bluuebunny/crossref_metadata_2025 huggingface dataset:
SLEEP AND CHILDHOOD MENTAL HEALTH: ROLE OF PHYSICAL ACTIVITY AND CARDIORESPIRATORY FITNESS
Authors: Fochesatto Camila Felin , Gaya Adroaldo , Brand Caroline , Mota Jorge , Bandeira Denise Ruschel , Lemes Vanilson Batista , Martins Clarice Maria de Lucena , Gaya Anelise Reis
Published: January 2020

ABSTRACT Introduction: Sleep is considered an important health indicator and plays a key role in brain development and plasticity. Objective: To ascertain whether there is a relationship between sleep quality and mental health indicators and whether organized physical activity (PA) or cardiorespiratory fitness (CRF) act as moderators of this association. Methods: This is a cross-sectional study with a quantitative approach. The sample consisted of 226 students between six and 11 years of age, male and female, in the early years of elementary education at a public school in Porto Alegre, Brazil, which was selected for convenience. CRF was measured by running test and six-minute walk. Sleep quality and organized physical activity outside of school were verified through an anamnesis, socioeconomic status through an adaptation of the ABEP (Brazilian Association of Research Companies) questionnaire, and mental health indicators with the assistance of the Strengths and Difficulties Questionnaire, all answered by parents. Frequencies, means, standard deviations and generalized linear models were used for the data analysis, while a 95% confidence interval was used for the analyses. Results: Sleep quality was associated with total difficulties (β=7.659, p<0.001), emotional symptoms (β= 1.754; p=0.001), hyperactivity/inattentiveness (β=3.054, p <0.001), conduct problems (β=1.619, p<0.001) and peer relationship problems (β=1.231; p=0.007) in boys. In girls it was related to total difficulties (β=3.421; p=0.006), and conduct problems (β=1.235; p=0.003). However, the interactions were not significant. Conclusion: Although they occur independently, stress is placed on the importance of sleeping well, engaging in organized PA and having good CRF levels for the improvement and maintenance of mental health. Level of evidence III; Case-control study.
DANCE IN THE TREATMENT OF CHILDHOOD OBESITY: A PROPOSED PROTOCOL
Authors: Monteiro Camila de Paula , Almeida Mariana Luciano de , Bueno Júnior Carlos Roberto
Published: January 2020

ABSTRACT Introduction: Low levels of daily physical activity is considered to be one of the causes of the exorbitant increase in overweight and obese children, and associated comorbidities. Therefore, it is vital to develop strategies that will be implemented consistently, to improve this situation. Studies have used dance as a resource for training overweight and obese children, but the lack of information about the creation process and its respective stages reduce the possibility of these proposals being effectively applied. Objectives: To describe the steps in the creation of a dance protocol as a training resource, and its effectiveness in improving the health parameters of overweight and obese children. Methods: 30 children (9 ± 1.1 years) underwent training sessions consisting of a five-minute warm-up at 60% HRmax., and four 10-minute sessions at 70% to 80% at HRmax. interspersed with five 2-minute active recovery periods at 60% HRmax. The sessions were carried out three times a week, and lasted 60 minutes each, over a 13-week period. Before and after the training, the body composition, body mass index (BMI), BMI z-score, waist circumference (WC), waist-to-height ratio (WHtR), systolic (SBP) and diastolic (DBP) blood pressure and blood variables were measured. Statistical analysis was performed using a mixed effects regression model. Results: After training with Afro-Brazilian dance, there was a significant reduction (p<0.05) in the BMI z-score and waist-to-height ratio. Conclusion: Afro-Brazilian dance training was a strategy with a positive effect on BMI z-score and waist-to-height ratio in overweight and obese children. Level of evidence IV; Case series.
THE IMPACT OF BRAZILIAN SAMBA ON PARKINSON’S DISEASE: ANALYSIS BY THE DISEASE SUBTYPES
Authors: Tillmann Ana Cristina , Swarowsky Alessandra , Andrade Alexandro , Moratelli Jéssica , Boing Leonessa , Vieira Melissa de Carvalho Souza , Leitão Alice Erwig , Guimarães Adriana Coutinho de Azevedo
Published: January 2020

ABSTRACT Introduction: People with Parkinson's disease constantly have low levels of physical activity. Dancing has become increasingly important for treating the disease and can help improve non-motor symptoms. Objective: To analyze the influence of Brazilian samba on the non-motor symptoms of PD according to TD and PGID subtypes. Methods: A 12-week, non-randomized clinical trial, through comparison with a control group. The 23 individuals who agreed to participate in the activities formed the experimental group (EG) and the 24 individuals who opted not to participate in the Brazilian samba classes comprised the control group (CG). A questionnaire was applied, composed of validated instruments. Mini Mental State Examination – MMSE; HY – Disability Scale; Unified Parkinson's Disease Rating Scale – UPDRS 1 and total values; Parkinson's Disease Questionnaire – PDQ-39, Parkinson's Disease Sleep Scale – PDSS; Beck Depression Inventory – BDI; Fatigue Severity Scale – FSS and Magnitude of Perceived Changes. Results: After the twelve weeks of intervention, it was observed that the EG showed improvement in the scores of all the tests. The comparison between groups, however, indicated a significant difference in the post-UPDRS1 period in which the EG presented improvement in cognitive impairment, while the CG presented a deficit in these values. The results of the division between disease subtypes show a greater change in the values between individuals of the TD group, when comparing the EG with the CG. For the EG, the greatest difference between pre- and post- intervention was fatigue. Conclusion: There was a positive trend in all the variables studied after the application of the protocol. This demonstrates that interventions such as dance may have greater effects on non-motor symptoms, depending on the expected progression of the disease. The scarcity of studies that use this approach in their analyses may explain the lack of evidence in this symptomatology related to dance. Level of evidence II; Therapeutic studies – Investigating the results of treatment.
Neriidae (Diptera: Schizophora) of the Northeastern Brazil: new records and an identification key
Authors: Sepúlveda Tatiana A. , Gomes Lucas R. P. , Limeira-de-Oliveira Francisco
Published: January 2020

Abstract: Here, we provide a list of seven species collected in the Brazilian states of Ceará, Maranhão and Piauí, housed in the Coleção Zoológica do Maranhão (CZMA), Cerantichir peruana (Hennig, 1937), Glyphidops durus (Cresson, 1926), Glyphidops filosus (Fabricius, 1805), Glyphidops flavifrons (Bigot, 1886), Glyphidops vittatus (Cresson, 1912), Nerius pilifer Fabricius, 1805 and Nerius plurivittatus Bigot, 1886. Representatives of Neriidae are recorded and mapped for the first time in the states of Ceará, Maranhão and Piauí, while the species C. peruana, G. durus, G. flavifrons and G. vittatus represent new records for the Northeast Region of Brazil. A key for the identification and diagnoses of Northeastern Brazilian neriids are provided.
Simulación de trazos de rayos de un triplete de Cooke
Authors: Montalvo R.A. , Choque J.I
Published: January 2020

Resumo En el presente trabajo, desarrollamos el modelo teórico de un triplete de Cooke en un ambiente que ejecuta programas con rapidez; lo que significa que puede construir superficies; incrementándolas y resolviendo diseños más complejos y elaborados. Este resultado es comparado con el dispositivo óptico elaborado con el software OSLO EDU [1]. Mostramos como un simple código se presenta como una herramienta computacional para la enseñanza de la óptica geométrica y paraxial de primer orden para un curso introductorio de óptica.
Acute kidney injury in cancer patients
Authors: César Bruno Nogueira , Durão Júnior Marcelino de Souza
Published: January 2020

SUMMARY The increasing prevalence of neoplasias is associated with new clinical challenges, one of which is acute kidney injury (AKI). In addition to possibly constituting a clinical emergency, kidney failure significantly interferes with the choice and continuation of antineoplastic therapy, with prognostic implications in cancer patients. Some types of neoplasia are more susceptible to AKI, such as multiple myeloma and renal carcinoma. In cancer patients, AKI can be divided into pre-renal, renal (intrinsic), and post-renal. Conventional platinum-based chemotherapy and new targeted therapy agents against cancer are examples of drugs that cause an intrinsic renal lesion in this group of patients. This topic is of great importance to the daily practice of nephrologists and even constitutes a subspecialty in the field, the onco-nephrology.
Peritoneal Dialysis
Authors: Andreoli Maria Claudia Cruz , Totoli Claudia
Published: January 2020

SUMMARY Peritoneal dialysis (PD) is a renal replacement therapy based on infusing a sterile solution into the peritoneal cavity through a catheter and provides for the removal of solutes and water using the peritoneal membrane as the exchange surface. This solution, which is in close contact with the capillaries in the peritoneum, allows diffusion solute transport and osmotic ultrafiltration water loss since it is hyperosmolar to plasma due to the addition of osmotic agents (most commonly glucose). Infusion and drainage of the solution into the peritoneal cavity can be performed in two ways: manually (continuous ambulatory PD), in which the patient usually goes through four solution changes throughout the day, or machine-assisted PD (automated PD), in which dialysis is performed with the aid of a cycling machine that allows changes to be made overnight while the patient is sleeping. Prescription and follow-up of PD involve characterizing the type of peritoneal transport and assessing the offered dialysis dose (solute clearance) as well as diagnosing and treating possible method-related complications (infectious and non-infectious).
HIV-related nephropathy: new aspects of an old paradigm
Authors: Reghine Érica Lofrano , Foresto Renato Demarchi , Kirsztajn Gianna Mastroianni
Published: January 2020

SUMMARY The scenario of infection by the human immunodeficiency virus (HIV) has been undergoing changes in recent years, both in relation to the understanding of HIV infection and regarding the treatments available. As a result, the disease, which before was associated with high morbidity and mortality, is now seen as a chronic disease that can be controlled, regarding both transmission and symptoms. However, even when the virus replication is well controlled, the infected patient remains at high risk of developing renal involvement, either by acute kidney injury not associated with HIV, nephrotoxicity due to antiretroviral drugs, chronic diseases associated with increased survival, or glomerular disease associated to HIV. This review will cover the main aspects of kidney failure associated with HIV.
Drug-induced nephrotoxicity
Authors: Sales Gabriel Teixeira Montezuma , Foresto Renato Demarchi
Published: January 2020

SUMMARY Acute kidney injury is a very common diagnosis, present in up to 60% of critical patients, and its third main cause is drug toxicity. Nephrotoxicity can be defined as any renal injury caused directly or indirectly by medications, with acute renal failure, tubulopathies, and glomerulopathies as common clinical presentations. Some examples of drugs commonly associated with the acute reduction of glomerular filtration rate are anti-inflammatories, antibiotics, such as vancomycin and aminoglycosides, and chemotherapeutic agents, such as cisplatin and methotrexate. Cases of tubulopathy are very common with amphotericin B, polymyxins, and tenofovir, and cases of glomerulopathies are common with VEGF inhibitors, bisphosphonates, and immunotherapy, and it is also common to have more than one clinical presentation related to a single agent. Early diagnosis is essential for the good evolution of the patient, with a reduction of renal exposure to the toxic agent, which requires knowing the risk factors and biomarkers. General measures such as correcting hydroelectrolytic disorders and hypovolemia, monitoring the serum level, avoiding combinations with the synergy of renal injury, and looking for similar options that are less toxic are the foundations for the treatment of complications that are still common and often preventable.
Cross-cultural adaptation of the Zero Mothers Die (ZMD App) in Brazil: contributing to digital health with the approach on care centred for e-pregnant woman
Authors: Silva Angelica Baptista , Assumpção Augusta Maria Batista de , Andrade Filha Ianê Germano de , Regadas Cláudia Tavares , Castro Márcia Corrêa de , Silva Carlos Renato Alves , Assumpção Marlene Roque , Santos Rafaele Cristine Barcelos dos , Silvério Talita Osório , Santos Priscila Barbosa dos , Silva Danielle Aparecida da , Paulino Beatriz Vieira , Pastorelli Pernelle Paula Laurencine
Published: January 2020

Abstract Objectives: to describe the adaptation process of the Zero Mothers Die app, developed in Europe, is to combat maternal mortality, was brought into the Brazilian context with an individualized auscultation methodology for pregnant women and mothers who attended a high complexity referred teaching hospital. Methods: the research consisted of two parts: the participant observation technique was used by health professionals to translate the platform; with an approach in the service with online forms for pregnant women, and the content analysis was performed by grounded theory of the data. During five months, 109 pregnant women and mothers installed the app, but only 17 completed the questionnaire. Results: the women and health professionals pointed out questions such as interactivity, application interface, content, pregnancy and childcare clinical management, which contributed for the Brazilian version. Conclusions: the participatory medicine and e-pregnant woman are new premises of a humanization policy for women and childcare. The insertion of an app with information based on the best evidence in the prenatal routine in the health establishments with teaching activities that can provide new dialogue connections with the pregnant women and chances to update the professional in training.
Perineal outcomes and its associated variables of water births versus non-water births: a cross-sectional study
Authors: Camargo Joyce da Costa Silveira de , Varela Vitor , Ferreira Fernanda Marçal , Chofakian Christiane Borges do Nascimento , Osava Ruth Hitomi , Araújo Natalúcia Matos , Narchi Nadia , Santos Maria Elisabete , Nené Manuela , Grande Catarina
Published: January 2020

Abstract Objectives: to describe the perineal outcomes of women who had delivered in water and out of water. Methods: a cross-sectional and quantitative study developed in a public hospital in Setúbal, Portugal. The population was of women who participated in the "Water Birth Project" in the period from 2011 to 2014, which gave birth in water and out of water. 104 women were selected according to established inclusion criteria. The groups were compared according to the following variables: demographics, obstetric information, delivery care and perineal outcomes. The data were analyzed in the Stata(r) software, with descriptive and bivariate statistics (chi-square and Fisher's test). Results: the medical records of 73 women who gave birth in water and 31 women who gave birth out of water were studied. Water deliveries were significantly associated with fewer perineal lacerations, lower rates of episiotomy, and shorter delivery time. Conclusions: the results of the study suggest that childbirth in water has a protective effect against severe third or fourth degree perineal tears, during fetal expulsion in water.
Factors associated with the route of birth delivery in a city in the Northeast region in the State of Rio Grande do Sul, Brazil
Authors: Rasador Silvane , Abegg Claides
Published: January 2020

Abstract Objectives: to investigate factors associated with the route of birth delivery in a hospital extending public and private healthcare services, in the Northeast region in the State of Rio Grande do Sul. Methods: a cross-sectional study with 676 postpartum women, conducted from January to May 2017. The data were collected from the hospital records and women were interviewed shortly after childbirth in the maternity. Data analysis was performed by associating the Pearson’s chi-square and the Poisson regression tests with robust variance. Results: the prevalence of cesarean sections was 58.7%, that is, 41.7% in public health-care and 83.9% in private healthcare. The main reason for having a cesarean section was having had a previous one (PR=5.69; CI95%=3.64 - 8.90; p<0.001), followed by having source of childbirth financing (PR=1.54; CI95%=1.27 - 1.87; p<0.001), having source of prenatal care financing (PR=1.48; CI95%=1.22 - 1.79; p<0.001), the childbirth and prenatal care professional (PR=1.46; CI95%=1.28 - 1.66; p<0.001) and the prenatal care professional (PR=1.43; CI95%=1.07 - 1.90; p=0.016). Conclusions: the high cesarean section rates identified in this study were mainly associated with previous cesarean section. The findings suggest a change in the current childbirth care model in the city, characterized as highly medicalized, focused on the physician and on hospital care.
Epidemiological profile of patients with congenital and gestational syphilis in a city in the State of São Paulo, Brazil
Authors: Maschio-Lima Taiza , Machado Iara Lúcia de Lima , Siqueira João Paulo Zen , Almeida Margarete Teresa Gottardo
Published: January 2020

Abstract Objectives: to assess the epidemiological profile of congenital and syphilis during pregnancy in residents of São José do Rio Preto in São Paulo State. Methods: ecological study of the epidemiological profile of patients with congenital and gestational syphilis, based on the Sistema de Informação de Agravos de Notificação (Information System for Notifiable Diseases) from 2007 to 2016. Results: there were 396 cases of syphilis reported in pregnant women and 290 of congenital syphilis. In 2016, the rate of detecting syphilis in pregnant women was 13.2 cases/1,000 live births, while congenital syphilis the incidence rate was 6.5 cases/1,000 live births. For gestational syphilis, 54% of the diagnosis was performed in 2nd or 3rd trimester and 85% were reported at the primary care. Adequate treatment for pregnant women occurred in 96% of the notifications with 52% of partners treated. In congenital syphilis, 82% of the mothers underwent prenatal care. However, 94% of the pregnant women were treated inadequately while 82% of the partners did not receive any treatment. Conclusions: there has been an increase in the number of cases of gestational syphilis in pregnant women and a decrease in the cases of congenital syphilis from 2014. These results showed that the goal of 0.5 case/1,000 live births proposed by World Health Organization is still far from being achieved in this city.
Structure and content of the maternal representations of Mexican teenagers during their first pregnancy
Authors: Franco-Ramírez Julieta Armida , Cabrera-Pivaral Carlos Enrique , Zárate-Guerrero Gabriel , Franco-Chávez Sergio Alberto , Covarrubias-Bermúdez María de los Ángeles , Zavala-González Marco Antonio
Published: January 2020

Abstract Objectives: understand the structure and content of the maternal representations of Mexican teenagers during their first pregnancy. Methods: a study was carried out with qualitative methodology based on the concept of maternal representation and the theory of social representations with 30 adolescents who attended prenatal control at the Civil Hospital of Guadalajara "Fray Antonio Alcalde", in Jalisco, Mexico. The participants were interviewed with the consent of their tutors. Classical content analysis techniques were used to obtain codes and thematic categories to develop a conceptual map that explains maternal representations. Results: the maternal representation was identified: "Pregnant but reunited, a legitimated bad decision", which was composed of social meanings towards adolescent pregnancy, family dynamics, expectations towards motherhood, and the feelings experienced by the adolescent during the pregnancy. The content of the representations was heterogeneous for most of the identified categories; however, it is identified that the desire for pregnancy guides the expectations of the adolescent about her future way of being as a mother. Conclusions: the desire of women for pregnancy, the level of participation of the couple, and the social meanings of adolescent pregnancy, have an outstanding role in the development of models of maternal representations.
Factors associated with the presence of cleft lip and / or cleft palate in Brazilian newborns
Authors: Shibukawa Bianca Machado Cruz , Rissi Gabrieli Patricio , Higarashi Ieda Harumi , Oliveira Rosana Rosseto de
Published: January 2020

Abstract Objectives: to analyze the trend and the associated factors with the presence of cleft lip and/or cleft palate in Brazilian newborns, in order to verify possible associations with maternal care and newborn factors. Methods: a cross-sectional and ecological study, involving all live births in Brazil, recorded in the Information System on Live Births from 2005 to 2016. Maternal and infant information were evaluated using trend analysis and odds ratio, with a 95% confidence interval. The analyses were performed using SPSS software. Results: we analyzed 17,800 live births with presence of cleft lip and/or cleft palate. The Brazilian prevalence rate was 0.51 / 1000 live births, with South and Southeast Regions registering higher rates than the national rate. There was an association with maternal age above 35 years old, with no partner, less than seven prenatal consultations, premature birth and cesarean section. About the factors of the newborn, being male, Apgar less than seven in the 1st and 5th minutes of life, low birth weight and white color were associated. Conclusions: Brazil has an increasing tendency for cleft lip and/or cleft palate (p=0.019), reinforcing the need to strengthen health care networks, providing adequate support for newborn with cleft lip and/or cleft palate and their families.
Prevalence and factors associated with the occurrence of urinary incontinence during pregnancy
Authors: Santini Ana Carolina Monteiro , Santos Elisiane Souza , Vianna Luana Schneider , Bernardes João Marcos , Dias Adriano
Published: January 2020

Abstract Objectives: to determine the prevalence of urinary incontinence (UI) during pregnancy, to identify and quantify the factors associated with gestational UI. Methods: a cross-sectional study carried out with women admitted for deliveries in all maternity wards in the city of Botucatu (São Paulo). Data were collected through a structured questionnaire, based on the literature, containing questions about the occurrence of UI, its types, risk factors and moments when urinary losses occurred. Associations between UI and the predictive variables were analyzed with logistic regression models. Results: 950 women were interviewed, out of which 472 complained of urinary losses during pregnancy, resulting in a prevalence of 49.68% (CI95%= 46.51 - 52.86). The majority (61.8%) were classified as mixed UI. Among the covariates investigated, smoking (OR= 4.56), illicit drugs use (OR= 25.14), stimulant foods (OR= 1.84), constipation (OR=1.99), hypertensive disorders during gestation (OR= 3.23), gestational diabetes mellitus (OR= 2.89), parity (OR= 1.52) and previous caesarean sections (OR= 2.56) increased the chance of urinary losses during pregnancy. Conclusions: there was a high prevalence of UI during pregnancy. This condition was strongly associated with lifestyle habits and gestational morbidities. Finally, it is worth high-lighting the fact that delivery via caesarean section increased the chance of UI in subsequent pregnancies.
Prenatal and puerperal care and indicators of severity: a study about the information available on pregnant women’s card
Authors: Souza Ivelise Araújo de , Serinolli Mário Ivo , Novaretti Márcia Cristina Zago
Published: January 2020

Abstract Objectives: to identify and to discuss the frequency of the prenatal and puerperal care of pregnant women from the eastern zone of São Paulo city, São Paulo State, Brazil, categorizing it according to the Kessner Index modified in 1993 by Takeda. We used the data avai-lable on the card of pregnant woman and the discharge summaries, correlating the results with the indicators of severity in childbirth. Methods: this is a descriptive, cross-sectional quantitative study based on the analysis of the variables of the pregnant woman's card and the diagnoses identified in the discharge summaries. Data were collected through a field survey conducted in the Eastern zone of the city of São Paulo city, São Paulo State, Brazil. A statistical analysis was used to identify asso-ciations between the categorization and the severity indicators listed in the discharge summaries. Results: it was observed that prenatal care in the Eastern zone of São Paulo city, São Paulo State, Brazil was classified as intermediate (56.9%) in the majority of women. Regarding this categorization with the severity indicators, there is a higher incidence of risks for inappropriate categorization (8.89%) when compared to the appropriate (1.67%) and the intermediate (4.44%) ones. Conclusions: it was possible to conclude that the more adequate prenatal care, the lower the chances of unfavorable outcomes and incidence of risks.
The ineffectiveness of antimicrobial photodynamic therapy in the absence of preincubation of the microorganisms in the photosensitizer
Authors: Galo Ítalo Dany Cavalcante , Carvalho Jéssica Assis , Santos Jessyca Luana Melo Costa , Braoios Alexandre , Prado Rodrigo Paschoal
Published: January 2020

Abstract Introduction: Considering its potential as an alternative therapy to combat multiresistant bacteria, photodynamic therapy has been improved and better studied in recent years, and determining its optimized application patterns is important. Objective: This study aimed to evaluate the action of antimicrobial photodynamic therapy mediated by methylene blue in the absence of preincubation of infectious agents in the photosensitizer. Method: Standard strains of Staphylococcus aureus and Pseudomonas aeruginosa were used, which was or was not submitted to two methylene blue concentrations (0.1 μg/mL and 500 mg/mL) applied alone or in combination with a variety of red laser emission parameters (660 nm); in both cases, the streak was performed immediately after mixing between the photosensitizer and the solution containing the bacteria. Results: In the dishes with only methylene blue application neither antibacterial was produced, nor inhibition at the application points of the photodynamic therapy in the case of the bacterium Pseudomonas aeruginosa. However, in the cultures of Staphylococcus aureus in which laser emission was associated with the concentration of 500 mg/mL of the photosensitizer, inhibition was present at the laser application points. Conclusion: The time of exposure to the photosensitizer prior to the application of phototherapy seems to be an essential factor for the optimized action of photodynamic therapy, especially in the case of Gram-negative bacteria.
Maximum voluntary muscle contraction and fatigue in multibacillary leprosy
Authors: Sobral Luciane Lobato , Santos Marcio Clementino de Souza , Rocha Larissa Salgado de Oliveira , Callegari Bianca , Souza Givago da Silva , Teodori Rosana Macher
Published: January 2020

Abstract Introduction: The impairment of muscle strength and fatigue in leprosy remains a problem that requires careful attention to avoid or minimize its progression, as well as prevention of disabilities and deformities. Objective: To investigate the maximum voluntary contraction and time to muscle fatigue in leprosy patients. Method: A total of 21 leprosy patients and 21 healthy subjects completed the sample. The method used to determine the maximum voluntary contraction (MVC) of the handgrip followed the recommendation of the American Society of Hand Therapists with the use of a hydraulic hand grip dynamometer. The test was performed three times with each hand, with a time interval of 60 seconds between successive trials. The subject was instructed to perform a maximal isometric force against the dynamometer for 5 seconds. The peaks were recorded and used for the fatigue test. For the fatigue test, we recorded the electromyogram of the forearm muscles to offline determine the onset time for the muscle contraction (14 bits, Miograph 2 USB®, Miotec, Brazil). Results: Leprosy patients had lower MVC compared with healthy subjects (p > 0.05), both in the dominant and the non-dominant hands. The time to fatigue in the leprosy and control groups was similar (p < 0.05). We observed that leprosy patients had more contractions than the healthy subjects (22.6 ± 11.8 contractions for the leprosy group vs. 12.3 ± 6.9 contractions for the control group, p > 0.05). Conclusion: Multibacillary leprosy patients lost muscle force without modifying the resistance to fatigue.
The role of cultural engagement for older adults: an integrative review of scientific literature
Authors: Bernardo Lilian Dias , Carvalho Claudia Reinoso Araújo de
Published: January 2020

Abstract Objective: to understand the role of cultural engagement in the lives of older adults. Method: an integrative literature review of publications from 2014 and 2019 in English, Portuguese, and Spanish was conducted. The Scopus, Web of Science, MEDLINE/PubMed, CINAHL, PsycNET®, LILACS, SciELO Citation Index and Science Direct databases were used as sources of information. The descriptors “aged” and the related term “cultural engagement” in the three idioms were used in the search, together with the Boolean operators “AND” or “ OR”. A total of 12 articles that met the inclusion criteria were found. These were categorized based on the theme. No Brazilian studies were found. Results: the panorama found revealed that older adults are more interested in receptive cultural activities, such as going to museums, exhibitions and the theater, as these enrich and add greater social value to their lives. Cultural engagement was associated with a reduction in the incidence of neuropsychiatric disorders (dementia and depression), as well as reducing the incidence of episodes of violence. Participation in cultural activities also constituted a protective factor for cognitive abilities and for the reduction of chronic pain. There is also evidence that associates cultural engagement with a better perception of quality of life and greater well-being, happiness and positive affect, as well as the reduction of negative affect. Conclusion: engaging in cultural activities is a way of understanding and respecting cultural diversity, salvaging social identities, and enjoying and providing experiences of great social value, with beneficial impacts in the lives of older adults.
Matriz de Competências para Programas de Residência Médica em Endocrinologia e Metabologia
Authors: Valente Ana Augusta Motta Oliveira , Caldato Milena Coelho Fernandes
Published: January 2020

ABSTRACT Introduction Medical competencies have become the focus of Medical Education at all levels around the world. In this context the Medical Residency Programs (MRP) in Brazil have begun to seek a competency-based curriculum to improve the specialist training. Objective To develop a proposed Competency Matrix for Medical Residency Programs in Endocrinology and Metabolism (MREM). Methodology The study was divided into four phases. The first phase consisted of a bibliographical review and construction of the Pilot Matrix. In the second phase the Pilot Matrix was applied to endocrinologists from Belém, with subsequent data analysis and construction of the Structured Matrix. The third phase started with the implementation of the Structured Matrix at the Brazilian Congress of Endocrinology and Metabolism – CBEM 2016 with a total of 49 responses. Based on the Delphi methodology, the 230 competencies of each one of the matrices were analyzed and a questionnaire containing competences with a discrepancy level greater than 10% was created, including some suggestions from the experts. In the fourth and last phase, also using Delphi methodology, the questionnaire was sent by email and data analysis and construction of the MREM proposal was performed. Results In the second, third and fourth phases, the response rate of Endocrinologists was 73.3%, 51% and 76.4%, respectively. With the Southeast region of Brazil presenting the largest number of participants. There are 219 competencies in the Pilot Matrix, 230 in the Structured Matrix and 244 in the final MREM proposal. The competency areas of Diabetes and Obesity, Metabolic Syndrome and Alterations of Appetite were those which showed major change and suggestions. In all phases, only 2 competencies were excluded. The suggestions made in the third phase were unanimously accepted. Conclusion The MREM proposal was concluded with 21 areas and 244 competencies, 33 classified as prerequisites, 157 as essential competencies, 36 as desirable and 18 as advanced. The competencies were distributed as follows in the MCPRMEM: “Fundamental” field with 100 competencies, with 15 prerequisites, 65 core competencies, 14 desirable and 6 advanced ones; “Specific Knowledge” field with 132 competences, with 18 prerequisites, 87 essential competences, 19 desirable and 8 advanced; and “Complementary Training” field with 12 skills, no prerequisites, 5 core competencies, 3 desirable and 4 advanced skills.
Competency Matrix for Medical Residency Programmes in Endocrinology and Metabolism
Authors: Valente Ana Augusta Motta Oliveira , Caldato Milena Coelho Fernandes
Published: January 2020

ABSTRACT Introduction Medical competencies have become the focus of Medical Education at all levels around the world. In this context the Medical Residency Programs (MRP) in Brazil have begun to seek a competency-based curriculum to improve the specialist training. Objective To develop a proposed Competency Matrix for Medical Residency Programs in Endocrinology and Metabolism (MREM). Methodology The study was divided into four phases. The first phase consisted of a bibliographical review and construction of the Pilot Matrix. In the second phase the Pilot Matrix was applied to endocrinologists from Belém, with subsequent data analysis and construction of the Structured Matrix. The third phase started with the implementation of the Structured Matrix at the Brazilian Congress of Endocrinology and Metabolism – CBEM 2016 with a total of 49 responses. Based on the Delphi methodology, the 230 competencies of each one of the matrices were analyzed and a questionnaire containing competences with a discrepancy level greater than 10% was created, including some suggestions from the experts. In the fourth and last phase, also using Delphi methodology, the questionnaire was sent by email and data analysis and construction of the MREM proposal was performed. Results In the second, third and fourth phases, the response rate of Endocrinologists was 73.3%, 51% and 76.4%, respectively. With the Southeast region of Brazil presenting the largest number of participants. There are 219 competencies in the Pilot Matrix, 230 in the Structured Matrix and 244 in the final MREM proposal. The competency areas of Diabetes and Obesity, Metabolic Syndrome and Alterations of Appetite were those which showed major change and suggestions. In all phases, only 2 competencies were excluded. The suggestions made in the third phase were unanimously accepted. Conclusion The MREM proposal was concluded with 21 areas and 244 competencies, 33 classified as prerequisites, 157 as essential competencies, 36 as desirable and 18 as advanced. The competencies were distributed as follows in the MCPRMEM: “Fundamental” field with 100 competencies, with 15 prerequisites, 65 core competencies, 14 desirable and 6 advanced ones; “Specific Knowledge” field with 132 competences, with 18 prerequisites, 87 essential competences, 19 desirable and 8 advanced; and “Complementary Training” field with 12 skills, no prerequisites, 5 core competencies, 3 desirable and 4 advanced skills.
Role-Play como Estratégia Pedagógica para Problematizar as Linhas de Cuidado Integral em Saúde aos Adolescentes e Jovens
Authors: Paulino Danilo Borges , Rosa Gabriela Ferreira de Camargos , Alves Guilherme Henrique de Faria , Barros Matheus Cesar Vieira , Oliveira Bruna Carolina de , Raimondi Gustavo Antonio
Published: January 2020

RESUMO Diante da necessidade de integrar o debate de gênero e sexualidade à formação médica, uma unidade curricular de Saúde Coletiva de um curso de Medicina público federal propôs a metodologia da Aprendizagem Baseada em Projetos (ABPj) para essa formação. Nessa proposta pedagógica, os estudantes constroem um produto final como recurso para intervenção/aprimoramento da realidade. Dessa forma, a metodologia da Problematização, com o Arco de Maguerez, forneceu o subsídio à concretização desses produtos. Cada um desses projetos utilizou uma das políticas públicas relacionadas ao debate em torno do gênero e da sexualidade. Neste artigo, relata-se o projeto relacionado à Política Pública de Atenção Integral à Saúde de Adolescentes e Jovens na Promoção, Proteção e Recuperação da Saúde. Na apresentação desse produto foi utilizada a metodologia do role-play, com três cenas, para intervenção/aprimoramento da realidade observada/vivida. Essa experiência também conquistou a premiação de melhor trabalho apresentado naquele ano no Congresso Brasileiro de Educação Médica, construindo nessa escola médica um espaço formal para o desenvolvimento de competências no tocante aos determinantes sociais de gênero e sexualidade, para uma prática médica integral e equânime. Este relato de experiência destaca ainda a relevância do uso de metodologias ativas, como a ABPj e role-play, na educação médica.
Percepção dos Estudantes de Medicina sobre Comunicação de Más Notícias na Formação Médica
Authors: Dias Natália Caroline , Pio Danielle Abdel Massih
Published: January 2020

RESUMO Introdução A comunicação se apresenta como uma habilidade que deve ser conquistada na graduação médica, configurando-se como um campo de conhecimento a ser contemplado no que se refere à formação médica. A forma como a comunicação é feita, incluindo seu conteúdo, constitui um importante elemento do vínculo estabelecido entre paciente, equipe, família e instituição de saúde. Diante das Diretrizes Curriculares Nacionais, estimula-se a aprendizagem por meio de metodologias ativas, com a comunicação como parte do processo ensino-aprendizagem, com o desafio de contemplar a comunicação de más notícias de forma efetiva na formação. Objetivo Analisar as percepções de estudantes de Medicina que cursam um currículo organizado com metodologias ativas acerca da comunicação de más notícias na formação. Método Tratou-se de um estudo qualitativo, realizado na Faculdade de Medicina de Marília (SP). Participaram da pesquisa 39 estudantes da primeira à sexta série do curso de Medicina. A coleta de dados foi realizada por meio de entrevista semiestruturada, e os dados foram analisados por meio da técnica de Análise de Conteúdo, na modalidade temática. Resultados e discussão Com base na análise realizada, foram identificadas quatro categorias temáticas: Dificuldades em definir “comunicação de más notícias”: produto ou processo?; É possível aprender a dar ou receber más notícias pela experiência?; Dificuldades na implementação do currículo integrado: insuficiente articulação teórico-prática em comunicação de más notícias; Valorizando a comunicação de más notícias: é preciso preparo teórico, técnico e emocional. Os resultados permitem um olhar circunscrito e importante da percepção dos estudantes sobre a comunicação de más notícias dentro da proposta curricular. Considerações finais Aponta-se que os participantes do estudo percebem a necessidade de maior articulação teórico-prática, preparo dos docentes e um cuidado com a formação pessoal e profissional dos estudantes acerca do que abrange a comunicação de más notícias. Espera-se que o estudo contribua para ampliação dos olhares acerca do tema no que se refere ao desenvolvimento de habilidades comunicacionais nos profissionais de saúde a partir da graduação.
O Cinema como Recurso Educacional no Ensino de Atitudes Humanísticas a Estudantes de Medicina
Authors: Picanço Thaíla Soares da Costa , Nazima Maira Tiyomi Sacata Tongu , Santos Braulio Erison França dos , Picanço Júnior Olavo Magalhães , Cambraia Maria Izabel de Albuquerque , Morais Leila do Socorro da Silva , Pena Luis Felipe da Silva , Costa Karina Suzany Nery
Published: January 2020

ABSTRACT Introduction Contemporary medical education prioritizes the development of scientific knowledge and technical skills, associated with professional attitudes. Attitudes are components of affective ability and influence medical practice, so they should be taught systematically during undergraduate training. The use of films as a pedagogical resource in medical training allows reflection on the biopsychosocial context in which the patient is inserted, contributing to the development of humanistic attitudes among students and future physicians. Objective To evaluate the effectiveness of cinema as an educational resource in teaching humanistic attitudes to medical students. Material and Methods A cross-sectional, quasi-experimental, qualitative and quantitative study was carried out with 107 students from the first to sixth year of the medical course of the Federal University of Amapá. The Medical Students Attitude Scale (validated by the author Maria de Fátima Colares, 2002) was used before and after the exhibition of films related to relevant themes in the medical area. This psychometric scale is composed of multiple-choice Likert-type responses and aims to assess the attitudes of medical students regarding the following factors: primary health care; psychological and emotional aspects involved in diseases; ethical aspects in professional practice; mental illness, death-related situations; scientific research. The Wilcoxon Rank Test was used to compare data from paired samples. Results All the factors evaluated by the medical students attitudes scale related to relevant aspects of medical practice showed a significant increase in the frequency of positive attitudes (p < 0.05) among the first- to fourth-year students following the cinema sessions. The fifth- and sixth-year students did not present significant changes in attitudes related to death, mental illness and contribution to the scientific advancement of medicine. Conclusion Cinema is an effective pedagogical tool in teaching humanistic attitudes in the preclinical series of the medical course.
Films as an Educational Resource in the Teaching of Humanistic Attitudes to Medicine Students
Authors: Picanço Thaíla Soares da Costa , Nazima Maira Tiyomi Sacata Tongu , Santos Braulio Erison França dos , Picanço Júnior Olavo Magalhães , Cambraia Maria Izabel de Albuquerque , Morais Leila do Socorro da Silva , Pena Luis Felipe da Silva , Costa Karina Suzany Nery
Published: January 2020

ABSTRACT Introduction Contemporary medical education prioritizes the development of scientific knowledge and technical skills, associated with professional attitudes. Attitudes are components of affective ability and influence medical practice, so they should be taught systematically during undergraduate training. The use of films as a pedagogical resource in medical training allows reflection on the biopsychosocial context in which the patient is inserted, contributing to the development of humanistic attitudes among students and future physicians. Objective To evaluate the effectiveness of cinema as an educational resource in teaching humanistic attitudes to medical students. Material and Methods A cross-sectional, quasi-experimental, qualitative and quantitative study was carried out with 107 students from the first to sixth year of the medical course of the Federal University of Amapá. The Medical Students Attitude Scale (validated by the author Maria de Fátima Colares, 2002) was used before and after the exhibition of films related to relevant themes in the medical area. This psychometric scale is composed of multiple-choice Likert-type responses and aims to assess the attitudes of medical students regarding the following factors: primary health care; psychological and emotional aspects involved in diseases; ethical aspects in professional practice; mental illness, death-related situations; scientific research. The Wilcoxon Rank Test was used to compare data from paired samples. Results All the factors evaluated by the medical students attitudes scale related to relevant aspects of medical practice showed a significant increase in the frequency of positive attitudes (p < 0.05) among the first- to fourth-year students following the cinema sessions. The fifth- and sixth-year students did not present significant changes in attitudes related to death, mental illness and contribution to the scientific advancement of medicine. Conclusion Cinema is an effective pedagogical tool in teaching humanistic attitudes in the preclinical series of the medical course.
Aprendizagem Baseada em Problemas: Contribuição para Médicos Pediatras
Authors: Reis Fabiana Vieira Duarte de Souza , Passos Antônio Henrique Rodrigues dos , Higa Elza de Fátima Ribeiro
Published: January 2020

RESUMO Introdução A Aprendizagem Baseada em Problemas (ABP) tem se destacado na educação médica por ser uma proposta fundamentada no construtivismo, com a finalidade de desenvolver a autonomia e o raciocínio crítico do estudante para tomada de decisões. Objetivo Por conta das dificuldades encontradas pelos graduandos e das escassas informações relativas à contribuição da ABP para a prática clínica de médicos pediatras, objetivou-se avaliar a contribuição da ABP para a formação dos médicos pediatras. Metodologia Trata-se de uma série de casos de abordagem descritiva, desenvolvida com médicos pediatras egressos de duas instituições públicas de ensino. A definição da amostra ocorreu de forma intencional, amostragem não probabilística, em que os atributos dos participantes são definidos conforme o objeto de estudo, a fim de selecionar quais os indivíduos são mais adequados para serem incluídos na amostra, a qual é composta por dez médicos pediatras, sendo cinco egressos de cada instituição. Para responderem ao questionário, selecionaram-se médicos especialistas em pediatria. A coleta de dados foi realizada pela pesquisadora principal, por meio de três questões semiestruturadas respondidas via e-mail. As respostas dos entrevistados às questões abertas foram analisadas pelo método de análise reflexão-síntese, que pressupõe a análise e síntese de conteúdo mediadas pela sensibilidade e pela razão. Resultados Os resultados obtidos entre 2003 e 2012 indicaram que 28% dos médicos pediatras apresentavam título de especialista e 72% não o tinham esse título. Os discursos apresentados pelos participantes permitiram identificar que a ABP contribuiu para a formação e atuação dos médicos pediatras em diferentes aspectos, proporcionando a busca de conhecimento, a habilidade para trabalhar em equipe e a facilidade para realizar o manejo clínico de forma interdisciplinar e holística. Porém, os discursos também demonstraram que esse método pode não favorecer o aprofundamento das matérias básicas. Conclusão A ABP contribuiu para a formação e atuação do médico pediatra, porém pode não ter favorecido o aprofundamento das matérias básicas.