RESUMEN
Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy that consists in the use of antiretroviral drugs by seronegative people at risk of HIV. Negative perceptions, inadequate understanding, and access barriers have been associated with decreased medication adherence. Manaus is the largest city in the Brazilian Amazon, where the incidence of HIV/AIDS is high, and the rates of adherence to the antiretroviral treatment for HIV and PrEP are low. In this qualitative study among PrEP users, mostly MSM, we explored perceptions, knowledge, and access barriers. We conducted 21 in-depth interviews with an intentionally sampled group of participants who had used PrEP at least once in their lifetime, selected through the snowball technique, between April and July 2022. A thematic analysis was conducted with a predominantly inductive approach. We highlight three relevant themes: (i) access to information about PrEP and its influences on users, (ii) access, monitoring, and barriers encountered, and (iii) facilitators for PrEP adherence and sexual behaviors. One of the negative perceptions identified in the study involves a misunderstanding of the association between PrEP users and the HIV/AIDS status. Participants revealed that some non-PrEP users suspect that individuals claiming PrEP usage are concealing an HIV-positive status to engage in unprotected sex. Lack of information by health professionals regarding HIV prevention methods poses significant barriers to PrEP access and adherence. Participants emphasized social media's crucial role in PrEP awareness. The results suggest a need to increase digital outreach regarding PrEP, decentralize PrEP services, and provide comprehensive healthcare training to improve the effectiveness of the preventive measure.
Asunto(s)
Infecciones por VIH , Conocimientos, Actitudes y Práctica en Salud , Homosexualidad Masculina , Profilaxis Pre-Exposición , Investigación Cualitativa , Humanos , Masculino , Brasil , Adulto , Homosexualidad Masculina/psicología , Infecciones por VIH/prevención & control , Persona de Mediana Edad , Fármacos Anti-VIH/uso terapéutico , Fármacos Anti-VIH/administración & dosificación , Accesibilidad a los Servicios de Salud , Adulto Joven , Cumplimiento de la Medicación/psicología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Conducta Sexual/psicología , PercepciónRESUMEN
Purpose: Most studies assessing hair cortisol were conducted with adults. As specific guidelines for infant hair collection are lacking, we developed a hair collection protocol for 12-month-old infants and assessed its acceptability and feasibility. Results: Out of the total (N = 45), 95.6 % (n = 43) of caregivers consented to the procedure, while one caregiver did not consent (2.2 %), and another requested the procedure to be halted before required amount of hair had been reached (2.2 %). Furthermore, two (4.4 %) infants did not have enough hair for collection. There was no attrition due to infant fussiness/crying. Discussion: We learned five lessons which can help to enhance reproducibility, mother's consent, and mother-infant comfort and acceptance of the procedure. The first lesson is to have the infant sit on the caregiver's lap to ensure the infant feels safe and remains relatively still. The second is to reassure caregivers by showing hair samples representing the amount to be cut as well as by clarifying no unaesthetic gaps would be visible. The third is to caress the infant's head to habituate them to the hair manipulation and to make soap bubbles as distractors. The fourth is to take extra care when securing the lock of hair for cutting because the infant scalp is thin and malleable. The fifth is to place a precision scale in the collection room to ensure the necessary weight is reached. Conclusion: Our hair collection protocol developed for 12-month-old infants was deemed feasible and acceptable, filled an important literature gap concerning the absence of published protocols for infants, and will contribute to increase the replicability and collection efficiency for other research teams.
RESUMEN
This study evaluated the photoactivation of hydrogen peroxide gels at different concentrations using blue or violet LED in terms of whitening efficacy and tooth sensitivity. Forty patients were randomly divided into 4 groups: HP6V (violet LED and 6% hydrogen peroxide), HP6B (blue LED and 6% hydrogen peroxide), HP35V (violet LED and 35% hydrogen peroxide), and HP35B (blue LED and 35% hydrogen peroxide). The L*, a* and b* values were measured before, 1 week and 3 months after treatment, and the ΔE and ΔWID values were calculated. Tooth sensitivity was measured using a visual analogue scale (VAS) before, immediately after, and 24 h after bleaching. The ΔE, ΔWID and bleaching sensitivity values were subjected to the ANOVA test and Bonferroni post-test. HP35V and HP35B showed higher whitening efficacy than HP6VL, while HP6V did not show statistical differences compared to the other groups. Regarding bleaching-related sensitivity, the HP6V and HP6B groups presented the lowest values when compared to HP35V and HP35B. HP6V showed whitening efficacy comparable to HP35V and HP35B but with reduced tooth sensitivity. TRIAL REGISTRATION NUMBER: NCT06165458; registration date: 12/09/2023.
Asunto(s)
Sensibilidad de la Dentina , Peróxido de Hidrógeno , Blanqueadores Dentales , Blanqueamiento de Dientes , Humanos , Blanqueamiento de Dientes/métodos , Blanqueamiento de Dientes/instrumentación , Femenino , Adulto , Blanqueadores Dentales/administración & dosificación , Masculino , Adulto Joven , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
BACKGROUND: Sexually Transmitted Infections (STIs), such as Human Immunodeficiency Virus (HIV) transmitted by biological, socioeconomic and cultural factors that increase the vulnerability of certain population groups such as civil construction workers. OBJECTIVE: To evaluate the knowledge of workers in the construction industry about infection by HIV and associated factors. METHODS: A cross-sectional, analytical study was conducted, including 381 construction workers, in the cities of João Pessoa, Cabedelo, and Santa Rita, in the State of Paraíba, Brazil, performed through interviews, using a data collection instrument with social demographic variables and the HIV Knowledge Questionnaire. Data were analyzed using descriptive measures, and for comparison between the categories the Kruskal-Wallis test was used, with margin of error of 5%. RESULTS: A predominance of male workers was observed (97.4%) among 381 workers; aged 30-39 (34.1%); married (81.4%); with up to eight years of education (66.6%); family income of up to 2x the minimum wage (52.8%) and coming from the country (43.8%). The average of correct responses was 63.3%, with higher indices (70.0%) related to transmission and forms of prevention. There were higher percentages of hits among those who had studied for 12 years or more. Workers from the capital of Paraíba presented a higher number of correct responses (67.44%). CONCLUSIONS: There is a low index of knowledge of construction workers about HIV, highlighting their consequent vulnerability to acquiring this infection.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Industria de la Construcción , Conocimientos, Actitudes y Práctica en Salud , Humanos , Industria de la Construcción/estadística & datos numéricos , Masculino , Estudios Transversales , Adulto , Brasil/epidemiología , Femenino , Encuestas y Cuestionarios , Persona de Mediana Edad , Infecciones por VIHRESUMEN
Este estudo avaliou o reconhecimento (imitação, identidade e identificação) e a nomeação de estímulos emocionais de valência negativa (raiva e tristeza) e positiva (alegria e surpresa) em conjunto com a influência dos tipos de estímulos utilizados (social-feminino, social-masculino, familiar e emoji) em crianças e jovens adultos com autismo ou síndrome de Down, por meio de tarefas aplicadas pela família e mediadas por recursos tecnológicos durante a pandemia de covid-19. Participaram cinco crianças e dois jovens adultos com autismo e uma criança e dois jovens adultos com síndrome de Down. Foram implementadas tarefas de identidade, reconhecimento, nomeação e imitação, com estímulos faciais de função avaliativa (sem consequência diferencial) e de ensino (com consequência diferencial, uso de dicas e critério de aprendizagem), visando a emergência da nomeação emocional por meio do ensino das tarefas de reconhecimento. Os resultados da linha de base identificaram que, para os participantes que apresentaram menor tempo de resposta para o mesmo gênero, a diferença de tempo de resposta foi em média 57,28% menor. Em relação à valência emocional, 50% dos participantes apresentaram diferenças nos acertos, a depender da valência positiva e negativa, sendo que 66,66% apresentaram diferenças para o tempo de resposta a depender da valência emocional. Após o procedimento de ensino, os participantes mostraram maior número de acertos nas tarefas, independentemente do gênero de estímulo e valência emocional, criando ocasião para generalização da aprendizagem de reconhecimento e nomeação de emoções, além de consolidar a viabilidade de estratégias de ensino mediadas por recursos tecnológicos e aplicadas por familiares.(AU)
This study evaluated the recognition (imitation, identity, and identification) and naming of negative (anger and sadness) and positive (joy and surprise) emotional stimuli alongside the influence of the types of stimuli (social-female, social-male, family, and emoji) in children and young adults with autism and Down syndrome, via tasks applied by the family and mediated by technological resources, during the COVID-19 pandemic. Five children and two young adults with autism and one child and two young adults with Down syndrome participated. Identity, recognition, naming, and imitation tasks were planned and implemented using facial stimuli with evaluative (without differential consequence) and teaching (with differential consequence, tips, and learning criteria) functions, aiming at the emergence of emotional naming from the recognition teaching tasks. The baseline results showed that, for participants who had a shorter response time for the same gender, the response time difference was on average 57.28% lower. Regarding the emotional valence, 50% of the participants showed differences in the correct answers, depending on the positive and negative valence, and 66.66% showed differences in the response time depending on the emotional valence. After the teaching procedure, the participants showed a greater number of correct answers in the tasks, regardless of the stimulus type and emotional valence, creating an opportunity for generalizing learning of emotion recognition and naming, in addition to consolidating the feasibility of teaching strategies mediated by technological resources and applied by family members.(AU)
Este estudio evaluó el reconocimiento (imitación, identidad e identificación) y la denominación de estímulos emocionales negativos (enfado y tristeza) y positivos (alegría y sorpresa) y la influencia de los tipos de estímulos utilizados (social-femenino, social-masculino, familiar y emoji ) de niños y jóvenes con autismo o síndrome de Down, a través de tareas aplicadas por la familia, mediadas por recursos tecnológicos durante la pandemia de la covid-19. Participaron cinco niños y dos adultos jóvenes con autismo, y un niño y dos adultos jóvenes con síndrome de Down. Se planificaron e implementaron tareas de identidad, reconocimiento, nombramiento e imitación con estímulos faciales con función evaluativa (sin consecuencia diferencial) y enseñanza (con consecuencia diferencial, uso de ayudas y criterios de aprendizaje), buscando la emergencia del nombramiento emocional después de la enseñanza de tareas de reconocimiento. Los resultados de la línea de base identificaron que para los participantes que tenían un tiempo de respuesta más corto para el mismo género, la diferencia en el tiempo de respuesta fue un 57,28% menor. En cuanto a la valencia emocional, el 50% de los participantes mostraron diferencias en las respuestas correctas, en función de la valencia positiva y negativa, y el 66,66% tuvieron diferencias en el tiempo de respuesta, en función de la valencia emocional. Después del procedimiento de enseñanza, los participantes mostraron mayor número de aciertos en las tareas evaluadas, independientemente del tipo de estímulo o valencia emocional, lo que genera una oportunidad para la generalización del aprendizaje de reconocimiento y denominación de emociones, además de consolidar la viabilidad de estrategias de enseñanza mediadas por recursos tecnológicos y aplicadas por la familia.(AU)
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Adulto , Adulto Joven , Trastorno Autístico , Familia , Síndrome de Down , Emoción Expresada , Emociones , Ansiedad , Relaciones Padres-Hijo , Padres , Percepción , Distorsión de la Percepción , Personalidad , Juego e Implementos de Juego , Prejuicio , Psiquiatría , Psicología , Psicología Social , Atención , Recursos Audiovisuales , Signos y Síntomas , Deseabilidad Social , Medio Social , Valores Sociales , Socialización , Estereotipo , Análisis y Desempeño de Tareas , Percepción Visual , Mujeres , Conducta , Imagen Corporal , Procesamiento de Imagen Asistido por Computador , Simbolismo , Actividades Cotidianas , Inteligencia Artificial , Adaptación Psicológica , Pesar , Actitud , Terapia Cognitivo-Conductual , Niño , Crianza del Niño , Cromosomas , Ensayo Clínico , Competencia Mental , Cuidadores , Cognición , Detección de Señal Psicológica , Comunicación , Conciencia , Intuición , Observación , Trastorno de Movimiento Estereotipado , Trastornos de los Cromosomas , Autonomía Personal , Hijos Adultos , Confianza , Comprensión , Delegación al Personal , Compresión de Datos , Educación , Educación de las Personas con Discapacidad Intelectual , Educación Especial , Ego , Empatía , Conducta Exploratoria , Cara , Expresión Facial , Competencia Cultural , Adulto Joven , Miedo , Retroalimentación , Inteligencia Emocional , Estigma Social , Pandemias , Habilidades Sociales , Normas Sociales , Ajuste Emocional , Optimismo , Metacognición , Reconocimiento Facial , Trastorno del Espectro Autista , Análisis Aplicado de la Conducta , Automanejo , Respeto , Regulación Emocional , Generalización Psicológica , Genética , Interacción Social , Reconocimiento de Identidad , COVID-19 , Gestos , Entrenamiento Cognitivo , Apoyo Familiar , Velocidad de Procesamiento , Manejo Psicológico , Imaginación , Relaciones Interpersonales , Lenguaje , Acontecimientos que Cambian la Vida , Memoria a Corto Plazo , Hombres , Trastornos Mentales , Procesos Mentales , Discapacidad Intelectual , Enfermedades del Sistema Nervioso , Manifestaciones Neurológicas , Neurología , Pruebas Neuropsicológicas , Comunicación no VerbalRESUMEN
A visita domiciliar puerperal consiste em uma das atividades inerentes à Estratégia de Saúde da Família e se caracteriza como um importante instrumento de intervenção no contexto familiar. A abordagem multiprofissional e interdisciplinar no contexto domiciliar tem se mostrado uma estratégia positiva, que promove a atenção integral, facilita o cuidado e o vínculo e proporciona aos profissionais conhecer a realidade em que a família está inserida. Diante do exposto, este artigo objetiva relatar a experiência de profissionais de saúde residentes em Saúde da Família e Comunidade dos núcleos profissionais de enfermagem, nutrição e odontologia em visitas puerperais. Foram realizadas doze visitas domiciliares às puérperas e aos RN no município de Iguatu-CE, durante o período de novembro de 2018 a março de 2019. Durante as visitas, foram realizadas condutas clínicas voltadas à puérpera e ao recém-nascido, além do repasse de orientações e cuidados, de forma a promover saúde e prevenir agravos. A inserção da equipe multiprofissional nas visitas puerperais foi uma experiência de grande relevância tanto para as profissionais de saúde como para os pacientes, pois possibilitou, através da educação em saúde, a ampliação do cuidado com a saúde materno-infantil, o fornecimento de orientações e, com isso, a melhoria da qualidade de saúde e de vida da população atendida com esta prática.
The postpartum home visit consists of one of the activities inherent in the Family Health Strategy and it is featured as an important intervention instrument in the family context. The multiprofessional and interdisciplinary approach in the home context has been shown to be a positive strategy that promotes integral care, facilitates care and bonding, and allows professionals to know the reality in which the family is inserted. Considering the above, this paper aims to report the experience of resident health professionals in Family and Community Health of the professional nuclei of nursing, nutrition and dentistry in puerperal visits. Twelve home visits were conducted to puerperal and newborn infants in the municipality of Iguatu-CE during the period from November 2018 to March 2019. During the visits, clinical procedures were performed for the puerperal woman and the newborn, as well as the transfer of guidelines and care, in order to promote health and prevent diseases. The inclusion of the multiprofessional team in the puerperal visits was an experience of great value for both health professionals and patients, because it enabled through health education, the expansion of maternal and child health care, the provision of guidelines and thereby improving the quality of health and life of the population assisted with this practice.
Asunto(s)
Atención Integral de Salud , Periodo PospartoRESUMEN
Long-term-ecological-research (LTER) faces many challenges, including the difficulty of obtaining long-term funding, changes in research questions and sampling designs, keeping researchers collecting standardized data for many years, impediments to interactions with local people, and the difficulty of integrating the needs of local decision makers with "big science". These issues result in a lack of universally accepted guidelines as to how research should be done and integrated among LTER sites. Here we discuss how the RAPELD (standardized field infrastructure system), can help deal with these issues as a complementary technique in LTER studies, allowing comparisons across landscapes and ecosystems and reducing sampling costs. RAPELD uses local surveys to understand broad spatial and temporal patterns while enhancing decision-making and training of researchers, local indigenous groups and traditional communities. Sampling of ecological data can be carried out by different researchers through standardized protocols, resulting in spatial data that can be used to answer temporal questions, and allow new questions to be investigated. Results can also be integrated into existing biodiversity networks. Integrated systems are the most efficient way to save resources, maximize results, and accumulate information that can be used in the face of the unknown unknowns upon which our future depends.
Asunto(s)
Biodiversidad , Ecosistema , Humanos , Estudios LongitudinalesRESUMEN
BACKGROUND: Hypericin (HYP) is a natural compound widely used as a food supplement. The encapsulation of HYP into nanosystems, such as nanostructured lipid carriers (NLC), is a promising strategy for delivering this lipophilic molecule and protecting it from degradation. OBJECTIVE: This study aims to develop and validate an analytical method to quantify the encapsulation efficiency of HYP in NLC. METHOD: A reverse-phase high-performance liquid chromatography (HPLC) method was developed and validated according to the International Conference on Harmonization (ICH) guide Q2 (R1). NLC was prepared through the ultrasonication method, and HYP encapsulation efficiency was evaluated using the validated method. RESULTS: Separation was achieved using an isocratic mobile phase composed of acetonitrile, methanol, and ammonium acetate buffer (10 mM, pH 5.0) (54:36:10, v/v/v) and a reverse stationary phase. The specificity, linearity, precision, accuracy, and robustness of the method were assessed and confirmed during the validation. Furthermore, the validated method was able to determine the encapsulation efficiency of HYP in NLC. CONCLUSIONS: The HPLC method was validated, and the results indicated the ability of NLC to deliver HYP compounds for further application as a food supplement. HIGHLIGHTS: HYP is used as a food supplement and for photodynamic therapy (PDT). The developed method was specific, linear, precise, accurate, and robust. NLCs showed a high ability to encapsulate HYP.
Asunto(s)
Nanoestructuras , Límite de Detección , Nanoestructuras/química , Cromatografía Líquida de Alta Presión/métodos , LípidosRESUMEN
The COVID-19 pandemic has challenged managers and exposed weaknesses in health systems. In Brazil, the pandemic emerged amid difficulties to work in the Brazilian Unified Health System (SUS) and in health surveillance (HS). The purpose of this article is to analyze the effects of COVID-19 on the organization, working conditions, management, and performance of HS, according to the perception of capital city managers from three regions of Brazil. This is an exploratory, descriptive research with qualitative analysis. The Iramuteq software was used in the treatment of the textual corpus and analysis of descending hierarchical classification, which generated four classes: characteristics of HS work during the pandemic (39.9%), HS organization and working conditions during the pandemic (12.3%), effects of the pandemic on work (34.4%), and the class of the health protection of workers and the population (13.4%). HS implemented remote work, expanded work shifts, and diversified its actions. However, it faced difficulties with personnel, infrastructure, and insufficient training. The present study also pointed out the potential for joint actions concerning HS.
A pandemia de COVID-19 desafiou gestores e explicitou fragilidades dos sistemas de saúde. No Brasil, a pandemia surgiu em meio a dificuldades para o trabalho no SUS e na vigilância sanitária (VISA). O objetivo deste artigo é analisar os efeitos da COVID-19 sobre a organização, as condições de trabalho, a gestão e a atuação de VISA, conforme a percepção de gestores de capitais de três regiões do Brasil. É uma pesquisa exploratória, descritiva, com análise qualitativa. Utilizou-se o software Iramuteq no tratamento do corpus textual e a análise de classificação hierárquica descendente gerou quatro classes: características do trabalho de VISA na pandemia (39,9%), organização e condições de trabalho de VISA na pandemia (12,3%), efeitos da pandemia sobre o trabalho (34,4%) e proteção da saúde de trabalhadores e da população (13,4%). A VISA implantou trabalho remoto, ampliou turnos de trabalho e diversificou suas ações. Entretanto, enfrentou dificuldades de pessoal, infraestrutura e capacitação insuficiente. O estudo apontou as potencialidades das ações conjuntas para a VISA.
Asunto(s)
COVID-19 , Humanos , Pandemias , Programas de Gobierno , Recursos Humanos , Brasil/epidemiología , Personal de SaludRESUMEN
This study aimed to analyze the management of hemotherapy services (HS) in the context of the COVID-19 pandemic from the perspective of municipal managers in different regions of Brazil. A qualitative approach with semi-structured interviews was applied to HS managers in the three Brazilian capitals, from different regions of Brazil, during the period between September 2021 and April 2022. The textual content of the interviews was submitted to lexicographic textual analysis using the free access software, Iramuteq. The managers' perceptions resulted from the descending hierarchical classification (DHC) analysis, which generated six classes: availability of resources for the development of work; installed capacity of services; strategies and challenges for attracting blood donors; risks and worker protection; measures for crisis management; and communication strategies for the adhesion of candidates for donation. The analysis highlighted several strategies used by the management, as well as pointed out limits and challenges for HS organization and management, exacerbated in the context of the pandemic.
Estudo que teve por objetivo analisar a gestão dos serviços hemoterápicos (SH) no contexto da pandemia de COVID-19, na perspectiva de gestores de municípios de diferentes regiões do Brasil. Pesquisa de abordagem qualitativa com entrevistas semiestruturadas aplicadas a gestores dos SH das três capitais brasileiras de diferentes regiões do Brasil, no período de setembro de 2021 a abril de 2022. O conteúdo textual das entrevistas foi submetido à análise textual lexicográfica a partir do uso do software Iramuteq, de acesso gratuito. As percepções dos gestores resultaram da análise da classificação hierárquica descendente (CHD), que gerou seis classes: disponibilidade de recursos para o desenvolvimento do trabalho; capacidade instalada dos serviços; estratégias e desafios para captação de doadores de sangue; riscos e proteção dos trabalhadores; medidas para gestão da crise; estratégias de comunicação para a adesão de candidatos para doação. A análise evidenciou diversas estratégias utilizadas pela gestão, bem como apontou limites e desafios para a organização e a gestão de serviços hemoterápicos, agudizados no contexto da pandemia.
Asunto(s)
COVID-19 , Humanos , Pandemias , Brasil/epidemiología , Investigación CualitativaRESUMEN
Resumo Estudo que teve por objetivo analisar a gestão dos serviços hemoterápicos (SH) no contexto da pandemia de COVID-19, na perspectiva de gestores de municípios de diferentes regiões do Brasil. Pesquisa de abordagem qualitativa com entrevistas semiestruturadas aplicadas a gestores dos SH das três capitais brasileiras de diferentes regiões do Brasil, no período de setembro de 2021 a abril de 2022. O conteúdo textual das entrevistas foi submetido à análise textual lexicográfica a partir do uso do software Iramuteq, de acesso gratuito. As percepções dos gestores resultaram da análise da classificação hierárquica descendente (CHD), que gerou seis classes: disponibilidade de recursos para o desenvolvimento do trabalho; capacidade instalada dos serviços; estratégias e desafios para captação de doadores de sangue; riscos e proteção dos trabalhadores; medidas para gestão da crise; estratégias de comunicação para a adesão de candidatos para doação. A análise evidenciou diversas estratégias utilizadas pela gestão, bem como apontou limites e desafios para a organização e a gestão de serviços hemoterápicos, agudizados no contexto da pandemia.
Abstract This study aimed to analyze the management of hemotherapy services (HS) in the context of the COVID-19 pandemic from the perspective of municipal managers in different regions of Brazil. A qualitative approach with semi-structured interviews was applied to HS managers in the three Brazilian capitals, from different regions of Brazil, during the period between September 2021 and April 2022. The textual content of the interviews was submitted to lexicographic textual analysis using the free access software, Iramuteq. The managers' perceptions resulted from the descending hierarchical classification (DHC) analysis, which generated six classes: availability of resources for the development of work; installed capacity of services; strategies and challenges for attracting blood donors; risks and worker protection; measures for crisis management; and communication strategies for the adhesion of candidates for donation. The analysis highlighted several strategies used by the management, as well as pointed out limits and challenges for HS organization and management, exacerbated in the context of the pandemic.
RESUMEN
Resumo A pandemia de COVID-19 desafiou gestores e explicitou fragilidades dos sistemas de saúde. No Brasil, a pandemia surgiu em meio a dificuldades para o trabalho no SUS e na vigilância sanitária (VISA). O objetivo deste artigo é analisar os efeitos da COVID-19 sobre a organização, as condições de trabalho, a gestão e a atuação de VISA, conforme a percepção de gestores de capitais de três regiões do Brasil. É uma pesquisa exploratória, descritiva, com análise qualitativa. Utilizou-se o software Iramuteq no tratamento do corpus textual e a análise de classificação hierárquica descendente gerou quatro classes: características do trabalho de VISA na pandemia (39,9%), organização e condições de trabalho de VISA na pandemia (12,3%), efeitos da pandemia sobre o trabalho (34,4%) e proteção da saúde de trabalhadores e da população (13,4%). A VISA implantou trabalho remoto, ampliou turnos de trabalho e diversificou suas ações. Entretanto, enfrentou dificuldades de pessoal, infraestrutura e capacitação insuficiente. O estudo apontou as potencialidades das ações conjuntas para a VISA.
Abstract The COVID-19 pandemic has challenged managers and exposed weaknesses in health systems. In Brazil, the pandemic emerged amid difficulties to work in the Brazilian Unified Health System (SUS) and in health surveillance (HS). The purpose of this article is to analyze the effects of COVID-19 on the organization, working conditions, management, and performance of HS, according to the perception of capital city managers from three regions of Brazil. This is an exploratory, descriptive research with qualitative analysis. The Iramuteq software was used in the treatment of the textual corpus and analysis of descending hierarchical classification, which generated four classes: characteristics of HS work during the pandemic (39.9%), HS organization and working conditions during the pandemic (12.3%), effects of the pandemic on work (34.4%), and the class of the health protection of workers and the population (13.4%). HS implemented remote work, expanded work shifts, and diversified its actions. However, it faced difficulties with personnel, infrastructure, and insufficient training. The present study also pointed out the potential for joint actions concerning HS.
RESUMEN
Introduction: Focal cortical dysplasia (FCD) is a common cause of pharmacoresistant epilepsy. According to the 2022 International League Against Epilepsy classification, FCD type II is characterized by dysmorphic neurons (IIa and IIb) and may be associated with balloon cells (IIb). We present a multicentric study to evaluate the transcriptomes of the gray and white matters of surgical FCD type II specimens. We aimed to contribute to pathophysiology and tissue characterization. Methods: We investigated FCD II (a and b) and control samples by performing RNA-sequencing followed by immunohistochemical validation employing digital analyses. Results: We found 342 and 399 transcripts differentially expressed in the gray matter of IIa and IIb lesions compared to controls, respectively. Cholesterol biosynthesis was among the main enriched cellular pathways in both IIa and IIb gray matter. Particularly, the genes HMGCS1, HMGCR, and SQLE were upregulated in both type II groups. We also found 12 differentially expressed genes when comparing transcriptomes of IIa and IIb lesions. Only 1 transcript (MTRNR2L12) was significantly upregulated in FCD IIa. The white matter in IIa and IIb lesions showed 2 and 24 transcripts differentially expressed, respectively, compared to controls. No enriched cellular pathways were detected. GPNMB, not previously described in FCD samples, was upregulated in IIb compared to IIa and control groups. Upregulations of cholesterol biosynthesis enzymes and GPNMB genes in FCD groups were immunohistochemically validated. Such enzymes were mainly detected in both dysmorphic and normal neurons, whereas GPNMB was observed only in balloon cells. Discussion: Overall, our study contributed to identifying cortical enrichment of cholesterol biosynthesis in FCD type II, which may correspond to a neuroprotective response to seizures. Moreover, specific analyses in either the gray or the white matter revealed upregulations of MTRNR2L12 and GPNMB, which might be potential neuropathological biomarkers of a cortex chronically exposed to seizures and of balloon cells, respectively.
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Objetivo: estimar a prevalência e fatores associados ao uso do preservativo em população ribeirinha. Materiais e método: estudo transversal, analítico, realizado com 209 ribeirinhos do estado da Paraíba, Brasil, de junho a outubro de 2019. Os dados foram coletados por meio de entrevista individual e privativa com a utilização de um questionário estruturado com variáveis sociodemográficas e de comportamento sexual. As análises foram realizadas pela regressão de Poisson e estimadas as razões de prevalência. Análises bivariadas e múltiplas foram utilizadas para identificar associação entre as variáveis sociodemográficas e comportamentais com o uso do preservativo. Resultados: a prevalência estimada de uso do preservativo foi de 18,2% (IC: 95% 13,0-23,4). Ribeirinhos com idade maior que 40 anos apresentaram menor probabilidade de uso do preservativo (RP = 0,53; IC: 95% 0,34-0,83). Por sua vez, ribeirinhos com mais de oito anos de estudo apresentaram maior probabilidade de uso do preservativo (RP = 3,94; IC 95% 2,65-5,88).Conclusões: a prevalência do uso do preservativo entre os ribeirinhos foi baixa. Entretanto, indivíduos com maior escolaridade apresentaram maiores chances de uso. A prevenção combinada é uma alternativa para o controle das infecções transmissíveis, sendo o preservativo a principal medida de prevenção; portanto, compreender as singu-laridades da população ribeirinha e os fatores de risco para a boa adesão é imprescindível
Objetivo: estimar la prevalencia y los factores asociados al uso del preservativo en una población ribereña. Materiales y método: estudio transversal analítico, realizado con 209 habitantes ribereños del estado de Paraíba, Brasil, entre junio y octubre de 2019. Los datos fueron recolectados a través de entrevistas individuales y privadas mediante un cuestionario estructurado con variables socio-demográficas y de comportamiento sexual. Los análisis se realizaron utilizando la regresión de Poisson, estimando las razones de prevalencia. Se utilizaron análisis bivariados y múltiples para identificar la asociación entre las variables sociodemográficas y conductuales relacionadas con el uso del preservativo. Resultados: la prevalencia estimada del uso de preservativo fue de 18,2 % (IC = 95 % 13,0-23,4). Los habitantes ribereños mayores de 40 años reportaron una menor probabilidad de uso del condón (RP = 0,53; IC del 95 %: 0,34-0,83). Por otro lado, los individuos con más de 8 años de escolaridad fueron más propensos a utilizar preservativo (RP = 3,94; IC 95 %: 2,65-5,88). Conclusiones: la prevalencia del uso del preservativo entre la población estudiada fue baja. Sin embargo, aquellos individuos con mayor grado de escolaridad fueron más propensos a emplearlo. La prevención combinada es una alternativa para el control de las infecciones transmisibles, siendo el preservativo la principal medida preventiva. Por lo tanto, resulta fundamental conocer las singularidades de la población ribereña y los factores de riesgo para una buena adherencia.
Objective: To estimate the prevalence and factors associated with condom use in a riverside population. Materials and method: Cross-sectional and analytical study with 209 riverside inhabitants in the state of Paraíba, Brazil, from June to October 2019. Data were collected through individual and private interviews using a structured questionnaire with sociodemographic and sexual behavior-related variables. Analysis was conducted using Poisson regression. Prevalence ratios were estimated. Bivariate and multiple analyzes were used to identify the association between sociodemographic and behavioral variables with condom use. Results: The estimated prevalence of condom use was 18.2% (95% CI: 13.0-23.4). Riverside people over 40 years were less likely to use condoms (PR = 0.53; 95% ci: 0.34-0.83). On the other hand, individuals with more than 8 years of schooling were more likely to use condoms (PR = 3.94; 95% CI: 2.65-5.88). Conclusions: The prevalence of condom use among participants was low. However, individuals with higher education attainment were more likely to use it. Combined prevention is an alternative to control communicable infections, with condoms being the main prevention measure. Consequently, understanding the singularities of similar populations and the risk factors for good adherence to condom use is essential.
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Humanos , Población Rural , Dispositivos Anticonceptivos , Poblaciones Vulnerables , Salud Sexual , Conductas de Riesgo para la SaludRESUMEN
O presente estudo objetiva analisar as contribuições políticas das práticas sociais do lazer promovidas pela Secretaria Municipal de Esporte, Juventude e Lazer (SEJEL) para os feirantes do Ver-o-Peso (2018 a 2019) privilegiando o lazer no cotidiano dos feirantes enquanto direito social. Questões norteadoras: Existe alguma contribuição política pela SEJEL que garanta o Lazer enquanto direito Social em prol dos feirantes do Ver-o-Peso. Se existe? Como existe? Problema Como contribuir para as políticas da SEJEL que garanta o Lazer enquanto direito social, em prol dos feirantes do Ver-o-Peso? Metodologia: pesquisa documental qualitativa, enfoque materialismo dialético, método dialético, coleta de dados: jornal, vídeo, blog da SEJEL, leis, projeto de lazer da prefeitura para os feirantes. Resultado: as políticas da SEJEL estão enquadradas com um significado recreativo, havendo necessidade da efetivação de políticas públicas de lazer consolidadas com os feirantes para a compreensão enquanto direito social, e, também por parte dos governantes quando o mesmo está sendo vivido e entendido pelas vias do senso comum somente como descanso, entretenimento e mercadoria. A promoção social do lazer pode estar atrelada a um serviço muitas vezes de forma limitada e alienante de convívio social.
Objective: to analyze the contributions of the social practices of leisure promoted by the municipal Sport, Youth andSport (SEJEL) to the vendors of the Ver-o-Peso (2018 to 2019) for the quality and style of life of them, as well as for that leisure becomes privileged in everyday merchants and practice as a social right of citizenship under the foundations of public policies of leisure. Methodology: qualitative desk research, focus dialectical materialism, dialectical method, data collection, newspaper, video, blog SEJEL, laws, leisure project of city hall to the fairground. Result: The public policies of social practices of leisure SEJEL (2008 to 2012) is framed with a recreational significance, requiring the execution of public policy leisure consolidated with the vendors to understand as a social right, and also by the rulers when it is lived and understood by way of common sense only as entertainment and merchandise. The social promotion of leisure can be linked to a service often quite limited and alienating.
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Política PúblicaRESUMEN
RESUMO Objetivo classificar a qualidade da assistência de enfermagem e analisar a associação entre as caraterísticas dos profissionais e a execução de medidas preventivas de lesão por pressão em crianças hospitalizadas. Métodos estudo observacional, transversal, realizado com 235 profissionais de enfermagem. O instrumento de Prevenção de Lesão por Pressão possui três domínios, com 23 itens: Medidas preventivas e detecção precoce de lesão por pressão (9); Medidas de alívio de pressão (8) e Avaliação e notificação (6), analisados pelo Índice de Positividade para Qualidade da Assistência. Resultados predominou sexo feminino (98,7%), com idade média de 38,83 ± 9,94 anos, técnicos de enfermagem (57,4%) e com tempo de experiência profissional superior a cinco anos (77,1%). Constatou-se assistência predominantemente sofrível nos três domínios, em 82,6% das ações. Encontrou-se associação significante com as variáveis "participação em cursos" e "desgaste no trabalho" e uma tendência mais frequente de realização das medidas na faixa etária 31-40 anos. Conclusão a assistência de enfermagem foi predominantemente sofrível; a assistência associou-se à participação em cursos de aperfeiçoamento e desgaste no trabalho. Contribuições para a prática evidenciou-se a necessidade do investimento em capacitação profissional e oferta de insumos considerados indispensáveis para viabilizar uma assistência qualificada e segura.
ABSTRACT Objective to classify the quality of nursing care and analyze the association between professionals' characteristics and the implementation of preventive measures for pressure injuries in hospitalized children. Methods this observational, cross-sectional study involved 235 nursing professionals. The Pressure Injury Prevention instrument comprised three domains with a total of 23 items: Preventive measures and early detection of pressure injuries (9 items), Pressure relief measures (8 items), and Assessment and reporting (6 items), analyzed using the Positivity Index for Quality of Care. Results Most participants were females (98.7%), with a mean age of 38.83 ± 9.94 years, nursing technicians (57.4%), and had more than five years of experience (77.1%). Nursing care was predominantly inadequate across all three domains, with 82.6% of actions rated as poor. Significant associations were found between "participation in training courses" and "work-related exhaustion". There was a trend towards increased compliance with measurements among professionals aged 31-40. Conclusion nursing care was predominantly poor and participation in training courses and the presence of exhaustion were associated with better adherence to preventive measures. Contributions to practice the study highlights the pressing need for investments in professional training and the provision of necessary resources to support high-quality and safe nursing care.
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Pediatría , Calidad de la Atención de Salud , Enfermería , Úlcera por Presión , Seguridad del PacienteRESUMEN
Este debate, resultado de um breve estudo sobre o periódico Vigilância Sanitária em Debate: Sociedade, Ciência & Tecnologia (Visa em Debate) em sua primeira década, teve como objetivo apresentar uma visão panorâmica das publicações, que foram classificadas em categorias previamente definidas; também foram identificadas as instituições às quais os autores das publicações estavam vinculados. A categoria Objetos sob Controle Sanitário abriga o maior quantitativo de publicações, com 72,0% do total, entre as quais predominam alimentos, medicamentos, e serviços de saúde e de interesse da saúde. As categorias Sistema Nacional de Vigilância Sanitária; Regulação e Vigilância Sanitária; Doenças, Agentes, Epidemiologia; e Tecnologias Analíticas apresentam quantitativos semelhantes, em torno de 7,0%. Entre as instituições de vínculos dos autores, as universidades e outras instituições de ensino superior são aquelas com maior número de vínculos, em todas as regiões. A Região Sudeste concentra o maior número de referências, seguida do Nordeste, Sul, Centro-Oeste e, por último, a Região Norte. Também foram referidos vínculos a universidades de outros países, como Canadá, França, Portugal e Colômbia. Observou-se uma grande diversidade de temáticas em todas as categorias de classificação das publicações, também lacunas e/ou poucos trabalhos em certos temas relevantes para a área. Este estudo denota que o periódico vem se constituindo um relevante veículo de disseminação do conhecimento em saúde em geral e vigilância sanitária em especial. Neste pouco tempo já foi indexada em importantes bases de dados científicos e conta com uma boa classificação Qualis/Capes na área interdisciplinar da saúde, o que contribui para um número crescente de publicações oriundas de renomadas universidades.
This debate is the result of a brief study in the journal Health Surveillance in Debate: Society, Science & Technology (Visa em Debate) in its first decade. The objective is to present a panoramic view of the publications of this journal. The articles were classified into previously defined categories and the institutions to which the authors of the publications were linked were also identified. The category "Objects Under Sanitary Control" contains the largest number of publications, with 72.0% of the total, among which food, medicines and health services predominated. The categories "National Health Surveillance System", "Health Regulation and Surveillance", "Diseases, Agents, Epidemiology", and "Analytical Technologies" presented similar amounts of around 7.0%. Among the authors' affiliation institutions, universities and other higher education institutions are the ones with the highest number, in all regions. The Southeast region possesses the largest number of references, followed by the Northeast, South, Midwest, and finally the North region. In addition, links to universities in other countries, such as Canada, France, Portugal, and Colombia, were mentioned. A great diversity of themes was observed in all categories of classification and there are still gaps and/or few works in certain themes that are relevant to the area. This study shows that the journal has become a relevant vehicle for the dissemination of knowledge in health in general, and sanitary surveillance, in particular. In this short time, this journal has already been indexed in relevant scientific databases and has a good Qualis/Capes classification in the interdisciplinary area of health, which contributes to a growing number of publications from renowned universities.
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OBJECTIVE: To assess health-related quality of life and its predictors among people with chronic wounds. MATERIAL AND METHODS: A cross-sectional, analytical study was conducted with 85 people with chronic wounds, from July to September 2019, at a university hospital in the state of Paraíba, Brazil. Data were collected using forms and the Cardiff Wound Impact Schedule (CWIS). For data analysis, multiple linear regression was performed. RESULTS: The mean quality of life score according to the CWIS was 45.57. The variables gender, marital status, comorbidities, duration of injury and appearance of exudate were negatively associated with the well-being domain. Injury duration, tissue depth, tissue type, and exudate volume were variables negatively associated with physical symptoms and mastery of daily living. Religion, wound origin, duration, lesion size, and tissue depth were negatively associated with the social life domain. CONCLUSION: Sociodemographic characteristics and wound-related aspects need to be considered when assessing and caring for patients with chronic wounds to ensure a better quality of life.
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Calidad de Vida , Humanos , Encuestas y Cuestionarios , Estudios Transversales , BrasilRESUMEN
OBJECTIVES: To assess the improvement on oral health-related quality of life (OHRQoL) of individuals with cervical dentin hypersensitivity (CDH) with the noncarious cervical lesion (NCCLs) subjected to different treatments. MATERIAL AND METHODS: A single-blind randomized clinical trial was conducted with patients (n = 74) randomly allocated into three groups according to the treatment performed: PO, potassium oxalate (Oxa-Gel BF); LL, low-power laser irradiation; and POLL, potassium oxalate (Oxa-Gel BF) associated with low-power laser irradiation. The treatments were applied in four steps, weekly. The questionnaire Oral Health Impact Profile (OHIP-14) was applied before initiating and immediately after the fourth session. The greater the sum of the score, the smaller the measurement of OHRQoL. RESULTS: The total mean values of the variables at the final moment were significantly lower than the initial one for all dimensions (p value ranging from < 0.001 to 0.006). Furthermore, the OHIP-14 scores final analysis between the groups indicated that the POLL group compared to LL had a significantly lower final score for the functional limitation (p = 0.009), physical pain (p = 0.049), and psychological discomfort (p = 0.035) dimensions and that group PO compared to group LL had a significantly lower final score for the functional limitation dimension (p = 0.024). CONCLUSIONS: There was a reduction in the OHIP-14 score for all dimensions, indicating an improvement in patients' quality of life after the use of desensitizing therapies. Patients in group LL had a higher functional limitation, physical pain, and psychological discomfort. CLINICAL RELEVANCE: This study indicated improvement of desensitizing therapies for CDH to improve patients' OHRQoL. TRIAL REGISTRATION: This trial was registered in the Brazilian Clinical Trials Registry Platform (REBEC protocol number RBR-4ybjmt).
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Sensibilidad de la Dentina , Úlceras Bucales , Humanos , Calidad de Vida/psicología , Salud Bucal , Sensibilidad de la Dentina/tratamiento farmacológico , Método Simple Ciego , Encuestas y Cuestionarios , Ácido Oxálico/uso terapéutico , DolorRESUMEN
In developing countries, agriculture generally represents a large fraction of GHG emissions reported in National Inventories, and emissions are typically estimated using Tier 1 IPCC guidelines. However, field data and locally adapted simulation models can improve the accuracy of IPCC estimations. In this study we aimed to quantify anthropogenic N2O emissions from croplands of Argentina through field measurements, model simulations and IPCC guidelines. We measured N2O emissions and their controlling factors in 62 plots of the Pampas Region with corn, soybean and wheat/soybean crops and in unmanaged grasslands. We accounted for gross emissions from crops and background emissions from unmanaged grasslands to calculate net anthropogenic emissions from crops as the difference between them. We calibrated and evaluated the DayCent model and then simulated different weather and management scenarios. Finally, we applied IPCC guidelines to estimate anthropogenic N2O emissions at the same plots. The DayCent model accurately simulated annual N2O emission for all crops as compared to measured data (RMSE = 1.4 g N ha-1 day-1). Measured and simulated emissions in soybean crops were higher than in corn and wheat/soybean crops. Gross N2O emissions ranged from 1.4 to 5.1 kg N ha-1 yr-1 for current environmental (soil and weather) and management (crops and fertilizer doses) conditions. Background emissions ranged between 1.1 and 1.3 kg N ha-1 yr-1, and therefore net anthropogenic emissions ranged from 0.3 to 4.0 kg N ha-1 yr-1. IPCC Tier 1 emission factors underestimated N2O releases from soybean, that were on average 4.87 times greater when estimated with DayCent and observations (0.53 vs 2.47 and 2.69 kg N ha-1 yr-1, respectively). On the contrary, IPCC estimates for corn and wheat/soybean crops were similar to modeled and measured values. Our results suggest that N2O emissions from the vast 15 million ha of soybean croplands in the Pampas Region may be substantially underestimated.