Wilma Zanetti [[email protected]] ESTENOSE AÓRTICA - UM ESTUDO DE CASO A população idosa tem patologias freqüentes tais como diabetes, problemas neurológicos, hepatológicos, hematológicos, nefropatias e cardiovasculares dentre os quais está a estenose aórtica. As principais causas de estenose aórtica são a congênita, reumática e a degenerativa ou senil (RANGEL, 2006). A
Microsoft word - wellness policyindiana-elem and secd.docIndiana Area School District recognizes that student wellness and proper nutrition are related to students’ physical well-being, growth, development, and readiness to learn. The Board is committed to providing a school environment that promotes student wellness, proper nutrition, nutrition education, and regular physical activity as part of the total learning experience. In a healthy school environment, students will learn about and participate in positive dietary and lifestyle practices that can improve student achievement. To ensure the health and well-being of all students, the Board establishes that the A comprehensive nutrition program consistent with federal and state requirements. Access at reasonable cost to foods and beverages that meet established nutritional guidelines. Physical education courses and opportunities for developmentally appropriate physical activity during the school day. Curriculum and programs for grades K-12 that are designed to educate students about proper nutrition and lifelong physical activity, in accordance with State Board of Education curriculum regulations and academic standards. The Superintendent shall be responsible to monitor district schools, programs, and curriculum to ensure compliance with this policy, related policies and established guidelines or administrative regulations. Each building principal or designee shall report to the Superintendent regarding Staff members responsible for programs related to student wellness shall report to the Superintendent regarding the status of such programs. The Superintendent shall periodically report to the Board on the district’s compliance with law and policies related to student wellness. The report may Assessment of school environment regarding student wellness issues. Evaluation of food services program. Review of all foods and beverages sold in schools for compliance with established nutrition guidelines. Listing of activities and programs conducted to promote nutrition and physical activity. Recommendations for policy and/or program revisions. Suggestions for improvement in specific areas. Feedback received from district staff, students, parents/guardians, community members and Wellness Committee. An assurance that district guidelines for reimbursable meals are not less restrictive than regulations and guidelines issued for schools in accordance with federal law shall be provided periodically by the Business Manager. The Wellness Committee shall be comprised of at least one (1) of each of the following: School Board member, district administrator, district food service representative, student, parent/guardian, member of the public. Optional members of the committee may include the following: teacher, school nurse, school counselor, coach, classified staff, representative of community organization, food vendor or other individuals. The Wellness Committee shall serve as an advisory committee regarding student health issues and shall be responsible for developing a Student Wellness Policy that complies with law to recommend to the Board for adoption. The Wellness Committee may examine related research and laws, assess student needs and the current school environment, review existing Board policies and administrative regulations, and raise awareness about student health issues. The Wellness Committee may make policy recommendations to the Board related to other health issues necessary to promote student wellness. The Wellness Committee may survey parents/guardians and/or students; conduct community forums or focus groups; collaborate with appropriate community agencies and organizations; and engage in similar activities, within the budget established for these purposes. The Wellness Committee shall provide periodic reports to the Superintendent or designee regarding the status of its work, as required. The goal of nutrition education is to teach, encourage and support healthy eating by students. Promoting student health and nutrition enhances readiness for learning and increases student achievement. 1. Students will have the opportunity to participate in a variety of classroom nutrition education learning experiences that include the following characteristics: • Nutrition knowledge: including but not limited to the benefits of healthy
eating, essential nutrients, nutritional deficiencies, principles of healthy weight management, the use and misuse of dietary supplements, and safe food preparation, handling, and storage.
• Nutrition related skills: including but not limited to planning a healthy
meal, understanding and using food labels, and critically evaluating nutrition information and commercial food advertising; and • Assessment of personal eating habits: setting goals for improvement, and
2. Nutrition lessons will be designed for integration within the sequential, comprehensive elementary health education program; will incorporate physical activity lessons; and will be based upon the most recent Dietary Guidelines for Americans and the USDA MyPyramid food guidance system. 3. A local Assessment program shall be implemented to track student progress on Health, Safety and Physical Education academic standards. 4. We will coordinate other existing wellness initiatives through our local District schools shall contribute to the effort to provide students opportunities to accumulate at least sixty (60) minutes of age-appropriate physical activity on all or most days of the week. That time will include physical activity outside the school environment, such as outdoor play at home, sports, etc. Students shall participate daily in a variety of age-appropriate physical activities designed to achieve optimal health, wellness, fitness, and performance benefits. Age-appropriate physical activity opportunities, such as recess; before and after school; during lunch; clubs; intramurals; and interscholastic athletics, shall be provided to meet the needs and interests of all students, in addition to planned physical education. A physical and social environment that encourages safe and enjoyable activity for all students shall be maintained. Extended periods of student inactivity, two (2) hours or more, shall be discouraged. Physical activity breaks shall be provided for elementary students during classroom hours. After-school programs shall provide developmentally appropriate physical activity for participating children. District schools shall partner with parents/guardians and community members to institute programs that support physical activity. Physical activity shall not be used as a form of punishment. Students and the community shall have access to physical activity facilities outside school hours. Quality physical education instruction that promotes lifelong physical activity and provides instruction in the skills and knowledge necessary for lifelong participation shall be provided. Physical education classes shall be the means through which all students learn, practice and are assessed on developmentally appropriate skills and knowledge necessary for lifelong, health-enhancing physical activity. A comprehensive physical education course of study that focuses on providing students the skills, knowledge and confidence to participate in lifelong, health-enhancing physical activity shall be implemented. A varied and comprehensive curriculum that leads to students becoming and remaining physically active for a lifetime shall be provided in the physical education program. A sequential physical education program consistent with State Board of Education curriculum regulations and Health, Safety and Physical Education academic standards shall be developed and implemented. Adequate amounts of planned instruction shall be provided in order for students to achieve the proficient level for the Health, Safety and Physical Education academic standards. A local assessment system shall be implemented to track student progress on the Health, Safety and Physical Education academic standards. Students shall be moderately to vigorously active as much time as possible during a physical education class. Documented medical conditions and disabilities shall be accommodated during class. Safe and adequate equipment, facilities and resources shall be provided for physical education courses. Physical education shall be taught by certified health and physical education teachers. Appropriate professional development shall be provided for physical education staff. Physical education classes shall have a teacher-student ratio comparable to those of other courses. Physical activity shall not be used as a form of punishment. District schools shall provide adequate space, as defined by the district, for eating and serving school meals. Students shall be provided a clean and safe meal environment. Students shall be provided adequate time to eat: ten (10) minutes sit down time for breakfast; twenty (20) minutes sit down time for lunch. Meal periods shall be scheduled at appropriate hours, as defined by the district. Drinking water shall be available at all meal periods and throughout the school day. Students shall have access to hand washing or sanitizing before meals and snacks. Qualified nutrition professionals shall administer the school meals program. Professional development shall be provided for district nutrition staff. Access to the food service operation shall be limited to authorized staff. Nutrition content of school meals shall be available to students and parents/ guardians. Students and parents/guardians may be involved in menu selections through various means. To the extent possible, the district shall utilize available funding and outside programs to enhance student wellness. Food shall not be used in the schools as a reward or punishment. The district shall provide appropriate training to all staff on the components of the Student Wellness Policy. Goals of the Student Wellness Policy shall be considered in planning all school based activities. Fundraising projects submitted for approval shall be supportive of healthy eating and student wellness. Administrators, teachers, food service personnel, students, parents/guardians, and community members shall be encouraged to serve as positive role models through district programs, communications and outreach efforts. The district shall support the efforts of parents/guardians to provide a healthy diet and daily physical activity for children by communicating relevant information through various methods. All foods available in district schools during the school day shall be offered to
students with consideration for promoting student health and reducing childhood
Foods provided through the National School Lunch or School Breakfast Programs
shall comply with federal nutrition standards under the School Meals Initiative.
Competitive foods are defined as foods offered at school other than through the
National School Lunch or School Breakfast Programs and include a la carte foods,
snacks and beverages; vending food, snacks and beverages; school store food, snacks and beverages; fundraisers; classroom parties; holiday celebrations; and food from home. All competitive foods available to students in the Junior High and Senior High schools shall comply with the Indiana Area School District Nutritional Standards for Competitive Foods and are available on the district’s website (www.iasd.cc). All competitive foods available to students in the elementary schools shall comply with the Pennsylvania Department of Educations Standards for Competitive Foods. The nutritional standards shall be implemented as a three (3) step plan. Nutrition information for a la carte snacks and beverages offered in snack bars, meal service lines, vending and school stores is readily available to students, parents and the school community. Nutritious and appealing foods such as fruits, vegetables, low and non –fat dairy products and whole grain products will be available wherever food is sold or offered on the school campus during the school day. All a la carte snacks and beverages offered for sale to students during the school day comply with USDA regulations prohibiting the sale of “foods of minimal nutritional value.” A minimum of 75% of snack foods sold in vending machines, snack bars, school stores, and concession stands as well as a la carte offerings that are part of the school meals program, will meet the criteria outlined below. This 75% level represents a required minimum standard. The percentage of foods and beverages meeting these parameters may be increased at any time by the recommendation of the Indiana Area School District Wellness Committee. • No more than 200 total calories per package • No more than 10% calories from saturated fat • No more than 480 mg sodium • Excludes fruits, vegetables, nuts, seeds, and nut butters • 100% fruit and vegetable juice, limited to 12 oz. portion size • Fat-free and 1% milk, 8-16 oz. portion size • Water and flavored water without added sugar, unlimited portion size • Caffeine free except flavored milk • Carbonated water and carbonated 100% fruit juice with USDA The district shall assess and, to the extent possible, implement improvements to make walking and biking to school safer and easier for students. The district shall cooperate with local municipalities, public safety agency, police departments, and community organizations to develop and maintain safe routes to school. District administrators shall seek and utilize available federal and state funding for safe routes to school, when appropriate. Child Nutrition and WIC Reauthorization Act of 2004 – P.L. 108-265 Sec. 204
Synthesis of a-L-Threofuranosyl Nucleoside TriphosphatesKeyong Zou,1 Allen Horhota,3 Biao Yu,2 Jack W. Szostak,1 Larry W. 1Howard Hughes Medical Institute, and Department of Molecular Biology,Massachusetts General Hospital, Boston, Massachusetts 02184, and 2State KeyLaboratory of Bio-organic and Natural Products Chemistry, Shanghai Institute of OrganicChemistry, Chinese Academy of Sciences, 3