Density and behavior of capybara (Hydrochoerus hydrochaeris) ticks (Acari: Ixodidae) Amblyomma sculptum and Amblyomma dubitatum with notes on Rickettsia bellii infection: Assessing human exposure risk.

In several urban and peri­urban areas of Brazil, populations of Amblyomma sculptum and Amblyomma dubitatum ticks are maintained by capybaras (Hydrochoerus hydrochaeris). In some of these areas, this host and these tick species are associated with Brazilian spotted fever (BSF), a lethal human disease caused by the bacterium Rickettsia rickettsii. In this work, we evaluated the risk of human exposure to these tick species using four collection techniques to discern host-seeking behavior. The study was carried out in 10 urban sites inhabited by capybaras in Uberlândia, a BSF-free municipality in southeastern Brazil. Ticks were collected in areas of 400 m2 at each site and at three seasons. Within the same municipality, the distance and speed of A. sculptum nymphs moving towards the CO2 traps were evaluated. In a sample of ticks Rickettsia DNA was investigated. During the study period, 52,953 ticks were collected. Among these, 83.4 % were A. sculptum (1,523 adults, 10,545 nymphs and 32,104 larvae) and 16.6 % were A. dubitatum (464 adults, 2,153 nymphs and 6,164 larvae). An average annual questing tick density of 4.4/m² was observed, with the highest density recorded at one site in autumn (31.8/m²) and the lowest in summer at another site (0.03/m²). The visual search yielded the highest proportion of A. sculptum larvae, constituting 47 % of the total and 63.6 % of all A. sculptum larvae. In contrast, CO2 traps collected a greater proportion of nymphs and adults of A. sculptum ticks. In the case of A. dubitatum, the CO2 trap was the most efficient technique with 57.7 % of captures of this species, especially of nymphs (94.5 % of captures) and adults (97.8 % of captures). Ticks' ambush height on vegetation (9 to 77 cm), observed by visual search 30 times, yielded a total of 20,771 ticks. Of these, 28 (93 %) were A. sculptum ticks, with only two (7 %) identified as A. dubitatum ticks. Among A. sculptum ticks, the nymph was the most attracted stage to humans and larva in the case of A. dubitatum. Amblyomma sculptum adults and nymphs were significantly more attracted to humans than those of A. dubitatum, but A. dubitatum larvae were significantly more attracted than the same stage of A. sculptum. The maximum distance and speed of horizontal displacement for A. sculptum nymphs were five meters and 2.0 m/h, respectively. The only species of Rickettsia detected in ticks, exclusively in A. dubitatum, was R. bellii. Importantly, it was observed that the higher the proportion of A. sculptum in the community of ticks, the lower the rate of infection of A. dubitatum by R. bellii. In conclusion, host-seeking behavior differed between the two tick species, as well as between stages of the same species. A greater restriction of A. dubitatum ticks to the soil was observed, while larvae and nymphs of A. sculptum dispersed higher in the vegetation. The behavior presented by A. sculptum provides greater opportunities for contact with the hosts, while A. dubitatum depends more on an active search for a host, the hunter behavior. Taken together, these observations show that a human being crossing an area infested with A. sculptum and A. dubitatum ticks will have almost exclusive contact with A. sculptum larvae and/or nymphs. Humans in a stationary position (sitting, lying or immobile) are exposed to both tick species, but they are more attractive to adults and mainly nymphs of A. sculptum compared to the corresponding stages of the tick A. dubitatum. The negative effect of A. sculptum on A. dubitatum infection by R. bellii deserves further studies.

A systematic study on the characteristics and applications of laccases produced by fungi: insights on their potential for biotechnologies.

Laccases are polyphenol oxidase enzymes and form the enzyme complex known for their role in wood decomposition and lignin degradation. The present study aimed to systematically review the state-of-the-art trends in scientific publications on laccase enzymes of the last 10 years. The main aspects checked included the laccase-producing fungal genera, the conditions of fungal growth and laccase production, the methods of immobilization, and potential applications of laccase. After applying the systematic search method 177 articles were selected to compound the final database. Although various fungi produce laccase, most studies were Trametes and Pleurotus genera. The submerged fermentation (SmF) has been the most used, however, the use of solid-state fermentation (SSF) appeared as a promising technique to produce laccase when using agro-industrial residues as substrates. Studies on laccase immobilization showed the covalent bonding and entrapment methods were the most used, showing greater efficiency of immobilization and a high number of enzyme reuses. The main use of the laccase was in bioremediation, especially in the discoloration of dyes from the textile industry and the degradation of pharmaceutical waste. Implications and consequences of all these findings in biotechnology and environment, as well as the trends and gaps of laccase research were discussed.

Violence against women in the media during the Covid-19 pandemic.

OBJECTIVE: To describe situations of violence against women in the Covid-19 pandemic reported in the media. METHOD: Documentary, qualitative research, in a virtual environment, carried out with 39 reports published in the newspaper O Globo and the Universo On-line portal, between March 2020 and July 2021, in Salvador - BA. Data organization followed the steps of content analysis, with a discussion based on the scientific literature. RESULTS: In the analysis process, four core meanings were organized: social isolation denounces situations of domestic violence; Economic crisis and closed doors: justify more violence?; Tools available for ending violence against women: what changes with the pandemic?; The gender and color of violence in the pandemic. FINAL CONSIDERATIONS: The media released alarming data on the intensification and susceptibility of women to different types and situations of violence, especially during social isolation, in the Covid-19 pandemic.

More than just an insect killer: The non-insecticidal activities of Bacillus thuringiensis with biotechnological potential.

Bacillus thuringiensis (Bt) is known for the biological control of important insect pests, but scientific advances have revealed several interesting characteristics, in addition to this classical function as a bioinsecticide. To investigate the current knowledge about these non-insecticidal activities, a systematic research on primary data in the scientific literature was conducted on alternative functions of Bt with biotechnological potential. Out of a total of 140 articles selected, 15 non-insecticidal Bt activities were found. Publications related to this topic are available since 1971, and different metadata were reported, such as biomolecules and genes involved in Bt performances in non-insecticidal bioactivities. A total of 11 Bt activities with different effect measures (response variables) were identified, with an average of 48 distinct Bt strains evaluated per activity. Approximately 81.2% of all identified experiments/tests deal with the direct effects of Bt on target cells/organisms, with 36.3% of the strains within these studies tested for antibacterial action; of all microbial targets tested, 92.8% are bacteria, which led to 75.2% of the experimental conditions for all direct activities being performed in vitro. Regarding indirect Bt activities, 67.6% of these studies reported tritrophic Bt-plant-pathogen interactions. Bioremediation also appears as a relevant Bt activity being investigated in-depth. Alternative Bt activities offer innovative ways of developing biotechnology for different areas of anthropic interest; hence, we also focus on the possibility of finding multifunctional strains of Bt, as this may be advantageous from a bioeconomic point of view. Our findings are discussed in terms of research trends, aspects, details and depth of the current knowledge on alternative non-insecticidal Bt traits. We also discuss the potential application of this science for useful technological developments, aiming at solving issues related to human health, sustainable agriculture and environmental preservation/restoration.

Water drinking during aerobic exercise improves the recovery of non-linear heart rate dynamics in coronary artery disease: crossover clinical trial.

Introduction: The post-exercise recovery is a period of vulnerability of the cardiovascular system in which autonomic nervous system plays a key role in cardiovascular deceleration. It is already known that individuals with coronary artery disease (CAD) are at greater risk due to delayed vagal reactivation in this period. Water ingestion has been studied as a strategy to improve autonomic recovery and mitigate the risks during recovery. However, the results are preliminary and need further confirmation. Therefore, our aim was to investigate the influence of individualized water drinking on the non-linear dynamics of heart rate during and after aerobic exercise in CAD subjects. Methods: 30 males with CAD were submitted to a control protocol composed of initial rest, warming up, treadmill exercise, and passive recovery (60 min). After 48 hours they performed the hydration protocol, composed of the same activities, however, with individualized water drinking proportional to the body mass lost in the control protocol. The non-linear dynamics of heart rate were assessed by indices of heart rate variability extracted from the recurrence plot, detrended fluctuation analysis, and symbolic analysis. Results and discussion: During exercise, the responses were physiological and similar in both protocols, indicating high sympathetic activity and reduced complexity. During recovery, the responses were also physiological, indicating the rise of parasympathetic activity and the return to a more complex state. However, during hydration protocol, the return to a more complex physiologic state occurred sooner and non-linear HRV indices returned to resting values between the 5th and 20th minutes of recovery. In contrast, during the control protocol, only a few indices returned to resting values within 60 minutes. Despite that, differences between protocols were not found. We conclude that the water drinking strategy accelerated the recovery of non-linear dynamics of heart rate in CAD subjects but did not influence responses during exercise. This is the first study to characterize the non-linear responses during and after exercise in CAD subjects.

Balancing client preferences and population-level goals: a qualitative study of the ways in which public health providers and facility administrators interpret and incentivise quality of care in contraceptive counselling in Ethiopia, Mexico and India.

Recent work in family planning has shifted from an instrumentalist perspective on quality in contraceptive counselling, which views quality as a means to encourage contraceptive uptake, to privilege quality of care as a valued end in itself. In this context of shifting narratives about quality, it is important to understand how health systems and providers navigate potential conflicts between instrumentalist definitions of quality versus a person-centred definition that considers meeting clients' contraceptive needs and preferences as an important end goal in and of itself. However, we know little about how providers and other health system stakeholders interpret the concept of quality in counselling, and how their experiences with different quality monitoring systems influence their ability to provide person-centred care. This qualitative study draws from 51 in-depth interviews with public healthcare providers and health facility administrators in Ethiopia, Mexico and India. Across all three countries, except for some cases in India, administrators were concerned with encouraging uptake of contraceptives in order to meet local and national level goals on contraceptive uptake and maternal health. In contrast, providers were more concerned with responding to client desires and needs. However, participants across all levels shared the opinion that successful counselling should end with contraceptive uptake. We conclude that the instrumentalist view of quality counselling continues to prevail across all three countries. Our findings suggest that encouraging healthcare providers and administrators to meet even relatively broad targets set by government reinforces an instrumentalist approach, as opposed to an approach that privileges person-centred care.

O uso de realidade virtual no cateterismo intravenoso periférico em crianças/adolescentes: relato de experiência / The use of virtual reality in peripheral intravenous catheterization in children/adolescents: experience report / El uso de la realidad virtual en el cateterismo intravenoso periférico en niños/adolescentes: reporte de experiencia

Conclusão: a realidade virtual é um recurso que pode ser utilizado como distração durante o cateterismo intravenoso periférico. Para os discentes, houve reflexão sobre o tratamento adequado de enfermagem em pediatria, além do desenvolvimento de habilidades de comunicação e senso crítico

Conclusion: virtual reality is a resource that can be used as a distraction during peripheral intravenous catheterization. For the learners, this experience prompted reflection on appropriate pediatric nursing care, in addition to fostering the development of communication skills and critical thinking

Conclusión: la realidad virtual es un recurso que se puede utilizar como distracción durante la cateterización intravenosa periférica. Para los aprendices, esta experiencia llevó a una reflexión sobre la atención de enfermería pediátrica adecuada, además de fomentar el desarrollo de habilidades de comunicación y pensamiento crítico

Trend in hospitalizations due to ambulatory care-sensitive conditions in the Federal District.

OBJECTIVES: to analyze the trend, according to sex, of Ambulatory Care-Sensitive Conditions in the Primary Health Care of the Federal District, from 2009 to 2019. METHODS: ecological trend study using ACSC hospitalization data available in the Hospitalization System of the Single Health System. The Prais-Winsten method was used to calculate the annual rate variation, expressed in percentages. The dependent variable was the logarithm of the rates, and the independent one, the years in the time series. RESULTS: the Federal District registered 2,103,951 general hospitalizations, 16.4% of which were due to Ambulatory Care-Sensitive Conditions. Males had a higher rate of hospitalization in the period, and both sexes showed a stationary trend. CONCLUSIONS: the time trend of Ambulatory Care- Sensitive Conditions was stationary, but further studies are necessary regarding primary health care coverage.

Influence of physical fitness of coronary disease patients on vagal reentry and heart rate recovery after exercise with and without fluid replacement.

BACKGROUND: Fluid replacement during exercise has been studied as an important strategy to enhance recovery, however, studies are needed to investigate the effect of this strategy in different physical profiles. The aim of the study was to investigate the influence of physical fitness of coronary artery disease (CAD) patients on vagal reentry and heart rate recovery after exercise performed with and without fluid replacement. METHODS: Nonrandomized crossover clinical trial. Thirty-three CAD patients were submitted to (I) cardiopulmonary exercise test: to divide the sample into lower and higher VO2  peak groups; (II) control protocol (CP): composed of rest, aerobic exercise and passive recovery; (III) hydration protocol (HP): composed of the same activities as the CP, but with water intake during exercise. The recovery was evaluated by vagal reentry and heart rate recovery immediately after exercise. RESULTS: The results did not show significant differences between the higher and lower VO2  peak groups. In addition, the hydration strategy adopted was not able to cause significant changes between control and HPs, regardless of group. However, a time effect was observed, suggesting anticipation of vagal reactivation and heart rate reduction in HP. CONCLUSIONS: Physical fitness did not influence vagal reentry and heart rate recovery in CAD patients after exercise. However, the hydration strategy seems to have anticipated vagal reentry and produced a more efficient reduction in heart rate regardless of the individuals' physical fitness, but these results should be analyzed with caution due to the absence of significant differences between groups and protocols.

Oferta de leitos exclusivos para Covid-19 no estado do Espírito Santo / Offer of exclusive beds for COVID-19 in the state of Espírito Santo

RESUMO A pandemia trouxe vários desafios a toda estrutura social, requisitando a organização e desenvolvimento de políticas públicas para conduzir o quadro sanitário. Com relação à saúde, as ações inicialmente envolveram medidas não farmacológicas e preparação do sistema de saúde. No caso do Brasil, em março de 2020 foram deliberadas portarias específicas sobre a oferta de leitos UTI Covid-19. Em abril de 2020, o estado do Espírito Santo iniciou a estruturação dos hospitais referência para Covid-19 habilitando leitos em hospitais públicos de gestão direta e indireta, e em hospitais privados e filantrópicos. Assim sendo, o objetivo deste estudo é analisar a relação de compra e oferta de leitos exclusivos para Covid-19 pela rede SUS no estado do Espírito Santo. Os dados revelam uma rede com diferentes formatos jurídicos, com forte presença de setor filantrópico, seja por Organizações Sociais de Saúde (OSS) ou hospitais. Por fim, o estudo concluiu que a condução da rede hospitalar para leitos UTI Covid-19 ocorreu pela heterogeneidade de formatos jurídicos, com a participação da gestão pública direta substituída por diferentes tipos de gestão, condicionando o estado a reafirmar as contratualizações conforme lógica do mercado.

ABSTRACT The pandemic brought several challenges to the entire social structure, demanding the organization and development of public policies to guide the health situation. With regard to health, actions so far have involved non-pharmacological measures and preparation of the health system. In the case of Brazil, in March 2020, specific ordinances were deliberated on the offer of COVID-19 ICU beds. In April 2020, the state of Espírito Santo began structuring reference hospitals for COVID-19, enabling beds in public hospitals under direct and indirect management, and in private and philanthropic hospitals. Therefore, the objective of this study is to analyze the relationship of purchase and supply of exclusive beds for COVID-19 by the SUS network in the State of Espírito Santo. The data reveal a network with different legal formats, with a strong presence of the philanthropic sector, whether by Social Health Organizations (OSS) or hospitals. Finally, the study concluded that the conduction of the hospital network for COVID-19 ICU beds occurred due to the heterogeneity of legal formats, with the participation of direct public management replaced by different types of management, conditioning the state to reaffirm the contractualizations according to market logic.

Analysis of Barriers to Public and Private Cardiac Rehabilitation Programs in Patients with Low and High Adherence.

INTRODUCTION: Participants in cardiac rehabilitation programs have low adherence to their sessions, which makes extremely important to recognize the barriers that cause non-adherence, identifying whether the type of service and level of adherence influence these barriers. METHODS: This is a cross-sectional observational study, in which 220 individuals (66.80±11.59 years) of both genders who are members of public and private exercise-based cardiac rehabilitation programs participated. The volunteers were divided according to the level of adherence, considering patients with low adherence (PLA) those with < 70% of attendance and high adherence (PHA) those with > 70%. Then, initial evaluation, Cardiac Rehabilitation Barriers Scale, analysis of socioeconomic level, Hospital Anxiety and Depression Scale, and Mini-Mental State Examination were applied. RESULTS: Higher total barriers were found in PLA in the public service compared to PHA in the private service (P=0.023). In the subscale "perceived need", PHA in the public service showed higher values than PLA and PHA in the private service (P≤0.001). The "access" barrier was higher for PHA in the public service when compared to PHA in the private service (P=0.024). PHA in the public service exhibited a higher barrier regarding questions about distance, transportation problems, cost, and time constraints. CONCLUSION: The public program presents higher barriers in the questions and categories compared to the private program, mainly the PHA. Furthermore, there are differences in the profile of the participants regarding socioeconomic and anxiety levels, treatment time, ethnicity, and city where they live.

Analysis of Barriers to Public and Private Cardiac Rehabilitation Programs in Patients with Low and High Adherence

ABSTRACT Introduction: Participants in cardiac rehabilitation programs have low adherence to their sessions, which makes extremely important to recognize the barriers that cause non-adherence, identifying whether the type of service and level of adherence influence these barriers. Methods: This is a cross-sectional observational study, in which 220 individuals (66.80±11.59 years) of both genders who are members of public and private exercise-based cardiac rehabilitation programs participated. The volunteers were divided according to the level of adherence, considering patients with low adherence (PLA) those with < 70% of attendance and high adherence (PHA) those with > 70%. Then, initial evaluation, Cardiac Rehabilitation Barriers Scale, analysis of socioeconomic level, Hospital Anxiety and Depression Scale, and Mini-Mental State Examination were applied. Results: Higher total barriers were found in PLA in the public service compared to PHA in the private service (P=0.023). In the subscale "perceived need", PHA in the public service showed higher values than PLA and PHA in the private service (P≤0.001). The "access" barrier was higher for PHA in the public service when compared to PHA in the private service (P=0.024). PHA in the public service exhibited a higher barrier regarding questions about distance, transportation problems, cost, and time constraints. Conclusion: The public program presents higher barriers in the questions and categories compared to the private program, mainly the PHA. Furthermore, there are differences in the profile of the participants regarding socioeconomic and anxiety levels, treatment time, ethnicity, and city where they live.

Trend in hospitalizations due to ambulatory care-sensitive conditions in the Federal District / Tendencia de las internaciones por condiciones sensibles a la atención primaria de salud en Distrito Federal / Tendência das internações por condições sensíveis à atenção primária à saúde no Distrito Federal

ABSTRACT Objectives: to analyze the trend, according to sex, of Ambulatory Care-Sensitive Conditions in the Primary Health Care of the Federal District, from 2009 to 2019. Methods: ecological trend study using ACSC hospitalization data available in the Hospitalization System of the Single Health System. The Prais-Winsten method was used to calculate the annual rate variation, expressed in percentages. The dependent variable was the logarithm of the rates, and the independent one, the years in the time series. Results: the Federal District registered 2,103,951 general hospitalizations, 16.4% of which were due to Ambulatory Care-Sensitive Conditions. Males had a higher rate of hospitalization in the period, and both sexes showed a stationary trend. Conclusions: the time trend of Ambulatory Care- Sensitive Conditions was stationary, but further studies are necessary regarding primary health care coverage.

RESUMEN Objetivos: analizar tendencia de Internaciones por Condiciones Sensibles a la Atención Primaria por sexo en Distrito Federal desde 2009 a 2019. Métodos: estudio ecológico de tendencia con datos de ICSAP disponibles en el Sistema de Internaciones Hospitalarias del Sistema Único de Salud. Utilizado método de Prais-Winsten para el cálculo de la variación porcentual anual de las tasas. La variable dependiente fue el logaritmo de las tasas, y la independiente, los años de la serie temporal. Resultados: Distrito Federal registró 2.103.951 internaciones generales, siendo 16,4% Internaciones por Condiciones Sensibles a la Atención Primaria. El sexo masculino obtuvo la mayor tasa de internación en todo el periodo y hubo tendencia estacionaria tanto para el sexo masculino mientras el femenino. Conclusiones: las tendencias temporales de las Internaciones por Condiciones Sensibles a la Atención Ambulatoria mostradas estacionarias, pero resaltada la necesidad de estudios de correlación con la cobertura de la atención primaria de salud.

RESUMO Objetivos: analisar a tendência das Internações por Condições Sensíveis à Atenção Primária por sexo no Distrito Federal, no período de 2009 a 2019. Métodos: estudo ecológico de tendência com dados de ICSAP disponíveis no Sistema de Internações Hospitalares do Sistema Único de Saúde. Utilizou-se o método de Prais-Winsten para o cálculo da variação percentual anual das taxas. A variável dependente foi o logaritmo das taxas; e a variável independente, os anos da série temporal. Resultados: o Distrito Federal registrou 2.103.951 internações gerais, sendo 16,4% Internações por Condições Sensíveis à Atenção Primária. O sexo masculino obteve a maior taxa de internação em todo o período, e houve tendência estacionária tanto para o sexo masculino quanto para o sexo feminino. Conclusões: as tendências temporais das Internações por Condições Sensíveis à Atenção Primária mostraram-se estacionárias, porém ressalta-se a necessidade de estudos de correlação com a cobertura da Atenção Primária à Saúde.

Comportamento de idosos para a promoção da saúde: análise segundo a teoria de Nola Pender / Older adults' behavior for health promotion: analysis according to Nola Pender's theory / Comportamiento de ancianos para promover la salud: análisis según la teoría de Nola Pender

Objetivo: Analisar o comportamento de idosos em relação à promoção da saúde segundo a teoria de Nola Pender. Métodos: Pesquisa participante de abordagem qualitativa, realizada em uma Instituição de Ensino Superior de Brasília (Distrito Federal), Brasil. Os dados foram coletados ao longo de quatro encontros presenciais, por meio da estratégia de grupo de reflexão, com base em questões norteadoras especificas para cada encontro. Para a análise dos dados, utilizou-se a Teoria de Promoção da Saúde de Nola Pender que pressupõe a avaliação de características e experiências individuais, dos sentimentos e conhecimentos sobre o comportamento que se quer alcançar e do comportamento de promoção da saúde desejável. Resultados: Participaram 13 idosos, os quais revelaram que a autoestima, o trabalho e a participação em diversas atividades familiares, culturais e religiosas os ajudam a realizar ações que promovem sua saúde. Eles desejam modificar alguns comportamentos e conservar outros, em função do beneficio percebido. influências interpessoais e situações como renda, doenças, religião, escolaridade e acesso a bens e serviços são apontados como fatores que influenciam as mudanças de comportamento em saúde. Conclusão: o comportamento dos idosos revelou esforços para manter e ampliar sua saúde e graus de autonomia.

Objective: To analyze older adults' behavior in relation to health promotion according to Nola Pender's theory. Methods: This is participatory research with a qualitative approach, carried out at a Higher Education Institution in Brasília (Federal District), Brazil. Data were collected over four on-site meetings, through the reflection group strategy, based on specific guiding questions for each meeting. For data analysis, Nola Pender's Health Promotion Theory was used, which presupposes assessing individual characteristics and experiences, behavior-specific cognitions and affect and behavioral outcome. Results: The study included 13 older adults, who revealed that self-esteem, work and participation in various family, cultural and religious activities help them carry out actions that promote their health. They wish to modify some behaviors and maintain others, depending on the perceived benefit. Interpersonal influences and situations such as income, illness, religion, education and access to goods and services are highlighted as factors that influence changes in health behavior. Conclusion: Older adults' behavior revealed efforts to maintain and expand their health and degrees of autonomy.

Objetivo: Analizar el comportamiento de los ancianos frente a la promoción de la salud desde la perspectiva del modelo teórico de Nola Pender. Métodos: Estudio de investigación participante con abordaje cualitativo, con 13 ancianos. Los datos fueron recolectados a través de la estrategia de grupos de reflexión, a partir de preguntas orientadoras elaboradas por los investigadores. Se utilizó la Teoría de Enfermería de Promoción de la Salud de Nola Pender. Resultados: Hubo interrelación entre las características y vivencias individuales de los ancianos, sus sentimientos y conocimientos sobre el comportamiento deseado y el comportamiento deseado de promoción de la salud. Conclusión: Este estudio permite reflexionar sobre las condiciones y motivaciones que llevan a los ancianos a tener determinados comportamientos, que influyen en su estado de salud. Contribuciones para la práctica: Reflexión de los profesionales de la salud sobre la creación de nuevas estrategias para la implementación de acciones de promoción de la salud de la población anciana.

Orientação ao paciente em pós-operatório de traqueostomia no processo de alta para o domicílio: revisão integrativa / Patient guidance during discharge after a tracheostomy: an integrative review

RESUMO Objetivo mapear as orientações fornecidas pelo enfermeiro para o autocuidado de pacientes no pós-operatório de traqueostomia durante o período de transição hospital-casa. Métodos trata-se de uma revisão integrativa. Utilizou-se o acrônimo PCC, considerando População - pacientes adultos em uso de traqueostomia; Conceito - autocuidado (educação/orientação pelo enfermeiro); e Contexto - períodos operatórios e cuidado domiciliar, com base na questão: Quais orientações para o autocuidado devem ser dadas pelo enfermeiro ao paciente em pós-operatório de traqueostomia no processo de alta hospitalar para o domicílio? Realizou-se busca ampla e seus resultados foram tratados por dois revisores e organizados com foco no fenômeno de interesse. Resultados encontrou-se 1.940 artigos e 28 foram selecionados. 16 fenômenos de interesse foram organizados em três categorias: manejo da traqueostomia, cuidados com as vias aéreas, e atividades de vida diária. Conclusão verificou-se que as orientações para o autocuidado estão relacionadas ao cuidado direto com o estoma, a atuação em emergências no domicílio e questões psicossociais. Contribuições para a prática a identificação, sumarização e organização das evidências sobre práticas clínicas do enfermeiro possibilitam o consumo de material de qualidade, para rápida implementação na prática clínica, sobretudo no que concerne ao preparo para alta dos pacientes com uso de traqueostomia.

ABSTRACT Objective to map the orientations provided by nurses for the self-care of patients during the postoperative period of tracheostomy and their transition from hospital to home. Methods this is an integrative review. We used the PCC acronym, where the Population was adult patients with tracheostomy; the Concept, self-care (education/orientation by the nurse); and the Context, operation periods and home care. The study was based on the question: What guidelines for self-care should the nurse given to patients in the postoperative period of a tracheostomy and in the process of discharge? We carried out a wide search, whose results were reviewed by two researchers and organized around the phenomenon of interest. Results 1,940 articles were found and 28 were selected. 16 phenomena of interest were organized into three categories: tracheostomy management, airway care, and activities of daily living. Conclusion Self-care guidance is related to direct care of the stoma, how to act in home emergencies, and psychosocial aspects. Contributions to practice identifying, summarizing, and organizing evidence about nursing clinical practice creates quality materials that can be implemented fast into clinical practice, especially in regard to preparing patients with tracheostomy for their discharge.

Physical load and heart rate behavior in workers in the slaughterhouse and meat packing industries / Carga física e comportamento da frequência cardíaca em trabalhadores de frigorífico

Abstract High physical overload during the workday and some conditions present in the workplace can generate several losses in the worker's health. The use of tools capable of identifying physical load (PL), such as heart rate (HR) analysis, is essential. The aim of the study was to evaluate the physical load and heart rate behavior of workers in the slaughterhouse. The cardiovascular load reached by two individuals was 12% and 24%. In relation to the PL rating, they fit as moderately heavy to heavy work. The HR, was higher at the end of the work when compared to the beginning. Furthermore, it was pointed out that the temperature, noise, and body mass index were above normality values. The physical workload was classified as moderately heavy to heavy. The limit HR was reached in some moments of the work by one of the workers and two of them reached higher HR values at the end of the work.

Resumo A elevada sobrecarga física durante a jornada de trabalho e algumas condições presentes no ambiente de trabalho podem gerar diversos prejuízos na saúde do trabalhador. A utilização de ferramentas capazes de identificar a carga física (CF), como a análise da frequência cardíaca (FC), é fundamental. O objetivo do estudo foi avaliar o comportamento da carga física e da frequência cardíaca dos trabalhadores de frigorífico. A carga cardiovascular alcançada por dois indivíduos foi de 12% e 24%. Em relação à classificação da CF, enquadram-se como trabalhos moderadamente pesados ​​a pesados. A FC, foi maior no final do trabalho quando comparado ao início. Além disso, apontou-se que a temperatura, o ruído e o índice de massa corporal estavam acima dos valores da normalidade. A CF de trabalho foi classificada como moderadamente pesada a pesada. A FC limite foi atingida em alguns momentos do trabalho por um dos trabalhadores e dois deles atingiram valores maiores de FC ao final do trabalho.

How visitation affects the behavior and welfare of different species of captive amazonian primates? / Como a visitação afeta o comportamento e o bem-estar de diferentes espécies de primatas cativos da Amazônia? / ¿Cómo visitas afectan el comportamiento y bienestar de diferentes especies de primates en cautiverio en Amazonia?

This study had the purpose of understanding the effects of visitation on behavioral patterns and on the well-being of primates in captivity. Five Amazonian primate species were observed using the focal animal method: Ateles chamek, Ateles belzebuth, Ateles paniscus, Lagothrix cana, and Sapajus apella. Two categories of visitor behavioral observations were adopted - active and passive. From the total number of records, the behavior of primates could be observed in 53.7% of the notes in the presence of visitors. The behavior of the visitors in front of the cages was considered passive in 91.2% of those records. The three species of Ateles reacted in different ways in the presence and absence of visitors. The type of visitor behavior had influence on the behavior of the primate (Chi-square=22.9, p<0.001). Stress indicating behaviors (CIE) represented 3.3% of the behavioral repertoire of the species (n=253 records). The primates presented a varied number of CIE, which included indexes of reduced well-being levels. A. belzebuth was ranked first as the species most affected by visitation. These results show the importance of understanding the stress effects on the behavioral pattern of captive primates in relation to visitation and other factors, leading to alternative actions for the zoo in order to improve the level of their welfare.(AU)

O entendimento dos efeitos da visitação nos padrões comportamentais e no bem-estar dos primatas em cativeiro foi o objetivo deste estudo. Por meio do método animal focal foram realizadas observações de cinco espécies de primatas amazônicos: Ateles chamek, Ateles belzebuth, Ateles paniscus, Lagothrix cana e Sapajus apella. Para observações comportamentais dos visitantes, foram adotadas duas categorias, ativo e passivo. Do total de registros, encontrou-se que os comportamentos dos primatas foram exibidos em 53,7% das anotações na presença de visitantes. O comportamento dos visitantes diante dos recintos foi em 91,2% considerado passivo. As três espécies de Ateles reagiram de formas diferentes na presença e ausência de visitantes. O tipo de comportamento dos visitantes teve influência no comportamento dos primatas (Chi-quadrado=22,9, p<0,001). Os comportamentos indicadores de estresse (CIE) representaram 3,3% do repertório comportamental das espécies (n=253 registros). Os primatas apresentaram um número variado de CIE, apresentando indicadores de reduzido grau de bem-estar. A. belzebuth esteve em primeiro lugar no ranking das espécies mais afetadas pela visitação. Estes resultados mostraram a importância de compreender os efeitos do estresse no padrão comportamental dos primatas cativos relacionados a visitação e outros fatores, levando ao zoológico alternativas que conduzam a ações para melhorar o grau de bem-estar.(AU)

Comprender los efectos de visitaciones en los estándares comportamentales y en el bienestar de los primates en cautiverio fue el objetivo de este estudio. Mediante el método de animales focales se realizaron observaciones en cinco especies de primates amazónicos: Ateles chamek, Ateles belzebuth, Ateles paniscus, Lagothrix cana y Sapajus apella. Para observaciones comportamentales de los visitantes, se adoptaron dos categorías, activa y pasiva. Del total de registros, se encontró que los comportamientos de los primates se mostraron en 53,7% de las notas en presencia de visitantes. El comportamiento de los visitantes frente a los recintos fue considerado pasivo en un 91,2%. Las tres especies de Ateles reaccionaron de manera diferente a la presencia y ausencia de visitantes. El tipo de comportamiento de los visitantes influyó en el comportamiento de los primates (Chi-cuadrado=22,9, p<0,001). Los comportamientos indicadores de estrés (CIE) representaron el 3,3% del repertorio conductual de la especie (n=253 registros). Los primates presentaron un número variado de CIE, mostrando indicadores de un reducido grado de bienestar. A. belzebuth ocupó el primer lugar en el ranking de las especies más afectadas por las visitas. Estos resultados mostraron la importancia de comprender los efectos del estrés en el estándar comportamental de los primates en cautivos relacionados con las visitas y otros factores, llevando al zoológico alternativas que conduzcan a acciones para mejorar el grado de bienestar.(AU)

Factors related to the pattern of alcohol consumption in rural women / Factores relacionados con el patrón de consumo de alcohol entre las mujeres rurales / Fatores relacionados ao padrão de consumo de bebida alcoólica em mulheres rurais

ABSTRACT Objective: to investigate factors related to the pattern of alcohol consumption in rural women. Method: this is a quantitative study of non-probabilistic convenience sampling carried out with 259 women from a rural community in Bahia in primary health care. A structured form and the Alcohol Use Disorders Identification Test were used. Data were analyzed using descriptive statistics to estimate the independent contribution of each variable to the probability of outcomes related to alcohol consumption. Logistic regression analysis was applied using the R 4.0.2 software for Windows, with variables in decreasing order of statistical significance. Results: the sample was composed of women between 30 and 49 years old, predominantly black, with religion, with a partner, who complete high school, remunerated activity, family income less than one minimum wage, and living in their own or assigned home. Having a religion reduces the chance of consuming alcohol by 0.15%. Living in a house with up to 3 residents, "not being injured because of drinking" and having a religion increase, respectively, by 89.1, 21.7, and 8.43% the chances of staying in the low-risk zone. Not having a religion increases the chances of moderate drinking by 97.4%. Being injured because of drinking increases the chances of making harmful consumption of alcoholic beverages by 98.9%. Not having a religion and being injured because of drinking increases the chances of using alcohol with probable dependence by 99.7%. Conclusion: religion proved to be a protective factor for greater consumption of alcoholic beverages. On the other hand, being injured or hurting someone because of drinking was characterized as a risk factor.

RESUMEN Objetivo: investigar los factores relacionados con el patrón de consumo de alcohol entre las mujeres rurales. Método: estudio cuantitativo de muestreo no probabilístico por conveniencia, con 259 mujeres de una comunidad rural de Bahía, en atención primaria de salud. Se utilizó un for mulario estructurado y el Test de Identif icación de Trastornos por Consumo de Alcohol. Los datos se analizaron mediante estadísticas descriptivas para estimar la contribución independiente de cada variable en la probabilidad de resultados relacionados con el consumo de alcohol. El análisis de regresión logística se aplicó utilizando el programa informático R 4.0.2 para Windows, con las variables en orden descendente de significación estadística. Resultados: muestra compuesta por mujeres de 30 a 49 años, predominantemente negras, religiosas, con pareja, educación secundaria completa, actividad remunerada, ingresos familiares inferiores a un salario mínimo, que viven en casa propia o asignada. Tener una religión disminuye la posibilidad de consumir bebidas alcohólicas en un 0,15%. Tener hasta 03 residentes, "no haber sufrido daños por la bebida" y tener una religión aumentan las posibilidades de permanecer en la zona de bajo riesgo en un 89,1, 21,7 y 8,43 veces. El hecho de no tener una religión aumenta las posibilidades de beber con moderación en un 97,4%. Sufrir un accidente a causa de la bebida aumenta en un 98,9% las probabilidades de que el consumo de alcohol sea perjudicial. No tener religión y ser perjudicado por la bebida aumentó en un 99,7% las posibilidades de consumo de bebidas alcohólicas con probable dependencia. Conclusión: la religión se evidenció como un factor de protección para el aumento del consumo de bebidas alcohólicas, y resultar herido o lesionado por beber se caracterizó como un factor de riesgo.

RESUMO Objetivo: investigar fatores relacionados ao padrão de consumo de bebida alcoólica em mulheres rurais. Método: estudo quantitativo de amostragem não probabilística por conveniência realizado com 259 mulheres de comunidade rural da Bahia na atenção primária à saúde. Utilizouse formulário estruturado e o Alcohol Use Disorders Identification Test. Os dados foram analisados empregando estatísticas descritivas para estimar a contribuição independente de cada variável na probabilidade dos desfechos relacionados ao consumo de bebida alcoólica. Aplicou-se a análise de regressão logística pelo software R 4.0.2 for Windows, com variáveis em ordem decrescente de significância estatística. Resultados: amostra composta por mulheres de 30 a 49 anos, predominantemente pretas, com religião, com companheiro, ensino médio completo, atividade remunerada, renda familiar menor que um salário mínimo, residentes em casa própria ou cedida. Ter religião diminui em 0,15% a chance de consumir bebida alcoólica. Morar em habitação com até 3 residentes, "não ficar ferida porque bebeu" e ter religião aumentam, respectivamente, em 89,1, 21,7 e 8,43% as chances de se manter na zona de baixo risco. Não possuir religião aumenta em 97,4% as chances de beber moderadamente. Ficar ferida porque bebeu aumenta em 98,9% as chances de fazer consumo nocivo de bebida alcoólica. Não ter religião e ficar ferida porque bebeu aumentam em 99,7% as chances de fazer uso de bebida alcoólica com provável dependência. Conclusão: a religião evidenciou-se como fator de proteção para o maior consumo de bebida alcoólica. Por outro lado, ficar ferida ou ferir alguém porque bebeu, se caracterizou como fator de risco.

Hydration Influence on the Autonomic Recovery of the Coronary Diseases Patient: Geometric Indices Analysis.

Purpose: To evaluate the recovery period of autonomic modulation, through geometric indices of heart rate variability (HRV), on coronary artery disease (CAD) patients submitted to a cardiovascular rehabilitation session (CR), associated with hydration. Methods: Thirty male participants of a CR program, diagnosed with CAD were submitted to the control (CP) and hydration protocol (HP) characterized by a CR session. Only during HP were the participants given 8 equal portions of water. The water amount was determined through the hydric loss measured at the CP. During the protocols, the heart rate was measured beat-by-beat at rest (5-10 minutes[M1]) and at recovery (0-5 minutes [M2], 5-10 minutes [M3], 15-20 minutes [M4], 25-30 minutes [M5], 40-45 minutes [M6], 55-60 minutes [M7]) for the HRV analysis, performed by the geometric indices: TINN, RRTRI, SD1, SD2 and SD1/SD2 ratio. Results: Statistically significant differences were observed between the protocols (SD1, pvalue = 0.022), moments (TINN, pvalue = 0.001; SD1, pvalue = 0.019; SD2, pvalue = 0.001; SD1/SD2, pvalue = 0.001) and moments vs. protocol interaction (SD1, pvalue = 0.019). The SD1 index pointed to acceleration of parasympathetic recovery in the first minutes after exercising (HP recovery after M3 [86.07 ± 32.31%] vs. CP recovery after M5[86.43 ± 24.56]) and increase in global variability (TINN-HP remained increased in longer, until M5 (M1 83.10 ± 55.76 ms to M5 116.82 ± 67.54 ms) vs. CP that remained increased for a short time, until M2 (M1 77.93 ± 68.56 ms to M2 134.82 ± 56.08 ms). Conclusions: In CAD patients, hydration promoted a more efficient recovery on parasympathetic autonomic modulation and increased the global HRV in the recovery period.