bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in lower extremity blood flow during advancing phases of pregnancy and the effects of special footwear
Authors: Gimunová Marta , Zvonař Martin , Kolářová Kateřina , Janík Zdeněk , Mikeska Ondřej , Musil Radek , Ventruba Pavel , Šagat Peter
Published: September 2017

Abstract Background During pregnancy, a number of changes affecting venous blood flow occur in the circulatory system, such as reduced vein wall tension or increased exposure to collagen fibers. These factors may cause blood stagnation, swelling of the legs, or endothelial damage and consequently lead to development of venous disease. Objectives The aim of this study is to evaluate the effect of special footwear designed to improve blood circulation in the feet on venous blood flow changes observed during advancing phases of pregnancy. Methods Thirty healthy pregnant women participated in this study at 25, 30, and 35 weeks of gestation. Participants were allocated at random to an experimental group (n = 15) which was provided with the special footwear, or a control group (n = 15). At each data collection session, Doppler measurements of peak systolic blood flow velocity and cross-sectional area of the right popliteal vein were performed using a MySonoU6 ultrasound machine with a linear transducer (Samsung Medison). The differences were compared using Cohen’s d test to calculate effect size. Results With advancing phases of pregnancy, peak systolic velocity in the popliteal vein decreased significantly in the control group, whereas it increased significantly in the experimental group. No significant change in cross-sectional area was observed in any of the groups. Conclusions Findings in the experimental group demonstrated that wearing the footwear tested may prevent venous blood velocity from reducing during advanced phases of pregnancy. Nevertheless, there is a need for further investigation of the beneficial effect on venous flow of the footwear tested and its application.
Compreendendo o Universo numa Perspectiva Newtoniana
Authors: Costa Francisco Ernandes Matos
Published: September 2017

As descobertas e avanços científicos devem tornar-se acessíveis a estudantes de graduação e da educação básica. Neste artigo, discutimos as principais ideias cosmológicas atuais utilizando conceitos de gravitação newtoniana, fluidos e as leis da termodinâmica. A abordagem apresentada aqui pode ser feita em um curso introdutório de graduação da área de ciências exatas.
Assessment of HER-2 status in invasive breast cancer in Brazil
Authors: Arias Victor Eduardo Arrua , Gobbi Helenice , Ioshii Sérgio Ossamu , Scapulatempo Cristovam , Paz Alexandre Rolim da , Silva Vinicius Duval da , Uchôa Diego , Zettler Claudio , Soares Fernando Augusto
Published: September 2017

Summary Objective: To characterize the frequency of HER-2-positive breast cancer in Brazil. Method: In this prospective observational study, we first ascertained the HER-2 status of invasive breast cancer specimens by automated immunohistochemistry (IHC). For specimens classified as 2+ by IHC, we performed in situ hybridization (ISH). Results: From February, 2011 to December, 2012, 1,495 breast specimens were registered, and 1,310 samples collected at 24 centers were analyzed. Median patient age was 54 years, and the majority of samples were obtained from segmental (46.9%) or radical mastectomy (34.4%). The predominant histological type was invasive breast carcinoma of no special type (85%), 64.3% had tubule formation (grade 3), and estrogen/progesterone receptors (ER/PR) were positive in 77.4/67.8% of the specimens analyzed, respectively. Using IHC, we found a negative HER-2 status (0 or 1+) in 72.2% of specimens, and 3+ in 18.5%; the 9.3% scored as 2+ were further analyzed by ISH, of which 15.7% were positive (thus, 20.0% of samples were HER-2- -positive by either method). We found no association between HER-2 scores and menopausal status or histological type. Tumors classified as 3+ came from younger patients, and had higher histological grade and less frequent expression of ER/PR. In the North region of Brazil, 34.7% of samples were 3+, with lower frequencies in the other four regions of the country. Conclusion: Our findings provide estimates for the frequency of HER-2 positivity in Brazil and raise the hypothesis that biological differences may underlie the different distribution of breast-cancer phenotypes among different Brazilian regions.
Levels of uric acid and increased diastolic blood pressure: Risk factors for atrial fibrillation in patients older than 60 years
Authors: Castro-Torres Yaniel , Khan Nabeel Yar , Carmona-Puerta Raimundo
Published: September 2017

Summary Objective: To characterize the maximum P-wave duration (Pmax) and P-wave dispersion (PWD) according to blood pressure (BP) and uric acid (UA) levels in geriatric patients. Method: An analytical study was performed in 83 patients aged over 60 years treated at the Family Medical Office 5 of the Aracelio Rodríguez Castellón Polyclinic, in Cienfuegos, Cuba between January and December 2015. The sample was divided into two groups (patients with hyperuricemia and patients with normal UA levels). Results: We found a linear and significant correlation between diastolic BP and Pmax in patients with hyperuricemia (r=0.695; p=0.026), but not in patients with normal UA (r=0.048; p=0.757). A linear and significant correlation was demonstrated between diastolic BP and PWD in patients with hyperuricemia (r=0.657; p=0.039), but not in patients with normal UA (r=0.054; p=0.730). Conclusion: There is correlation between diastolic BP and Pmax plus PWD in elderly patients with hyperuricemia.
Antiretroviral changes during the first year of therapy
Authors: Bandeira Antonio Carlos Policarpo Carmo Sá , Elias Darcielle Bruna Dias , Cavalcante Malena Gadelha , Lima Denise Girão Limaverde , Távora Lara Gurgel Fernandes
Published: September 2017

Summary Introduction: The Brazilian HIV/AIDS management and treatment guideline (PCDT), published in 2013, recommends and standardizes the use of highly active antiretroviral therapy (HAART) in all adult patients, in spite of LTCD4 count. This study aimed to analyze the first year of HAART use in patients from a reference center on HIV/AIDS management in Fortaleza, Ceará. Method: This descriptive study reviewed all prescription forms of antiretroviral regimens initiation and changes from January to July 2014. All antiretroviral regimen changes that occurred during the first year of therapy were evaluated. Data were analyzed with SPSS version 20. Mean, standard deviation and frequency, Student’s t and Mann-Whitney tests calculations were used, with significance at p<0.05. Results: From 527 patients initiating HAART, 16.5% (n=87) had a regimen change in the first year. These patients were mostly male (59.8%; n=52), aged 20 to 39 years, with only one HAART change (72.4%; n=63). Efavirenz was the most often changed drug, followed by tenofovir, zidovudine and lopinavir/ritonavir. Mean time of HAART changes was 120 days, with adverse reactions as the most prevalent cause. HAART was effective in decreasing viral load since second month of treatment (p=0.003) and increasing LTCD4 lymphocytes since fifth month (p<0.001). Conclusion: The main cause of initial HAART changes was adverse reaction and most patients had only one change in the HAART regimen. HAART prescription was in accordance to the PCDT from 2013.
Risk factors and complications in type 2 diabetes outpatients
Authors: Silva Ellen Fernandes Flávio , Ferreira Cristiane Maria Mendes , Pinho Lucineia de
Published: September 2017

Summary Objective: Our study investigated type 2 diabetes mellitus (T2DM) outpatients attending a university hospital in Montes Claros, MG, to estimate the prevalence of risk factors and their association with diabetes complications. Method: This was a quantitative, documental, retrospective and analytical study. Medical records of 95 outpatients with T2DM treated in this hospital from 2011 to 2015 were analyzed. Data were collected according to a structured questionnaire surveying sociodemographic, anthropometric and biochemical data and clinical and lifestyle aspects. Regression analysis was used to evaluate the association between risk factor variables and complications. Results: With a mean age of 54 years, the study population showed irregular blood glucose control, despite the use of hypoglycemic medication, and did not have a healthy lifestyle. The main complication reported was high blood pressure (HBP), occurring in 70.9% of patients. The prevalence of complications was positively associated with patients receiving insulin treatment (p=0.042) and multidisciplinary monitoring (p=0.050). Conclusion: The associations identified reflect the condition of patients that were already treating diabetes and its complications, especially HBP. The characteristics of the study population indicate the need to improve clinical follow-up and increase motivation for healthy behaviors.
Pelvic floor muscle training protocol for stress urinary incontinence in women: A systematic review
Authors: Oliveira Marlene , Ferreira Margarida , Azevedo Maria João , Firmino-Machado João , Santos Paula Clara
Published: September 2017

Summary Introduction: Strengthening exercises for pelvic floor muscles (SEPFM) are considered the first approach in the treatment of stress urinary incontinence (SUI). Nevertheless, there is no evidence about training parameters. Objective: To identify the protocol and/or most effective training parameters in the treatment of female SUI. Method: A literature research was conducted in the PubMed, Cochrane Library, PEDro, Web of Science and Lilacs databases, with publishing dates ranging from January 1992 to March 2014. The articles included consisted of English-speaking experimental studies in which SEPFM were compared with placebo treatment (usual or untreated). The sample had a diagnosis of SUI and their age ranged between 18 and 65 years. The assessment of methodological quality was performed based on the PEDro scale. Results: Seven high methodological quality articles were included in this review. The sample consisted of 331 women, mean age 44.4±5.51 years, average duration of urinary loss of 64±5.66 months and severity of SUI ranging from mild to severe. SEPFM programs included different training parameters concerning the PFM. Some studies have applied abdominal training and adjuvant techniques. Urine leakage cure rates varied from 28.6 to 80%, while the strength increase of PFM varied from 15.6 to 161.7%. Conclusion: The most effective training protocol consists of SEPFM by digital palpation combined with biofeedback monitoring and vaginal cones, including 12 week training parameters, and ten repetitions per series in different positions compared with SEPFM alone or a lack of treatment.
Mild cognitive impairment and progression to dementia of Alzheimer's disease
Authors: Steiner Ana Beatriz Quintes , Jacinto Alessandro Ferrari , Mayoral Vânia Ferreira de Sá , Brucki Sonia Maria Dozzi , Citero Vanessa de Albuquerque
Published: September 2017

Summary The increase in life expectancy in the Brazilian population raises questions about the preparation of the public health system in identifying elderly patients with signs of cognitive impairment. Currently, as a consequence of the long duration of preclinical phase of Alzheimer's disease, efforts of early detection have been emphasized. Clinical dementia presents an important impact on the individual's caregivers, family, society and economy. Identifying individuals who already have some cognitive impairment, despite remaining functional, as well as analyzing associated comorbidities, constitutes an opportunity to analyze possibilities for future interventions. Dementias are clinical conditions that impose a burden on the health system with its high costs, whereas the identification of individuals with cognitive impairment without dementia can aid patients and their families to plan the future and mitigate costs. This narrative revision can provide general practitioners with more information on the subject.
Urinary EN-2 to predict prostate cancer: Systematic review and meta-analysis
Authors: Rosa Maria Inês da , Dondossola Eduardo Ronconi , Alexandre Maria Cecilia Manenti , Madeira Kristian , Cardoso Florentino de Araújo , Grande Antonio José
Published: September 2017

Summary Introduction: Prostate cancer is the second type of cancer diagnosed and the fifth cause of death in men worldwide. Early diagnosis helps to control disease progression. Currently, prostate specific antigen is the standard biomarker, as it has a broad scope of identification and, thus, new and more specific biomarkers must be studied. Objective: To evaluate the accuracy of engrailed-2 protein (EN2) in urine as a prostate cancer biomarker. Method: A comprehensive search was conducted in the period from January 2005 to July 2016 using the following electronic databases: Medline (PubMed), Embase, Cochrane Library and Lilacs. The keywords used in the databases were: "engrailed-2," "EN2," "prostatic neoplasms." The search was limited to humans and there was no language restriction. Critical appraisal of the included studies was performed according to Quadas-2. Statistical analysis was performed using Meta-DiSc® and RevMan 5.3 softwares. Results: A total of 248 studies were identified. After title and abstract screening, 231 studies were removed. A total of 17 studies were read in full and two studies were included in the meta-analysis. The pooled sensitivity was 66% (95CI 0.56-0.75) and specificity was 89% (95CI 0.86-0.92). The DOR was 15.08 (95CI 8.43-26.97). Conclusion: The EN2 test showed high specificity (89%) and low sensitivity (66%).
Association between renal cysts and abdominal aortic aneurysm: A case-control study
Authors: Veiga Hélio Miguel de Azevêdo Bião , Silva Leandro José Correia da , Bellucci Carlos Henrique Suzuki , Santos Marcus Vinicius Miranda dos , Tiraboschi Ricardo Brianezi , Paschoalin Victor Pereira , Borba Lucas , Gomes Cristiano Mendes , Bastos-Netto José Murillo , Bessa Junior José de
Published: September 2017

Summary Objective: To investigate the positive association between the presence of simple renal cysts (SRCs) and abdominal aortic aneurysm (AAA). Method: In a retrospective case-control study including subjects aged > 50 years, we evaluated the incidence of SRCs on computed tomography (CT) scan. We compared 91 consecutive patients with AAA referred from the Division of Vascular Surgery and 396 patients without AAA, randomly selected after being matched by age and gender from 3,186 consecutive patients who underwent abdominal CT. SRC was defined as a round or oval low-attenuation lesion with a thin wall and size > 4 mm on CT without obvious evidence of radiographic enhancement or septations. Patients were considered as having AAA if the size of aorta was greater than 3.0 cm. Results: Patients with AAA and without AAA were similar in terms of age (67.9± 8.41 vs. 68.5±9.13 years) (p=0.889) and gender (71.4 vs. 71.2% of male subjects, respectively) (p=0.999). There was no difference in the prevalence of SRC between case and controls. Among individuals with AAA, 38 (41.8%; [95CI 32.5-52.6]) had renal cysts compared to 148 (37.4%; [95CI 32.7-42.2]) in the control group (p=0.473), with a prevalence ratio (PR) of 1.16 (95CI 0.80-1.68). Conclusion: We found no significant differences in the prevalence of SRCs among patients with AAA and controls. Our findings suggest that the presence of SRCs is not a risk factor or a marker for AAA.
Flexible ureterorenoscopy in position or fusion anomaly: Is it feasible?
Authors: Astolfi Rafael Haddad , Freschi Gustavo , Berti Fernando Figueiredo , Gattas Nelson , Molina Junior Wilson Rica , Meller Alex
Published: September 2017

Summary Objective: To analyze the results of flexible ureterorenoscopy (F-URS) with holmium laser in the treatment of kidney stones with ectopic and fusion anomalies (horseshoe kidney and rotation anomalies). Method: We reviewed data from 13 patients with fusion and ectopic renal anomalies that underwent F-URS from April 2011 to April 2017. We analyzed demographic and clinical data (age, gender, BMI, anatomical abnormality, location and dimension of the renal calculi) and perioperative data (method of treatment, stone-free rate, number of days with DJ catheter and perioperative complications). Results: The mean stone size was 12.23 +/- 5.43 mm (range 6-22mm), located in the inferior (58.33%) and middle (16.76%) calyceal units, renal pelvis (16.67%) and multiple locations (8.33%). All 13 patients were treated with Ho-Yag laser, using dusting technique (25%), fragmentation and extraction of the calculi (58.33%) and mixed technique (16.67%). We did not have any severe perioperative complication. After 90 days, nine patients (75%) were considered stone free. Conclusion: Our data suggest that F-URS is a safe and feasible choice for the treatment of kidney stones in patients with renal ectopic and fusion anomalies.
Low serum testosterone is a predictor of high-grade disease in patients with prostate cancer
Authors: Albuquerque George A. M. Lins de , Guglielmetti Giuliano B. , Barbosa João Arthur B. A. , Pontes Jr. José , Fazoli Arnaldo J. C. , Cordeiro Maurício D. , Coelho Rafael F. , Carvalho Paulo Afonso de , Gallucci Fábio P. , Padovani Guilherme P. , Park Rubens , Cury José , Nonemacher Henrique , Srougi Miguel , Nahas William C.
Published: September 2017

Summary Objective: To evaluate the relation between serum total testosterone (TT) and prostate cancer (PCa) grade and the effect of race and demographic characteristics on such association. Method: We analyzed 695 patients undergoing radical prostatectomy (RP), of whom 423 had serum TT collected. Patients were classified as having hypogonadism or eugonadism based on two thresholds of testosterone: threshold 1 (300 ng/dL) and threshold 2 (250 ng/dL). We evaluated the relation between TT levels and a Gleason score (GS) ≥ 7 in RP specimens. Outcomes were evaluated using univariate and multivariate analyses, accounting for race and other demographic predictors. Results: Out of 423 patients, 37.8% had hypogonadism based on the threshold 1 and 23.9% based on the threshold 2. Patients with hypogonadism, in both thresholds, had a higher chance of GS ≥ 7 (OR 1.79, p=0.02 and OR 2.08, p=0.012, respectively). In the multivariate analysis, adjusted for age, TT, body mass index (BMI) and race, low TT (p=0.023) and age (p=0.002) were found to be independent risk factors for GS ≥ 7. Among Black individuals, low serum TT was a stronger predictor of high-grade disease compared to White men (p=0.02). Conclusion: Hypogonadism is independently associated to higher GS in localized PCa. The effect of this association is significantly more pronounced among Black men and could partly explain aggressive characteristics of PCa found in this race.
Contemporary surgical treatment of benign prostatic hyperplasia
Authors: Nunes Ricardo Luís Vita , Antunes Alberto Azoubel , Constantin Davi Souza
Published: September 2017

Summary Benign prostatic hyperplasia (BPH) is a common condition in adult men and its incidence increases progressively with aging. It has an important impact on the individual’s physical and mental health and its natural progression can lead to serious pathological situations. Although the initial treatment is pharmacological, except in specific situations, the tendency of disease progression causes a considerable portion of the patients to require surgical treatment. In this case, there are several options available today in the therapeutic armamentarium. Among the options, established techniques, such as open surgery and endoscopic resection using monopolar energy, still prevail in the choice of surgeons because they are more accessible, both from a socioeconomic standpoint in the vast majority of medical services and in terms of training of medical teams. On the other hand, new techniques and technologies arise sequentially in order to minimize aggression, surgical time, recovery and complications, optimizing results related to the efficacy/safety dyad. Each of these techniques has its own peculiarities regarding availability due to cost, learning curve and scientific consolidation in order to achieve recognition as a cutting-edge method in the medical field. The use of bipolar energy in endoscopic resection of the prostate, laser vaporization and enucleation techniques, and videolaparoscopy are examples of new options that have successfully traced this path. Robot-assisted surgery has gained a lot of space in the last decade, but it still needs to dodge the trade barrier. Other techniques and technologies will need to pass the test of time to be able to conquer their space in this growing market.
PSA screening for prostate cancer
Authors: Sadi Marcus V.
Published: September 2017

Summary Screening of prostate cancer with prostate-specific antigen (PSA) is a highly controversial issue. One part of the controversy is due to the confusion between population screening and early diagnosis, another derives from problems related to the quality of existing screening studies, the results of radical curative treatment for low grade tumors and the complications resulting from treatments that affect the patient’s quality of life. Our review aimed to critically analyze the current recommendations for PSA testing, based on new data provided by the re-evaluation of the ongoing studies and the updated USPSTF recommendation statement, and to propose a more rational and selective use of PSA compared with baseline values obtained at an approximate age of 40 to 50 years.
Conhecimento de Libras pelos Médicos do Distrito Federal e Atendimento ao Paciente Surdo
Authors: Gomes Letícia Ferreira , Machado Fernanda Cordeiro , Lopes Mayara Melo , Oliveira Raiane Soares , Medeiros-Holanda Bruno , Silva Luciana Bonifácio , Barletta Janaína Bianca , Kandratavicius Ludmyla
Published: September 2017

RESUMO O ensino da Língua Brasileira de Sinais (Libras) nas escolas médicas é pouco difundido, e este cenário pode dificultar o atendimento de importante parcela da população: o paciente surdo. De acordo com o Instituto Brasileiro de Geografia e Estatística (IBGE), cerca de 24% da população brasileira tem algum tipo de deficiência, sendo parte de um grupo conhecido como vulneráveis. A surdez está entre as deficiências mais prevalentes, e no contexto do atendimento médico a dificuldade em atender integralmente o paciente surdo constitui um problema de saúde pública relevante, mas pouco abordado. O objetivo do presente estudo foi avaliar o conhecimento de Libras por médicos do Distrito Federal e sua percepção frente ao atendimento de pacientes surdos. Assim, foi realizado um estudo observacional transversal e descritivo com aplicação de questionários a 101 médicos escolhidos ao acaso, atuantes no Sistema Único de Saúde (SUS) no Distrito Federal. Foram entrevistados médicos de 24 especialidades, com idade média de 41 anos. Deles, 92,1% já atenderam um paciente surdo e 76,2% consideraram o conhecimento de Libras importante para sua prática médica, mas apenas um relatou conhecimento básico na lingua. Quanto ao sentimento do médico no atendimento, houve predomínio de incerteza e desconforto. Um número significativo de médicos já realizou atendimento de pacientes surdos em sua prática profissional no SUS, e a maioria considerou o conhecimento de Libras relevante, especialmente os médicos com menos de 55 anos de idade. Possivelmente, o sentimento de desconforto no atendimento decorre do predominante desconhecimento da língua pelos médicos e da conseguinte dificuldade durante o atendimento. Destaca-se a importância da implantação ou ampliação do estudo de Libras antes ou durante a formação médica e dos demais cursos da área de saúde. A conscientização dos profissionais de saúde perante o atendimento integral do paciente surdo é um passo fundamental na implementação efetiva do ensino de Libras de forma especializada no ensino superior, resultando em maior confiança e qualidade na relação médico-paciente.
Team-Based Learning: Successful Experience in a Public Health Graduate Program
Authors: Silva Junior Geraldo Bezerra da , Medeiros Maria Angelina Silva , Oliveira Juliana Gomes Ramalho de , Catrib Ana Maria Fontenele , Jardim Maria Helena de Agrela Gonçalves
Published: September 2017

ABSTRACT Background: In the review of curriculum matrices, the elaboration of learning strategies that combine theory and practice is extremely important, allowing the building of new concepts and learning methods by the students. Team-based learning (TBL) is growing in academic centers and refers to the pedagogic strategy grounded in constructivism. The aim of this research was to describe the application of TBL in a Public Health graduate program. Methods: TBL was applied in a class with 22 students in the discipline “Quantitative Research in Health” of the Public Health graduate program (Master degree) at the University of Fortaleza, Brazil, in 2016. The discipline was structured in 8 lessons, approaching the thematic of quantitative research. Before each class the students were required to study the contents at home, a test was done for each subject in the beginning of each class (individually and then in teams of 5 or 6 students) and then a brief review was performed by the professor, where the students could ask questions and solve any doubt. At the end of the semester an evaluation questionnaire was applied with objective questions and a qualitative survey. Results: The application of TBL was done in a class with 22 students of the Public health Master Program, aged 22 to 36 years, and 83.3% were female. The method was well received by the students. All the evaluations and discussions went on without any problem. There were some complaints about the requirement to study at home prior to the classes. Students’ evaluation of the discipline and the TBL method was satisfactory with answers’ average score of 4.7 (scale 0-5). The lowestscore was achieved by the question number 11 (4.3) about the students motivation for their study at home. The comparison with the evaluation of the previous semester (where a traditional method was applied) evidenced higher scores for the TBL method. Conclusions: The application of TBL was satisfactory and the main difficulty presented by students was the requirement for previous study at home. TBL was better evaluated than the traditional method.
RELAÇÃO TEORIA-PRÁTICA NOS CURSOS DE MESTRADO ACADÊMICO E PROFISSIONAL NA ÁREA DA SAÚDE COLETIVA
Authors: Hortale Virginia Alonso , Santos Gideon Borges dos , Souza Kátia Mendes de , Vieira-Meyer Anya Pimentel Gomes Fernandes
Published: September 2017

Resumo O presente estudo partiu da percepção da existência de semelhanças e diferenças na relação teoria-prática em cursos de mestrado, modalidades acadêmica e profissional na área da Saúde Coletiva. Adotou-se como pressuposto que, nesta relação, as propostas de mestrado profissional não partem da prática profissional dos agentes como cenário para construir novos conhecimentos e tecnologias, mas tendem a reproduzir o modelo hegemônico de formação consolidado no mestrado acadêmico. A partir das categorias ‘relação academia-contexto profissional’, ‘quadro docente’, ‘trabalho final e justificativa para o curso’, o estudo com abordagem qualitativa realizou-se por meio de análise documental e de propostas de cursos, além de entrevistas com coordenadores dos cursos. Para aprofundar a discussão, selecionaram-se sete instituições de ensino superior que ofereciam cursos nessas modalidades. Conclui-se que essa relação é mais complexa no mestrado profissional, e que este, como prevê a legislação, buscou consolidar uma identidade distinta da especialização e do mestrado acadêmico, o que pode caracterizar a principal diferença entre as modalidades. No entanto, seus processos ainda adotam os mesmos referenciais e práticas que o mestrado acadêmico.
AGENTES COMUNITÁRIOS DE SAÚDE NA ATENÇÃO PRIMÁRIA NO BRASIL: MULTIPLICIDADE DE ATIVIDADES E FRAGILIZAÇÃO DA FORMAÇÃO
Authors: Samudio Jania Lurdes Pires , Brant Letícia Carneiro , Martins Ana Clara de Freitas Dias Costa , Vieira Maria Aparecida , Sampaio Cristina Andrade
Published: September 2017

Resumo O estudo teve como objetivo avaliar, mediante revisão integrativa, o conhecimento produzido na literatura acerca das atividades desempenhadas pelos agentes comunitários de saúde no Brasil e em outros países. A busca de dados, realizada no período de 2010 a 2014, abrangeu: Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior; biblioteca eletrônica Scientific Electronic Library Online; Literatura Latino-Americana e do Caribe em Ciências da Saúde; Medical Literature Analysis and Retrieval System On-line e US National Library of Medicine National Institutes of Health. Dos 240 estudos identificados, 27 foram incluídos nesta revisão. A literatura evidencia as funções que os agentes comunitários de saúde exercem, em variedade de ações em diversos contextos geográficos e culturais. O agente tem diferentes inserções no mercado de trabalho e vivencia fragilidades, oriundas de contextos socioculturais da comunidade, da necessidade de maior reconhecimento do sistema de saúde e da equipe. Sua posição entre a comunidade e a equipe de saúde é estratégica, contribuindo para a saúde da comunidade. Deve-se proporcionar formação propícia à sua atuação e possibilitar o acesso à educação permanente, além de se promoverem recursos para maior valorização da equipe de saúde em sua relação com a sociedade.
POLÍTICA DE RESIDÊNCIA MÉDICA E CARÊNCIA DE ESPECIALISTAS EM GINECOLOGIA E OBSTETRÍCIA NO SUS EM PERNAMBUCO
Authors: Martins Emanuella Margareth Lima Rolim , Albuquerque Paulette Cavalcanti de , Oliveira Júnior Fernando José Moreira de , Figueiredo Filho Dalson Britto
Published: September 2017

Resumo A distribuição eficiente de profissionais de saúde, em especial os médicos, é um dos principais problemas enfrentados pelos gestores de políticas públicas da saúde. Na tentativa de resolver essa problemática, o estado de Pernambuco está ampliando o número de graduandos de medicina, inclusive de maneira interiorizada, e incentivando os programas de residência médica, com aumento de vagas e programas. Tais ações são estratégias para a fixação e o provimento do profissional médico. O objetivo geral do estudo que deu origem a este artigo foi apresentar a política de residência médica como estratégia de formação de recursos humanos para o Sistema Único de Saúde e demonstrar a carência de médicos especialistas em ginecologia e obstetrícia para o Sistema Único de Saúde de Pernambuco, a partir da desassistência ao parto. Os resultados encontrados demonstraram maior procura dos médicos pela especialidade de ginecologia e obstetrícia ao longo dos anos, porém existe grande concentração dessa especialidade na região próxima à capital (Recife) e de partos em determinadas localidades do estado.
PROBLEMAS BIOÉTICOS NO COTIDIANO DO TRABALHO DE PROFISSIONAIS DE EQUIPES DE SAÚDE DA FAMÍLIA
Authors: Valadão Patrícia Aparecida da Silva , Lins Liliane , Carvalho Fernando Martins
Published: September 2017

Resumo A pesquisa buscou identificar e avaliar os problemas bioéticos envolvidos no cotidiano de trabalho de profissionais de duas equipes da Estratégia Saúde da Família. Neste estudo qualitativo, realizaram-se entrevistas individuais semiestruturadas com 16 profissionais da equipe de saúde da família de Salvador, Bahia, de fevereiro a outubro de 2015. Utilizou-se a análise de conteúdo proposta por Bardin, assim como a bioética principialista e o pensamento complexo de Edgar Morin. Identificaram-se duas categorias: ‘Problemas bioéticos no cotidiano de trabalho da equipe de saúde da família’ e ‘A relação interprofissional na equipe de saúde da família’. Na primeira categoria, evidenciaram-se falta de companheirismo e colaboração entre os membros da equipe; ações verticalizadas da gestão; dificuldades em preservar a privacidade do usuário e dos profissionais. Na segunda, destacaram-se a disparidade de poder nas relações interprofissionais e o encontro ‘frio’ entre núcleo de apoio e assistência à saúde da família e equipe. Concluiu-se que a equipe de saúde da família não tem avançado no aperfeiçoamento do trabalho em equipe interdisciplinar. Os problemas identificados ferem os princípios do enfoque principialista da bioética, esgarçam o tecido social do trabalho na Estratégia Saúde da Família e contribuem para a descaracterização da atenção básica.
A ESTRATÉGIA SAÚDE DA FAMÍLIA E A ESCOLA NA EDUCAÇÃO SEXUAL: UMA PERSPECTIVA DE INTERSETORIALIDADE
Authors: Pinheiro Aldrin de Sousa , Silva Lucia Rejane Gomes da , Tourinho Maria Berenice Alho da Costa
Published: September 2017

Resumo A pesquisa analisou como o trabalho de educação sexual de adolescentes e jovens é desenvolvido na perspectiva da intersetorialidade de saúde e educação. Foram levantadas as características pedagógicas e metodológicas usadas por professores e profissionais da Estratégia Saúde da Família de um município do sul da Amazônia ocidental, assim como as perspectivas de interseção da escola com os serviços de saúde para a educação sexual. A pesquisa foi realizada no período de maio a setembro de 2013. Optou-se pela abordagem qualitativa. Após entrevista semiestruturada, utilizou-se a análise de conteúdo para o levantamento das categorias temáticas. O trabalho de educação sexual caracterizou-se por atividades pontuais motivadas pela demanda. A família foi considerada a principal responsável pela educação sexual, e o despreparo profissional mostrou-se fator importante para a não realização desse tipo de educação. As perspectivas intersetoriais pontuadas pelos participantes ficaram limitadas às ações já existentes na prática, como palestras e projetos, dentre outras. A intersetorialidade para o trabalho de educação sexual parece transitar no campo das ideias, amarrada aos discursos. Apesar de iniciativas governamentais a estimularem, essas perspectivas não têm dado conta da complexidade que envolve sua legitimação. É necessário que novas estratégias para o trabalho da educação sexual sejam discutidas.
Biogeography of Amazonian fishes: deconstructing river basins as biogeographic units
Authors: Dagosta Fernando C. P. , Pinna Mário de
Published: September 2017

ABSTRACT Biogeography of Amazonian fishes (2,500 species in vastly disjunct lineages) is complex and has so far been approached only partially. Here, we tackle the problem on the basis of the largest database yet on geographical distribution and phylogenetic relationships of Amazonian fishes, including all information available. Distributions of 4,095 species (both Amazonian and outgroups) and 84 phylogenetic hypotheses (comprising 549 phylogenetically-informative nodes) were compiled, qualified and plotted onto 46 areas (29 Amazonian and 17 non-Amazonian). The database was analyzed with PAE, CADE, BPA and BPA0, yielding largely congruent results and indicating that biogeographic signal is detectable on multiple dimensions of fish distribution, from single species ranges to cladistic congruence. Agreement is especially pronounced in deeper components, such as Trans-Andean, Cis-Andean, Western Amazon and Orinoco basins. Results show that all major Amazonian tributaries, as well as the Amazon basin itself, are non-monophyletic and constitute hybrid sets of heterogeneous biotic partitions. Amazonian drainages should not be assumed a priori as historically cohesive areas, contrary to widespread practice. Our hypothesis allows re-evaluation of broader issues in historical biogeography, such as the predictive power of biogeographic hypotheses, the vicariant/dispersal duality, the significance of widely distributed taxa, and the need for temporal dimension in biogeographic patterns.
The protected areas system in Brazil as a baseline condition for wetlands management and fish conservancy: the example of the Pantanal National Park
Authors: Polaz Carla N. M. , Ferreira Fabio C. , Petrere Júnior Miguel
Published: September 2017

ABSTRACT Considering the need for the Brazilian government to develop tools for environmental monitoring for biodiversity conservancy purposes in the national protected areas system, this paper focuses on determining reference site metrics (or baselines) for adapting the Index of Biotic Integrity (IBI) based on the fish assemblages in the Pantanal National Park (PNP). The habitats in the PNP were grouped into four categories: main rivers, corixos (channels connecting the floodplain), permanent bays, and temporary bays. Fish samplings were performed at 12 points during the dry season (Oct-Nov 2010 and 2011). 146 fish species were identified from the total 18,954 individuals collected with standardized fishing gear. There was no association between the structure of the fish assemblage and categories, suggesting a theory on homogeneity of habitats. The final IBIPNP consists of nine metrics, most of them were framed in excellent class, some in fair, and none in poor. There was no significant difference in IBIPNP scores between the two sampled years. This approach provides a direct application for wetland management purposes.
Sexualidad, migraciones y fronteras en contextos de integración sur-sur
Authors: Ruiz Martha Cecilia
Published: September 2017

Resumen Este artículo se pregunta sobre los procesos de diferenciación, jerarquización e inclusión/exclusión de poblaciones migrantes en contextos migratorios sur-sur, y sobre el rol que juega la sexualidad en estos procesos. Partiendo de un estudio etnográfico sobre las migrantes peruanas y colombianas en el sector del comercio sexual de Ecuador, se analiza la manera en que la sexualidad se convierte en un sitio privilegiado para re-imaginar las diferencias y jerarquías nacionales en un mundo globalizado e integrado regionalmente, y se explica cómo los regímenes de control sobre las migraciones y la sexualidad femenina se articulan entre sí para restablecer el orden idealizado de la nación.
Activismo católico antiabortista en Argentina: performances, discursos y prácticas
Authors: Bessone Pablo Gudiño
Published: September 2017

Resumen Este artículo se interesa en el accionar político del activismo católico antiabortista en Argentina y las distintas performances de acción colectiva que tales grupos desarrollan en el espacio público urbano. Repara en la forma en que dichos grupos autodenominados pro-vida mantienen un discurso de oposición a la legalización del aborto con base en el despliegue de argumentaciones científicas y bioéticas. Esto, en tanto modo de contrarrestar la presencia y movilización de las organizaciones feministas y ejercer oposición a las demandas de ley de interrupción voluntaria del embarazo.
Superación de la violencia de pareja: revisión
Authors: Lopez-Ramirez Estefania , Sosa Gladys Rocío Ariza
Published: September 2017

Resumen Las investigaciones sobre violencia en las relaciones de pareja generalmente no se enfocan en lo que sucede cuando se termina la relación. Por ello se planteó una revisión narrativa con una búsqueda sistemática con el objetivo de comprender el significado de superación de la violencia y cómo las personas que deciden salir de una relación violenta logran dejar atrás la violencia. Los artículos seleccionados muestran las diferentes salidas que van desde poner fin a la relación, denunciar a las autoridades, morir en manos del maltratador, matar a la pareja o suicidarse. Las alternativas halladas pueden dar fin a la violencia o permitir que esta continúe e incluso empeore. Como conclusión se propone una definición de superación de la violencia en las relaciones de pareja.
Ciência, justiça e antropologia no debate sul-africano da AIDS: produção de sensibilidades e regulação moral entre especialistas
Authors: Sanabria Guillermo Vega
Published: September 2017

Resumo O texto relata minha experiência enquanto pesquisava o :debate da AIDSd ocorrido na África do Sul na década de 2000. A partir de pesquisa em arquivos, entrevistas e observação participante em ambientes acadêmicos e entre especialistas da AIDS, exploro as críticas de alguns dos meus interlocutores contra o suposto relativismo e a alegada postura dos antropólogos em face da controvérsia. Em meio a constantes apelos para combater o negacionismoc da AIDS, desconfiança e mesmo aberto rechaço ao pensamento antropológico, analiso minha inserção em redes de pesquisadores e ativistas na Cidade do Cabo, à luz do enfrentamento entre “ortodoxos” ou defensores da ciência da AIDSc e negacionistasn ou dissidentesd. A dificuldade habitual da pesquisa etnográfica é atualizada neste caso, mas ele também coloca um novo desafio: como pode o conhecimento antropológico contribuir para uma melhor compreensão de disputas, sobretudo quando, do ponto de vista .nativon, tais disputas parecem insuperáveis ou inexistem?
“Ninguna mujer...” El abolicionismo de la prostitución en la Argentina
Authors: Morcillo Santiago , Varela Cecilia
Published: September 2017

Resumen Los debates feministas sobre la prostitución han sufrido una creciente polarización en la última década. El presente artículo constituye una exploración en torno a ciertas expresiones del abolicionismo en Argentina. Partimos del análisis de dos escenas que retratan experiencias que hemos tenido al investigar sobre el mercado sexual en ese contexto de polarización. En primer lugar, buscamos describir y analizar los elementos presentes en estas escenas que pueden remitir a concepciones esencialistas y prácticas políticas que contribuyen a la segregación de las mujeres que se definen políticamente como “trabajadoras sexuales”, como “otras” de ese movimiento. En segundo lugar, nos interrogamos sobre las condiciones de posibilidad de esta deriva de algunas vertientes del movimiento abolicionista local.
Aquém do fundamentalismo, além da intolerância: hostilidade e hospitalidade no debate sobre direitos de gays e lésbicas
Authors: Nagamine Renata Reverendo Vidal K. , Natividade Marcelo Tavares
Published: September 2017

Resumo O artigo explora as possibilidades e os limites das noções de ‘fundamentalismo’, tolerância’ e ‘intolerância’ e avalia os potenciais ganhos das noções de ‘hostilidade’ e ‘hospitalidade’ para a análise de controvérsias contemporâneas sobre política sexual. Elabora sobre uma controvérsia que se instaurou em torno da consulta popular sobre o casamento entre pessoas do mesmo sexo na Irlanda, em 2015. Procura-se delinear os contornos das duas noções propostas como categorias teóricas em antropologia. O artigo discute conceitos do campo da antropologia da religião a partir da análise de controvérsias e da análise qualitativa de um caso, com base em pesquisa documental e bibliográfica.
Saúde sexual e reprodutiva, conservadorismo religioso e acesso a medicamentos: uma discussão sobre a estratégia global de advocacy do Consórcio Internacional sobre Contracepção de Emergência
Authors: Bastos Luiza Lena , Ventura Miriam , Brandão Elaine Reis
Published: September 2017

Resumo O Consórcio Internacional sobre Contracepção de Emergência (ICEC) é uma organização não governamental, criada em 1996 por iniciativa da Fundação Rockefeller. O ICEC tem sido o principal interlocutor no cenário mundial na defesa do acesso à contracepção de emergência (CE) e na sua difusão nos, assim chamados, países em desenvolvimento. Seu website é uma importante fonte de informação e veículo para advogar em prol dos CE. Foi realizada uma análise temática em documentos selecionados do website do ICEC disponíveis no período de 2013 e 2014. Este artigo indaga se a ausência de uma discussão ampla sobre sexualidade e direitos humanos, constatada no material analisado, seria pautada por um cenário político de acirrado fundamentalismo religioso.
Présence et Micropolitique du Sensible: Ouverture Alcina, un cas de composition postdramatique
Authors: Giorgi Margherita De
Published: September 2017

Résumé: La notion de présence suscite un débat très animé dans la scène actuelle des arts vivants. Ce texte donne un aperçu des théories récentes et ensuite propose une approche à l’étude de la présence au prisme des épistémologies des pratiques du corps et du geste, ainsi que de la notion d’affect (Massumi, 1995; 2015). Ensuite, l’analyse d’ Ouverture Alcina, solo de la compagnie italienne Teatro delle Albe, relit la présence en tant que restitution d’un travail physique, performatif et compositionnel, à savoir un dispositif fabriquant un discours politique à travers l’expérience perceptive du spectateur.
Uma Alma que Dança ou Despenca: corpo e presença na experiência literária
Authors: Diniz Ligia G.
Published: September 2017

Resumo: Este artigo reflete sobre a dimensão afetiva da leitura de textos poéticos e ficcionais. Proponho que a imaginação é o espaço em que nos aproximamos das obras literárias por meio de sensações e emoções. Para tal, desenvolvo um conceito de presença voltado para a experiência literária, em que o corpo do leitor é mobilizado a partir de efeitos disparados pelo texto em contato com seu imaginário.
La Metodología de Actuación Realista como Dispositivo de Atenuación de la Presencia del Actor en Teatro y Cine
Authors: Mauro Karina
Published: September 2017

Resumen: En el presente trabajo nos proponemos analizar la metodología de actuación realista como dispositivo de atenuación de la presencia del actor. Consideramos que el sistema Stanislavski constituyó la primera y más acabada resolución técnica a una larga aspiración por la transparencia del enunciado escénico hacia el referente. Para ello, se propuso reducir el carácter disruptivo y acontecimental de la exhibición pública del cuerpo y de la acción del actor a través de una serie de procedimientos que analizaremos en este artículo.
Presença Diluída em Rouge Mékong: uma proposição para a cena intermedial
Authors: Oliveira Fernanda Areias , Isaacsson Marta , Biasuz Maria Cristina
Published: September 2017

Resumo: Descreve-se neste artigo a presença mediada por dispositivos de imagem. O recorte proposto situa a cena contemporânea intermedial, emergindo como estudo de destaque o espetáculo imersivo Rouge Mékong, desenvolvido pelo coletivo canadense de artistas interdisciplinares, Collectif Lebovitz. A referida experiência nos guiará como obra sistematizadora do conceito efeito de presença, desenvolvido por Josette Féral, e aqui investigado como constituinte da dramaturgia desse espetáculo. Investiga-se ainda a apresentação de discussões voltadas para a presença do ator mediada pela tecnologia da imagem virtual e as possibilidades de percepção sobre o espectador levantadas por Auslander (2008), Féral (2012) e Lehmann (2007) quando em relação à cena intermedial.
Narratives of mothers of children with autism spectrum disorders: focus on eating behavior
Authors: Lázaro Cristiane P. , Pondé Milena P.
Published: September 2017

Abstract Objective To investigate the eating behavior of individuals with autism through their mothers’ narratives. Methods The study of narratives was used to report on the narrators’ experiences. Data on the eating habits of individuals with autism were collected using semi-structured interviews held individually with the mothers. The interviews were recorded, transcribed and codified using the NVivo software program. Results Eighteen mothers of boys/young men with autism participated in the study. Analysis yielded three major categories: eating patterns, the family's attitudes to the child's eating habits, and food-related behavior. Conclusion Results show that autism-related factors may affect the child's food choices. Environmental factors, particularly the parents’ behavior, may also play a decisive role, both in reinforcing the child's food choices and in encouraging a healthier and more diversified diet. Professionals should instruct parents regarding their decisive role in reinforcing or discouraging inappropriate mealtime behavior in children with autism.