.55 / Chapter 1.5.3.2 --- Diabetes Mellitus Clinic --- p.56 / Chapter 1.5.3.3 --- Smoking Cessation Clinic --- p.57 / Chapter 1.5.3.4 --- Anticoagulation Clinic --- p.57 / Chapter 1.5.3.5 --- Haematology-oncology Clinic --- p.57 / Chapter 1.5.4 --- Pharmacist-managed Lipid Clinics --- p.58 / Chapter 1.6 --- Objective & General Aims of the Study --- p.60 / Chapter 1.6.1 --- Objectives --- p.60 / Chapter 1.6.2 --- Study Hypothesis --- p.60 / Chapter 1.6.3 --- General Aims of the Study --- p.60 / Chapter Chapter 2 --- Methodology of Study --- p.62 / Chapter 2.1 --- Background Setting --- p.62 / Chapter 2.2 --- Subject Selection and Recruitment --- p.62 / Chapter 2.3 --- Intervention and Control Groups --- p.63 / Chapter 2.4 --- Validation of Survey --- p.67 / Chapter 2.5 --- Data Collection --- p.67 / Chapter 2.6 --- Outcome Measures --- p.68 / Chapter 2.6.1 --- Lipid value changes --- p.68 / Chapter 2.6.2 --- Compliance rate with medications --- p.68 / Chapter 2.6.3 --- Patient satisfaction survey assessment --- p.69 / Chapter 2.6.4 --- Time spent and Cost of clinical pharmacist --- p.69 / Chapter 2.7 --- Statistical Analysis --- p.70 / Chapter 2.7.1 --- Sample Size Calculation --- p.70 / Chapter 2.7.2 --- Methods of Statistical Analysis --- p.71 / Chapter Chapter 3 --- Results of Study --- p.72 / Chapter 3.1 --- Recruitment Details --- p.72 / Chapter 3.2 --- Demographic Characteristics of Patients --- p.73 / Chapter 3.3 --- Drug Therapy of Patients during Study Period --- p.75 / Chapter 3.4 --- LDL-C Lowering Potency of Statin Doses Prescribed --- p.80 / Chapter 3.5 --- Coronary Heart Disease Risk Category of Patients --- p.84 / Chapter 3.6 --- Lipid Profile Changes --- p.85 / Chapter 3.7 --- NCEP ATP III LDL-C Goal Attainment --- p.87 / Chapter 3.8 --- Relationship between Patient Characteristics and LDL-C Goal Attainment --- p.91 / Chapter 3.9 --- Compliance with Medications --- p.94 / Chapter 3.10 --- Pharmacist Intervention --- p.98 / Chapter 3.10.1 --- Range of Pharmacist Intervention --- p.98 / Chapter 3.10.2 --- Time spent by Pharmacist --- p.100 / Chapter 3.10.2.1 --- Time spent on Documentation --- p.100 / Chapter 3.10.2.2 --- Time spent on Direct Communication with Patients --- p.101 / Chapter 3.10.3 --- Cost of Clinical Pharmacy Service at the Lipid Clinic --- p.102 / Chapter 3.10.3.1 --- Cost of Pharmacist Involvement --- p.102 / Chapter 3.10.3.2 --- Potential Healthcare Cost Saving --- p.103 / Chapter 3.11 --- Clinical Pharmacy Service Satisfaction Survey --- p.105 / Chapter 3.11.1 --- Validation of Survey --- p.105 / Chapter 3.11.2 --- Questionnaire Survey for Intervention and Control Groups --- p.107 / Chapter 3.11.3 --- Physician Questionnaire Survey on Clinical Pharmacy Service --- p.110 / Chapter Chapter 4 --- Discussion --- p.111 / Chapter 4.1 --- Clinical Outcomes of Study --- p.111 / Chapter 4.1.1 --- Changes in Lipid Parameters --- p.111 / Chapter 4.1.2 --- Reduction in CHD risk --- p.113 / Chapter 4.1.3 --- Attainment in NCEP ATP III LDL-C goals --- p.114 / Chapter 4.1.4 --- Predictors for LDL-C Goal Attainment --- p.117 / Chapter 4.2 --- Drug-related Problems --- p.119 / Chapter 4.2.1 --- Statin Dosing and LDL-C Lowering Potency --- p.119 / Chapter 4.2.2 --- Adherence to Drug Therapy --- p.121 / Chapter 4.2.3 --- Polypharmacy --- p.126 / Chapter 4.2.4 --- Adverse Drug Events and Drug Interactions --- p.129 / Chapter 4.2.5 --- Patient Busy Lifestyle --- p.131 / Chapter 4.3 --- Role of Clinical Pharmacist --- p.133 / Chapter 4.3.1 --- Role of Pharmacist --- p.133 / Chapter 4.3.2 --- Multidisciplinary Team --- p.135 / Chapter 4.3.3 --- Healthcare Cost Saving --- p.137 / Chapter 4.4 --- Limitations of Study --- p.139 / Chapter 4.5 --- Further Study --- p.142 / Chapter Chapter 5 --- Conclusion --- p.144 / Chapter 5.1 --- Conclusion of Study --- p.144 / Bibliography --- p.145 / Appendices --- p.158 / Appendix I Data collection form --- p.158 / Appendix II Information sheet on study protocol to patient --- p.160 / Appendix III Patient consent form for study --- p.164 / Appendix IV Framingham risk scoring system for male --- p.165 / Appendix V Framingham risk scoring system for female --- p.166 / Appendix VI Patient educational leaflet --- p.167 / Appendix VII Physician-pharmacist communication sheet --- p.169 / Appendix VIII Telephone checklist --- p.170 / Appendix IX Questionnaire survey provided to Intervention Group --- p.172 / Appendix X Questionnaire survey provided to Control Group --- p.174 / Appendix XI Questionnaire survey provided to Physicians --- p.176

Introduction. The HIV prevalence among men who have sex with men (MSM) in China keeps increasing sharply. A high proportion of the MSM in China have male regular sex partner (RP) and prevalence of unprotected anal intercourse (UAI) involving such RP is higher than when non-RP is involved. Trust, intimacy and cognitive factors are the factors associated with UAI with RP. Several cross-sectional studies have been demonstrated the important factors associated with UAI with RP among MSM in China. However, no study about intervention for MSM-RP is found to be conducted. To reduce UAI with RP, an intervention tailored to RP is urgently developed and identified its efficacy. / Objectives. The study aimed to describe the prevalence of UAI, as well as of which associated factors among MSM-RP in Beijing and Chengdu, China, and to evaluate the efficacy of an enhanced HIV voluntary counseling and testing (VCT) in increasing condom use with RP among MSMRP in China by a randomized controlled trial (RCT). / Subjects and Methods. A cross-sectional survey and a randomized controlled trial have been conducted. For the cross-sectional survey, total 307 HIV negative MSM who have RP have been recruited by three ways. Face to face interview has been conducted to participants. Based on the associated factors found in the cross-sectional survey, interventions including video, education leaflets and enhanced counseling contents have been tailored to RP among MSMRP. For the randomized controlled trial, total 336 MSMRP have been recruited and randomly assigned 169 subjects to the Intervention Group in which participants have been given enhanced VCT plus an audio-visual and four leaflets components and 167 subjects to the Control Group in which participants have been given only standard-of-care VCT at the baseline. Evaluation was conducted at Month 3 and 6. Statistical methods such as descriptive analyses, Chi-square test and logistic regression were used in this study. / Results. The results have been found were the prevalence of UAI with RP among MSMRP was 52.4%, and the Theory of Planned Behavior (TPB) related cognitions, trust, intimacy, depression and anxiety were associated with UAI with RP among MSMRP. In the RCT study, participants in the Intervention Group had less UAI (36.1% vs. 49.1%) than those of the Control Group at Month 3. / Conclusions. This study showed a high prevalence of UAI among MSMRP, whilst trust, intimacy and cognitive factors were associated with UAI with RP. The efficacy of Enhanced VCT tailored to RP has been identified. The acceptability and feasibility of the tailored intervention were demonstrated. In the future HIV prevention programs, the effective intervention should be considered to be incorporated into standard-of-care VCT procedures and be implemented in the specific population. / 介紹：中國男男性接觸者中的愛滋病發病率一直保持著上升的狀態。而在中國男男性接觸者中有很大比例存在著固定性伴侶。男男性接觸者同固定性伴發生無保護肛交行為的比例大於其同非固定性伴。信任，親密以及認知因素已經被證實是影響男男性接觸者同其固定性伴發生無保護肛交行為的因素。但是在中國還沒有發現專門針對有固定性伴的男男性接觸者的干預研究。為了降低男男性接觸者同其固定性伴的無保護肛交的發生率，針對有固定性伴的男男性接觸者的干預方法應該被發展同時證實其有效性。 / 目的：本研究目的在於調查北京及成都男男性接觸者的固定性伴的比例，及其影響因素，包括健康行為理論的影響因素以及人際關係因素。同時，本研究也驗證了以隨機對照實驗來評估針對有固定性伴男男性接觸者的提高型愛滋病自願檢測諮詢對減少其高危性行為的效果。 / 對象與方法：本研究由橫斷面研究以及隨機對照試驗組成。在橫斷面調查中，307名愛滋病陰性的有固定性伴的男男性接觸者被招募。基於在橫斷面調查中發現的對男男性接觸者與固定性伴間發生無保護性行為的影響因素，一項專門針對有固定性伴的男男性接觸者的提高型愛滋病自願檢測諮詢干預方法被發展應用了隨機對照試驗中已驗證其有效性。在隨機對照試驗中，169名和167名研究對象被招募並分別被隨機分配到干預組（接受提高型愛滋病自願檢測諮詢）和對照組（接受標準型愛滋病自願檢測諮詢）中。分別於干預後的3個月和6個月回訪進行干預結果的評估。在本次研究中，運用了卡方检验和logistic回歸等統計學方法。 / 結果：在橫斷面調查中發現，男男性接觸者同固定性伴的無保護肛交發生率為52.4%。影響與固定性伴無保護肛交的因素包括：健康行為理論（TPB）相關的認知，信任，親密以及抑鬱和焦慮。在隨機對照試驗中發現，在3個月隨訪中干預組的男男性接觸者與固定性伴發生無保護肛交的比例較對照組明顯降低（36.1% vs. 49.1%）。 / 結論：本研究結果顯示中國男男性接觸者的固定性伴的比例很高，同時幾乎一半的有固定性伴的的男男性接觸者同時有多個性伴，這就有增加感染愛滋病及其他性病的風險。一項針對有固定性伴的男男性接觸者設計的提高型愛滋病自願檢測諮詢方法在降低其危險性行為上的可接受性和有效性已經被證實。提示在今後的愛滋病干預項目中可以進一步的推廣應用。 / Li, Chunrong. / Thesis Ph.D. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 149-178). / Abstracts and appendixes also in Chinese. / Title from PDF title page (viewed on 05, October, 2016). / Li, Chunrong. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

O objetivo desse estudo foi avaliar os efeitos da administração prévia de antibiótico na incidência de complicações infecciosas em procedimentos de estimulação cardíaca artificial. Os pacientes foram selecionados em um estudo duplo-cego e randomizado (1:1). Grupo I Cefazolina (1,0g dose única) versus grupo II placebo. O comitê de segurança interrompeu o estudo após a inclusão de 649 pacientes devido à diferença entre os grupos (group I 314; grupo II 335 pacientes) em favor do uso de antibiótico: 2 infectados (0,63%) versus 11 infectados no grupo placebo (3,28%); p=0,016. Marcadores identificados por análise univariada: não uso de antibiótico; procedimentos de implantes (versus trocas); hematoma pós-operatório e duração do procedimento. O não uso de antibiótico e hematoma pós-operatório foram significantes em análise multivariada / The objective of this study was to evaluate the effects of the previous venous antibiotic administration in the incidence of infectious complications in cardiac stimulation surgical procedures. Patients were selected in a double blind, randomized (1:1) trial. Group I Cefazolin (1,0g one dose) versus group II placebo. The security committee interrupted the trial after inclusion of 649 patients due to differences between groups (group I 314; group II 335 patients) in favor of the antibiotic arm: 2 infected patients (0,63%) versus 11 infected patients in the placebo arm (3,28%); p=0,016. Markers identified by univariate analysis: non-use of preventive antibiotic; implant procedures (versus replacement); post-operative haematoma and procedure duration. The non-use of antibiotic and the post-operative haematoma were independent predictors of infection in multivariate analysis

INTRODUÇÃO: A incapacidade física e psicológica, incluindo o medo de quedas, está relacionada à diminuição da satisfação com a vida na osteoporose (OP). O impacto de um programa de treino de equilíbrio para melhorar a qualidade de vida não está bem estabelecido. O objetivo deste estudo, portanto, foi investigar a eficácia que um programa de treino de equilíbrio, realizado durante um período de 12 meses, pôde provocar na qualidade de vida, no equilíbrio funcional e nas quedas em mulheres idosas com osteoporose. MÉTODOS: Sessenta mulheres com OP senil (idade: 65 a 85 anos) do Ambulatório de Doenças Osteometabólicas foram randomizadas e divididas em 2 grupos: Grupo Equilíbrio (GE) 30 pacientes que realizaram intervenção e Grupo Controle (GC) 30 pacientes sem intervenção. O programa de treino de equilíbrio incluiu técnicas para melhorar o equilíbrio durante o período de 12 meses (1sessão de 1h/semana de exercícios complementados com exercícios feitos em casa). A qualidade de vida foi avaliada antes e no final do estudo utilizando o questionário Osteoporosis Assessment Questionnaire (OPAQ), o equilíbrio funcional foi avaliado pela escala Berg Balance Scale (BBS). As quedas no ano anterior foram anotadas e comparadas durante o período de estudo. RESULTADOS: A comparação dos domínios do OPAQ (INICIAL - FINAL) revelou uma melhora significativa da qualidade de vida em todos os parâmetros do GE em relação ao GC: bem-estar geral (1,61 ± 1,44 vs. -1,46 ± 1,32, p <0,001), função física (1,30 ± 1,33 vs. -0,36 ± 0,82, p<0,001), estado psicológico (1,58 ± 1,36 vs. -1,02 ± 0,83, p <0,001), sintomas (2,76 ± 1,96 vs. -0,63 ± 0,87, p <0,001), interação social (1,01 ± 1,51 vs. 0,35 ± 1,08, p <0,001). Esse benefício global foi acompanhado por uma melhora da escala de equilíbrio BBS (-5,5 ± 0,5 vs. 5,67 ± 4,88 p <0,001) e da redução das quedas em 50% no GE vs. 26,6% para o GC (RR: 1,88, p <0,025). CONCLUSÃO: O programa de treino de equilíbrio para mulheres com OP, realizado por 12 meses, proporcionou uma melhor qualidade de vida e uma melhora no estado de saúde global paralelamente aos benefícios no equilíbrio funcional e na redução das quedas / INTRODUCTION: Physical and psychological incapacity, including fear of falling is related to decreased satisfaction with life in osteoporosis (OP). The impact of a balance exercise programs on improving the quality of life is not well established. We have, therefore, investigated the effect of 12-month Balance Training Program in quality of life, functional balance and falls in elderly OP women. METHODS: Sixty consecutive women with senile OP were randomized into a Balance Training Group (BT) of 30 patients and no intervention control group (CG) of 30 patients. The BT program included techniques to improve balance over a period of 12 months (1h exercise session/week and home-based exercises). The quality of life was evaluated before and at the end of the trial using the Osteoporosis Assessment Questionnaire (OPAQ), functional balance was evaluated by Berg Balance Scale (BBS). Falls in the preceding year were noted and compared to the period of study. RESULTS: The comparison of OPAQ variations (INITIAL-FINAL) revealed a significant improvement in quality of life in all parameters for BT compared to CG: well-being (1.61 ± 1.44 vs. -1.46 ± 1.32, p<0001), physical function (1.30 ± 1.33 vs. 0.36 ± 0.82, p<0.001), psychological status (1.58 ± 1.36 vs. 1.02 ± 0.83, p<0.001), symptoms (2.76 ± 1.96 vs. 0.63 ± 0.87, p<0.001), social interaction (1.01 ± 1.51 vs. 0.35 ± 1.08, p<0.001). Of note, this overall benefit was paralleled by an improvement of BBS (-5.5 ± 5.67 vs. +0.5 ± 4.88 p<0.001) and a reduction of falls in 50% in BT group vs. 26.6% for the CG (RR: 1.88, p<0.025). CONCLUSION: The long-term Balance Training Program of OP women provides a striking overall health quality of life improvement in parallel with improving functional balance and reduced falls

Introdução: a prevalência de obesidade infantil tem aumentado rapidamente no Brasil nas últimas décadas. Por isso, há uma necessidade urgente de desenvolver estratégias efetivas na prevenção e controle da obesidade infantil. Neste contexto, foi desenvolvido um programa de intervenção com educação nutricional e atividade física no âmbito escolar, com o objetivo de prevenção e controle da obesidade, denominado TriAtiva: educação, alimentação e atividade física. Métodos: trata-se de um estudo controlado randomizado por conglomerado, conduzido em 12 escolas municipais da cidade de Porto Alegre/RS (6 escolas intervenção e 6 escolas controle), do primeiro ao quarto ano do ensino fundamental, durante um ano letivo. O Programa TriAtiva foi implementado nas escolas de intervenção, através de práticas educativas relacionadas à alimentação saudável e à atividade física, visando ao desenvolvimento da saúde do aluno em um ambiente favorável, com o envolvimento da comunidade escolar e dos familiares. Foi considerado desfecho primário o índice de massa corporal e como desfechos secundários o percentual de gordura corporal, circunferência da cintura, além da prevalência, incidência e remissão do excesso de peso e obesidade. Resultados: foram avaliados 600 escolares, com uma perda de 10,3% até o final do estudo. Comparados ao grupo controle, escolares do grupo intervenção apresentaram redução no índice de massa corporal (IMC), com diferença de média padronizada (DMP) de -0,18 (IC95%: -0,27 a -0,08; P=0,002), no peso com DMP de -0,10 (IC95%: - 0,16 a -0,04; P=0,004) e no escore Z do IMC com DMP de -0,19 (IC95%: -0,29 a -0,09; P=0,002), todos com significância estatística. Também houve redução, mas não estatisticamente significativa, na circunferência da cintura com DMP de -0,07 (IC95%: -0,13 a 0,02; P=0,06) e no percentual de gordura corporal com DMP de -0,07 (IC95%: -0,28 a 0,14; P=0,47). O grupo intervenção apresentou mudança com a redução na prevalência de excesso de peso e obesidade com odds ratio (OR) de 0,77 (IC95%:0,61 a 0,97; P=0,02) e OR de 0,54 (IC95%: 0,44 a 0,67; P<0,001), respectivamente. Também houve aumento na remissão do excesso de peso e obesidade, com OR de 3,57 (IC95%: 1,39 a 9,09; P=0,008) e OR de 7,69 (IC95%: 3,94 a 14,28; P<0,001), respectivamente. Mas não houve mudanças na incidência do excesso de peso com OR de 0,57 (IC95%: 0,20 a 1,62; P= 0,29) e na obesidade com OR de 0,89 (IC95%: 0,18 a 4,28; P=0,88). Conclusão: o Programa TriAtiva apresentou efeitos positivos no IMC e mudanças favoráveis na prevalência e remissão da obesidade, após o término do programa, tornando-se um aliado na prevenção e controle da obesidade, no âmbito escolar. Registro Brasileiro de Ensaios Clínicos: RBR- 2xx2z4. / Introduction: The prevalence of childhood obesity has increased rapidly in Brazil in the last decades. Therefore, there is an urgent necessity to develop effective strategies for the prevention and control of childhood obesity. In this context, it was developed an intervention program with nutrition education and physical activity at schools, with objectives to prevent and control obesity, called TriAtiva: education, nutrition and physical activity. Methods: This is a cluster randomized controlled trial, conducted in 12 public schools in Porto Alegre/RS (6 intervention schools and 6 control schools), from first to fourth grade from elementary school during one school year. The TriAtiva Program was implemented in the intervention schools through educational practices associated to healthy eating and physical activity, aimed the development of the health for student in a favorable environment, with the involvement of the school community and family. The body mass index was considered the primary outcome and the secondary outcomes were the percentage of body fat, waist circumference, beyond the prevalence, incidence and remission of overweight and obesity. Results: 600 students were assessed, the loss was 10.3% until the end of the study. Compared to the control group, students in the intervention group showed a reduction in body mass index (BMI), the standardized mean difference (SMD) was -0.18 (95% CI: -0.27 to -0.08; P = 0.002 ), SMD for the weight was -0.10 (95% CI: - 0.16 to -0.04; P = 0.004) and for BMI z-score was -0.19 (95% CI: -0.29 to -0.09; P = 0.002), all with statistical significance. There was a reduction, but not statistically significant, in waist circumference, where SMD was -0.07 (95% CI: -0.13 to 0.02; P = 0.06) and SMD for percentage of body fat was -0.07 (95% CI: -0.28 to 0.14; P = 0.47). The intervention group showed a change with a reduction in the prevalence of overweight and obesity, odds ratio (OR) was 0.77 (95% CI: 0.61 to 0.97; P = 0.02) and 0.54 (95% CI: 0.44 to 0.67; P < 0.001), respectively. Also there was an increase in the remission of overweight and obesity, where OR was 3.57 (95% CI: 1.39 to 9.09; P = 0.008) and 7.69 (95% CI: 3.94 to 14.28; P < 0.001), respectively. Although there were no changes in the incidence of overweight where OR was 0.57 (95% CI: 0.20 to 1.62; P = 0.29) and for obesity OR was 0.89 (95% CI: 0.18 to 4.28; P = 0.88). Conclusion: TriAtiva program showed positive effects on BMI and favorable changes in the prevalence and remission of obesity, after the program ends, becoming an allied in the prevention and control of obesity at schools. Brazilian Clinical Trials Registry (ReBec): RBR- 2xx2z4.

Made available in DSpace on 2015-07-22T20:49:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-10-28 / Em 2002, o Estado de Mato Grosso aderiu à segunda fase de intensificação Programa Nacional de Controle do Câncer do Colo do Útero (PNCCU) como medida de enfrentamento das altas taxas da doença e de morte por neoplasia cervical. Com o objetivo de analisar os principais resultados do PNCCU, foi feito um estudo em duas partes. A primeira parte teve como objetivo levantar o perfil da doença e a cobertura do exame rastreamento pelo PNCCU no Estado. Os objetivos da segunda parte foram: analisar o seguimento clínico da população rastreada, analisar as diferentes características evolutivas da doença associadas aos fatores sócio-demográficos e clínicos, bem como analisar o risco de óbito e a taxa de sobrevida estratificada pelas variáveis sócio-demográficas e clínicas das mulheres que apresentaram carcinoma invasivo. Na primeira parte, foi utilizado estudo do tipo transversal e na segunda parte, foi realizado um estudo de coorte. O período do estudo compreendeu de 2002 a 2007 e abrangeu todos os municípios do Estado de Mato Grosso. A população estudada na primeira fase do estudo correspondeu todas as mulheres que fizeram o exame de rastreamento no ano de 2002. Na segunda parte do estudo, a população correspondeu a uma amostra aleatória representativa das mulheres que apresentaram alterações citológicas na primeira fase do estudo, totalizando 323 mulheres. A fonte de dados utilizada foi o sistema de informação oficial de saúde, dentre eles o SISCOLO, SIM, APAC, além de dados oficiais da Secretaria Estadual de Saúde/MT (SES/MT), dados disponíveis no site do INCA e do DATASUS e prontuários clínicos. Para análise estatística dos dados foram utilizadas técnicas descritivas e inferenciais. Na parte descritiva foram utilizados tabelas, gráficos e medidas de posição e de dispersão. Para avaliar a o risco de adoecer por carcinoma cervical invasor foi utilizado regressão logística univariada e multivariada. Para analisar a taxa de sobrevida global foi utilizado o estimador de Kaplan-Meier e para analisar os fatores prognósticos, foi utilizado o modelo de riscos proporcionais de Cox. Dentre os principais resultados, destaca-se que no período estudado, Mato Grosso apresentou taxas de incidência elevadas, acima da média nacional. Os dados do seguimento clínico mostraram os diferentes desfechos, dentre eles, destaca-se que: entre as 323 mulheres, 18 (6,2%) foram a óbito tendo o câncer do colo do útero como causa básica da morte. Foi analisado o risco de a doença evoluir para o carcinoma invasor, segundo as variáveis sócio-demográficas e clínicas, sendo que as variáveis: faixa etária, estado civil, tabagismo, menarca e município foram as que apresentaram forte associação com a doença na fase invasora. Já na análise de sobrevivência, a taxa de sobrevida global em 60 meses, estimada pelo método de Kaplan-Meier, foi de 66,7%. No modelo final de risco proporcional de Cox, as variáveis com maior risco de óbito foi o estágio avançado da doença e a raça/cor. Estes dados levam a concluir que a doença no Estado de Mato Grosso tem uma determinação social muito grande, considerando a dificuldade de acesso aos serviços de saúde da população desfavorecida pelas condições raciais, sócio-econômicas, e chegam aos serviços com a doença em fase adiantada, quando a chance de sobrevivência é muito pequena. Conclui-se que para o efetivo combate a doença são necessárias políticas governamentais, como o PNCCU, que garantam a universalidade da assistência, principalmente da população desfavorecida socialmente. / In 2002, the State joined the second phase of intensification of the National Program for the Control of Cervical Cancer (PNCCU) as a measure to deal with the high rates of the disease and of death by cervical neoplasia. With the aim of analyzing the main PNCCU results, a two-stage study was carried out. The first phase aimed at presenting the disease profile and the coverage of the screening exam by the PNCCU in the State. The aims of the second phase were to analyze the clinical follow-up of the population that was screened, analyze the different evolutionary characteristics of the disease associated to socio-demographic and clinic factors, as well as analyze the factors associated to death risk and the stratified survival rate by the socio-demographic and clinical variables of women that presented invasive carcinoma. In the first part, the cross-sectional study was used and a cohort study was used in the second phase. The period of study was from 2002 to 2007 and comprised all the municipalities of the State of Mato Grosso. The population studied in the first phase of the study was all the women who had undergone the screening test in 2002. The population used in the second phase of the study was a representative random sample of those that presented cytological alterations in the first phase of the study, a total of 323 women. The source of data used was the official health information system, among them the SISCOLO, SIM, APAC, and also the official data of the State Health Department/MT (SES/MT), data available in the INCA and DATASUS sites and medical records. For the statistical analysis of the data, descriptive and inferential techniques were used. In the descriptive part, tables, graphics and position and dispersion measures were used. In order to evaluate the risk of being sick due to invasive cervical carcinoma, the univariate and multivariate logistic regression analysis was used. The Kaplan-Meier estimator was used to analyze the survival rate and to analyze the prognostic factors, the Cox proportional hazards model was used. Among the main results it is highlighted that in 2002, Mato Grosso presented high incidence rates, above the national average. The data of the clinical follow up showed the different clinical outcomes, among the 323 women, 18 (6,2%) died having as the basic cause of death the cervical cancer. The risk of the disease developing into the invasive carcinoma was analyzed according to the socio-demographic and clinical variables, and the variables: age group, marital status, smoking history, menopause and municipality were those that presented a strong association with the disease in the invasive phase. However, in the survival analysis, the global survival rate in 60 months, estimated by the Kaplan-Meier method, was of 66,7%. In the final Cox proportional hazards model, the variables with higher death risk was the advanced stage of the disease and the race/color. These data lead to a conclusion that the disease in the State of Mato Grosso has a very large social determination, considering the difficulties in the access to the health services by the population affected by racial, socio-economic conditions that arrive in the health services with the disease in an advanced stage, when the survival probability is very small. The conclusion is that for the effective fight against the disease governmental policies such as the PNCCU are necessary, and that the universality of the assistance be guaranteed, mainly to the socially disadvantaged population. / TEDE / BV UNIFESP: Teses e dissertações

Submitted by Priscila Nascimento (pnascimento@icict.fiocruz.br) on 2013-04-04T12:50:13Z No. of bitstreams: 1 Roberta_De_Cicco.pdf: 4498323 bytes, checksum: 319d5139fb190dd433ffe95be1553e8e (MD5) / Approved for entry into archive by Priscila Nascimento(pnascimento@icict.fiocruz.br) on 2013-04-04T12:55:00Z (GMT) No. of bitstreams: 1 Roberta_De_Cicco.pdf: 4498323 bytes, checksum: 319d5139fb190dd433ffe95be1553e8e (MD5) / Made available in DSpace on 2013-04-04T12:55:00Z (GMT). No. of bitstreams: 1 Roberta_De_Cicco.pdf: 4498323 bytes, checksum: 319d5139fb190dd433ffe95be1553e8e (MD5) Previous issue date: 2012 / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil. / O ensino das DST no contexto escolar apresenta potencialidades e limites resultantes de ações dos campos da saúde e da educação, principalmente de professores de biologia e das diferentes perspectivas culturais e sociais que repercutem nas atitudes e decisões dos sujeitos sobre sua sexualidade. No que tange as ações educativas voltadas à sexualidade, as práticas sociais de informação, educação e comunicação são importantes para a promoção da saúde no ensino. Entretanto, estudos sobre o impacto de programas de educação sexual direcionados a adolescentes vêm mostrando que estratégias de prevenção inspiradas em atividades ou programas não são suficientes para promover mudança nas práticas sexuais dos indivíduos. O objetivo deste trabalho é compreender as potencialidades e os limites do ensino das DST a partir da abordagem socioantropológica. O estudo inclui análise de documentos oficiais da saúde e da educação (incluindo o livro didático, a partir das Coleções de Biologia do Catálogo do PNLEM/2009), observação direta e entrevistas com alunos de 17 a 19 anos, e professores de biologia na faixa etária de 43 a 50 anos, de uma escola estadual da região metropolitana do RJ. Os resultados apontam que as DST nos livros didáticos estão em sua maioria associadas a aspectos estritamente biológico com maior ênfase na AIDS e encontrados sob a forma de textos complementares e/ou associado à reprodução humana. Contudo, o posicionamento e concepções dos jovens acerca da iniciação sexual trazem questionamentos relativos às atitudes e cuidados voltados a este evento que vão além do conteúdo biológico, indicam diferença de gênero a respeito das concepções de sexualidade, do processo saúde/doença, dos cuidados do corpo e as decisões que envolvem a iniciação sexual. Assinalam também as dificuldades práticas do ensino e nas estratégias de abordagem no contexto escolar. Apontamos, portanto, como relevante, a necessidade de se considerar os aspectos assinalados quando estivermos discutindo diferentes estratégias e possibilidades de abordagem do tema das DST no contexto do ensino. / STD education in the school environment presents potential and boundaries as a consequence of activities on health and education areas, especially from teachers of biology and from different cultural and social perspectives that have an effect on the attitude and decision of individuals about their sexuality. Regarding the educational activities about sexuality, social activities of information, education and communication are important for health promotion at school. However, studies about the impact of sex education programs focused on teenagers have shown that warning strategies inspired by activities or programs are not sufficient to make changes in the individual’s sexual attitude. The objective of this study is to understand the possibilities and limitations of the teaching of DST from the anthropological approach. The study includes analysis of official documents in health and education areas (including the textbook of the Collections Catalogue of PNLEM/2009 Biology), direct observation and interviews with students age between 17 to 19 and teachers of biology who are 43-50 years old, both study and work at a school in the metropolitan region of the state of Rio de Janeiro, respectively. The results indicate that DST, in the textbooks, are mostly associated to biological aspects only, emphasizing AIDS and are shown as complementary texts and / or associated with human reproduction. However, the young people’s behavior and point of view about the start of sexual life bring doubts concerning attitudes and care to this event beyond the organic content, indicate gender differences regarding the sexuality concept, health / disease process, the care about body and the decisions involving the start of sexual life. The young people also point out the difficulties of the teaching methods and strategies of approach in the school environment. We, therefore, highlight the need of considering the aspects emphasized in this study while discussing different strategies and possibilities for addressing the issue of STDs in the education context.

INTRODUÇÃO: A incapacidade física e psicológica, incluindo o medo de quedas, está relacionada à diminuição da satisfação com a vida na osteoporose (OP). O impacto de um programa de treino de equilíbrio para melhorar a qualidade de vida não está bem estabelecido. O objetivo deste estudo, portanto, foi investigar a eficácia que um programa de treino de equilíbrio, realizado durante um período de 12 meses, pôde provocar na qualidade de vida, no equilíbrio funcional e nas quedas em mulheres idosas com osteoporose. MÉTODOS: Sessenta mulheres com OP senil (idade: 65 a 85 anos) do Ambulatório de Doenças Osteometabólicas foram randomizadas e divididas em 2 grupos: Grupo Equilíbrio (GE) 30 pacientes que realizaram intervenção e Grupo Controle (GC) 30 pacientes sem intervenção. O programa de treino de equilíbrio incluiu técnicas para melhorar o equilíbrio durante o período de 12 meses (1sessão de 1h/semana de exercícios complementados com exercícios feitos em casa). A qualidade de vida foi avaliada antes e no final do estudo utilizando o questionário Osteoporosis Assessment Questionnaire (OPAQ), o equilíbrio funcional foi avaliado pela escala Berg Balance Scale (BBS). As quedas no ano anterior foram anotadas e comparadas durante o período de estudo. RESULTADOS: A comparação dos domínios do OPAQ (INICIAL - FINAL) revelou uma melhora significativa da qualidade de vida em todos os parâmetros do GE em relação ao GC: bem-estar geral (1,61 ± 1,44 vs. -1,46 ± 1,32, p <0,001), função física (1,30 ± 1,33 vs. -0,36 ± 0,82, p<0,001), estado psicológico (1,58 ± 1,36 vs. -1,02 ± 0,83, p <0,001), sintomas (2,76 ± 1,96 vs. -0,63 ± 0,87, p <0,001), interação social (1,01 ± 1,51 vs. 0,35 ± 1,08, p <0,001). Esse benefício global foi acompanhado por uma melhora da escala de equilíbrio BBS (-5,5 ± 0,5 vs. 5,67 ± 4,88 p <0,001) e da redução das quedas em 50% no GE vs. 26,6% para o GC (RR: 1,88, p <0,025). CONCLUSÃO: O programa de treino de equilíbrio para mulheres com OP, realizado por 12 meses, proporcionou uma melhor qualidade de vida e uma melhora no estado de saúde global paralelamente aos benefícios no equilíbrio funcional e na redução das quedas / INTRODUCTION: Physical and psychological incapacity, including fear of falling is related to decreased satisfaction with life in osteoporosis (OP). The impact of a balance exercise programs on improving the quality of life is not well established. We have, therefore, investigated the effect of 12-month Balance Training Program in quality of life, functional balance and falls in elderly OP women. METHODS: Sixty consecutive women with senile OP were randomized into a Balance Training Group (BT) of 30 patients and no intervention control group (CG) of 30 patients. The BT program included techniques to improve balance over a period of 12 months (1h exercise session/week and home-based exercises). The quality of life was evaluated before and at the end of the trial using the Osteoporosis Assessment Questionnaire (OPAQ), functional balance was evaluated by Berg Balance Scale (BBS). Falls in the preceding year were noted and compared to the period of study. RESULTS: The comparison of OPAQ variations (INITIAL-FINAL) revealed a significant improvement in quality of life in all parameters for BT compared to CG: well-being (1.61 ± 1.44 vs. -1.46 ± 1.32, p<0001), physical function (1.30 ± 1.33 vs. 0.36 ± 0.82, p<0.001), psychological status (1.58 ± 1.36 vs. 1.02 ± 0.83, p<0.001), symptoms (2.76 ± 1.96 vs. 0.63 ± 0.87, p<0.001), social interaction (1.01 ± 1.51 vs. 0.35 ± 1.08, p<0.001). Of note, this overall benefit was paralleled by an improvement of BBS (-5.5 ± 5.67 vs. +0.5 ± 4.88 p<0.001) and a reduction of falls in 50% in BT group vs. 26.6% for the CG (RR: 1.88, p<0.025). CONCLUSION: The long-term Balance Training Program of OP women provides a striking overall health quality of life improvement in parallel with improving functional balance and reduced falls

Introdução: a prevalência de obesidade infantil tem aumentado rapidamente no Brasil nas últimas décadas. Por isso, há uma necessidade urgente de desenvolver estratégias efetivas na prevenção e controle da obesidade infantil. Neste contexto, foi desenvolvido um programa de intervenção com educação nutricional e atividade física no âmbito escolar, com o objetivo de prevenção e controle da obesidade, denominado TriAtiva: educação, alimentação e atividade física. Métodos: trata-se de um estudo controlado randomizado por conglomerado, conduzido em 12 escolas municipais da cidade de Porto Alegre/RS (6 escolas intervenção e 6 escolas controle), do primeiro ao quarto ano do ensino fundamental, durante um ano letivo. O Programa TriAtiva foi implementado nas escolas de intervenção, através de práticas educativas relacionadas à alimentação saudável e à atividade física, visando ao desenvolvimento da saúde do aluno em um ambiente favorável, com o envolvimento da comunidade escolar e dos familiares. Foi considerado desfecho primário o índice de massa corporal e como desfechos secundários o percentual de gordura corporal, circunferência da cintura, além da prevalência, incidência e remissão do excesso de peso e obesidade. Resultados: foram avaliados 600 escolares, com uma perda de 10,3% até o final do estudo. Comparados ao grupo controle, escolares do grupo intervenção apresentaram redução no índice de massa corporal (IMC), com diferença de média padronizada (DMP) de -0,18 (IC95%: -0,27 a -0,08; P=0,002), no peso com DMP de -0,10 (IC95%: - 0,16 a -0,04; P=0,004) e no escore Z do IMC com DMP de -0,19 (IC95%: -0,29 a -0,09; P=0,002), todos com significância estatística. Também houve redução, mas não estatisticamente significativa, na circunferência da cintura com DMP de -0,07 (IC95%: -0,13 a 0,02; P=0,06) e no percentual de gordura corporal com DMP de -0,07 (IC95%: -0,28 a 0,14; P=0,47). O grupo intervenção apresentou mudança com a redução na prevalência de excesso de peso e obesidade com odds ratio (OR) de 0,77 (IC95%:0,61 a 0,97; P=0,02) e OR de 0,54 (IC95%: 0,44 a 0,67; P<0,001), respectivamente. Também houve aumento na remissão do excesso de peso e obesidade, com OR de 3,57 (IC95%: 1,39 a 9,09; P=0,008) e OR de 7,69 (IC95%: 3,94 a 14,28; P<0,001), respectivamente. Mas não houve mudanças na incidência do excesso de peso com OR de 0,57 (IC95%: 0,20 a 1,62; P= 0,29) e na obesidade com OR de 0,89 (IC95%: 0,18 a 4,28; P=0,88). Conclusão: o Programa TriAtiva apresentou efeitos positivos no IMC e mudanças favoráveis na prevalência e remissão da obesidade, após o término do programa, tornando-se um aliado na prevenção e controle da obesidade, no âmbito escolar. Registro Brasileiro de Ensaios Clínicos: RBR- 2xx2z4. / Introduction: The prevalence of childhood obesity has increased rapidly in Brazil in the last decades. Therefore, there is an urgent necessity to develop effective strategies for the prevention and control of childhood obesity. In this context, it was developed an intervention program with nutrition education and physical activity at schools, with objectives to prevent and control obesity, called TriAtiva: education, nutrition and physical activity. Methods: This is a cluster randomized controlled trial, conducted in 12 public schools in Porto Alegre/RS (6 intervention schools and 6 control schools), from first to fourth grade from elementary school during one school year. The TriAtiva Program was implemented in the intervention schools through educational practices associated to healthy eating and physical activity, aimed the development of the health for student in a favorable environment, with the involvement of the school community and family. The body mass index was considered the primary outcome and the secondary outcomes were the percentage of body fat, waist circumference, beyond the prevalence, incidence and remission of overweight and obesity. Results: 600 students were assessed, the loss was 10.3% until the end of the study. Compared to the control group, students in the intervention group showed a reduction in body mass index (BMI), the standardized mean difference (SMD) was -0.18 (95% CI: -0.27 to -0.08; P = 0.002 ), SMD for the weight was -0.10 (95% CI: - 0.16 to -0.04; P = 0.004) and for BMI z-score was -0.19 (95% CI: -0.29 to -0.09; P = 0.002), all with statistical significance. There was a reduction, but not statistically significant, in waist circumference, where SMD was -0.07 (95% CI: -0.13 to 0.02; P = 0.06) and SMD for percentage of body fat was -0.07 (95% CI: -0.28 to 0.14; P = 0.47). The intervention group showed a change with a reduction in the prevalence of overweight and obesity, odds ratio (OR) was 0.77 (95% CI: 0.61 to 0.97; P = 0.02) and 0.54 (95% CI: 0.44 to 0.67; P < 0.001), respectively. Also there was an increase in the remission of overweight and obesity, where OR was 3.57 (95% CI: 1.39 to 9.09; P = 0.008) and 7.69 (95% CI: 3.94 to 14.28; P < 0.001), respectively. Although there were no changes in the incidence of overweight where OR was 0.57 (95% CI: 0.20 to 1.62; P = 0.29) and for obesity OR was 0.89 (95% CI: 0.18 to 4.28; P = 0.88). Conclusion: TriAtiva program showed positive effects on BMI and favorable changes in the prevalence and remission of obesity, after the program ends, becoming an allied in the prevention and control of obesity at schools. Brazilian Clinical Trials Registry (ReBec): RBR- 2xx2z4.