BackgroundThe aim of this study was to compare pelvic floor muscle (PFM) strength using transvaginal digital palpation in healthy continent women in different age groups, and to compare the inter- and intra-rater reliability of examiners performing anterior and posterior vaginal assessments.MethodsWe prospectively studied 150 healthy multiparous women. They were distributed into four different groups, according to age range: G1 (n = 37), 30–40 years-old; G2 (n = 39), 41–50 years-old; G3 (n = 39), 51–60 years-old; and G4 (n = 35), older than 60 years-old. PFM strength was evaluated using transvaginal digital palpation in the anterior and posterior areas, by 3 different examiners, and graded using a 5-point Amaro’s scale.ResultsThere was no statistical difference among the different age ranges, for each grade of PFM strength. There was good intra-rater concordance between anterior and posterior PFM assessment, being 64.7%, 63.3%, and 66.7% for examiners A, B, and C, respectively. The intra-rater concordance level was good for each examiner. However, the inter-rater reliability for two examiners varied from moderate to good.ConclusionsAge has no effect on PFM strength profiles, in multiparous continent women. There is good concordance between anterior and posterior vaginal PFM strength assessments, but only moderate to good inter-rater reliability of the measurements between two examiners.

Purpose Sexual performance is related to proprioception and pelvic floor muscle strength (PFMS). The aim of this study was to correlate sexual activity and orgasm with PFMS. Materials and Methods A total of 140 healthy continent female were prospectively distributed into 4 groups according to age: Group 1 (G1), 30–40; Group 2 (G2), 41–50; Group 3 (G3), 51–60; Group 4 (G4), over 60 years old. Evaluated parameters were: frequency of sexual activity and orgasm achievement; body mass index (BMI) and objective evaluation of PFMS using perineometer and surface electromyography. Results BMI was higher in G4 compared to G1 (p=0.042). Women who reported sexual activity was significantly higher in G1 compared to G3 and G4 (94.1% vs. 66.7% and 37.5%, respectively; p=0.001). Orgasm was more frequently in G1 compared to G3 and G4 (91.2% vs. 63.9% and 28.1%, respectively; p=0.001), demonstrating that sexual activity and orgasm decrease after age 51. The duration of PFM contraction was significantly higher in women who had sexual intercourse (p=0.033) and orgasm (p=0.018). Conclusions Although the frequency of sexual intercourse and orgasm may decrease with aging, a relationship between sexual activity and PFMS remains apparent, once both sexually active women and those who have orgasms showed better PFM endurance than non-sexually active ones.

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RESUMO:A educação a distância (EaD) foi reconhecida pela primeira vez na Lei de Diretrizes e Bases da Educação (LBD) em 1996, e refere-se a uma modalidade de ensino-aprendizagem onde os alunos e tutores estão separados, contudo conectados por meio de diversas tecnologias como a internet. A EaD vem crescendo gradativamente com o passar dos anos, e tem sido constante a sua utilização em diversas modalidades de cursos, sejam técnicos, de graduação ou pós-graduação. Os cursos de enfermagem, assim como outros cursos da área da saúde, têm usado a EaD com o intuito de facilitar o acesso a aprendizagem, oferecendo ao aluno ensino de qualidade e conhecimento de novas tecnologias. Este estudo foi desenvolvido com o intuito de analisar a EaD, assim como sua aplicação nos cursos de enfermagem. Para tanto foi realizada uma revisão de literatura qualitativa de pesquisa teórica. Foram retirados artigos em bases de dados nacionais publicados no período de 2002 a 2014. PALAVRAS-CHAVE:Educação a distância. Enfermagem. Aplicabilidade na enfermagem. RESUMEN: La educación a distancia (EaD) fue reconocida por primera vez en la Ley de Directrices y Bases de la Educación (LBD) en 1996, y se refiere a una modalidad de enseñanza-aprendizaje en la cual los alumnos y sus tutores están separados y sin embargo conectados por medio de diversas tecnologías como Internet. La EaD ha1Universidade Estadual de Campinas (Unicamp), Campinas -SP -Brasil. Professora Doutora da Área de Enfermagem na Saúde da Mulher e do Recém-nascido/FENF. Doutora pela

Objectives To assess the correlation between hormonal status and pelvic floor muscle strength. Methods A total of 140 continent women were prospectively evaluated, and divided into four groups according to age: group 1 (n = 34) aged 30–40 years; group 2 (n = 38) aged 41–50 years; group 3 (n = 35) aged 51–60; and group 4 (n = 33) aged >60 years. The following parameters were evaluated: demographic data using clinical questionnaire; hypermobility of the bladder neck using swab test; vaginal trophism by gynecological examination; hormonal status of the vagina by cytology; and pelvic floor muscle strength using a perineometer and electromyography. Results There were no statistical differences between pelvic floor muscle strength, demographic characteristics, vaginal trophism and hypermobility of the bladder neck between groups (P > 0.05). There was a larger number of women with vaginal atrophy among those aged >60 years. Vaginal trophism assessed by pelvic examination was highly consistent with the findings of colpocytology (kappa test = 0.888). Electromyography showed that women with hypermobility had lower muscle resistance (endurance) when compared with those without hypermobility. Conclusions Although vaginal atrophy is more intense in women aged >60 years, no difference can be found in the pelvic floor muscle strength during the physiological aging process in continent women. As a consequence, trophism is not the only factor related to pelvic floor muscle strength, and it should not preclude the selection of patients who are referred to prophylaxis.

RESUMO:O presente estudo teve como objetivo analisar a educação à distância no Brasil e seu uso na educação especial como inclusão escolar. Para tanto foi realizado um estudo e levantamento bibliográfico sobre o assunto em periódicos, revistas científicas nacionais e livros para a presente discussão. Observa-se que a educação à distância é uma modalidade em constante crescimento no Brasil, e as novas tecnologias de informação e comunicação podem contribuir na educação, sendo uma possibilidade de inclusão no processo de ensino e aprendizagem. Entretanto, a inclusão dos sujeitos com alguma deficiência, ainda está acontecendo, pois diante das possibilidades e perspectivas, e dos avanços, requer maior participação dos agentes públicos através de políticas públicas. Para que a educação especial e a inclusão escolar aconteçam de forma efetiva, se faz necessário que o professor possa permanecer na formação continuada, com isso, atender o deficiente nos processos de ensino e aprendizagem, ou seja, o professor educador deve

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