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Introduction: the COVID-19 pandemic sparked a serious health crisis in which non-essential medical services were suspended, with the management of serious diseases not related to the pandemic, including glaucoma, becoming secondary in importance. With the flexibilization of social isolation measures, resuming outpatient care was necessary, respecting the health equity provided by the Brazilian Unified Health System.Objective: to describe a risk classification of glaucoma progression based on clinical ophthalmology criteria during the COVID-19 pandemic.Methods: observational study of an administrative nature. A review was carried out of the medical records of patients who had scheduled appointments between March and September of 2020 in the glaucoma sector of the FMABC University Center's Department of Ophthalmology. A total of 489 medical records (881 eyes) were reviewed, and patients were divided into 4 groups according to the risk of glaucoma progression. Eyes were evaluated for visual acuity (VA), optic disc cup, pachymetry, intraocular pressure (IOP), mean number of eyes drop medications used, and global visual field indexes.Results: groups were homogeneous in terms of age (mean 67.04 ± 11.72 years) and sex (55.5% women and 44.5% men). Primary open-angle glaucoma was the most prevalent etiology, present in 45.2% of patients, followed by primary angle-closure glaucoma in 15.7%. The groups were compared with each other, and a statistical difference (p<0.005) was found in 04 of the 08 aspects analyzed: VA, optic disc cup, IOP and mean number of eyes drop medications used.Conclusion: the risk classification for progression proposed in this study was easily applied and aided managers in prioritizing the most serious care during the COVID-19 pandemic
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Introduction: fake news is one of the most frequently discussed subjects in the media, a problem that has become more evident with the rise of social and digital networks assuming the role of main information disseminators. From this perspective, it is important to be connected to a simple, fast communication vehicle that reaches many people. Media may also damage quality of scientific health communication with a negative impact on citizens' lives.Objective: in this context, this article aims to reflect on fake news and the coronavirus disease (COVID-19) pandemic, which has devastated the world since the beginning of 2020, particularly in Brazil.Methods: countless actions have been taken to contain what the World Health Organization (WHO) calls an "infodemic" that is present in everyday life, invading houses, mobile phones, and computers, in a time of social isolation and working from home. In this scenario, it is up to journalists, communicators, scientists, and health professionals jointly to share important information and to communicate about health and science in a responsible way.Conclusion: in a crisis it becomes essential that information reaches a large number of people and community leaders in order to influence people positively, which might help to save lives
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Introduction: the Sustainable Development Goals define the goals that were defined to be achieved by the signatory member countries to reach by 2030 with the purpose of reducing indicators to promote equality and equity for all.Objective: to describe the path taken towards the adoption of the 2030 Agenda, from its antecedents, main concepts and innovations, resulting in a fundamental and guiding element in the formulation of public policies.Methods: study based on secondary sources of literature relevant to the topic, considering articles from national and international journals and recent productions on the Sustainable Development GoalsResults: the challenges of internalizing the Sustainable Development Goals, with the definition of national goals and indicators, addresses the challenges and setbacks in their implementation, especially with the national reorientation aimed at fulfilling the 2030 Agenda from this year onwards, especially in light of mid-cycle assessments, to take place this year.Conclusion: the demobilization in the adoption of the 2030 Agenda at the Federal level, from 2019 onwards, as the global political scenario of successive crises has severely impacted the fulfillment of the agreed objectives, an accelerated effort to resume policies is necessary, involving public agents , civil society and academia, so that the second half of the time frame for implementing the 2030 Agenda is more assertive and achieves the proposed objectives and goals, without effectively leaving anyone behind
Introdução: os Objetivos do Desenvolvimento Sustentável definem as metas que foram definidas para ser alcançadas pelos países membros signatários para alcançar até 2030 com o propósito de diminuir indicadores para promoção de igualdade e equidade de todos. Objetivo: descrever o caminho percorrido para a adoção da Agenda 2030, desde seus antecedentes, principais conceitos e inovações, resultando em elemento fundamental e orientador na formulação de políticas públicas. Método: estudo consubstanciado em fontes secundárias da literatura pertinente à temática, considerando artigos de periódicos nacionais e internacionais e produções recentes sobre os Objetivos de Desenvolvimento Sustentável.Resultados: os desafios da internalização dos Objetivos de Desenvolvimento Sustentável, com a definição de metas e indicadores nacionais aborda os desafios e revezes na sua implementação, especialmente com a reorientação nacional visando o cumprimento da Agenda 2030 à partir do presente ano, em especial à luz das avaliações de meio de ciclo, a ocorrer este ano.Conclusão: a desmobilização na adoção da Agenda 2030 na esfera Federal, a partir de 2019, como o cenário político mundial de sucessivas crises, impactaram severamente no cumprimento dos objetivos pactuados, é necessário um esforço acelerado de retomada de políticas, que envolva agentes públicos, sociedade-civil e academia, para que a segunda metade do intervalo temporal de implementação da Agenda 2030 seja mais assertivo e alcance os objetivos e metas propostos, sem deixar efetivamente ninguém para trás
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Introduction: there is evidence that multidisciplinary interventions are an efficient approach to achieving weight loss and other health-related goals. However, dropout rates of these programs are high among adolescents. The suggestion is that understanding the motivation of individuals to participate in these projects is fundamental to developing strategies for permanence and, consequently, promoting better results.Objective: the main aim of this study was to describe the motivations of overweight adolescents participating in a multidisciplinary health promotion project.Methods: this qualitative study was conducted from March to July 2021 using the Bardin content analysis technique. The tool used for data collection was the semi-structured interview, analyzed means by the software QSR NVivo 11 by grouping the speech into clusters. These, in turn, were evaluated in three categories: (1) motivation, (2) food, and (3) physical exercise.Results: the age of the participants was 13.8 ± 2.4 years old, with body mass index of 31.8 ± 8.5 kg/m². Regarding family income, 41.66% had a monthly payment of 3 to 6 minimum wages. Regarding parents' educational level, 70.83% of mothers had completed higher education, while 29.16% had completed high school. According to the respondent's answers, weight loss was the greatest motivation to participate in a multidisciplinary obesity treatment program. In category 2, it was observed that adolescents associated the act of eating with feelings such as anxiety and nervousness. In category 3, the impact of the pandemic was found under the modalities of physical exercise practiced.Conclusion: the results describe the motivation of overweight adolescents to participate in a multidisciplinary program, in addition to elucidating participants' perception of their health and related habits, strategies for health promotion, and consequent improvement of the quality of life of these individuals.
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Introduction: the aging that happens in the world is already a reality in remote and fast areas of the interior of Amazonas; with the population increasing each day more longevous, it is necessary to understand the aging process in these regions where the practice of physical activity is a reality, it was described the presence of life purpose in a group of older people who practice physical activity in the community. Objective: we investigated the presence of life purpose in older people who practiced physical activity before and during the covid-19 pandemic in the interior of Amazonas. Methods: this longitudinal study was conducted with 63 older people who practiced physical activity in a group before and during the covid 19 pandemic in the countryside of Amazonas. Sociodemographic and health characteristics were assessed, as well as well-being and life direction, through the life purpose questionnaire. Results: the elderly in this study have been followed since 2019; before the covid 19 pandemic struck the world, they practiced regular physical activity and had to temporarily suspend their training during the critical period of the pandemic. The group is composed mainly of older adults between the ages of 60 and 79; most are illiterate, have an income of not even one minimum wage, report living with someone, and say their vision as the regular or poor yet still present presence of life purpose and life direction. Conclusion: during the Covid-19 pandemic and social isolation, the elderly had a reduced perception of purpose in life, although they reported joy and satisfaction with life
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Introduction: In chronic diseases, QoL depends on several factors such as the type and duration of the disease, its treatment and side effects, the severity of symptoms, medication effects, patient age, limitations and self-care capacity. In chronic kidney disease it has also become a measure of health outcome.Objective: assess the association between QoL and socioeconomic, lifestyle and clinical factors of patients on HD.Methods: This is a cross-sectional epidemiological census, carried out among 1,024 patients on hemodialysis from all hemodialysis units at the metropolitan region in the Espirito Santo's, Brazil . Sociodemographic, lifestyle and clinical characteristics data were used. QoL was assessed using the Short-Form health Survey-36 (SF-36). Data were analysed by multiple linear regression.Results: The best QoL was represented by mental health (72.16) and the worst QoL by the physical aspect (26.78). After multiple linear regression, predictors of QoL were identified, with emphasis on males, a predictor of better QoL for 5 of the 8 domains and the summaries of the physical and mental components. Education, associated with 5 domains, gives greater reference to income. Physical activity was a predictor of 7 of the 8 QoL domains and the summary of the physical component. Among the clinical variables, the number of complications is associated with 7 of the 8 domains and summaries of the physical and mental components.Conclusion: Male sex is highlighted as a predictor of better physical and mental health and elderly people with better mental health, despite the impairment in physical health. The absence of physical activity is associated with worse physical and mental health. Clinically, having 3 or more intradialytic complications was associated with worse physical and mental QoL
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Introduction: COVID-19 unfolded differently in Pará and Rio Grande do Sul, Brazil, owing to distinct socioeconomic contexts. From 2020 to 2022, both states implemented diverse measures against the virus SARS-CoV-2, including vaccination and variant monitoring, tailored to their specific challenges. Understanding regional impacts on COVID-19 indicators is crucial for designing effective control strategies. Objective: to analyze the incidence, mortality, and lethality of COVID-19 in Pará and Rio Grande do Sul and the trends of these indicators from 2020 to 2022. Methods: ecological study with time series from public and official data available in the Health Secretariat of Pará and Rio Grande do Sul, including all cases and deaths by COVID-19 from February 2020 to December 2022. Lethality, mortality, and incidence rates were calculated. Prais-Winsten regression analysis was used, and trends were classified as stationary, increasing, or decreasing. Significant differences were considered when the p-value is <0.05. Results: when examining the lethality rates between the states of Para and Rio Grande do Sul, an observable trend emerged during the analyzed period. It became evident that the total lethality rate consistently remained higher in Para. Noteworthy peaks in lethality were mainly observed during the months of April 2020, May 2020, and March 2021. The incidence rates showed increasing trends during 2020, both in Pará with a daily percentage change (DPC) of 1.69% (p <0.05) and in Rio Grande do Sul with a DPC of 1.70% (p<0.05). In 2021, the incidence was decreasing (p <0.05) in both states, with a DPC of 0.60% in Pará and 0.64% in Rio Grande do Sul and continued this trend in Pará in 2022 (DPC of -0.50% p <0.05), becoming stationary in Rio Grande do Sul, with a non-significant p-value (p> 0.05).Conclusion: the positive impact of the vaccination program is reflected in the evolution of the pandemic. During the study period Rio Grande do Sul and Para exhibited a stationary incidence trend, emphasizing the need for continued monitoring of cases and morbidity across various age and demographic groups.
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Introduction: the progression of SARS-CoV-2 highlighted the Americas region for the number of COVID-19 cases and deaths. In Brazil, the Southeast region was one of the most affected, especially the state of Rio de Janeiro, due to its cosmopolitan characteristics.Objective: to analyze temporal variations in the incidence, mortality and lethality of COVID-19 in the state of Rio de Janeiro from January 2020 to December 2022.Methods: ecological time-series study with publicly available data on COVID-19 cases and deaths. Crude incidence, mortality, and fatality rates, and estimates of percent daily change (DPC) were analyzed using Prais-Winsten linear regression. With calculation of crude rates were performed using Microsoft Excel 2019, and DPC estimates were performed using STATA MP 17.0 software.Results: 2.5 million cases and 76 thousand COVID-19 deaths were confirmed in the state of Rio de Janeiro from 2020 to 2022, with lethality declining from 4.89% to 0.60%. The highest lethality occurred in May 2020 (11.59%), October 2021 (9.13%) and March 2022 (6.78%), showing a stationary trend. In 2020, incidence and mortality rates peaked in December (797.76 per 100,000 inhabitants) and May (43.96 per 100,000 inhabitants), respectively, followed by subsequent declines. Incidence trend was increasing in 2020 and stationary in 2022, while mortality decreased in 2021 and 2022 after stability in 2020.Conclusion: The incidence of COVID-19 peaked in 2020 and subsequently declined, suggesting partial transmission control. Mortality stabilized after 2020, indicating evolution in health care. Lethality showed a stationary trend, indicating an improvement in hospital capacity. The divergent behavior of the epidemiological indicators reflected the complex dynamics of the pandemic in the analyzed state. There were 790 thousand deaths from COVID-19 in the State of Rio de Janeiro in the period from 2020 to 2022.
Introdução: a progressão do SARS-CoV-2 destacou a região das Américas pelo número de casos e óbitos de COVID-19. No Brasil, a região Sudeste foi uma das mais afetadas, em especial o estado do Rio de Janeiro, devido suas características cosmopolitas.Objetivo: analisar as variações temporais da incidência, mortalidade e letalidade da COVID-19 no estado do Rio de Janeiro no período de janeiro de 2020 a dezembro de 2022.Método: estudo ecológico de séries temporais com dados de acesso público de casos e óbitos de COVID-19. Analisou-se as taxas brutas de incidência, mortalidade e letalidade, e estimativas das taxas de variação percentual diária (DPC) utilizando a regressão linear de Prais-Winsten. Para o cálculo das taxas brutas usou-se o aplicativo Microsoft Excel 2019, e na estimativa da DPC o software STATA MP 17.0.Resultados: foram confirmados 2,5 milhões de casos e 76 mil óbitos por COVID-19 no estado do Rio de Janeiro, no período de 2020 a 2022, com letalidade declinando de 4,89% para 0,60%. A maior letalidade ocorreu em maio de 2020 (11,59%), outubro de 2021 (9,13%) e março de 2022 (6,78%), com tendência estacionária no período. Em 2020, as taxas de incidência e mortalidade, atingiu pico em dezembro (797,76/100 mil hab.), com posterior declínio e em maio (43,96/100 mil hab.), também com posterior queda, respectivamente. A tendência de incidência foi crescente em 2020 e estacionária em 2022, a mortalidade decresceu em 2021 e 2022, após estabilidade em 2020.Conclusão: a incidência de COVID-19 atingiu pico em 2020 e decresceu posteriormente, sugerindo controle parcial da transmissão. A mortalidade se estabilizou após 2020, indicando evolução da assistência à saúde. A letalidade apresentou tendência estacionária no período, sinalizando melhoria da capacidade hospitalar. O comportamento divergente dos indicadores epidemiológicos refletiu a complexa dinâmica da pandemia no estado do Rio de Janeiro. Houve 790 mil óbitos por COVID-19 no Estado do Rio de Janeiro no período de 2020 a 2022.
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Introduction: the COVID-19 pandemic has impacted on mortality and several adverse health outcomes. It has also affected education as schools and universities had to adapt to remote learning due to social isolation strategies.Objective: to analyze the pandemic's impact on medical education including undergraduate and graduate students and lecturers, as follow: i) teaching methods adopted by education institutes during shutdown, ii) students and lecturers' perceptions and iii) impacts on students' mental health.Methods: this systematic review includes the following study designs: cross-sectional, surveys, case-control, cohort, and clinical trials. The literature search was performed in four databases: PubMed, Scopus, Embase, and SciELO . The risk of bias and the quality of the evidence were evaluated.Results: a total of 1,576 articles were identified through searching databases, and 40 articles were included. We found the use of several teaching methods such as virtual platforms and social media, pre-recorded videos, discussion forums and others. Student's challenges related to interference during online study such as family distractions, lack of a study room, challenges with internet connectivity, difficulties in communication between students and lecturers, gaps encountered during clinical skills learning. Lecturers' challenges were difficulty in grasping students' progress and learning outcomes and the lack of experience in online teaching. Only five studies explored mental health issues of medical students and found the occurrence of depression, anxiety, and stress. However, their prevalence was not comparable due to the use of different diagnostic instruments.Conclusion: there has been a wide range of teaching methods implemented for distance learning of medical students globally. The perceptions of medical students about these methods and their impact were also varied. Infrastructure, family, and curriculum problems represented the greatest difficulties in adherence and satisfaction with distance learning. However, the flexibility of digital learning was one of the factors that helped reduce these problems. Regarding mental health, the occurrence of anxiety, depression, and stress was reported.
Introdução: a pandemia de COVID-19 teve impacto na mortalidade e em vários resultados adversos para a saúde. Também afetou a educação, pois escolas e universidades tiveram que se adaptar ao ensino remoto devido às estratégias de isolamento social.Objetivo: analisar o impacto da pandemia na educação médica, incluindo alunos de graduação e pós-graduação e professores, a saber: i) métodos de ensino adotados pelas instituições de ensino durante a paralisação, ii) percepções de alunos e professores e iii) impactos na saúde mental dos alunos.Método: esta revisão sistemática inclui os seguintes desenhos de estudo: transversal, surveys, caso-controle, coorte e ensaios clínicos. A pesquisa bibliográfica foi realizada em quatro bases de dados: PubMed, Scopus, Embase e SciELO. O risco de viés e a qualidade da evidência foram avaliados.Resultados: um total de 1.576 artigos foram identificados por meio de busca em bancos de dados, e 40 artigos foram incluídos. Constatamos a utilização de diversos métodos de ensino como plataformas virtuais e redes sociais, vídeos pré-gravados, fóruns de discussão e outros. Desafios dos alunos relacionados à interferência durante o estudo online, como distrações familiares, falta de uma sala de estudo, desafios com conectividade à Internet, dificuldades de comunicação entre alunos e professores, lacunas encontradas durante o aprendizado de habilidades clínicas. Os desafios dos professores foram a dificuldade em compreender o progresso dos alunos e os resultados de aprendizagem e a falta de experiência no ensino online. Apenas cinco estudos exploraram questões de saúde mental de estudantes de medicina e encontraram a ocorrência de depressão, ansiedade e estresse. No entanto, sua prevalência não foi comparável devido ao uso de diferentes instrumentos de diagnóstico.Conclusão: existe uma ampla gama de métodos de ensino implementados para o ensino a distância de estudantes de medicina em todo o mundo. As percepções dos estudantes de medicina sobre esses métodos e seu impacto também foram variadas. Problemas de infraestrutura, família e currículo representaram as maiores dificuldades de adesão e satisfação com o ensino a distância. No entanto, a flexibilidade do aprendizado digital foi um dos fatores que ajudou a reduzir esses problemas. Em relação à saúde mental, foi relatada a ocorrência de ansiedade, depressão e estresse.
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Introduction: the first COVID-19 case in Brazil was confirmed on February 26, 2020. As of March 17, 2023, the Ministry of Health reported 699,634 deaths from COVID-19, with a case fatality rate of 1.9%. The impact of the COVID-19 pandemic in Brazil extends to socioeconomic and healthcare systems, reflecting significant regional disparities. Objective: To analyze mortality, incidence, and case fatality rates for COVID-19 in the states of Paraná and Santa Catarina, in the southern region of Brazil. Methods: This is an ecological time-series study using official Brazilian secondary data for COVID-19 cases and deaths. Data were extracted from the dashboard of the State Health Department of Santa Catarina and Paraná. Temporal series were developed for trend analysis using the Prais-Winsten regression model. Statistical analyses were performed using STATA 14.0 software (College Station, TX, USA, 2013). Results: In the analysis of rates over the entire period, trends for mortality, case fatality, and incidence in the state of Santa Catarina are decreasing, decreasing, and stationary, respectively. In Paraná, rates over the entire period showed a stationary trend for mortality, decreasing for case fatality, and increasing for incidence. Conclusion: COVID-19 had a devastating effect on the states of Santa Catarina and Paraná. Both states experienced the progression of the COVID-19 pandemic, with higher case fatality and mortality rates observed in Paraná, while Santa Catarina had a higher incidence rate over the three years of the COVID-19 pandemic.
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Introdução: a terapia trombolítica é a principal medida salvadora adotada em vítimas de acidente vascular cerebral isquêmico (AVCI), adequada para a maioria delas. Entretanto, alguns pacientes não apresentam evolução clínica, piorando o prognóstico, o que constitui uma lacuna científica essencial. Objetivo: analisar os determinantes da não melhora clínica em pacientes com AVC em uso de trombolíticos rt-PA.Método: estudo observacional retrospectivo caso-controle, realizado de 2014 a 2017 por meio de busca ativa de prontuários de pacientes com AVC submetidos à terapia trombolítica em um hospital de referência no Ceará. A falência clínica foi caracterizada como ausência de redução no National Institutes of Health Stroke Scale-Score (NIHSS).Resultados: um total de 139 pacientes incluídos no estudo em uma única unidade de AVC. A média de idade foi de 66,14 anos (variando de 34 a 95). O seguimento de 24 horas foi completado em 100% dos pacientes. Resultado favorável 24 horas pós-trombólise foi observado em 113 pacientes (81,29%), e não houve melhora clínica em 26 (18,7%). A transformação hemorrágica pós-trombólise foi um forte preditor de não melhora (p=0,004), e diabetes foi o principal fator de risco modificável encontrado (p=0,040).Conclusão: diabetes e transformação hemorrágica após trombólise foram identificados como fatores de risco para não melhora clínica em pacientes com AVC agudo submetidos à terapia trombolítica.
Introduction: thrombolytic therapy is the primary saving measure adopted in ischemic cerebrovascular accident (ICVA) victims, adequate for most of them. However, some patients do not show clinical progress, worsening the prognosis, which constitutes an essential scientific gap.Objective: to analyze the determinants of clinical non-improvement in stroke patients who used rt-PA thrombolytic agentes.Methods: retrospective observational case-control study, carried out from 2014 to 2017 through an active search of medical records of CVA patients undergoing thrombolytic therapy in a reference hospital in Ceará. Clinical failure was characterized as no reduction in the National Institutes of Health Stroke Scale-Score (NIHSS).Results: a total of 139 patients enrolled in the study in a single CVA unit. The mean age was 66.14 years (range 34 to 95). The 24-hour follow-up was completed in 100% of patients. A favorable result 24 hours post-thrombolysis was observed in 113 patients (81.29%), and there was no clinical improvement in 26 (18.7%). Post-thrombolysis hemorrhagic transformation was a strong predictor of no improvement (p=0.004), and diabetes was the main modifiable risk factor found (p=0.040).Conclusion: diabetes and hemorrhagic transformation after thrombolysis were identified as risk factors for clinical non-improvement in patients with acute stroke undergoing thrombolytic therapy.
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Introduction: breastfeeding is the most effective way to feed the child in the first six months of life exclusively and up to two years as a complementary form, as it provides a healthy development. However, in some situations it is impossible among them in children with food allergies such as Cow's Milk Protein Allergy (APLV). This condition can be defined as an adverse reaction of the immune system, caused by antigens present in the food that triggers the allergy.Objective: analyze the information on the labeling of infant formulas for infants with allergies to cow's milk protein (APLV), sold in pharmacies in Sobral/CE.Methods: cross-sectional, exploratory, quantitative and qualitative study. After data collection, the labels were analyzed based on a check list composed by the current legislation in accordance with RDC 45/2011, measuring the number of adjustments and inadequacies.Results: of the seven formulas analyzed, five were 100% adequate, when considering all the provisions that made up the check list. Of these were FAB-1 B, FAB-1 C, FAB-1 E, FAB-1 F, FAB-2 A, they were all in accordance with the dimensions established by RDC 45/2011, it is already in relation to formulas with inadequacy we observed that FAB-1 A was 2.22% in dimension two in which the micronutrient riboflavin was above the recommended range and FAB-1 D was 2.22% in dimension two, the carbohydrate macronutrient above the recommended range. In view of this, what we observed was that most of the formulas analyzed were within the labeling standards specified in Resolution RDC 45/2011, despite the many regulatory standards that govern the labeling and marketing of infant foods, it was realized that there is still a need for regulation stricter in this regard so that the legislation is fully complied with.Conclusion: according to what was evaluated about formulas for infants with APLV in relation to the labeling standards of the current legislation, some inadequacies were found. Therefore, this study showed a greater number of non-conformities in relation to the essential characteristics of composition and quality, despite the many regulatory standards that govern the labeling and marketing of infant foods, it is clear that they are still not fully complied with. It was found that we still need to evolve in the Elaboration, execution and inspection of the labels of formulas for infants with Allergy to Cow's Milk Protein (APLV), in order to minimize these non-conformities and offer the best food within the recommended standard, however these studies are necessary in order to better show and discuss the legislation referring to these products.
Introdução: a amamentação é a forma mais eficaz de alimentar a criança nos primeiros seis meses de vida exclusivamente e até os dois anos como forma complementar, pois proporciona um desenvolvimento saudável. No entanto, em algumas situações, é impossível entre eles em crianças com alergia alimentar, como a alergia à proteína do leite de vaca (APLV). Essa condição pode ser definida como uma reação adversa do sistema imunológico, causada por antígenos presentes nos alimentos que desencadeiam a alergia.Objetivo: analisar as informações sobre a rotulagem de fórmulas infantis para lactentes com alergia à proteína do leite de vaca (APLV), comercializadas em farmácias de Sobral/CE.Método: estudo transversal, exploratório, quantitativo e qualitativo. Após a coleta de dados, os rótulos foram analisados com base em um check list composto pela legislação vigente de acordo com a RDC 45/2011, mensurando o número de adequações e inadequações.Resultados: das sete fórmulas analisadas, cinco foram 100% adequadas, quando consideradas todas as disposições que compunham o check list. Destes eram FAB -1 B, FAB -1 C, FAB -1 E, FAB -1 F, FAB -2 A, todos estavam de acordo com as dimensões estabelecidas pela RDC 45/2011, já está em relação às fórmulas com inadequação observamos que FAB-1 A foi de 2,22% na dimensão dois em que a micronutriente riboflavina estava acima da faixa recomendada e FAB-1 D foi de 2,22% na dimensão dois, o macronutriente carboidrato acima da faixa recomendada. Diante disso, o que observamos foi que a maioria das fórmulas analisadas estava dentro dos padrões de rotulagem especificados na Resolução, apesar das inúmeras normas regulamentadoras que regem a rotulagem e comercialização de alimentos infantis, percebeu-se que ainda existe necessidade de regulamentação mais rigorosa nesse sentido, para que a legislação seja integralmente cumprida.Conclusão: de acordo com o que foi avaliado sobre as fórmulas para lactentes com APLV em relação aos padrões de rotulagem da legislação vigente foram encontradas algumas inadequações. Portanto esse estudo apresentou maior número de inconformidades em relação as características essênciais de composição e qualidade, apesar das muitas normas regulamentadoras que regem a rotulagem e comercialização de alimentos infantis, percebe-se que ainda não são totalmente cumpridas. Verificou-se que ainda precisamos evoluir na Elaboração, execussão e fiscalização dos rótulos das fórmulas para lactentes com Alergia a Proteína do Leite de Vaca (APLV), a fim de minimizar essas não conformidades e ofererer o melhor alimento dentro do padrão preconizado, no entanto faz-se necessários estes estudos a fim de mostrar e discutir melhor as legislações referentes a esses produtos.
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Introduction: the United Nations recognizes traffic accidents as a serious public health problem all over the world, because they are accompanied by a high morbidity and mortality rate. Traffic causes the death of approximately 1.3 million people and the disability of millions more.Objective: to evaluate mortality from traffic accidents among motorcyclists, pedestrians and hospital costs that occurred in the city of São Paulo, Brazil, from 1999 to 2019.Methods: this is a retrospective time series study with official micro data, collected by place of occurrence among motorcycle drivers, pedestrians and hospital costs from 1999 to 2019, in the city of São Paulo, SP, Brazil.Results: in the city of São Paulo, from 1999 to 2019, there were 144,186 thousand deaths resulting from land transport accidents, projecting 5,293 thousand deaths specifically with motorcyclists. Proportional mortality from was higher in the mean age group of 29 years, predominantly in males, with emphasis on white race/skin color. The costs per death stand out for motorcyclists with an average of R$: 49,078.18, with regard to deaths by sex, male predominated in relation to female.Conclusion: there was a high death rate, both in motorcyclists and pedestrians, with the latter having a higher average. Thus, these findings provide relevant information on the magnitude of the public health problem to guide us on control strategies for these causes.
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Introdução: a insegurança alimentar tem efeitos importantes e agravantes na saúde humana, especialmente na saúde mental das mães e crianças.Objetivo: avaliar as inter-relações do Transtorno mental comum (TMC) e Insegurança Alimentar, em famílias assistidas por programa adicional de transferência de renda no Ceará.Método: estudo transversal foi realizado no Ceará, caracterizado como um dos estados mais pobres do país, em uma amostra de 484 famílias, com crianças menores de seis anos, beneficiárias do Cartão Mais Infância Ceará (CMIC), em 24 municípios. Foram analisados o perfil social e econômico das famílias, moradia, dados sobre a saúde e educação, violência, saúde mental, insegurança alimentar, trabalho e renda. Utilizou-se modelos de Regressão de Poisson, ajustados para o efeito amostral.Resultados: das 484 famílias, 86% encontravam-se em situação de IA;36% apresentavam IA Grave. A presença do TMC materno aumentou em 73% o risco de IA Grave na família (p<0,001). A análise de regressão, mostrou que o TMC se manteve como o fator de risco associado à IA Grave, com mães com TMC mostrando um risco ajustado 64% mais elevado, em comparação às outras mães (p=0,002). Não dispor de água tratada no domicílio, apresentou uma medida ajustada de 55% maior risco de IA Grave (p=0,011).Conclusão: as mães assistidas possuem elevada prevalência de TMC e com perfil de alta vulnerabilidade, sendo necessário suporte social e nutricional, acompanhamento da saúde mental dessas mulheres, para melhor cuidar dos filhos.Palavras-chave: segurança alimentar, criança, saúde mental, nutrição, avaliação de programas.
Backgroung: the prevalence of moderate or severe food insecurity (FI) in the world will reach 2.4 billion people in 2020. Common Mental Disorders (CMDs) affect one in five people, reaching all social classes.Objective: to examine the associations between CMDs and FI in the most vulnerable population, mothers of young children.Methods: population-based cross-sectional observational study, interviewing 484 families with children under six years of age, beneficiaries of the cash transfer program Cartão Mais Infância Ceará (CMIC), in 24 municipalities of Ceara. Poisson regression models were used, adjusted for the sampling effect.Results: 86% of the families were in a situation of FI, with 36% expressing a severe FI, a condition compatible with hunger. In relation to CMDs, it was observed that the prevalence of severe FI increased significantly, affecting 53% of mothers with CMDs against 31% of those without the disorder (p<0.001). Regression analysis showed that CMDs remained the risk factor most associated with severe FI, with mothers with CMDs having a 64% higher adjusted risk compared to other mothers (p=0.002). In the final model, the condition of not having treated water at home was associated with a 55% higher adjusted risk of severe FI (p=0.011), and two factors were close to statistical significance, namely: not feeling safe at home (possibility of domestic violence) and growing edible plants at home, with adjusted measures of 48% risk and 13% protection, respectively.Conclusion: 13% of this population live with very high rates of severe FI, compatible with hunger, concomitant with CMDs. As aggravating factors of severe FI and CMDs, public social support programs are necessary to have a real positive impact on the quality of life of this population.
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Introduction: the National Policy for Permanent Health Education is a strategy for training workers in the Brazilian Unified Health System.Objective: we sought to evaluate the implementation of the Permanent Health Education Policy from the perspective of professionals from the Expanded Center for Family Health and Primary Care in the city of Vitória, Espírito Santo.Methods: this is a case study, quantitative and qualitative research, with triangulation of methods. A Logic Model and an Analysis and Judgment Matrix were prepared based on document analysis and scientific literature.Results: 49 questionnaires were applied and 28 interviews were conducted with health professionals with at least one year of experience in the position. A descriptive analysis of the quantitative data (absolute and relative frequencies) was performed using SPSS version 21.0, and thematic content analysis of the interviews was conducted using MAXQDA (22.0.1), with the results being applied to the matrix, following the score for each classification level of the criteria provided for in the Governance, Technical Quality, and Sustainability dimensions.Conclusion: the full degree of implementation of the policy was obtained in the view of the teams, with facilitating factors such as the good performance of the Technical School of Health.
Introdução: a Política Nacional de Educação Permanente em Saúde é uma estratégia para formação dos trabalhadores do Sistema Único de Saúde.Objetivo: buscou-se avaliar a implementação da Política de Educação Permanente em Saúde na visão de profissionais do Núcleo Ampliado de Saúde da Família e Atenção Primária do município de Vitória, Espírito Santo.Método: trata-se de uma pesquisa quanti-qualitativa, do tipo estudo de caso, com triangulação de métodos. Foram elaborados um Modelo Lógico e uma Matriz de Análise e Julgamento a partir de análise documental e da literatura científica.Resultados: foram aplicados 49 questionários e realizadas 28 entrevistas com profissionais de saúde com pelo menos um ano de atuação no cargo. Foi realizada a análise descritiva dos dados quantitativos (frequências absolutas e relativas), por meio do SPSS versão 21.0, e a análise de conteúdo temática das entrevistas, com auxílio do MAXQDA (22.0.1), sendo os resultados aplicados na matriz, seguindo a pontuação de cada nível de classificação dos critérios previstos nas dimensões Governança, Qualidade Técnica e Sustentabilidade. Conclusão: obteve-se o grau pleno de implementação da política na visão das equipes, com fatores facilitadores como a boa atuação da Escola Técnica de Saúde.
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Introduction: Down syndrome is the most common genetic cause of intellectual disability, and the use of augmented reality can be improving the cognitive, motor, and literacy skills of this population Objective: to compare statistical differences in learning between individuals with Down syndrome and individuals with typical development using augmented reality games.Methods: we compared the reaction time before and after the virtual reality tasks, in addition to the performance in these tasks, which consisted of correctly identifying numbers and letters in 46 people with Down syndrome and 46 controls with typical development.Results: our results indicate that the total points for the typical development group were higher (M = 13.0 and 11.9) when compared to the Down syndrome group (M = 6.6 and 4.6) for letters of the alphabet and numbers, respectively. Furthermore, the results indicated that participants in both groups were more accurate in identifying alphabetic symbols when compared to numerical symbols, and both groups were sensitive to the number of symbols presented in each phase. The down syndrome group had a lower performance when compared to the typical development group.Conclusion: despite the need for further studies, our results support the outcome that there is clinical utility of an intervention based on virtual reality tasks for people with Down syndrome. In conclusion, the use of this technology to improve the reaction time of this population is considered useful
Introdução: a síndrome de Down é uma das principais doenças genéticas que causam deficiência intelectual, e o uso da realidade aumentada pode aumentar as habilidades cognitivas, motoras e de aprendizado dessa população. Objetivo: comparar diferenças estatísticas na aprendizagem entre indivíduos com síndrome de Down e indivíduos com desenvolvimento típico usando jogos de realidade aumentada.Métodos: comparamos o tempo de reação antes e depois das tarefas de realidade virtual, além do desempenho nessas tarefas, que consistiam em identificar corretamente números e letras em 46 pessoas com síndrome de Down e 46 controles com desenvolvimento típico.Resultados: nossos resultados indicam que o total de pontos para o grupo de desenvolvimento típico foi maior (M = 13,0 e 11,9) quando comparado ao grupo com síndrome de Down (M = 6,6 e 4,6) para letras do alfabeto e números, respectivamente. Além disso, os resultados indicaram que os participantes de ambos os grupos foram mais precisos na identificação de símbolos alfabéticos quando comparados aos símbolos numéricos, e ambos os grupos foram sensíveis ao número de símbolos apresentados em cada fase. O grupo com síndrome de Down teve desempenho inferior quando comparado ao grupo de desenvolvimento típico.Conclusão: apesar da necessidade de mais estudos, nossos resultados suportam a utilidade clínica de uma intervenção baseada em tarefas de realidade virtual para pessoas com síndrome de Down. Em conclusão, considera-se útil o uso dessa tecnologia para melhorar o tempo de reação dessa população
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Introduction: domestic violence is characterized as a growing public health problem that has major consequences, in addition to violating the human rights of women who are in situations of violence.Objective: describe the construction and content validation of an instrument to identify domestic violence against women from the perspective of the applicability of a decision model.Methods: this is a methodological study composed of two phases: the first was the elaboration of the instrument, based on an integrative review of the literature; the second, content validation, through the evaluation of the instrument by ten specialists, with expertise in the area of domestic violence against women. For analysis, the Content Validity Index (CVI≥0.80) was calculated.Results: of the 23 items initially submitted to validation, 65.2% (n = 15) achieved CVI equal to or greater than (0.80) and 34.8% (n = 8) had CVI lower than (0.80). After making the changes suggested by the experts in the first round, a second version of the instrument was constructed and sent back to the participating judges, adjusting the proposed items. In this second evaluation round, the adjusted and added items reached CVI equal to or greater than 0.90.Conclusion: the instrument was considered valid and adequate to identify domestic violence against women, serving as a source for the construction of health indicators and for coping with this problem.
Introdução: a violência doméstica é caracterizada como um problema crescente de saúde pública que gera grandes consequências, além da violação aos direitos humanos das mulheres que se encontram em situação de violencia.Objetivo: descrever a construção e validação de conteúdo de um instrumento visando identificar a violência doméstica contra a mulher na perspectiva da aplicabilidade de um modelo de decisão.Método: trata-se de um estudo metodológico composto de duas fases: a primeira foi a elaboração do instrumento, a partir de revisão integrativa da literatura; a segunda, de validação de conteúdo, mediante a avaliação do instrumento por dez especialistas, com expertise na área de violência doméstica contra a mulher. Para análise, calculou-se o Índice de Validade de Conteúdo (IVC≥0,80).Resultados: dos 23 itens submetidos inicialmente à validação, 65,2% (n = 15) alcançaram IVC igual ou maior que (0,80) e 34,8% (n = 8) obtiveram IVC inferior a (0,80). Após realizar as alterações sugeridas pelas especialistas na primeira rodada foi construída uma segunda versão do instrumento e reenviada às juízas participantes, ajustando-se os itens propostos. Nesta segunda rodada de avaliação, os itens ajustados e acrescentados alcançaram IVC igual ou maior que 0.90.Conclusão: o instrumento foi considerado válido e adequado para identificar a violência doméstica contra a mulher, servindo como fonte para a construção de indicadores de saúde e para o enfrentamento dessa problemática.
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Abstract The World Health Organization is the global coordinating agency for the response to the COVID-19 pandemic. In March 2023, the WHO announced the end of the COVID-19 emergency phase. The end of the Public Health Emergency of International Concern does not mean that COVID-19 has ceased to be a health threat. The worldwide spread of the disease continues to be characterized as a pandemic. The significance of this decision is aimed at public health systems everywhere for countries to transition from emergency mode to management of COVID-19 along with other infectious diseases. The COVID-19 pandemic is not over. The population got tired of the virus, however, the virus did not get tired of the human population. Non-pharmacological preventive measures, vaccination and health education continue to be the arsenal we must control this disease today.
Resumo A Organização Mundial da Saúde é a agência coordenadora global para a resposta à pandemia da COVID-19. No mês de março de 2023 a OMS anunciou o fim da fase de emergência da COVID-19. O fim da Emergência de Saúde Pública de Importância Internacional não significa que a COVID-19 tenha deixado de ser uma ameaça à saúde. A propagação mundial da doença continua caracterizada como uma pandemia. O significado dessa decisão é direcionado aos sistemas de saúde pública em todos os locais para os países realizarem a transição do modo de emergência para o de manejo da COVID-19 juntamente com outras doenças infecciosas. A pandemia da COVID-19 não acabou. A população cansou do vírus, entretanto, o vírus não cansou da população humana. As medidas preventivas não farmacológicas, a vacinação e a educação em saúde continua sendo o arsenal que temos para controlar essa doença nos dias atuais.
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Objective: To evaluate the antioxidant activity of extracts of dried flowers of Tithonia diversifolia (Hemsl) A. Gray (T. diversifolia) dry flower-a shrubby plant belonging to the Asteraceae family and very common in Brazil, providing data to help prevent premature aging skin. Methods: The tests of phytochemical screening included total phenols, tannins, flavonoids, alkaloids and saponins. The active antioxidant was determined by 2,2-diphenyl-1-picryl-hydrazyl method. Results: The phytochemical screening of T. diversifolia dry flowers revealed the presence o phenolic compounds (tannins, flavonoids and total phenols), while alkaloids and saponins were not detected. The IC50 values showed a strong antioxidant activity of the plant extracts. Conclusions: Therefore, this study suggests the possibility of using dry flowers extracts of T diversifolia for the prevention of cell aging, as was shown to have significant antioxidant activity.