Prevalence of hysterectomy and associated factors in Brazilian women aged 50 and older: findings from the Brazilian Longitudinal Study of Ageing (ELSI-Brazil).

BACKGROUND: Hysterectomy is a gynaecological surgical procedure in which the uterus is removed as a treatment for both malignant and benign gynaecological diseases. A hysterectomy is also performed to minimise risks in women with problems related to the uterus. This study aimed to estimate the prevalence of reported hysterectomy and associated risk factors in Brazilian women aged 50 and older. METHODS: A cross-sectional study using data from the Brazilian Longitudinal Study of Ageing (ELSI-Brazil) was conducted. A total of 5,293 women aged 50 and over who participated in the ELSI-Brazil study in 2015 and 2016 were included. The prevalence rate of hysterectomy was estimated and the main reasons for performing the surgery were identified. The bivariate analyses utilised the chi-square test, while multivariate analyses employed Poisson regression with a robust estimator. RESULTS: The reported prevalence of hysterectomy was 17.8%. The most prevalent reason for the surgery was the presence of uterine myoma. Significant and independent associations were observed in women aged 63 and older, married, having undergone preventive exams, hormonal treatment, had up to three deliveries and having a private health plan. CONCLUSION: The main objective of the study was achieved. The prevalence of hysterectomy in Brazilian women aged 50 and older was 17.8%. Significant associations were observed with participants' sociodemographic and clinical characteristics reinforcing the importance of considering the reproductive characteristics of women as indicators of health status.

Using metabolic networks to predict cross-feeding and competition interactions between microorganisms.

Understanding the interactions between microorganisms and their impact on bacterial behavior at the community level is a key research topic in microbiology. Different methods, relying on experimental or mathematical approaches based on the diverse properties of bacteria, are currently employed to study these interactions. Recently, the use of metabolic networks to understand the interactions between bacterial pairs has increased, highlighting the relevance of this approach in characterizing bacteria. In this study, we leverage the representation of bacteria through their metabolic networks to build a predictive model aimed at reducing the number of experimental assays required for designing bacterial consortia with specific behaviors. Our novel method for predicting cross-feeding or competition interactions between pairs of microorganisms utilizes metabolic network features. Machine learning classifiers are employed to determine the type of interaction from automatically reconstructed metabolic networks. Several algorithms were assessed and selected based on comprehensive testing and careful separation of manually compiled data sets obtained from literature sources. We used different classification algorithms, including K Nearest Neighbors, XGBoost, Support Vector Machine, and Random Forest, tested different parameter values, and implemented several data curation approaches to reduce the biological bias associated with our data set, ultimately achieving an accuracy of over 0.9. Our method holds substantial potential to advance the understanding of community behavior and contribute to the development of more effective approaches for consortia design.IMPORTANCEUnderstanding bacterial interactions at the community level is critical for microbiology, and leveraging metabolic networks presents an efficient and effective approach. The introduction of this novel method for predicting interactions through machine learning classifiers has the potential to advance the field by reducing the number of experimental assays required and contributing to the development of more effective bacterial consortia.

Promising activity of etomidate against mixed biofilms of fluconazole-resistant Candida albicans and methicillin-resistant Staphylococcus aureus.

Introduction. Candida albicans and Staphylococcus aureus are recognized for their development of resistance and biofilm formation. New therapeutic alternatives are necessary in this context.Hypothesis. Etomidate shows potential application in catheters against mixed biofilms of fluconazole-resistant C. albicans and methicillin-resistant S. aureus (MRSA).Aim. The present study aimed to evaluate the activity of etomidate against mixed biofilms of fluconazole-resistant C. albicans and MRSA.Methodology. The action of etomidate against mature biofilms was verified through the evaluation of biomass and cell viability, and its ability to prevent biofilm formation in peripheral venous catheters was determined based on counts of colony forming units (c.f.u.) and confirmed by morphological analysis through scanning electron microscopy (SEM).Results. Etomidate generated a reduction (P<0.05) in biomass and cell viability starting from a concentration of 250 µg ml-1. In addition, it showed significant ability to prevent the formation of mixed biofilms in a peripheral venous catheter, as shown by a reduction in c.f.u. SEM revealed that treatment with etomidate caused substantial damage to the fungal cells.Conclusion. The results showed the potential of etomidate against polymicrobial biofilms of fluconazole-resistant C. albicans and MRSA.

Análise do filme lacrimal e dos sintomas de olho seco em pacientes submetidos à facoemulsificação / Analysis of the tear film and dry eye symptoms in patients undergoing phacoemulsification

RESUMO Objetivo: Avaliar o filme lacrimal e os sintomas de olho seco antes e após a realização da facoemulsificação. Métodos: Participaram deste estudo clínico 51 pacientes diagnosticados com catarata (55% mulheres; 78% brancos; 71,2 ± 6,5 anos de idade; sem uso de colírio lubrificante) que foram submetidos à facoemulsificação em um hospital na cidade de Aparecida (SP). A análise do filme lacrimal foi feita pelo teste de ruptura do filme lacrimal, e os sintomas de olho seco foram avaliados pelo Índice de Doença da Superfície Ocular, ambos antes da cirurgia e 30 e 60 dias de pós-operatório. Resultados: Na análise pré-operatória, 25,5% dos pacientes tinham olho seco pelo critério subjetivo (Índice de Doença da Superfície Ocular ≥ 25%), enquanto a proporção de pacientes com olho seco foi de 92,2% pelo critério objetivo (teste de ruptura do filme lacrimal < 10 segundos). Não houve correlação entre o teste de ruptura do filme lacrimal e o Índice de Doença da Superfície Ocular (r = −0,14; p = 0,33). Não foi observada redução dos sintomas de olho seco (15,9 ± 17,6 versus 12,2 ± 13,2 versus 7,8 ± 11,5; p < 0,001) e nem do tempo de ruptura do filme lacrimal (6,2 ± 2,2 vs. 4,3 ± 2,0 versus 6,9 ± 2,0 segundos; p < 0,001) no pré, 30 e 60 dias após a cirurgia. Conclusão: A facoemulsificação desencadeia sintomas de olho seco e altera os valores do teste de ruptura do filme lacrimal e do Índice de Doença da Superfície Ocular, havendo melhora depois da cirurgia, com o passar dos dias. Observou-se que, após os 60 dias, os sintomas de olho seco avaliados pelo Índice de Doença da Superfície Ocular apresentaram melhora. Em relação ao filme lacrimal, avaliado pelo teste de ruptura do filme lacrimal, observou-se que houve piora estatisticamente significativa aos 30 dias, seguida de melhora no pós-operatório de 60 dias. Os resultados sugerem que a análise clínica do olho seco deve ser realizada por diferentes métodos, preferencialmente objetivos.

ABSTRACT Objective: To evaluate the tear film and dry eye symptoms before and after phacoemulsification. Methods: Fifty-one patients diagnosed with cataracts participated in this clinical study (55% female; 78% white; 71.2 ± 6.5 years old; without the use of lubricating eye drops) and underwent phacoemulsification at a hospital in Aparecida (SP). Tear film analysis was performed by the tear film break-up test and dry eye symptoms were assessed by the Ocular Surface Disease Index, both before surgery and 30 and 60 days after surgery. Results: In the preoperative analysis, 25.5% of the patients had dry eye according to the subjective criterion (Ocular Surface Disease Index ≥ 25%), while the proportion of patients with dry eye was 92.2% according to the objective criterion (tear film break-up test < 10 seconds). There was no correlation between tear film break-up test and Ocular Surface Disease Index (r = −0.14; p = 0.33). There was no reduction in dry eye symptoms (15.9 ± 17.6 versus 12.2 ± 13.2 versus 7.8 ± 11.5; p<0.001) nor in tear film break-up time (6.2 ± 2.2 versus 4.3 ± 2.0 versus 6.9 ± 2.0 seconds; p < 0.001) before, 30 and 60 days after surgery. Conclusion: Phacoemulsification triggers dry eye symptoms and changes Ocular Surface Disease Index and tear film break-up test values, with improvement over the postoperative days. Sixty days after surgery, the symptoms of dry eye assessed according to the Ocular Surface Disease Index improved. Regarding the tear film, evaluated by tear film break-up test, it was observed that there was a statistically significant worsening at 30 days, followed by an improvement in the postoperative period of 60 days. The results suggest that the clinical analysis of dry eye should be performed using different methods, preferably objective ones.

A qualitative study on emotional labor and work-family conflictin caregivers working in nursing homes / Un estudio cualitativo sobre el trabajo emocional y el conflicto trabajo-familia en cuidadores que trabajan en residencias de ancianos

A pesar de la evidencia que sugiere que el trabajo de cuidado implica la realización de trabajo emocional y experiencias de conflicto trabajo-familia, la relación de estas dos experiencias de trabajo sigue sin ser examinada. El presente estudio tiene como objetivo explorar las experiencias de desempeño del trabajo emocional y el conflicto trabajo-familia y sus vínculos entre los cuidadores que trabajan en hogares de ancianos. Para abordar la pregunta de investigación, utilizamos entrevistas semiestructuradas con una muestra de 24 mujeres cuidadoras que trabajan a tiempo completo en residencias de ancianos en el centro y norte de Portugal. Los resultados revelaron la presencia de trabajo emocional, Conflicto Trabajo-Familia y un impacto del trabajo emocional en Conflicto Trabajo-Familia basado en la tensión. En general, los resultados sugirieron que el trabajo emocional tiene efectos en Conflicto Trabajo-Familia, lo que apunta a la necesidad de que los directores de las instituciones de cuidado de ancianos consideren formas de reducir estos efectos nocivos en los trabajadores.(AU)

Despite evidence suggesting that care work involves the perfor-mance of emotional labor an experience of work-family conflict, the rela-tion of these two work experiences remain under-examined. The present study aims to fill this gap by exploring the experiences of performing emo-tional labor and work-family conflict and their links among caregivers working in nursing homes. To address the research question, we used semi-structured interviews with a sample of 24 female caregivers working full-time in nursing homes in the center and north of Portugal. The results revealed the presence of emotional labor, work-family conflict, and an im-pact of emotional labor in strain-based work-family conflict. Overall, the results suggested that emotional labor has effects on work-family conflict, pointing to the need that directors of elderly care institutions should con-sider ways of reducing these harmful effects on worker.(AU)

Analysis of biomechanics in athletes with disabilities: a systematic and narrative review / Análise da biomecânica em atletas com deficiência: uma revisão sistemática e narrativa

Abstract Introduction Specifically in athletes with disabilities, investigations and biomechanical understanding seem to be even more relevant, as they provide data on how a certain type of disability limits sports practice and also describe parameters that allow the suggestion of relevant adaptations capable of guaranteeing a higher level comfort to practitioners. Objective To describe patterns of biomechanical behavior during exercise in athletes with disabilities, and to discuss possible relationships between the type of disability and the sport practiced. Methods This study performed a search in five electronic databases from the oldest records available until July 2020 using a search strategy that combined terms related to "athletes with disabilities" and "biomechanical analysis." Inclusion criteria: population (amateur or professional athletes with disabilities), intervention (sports practice), study design (observational), outcome (having evaluated biomechanics during sports practice). The biomechanical variables of interest included kinematic, kinetic, or electromyographic outcome measures. Results Tewnty-six articles met the inclusion criteria (n = 705 participants). Biomechanical analysis showed that there is a greater inclination in the angle of the head and an increase in the kinematic variables in blind athletes, which result in less distance, speed, and performance; compensatory body patterns, reduced mooring strength, speed, joint amplitude, and reduced final performance are observed in amputated limbs of amputees; and there was a strong correlation between the subject's functional classification and kinematic parameters in wheelchair athletes, with this being proportional to the level of impairment. Conclusion The outcomes demonstrated that the type of disability and the level of functional limitation are proportionally related to biomechanics in athletes with disabilities.

Resumo Introdução Em atletas com deficiência, as investigações e o entendimento biomecânico parecem ser ainda mais relevantes ao fornecer dados sobre de que modo determinado tipo de deficiência limita a prática esportiva e, ainda, descrever parâmetros que permitam sugestão de adaptações pertinentes capazes de garantir maior nível de conforto aos praticantes. Objetivo Descrever padrões de comportamento biomecânico durante o exercício em atletas com deficiência e discutir possíveis relações entre o tipo de deficiência e o esporte praticado. Métodos Este estudo realizou uma busca em cinco bases de dados eletrônicas a partir dos registros mais antigos disponíveis até julho de 2020, utilizando uma estratégia de busca que combinou termos relacionados a "atletas com deficiência" e "análise biomecânica". Critérios de inclusão: população (atletas amadores ou profissionais com deficiência), intervenção (prática esportiva), desenho do estudo (observacional), resultado (ter avaliado a biomecânica durante a prática esportiva). As variáveis biomecânicas de interesse incluíram medidas de desfecho cinemáticas, cinéticas ou eletromiográficas. Resultados Vinte e seis estudos atenderam aos critérios de inclusão (n = 705 participantes). Os resultados mostraram que há maior inclinação do ângulo da cabeça e aumento das variáveis cinemáticas em atletas cegos, resultando em menor distância, velocidade e desempenho; padrões corporais compensatórios, redução da força de amarração, velocidade, amplitude articular e desempenho final reduzido são observados em membros amputados de amputados; e parece haver relação entre a classificação funcional do sujeito e os parâmetros cinemáticos em atletas de cadeira de rodas, sendo esta proporcional ao grau de comprometimento. Conclusão Os resultados demonstraram que o tipo de deficiência e o nível de limitação funcional estão proporcionalmente relacionados à biomecâ-nica em atletas com deficiência.

Are prosodic effects on sentence comprehension dependent on age? / Os efeitos prosódicos na compreensão de frases variam de acordo com a idade?

ABSTRACT Purpose to investigate prosodic boundary effects on the comprehension of attachment ambiguities in Brazilian Portuguese and to test two hypotheses relying on the notion of boundary strength: the absolute boundary hypothesis (ABH) and the relative boundary hypothesis (RBH). Manipulations of prosodic structure influence how listeners interpret syntactically ambiguous sentences. However, the role of prosody in spoken language comprehension of sentences has received limited attention in languages other than English, particularly from a developmental perspective. Methods Twenty-three adults and 15 children participated in a computerized sentence comprehension task involving syntactically ambiguous sentences. Each sentence was recorded in eight different prosodic forms with acoustic manipulations of F0, duration and pause varying the boundary size to reflect predictions of the ABH and RBH. Results Children and adults differed in how prosody influenced their syntactic processing and children were significantly slower than adults. Results indicated that interpretation of sentences varied according to their prosodic forms. Conclusion Neither the ABH or the RBH explained how children and adults who speak Brazilian Portuguese use prosodic boundaries to disambiguate sentences. There is evidence that the way prosodic boundaries influence disambiguation varies cross-linguistically.

RESUMO Objetivo investigar os efeitos de fronteiras prosódicas na compreensão de ambiguidades sintáticas no português brasileiro além de testar duas hipóteses baseadas na noção de intensidade de fronteira: a hipótese de fronteira absoluta (ABH) e a hipótese de fronteira relativa (RBH). Manipulações da estrutura prosódica influenciam como os ouvintes interpretam frases sintaticamente ambíguas. No entanto, o papel da prosódia na compreensão da linguagem oral tem recebido atenção limitada em línguas além do inglês, particularmente do ponto de vista do desenvolvimento. Método Vinte e três adultos e 15 crianças participaram de uma tarefa computadorizada de compreensão de frases envolvendo frases sintaticamente ambíguas. Cada frase foi gravada em oito formas prosódicas diferentes com manipulações acústicas de F0, duração, e pausa, variando o tamanho da fronteira prosódica de modo a transparecer as previsões da ABH e RBH. Resultados Crianças e adultos diferiram em como a prosódia influenciou o processamento sintático; as crianças foram significativamente mais lentas que os adultos. Os resultados indicaram que a interpretação das frases variou de acordo com suas formas prosódicas. Conclusão Nenhuma das hipóteses (ABH ou RBH) explica como crianças e adultos falantes do Português brasileiro utilizam as fronteiras prosódicas para desambiguar frases. Há evidências de que a maneira com a qual os limites prosódicos influenciam a desambiguação de frases varia entre os idiomas.

Risk factors independently associated with the maintenance of severe restriction of oral intake and alternative feeding method indication at hospital outcome in patients after acute ischemic stroke

Abstract Background and aims From a clinical point of view, post-stroke patients present difficulties in swallowing management. The purpose of this research was to identify risk factors that were independently related to the maintenance of a severe restriction of oral intake in patients affected by acute ischemic stroke. Methods The authors conducted a prospective observational cohort study of patients with dysphagia post-acute ischemic stroke who were admitted to an Emergency Room (ER). Demographic and clinical data were collected at ER admission. Swallowing data was based on The Functional Oral Intake Scale (FOIS) and was collected at two distinct moments: initial swallowing assessment and at the patient outcome. Patients were divided into two groups according to their FOIS level assigned on the last swallowing assessment (at hospital outcome): G1 with severe restriction of oral intake and indication of feeding tube - patients with FOIS levels 1 to 4; G2 without restriction of food consistencies in oral intake - patients with FOIS levels 5 to 7. Results One hundred and six patients were included in our study. Results of the multivariate logistic regression model for the prediction of maintenance of a severe restriction of oral intake at hospital outcome in patients post-acute ischemic stroke indicated that increasing age (p = 0.006), and dysarthria (p = 0.003) were associated with higher chances of presenting severe restriction of oral intake at hospital outcome. Conclusions Patients with acute ischemic stroke in an Emergency Room may experience non-resolved severe dysphagia, indicating the need to prepare for the care/rehabilitation of these patients.

Análise de preditores de risco cumulativo para a gagueira persistente: percepção familiar e quantidade de rupturas da fala / Analysis of cumulative risk predictors for persistent stuttering: family perception and amount of speech disruptions

RESUMO Objetivo Pesquisar duas variáveis independentes consideradas como possíveis preditores de risco cumulativo para a gagueira persistente (GP): percepção familiar da gagueira e quantidade de rupturas da fala. Método Participaram 452 crianças, com idade entre 3 a 11:11 anos, de ambos os gêneros, divididos em 4 grupos: grupo 1 (GGQ), 158 crianças com percentual de rupturas gagas ≥3% e queixa familiar de gagueira; grupo 2 (GGS), 42 crianças com percentual de rupturas gagas ≥3% e sem queixa familiar de gagueira; grupo 3 (FQ), 94 crianças com percentual de rupturas gagas ≤2.9% com queixa familiar de gagueira e grupo 4 (FS), 158 crianças com percentual de rupturas gagas ≤2.9 sem queixa familiar de gagueira. Resultados Para o grupo GGQ há relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala típicas da gagueira e houve predominância de crianças do sexo masculino. Para o grupo GGS não houve relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala. Para o grupo FQ não houve relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala. Para o grupo FS houve relação significante entre a ausência de queixa familiar de gagueira e a reduzida quantidade de rupturas de fala. Conclusão O percentual de rupturas ≥3% é um indicador de risco para a GP. A queixa familiar de rupturas do tipo repetições pode ser um indicador de risco para a GP. A queixa familiar de gagueira, isoladamente, não deve ser considerada como indicador de GP.

ABSTRACT Purpose To investigate two independent variables considered as two possible predictors of cumulative risk for persistent stuttering: family perception of stuttering and amount of speech disruptions. Methods Participants were 452 children, aged 3 to 11:11 years, male and female, divided into 4 groups: group 1 (SCG), composed of 158 children who presented a percentage of stuttered speech disruptions ≥ 3% and family complaint of stuttering; group 2 (SWCG), 42 children who presented percentage of stuttered speech disruptions ≥ 3% and without family complaint of stuttering; group 3 (FCG), 94 children who presented percentage of stuttered speech disruptions ≤ 2. 9% with family complaints of stuttering and group 4 (FWCG), 158 children who presented a percentage of stuttered speech disruptions ≤ 2.9 without family complaints of stuttering. Results For the SCG group, there was a significant relationship between family complaints of stuttering and the number of speech disruptions typical of stuttering. In this group, there was a predominance of male children. For the SWCG group, there was no significant relationship between family complaints of stuttering and the number of speech disruptions. For the FCG group, there was no significant relationship between family complaints of stuttering and the number of speech disruptions. For the FWCG group, there was a significant relation between the absence of a family complaint of stuttering and the reduced number of speech disruptions. Conclusion The percentage of speech disruptions ≥ 3% is a risk indicator for persistent stuttering. The percentage of speech disruptions ≤ 2.9% associated with syllable and sound repetitions can be a risk indicator for persistent stuttering. Family complaints of syllable and sound repetitions may be a risk indicator for persistent stuttering. Family complaints of stuttering alone should not be considered an indicator of persistent stuttering.

Correlação entre achados da avaliação clínica miofuncional orofacial, a pressão e a atividade eletromiográfica da língua na deglutição em indivíduos com diferentes alterações da motricidade orofacial / Correlation between findings of the oral myofunctional clinical assessment, pressure and electromyographic activity of the tongue during swallowing in individuals with different orofacial myofunctional disorders

RESUMO Objetivo correlacionar os achados da avaliação clínica miofuncional orofacial, pressão de língua e da eletromiografia de superfície (EMGs) da deglutição de grupos de pacientes com diferentes alterações da motricidade orofacial. Método 44 pacientes (20 homens e 24 mulheres com idades entre 17 e 63 anos), com diferentes alterações miofuncionais orofaciais foram avaliados por meio da Avaliação Miofuncional Orofacial com Escores Expandido (AMIOFE-E), avaliação da amplitude mandibular e antropometria facial, mensuração da pressão de língua (ponta e dorso) e exame de Eletromiografia de Superfície (EMGs) em região supra hioidea na tarefa de deglutição de saliva e diferentes volumes de água. Resultados a análise estatística encontrou algumas correlações fracas que envolvem a pressão do dorso de língua e sugerem que quanto maior for a medida do terço inferior, menor será a pressão do dorso da língua; quanto maior for a medida dos trespasses (vertical e horizontal) maior será a pressão do dorso da língua; quanto maior for a pontuação da avaliação de postura e funções orofaciais, maior será a pressão do dorso de língua e quanto maior for a pressão do dorso de língua, maior será a pressão da ponta da língua. Conclusão os resultados sugerem que as alterações miofuncionais orofaciais encontradas nos diferentes grupos de pacientes estão mais relacionadas às discrepâncias maxilomandibulares do que às patologias pesquisadas no presente estudo.

ABSTRACT Purpose To correlate the findings regarding the myofunctional orofacial examination, tongue pressure and surface electromyography (sEMG) of deglutition in individuals with different orofacial myofunctional disorders. Methods 44 patients (20 males and 24 females, aged between 17 and 63 years old) with different orofacial myofunctional changes were clinically assessed using the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-E). In addition, the range of mandibular movements and facial anthropometry were measured, along with the assessment of the tongue pressure (tip and dorsum) and of the electrical activity of the suprahyoid muscles during deglutition, using surface electromyography (sEMG). Results The statistical analysis found weak correlations between tongue dorsum pressure values, suggesting that the greater the measurement of the lower third of the face, the lower the pressure of the tongue dorsum; the greater the measurement of the overlaps (vertical and horizontal), the higher the pressure of the tongue dorsum; the higher the score from the orofacial evaluation and orofacial functions assessment, the higher the pressure of the tongue dorsum; and the higher the pressure of the tongue dorsum, the higher the pressure of the tongue tip. Conclusion The present study results indicate that the orofacial myofunctional changes found in different groups of patients are more related to the maxillomandibular discrepancies than to the pathologies investigated herein.

Characterization of feeding skills and clinical markers of preterm newborns with gastroschisis in a neonatal therapy unit / Caracterização das habilidades de alimentação e marcadores clínicos de recém-nascidos prematuros com gastrosquise em unidade de terapia neonatal

ABSTRACT Objective To describe the clinical and feeding findings of premature infants with gastroschisis (GTQ) in a neonatal intensive care unit and compare them to preterm infants (NBs) without congenital anomalies. Methods A retrospective case-control study was conducted with 50 premature NBs (25 with GTQ and 25 without comorbidities - control group). The NBs were compared regarding demographic and clinical data: risk of mortality and speech-language assessment (nonnutritive and nutritive sucking). Subsequently, a multiple logistic regression model was applied to determine the variables associated with the negative speech therapy outcome (speech therapy discharge after more than 7 days considering the first speech therapy evaluation). Results The results of the first analysis indicated that there was a difference between the GTQ and the CG for the following variables: total time in days of hospitalization; use of mechanical ventilation (invasive x noninvasive); days of life on the date of the first speech-language assessment; use of alternative feeding route; and the GTQ group had worse results. The results of the multiple logistic regression indicated that the diagnosis of GTQ, the use of invasive mechanical ventilation, and the absence of adequate intraoral pressure during the first speech-language evaluation were risk factors for a negative speech-language outcome. Conclusion The feeding skills of preterm infants with QTG are related to the severity of the condition (gastrointestinal tract complications), requiring longer hospitalization, use of invasive mechanical ventilation, prolonged use of alternative feeding route and requiring more speech therapy to start oral feeding.

RESUMO Objetivo Descrever os achados clínicos e de alimentação de prematuros com gastrosquise (GTQ) em uma unidade de terapia intensiva neonatal comparando-os a recém-nascidos (RNs) prematuros sem anomalias congênitas. Método Foi realizado estudo caso controle de caráter retrospectivo com 50 RNs prematuros (25 com GTQ e 25 sem comorbidades - grupo controle). Os RNs foram comparados quanto aos dados demográficos clínicos: risco de mortalidade e de avaliação fonoaudiológica (sucção não nutritiva e nutritiva). Posteriormente foi aplicado o modelo de regressão logística múltipla a fim de determinar as variáveis associadas ao desfecho fonoaudiológico negativo (alta fonoaudiológica após mais de 7 dias considerando a primeira avaliação fonoaudiológica). Resultados Os resultados da primeira análise indicaram que houve diferença entre o GTQ e o GC para as seguintes variáveis: tempo total em dias de internação; uso de ventilação mecânica (invasiva x não invasiva); dias de vida na data da primeira avaliação fonoaudiológica; uso de via alternativa de alimentação, sendo que o grupo GTQ apresentou piores resultados. Os resultados da regressão logística múltipla indicaram que o diagnóstico de GTQ, uso de ventilação mecânica invasiva e ausência de pressão intraoral adequada durante a primeira avaliação fonoaudiológica foram fatores de risco para o desfecho fonoaudiológico negativo. Conclusão As habilidades de alimentação dos prematuros com GTQ está relacionada à gravidade do quadro (complicações do trato gastro digestivo), exigindo maior tempo de internação, uso de ventilação mecânica invasiva, uso prolongado de via alternativa de alimentação e necessidade de mais atendimento fonoaudiológico para iniciar a alimentação por via oral.

Effect of low temperature and room temperature on the depth of cure of bulk-fill composite resins

The study analyzed the influence of temperature on the depth of cure of bulk-fill composite resins. Three discs (ISO 4049/2000) from each group were made, and four restorative materials were investigated: Opus Bulk-Fill Flow, Opus Bulk-Fill APS, Filtek™ One Bulk-Fill, and Filtek™ Bulk-Fill Flow. They were light-cured (Gnatus ± 1,200 mW/cm2) for 20 seconds, varying the temperature (23°C and 5°C) and simulating the use of the product both at room temperature and under refrigeration. The materials were inserted in aluminum matrices with 10 mm in depth and 4 mm in diameter. A clear film strip and a glass microscope slide were positioned at the top and bottom surfaces. The material was condensed and light-cured with the tip of the light source in close contact, for 20 seconds on the top surface. Immediately after irradiation, the samples were removed from the mold, and the uncured part was removed with a plastic spatula. The measurement was performed with a micrometer ± 0.1 mm, and the value was divided by 2. The data were analyzed with two-way ANOVA at a significance of 0.05. There was a statistical difference in the temperature between the results obtained in Opus Bulk-Fill APS (p <0.001) and Filtek™ Bulk-Fill Flow (p = 0.018) resins. For the temperature of 5°C, Filtek™ Bulk-Fill Flow showed a statistical difference compared to the other resins, while Opus Bulk-Fill Flow and Opus Bulk-Fill APS did not. For the temperature of 23°C, Filtek™ Bulk-Fill Flow maintained the statistical difference from the others, but Filtek™ One Bulk-Fill and Opus Bulk-Fill APS did not present statistical differences. Storing the Filtek™ Bulk-Fill Flow composite resin in the refrigerator caused a greater depth of cure than the other resins, and the depth of cure decreased at room temperature. As for Opus Bulk-Fill APS, the depth of cure decreased proportionally to the temperature decrease. The temperature may affect the depth of cure of some composite resins.

Processamento e conservação de enxertos de pele: uma abordagem com foco nos métodos de criopreservação, liofilização e glicerolização / Skin grafts processing and conservation: an approach focusing on cryopreservation, freeze-drying and glycerol conservation methods

Introdução: o uso de substitutos cutâneos para o tratamento de diversas feridas graves é uma forma eficiente de prevenir infecções e favorecer o processo de reepitelização. No entanto, tecidos biológicos estão suscetíveis a degradação e contaminação. Por isso, devem ser submetidos a rigorosos protocolos de processamento e testes que comprovem suas contribuições benéficas e segurança de aplicação. Objetivo: trazer uma abordagem sobre as principais características dos métodos de criopreservação, glicerolização e liofilização e sua consequencia nos aspectos imunológicos, microbiológicos e de viabilidade tecidual de enxertos de pele humana. Metodologia: foi realizada uma busca online utilizando as palavras chaves "criopreservação", "liofilização", "glicerolização", "enxertos", "processamento tecidual" e "engenharia dos tecidos" em múltiplas combinações nos bancos de dados PubMed, LILACS e ScienceDirect. Resultados: 200 artigos científicos foram obtidos, 26 excluídos por duplicidade, 92 selecionados para leitura integral a partir da leitura de seus resumos e 27 utilizados na construção desta revisão. A liofilização e a glicerolização são métodos semelhantes considerando a viabilidade tecidual. O uso de glicerol traz como principal desvantagem sua citotoxicidade quando comparado aos outros métodos. A criopreservação mantém os tecidos viáveis. Contudo, pode ser mais cara e trazer riscos de transmissão de microorganismos patogênicos. De modo geral, não é bem estabelecido quais os melhores métodos de conservação para uma adequada conservação da viabilidade dos enxertos de pele. Considerações Finais: os 3 métodos, liofilização, glicerolização e criopreservação, possuem aplicabilidade na conservação de enxertos. A falta de padronização na aplicação de enxertos apesar de sua frequente aplicação e a escassez de estudos recentes sobre o tema justificam o presente estudo.

Introduction: the use of skin substitutes for treatment of several wounds is an efficient way to prevent infections and allow the re-epithelialization process. However, biological tissues are susceptible to degradation and contamination. Therefore, they must undergo rigorous processing and testing protocols that prove their beneficial contributions and application security. Objective:to bring an approach on the main characteristics of cryopreservation, freeze-drying and glycerol conservation methods and their implications on immunological, microbiological and tissue viability aspects when applied to human skin grafts. Methodology:a mostly online search was performed using the keywords "cryopreservation", "freeze-drying", "glycerol conservation", "grafts", "tissue processing" and "tissue engineering" in multiple combinations in PubMed, LILACS and ScienceDirect databases. Results: 200 scientific articles were rescued, 26 excluded by duplicity, 92 selected for full reading from the reading of their abstracts and 27 used in the construction of this review. Freeze-drying and glycerol conservation are similar methods, with glycerol conservation having greater economic advantage. The use of glycerol presents cytotoxicity when compared to the other methods. Cryopreservation keeps tissues viable, however, is more expensive and carry risks of transmission of pathogenic microorganisms. Overall, there is a lack of clarity about the importance of viability in the performance of skin grafts. Final considerations: the 3 methods have applicability in graft conservation. The lack of standardization in graft application despite its frequent application and the scarcity of recent studies on the subject justify the present study.

Ensaio clínico de tratamento - em três modalidades - para crianças com distúrbios da fluência e gagueira / Treatment clinical trial - three types - for children with fluency disorders and stuttering

RESUMO Objetivo Delinear um ensaio clínico de tratamento - em três modalidades - que verificasse se os tramentos testados para a gagueira crônica do desenvolvimento (GCD) apresentam indicadores que permitam reunir informações para a continuidade da sua aplicação, estabelecendo uma relação benefício-risco eficaz e segura. Método Para a realização do estudo foram analisadas 252 crianças, com idades entre 2 e 12 anos, que realizaram avaliação e tratamento para a GCD. Dentre as crianças atendidas, 93 cumpriram todos os critérios de elegibilidade. Após a obtenção dos escores de risco para GCD (Protocolo de Risco para a Gagueira do Desenvolvimento) todas as crianças foram avaliadas segundo seu perfil da fluência e grau de gravidade da gagueira. Foram aplicados os tratamentos para GCD: Programa Verde; Programa Amarelo e Programa Vermelho. A determinação do tratamento mais indicado para cada criança foi baseada na análise do grau de risco para a GCD. Resultados Todos os programas terapeuticos apresentaram resultados de melhora pós-tratamento consistentes nos segmentos analisados com exceção de: repetição de palavras; prolongamentos no final das palavras e intrusão de sons/segmentos. Conclusão Os programas terapêuticos testados - verde, amarelo e vermelho - foram eficientes para a ampla maioria dos participantes. A intervenção direta, aplicada no Programa Vermelho, foi altamente eficiente para a promoção da fala fluente, indicando que para os casos com maior índice de cronicidade a aplicação de técnicas específicas é indicada.

ABSTRACT Purpose To present a treatment clinical trial, involving three types of treatment for chronic developmental stuttering (CDS), to verify whether they present indicators and sufficient information to establish an effective and safe benefit-risk relationship. Methods The study included 252 children between 2 and 12 years old, who underwent assessment and treatment for CDS. Among the selected children, 93 met the established inclusion criteria. After obtaining the scores for the risk of CDS (Protocol for the Risk of Developmental Stuttering), all children were assessed according to their fluency profile and the severity level of stuttering. The children underwent treatment for CDS Green, Yellow and Red Programs. The treatment chosen for each child was based on the analysis of the risk for CDS. Results All therapeutic programs presented positive results in the post-treatment assessment considering the analyzed parameters, with the exception of word repetition, sound prolongation at the end of words, and intrusion of sounds/word segments. Conclusion The tested therapeutic programs - green, yellow, and red - were efficient for most of the participants. The direct intervention used in the Red Program was highly efficient in promoting fluent speech. This result suggests that for most of the patients with a higher risk of developing the chronic form of stuttering, the use of specific fluency promotion techniques is indicated.

Decannulation: a retrospective cohort study of clinical and swallowing indicators of success

Abstract Objective: To investigate the clinical and swallowing indicators related to a successful decannulation process during the hospital stay. Methods: A retrospective cohort clinical study. The study sample comprised a heterogeneous patient population who had submitted to a tracheostomy procedure in a tertiary hospital. Patients were divided into two groups (dec-annulated vs. non-decannulated) and compared not only in terms of demographic and clinical data but also the results of a swallowing assessment and intervention outcome. Results: Sixty-four patients were included in the present study: 25 (39%) who had been successfully decannulated, and 39 (61%) who could not be decannulated. Between-group comparisons indicated that both groups presented similar clinical and demographic characteristics. The groups also presented similar swallowing assessment results prior to intervention. However, significant differences were observed regarding the time to begin swallowing rehabilitation. The decannulated group was assessed nine days earlier than the non-decannulated group. Other significant differences included the removal of the alternate feeding method (72.0% of decannulated patients vs. 5.1% of non-decannulated patients) and the reintroduction of oral feeding (96.0% of decannulated patients vs. 41.0% of non-decannulated patients) and functional swallowing level at patient disclosure. The non-decannulated patient group presented higher death rates at disclosure. Conclusion: The results of the present study indicated that the following parameters were associated with a successful decannulation process: early swallowing assessment, swallowing rehabilitation, and improvement in the swallowing functional level during the hospital stay. The maintenance of low swallowing functional levels was found to be negatively associated with successful decannulation. HIGHLIGHTS Deccanulation indicators were investigated in patients who were submitted to a tracheostomy procedure. Early swallowing evaluation and rehabilitation were associated with a successful decannulation process. Low swallowing functional levels were negatively associated with the success of decannulation.

Citizenship fatigue as mediator between compulsory citizenship behavior and work-family conflict / Fadiga de cidadania como mediador entre comportamentos obrigatórios de cidadania e conflito trabalho-família / La fatiga de la ciudadanía como mediadora entre comportamientos obligatorios de ciudadanía y conflicto trabajo-familia

Framed by the conservation of resources theory, we investigated the mediating role of citizenship fatigue in the relationship between compulsory citizenship behavior and work-family conflict. Using a sample of 171 women (M = 41.16, SD = 10.18) working in facilities for the elderly in Portugal, we examined the direct and indirect relationship between compulsory citizenship behavior and work-family conflict. The data, collected using a self-reported questionnaire, shows that compulsory citizenship behavior influences work-family conflict with citizenship fatigue as a mediator. Theoretical and practical implications are discussed.

Apoiados na teoria da conservação de recursos, investigamos o papel mediador da fadiga de cidadania na relação entre os comportamentos obrigatórios de cidadania organizacional e o conflito trabalho-família. Com base numa amostra de 171 mulheres (M = 41,16; SD = 10,18) a trabalhar em instituições para idosos em Portugal, examinámos a relação direta e indireta entre comportamentos obrigatórios de cidadania organizacional e o conflito trabalho-família. Os dados recolhidos através de um questionário de autopreenchimento mostram que os comportamentos obrigatórios de cidadania influenciam o conflito trabalho-família e que esta relação é mediada pela fadiga de cidadania. Implicações teóricas e práticas são discutidas.

Con base en la teoría de la conservación de recursos, investigamos el papel mediador de la fatiga de la ciudadanía en la relación entre los comportamientos de ciudadanía organizacional y el conflicto trabajo-familia. A partir de una muestra de 171 mujeres (M = 41.16; SD = 10,18) que trabajan en instituciones para la tercera edad en Portugal, examinamos la relación directa e indirecta entre comportamientos obligatorios de ciudadanía organizacional y el conflicto trabajo-familia. El resultado muestra que los comportamientos obligatorios de ciudadanía influyen en el conflicto trabajo-familia y que esta relación está mediada por la fatiga ciudadana. Se discuten las implicaciones teóricas y prácticas.

A influência da hereditariedade na ocorrência de variáveis preditoras na gagueira crônica do desenvolvimento / The influence of heredity on the predictor variables of chronic developmental stuttering

RESUMO Objetivo Testar a variável da hereditariedade familiar para a gagueira crônica do desenvolvimento (GCD) como preditora de efeito direto no desfecho da fluência da fala em crianças. Métodos Participaram do estudo 200 crianças, de 2 a 12 anos, de ambos os gêneros, sem distinção de raça e nível sócio-econômico-cultural, que apresentaram queixa de GCD, sem outras intercorrências de linguagem e/ou audição, no período de cinco anos. Os 200 participantes deste estudo foram divididos em três grupos (baixo risco para GCD, médio risco para GCD e alto risco para GCD) conforme os indicadores de risco aferidos pelo Protocolo de risco para a gagueira do desenvolvimento. Para determinação da variável de controle (hereditariedade positiva para a gagueira) foi considerado afetado o participante que apresentava familiar de primeiro grau (pai, mãe, irmãos) que se auto identificava como pessoa com gagueira. Todos os participantes foram avaliados segundo o Protocolo de risco para a gagueira do desenvolvimento e pela Avaliação do Perfil da Fluência de Fala. Resultados Os grupos de baixo, médio e alto risco para GCD com hereditariedade positiva não se diferenciaram estatisticamente dos grupos de baixo, médio e alto risco para GCD com hereditariedade negativa para nenhuma das variáveis demográficas e resultado da análise do Perfil de Fluência da Fala. Conclusão A variável hereditariedade não indicou o grau de risco na manifestação da fala nem identificou, decisivamente, as crianças em risco de persistência para a GCD.

ABSTRACT Purpose To test if the variable family heredity for chronic developmental stuttering (CDS) is a direct predictor of the speech fluency outcome in children. Methods Participants of the study were 200 children, between 2 and 12 years of age, of both genders, with no racial and socioeconomic distinction, diagnosed with a complaint of CDS, and with no language and/or hearing comorbidity, over a period of 5 years. Participants were divided in three study groups (low risk for CDS, moderate risk for CDS, and high risk for CDS) according to the risk indicators determined by the Risk Protocol for Developmental Stuttering. In order to determine the control variable (positive heredity for stuttering), we considered the participant as being affected if he/she presented a first-degree family member (father, mother, siblings) who self-declared themselves as a person who stuttered. All of the participants were assessed according to Risk Protocol for Developmental Stuttering and to The Speech Fluency Profile Assessment. Results No significant difference was observed for the demographic variables and for the results on The Fluency Profile Assessment among the groups with mild, moderate and high risk of stuttering when comparing the groups with positive and negative family heredity. Conclusion The variable family heredity did not indicate the risk level for the manifestation of stuttering and also did not identify those at risk of presenting CDS.

Construção e validação de instrumento para disciplinas de Enfermagem Forense e similares / Construction and validation of an instrument for Forensic Nursing and similar graduation disciplines

RESUMO Objetivo construir e validar um questionário de rastreamento de disciplinas e conteúdos de Enfermagem Forense e similares em cursos de graduação. Métodos estudo metodológico de construção e validação de conteúdo e de semântica. Os itens foram construídos e categorizados por meio da análise de conteúdo, com base no referencial teórico nacional e internacional de Enfermagem Forense, estruturado em três seções com perguntas dicotômicas e abertas. Realizaram-se as validações de conteúdo e de semântica adotando Índice de Concordância de 80% entre os juízes, com a técnica brainstorming. Resultados as seções referem-se a: identificação dos cursos, das disciplinas de Enfermagem Forense e de Violência, e dos conteúdos de Enfermagem Forense. Conclusão o Questionário de Rastreamento de Disciplinas e Conteúdos de Enfermagem Forense nos Cursos de Graduação em Enfermagem foi considerado viável e amplo para avaliar a situação das disciplinas de Enfermagem Forense e de Violência nos cursos de Enfermagem das Instituições de Ensino Superior.

ABSTRACT Objective to construct and validate a questionnaire for tracking disciplines and content of Forensic Nursing and similar disciplines in undergraduate courses. Methods methodological study for the construction and validation of content and semantics. The items were constructed and categorized using content analysis, based on the national and international theoretical framework of Forensic Nursing, structured in three sections with dichotomous and subjective questions. Content and semantics were validated using the brainstorming technique and an 80% concordance index among the judges. Results the sections were: identification of courses, of disciplines of Forensic Nursing and Violence, and contents of Forensic Nursing discipline. Conclusion the Forensic Nursing Discipline and Content Supervision Questionnaire for Graduation Nursing Courses was considered easy to use and dynamic to assess the situation of Forensic Nursing and Violence-related subjects in Nursing courses at college Institutions.

Efeitos do uso de diferentes tecnologias educacionais na aprendizagem conceitual sobre o sistema miofuncional orofacial / Effects of the use of different educational technologies in conceptual learning of the orofacial myofunctional system

RESUMO Objetivo Comparar três métodos de aprendizagem sobre anatomia e fisiologia do sistema miofuncional orofacial, sendo dois interativos (uso de softwares educacionais) e um tradicional, quanto à aprendizagem conceitual de estudantes de graduação em Fonoaudiologia. Métodos Participaram 36 estudantes do segundo ano, alocados randomicamente em grupos: Grupo 1 (G1) - método interativo com jogo computacional 2D (n=12); Grupo 2 (G2) - método interativo com modelo computacional 3D (n=12); Grupo 3 (G3) - método tradicional (textos e figuras 2D) (n=12). Os métodos de aprendizagem foram aplicados durante estudo complementar, por sete semanas, após aula expositiva. Foi realizada uma avaliação de conhecimento antes da aplicação dos métodos de aprendizagem, imediatamente após e seis meses depois da conclusão, e o desempenho dos grupos, nos três momentos, foi comparado. Os dados foram analisados no software SPSS, versão 21 (nível de significância de 5%). Resultados Predominaram sujeitos do gênero feminino, com média de idade de 22,0 (±4,7) anos (F2,33=60,72, p=0,260). Os resultados indicaram que, no G1, apenas o pré-teste diferiu do pós-teste, enquanto no G2 e no G3 o pré-teste diferiu do pós-teste e do pós-teste tardio. Ao verificar a interação entre o desempenho dos grupos e os momentos de avaliação, observou-se que os resultados do GI foram inferiores aos dos demais grupos (F2,22=722,30 p<0,001). Conclusão O uso de modelo computacional 3D foi comparável ao do método tradicional para a aprendizagem conceitual e retenção de conhecimento, em curto e longo prazo, sendo ambos mais eficazes do que o uso de jogo computacional 2D.

ABSTRACT Purpose Compare three learning methods on Anatomy and Physiology of the Orofacial Myofunctional System (OMS): two interactive methods with educational software and one traditional method, regarding the conceptual learning of Speech-Language and Hearing Sciences (SLHS) undergraduate students. Methods Thirty-six students were randomly divided into three groups: Group 1 (G1) - 2D computer game-based method (n=12); Group 2 (G2) - 3D computational model method (n=12); Group 3 (G3) - traditional method (texts and 2D images) (n=12). The learning methods were applied during a complementary study schedule, for seven weeks, after a lecture. Knowledge assessments were conducted prior to the application of the learning methods, immediately after, and six months after completion; the performance of the groups at the three moments was compared. Data were analyzed in SPSS 21 software (p≤0.005). Results Female individuals were predominant, with mean age of 22.0 (±4.7) years (F2.33=60.72; p=0.260). The results show that only the pre-test differed from the short-term test in the G1, whereas the pre-test differed from the short- and the long-term tests in the G2 and G3. Regarding correlation between the performance of the groups and the moments of evaluation, it was observed that the results for the G1 were inferior (F2.22=722.30; p<0.001). Conclusion The 3D computational model was comparable to the traditional method for short- and long-term conceptual learning and knowledge retention, and both were more effective than the 2D computer game.