Cacería para autoconsumo durante la pandemia de COVID-19: el caso de las comunidades Matsigenkas del Parque Nacional del Manu

En este trabajo, se hipotetiza el periodo de aislamiento, la inmovilización y la migración inversa que sucedidos durante la pandemia del COVID-19 (años 2020 y 2021) incrementaron la capacidad de caza de las comunidades Matsigenkas asentadas en el Parque Nacional del Manu (PN Manu). Para esto, evaluamos los cambios en los patrones del volumen de extracción de la caza a través de un monitoreo participativo utilizando el modelo de monitoreo de la intensidad de cacería. Se evidenció que hubo un incremento de la capacidad de caza de las comunidades nativas. Los volúmenes más altos de extracción y el mayor incremento del número de cazadores, esfuerzo y área de cacería se dieron en el periodo 2020 - 2021, cuando las medidas de aislamiento e inmovilización fueron establecidas. Sin embargo, hubo una disminución de los indicadores para la temporada 2021 - 2022, año en que se flexibilizaron las medidas de aislamiento y se dio la reactivación económica, permitiendo que las personas retornaran a sus actividades económicas y educativas fuera del PN Manu. Se debe considerar que los efectos de solo un año de pandemia sobre los medios de subsistencia de las comunidades pudieron afectar la abundancia de la fauna silvestre, donde el mono maquisapa y mono choro (especies vulnerables) tuvieron altos incrementos de extracción. Por otro lado, nuestros resultados indicarían que el buen estado de conservación del PN Manu permitió la provisión de alimentos a las comunidades durante la pandemia. Se recomienda la planificación de programas que mitiguen los efectos negativos de pandemias o eventos semejantes, además se señala la importancia de medir el grado de resiliencia de las principales especies de caza, ya que el incremento de caza también podría tener efectos sobre la seguridad alimentaria de estas comunidades.

In this work, we hypothesize that the period of isolation, immobilization, and reverse migration that occurred during the COVID-19 pandemic (years 2020 and 2021) increased the hunting capacity of the Matsigenka communities settled in Manu National Park (PN Manu). To evaluate this, we assessed changes in hunting volume patterns through participatory monitoring using the hunting intensity monitoring model. It was evident that there was an increase in the hunting capacity of Matsigenka communities. The highest extraction volumes and the greatest increase in the number of hunters, hunting effort, and hunting area occurred in the 2020-2021 period, the year in which isolation and immobilization measures were established. However, there was a decrease in the indicators for the 2021-2022 period, the year in which isolation measures were relaxed and economic reactivation occurred, allowing people to return to their economic and educational activities outside PN Manu. It should be considered that the effects of only one year of the pandemic on the livelihoods of the communities could have affected the abundance of wildlife, with vulnerable species such as maquisapa monkeys and choro monkeys experiencing high extraction rates. On the other hand, our results indicate that the good conservation status of PN Manu provided food provisions for the communities during the pandemic. Planning programs to mitigate the negative effects of pandemics or similar events is recommended, and the importance of measuring the resilience of key hunting species is emphasized, as increased hunting could also have effects on the food security of these communities.

Sarcopenia, chronic pain, and perceived health of older: a cross-sectional study / Sarcopenia, dor crônica e percepção de saúde do idoso: um estudo transversal

Abstract Introduction Aging is a dynamic and progressive process that can be associated with the presence of morbidities, such as chronic diseases, and functional decline, characteristic of sarcopenia, which directly affects the self-perceived health of the older. Objective To test the hypothesis that there is an association between sarcopenia, chronic pain, and perceived health in the older. Methods The study used a quantitative approach and enrolled 43 sarcopenic elderly individuals registered in the University of The Third Age Program (UATI) at Universidade do Estado da Bahia, in Brazil, between November and December 2019. Data included patients' sociodemographic and anthropometric characteristics, self-reported morbidities, multimorbidity, history of chronic pain and perceived health. The data were subjected to descriptive statistical analyses. Crossing of data was performed using Pearson's chi-square test, and the correlation coefficient was assessed using Cramer's Phi and V tests. Results There was an association of sarcopenia with chronic pain (p = 0.027) and with age group (p = 0.016), however not with perceived health (p = 0.09). There was also no association between age range and chronic pain (p > 0.05). Conclusion According to the findings of this study, it can be concluded that sarcopenia is associated with the presence of chronic pain and the age of the elderly, not being associated with the perception of health. However, the age of the elderly was not associated with the presence of chronic pain.

Resumo Introdução O envelhecimento é um processo dinâmico e progressivo que pode estar associado à presença de morbidades, como doenças crônicas, e ao declínio funcional, característico da sarcopenia, que afeta diretamente a autopercepção de saúde do idoso. Objetivo Testar a hipótese de que existe associação entre sarcopenia, dor crônica e percepção de saúde em idosos. Métodos O estudo utilizou uma abordagem quantitativa e envolveu 43 idosos sarcopênicos cadastrados na Universidade Aberta da Terceira Idade (UATI) da Universidade do Estado da Bahia, no Brasil, entre novembro e dezembro de 2019. Dados incluíram características sociodemográficas e antropométricas dos pacientes, morbidades autorreferidas, multimorbidade, história de dor crônica e percepção de saúde. Os dados foram submetidos a análises estatísticas descritivas. O cruzamento dos dados foi feito pelo teste de qui-quadrado de Pearson e o coeficiente de correlação foi avaliado pelos testes Phi e V de Cramer. Resultados Houve associação da sarcopenia com dor crônica (p = 0,027) e com faixa etária (p = 0,016), porém não houve associação com a percepção de saúde (p = 0,09). Também não houve associação entre faixa etária e dor crônica (p > 0,05). Conclusão De acordo com os achados deste estudo, pode-se concluir que a sarcopenia está associada à presença de dor crônica e à idade do idoso, não estando associada à percepção de saúde. No entanto, a idade dos idosos não foi associada à presença de dor crônica.

Ajuste escolar, empatía y conectividad con el medio ambiente natural en el marco de la educación ambiental en educación secundaria en España / School adjustment, empathy and connectedness with the natural environment in environmental education in Spanish secondary education

Resumen En investigaciones recientes se ha constatado que la empatía y la conectividad con el medioambiente natural son variables predictoras de la conducta proambiental. Sin embargo, no se han realizado trabajos en los que se analicen las relaciones entre estas dimensiones y el ajuste en la escuela, un escenario en el que tienen lugar gran parte de los programas relacionados con la educación ambiental y cuya finalidad es la de promover conductas proambientales. Con el presente trabajo se pretende analizar las relaciones entre el ajuste escolar, la empatía y la conectividad con el medioambiente natural en función del género. La muestra estuvo constituida por 881 estudiantes (47.2 % chicos), escolarizados en centros de educación secundaria (España), con edades comprendidas entre los 12 y los 17 años (M = 13.67 y SD = 1.32). Se administró una batería de instrumentos para medir el ajuste escolar, la empatía y la conectividad con el medioambiente natural. Se realizó un MANOVA para el análisis de los datos. Los resultados obtenidos mostraron que el ajuste escolar, la empatía y la conectividad se relacionan significativamente y que el género desempeña un rol significativo en estas relaciones. También se observó que chicos y chicas con alto ajuste escolar diferían en empatía emocional, pero no en conectividad. Se discuten los resultados obtenidos y se recomienda la incorporación del ajuste escolar en los estudios y programas relacionados con la educación ambiental.

Abstract In recent research it has been observed that empathy and connectedness with the natural environment are relevant predictive variables of pro-environmental behaviour. However, no work has been done in which the relationships between these dimensions and the adjustment in the school are analysed, a context in which most of the programs related to environmental education, whose purpose is to promote pro-environmental behaviours, take place. The general aim of this paper is to analyse the relationships between school adjustment, empathy and connectedness with the natural environment according to gender. School adjustment is defined as the adolescent's ability to adapt to this context and includes aspects such as academic performance, adaptation to school rules, respect for the teacher as an authority figure, the student's attitude towards school and participation in school activities. Empathy is conceptualized as the awareness of the emotions and cognitions of others, and it is important in the school context for the promotion of coexistence and prevention of aggressive behaviors. Like empathy with people, empathy with the natural environment is a social-emotional process. It is a process that focuses on the ability to feel and understand everything related to that medium. In this line, an essential aspect of empathy is its influence on the attitudes and behaviors of people in general and towards the natural environment. An aspect related to empathy is connectedness which refers to the identification of human beings with the natural environment and the relationships they establish with it. In such a way that to study the connection with nature is to try to understand how people build their relationships and identify themselves with it. Connectedness to the natural environment is related in a negative sense to selfish beliefs and attitudes and in a positive sense to the development of attitudes towards the natural environment and ecological behavior in general. These aspects are taken into account in this work. The sample was composed of 881 students (47.2 % boys), enrolled in secondary education (Spain), aged between 12 and 17 (M = 13.67 y SD = 1.32). A battery of instruments to measure school adjustment, empathy and connectedness with the natural environment was administered. A MANOVA was used for data analysis. The results showed that the school adjustment, empathy and connectedness were significantly related and that gender had a significant role in these relationships. It was also observed that boys and girls with high school adjustment differed in emotional empathy, but not in connectedness. Results obtained are discussed and the inclusion of the school adjustment in the studies and programs related to environmental education is recommended. These results raise the idea that school adjustment, connectedness and empathy should be the subject of further analysis because their results would help to incorporate new ideas and proposals into education and intervention programs regarding the natural environment. It was expected that environmental connectedness in adolescents had the same sign as their connectedness with school, family, etc. because many studies have observed that girls have greater connectedness in these scenarios than boys; however, this result deserves a greater exploration regarding gender and its relationships with other connectedness It is recommended that the results presented be considered in future environmental education programs, mainly aimed at students and their families. All this will benefit these educational programs and interventions aimed at enhancing respect and awareness of the natural environment. In short, the promotion of pro-environmental behaviors should be defended through environmental education that seeks to ensure the health and well-being of all citizens.

Multimodal Neuromonitoring During Pediatric Cardiac Surgery

Abstract Introduction: Neuromonitoring (electroencephalogram [EEG] and cerebral oximetry) is essential for appropriate anesthesia and neuroprotection assessment during pediatric cardiac surgery. Methods: We describe the intraoperative pediatric multimodal and multiparametric neuromonitoring pattern of the software system Neuron-Spectrum (Kandel®) that consists of continuous electroencephalogram (cEEG), spectral analysis, amplitude-integrated electroencephalogram (aEEG), depth of anesthesia monitor (NINDEX), and regional cerebral and somatic oximetry (near-infrared spectroscopy-INVOS™). A physiological algorithm for management using neuromonitoring and physiological data is also described. Results: Visual data examples are presented for interpretation of the cerebral perfusion and oxygenation, neurophysiological state, anesthesia depth, possible neurologic predictions, and identification of cerebral drug effects (EEG signature). Conclusion: The neuromonitoring model can be an effective tool for anesthesia control and to provide adequate cerebral oxygenation during surgery.

Fenomenologia e Psicologia da Saúde: uma análise da produção acadêmica Brasileira / Phenomenology and Health Psychology: a review of Brazilian academic production / Fenomenología y Psicología de la Salud: una revisión de la producción académica de Brasil

O objetivo deste trabalho é investigar as contribuições da Fenomenologia para a Psicologia da Saúde a partir da produção acadêmica brasileira. A pesquisa foi realizada nas bases de dados SciELO (Scientific Eletronic Library Online), PePSIC (Periódicos Eletrônicos em Psicologia) e LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde), sendo selecionados e analisados treze artigos, publicados entre 2000 e 2018. Constatou-se que a Fenomenologia contribui de várias maneiras, enquanto epistemologia de Edmund Husserl, como abordagem que apresenta uma visão de ser humano e de mundo através de vários fenomenólogos, como método fenomenológico filosófico adaptado à Psicologia por diversos autores. Em Psicologia da Saúde, as pesquisas revelam uma compreensão do processo saúde-doença-cuidado tanto através da análise das experiências vivenciais de usuários que buscam os serviços de saúde, quanto pela atuação do profissional psicólogo com predomínio da visão biopsicossocial. Revela-se uma pluralidade de concepções teóricas e percursos metodológicos tanto em Fenomenologia como em Psicologia da Saúde, sendo promissor o avanço de pesquisas em Psicologia da Saúde através das contribuições advindas da Fenomenologia.

This study aimed to investigate the contributions of Phenomenology to Health Psychology based on Brazilian academic production. A search in the SciELO (Scientific Electronic Library Online), PePSIC (Electronic Psychology Journals) and LILACS (Latin American and Caribbean Health Sciences Literature) databases was performed and thirteen papers published between 2000 and 2018 were selected and analyzed. It was found that Phenomenology contributes in many ways while Edmund Husserl's epistemology, as well as an approach that presents a view of the world and human beings by means of a number of phenomenologists, and as a philosophical phenomenological method adapted to Psychology by various authors. As far as Health Psychology is concerned, research brings an understanding of the health-disease-care process both by the analysis of the experiences of users who turn to health services as well as by professional psychologists' practice within a biopsychosocial perspective. A plurality of theoretical conceptions and methodological pathways is observed both when it comes to Phenomenology and Health Psychology, thus further studies on Health Psychology stemming from the contributions of Phenomenology are promising.

El objetivo de este trabajo es investigar las contribuciones de la Fenomenología a la Psicología de la Salud a partir de la producción académica nacional. La investigación fue realizada en las bases de datos SciELO (Scientific Eletronic Library Online), PePSIC (Periódicos Electrónicos en Psicología) y LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud), siendo seleccionados y analizados trece artículos, publicados entre 2000 y 2018. Se constató que la Fenomenología contribuye de varias maneras como epistemología de Edmund Husserl; como enfoque que presenta una visión de ser humano y de mundo a través de varios fenomenólogos; como método fenomenológico filosófico adaptado a la Psicología por diversos autores. En Psicología de la Salud, las investigaciones revelan una comprensión del proceso salud-enfermedad-cuidado tanto a través del análisis de las experiencias vivenciales de usuarios que buscan los servicios de salud, como por la actuación del profesional psicólogo con predominio de la visión biopsicosocial. Se revela una pluralidad de concepciones teóricas y recorridos metodológicos tanto en Fenomenología como en Psicología de la Salud, siendo promisor el avance de investigaciones en Psicología de la Salud a través de las contribuciones provenientes de la Fenomenología.

Síndrome compartimental abdominal / Abdominal compartment syndrome

Resumen El síndrome compartimental abdominal (SCA) se define como la disfunción orgánica causada por la hipertensión intraabdominal (HIA). Ambas son complicaciones frecuentes en pacientes graves ingresados en las unidades de cuidados intensivos (UCI). Las manifestaciones clínicas asociadas suelen ser inespecíficas, por lo que dichas entidades deben ser sospechadas ante pacientes críticos con factores de riesgo. El diagnóstico de la HIA se realiza midiendo de forma indirecta la presión intraabdominal (PIA), generalmente por medio de una sonda vesical. El tratamiento consiste en medidas de soporte, y en algunos casos es necesaria la descompresión abdominal quirúrgica. En esta revisión se presenta la fisiopatología de ambas entidades, así como el enfoque diagnóstico y terapéutico.

Abstract Abdominal compartment syndrome (ACS) is defined as an organ dysfunction caused by intra-abdominal hypertension (IAH). Both are common complications in severe patients admitted to intensive care units. The associated clinical manifestations are usually non-specific and, therefore, such entities should be suspected in critical patients with risk factors. The diagnosis of IAH is made by indirectly measuring intrabdominal pressure, usually by means of a urinary catheter. Treatment consists of supportive measures and, in some cases, surgical abdominal decompression. In this review the physiopathology of both entities is described, as well as the diagnostic and therapeutic approach.

Pandemia por el SARS-CoV-2: aspectos biológicos, epidemiológicos y clínicos / SARS-CoV-2 Pandemic. Biological, epidemiological, clinical aspects

El objetivo principal de este trabajo es describir los principales aspectos biológicos, epidemiológicos y clínicos,con especial énfasis en la fisiopatología, ocasionado por el SARS-CoV-2.El Coronavirus 2 del Síndrome Agudo Respiratorio Severo,es un orthocoronavirinae, del grupoI V, pertenecientes al género betacoronavirus,que causa la actual enfermedad pandémica definida por la Organización Mundial de la Salud (OMS)(2020), como COVID-19.Esta es considerada por los expertos mundiales como una infección viral emergente. Su origenes veterinario y su transmisión zoonótica, a partir de virus que tienen como reservorios a murciélagos y como hospedador intermediario al pangolín, desde el cual se infiere que pudo adaptarse al ser humano, para transmitirse de persona a persona,mediante gotitas respiratorias y secreciones nasales contaminadas con partículas altamente infecciosas. No se descarta la transmisión fecal-oral. La enfermedad posee un periodo de incubación de 2 a 14 días (promedio:5,2 días) y hasta ahora las medidas de prevención y control más eficientes son la cuarentena social obligatoria, el uso de tapabocas, lavado de manos con agua y jabón por al menos 20 segundos,o con productos en gel con alcohol al 70%, mantener una distancia mínima entre las personas de 2 metros. Lo aprendido de los otros dos betacoronavirus humanos relacionados, causantes de las epidemias previas: SARS-CoVen 2002-2003 y el MERSen 2012 ,permiten encarar de mejor forma la actual pandemia(AU)

The main objective of this work is to describe the main biological, epidemiological and clinical aspects, with special emphasis on pathophysiology, caused by SARS-CoV-2. Coronavirus 2 of Severe Acute Respiratory Syndrome is a member of group IV orthocoronavirinae, belonging to the betacoronavirus genus, which causes the current pandemic disease defined by the World Health Organization as COVID-19. This is considered by world experts as an emerging viral infection. Its origin is veterinary and its zoonotic transmission, from viruses that have bats as reservoirs to pangolin an as an intermediate host, from which it is inferred that it could have adapted to the human being, transmitted from person to person by means of respiratory droplets, and highly infectious contaminated nasal secretions Fecal-oral transmission is not ruled out. The disease has an incubation period of 2 to 14 days (5.2 days in mean), and until now the most efficient prevention and control measures are the obligatory social quarantine, the use of face masks, hand washing with soap and water for at least 20 seconds, or with products in gel with 70 alcohol, keeping a minimum distance between people of 2 meters. What has been learned from the other two related human betacoronaviruses that caused the previous epidemics: SARS-CoV in 2002-2003 and MERS in 2012, allow us to better face the current pandemic(AU)

Role of acute hemodilution in blood transfusion rate in patients submitted to scoliosis surgery: observational retrospective study / Papel da hemodiluição aguda na taxa de transfusão sanguínea em pacientes submetidos a tratamento cirúrgico de escoliose: estudo observacional retrospectivo

Abstract Background and objectives: The study assessed the role of acute hemodilution in the blood transfusion rate in patients submitted to surgical treatment of scoliosis. Methods: Retrospective observational study performed at Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (HC-FMRP-USP). Medical charts of patients submitted to elective correction of scoliosis between January 1996 and December 2016 were analyzed. Variables assessed were: age, weight, sex, presence of comorbidities, data regarding anesthesia and surgery, lab data, adverse events and blood transfusion rate. The final sample consisted of 33 procedures performed by the same anesthesiologist and same surgeon, divided into two groups: Hemodilution Group (n = 16) and Control Group (n = 17). Indication of acute normovolemic hemodilution was determined by patient refusal of blood transfusion for religious reasons. Results: The sample was statistically homogeneous and the groups were compared in terms of the attributes analyzed. The volume of homologous blood used by the Hemodilution Group was significantly lower than the Control Group (p = 0.0016). The percentage of patients who required transfusion was 12.5% in the Hemodilution Group, while it was 70.69% (p = 0.0013) in the Control Group. Upon hospital discharge, mean values of hemoglobin and hematocrit between groups did not present significant differences (p = 0.0679; p = 0.1027, respectively). Conclusions: Acute normovolemic hemodilution, in scoliosis correction surgeries, reduces blood transfusion rates, meeting patient needs without increasing adverse events or infection rates.

Resumo Justificativa e objetivos: Este estudo avaliou o papel da hemodiluição aguda na taxa de transfusão sanguínea em pacientes submetidos a tratamento cirúrgico de escoliose. Método: Estudo observacional retrospectivo realizado no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (HCFMRP/USP). Analisados prontuários de pacientes submetidos à correção de escoliose no período entre janeiro de 1996 a dezembro de 2016, em regime eletivo. As variáveis avaliadas foram: idade, peso, sexo, presença de doenças concomitantes, dados referentes à anestesia e à cirurgia, dados laboratoriais, eventos adversos e taxa de transfusão sanguínea. A amostra final foi composta por 33 procedimentos realizados pelo mesmo médico anestesiologista e pelo mesmo cirurgião, divididos em dois grupos: Grupo Hemodiluição (n = 16) e Grupo Controle (n = 17). A indicação de hemodiluição normovolêmica aguda foi determinada pela recusa à transfusão sanguínea pelos pacientes, por motivos religiosos. Resultados: A amostra foi estatisticamente homogênea e os grupos foram comparados considerando os atributos analisados. O volume de sangue homólogo utilizado pelo Grupo Hemodiluição foi significativamente menor que no Grupo Controle (p = 0,0016). A porcentagem de pacientes que necessitou transfusão foi de 12,5% no grupo Hemodiluição, enquanto no Grupo Controle foi de 70,69% (p = 0,0013). Na alta hospitalar, os valores médios de hemoglobina e hematócrito entre os grupos não apresentaram diferenças significantes (p = 0,0679; p = 0,1027, respectivamente). Conclusões: A hemodiluição normovolêmica aguda, em cirurgias para correção de escoliose, reduz a taxa de transfusão sanguínea, satisfazendo as necessidades dos pacientes sem aumentar as taxas de eventos adversos e de infecção.

Geographic variation of individual venom profile of Crotalus durissus snakes

South American rattlesnakes are represented in Brazil by a single species, Crotalus durissus, which has public health importance due to the severity of its envenomation and to its wide geographical distribution. The species is subdivided into several subspecies, but the current classification is controversial. In Brazil, the venoms of C. d. terrificus and C. d. collilineatus are used for hyperimmunization of horses for antivenom production, even though the distinction of these two subspecies are mostly by their geographical distribution. In this context, we described a comparative compositional and functional characterization of individual C. d. collilineatus and C. d. terrificus venoms from three Brazilian states. Methods: We compared the compositional patterns of C. d. terrificus and C. d. collilineatus individual venoms by 1-DE and RP-HPLC. For functional analyzes, the enzymatic activities of PLA2, LAAO, and coagulant activity were evaluated. Finally, the immunorecognition of venom toxins by the crotalic antivenom produced at Butantan Institute was evaluated using Western blotting. Results: The protein profile of individual venoms from C. d. collilineatus and C. d. terrificus showed a comparable overall composition, despite some intraspecific variation, especially regarding crotamine and LAAO. Interestingly, HPLC analysis showed a geographic pattern concerning PLA2. In addition, a remarkable intraspecific variation was also observed in PLA2, LAAO and coagulant activities. The immunorecognition pattern of individual venoms from C. d. collilineatus and C. d. terrificus by crotalic antivenom produced at Butantan Institute was similar. Conclusions: The results highlighted the individual variability among the venoms of C. durissus ssp. specimens. Importantly, our data point to a geographical variation of C. durissus ssp. venom profile, regardless of the subspecies, as evidenced by PLA2 isoforms complexity, which may explain the increase in venom neurotoxicity from Northeastern through Southern Brazil reported for the species.(AU)

Efeitos de um programa de treinamento funcional nas atividades da vida diária e capacidade funcional de idosos da UATI: um ensaio clínico / Effects of a functional training program in the activities of daily life and functional capacity of elderly persons of UATI: a clinical test

INTRODUÇÃO: O envelhecimento humano provoca alterações biopsicossociais que interferem nas atividades da vida diária (AVD) e o treinamento funcional pode atuar como um recurso terapêutico para prevenir, minimizar ou reverter esses quadros. OBJETIVO: testar a hipótese de que o treinamento funcional melhora a capacidade de realização das AVD e a capacidade funcional de idosos sedentários. MATERIAIS E MÉTODOS: Ensaio clínico de braço único, do tipo antes e após a intervenção no mesmo grupo. Foram incluídas idosas da Universidade Aberta da Terceira Idade, com 60 anos ou mais, a mais de três meses sem realizar exercício físico, com indicação médica e fisioterapêutica para exercícios e, como exclusão, apresentar declínio cognitivo de acordo com o Mini Exame do Estado Mental (MEEM) e frequência menor que 70%. Coletados dados sociodemográficos, antropométricos, morbidades autorreferidas, capacidade funcional e de realização das AVD. O treinamento funcional ocorreu duas vezes na semana com duração de 60 minutos por sessão, durante quatro meses. Os dados foram submetidos à estatística descritiva e teste t. O projeto foi aprovado pelo comitê de ética com CAAE: 02585813.0.0000.0057. RESULTADOS: Participaram 16 idosas, todas do sexo feminino, média da idade de 69,6 + 6,6 anos, a maioria com baixa escolaridade (52,5%) baixa renda (56,3 < um salário mínimo), viúvas (50%) e 75,1% acima do peso. Dentre as morbidades, prevaleceu dor crônica (25%). Os testes de capacidade funcional e AVD, demonstraram resultados positivos da intervenção com p < 0,05 e constatou-se que a melhora funcional foi maior nos idosos de 60 a 69 anos (p < 0,05). CONCLUSÃO: Treinamento funcional melhora a capacidade funcional e realização das AVD de idosos, independente da faixa etária, porém, essa melhora é mais pronunciada entre os idosos com menos idade.

INTRODUCTION: Human aging causes biopsychosocial changes that interfere with the activities of daily living (ADL) and functional training can act as a therapeutic resource to prevent, minimize or reverse these clinical features. OBJECTIVE: To test the hypothesis that functional training improves the ability to perform ADL and the functional capacity of sedentary elderly. METHODS: Single-arm trial with before and after intervention analysis in the same group. Elderly of the 'Universidade Aberta da Terceira Idade', aged 60 years and older, with more than three months without physical exercise, with a medical and physiotherapeutic indication for exercise, were included in the study, and were excluded the ones who presented cognitive decline according to the Mini Mental State Exam (MMSE) and frequency less than 70%. Sociodemographic and anthropometric data, self-reported morbidities, functional capacity and ADL performance were collected. Functional training occurred twice a week, 60 minutes per session for four months. Data were submitted to descriptive statistics and t test. This study was approved by the ethics committee with number 02585813.0.0000.0057. RESULTS: Participants were 16 elderlies, with mean age 69.6 ± 6.6 years, the majority with low schooling (52.5%), low income (56.3

Cumplimiento de los criterios del indicador Prevención de infecciones de vías urinarias en un hospital de tercer nivel / Compliance of the Prevention of urinary tract infections indicator in a third level hospital

Introducción: según la incidencia que presenta el indicador Prevención de infecciones de vías urinarias, 80% de estas son ocasionadas en las unidades de salud por el uso de una sonda vesical. Con la finalidad de disminuir este problema, se implementó el indicador de calidad de los servicios de enfermería. Objetivo: identificar el cumplimiento de los criterios del indicador Prevención de infecciones de vías urinarias en pacientes con sonda vesical instalada en una unidad de tercer nivel. Métodos: estudio observacional, descriptivo, prospectivo, transversal del tipo sistemas de salud, en el que participaron 74 pacientes, en el periodo de septiembre a octubre del 2017, con un muestreo por conveniencia mediante observación al personal de enfermería que atiende pacientes con sonda vesical instalada durante el periodo de recolección de datos en los turnos matutino y vespertino, con el formato de sistema INDICAS (F1-PIVUPSVI/12). Se hizo el análisis mediante estadística descriptiva. Resultados: en relación con el nivel del cumplimiento del indicador Prevención de infecciones de vías urinarias en pacientes con sonda vesical instalada, este arrojó un 89.1% en rojo (66), equivalente a 70% o menos, y 18.9% en amarillo (8), que equivale al nivel del cumplimiento en un rango que va de 71 a 90%. Conclusiones: de acuerdo con datos estadísticos, se encuentra el indicador en rojo, con base en el sistema INDICAS de la Secretaría de Salud.

Introduction: According to the incidence showed by the Prevention of urinary tract infections in patients with a bladder catheter indicator, 80% of these infections is caused by the use of a bladder catheter. In order to reduce this problem, it was implemented the nursing service quality indicator. Objective: To identify compliance with the criteria of the indicator Prevention of urinary tract infections in patients with a bladder catheter in a third level unit. Methods: Observational, descriptive, prospective, cross-sectional, health systems sort of study, which included 74 patients from September to October of 2017, with a convenience sample by observation to the nursing staff that takes care of patients with bladder catheter installed during the period of data collection in the morning and afternoon shifts with INDICAS system format (F1-PIVUPSVI/12). Analysis was performed with descriptive statistics. Results: The level of compliance with the Prevention of urinary tract infections in patients with a bladder catheter indicator resulted in 89.1% in red (66), equivalent to 70% or less, and 18.9% in yellow (8), equivalent to a level of compliance ranging from 71 to 90%. Conclusions: According to statistical data, the indicator is in red, based on the Secretaría de Salud (Health Secretary) INDICAS system.

Qualidade de vida de idosos hipertensos e diabéticos da comunidade: um estudo observacional / Quality of life of elderly hypertensive and diabetics of the community: an observational study

INTRODUÇÃO: O envelhecimento da população brasileira provocou modificações no perfil das morbidades, aumentando as doenças crônicas não transmissíveis (DCNT), principalmente hipertensão e diabetes, interferindo na qualidade de vida. OBJETIVO: Avaliar a qualidade de vida de idosos hipertensos e diabéticos da comunidade, analisar suas correlações e caracterizar o perfil desses idosos. MATERIAIS E MÉTODO: Estudo observacional, transversal, com 108 idosos da comunidade com 60 anos ou mais. Na coleta de dados, aplicaram-se questionários sociodemográficos, antropométricos, de morbidades, avaliação do comprometimento cognitivo, por meio do Mini Exame do Estado Mental, e da qualidade de vida por meio do WHOQOL-OLD. Os dados foram submetidos à estatística descritiva, análise de variância para comparação de médias entre os grupos e correlação de Pearson para testar a associação da qualidade de vida com o quantitativo de DCNT. RESULTADOS: A média de idade foi 70±6 anos, predominância do sexo feminino (85,2%); baixa escolaridade (75,8%); baixa renda (51,9%); morando com familiares (80,6%) e casados (46,3%). Em relação às DCNT, 37,0% eram hipertensos, 18,5% diabéticos e 14,8% tinham associação das duas. Os idosos sem DCNT apresentaram médias do WHOQOL-OLD maiores que os demais grupos com pelo menos uma DCNT e houve correlação negativa da quantidade de DCNT e a qualidade de vida. CONCLUSÃO: DCNT influenciam negativamente a qualidade de vida dos idosos, sendo que idosos sem DCNT apresentaram melhor qualidade de vida, comparados aos hipertensos, diabéticos ou com associação de ambas e, o medo de morrer foi a variável que apresentou maior interferência na qualidade de vida dos idosos.

INTRODUCTION: With the aging of the Brazilian population, there was a change in the morbidity profile, with a consequent increase in chronic noncommunicable diseases (CNCD) OBJECTIVE: To evaluate the quality of life of elderly diabetic and hypertensive in the community and characterize the profile of these elderly people. MATERIALS AND METHODS: 108 elderly subjects were investigated in a cross-sectional observational study. Data collection included questionnaires containing sociodemographic, anthropometric and self-reported morbidity data, as well as the evaluation of cognitive impairment through the Mini Mental State Examination and quality of life through the WHOQOL-OLD. Data were submitted to descriptive statistics, analysis of variance for comparison of means between groups and Pearson correlation to test the association of quality of life with the quantitative of CNCD. RESULTS: Mean age 70 ± 6, predominantly female (85.2%); low schooling (75.8%); low income (51.9%); living with relatives (80.6%) and married (46.3%). They were hypertensive (37.0%), diabetics (18.5%) and both (14.8%). Elderly non-CNCD had WHOQOL-OLD averages higher than the other groups with at least one CNCD, and there was a moderate and statistically significant negative association of the amount of CNCD and quality of life. CONCLUSION: CNCD negatively influence the quality of life of the elderly, and the elderly without chronic disease presented better quality of life when compared to the elderly with the presence of hypertension, diabetes or both, and the fear of dying was the variable that presented greater interference in the quality of life of the elderly.

Neuroprotective anesthesia regimen and intensive management for pediatric cardiac surgery with cardiopulmonary bypass: a review and initial experience

Abstract This article describes our proposal for routine anesthesia, intraoperative medical management, cerebral and physiological monitoring during pediatric cardiac surgery with cardiopulmonary bypass that intend to provide appropriate anesthesia (analgesia, hypnosis), neuroprotection, adequate cerebral and systemic oxygen supply, and preventing against drugs neurotoxicity. A concise retrospective data is presented.

Quantitative Myasthenia Gravis Score: a Brazilian multicenter study for translation, cultural adaptation and validation / Teste Quantitativo para Miastenia Gravis: estudo multicêntrico brasileiro para tradução, adaptação cultural e validação

ABSTRACT Objective To perform the translation, cross-cultural adaptation and validation of the Quantitative Myasthenia Gravis Score (QMGS) to Brazilian Portuguese in accordance with international ethical standards. Methods The following steps were taken: (1) implementation of the translation protocol and transcultural adaptation, (2) validation of the adapted content, and (3) assessment of reliability. To check intra- and inter-observer reproducibility, each patient underwent two interviews with interviewer-A and one with B. The QMGS was compared to the Myasthenia Gravis Composite Scale and Myasthenia-specific Quality of Life Questionnaire. Results Our study group consisted of 30 patients, with a mean age of 47.6±11.4 years and a mean duration of illness of 11.33±8.49 years. Correlation between the QMGS and MGC was very strong (r = 0.928; p < 0.001) and substantial between the QMGS and MG-QOL 15 (r = 0.737; p < 0.001). Conclusion The Brazilian Portuguese translation, and validation of the QMGS was successfully performed.

RESUMO Objetivo O objetivo foi realizar a tradução e validação do teste quantitativo para Miastenia Gravis (QMGS) para Português do Brasil, de acordo com as diretrizes internacionais. Métodos Foram realizadas as etapas de implementação do protocolo de tradução e adaptação transcultural, validação do conteúdo adaptado e avaliação da confiabilidade. Para verificar a reprodutibilidade intra e inter-observador cada paciente foi submetido a duas entrevistas por um entrevistador-A e um B. O QMGS foi comparado ao MG Composite Scale e Myasthenia-specific Quality of Life Questionnaire. Resultados O estudo inclui 30 pacientes, com a média de idade de 47,6±11,4 anos e tempo médio de doença de 11,33±8,49 anos. A correlação entre QMGS e MGC apresentou-se muito forte (r = 0,928; p < 0,001) e substancial entre QMGS e MG-QOL 15 (r = 0,737; p < 0,001). Conclusão A tradução, e validação do QMGS para o português do Brasil foi realizada com sucesso.

La información situacional probabilística en el deporte: un metaanálisis / Situational probability information in sport: A meta-analysis

Resumen El objetivo del estudio es cuantificar el efecto de la información situacional probabilística (ISP) sobre el rendimiento deportivo y en concreto sobre el inicio en el tiempo de respuesta y la precisión de los deportistas. Existe evidencia científica de que los deportistas de mayor nivel deportivo desarrollan la habilidad perceptiva para usar la ISP, realizando comportamientos anticipatorios, si bien se desconoce la magnitud de dicho efecto. Se realiza un metaanálisis de efectos aleatorios para cuantificar el tamaño del efecto (TE) de la ISP en el comportamiento motor de los deportistas. Los resultados muestran un TE medio final grande de 1.29 para el tiempo de respuesta (en 7 estudios y 252 participantes) y de 1.31 para la precisión (en nueve investigaciones y 292 participantes), seleccionados de acuerdo con los criterios establecidos. Con la limitación del reducido número de estudios analizados (n = 9), los resultados indican que los deportistas expertos anticipan más respuestas y con más precisión que los noveles debido al uso de la ISP. Se recomienda entrenar perceptivamente la identificación y el uso de la ISP a nivel deportivo, ya que aquellos deportistas que hagan un mejor uso de esta información contextual podrán anticipar sus respuestas con precisión.

Abstract The aim of the study is to quantify the effect of Situational Probability Information (SPI) on athletic performance, specifically on the onset of the response time and the accuracy of athletes. There is scientific evidence that shows that higher sport level athletes develop the perceptive skills to use SPI, thereby performing anticipatory behaviors. However, the magnitude of this effect remains unknown. A meta-analysis of random effects was carried out to quantify the effect size (ES) of SPI on the motor behavior of athletes. The results showed an overall final mean ES of 1.29 for the response time (in 7 studies and 252 participants), and 1.31 for accuracy (in 9 studies and 292 participants), according to the criteria established. With the limitation of the low number of studies analyzed (n = 9), the results suggest that expert athletes anticipate more frequently and with higher accuracy than beginners, due to the use of SPI. It is recommended to train in the identification and use of the SPI in the sports domain, as athletes who use this contextual information more effectively could anticipate the responses with precision.

Brazilian-Portuguese translation, cross-cultural adaptation and validation of the Myasthenia Gravis Composite scale. A multicentric study / Tradução, adaptação cultural e validação da escala composta de Miastenia Grave para a lingua portuguesa do Brasil. Estudo multicêntrico

ABSTRACT Objective To perform the translation, cultural adaptation and validation of the Myasthenia Gravis Composite (MGC) scale in Brazil. Methods The study was conducted at three neuromuscular disease research centers in accordance with the international ethical standards, following a multi-modal approach and was conducted in three steps consisting of translation, cultural adaptation, and validation according to international guidelines. The final version of the MGC was applied in a sample of 27 MG patients and the total score was compared to a Portuguese version of the MG-QOL-15. Results The internal consistency verified by Cohen’s Kappa test was excellent (0.766). The correlation between the MGC and MG-QOL-15 was strong (R = 0.777; p = 0.000). No significant differences were found between the responses of patients in the first and second applications of the MGC. Conclusion The MGC scale, validated into Brazilian Portuguese, has proven to be a reliable instrument that is easy to use, and is highly reproducible.

RESUMO Objetivo Realizar a tradução e a adaptação transcultural da escala composta de Miastenia Grave (ECMG) Myasthenia Gravis Composite (MGC) no Brasil. Métodos O estudo foi realizado em três centros de investigação em doenças neuromusculares, de acordo com as normas éticas internacionais, consistindo em tradução, adaptação cultural e validação de acordo com as diretrizes internacionais. A versão final do MGC ECMG foi aplicada em vinte e sete pacientes com MG e a pontuação total foi comparada ao questionário MG-QOL 15. Resultados A consistência interna verificada pelo teste Kappa de Cohen foi excelente (0,766) e a correlação entre o a ECMG MGC e MG-QOL 15 foi positiva (R = 0,777; p = 0,000). Não foram encontradas diferenças entre as respostas dos pacientes na primeira e segunda aplicação da MGC. Conclusão A ECMG escala MGC validada para o Português do Brasil provou ser um instrumento confiável, de fácil aplicação e altamente reprodutível.

Nocturnal oxyhemoglobin desaturation during sleep in congestive heart failure patients / Dessaturação da oxihemoglobina durante o sono em pacientes com insuficiência cardíaca congestiva

Abstract Introduction: Sleep breathing disorders occur in 45% of patients with heart failure, with 36%-50% manifesting Cheyne-Stokes respiration with central sleep apnea and 12% exhibiting obstructive sleep apnea. Several studies have shown that sleep pathophysiology may negatively affect the cardiovascular system and that cardiac dysfunction alters sleep and respiration. Objective: The aim of this study was to examine oxyhemoglobin desaturation during sleep in patients with congestive heart failure (CHF) using overnight pulse oximetry. Methods: Overnight pulse oximetry was conducted in the patients' homes with wrist pulse oximeters and finger probes that were placed around the forefingers of 15 patients with CHF and ejection fractions less than 50%, who were classified as New York Heart Association functional classes II and III. Results: The patients were divided into two groups. The first group consisted of seven patients with oxyhemoglobin desaturation indices of over 5 events/h, and the second group contained eight patients with oxyhemoglobin desaturation indices of 5 or less events/h. Student's t-tests did not show any significant differences between the groups. The patients' body mass indices correlated positively with the total desaturation episodes and desaturation time less than 90% and correlated negatively with the arterial oxygen saturation nadir. Conclusion: Pulse oximetry monitoring during sleep can be used to detect sleep breathing disorders in stable patients with CHF.

Resumo Introdução: Os distúrbios respiratórios do sono ocorrem em 45% dos pacientes com insuficiência cardíaca, com 36%-50% manifestando respiração Cheyne-Stokes com apneia do sono central e 12% exibindo apneia obstrutiva do sono. Vários estudos têm demonstrado que a fisiopatologia do sono pode afetar negativamente o sistema cardiovascular e que a disfunção cardíaca altera o sono e a respiração. Objetivo: Examinar a dessaturação da oxihemoglobina durante o sono em pacientes com insuficiência cardíaca congestiva (ICC), utilizando a oximetria de pulso durante a noite. Métodos: A oximetria de pulso noturna foi realizada nas casas dos pacientes com oxímetros de pulso acoplados ao redor dos dedos indicadores de 15 pacientes com ICC e fração de ejeção menor que 50%, sendo classificados pelo New York Heart Association como classes funcionais II e III. Resultados: Os pacientes foram divididos em dois grupos. O primeiro grupo era composto por sete pacientes com índices de dessaturação da oxihemoglobina (IDO) maior que 5 eventos/h e o segundo grupo continha oito pacientes com IDO igual ou menos que 5 eventos/h. Testes t de Student não apresentou diferenças significativas entre os grupos. Os índices de massa corporal dos pacientes foram positivamente correlacionados com o total de episódios de dessaturação e tempo de dessaturação inferior a 90% e negativamente com a saturação de oxigênio arterial. Conclusão: O monitoramento da oximetria de pulso durante o sono pode ser usado para detectar distúrbios respiratórios do sono em pacientes estáveis com ICC.