ABSTRACT BACKGROUND: Considering the ability of the health and self-management in diabetes questionnaire (HASMID-10) to verify the impact of self-management on diabetes, we highlight its relevance to scientific research and clinical applicability. However, to date, no study has been conducted to scientifically support its use in other languages. OBJECTIVE: To translate, cross-culturally adapt, and validate the HASMID-10 into the Brazilian Portuguese. DESIGN AND SETTING: A translation, cross-cultural adaptation, and validation study conducted at Ceuma University. METHODS: Study was conducted in accordance with the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and Consensus-based Standards for the Selection of Health Measurement Instruments. We included participants of both sexes diagnosed with diabetes, aged between 18 and 64 years, and without cognitive deficits or any other limitations that would prevent them from answering the questionnaire. We assessed participants using the problem areas in diabetes (PAID) scale and HASMID-10. We assessed reliability using a test-retest model with a 7-day interval between assessments. We used intraclass correlation coefficient (ICC), 95% confidence interval (CI), standard error of measurement (SEM), minimum detectable difference (MDD), Spearman correlation coefficient, and floor and ceiling effects. RESULTS: Sample comprised 116 participants, most of whom were women, overweight, non-practitioners of physical activity, and nonsmokers. We observed significant correlations (P = 0.006; rho = −0.256) between the HASMID-10 and PAID, adequate reliability (ICC = 0.780) and internal consistency (Cronbach's alpha = 0.796). No ceiling or floor effects were observed. CONCLUSION: HASMID-10 has adequate measurement properties and may be used for Brazilians.

ABSTRACT BACKGROUND: Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas. OBJECTIVE: This study aimed to systematically review the literature on the knowledge and attitudes of rural healthcare providers regarding cases of domestic violence against women. DESIGN AND SETTING: Systematic review developed at Universidade Federal de Uberlândia. METHODS: We conducted an electronic search of six databases, which only included observational studies, regardless of the year, language, or country of publication, except for studies that used secondary data and were exclusively qualitative. Two reviewers performed the selection, data extraction, and risk of bias assessment using a specific Joanna Briggs Institute tool. RESULTS: Six studies met the inclusion criteria. All the studies had a low risk of bias. Approximately 38% of these professionals identified injuries caused by violence in patients. When asked about knowing the correct attitude to take in cases of confirmed violence, between 12% and 64% of rural healthcare providers answered positively; most of them would refer to specialized institutions and promote victim empowerment and counseling. The number of professionals with an educational background in the field ranged from 16% to 98%. CONCLUSIONS: The evident disparity across studies shows that some professionals have suboptimal knowledge and require training to adopt the correct attitude when identifying female victims of domestic violence in clinical practice. SYSTEMATIC REVIEW REGISTRATION: This systematic review was registered in the Open Science Framework Database under the registration http://doi.org/10.17605/OSF.IO/B7Q6S.

Hypertension is one of the primary modifiable risk factors for morbidity and mortality worldwide, being a major risk factor for coronary artery disease, stroke, and kidney failure. Furthermore, it is highly prevalent, affecting more than one-third of the global population. Blood pressure measurement is a MANDATORY procedure in any medical care setting and is carried out by various healthcare professionals. However, it is still commonly performed without the necessary technical care. Since the diagnosis relies on blood pressure measurement, it is clear how important it is to handle the techniques, methods, and equipment used in its execution with care. It should be emphasized that once the diagnosis is made, all short-term, medium-term, and long-term investigations and treatments are based on the results of blood pressure measurement. Therefore, improper techniques and/or equipment can lead to incorrect diagnoses, either underestimating or overestimating values, resulting in inappropriate actions and significant health and economic losses for individuals and nations. Once the correct diagnosis is made, as knowledge of the importance of proper treatment advances, with the adoption of more detailed normal values and careful treatment objectives towards achieving stricter blood pressure goals, the importance of precision in blood pressure measurement is also reinforced. Blood pressure measurement (described below) is usually performed using the traditional method, the so-called casual or office measurement. Over time, alternatives have been added to it, through the use of semi-automatic or automatic devices by the patients themselves, in waiting rooms or outside the office, in their own homes, or in public spaces. A step further was taken with the use of semi-automatic devices equipped with memory that allow sequential measurements outside the office (ABPM; or HBPM) and other automatic devices that allow programmed measurements over longer periods (HBPM). Some aspects of blood pressure measurement can interfere with obtaining reliable results and, consequently, cause harm in decision-making. These include the importance of using average values, the variation in blood pressure during the day, and short-term variability. These aspects have encouraged the performance of a greater number of measurements in various situations, and different guidelines have advocated the use of equipment that promotes these actions. Devices that perform HBPM or ABPM, which, in addition to allowing greater precision, when used together, detect white coat hypertension (WCH), masked hypertension (MH), sleep blood pressure alterations, and resistant hypertension (RHT) (defined in Chapter 2 of this guideline), are gaining more and more importance. Taking these details into account, we must emphasize that information related to diagnosis, classification, and goal setting is still based on office blood pressure measurement, and for this reason, all attention must be given to the proper execution of this procedure.

La hipertensión arterial (HTA) es uno de los principales factores de riesgo modificables para la morbilidad y mortalidad en todo el mundo, siendo uno de los mayores factores de riesgo para la enfermedad de las arterias coronarias, el accidente cerebrovascular (ACV) y la insuficiencia renal. Además, es altamente prevalente y afecta a más de un tercio de la población mundial. La medición de la presión arterial (PA) es un procedimiento OBLIGATORIO en cualquier atención médica o realizado por diferentes profesionales de la salud. Sin embargo, todavía se realiza comúnmente sin los cuidados técnicos necesarios. Dado que el diagnóstico se basa en la medición de la PA, es claro el cuidado que debe haber con las técnicas, los métodos y los equipos utilizados en su realización. Debemos enfatizar que una vez realizado el diagnóstico, todas las investigaciones y tratamientos a corto, mediano y largo plazo se basan en los resultados de la medición de la PA. Por lo tanto, las técnicas y/o equipos inadecuados pueden llevar a diagnósticos incorrectos, subestimando o sobreestimando valores y resultando en conductas inadecuadas y pérdidas significativas para la salud y la economía de las personas y las naciones. Una vez realizado el diagnóstico correcto, a medida que avanza el conocimiento sobre la importancia del tratamiento adecuado, con la adopción de valores de normalidad más detallados y objetivos de tratamiento más cuidadosos hacia metas de PA más estrictas, también se refuerza la importancia de la precisión en la medición de la PA. La medición de la PA (descrita a continuación) generalmente se realiza mediante el método tradicional, la llamada medición casual o de consultorio. Con el tiempo, se han agregado alternativas a través del uso de dispositivos semiautomáticos o automáticos por parte del propio paciente, en salas de espera o fuera del consultorio, en su propia residencia o en espacios públicos. Se dio un paso más con el uso de dispositivos semiautomáticos equipados con memoria que permiten mediciones secuenciales fuera del consultorio (AMPA; o MRPA) y otros automáticos que permiten mediciones programadas durante períodos más largos (MAPA). Algunos aspectos en la medición de la PA pueden interferir en la obtención de resultados confiables y, en consecuencia, causar daños en las decisiones a tomar. Estos incluyen la importancia de usar valores promedio, la variación de la PA durante el día y la variabilidad a corto plazo. Estos aspectos han alentado la realización de un mayor número de mediciones en diversas situaciones, y diferentes pautas han abogado por el uso de equipos que promuevan estas acciones. Los dispositivos que realizan MRPA o MAPA, que además de permitir una mayor precisión, cuando se usan juntos, detectan la hipertensión de bata blanca (HBB), la hipertensión enmascarada (HM), las alteraciones de la PA durante el sueño y la hipertensión resistente (HR) (definida en el Capítulo 2 de esta guía), están ganando cada vez más importancia. Teniendo en cuenta estos detalles, debemos enfatizar que la información relacionada con el diagnóstico, la clasificación y el establecimiento de objetivos todavía se basa en la medición de la presión arterial en el consultorio, y por esta razón, se debe prestar toda la atención a la ejecución adecuada de este procedimiento.

A hipertensão arterial (HA) é um dos principais fatores de risco modificáveis para morbidade e mortalidade em todo o mundo, sendo um dos maiores fatores de risco para doença arterial coronária, acidente vascular cerebral (AVC) e insuficiência renal. Além disso, é altamente prevalente e atinge mais de um terço da população mundial. A medida da PA é procedimento OBRIGATÓRIO em qualquer atendimento médico ou realizado por diferentes profissionais de saúde. Contudo, ainda é comumente realizada sem os cuidados técnicos necessários. Como o diagnóstico se baseia na medida da PA, fica claro o cuidado que deve haver com as técnicas, os métodos e os equipamentos utilizados na sua realização. Deve-se reforçar que, feito o diagnóstico, toda a investigação e os tratamentos de curto, médio e longo prazos são feitos com base nos resultados da medida da PA. Assim, técnicas e/ou equipamentos inadequados podem levar a diagnósticos incorretos, tanto subestimando quanto superestimando valores e levando a condutas inadequadas e grandes prejuízos à saúde e à economia das pessoas e das nações. Uma vez feito o diagnóstico correto, na medida em que avança o conhecimento da importância do tratamento adequado, com a adoção de valores de normalidade mais detalhados e com objetivos de tratamento mais cuidadosos no sentido do alcance de metas de PA mais rigorosas, fica também reforçada a importância da precisão na medida da PA. A medida da PA (descrita a seguir) é habitualmente feita pelo método tradicional, a assim chamada medida casual ou de consultório. Ao longo do tempo, foram agregadas alternativas a ela, mediante o uso de equipamentos semiautomáticos ou automáticos pelo próprio paciente, nas salas de espera ou fora do consultório, em sua própria residência ou em espaços públicos. Um passo adiante foi dado com o uso de equipamentos semiautomáticos providos de memória que permitem medidas sequenciais fora do consultório (AMPA; ou MRPA) e outros automáticos que permitem medidas programadas por períodos mais prolongados (MAPA). Alguns aspectos na medida da PA podem interferir na obtenção de resultados fidedignos e, consequentemente, causar prejuízo nas condutas a serem tomadas. Entre eles, estão: a importância de serem utilizados valores médios, a variação da PA durante o dia e a variabilidade a curto prazo. Esses aspectos têm estimulado a realização de maior número de medidas em diversas situações, e as diferentes diretrizes têm preconizado o uso de equipamentos que favoreçam essas ações. Ganham cada vez mais espaço os equipamentos que realizam MRPA ou MAPA, que, além de permitirem maior precisão, se empregados em conjunto, detectam a HA do avental branco (HAB), HA mascarada (HM), alterações da PA no sono e HA resistente (HAR) (definidos no Capítulo 2 desta diretriz). Resguardados esses detalhes, devemos ressaltar que as informações relacionadas a diagnóstico, classificação e estabelecimento de metas ainda são baseadas na medida da PA de consultório e, por esse motivo, toda a atenção deve ser dada à realização desse procedimento.

Abstract Objective The aim of this study was to analyze the effects of fluid overload related to mechanical ventilation, renal replacement therapy, and evolution to discharge or death in critically ill children. Methods A retrospective study in a Pediatric Intensive Care Unit for two years. Patients who required invasive ventilatory support and vasopressor and/or inotropic medications were considered critically ill. Results 70 patients were included. The mean age was 6.8 ± 6 years. There was a tolerable increase in fluid overload during hospitalization, with a median of 2.45% on the first day, 5.10% on the third day, and 8.39% on the tenth day. The median fluid overload on the third day among those patients in pressure support ventilation mode was 4.80% while the median of those who remained on controlled ventilation was 8.45% (p = 0.039). Statistical significance was observed in the correlations between fluid overload measurements on the first, third, and tenth days of hospitalization and the beginning of renal replacement therapy (p = 0.049) and between renal replacement therapy and death (p = 0.01). The median fluid overload was 7.50% in patients who died versus 4.90% in those who did not die on the third day of hospitalization (p = 0.064). There was no statistically significant association between death and the variables sex or age. Conclusions The fluid overload on the third day of hospitalization proved to be a determinant for the clinical outcomes of weaning from mechanical ventilation, initiation of renal replacement therapy, discharge from the intensive care unit, or death among these children.

ABSTRACT Objective: to analyze the prevalence of practices in childbirth care, obstetric and neonatal adverse events and their association with care models in three public health services. Method: this is a prospective cohort study carried out with 548 dyads, postpartum women and their newborns, whose pregnancy was of usual risk and vaginal birth, admitted to hospital in three public services, one with an exclusive care model by nurse-midwives (service A), one with a collaborative model involving obstetric doctors and nurses (service B) and one with an exclusive medical care model (service C). Initially, an interview was carried out with participants, and a second contact was carried out 42 days after birth to complement the collection of the adverse event outcome. Results: in service A, no woman underwent the Kristeller maneuver, episiotomy, directed pushing or more than one vaginal examination per hour. Meanwhile, in service C, 19.3%, 39.9%, 77.1% and 26.3% of women underwent these interventions, respectively. Adverse events occurred in 19.2% of the dyads. Occurrence of adverse events was associated with not using partograph (p=0.001; OR: 11.03; CI: 2.64-45.99) and episiotomy (p=0.042; OR: 1.72; CI: 1. 02-2.91). The mean probability of experiencing an adverse event was 5% in service A, 21% in service B and 24% in service C. Conclusion: adverse events had a lower mean probability of occurrence in the service exclusively operated by nurse-midwives, in which greater application of recommendations for labor and birth care was identified.

RESUMEN Objetivo: analizar la prevalencia de prácticas en la atención del childbirth, eventos adversos obstétricos y neonatales y su asociación con los modelos de atención en tres servicios públicos de salud. Método: estudio de cohorte prospectivo realizado con 548 binomios, puérperas y sus recién nacidos, cuyo embarazo fue de riesgo habitual y childbirth vaginal, hospitalizados en tres servicios públicos, uno con modelo de atención exclusiva por enfermeras obstétricas (servicio A), otro con modelo colaborativo. modelo con la labor de médicos y enfermeras obstetras (servicio B) y otro con un modelo de asistencia médica exclusiva (servicio C). Inicialmente se realizó una entrevista a los participantes y se realizó un segundo contacto a los 42 días del nacimiento para complementar la recopilación del resultado del evento adverso. Resultados: en el servicio A ninguna mujer fue sometida a maniobra de Kristeller, episiotomía, pujo dirigido o más de un examen vaginal por hora. Mientras tanto, en el servicio C, el 19,3%, 39,9%, 77,1% y 26,3% de las mujeres se sometieron a estas intervenciones, respectivamente. Los eventos adversos ocurrieron en el 19,2% de los binomios. La aparición de eventos adversos se asoció con la no utilización del partographa (p=0,001; OR: 11,03; IC: 2,64-45,99) y episiotomía (p=0,042; OR: 1,72; IC: 1,02-2,91). La probabilidad promedio de experimentar un evento adverso fue del 5% en el servicio A, del 21% en el servicio B y del 24% en el servicio C. Conclusión: los eventos adversos tuvieron menor probabilidad promedio de ocurrencia en el servicio operado exclusivamente por enfermeras obstétricas, en el que se identificó mayor aplicación de las recomendaciones de asistencia al childbirth y nacimiento.

RESUMO Objetivo: analisar a prevalência de práticas na atenção ao parto, eventos adversos obstétricos e neonatais e sua associação com modelos assistenciais em três serviços de saúde públicos. Método: estudo coorte prospectivo realizado com 548 binômios, puérperas e seus recém-nascidos, cuja gestação foi de risco habitual e o parto vaginal, internados em três serviços públicos, sendo um com modelo de assistência exclusivo por enfermeiras obstetras (serviço A), um com modelo colaborativo com atuação de médicos e enfermeiras obstetras (serviço B) e um com modelo de assistência exclusiva médica (serviço C). Inicialmente, foi realizada uma entrevista com as participantes e um segundo contato foi realizado após 42 dias do parto para complementar a coleta do desfecho evento adverso. Resultados: no serviço A, nenhuma mulher foi submetida à manobra de Kristeller, episiotomia, incentivos a puxos dirigidos ou mais de um toque vaginal por hora. Enquanto, no serviço C, 19,3%, 39,9%, 77,1% e 26,3% das mulheres foram submetidas a essas intervenções, respectivamente. Os eventos adversos ocorreram em 19,2% dos binômios. A ocorrência dos eventos adversos foi associada ao não uso do partograma (p=0,001; OR: 11,03; IC: 2,64-45,99) e episiotomia (p=0,042; OR: 1,72; IC: 1,02-2,91). A probabilidade média de apresentar algum evento adverso foi de 5% no serviço A, 21% no serviço B e 24% no serviço C. Conclusão: os eventos adversos apresentaram menor probabilidade média de ocorrência no serviço com atuação exclusiva de enfermeiras obstetras, no qual se identificou maior aplicação das recomendações para assistência ao parto e nascimento.

Abstract Oral cancer is a public health problem worldwide with approximately 300,000 new cases diagnosed every year and more than 170,000 deaths annually. Squamous cell carcinoma (SCC) accounts for approximately 90% of all oral malignancies and it is frequently preceded by lesions known as oral potentially malignant disorders (OPMDs). Screening programs for early detection of oral lesions have been conducted. Therefore, the objective of this research was to carry out an active search in a screening program in the city of Piracicaba, Brazil. High-risk patients were identified at the city’s health center through their medical records and referred for dental consultation. Other patients who opportunistically sought dental care were also seen and if they did not present risk factors for SCC, they were considered low-risk. A total of 756 patients were examined, and 445 met the criteria for the high-risk group and 311 for the low-risk group. It was possible to diagnose 27 OPMDs and six SCCs – 21 OPMDs and six SCCs occurred in high-risk patients and six OPMDs in low-risk patients. A chi-square test was applied and a statistically significant value (p = 0.006) was obtained for the detection of OPMD and SCC in patients of the high-risk group. Screening of high-risk patients through active search proved to be an effective program for diagnosing OPMD and SCC. Therefore, we encourage its implementation on a large scale to reduce the current scenario of this disease.

Abstract The objective of this study was to evaluate the performance of a handheld NIR spectrometer for non-destructive quality analysis of apples and pears produced in the Brazilian Semi-arid region. NIR spectra were acquired with a portable spectrometer in the wavelength range of 750–1065 nm and reference analyses of dry matter content (DMC) and soluble solids content (SSC) were measured weekly during 10 weeks of storage at 0.5 °C. Spectra were pre-processed with standard normal variate and used to develop DMC and SSC models using partial least squares regression with full cross-validation. The models were validated using data not included in the calibration. Satisfactory prediction results were obtained for SSC in apples (R² = 0.58) and pears (R² = 0.55), and for DMC in apples (R² = 0.55) and pears (R² = 0.65). All prediction models showed a relative root mean square error of prediction lower than 8%. These findings indicate that the NIR spectrometer is a promising tool to be used for a rapid and non-destructive determination of internal quality traits in apples and pears.

Resumo O objetivo deste estudo foi avaliar o desempenho de um espectrômetro portátil NIR na análise não destrutiva da qualidade de maçãs e peras produzidas na região semiárida brasileira. Os espectros NIR foram coletados com um espectrômetro portátil na faixa de comprimentos de onda de 750–1.065 nm, e as análises de referência de conteúdo de matéria seca (CMS) e conteúdo de sólidos solúveis (CSS) foram mensurados semanalmente durante 10 semanas de armazenamento a 0,5 °C. Os espectros foram pré-processados com a variação normal padrão e utilizados para desenvolver modelos de CMS e CSS usando a regressão dos quadrados mínimos parciais com validação cruzada completa. Os modelos foram validados externamente usando dados não incluídos na calibração. Resultados de predição satisfatórios foram obtidos para CSS em maçãs (R² = 0.58) e peras (R² = 0.55), e para CMS em maçãs (R² = 0.55) e peras (R² = 0.65). Todos os modelos de predição apresentaram raiz quadrada do erro médio quadrático de predição relativo menor que 8%. Estes resultados indicam que o espectrômetro NIR é uma ferramenta promissora para uma determinação rápida e não destrutiva dos atributos de qualidade interna de maçãs e peras.

Abstract The objective of this work was to evaluate the effects of additives and storage time on the quality and aerobic deterioration of silages of pineapple crop waste. A completely randomized design was used, in a 3×3 factorial arrangement, with three treatments: pineapple waste silage without additives or with the addition of cornmeal or wheat bran (20% fresh matter) at three storage times (60, 90, and 120 days). After each storage time, losses and aerobic deterioration were quantified, chemical composition was analyzed, and digestibility assays were performed. The storage time of 120 days resulted in higher dry matter losses in all treatments. The additives incremented the dry matter contents of the pineapple-based silages, which went from 182.1 g kg−1 (control silage) to 298.7 and 297.6 g kg−1 (cornmeal and wheat bran, respectively). The control silage with the addition of cornmeal showed the highest dry matter digestibility (739.7 g kg−1) and lowest neutral detergent fiber content (251.9 g kg−1). The production of CO2 started to increase on the first day of air exposure in silages without additives, but only after six days in those with additives. Including cornmeal as an additive in the silage of pineapple crop waste improves its digestibility and reduces its deterioration speed.

Resumo O objetivo deste trabalho foi avaliar os efeitos de aditivos e tempos de armazenamento sobre a qualidade e a deterioração aeróbia de silagens de resíduos de cultura do abacaxi. Utilizou-se um delineamento inteiramente casualizado, em arranjo fatorial 3×3, com três tratamentos: silagem de resíduos culturais de abacaxi sem aditivo ou aditivada com fubá de milho ou farelo de trigo (20% da matéria fresca), em três tempos de armazenamento (60, 90 e 120 dias). Após cada tempo de armazenamento, realizaram-se quantificações de perdas e deterioração aeróbia, análises da composição química e ensaios de digestibilidade. O tempo de armazenamento por 120 dias resultou em maiores perdas de matéria seca em todos os tratamentos. Os aditivos incrementaram os teores de matéria seca das silagens à base de abacaxi, que passaram de 182,1 g kg−1 (silagem controle) para 298,7 e 297,6 g kg−1 (fubá de milho e farelo de trigo, respectivamente). A silagem controle adicionada de fubá de milho apresentou maior digestibilidade da matéria seca (739,7 g kg−1) e menor teor de fibra em detergente neutro (251,9 g kg−1). A produção de CO2 aumentou a partir do primeiro dia de exposição ao ar nas silagens não aditivadas, mas apenas a partir do sexto dia nas aditivadas. A inclusão do fubá de milho como aditivo na silagem de resíduos de abacaxi melhora sua digestibilidade e reduz sua velocidade de deterioração.

ABSTRACT Purpose: to investigate, examine and synthesize evidence from studies on permanent education for health professionals aimed at the covid-19 pandemic. Methods: six national and international indexed sources will be searched. The review will include studies with any methodological approach, addressing permanent education for health professionals during the covid-19 pandemic. The context of health services in any scenario will be considered - national or international primary, specialized, or hospital healthcare. Final Considerations: research results are expected to reveal the topics approached in permanent health education in various national and international contexts. The review will also list the gains and problems found in various places while applying permanent education as a strategy to fight the covid-19 pandemic.

RESUMO Objetivo: investigar/examinar e sintetizar evidências de estudos sobre Educação Permanente para profissionais da saúde voltada para a pandemia da covid-19. Métodos: serão realizadas buscas em seis fontes indexadas nacionais e internacionais. Serão incluídos estudos de qualquer natureza metodológica, que abordem o uso da Educação Permanente para profissionais da saúde na pandemia da covid-19. Será considerado o contexto de serviços de saúde em qualquer cenário, seja a atenção primária, especializada ou hospitalar nos âmbitos nacional e internacional. Considerações Finais: espera-se que os resultados desta pesquisa revelem as temáticas abordadas ao longo das ações de Educação Permanente em diversos contextos nacionais e internacionais. Além disso, serão elencados os ganhos obtidos e os problemas encontrados em diversos territórios no contexto da aplicação da Educação Permanente como estratégia de enfrentamento à pandemia da covid-19.

Resumo A preocupação com a exploração desenfreada dos recursos naturais tem aumentado nas últimas décadas, principalmente envolvendo a água e seu tratamento. Paradoxalmente, uma das fontes de poluição da água é justamente o seu tratamento, devido ao uso de floculantes químicos, que acabam gerando lodos que podem ser altamente agressivos ao meio ambiente. Uma das formas de resolver este problema é utilizar floculantes naturais para esta finalidade, uma vez que são biodegradáveis e não agridem a natureza. O objetivo deste trabalho foi avaliar a eficiência de um floculante natural produzido com taninos extraídos da casca do cajueiro (Anacardium occidentale) e compará-lo com dois coagulantes comerciais, Tanfloc® e cloreto de ferro. A água para tratamento foi coletada de um açude. A casca do cajueiro foi coletada, moída e submetida à extração em água quente para obtenção dos taninos, e o produto da extração foi cationizado. Os testes de floculação foram realizados utilizando-se o jar test com soluções nas concentrações de 33,3, 66,7 e 100 mg L-1. A turbidez e o pH foram analisados antes e após a floculação. Dentre os floculantes avaliados, os taninos cationizados produziram as melhores respostas tanto para remoção de turbidez quanto para pH final da água tratada. O Tanfloc® também apresentou resultados satisfatórios quanto à remoção de turbidez. O cloreto de ferro, além de não clarificar adequadamente a água, a deixou muito ácida. Como os taninos cationizados praticamente não alteraram o pH e foram eficazes na remoção da turbidez, consistem em um produto interessante para o tratamento da água.

Abstract Concern about the overexploitation of natural resources has increased in recent decades, especially involving water and its treatment. Paradoxically, one of the sources of water pollution is the treatment itself, due to the use of chemical flocculants, which end up generating sludge that may be highly aggressive to the environment. One of the ways to solve this problem is to use natural flocculants for this purpose, since they are biodegradable and do not harm nature. This study evaluated the efficiency of a natural flocculant produced from tannins extracted from the bark of the cashew tree (Anacardium occidentale) and compared it with two commercial coagulants, Tanfloc® and iron chloride. The water for treatment was collected from a weir. The cashew trees’ bark was collected, ground, and submitted to hot-water extraction to yield the tannins, and the extraction product was cationized. The flocculation tests were carried out using the jar test with solutions having concentrations of 33.3, 66.7, and 100 mg L-1. Turbidity and pH were analyzed before and after flocculation. Among the assessed flocculants, the cationized tannins produced the best responses both for removal of turbidity and final pH of the treated water. Tanfloc® also produced satisfactory results regarding turbidity removal. The iron chloride, besides not properly clarifying the water, left it very acidic. Since the cationized tannins practically did not change the pH and were effective in the removal of turbidity, they represent an interesting, sustainable alternative product to treat the water.

Temporomandibular disorder (TMD) is recognized for its high prevalence, presenting characteristic signs and symptoms. Cervical spine pain is present in 70% of diagnosed TMD cases. Aim To verify if women with TMD present changes in isometric muscle strength in the scapula elevation. Methods This is an observational, cross-sectional study. Thirty-five women, aged 22.89±2.04 years, were divided into the TMD group (TMDG), diagnosed with TMD according to the DC/TMD, and control group (CG), with asymptomatic individuals. The volunteers accessed a online link by the smartphone in order to answer questions on personal data, the Fonseca Anamnestic Index (FAI), Neck Disability Index (NDI), and Masticatory preference. In all participants, evaluation of the force of the scapula elevation muscles was performed, using a load cell model MM-100 (Kratos® SP, Brazil). Data were analyzed descriptively using the maximum, mean, and standard deviation and a two-way ANCOVA test was applied for all variables. A significance level of 5% was considered. Results There were no statistically significant differences between the TMDG and CG for the maximal and mean muscle strength of scapular elevation. There were statistically significant differences in FAI (p <0.001*) between the CG and the TMDG. Conclusion Based on the results, it was not possible to confirm the hypothesis that women diagnosed with TMD present lower isometric strength during scapular elevation (right/left).

Resumo: A pesquisa clínica, como parte de um processo de inovação, gera dados úteis para avaliação de diversas soluções tecnológicas em saúde, perfazendo um elo entre a pesquisa científica e a translação do conhecimento em inovações benéficas à sociedade. Entretanto, os dados clínicos gerados parecem não estar disponíveis adequadamente à comunidade científica e à sociedade. O presente estudo buscou analisar o potencial das bases de registros clínicos como fonte de informação relevante às pesquisas científicas e, para isso, foi realizada uma análise comparativa de 27 correlações de estudos clínicos de três diferentes tecnologias e seus artigos científicos em duas fontes de informação distintas. Nesse universo amostral, observou-se importante e limitante dificuldade em associar com exatidão os dados dessas fontes. Foi possível, ainda, observar um grande lapso temporal (40 meses em média) entre o encerramento de um estudo e a publicização dos resultados. Considerando os estudos finalizados, 56% não tiveram seus resultados publicados em nenhum dos canais estudados. A publicação dos estudos clínicos pode se mostrar ainda mais negligenciada quando se percebe que, além da ausência de resultados, não há qualquer informação desses estudos em publicações científicas. Assim, as bases de registros clínicos se apresentam como uma fonte de informação em potencial - e, por vezes, única - para suprir conhecimento na busca por novas soluções tecnológicas em saúde.

Abstract: As part of the innovation process, clinical research generates valuable data to assess technological solutions in healthcare, linking scientific research and knowledge transfer to provide beneficial innovations for society. However, the generated clinical data do not appear to be adequately available to the scientific community and society. The present study seeks to analyze the effectiveness of databases of clinical records as a source of relevant information for scientific research. We conducted a comparative analysis of 27 correlations of clinical trials between three different technologies and their scientific articles by consulting two information sources. Making connections between the data from these sources proved to be challenging. In addition, a considerable time lag (40 months on average) was observed between the end of the study and the publication of the results. Among the completed studies, 56% had not published their results in any of the channels studied. In addition to the paucity of reported results, the poor publication record of clinical trials is further evident in the lack of information on these studies in scientific publications. Thus, databases of clinical records are a potential source of information and may come to represent a central tool in the search for new technological solutions in healthcare.

BACKGROUND The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants has become a major concern contributing to increased morbidity and mortality worldwide. OBJECTIVES Here we describe the replacement of the Gamma variant of concern (VOC) with Delta in the western Brazilian Amazon. METHODS In this study, we analysed 540 SARS-CoV-2 positive samples determined by qualitative real-time RT-PCR selected in the state of Rondônia between June and December 2021. The positive cohort was sequenced through next-generation sequencing (NGS) and each sample was quantified using real-time RT-qPCR, the whole genome sequence was obtained, SARS-CoV-2 lineages were classified using the system Pango and the maximum likelihood (ML) method was used to conduct phylogenetic analyses. FINDINGS A total of 540 high-quality genomes were obtained, where the Delta VOC showed the highest prevalence making up 72%, with strain AY.43 being the most abundant, while the Gamma VOC was present in 28%, where the P.1 strain was the most frequent. In this study population, only 32.96% (178/540) had completed the vaccination schedule. MAIN CONCLUSIONS This study highlighted the presence of Gamma and Delta variants of SARS-CoV-2 in RO. Furthermore, we observed the replacement of the Gamma VOC with the Delta VOC and its lineages.

RESUMO O objetivo foi avaliar a relação espacial dos indicadores de saneamento (acesso à água e ao esgoto), considerando a modelagem da concessão da Companhia Estadual de Águas e Esgotos do Rio de Janeiro (Cedae), e a sua possível relação com a incidência da Covid-19, nos bairros com e sem áreas de favelas. Os dados de casos confirmados da Covid-19 analisados foram obtidos no Painel Saúde do Rio de Janeiro. Foi considerado o fracionamento do município em quatro blocos regionais. Nos 163 bairros da cidade, a taxa de incidência média foi de 9,78 casos/1.000 hab. Os bairros com as menores taxa de incidência foram aqueles com predominância de aglomerados subnormais (favelas), baixa renda per capita e cobertura de saneamento, sugerindo maior lacuna de testagem e subnotificação de casos. Reduzir a inequidade e o racismo estrutural deveria ser prioritário. A sindemia da Covid-19 contribuiu fortemente para perdas socioeconômicas e de saúde pública significativas. Em um cenário de reconstrução, é imprescindível retomar o compromisso para com os Objetivos de Desenvolvimento Sustentável da Agenda 2030 das Nações Unidas.

ABSTRACT This assessment aimed to evaluate the putative spatial relationship between sanitation indicators (access to water and sewage) considering the Rio de Janeiro State Water and Sewage Company (CEDAE) parameters and the COVID-19 incidence among districts with and without slum areas. The data of confirmed COVID-19 cases analyzed were obtained from the Rio de Janeiro Health Panel. We considered the division of the municipality into four regional blocks. The mean COVID-19 incidence was 9.78 cases/1,000 inhabitants in the 163 city districts. The lowest COVID-19 incidence rate was most reported in slum regions, with lower per capita income and sanitation coverage, suggesting a significant gap in testing and case underreporting. Reducing inequality and structural racism should be a priority. The COVID-19 syndemic strongly contributed to significant socioeconomic and public health losses. Our commitment to the Sustainable Development Goals of the 2030 agenda of the United Nations is pivotal in a backdrop of reconstruction.

ABSTRACT Introduction: The instructive therapeutic toy can reveal the needs implicit to the patient and help them understand the methodologies, diagnoses and therapies to which they will be subjected, which promotes his peace of mind, safety and agreement with treatment, in addition to providing better interaction with healthcare professionals. Objective: To analyze the effects of using the instructive therapeutic toy in the preparation of the hospitalized child prior to performing intravenous therapy. Methods: Quasiexperimental study with a quantitative approach, carried out in a public pediatric hospital in Juazeiro do Norte City, Ceará, Brazil. The study population consisted of 31 preschool and school-age children. Data collection was carried out from July to September 2019, through observation, and the analysis was carried out by means of the Statistical Package for the Social Sciences program, using t-test and McNemar’s test. Results: There was a statistically significant reduction in all the variables that indicate the child´s lower acceptance of intravenous therapy, with the exception of the variable they collaborate passively. However, there was a statistically significant increase in some variables that indicate the child’s greater acceptance of intravenous therapy. Conclusion: The instructive therapeutic toy is established as a fundamental technological tool for promoting responsibility, autonomy and co-responsibility of health care, valuating the subject/user as a singular human being, and the deconstruction of dehumanized health practices, especially in pediatric nursing.

RESUMEN Introducción: El juguete terapéutico instructivo puede revelar las necesidades implícitas al paciente y ayudarle a comprender las metodologías, diagnósticos y terapias a las que será sometido, lo que promueve su tranquilidad, seguridad y acuerdo con el tratamiento, además de proporcionar una mejor interacción con los profesionales de la salud. Objetivo: Analizar los efectos del uso del juguete terapéutico instructivo en la preparación del niño hospitalizado para realizar la terapia intravenosa. Métodos: Estudio cuasi-experimental de enfoque cuantitativo, realizado en un hospital pediátrico público de la ciudad de Juazeiro do Norte- Ceará, Brasil. La población de estudio fue compuesta por 31 niños en edad preescolar y escolar. La recolección de datos se realizó de julio a septiembre de 2019, a través de la observación, y el análisis se realizó a través del programa Statistical Package for the Social Sciences, por medio de la Prueba t y McNemar. Resultados: Hubo una reducción estadísticamente significativa de todas las variables que indican una menor aceptación del niño a la terapia intravenosa, con la excepción de la variable colabora pasivamente. Si bien hubo un aumento estadísticamente significativo en algunas variables que indican una mayor aceptación del niño a la terapia intravenosa. Conclusión: El juguete terapéutico instructivo se establece como una herramienta tecnológica fundamental para la promoción de la responsabilidad, la autonomía y la corresponsabilidad del cuidado de la salud, valoración del sujeto/usuario como un ser humano singular, y la deconstrucción de prácticas de salud deshumanizadas, especialmente en enfermería pediátrica.