Population genomics of post-glacial western Eurasia.

Western Eurasia witnessed several large-scale human migrations during the Holocene1-5. Here, to investigate the cross-continental effects of these migrations, we shotgun-sequenced 317 genomes-mainly from the Mesolithic and Neolithic periods-from across northern and western Eurasia. These were imputed alongside published data to obtain diploid genotypes from more than 1,600 ancient humans. Our analyses revealed a 'great divide' genomic boundary extending from the Black Sea to the Baltic. Mesolithic hunter-gatherers were highly genetically differentiated east and west of this zone, and the effect of the neolithization was equally disparate. Large-scale ancestry shifts occurred in the west as farming was introduced, including near-total replacement of hunter-gatherers in many areas, whereas no substantial ancestry shifts happened east of the zone during the same period. Similarly, relatedness decreased in the west from the Neolithic transition onwards, whereas, east of the Urals, relatedness remained high until around 4,000 BP, consistent with the persistence of localized groups of hunter-gatherers. The boundary dissolved when Yamnaya-related ancestry spread across western Eurasia around 5,000 BP, resulting in a second major turnover that reached most parts of Europe within a 1,000-year span. The genetic origin and fate of the Yamnaya have remained elusive, but we show that hunter-gatherers from the Middle Don region contributed ancestry to them. Yamnaya groups later admixed with individuals associated with the Globular Amphora culture before expanding into Europe. Similar turnovers occurred in western Siberia, where we report new genomic data from a 'Neolithic steppe' cline spanning the Siberian forest steppe to Lake Baikal. These prehistoric migrations had profound and lasting effects on the genetic diversity of Eurasian populations.

An integrative skeletal and paleogenomic analysis of stature variation suggests relatively reduced health for early European farmers.

Human culture, biology, and health were shaped dramatically by the onset of agriculture ∼12,000 y B.P. This shift is hypothesized to have resulted in increased individual fitness and population growth as evidenced by archaeological and population genomic data alongside a decline in physiological health as inferred from skeletal remains. Here, we consider osteological and ancient DNA data from the same prehistoric individuals to study human stature variation as a proxy for health across a transition to agriculture. Specifically, we compared "predicted" genetic contributions to height from paleogenomic data and "achieved" adult osteological height estimated from long bone measurements for 167 individuals across Europe spanning the Upper Paleolithic to Iron Age (∼38,000 to 2,400 B.P.). We found that individuals from the Neolithic were shorter than expected (given their individual polygenic height scores) by an average of −3.82 cm relative to individuals from the Upper Paleolithic and Mesolithic (P = 0.040) and −2.21 cm shorter relative to post-Neolithic individuals (P = 0.068), with osteological vs. expected stature steadily increasing across the Copper (+1.95 cm relative to the Neolithic), Bronze (+2.70 cm), and Iron (+3.27 cm) Ages. These results were attenuated when we additionally accounted for genome-wide genetic ancestry variation: for example, with Neolithic individuals −2.82 cm shorter than expected on average relative to pre-Neolithic individuals (P = 0.120). We also incorporated observations of paleopathological indicators of nonspecific stress that can persist from childhood to adulthood in skeletal remains into our model. Overall, our work highlights the potential of integrating disparate datasets to explore proxies of health in prehistory.

Bauhinia pulchella: chemical constituents, antioxidant and alpha-glucosidase inhibitory activities.

Phytochemical investigation of the stems of B. pulchella led to the isolation of the known compounds identified as a mixture of taraxerone (1) and ß-amirenone (2), a mixture of sitosterol (3) and stigmasterol (4), 2-hydroxy-3,5-dimethoxybibenzyl (5), 3',4'-dihydroxyphenyl-chroman-7-ol (6), fisetinidol (7), epicatechin (8), guibourtinidol (9), vanillic acid (10), 6'-O-vanilloylisotachioside (11) and 6'-O-syringoylisotachioside (12). The structures of these compounds were elucidated on the basis of their NMR spectroscopic data. The antioxidant activity of compound 7 has been investigated using DPPH° and ABTS°+ assays and the results showed inhibition in the both models. The compounds 6, 7 and 9 showed strong alpha-glucosidase inhibitory activities, being more active than acarbose, the positive control. In addition, all the compounds were isolated from B. pulchella for the first time, and among them, compounds 11 and 12 have not been reported previously from this genus.

Cuaderno complementario sobre Estudio de la ideología y la política para técnicos de la salud / Complementary notebook about the Study of ideology and policy for health technicians

RESUMEN Fundamento: en las carreras de las ciencias técnicas que se estudian en las universidades médicas se imparte la asignatura Estudio de la Ideología y la Política con el fin de enseñar al estudiante el devenir histórico-lógico del pueblo cubano, y su ejemplo y trascendencia para el mundo. Objetivo: elaborar un cuaderno complementario para el trabajo independiente de los estudiantes con actividades de carácter desarrollador y de evaluación del aprendizaje. Métodos: se realizó una investigación de desarrollo en la Filial de Ciencias Médicas "Dr. Eusebio Hernández Pérez" en Colón, Matanzas, durante los cursos escolares 2016-2017 y 2017-2018. Se utilizaron métodos teóricos: analítico-sintético, inductivo-deductivo y sistémico-estructural; y empíricos: análisis documental del programa y las orientaciones metodológicas, y encuesta en forma de entrevista a profesores para corroborar si la bibliografía recomendada era suficiente para el cumplimiento de los objetivos previstos y si favorece el estudio independiente de los contenidos de la asignatura. El cuaderno fue valorado por criterio de especialistas. Resultados: se evidenció un déficit bibliográfico para su estudio, sus contenidos están dispersos en varios textos lo cual dificulta el trabajo independiente de los estudiantes, por lo que fue confeccionado un cuaderno complementario que contiene tres unidades y varias actividades en correspondencia con el cumplimiento de los objetivos del programa. Conclusiones: el material contribuye a solucionar las insuficiencias detectadas y fue valorado por criterio de especialistas como pertinente, novedoso y útil; constituye una herramienta esencial para apoyar el trabajo independiente de los estudiantes y la evaluación del aprendizaje.

ABSTRACT Background: in technical science careers that are studied in medical universities, the Study of Ideology and Politics subject is taught with the aim of teaching the historical-logical evolution of the Cuban people, and its example and transcendence for the world, to the students. Objective: to create a supplementary notebook for the independent work of students with activities of developmental character and learning evaluation. Methods: at the "Dr. Eusebio Hernández Pérez" Medical Sciences Subsidiary in Colón, Matanzas, a development research was carried out during the 2016-2017 and 2017-2018 academic years. Theoretical methods were used: analytical-synthetic method, inductive-deductive method and systemic-structural method; and empirical methods: documentary analysis of the program and the methodological guidelines, and an interview survey with teachers to verify whether the recommended bibliography was sufficient for the fulfillment of the foreseen objectives and whether it helps the independent study of the subject contents. The supplementary notebook was evaluated according to the criteria of specialists. Results: for this study a bibliographical deficit was evident, contents were scattered in several texts which made the independent work of students difficult, so a supplementary notebook which contains three units and several activities was made in such a way the objectives of the program were fulfilled. Conclusions: the supplementary notebook contributes to solve the insufficiencies were found and it was valued by specialists as pertinent, novel and useful; it is an essential tool to support the independent work of students and learning assessment.

Ethno-knowledge and attitudes regarding snakebites in the Alto Juruá region, Western Brazilian Amazonia.

BACKGROUND: The Alto Juruá region, located in the extreme western part of the Brazilian Amazonia, possesses an indigenous and riverine population which is involved in agricultural and forest extraction activities, and is a region that stands out for its high incidence of snakebites. OBJECTIVES: To assess the attitudes of the victims, the characteristics of the snakes and the circumstances of the snakebites which occurred in a region where human populations are highly exposed to snakes. METHODS: The study was conducted at the Regional Hospital of Juruá in the Municipality of Cruzeiro do Sul (Acre), which regularly attends victims of snakebites in the Alto Juruá region. The snakes that caused the envenomations were identified from clinical and epidemiological diagnosis of the symptoms and signs that patients presented during hospital, and by enzyme immunoassay for venom detection using serum samples of the patients, or by identification of the snake responsible for the envenomation when it was taken to the hospital or photographed. People who suffered or witnessed the snakebite were interviewed to assess the circumstances of the bite, the attitude adopted after the accident and whether they recognized the species of snake that caused the envenomation. RESULTS: There were 133 cases of snakebite (76.24/100.000 inhabitants), mainly involving male individuals living in the rural area and who had a low level of education. The most affected groups were farmers (48%) and children and teenagers (39%). It was observed that 8.3% of them presented a history of recurrence for bites. The lower limbs were the most affected anatomical region (84%). The Bothrops atrox snake, mainly small specimens (mostly juveniles), was the main species involved in the envenomations (83.4%). Snakebites occurred mainly in forest areas, backyards of houses in rural areas and near to aquatic environments, during activities (walking, farming, extractivism, hunting). Most of the time, the snake was on the ground and the bite occurred because of the approximation of the individual, either by trampling or by approximation of a hand. Half of the victims performed some kind of inadequate first aid (not drinking water, use of tourniquet, incision at the site of the bite, use of black stone, drinking a compound "Específico Pessoa"). CONCLUSIONS: Snakebite is an important cause of morbidity in the Alto Juruá region. Bothrops bites are mostly caused by small-sized specimens, probably due to the greater abundance of B. atrox juveniles, and also because small snakes are more difficult for people to see. People are more often bitten on the lower limbs probably due to the size of B. atrox (small and medium) and because the snakes are usually on the ground in most situations. Many victims resort to ineffective actions that can cause complications and also delay serotherapy. A low level of education is a factor that may contribute to worse outcomes in snakebites since it is associated with a lack of knowledge of preventive and first aid measures.

Protagonismo do acadêmico de enfermagem em projeto de vivência universitária: hidroterapia na gestação / Protagonism of the nursing scholar in a university experience project: hydrotherapy during pregnancy / Protagonismo del académico de enfermería en proyecto de vivencia universitaria: hidroterapia en la gestación

Objetiva-se analisar o projeto de Vivência Universitária com gestantes em uma Unidade Saúde da Família de Sinop- MT, destacando o incentivo ao protagonismo do acadêmico de enfermagem. Trata-se de um relato de experiência do projeto de vivência "hidroterapia na gestação", com envolvimento de graduandos, profissionais da saúde, trabalhadores da equipe, gestantes e colaboradores da comunidade acadêmica e local. Os acadêmicos puderam desenvolver um plano de trabalho, implementá-lo e avaliá-lo, aprimorando conhecimentos e aplicando-os à realidade. Por meio do projeto, reconheceram a relevância da prática de exercícios físicos na gestação; a necessidade de articular saberes, práticas e sujeitos para ações de promoção à saúde; e as contribuições em sua formação acadêmica, por meio de projetos que o integrem ao contexto dos indivíduos/comunidades. É importante o incentivo ao protagonismo acadêmico, com vistas ao preparo profissional, assentado numa perspectiva de atendimento integral. São necessárias novas ações de promoção à saúde, incluindo gestantes/acompanhantes.(AU)

The aim of this study is to analyze the project of University Experience with pregnant women in a Family Health Unit of Sinop-MT, highlighting the incentive to the role of the nursing student. This is an experience report of the "hydrotherapy in the gestation" experience project, involving undergraduates, health professionals, staff workers, pregnant women and employees of the academic and local community. Academics were able to develop a work plan, implement it and evaluate it, improving knowledge and applying it to the reality. Through the project they recognized the relevance of the practice of physical exercises during pregnancy; the need to articulate knowledge, practices and subjects for health promotion actions; and, the contributions in its academic formation, through projects that integrate it to the context of the individuals/communities. It is important to encourage academic leadership, with a view to professional preparation, based on a comprehensive care perspective. New health promotion actions are needed, including pregnant women/companions.(AU)

El objetivo de este estudio es analizar el proyecto de Experiencia Universitaria con mujeres embarazadas en una Unidad de Salud Familiar de Sinop-MT, destacando el incentivo para el papel del estudiante de enfermería. Este es un informe de la experiencia del proyecto de experiencia "hidroterapia en la gestación", que involucra a estudiantes universitarios, profesionales de la salud, trabajadores del personal, mujeres embarazadas y empleados de la comunidad académica y local. Los académicos pudieron desarrollar un plan de trabajo, implementarlo y evaluarlo, mejorando el conocimiento y aplicándolo a la realidad. A través del proyecto reconocieron la relevancia de la práctica de ejercicios físicos durante el embarazo; la necesidad de articular conocimientos, prácticas y temas para acciones de promoción de la salud; y, las aportaciones en su formación académica, a través de proyectos que la integran al contexto de los individuos/comunidades. Es importante fomentar el liderazgo académico, con miras a la preparación profesional, sobre la base de una perspectiva de atención integral. Se necesitan nuevas acciones de promoción de la salud, incluidas las mujeres embarazadas/acompañantes.(AU)

The genomic history of the Iberian Peninsula over the past 8000 years.

We assembled genome-wide data from 271 ancient Iberians, of whom 176 are from the largely unsampled period after 2000 BCE, thereby providing a high-resolution time transect of the Iberian Peninsula. We document high genetic substructure between northwestern and southeastern hunter-gatherers before the spread of farming. We reveal sporadic contacts between Iberia and North Africa by ~2500 BCE and, by ~2000 BCE, the replacement of 40% of Iberia's ancestry and nearly 100% of its Y-chromosomes by people with Steppe ancestry. We show that, in the Iron Age, Steppe ancestry had spread not only into Indo-European-speaking regions but also into non-Indo-European-speaking ones, and we reveal that present-day Basques are best described as a typical Iron Age population without the admixture events that later affected the rest of Iberia. Additionally, we document how, beginning at least in the Roman period, the ancestry of the peninsula was transformed by gene flow from North Africa and the eastern Mediterranean.

Did the Romans introduce the Egyptian mongoose (Herpestes ichneumon) into the Iberian Peninsula?

New finds of bones of the Egyptian Mongoose (Herpestes ichneumon), one from Portugal and one from Spain, were directly 14C dated to the first century AD. While the Portuguese specimen was found without connection to the Chalcolithic occupation of the Pedra Furada cave where it was recovered, the Spanish find, collected in the city of Mérida, comes from a ritual pit that also contained three human and 40 dog burials. The finds reported here show that the Egyptian mongoose, contrary to the traditional and predominant view, did not first arrive in the Iberian Peninsula during the Muslim occupation of Iberia. Instead, our findings are consistent with the hypothesis that the species was first introduced by the Romans, or at least sometime during the Roman occupation of Hispania. Therefore, radiocarbon dating of new archaeological finds of bones of the Egyptian Mongoose (Herpestes ichneumon) in the Iberian Peninsula push back the confirmed presence of the species in the region by approximately eight centuries, as the previously oldest dated record is from the ninth century. With these new dates, there are now a total of four 14C dated specimens of Egyptian mongooses from the Iberian Peninsula, and all of these dates fall within the last 2000 years. This offers support for the hypothesis that the presence of the species in Iberia is due to historical introductions and is at odds with a scenario of natural sweepstake dispersal across the Straits of Gibraltar in the Late Pleistocene (126,000-11,700 years ago), recently proposed based on genetic data.

The maternal genetic make-up of the Iberian Peninsula between the Neolithic and the Early Bronze Age.

Agriculture first reached the Iberian Peninsula around 5700 BCE. However, little is known about the genetic structure and changes of prehistoric populations in different geographic areas of Iberia. In our study, we focus on the maternal genetic makeup of the Neolithic (~ 5500-3000 BCE), Chalcolithic (~ 3000-2200 BCE) and Early Bronze Age (~ 2200-1500 BCE). We report ancient mitochondrial DNA results of 213 individuals (151 HVS-I sequences) from the northeast, central, southeast and southwest regions and thus on the largest archaeogenetic dataset from the Peninsula to date. Similar to other parts of Europe, we observe a discontinuity between hunter-gatherers and the first farmers of the Neolithic. During the subsequent periods, we detect regional continuity of Early Neolithic lineages across Iberia, however the genetic contribution of hunter-gatherers is generally higher than in other parts of Europe and varies regionally. In contrast to ancient DNA findings from Central Europe, we do not observe a major turnover in the mtDNA record of the Iberian Late Chalcolithic and Early Bronze Age, suggesting that the population history of the Iberian Peninsula is distinct in character.

Mortalidade infantil na percepção de gestores e profissionais de saúde: determinantes do seu declínio e desafios atuais em município do sul do Brasil / Infant mortality in the perception of health managers and professionals: determinants of its decline and current challenges in a southern Brazilian town

Este estudo objetivou analisar a percepção de gestores e profissionais da saúde sobre os determinantes para o declínio da mortalidade infantil nas últimas décadas, bem como os desafios para a continuidade da redução dos valores desse indicador em Londrina (PR). Foi realizado uma pesquisa qualitativa com análise de entrevistas de 38 gestores, profissionais de saúde e pesquisadores, selecionados pela técnica da bola de neve. Na visão dos entrevistados, os determinantes para a redução da mortalidade infantil foram melhorias das condições de vida e medidas implantadas por políticas públicas e ações setoriais e extrassetoriais. Os desafios atuais dizem respeito, principalmente, à qualificação da assistência pré-natal, à redução da gravidez na adolescência, à melhoria da atenção hospitalar ao recém-nascido prematuro, à prevenção da prematuridade e ao financiamento do Sistema Único de Saúde (SUS). O aumento da proporção de mortes neonatais torna mais complexo e difícil reduzir a mortalidade infantil. Compreender as dificuldades e identificar os desafios, sob a percepção de gestores e profissionais da saúde, pode contribuir para o planejamento das ações necessárias para a melhoria da saúde das crianças menores de 1 ano e para a redução da mortalidade infantil.(AU)

Global body posture and plantar pressure distribution in individuals with and without temporomandibular disorder: a preliminary study.

OBJECTIVE: The aim of this study was to evaluate body posture and the distribution of plantar pressure at physiologic rest of the mandible and during maximal intercuspal positions in subjects with and without temporomandibular disorder (TMD). METHODS: Fifty-one subjects were assessed by the Diagnostic Criteria for Research on Temporomandibular Disorders and divided into a symptomatic group (21) and an asymptomatic group (30). Postural analysis for both groups was conducted using photogrammetry (SAPo version 0.68; University of São Paulo, São Paulo, Brazil). The distribution of plantar pressures was evaluated by means of baropodometry (Footwork software), at physiologic rest and maximal intercuspal positions. RESULTS: Of 18 angular measurements, 3 (17%) were statistically different between the groups in photogrammetric evaluation. The symptomatic group showed more pronounced cervical distance (P = .0002), valgus of the right calcaneus (P = .0122), and lower pelvic tilt (P = .0124). The baropodometry results showed the TMD subjects presented significantly higher rearfoot and lower forefoot distribution than those in the asymptomatic group. No differences were verified in maximal intercuspal position in the between-group analysis and between the 2 mandibular positions in the within-group analysis. CONCLUSIONS: Subjects with and without TMD presented with global body posture misalignment. Postural changes were more pronounced in the subjects with TMD. In addition, symptomatic subjects presented with abnormal plantar pressure distribution, suggesting that TMD may have an influence on the postural system.

Analysis of the Level of Dysphagia, Anxiety, and Nutritional Status Before and After Speech Therapy in Patients with Stroke

Introduction: The rehabilitation in oropharyngeal dysphagia evidence-based implies the relationship between the interventions and their results. Objective: Analyze level of dysphagia, oral ingestion, anxiety levels and nutritional status of patients with stroke diagnosis, before and after speech therapy. Method: Clinical assessment of dysphagia partially using the Protocol of Risk Assessment for Dysphagia (PARD), applying the scale Functional Oral Intake Scale for Dysphagia in Stroke Patients (FOIS), Beck Anxiety Inventory (BAI) and the Mini Nutritional Assessment MNA®. The sample consisted of 12 patients, mean age of 64.6 years, with a medical diagnosis of hemorrhagic and ischemic stroke and without cognitive disorders. All tests were applied before and after speech therapy (15 sessions). Statistical analysis was performed using the chi-square test or Fisher's exact test, McNemar's test, Bowker's symmetry test and Wilcoxon's test. Results: During the pre-speech therapy assessments, 33.3% of patients had mild to moderate dysphagia, 88.2% did not receive food orally, 47.1% of the patients showed malnutrition and 35.3% of patients had mild anxiety level. After the therapy sessions, it was found that 33.3% of patients had mild dysphagia, 16.7% were malnourished and 50% of patients had minimal level of anxiety. Conclusion: There were statistically significant evolution of the level of dysphagia (p = 0.017) and oral intake (p = 0.003) post-speech therapy. Although not statistically significant, there was considerable progress in relation to the level of anxiety and nutritional status...

Analysis of the level of Dysphagia, anxiety, and nutritional status before and after speech therapy in patients with stroke.

INTRODUCTION: The rehabilitation in oropharyngeal dysphagia evidence-based implies the relationship between the interventions and their results. OBJECTIVE: Analyze level of dysphagia, oral ingestion, anxiety levels and nutritional status of patients with stroke diagnosis, before and after speech therapy. METHOD: Clinical assessment of dysphagia partially using the Protocol of Risk Assessment for Dysphagia (PARD), applying the scale Functional Oral Intake Scale for Dysphagia in Stroke Patients (FOIS), Beck Anxiety Inventory (BAI) and the Mini Nutritional Assessment MNA(®). The sample consisted of 12 patients, mean age of 64.6 years, with a medical diagnosis of hemorrhagic and ischemic stroke and without cognitive disorders. All tests were applied before and after speech therapy (15 sessions). Statistical analysis was performed using the chi-square test or Fisher's exact test, McNemar's test, Bowker's symmetry test and Wilcoxon's test. RESULTS: During the pre-speech therapy assessments, 33.3% of patients had mild to moderate dysphagia, 88.2% did not receive food orally, 47.1% of the patients showed malnutrition and 35.3% of patients had mild anxiety level. After the therapy sessions, it was found that 33.3% of patients had mild dysphagia, 16.7% were malnourished and 50% of patients had minimal level of anxiety. CONCLUSION: There were statistically significant evolution of the level of dysphagia (p = 0.017) and oral intake (p = 0.003) post-speech therapy. Although not statistically significant, there was considerable progress in relation to the level of anxiety and nutritional status.

Acute effects of cocaine, morphine and their combination on bioenergetic function and susceptibility to oxidative stress of rat liver mitochondria.

AIMS: Cocaine and heroin are frequently co-abused in a combination known as speedball. Despite the relevance of the liver in the metabolism and detoxification of these drugs, little is known about the impact of speedball on liver function. MAIN METHODS: In this work, we evaluated the effects of cocaine, morphine and morphine+cocaine (Mor+Coc) combination (1:1) in isolated rat liver mitochondria, upon glutamate/malate or succinate energization, on bioenergetics and oxidative stress-related parameters by using Clark O2, Ca(2+), TPP(+) and pH electrodes and by measuring thiobarbituric acid reactive substances (TBARS) and H2O2 production. KEY FINDINGS: Cocaine and Mor+Coc at the higher concentrations (1mM) similarly increased O2 consumption at state 2, state 4 and state oligomycin. In these conditions, maximum respiration was decreased only upon glutamate/malate energization, suggesting an involvement of complex I. Morphine (1mM) only increased state 2 respiration. Cocaine and Mor+Coc induced a similar decrease in maximum mitochondrial membrane potential and in ADP-induced depolarization, whereas morphine had no effect. The drugs and their combination similarly decreased mitochondrial ATPase activity and had no effect on Ca(2+)-induced permeability transition. Morphine and Mor+Coc prevented lipid peroxidation, since in these conditions there was a decrease in O2 consumption and in TBARS upon ADP/Fe(2+) stimulus, and a decrease in H2O2 formation, suggesting an antioxidant effect. Interestingly, heroin did not share morphine antioxidant properties. SIGNIFICANCE: Our results show that the sequential direct exposure of liver mitochondria to morphine and cocaine does not alter the effects observed in the presence of each drug alone.

Low level laser therapy as an adjunctive technique in the management of temporomandibular disorders.

The purpose of this study was to assess the effect of low level laser therapy on subjects with intra-articular temporomandibular disorders (IA-TMD), and to quantify and compare severity of signs and symptoms before, during, and after the laser applications. The sample consisted of 45 subjects randomly divided into three groups (G) of 15 subjects each: G-I: 15 individuals with IA-TMD submitted to an energy dose of 52.5 J/cm2; G-II: dose of 105.0 J/cm2; and G-III: placebo group (0 J/cm2). In all groups, the applications were performed on condylar points on the masseter and anterior temporalis muscles. Two weekly sessions were held for five weeks, totaling 10 applications. The assessed variables were: mandibular movements and painful symptoms evoked by muscle palpation. These variables were measured before starting the study, then immediately after the first, fifth, and tenth laser application, and finally, 32 days after completing the applications. The results showed that there were statistically significant differences for G-I and G-II at the level of 1% between the doses, as well as between assessments. Therefore, it was concluded that the use of low level laser increased the mean mandibular range of motion and reduced painful symptoms in the groups that received effective treatment, which did not occur in the placebo group.

Avaliação eletromiográfica dos músculos da mastigação de indivíduos com desordem temporomandibular submetidos a acupuntura / Surface electromyography of masticatory muscles in individuals with temporomandibular disorder submitted to acupuncture

OBJETIVO: Avaliar o efeito da acupuntura na atividade eletromiográfica dos músculos mastigatórios em pacientes com desordem temporomandibular (DTM). MÉTODOS: Quarenta mulheres, de 20 a 40 anos e com diagnóstico de DTM foram avaliadas por meio da eletromiografia dos músculos masseter e temporal (fascículo anterior). As participantes foram distribuídas em grupos de estudo (GE), cujo tratamento com acupuntura foi aplicado logo após a avaliação inicial, e de controle (GC), que recebeu o tratamento após cinco semanas desta avaliação. Os registros eletromiográficos foram coletados na avaliação inicial (Av), imediatamente após uma sessão de acupuntura (R1) e ao final de dez sessões (R10) no GE. O GC foi avaliado no início (Av) e após cinco semanas (R10), enquanto aguardava o tratamento. A acupuntura foi realizada duas vezes na semana, por cinco semanas ininterruptas. Os resultados foram analisados estatisticamente. RESULTADOS: Na posição de repouso mandibular, o GE apresentou redução significativa da atividade eletromiográfica do músculo temporal esquerdo em R1 e nos músculos temporal direito e esquerdo em R10. No GC, a atividade no músculo temporal esquerdo aumentou após cinco semanas. Na mastigação, houve redução da atividade no músculo masseter direito no GE. CONCLUSÃO: A acupuntura reduziu a atividade elétrica dos músculos temporais na posição de repouso mandibular, proporcionando melhor equilíbrio muscular entre estes e os músculos masseteres. Não houve um efeito uniforme da acupuntura sobre os músculos avaliados durante a máxima intercuspidação e a mastigação, não apresentando melhora na sua qualidade.

PURPOSE: To assess the effect of acupuncture on the electromyographic activity of masticatory muscles in patients with temporomandibular disorder (TMD). METHODS: Forty women, from 20 to 40 years old, with TMD diagnosis were assessed using the electromyography of the masseter and temporal (anterior fascicle) muscles. Participants were distributed into study group (SG), which received acupuncture treatment soon after the first assessment, and control group (CG), which received the treatment five weeks after this assessment. The electromyography was accomplished at the first evaluation (Av), immediately after one session of acupuncture (R1), and after ten sessions (R10) in the SG. The CG was evaluated at the beginning (Av) and after five weeks (R10), while waiting for the treatment. The acupuncture was carried out twice a week, for five uninterrupted weeks. Results were statistically analyzed. RESULTS: At the rest mandibular position, the SG showed a significant decrease in the left temporal muscle activity in R1, and in the right and left temporal muscles in R10. In the CG, the activity increased in the left temporal muscle after five weeks (R10). During chewing, the activity decreased in the right masseter in the SG. CONCLUSION: Acupuncture reduced the temporal muscles activity at rest mandibular position, providing better muscular balance between these and masseter muscles. There was not a uniform effect of the acupuncture on the assessed muscles assessed during maximal intercuspal position and chewing, showing no improvement in the quality of their activity.

Acupuntura como recurso terapêutico na dor e na gravidade da desordem temporomandibular / Acupuncture as therapeutic resource in the pain and in the severity of the temporomandibular disorder

Este estudo avaliou o efeito da acupuntura no nível de dor e gravidade da Desordem Temporomandibular (DTM). Participaram dele 40 mulheres entre 20 e 40 anos com DTM diagnosticada pelo Research Diagnostic Criteria (RDC/TMD). A dor foi avaliada pela escala visual analógica e a gravidade da desordem pelos Índices de Disfunção Craniomandibular e de Fonseca. As 20 primeiras participantes foram submetidas a acupuntura duas vezes na semana por cinco semanas ininterruptas e, após o período, foram reavaliadas. Os dados destas participantes constituíram os resultados para o grupo acupuntura. As demais voluntárias receberam o tratamento após o primeiro grupo e seus dados, coletados no início e após cinco semanas sem tratamento, foram utilizados para controle. Na análise estatística foram levados em conta os testes de Wilcoxon para o nível de dor e Índice Craniomandibular e Teste t de Student para o Índice de Fonseca, com nível de significância de 5. Houve redução significante no nível de dor (p=0,000) e na gravidade da DTM pelos Índices Craniomandibular (p=0,004) e de Fonseca (p=0,000) após o tratamento. O grupo controle não apresentou melhora. A efetividade da acupuntura foi demonstrada pela melhora no nível da dor e na gravidade da DTM.

This study assessed the effect of acupuncture on the pain level and severity of the temporomandibular disorder (TMD). Forty women with TMD diagnosed by Research Diagnostic Criteria, from 20 and 40 years old, took part in the study. Pain was assessed by visual analogue scale and severity by the Craniomandibular Dysfunction and Fonseca Indexes. The first 20 volunteers were undergone to acupuncture twice a week for five weeks without interruption, and after they were reassessed. The results of these participants constituted acupuncture group. The other volunteers received the treatment after the first group and their data, collected in the beginning and after five weeks without treatment, were utilized as control. Statistical analysis of the pain and the Craniomandibular Index was carried out by the Wilcoxon test and the Fonseca index by the Student's t-test, with significance level of 5. There was significant reduction in the pain level (p=0.000) and severity of TMD by the Craniomandibular (p=0.004) and Fonseca Indexes (p=0.000) after the treatment. The control group showed no improvement. The effectiveness of the acupuncture was demonstrated by the improvement in the pain and severity of TMD.

Percepção dos enfermeiros sobre o uso do brinquedo terapêutico / Nurses' perceptions on the use of therapeutic play

Percepção dos Enfermeiros sobre o uso do Brinquedo Terapêutico no alívio da dor na criança O Brinquedo Terapêutico é reconhecido, cada vez mais, como uma estratégia eficaz no alívio da dor da criança. Objectivos: Analisar a percepção das enfermeiras da equipe da USF-Lusitana sobre o uso do Brinquedo terapêutico, antes e após uma intervenção formativa. Definir uma norma de "Boa Prática" para a preparação da criança, em idade pré-escolar, para a vacinação. Metodologia: Trata-se de um estudo qualitativo, exploratório-descritiva e comparativa. Os dados foram colhidos através de um questionário, aplicado, antes e depois de uma intervenção formativa, aos enfermeiros da USF. Resultados: A análise dos dados evidenciou benefícios para a criança e família, para a relação terapêutica e após a formação também para o ambiente. Conclusão: Foi reconhecido pelos enfermeiros que o brinquedo terapêutico é uma estratégia eficaz na redução do nível de dor e elaborada uma norma que introduz esta estratégia na preparação das crianças, com 5/6 anos, para a vacinação.

Perception of nurses on the use of therapeutic play in relieving pain in children The therapeutic play is recognized increasingly as an effective strategy for relieving the pain on child.Objective: To analyze the perception of USF Lusitana nurses on the use of therapeutic play, before and after a formative intervention. Set a standard of "Good Practice" for preparing the child in preschool age, for vaccination.Methodology: It is a qualitative study, exploratory-descriptive and comparative. Data were collected through a questionnaire applied, before and after a formative intervention, to the USF nurses. Results: Data analysis showed benefits for the child and family in the therapeutic relationship and, after pair formation, also for the environment.Conclusion: It´s now recognized by nurses that therapeutic play is an effective strategy in reducing the level of pain and developed a standard that introduces this strategy in the preparation of children, with 5 / 6 years, for vaccination.

Família, cultura e práticas de saúde: um estudo bibliométrico / Familia, cultura y prácticas de salud: un estudio bibliométrico / Family, Culture and Health Practices: a bibliometric study

Pesquisa bibliométrica que analisou a visibilidade da produção científica abrangendo a temática família, cultura e práticas de saúde na base de dados LILACS, no período 2003-2008. Evidenciaram-se as temáticas: terapias complementares, saúde no domicílio, violência e drogas e os descritores: antropologia cultural, cultura, família, Brasil, medicina tradicional, transtornos relacionados ao uso de substâncias e programa saúde da família. Os anos de 2004 e 2005 corresponderam a 46,6% das publicações. Os periódicos da Região Sudeste e do Estado de Santa Catarina/Brasil contribuíram com 68,5% das publicações. A enfermagem e a saúde pública foram responsáveis por 77,5% dessas publicações, 73,3% das produções foram artigos e 26,7% teses/dissertações. Considera-se que tais resultados fornecem subsídios a outras produções científicas, à enfermagem e às diversas áreas do conhecimento.

This bibliometric study examined the visibility of scientific production on the subject of family, culture and health practices in the LILACS database from 2003 to 2008. The themes that emerged were: complementary therapies, health at home, violence and drugs; and the descriptors: cultural anthropology, culture, family, Brazil, traditional medicine, substance use-related disorders and family health program. Publications were distributed as follows: 46.6% dated from 2004 and 2005; 68.5% were contributed by periodicals from Brazil’s Southeast Region and Santa Catarina State; 77.5% related to the fields of nursing and public health; 73.3% were papers and 26.7%, theses. We believe that these results provide input for other scientific productions, nursing and various other fields of scientific knowledge.

Investigación bibliométrica que analizó la visibilidad de las publicaciones científicas sobre el tema: familia, cultura y prácticas de salud, en la base de datos LILACS, 2003-2008. Se destacaron los siguientes temas: terapias complementarias, salud en el hogar, violencia y drogas; y los descriptores: antropología cultural, cultura, familia, Brasil, medicina tradicional, trastornos relacionados al uso de substancias, y programa de salud familiar. El 46,6% de las publicaciones corresponde a los años 2004 y 2005. Las revistas de la Región Sudeste y del Estado de Santa Catarina contribuyeron con el 68,5% de las publicaciones. Enfermería y salud pública fueron responsables por 77,5% de esas publicaciones, el 73,3% de las publicaciones fueron artículos y 26,7% tesis. Se considera que esos resultados proporcionan aportes a otras publicaciones científicas, a la enfermería y a las diversas áreas del conocimiento.

Signs of trauma in an adult parietal bone exhumed from a Portuguese prehistoric collective burial.

A fragment of parietal bone from an adult individual of unknown sex exhumed from the collective burial of Praia da Samarra (Sintra, Portugal), dated to the end of the Neolithic, presents signs of different types of trauma. These include thinning of the skull vault and incisions marks. Differential diagnoses for these alterations are discussed: for the first one, depressed skull factures is the most likely cause. For the incisions, trepanation (more probable) and trauma due to a sharp force are proposed. These hypotheses are also discussed in terms of other similar findings from coeval Portuguese collective burials.