bluuebunny/crossref_metadata_2025 huggingface dataset:
Health promotion actions and maternal near miss: an integrative review
Authors: Araújo Lívia Mara de , Almeida Maria Evilene Macena de , Damasceno Ana Kelve de Castro , Vasconcelos Camila Teixeira Moreira , Castro Régia Christina Moura Barbosa
Published: January 2021

Objective: to identify health promotion actions to reduce maternal near misses. Methods: this is an integrative review of the literature. The search for the articles was carried out in the MEDLINE/PubMed, CINAHL, LILACS, SCOPUS, and Web of Science databases, using the following combination: Near Miss, Healthcare AND Health promotion AND Maternal Welfare OR Maternal Health. Results: the 17 studies selected addressed the following recommendations on health promotion actions to decrease maternal near miss: enhancing prenatal care; access to reproductive planning; guidance and preparation for childbirth; education as an inclusion policy; continuing education for professionals and improvement of the regulation system. Conclusion: health promotion actions were evidenced in the study: carrying out effective prenatal care and actions related to management concerning professional training, adequate physical support in health units, and an organized and effective care network.
Environmental risks for falls of elderly attended by the Family Health Strategy team
Authors: Nogueira Iara Sescon , Ulbinski Nayana Flor , Jaques André Estevam , Baldissera Vanessa Denardi Antoniassi
Published: January 2021

Objective: to analyze the environmental risk for falls among the elderly living in the area covered by a Family Health Strategy team. Methods: cross-sectional research, using, as a data source, 80 forms of environmental risk evaluation of elderly falls. The collected data were transcribed and organized in a computerized spreadsheet, using the Microsoft Excel® program, and analyzed using descriptive statistics. Results: most elderly’s households were classified as low risk for falls (56.3%) and showed at least one environmental risk (94.0%), being the most frequently found in the bathroom (47.5%), in stairs (46.2%), and associated to light (41.2%). Conclusion: environmental risks were observed in different places of the households, highlighting the bathroom, stairs, and little light in the room, most of them being classified as a low environmental risk for falls.
Teorías sobre el cine de Miguel Delibes
Authors: Gil-Albarellos Susana
Published: January 2021

De 1953 a 1999 Miguel Delibes publica en diferentes medios de comunicación una serie de artículos acerca del cine tratando diversos aspectos: reseña estrenos cinematográficos, reflexiona sobre géneros, sobre el cine español y europeo, sobre avances técnicos de la industria cinematográfica y sobre algunas de las adaptaciones de sus obras literarias al cine. Todos estos documentos, examinados actualmente y en conjunto, conforman una poética del arte cinematográfico escasamente señalado hasta la fecha y constituyen una importante aportación al estudio de la historia de la crítica cinematográfica en España. En esta investigación analizo y examino las principales contribuciones del escritor a esa poética del cine.
Más allá de las mujeres fálicas
Authors: Rodríguez Santos José María
Published: January 2021

En este trabajo se pretende mostrar cómo en las ficciones del siglo xxi es posible encontrar modelos de heroínas que trascienden a las denominadas mujeres fálicas, caracterizadas por asumir determinadas características tradicionalmente asignadas a los hombres como la violencia, pero sin desprenderse de sus rasgos estereotípicamente femeninos, sobre todo en cuanto a su hipersexualización. Se propone el análisis de tres modelos de heroínas de géneros ficcionales distintos como son Arya Stark, Lisbeth Salander y Katniss Everdeen.
La imago mundi de Juan Bonilla
Authors: Gutiérrez Valencia Cristina
Published: January 2021

La narrativa breve de Juan Bonilla muestra una concepción del género en el filo entre el realismo y el cuestionamiento de la realidad. La imagen del mundo representada en sus relatos refleja la sociedad posmoderna y del simulacro a través de las técnicas de la narrativa de la imagen: la copia, la imitación, la autoficción y metaficción y la intertextualidad se combinan con la tecnología de las pantalla, tematizando la televisión o los videojuegos para reflexionar sobre los nuevos modos de representación del mundo.

Palabras clave: Juan Bonilla, posmodernismo, simulacro, narrativa de la imagen, televisión
La mujer a través del cine indio
Authors: Soto Moreno Krishna
Published: January 2021

La compleja realidad de la mujer india, analizada a través de su imagen en el cine de ese país, nos ha llevado a dividir este artículo desde la construcción de la identidad de la cultura india hasta el papel que en ella desempeña la mujer. Veremos así la idealización de la mujer-madre y su carácter simbólico: mujer sumisa y tradicional; y la de la mujer moderna, profesional libre, a veces occidentalizada, que es dueña de su vida. Lo que llamamos cultura de la violación es un tema recurrente en bastantes filmes indios. Como reflejo de la cultura india, en los filmes más típicamente bollywoodienses juegan un papel fundamental la música, el color y las coreografías como metáforas de la pasión humana. Para los temas relacionados con la sexualidad se crean códigos de representación erótico-artísticos tales como la lluvia, la naturaleza, las expresiones corporales, los sueños, etc. Todo esto reflejado en algunos ejemplos fílmicos, ya sea cine independiente como el de Bollywood.
En un lugar de Scranton, Pensilvania: la belleza de las cosas normales en los personajes de "The Office".
Authors: Alés Dani
Published: January 2021

El presente artículo analiza la progresiva evolución de los personajes principales en The Office, y cómo cada uno de ellos encarna, a través de este proceso, la idea principal de la serie: que hay algo extraordinario en el corazón de las cosas normales.
La proyección fructuosa en La estación violenta (1958) de Octavio Paz, desde el análisis figurativo
Authors: Delgado Del Aguila Jesús Miguel
Published: January 2021

Este artículo tiene como objetivo confrontar la cosmovisión de Octavio Paz, desde la configuración ominosa que le atribuye al hombre y la sugerencia inferida por conllevar su tránsito óptimo de una suspensión o un truncamiento al dinamismo o la concretización de proyectos y utopías. Esa interpretación literaria se desarrolla de «Máscaras del alba» y «Repaso nocturno» de su poemario La estación violenta (1958). Para demostrar esa condensación autoral y comprender su intención, añado la epistemología de Stefano Arduini en función de los campos figurativos que son de utilidad como sistema organizativo de los tropos y que se rigen de pensamientos metafórico, sinecdóquico, metonímico, elíptico, antitético y repetitivo, según cada caso. Esta taxonomía ha sido estudiada por el crítico Camilo Fernández Cozman, quien incorpora para un análisis más fructuoso la intervención de los interlocutores que participan en el discurso lírico.
Revealing the nanoindentation response of a single cell using a 3D structural finite element model
Authors: Yang Wenjian , Lacroix Damien , Tan Lay Poh , Chen Jinju
Published: January 2021

Changes in the apparent moduli of cells have been reported to correlate with cell abnormalities and disease. Indentation is commonly used to measure these moduli; however, there is evidence to suggest that the indentation protocol employed affects the measured moduli, which can affect our understanding of how physiological conditions regulate cell mechanics. Most studies treat the cell as a homogeneous material or a simple core–shell structure consisting of cytoplasm and a nucleus: both are far from the real structure of cells. To study indentation protocol-dependent cell mechanics, a finite element model of key intracellular components (cortex layer, cytoplasm, actin stress fibres, microtubules, and nucleus) has instead been developed. Results have shown that the apparent moduli obtained with conical indenters decreased with increasing cone angle; however, this change was less significant for spherical indenters of increasing radii. Furthermore, the interplay between indenter geometry and intracellular components has also been studied, which is useful for understanding structure-mechanics-function relationships of cells.
Controlling the high temperature deformation behavior and thermal stability of ultra-fine-grained W by re alloying
Authors: Kappacher Johann , Renk Oliver , Kiener Daniel , Clemens Helmut , Maier-Kiener Verena
Published: January 2021

Due to their outstanding properties, ultra-fine-grained tungsten and its alloys are promising candidates to be used in harsh environments, hence it is crucial to understand their high temperature behavior and underlying deformation mechanisms. Therefore, advanced nanoindentation techniques were applied to ultra-fine-grained tungsten–rhenium alloys up to 1073 K. A continuous hardness decrease up to 0.2 $$T_{\text{m}}$$

T
m

is rationalized by a still dominating effect of the Peierls stress. However, the absence of well-established effects of Rhenium alloying, resulting in a reduced temperature dependence of strength for coarse-grained microstructures, was interpreted as an indication for a diminishing role of kink-pair formation in ultra-fine-grained metals with sufficiently fine grain size. Despite slight grain growth in W, dislocation–grain boundary interaction was identified as the dominating deformation mechanism above 0.2 $$T_{\text{m}}$$

T
m

. Interaction and accommodation of lattice dislocations with grain boundaries was affected by a reduced boundary diffusivity through alloying with Re.

Graphic abstract
Popping of Cavities in the Near-Surface Coal-Bearing Strata of the Donets Basin
Authors:   N. P. Semenenko Institute of Geochemistry, Mineralogy and Ore Formation of the National Academy of Sciences of Ukraine, Feofanov Andrey
Published: January 2021

Long-term research has proved the connection between old mine workings preserved at the outcrops of coal seams and land subsidence, and sinkhole collapse. Now the causes and types of such disturbances are determined, the most dangerous of which are caves, over various types of the abandoned mine workings. In addition to it, a method has been developed and improved for assessing the hazard rate of any abandoned working (cavity) with relation to sinkholes for mining and geological conditions of the Donets Basin. At the same time, a number of cases are known when cavities wiped out due to the failure of the overlying rocks reappeared on the upper levels, threatening to generate surface depression. Thus, the former, but already liquidated cavity seemed to pop in the overlying rocks. The understudied process of cavities moving in the subsurface coal-bearing strata from the places of their original location towards the surface in the Donets Basin is described. The computation of stage-by-stage popping of relatively undestroyed mine opening (cavity) in coalbearing strata of different strength is made. The conditions and factors contributing to the popping of the remaining cavities towards the overlying levels are determined. An assumption (hypothesis) on the inevitability of popping of any abandoned working or cavity preserved on the upper levels, with a favorable combination of the affecting factors is made. The necessity for this process to be taken into account in assessing the hazard rate of the surface areas undermined by the abandoned mine workings at shallow depths due to their potential capability of making sinkholes is demonstrated. The effective reference documents regulating the procedure for assessing the hazard rate of abandoned mine workings (cavities) at shallow depths do not take into account popping of cavities that hurts correctness of the results obtained for them.
Russian-language adaptation of the international nomenclature of International Consensus on Antinuclear Antibody (ANA) Patterns (ICAP)
Authors: Tkachenko O. Yu. , Lapin S. V. , Mazing A. V. , Totolian Areg A.
Published: January 2021

Antinuclear antibodies (ANAs) represent a spectrum of autoantibodies targeted for various nuclear and cytoplasmic components of the cells. Indirect immunofluorescence assay (IIF) is the main detection method for “antinuclear factor”. A positive ANA test is usually reported as a titer and a pattern of fluorescence. The ANA patterns refers to the distribution of staining produced by antibodies that react with antigens located in nucleus and cytoplasm of HEp-2 cells. To standardize nomenclature and descriptions of the various fluorescence patterns of antinuclear factor (ANF), the Initiative of the International Consensus on ANA Patterns (ICAP) group was developed in 2014. The aim of ICAP is to promote consensus regarding nomenclature of ANA patterns, a microphotograph database, as well as classification depending on the employee skills. Information on the main characteristics, as well as specific clinical associations of the patterns is available at www.ANApatterns.org. In ANA classification trees, the patterns are indicated by the #AC (anticell pattern) alphanumeric code, being divided into nuclear, cytoplasmic and mitotic groups. Depending on the clinical significance and/or ease of recognition, this nomenclature focuses on the differences between the patterns described by specialists at competent and expert levels. Of the nuclear types, the most significant are homogeneous, speckled, dense fine-speckled, centromere, nucleolar, nuclear dots. The cytoplasmic types may be discerned into fibrillar, speckled, mitochondrial, Golgi, rods and rings. On leaders, behalf of the ICAP translation team is headed by the Full Member of Russian Academy of Sciences, Professor A.A. Totolian, under the auspices of the Russian Research Society of Immunologists. In this article, we present the Russianlanguage adaptation of the ICAP nomenclature, in order to ensure unification and standardization of ANA detection results in the patients with autoimmune diseases.
Stimulating effect of double-stranded yeast RNA on the activity of interferon system genes
Authors: Bateneva A. V. , Gamaley S. G. , Danilenko E. D. , Lebedev R. L.
Published: January 2021

Influence of double-stranded RNA (dsRNA) from Saccharomyces cerevisiae yeast upon expression levels of the macrophage genes encoding TLR3 receptor, interferons alpha and beta (IFNα, IFNβ), 2’,5’-oligoadenylate synthetase (OAS) and protein kinase R (PKR) enzymes has been studied in the J774 mouse histiocytic cell culture and in vivo in Balb/c mice. It has been shown that dsRNA exerts a selective activating effect on genes of TLR3 receptor, antiviral proteins IFNα, IFNβ, and OAS, both in vitro and in vivo. With J774 cell culture, the highest induction capacity was observed for the IFNβ gene: 365 to 802-fold. The stimulatory effect was dependent on the dose of dsRNA in the range of 16.9 to 125 μg/ml. The preparation enhanced IFNα gene activity to lesser degree (more than 10-fold), TLR3 and OAS (3 to 4-fold), while the expression levels for these genes were not significantly dependent on the dose of dsRNA. The stimulating effect of dsRNA was dosedependent in murine peritoneal macrophages. The maximum activating effect of the preparation was shown upon administration of the effective antiviral dose (0.5 mg of dsRNA/kg). Five hours after intraperitoneal injection of dsRNA, the highest level of mRNA synthesis was observed for IFNα (54-fold), OAS (43-fold) and TLR3 (28-fold) genes. Expression of the IFNβ gene increased to a lesser degree (9-fold). An increase in the dose of preparation to 1.5 mg/kg led to decrease of the stimulatory effect. Expression levels of the IFNα, TLR3, and OAS genes in that case decreased by 2-4-fold as compared to a lower dose, and the PKR gene expression was 5-fold lower compared to the control. One day after dsRNA administration, a tendency was observed for both experimental groups towards a decreased transcription of macrophage genes, if compared with the 5-hour term. The weakening of gene activity was less pronounced in animals treated with dsRNA at the dose of 1.5 mg/kg. The transcription indices for IFNβ, OAS, and TLR3 genes were much higher during this period (5-10-fold higher than the control values). The dynamics of PKR gene transcription in both experimental systems was significantly different from the expression of other studied genes. The dsRNA preparation at this dose range did not have a pronounced stimulatory effect upon expression of this gene. A moderate increase in PKR gene activity in macrophages of mice was observed only a day following intraperitoneal administration of dsRNA. Concentrations and length of dsRNA molecules are known to be critical factors to the PKR gene activation. An ability to increase the expression of the gene is shown at low dsRNA concentrations (10-7 g/ml and below), while highly polymeric dsRNAs weaken the gene activity. Since the doses and concentrations of dsRNA used in our experiments were significantly different from those mentioned above, it could, in general, affect regulation of PKR gene transcription towards reduction of the stimulatory effect.
Association between “a body shape index” and mortality: Bambuí Cohort Study of Aging, Brazil
Authors: Nascimento-Souza Mary Anne , Mambrini Juliana Vaz de Melo , Peixoto Sérgio Viana , Lima-Costa Maria Fernanda
Published: January 2021

This article aims to evaluate the joint and separate association between abdominal and general adiposity indicators and mortality. Data was collected from 1,366 older adults in the Bambuí Cohort Study of Aging with complete information for all variables of interest. The outcome variable was all-cause time until death; exposure variables were a body shape index (ABSI), waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI), assessed at the beginning of the study, and at the 3rd, 5th and 11th year of follow-up. Association between the quartiles of anthropometric indicators and mortality was calculated using an extended Cox proportional hazards model and adjusted for socioeconomic and behavioral confounding factors. Older adults in the 4th ABSI quartile had a higher risk of mortality regardless of BMI (1.27; 95%CI: 1.01-1.58), but this association was not observed in sensitivity analyses. Older adults in the 2nd, 3rd and 4th BMI quartiles had a lower risk of mortality, even when adjusted for WC or ABSI. WC and WHtR showed no association consistent with all-cause mortality after adjustment for confounding factors. Considering the loss of significance in the sensitivity analyses, ABSI’s predictive capacity for mortality is still weak. Thus, adopting ABSI in clinical practice or in epidemiological surveys, in conjunction or replacing BMI and WC, requires more in-depth studies.
The vulnerabilities of lives: Zika, women and children in Alagoas State, Brazil
Authors: Ambrogi Ilana G. , Brito Luciana , Diniz Debora
Published: January 2021

Abstract: Until 2015, Zika was mostly unknown in Brazil and in the world. Since then, the Zika virus has been found to be vertically transmitted and to cause congenital Zika syndrome (CZS). This study aims to describe and analyze the vulnerabilities of the women and children most affected by the Zika epidemic in Brazil. Alagoas has the lowest Human Development Index in Brazil and one of the highest rates of adolescent pregnancy. Between December 2016 and March 2017, interviews were conducted with 54 women with children affected by Zika. The interviews had two components: a narrative-oriented conversation and a semi-structured questionnaire. This comprehensive mixed methods case study represented 45% of the confirmed CZS cases and 20% of the cases under investigation in the state at that time. The women are predominantly Afro-Brazilian; most experienced their first pregnancy during adolescence, and had little education. Many were not covered by social protection programs and were not receiving adequate health care. The rights and needs of these women and children are impacted by a systemic lack of access to services and medications. There is inadequate transportation to services that many families depend on. Discrimination against their children with disabilities is a new and complex concept in their lives. The Zika epidemic has compounded rights violations in their lives and worsened their social and economic layers of vulnerability. There is an urgent need for a robust public response to guarantee the rights of these women and children and to implement mechanisms to prevent and eliminate their vulnerabilities.
Descrição do consumo de psicofármacos na atenção primária à saúde de Ribeirão Preto, São Paulo, Brasil
Authors: Oliveira Júlia Raso Ferreira de , Varallo Fabiana Rossi , Jirón Marcela , Ferreira Iahel Manon de Lima , Siani-Morello Manuela Roque , Lopes Vinícius Detoni , Pereira Leonardo Régis Leira
Published: January 2021

O consumo de psicofármacos é considerado um problema de saúde pública devido ao potencial de dependência e ocorrência de eventos adversos. Nesse contexto, o presente estudo teve como objetivo caracterizar o consumo de psicofármacos dispensados em unidades básicas de saúde de Ribeirão Preto, São Paulo, Brasil. Conduziu-se um estudo ecológico, com consulta à base de dados Hygia de 2008 a 2012. Foram extraídas as variáveis: psicofármaco dispensado, quantidade dispensada no ano, sexo e faixa etária dos pacientes. Para cada psicofármaco foi calculada a dose diária definida por 1.000 habitantes/dia (DDD/1.000PD), a dose diária definida por 1.000 habitantes/dia considerando-se 75% da população (DDD75%/1.000PD) que retiraram medicamento pelo Sistema Único de Saúde (SUS) e a dose diária prescrita (DDP). Comparou-se a taxa de crescimento populacional com a de crescimento do consumo dos medicamentos. Foram identificados 1.577.241 pacientes que retiraram medicamentos no período avaliado, dos quais 287.373 (18,2%) utilizaram pelo menos um sujeito a controle especial. Houve aumento do consumo total dos psicofármacos (DDD/1.000PD), porém, após a comparação com a taxa de crescimento populacional, apenas a da sertralina (p = 0,021), risperidona (p = 0,034) e do clonazepam (p = 0,043) foram superiores. As DDP de sete fármacos estavam maiores que a DDD da Organização Mundial da Saúde (OMS). As discrepâncias entre DDD e DDP podem ser úteis como estratégia para triar pacientes elegíveis ao cuidado farmacêutico, pois podem contribuir na prevenção de morbimortalidade relacionada ao uso de medicamentos.
Impacto del control de tabaco en los costos asistenciales del infarto agudo de miocardio en Uruguay: costos en base a Grupos Relacionados por el Diagnóstico
Authors: Paolillo-Cabrera Elbio , Torres Frank , Machado Federico , Scasso Alberto , Alvarado Alicia , Genta Diego , Tort Pablo , Tortorella Silvina , Laluz Sandra , Cabrera Daniela , Sandoya Edgardo
Published: January 2021

El tabaco es la principal causa modificable de enfermedad cardiovascular, cáncer y enfermedades respiratorias, por lo que es un serio problema de salud pública universal. En 2006, Uruguay implementó el Convenio Marco para el Control del Tabaco de la Organización Mundial de la Salud (CMCT-OMS), y consiguió un descenso de la tasa de fumadores y mejoras en la salud cardiovascular y respiratoria. Se investigó el impacto clínico y económico de las medidas de control de tabaco sobre los costos asistenciales del infarto agudo de miocardio, que se redujo un 17%. No se incluyeron los costos evitados por otras patologías. Se investigó lo ocurrido en una institución sanitaria y se proyectó a toda la población del país. El análisis de costos se realizó usando la metodología del sistema de los Grupos Relacionados por el Diagnóstico (GRD), combinada con los informes contables de la institución. Además de los costos de internación, se incluyeron los relacionados con los traslados, los de los procedimientos cardiovasculares invasivos y los gastos sanitarios de los 12 meses posteriores al evento agudo. El costo por paciente fue de USD 12.037. Considerando un descenso de 500 infartos por año, el ahorro anual estimado es de USD 6.000.000 en costos asistenciales de los infartos evitados; a lo que debería agregarse otros ahorros de costos por pérdida laboral, discapacidad posterior y años de vida prematura perdidos por fallecimiento del paciente. La exitosa política de control del tabaco ha sido la principal medida de salud pública en los últimos 30 años en nuestro país. Esta investigación busca contribuir al camino trazado por la Organización Mundial de la Salud (OMS).
Social support from family and friends for physical activity in adolescence: analysis with structural equation modeling
Authors: Lisboa Tailine , Silva Walan Robert da , Silva Diego Augusto Santos , Felden Érico Pereira Gomes , Pelegrini Andreia , Lopes Jessica de Jesus Dutra , Beltrame Thais Silva
Published: January 2021

Social support is an important predictor for the maintenance of physical activity in adolescence. Thus, the social-ecological approach values the impact of individuals or groups interaction with available resources in the social environment for adopting an active lifestyle. This study analyzes social support from family and friends for adolescents to practice physical activity. Guided by the Social-Ecological Theory, an observational cross-sectional structural equations modeling was applied to 2,710 Brazilians adolescents aged from 14 to 18 years. We identified that the greater the social support from friends (β = 0.30; RMSEA = 0.065; CFI = 0.953; TLI = 0.922; SRMR = 0.048) and family, the greater the adolescents physical activity (β = 0.27; RMSEA = 0.015; CFI = 0.997; TLI = 0.995; SRMR = 0.013). However, support from both sources indicated no adequate adjustment values in the same study model. Our findings suggest that adolescents who perceive social support from family members or friends practice more physical activity, confirming that social support is important for physical activity promotion.
Birth weight of indigenous children in Brazil: results of the First National Survey of Indigenous People’s Health and Nutrition
Authors: Ferreira Aline Alves , Souza Mirian Carvalho de , Cardoso Andrey Moreira , Horta Bernardo Lessa , Santos Ricardo Ventura , Welch James R. , A. Coimbra Jr. Carlos E.
Published: January 2021

Birth weight is an important predictor of perinatal, infant, and preschool-age children morbimortality. However, information about indigenous children’s birth weight is still scarce. This study aimed to analyze the birth weight of indigenous children based on data from the First National Survey of Indigenous People’s Health and Nutrition, Brazil (2008-2009). This is the first study to address indigenous children’s birth weight based on a nationwide representative sample. Mean birth weights and the respective standard deviations were calculated according to geopolitical region, sex, type of birth, and birthplace. The chi-square test was used to analyze differences in proportions, and Kruskal-Wallis and Mann-Whitney U tests in means, considering sample design and data normality. We found no records on birth weight in the researched documents for 26.7% of the 6,128 sampled children. The mean birth weight for the 3,994 children included in the analyses was 3,201g (standard deviation - SD ± 18.6g), regardless of sex, type of birth, and birthplace. The prevalence of low birth weight was 7.6% (n = 302) and was significantly higher among girls. Boys presented significantly higher mean birth weight than girls, regardless of the geopolitical region. Low birth weight was slightly less frequent among indigenous children when compared to Brazilian children in general. Our study indicates the need to improve prenatal care and the quality of consultation records for indigenous women as a strategy to promote safe pregnancy and childbirth.
Inequidades sociales en madres adolescentes y la relación con resultados perinatales adversos en poblaciones sudamericanas
Authors: Ratowiecki Julia , Santos María Rita , Poletta Fernando , Heisecke Silvina , Elias Dario , Gili Juan , Gimenez Lucas , Pawluk Mariela , Uranga Rocio , Cosentino Viviana , Campaña Hebe , Rittler Mónica , Camelo Jorge S. López
Published: January 2021

Resumen: El objetivo fue explicar las diferencias en la frecuencia de eventos perinatales adversos entre madres adolescentes con baja y alta escolaridad. La muestra poblacional se recogió en la base de datos del Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC). Entre 2.443.747 nacimientos ocurridos en 93 hospitales, se reclutaron 66.755 recién nacidos vivos, sin defectos congénitos, durante el período 2000-2017. Las madres adolescentes se clasificaron según su escolaridad en: baja, media y alta. Se utilizó un modelo multivariado, que incluyó efectos reproductivos, acceso a servicios de salud, variables demográficas-socioeconómicas, así como de grupo étnico. El modelo de descomposición de Fairlie se aplicó para cuantificar la contribución de variables explicativas en las frecuencias de eventos perinatales adversos. De los 66.755 recién nacidos investigados, el 21,1% (n = 14.078) fue primigrávida de madres adolescentes. La distribución por escolaridad materna fue de 24,2%, 59,8% y 16% para baja, media y alta escolaridad, respectivamente. Las mayores frecuencias de eventos perinatales adversos se observaron en madres adolescentes con baja escolaridad. La variable “acceso a servicios de salud” explicó un 35%, 37% y 23% de las disparidades en el bajo peso al nacimiento, prematuridad y retardo de crecimiento intrauterino, respectivamente, entre madres adolescentes con baja y alta escolaridad. El bajo número de consultas prenatales fue el único factor de riesgo para los dos niveles de escolaridad y la variable que mejor explica las diferencias entre las frecuencias de eventos perinatales adversos. Desde el punto de vista de la salud pública, ellos representan una intervención de bajo coste, con posibilidad de que se incrementen mediante información adecuada para la población y medidas sistemáticas en los niveles de atención primaria.
Anuran fauna of the Parque Estadual Carlos Botelho - Núcleo Sete Barras, southeastern Brazil: species composition, use of breeding sites, and seasonal patterns of breeding activity
Authors: Bertoluci Jaime , Sawakuchi Henrique Oliveira , Ortiz Carolina , Brassaloti Ricardo Augusto , Wagner Ribeiro-Júnior José , Famelli Shirley
Published: January 2021

Abstract: The goal of this work was to study the species composition, the use of breeding sites, and the seasonal patterns of breeding activity of the anuran fauna from Parque Estadual Carlos Botelho - Núcleo Sete Barras, state of São Paulo, southeastern Brazil. Fieldwork was carried out from September 2005 to October 2007 through two main methods: active visual search inside a 10 ha- permanent plot and aural and visual search in seven previously selected aquatic breeding habitats. Species richness was related to the sampling effort by means of species accumulation curve and through non-parametric estimators. Thirty-three species distributed in 12 families were recorded, from which 69% are endemic to the Atlantic Forest. Trachycephalus mesophaeus represents a new record for the park. Cycloramphus lutzorum is included as Data Deficient in the IUCN list. The species accumulation curve did not stabilize, showing some tendency to rise. The use of breeding sites by 20 species was compared using cluster analysis, which revealed two major groups: the first with five species (two habitat generalists and three stream specialists) and the second composed by the other species (with different reproductive modes associated with flooded environments). The breeding period of most species was associated to the rainy season (October to February), and only Scinax hayii showed continuous breeding activity during the entire period of study.
Conhecimento e expectativas de acadêmicos de fisioterapia sobre a atuação profissional na atenção primária à saúde
Authors: Rosa Carolina Gomes , Stigger Felipe de Souza , Lemos Adriana Torres de
Published: January 2021

RESUMO A promulgação do SUS apontou uma nova concepção de saúde não mais focada na ausência de doenças. Fez-se necessário o fortalecimento de ações no nível primário sendo elaborada a Política Nacional de Atenção Básica para promover, proteger e reabilitar a saúde dos indivíduos e coletividades. A Fisioterapia precisa se adequar para se aproximar da Atenção Primária à Saúde (APS) e aos novos modelos de atenção à saúde, o que é recomendado pelas Diretrizes Curriculares Nacionais do Curso de Fisioterapia. O objetivo do estudo é investigar o conhecimento e as expectativas de acadêmicos de Cursos de Fisioterapia de Porto Alegre e região metropolitana sobre a atuação do fisioterapeuta na Atenção Primária à Saúde. Foi realizado estudo observacional, descritivo, transversal, com questionário on-line composto por 13 questões, objetivas e dissertativas. Para verificar as associações, utilizou-se o teste qui-quadrado e adotou-se significância de 5%. 171 acadêmicos de Fisioterapia (90,53% do sexo feminino, com idades entre 18 e 55 anos) participaram do estudo. A minoria dos participantes registrou corretamente as quatro atividades e locais de atuação da Fisioterapia na APS. Para as atividades, foram utilizados termos amplos como “promoção” e “prevenção”; “Unidade de Saúde” foi o local mais frequentemente citado. Do total, 43,2% apontaram se sentirem preparados.
Análise eletromiográfica de músculos do tronco e pelve durante o leg circle no solo e com molas no Cadillac
Authors: Paula Rosangela Menezes de , Dhein William , Souza Catiane , Wagner Neto Edgar Santiago , Loss Jefferson Fagundes
Published: January 2021

RESUMO O objetivo do estudo é investigar, através da EMG, se é possível alterar a exigência dos músculos estabilizadores do tronco e da pelve, executando o exercício Leg Circle no solo e com diferentes posicionamentos das molas no Cadillac. Treze instrutoras praticantes de Pilates por no mínimo seis meses e sem dor realizaram 10 repetições do exercício Leg Circle em três situações: (1) Solo; (2) Molas altas (MA); (3) Molas médias (MM). Foram obtidos dados de EMG dos músculos oblíquo interno do abdômen/transverso do abdômen (OI/TS), oblíquo externo do abdômen (OE), reto abdominal (RA) e multífidos (MU) apresentados em percentual da CIVM. As comparações foram realizadas através da ANOVA de medidas repetidas (α=0,05). Todos os músculos sofreram influência do posicionamento da mola. No solo, as maiores ativações ocorreram nos músculos RA e OE, enquanto nas execuções realizadas com molas, os músculos mais recrutados foram OI/TS (MM) e MU (MA). Os músculos RA e OE não obtiveram diferenças entre as situações MA e MM. A execução do exercício Leg Circle no solo e com molas gera alterações no recrutamento dos músculos avaliados. Observa-se também que, ao analisar o exercício realizado no Cadillac entre molas altas e molas médias, houve diferença apenas para os músculos OI/TS e MU.
Aplicação da escala Spinal Alignment and Range of Motion Measure (SAROMM) em crianças e adultos com paralisia cerebral, em uma instituição de abrigagem de Porto Alegre (RS)
Authors: Cominetti Emanuele Priscila Alves , Gerzson Laís Rodrigues , Almeida Carla Skilhan de
Published: January 2021

RESUMO O objetivo do estudo foi descrever o perfil de crianças e adultos institucionalizados com Paralisia Cerebral, bem como, suas alterações musculoesqueléticas, alinhamento da coluna vertebral e amplitude de movimento; também, traçar estratégias para minimizar o avanço das deformidades já instaladas. Estudo de caráter transversal e descritivo. Crianças e adultos com Paralisia Cerebral de uma Instituição de abrigagem da cidade de Porto Alegre/RS foram avaliados (n=28). Utilizou-se a escala Spinal Alignment and Range of Motion Measure (SAROMM) para avaliar as deformidades e Gross Motor Function Classification System (GMFCS) para classificar o nível funcional. 96% dos sujeitos foram do tipo espástico; 42,85% apresentaram nível motor V do total dos participantes; as maiores deformidades encontradas foram em joelho, quadril e coluna avaliados pela escala de SAROMM, associado com a idade mais avançada e quadro de quadriplegia espástica, com diagnóstico clínico em prontuário. Sujeitos maiores de 20 anos obtiveram uma pontuação média de 68,7 (varia de 0 a 104) e sujeitos menores de 20 anos, sua pontuação média foi de 55,1 pontos, sendo quanto menor, melhor o alinhamento e menos deformidades. Sujeitos com PC de um local de abrigagem apresentaram, na sua maioria, espasticidade do tipo bilateral dos quatro membros, nível de GMFCS predominante foi o V e alterações articulares em joelhos, quadril e coluna vertebral como maiores deformidades encontrada. As estratégias devem ser traçadas e iniciadas o mais cedo possível para diminuir e ou minimizar deformidades e a escala SAROMM pode ser uma escolha para avaliar esse público.
Frequência de incontinência urinária em mulheres praticantes de crossfit: um estudo transversal
Authors: Lopes Erlon , Apolinário Amanda , Barbosa Leila , Moretti Eduarda
Published: January 2021

RESUMO O objetivo deste estudo foi verificar a frequência de Incontinência Urinaria (IU) em mulheres praticantes de Crossfit. Realizou-se um estudo de corte transversal com mulheres que praticavam Crossfit há, pelo menos, 6 meses ininterruptos, com idade entre 18 a 35 anos e frequência de treino de, no mínimo, três vezes por semana. Foram aplicados questionários de avaliação individual compostos por dados sociodemográficas, antropométricos e esportivos, além do International Consultation on Incontinence Questionnaire - Short Form (ICIQ-UI-SF), para identificar a presença de IU. Também por meio do ICIQ-IU-SF foram identificados a frequência e quantidade de perda de urina e interferência da IU na qualidade de vida (QV) das mulheres incontinentes. Essas mulheres também responderam a um questionário acerca da gravidade da IU. A amostra total do estudo foi de 50 mulheres, das quais 10 (20%) apresentaram IU. A maioria das mulheres incontinentes apresentou IU de gravidade moderada e de interferência leve na QV. Ademais, observou-se associação entre ter histórico de IU e apresentar IU (RP=5,33; IC95%=1,41 a 20,10). Diante do exposto, conclui-se que a frequência de IU em mulheres praticantes de Crossfit foi de 20%, sendo a IU, em sua maioria, de gravidade moderada e de leve interferência na QV.
Self-Estimated Functional Inability because of Pain questionnaire for Brazilian workers with musculoskeletal pain: face and content validity
Authors: Pinheiro Cezar Augusto Brito , Fidelis-de-Paula-Gomes Cid André , Barros Vinício dos Santos , Melo Josane Soares Pinto , Bassi-Dibai Daniela , Dibai-Filho Almir Vieira
Published: January 2021

ABSTRACT Our study aimed to perform the face and content validity of Self-Estimated Functional Inability because of Pain (SEFIP) for workers, here called the SEFIP-work questionnaire. This is a questionnaire validity study. Our group previously translated and adapted the original version of the SEFIP, which was developed to investigate musculoskeletal pain and dysfunction to be applied to dancers (SEFIP-dance). However, due to the broad scope of the SEFIP-dance, we made changes and adaptations in the Brazilian Portuguese version of the SEFIP-dance to allow its use in workers. Therefore, face and content validity were performed for the development of the SEFIP-work based on opinions of committee of occupational disease and rehabilitation experts. After face and content validity, this SEFIP-work version was applied to 30 working individuals with musculoskeletal pain. The participants were native Brazilian Portuguese speakers aged 18 years and older. Thus, three changes were made to the questionnaire. All participants understood the SEFIP-work items and alternatives. The average total SEFIP-work score was 6.59 (SD=3.66), with the item “parte inferior das costas” (lower back) being the most marked (n=28; 93.33%), with an average score of 1.18 (SD=0.73). In conclusion, the Brazilian Portuguese version of SEFIP-work presents an acceptable level of understanding by workers in the investigation of musculoskeletal pain or discomfort.
Análise do tempo de retirada do respirador artificial no paciente submetido a traqueostomia precoce e após sete dias de ventilação mecânica invasiva
Authors: Mota Jonas Davi Heiderick , Rodrigues Yuri de Souza , Souza Flávia dos Santos Lugão de
Published: January 2021

RESUMO A realização da traqueostomia precoce pode reduzir o tempo de ventilação do paciente, facilitando o desmame da prótese ventilatória. Além disso, reduz os custos de internação. Este estudo tem como objetivo analisar o tempo de retirada do respirador no paciente traquestomizado precocemente após sete dias de ventilação. Trata-se de pesquisa documental, retrospectiva, de carácter descritivo, sendo a coleta de dados realizada nos documentos de indicadores hospitalares de unidade de terapia intensiva de um hospital da Zona da Mata mineira. Foram coletados dados de 50 pacientes que obtiveram sucesso e preencheram os critérios de desmame da ventilação mecânica, entre homens e mulheres, com média de idade de 56,6 anos. Para análise estatística, os pacientes foram divididos em dois grupos: grupo precoce, de pacientes que realizaram traqueostomia com menos de sete dias de intubação orotraqueal; e grupo tardio, de pacientes que permaneceram por mais de sete dias com tubo orotraqueal até a realização da traqueostomia. Obtivemos um resultado significativo (p=0,04) quanto aos dias em ventilação mecânica após a realização de traqueostomia, demonstrando que nos pacientes com traqueostomia precoce houve menos dias em ventilação mecânica invasiva do que nos pacientes com traqueostomia tardia. Foi constatado um resultado significativamente menor do tempo de ventilação dos pacientes traquestomizados precocemente quando comparados com a traqueostomia tardia. Ensaios clínicos randomizados de alta qualidade são necessários para avaliar melhor as possíveis diferenças da retirada da ventilação mecânica entre pacientes traqueostomizados.
Activation of pelvic floor, lumbar and abdominal musculature during a simulated manual material handling task: a cross-sectional study
Authors: Barros Fernanda Cabegi de , Driusso Patricia , Roberto Fernanda , Batistão Mariana Vieira , Corrêa Mikaela , Sato Tatiana de Oliveira
Published: January 2021

ABSTRACT Pelvic floor muscles act synergistically with the abdominal and lumbar muscles contributing to spine and pelvic control. These muscles are activated during activities that increase intra-abdominal pressure, such as manual material handling. The aim of our study was to assess the electrical activity of the lumbar, abdominal and pelvic floor muscles during manual material handling with different loads. This is a cross-sectional study with sixteen nulliparous continent women aged between 18 and 35 years. An electromyographic system was used to evaluate the activation of the multifidus, erector spinal (iliocostal) and abdominal rectus muscles bilaterally (Trigno Wireless®, DelSys®, Boston, USA) and another for the pelvic floor muscles (Thought Technology Ltd, Canadá). Electromyographic data were collected during manual handling of three loads: light (1.5 kg), medium (4.5 kg) and heavy (11.3 kg). Repeated measures ANOVA was applied to compare the activation among loads at a 5% level of significance (α = 0.05). There was a significant increase in the activation of the lumbar and abdominal musculature as the load increases. No difference among loads was found for the pelvic floor muscle activation. Pelvic floor muscles did not increase their activation in function of the load, as occur for the lumbar and abdominal muscles in nulliparous continent women. These findings need to be confirmed for incontinent woman, since it could have clinical implications for designing both occupational tasks and pelvic floor rehabilitation.
CONSENSUS OF PUBLIC HEALTH PROFESSORS ON THE MAIN PEDAGOGICAL APPROACHES FOR TRAINING IN THE BRAZILIAN UNIFIED HEALTH SYSTEM
Authors: Lima Jônia Cybele Santos , Lima Rafael Rodolfo Tomaz de , Gomes Sávio Marcelino , Lopes Ana Patrícia de Freitas , Bezerra Isaac Newton Machado , Noro Luiz Roberto Augusto
Published: January 2021

ABSTRACT Objective: to establish consensus from experts on the essential elements for training aimed at the Unified Health System (Sistema Único de Saúde), considering public health assumptions and the Brazilian National Curriculum Guidelines (DCN - Diretrizes Curriculares Nacionais). Method: this is an evaluability assessment carried out with public health professors based on a logical model built with a focus on DCN and on large areas of public health. Criteria matrix validation was performed through Delphi consensus, carried out in three rounds between June and August 2017. The database was built in an Excel spreadsheet and analyzed after each round. At the end of the last round, the database presented its final composition for export to the Stata software, in which statistical analysis was performed. Results: at the end of three rounds, 18 experts validated the criteria matrix composed of 40 items. The most significant approaches were related to the subdimensions Health care, Popular education, Humanization, Popular participation, Social accountability, and Planning and management. Conclusion: the validated criteria matrix is characterized as an important instrument for knowledge construction based on a premise that, by taking over the essential skills for training at DCN, the training process may be problematized by all actors involved. The current Brazilian political scenario, crossed by austerity policies that challenge consolidating the main constitutional rights, should serve as encouragement for a professional training aligned with public interests, especially DCN, in health courses.
ESTÁGIO URGÊNCIA E EMERGÊNCIA: PROJETO INTEGRADO DE AVALIAÇÃO DO ENSINO MÉDICO
Authors: Arenson-Pandikow Helena M. , Bordin Ronaldo , Wolff Jane Maria Reos , Brum Maria Carlota Borba
Published: January 2021

Resumo: Este trabalho descreve o nível referido de aquisição de habilidades psicomotoras na área de urgência e emergência, obtidas por estudantes de Medicina do 11º semestre, durante um mês de treinamento no Hospital Municipal de Pronto Socorro de Porto Alegre (HPS-PoA). Questionários contendo uma listagem de habilidades técnicas inquiriam, antes do treinamento e imediatamente após, se os alunos consideravam-se aptos ao desempenho dessas habilidades. Na análise, as habilidades foram agrupadas de acordo com áreas de treinamento: clínica médica, politraumatizados, sutura, traumatologia e hemoterapia. Houve incremento significativo de respondentes que se consideraram aptos em 23 das 32 habilidades listadas. Quanto ao desempenho não houve diferença significativa em 15 das habilidades estudadas. Estes resultados sugerem que o fato do aluno julgar-se apto à execução de uma habilidade não significa que ele a lenha desempenhado durante seu período de treinamento.
Negacionismo da Covid-19 e educação popular em saúde: para além da necropolítica
Authors: Morel Ana Paula Massadar
Published: January 2021

Resumo As expressões do negacionismo da pandemia da Covid-19 recorrentes no Brasil estão relacionadas ao crescimento da extrema-direita e produzem o aumento da necropolítica. Percebemos uma ‘crise de interpretação’ que aponta a ‘ignorância’ como causa única da popularização do negacionismo. Buscaremos problematizar tal fenômeno, indo além dessa interpretação comum. Ancorado em uma ausência de mundo compartilhado, o negacionismo cresce com o ‘déficit de prática comum’. É preciso, entretanto, diferenciar as posições envolvidas: há aqueles que negam visando ao lucro, baseado em um desejo de morte e extermínio, e os que entram em negação por conta de uma realidade tão dura de que são vítimas. Diante disso, as ações educativas que têm por referência a educação popular em saúde são estratégias importantes para se enfrentar tal fenômeno, mobilizando as noções freirianas de diálogo e conflito. Essas ações permitem não ‘desconstruir’ os cuidados em saúde, mas ‘acrescentam realidade’ a eles, trazendo a importância de se considerarem as condições de vida das classes populares. Por fim, compreendendo o vínculo indissociável entre educação popular e movimentos sociais, apresentamos como movimentos de favela têm enfrentado o negacionismo em defesa da vida.