Factors associated with the length of breastfeeding during the COVID-19 pandemic: a survival study.

OBJECTIVE: To investigate the repercussions of COVID-19 on the length of breastfeeding and analyze the associated factors in Belo Horizonte, Minas Gerais, Brazil. METHOD: This is an epidemiological, prospective cohort study. Data were collected from medical records and through telephone interviews. Women who weaned were estimated using Kaplan-Meier survival analysis. The log-rank test was used to verify differences between groups, analyzing weaning time, according to sociodemographic and clinical characteristics. The values of hazard ratio and 95% confidence intervals were estimated using Cox regression analysis. RESULTS: A total of 1,729 women participated in the study. During the COVID-19 pandemic, brown women and women undergoing cesarean section were more likely to stop breastfeeding. CONCLUSION: The birth route and mothers' ethnic characteristics were associated with early weaning during the COVID-19 pandemic. Such findings are important to guide the assistance of the multidisciplinary team, especially nursing, during the post-pandemic period and in future epidemiological scenarios.

Seroprevalence and risk factors for Neospora caninum and Toxoplasma gondii in dairy cattle from São Paulo State, Brazil.

Neospora caninum is a major cause of reproductive loss in cattle worldwide as it leads to abortion and animal repositioning. Although Toxoplasma gondii does not cause a reproductive problem in cattle, consuming raw or uncooked beef poses the risk of transmission. This study aimed to evaluate the occurrence of anti-N. caninum and anti-T. gondii antibodies in dairy cattle in the West and Northwest regions of São Paulo State, Brazil. A total of 653 serum samples from dairy cows were analyzed using an indirect immunofluorescence assay (IFA). Epidemiological data from the farms were associated with the serological results of the animals by logistic regression based on the presence of antibodies. The frequencies of the antibodies against N. caninum and T. gondii were 41.6% (272/653) and 11.5% (75/653), respectively. A statistically significant association was observed between: the serum anti-N. caninum antibodies and breed, history of food supplementation for calves, introduction of outside animals that later presented reproductive problems, and history of reproductive problems by the trimester of gestation. The present study highlights the importance of neosporosis in dairy cattle in the study regions and that the inclusion of this parasite in the investigation of animals with reproductive disorders is important.

Influence of digital health literacy on online health-related behaviors influenced by internet advertising.

BACKGROUND: The frequency of health-related information seeking on the internet and social media platforms has increased remarkably. Thus, the ability to understand and select accurate health-related information online, known as EHealth literacy, is crucial for the population. Therefore, this study aimed to evaluate how eHealth literacy influences the critical analysis of oral health-related information obtained from the Internet and its influence on oral health-related behaviors.  METHODS: A cross-sectional online study was conducted with 418 Brazilian adults who responded to the eHEALS questionnaire, with questions regarding the influence of online information on oral health decisions. Socioeconomic and demographic characteristics were also collected. RESULTS: The mean eHEALS score was 27.85 (± 8.13), with a range spanning from 8 to 40 points. Participants with higher eHEALS scores reported using social media platforms to seek for dentists and to acque information about symptoms, diagnoses, and treatments. Furthermore, this group tended not to disregard professional health recommendations based on Internet information and abstained from utilizing products promoted by digital influencers. In multivariate models, increased eHEALS scores were associated with reduced consumption of products endorsed by digital influencers. CONCLUSIONS: The findings from this study suggest that individuals with higher scores on the eHealth literacy questionnaire often conduct research on their health status and seek for health care providers on the Internet. Moreover, these individuals were less likely to be influenced by digital influencers.

EFFECTS OF BEEF SEMEN AND BEEF EMBRYO STRATEGIES ON PROFITABILITY: Economics of using beef semen and beef in vitro produced embryo transfer in Jersey herds.

Dairy herds have adopted sexed semen (SS) and beef semen (BS) to control heifer inventory and increase calf sales revenue. Beef in vitro-produced embryo transfer (beef IVP-ET) may be an alternative to increase calf sales revenue. Besides, raising those Jersey beef crossbred and/or pure beef animals in a dairy system may be a new source of revenue. We aimed to evaluate breed strategies combining dairy conventional semen (CS), SS, BS, and beef IVP-ET on herd dynamics and profitability by marketing those animals with one-day-old or raising them to 180 kg. A Markov chain model was developed to maximize the profitability of Jersey herds by changing the number of dairy heifers sold at birth and the culling rate of 3rd and greater parity cows. The model presents inputs on the reproductive and productive performance of heifers and cows over time. The last year's data (year 10 - steady state) was used to calculate accrual operational cost and revenue per cow per year. We varied the breeding strategy by breeding order and parities, the embryo transfer cost ($85 or $170), the pure beef calf market price ($200 or $300), and by marketing Jersey-beef and pure beef animals with one-day-old or raising them to 180 kg. A total of 8 scenarios + default scenario were simulated. Overall, the proportion of SS use was 47.3 ± 0.6%. For the scenarios replacing all CS breedings with BS breedings, the proportion of CS and BS used was 52.3 ± 0.6. When beef IVP-ET was used, the percentage of BS and beef IVP-ET used was 22.4 ± 0.1% and 31.0 ± 0.1%, respectively. We observed that when we compared SS:BS with the default scenario, the production of purebred Jersey male calves was reduced by 83.5%, and profit/cow per year was increased from $113.5 to $203.3 with SS:BS. When a beef IVP-ET of $85 per transfer was used (scenarios 2 and 3), profit/cow per year was $145.5 and $176.2 for a pure-beef calf price of $200 and $300, respectively. In scenario 4, with a beef IVP-ET cost of $170, the lowest profit ($52.9 per cow per year) was found when marketing one-day-old pure-beef calves at $200. The highest profit was achieved for scenario raising the Jersey-beef crossbred animals to 180 kg ($232.9, scenario 6), followed by scenario 7 ($222.9, SS:BS:IVP-ET) with an embryo transfer cost of $85. Under the current market conditions, combining SS and BS in the reproductive program was a feasible economic opportunity for Jersey herds, yielding the highest net return. The adoption of beef IVP-ET in a reproductive program can potentially increase profit/cow per year, but its profitability will depend on the beef IVP-ET pregnancy cost, the pure-beef market price, calf performance, and the herd reproductive performance. In conclusion, raising the Jersey-beef crossbred calves may be a profitable strategy, and dairy producers need to evaluate the best option to invest in since it will take an extra risk to produce high-quality animals to the market.

Association of morbidity, mortality, and average daily gain with transfer of passive immunity in dairy-beef crossbred calves up to 60 d of life.

Adequate transfer of passive immunity (TPI) is a cornerstone for a proper health status of calves. In the literature, there is limited information on the prevalence of failure of TPI in dairy-beef crossbred calves and its impact on morbidity, mortality, and average daily gain (ADG) during the preweaning period. Therefore, this study aimed to evaluate the association between TPI with morbidity, mortality, and ADG in pre-weaned dairy-beef crossbred calves. A total of 1,055 newborn dairy-beef crossbred calves were enrolled upon arrival at a calf-raising facility in California from January to August 2021. Farm of origin, genetic breed group, sex, and body weight were recorded upon arrival. Blood was collected at 24 ± 1 h post-arrival to evaluate serum IgG concentration, serum total protein (TP), and packed cell volume. Morbidity (diarrhea and respiratory treatment records) and mortality were recorded daily until 60 d of life. Calves were grouped into 2 genetic breed groups: Holstein x Beef (Ho x Be, 49.6%) and Jersey × Beef crossbred calves (Je × Be, 50.4%). Descriptive statistics and Cox proportional hazard models were created to evaluate the association of TPI categories for serum IgG (TPI-IgG: poor: < 10.0 g/L, fair: 10.0 - 17.9 g/L, good: 18.0 - 24.9 g/L, and excellent: ≥ 25.0 g/L) and TP (TPI-TP: poor: < 5.1 g/dL, fair: 5.1 - 5.7 g/dL, good: 5.8 - 6.1 g/dL, and excellent: ≥ 6.2 g/dL), sex, and genetic breed group with morbidity and mortality. Additionally, a mixed linear regression was performed to evaluate the association of sex, genetic breed group, and TPI categories with ADG. Overall morbidity and mortality were 84.8% (n = 895) and 2.5% (n = 26). Calves classified as TPI-IgG excellent were associated with the lowest (43.2% less) hazard of being treated compared with TPI-IgG poor calves. For mortality, dairy-beef crossbred calves with TPI-IgG excellent were associated with a reduction of 82.0% in the hazard of dying compared with TPI-IgG poor. The TPI-IgG poor and TPI-IgG fair calves were associated with a decreased ADG of 101.0 and 98.8 g/d, respectively, in comparison with TPI-IgG good calves. Average daily gain of TPI-IgG good and TPI-IgG excellent calves were not different. In our study, dairy-beef crossbred calves enrolled may have endured challenging conditions that increased morbidity. This reinforces the importance of high IgG levels to decrease morbidity and mortality and maximize ADG in dairy-beef crossbred calves raising systems. Further research should evaluate the long-term effects of TPI categories on the health and performance of dairy-beef crossbred calves.

The relationship between working memory capacity, bilingualism, and ambiguous relative clause attachment.

Working memory (WM) capacity has been shown to influence how readers resolve syntactic ambiguities. Building on the work of Swets et al. (2007, Journal of Experimental Psychology: General, 136[1], 64-81), the goal of the present study was to assess the effects of working memory and language proficiency on first language (L1) relative clause attachment decisions across three different language samples: English monolinguals, L1-L2 Spanish-English heritage bilinguals, and L1-L2 Mandarin-English bilinguals. Binomial logistic regression analyses demonstrated that low WM span is associated with a preference to attach ambiguous relative clauses higher in the syntactic structure, as reported by Swets et al. (2007), and contrary to a recency strategy. We also observed that proficiency in L1 and L2 have little effect, suggesting that relative clause attachment preferences primarily reflect the properties of the language and the working memory capacity of the comprehender.

Validation of the Brazilian 10-item Cervantes Scale for the assessment of menopausal symptoms.

Objective: To validate the 10-item Cervantes Scale (CS-10) among Brazilian women. Methods: This is a cross-sectional observational study involving women in the community aged 40-55 years in the Southern region of Brazil. They completed a general health, habits and socio-demographic questionnaire, the CS-10 and the Women's Health Questionnaire (WHQ). Women unable to understand the survey, not consenting to participate, or having incapacity imposing difficulties during the completion of the questionnaire were excluded. A Confirmatory Factor Analysis (CFA) was conducted with the AMOS 16.0 software. Chi-square of degrees of freedom (χ2/df), the Comparative Fit Index (CFI), the Tucker-Lewis Index (TLI) and the Root-Mean-Square Error of Approximation (RMSEA) were used as indices of goodness of fit. Cronbach's alpha coefficient was used for internal consistency. Results: A total of 422 women were included (premenopausal n=35, perimenopausal n=172, postmenopausal n=215). The CFA for the CS-10 showed a good fit (χ²/df=1.454, CFI=0.989; TLI=0.985; RMSEA=0.033; CI 90%=0.002-0.052; PCLOSE=0.921; Model p=0.049). Good reliability was established in CS-10 and WHQ (Cronbach's alpha=0.724). Postmenopausal women had higher total CS-10 scores (p≤0.0001), reflecting worse quality of life (QoL) related to menopause symptoms and confirming the greater symptomatology evaluated by high total scores for WHQ found in this population when compared to those in the premenopausal period (p=0.041). Conclusion: The CS-10 is a consistent tool for health-related QoL in Brazilian mid-aged women.

Perceptual Clauses as Units of Production in Visual Descriptions.

Describing our visual environments is challenging because although an enormous amount of information is simultaneously available to the visual system, the language channel must impose a linear order on that information. Moreover, the production system is at least moderately incremental, meaning that it interleaves planning and speaking processes. Here, we address how the operations of these two cognitive systems are coordinated given their different characteristics. We propose the concept of a perceptual clause, defined as an interface representation that allows the visual and linguistic systems to exchange information. The perceptual clause serves as the input to the language formulator, which translates the representation into a linguistic sequence. Perceptual clauses capture speakers' ability to describe visual scenes coherently while at the same time taking advantage of the incremental abilities of the language production system.

Hemodiafiltration versus Hemodialysis in End-Stage Kidney Disease: A Systematic Review and Meta-Analysis.

Rationale & Objective: The use of hemodiafiltration (HDF) as a kidney replacement therapy (KRT) in patients with end-stage kidney disease (ESKD) has sparked a debate regarding its advantages over conventional hemodialysis (HD). The present study aims to shed light on this controversy by comparing mortality rates and cause-specific deaths between ESKD patients receiving HDF and those undergoing HD. Study Design: Systematic review and meta-analysis of randomized controlled trials (RCTs). The search was conducted using PubMed, EMBASE, and Cochrane Central on July 1, 2023. Setting & Participants: Adult patients with ESKD on regular KRT. Exposure: Studies with participants undergoing HDF. Outcomes: Primary outcomes were all-cause mortality, cardiovascular (CV) mortality, deaths related to infections, and kidney transplant. We also evaluated the endpoints for deaths related to malignancy, myocardial infarction, stroke, arrhythmias, and sudden death. Analytical Approach: We included RCTs evaluating HDF versus HD. Crossover trials and studies with overlapping populations were excluded. Two authors independently extracted the data following predefined search criteria and quality assessment. The risk of bias was assessed with Cochrane's RoB2 tool. Results: We included 5 RCTs with 4,143 patients, of which 2,078 (50.1%) underwent HDF, whereas 2,065 (49.8%) were receiving HD. Overall, HDF was associated with a lower risk of all-cause mortality (risk ratio [RR], 0.81; 95% confidence interval [CI], 0.73-0.91; P < 0.001; I2 = 7%) and a lower risk of CV-related deaths (RR, 0.75; 95% CI, 0.61-0.92; P = 0.007; I2 = 0%). The incidence of infection-related deaths was also significantly different between therapies (RR, 0.69; 95% CI, 0.50-0.95; P = 0.02; I2 = 26%). Limitations: In individual studies, the HDF groups achieved varying levels of convection volume. Conclusions: Compared with those undergoing HD, patients receiving HDF experienced a reduction in all-cause mortality, CV mortality, and infection-related mortality. These results provide compelling evidence supporting the use of HDF as a beneficial intervention in ESKD patients undergoing KRT. Registration: Registered at PROSPERO: CRD42023438362.

Age-related Morphofunctional Changes in Sickle Cell Mice Bone Marrow Mesenchymal Stromal Cells.

BACKGROUND AND OBJECTIVES: Bone marrow mesenchymal stromal cells (BM-MSCs) are key elements of the hematopoietic niche and participate in the regulatory mechanisms of hematopoietic stem cells (HSCs). Hematological diseases can affect MSCs and their functions. However, the dysregulations caused by sickle cell disease (SCD) are not fully elucidated. This work explored changes in BM-MSCs and their relationship with age using sickle cell mice (Townes-SS). MATERIALS AND METHODS: BM-MSCs were isolated from Townes-SS, and control groups 30- and 60-day-old Townes-AA and C57BL/6 J. RESULTS: The BM-MSCs showed no morphological differences in culture and demonstrated a murine MSC-like immunophenotypic profile (Sca-1+, CD29+, CD44+, CD90.2+, CD31-, CD45-, and CD117-). Subsequently, all BM-MSCs were able to differentiate into adipocytes and osteocytes in vitro. Finally, 30-day-old BM-MSCs of Townes-SS showed higher expression of genes related to the maintenance of HSCs (Cxcl12, Vegfa, and Angpt1) and lower expression of pro-inflammatory genes (Tnfa and Il-6). However, 60-day-old BM-MSCs of Townes-SS started to show expression of genes related to reduced HSC maintenance and increased expression of pro-inflammatory genes. CONCLUSION: These results indicates age as a modifying factor of gene expression of BM-MSCs in the context of SCD.

Individual and Contextual Factors Associated with Adolescents' Self-Perceived Need for Treatment.

The present study aimed to investigate associations between the self-perceived dental treatment need and clinical factors, familial characteristics, and school context in adolescents. A cross-sectional study was conducted with a representative sample of 746 students aged 15 to 19 years in a medium-sized city in Brazil. Data collection involved the use of a sociodemographic questionnaire, an oral health questionnaire, and the Family Adaptability and Cohesion Scales (FACES III) instrument. Clinical examinations were performed by two trained and calibrated examiners (Kappa > 0.80) using the Nyvad criteria. A robust logistic regression analysis for complex samples was performed using a multilevel approach (α = 5%). The individual factors associated with the self-perceived treatment need were dental pain (OR = 1.08; 95% CI: 1.01-1.16), the loss of the first molars (OR = 1.09; 95% CI: 1.03-1.15), and disengaged family cohesion (OR = 1.15; 95% CI: 1.01-1.31). In terms of context, attending a public school was associated with the self-perceived treatment need (OR = 1.17; 95% CI: 1.02-1.33). Thus, the individual factors of toothache, tooth loss, and a disengaged family, as well as the school context, exerted an influence on the self-perceived treatment need.

Recycling composted human feces as biofertilizer for crop production: Assessment of soil and lettuce plant tissue contamination by Escherichia coli and human adenovirus.

Using waste from sewage systems, particularly human excreta, could save resources and increase soil fertility, contributing to nutrient management. However, because of the pathogenic content in human feces, this resource can pose health risks to farmers and consumers. Therefore, this work analyzed the behavior of the microorganisms: Escherichia coli ATCC13706 and human adenovirus (HAdV-2) in the soil and the internal part of the plant tissue during the vegetative stage after applying spiked composted human feces as biofertilizer. In a greenhouse, we simulated the application of the biofertilizer in lettuce cultivation by spiking three concentrations of E. coli (6.58, 7.31, and 8.01 log10 CFU.g-1) and HAdV-2 (3.81, 3.97, and 5.92 log10 PFU.g-1). As a result, we achieved faster decay in soil at higher concentrations of E. coli. We estimated linear decay rates of -0.07279, -0.09092, and -0.115 days, corresponding to T90s of 13.7, 11.0, and 8.6 days from higher to smaller concentrations of E. coli, respectively. The estimated periods for the inactivation of 4 logarithmic units of E. coli bacteria in soil are longer than the cultivation period of lettuce for all concentrations studied. Concerning the bacterial contamination in plants, we found E. coli in the internal part of the leaves at the highest concentration tested during the first three weeks of the experiment. Furthermore, HAdV-2 was found in roots at a stable concentration of 2-2.3 log10 PFU.g-1 in five of the six samples analyzed. Therefore, bacterial infection could pose a risk, even if fresh greens are washed before consumption, especially for short-term cultures. Regarding viral infection, a positive result in the roots after disinfection may pose a risk to root and tubercule vegetables. These discoveries highlight the importance of conducting comprehensive evaluations of hygiene practices in incorporating organic amendments in crops, explicitly aiming to minimize the risk of post-contamination.

Puerperal women's social interactions related to their sexual health after childbirth.

OBJECTIVE: To analyze puerperal women's experiences of sexual health after childbirth from the perspective of symbolic interactionism. METHOD: Descriptive, qualitative study. Twenty semi-structured interviews were conducted by videoconference with women in the remote puerperium, captured by snowball technique and searched for "seeds" on Instagram®. Bardin's content analysis and Symbolic Interactionism were used as references. RESULTS: The puerperal women signify sexual health from a perspective of comprehensive healthcare. However, due to the duality between "being a woman" and "being a mother", they recognize fear, bodily transformations and changes in focus from the love relationship to caring for the baby as factors that interfere with sexual health. And they choose to put themselves aside, prioritizing caring for others. They re-signify sexual health by recognizing the importance of taking care of themselves in biopsychosocial aspects and try to recover self-care for a healthy sexual experience. CONCLUSION: Despite the meanings attributed, women's social interactions with the puerperium interfere negatively with sexual health. Professionals should be sensitized to the inclusion of actions that promote changes in the social action of these women towards self-care.

Activity of extracts and terpenoids from Tontelea micrantha (Mart. ex Schult.) A.C.Sm. (Celastraceae) against pathogenic bacteria.

The pharmacological properties of plant extracts and phytochemicals, such as flavonoids and terpenoids, remain of great interest. In this work, the effect of extracts, friedelan-3,21-dione, and 3ß-O-D-glucosyl-sitosterol isolated from Tontelea micrantha roots was evaluated against Staphylococcus aureus, Bacillus subtilis, Klebsiella pneumoniae, Klebsiella oxytoca and Escherichia coli. The antibacterial activity was evaluated by the minimum inhibitory and bactericidal concentrations (MIC and MBC, respectively), and the synergistic effect was assessed by the Checkerboard assay. Furthermore, the cytotoxicity of the plant-derived compounds against Vero cells was measured by the 3-(4 5-dimethylthiazol-2-yl)-2 5-diphenyltetrazolium bromide (MTT) method. The biological effects of the isolated compounds were predicted using the PASS online software. The chloroform and hexane extracts of T. micrantha roots showed promising antibacterial effect, with MIC in the range of 4.8-78.0 µg/mL. Further analyses showed that these compounds do not affect the integrity of the membrane. The combination with streptomycin strongly reduced the MIC of this antibiotic and extracts. The extracts were highly toxic to Vero cells, and no cytotoxicity was detected for the two terpenoids isolated from them (i.e. friedelan-3,21-dione and 3ß-O-D-glucosyl-sitosterol; CC50 > 1000 µg/mL). Therefore, extracts obtained from T. micrantha roots significantly inhibited bacterial growth and are considered promising agents against pathogenic bacteria. The cytotoxicity results were very relevant and can be tested in bioassays.

Farmers' Perceptions on Implementing Automatic Milking Systems in Large USA Dairies: Decision-Making Process, Management Practices, Labor, and Herd Performance.

Automatic Milking System (AMS) installations are increasing in the USA despite the higher investment cost than conventional systems. Surveys on AMSs conducted outside the USA focused on small-medium herds, specific regions, or aspects of AMS milking. This study described farmers' perceptions about the decision-making process of adopting an AMS in the USA's large dairies (≥7 AMS boxes) regarding changes in technology, housing, management practices, labor, herd performance, and health. After being contacted, 27 of 55 farmers from large AMS herds completed the survey. The main reasons for adopting an AMS were labor costs, cows' welfare, and herd performance. Most farms constructed new barns, used a free-flow traffic system, and changed their feed management. Increases in water and energy use were perceived by 42% and 62% of farmers, respectively. Farmers estimated decreases in labor costs of over 21%, and AMS employees worked 40-60 h/week. Milk production increases were reported by 58%, with 32% observing higher milk fat and protein content. Easier sick cow detection, better mastitis management, and improvements in pregnancy rates were reported. Thus, farmers transitioning to AMSs perceived altered resource utilization, labor cost savings, and improvements in employee quality of life, animal welfare, and farm management. While 54% of respondents would recommend an AMS to other farms, 38% suggested considering additional aspects prior to adoption.

Instructional and didactic support tool for teaching-learning Post-Partum Haemorrhage care in simulated settings: Creation and validation.

OBJECTIVE: To describe the creation and validation process of an instructional, didactic and self-applied support tool for teaching-learning Post-Partum Haemorrhage care in simulated settings. BACKGROUND: Students frequently face difficulties performing the actions in the proper sequence in Post-Partum Haemorrhage simulated cases. Even in a controlled environment, anxiety, nervousness and fear of making mistakes are evident, which render the simulated experience highly stressful. Having a tool with a guideline can help students perform these actions more assertively. DESIGN: A methodological study to develop a didactic tool. METHODS: The creation process of the didactic tool, called Instructional Disk for the Management of Post-Partum Haemorrhage, was divided into five phases: Analysis, Design, Development, Implementation and Evaluation. Nine experts specialised in Obstetrics and Midwifery validated the tool by answering a questionnaire with nine items; in turn, 32 undergraduate Midwifery program students carried out the evaluation using a questionnaire on applicability, functionality, clarity, coherence and usability of the tool in Post-Partum Haemorrhage simulated stations. The data were analysed descriptively, considering absolute agreement when the answers to all questions in the five-point Likert scale corresponded to 5 (I totally agree). The Content Validity Index was calculated for the experts' questionnaires. RESULTS: In the validation stage, the experts agreed or totally agreed with all nine items, reaching a Content Validity Index = 1. In the total scores assigned by the experts, there was a variation between 80.0% and 100% absolute agreement, with a mean of 95.6%. In the students' assessment, the variation was between 87.5% and 100% absolute agreement, with a mean of 97.7%, in the eight items evaluated. The agreement level above 90% among experts and students was considered high. CONCLUSIONS: The Instructional Disk for the Management of Post-Partum Haemorrhage was validated by experts with extensive experience in Obstetrics and Midwifery care and teaching, ensuring that the content included in the guidelines for the management of Post-Partum Haemorrhage adopted in Brazil is covered. The students positively evaluated this support tool for learning the care to be provided in Post-Partum Haemorrhage cases in the simulated stations.

A espiritualidade e o luto na morte perinatal: uma revisão narrativa / Spirituality and bereavement in perinatal death: a narrative review

A morte perinatal, compreendida como a morte de um feto entre 28 semanas ou mais de gestação e nascido vivo com menos de 28 dias de idade, envolve aspectos multidimensionais do sofrimento familiar. Entre as estratégias existentes de como lidar com esse sofrimento, a espiritualidade, entendida como busca pessoal de compreensão das questões existenciais humanas e suas relações com o sagrado e transcendente, pode ser uma forma de ressignificar esse processo de luto. Investigar a influência da espiritualidade no luto familiar decorrente de mortes perinatais. Foi realizada uma pesquisa no PUBMED utilizando os descritores DeCs/Mesh "Bereavement", "Perinatal death" e "Spirituality" no mês de junho de 2023. Foram incluídos 14 artigos nesta revisão narrativa. Realizar rituais que honrem a memória do bebê, identificando-o como membro da família favorecem o processo de elaboração e aceitação do luto. A autorreflexão acerca do processo da perda torna-se inerente para ressignificar o luto perinatal como uma "experiência humana natural". Além disso, a espiritualidade representa um meio de fortalecimento e ressignificação tanto para a mãe quanto para os familiares diante do sofrimento experienciado. Por fim, há uma carência de profissionais de saúde e religiosos qualificados que consigam abordar de uma maneira sistemática a oferecer melhora no processo e na qualidade assistencial da perda materna. A experiência do luto perinatal pode assumir novos valores e significados ao ser reconhecida, respeitada e auxiliada por profissionais qualificados em abordar sobre o tema, sendo a espiritualidade um aspecto importante para a elaboração do luto materno.

Perinatal death, understood as the death of a fetus between 28 weeks or more of gestation and a live birth less than 28 days old, involves multidimensional aspects of family suffering. Among the existing strategies for dealing with this suffering, spirituality, understood as a personal search for understanding human existential issues and their relationships with the sacred and transcendent, can be a way of giving new meaning to this grieving process. Investigate the influence of spirituality on family bereavement resulting from perinatal deaths. A search was carried out on PUBMED using the DeCs/Mesh descriptors "Bereavement", "Perinatal death" and "Spirituality" in June 2023. 14 articles were included in this narrative review. Performing rituals that honor the baby's memory, identifying them as a member of the family, favors the process of elaboration and acceptance of bereavement. Self-reflection about the process of loss becomes inherent to re-signify perinatal bereavement as a "natural human experience". Furthermore, spirituality represents a means of strengthening and giving new meaning for both the mother and family members in the face of the suffering experienced. Finally, there is a lack of qualified health and religious professionals who can systematically approach and improve the process and quality of care for maternal loss. The experience of perinatal bereavement can take on new values and meanings when recognized, respected and assisted by professionals qualified to address the topic, with spirituality being an important aspect in the elaboration of maternal bereavement.

Plano de pós-parto para gestantes e puérperas: produção de material educativo / Plan de posparto para mujeres embarazadas y puérperas: producción de material educativo / Postpartum plan for pregnant and postpartum women: production of educational material

Resumo Objetivo Desenvolver e validar material educativo para a construção de um plano de pós-parto pela mulher no ciclo gravídico-puerperal, com ou não profissionais da saúde. Métodos Estudo metodológico, organizado em três etapas. 1) Análise e seleção de conteúdo, elaboração teórica do projeto e adaptação na linguagem; 2) Produção do material, com elaboração do design gráfico e projeto ilustrativo; 3) Validação com sete juízes nas áreas de saúde da mulher e educação em saúde. A coleta de dados foi executada com a aplicação de um questionário de caracterização e o Suitability Assessment of Materials for evaluation of health-related information for adults (SAM). A análise se deu por estatística descritiva e Índice de Validade de Conteúdo, sendo considerados aprovados os itens que apresentassem valor igual ou superior a 0,80. Resultados O plano de cuidado intitulado "Meu plano de pós-parto" apresentou ótima aceitação e confiabilidade, evidenciado por um Índice de Validade de Conteúdo global de 0,98. As principais sugestões apresentadas foram a respeito da adaptação da escrita para uma linguagem mais simples e acessível, sendo estas aceitas pelas autoras. Os especialistas apontaram a importância e relevância do plano de pós-parto para o público-alvo. Conclusão O material demonstrou ser um instrumento válido e confiável para a utilização das mulheres durante o ciclo gravídico puerperal, favorecendo uma reflexão sobre os cuidados e preparo precoce para enfrentamento deste período.

Resumen Objetivo Elaborar y validar material educativo para la creación de un plan de posparto por la mujer durante el embarazo y el puerperio, con o sin profesionales de la salud. Métodos Estudio metodológico, organizado en tres etapas: 1) análisis y selección de contenido, elaboración teórica del proyecto y adaptación del lenguaje; 2) producción del material, con elaboración del diseño gráfico y proyecto ilustrativo, y 3) validación por siete jueces de áreas de la salud de la mujer y educación para la salud. La recopilación de datos se llevó a cabo mediante la aplicación de un cuestionario de caracterización y el Suitability Assessment of Materials for evaluation of health-related information for adults (SAM). El análisis se realizó con estadística descriptiva y con el Índice de Validez de Contenido, donde se consideraron aprobados los ítems que presentaron un valor igual o superior a 0,80. Resultados El plan de cuidado llamado "Mi plan de posparto" presentó una excelente aceptación y fiabilidad, demostradas con un Índice de Validez de Contenido global de 0,98. Las principales sugerencias propuestas fueron sobre adaptar la escritura a un lenguaje más simple y accesible, y las autoras las aceptaron. Los especialistas señalaron la importancia y la relevancia del plan de posparto para el público destinatario. Conclusión El material demostró ser un instrumento válido y confiable para que lo utilicen mujeres durante el embarazo y el puerperio, y así favorecer una reflexión sobre los cuidados y la preparación temprana para enfrentar este período.

Abstract Objective To develop and validate an educational material for the construction of a postpartum plan by women in the pregnancy-puerperal cycle, with or without health professionals. Methods Methodological study, organized in three stages. 1) Content analysis and selection, theoretical elaboration of the project and language adaptation; 2) Production of material, with preparation of graphic design and illustrative project; 3) Validation with seven judges in the areas of women's health and health education. Data collection was carried out using a characterization questionnaire and the Suitability Assessment of Materials for evaluation of health-related information for adults (SAM). The analysis was carried out using descriptive statistics and Content Validity Index, with items that presented a value equal to or greater than 0.80 being considered approved. Results The care plan entitled "My postpartum plan" showed excellent acceptance and reliability, evidenced by an overall Content Validity Index of 0.98. The main suggestions presented were about adapting the writing to a simpler and more accessible language, which were accepted by the authors. Experts highlighted the importance and relevance of the postpartum plan for the target audience. Conclusion The material proved to be a valid and reliable instrument for use by women during the pregnancy and puerperal cycle, encouraging reflection on care and early preparation to face this period.

Seroprevalence and risk factors for Neospora caninum and Toxoplasma gondii in dairy cattle from São Paulo State, Brazil / Soroprevalência e fatores de risco para Neospora caninum e Toxoplasma gondii em bovinos leiteiros do Estado de São Paulo

Abstract Neospora caninum is a major cause of reproductive loss in cattle worldwide as it leads to abortion and animal repositioning. Although Toxoplasma gondii does not cause a reproductive problem in cattle, consuming raw or uncooked beef poses the risk of transmission. This study aimed to evaluate the occurrence of anti-N. caninum and anti-T. gondii antibodies in dairy cattle in the West and Northwest regions of São Paulo State, Brazil. A total of 653 serum samples from dairy cows were analyzed using an indirect immunofluorescence assay (IFA). Epidemiological data from the farms were associated with the serological results of the animals by logistic regression based on the presence of antibodies. The frequencies of the antibodies against N. caninum and T. gondii were 41.6% (272/653) and 11.5% (75/653), respectively. A statistically significant association was observed between: the serum anti-N. caninum antibodies and breed, history of food supplementation for calves, introduction of outside animals that later presented reproductive problems, and history of reproductive problems by the trimester of gestation. The present study highlights the importance of neosporosis in dairy cattle in the study regions and that the inclusion of this parasite in the investigation of animals with reproductive disorders is important.

Resumo Neospora caninum é uma das principais causas de perda reprodutiva em bovinos em todo o mundo, pois leva ao aborto e ao reposicionamento animal. Embora o Toxoplasma gondii não cause problemas reprodutivos em bovinos, o consumo de carne bovina crua ou não cozida apresenta risco de transmissão. Este estudo teve como objetivo avaliar a ocorrência de anticorpos anti-N. caninum e anti-T. gondii em bovinos leiteiros nas regiões Oeste e Noroeste do Estado de São Paulo, Brasil. Um total de 653 amostras de soro de bovinos leiteiros, foi analisado utilizando-se o ensaio de imunofluorescência indireta (IFI). Os dados epidemiológicos das propriedades foram associados aos resultados sorológicos dos animais por meio de regressão logística. As frequências dos anticorpos contra N. caninum e T. gondii foram 41,6% (272/653) e 11,5% (75/653), respectivamente. Foi observada associação estatisticamente significativa entre: soropositividade para N. caninum e raça, histórico de suplementação alimentar para bezerros, introdução de animais externos que, posteriormente, apresentaram problemas reprodutivos e histórico de problemas reprodutivos no segundo trimestre de gestação. O presente estudo destaca a importância da neosporose em bovinos leiteiros, nas regiões de estudo, e a inclusão deste parasita na investigação de animais com distúrbios reprodutivos é fundamental.

Validation of the Brazilian 10-item Cervantes Scale for the assessment of menopausal symptoms

Abstract Objective: To validate the 10-item Cervantes Scale (CS-10) among Brazilian women. Methods: This is a cross-sectional observational study involving women in the community aged 40-55 years in the Southern region of Brazil. They completed a general health, habits and socio-demographic questionnaire, the CS-10 and the Women's Health Questionnaire (WHQ). Women unable to understand the survey, not consenting to participate, or having incapacity imposing difficulties during the completion of the questionnaire were excluded. A Confirmatory Factor Analysis (CFA) was conducted with the AMOS 16.0 software. Chi-square of degrees of freedom (χ2/df), the Comparative Fit Index (CFI), the Tucker-Lewis Index (TLI) and the Root-Mean-Square Error of Approximation (RMSEA) were used as indices of goodness of fit. Cronbach's alpha coefficient was used for internal consistency. Results: A total of 422 women were included (premenopausal n=35, perimenopausal n=172, postmenopausal n=215). The CFA for the CS-10 showed a good fit (χ²/df=1.454, CFI=0.989; TLI=0.985; RMSEA=0.033; CI 90%=0.002-0.052; PCLOSE=0.921; Model p=0.049). Good reliability was established in CS-10 and WHQ (Cronbach's alpha=0.724). Postmenopausal women had higher total CS-10 scores (p≤0.0001), reflecting worse quality of life (QoL) related to menopause symptoms and confirming the greater symptomatology evaluated by high total scores for WHQ found in this population when compared to those in the premenopausal period (p=0.041). Conclusion: The CS-10 is a consistent tool for health-related QoL in Brazilian mid-aged women.