ABSTRACT Rare emerging pathogens such as Saprochaete clavata are associated with invasive fungal diseases, high morbidity, mortality, rapidly fatal infections, and outbreaks. However, little is known about S. clavata infections, epidemiology, risk factors, treatment, biofilms, and disease outcomes. The objective of this study was to describe a new case of severe S. clavata infection in a patient diagnosed at a referral children’s hospital in Brazil, including antifungal minimal inhibitory concentration, S. clavata biofilm characterization, and molecular characterization. The S. clavata isolated from an immunocompromised 11-year-old male patient was characterized using MALDI-TOF, Gram staining, scanning electron microscopy (SEM), and next generation sequencing (NGS) of genomic DNA. Biofilm production was also evaluated in parallel with determining minimal inhibitory concentration (MIC) and biofilm sensitivity to antifungal treatment. We observed small to medium, whitish, farinose, dry, filamentous margin colonies, yeast-like cells with bacillary features, and biofilm formation. The MALDI-TOF system yielded a score of ≥ 2,000, while NGS confirmed S. clavata presence at the nucleotide level. The MIC values (in mg L-1) for tested drugs were as follows: fluconazole = 2, voriconazole ≤ 2, caspofungin ≥ 8, micafungin = 2, amphotericin B = 4, flucytosine ≤ 1, and anidulafungin = 1. Amphotericin B can be active against S. clavata biofilm and the fungus can be susceptible to new azoles. These findings were helpful for understanding the development of novel treatments for S. clavata-induced disease, including combined therapy for biofilm-associated infections.

ABSTRACT Background: The aim of this research was to investigate the efficiency of methods to overcome primary dormancy and biochemical processes associated with germination of Erythrina falcata Benth seeds. Seeds were submitted to dormancy overcoming treatments and the water uptake pattern was analysed. We then evaluated the activity of the antioxidant enzymes SOD, CAT, and APX, and quantified lipid peroxidation levels, hydrogen peroxide content and total protein content. The experiments were performed in a completely randomized design and the statistical analysis used was Scott-Knott test at 5% probability. Results: Mechanical scarification with sandpaper leads to approximately 94% of germination in E. falcata, while control non-scarified seeds show only approximately 37% of germination. Treatments with hot water led to high mortality in E. falcata seeds. Rapid water absorption was observed in the first 18 hours of imbition when the seeds were scarified with sandpaper, and radicle emergence was observed after 36 hours. During imbibition there was an increase of antioxidant enzyme activity and a decrease in lipid peroxidation and H2O2 production, suggesting an efficient mechanism for regulating imbibition damage. A decrease in the total protein content was observed during germination of E. falcata seeds. Conclusions: Mechanical scarification is an efficient method for breaking dormancy of E. falcata seeds. During germination of E. falcata seeds there is a reduction in the production of H2O2 and lipid peroxidation, and an increase in the activity of antioxidant enzymes. The total protein content decreased along the germination time.

ABSTRACT Background: Although most coronavirus disease 2019 (COVID-19) infections are mild, some patients have severe clinical conditions requiring hospitalization. Data on the severity of COVID-19 in Brazil are scarce and are limited to public databases. This study aimed to investigate the clinical and laboratory factors associated with the severity of COVID-19 in a cohort of hospitalized adults from two hospitals in Northeast Brazil. Methods: Patients over 18 years of age who were hospitalized between August 2020 and July 2021 with a confirmed diagnosis of COVID-19 were included. The patients were classified into two groups: moderate and severe. Clinical, laboratory and imaging parameters were collected and compared between the groups. A multivariate logistic regression model was used to determine the predictors of COVID-19 severity. Results: This study included 495 patients (253 moderate and 242 severe). A total of 372 patients (75.2%) were between 18 and 65 years of age, and the majority were male (60.6%; n = 300). Patients with severe disease had higher levels of leukocytes, neutrophils, platelets, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, blood glucose, C-reactive protein, ferritin, D-dimer, aspartate aminotransferase, creatinine, and urea (p < 0.05). In multivariate logistic regression, the following variables were significant predictors of COVID-19 severity: leukocytes (odds ratio [OR] 3.27; 95% confidence interval [CI] 2.12-5.06), international normalized ratio (INR) (OR 0.22, 95% CI 0.14-0.33), and urea (OR 4.03; 95% CI 2.21-7.35). Conclusions: The present study identified the clinical and laboratory factors associated with the severity of COVID-19 in hospitalized Brazilian individuals.

Abstract This in vitro study evaluated the impact of TiO2 nanotubes (n-TiO2) incorporated into glass ionomer cement (GIC) on Streptococcus mutans (S. mutans) characteristics at cellular and molecular levels. n-TiO2, synthesized by the alkaline method (20 nm in size), was added to Ketac Molar EasyMix® at 0%, 3%, 5%, and 7% by weight. S. mutans strains were cultured on GIC disks with addition or not of n-TiO2 for 1, 3, and 7 days and the following parameters were assessed: inhibition halo (mm) (n=3/group); cell viability (live/dead) (n=5/group); cell morphology (SEM) (n=3/group); and gene expression by real-time PCR (vicR, covR, gtfB, gtfC, and gtfD) (n=6/group). The data were analyzed by the Kruskal-Wallis test, repeated-measures ANOVA or two-way ANOVA, and Tukey’s and Dunn’s post-hoc tests (α=0.05). The agar diffusion test showed a higher antibacterial property for 5% n-TiO2 compared with 3% and 7% (p<0.05) with no effect of time (1, 3, and 7 days). The cell number was significantly affected by all n-TiO2 groups, while viability was mostly affected by 3% and 5% n-TiO2, which also affected cell morphology and organization. Real-time PCR demonstrated that n-TiO2 reduced the expression of covR when compared with GIC with no n-TiO2 (p<0.05), with no effect of time, except for 3% n-TiO2 on vicR expression. Within-group and between-group analyses revealed n-TiO2 did not affect mRNA levels of gtfB, gtfC, and gtfD (p>0.05). Incorporation of n-TiO2 at 3% and 5% potentially affected S. mutans viability and the expression of key genes for bacterial survival and growth, improving the anticariogenic properties of GIC.

Resumo Cruá vermelho é um fruto aromático ainda pouco conhecido, originário da América Tropical, provavelmente do Brasil. É utilizado para fins alimentar, medicinal, repelente de insetos e aromatização de ambientes. Pouco se sabe acerca de suas características nutricionais. Diante do exposto, o presente trabalho visou realizar a caracterização física, físico-química e nutricional do fruto cruá vermelho. Os frutos foram caracterizados quanto a composição centesimal, pH, sólidos solúveis (SS), acidez titulável (AT), cálculo da ingestão diária recomendada (IDR), antocianinas, carotenoides totais, vitamina C e atividade antioxidante da polpa. A estabilidade dos carotenoides, da vitamina C e da cor dos frutos foi acompanhada durante 21 dias de armazenamento sob congelamento a -18 °C. Os carotenoides, a vitamina C e a cor do fruto foram afetados pelo congelamento durante o armazenamento. O fruto apresenta características apreciáveis do ponto de vista nutricional e funcional, uma vez que o consumo diário de 100 g de sua polpa fornece uma apreciável fração de nutrientes recomendados para ingestão diária por um indivíduo adulto. O fruto apresenta um baixo valor calórico, fato interessante para preparações dietéticas, além de apresentar capacidade antioxidante e compostos fitoquímicos de interesse para a saúde humana, como carotenoides e antocianinas. Em relação à preservação dos compostos bioativos apresentados pelo fruto, verificou-se que o congelamento não foi eficaz para a preservação de carotenoides e vitamina C. Diante de todas as características apresentadas, cruá vermelho se apresenta como uma excelente alternativa para inclusão na alimentação humana.

Abstract Musk cucumber (Sicana odorifera Naudin) is a still little-known aromatic fruit native of Tropical America, probably Brazil. It is used as food and insect repellent, for medicinal purposes, and to flavor environments. Little is known about its nutritional characteristics. In this context, this study aimed to perform the physical, physicochemical and nutritional characterization of musk cucumber. The fruits were characterized according to their chemical composition, pH, soluble solids (SS), titratable acidity (TA), recommended daily intake (RDI), anthocyanins, total carotenoids, vitamin C, and antioxidant activity of the pulp. The stability of carotenoids, vitamin C, and fruit color was monitored for 21 days of frozen storage (-18 °C). Carotenoids, vitamin C, and fruit color were affected by freezing during storage. The fruit has appreciable characteristics from a nutritional and functional point of view, since the daily consumption of 100 g of its pulp provides a significant fraction of nutrients recommended for daily intake by an adult. The fruit presents low caloric value - an interesting fact for dietary preparations, in addition to having antioxidant capacity and phytochemicals of interest to human health, such as carotenoids and anthocyanins. Regarding the bioactive compounds present in the fruit, it was found that freezing was not effective to preserve carotenoids and vitamin C. Given all the characteristics presented, musk cucumber is an excellent alternative for inclusion in human diet.

RESUMO O objetivo do presente estudo é apresentar uma abordagem de tratamento em um caso de cárie na primeira infância (CPI). Uma menina de 5 anos foi encaminhada à área de Odontopediatria com múltiplas perdas dentárias precoces, dificuldades mastigatórias, amamentação prolongada e baixa qualidade de vida, com diagnóstico de CPI severa. Um plano de tratamento em três fases foi implementado: 1. Controle da doença – consistindo em mudanças comportamentais nos hábitos de higiene bucal, orientação alimentar, remoção profissional do biofilme seguida de aplicação de flúor e restaurações provisórias; 2. Controle de infecção – exodontias e pulpotomia; e 3. Reabilitação funcional – restaurações diretas e semi-indiretas de resina, próteses parcial e total removíveis nos maxilares inferior e superior, respectivamente. Em conclusão, a abordagem multidisciplinar proposta resultou em um impacto positivo na nutrição e crescimento do paciente, produção da fala, comunicação, autoimagem e socialização, levando a uma melhoria da qualidade de vida.

ABSTRACT The aim of the current study is to present a treatment approach in a case of severe early childhood caries (ECC). A 5-year-old girl was referred to the Pediatric Dentistry Division with multiple premature tooth loss, masticatory difficulties, prolonged breast-feeding, and low quality of life, who was diagnosed with severe ECC. A three-phased treatment plan was implemented: 1. Disease control – consisting of behavioral changes in oral hygiene habits, diet guidance, professional biofilm removal followed by fluoride application and temporary restorations; 2. Infection control – teeth extractions and pulpotomy; and 3. Functional rehabilitation – direct and semi-indirect resin restorations, a removable partial and total prostheses in the lower and upper jaws, respectively. In conclusion, the proposed multidisciplinary approach resulted in a positive impact on the patient’s nutrition and growth, speech production, communication, self-image, and social functioning leading to an improved quality of life.

RESUMO O objetivo foi avaliar as atividades de vida diária (AVD) e fatores de risco para o desenvolvimento de sintomas depressivos nos pacientes com doença pulmonar obstrutiva crônica (DPOC). Estudo transversal realizado no ambulatório de Pneumologia do Hospital Universitário Oswaldo Cruz. Participaram do estudo 202 pacientes com DPOC. Foram avaliados os dados sociodemográficos e antropométricos; as AVD, através do Pulmonary Functional Status and Dyspnea Questionnaire - Modified version (PFSDQ-M); e a presença de sintomas depressivos por meio do inventário de depressão de Beck. Todos os domínios (dispneia, fadiga e mudanças de atividades) do PFSDQ-M se apresentaram comprometidos nos pacientes com sintomas depressivos. A prevalência de sintomas depressivos foi de 38,6%. As chances de desenvolvimento desses sintomas ocorreram para aqueles que utilizavam mais de um broncodilatador (OR: 2,82, IC95%: 1,47-5,38, p=0,002), que apresentavam dislipidemias (OR: 2,74, IC95%: 1,24-6,07, p=0,012), que possuíam cardiopatia (OR: 2,82, IC95%: 1,18-6,74, p=0,02); que apresentavam expectoração (OR: 2,44, IC95%: 1,2-4,95, p=0,014); e não tinham companheiros (OR: 2,58, IC95%: 1,36-4,9, p=0,004). Pacientes com DPOC com sintomas depressivos apresentaram todos os domínios das AVD comprometidos em relação aos pacientes sem esses sintomas.

ABSTRACT This cross-sectional study assessed the activities of daily living (ADL) and risk factors for developing depressive symptoms in patients with chronic obstructive pulmonary disease (COPD) and was carried out at the pulmonology outpatient clinic of the Hospital Universitário Oswaldo Cruz. Two hundred two (202) patients with COPD participated in the study. We evaluated the sociodemographic and anthropometric data, the ADL by means of Pulmonary Functional Status and Dyspnea Questionnaire - Modified version (PFSDQ-M), and the presence of depressive symptoms using the Beck Depression Inventory (BDI). All domains (dyspnea, fatigue and activity changes) of PFSDQ are compromised in patients with depressive symptoms. The prevalence of depressive symptoms was 38.6%. The chance of developing these symptoms was higher for those who used more than one bronchodilator (OR: 2.82, CI 95%: 1.47-5.38, p=0.002), presented dyslipidemias (OR: 2.74, CI95%: 1.24-6.07, p=0.012), had a heart disease (OR: 2.82, CI 95%: 1.18-6.74, p=0.020), presented expectoration (OR: 2.44, CI 95%: 1.2-4.95, p=0.014) or did not have a partner (OR: 2.58, CI 95%: 1.36-4.9, p=0.004). COPD patients with depressive symptoms had all domains of ADL compromised compared to patients without these symptoms.

RESUMEN El objetivo fue evaluar las actividades de la vida diaria (AVD) y los factores de riesgo para el desarrollo de síntomas depresivos en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). Estudio transversal realizado en el ambulatorio de Neumología del Hospital Universitario Oswaldo Cruz. En el estudio, participaron 202 pacientes con EPOC. Se evaluaron los datos sociodemográficos y antropométricos, las AVD por medio de Pulmonary Functional Status and Dyspnea Questionnaire: Modified version (PFSDQ-M), y la presencia de síntomas depresivos por medio del Inventario de depresión de Beck. Todos los dominios (disnea, fatiga y cambios en las actividades) del PFSDQ-M estuvieron comprometidos en pacientes con síntomas depresivos. La prevalencia de síntomas depresivos fue del 38,6%. Las posibilidades para el desarrollo de estos síntomas ocurrieron para aquellos que utilizaban más de un broncodilatador (OR: 2,82, IC95%: 1,47-5,38, p=0,002), que tenían dislipidemias (OR: 2,74, IC95%: 1,24-6,07, p=0,012), que tenían enfermedad cardiaca (OR: 2,82, IC95%: 1,18-6,74, p=0,02), que tenían expectoración (OR: 2,44, IC95%: 1,2-4,95, p=0,014), y no tenían parejas (OR: 2,58, IC95%: 1,36-4,9, p=0,004). Los pacientes con EPOC y síntomas depresivos tuvieron todos los dominios de las AVD afectados en comparación con los pacientes sin estos síntomas.

ABSTRACT The objective of the present study was to develop a methodology to obtain the enriched fraction of ram seminal vesicle protein 14 (RSVP14). The study was developed using Morada Nova rams, from which semen samples were collected weekly. Seminal plasma proteins were precipitated with cold ethanol, and then 6.15 mg/mL of total proteins were subjected to liquid gelatin affinity chromatography using a Gelatin-Sepharose matrix coupled to an automated chromatographic system. Proteins were eluted into four fractions (A, B, C, and D), in which A and B contained non-gelatin-binding proteins, and C and D fractions contained gelatin-binding proteins. Gels were analyzed by Quantity One software, in which five protein bands were detected in fraction D, with molecular weights between 12 and 30 kDa. The gelatin-binding proteins (fraction D) were loaded into a HiTrap™ Heparin HP affinity column. Two chromatographic fractions were separated (D1 and D2), in which D1 contained non-heparin-binding proteins, and D2 contained heparin-binding proteins. Proteins from the last two peaks were subjected to 12.5% SDS-PAGE and Western Blot. Two bands with molecular weight of 14 and 24 kDa, contained in fraction D1, were excised from gel and subjected to tandem mass spectrometry, identifying the proteins RSVP14 and RSVP24. Thus, the chromatographic methods of the present study are efficient to capture the enriched fraction of RSVP14.

Resumo Objetiv Avaliar o ambiente hospitalar onde a enfermagem exerce sua prática comparando hospitais públicos e privados e descrever as características que receberam avaliação desfavorável (≤ 2,5 pontos) na percepção dos profissionais. Métodos Estudo comparativo e transversal realizado em cinco hospitais (dois públicos - A e B e três privados - C, D e E) de um município do interior do estado de São Paulo, com 1773 profissionais de enfermagem. Os instrumentos utilizados foram: ficha para caracterização da amostra e a versão brasileira da Practice Environment Scale. Na análise dos dados, foram utilizadas estatísticas descritivas e inferenciais. Para comparar os hospitais foi utilizado o teste Kruskall Wallis, seguido pelo pós-teste de Dunn e a regressão multinomial. Resultados Na comparação dos hospitais, os hospitais D e E alcançaram médias superiores aos demais e diferenças significantes (p<0,0001) foram obtidas com relação às cinco subescalas do instrumento utilizado. Na regressão multinomial, o hospital D obteve 5,8; o E 5,2; o C 3,0 e o A 2,7 chances de possuir um ambiente mais favorável, quando comparados ao hospital B. Os itens com nota inferior a 2,5 foram associados, especialmente, a falta de oportunidade de desenvolvimento, reconhecimento, gestão participativa e dimensionamento adequado. Conclusão Os hospitais privados apresentaram melhor desempenho quando comparados aos públicos e as características que receberam pior avaliação estavam relacionadas à participação dos enfermeiros nos assuntos hospitalares, fundamentos voltados para a qualidade, suporte dos gestores à equipe e adequação de recursos.

Abstract Objective To evaluate the hospital environment where nursing performs its practice comparing public and private hospitals and describing the characteristics that received unfavorable evaluation (≤ 2.5 points) in the professionals’ perception. Methods A comparative and cross-sectional study was conducted in five hospitals (two public hospitals - A and B; and three private ones - C, D and E) from a city in the countryside of the state of São Paulo, with a total of 1773 nursing professionals. The instruments used were: data sheet for characterization of the sample and the Brazilian version of the Practice Environment Scale. In the data analysis, we used descriptive and inferential statistics. To compare the hospitals, we used the Kruskall Wallis test, followed by the Dunn post-test and the multinomial regression. Results In the comparison of hospitals, D and E hospitals reached mean above the others and significant differences (p<0.0001) were obtained in relation to the five subscales of the instrument used. In the multinomial regression, hospital D obtained 5.8; hospital E 5.2; hospital C 3.0 and hospital A 2.7 chances of having a more favorable environment when compared to hospital B. Items with a score lower than 2.5 were associated, especially, lack of opportunity for development, recognition, participatory management and proper sizing. Conclusion Private hospitals showed better performance when compared to the public ones, and the characteristics that received the worst evaluation were related to the participation of nurses in hospital affairs based on quality, support of the managers to the team and adequacy of resources.

Resumen Objetivo evaluar el ambiente hospitalario donde la enfermería ejerce su práctica comparando hospitales públicos y privados y describir las características que recibieron evaluación desfavorable (≤ 2,5 puntos) según la percepción de los profesionales. Métodos estudio comparativo y transversal realizado en cinco hospitales (dos públicos: A y B; tres privados: C, D y E) de un municipio del interior del estado de São Paulo, con 1.773 profesionales de enfermería. Los instrumentos utilizados fueron: ficha para caracterización de la muestra y la versión brasileña de la Practice Environment Scale. En el análisis de los datos, se utilizaron estadísticas descriptivas e inferenciales. Para comparar los hospitales, se utilizó la prueba Kruskall Wallis, seguida de la prueba posterior de Dunn y la regresión multinomial. Resultados en la comparación de los hospitales, los hospitales D y E alcanzaron promedios superiores a los demás y se obtuvieron diferencias significativas (p<0,0001) con relación a las cinco subescalas del instrumento utilizado. En la regresión multinomial, el hospital D obtuvo 5,8; el E 5,2; el C 3,0 y el A 2,7 chances de poseer un ambiente más favorable, al compararlos con el hospital B. Los ítems con nota inferior a 2,5 fueron asociados, especialmente, a la falta de oportunidad de crecimiento, reconocimiento, gestión participativa y dimensionamiento adecuado. Conclusión los hospitales privados presentaron mejor desempeño al compararlos con los públicos y las características que recibieron peor evaluación estaban relacionadas con la participación de los enfermeros en los asuntos hospitalarios, fundamentos orientados a la calidad, apoyo de los gestores al equipo y adecuación de recursos.

Abstract Objective To evaluate the hospital environment where nursing performs its practice comparing public and private hospitals and describing the characteristics that received unfavorable evaluation (≤ 2.5 points) in the professionals’ perception. Methods A comparative and cross-sectional study was conducted in five hospitals (two public hospitals - A and B; and three private ones - C, D and E) from a city in the countryside of the state of São Paulo, with a total of 1773 nursing professionals. The instruments used were: data sheet for characterization of the sample and the Brazilian version of the Practice Environment Scale. In the data analysis, we used descriptive and inferential statistics. To compare the hospitals, we used the Kruskall Wallis test, followed by the Dunn post-test and the multinomial regression. Results In the comparison of hospitals, D and E hospitals reached mean above the others and significant differences (p<0.0001) were obtained in relation to the five subscales of the instrument used. In the multinomial regression, hospital D obtained 5.8; hospital E 5.2; hospital C 3.0 and hospital A 2.7 chances of having a more favorable environment when compared to hospital B. Items with a score lower than 2.5 were associated, especially, lack of opportunity for development, recognition, participatory management and proper sizing. Conclusion Private hospitals showed better performance when compared to the public ones, and the characteristics that received the worst evaluation were related to the participation of nurses in hospital affairs based on quality, support of the managers to the team and adequacy of resources.

Resumen Objetivo evaluar el ambiente hospitalario donde la enfermería ejerce su práctica comparando hospitales públicos y privados y describir las características que recibieron evaluación desfavorable (≤ 2,5 puntos) según la percepción de los profesionales. Métodos estudio comparativo y transversal realizado en cinco hospitales (dos públicos: A y B; tres privados: C, D y E) de un municipio del interior del estado de São Paulo, con 1.773 profesionales de enfermería. Los instrumentos utilizados fueron: ficha para caracterización de la muestra y la versión brasileña de la Practice Environment Scale. En el análisis de los datos, se utilizaron estadísticas descriptivas e inferenciales. Para comparar los hospitales, se utilizó la prueba Kruskall Wallis, seguida de la prueba posterior de Dunn y la regresión multinomial. Resultados en la comparación de los hospitales, los hospitales D y E alcanzaron promedios superiores a los demás y se obtuvieron diferencias significativas (p<0,0001) con relación a las cinco subescalas del instrumento utilizado. En la regresión multinomial, el hospital D obtuvo 5,8; el E 5,2; el C 3,0 y el A 2,7 chances de poseer un ambiente más favorable, al compararlos con el hospital B. Los ítems con nota inferior a 2,5 fueron asociados, especialmente, a la falta de oportunidad de crecimiento, reconocimiento, gestión participativa y dimensionamiento adecuado. Conclusión los hospitales privados presentaron mejor desempeño al compararlos con los públicos y las características que recibieron peor evaluación estaban relacionadas con la participación de los enfermeros en los asuntos hospitalarios, fundamentos orientados a la calidad, apoyo de los gestores al equipo y adecuación de recursos.

Resumo Objetiv Avaliar o ambiente hospitalar onde a enfermagem exerce sua prática comparando hospitais públicos e privados e descrever as características que receberam avaliação desfavorável (≤ 2,5 pontos) na percepção dos profissionais. Métodos Estudo comparativo e transversal realizado em cinco hospitais (dois públicos - A e B e três privados - C, D e E) de um município do interior do estado de São Paulo, com 1773 profissionais de enfermagem. Os instrumentos utilizados foram: ficha para caracterização da amostra e a versão brasileira da Practice Environment Scale. Na análise dos dados, foram utilizadas estatísticas descritivas e inferenciais. Para comparar os hospitais foi utilizado o teste Kruskall Wallis, seguido pelo pós-teste de Dunn e a regressão multinomial. Resultados Na comparação dos hospitais, os hospitais D e E alcançaram médias superiores aos demais e diferenças significantes (p<0,0001) foram obtidas com relação às cinco subescalas do instrumento utilizado. Na regressão multinomial, o hospital D obteve 5,8; o E 5,2; o C 3,0 e o A 2,7 chances de possuir um ambiente mais favorável, quando comparados ao hospital B. Os itens com nota inferior a 2,5 foram associados, especialmente, a falta de oportunidade de desenvolvimento, reconhecimento, gestão participativa e dimensionamento adequado. Conclusão Os hospitais privados apresentaram melhor desempenho quando comparados aos públicos e as características que receberam pior avaliação estavam relacionadas à participação dos enfermeiros nos assuntos hospitalares, fundamentos voltados para a qualidade, suporte dos gestores à equipe e adequação de recursos.

ABSTRACT. Agricultural species are subjected to a variety of biotic and abiotic stresses, which are the main limitations to crop production. In this context, contamination by trace elements is characterized as an abiotic stress that represents an environmental problem. Due to the physical and chemical similarities between cadmium and zinc, these elements may interact in the environment and may cause antagonistic or synergistic effects. In this way, physiological mechanisms to exclude, detoxify or compartmentalize trace elements that are in excess are crucial for plant survival when exposed to high concentrations of these elements. In this way, the aim of this study was to understand the physiological responses of Phaseolus vulgaris plants subjected to increasing doses of Cd and Zn for 21 days in different soil, Cambisol and Latosol. The activity of antioxidant enzymes, such as SOD, CAT, and APX; hydrogen peroxide content; lipid peroxidation; chlorophyll index; photosynthetic rate; stomatal conductance; and transpiration were analysed. The data obtained showed a specific behaviour of Phaseolus vulgaris plants in each soil analysed. Moreover, it was observed that interactions between both elements resulted in a synergistic effect, negatively affecting all of the parameters analysed.

RESUMO A murcha de esclerotinia, causada por Sclerotinia minor e S. sclerotiorum, é uma das mais importantes doenças que afetam a cultura da alface no Brasil. Em estudos anteriores os isolados de Trichoderma asperellum (IBLF 897, IBLF 904 and IBLF 914) e de T. asperelloides (IBLF 908), foram selecionados para o controle biológico dessa doença. Neste estudo subsequente foi avaliada a compatibilidade desses isolados com pesticidas utilizados na cultura da alface no Brasil. Inicialmente o crescimento micelial dos isolados foi avaliado em meio de cultura acrescido com os pesticidas. Em seguida, o efeito dos pesticidas sobre o parasitismo do isolado de T. asperellum IBLF 914 em iscas e escleródios de S. minor e S. sclerotiorum e a sobrevivência de plântulas de alface foi avaliado em caixas tipo gerbox, após aplicação sobre a iscas e escleródios do antagonista e dos pesticidas em suas respectivas doses comerciais. Os fungicidas pencicuron, mandipropamid e o insecticida imidacloprida não afetaram o crescimento micelial dos isolados de Trichoderma. O fungicida iprodione não afetou o crescimento micelial dos isolados de T. asperellum, mas o isolado de T. asperelloides foi sensível a partir da concentração de 10 µg.L-1 do fungicida. Procimidone reduziu o crescimento micelial dos isolados de Trichoderma a partir da concentração de 10 µg.L-1 de fungicida, e axozistrobina reduziu a germinação dos conídios dos isolados do antagonista, apresentando DLs 50 entre 0,36 e 0,42 µg.L-1 de fungicida. Por outro lado, no experimento realizado em caixas tipo gerbox, nenhum pesticida reduziu o parasitismo de escleródios e iscas, bem como o controle de S. minor e S. sclerotiorum em plântulas de alface. Os resultados indicam que o controle biológico da murcha de esclerotínia com o isolado de T. asperelum IBLF 914 pode ser compatível com os demais tratamentos fitossanitários realizados na cultura da alface.

ABSTRACT Lettuce drop, caused by Sclerotinia minor and S. sclerotiorum, is one of the most important diseases that affect lettuce crop in Brazil. In previous studies, isolates of Trichoderma asperellum (IBLF 897, IBLF 904 and IBLF 914) and T. asperelloides (IBLF 908) were selected for the biocontrol of this disease. In this subsequent study, the compatibility of these isolates with pesticides used in lettuce crop in Brazil was evaluated. Initially, the mycelial growth of isolates was evaluated in culture medium plus pesticides. Then, the effect of pesticides on the parasitism of T. asperelloides isolate IBLF 914 in baits and sclerotia of S. minor and S. sclerotiorum, as well as on the survival of lettuce seedlings, was evaluated in gerboxes after application on baits and sclerotia of the antagonist with pesticides at their respective commercial doses. The fungicides pencycuron and mandipropamid and the insecticide imidacloprid did not affect the mycelial growth of Trichoderma isolates. The fungicide iprodione did not affect the mycelial growth of T. asperellum isolates. but the isolate of T. asperelloides was sensitive from the concentration of 10 µg.L-1 fungicide. Procymidone reduced the mycelial growth of Trichoderma isolates from the concentration of 10 µg.L-1 fungicide, and azoxystrobin reduced the conidial germination of the isolates of the antagonist, showing LD50 between 0.36 and 0.42 µg.L-1 fungicide. On the other hand, in the experiment carried out in “gerboxes”, none of the pesticides reduced the parasitism of baits and sclerotia or reduced the control of S. minor and S. sclerotiorum in lettuce seedlings. Results indicate that the biological control of lettuce drop with T. asperelum isolate IBLF 914 can be compatible with the remaining phytosanitary treatments used in lettuce crop.

Resumo Objetivo Elaborar, validar e avaliar uma cartilha educativa para a promoção da autoeficácia materna na prevenção da diarreia infantil. Método Estudo metodológico, desenvolvido a partir da elaboração, validação e avaliação do material educativo por 30 juízes de conteúdo e três técnicos. Para validação, avaliou-se clareza da linguagem, pertinência prática e relevância teórica, calculando-se o Índice de Validade de Conteúdo para cada item; e aplicou-se o instrumento Suitability Assesment of Materials (SAM) para avaliação da cartilha. Resultados A cartilha teve como título “Você é capaz de prevenir a diarreia no seu filho!” e foi elaborada tendo como referencial a Teoria da Autoeficácia. Os juízes de conteúdo atribuíram Índice de Validade de Conteúdo (IVC) global de 0,88 para clareza da linguagem, 0,91 para pertinência prática e 0,92 para relevância teórica; e os juízes técnicos atribuíram IVC de 0,96, 1,00 e 1,00 para os mesmos itens avaliados, respectivamente. A avaliação dos juízes de conteúdo e técnicos a partir do SAM classificou o material como “superior”, com média de 88,7% e 90,1%, respectivamente. Conclusão A cartilha apresenta conteúdo e aparência adequados para a promoção da autoeficácia materna na prevenção da diarreia infantil.

Abstract Objective Elaborate, validate and evaluate an educational reader to promote maternal self-efficacy in the prevention of childhood diarrhea. Method Methodological study, developed based on the elaboration, validation and evaluation of educational material by 30 content judges and three technicians. For the validation, the clarity of the language, practical pertinence and theoretical relevance were considered, calculating the Content Validity Index for each item; and the tool Suitability Assessment of Materials (SAM) was applied to evaluate the reader. Results The reader was titled “You can prevent diarrhea in you child” was elaborated in the framework of Self-Efficacy Theory. The content judges attributed a global Content Validity Index (CVI) of 0.88 for language clarity, 0.91 for practical pertinence and 0.92 for theoretical relevance; and the technical judges attributed CVI of 0.96, 1.00 and 1.00 for the same items assessed, respectively. The assessment of the content and technical judges based on the SAM tool classified the material as “superior”, with average coefficients of 88.7% and 90.1%, respectively. Conclusion The reader was considered appropriate in terms of face and content validation to promote maternal self-efficacy in the prevention of childhood diarrhea.

Resumen Objetivo Elaborar, validar y evaluar una libreta educativa para la promoción de la Autoeficacia materna en la prevención de la diarrea infantil. Método Estudio metodológico desarrollado partiendo de la elaboración, validación y evaluación del material educativo por 30 expertos en contenido y tres técnicos. Para la validación se evaluó claridad del lenguaje, adecuación práctica y relevancia teórica, calculándose el Índice de Validez de Contenido para cada ítem; y se aplicó el instrumento Suitability Assessment of Materials (SAM) para evaluación de la libreta. Resultados La libreta se tituló “¡Tú eres capaz de prevenir la diarrea de tu hijo!”, y fue elaborada sobre el referencial de la Teoría de la Autoeficacia. Los expertos en contenido le otorgaron Índice de Validez de Contenido (IVC) global de 0,88 a la claridad del lenguaje, 0,91 a adecuación práctica y 0,92 a relevancia teórica; y los técnicos puntuaron con IVC de 0,96, 1,00 y 1,00 a los mismos ítems evaluados, respectivamente. La evaluación de los expertos en contenido y técnicos a partir del SAM clasificaron al material como “superior”, con promedio de 88,7% y 90,1%, respectivamente. Conclusión La libreta ofrece contenido y apariencia adecuados para promoción de Autoeficacia materna en la prevención de la diarrea infantil.

Abstract Objective Elaborate, validate and evaluate an educational reader to promote maternal self-efficacy in the prevention of childhood diarrhea. Method Methodological study, developed based on the elaboration, validation and evaluation of educational material by 30 content judges and three technicians. For the validation, the clarity of the language, practical pertinence and theoretical relevance were considered, calculating the Content Validity Index for each item; and the tool Suitability Assessment of Materials (SAM) was applied to evaluate the reader. Results The reader was titled “You can prevent diarrhea in you child” was elaborated in the framework of Self-Efficacy Theory. The content judges attributed a global Content Validity Index (CVI) of 0.88 for language clarity, 0.91 for practical pertinence and 0.92 for theoretical relevance; and the technical judges attributed CVI of 0.96, 1.00 and 1.00 for the same items assessed, respectively. The assessment of the content and technical judges based on the SAM tool classified the material as “superior”, with average coefficients of 88.7% and 90.1%, respectively. Conclusion The reader was considered appropriate in terms of face and content validation to promote maternal self-efficacy in the prevention of childhood diarrhea.

Resumen Objetivo Elaborar, validar y evaluar una libreta educativa para la promoción de la Autoeficacia materna en la prevención de la diarrea infantil. Método Estudio metodológico desarrollado partiendo de la elaboración, validación y evaluación del material educativo por 30 expertos en contenido y tres técnicos. Para la validación se evaluó claridad del lenguaje, adecuación práctica y relevancia teórica, calculándose el Índice de Validez de Contenido para cada ítem; y se aplicó el instrumento Suitability Assessment of Materials (SAM) para evaluación de la libreta. Resultados La libreta se tituló “¡Tú eres capaz de prevenir la diarrea de tu hijo!”, y fue elaborada sobre el referencial de la Teoría de la Autoeficacia. Los expertos en contenido le otorgaron Índice de Validez de Contenido (IVC) global de 0,88 a la claridad del lenguaje, 0,91 a adecuación práctica y 0,92 a relevancia teórica; y los técnicos puntuaron con IVC de 0,96, 1,00 y 1,00 a los mismos ítems evaluados, respectivamente. La evaluación de los expertos en contenido y técnicos a partir del SAM clasificaron al material como “superior”, con promedio de 88,7% y 90,1%, respectivamente. Conclusión La libreta ofrece contenido y apariencia adecuados para promoción de Autoeficacia materna en la prevención de la diarrea infantil.

Resumo Objetivo Elaborar, validar e avaliar uma cartilha educativa para a promoção da autoeficácia materna na prevenção da diarreia infantil. Método Estudo metodológico, desenvolvido a partir da elaboração, validação e avaliação do material educativo por 30 juízes de conteúdo e três técnicos. Para validação, avaliou-se clareza da linguagem, pertinência prática e relevância teórica, calculando-se o Índice de Validade de Conteúdo para cada item; e aplicou-se o instrumento Suitability Assesment of Materials (SAM) para avaliação da cartilha. Resultados A cartilha teve como título “Você é capaz de prevenir a diarreia no seu filho!” e foi elaborada tendo como referencial a Teoria da Autoeficácia. Os juízes de conteúdo atribuíram Índice de Validade de Conteúdo (IVC) global de 0,88 para clareza da linguagem, 0,91 para pertinência prática e 0,92 para relevância teórica; e os juízes técnicos atribuíram IVC de 0,96, 1,00 e 1,00 para os mesmos itens avaliados, respectivamente. A avaliação dos juízes de conteúdo e técnicos a partir do SAM classificou o material como “superior”, com média de 88,7% e 90,1%, respectivamente. Conclusão A cartilha apresenta conteúdo e aparência adequados para a promoção da autoeficácia materna na prevenção da diarreia infantil.

RESUMO Objetivo: validar uma cartilha educativa, quanto a conteúdo e aparência, elaborada para promover a autoeficácia materna na prevenção da diarreia infantil. Método: estudo metodológico com participação de 31 mães de crianças menores de cinco anos de idade, no qual se procedeu à validação da cartilha Você é capaz de prevenir a diarreia no seu filho! a partir do Índice de Validade de Conteúdo (IVC), sendo avaliada quanto aos domínios compreensão, atratividade, autoeficácia, aceitação cultural e persuasão. Resultados: a cartilha foi considerada clara e relevante, com média de concordância de 99,4% e 99,8%, respectivamente. O IVC global foi de 0,99, evidenciando nível satisfatório de concordância entre as mães. A avaliação dos domínios gerou resultados satisfatórios. Conclusão: a cartilha foi considerada válida pelo público-alvo, podendo ser implementada para promoção da confiança materna em prevenir a diarreia infantil.

ABSTRACT Objective: to validate an educational primer, regarding content and design, for promoting maternal self-efficacy in preventing childhood diarrhea. Method: methodological study composed of 31 mothers of children under five years of age, in which the validation of the primer You can prevent diarrhea in your child! was carried out from the Content Validity Index (CVI), being evaluated as to the domains understanding, attractiveness, self-efficacy, cultural acceptance, and persuasion. Results: the primer was considered relevant and clear, with average concordance of 99.4% and 99.8%, respectively. The overall CVI was of 0.99, evidencing satisfactory level of agreement between the mothers. The assessment of domains generated satisfactory results. Conclusion: the primer was considered valid by the target audience; thus, it can be implemented for promoting maternal confidence to prevent childhood diarrhea.

RESUMEN Objetivo: validar una cartilla educativa, cuanto al contenido y la apariencia, elaborada para promocionar la autoeficacia materna en la prevención de la diarrea infantil. Método: Estudio metodológico con participación de 31 madres de niños menores de cinco años de edad, en el cual se ha procedido a la validez de la cartilla ¡Usted es capaz de prevenir la diarrea en su hijo! (en portugués: Você é capaz de prevenir a diarreia no seu filho!) desde el Índice de Validez de Contenido (IVC), siendo evaluada cuanto a los dominios comprensión, atracción, autoeficacia, aceptación cultural y persuasión. Resultados: La cartilla ha sido considerada clara y relevante, con el promedio de concordancia del 99,4% y del 99,8%, respectivamente. El IVC global ha sido de 0,99, evidenciando nivel satisfactorio de concordancia entre las madres. La evaluación de los dominios ha generado resultados satisfactorios. Conclusión: La cartilla ha sido considerada válida por el público-objetivo, pudiendo ser implementada para promoción de la confiabilidad materna en prevenir la diarrea infantil.