Abstract The pathogenesis of systemic lupus erythematosus (SLE) is complex. Few studies in Brazilian population have addressed cell phenotypes associated with immunological responses and their associations with SLE activity. The aim of this study is to investigate cell phenotypes associated to SLE diagnosis, treatment and activity. Twenty-eight SLE female patients (17 inactive, 11 active) and 10 healthy women were included in this study. Markers of natural killer (Nk), T and B cells in peripheral blood were evaluated by flow cytometry. Nkt cells were decreased only in SLE active patients. Activated CD4+, regulatory T FoxP3+ and B cells were decreased in both active and inactive SLE patients, compared to control group. The data corroborate the disruption of immune regulatory response in SLE patients and suggest phenotipic changes as possible biomarkers of SLE activity.

ABSTRACT Sporotrichosis is the most frequent subcutaneous mycosis in Latin America. It is caused by species of the genus Sporothrix. Infection in humans occurs through the entry of the fungus into the skin. Zoonotic outbreaks involving cats in the transmission of the disease have been frequently reported. The lymphocutaneous form is the most commonly observed and the upper limbs are the most affected sites. We report a case of a 64-year-old healthy female patient with a lymphocutaneous form with rapid progression of lesions, which was refractory to initial treatment with itraconazole. Treatment with liposomal amphotericin B was performed with a satisfactory resolution, but aesthetic and functional sequelae in the left upper limb were installed.

Abstract Background Management delays imply worse outcomes in rheumatoid arthritis (RA) and, therefore, should be minimized. We evaluated changes in diagnostic and treatment delays regarding RA in the last decades in Brazil. Methods Adults fulfilling the ACR/EULAR (2010) criteria for RA were assessed. Delays in diagnosis and treatment, and the frequencies of early management initiation within thresholds (windows of opportunity) of 3, 6, and 12 months from symptoms onset were evaluated. The Mann–Kendall trend test, chi-squared tests with Cramer’s V effect sizes and analysis of variance were conducted. Results We included 1116 patients: 89.4% female, 56.8% white, mean (SD) age 57.1 (11.5) years. A downward trend was found in diagnostic (tau = - 0.677, p < 0.001) and treatment (tau = - 0.695, p < 0.001) delays from 1990 to 2015. The frequency of early management increased throughout the period, with ascending effect sizes across the 3-, 6-, and 12-month windows (V = 0.120, 0.200 and 0.261, respectively). Despite all improvements, even in recent years (2011–2015) the diagnostic and treatment delays still remained unacceptably high [median (IQR): 8 (4–12) and 11 (5–17) months, respectively], with only 17.2% of the patients treated within the shortest, 3-month window. Conclusion The delays in diagnosis and treatment of RA decreased during the last decades in Brazil. Improvements (effect sizes) were greater at eliminating extreme delays (≥ 12 months) than in attaining really short management windows (≤ 3 months). Very early treatment was still an unrealistic goal for most patients with RA.

Abstract Background Early rheumatoid arthritis (RA) offers an opportunity for better treatment outcomes. In real-life settings, grasping this opportunity might depend on access to specialized care. We evaluated the effects of early versus late assessment by the rheumatologist on the diagnosis, treatment initiation and long-term outcomes of RA under real-life conditions. Methods Adults meeting the ACR/EULAR (2010) or ARA (1987) criteria for RA were included. Structured interviews were conducted. The specialized assessment was deemed “early” when the rheumatologist was the first or second physician consulted after symptoms onset, and “late” when performed afterwards. Delays in RA diagnosis and treatment were inquired. Disease activity (DAS28-CRP) and physical function (HAQ-DI) were evaluated. Student's t, Mann-Whitney U, chi-squared and correlation tests, and multiple linear regression were performed. For sensitivity analysis, a propensity score-matched subsample of early- vs. late-assessed participants was derived based on logistic regression. The study received ethical approval; all participants signed informed consent. Results We included 1057 participants (89.4% female, 56.5% white); mean (SD) age: 56.9 (11.5) years; disease duration: 173.1 (114.5) months. Median (IQR) delays from symptoms onset to both RA diagnosis and initial treatment coincided: 12 (6–36) months, with no significant delay between diagnosis and treatment. Most participants (64.6%) first sought a general practitioner. Notwithstanding, 80.7% had the diagnosis established only by the rheumatologist. Only a minority (28.7%) attained early RA treatment (≤ 6 months of symptoms). Diagnostic and treatment delays were strongly correlated (rho 0.816; p < 0.001). The chances of missing early treatment more than doubled when the assessment by the rheumatologist was belated (OR 2.77; 95% CI: 1.93, 3.97). After long disease duration, late-assessed participants still presented lower chances of remission/low disease activity (OR 0.74; 95% CI: 0.55, 0.99), while the early-assessed ones showed better DAS28-CRP and HAQ-DI scores (difference in means [95% CI]: −0.25 [−0.46, −0.04] and − 0.196 [−0.306, −0.087] respectively). The results in the propensity-score matched subsample confirmed those observed in the original (whole) sample. Conclusions Early diagnosis and treatment initiation in patients with RA was critically dependent on early access to the rheumatologist; late specialized assessment was associated with worse long-term clinical outcomes.

Abstract Objective: To analyze the prevalence of Mycobacterium leprae detection and the associated factors among social contacts in the school environment of multibacillary cases living in a hyperendemic municipality of the state of Mato Grosso. Methods: Cross-sectional study with 236 social contacts of multibacillary leprosy from public schools and residents in Cuiabá (Mato Grosso) in 2018. The sources of information were interviews and nasal swab tests for molecular analysis by polymerase chain reaction - PCR. For the prevalence ratio estimates, crude and adjusted analyses were performed using robust Poisson regression and their respective confidence intervals (95% CI). The ArcGIS 9.1 software was used for the geographic distribution analyses. Results: The prevalence of detection of M. leprae in social contacts was 14%. A total of 63.6% of the schools surveyed had 5.1% to 50% of the social contacts of leprosy with positive PCR. The analysis of the geographic distribution in the neighborhoods showed a high prevalence of infection, being higher than 50% in some localities. The highest proportion of positive results occurred in the northern region of the city and from a precarious socioeconomic class. Conclusion: The results showed a high prevalence of detection of M. leprae among social contacts in areas with poor socioeconomic conditions. In these regions, there is a greater risk of

RESUMO A internacionalização do ensino superior vem ganhando importância teórica e empírica nas décadas recentes. Nesse contexto, este artigo objetiva descrever e analisar a internacionalização de escolas de negócios a partir das atividades dos acadêmicos e com base nas proposições defendidas pela Teoria da Troca Social (SET, do inglês Social Exchange Theory). Para atingir nosso objetivo, conduzimos 39 entrevistas com acadêmicos de escolas de negócios dos Estados Unidos e do Brasil, incluindo Instituto Tecnológico de Massachusetts (MIT), Harvard, Fundação Getulio Vargas (FGV) e Universidade de São Paulo (USP). Temos como principais achados: (i) existem recompensas individuais que não são abordadas pela SET; (ii) há benefícios para outras partes interessadas que não são contemplados pela SET; (iii) há certas decisões não racionais não previstas pela SET; (iv) e a condição de equivalência entre custos e recompensas prevista pela SET apresenta fragilidades. Com esses resultados, trazemos contribuições teóricas e empíricas para a temática.

ABSTRACT The internationalization of higher education has gained in theoretical and empirical importance in recent decades. In this context, this article aims to describe and analyze the internationalization of business schools from the activities of their academics and based on the propositions defended by the Social Exchange Theory (SET). To achieve our goal we conducted 39 interviews with academics from business schools in the United States and Brazil, including Massachusetts Institute of Technology (MIT), Harvard, Getulio Vargas Foundation (FGV) and University of Sao Paulo (USP). We found that: (i) there are individual rewards that are not addressed by SET; (ii) there are benefits to third parties not covered by SET; (iii) certain non-rational choices are not provided by SET; and (iv) the condition of equivalence between costs and rewards provided by SET has its weaknesses. With these findings we add theoretical and empirical contributions to our theme.

RESUMEN La internacionalización de la educación superior ha ganado importancia teórica y empírica en las últimas décadas. En este contexto, este artículo tiene como objetivo describir y analizar la internacionalización de las escuelas de negocios a partir de las actividades de los académicos y de las propuestas defendidas por la Teoría del Intercambio Social (SET). Para lograr nuestro objetivo, realizamos 39 entrevistas con académicos de escuelas de negocios de Estados Unidos y Brasil, incluidos Instituto de Tecnología de Massachusetts (MIT), Harvard, Fundação Getulio Vargas (FGV) y la Universidad de São Paulo (USP). Los resultados principales son: (i) que hay recompensas individuales que la SET no aborda; (ii) que hay beneficios para las partes interesadas no cubiertos por la SET; (iii) que hay ciertas decisiones no racionales no previstas por la SET; (iv) y que la condición de equivalencia entre costos y recompensas prevista por la SET tiene debilidades. Con estos resultados aportamos contribuciones teóricas y empíricas al tema.

Resumo Objetivo Analisar os significados das masculinidades durante a vivência do câncer peniano e seus tratamentos. Métodos Abordagem qualitativa de pesquisa amparada em referencial teórico da antropologia médica e das masculinidades, com o emprego do método narrativo. Foram entrevistados em profundidade 18 homens com neoplasia peniana em um hospital referência em uro-oncologia do estado de São Paulo. Cada participante foi entrevistado com roteiro de investigação, em média três vezes, sendo as entrevistas audiogravadas, transcritas e analisadas conforme a análise temática indutiva. Resultados Seis participantes realizaram a penectomia parcial e 12 total. Em relação ao estado civil, participaram dois viúvos, dois solteiros, três divorciados e 11 casados, com média de idade de 54 anos. A extirpação do pênis promoveu mudanças significativas na forma como os homens performavam suas masculinidades, sobretudo a hegemônica. Portanto, essa experiência lhes permitiu reinterpretar suas condições de saúde na tentativa de identificar outros elementos hegemônicos que sustentassem suas imagens masculinas. Para alguns foi possível representar um homem inteiro, porém outros se consideram agora meio-homens. Conclusão O adoecimento rompeu com o fluxo biográfico dos participantes, pois antes do câncer peniano a hegemonia os representava como masculinos, entretanto, após a penectomia, eles perdem um órgão que socialmente traz atributos como força, poder, trabalho e virilidade, situação que lhes trouxe a necessidade de reinterpretar o ser masculino em suas culturas. A enfermagem, para promover o cuidado integral ao homem, deve considerar que as masculinidades interferem no processo saúde e doença.

Abstract Objective To analyze masculinity meanings during penile cancer experience and its treatments. Methods Qualitative approach supported in the theoretical framework of medical anthropology and masculinities, with the use of the narrative method. We interviewed in-depth 18 men with penile cancer in a referential Urologic Oncology hospital from the state of São Paulo. Each participant was interviewed on average three times, with a structured script, being the interviews audio-recorded, transcribed, and analyzed according to the inductive thematic analysis. Results Six patients were submitted to the partial penectomy and 12 to the total penectomy. Regarding the marital status, six were widowers, two single, three divorced, and 11 married, with an average age of 54 years old. The penis extirpation fostered significant change in the way men performed their masculinities, even the hegemonic. Thus, this experience allowed them to reinterpret their health conditions to identify other hegemonic elements that sustained their masculine images. For a few, it was possible to represent a full man however, others considered themselves half-men. Conclusion The illness broke the participant’s biographic flow because, before penile cancer, the hegemony represented them as masculines, however, after the penectomy, they have lost an organ that is socially related to attributes such as strength, power, work, and virility, situation that brought them the necessity to reinterpret being masculine in their culture. To promote integrality of care to man the nursing must consider that masculinities interfere in the process of health and disease.

Resumen Objetivo Analizar los significados de las masculinidades durante la vivencia del cáncer de pene y sus tratamientos. Métodos Enfoque cualitativo de investigación respaldado en el marco referencial teórico de la antropología médica y de las masculinidades, con el uso del método narrativo. Fueron entrevistados en profundidad 18 hombres con neoplasia de pene en un hospital de referencia en urología oncológica del estado de São Paulo. Cada participante fue entrevistado con guion de investigación, tres veces en promedio. Las entrevistas fueron grabadas, transcriptas y analizadas de acuerdo con el análisis temático inductivo. Resultados Seis participantes realizaron penectomía parcial y 12 total. Respecto al estado civil, participaron dos viudos, dos solteros, tres divorciados y 11 casados, con un promedio de edad de 54 años. La extirpación del pene generó cambios significativos en la forma como los hombres practicaban su masculinidad, sobre todo la hegemónica. Por lo tanto, esta experiencia les permitió interpretar sus condiciones de salud en el intento de identificar otros elementos hegemónicos que sostengan su imagen masculina. Para algunos fue posible representar un hombre entero, pero otros ahora se consideran medio hombres. Conclusión La enfermedad rompió con el flujo biográfico de los participantes, ya que antes del cáncer de pene, la hegemonía los representaba como masculinos; sin embargo, después de la penectomía, perdieron un órgano que socialmente trae atributos como fuerza, poder, trabajo y virilidad, situación que les produjo la necesidad de reinterpretar el ser masculino en su cultura. Para promover el cuidado integral del hombre, la enfermería debe considerar que las masculinidades interfieren en el proceso salud y enfermedad.

Abstract: Objective: To describe an innovative alternative to exploratory laparotomy in a newborn with a sub capsular hepatic hematoma secondary to umbilical vein catheterization. Clinical Case: A preterm baby with a history of hyaline membrane disease, pulmonary hypertension, and large patent ductus arteriosus, requiring mechanical ventilation and the use of vasoactive drugs. Umbilical catheters were inserted and through an abdomen X-ray, we observed their proper position. The patient evolved with greater requirements of vasoactive drugs, abdominal wall pallor, and abdominal distention. Abdominal ultrasound showed a subcapsular hepatic hematoma, with no signs of active bleeding, so expectant management was decided. The patient required increased vasoactive drugs and presented a decrease in hematocrit. New ultrasound showed a larger subcapsular hematoma, abundant perihe patic fluid, and the intraparenchymal position of the umbilical catheter was confirmed. Endovascular embolization was performed through the umbilical catheter with Gelita®, achieving occlusion of the capsular path. Posterior ultrasound showed a reduction of the hematoma. Conclusions: The use of embolization through angiography is not commonly used in pediatric emergencies. It is a procedure with fewer comorbidities and complications than exploratory laparotomy, therefore it should be considered as first-line therapy in patients like the one presented above. The limitation for its routine performance is the lack of available angiography operating room and trained interventional radio logy team.

Resumen: Objetivo: Describir una alternativa innovadora a la laparotomía exploradora en un recién nacido con un hematoma hepático subcapsular secundario a la inserción de un catéter venoso umbilical. Caso Clínico: Paciente de pretérmino con antecedentes de enfermedad de membrana hialina, hipertensión pulmonar y ductus arterioso persistente amplio, que requirió ventilación mecánica y uso de drogas vasoactivas. Se instalaron catéteres umbilicales, fueron controlados con radiografía de abdomen an teroposterior, en la que impresionaron estar adecuadamente posicionados. Evolucionó con mayor requerimiento de drogas vasoactivas, palidez de pared abdominal y distensión abdominal. Bajo eco grafía se diagnosticó un hematoma hepático subcapsular contenido, sin signos de sangrado activo, por lo que se decidió conducta expectante. Aumentó requerimiento de drogas vasoactivas y presentó caída de hematocrito. La ecografía de control encontró un hematoma subcapsular de mayor tamaño, abundante liquido perihepático y se confirmó la posición intraparenquimatosa de la punta del catéter umbilical. Se realizó embolización endovascular a través del catéter umbilical con Gelita®, logrando oclusión del trayecto capsular. La ecografía de control mostró disminución del hematoma. Es un procedimiento con menos comorbilidades y complicaciones que la laparotomía exploradora, por lo que debería ser una terapia de primera línea en pacientes como el presentado. Las limitaciones para su realización rutinaria son la disponibilidad de pabellón de angiografía y la presencia de un equipo entrenado de radiología intervencionista. Conclu siones: El uso de embolización por angiografía no es comúnmente utilizado en urgencias pediátricas.

Abstract INTRODUCTION: Cardiac involvement seems to impact prognosis of COVID-19, being more frequent in critically ill patients. We aimed to assess the prognostic value of right ventricular (RV) and left ventricular (LV) dysfunction, evaluated by bedside echocardiography (echo), in patients hospitalized with COVID-19. METHODS: Patients admitted in 2 reference hospitals in Brazil from Jul to Sept/2020 with confirmed COVID-19 and moderate/severe presentations underwent clinical and laboratory evaluation, and focused bedside echo (GE Vivid-IQ), at the earliest convenience, with remote interpretation. The association between demographics, clinical comorbidities and echo variables with all-cause hospital mortality was assessed, and factors significant at p<0.10 were put into multivariable models. RESULTS: Total 163 patients were enrolled, 59% were men, mean age 64±16 years, and 107 (66%) were admitted to intensive care. Comorbidities were present in 144 (88%) patients: hypertension 115 (71%), diabetes 61 (37%) and heart failure 22 (14%). In-hospital mortality was 34% (N=56). In univariate analysis, echo variables significantly associated with death were: LV ejection fraction (LVEF, OR=0.94), RV fractional area change (OR=0.96), tricuspid annular plane systolic excursion (TAPSE, OR=0.83) and RV dysfunction (OR=5.3). In multivariate analysis, after adjustment for clinical and demographic variables, independent predictors of mortality were age≥63 years (OR=5.53, 95%CI 1.52-20.17), LVEF<64% (OR=7.37, 95%CI 2.10-25.94) and TAPSE<18.5 mm (OR=9.43, 95% CI 2.57-35.03), and the final model had good discrimination, with C-statistic=0.83 (95%CI 0.75-0.91). CONCLUSION: Markers of RV and LV dysfunction assessed by bedside echo are independent predictors of mortality in hospitalized COVID-19 patients, after adjustment for clinical variables.

Abstract Background: Rheumatoid arthritis (RA) is a common autoimmune systemic inflammatory disease. In addition to joint involvement, RA patients frequently have other comorbidities, such as cardiovascular diseases. Drugs used for RA treatment may increase or decrease the risk of a cardiovascular event. This study aims to analyze cardiovascular risk comorbidities in patients with RA and the correlation with the use of anti-rheumatic drugs. Methods: Cross-sectional study conducted based on the real-life rheumatoid arthritis study database - REAL, a prospective observational cohort study. Associations between the use of anti-rheumatic drugs and the presence of comorbidities were represented by their prevalence ratio and evaluated using the Chi-square or Fisher’s Exact tests. Results: We assessed 1116 patients, 89.4% women, mean age of 55.15 years and predominance of seropositive disease. 63.3% had some cardiovascular comorbidity, predominantly hypertension (49.9%). The use of glucocorticoids was observed in 47.4% of patients and there was a significant tendency of lower use of these drugs in the presence of dyslipidemia (PR: 0.790; p = 0.007). We observed that the presence of cardiovascular comorbidities was associated with higher use of bDMARDs (PR:1.147; p = 0.003). Conclusions: The presence of cardiovascular risk comorbidities was confirmed to be higher in RA patients. Different treatment strategies using less glucocorticoids in the presence of dyslipidemia and more common use of bDMARDs in patients with cardiovascular comorbidities suggest that rheumatologists are aware of the potential influence of the DMARDs in the risk of cardiovascular event. Reinforcing these results, we highlight the need for a better baseline assessment to guide the choice of anti-rheumatic drugs in RA patients who have comorbidities.

RESUMO: O objetivo deste estudo foi investigar o efeito anestésico dos óleos essenciais (EOs) de Lippia alba (quimiotipos citral e linalool - EOLA-C e EOLA-L respectivamente) e Lippia origanoides (quimiotipo carvacrol- EOLO-Ca) em juvenis de tambaqui (Colossoma macropomum). As concentrações testadas dos EOs de L. alba e L. origanoides foram: 25, 50, 100 ou 200 μL/L. O tempo para atingir os estágios de sedação, anestesia profunda, recuperação e frequência ventilatória foram monitorados em cada concentração de EO. Os resultados indicam que todas as concentrações testadas dos OE induziram a anestesia do tambaqui e que a frequência ventilatória foi alterada pelos EOs. L. origanoides mostrou o tempo mais rápido para induzir sedação e anestesia, mas os tempos de recuperação foram longos. EO L. alba (citral 100 μL/L e linalol 200 μL/L) pode ser utilizado como anestésico em juvenis de tambaqui, pela eficiência em anestesiar e recuperar.

ABSTRACT: The aim of this study was to investigate the anesthetic effect of the essential oils (EOs) of Lippia alba (citral and linalool chemotypes, EOLA-C and EOLA-L respectively) and Lippia origanoides (chemotype carvacrol, EOLO-Ca) on tambaqui (Colossoma macropomum) juveniles. The tested concentrations of the L. alba and L. origanoides EOs were: 25, 50, 100, and 200 μL/L. Time required to reach the stages of sedation, deep anesthesia, and recovery, as well as ventilatory frequency, were monitored for each EO concentration. The results indicated that all EO concentrations tested induced tambaqui anesthesia and that the ventilatory frequency was altered by the EOs. L. origanoides showed the shortest time to induce sedation and anesthesia, but had long recovery times. L. alba EO (citral 100 μL/L and linalool 200 μL/L) can be used to efficiently anaesthetise tambaqui juveniles with an efficient recovery.

RESUMO Objetivo: caracterizar e comparar o desempenho ortográfico de estudantes com e sem Transtorno de Déficit de Atenção e Hiperatividade. Métodos: amostra composta de 244 alunos brasileiros de 3° ao 5° ano, de três escolas públicas (189 sem e 55 com transtorno), de ambos os sexos, avaliados por meio de um ditado de palavras por meio da classificação em tipos de erros ortográficos. O desempenho médio foi comparado por ano escolar, condição (com ou sem Transtorno de Déficit de Atenção e Hiperatividade) e interação entre ano e condição. As médias também foram comparadas com resultados de pesquisa de Moojen (2011), um estudo sobre desempenho ortográfico no Ensino Fundamental. Resultados: os estudantes com o transtorno evidenciaram maior média no total de erros e nas tipologias Conversor Fonema/Grafema, Regras Contextuais Simples e Irregularidades da Língua. No grupo sem Transtorno de Déficit de Atenção e Hiperatividade houve uma maior redução de erros entre os anos escolares (3°, 4° e 5° ano). Em relação ao estudo de Moojen (2011), os alunos com o transtorno apresentaram média inferior. Conclusão: as evidências mostraram que a presença do Transtorno de Déficit de Atenção e Hiperatividade influenciou o desempenho ortográfico dos estudantes avaliados.

ABSTRACT Purpose: to characterize and compare the spelling performance of students with and without Attention Deficit Hyperactivity Disorder. Methods: sample including 244 Brazilian students from the 3rd to the 5th year, from three public schools (189 without and 55 with the disorder). Students were assessed and classified according to the spelling errors in a word dictation. The average performance was compared per school year, condition (having Attention Deficit Hyperactivity Disorder or not) and interaction between year and condition. The performance was also compared to the results of the study by Moojen (2011), on orthographic performance in Elementary School. Results: students with Attention Deficit Hyperactivity Disordershowed a higher average in the total number of errors, in the Phoneme/Grapheme Conversion, Simple Contextual Rules and Language Irregularities categories. In the group without Attention Deficit Hyperactivity Disorder, there was a greater reduction of errors among the school grades (3rd, 4th, 5th). In relation to the study by Moojen (2011), students with the disorder had a lower average. Conclusion: evidence showed that the presence ofAttention Deficit Hyperactivity Disorderinfluenced the spelling performance of the students evaluated.

Abstract This study compared the effects of two metacognitive interventions on writing, working memory (WM), and behavioral symptoms of students with attention-deficit/hyperactivity disorder (ADHD). The disorder was clinically diagnosed by a multidisciplinary team according to DSM-IV criteria. The first approach consisted of a combined intervention in text production and WM while the second focused only on WM. Participants were 47 students from the fifth to ninth grades of two public elementary schools in Porto Alegre (Brazil), randomized to one of the two interventions groups. Writing and WM were assessed before, immediately after, and 3 months after the interventions. The results suggest that both interventions contributed to improving behavior and school performance, whereas only the combined intervention increased the overall quality of narrative text, organization of paragraphs, and denouement.

RESUMO Objetivo: analisar as circunstâncias da criação do primeiro curso de graduação em enfermagem do Espírito Santo a partir da expansão dos cursos de graduação em enfermagem no Brasil na década de 1970. Método: estudo sócio-histórico documental, com abordagem qualitativa. O recorte temporal compreende o período de 1972 a 1976, sendo o marco inicial demarcado pela III Reunião de Ministros da Saúde das Américas, ocorrida no Chile. Foram utilizadas como fontes primárias centrais dois documentos escritos: o relatório do trabalho intitulado “Dados sobre a formação do pessoal de enfermagem do Brasil”, produzido pela Comissão de Documentação e Estudos da Associação Brasileira de Enfermagem, publicado em 1969, e o relatório “Desenvolvimento do Ensino Superior de Enfermagem no Brasil”, publicado pelo Departamento de Assuntos Universitários do Ministério da Educação e da Cultura, em 1979. Resultados: a expansão do número de cursos de graduação em enfermagem no Brasil na década de 1970, a partir do Plano Decenal de Saúde Para as Américas, propiciou condições favoráveis para criação do primeiro curso de graduação em enfermagem do Espírito Santo. Conclusão: o Brasil, por meio do Departamento de Assuntos Universitários do Ministério da Educação e da Cultura e com o apoio da Associação Brasileira de Enfermagem, iniciou uma política de desenvolvimento da enfermagem, onde foram criados, na década de 1970, um expressivo número de cursos de graduação em enfermagem, possibilitando além do aumento do quantitativo de enfermeiros uma melhor distribuição geográfica desses profissionais.

ABSTRACT Objective: to analyze the circumstances of the creation of the first nursing undergraduate course in Espírito Santo from the expansion of nursing undergraduate courses in Brazil in the 1970s. Method: socio-historical documentary study, with a qualitative approach. The period covered was from 1972 to 1976, the initial milestone set by the III Meeting of the Ministers of Health of the Americas, held in Chile. Two written documents were used as central primary sources: the report of the work entitled “Data on the Training of Nursing Personnel in Brazil”, produced by the Documentation and Studies Commission of the Brazilian Nursing Association, published in 1969, and the report “Nursing Higher Education Development in Brazil”, published by the Department of University Affairs of the Ministry of Education and Culture in 1979. Results: The increase in the number of undergraduate nursing courses in Brazil in the 1970s, based on the Ten-Year Health Plan for the Americas, provided favorable conditions for the creation of the first nursing undergraduate course in Espírito Santo. Conclusion: Brazil, through the Department of University Affairs of the Ministry of Education and Culture and with the support of the Brazilian Nursing Association, initiated a nursing development policy, in which, during the 1970s, a significant number undergraduate courses in nursing were created, allowing a better geographical distribution of nurses in addition to the increase in the number of these professionals.

RESUMEN Objetivo: analizar las circunstancias de la creación del primer curso de graduación en enfermería del Espírito Santo a partir de la expansión de los cursos de graduación en enfermería en Brasil en la década de 1970. Método: estudio socio-histórico documental, con abordaje cualitativo. El recorte temporal comprende el período de 1972 a 1976, siendo el marco inicial demarcado por la III Reunión de Ministros de Salud de las Américas, ocurrida en Chile. Se utilizaron como fuentes primarias centrales dos documentos escritos: el informe del trabajo titulado “Datos sobre la forma-ción del personal de enfermería de Brasil”, producido por la Comisión de Documentación y Estudios de la Asociación Brasileña de Enfermería, publicado en 1969, y el informe “Desarrollo de la Enseñanza Superior de Enfermería en Brasil”, publicado por el Departamento de Asuntos Universitarios del Ministerio de Educación y Cultura en 1979. Resultados: la expansión del número de cursos de graduación en enfermería en Brasil en la década de 1970, a partir del Plan Decenal de Salud para las Américas, propició condiciones favorables para la creación del primer curso de graduación en enfermería del Espíritu Santo. Conclusión: Brasil, a través del Departamento de Asuntos Universitarios del Ministerio de Educación y Cultura y con el apoyo de la Asociación Brasileña de Enfermería, inició una política de desarrollo de la enfermería, donde se crearon, en la década de 1970, un expresivo número de cursos de graduación en enfermería, posibilitando además del autismo del cuantitativo de enfermeros una mejor distribución geográfica de esos profesionales.

ABSTRACT Objective: to analyze the circumstances of the creation of the first nursing undergraduate course in Espírito Santo from the expansion of nursing undergraduate courses in Brazil in the 1970s. Method: socio-historical documentary study, with a qualitative approach. The period covered was from 1972 to 1976, the initial milestone set by the III Meeting of the Ministers of Health of the Americas, held in Chile. Two written documents were used as central primary sources: the report of the work entitled “Data on the Training of Nursing Personnel in Brazil”, produced by the Documentation and Studies Commission of the Brazilian Nursing Association, published in 1969, and the report “Nursing Higher Education Development in Brazil”, published by the Department of University Affairs of the Ministry of Education and Culture in 1979. Results: The increase in the number of undergraduate nursing courses in Brazil in the 1970s, based on the Ten-Year Health Plan for the Americas, provided favorable conditions for the creation of the first nursing undergraduate course in Espírito Santo. Conclusion: Brazil, through the Department of University Affairs of the Ministry of Education and Culture and with the support of the Brazilian Nursing Association, initiated a nursing development policy, in which, during the 1970s, a significant number undergraduate courses in nursing were created, allowing a better geographical distribution of nurses in addition to the increase in the number of these professionals.

RESUMEN Objetivo: analizar las circunstancias de la creación del primer curso de graduación en enfermería del Espírito Santo a partir de la expansión de los cursos de graduación en enfermería en Brasil en la década de 1970. Método: estudio socio-histórico documental, con abordaje cualitativo. El recorte temporal comprende el período de 1972 a 1976, siendo el marco inicial demarcado por la III Reunión de Ministros de Salud de las Américas, ocurrida en Chile. Se utilizaron como fuentes primarias centrales dos documentos escritos: el informe del trabajo titulado “Datos sobre la forma-ción del personal de enfermería de Brasil”, producido por la Comisión de Documentación y Estudios de la Asociación Brasileña de Enfermería, publicado en 1969, y el informe “Desarrollo de la Enseñanza Superior de Enfermería en Brasil”, publicado por el Departamento de Asuntos Universitarios del Ministerio de Educación y Cultura en 1979. Resultados: la expansión del número de cursos de graduación en enfermería en Brasil en la década de 1970, a partir del Plan Decenal de Salud para las Américas, propició condiciones favorables para la creación del primer curso de graduación en enfermería del Espíritu Santo. Conclusión: Brasil, a través del Departamento de Asuntos Universitarios del Ministerio de Educación y Cultura y con el apoyo de la Asociación Brasileña de Enfermería, inició una política de desarrollo de la enfermería, donde se crearon, en la década de 1970, un expresivo número de cursos de graduación en enfermería, posibilitando además del autismo del cuantitativo de enfermeros una mejor distribución geográfica de esos profesionales.

RESUMO Objetivo: analisar as circunstâncias da criação do primeiro curso de graduação em enfermagem do Espírito Santo a partir da expansão dos cursos de graduação em enfermagem no Brasil na década de 1970. Método: estudo sócio-histórico documental, com abordagem qualitativa. O recorte temporal compreende o período de 1972 a 1976, sendo o marco inicial demarcado pela III Reunião de Ministros da Saúde das Américas, ocorrida no Chile. Foram utilizadas como fontes primárias centrais dois documentos escritos: o relatório do trabalho intitulado “Dados sobre a formação do pessoal de enfermagem do Brasil”, produzido pela Comissão de Documentação e Estudos da Associação Brasileira de Enfermagem, publicado em 1969, e o relatório “Desenvolvimento do Ensino Superior de Enfermagem no Brasil”, publicado pelo Departamento de Assuntos Universitários do Ministério da Educação e da Cultura, em 1979. Resultados: a expansão do número de cursos de graduação em enfermagem no Brasil na década de 1970, a partir do Plano Decenal de Saúde Para as Américas, propiciou condições favoráveis para criação do primeiro curso de graduação em enfermagem do Espírito Santo. Conclusão: o Brasil, por meio do Departamento de Assuntos Universitários do Ministério da Educação e da Cultura e com o apoio da Associação Brasileira de Enfermagem, iniciou uma política de desenvolvimento da enfermagem, onde foram criados, na década de 1970, um expressivo número de cursos de graduação em enfermagem, possibilitando além do aumento do quantitativo de enfermeiros uma melhor distribuição geográfica desses profissionais.