Ethnobotanical knowledge on non-conventional food plants and medicinal plants in Extractivist Reserve in the Brazilian Amazon / Conocimiento etnobotánico sobre plantas alimenticias no convencionales y plantas medicinales en una Reserva Extractivista en la Amazonía Brasileña

Information on the knowledge and ways of using food and medicinal plants by traditional populations, family farmers and Brazilian native population in the Amazon is essential to guarantee the food sovereignty of these groups. This study was conducted using semi-structured interviews applied to local respondents. A total of 269 species of both non-conventional food plants and medicinal plants were identified, distributed in 83 botanical families and 198 genera. The Arecaceae and Lamiaceae families had the highest species richness (11 and 7, respectively). The Shannon-Wiener (H') and Pielou (J') diversity indices were considered high (5.02 and 0.9, respectively) when compared to other ethnobotanical works. In the environment in which these families are found, these species become the only food and medicinal resources available.

La información sobre los saberes y formas de uso de las plantas alimenticias y medicinales por parte de las poblaciones tradicionales, agricultores familiares e indígenas brasileños en la Amazonía es fundamental para garantizar la soberanía alimentaria de estos grupos. Este estudio se realizó utilizando entrevistas semiestructuradas aplicadas a encuestados locales. Se identificaron un total de 269 especies tanto de plantas alimenticiasno convencionales como de plantas medicinales, distribuidas en 83 familias botánicas y 198 géneros. Las familias Arecaceae y Lamiaceae tuvieron la mayor riqueza de especies (11 y 7, respectivamente). Los índices de diversidad de Shannon-Wiener (H') y Pielou (J') fueron considerados altos (5,02 y 0,9, respectivamente) en comparación con otros trabajos etnobotánicos. En el ambiente en que se encuentran estas familias, estas especies se convierten en los únicos recursos alimenticios y medicinales disponibles.

"Nenhuma Pessoa Idosa Merece Passar por Isso": Compreensão da Violência para Mulheres Gerontes / "Ninguna Persona Adulta Mayor Merece Pasar Por Esto": Comprensión de la Violencia para las Mujeres Adultas Mayores / "No Elderly Person Deserves to Go Through This": Understanding Violence Towards Elderly Women

Resumo Introdução: A violência contra idosos é um fenômeno crescente, ocasionando prejuízos à saúde, com diferentes desfechos e consequências às vítimas. A chance de idosas sofrerem-na no âmbito familiar supera a dos homens, sendo o gênero um fator de risco considerável. Objetivo: Analisar a compreensão da violência contra pessoas idosas segundo mulheres gerontes. Metodologia: Pesquisa descritiva com abordagem qualitativa desenvolvida com 22 idosas de uma comunidade no estado da Paraíba, Brasil, escolhidas por conveniência. Utilizou-se para coleta de dados entrevistas semiestruturadas, processadas pelo software Iramuteq, com posterior Análise de Conteúdo. Resultados: Foram evidenciadas cinco classes: ciclo de violência; rede de apoio ao idoso vítima de violência; Vivência de situações violentas; violência financeira; e simbologia da violência na sociedade, as quais denotam compreensão da violência envolvendo os diferentes tipos. Apoiam-se nos fatores da vivência familiar, cultura e outros, consubstanciando o profissional de saúde como fundamental para o desfecho. O gênero influenciou no que concerne ao olhar lançado sobre a violência física e psicológica, bem como na relevância dada às equipes de saúde para identificação de ocorrências e prevenção de possíveis danos. Conclusão: Os diversos tipos de violência contra a pessoa idosa foram reconhecidos, incluindo fatores individuais, comunitários e sociais no ciclo violento. Além disso, associaram o envelhecimento a maior suscetibilidade para sofrer violência, independente da tipologia. Destaca-se a potencialidade do serviço de saúde na assistência à pessoa idosa vítima de violência, elucidando casos e atuando precocemente para interrupção dos ciclos perpetrados, exigindo a necessidade constante de atualização profissional para lidar com situações detectadas.

Resumen Introducción: La violencia contra las personas adultas mayores es un fenómeno creciente, que causa daños a la salud, con diferentes desenlaces y consecuencias para las víctimas. La posibilidad de que las mujeres adultas mayores la sufran en el ámbito familiar supera la de los hombres, siendo el género un factor de riesgo considerable. Objetivo: Analizar la comprensión de la violencia contra las personas mayores según las mujeres adultas mayores. Metodología: Investigación descriptiva con enfoque cualitativo desarrollada con 22 mujeres adultas mayores de una comunidad en el estado de Paraíba, Brasil, elegidas por conveniencia. Para la recolección de datos, se utilizaron entrevistas semiestructuradas, procesadas por el software Iramuteq, con posterior análisis de contenido. Resultados: Se evidenciaron cinco tipos de violencia: ciclo de la violencia, red de apoyo población adulta mayor víctima de violencia, experimentar situaciones violentas, violencia financiera y simbología de la violencia en la sociedad, que denotan la comprensión de la violencia de diferentes tipos. Estas ideas están respaldadas en los factores de la experiencia familiar, la cultura y otros, donde la persona profesional de la salud se identifica como fundamental para el cuidado y apoyo. El género influyó en la mirada lanzada sobre la violencia física y psicológica, así como en la relevancia dada a los equipos de salud para la identificación de sucesos y la prevención de posibles daños. Conclusión: Se han reconocido los diversos tipos de violencia contra las personas mayores, incluidos los factores individuales, comunitarios y sociales en el ciclo de violencia. Además, asociaron el envejecimiento con una mayor susceptibilidad a sufrir violencia, independientemente de la tipología. Destaca la potencialidad del servicio de salud en la asistencia a la persona mayor víctima de violencia, mediante la identificación de casos y la actuación temprana para la interrupción de los ciclos perpetrados. De manera que, se evidencia la necesidad constante de actualización profesional para hacer frente a situaciones detectadas.

Abstract Introduction: Violence against the elderly is a growing phenomenon, causing damage to health, with different outcomes and consequences to the victims. The possibility of elderly women suffering it in the family context surpasses that of men, with gender being a considerable risk factor. Objective: To analyze the understanding of violence against the elderly according to elderly women. Method: Descriptive research with a qualitative approach developed with 22 elderly women from a community in the state of Paraíba, Brazil, chosen for convenience. The data collection was based on semi-structured interviews, processed by the Iramuteq software, with subsequent Content Analysis. Results: Five classes of violence against the elderly were evidenced: cycle of violence; support network for the elderly victims of violence; experience of violent situations; financial violence; and symbolism of violence in society, which denote an understanding of violence involving the different types. They are based on the factors of family experience, culture, and others, placing the health professional as a fundamental element for care and support. Gender influenced the perspective on physical and psychological violence, as well as the relevance given to health teams for the identification of occurrences and the prevention of possible damage. Conclusion: The various types of violence against the elderly have been recognized, including individual, community, and social factors in the violent cycle. In addition, they associated aging with greater susceptibility to suffering violence, regardless of the typology. It highlights the potential of the health service in assisting the elderly victim of violence, elucidating cases, and acting early to interrupt the cycles perpetrated, requiring the constant need for professional updating to deal with detected situations.

Relação enfermeiro-pessoa afetada pela Tuberculose fundamentada na teoria do alcance de metas de imogene king / La relación enfermería-Persona afectada por la Tuberculosis, según la Teoría del logro de objetivos de imogene king / The nurse-tuberculosis patient relationship according to Imogene King's theory of goal achievement

Resumo Introdução: As ações desenvolvidas na Atenção Primária à Saúde são um dos pontos fortes de combate à tuberculose. Nesse nível de atenção, o contato contínuo do enfermeiro por meio da consulta de enfermagem permite manter relação com a população adoecida. Diante da relação enfermeiro-pessoa cuidada para o estabelecimento do vínculo e adesão ao tratamento contra tuberculose, compreende-se a importância do referencial teórico de Imogene King para estruturar a interação enfermeiro-pessoa cuidada e oferecer uma dinâmica para esse processo. Objetivo: Analisar a relação enfermeiro-pessoa afetada pela tuberculose fundamentada na Teoria do Alcance de Metas de Imogene King. Método: Estudo descritivo com abordagem qualitativa, com 14 enfermeiros da APS, selecionadas por conveniência. A coleta de dados ocorreu de agosto a novembro de 2018, por meio de entrevista semiestruturada, elaborada com base no Registro Meta-Orientado de Enfermagem de Imogene King. Os dados foram analisados de forme qualitativa pelo Software IRAMUTEQ. A pesquisa foi aprovada pelo Comitê de Ética. Resultados: Após a análise, emergiram quatro classes: 1) relação estabelecida com base no acolhimento; 2) relação enfermeiro-pessoa com tuberculose e o apoio de outros profissionais e familiares; 3) relação estabelecida com vistas ao cumprimento do tratamento; e 4) relação estabelecida para enfrentamento do preconceito diante da tuberculose. Conclusão: O acolhimento, a família e o vínculo entre profissional, paciente e equipe da Atenção Primária à Saúde fortalecem o enfrentamento da doença e reforçam a adesão ao tratamento medicamentoso.

Resumen Introducción: Uno de los puntos fuertes de la lucha contra la tuberculosis son las acciones desarrolladas en la atención primaria de salud. En este nivel asistencial, el contacto continuo de las enfermerías a través de la consulta de enfermería permite mantener una relación con la población enferma. Frente a la relación enfermería-persona para el establecimiento del vínculo y la adherencia al tratamiento contra la tuberculosis, se entiende la importancia del referente teórico de Imogene King para estructurar la interacción enfermería-persona y ofrecer una dinámica para este proceso. Objetivo: Análisis de la relación entre el personal de enfermería y las personas afectadas por la tuberculosis, a partir de la teoría del logro de objetivos de Imogene King. Método: Estudio descriptivo con abordaje cualitativo, con 14 enfermeras de atención primaria de salud, seleccionadas por conveniencia. La recolección de datos ocurrió de agosto a noviembre de 2018, a través de una entrevista semiestructurada, elaborada con base en el registro meta-orientado de enfermería de Imogene King. Los datos fueron analizados cualitativamente utilizando el software IRAMUTEQ. La investigación fue aprobada por el Comité de Ética. Resultados: Después del análisis, surgieron cuatro clases: 1) relación establecida con base en la recepción, 2) relación enfermería-persona con tuberculosis y apoyo de otras personas profesionales y familiares, 3) relación establecida con miras al cumplimiento del tratamiento y 4) relación establecida para combatir los prejuicios contra la tuberculosis. Conclusión: La acogida, la familia y el vínculo entre profesional, paciente y equipo de atención primaria de salud fortalecen el afrontamiento de la enfermedad y refuerzan la adherencia al tratamiento farmacológico.

Abstract Introduction: One of the main aspects in the fight against tuberculosis are the actions developed in Primary Health Care (PHC). At this level of care, the nurse's continuous contact through the nursing consultation allows them to maintain a relationship with the sick population. Regarding the nurse-patient relationship for establishing a bond and the compliance with tuberculosis treatment, we understand the importance of Imogene King's theoretical framework for structuring the nurse-patient interaction and offering a dynamic for this process. Objective: To analyze the nurse-tuberculosis patient relationship based on Imogene King's Theory of Goal Achievement. Method: A descriptive study with a qualitative approach, with 14 PHC nurses, selected by convenience. Data were collected from August to November 2018 through semi-structured interviews based on Imogene King's Meta-Oriented Nursing Record. The data were analyzed qualitatively using the IRAMUTEQ software. The research was approved by the Ethics Committee. Results: After the analysis, four classes emerged: 1) relationship established on the basis of welcoming; 2) nurse-tuberculosis patient relationship and the support of other professionals and family members; 3) relationship established towards treatment compliance; and 4) relationship established to confront prejudice associated with tuberculosis. Conclusion: The welcoming, the family, and the bond between the professional, the patient and Primary Health Care team strengthen the coping with the disease and reinforce the compliance with the pharmacological treatment.

Influencia da Qualidade do Sono na Qualidade de Vida no Trabalho de Policais Militares / Influencia de la Calidad del Sueño en la Calidad de Vida en el Trabajo de la Policía Militar / Influence of Sleep Quality on the Quality of Life and Work of Military Police Officers

Resumo Introdução: A profissão policial é considerada de alto risco e exige um vigor físico e mental do trabalhador diante do serviço realizado. De tal modo que uma boa qualidade do sono é importante, pois impacta diretamente em diversos aspectos na saúde desses trabalhadores. Ademais, a falta de uma boa qualidade do sono devido ao trabalho pode influenciar negativamente a qualidade de vida no trabalho. Objetivo: Analisar a influência da qualidade do sono na qualidade de vida no trabalho de policiais militares. Metodologia: Estudo quantitativo, correlacionalde corte transversal, realizado no primeiro semestre de 2019, com policiais de três municípios da Bahia, Brasil. Foram utilizados três instrumentos: sociodemográfico e características laborais; qualidade de vida de vida no trabalho; e qualidade do sono. Foi aplicado o teste do qui quadrado para as variáveis sociodemograficas e ocupacionais. Posteriormente, foi aplicado o teste de correlação de Spearman entre a qualidade do sono com as dimensões da qualidade de vida no trabalho. Resultados: Evidenciou-se entre os 298 policiais que a mediana da idade foi de 40 anos e tempo de serviço ≤ 7 anos, observou-se também que os policiais com pior qualidade do sono apresentaram qualidade de vida no trabalho insatisfatória em todas as dimensões (biológica/fisiológica; psicológica/comportamental; sociológica/relacional; econômica/política, ambiental/organizacional). Conclusão: Os policiais sofrem com a qualidade do sono e consequentemente influencia negativamente a qualidade de vida no trabalho. Assim, há uma necessidade de desenvolver ações no ambiente de trabalho que possam diminuir os afastamentos decorrentes dos problemas de saúde ocasionados pela qualidade do sono.

Resumen Introdución: La formación policial se considera de alto riesgo y requiere vigor físico y mental por parte de la persona trabajadora antes de realizar el servicio. Para esto, la buena calidad de sueño es importante, ya que impacta directamente en la salud de la población trabajadora en varios aspectos. Además, la falta de una buena calidad de sueño debido al trabajo puede influir negativamente en la calidad de vida fuera del trabajo. Objetivo: Analizar la influencia de la calidad del sueño en la calidad de vida en el trabajo de policías militares. Metodología: Estudio cuantitativo, correlacional transversal, realizado en el primer semestre de 2019, con policías de tres municipios de Bahía, Brasil. Se utilizaron tres instrumentos: características sociodemográficas y laborales, calidad de vida en el trabajo y calidad de sueño. Se aplicó la prueba chi cuadrado para las variables sociodemográficas y ocupacionales. Posteriormente, se aplicó la prueba de correlación de Spearman entre la calidad del sueño y las dimensiones de calidad de vida en el trabajo. Resultados: La muestra fue de 298 policías, la mediana de edad fue de 40 años y la antigüedad en el servicio fue ≤ 7 años. También, se observó quienes tuvieron peor calidad de sueño, también tuvieron una calidad de vida en el trabajo insatisfactoria en todos sus dimensiones (biológica/fisiológica; psicológica/conductual; sociológica/relacional; económica/política, ambiental/organizacional). Conclusión: Quienes son agentes de policía sufren de mala calidad de sueño y, en consecuencia, se influye negativamente su calidad de vida en el trabajo. Por lo tanto, existe la necesidad de desarrollar acciones en el lugar de trabajo que pueda reducir los riesgos de problemas de salud causados por la calidad del sueño.

Abstract Background: Police training is considered high risk and demands physical and mental vigor from the worker before preforming the service. Therefore, sleep quality is important as it directly impacts the health of these workers in several aspects. Furthermore, the lack of sleep quality due to work can negatively influence the quality of life outside of work. Aim: To analyze the influence of sleep quality on the quality of life and work of military police officers. Methods: A quantitative, cross-sectional correlational study, conducted in the first half of 2019 with police officers from three municipalities in Bahia, Brazil. Three instruments were used: sociodemographic and work characteristics; quality of life at work; and sleep quality. The chi-square test was applied for sociodemographic and occupational variations. Subsequently, the Spearman correlation test was applied between sleep quality and the quality of life and work dimensions. Results: Among the 298 police officers the median age was 40 years and the length of service was ≤ 7 years. It was also observed that police officers with poorer sleep quality had an unsatisfactory quality of life at work in all its dimensions (biological/physiological; psychological/behavioral; sociological/relational; economic/political, environmental/organizational). Conclusion: Police officers suffer from poor sleep quality and this negatively influence their quality of life and work. Therefore, there is a need to develop actions in the workplace that may reduce the risks of health problems caused by poor sleep quality.

Cultura de segurança em unidades de terapia intensiva na perspectiva da equipe multiprofissional: Estudo multicêntrico / Cultura de seguridad en unidades de terapia intensiva en la perspectiva del equipo multiprofesional: Estudio multicéntrico / Safety Culture in intensive care units from multiprofessional team perspective: A multicenter study

Resumo Introdução: A Cultura de Segurança do Paciente é considerada um importante componente estrutural dos serviços, que favorece a implantação de práticas seguras e a diminuição da ocorrência de eventos adversos. Objetivo: Identificar os fatores associados à cultura de segurança do paciente nas unidades de terapia intensiva adulto em hospitais de grande porte da região Sudeste do Brasil. Método: Estudo transversal do tipo survey e multicêntrico. Participaram 168 profissionais de saúde de quatro unidades (A, B, C e D) de terapia intensiva adulto. Foi utilizado o questionário "Hospital Survey on Patient Safety Culture". Considerou-se como variável dependente o nível de cultura de segurança do paciente e variáveis independentes aspectos sociodemográficos e laborais. Foram usadas estatísticas descritivas e para a análise dos fatores associados foi elaborado um modelo de regressão logística múltipla. Resultados: Identificou-se associação entre tipo de hospital com onze dimensões da cultura de segurança, quanto à função a categoria profissional médico, técnico de enfermagem e enfermeiro foram relacionadas com três dimensões; o gênero com duas dimensões e tempo de atuação no setor com uma dimensão. Conclusão: Evidenciou-se que o tipo de hospital, categoria profissional, tempo de atuação no setor e gênero foram associados às dimensões de cultura de segurança do paciente.

Resumen Introducción: La cultura de seguridad del paciente se considera un componente estructural importante de los servicios, que favorece la aplicación de prácticas seguras y la reducción de la aparición de acontecimientos adversos. Objetivo: Identificar los factores asociados a la cultura de seguridad del paciente en unidades de terapia intensiva adulto en hospitales de la región Sudeste del Brasil. Metodología: Estudio transversal de tipo encuesta y multicéntrico. Participaron 168 profesionales de salud de cuatro unidades (A, B, C y D) de terapia intensiva adulto. Se utilizó el cuestionario "Hospital Survey on Patient Safety Culture". Se consideró como variable dependiente el nivel de cultura de seguridad del paciente y variables independientes los aspectos sociodemográficos y laborales. Fueron usadas estadísticas descriptivas y, para analizar los factores asociados, fue elaborado un modelo de regresión logística múltiple. Resultados: Se identificó asociación entre tipo de hospital con once dimensiones de cultura de seguridad del paciente. En relación a la función, personal médico, técnicos de enfermería y personal de enfermería fueron asociados con tres dimensiones, el género con dos dimensiones y tiempo de actuación con una dimensión en el modelo de regresión. Conclusión: Se evidenció que el tipo de hospital, función, tiempo de actuación en el sector y género fueron asociados a las dimensiones de la cultura de seguridad del paciente.

Abstract Introduction: Patient safety culture is considered an important structural component of the services, which promotes the implementation of safe practices and the reduction of adverse events. Objective: To identify the factors associated with patient safety culture in adult intensive care units in large hospitals in Belo Horizonte. Method: Cross-sectional survey and multicenter study. A total of 168 health professionals from four units (A, B, C and D) of adult intensive care participated. The questionnaire "Hospital Survey on Patient Safety Culture" was used. The patient's level of safety culture was considered as a dependent variable, and sociodemographic and labor aspects were the independent variables. Descriptive statistics were used and a multiple logistic regression model was developed to analyze the associated factors. Results: An association was identified between the type of hospital and eleven dimensions of the safety culture. In terms of function, the doctors, nursing technicians, and nurse were related to three dimensions; gender with two dimensions, and time working in the sector with one dimension. Conclusion: It was evidenced that the type of hospital, function, time working in the sector, and gender were associated with the dimensions of patient safety culture.

Contaminação ambiental de uma agroindústria familiar de queijo colonial no sudoeste paranaense / Environmental contamination of a family colonial cheese agroindustry in the southwest of Parana

As falhas na higienização em um estabelecimento de alimentos podem refletir em problemas causando a contaminação ou deterioração do produto produzido. Esta pesquisa foi motivada por reclamações de consumidores informando que os queijos apresentaram fungos, mesmo estando dentro do prazo de validade e por solicitação do Serviço de Inspeção Municipal. O objetivo desta pesquisa foi avaliar a contaminação ambiental em uma agroindústria da agricultura familiar produtora de queijo colonial no Sudoeste Paranaense. Foram realizadas a contagem para aeróbios mesófilos em equipamentos e superfícies que entram em contato com o alimento e análise microbiológica ambiental de bolores e leveduras na sala de secagem dos queijos. A coleta foi realizada com método de esfregaço de suabe estéril para aeróbios mesófilos e semeadas em placas de Petri com Ágar Padrão de Contagem. Para a coleta ambiental foram expostas placas de Petri com ágar Saboraund durante 15 minutos. Os resultados demonstraram ausência de contaminação nas superfícies, mas foram encontrados bolores e leveduras de forma acentuada na sala de secagem dos queijos, o que pode contribuir para a deterioração do produto, diminuindo sua validade. Para minimizar as perdas por contaminação é necessário que o processo de higienização dos ambientes seja realizado de forma eficiente.

Failures in hygiene in a food establishment can result in problems causing contamination or deterioration of the product produced. This research was motivated by complaints from consumers reporting that the cheeses had mold, even though they were within their expiration date and at the request of the Municipal Inspection Service. This research was to evaluate environmental contamination in an agroindustry in the family farm producing colonial cheese in Southwest Paraná. For the microbiological assessment of environmental contamination, counting for mesophilic aerobes was carried out on equipment and surfaces that come into contact with food and, environmental microbiological analysis of molds and yeast in the cheese drying room. The collection was carried out using the sterile swab smear for mesophilic aerobes and seeded in Petri dishes with Counting Standard Agar. For environmental collection, sheets of Petri with Saboraund agar for 15 minutes. The results demonstrated absence of contamination on surfaces. But the presence of molds and yeasts in the drying room cheeses, which can contribute to the deterioration of the product and thus reduce the validity. To minimize losses due to contamination, it is It is necessary that the process of cleaning and disinfecting environments is carried out efficiently.

Higienização de ambiente em agroindústria familiar de embutidos cárneos / Environmental hygienization in family meat product

A higienização é um procedimento importante na indústria de alimentos e sua realização deve ocorrer rotineiramente para evitar que os alimentos sejam contaminados. Além disso, todos os manipuladores de alimentos devem receber treinamentos de modo a entender como ocorrem as contaminações e como evitá-las, para que não ocorra deterioração antecipada dos alimentos e para que não exponham os consumidores ao risco de doenças transmitidas por alimentos em caso de contaminação. Esta pesquisa avaliou o processo de higienização e sua eficiência em superfícies presentes em uma agroindústria da agricultura familiar produtora de embutidos cárneos. Apesar de ter instalações adequadas a agroindústria apresentava inadequações quanto aos produtos utilizados e a frequência inadequada para uma higienização eficiente. Foi realizada análise microbiológica das superfícies dos equipamentos para contagem de aeróbios mesófilos e notou-se uma elevada carga microbiana que indicou uma baixa eficiência no processo de higienização. Sugeriu-se melhorias na higiene ambiental associado à instrução dos colaboradores, para contribuir na promoção da qualidade dos produtos, aumento dos lucros e salvaguardando a saúde do consumidor.

Hygiene is an important procedure in the food industry, and its performance must occur routinely to prevent food from being contaminated. In addition, all food handlers must receive training in order to understand how contamination occurs and how to avoid it, so that there is no anticipated deterioration of food and that consumers are not exposed to the risk of foodborne diseases. in case of contamination by pathogenic microorganisms. Thus, this research evaluated the cleaning process and its efficiency on surfaces present in a family farming agroindustry that produces meat products, which despite having adequate facilities, had some difficulties such as product use and inadequate frequency for eficiente cleaning. After performing a microbiological analysis to count surface mesophilic aerobes, a high level of contamination was noted, relating to low efficiency in the cleaning process. Improvements in environmental hygiene are suggested, associated with the instruction of employees for the implementation of the Standard Operating Hygiene Procedure, promoting improvements in product quality, increasing profits and safeguarding consumer health.

Avaliação das boas práticas de fabricação e da contaminação de preparações cárneas de restaurantes institucionais e comerciais na cidade de Americana, SP / Evaluation of good manufacturing practices and contamination in meat preparations from institutional and commercial restaurants in the city of Americana/SP

Diante do ritmo acelerado da vida contemporânea, observa-se um aumento na tendência dos indivíduos em optar por realizar suas refeições fora de casa. A carne, reconhecida como um componente essencial na alimentação dos brasileiros, está suscetível à contaminação pois apresenta ambiente favorável à proliferação de microrganismos patogênicos. Fazendo-se necessária uma análise de contaminação pós-produção afim de evitar Doenças Transmitidas por Alimentos. No presente estudo objetivouse avaliar as boas práticas de fabricação e contaminação de preparações de carne bovina assada, de restaurantes particulares e institucionalizados no município de Americana-SP. Amostras de carne prontas para o consumo foram obtidas de seis estabelecimentos comerciais e seis institucionais. Durante a coleta, foram verificadas as temperaturas e realizadas análises de conformidades com a RDC n° 275, de 2002. As amostras foram examinadas para detectar a presença ou ausência de E. coli e coliformes termotolerantes a 45° C. Para a análise foi realizada a técnica de tubos múltiplos para quantificar a totalidade dos coliformes. Observou-se que, conforme estipulado pela Resolução n°43 de 2015, nenhuma das amostras oriundas de restaurantes comerciais, e a maioria das provenientes de restaurantes institucionais, atingiram as temperaturas requeridas. No que concerne à identificação de E. coli através de testes microbiológicos, foi constatado que seis amostras de restaurantes comerciais e quatro de restaurantes institucionais testaram positivo para a presença deste microrganismo. Conclui-se que as amostras de restaurantes comerciais apresentaram níveis de contaminação superiores em comparação com as amostras de restaurantes institucionais.

Given the fast-paced rhythm of contemporary life, there is an increase in individuals choosing to have their meals outside the home. Meat, recognized as an essential component in the Brazilian diet, is susceptible to contamination as it provides a favorable environment for the proliferation of pathogenic microorganisms. It is necessary to conduct post-production contamination analysis to prevent Foodborne Diseases. This study aimed to evaluate the good manufacturing practices and contamination of roasted beef preparations from private and institutional restaurants in the city of Americana-SP. Samples of ready-to-eat meat were obtained from six commercial establishments and six institutional ones. During collection, temperatures were checked, and conformity analyses were conducted according to RDC No. 275, 2002. The samples were examined for the presence or absence of E. coli and thermotolerant coliforms at 45°C using the multiple tube technique to quantify the total coliforms. It was observed that, as stipulated by Resolution No. 43, 2015, none of the samples from commercial restaurants and the majority from institutional restaurants reached the required temperatures. Regarding the identification of E. coli through microbiological tests, it was found that six samples from commercial restaurants and four from institutional ones tested positive for the presence of this microorganism. It is concluded that samples from commercial restaurants showed higher contamination levels compared to institutional restaurant samples.

Multiple Causes of Death Associated with Pediatric Cardiopulmonary Arrest from 1996 to 2019 in Brazil. / Causas Múltiplas de Morte Associadas à Parada Cardiorrespiratória Pediátrica de 1996 a 2019 no Brasil.

BACKGROUND: In pediatrics, cardiopulmonary arrest (CPA) is associated with high mortality and severe neurologic sequelae. Information on the causes and mechanisms of death below the age of 20 years could provide theoretical support for health improvement among children and adolescents. OBJECTIVES: To conduct a population analysis of mortality rates due to primary and multiple causes of death below the age of 20 years in both sexes from 1996 to 2019 in Brazil, and identify the frequency in which CPA was recorded in the death certificates (DCs) of these individuals and the locations where the deaths occurred, in order to promote strategies to improve the prevention of deaths. METHOD: Ecological time-series study of deaths below the age of 20 years from 1996 to 2019, evaluating the mortality rates (MRs) and proportional mortality (PM) by primary cause of death. We analyzed the percentages of CPA recorded in any line of the DC and the location where the deaths occurred. We calculated the MRs per 100,000 inhabitants and the PM by primary cause of death under the age of 20 years according to sex and age group, the percentages of death from primary causes by age group when CPA was described in any line of Parts I and II of the DC, and the percentage of deaths from primary causes according to their location of occurrence. We retrieved the data from DATASUS, IBGE, and SINASC. RESULTS: From 1996 to 2019, there were 2,151,716 deaths below the age of 20 years in Brazil, yielding a mortality rate of 134.38 per 100,000 inhabitants. The death rate was highest among male neonates. Of all deaths, 249,334 (11.6%) had CPA recorded in any line of the DC. Specifically, CPA was recorded in 49,178 DCs between the ages of 1 and 4 years and in 88,116 of those between the ages of 29 and 365 days, corresponding, respectively, to 26% and 22% of the deaths in these age groups. These two age groups had the highest rates of CPA recorded in any line of the DC. The main primary causes of death when CPA was recorded in the sequence of death were respiratory, hematologic, and neoplastic diseases. CONCLUSION: Perinatal and external causes were the primary causes of death, with highest MRs under the age of 20 years in Brazil from 1996 to 2019. When multiple causes of death were considered, the main primary causes associated with CPA were respiratory, hematologic, and neoplastic diseases. Most deaths occurred in the hospital environment. Better understanding of the sequence of events in these deaths and improvements in teaching strategies in pediatric cardiopulmonary resuscitation are needed.

FUNDAMENTO: Em pediatria, a parada cardiorrespiratória (PCR) está associada a alta mortalidade e graves sequelas neurológicas. Informações sobre as causas e mecanismos de morte abaixo de 20 anos poderiam fornecer subsídios teóricos para a melhoria da saúde de crianças e adolescentes. OBJETIVOS: Realizar uma análise populacional das taxas de mortalidade por causas primárias e múltiplas de morte abaixo de 20 anos, em ambos os sexos, no período de 1996 a 2019, no Brasil, e identificar a frequência com que a PCR foi registrada nas declarações de óbito (DOs) desses indivíduos e os locais de ocorrência dos óbitos, a fim de promover estratégias para melhorar a prevenção de mortes. MÉTODO: Estudo ecológico de séries temporais de óbitos em indivíduos menores de 20 anos, no período de 1996 a 2019, avaliando as taxas de mortalidade (TMs) e a mortalidade proporcional (MP) por causa básica de morte. Foram analisados os percentuais de PCR registrados em qualquer linha da DO e o local de ocorrência dos óbitos. Foram calculadas as TMs por 100 mil habitantes e a MP por causa básica de morte nos menores de 20 anos segundo sexo e faixa etária, os percentuais de óbito por causas básicas por faixa etária quando a PCR foi descrita em qualquer linha das Partes I e II da DO, e o percentual de óbitos por causas básicas segundo o local de ocorrência. Os dados foram retirados do DATASUS, IBGE e SINASC. RESULTADOS: De 1996 a 2019, ocorreram 2.151.716 óbitos de menores de 20 anos, no Brasil, gerando uma taxa de mortalidade de 134,38 por 100 mil habitantes. A taxa de óbito foi maior entre os recém-nascidos do sexo masculino. Do total de óbitos, 249.334 (11,6%) tiveram PCR registrada em qualquer linha da DO. Especificamente, a PCR foi registrada 49.178 vezes na DO na faixa etária entre 1 e 4 anos e em 88.116 vezes entre 29 e 365 dias, correspondendo, respectivamente, a 26% e 22% dos óbitos nessas faixas etárias. Essas duas faixas etárias apresentaram as maiores taxas de PCR registradas em qualquer linha da DO. As principais causas básicas de óbito quando a PCR foi registrada na sequência de óbitos foram doenças respiratórias, hematológicas e neoplásicas. CONCLUSÃO: As causas perinatais e externas foram as principais causas de morte, com maior TM nos menores de 20 anos no Brasil de 1996 a 2019. Quando consideradas as causas múltiplas de morte, as principais causas primárias associadas à PCR foram as doenças respiratórias, hematológicas e neoplásicas. A maioria dos óbitos ocorreu no ambiente hospitalar. Melhor compreensão da sequência de eventos nesses óbitos e melhorias nas estratégias de ensino em ressuscitação cardiopulmonar pediátrica são necessárias.

Analysis of signs and symptoms in confirmed cases of severe dengue among children aged 0 to 10 years old.

OBJECTIVE: The prevalent symptoms of severe dengue in pediatric patients are divided into three subgroups: severe plasma leakage, severe bleeding, and severe organ damage. In addition, the seasonal patterns of the disease and the outcomes of cure or death from dengue were evaluated. METHODS: An epidemiological, observational, analytical, cross-sectional study was conducted with data from the Notifiable Disease Information System (SINAN - Sistema de Informação de Agravos de Notificação and DATASUS - Departamento de Informática do Sistema Único de Saúde) of the Ministry of Health from 2019 to 2020. RESULTS: During the study period, 1,857 cases of severe dengue were observed in the pediatric age group, with the most common symptoms being respiratory failure, melena, hematemesis, and altered level of consciousness. The total proportion of patients hospitalized for severe dengue was 89.6%, and 51.2% of these patients died, corroborating the importance of early detection of the disease. CONCLUSION: Severe dengue is more prevalent during the seasonal period, with hot and humid characteristics owing to the mechanism involved in the viral cycle. The most prevalent symptoms of severe dengue in pediatric patients were respiratory failure alone, gastrointestinal bleeding, and altered level of consciousness. It is important to identify signs of severity for early intervention and a better prognosis, considering that death is closely related to a delayed diagnosis.

Impact of sustained virologic response on glucose parameters among patients with chronic hepatitis C treated with direct-acting antivirals.

Objective: The aim of this study was to evaluate the glycated hemoglobin (HbA1c) levels before and after sustained virologic response (SVR) and investigate the baseline characteristics associated with improved glycemic control in patients with chronic hepatitis C (CHC) achieving SVR after directacting antivirals (DAA) therapy. Materials and methods: Consecutive adult patients with CHC who achieved SVR after DAA treatment between January 2016 and December 2017 at Hospital de Clínicas de Porto Alegre (RS, Brazil) were prospectively included. Levels of HbA1c were measured up to 24 weeks before DAA therapy and 12 weeks after SVR. Exclusion criteria were decompensated cirrhosis, HIV and/or hepatitis B virus, liver disease of other etiologies, and/or modification of prediabetes/ type 2 diabetes mellitus (PDM/T2DM) management. The primary outcome was a comparison of HbA1c levels before and after SVR. Secondary outcomes were the baseline variables associated with improved glycemic control. Results: The study included 207 patients with a mean age of 60.6±10.7 years, of whom 51.7% were women, 56% had cirrhosis, 37.7% had HCV genotype 3, and 54.5% had baseline T2DM or PDM. The median HbA1c level reduced significantly after SVR (5.5%, interquartile range [IQR] 4.9%-6.3%) compared with baseline (5.7%, IQR 5.3%-6.7%; p = 0.01). The baseline characteristics associated with improved HbA1c after SVR were cirrhosis, genotype 3, and age ≤ 60 years. Conclusion: Among patients with CHC, SVR after DAA was associated with HbA1c reduction, particularly in those with cirrhosis, genotype 3, and age ≤ 60 years.

Epidemiological profile of neuroendocrine tumors in adults in Brazil.

Objective: Neuroendocrine tumors (NETs) are a set of diseases that originate from neuroendocrine cells, which comprises a diffuse endocrine system present in various organs of the body. These tumors are more frequent in the gastrointestinal tract (70%) and the bronchopulmonary system (20%-30%). A NET incidence rate of 1-5 per 100,000 inhabitants has been estimated for several European countries and the USA employing 20 years of data. However, no comprehensive studies on this rare neoplasm are available in Brazil. In this context, the aim of this study was to characterize the epidemiological NET profile in the country. Materials and methods: This is a retrospective descriptive observational study based on data from Hospital Cancer Records available at the Brazilian National Cancer Institute and the São Paulo Oncocentro Foundation. Demographic, clinical and treatmentrelated variables were analyzed from selected cases employing descriptive statistics. Results and Conclusion: A total of 15,859 cases were identified, most occurring in males (53.4%) and in individuals under 65 years old (63.3%). Small cell carcinoma was the most frequent histological type (46.7%). Bronchopulmonary tumors were the most frequent NETs, followed by pancreatic tumors, with cases mostly concentrated in high complexity centers in the Brazilian Southeast and treated mainly with surgery and chemotherapy, with over half of the patients diagnosed in advanced stages of the disease.

What is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians?

OBJECTIVE: To estimate the prevalence of multimorbidity in elderly people and its association with sociodemographic characteristics, lifestyle, and anthropometry. METHODS: This was a cross-sectional study using data from the National Health Survey, 2019. A total of 22,728 elderly individuals from all 27 Brazilian states were randomly selected. Poisson regression models with robust variance were employed, and a significance level of 5% was adopted. RESULTS: The prevalence of multimorbidity was 51.6% (95% CI: 50.4-52.7), with the highest estimates observed in the South and Southeast. Multimorbidity was associated with being female (aPR = 1.33; 95% CI: 1.27-1.39), being 80 years old or older (aPR = 1.12; 95% CI: 1.05-1.19), having low education (aPR = 1.16; 95% CI: 1.07-1.25), past cigarette use (aPR = 1.16; 95% CI: 1.11-1.21), insufficient physical activity (aPR = 1.13; 95% CI: 1.06-1.21), and screen use for 3 hours or more per day (aPR = 1.13; 95% CI: 1.08-1.18). CONCLUSION: Multimorbidity affects more than half of the elderly population in Brazil and is associated with social, demographic, and behavioral factors.

Josicélia Dumêt Fernandes' professional trajectory: contributions to psychiatric and mental health nursing.

OBJECTIVES: to analyze nurse Josicélia Dumêt Fernandes' life story, with emphasis on her work in the psychiatry and mental health fields. METHODS: historical, qualitative research. Semi-structured interviews and documentary research were used as data collection techniques, collected from September to October 2021. For data analysis, we opted for the content analysis method and comparison with the Foucauldian philosophical framework. RESULTS: four categories emerged: Transforming herself and mental health practices; (Re)framing professional practice; Nursing practice and power relations; and The paths and implications in the psychiatry and mental health fields. FINAL CONSIDERATIONS: the study of the biographer demonstrates a search for transformation of herself and mental health practices, with a rupture in paradigms and reframing of her practice in psychiatry and mental health.

Prevalence of anticipatory nausea and vomiting in breast cancer patients undergoing highly emetogenic chemotherapy.

OBJECTIVE: Anticipatory nausea and vomiting are unpleasant symptoms observed before undergoing chemotherapy sessions. Less is known about the occurrence of symptoms since the advent of the new neurokinin-1 antagonist. METHODS: This prospective cohort study was performed at a single Brazilian Institution. This study included breast cancer patients who received doxorubicin and cyclophosphamide chemotherapy and an appropriate antiemetic regimen (dexamethasone 10 mg, palonosetron 0.56 mg, and netupitant 300 mg in the D1 followed by dexamethasone 10 mg 12/12 h in D2 and D4). Patients used a diary to record nausea, vomiting, and use of rescue medication in the first two cycles of treatment. The prevalence of anticipatory nausea and vomiting was assessed before chemotherapy on day 1 of C2. RESULTS: From August 4, 2020, to August 12, 2021, 60 patients were screened, and 52 patients were enrolled. The mean age was 50.8 (28-69) years, most had stage III (53.8%), and most received chemotherapy with curative intent (94%). During the first cycle, the frequency of overall nausea and vomiting was 67.31%, and that of severe nausea and vomiting (defined as grade>4 on a 10-point visual scale or use of rescue medication) was 55.77%. Ten patients had anticipatory nausea and vomiting (19.23%). The occurrence of nausea and vomiting during C1 was the only statistically significant predictor of anticipatory nausea and vomiting (OR=16, 95%CI 2.4-670.9, p=0.0003). CONCLUSION: The prevalence of anticipatory nausea is still high in the era of neurokinin-1 antagonists, and failure of antiemetic control in C1 remains the main risk factor. All efforts should be made to control chemotherapy-induced nausea or nausea and vomiting on C1 to avoid anticipatory nausea.

Cancer patient satisfaction regarding the quality of information received: psychometric validity of EORTC QLQ-INFO25.

OBJECTIVES: to psychometrically validate the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire EORTC QLQ-INFO25 instrument and identify the domains that influence patients' perception of the information received. METHODS: a cross-sectional methodology with cancer patients in a Brazilian philanthropic hospital institution. Sociodemographic and clinical instruments, EORTC QLQ-C30, EORTC QLQ-INFO25 and Supportive Care Needs Survey - Short Form 34 were used. Analysis occurred using Cronbach's alpha coefficients, intraclass correlation, test-retest and exploratory factor analysis. RESULTS: 128 respondents participated. Cronbach's alpha coefficient was 0.85. The test-retest obtained p-value=0.21. In the factor analysis, one item was excluded. Satisfaction with the information received was 74%, with three areas with averages below 70%. In open-ended questions, there was a greater desire for information. CONCLUSIONS: validity evidence was obtained with instrument reliability, consistency and stability. Respondents expressed satisfaction with the information received.

Epidemiological analysis of congenital glaucoma: a national scenario.

INTRODUCTION: Congenital glaucoma is a disease that involves increased intraocular pressure and can result in irreversible visual deterioration. The study of epidemiology allows the delineation of the characteristics associated with patients and specific risk factors. OBJECTIVE: The objective of this study was to examine epidemiological trends, place of residence, duration of gestation, sex, and race of the newborn diagnosed with congenital glaucoma in Brazil. METHODS: Data from SINASC (National Live Birth System) were used to analyze the period from 2017 to 2021 in Brazil. Linear regression and analysis of variance tests were employed to assess significance. The statistical significance was determined by p<0.05. RESULTS: A total of 47 cases of congenital glaucoma were identified in Brazil during the study period, with the highest incidence between the years of 2018 and 2021. The analysis of the distribution indicated that the states with the highest incidence were São Paulo, followed by Rio Grande do Sul and Pernambuco. Approximately 60% of cases occurred in male individuals, compared with 19 female cases. The ethnic analysis showed the highest incidence among whites and mixed. Regarding the length of pregnancy, statistical differences were observed between newborns of different periods of gestation. Infants born from pregnancies lasting between 28 and 31 weeks and 32 and 36 weeks were significant when analyzed with the group between 37 and 41 weeks. CONCLUSION: Studies on the mechanisms of congenital glaucoma seek to improve knowledge about the disease. Epidemiological evaluation is essential for identifying demographic and clinical patterns of the disease.

Implementation and use of electronic patient records in the Brazilian Air Force: a cross-sectional study1.

OBJECTIVE: The objective was to analyze the implementation and use of the electronic patient record in the health services of the Brazilian Air Force. METHODS: This is a cross-sectional study carried out with 234 physicians, between March and May 2021. The data collection instrument was sent by email. The electronic patient record was implemented in the Air Force approximately 3 years ago (64.5%), and about 81% of the physicians received training to operate it. RESULTS: The most common records involve data related to consultations (90.1%) and interviews with physical examination (67.1%). Physicians cited that information storage (75.6%), agility, and feasibility of recording (55.1%) were the main advantages of the electronic patient record. As disadvantages, problems in electronic equipment (69.7%) and system errors (65%) were reported. Most participants considered that the implementation had a positive impact on work dynamics (75.6%) and productivity (66.7%), mainly regarding the components "Work processes" (57.3%) and "Amount of carried out activities" (21.4%). Keeping records was significantly associated with the job position (p<0.001), type of unit (p=0.008), time of implementation (p<0.001), and participation in training (p=0.028). CONCLUSION: The implementation of the electronic patient record in the Air Force was recently done, and just over half of the physicians were trained prior to the implementation. The tool is considered compatible with work processes and has a positive effect on productivity.

Epidemiological analysis of congenital syphilis in the State of Paraná, Brazil.

INTRODUCTION: Congenital syphilis is a complex public health issue caused by the transmission of Treponema pallidum. Brazil has high incidence rates, with a distinct transmission pattern surpassing other notifiable diseases. OBJECTIVE: The objective of this study was to examine epidemiological trends, incidence rate, mortality, geographical distribution, prenatal care, and diagnostic determination timing of congenital syphilis in Paraná State. METHODS: Data from Department of Informatics of the Single Health System were used to analyze the period from 2015 to 2021 in Paraná. Linear regression and t-tests were employed to assess significance. Statistical significance was determined by p<0.05. RESULTS: A total of 5,096 notifications of congenital syphilis were recorded in Paraná over the examined period. The metropolitan region is a notable clustering of cases, following Londrina, Maringá, and Foz do Iguaçu. The age group with the highest cases is found between 20 and 24 years (34.93%). Regarding maternal education, a higher occurrence was noticed in incomplete lower secondary education mothers (22.12%). Regarding ethnic background, 3,792 women were identified as white, which was the majority of this analysis (74.41%). Diagnosed maternal syphilis throughout the prenatal phase during 2015-2018 exhibited a noteworthy increase (p<0.05). Most women received prenatal care (p<0.05), even though a significant number received the diagnosis at the delivery or after it. The average infant mortality rate associated with congenital syphilis in Paraná was 0.03. CONCLUSION: Paraná State serves as a representative sample of this epidemiological situation, providing significant insights into the intricacies of congenital syphilis incidence. Further comparative investigations including diverse regions within Brazil are necessary.