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INTRODUCTION: The inclusion of health professionals who have some type of disability brings benefits, such as the increase in empathy that facilitates the relationship with patients. In this work, we present a case study on the inclusion of an undergraduate Dentistry student with upper limb agenesis. PURPOSE: In order to improve the quality of life for people with upper limb agenesis, it is urgent to establish inclusion strategies in the educational field. This process included the use of assistive technologies to allow the manipulation of instruments used in the practice of dental clinical activities, enabling future Dentists with upper limb agenesis to have an equal education in relation to their academic peers. CASE SELECTION: The case study presented in this work consists of the follow-up of G., a 23-year-old female Dentistry student. The developed adaptations were made using a low-temperature thermoplastic. The expert team that participated in this process was formed by three occupational therapists and three Dentistry professors. The process included several stages, being the last one the integration, in which training sessions were performed. OUTCOMES: The process was accessed using two main tools: quantitative questionnaires and qualitative interviews. After the proposed intervention, the volunteer presented a gradual evolution in her occupational performance with the use of most adaptations, promoting her functional training. DISCUSSIONS: Most adaptations allowed G. to perform the activities satisfactorily, with the precision inherent to these tasks, even with little training time. CONCLUSIONS: This case study demonstrates the high applicability of the proposed technologies.

In order to improve the quality of life for people with upper limb agenesis, it is urgent to establish inclusion strategies in the educational field, as assessed in this study caseThe inclusion process of Dentistry students can include the use of assistive technology to allow the manipulation of instruments for the practice of clinical activitiesOur study suggests that the assistive adpatations promote a gradual evolution in the students' occupational performance, functional training and motor qualification.

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OBJECTIVE: To investigate knee pain prevalence, associated factors, and functional impairment among adolescents. METHOD: This was a cross-sectional study conducted between May and June 2014 with a random sample of 619 adolescents aged between 10 and 17 years. Knee pain prevalence was investigated using the Nordic Questionnaire for Osteomuscular Symptoms and a number of independent variables (demographic data, nutritional status, form of carrying backpacks, and pain during and after walking) obtained by self-report questionnaires. Physical impairment of the knee was assessed using the Brazilian version of the Knee injury and Osteoarthritis Outcome Score questionnaire. Poisson regression analysis was used to estimate the ratios of crude and adjusted knee pain association with the investigated factors. ANOVA and Kruskal-Wallis tests were used to compare median functional impairment. RESULTS: Knee pain prevalence over the last 7 days was 22.6%. Factors having significant association with the outcome were: being between 12 and 14 years old (PR: 1.67; 95% CI: 1.07-2.58; p<0.01), being between 15 and 17 years old (PR: 2.44; 95% CI: 1.51-3.94; p=0.01), and not doing physical education at school (PR: 0.54; 95% CI: 0.35-0.82; p=0.01). Total functional capacity among adolescents with pain was significantly lower among girls (68.7 points; PD±15.1) when compared with boys (74.3 points; PD±12.7) (p=0.02). The mean value of disabling pain was lower (55.1 points; PD±12.3) among adolescents who were physically active in their leisure time compared to those who were insufficiently active (60.4 points; PD±12.4) (p=0.02). CONCLUSION: The results of this study show that knee pain among adolescents with no previous history should be investigated, particularly among older adolescents who do not have physical education at school, since it is highly prevalent and can result in functional impairment. Regarding functionality, more attention should be given to girls and adolescents who were physically active in their leisure time.

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Objetivo Objetivou-se identificar como está incluído o fisioterapeuta na atenção básica (AB) e a visão dos gestores em saúde do papel e da inserção deste profissional junto à equipe de saúde. Métodos Estudo qualitativo realizado com secretários de saúde de 22 municípios do extremo sul do Brasil. Resultados Existem na região 45 fisioterapeutas inseridos na AB, destes apenas um na Estratégia da Saúde da Família (ESF) e dois em Núcleos de Apoio a Saúde da Família (NASF), 13 gestores mencionaram o fisioterapeuta como sendo o profissional apenas da reabilitação, outros ainda afirmam que ele tem formação de nível técnico. Nos municípios que possuem o profissional inserido na ESF/NASF os gestores o identificaram como um importante integrante para complementação da equipe. Dentre as dificuldades para inserção deste profissional na AB, a falta de recurso financeiro para contratação foi o fator mais referenciado. Discussão Existe uma compreensão restrita por parte dos gestores em saúde sobre o papel do fisioterapeuta na AB, sobretudo pela maioria que não tem este profissional inserido em suas equipes de saúde da família, já a falta de priorização na destinação das verbas orçamentárias não favorece a inclusão efetiva de profissionais que não são considerados pela legislação como fazendo parte da equipe mínima. A inserção do fisioterapeuta na AB ainda é limitada, sendo necessária uma ampliação do olhar dos gestores das possibilidades de atuação deste profissional, inclusive como promotor da saúde.(AU)

Objective Study aimed to identify how physical therapists are included in primary care (PC), the perspectives of health managers, and the role that the inclusion of this professional in the health team plays. Methods Qualitative study involving health secretaries of 22 municipalities in southern Brazil. Results 45 physiotherapists in the region were included in PC. One of these was in the Family Health Strategy (FHS), and two were in the Nuclei of Support to Family Health (NSFH). 13 administrators cited the physiotherapists as professionals solely for rehabilitation; others think that they have formation at a technical level. However, in municipalities that have included the professionals in the FHS / NSFH, they were identified as important members of the team. Among the difficulties of inclusion, the lack of financial resources for hiring was the most commonly reported factor. Discussion There is a limited understanding from health managers regarding the role of physiotherapists in PC, especially from the majority who do not have access to this professional in their family health teams. This is because the lack of prioritization in the allocation of budget funds is not conducive to the effective inclusion of professionals who are not considered by the law as part of the minimum team. The insertion of the physiotherapist PC is further limited; a magnification of the look of the managers of the possibilities of action of this professional is required, including as a health promoter.(AU)

Objetivos Identificar cómo se incluye el fisioterapeuta en la atención primaria (AP), la visión del gestión de la salud y el papel de la inserción de este profesional en el equipo de salud. Métodos Estudio cualitativo con secretarios de salud de 22 municipios del sur de Brasil. Resultados Hay 45 fisioterapeutas de la región insertado en AP, uno en la Estrategia de Salud Familiar (ESF) y dos em los Núcleos de Apoyo para Salud de la Familia (NASF), 13 secretarios comentaron que se trataba de un profesional que trabaja solamente con rehabilitación, otros creen que tiene formación del nivel técnico, en los municipios que se han incorporado al profesional en el ESF / NASF lo identificó como un miembro importante del equipo. Entre las dificultades la falta de recursos financieros para la contratación fue el factor más referenciada. Discusión Hay una comprensión limitada por los administradores sobre el papel del fisioterapeuta en AP, especialmente los que no tienen este profesional insertado en sus equipos de salud familiar, ya la falta de priorización en la asignación de recursos presupuestarios no es propicio para la inclusión efectiva de los profesionales que no son considerados por la ley como parte del mínimo de personal. La inserción de la fisioterapeuta AP es aún limitada, una ampliación de la mirada de los gestores de las posibilidades de acción de estos profesionales incluyendo como promotora de salud.(AU)

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Objective Study aimed to identify how physical therapists are included in primary care (PC), the perspectives of health managers, and the role that the inclusion of this professional in the health team plays. Methods Qualitative study involving health secretaries of 22 municipalities in southern Brazil. Results 45 physiotherapists in the region were included in PC. One of these was in the Family Health Strategy (FHS), and two were in the Nuclei of Support to Family Health (NSFH). 13 administrators cited the physiotherapists as professionals solely for rehabilitation; others think that they have formation at a technical level. However, in municipalities that have included the professionals in the FHS / NSFH, they were identified as important members of the team. Among the difficulties of inclusion, the lack of financial resources for hiring was the most commonly reported factor. Discussion There is a limited understanding from health managers regarding the role of physiotherapists in PC, especially from the majority who do not have access to this professional in their family health teams. This is because the lack of prioritization in the allocation of budget funds is not conducive to the effective inclusion of professionals who are not considered by the law as part of the minimum team. The insertion of the physiotherapist PC is further limited; a magnification of the look of the managers of the possibilities of action of this professional is required, including as a health promoter.

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The importance of viruses in aquatic ecosystem functioning has been widely described. However, few studies have examined tropical aquatic ecosystems. Here, we evaluated for the first time viruses and their relationship with other planktonic communities in an Amazonian freshwater ecosystem. Coupling between viruses and bacteria was studied, focusing both on hydrologic dynamics and anthropogenic forced turbidity in the system (Lake Batata). Samples were taken during four hydrologic seasons at both natural and impacted sites to count virus-like particles (VLP) and bacteria. In parallel, virus-infected bacteria were identified and quantified by transmission electron microscopy (TEM). Viral abundance ranged from 0.5 × 107 ± 0.2 × 107 VLP ml⁻¹ (high-water season, impacted site) to 1.7 × 107 ± 0.4 × 107 VLP ml⁻¹ (low-water season, natural site). These data were strongly correlated with the bacterial abundance (r² = 0.84; P < 0.05), which ranged from 1.0 × 106 ± 0.5 × 106 cells ml⁻¹ (high water, impacted site) to 3.4 × 106 ± 0.7 × 106 cells ml⁻¹ (low water, natural site). Moreover, the viral abundance was weakly correlated with chlorophyll a, suggesting that most viruses were bacteriophages. TEM quantitative analyses revealed that the frequency of visibly infected cells was 20%, with 10 ± 3 phages per cell section. In general, we found a low virus-bacterium ratio (<7). Both the close coupling between the viral and bacterial abundances and the low virus-bacterium ratio suggest that viral abundance tends to be driven by the reduction of hosts for viral infection. Our results demonstrate that viruses are controlled by biological substrates, whereas in addition to grazing, bacteria are regulated by physical processes caused by turbidity, which affect underwater light distribution and dissolved organic carbon availability.

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A mímica facial é fundamental para a expressão e comunicação humana, que são possíveis apenas através da integridade do nervo facial. Sendo assim, a paralisia facial periférica (PFP) pode deixar seqüelas estéticas, funcionais e psicológicas. A causa mais comum é a paralisia de Bell (50 a 80 por cento), onde a maioria dos pacientes apresenta manifestação unilateral. O acometimento bilateral simultâneo é raro, sendo a leucemia a neoplasia que com maior freqüência pode resultar nesse tipo de manifestação. A seguir, relatamos o caso de um paciente de dezoito anos de idade apresentando leucemia linfóide aguda (LLA) e PFP simultânea, ambas refratárias ao tratamento quimioterápico, culminando com o óbito cinco meses após o início da PFP. Realizou-se considerações importantes sobre a fisiopatologia da PFP na LLA, além de uma revisão da literatura.