Awake Prone Positioning in COVID-19 Hypoxemic Respiratory Failure: Exploratory Findings in a Single-center Retrospective Cohort Study.

BACKGROUND: Awake prone positioning has been widely used in patients with COVID-19 respiratory failure to avoid intubation despite limited evidence. Our objective was to evaluate if prone positioning is associated with a reduced intubation rate when compared to usual care. METHODS: This was a retrospective cohort study in the emergency department of a large quaternary hospital in Sao Paulo. We retrieved data from all admitted patients in need of oxygen supplementation (>3 L/min) and tachypnea (>24 ipm) from March 1 to April 30, 2020, excluding those who had any contraindication to the prone position or who had an immediate need for intubation. The primary endpoint was endotracheal intubation up to 15 days. Secondary outcomes included a 6-point clinical outcome ordinal scale, mechanical ventilation-free days, admission to the intensive care unit, and need of hemodialysis and of vasoactive drugs, all assessed at or up to 15 days. We analyzed unadjusted and adjusted effect estimates with Cox proportional hazards models, logistic regression, quantile regression, and sensitivity analyses using propensity score models. RESULTS: Of 925 suspected COVID-19 patients admitted off mechanical ventilation, 166 patients fulfilled inclusion and exclusion criteria: 57 were exposed to prone positioning and 109 to usual care. In the intervention group, 33 (58%) were intubated versus 53 (49%) in the control group. We observed no difference in intubation rates in the univariate analysis (hazard ratio = 1.21, 95% confidence interval [CI] = 0.78 to 1.88, p = 0.39) nor in the adjusted analysis (hazard ratio = 0.90, 95% CI = 0.55 to 1.49, p = 0.69). Results were robust to the sensitivity analyses. Secondary outcomes did not differ between groups. CONCLUSIONS: Awake prone positioning was not associated with lower intubation rates. Caution is necessary before widespread adoption of this technique, pending results of clinical trials.

Associations between maternal responsiveness due to the number of offspring and motor development / Associações entre responsividade materna em função da prole e desenvolvimento motor / Asociaciones entre la responsividad maternal en función de la descendencia y desarrollo motor

Maternal responsiveness (MR) is a predictor of the acquisition of motor skills by premature infants. This study aimed to verify associations between MR due to the number of offspring and motor development (MD) in preterm infants. Eighteen dyads participated in this study, divided into three groups: primiparous mothers with twin newborns (PMT), primiparous mothers (PM), and multiparous mothers (MM). Medical Records, the Social Interaction Scale (SIS), and a Motor Development Observation Protocol were used. In the Adaptive Fine Motor Development (AFMD), the PMT group presented more frequent "normal" outcomes (5; 83.3%), with a mean score of 13.2 points in the SIS (p < 0.0001). For those that evolved with "risk," in both AFMD and gross motor development (GMD), the MM group stood out (4; 66.7%), presenting a mean SIS score of 12.1 (p < 0.0001). The MR quality as a function of the offspring number is associated with AFMD and GMD of premature infants in the first year of life.

A responsividade materna (RM) é um preditor da aquisição de habilidades motoras de prematuros. O objetivo deste estudo foi verificar associações entre a RM e o desenvolvimento motor (DM) de prematuros em função do tamanho da prole. Participaram 18 díades, distribuídas em três grupos: mães primíparas e neonatos gemelares (MPG), mães primíparas (MP) e mães multíparas (MM). Utilizaram-se ficha clínica, Escala de Interação Social (EIS) e Protocolo de Observação do DM. No desenvolvimento motor fino adaptativo (DMFA), o grupo MPG apresentou desfecho "normal" mais frequente (5; 83,3%), com escore 13,2 pontos na EIS (p < 0,0001). Entre aqueles que evoluíram com "risco" tanto no DMFA quanto no desenvolvimento motor grosseiro (DMG), o grupo de MM se destacou (4; 66,7%), apresentando escore de 12,1 (p < 0,0001). A qualidade da RM mostrou estar associada com o DMFA e DMG de prematuros no primeiro ano de vida, em função do tamanho da prole.

La responsividad materna (RM) es predictor de la adquisición de habilidades motoras de prematuros. El objetivo de este estúdio fue verificar las asociaciones entre la RM y el desarrollo motor (DM) de los bebés prematuros según el tamaño de la descendencia. Participó 18 díades, en tres grupos: madres primíparas y recién nacidos gemelos (MPG), madres primíparas (MP) y madres multíparas (MM). Se utilizaron ficha clínica, Escala de Interacción social (EIS), Protocolo de Observación del DM. En el Desarrollo Motor Fino Adaptativo (DMFA), el grupo MPG presentado el resultado común más frecuente (5; 83,3%), con una puntuación de 13,2 EIS (p < 0,0001). Los que evolucionaron con "riesgo" en los DMFA y desarrollo motor grueso (DMG), las MM se destacaron (4; 66,7%), con puntuación de 12,1 (p < 0,0001). Calidad de la RM asocia con DMFA y DMG de prematuros en el primero año de vida en función del tamaño de la descendencia.

Kinematic Characteristics of Sit-to-Stand Movements in Patients With Low Back Pain: A Systematic Review.

OBJECTIVE: The purpose of this review was to identify different kinematic characteristics between the movements of sit-to-stand-to-sit, sit-to-stand, or stand-to-sit of individuals with and without low back pain (LBP). METHODS: A systematic search was conducted on scientific databases. The analyzed kinematic variables were duration of the movement, reproduction of the movement, ranges of motion, velocity, and acceleration. The studies were appraised for methodological quality using the Downs & Black scale and for the level of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS: After all screening stages, this systematic review comprised 8 cross-sectional studies. When comparing the patients with LBP vs controls, patients with LBP take longer to perform the sit-to-stand-to-sit, sit-to-stand, and stand-to sit movements (eg, 9.33 ± 1.49 seconds vs 8.29 ± 1.23 seconds in the sit-to-stand-to-sit movement), show decreased mobility of the lumbar spine (eg, 26.21° ± 8.76° vs 32.07° ± 6.77° in the sit-to-stand-to-sit movement) and the hip (eg, 51.0° vs 77.25° in the sit-to-stand movement), present decreased velocity of the trunk (eg, 95.31° ± 25.13°/s vs 138.23° ± 23.42°/s in the sit-to-stand-to-sit movement) and the hip (eg, 46° ± 13°/s vs 69° ± 13°/s in the sit-to-stand movement), and decreased overall acceleration of the trunk (eg, 280.19° ± 113.08°/s2 vs 460.16° ± 101.49°/s2 in the sit-to-stand-to-sit movement), besides presenting greater variability of the trunk (eg, 5.53° ± 0.48° vs 4.32° ± 0.46° in the sit-to-stand movement). CONCLUSION: There are kinematic alterations in the lumbar spine, the hip, and the trunk of patients with LBP. However, information about pelvic and overall trunk mobility, velocity, and acceleration of the lumbar spine; and mobility, speed, and acceleration of hip and pelvis remain incipient in individuals with LBP. Based on the Grading of Recommendations Assessment, Development, and Evaluation criteria, the results of this review indicate that there is low scientific evidence on the characteristics of the kinematic variables (duration of the movement, reproduction of the movement, range of motion, velocity, and acceleration) of the trunk, lumbar spine, pelvis, and hip in patients with LBP.

Running and Walking Foot Loading in Children Aged 4-10 Years.

Although previous reports have provided normative plantar pressure data for walking in children, evaluation during running is lacking. This study aimed to compare foot loading patterns during running and walking in children aged 4-10 years. Furthermore, the relationship between running baropodometric parameters and anthropometric measures was investigated. Foot loading of 120 volunteers was evaluated during running and walking using an Emed AT-4 pressure platform. Analyses were performed for 5 anatomical regions (rearfoot, midfoot, forefoot, hallux, and lesser toes). Higher peak pressure and maximum force values were seen under most foot regions during running in comparison with walking, whereas relative contact area tended to increase only in the midfoot. Data for running indicated that aging explained less than 23% of the variance of plantar loads and contact area. Running foot loads were more associated with height, body mass, and foot length. This study's data described plantar loads under the feet of children were greater during running. Aging was associated with little increase in running plantar loads and larger contact areas. Results may be useful as reference to characterize foot loading during running and in the development of orthoses in clinical applications or products such as sport shoes for children.

Influência do ambiente sobre a funcionalidade de crianças / Influence of the environment on children's functionality / Influencia del ambiente para la funcionalidad de niños

Objetivo: Avaliar o perfil funcional de crianças ribeirinhas a fim de correlacionar a influência do ambiente no desempenho das suas atividades relacionadas ao autocuidado, à mobilidade e à função social. Métodos: Estudo descritivo e transversal realizado no município de Cachoeira do Arari, Pará, comunidade Caracará, em maio de 2017, com 50 crianças, de 5 anos a 7 anos e 6 meses, e seus respectivos cuidadores. Aplicou-se um questionário de identificação infantil como critério de inclusão e avaliaram-se os participantes selecionados por meio do Inventário de Avaliação Pediátrica de Incapacidades (PEDI) e pela entrevista sociodemográfica (ABEP). Submeteram-se os dados ao teste de aderência de Shapiro-Wilk e, em seguida, aos testes do qui-quadrado e de correlação de Pearson, com nível de significância de 5%. Resultados: As crianças apresentaram desempenho funcional adequado para as áreas: Habilidades funcionais em autocuidado (HFAC) (70%, p<0,001); Habilidades funcionais em mobilidade (HFM) (72%, p<0,001); Habilidades funcionais em função social (HFFS) (94%, p<0,001); Assistência do cuidador em autocuidado (ACAC) (94%, p<0,001); Assistência do cuidador em função social (ACFS) (66%, p<0,001), exceto na Assistência do cuidador em mobilidade (ACM). Uma correlação moderadamente positiva foi encontrada entre as áreas: HFFS e HFAC (r=0,618, p<0,001), ACAC e HFAC (r=0,641, p<0,001), ACM e HFM (r=0,673, p<0,001), ACFS e HFAC (r=0,581, p<0,001) e ACFS e HFFS (0,647, p<0,001). Conclusão: Observou-se que as crianças ribeirinhas apresentam perfil funcional adequado à faixa etária e que o ambiente não influenciou negativamente nas suas atividades relacionadas ao autocuidado, à mobilidade e à função social.

Objective: To evaluate the functional profile of riverside children to correlate the influence of the environment on the performance of their activities related to self-care, mobility, and social function. Methods: A descriptive and cross-sectional study conducted in the municipality of Cachoeira do Arari, Pará, Caracará community, in May 2017, with 50 children, aged from 5 years to 7 years and 6 months, and their respective caregivers. A child identification questionnaire was applied as an inclusion criterion and the selected participants were assessed through the Pediatric Disability Assessment Inventory (PEDI) and the sociodemographic interview (ABEP). The data were submitted to the Shapiro-Wilk adherence test and then to the chi-square and Pearson correlation tests, with a significance level of 5%. Results: The children showed adequate functional performance for the following areas: Functional skills in self-care (HFAC) (70%, p <0.001); Functional mobility skills (HFM) (72%, p <0.001); Functional skills in social function (HFFS) (94%, p <0.001); Caregiver assistance in self-care (ACAC) (94%, p <0.001); and Caregiver assistance in social function (ACFS) (66%, p <0.001), except for Mobile caregiver assistance (ACM). A moderately positive correlation was found between the areas: HFFS and HFAC (r = 0.618, p <0.001), ACAC and HFAC (r = 0.641, p <0.001), ACM and HFM (r = 0.673, p <0.001), ACFS and HFAC (r = 0.581, p <0.001), and ACFS and HFFS (0.647, p <0.001). Conclusion: It was observed that riverside children have a functional profile appropriate to the age group and that the environment did not negatively influence their activities related to self-care, mobility, and social function.

Objetivo: Evaluar el perfil funcional de niños ribereños para correlacionar la influencia del ambiente para el rendimiento de sus actividades relacionadas con el auto cuidado, la movilidad y la función social. Métodos: Estudio descriptivo y transversal realizado en el municipio de Cachoeira de Arari, Pará, comunidad Caracará, en mayo de 2017 con 50 niños entre 5 y 7 años y 6 meses y sus respectivos cuidadores. Se aplicó un cuestionario para la identificación infantil como criterio de inclusión y se evaluaron los participantes elegidos a través del Inventario de Evaluación Pediátrica de Discapacidades (IEPD) y por la entrevista sociodemográfica (ABEP). Se ha puesto los datos a la prueba de adherencia de Shapiro-Wilk y, a continuación, a las pruebas de Chi-cuadrado y correlación de Pearson con el nivel de significancia del 5%. Resultados: Los niños presentaron el rendimiento funcional adecuado para las áreas: Habilidades funcionales en el auto cuidado (HFAC) (70%, p<0,001); Habilidades funcionales en la movilidad (HFM) (72%, p<0,001); Habilidades funcionales en la función social (HFFS) (94%, p<0,001); Asistencia del cuidador para el auto cuidado (ACAC) (94%, p<0,001); Asistencia del cuidador para la función social (ACFS) (66%, p<0,001), excepto en la Asistencia del cuidador en la movilidad (ACM). Ha sido encontrada una correlación positiva moderada entre las áreas: HFFS y HFAC (r=0,618, p<0,001), ACAC y HFAC (r=0,641, p<0,001), ACM y HFM (r=0,673, p<0,001), ACFS y HFAC (r=0,581, p<0,001) y ACFS y HFFS (0,647, p<0,001). Conclusión: Se observó que los niños ribereños presentan el perfil funcional adecuado para su franja de edad y que el ambiente no ha influenciado de manera negativa con sus actividades relacionadas con el auto cuidado, la movilidad y la función social.

Plantar pressure distribution during running in early childhood.

INTRODUCTION: Plantar loads represent a reliable estimation of the mechanical efficiency of movement. The aim of this study was to describe and compare plantar pressure measures during running in children 4-6 years of age. METHODS: Twenty-eight children were divided into three groups (4, 5 6 year-olds). Plantar pressure during running at self-selected speed was recorded using an Emed-AT platform (Novel). Contact area, peak pressure, relative maximum force, and relative contact time were analyzed under five different plantar regions. Foot length and dynamic plantar arch index were calculated. The MANOVA and Bonferroni post-hoc were used to compare groups. Level of significance was set at p < 0.05. RESULTS: BMI and arch index did not differ between the age groups. When compared to the younger groups, 6-year-old children produced higher loads of peak pressure (p < 0.01) and maximum force (p < 0.01), larger contact area (p < 0.01) and longer contact time (p < 0.05) under most foot regions, except for maximum force under the midfoot (p < 0.05). CONCLUSIONS: Foot structure and plantar loads during running seem to be still developing in 6-year-olds. These children present different values of peak pressure, maximum force, contact time, and contact area than 4 and 5-year-olds, with higher values in the forefoot and lower values in the midfoot.

Childhood obesity is associated with altered plantar pressure distribution during running.

BACKGROUND: Obesity is associated with higher foot loading during walking. The impact of this condition on running, however, has yet to be elucidated. RESEARCH QUESTION: The purpose of this study was to examine the association between childhood obesity and plantar pressure distribution during running. METHODS: Forty-two volunteers aged 5-10 years took part in this cross-sectional study. Body mass index (BMI) was assessed for obesity classification. Peak plantar pressure was evaluated during running at self-selected speed using an Emed AT-4 pressure platform. RESULTS AND SIGNIFICANCE: BMI was correlated to peak pressure at whole foot (r = 0.340; p = .027), midfoot (r = 0.550; p < .001) and forefoot (r = 0.454; p = .003). Regarding other baropodometric parameters, obese children generated more forces during running compared to their leaner counterparts (all p < .050), except at the hallux. Also, obese children had a larger contact area under all the foot regions (all p < .050). These findings provide evidence that childhood obesity is associated with increased plantar pressure during running at self-selected speeds and support the concept that obese children are at higher risk of developing foot discomfort and pain.

Development and Validation of Prediction Equations for Spinal Curve Angles Based on Skin Surface Measurements.

OBJECTIVE: The purpose of this study was to develop, assess the reliability of, and validate prediction equations that estimate the sagittal curves of the spine from the skin surface. METHODS: Forty digital panoramic radiographs were used to develop the prediction equation, and 59 radiographs were used to assess reliability and validate the equations. For evaluation of the thoracic and lumbar curves, anatomical reference points were marked on the vertebral body, spinous process, and skin surface at the C6, C7, T2, T4, T6, T8, T10, T12, L2, L4, and S2 vertebrae. Three third-degree polynomials were obtained, estimated with the least squares method: inner curves from the centroid of the vertebral bodies and from the apex of the spinous processes and external curve from the skin surface. The magnitude of the curves of each region was estimated based on the angle between tangent lines at several vertebral levels. Prediction equations were obtained (simple linear regression) for the vertebral levels that had the best correlation between the inner and surface curves. The validation of the prediction equations was confirmed using Pearson's correlation (r), Student t test, and root mean square error. The reliability of the method was confirmed using the intraclass correlation coefficient, standard error of measurement, and minimal detectable change (α = 0.05). RESULTS: The best correlations were obtained between the T4-T12 (thoracic) and T10-S2 (lumbar) levels (r > 0.85). For the intrarater and interrater reliability, the correlation was higher than 0.965 and higher than 0.896, respectively. There was a significant and strong correlation between estimated and actual values for the thoracic and lumbar curves, which was confirmed by the t-test results and by the root mean square error inferior to 1°. CONCLUSION: Prediction equations can precisely and accurately estimate the angles of the internal sagittal curves of the spine from the skin surface.

Profissionais de Unidades Básicas de Saúde sobre a triagem neonatal / Professionals in Basic Health Units about neonatal screening

Objetivo Descrever o conhecimento dos profissionais de saúde sobre a triagem neonatal. Métodos Trata-se de um estudo exploratório, descritivo, quantitativo realizado com 122 profissionais de saúde (57 enfermeiros, 57 técnicos de enfermagem e 8 médicos) que trabalhavam nas Unidades Básicas de Saúde de Uberaba, Minas Gerais. Os participantes responderam a um questionário semiestruturado e os dados foram analisados de forma descritiva. Resultados Houve predomínio do sexo feminino (93,5%) e idade média de 39 anos. Quanto às doenças detectadas pela triagem neonatal, a fibrose cística e anemia falciforme foram citadas por 89,4% dos participantes, a fenilcetonúria e hipotireoidismo congênito por 78,9% e 75,6%, respectivamente, e a hiperplasia adrenal congênita por 43,1%. Apenas 24,4% dos participantes mencionaram a deficiência da biotinidase. A maioria dos participantes (aproximadamente 90.0%) citaram que a triagem neonatal dever ser realizada entre o terceiro e o sétimo dias de vida do neonato e que sua finalidade é a detecção de doenças tratáveis. Quanto ao momento ideal para orientações sobre a triagem neonatal, a maioria citou o pré-natal (74,8%) seguido pela alta hospitalar e antes da coleta do exame, com valores de 43,1% cada. Cerca de 30.0% dos participantes não sabiam para onde encaminhar as amostras após a coleta e 70.0% não realizaram reciclagens sobre o assunto. Conclusão Os resultados mostram um conhecimento insuficiente sobre triagem neonatal. Essa lacuna poderia ser preenchida com ações de educação continuada, que proporcionariam uma melhora na qualidade da assistência prestada ao binômio mãe/filho.

Objective Describe health professionals' knowledge of neonatal screening. Methods This was an exploratory, descriptive, and quantitative study with 122 health professionals (57 nurses, 57 nursing technicians, and 8 physicians) who worked at the Basic Health Units of Uberaba, Minas Gerais. Participants answered a semi-structured questionnaire and the data was analyzed in a descriptive way. Results There was a predominance of females (93.5%), and the mean age was 39 years. As for the diseases detected by neonatal screening, cystic fibrosis and sickle cell anemia were mentioned by 89.4% of the participants, phenylketonuria and congenital hypothyroidism by 78.9% and 75.6%, respectively, and congenital adrenal hyperplasia by 43.1%. Only 24.4% of the participants mentioned biotinidase deficiency. The majority (roughly 90.0%) of the participants mentioned that Neonatal Screening should be performed between the 3rd and the 7th day of the newborn's life, and that its purpose is the detection of treatable diseases. Regarding the ideal timing for guidelines on neonatal screening, the majority cited prenatal care (74.8%) followed by hospital discharge, and before the collection of the exam, with values of 43.1% each. About 30.0% of participants did not know where to forward the samples after collection and 70.0% did not undergo refresher courses on the subject. Conclusion The results show an insufficient knowledge about neonatal screening. This gap could be filled with continuous education actions, which would improve the quality of care provided to the mother/child binomial.

Trajetória acadêmica de professoras aposentadas do Serviço Social / Teaching and the academic career of retired teachers of social work

Resumo: A discussão deste texto originou-se de uma pesquisa de pós-doutoramento, no qual se investigam as docentes aposentadas do curso de Serviço Social da UECE. A curiosidade advém de compreender as trajetórias dessas professoras, pioneiras do curso, e perseguir o sentido que atribuíram à prática docente. Foram revelados a relevância da experiência profissional como condição para o magistério, a ausência de mestrado e doutorado na sua formação, além de fortes traços humanistas em seus discursos.

Abstract: The following discussion stemmed from a post-doctoral research, which investigates the retired teachers of UECE's Social Service course. Curiosity is derived from the understanding of the trajectories of these teachers, the pioneers of this Course, and from the pursuit of the meaning which they have granted to teaching practice. The relevance of professional experience has been revealed as a condition for teaching; the inexistence of Masters and Doctorate degrees in their training, plus strong humanistic traits in their speeches.

[Leisure-time physical activity and licit substance use in a population sample of young adults]. / Atividade física de lazer e uso de substâncias lícitas em uma amostra populacional de adultos jovens.

The scope of this study was to assess the prevalence and factors associated with leisure-time physical activity, as well as to verify its association with licit substance use in a population sample of young adults. It is a cross-sectional population-based study with young adults aged between 18 and 35 years old, living in the urban area of the city of Pelotas in the Brazilian State of Rio Grande do Sul. Sample selection was performed by clusters, being composed of 1953 individuals, among the 82 selected census tracts. The practice of physical activity was evaluated using the International Physical Activity Questionnaire (IPAQ). The chi-square and Poisson regression tests were used for statistical analysis. The prevalence of young adults active in leisure-time physical activity was 25.3%; most were single males between 18 and 23 years, belonging to the people in the highest economic bracket and not smoking on a daily basis. Specific strategies should be developed to promote an active and healthy lifestyle, focusing on incentives for older, lower income class women who smoke.

Atividade física de lazer e uso de substâncias lícitas em uma amostra populacional de adultos jovens / Leisure-time physical activity and licit substance use in a population sample of young adults

Resumo O objetivo do estudo foi mensurar a prevalência e os fatores associados à prática de atividade física de lazer, bem como verificar a associação desta com o uso de substâncias lícitas em uma amostra populacional de adultos jovens. Estudo transversal de base populacional com adultos jovens de 18 a 35 anos de idade, residentes da zona urbana da cidade de Pelotas-RS (Brasil). A seleção amostral foi realizada por conglomerados, sendo constituída por 1953 indivíduos, dentre 82 setores censitários sorteados. A prática de atividade física foi avaliada por meio do Questionário Internacional de Atividade Física (IPAQ). Para a análise estatística utilizou-se a regressão de Poisson. A prevalência de jovens ativos em atividade física de lazer foi de 25,3% e esteve associada a ser do sexo masculino, ter entre 18 e 23 anos de idade, pertencer ao maior tercil do indicador econômico nacional e não fazer uso diário de tabaco. Sabendo-se da importância da atividade física de lazer para a saúde, os incentivos para esta prática devem ser focados nos grupos de mulheres, de maior idade, de estratos econômicos inferiores e que fazem uso de tabaco.

Abstract The scope of this study was to assess the prevalence and factors associated with leisure-time physical activity, as well as to verify its association with licit substance use in a population sample of young adults. It is a cross-sectional population-based study with young adults aged between 18 and 35 years old, living in the urban area of the city of Pelotas in the Brazilian State of Rio Grande do Sul. Sample selection was performed by clusters, being composed of 1953 individuals, among the 82 selected census tracts. The practice of physical activity was evaluated using the International Physical Activity Questionnaire (IPAQ). The chi-square and Poisson regression tests were used for statistical analysis. The prevalence of young adults active in leisure-time physical activity was 25.3%; most were single males between 18 and 23 years, belonging to the people in the highest economic bracket and not smoking on a daily basis. Specific strategies should be developed to promote an active and healthy lifestyle, focusing on incentives for older, lower income class women who smoke.

Representações parentais: bases conceituais e instrumento de avaliação / Parental representation: conceptual basis and an instrument of assessment

O conceito da representação mental tem se tornado um constructo relevante na psicanálise, estando associado a diferentes denominações e definições. Desta forma, o objetivo deste artigo é abordar as bases conceituais do constructo da representação parental, na perspectiva da psicanálise contemporânea, a partir da contribuição da teoria das relações objetais e da teoria do apego. Além disso, buscou-se demonstrar as possibilidades de avaliação sobre as representações mentais, principalmente da representação parental sob a perspectiva da criança, destacando o instrumento MacArthur Story Stem Battery (Emde, Wolf & Oppenheim, 2003). Ressalta-se que o entendimento contemporâneo do mundo interno de representações do indivíduo reflete um esquema complexo de transações dialéticas entre as experiências reais, as regras de organização do conhecimento interpessoal e a história pessoal. O MSSB indicou ser um instrumento amplamente utilizado em investigações, com características úteis para o trabalho clínico.(AU)

The concept of mental representation has become a relevant construct in psychoanalysis and is associated with different definitions. Therefore, the aim of this article is to discuss about the conceptual basis of the parental representation, in the modern psychoanalysis perspective, considering the contribution of the object-relations theory and the attachment theory. Moreover, the possibilities of evaluation of the mental representations ­ mainly of the parental representation on the child's perspective ­ using the instrument MacArthur Story Stem Battery (Emde, Wolf & Oppenheim, 2003) ­ were evaluated. It is relevant to emphasize that the modern understanding of the inside world of representations of the person reflects a complex scheme of dialectical transactions among the real experiences, the rules of organization of the interpersonal knowledge and the personal history. The MSSB has been quite a useful instrument, with suitable characteristics for the clinical work.(AU)

A representação materna em crianças com mães depressivas / Maternal representation in children with depressive mothers / La representación materna en niños con madres deprimidas

Pesquisas apontam que a depressão materna é um fator de risco para a psicopatologia infantil. O objetivo deste estudo foi identificar as representações maternas de crianças com mães com Transtorno Depressivo. Trata-se de um estudo de casos múltiplos com três duplas de mãe-criança, tendo as crianças entre 7 e 10 anos. Os instrumentos foram Inventário de Depressão de Beck (BDI), Child Behavior Checklist (CBCL) e MacArthur Story Stem Battery (MSSB), instrumento que utiliza narrativas para avaliar as representações parentais. Nas narrativas infantis, prevaleceram representações maternas disciplinares, associadas a conflitos e pouca afetividade nas interações. Conclui-se que a identificação das características da representação materna é um recurso importante para o desenvolvimento de intervenções psicoterapêuticas adequadas, bem como de programas que visem à prevenção da psicopatologia infantil...

Research indicates that maternal depression is a risk factor for child psychopathology. The aim of this study was to identify maternal representations of children with mothers with Major Depressive Disorder. It is a multiple case study with three pairs of mother-child between 7 and 10 years old. The instruments were the Beck Depression Inventory (BDI), Child Behavior Checklist (CBCL), and MacArthur Story Stem Battery (MSSB), an instrument that uses narratives to assess parental representations. In the children's narratives maternal representations were disciplinary, with conflict and lack of affective interactions. We concluded that the identification of the characteristics of maternal representation is an important resource for the development of appropriate psychotherapeutic interventions, as well as programs aimed at prevention of child psychopathology...

Las investigaciones indican que la depresión materna es un factor de riesgo para la psicopatología infantil. El objetivo de este estudio fue identificar las representaciones maternas de niños con madres con trastorno depresivo. Se trata de un estudio de múltiples casos con tres pares de madre-hijo en que los niños tienen entre 7 y 10 años. Los instrumentos utilizados fueron el Inventario de Depresión de Beck (BDI), Child Behavior Checklist (CBCL) y MacArthur History Stem Battery (MSSB), un instrumento que se utiliza de narrativas para evaluar las representaciones parentales. En las historias de los niños han prevalecido las representaciones maternas disciplinarias, asociadas a conflictos y falta de interacciones afectivas. Se concluye que la identificación de las características de la representación materna es un recurso importante para el desarrollo de intervenciones psicoterapéuticas apropiadas, así como programas destinados a la prevención de la psicopatología infantil...

A representação materna em crianças com mães depressivas / Maternal representation in children with depressive mothers / La representación materna en niños con madres deprimidas

Pesquisas apontam que a depressão materna é um fator de risco para a psicopatologia infantil. O objetivo deste estudo foi identificar as representações maternas de crianças com mães com Transtorno Depressivo. Trata-se de um estudo de casos múltiplos com três duplas de mãe-criança, tendo as crianças entre 7 e 10 anos. Os instrumentos foram Inventário de Depressão de Beck (BDI), Child Behavior Checklist (CBCL) e MacArthur Story Stem Battery (MSSB), instrumento que utiliza narrativas para avaliar as representações parentais. Nas narrativas infantis, prevaleceram representações maternas disciplinares, associadas a conflitos e pouca afetividade nas interações. Conclui-se que a identificação das características da representação materna é um recurso importante para o desenvolvimento de intervenções psicoterapêuticas adequadas, bem como de programas que visem à prevenção da psicopatologia infantil(AU)

Research indicates that maternal depression is a risk factor for child psychopathology. The aim of this study was to identify maternal representations of children with mothers with Major Depressive Disorder. It is a multiple case study with three pairs of mother-child between 7 and 10 years old. The instruments were the Beck Depression Inventory (BDI), Child Behavior Checklist (CBCL), and MacArthur Story Stem Battery (MSSB), an instrument that uses narratives to assess parental representations. In the children's narratives maternal representations were disciplinary, with conflict and lack of affective interactions. We concluded that the identification of the characteristics of maternal representation is an important resource for the development of appropriate psychotherapeutic interventions, as well as programs aimed at prevention of child psychopathology(AU)

Las investigaciones indican que la depresión materna es un factor de riesgo para la psicopatología infantil. El objetivo de este estudio fue identificar las representaciones maternas de niños con madres con trastorno depresivo. Se trata de un estudio de múltiples casos con tres pares de madre-hijo en que los niños tienen entre 7 y 10 años. Los instrumentos utilizados fueron el Inventario de Depresión de Beck (BDI), Child Behavior Checklist (CBCL) y MacArthur History Stem Battery (MSSB), un instrumento que se utiliza de narrativas para evaluar las representaciones parentales. En las historias de los niños han prevalecido las representaciones maternas disciplinarias, asociadas a conflictos y falta de interacciones afectivas. Se concluye que la identificación de las características de la representación materna es un recurso importante para el desarrollo de intervenciones psicoterapéuticas apropiadas, así como programas destinados a la prevención de la psicopatología infantil(AU)

Efficiency of snake sampling methods in the Brazilian semiarid region.

The choice of sampling methods is a crucial step in every field survey in herpetology. In countries where time and financial support are limited, the choice of the methods is critical. The methods used to sample snakes often lack objective criteria, and the traditional methods have apparently been more important when making the choice. Consequently researches using not-standardized methods are frequently found in the literature. We have compared four commonly used methods for sampling snake assemblages in a semiarid area in Brazil. We compared the efficacy of each method based on the cost-benefit regarding the number of individuals and species captured, time, and financial investment. We found that pitfall traps were the less effective method in all aspects that were evaluated and it was not complementary to the other methods in terms of abundance of species and assemblage structure. We conclude that methods can only be considered complementary if they are standardized to the objectives of the study. The use of pitfall traps in short-term surveys of the snake fauna in areas with shrubby vegetation and stony soil is not recommended.

Study of serum ferritin in donors of two red blood cells units collected by apheresis.

OBJECTIVE: To analyze the recovery of iron stores without supplementation, when keeping an interval of six months between donations. MATERIAL AND METHODS: From April 2007 to May 2011, 308 regular and voluntary donors were selected. The apheresis collections were performed using ALYX® Component Collection System-Fenwal™. The hematological parameters were analyzed using the Cell DIN Sapphire - Abbot Diagnostics, and the serum ferritin by sandwich immunoassay method with fluorescence detection in final phase (ELFA) - Vidas® Ferritin-Biomérieux SA. A descriptive statistical analysis was performed for each hematological parameters and serum ferritin. RESULTS: The median hemoglobin concentration was 15.6g/dL (14, 18.4) in the first procedure and remains constant at subsequent donations. The ferritin median concentration was 64.6 µg/L (7.2, 886). A decrease of 15.6% was observed when compared the first to the second procedure with a median 54.6 µg/L (8.3, 213.7). Paradoxically, this decrease is not evident in the subsequent procedures, where an increase of 14.6% and 3.4% for the third and fourth procedure respectively was observed. Changes in ferritin values show statistically significant differences between the first and second collection, but this difference disappeared in subsequent donations. The analysis of MCH in each collection indicates that the significant difference between first and second donation (p1-2<0.05) and between first and third (p1-3=0.015), agree with the greatest decline of the ferritin found between procedures and the beginning of the stabilization of ferritin levels. COMMENTARY: The determination of ferritin appears not to be the most important parameter to consider at the time of donor selection and suggests that other factors unrelated to the donation may play a significant role. A decrease in serum ferritin was observed at the beginning, but it seems to attend a recovery and stabilization in the successive procedures.

A cinesioterapia reduz a dor no membro superior de mulheres submetidas à mastectomia ou quadrantectomia / Kinesiotherapy decreases upper limb pain in females submitted to mastectomy or quadratectomy

JUSTIFICATIVA E OBJETIVOS: A fisioterapia é uma importante ferramenta na reabilitação após a cirurgia para tratamento do câncer de mama. Os objetivos do estudo foram comparar a amplitude de movimento (ADM), a intensidade de dor no membro superior (MS) homolateral à cirurgia e caracterizá-la antes, durante e após programa de cinesioterapia, além de correlacionar estas variáveis. MÉTODO: Foram incluídas 39 mulheres submetidas ao tratamento cirúrgico do câncer de mama. O programa de fisioterapia envolveu alongamento, exercícios ativo-livres e ativo-assistidos de MS. A ADM foi avaliada pela goniometria, a intensidade de dor pela escala analógica visual (EAV) e caracterizada pelo questionário de dor de McGill no início, após 10 e após 20 sessões de cinesioterapia. Do McGill, foi obtido o escore do número de palavras escolhidas (NWC), do índice de avaliação da dor (PRI) e de suas categorias. Utilizou-se o Wilcoxon Signed Rank Test e correlação de Spearman, considerando p < 0,05. RESULTADOS: Verificou-se redução da intensidade de dor quando comparada a 1ª com a 10ª sessão (p = 0,033). Observou-se aumento significativo da ADM e diminuição significativa do PRI total e NWC quando comparado o início com a 10ª sessão e início e 20ª sessão. Todas as categorias do PRI diminuíram significativamente após a 10ª e 20ª sessão, exceto a afetiva. Não foi encontrada correlação entre ADM, EAV, NWC e PRI. CONCLUSÃO: A cinesioterapia melhorou a ADM e reduziu a dor no MS, especialmente no início da intervenção, evidenciando a importância da abordagem inicial da fisioterapia.

BACKGROUND AND OBJECTIVES: Physical therapy is a major rehabilitation tool after breast cancer surgery. This study aimed at comparing movement amplitude (MA), pain intensity in upper limb ipsilateral to surgery (UL) and at characterizing pain before, during and after a kinesioteraphy program, in addition to correlating such variables. METHOD: Participated in this study 39 females submitted to breast cancer surgery. Physical therapy program has involved UL stretching, free-active and free-assisted exercises. MA was evaluated by goniometry; pain intensity was evaluated by visual analog scale (VAS) and characterized by McGill pain questionnaire in the beginning, after 10 and after 20 kinesiotherapy sessions. McGill has supplied the score of number of words chosen (NWC), of pain evaluation index (PEI) and of its categories. Wilcoxon Signed Rank Test and Spearman correlation test were used, considering p < 0.05. RESULTS: There has been pain intensity decrease when comparing the 1st to the 10th session (p = 0.033). There has been significant MA improvement and significant decrease of total PEI and NWC when the beginning was compared to the 10th session and to the 20th session. All PEI categories have significantly decreased after 10th and 20th sessions, except for the affective. No correlation was found among MA, VAS, MWC and PEI. CONCLUSION: Kinesiotherapy has improved MA and has decreased UL pain, especially in the beginning of the intervention, showing the importance of an early physical therapy approach.