Preparing Collared Peccary (Pecari tajacu Linnaeus, 1758) for Reintroduction into the Wild: A Screening for Parasites and Hemopathogens of a Captive Population.

The reintroduction of captive animals to the wild helps restore endangered species, but it risks pathogen transmission, harming wild populations. Such transmission can impact the genetic diversity and long-term viability of these populations. This study assessed parasite diversity and load in captive Pecari tajacu, a species native to the Americas and culturally significant to Brazilian indigenous culture, prior to reintroduction. Samples from 24 peccaries were analyzed for ectoparasites, hemopathogens, and stool parasites with direct and molecular analysis. Findings showed that various parasites were present. Two peccaries (8.3%) were infested by the adult tick Amblyomma sculptum. Six (25.0%) tested positive for Trypanosoma evansi, four (16.7%) for hemobacteria of the family Anaplasmataceae, twelve (50.0%) for hemotropic Mycoplasma, and seven (29.2%) for Leishmania braziliensis. Stool samples indicated multiple parasites, with sixteen (66.7%) peccaries infected by Strongylida order parasites, Spiruridae in three (12.5%), and Ascaris suum in one (4.2%) animal. Cysts of Balantidium sp. were found in twenty (83.3%), Entamoeba polecki in five (20.8%), and Iodamoeba bütschlii in two (8.3%) peccaries. To our current knowledge, this is the first global report of Leishmania braziliensis, Iodamoeba bütschlii, and Entamoeba polecki in P. tajacu, irrespective of the environment, including both captivity and wild conditions. Some of these parasites are common in domestic animals, and others are zoonotic, indicating potential interspecies pathogen transmission.

Household outbreak of sporotrichosis: towards the One Health approach.

Although sporotrichosis requires a broad approach for control, few reports have described the relationship between the index case and secondary contacts. In the present work, we report an outbreak involving a woman, a dog, and two cats from the same household environment, including the clinical and epidemiological aspects and outcomes, and discuss the importance of a One Health approach to face this neglected disease. The joint efforts of professionals such as veterinarians and physicians are essential for early diagnosis and surveillance, which contributes to the rapid identification and control of zoonotic sporotrichosis outbreaks.

Recommended intake of fruits and vegetables in a capital of southeastern Brazil: prevalence and associated factors in Belo Horizonte, Minas Gerais, 2010 - 2019 / Consumo recomendado de frutas e hortaliças em uma capital do sudeste do Brasil: prevalência e fatores associados em Belo Horizonte, Minas Gerais, 2010 - 2019

Cross-sectional population-based study with data from VIGITEL, a telephone survey conducted by the Ministry of Health. The recommended intake of fruits and vegetables (FV) were analyzed for Belo Horizonte, between 2010 and 2019 and aims to contribute to improvements in the formulation of local policies, considering the scarcity of these studies in the capital of Minas Gerais. The sample consisted of 19.454 participants whose frequency of recommended intake of these foods was evaluated and compared in terms of obtaining financial aid for families in poverty, gender, age and schooling, using statistical analysis and considering a significance level of 0.05. In all years, the recommended intake prevailed among women, and, over the period, approximately 31% of the entire population surveyed intakes FV as recommended. There was a rejection among young people aged 18 to 24 years in relation to the intake of these foods. More years of studies were favorably associated with the recommended FV intake and among those who received financial aid, an increase of 9% was observed, considering the period. Sociodemographic and economic factors have an important influence on the recommended FV intake and, being subject to intervention, they can help the health of the population.

Estudo transversal de base populacional com dados do VIGITEL, inquérito telefônico realizado pelo Ministério da Saúde. O consumo recomendado de frutas e hortaliças (FH) foi analisado para Belo Horizonte, entre 2010 e 2019 e visa contribuir para melhorias nas formulações das políticas locais, considerando a escassez desses estudos na capital mineira. A amostra foi composta por 19.454 participantes cuja frequência do consumo recomendado desses alimentos foram avaliadas e comparadas quanto à obtenção de ajuda financeira por famílias em situação de pobreza, gênero, idade e escolaridade, utilizando-se análise estatística e considerando o nível de significância de 0,05. Em todos os anos, o consumo recomendado prevaleceu entre as mulheres, sendo que, ao longo do período, aproximadamente 31% de toda a população pesquisada consumiu FH como recomendado. Observou-se uma repulsa entre os jovens de 18 a 24 anos em relação ao consumo desses alimentos. Mais anos de estudos se associaram favoravelmente ao consumo recomendado de FH e entre aqueles que receberam auxílio financeiro foi observado o aumento de 9%, considerando o período. Fatores sociodemográficos e econômicos têm importante influência sobre o consumo de FH e, sendo passíveis de intervenção podem auxiliar na saúde da população.

Household outbreak of sporotrichosis: towards the One Health approach

ABSTRACT Although sporotrichosis requires a broad approach for control, few reports have described the relationship between the index case and secondary contacts. In the present work, we report an outbreak involving a woman, a dog, and two cats from the same household environment, including the clinical and epidemiological aspects and outcomes, and discuss the importance of a One Health approach to face this neglected disease. The joint efforts of professionals such as veterinarians and physicians are essential for early diagnosis and surveillance, which contributes to the rapid identification and control of zoonotic sporotrichosis outbreaks.

Adoecimento psíquico, assimetrias de gênero na Medicina e necessidade de intervenção: uma revisão de literatura / Mental illness, asymmetries between genders in the medical profession, and the need for intervention: a literature review / Enfermarse psíquicamente, asimetrías de género en la medicina y necesidad de intervención: una revisión de la literatura

A Medicina possui um notório impacto adoecedor sobre seus profissionais. Isso é acertado se comparando as altas prevalências de depressão e suicídio na população médica com aquelas relativas à população geral. Entretanto, observadas as assimetrias de gênero existentes nas relações humanas, emerge a necessidade da busca para a elucidação de disparidades de gênero no interior dos âmbitos profissionais e acadêmicos da Medicina, além de propostas capazes de alterar aspectos nocivos da carreira. Para tanto, realizou-se uma revisão da literatura pela análise de trinta artigos publicados nas plataformas PubMed/Medline e Google Scholar em português, inglês e francês, nos últimos dez anos. Os achados permitiram acertar uma vulnerabilidade do gênero feminino, uma vez imerso no âmbito médico, traduzida em maior crescimento de índices de depressão e suicídio. Foram apontadas propostas de alteração dessa realidade por meio de estratégias de caracteres preventivo e interventivo. (AU)

The medical profession has notorious health impacts on professionals, shown by the proportionately higher prevalence of depression and suicide among doctors than in the general population. However, given the asymmetries between genders in human relations, there is the need to elucidate gender disparities within the medical profession and Academia, and develop proposals capable of minimizing the harmful aspects of the career. To this end, we conducted a literature review that included the analysis of thirty articles published in Portuguese, English and French in PubMed/Medline and Google Scholar over the last ten years. The findings confirm the vulnerability of female doctors, manifested in increased rates of depression and suicide. We propose measures to improve this situation through prevention and intervention strategies. (AU)

La Medicina tiene un notorio impacto como causador de enfermedades en sus profesionales. Eso es acertado si se comparan las altas prevalencias para depresión y suicidio en la población médica con las relativas a la población en general. No obstante, observadas las asimetrías de género existentes en las relaciones humanas, surge la necesidad de la búsqueda para elucidar disparidades de género en el interior de los ámbitos profesionales y académicos de la Medicina, además de propuestas capaces de alterar aspectos nocivos de la carrera. Para ello, se realizó una revisión de la literatura, mediante análisis de treinta artículos, publicados en las plataformas PubMed/Medline y Google Scholar en portugués, inglés y francés, en los últimos diez años. Los hallazgos permitieron acertar una vulnerabilidad del género femenino, una vez inmerso en el ámbito médico, traducida en un mayor crecimiento en índices de depresión y suicidio. Se señalaron propuestas de alteración de esta realidad por medio de estrategias con carácter de prevención e intervención. (AU)

Functional and morphological analysis of isolates of phylloplane and rhizoplane endophytic bacteria interacting in different cocoa production systems in the Amazon.

Endophytic bacteria colonize different internal tissues of plants without damaging their cells. They can establish themselves in the same niche as other microorganisms and develop antagonistic activities against phytopathogens. There is little research on the functional and morphological characterization of these bacteria in production systems in the Amazon. Thus, the objective of this work was to functionally and morphologically characterize endophytic bacteria isolated from cocoa trees (Theobroma cacao L.) and evaluate their antagonistic potential against phytopathogens. A total of 197 endophytic bacteria isolates were obtained from leaves and roots of cocoa plants with different production systems and at different times of the year. The characterization of functional groups consisted of proteolytic, amylolytic and cellulolytic activity and ability to fix nitrogen and solubilize phosphate. Morphological diversity was evaluated mainly according to the following parameters: shape, color, size and elevation of the colony. Thirteen isolates of endophytic bacteria, selected by cluster analysis, were used to evaluate the antagonistic potential in paired trials against four species of phytopathogenic fungi. The largest amount of endophytic bacteria was isolated from the root (95.9%), in the dry season. The most expressive activities with regards to the enzyme index were amylolytic (71.9%), proteolytic (70.2%) and nitrogen fixing (38.6%), respectively. The similarity analysis formed two clusters with isolates CS R 2.4 and CS R 2.25 exhibiting 100% similarity. Five isolates displayed inhibitory activity against phytopathogenic fungi, most notably isolate TS R 2.19, which exhibited antagonistic activity against all fungi and mycelial growth inhibition rates between 25.7% and 50.7%. Understanding the interaction between endophytes in cocoa plants is important as a possible additional tool in biological control. Our studies are incipient and the first to be carried out in different cocoa production systems in the state of Pará, Brazil.

Characterization of animal sporotrichosis in a highly urbanized area.

An epidemiological characterization of animal sporotrichosis was carried out between 2017 and 2018, in a highly urbanized area in Brazil, including outcomes and the spatial distribution of the cases according to the health vulnerability index (HVI) of the study territory. One hundred and sixty-five cats and four dogs suspected of sporotrichosis were identified by a surveillance and control program previously implemented in the study area. One hundred and five of these animals (62.1 %) were considered positive for Sporothrix spp., of which 103 were cats and two were dogs. Cases predominated among male cats (53.4 %), although gender did not present a statistically significant association (p > 0.05) with sporotrichosis cases. Considering the positive cats, 55.4 % were not neutered and free access to the street was reported as a habit for 86.4 % of them. Roaming free in the streets increased the chance of infection by 2.54 times. We observed a high frequency of euthanasia or death (48.8 %) among 86 infected cats available to be included in the follow-up stage of the study, even when they were treated (46.5 %) and a low cure rate (31 %). The disease spread, unrelated to the HVI in the territory. Data produced suggested that avoiding access to the street seems to have greater importance to sporotrichosis control in cats than neutering and reinforces the importance of health education, especially in relation to responsible feline ownership. The free offer of diagnosis and treatment also should be taken into consideration as important measures to control the disease.

Implementation of an Animal Sporotrichosis Surveillance and Control Program, Southeastern Brazil.

We report the implementation of an animal sporotrichosis surveillance and control program that evaluates strategies to identify suspected and infected cats in a municipality in southeastern Brazil. All adopted measures reinforced the program, although strategies had different abilities to detect the presence of infection.

Desafios da pandemia para a mentoria: o papel dos mentores juniores e das redes sociais / Challenges of the pandemic for mentoring: the role of junior mentors and social networks

Resumo: Introdução: A aprovação no curso de Medicina traz consigo a euforia e, por vezes, associa-se a grandes mudanças no dia a dia dos alunos. Essas mudanças estão relacionadas a momentos de medo, sofrimento e adaptação. Os programas de mentoria surgem como espaços importantes de cuidado que oferecem acolhimento e suporte às vivências dos alunos, de modo a contribuir para o desenvolvimento pessoal e acadêmico deles. Relato de experiência: Diante da necessidade de adaptar o ensino presencial ao modelo remoto, em detrimento da pandemia de Covid-19, o programa de mentoria da Universidade Federal do Rio Grande do Norte investiu na realização de atividades on-line, protagonizadas por monitores denominados mentores juniores. Essas atividades se valeram do potencial das mídias sociais, por meio das plataformas de videoconferência, além de interações nas redes sociais, para realizar os encontros e promover a manutenção do vínculo, bem como proporcionar um espaço de acolhimento e integração entre estudantes e mentores. Discussão: A partir da realização de atividades remotas, alunos e mentores mostraram-se muito participativos e satisfeitos. A atuação dos mentores juniores na elaboração dessas atividades virtuais foi um importante diferencial, possibilitando o engajamento dos mais tímidos e daqueles que tinham dificuldade em cumprir os horários presenciais. Conclusão: Mediante a observação no desenvolvimento das atividades do programa e com base na avaliação dos alunos e mentores sobre o desempenho da mentoria no semestre remoto, considera-se que é de grande valia investir no potencial das mídias sociais para impulsionar as reuniões dos grupos de mentoria, garantir a manutenção do acolhimento e suporte aos alunos, bem como para estreitar os vínculos entre os participantes. Sob esse prisma, é necessário considerar a possibilidade de adotar um modelo misto no aperfeiçoamento do programa de mentoria.

Abstract: Introduction: Being accepted for medical school brings euphoria, and is sometimes associated to major changes in the student's daily life. These changes pertain to moments of fear, suffering and adaptation. The mentoring programs, therefore, appear as essential care spaces, offering welcoming and support to students, in order to contribute to their personal and academic development. Experience Report: Faced with the need to adapt from face-to-face teaching to the remote model, to help control the Covid-19 pandemic, the Mentoring program of the Federal University of Rio Grande do Norte invested in conducting online activities led by junior mentors. These activities took advantage of the potential of social media, through video conferencing platforms, in addition to interactions on social networks, to hold the meetings and maintain the link, as well as providing a space for welcoming and integrating students and mentors. Discussion: In relation to the remote activities, students and mentors were found to be very participative and satisfied. The role of junior mentors in developing these virtual activities was an important differential, enabling the engagement of the most timid and those who had difficulty in meeting the face-to-face schedules. Conclusion: Through observation during the development of the program activities, and based on the evaluation of students and mentors on the performance of mentoring in the remote semester, the conclusion is drawn that it is important to invest in the potential of social media to boost mentoring group meetings, ensure that the students are offered reception and support, and to strengthen the bonds with the participants. In light of this, it is necessary to consider the possibility of adopting a mixed teaching model to improve the mentoring program.

Sintomas de Depressão, Ansiedade e Estresse em Estudantes de Medicina e Estratégias Institucionais de Enfrentamento / Symptoms of Depression, Anxiety and Stress in Medical Students and Institutional Coping Strategies

Resumo: Introdução: Este estudo teve como propósito estimar a prevalência de sintomas de estresse, depressão e ansiedade dos estudantes de Medicina da Universidade Federal do Rio Grande do Norte (UFRN), associando-os com outros fatores. Métodos: Trata-se de um estudo quantitativo epidemiológico, do tipo transversal. Participaram desta pesquisa estudantes de Medicina da UFRN, distribuídos equitativamente entre os diferentes períodos do curso. Entregaram-se 288 questionários, no entanto validaram-se 279, os demais não foram respondidos corretamente. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa da UFRN (Parecer nº 2.009.026) e todos os voluntários assinaram o Termo de Consentimento Livre e Esclarecido (TCLE), após serem informados sobre os objetivos da pesquisa. Para a coleta dos dados, utilizaram-se os seguintes instrumentos: 1. ficha de Identificação para os dados sociodemográficos, 2. Inventário de Sintomas de Stress para Adultos de Lipp (ISSL), 3. Inventário de Depressão de Beck (IDB) e 4. Inventário de Ansiedade de Beck (BAI). Para análise dos resultados, realizaram-se análises descritivas a partir da média, do desvio padrão e da frequência dos dados coletados. A análise inferencial foi realizada para verificar a associação entre as variáveis de desfechos e os atributos dos estudantes. Resultados: Dos estudantes entrevistados, 66,3% tinham estresse e a maioria estava na fase de resistência (58,4%) com predominância de sintomas psicológicos (42,3%). Em relação à sintomatologia depressiva, 28% dos estudantes apresentavam sintomas: 51,3% com sinais de depressão de leve a moderada, 35,9% com sinais de depressão moderada e 12,8% com sinais de depressão severa. No que se refere à sintomatologia ansiosa, 66,3% dos estudantes apresentavam sinais de ansiedade em seu grau mínimo; e 33,7%, sinais de ansiedade leve, moderada ou severa. Desses últimos, 21,9% tinham sinais de ansiedade leve; 10,8%, sinais de ansiedade moderada; e 1%, sinais de ansiedade severa. Conclusões: Diante disso, acredita-se que as instituições de ensino superior devem se comprometer com o desenvolvimento integral dos seus estudantes apresentando estratégias institucionais para o enfrentamento dessa realidade.

Abstract: Introduction: The purpose of this study was to estimate the prevalence of stress, depression and anxiety symptoms among medical students of the Federal University of Rio Grande do Norte, associating them with other factors. Methods: This is a quantitative cross-sectional epidemiological study. Medical students from the Federal University of Rio Grande do Norte participated in this study, distributed equally among the different periods of the course. 288 questionnaires were delivered; however, 279 were validated, while the others were not answered correctly. This study was approved by the Research Ethics Committee of UFRN (Opinion n. 2,009,026) and all volunteers signed the free and informed consent (FIC) form, after being informed about the research objectives. The following instruments were used to collect the data: (1) Identification card for the socio-demographic data, (2) Inventory of Stress Symptoms for Adults of Lipp (ISSL), (3) Beck Depression Inventory - BDI, (4) Beck Anxiety Inventory (BAI). For the analysis of the results, descriptive analyzes were performed based on the mean, standard deviation and frequency of the collected data. Inferential analysis was performed to verify the association between outcome variables and student attributes. Results: Of the interviewed students, it was observed that 66.3% had stress symptoms and the majority was in the resistance phase (58.4%) with a predominance of psychological symptoms (42.3%). In relation to depressive symptomatology, 28% of the students had symptoms, with 51.3% showing signs of mild to moderate depression, 35.9% signs of moderate depression and 12.8% showing signs of severe depression. Regarding the anxious symptomatology, 66.3% of the students showed minimal signs of anxiety and 33.7% showed signs of mild, moderate or severe anxiety. Of the latter, 21.9% had signs of mild anxiety, 10.8% signs of moderate anxiety and 1% signs of severe anxiety. Conclusions: In view of this, it is believed that higher education institutions should commit themselves to the integral development of their students, offering institutional strategies for students to cope with this reality.

Programa de Mentoria do Curso de Medicina da Universidade Federal do Rio Grande do Norte: Atividades Integrativas em Foco / The Universidade Federal do Rio Grande do Norte Medicine Course Mentoring Program: Integrative Activities in Focus

Resumo: Introdução: Ao ingressarem no curso de Medicina, os estudantes se deparam com desafios inerentes à formação que podem ser geradores de estresse e ansiedade, comprometendo seu bem-estar e desempenho acadêmico. Diante disso, o curso de Medicina da Universidade Federal do Rio Grande do Norte (UFRN) implantou em 2015 um programa de mentoria que se propõe a contribuir para o desenvolvimento profissional e pessoal do estudante, adotando-se como um diferencial a realização de atividades integrativas. Método: Participam desse programa 25 professores do curso de Medicina da UFRN, que atuam como mentores, 25 monitores ou mentores juniores, que têm o papel de intermediar a comunicação entre os participantes, como também auxiliar no planejamento e desenvolvimento das atividades, e 317 alunos de diversos períodos do curso médico. Além dos encontros mensais regulares, no final de cada semestre, os mentores e mentores juniores organizam a atividade integrativa que agrega todos os discentes e docentes do programa e possibilitam a construção de uma relação mais próxima entre mentores e mentorandos, bem como contribuem para a estruturação de um ambiente universitário mais acolhedor e equânime. Resultado: Em avaliação on-line sobre o programa, os alunos destacaram a "troca de experiências, de sugestões e a ajuda no curso sobre diversos temas" e "adquirir experiência de um profissional experiente" como principais motivações para participar da atividade. Contudo, enfatizaram a falta de tempo para conciliar os encontros com as demais atividades acadêmicas como principal obstáculo para participar do programa. Com a pandemia da Covid-19, mantiveram-se as atividades do programa no modelo on-line, e obteve-se importante engajamento dos participantes, o que representou uma estratégia de enfrentamento do isolamento social e de promoção da saúde mental para os estudantes. Conclusão: Observamos, a partir do engajamento e dos feedbacks recebidos, que o programa, apesar de apresentar alguns desafios, vem se configurando como uma iniciativa capaz de transformar as relações interpessoais entre discentes e mentores, ao promover a integração entre alunos dos diferentes períodos do curso e criar um ambiente favorável ao diálogo e à construção do conhecimento.

Abstract: Introduction: Upon starting their medical course, students are faced with challenges inherent to training, which can generate stress and anxiety, compromising their well-being and academic performance. In view of this, in 2015 the Medicine course at the Federal University of Rio Grande do Norte (UFRN) implemented a Mentoring Program, which aims to contribute to students' professional and personal development, focusing on integrative activities to strengthen bonds between the participants. Method: This program involves the participation of 25 professors from the UFRN Medicine course, who act as mentors, 25 monitors or mentors, who have the role of mediating communication between participants and assisting in the planning and development of activities; and about 317 students and various academic periods of the medical course. In addition to the regular monthly meetings, at the end of each semester, mentors and junior mentors organize the integrative activity that brings together all the students and teachers of the program and have stimulated a closer relationship between mentors and mentees, as well as contributing toward the structuring of a more welcoming and equitable university environment. Result: In an online assessment of the program, students highlighted the "exchange of experiences, suggestions and help with the course on various topics" and "acquiring experience from an experienced professional" as the main motivations for participating in the activity. On the other hand, they emphasized the lack of time to reconcile meetings with other academic activities as the main obstacle to participating in the program. With the onset of the Covid-19 pandemic, the program activities continued online and important engagement was achieved among the participants, thus constituting a strategy to face social isolation and promote the mental health of undergraduate medical students. Conclusion: From the engagement and the feedback received, it was observed that the program, despite presenting some challenges, represents an initiative capable of transforming interpersonal relationships between students and mentors, promoting integration between students from different academic periods of the course and creating a favourable environment for dialogue and knowledge construction.

Estresse e Residência Multiprofissional em Saúde: Compreendendo Significados no Processo de Formação / Stress and Multiprofessional Residence in Health: Understanding Meanings in the Training Process

RESUMO Durante o processo de formação, os residentes multiprofissionais em saúde estão expostos a eventos estressores que podem comprometer sua trajetória profissional. Este estudo avaliou o estresse de pós-graduandos do Programa de Residência Integrada Multiprofissional em Saúde (RIMS) em uma maternidade-escola, como também buscou compreender os significados atribuídos pelos residentes diante desse processo. A pesquisa compreendeu duas abordagens metodológicas, quantitativa e qualitativa, de forma complementar. Assim, participaram deste estudo 26 sujeitos, distribuídos de forma equivalente entre o primeiro e o segundo ano do Programa de Terapia Intensiva Neonatal. Para coleta de dados, foram aplicados os seguintes instrumentos: ficha de identificação, que abordou questões socioculturais, Inventário de Sintomas de Estresse para Adultos de Lipp (ISSL), além de um questionário com questões abertas. Para análise dos resultados, foram realizadas a tabulação e a análise das frequências, utilizando-se o programa PSPP, versão 1.0.1. Na abordagem qualitativa, foi utilizada a técnica de análise de conteúdo de Bardin. Verificou-se que 96,2% dos pesquisados apresentaram estresse. Destes, 72% estavam na fase de resistência e 28% na quase exaustão, predominando os sintomas psicológicos (68%). A análise qualitativa permitiu identificar que a sobrecarga de atividades e a escassez de articulação entre teoria e prática foram fatores desafiadores no cotidiano da formação. Além disso, em relação aos fatores gratificantes vivenciados durante a residência, o trabalho interdisciplinar e o reconhecimento do trabalho por parte do usuário foram considerados, pelos residentes, vivências gratificantes. Já a dificuldade de reconhecimento do trabalho por parte da equipe, a preceptoria e a mão de obra barata foram vistas como fatores relacionados a sentimentos de frustração. É indispensável elaborar políticas públicas a fim de aprimorar os projetos pedagógicos dos Programas de Residência Multiprofissional em Saúde (PRMS), contribuindo para a saúde física e mental dos residentes.

ABSTRACT During the training process, multiprofessional health residents are exposed to stressful events that may compromise their professional trajectory. This study aimed to assess the stress suffered by graduate students of the Multiprofessional Integrated Health Residency Program (RIMS) at a maternity school, as well understand the meanings attributed by the residents of this process. The research comprised two complementary methodological approaches: quantitative and qualitative. Thus, 26 subjects participated in the study, distributed equally between the first and second years of the Neonatal Intensive Care Program. The following data collection instruments were applied: identification form, which addressed socio-cultural issues, the Lipp Adult Stress Symptom Inventory (ISSL), and a questionnaire with open-ended questions. For analysis of the results, tabulation and frequency analysis were carried out using the program PSPP, version 1.0.1. Bardin content analysis was was the qualitative method adopted. It was verified that 96.2% of the respondents presented stress, of whom 72% were in the resistance phase and 28% at near-exhaustion, with a prevalence of psychological symptoms (68%). The qualitative analysis allowed us to identify that overload of activities and lack of articulation between theory and practice were challenging factors in the daily life of the trainees. Furthermore, in relation to gratifying factors experienced during the residence, interdisciplinary work and recognition of one's work by the user were considered by the residents to be rewarding experiences. Difficulty in achieving recognition of the work by the team, the preceptors and the cheap labor, meanwhile, were seen as factors related to feelings of frustration. It is essential that public policies be developed in order to improve the pedagogical projects of the Multiprofessional Health Residency Programs (PRMS), contributing to the physical and mental health of the residents.

Resultados das conformidades e não conformidades dos parâmetros microbiológicos de queijo Minas Artesanal Canastra / Conformity and non-conformity results of the microbiological parameters of Minas Artesanal Canastra cheese

O objetivo do trabalho foi analisar a qualidade microbiológica do Queijo Minas Artesanal produzido por queijarias certificadas da microrregião Canastra durante os anos de 2016 e 2017, utilizando os resultados das análises microbiológicas do queijo nestes anos. Foram encontradas não conformidades nos queijos estudados em 7,84% das amostras para Coliformes totais, 3,92% para coliformes termotolerantes e 9,8% para Staphylococcus coagulase positivo, porém nenhuma análise apresentou presença de Listeria spp. ou Salmonella spp. Apesar das principais bactérias patogênicas não terem sido encontradas, as não conformidades indicam a necessidade da orientação do produtor sobre as Boas Práticas de Fabricação e de Ordenha. Além disto, é imprescindível a orientação sobre as exigências do órgão fiscalizador e a realização da análise do queijo periodicamente, tornando possível o acompanhamento da qualidade do queijo produzido na região e a correção das não conformidades encontradas.

Palliative care: A proposal for undergraduate education in Medicine / Cuidados paliativos: Uma proposta para o ensino da graduação em Medicina

Objective: to propose essential competencies for the teaching of palliative care on undergraduate Medicine courses. Method: a documentary analysis of the literature on general competencies in palliative care was initially carried out, to construct a framework with suggestions of essential competencies for undergraduate education in Brazil. The elaborated material was then presented individually to eight professionals from a range of areas for analysis. All the professionals had specialized training in palliative care, and the material was accompanied by an interview with three open questions. The categorical thematic content analysis proposed by Bardin was used in the documentary analysis and the interviews with the professionals. Results: the initial documentary analysis resulted in five categories, eight subcategories and 96 units of analysis, based on which the researcher was able to construct the suggestions for competences, which were distributed with their respective contents in a framework with five modules. Six categories, 12 subcategories and 168 analysis units emerged from the interviews with the professionals following a reading of the material. From the discourse contained in the subcategories and units of analysis, suggestions emerged for a better distribution of the modules, resulting in the renaming of the same (Basic principles of palliative care, Symptom management, Teamwork, Ethical and legal issues, Care in the last moments of life). Conclusion: the discussion and improvement of the palliative care competencies suggested in this study will be essential at medical education forums, providing clarity about what is really required in general practitioner training.

Objetivo: Propor competências essenciais para o ensino de Cuidados Paliativos nos cursos de graduação em Medicina. Método: Inicialmente, foi feita uma análise documental na literatura sobre competências gerais em Cuidados Paliativos, no sentido de construir um quadro com sugestões de competências essenciais para o ensino de graduação no Brasil. A seguir, o material elaborado foi apresentado individualmente a oito profissionais com formação especializada em cuidados paliativos de diferentes áreas para análise, acompanhado de uma entrevista com três questões abertas. Na análise documental e nas entrevistas com os profissionais, foi utilizada a análise de conteúdo temática categorial proposta por Bardin. Resultados: A análise documental inicial resultou em cinco categorias, oito subcategorias e 96 unidades de análise que deram subsídio ao pesquisador para construção das sugestões de competências, distribuídas num quadro em cinco módulos, com seus respectivos conteúdos. Das entrevistas com os profissionais, após leitura do material que lhes foi entregue, emergiram seis categorias, 12 subcategorias e 168 unidades de análise. Das falas contidas nas subcategorias e unidades de análise, emergiram sugestões para melhor distribuição dos módulos, resultando na renomeação destes (Princípios básicos dos Cuidados Paliativos, Manejo de sintomas, Trabalho em Equipe, Questões Éticas e Legais, Assistência nos Últimos Momentos de Vida). Conclusão: A discussão e aprimoramento das competências em Cuidados Paliativos sugeridas nesse estudo serão essenciais durante os fóruns de educação médica, para que possamos ter mais clareza do que realmente é necessário para a formação do médico generalista.

Aerobic Training Improves Quality of Life in Women with Polycystic Ovary Syndrome.

PURPOSE: To investigate the effects of a supervised aerobic exercise training intervention on health-related quality of life (HRQL), cardiorespiratory fitness, cardiometabolic profile, and affective response in overweight/obese women with polycystic ovary syndrome (PCOS). METHODS: Twenty-seven overweight/obese inactive women with PCOS (body mass index, ≥ 25 kg·m; age 18 to 34 yr) were allocated into an exercise group (n = 14) and a control group (n = 13). Progressive aerobic exercise training was performed three times per week (~150 min·wk) over 16 wk. Cardiorespiratory fitness, HRQL, and cardiometabolic profile were evaluated before and after the intervention. Affective response (i.e., feeling of pleasure/displeasure) was evaluated during the exercise sessions. RESULTS: The exercise group improved 21% ± 12% of cardiorespiratory fitness (P < 0.001) and HRQL in the following domains: physical functioning, general health, and mental health (P < 0.05). Moreover, the exercise group decreased body mass index, waist circumference, systolic and diastolic blood pressure, and total cholesterol level (P < 0.05). The affective response varied from "good" to "fairly good" (i.e., positive affective response) in an exercise intensity-dependent manner during the exercise training sessions. CONCLUSIONS: Progressive aerobic exercise training improved HRQL, cardiorespiratory fitness, and cardiometabolic profile of overweight/obese women with PCOS. Moreover, the participants reported the exercise training sessions as pleasant over the intervention. These results reinforce the importance of supervised exercise training as a therapeutic approach for overweight/obese women with PCOS.

Estresse na Formação Médica: como Lidar com Essa Realidade? / Stress in Medical Education: How to Face This Reality?

RESUMO Ao ingressarem no curso de Medicina, os estudantes se sentem eufóricos e realizados. No entanto, os desafios inerentes à formação podem ser fonte de estresse e angústia, comprometendo o bem-estar desses estudantes. Assim, este estudo se propôs a explorar as causas do estresse na formação médica e os modos de enfrentamento dos estudantes de uma universidade em Montreal, Canadá. Trata-se de um estudo exploratório, com abordagem metodológica qualitativa, mediante um questionário semiestruturado. Participaram do estudo 18 estudantes distribuídos entre o primeiro e o quarto ano do curso de Medicina. Os principais eventos estressores mencionados pelos entrevistados foram: dificuldade em conciliar as atividades acadêmicas e a vida pessoal, avaliações de desempenho, relação com professores/residentes e pacientes, além de terem que morar longe da família. Diante desses eventos, os estudantes desenvolveram estratégias adaptativas e algumas não adaptativas. Entre as estratégias adaptativas, eles mencionaram: falar sobre sentimentos negativos, apoio psicológico, atividades de lazer e apoio espiritual. Em relação às respostas não adaptativas, foram observados sentimentos negativos, como angústia e tristeza, negação da realidade, bebida alcoólica e drogas para recreação. Nesse contexto, as universidades precisam reconhecer essa realidade, de modo a construir estratégias institucionais que possam ajudar os estudantes a lidar com os eventos estressores, para que, assistidos nas próprias necessidades, consigam enxergar as necessidades psicossociais dos pacientes.

ABSTRACT When undergraduate students enter medical school they feel euphoric and fulfilled. However, challenges related to academic development may cause feelings of stress and torment, which compromises students’ wellbeing. This study is aimed at exploring the main causes of stress on medical training, and strategies of facing it used by the medical students of the University of Montreal, Canada. This is an exploratory approach, using a qualitative methodology through a semi-structured survey. Eighteen medical students from first to fourth-year were examined. The major stressing events cited by the students were the following: difficulty in reconciling academic work and personal life, performance exams, interaction with teachers and residents, relationship with patients, as well as the fact of living far from their hometown. In order to face these events, medical students develop adaptive and some non-adaptive strategies. Among the adaptive strategies, students mentioned: expressing their negative feelings, psychological support, leisure activities and spiritual support. As far as the non-adaptive answers are concerned, negative feelings were observed, such as distress and sorrow, denial of reality, alcohol use and recreational drug use. In this context, university authorities must review this situation, in such a way as to provide institutional strategies capable of promoting the recognition of their students’ emotional demands. Students could then take better care of the psychosocial aspects of their patients.

IL28B gene polymorphisms in mono- and HIV-coinfected chronic hepatitis C patients.

INTRODUCTION: Single-nucleotide polymorphisms (SNPs) associated with hepatitis C virus (HCV) clearance were identified near the IL28B gene. Coinfection by the human immunodeficiency virus (HIV) influences the course of HCV contributing to liver damage. Nevertheless, little is known about the relationship between these SNPs and HCV/HIV coinfection. Our aim was to estimate the frequencies of the allelic and genotypic variants of the IL28B polymorphisms rs12979860 (C/T) and rs8099917 (T/G) and their possible association with the establishment of HCV infection. METHODOLOGY: A total of 199 non-infected controls and 230 patients with chronic hepatitis C, including 53 coinfected with HIV, participated in the study. Genotyping consisted of polymerase chain reaction and subsequent analysis of the restriction patterns resulting from exposure to endonucleases. RESULTS: Among the controls with established results, 47.4% (90/190) exhibited the rs12979860 CC genotype, 43.7 CT, and 8.9% TT, whereas 29.1% (66/227), 51.5%, and 19.4% of the patients exhibited the CC, CT, and TT genotypes, respectively. With respect to rs8099917, 66.8% (133/199) of the controls exhibited the TT genotype, 31.2% TG, and 2.0% GG, whereas 56.1% (129/230), 40.9%, and 3.0% of the patients exhibited the TT, TG, and GG genotypes, respectively. CONCLUSION: The frequencies of the rs12979860 C allele and CC genotype and of the rs8099917 T allele and TT genotype were significantly higher among controls compared with patients, thus confirming the suggested protective effect against HCV infection. No significant difference was observed in the genotype and allelic distributions between the mono- and coinfected patients.

Higienização das mãos e promoção da segurança do paciente: avaliação de processo

Este estudo teve como objetivo avaliar o processo de higienização das mãos pelos profissionais de saúde no Centro de Terapia Intensiva (CTI) Adulto e na Unidade de Terapia Intensiva (UTI) Neonatal e Pediátrica de um hospital público da cidade do Rio de Janeiro. Para isso foram aplicados três formulários de observação. O primeiro foi disponibilizado pela Organização Mundial de Saúde para implantação da estratégia multimodal para melhoria de higienização das mãos. Os demais formulários foram elaborados pela autora deste estudo avaliativo contendo uma lista de verificação com os passos a serem seguidos para a execução da técnica de higienização das mãos com água e sabonete e com preparações alcoólicas. Trata-se de um estudo avaliativo de perfil formativo, com abordagem centrada na administração e que utilizou o modelo CIPP que permitiu concentrar a avaliação em um aspecto específico do objeto avaliado - a higienização das mãos. A técnica de observação foi utilizada para a coleta de dados deste estudo. Os resultados apresentados nesta avaliação referentes à adesão a higienização das mãos evidenciaram que a UTI Neonatal e Pediátrica encontra-se com taxa de adesão 74,5% enquanto o CTI Adulto encontra-se com uma taxa de 48%.

Em ambos os setores a preferência dos profissionais foi pela técnica de higienização das mãos com água e sabonete. Quanto a esta, os principais pontos críticos encontrados em ambos os setores foram o dorso dos dedos, os polegares, as polpas digitais e unhas e os espaços interdigitais. Como recomendações, sugere-se a melhoria do conhecimento dos profissionais de saúde acerca dos momentos indicados para a higienização das mãos, colocação das instruções com os momentos indicados para higienização das mãos no ambiente de assistência e como executá-la ao lado dos dispensadores de sabonete e preparações alcoólicas bem como instituir uma política hospitalar referente ao uso de adornos no CTI Adulto. Palavras chave: avaliação em saúde. higiene das mãos. infecção hospitalar.

O uso do brinquedo durante a hospitalização infantil: saberes e práticas da equipe de enfermagem / The use of toys during child's hospitalization: knowledge and practices of the nursing team

Pesquisa de campo descritiva com abordagem qualitativa que teve por objetivo compreender as percepções da equipe de enfermagem de uma unidade de internação pediátrica quanto ao uso do Brinquedo/Brinquedo Terapêutico. Os dados coletados mediante técnica de grupo focal, tendo por sujeitos 16 profissionais de enfermagem, foram submetidos à análise de conteúdo modalidade temática, da qual emergiram duas categorias temáticas: O brinquedo é percebido segundo sua função recreativa e catártica durante a hospitalização da criança;O ato de brincar é normalmente delegado a profissionais não pertencentes à equipe de enfermagem. Os resultados apontaram que os profissionais consideram o uso brinquedo importante e benéfico ao desenvolvimento do cuidado infantil, porém nem todos o inserem em sua prática cotidiana, delegando esta atividade aos profissionais de outras áreas. Sinaliza-se a importância de fornecer subsídios à equipe de enfermagem para que atividades lúdicas, com finalidades terapêuticas ou recreativas, integrem a assistência pediátrica.

Search descriptive field with a qualitative approach that aimed to understand the perceptions of the nursing team of a pediatric inpatient unit on the use of Toy / Therapeutic Toy. The data collected through focus group technique, with the subject of 16 nurses, who underwent thematic content analysis, from which emerged two themes: The toy is perceived according to its recreational and cathartic function during the hospitalization of the child; the act of playing is normally delegated to professionals who do not belong to the nursing team. The results showed that professionals consider important and beneficial the use of toy to the development of child care, but not all input it in their daily practice, delegating this activity to professionals of other fields. It signals the importance of providing subsidies to the nursing staff for fun activities for therapeutic or recreational purposes, integrating pediatric care

Interleukin 28B-related polymorphisms: a pathway for understanding hepatitis C virus infection?

AIM: To analyze the role of rs12979860 and rs8099917 polymorphisms in hepatitis C virus (HCV) genotype 1 infection of Brazilians. METHODS: A total of 145 adult patients diagnosed with genotype 1 chronic hepatitis C (CHC) who had completed a 48-wk regimen of pegylated-interferon α-2a or -2b plus ribavirin combination therapy were recruited from six large urban healthcare centers and 199 healthy blood donors (controls) from a single site between January 2010 and January 2012. Data on the patients' response to treatment was collected. Polymerase chain reaction-restriction fragment length polymorphism genotyping of the interleukin (IL)28B gene fragment encompassing the single nucleotide polymorphisms (SNPs) rs12979860 (C/T) and rs8099917 (T/G) was carried out for 79 of the CHC patients and 199 of the controls. Bi-directional amplicon sequencing of the two SNPs was carried out for the remaining 66 CHC patients. RESULTS: SNP rs12979860 genotyping was successful in 99.5% of the controls and 97.2% of the CHC patients, whereas the SNP rs8099917 genotyping was successful in 95.5% of the controls and 100% of the CHC patients. The genotype and allele distributions for both rs12979860 and rs8099917 were significantly different between the control and CHC patient groups, with significantly higher genotype frequencies of CC and TT in the controls (P = 0.037 and 0.046, respectively) and of TT and GG in the CHC patients (P = 0.0009 and 0.0001, respectively). Analysis of the CHC patients who achieved sustained virological response (SVR) to treatment (n = 55) indicated that the rs12979860 C allele and CC genotype were predictors of SVR (P = 0.02). No significant correlation was found between rs8099917 genotypes and treatment response, but carriers of the T allele showed significantly higher rates of SVR (P = 0.02). Linkage disequilibrium analysis of the group that achieved SVR showed a significant association between rs12979860 and rs8099917 (P = 0.07). CONCLUSION: The higher allele frequency of rs12979860 C and rs8099917 T observed in non-HCV-infected individuals may indicate a potential protective role for these IL28B-related polymorphisms.