Infectious etiology and indicators of malabsorption or intestinal injury in childhood diarrhea. / Etiología infecciosa e indicadores de malabsorción o daño intestinal en diarrea infantil

INTRODUCTION: The multifactorial etiology of gastroenteritis emphasizes the need for different laboratory methods to identify or exclude infectious agents and evaluate the severity of diarrheal disease. OBJECTIVE: To diagnose the infectious etiology in diarrheic children and to evaluate some fecal markers associated with intestinal integrity. MATERIALS AND METHODS: The study group comprised 45 children with diarrheal disease, tested for enteropathogens and malabsorption markers, and 76 children whose feces were used for fat evaluation by the traditional and acid steatocrit tests. RESULTS: We observed acute diarrhea in 80% of the children and persistent diarrhea in 20%. Of the diarrheic individuals analyzed, 40% were positive for enteropathogens, with rotavirus (13.3%) and Giardia duodenalis (11.1%) the most frequently diagnosed. Among the infected patients, occult blood was more evident in those carrying pathogenic bacteria (40%) and enteroviruses (40%), while steatorrhea was observed in infections by the protozoa G. duodenalis (35.7%). Children with diarrhea excreted significantly more lipids in feces than non-diarrheic children, as determined by the traditional (p<0.0003) and acid steatocrit (p<0.0001) methods. Moreover, the acid steatocrit method detected 16.7% more fecal fat than the traditional method. CONCLUSIONS: Childhood diarrhea can lead to increasingly severe nutrient deficiencies. Steatorrhea is the hallmark of malabsorption, and a stool test, such as the acid steatocrit, can be routinely used as a laboratory tool for the semi-quantitative evaluation of fat malabsorption in diarrheic children.

Introducción. La etiología multifactorial de la gastroenteritis enfatiza la necesidad de usar diferentes métodos de laboratorio para identificar o excluir agentes infecciosos y evaluar la gravedad de la enfermedad diarreica. Objetivo. Diagnosticar la etiología infecciosa de la diarrea en niños y evaluar algunos marcadores fecales asociados con la integridad intestinal. Materiales y métodos. Se estudiaron 45 niños con enfermedad diarreica, en los cuales se evaluaron la presencia de enteropatógenos y los marcadores de malabsorción. Se analizaron las muestras fecales de 76 niños, mediante las pruebas de esteatocrito tradicional y esteatocrito ácido, para la cuantificación de la grasa. Resultados. Se observó diarrea aguda en el 80 % de los niños y diarrea persistente en el 20 %. De los individuos con diarrea, el 40 % fue positivo para enteropatógenos; los más diagnosticados fueron rotavirus (13,3 %) y Giardia duodenalis (11,1 %). Entre los pacientes infectados, la sangre oculta fue más evidente en aquellos portadores de bacterias patógenas (40 %) o enterovirus (40%), mientras que la esteatorrea se observó en infecciones por el protozoo G. duodenalis (35,7 %). Los niños con diarrea excretaron significativamente más lípidos en las heces que aquellos sin diarrea, según lo determinado por los métodos de esteatocrito tradicional (p<0,0003) y esteatocrito ácido (p<0,0001). Conclusiones. La diarrea infantil puede provocar deficiencias graves de nutrientes. La esteatorrea es distintiva de la malabsorción intestinal y puede detectarse mediante la estimación del esteatocrito ácido. Esta prueba podría utilizarse de forma rutinaria como una herramienta de laboratorio para la evaluación semicuantitativa de la malabsorción de grasas en niños con diarrea.

Comparison of different dual-wavelength photobiomodulation protocols application in third molar extractions. A split-mouth randomized controlled trial.

OBJECTIVE: To compare the use of PBMT in the soft tissue and bone healing after third molar extraction using the dual-wavelength laser directly into the post-extraction alveoli (PBMT-I), or PBMT with a red laser directly into the alveoli and with an infrared laser externally on the patient's face (PBMT-IE). METHODS: Twenty patients underwent extraction of four third molars were involved in this split-mouth double-blind randomized controlled trial. The Post-extraction alveoli were treated with the following protocols: PBMT-IE: Application of a red laser directly into the alveolus, and infrared laser irradiation transcutaneously and PBMT-I: Application of dual-wavelength laser intraorally. Patients were clinically evaluated 3, 7, 14, 30, and 90 days after the surgical procedure. The analyses in this study were divided into qualitative (centered on the patient's report and on the evaluators' analysis), and quantitative analyses (measurement of the vertical and horizontal dimensions of the face with the objective of measuring post-surgical edema and radiographic analyses for evaluation of the density and structure of the newly formed bone). RESULTS: A progressive improvement was observed in all parameters evaluated in this study, however, this improvement was time dependent, with no distinct effect observed between the PBMT treatments applied. CONCLUSION: The different dual-wavelength PBMT protocols induced a similar postoperative clinical course in third molar extraction surgeries, with a reduced occurrence of complications and a good healing pattern of hard and soft tissues.

Green tea and hyaluronic acid gel enhance fibroblast activation and improves the gingival healing post-third molar extraction.

This study evaluates the effects of a green tea (Camellia sinensis) and hyaluronic acid gel on fibroblast activity and alveolar bone repair following third molar extractions. By examining the gene expression related to cell survival, proliferation, and angiogenesis, the study bridges in vitro findings with clinical outcomes in a split-mouth randomized trial. Human fibroblasts were exposed to the treatment gel, analysing gene expression through RT-qPCR. Twenty participants undergoing bilateral third molar extractions received the test gel on one side and a placebo on the other. Assessments included patient-reported outcomes, professional evaluations, and radiographic analyses at multiple postoperative intervals. The test gel significantly enhanced AKT, CDKs, and VEGF gene expressions, indicating a positive effect on angiogenesis and cell proliferation. Clinically, it resulted in reduced exudate, swelling, and secondary interventions, with radiographs showing improved alveolar bone density after 90 days. The green tea and hyaluronic acid gel significantly improves soft tissue and bone healing post-extraction, offering a promising adjunctive therapy for enhancing postoperative recovery. This gel represents a novel adjuvant treatment option for facilitating improved healing outcomes after third molar extractions, highlighting its potential utility in clinical dental practice.

Efficacy of analgesia promoted by lidocaine and articaine in third molar extraction surgery. A split-mouth, randomized, controlled trial.

PURPOSE: The aim of this study was to compare the analgesic efficacy of 4% articaine associated with epinephrine (1:100,000), and 2% lidocaine associated with epinephrine (1:100,000) in third molar extraction surgery. METHODS: Sixty patients who underwent surgeries to extract upper and lower third molars were included in this split-mouth, double-blind, randomized, controlled trial. The groups in this study were divided according to the anesthetic solution used to provide local anesthesia during extraction of upper and lower third molars: (1) 4% articaine associated with epinephrine (1:100,000); (2) 2% lidocaine associated with epinephrine (1:100,000). The time to the beginning and end of the sensation of analgesia, pain sensation according to the VAS scale, and number of anesthetic tubes necessary for supplementation were analyzed. RESULTS: It was found that the onset time for analgesia was shorter on the side anesthetized with articaine compared to the side anesthetized with lidocaine (122.1 ± 52.90 s vs. 144.5 ± 68.85 s) (p < 0.05). In addition, the number of tubes used for anesthetic supplementation was also reduced on the articaine side compared to the lidocaine side (0.26 ± 0.48 vs. 0.50 ± 0.75) (p < 0.05). There were no differences between the anesthetic solutions in the other evaluated parameters. CONCLUSION: It can be concluded that the use of 4% articaine associated with epinephrine (1:100,000) reduced the time of onset of analgesia and the necessity for anesthetic supplementation in third molar extraction surgeries compared to the use of 2% lidocaine associated with epinephrine (1:100,000).

Detection of IgG Anti-Giardia duodenalis Antibodies in Sera by Indirect Immunofluorescence and Western Blotting Assays.

INTRODUCTION: Serological assays are alternative laboratory tools for the diagnosis of parasitic infections. The aim of this work was to evaluate the performance of the indirect fluorescent antibody test (IFAT) and Western blotting (WB) for the detection of IgG anti-Giardia antibodies in human sera. METHODOLOGY: Sera from individuals infected with Giardia duodenalis, other parasites or non-parasitized were selected for serological assays. Ninety-seven sera were tested by IFAT at 1:20 and 1:40 dilutions and of these, 40 samples were also analyzed by WB. RESULTS: The sensitivity and specificity of the IFAT was 97% and 46.9% at 1:20 sera dilution, and 39.4% and 59.4% at 1:40 sera dilution. The low molecular weight polypeptides fractions of 25 kDa, 27-31 kDa and 45-55 kDa were the most frequently identified by the sera of individuals infected with G. duodenalis, along with low cross-reactivity, presenting an individual sensitivity of 42.8%, 50.0% and 57.1%, and specificity of 83.3%, 83.3% and 91.7%, respectively. The highest overall sensitivity of WB (85.7%) was based on the immunoreactivity of sera with at least one of those proteins. The concordance between the detection of G. duodenalis in feces by microscopy and the WB results was considered substantial (Kappa = 0.61). CONCLUSION: Constant exposure to Giardia infection throughout a lifetime can maintain high levels of specific antibodies in serum, even without active infection. Moreover, proteins found in intestinal amoebas may hinder the serological diagnosis of giardiasis in endemic areas due to cross-reactivity, which can be partially solved using Giardia low molecular weight proteins.

Ensino da segurança do paciente: a interdisciplinaridade na ótica de professores de enfermagem / Teaching on patient safety: interdisciplinarity from the perspective of nursing teachers

Objetivo: Compreender a visão dos docentes de enfermagem sobre a abordagem interdisciplinar da temática segurança do paciente no curso. Métodos: Estudo descritivo e exploratório, de abordagem qualitativa, realizado com professores de uma instituição de ensino superior do centro-oeste do Brasil. A coleta de dados aconteceu entre os meses de novembro de 2020 e fevereiro de 2021, a partir de entrevista gravada por meio da plataforma Google Meet, que teve duração entre 15 a 30 minutos. As entrevistas foram transcritas e submetidas à análise de conteúdo temática. Resultados: A partir das análises, emergiram duas categorias. A primeira "A segurança do paciente nas entrelinhas do ensino de enfermagem" versou sobre a discussão da temática de maneira implícita entre as disciplinas; e a segunda categoria "Estratégias de ampliação da abordagem da segurança do paciente no ensino de enfermagem" apresentou estratégias de expansão da abordagem do conteúdo. Conclusão: Reconheceu-se que a segurança do paciente é relevante, a qual necessita de uma abordagem em diferentes linhas do ensino na enfermagem, e que os docentes devem utilizar recursos inovadores para difundir a prática do cuidado seguro. Descritores: Segurança do paciente; Ensino; Enfermagem; Docentes.

Objective: To understand the view of nursing teachers on the interdisciplinary approach to patient safety in the course. Methods: Descriptive and exploratory study, with a qualitative approach, conducted with teachers from a higher education institution in the Midwest of Brazil. Data collection took place between November 2020 and February 2021,based on an interview recorded through the Google Meet platform, which lasted between 15 and 30 minutes. The interviews were transcribed and submitted to thematic content analysis. Results: From the analyses, two categories emerged. The first "Patient safety between the lines of nursing teaching" dealt with the discussion of the theme implicitly between disciplines; and the second category "Strategies for expanding the approach to patient safety in nursing teaching" introduced strategies for expansion of the content approach. Conclusion: It is recognized that patient safety is relevant, which requires an approach in different lines of nursing teaching, and that teachers should use innovative resources to disseminate the practice of safe care. Descriptors: Patient safety; Teaching; Nursing; Faculty.

A higher number of SARS-COV-2 infections in quilombola communities than in the local population in Brazil.

The historical and social vulnerability of quilombola communities in Brazil can make them especially fragile in the face of COVID-19, considering that several individuals have precarious health systems and inadequate access to water. This work aimed to characterize the frequency of SARS-COV-2 infections and the presence of IgM and IgG SARS-CoV-2 antibodies in quilombola populations and their relationship with the presence of risk factors or preexisting chronic diseases in the quilombola communities. We analyzed the sociodemographic and clinical characteristics, serological status, comorbidities, and symptoms of 1,994 individuals (478 males and 1,536 females) from 18 Brazilian municipalities in the State of Sergipe of quilombola communities, which were evaluated at different epidemiological weeks, starting at the 32nd (August 6th) and ending at the 40th (October 3rd) epidemiological week. More than 70% of studied families live in rural areas and they have an extreme poverty social status. Although we found a higher number of SARS-COV-2 infections in quilombola communities than in the local population, their SARS-CoV-2 reactivity and IgM and IgG positivity varied across the communities investigated. Arterial hypertension was the most risk factor, being found in 27.8% of the individuals (9.5% in stage 1, 10.8% in stage 2, and 7.5% in stage 3). The most common COVID-19 symptoms and comorbidities were headache, runny nose, flu, and dyslipidemia. However, most individuals were asymptomatic (79.9%). Our data indicate that mass testing must be incorporated into public policy to improve the health care system available to quilombola populations during a future pandemic or epidemic.

Challenges in Direct Detection of Flaviviruses: A Review.

Arthropods transmit arboviruses via mosquito and tick bites to humans and other animals. The genus flavivirus, which causes diseases, sequelae, and thousands of deaths, mainly in developing and underdeveloped countries, is among the arboviruses of interest to public health. Given the importance of early and accurate diagnosis, this review analyzes the methods of direct detection of flaviviruses, such as reverse transcription loop-mediated isothermal amplification, microfluidics, localized surface plasmon resonance, and surface-enhanced Raman scattering, and presents the advantages, disadvantages, and detection limits identified in studies reported in the literature for each methodology. Among the different methods available, it is essential to balance four fundamental indicators to determine the ideal test: good sensitivity, high specificity, low false positive rate, and rapid results. Among the methods analyzed, reverse transcription loop-mediated isothermal amplification stands out, owing to result availability within a few minutes, with good sensitivity and specificity; in addition, it is the best-characterized methodology.

Comparison of High-Intensity Interval Training to Moderate-Intensity Continuous Training for Functioning and Quality of Life in Survivors of COVID-19 (COVIDEX): Protocol for a Randomized Controlled Trial.

OBJECTIVE: The purpose of this study was to compare high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) for feasibility, safety, adherence, and short- and long-term efficacy in improving functioning and health-related quality of life in survivors of coronavirus disease 2019 (COVID-19). METHODS: COVIDEX is a two-pronged, parallel-group, randomized controlled trial with an 8-week training intervention. The study participants will be 94 patients aged >18 years, admitted to a specialized post-COVID center. Participants will be randomized to HIIT (4 × 4 minutes of high-intensity work periods at 85% to 90% of peak heart rate) and MICT (47 minutes at 70% to 75% peak heart rate) groups for biweekly sessions for 8 weeks. The participants will undergo 2 phases of supervised training (phases 1 and 2) of 4 weeks each, in a public, specialized, post-COVID center. In phase 1, we will assess and compare the feasibility, acceptability, and short-term efficacy of HIIT and MICT intervention. In phase 2, the long-term efficacy of HIIT and MICT will be assessed and compared regarding function and health-related quality of life. To prevent any expectation bias, all study participants and assessors will be blinded to the study hypotheses. Group allocation will be masked during the analysis. All statistical analyses will be conducted following intention-to-treat principles. IMPACT: This study is the first randomized controlled trial that will compare the feasibility, safety, adherence, and efficacy of the HIIT and MICT intervention programs in this population. The findings will potentially provide important information and assist in clinical decision making on exercise to optimize the benefits of clinical health care in survivors of COVID-19.

Perfil de profissionais de saúde na pandemia covid-19 no Rio de Janeiro: um estudo web surveys / Profile of healthcare workers during the covid-19 pandemic in Rio de Janeiro: a web survey study

OBJETIVO: Identificar o perfil dos profissionais de 3º grau da área da saúde que atuaram no início da pandemia causada pelo vírus SARS-CoV-2. MÉTODO: Trata-se um estudo quantitativo com 155 profissionais de nível superior que participaram de uma web survey, cuja análise ocorreu por meio de estatística descritiva. RESULTADOS: O grupo foi composto predominantemente por enfermeiras, assistentes sociais, médicos, psicólogos e nutricionistas. Todos tinham orientação heterossexual, identidade cisgênero, idade entre 25 e 49 anos, eram autodeclarados como brancos, adeptos da religião católica, casados ou em união estável, possuindo pós-graduação, com vínculo profissional estatutário, mais de um filho em idade escolar e vivendo com três a quatro pessoas no mesmo domicílio. CONCLUSÃO: O perfil caracterizado pode ser útil para dialogar com estudos sobre saúde do trabalhador, risco ocupacional, trabalho remunerado e atividades privadas de profissionais da área de saúde.

OBJECTIVE: To identify the profile of tertiary healthcare workers working at the beginning of the SARS-CoV-2 pandemic. METHOD: This is a quantitative study involving 155 tertiary healthcare professionals who participated in a web survey, and the analysis was performed using descriptive statistics. RESULTS: The group consisted mainly of nurses, social workers, doctors, psychologists, and nutritionists. All identified as heterosexual, cisgender, between the ages of 25 and 49, self-identified as white, Catholic, married or in a stable relationship, with a postgraduate education, a legal professional affiliation, more than one school-age child, and living with three to four people in the same household. CONCLUSION: The characterized profile may be useful for engaging in studies on workers' health, occupational risk, paid work, and private activities of health professionals.

Efficacy of antibiotic prophylaxis on third molar extraction / Eficácia da profilaxia antibiótica na extração de terceiros molares

Introduction: Third molar extraction surgery is a common dental procedure, often challenging with increased post-operative complications. The need for antibiotic prophylaxis in these cases remains debated. Objective: The aim of this study was to evaluate the effect of antibiotic prophylaxis on the postoperative clinical course of third molar extraction surgeries. Material and method: Sixty-three patients were randomly allocated into two groups after extraction of the four third molars. ATB group (N = 33) the patients received 1g of amoxicillin one hour before the surgical procedure, CTR group (N = 30) the patients did not receive antibiotic prophylaxis. Clinical analyses were performed at 3, 7, 14, and 30 days after the surgical procedure. These analyses consisted of assessing oedema, variation in mouth opening, and soft tissue healing. Furthermore, patient-centered analyses were also carried out through the application of the visual analogue scale (VAS) to assess pain, inflammation, bleeding, difficulty opening the mouth, and chewing. Result: No influence of antibiotic prophylaxis was observed on the evolution of clinical parameters of healing, oedema, and mouth opening. Patients did not notice differences regarding their comfort during the postoperative period. Conclusion: The incidence of complications observed in the present study was low and was not related to infectious processes. The use of prophylactic antibiotic therapy has no beneficial effects on the postoperative clinical course in third molar extraction.

Introdução: Exodontia de terceiro molar é um procedimento odontológico comum, frequentemente desafiador, com complicações pós-operatórias aumentadas. A necessidade de profilaxia com antibióticos nesses casos ainda é motivo de debate. Objetivo: O objetivo deste estudo foi avaliar o efeito da profilaxia com antibióticos no curso clínico pós-operatório das cirurgias de extração do terceiro molar. Material e método: Sessenta e três pacientes foram randomicamente alocados em dois grupos posteriormente a cirurgia de exodontia dos quatro terceiros molares. Grupo ATB (N = 33) utilizou 1g de amoxicilina uma hora antes do procedimento cirúrgico e grupo CTR (N = 30) sem profilaxia antibiótica. Os dentes foram classificados de acordo com Pell & Gregory e Winter. Análises clínicas foram realizadas nos períodos de 3, 7, 14 e 30 dias após o procedimento cirúrgico. As análises consistiram na avaliação do edema, variação de abertura de boca e a cicatrização dos tecidos moles. Também foram executadas análises centradas nos pacientes por meio da aplicação da escala visual analógica (VAS) para avaliação de dor, inflamação, sangramento, dificuldade de abertura bucal e de mastigação. Resultado: Não houve diferenças entre os grupos em relação ao posicionamento dos dentes. Não foi observada influência da profilaxia antibiótica nos parâmetros clínicos de cicatrização, edema e abertura de boca. Os pacientes não notaram diferenças em relação ao seu conforto no pós-operatório. Conclusão: A incidência de complicações foi baixa e não foi relacionada a processos infecciosos. O uso de antibioticoterapia profilática não apresentou efeitos benéficos para o curso clínico pós-operatório em exodontia de terceiros molares.

A violência, as mulheres e o Estado: dificuldades e estratégias / Violence, women and the State: difficulties and strategies

Este artigo é parte de uma pesquisa de mestrado que teve como objetivo caracterizar a Rede de Enfrentamento à Violência Contra às Mulheres em um município do Centro-Oeste do Rio Grande do Sul, Brasil. O acesso às participantes ocorreu a partir da estratégia de amostragem Bola de Neve. O estudo contou com 11 participantes provindas de diferentes esferas da Rede de Enfrentamento municipal. Foram analisadas as principais dificuldades e estratégias relatadas pelas participantes no trabalho de Enfrentamento à violência contra a mulher. Como principais dificuldades, foram apontadas: a falta de investimento do Estado, a desestruturação/fragmentação da Rede e a individualização/pessoalização do trabalho prestado. Como principais estratégias: a formação de vínculos pessoais de trabalho e o desenvolvimento do trabalho voluntário para suprir as lacunas. As conclusões apontam para uma rede despolitizada, fragilizada e distante de seus ideais garantidores da cidadania.

Effect of the association of infra-red and red wavelength photobiomodulation therapy on the healing of post-extraction sockets of third lower molars: a split-mouth randomized clinical trial.

The aim of this study was to evaluate the effect of photobiomodulation therapy (PBMT) with the association of red and infra-red laser therapy in the healing of the post-extraction sockets of third lower molars. Twenty patients were submitted to extraction of lower third molars and the post-extraction sockets were treated using two different approaches in a randomized split-mouth design: The test side received the PBMT with red (λ 660 nm) and infra-red laser therapy (λ 808 nm) and the control side was not irradiated. The PBMT was applied immediately and 3 and 7 days after the surgical procedure. Post-extraction socket healing was assessed by the bone repair score, bone density, and fractal dimension analysis 7 and 90 days after the surgical procedure, using cone-beam computed tomography images. Additionally, clinical analyses were performed 3, 7, 14, 30, and 90 days after the surgical procedure, considering the occurrence of pain, edema, and bleeding, as well as the quality of the oral mucosa repair, assessed using a visual analogue scale. The clinical analysis showed that PBMT reduced edema and improved the repair of oral mucosa at 7 days after surgery, while the tomographic analysis showed no significant differences between groups. Dual-wavelength PBMT improved the post-operative clinical course in patients undergoing lower third molar extraction, without altering bone repair.

[Trend in the prevalence of anemia in children from maroon communities according to two population-based surveys in Alagoas State, Brazil (2008-2018)]. / Evolução da prevalência de anemia em crianças quilombolas, segundo dois inquéritos de base populacional em Alagoas, Brasil (2008-2018).

The study aimed to assess trends in the prevalence of anemia in children from quilombos (maroon communities) in Alagoas State, Brazil. This was a descriptive study comparing the results of two household surveys (2008; n = 950 and 2018; n = 426), involving a sample of children from 6 to 59 months of age. Anemia was diagnosed as hemoglobin < 110g/L (HemoCue). Prevalence rates between the two surveys were described by percentage and by prevalence ratio (PR) and 95% confidence interval (95%CI), calculated by Poisson regression. Prevalence rates for anemia in 2008 and 2018 were 53% (95%CI: 49.8-56.1) and 38% (95%CI: 33.4-42.6), respectively, or a decrease of 28.3% (RP = 0.72; 95%CI: 0.63-0.82). Children 6 to 24 months of age had higher anemia rates than those 25 to 59 months of age, both in 2008 (72% vs. 44%) and in 2018 (54.8% vs. 28.3%). There was a reduction in prevalence in both age brackets (23.9% and 35.7%, respectively). This sharper decline in older children meant that younger children had nearly double the prevalence rate compared to older children (PR = 1.94; 95%CI: 1.53-2.46). In conclusion, there was a major decline in prevalence of anemia during the period studied, but anemia persisted as a relevant public health problem, especially in children 6 to 24 months of age. The children in the sample are exposed to harsh social vulnerabilities, evidencing that health promotion for this population requires more than actions in the public health sphere itself. Healthcare workers and administrators should be alert to the data presented here, aimed at implementation of measures to confront the social and health iniquities that contribute to greater vulnerability in this ethnic-racial group.

Objetivou-se avaliar a evolução da prevalência de anemia em crianças quilombolas de Alagoas, Brasil. Trata-se de uma análise descritiva comparando resultados de dois inquéritos domiciliares (2008; n = 950 e 2018; n = 426), envolvendo amostra das crianças de 6 a 59 meses. A anemia foi diagnosticada com hemoglobina < 110g/L (HemoCue). As prevalências entre os dois inquéritos foram descritas percentualmente e pela razão de prevalência (RP) e intervalo de 95% de confiança (IC95%), calculados por regressão de Poisson. As prevalências de anemia em 2008 e 2018 foram, respectivamente, 53% (IC95%: 49,8-56,1) e 38% (IC95%: 33,4-42,6), configurando um declínio de 28,3% (RP = 0,72; IC95%: 0,63-0,82). Crianças de 6 a 24 meses foram mais acometidas do que aquelas de 25 a 59 meses, tanto em 2008 (72% vs. 44%) como em 2018 (54,8% vs. 28,3%). Houve redução de prevalência em ambas as faixas etárias (23,9% e 35,7%, respectivamente). Essa redução mais pronunciada nas crianças mais velhas fez que as mais jovens passassem a ter quase o dobro da prevalência vista nas de maior idade (RP = 1,94; IC95%: 1,53-2,46). Conclui-se que houve declínio expressivo da prevalência de anemia durante o período avaliado, persistindo, porém, como relevante problema de saúde pública, sobretudo entre as crianças de 6 a 24 meses. As crianças avaliadas sobrevivem em grande vulnerabilidade social, evidenciando-se que, para promover a saúde dessa população, não são suficientes ações no âmbito da saúde pública. Gestores e profissionais de saúde devem estar atentos aos dados aqui apresentados, visando à implementação de medidas para enfrentamento das iniquidades sociais e de saúde que contribuem para maior vulnerabilidade desse grupo étnico-racial.

El objetivo fue evaluar la evolución de la prevalencia de anemia en niños quilombolas de Alagoas, Brasil. Se trata de un análisis descriptivo, comparando resultados de dos encuestas domiciliarias (2008; n = 950 y 2018; n = 426), implicando en la muestra a niños de 6 a 59 meses. La anemia se diagnosticó con hemoglobina < 110g/L (HemoCue). Las prevalencias entre los dos cuestionarios fueron descritas porcentualmente y por la razón de prevalencia (RP) e intervalo de 95% de confianza (IC95%), calculados por regresión de Poisson. Las prevalencias de anemia en 2008 y 2018 fueron, respectivamente, 53% (IC95%: 49,8-56,1) y 38% (IC95%: 33,4-42,6), configurando un declive de un 28,3% (RP = 0,72; IC95%: 0,63-0,82). Los niños de 6 a 24 meses estuvieron más afectados que aquellos de 25 a 59 meses, tanto en 2008 (72% vs. 44%), como en 2018 (54,8% vs. 28,3%). Hubo una reducción de prevalencia en ambas franjas etarias (23,9% y 35,7%, respectivamente). Esta reducción más pronunciada en niños mayores provocó que los más jóvenes pasasen a tener casi el doble de la prevalencia, vista en aquellos de mayor edad (RP = 1,94; IC95%: 1,53-2,46). Se concluye que hubo un declive expresivo de la prevalencia de anemia durante el período evaluado, persistiendo, no obstante, como un relevante problema de salud pública, sobre todo entre los niños de 6 a 24 meses. Los niños evaluados sobreviven bajo una gran vulnerabilidad social, evidenciándose que para la promoción de la salud de esa población no son suficientes acciones en el ámbito de la salud pública. Gestores y profesionales de salud deben estar atentos a los datos aquí presentados, con el fin de implementar medidas para enfrentar las inequidades sociales y de salud que contribuyen a una mayor vulnerabilidad de ese grupo étnico-racial.

Perspectivas de adolescentes sobre a prática de cuidado dos irmãos: um estudo qualitativo / Perspectives of adolescents about their sibling caretaking: a qualitative study / Perspectivas de los adolescentes sobre la práctica de cuidado del hermano: un estudio cualitativo

Este estudo buscou investigar as perspectivas de adolescentes sobre a prática de cuidado dos irmãos. A amostra foi composta por seis adolescentes de ambos os sexos, com idades entre 11 e 19 anos. Os dados foram coletados por meio de entrevistas semiestruturadas e as informações foram submetidas à análise de conteúdo. Ressalta-se a importância das atividades desempenhadas pelos adolescentes no contexto familiar para o sustento financeiro da família. A percepção do cuidador sobre o cuidado dispensado aos irmãos abarcou aspectos positivos e negativos, sendo também considerada uma prática normal e rotineira. Dentre os pontos positivos, constatou-se transmitir algo de bom aos irmãos, os desafios e facilidades na realização de atividades de cuidado com os irmãos menores. A prática do cuidado pode contribuir para o sentimento de importância no contexto familiar, como também ser percebida como uma falha das mães no cumprimento de suas responsabilidades. As percepções negativas referiram-se à limitação dos tempos de lazer, à rotina estressante e à mediação de brigas entre os irmãos menores. Evidencia-se a importância de analisar o que essa prática representa para os adolescentes cuidadores, já que esta pode estar associada a sentimentos de desconforto, influenciar o bem-estar, bem como limitar a realização de atividades de lazer.(AU)

This study sought to investigate the perspectives of adolescents about their sibling caretaking. The sample consisted of six adolescents of both sexes, aged between 11 and 19 years old. The data were collected through semi-structured interviews and were submitted to content analysis. The importance of the activities performed by adolescents in the family context for the financial support of the family is emphasized. The caregiver's perception of the care given to siblings contained positive and negative aspects, and was also considered to be routine practice. Among the positives factors, it was found to transmit something good to the siblings, the challenges and facilities in carrying out care activities to younger siblings. The sibling caretaking practice can contribute to the feeling of importance in the family context, as well as being perceived as a failure of mothers in carrying out their responsibilities. Negative perceptions referred to the limitation of leisure time, the stressful routine and the mediation of fights between younger siblings. The importance of analyzing what this practice represents for young caregivers is evident, as it can be associated with uncomfortable feelings, influence well-being, as well as limit the performance of leisure activities.(AU)

Este estudio buscó investigar las perspectivas de los adolescentes sobre la práctica del cuidado de los hermanos. La muestra estuvo formada por seis adolescentes de ambos sexos, con edades comprendidas entre los 11 y los 19 años. La información se recopiló a través de entrevistas semiestructuradas y la información se sometió a análisis de contenido. Se enfatiza la importancia de las actividades que realizan los adolescentes en el contexto familiar para el apoyo financiero de la familia. La percepción del cuidador sobre el cuidado brindado a los hermanos contenía aspectos tanto positivos como negativos, y también se considera una práctica normal y rutinaria. Entre los puntos positivos, se encontró transmitir algo bueno a los hermanos, los desafíos y facilidades para realizar actividades de cuidado con los hermanos menores. La práctica del cuidado puede contribuir al sentimiento de importancia en el contexto familiar, además de ser percibida como un fracaso de las madres en el cumplimiento de sus responsabilidades. Las percepciones negativas se referían a la limitación del tiempo libre, la rutina estresante y la mediación de peleas entre hermanos menores. Es evidente la importancia de analizar lo que representa esta práctica para los cuidadores adolescentes, ya que puede asociarse a sentimientos de malestar, influir en el bienestar, así como limitar la realización de actividades de ocio.(AU)

Abordagem cognitivo-comportamental na escola: possibilidades de intervenção / Cognitive behavioral approach at school: possibilities for intervention

RESUMO O objetivo deste artigo é descrever técnicas grupais desenvolvidas nas turmas do 3º e 6º ano do ensino fundamental de uma escola municipal situada em uma cidade do interior do estado do Rio Grande do Sul. As técnicas tiveram o intuito de intervir em demandas escolares associadas a relações interpessoais e comportamentos desafiadores e opositores tendo como base os pressupostos teóricos e práticos da abordagem cognitivo-comportamental. Os grupos foram homogêneos, com média de 10 estudantes, com objetivo de psicoeducação e de orientação/ treinamento, visando a promoção de saúde na escola. A experiência relatada colabora com a práxis metodológica da área a qual pertence, oferecendo relatos de práticas singulares que podem ser adaptadas a outros contextos e demandas escolares similares.

ABSTRACT The objective of this article is to describe group techniques that have developed in the 3rd and 6th grade classes of a municipal school located in a city in the state of Rio Grande do Sul. These techniques, based on the theoretical and practical assumptions of cognitive behavioral theory, have intended to intervene in school demands related to interpersonal relationships and challenging behavior and opposing behaviors. The groups have been homogeneous, with an average of 10 students, aiming at psychoeducation and orientation / training, with the objective at to promote health at school. The reported experience collaborates with the methodological praxis of the area to which it belongs, offering reports of singular practices that can be adapted to other similar contexts and school demands.

DIREITOS HUMANOS NA ATUAÇÃO DE PSICÓLOGOS NA SOCIOEDUCAÇÃO / HUMAN RIGHTS IN THE PRACTICE OF PSYCHOLOGISTS IN SOCIO-EDUCATION / LOS DERECHOS HUMANOS EN EL DESEMPEÑO DE LOS PSICÓLOGOS EN SOCIOEDUCACIÓN

O estudo tem como objetivo investigar como a medida socioeducativa - MSE, na concepção dos profissionais participantes, vem influenciando na proteção e promoção dos direitos dos adolescentes em cumprimento de medida socioeducativa. Foram realizadas entrevistas semiestruturadas com seis psicólogos que trabalham com MSE. As entrevistas foram transcritas e analisadas qualitativamente. As respostas revelam o aspecto negativo das concepções socioculturais e das informações midiáticas sobre o adolescente em MSE, configurando inclusive em um desserviço ao desenvolvimento das Medidas de forma que impactam em desarticulações na rede de atendimento e inflam os preconceitos sociais. Quanto às garantias de direitos analisou-se pontos como: estrutura física, acesso à educação, respeito às individualidades dos adolescentes e acesso aos serviços básicos de saúde e assistência. Destaca-se a relevância de investir em capacitações para os profissionais não somente do sistema socioeducativo, mas de todas as políticas que devem assistir os adolescentes em cumprimento de MSE.

The study aims to investigate as a socio-educational measure - MSE, in the conception of participating professionals, which influences the protection and promotion of the rights of adolescents in compliance with socio-educational measure. Semi-structured interviews were conducted with six psychologists who work with MSE. The interviews were transcribed and analyzed qualitatively. The answers reveal the negative aspect of socio-cultural conceptions and media information about the adolescent in MSE, which also constitutes a disservice to the development of Measures in a way that impacts disarticulations in the service network and inflames social prejudices. As for the guarantee of rights, points were analyzed such as: physical structure, access to education, respect for the adolescents' individualities and access to basic health and assistance services. The relevance of investing in training for professionals is highlighted, not only from the socio-educational system, but from all policies that should assist adolescents in compliance with MSE.

El estudio tiene como objetivo investigar cómo la medida socioeducativa - MSE, en opinión de los profesionales participantes, ha influido en la protección y promoción de los derechos de los adolescentes en cumplimiento de la medida socioeducativa. Se realizaron entrevistas semiestructuradas con seis psicólogos que trabajan con MSE. Las entrevistas fueron transcritas y analizadas cualitativamente. Las respuestas revelan el aspecto negativo de las concepciones socioculturales y la información de los medios sobre los adolescentes en MSE, configurar incluso un perjuicio para el desarrollo de las Medidas de manera que afecte las interrupciones en la red de servicios e infla los prejuicios sociales. En cuanto a las garantías de derechos, se analizaron puntos como: estructura física, acceso a la educación, respeto a las individualidades de los adolescentes y acceso a servicios básicos de salud y asistencia. Se destaca la importancia de invertir en capacitación para profesionales, no solo desde el sistema socioeducativo, sino desde todas las políticas que deberían ayudar a los adolescentes a cumplir con las MSE.

Construindo "teias": fragilidades e potencialidades para o enfrentamento da violência contra a mulher / Building "cobwebs": fragilities and potentialities in order to face violence against women / Construyendo "telarañas": fragilidades y potencialidades para el enfrentamiento de la violencia contra la mujer

RESUMO A violência contra as mulheres possui caráter multidimensional e multideterminado. Portanto, a atenção voltada para estas situações deve abranger uma rede articulada e representativa de suas necessidades. Este artigo é um recorte de uma pesquisa qualitativa exploratória que teve como objetivo mapear a Rede de Enfrentamento à Violência Contra as Mulheres de um município gaúcho. Utilizou- -se da amostragem por Bola de Neve para coleta de informações e construção do fluxograma de indicações. A principal problemática apresentada é que, contrapondo o que é previsto pelas políticas vigentes, o trabalho em redes vem se construindo informalmente. Existem dois principais núcleos, o da Saúde e o Jurídico. Os setores da Assistência e Segurança Pública permanecem em segundo plano de funcionamento e reconhecimento. Além disso, a não existência de serviços, como o Centro de Referência, é um resultado preocupante, que direciona ao pouco engajamento do Estado com as estratégias de enfrentamento da violência.

ABSTRACT Violence against women has a multidimensional and multidetermined character. Therefore, the attention focused on these situations must cover an articulated network that represents its needs. This article is a summary of a qualitative exploratory research that aimed to map the Rede de Enfrentamento à Violência Contra as Mulheres (Combat Network of Violence Against Women) in a Brazilian southern municipal ity. The snowball sampling was used to collect information and construct a flow chart of indications. The main problem presented is that, in contrast to what is foreseen by the current public policies, networking has been constructed informally from participant's contacts. There are two main sectors, Health and Juridical front. The sectors of Public Assistance and Public Security remain in the background of operation and recognition. In addition, the lack of services, such as the Reference Center, is one of the most concerning results, which directs the lack of engagement of the State with coping strategies.

RESUMEN La violencia contra la mujer tiene un carácter multidimensional y multideterminador. Por lo tanto, la atención enfocada en estas situaciones debe cubrir una red articulada que represente sus necesidades. Este artículo es un recorte de una investigación cualitativa exploratoria que tuvo como objetivo mapear la Red de Enfrentamiento a la Violencia Contra las Mujeres de un municipio gaucho. Se utilizó del muestreo por Bola de Nieve para recopilar información y construir un diagrama de indicaciones. La principal problemática presentada es que, contrariamente a lo previsto por las políticas vigentes, el trabajo en redes se viene construyendo informalmente. Hay dos núcleos principales, el de la Salud y el Jurídico. Los sectores de Asistencia y Seguridad Pública permanecen en segundo plano de funcionamiento y reconocimiento. Además, la inexistencia de servicios, como el Centro de Referencia, es uno resultado preocupante, que apunta al poco compromiso del Estado con las estrategias de enfrentamiento a la violencia.

Trago junto comigo: consequências da violência sexual / I bring it with me: consequences of sexual violence / Lo llevo conmigo: consecuencias de la violencia sexual

Este artigo, realizado por meio de um estudo de caso explanatório, teve como objetivo compreender as consequências da violência sexual. Foram realizadas entrevistas semiestruturadas com duas mulheres, sendo uma que vivenciou violência sexual e outra que atua como profissional nos atendimentos a esta questão. Os dados foram analisados qualitativamente, por meio da técnica de análise de conteúdo temática, resultando em duas categorias nomeadas de: "A violência refletida: as consequências da VS" e "Redes de apoio: a busca por suporte e o acolhimento a quem sofreu VS". Os impactos da violência sexual são globais na vida de quem sofre este tipo de violência, atingindo todos os contextos, de forma direta ou indireta. Faz-se necessária a discussão sobre a violência sexual, de modo livre, sem tabus, incentivando a problematização das questões de gênero envolvidas.

The aim of this article is to understand the consequences of sexual violence, and, for this purpose, an explanatory case study was undertaken. The data were collected from semi-structured interviews with women involved in this issue and were investigated according to the content analysis method, resulting in three categories: "Thinking about violence: consequences of sexual violence on victim's behavior"; "Social support networks: a search for support and an embrace of those who suffered sexual violence" and "Global impact of sexual violence". Finally, one can observe that sexual violence has serious effects on those who have suffered it, affecting all aspects of life, directly or indirectly. The effects and the occurrences of this kind of violence are influenced by social gender issues.

Este artículo fue realizado por medio de un estudio de caso explicativo y tuvo como objetivo comprender las consecuencias de la violencia sexual. Fueron realizadas entrevistas semi estructuradas con dos mujeres, siendo una de ellas víctima de violencia sexual y la otra una profesional que actúa en la atención a estos casos. Los datos fueron analizados cualitativamente por medio de la técnica de análisis de contenido temática, resultando en dos categorías nombradas: "La violencia reflejada: las consecuencias de VS" y "Redes de apoyo: la búsqueda por atención y la acogida a quién sufrió VS". Los impactos de la violencia sexual son globales en la vida de quién la sufre, afectándola en todos los contextos, de modos directos o indirectos. Es necesaria la discusión sobre la violencia sexual de modo libre, sin tabúes, incentivando la discusión de las cuestiones de género relacionadas.