Density and diversity of Culicidae (Diptera), with analysis of viral circulation, in urban public establishments in Northern Paraná, Brazil

ABSTRACT Brazil has been suffering a dengue (DENV) epidemic in 2019 and 2022 and records cases of Zika (ZIKV) and chikungunya (CHIKV). Londrina city, Paraná, stands out for the number of cases and deaths from dengue. Therefore, this study aimed to verify the density and diversity of mosquitoes present in urban public establishments of Londrina, to analyze their ecological relationships, and to investigate the presence of the DENV, ZIKV, and CHIKV. Ovitraps were installed in outdoor sites in two public establishments in each region of Londrina, while adult culicids were caught indoors with a Nasci aspirator. A total of 5077 eggs were obtained in 77 ovitraps. The South region had the highest infestation while the East had the lowest (Ovitrap Positivity Index: 38% and 25%; Egg Density Index: 67.83 and 19.03, respectively). From eggs, 704 Aedes aegypti females and 71 Aedes albopictus females were obtained, while in the aspiration of adults, 99 A. aegypti and 11 Culex quinquefasciatus were captured, the highest number in the West and the lowest in the North. The DENV-II virus was detected in a pool of 17 A. aegypti females in the West region. The results demonstrate high density of pathogen vector species, mainly A. aegypti, in and around establishments, alerting to the need for constant local entomological surveillance to prevent viral circulation, mainly in crowded places. The presence of A. albopictus around the establishments also alerts to the urbanization of the species and potential participation in the viral circulation, demonstrating the need for constant monitoring.

Learning challenges in Physical Therapy, Speech-Language-Hearing Sciences, and Occupational Therapy undergraduate programs during the COVID-19 pandemic.

PURPOSE: COVID-19 posed numerous challenges to educational programs that had to quickly adapt to remote online learning (ROL) to ensure the continuity of health professional training over the pandemic. We aimed to assess the students' and professors' perceptions of the teaching-learning process in the Physical Therapy, Speech-Language-Hearing Sciences, and Occupational Therapy undergraduate programs at a Brazilian public university. METHODS: We used an electronic self-reported questionnaire with multiple-choice questions on a Likert scale ranged 1-5; higher the score, higher the level of agreement/importance/satisfaction. RESULTS: Most of undergraduate students and teachers had previous experience using information and communication technologies, and 85% stated their preference for in-person learning. Students expressed their appreciation for more active learning methodologies with clear objectives, accessible content, and visualization of abstract concepts. Regarding benefits and barriers, some similar perceptions were observed between students and teachers with ROL favoring time management, benefits in the teaching-learning process, satisfaction and motivation with the course content, and low attendance rates to general academic activities due to absent or poor access to technological resources. CONCLUSION: ROL is an alternative learning mode when the in-person classes cannot be carried out, as in the case of the COVID-19 pandemic. ROL is believed to be unfit to replace in-person learning, although it can complement the traditional classroom-based education in a hybrid model, respecting the nature of each program in the field of health that requires in-person practical training.

Learning challenges in Physical Therapy, Speech-Language-Hearing Sciences, and Occupational Therapy undergraduate programs during the COVID-19 pandemic / Desafios de aprendizagem nos cursos de graduação em Fisioterapia, Fonoaudiologia e Terapia Ocupacional durante a pandemia de COVID-19

ABSTRACT Purpose COVID-19 posed numerous challenges to educational programs that had to quickly adapt to remote online learning (ROL) to ensure the continuity of health professional training over the pandemic. We aimed to assess the students' and professors' perceptions of the teaching-learning process in the Physical Therapy, Speech-Language-Hearing Sciences, and Occupational Therapy undergraduate programs at a Brazilian public university. Methods We used an electronic self-reported questionnaire with multiple-choice questions on a Likert scale ranged 1-5; higher the score, higher the level of agreement/importance/satisfaction. Results Most of undergraduate students and teachers had previous experience using information and communication technologies, and 85% stated their preference for in-person learning. Students expressed their appreciation for more active learning methodologies with clear objectives, accessible content, and visualization of abstract concepts. Regarding benefits and barriers, some similar perceptions were observed between students and teachers with ROL favoring time management, benefits in the teaching-learning process, satisfaction and motivation with the course content, and low attendance rates to general academic activities due to absent or poor access to technological resources. Conclusion ROL is an alternative learning mode when the in-person classes cannot be carried out, as in the case of the COVID-19 pandemic. ROL is believed to be unfit to replace in-person learning, although it can complement the traditional classroom-based education in a hybrid model, respecting the nature of each program in the field of health that requires in-person practical training.

RESUMO Objetivo O COVID-19 impôs inúmeros desafios aos programas educacionais que tiveram que se adaptar rapidamente ao aprendizado remoto on-line (ARO) para garantir a continuidade da formação dos profissionais de saúde durante a pandemia. O objetivo do estudo foi avaliar a percepção de alunos e professores sobre o processo ensino-aprendizagem dos cursos de graduação em Fisioterapia, Fonoaudiologia e Terapia Ocupacional de uma universidade pública brasileira. Métodos Foi utilizado um questionário eletrônico autoaplicável com questões de múltipla escolha em escala Likert de 1 a 5; quanto maior a pontuação, maior o nível de concordância/importância/satisfação. Resultados A maioria dos alunos de graduação e professores tinha experiência anterior no uso de tecnologias de informação e comunicação, e 85% afirmaram preferir o ensino presencial. Os alunos expressaram preferência por metodologias de aprendizagem mais ativas, com objetivos claros, conteúdo acessível e visualização de conceitos abstratos. Em relação aos benefícios e barreiras, algumas percepções semelhantes foram observadas entre alunos e professores com ARO favorecendo a gestão do tempo, benefícios no processo ensino-aprendizagem, satisfação e motivação com o conteúdo do curso e baixa frequência às atividades acadêmicas gerais por ausência ou dificuldade de acesso aos recursos tecnológicos. Conclusão O ARO pode ser uma modalidade alternativa de aprendizado quando as aulas presenciais não podem ser realizadas, como no caso da pandemia do COVID-19. Porém, o ARO é inadequado para substituir a aprendizagem presencial, embora possa complementar a educação presencial tradicional em um modelo híbrido, respeitando a natureza de cada programa na área da saúde que exige formação prática presencial.

Is there a precise correlation between the lengths of the peritoneal reflection and the middle rectal valve?

Introduction: Pelvic anatomy remains a challenge, and thorough knowledge of its intricate landmarks has major clinical and surgical implications in several medical specialties. The peritoneal reflection is an important landmark in intraluminal surgery, rectal trauma, impalement, and rectal adenocarcinoma. Objectives: To investigate the correlation between the lengths of the middle rectal valve and of the peritoneal reflection determined with rigid sigmoidoscopy and to determine whether there are any differences in the location of the peritoneal reflection between the genders and in relation to body mass index (BMI) and parity. Design: We prospectively investigated the location of the middle rectal valve and of the peritoneal reflection via intraoperative rigid sigmoidoscopy in colorectal cancer patients undergoing elective colorectal surgery. Results: We evaluated 38 patients with a mean age of 55.5 years old (57.5% males) who underwent colorectal surgery at the coloproctology service of the Hospital Santa Marcelina, São Paulo, state of São Paulo, Brazil. There was substantial agreement between the lengths of the middle rectal valve and of the peritoneal reflection (Kappa = 0.66). In addition, the peritoneal reflection was significantly lower in overweight patients (p = 0.013 for women and p < 0.005 for men) and in women with > 2 vaginal deliveries (p = 0.009), but there was no significant difference in the length of the peritoneal reflection between genders (p = 0.32). Conclusion: There was substantial agreement between the lengths of the peritoneal reflection and of the middle rectal valve, and the peritoneal reflection was significantly lower in overweight patients and in women with more than two vaginal deliveries. (AU)

New traps for the capture of Aedes aegypti (Linnaeus) and Aedes albopictus (Skuse) (Diptera: Culicidae) eggs and adults.

The control of arboviruses carried by Aedes aegypti (Linnaeus) and Aedes albopictus (Skuse) can be performed with tools that monitor and reduce the circulation of these vectors. Therefore, the efficiency of four types of traps in capturing A. aegypti and A. albopictus eggs and adults, with the biological product Vectobac WG, was evaluated in the field. For this, 20 traps were installed in two locations, which were in the South (Londrina, Paraná) and North (Manaus, Amazonas) Regions of Brazil, from March to April 2017 and January to February 2018, respectively. The UELtrap-E (standard trap) and UELtrap-EA traps captured A. aegypti and A. albopictus eggs: 1703/1866 eggs in Londrina, and 10268/2149 eggs in Manaus, respectively, and presented high ovitraps positivity index (OPI) values (averages: 100%/100% in Londrina, and 100%/96% in Manaus, respectively); and high egg density index (EDI) values (averages: 68/75 in Londrina, and 411/89 in Manaus, respectively), so they had statistically superior efficiency to that of the CRtrap-E and CRtrap-EA traps in both regions, that captured less eggs and adults: 96/69 eggs in Londrina, and 1091/510 eggs in Manaus, respectively. Also presented lower OPI values (averages: 28%/4% in Londrina, and 88%/60% in Manaus, respectively); and lower EDI values (averages: 10.5/9 in Londrina, and 47/30 in Manaus, respectively). The capture ratios of Aedes adults in the UELtrap-EA and CRtrap-EA traps in Londrina and Manaus were 53.3%/29.5% and 0%/9.8%, respectively. UELtrap-EA can be adopted as efficient tool for Aedes monitoring due to their high sensitivity, low cost and ease of use.

Percepção dos estudantes em relação às possibilidades de aprendizado e seu papel no contexto da pandemia da COVID-19 / Students' perception of learning possibilities and their role in the context of the COVID-19 pandemic

O advento da pandemia da COVID-19 em 2020 impôs mudanças inesperadas nas práticas educacionais, o que implicou na transição emergencial dos cursos tradicionalmente oferecidos na modalidade de ensino presencial para o ensino remoto online. Este estudo teve como objetivo conhecer a percepção dos estudantes brasileiros de Terapia Ocupacional sobre as possibilidades de aprendizado e seu papel nos campos de prática profissional durante a pandemia. Foi realizado um estudo quantitativo transversal por meio da aplicação de um questionário online. Participaram 236 estudantes de cursos públicos e privados de graduação em Terapia Ocupacional. Os participantes concordaram com a implementação do ensino remoto durante a pandemia, mas defenderam que a formação seja desenvolvida integralmente de modo presencial após o término dessa emergência. A maioria afirmou que seu estado emocional na pandemia prejudicava o aprendizado. Os estudantes reconheceram a relevância de sua atuação nos campos de prática e em maioria sentiam-se despreparados para prestar assistência à população no formato de teleatendimento. Espera-se que esse estudo contribua com o planejamento e melhorias nos cursos enquanto for necessário manter o ensino remoto, assim como, para avaliações da formação em terapia ocupacional durante e após a pandemia.

The advent of the COVID-19 pandemic in 2020 imposed unexpected changes in educational practices, which involved the emergency transition of courses traditionally offered in the modality of face-to-face teaching to remote online teaching. This study aimed to know the perception of Brazilian occupational therapy students about the possibilities of learning and their role in the fields of professional practice during the pandemic. A cross-sectional quantitative study was conducted through the application of an online questionnaire. Participants were 236 students of public and private undergraduate courses in Occupational Therapy. The participants agreed to the implementation of remote education during the pandemic, but argued that training be fully developed in person after the end of this emergency. Most said that their emotional state in the pandemic impaired learning. The students recognized the relevance of their performance in the fields of practice but they felt unprepared to provide assistance to the population in the format of telehealth practices. It is expected that this study will contribute to the planning and improvements in the courses as long as it is necessary to maintain remote education, as well as to evaluate the training in occupational therapy during and after the pandemic

Inclusão de pessoas com deficiência no trabalho: estudo da comunicação / Work inclusion of people with disabilities: a communication study

Este estudo buscou compreender o processo de comunicação entre pessoas com e sem deficiência no contexto de trabalho e, a partir disso, descrever a comunicação como uma dimensão a ser considerada para a construção de um clima organizacional facilitador da inclusão. Trata-se de uma pesquisa exploratória descritiva com abordagem qualitativa. Participaram do estudo nove trabalhadores com deficiência. Os dados foram coletados por entrevistas semiestruturadas e analisados de acordo com o método de análise de conteúdo temática. Foram elencadas quatro categorias analíticas que permitiram aprofundar o conhecimento sobre as dinâmicas de comunicação e de inclusão/exclusão, sendo elas: cotidiano de trabalho, processo seletivo, barreiras para permanência no trabalho, e engajamento no trabalho. Esta pesquisa constatou que os desafios para a inclusão no mercado de trabalho permanecem e apontou a comunicação como um componente a ser considerado no processo. A comunicação é uma ferramenta estratégica para a inclusão das pessoas com deficiência no trabalho, mas que ainda persistem barreiras que precisam ser superadas e facilitadores que podem ser potencializados

This study aims to understand the process of communication between people with and without disabilities in the workplace and, from that, describe communication as a dimension to be considered in the construction of an inclusive organizational climate. This is an exploratory descriptive research with a qualitative approach. Nine workers with disabilities participated in the study. Data were collected through semi-structured interviews and analyzed according to the to the method of content analysis. Four analytical categories were listed that allowed a deeper understanding about the dynamics of communication and inclusion/exclusion, namely: daily work, selection process, barriers to the permanence at work and work engagement. This research has evidenced that the challenges for inclusion in the labor market remain and referred to communication as a component to be considered in the process. Communication is a strategic tool for the inclusion of people with disabilities at work, but there are still barriers that need to be overcome and facilitators that can be potentialized

Núcleo Poiesis: uma construção interinstitucional para o fortalecimento dos estudos e práticas sobre terapia ocupacional e trabalho / PoiesisNucleus: an interinstitutional construction to strengthen studies and practices on occupational therapy and work

O Núcleo Poiesis -Laboratório Interinstitucional de Terapia Ocupacional e Trabalho, nasceu da vontade de estabelecer ações coletivas, parcerias interinstitucionais e experimentações acadêmicas entre docentes e terapeutas ocupacionais que estudam o trabalho. Esse relato de experiência descreve o processo deconstrução do Núcleo Poiesis, apresenta o perfil de suas pesquisadoras,suas produções e parcerias, seus projetos futuros e as contribuiçõesdesse grupo para os estudos e práticas sobre terapia ocupacionale trabalho. Enquanto coletivo, as produções somaram até então doisartigos, quatro capítulos de livros, além de parcerias interinstitucionaisem ensino, pesquisa e extensão, coordenação de debates sobreterapia ocupacional e trabalho nos principais congressos, eventose instituições representativas da profissão no país. Conclui-se quea experiência coletiva de pares promoveu uma interlocução entreas universidades espalhadas por todo território nacional, o que éindispensável para promover trocas de experiências, saberes e práticas no campo do trabalho e Terapia Ocupacional.

he Poiesis Nucleus - Interinstitutional Laboratory of Occupational Therapy and Work was born from the desire to set collective actions, inter-institutional partnerships, and academic dialogues between professors and occupational therapists that study work. This experience report describes the Nucleus building process. Also, it presents a profile of its researchers' members, productions, partnerships, future projects, and the contributions of this group to the studies and practices about occupational therapy and work. As a collective, the productions have summed up to two papers, four book chapters, inter-institutional partnerships in teaching, research, and extension activities, and debates about Occupational Therapy and work in academic events, with the leading professional's institutions in the country. It is concluded that the collective experience of peers promoted a dialogue between universities spread throughout the national territory, which is essential to promote exchanges of experiences, knowledge, and practices in the work field and Occupational Therapy

Os trabalhadores do contexto hospitalar em tempos de pandemia: singularidades, travessias e potencialidades / Hospital workers in times of pandemic: singularities, journeys and potential / Los trabajadores del contexto hospitalario en tiempos de pandemia: singularidades, travesías y potencialidades

Este relato de experiência teve como objetivo apresentar algumas singularidades, travessias e potencialidades advindas da construção e do desenvolvimento do Programa de Terapia Ocupacional, Saúde e Trabalho (ProTost) em um hospital universitário durante os meses iniciais da pandemia. Esse programa foi orientado pelos princípios da Ergonomia da Atividade e da Psicodinâmica do Trabalho e pautou-se na necessidade de construção de ações participativas. Foram realizados grupos de reflexão sobre o trabalho envolvendo 15 setores do hospital e 140 trabalhadores. Os grupos proporcionaram aos trabalhadores espaços de escuta coletiva sobre o trabalho e ampliaram a visibilidade dos esforços empreendidos e os processos de reconhecimento horizontal e vertical. Além disso, contribuíram para o estudo de situações de trabalho, as discussões sobre transformações nos processos de trabalho e a construção de estratégias para enfrentamento dos desafios vivenciados no hospital que foram agravados pelo advento da pandemia. (AU)

The aim of this experience report is to present singularities, journeys and potential arising from the development and implementation of the Occupational Therapy, Health and Work Program (ProTOST) in a university hospital during the first months of the pandemic. The program was guided by the principles of activity ergonomics and psychodynamics of work and based on the need to build participatory actions. Work reflection groups were created involving 15 hospital sectors and 140 workers. The groups provided staff with spaces for collective listening about work and increased the visibility of efforts and horizontal and vertical recognition processes. In addition, they contributed to the study of work situations, discussions about the transformation of work processes and building strategies to address the challenges faced by the hospital aggravated by the pandemic. (AU)

Este relato de experiencia tuvo el objetivo de presentar algunas singularidades, travesías y potencialidades provenientes de la construcción y desarrollo del Programa de Terapia Ocupacional, Salud y Trabajo (ProTOST) en un hospital universitario durante los meses iniciales de la pandemia. Ese programa fue orientado por los principios de la Ergonomía de la Actividad y de la Psicodinámica del Trabajo y tuvo como pauta la necesidad de construcción de acciones participativas. Se realizaron grupos de reflexión sobre el trabajo que envolvieron 15 sectores del hospital y a 140 trabajadores. Los grupos proporcionaron a los trabajadores espacios de escucha colectiva sobre el trabajo y ampliaron la visibilidad de los esfuerzos emprendidos y los procesos de reconocimiento horizontal y vertical. Además, contribuyeron con el estudio de situaciones de trabajo, discusiones sobre transformaciones en los procesos de trabajo y la construcción de estrategias para enfrentamiento de los desafíos vividos en el hospital que se vieron agravados por la llegada de la pandemia. (AU)

Lactic Bacterium and Bacillus Sp. Biofilms Can Decrease the Viability of Salmonella Gallinarum, Salmonella Heidelberg, Campylobacter Jejuni and Methicillin Resistant Staphylococcus Aureus on Different Substrates

ABSTRACT This study aimed to evaluate the efficacy of biofilms formed by lactic acid bacteria and Bacillus sp. (BLA) in preventing and controlling the formation of wild biofilms and/or planktonic forms of Salmonella Gallinarum (SG), Salmonella Heidelberg (SH), and methicillin-resistant Staphylococcus aureus (MRSA) on different surfaces. The SH and SG viability was evaluated in polystyrene plates, wood shavings, and soil samples. Two protocols were developed to examine the use of BLA in a preventive and control application. For analysis of Campylobacter jejuni (CJ) BLA was used only preventively in a polystyrene plate. Results showed that BLA was effective in preventing the growth of SG and SH in all matrices. The effectiveness of BLA for MRSA was lower than for SG and SH. The efficiency of BLA in preventing CJ growth seems to be related to the initial CJ contamination. BLA proves to be a potential alternative to control food-borne pathogens commonly encountered in animal production and food industry.

Perforated acute abdomen in a patient with COVID-19: an atypical manifestation of the disease / Abdome agudo perfurativo em paciente com COVID-19: uma manifestação atípica da doença

Abstract Introduction: The Coronavirus belongs to a family of RNA viruses that can cause respiratory infection, with the possibility of gastrointestinal manifestations in approximately 5-50% of the cases. Objective: To report a surgical case with a diagnosis of COVID-19 that developed acute perforated abdomen and pneumothorax. Case report: This was an 80-year-old female patient with respiratory symptoms, with dry cough and fever and diffuse abdominal pain with signs of peritonitis. She had leukocytosis, kidney dysfunction and an increase in D-dimer with positive PCR for COVID. Computed tomography of the chest and abdomen showed pneumothorax on the right and extensive pneumoperitoneum. Conclusion: The presentation of COVID-19 with severe pulmonary and abdominal complications requires specialized and emergency treatments, but it has high mortality rates.

Resumo Introdução: O coronavírus pertence a uma família de vírus RNA que pode causar infecção respiratória com possibilidade de manifestações gastrintestinais em torno de 5% a 50% dos casos. Objetivo: Relatar caso operado com diagnóstico de COVID-19 e evolução com abdome agudo perfurativo e pneumotórax. Relato do caso: Paciente do sexo feminino de 80 anos com sintomas respiratórios com tosse seca e febre e dor abdominal difusa com sinais de peritonite. Apresentava leucocitose, disfunção renal e aumento de D-dímero com PCR positivo para COVID. Tomografia computadorizada de tórax e abdome demonstrando pneumotórax à direita e extenso pneumoperitônio. Conclusão: A apresentação do COVID-19 com sérias complicações pulmonar e abdominal requer tratamentos especializados e em regime de emergência, entretanto com altas taxas de mortalidade.

Transporte aéreo e passageiros com deficiência auditiva: barreiras e facilitadores / Air transport and passengers with hearing impairments: barriers and facilitators

Este estudo teve como objetivo compreender as barreiras e facilitadores para a participação das pessoas com deficiência auditiva em viagens aéreas. Fundamentou-se na abordagem da ergonomia da atividade. Os dados foram coletados por meio de questionário, observações diretas durante as viagens e entrevistas de autoconfrontação com passageiros com deficiência auditiva. Constatou-se a existência de barreiras relacionadas a fatores sociais, como comunicação, e ambientais, como sinalização nos aeroportos. Entre os facilitadores das viagens destacaram-se a comunicação com trabalhadores que têm conhecimento da língua de sinais e legendas nos conteúdos de entretenimento a bordo. Este estudo espera dar visibilidade às experiências de viagens de passageiros com deficiência auditiva e, a partir disso, contribuir para a melhoria das condições e procedimentos do transporte aéreo e orientar a formação de pessoal visando prestar serviços adequados aos diversos passageiros

This study aims to understand the barriers and facilitators to the participation of persons with hearing disability in air travel. This study was based on the assumptions of activity-centered ergonomics. Data was collected by means of a questionnaire, direct observations during trips and self-confrontation interviews with passengers with hearing disability. The study findings include barriers related to social factors, such as communication, and environmental factors, such as airport signage. Air travel facilitators included communication in sign language with workers and closed-captioned in-flight entertainment for passengers. This study hopes to give visibility to travel experiences of passengers with hearing disability, and from that to contribute to the improvement of air transport conditions and procedures and to guide staff training aiming to provide adequate services to diverse passengers

Occurrence of BIOMPHALARIA GLABRATA and PHYSA ACUTA (gastropoda: mollusca) snails in Quinta da Boa Vista municipal park, Rio de Janeiro, RJ, Brazil

The human species has an emotional connection with nature called "biophilia" (or, love for life). This connection goes from generation to generation, being one of the reasons why green spaces are present in large cities. Quinta da Boa Vista is a municipal park in Rio de Janeiro located in the São Cristóvão neighborhood in the northern part of the city. Its main attraction is the artificial lake system, a leisure attraction for the local community. This article reports the presence of Biomphalaria glabrata and Physa acuta snails around the main lake in the Quinta da Boa Vista Municipal Park in Rio de Janeiro, RJ. Seventy-one B. glabrata and twenty-seven P. acuta snails were collected. The snails were measured and examined for the presence of trematode larvae according to standardized procedures. The prevalence rate of B. glabrata was estimated at 15.5%. Rediae and cercariae resembling those of the species Typhlocoelum cucumerinum (Typhlocoelidae, Digenea) which parasitizes aquatic birds of the order Anseriformes were found. This study reinforces the importance of monitoring park lakes and ponds to better understand the risk of helminth transmission by molluscan vectors.

Sala de espera: uma possibilidade de intervenção em Saúde do Trabalhador / The waiting room: a possibility of intervention in Workers' Health

Resumo Introdução Este trabalho relata a experiência da reconfiguração da sala de espera de um serviço público de Atenção à Saúde do Trabalhador vinculado a um Hospital Universitário. Objetivo As ações realizadas tiveram como objetivo transformar o momento de espera em uma oportunidade para o desenvolvimento de ações de educação em saúde, promovendo a reflexão sobre o trabalho e o processo de saúde-doença a partir do favorecimento das interações entre usuários. Buscou-se ainda contribuir para ampliar o protagonismo desses em relação ao cuidado com a própria saúde e transcender a ações de assistência oferecendo intervenções mais diversas no serviço. Método O projeto na sala de espera foi estruturado em duas etapas: revisão de literatura sobre saúde do trabalhador e sala de espera e desenvolvimento e implementação da proposta de reconfiguração. Resultados O ponto de partida foi o levantamento de opiniões sobre a sala de espera, realizado por meio de entrevistas estruturadas com 52 usuários, acompanhantes, servidores e estagiários do serviço. 71,2% dos participantes responderam positivamente que mudariam algo na sala de espera. A proposta final considerou as possibilidades do ambiente e do serviço, as sugestões dos entrevistados e os propósitos da reconfiguração da sala de espera. Houve a modificação do layout das cadeiras e foram realizados grupos de discussão sobre saúde e trabalho com os usuários. Conclusão Espera-se com a divulgação desse processo ressaltar as potencialidades da sala de espera e incentivar a utilização desse espaço para o desenvolvimento de ações em outros serviços de saúde do trabalhador.

Abstract Introduction This study reported the experience of the reconfiguration of the waiting room of a Workers' Health Care public service linked to a University Hospital. Objective The actions taken had the objective of transforming the waiting time for the development of health educational interventions, fostering the reflection on the work and the health-illness process by favoring users interactions. The intention was also to enhance their protagonism towards their health and to transcend the assistance actions offering a more diverse set of courses of action in the service. Method The waiting-room project was structured in two phases: literature review on the worker´s health and the waiting room and development and implementation of the reconfiguration proposal. Results In this phase, the starting point was the collecting of opinions about the waiting room that was held by structured interviews with users, companions, employees, and interns of the service. In 52 people interviewed, 71.2% answered that they would positively change something in the waiting room. The final elaborated proposal considered the possibilities of the environment and the service and the suggestions of the interviewees and the purposes of the waiting room reconfiguration. There has been a change in the layout of the chairs and discussion groups with users were held. Conclusion This process is expected to highlight the potential of the waiting room and encourage the use of this space for the development of actions in other workers´ health services.

Passageiros com deficiência visual no transporte aéreo: avaliação da acessibilidade em aeroportos / Passengers with visual disability in air transport: evaluation of airports' accessibility

Resumo Introdução Nas últimas décadas ocorreram mudanças no entendimento da deficiência e avanços no que tange aos direitos humanos das pessoas com deficiência. Apesar disso, estudos mostram que essas pessoas ainda encontram barreiras que restringem sua participação nos diversos contextos sociais, como o transporte aéreo. Objetivo Analisar as condições e procedimentos de acessibilidade em aeroportos brasileiros e compreender as experiências de viagem de pessoas com deficiência visual nas fases de pré-voo, embarque e desembarque. Método Pesquisa com abordagem quantitativa-qualitativa realizada a partir de observação participante em viagens aéreas, entrevista de autoconfrontação com passageiros com deficiência visual e verificação do cumprimento das regras sobre condições e procedimentos de acessibilidade por meio de checklists baseados na norma ABNT NBR-9050/2015 e na Resolução ANAC nº 280/2013. Resultados Participaram do estudo sete passageiros com deficiência visual, incluindo pessoas com cegueira ou com baixa visão, e 30 gerentes de base e supervisores vinculados a quatro companhias aéreas que operam no transporte aéreo doméstico brasileiro. Foram analisados 10 aeroportos, nos quais os passageiros vivenciaram dificuldades que se relacionam, principalmente, a inadequação, descontinuidade e insuficiência das informações e sinalizações, descumprimento e desconhecimento dos procedimentos relativos à acessibilidade, impropriedade da alocação de assentos preferenciais e do atendimento prestado aos passageiros. Conclusão O estudo evidenciou descumprimento das normas e resoluções relativas à acessibilidade além de problemas que afetam a orientação espacial, o deslocamento e a comunicação nas viagens aéreas. Espera-se contribuir para a transformação da acessibilidade nos aeroportos brasileiros, visando favorecer a participação das pessoas com deficiência nas viagens aéreas.

Abstract Introduction In the last decades, there have been changes in the understanding of disability and advances in the human rights of people with disabilities. Nevertheless, studies show that disabled people still encounter barriers which restrict their participation in various social contexts, such as air transportation. Objective To analyze accessibility conditions and procedures in Brazilian airports and to understand the travel experiences of people with visual impairment in the pre-flight, embarkation and disembarkation phases. Method Quantitative-qualitative research based on participant observation in air travel, auto-confrontation interview with visually impaired passengers, and verification of rules compliance of accessibility conditions and procedures through checklists based on ABNT NBR-9050/2015 and ANAC Resolution nº 280/2013. Results The participants were seven passengers with visual impairment, either blind or with low vision plus 30 managers and supervisors linked to four different airlines that operate in the Brazilian air transportation. Ten airports were analyzed, in which passengers experienced difficulties related, mainly, to the inadequacy, discontinuity and insufficiency of information and signage; noncompliance with and lack of knowledge of accessibility procedures; inappropriate allocation of preferential seats and attendance to passengers. Conclusion Besides evidencing the noncompliance with the norms and resolutions related to accessibility, the study also evidenced problems that affect the spatial orientation, the displacement and the communication in travels. Having all this compiled data, contributions to transformation of accessibility in Brazilian airports is expected, with a view to favoring the participation of people with disabilities in air travel.

Th17 pathway in recent-onset autoimmune diabetes.

AIMS: Evaluate the participation of IL-17 pathway in T1D pathogenesis. T helper 17 cells are potent, highly inflammatory cells that produce interleukin 17A (IL-17A), considered a mediator of various immune disorders. However, their role in Type 1 diabetes (T1D) pathogenesis in humans is not totally elucidated. METHODS: The expression of IL-17 Receptor A (IL-17RA) in peripheral T lymphocytes and IL-17A serum levels in recent-onset patients with T1D were compared with healthy controls. IL-17A gene variants were evaluated in a greater cohort. RESULTS: Patients with recent-onset T1D (less than 6 months of diagnosis) exhibited lower expression of IL-17RA in CD3+ T (% of cells = 31.3% × 43.6%; p = .041) and CD4+ T cells (11.1% × 25.2%; p = .0019) and lower number of IL-17RA in CD4+ T cells (MFI = 1.16 × 4.56; p = .03) than controls. IL-17RA expression in CD8+ T cells and IL-17A serum levels were similar in both groups. The coding regions and boundary intron sequences of IL17A were sequenced. Seventeen allelic variants, including three novel variants in exon 3 (3'UTR n) were identified, but no one was associated with T1D susceptibility, as well as the resulting haplotypes and diplotypes. The expression of IL-17RA was not correlated with metabolic variables (glucose and HbA1c levels) or pancreatic autoantibodies titers. CONCLUSIONS: The lower expression of IL-17RA in CD3+ and CD4+ T cells suggests a reduced effect of IL-17A in immune response of recent-onset T1D patients, at least at peripheral tissues. IL-17A allelic variants were not related with T1D susceptibility.

Importance of Zinc Transporter 8 Autoantibody in the Diagnosis of Type 1 Diabetes in Latin Americans.

There is a scarcity of data of zinc transporter-8 autoantibody (ZnT8A) on mixed populations such as Brazilian. Therefore, we evaluated the relevance of ZnT8A for type 1 diabetes (T1D) diagnosis and the role of ZnT8 coding gene (SLC30A8) in T1D predisposition. Patients with T1D (n = 629; diabetes duration = 11 (6-16) years) and 651 controls were genotyped for SLC30A8 rs16889462 and rs2466295 variants (BeadXpress platform). ZnT8 triple antibody was measured by ELISA; glutamic acid decarboxylase (GAD65A) and protein tyrosine phosphatase (IA-2A) autoantibodies by radioimmunoassay. RESULTS: Znt8A was detected in 68.7% of recent-onset T1D patients and 48.9% of the entire patient cohort, similar to GAD65A (68.3% and 47.2%) and IA-2A (64.8% and 42.4%) positivities respectively. ZnT8A was the only antibody in 8.4% of patients. Znt8A and IA2A frequencies and titers were independent of gender and ethnicity, whereas GAD65A titers were greater in females. The diabetes duration-dependent decline in ZnT8A frequency was similar to GAD65A and IA-2A. The SLC30A8 rs2466293 AG + GG genotypes were associated with T1D risk in non-European descents (56.2% × 42.9%; p = 0.018), and the GG genotype with higher ZnT8A titers in recent-onset T1D: 834.5 IU/mL (711.3-2190.0) × 281 IU/mL (10.7-726.8); p = 0.027. Conclusion ZnT8A detection increases T1D diagnosis rate even in mixed populations. SLC30A8 rs2466293 was associated with T1D predisposition in non-European descents.

The influence of population stratification on genetic markers associated with type 1 diabetes.

Ethnic admixtures may interfere with the definition of type 1 diabetes (T1D) risk determinants. The role of HLA, PTPN22, INS-VNTR, and CTLA4 in T1D predisposition was analyzed in Brazilian T1D patients (n = 915), with 81.7% self-reporting as white and 789 controls (65.6% white). The results were corrected for population stratification by genotyping 93 ancestry informative markers (AIMs) (BeadXpress platform). Ancestry composition and structural association were characterized using Structure 2.3 and STRAT. Ethnic diversity resulted in T1D determinants that were partially discordant from those reported in Caucasians and Africans. The greatest contributor to T1D was the HLA-DR3/DR4 genotype (OR = 16.5) in 23.9% of the patients, followed by -DR3/DR3 (OR = 8.9) in 8.7%, -DR4/DR4 (OR = 4.7) in 6.0% and -DR3/DR9 (OR = 4.9) in 2.6%. Correction by ancestry also confirmed that the DRB1*09-DQB1*0202 haplotype conferred susceptibility, whereas the DRB1*07-DQB1*0202 and DRB1*11-DQB1*0602 haplotypes were protective, which is similar to reports in African-American patients. By contrast, the DRB1*07-DQB1*0201 haplotype was protective in our population and in Europeans, despite conferring susceptibility to Africans. The DRB1*10-DQB1*0501 haplotype was only protective in the Brazilian population. Predisposition to T1D conferred by PTPN22 and INS-VNTR and protection against T1D conferred by the DRB1*16 allele were confirmed. Correcting for population structure is important to clarify the particular genetic variants that confer susceptibility/protection for T1D in populations with ethnic admixtures.