Interaction Dynamics with Babies During Shared Reading Practices / Dinâmicas de Interação em Situações de Leitura Compartilhada com Bebês / Dinámicas de Interacción con Bebés durante Momentos de Lectura Compartida

Abstract This paper examines the triadic dynamics of baby-teacher-book during shared reading in an Early Childhood Education School to explain how educational teaching practices can enhance initial reading experiences and development processes in Early Childhood. A ten-months-old baby and a teacher participated in this study and, as an instrument for data collection, reading situations were registered and later these sessions were weighted through use of microgenetic analysis. From the analysis of the data present in the detailed case, it was identified the emergence of qualitative indicators that favoured the involvement of the baby in the activity, the mediation and educational actions of the teacher and the use of the book were more frequent. The effective use of the object book with that baby has contributed to qualitative changes in the baby's development and learning and emphasizes the incentive to share reading with other children.

Resumo Este estudo teve como objetivo examinar a dinâmica da tríade bebê-professora-livro durante a leitura compartilhada em uma Escola de Educação Infantil a fim de explicar como as práticas educativas de ensino potencializam experiências iniciais de leitura e processos de desenvolvimento na Primeira Infância. Uma bebê de dez meses e uma professora participaram desse estudo e como instrumento para coleta de dados foi utilizado a vídeogravação de momentos de leitura e posteriormente essas sessões foram ponderadas através da análise microgenética. A partir das análises dos dados presentes no caso detalhado, identificou-se a emergência de indicadores qualitativos que favoreceram o engajamento da bebê na atividade, sendo que a mediação e ações educativas da professora e do uso do livro foram mais frequentes. O uso efetivo do livro-objeto pode ter contribuído para mudanças qualitativas no desenvolvimento e aprendizagem da bebê e enfatiza a necessidade de incentivar o compartilhamento da leitura nessas idades.

Resumen Este artículo tuvo como objetivo examinar la dinámica de la tríada bebé-maestra-libro durante la lectura compartida en una Escuela de Educación Infantil con el fin de explicar cómo las prácticas docentes educativas pueden potenciar las experiencias iniciales de lectura y los procesos de desarrollo en la Primera Infancia. En este estudio participó una bebé de diez meses y una maestra y como instrumento de recolección de datos se utilizó la grabación en video de los momentos de lectura y posteriormente estas sesiones fueron ponderadas a través del análisis microgenético. A partir del análisis de los datos presentes en este caso, se identificó la emergencia de indicadores cualitativos que favorecen la participación de la bebé en la actividad, siendo más frecuentes la mediación y las acciones educativas de la docente, así como el uso del libro. El uso efectivo del libro objeto con la bebé ha contribuido a cambios cualitativos en el desarrollo y aprendizaje de los niños y enfatiza el incentivo de compartir la lectura con otros niños pequeños.

Oleic acid-containing semisolid dosage forms exhibit in vivo anti-inflammatory effect via glucocorticoid receptor in a UVB radiation-induced skin inflammation model.

The treatment of cutaneous inflammation with topical corticosteroids may cause adverse effects reinforcing the need for therapeutic alternatives to treat inflammatory skin disorders. We investigated the anti-inflammatory effect of oleic acid (OA), a fatty acid of the omega-9 (ω-9) family, and we point out it as an alternative to treat inflammatory skin disorders. OA was incorporated into Lanette®- or Pemulen® TR2-based semisolid preparations and the pH, spreadability, rheological behavior and in vivo anti-inflammatory performance in a UVB radiation-induced skin inflammation model in mice were assessed. The anti-inflammatory activity was verified after single or repeated treatment of the mouse ear following the UVB. The OA action on glucocorticoid receptors was investigated. Both semisolids presented pH values compatible with the deeper skin layers, appropriate spreadability factors, and non-Newtonian pseudoplastic rheological behavior. Pemulen® 3% OA inhibited ear edema with superior efficacy than Lanette® 3% OA and dexamethasone after a single treatment. Pemulen® 3% OA and dexamethasone also reduced inflammatory cell infiltration. After repeated treatments, all formulations decreased the ear edema at 24 h, 48 h and 72 h after UVB. OA in semisolids, especially Pemulen® TR2-based ones, presented suitable characteristics for cutaneous administration and its anti-inflammatory activity seems to occur via glucocorticoid receptors. OA was also capable to reduce croton oil-induced skin inflammation. Besides, the ex vivo skin permeation study indicated that OA reaches the receptor medium, which correlates with a systemic absorption in vivo. The natural compound OA could represent a promising alternative to those available to treat inflammatory skin disorders.

Protective effects of a polyphenol-enriched fraction of the fruit peel of Annona crassiflora Mart. on acute and persistent inflammatory pain.

Different parts of Annona crassiflora Mart., a native species from Brazilian savanna, were traditionally used for the treatment of a wide variety of ailments including arthritis. Thus, this study aimed to investigate the possible antinociceptive and anti-inflammatory properties of a polyphenol-enriched fraction of the fruit peel of A. crassiflora, named here as EtOAc, in mice. Pro-inflammatory cytokines and nitric oxide (NO) production were evaluated in LPS-activated macrophages. Then, EtOAc fraction was administered by oral route in male C57BL/6/J mice, and the animals were submitted to glutamate-induced nociception and complete Freund's adjuvant (CFA)-induced monoarthritis tests to assess nociception (mechanical, spontaneous and cold pain) and inflammation (edema and neutrophil infiltration), and to the open-field and rotarod tests for motor performance analysis. EtOAc fraction inhibited the production of IL-6 and NO in the LPS-induced macrophages, and reduced spontaneous nociception induced by glutamate, without altering the animals' locomotor activity. In addition, the polyphenol-enriched fraction was able to revert the early and late hyperalgesia induced by CFA, as well as edema at the acute phase. Reduction of myeloperoxidase activity and inflammatory cell infiltration was observed in the paw tissue of mice injected with CFA and treated with EtOAc fraction. Together, our results support the antinociceptive and anti-inflammatory effects of the polyphenol-enriched fraction of A. crassiflora fruit peel and suggest that these effects are triggered, at least in part, by suppressing pro-inflammatory cytokines and neutrophils infiltration.

Análise da primeira compra unificada de antineoplásicos organizada pelo Núcleo Estadual do Ministério da Saúde no Rio de Janeiro e conduzida pelo Instituto Nacional de Câncer / [Analysis of the first unified purchase of antineoplastics organized by the State Nucleus of the Ministry of Health in Rio de Janeiro and conducted by National Cancer Institute]

Em 2016 foi realizada pelo Instituto Nacional de Câncer a primeira compra unificada de medicamentos antineoplásicos organizada pelo Núcleo Estadual do Ministério da Saúde no Rio de Janeiro com o intuito de agregar as demandas das nove unidades federais de saúde para obtenção de melhores preços. O objetivo do estudo foi descrever o perfil desta compra quanto aos medicamentos adquiridos, quantidades de compra, instituições participantes, situação final do item no certame, fornecedores contratados e preços praticados e analisar esses preços através de sua comparação com preços iniciais estimados, preços tabelados pelo governo e preços obtidos nas compras centralizadas pelo próprio Ministério da Saúde. Foi conduzido estudo exploratório, quantitativo e transversal, com base nos dados provenientes do Pregão Eletrônico no 173/2016, do Portal de Compras do Governo Federal, da Lista de Preços da Câmara de Regulação do Mercado de Medicamentos e do Sistema de Gerenciamento de Estoque do Serviço Central de Abastecimento do INCA. Os medicamentos foram categorizados pela Classificação Anatômico- Terapêutico-Químico. Foram incluídos no estudo somente aqueles pertencentes aos subgrupos L01 (antineoplásicos) e L02 (terapia endócrina). As variáveis estudadas foram nome do fármaco, apresentação, unidade de fornecimento, situação final da proposta, motivo da frustração, marca vencedora, fornecedor contratado, declaração de microempresa/empresa de pequeno porte, quantidades adquiridas, preços praticados e isenção de ICMS. Os dados foram tabelados e os cálculos estatísticos de frequências absoluta e relativa foram realizados através do Microsoft Excel®. Foram licitados 165 medicamentos, sendo incluídos no estudo um total de 132 com montante financeiro inicial estimado em R$ 265.948.482,53. Ao final, 100 antineoplásicos foram homologados correspondendo a 5.342.932 unidades farmacotécnicas (UF) adquiridas com valor final total de R$ 170.210.950,09, representando redução de 36% com relação à estimativa inicial de gasto contratado. A compra unificada resultou em representativo volume de UF adquiridas e em elevado valor financeiro contratado, sendo que o INCA se destacou em ambos, concentrando 67% das UF adquiridas e 42,6% do volume financeiro envolvido. Dos 23 fornecedores contratados, 65,2% eram distribuidores. Foi observado que os medicamentos com maiores descontos entre o preço tabelado e o preço de ata eram em sua maioria genéricos, enquanto aqueles com menores descontos possuíam um só fabricante. Foi constatada existência de medicamentos com preço estimado acima do preço tabelado pela CMED, resultando, inclusive, em preço de ata maior que o preço tabelado provavelmente por dificuldades na compreensão da aplicação da alíquota de ICMS. O imatinibe foi o único medicamento do rol de antineoplásicos de compra centralizada do Ministério da Saúde cuja aquisição unificada resultou em preço menor. A estimativa de preços mostrou-se ser etapa fundamental para o sucesso do processo de compras, pois problemas na precificação podem resultar em compras antieconômicas. A estratégia de unificação de demanda parece ser efetiva para medicamentos onde há concorrência no mercado. Contudo, para medicamentos sob monopólio, a negociação direta com o fornecedor parece ser mais vantajosa, visto que os preços obtidos na licitação de alguns medicamentos de alto custo ficaram iguais ou próximos aos tabelados pela CMED, o que não representou uma economia nestes casos.

In 2016 occurred the first unified purchase of antineoplastic drugs organized by the State Nucleus of the Ministry of Health in Rio de Janeiro and carried out by the Brazilian National Cancer Institute (INCA) in order to aggregate the demands of nine federal health units to obtain better prices. The purpose of this study was the description of the purchase's profile, following terms such as: acquired medicines, institutions involved, the situation of the item after public tender, suppliers, volumes, prices and expenses contracted; and the analysis of said prices through their comparison with initial auction prices, price caps set by Drug Market Regulation Chamber (CMED) and those obtained in centralized procurement processes by the own Ministry of Health. An exploratory, quantitative and cross-sectional study was conducted, based on data from Eletronic Auction 173/2016, Federal Government Electronic Procurement Portal, Price Cap List of CMED and inventory management system of the Central Supply Service of INCA. The medicines were categorized by Anatomical Therapeutic Classification and those belonging to the L01 (antineoplastic) and L02 (endocrine therapy) subgroups were included in the study. The variables studied were: medicine, presentation, supply unit, situation of the item after bidding, reasons of failed bidding process, winning brand, contracted suppliers, statement of micro or small enterprises, final volume acquired, unit purchase price and tax over circulation of goods and services (ICMS) exemption. Data were tabulated and statistical calculations of absolute and relative frequencies were performed using Microsoft Excel®. Total of 165 medicines were tendered but only 132 were included in the study. It totalized financial amount estimated at R$ 265,948,482.53. At the end of the bid, 100 antineoplastics were homologated corresponding to 5,342,932 units acquired and final expenses contracted of R$ 170,210,950.09, resulting in a 36% expenses reduction. The unified purchase resulted in a significant number of units acquired and impressive expenses contracted, with INCA standing out in both, concentrating 67% of the units acquired and 42.6% of the expenses involved. Of the 23 contracted suppliers, 65.2% were distributors. It was observed that drugs with the greatest discounts between the price cap and the price offered were mostly generic, while those with lower discounts had only one manufacturer. Medicines with an estimated price above the price cap set by the CMED resulted also in high price after bidding process probably due to difficulties in understanding the application of the ICMS. Imatinib mesylate was the only drug in unified bid that resulted in a lower price in comparison with centralized procurement conducted by the Ministry of Health. The estimation of prices has proved to be a fundamental step for the success of the bidding process, as problems in pricing can result in uneconomic purchases. The demand-unification strategy appears to be effective for drugs in a competitive market. For drugs under monopoly, direct negotiation with suppliers seems to be more advantageous, since the prices obtained in the bidding for some high-cost drugs were the same as or close to the price cap of CMED, which did not represent an economy.

Influência da atividade física na saúde / The influence of physical activity in health

O presente trabalho apresenta uma revisão sistemática dos estudos obtidos dos bancos de dados do Lilacs e Medline de 1982 a 2006 que avaliam a temática relativa à atividade física e o estado de saúde dos indivíduos. O objetivo desta revisão foi identificar as condições relativas à saúde dos indivíduos que são indulgenciados pela prática regular de atividade física e caracterizar os métodos existentes de avaliação da atividade física. A relação da atividade física com a saúde é estudada há muitos anos e cada vez mais descobertas confirmam que a prática de atividade física regular atua diretamente na prevenção de doenças crônicas não transmissíveis tais como, diabetes, obesidade, hipertensão, doenças cardíacas, osteoporose e alguns tipos de câncer. Mesmo conhecendo os benefícios dessa prática, poucas pessoas estão engajadas na prática de atividade física regular e o índice de desistência para aqueles que participam de programas de exercícios iniciais é alto. A Organização Mundial de Saúde estabeleceu a estratégia global para o incentivo à prática de atividade física e recentemente o Ministério da Saúde elaborou a Política Nacional de Promoção da Saúde que tem como base das ações comunitárias o mapeamento das práticas de atividades físicas realizadas pela população.

This article presents a systematic review of Lilacs and Medline databases, from the period of 1982 to 2006, including studies linking physical activities and health aspects of individuals’ life. The aim of this review was to identify health factors that are infl uenced by regular physical activity and to characterize existing methods to evaluate physical activity. The association between physical activity and health has been studied for many years and the fi ndings confi rm that the practice of regular physical activity acts in the prevention of non-communicable chronic diseases such as diabetes, obesity, hypertension, heart diseases, osteoporosis and some types of cancer. Even knowing the benefi ts of exercise, few people are engaged in the practice of regular physical activity and there is a high rate of discontinuance of those that enroll in initial exercising programs. The World Health Organization has published the global strategy to promote physical activity and recently the Brazilian Ministry of Education launched the National Policy of Health Promotion that has as a basic community the action characterization of physical activity pattern in the population. Among the available methods to evaluate physical activities questionnaires can be used in large groups of individuals due to their feasibility and low cost. Therefore, it is of utmost importance that health professionals know the lifestyle of the population to introduce effective interventions and defi ne effective strategies to increase the practice of regular physical activity.