bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimation of health impact from digitalizing last-mile Logistics Management Information Systems (LMIS) in Ethiopia, Tanzania, and Mozambique: A Lives Saved Tool (LiST) model analysis
Authors: Fritz Jenna , Herrick Tara , Gilbert Sarah Skye
Published: October 2021

Background

Digital health has become a widely recognized approach to addressing a range of health needs, including advancing universal health coverage and achieving the Sustainable Development Goals. At present there is limited evidence on the impact of digital interventions on health outcomes. A growing body of peer-reviewed evidence on digitalizing last-mile electronic logistics management information systems (LMIS) presents an opportunity to estimate health impact.

Methods

The impact of LMIS on reductions in stockouts was estimated from primary data and peer-reviewed literature, with three scenarios of impact: 5% stockout reduction (conservative), 10% stockout reduction (base), and 15% stockout reduction (optimistic). Stockout reduction data was inverted to stock availability and improved coverage for vaccines and essential medicines using a 1:1 conversion factor. The Lives Saved Tool (LiST) model was used to estimate health impact from lives saved in newborns and children in Mozambique, Tanzania, and Ethiopia between 2022 and 2026 across the three scenarios.

Results

Improving coverage of vaccines with a digital LMIS intervention in the base scenario (conservative, optimistic) could prevent 4,924 (2,578–6,094), 3,998 (1,621–4,915), and 17,648 (12,656–22,776) deaths in Mozambique, Tanzania, and Ethiopia, respectively over the forecast timeframe. In addition, scaling up coverage of non-vaccine medications could prevent 17,044 (8,561–25,392), 21,772 (10,976–32,401), and 34,981 (17,543–52,194) deaths in Mozambique, Tanzania, and Ethiopia, respectively. In the base model scenario, the maximum percent reduction in deaths across all geographies was 1.6% for vaccines and 4.1% for non-vaccine medications.

Interpretation

This study projects that digitalization of last-mile LMIS would reduce child mortality by improving coverage of lifesaving health commodities. This analysis helps to build the evidence base around the benefits of deploying digital solutions to address health challenges. Findings should be interpreted carefully as stockout reduction estimates are derived from a small number of studies.
Porcine placenta hydrolysate as an alternate functional food ingredient: In vitro antioxidant and antibacterial assessments
Authors: Laosam Phanthipha , Panpipat Worawan , Yusakul Gorawit , Cheong Ling-Zhi , Chaijan Manat
Published: October 2021

The production of bioactive peptides from animal-based raw materials highly depends on enzymatic hydrolysis. Porcine placenta is an underutilized biomass in Thailand’s pig farms, yet it is still a source of proteins and beneficial compounds. Porcine placenta could be used as a protein substrate for the production of enzymatic hydrolysate, which could be employed as a functional food ingredient in the future. The goal of this study was to enzymatically produce porcine placenta hydrolysates (PPH) using three commercial enzymes (Alcalase, Flavouzyme, and papain) and evaluate theirin vitroantioxidant and antibacterial activity. The degree of hydrolysis (DH) increased as the enzyme load and hydrolysis time increased, but the DH was governed by the enzyme class. The maximum DH was found after using 10% enzyme for 20 min of hydrolysis (36.60%, 31.40%, and 29.81% for Alcalase, Flavouzyme, and papain). Depending on the enzyme type and DH, peptides of various sizes (0.40–323.56 kDa) were detected in all PPH. PPH created with Alcalase had an excellent reducing capacity and metal chelating ability (p< 0.05), whereas PPH made with Flavourzyme and Papain had higher DPPH•and ABTS•+inhibitory activities (p< 0.05). Papain-derived PPH also had a strong antibacterial effect againstStaphylococcus aureusandEscherichia coli, with clear zone values of 17.20 mm and 14.00 mm, respectively (p< 0.05). When PPH was transported via a gastrointestinal tract model system, its antioxidative characteristics were altered. PPH’s properties and bioactivities were thus influenced by the enzyme type, enzyme concentration, and hydrolysis time used. Therefore, PPH produced from porcine placenta can be categorized as an antioxidant and antibacterial alternative.
Automated genotyping of microsatellite loci from feces with high throughput sequences
Authors: Salado Isabel , Fernández-Gil Alberto , Vilà Carles , Leonard Jennifer A.
Published: October 2021

Ecological and conservation genetic studies often use noninvasive sampling, especially with elusive or endangered species. Because microsatellites are generally short in length, they can be amplified from low quality samples such as feces. Microsatellites are highly polymorphic so few markers are enough for reliable individual identification, kinship determination, or population characterization. However, the genotyping process from feces is expensive and time consuming. Given next-generation sequencing (NGS) and recent software developments, automated microsatellite genotyping from NGS data may now be possible. These software packages infer the genotypes directly from sequence reads, increasing throughput. Here we evaluate the performance of four software packages to genotype microsatellite loci from Iberian wolf (Canis lupus) feces using NGS. We initially combined 46 markers in a single multiplex reaction for the first time, of which 19 were included in the final analyses. Megasat was the software that provided genotypes with fewer errors. Coverage over 100X provided little additional information, but a relatively high number of PCR replicates were necessary to obtain a high quality genotype from highly unoptimized, multiplexed reactions (10 replicates for 18 of the 19 loci analyzed here). This could be reduced through optimization. The use of new bioinformatic tools and next-generation sequencing data to genotype these highly informative markers may increase throughput at a reasonable cost and with a smaller amount of laboratory work. Thus, high throughput sequencing approaches could facilitate the use of microsatellites with fecal DNA to address ecological and conservation questions.
Brain-derived neurotrophic factor promotes immune reconstitution following radiation injury via activation of bone marrow mesenchymal stem cells
Authors: Sharma Guru Prasad , Frei Anne C. , Narayanan Jayashree , Gasperetti Tracy , Veley Dana , Amjad Asma , Albano Katherine , Fish Brian L. , Himburg Heather A.
Published: October 2021

Brain-derived neurotrophic factor (BDNF) is a member of the nerve growth factor family which has been extensively studied for its roles in neural development, long-term memory, brain injury, and neurodegenerative diseases. BDNF signaling through tropomyosin receptor kinase B (TrkB) stimulates neuronal cell survival. For this reason, small molecule TrkB agonists are under pre-clinical develoment for the treatment of a range of neurodegenerative diseases and injuries. Our laboratory recently reported BDNF is secreted by pro-regenerative endothelial progenitor cells (EPCs) which support hematopoietic reconstitution following total body irradiation (TBI). Here we report BDNF-TrkB signaling plays a novel regenerative role in bone marrow and thymic regeneration following radiation injury. Exogenous administration of BDNF or TrkB agonist 7,8-dihydroxyflavone (7,8-DHF) following myelosuppressive radiation injury promoted faster recovery of mature blood cells and hematopoietic stem cells capable of multi-lineage reconstitution. BDNF promotes hematopoietic regeneration via activation of PDGFRα+bone marrow mesenchymal stem cells (MSCs) which increase secretion of hematopoietic cytokines interleukin 6 (IL-6) and leukemia inhibitory factor (LIF) in response to TrkB activation. These data suggest pharmacologic activation of the BDNF pathway with either BDNF or 7,8-DHF may be beneficial for treatment of radiation or chemotherapy induced myelosuppression.
Costs and cost-effectiveness of Gene Xpert compared to smear microscopy for the diagnosis of pulmonary tuberculosis using real-world data from Arsi zone, Ethiopia
Authors: Kaso Abdene Weya , Hailu Alemayehu
Published: October 2021

Background

Early diagnosis and treatment are one of the key strategies of tuberculosis control globally, and there are strong efforts in detecting and treating tuberculosis cases in Ethiopia. Smear microscopy examination has been a routine diagnostic test for pulmonary tuberculosis diagnosis in resource-constrained settings for decades. Recently, many countries, including Ethiopia, are scaling up the use of Gene Xpert without the evaluation of the cost and cost-effectiveness implications of this strategy. Therefore, this study evaluated the cost and cost-effectiveness of Gene Xpert (MTB/RIF) and smear microscopy tests to diagnosis tuberculosis patients in Ethiopia.

Methods

We compared the costs and cost-effectiveness of tuberculosis diagnosis using smear microscopy and Gene Xpert among 1332 patients per intervention in the Arsi zone. We applied combinations of top-down and bottom-up costing approaches. The costs were estimated from the health providers’ perspective within one year (2017–2018). We employed “cases detected” as an effectiveness measure, and the incremental cost-effectiveness ratio was calculated by dividing the changes in cost and change in effectiveness. All costs and incremental cost-effectiveness ratio were reported in 2018 US$.

Results

The unit cost per test for Gene Xpert was $12.9 whereas it is $3.1 for AFB smear microscopy testing. The cost per TB case detected was $77.9 for Gene Xpert while it was $55.8 for the smear microscopy method. The cartridge kit cost accounted for 42% of the overall Gene Xpert’s costs and the cost of the reagents and consumables accounted for 41.3% ($1.3) of the unit cost for the smear microscopy method. The ICER for the Gene Xpert strategy was $20.0 per tuberculosis case detected.

Conclusion

Using Gene Xpert as a routine test instead of standard care (smear microscopy) can be potentially cost-effective. In the cost scenario analysis, the price of the cartridge, the number of tests performed per day, and the life span of the capital equipment were the drivers of the unit cost of the Gene Xpert method. Therefore, Gene Xpert can be a part of the routine TB diagnostic testing strategy in Ethiopia.
SARS-CoV-2 infection in central North Carolina: Protocol for a population-based longitudinal cohort study and preliminary participant results
Authors: Miller Elyse M. , Law Elle A. , Ajeen Rawan , Karasik Jaclyn , Mendoza Carmen , Abernathy Haley , Garrett Haley , King Elise , Wallace John , Zelek Michael , Edwards Jessie K. , Xiong Khou , Beatty Cherese , Fleischauer Aaron T. , Ciccone Emily J. , Shook-Sa Bonnie E. , Aiello Allison E. , Boyce Ross M.
Published: October 2021

Public health surveillance systems likely underestimate the true prevalence and incidence of SARS-CoV-2 infection due to limited access to testing and the high proportion of subclinical infections in community-based settings. This ongoing prospective, observational study aimed to generate accurate estimates of the prevalence and incidence of, and risk factors for, SARS-CoV-2 infection among residents of a central North Carolina county. From this cohort, we collected survey data and nasal swabs every two weeks and venous blood specimens every month. Nasal swabs were tested for the presence of SARS-CoV-2 virus (evidence of active infection), and serum specimens for SARS-CoV-2-specific antibodies (evidence of prior infection). As of June 23, 2021, we have enrolled a total of 153 participants from a county with an estimated 76,285 total residents. The anticipated study duration is at least 24 months, pending the evolution of the pandemic. Study data are being shared on a monthly basis with North Carolina state health authorities and future analyses aim to compare study data to state-wide metrics over time. Overall, the use of a probability-based sampling design and a well-characterized cohort will enable collection of critical data that can be used in planning and policy decisions for North Carolina and may be informative for other states with similar demographic characteristics.
Enabling access to molecular monitoring for chronic myeloid leukemia patients is cost effective in China
Authors: Maheshwari Vikalp Kumar , Slader Cassandra , Dani Nidhi , Gkitzia Christina , Yuan Quan , Xiong Tengbin , Liu Yu , Viana Ricardo
Published: October 2021

Objective

To determine the cost effectiveness of molecular monitoring in patients with chronic myeloid leukemia in the chronic phase (CML-CP) compared to no molecular monitoring from a Chinese payer perspective.

Methods

Analyses were conducted using a semi-Markov model with a 50-year time horizon. Population data from multicenter registry-based studies of Chinese patients with CML-CP informed the model. Transition probabilities were based on time-to-event data from the literature. Utility values were obtained from published studies and were assumed to be the same for patients with and without molecular monitoring. Costs were based on values commonly used in the Chinese healthcare system, including drug acquisition, drug administration, follow-up, treatment for disease progression, molecular monitoring, and terminal care costs, and were in the local currency (2020 Chinese Yuan RMB [¥]). Outcomes were total life-years (LYs) and quality-adjusted life years (QALYs), lifetime costs, and incremental cost-effectiveness ratio.

Results

Molecular monitoring was dominant to no molecular monitoring, with increased LYs (1.52) and QALYs (1.90) and costs savings (¥93,840) over a lifetime compared to no monitoring in discounted analyses. The opportunity of patients that receive molecular monitoring to discontinue treatment during treatment-free remission, an opportunity not afforded to those without molecular monitoring, was the principle driver of this result. Results were similar across multiple clinical scenarios. Particularly, molecular monitoring remained dominant even if the proportion of patients achieving deep molecular response (DMR) was reduced by 10%-30%, or the proportion of patients maintaining DMR for 1 year was reduced by 10%-30% or increased by 10%. Cost savings in these scenarios ranged from ¥62,230 to ¥103,964.

Conclusions

Overall, this analysis demonstrates that adherence to guideline recommendations of regular molecular monitoring of patients with CML-CP treated with TKIs provides significant clinical benefit that leads to substantial cost savings compared to no molecular monitoring from the perspective of a Chinese payer. In a time where healthcare systems have limited resources to allocate to optimal patient care, investment in molecular monitoring is an ideal choice for improving patient benefits at a reduced cost.
Self-Instantiation and Self-Participation
Authors: J. Augustín Michael
Published: October 2021

While each Form is what it is to be F, some Forms also instantiate F (or “self-instantiate”). Here I consider whether the explanation for a Form’s instantiating F should be the Form’s participating in itself. First, I motivate the need for an explanation of self-instantiation. Second, I consider the advantages and disadvantages of self-participation alongside an alternative explanation—that the Form’s being what it is to be F is a sufficient explanation of its instantiation of F. The result is not a conclusive case for self-participation, but only some initial considerations in favor of it.
HOW MIGHT DEFICIT ACCUMULATION GIVE RISE TO FRAILTY?
Authors: Rockwood K. , Mitnitski A.
Published: October 2021

Frailty is a multiply determined vulnerability state. People who are frail are at risk of many adverse health outcomes, including death. For any individual, this risk can only be expressed probabilistically. Even very fit people can suddenly die or become catastrophically disabled, but their risk of both is much lower than a very frail person, who might nevertheless suddenly succumb without worsening health. Frailty occurs with ageing, a stochastic, dynamic process of deficit accumulation. Deficits occur ubiquitously at subcellular levels, ultimately affecting tissues, organs and integrated organ action, especially under stress. Some people are disposed to accumulate deficits at higher rates, but on average, deficit accumulation varies across the life course and likely is mutable. In this way, the clinical definition of frailty is distinct from the statistical definition, which sees frailty as a fixed factor for an individual. Recent, early animal work links subcellular deficits to whole body frailty. In humans, clinically detectable health deficits combine to increase the risk of adverse health outcomes. The rate of deficit accumulation occurs with remarkable regularity around the world, as does a limit to frailty. Of note, when 20+ deficits are counted, these characteristics are indifferent to which deficits are considered. The expression of risk in relation to deficit accumulation varies systematically. For example, at any given level of deficit accumulation, men are more susceptible to adverse health outcomes than are women. Likewise, in China, the lethality of deficit accumulation appears to be higher than in Western countries. In consequence, it may be necessary to better distinguish between frailty and physiological reserve; the latter may apply chiefly in relation to microscopic deficits. The expression of frailty risk in relation to deficit accumulation depends on the environment, including both the physical and social circumstances in which people find themselves.
POTENTIAL PROGNOSTIC VALUE OF HANDGRIP STRENGTH IN OLDER HOSPITALIZED PATIENTS
Authors: Savino E. , Sioulis F. , Guerra G. , Cavalieri M. , Zuliani G. , Guralnik J.M. , Volpato S.
Published: October 2021

Objective measures of physical function are useful prognostic tools also for hospitalized elders. Low handgrip strength is predictive of poor outcomes and it can be assessed also in a sitting position, representing a potential alternative measure in bedridden patients. We evaluated grip strength prognostic value in hospitalized older patients. Design: Prospective cohort study. Setting: Geriatric, medical ward of an academic medical center in Ferrara, Italy. Participants: Patients aged 65 and older (N = 88) admitted to the hospital for an acute medical condition. Measurements: Patients were evaluated for grip strength at hospital admission and were re-evaluated at discharge. After discharge, they were followed every 3 months for 1 year by telephone interviews to assess new hospitalizations and vital status. Results: The mean age of the sample was 77.3 years, 47% were women. At admission, mean height standardized handgrip strength was 15.7±5 kg/m; men had greater strength (p<0.001). There was a direct relationship of admission grip strength with BMI (p<0.05), serum albumin (p=0.07), and Short Physical Performance Battery score (p<0.05), and an inverse relationship with age (gender-adjusted p value <0.01). In multiple regression analysis, after adjustment for possible confounders, patients in third tertile of grip strength had a shorter hospital stay compared to those in the first tertile (β -2.8; p<0.05). Patients with higher grip strength at discharge also had a lower risk of rehospitalization or death over the follow-up, although the result was not statistically significant (OR: 0.68; 95% CI: 0.30-1.52). Conclusion: In older hospitalized medical patients, grip strength assessment might provide useful prognostic information.
Implicações do uso do solo na ocorrência de feições erosivas em São Pedro (SP)
Authors: Daniel Evandro , Vieira Bianca Carvalho , Martins Tiago Damas
Published: October 2021

Embora a erosão seja um processo natural associada aos fatores naturais como litologia, solo, morfologia das encostas e a chuva, a ação antrópica interfere na sua dinâmica, pois práticas inadequadas de uso podem potencializar a evolução dos processos. Neste contexto, este trabalho teve como objetivo analisar as implicações do uso do solo e sua influência na gênese e distribuição das feições erosivas da bacia do córrego Espraiado, São Pedro (SP), a partir de quatro cenários: 1962, 1972, 2000 e 2020. Os mapas do uso do solo e das feições erosivas foram realizados a partir de ortofotos, trabalho de campo e por um método integrado de correlação e validação entre as feições erosivas e o uso do solo, utilizando um índice estatístico potencial de erosão. Os resultados mostraram que as classes de solo exposto e pastagens são as mais suscetíveis em todos os cenários, havendo uma redução da área total das feições erosivas a partir de 2000, devido ao aumento do percentual das classes mata, área urbana consolidada e silvicultura. Por fim, as maiores suscetibilidades das classes de solo exposto e de pasto também estão associadas às classes de curvaturas côncavas e declividade entre 20 e 40%.
α-Mangosteen as An Oxidative Inhibitor in Hepatocellular Carcinoma
Authors: Harliansyah Harliansyah , Rahmah Nunung Ainur , Kuslestari Kuslestari
Published: October 2021

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and the second leading cause of cancer mortality worldwide. Many strategies to discover molecular-based therapy are currently being implemented to overcome the resistance in HCC treatment. Cancer research is more targeted at molecular level of natural ingredients treatment as chemoprevention to reduce carcinogenesis risk. One of the natural compounds that serve as chemopreventive agent is mangosteen. α-Mangosteen, a xanthone commonly found in the fruit hull of Garcinia mangostana Linn, possess as an antioxidant. This study aims to determine the levels of reactive oxygen species (ROS), malondialdehyde (MDA), and protein carbonyl (PC) as the biomarkers of oxidative stress on untreated HepG2 cells compared to α-mangosteen-treated HepG2 cells. The results indicated that α-mangosteen has a cytotoxic effect on HepG2 cells with IC50=242.58 μg/mL and reduced ROS level 23.15±4.29% at 200 μg/mL. The MDA level of HepG2 cells was not significantly higher than on WRL-68 by 7.6%, 17.93%, 28.8%, 35.32%, and 61.95% at 100, 200, 500, 800, and 1000 μg/mL respectively. α-Mangosteen at 100 and 200 μg/mL reduced protein carbonyl by 76.24 and 79.84% in HepG2 cells line while compared to normal liver cells line (WRL-68) significantly (P<0.05). In conclusion, α-mangosteen reduced levels of ROS, MDA and PC. Therefore, α-mangosteen is a potential anti-cancer agent through oxidative stress inhibition.Keyword: free radical, HepG2 cells, α-mangosteen, oxidative stress.
Persistent hypoaldosteronism post-adrenalectomy for primary aldosteronism – a role for pre-operative spironolactone?
Authors: Angus Lachlan M , Yang Jun , Cheung Ada S
Published: October 2021

Primary aldosteronism is one of the most common (affecting up to 10%) yet treatable causes of hypertension in our community, notable due to an associated elevated risk of atrial fibrillation, stroke and myocardial infarction compared to essential hypertension. Guidelines have focussed on improving case detection due to significant underdiagnosis in the community. While our case experienced significant delay in diagnosis, we highlight a state of protracted, persistent post-operative hypoaldosteronism which manifested with severe hyponatraemia and hyperkalaemia, necessitating long-term mineralocorticoid replacement. We discuss whether pre-operative mineralocorticoid receptor antagonists to stimulate aldosterone secretion from the contralateral gland may have prevented this complication.

Learning points

Hypoaldosteronism is an uncommon complication of adrenalectomy for primary aldosteronism, typically manifesting with hyperkalaemia and hyponatraemia. While most cases are transient, it may be persistent, necessitating ongoing mineralocorticoid replacement.

Routine electrolyte monitoring is recommended post-adrenalectomy.

Risk factors for hypoaldosteronism include age >50 years, duration of hypertension >10 years, pre-existing renal impairment and adrenal adenoma size >2 cm.

Mineralocorticoid receptor antagonists may assist in the management of hypokalaemia and hypertension pre-operatively. However, it is unclear whether this reduces the risk of post-operative hypoaldosteronism.
Social inequalities for student leaders and professional organizations: Florence Nightingale’s political legacy
Authors: Silva Kênia Lara da , França Bruna Dias , Schreck Rafaela Siqueira Costa , Gandra Elen Cristiane , Silva Letícia Luzia Ferreira
Published: October 2021

ABSTRACT Objectives: to analyze the nursing systems of understanding and social inequalities from the perspective of student leaders and representatives of nursing professional organizations. Methods: qualitative research supported by the theoretical framework of Marxist dialectics. Threerepresentatives of professional organizations and five student leaders participated in the study. Datawere obtained from individual interviews and submitted to Critical Discourse Analysis. Results: thediscourses are marked by commitment, relational identification and characterize the position of obligation and necessity of nursing in acting with the individuals in situations of inequality, indicating accountability as a social practice. Among the competencies necessary for nursing in confronting social inequalities, political competence is central and is associated with health advocacy. Final Considerations: we conclude that acting on social inequalities is part of the historical construction of nursing. Here, we emphasized the historical importance of Florence Nightingale and her legacy for political action and leadership in nursing.
Meaning of work from the perspective of hospital nurses
Authors: Franco Meirieli Faza , Farah Beatriz Francisco , Amestoy Simone Coelho , Thofehrn Maira Buss , Porto Adrize Rutz
Published: October 2021

ABSTRACT Objectives: to know the meaning of the role of nurses in the hospital environment. Methods: this is a descriptive study with a qualitative approach, whose setting was a university hospital in Minas Gerais with 50 nurses. Data were collected through interviews and analyzed according to content analysis, with the contribution of the Interface software from R pour les Analyzes Multidimensionalnelles de Textes et de Questionnaires. Results: three categories emerged: “Nurses’ daily work in the hospital environment”; “Work motivation as an influential factor in the meaning of work”; “The two faces of the meaning of work: pleasure and suffering”. Nurses attributed a positive meaning to their work. Final Considerations: three dimensions of the meaning of work were highlighted: individual, organizational and social. These influenced the professional, social, working and individual life of nurses.
Nursing in Brazil: socioeconomic analysis with a focus on the racial composition
Authors: Marinho Gerson Luiz , Oliveira Bruno Luciano Carneiro Alves de , Cunha Carlos Leonardo Figueiredo , Tavares Felipe Guimarães , Paz Elisabete Pimenta Araújo
Published: October 2021

ABSTRACT Objectives: to analyze the socioeconomic characteristics of nurses and nursing technicians living in Brazil according to color/race. Methods: based on the 2010 Demographic Census sample, 62,451 nursing professionals (nurses and technicians) living in Brazil were selected. Differences in monthly income were estimated by multivariate models, stratified by color or race groups (white, brown, and black). Results: the majority were technicians (61.9%) of white color (54.3%). The income of white nurses exceeded that of brown and black nurses by more than a quarter; among technicians, white professionals had an income approximately 11% higher than brown and black nurses. Conclusions: differences between incomes of nursing workers were associated with ethnic/racial background, revealing situations in which white professionals systematically presented more favorable job and income conditions than black and brown professionals.
Clinical characterization, disability, and mortality in people with strokes during 90 days
Authors: Moraes Mariana de Almeida , Mussi Fernanda Carneiro , Muniz Ludmila Santos , Sampaio Elieusa e Silva , Leitão Tatiana de Sena , Santos Carlos Antônio de Souza Teles , Jesus Pedro Antônio Pereira de
Published: October 2021

ABSTRACT Objectives: to describe clinical characteristics and mortality of people with ischemic cerebrovascular accidents (strokes); to compare disability before the event and 90 days after. Methods: longitudinal study with 308 people hospitalized in Salvador-BA. Data collection took place from 03/2019 to 01/2020. Descriptive and inferential statistics were used. Results: mean age was 64.8 years, and National Institute of Health Stroke Scale score was 10.7. The median length of stay in the hospital was 11 days. Afro-descendants predominated (84%), elementary educational level (68.4%), income up to three minimum wages (89.1%), arrival within 4.5 hours of symptoms (57.9%) and admission to a specialized unit (71.8%). Prevalence of thrombolysis: 26%. The asymptomatic before the event category predominated (85.3%) as did the moderate/severe disability (41.5%) after 90 days. 19.7% of the sample evolved to death. Conclusions: the high mortality and disability generated by the event have implications for health management and care.
Prevention of domestic accidents in childhood: knowledge of caregivers at a health care facility
Authors: Santos Rayanne Rodrigues dos , Machado Maria Estela Diniz , Gomes Ana Leticia Monteiro , Aguiar Rosane Cordeiro Burla de , Christoffel Marialda Moreira
Published: October 2021

ABSTRACT Objective: To analyze caregivers’ knowledge about prevention of domestic accidents in early childhood and its association with education level. Methods: This is a cross-sectional study conducted in a Primary Care Unit in Niterói with caregivers (convenience sample) of children under 6 years old. To classify the knowledge, we adopted the Positivity Index; to verify the association between the variable “schooling” and knowledge, the chi square test was used; statistically significant results: p < 0.05. Results: A total of 256 caregivers participated; 93.5% showed adequate knowledge. In the individual items, the knowledge (100%) about prevention of accidents with sharp toys, firearms, intoxication by products stood out; and less frequently (64.5%), the knowledge of the information contained in the Child’s Health Booklet. There was no statistically significant association (p = 0.237) between education and knowledge. Conclusion: The caregivers presented knowledge about the prevention of domestic accidents, and this was not associated with the level of education.
Effect of music combined with swaddling on pain in full-term newborns: randomized clinical trial
Authors: Melo Gleicia Martins de , Cardoso Maria Vera Lúcia Moreira Leitão , Almeida Paulo César de , Rodrigues Elisa Conceição
Published: October 2021

ABSTRACT Objectives: to evaluate the effect of music applied within ten and 15 minutes, combined with swaddling, on behavioral (facial action) and physiological (heart rate) responses to pain in full-term newborns, before and during venipuncture for blood sampling. Methods: a randomized, triple-blind, clinical trial with 52 rooming in infants randomly assigned to four groups of 13: Experimental 1 (music [ten minutes] plus swaddling), Experimental 2 (music [15 minutes] plus swaddling), Control 1 (no music [ten minutes] plus swaddling), and Control 2 (no music [15 minutes] plus swaddling). Pain was measured using the Neonatal Facial Coding System in the basal and procedural moments. Results: experimental 2 group showed high pain absence (p < 0.05); low heart rate mean (p < 0.0001) in the basal and procedural (antisepsis, puncture, blood squeezing/aspiration, compression) moments. Conclusions: neonates who listened to 15 minutes of music plus swaddling showed a greater absence of facial pain actions.
Planned home birth assistance: challenges during the COVID-19 pandemic
Authors: Webler Natália , Almeida Lilian Conceição Guimarães de , Carneiro Jordana Brock , Campos Luana Moura , Glaeser Tanila Amorim , Santos Margarete Costa , Couto Telmara Menezes
Published: October 2021

ABSTRACT Objective: To understand the challenges faced by urban midwives in assisting planned home births during the COVID-19 pandemic. Methods: Qualitative study, based on the Collective Subject Discourse methodological framework, carried out with eight professionals, members of a birth care collective from the northeast region of Brazil. Data was collected between September and October of 2020 using the focus group technique. Results: The collective discourses revealed five central ideas: Changing assistance strategy; Dealing with frustration; Facing the fear of contamination; Avoiding exposure to the virus; and Keeping distance during the care process. Final considerations: The challenging condition the pandemic brings to the care of planned home births is made evident, being marked by the need for collective protection and the pressure of following health recommendations. The study also points out the need for official protocols and good quality information based on scientific evidence and humanizing principles to guide health care.
A REESTRUTURAÇÃO DO COLÉGIO UNIVERSITÁRIO DA UFMA NO PROCESSO DE URBANIZAÇÃO DE SÃO LUÍS (1960-1980)
Authors: CASTELLANOS SAMUEL LUIS VELÁZQUEZ , OLIVEIRA WILSON RAIMUNDO DE
Published: October 2021

RESUMO: Neste artigo debate-se o processo de implantação e instalação do Colégio Universitário da Universidade Federal do Maranhão no contexto de modernização do ensino no estado (1960/1980) e de sua transferência e reestruturação para o bairro periférico da Vila Palmeira em São Luís como Colégio de Aplicação. Analisa-se a conjuntura político-educacional que viabilizou a remoção desta unidade integrada do campus universitário como modalidade escolar de escolarização restrita a uma pequena e seletiva clientela, para uma comunidade pobre na periferia da capital. Apontam-se os confrontos entre estratégias impostas pela política educacional/gestão funcionalista do estado, e táticas de apropriação dos professores, funcionários, alunos, lideranças e organizações comunitárias pertencentes a uma cultura local, que em função de interesses interligados, defenderam a instituição como instância de pertença, permanência e sobrevivência. Utilizam-se jornais, legislação e documentação do arquivo escolar como fontes norteadas pelo referencial teórico-metodológico da história cultural. Conclui-se que a defesa constante da comunidade local, professores e funcionários pelo papel/lugar do Colégio de Aplicação como imagem simbólica e concreta de superação neste bairro suburbano e sua efetivação como escola-laboratório, campo de estágio e espaço de educação permanente e de adultos, se constitui numa moeda de troca destes indivíduos para ter acesso ao mercado de bens simbólicos e um caminho para capitalizar possibilidades de ascensão social via sucesso escolar.
Metabarcoding advances for ecology and biogeography of Neotropical protists: what do we know, where do we go?
Authors: Ritter Camila Duarte , Machado Arielli Fabrício , Ribeiro Karine Felix , Dunthorn Micah
Published: October 2021

Abstract: The Neotropics is one of the most diverse regions of the globe in terms of plants and animal species. Regarding the microbial world, however, little is known about the diversity and biogeography patterns of microorganisms in the Neotropics. The biogeography of several microbial taxonomic groups is still missing and/or incomplete, such as the protists. Despite the hard taxonomic identification of protists, the advance of molecular techniques (e.g., metabarcoding) have allowed to better explore the distribution of several protistan groups. Our goal here was to summarize the available information of Neotropical protists, focusing on metabarcoding studies, to explore what these data evidence on their ecology and biogeography. For this, we reviewed the findings from all articles that focused on or included the terrestrial protists using a metabarcoding approach and identified the gaps and future perspectives in this research field. We found that Neotropical protistan diversity patterns seem to be, at least in part, congruent with that of macro-organisms and, different than plants and bacteria, just weakly explained by environmental variables. We argue that studies with standardized protocols including different ecoregions are necessary, such as temperate forests, grasslands, and savannas from Southern of South America and Northern Atlantic Forest, to fully characterize the ecology and biogeography on Neotropical protists. Furthermore, dismembering evolutionary lineages and functional guilds of protists are important to better understand the relationship between diversity, dispersal abilities, and functionality of particular taxa of protists in their habitats.
Obstetric practices in childbirth care and usual risk birth
Authors: Alcântara Natália de Abreu , Silva Thais Jormanna Pereira
Published: October 2021

Abstract Objectives: to analyze the incidence of obstetric practices in labor and childbirth care at usual risk in a tertiary hospital. Methods: cross-sectional, descriptive study with a quantitative approach. Data were collected from 314 Monitoring Sheets of Labor and Childbirth Care of women who had their birth attended at the institution, from July 2017 to July 2018. The study was approved by the research ethics committee, with the embodied opinion number 2.822.707. Results: most women in the study were between 20 and 34 years old, coming from the city of Fortaleza, Ceará; had completed high school; and had unpaid work. The prevalence of good practices was identified: umbilical cord clamping in a timely manner (81.5%), immediate skin-to-skin contact (73.9%), breastfeeding in the childbirth room (74.2%), freedom of position and movement (72.3%), completion of the partograph (66.6%), presence of a companion (66.2%), offer of a liquid diet (65%), and non-pharmacological methods for pain relief (54.8%). As for interventional practices, we identified: venoclysis (42.4%), oxytocin infusion (29%), and amniotomy (11.1%). Conclusions: advances in the adoption of good practices based on scientific evidence are noteworthy; however, the technocratic model of childbirth care for women at normal risk persists.
Educational technology on expressing breast milk: development and validation of a Serious Game
Authors: Moraes Vanessa Correa de , Ferraz Lucimare
Published: October 2021

Abstract Objectives: to develop and validate a Serious Game about expressing breast milk for occupational nurses working in agribusiness companies. Method: methodological study, carried out in three stages: construction, evaluation and validation of the Serious Game. This study was carried out in 2020, included nine nurses from an agribusiness company and nine specialists in obstetrics and health worker. Results: the game was structured in four phases: preparation for expressing milk (previous general care needed for expressing milk); methods for expressing milk (techniques to express milk); storage (care related to containers and temperature); the use of breast milk (transport, thawing method, and provision to the child). The content was validated by experts, obtaining an overall Índice de Validade de Conteúdo(Content Validity Index) of 86.72%. The game was tested by occupational nurses, and its “usability” was validated by the System Usability Scale instrument, with an index of 83.89%, and the “knowledge improvement” by the EGameFlow instrument with a mean of 6.52. Conclusion: the Expressing Milk Game technology obtained a high level of validity in terms of content and usability, demonstrating that it is an educational technology for health professionals to guide the maintenance of breastfeeding to nursing mothers.
Factors associated with recurrent wheezing in the first year of life among premature newborns from Neonatal Intensive Care Units
Authors: Ramos Andréia Caroline Ribeiro , Castro Patrícia Soares , Souza Rafael Gomes , Carneiro Jair Almeida , Pinho Lucineia de , Caldeira Antônio Prates
Published: October 2021

Abstract Objectives: to determine the prevalence and factors associated with recurrent wheezing in the first year of life among premature newborns from Neonatal Intensive Care Units, in the city of Montes Claros, northern Minas Gerais. Methods: cross-sectional study, with data collection from medical records of a follow-up clinic, interviews with mothers and, eventually, search in hospital records. Bivariate analyzes were carried out between sociodemographic and clinical characteristics and recurrent wheezing. Variables associated up to the level of 20% were analyzed by binary logistic regression, and associations defined by the Odds Ratio and respective 95% confidence intervals. Only variables associated with a 5% significance level were maintained in the final model of logistic regression. Results: among 277 infants studied, about one fifth (21.3%) were extremely low birth weight preterm and more than half (60.7%) had birth weight below 1500 grams. The prevalence of recurrent wheezing was 14.4% (CI95% = 10.3-18.4). Mechanical ventilation (OR = 2.12; CI95% = 1.09-4.76; p = 0.030) and oxygen therapy time ≥ 15 days (OR = 2.49; CI95%= 1.12-5.00; p = 0.010) were the risk factors for the event. Conclusions: there is a high prevalence of recurrent wheezing in the evaluated group and the associated variables reiterate the risk of prolonged oxygen therapy and mechanical ventilation for premature newborns.
Prevalence of HIV, Syphilis, Hepatitis B and C in pregnant women at a maternity hospital in Salvador
Authors: Freire Jacielma de Oliveira , Schuch Jaqueline Bohrer , Miranda Mariana Freire de , Roglio Vinícius Serafini , Tanajura Helita , Victa Ana Gabriela Lima Bispo de , Diemen Lisia von
Published: October 2021

Abstract Objectives: to calculate the prevalence and rate per 1,000 live births of sexually transmitted infections (STI) in pregnant women at a public maternity hospital in Salvador. Methods: this descriptive, cross-sectional study retrospectively collected data from compulsory notifications and medical records of pregnant women with STI seen at a maternity hospital in northeastern Brazil between 2014 and 2017 (n = 520). Prevalence and rate per 1,000 live births were estimated for hepatitis B, hepatitis C, HIV, and syphilis. Associations between STI and other clinical and sociodemographic variables were investigated. Results: most pregnant women were born and resided in Salvador, presented a mean age of 26.4 years, self-reported mixed-race and had unplanned pregnancies. Prevalence and rates per 1,000 live births were, respectively: 0.26% and 3.39 for hepatitis B, 0.06% and 0.79 for hepatitis C, 0.47% and 6.23 for HIV, and 2.46% and 32.2 for syphilis. Conclusion: higher prevalence and rates of infection per 1,000 live births were seen at the maternity hospital in northeastern Brazil compared to official data provided by the Brazilian government, notably with regard to HIV and syphilis. The appropriate epidemiological notification of STI, especially in pregnant women, enables the elaboration of effective preventive strategies incorporating specific sociodemographic and clinical characteristics.
A relação entre intensificação no uso de agrotóxicos e intoxicações nos estabelecimentos agropecuários do Brasil
Authors: Rodrigues Loredany Consule Crespo , Féres José Gustavo
Published: October 2021

Resumo: Este estudo verifica a relação entre a intensidade do uso de agrotóxicos e o número de intoxicações nos estabelecimentos agropecuários do Brasil. A partir dos dados do Censo Agropecuário 2006, utilizou-se do Propensity Score Generalizado (PSG) para tornar os municípios com diferentes intensidades do uso de agrotóxicos comparáveis. Os resultados revelam que a proporção de estabelecimentos com pessoas intoxicadas aumenta à medida que se intensifica o uso de pesticidas, demonstrando efeito negativo e estatisticamente significativo dos agrotóxicos sobre a saúde. Nesse contexto, os serviços de assistência técnica e extensão rural (ATER), por meio do auxílio aos agricultores em relação ao uso e manuseio adequados de pesticidas e do incentivo à adoção de alternativas sustentáveis de manejo de pragas, tornam-se essenciais para mitigação dos riscos à saúde associados ao uso de agrotóxicos. Em conjunto com a ampliação dos serviços de ATER, destaca-se a importância do desenvolvimento de produtos mais eficientes e menos nocivos à saúde e ao meio ambiente.
Comprando qualidade: costume, gosto e reciprocidade nas feiras livres do Vale do Jequitinhonha
Authors: Cruz Maria Sirlene da , Ribeiro Eduardo Magalhães , Perondi Miguel Angelo , Araujo Alexandro Moura , Maltez Marcos Antonio Pereira da Fonseca
Published: October 2021

Resumo Este artigo analisa cinco feiras livres que abastecem uma parte substancial da população urbana do Alto Jequitinhonha na contramão do sistema agroalimentar dominante. Usando dados de fontes primárias e secundárias, são analisadas as relações estabelecidas entre consumidores e vendedores – os quais, em sua maioria, são agricultores – para interpretar as dimensões culturais e econômicas do abastecimento das pequenas cidades. O resultado da pesquisa indica que as feiras se relacionam com a identidade cultural alimentar, o abastecimento de grande parte da população urbana e movimenta parte expressiva da economia local dos municípios.
CONCEPÇÕES E ITINERÁRIOS TERAPÊUTICOS DE PESSOAS EM SOFRIMENTO PSÍQUICO EM CONTEXTOS QUILOMBOLAS
Authors: Aciole Danila Cristiny de Araújo Moura , Silva Josevânia da
Published: October 2021

Resumo O estudo teve por objetivo analisar as concepções sobre o sofrimento psíquico e os cuidados em saúde mental na perspectiva de pessoas com diagnóstico de transtorno mental, residentes em comunidades quilombolas. Trata-se de uma pesquisa com abordagem qualitativa. Participaram nove pessoas de duas comunidades quilombolas do interior do Estado de Pernambuco. Os dados foram coletados através de questionário sociodemográfico e uma entrevista do tipo relato de vida e analisados a partir da Análise de Conteúdo Temática. As categorias temáticas versaram sobre o sofrimento psíquico e as estratégias de cuidado utilizadas pelos participantes no cuidado em saúde mental. Dentre os itinerários terapêuticos dos sujeitos, destacam-se estratégias pautadas no saber biomédico e o cuidado baseado no saber popular.
CAMPO DE POTÊNCIA: PISTAS PARA A PRODUÇÃO DE UMA ARMA CONCEITUAL
Authors: Rosa Leandro Amorim , Sandoval Salvador Antonio Mireles
Published: October 2021

Resumo O artigo objetiva apresentar a proposta teórica denominada campo de potência. O conceito foi elaborado a partir de pesquisa junto a jovens que participaram de ocupações escolares no estado de São Paulo em 2015 e/ou 2016. A pesquisa teve como fundamento teórico a articulação entre a psicologia histórico-cultural e o pensamento político gramsciano. O campo de potência se configura como um instrumento psicossocial composto por três dimensões entrelaçadas e indissociáveis: potência de agir; aprendizado e desenvolvimento; práxis política. O campo de potência se caracteriza como um ambiente físico e social que favorece a produção de potência de agir; subjetividades e relações democráticas e democratizantes; e práxis política reflexiva e criativa - com caraterísticas multitudinárias. Entende-se que a ação psicossocial pautada no campo de potência possa contribuir com o fortalecimento de movimentos de luta por direitos, bem como com a atuação junto a espaços diversos como: saúde, educação e assistência social.