Prevalence, Characteristics and Socio-Demographic Correlates of Self-Stigma among Leprosy Affected Persons - A Case Study

This study has determined the prevalence of self-stigma, its characteristics in terms of alienation, stereotype endorsement, perceived discrimination and social withdrawal and stigma resistance among leprosy-affected persons and its relationship and extent of this relationship with various socio-demographic features. This has been done by carrying out a cross-sectional survey of 120 active people affected by leprosy during 2020-21. An internationally validated and standardised instrument (ISMI) was used to measure self-stigma. Statistical techniques such as independent t-test, Pearson’s and point biserial correlation and regression analysis were used for data analysis. The study found significant correlations between ISMI self-stigma scores and socio- demographic variables with moderate to minor deviation across the four components of the ISMI scale. The high to low correlation of various components of the ISMI scale found is discrimination experience, followed by stigma resistance, stereotype endorsement and alienation. Overall, the highest self-stigma was found in disabled people affected by leprosy, followed by those whose age was less than 40 years, followed by unemployed and male people affected by leprosy. It was concluded that alienation was maximum among people affected by leprosy who were either disabled, aged less than 40 years or were males. Discrimination experience was reported mainly by unemployed, disabled, males and younger people affected by leprosy. The findings indicate that proper methodology and components of Cognitive Behavioural Therapy may help reduce self-stigma among leprosy-affected persons

Qualidade de vida e comportamentos durante a pandemia da COVID-19: Um estudo transversal / Quality of life and behaviors during the COVID-19 pandemic: A cross-sectional study

Pesquisa transversal com objetivo de analisar a associação entre qualidade de vida e comportamentos desenvolvidos por indivíduos hipertensos durante o período de isolamento social, devido à pandemia da COVID-19. O estudo foi realizado através de ligações telefônicas e avaliou adultos cadastrados na atenção primária de saúde. A prática de atividade física foi avaliada pelo Questionário Internacional de Atividade Física, sendo somadas a duração e a frequência das atividades e o tempo total sentado durante a semana e fim de semana. A qualidade de vida foi analisada através do Sistema Descritivo ­ EQ-5D, considerando o score utilidade e o estado geral de saúde. Presença de doenças e comportamentos durante o isolamento social, assim como aspecto emocional e ambiente para realização de atividades físicas foram analisados. Foram utilizados os testes t de Studant e ANOVA one way para comparação de grupos e ANCOVA para comparações entre os grupos ajustadas. A significância estatística foi pré-fixada em valores inferiores a 5%. Foram entrevistados 659 hipertensos, com idade entre 41 e 93 anos. Observou-se maior qualidade de vida naqueles que praticaram exercício físico (p = 0,015), que não relataram ter a saúde emocional afetada pela pandemia (p = 0,001) e que responderam ter ambiente favorável em casa para prática de atividade física, (p = 0,001). Em conclusão, a qualidade de vida associou-se aos comportamentos positivos dos participantes durante a pandemia, como a prática de atividade física, contudo é necessário que os órgãos públicos se atentem aos baixos níveis de atividade física da população provocados pela pandemia

Cross-sectional research with the objective of analyzing the association between quality of life and behaviors developed by hypertensive individuals during the period of social isolation, due to the COVID-19 pandemic. The study was carried out through telephone calls and evaluated adults registered in primary health care. The practice of physical activity was assessed by the International Physical Activity Questionnaire, adding the duration and frequency of activities and the total time sitting during the week and weekend. Quality of life was analyzed using the Descriptive System ­ EQ-5D, considering the utility score and general health status. Presence of diseases and behaviors during social isolation, as well as the emotional aspect and environment for carrying out physical activities were analyzed. Student's t-test and one-way ANOVA were used for group comparisons and ANCOVA for adjusted between-group comparisons. Statistical significance was pre-set at values below 5%. 659 hypertensive adults aged between 41 and 93 years were interviewed. A better quality of life was observed in hypertensive individuals who practiced physical exercise (p = 0.015), who did not report having their emotional health affected by the pandemic (p = 0.001) and who responded that they had a favorable environment at home for the practice of physical activity, (p = 0.001). In conclusion, QoL was associated with the positive behaviors of the participants during the pandemic, such as the practice of physical activity, however, it is necessary for public agencies to pay attention to the low levels of PA in the population caused by the pandemic

Corpo afetado: uma experiência de autorrastreamento com uma tecnologia vestível / Affected body: a self-tracking experience with a wearable technology / Cuerpo afectado: una experiencia de autoseguimiento con una tecnología vestible

RESUMO Este artigo explora a produção de significados sobre prática de dados na cultura digital a partir de uma experiência de autorrastreamento de exercícios físicos. O objetivo é problematizar a emergência de um corpo que afetou e foi afetado por uma tecnologia vestível durante uma experiência de autorrastreamento. Metodologicamente, o trabalho seguiu o formato de um relato ator-rede pautado por uma vivência de autorrastreamento. Em sua composição analítica-descritiva, o texto articula elementos da Teoria Ator-Rede e conceitos que enredam estudos de autorrastreamento como prática de dados. Foi possível identificar mobilizadores do "faz-fazer" produzido nas múltiplas afetações de um corpo híbrido, performativo e sensível às diferenças registradas no mundo.

ABSTRACT This article explores the production of meanings about data practices in digital culture based on an experience of self-tracking physical exercises. The aim is to problematize the emergence of a body that affected and was affected by a wearable technology during a self-tracking experience. Methodologically, the work followed the format of an actor-network report guided by an experience of self-tracking. In its analytical-descriptive composition, the text articulates elements of the Actor-Network Theory and concepts that entangle self-tracking studies as a data practice. It was possible to identify mobilizers of the "making-do" produced in the multiple affectations of a hybrid body, performative and sensitive to the differences registered in the world.

RESUMEN Este artículo explora la producción de significados sobre práctica de datos en la cultura digital a partir de una experiencia de autoseguimiento de ejercicios físicos. El objetivo es problematizar la emergencia de un cuerpo que afectó y fue afectado por una tecnología vestible durante una experiencia de autoseguimiento. Metodológicamente, el trabajo siguió el formato de un informe actor-red pautado por una experiencia de autoseguimiento. En su composición analítico-descriptiva, el texto articula elementos de la Teoría del Actor-Red y conceptos que enredan estudios de autoseguimiento como práctica de datos. Fue posible identificar movilizadores del 'hace-hacer' producido en las múltiples afectaciones de un cuerpo híbrido, performativo y sensible a las diferencias registradas en el mundo.

Experience in the Treatment of Reverse Psoriasis Based on Location-Based Syndrome Differentiation / 中医杂志

To summarize the experience in treating reverse psoriasis based on location-based syndrome differentiation. It is believed that the main pathological factors in the onset of reverse psoriasis are dampness， heat， stasis， and toxins. In clinical practice， treatment is tailored based on the location-based syndrome differentiation and treatment according to the presence of dampness， heat， stasis， and toxins. For cases that manifest predominantly in the upper body with wind-heat attacking the surface， the treatment focuses on clearing heat， dispersing wind， and relieving itching， and a self-designed Sanhua Decoction （三花汤） is used. Alternatively， for cases with blood heat accumulating and stagnation， the treatment emphasizes on clearing heat and toxins， and cooling blood to eliminate skin lesions， and self-designed Sancao Decoction （三草汤） is employed. For cases that mainly affect the middle part of the body with damp-heat stagnating in the spleen， the treatment focuses on clearing heat， resolving toxins， and drying dampness while invigorating the spleen， and a self-designed Sanhuang Decoction （三黄汤） is applied. For cases with stasis and heat intertwining， the treatment aims to resolve stasis， clear heat， and activate collaterals while detoxifying， and a self-designed Santeng Decoction （三藤汤） is used. For cases that predominantly affect the lower part of the body with damp-heat descending， the treatment focuses on detoxification， eliminating dampness， and clearing and promoting the lower jiao， and a self-made Sanling Decoction （三苓汤） is used. For cases with cold and dampness accumulating and toxins， the treatment emphasizes on warming yang， supplementing qi， and detoxification while eliminating dampness， and a self-made Sanshen Decoction （三参汤） is prescribed.

Factors Influencing Leprosy-Affected People for Migration, Distant Registration and their Effect on Leprosy Services in Bangladesh

The research investigated factors affecting migration, distant registration and their expected effects on leprosy service in Bangladesh. This qualitative study was conducted from April 2018 to September 2019. 130 leprosy-affected people (LAP) were selected for in-depth interview (IDI) and 23 professionals for Key informant's interview. A Semi-structured interview guide was used for data collection. Different factors were identified by key informants (KIs) and IDI participants (IDIPs) both for migration and for distant registration. Main factors for migration of LAP, mentioned by both groups, were fear of social exclusion. Lack of treatment facilities under the treatment category, job transfer under financial category and marriage under the personal category are the other main influencing factors for migration. Reasons for leprosy cases registering in distant places are similar to reasons for migration: lack of expert professionals under treatment category, relatives' influence under the personal category and job transfer under the financial category. It is concluded that migration and distant registration should be considered in studying the geographical distribution of leprosy. Interpretations proposed by key informants may not reflect the actual field situation. The opinions of those directly affected by leprosy should be sought and heeded in designing and evaluating leprosy programmes.

Effect of silver diamine fluoride, potassium iodide, and glutathione on micro-shear bond strength of glass ionomer cement to caries affected dentine

Background: Silver diamine fluoride (SDF, 38%) is an efficient topical fluoride used to arrest dental caries though it causes black staining of both teeth and restoration. The application of potassium iodide (KI) after SDF reduces the stain, but the color change is only temporary. An alternative method suggested is by mixing glutathione (GSH) with SDF, which preserves the silver ions of SDF within the solution. Hence, the purpose of this in vitro study was to evaluate the microshear bond strength (?SBS) of glass ionomer cement (GIC) to caries affected dentin (CAD) pretreated with SDF/KI/GSH. Materials and Methods: Thirty dentine slices of 2 mm thickness from human permanent upper premolars were demineralized using pH cycling method to mimic CAD. They were allocated to three groups of 10 each and treated with SDF, SDF-KI (SDF followed by KI), SDF + GSH (SDF mixed with GSH), respectively. Specimens were bonded with GICs. The ?SBS was assessed using a universal testing machine and the data obtained were analyzed using one-way ANOVA and Tukey's post hoc test. Results: The ?SBS (mean ± standard deviation) values for groups SDF, SDF-KI, and SDF + GSH were 4.81 ± 2.026, 5.78 ± 1.809, 8.18 ± 2.828 megapascal respectively. Group 3 showed significantly better bond strength compared to groups 1 and 2. In group 2, the addition of KI showed better bond strength when compared to group 1, but the difference was not statistically significant. Conclusion: Pretreatment of teeth with GSH along with SDF application showed significantly better bond strength of GIC to CAD compared to SDF and SDF-KI.

How people affected by Chagas disease have struggled with their negligence: history, associative movement and World Chagas Disease Day

It is well documented that Chagas disease (CD) can pose a public health problem to countries. As one of the World Health Organization Neglected Tropical Diseases undoubtedly calls for comprehensive healthcare, transcending a restricted biomedical approach. After more than a century since their discovery, in 1909, people affected by CD are still frequently marginalised and/or neglected. The aim of this article is to tell the story of their activism, highlighting key historical experiences and successful initiatives, from 1909 to 2019. The first association was created in 1987, in the city of Recife, Brazil. So far, thirty associations have been reported on five continents. They were created as independent non-profit civil society organisations and run democratically by affected people. Among the common associations' objectives, we notably find: increase the visibility of the affected; make their voice heard; build bridges between patients, health system professionals, public health officials, policy makers and the academic and scientific communities. The International Federation of Associations of People Affected by CD - FINDECHAGAS, created in 2010 with the input of the Americas, Europe and the Western Pacific, counts as one of the main responses to the globalisation of CD. Despite all the obstacles and difficulties encountered, the Federation has thrived, grown, and matured. As a result of this mobilisation along with the support of many national and international partners, in May 2019 the 72nd World Health Assembly decided to establish World Chagas Disease Day, on 14 April. The associative movement has increased the understanding of the challenges related to the disease and breaks the silence around Chagas disease, improving surveillance, and sustaining engagement towards the United Nations 2030 agenda.

Guía de prácticas para enfermería en la atención a los cuidadores de pacientes con demencia / A Nursing Practice Guide for Attending Caregivers of Dementia Patients

Introducción: A partir de las necesidades de enfermería es posible realizar el trabajo comunitario con pautas a seguir de manera organizada, teniendo en cuenta que estén vinculadas con la promoción de salud. Objetivo: Diseñar una guía de prácticas para Enfermería en la atención al cuidador de pacientes con demencia. Métodos: Investigación de desarrollo tecnológico, se trabajó con un universo de 80 cuidadores principales y cinco enfermeras del departamento de Salud Mental del municipio de Marianao, La Habana, en el período del 2016-2017, se utilizaron como técnicas la revisión documental, encuestas, la escala de Zarit y consulta a expertos. Resultados: Los cuidadores fueron mayoritariamente los hijos, del sexo femenino, amas de casas, con nivel de escolaridad universitario y todos habían experimentado ansiedad y depresión. Las tres primeras necesidades humanas de enfermería afectadas fueron: la comunicación, el autocuidado, el sueño y el descanso, más de la mitad presentaron sobrecarga intensa. Se identificó que el personal de enfermería requiere conocimientos para la atención al cuidador, lo que justificó la elaboración de la guía. Conclusiones: Se reconoció una sobrecarga intensa y necesidades de enfermería afectadas descritas por Virginia Henderson en los cuidadores principales, lo que permite realizar acciones de promoción de salud y prevención de enfermedades a través de la guía de prácticas para enfermería, que se sometió a validación por expertos(AU)

Introduction: Based on nursing needs, community work can be carried out following organized guidelines, taking into account that they are associated to health promotion. Objective: To design a nursing practice guide for attending the caregivers of dementia patients. Methods: In this technological development research, we worked with a population of 80 main caregivers and five nurses from the Mental Health department of Marianao Municipality, Havana, in the period 2016-2017. Document review and the survey were used as techniques, together with the Zarit scale and consults to experts. Results: The caregivers were mainly the children, belonged to the female sex, were housewives, with university education, and all had experienced anxiety and depression. The first three human nursing needs affected were communication, self-care, sleep, and rest, more than half the group presented intense overburden. The nursing staff was identified to requires knowledge for attending the caregiver, which justified the guide preparation. Conclusions: Intense overburden and affected nursing needs were observed, as described by Virginia Henderson for the main caregivers, which allows health promotion and disease prevention actions to be carried out through the nursing practice guide, which was validated by experts(AU)

Effect of Using Biomimetic Analogs on Dentin Remineralization with Bioactive Cements

Abstract This study evaluated the impact of using biomimetic analogs (poly-acrylic acid and sodium tri-meta-phosphate) on dentin remineralization using two cement materials, the first is calcium silicate based and the second is calcium hydroxide based materials. Two standardized occlusal cavities (mesial and distal) were prepared within dentin after removal of occlusal enamel. Artificial demineralized dentin was induced through pH cycling (8 h in demineralizing and 16 h in remineralizing solutions). Demineralized cavities were divided into four groups; two groups received cement materials. The other groups were first treated with biomimetic analogs then restored with pulp cement materials. Teeth were sectioned buccolingually into two halves. Treated cavities with analogs were stored in simulated body fluid containing poly-acrylic acid. Untreated cavities were stored in simulated body fluid only. Ground unstained sections of demineralized dentin were examined using light microscope. Specimens were examined after 1, 6 and 12 weeks of storage using energy dispersive X-ray Spectroscopy (EDX) and Vickers microhardness was evaluated. Two-way ANOVA was used to analyze data statistically. Calcium silicate-based cement group with biomimetic analogs showed the highest statistically significant calcium and phosphorous wt% in addition to highest surface hardness values after 12 weeks of storage. Demineralized dentin ground sections showed increase in light zones after total period of storage. Calcium silicate-based cement showed the best ability to enrich the artificial carious dentin with ions for remineralization. Using biomimetic analogs had a significant impact on demineralized dentin surface hardness improvement.

Resumo Este estudo avaliou o impacto do uso de análogos biomiméticos (ácido poli-acrílico e tri-meta-fosfato de sódio) na remineralização da dentina usando dois materiais de cimento, o primeiro à base de silicato de cálcio e o segundo à base de hidróxido de cálcio. Duas cavidades oclusais padronizadas (mesial e distal) foram preparadas na dentina após a remoção do esmalte oclusal. A dentina desmineralizada artificial foi induzida por ciclagem de pH (8 h em soluções desmineralizantes e 16 h em soluções remineralizantes). Cavidades desmineralizadas foram divididas em quatro grupos; dois grupos receberam materiais de cimento. Os outros grupos foram tratados primeiro com análogos biomiméticos e depois restaurados com materiais de cimento de celulose. Os dentes foram seccionados bucolingualmente em duas metades. As cavidades tratadas com análogos foram armazenadas em fluido corporal simulado contendo ácido poli-acrílico. As cavidades não tratadas foram armazenadas apenas em fluido corporal simulado. Secções não coradas de dentina desmineralizada foram examinadas usando microscópio óptico. As amostras foram examinadas após 1, 6 e 12 semanas de armazenamento usando Espectroscopia de Raios-X dispersiva por energia (EDX) e microdureza Vickers. ANOVA a dois fatores foi usada para analisar os dados estatisticamente. O grupo de cimento à base de silicato de cálcio com análogos biomiméticos apresentou os maiores percentagens em peso estatisticamente significantes de cálcio e fósforo, além dos maiores valores de dureza superficial após 12 semanas de armazenamento. Seções desmineralizadas de dentina mostraram aumento nas zonas de luz após o período total de armazenamento. O cimento à base de silicato de cálcio mostrou a melhor capacidade de enriquecer a dentina cariada artificial com íons para remineralização. O uso de análogos biomiméticos teve um impacto significativo na melhoria da dureza superficial da dentina desmineralizada.

"isso é tirar a vida das pessoas": barragens e violação de direitos / "eso es quitarle la vida a las personas": represas y violación de derechos / "this is taking people's lives": dams and violation of rights

Resumo Este estudo possui o objetivo de analisar as interfaces entre a implantação da hidrelétrica de Itá em Santa Catarina e a violação dos Direitos Humanos de agricultores atingidos pela obra que permaneceram residindo no entorno reservatório após a finalização do empreendimento. O estudo, de cunho qualitativo, fundamentou-se na pesquisa participante. A coleta de dados iniciou em fevereiro de 2016 e foi concluída em dezembro do mesmo ano. Foram entrevistadas 12 pessoas atingidas pela construção da barragem de Itá, além de observações participantes periódicas em toda região rural do entorno do reservatório. Os dados obtidos foram submetidos à análise de conteúdo. Os resultados da pesquisa apontam que, os participantes do estudo tiveram violados os direitos à saúde, educação, emprego e infraestrutura, perdendo também projetos de vidas. Portanto, é necessário atentar para o atual formato de implantação de barragens construindo políticas públicas que garantam os direitos das populações atingidas por estes empreendimentos.

Resumen El objetivo del estudio es analizar las relaciones entre la implantación de la hidroeléctrica de Itá, en Santa Catarina, y la violación de derechos humanos de agricultores que permanecieron viviendo en el entorno del embalse tras su finalización y que fueron afectados por él. El estudio, de tipo cualitativo, se fundamentó en la investigación participativa. La recolección de datos empezó en febrero de 2016 y concluyó en diciembre del mismo año. Se entrevistaron a 12 personas afectadas por la construcción de dicha represa, además de la realización de periódicas observaciones participantes en su entorno rural. Los datos obtenidos fueron sometidos al análisis de contenido. Los resultados demostraron que los entrevistados sufrieron violación de derechos a salud, educación, empleo e infraestructura, perdiendo, incluso, proyectos de vida. Así, es necesario examinar las actuales formas de implantación de represas a través de políticas públicas que garanticen los derechos de las poblaciones afectadas.

Abstract This study aims to analyze the interfaces between the implementation of Itá hydroelectric power plant in the Brazilian state of Santa Catarina and the violation of human rights of the farmers who remained living in the reservoir's surrounding area after the project was finished and who were affected by it. The qualitative study was based on participant research. Data collection began in February 2016 and was completed in December of the same year. Twelve people affected by the construction of Itá dam were interviewed, and there were periodic participant observations in all rural areas surrounding the reservoir. Data were submitted to content analysis. Research results indicated that the research participants had their rights to health, education, employment and infrastructure violated, losing also their life projects. Therefore, it is necessary to focus on the current model for dam implantation by developing public policies that ensure the rights of populations affected by these enterprises.

Acupuncture at pharyngeal acupoints for true bulbar paralysis after cerebral infarction: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical effect of acupuncture at the affected side and both sides of the pharyngeal acupoints for true bulbar paralysis after cerebral infarction.@*METHODS@#A total of 66 patients with true bulbar paralysis after cerebral infarction were randomly divided into an unilateral group and a bilateral group, 33 cases in each group, 1 case dropped off in each group at last. On the basis of conventional drugs and electro-nape-acupuncture treatment, the patients in the unilateral group were treated with acupuncture at the affected side's , and (Extra), while patients in the bilateral group were treated with acupuncture at the both sides' , and The treatment was performed once a day, 6 days a week, and the clinical effect was assessed after 21-day therapy. The swallowing and vocalization of the two groups were evaluated by dysphagia grading scale, Kubota water swallowing test and GRBAS grading scale before and after treatment.@*RESULTS@#After 21 days of treatment, the scores of the dysphagia grading scale in the two groups were both improved (<0.01), and the unilateral group was superior to the bilateral group (<0.01). The GRBAS grading scale and Kubota water swallowing test grading after treatment were improved in both groups (<0.01), and the unilateral group was superior to the bilateral group (<0.05, <0.01).@*CONCLUSION@#Acupuncture at the pharyngeal acupoints of the affected side achieves much better therapeutic effect on true bulbar paralysis as compared with the acupoints of the bilateral sides.

As dificuldades da participação: desencontro de interesses na recuperação do rio doce / The difficulties of participation: interests mismatchs in rio doce recovery / Las dificultades de la participación: desencuentro de intereses en la recuperación del rio doce / Les difficultés de la participation: intérêts introuvable dans la récupération de rio doce

O exame de experiência de implementação de uma tecnologia participativa (CRCMOP) nas comunidades atingidas pelo desastre do Rio Doce, no Espírito Santo, ao longo de dois anos, permite atentar para as dificuldades da participação da população atingida na governança da gestão do desastre, especificamente na definição das ações de reparação, compensação e indenização a serem realizadas pela Fundação Renova. Argumentamos que a formulação de demandas e sua projeção às instituições competentes para acolhe-las e lhes dar resposta depende de pressupostos relativos a duas dimensões: cognitivo simbólica e sócio- institucional. Ambas, em boa medida, ausentes no caso das comunidades atingidas, particularmente daquelas situadas na foz do rio. Por isso, argumentamos, a gestão do desastre socioambiental ocasionado pelo rompimento da barragem de Fundão acusa uma forma peculiar de desencontro de interesses entre comunidades atingidas e instituições incumbidas dessa gestão. As dificuldades diagnosticadas podem ser comuns a outros contextos de grandes desastres.

Examining the experience of implementing a participatory technology (CRCMOP) in the communities affected by the Rio Doce disaster in Espírito Santo over two years reveals the difficulties of affected population participation in disaster management governance, specifically in taking part in the definition of reparation, compensation and indemnity measures to be carried out by the Renova Foundation. We argue that the formulation of claims and their statement vis-à-vis the competent institutions that are supposed to receive and respond to them depends on assumptions concerning two dimensions: symbolic-cognitive and socio-institutional. Both are largely absent in affected communities, particularly those at the mouth of the river. Therefore, we argue, the management of the socio-environmental disaster caused by the Fundão dam burst rupture presents a peculiar form difficulty: a mismatch of interests between affected communities and institutions responsible for managing it. Diagnosed difficulties may be common to other major disaster contexts. These difficulties, here diagnosed, may also be common to other major disaster contexts.

El examen de una experiencia de implantación de una tecnología participativa (CRCMOP) en las comunidades afectadas por el desastre del Rio Doce (Espírito Santo), durante dos años, permite iluminar las dificultades de la participación de la población afectada en la gobernanza de la gestión del desastre, específicamente, en las acciones de reparación, compensación e indemnización que debe realizar la Fundación Renova. Argumentamos que la formulación de demandas y su proyección hacia las instituciones competentes para acogerlas y darles respuesta depende de presupuestos relativos a dos dimensiones: cognitivo-simbólica e socio-institucional. Ambas, en buena medida, ausentes en el caso de las comunidades afectadas, particularmente de aquellas situadas en la boca del rio. Argumentamos que la gestión del desastre socioambiental causado por la ruptura de la presa de Fundão acusa una forma peculiar de desencuentro de intereses entre comunidades afectadas e instituciones responsables por esa gestión. Las dificultades diagnosticadas pueden ser comunes a otros contextos de grandes desastres.

L'examen d'une expérience de mise en oeuvre d'une technologie participative (CRCMOP) dans les communautés affectées par la catastrophe de Rio Doce (Espirito Santo) au cours des deux années, nous permet d'éclairer les difficultés dela participation despersonnes affectées dans la gestion de la catastrophe, en particulier, dans les actions de réparation et d'indemnisation qui doivent être menées par la Fondation Renova. Nous soutenons que la formulation des demandes a les institutions responsable de recevoir les demandes et d'y répondre dépend a deux conditions concernant a les dimensions cognitive-symbolique et socio-institutionnelle. Les deux sont, dans une large mesure, absents dans le cas des communautés affectées, en particulier celles situées à l'embouchure de la rivière du Doce. Nous soutenons ausssi que la gestion de la catastrophe socio-environnementale causée par la rupture du barrage de Fundão montre une forme particulière de décalage des intérêts entre les communautés affectées et les institutions responsables de cette gestion. Les difficultés diagnostiquées peuvent être communes à d'autres contextes de catastrophes majeures.

Health Status of Leprosy Affected People in Rehabilitation Colonies of Uttarakhand

In the post elimination era for leprosy in India, with changing disease epidemiology and controlled incidence rates, now the focus must shift to rehabilitative strategies for leprosy affected persons (LAP) residing in leprosy rehabilitation colonies. For this, firstly it is important to reassess their socioeconomic and health status before making any recommendations. This study has been conducted among 137 LAP residing in 7 such colonies in Uttarakhand, who were interviewed on a predesigned, pretested questionnaire with aims to study the overall health status of LAPs, to assess their awareness about the disease and to assess their access to various health facilities and make recommendation for their rehabilitation. Out of 137 participants, 72% belonged to 41-80 years' age group. 85% of study participants were either illiterate or had less than or equal to primary education. More than half of the participants were engaged in begging. 87% LAPs had disabilities in hands and feet, 28.3% had disability in eyes. 24% participants had BMI <18.5. 13.9% participants had diabetes, 28.5% - Hypertension, and 13.1% had history of Tuberculosis. NGO's hospital/ private clinic is the nearest health facility for 62.8% of LAPs. Although all inhabitants (100%) are getting support from the government in form of land for rehabilitation colonies, disability cards etc., however, 44.53% had not been visited by any government functionary in the last month indicating need for proper supervision. Socioeconomic and health status of LAPs was found to be poor with most being illiterate, disabled, having comorbidities like diabetes mellitus. Strategies should be considered to improve the access to government services and developing collaboration with certain NGO's for strengthening of health infrastructure and administration, disability care and rehabilitation.

Factors Influencing Participation Restrictions among Persons Affected by Leprosy

To compare the factors associated with the participation restriction of person affected by leprosy in cross cultural contexts, this study was carried out from four states viz. Uttar Pradesh (UP), Chhattisgarh (CG), Andhra Pradesh (AP) and Tamil Nadu (TN) during the period from 2016 to 2017. Cross sectional study design was used in this study using the standardized Participation scale, along with socio-demographic variables were analysed for a total of 379 persons affected by leprosy. The findings from each state were compared with other states. The study concludes that participation restrictions are highly influenced by education and type of occupation in most of the states. The variables such as gender, age, locality and disability are moderately affecting the participation restrictions in some states. Income groups and Type of membership are affecting the participation restrictions in some states compared with others. The variables such as marital status, Religion and caste has no specific influence on participation restriction. Diverse influence of independent factors observed among various states indicates the need of independent strategies for each state to address the underlying cultural issues and challenges.

Prácticas pa ra la prevención de accidentes en el hogar en cuidadores de niños de 1 a 5 años en un barrio de Cartagena (Colombia) / Practices for the prevention of accidents in the home in caregivers of children from 1 to 5 years in a district of Cartagena (Colombia)

Introducción: los accidentes en la población infantil constituyen una importante causa de morbilidad y mortalidad convirtiéndose hoy día en un problema de salud pública mundial, principalmente la población más afectada son los niños en etapa preescolar, por la vulnerabilidad y dependencia del cuidador. Objetivos: describir las prácticas para la prevención de accidentes en el hogar en cuidadores de niños de 1 a 5 años en un barrio de Cartagena (Colombia). Materiales y métodos: estudio cuantitativo descriptivo transversal. Constituido por 354 cuidadores de niños menores de 5 años, se utilizó la técnica de observación y la aplicación del instrumento con base a la práctica N° 15 de AIEPI (Atención Integrada a las Enfermedades Prevalentes de la Infancia). Resultados: socio demográficamente los cuidadores fueron principalmente de género femenino (87%), con 20 ­ 29 años de edad (44,9%), madres de los niños (61,3%), conviven en unión libre (54,2%), son bachilleres (50,3%), de estrato uno (91,8%), amas de casa (62,7%), con hijos (93,8%), residen en casas (54,5%). Los niños de 1 a 5 años fueron mayoritariamente de género masculino (51,7%), y han presentado accidentes (75,1%), sobre todo, caídas (61,9%). El nivel de riesgo de accidentes en el hogar fue bajo (85%), y las prácticas de prevención suelen ser regulares (55,1%). Conclusión: los niños enfrentan relativamente bajo riesgo de accidente en el hogar, sin embargo, las prácticas para prevenirlos resultan ser regulares..(AU)

Introduction: accidents in children are an important cause of morbidity and mortality,becoming today a global public health problem, mainly the most affected population are children in preschool, for the vulnerability and dependence of the caregiver. Objectives:to describe the practices for the prevention of accidents at home in caregivers of children from 1 to 5 years of age, in a neighborhood of Cartagena (Colombia). Materials and methods: quantitative, descriptive and cross-sectional study. Consisting of 354 caregivers of children under 5 years of age, the technique of observation and the application of the instrument was used based on practice No. 15 of IMCI (Integrated Management of Childhood Illness). Results: demographic partner caregivers were mainly female (87%), with 20 - 29 years of age (44.9%), mothers of children (61.3%), live together in a free union (54.2%), are high school graduates (50.3%), of stratum one (91.8%), housewives (62.7%), with children (93.8%), reside in houses (54.5%). Children from 1 to 5 years old were male (51.7%), and had accidents (75.1%), especially falls (61.9%). The level of accident risk in the home was low (85%), and prevention practices are usually regular (55.1%). Conclusion: children face relatively low risk of accident in the home, however, practices to prevent them turn out to be regular..(AU)

Relationship of an osteoarthritis of the knee and a knee pain of single-leg on the bilateral difference of ground reaction force in stepping / 体力科学

In this study, we investigated the relationship of an osteoarthritis of the knee (OA) and a knee pain of single-leg on the bilateral difference of ground reaction force in stepping. The subjects were 29 middle-aged women (mean age 63.7±6.7 years). We categorized them into groups based on the following conditions: osteoarthritis of the knee (OA groups; n = 9), knee pain (KP groups; n = 7), and no pain (NP groups; n = 13). We measured the ground reaction force in a vertical direction when stepping on a platform. The evaluation variables were as follows: peak of ground reaction force at the early stance phase (F1), middle phase (F2), and late phase (F3). We calculated the bilateral difference of ground reaction force of the left and right leg and the affected side and the unaffected side ratio. The result of two way ANOVA, there was a significant difference between the leg in F1 and F3 and the group at F2. The result of comparison between the OA groups and the KP groups, there was no significant difference in the unaffected side and the affected side ratio, those in the OA groups tended to have a load on the unaffected side, while those in the KP groups had a load on the affected side. Therefore, it was suggested that there was the relationship of the OA and a knee pain of single-leg on the bilateral difference of ground reaction force in stepping.

Construção de hidrelétricas e populações atingidas no Brasil: uma revisão sistemática / Construction of hydroelectric power plants and affected populations in Brazil: a systematic review

Este estudo possui o objetivo de realizar uma revisão sistemática dos artigos produzidos no Brasil nos últimos dez anos acerca dos grandes empreendimentos hidrelétricos e dos seus impactos às populações atingidas. A busca foi realizada na Biblioteca Virtual em Saúde Psicologia e na Biblioteca Virtual de Saúde. Localizaram-se 329 trabalhos, sendo que 42 deles foram utilizados para o desenvolvimento deste estudo. Os resultados apontaram para uma equidade entre o número de artigos teóricos e empíricos, demonstrando que as revistas com maior número de publicações estão vinculadas a áreas interdisciplinares, envolvendo a geografia, o meio ambiente e a sociologia. Quanto aos principais resultados, identificou-se um declínio geral nas condições de saúde física e mental, a implantação de políticas reparatórias insuficientes e o papel do Movimento dos Atingidos por Barragens como estratégia de resistência social e política.(AU)

This study aims to carry out a systematic review of the articles that have been produced in Brazil in the last ten years about large hydroelectric power plant projects and their impacts on populations directly or indirectly affected. A search for different articles was performed in the Virtual Health Library in Psychology and in the Virtual Health Library. A total of 329 studies were found, and 42 of them were used in this study. The results show evenness between the numbers of theoretical and empirical articles, which demonstrate that journals with the greatest number of publications are linked to interdisciplinary areas, involving geography, environment and sociology. As for the studies' main results, an overall decrease in physical and mental health conditions, the implementation of insufficient reparative policies and the role of the Movement of People Affected by Dams as a strategy of social and political resistance were identified.(AU)

Relationship between Ipsilateral Motor Deficits on the Less-Affected Side and Motor Function Stage on the Affected Side

PURPOSE: Aim of this study was to investigate whether there are ipsilateral motor deficits for visuospatial accuracy and fine movements by making a comparison between stroke patients and healthy subjects. We examined whether ipsilateral motor deficits are influenced by the level of functional movements and muscle strength of the upper and lower extremities of the affected side. METHODS: Thirty post-stroke subjects and 20 normal aged matched subjects were recruited. Outcome measures for less-affected side were the tracking task and nine-hole pegboard test. Fugl-Meyer test and motricity index were applied for the measurement of functional movements and muscle strength of affected side. RESULTS: Tracking task and nine-hole pegboard test was significantly different between control and experimental group. In terms of accuracy index according to tracking, the experimental group showed a lower accuracy index in the MCP joint than the control group. However, there were no significant difference relation between the level of motor function of the affected side and the motor deficit level of ipsilateral side. CONCLUSION: Ipsilateral motor deficits may have significant clinical implications. It needs to be noted that although many patients, families, and medical staff are focused only on motor deficits of the affected side, motor deficits of the sound side can cause difficulties in daily living movements requiring delicate movements. In addition, there was no significant correlation between the level of motor function of the affected side and motor deficits of the sound side.

Effect of caries-affected dentin on one-step universal and multi-step etch-and-rinse adhesives' bond strength / Efeito da dentina cariada na resistência adesiva de um sistema adesivo universal e um de condicionamento ácido total

Objective: To evaluate the influence of caries-affected dentin on bond strength of a universal one-step and a multi-step etch-and-rinse adhesive system. Material and method: Enamel of 60 third human molars with and without caries was removed to expose dentin. The teeth were randomly assigned to six groups: Single Bond Universal (3M ESPE, St. Paul, MN, USA) in etch-and-rinse and in self-etch mode and Prime & Bond NT (Dentsply Co, Konstanz, Germany), all on sound and caries-affected dentin. Smear layer of the 30 sound dentin specimens was standardized by polishing with 600-grit SiC paper under water cooling. Residual infected dentin of the 30 caries-affected specimens was removed with a number 4 CA carbide bur until no caries smooth tissue was detectable by tactile-visual inspection. Cylinders of a light cured composite resin (Filtek Z350 XT, 3M ESPE) were built up using starch tubes and microshear test was performed until failure. The data was analyzed by one-way ANOVA and Tukey's post hoc test. Result: Significant differences in microshear bond strength (μSBS) were observed for the caries-affected groups, but not for sound dentin. The μSBS of Single Bond Universal were not influenced by the application protocol on sound dentin, however they were lower in the caries-affected group with both application protocols. The μSBS for Prime & Bond NT was not influenced by the dentin conditions. Conclusion: Caries-affected dentin decrease in bond strength of Single Bond Universal in comparison to sound dentin. The bond strength of Prime & Bond NT was not altered by substrate conditions.

Objetivo: Avaliar a influência da dentina afetada na resistência de união de um sistema adesivo universal e de um adesivo de condicionamento ácido total acetonado. Material e método: As faces oclusais de 60 terceiros molares humanos, hígidos e cariados, foram removidas a fim de expor o substrato dentinário. Os dentes foram divididos aleatoriamente em 6 grupos: Single Bond Universal (3M Dental Products, Seefeld, Germany), nos protocolos de condicionamento total e autocondicionante, e Prime&BondNT (DentsplyDeTrey, Konstanz, Germany), em dentina hígida e afetada. A smearlayer de 30 espécimes de dentina hígida foi padronizada com lixas de granulação 600. A dentina residual infectada de 30 espécimes foi removida com uma broca carbide número 4 até que nada fosse detectável por uma inspeção clínica. Pinos de resina composta (Filtek Z350 XT, 3M ESPE, St. Paul, MN) foram construídos usando tubos de amido como matriz. O teste de microcisalhamento foi realizado em uma máquina universal de testes até que houvesse a fratura. Resultado: Diferenças significantes foram observadas na resistência de união apenas para os espécimes de dentina afetada. A resistência de união do Single Bond Universal não foi influenciada pelo protocolo de aplicação nos espécimes de dentina hígida, mas diminuiu para os espécimes de dentina afetada, enquanto que o desempenho da adesão do Prime&BondNT não foi influenciada pela condição dentinária. Conclusão: A dentina afetada reduziu a resistência de união do Single Bond Universal, em comparação à dentina hígida. A resistência de união do Prime & Bond NT não foi alterada pela condição dos substratos.

Aprendendo a ser afetado: contribuições para a educação em ciências na educação infantil / Learning to be affected: contributions to science education in early childhood education

RESUMO: O vínculo entre educação científica e educação infantil tem se constituído de modo tímido. Isso porque, muitas vezes, pensa-se equivocadamente que a maneira como a criança pequena interroga e investiga o mundo à sua volta não é apropriada. No entanto, fazendo uso da teoria ator-rede e de sua concepção de aprendizagem, analisamos episódio no qual crianças de 4 e 5 anos estavam engajadas na exploração de pistas deixadas em um jardim de uma Unidade Municipal de Educação Infantil. Nossos achados indicam que as crianças participam ativamente de atividades investigativas e aprendem a ser afetadas pelos elementos constitutivos do espaço designado para a exploração. Além disso, as crianças foram capazes de transformar os objetos tecnológicos disponibilizados em instrumentos científicos. Nossa análise foi possível por romper com uma concepção de aprendizagem como apropriação conceitual. Nesse sentido, procuramos entender a aprendizagem como capacidade de ser afetado e, portanto, como construção de um corpo.

ABSTRACT: The link between Science Education and Early Childhood Education has been constituted in a timid way. This is because it is often thought that the way the young child investigates the world around him/her is wrong or not appropriate. However, using the actor-network theory and its conception of learning in this study, we analyze an episode in which children aged 4 and 5 years old were engaged in the exploration of clues left in the courtyard of a Municipal Unit of Early Childhood Education. Our findings indicate that children actively participate in investigative activities and learn to be affected by the constituent elements of the designated space for exploration. More over, children were able to turn technological objects available on scientific instruments. Through our analysis, we were able to break away from the concept of learning as conceptual appropriation. In that sense, we sought to understand learning as an ability to be affected and, therefore, as building a body.