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This paper investigates the challenges faced by health professionals working with children with disabilities, with the aim of identifying areas for improvement. Employing a focus group method, the study involved knowledge levelling, discussions, problematization, cause formulation, and validation. A diverse team of ten professionals participated, including physiotherapists, speech therapists, occupational therapists, psychologists, nursing technicians, and social workers. Findings reveal organisational inflexibility in appointment scheduling, lack of deadlines affecting case monitoring, and the mental strain of immediate clinical responses. Effective communication and multidisciplinary care emerge as beneficial. Proposed improvements include flexible space utilisation, enhanced room design, structured collaboration training, role clarification, parent partnerships, flexible scheduling, and continuous professional development. This study unveils unique challenges and rewards in the healthcare environment, offering insights into causative factors and practical strategies for enhancing the work of health professionals working with children with disabilities.

Health professionals working with children with disabilities encounter various challenges in their daily practice. This research identifies key areas for improvement, including enhancing collaboration among team members, optimising physical spaces, and providing ongoing training and support. By addressing these challenges and implementing the proposed improvement strategies, practitioners can better meet the complex needs of children with disabilities and improve overall patient care outcomes.

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O sexo é um importante fator a ser considerado na compreensão da dependência de cuidados na velhice. Objetivo:Verificar fatores associados à dependência, dentro e fora de casa, em pessoas idosas com 75 anos ou mais, com ênfase na diferença entre os sexos. Metodologia:Pesquisa transversal com dados do estudo FIBRA. A capacidade funcional nas Atividades Instrumentais de Vida Diária (AIVD) foi dividida em atividades realizadas dentro de casa (uso do telefone, manejo da medicação, tarefas domésticas e preparo da refeição) e atividades realizadas fora de casa (fazer compras, utilizar transporte e manejo do dinheiro). As variáveis independentes incluíram aspectos sociodemográficas e de saúde. Foram estimadas razões de prevalência por meio de modelos de regressão múltipla de Poisson a fim de verificar as variáveis associadas com dependência dentro e fora de casa. Resultados:A amostra foi composta por 804 idosos. Dentro de casa, não houve fatores associados à dependência para o sexo masculino. Enquanto para o sexo feminino, os fatores associados foram fragilidade (RP = 1,99; 95%IC: 1,26-3,15) e 80 anos e mais (RP = 1,41; 95%IC: 1,05-1,89). Quanto à dependência fora de casa, a fragilidade destacou-se como um fator associado a ambos os sexos, masculino (RP = 2,80 95%IC: 1,17-6,64) e feminino (RP = 1,98 95%IC: 1,24-3,17). Conclusões:Para o sexo feminino, a idade avançada e a fragilidade foram os fatores de maior associação com dependência, tanto para o ambiente dentro quanto fora de casa. Para o sexo masculino, a fragilidade foi o único e grande determinante de dependência nas atividades fora de casa, apresentando prevalência maior do que a encontrada na amostra do sexo feminino (AU).

Sexis an important factor to be considered tocomprehendoldage care dependencyObjective:Verify associated factors to dependency, in and out of home, in persons with 75 years or more, with emphasis on sexdifferences. Methodology:Cross-sectional research with data from the FIBRA Study. The functional dependence in Instrumental Activities of Daily Living (IADL) was divided in activities performed inside home (using telephone, managing medicine, housework and meal preparation) and activities performed outside home (shopping, transportation and managing finances).The independent variable included health and sociodemographic aspects. Estimates on prevalence ratios were made using multiple Poisson regression models to verify the many variables associated with dependency inside and outside home. Results:The sample was composed of 804 older people. Inside home there were not any factors associated with dependency in the males. However, in the females the associated factors were frailty (PR = 1.99; 95%CI: 1.26-3.15) and 80 and older (PR = 1.41; 95%CI: 1.05-1.89). As to dependency outside home, frailty was a factor that stood out in both sexes, male (PR = 2.80 95%CI: 1.17-6.64) and female (PR = 1.98 95%CI: 1.24-3.17). Conclusions:To women, older age and frailty were the strongest factors of dependency, to both inside and outside home. To men, frailty was the strongest and single dependency factor for dependency in outside activities, showing a higher prevalence than that of the female sex (AU).

El sexo es un factor importante queconsiderar en la comprensión de la dependencia del cuidado en la vejez. Objetivo:Verificar los factores vinculados a la dependencia, dentro y fuera del hogar, en ancianos de 75 años o más, con énfasis en la diferencia entre los sexos. Metodología:Investigación transversal con datos del estudio FIBRA. La capacidad funcional en las Actividades Instrumentales de la Vida Diaria (AIVD) se dividió en actividades realizadas dentro del hogar (uso del teléfono, administración de medicamentos, tareas domésticas y preparación de comidas) y actividades realizadas fuera del hogar (hacer compras, uso del transporte y manejo del dinero). Las variables independientes incluyeron aspectos sociodemográficos y de salud. Las razones de prevalencia se estimaron utilizando modelos de regresión múltiple de Poisson con el fin de verificarlas variables vinculadas con la dependencia dentro y fuera del hogar. Resultados:El muestreofue constituidopor 804 ancianos. Dentro del hogar, no hubo factores asociados con la dependencia de los hombres. Mientras que, para las mujeres, los factores asociados fueron fragilidad (RP = 1,99; IC95%: 1,26-3,15) y 80 años y más (RP = 1,41; IC95%: 1,05-1,89). En cuanto a la dependencia fuera del hogar, la fragilidad se destacó como un factor asociado a ambos sexos, masculino (RP = 2,80 IC95%: 1,17-6,64) y femenino (RP = 1,98 IC95%: 1,24-3,17). Conclusiones: Para el sexo femenino, la edad avanzada y la fragilidad fueron los factores más vinculados a la dependencia, tanto para el ambiente dentro como fuera del hogar. Para los varones, la fragilidad fue el único determinante importante de dependencia en actividades fuera del hogar, con una prevalencia mayor que la encontrada en elmuestreofemenino (AU).

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O objetivo deste estudo foi avaliar a qualidade de vida de pacientes com câncer do trato gastrointestinal em um hospital oncológico no Maranhão. Trata-se de um estudo transversal de abordagem quantitativa realizado em um serviço oncológico com pacientes em tratamento, aplicando-se o European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30) para avaliação da qualidade de vida. Os dados foram analisados por meio de estatística descritiva e do teste t, considerando nível de significância de 5%. A maior parte dos participantes eram do sexo masculino (62,7%), na faixa etária de 50 a 79 anos (74,5%), de raça/cor parda (86,2%), casados/em união estável (47,0%), católicos (52,9%), com ensino fundamental (58,8%) e renda de um a dois salários-mínimos (58,8%). Com relação às variáveis clínicas, a neoplasia de estômago predominou em 58,8%, sendo diagnosticados entre seis meses e dois anos (52,9%). Quanto ao tratamento, 47,0% iniciaram-no em até três meses, além disso, havia aqueles que estavam no segundo tratamento (72,5%). O tratamento quimioterápico representou 94,1% dos pacientes e, quanto aos fatores de risco, não fumantes representavam 54,9%, etilistas 60,7%, e sem histórico familiar de câncer 49,0%. Em relação aos escores de saúde global, a média foi de 64,5%, o sintoma da insônia de 39,2%. Já em escala funcional, o comprometimento físico foi de 78,8% dos pacientes. A qualidade de vida foi considerada satisfatória pelos pacientes. Apesar disso, o funcionamento físico apresentou menor impacto que o emocional, o que representa melhores tratamentos com menores efeitos físicos, visto que os pacientes oncológicos tendem a apresentar mais limitações na função física, o que torna inferior sua qualidade de vida.

This study aimed to evaluate the quality of life of patients with cancer of the gastrointestinal tract in an oncology hospital in Maranhão (Brazil). This is a cross-sectional study with a quantitative approach, carried out in an oncology service with patients undergoing treatment, applying the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30) to assess the quality of life, the data were analyzed by using descriptive statistics and T test considering a significance level of 5%. 51 male patients participated (62.7%), in the age group from 50 to 79 years old (74.5%), of brown color (86.2%), married/in stable union (47.0%), Catholics (52.9%), having elementary schooling (58.8%), and income of 1 to 2 minimum wages (58.8%). Regarding the clinical variables, stomach neoplasms predominated in 58.8%, they were diagnosed between six months and two years (52.9%). As for treatment, 47.0% started with up to three months, were in the second treatment (72.5%), 94.1% had chemotherapy, and as for risk factors, non-smokers were 54.9%, alcoholics were 60.7%, and those without family history of cancer were 49.0%. Regarding the global health scores, the average was 64.5%, insomnia symptom was 39.2%, and in the functional scale, physical impairment was 78.8%. The quality of life was considered satisfactory by the patients. Despite this, physical functioning had less impact than emotional functioning, which represents better treatments with less physical effects, since cancer patients tend to have more limitations in physical function, which worsens their quality of life.

Este estudio tuvo por objetivo evaluar la calidad de vida de pacientes con cáncer del tracto gastrointestinal en un hospital oncológico de Maranhão (Brasil). Se trata de un estudio transversal con enfoque cuantitativo, realizado en un servicio de oncología con pacientes en tratamiento, aplicando el European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30) para evaluar la calidad de vida, los datos se analizaron mediante estadística descriptiva y prueba T considerando un nivel de significación del 5%. Participaron 51 pacientes del sexo masculino (62,7%), del grupo etario de 50 a 79 años (74,5%), el color pardo (86,2%), casado/unión estable (47,0%), católicos (52,9%), nivel de estudios primaria (58,8%) e ingresos de 1 a 2 salarios (58,8%). En cuanto a las variables clínicas, predominó el cáncer de estómago en el 58,8%, se diagnosticaron entre los seis meses y los dos años (52,9%). En cuanto al tratamiento, el 47,0% lo inició con hasta tres meses, el 72,5% estaba en el segundo tratamiento, el 94,1% realizaba quimioterapia, y en cuanto a los factores de riesgo, el 54,9% eran no fumadores, el 60,7% alcohólicos y el 49,0% no tenía antecedentes familiares de cáncer. En cuanto a los puntajes globales de salud, el promedio fue del 64,5%, el síntoma de insomnio del 39,2%, y en la escala funcional, el deterioro físico fue del 78,8%. La calidad de vida fue considerada satisfactoria por los pacientes. A pesar de esto, el funcionamiento físico tuvo un impacto menor que el funcionamiento emocional, lo que representa mejores tratamientos con menos efectos físicos, ya que los pacientes con cáncer tienden a presentar más limitaciones en la función física, lo que empeora su calidad de vida.

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The objective of this study was to adapt the instrument "Primary Care Assessment Tool (PCATool)-professional version" to measure the performance of the care provided by Primary Health Care (PHC) to the health of the elderly, from the perspective of professionals. The original instrument was critically analyzed by specialists with experience in Gerontology and PHC in relation to the health specificities of the elderly, with 64 syntactic-semantic adaptations and 28 inclusions of new parameters. The adapted instrument was applied to 105 health professionals from PHC in Campinas-SP and, compared to the original instrument, the adaptation proved to be able to distinguish the new parameters with statistically significant differences, and in the sample of the analyzed professionals the performance obtained was better avaliated in relation to "Accessibility" and "Comprehensiveness" attributes, and worse avaliated in the attributes "Longitudinality", "Coordination", "Essential and General Scores". In the adapted instrument, it was verified adequate results in terms of content validity and reliability, good discriminative capacity in relation to the specificities of the elderly population, and potential to become a national instrument for evaluating PHC in care to the elderly.

O objetivo do trabalho foi adaptar o instrumento "Primary Care Assessment Tool (PCATool)-versão profissionais" para medir o desempenho do cuidado prestado pela Atenção Primária à Saúde (APS) à saúde do idoso, na ótica dos profissionais. O instrumento original foi criticamente analisado por especialistas com experiência em Gerontologia e APS em relação às especificidades de saúde do idoso, sendo realizadas 64 adaptações sintático-semânticas e 28 inclusões de novos parâmetros. O instrumento adaptado foi aplicado em 105 profissionais de saúde da APS em Campinas-SP e, comparativamente em relação ao instrumento original, a adaptação mostrou-se capaz de observar parâmetros distintos com diferenças estatisticamente significativas, sendo que na amostra de profissionais analisada o desempenho verificado foi melhor nos atributos "Acessibilidade" e "Integralidade", e pior em "Longitudinalidade", "Coordenação", "Escores Essencial e Geral". O instrumento adaptado obteve resultados adequados de validade de conteúdo e confiabilidade, boa capacidade discriminativa em relação às especificidades da população idosa e potencial para se constituir em instrumento nacional de avaliação da APS no cuidado ao idoso.

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Resumo O objetivo do trabalho foi adaptar o instrumento "Primary Care Assessment Tool (PCATool)-versão profissionais" para medir o desempenho do cuidado prestado pela Atenção Primária à Saúde (APS) à saúde do idoso, na ótica dos profissionais. O instrumento original foi criticamente analisado por especialistas com experiência em Gerontologia e APS em relação às especificidades de saúde do idoso, sendo realizadas 64 adaptações sintático-semânticas e 28 inclusões de novos parâmetros. O instrumento adaptado foi aplicado em 105 profissionais de saúde da APS em Campinas-SP e, comparativamente em relação ao instrumento original, a adaptação mostrou-se capaz de observar parâmetros distintos com diferenças estatisticamente significativas, sendo que na amostra de profissionais analisada o desempenho verificado foi melhor nos atributos "Acessibilidade" e "Integralidade", e pior em "Longitudinalidade", "Coordenação", "Escores Essencial e Geral". O instrumento adaptado obteve resultados adequados de validade de conteúdo e confiabilidade, boa capacidade discriminativa em relação às especificidades da população idosa e potencial para se constituir em instrumento nacional de avaliação da APS no cuidado ao idoso.

Abstract The objective of this study was to adapt the instrument "Primary Care Assessment Tool (PCATool)-professional version" to measure the performance of the care provided by Primary Health Care (PHC) to the health of the elderly, from the perspective of professionals. The original instrument was critically analyzed by specialists with experience in Gerontology and PHC in relation to the health specificities of the elderly, with 64 syntactic-semantic adaptations and 28 inclusions of new parameters. The adapted instrument was applied to 105 health professionals from PHC in Campinas-SP and, compared to the original instrument, the adaptation proved to be able to distinguish the new parameters with statistically significant differences, and in the sample of the analyzed professionals the performance obtained was better avaliated in relation to "Accessibility" and "Comprehensiveness" attributes, and worse avaliated in the attributes "Longitudinality", "Coordination", "Essential and General Scores". In the adapted instrument, it was verified adequate results in terms of content validity and reliability, good discriminative capacity in relation to the specificities of the elderly population, and potential to become a national instrument for evaluating PHC in care to the elderly.

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We typed 600 methicillin-resistant Staphylococcus aureus (MRSA) isolates collected in 51 hospitals in the Rio de Janeiro, Brazil, metropolitan area during 2014-2017. We found that multiple new clonal complex (CC) 5 sequence types had replaced previously dominant MRSA lineages in hospitals. Whole-genome analysis of 208 isolates revealed an emerging sublineage of multidrug-resistant MRSA, sequence type 105, staphylococcal cassette chromosome mec II, spa t002, which we designated the Rio de Janeiro (RdJ) clone. Using molecular clock analysis, we hypothesized that this lineage began to expand in the Rio de Janeiro metropolitan area in 2009. Multivariate analysis supported an association between bloodstream infections and the CC5 lineage that includes the RdJ clone. Compared with other closely related isolates, representative isolates of the RdJ clone more effectively evaded immune function related to monocytic cells, as evidenced by decreased phagocytosis rate and increased numbers of viable unphagocytosed (free) bacteria after in vitro exposure to monocytes.

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ABSTRACT Purpose: This study aimed to verify if patients with developmental dyslexia present deficits coherent with visual magnocellular dysfunction. Methods: Participants with confirmed diagnosis of developmental dyslexia (n=62; age range=8-25 years; mean age=13.8 years, standard deviation=3.9; 77% male) were compared to a control group with normal development, matched for age, sex, ocular dominance, visual acuity, and text comprehension. The frequency-doubling technology perimetry was used to evaluate the peripheral visual field contrast sensitivity threshold. The Visagraph III Eye-Movement Recording System was used to evaluate ocular motor skills during text reading. Results: The developmental dyslexia group had significantly worse contrast sensitivity in the frequency-doubling technology, with strong effect size, than the matched control group. The developmental dyslexia group had more eyes classified in the impaired range of sensitivity threshold to detect frequency-doubling illusion than the control group. Moreover, the developmental dyslexia group had poorer ocular motor skills and reading performance, revealed by a difference in ocular fixations, regressions, span recognition, reading rate, and relative efficiency between groups. A significant correlation was found between contrast sensitivity and ocular motor skills. Participants with good relative efficiency had significantly better contrast sensitivity than participants with poor relative efficiency. Conclusions: The developmental dyslexia group presented a markedly worse performance in visual variables related to visual magnocellular function (i.e., frequency-doubling technology perimetry and ocular motor skills) compared with a matched control group. Professionals need to be aware of the importance of evaluating vision of individuals with developmental dyslexia beyond visual acuity and including in their assessments instruments to evaluate temporal processing, with contrast sensitivity threshold.

RESUMO Objetivo: Verificar se pacientes com dislexia do de­senvolvimento (DD) apresentam déficits coerentes com uma disfunção magnocelular visual. Métodos: Participantes com diagnóstico confirmado de dislexia do desenvolvimento (n=62; faixa etária=8 a 25 anos; Média da idade=13.8 anos, desvio padrão=3.9; 77% homens) foram comparados a um grupo con­trole com desenvolvimento típico, pareado por idade, sexo, dominância ocular, acuidade visual e compreensão de texto. A perimetria Frequency-Doubling Technology avaliou o limiar de sensibilidade ao contraste do campo visual periférico. O ras­treador ocular Visagraph-III registrou os movimentos dos olhos durante leitura de texto. Resultados: O grupo com dislexia do desenvolvimento apresentou piores limiares de sensibilidade no Frequency-Doubling Technology , com tamanho de efeito forte, do que o grupo controle. O grupo com dislexia do desenvolvimento apresentou mais olhos classificados com déficits na sensibilidade à ilusão de frequência duplicada do que o grupo controle. O grupo com dislexia do desenvolvimento apresentou pior habilidade motora ocular e no desempenho de leitura, revelado pela diferença entre os grupos em relação às fixações oculares, regressões, alcance de reconhecimento, taxa de leitura e eficiência relativa. Foi encontrada correlação significativa entre a sensibilidade ao contraste e as habilidades motoras oculares. Os participantes com boa eficiência relativa apresentaram uma sensibilidade ao contraste significativamente melhor do que os participantes com baixa eficiência relativa. Conclusões: O grupo com dis­lexia do desenvolvimento apresentou desempenho inferior nas variáveis visuais relacionadas à função visual magnocelular (i.e., perimetria de frequência duplicada e habilidades motoras oculares), quando comparado ao grupo controle pareado. Os profissionais precisam estar cientes da importância de investigar a visão dos pacientes com dislexia do desenvolvimento além da acuidade visual e incluir nos seus procedimentos diagnósticos instrumentos para avaliar o processamento temporal, com limiar de sensibilidade ao contraste.

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PURPOSE: This study aimed to verify if patients with developmental dyslexia present deficits coherent with visual magnocellular dysfunction. METHODS: Participants with confirmed diagnosis of developmental dyslexia (n=62; age range=8-25 years; mean age=13.8 years, standard deviation=3.9; 77% male) were compared to a control group with normal development, matched for age, sex, ocular dominance, visual acuity, and text comprehension. The frequency-doubling technology perimetry was used to evaluate the peripheral visual field contrast sensitivity threshold. The Visagraph III Eye-Movement Recording System was used to evaluate ocular motor skills during text reading. RESULTS: The developmental dyslexia group had significantly worse contrast sensitivity in the frequency-doubling technology, with strong effect size, than the matched control group. The developmental dyslexia group had more eyes classified in the impaired range of sensitivity threshold to detect frequency-doubling illusion than the control group. Moreover, the developmental dyslexia group had poorer ocular motor skills and reading performance, revealed by a difference in ocular fixations, regressions, span recognition, reading rate, and relative efficiency between groups. A significant correlation was found between contrast sensitivity and ocular motor skills. Participants with good relative efficiency had significantly better contrast sensitivity than participants with poor relative efficiency. CONCLUSIONS: The developmental dyslexia group presented a markedly worse performance in visual variables related to visual magnocellular function (i.e., frequency-doubling technology perimetry and ocular motor skills) compared with a matched control group. Professionals need to be aware of the importance of evaluating vision of individuals with developmental dyslexia beyond visual acuity and including in their assessments instruments to evaluate temporal processing, with contrast sensitivity threshold.

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ABSTRACT Purpose: to provide an integrative review of indexed articles published from 2009 to 2019 on the effect of spectral overlays on visual parameters and reading ability. Methods: keywords were used to search seven databases. Duplicate entries, reviews, literature reviews, editor's comments, and congress abstracts were excluded, as well as papers that were not relevant, based on their titles and abstracts. A total of 52 articles, which were read in full, were eligible at this stage. Of these, 12 articles, published in Portuguese or English from 2009 to 2019, were included. Results: all 12 articles included evaluated the effect of overlays on the reading rate. There was an improvement in different visual parameters (ocular accommodation and eye movement), facial recognition, and reading (reading rate, relative efficiency, and comprehension). The use of overlays reduced visual stress regardless of refractive, orthoptic or cognitive disorders. The associated conditions investigated were autism spectrum disorder, Tourette syndrome, stroke, deafness, dyslexia, and auditory temporal processing disorder. Conclusion: the effectiveness of overlays in improving reading quality is consistently demonstrated in the literature. The reviewed articles showed that the overlays' effect is more expressive when the visual stress is associated with conditions that present sensory alterations and cortical hyperactivity.

RESUMO Objetivo: oferecer uma revisão integrativa dos artigos indexados publicados de 2009 a 2019 sobre o efeito das lâminas espectrais (overlays) em parâmetros visuais e na habilidade de leitura. Métodos: utilizou-se a pesquisa de palavras-chave em sete bancos de dados. Foram excluídos registros duplicados, revisões de literatura, resenhas, comentários do editor, resumos de congressos, e os não pertinentes de acordo com os títulos e resumos. Os 52 artigos sobre o uso dos overlays no estágio de elegibilidade foram lidos na íntegra. Foram incluídos 12 artigos completos, publicados em português ou em inglês entre 2009-2019. Resultados: os 12 artigos incluídos avaliaram o efeito dos overlays na taxa de leitura. Houve melhora em diferentes parâmetros visuais (acomodação, movimentação ocular), no reconhecimento facial e em leitura (taxa de leitura, eficiência relativa e em compreensão). Independentemente de problemas refracionais, ortópticos ou cognitivos, o uso dos overlays reduziu o estresse visual. As condições associadas investigadas foram o transtorno do espectro autista, síndrome de Tourette, acidente vascular cerebral, surdez, dislexia, e alteração no processamento auditivo temporal. Conclusão: a eficácia dos overlays na melhora da qualidade de leitura foi demonstrada de forma consistente na literatura. Os artigos revisados verificaram que os overlays apresentam efeito mais expressivo quando o estresse visual está associado às condições que apresentam alterações sensoriais e à hiperatividade cortical.

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ABSTRACT Purpose: to verify whether students screened with altered auditory temporal processing are more likely to present altered visual processing. Methods: the sample consisted of 68 children, aged from 9 to 12 years, 53% males, from the 5th and 6th grades of a public school. All children with alterations in the audiological or ophthalmological evaluation were excluded. The Duration Pattern Test (screening for auditory temporal skill), the Reading Perceptual Scale (visual stress symptom questionnaire and colored overlays selection) and the Rate of Reading Test (number of words correctly read per minute) were used. Appropriate statistical tests were applied adopting the significance level lower than 0.05. Results: participants screened with abnormal auditory processing had higher visual stress symptoms and lower reading rate, with a significant and moderate effect (p< 0.05; d< 0.71), when compared to their peers with normal auditory processing. Among the children with altered Duration Pattern Test, 58% improved the reading rate with the use of colored overlays, whereas 29% did so in the control group (Odds Ratio = 3.4, p = 0.017). Conclusion: children screened with altered auditory temporal processing presented a three times higher possibility of association with visual processing alterations, due to shared magnocellular system.

RESUMO Objetivo: verificar se alunos rastreados com processamento auditivo temporal alterado possuem maior probabilidade de apresentar processamento visual alterado. Métodos: participaram 68 crianças, de 9 a 12 anos, 53% meninos, do 5° e 6° ano do ensino fundamental de uma escola estadual. Foram excluídas todas as crianças com alterações na avaliação audiológica ou oftalmológica. Foram utilizados o Teste do Padrão de Duração (rastreio da habilidade auditiva de ordenação temporal), a Escala de Percepção Visual de Leitura (questionário de sintomas de estresse visual e seleção das lâminas espectrais) e o Teste de Taxa de Leitura (número de palavras lidas corretamente por minuto). Foram aplicados os testes estatísticos pertinentes adotando o nível de significância menor que 0,05. Resultados: participantes rastreados com processamento auditivo alterado apresentaram mais sintomas de estresse visual e menor taxa de leitura, de forma significante e moderada (p < 0.05; d < 0.71), quando comparados aos seus pares com processamento auditivo normal. Dentre as crianças com alteração no Teste do Padrão de Duração, 58% melhoraram a taxa de leitura com o uso da lâmina espectral, comparadas a 29% do grupo controle (Odds Ratio = 3.4; p = 0.017). Conclusão:alunos rastreados com processamento auditivo temporal alterado apresentam uma chance três vezes maior de associação com alterações no processamento visual, por compartilhamento na via magnocelular.

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A simple, low cost and easy-to-operate 3D stereophotogrammetry system was developed to measure the kinematic pattern of head stabilisation during visual tasks. The system differs from commercially available ones since it: (a) takes into account the gaze motor coordination characteristics and measures the head translations quantified at the point that best represents the translations caused by the eyes' movement during visual tasks, that is, the midpoint between the eyes; (b) offers minimum restriction to the head movement and minimum interference with it; (c) innovates when using the position coordinates produced by a free-online tracker software. The system was effective in recording the head movements and its RMS total error was 0.705 mm with ±0.808 mm standard deviation. This represents an RMS total error of 3.5%, considered satisfactory because it provided results with a confidence level higher than 95%. The system was effective to record differences in head movements of 11 individuals in open and closed eyes conditions and revealed the direction-specific feature of the head displacements size. The results showed that the system is a cost-effective and accurate alternative for studies needing to accurately measure head movements during visual tasks.

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As lâminas espectrais são importantes ferramentas para minimizar distorções visuoperceptuais durante a leitura, aumentar o conforto visual e a fluência do leitor. Objetivo: Realizar uma revisão sistemática de todos os estudos que verificaram a prevalência da população beneficiada com ouso das lâminas espectrais. Método: Todos os títulos e resumos dos 225 artigos completos, de1980 a 2017, foram avaliados independentemente por dois autores. Da seleção final, 26 estudos sobre a prevalência do uso de lâminas espectrais foram lidos na íntegra. Resultados: 63% da população em geral informam melhora perceptual da qualidade do texto com o uso das lâminas. A prevalências por meio do uso prolongado da lâmina, por pelo menos dois meses, revela um índice de 30% da população geral. Por fim, sob uso de lâminas, 33% da população melhorou a velocidade de leitura, quantificada via Rate of Reading Test, tendo 18% apresentado ganhos de moderados a robustos. Os grupos clínicos que apresentam maior probabilidade de ganhos na velocidade de leitura com o uso da lâmina espectral são, respectivamente: Síndrome de Tourette, Esclerose Múltipla, Transtorno do Espectro Autista, Dificuldade de Leitura. Conclusão: grande proporção da população apresenta ganhos na qualidade visual com o uso das lâminas espectrais, sendo esses índices maiores nos transtornos com hiperexcitabilidade cortical.(AU)

Spectral overlays are important interventions to reduce visual-perceptual distortions during reading, providing more comfort, fluency to the reader. Objective: systematically review all studies that assessed the population impact of the spectral overlays. Method: All titles and abstracts of 225 complete articles, from 1980 to 2017, were evaluated independently by two authors. In the final selection, 26 studies on the prevalence of the use of colored overlays were read in full. Results: 63% of children in the general population inform perceptual improvement in text clarity with the use of overlays. The prevalence with the sustained use of at least two months is revealed in 30% of the general population. Finally, under the use of overlays, 33% of the population improved reading speed, quantified via Rate of Reading Test, with 18% presenting moderate to robust gains. The clinical groups that are most likely to gain reading speed with the use of overlays are, respectively: Tourette Syndrome, Multiple Sclerosis, Autistic Spectrum Disorder, Reading Difficulty. Conclusion: a large proportion of the general population improves their visual quality with the use of spectral overlays, with disorders with cortical hyperexcitability presenting higher percentage.(AU)

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PURPOSE: This work evaluated the nanomechanical properties of bone surrounding submerged and immediately loaded implants after 3 years in vivo. It was hypothesized that the nanomechanical properties of bone would markedly increase in immediately and functionally loaded implants compared with submerged implants. MATERIALS AND METHODS: The second, third, and fourth right premolars and the first molar of 10 adult Doberman dogs were extracted. After 6 months, 4 implants were placed in 1 side of the mandible. The mesial implant received a cover screw and remained unloaded. The remaining 3 implants received fixed dental prostheses within 48 hours after surgery that remained in occlusal function for 3 years. After sacrifice, the bone was prepared for histologic and nanoindentation analysis. Nanoindentation was carried out under wet conditions on bone areas within the plateaus. Indentations (n = 30 per histologic section) were performed with a maximum load of 300 µN (loading rate, 60 µN per second) followed by a holding and unloading time of 10 and 2 seconds, respectively. Elastic modulus (E) and hardness (H) were computed in giga-pascals. The amount of bone-to-implant contact (BIC) also was evaluated. RESULTS: The E and H values for cortical bone regions were higher than those for trabecular bone regardless of load condition, but this difference was not statistically significant (P > .05). The E and H values were higher for loaded implants than for submerged implants (P < .05) for cortical and trabecular bone. For the same load condition, the E and H values for cortical and trabecular bone were not statistically different (P > .05). The loaded and submerged implants presented BIC values (mean ± standard deviation) of 57.4 ± 12.1% and 62 ± 7.5%, respectively (P > .05). CONCLUSION: The E and H values of bone surrounding dental implants, measured by nanoindentation, were higher for immediately loaded than for submerged implants.

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OBJETIVO: Descrever os cuidados familiares aos lactentes com doenças respiratórias a partir da prática educativa do enfermeiro. MÉTODO: Estudo descritivo-exploratório com abordagem qualitativa. Como cenário, um ambulatório de pediatria de um hospital universitário do Rio de Janeiro. A coleta de dados ocorreu entre os meses de setembro de 2013 e janeiro de 2014 por meio de entrevistas semiestruturadas com as mães dos lactentes. Análise de conteúdo do tipo temática. RESULTADOS: Os dados coletados produziram duas categorias: Cuidados domiciliares aos lactentes com doenças respiratórias e Facilidades e dificuldades familiares no cuidado domiciliar de lactentes com doenças respiratórias. A prática pautou-se nos cuidados de manutenção da vida, com adoção das medidas de controle ambiental e de reparação, com a prevalência da automedicação. CONCLUSÃO: A prática educativa dialógica contribui para cuidar dos lactentes de modo integral no contexto socioambiental da saúde.

AIM: To describe the family care aimed at infants with respiratory diseases from the educational practice of nurses. METHOD: This is a descriptive study using a qualitative approach. An outpatient pediatric clinic of a university hospital in Rio de Janeiro was the study scenario. Data collection took place between the months of September 2013 and January 2014 through semi-structured interviews with the mothers of infants. A thematic content analysis was used. RESULTS: The data collected produced two categories: home-based care for infants with respiratory diseases, and family facilities and difficulties in terms of the home care aimed at infants with respiratory diseases. The practice was guided by life-sustaining care, by means of the adoption of environmental control measures and repair, with the prevalence of self-medication. CONCLUSION: A dialogic educational practice helps to take care of the integral mode of infants in the context of environmental health.

OBJETIVO: Describir los cuidados familiares a los lactantes con enfermedades respiratorias a partir de la práctica educativa del enfermero. MÉTODO: Estudio descriptivo-exploratorio con abordaje cualitativo. Como escenario, un ambulatorio de pediatría de un hospital universitario de Rio de Janeiro. La colecta de datos ocurrió entre los meses de septiembre de 2013 y enero de 2014 por medio de entrevistas semiestructuradas con las madres de los lactantes. Análisis de contenido del tipo temático. RESULTADOS: Los datos colectados produjeron dos categorías: Cuidados domiciliares a los lactantes con enfermedades respiratorias y Facilidades y dificultades familiares en el cuidado domiciliar de lactantes con enfermedades respiratorias. La práctica se pautó en los cuidados de mantenimiento de la vida, con adopción de las medidas de control ambiental y de reparación, con la prevalencia de la automedicación. CONCLUSIÓN: La práctica educativa dialógica contribuye para cuidar de los lactantes de modo integral en el contexto socio ambiental de la salud.

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Systemic anticoagulation with unfractionated heparin is commonly used in maintenance hemodialysis (HD), but it increases the risk of bleeding complications. We investigated whether the use of citrate-enriched bicarbonate based dialysate (CD) would reduce systemic anticoagulation without compromising the efficacy of reprocessed dialyzers. This is a crossover study in which half of a total of 30 patients initially underwent HD with acetate-enriched bicarbonate based dialysate and a standard heparin dose of ∼ 100 IU/kg (Treatment A), whereas the remaining patients were treated with CD and a 30% reduced heparin dose (Treatment B). After 12 consecutive HD sessions in each treatment, the dialysate and heparin doses were reversed, then followed for another period of 12 HD sessions. The two treatment phases were split by a washout period of six HD sessions using acetate-enriched bicarbonate based dialysate and standard heparin dose. Systemic anticoagulation was higher in Treatment A. The activated partial thromboplastin time at the end of HD session was 68 ± 36 seconds in Treatment A and 47 ± 16 seconds in Treatment B (P = 0.005). Sixty-eight percent of the dialyzers remained adequate until the 12th use in Treatment A and 61% did so in Treatment B (P = 0.63). Patients had three and 24 cramps episodes during Treatment A and B, respectively (P < 0.001). Nine and 26 symptomatic intradialytic hypotension episodes were seen in Treatment A and B, respectively, (P = 0.003). In conclusion, the use of CD had a favorable effect on anticoagulation in the extracorporeal circuit in patients on maintenance HD, but it was also associated with more hypotension and cramps.

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A pesquisa aborda a prática educativa do enfermeiro na consulta de enfermagem aos familiares de lactentes com doenças respiratórias. Objetivos: conhecer as concepções de familiares sobre cuidados aos lactentes com doenças respiratórias a partir da prática educativa do enfermeiro visando à elaboração de prática educativa em sala de espera; descrever a concepção do familiar sobre os cuidados aos lactentes a partir da prática educativa do enfermeiro; discutir as concepções dos familiares acerca do cuidado ao lactente com doença respiratória, estabelecendo sua articulação com a prática educativa do enfermeiro na perspectiva da autonomia no cuidado e; elaborar uma prática educativa para ser utilizada em sala de espera. Referencial teórico pautado na pedagogia da autonomia de Paulo Freire. Métodos: pesquisa exploratória descritiva, qualitativa, desenvolvido no ambulatório de pediatria de um hospital universitário do estado do Rio de Janeiro, entre agosto de 2012 e junho de 2014. Os participantes da pesquisa foram mães dos lactentes com problemas respiratórios recorrentes, que tinham recebido orientação específica do enfermeiro sobre cuidados durante as manifestações das doenças respiratórias. Os dados foram coletados por entrevista semiestruturada e tratados por análise de conteúdo do tipo temática. Resultados e discussão: Emergiram três categorias: Concepção de cuidar e saberes familiares sobre sinais e sintomas respiratórios; Prática de cuidados e vivências dos familiares no cuidado ao lactente após a orientação do enfermeiro; Prática educativa na consulta de enfermagem como estratégia para favorecer a autonomia dos familiares no cuidado. O cuidar foi associado aos cuidados de manutenção da vida, afetividade, direito, dever e proteção para com seus lactentes. As mães demonstraram conhecimentos acerca da identificação dos sinais e sintomas respiratórios bem como dos sinais de alarme. A prática de cuidados aos lactentes era pautada em cuidados de manutenção da vida, com adoção de medidas de controle ambiental e de reparação, com a prevalência da automedicação. A prática educativa foi considerada de extrema importância para novos aprendizados e a consulta de enfermagem foi considerada como um momento de acolhimento, diálogo e reflexão. Conclusão: A consulta de enfermagem foi valorizada pelas mães como espaço de diálogo. Elas perceberam mudanças conscientes em seu cotidiano, que reduziram os problemas respiratórios dos lactentes. A prática educativa realizada em uma vertente dialógica aproximou as mães dos enfermeiros, favorecendo o processo ensino-aprendizagem, em que as mães manifestaram suas indagações, angústias e queixas. Entretanto, alguns problemas enfrentados pelos familiares são decorrentes de suas condições de vida e da dificuldade de acesso aos serviços da saúde em situações de urgência, requerendo aprofundamento de discussões em outros espaços. O produto desta pesquisa é a instituição da sala de espera como espaço para compartilhar saberes e promover saúde. Esta proposta pretende desenvolver uma prática educativa consoante aos temas emergidos na pesquisa e aos de interesse dos usuários, com vistas à ampliar as discussões, melhorar a comunicação entre enfermeiro e familiares de lactentes, estimulando sua autonomia no cuidado, na prática cotidiana, e o exercício de cidadania

The research discusses the educational practice of nurses in nursing consultation to families of infants with respiratory diseases. Aims: To learn the concepts of family about care for infants with respiratory diseases from educational nursing practice aiming at the elaboration of educational practice in the waiting room; describe the understanding of the family about the care of infants from the educational practice of the nurse; discuss the conceptions of the family regarding the care to infants with respiratory disease, establishing its joint with educational practice of the nurses from the perspective of autonomy of care; develop an educational practice to be used in the waiting room. Theoretical framework grounded in the pedagogy of Paulo Freire autonomy. Methods: It is a descriptive exploratory qualitative research, developed at the pediatric clinic of a university hospital in the state of Rio de Janeiro, between August 2012 and June 2014. Survey participants were mothers of infants with recurrent respiratory problems, who had received specific orientation of nurses about care during demonstrations of respiratory diseases. The technique for data collection was a semi-structured interview, and for the treatment of the data, the analysis of thematic content. Results and discussion: three categories emerged: Conception of care and family knowledge about respiratory signs and symptoms; Care practice and experiences of family members in the care for the infant after the guidance of the nurse; Educational practice in nursing consultation as a strategy to promote the autonomy of the family in care. The care was associated with maintenance of life care, affection, right, duty and protection to their infants. Mothers demonstrated knowledge about the identification of respiratory signs and symptoms and recognition of warning signs. The practice of care to infants was grounded in care of the maintenance of life, with the adoption of environmental control measures and repair, with the prevalence of self-medication. Educational practice was considered extremely important for new learning and nursing consultation was regarded as a moment of acceptance, dialogue and reflection. Conclusion: The nursing consultation was valued by mothers as a dialogic space. They realized conscious changes in their daily lives, which reduced the respiratory problems of infants. Educational practice held in a dialogical aspect approached nurses and mothers, favoring the teaching-learning process, from the opportunity of these mothers express their questions, worries and complaints. However, some problems faced by families are due to their living conditions and poor access to health services in emergency situations, requiring deepening of discussions in other spaces. The product of this research is the establishment of the waiting room as a place to share knowledge and promote health. This proposal aims to develop an educational practice according to themes emerged in the research and of interest to users, in order to broaden the discussion, improve communication between nurses and families of infants, stimulating autonomy in care, in everyday practice and exercise citizenship

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The ethogram description of confined goats is an alternative that helps identify animals' behaviour, their main behavior and the importance of developing production systems that provide better welfare conditions. This paper aims to describe the ethogram of three genetic groups of confined goats: Azul, Moxotó and Graúna, through monitoring video images, using 9 animals kept in individual pens, monitored by video cameras mounted on the roof of each pen. As for the design and description of ethogram, 810 hours of video image were recorded and analysed, these being from being nine hours a day periods; three in the morning, afternoon and night. We identified 34 visual behaviours, which were grouped into eight categories according to their functional character: food = 4), social interaction (n = 6), displacement (n = 2), resting (n = 3), grooming (n = 4), neutral position (n = 3), bipedal (n = 5) and other activities (n = 7). In conclusion, behaviors described in the ethogram were similar for all three genetic groups. Goats conduct their daily routine with sequences of behaviour that involve eating (food intake or selection) and resting or ruminating, with social interactions and other activities having happened more frequently in the afternoon and at that time in the afternoon before being provided with food.

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The ethogram description of confined goats is an alternative that helps identify animals' behaviour, their main behavior and the importance of developing production systems that provide better welfare conditions. This paper aims to describe the ethogram of three genetic groups of confined goats: Azul, Moxotó and Graúna, through monitoring video images, using 9 animals kept in individual pens, monitored by video cameras mounted on the roof of each pen. As for the design and description of ethogram, 810 hours of video image were recorded and analysed, these being from being nine hours a day periods; three in the morning, afternoon and night. We identified 34 visual behaviours, which were grouped into eight categories according to their functional character: food = 4), social interaction (n = 6), displacement (n = 2), resting (n = 3), grooming (n = 4), neutral position (n = 3), bipedal (n = 5) and other activities (n = 7). In conclusion, behaviors described in the ethogram were similar for all three genetic groups. Goats conduct their daily routine with sequences of behaviour that involve eating (food intake or selection) and resting or ruminating, with social interactions and other activities having happened more frequently in the afternoon and at that time in the afternoon before being provided with food.(AU)

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Aim: To produce an educational video to help the relatives of breast-fed infants suffering from respiratory disease. Method: This is a qualitative descriptive study using a qualitative approach based on Paulo Freire's theory entitled Pedagogy of Autonomy. It will be conducted at the Antonio Pedro University Hospital. The participants will be the relatives of breast-fed infants with respiratory disease who have received preventive care instructions from the nursing staff. The data will be collected between August and October, 2013, using semi-structured interviews and will be analyzed using the Thematic Content Analysis Technique...

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