Trajectory Patterns of Weight and Length in Children: From Birth Until 2-Years of Age.

OBJECTIVE: The aim was to identify trajectory patterns of weight and length in children from birth until two years of life and establish associations with maternal and child characteristics. METHODS: A mixed-cohort study was conducted in public health services in Colombo-PR, Brazil, between 2018 and 2022. Pregnancy information was gathered through anthropometric data collection and questionnaires. Birth data were extracted from birth record forms, while weight and length data in the first two years of life were obtained from physical and electronic health service records. Weight and length trajectory patterns were identified using a group-based trajectory model. The definition of the number of trajectory patterns to be selected considered the model fit to the type of variable, its practical utility, as well as the probabilities of group membership. RESULTS: Two trajectory patterns of weight and length were identified among the children. The majority exhibited a pattern of weight (67.8%, n = 382) and length (90.9%, n = 472) considered high and stable, with a tendency to decelerate from one and a half years of age. The probability of belonging to the lower weight gain group was associated with female sex (41.5%, p < 0.001), smoking during pregnancy (48.7%, p = 0.008), prematurity (65.0%, p = 0.001), cesarean delivery (36.4%, p = 0.009), small for gestational age (69.0%, p < 0.001), and twinning (69.2%, p = 0.002). Similarly, the probability of belonging to the lower length gain group was associated with female sex (11.7%, p < 0.001), smoking during pregnancy (20.6%, p = 0.003), cesarean delivery (10.1%, p = 0.048), born small for gestational age (46.4%, p < 0.001), and twinning (46.1%, p < 0.001). CONCLUSION: Conditions during pregnancy and childbirth can impact growth patterns in the first two years of life.

Tempo de tela, qualidade da dieta de adolescentes e características do entorno escolar / Screen time, quality of the adolescent diet, and profile of the school environment

Resumo Objetivou-se investigar a associação entre o tempo de uso excessivo de diferentes telas, a qualidade da dieta em adolescentes e características do entorno escolar. Adolescentes de 30 escolas estaduais de Curitiba/PR relataram tempo de tela: televisão, videogame e portáteis. A qualidade da dieta foi avaliada pela frequência de consumo de alimentos. A renda do entorno escolar foi obtida do Censo. O ambiente construído para atividade física investigado por observação sistemática do entorno escolar. A regressão de Poisson multinível foi empregada para estimar associações com as variáveis de exposição. Entre 1.200 adolescentes, 50,9% do sexo masculino, 74,4% tiveram tempo excessivo de tela. O tempo excessivo de TV (56,5%) esteve associado à pior qualidade da alimentação. O tempo excessivo de videogame (22,0%) foi menor no sexo feminino (RP 0,25; IC95% 0,18;0,36), associado à pior qualidade da alimentação, à menor renda do entorno escolar, e à pior classificação do ambiente construído para atividade física. O tempo excessivo de telas portáteis (53,2%) apresentou tendência de aumento com a renda do entorno escolar. O uso excessivo de TV e telas portáteis foi amplamente praticado por adolescentes, com diferentes variáveis demográficas e contextuais associadas de acordo com o tipo de dispositivo utilizado.

Abstract Adolescents from 30 state schools in Curitiba, State of Paraná, reported total screen time, namely television, video games and laptops. Diet quality was assessed by the frequency of food consumption. The income of the school environment was taken from the Census. The built environment for physical activity was investigated by systematic observation of the school surroundings. Multilevel Poisson Regression was used to estimate associations with the exposure variables. Among 1,200 adolescents, 50.9% being male, and 74.4% were found to be exposed to excessive screen time. Excessive TV screen time (56.5%) was associated with poor diet quality. Excessive video game time (22.0%) was lower among females (PR 0.25; 95%CI 0.18;0.36), associated with poor diet quality, lower school environment income, and the worst classification of the built environment for physical activity. Excessive use of portable screens (53.2%) tended to increase with the income of the school environment. Excessive use of TV and laptops was widespread among adolescents, with different demographic and contextual variables associated according to the type of device used.

Panorama dos esportes ginásticos olímpicos nos municípios paranaenses / Panorama of olympic gymnastics in municipalities of paraná state

RESUMO Este artigo objetivou analisar o panorama dos esportes ginásticos olímpicos nos municípios paranaenses. Metodologicamente, seguiu-se os critérios da análise descritiva com coleta de dados realizada em três etapas distintas: 1) coleta de registros sobre a oferta das modalidades gímnicas no instrumento de pesquisa GEEM, do Instituto de Pesquisa Inteligência Esportiva; 2) consulta a documentos e notícias nos portais oficiais da Secretaria de Esporte do Paraná e Federação Paranaense de Ginástica; e 3) cruzamento dos dados levantados. Conclui-se que há ênfase na oferta de Ginástica Artística Feminina e Ginástica Rítmica, sem fomento à Ginástica de Trampolim - especialmente nos Jogos oficiais do Estado -, sendo que 16% dos municípios paranaenses incentivam ao menos uma das práticas gímnicas competitivas, seja na Formação Esportiva, Excelência Esportiva ou Esporte para a Vida Toda.

ABSTRACT This article aimed to analyze the panorama of Olympic gymnastics in municipalities of Paraná. Methodologically, the study followed the criteria of descriptive analysis with data collection conducted in three distinct stages: 1) gathering records on the provision of gymnastic modalities using the GEEM research tool from the Instituto de Pesquisa Inteligência Esportiva; 2) consulting documents and news on the official portals of the Sports Department of Paraná and the Paraná Gymnastics Federation; and 3) cross-referencing the collected data. It is concluded that there is an emphasis on the provision of Women's Artistic Gymnastics and Rhythmic Gymnastics, with little support for Trampoline Gymnastics - especially in official state games - as only 16% of municipalities in Paraná encourage at least one of the competitive gymnastic practices, whether in Sports Training, Sports Excellence, or Lifelong Sports.

Dietary patterns and socioeconomic, demographic, and health-related behaviors during pregnancy. A cross-sectional study

ABSTRACT BACKGROUND: The identification and understanding of dietary factors and other characteristics that influence gestational weight gain can contribute to the formulation of strategies to promote healthy eating habits before and during pregnancy. OBJECTIVE: To investigate the association between dietary patterns, sociodemographic and obstetric characteristics, and health-related behaviors in pregnant women. DESIGN AND SETTING: A cross-sectional study was conducted on women undergoing prenatal care in the Unified Health System of Colombo, Paraná, Brazil, from February 2018 to September 2019. METHOD: A weekly food frequency questionnaire was administered, and dietary patterns were identified through factor analysis. Median regression models were constructed to identify the associations between dietary pattern scores and variables. RESULTS: Complete data were obtained from 495 pregnant women. Three dietary patterns were identified: 1) "healthy," with higher factor loadings for the weekly consumption of raw vegetables, cooked vegetables, and fresh fruits; 2) "Western," including soft drinks or artificial juice, candies, milk, and dairy products, and processed cold meat; and 3) "traditional," beans and meat. Pregnant women aged 30 years or older (coefficient [Coef.] 0.86, 95% confidence interval [CI] 0.38-1.33) with moderate/intense physical activity (Coef. 0.32, 95% CI 0.02-0.62) had higher adherence to the "healthy" pattern. Adolescents and smokers adhered more to the "traditional" pattern (Coef. 0.17, 95% CI 0.01-0.33). CONCLUSION: Age, smoking status, and physical activity were associated with dietary patterns in pregnant women.

Dietary patterns and socioeconomic, demographic, and health-related behaviors during pregnancy. A cross-sectional study.

BACKGROUND: The identification and understanding of dietary factors and other characteristics that influence gestational weight gain can contribute to the formulation of strategies to promote healthy eating habits before and during pregnancy. OBJECTIVE: To investigate the association between dietary patterns, sociodemographic and obstetric characteristics, and health-related behaviors in pregnant women. DESIGN AND SETTING: A cross-sectional study was conducted on women undergoing prenatal care in the Unified Health System of Colombo, Paraná, Brazil, from February 2018 to September 2019. METHOD: A weekly food frequency questionnaire was administered, and dietary patterns were identified through factor analysis. Median regression models were constructed to identify the associations between dietary pattern scores and variables. RESULTS: Complete data were obtained from 495 pregnant women. Three dietary patterns were identified: 1) "healthy," with higher factor loadings for the weekly consumption of raw vegetables, cooked vegetables, and fresh fruits; 2) "Western," including soft drinks or artificial juice, candies, milk, and dairy products, and processed cold meat; and 3) "traditional," beans and meat. Pregnant women aged 30 years or older (coefficient [Coef.] 0.86, 95% confidence interval [CI] 0.38-1.33) with moderate/intense physical activity (Coef. 0.32, 95% CI 0.02-0.62) had higher adherence to the "healthy" pattern. Adolescents and smokers adhered more to the "traditional" pattern (Coef. 0.17, 95% CI 0.01-0.33). CONCLUSION: Age, smoking status, and physical activity were associated with dietary patterns in pregnant women.

Vigilância civil em saúde, estudos de população e participação popular / Civilian health surveillance, population studies and participation

RESUMO Em meados dos anos 1990, Victor Valla propôs a incorporação da participação da população à prática da vigilância em saúde, por meio da educação popular de Paulo Freire. Esse contraponto às práticas tradicionais da vigilância, nomeadas vigilância civil da saúde, somam-se à concepção ampliada de saúde, e possuem forte ligação com a perspectiva crítica da epidemiologia enquanto meio de compreender a relação dialética entre classes sociais e seus espaços vividos. A prática da vigilância civil pretende superar lacunas importantes deixadas pelos métodos tradicionais de investigação em saúde pública, como falta de atenção aos contextos socioculturais, construção do risco localizada somente no indivíduo e representação de agendas de saúde pública que privilegiam e patologizam certos comportamentos. Nesse sentido, o presente trabalho debate o conceito de vigilância civil da saúde, o locus de discussão dos estudos de população na reificação do papel do efeito contextual para a explicação da produção social da saúde e a incorporação da participação popular à vigilância em saúde como elemento de transformação social. O aprofundamento dessa discussão, no limite, permite uma construção participativa de novos modelos de saúde concentrados na redução efetiva das iniquidades em saúde e, consequentemente, universalização efetiva do direito à saúde.

ABSTRACT In the mid-1990s, Victor Valla proposed to incorporate the population participation in the practice of health surveillance, through Paulo Freire's popular education. This counterpoint to traditional surveillance practices, called civil health surveillance, added to the expanded concept of health, and has a strong connection with the critical perspective of Epidemiology as a means to understand the dialectical relationship between social classes and their lived spaces. The practice of civil surveillance aims to overcome essential gaps left by traditional methods of public health investigation. It includes a lack of attention to socio-cultural contexts, the construction of risk located only in the individual, and the representation of public health agendas that privilege and pathologize certain behaviors. This paper discusses the concept of civil health surveillance, the locus of discussion of population studies in the reification of the role of the contextual effect in explaining the social production of health and the incorporation of popular participation in health surveillance as an element of social transformation. The deepening of this discussion allows a participatory construction of new health models focused on the effective reduction of health inequities and, consequently, the effective universalization of the right to health.

Losartan Attenuates Radiation-Induced Damage on Testes and Accelerates Tubular Regeneration.

Male germ cells are particularly susceptible to radiation; infertility being a common consequence after radiotherapy as it impairs spermatogenesis. This study aimed to test whether treatment with losartan (LOS), a selective antagonist of angiotensin II receptor subtype 1 (AT1R), can prevent or attenuate the acute and long-term radiation-induced damage to testes. Wistar rats were randomly distributed into six groups, three of which were studied on day 2 after irradiation: control (CTRL 2), irradiated non-treated (IR 2), and irradiated and treated with LOS (IRLOS 2); and three other groups that were studied on day 60 after irradiation: control (CTRL 60), irradiated non-treated (IR 60), and irradiated and treated with LOS (IRLOS 60). Seven consecutive days before and on the day of irradiation with 2.5 Gy directly administered in the scrotum, the animals were treated with LOS (34 mg/kg/two times/day). This treatment was continued 2 or 60 days after irradiation. The sperm quality was assessed from epididymis cauda. In addition, the testes were submitted to histopathological and morphometric-stereological analysis as well as the proliferating cell nuclear antigen (PCNA) quantification. Serum FSH and LH and plasma testosterone levels were also determined. The data obtained 2 days after the irradiation showed germ cell apoptosis, formation of vacuoles in the seminiferous epithelium, sloughing of germ cells into the lumen, and retention and phagocytosis of step-19 spermatids in Sertoli basal cytoplasm. The treatment with LOS in this period did not prevent or attenuate a radio-induced damage to the testes, illustrating that this drug does not protect against apoptosis derived from direct effects of radiation. On the other hand, 60 days after exposure, the data evidenced the deleterious effects of ionizing radiation on the testes as decreasing of testicular, epididymal, and seminal vesicle masses; tubular atrophy; reduction of cellular proliferation; and loss of germ cells. LOS was able to prevent some of those deleterious effects, promoting improvements in seminal vesicle mass, sperm vitality, plasma testosterone levels, vacuole number, and cell proliferation. In conclusion, inhibition of the AngII/AT1R axis by LOS is effective in protecting the indirect/delayed radiation damage resulting from oxidative stress established in the tissue.

Th22 cytokines and yellow fever: Possible implications for the immunopathogenesis of human liver infection.

Yellow fever (YF) is an infectious disease considered a public health problem in tropical and subtropical areas. YF has many pathophysiological events that are correlated with the host immune response. In this study, the in situ Th22 cytokine profile was evaluated. Liver tissue samples were collected from 21 YFV-positive patients who died of the disease and five flavivirus-negative controls who died of other causes and whose hepatic parenchyma architecture was preserved. Immunohistochemical (IHC) analysis of tissues in the hepatic parenchyma of YF cases showed significantly higher expression of interleukin (IL)-22, IL-13, tumour necrosis factor-alpha, and FGF basic (FGF b) in YFV-positive cases than that in flavivirus-negative controls. These results indicate that the response of Th22 cytokines emerges as an alternative for a better understanding of adaptive immunity in the hepatic parenchyma, highlighting the role of cytokines in the repair and suppressive responses in the immunopathogenesis of YFV infection.

Sensitivity of different DNA extraction methods and PCR to detect resistance in patients with leprosy stratified by the bacilloscopic index

ABSTRACT Introduction: Antimicrobial resistance in leprosy is an emerging problem, and the quantitative impact of low bacilloscopic indexes (BIs) on the sensitivity of molecular tests is unknown. We aimed to evaluate the sensitivity of gene sequencing for the detection of mutations related to antimicrobial resistance in Mycobacterium leprae in patients with low BIs using an analytical model. Methods: Patients with leprosy were included and divided into two groups depending on their BIs (≥ 2+ and < 2+). The sensitivities of the two DNA extraction methods were compared after amplifying and sequencing the repetitive element (RLEP), folP1, rpoB and gyrA in M. leprae. Results: We included 56 patients with leprosy: 35 had BIs less than 2+ (22 had negative slit-skin smear [SSS] results) and 21 patients had BIs greater than or equal to 2+. The sensitivity of the amplification of the RLEP target and the gene sequencing of folP1, rpoB and gyrA was 50 to 70% lower in patients with a BI less than 2+ and was significantly reduced in patients with lower BIs for all targets (p < 0.001). One patient had a mutation in the folP1 gene, and 14 patients had mutations in the gyrA gene, but no mutations related to antimicrobial resistance were found. Conclusions: We can conclude that the sensitivity of molecular tests is directly related to the BI, but these tests can still detect up to 20% of the targets in patients with BIs < 2+. New strategies to improve the sensitivity for detecting antimicrobial resistance in leprosy patients and reasonable clinical criteria for follow-up and the introduction of alternative treatments must be developed.

Comparação entre as avaliações visual e instrumental da cor dentária: uma revisão da literatura / Comparison between the visual and instrumental assessments of dental color: a literature review

O objetivo do estudo foi realizar uma revisão narrativa da literatura para comparar os métodos visual e instrumental de seleção da cor dentária, correlacionando-os com o fator experiência e a educação continuada. Utilizou-se como base de dados a MEDLINE na qual foram aplicados os descritores "visualshade match", "color measurement", "spectrophotometer" e "tooth color determination". Os critérios de inclusão foram artigos publicados entre 2010 e 2020que abordassem uma análise comparativa entre as duas modalidades de seleção da cor dentária. Se enquadraram nos critérios de exclusão estudos que não contemplavam a temática abordada e aqueles publicados nos anos anteriores a 2010, além das revisões de literatura. No total, onze artigos foram selecionados para compor essa revisão. Os estudos demonstraram que o método instrumental apresentou maior confiabilidade e reprodutibilidade quando comparado ao método visual, isso se deve ao fato de a escolha de cor através de instrumentos eletrônicos proporcionar melhor precisão e atenuação da subjetividade. No que concerne a experiência como fator influenciador da seleção de cor, os estudos são controversos. Mesmo evidenciando melhor precisão, a estimativa instrumental apresenta limitações devido à dificuldade de aferição em função da convexidade da anatomia dentária. Desse modo, foi descrito que a associação de métodos é capaz de elevar a confiabilidade da escolha de cor, melhorando o resultado estético. Não houve consenso entre os estudos com relação à influência da experiência, no entanto, a educação continuada foi sugerida na literatura como alternativa para formar profissionais mais confiantes no processo de seleção de tonalidades(AU)

The goal of this study was to carry out a narrative review of the literature to compare the visual and instrumental methods of tooth color selection, correlating them with the experience factor and continuing education. MEDLINE was used as a database in which the descriptions such as "visual shade match", "color measurement", "spectrophotometer" and "tooth color determination" were applied. The inclusion criteria were articles published between 2010 and 2020 that addressed a comparative analysis between the two types of tooth color selection. The exclusion criteria included studies that did not contemplate the theme addressed and those published in the years prior to 2010, in addition to literature reviews. In total, eleven articles were selected to compose this review. Studies have shown that the instrumental method showed greater reliability and reproducibility when compared to the visual method, this is due to the fact that the color's choice through electronic instruments provides better precision and lessened subjectivity. Regarding experience as na influencing factor in color selection, studies are controversial. Even with better precision, the instrumental estimation has limitations due to the difficulty of measuring it due to the convexity of the dental anatomy. Thus, it was described that the association of the methods is able to increase the reliability of the color's choice, improving the aesthetic result. There was no consensus among the studies in regard to the experiment's influence, however, continuing education was suggested in the literature as an alternative in order to form more confident professionals when it comes to the shade selection process(AU)

Ação inseticida in vitro do óleo essencial de Lippia gracilisSchauer sobre Damalinia Bovicola ovis (Schrank, 1781) / In vitro action of Lippia gracilis Schauer essential oil on Damalinia Bovicola ovis (Schrank, 1781)

O objetivo deste trabalho é avaliar a eficácia inseticida in vitro do óleo essencial de Lippia gracilis sobre Bovicolaovis. Os espécimes (n = 900) de B.ovis foram coletados de ovinos naturalmente infestados, distribuídos aleatoriamente em grupos, e submetidos aos diferentes tratamentos: (G1) 1.000 a 15,6 mg/ml óleo essencial de Lippia gracilis; (G2) Tween 80 a 3% (controle negativo), e: (G3) Amitraz 1,25 g/mL (controle positivo). Realizou-se 4 réplicas (25 piolhos por réplica) para cada tratamento. A viabilidade dos piolhos foi avaliada nos tempos de 1, 3, 6, 24, 48 e 72 h. Os dados foram expressos em eficácia média ± desvio padrão (SPSS versão 23.0) e diferenças estatísticas dos grupos experimentais foram obtidas por Kruskal-Wallis e Friedman. Para obtenção da CI50e CI90 foi realizada Regressão de Probit, com nível de significância de p< 0,05. O óleo essencial de L. gracilis nas concentrações de 100 a 62,5 mg/mL apresentaram eficácia de 100%, 1 h pós-exposição. Os valores de CI50 e CI90 foram 18,1 mg/mL e 44,9 mg/mL, respectivamente. Dessa forma, concluímos que o óleo essencial de L. gracilis apresentou eficácia sobre B.ovis in vitro.

The objective of this work is to evaluate the in vitro insecticidal efficacy of the essential oil of Lippia gracilis against Bovicolaovis. The specimens (n = 900) of B.ovis were collected from naturally infested sheep, randomly distributed in groups, and subjected to different treatments: (G1) 1,000 to 15.6 mg/ml essential oil of Lippia gracilis; (G2) 3% Tween 80 (negative control), and: (G3) Amitraz 1.25 g/mL (positive control). 4 replicates (25 lice per replica) were performed for each treatment. Louse viability was assessed at 1, 3, 6, 24, 48 and 72 h. The data were expressed as mean efficacy ± standard deviation (SPSS version 23.0) and statistical differences in the experimental groups were obtained by Kruskal-Wallis and Friedman. Probit regression was performed to obtain the IC50 and CI90, with a significance level of p <0.05. The essential oil of L. gracilis at concentrations of 100 to 62.5 mg/mL showed 100% efficacy, 1 h post-exposure. The IC50 and CI90 values were 18.1 mg/mL and 44.9 mg/mL, respectively. Thus, we conclude that L. gracilis essential oil is effective on B. ovis.

Ação inseticida in vitro do óleo essencial de Lippia gracilis Schauer sobre Damalinia Bovicola ovis (Schrank, 1781) / In vitro action of Lippia gracilis Schauer essential oil on Damalinia Bovicola ovis (Schrank, 1781)

O objetivo deste trabalho é avaliar a eficácia inseticida in vitro do óleo essencial de Lippia gracilis sobre Bovicolaovis. Os espécimes (n = 900) de B.ovis foram coletados de ovinos naturalmente infestados, distribuídos aleatoriamente em grupos, e submetidos aos diferentes tratamentos: (G1) 1.000 a 15,6 mg/ml óleo essencial de Lippia gracilis; (G2) Tween 80 a 3% (controle negativo), e: (G3) Amitraz 1,25 g/mL (controle positivo). Realizou-se 4 réplicas (25 piolhos por réplica) para cada tratamento. A viabilidade dos piolhos foi avaliada nos tempos de 1, 3, 6, 24, 48 e 72 h. Os dados foram expressos em eficácia média ± desvio padrão (SPSS versão 23.0) e diferenças estatísticas dos grupos experimentais foram obtidas por Kruskal-Wallis e Friedman. Para obtenção da CI50e CI90 foi realizada Regressão de Probit, com nível de significância de p< 0,05. O óleo essencial de L. gracilis nas concentrações de 100 a 62,5 mg/mL apresentaram eficácia de 100%, 1 h pós-exposição. Os valores de CI50 e CI90 foram 18,1 mg/mL e 44,9 mg/mL, respectivamente. Dessa forma, concluímos que o óleo essencial de L. gracilis apresentou eficácia sobre B.ovis in vitro.

The objective of this work is to evaluate the in vitro insecticidal efficacy of the essential oil of Lippia gracilis against Bovicolaovis. The specimens (n = 900) of B.ovis were collected from naturally infested sheep, randomly distributed in groups, and subjected to different treatments: (G1) 1,000 to 15.6 mg/ml essential oil of Lippia gracilis; (G2) 3% Tween 80 (negative control), and: (G3) Amitraz 1.25 g/mL (positive control). 4 replicates (25 lice per replica) were performed for each treatment. Louse viability was assessed at 1, 3, 6, 24, 48 and 72 h. The data were expressed as mean efficacy ± standard deviation (SPSS version 23.0) and statistical differences in the experimental groups were obtained by Kruskal-Wallis and Friedman. Probit regression was performed to obtain the IC50 and CI90, with a significance level of p <0.05. The essential oil of L. gracilis at concentrations of 100 to 62.5 mg/mL showed 100% efficacy, 1 h post-exposure. The IC50 and CI90 values were 18.1 mg/mL and 44.9 mg/mL, respectively. Thus, we conclude that L. gracilis essential oil is effective on B. ovis.

Medication time out as a strategy for patient safety: reducing medication errors.

OBJECTIVES: to analyze the implementation of the medication time out strategy to reduce medication errors. METHODS: this is a quantitative, cross-sectional, inferential study, with direct observation of the implementation of the medication time out strategy, carried out in a cardiac intensive care unit of a university hospital in Rio de Janeiro. RESULTS: 234 prescriptions with 2,799 medications were observed. Of the prescriptions analyzed, 143 (61%) had at least one change with the use of the strategy. In the prescriptions altered, 290 medications had some type of change, and 104 (35.9%) changes were related to potentially harmful medication. During the application of the strategy, prescriptions with polypharmacy had 1.8 times greater chance of presenting an error (p-value = 0.031), which reinforces the importance of the strategy for prescriptions with multiple medications. CONCLUSIONS: the implementation of the medication time out strategy contributed to the interception of a high number of medication errors, using few human and material resources.

Prevalência da dor em estudantes universitários: uma revisão sistemática / Prevalence of pain in university students: a systematic review

Objetivo: revisar estudos sobre a prevalência e os fatores relacionados a dor em estudantes universitários brasileiros. Métodos: revisão sistemática com registro na Prospero (CRD42020204197), de artigos publicados em periódicos nacionais e internacionais, nas bases Pubmed, Ebsco, Lilacs, Medline, Portal da BVS, Google Acadêmico e SciELO. Descritores: "Pain", "Chronic Pain", Students", "Students, Health Occupations" e "Universities". Incluídos: a) estudos observacionais; b) transversais; c) publicados em periódicos nacionais ou internacionais; d) redigidos em inglês ou português; e) desenvolvidos com acadêmicos, em instituições de ensino superior brasileiras; f) que tenham avaliado a prevalência e fatores relacionados a dor; g) Tais estudos deviam estar disponíveis na íntegra. Não foram realizadas restrições quanto ao período de publicação dos estudos. Excluídos: h) estudos que não relataram a metodologia aplicada para mensuração do desfecho; i) estudos com instrumentos que não avaliaram a dor como desfecho primário, posteriormente apresentando dados insuficientes para análise dos resultados; j) estudos com acadêmicos de outros países; e k) estudos com inconsistência dos dados relacionados a amostra e seus principais resultados. O risco de viés foi avaliado com a escala Downs and Black e a proposta por Hoy. Resultados: as buscas identificaram 67 artigos, contudo, após análise, 10 foram incluídos. Esses eram estudos transversais, publicados entre 2011 e 2019, sendo cinco deles da região Nordeste. A amostra totalizou 3.268 acadêmicos, sendo 68% mulheres. A prevalência da dor variou entre 14,4% e 98% e a dor crônica entre 11,5% e 59,7%. A maior percepção da dor autorrelatada foi de 4,12 ± 2,15. As principais queixas álgicas foram nas regiões de lombar e de membros superiores. Na análise metodológica, os estudos possuem moderado a alto risco de viés. Conclusões: por fim, as evidências indicam uma alta prevalência de dor, bem como sua cronificação em universitários. Contudo, estudos com adequado rigor metodológico ainda são necessários para a confirmação dos resultados apresentados.

Objective: to review studies on the prevalence and factors related to pain in Brazilian university students. Methods: systematic review with PROSPERO record (CRD42020204197), of articles published in national and international journals, in PUBMED, EBSCO, LILACS, MEDLINE, VHL Portal, Google Scholar and SciELO. Descriptors: "Pain", "Chronic Pain", Students "," Students, Health Occupations "and" Universities ". Included: a) Observational studies; b) transversal; c) published in national or international journals; d) written in English or Portuguese; e) developed with academics, in Brazilian higher education institutions; f) who have assessed the prevalence and factors related to pain; g) Such studies should be available in full. There were no restrictions on the period of publication of the studies. Excluded: h) studies that did not report the methodology applied to measure the outcome; i) studies with instruments that did not evaluate pain as a primary outcome, subsequently presenting insufficient data to analyze the results; j) studies with academics from other countries and k) studies with inconsistent data related to the sample and its main results. The risk of bias was assessed using the Downs and Black scale and proposed by Hoy. Results: searches identified 67 articles, however, after analysis 10 were included. These were cross-sectional studies, published between 2011 and 2019, 5 of them from the Northeast region. The sample totaled 3,268 students, 68% of whom were women. The prevalence of pain varied between 14.4% and 98% and chronic pain between 11.5% and 59.7%. The highest perception of self-reported pain was 4.12 ± 2.15. The main pain complaints were in the lower back and upper limbs. In the methodological analysis, studies have a moderate to high risk of bias. Conclusions: finally, the evidence indicates a high prevalence of pain, as well as its chronicity in university students. However, studies with adequate methodological rigor are still needed to confirm the results presented.

Medication time out as a strategy for patient safety: reducing medication errors / Medication time out como una estrategia para la seguridad del paciente: reducir los errores de medicación / Medication time out como estratégia para a segurança do paciente: reduzindo erros de medicação

ABSTRACT Objectives: to analyze the implementation of the medication time out strategy to reduce medication errors. Methods: this is a quantitative, cross-sectional, inferential study, with direct observation of the implementation of the medication time out strategy, carried out in a cardiac intensive care unit of a university hospital in Rio de Janeiro. Results: 234 prescriptions with 2,799 medications were observed. Of the prescriptions analyzed, 143 (61%) had at least one change with the use of the strategy. In the prescriptions altered, 290 medications had some type of change, and 104 (35.9%) changes were related to potentially harmful medication. During the application of the strategy, prescriptions with polypharmacy had 1.8 times greater chance of presenting an error (p-value = 0.031), which reinforces the importance of the strategy for prescriptions with multiple medications. Conclusions: the implementation of the medication time out strategy contributed to the interception of a high number of medication errors, using few human and material resources.

RESUMEN Objetivos: analizar la implantación de la estrategia medication time out para disminuir los errores relacionados a la medicación. Métodos: se trata de un estudio cuantitativo, transversal, inferencial, con observación directa de la realización de la estrategia medication time out, llevado a cabo en una unidad de cuidados intensivos de cardiología de un hospital universitario de Río de Janeiro. Resultados: se observaron 234 prescripciones con 2.799 medicamentos. De las prescripciones analizadas, 143 (61%) sufrieron por lo menos una alteración con la utilización de la estrategia. En las prescripciones alteradas, 290 medicamentos tuvieron algún tipo de variación, de las cuales 104 (35,9%) estaban relacionadas con medicamentos potencialmente peligrosos. Durante la aplicación de la estrategia, las recetas con polifarmacia presentaban una probabilidad de error 1,8 veces mayor (valor p = 0,031), lo que refuerza la importancia de la estrategia para las recetas con múltiples fármacos. Conclusiones: la aplicación de la estrategia medication time out contribuyó a la interceptación de un elevado número de errores de medicación, valiéndose de pocos recursos humanos y materiales.

RESUMO Objetivos: analisar a implantação da estratégia medication time out para redução de erros relacionados a medicamentos. Métodos: trata-se de um estudo quantitativo, transversal, inferencial, com observação direta da realização da estratégia medication time out, realizado em uma unidade cardiointensiva de um hospital universitário do Rio de Janeiro. Resultados: foram observadas 234 prescrições, com 2.799 medicamentos. Das prescrições analisadas, 143 (61%) sofreram pelo menos uma alteração com a utilização da estratégia. Nas prescrições alteradas, 290 medicamentos sofreram algum tipo de alteração, sendo 104 (35,9%) relacionadas a medicamentos potencialmente perigosos. Durante a aplicação da estratégia, prescrições com polifarmácia apresentaram 1,8 vezes maior chance de ocorrência de erro (p valor=0,031), o que reforça a importância da estratégia para prescrições com múltiplos medicamentos. Conclusões: a implantação da estratégia medication time out contribuiu para a interceptação de um número elevado de erros de medicação, utilizando poucos recursos humanos e materiais.

Eventos adversos pós-vacinação em idosos no Estado de São Paulo, Brasil, de 2015 a 2017 / Post-vaccination adverse events in the elderly in the State of São Paulo, Brazil, 2015 to 2017 / Eventos adversos posvacunación en ancianos del Estado de São Paulo, Brasil, de 2015 a 2017

A vacinação é uma das ações de saúde pública que tem colaborado com a diminuição da incidência das doenças imunopreveníveis. No entanto, as vacinas podem acarretar eventos adversos pós-vacinação. Assim, este estudo teve como objetivos: analisar a prevalência dos eventos adversos pós-vacinação em pessoas idosas; levantar os eventos notificados; identificar as vacinas que causaram eventos e verificar os eventos adversos pós-vacinação e as vacinas administradas que acarretaram internações no Estado de São Paulo, Brasil, nos anos de 2015 a 2017. Estudo descritivo, transversal, de abordagem quantitativa com base nas notificações de eventos adversos pós-vacinação registradas no Sistema de Informações do Programa Nacional de Imunizações. Os resultados mostraram que dentre as 15.196.080 pessoas idosas imunizadas, ocorreram 207 notificações de eventos adversos pós-vacinação, sendo 187 (89%) devido a evento adverso não grave e 15 (8%) por erro de imunização. A maioria dos acometidos era: do sexo feminino (86%); raça branca (49%); com idades de 60 a 69 anos (70%). Dentre as manifestações clínicas destacamos as reações nos locais das aplicações (84%). Constatou-se que 131 casos (64%) evoluíram para cura sem sequelas. Em relação às internações, verificou-se que duas pessoas (2%) foram hospitalizadas devido a efeito adverso grave, a primeira recebeu as vacinas: difteria/tétano adulto (dT), pneumocócica (Pn23) e influenza, e a segunda recebeu Pn23. Observaram-se informações incompletas nas notificações de eventos adversos pós-vacinação. Conclui-se que a notificação do eventos adversos pós-vacinação é essencial. Faz-se necessário o comprometimento dos profissionais no preenchimento adequado da notificação, e ainda, a supervisão da vigilância sanitária visando à qualidade da assistência prestada à pessoa idosa acometida por eventos adversos pós-vacinação.

Vaccination is one of the public health measures that has most contributed to decreasing the incidence of vaccine-preventable diseases. However, vaccines can lead to post-vaccination adverse events. This study thus aimed to analyze the prevalence of post-vaccination adverse events in elderly persons, determine the reported post-vaccination adverse events, identify the vaccines that cause post-vaccination adverse events, and verify the post-vaccination adverse events and vaccines that lead to hospitalizations in the State of São Paulo, Brazil, from 2015 to 2017. This was a descriptive cross-sectional study with a quantitative approach based on notifications of post-vaccination adverse events recorded in the Information System of the National Immunization Program. The results showed that of the 15,196,080 elderly persons that were immunized, there were 207 reports of post-vaccination adverse events, of which 187 (89%) were non-serious adverse events and 15 (8%) due to immunization errors (IE). The majority of the patients were female (86%), white (49%), and from 60 to 69 years of age (70%). Clinical manifestations featured local reactions at the injection site (84%). There were 131 cases (64%) that evolved to cure without sequelae. Two individuals (2%) were hospitalized due to serious adverse events. The first had received adult diphtheria/tetanus (dT), pneumococcal (Pn23), and influenza vaccines, and the second had received Pn23. The post-vaccination adverse events notifications showed incomplete information. In conclusion, notification of post-vaccination adverse events is essential. Health professionals need to be committed to adequate completion of the notification forms, with health surveillance supervision aimed at quality of care for elderly persons with post-vaccination adverse events.

La vacunación es una de las acciones de salud pública que ha colaborado a la disminución de la incidencia de enfermedades inmunoprevenibles. No obstante, las vacunas pueden acarrear eventos adversos de posvacunación. Por ello, este estudio tuvo como objetivos: analizar la prevalencia de los eventos adversos de posvacunación en personas ancianas; recoger los eventos adversos de posvacunación notificados; identificar las vacunas que causaron eventos eventos adversos de posvacunación y verificar los eventos eventos adversos de posvacunación y las vacunas administradas que provocaron internamientos en el Estado de São Paulo, Brasil, durante los años de 2015 a 2017. Estudio descriptivo, transversal, de abordaje cuantitativo basado en las notificaciones de eventos adversos de posvacunación, registradas en el Sistema de Información del Programa Nacional de Inmunizaciones. Los resultados mostraron que, entre las 15.196.080 personas ancianas inmunizadas, ocurrieron 207 notificaciones de eventos adversos de posvacunación, siendo 187 (89%) debidas a un evento adverso no grave y 15 (8%) por error de inmunización. La mayoría de los afectados era del sexo femenino (86%); raza blanca (49%); con edad de 60 a 69 años (70%). Entre las manifestaciones clínicas se destacaron las reacciones en los lugares de la aplicación de la vacuna (84%). Se constató que 131 casos (64%) evolucionaron a una cura sin secuelas. En relación con los internamientos se verificó que dos personas (2%) fueron hospitalizadas, debido a un efecto adverso grave, la primera recibió las vacunas: difteria/tétano adulto (dT), neumocócica (Pn23) y gripe y la segunda recibió Pn23. Se observó información incompleta en las notificaciones de eventos adversos de posvacunación. Se concluye que la notificación del eventos adversos de posvacunación es esencial. Es necesario el compromiso de los profesionales en la cumplimentación adecuada de la notificación e incluso, la supervisión de la vigilancia sanitaria, con el fin de analizar la calidad de la asistencia prestada a la persona anciana afectada por eventos adversos pós- vacinação.

e-SUS AB na cidade do Rio de Janeiro: projeto e implantação do sistema de informação em saúde / e-SUS AB in the city of Rio de Janeiro: design and implementation of the information health system

Resumo Introdução O município do Rio de Janeiro possui a segunda maior rede absoluta de Atenção Primária à Saúde (APS) do Brasil. A implantação do e-SUS AB no município foi programada de acordo com o perfil encontrado nos diferentes territórios de saúde, as Áreas Programáticas (AP). Objetivo Relatar a experiência de profissionais da gestão municipal do período de 2017 a 2020. Método Foram realizadas a análise documental e a verificação de dados da Secretaria Municipal de Saúde. Resultados A implantação do PEC e-SUS ocorreu de forma gradual entre as AP do município do Rio de Janeiro. Houve desafios com relação à migração de dados para a alimentação de relatórios do Sistema de Informação em Saúde para a Atenção Básica (SISAB), sistematização das diretrizes de implementação, fluxo e alimentação da informação no sistema. Contudo, eles proporcionaram uma curva de aprendizado para a gestão e equipes de saúde, tanto na implantação quanto na operacionalização do sistema. Ao final, a implantação do sistema na cidade foi eficiente e apresenta benefícios a médio e longo prazo para a população e para as equipes e gestores em saúde. Conclusão Ainda que haja integração do e-SUS dentro da cidade do Rio de Janeiro, é necessário haver o monitoramento constante e a elaboração de protocolos de interoperabilidade para a efetividade da informação em saúde dentro do município.

Abstract Background The municipality of Rio de Janeiro has the second largest Primary Health Care (PHC) network in Brazil. The implementation of the Unified Health System-PHC application program (e-SUS AB) in the municipality was planned according to the profile found in the different health territories, called Programmatic Areas (PA). Objective To report the experience of municipal management professionals between 2017 and 2020. Method Document analysis and verification of data from the Municipal Health Department were carried out. Results Implementation of the Citizens' Electronic Medical Record (PEC) of the e-SUS AB occurred gradually in the PA in the municipality. There were challenges regarding data migration to feed the Primary Health Care Information System (SISAB) reports and systematization of the implementation guidelines, flow, and feed of information into the system. However, they provided a learning curve for management and health teams, both in the implementation and operationalization of the system. The implementation of the system in the city was efficient and presents medium- and long-term benefits, both for the population and for health teams and managers. Conclusion Although the e-SUS AB is integrated in Rio de Janeiro, it is necessary to constantly monitor and develop interoperability protocols for the effectiveness of health information within the municipality.

Evidências de Validade da Escala de Autoeficácia da Bateria de Avaliação de Indicadores da Depressão Infantojuvenil / Validity Evidences of Evaluation Battery for Childhood Depression Indicators Self-efficacy Scale / Evidencias de Validez de la Escala de Autoeficacia de la Batería de Evaluación de Indicadores de la Depresión Infantojuvenil

Este estudo analisou evidências de validade da Escala de Autoeficácia da Bateria de Avaliação de Indicadores da Depressão Infatojuvenil, avaliou a validade divergente da escala em relação à depressão e examinou a distribuição social da autoeficácia segundo as variáveis sexo, idade e ano escolar. A amostra consistiu de 388 adolescentes, com idades entre 14 e 19 anos que responderam a um questionário sociodemográfico e à Escala de Autoeficácia. A Análise Fatorial Exploratória foi conduzida por meio do software Factor. Os resultados indicaram a unidimensionalidade da medida, explicando 56,3% de variância. Os índices de ajuste do modelo e o índice de confiabilidade foram satisfatórios. A avaliação da distribuição social mostrou que houve relações estatisticamente significativas quanto ao sexo e a idade. Constatou-se que a Escala de Autoeficácia apresentou boas propriedades psicométricas, o que recomenda seu uso por parte da comunidade científica e profissional para futuras pesquisas, intervenções e avaliações da autoeficácia em adolescentes. (AU)

This study analyzed validity evidences of the Evaluation Battery for Childhood Depression Indicators Self-efficacy Scale, assessed the divergent validity of the scale in relation to depression and examined the social distribution of self-efficacy according to gender, age, and school grade. The sample consisted of 388 adolescents, aged between 14 and 19 years old. It was administered a sociodemographic questionnaire and the Self-efficacy Scale. Exploratory Factor Analysis was conducted using the Factor software. The results indicated the unidimensionality of the scale, explained 56.3% of the total variance. The fit indices of the model and the reliability index were satisfactory. The evaluation of the social distribution showed statistically significant relationships between self-efficacy, sex and age. Finally, the Self-efficacy Scale showed satisfactory psychometric properties, which recommend its use by the scientific and professional community for future research, interventions, and evaluations of the self-efficacy in adolescents. (AU)

Este estudio analizó evidencias de validez de la Escala de Autoeficacia de la Batería de Evaluación de Indicadores de la Depresión Infantojuvenil, evaluó la validez divergente de la escala en relación a la depresión y examinó la distribución social de la autoeficacia según las variables sexo, edad y grado escolar. La muestra consistió de 388 adolescentes entre 14 y 19 años. Fueron empleados un cuestionario sociodemográfico y la Escala de Autoeficacia. El Análisis Factorial Exploratorio fue conducido por medio del software Factor. Los resultados revelaron la unidimensionalidad de la medida, explicando 56,3% de la varianza. Los índices de ajuste del modelo y de confiabilidad fueron satisfactorios. La evaluación de la distribución social mostró que hubo relaciones estadísticamente significativas entre autoeficacia, sexo y edad. Finalmente, se constató que la Escala de Autoeficacia presentó buenas propiedades psicométricas, lo que recomienda su uso por parte de la comunidad científica y profesional para futuras investigaciones y evaluaciones de la autoeficacia de adolescentes. (AU)

Ações para o fortalecimento da resiliência em adolescentes / Actions for enhancing resilience among adolescents

Resumo A consolidação de práticas voltadas para o fortalecimento da resiliência corrobora com a atual mudança de paradigmas no âmbito da promoção da saúde de adolescentes, em que se considera a singularidade do sujeito, assim como sua relação com o meio. Identificar fatores protetivos envolvidos no processo de resiliência em adolescentes. Este trabalho revisa publicações indexadas que descrevem modelos e intervenções de atendimento ao adolescente. A análise dos textos consistiu em: 1) comparar as semelhanças e diferenças entre os conceitos utilizados; e 2) identificar, agrupar e compilar os fatores de proteção mais citados. Foram analisados 17 artigos que trabalham o fortalecimento da resiliência em seis contextos práticos distintos. A partir dos fatores de proteção encontrados foram geradas 17 ações norteadoras para desenvolvimento de trabalhos educativos em saúde. Fatores protetivos relacionado "Resolução de problemas", "Valorização do sujeito" e "Habilidade de comunicação" foram identificados em diversos contextos de estudo sobre adolescência. Esses fatores constituem aspectos transversais necessários ao fortalecimento da resiliência e devem ser estimulados conjuntamente a fim de favorecer o desenvolvimento saudável do adolescente.

Abstract The consolidation of practices aimed at enhancing resilience corroborates the current paradigm shift within the scope of adolescent health promotion, in which the individual's singularity is considered, as well as his/her relationship with the environment. The scope of the undertaking was to identify protective factors involved in the process of resilience among adolescents. This paper reviews indexed publications describing adolescent care models and interventions. The analysis of the texts consisted of: 1) comparing the similarities and differences between the concepts used; and 2) identifying, grouping and compiling the most cited protection factors. A total of 17 articles that strive to enhance resilience in six different practical contexts were analyzed. Based on the protection factors found, 17 actions were generated to guide the development of educational works in health. Protective factors related to "Problem solving", "Valorization of the individual" and "Ability in communication" were identified in several contexts of study on adolescence. These factors represent transversal aspects necessary to enhance resilience and should be stimulated together in order to foster the healthy development of adolescents.

Otimismo: teoria e aplicabilidade para a psicologia / Optimism: theory and applicability for health / Optimismo: teoría e aplicabilidad para la psicología

Estudos revelam que otimistas apresentam mais comportamentos de promoção de saúde, maior qualidade de vida e melhores índices de saúde física e mental. Diante disso, este trabalho objetivou apresentar aspectos conceituais, principais medidas usadas para aferir o otimismo e evidências de pesquisa em relação ao otimismo, por meio de um estudo teórico. Inicialmente, delimitou-se o conceito de otimismo, teoria e seus principais tipos. Em seguida, abarcaram-se evidências da relação do otimismo com saúde, coping e bem-estar, caracterizando o seu impacto na saúde das pessoas. Elencaram-se, por fim, intervenções relacionadas à manutenção ou ao aumento dos níveis de otimismo e seus resultados. Em geral, viu-se que o otimismo influencia positivamente o ajustamento psicológico em diferentes contextos. Ao final, foram feitas recomendações de novos estudos, com base nas lacunas detectadas na produção nacional a respeito da temática.

Studies have shown that optimists have better performance in health promotion, higher quality of life, and better rates of physical and mental health. Therefore, this work aimed at presenting the conceptual aspects, the main measures used to assess optimism, and the sources of research concerning optimism, through a theoretical study. Initially, we delimited the concept of optimism, theory, and its main types. Next, we included the evidence of the relationship of optimism with health, coping, and well-being, characterizing its impact on people's health. Finally, we added work related to the maintenance or increase of levels of optimism and results. In general, optimism has been shown to positively influence psychological adjustment in different contexts. In the end, new studies were revealed based on the gaps detected in the national production on the subject.

Los estudios revelan que los optimistas presentan más comportamientos de promoción de salud, mayor calidad de vida y mejores índices de salud física y mental. En este sentido, este trabajo objetivó presentar aspectos conceptuales, principales medidas usadas para medir el optimismo y evidencias de investigación en relación al optimismo, a través de un estudio teórico. Inicialmente, se delimitó el concepto del optimismo, teoría y sus principales tipos. A continuación, se abarcaron evidencias de la relación del optimismo con salud, coping y bienestar, caracterizando su impacto en la salud de las personas. Se definieron, por fin, intervenciones relacionadas con el mantenimiento o el aumento de los niveles de optimismo y sus resultados. En general, se vio que el optimismo influye positivamente en el ajuste psicológico en diferentes contextos. Al final, se hicieron recomendaciones de nuevos estudios sobre la base de las lagunas detectadas en la producción nacional con respecto a la temática.