Nursing students' professional values for reinforcing the professional identity.

OBJECTIVES: to understand the nursing students' professional values in different Brazilian universities and verify a correlation between the "Professional Value" and the sociodemographic variables. METHODS: quantitative, cross-sectional, and descriptive study conducted through an electronic questionnaire with a Professional Values Scale (NPVS-3). Participants were Nursing students of all semesters from three universities - two in the Southeast region and one in the North region. RESULTS: of the 337 participating Nursing students, 282 were female. The Caring dimension presented the highest score (mean=46.61), and Professionalism, the lowest score (mean=34.65). A statistically significant association was detected between the Caring dimension, "university where is attending," and "gender." CONCLUSIONS: the results indicate the Caring dimension as the one containing the most scored professional values since the nurses' training, and the relation of those values in such dimension is more significant in the female sample.

Predicting congenital syphilis cases: A performance evaluation of different machine learning models.

BACKGROUND: Communicable diseases represent a huge economic burden for healthcare systems and for society. Sexually transmitted infections (STIs) are a concerning issue, especially in developing and underdeveloped countries, in which environmental factors and other determinants of health play a role in contributing to its fast spread. In light of this situation, machine learning techniques have been explored to assess the incidence of syphilis and contribute to the epidemiological surveillance in this scenario. OBJECTIVE: The main goal of this work is to evaluate the performance of different machine learning models on predicting undesirable outcomes of congenital syphilis in order to assist resources allocation and optimize the healthcare actions, especially in a constrained health environment. METHOD: We use clinical and sociodemographic data from pregnant women that were assisted by a social program in Pernambuco, Brazil, named Mãe Coruja Pernambucana Program (PMCP). Based on a rigorous methodology, we propose six experiments using three feature selection techniques to select the most relevant attributes, pre-process and clean the data, apply hyperparameter optimization to tune the machine learning models, and train and test models to have a fair evaluation and discussion. RESULTS: The AdaBoost-BODS-Expert model, an Adaptive Boosting (AdaBoost) model that used attributes selected by health experts, presented the best results in terms of evaluation metrics and acceptance by health experts from PMCP. By using this model, the results are more reliable and allows adoption on a daily usage to classify possible outcomes of congenital syphilis using clinical and sociodemographic data.

Nursing students' professional values for reinforcing the professional identity / Valores profesionales de los estudiantes de Enfermería para el fortalecimiento de la identidad profesional / Valores profissionais dos estudantes de Enfermagem para o fortalecimento da identidade profissional

ABSTRACT Objectives: to understand the nursing students' professional values in different Brazilian universities and verify a correlation between the "Professional Value" and the sociodemographic variables. Methods: quantitative, cross-sectional, and descriptive study conducted through an electronic questionnaire with a Professional Values Scale (NPVS-3). Participants were Nursing students of all semesters from three universities - two in the Southeast region and one in the North region. Results: of the 337 participating Nursing students, 282 were female. The Caring dimension presented the highest score (mean=46.61), and Professionalism, the lowest score (mean=34.65). A statistically significant association was detected between the Caring dimension, "university where is attending," and "gender." Conclusions: the results indicate the Caring dimension as the one containing the most scored professional values since the nurses' training, and the relation of those values in such dimension is more significant in the female sample.

RESUMEN Objetivos: conocer los valores profesionales de los estudiantes de Enfermería en diferentes universidades brasileñas y verificar la existencia de relación entre las variables "Valor profesional" y las variables sociodemográficas. Métodos: estudio cuantitativo, transversal y descriptivo, realizado por encuesta electrónica conteniendo la Escala de Valores Profesionales (NPVS-3). Participaron estudiantes de todos los semestres de Enfermería de tres universidades - dos en la Región Sudeste y una en la Región Norte. Resultados: de los 337 estudiantes de Enfermería participantes, 282 son del género femenino. La dimensión Cuidado presentó mayor puntuación (mediana=46,61); y el Profesionalismo, la menor puntuación (mediana=34,65). Encontrado relación estadísticamente significante de la dimensión "Cuidado" con "universidad que estudia" y "género". Conclusiones: los resultados apuntan la dimensión Cuidado como la que contiene los valores profesionales más puntuados desde la formación del enfermero, siendo que la relación de esos valores en tal dimensión está más acentuada en la muestra del género femenino.

RESUMO Objetivos: conhecer os valores profissionais dos estudantes de Enfermagem em diferentes universidades brasileiras e verificar a existência de relação entre as variáveis "Valor profissional" e as variáveis sociodemográficas. Métodos: estudo quantitativo, transversal e descritivo, realizado por questionário eletrônico contendo a Escala de Valores Profissionais (NPVS-3). Participaram estudantes de todos os semestres de Enfermagem de três universidades - duas na Região Sudeste e uma na Região Norte. Resultados: dos 337 estudantes de Enfermagem participantes, 282 são do gênero feminino. A dimensão Cuidado apresentou maior pontuação (média=46,61); e o Profissionalismo, a menor pontuação (média=34,65). Encontrou-se associação estatisticamente significante da dimensão "Cuidado" com "universidade que estuda" e "gênero". Conclusões: os resultados apontam a dimensão Cuidado como a que contém os valores profissionais mais pontuados desde a formação do enfermeiro, sendo que a relação desses valores em tal dimensão está mais acentuada na amostra do gênero feminino.

On usage of artificial intelligence for predicting mortality during and post-pregnancy: a systematic review of literature.

BACKGROUND: Care during pregnancy, childbirth and puerperium are fundamental to avoid pathologies for the mother and her baby. However, health issues can occur during this period, causing misfortunes, such as the death of the fetus or neonate. Predictive models of fetal and infant deaths are important technological tools that can help to reduce mortality indexes. The main goal of this work is to present a systematic review of literature focused on computational models to predict mortality, covering stillbirth, perinatal, neonatal, and infant deaths, highlighting their methodology and the description of the proposed computational models. METHODS: We conducted a systematic review of literature, limiting the search to the last 10 years of publications considering the five main scientific databases as source. RESULTS: From 671 works, 18 of them were selected as primary studies for further analysis. We found that most of works are focused on prediction of neonatal deaths, using machine learning models (more specifically Random Forest). The top five most common features used to train models are birth weight, gestational age, sex of the child, Apgar score and mother's age. Having predictive models for preventing mortality during and post-pregnancy not only improve the mother's quality of life, as well as it can be a powerful and low-cost tool to decrease mortality ratios. CONCLUSION: Based on the results of this SRL, we can state that scientific efforts have been done in this area, but there are many open research opportunities to be developed by the community.

Friction ridge analysis in disaster victim identification (DVI): Brazilian case studies.

Depending on the magnitude and nature of a disaster, identifying the victims can be a complex task that requires coordinated work by disaster victim identification (DVI) teams based on pre-established protocols. Thus, the analysis of fingerprints has been presented as a method to establish, when possible, the identity of the victims during the DVI process. This study discusses the importance of this primary method of identification and the results obtained in four different disasters in which Brazilian DVI teams were involved: the Air France Flight AF447 plane crash in the Atlantic Ocean, floods and mudslides in the State of Rio de Janeiro, Brazil, the LaMia Flight 2933 plane crash in Colombia, and the tailings dam collapse in Brumadinho, Brazil. Here, we also report the use of the automatic fingerprint capture and identification system, called Alethia, developed by the Federal Police of Brazil and used in the victim identification process in the two latter events mentioned above.Key pointsThis article presents four different disasters that occurred in Brazil and overseas and involved Brazilian DVI teams in the identification process, focusing on fingerprint identification (Air France Flight AF447, floods and mudslides in the State of Rio de Janeiro, Brazil, LaMia Flight 2933, and the Brumadinho tailings dam collapse).This article also describes the evolution of the DVI process in Brazil, including a description of the technology currently used by Brazilian fingerprint experts (Alethia).This article reports how the Alethia System was used in the disasters and how it optimized the human identification process when compared to traditional methods.

Quality of Life and Associated Factors Among Male Wheelchair Handball Athletes.

Although scarce, some recent studies have observed good self-reported quality of life (QOL) among wheelchair users who are involved in adapted sports. These findings have encouraged further investigations, particularly investigations of combined sociodemographic and sport factors in the study of QOL. In this study we analyzed the association between sociodemographic and sport factors with QOL in a cross-sectional study of 105 male wheelchair handball (WH) athletes with higher and lower QOL. We used the World Health Organization Quality of Life - BREF (WHOQOL-BREF) scale to evaluate the respondents QOL; and we used a sociodemographic questionnaire to evaluate associated sociodemographic and sport factors. A logistic regression analysis found these athletes' good QOL to be generally characterized by stable marital status, disability due to cerebral palsy, the use of locomotion/mobility resources, full independence, bi-weekly training, and the use of a custom-made wheelchair for around 70% of their daily living activities. These findings support the role of such sociodemographic and sport factors in determining QOL among these WH respondents. These findings reveal the important issues to be considered in the sport modality when attempting to improve the QOL and functionality of these participants and perhaps WH athletes worldwide.

Early Growth Parameters as Predictors of Developmental Delay Among Children Conceived During the 2015-2016 Zika Virus Outbreak in Northeastern Brazil.

BACKGROUND: Identifying infants with congenital infection for early intervention will likely be challenging in future Zika virus outbreaks. We investigated indicators of risk for developmental delay among children born with and without obvious manifestations of congenital Zika virus infection. METHODS: We evaluated 120 children conceived during the 2015-2016 Zika virus outbreak in Paraíba, Brazil. We analyzed data from children at birth; ages 1-7 months and approximately 24 months, using medical records (i.e., anthropometric measurements diagnoses), medical evaluation (i.e., Zika/other laboratory tests, dysmorphic features), and parent report (seizures, developmental delay). We used a Bayesian modeling approach to identify predictors of developmental delay. RESULTS: Head circumference (HC) and length at birth and rates of growth for HC and length at follow-up were consistent across domains of developmental delay; (e.g., for every 1 cm per month decrease in HC growth rate; there was a corresponding decrease in the gross motor z-score). Modeling results indicated that HC and length at birth, and follow-up HC and length rates of growth, were predictive of developmental delay. CONCLUSION: These findings suggest that accurate measurement and frequent monitoring of HC and length, especially in the first few months of life, may be useful for identifying children possibly congenitally exposed to Zika virus who could benefit from early intervention services.

Functional Outcomes among a Cohort of Children in Northeastern Brazil Meeting Criteria for Follow-Up of Congenital Zika Virus Infection.

Following the large outbreak of Zika virus in the Western Hemisphere, many infants have been born with congenital Zika virus infection. It is important to describe the functional outcomes seen with congenital infections to allow for their recognition and appropriate interventions. We evaluated 120 children conceived during the 2015-2016 Zika virus outbreak in Paraíba, Brazil, who were approximately 24 months old, to assess functional outcomes. All children met either anthropometric criteria or laboratory criteria suggestive of possible congenital Zika virus infection. We collected results of previous medical evaluations, interviewed parents, and performed physical examinations and functional assessments, for example, the Hammersmith Infant Neurological Examination (HINE). We compared patterns of neurologic outcomes and developmental delay at age 24 months by whether children met anthropometric or laboratory criteria, or both. Among children meeting both criteria, 60% (26/43) were multiply affected (had severe motor impairment, severe developmental delay, and suboptimal HINE scores), compared with 5% (3/57) meeting only laboratory criteria and none (0/20) meeting only anthropometric criteria. Of the remaining 91 children, 49% (45) had developmental delay, with more severe delay seen in children meeting both criteria. Although children meeting physical and laboratory criteria for potential congenital Zika virus infection were more severely affected, we did identify several children with notable adverse neurologic outcomes and developmental delay with no physical findings but potential laboratory evidence of Zika virus infection. Given this, all children who were potentially exposed in utero to Zika virus should be monitored in early childhood for deficits to allow for early intervention.

Protocolo Avaliativo de Iniciação Esportiva em Cadeira de Rodas: uma alternativa de avaliação para pessoas com deficiência física

RESUMO O estudo teve como objetivo apresentar o Protocolo Avaliativo de Iniciação Esportiva em Cadeira de Rodas - PAIE-CR e verificar em quais áreas dos componentes motores (habilidades motoras fundamentais e capacidades físicas), um programa de iniciação esportiva em cadeira de rodas exerceu influência, antes e após a intervenção proposta. A intervenção foi composta por 24 sessões. Participaram desse estudo três crianças (6 a 10 anos) com deficiência física, comprometimento nos membros inferiores. O PAIE-CR é composto por nove testes divididos em quatro grupos de componentes: estabilização; locomoção; manipulação e combinados. Acredita-se que o instrumento oportuniza o acompanhamento e permite avaliar os componentes inerentes à iniciação esportiva em cadeira de rodas do educando.

ABSTRACT The purpose of this study was to present a Wheelchair Sportive Initiation Protocol (WSIP). In addition we verified the effects of a sport initiation program in the target motor components fields (considering the main motor skills and capabilities for sport initiation in wheelchair). The intervention was carried out over 24 sessions. Three children aged 6-10 years with physical disability and lower limbs impairment participated in this study. The WSIP is composed for nine tests divided in four components groups: stabilization; locomotion; manipulation and matched. We believe that the instrument enables the assessment as well as follow-up of the learner with physical disability. Moreover, the WSIP allows assessing the components regarding the sport initiation in wheelchair.

RESUMEN El estudio en cuestión tuvo como objetivo presentar el Protocolo de Evaluación de Iniciación Deportiva en Silla de Ruedas - PEIDSR y verificar en qué áreas de las habilidades motoras básicas y fundamentos deportivos, el programa de iniciación deportiva en silla de ruedas ejerció mayor o menor influencia, antes y después de la intervención propuesta. Se trata de una investigación de campo del tipo cuantitativo-descriptivo, volcada al estudio de evaluación de programa. En este estudio participaron tres niños (6 a 10 años) con discapacidad física, comprometimiento en los miembros inferiores. Los parámetros de evaluación utilizados, en la aplicación del PEIDSR demostró que el mismo logró atender las necesidades del estudio, ya que fue posible evaluar cada una de las variables del programa y del estudio.

Perfil sociodemográfico de praticantes de handebol em cadeira de rodas

RESUMO Objetivou-se caracterizar o perfil sociodemográfico de praticantes de handebol em cadeira de rodas (HCR) no Brasil. Trata-se de um estudo descritivo, feito com 105 sujeitos. Aplicou-se um questionário elaborado para o estudo, analisado através de estatística descritiva. Constatou-se que a maioria dos praticantes não exercia atividade laboral e tinha o ensino médio completo. Grande parte dos atletas praticou esportes durante a infância e antes da aquisição da deficiência. Contudo, seus treinamentos acontecem numa frequência inferior ao que se recomenda para esportes de rendimento. Conclui-se que o HCR ainda é um esporte em ascensão e executado de forma amadora no país e necessita de maior fomento.

ABSTRACT The objective of this study was to characterize the socio-demographic profile of WCH players in Brazil. This is a descriptive study, carried out with 105 players. A questionnaire developed for the study was used and the answers were analyzed through the descriptive statistics. It was found that the most of players had no job and presented the full high school. Most of the players used to play sports during their childhood and before the acquisition of disability. However, their training sessions happens in a lower frequency than that recommended for sports performance. In conclusion, the WCH is still a sport on rising and it has been developing by amateur way in the country and needs further development.

RESUMEN El objetivo fue definir el perfil sociodemográfico de los jugadores de balonmano en silla de ruedas (BSR) de Brasil. Se trata de un estudio descriptivo, feito con 105 individuos. Se aplicó un cuestionario elaborado para el estudio y las respuestas se analizaron mediante estadística descriptiva. Se constató que la mayoría de los jugadores no ejercía actividad laboral, había completado la enseñanza media, no tenía enfermedades y no hacía uso de un medicamento controlado. Gran parte de los jugadores practicaron deportes durante la infancia y antes de la adquisición de la discapacidad. Sin embargo, sus entrenamientos se producen con una frecuencia inferior a lo que se recomienda para el rendimiento deportivo. Se concluye que el BSR continúa siendo un deporte en ascenso que se juega de forma amateur.

Maternal Supplementation With Avocado (Persea americana Mill.) Pulp and Oil Alters Reflex Maturation, Physical Development, and Offspring Memory in Rats.

Avocado (Persea americana Mill.) is an oleaginous fruit source of fatty acids with high levels of neuroprotective phytocomplexes. The objective of this study was to evaluate the development of reflex and somatic maturation, fatty acid profiles in the brain, and memory in different stages of life in the offspring of dams supplemented with avocado pulp and oil during gestation and lactation. The dams were randomly divided into three groups (n = 15 pups/group), and recieved by gavage supplementation: control group (CG)-distilled water; Avocado Oil (AO)-3,000 mg avocado oil/kg animal weight, and Avocado Pulp (AP)-3,000 mg avocado pulp/kg animal weight. We performed the following tests: Analysis of Somatic Development and Ontogeny of Postnatal Reflex (T0 to T21), the Open Field Habituation Test and the Object Recognition Test (ORT) in the adolescent (T45) and adult (T90) phases. The cerebral fatty acids content was evaluated at times T0, T21, T45, and T90. The results were analyzed using the statistical program GraphPad Prism and significant statistics were considered when p < 0.05. Acceleration of reflex maturation and reflex ontogeny was observed in the offspring of AO and AP fed dams, with the results being more pronounced in the pulp fed group (p < 0.05). All groups presented a decrease in the ambulation parameter in the second exposure to the Open Field Habituation Test, at T45 and T90 (p < 0.05). In the ORT, the AO and AP offspring presented memory improvements in the short and long term in the adult and adolescent phases (p < 0.05). The results of the brain fatty acid profiles presented higher polyunsaturated fatty acids (PUFA) content in the AO and AP groups at T21, T45, and T90. The docosahexaenoic fatty acid (DHA) content was higher at T21 (AO and AP), at T45 (AO and AP), and at T90 (AP) (p < 0.05). The arachidonic acid (ARA) content was higher at T45 (AO and AP), and at T90 (AO) (p < 0.05). Maternal supplementation with avocado oil and pulp anticipates reflex maturation and somatic postnatal development, and improves memory during the adolescent and adult phases.

Health and Development at Age 19-24 Months of 19 Children Who Were Born with Microcephaly and Laboratory Evidence of Congenital Zika Virus Infection During the 2015 Zika Virus Outbreak - Brazil, 2017.

In November 2015, the Brazilian Ministry of Health (MOH) declared the Zika virus outbreak a public health emergency after an increase in microcephaly cases was reported in the northeast region of the country (1). During 2015-2016, 15 states in Brazil with laboratory-confirmed Zika virus transmission reported an increase in birth prevalence of microcephaly (2.8 cases per 10,000 live births), significantly exceeding prevalence in four states without confirmed transmission (0.6 per 10,000) (2). Although children with microcephaly and laboratory evidence of Zika virus infection have been described in early infancy (3), their subsequent health and development have not been well characterized, constraining planning for the care and support of these children and their families. The Brazilian MOH, the State Health Secretariat of Paraíba, and CDC collaborated on a follow-up investigation of the health and development of children in northeastern Brazil who were reported to national surveillance with microcephaly at birth. Nineteen children with microcephaly at birth and laboratory evidence of Zika virus infection were assessed through clinical evaluations, caregiver interviews, and review of medical records. At follow-up (ages 19-24 months), most of these children had severe motor impairment, seizure disorders, hearing and vision abnormalities, and sleep difficulties. Children with microcephaly and laboratory evidence of Zika virus infection have severe functional limitations and will require specialized care from clinicians and caregivers as they age.

Microbiota de úlceras venosas pós uso de "Bota de Unna" / Microorganisms present after use of Unna's boot from ulcers venous patient

Modelo do Estudo: Foi realizado um estudo individual, analítico, observacional, longitudinal prospectivo, controlado, estudo de coortes concorrente, realizado no período de abril de 2013 a novembro de 2014. Objetivo: Avaliar a microbiota presente no exudato da úlcera venosa de pacientes com "Bota de Unna" e a sua resistência aos antimicrobianos. Métodos: Foram coletadas amostras do exudato de feridas de pacientes com o uso de "Bota de Unna" e de terapia tópica durante a troca do curativo e após sete dias. Os micro-organismos isolados foram identificados e testados quanto à susceptibilidade a antimicrobianos: Resultado: Os micro-organismos Gram positivos isolados foram: S. aureus, E. faecalis, S. xylosus e S. haemolyticus. Os micro-organismos Gram negativos foram: E. coli, P. aeruginosa, S. plymuthica, P. mirabilis, K. pneumoniae, K. oxytoca, P. stuartii, P. vulgaris, A. hydrophila, S. marcescens, A.baumannii, E. cloacae e Tatumella sp. O percentual de crescimento e a microbiota no exudato da úlcera após sete dias não foi significante entre os dois tipos de curativo. O aumento de resistência dos cocos Gram positivos aos antimicrobianos testados nos pacientes que utilizam a "Bota de Unna" foi maior do que nos pacientes sem bota (p=0,0093). Conclusão: O número de micro-organismos na microbiota do exudato da úlcera venosa após troca do curativo é maior independentemente do tipo do curativo. Os cocos Gram-positivos apresentam aumento de resistência aos antimicrobianos nos pacientes que utilizam a "Bota de Unna" (AU)

Model Study: A special analytical observational prospective longitudinal and controlled study of concurrent cohort was conducted from April 2013 to November 2014. Objective: To evaluate the microbiota present in the secretion of venous ulcer patients with "Unna Boot" and their resistance to antimicrobials. Methods: secretion samples were collected from wounds of patients with and without the use of "Unna Boot" and topic therapy during the dressing change and after seven days. The isolated microorganisms were identified and tested for antimicrobial susceptibility: Result: The isolated Gram-positive microorganisms were: S. aureus, E. faecalis, S. haemolyticus and S. xylosus. Gram-negative microorganisms were E. coli, P. aeruginosa, S. plymuthica, P. mirabilis, K. pneumoniae, K. oxytoca, P. stuartii, P. vulgaris, A. hydrophila, S. marcescens, A. baumannii, E. cloacae and Tatumella sp. The growth percentage and the microbiota in the secretion of the ulcer after seven days was not significant between the two types of dressing. The resistance of Gram-positive cocci to antimicrobials in patients using the "Unna Boot" was higher than in patients without boot (p = 0.0093). Conclusion: The number of microorganisms in microbial secretion venous ulcer after dressing change is higher regardless of the type of dressing. The positive cocci increased antimicrobial resistance in patients using the "Unna Boot".(AU)

Análise de implicação profissional: um dispositivo disparador de processos de educação permanente em saúde / Analysis of professional implication: a device triggering process of Permanent Education in Health

Esta tese teve por objetivo geral analisar a implicação profissional com os apoiadores de humanização e os articuladores de Educação Permanente em Saúde (EPS) dos municípios do Departamento Regional de Saúde (DRS) de Araraquara/São Paulo. Trata-se de uma pesquisa-intervenção Socioclínica, de abordagem qualitativa, realizada com os apoiadores de humanização e os articuladores de EPS dos 24 municípios que compõem o DRS em questão. Foram realizadas entrevistas individuais com 07 sujeitos que desenvolviam ambas as funções em seus municípios e 12 entrevistas grupais, sendo 11 compostas pelo apoiador e articulador e 01 composta por um grupo de 06 apoiadores do município. Portanto, 35 apoiadores e articuladores participaram da pesquisa-intervenção em questão. Foram também utilizados enquanto dispositivos analíticos para a produção dos dados desta pesquisa-intervenção: dez encontros mensais com os apoiadores e articuladores; sete encontros de planejamento e análise e o diário de pesquisa. As entrevistas e os encontros com os apoiadores e articuladores foram transcritos e as apreensões feitas nos encontros de planejamento e análise foram redigidos no diário de pesquisa. Todo esse material, bem como outras anotações feitas em diário, foi analisado a partir dos princípios da Socioclínica Institucional, sendo que um deles corresponde aos momentos de restituição, possibilitando um aprofundamento coletivo das análises realizadas. Os resultados foram apresentados a partir das dimensões libidinal, ideológica e organizacional que compõem a implicação profissional. Dessa forma, identificamos e analisamos com os apoiadores e articuladores os atravessamentos que a profissão inicial (enfermeiro, dentista, psicólogo, etc.) exerce sobre o fazer apoio; a contradição em se pensar em um perfil pronto para o desenvolvimento dessa função; os sentimentos de desânimo, pessimismo e otimismo enquanto componentes da dimensão ideológica que também atravessam o fazer apoio e a articulação de EPS; o tempo, o modo de fazer a gestão e o poder político enquanto analisadores da dimensão organizacional dos apoiadores e dos articuladores; e a ausência/presença do desejo, a vontade de agradar os profissionais de saúde, desenvolvendo uma relação harmônica no trabalho enquanto pistas analisáveis da dimensão libidinal dos apoiadores e dos articuladores. Na medida que o trabalho de análise com os apoiadores e articuladores prosseguiu, mudanças nos modos de se pensar e fazer apoio às equipes de saúde e também o pensar sobre o trabalho de apoiar e articular a EPS foi se modificando, fazendo com que esses profissionais entrassem, eles mesmos, em processos de EPS, refletindo e interrogando o próprio trabalho. O pesquisador ao realizar a análise de implicação também se colocou em processo de interrogação de sua prática, experienciando também a EPS em ato. Concluímos que a análise de implicação profissional consiste em um potente dispositivo disparador de processos de EPS

This thesis had as general objective to analyze the professional implication with the humanization supporters and the articulators of Permanent Health Education (PHE) of the municipalities of the Regional Department of Health (RDH) of Araraquara/São Paulo. It is a Socioclinic intervention research, with a qualitative approach, carried out with the humanization supporters and the articulators of PHE of the 24 municipalities that compose the mentioned RDH. Individual interviews were carried out with 07 participants who performed both functions in their municipalities and 12 group interviews, of which 11 were composed of the supporter and articulator and 01 were composed of a group of 06 supporters of the municipality. Therefore, 35 supporters and articulators participated in the intervention research in question. They were also used as analytical devices for the production of the data of this intervention research: ten monthly meetings with the supporters and articulators; seven planning and analysis meetings and the research diary. The interviews and meetings with the supporters and articulators were transcribed and the apprehensions made in the planning and analysis meetings were written in the research diary. All this material, as well as other diary entries, were analyzed based on the principles of Socioclinic Institutional, one of which corresponds to the moments of restitution, allowing a collective deepening of the analyzes carried out. The results were presented from the libidinal, ideological and organizational dimensions that make up the professional implication. In this way, we identify and analyze with the supporters and articulators the crossings that the initial profession (nurse, dentist, psychologist, etc.) exercises on making support; the contradiction in thinking of a ready profile for the development of this function; the feelings of discouragement, pessimism and optimism as components of the ideological dimension that also cross the support and articulation of PHE; time, management and political power as analysts of the organizational dimension of supporters and articulators; and the absence/presence of desire, the willingness to please health professionals, developing a harmonious relationship at work as analysable clues to the libidinal dimension of supporters and articulators. As the work of analysis with the supporters and articulators continued, changes in ways of thinking and supporting health teams and also thinking about the work of supporting and articulating the PHE was changing, causing these professionals to enter, themselves, in processes of PHE, reflecting and questioning the work itself. The researcher, when performing the implication analysis, also put himself in the process of interrogating his practice, also experiencing PHE in action. We conclude that the professional implication analysis consists of a powerful device triggering PHE processes

Análise de implicação profissional: um dispositivo disparador de processos de educação permanente em saúde / Analysis of professional implication: a device triggering process of Permanent Education in Health

Esta tese teve por objetivo geral analisar a implicação profissional com os apoiadores de humanização e os articuladores de Educação Permanente em Saúde (EPS) dos municípios do Departamento Regional de Saúde (DRS) de Araraquara/São Paulo. Trata-se de uma pesquisa-intervenção Socioclínica, de abordagem qualitativa, realizada com os apoiadores de humanização e os articuladores de EPS dos 24 municípios que compõem o DRS em questão. Foram realizadas entrevistas individuais com 07 sujeitos que desenvolviam ambas as funções em seus municípios e 12 entrevistas grupais, sendo 11 compostas pelo apoiador e articulador e 01 composta por um grupo de 06 apoiadores do município. Portanto, 35 apoiadores e articuladores participaram da pesquisa-intervenção em questão. Foram também utilizados enquanto dispositivos analíticos para a produção dos dados desta pesquisa-intervenção: dez encontros mensais com os apoiadores e articuladores; sete encontros de planejamento e análise e o diário de pesquisa. As entrevistas e os encontros com os apoiadores e articuladores foram transcritos e as apreensões feitas nos encontros de planejamento e análise foram redigidos no diário de pesquisa. Todo esse material, bem como outras anotações feitas em diário, foi analisado a partir dos princípios da Socioclínica Institucional, sendo que um deles corresponde aos momentos de restituição, possibilitando um aprofundamento coletivo das análises realizadas. Os resultados foram apresentados a partir das dimensões libidinal, ideológica e organizacional que compõem a implicação profissional. Dessa forma, identificamos e analisamos com os apoiadores e articuladores os atravessamentos que a profissão inicial (enfermeiro, dentista, psicólogo, etc.) exerce sobre o fazer apoio; a contradição em se pensar em um perfil pronto para o desenvolvimento dessa função; os sentimentos de desânimo, pessimismo e otimismo enquanto componentes da dimensão ideológica que também atravessam o fazer apoio e a articulação de EPS; o tempo, o modo de fazer a gestão e o poder político enquanto analisadores da dimensão organizacional dos apoiadores e dos articuladores; e a ausência/presença do desejo, a vontade de agradar os profissionais de saúde, desenvolvendo uma relação harmônica no trabalho enquanto pistas analisáveis da dimensão libidinal dos apoiadores e dos articuladores. Na medida que o trabalho de análise com os apoiadores e articuladores prosseguiu, mudanças nos modos de se pensar e fazer apoio às equipes de saúde e também o pensar sobre o trabalho de apoiar e articular a EPS foi se modificando, fazendo com que esses profissionais entrassem, eles mesmos, em processos de EPS, refletindo e interrogando o próprio trabalho. O pesquisador ao realizar a análise de implicação também se colocou em processo de interrogação de sua prática, experienciando também a EPS em ato. Concluímos que a análise de implicação profissional consiste em um potente dispositivo disparador de processos de EPS

This thesis had as general objective to analyze the professional implication with the humanization supporters and the articulators of Permanent Health Education (PHE) of the municipalities of the Regional Department of Health (RDH) of Araraquara/São Paulo. It is a Socioclinic intervention research, with a qualitative approach, carried out with the humanization supporters and the articulators of PHE of the 24 municipalities that compose the mentioned RDH. Individual interviews were carried out with 07 participants who performed both functions in their municipalities and 12 group interviews, of which 11 were composed of the supporter and articulator and 01 were composed of a group of 06 supporters of the municipality. Therefore, 35 supporters and articulators participated in the intervention research in question. They were also used as analytical devices for the production of the data of this intervention research: ten monthly meetings with the supporters and articulators; seven planning and analysis meetings and the research diary. The interviews and meetings with the supporters and articulators were transcribed and the apprehensions made in the planning and analysis meetings were written in the research diary. All this material, as well as other diary entries, were analyzed based on the principles of Socioclinic Institutional, one of which corresponds to the moments of restitution, allowing a collective deepening of the analyzes carried out. The results were presented from the libidinal, ideological and organizational dimensions that make up the professional implication. In this way, we identify and analyze with the supporters and articulators the crossings that the initial profession (nurse, dentist, psychologist, etc.) exercises on making support; the contradiction in thinking of a ready profile for the development of this function; the feelings of discouragement, pessimism and optimism as components of the ideological dimension that also cross the support and articulation of PHE; time, management and political power as analysts of the organizational dimension of supporters and articulators; and the absence/presence of desire, the willingness to please health professionals, developing a harmonious relationship at work as analysable clues to the libidinal dimension of supporters and articulators. As the work of analysis with the supporters and articulators continued, changes in ways of thinking and supporting health teams and also thinking about the work of supporting and articulating the PHE was changing, causing these professionals to enter, themselves, in processes of PHE, reflecting and questioning the work itself. The researcher, when performing the implication analysis, also put himself in the process of interrogating his practice, also experiencing PHE in action. We conclude that the professional implication analysis consists of a powerful device triggering PHE processes

Pediatric vascular trauma in Manaus, Amazon - Brazil.

OBJECTIVE:: to assess the incidence of pediatric vascular injuries in patients treated at the Emergency Room of the Eastern Children's Hospital, in Manaus. METHODS:: we conducted a retrospective study of pediatric patients who suffered vascular injuries treated between February 2001 to February 2012. RESULTS:: we studied 71 patients, predominantly male (78.87%), with a mean age of 7.63 years. The predominant mechanism of injury was stab wound in 27 patients (38.03%). The average hospital stay was 10.18 days; 16 patients required care in intensive care unit, with average stay of 8.81 days. The main injuries occurred in the extremities, the upper limb being the most affected, with lesions of the ulnar artery in 13 (15.66%) and radial in 10 (12.04%). The mostly applied procedure was vascular exploration 35 (32.4%). Complications occurred in nine patients (12.68%). Mortality was 1.4%, in one patient with a lesion of the common iliac vein and the inferior vena cava due fall from height. CONCLUSION:: pediatric vascular injury occurred predominantly in the extremities. The dimensions of the injured vessels made surgical correction more complex and increased complication rates, particularly amputations. OBJETIVO:: avaliar a incidência de traumatismos vasculares pediátricos em doentes atendidos no Hospital Pronto Socorro da Criança Zona Leste, na cidade de Manaus. MÉTODOS:: estudo retrospectivo de doentes pediátricos vítimas de traumatismos vasculares atendidos no período de fevereiro de 2001 a fevereiro de 2012. RESULTADOS:: foram estudados 71 doentes com predominância do sexo masculino (78,87%) com média de idade de 7,63 anos. O mecanismo de trauma predominante foi o ferimento por arma branca em 27 pacientes (38,03%). A média de internação foi 10,18 dias, com 16 doentes necessitando de cuidados em unidade de tratamento intensivo com permanência média de 8,81 dias. As principais lesões ocorreram em extremidades, com predomínio do membro superior, com lesões das artérias ulnar em 13 (15,66%) e radial em dez (12,04%). O procedimento mais utilizado foi a exploração vascular 35 (32,4%). Em nove doentes (12,68%) ocorreram complicações. A mortalidade foi 1,4%, em um paciente com lesão da veia ilíaca comum e da veia cava inferior, devido à queda de altura. CONCLUSÃO:: o traumatismo vascular pediátrico ocorreu predominantemente em extremidades. As dimensões dos vasos lesionados tornaram a correção cirúrgica mais complexa e aumentaram os índices de complicações, particularmente, de amputações.

Pediatric vascular trauma in Manaus, Amazon - Brazil / Traumatismos vasculares pediátricos na cidade de Manaus, Amazonas - Brasil

ABSTRACT Objective: to assess the incidence of pediatric vascular injuries in patients treated at the Emergency Room of the Eastern Children's Hospital, in Manaus. Methods: we conducted a retrospective study of pediatric patients who suffered vascular injuries treated between February 2001 to February 2012. Results: we studied 71 patients, predominantly male (78.87%), with a mean age of 7.63 years. The predominant mechanism of injury was stab wound in 27 patients (38.03%). The average hospital stay was 10.18 days; 16 patients required care in intensive care unit, with average stay of 8.81 days. The main injuries occurred in the extremities, the upper limb being the most affected, with lesions of the ulnar artery in 13 (15.66%) and radial in 10 (12.04%). The mostly applied procedure was vascular exploration 35 (32.4%). Complications occurred in nine patients (12.68%). Mortality was 1.4%, in one patient with a lesion of the common iliac vein and the inferior vena cava due fall from height. Conclusion: pediatric vascular injury occurred predominantly in the extremities. The dimensions of the injured vessels made surgical correction more complex and increased complication rates, particularly amputations.

RESUMO Objetivo: avaliar a incidência de traumatismos vasculares pediátricos em doentes atendidos no Hospital Pronto Socorro da Criança Zona Leste, na cidade de Manaus. Métodos: estudo retrospectivo de doentes pediátricos vítimas de traumatismos vasculares atendidos no período de fevereiro de 2001 a fevereiro de 2012. Resultados: foram estudados 71 doentes com predominância do sexo masculino (78,87%) com média de idade de 7,63 anos. O mecanismo de trauma predominante foi o ferimento por arma branca em 27 pacientes (38,03%). A média de internação foi 10,18 dias, com 16 doentes necessitando de cuidados em unidade de tratamento intensivo com permanência média de 8,81 dias. As principais lesões ocorreram em extremidades, com predomínio do membro superior, com lesões das artérias ulnar em 13 (15,66%) e radial em dez (12,04%). O procedimento mais utilizado foi a exploração vascular 35 (32,4%). Em nove doentes (12,68%) ocorreram complicações. A mortalidade foi 1,4%, em um paciente com lesão da veia ilíaca comum e da veia cava inferior, devido à queda de altura. Conclusão: o traumatismo vascular pediátrico ocorreu predominantemente em extremidades. As dimensões dos vasos lesionados tornaram a correção cirúrgica mais complexa e aumentaram os índices de complicações, particularmente, de amputações.

Belimumab for the treatment of corticosteroid-dependent systemic lupus erythematosus: from clinical trials to real-life experience after 1 year of use in 48 Brazilian patients.

The objective of the study was to evaluate prospectively real-life experience on the effect of belimumab on patients with active systemic lupus erythematosus (SLE). Forty-eight patients with active SLE were evaluated after 1 year of continuous treatment. Thirty-eight patients were still on treatment at the end of 1 year, and it was possible to observe significant clinical improvement in the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score with a decrease from 12 ± 3.0 to 2.5 ± 2.5, also a decrease on the daily steroid dose from 30 ± 12.5 to 7.5 ± 5.0 mg and partial improvement on serology. Belimumab treatment is associated with real benefit in the majority of patients that maintain active disease in spite of continuing on standard of care.

Heart rate recovery after physical exertion tests in elderly hypertensive patients undergoing resistance training / Recuperação da frequência cardíaca após testes de esforço em idosas hipertensas submetidas a treinamento resistido

Abstract Introduction: Heart rate recovery after exercise is a valuable variable, associated with prognosis and it has been used as an indicator of cardiorespiratory fitness, especially in patients with heart disease, as hypertensive patients. Objective: This study aimed to analyze the response of heart rate recovery in elderly hypertensive patients undergoing a resistance training program. Methods: Sample was composed for 10 elderly women with a mean age of 70.7 ± 7.4 years. Exercise test and six-minute walk test were developed and we checked heart rate recovery in the 1st and 2nd minute post tests, before and after resistance training. Results: There was an increase in mean heart rate recovery in the analyzed minutes in both tests, but only in the 1st minute after six minutes walk test we found a significant increase (p = 0.02). Conclusion: The results suggest the efficacy of resistance training to improve cardiorespiratory fitness of elderly hypertensive patients.

Resumo Introdução: A recuperação da freqüência cardíaca após o exercício é uma variável valiosa que está associada com o prognóstico e vem sendo utilizada como indicador do condicionamento cardiorrespiratório, principalmente em pacientes cardiopatas, como é o caso dos hipertensos. Objetivo: O presente estudo objetivou analisar a resposta da recuperação da freqüência cardíaca em idosas hipertensas submetidas a programa de treinamento resistido. Métodos: A Amostra foi composta de 10 idosas com média de idade de 70,7 ± 7,4 anos. Realizou-se o teste ergométrico, o teste de caminhada de seis minutos e verificou-se a recuperação da freqüência cardíaca no 1° e 2° minutos após a realização dos testes pré e pós-treinamento resistido. Resultados: Observou-se aumento na média da recuperação da freqüência cardíaca nos minutos analisados em ambos os testes, porém apenas no 1° minuto após o teste de caminhada de seis minutos encontrou-se aumento significativo (p = 0,02). Conclusão: Os resultados sugerem eficácia do treinamento resistido para melhorar o condicionamento cardiorrespiratório das pacientes.

Iniciação esportiva em cadeira de rodas: estruturação de um programa para crianças com deficiência física / Initiatuion to wheelchair sports: structure of a program for children with physical disabilities / Iniciación deportiva en illa de ruedas: estructuración de un programa para niños con discapacidades físicas

O estudo em questão teve o objetivo de descrever um programa de iniciação esportiva em cadeira de rodas voltado a crianças com deficiência física com idade entre seis e dez anos. Trata-se de um estudo descritivo com base empírica, por meio do qual foi possível obter como resultados as etapas estruturantes do programa, conforme detalhamento: compreensão da condição físico-motora do participante; adaptação à cadeira de rodas; elaboração dos objetivos do programa; reconhecimento dos espaços; seleção dos conteúdos programáticos; planejamento das estratégias de ensino; estrutura das aulas. Concluiu-se que os pressupostos adotados para a construção do programa demonstraram ser adequados às características, necessidades e interesses do público em questão.

This study aimed to describe a wheelchair sports initiation program to children with physical disabilities aged from six to ten years old. This is a descriptive study with empirical basis, through which was possible to obtain as results the structuring stages of the program, as the following details: understanding the physical motor condition of the participant; adaptation to the sports wheelchair; setting program goals; recognition of spaces; selection of the syllabus; planning teaching strategies; structure of classes. It was concluded that the assumptions adopted for the construction of sports initiation in wheelchair program proved to be suitable to the characteristics, needs and interests of the specific public.

El presente estudio tuvo como objetivo describir un programa de iniciación deportiva en silla de ruedas dirigida a niños con discapacidad física de 06 a 10 años. Se trata de un estudio descriptivo con base empírica, a través del cual fue posible obtener resultados en las etapas de estructuración del programa, como se detalla en la continuación: comprensión de la condición físico-motora del participante; adaptación a la silla de ruedas; establecimiento de los objetivos del programa; reconocimiento de los espacios; selección de contenidos del programa; planificación de las estrategias de enseñanza; estructura de clases. Se concluyó que los supuestos adoptados para la construcción del programa demostraron ser apropiados a las características, necesidades e intereses del público estudiado.