Triglyceride-glucose index demonstrates reasonable performance as a screening tool but exhibits limited diagnostic utility for insulin resistance: Data from the ELSA-Brasil cohort.

Insulin resistance (IR) is a key risk factor for chronic metabolic diseases, but its laboratory diagnosis is still costly; thus, the triglyceride-glucose (TyG) index has been proposed as a surrogate method. Our aim was to provide a detailed analysis of cutoffs and test the hypothesis that the TyG index would present reasonable performance parameters for IR screening. This is a cross-sectional study with baseline data from 12,367 eligible participants of both sexes (aged 35-74 years) from the Brazilian Longitudinal Study of Adult Health. TyG correlation and agreement with the Homeostasis Model Assessment for Insulin Resistance were analyzed. Positive and negative predictive values (PV+, PV-) and likelihood ratio (LR+, LR-) were calculated. A moderate positive correlation between TyG and Homeostasis Model Assessment for Insulin Resistance was observed (Pearson r = 0.419). The area under the receiver operating characteristic curve of TyG for IR diagnosis was 0.742 and the optimal cutoff was 4.665, reaching a kappa agreement value of 0.354. For this cutoff, a PV+ of 59.3% and PV- of 76.0%, as well as an LR+ of 2.07 and LR- of 0.45 were obtained. Alternatively, because high sensitivity is desired for screening tests, selecting a lower cutoff, such as 4.505, increases the PV- to 82.1%, despite decreasing the PV+ to 50.8%. We conclude that TyG has important performance limitations for detecting IR, but that it may still be reasonably useful to help screening for IR in adults because it can be calculated from low-cost routine blood tests.

Examining the Usage Patterns of Non-Nutritive Sweeteners among Non-Diabetic Individuals: Insights from the Longitudinal Study of Adult Health (ELSA-Brasil).

BACKGROUND: Although non-nutritive sweeteners (NNSs) were formulated primarily for sugar-restricted diets, nowadays, their consumption has become widespread among the general population. Thus, the purpose of this study was to estimate the prevalence of the regular use of NNSs and their associated factors among non-diabetic individuals from the baseline of the Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: In total, 9226 individuals were analysed, and the regular consumption of NNSs was defined as follows: NSSs are used at least once a day. Associations between exposure and outcomes were analysed using chi-square and Student's t-tests. Significant variables were inserted into a binary logistic regression model to determine the adjusted association measures (significance level of 5%). RESULTS: The prevalence of regular NNS consumption was 25.7%. Regular NNS consumption increased with age, categories of BMI, income, and schooling. The odds of regularly consuming NNSs were 1.9-times higher among women, 6.1-times higher among obese individuals, and 1.8-times higher among those with higher schooling and income. CONCLUSIONS: Specific groups seem to present a larger association relative to the use of NNS. Based on the significant overall prevalence of the regular use of NNSs, a discussion regarding country-wide policies related to their intake is needed to address recent WHO directions concerning this additive.

Vulnerability in adolescents' daily life during the COVID-19 pandemic.

OBJECTIVE: To know the vulnerability in adolescents' daily life during the COVID-19 pandemic. METHOD: Qualitative research carried out with 25 adolescents from a public school in a municipality in southern Brazil in the second half of 2021 through individual semi-structured interviews. Data were submitted to thematic content analysis and interpreted with the vulnerability theoretical framework. RESULTS: These adolescents' daily lives during the COVID-19 pandemic presented difficulties in keeping family members working, changing habits and routines, accessing classes, the internet and increasing intra-family violence. CONCLUSION: Vulnerability in adolescents' daily life during the pandemic can be identified as the absence of interaction in the school context and access to learning resources, reflecting on individual and social vulnerability. Unemployment and possible access to other sources of income have an impact on programmatic vulnerability. Reflection on practices in the context of health and school is suggested, based on the vulnerability identified in adolescents' daily lives during the COVID-19 pandemic.

Cardiac Autonomic Function and Functional Capacity in Post-COVID-19 Individuals with Systemic Arterial Hypertension.

Individuals diagnosed with systemic arterial hypertension (SAH) are considered risk groups for COVID-19 severity. This study assessed differences in cardiac autonomic function (CAF) and functional capacity (FC) in SAH individuals without COVID-19 infection compared to SAH individuals post-COVID-19. Participants comprised 40 SAH individuals aged 31 to 80 years old, grouped as SAH with COVID-19 (G1; n = 21) and SAH without COVID-19 (G2; n = 19). CAF was assessed via heart rate variability (HRV), measuring R-R intervals during a 10-min supine period. Four HRV indices were analyzed through symbolic analysis: 0V%, 1V%, 2LV%, and 2UV%. FC assessment was performed by a 6-min walk test (6MWT). G1 and G2 showed no significant differences in terms of age, anthropometric parameters, clinical presentation, and medication use. G2 exhibited superior 6MWT performance, covering more distance (522 ± 78 vs. 465 ± 59 m, p < 0.05). Specifically, G2 demonstrated a moderate positive correlation between 6MWT and the 2LV% index (r = 0.58; p < 0.05). Shorter walking distances were observed during 6MWT in SAH individuals post-COVID-19. However, the study did not find impaired cardiac autonomic function in SAH individuals post-COVID-19 compared to those without. This suggests that while COVID-19 impacted FC, CAF remained relatively stable in this population.

Fault Diagnosis in Analog Circuits Using Swarm Intelligence.

Open or short-circuit faults, as well as discrete parameter faults, are the most commonly used models in the simulation prior to testing methodology. However, since analog circuits exhibit continuous responses to input signals, faults in specific circuit elements may not fully capture all potential component faults. Consequently, diagnosing faults in analog circuits requires three key aspects: identifying faulty components, determining faulty element values, and considering circuit tolerance constraints. To tackle this problem, a methodology is proposed and implemented for fault diagnosis using swarm intelligence. The investigated optimization techniques are Particle Swarm Optimization (PSO) and the Bat Algorithm (BA). In this methodology, the nonlinear equations of the tested circuit are employed to calculate its parameters. The primary objective is to identify the specific circuit component that could potentially exhibit the fault by comparing the responses obtained from the actual circuit and the responses obtained through the optimization process. Two circuits are used as case studies to evaluate the performance of the proposed methodologies: the Tow-Thomas Biquad filter (case study 1) and the Butterworth filter (case study 2). The proposed methodologies are able to identify or at least reduce the number of possible faulty components. Four main performance metrics are extracted: accuracy, precision, sensitivity, and specificity. The BA technique demonstrates superior performance by utilizing the maximum combination of accessible nodes in the tested circuit, with an average accuracy of 95.5%, while PSO achieved only 93.9%. Additionally, the BA technique outperforms in terms of execution time, with an average time reduction of 7.95% reduction for the faultless circuit and an 8.12% reduction for the faulty cases. Compared to the machine-learning-based approach, using BA with the proposed methodology achieves similar accuracy rates but does not require any datasets nor any time-demanding training to proceed with circuit diagnostic.

Vulnerability in adolescents' daily life during the COVID-19 pandemic / Vulnerabilidad en la vida cotidiana de los adolescentes durante la pandemia de COVID-19 / Vulnerabilidade no cotidiano de adolescentes na pandemia de COVID-19

ABSTRACT Objective: To know the vulnerability in adolescents' daily life during the COVID-19 pandemic. Method: Qualitative research carried out with 25 adolescents from a public school in a municipality in southern Brazil in the second half of 2021 through individual semi-structured interviews. Data were submitted to thematic content analysis and interpreted with the vulnerability theoretical framework. Results: These adolescents' daily lives during the COVID-19 pandemic presented difficulties in keeping family members working, changing habits and routines, accessing classes, the internet and increasing intra-family violence. Conclusion: Vulnerability in adolescents' daily life during the pandemic can be identified as the absence of interaction in the school context and access to learning resources, reflecting on individual and social vulnerability. Unemployment and possible access to other sources of income have an impact on programmatic vulnerability. Reflection on practices in the context of health and school is suggested, based on the vulnerability identified in adolescents' daily lives during the COVID-19 pandemic.

RESUMEN Objetivo: Conocer la vulnerabilidad en el cotidiano de los adolescentes ante la pandemia de COVID-19. Método: Investigación cualitativa, realizada con 25 adolescentes de una escuela pública de un municipio del sur de Brasil, en el segundo semestre de 2021, a través de entrevistas semiestructuradas individuales. Los datos fueron sometidos al análisis de contenido temático e interpretados con el referencial teórico de la vulnerabilidad. Resultados: El cotidiano de estos adolescentes durante la pandemia de la COVID-19 presentó dificultades para conservar el trabajo de los familiares, cambio de hábitos y rutinas, acceso a clases, internet y aumento de la violencia intrafamiliar. Conclusión: La vulnerabilidad en el cotidiano de los adolescentes durante la pandemia se puede identificar como la ausencia de interacción en el contexto escolar y acceso a los recursos de aprendizaje, reflexionando sobre la vulnerabilidad individual y social. El desempleo y el posible acceso a otras fuentes de ingresos inciden en la vulnerabilidad programática. Se sugiere la reflexión sobre las prácticas en el contexto de la salud y la escuela, a partir de la vulnerabilidad identificada en el cotidiano de los adolescentes en la pandemia de la COVID-19.

RESUMO Objetivo: Conhecer a vulnerabilidade no cotidiano de adolescentes na pandemia de COVID-19. Método: Pesquisa qualitativa, realizada com 25 adolescentes de uma escola pública em um município do Sul do Brasil, no segundo semestre de 2021, por meio de entrevistas semiestruturadas individuais. Os dados foram submetidos à análise temática de conteúdo e interpretados com o referencial teórico da vulnerabilidade. Resultados: O cotidiano desses adolescentes na pandemia de COVID-19 apresentou-se com dificuldades na manutenção de empregos dos familiares, mudança de hábitos e rotinas, forma de acesso às aulas, internet e aumento da violência intrafamiliar. Conclusão: A vulnerabilidade no cotidiano de adolescentes durante a pandemia pode ser identificada como a ausência do convívio no contexto escolar e acesso aos recursos para aprendizagem, refletindo na vulnerabilidade individual e social. O desemprego e o possível acesso de outras fontes de renda repercutem na vulnerabilidade programática. Sugere-se a reflexão sobre práticas no contexto da saúde e da escola, tendo por base a vulnerabilidade identificada no cotidiano de adolescentes na pandemia de COVID-19.

Dynamical nonequilibrium molecular dynamics simulations identify allosteric sites and positions associated with drug resistance in the SARS-CoV-2 main protease

The SARS-CoV-2 main protease (Mpro) plays an essential role in the coronavirus lifecycle by catalysing hydrolysis of the viral polyproteins at specific sites. Mpro is the target of drugs, such as nirmatrelvir, though resistant mutants have emerged that threaten drug efficacy. Despite its importance, questions remain on the mechanism of how Mpro binds its substrates. Here, we apply dynamical nonequilibrium molecular dynamics (D-NEMD) simulations to evaluate structural and dynamical responses of Mpro to the presence and absence of a substrate. The results highlight communication between the Mpro dimer subunits and identify networks, including some far from the active site, that link the active site with a known allosteric inhibition site, or which are associated with nirmatrelvir resistance. They imply that some mutations enable resistance by altering the allosteric behaviour of Mpro. More generally, the results show the utility of the D-NEMD technique for identifying functionally relevant allosteric sites and networks including those relevant to resistance.

Acute Flaxseed Intake Reduces Postprandial Glycemia in Subjects with Type 2 Diabetes: A Randomized Crossover Clinical Trial.

Background: Postprandial glycemic excursions are associated with impairment control of diabetes mellitus. Long-term consumption of flaxseed can lower blood glucose levels; however, its effects on the postprandial glycemic response remain unknown. Therefore, this study aimed to evaluate the acute effects of raw flaxseed consumption on the 2 h postprandial glycemic curve in men with type 2 diabetes mellitus (T2DM). Methods: This was a randomized crossover clinical trial. Nineteen men with T2DM were randomly assigned a standardized breakfast without (control) or with a previous intake of 15 g of ground raw golden flaxseed (flax). Glycemia was measured at fasting and postprandial at 15, 30, 45, 60, 90, and 120 min. Palatability markers (visual appeal, smell, and pleasantness of taste) and taste intensity (sweetness, saltiness, bitterness, sourness, and creaminess) were evaluated. Results: The peak glucose rise and the 2 h AUC glycemic response reduced in the flax group by 17% (p = 0.001) and 24% (p < 0.001), respectively. The glucose peak time, palatability, and taste parameters did not differ between the two groups. Conclusions: Ingestion of 15 g of ground raw golden flaxseed before breakfast decreases the 2 h postprandial glycemic response in men with T2DM.

Eficácia do exergaming na aderência a reabilitação cardíaca fase II: um protocolo de ensaio clínico randomizado / Effectiveness of exergaming on the phase II cardiac rehabilitation adherence: a randomized clinical trial protocol

Introdução: O exergaming, dado o seu perfil lúdico, pode tornar a Reabilitação Cardíaca (RC) mais atrativa. Assim, questiona-se se o exergaming pode reduzir a evasão dos pacientes à RC. Objetivo: Analisar a eficácia do exergaming na aderência à RC fase dois. Métodos: Ensaio clínico randomizado, incluindo pacientes com doenças cardíacas, de ambos os sexos, maiores de 18 anos, admitidos na RC fase dois; excluídos os com contraindicações a essa intervenção. Os participantes serão alocados em dois grupos, com 30 indivíduos cada: grupo intervenção, que realizará o exergaming no Nintendo Wii; grupo controle, realizará exercício em esteira. A intervenção de ambos os grupos será de intensidade moderada, 30 minutos por sessão, três vezes por semana, por 12 semanas. A aderência à RC será identificada através da porcentagem do comparecimento às sessões. Resultados: As variáveis dos grupos serão comparadas por meio do Teste T de Student ou MannWhitney. O teste do qui-quadrado será utilizado para comparação das variáveis categóricas, quando inadequado, o exato de Fischer. Nível de significância será 5%. Conclusão: Esta investigação auxiliará na elucidação da eficácia do exergame na adesão à RC fase dois e quanto a outros desfechos secundários, como a melhora da capacidade de exercício.

Perfil das internações de crianças por malformações congênitas do aparelho circulatório no Brasil de 2010 a 2020 / Profile of Children's hospitalization due to congenital malformations of the circulatory apparatus in Brazil from 2010 to 2020

Introdução: a malformação congênita do aparelho circulatório é definida como qualquer anormalidade na estrutura e/ou função do coração durante a fase do desenvolvimento embrionário, podendo interferir no fluxo sanguíneo. Suas manifestações ocorrem em qualquer fase do desenvolvimento. No Brasil, essa enfermidade representa a segunda principal causa de mortalidade em crianças menores de um ano, caracterizando-se um problema de saúde pública. Objetivo: descrever o perfil das internações de crianças por malformações congênitas do aparelho circulatório no Brasil, de 2010 a 2020. Metodologia: trata-se de um estudo ecológico, realizado por meio de dados secundários, no período de 2010 a 2020. Analisaram-se as variáveis número de internações, sexo, região, raça/cor, faixa etária, custos hospitalares, óbito e taxa de mortalidade. As informações coletadas foram armazenadas e analisadas no software Microsoft Excel Office, versão de 365. Resultados: entre 2010 e 2020, foram notificadas 118.792 internações por essa comorbidades de crianças por malformação congênita do aparelho circulatório, sendo 51% do sexo masculino, com predomínio da cor branca (36%), tendo a região Sudeste apresentado o maior percentual de internações (43,5%). Observou-se maior ocorrência em crianças abaixo de um ano (62,7%), gerando um custo de 650 milhões de reais em serviços hospitalares. O maior percentual de internações ocorreu em 2019 (10,9%). Houve 10.477 óbitos entre 2010 e 2020 (8,8%), sendo 85,8% na população abaixo de um ano e 37,7% na região Sudeste. A taxa de mortalidade de crianças por essa comorbidade foi de 8,82/100 mil habitantes. Conclusão: observou-se que as malformações congênitas do aparelho circulatório, no período analisado, apresentaram uma distribuição homogênea em relação ao sexo, sendo mais frequentes na raça/cor branca, na região Sudeste e na faixa etária menor que um ano, gerando altos custos em serviços hospitalares.

Introduction: congenital malformation of the circulatory system is defined as any abnormality in the structure and/or function of the heart during the embryonic development phase, which may interfere with blood flow. Its manifestations can occur at any stage of development. In Brazil, it represents the second leading cause of mortality in children under one year of age, characterizing a public health problem. Objective: to describe the profile of hospitalizations of children due to congenital malformations of the circulatory system in Brazil, from 2010 to 2020. Method: this is an ecological study, using secondary data from the Informatics Department of the Unified Health System, by the Hospital Information System of the Unified Health System, from 2010 to 2020. The following variables were analyzed: number of admissions, sex, region, race/color, age group, hospital costs, death and mortality rate. From the information acquired by the TabNet tool, for purposes of processing and analyzing the information collected, data were stored and analyzed in Microsoft Excel Office software, version 365. Results: between 2010 and 2020, 118,792 hospitalizations were reported in children due to congenital malformation of the circulatory system, 51% of whom were male, with a predominance of whites (36%). Southeast region was the region with the highest percentage of hospitalizations (43.5%). A higher occurrence was observed in children under one year of age (62.7%), generating a cost of 650 million reais in hospital services. The highest percentage of hospitalizations was registered in the year 2019 (10.9%). There were 10,477 deaths between 2010 and 2020 (8.8%), being 85.8% in the population under one year of age and 37.7% in the Southeast region. The mortality rate of children due to this comorbidity was 8.82/100 thousand inhabitants. Conclusion: it was observed that the congenital malformations of the circulatory system, in the analyzed period, presented a homogeneous distribution in relation to sex, being more frequent in the white race/color, in the Southeast region and in the age group under one year, generating high costs in services hospitals.

Discovery of SARS-CoV-2 Mpro Peptide Inhibitors from Modelling Substrate and Ligand Binding

The main protease (Mpro) of SARS-CoV-2 is central to its viral lifecycle and is a promising drug target, but little is known concerning structural aspects of how it binds to its 11 natural cleavage sites. We used biophysical and crystallographic data and an array of classical molecular mechanics and quantum mechanical techniques, including automated docking, molecular dynamics (MD) simulations, linear-scaling DFT, QM/MM, and interactive MD in virtual reality, to investigate the molecular features underlying recognition of the natural Mpro substrates. Analyses of the subsite interactions of modelled 11-residue cleavage site peptides, ligands from high-throughput crystallography, and designed covalently binding inhibitors were performed. Modelling studies reveal remarkable conservation of hydrogen bonding patterns of the natural Mpro substrates, particularly on the N-terminal side of the scissile bond. They highlight the critical role of interactions beyond the immediate active site in recognition and catalysis, in particular at the P2/S2 sites. The binding modes of the natural substrates, together with extensive interaction analyses of inhibitor and fragment binding to Mpro, reveal new opportunities for inhibition. Building on our initial Mpro-substrate models, computational mutagenesis scanning was employed to design peptides with improved affinity and which inhibit Mpro competitively. The combined results provide new insight useful for the development of Mpro inhibitors.

Caring ability of urban and rural family caregivers: association with overburden, stress and coping.

OBJECTIVE: To correlate caring ability with overburden, stress and coping of urban and rural family caregivers of patients undergoing cancer treatment. METHOD: Cross-sectional study, carried out in a referral hospital for cancer treatment, with urban and rural caregivers who responded the following instruments: questionnaire of sociodemographic characterization of the caregiver and the care provided, Perceived Stress scale, Burden Interview scale and Brief COPE. Pearson's correlation test was used for statistical analysis, with a significance level ≤5%. RESULTS: A total of 163 urban caregivers and 59 rural caregivers participated in the study. Between the caring ability and stress, a negative and moderate correlation was found in rural caregivers. In the relationship between the caring ability and the overburden, there was a statistically significant correlation in urban caregivers in the interpersonal relationship and perception of self-efficacy factor. Between coping and the caring ability, a positive and moderate correlation was identified in coping focused on the problem in the knowledge dimension in urban caregivers. CONCLUSION: Urban caregivers had greater intensity of overburden and coping focused on the problem in relation to the caring ability.

Caring ability of urban and rural family caregivers: association with overburden, stress and coping / Habilidad de cuidadores familiares urbanos y rurales: relación con la sobrecarga, el estrés y el afrontamiento (coping) / Habilidade de cuidado de cuidadores familiares urbanos e rurais: relação com a sobrecarga, estresse e coping

ABSTRACT Objective: To correlate caring ability with overburden, stress and coping of urban and rural family caregivers of patients undergoing cancer treatment. Method: Cross-sectional study, carried out in a referral hospital for cancer treatment, with urban and rural caregivers who responded the following instruments: questionnaire of sociodemographic characterization of the caregiver and the care provided, Perceived Stress scale, Burden Interview scale and Brief COPE. Pearson's correlation test was used for statistical analysis, with a significance level ≤5%. Results: A total of 163 urban caregivers and 59 rural caregivers participated in the study. Between the caring ability and stress, a negative and moderate correlation was found in rural caregivers. In the relationship between the caring ability and the overburden, there was a statistically significant correlation in urban caregivers in the interpersonal relationship and perception of self-efficacy factor. Between coping and the caring ability, a positive and moderate correlation was identified in coping focused on the problem in the knowledge dimension in urban caregivers. Conclusion: Urban caregivers had greater intensity of overburden and coping focused on the problem in relation to the caring ability.

RESUMEN Objetivo: Correlacionar la habilidad del cuidado con la sobrecarga, el estrés y el afrontamiento (coping ) de familiares urbanos y rurales cuidadores de pacientes en tratamiento oncológico. Método: Se trata de un estudio transversal, realizado en un hospital referencia en tratamiento oncológico, con cuidadores de los medios urbano y rural que respondieron a los instrumentos: cuestionario de caracterización sociodemográfica del cuidador y de la atención prestada, escala de Estrés Percibido, escala de Entrevista de Carga y COPE 28. Para el análisis estadístico se utilizó la prueba de Correlación de Pearson, con nivel de significación ≤5%. Resultados: Participaron 163 cuidadores urbanos y 59 cuidadores rurales. Entre la capacidad del cuidado y el estrés, se constató una correlación negativa y moderada en los cuidadores rurales. En la relación de la habilidad del cuidado y la sobrecarga, se comprobó una correlación estadísticamente significativa entre los cuidadores urbanos en el factor de la relación interpersonal y en la percepción de la autoeficacia. Entre el afrontamiento y la habilidad del cuidado, se identificó una correlación positiva y moderada en el afrontamiento, centrado en el problema de la dimensión de conocimientos de los cuidadores urbanos. Conclusión: Los cuidadores urbanos presentaron una mayor intensidad de sobrecarga y coping enfocado en el problema de la relación con la capacidad del cuidado.

RESUMO Objetivo: Correlacionar a habilidade de cuidado com a sobrecarga, o estresse e o coping de cuidadores familiares urbanos e rurais de pacientes em tratamento oncológico. Método: Estudo transversal, realizado em um hospital de referência no tratamento oncológico, com cuidadores do contexto urbano e rural que responderam aos instrumentos: questionário de caracterização sociodemográfica do cuidador e do cuidado prestado, escala de Estresse Percebido, escala Burden Interview e COPE Breve. Para a análise estatística, foi utilizado o teste de Correlação de Pearson, com nível de significância ≤5%. Resultados: Participaram 163 cuidadores urbanos e 59 cuidadores rurais. Entre a habilidade de cuidado e o estresse, constatou-se correlação negativa e moderada nos cuidadores rurais. Na relação da habilidade de cuidado e a sobrecarga, verificou-se correlação estatisticamente significativa nos cuidadores urbanos no fator relação interpessoal e percepção de autoeficácia. Entre o coping e a habilidade de cuidado, identificou-se correlação positiva e moderada no coping focado no problema na dimensão conhecimento nos cuidadores urbanos. Conclusão: Cuidadores urbanos apresentaram maior intensidade de sobrecarga e coping focado no problema na relação com a habilidade de cuidado.

Social representations of nursing students on the rights of health users.

OBJECTIVE: To identify the social representations of undergraduate nursing students in the third and eighth term of the course on the rights of health users. METHODS: Qualitative research using the framework of the structural approach to the Theory of Social Representations. A total of 92 students participated. The free evocation technique was used and data was processed in the EVOC software. RESULTS: In the social representations of the third term students, words related to health policies were not observed, but there is an evaluation of the service in the institutions. Among the eighth-grade students, the concepts that support the policies of the Unified Health System are evident. FINAL CONSIDERATIONS: There is a consolidation of the students' knowledge throughout the course, with a more elaborated knowledge about the users' right, supported by principles of the SUS. Undergraduate education is an important space for discussing the construction and exercise of citizenship, including the right to health.

Social representations of nursing students on the rights of health users / Representaciones Sociales de estudiantes de enfermería sobre los derechos de los usuarios de la salud / Representações sociais de estudantes de enfermagem sobre os direitos dos usuários da saúde

ABSTRACT Objective: To identify the social representations of undergraduate nursing students in the third and eighth term of the course on the rights of health users. Methods: Qualitative research using the framework of the structural approach to the Theory of Social Representations. A total of 92 students participated. The free evocation technique was used and data was processed in the EVOC software. Results: In the social representations of the third term students, words related to health policies were not observed, but there is an evaluation of the service in the institutions. Among the eighth-grade students, the concepts that support the policies of the Unified Health System are evident. Final considerations: There is a consolidation of the students' knowledge throughout the course, with a more elaborated knowledge about the users' right, supported by principles of the SUS. Undergraduate education is an important space for discussing the construction and exercise of citizenship, including the right to health.

RESUMEN Objetivo: Identificar las representaciones sociales de los estudiantes universitarios de enfermería del tercer y octavo período del curso, sobre los derechos de los usuarios de la salud. Métodos: Se trata de una investigación cualitativa con referencial del enfoque estructural de la Teoría de las Representaciones Sociales, realizada entre 92 estudiantes mediante la técnica de evocación libre y el software EVOC para el procesamiento de los datos. Resultados: En las representaciones sociales de los estudiantes del tercer período no se observan términos relacionados con las políticas de salud, aunque existe una evaluación de la atención de las instituciones. En los estudiantes del octavo, hay conceptos que demuestran apoyo a las políticas del Sistema Único de Salud. Consideraciones finales: A lo largo del curso se produce una reificación del conocimiento de los estudiantes, con un saber elaborado sobre el derecho de los usuarios y basado en los principios del SUS. La educación universitaria es un espacio importante de problematización para la construcción de la ciudadanía y su ejercicio, incluyendo el derecho a la salud.

RESUMO Objetivo: Identificar as representações sociais de estudantes de graduação em enfermagem, do terceiro e oitavo período do curso, sobre os direitos dos usuários da saúde. Método: Pesquisa qualitativa com referencial da abordagem estrutural da Teoria das Representações Sociais. Participaram 92 estudantes. Utilizou-se a técnica de evocações livres, sendo os dados processados pelo software EVOC. Resultados: Nas representações sociais dos estudantes do terceiro período, não se observam termos relacionados às políticas de saúde, mas há avaliação sobre o atendimento nas instituições. Nas dos estudantes do oitavo, evidenciam-se conceitos sustentadores de políticas do Sistema Único de Saúde. Considerações finais: Nas representações sociais dos estudantes do terceiro período, não se observam termos relacionados às políticas de saúde, mas há avaliação sobre o atendimento nas instituições. Nas dos estudantes do oitavo, evidenciam-se conceitos sustentadores de políticas do Sistema Único de Saúde.

Características sociodemográficas e clínicas de adolescentes candidatos à doação de sangue em um hemocentro / Características sociodemográficas y clínicas de adolescentes candidatos a donación de sangre en un hemocentro / Sociodemographic and clinical characteristics of adolescent candidates for blood donation in a hemotherapy service

Objetivo: conhecer as características sociodemográficas e clínicas de adolescentes de 16 e 17 anos candidatos à doação de sangue em um Hemocentro Regional do Estado do Rio Grande do Sul. Método: estudo transversal, descritivo, desenvolvido com base nos registros do banco de dados de um Hemocentro no período de janeiro de 2012 a dezembro de 2016, conforme critério de ampliação de seleção de doadores da Portaria nº 1.353/ 2011. Resultados: o total de candidatos à doação de sangue entre 16 e 17 anos foi de 473 pessoas, com predomínio de candidatos aptos à doação (78,2%), do sexo feminino (57,5%), de cor caucasiana (72,5%), que doavam pela primeira vez (86%) de forma voluntária. Conclusão: a possibilidade de doação de sangue, incluindo os adolescentes, necessita ser amplamente divulgada e ações de marketing e de educação em saúde utilizadas como estratégias para sensibilização, captação e fidelização.

Objective: to know the sociodemographic and clinical characteristics of adolescents aged 16 and 17 who are candidates for blood donation in a Regional hemotherapy service in the State of Rio Grande do Sul. Method: cross-sectional, descriptive study, developed based on the records of a hemoterapy service database from January 2012 to December 2016, according to the criteria for expanding the selection of donors in Ordinance No. 1.353 / 2011. Results: the total number of blood donation candidates between 16 and 17 years old was 473 people, with a predominance of candidates suitable for donation (78.2%), female (57.5%), Caucasian (72.5% ), who donated for the first time (86%) voluntarily. Conclusion: the possibility of blood donation, including adolescents, needs to be widely publicized and marketing and health education actions used as strategies for raising awareness, attracting and retaining customers.

Objetivo: Conocer las características sociodemográficas y clínicas de los adolescentes de 16 y 17 años candidatos para la donación de sangre en un servicio de hemoterapia en el Estado de Rio Grande do Sul. Método: Estudio descriptivo transversal, desarrollado en base a los registros de una base de datos de servicio de hemoterapia desde enero de 2012 hasta diciembre de 2016, de acuerdo con los criterios para ampliar la selección de donantes en la Ordenanza N ° 1.353/2011. Resultados: El número total de candidatos para donación de sangre entre 16 y 17 años fue 473 personas, con predominio de candidatos aptos para la donación (78,2%), mujeres (57,5%), caucásicas (72,5% ), que donó por primera vez (86%) voluntaria. Conclusión: la posibilidad de donación de sangre, incluidos los adolescentes, debe ser ampliamente publicitada y las acciones de marketing y educación sanitaria deben usarse como estrategias para crear conciencia, atraer y retener clientes.

Escolarização de pessoas com Transtornos do Espectro Autista (TEA) em idade adulta: relatos e perspectivas de pais e cuidadores de adultos com TEA / Schooling of people with Autism Spectrum Disorder (ASD) in adulthood: reports and perspectives of parents and caregivers of adults with ASD

Resumo A Política Nacional da Educação, dentro da perspectiva da educação inclusiva, orienta que os sistemas de ensino e aprendizagem garantam o acesso desde a educação infantil até o ensino superior/profissionalizante. A literatura da área revela a necessidade de uma maior compreensão acerca dos processos de escolarização para pessoas com TEA nas diversas etapas da vida. Este trabalho teve como objetivo identificar perspectivas de familiares de adultos com TEA em relação às instituições que se propõem a atenção aos autistas na vida adulta. Objetivou também identificar como foi o percurso escolar, os aspectos positivos e desafios, sob o ponto de vista de seus familiares. O método incluiu a administração de dois questionários, analisados através de estatística descritiva e da técnica do Discurso do Sujeito Coletivo (DSC). Participaram do estudo 67 pais/cuidadores de adultos com TEA residentes em 14 estados brasileiros. Os resultados evidenciam exclusão vivenciada por esses adultos em seu processo de escolarização desde o período da infância/adolescência até a idade adulta. Verifica-se que a maior parte destes autistas esteve inserida somente em instituições educacionais especiais, sendo que somente oito chegaram a instituições regulares de ensino na idade adulta. As dificuldades relatadas estavam relacionadas à inserção, qualidade dos serviços e permanência nas instituições escolares. Foram apresentados como pontos positivos a ampliação da socialização e o ganho de habilidades. Por fim estes familiares apresentam suas perspectivas sobre como deveriam ser as instituições aptas a receberem a pessoa com TEA, já em idade adulta, englobando atendimentos individualizados e de forma integral.

Abstract The Educational National Policy, within the perspective of inclusive education, orients teaching and learning systems to guarantee access since preschool until high school/vocational school. The literature on the field reviews the need for a greater understanding of schooling processes for people with ASD in the different stages of life. This study has aimed to identify the perspective of families of adults with ASD regarding the institutions that offer care to autistic people during adulthood. The study has also aimed to identify the educational trajectory, its positive aspects/challenges, under the outlook of their family members. The research methodology includes the provision of two questionnaires, subsequently analyzed under descriptive statistics and Collective Subject Discourse Methodology (CSD). In total, 67 parents/caregivers of adults with ASD, residents in 14 Brazilian states, were part of the study. The results reveal the exclusion experienced by these adults in their educational trajectories, since their childhood/adolescence, until their adulthood. Moreover, it is noted that most of them have been inserted only in special education institutions, with only eight reaching regular teaching institutions within adulthood. The reported challenges were related to inclusion, service quality and permanence in the educational institutions. As for positive aspects, the expansion of socialization and the gain of new skills have been highlighted. Ultimately, these family members showed their perspectives on characteristics institutions should have, in order to be considered suitable to care for people with ASD during adulthood, comprising individual and comprehensive care.

Desafios do usuário frente a estomia: entre o real e o almejado / Challenges of the user against the stoma: between the real and the desired / Desafíos del usuario frente a la estomia: entre lo real y lo anhelado

Conhecer os desafios enfrentados pelos usuários com estomia fornece subsídios para a enfermagem atuar de forma efetiva no auxilio frente as demandas dessas pessoas. A partir disso indaga-se: Qual a percepção da pessoa com estomia intestinal após a alta hospitalar? O objetivo foi identificar as dificuldades e facilidades encontradas pelas pessoas com estomia intestinal após alta hospitalar. É de natureza qualitativa, de caráter descritivo e exploratório. Foi desenvolvido em um hospital universitário e contou com a participação de 11 pessoas com estomias intestinais. A técnica de coleta de dados foi a entrevista semiestruturada, e a análise de conteúdo temático. Os resultados possibilitaram a construção das categorias (in)compreensão com os cuidados da estomia no domicílio e entre o real e o almejado. Conclui-se que a assistência prestada às pessoas com estomia ainda possui um foco curativista, fazendo com que recebam a alta carentes de informações cruciais para que possam dar continuidade ao cuidado no domicílio.(AU)

Knowing the challenges faced by users with stomies provides subsidies for nursing to act effectively in the face of the demands of these people. From this we ask: What is the perception of the person with intestinal stomies after discharge from hospital? The objective was to identify the difficulties and facilities found by people with intestinal stomies after discharge. It is qualitative, descriptive and exploratory in character. It was developed in a university hospital and counted on the participation of 11 people with intestinal stomies. The technique of data collection was the semistructured interview, and the thematic content analysis. The results allowed the construction of the categories (in) comprehension with the care of the stoma in the home and between the real and the desired one. It is concluded that the care provided to people with stomies still has a curative focus, making them receive the lack of crucial information so that they can continue the care at home.(AU)

Conocer los desafíos enfrentados por los usuarios con estomia proporciona subsidios para la enfermería actuar de forma efectiva en el auxilio frente a las demandas de esas personas. A partir de eso se indaga: ¿cuál es la percepción de la persona con estomía intestinal después del alta hospitalaria? El objetivo fue identificar las dificultades y facilidades encontradas por las personas con estomía intestinal después del alta hospitalaria. Es de naturaleza cualitativa, de carácter descriptivo y exploratorio. Fue desarrollado en un Hospital Universitario y contó con la participación de 11 personas con estomias intestinales. La técnica de recolección de datos fue la entrevista semiestructurada, y el análisis de contenido temático. Los resultados posibilitar la construcción de las categorías (in) comprensión con los cuidados de la estomia en el domicilio, y entre lo real y lo anhelado. Se concluye que la asistencia prestada a las personas con estomia todavía tiene un foco curativista, haciendo que reciban la alta carencia de informaciones cruciales para que puedan dar continuidad al cuidado en el domicilio.(AU)

Estratégias de coping utilizadas por pais de neonatos em terapia intensiva, revisão integrativa / Coping strategies used by neonate parents in intensive therapy, integrative review

Objetivo: identificar as evidências científicas acerca das estratégias de coping utilizadas por pais de recém-nascidos internados em unidades de terapia intensiva neonatal em periódicos nacionais e internacionais, nos últimos 20 anos. Metodologia: revisão integrativa da literatura, artigos obtidos nas bases de dados Literatura Científica da América Latina e Caribe e National Library of Medicine. Encontrados 111 artigos, destes, seis disponibilizados na íntegra. Resultados: emergiram duas categorias analíticas: "Estratégias de coping utilizadas por pais diante da internação do filho em terapia intensiva"; "Estratégias de coping utilizadas por pais diante da morte de um filho". Conclusão: os pais dos recém-nascidos em terapia intensiva vivenciam o estresse e utilizam estratégias de coping, desde a internação até a alta ou óbito neonatal. (AU)

Objective: to identify the scientific evidence about coping strategies used by parents of neonates hospitalized in neonatal intensive care units in national and international journals in the last 20 years. Methodology: integrative review of the literature, articles obtained in the Latin American and Caribbean Scientific Literature databases and National Library of Medicine. Found 111 articles, of these, six made available in full. Results: two analytical categories emerged: "coping strategies used by parents regarding the hospitalization of the child in intensive care"; "Coping strategies used by parents on the death of a child". Conclusion: the parents of the newborns in intensive care experience stress and use coping strategies, from hospitalization to discharge or neonatal death. (AU)

Objetivo: evaluar las evidencias científicas acerca de las estrategias de coping utilizadas por padres de recién nacidos internados en unidades de terapia intensiva neonatal en periódicos nacionales e internacionales en los últimos 20 años. Método: revisión integrativa de la literatura, artículos obtenidos en las bases de datos Literatura científica de América Latina y el Caribe y National Library of Medicine. Se encontraron 111 artículos, de éstos, seis disponibles en su totalidad. Resultados: emergieron dos categorías analíticas: "Estrategias de coping utilizadas por padres en la internación y alta del hijo en terapia intensiva"; "Estrategias de coping utilizadas por padres ante la muerte de un hijo". Conclusión: los padres de los recién nacidos en terapia intensiva vivencian el estrés y utilizan estrategias de coping, desde la internación hasta la alta o muerte neonatal. (AU)

Estresse percebido em familiares de pacientes em sala de espera de um centro cirúrgico / Perceived stress in relatives of patients in a waiting room of a surgical center

Objetivo: avaliar o estresse percebido de familiares de pacientes em sala de espera de um Centro Cirúrgico e relacioná-lo com variáveis sociodemográficas. Metodologia: estudo transversal com 104 familiares de pacientes submetidos à cirurgia que estavam na sala de espera de um Centro Cirúrgico. Foram utilizados o Formulário de Caracterização Sociodemográfica e Escala de Estresse Percebido. Resultados: As maiores médias da Escala de Estresse Percebido pertencem às mulheres, maiores de 40 anos, sem companheiro, com filhos, que recebem menos de três salários mínimos e que cursaram o ensino médio, com diferença estatística significativa observada para variável sexo, exclusivamente. Em geral, os familiares encontravam-se em nível baixo de estresse. Conclusão: A espera em sala de Centro Cirúrgico pode contribuir com o surgimento de sentimentos como ansiedade, nervosismo e, consequentemente, estresse. É importante incluir o familiar no cuidado de enfermagem, o que inclui a prestação de informações, diálogo e respeito. (AU)

Objective: to evaluate the perceived stress of relatives of patients in the waiting room of a Surgical Center and to relate it to sociodemographic variables. Methodology: a cross-sectional study with 104 relatives of patients submitted to surgery who were in the waiting room of a Surgical Center. The Sociodemographic Characterization Form and Perceived Stress Scale were used. Results: The highest averages of the Perceived Stress Scale belong to women over 40 years of age, without partners, with children, who receive less than three minimum wages and who attended high school, with a statistically significant difference observed for sex exclusively. In general, the family members were in a low level of stress. Conclusion: The waiting room in Surgical Center can contribute with the emergence of feelings like anxiety, nervousness and consequently stress. It is important to include the family member in nursing care, which includes providing information, dialogue and respect. (AU)

Objetivo: evaluar el estrés percibido de familiares de pacientes en sala de espera de un Centro Quirúrgico y relacionarlo con variables sociodemográficas. Metodología: estudio transversal con 104 familiares de pacientes sometidos a la cirugía que estaban en la sala de espera de un Centro Quirúrgico. Se utilizó el Formulario de Caracterización Sociodemográfica y Escala de estrés percibido. Resultados: Las mayores medias de la Escala de estrés percibido pertenecen a las mujeres, mayores de 40 años, sin compañero, con hijos, que reciben menos de tres salarios mínimos y que cursaron la enseñanza media, con diferencia estadística significativa observada para variable sexo, exclusivamente. En general, los familiares se encontraban a un nivel bajo de estrés. Conclusión: La espera en sala de Centro Quirúrgico puede contribuir con el surgimiento de sentimientos como ansiedad, nerviosismo y consecuentemente estrés. Es importante incluir al familiar en el cuidado de enfermería, que incluye la prestación de informaciones, diálogo y respeto. (AU)