Experiences of children with congenital Zika syndrome while using motorized mobility: a qualitative study using the photovoice method.

AIM: The congenital Zika Syndrome (CZS) often leads to severe motor impairment in affected children, making independent walking unlikely. Early introduction of motorized mobility through ride-on cars has been recommended for young children with severe motor impairment, enabling independent movement in various environments. This study aims to explore mothers' perceptions of their children's experiences while using ride-on cars at home and in the community, focusing on children with CZS. METHODS: This is a qualitative and descriptive study design using the Photovoice method. Four mothers of children with CZS, participating in the 'Go Zika Go' intervention project, were included. The research involved the following six steps: 1) Presentation of guide questions and Photovoice training; 2) Participants capturing photos; 3) Individual interviews to contextualize the photos; 4) Transcription and data analysis using thematic analysis principles; 5) Validation of analyses by mothers; and 6) Exhibition of photos to the community. RESULTS: The mothers and researchers selected the 21 most relevant photographs, which revealed five main themes related to the use of motorized ride-on cars: 1) Experiences of participation; 2) Independence in mobility; 3) Characteristics of mobility devices; 4) Family support; and 5) Accessibility of the environment. CONCLUSION: The narratives provided by participants, along with photographs depicting the daily lives of children with CZS, shed light on aspects of functionality, autonomy, and participation. The use of these devices contributes to overall equity, breaking down social and cultural barriers and enabling children with disabilities to be seen as equals by their peers.

To understand the barriers and facilitators experienced by children with Congenital Zika Syndrome (CZS) when using motorized ride-on cars at home and in the community can contribute to the planning of interventions aimed at implementing motorized mobility as an intervention modality for children with severe motor and cognitive impairments in low- and middle-income countries.The Photovoice method can be useful to capture the experiences of children with severe disabilities such as Congenital Zika Syndrome while using adapted motorized ride-on cars.Involving mothers of children with severe disabilities as co-researchers can contribute to the advancement of more relevant research for the public/patient, considering that they are specialists by knowledge.The use of motorized mobility for children with CZS can minimize social disadvantages, favor equity in its entirety, providing for the breakdown of cultural and attitudinal barriers.

Epstein-Barr Virus-Associated Carcinoma of the Larynx: A Systematic Review with Meta-Analysis.

Over the past few decades, several publications have investigated the role of Epstein-Barr virus (EBV) in head and neck squamous cell carcinomas, and an increasing number of them have shown its presence in laryngeal tumors. The purpose of this meta-analysis was to evaluate the association of EBV with laryngeal carcinoma. The search was carried out in two databases, Scopus and PubMed, using the following terms: "Epstein-Barr virus" and "laryngeal carcinoma". A total of 187 records were found, of which 31 were selected for meeting the inclusion and exclusion criteria. The meta-analysis yielded an overall pooled prevalence of 43.72% (95% confidence interval (CI): 34.35-53.08). Studies carried out in Europe and Eurasia had slightly higher pooled prevalence than other subgroups, while the prevalence of studies performed in developed countries was higher than in developing countries (46.37% vs. 34.02%). Furthermore, laryngeal carcinoma occurred almost three times as often among EBV-infected individuals compared to those without EBV infection (odds ratio = 2.86 (95% CI: 1.18-6.90); Begg's test, p = 0.843 and Egger's test, p = 0.866). Our findings support the idea that EBV is related to laryngeal carcinoma. However, further studies are needed before recognizing a definitive etiological role of EBV in the development and/or progression of laryngeal carcinomas.

Characterization of the sand fly fauna in Barbalha, one of the municipalities with the highest leishmaniasis rates in Brazil.

Leishmaniases are a complex of sand fly-borne diseases that are considered a public health issue in several countries. Brazil presents high leishmaniases rates. The South of Ceará State, known as Cariri region, shows worrying statistics mainly on American tegumentary leishmaniasis. In Barbalha, which is one of the municipalities in this region, there is still a lack of studies regarding the local phlebotomine (Diptera: Psychodidae) fauna in order to help clarify the high rates. This study aimed to characterize such fauna by capturing sand flies with light traps during a four-year period. A total of 3730 sand flies were captured, of which 37.8% were females. Fourteen species were found: 13 of the Lutzomyia genus and one of the Brumptomyia genus. Of the Lutzomyia species, four were proven and five had potential involvement in leishmaniasis transmission. Lutzomyia longipalpis was the most common species (66.97%). This predominance, especially in the urban area, indicates its epidemiological importance and adaptation to environmental conditions modified by human activity. In fact, further studies are still required to accurately determine the behavioral features of these vectors in order to guide public health measurements towards its control and prevention.

Prevention Actions of Burnout Syndrome in Nurses: An Integrating Literature Review.

AIMS: To identify the strategies for the prevention of burnout syndrome in nurses; and discuss the results for future interventions that can decrease burnout in these professionals. DESIGN: An integrative review of the literature. DATA SOURCES: PubMed, Lilacs, Medline, Scielo, and Science Direct, from April 2018 to July 2018. METHODS: The sources were in all 553 references were found. The following guiding question was: Which interventions for the prevention of burnout in nurses have been applied and have obtained high effectiveness? RESULTS: Based on the inclusion and exclusion factors, 30 studies were selected for analysis. The studies were categorized in individual, group and organizational, being the studies with actions in groups those of greater prevalence. CONCLUSION: The actions used to cope with burnout were, for the most part, effective, with some demonstrating greater success than others. From the 30 reviewed studies, the results did not obtain satisfactory improvement in burnout in only three interventions: 1) Systematic nursing supervision; 2) Basic nursing care; and 3) Psycho-oncological training program.

American cutaneous leishmaniasis in a northeast Brazilian city: clinical and epidemiological features.

INTRODUCTION: This study characterized the clinico-epidemiological profile of American cutaneous leishmaniasis (ACL) cases in Barbalha, Ceará State, Brazil. METHODS: Medical records of 363 patients visiting Federal University of Cariri between 2009 and 2014 were analyzed. RESULTS: ACL was more prevalent in men with low education level from rural zones. The main presentation was a single ulcer, mainly in the lower limbs, and 49.8% also presented lymphadenomegaly. The annual incidence ranged from 2.83 to 22.60 per 10,000 inhabitants. CONCLUSIONS: The rates observed in this study indicate the importance of additional research to contribute to the control of this endemic disease.

American cutaneous leishmaniasis in a northeast Brazilian city: clinical and epidemiological features

Abstract INTRODUCTION This study characterized the clinico-epidemiological profile of American cutaneous leishmaniasis (ACL) cases in Barbalha, Ceará State, Brazil. METHODS Medical records of 363 patients visiting Federal University of Cariri between 2009 and 2014 were analyzed. RESULTS ACL was more prevalent in men with low education level from rural zones. The main presentation was a single ulcer, mainly in the lower limbs, and 49.8% also presented lymphadenomegaly. The annual incidence ranged from 2.83 to 22.60 per 10,000 inhabitants. CONCLUSIONS: The rates observed in this study indicate the importance of additional research to contribute to the control of this endemic disease.

Atypical presentations of cutaneous leishmaniasis: A systematic review.

Cutaneous Leishmaniasis (CL) is endemic in 88 countries, showing relevant prevalences. The aim of this study was to perform a systematic review on atypical lesions of CL around the world, addressing clinico-epidemiological, immunological and therapeutic aspects. A search of the literature was conducted via electronic databases Scopus and PubMed for articles published between 2010 and 2015. The search terms browsed were "cutaneous leishmaniasis", "atypical" and "unusual". Based on the eligibility criteria, 34 out of 122 articles were included in the final sample. Atypical lesions may include the following forms: erythematous volcanic ulcer, lupoid, eczematous, erysipeloid, verrucous, dry, zosteriform, paronychial, sporotrichoid, chancriform and annular. In any cases, they seem to be another disease like subcutaneous and deep mycosis, cutaneous lymphoma, pseudolymphoma, basal and squamous cell carcinoma. The lesions have been reported in the face, cheeks, ears, nose, eyelid, limbs, trunk, buttocks, as well as in palmoplantar and genital regions; sometimes occurring in more than one area. The reason for clinical cutaneous leishmaniasis pleomorphism is unclear but immunosuppression seems to play an important role in some cases. There are no established guidelines for the treatment of atypical cutaneous leishmaniasis. However, pentavalent antimonials remain as first line treatment for all forms of leishmaniasis even for HIV-infected patients and atpical forms. Finally, to diagnose an atypical lesion properly, the focus has to be on the medical history and the origin of the patient, comparing them to the natural history of leishmaniasis and always reminding of possible atypical presentations, to then start searching for the best diagnostic method and treatment, reducing the misdiagnosis rate and, subsequently, controlling the disease progression. Thereby, contributing for breaking the transmission chain of the parasite, due to early correct diagnosis which, in turn, contributes to reduce the prevalence.

Síndrome De Down: Reação das Mães Frente à Notícia e a Repercussão na Intervenção Fisioterapêutica da Criança / Down Syndrome: Mothers' Reaction Towards This News and the Repercussion on the Physiotherapeutic Intervention of the Child

Introdução: A síndrome de Down (SD) é uma condição genética caracterizada pela existência de um cromossomo extra no par cromossômico 21. O nascimento de um bebê com SD representa, na maioria das vezes, um momento traumático para a família. Excluídos os riscos de uma cardiopatia grave, o bebê é indicado à intervenção precoce da fisioterapia. Objetivo: Identificar e mostrar os efeitos que a notícia pode desencadear nas mães do bebê com SD e como isso pode influenciar na demora pela busca do fisioterapeuta, pondo em risco o desenvolvimento neuropsicomotor (DNPM) desta criança. Material e métodos: Estudo de caráter qualitativo e observacional por meio de entrevistas com cinco mães de crianças com SD, usuárias do Serviço de Fisioterapia Infantil da Universidade Federal da Paraíba. Os critérios de inclusão foram ter tido e/ou ter filho(s) com o diagnóstico confirmado de SD. O fator de exclusão está na presença de neuropatias que potencializem os sinais e sintomas convencionais da SD. Resultados: Com relação à reação das mães frente à notícia, pôde-se verificar que todas sofreram um impacto primário ao saberem que o filho não era aquele desejado. As sensações vividas e relatadas por essas mães foram de tristeza, frustração, rejeição/desgraça, medo e choque. Conclusão: As mães entrevistadas experimentaram a perda do filho idealizado e vivenciaram o "luto", no entanto, seus filhos foram encaminhados para a fisioterapia precocemente e receberam acompanhamento profissional para estimulação do quadro neuropsicomotor da criança, o que evidencia um comportamento de superação, saindo do luto à luta. (AU)

Introduction: Down syndrome (DS) is a genetic condition characterized by trisomy of the chromosome 21. The birth of a newborn with DS means, in most cases, a traumatic moment for the family. If severe heart disease is not detected, the infant should be referred to physical therapy sessions early. Objective: To identify and show the effects that the news may trigger on mothers of infants with DS and how this delays the search for physical therapy, which puts at risk the neuropsychomotor development (NPMD) of the child. Material and methods: This was a qualitative and observational study using interviews with five mothers of children with DS, users of the Pediatric Physical Therapy Service at Universidade Federal da Paraíba. The inclusion criteria was to have had and/or to have at least one child with DS diagnosed by karyotype analysis. The exclusion factor was to have neuropathies that maximize the conventional signs and symptoms of DS. Results: With regard to the mothers' reaction upon the news, it was verified that all of them suffered the elementary impact by learning that their child was carrying an unexpected condition. The emotions they experienced and reported were sadness, frustration, rejection/doom, fear and shock. Conclusion: All interviewed mothers experienced "mourning" over the loss of their ideal-wanted child. However, their children were referred early to physical therapy services and had professional support for stimulation of their psychomotor development, which shows an overcoming behavior of mothers by leaving mourning towards fight. (AU)

Aspectos biopsicossociais de puérperas adolescentes no município de João Pessoa, Paraíba, Brasil / Biopsychosocial aspects of puerperal adolescents in the city of João Pessoa, Paraíba, Brazil

Objetivo: Identificar as características biopsicossociais de gestantes adolescentes, nas maternidades do Hospital Universitário Lauro Wanderley e do Instituto Cândida Vargas,no município de João Pessoa, Paraíba, Brasil. Material e Métodos: Trata-se de um estudo descritivo, observacional e com caráter transversal, cuja amostra foi constituída por104 adolescentes, na faixa etária entre 13 e 19 anos, que se encontravam no pós-parto imediato. Na coleta de dados,foram utilizadas informações constantes nos prontuários e nas entrevistas com as mães no pós-parto imediato. Resultados: A média de idade das participantes foi de 18,5 ±1,4 anos; 52,4% eram da cor parda; 61,5% encontravam-se fora da escola; 90% estudaram em escola pública. Referente à escolaridade, predominou o ensino fundamental (55,8%).A família e o parceiro apoiaram a adolescente na gestação,em 94,2% e 87,5% dos casos, respectivamente. Conclusão: Verificou-se que a faixa etária mais frequente das mães adolescentes era entre 16 e 19 anos de idade, embora também exista uma taxa significativa dos 17 aos 19 anos. Além disso,houve uma alta prevalência de mães que abandonaram os estudos devido à gestação, porém, de um modo geral, as adolescentes puderam contar com o apoio da família e do pai do bebê.

Objective: To identify the biopsychosocial characteristics of pregnant adolescents assisted in the maternities of Lauro Wanderley University Hospital and Candida Vargas Institute, in the city of João Pessoa, Paraíba, Brazil. Material and Methods: This was a descriptive, observational and cross sectional study, whose sample consisted of 104 adolescents, aged between 13 and 19 years, whom were approached in the immediate postpartum period. The data were collected from medical records and interviews with the mothers in the immediate postpartum period. Results: The mean age of participants was 18.5±1.4 years; 52.4 % had mixed ethnicity;61.5% had dropped out of school; 90% had studied in a public school. There was a predominance of the elementary education level (55.8%). The family and the partner supported the adolescent during pregnancy in 94.2% and 87.5% of cases, respectively. Conclusion: The most common age group of adolescent mothers was between 16 and 19 years, although there was a significant rate of mothers aged between 17 and 19 years. In addition, there was a high prevalence of mothers who dropped out of school due to pregnancy; however, in general, the adolescents were supported by their family and child’s father.

Repercussões da imersão sobre a pressão arterial em gestantes / Repercussion of immersion on blood pressure in pregnant women / Repercusiones de la inmersión en la presión arterial de gestantes

Revisamos na literatura as modificações da PA em gestantes durante a imersão para compreender os fatores que influenciam esse comportamento. Observa-se que a PA de repouso é reduzida com a imersão em meio aquático, sendo esta redução proporcional ao nível de imersão. Fatores como temperatura da água, posição corporal, profundidade e tempo de imersão influenciam nas respostas fisiológicas do organismo a essa condição. Contudo, os estudos apresentam diferentes parâmetros para tais variáveis, o que dificulta o estabelecimento de uma adequada indicação desta modalidade como recurso terapêutico.

We reviewed the changes of BP in pregnant women during immersion to understand the factors that influence this behavior. It is observed that resting BP is reduced by immersion in water, this reduction is proportional to the level of immersion. Factors such as water temperature, body position, depth and immersion time influence the body's physiological responses to this condition. However, the studies have different parameters for these variables, which hinders the establishment of an adequate indication of this modality as a therapeutic resource.

Revisamos en la literatura sobre los cambios de la presión arterial en mujeres embarazadas durante la inmersión para comprender los factores que influyen en este comportamiento. Se observa que en reposo se reduce la presión arterial por inmersión en agua, esta reducción es proporcional al nivel de inmersión. Factores como temperatura del agua, posición corporal, profundidad y tiempo de inmersión tienen influencia en las respuestas fisiológicas del organismo a esa condición.?Sin embargo, los estudios tienen parámetros diferentes para estas variables, lo que dificulta el establecimiento de una indicación adecuada de esta modalidad como un recurso terapéutico.