[Social participation in Chile's healthcare system: Reflective contributions from bioethics.] / Participación social en el sistema de salud de Chile: aportes reflexivos desde la bioética.

Social participation in health is related to the ability of collectives to intervene in the healthcare system. From a bioethical perspective, the relevance of social participation in health has been emphasized due to its positive effects at the level of social groups, the healthcare structure, and democratic political systems. To ensure social participation in health, bioethics advocates for the incorporation of deliberation as a tool for making binding decisions. The aim of this essay is to reflect on social participation in the history of Chile's healthcare system from a bioethical perspective. The main reflections indicate that participation is consultative in nature, lacking deliberation and, therefore, the distribution of power. Additionally, social participation has been redefined under the label of "citizen," promoting an instrumental, individual, and client-oriented character in healthcare. To subvert this situation, it is necessary to incorporate bioethical reflections into the healthcare structure to enable communities to consistently influence the healthcare system.

La participación social en salud se relaciona con la capacidad de intervención de los colectivos en el sistema sanitario. Desde la bioética, se ha enfatizado en la relevancia de la participación social en salud debido a los efectos positivos a nivel de los grupos sociales, de la estructura sanitaria y de los sistemas políticos democráticos. Para asegurar la participación social en salud, la bioética aboga por la incorporación de la deliberación como herramienta para la toma de decisiones vinculantes. El objetivo del presente ensayo es reflexionar sobre la participación social en la historia del sistema de salud de Chile desde la óptica de la bioética. Las principales reflexiones indican que la participación es de tipo consultiva, sin deliberación y, por tanto, sin distribución de poder. Asimismo, la participación social fue resignificada por la etiqueta de "ciudadana", potenciando el carácter instrumental, individual y clientelar en salud. Para subvertir esta situación, se requiere incluir reflexiones bioéticas en la estructura sanitaria con el propósito que las comunidades puedan incidir de manera consistente en el sistema de salud.

Efficacy of pelvic floor physiotherapy intervention for stress urinary incontinence in postmenopausal women: systematic review.

INTRODUCTION AND HYPOTHESIS: Our objective was to evaluate the effectiveness of pelvic floor physiotherapy interventions for stress urinary incontinence (SUI) in postmenopausal women. METHODS: Searches were performed in MEDLINE/PubMed, PEDro, Cochrane Library Registry and LILACS databases until October 2021. Only randomized controlled trials (RCTs) which had physiotherapy interventions as primary outcome were included. There were no restrictions on the year of publication or language. Qualitative methodology was evaluated using the PEDro scale. RESULTS: After applying inclusion/exclusion criteria and quality control, 6 randomized controlled trials were included in this systematic review. Methodological quality of trials varied from 5 to 8 (out of 10 possible points in PEDro scale score). Sample consisted of 715 subjects; mean age was between 51.6 and 66.3 years; SUI severity scale ranged from small to severe. Interventions were pelvic floor muscle training (PFMT); vaginal cone (VC); biofeedback (BF); electrical muscle stimulation (EMS); radiofrequency (RF) and electroacupuncture (EA). Pelvic floor physiotherapy was effective in all studies, however, meta-analysis was considered irrelevant due to the heterogeneity of the reported interventions. CONCLUSION: There is not a literature consensus about the most effective pelvic floor physiotherapy intervention applied to stress urinary incontinence in postmenopausal women. It seems appropriate to state that further randomized controlled clinical trials should be done, due to the limited number of studies and heterogeneity of physiotherapeutic interventions applied to date. TRIAL REGISTRATION: This systematic review is registered in PROSPERO in the trial registration CRD42021255062.

Participación social en el sistema de salud de Chile: aportes reflexivos desde la bioética / Social participation in Chile's healthcare system: Reflective contributions from bioethics

RESUMEN La participación social en salud se relaciona con la capacidad de intervención de los colectivos en el sistema sanitario. Desde la bioética, se ha enfatizado en la relevancia de la participación social en salud debido a los efectos positivos a nivel de los grupos sociales, de la estructura sanitaria y de los sistemas políticos democráticos. Para asegurar la participación social en salud, la bioética aboga por la incorporación de la deliberación como herramienta para la toma de decisiones vinculantes. El objetivo del presente ensayo es reflexionar sobre la participación social en la historia del sistema de salud de Chile desde la óptica de la bioética. Las principales reflexiones indican que la participación es de tipo consultiva, sin deliberación y, por tanto, sin distribución de poder. Asimismo, la participación social fue resignificada por la etiqueta de "ciudadana", potenciando el carácter instrumental, individual y clientelar en salud. Para subvertir esta situación, se requiere incluir reflexiones bioéticas en la estructura sanitaria con el propósito que las comunidades puedan incidir de manera consistente en el sistema de salud.

ABSTRACT Social participation in health is related to the ability of collectives to intervene in the healthcare system. From a bioethical perspective, the relevance of social participation in health has been emphasized due to its positive effects at the level of social groups, the healthcare structure, and democratic political systems. To ensure social participation in health, bioethics advocates for the incorporation of deliberation as a tool for making binding decisions. The aim of this essay is to reflect on social participation in the history of Chile's healthcare system from a bioethical perspective. The main reflections indicate that participation is consultative in nature, lacking deliberation and, therefore, the distribution of power. Additionally, social participation has been redefined under the label of "citizen," promoting an instrumental, individual, and client-oriented character in healthcare. To subvert this situation, it is necessary to incorporate bioethical reflections into the healthcare structure to enable communities to consistently influence the healthcare system.

The Text Mining Technique Applied to the Analysis of Health Interventions to Combat Congenital Syphilis in Brazil: The Case of the "Syphilis No!" Project.

Congenital syphilis (CS) remains a threat to public health worldwide, especially in developing countries. To mitigate the impacts of the CS epidemic, the Brazilian government has developed a national intervention project called "Syphilis No." Thus, among its range of actions is the production of thousands of writings featuring the experiences of research and intervention supporters (RIS) of the project, called field researchers. In addition, this large volume of base data was subjected to analysis through data mining, which may contribute to better strategies for combating syphilis. Natural language processing is a form of knowledge extraction. First, the database extracted from the "LUES Platform" with 4,874 documents between 2018 and 2020 was employed. This was followed by text preprocessing, selecting texts referring to the field researchers' reports for analysis. Finally, for analyzing the documents, N-grams extraction (N = 2,3,4) was performed. The combination of the TF-IDF metric with the BoW algorithm was applied to assess terms' importance and frequency and text clustering. In total, 1019 field activity reports were mined. Word extraction from the text mining method set out the following guiding axioms from the bigrams: "confronting syphilis in primary health care;" "investigation committee for congenital syphilis in the territory;" "municipal plan for monitoring and investigating syphilis cases through health surveillance;" "women's healthcare networks for syphilis in pregnant;" "diagnosis and treatment with a focus on rapid testing." Text mining may serve public health research subjects when used in parallel with the conventional content analysis method. The computational method extracted intervention activities from field researchers, also providing inferences on how the strategies of the "Syphilis No" Project influenced the decrease in congenital syphilis cases in the territory.

Chemical composition and larvicidal activity of the essential oil of Pimenta dioica leaves / Composición química y actividad larvicida del aceite esencial de hojas de Pimenta dioica

In this study, we investigated the main constituent, the predominant class and biological activity of the essential oil extracted from the leaves of Pimenta dioica and the pattern of the major constituent against larvae in the third stage of Aedes aegypti. For this reason, we extracted the oil by hydrodistillation, identified its components by gas chromatography coupled with mass spectrometry (GC/MS) and calculated the lethal concentration (LC50) of the larvicidal activity using the Reed-Muench method. The results show that the oil consists mainly of eugenol, in which the phenylpropanoid class predominated and the lethal concentration, LC50, was 38.86 µg mL-1at a confidence level of 2.25 µg mL-1, while the eugenol standard presented LC5079.75 µg mL-1at a confidence level of 2.10 µg mL-1. Given the facts, we conclude that the oil is more active than the standard and that it has the potential to replace chemical larvicides.

En este estudio, investigamos el constituyente principal, la clase predominante y la actividad biológica del aceite esencial extraído de las hojas de Pimenta dioica y el patrón del constituyente principal contra las larvas en la tercera etapa de Aedes aegypti. Por este motivo, extrajimos el aceite por hidrodestilación, identificamos sus componentes mediante cromatografía de gases acoplada a espectrometría de masas (GC/MS) y calculamos la concentración letal (CL50) de la actividad larvicida mediante el método Reed-Muench. Los resultados muestran que el aceite está constituido principalmente por eugenol, en el que predominó la clase fenilpropanoide y la concentración letal, CL50, fue de 38,86 µg.mL-1 a un nivel de confianza de 2,25 µg.mL-1, mientras que el estándar de eugenol presentó CL50 79,75 µg.mL -1 a un nivel de confianza de 2,10 µg.mL-1. Dados los hechos, concluimos que el aceite es más activo que el estándar y que tiene el potencial de reemplazar los larvicidas químicos.

Chemical composition and larvicidal activity of essential oil of the bark of Citrus sinensis (L.) Osbeck / Composição Química e atividade larvicida do óleo essencial das cascas do Citrus sinensis (L.) Osbeck / Composición química y actividad larvicida del aceite esencial de corteza de Citrus sinensis (L.) Osbeck

SUMMARY Aim: We determined the chemical composition and larvicidal activity of the essential oil distilled from the Citrus sinensis (L.) Osbeck husks and the pattern of the major constituent. Materials and methods: For this, we distill the oil by hydrodistillation, identify the components by gas chromatography coupled with mass spectrometry (GC-MS), test the larvicidal activity against Aedes aegypti and calculate the lethal concentration at 50% (LC50) by the Reed-Muench method and the confidence interval by the Pizzi method for both oil and standard. Results: It showed that the oil consists mostly of limonene and showed larvicidal activity (LC50 of 199.01 (± 2.10) μg-mL-1) greater than the lemonade standard (126.03 (± 2.09) μg-mL-1). Conclusion: Therefore, we conclude that distilled oil has the potential to replace chemical larvicides.

RESUMO Objetivo: Determinamos a composição química e a atividade larvicida do óleo essencial destilado das cascas do Citrus sinensis (L.) Osbeck e do padrão do constituinte majoritário. Materiais e métodos: Para isso, destilamos o óleo por hidrodestilação, identificamos os componentes por cromatografía gasosa acoplada à espectrometria de massas (CG-EM), testamos a atividade larvicida contra o Aedes aegypti e calculamos a concentração letal a 50% (CL50) pelo método Reed-Muench e o intervalo de confiança pelo método de Pizzi tanto para o óleo quanto para o padrão. Resultados: O óleo é constituído em sua maior parte por limoneno e apresentou atividade larvicida (CL50 de 199.01 (± 2,10) μg-mL-1) maior que o padrão limonento (126,03 (± 2,09) μg-mL-1). Conclusões: Portanto, concluímos que o óleo destilado tem potencial para substituir os larvicida químicos.

RESUMEN Objetivo: Determinamos la composición química y actividad larvicida del aceite esencial destilado de las cáscaras de Citrus sinensis (L.) Osbeck y el patrón del constituyente mayoritario. Materiales y métodos: Para ello destilamos el aceite por hidrodestilación, identificamos los componentes mediante cromatografía de gases acoplada a espectrometría de masas (CG-EM), testeamos la actividad larvicida frente a Aedes aegypti y calculamos la concentración letal al 50% (CL50) por el método Reed- Muench y el intervalo de confianza por el método de Pizzi tanto para aceite como para la muestra estándar. Resultados: El aceite consiste principalmente en limoneno y mostró actividad larvicida (CL50 de 199,01 (± 2,10) μg-mL-1) mayor que el estándar de limonada (126,03 (± 2,09) μg-mL-1). Conclusiones: Por lo tanto, concluimos que el aceite destilado tiene el potencial de reemplazar los larvicidas químicos.

Composição química e atividade antibacteriana do óleo essencial dos frutos da Pimenta dioica / Chemical composition and antibacterial activity of essential oil from fruits of Pimenta dioica

RESUMO Neste estudo descrevemos a extração, composição química e a atividade antibacteriana do óleo essencial extraído dos frutos da Pimenta dioica. Para isso, extraímos o óleo por hidrodestilação; identificamos os compostos por cromatografía gasosa acoplada ao espectrómetro de massa (CG/EM); quantificamos o componente majoritário por espectrometria UV-vis e voltametria; e determinamos a atividade antibacteriana contra Escherichia coli, Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa e Serratia odorifera pelo método de difusão em disco. Os resultados mostraram que o óleo é composto em sua maioria por eugenol e sua quantidade está em, aproximadamente, 78,15%, cuja classe predominante foi a dos monoterpenos. Além disso, as bactérias testadas com o óleo essencial apresentaram halos de inibição, variando de 11 a 21 mm. Portanto, o óleo é um potencial agente antibacteriano.

SUMMARY In this study we describe the extraction, chemical composition, and antibacterial activity of the essential oil extracted from fruits of Pimenta dioica. For this, we extracted the oil by hydrodistillation; we identified the compounds by Gas Chromatography coupled to the Mass Spectrometer (CG/MS); we quantified the major component by vis-UV Spectrometry and Voltammetry; and we determined the antibacterial activity against Escherichia coli, Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa, and Serratia odorifera, using the disk diffusion method. The results showed that the oil is composed mostly of eugenol and its quantity is approximately 78.15%, whose predominant class was that of monoterpenes. In addition, the bacteria tested with the essential oil showed inhibition halos, ranging from 11 to 21 mm. Therefore, the oil is a potential antibacterial agent.

Drivers of multidimensional eco-innovation: empirical evidence from the Brazilian industry.

The study analyses the relationships between the main drivers of eco-innovation introduced by innovative industries, focused on cooperation strategy. Eco-innovation is analysed by means of a multidimensional identification strategy, showing the relationships between the independent variables and the variable of interest. The literature discussing environmental innovation is different from the one discussing other types of innovation inasmuch as it seeks to grasp its determinants and to mostly highlight the relevance of environmental regulation. The key feature of this paper is that it ascribes special relevance to cooperation strategy with external partners and to the propensity of innovative industry introducing eco-innovation. A sample of 35,060 Brazilian industries were analysed, between 2003 and 2011, by means of Binomial, Multinomial and Ordinal logistic regressions with microdata collected with the research and innovation department (PINTEC) from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística). The econometric results estimated by the Logit Multinomial method suggest that the cooperation with external partners practiced by innovative industries facilitates the adoption of eco-innovation in dimension 01 with probability of 64.59%, 57.63% in dimension 02 and 81.02% in dimension 03. The data reveal that the higher the degree of eco-innovation complexity, the harder industries seek to obtain cooperation with external partners. When calculating with the Logit Ordinal and Binomial models, cooperation increases the probability that the industry is eco-innovative in 65.09% and 89.34%, respectively. Environmental regulation and innovation in product and information management were also positively correlated as drivers of eco-innovation.

Schistosomiasis mansoni in families of fishing workers of endemic area of Alagoas / Esquistosomiasis mansónica en familias de trabajadores de la pesca de área endémica de Alagoas / Esquistossomose mansônica em famílias de trabalhadores da pesca de área endêmica de Alagoas

Abstract Objective: To analyze the epidemiological and clinical aspects involved in the transmission and manifestation of schistosomiasis in a community of fishermen from the endemic area of Alagoas. Methods: Epidemiological, transversal, prospective, descriptive, quantitative study. The coproparasitological survey included 275 family units of fish workers and the epidemiological and clinical ones, those with a positive diagnosis for S. mansoni. Results: The prevalence of schistosomiasis was 13.9% (fishermen), 2.1% (shellfish) and 2.1% (family members). The occurrence of the infection varied according to gender, age, ethnicity and socioeconomic status. Exposure occurred near the home. Autochthonous and predominant low parasite burden, intestinal clinical presentation, abdominal pain and diarrhea were observed. There were no nutritional and pressure changes associated with parasitosis. Adherence to drug therapy and use of the schistosomicidal drug was feared. Conclusion: Fish workers are at high risk for contracting the disease with clinical hepatointestinal manifestation, which requires more intense health actions.

Resumen Objetivo: Analizar los aspectos epidemiológicos y clínicos involucrados en la transmisión y manifestación de la esquistosomiasis en una comunidad de pescadores de área endémica de Alagoas. Métodos: Estudio epidemiológico, transversal, prospectivo, descriptivo, cuantitativo. La encuesta coproparasitológica contempló 275 unidades familiares de los trabajadores de la pesca y el epidemiológico y clínico, aquellos con diagnóstico positivo para S. mansoni. Resultados: La prevalencia de la esquistosomiasis fue 13,9% (pescadores), 2,1% (marisqueras) y 2,1% (familiares). La ocurrencia de la infección varió según el género, edad, etnia y condición socioeconómica. La exposición ocurrió cerca del domicilio. Se observó autoctonía y predominio de carga parasitaria baja, presentación clínica intestinal, dolor abdominal y diarrea. No hubo alteraciones nutricionales y presión arterial asociadas a la parasitosis. Existia el temor de la adhesión a la terapia medicamentosa y al uso de la droga esquistomicida. Conclusión: Los trabajadores de la pesca presentan alto riesgo para contraer la enfermedad con manifestación clínica hepatointestinal, lo que requiere acciones de salud más intensas.

Resumo Objetivo: Analisar os aspectos epidemiológicos e clínicos envolvidos na transmissão e manifestação da esquistossomose em uma comunidade de pescadores de área endêmica de Alagoas. Métodos: Estudo epidemiológico, transversal, prospectivo, descritivo, quantitativo. O inquérito coproparasitólogico contemplou 275 unidades familiares de trabalhadores da pesca e o epidemiológico e clínico, àqueles com diagnóstico positivo para S. mansoni. Resultados: A prevalência da esquistossomose foi 13,9% (pescadores), 2,1% (marisqueiras) e 2,1% (familiares). A ocorrência da infecção variou conforme gênero, idade, etnia e condição socioeconômica. A exposição ocorreu próxima ao domicílio. Observou-se autoctonia e predominância de carga parasitária baixa, apresentação clínica intestinal, dor abdominal e diarreia. Não ocorreram alterações nutricionais e pressóricas associadas à parasitose. Houve receio na adesão à terapêutica medicamentosa e ao uso do fármaco esquistossomicida. Conclusão: Os trabalhadores da pesca apresentam alto risco para contrair a doença com manifestação clínica hepatointestinal, o que requer ações de saúde mais fortalecidas.

Ecobiological context of home visits from the perspective of users in the municipality of Aracaju, state of Sergipe - SE, Brazil / Contexto ecobiológico da visita domiciliar sob a perspectiva dos usuários no município de Aracaju/SE

A quantitative study was conducted in the municipality of Aracaju/State of Sergipe - SE, Brazil, to construct and analyse the ecomap of users (216 users) who received a home visit from the Family Health Teams (Equipes de Saúde da Família). The study showed that half of the users (50.5%) were over 60 years old, 77.8% were female, 68.0% had a low educational level, 49.1% were retired, 83.3% reported being bedridden, 53.2% reported a chronic injury as the reason for having the visit, 62.5% did not know the nursing assistant professional, 58.8% had a family caregiver, 94.4% considered the visit important, and 75.9% were informed about their right to a visit but considered it a privilege. The home visit is perfectly feasible, humanising and welcoming; it is a unique opportunity to immerse into and get to know the environment of families, delivering services in a more humane and welcoming space.

Estudo quantitativo realizado no município de Aracaju/Se que objetivou a construção e análise de ecomapa do universo de usuários (216 usuários) que receberam visita domiciliar das Equipes de Saúde da Família. O estudo revelou que metade dos usuários (50,5%) tinham mais de 60 anos, 77,8% eram do gênero feminino, 68,0% com baixa escolaridade, 49,1% aposentados; 83,3% relataram o fato de estarem acamados e 53,2% referiram agravo crônico como motivo para receber a visita, 62,5% desconheciam o profissional auxiliar de enfermagem, 58,8% tinham cuidador familiar, 94,4% consideravam a visita importante e 75,9% foram informados do direito a visita, mas a consideravam um privilégio. A visita domiciliar é perfeitamente exeqüível, humanizadora e acolhedora; é uma oportunidade ímpar de imergir e conhecer o ambiente das famílias, prestando atendimento em espaço mais humano e acolhedor.

Computerized Auditory Training in Students: Electrophysiological and Subjective Analysis of Therapeutic Effectiveness.

Introduction Computerized auditory training (CAT) has been building a good reputation in the stimulation of auditory abilities in cases of auditory processing disorder (APD). Objective To measure the effects of CAT in students with APD, with typical or atypical phonological acquisition, through electrophysiological and subjective measures, correlating them pre- and post-therapy. Methods The sample for this study includes14 children with APD, subdivided into children with APD and typical phonological acquisition (G1), and children with APD and atypical phonological acquisition (G2). Phonological evaluation of children (PEC), long latency auditory evoked potential (LLAEP) and scale of auditory behaviors (SAB) were conducted to help with the composition of the groups and with the therapeutic intervention. The therapeutic intervention was performed using the software Escuta Ativa (CTS Informática, Pato Branco, Brazil) in 12 sessions of 30 minutes, twice a week. For data analysis, the appropriate statistical tests were used. Results A decrease in the latency of negative wave N2 and the positive wave P3 in the left ear in G1, and a decrease of P2 in the right ear in G2 were observed. In the analysis comparing the pre- and post-CAT groups, there was a significant difference in P1 latency in the left ear and P2 latency in the right ear, pre-intervention. Furthermore, eight children had an absence of the P3 wave, pre-CAT, but after the intervention, all of them presented the P3 wave. There were changes in the SAB score pre- and post-CAT in both groups. The presence of correlation between the scale and some LLAEP components was observed. Conclusion The CAT produced an electrophysiological modification, which became evident in the effects of the effects of neural plasticity after CAT. The SAB proved to be useful in measuring the therapeutic effects of the intervention. Moreover, there were behavioral changes in the SAB (higher scores) and correlation with LLAEP.

Computerized Auditory Training in Students: Electrophysiological and Subjective Analysis of Therapeutic Effectiveness

Abstract Introduction Computerized auditory training (CAT) has been building a good reputation in the stimulation of auditory abilities in cases of auditory processing disorder (APD). Objective To measure the effects of CAT in students with APD, with typical or atypical phonological acquisition, through electrophysiological and subjective measures, correlating them pre- and post-therapy. Methods The sample for this study includes14 children with APD, subdivided into children with APD and typical phonological acquisition (G1), and children with APD and atypical phonological acquisition (G2). Phonological evaluation of children (PEC), long latency auditory evoked potential (LLAEP) and scale of auditory behaviors (SAB) were conducted to help with the composition of the groups and with the therapeutic intervention. The therapeutic intervention was performed using the software Escuta Ativa (CTS Informática, Pato Branco, Brazil) in 12 sessions of 30 minutes, twice a week. For data analysis, the appropriate statistical tests were used. Results A decrease in the latency of negative wave N2 and the positive wave P3 in the left ear in G1, and a decrease of P2 in the right ear in G2 were observed. In the analysis comparing the pre- and post-CAT groups, there was a significant difference in P1 latency in the left ear and P2 latency in the right ear, pre-intervention. Furthermore, eight children had an absence of the P3 wave, pre-CAT, but after the intervention, all of them presented the P3 wave. There were changes in the SAB score pre- and post-CAT in both groups. The presence of correlation between the scale and some LLAEP components was observed. Conclusion The CAT produced an electrophysiological modification, which became evident in the effects of the effects of neural plasticity after CAT. The SAB proved to be useful in measuring the therapeutic effects of the intervention. Moreover, there were behavioral changes in the SAB (higher scores) and correlation with LLAEP.

Evaluation of facial attractiveness in black people according to the subjective facial analysis criteria.

OBJECTIVE: The objective of this study was to evaluate the facial attractiveness in 30 black individuals, according to the Subjective Facial Analysis criteria. METHODS: Frontal and profile view photographs of 30 black individuals were evaluated for facial attractiveness and classified as esthetically unpleasant, acceptable, or pleasant by 50 evaluators: the 30 individuals from the sample, 10 orthodontists, and 10 laymen. Besides assessing the facial attractiveness, the evaluators had to identify the structures responsible for the classification as unpleasant and pleasant. Intraexaminer agreement was assessed by using Spearman's correlation, correlation within each category using Kendall concordance coefficient, and correlation between the 3 categories using chi-square test and proportions. RESULTS: Most of the frontal (53. 5%) and profile view (54. 9%) photographs were classified as esthetically acceptable. The structures most identified as esthetically unpleasant were the mouth, lips, and face, in the frontal view; and nose and chin in the profile view. The structures most identified as esthetically pleasant were harmony, face, and mouth, in the frontal view; and harmony and nose in the profile view. The ratings by the examiners in the sample and laymen groups showed statistically significant correlation in both views. The orthodontists agreed with the laymen on the evaluation of the frontal view and disagreed on profile view, especially regarding whether the images were esthetically unpleasant or acceptable. CONCLUSIONS: Based on these results, the evaluation of facial attractiveness according to the Subjective Facial Analysis criteria proved to be applicable and to have a subjective influence; therefore, it is suggested that the patient's opinion regarding the facial esthetics should be considered in orthodontic treatmentplanning.

Equipamentos de proteção individual utilizados por profissionais de enfermagem em centros de material e esterilização / Personal protective equipment used by nursing professionals in materials and sterilization centers / Equipos de protección individual utilizados por profesionales de enfermería en centros de material y esterilización

Objetivo: Verificar o uso de equipamento de proteção individual (EPI) por profissionais de Enfermagem em Centros de Material e Esterilização (CME). Método: Estudo quantitativo, realizado com 50 profissionais em dois hospitais de João Pessoa, Paraíba, por meio da aplicação de um questionário semiestruturado. Este trabalho foi aprovado pelo Comitê de Ética e Pesquisa (CEP), sob CAEE número 47355315.3.0000.5183. Resultados: Constatou-se que, entre os participantes, 96% são do sexo feminino, 36% têm técnico de Enfermagem e 58% contam mais de 10 anos de experiência. Quanto ao uso de EPI, 74% os utilizam frequentemente, 40% consideram ter pouca qualidade, 50% acham desnecessário e 68% não se adaptam às atividades. Estiveram expos-tos a risco ocupacional 74% dos profissionais. Participaram de treinamento sobre o tema 66% dos entrevistados e 98% reconheceram a importância da capacitação. Conclusão: Resultados apontam que os profissionais não usam regularmente os EPI, expondo-se aos riscos. Ressalta-se a necessidade de realização de uma educação permanente a fim de sensibilizá-los quanto aos cuidados.

Objective: To verify the use of personal protective equipment (PPE) by Nursing professionals in Central Sterile Supply Department (CSSD). Method: Quantitative study conducted with 50 professionals in two hospitals of João Pessoa, Paraíba, with the application of a semi-structured ques-tionnaire. This study was approved by the Research Ethics Committee, CAEE number 47355315.3.0000.5183. Results: Among the participants, 96% are female, 36% have technical nursing courses, and 58% report having more than 10 years of experience. As to the use of PPE, 74% use it frequently, 40% consider it to have low quality, 50% think it is unnecessary, and 68% do not adjust to the activities. Seventy-four percent of the professionals were expo-sed to occupational risk. The training reached 66% of the interviewees, and 98% recognized its importance. Conclusion: The results indicate that pro-fessionals do not use PPE regularly, and are therefore exposed to risk. It is important to emphasize the need to provide continuous education in order to increase the awareness regarding care.

Objetivo: Verificar el uso de equipo de protección individual (EPI) por profesionales de Enfermería en Centros de Material y Esterilización (CME). Método: Estudio cuantitativo, realizado con 50 profesionales en dos hospitales de João Pessoa, Paraíba, por medio de la aplicación de un cuestionario semi-estructurado. Este trabajo fue aprobado por el Comité de Ética e Investigación (CEP), bajo CAEE número 47355315.3.0000.5183. Resultados: Se constató que, entre los participantes, el 96% es del sexo femenino, un 36% tiene técnico de Enfermería y un 58% cuenta más de 10 años de experiencia. Cuanto al uso de EPI, el 74% los utiliza frecuentemente, un 40% considera tener poca calidad, un 50% lo cree innecesario y un 68% no se adapta a las actividades. Estuvieron expuestos a riesgo ocupacional el 74% de los profesionales. Participaron de capacitación sobre el tema el 66% delos entrevistados y el 98% reconoció la importancia de la capacitación. Conclusión: Resultados apuntan que los profesionales no usan regularmente los EPI, exponiéndose a los riesgos. Se destaca la necesidad de realización de una educación permanente a fin de sensibilizarlos cuanto a los cuidados.

Impacto do Programa "Bolsa Família" sobre a qualidade da dieta das famílias de Pernambuco no Brasil / The impact of the "Bolsa Família" Program on household diet quality, Pernambuco State, Brazil

Resumo Este artigo analisa o impacto do Programa Bolsa Família (PBF) sobre a qualidade da dieta dos domicílios do estado de Pernambuco utilizando dados da Pesquisa de Orçamento Familiar (POF-IBGE) entre 2008-2009. O método Propensity Score Matching, que corrige o viés de seleção amostral, foi utilizado para realizar a comparação entre as famílias beneficiárias e as não beneficiárias do Programa. Os resultados mostram que o valor médio do Índice de Qualidade da Dieta (IQD) para as famílias beneficiárias do Programa supera em 9,05 o valor médio do IQD das famílias não participantes do PBF. Os resultados corroboram a eficácia do PBF em elevar a qualidade da dieta das famílias, principalmente quanto à redução de gordura e sódio, e aumento da variedade.

Abstract This article analyzes the impact of the Bolsa Família Program (BFP) on the quality of dietsamong households from Pernambuco State using data from the 2008-2009 Brazilian Household Budget Survey. The propensity score matching method, which corrects the sample selection bias, was used to make a comparison between beneficiary families and beneficiaries not in the program. The results show that beneficiary families in the Program scored, on average, 9.05 more on the Diet Quality Index (DQI), compared with families not participating in the BFP. The results point to the effectiveness of the BFP in improving the quality of family diets, particularly in reducing fat and sodium, and increasing variety.

Evaluation of facial attractiveness in black people according to the subjective facial analysis criteria

ABSTRACT Objective: The objective of this study was to evaluate the facial attractiveness in 30 black individuals, according to the Subjective Facial Analysis criteria. Methods: Frontal and profile view photographs of 30 black individuals were evaluated for facial attractiveness and classified as esthetically unpleasant, acceptable, or pleasant by 50 evaluators: the 30 individuals from the sample, 10 orthodontists, and 10 laymen. Besides assessing the facial attractiveness, the evaluators had to identify the structures responsible for the classification as unpleasant and pleasant. Intraexaminer agreement was assessed by using Spearman's correlation, correlation within each category using Kendall concordance coefficient, and correlation between the 3 categories using chi-square test and proportions. Results: Most of the frontal (53. 5%) and profile view (54. 9%) photographs were classified as esthetically acceptable. The structures most identified as esthetically unpleasant were the mouth, lips, and face, in the frontal view; and nose and chin in the profile view. The structures most identified as esthetically pleasant were harmony, face, and mouth, in the frontal view; and harmony and nose in the profile view. The ratings by the examiners in the sample and laymen groups showed statistically significant correlation in both views. The orthodontists agreed with the laymen on the evaluation of the frontal view and disagreed on profile view, especially regarding whether the images were esthetically unpleasant or acceptable. Conclusions: Based on these results, the evaluation of facial attractiveness according to the Subjective Facial Analysis criteria proved to be applicable and to have a subjective influence; therefore, it is suggested that the patient's opinion regarding the facial esthetics should be considered in orthodontic treatmentplanning.

RESUMO Objetivo: avaliar, quanto à agradabilidade facial, uma amostra de 30 indivíduos negros, de acordo com os critérios da Análise Facial Subjetiva. Métodos: fotografias frontais e de perfil de 30 indivíduos negros foram avaliadas quanto à agradabilidade facial e classificadas como esteticamente desagradáveis, aceitáveis ou agradáveis, por 50 avaliadores, sendo: 30 indivíduos da amostra, 10 ortodontistas e 10 leigos. Além de avaliar a agradabilidade facial, os avaliadores tiveram que identificar as estruturas responsáveis pela classificação como desagradável ou agradável. A concordância intraexaminador foi avaliada por meio da correlação de Spearman. Já a correlação dentro de cada categoria foi analisada por meio do coeficiente de concordância de Kendall, e a correlação entre as três categorias foi estabelecida por meio dos testes qui-quadrado e de proporção. Resultados: a maioria das fotografias frontais (53,5%) e de perfil (54,9%) foi classificada como esteticamente aceitável. As estruturas mais identificadas como esteticamente desagradáveis foram: boca, lábios e rosto, na fotografia frontal; e nariz e queixo, na fotografia de perfil. As estruturas mais identificadas como esteticamente agradáveis foram: harmonia, rosto e boca, na fotografia de frente; e harmonia e nariz, na de perfil. As avaliações realizadas pelos examinadores nos grupos amostra e leigos mostraram uma correlação estatisticamente significativa em ambas as posições. Os ortodontistas concordaram com os leigos sobre a avaliação na perspectiva frontal e discordaram sobre a de perfil, especialmente no que diz respeito às imagens consideradas esteticamente desagradáveis ou aceitáveis. Conclusões: com base nesses resultados, a avaliação da agradabilidade facial, de acordo com critérios da Análise Facial Subjetiva, provou ser aplicável e ter uma influência subjetiva. Assim, sugere-se que a opinião do paciente sobre a estética facial seja considerada no planejamento do tratamento ortodôntico.

Programa de reabilitação auditiva: mudanças na autopercepção de restrição de participação em idosos / Aural rehabilitation program: changes in self-perceived participation restrictions on the elderly

Objetivo: Este estudo visa a apresentar um Programa de Reabilitação Auditiva voltado aos idosos, usuários de próteses auditivas, caracterizando a população atendida neste programa quanto ao tipo e grau de perda auditiva, idade de início da terapia, tempo de protetização e escolaridade, além de avaliar as mudanças na autopercepção de restrição de participação, após tal intervenção terapêutica. Método: Trata-se de uma pesquisa descritiva e qualitativa. Elaborou-se um Programa de Reabilitação Auditiva, com 12 sessões individuais de atendimento fonoaudiológico voltado ao público da terceira idade e fizeram parte da amostra dez idosos usuários de prótese auditiva bilateral. Para avaliar as mudanças na autopercepção da restrição de participação, utilizou-se o questionário Hearing Handicap Inventory for the Elderly ­ Screening (HHIE-S) em dois momentos distintos, pré e pós-participação, em tal programa. Resultados: Da caracterização da população, observou-se que a maioria tem baixo nível de escolaridade e, na sua maioria, é composta por homens e média de 77 anos de idade no início da terapia de reabilitação auditiva. A autopercepção de restrição de participação dos idosos diminuiu após treinamento auditivo, mostrando que tal intervenção trouxe benefícios a suas vidas. Conclusão: O estudo mostrou que programas de reabilitação auditiva podem acarretar melhora na qualidade de vida da população da terceira idade. (AU)

Objective: It aims to present a Aural Rehabilitation Program for the elderly, users of hearing aids, featuring the population served in this program on the type and degree of hearing loss, age at onset of therapy, prosthetization time and educational level. Besides assessing the changes in self-perceived participation restrictions after such therapeutic intervention. Method: This is a descriptive and qualitative research. It was conducted a Aural Rehabilitation Program, with 12 individual sessions of speech therapy aimed to the public of the third age and the sample consisted of ten elderly user of bilateral hearing aid. To assess changes in self-perceived participation restrictions, was used the Hearing Handicap Inventory for the Elderly ­ Screening questionnaire (HHIE-S) at two different moments, before and after participation in such program. Results: Of the population's characterization, it was observed that the majority have low level of education, mostly composed of men and average of 77 years of age at onset of aural rehabilitation therapy. The self-perceived participation restrictionsof the elderly decreased after auditory training, showing that suchintervention brought benefits to their lives. Conclusion: The study found that aural rehabilitation programs can lead to improvements in quality of life on the elderly population. (AU)

Cortical auditory evoked potentials in full-term and preterm neonates. / Potenciais evocados auditivos corticais em neonatos nascidos a termo e pré-termo.

PURPOSE: To measure the exogenous components of the cortical auditory evoked potential (CAEP) in term and preterm newborns and compare them considering the variables latency and amplitude. METHODS: This is a cross-sectional, prospective, comparative, contemporary study. One hundred twenty-seven newborns were evaluated; 96 of these were included in the study after analysis of the exams by three referees. Participants were divided into two groups: Term Group: 66 infants and Preterm Group: 30 neonates. The recordings of CAEP were performed using surface electrodes with newborns comfortably positioned in the lap of their mothers and/or guardians in natural sleep. To this end, binaural verbal stimuli were presented with /ba/ as the frequent stimulation and /ga/ the rare stimulus, at an intensity of 70 dB HL, through insert earphones. The presence or absence of exogenous components and the latency and amplitude of P1 and N1 were analyzed in both groups. Pertinent tests were used in the statistical analysis of data. RESULTS: The latency of the waves P1 and N1 was smaller in participants in the Term Group. However, there were no statistically significant differences in the amplitude of P1 and N1 between the groups. No difference between the groups was found when comparing the presence and absence of the components P2 and N2. CONCLUSION: It is possible to measure the CAEP in term and preterm neonates. There was influence of the maturational process only on the measure of latency of the components P1, binaurally, and N1, in the left ear, which were smaller in participants in the Term Group.

Potenciais evocados auditivos corticais em neonatos nascidos a termo e pré-termo / Cortical auditory evoked potentials in full-term and preterm neonates

RESUMO Objetivo Mensurar os potenciais exógenos do potencial evocado auditivo cortical (PEAC) em neonatos nascidos a termo e pré-termo, além de compará-los, considerando as variáveis latência e amplitude dos componentes. Método Estudo transversal, prospectivo, contemporâneo e comparativo. Foram avaliados 127 neonatos; destes, foram considerados 96, após análise dos exames por três juízes, distribuídos em dois grupos: Grupo Termo: 66 neonatos e Grupo Pré-termo: 30 neonatos. Os registros do PEAC foram feitos com os neonatos posicionados no colo da mãe e/ou responsável, em sono natural, por meio de eletrodos de superfície. Foram apresentados estímulos verbais binauralmente, sendo /ba/ o estímulo frequente e /ga/ o estímulo raro, na intensidade de 70 dBNA, por meio de fones de inserção. Foi analisada a presença ou ausência dos componentes exógenos em ambos os grupos, bem como, latência e amplitude de P1 e N1. Para análise dos dados, utilizaram-se os testes pertinentes. Resultados A latência da onda P1 bilateralmente e N1 na orelha esquerda foi menor no Grupo Termo. No entanto, não houve diferença estatisticamente significante quanto à amplitude de P1 e N1 entre os grupos. Na comparação entre presença e ausência dos componentes P2 e N2, também não foi observada diferença entre os grupos. Conclusão É possível mensurar os PEAC, em neonatos nascidos a termo e pré-termo. Verificou-se influência do processo maturacional apenas na medida da latência dos componentes P1 bilateralmente e N1 na orelha esquerda, sendo estas menores no Grupo Termo.

ABSTRACT Purpose To measure the exogenous components of the cortical auditory evoked potential (CAEP) in term and preterm newborns and compare them considering the variables latency and amplitude. Methods This is a cross-sectional, prospective, comparative, contemporary study. One hundred twenty-seven newborns were evaluated; 96 of these were included in the study after analysis of the exams by three referees. Participants were divided into two groups: Term Group: 66 infants and Preterm Group: 30 neonates. The recordings of CAEP were performed using surface electrodes with newborns comfortably positioned in the lap of their mothers and/or guardians in natural sleep. To this end, binaural verbal stimuli were presented with /ba/ as the frequent stimulation and /ga/ the rare stimulus, at an intensity of 70 dB HL, through insert earphones. The presence or absence of exogenous components and the latency and amplitude of P1 and N1 were analyzed in both groups. Pertinent tests were used in the statistical analysis of data. Results The latency of the waves P1 and N1 was smaller in participants in the Term Group. However, there were no statistically significant differences in the amplitude of P1 and N1 between the groups. No difference between the groups was found when comparing the presence and absence of the components P2 and N2. Conclusion It is possible to measure the CAEP in term and preterm neonates. There was influence of the maturational process only on the measure of latency of the components P1, binaurally, and N1, in the left ear, which were smaller in participants in the Term Group.

Audiometria de reforço visual em lactentes nascidos a termo e pré-termo: nível mínimo de resposta / Visual reinforcement audiometry in infants who born term and pre-term: minimum response level / Audiometría de refuerzo visual en infantes nacidos a término y pre ­ término: nivel mínimo de respuesta

Objetivo: analisar os Níveis Mínimos de Respostas (nmrs) em lactentes, nascidos a termo e pré-termo e investigar a relação entre os nmrs e os diferentes Indicadores de Risco para Deficiência Auditiva (irdas). Método: a amostra foi composta por 114 lactentes que apresentaram resultado "passa" na Triagem Auditiva Neonatal (TAN), de seis a oito meses de idade, distribuídos em dois grupos conforme a idade gestacional. Grupo Termo: 75 lactentes. Grupo Pré-termo: 39 lactentes. Realizou-se a Audiometria de Reforço Visual (ARV) com o audiômetro pediátrico, buscando os nmrs. Resultados: não houve diferença estatisticamente significante entre NMR em relação ao lado de apresentação. Os nmrs em 2 khz e 4 khz no Grupo Termo foram menores nos bebês do gênero feminino. Ao comparar nmrs dos dois grupos, não houve diferença estatisticamente significante. Os maiores nmrs apareceram entre os lactentes que apresentaram os seguintes IRDA: permanência na Unidade de Terapia Intensiva (UTI), uso de medicação ototóxica, ventilação mecânica e uso de fumo pela mãe durante o período gestacional. Conclusão: não houve diferença estatisticamente significante nos nmrs em relação ao lado de apresentação dos estímulos e entre os grupos. Observou-se que os lactentes do gênero feminino, do Grupo Termo, apresentaram menores nmrs nas frequências de 2KHz e 4KHz. Alguns irdas influenciaram no desempenho dos lactentes na ARV.

Objective: To analyze the Minimum Response Level (MRL) in infants, born term and preterm, considering some variables. In addition, to investigate the relationship between MRL and different Risk Indicators for Hearing Loss (RIHL). Methods: The sample consisted of 114 infants who had result "pass" in Newborn Hearing screening, from six to eight months old, distributed into two groups according to gestational age. Term group: 75 infants and Pre-term group: 39 infants. The Visual Reinforcement Audiometry (VRA) was made with a pediatric audiometer, seeking the MRL. Results: There was no statistically significant difference in the MRL regarding the side of the presentation. The MRL's in 2 khz and 4 khz in the Term Group were lower in female babies. Comparing the MRL between the two groups there was not statistically significant difference. The higher MRL's are among the infants with the following RIHL: Intensive care unit (ICU) hospitalization, use of ototoxic drugs, mechanical ventilation and tobacco use by the mother during pregnancy. Conclusion: There was no statistically significant difference in the MRL regarding the side of the presentation of the stimuli and between groups. It was observed that the female infants of the term group had lower mrls in the frequencies of 2KHz and 4KHz. Some RIHL influenced the performance of infants in the VRA.

Evaluar los Nivel Mínimo de Respuesta(NMRs) en infantes, nacidos a término y pretérmino, teniendo en cuenta algunas variables. Además de investigar la relación entre el NMR y diferentes indicadores de riesgo para la pérdida auditiva(IRPAs). Metodos: La muestra fue constituida por 114 infantes que aprobaran el la Screeening Auditivo para Recién (SARN), com seis a ocho meses, divididos en dos grupos según la edad gestacional. Grupo Término: 75 infantes y Grupo pre-término: 39 infantes. La Audiometría de Refuerzo Visual (ARV) se realizó con el audiómetro pediátrico, buscando el NMR. Resultados: No hubo diferencia estadísticamente significativa entre NMR en relación al lado de la presentación. El NMR en 2 KHz y 4 KHz en el Grupo Término fueron inferiores en bebés de sexo femenino. Al comparar el NMR entre los dos grupos no hubo diferencia estadísticamente significativa. Los infantes que presentaron los IRPA: estancia en la unidad de terapia intensiva (UTI), el uso de medicamentos ototóxicos, la ventilación mecánica y el uso de tabaco por la madre durante el embarazo presentaron mayor NMRs. Conclusión: No hubo diferencia estadísticamente significativa en los NMRs en relación al lado de la presentación de los estímulos y entre los grupos. Se observó que los infantes del sexo femenino del Grupo Término tenían NMRs más bajos en la frecuencia de 2 KHz y 4 KHz. Algunos IRPAs influyen en el rendimiento de los infantes en la ARV.