Detraining and Retraining Effects from a Multicomponent Training Program on the Functional Capacity and Health Profile of Physically Active Prehypertensive Older Women.

BACKGROUND: Resuming a physical exercise program after a period of cessation is common in older women. Monitoring the responses during this detraining (DT) and retraining (RT) may allow us to analyze how the body reacts to an increase and a reduction in physical inactivity. Therefore, we conducted a follow-up training, DT, and RT in prehypertensive older women to analyze the response to these periods. METHODS: Twenty-three prehypertensive older women (EG; 68.3 ± 2.8 years; 1.61 ± 0.44 m) performed 36 weeks of the multicomponent training program (MTP) followed by twelve weeks of DT plus eight weeks of RT. Fifteen prehypertensive older women (CG; 66.3 ± 3.2 years; 1.59 ± 0.37 m) maintained their normal routine. Functional capacity (FC), lipid, and hemodynamic profile were assessed before, during 24 and 36 weeks of the MTP, after 4 and 12 weeks of DT, and after 8 weeks of RT. RESULTS: After 24 weeks of the MTP, only SBP did not improve. Four weeks of DT did not affect lower body strength (30-CS), TC, or GL. Eight weeks of RT improved BP (SBP: -2.52%; ES: 0.36; p < 0.00; DBP: -1.45%; ES: 0.44; p < 0.02), handgrip strength (3.77%; ES: 0.51; p < 0.00), and 30-CS (3.17%; ES: 0.38; p < 0.04) compared with 36 weeks of the MTP. CONCLUSIONS: Eight weeks of RT allowed patients to recover the benefits lost with detraining, which after only four weeks affected them negatively, and the systematic practice of exercise contributed to greater regulation of BP since 24 weeks of the MTP proved not to be enough to promote positive effects of SBP.

Factores que influyen en la alfabetización en salud de los pacientes con enfermedad arterial coronaria / Factors that influence health literacy in patients with coronary artery disease / Fatores que influenciam o letramento em saúde em pacientes com doença arterial coronariana

Objetivo: investigar los factores que influyen en la alfabetización en salud de los pacientes con enfermedad arterial coronaria. Método: estudio transversal, que incluyó 122 pacientes con enfermedades coronarias (60,7% del sexo masculino; 62,07±8,8 años); se evaluó la alfabetización en salud y el conocimiento específico sobre la enfermedad mediante entrevistas con los participantes, utilizando el Short Test of Functional Health Literacy in Adults e Short version of the coronary artery disease education questionnaire. Los datos fueron descritos por medidas de tendencia central y frecuencias. Los factores que influyen en la alfabetización en salud se determinaron mediante un modelo de regresión lineal. El nivel de significación adoptado fue del 5%. El estudio fue aprobado por el Comité de Ética e Investigación. Resultados: la edad y la hipertensión mostraron una relación inversa y significativa con la alfabetización en salud. Por otro lado, un mayor nivel educativo y tener empleo se asociaron con puntajes más altos en el instrumento de alfabetización en salud. El conocimiento específico sobre la enfermedad no influyó en la alfabetización en salud. Las variables del modelo de regresión explicaron el 55,3% de alfabetización inadecuada. Conclusión: en el presente estudio, se concluyó que el conocimiento sobre la enfermedad no influye en la alfabetización en salud, pero los profesionales deben considerar los factores sociodemográficos y clínicos para planificar las intervenciones.

Objective: to investigate the factors that exert an influence on health literacy in patients with coronary artery disease. Methods: a crosssectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee. Results: age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy. Conclusion: this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.

Objetivo: investigar os fatores que influenciam o letramento em saúde em pacientes com doença arterial coronariana. Método: estudo transversal, incluindo 122 pacientes com coronariopatias (60,7% do sexo masculino; 62,07±8,8 anos); letramento em saúde e conhecimento específico da doença foram avaliados por meio de entrevista com os participantes, pelo Short Test of Functional Health Literacy in Adults e Short version of the coronary artery disease education questionnaire. Os dados foram descritos por medidas de tendência central e frequências. Fatores que influenciam o letramento em saúde foram determinados por modelo de regressão linear. O nível de significância adotado foi de 5%. O estudo foi aprovado pelo Comitê de Ética e Pesquisa. Resultados: idade e hipertensão apresentaram uma relação inversa e significativa com letramento em saúde. Por outro lado, maior escolaridade e estar empregado associaram-se com maiores pontuações no instrumento de letramento em saúde. O conhecimento específico da doença não influenciou o letramento em saúde. As variáveis do modelo de regressão explicaram 55,3% do letramento inadequado. Conclusão: no presente estudo o conhecimento sobre a doença não influência o letramento em saúde, mas os profissionais devem considerar os fatores sociodemográficos e clínicos para planejar as intervenções.

Factors that influence health literacy in patients with coronary artery disease / Fatores que influenciam o letramento em saúde em pacientes com doença arterial coronariana / Factores que influyen en la alfabetización en salud de los pacientes con enfermedad arterial coronaria

OBJECTIVE: to investigate the factors that exert an influence on health literacy in patients with coronary artery disease. METHODS: a cross sectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee. RESULTS: age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy. CONCLUSION: this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.

OBJETIVO: investigar os fatores que influenciam o letramento em saúde em pacientes com doença arterial coronariana. MÉTODO: estudo transversal, incluindo 122 pacientes com coronariopatias (60,7% do sexo masculino; 62,07±8,8 anos); letramento em saúde e conhecimento específico da doença foram avaliados por meio de entrevista com os participantes, pelo Short Test of Functional Health Literacy in Adults e Short version of the coronary artery disease education questionnaire. Os dados foram descritos por medidas de tendência central e frequências. Fatores que influenciam o letramento em saúde foram determinados por modelo de regressão linear. O nível de significância adotado foi de 5%. O estudo foi aprovado pelo Comitê de Ética e Pesquisa. RESULTADOS: idade e hipertensão apresentaram uma relação inversa e significativa com letramento em saúde. Por outro lado, maior escolaridade e estar empregado associaram-se com maiores pontuações no instrumento de letramento em saúde. O conhecimento específico da doença não influenciou o letramento em saúde. As variáveis do modelo de regressão explicaram 55,3% do letramento inadequado. CONCLUSÃO: no presente estudo o conhecimento sobre a doença não influência o letramento em saúde, mas os profissionais devem considerar os fatores sociodemográficos e clínicos para planejar as intervenções.

OBJETIVO: investigar los factores que influyen en la alfabetización en salud de los pacientes con enfermedad arterial coronaria. MÉTODO: estudio transversal, que incluyó 122 pacientes con enfermedades coronarias (60,7% del sexo masculino; 62,07±8,8 años); se evaluó la alfabetización en salud y el conocimiento específico sobre la enfermedad mediante entrevistas con los participantes, utilizando el Short Test of Functional Health Literacy in Adults e Short version of the coronary artery disease education questionnaire. Los datos fueron descritos por medidas de tendencia central y frecuencias. Los factores que influyen en la alfabetización en salud se determinaron mediante un modelo de regresión lineal. El nivel de significación adoptado fue del 5%. El estudio fue aprobado por el Comité de Ética e Investigación. RESULTADOS: la edad y la hipertensión mostraron una relación inversa y significativa con la alfabetización en salud. Por otro lado, un mayor nivel educativo y tener empleo se asociaron con puntajes más altos en el instrumento de alfabetización en salud. El conocimiento específico sobre la enfermedad no influyó en la alfabetización en salud. Las variables del modelo de regresión explicaron el 55,3% de alfabetización inadecuada. CONCLUSIÓN: en el presente estudio, se concluyó que el conocimiento sobre la enfermedad no influye en la alfabetización en salud, pero los profesionales deben considerar los factores sociodemográficos y clínicos para planificar las intervenciones.

Educational program for self-care in heart failure: PEAC-IC: randomized control trial

BACKGROUND: Worldwide, approximately 64 million people live with signs and symptoms of heart failure(HF), considered one of the leading causes of morbidity and mortality, hospitalizations and worsening of quality of life. Self-care is a nonpharmacological approach to control the progression of HF, which involves behaviors to maintain health and monitor and manage symptoms. However, self-care still insufficient among this population in Brazil and worldwide. The Educational Program for Self-Care in Heart Failure (PEAC-CI) is an acceptable and feasible intervention that needs to be evaluated for its effectiveness. OBJECTIVE: To evaluate the effectiveness of the PEAC-IC in improving self-care behaviors (primary outcome), knowledge, quality of life, the number of hospitalizations, and access to emergency services in patients with HF (secondary outcome). METHODS: A parallel randomized clinical trial with HF patients recruited in a clinical cardiology ward and outpatient settings of the Dante Pazzanese Institute of Cardiology in São Paulo/Brazil. Participants were randomized to the intervention group (IG), receiving the PEAC-CI intervention, and the control group (CG), receiving standard care. The intervention consisted of a face-to-face session followed by five structured telephone contacts every week during six weeks. Standard care consisted of general guidance during hospital discharge and outpatient follow-ups with medical and nursing consultations when indicated. The outcomes were assessed in seventh week or after the six sessions of the implementation of PEAC-IC, and then third and sixth month after the first assessment in both groups. The primary outcome was measured with the Self-Care of HF Index v.6.2, which measures selfcare maintenance, management, and confidence; scores of these three scales range between 0-100, with higher scores meaning better self-care. RESULTS: We enrolled 80 patients, and 56 completed the entire intervention. These patients were mostly males (52.5%), with a mean age of 61.8 years (SD= 12,6) 44.9% white, with a diagnosis of HF from an average of 174.9 (SD=158,3), 50% in New York Heart Association functional class III. At baseline, self-care maintenance, management, and confidence scores were 51.6, 56.2, and 54.1, respectively. At the seven-week follow-up, the IG scored 72.3 on self-care maintenance, while the CG scored 61. The difference between the two groups, assessed with the linear mixed model, was clinically and statistically significant (p0.05). CONCLUSION: The PEAC-CI has effectively improved self-care maintenance in patients with HF. Even though the improvement in the secondary outcomes was not statistically significant, we observed a trend towards statistically significance. Key-words: nursing; heart failure; self-care; randomized controled trial.

Caracterização do processo de doação de órgãos em uma região do nordeste brasileiro / Caracterización del proceso de donación de órganos en una región de Brasil / Caracterization of the organ donation process in a region of northeast Brazil

Introdução: O processo de doação de órgãos e tecidos é definido por ações a fim de transformar um Potencial Doador (PD) em doador efetivo e inicia-se com o diagnóstico de morte encefálica. Objetivo: Analisar o perfil clínico e sociodemográfico dos potenciais doadores de órgãos, como também os fatores que influenciam na doação de órgãos. Métodos: Trata-se de uma pesquisa quantitativa, transversal, retrospectiva e analítica realizada através da coleta de dados de 455 prontuários de pacientes com diagnóstico de Morte Encefálica, de uma Região do Nordeste brasileiro, utilizando formulário estruturado. Posteriormente realizaram-se análises descritivas e nas associações entre as variáveis independentes e dependente, utilizou-se o teste qui-quadrado de Pearson Resultados: As faixas etárias de maior incidência foram entre 21 a 40 anos e 41 a 60 anos, com 33,8% cada, prevalecendo o sexo masculino (64,1%). Em relação à causa da morte, predominou o Trauma Cranioencefálico com 36,5%. Foram entrevistados 83,3% dos familiares e desses, 53,5% autorizaram a doação. Quanto à relação das respostas das entrevistas com os familiares e o sexo dos PD o sexo masculino se destacou com 59,01% das entrevistas positivas, quanto a entrevista e faixa etária, não foram encontradas diferenças significativas. Correlacionando o resultado das entrevistas familiares e a causa da morte, 40,63% destas tinham como causa o trauma cranioencefálico, e desse total, 63,63% tiveram a doação autorizada. Conclusão: A maioria dos doadores efetivos foram jovens e do sexo masculino, com prevalência do trauma craneoencefálico como causa da morte encefálica e da aceitação familiar para a doação.

Introducción: El proceso de donación de órganos y tejidos se define por las acciones encaminadas a transformar a una persona donante potencial (DP) en donante efectiva. Este proceso comienza con el diagnóstico de muerte encefálica. Objetivo: Analizar el perfil clínico y sociodemográfico de potenciales donantes de órganos, así como los factores que influyen en la donación de órganos. Métodos: Se trata de una investigación cuantitativa, transversal, retrospectiva y analítica realizada a partir de la recopilación de datos de 455 prontuarios de pacientes con diagnóstico de muerte encefálica, en una región del Nordeste de Brasil, utilizando un formulario estructurado. Posteriormente, se realizaron análisis descriptivos y, en las asociaciones entre las variables independiente y dependiente, se utilizó la prueba chi-cuadrado de Pearson Resultados: Los grupos de edad con mayor incidencia fueron de 21 a 40 años y de 41 a 60 años, con un 33.8 % cada uno, con predominio del sexo masculino (64.1 %). En cuanto a la causa de muerte, predominó el trauma craneoencefálico con un 36.5 %. Se entrevistó al 83.3 % de familiares y, de este grupo, el 53.5 % autorizó la donación. En cuanto a la relación entre las respuestas de las entrevistas a familiares y el sexo del TP, se destacó el sexo masculino con un 59.01 % de las entrevistas positivas; en cuanto a la entrevista y grupo de edad no se encontraron diferencias significativas. Correlacionando los resultados de las entrevistas familiares y la causa de muerte, el 40.63 % fue por trauma craneoencefálico y, de ese total, el 63.63 % tenía autorizada la donación. Conclusión: Los donantes más efectivos fueron jóvenes y varones, con predominio del traumatismo craneoencefálico como causa de muerte encefálica y aceptación familiar de la donación.

Introduction: The process of organ and tissue donation is defined by actions to transform a Potential Donor (PD) into an effective donor and begins with the diagnosis of brain death. Objective: To analyze the clinical and sociodemographic profile of potential organ donors, as well as the factors that influence organ donation. Methods: This is a quantitative, cross-sectional, retrospective, and analytical research carried out in a region of Northeast Brazil by collecting data from 455 medical records of patients with brain death, who were diagnosed using a structured form. Subsequently, descriptive analyzes were carried out and for the associations between the independent and dependent variables, the Pearson's chi-square test was used. Results: The age groups with the highest incidence were between 21 to 40 years old and 41 to 60 years old, with a 33.8 % each, with a predominance of males (64.1%). Regarding the cause of death, traumatic brain injury was the most common with a 36.5% of the sample. From the 83.3% of the family members that were interviewed, 53.5% of them authorized the donation. Male potential donors constituted the 59.01% of the authorized donations (positive interviews). There was no relationship between the interview results and the age group of the PD. When correlating the results of family interviews and the cause of death, 40.63% of them were caused by traumatic brain injury and, out of this total, 63.63% had the donation authorized. Conclusion: The most effective donors were young and male whose cause of brain death was traumatic brain injury and whose families allowed the donation.

Intervenção educativa multiprofissional para conservação de energia em paciente idosa com insuficiência cardíaca: relato de experência / Multidisciplinary educational intervention for energy conservation in elderly patients with heart failure: experience report

INTRODUÇÃO: A insuficiência cardíaca (IC) é a via final das cardiopatias, causando nos acometidos congestão pulmonar, dispneia, ortopneia, fadiga e edema, comprometendo a qualidade de vida dos portadores de IC. OBJETIVO: Relatar a experiência de desenvolvimento e implementação de um plano terapêutico individualizado destinado à atenção a paciente com IC hospitalizada. METODOLOGIA: Trata-se de um relato de caso que traz menção à intervenção educativa realizada durante um cenário de atuação Multiprofissional do Programa de Residência Multiprofissional em Saúde Cardiovascular em instituição pública da cidade de São Paulo especializada em cardiologia. O grupo realizou a coleta de dados e reunião com familiares e pessoas de referência envolvidas no cuidado de uma paciente com IC internada em uma enfermaria, afim de esclarecimento de dados que direcionassem a conduta profissional. Foram estabelecidas as necessidades por meio de uma coleta de dados com uso de escalas e questionários validados e foi estabelecido como diagnóstico de enfermagem prioritário tolerância à atividade diminuída, de acordo com a Taxonomia NANDA-I. Todo o processo foi pautado na Teoria Holística de Myra Levine para compreender e embasar os processos adaptativos incluídos no processo saúde-doença, além de planejar os cuidados transicionais. RESULTADOS: Paciente idosa, portadora de IC de etiologia valvar, Classe Funcional NYHA III e verbalizava sua insatisfação com a sua situação clínica. A partir das necessidades levantadas, traçou-se uma intervenção educativa com o objetivo de favorecer o autocuidado frente às novas situações vivenciadas a partir do adoecimento, respeitando os desejos e o sentido atribuído à vida da paciente e de auxiliá-la com orientações baseadas em evidências científicas sobre métodos para conservação de energia, a fim de melhorar os sintomas apresentados. Sendo assim, optou-se pela construção de um livro contendo um breve resumo da história do sujeito, orientações sobre os cuidados necessários, sobretudo sobre medidas de conservação de energia, e um espaço para que este possa se expressar. Com isso, o vínculo entre paciente- -profissional foi aprimorado e, ainda na internação, apresentou melhora importante dos sintomas, evoluindo para Classe Funcional NYHA II. CONCLUSÃO: Durante a intervenção da equipe multiprofissional pautada em modelos teóricos, foi possível o estabelecimento de vínculo entre paciente, rede de apoio e equipe. Ademais, houve melhora dos sintomas apresentados, caracterizando um avanço no processo de adaptação da paciente frente à sua nova realidade.

Intra- and inter-individual variability in the underwater pull-out technique in 200 m breaststroke turns.

The purpose of the present study was to investigate the intra- and inter-individual variability in arm-leg coordination during the underwater phase of the turn segment in 200 m breaststroke. Thirteen male swimmers were recruited and performed a 200 m breaststroke in a pre-calibrated 25 m pool. Sub-phases during the underwater segment were obtained using a notational analysis, and the mean velocity, displacement and duration during each sub-phase were obtained. A hierarchical cluster analysis (HCA) was performed using the analysed variables in all phases to identify inter-individual variability and random intra-individual variability. In addition, a linear mixed model (LMM: lap as a fixed effect and the participant as a random effect) was conducted to investigate systematic intra-individual variability. HCA identified three coordination patterns that were distinguished by the timing of the dolphin kick relative to the arm pull-out and the duration of the glide with arms at the side. All swimmers except one performed the arm pull-out after the dolphin kick. Nine swimmers maintained one coordination pattern, but other swimmers switched their coordination during the trial, particularly by shortening the duration of the glide with arms at the side. LMM showed a linear decrease (from the first to the last turn) in the time gap between the end of the dolphin kick and the start of the arm pull-out (a glide with the streamlined body position; F = 9.64, p = 0.034) and the glide duration with the arms at the side (F = 11.66, p = 0.015). In conclusion, both inter- and intra-individual variabilities during the underwater phase were evident in 200 m breaststroke turns, which were categorised into three patterns based on the timing of the dolphin kick and the duration of glides.

Factors that influence health literacy in patients with coronary artery disease. / Factores que influyen en la alfabetización en salud de los pacientes con enfermedad arterial coronaria.

OBJECTIVE: to investigate the factors that exert an influence on health literacy in patients with coronary artery disease. METHODS: a crosssectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee. RESULTS: age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy. CONCLUSION: this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.

Intervenções de enfermagem na terapia com anticoagulante oral: Uma revisão integrativa / Nursing interventions on oral anticoagulation therapy: An integrative review

INTRODUÇÃO: A terapia com anticoagulantes orais é o esquema terapêutico complexo para a prevenção de eventos tromboembólicos. Atualmente, com todas as exigências para melhoria da qualidade assistencial e diminuição de custos na atual demanda de desenvolvimento de pesquisa, faz necessário intervenções multiprofissionais com componentes educativos para auxiliar no manejo da TACO. No âmbito da contribuição da enfermagem, a utilização de linguagem padronizada pode auxiliar enfermeiros de diferentes contextos e nacionalidades para que assim possam atuar respaldados em evidências. OBJETIVOS: identificar na literatura as intervenções em saúde dentro da terapia e estratificá-las com nível de evidência e mapear as ações de enfermagem encontradas na literatura as intervenções/atividades propostas pela Nursing Interventions Classification. MÉTODOS: Trata-se de um estudo de revisão integrativa, seguido de mapeamento cruzado, através da Biblioteca Virtual em Saúde, que trará artigos do IBECS, LILACS, BDENF e MEDLINE. Para realização do mapeamento cruzado foram utilizadas as regras adaptadas, baseadas em Lucena e Barros (2005). RESULTADOS: Foram selecionados 16 artigos conforme fluxograma PRISMA, com dados sociodemográficos e nível de evidência. As intervenções para adesão foram agrupadas em grupos: educação, autogestão e tratamento diretamente observados, com o mapeamento realizado de acordo com o Nursing Interventions Classification. CONCLUSÃO: As intervenções incluem questões educacionais, de autogerenciamento e tratamento diretamente observado a fim de promover a adesão do paciente dentro da terapia, para isso as evidências apontam para o tratamento em centros especializados que por sua vez despendem da utilização de mhealth, pill boxes, recursos áudio visuais, cartilhas, consultas voltadas para as particularidades do paciente.

Construção do Plano Municipal de Saúde na perspectiva distrital: experiências e desafios no contexto pandêmico / Construction of the Municipal Health Plan from the district perspective: experiences and challenges in the pandemic context

RESUMO Relato de experiência sobre o processo de construção do Plano Municipal de Saúde sob perspectiva distrital de residentes em Planejamento e Gestão. O processo de elaboração do Plano Municipal de Saúde de Salvador (2022-2025), com a mobilização dos Distritos Sanitários (DS) para elaboração da Análise de Situação de Saúde (Asis), teve início em abril/2021. Três residentes em Planejamento e Gestão, sob supervisão docente e acompanhamento da preceptoria, vivenciaram todo o processo, uma vez que estavam envolvidas no contexto de um dos doze DS do município. Por meio do levantamento e do acesso aos sistemas de informação em saúde e de contatos com gestores e técnicos, foi elaborada a Asis do DS do período de 2010-2020. Reuniões para compartilhamento e mobilização da situação distrital foram realizadas com diversos atores, anteriormente à oficina distrital, para priorização dos problemas de saúde que tiveram como produto final o relatório distrital. O processo de elaboração da Asis distrital possibilitou a compreensão da importância do planejamento em saúde e sua aplicabilidade, contribuindo para o processo formativo das residentes, no desenvolvimento de competências e habilidades, considerando a realidade sanitária e epidemiológica.

ABSTRACT Experience report on the construction process of the Municipal Health Plan from the district perspective of residents in Planning and Management. The elaboration process of the Municipal Health Plan of Salvador (2022-2025), with the mobilization of Health Districts (DS) for the elaboration of the Health Situation Analysis (ASIS), began in April/2021. Three residents in Planning and Management, under the supervision of teachers and monitoring of the preceptorship, experienced the whole process, since they were involved in the context of one of the twelve health districts of the municipality. Through the survey and access to health information systems and contacts with managers and technicians, the ASIS of the DS for the period 2010-2020 was prepared. Meetings for sharing and mobilizing the district situation were held with various actors, prior to the district workshop, to prioritize health problems, which resulted in the district report. The process of elaborating the district ASIS made it possible to understand the importance of health planning and its applicability, contributing to the training process of residents, in the development of skills and abilities, considering the health and epidemiological reality.

Changes in Muscular Activity in Different Stable and Unstable Conditions on Aquatic Platforms.

The present study aimed to analyse and compare the muscle activity of twelve participants (seven men and five women) (age 20.1 ± 0.9 years; height 170.5 ± 10 cm; body mass: 64.86 ± 8.3 kg) in two exercises, each with two variants: squat (dynamic and static) and plank (hands and elbows) in a stable environment on land and an unstable environment on an aquatic platform. The erector spinae, biceps femoris, rectus femoris, external oblique, and rectus abdominis muscles were evaluated using surface electromyography. The dynamic squat increases the recruitment of the biceps femoris and external oblique, while the static squat demands greater activation of the rectus femoris. The elbow plank exercise increases the recruitment of erector spinae muscles, and the hand plank exercise increases the recruitment of the erector spinae and external oblique. In conclusion, performing exercises in unstable conditions on an aquatic platform slightly increases muscle recruitment.

Factors associated with caregivers' contribution to self-care in heart failure. / Fatores associados à contribuição dos cuidadores para o autocuidado na insuficiência cardíaca.

OBJECTIVE: to analyze the caregiver's contribution to self-care in heart failure and the predictor variables of this contribution. METHOD: a cross-sectional descriptive and analytical study, with the participation of 140 dyads (patients and caregivers). The contribution to self-care was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index. Caregivers and patients were interviewed separately to obtain the data. Multiple linear regressions were used to verify predictor variables of caregiver contribution. RESULTS: the mean score for contribution to maintenance self-care was 62.7 (SD=7.1), for management, 62.9 (SD=20.4) and for confidence was 63.3 (SD=22.1). The variables number of patient's medications, caregiver being related to the patient, social perception of caregiver, health-related quality of life of the patient and caregiver's confidence in contributing to self-care were predictors of caregiver's contribution to maintenance or management self-care. CONCLUSION: the caregiver's contribution was insufficient. The social support perceived by the caregiver, the type of relationship the caregiver to the patient, the number of medications used by the patient, as well as the caregiver's confidence in contributing to self-care are variables that should be considered to assess the risk of insufficient contribution of the caregiver.

The Effect of Handlebar Height and Bicycle Frame Length on Muscular Activity during Cycling: A Pilot Study.

The cycling literature is filled with reports of electromyography (EMG) analyses for a better understanding of muscle function during cycling. This research is not just limited to performance, as the cyclist's goal may be rehabilitation, recreation, or competition, so a bicycle that meets the rider's needs is essential for a more efficient muscular activity. Therefore, the purpose of this study was to understand the contribution of the activity of each of the following muscles: TD (trapezius descending), LD (latissimus dorsi), GM (gluteus maximus), and AD (anterior deltoid) in response to different bicycle-rider systems (handlebar height; bicycle frame length) and intensities in a bicycle equipped with a potentiometer. Surface EMG signals from muscles on the right side of the body were measured. A general linear model test was used to analyze the differences between muscle activation in the test conditions. Effect sizes were calculated using a partial Eta2 (η2). The level of significance was set at 0.05. Muscle activation of different muscles differs, depending on the cycling condition (Pillai's trace = 2.487; F (36.69) = 9.300; p < 0.001. η2 = 0.958), mostly during low intensities. In high intensities, one specific pattern emerges, with a greater contribution of GM and TD and weaker participation of LD and AD, enhancing the cycling power output.

Arm-leg coordination during the underwater pull-out sequence in the 50, 100 and 200 m breaststroke start.

OBJECTIVES: To investigate the arm-leg coordination from different perspectives of motor control during the underwater start sequence to understand whether differences exist between the three competitive breaststroke swimming events. DESIGN: Cross-sectional study. METHODS: Forty-one breaststroke races (with race times relative to the world record): 50-meter (n = 14, 87.6%), 100-meter (n = 14, 88.5%) and 200-meter (n = 13, 85.4%) were recorded. A race analysis system tracked the two-dimensional displacement of the head. Key points from the underwater start sequence were obtained from notational analysis in order to compute seven time-gaps and four phases to assess the arm-leg coordination and timing of the dolphin kick. A one-way ANOVA with Bonferroni post-hoc correction was used to assess differences between the time gaps and phases for the three events. RESULTS: Differences between the three events were found for total underwater glide, and the first (T0) and second (T1) major glide phase. No differences between the events were found in relative duration and distance for the time gaps related to arm-leg coordination (T1-3, T4, T6) and timing of the dolphin kick (T4-5) during the underwater start sequence. CONCLUSIONS: The arm-leg coordination and timing of the dolphin kick showed no difference between the events, but the total underwater glide duration was longer in both the 100- and 200-meter compared with the 50-meter start. This shows that swimmers did not change the complex inter-limb coordination between the competitive events, but only modified the least complex movement, gliding, to adapt to the swimming speed of the respective events.

Transitional care from the hospital to the home in heart failure: implementation of best practices / Cuidado de transición del hospital al domicilio en la insuficiencia cardíaca: implementación de las mejores prácticas / Cuidado transicional do hospital para o domicílio na insuficiência cardíaca: implementação das melhores práticas

ABSTRACT Objectives: Assess the compliance of the implementation of better evidence in the transitional care of the person with heart failure from the hospital to the home. Methods: Evidence implementation project according to the JBI methodology in a cardiology hospital in São Paulo. Six criteria were audited before and after implementing strategies to increase compliance with best practices. 14 nurses and 22 patients participated in the audits. Results: In the baseline audit, compliance was null with five of the six criteria. Strategies: training of nurses; reformulation of the hospital discharge form and guidance on self-care in care contexts; and making telephone contact on the 7th, 14th and 21st days after discharge. In the follow-up audit, there was 100% compliance with five of the six criteria. Conclusion: The project made it possible to increase the compliance of transitional care practices in people with heart failure with the recommendations based on the best evidence.

RESUMEN Objetivos: Evaluar la conformidad de implementación de mejores evidencias en cuidado de transición de personas con insuficiencia cardíaca del hospital al domicilio. Métodos: Proyecto de implementación de evidencias conforme metodología del JBI en hospital cardiológico de São Paulo. Seis criterios fueron auditados antes y post implementación de estrategias para aumentar la conformidad con las mejores prácticas. Participaron de las auditorías 14 enfermeros y 22 pacientes. Resultados: Auditoría de base, la conformidad fue nula con cinco de los seis criterios. Estrategias: capacitación de enfermeros; reformulación de ficha de alta hospitalaria y orientaciones sobre autocuidado en contextos de cuidado; y realización de contacto telefónico al 7º, 14º y 21º días post alta. Auditoría de seguimiento, hubo 100% de conformidad con cinco de los seis criterios. Conclusión: El proyecto permitió aumentar la conformidad de las prácticas de cuidado de transición en personas con insuficiencia cardíaca con las recomendaciones basadas en las mejores evidencias.

RESUMO Objetivos: Avaliar a conformidade da implementação de melhores evidências no cuidado transicional da pessoa com insuficiência cardíaca do hospital para o domicílio. Métodos: Projeto de implementação de evidências conforme metodologia do JBI em um hospital cardiológico em São Paulo. Seis critérios foram auditados antes e depois da implementação de estratégias para aumentar a conformidade com as melhores práticas. Participaram das auditorias 14 enfermeiros e 22 pacientes. Resultados: Na auditoria de base, a conformidade foi nula com cinco dos seis critérios. Estratégias: capacitação dos enfermeiros; reformulação da ficha de alta hospitalar e orientações sobre autocuidado nos contextos de cuidado; e realização de contato telefônico no 7º, 14º e 21º dias após alta. Na auditoria de seguimento, houve 100% de conformidade com cinco dos seis critérios. Conclusão: O projeto permitiu aumentar a conformidade das práticas de cuidado transicional em pessoas com insuficiência cardíaca com as recomendações baseadas nas melhores evidências.

Factors associated with caregivers' contribution to self-care in heart failure / Fatores associados à contribuição dos cuidadores para o autocuidado na insuficiência cardíaca / Factores asociados a la contribución de los cuidadores para el autocuidado de la insuficiencia cardiaca

OBJETIVO: analisar a contribuição do cuidador para o autocuidado na insuficiência cardíaca e variáveis preditoras desta contribuição. MÉTODO: estudo transversal descritivo e analítico, com a participação de 140 díades (pacientes e cuidadores). A contribuição para o autocuidado foi avaliada por meio do Caregiver Contribution to Self-Care of Heart Failure Index. Cuidadores e pacientes foram entrevistados separadamente para obtenção dos dados. A regressão linear múltipla foi utilizada para verificar variáveis preditoras da contribuição do cuidador. RESULTADOS: a pontuação média de contribuição para o autocuidado de manutenção foi 62,7 (DP=7,1), de manejo, 62,9 (DP=20,4) e na confiança foi 63,3 (DP=22,1). A variáveis número de medicamentos do paciente, cuidador ter parentesco com o paciente, percepção social do cuidador, qualidade de vida relacionada à saúde do paciente e a confiança do cuidador na contribuição para o autocuidado foram preditoras da contribuição do cuidador para o autocuidado de manutenção ou de manejo. CONCLUSÃO: a contribuição do cuidador foi insuficiente. O apoio social percebido pelo cuidador, cuidador ter ou não parentesco com o paciente, número de medicamentos utilizados pelo paciente, bem como a confiança do cuidador em contribuir para o autocuidado são variáveis que devem ser consideradas para avaliar o risco de contribuição insuficiente do cuidador.

OBJECTIVE: to analyze the caregiver's contribution to self-care in heart failure and the predictor variables of this contribution. METHOD: a cross-sectional descriptive and analytical study, with the participation of 140 dyads (patients and caregivers). The contribution to self-care was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index. Caregivers and patients were interviewed separately to obtain the data. Multiple linear regressions were used to verify predictor variables of caregiver contribution. RESULTS: the mean score for contribution to maintenance self-care was 62.7 (SD=7.1), for management, 62.9 (SD=20.4) and for confidence was 63.3 (SD=22.1). The variables number of patient's medications, caregiver being related to the patient, social perception of caregiver, health related quality of life of the patient and caregiver's confidence in contributing to self-care were predictors of caregiver's contribution to maintenance or management self-care. CONCLUSION: the caregiver's contribution was insufficient. The social support perceived by the caregiver, the type of relationship the caregiver to the patient, the number of medications used by the patient, as well as the caregiver's confidence in contributing to self-care are variables that should be considered to assess the risk of insufficient contribution of the caregiver.

OBJETIVO: analizar la contribución del cuidador para el autocuidado en la insuficiencia cardiaca y las variables predictoras de esa contribución. MÉTODO: estudio transversal descriptivo y analítico, con la participación de 140 díadas (pacientes y cuidadores). La contribución para el autocuidado fue evaluada por medio del Caregiver Contribution to Self-Care of Heart Failure Index. Los cuidadores y pacientes fueron entrevistados separadamente para obtención de los datos. La regresión linear múltiple fue utilizada para verificar variables predictoras de la contribución del cuidador. RESULTADOS: la puntuación média de contribución para el autocuidado de manutención fue 62,7 (DE=7,1), de administración fue 62,9 (DE=20,4) y de confianza fue 63,3 (DE=22,1). Las variables: número de medicamentos del paciente, cuidador tener parentesco con el paciente, percepción social del cuidador, calidad de vida relacionada a la salud del paciente y la confianza del cuidador en la contribución para el autocuidado, fueron predictoras de la contribución del cuidador para el autocuidado de manutención o de administración. CONCLUSIÓN: la contribución del cuidador fue insuficiente. El apoyo social percibido por el cuidador, el cuidador tener o no parentesco con el paciente, el número de medicamentos utilizados por el paciente y la confianza del cuidador en contribuir para el autocuidado, son variables que deben ser consideradas para evaluar el riesgo de contribución insuficiente del cuidador.

Arm - Leg coordination profiling during the dolphin kick and the arm pull-out in elite breaststrokers.

In breaststroke races, the dolphin kick could finish before, at the same time, or during the arm pull-out, but it is unclear how swimmers perform this technique. The aim of this study was to investigate whether swimmers glide between the dolphin kick and arm pull-out, favour continuity or even overlap those two phases, as it would impact the active underwater sequence. Fourteen international and national male swimmers performed 100-m breaststroke with all-out effort in a pre-calibrated 25 m swimming pool. A multi-camera system tracked the head of the swimmers. Key points of the active underwater sequence were obtained from notational analysis. A hierarchical cluster analysis identified three coordination profiles. All swimmers started their dolphin kick before the arm pull-out. However, one swimmer started the arm pull-out before the end of the dolphin kick, seven swimmers started the arm pull-out after the end of the dolphin kick, and four swimmers synchronised the beginning of the arm pull-out and the end of the dolphin kick, while two other swimmers mixed two coordination profiles among the start and the three turns. Those different profiles allow achieving similar performance outcome, suggesting individual training regarding the underwater phase.

Odontologia para Pacientes com Necessidades Especiais no ensino de graduação: percepção de discentes e docentes em uma instituição do Piauí e um panorama brasileiro / Dentistry for Special Needs Patients in undergraduate teaching: perception of students and professors at a university in Piaui and a Brazilian overview

A inexperiência do graduando em Odontologia no manejo de Pacientes com Necessidades Especiais (PNE) gera lacunas na formação e pode contribuir para a barreira de acesso desses indivíduos aos serviços de saúde bucal. Este estudo analisou a percepção de discentes e docentes do curso de Odontologia da Universidade Federal do Piauí (UFPI)sobre a inclusão de atendimento a PNE no ensino de graduação e o panorama nacional da oferta de disciplina de PNE na estrutura curricular de cursos de Odontologia. Foi realizado um estudo transversal, descritivo e exploratório, com aplicação de questionários a discentes e docentes do curso de Odontologia da UFPI. As matrizes curriculares dos cursos foram consultadas em endereços eletrônicos institucionais. Foi realizada análisedescritiva dos dados e teste Exato de Fisher foi aplicado. A maioria dos discentes relataram nunca ter atendido um PNE (54,8 %) e,destes, 67,7% não se sentem preparados para este atendimento. A maioria dos discentes (84,7%) e docentes (53,8%) aprova a obrigatoriedade da disciplina de PNE na estrutura curricular. Insegurança foi a reação mais comum dos discentes ao atendimento odontológico fictício a um paciente PNE. Entre os docentes participantes do estudo, 73,1% informaram já ter atendido PNE. Em 67,8% dos cursos de Odontologia pesquisados há oferta de disciplina de PNE. Em conclusão, a ausência de atendimento a PNE gera insegurança aos graduandos em Odontologia. A inclusão do tema PNE na matriz curricular é apoiada por discentes e docentes. A disciplinaestá presente na maioria dos cursos de Odontologia do Brasil (AU).

Dentistry undergraduates do not acquire much experience managing Patients with Special Needs (PSN) during their university training. This knowledge deficit contributes to the situation where PSNs face barriers to accessing oral health services. This study was a cross-sectional, descriptive and exploratory study about the perception of Dentistry students and professors at the Federal University of Piaui (UFPI -Brazil) on whether care of PSN should be included in their course. The reactions ofstudents facing a simulated situation of dental care for PSN was also analyzed. A survey of the situation regarding PSN inclusion at other universities in Brazil was alsocarried out. Professors and students filled out questionnaires and information regarding university curriculums was collected from their websites. Descriptive data analysis was performed, and Fisher's exact test was applied. Most UFPI students reported never having treated a PSN (54.8%) and, of these, 67.7% did not feel confident to providethis treatment. Most professors (73.1%) reported having treated PSN. Most students (84.7%) and professors(53.8%) agree that Dentistry for PSN should be mandatory in the curricular structure. Lack of confidencewas the most common reaction of students to a simulation ofdental care for a PSN. Dentistry for PSN is part of the curriculum of 67.8% of the Dentistry courses surveyed. In conclusion, the lack of Dentistry for PSN during student training can makedentists-to-be unsure about how to treat PSN in real-life situations. The inclusion of dental care for PSN in the curriculum is supported by students and teachers. The topic is present in most Dentistry courses in Brazil (AU).

Transitional care from the hospital to the home in heart failure: implementation of best practices.

OBJECTIVES: Assess the compliance of the implementation of better evidence in the transitional care of the person with heart failure from the hospital to the home. METHODS: Evidence implementation project according to the JBI methodology in a cardiology hospital in São Paulo. Six criteria were audited before and after implementing strategies to increase compliance with best practices. 14 nurses and 22 patients participated in the audits. RESULTS: In the baseline audit, compliance was null with five of the six criteria. Strategies: training of nurses; reformulation of the hospital discharge form and guidance on self-care in care contexts; and making telephone contact on the 7th, 14th and 21st days after discharge. In the follow-up audit, there was 100% compliance with five of the six criteria. CONCLUSION: The project made it possible to increase the compliance of transitional care practices in people with heart failure with the recommendations based on the best evidence.

The Acute Effects of a Swimming Session on the Shoulder Rotators Strength and Balance of Age Group Swimmers.

The purpose of this study was to analyze the acute effects of a standardized water training session on the shoulder rotators strength and balance in age group swimmers, in order to understand whether a muscle-strengthening workout immediately after the water training is appropriate. A repeated measures design was implemented with two measurements performed before and after a standardized swim session. 127 participants were assembled in male (n = 72; age: 16.28 ± 1.55 years, height: 174.15 ± 7.89 cm, weight: 63.97 ± 6.51 kg) and female (n = 55; age: 15.29 ± 1.28 years, height: 163.03 ± 7.19 cm, weight: 52.72 ± 5.48 kg) cohorts. The isometric torque of the shoulder internal (IR) and external (ER) rotators, as well as the ER/IR ratios, were assessed using a hand-held dynamometer. Paired sample t-tests and effect sizes (Cohen's d) were used (p ≤ 0.05). No significant differences were found on the shoulder rotators strength or balance in males after training. Females exhibited unchanged strength values after practice, but there was a considerable decrease in the shoulder rotators balance of the non-dominant limb (p < 0.01 d = 0.366). This indicates that a single practice seems not to affect the shoulders strength and balance of adolescent swimmers, but this can be a gender specific phenomenon. While muscle-strengthening workout after the water session may be appropriate for males, it can be questionable regarding females. Swimming coaches should regularly assess shoulder strength levels in order to individually identify swimmers who may or may not be able to practice muscle strengthening after the water training.