A influência dos níveis de atividade física nos parâmetros da marcha durante atividades de dupla tarefa em idosos / The influence of physical activity on gait parameters during dual-task activities in the older people

Resumo Objetivo Analisar as possíveis diferenças nas variáveis ​​cinemáticas da marcha entre idosos fisicamente ativos e fisicamente inativos durante a realização de atividades de dupla tarefa. Metodo: Participaram idosos, com idade entre 60 e 75 anos, divididos em dois grupos: fisicamente inativo (FI) (n=20) e fisicamente ativo (FA) (n=20). Os participantes foram agrupados igualmente em dez indivíduos do sexo feminino e masculino, classificados por meio do Questionário Internacional de Atividade Física (International Physical Activity Questionnaire - IPAQ). Os participantes realizaram inicialmente tarefas simples (aritmética, fluência verbal e marcha) e depois realizaram atividades de dupla tarefa, associando a marcha com as duas atividades cognitivas (aritmética e fluência verbal). Foram analisadas as variáveis ​​velocidade, cadência, comprimento da passada, largura do passo, tempo da passada e duplo apoio. Para comparar as variáveis ​​por tarefa e grupo, foi utilizado o modelo de Equações de Estimativas Generalizadas (GEE) complementado pelo teste de Bonferroni. Resultados Na análise intragrupo, ambos os grupos apresentaram reduções significativas na velocidade, cadência, largura da passada, tempo da passada e duplo apoio, tanto na dupla tarefa aritmética quanto na dupla tarefa de fluência verbal. No entanto, nas comparações entre os grupos, não houve diferenças estatisticamente significativas em nenhum parâmetro cinemático analisado, tanto na análise da marcha simples quanto nas tarefas duplas. Conclusão As duplas tarefas influenciaram negativamente os parâmetros cinemáticos da marcha em ambos os grupos. No entanto, o nível de atividade física não pode ser considerado um fator que minimiza os efeitos da dupla tarefa na marcha de idosos.

Abstract Objective To analyze the possible differences in the kinematic variables of gait between physically active and physically inactive older people while performing dual-task activities. Method Older individuals, aged between 60 and 75 years, participated, divided into two groups: physically inactive (PI) (n=20) and physically active (PA) (n=20). Participants were equally grouped into ten female and male individuals, classified using the International Physical Activity Questionnaire (IPAQ). Participants initially performed simple tasks (arithmetic, verbal fluency, and gait) and then performed dual task activities, associating gait with the two cognitive activities (arithmetic and verbal fluency). The variables velocity, cadence, stride length, step width, stride time and double support were analyzed. To compare variables according to task and group, the Generalized Estimating Equations (GEE) model complemented by the Bonferroni test was used. Results In the intragroup analysis both groups showed significant decreases in velocity, cadence, step width, stride time and double support, both in the arithmetic dual task and in the verbal fluency dual task. However, in the comparisons between the groups, there were no statistically significant differences in any kinematic parameter analyzed, both in the single gait analysis and in the dual tasks. Conclusion The dual tasks had a negative influence on the kinematic gait parameters in both groups. However, the level of physical activity can not be considered a factor that minimizes the effects of the dual task on gait in the older people.

A Klebsiella variicola Plasmid Confers Hypermucoviscosity-Like Phenotype and Alters Capsule Production and Virulence.

Hypermucoviscosity (hmv) is a capsule-associated phenotype usually linked with hypervirulent Klebsiella pneumoniae strains. The key components of this phenotype are the RmpADC proteins contained in non-transmissible plasmids identified and studied in K. pneumoniae. Klebsiella variicola is closely related to K. pneumoniae and recently has been identified as an emergent human pathogen. K. variicola normally contains plasmids, some of them carrying antibiotic resistance and virulence genes. Previously, we described a K. variicola clinical isolate showing an hmv-like phenotype that harbors a 343-kb pKV8917 plasmid. Here, we investigated whether pKV8917 plasmid carried by K. variicola 8917 is linked with the hmv-like phenotype and its contribution to virulence. We found that curing the 343-kb pKV8917 plasmid caused the loss of hmv, a reduction in capsular polysaccharide (P < 0.001) and virulence. In addition, pKV8917 was successfully transferred to Escherichia coli and K. variicola strains via conjugation. Notably, when pKV8917 was transferred to K. variicola, the transconjugants displayed an hmv-like phenotype, and capsule production and virulence increased; these phenotypes were not observed in the E. coli transconjugants. These data suggest that the pKV8917 plasmid carries novel hmv and capsule determinants. Whole-plasmid sequencing and analysis revealed that pKV8917 does not contain rmpADC/rmpA2 genes; thus, an alternative mechanism was searched. The 343-kb plasmid contains an IncFIB backbone and shares a region of ∼150 kb with a 99% identity and 49% coverage with a virulence plasmid from hypervirulent K. variicola and multidrug-resistant K. pneumoniae. The pKV8917-unique region harbors a cellulose biosynthesis cluster (bcs), fructose- and sucrose-specific (fru/scr) phosphotransferase systems, and the transcriptional regulators araC and iclR, respectively, involved in membrane permeability. The hmv-like phenotype has been identified more frequently, and recent evidence supports the existence of rmpADC/rmpA2-independent hmv-like pathways in this bacterial genus.

Criação e desenvolvimento de aplicativo para crianças em tratamento oncológico: interdisciplinaridade e cocriação / Creation and development of mobile application for children in oncological treatment: interdisciplinarity and co-creation

Apesar do avanço nos tratamentos contra o câncer infantil e o crescente índice de cura, chegando a 80%, quando diagnosticado e encaminhado a centros de tratamento oncológico precocemente, o diagnóstico continua sendo motivo de sofrimento e medo para os pacientes e seus familiares,tanto pela mitificação da doença, quanto pela falta de materiais adequados disponíveis para se buscar informações. O presente artigo apresenta o desenvolvimento de um material acessível, um aplicativo, composto por 20 minijogos que explicam o câncer e o seu tratamento, para crianças diagnosticadas com a doença. Foram aplicados conceitos e princípios da Cocriação, Interdisciplinaridade, Design Thinking, MetodologiaÁgil e do Design Centrado no Paciente. A participação efetiva no projeto de partes interessadas permitiram acesso integrado às informações, facilitando a compreensão, identificação e codificação, que resultaram na geração de conhecimento facilmente acessível para a população-alvo, bem como na promoção do empoderamento e do engajamento, permitindo aos pacientes e a seus familiares a apropriação do novo contexto, transformando-os de indivíduos passivos em agentes transformadores.

Significados del trabajo en mujeres que realizan trabajos productivo y reproductivo / Meaning of working in women who do productive and reproductive works

Resumen Objetivo: El presente artículo de investigación buscó analizar el significado del trabajo en mujeres con trabajo productivo (MTP) y reproductivo (MTR) en la ciudad de Cali, Colombia. Para ello se consideraron las subcategorías: centralidad, normas sociales, valores laborales, tipo de actividad realizada y trayectorias laborales. Método: Se realizó una investigación cualitativa con diseño fenomenológico. Se empleó una guía de entrevista semiestructurada. Participaron 6 mujeres con MTP y 6 mujeres con MTR contactadas por bola de nieve, entre los 30 y 40 años. Resultados: Se encontró que las MTP presentan mayor centralidad que las MTR; los derechos de las MTP están centrados en aspectos legales y los de las MTR, en aspectos simbólicos asociados al reconocimiento de los familiares. Los deberes de las MTP se enfocan en sus funciones laborales y los de las MTR, en todas las labores cotidianas del hogar. Los valores laborales de las MTP enfatizan en mayores sueldos, mayor independencia, horario flexible, mejor trato y ocupar posiciones de dirección; en las MTR se destaca el ganar un sueldo para suplir necesidades propias y del hogar, y contar con más participación por parte de pareja y familiares. Conclusión: Ambos significados se relacionan con aspectos de género sobre la división sexual del trabajo como algo natural, incluso para las MTP, donde la mujer es la responsable del trabajo reproductivo, viéndose la participación de la pareja como una ayuda o favor, y no como una responsabilidad compartida.

Abstract Objective: This paper analyzes the meaning of working in Women with Productive Work (WPW) and Women with Reproductive Work (WRW) in Cali city, Colombia. To achieve this purpose, four dimensions proposed by the MOW (1987) were studied: centrality, social norm and work values, kind of work and work trajectories. Method: A qualitative research was carried out based on phenomenological design. Semi-structured interview guides. Six WPW and six WRW were chosen randomly with an age among 30 and 40 years. Results: It was found that the WPW present more centrality than the WRW; also, the WPW's rights are based on legal aspects, while WRW's rights are based on symbolic values associated to the recognition of their relatives. The duties of the WPW are focused on the specific function of their job's nature, meanwhile for the WRW their duties cover all daily tasks demanded from their household. Women with productive occupations have their work values highlighted by bigger incomes, more independency, flexible schedules and the prospect of occupying a directive position; as long as for the women with a reproductive occupation they are encouraged for getting a better income to supply their own necessities or the family's, as well as to rely on their respective partner's or family's support. Conclusion: Both groups have been permeated by a default genre perspective that empowers a sexual division of the work activities, such that it is taken for granted that women are responsible for all the household activities and reproductive work even when they are performing the same productive activities as their partners, whose participation in such household activities is usually regarded as a help or even a favor, not as a shared responsibility.

Antibacterial activity against Streptococcus mutans and diametrical tensile strength of an interim cement modified with zinc oxide nanoparticles and terpenes: An in vitro study.

STATEMENT OF PROBLEM: Interim restorations are occasionally left in the mouth for extended periods and are susceptible to bacterial infiltration. Thus, dental interim cements with antibacterial properties are required. PURPOSE: The purpose of this in vitro study was to determine in vitro antibacterial activity against Streptococcus mutans and to compare the diametrical tensile strength (DTSs) of dental interim cement modified with zinc oxide nanoparticles (ZnO-NPs) with that of cement modified with terpenes. MATERIAL AND METHODS: Antibacterial properties of ZnO-NPs, terpenes, and dental interim cement modified with ZnO-NPs and cement modified with terpenes against S mutans were tested according to minimum inhibitory concentration (MIC) and direct contact inhibition (DCI). Tensile strength levels were evaluated using DTS. Results were analyzed using the Kolmogorov-Smirnov, ANOVA, and Tamhane tests (α=.05). RESULTS: The MICs of ZnO-NPs and terpenes against S mutans were 61.94 µg/g and 0.25% v/v, respectively. The DCI assay under the cylinders of cement (area of contact with the agar surface) revealed significant bacterial growth inhibition on Temp-Bond NE specimens with ZnO-NPs at MIC of 495.2 µg/g (8× MIC) and with terpenes at MIC 0.999% v/v (4× MIC) (P<.05). The Temp-Bond NE cement cylinder (control group) showed the lowest DTS (1.05 ±0.27 MPa) of all other test groups. In the Zn-NPs group, the greatest increase occurred in the NP8 (8× MIC; 495.2 µg/g) group with a value of 1.50 ±0.23 MPa, a significant increase in DTS compared with the control and terpene groups (P<.05). In the terpene group, the highest increase corresponded to group T2 (2× MIC; 0.4995% v/v) with a value of 1.29 ±0.18 MPa. CONCLUSIONS: The addition of terpenes and ZnO-NPs to interim cement showed antibacterial activity when in contact with S. mutans ATCC 25175. Both terpenes and ZnO-NPs antimicrobial agents increased diametral tensile strength.

Experiencias del personal de enfermería de salud mental ante estresores ocupacionales en una Institución prestadora de Servicios de Cali, Colombia / Experiences of mental health nursing staff at occupational stressors in a service provider institution in Cali, Colombia

Resumen Introducción: El personal de enfermería que atiende pacientes psiquiátricos, se enfrenta a estresores ocupacionales diferenciados. Objetivo: Interpretar las experiencias del personal de enfermería de salud mental ante estresores ocupacionales, desde tres modelos de estrés de corte transaccional y de la Teoría de Papeles de Goffman. Materiales y métodos: Estudio cualitativo y fenomenológico. Se realizaron entrevistas semi-estructuradas a enfermeras de una Institución Prestadora de Salud, para el análisis se empleó el análisis de contenido y mapa de asociación de ideas. Resultados: Los principales estresores ocupacionales encontrados fueron: recursos físicos desfavorables y ausencia de otros, características de los pacientes, sobrecarga laboral, conflictos interpersonales, falta de preparación, e impuntualidad en salario. Como consecuencia se encontró cambios en la salud mental del personal y en la prestación de los servicios que brindan. Conclusiones: La manera en que está configurado el sistema de trabajo en la institución presenta estresores ocupacionales que afectan a todas las participantes, quienes los afrontan a través de sus capacidades personales, los recursos disponibles, las redes de apoyo y la experiencia adquirida; todo ello permeado por los modos en que comprenden e interpretan su rol en el marco del trabajo.

Abstract Introduction: Nursing staff, who attend psychiatric patients, are confronted with differentiated occupational stressors. Objective: Interpret the experiences of mental health nursing staff when facing occupational stressors, ranging from three transactional cut stress models and Goffman paper theory. Materials and methods: A qualitative and phenomenological study was conducted. Semi-structured interviews were carried out with nurses from a health care institution. The analysis of content and map of the association of ideas was employed for the analysis. Results: The main occupational stressors found were: unfavorable physical resources and absence of others, patient characteristics, labor overload, interpersonal conflicts, lack of preparation and unpunctuality in salary. As a result, changes in the mental health of the staff and the provision of the services provided were found. Conclusions: The way in which the system of work is configured in the institution presents occupational stressors that affect all the participants, who confront them through their personal capacities, the available resources, the networks of support and the experience acquired; all this is permeated by the ways in which they understand and interpret their role in the framework of work.

Draft Genome Sequence of the First Hypermucoviscous Klebsiella variicola Clinical Isolate.

An antibiotic-susceptible and hypermucoviscous clinical isolate of Klebsiella variicola (K. variicola 8917) was obtained from the sputum of an adult patient. This work reports the complete draft genome sequence of K. variicola 8917 with 103 contigs and an annotation that revealed a 5,686,491-bp circular chromosome containing a total of 5,621 coding DNA sequences, 65 tRNA genes, and an average G+C content of 56.98%.

[Characterization of SHV-5 beta-lactamase-producing Klebsiella pneumoniae in an intensive care unit]. / Caracterización de Klebsiella pneumoniae productora de la beta-lactamasa SHV-5, en una unidad de cuidados intensivos.

OBJECTIVE: To perform the molecular characterization of Klebsiella pneumoniae isolates from pediatric patients and health care workers at the intensive care unit of a tertiary care hospital in Mexico City. MATERIAL AND METHODS: Fifteen Klebsiella pneumoniae isolates collected during an outbreak in June 1996 were analyzed; eight were from patients and seven from health care workers of Mexico's Children's Hospital. Characterization of isolates was carried out by pulsed field gel electrophoresis (PFGE), random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR) and serotyping, beta-Lactamase isoelectric focusing (IEF), and nucleotide sequencing of PCR products. RESULTS: Serotype 61 was predominant and correlated with genomic fingerprints of RAPD and PFGE in 11 of 15 isolates. One SHV-5-producer predominant clone with a high case-fatality rate was identified. CONCLUSIONS: Molecular biology techniques are useful tools to characterize the K. pneumoniae clone isolated from patients and health care workers, suggesting potential cross-transmission. These data call for strengthening control programs to prevent dissemination of nosocomial infections in the studied hospital.

Caracterización de Klebsiella pneumoniae productora de la beta-lactamasa SHV-5, en una unidad de cuidados intensivos / Characterization of SHV-5 beta-lactamase-producing Klebsiella pneumoniae in an intensive care unit

OBJETIVO: Caracterizar molecularmente los aislamientos de Klebsiella pneumoniae obtenidos de pacientes pediátricos y del personal de salud en la unidad de cuidados intensivos de un hospital de tercer nivel de atención en la Ciudad de México, Distrito Federal. MATERIAL Y MÉTODOS: Se analizaron 15 aislamientos de Klebsiella pneumoniae colectadas de un brote durante el mes de junio de 1996, ocho de pacientes y siete de personal del Hospital Infantil de México. Los aislamientos fueron caracterizados por electroforesis en gel de campos pulsados (EGCP), amplificación azarosa del polimorfismo de ADN por reacción en cadena de la polimerasa (AAPD-PCR), y serotipificación, isoelectroenfoque de beta-lactamasas y secuenciación nucleotídica de productos de la reacción en cadena de la polimerasa. RESULTADOS: El serotipo predominante fue el 61 y correlacionó con los perfiles de AAPD-PCR y EGCP en 11 de los 15 aislamientos. Se identificó una clona predominante productora de SHV-5 con una alta letalidad. CONCLUSIONES: Las técnicas de biología molecular fueron herramientas muy útiles en la caracterización de la clona de K. pneumoniae identificada en pacientes y el personal hospitalario, que sugirieron una posible transmisión cruzada. Estos resultados ilustran que se debe apoyar el fortalecimiento de los programas de control para evitar la diseminación de infecciones nosocomiales en esa unidad en estudio.

OBJECTIVE: To perform the molecular characterization of Klebsiella pneumoniae isolates from pediatric patients and health care workers at the intensive care unit of a tertiary care hospital in Mexico City. MATERIAL AND METHODS: Fifteen Klebsiella pneumoniae isolates collected during an outbreak in June 1996 were analyzed; eight were from patients and seven from health care workers of Mexico's Children's Hospital. Characterization of isolates was carried out by pulsed field gel electrophoresis (PFGE), random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR) and serotyping, beta-Lactamase isoelectric focusing (IEF), and nucleotide sequencing of PCR products. RESULTS: Serotype 61 was predominant and correlated with genomic fingerprints of RAPD and PFGE in 11 of 15 isolates. One SHV-5-producer predominant clone with a high case-fatality rate was identified. CONCLUSIONS: Molecular biology techniques are useful tools to characterize the K. pneumoniae clone isolated from patients and health care workers, suggesting potential cross-transmission. These data call for strengthening control programs to prevent dissemination of nosocomial infections in the studied hospital.

Avaliaçäo do diagnóstico e tratamento da crise convulsiva no Setor de Energência pediátrica / Diagnostic and treatment evaluation of seizures crises in the pediatric emergency setting

Conhecer as condutas terapêuticas e diagnósticas dos pediatras em serviços de emergênciafrente a crianças em crise convulsiva. Estudo transversal, consistindo de um questionário estruturado sobre o tratamento da crise convulsiva aplicado a 31 pediatras de emergências de Petrópolis.A maioria dos pediatras (80 por cento, IC 62,5-92,5) trata a criança sempre que chega à emergência em crise, independentemente de sua duraçäo. O diazepam endovenoso é a primeira droga usada por todos. Há um grande uso de fenobarbital intramuscular (61 por cento, 42,1-78,1), sendo a fenitoína endovenosa a segunda opçäo (58 por cento, 39,0-75,4). Poucos usam o diazepam retal (10 por cento, 2,0-25,7), fenobarbital endovenoso (23 por cento, 9,6-41,1) e midazolam endovenoso (19 por cento, 7,4-34,5). As medidas de suporte na convulsäo säo adequadamente usadas pela quase totalidade dos entrevistados. A grande maioria dos entrevistados (75 por cento, 55,4-88,1) tem acesso ao parecer do especialista para decisöes quanto à internaçäo, realizaçäo de exames complementares, e prescriçäo de medicaçäo para casa. Há uma identificaçäo imprecisa das indicaçöes de punçäo lombar na convulsäo febril. Dezenove entrevistados (61 por cento) acham importante a opiniäo do neurologista na emergência. Noventa e quatro por cento dos entrevistados (78,6-99,2) mostram desejo de reciclage, principalmente sobre estado de mal epiléptico (96 por cento, 74,2-97,6) e drogas antiepilépticas (80 por cento, 55,4-88,1). O atendimento das crianças em crise convulsiva é feito satisfatoriamente pelos pediatras. Algumas orientaçöes devem ser feitas sobre administraçäo de drogas antiepilépticas e a investigaçäo da convulsäo febril. O interesse pela reciclagem abre caminho para propostas de educaçäo continuada na área de epilepsia