ANALYSIS OF THE APPROACH TO SICKLE CELL ANEMIA IN NATURAL SCIENCE TEXTBOOKS / ANÁLISIS DEL ABORDAJE DE LA ANEMIA FALCIFORME EN LOS LIBROS DE TEXTO DE CIENCIAS NATURALES / ANÁLISE DA ABORDAGEM SOBRE A ANEMIA FALCIFORME EM LIVROS DIDÁTICOS DE CIÊNCIAS DA NATUREZA

This work aimed to analyze the Sickle Cell Anemia (SCA) approach in Natural Sciences textbook collections approved in 2021 National Textbook and Teaching Material Program (PNLD) for High School. The focus of these analyses was: the racial discourse associated with SCA and scientific racism; health approaches; and adequacy from a clinical-scientific point of view. To this end, the content analysis proposed by Bardin was adopted, involving textbooks floating reading, the creation or adaptation of categories and indicators for analysis, the material description and the interpreting the data collected. The data was compared with previous analyses of the approach to SCA in biology textbooks from the 2012 and 2015 PNLD. The approach to SCA, when it did occur in the current collections, was linked to natural selection, without focusing on racial issues, and based on a molecular description. There was a silencing of the approach to SCA in relation to the findings of previous research. In addition, biomedical and reductionist approaches to SCA continued to predominate, disregarding socio-political and historical aspects related to the disease.

El objetivo de este estudio fue analizar el abordaje de la Anemia Falciforme (AF) en las colecciones de Ciencias Naturales y sus Tecnologías aprobadas en el Programa Nacional de Libros de Texto y Material Didáctico (PNLD) 2021 para la enseñanza media. El foco de ese análisis fue: el discurso racial asociado a la Anemia Falciforme y el racismo científico; los abordajes de salud; y la adecuación del punto de vista clínico-científico. Para ello, se adoptó el análisis de contenido propuesto por Bardin, que implica la lectura flotante de las colecciones, la creación o adaptación de categorías e indicadores para el análisis, la descripción del material y la interpretación de los datos. Los datos se compararon con análisis anteriores sobre el abordaje de la AF en los libros de texto de biología de los PNLD de 2012 y 2015. La aproximación a la AF, cuando se producía en las colecciones actuales, estaba vinculada a la selección natural, sin centrarse en cuestiones raciales, y basada en una descripción molecular. Hubo un silenciamiento del abordaje de la AF en relación a los hallazgos de investigaciones anteriores. Además, siguieron predominando los enfoques biomédicos y reduccionistas de la AF, sin tener en cuenta los aspectos sociopolíticos e históricos relacionados con la enfermedad.

Este trabalho objetivou analisar a abordagem sobre a Anemia Falciforme (AF) nas coleções de Ciências da Natureza e Suas Tecnologias aprovadas no Programa Nacional do Livro e do Material Didático (PNLD) de 2021 para o Ensino Médio. Os focos desta análise foram: o discurso racial associado a AF e ao racismo científico; as abordagens de saúde; e a adequação do ponto de vista clínico-científico. Para tanto, adotou-se a análise de conteúdo proposta por Bardin, envolvendo a leitura flutuante das coleções, a criação ou a adaptação de categorias e indicadores para análise, a descrição do material e a interpretação dos dados. Os dados foram comparados com análises anteriores sobre a abordagem da AF em livros didáticos de biologia do PNLD de 2012 e de 2015. A abordagem da AF, quando ocorreu nas coleções atuais, esteve atrelada a seleção natural, sem pautar questões raciais, e a partir de uma descrição molecular. Observou-se um silenciamento na abordagem sobre a AF em relação aos achados de pesquisas anteriores. Além disso, manteve-se a predominância de abordagens biomédicas e reducionistas sobre a AF, desconsiderando aspectos sociopolíticos e históricos relacionados a doença.

Translation, transcultural adaptation into Brazilian Portuguese and concurrent validity of the rheumatoid arthritis assessment scale (RAKAS-13/Brazil).

BACKGROUND: Knowledge of patients about Rheumatoid Arthritis (RA) is a necessary aspect to better approach self-management support in a patient-centered manner. The research instrument known as the Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS), consisting of 13 items, is simple, reliable and reproducible, and can be applied in both clinical practice and research protocols. OBJECTIVE: This study aimed to translate and culturally adapt the RAKAS vocabulary into Brazilian Portuguese and to evaluate its concurrent validity. METHODS: The RAKAS was translated into Brazilian Portuguese and administered to 52 elderly women with RA recruited between May 2021 and May 2022. Concurrent validity was assessed using the Spearman's correlation coefficient between RAKAS and Patient Knowledge Questionnaire (PKQ). RESULTS: The participants considered RAKAS-13/BRAZIL easy to understand and did not report any doubts in answering the final version. Concurrent validity of the RAKAS-13/BRAZIL was low compared to the PKQ (ρ = 0.283, p = 0.038). CONCLUSION: The Brazilian Portuguese version of the RAKAS (RAKAS-13/BRASIL) proved to be a questionnaire that was easy and quick to administer to assess patient knowledge about Rheumatoid Arthritis, despite its low correlation with the PKQ in the present study.

Compliance with the 24-h movement behaviors guidelines among urban and rural Brazilian preschoolers.

BACKGROUND: The importance of movement behaviors for health is well-known, although few studies have examined the compliance with movement guidelines in preschoolers from different living contexts. This study reported the compliance with the 24-h movement behaviors guidelines among low-income Brazilian preschoolers from rural and urban areas, according to age. METHODS: A total of 453 preschoolers (n = 222 urban), aged between 3 and 5 years, provided physical activity (PA) data (Actigraph wGT3X). Sleep duration, and screen time were parent-reported. Preschoolers were classified as compliant/non- compliant with the 24-h movement guidelines, according to age. The association between prevalence of compliance with the recommendations and the children's living setting were estimated (SPSS; 27.0). RESULTS: Preschoolers were active (mean = 299.19 ± 76.42; and 369.76 ± 95.56 min/day in urban and rural areas, respectively), though moderate-to-vigorous physical activity (MVPA) time was below the 60 daily minutes recommended in both urban and rural settings (mean = 38.39 ± 21.36; and 47.32 ± 24.28, respectively). None of the urban children complied with the three recommendations simultaneously, while in the rural area, only 2.6% were compliant. Single movement behaviors compliances in the urban setting were 6.8%, 28.8% and 5.4% for PA, sleep, and screen time, respectively; while for rural settings were 16.5%, 21.2%, and 7.4%. Living in the rural area was related to the compliance with PA recommendation for the 5-year-old preschoolers. CONCLUSION: In both urban and rural Brazilian areas, very few preschoolers are compliant with the guidelines, and more than one third of the children do not comply with any of the recommendations. Strategies and programs to promote compliance with movement behaviors guidelines should consider children's living setting and their age groups.

An outbreak of type C botulism in free-ranging Southern lapwing (Vanellus chilensis).

In the fall of 2021, a significant mortality event in free-ranging Southern Lapwing (Vanellus chilensis) occurred on a soccer field in southern Brazil. Approximately 130 adult southern lapwings died after showing weakness and flaccid paralysis, characterized by the inability to move or fly and drooped wings. Due to the large number of animals affected, there was concern that they had been criminally poisoned. The affected birds were found to have ingested maggots in fresh poultry litter incorporated into the grass surface. Postmortem examinations of four southern lapwings revealed no significant gross and histological findings. Polymerase Chain Reaction (PCR) for influenza A virus, flavivirus, and paramyxovirus was negative. Based on the epidemiological and clinical findings and the negative viral results, a presumptive diagnosis of botulism was made. This diagnosis was confirmed through mouse bioassay and seroneutralization, which detected botulinum toxin type C. Maggots loaded with botulinum neurotoxins were the probable vehicle for intoxication in the outbreak. Considering the impact of avian botulism on wild bird populations, our results may help prevent similar outbreaks in the future.

Co-occurrence of periodontal lesions and dental wear in incisor and masticatory teeth in two sheep flocks in Brazil.

BACKGROUND: Periodontitis and tooth wear are multifactorial diseases with distinct etiopathogenesis that affect the health, feed efficiency and welfare of sheep. METHODS: This study evaluated the co-occurrence of tooth wear and periodontal lesions in 129 ewes from two Brazilian flocks, clinically classified the lesions and presence of dental calculus, and identified potential pathogens in the dental biofilm of 63 ewes by polymerase chain reaction. RESULTS: Of the 129 ewes included in the study, 75 presented periodontal lesions, while all animals presented tooth wear and dental calculus. Of the animals with periodontal lesions, 16.2% had lesions in incisor teeth and 52.7% in masticatory teeth. Regarding excessive tooth wear, 38.6% had severe wear on the incisor teeth and 89.1% on the masticatory teeth. Ewes older than 36 months had a higher frequency of periodontal lesions in incisor teeth (p < 0.001) and a greater amount of dental calculus (p < 0.001), but there was no association between tooth wear and animal age. Fusobacterium nucleatum, Tannerella forsythia and Fusobacterium necrophorum predominated in periodontal lesions. LIMITATION: This study is limited by the small sample size and lack of diagnostic imaging to assess periodontal disease. CONCLUSION: The co-occurrence of periodontal lesions and excessive dental wear involving both the incisor and masticatory teeth suggests that although the two diseases have different aetiologies, they likely have common risk factors.

Translation, transcultural adaptation into Brazilian Portuguese and concurrent validity of the rheumatoid arthritis assessment scale (RAKAS-13/Brazil)

Abstract Background Knowledge of patients about Rheumatoid Arthritis (RA) is a necessary aspect to better approach self-management support in a patient-centered manner. The research instrument known as the Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS), consisting of 13 items, is simple, reliable and reproducible, and can be applied in both clinical practice and research protocols. Objectives This study aimed to translate and culturally adapt the RAKAS vocabulary into Brazilian Portuguese and to evaluate its concurrent validity. Methods The RAKAS was translated into Brazilian Portuguese and administered to 52 elderly women with RA recruited between May 2021 and May 2022. Concurrent validity was assessed using the Spearman's correlation coefficient between RAKAS and Patient Knowledge Questionnaire (PKQ). Results The participants considered RAKAS-13/BRAZIL easy to understand and did not report any doubts in answering the final version. Concurrent validity of the RAKAS-13/BRAZIL was low compared to the PKQ (ρ = 0.283, p = 0.038). Conclusion The Brazilian Portuguese version of the RAKAS (RAKAS-13/BRASIL) proved to be a questionnaire that was easy and quick to administer to assess patient knowledge about Rheumatoid Arthritis, despite its low correlation with the PKQ in the present study.

Ileal inflammation is reduced due to treatment with a metalloprotease from BmooMP-α-I snake venom in an experimental model of Toxoplasma gondii infection.

The selection process for advanced therapies in patients with inflammatory bowel diseases (IBDs) must prioritize safety, especially when considering new biologic agents or oral molecule modulators. In C57BL/6 mice, oral infection with Toxoplasma gondii induces intestinal inflammation through excessive tumor necrosis factor (TNF) production, making TNF neutralization a potential therapeutic intervention. Considering this, the present study aimed to evaluate the therapeutic effects of BmooMP-α-I, a snake venom metalloprotease isolated from Bothrops moojeni, which could promote TNF hydrolysis, in treating T. gondii-induced ileitis. The results showed that C57BL/6 mice orally infected with 50 cysts of T. gondii from the Me49 strain and treated with BmooMP-α-I exhibited prolonged survival and improved morbidity scores. Additionally, the treatment ameliorated both the macroscopic and microscopic aspects of the intestine, reduced macrophage influx, and decreased the production of inflammatory mediators by mesenteric lymph node cells. These findings provide compelling experimental evidence supporting the ability of BmooMP-α-I to alleviate ileal inflammation. Considering that the currently available therapeutic protocols are not completely effective and often result in side effects, the exploration of alternative strategies involving novel therapeutic agents, as demonstrated in this study, has the potential to significantly enhance the quality of life for patients suffering from inflammatory bowel diseases.

Seroprevalence of Equine Leptospirosis in the State of Goiás, Brazil.

Leptospirosis, caused by Leptospira, is a zoonotic disease that, in horses, is linked to abortions, uveitis, and sporadic occurrences of liver and kidney disease, often resulting in significant economic losses for farmers. Research on the prevalence of leptospirosis in horses in the central-west region of Brazil has been relatively scarce. Thus, the present study aimed to determine the prevalence of leptospirosis in equine herds in the state of Goiás (Central Brazil). Blood samples were collected from 894 equids at 294 randomly selected farms divided into three different strata according to their herd characteristics. The microscopic agglutination test for the detection of anti-Leptospira agglutinins was carried out and the results showed that among the 294 sampled farms, 213 (72.9%; CI 95% 71.7-78.9) had one or more animals positive for leptospirosis, and of the 894 horses sampled, 513 (61.6%; CI 95% 54.3-69.0) were seropositive for leptospirosis. Djasiman, Icterohaemorrhagiae, and Australis were the most prevalent serogroups. The results showed a high prevalence of seropositive animals and a widespread distribution of positive farms in the state of Goiás. Thus, environmental sanitation measures and health education to prevent and control equine leptospirosis in the state are required.

Advanced lithium disilicate: A comparative evaluation of translucency and fatigue failure load to other ceramics for monolithic restorations.

The aim of this in vitro study was to evaluate the surface roughness, translucency, fatigue failure load (FFL), and number of cycles for fatigue failure (CFF) of a recently released lithia-based material called advanced lithium disilicate and three other ceramics indicated for monolithic restorations. First, ALD (advanced lithium disilicate, CEREC Tessera, Dentsply Sirona), LD (lithium disilicate, IPS e. max CAD, Ivoclar), LS (lithium silicate-disilicate, Suprinity, Vita Zahnfabrik), and 4Y-PSZ (Yttria-stabilized zirconia, IPS e.max ZirCAD MT, Ivoclar) discs (n = 15, Ø = 10 mm and thickness = 1.0 mm) were fabricated from CAD/CAM blocks/discs, A2 shade. The discs were sintered/crystallized and subsequently analyzed by a rugosimeter (Mitutoyo SJ-410) to determine Ra and Rz surface roughness parameters. Next, they were evaluated to determine the translucency parameter (TP) using a bench-top spectrophotometer (SP60, EX-Rite). The discs were subsequently cemented to glass fiber epoxy resin discs, and the specimens were tested under cyclic loading (Step-test), immersed in distilled water at a frequency of 20 Hz, with an initial cyclic load of 200 N for 5,000 cycles and increments of 50 N every 10,000 cycles until failure. Fatigue failure load (FFL) and number of cycles for fatigue failure (CFF) were recorded for subsequent Kaplan Meier analysis, with post-hoc Mantel-Cox and Weibull analysis (α = 0.05). Complementary fractographic, topographic and energy dispersive spectroscopy analyses (EDS) were performed. 4Y-PSZ showed higher survival (p < 0.05), with higher FFL and CFF (1077 N; 180,333 cycles), followed by LD (980 N; 161,000 cycles), LS (937 N; 152,333 cycles) and ALD (910 N; 147,000 cycles). No differences were observed between the tested groups regarding Weibull modulus. ALD presented TP (28.14) equal to DL (28.27) and higher than LS (25.51). All lithia-based materials had higher translucency than 4Y-PSZ (TP = 8.62) (p < 0.05). ALD appears to have a similar elemental composition to LD and LSD for oxygen and silicon. ALD and LSD have a similar zirconium content. Fractures originated on the cemented surface of the ceramic discs. Lithia-based ceramics showed lower surface roughness, with ALD (Ra = 0.04 µm; Rz = 0.66 µm) showing the lowest values (p < 0.05). Despite showing lower FFL when compared to LD and 4Y-PSZ, ALD has compatible translucency and mechanical fatigue performance with its indication for fabricating monolithic, anterior and posterior adhesively cemented single-unit restorations. However, further studies are needed to substantiate its clinical performance.

Estratégias de enfrentamento na Atenção Primária à Saúde na pandemia de Covid-19 em Minas Gerais, Brasil / Coping strategies in Primary Health Care in the COVID-19 pandemic in Minas Gerais, Brazil

RESUMO Objetivou-se analisar as ações da Atenção Primária à Saúde (APS) em resposta à pandemia de Covid-19 em municípios de Minas Gerais. Trata-se de um estudo quantitativo, observacional e transversal. A coleta de dados foi realizada mediante a aplicação de um questionário on-line, no qual participaram 278 secretários municipais de saúde do estado de Minas Gerais e/ou coordenadores da APS. A estrutura em saúde se demonstrou capaz de proporcionar o desenvolvimento de funções gerenciais com base em dados e informações ao longo da pandemia. Entre as ações de enfrentamento na população, estão o uso de protocolos, de máscaras, utilização de barreiras físicas, penalidade por aglomeração e recursos de telefonia para o esclarecimento de dúvidas sobre a Covid-19. Quanto às dificuldades de controle dessa doença pelos colaboradores na APS, foram citadas baixa remuneração profissional, precária organização do trabalho, demora dos resultados nos exames, subnotificação, falta de equipamentos e recursos tecnológicos. Conclui-se que inúmeras medidas e ferramentas adotadas para o controle da pandemia foram utilizadas pelas autoridades municipais. No entanto, apesar de os recursos tecnológicos, como o e-SUS, disponibilizarem dados epidemiológicos sobre a Covid-19, capazes de auxiliar no planejamento de ações em saúde, essas ferramentas necessitam de aperfeiçoamentos.

ABSTRACT The aim was to analyze Primary Health Care (PHC) actions in response to the COVID-19 pandemic in municipalities in Minas Gerais. This is a quantitative, observational, and cross-sectional study. Data collection was carried out through the application of an online questionnaire, in which 278 municipal health secretaries from the state of Minas Gerais and/or coordinators of PHC took part. The health structure proved to be capable of providing the development of management functions based on data and information throughout the COVID-19 pandemic. Among the actions to face the population are the use of protocols, masks, use of physical barriers, penalty for crowding, and telephony resources to clarify doubts about COVID-19. As for the difficulties in controlling this disease by employees in the PHC, low professional remuneration, poor work organization, delay in test results, underreporting, lack of equipment and technological resources were mentioned. It is concluded that the numerous measures and tools adopted to control the COVID-19 pandemic were used by municipal authorities. However, despite technological resources, such as the e-SUS, providing epidemiological data on COVID-19, capable of assisting in the planning of health actions, these tools need to be improved.

The pandemic changes daily life and ways of living: technosociality and user/families experiences.

OBJECTIVES: understand the changes imposed by the COVID-19 pandemic in the daily lives of users of Primary Health Care and their families and its impact on self-care and health promotion. METHODS: this is a holistic-qualitative multiple case study, based on the Comprehensive Sociology of Everyday Life, in which 61 users participated. RESULTS: experiencing a new daily life in COVID-19 pandemic times, users express their feelings, adaptation to new habits and ways of living. Health technologies and virtual social networks stand out in helping with everyday tasks, in communicating with loved ones and health professionals, and in validating dubious information. Faith and spirituality arise in the face of uncertainty and suffering. FINAL CONSIDERATIONS: it is imperative to pay close attention to the changes in daily life caused by the COVID-19 pandemic, in order to offer care directed to the singular and collective needs.

Purple tea: chemical characterization and evaluation as inhibitor of pancreatic lipase and fat digestion in mice.

A variety of the classic green tea plant, Camellia sinensis, was developed and is exclusive to Kenya. Due to high content of anthocyanin polyphenols in its leaves, the beverage obtained from this variety is purple in color and is the origin of the name purple tea. This work had two main purposes. The first one was to identify and quantify the major anthocyanin polyphenols in a hot water aqueous extract of the purple tea leaves. The second one was to test the hypothesis if this extract is capable of inhibiting triglyceride absorption considering that anthocyanin polyphenolics have been frequently associated to antilipidemic effects. Parallel experiments were always done with a similar green tea extract for comparison purposes. The antioxidant, anti-inflammatory, and cytotoxic activities of both tea varieties are similar. The purple tea extract, however, was strongly inhibitory toward the pancreatic lipase (minimal IC50 = 67.4 µg mL-1), whereas the green tea preparation was a weak inhibitor. Triglyceride digestion in mice was inhibited by the purple tea extract starting at 100 mg kg-1 dose and with a well-defined dose dependence. Green tea had no effect on triglyceride digestion at doses up to 500 mg kg-1. The latter effect is probably caused by several components in the purple tea extract including non-anthocyanin and anthocyanin polyphenols, the first ones acting solely via the inhibition of the pancreatic lipase and the latter by inhibiting both the lipase and the transport of free fatty acids from the intestinal lumen into the circulating blood. The results suggest that the regular consumption of Kenyan purple tea can be useful in the control of obesity.

Infodemia e (des)informação na pandemia da covid-19: tecnossocialidade na atenção primária à saúde / Infodemia y (des)información en la pandemia de COVID-19: tecnosocialidad en la atención primaria de salud / Infodemic and (dis)information in the COVID-19 pandemic: Social technology in primary health care

Objetivo: compreender as potências e limites da tecnossocialidade, bem como as estratégias de boa comunicação e prevenção da circulação de fake news no cotidiano dos profissionais da atenção primária na pandemia da covid-19. Materiais e método: estudo de casos múltiplos integrado-qualitativo, fundamentado na sociologia compreensiva do cotidiano, com inclusão de 47 profissionais de saúde de um município de Santa Catarina e de dois municípios de Minas Gerais, Brasil. A coleta de dados foi realizada entre abril e outubro de 2021, e teve como fontes de evidência a entrevista individual aberta e as notas de campo. Resultados: constituem-se potências a continuidade de cuidados à saúde em meio à pandemia, o estreitamento da comunicação entre profissionais e usuários, e o recebimento de resultados de exames por usuários pelo WhatsApp. Contudo, limites ainda precisam ser superados, como a infodemia e a desinformação pela disseminação das fake news nas redes sociais, e a inacessibilidade à internet, principalmente em classes sociais baixas. Conclusões: a aceleração do uso da tecnossocialidade na pandemia proporcionou avanços no campo da saúde, porém ocasionou a infodemia e o aumento da circulação de notícias falsas. Uma parte da população ainda enfrenta dificuldade de acesso e uso da internet, principalmente em classes sociais baixas. Dessa forma, os profissionais de saúde apresentam o importante papel educativo, ao compartilhar informações verídicas à população com uso de ferramentas virtuais.

Objetivo: comprender las fortalezas y los límites de la tecnosocialidad y las estrategias para una buena comunicación y prevención de la circulación de noticias falsas en el cotidiano de los profesionales de atención primaria durante la pandemia de COVID-19. Materiales y método: estudio de caso múltiple integrado-cualitativo, basado en la sociología integral de la vida cotidiana, con la inclusión de 47 profesionales de la salud de un municipio de Santa Catarina y dos municipios de Minas Gerais, Brasil. La recolección de datos se realizó entre abril y octubre de 2021 y tuvo como fuentes de información una entrevista individual abierta y las notas de campo recopiladas. Resultados: la continuidad de la atención en salud en medio de la pandemia, el fortalecimiento de la comunicación entre profesionales y usuarios y la recepción de los resultados de las pruebas por parte de los usuarios a través de WhatsApp se constituyen como elementos clave de la prestación de los servicios de salud. Sin embargo, existen límites aún por superar, como la infodemia y la desinformación generadas por la difusión de noticias falsas en redes sociales y la accesibilidad a internet, especialmente en las clases sociales más bajas. Conclusiones: la aceleración del uso de tecnosocialidad en la pandemia generó avances en el campo de la salud, pero también infodemia y un aumento de la circulación de noticias falsas. Una parte de la población todavía tiene dificultades para acceder y utilizar Internet, especialmente las clases sociales más bajas. De esta forma, los profesionales de la salud juegan un importante papel educativo al compartir información veraz con la población a través de herramientas virtuales.

Objective: To understand the strengths and limits of technosociality and the role of good communication strategies aimed at preventing the spread of fake news in the daily life of primary care professionals during the covid-19 pandemic. Materials and method: Integrated and qualitative multiple case study based on the integral sociology of daily life, with the participation of 47 health professionals from one municipality in Santa Catarina and two municipalities in Minas Gerais, Brazil. Data collection was carried out between April and October 2021 through individual interviews and field notes. Results: The continuity of health care in the midst of a pandemic, the strengthening of communication between professionals and users, and the reception of test results by users through WhatsApp are identified as key elements. However, there are still limits to be overcome, such as the infodemic and misinformation due to the spread of fake news on social networks or barriers to internet accessibility, especially in the lower social classes. Conclusions: The increased use of technosociality during the pandemic favored certain advances in health care. However, this situation also caused an infodemic and the growth of fake news circulation. Currently, part of the population is still facing difficulties in internet access and usage, especially those from lower social classes. Therefore, health professionals could play an important educational role by sharing accurate information through virtual tools.

Resposta dos parâmentros do andar após intervenção com dicas auditivas rítmicas em idosos com doença de Parkinson / Response of gait parameters after intervention with rhythmic auditory cues in older people with parkinson's disease

Introdução: os comprometimentos do andar em idosos com doença de Parkinson (DP) estão associados à elevada ocorrência de quedas e à redução dos níveis de independência. O objetivo do estudo foi comparar a resposta dos parâmetros do andar em idosos com doença de Parkinson (DP), durante, imediatamente após e até uma hora após o término de uma sessão de treinamento do andar com e sem dicas auditivas rítmicas, utilizando três ritmos diferentes para o grupo dica (10% abaixo da cadência preferida, cadência preferida e 10% acima) e um ritmo diferente para o grupo controle (velocidade usual de cada participante). Métodos: vinte e nove idosos foram aleatoriamente distribuídos em dois grupos: "controle" e "dica". As sessões de intervenção tiveram 30 minutos de duração e a diferença entre os grupos foi a utilização de dicas auditivas rítmicas oferecidas por um metrônomo no grupo dica. O andar foi avaliado antes, durante e até uma hora após a sessão de intervenção. Resultados: os grupos apresentaram desempenhos similares ao longo das avaliações, com aumento do comprimento do passo e redução da variabilidade da duração do passo. Conclusão: a sessão de intervenção com dicas auditivas rítmicas apresentou efeitos similares aos da sessão de treino sem dica para o andar de idosos com DP.(AU)

Introduction: Gait impairments in older people with Parkinson's disease (PD) are associated with a high occurrence of falls and reduced levels of patients' independence. The objective of the study was to compare the response of gait parameters in older people with Parkinson's disease (PD), during, immediately after, and up to 1h after the end of a single locomotion training session with and without rhythmic auditory cues, using 3 different rhythms for the tip group (10% below the preferred cadence, preferred cadence and 10% above) and 1 different rhythm for the control group (usual speed of each participant). Materials and method: 29 older people were randomly assigned to two groups: Control and "Cue". The intervention sessions lasted 30 minutes and the difference between the groups was the use of rhythmic auditory cues offered by a metro-nome in the Cue group. Gait was assessed before, during, and up to 1 hour after the intervention session. Results: The groups showed similar performances throughout the assessments, with increased step length and reduced step time variability in response to the intervention (compared to the baseline assessment). Conclusion: The intervention session with rhythmic auditory cues had similar effects on gait as the session without cues in older people with PD.(AU)

Redes de apoio no continuum processo de reabilitação no quotidiano de pessoas com lesão medular / Redes de apoyo en el continuum proceso de rehabilitación en el cotidiano de personas con lesión medular / Support networks in the continuum rehabilitation process in the daily life of people with spinal cord injury

RESUMO Objetivo: compreender a rede de apoio no continuum processo de reabilitação no quotidiano de pessoas com lesão medular. Metodologia: estudo descritivo, de natureza qualitativa, fundamentado na Sociologia Compreensiva e do Quotidiano, com 23 pessoas com lesão medular, acompanhadas em Serviço de Enfermagem e de Reabilitação do sul do Brasil. Para a coleta de dados, utilizou-se do prontuário, genograma, ecomapa e entrevista individual. Para a análise da entrevista, utilizou-se a Análise de Conteúdo. Resultados: ao ingressar no Programa de Reabilitação, as redes de apoio se configuravam como uma vinculação fraca quando a inacessibilidade era uma barreira, especificamente, o trabalho/escola; hobby/lazer. As vinculações fortes consideram as redes cuidador principal, centro de saúde, amigos, orientação religiosa e família. Considerações finais: as redes de apoio que circundam cada indivíduo com lesão medular e a família e como elas se relacionam, auxiliam o enfrentamento do novo ritmo de vida, colaborando para o alcance das metas de reabilitação e ressocialização.

RESUMEN Objetivo: comprender la red de apoyo en el continuum proceso de rehabilitación en el cotidiano de personas con lesión medular. Metodología: estudio descriptivo, de naturaleza cualitativa, fundamentado en la Sociología Comprensiva y del Cotidiano, con 23 personas con lesión medular, acompañadas en Servicio de Enfermería y de Rehabilitación del sur de Brasil. Para la recolección de datos, se utilizó el registro médico, genograma, ecomapa y entrevista individual. Para el análisis de la entrevista, se utilizó el Análisis de Contenido. Resultados: al ingresar en el Programa de Rehabilitación, las redes de apoyo se configuraban como una vinculación débil cuando la inaccesibilidad era una barrera, específicamente, el trabajo/escuela; pasatiempo/ocio. Las vinculaciones fuertes consideran las redes: cuidador principal, centro de salud, amigos, orientación religiosa y familia. Consideraciones finales: las redes de apoyo, que rodean a cada individuo con lesión medular y a la familia y cómo se relacionan, ayudan a enfrentar el nuevo ritmo de vida, colaborando para el logro de las metas de rehabilitación y resocialización.

ABSTRACT Objective: to understand the support network in the continuum process of rehabilitation in the daily life of people with spinal cord injury. Methodology: a descriptive study of a qualitative nature, based on Comprehensive Sociology and Everyday Life, with 23 people with spinal cord injury, accompanied by a Nursing and Rehabilitation Service in southern Brazil. For data collection, we used the medical record, genogram, ecomap and individual interview. Content Analysis was used to analyze the interview. Results: when entering the Rehabilitation Program, the support networks were configured as a weak link when inaccessibility was a barrier, specifically, work/school; hobby/leisure. Strong bonds consider the main caregiver networks, health center, friends, religious orientation and family. Final thoughts: the support networks that surround each individual with spinal cord injury and the family and how they relate, help to cope with the new rhythm of life, collaborating to achieve the goals of rehabilitation and resocialization.

Fatores sociodemográficos e clínicos associados à ansiedade em mulheres hipertensas: estudo transversal / Factores sociodemográficos y clínicos asociados a la ansiedad en mujeres hipertensas: estudio transversal / Sociodemographic and clinical factors associated with anxiety in hypertensive women: a cross-sectional study

Resumo Objetivo Verificar a prevalência da ansiedade e sua associação com os fatores sociodemográficos e clínicos em mulheres com hipertensão arterial sistêmica. Métodos Estudo transversal com 258 mulheres com hipertensão arterial sistêmica diagnosticada há pelo menos seis meses e que eram atendidas no ambulatório de Hipertensão Arterial de uma instituição pública voltada ao ensino, pesquisa e assistência na cidade de São Paulo. O instrumento continha dados sociodemográficos, clínicos e de hábitos de vida e foi preenchido por meio de uma entrevista. A ansiedade foi avaliada pelo inventário de Ansiedade Traço e classificada em baixa, moderada, elevada e muito elevada. A avaliação da associação entre os fatores sociodemográficos e clínicos com o nível de ansiedade foi realizada pelos testes de associação e regressão logística simples multinomial, considerando o nível de significância de 5%. Resultados Identificou-se que 70,5% apresentavam ansiedade moderada e 19,4% elevada. Na regressão logística multinomial simples identificou-se que quanto maior a idade maior a chance de ansiedade elevada (p=0,01; Odds Ratio =1,09), as mulheres sem companheiro tinham maiores chances de ansiedade elevada (p=0,02, Odds Ratio =3,19) e com o aumento da renda mensal familiar menor foi a chance de ansiedade elevada (p=0,04, Odds Ratio =0,99). Conclusão Houve alta prevalência de ansiedade moderada na população estudada e a ausência de companheiro foi o fator que melhor explicou o fenômeno de ansiedade. Os enfermeiros devem propor intervenções, principalmente para estas pessoas, com o intuito de reduzir tal sentimento.

Resumen Ocurrencias Verificar la prevalencia de la ansiedad y su relación con los factores sociodemográficos y clínicos en mujeres con hipertensión arterial sistémica. Métodos Estudio transversal con 258 mujeres con hipertensión arterial sistémica diagnosticadas hace seis meses por lo menos y que habían sido atendidas en consultorios externos de Hipertensión Arterial de una institución pública orientada a la educación, investigación y atención en la ciudad de São Paulo. El instrumento contenía datos sociodemográficos, clínicos y de hábitos de vida y fue completado mediante una encuesta. La ansiedad fue evaluada mediante el inventario de rasgos de ansiedad y clasificada como baja, moderada, alta o muy alta. La evaluación de la relación entre los factores sociodemográficos y clínicos con el nivel de ansiedad fue realizada con la prueba de asociación y regresión logística simple multinominal, con un nivel de significación de 5 %. Resultados Se identificó que el 70,5 % presentó ansiedad moderada y el 19,4 % alta. En la regresión logística multinomial simple se identificó que, cuanto mayor era la edad, mayor era la probabilidad de ansiedad alta (p=0,01; Odds Ratio =1,09), las mujeres sin compañero tenían mayores probabilidades de ansiedad alta (p=0,02, Odds Ratio =3,19) y con el aumento de los ingresos familiares mensuales, la probabilidad de ansiedad alta fue menor (p=0,04, Odds Ratio =0,99). Conclusión Se observó una alta prevalencia de ansiedad moderada en la población estudiada y la ausencia de compañero fue el factor que mejor explicó el fenómeno de ansiedad. Los enfermeros deben proponer intervenciones, principalmente para estas personas, con el objetivo de reducir ese sentimiento.

Abstract Objective To verify the prevalence of anxiety and its association with sociodemographic and clinical factors in women with hypertension. Method This is a cross-sectional study with 258 women with hypertension diagnosed for at least six months and who were treated at the hypertension outpatient clinic of a public institution dedicated to teaching, research and care in the city of São Paulo. The instrument contained sociodemographic, clinical and lifestyle data and was completed through an interview. Anxiety was assessed by the State-Trait Anxiety inventory and classified as low, moderate, high and very high. The assessment of the association between sociodemographic and clinical factors with anxiety level was performed using association tests and simple multinomial logistic regression, considering a significance level of 5%. Results It was found that 70.5% had moderate anxiety and 19.4% had high anxiety. In the simple multinomial logistic regression, it was identified that the older the age, the greater the chance of high anxiety (p=0.01; Odds Ratio =1.09), women without a partner were more likely to have high anxiety (p=0.02, Odds Ratio =3.19), and with increasing monthly family income, the chance of high anxiety was lower (p=0.04, Odds Ratio =0.99). Conclusion There was a high prevalence of moderate anxiety in the population studied and the absence of a partner was the factor that best explained the anxiety phenomenon. Nurses should propose interventions, especially for these people, in order to reduce this feeling.

The pandemic changes daily life and ways of living: technosociality and user/families experiences / La pandemia cambia la cotidianidad y los modos de vivir: tecnosocialidad y experiencias de usuarios/familias / A pandemia muda o quotidiano e modos de viver: tecnossocialidade e experiências de usuários/famílias

ABSTRACT Objectives: understand the changes imposed by the COVID-19 pandemic in the daily lives of users of Primary Health Care and their families and its impact on self-care and health promotion. Methods: this is a holistic-qualitative multiple case study, based on the Comprehensive Sociology of Everyday Life, in which 61 users participated. Results: experiencing a new daily life in COVID-19 pandemic times, users express their feelings, adaptation to new habits and ways of living. Health technologies and virtual social networks stand out in helping with everyday tasks, in communicating with loved ones and health professionals, and in validating dubious information. Faith and spirituality arise in the face of uncertainty and suffering. Final Considerations: it is imperative to pay close attention to the changes in daily life caused by the COVID-19 pandemic, in order to offer care directed to the singular and collective needs.

RESUMEN Objetivos: comprender los cambios impuestos por la pandemia de la COVID-19 en el cotidiano de los usuarios de la Atención Primaria de Salud y sus familias y su impacto en el autocuidado y la promoción de la salud. Métodos: se trata de un estudio de caso múltiple holístico-cualitativo, basado en la Sociología Integral de la Vida Cotidiana, en el que participaron 61 usuarios. Resultados: experimentando una nueva cotidianidad en tiempos de la pandemia del COVID-19, los usuarios expresan sus sentimientos, adaptación a nuevos hábitos y formas de vivir. Las tecnologías de la salud y las redes sociales virtuales se destacan para ayudar en las tareas cotidianas, en la comunicación con los seres queridos y profesionales de la salud, y en la validación de información dudosa. La fe y la espiritualidad surgen ante la incertidumbre y el sufrimiento. Consideraciones Finales: es imperativo prestar mucha atención a los cambios en la vida cotidiana provocados por la pandemia de la COVID-19, a fin de ofrecer una atención dirigida a las necesidades singulares y colectivas.

RESUMO Objetivos: compreender as mudanças impostas pela pandemia de COVID-19 no quotidiano de usuários da Atenção Primária à Saúde e suas famílias e seu impacto no autocuidado e na promoção da saúde. Métodos: trata-se de estudo de casos múltiplos holístico-qualitativo, fundamentado na Sociologia Compreensiva do Quotidiano, no qual participaram 61 usuários. Resultados: vivenciando um novo quotidiano em tempos da pandemia de COVID-19, os usuários expressam seus sentimentos, a adaptação aos novos hábitos e modos de viver. As tecnologias em saúde e as redes sociais virtuais se destacam no auxílio às tarefas cotidianas, para a comunicação com entes queridos e os profissionais da saúde, e na validação de informações duvidosas. A fé e a espiritualidade surgem diante de incertezas e sofrimento. Considerações Finais: é imperativo um olhar atento às transformações no quotidiano causadas pela pandemia de COVID-19, a fim de ofertar um cuidado direcionado às necessidades singulares e do coletivo.

Mutually exclusive disorder-dependent hearing discomfort in first-episode psychosis and panic disorder: two experiments using the same auditory stimulus set and two similar musical sequences.

We investigated the level of hearing tolerance in patients with first-episode psychosis (FEP) and panic disorder (PD) as compared to two different groups of healthy controls (HC, HC2), one for each experiment, because we used two distinct psychophysical paradigms. We evaluated auditory discomfort of 28 volunteers (14 with FEP and 14 HC) in the first study and of 42 volunteers (21 with PD and 21 HC2) in the second study. We presented 20 sounds: 16 pure-tone frequency sweeps (specially designed for use with FEP) and 11 s or 13 s musical sequences from the very beginning of the music "Play the Game" (PLAY) from Queen and its reverses. The first procedure used a Likert-like 0-10 scale ranging from "nothing bad" to "too bad" where volunteers made vertical marks along a horizontal line according to their discomfort. The second procedure involved subjective magnitude estimation online due to the SARS-COV-19 pandemic. Sounds were placed online and played by PD and HC2 volunteers themselves after having listened to the standard (the first 8 s from RADIO, "Radio Ga Ga" by Queen). Then, PD and HC2 volunteers were asked to assign values equal to, or multiples of 10 that felt like, or proportional to, their hearing "discomfort" in comparison with Sound 00 (RADIO). Our findings showed that FEP volunteers assign more discomfort to the 16 specially designed frequency sweep stimuli that appear not to affect HC, HC2, and PD. On the other hand, musical sequences from PLAY caused strong discomfort to PD in the reverse mode, but did not seem to affect HC, HC2, and FEP. Further experiments using the exact same paradigm with FEP and PD are needed to explore these findings.

Pandemia e tecnossocialidade modificam o quotidiano de profissionais de saúde / Pandemic and techno-sociality modify the daily life of healthcare professionals / La pandemia y la tecnosocialidad modifican el cotidiano de los profesionales de la salud

Objetivo: compreender a tecnossocialidade no quotidiano de profissionais de saúde da Atenção Primária à Saúde e de unidades de referência na pandemia de COVID-19. Método: estudo integrado-qualitativo, por meio de casos múltiplos, fundamentado na Sociologia Compreensiva do Quotidiano, realizado com 47 profissionais da saúde. Resultados: com a pandemia, muitas ações em saúde foram interrompidas ou readaptadas para o formato online, mediante o uso da tecnossocialidade para realizar grupos com usuários, reuniões com a gestão, capacitações profissionais, busca de informações em saúde e comunicação com a família e amigos. Apesar de as tecnologias em saúde e redes sociais virtuais serem passíveis ao cuidado à saúde e muito utilizadas em tempos de COVID-19, revelam-se incapazes de substituir o contato presencial. Conclusões: as redes sociais virtuais e tecnologias fortalecidas, ao longo da pandemia, pela efetividade de sua utilização para garantia do distanciamento social, possibilitam atenção segura facilitando o cotidiano de trabalho dos profissionais, dos usuários e a organização das ações nos serviços de saúde.

Objective: to understand techno-sociality in the daily lives of personnel in primary health care and referral units during the COVID-19 pandemic. Materials and methods: this integrated, qualitative, multiple-case study of 47 health professionals was based on the Comprehensive Sociology of Everyday Life. Results: with the pandemic, many health actions were interrupted or adapted to the online format by using techno-sociality to conduct user groups, management meetings, training, health information searches, and communication with relatives and friends. Although health technologies and virtual social networks can be deployed in health care and have been widely used in the COVID-19 pandemic, they have proven unable to replace face-to-face contact. Conclusion: virtual social networks and technologies were strengthened during the pandemic, given their effectiveness in ensuring social distance, allowing safe care, facilitating the day-to-day work of health personnel and users, and the organization of actions in health services.

Objetivo: comprender la tecnosocialidad en el cotidiano de los profesionales de la salud en la Atención Primaria de Salud y en las unidades de referencia en la pandemia de la COVID-19. Método: estudio integrado-cualitativo, por medio de casos múltiples, basado en la Sociología de la Vida Cotidiana, realizado junto a 47 profesionales de la salud. Resultados: con la pandemia, muchas acciones de salud fueron interrumpidas o readaptadas al formato 'remoto', mediante el uso de la tecnosocialidad para formar grupos con usuarios, reuniones con directivos, brindar formación profesional, buscar de información en salud y comunicarse con familiares y amigos. Si bien las tecnologías en la salud y las redes sociales virtuales son pasibles a la atención médica y ampliamente utilizadas en tiempos de COVID-19, se muestran incapaces de remplazar el contacto presencial. Conclusion: las redes sociales virtuales y tecnologías fortalecidas a lo largo la pandemia, por la efectividad de su utilización para garantizar el distanciamiento social, permiten una atención segura, facilitando el trabajo de los profesionales, los usuarios y la organización de las acciones en los servicios de salud.

Accuracy of Tools to Differentiate Single From Recurrent Fallers Pre-Frail Older Women.

Objectives: The objectives of this study were to analyze and compare musculoskeletal and functional performance and present cutoff points to differentiate pre-frail community-dwelling older women regarding their fall history: non fallers (0 falls), fallers (single fall), and recurrent fallers (≥2 falls). Method: This is a cross-sectional, retrospective study on 90 pre-frail community-dwelling older women (71.2 ± 4.49 years) according to Fried criteria. We assessed peak torque (PT) (isokinetic dynamometer), muscle architecture/mass (ultrasound/dual-energy X-ray absorptometry), and the following functional performance: usual gait speed (UGS), fast gait speed (FGS), walking speed reserve (WSR), cadence and step length, and timed up and go. Results: The recurrent fallers presented lower UGS (1.12 ± 0.18 vs. 1.29 ± 0.28 m/s; p = 0.05) and isometric PT of knee extensors than the fallers (89.88 ± 20.99 vs. 115.55 ± 23.09 Nm; p = 0.01), and lower FGS than the fallers (1.35 ± 0.26 vs. 1.5 ± 0.29 m/s; p = 0.03) and non-fallers (1.35 ± 0.26 vs. 1.52 ± 0.26 m/s; p = 0.01). The outcomes that differentiated the fallers from the non-fallers were both WSR calculated as a difference (WSRdiff) (≤0.26 m/s) and WSR calculated as a ratio (WSRratio) (≤1.25 m/s), while to differentiate the recurrent fallers from the non-fallers were FGS (≤1.44 m/s) and step length (≤73 cm). The following cutoff points might be used to differentiate recurrent fallers and fallers: UGS (≤1.12 m/s), FGS (≤1.34m/s), step length (≤73 cm), PT knee extension (≤114.2 Nm), PT knee flexion (≤46.3 Nm), and PT ankle dorsiflexion (≤22.1 Nm). Conclusion: Recurrent fallers community-dwelling pre-frail older women presented a worse musculoskeletal and functional performance when compared to the non-fallers and fallers. Gait speed, step length, PT of both knee extension and flexion, and ankle dorsiflexion can be used to identify both single and recurrent fallers pre-frail older women, contributing to guide interventions and prevent falls and fractures.