ABSTRACT COVID-19 is commonly associated with high serum levels of pro-inflammatory cytokines, and the post-infection status can disturb self-tolerance and trigger autoimmune responses. We are reporting a 45-year-old male who was admitted with fatigue, jaundice, elevated liver enzymes (with cholestatic pattern), and acute kidney injury two weeks after recovering from a mild SARS-CoV-2 infection. Serologies for viral hepatitis and anti-mitochondrial antibody were negative, while anti-nuclear and anti-smooth muscle antibodies were positive. There were no signs of chronic liver disease, and a magnetic resonance cholangiography showed no dilatation of biliary ducts. Histologic evaluation of the liver evidenced numerous foci of lobular necrosis without ductopenia or portal biliary reaction. Considering the autoantibody profile and histologic changes, the medical team started oral prednisone, but there was a suboptimal biochemical response in the outpatient follow-up. Two months later, a second liver biopsy was performed and revealed non-suppurative destructive chronic cholangitis, extensive areas of confluent necrosis with hepatocytes regenerating into pseudorosettes, and numerous plasma cells. According to the Paris Criteria, the patient was then diagnosed with an autoimmune hepatitis-primary biliary cholangitis overlap syndrome (AIH-PBC-OS). After adding azathioprine and ursodeoxycholic acid to the treatment, there was a satisfactory response. This is the second worldwide report of an AIH-PBC-OS triggered by COVID-19, but the first case with a negative anti-mitochondrial antibody. In this setting, histologic evaluation of the liver by an experienced pathologist is a hallmark of achieving the diagnosis and correctly treat the patient.

ABSTRACT Objective: To describe behaviors with oral hygiene items in single-bathroom households during the domiciliary isolation of individuals with positive 'Reverse transcriptase polymerase chain reaction' (RTPCR+) in southern Brazil. Material and Methods: Cross-sectional study was conducted with Research and Monitoring Sector of COVID-19 data from Palhoça, Brazil, of individuals aged ≥18 years, living in a singlebathroom household, who had an RT-PCR positive. A link of Google Forms was used. Socio-demographic information, characteristics during the home isolation, oral hygiene, and behaviors with oral hygiene items in the bathroom were collected. Descriptive stratified analyses according to age were conducted (<40 and ≥40 years). Results: Among 524 individuals, 36% were aged ≥40 years. During isolation, according to the behaviors with oral hygiene items in the household single-bathroom, 70% (95%CI 64.9-75.5) of the youngest participants reported sharing toothbrushes in the same container and 30% (95%CI 24.4-35.1) of the oldest; use of the same toothpaste was reported by 67% (95%CI 62.8-71.7) of the youngest and 33% (95%CI 28.337.3) of the oldest participants. For the outcome of sharing the same toothpaste, the chances for the youngest and the oldest to share the same toothbrush container was 11 times and 6 times more, respectively. Conclusion: The individuals related good oral hygiene habits; however, behaviors with oral hygiene items in the bathroom were neglected, especially by the younger individuals.

RESUMO Mesmo nos estágios iniciais do comprometimento cognitivo, os idosos podem apresentar alterações motoras importantes. No entanto, não há estudos que tenham investigado o timed up and go (TUG) e suas subtarefas como preditores do comprometimento da capacidade funcional ao longo do tempo nessa população. Objetivos: O objetivo deste estudo foi verificar se o teste timed up and go (TUG) e suas subtarefas podem predizer o declínio funcional ao longo de 32 meses em idosos com comprometimento cognitivo leve (CCL) e doença de Alzheimer leve (DA). Métodos: Este é um estudo prospectivo de acompanhamento de 32 meses, que incluiu no início do estudo 78 idosos (CCL: n=40; DA: n=38). O TUG e suas subtarefas (sentar para levantar, caminhar para frente, virar, caminhar para trás e girar para sentar) foram realizados na linha de base pelo sistema Qualisys Motion. A capacidade funcional foi avaliada no início e após 32 meses. Resultados: Depois do seguimento, a amostra foi composta de 45 idosos (CCL: n=25; DA: n=20). Destes, 28 tiveram a capacidade funcional diminuída (CCL: n=13; DA: n=15). Nenhuma variável do TUG previu declínio funcional significativamente estatístico (p>0,05) em nenhum dos grupos, por meio da análise de regressão logística univariada com a covariável sexo. Conclusões: Embora os idosos com CCL e DA leve tenham tido sua capacidade funcional diminuída, o teste TUG e suas subtarefas não puderam prever esse declínio em 32 meses.

ABSTRACT. Even in the early stages of cognitive impairment, older people can present important motor alterations. However, there are no studies that have investigated Timed Up and Go (TUG) and its subtasks in predicting impairment of functional capacity over time in this population. Objectives: The aim of this study was to verify if the TUG test and its subtasks can predict functional decline over 32 months in older adults with mild cognitive impairment (MCI) and mild Alzheimer's disease (AD). Methods: This is a prospective 32-month follow-up study, including at baseline 78 older adults (MCI: n=40; AD: n=38). The TUG and its subtasks (e.g., sit-to-stand, walking forward, turn, walking back, and turn-to-sit) were performed at baseline using the Qualisys Motion system. Functional capacity was assessed at baseline and after 32 months. Results: After follow-up, the sample had 45 older adults (MCI: n=25; AD: n=20). Of these, 28 declined functional capacity (MCI: n=13; AD: n=15). No TUG variable significantly predicted (p>0.05) functional decline in both groups, by univariate logistic regression analysis with the covariate gender. Conclusions: Although older adults with MCI and mild AD declined functional capacity, the TUG test and its subtasks could not predict this decline over 32 months.

Resumo Introdução idosos em Instituições de Longa Permanência (ILPIs) possuem comprometimento da capacidade funcional e maior prevalência de agravos bucais. Destaca-se o papel do profissional enfermeiro na avaliação integral do idoso inclusive com instrumentos para identificação e encaminhamento para tratamento odontológico. Objetivo descrever a confiabilidade intra e interobservador, na avaliação da saúde bucal de idosos em ILPIs por vídeo. Material e método estudo metodológico, em três ILPIs da Grande Florianópolis, Sul do Brasil. Foi utilizado o instrumento Avaliação da Saúde Bucal para Triagem Odontológica (ASBTO), que possui oito categorias (“lábios”, “língua”, “gengivas/tecidos”, “saliva”, “dentes naturais”, “dentadura”, “higiene” e “dor de dente”), segundo escores 0=saudável, 1=presença de alterações (podendo haver necessidade de atendimento), 2=não saudável (necessidade de atendimento) e escore final de 0 a 16. Um Enfermeiro, em cada ILPI, avaliou as condições bucais presencialmente e realizou vídeo com smartphone de cada idoso. Um cirurgião-dentista avaliou as condições bucais à partir desses vídeos. Foi estimado o teste de Kappa, p<0,05. Resultado amostra de 34 idosos, 71% do sexo feminino. Confiabilidade interobservador entre os enfermeiros 1 e 2 e cirurgião-dentista para “lábios” e “dentes naturais” foi classificada como fraca e excelente/muito boa para dor de dente e condição das dentaduras segundo dois enfermeiros. Confiabilidade intraobservador dos enfermeiros foi classificada como fraca para avaliação dos “dentes naturais”. Conclusão o ASBTO mostrou-se confiável na avaliação das condições de prótese e dor, entretanto sugere-se maior capacitação dos Enfermeiros para o reconhecimento de condições bucais que requerem atendimento odontológico, assim como, a gestão deste processo pelo cirurgião-dentista e ILPIs.

Abstract Introduction older persons in Long-Term Care (LTC) facilities have functional impairments and a higher disease prevalence. Nurses’ comprehensive assessment of older persons’ health is highlighted, including using tools for screening dental treatment needs. Objective to report the intra- and inter-observer reliability of older adults’ oral health assessment in LTC facilities by video. Material and method descriptive study, in three LTC facilities, in the Florianópolis region, Southern Brazil. Data were collected according to Oral Health Assessment Tool (OHAT), which presents 8 categories (“lips, tongue, gums/tissues, saliva, natural teeth, dentures, dental hygiene, and toothache”), and the scores 0=healthy, 1=presence of changes (could be a need for care), 2=unhealthy (need for dental service); final score from 0 to 16. In each LTC facility, a Nurse assessed oral conditions and made a video of each older adult using a smartphone. The dentist performed the oral health assessment through the videos. Estimated Kappa test, p<0.05. Result the sample was 34 older adults, 71% were female. Interobserver reliability between Nurses 1 and 2 and Dentist for “lips” and “natural teeth” was classified as poor and excellent/very good for toothache and denture conditions. The nurse’s intraobserver reliability was classified as weak for the “natural teeth” assessment. Conclusion the OHAT showed reliability for assessing denture conditions and pain. However, nurses’ training for recognizing oral conditions that require dental care is suggested, as well as the management of this action by the dentist and LTC facilities.

RESUMO. Mesmo nos estágios iniciais do comprometimento cognitivo, os idosos podem apresentar alterações motoras importantes. No entanto, não há estudos que tenham investigado o timed up and go (TUG) e suas subtarefas como preditores do comprometimento da capacidade funcional ao longo do tempo nessa população. Objetivos: O objetivo deste estudo foi verificar se o teste timed up and go (TUG) e suas subtarefas podem predizer o declínio funcional ao longo de 32 meses em idosos com comprometimento cognitivo leve (CCL) e doença de Alzheimer leve (DA). Métodos: Este é um estudo prospectivo de acompanhamento de 32 meses, que incluiu no início do estudo 78 idosos (CCL: n=40; DA: n=38). O TUG e suas subtarefas (sentar para levantar, caminhar para frente, virar, caminhar para trás e girar para sentar) foram realizados na linha de base pelo sistema Qualisys Motion. A capacidade funcional foi avaliada no início e após 32 meses. Resultados: Depois do seguimento, a amostra foi composta de 45 idosos (CCL: n=25; DA: n=20). Destes, 28 tiveram a capacidade funcional diminuída (CCL: n=13; DA: n=15). Nenhuma variável do TUG previu declínio funcional significativamente estatístico (p>0,05) em nenhum dos grupos, por meio da análise de regressão logística univariada com a covariável sexo. Conclusões: Embora os idosos com CCL e DA leve tenham tido sua capacidade funcional diminuída, o teste TUG e suas subtarefas não puderam prever esse declínio em 32 meses.

ABSTRACT. Even in the early stages of cognitive impairment, older people can present important motor alterations. However, there are no studies that have investigated Timed Up and Go (TUG) and its subtasks in predicting impairment of functional capacity over time in this population. Objectives: The aim of this study was to verify if the TUG test and its subtasks can predict functional decline over 32 months in older adults with mild cognitive impairment (MCI) and mild Alzheimer’s disease (AD). Methods: This is a prospective 32-month follow-up study, including at baseline 78 older adults (MCI: n=40; AD: n=38). The TUG and its subtasks (e.g., sit-to-stand, walking forward, turn, walking back, and turn-to-sit) were performed at baseline using the Qualisys Motion system. Functional capacity was assessed at baseline and after 32 months. Results: After follow-up, the sample had 45 older adults (MCI: n=25; AD: n=20). Of these, 28 declined functional capacity (MCI: n=13; AD: n=15). No TUG variable significantly predicted (p>0.05) functional decline in both groups, by univariate logistic regression analysis with the covariate gender. Conclusions: Although older adults with MCI and mild AD declined functional capacity, the TUG test and its subtasks could not predict this decline over 32 months.

Abstract INTRODUCTION This systematic review aimed to assess antibiotic use in Brazilian hospitals in the 21st century, as well as to understand the different drug utilization metrics adopted to assess the consumption of these drugs. METHODS We systematically reviewed five databases (MEDLINE [Medical Literature Analysis and Retrieval System Online], CENTRAL [The Cochrane Central Register of Controlled Trials], EMBASE® [Excerpta Medica Database], Scopus [Elsevier’s abstract and citation database], and LILACS [Literatura Latino-Americana e do Caribe em Ciências da Saúde]) for observational or experimental studies that assessed antibiotic utilization in Brazilian hospitals. The main outcomes were the drug utilization metrics and the consumption of antibiotics. RESULTS We included 23 studies, of which 43.5% were carried out in adult and pediatric care units, 39.1% in adult units, and 17.4% in pediatric units. Regarding the complexity of healthcare, 26.1% of the studies were performed in intensive care units. Two drug utilization metrics were used in these studies: the defined daily dose (DDD) and the percentage of antibiotic prescriptions. The most commonly used antibiotic classes were third-generation cephalosporins, carbapenems, fluoroquinolones, and combinations of penicillins when the DDD was the adopted drug utilization metric. CONCLUSIONS Although few studies have been conducted, existing data indicate a high use of broad-spectrum antibiotics. We found that the lack of standardized antibiotic utilization metrics impaired the mapping of drug consumption at the national level.

ABSTRACT Despite the widespread use of chlorhexidine (CHX) to prevent infection, data regarding the in vitro action of CHX against methicillin-resistant Staphylococcus aureus (MRSA) are limited. Clinical isolates from Hospital das Clinicas, Sao Paulo, Brazil, identified during 2002/2003 and 2012/2013 were studied to describe the susceptibility to CHX and mupirocin, molecular characteristics, and virulence profile of MRSA. Susceptibility test to Mupirocin was performed by the disk diffusion method and to CHX by the agar dilution technique. PCR for virulence genes, mecA gene and Staphylococcal Cassette Chromosome mec (SCCmec) types were investigated as well. Mupirocin- and CHX-resistant isolates were sequenced using the IlluminaTM plataform. Two hundred and sixteen MRSA clinical isolates were evaluated: 154 from infected and 62 from colonized patients. Resistance to mupirocin was observed in four isolates assigned as SCCmec type III and STs (ST05; ST239 and ST105) carrying mupA and blaZ, two of them co-harboring the ileS gene. Only one isolate assigned as SCCmec type III was resistant to CHX (MIC of 8.0 μg.mL-1) and harbored the qacA gene. Resistance to chlorhexidine and mupirocin were found in isolates carrying qacA and mupA in our hospital. Since these genes are plasmid-mediated, this finding draws attention to the potential spread of resistance to mupirocin in our hospital.

ABSTRACT The consumption of meat and meat products can pose consumers into risk due to the presence of biological hazards that can cause foodborne diseases. Thus, this study aimed to compare the microbiological quality of illegal and inspected salami sold in the state of São Paulo, Brazil. For this purpose, 80 salami samples (40 illegal and 40 inspected) were purchased and their microbiological quality was assessed according to the protocol established by the Brazilian Ministry of Health. All samples were considered as acceptable for consumption according to the Brazilian law. However, the samples of illegal salami were significantly higher contaminated with bacteria belonging to the genus Staphylococcus (p = 0.002) and had a higher trend to be contaminated with total coliforms (p = 0.08) and thermotolerant ones (p = 0.07) compared to inspected salami. Salmonella spp. and coagulase-positive Staphylococcus were not detected. In conclusion, although all samples were considered as safe for consumption, illegal salami had a worse microbiological quality when compared to inspected ones.

ABSTRACT Carbon steel is used in various applications because of its excellent weldability, good mechanical resistance and low cost. However, its application becomes restricted due to its low corrosion resistance in neutral and acidic media, and it is necessary to use processes to retard the corrosive mechanism, such as the use of inhibitors. Many of the effective synthetic inhibitors used are associated with high cost and some have a high toxicity. In recent years, studies of corrosion inhibitors obtained from natural products have been increasing because they are environmentally sustainable and presents low-cost. Therefore, in the present study, different concentrations of the cocoa shell powder (Theobroma cacao) and hydroalcoholic extract were evaluated as a corrosion inhibitors of SAE 1008 carbon steel in 0.5 mol.L-1 sodium chloride solution. The inhibitory action of the cocoa residue was studied through gravimetric technique and electrochemical impedance spectroscopy (EIS). For the chemical characterization of the inhibitor, the Fourier Transform Infrared Spectroscopy (FTIR) was used. The EIS results showed that the corrosion inhibition efficiency of the steel decreased with the inhibitor concentration, reaching maximum values of 55.97% and 72.93%, for cocoa shell powder and hydroalcoholic extract, respectively. The gravimetric data confirmed the electrochemical results and through the study of the adsorption mechanism it was verified that the adsorbed inhibitor molecules follow the Flory-Huggins isotherm model, for both forms of the inhibitor. For all the concentrations evaluated, the cocoa shell powder did not represent an efficient corrosion inhibitor. In contrast, for the hydroalcoholic extract, at the concentration of 0.44 g.L-1, a good performance was verified as a corrosion inhibitor of SAE 1008 carbon steel in 0.5 mol.L-1 sodium chloride solution.

Abstract Objective: To describe the strengthening and weakening factors for breastfeeding. Method: This is a descriptive multiple case qualitative study, conducted in Curitiba, Parana, with members of 17 families with children between 6 and 12 months old, through semi-structured interview and construction of genograms, analyzed by the strategy of cross case synthesis. Results: 28 people participated in the study. Strengthening factors for breastfeeding were: the desire to breastfeed; child with facility for breastfeeding; mother with time available to the child; previous breastfeeding experience and family history of breastfeeding; the support and encouragement to breastfeed. Weakening factors were: negative expectations; the myth of weak milk; child’s disease; maternal illness; negative experiences of the mother; the absence of family history of breastfeeding; lack of a support network. Conclusion: Breastfeeding is a family and social phenomenon. Therefore, practices that go beyond the mother-baby dyad are necessary. The care process should include the social and subjective dimension, strengthening the support network of nursing mothers, in order to obtain more satisfactory professional practices that promote breastfeeding.

Resumen Objetivo: Describir los elementos fortalecedores y debilitadores de la lactancia. Método: Investigación con abordaje cualitativo del tipo estudio de casos múltiples con carácter descriptivo, llevado a cabo en el municipio de Curitiba, Paraná, con miembros de 17 familias compuestas de niños de 6 a 12 meses, mediante entrevista semiestructurada y construcción de genograma, analizados por la estrategia de síntesis de casos cruzados. Resultados: Participaron en el estudio 28 miembros. Fueron fortalecedores de la lactancia: el deseo de amamantar; niño con facilidad para mamar; madre con disponibilidad de tiempo para el niño; experiencia previa de la lactante y antecedentes familiares de lactancia; el apoyo y el incentivo para amamantar. Los debilitadores de la lactancia fueron: expectativas negativas; el mito de la leche flaca; la enfermedad del niño; las afecciones maternas; vivencias negativas de la madre; la ausencia de antecedentes familiares de lactancia; la ausencia de apoyo y soporte de la red. Conclusión: Amamantar es un fenómeno familiar y social, por lo que son necesarias prácticas promovedoras que extrapolen el binomio madre-bebé. En el proceso de cuidar se debe buscar la involucración de la dimensión social y subjetiva, mediante el fortalecimiento de la red de apoyo a las lactantes, a fin de lograrse prácticas profesionales más satisfactorias y promovedoras de la lactancia.

Resumo Objetivo: Descrever os elementos fortalecedores e fragilizadores da amamentação. Método: Pesquisa com abordagem qualitativa do tipo estudo de casos múltiplos com caráter descritivo, realizado no município de Curitiba, Paraná, com membros de 17 famílias compostas de crianças de 6 a 12 meses, por meio de entrevista semiestruturada e construção de genograma, analisados pela estratégia de síntese de casos cruzados. Resultados: Participaram do estudo 28 membros. Foram fortalecedores da amamentação: a vontade de amamentar; criança com facilidade para mamar; mãe com disponibilidade de tempo para a criança; experiência anterior da nutriz e antecedentes familiares de amamentação; o apoio e o incentivo para amamentar. Os fragilizadores da amamentação foram: expectativas negativas; o mito do leite fraco; a doença da criança; as afecções maternas; vivências negativas da mãe; a ausência de antecedentes familiares de amamentação; a falta de apoio e suporte da rede. Conclusão: Amamentar é um fenômeno familiar e social, portanto são necessárias práticas promotoras que extrapolem o binômio mãe-bebê. No processo de cuidar deve-se buscar o envolvimento da dimensão social e subjetiva, por meio do fortalecimento da rede de apoio das nutrizes, a fim de obterem-se práticas profissionais mais satisfatórias e promotoras da amamentação.

Abstract The objective of this study was to evaluate the effects of an hCG subdose applied at the Hou Hai acupoint as an ovulation inducer in donkeys. Eleven donkeys were distributed in randomized blocks in T1 = application of 1,500 IU of hCG intravenous (IV); T2 = 450 IU of hCG applied at the false acupoint (IV), and T3 = 450 IU of hCG applied at the Hou Hai acupoint. There was no difference (P > 0.05) between the treatments regarding the mean diameter of the pre-ovulatory follicle (34.5 ± 1.3 mm), the ovulation rate (96.97%), the interval between induction and ovulation (58.07 ± 16.82 h), the mean diameter of the CL (D0 = 23.0 ± 0.6; D2 = 27.7 ± 1.9 and D8 = 28.2 ± 0.8mm), and serum P4 concentrations (10.50 ± 2.99 ng.mL-1). The application of 450 IU of hCG at the Hou Hai acupoint increased ovulation rate (72.73%) more than 48 h after induction (P = 0.03) and a larger diameter of the CL on D4 (30.7 ± 5.1 mm) (P = 0.04). The vascularization area of the CL on D8, obtained by minimum number of colored pixel (NCP), was greater (P < 0.05) in the donkeys that received 1,500 IU of IV hCG (T1, 41.91 ± 1.17), and we found a positive correlation (P < 0.05) between mean NCP and P4 concentration in the donkeys that received 450 IU of hCG IV at the false acupoint (T2) or at the Hou Hai acupoint (T3). The application of 450 IU of hCG by IV route at the false acupoint or the Hou Hai acupoint was sufficient to induce ovulation in donkeys, demonstrating that the average dosage commonly used for this species is too high.

Resumo Objetivo: Descrever os elementos fortalecedores e fragilizadores da amamentação. Método: Pesquisa com abordagem qualitativa do tipo estudo de casos múltiplos com caráter descritivo, realizado no município de Curitiba, Paraná, com membros de 17 famílias compostas de crianças de 6 a 12 meses, por meio de entrevista semiestruturada e construção de genograma, analisados pela estratégia de síntese de casos cruzados. Resultados: Participaram do estudo 28 membros. Foram fortalecedores da amamentação: a vontade de amamentar; criança com facilidade para mamar; mãe com disponibilidade de tempo para a criança; experiência anterior da nutriz e antecedentes familiares de amamentação; o apoio e o incentivo para amamentar. Os fragilizadores da amamentação foram: expectativas negativas; o mito do leite fraco; a doença da criança; as afecções maternas; vivências negativas da mãe; a ausência de antecedentes familiares de amamentação; a falta de apoio e suporte da rede. Conclusão: Amamentar é um fenômeno familiar e social, portanto são necessárias práticas promotoras que extrapolem o binômio mãe-bebê. No processo de cuidar deve-se buscar o envolvimento da dimensão social e subjetiva, por meio do fortalecimento da rede de apoio das nutrizes, a fim de obterem-se práticas profissionais mais satisfatórias e promotoras da amamentação.

Abstract Objective: To describe the strengthening and weakening factors for breastfeeding. Method: This is a descriptive multiple case qualitative study, conducted in Curitiba, Parana, with members of 17 families with children between 6 and 12 months old, through semi-structured interview and construction of genograms, analyzed by the strategy of cross case synthesis. Results: 28 people participated in the study. Strengthening factors for breastfeeding were: the desire to breastfeed; child with facility for breastfeeding; mother with time available to the child; previous breastfeeding experience and family history of breastfeeding; the support and encouragement to breastfeed. Weakening factors were: negative expectations; the myth of weak milk; child’s disease; maternal illness; negative experiences of the mother; the absence of family history of breastfeeding; lack of a support network. Conclusion: Breastfeeding is a family and social phenomenon. Therefore, practices that go beyond the mother-baby dyad are necessary. The care process should include the social and subjective dimension, strengthening the support network of nursing mothers, in order to obtain more satisfactory professional practices that promote breastfeeding.

Resumen Objetivo: Describir los elementos fortalecedores y debilitadores de la lactancia. Método: Investigación con abordaje cualitativo del tipo estudio de casos múltiples con carácter descriptivo, llevado a cabo en el municipio de Curitiba, Paraná, con miembros de 17 familias compuestas de niños de 6 a 12 meses, mediante entrevista semiestructurada y construcción de genograma, analizados por la estrategia de síntesis de casos cruzados. Resultados: Participaron en el estudio 28 miembros. Fueron fortalecedores de la lactancia: el deseo de amamantar; niño con facilidad para mamar; madre con disponibilidad de tiempo para el niño; experiencia previa de la lactante y antecedentes familiares de lactancia; el apoyo y el incentivo para amamantar. Los debilitadores de la lactancia fueron: expectativas negativas; el mito de la leche flaca; la enfermedad del niño; las afecciones maternas; vivencias negativas de la madre; la ausencia de antecedentes familiares de lactancia; la ausencia de apoyo y soporte de la red. Conclusión: Amamantar es un fenómeno familiar y social, por lo que son necesarias prácticas promovedoras que extrapolen el binomio madre-bebé. En el proceso de cuidar se debe buscar la involucración de la dimensión social y subjetiva, mediante el fortalecimiento de la red de apoyo a las lactantes, a fin de lograrse prácticas profesionales más satisfactorias y promovedoras de la lactancia.

Resumo A alface é um vegetal mundialmente consumido. Porém, quando mal higienizada pode ser a causa de doenças transmitidas por alimentos. Esse trabalho teve como objetivo verificar o conhecimento dos manipuladores referente à lavagem e desinfecção de vegetais e avaliar a eficiência de diferentes processos de lavagem e desinfecção de alface (Lactuca sativa) comercializada em supermercados. Foi aplicado um questionário aos consumidores para conhecer as práticas de lavagem e desinfecção dos vegetais. Foram adquiridas 100 amostras de alfaces em diferentes supermercados. Para avaliar a qualidade microbiológica das alfaces, foram usados: alface sem tratamento (T0); lavagem com água tratada corrente (T1); imersão em água tratada por 30 minutos (T2); imersão em hipoclorito de sódio a 200 ppm por 15 minutos (T3); e 30 minutos (T4); imersão em solução de vinagre a 2% (T5); imersão em solução de vinagre a 20% (T6); imersão em hipoclorito de sódio a 50 ppm por 30 minutos (T7); e 15 minutos (T8). Após a realização dos tratamentos, foi realizada contagem total de bactérias heterotróficas e coliformes termotolerantes. A contagem média de bactérias heterotróficas encontradas antes da higienização (T0) foi de 5,54 log UFC/g. A maioria dos consumidores afirmou que faz a lavagem das alfaces apenas com água; somente 7,50% fazem a desinfecção; e 56,3% afirmam não ter conhecimento da maneira correta da higienização dos vegetais. Todos os métodos utilizados foram capazes de reduzir as contagens de bactérias heterotróficas, sendo que as melhores reduções foram apresentadas respectivamente pelos tratamentos T4 (2,27 log UFC/g) e T3 (2,09 log UFC/g). Nenhuma das amostras apresentou contaminação por coliformes antes e depois da higienização. Esses resultados permitem concluir que métodos de lavagem e desinfecção de alfaces são necessários para reduzir a contaminação microbiana nesse alimento antes do consumo e que se torna necessário orientar os consumidores da importância dessa prática.

Abstract Lettuce is a vegetable most consumed worldwide. However, when not properly sanitized, it can cause various foodborne illnesses. Thus, this research aimed to verify the knowledge of handlers regarding the washing and disinfection of vegetables, as well as to evaluate the efficiency of different processes of washing and disinfection of lettuce (Lactuca sativa) sold in supermarkets. A questionnaire was applied to consumers to know the practices used for washing and disinfecting vegetables. After, 100 samples of lettuce were purchased in different supermarkets. To evaluate the microbiological quality of lettuces we used: lettuce without treatment (T0); washing with running tap water (T1); immersion in treated water for 30 minutes (T2); immersion in sodium hypochlorite at 200 ppm for 15 minutes (T3); and 30 minutes (T4); immersion in 2% vinegar solution (T5); immersion in 20% vinegar solution (T6); immersion in sodium hypochlorite at 50 ppm for 30 minutes (T7); and 15 minutes (T8). After the treatments, we performed a total count of heterotrophic bacteria and thermotolerant coliforms. The mean heterotrophic bacteria count found before sanitation (T0) was 5.54 log UFC/g. Most consumers say they only wash lettuce with water and only 7.50% disinfect. In 56.3%, the consumers are not aware of the correct way to clean vegetables. All methods used were able to reduce heterotrophic bacteria counts and the best reductions were presented respectively by treatments T4 (2.27 log UFC/g) and T3 (2.09 log UFC/g). None of the samples showed thermotolerant coliforms contamination before and after cleaning. These results allow us to conclude that lettuce washing and disinfection methods are necessary to reduce microbial contamination in this food before consumption and that it is necessary to guide consumers of the importance of this practice.

Resumo Este trabalho objetiva analisar como a adoção de inovações tecnológicas pode afetar o desempenho de atividades ligadas às práticas e aos procedimentos realizados pelos órgãos do sistema de justiça criminal. Adota-se a metodologia qualitativa exploratória por meio da abordagem do estudo de caso acerca da implementação da ferramenta tecnológica PMSC Mobile pela Polícia Militar do estado de Santa Catarina (PMSC). Os resultados revelam que tal ferramenta contribui positivamente para a racionalização de registro de ocorrências policiais, para a melhor alocação de recursos financeiros e humanos e para a maior precisão dos registros de informações criminais. Contudo, a escassa regulamentação legal acerca das atribuições dos órgãos de segurança pública e a ausência de articulação entre os órgãos policiais civil e militar limitam o aprofundamento de medidas integrativas e o compartilhamento de informações em matéria de controle da criminalidade. O estudo traz duas contribuições principais: (i) descrever uma prática inovadora na área de segurança pública e (ii) ampliar o debate sobre os efeitos dessa ferramenta nas atividades desempenhadas por outros órgãos do sistema de justiça e na própria instrução processual penal.

Abstract This paper aims to analyze how the adoption of technological innovations can affect the performance of activities related to the practices and procedures carried out by the organs of the criminal justice system. The qualitative exploratory methodology is adopted through the approach of the case study about the implementation of a technological tool by the Military Police of the State of Santa Catarina (PMSC) called PMSC Mobile. The results show that such a tool contributes positively to the rationalization of administrative procedures, better allocation of financial and human resources, and a better qualification of the registry of criminal information. However, the scarce legal regulations on the role of organs and public security and the lack of coordination between civilian and military police forces limit the deepening of integrative measures and the sharing of information on crime control. The study has two main contributions: (i) to describe an innovative practice in the area of public security and (ii) to broaden the debate about the effects of this tool on the activities carried out by other organs of the justice system and on the criminal procedure itself.

RESUMO Objetivos: explorar a influência das práticas de atenção à saúde na sobrecarga das mães cuidadoras de crianças com necessidades especiais de saúde. Métodos: delineamento observacional, analítico, transversal, de abordagem quantitativa. Participaram 100 mães cuidadoras respondendo aos seguintes instrumentos: instrumento de caracterização; Escala de Sobrecarga para Cuidadores Informais; Percepção do Cuidado Centrado na Família- versão pais; Instrumento de Avaliação da Atenção Primária à Saúde - Versão Criança. Para análise estatística utilizou-se correlação de Spearman e análise de regressão linear univariada e multivariada. Resultados: o escore médio da sobrecarga foi 47.99. Houve correlação negativa entre a sobrecarga e os domínios colaboração e suporte da escala de percepção do cuidado centrado na família. No modelo de regressão linear multivariado, a variável longitudinalidade manteve relação significativa com a sobrecarga (p=0.023). Conclusões: um cuidado compartilhado, longitudinal e integrado entre famílias e serviços de saúde pode amenizar a sobrecarga das mães cuidadoras.

ABSTRACT Objectives: to explore the influence of health care practices on the burden of caregiver mothers of children with special health needs. Methods: observational, analytical, cross-sectional, quantitative study. Participation of 100 caregiver mothers, who responded the following instruments: characterization instrument; Burden Interview for Informal Caregivers; Perceptions of Family-Centered Care - Parents version; Evaluation Instrument for Primary Care - Child Version. For statistical analysis, were used the Spearman’s Correlation and univariate and multivariate linear regression analysis. Results: the mean burden score was 47.99. There was a negative correlation between the burden and the domains of collaboration and support of the Perceptions of Family-Centered Care scale. In the multivariate linear regression model, the longitudinality variable maintained a significant relation with the burden (p = 0.023). Conclusions: a shared, longitudinal and integrated care between families and health services can ease the burden of caregiver mothers.

RESUMEN Objetivos: explorar la influencia de las prácticas de atención a la salud en la sobrecarga de las madres cuidadoras de niños con necesidades especiales de salud. Métodos: investigación observacional, analítica, transversal y cuantitativa. Participaron 100 madres cuidadoras respondiendo a los siguientes instrumentos: instrumento de caracterización; Escala de Sobrecarga para Cuidadores Informales; Percepción del cuidado centrado en la familia- versión padres; Instrumento de Evaluación de la Atención Primaria a la Salud - Versión Niño. Para el análisis estadístico, se utilizó la correlación de Spearman y el análisis de regresión lineal univariado y multivariado. Resultados: la puntuación media de la sobrecarga fue de 47.99. Hubo correlación negativa entre la sobrecarga y los dominios colaboración y soporte de la escala de percepción del cuidado centrado en la familia. En el modelo de regresión lineal multivariado, la variable longitudinalidad mantuvo una relación significativa con la sobrecarga (p=0.023). Conclusiones: una atención compartida, longitudinal e integrada entre familias y servicios de salud puede amenizar la sobrecarga de las madres cuidadoras.