ABSTRACT The purpose of this study is to determine if there are differences in actual and perceived motor competence in rural schoolchildren, according to gender and participation in extracurricular sports; and if there is a relationship between actual motor competence, perceived motor competence, participation in extracurricular sports activities and the type of sports. A total of 120 primary school students (60.0% girls, age M=11.05 SD=1.05 years) from the commune of Perquenco in the La Araucanía Region, Chile, participated. The MOBAK Test was used for the assessment of actual motor competence and the SEMOK Questionnaire for the assessment of perceived motor competence. Boys performed better than girls in the object control of actual motor competence, with a significant difference (p<.001; PSest=.69); while no significant differences were found in perceived motor competence according to gender. Students who participate in extracurricular sports show higher values in actual (object control: p<.001; PSest=.27; self-movement: p<.001; PSest=.23) and perceived motor competence (object control: p=.005; PSest=.35; self-movement: p<.001; PSest=.31), with significant differences compared to those who do not participate in any extracurricular sports activity. Significant relationships were found between actual and perceived motor competence and participation in sports. The type of extracurricular sports was only associated with actual motor competence, where group sports were related to the object control (r=.378) and individual sports to the self-movement (r=-.350). The results suggest that gender and extracurricular sports play a relevant role in the motor competence of students from rural areas.

RESUMEN La presente investigación tiene como propósito determinar si existen diferencias en la competencia motriz real y percibida en escolares de contexto rural, en función del sexo y de la participación en actividades deportivas extraescolares; así como determinar la existencia de relaciones entre competencia motriz real, competencia motriz percibida, participación en actividades deportivas extraescolares y tipo de actividad deportiva. Participaron 120 estudiantes de enseñanza primaria (60.0% niñas, edad M=11.05 DE=1.05 años) de la comuna de Perquenco de la Región de La Araucanía, Chile. Se utilizó el Test MOBAK para la evaluación de la competencia motriz real y el Cuestionario SEMOK para la evaluación de la competencia motriz percibida. Los niños presentaron mejores resultados que las niñas en el control de objetos de la competencia motriz real, diferenciándose significativamente (p<.001; PSest=.69); mientras que en la competencia motriz percibida no se encontraron diferencias significativas entre ambos sexos. Los estudiantes que participan en actividades deportivas extraescolares presentan mayores valores en la competencia motriz real (control de objetos: p<.001; PSest=.27; control del cuerpo: p<.001; PSest=.23) y percibida (control de objetos: p=.005; PSest=.35; control del cuerpo: p<.001; PSest=.31), diferenciándose significativamente de los que no participan. Se encontraron relaciones significativas entre la competencia motriz real, percibida y participación en actividades deportivas. El tipo de actividad deportiva extraescolar se asoció sólo con la competencia motriz real, en donde los deportes colectivos se relacionan con el control de objetos (r=.378) y los deportes individuales con el control del cuerpo (r=-.350). Los resultados sugieren que el sexo y las actividades deportivas extraescolares cumplen un rol relevante en la competencia motriz de los estudiantes rurales.

RESUMO A presente investigação, a fim de determinar se existem diferenças na competência motora real e percebida em crianças das zonas rurais, de acordo com o género e a participação em actividades desportivas extracurriculares; bem como para determinar a existência de relações entre competência motora real, competência motora percebida, participação em actividades desportivas extracurriculares e tipo de actividade desportiva. Um total de 120 estudantes do ensino primario (60.0% raparigas, idade M=11.05 SD=1.05 anos) da comunidade de Perquenco na região de La Araucanía, Chile, participaram no estudo. O teste MOBAK foi utilizado para a avaliação da competência motora real e o questionário SEMOK para a avaliação da competência motora percebida. Os rapazes apresentaram melhores resultados do que as raparigas no control de objectos da competência motora real, diferindo significativamente (p<.001; PSest=.69); enquanto na percepção da competência motora não foram encontradas diferenças significativas entre ambos os sexos. Os estudantes que participam em actividades desportivas extracurriculares apresentam valores mais elevados na competência motora real (control do objecto: p<.001; PSest=.27; control do corpo: p<.001; PSest=.23) e percebida (control do objecto: p=.005; PSest=.35; control do corpo: p<.001; PSest=.31), diferindo significativamente dos que não participam. Foram encontradas relações significativas entre a competência motora real e percebida e a participação em actividades desportivas. O tipo de actividade desportiva extracurricular foi associado apenas à competência motora real, onde os desportos colectivos estão relacionados com control do objecto (r=.378) e os desportos individuais com control do corpo (r=-.350). Os resultados sugerem que o género e as actividades desportivas extracurriculares desempenham um papel relevante na competência motora dos estudantes rurais.

OBJECTIVE: To evaluate the prevalence of and the associated factors for metabolic syndrome (MS) among Latin American HIV-infected patients receiving antiretroviral therapy (ART) using baseline data from the RAPID II study. METHODS: A longitudinal study to evaluate the metabolic profile, cardiovascular disease (CVD) risk and associated treatment practices to reduce this risk has been conducted in seven Latin American countries (the RAPID II study). Adult HIV patients with at least six months of RT were enrolled. MS was defined following ATP-III criteria. Demographic and anthropometric data, serum biochemical and clinical parameters were compared in patients with and without MS using bivariate and multivariate analysis. RESULTS: A total of 4,010 patients were enrolled, 2,963 (74%) were males. Mean age (SD) was 41.9 (10.0) years. The prevalence of MS was 20.2%. Females had higher prevalence of MS than males (22.7% vs. 19.4%, p = 0.02). MS was driven by high triglycerides, low HDL-cholesterol and high blood pressure (HBP). Patients with MS had higher 10year CVD risk: 22.2% vs. 7.4%, p < 0.001. Age (OR: 1.05 per year), female gender (OR: 1.29), family history of CVD (OR: 1.28), CD4 cell count (OR: 1.09 per 100 cell increase), and protease inhibitor based-ART (OR: 1.33) correlated with MS in the multivariate analysis. CONCLUSIONS: Prevalence of MS in this setting was similar to that reported from developed countries. MS was driven by high triglycerides, low-HDL and HBP, and it was associated with higher risk of CVD. Traditional risk factors, female gender, immune reconstitution, and protease inhibitor based-ART correlated with MS.

OBJECTIVE: Determine the prevalence of metabolic abnormalities (MA) and estimate the 10-year risk for cardiovascular disease (CVD) among Latin American HIV-infected patients receiving highly active anti-retroviral therapy (HAART). METHODS: A cohort study to evaluate MA and treatment practices to reduce CVD has been conducted in seven Latin American countries. Adult HIV-infected patients with at least one month of HAART were enrolled. Baseline data are presented in this analysis. RESULTS: A total of 4,010 patients were enrolled. Mean age (SD) was 41.9 (10) years; median duration of HAART was 35 (IQR: 10-51) months, 44% received protease inhibitors. The prevalence of dyslipidemia and metabolic syndrome was 80.2% and 20.2%, respectively. The overall 10-year risk of CVD, as measured by the Framingham risk score (FRF), was 10.4 (24.7). Longer exposure to HAART was documented in patients with dyslipidemia, metabolic syndrome and type 2 diabetes mellitus. The FRF score increased with duration of HAART. Male patients had more dyslipidemia, high blood pressure, smoking habit and higher 10-year CVD than females. CONCLUSIONS: Traditional risk factors for CVD are prevalent in this setting leading to intermediate 10-year risk of CVD. Modification of these risk factors through education and intervention programs are needed to reduce CVD.

OBJECTIVES: To determine the effectiveness of an intervention for pharmacy workers in improving their recognition and management of sexually transmitted disease (STD) syndromes. METHODS: We randomly selected 14 districts (total population nearly 4 million) from the 24 districts of low socioeconomic status in Lima, Peru. We randomly assigned paired districts to receive training and support for management and prevention of STDs or a control intervention about management of diarrhoea. The STD intervention included interactive luncheon seminars on recognition and management of four STD syndromes (urethral discharge, vaginal discharge, genital ulcers, and pelvic inflammatory disease) and STD/HIV prevention counselling; monthly pharmacy visits by "prevention salespersons" who distributed materials that included "STD/HIV prevention packets" containing information, condoms, and cards given to patients for referral of their sex partners; and workshops for physicians on managing patients with STD syndromes referred from pharmacies. Standardized simulated patients visited pharmacies in intervention and control districts at one, three, and six months after training to assess outcomes. FINDINGS: Standardized simulated patients reported significantly better recognition and management (appropriate antimicrobial regimens provided for discharge syndromes and referral to specially trained physicians for genital ulcers or pelvic inflammatory disease) by pharmacy workers of all four STD syndromes. They also reported significantly more frequent recommendations for use of condoms and treatment of partners at pharmacies in intervention districts than in control districts (by "intention-to-train" analyses, P<0.05 for 47/48 primary outcome comparisons). CONCLUSION: Training was feasible and effectively improved pharmacy workers' practices.

OBJETIVO: Determinar la eficacia de una intervención destinada a mejorar el reconocimiento y manejo de los síndromes asociados a las enfermedades de transmisión sexual (ETS) por parte de los trabajadores de farmacia. MÉTODOS: Se seleccionaron aleatoriamente 14 de los 24 distritos de Lima, Perú, con bajo nivel socioeconómico. La población total de los 14 distritos seleccionados era de cerca de 4 millones. Los distritos fueron apareados y asignados aleatoriamente a una intervención que proporcionó entrenamiento y apoyo en el manejo y prevención de las ETS (distritos I) o a una intervención de control relacionada con el tratamiento de la diarrea (distritos C). La primera incluyó: seminarios interactivos sobre el reconocimiento y manejo de cuatro síndromes de las ETS (descarga uretral, flujo vaginal, úlceras genitales y enfermedad inflamatoria pélvica) y la consejería para la prevención de las ETS y la infección por VIH; «visitadores de la prevención» que visitaron mensualmente las farmacias para distribuir material que incluía «paquetes informativos sobre la prevención de las ETS/VIH», condones y tarjetas para que los pacientes enviaran a sus parejas sexuales a la consulta; y talleres para los médicos sobre cómo tratar a los pacientes enviados por las farmacias con síndromes de las ETS. Para evaluar los resultados se utilizaron pacientes simulados con síndromes estandarizados que acudieron a las farmacias de los distritos C e I uno, tres y seis meses después del periodo de entrenamiento. RESULTADOS: La evaluación con pacientes simulados mostró un significativo mejor reconocimiento y manejo (uso apropiado de antimicrobianos para descarga uretral y flujo vaginal, y referencia a médicos entrenados para los casos de úlceras genitales y enfermedad pélvica inflamatoria) por parte de los trabajadores de farmacia de los distritos de intervención para los 4 síndromes de ETS. Asimismo, se encontró que las recomendaciones sobre el uso de condones y el tratamiento de las parejas fue más frecuente en las farmacias de los distritos I que en las de los distritos C (P < 0,05 en 47 de las 48 comparaciones de los resultados en los análisis por "intención de entrenar"). CONCLUSIÓN: El entrenamientofue factible y mejoró efectivamente las prácticas de los trabajadores de farmacia.

OBJECTIF: Etablir l'efficacité d'une intervention à l'intention du personnel des pharmacies pour améliorer la reconnaissance et la prise en charge des syndromes liés aux maladies sexuellement transmissibles (MST). MÉTHODES: Sur les 24 districts socio-économiquement défavorisés que compte Lima (Pérou), nous en avons sélectionné 14 au hasard (où vivent au total près de 4 millions d'habitants). Nous les avons associés par paires aléatoires, un des districts bénéficiant d'une formation et d'un appui à la prise en charge et à la prévention des MST et l'autre d'une intervention sur la prise en charge des maladies diarrhéiques. L'intervention sur les MST comportait des déjeuners-séminaires interactifs sur la reconnaissance et la prise en charge de quatre syndromes liés aux MST (écoulement urétral, écoulement vaginal, ulcérations génitales, infection génitale haute) et sur les conseils pour la prévention des MST et du VIH ; des visites mensuelles dans les pharmacies de « représentants de la prévention » qui distribuaient du matériel d'information, notamment des « enveloppes de prévention MST/VIH » contenant des informations, des préservatifs et des fiches à remettre par les patients à leurs partenaires pour les orienter vers les soins ; des ateliers destinés aux médecins sur la prise en charge des patients adressés par les pharmacies pour des syndromes liés aux MST. De faux patients simulant des syndromes standardisés se sont rendus dans les pharmacies ciblées par l'intervention et dans les districts témoins un mois, trois mois et six mois après la formation pour évaluer les résultats. RÉSULTATS: Les faux patients ont signalé une amélioration nette de la reconnaissance et de la prise en charge des quatres syndromes par le personnel des pharmacies (traitements antimicrobiens fournis qui convenaient pour les syndromes d'écoulement, orientation vers un médecin spécialement formé pour les ulcérations génitales ou les infections génitales hautes). Ils ont également rapporté avoir reçu plus fréquemment, dans les pharmacies des districts couverts par l'intervention par rapport aux districts témoins, des conseils d'utiliser des préservatifs ou de faire traiter leurs partenaires (analyse « intention de formation », p<0,05pour 47/48 comparaisons des résultats primaires). CONCLUSION: La formation est possible et elle a effectivement amélioré les pratiques en pharmacie.