Effect of Acupressure on Dental Anxiety in Children: a Pilot Study for a Randomized Clinical Trial.

Background: Anxiety is an important problem in children in dental clinics. Acupressure may be a useful tool to assist in dental procedures in anxious children. Objectives: This pilot study was performed to examine the effects of acupressure on dental anxiety in children undergoing restorative procedures. Methods: Fourteen children aged 7-10 years and with at least one primary molar with caries on the dentine were included in the study. The participants also needed to score at least one point on the modified Venham Picture Test (VPTm) for the determination of anxiety. The children were randomly allocated to two groups: group A - non-documented points for the reduction of anxiety and induction of relaxation; group B - documented points (EX-HN3, Shen Men of auricular acupuncture). The anxiety scale was administered on three occasions: prior to the application of acupressure; immediately after sitting in the dental chair to undergo restorative treatment; and after removal of acupressure at the end of the restorative procedure. Heart rate (HR) was measured when each child sat in the dental chair, after the removal of carious tissue, and after the removal of acupressure. Results: After the procedure, HR (as an indicator of anxiety) was statistically significantly lower in group B than group A (p = 0.02). However, there was no significant difference between the groups regarding anxiety before and during the restorative procedure (VPTm and HR: p > 0.05). Conclusion: The children who received acupressure on documented points for the reduction of anxiety had a significantly lower HR after the restorative procedure. No significant between-group difference was found regarding anxiety measured using a psychometric evaluation (VPTm).

Soil-sediment linkage and trace element contamination in forested/deforested areas of the Itacaiúnas River Watershed, Brazil: To what extent land-use change plays a role?

Trace elements (TE) contamination in forested areas of the Itacaiúnas River Watershed (IRW), Brazilian Amazon, arouses growing interest owing to the rapid deforestation and mining activities. In this study, soils (surface, SS; bottom, BS) and stream sediments (SD) from forested/deforested areas of IRW were analyzed with the aim of (1) evaluating the major sources of TE (mainly As, Ba, Cd, Cu, Co, Cr, Hg, Mo, Mn, Ni, Pb, V, and Zn), and (2) examining the soil-sediment TE link related to land-use change and/or geologic factors. Compositional data analysis (CoDA) was used to eliminate data closure issues and the centred log-ratio (clr) transformation yielded better results in Principal Component Analysis (PCA). The TE distribution pattern was significantly different (p < 0.05) between forested and deforested areas, but in both areas the TE distribution pattern is significantly correlated between SS, BS, and SD, indicating a strong lithogenic control. PCA (clr-transformed) identified the major geochemical bedrock signature as Fe-Ti-V-Cu-Cr-Ni, which is nearly similar in soil and sediments. The more accentuated enrichment and the maximum number of anomalies of these elements were found in the Carajás Basin and are highly coincident with mineral deposits/local lithologies without clear indication of anthropogenic contamination from point sources. Besides geogenic factors, deforestation is also affecting TE distribution in the basin. In deforested areas, Mn was significantly enriched in the surface horizon. Furthermore, linear regression analysis shows stronger TE relationships between soils and sediments in deforested areas than in forested ones, reflecting higher erosion in the former. This could be the reason for the relatively higher enrichment of TE (e.g., Fe, Mn, Cu, Cr, Ni) in deforested sediments. The TE contamination using regional background values provides more accurate results than worldwide reference values. Thus, the former should be considered for a more realistic environmental risk assessment in IRW and other forest ecosystems in the Brazilian Amazon.

[Analysis of production, impact, and collaboration networks in scientific research in Scopus for Peru from 2000 to 2019]. / Análisis de producción, impacto y redes de colaboración en investigaciones científicas en Scopus en Perú de 2000 a 2019.

INTRODUCTION: Peru is a developing country with increasing scientific production. However, it is necessary to understand the trends, impact, and collaborative networks of research to plan for policy improvements. OBJECTIVE: We analyzed the production, impact, and collaboration networks in the Peruvian scientific production between 2000 and 2019. METHODS: We did an observational analytical study. We searched Scopus for all the publications with at least one author with a Peruvian affiliation declared in the author byline. A descriptive analysis of the different characteristics, trends, and scientific collaboration was carried out. Collaboration networks were plotted using VOSviewer. RESULTS: Between 2000 and 2019, Peru had a total of 24 482 publications in scientific journals, with an average annual growth of 13.6%. Of the total, 70% of all the articles were cataloged as Clinical Medicine and Biomedical Sciences. Only half of the articles had a Peruvian affiliation. The countries with the largest share of collaboration were the United States and Brazil, and the articles with international collaboration had the highest number of citations per publication. CONCLUSIONS: Scientific production in Peru has increased in recent years, with a significant percentage of publications based on international collaboration and led by authors with non-Peruvian affiliations. It is necessary to strengthen collaboration ties between Peruvian and foreign institutions. Furthermore, it is essential to propitiate further research that will help solve the country's problems.

INTRODUCCIÓN: Perú es un país en vías de desarrollo, con una producción científica en aumento. Sin embargo, es necesario entender las tendencias, el impacto y la colaboración de sus investigaciones para promover una mejora continua de las mismas. OBJETIVO: Buscamos analizar la producción, el impacto y las redes de colaboración en la producción científica peruana entre los años 2000 y 2019. MÉTODOS: Realizamos un estudio analítico observacional haciendo una búsqueda en Scopus de todas las publicaciones que hayan tenido al menos un autor peruano en su filiación. Sobre eso, realizamos un análisis descriptivo de las diferentes características, tendencias y tipo de colaboración científica. Graficamos las redes de colaboración mediante VOSviewer. RESULTADOS: Entre los años 2000 y 2019, Perú tuvo un total de 24 482 publicaciones en revistas científicas, con un crecimiento anual promedio de 13,6%. Del total de artículos científicos, 70% de todas las publicaciones pertenecieron a las áreas de medicina clínica y ciencias biomédicas. Solo la mitad de los artículos contaban con filiación peruana. Los países con mayor colaboración fueron Estados Unidos y Brasil, y los artículos con colaboración internacional tuvieron mayor cantidad de citas por publicación. CONCLUSIONES: En años recientes, ha habido un incremento de la producción científica en Perú, con un gran porcentaje de publicaciones basadas en la colaboración internacional y lideradas por autores con filiación no peruana. Es necesario fortalecer lazos de colaboración entre instituciones peruanas y extranjeras. Además, es fundamental el incitar un mayor liderazgo en investigaciones que solucionen problemas del país.

Integration of ozonation and an anaerobic expanded granular sludge bed reactor for micropollutant removal from sewage.

Conventional sewage treatment systems are generally not designed to remove micropollutants, requiring the development of new technologies, such as the combination of biological processes with advanced oxidative processes. The configuration of an anaerobic expanded granular sludge bed (EGSB) reactor stands out for its use of granular biomass and high sludge bed expansion. Ozonation is an advanced oxidative process that stands out as one of the most promising technologies for the degradation of micropollutants. Thus, the present work aimed to evaluate the removal of drugs through the application of ozonation as a polishing process for the effluent of an EGSB reactor that was fed with synthetic sewage. Ozonation was shown to be efficient in the degradation of these compounds, reaching removals above 90%. It was found that the degradation profile of each drug varied according to its chemical structure since some drugs are more susceptible to oxidation than others and since the concentrations of pharmaceuticals are also related to their removal. Moreover, the assessment of risks to the environment and human health confirmed the need to assess the best scenario for risk reduction considering all drugs, since even with almost complete removal of some compounds, the effluents still showed toxicity. Thus, the high removal efficiencies found for the evaluated micropollutants showed that this technique has the potential to be used to improve the quality of biological reactor effluents or even to be combined in effluent reuse systems.

Investigação dos culicídeos potencialmente associados à transmissão de febre amararela silvestre no Parque Estadual da Cantareira - Núcleo Engordador, São Paulo, Brasil / Investigation of Culicidae species potentially associated with wild yellow fever transmission in the Cantareira State Park Núcleo Engordador, São Paulo, Brazil

A febre amarela (FA) se mantém endêmica ou enzoótica na África e Américas do Sul e Central, causada por um arbovírus mantido em ciclos silvestres em que primatas não humanos (PNH) são os principais hospedeiros amplificadores e mosquitos das tribos Aedini e Sabethini são os transmissores. O homem participa deste ciclo como um hospedeiro acidental ao contatar áreas de mata com animais infectados e mosquitos transmissores. Durante o surto de FA ocorrido no estado de São Paulo entre os anos de 2016 e 2018 foram registradas mortes de PNH no Parque Estadual da Cantareira (PEC) e infecções humanas foram relatadas nas proximidades, sinalizando para o risco de transmissão do vírus amarílico neste remanescente de mata situado na região metropolitana de São Paulo. Foi objetivo de estudo investigar os culicídeos potencialmente associados à transmissão de febre amarela silvestre (CPAFAS) no PEC e elaborar um manual de coleta diurna de Culicidae em ambiente florestal urbano para auxiliar o trabalho de vigilância entomológica realizado no município de São Paulo (MSP). As coletas foram quinzenais no Núcleo Engordador, nas trilhas do Macuco e Mountain Bike, entre 10 e 14 horas, de março de 2019 a fevereiro de 2020. Para as coletas foram utilizados puçá entomológico para captura de indivíduos adultos e instalação de armadilhas larvitrampas (bambu e PET) no solo e na copa das árvores para coleta de imaturos. Para os adultos de CPAFAS foram estimadas a riqueza e abundância; comparou-se a diversidade da fauna coletada nas duas trilhas utilizando-se o teste de Mann-Whitney; correlacionou-se o total de indivíduos coletados com dados climáticos (temperatura, pluviosidade e umidade relativa do ar por meio do coeficiente de correlação de Sperman. Para os imaturos comparou-se a abundância do total de CPAFAS e Hg. leucocelaenus coletados nas larvitrampas nas duas alturas instaladas utilizando a análise de Wilcoxon. Foram coletados um total de 248 espécimes de adultos e 136 de imaturos de CPAFAS pertencentes a 13 espécies distribuídas nos gêneros Aedes, Haemagogus, Psorophora e Sabethes. Os resultados mostraram que não houve diferença estatisticamente significativa de diversidade entre as trilhas, indicando terem as mesmas características relativas à fauna de CPAFAS. Ocorreu correlação positiva entre o total de CPAFAS e as variáveis climáticas de temperatura e pluviosidade dos 30 dias que antecederam à coleta. Ao se comparar a abundância dos CPAFAS nas larvitrampas, observou-se a preferência por armadilhas de bambu. Em relação à altura de colocação das armadilhas a maior frequência ocorreu no bambu copa, quando se considerou o total de CPAFAS. Para Hg. leucocelaenus, não foi constatada diferença estatisticamente significativa no bambu copa ou solo indicando que a espécie explora diferentes níveis de habitats florestais. Estes resultados sinalizam que o PEC é uma área que merece atenção para a vigilância de vetores da FA, recomendando a continuação do monitoramento diurno no parque e em outras áreas vulneráveis à transmissão da FA no MSP e propondo à coordenação do Laboratório de Identificação e Pesquisa em Fauna Sinantrópica do MSP um manual de coleta diurna de culicídeos.

Yellow fever (YF) remains endemic or enzootic in Africa and South and Central America, is caused by an arbovirus maintained in wild cycles in which non-human primates (NHP) are the main hosts and mosquitoes from the Aedini and Sabethini tribes are the vectors. Humans participate of this cycle as accidental hosts when contacting forest areas with infected animals and mosquito vectors. During the YF outbreak that occurred in the state of São Paulo between 2016 and 2018, were recorded deaths of NHP in the Cantareira State Park (CSP) and human infections nearby, signaling the risk of the YF virus transmission in this area remaining of forest located in the metropolitan region of São Paulo. The aims of this study were to investigate the specimens of Culicidae potentially associated with the wild yellow fever transmission dynamics (CPAFAS) in the CSP and to develop a manual for daytime collection of Culicidae in an urban forest environment to assist the entomological surveillance activities carried out in the municipality of São Paulo (MSP). Collections performed fortnightly at Núcleo Engordador, on the Macuco and Mountain Bike trails, between 10 a.m. and 2 p.m., and from March 2019 to February 2020. To collections were used aerial insect nets to capture adult individuals and larvitraps traps (bamboo and PET) on soil and treetop for collecting immature. For CPAFAS adults, species richness and abundance were estimated; the diversity of fauna collected on the two trails was compared using the Mann-Whitney test; the total number of individuals collected was correlated with climatic data (temperature, rainfall and relative humidity) using Spearman's correlation coefficient. For immatures, the abundance of total CPAFAS and Hg. leucocelaenus collected from larvitraps in the two installed level were compared using Wilcoxon analysis. A total of 248 adults and 136 immature specimens of CPAFAS belonging to 13 species distributed between the genera Aedes, Haemagogus, Psorophora and Sabethes were collected. The results showed that there was no statistically significant difference in diversity between trails, indicating that they have the same characteristics regarding the CPAFAS fauna. There was a positive correlation between the total of CPAFAS and the climatic variables of temperature and rainfall in the 30 days prior to collection. When comparing the abundance of CPAFAS in larvitraps, the preference for bamboo traps was observed. Regarding the level of traps placement, the highest frequency occurred in bamboo traps placed at treetop level, when considering the total of CPAFAS. For Hg. leucocelaenus, no statistically significant difference was found between bamboo traps placed at treetop or soil level, indicating that the species explores different levels of forest habitats. These results indicate that the CSP is an area that deserves attention for YF vector surveillance. The continuation of daytime monitoring in the park and other areas vulnerable to YF transmission in the MSP is recommended and a manual for daytime collection of Culicidae is proposed to the coordination of the Identification and Research Laboratory in Synanthropic Fauna of the MSP.

Quality of life of nurses from the mobile emergency care service / Calidad de vida de los enfermeros del servicio de atención móvil de emergencias / Qualidade de vida de enfermeiros do serviço de atendimento móvel de urgências

ABSTRACT Objective: to evaluate the quality of life of nurses from the Mobile Emergency Care Service of the Federal District (Brazil) and to identify the domains that influenced this assessment. Method: an observational, descriptive, cross-sectional and quantitative study, with data obtained from 123 nurses who answered a questionnaire developed and structured in order to know sociodemographic and clinical variables and with the application of the World Health Organization Quality of Life Instrument Bref, to assess the quality of life. The data were submitted to descriptive statistics and inferential statics. Results: most of the nurses were women, aged between 20 and 40 years old, married, with a specialization degree and without any employment relation with another institution. Most (72.36%) considered their quality of life good or very good and were satisfied or very satisfied with their health (65.03%). The environment domain was the worst evaluated. A significant correlation was observed between the social relations (p=0.049) and environment (p=0.035) domains when correlated with the gender variable. The women rated their social relations and environment better than the men. Conclusion: the knowledge produced by this investigation may support the design of strategies that enable reducing the difficulties related to the life and work of nurses of the Mobile Emergency Care Service. Actions in this direction may contribute to the improvement of health, well-being and quality of life of the professionals and will have positive effects on the quality of health care provided to the population.

RESUMEN Objetivo: evaluar la calidad de vida de los enfermeros del Servicio de Atención Móvil de Emergencias del Distrito Federal (Brasil) e identificar los dominios que influenciaron en esa evaluación. Método: estudio de observación, descriptivo, transversal y cuantitativo, en el que se obtuvieron datos de 123 enfermeros que respondieron a un cuestionario desarrollado y estructurado para descubrir variables sociodemográficas y clínicas y en el que se aplicó el instrumento World Health Organization Quality of Life Instrument Bref para evaluar la calidad de vida. Los datos se sometieron a estadística descriptiva y inferencial. Resultados: en su mayoría, los enfermeros eran mujeres de 20 a 40 años de edad, casadas, con un nivel académico de especialización y sin ningún vínculo de empleo con otras instituciones. La mayor parte (72,36%) consideraron que su calidad de vida era buena o muy buena y se mostraron satisfechas o muy satisfechas con su salud (65,03%). El dominio del medio ambiente fue el peor evaluado. Se observó una correlación significativa entre los dominios de las relaciones sociales (p=0,049) y del medio ambiente (p=0,035) al correlacionarlos con la variable del sexo. Las mujeres evaluaron mejor que los hombres sus relaciones sociales y el medio ambiente. Conclusión: los conocimientos obtenidos gracias a esta investigación podrán ayudar a delinear estrategias que permitan reducir las dificultades relacionadas con la vida y el trabajo de los enfermeros del Servicio de Atención Móvil de Emergencias. Implementar acciones en este sentido podrá contribuir a mejorar la salud, el bienestar y la calidad de vida de los profesionales y tendrá efectos positivos sobre la calidad de la atención a la salud que se presta a la población.

RESUMO Objetivo: avaliar a qualidade de vida de enfermeiros do Serviço de Atendimento Móvel de Urgência do Distrito Federal (Brasil) e identificar os domínios que influenciaram nessa avaliação. Método: estudo observacional, descritivo, transversal e quantitativo, com dados obtidos de 123 enfermeiros que responderam a um questionário desenvolvido e estruturado para conhecer variáveis sociodemográficas e clínicas e com aplicação do World Health Organization Quality of Life Instrument Bref, para avaliar a qualidade de vida. Os dados foram submetidos à estatística descritiva e inferencial. Resultados: os enfermeiros eram em sua maioria mulheres, entre 20 a 40 anos, casadas, com nível acadêmico de especialização e sem vínculo empregatício com outra instituição. A maior parte (72,36%) considerou sua qualidade de vida boa ou muito boa e estava satisfeita ou muito satisfeita com a saúde (65,03%). O domínio meio ambiente foi o pior avaliado. Observou-se correlação significativa entre os domínios relações sociais (p=0,049) e meio ambiente (p=0,035) quando correlacionados à variável sexo. As mulheres avaliaram melhor suas relações sociais e o meio ambiente em relação aos homens. Conclusão: o conhecimento produzido por essa investigação poderá subsidiar o delineamento de estratégias que permitam diminuir as dificuldades relacionadas à vida e ao trabalho de enfermeiros do Serviço de Atendimento Móvel de Urgência. Ações nesse sentido poderão contribuir para a melhoria da saúde, do bem-estar e da qualidade de vida dos profissionais e terão efeitos positivos sobre a qualidade da assistência à saúde prestada à população.

Occupational stress of nurses from the Mobile Emergency Care Service.

OBJECTIVE: To evaluate stress, and to associate it with sociodemographic and clinical aspects of nurses from the Mobile Emergency Care Service. METHOD: This is an observational, cross-sectional and quantitative study conducted with 123 nurses, who answered a questionnaire to assess sociodemographic and clinical variables, and the Job Stress Scale, which evaluates stress in the workplace. RESULTS: The results indicated that most of them were women, 20 to 40 years old, married, without another employment bond and with specialization course. They had low control and low demand at work and performed a passive work. Women reported passive work and high stress levels, while men were equally divided in active and passive work with low stress levels. CONCLUSION: Passive work is harmful to health and it is related to lack of autonomy, decision-making, and social support. It may lead to reduced ability to solve problems faced in daily work routine.

Occupational stress of nurses from the Mobile Emergency Care Service / Estrés laboral de enfermeros en la Atención Móvil de Urgencia / Estresse ocupacional de enfermeiros do Serviço De Atendimento Móvel de Urgência

ABSTRACT Objective: To evaluate stress, and to associate it with sociodemographic and clinical aspects of nurses from the Mobile Emergency Care Service. Method: This is an observational, cross-sectional and quantitative study conducted with 123 nurses, who answered a questionnaire to assess sociodemographic and clinical variables, and the Job Stress Scale, which evaluates stress in the workplace. Results: The results indicated that most of them were women, 20 to 40 years old, married, without another employment bond and with specialization course. They had low control and low demand at work and performed a passive work. Women reported passive work and high stress levels, while men were equally divided in active and passive work with low stress levels. Conclusion: Passive work is harmful to health and it is related to lack of autonomy, decision-making, and social support. It may lead to reduced ability to solve problems faced in daily work routine.

RESUMEN Objetivo: evaluar el estrés y asociar los aspectos sociodemográficos y clínicos de los enfermeros que trabajan en el Atendimiento Móvil de Emergencias. Método: Este fue un estudio observacional, transversal y cuantitativo realizado con 123 enfermeros, que respondieron un cuestionario para conocer las variables sociodemográficas y clínicas, y la Job Stress Scale. Resultados: Los resultados indicaron que la mayoría eran mujeres, de 20 a 40 años, sin ninguna otra relación laboral ni especialización. Tenían bajo control y baja demanda en el trabajo y realizaron un trabajo considerado pasivo. Las mujeres reportaron trabajo pasivo y desgaste elevado, mientras que los hombres se dividieron entre trabajo activo y pasivo con desgaste bajo. Conclusión: el trabajo pasivo es perjudicial para la salud y está relacionado con la falta de autonomía y el poder de decisión. Puede llevar a una capacidad reducida para producir soluciones a los problemas que se enfrentan en el trabajo diario.

RESUMO Objetivo: Avaliar o estresse, associando-o aos aspectos sociodemográficos e clínicos de enfermeiros do Serviço de Atendimento Móvel de Urgências. Método: Trata-se de estudo observacional, transversal e quantitativo, realizado com 123 enfermeiros, que responderam a um questionário, para conhecer variáveis sociodemográficas e clínicas. Foi utilizada a Job Stress Scale, que avalia o estresse no trabalho. Resultados: Os resultados indicaram que a maioria eram mulheres, de 20 a 40 anos, casadas, sem outro vínculo empregatício e com especialização. Possuíam baixo controle, baixa demanda no trabalho e executavam trabalho considerado passivo. As mulheres referiram trabalho passivo e alto desgaste, enquanto os homens dividiram-se igualmente entre o perfil ativo e passivo com baixo desgaste. Conclusão: O trabalho passivo é nocivo à saúde e está relacionado à falta de autonomia, de poder de decisão e de suporte social. Pode conduzir à redução da capacidade de produzir soluções para os problemas enfrentados no cotidiano laboral.

A promoção à saúde na experiência de jovens promotores da saúde / Promoción de la salud en la experiencia de jóvenes promotores de la salud / Health promotion in the experience of young health promoters

RESUMO O presente artigo se baseia em uma pesquisa de mestrado profissional e tem por objetivo conhecer e analisar a experiência de jovens e adolescentes que participam de um projeto de promoção à saúde, voltado ao público jovem e adolescente. A experiência de promoção à saúde e de vivência da adolescência e da juventude pelos participantes do projeto é abordada pela técnica do grupo focal. Realiza-se análise das narrativas, indicando a maneira como os participantes enfrentam os impasses inerentes a esta etapa da vida e a função que o grupo ocupa para eles nesta empreitada. Os resultados apontam que a experiência no grupo atua como estímulo para o aumento da capacidade narrativa entre os participantes, que percebem melhora nas formas de comunicação e de relação, como fonte de construção de um laço afetivo entre os participantes, constituindo-se como importante fator de suporte social e como possibilidade de estreitamento de laço com a unidade de saúde e com os profissionais que nela atuam. Destaca-se ainda a importância de sustentação por parte dos profissionais de saúde da função da alteridade junto aos jovens e adolescentes, de modo a garantir a circulação da palavra e a manutenção de um diálogo aberto e franco com eles.

RESUMEN El presente artículo se basa en una investigación de maestría profesional y tiene como objetivo conocer y analizar la experiencia de los jóvenes y adolescentes que participan en un proyecto de promoción a la salud, dirigido al público joven y adolescente. La experiencia de promoción a la salud y de la vivencia de la adolescencia y de la juventud por los participantes del proyecto son tratadas por intermedio de la técnica del grupo focal. Se realiza análisis de las narrativas, indicando la manera como los participantes enfrentan los impasses inherentes a esta etapa de la vida y la función que el grupo ocupa para ellos. Los resultados apuntan que la experiencia en el grupo actúa como estímulo para el aumento de la capacidad narrativa entre los participantes, que perciben una mejora en las formas de comunicación y de relación, como fuente de construcción de un lazo afectivo entre los participantes, constituyéndose como importante factor de soporte social y como posibilidad de estrechamiento de lazo con la unidad de salud y con los profesionales que actúan en ella. Se destaca la importancia de sostén por parte de los profesionales de salud de la función de la alteridad junto a los jóvenes y adolescentes, a fin de garantizar la circulación de la palabra y el mantenimiento de un diálogo abierto y franco con ellos.

ABSTRACT This article is based on a professional master's research that aimed to know and analyze the experience of young people and adolescents who participate in a health promotion project for young people and adolescents. The experience of health promotion, as well as the reality of youth and adolescence are addressed by project participants through the focus group technique. An analysis of narratives is carried out, indicating the ways through which participants face the inherent dilemmas of this particular stage of life, as well as the role that the group plays for them in this task. The results indicate that the group experience stimulates an increase of narrative capacity among participants - who perceive improved communication and relatedness - and acts also as a source of construction of an affective bond between participants, constituting an important social support factor, by also creating closer ties with the health unit and the professionals who work there. Also important is the critical role of the health professionals in sustaining alterity for these youngsters, ensuring the free circulation of words, and maintaining an open and frank dialogue with them.

Futsal improve body composition and cardiorespiratory fitness in overweight and obese children. A pilot study

The aim of this study was to verify body composition, cardiorespiratory fitness, and biochemical markers of prepubertal overweight and obese boys to a 16-week futsal training program. Methods: Sixteen boys (age: 7-10 y, body mass index>thanat 95th percentileaccording to Center for Disease Control and Prevention; 35.5±7.4 percent fat) participated to futsal training program. The assessment of body composition was estimated using skinfold thickness, and the following variables were evaluated: total body mass, body mass index, body fat percentage, and lean body mass. Aerobic fitness measurementwas performed by gas exchange analysis in treadmill. In addition, an evaluation of the biochemical profile was conducted: triglycerides, total cholesterol, low density lipoprotein cholesterol, high-density lipoprotein cholesterol, plasma concentrations of glucose, and insulin. The futsal intervention included 60-min sessions performed two times/week. The mean intensity during training was between 57 to 88% of maximal heart rate of the age-predicted. Individual portable heart rate monitor controlled training intensity. Results: Significant increases in total body mass (4%), height (3%), lean body mass (8%), and significant 6%-decrease in body fat percentage was observed. Body mass index remained unchanged. Maximal oxygen uptake was elevated (p<0.018) by 11%. Biochemical markers were not modified after intervention. No association was found between body composition and metabolic variables. The effect size of futsal training on most variables was small (<0.5). Conclusion: Controlled intensity and adherence to this 16-week futsal training program were determinant to enhance body composition, and cardiorespiratory fitness in this group of prepubertal boys.(AU)

Efeito do treinamento com videogame ativo sobre o nível de equilíbrio de idosas ativas: estudo de caso / Effect of active video game training on the level of active elderly balance: case study

Introdução: O processo de envelhecimento está associado a modificações no controle postural, com grande impacto sobre o equilíbrio, favorecendo a ocorrência de quedas. O exercício físico, por meio dos videogames ativos (VGAs), proporciona maior entretenimento e aumenta a movimentação física durante o jogo. Objetivo: Analisar o efeito de cinco semanas de intervenção com VGA sobre o equilíbrio de idosas. Métodos: Trata-se de relato de três casos de idosas com histórico de instabilidade e quedas. As voluntárias foram avaliadas pré e pós intervenção por meio do teste da Escala de Equilíbrio de Berg (EEB). A intervenção foi realizada em dias alternados durante cinco semanas, totalizando dez sessões com o VGA Kinect Adventures. Resultados: Após cinco semanas de intervenção as idosas apresentaram diminuição no risco de quedas e desempenho satisfatório no equilíbrio, alcançando a pontuação máxima na escala EEB. Conclusão: O videogame ativo mostrou ser um instrumento viável para melhora do equilíbrio e diminui o risco de quedas. (AU)

Introduction: The aging process is associated with changes in postural control with grater impact about balance, favoring falls. The physical exercises with active videogame (AVG) provide entertainment and increase the physical movement during the game. Objective: To analyze the effect of five weeks of intervention with AVG in elderly balance. Methods: The article is about three elderly cases report with instability history and falls. The volunteers were evaluated with the Berg Balance Scale (BBS) before and after the intervention, that was realized in five weeks with alternate days, totaling ten sessions with AVG Kinect Adventures. Results: After five weeks with AVG intervention the elderly showed decrease about falls risk and balance satisfactory performance, reached the maximum score in BBS. Conclusion: The AVG was a viable tool improves the elderly balance and prevent falls. (AU)

Detection of Culex flavivirus and Aedes flavivirus nucleotide sequences in mosquitoes from parks in the city of São Paulo, Brazil.

The dengue viruses are widespread in Brazil and are a major public health concern. Other flaviviruses also cause diseases in humans, although on a smaller scale. The city of São Paulo is in a highly urbanized area with few green spaces apart from its parks, which are used for recreation and where potential vertebrate hosts and mosquito vectors of pathogenic Flavivirus species can be found. Although this scenario can contribute to the transmission of Flavivirus to humans, little is known about the circulation of members of this genus in these areas. In light of this, the present study sought to identify Flavivirus infection in mosquitoes (Diptera: Culicidae) collected in parks in the city of São Paulo. Seven parks in different sectors of the city were selected. Monthly mosquito collections were carried out in each park from March 2011 to February 2012 using aspiration and traps (Shannon and CD C-CO2). Nucleic acids were extracted from the mosquitoes collected and used for reverse-transcriptase and real-time polymerase chain reactions with genus-specific primers targeting a 200-nucleotide region in the Flavivirus NS5 gene. Positive samples were sequenced, and phylogenetic analyses were performed. Culex and Aedes were the most frequent genera of Culicidae collected. Culex flavivirus (CxFV)-related and Aedes flavivirus (AEFV)- related nucleotide sequences were detected in 17 pools of Culex and two pools of Aedes mosquitoes, respectively, among the 818 pools of non-engorged females analyzed. To the best of our knowledge, this is the first report of CxFV and AEFV in the city of São Paulo and Latin America, respectively. Both viruses are insect- specific flaviviruses, a group known to replicate only in mosquito cells and induce a cytopathic effect in some situations. Hence, our data suggests that CxFV and AEFV are present in Culex and Aedes mosquitoes, respectively, in parks in the city of São Paulo. Even though Flavivirus species of medical importance were not detected, surveillance is recommended in the study areas because of the presence of vertebrates and mosquitoes that could act as amplifying hosts and vectors of flaviviruses, providing the required conditions for circulation of these viruses.

Diversity and abundance of mosquitoes (Diptera:Culicidae) in an urban park: larval habitats and temporal variation.

Urban parks are areas designated for human recreation but also serve as shelter and refuge for populations of several species of native fauna, both migratory and introduced. In Brazil, the effect of annual climate variations on Aedes aegypti and dengue epidemics in large cities like São Paulo is well known, but little is known about how such variations can affect the diversity of mosquito vectors in urban parks and the risk of disease transmission by these vectors. This study investigates the influence of larval habitats and seasonal factors on the diversity and abundance of Culicidae fauna in Anhanguera Park, one of the largest remaining green areas in the city of São Paulo. Species composition and richness and larval habitats were identified. Seasonality (cold-dry and hot-rainy periods) and year were considered as explanatory variables and the models selection approach was developed to investigate the relationship of these variables with mosquito diversity and abundance. A total of 11,036 specimens from 57 taxa distributed in 13 genera were collected. Culex nigripalpus, Cx. quinquefasciatus and Aedes albopictus were the most abundant species. Bamboo internodes and artificial breeding sites showed higher abundance, while ponds and puddles showed greater richness. Significant relationships were observed between abundance and seasonality, with a notable increase in the mosquitos abundance in the warm-rainy periods. The Shannon and Berger-Parker indices were related with interaction between seasonality and year, however separately these predictors showed no relationship with ones. The increased abundance of mosquitoes in warm-rainy months and the fact that some of the species are epidemiologically important increase not only the risk of pathogen transmission to people who frequent urban parks but also the nuisance represented by insect bites. The findings of this study highlight the importance of knowledge of culicid ecology in green areas in urban environments.

Mosquito fauna in municipal parks of São Paulo City, Brazil: a preliminary survey.

A mosquito faunal survey was conducted from October 2010 to February 2011 in the municipal parks of São Paulo City, Brazil. A total of 7,015 specimens of 53 taxonomic categories grouped into 12 genera (Aedes, Anopheles, Coquilletidia, Culex, Limatus, Lutzia, Mansonia, Psorophora, Toxorhynchites, Trichoprosopon, Uranotaenia, and Wyeomyia) were collected. The largest and most peripheral parks showed greater species richness compared to smaller and more centralized parks.

Caracterização dos casos de violência física, psicológica, sexual e negligências notificados em Recife, Pernambuco, 2012 / Characterization of cases of physical, psychological and sexual violence and negligence reported in Recife, Pernambuco, 2012

Objetivo: descrever o perfil dos casos de violência notificados na cidade de Recife, Estado de Pernambuco, Brasil. Métodos: estudo descritivo que incluiu todos os casos de violência doméstica, sexual e outras violências registrados no Sistema de Informação de Agravos de Notificação (Sinan) de Recife-PE, em 2012. Resultados: foram notificados 3.119 casos de violência no ano estudado, sendo 67,3 por cento mulheres, 33,6 por cento na faixa etária de 0 a 9 anos e 51,6 por cento de cor da pele parda; a violência física foi a mais notificada (49,5 por cento); na violência sexual, o principal agressor era um desconhecido (30,7 por cento), sendo um familiar nos demais tipos de violência; metade dos casos foi encaminhada para outros serviços de saúde (50,2 por cento). Conclusão: entre os casos de violência notificados, as principais vítimas foram mulheres, crianças e indivíduos de cor da pele parda; as estratégias intersetoriais de apoio às vítimas de violência e seus familiares devem ser focadas nos grupos de maior vulnerabilidade.

Objective: to describe the profile of interpersonal violence cases reported in Recife – Pernambuco - Brazil. Methods: this is a cross-sectional study of cases of domestic, sexual and other violence registered on the Recife Notifiable Diseases Information System in 2012. Results: 3,119 cases of violence were reported. 67.3 per cent were female, 33.6 per cent aged 0 to 9 and 51.6 per cent dark-skinned. Physical violence was the main form of aggression reported (49.5 per cent). Concerning sexual violence, the main aggressor was unknown (30.7 per cent). In other types of violence most frequently the aggressor was a family member. Half of the cases were referred to other health services (50.2 per cent). Conclusion: in the above reported cases, highest prevalence of violence was detected in females, children and dark-skinned people. Intersectoral strategies to support victims and their families should focus on the most vulnerable groups identified in this study.

Fatores associados ao atraso do desenvolvimento motor de crianças prematuras internadas em unidade de neonatologia / Factors associated with late motor development in premature children admitted to a neonatology unit

Verificar a frequência do atraso do desenvolvimento motor em crianças prematuras internadas em unidade neonatal e identificar os fatores associados. MÉTODOS: estudo descritivo e analítico, realizado na Unidade Neonatal de uma maternidade de alto risco em Recife, Brasil. Avaliou-se o desenvolvimento motor, através do Test of Infant Motor Performance, de 98 crianças nascidas pré-termo com idade pós-conceptual mínima de 34 semanas, durante a internação, entre janeiro e julho de 2009. Analisaram-se associações entre variáveis maternas, neonatais e assistenciais com desenvolvimento motor. RESULTADOS: a média de idade pós-conceptual na avaliação foi de 37 semanas e 39,8 por cento das crianças apresentaram desenvolvimento motor alterado (atípico ou suspeito). Fatores significativamente associados ao desenvolvimento motor alterado foram: menor peso ao nascer; maior idade na avaliação; maior número de consultas pré-natais; ocorrência de hipóxia e displasia broncopulmonar; maior tempo de permanência na unidade de terapia intensiva e unidade neonatal. Houve tendência significante a um pior desenvolvimento motor com uso de oxigenoterapia e ventilação mecânica prolongadas. CONCLUSÕES: crianças prematuras internadas podem apresentar atraso precoce do desenvolvimento motor, de forma grave ou limítrofe. Peso ao nascer, morbidades neonatais e assistência recebida na unidade neonatal foram os fatores que mais influenciaram o desfecho. Esses resultados justificam o início de estratégias preventivas e estimulação ainda no período de internação...

To assess the frequency of late motor development in premature children admitted to a neonatal unit and to identify associated factors. METHODS: a descriptive analytical study carried out at the Neonatal Unit of a high-risk maternity hospital in Recife, Brazil. Motor development was assessed using the Test of Infant Motor Performance, in 98 preterm children with a minimal post-conception age of 34 weeks, during admission to hospital, between January and June 2009. Associations were examined between variables relating to the mother, the newborn, the care provided and motor development. RESULTS: the mean post-conception age on evaluation was 37 weeks and 39.8 percent of the children had some kind of impaired motor development (atypical or suspected to be atypical). Factors significantly associated with changes in motor development were: lower birth weight; higher age on evaluation; greater number of prenatal sessions; occurrence of hypoxia and bronco-pulmonary dysplasia; longer stay in ICU and neonatal unit. There was a significant trend for motor development to worsen with prolonged use of oxygen-therapy and mechanical ventilation. CONCLUSIONS: premature children admitted to hospital may show early signs of delayed motor development of a severe or borderline nature. Birth weight, neonatal morbidities and care received at the neonatal unit were the factors that most strongly influenced the outcome. These results justify initiation of preventive strategies and stimulation while the child is still in hospital...

Serologic, parasitic, and bacteriologic assessment of captive cracids (Aves: Galliformes: Cracidae) in Brazil.

Captive cracids (Aves: Galliformes: Cracidae), including endangered species, were studied (n = 130) for the assessment of health status, including Aburria jacutinga (black-fronted piping-guan, n = 42), Crax blumenbachii (red-knobbed curassow, n = 54), Craxfasciolata (bare-faced curassow, n = 28), and Penelope obscura (dusky-legged guan, n = 6). The exposure to Mycoplasma gallisepticum (MG), Mycoplasma synoviae (MS), Salmonella pullorum (SP), Salmonella gallinarum (SG), avian paramyxovirus-1 (APMV-1), and infectious bursal disease virus (IBDV) were determined by serology, and SG and SP also were evaluated by culture. Ectoparasites and endoparasites were identified using light microscopy. Sera were negative by the hemagglutination inhibition (HI) test for antibodies to MG or MS, although serum was reactive to MG (32%, 42/130) by the rapid serum agglutination test (SAT). Although positive reactions (26.9%, 35/130) for SP and SG were detected by SAT, cloacal swab cultures were negative for SP and SG. IBDV antibodies were detected by enzyme-linked immunosorbent assay in two dusky-legged guans (1.5%, 2/130). HI antibody titers to APMV-1 were found in 20 (15.3%) cracids, with titers ranging from 16 to 1,024. Fifty percent of birds (65/130) had ectoparasites. Lice (Menacanthus spp.) and mites (Astigmata: Analgesidae, Megninidae; Megninia spp.) were found in red-knobbed curassow; Megninia spp. also were found in bare-faced curassow, black-fronted piping-guan, and dusky-legged guan. Eleven black-fronted piping-guans presented dual parasitism by Megninia spp. and Ornithonyssus spp. Endoparasites were detected in 16.1% (21/130) of birds, and some with multiple parasites. Oocysts of coccidia and eggs of Capillaria spp. (Nematoda: Trichuroidea) were found in the feces of red-knobbed curassow. Eggs of Strongyloides spp. were found in the feces of bare-faced curassow, and eggs of Ascaridia spp., Capillaria spp., and Strongyloides spp. were found in black-fronted piping-guan. Cysts of Blastocystis spp. were found in dusky-legged guan. Antibodies to IBDV and APMV-1 indicate previous exposure. However, considering that birds were clinically normal, immune stimulation might have been from live chicken vaccine strain infections that are widely used in Brazilian poultry. The high parasitism levels indicate that a routine inspection for internal and external parasites is warranted.

Health assessment of captive tinamids (Aves, Tinamiformes) in Brazil.

Ninety-five (95) captive tinamids (Aves, Tinamiformes) of species Crypturellus obsoletus (brown tinamou), Crypturellus parvirostris (small-billed tinamou), Crypturellus tataupa (Tataupa tinamou), Crypturellus undulatus (undulated tinamou), Rhynchotus rufescens (red-winged tinamou), and Tinamus solitarius (solitary tinamou) were evaluated for diseases of mandatory control in the Brazilian Poultry Health Program (PNSA). Antibodies were detected by serum agglutination test (SAT) in 4 birds for Mycoplasma gallisepticum (MG) and in 27 birds for Salmonella Pullorum (SP) and Salmonella Gallinarum (SG). However, by hemagglutination inhibition (HI), sera were negative to MG and Mycoplasma synoviae (MS). Bacteriology was negative for SP and SG. No antibody was detected by HI to avian paramyxovirus type 1. However, antibodies to infectious bursal disease virus were detected in 9.4% (9/95) by ELISA. Fecal parasitology and necropsy revealed Capillaria spp. in 44.2% (42/95), Eimeria rhynchoti in 42.1% (40/95), Strongyloides spp. in 100% (20/20), Ascaridia spp., and unknown sporozoa in small-billed tinamou. Ectoparasites were detected in 42.1% (40/95) by inspection, and collected for identification. The louse Strongylocotes lipogonus (Insecta: Phthiraptera) was found on all Rhynchotus rufescens. An additional four lice species were found on 14 individuals. Traumatic lesions included four individual R. rufescens (4/40, 10%) with rhinotheca fracture, one with mandible fracture and three with posttraumatic ocular lesions (3/40, 7.5%). One C. parvirostris had phalangeal loss, another had tibiotarsal joint ankylosis and another had an open wound on the foot. Results suggest that major poultry infections/ diseases may not be relevant in tinamids, and that this group of birds, as maintained within distances for biosecurity purposes, may not represent a risk to commercial poultry. Ecto- and endoparasites were common, disseminated, and varied; regular monitoring of flocks is recommended for best performance.

Desenvolvimento motor de prematuros em unidade neonatal: fatores determinantes e avaliação precoce / Motor development of premature infants in neonatal unit: Determining factors and early evalution

Esta revisão se refere aos fatores biológicos e ambientais envolvidos no atraso do desenvolvimento motor de recém-nascidos prematuros internados em unidades de neonatologia, destacando a importância do diagnóstico precoce e do acompanhamento em longo prazo. As referências foram obtidas por meio dos bancos de dados Medline / Pubmed e SciELO, abrangendo o período de 1998 a 2010, a partir dos descritores recém-nascido prematuro, desenvolvimento infantil, fatores de risco e UTI neonatal, pesquisados de forma isolada e cruzada. O recém-nascido prematuro apresenta imaturidade global de órgãos e sistemas que lhe confere maior vulnerabilidade biológica, com maior predisposição às morbidades, inclusive neurológicas. Assim, muitas vezes necessita de longos períodos de internação em Unidade de Terapia Intensiva, cujo ambiente estressante pode atuar como fator deletério adicional, contribuindo para o comprometimento da maturação e organização do sistema nervoso e, consequentemente, prejudicando seu desenvolvimento neuropsicomotor. Uma série de morbidades maternas e neonatais, além dos longos períodos de internação dos recém-nascidos prematuros em unidades neonatais, pode levar ao atraso do desenvolvimento motor. Diante dessa problemática, torna-se essencial o reconhecimento dos fatores associados a esse atraso, bem como a realização de um diagnóstico precoce. Uma vez que os déficits podem perdurar até a adolescência ou vida adulta, o seguimento em longo prazo é fundamental para o reconhecimento de problemas tardios e para encaminhamento dos casos suspeitos à intervenção interdisciplinar.

This review refers to biological and environmental factors involved in delayed motor development in premature newborn infants hospitalized in neonatal units, highlighting the importance of early diagnosis and long-term monitoring. References were obtained from Medline/Pubmed and SciELO databases, covering the period from 1998 to 2010, using the uniterms premature newborn infants, infant development, risk factors and neonatal intensive care unit, which were investigated in isolated and cross-matched manner. Premature newborn infants suffer from organ and system immaturity, rendering them biologically vulnerable, with greater predisposition to morbidities, including neurological ones. Thus, it is very often necessary for the infant to spend extended periods in intensive care units, where a stressful atmosphere may bring about further deleterious effects, contributing to the impairment of the maturation and organization of the nervous system and, consequently, hinder neuropsychomotor development. A series of maternal and neonatal morbidities, as well as extended hospitalization periods in neonatal units for premature newborn infants may lead to delayed motor development. Given such a situation, it is not only essential to identify the factors associated to this delay, but also to make an early diagnosis. SInce neuromotor deficits persist into adolescence or adulthood, then long-term monitoring is essential in order to identify any future problems that may occur and refer suspected cases for interdisciplinary intervention.

Desenvolvimento motor de prematuros em unidade neonatal: fatores determinantes e avaliação precoce / Motor development of premature infants in neonatal unit: Determining factors and early evalution

Esta revisão se refere aos fatores biológicos e ambientais envolvidos no atraso do desenvolvimento motor de recém-nascidos prematuros internados em unidades de neonatologia, destacando a importância do diagnóstico precoce e do acompanhamento em longo prazo. As referências foram obtidas por meio dos bancos de dados Medline / Pubmed e SciELO, abrangendo o período de 1998 a 2010, a partir dos descritores recém-nascido prematuro, desenvolvimento infantil, fatores de risco e UTI neonatal, pesquisados de forma isolada e cruzada. O recém-nascido prematuro apresenta imaturidade global de órgãos e sistemas que lhe confere maior vulnerabilidade biológica, com maior predisposição às morbidades, inclusive neurológicas. Assim, muitas vezes necessita de longos períodos de internação em Unidade de Terapia Intensiva, cujo ambiente estressante pode atuar como fator deletério adicional, contribuindo para o comprometimento da maturação e organização do sistema nervoso e, consequentemente, prejudicando seu desenvolvimento neuropsicomotor. Uma série de morbidades maternas e neonatais, além dos longos períodos de internação dos recém-nascidos prematuros em unidades neonatais, pode levar ao atraso do desenvolvimento motor. Diante dessa problemática, torna-se essencial o reconhecimento dos fatores associados a esse atraso, bem como a realização de um diagnóstico precoce. Uma vez que os déficits podem perdurar até a adolescência ou vida adulta, o seguimento em longo prazo é fundamental para o reconhecimento de problemas tardios e para encaminhamento dos casos suspeitos à intervenção interdisciplinar.(AU)

This review refers to biological and environmental factors involved in delayed motor development in premature newborn infants hospitalized in neonatal units, highlighting the importance of early diagnosis and long-term monitoring. References were obtained from Medline/Pubmed and SciELO databases, covering the period from 1998 to 2010, using the uniterms premature newborn infants, infant development, risk factors and neonatal intensive care unit, which were investigated in isolated and cross-matched manner. Premature newborn infants suffer from organ and system immaturity, rendering them biologically vulnerable, with greater predisposition to morbidities, including neurological ones. Thus, it is very often necessary for the infant to spend extended periods in intensive care units, where a stressful atmosphere may bring about further deleterious effects, contributing to the impairment of the maturation and organization of the nervous system and, consequently, hinder neuropsychomotor development. A series of maternal and neonatal morbidities, as well as extended hospitalization periods in neonatal units for premature newborn infants may lead to delayed motor development. Given such a situation, it is not only essential to identify the factors associated to this delay, but also to make an early diagnosis. SInce neuromotor deficits persist into adolescence or adulthood, then long-term monitoring is essential in order to identify any future problems that may occur and refer suspected cases for interdisciplinary intervention.(AU)