ABSTRACT Purpose To determine evidence of concurrent and predictive criterion validity of the Communication Screening Instrument for children aged 0 to 36 months (IRC-36). Methods 78 parents/guardians of children who attend the childcare service of the Family Health Centers participated in the research, in addition to 33 children aged between 0 and 36 months, invited to the second stage of the study. In its first stage, 13 health professionals were trained to apply the IRC-36 to the children's parents/guardians. In the second moment, the parents responded to a new IRC-36 application, and the children were evaluated with Denver II. Results IRC-36 correlated with Denver II in more than half of the cases, confirming the instrument’s concurrent criterion validity. IRC-36 results in the first stage did not significantly correlate with Denver II. The instrument's cutoff value was 12, which is the reference value between children at risk and not at risk of communication disorders. The instrument had high sensitivity and an accuracy value within the recommended levels. The occurrence of risk of communication changes was higher in the second IRC-36 application. Conclusion The study presented evidence of concurrent criterion validity, indicating that the instrument has evidence of accuracy and validity measures to screen communication in children aged 0 to 36 months, being able to identify the risk for communication disorders.

RESUMO Objetivo Determinar evidências de validade de critério concorrente e preditiva do Instrumento de Rastreio da Comunicação de crianças de 0 a 36 meses (IRC-36). Método Participaram da pesquisa 78 pais/responsáveis de crianças que frequentam o serviço de puericultura das Unidades de Saúde da Família, além de 33 crianças com idades entre 0 e 36 meses, convidadas para segunda etapa do estudo. Na primeira etapa do estudo, 13 profissionais de saúde foram treinados para realizar a aplicação do IRC-36 nos pais/responsáveis das crianças. No segundo momento, os pais responderam a uma nova aplicação do IRC-36 e as crianças foram avaliadas com o Denver II. Resultados O IRC-36 apresentou correlação com o Denver II em mais da metade dos casos, confirmando a validade de critério concorrente do instrumento. Os resultados do IRC-36 da primeira etapa quando correlacionados com o Denver II, não apresentaram valores significativos. O valor de ponto de corte do instrumento foi 12, sendo este o valor de referência entre crianças em risco e sem risco para alteração da comunicação. O instrumento apresentou valor de acurácia dentro dos níveis preconizados e alta sensibilidade. A ocorrência de risco para alteração da comunicação apresentou-se maior na segunda aplicação do IRC-36. Conclusão O estudo apresentou evidências de validade de critério concorrente, indicando que o instrumento possui evidências de medidas de acurácia e de validade para o rastreio da comunicação de crianças de 0 a 36 meses sendo capaz de identificar risco para as alterações da comunicação.

Objectives: To summarize evidence-based cognitive-behavioral therapy (CBT) treatment and propose clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The literature on CBT interventions for adult OCD, including BT and exposure and response prevention, was systematically reviewed to develop updated clinical guidelines for clinicians, providing comprehensive details about the necessary procedures for the CBT protocol. We searched the literature from 2013-2020 in five databases (PubMed, Cochrane, Embase, PsycINFO, and Lilacs) regarding study design, primary outcome measures, publication type, and language. Selected articles were assessed for quality with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association. Results: We examined 44 new studies used to update the 2013 American Psychiatric Association guidelines. High-quality evidence supports CBT with exposure and response prevention techniques as a first-line treatment for OCD. Protocols for Internet-delivered CBT have also proven efficacious for adults with OCD. Conclusion: High-quality scientific evidence supports the use of CBT with exposure and response prevention to treat adults with OCD.

Objectives: To summarize evidence-based pharmacological treatments and provide guidance on clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The American Psychiatric Association (APA) guidelines for the treatment of OCD (2013) were updated with a systematic review assessing the efficacy of pharmacological treatments for adult OCD, comprising monotherapy with selective serotonin reuptake inhibitors (SSRIs), clomipramine, serotonin and norepinephrine reuptake inhibitors (SNRIs), and augmentation strategies with clomipramine, antipsychotics, and glutamate-modulating agents. We searched for the literature published from 2013-2020 in five databases, considering the design of the study, primary outcome measures, types of publication, and language. Selected articles had their quality assessed with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association (ACC/AHA). Results: We examined 57 new studies to update the 2013 APA guidelines. High-quality evidence supports SSRIs for first-line pharmacological treatment of OCD. Moreover, augmentation of SSRIs with antipsychotics (risperidone, aripiprazole) is the most evidence-based pharmacological intervention for SSRI-resistant OCD. Conclusion: SSRIs, in the highest recommended or tolerable doses for 8-12 weeks, remain the first-line treatment for adult OCD. Optimal augmentation strategies for SSRI-resistant OCD include low doses of risperidone or aripiprazole. Pharmacological treatments considered ineffective or potentially harmful, such as monotherapy with antipsychotics or augmentation with ketamine, lamotrigine, or N-acetylcysteine, have also been detailed.

Abstract This study aimed to obtain physicochemical characteristics and the fatty acid profile of bocaiuva nut oil and to evaluate the impact of its daily consumption on glucose, lipid, and energy metabolism in mice. The acidity content in the bocaiuva nut oil exceeded the maximum limit for crude oils (5.68 mg KOH g-1). However, the peroxide value is within the standard considered adequate for crude oils (3.33 mEq O2 kg-1). In the fatty acid profile, lauric (42.25%) and oleic (23.96%), saturated and monounsaturated, respectively, stand out. After 90 days of in vivo experimentation, the administered oil doses had not influenced the animals' food intake and body weight. Regarding the biochemical parameters, only the non-HDL fraction showed a significant difference, considering that this parameter represents the sum of atherogenic lipoproteins directly linked to atherogenic cholesterol. However, there was no statistical difference between the groups regarding histological changes in the liver, showing that the bocaiuva oil does not cause considerable damage to the liver, even though it is saturated oil. Results show that daily consumption of bocaiuva nut oil did not produce metabolic changes in mice.

Homens adolescentes que fazem sexo com homens (AHSH) apresentam vulnerabilidade aumentada ao HIV. O estudo teve como objetivo estimar a prevalência de HIV e fatores individuais, sociais e programáticos entre AHSH em Salvador, Bahia, Brasil. O estudo transversal foi baseado na análise dos dados da linha de base da coorte PrEP1519 em Salvador. Foram realizadas análises descritivas, bivariadas e multivariadas, usando as dimensões de vulnerabilidade ao HIV como níveis analíticos hierárquicos. Foram usados modelos de regressão logística para estimar as razões de chances (OR) da associação entre as variáveis preditoras e a infecção pelo HIV. A prevalência de infecção pelo HIV entre os 288 AHSH recrutados pelo projeto foi de 5,9% (IC95%: 3,7-9,3). A análise ajustada mostrou uma associação estatisticamente significativa entre a autoidentificação como profissional do sexo (OR = 3,74, IC95%: 1,03-13,60) e a infecção pelo HIV. Outras associações com significância estatística limítrofe foram: uso de aplicativos para achar parceiros sexuais (OR = 3,30, IC95%: 0,98-11,04), menor escolaridade (OR = 3,59, IC95%: 0,96-13,41), história de não ter sido contratado ou de ter sido demitido em função da orientação sexual (OR = 2,88, IC95%: 0,89-9,28) e falta de uso de serviços de saúde como fonte usual de cuidados (OR = 3,14, IC95%: 0,97-10,17). Foi encontrada uma alta prevalência de HIV entre AHSH em Salvador. Além disso, o estudo mostrou que fatores encontrados nas dimensões individual, social e programática estiveram associados à infecção pelo HIV entre esses AHSH. Recomendamos a intensificação das atividades de prevenção combinada entre AHSH.

Los hombres adolescentes que tienen sexo con hombres (AHSH) sufren más vulnerabilidad ante el VIH. El objetivo de este estudio fue estimar la prevalencia de VIH y los factores asociados individuales, sociales, y programáticos asociados entre AHSH en Salvador, Bahia, Brasil. Se trata de un estudio transversal, basado en el análisis de los datos de referencia de la cohorte PrEP1519 en Salvador. Se realizaron análisis descriptivos, bivariados, y multivariados usando las dimensiones de vulnerabilidad respecto al VIH, como los niveles jerárquicos de análisis. Los modelos de regresión logística se usaron para estimar las odds ratios (OR) de la asociación entre las variables predictoras y la infección por VIH. La prevalencia de infección por VIH entre los 288 AHSH reclutados para el proyecto fue 5,9% (IC95%: 3,7-9,3). El análisis ajustado reveló una asociación estadísticamente significativa entre autoidentificarse como un trabajador sexual (OR = 3,74, IC95%: 1,03-13,60) y la infección por VIH. Otras asociaciones con una significación estadística marginal fueron: uso de apps para encontrar pareja sexual (OR = 3,30, IC95%: 0,98-11,04), menos años de educación (OR = 3,59, IC95%: 0,96-13,41), no estar contratado o ser despedido de un trabajo debido a la orientación sexual (OR = 2,88, IC95%: 0,89-9,28), y no usar los servicios de salud como recurso habitual de atención sanitaria (OR = 3,14, IC95%: 0,97-10,17). Se identificó una alta prevalencia de VIH entre AHSH en Salvador. Asimismo, nuestro estudio halló que los factores desde una perspectiva individual, dimensión social, y dimensión programática estuvieron asociados con una infección por VIH entre AHSH. Recomendamos que se intensifiquen las actividades combinadas de prevención contra el VIH para AHSH.

Adolescent men who have sex with men (AMSM) are at a heightened vulnerability for human immunodeficiency virus (HIV). This study aimed to estimate the prevalence of HIV and associated individual, social, and programmatic factors among AMSM in Salvador, Bahia State, Brazil. This is a cross-sectional study which analyzed baseline data from the PrEP1519 cohort in Salvador. Descriptive, bivariate, and multivariate analyses were conducted using the dimensions of vulnerability to HIV as hierarchical levels of analysis. Logistic regression models were used to estimate the odds ratios (OR) of the association between predictor variables and HIV infection. The prevalence of HIV infection among the 288 AMSM recruited to the project was 5.9% (95%CI: 3.7-9.3). Adjusted analysis showed a statistically significant association between self-identifying as a sex worker (OR = 3.74, 95%CI: 1.03-13.60) and HIV infection. Other associations with borderline statistical significance were the use of application programs to find sexual partners (OR = 3.30, 95%CI: 0.98-11.04), low schooling level (OR = 3.59, 95%CI: 0.96-13.41), failing to be hired or being dismissed from a job because of sexual orientation (OR = 2.88, 95%CI: 0.89-9.28), and not using health services as a usual source of care (OR = 3.14, 95%CI: 0.97-10.17). We found a high HIV prevalence among AMSM in Salvador. Furthermore, our study found that individual, social, and programmatic factors were associated with HIV infection among these AMSM. We recommend intensifying HIV combined-prevention activities for AMSM.

Abstract The mixed wheat and bocaiuva (Acrocomia totai) flour allow the development of new products to meet the consumer demand for foods with a healthy and functional appeal. Our study aimed to evaluate the physical-chemical and rheological quality of mixed flours during storage. Mixed flours with 10 and 20% replacement of wheat flour with bocaiuva flour were conditioned in impermeable films to water vapor, oxygen and light and stored at ambient temperature for up to 120 days. Flours were submitted to periodical physical-chemical and rheological analyses. Moisture stayed within the legal limit, and water activity was considered adequate to inhibit microbial growth. Titrable acidity increased in the first 30 days of storage. Adding 20% of bocaiuva to the wheat flour enriched the mixture with twice the carotenoids and higher total phenol content. The bioactive compounds showed a slight reduction during storage. The mixed flour can be indicated for elaborating bread, loaf, pasta, cakes and biscuits. The falling numbers point to the need for correcting the flour by adding enzymes to produce fermented foods.

Adolescent men who have sex with men (AMSM) are at a heightened vulnerability for human immunodeficiency virus (HIV). This study aimed to estimate the prevalence of HIV and associated individual, social, and programmatic factors among AMSM in Salvador, Bahia State, Brazil. This is a cross-sectional study which analyzed baseline data from the PrEP1519 cohort in Salvador. Descriptive, bivariate, and multivariate analyses were conducted using the dimensions of vulnerability to HIV as hierarchical levels of analysis. Logistic regression models were used to estimate the odds ratios (OR) of the association between predictor variables and HIV infection. The prevalence of HIV infection among the 288 AMSM recruited to the project was 5.9% (95%CI: 3.7-9.3). Adjusted analysis showed a statistically significant association between self-identifying as a sex worker (OR = 3.74, 95%CI: 1.03-13.60) and HIV infection. Other associations with borderline statistical significance were the use of application programs to find sexual partners (OR = 3.30, 95%CI: 0.98-11.04), low schooling level (OR = 3.59, 95%CI: 0.96-13.41), failing to be hired or being dismissed from a job because of sexual orientation (OR = 2.88, 95%CI: 0.89-9.28), and not using health services as a usual source of care (OR = 3.14, 95%CI: 0.97-10.17). We found a high HIV prevalence among AMSM in Salvador. Furthermore, our study found that individual, social, and programmatic factors were associated with HIV infection among these AMSM. We recommend intensifying HIV combined-prevention activities for AMSM.

Los hombres adolescentes que tienen sexo con hombres (AHSH) sufren más vulnerabilidad ante el VIH. El objetivo de este estudio fue estimar la prevalencia de VIH y los factores asociados individuales, sociales, y programáticos asociados entre AHSH en Salvador, Bahia, Brasil. Se trata de un estudio transversal, basado en el análisis de los datos de referencia de la cohorte PrEP1519 en Salvador. Se realizaron análisis descriptivos, bivariados, y multivariados usando las dimensiones de vulnerabilidad respecto al VIH, como los niveles jerárquicos de análisis. Los modelos de regresión logística se usaron para estimar las odds ratios (OR) de la asociación entre las variables predictoras y la infección por VIH. La prevalencia de infección por VIH entre los 288 AHSH reclutados para el proyecto fue 5,9% (IC95%: 3,7-9,3). El análisis ajustado reveló una asociación estadísticamente significativa entre autoidentificarse como un trabajador sexual (OR = 3,74, IC95%: 1,03-13,60) y la infección por VIH. Otras asociaciones con una significación estadística marginal fueron: uso de apps para encontrar pareja sexual (OR = 3,30, IC95%: 0,98-11,04), menos años de educación (OR = 3,59, IC95%: 0,96-13,41), no estar contratado o ser despedido de un trabajo debido a la orientación sexual (OR = 2,88, IC95%: 0,89-9,28), y no usar los servicios de salud como recurso habitual de atención sanitaria (OR = 3,14, IC95%: 0,97-10,17). Se identificó una alta prevalencia de VIH entre AHSH en Salvador. Asimismo, nuestro estudio halló que los factores desde una perspectiva individual, dimensión social, y dimensión programática estuvieron asociados con una infección por VIH entre AHSH. Recomendamos que se intensifiquen las actividades combinadas de prevención contra el VIH para AHSH.

Homens adolescentes que fazem sexo com homens (AHSH) apresentam vulnerabilidade aumentada ao HIV. O estudo teve como objetivo estimar a prevalência de HIV e fatores individuais, sociais e programáticos entre AHSH em Salvador, Bahia, Brasil. O estudo transversal foi baseado na análise dos dados da linha de base da coorte PrEP1519 em Salvador. Foram realizadas análises descritivas, bivariadas e multivariadas, usando as dimensões de vulnerabilidade ao HIV como níveis analíticos hierárquicos. Foram usados modelos de regressão logística para estimar as razões de chances (OR) da associação entre as variáveis preditoras e a infecção pelo HIV. A prevalência de infecção pelo HIV entre os 288 AHSH recrutados pelo projeto foi de 5,9% (IC95%: 3,7-9,3). A análise ajustada mostrou uma associação estatisticamente significativa entre a autoidentificação como profissional do sexo (OR = 3,74, IC95%: 1,03-13,60) e a infecção pelo HIV. Outras associações com significância estatística limítrofe foram: uso de aplicativos para achar parceiros sexuais (OR = 3,30, IC95%: 0,98-11,04), menor escolaridade (OR = 3,59, IC95%: 0,96-13,41), história de não ter sido contratado ou de ter sido demitido em função da orientação sexual (OR = 2,88, IC95%: 0,89-9,28) e falta de uso de serviços de saúde como fonte usual de cuidados (OR = 3,14, IC95%: 0,97-10,17). Foi encontrada uma alta prevalência de HIV entre AHSH em Salvador. Além disso, o estudo mostrou que fatores encontrados nas dimensões individual, social e programática estiveram associados à infecção pelo HIV entre esses AHSH. Recomendamos a intensificação das atividades de prevenção combinada entre AHSH.

Abstract The aim of this study was to investigate uterine involution using ultrasonography techniques during postpartum. Postpartum ultrasonography evaluation (B-mode, color Doppler and Acoustic Radiation Force Impulse elastography) of the uterus was performed by transabdominal approach at immediate after birth and sequentially every 48 hours, during 30 days. The uterine echotexture did not present significant variations (P >0.05) being homogeneous in most evaluations; echogenicity of the uterus increased along the evaluation period (P =0.0452). Progressive and remarkable decrease of the total uterine diameter (UD) were observed (P <0.0001), especially during the first days postpartum. The thickness of uterine wall gradually decreased, as well the endometrial, myometrium and lumen diameters (P <0.0001). Uterine blood flow was assessed by Doppler and decreased during postpartum period, being significantly lower (P=0.0225) on the 30th day of postpartum. Uterine parenchyma presented as homogeneous dark areas (not deformable) on qualitative ultrasound elastography and the means shear velocity values of the uterine wall on quantitative elastography did not differ. This is the first study that evaluate the stiffness of uterine wall in healthy ewes, providing baseline data about quantitative and qualitative stiffness of the normal uterus, and it may be a useful tool for early diagnosis of uterine alterations during the postpartum period, using the reference parameter established for the assessment of uterine integrity during postpartum period.

Abstract Objective To map the interventions that can be performed by nurses in the various health care services for the management of anxiety symptoms in adults during COVID-19. Methods The scoping review was conducted according to the JBI manual. The review question was: What is the knowledge available in the literature on interventions to manage anxiety symptoms that can be used by nurses in the various health care services, in the adult population, during COVID-19? The data sources searched were: Virtual Health Library (VHL), EMBASE, PubMed, CINAHL, PsycINFo, Scopus and Web of Science. There was no limitation of year or language of publication. Results Were analyzed 85 articles. Studies have shown that, in general, the entire adult population has experienced changes in anxiety levels during the pandemic. Among the identified interventions, which can be carried out by nurses to manage anxiety symptoms, there was singular emphasis on the various forms of online interventions, with a frequency of 21.4% in the studies, followed by physical activities, with a frequency of 13.3%. Conclusion It was possible to map interventions that can reduce anxiety symptoms in the adult population as well as delimit those that can be applied by nurses, increasing the visibility of this category as protagonist of care in the various sectors of health services. Among the synthesized interventions, teleassistance, physical activity, cognitive exercises and non-pharmacological interventions stood out.

Resumen Objetivo Mapear las intervenciones que pueden ser realizadas por enfermeros en los diferentes servicios de atención a la salud para el manejo de los síntomas de ansiedad en adultos durante el COVID-19. Métodos La revisión de alcance fue realizada de acuerdo con el manual del Joanna Briggs Institute (JBI). La pregunta de revisión fue “¿Cuál es el conocimiento disponible en la literatura sobre las intervenciones de manejo de los síntomas de ansiedad que pueden ser utilizadas por enfermeros en los diferentes centros de atención a la salud, en la población adulta, durante el COVID-19?”. Las fuentes de datos investigadas fueron: Biblioteca Virtual em Saúde (BVS), EMBASE, PUBMED, CINAHL, PsycINFo, SCOPUS y Web of Science. No hubo restricción de año ni idioma de publicación. Resultados Se analizaron 85 artículos. Los estudios mostraron que, en general, toda la población adulta presentó cambios en los niveles de ansiedad durante la pandemia. Entre las intervenciones identificadas para el manejo de los síntomas de ansiedad, que pueden ser realizadas por enfermeros, se observó un singular énfasis en las diversas formas de intervenciones en línea, con frecuencia de 21,4 % en los estudios, seguida por actividades físicas, con frecuencia de 13,3 %. Conclusión Fue posible mapear las intervenciones que pueden reducir los síntomas de ansiedad de la población adulta, así como determinar las que pueden ser aplicadas por enfermeros, y así aumentar la visibilidad de esta categoría como protagonista del cuidado en los diferentes sectores de servicios de salud. Entre las intervenciones sintetizadas, se destaca la teleatención, la actividad física, los ejercicios cognitivos y las intervenciones no farmacológicas.

Resumo Objetivo Mapear as intervenções que podem ser realizadas por enfermeiros nos diversos serviços de atenção à saúde para o manejo dos sintomas de ansiedade em adultos durante a COVID-19. Métodos A revisão de escopo foi conduzida conforme o manual do Joanna Briggs Institute (JBI). A pergunta de revisão foi “Qual o conhecimento disponível na literatura sobre as intervenções de manejo dos sintomas de ansiedade que podem ser utilizadas por enfermeiros nos diversos serviços de atenção à saúde, na população adulta, durante a COVID-19?”. As fontes de dados pesquisadas foram: Biblioteca Virtual em Saúde (BVS), EMBASE, PUBMED, CINAHL, PsycINFo, SCOPUS e Web of Science. Não houve limitação de ano ou idioma de publicação. Resultados Foram analisados 85 artigos. Os estudos mostraram que, em geral, toda a população adulta apresentou mudanças nos níveis de ansiedade durante a pandemia. Entre as intervenções identificadas, que podem ser realizadas por enfermeiros para o manejo dos sintomas de ansiedade, houve singular destaque para as variadas formas de intervenções online , com frequência de 21,4% nos estudos, seguida pelas atividades físicas, com frequência de 13,3%. Conclusão Foi possível mapear as intervenções que podem reduzir os sintomas de ansiedade na população adulta, assim como delimitar as que podem ser aplicadas por enfermeiros, aumentando a visibilidade dessa categoria como protagonista do cuidado nos diversos setores de serviço de saúde. Dentre as intervenções sintetizadas, destacaram-se o teleatendimento, atividade física, exercícios cognitivos e intervenções não farmacológicas.Protocolo de registro do Artigo de Revisão: o protocolo de revisão está registrado no Open Science Framework (OSF), sob o número: https://doi.org/10.17605/OSF.IO/3Q2VT.

Abstract Objective To assess the association between social determinants of health and occurrence of hospital readmissions of people living with HIV. Methods This is a cross-sectional study, with data from 262 medical records of people with HIV who were hospitalized within a 12-month period, in Fortaleza, Ceará. Medical records available in full in the hospital file were included. The outcome variable was analyzed in two ways: readmission as a dichotomous variable (yes/no) and in a multinomial way, through the number of readmissions (none, 1-2, 3 or ≥4 readmissions). P<0.05 was considered significant with a confidence level of 95%. Results Of the people who used illicit drugs, 63% (n=51) were readmitted, compared to 47.3% (n=71) of those who did not use them (p=0.02). There was readmission in 66.7% (n=36) of people who earned up to one minimum wage and 48% (n=71) of those who earned between one and two minimum wages. There was a percentage of 30.8% (n=12) of rehospitalization in those away from work; 41.3% (n=26) in people who were performing work activities; and 60.9% (n=70) of readmission in unemployed. Conclusion The individual social determinant of health related to readmissions that stood out was age ≥ 40 years. Regarding the proximal determinants, illicit drug use was more related to the readmissions recorded. The intermediate determinant with the highest evidence of rehospitalization was related to the employment situation, since unemployed individuals had a higher percentage of three or more hospitalizations. Thus, the social determinants of health with an impact on the occurrence of hospital readmissions of people living with HIV were illicit drug use, people who received less than or equal to a minimum wage and who were unemployed.

Resumen Objetivo Evaluar la relación entre los determinantes sociales de la salud y los episodios de reinternación hospitalaria de personas que viven con el VIH. Métodos Estudio transversal, con datos de 262 historias clínicas de personas con VIH que fueron internadas durante un período de 12 meses en Fortaleza, Ceará. Se incluyeron historias clínicas disponibles en su totalidad en el archivo hospitalario. La variable de resultado fue analizada de dos formas: reinternación como variable dicotómica (sí/no) y de forma multinomial, mediante el número de reinternaciones (ninguna, 1-2, 3 o ≥4 reinternaciones). Se consideró significante p<0,05, con nivel de confianza de 95 %. Resultados De las personas que consumían drogas ilícitas, el 63 % (n=51) presentó reinternación, comparado con el 47,3 % de los que no consumían (p=0,02). Hubo reinternación en el 66,7 % (n=36) de las personas que ganaban hasta un salario mínimo y en el 48 % (n=71) de las que ganaban entre uno y dos salarios mínimos. Se observó un porcentaje de 30,8 % (n=12) de reinternaciones en personas con licencia laboral, un 41,3 % (n=26) en personas que estaban ejerciendo actividades laborales y un 60,9 % (n=70) de reinternaciones en personas desempleadas (p=0,001). Conclusión El determinante social de la salud individual relacionado con las reinternaciones que predominó fue la edad ≥ 40 años. Respecto a los determinantes proximales, el consumo de drogas ilícitas se vio más relacionado con las reinternaciones registradas. El determinante intermedio con mayor evidencia de reinternación se relacionó con la situación laboral, dado que las personas desempleadas presentaron un porcentaje mayor de tres internaciones o más. De esta forma, los determinantes sociales de la salud con impacto en los episodios de reinternación hospitalaria de personas que viven con el VIH fueron: consumo de drogas ilícitas, personas que ganaban un valor menor o igual a un salario mínimo y personas desempleadas.

Resumo Objetivo Avaliar a associação entre os determinantes sociais de saúde e a ocorrência de reinternação hospitalar de pessoas vivendo com HIV. Métodos Estudo transversal, com dados de 262 prontuários de pessoas com HIV, que foram internadas no período de 12 meses, em Fortaleza, Ceará. Foram incluídos prontuários disponíveis na íntegra no arquivo hospitalar. A variável de desfecho foi analisada de duas formas: reinternação como variável dicotômica (sim/não) e de forma multinomial, por meio do número de reinternações (nenhuma, 1-2, 3 ou ≥4 reinternações). Foi considerado significante p<0,05 com nível de confiança de 95%. Resultados Das pessoas que faziam uso de drogas ilícitas, 63% (n=51) apresentavam reinternação, em comparação aos 47,3% (n=71) daqueles não faziam uso (p=0,02). Houve reinternação em 66,7% (n=36) das pessoas que recebiam até um salário mínimo e 48% (n=71) das que recebiam entre um e dois salários mínimos. Ocorreu percentual de 30,8% (n=12) de reinternação em afastados do trabalho, 41,3%; (n=26) em pessoas que estavam exercendo atividades laborais e 60,9% (n=70) de reinternação em desempregados (p=0,001). Conclusão O determinante social de saúde individual relacionado às reinternações que obteve destaque foi idade ≥ 40 anos; quanto aos determinantes proximais, uso de drogas ilícitas esteve mais relacionado às reinternações registradas. O determinante intermediário com maior evidência de reinternação esteve relacionado à situação de trabalho, uma vez que os desempregados apresentaram maior percentual de três ou mais internações. Assim, os determinantes sociais de saúde com impacto na ocorrência de reinternação hospitalar de pessoas vivendo com HIV, foram: uso de drogas ilícitas, pessoas que recebiam valor menor ou igual a um salário mínimo e os desempregados.

ABSTRACT Adopting land-uses that contribute with a considerable litter input can affect the accumulation, protection, and bioavailability of organic carbon in the edaphic environment, compromising the different compartments of soil organic matter (SOM) and the associated benefits. Moreover, changes in seasons can influence the dynamic of SOM. Notably, the mechanisms involved in SOM stabilization and storage, particularly in agroforestry production areas, are still poorly explored. This study aimed to verify if the contents of soil organic carbon (SOC) and the physical fractions of the SOM are modified as a function of agroforestry systems implemented in the short term, and verify if seasonality can affect the compartmentalization of SOM in agrifood systems. Also, we tested if the carbon management index (CMI) is sensitive to detecting management practices quality across the unmanaged pasture, different agroforestry systems, and a reference area (forest). We measured soil physical properties, SOC content in bulk soil, particular organic carbon (POC), and mineral-associated organic carbon (MAOC) fractions at three different depths (0.00-0.05, 0.05-0.10, and 0.10-0.20 m) in response to the adoption of agroforestry systems. Our results show that after a short period of implementation of agroforestry systems, significant changes were observed in SOC contents and the physical fractions of SOM in the most superficial layers (0.00-0.05 and 0.05-0.10 m), with emphasis on the particulate fraction of SOM. We verified that the seasonality affected the SOC, POC, and MAOC contents. We also found that the CMI index was more sensitive and efficient in detecting changes arising from seasonality and the management practices involved. According to this index, it was possible to verify that the agroforestry system with the highest density of species for biomass production (AS3) has been accumulating more carbon in the soil. Therefore, this study provides relevant information regarding soil carbon management in agroforestry systems.

Abstract Objective: To compare high and low-fidelity simulations for the recognition of respiratory distress and failure in urgency and emergency pediatric scenarios. Methods: 70 fourth-year medical students were randomly distributed in high and low-fidelity groups and simulated different types of respiratory problems. Theory tests, performance checklists, and satisfaction and self-confidence questionnaires were used in the assessment. Face-to-face simulation and memory retention was applied. The statistics were evaluated by averages and quartiles, Kappa, and generalized estimating equations. The p-value was considered 0.05. Results: In the theory test there was an increase in scores in both methodologies (p < 0.001 ); in memory retention (p = 0.043) and at the end of the process the high-fidelity group had better results. The performance in the practical checklists was better after the second simulation (p > 0,05). The high-fidelity group felt more challenged in both phases (p = 0.042; p = 0.018) and showed greater self-confidence to recognize changes in clinical conditions and in memory retention (p = 0.050). The same group, in relation to the hypothetical real patient to be treated in the future, felt better confident to recognize respiratory distress and failure (p = 0.008; p = 0.004), and better prepared to make a systematic clinical evaluation of the patient in memory retention (p = 0.016). Conclusion: The two levels of simulations enhance diagnostic skills. High fidelity improves knowledge, leads the student to feel more challenged and more self-confident in recognizing the severity of the clinical case, including memory retention, and showed benefits regarding self-confidence in recognizing respiratory distress and failure in pediatric cases.

ABSTRACT: Brucellosis is a chronic contagious infectious zoonosis that affects the reproductive system of animals, causing economic and health losses. This study diagnosed Brucella spp. in commercial kennels, comparing PCR positivity in different biological samples (blood, semen, and vaginal secretion), as well as correlating these findings with reproductive indices. Hence, we analyzed dogs from kennels in the neighboring cities of Cuiabá and Várzea Grande/MT, Brazil. The reproductive histories of the animals were obtained and blood samples were collected from all animals (n=35); in addition, semen samples were collected from males (n=9) and vaginal swabs were collected from females (n=24) to perform polymerase chain reactions (PCR) for brucellosis. The findings indicated that vaginal swab PCR is an effective test to identify Brucella spp. For males, there were more positive results when testing blood samples, possibly because the male animals were at the beginning stage of infection.

RESUMO: A Brucelose é uma zoonose infectocontagiosa crônica que afeta o sistema reprodutivo dos animais, gerando prejuízos econômicos e sanitários. O objetivo do presente estudo foi diagnosticar a Brucella spp. em canis comerciais, comparando a positividade na PCR em diferentes amostras biológicas (sangue, sêmen e secreção vaginal) e correlacionar estes achados aos índices reprodutivos. Foram analisados cães provenientes de canis no município de Cuiabá e Várzea Grande/MT. Foi realizado o levantamento do histórico reprodutivo dos animais e em seguida, foi coletado o sangue em todos os animais (n=35), sendo sêmen nos machos (n=9) e swab vaginal (n=24) nas fêmeas para realização da técnica de Reação em Cadeia pela Polimerase (PCR) para brucelose. De acordo com os resultados, conclui-se que a PCR de swab vaginal é um teste efetivo para identificar Brucella spp., porém em machos, verifica-se que no sangue obtivemos mais positivos, possivelmente por estarem no início da infecção.

Resumo A pandemia de COVID-19 chegou ao Brasil em um contexto de crises política e econômica que aprofundaram desigualdades e vulnerabilidades já existentes. Ações de apoio ao outro foram empreendidas por pessoas e organizações no sentido de mitigar os efeitos da pandemia. Foram realizadas 34 entrevistas entre outubro e novembro de 2020 com a finalidade de identificar as ações de apoio efetivadas para ajudar o outro, analisando-as em termos de solidariedade (pandêmica). Solidariedade e individualismo apareceram com frequência nas entrevistas como qualificadores das ações. Além disso, foram identificados três núcleos em que essas ações foram operadas: a família, o condomínio e a comunidade. A família foi citada como forma de suporte mútuo fundamentado pelo parentesco. Já as ações do condomínio se subdividiram entre as ações para dentro dos muros (de suporte mútuo entre semelhantes) e para fora dos muros (que revelam a diferenciação entre o condomínio e locais mais pobres). A comunidade se mostra como uma forma mais potente de ação, com experiências de autogestão, apoio mútuo e vulnerabilidade compartilhada. Nesse sentido, os resultados nos animam a compreender a solidariedade como método transformador da sociedade, independentemente da presença do Estado.

Abstract The COVID-19 pandemic reached Brazil in a context of political and economic crises that have exacerbated existing inequalities and vulnerabilities. Individuals and organizations undertook actions to support others to mitigate the pandemic effects. Thirty-four interviews were conducted from October to November 2020 to identify the supportive actions to help others, analyzing them concerning (pandemic) solidarity. Solidarity and individualism frequently appeared in the interviews as qualifiers of such actions. Furthermore, we identified three cores in which these actions were staged: the family, the condominium, and the community. The family was mentioned as mutual support based on kinship. On the other hand, condominium actions were subdivided into intramural (mutual support actions among similar people) and extramural actions (which reveal the differentiation between the condominium and more impoverished places). The community emerges as a more powerful type of action, with self-management, mutual support, and shared vulnerability experiences. In this sense, the results encourage us to understand solidarity as a way of transforming society, regardless of the State’s presence.

Resumo A pandemia de COVID-19 chegou ao Brasil em um contexto de crises política e econômica que aprofundaram desigualdades e vulnerabilidades já existentes. Ações de apoio ao outro foram empreendidas por pessoas e organizações no sentido de mitigar os efeitos da pandemia. Foram realizadas 34 entrevistas entre outubro e novembro de 2020 com a finalidade de identificar as ações de apoio efetivadas para ajudar o outro, analisando-as em termos de solidariedade (pandêmica). Solidariedade e individualismo apareceram com frequência nas entrevistas como qualificadores das ações. Além disso, foram identificados três núcleos em que essas ações foram operadas: a família, o condomínio e a comunidade. A família foi citada como forma de suporte mútuo fundamentado pelo parentesco. Já as ações do condomínio se subdividiram entre as ações para dentro dos muros (de suporte mútuo entre semelhantes) e para fora dos muros (que revelam a diferenciação entre o condomínio e locais mais pobres). A comunidade se mostra como uma forma mais potente de ação, com experiências de autogestão, apoio mútuo e vulnerabilidade compartilhada. Nesse sentido, os resultados nos animam a compreender a solidariedade como método transformador da sociedade, independentemente da presença do Estado.

Abstract The COVID-19 pandemic reached Brazil in a context of political and economic crises that have exacerbated existing inequalities and vulnerabilities. Individuals and organizations undertook actions to support others to mitigate the pandemic effects. Thirty-four interviews were conducted from October to November 2020 to identify the supportive actions to help others, analyzing them concerning (pandemic) solidarity. Solidarity and individualism frequently appeared in the interviews as qualifiers of such actions. Furthermore, we identified three cores in which these actions were staged: the family, the condominium, and the community. The family was mentioned as mutual support based on kinship. On the other hand, condominium actions were subdivided into intramural (mutual support actions among similar people) and extramural actions (which reveal the differentiation between the condominium and more impoverished places). The community emerges as a more powerful type of action, with self-management, mutual support, and shared vulnerability experiences. In this sense, the results encourage us to understand solidarity as a way of transforming society, regardless of the State’s presence.