Quality of Nursing Care Perceived by People With HIV in Brazil: A Cross-Sectional Study.

ABSTRACT: We evaluated the quality of care provided by the nursing team within specialized care services (SCS) from the perspective of persons with HIV (PWH). A cross-sectional study was conducted in 25 SCS selected by a single-stage cluster sampling in 21 municipalities in Brazil. Systematic sampling was performed between October 2019 and March 2020 in the reception areas of SCS locations to choose the study population ( N = 377). The adapted and validated Quality of Care Through the Patient's Eyes-HIV (QUOTE-HIV) questionnaire was used to measure the quality of perceived care, and the Mann-Whitney test to compare the scores between men and women. Of the 377 PWH, most were women (57.71%), Black or Brown (85.9%), heterosexual (67.1%), and cisgendered (96.0%); the mean age was ≥30 years (76.1%). Users' evaluation of the care provided by SCS according to scores of importance and performance of the QUOTE-HIV instrument ranged from 5.60 to 8.95 and 0.03 to 0.76, respectively. The perception of PWH about the quality of care provided by the nursing team in SCS suggests that there are opportunities to improve.

Effectiveness of transdermal fluralaner in the treatment of Lynxacarus radovskyi (Acari: Listrophoridae) in naturally infested domestic cats.

Mites of the species Lynxacarus radovskyi, which are commonly found on domestic cats in Brazil, can cause discomfort, itching, and alopecia. The development of new, safer and more effective treatments with a broad spectrum of activity, including the use of isoxazolines, is needed. The purpose of this study was to assess the efficacy of transdermal fluralaner in domestic cats naturally infested with L. radovskyi. Twenty cats were evaluated by trichograms and divided into two groups of 10 animals. The control group was not treated, while the treated group was given a single topical dose of fluralaner, as per the manufacturer's instructions. The cats were reassessed for the presence of L. radovskyi eggs and mites on days D+7, D+14, D+28, D+42, D+56, D+70, D+84, and D+98. As of D+42, all the animals (100%) tested negative for mites, and remained parasite-free until the end of the study, while the control group tested positive throughout the experiment. It can be concluded that a single dose of fluralaner applied topically was effective in treating cats naturally infested with L. radovskyi.

Effect of phosphorus limitation on Se uptake efficiency in the microalga Nannochloropsis oceanica.

Microalgae are considered an efficient accumulator and promising source of Se for feed additive purposes. This study aimed at investigating, for the first time, the effect of phosphorus limitation on Se accumulation and uptake efficiency in N.oceanica. A range of phosphorus concentrations (0-2470 µM) were tested in either the presence or absence of sodium selenite (0, 5, 30 µM). Se accumulation was increased up to 16-fold and Se uptake efficiency was increased up to 3.6-fold under phosphorus growth-limiting concentrations. N.oceanica was then cultivated in a 1.8L flat-panel photobioreactor in batch operation under two phosphorus growth-limiting concentrations (250 and 750 µM) where the accumulation of Se in the microalgal biomass, as well as its presence in the spent medium were analysed. This study is the first to investigate the effect of phosphorus limitation for increasing Se accumulation in microalgae, and to prevent the release of Se in wastewater.

A Qualitative Study of the Spiritual Aspects of Parenting a Child with Down Syndrome.

Parenting a child with Down syndrome can sometimes present certain difficulties and, thus, spirituality may function as a dimension related to finding meaning in life and as a coping resource. Spirituality is a critical dimension of nursing care, but scarce knowledge is available to specifically inform family nursing practice. The aim of this study was to explore the spiritual aspects of parenting a child with Down syndrome, as a qualitative secondary analysis. This is an observational qualitative study, based on in-depth interviews from 42 participants. Data analysis found seven categories that concern meaning and purpose in life: hope, family strength, spiritual practices, personal beliefs, and love, and trust in healthcare providers. Spirituality is a resource in parents' lives who are living in this situation. Nurses should consider this dimension in supporting families and in improving management of this life and health condition.

Bio-based films/nanopapers from lignocellulosic wastes for production of added-value micro-/nanomaterials.

The growing demand for products with lower environmental impact and the extensive applicability of cellulose nanofibrils (CNFs) have received attention due to their attractive properties. In this study, bio-based films/nanopapers were produced with CNFs from banana tree pseudostem (BTPT) wastes and Eucalyptus kraft cellulose (EKC) and were evaluated by their properties, such as mechanical strength, biodegradability, and light transmittance. The CNFs were produced by mechanical fibrillation (after 20 and 40 passages) from suspensions of BTPT (alkaline pre-treated) and EKC. Films/nanopapers were produced by casting from both suspensions with concentrations of 2% (based in dry mass of CNF). The BTPT films/nanopapers showed greater mechanical properties, with Young's modulus and tensile strength around 2.42 GPa and 51 MPa (after 40 passages), respectively. On the other hand, the EKC samples showed lower disintegration in water after 24 h and biodegradability. The increase in the number of fibrillation cycles produced more transparent films/nanopapers and caused a significant reduction of water absorption for both raw materials. The permeability was similar for the films/nanopapers from BTPT and EKC. This study indicated that attractive mechanical properties and biodegradability, besides low cost, could be achieved by bio-based nanomaterials, with potential for being applied as emulsifying agents and special membranes, enabling more efficient utilization of agricultural wastes.

Estratégias de coping no ajustamento familiar de crianças hospitalizadas por Covid-19 e de suas cuidadoras primárias / Coping strategies in the family adjustment of children hospitalized for covid-19 and their primary caregivers

Introdução: A hospitalização infantil é uma experiência estressante para a própria criança e para sua família. Torna-se um processo singular quando a hospitalização é determinada pelo adoecimento por uma doença pandêmica, como a COVID-19. Embora seja um contexto desconhecido e aparentemente influenciado pelas experiências individuais e coletivas da pandemia por COVID-19, considerando-se outras situações de adoecimento, as famílias buscam estratégias que lhes possibilitam prosperar mesmo na adversidade. Portanto, parte-se do pressuposto que estratégias de Coping são adotadas pelas crianças e suas cuidadoras, a fim de se ajustarem à situação estressora. Objetivo: Analisar as estratégias de Coping de crianças e cuidadoras primárias no ajustamento familiar na situação de hospitalização por COVID-19. Metodologia: Trata-se de um estudo qualitativo exploratório, em que se usou o modelo de resiliência estresse e ajustamento de McCubbing, McCubbing (1993). Participaram dez crianças que foram hospitalizadas por COVID-19, em Belo Horizonte - MG, e quinze cuidadoras primários que tiveram suas crianças hospitalizadas pela COVID-19. A coleta de dados foi realizada por videochamada, a partir de um questionário para obter informações sociodemográficas, além da escala de MOS-SSS aplicados às cuidadoras primárias e dois roteiros de entrevista semiestruturada utilizados para as cuidadoras primárias e outro para as crianças. Os dados qualitativos foram analisados a partir da análise temática reflexiva conforme proposta por Braun e Clark (2016), com suporte do software MAXQDA©. Foram atendidas as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos conforme resoluções 466/12 e 510/2016. Resultados: Pela aplicação da escala de MOS-SSS, as cuidadoras primárias tinham alta percepção de apoio social. As cuidadoras primárias que referiram maior cumplicidade com a equipe e estratégias de prevenção contra o Coronavírus, tiveram apreciações predominantemente positivas e tenderam buscar o apoio dos profissionais. Aquelas que não perceberam este apoio, tiveram apreciações predominantemente negativas e relataram estratégias de Coping relacionadas a espiritualidade e a religiosidade, amar os seus filhos, se questionar e/ou negar a necessidade de hospitalização de suas crianças, a busca por apoio de familiares e amigos por meio de conversas por dispositivos eletrônicos e trocas de acompanhante, quando possível. Três díades crianças-cuidadoras primárias, não tiveram concordância em suas apreciações e apenas uma criança relatou apreciação predominantemente positiva. Elencou como motivo dessa apreciação o brincar e o uso de dispositivos eletrônicos como estratégias de Coping. As demais crianças, relataram maior intensidade de medo, tristeza, tédio e saudade, usaram dispositivos eletrônicos para jogar e conversar com suas famílias, passar o tempo com seus acompanhantes e brincar. Conclusão: A forma com que as crianças e seus cuidadoras primárias vivem e apreciam o momento da hospitalização está ligada às estratégias de enfrentamento utilizadas por elas. Os profissionais de saúde, são fundamentais para identificar as estratégias de Coping utilizadas pelas crianças e suas famílias, favorecendo a sua incorporação e apoiá-los em um ajustamento familiar mais positivo nesta situação de adoecimento.

Introduction: Children's hospitalization is a stressful experience for the child and the family. It becomes a unique process when hospitalization is determined by illness from a pandemic disease, such as COVID-19. Although it is an unknown context and apparently influenced by the individual and collective experiences of the pandemic by COVID-19, considering other situations of illness, families seek strategies that allow them to thrive even in adversity. Therefore, it is assumed that coping strategies are adopted by children and their caregivers in order to adjust to the stressful situation. Objective: To analyze the Coping strategies of children and primary caregivers in the family adjustment in the situation of hospitalization for COVID-19. Methodology: This is an exploratory qualitative study, in which McCubbing, McCubbing's (1993) model of stress resilience and adjustment was used. Ten children who were hospitalized for COVID-19 in Belo Horizonte - MG, and fifteen primary caregivers who had their children hospitalized for COVID-19 participated. The data collection was performed by video call, from a questionnaire to obtain sociodemographic information applied to the primary caregivers and two semi-structured interview scripts used for the primary caregivers and another one for the children. The qualitative data were analyzed from the reflective thematic analysis as proposed by Braun and Clark (2016), with support from the MAXQDA© software. Regulatory guidelines and standards for research involving human subjects as per resolutions 466/12 and 510/2016 were met. Results: Primary caregivers who reported greater complicity with the team and prevention strategies against Coronavirus, had predominantly positive appreciations and tended to seek support from professionals. Those who did not perceive this support had predominantly negative evaluations and reported coping strategies related to spirituality and religiosity, loving their children, questioning and/or denying the need for hospitalization of their children, the search for support from family members and friends through conversations by electronic devices and change of companion, when possible. Three children-primary caregiver's binomials did not agree in their assessments, and only one child reported a predominantly positive assessment. She listed playing and the use of electronic devices as coping strategies. The other children, reported higher intensity of fear, sadness, boredom and longing, used electronic devices to play and talk to their families, spend time with their companions and play. Conclusion: The way children and their primary caregivers live and enjoy the moment of hospitalization is linked to the coping strategies used by them. Health professionals, are fundamental to identify the Coping strategies used by children and their families, favoring their incorporation and supporting them in a more positive family adjustment in this situation of illness.

Nitrergic neurons of the forepaw representation in the rat somatosensory and motor cortices: A quantitative study.

Nitrergic neurons (NNs) are inhibitory neurons capable of releasing nitric oxide (NO) that are labeled with nicotinamide adenine dinucleotide phosphate diaphorase histochemistry. The rat primary somatosensory (S1) and motor (M1) cortices are a favorable model to investigate NN populations by comparing their morphology, since these areas share the border of forepaw representation. The distribution of the Type I NN of the forepaw representation in the S1 and M1 cortices of the rat in different laminar compartments and the morphological parameters related to the cell body and dendritic arborization were measured and compared. We observed that the neuronal density in the S1 (130 NN/mm3 ) was higher than the neuronal density in the M1 (119 NN/mm3 ). Most NN neurons were multipolar (S1 with 58%; M1 with 69%), and a minority of the NN neurons were horizontal (S1 with 6%; M1 with 12%). NN found in S1 had a higher verticality index than NN found in M1, and no significant differences were observed for the other morphological parameters. We also demonstrated significant differences in most of the morphological parameters of the NN between different cortical compartments of S1 and M1. Our results indicate that the NN of the forepaw in S1 and M1 corresponds to a neuronal population, where the functionality is independent of the different types of sensory and motor processing. However, the morphological differences found between the cortical compartments of S1 and M1, as well as the higher density of NNs found in S1, indicate that the release of NO varies between the areas.

Problem-solving and coping in family adaptation of children with Down Syndrome.

OBJECTIVE: To analyze problem-solving and coping strategies of parents of children with Down Syndrome in family adaptation. METHOD: This is a qualitative research that used the Resiliency Model of Family Stress, Adjustment, and Adaptation. Participants were mothers and/or fathers from 40 families of children aged 1 to 7 years diagnosed with DS. Directed content analysis was performed, supported by software and considering a code dictionary. RESULTS: Problem-solving and coping proved to be a set of actions, behaviors, efforts, and communications that contributed to family adaptation and favored balance between the demands imposed by Down Syndrome and the acquisition of resources by the family. CONCLUSION: In the first moment, which corresponds to the time of news or diagnosis of the syndrome and the first days after birth, internal and external resources, which represent coping, are developed to accept and refocus ideas and feelings towards Down Syndrome. Over time these resources have an effect and cause changes in family functioning patterns and in the relationship of these families with the outside world, as they seek child development.

Problem-solving and coping in family adaptation of children with Down Syndrome / Afrontamiento y resolución de problemas en la adaptación familiar de niños con Síndrome de Down / Coping e resolução de problemas na adaptação familiar de crianças com Síndrome de Down

ABSTRACT Objective: To analyze problem-solving and coping strategies of parents of children with Down Syndrome in family adaptation. Method: This is a qualitative research that used the Resiliency Model of Family Stress, Adjustment, and Adaptation. Participants were mothers and/or fathers from 40 families of children aged 1 to 7 years diagnosed with DS. Directed content analysis was performed, supported by software and considering a code dictionary. Results: Problem-solving and coping proved to be a set of actions, behaviors, efforts, and communications that contributed to family adaptation and favored balance between the demands imposed by Down Syndrome and the acquisition of resources by the family. Conclusion: In the first moment, which corresponds to the time of news or diagnosis of the syndrome and the first days after birth, internal and external resources, which represent coping, are developed to accept and refocus ideas and feelings towards Down Syndrome. Over time these resources have an effect and cause changes in family functioning patterns and in the relationship of these families with the outside world, as they seek child development.

RESUMEN Objetivo: Analizar las estrategias de afrontamiento y resolución de problemas de los padres de niños con Síndrome de Down en la adaptación familiar. Método: Investigación cualitativa, que utilizó el Modelo de Resiliencia, Estrés, Ajuste y Adaptación Familiar. Madres y/o padres de 40 familias participantes, niños de 1 a 7 años y diagnosticados de Síndrome de Down. Se realizó análisis de contenido dirigido, apoyado por software, considerando un diccionario de códigos. Resultados: El afrontamiento y la resolución de problemas se reveló como un conjunto de acciones, comportamientos, esfuerzos y comunicaciones que contribuyeron a la adaptación familiar, favoreciendo el equilibrio entre las demandas impuestas por el síndrome de Down y la adquisición de recursos por parte de la familia. Conclusión: En el período inicial, que comprende el momento de la noticia o diagnóstico del síndrome y los días que comienzan después del nacimiento, se desarrollan los recursos internos y externos que representan el afrontamiento para aceptar y replantear ideas y sentimientos relacionados con el Síndrome de Down. Con el tiempo, estos recursos repercuten en cambios en los patrones de funcionamiento familiar y en la relación de estas familias con el mundo exterior, en la búsqueda del desarrollo infantil.

RESUMO Objetivo: Analisar as estratégias de coping e resolução de problemas, de pais de crianças com Síndrome de Down, na adaptação familiar. Método: Investigação qualitativa, que utilizou o Modelo de Resiliência, Stress, Ajustamento e Adaptação Familiar. Participaram mães e/ou pais de 40 famílias, de crianças com idade entre 1 e 7 anos e diagnosticadas com Síndrome de Down. Realizou-se análise de conteúdo direcionada, apoiada por software , considerando um dicionário de códigos. Resultados: Coping e resolução de problemas se revelou como um conjunto de ações, comportamentos, esforços e comunicações que contribuíram para a adaptação familiar, favorecendo o equilíbrio entre as demandas impostas pela Síndrome de Down e a aquisição de recursos pela família. Conclusão: No período inicial, que compreende o momento da notícia ou diagnóstico da síndrome e os dias inicias após o nascimento, os recursos internos e externos que representam coping são desenvolvidos para aceitar e ressignificar ideias e sentimentos relacionados à Síndrome de Down. Ao longo do tempo, esses recursos repercutem em mudanças nos padrões familiares de funcionamento e na relação dessas famílias com o mundo externo, ao buscarem o desenvolvimento da criança.

Factors associated with the discontinuance of outpatient follow-up in neonatal units.

OBJECTIVES: to identify predisposing and enabling factors as well as the health needs associated with the discontinuance of outpatient follow-up of newborns who were hospitalized at neonatal intensive care unit. METHODS: cross-sectional study, using the behavioral model of health services use. The study was composed of 358 mothers and newborns referred to the outpatient follow-up after discharge. Characterization, perception of social support, postnatal depression, and attendance to appointments data were collected, analyzed by the R software (3.3.1). RESULTS: outpatient follow-up was discontinued by 31.28% of children in the first year after discharge. In multiple regression analysis, the chance of discontinuance was higher for newborns who used mechanical ventilation (OR = 1.68; 95%CI 1.04-2.72) and depended on technology (OR = 3.54; 95%CI 1.32-9.5). CONCLUSIONS: predisposing factors were associated with the discontinuance of follow-up; enabling factors and health needs did not present a significant association. Children with more complex health conditions require additional support to participate in follow-up programs, thus ensuring the continuity of care.

Trabalho em equipe na atenção básica à saúde: pesquisa bibliográfica / Teamwork in primary health care: bibliographic research / Trabajo en equipo en atención primaria de salud: investigación bibliografica

O objetivo foi analisar os aspectos conceituais do trabalho em equipe na atenção básica à saúde mediante pesquisa bibliográfica. Foram selecionados artigos indexados no período de 2003 a 2013, nas bases de dados LILACS e SciELO, com o tema trabalho em equipe na atenção básica. Para análise do material selecionado, foram utilizadas técnicas de leitura. Foram evidenciadas três categorias: a) Construção coletiva de práticas de saúde com objetivos comuns, como estratégia na produção do cuidado; b) Rede de relações, interações e integrações entre profissionais de saúde, corresponsabilizando os agentes técnicos na produção do cuidado; c) Interdisciplinaridade nas ações de saúde, envolvendo os saberes profissionais como estratégia para cuidado da população. Em suma, o trabalho em equipe favorece ruptura da assistência centrada no modelo biomédico, superando relações verticalizadas e saberes fragmentados, bem como construindo novas estratégias de intervenção na comunidade.

The objective was to analyze the conceptual aspects of teamwork in basic health care through bibliographic research. Articles indexed in the period 2003 to 2013 were selected in the LILACS and SciELO databases, with the theme teamwork in basic care. For the analysis of the selected material he used reading techniques. Three categories emerged: a) Collective construction of health practices with common objectives, as a strategy in the production of care; b) Network of relationships, interactions and integrations among health professionals, co-responsible for technical agents in the production of care; c) Interdisciplinarity in health actions, involving the professional knowledge as a strategy for care of the population. In short, teamwork favors the disruption of assistance centered on the biomedical model, overcoming vertical relationships and fragmented knowledge, as well as constructing new intervention strategies in the community.

El objetivo fue analizar los aspectos conceptuales del trabajo en equipo en atención básica de salud a través de la investigación bibliográfica. Se seleccionaron artículos indizados durante el período 2003-2013 en las bases de datos LILACS y SciELO con el tema trabajo en equipo en atención básica. Para el análisis del material seleccionado, fueron utilizadas técnicas de lectura. Surgieron tres categorías: a) Construcción colectiva de las prácticas de salud con objetivos comunes, como una estrategia en la producción de la atención; b) Red de relaciones, interacciones e integraciones entre los profesionales de la salud, corresponsabilizando los agentes técnicos en la producción de la atención; c) Interdisciplinariedad en acciones de salud, con el conocimiento profesional como una estrategia para la atención de la población. En definitiva, el trabajo en equipo favorece la ruptura de la asistencia centrada en el modelo biomédico, superando relaciones verticalistas y saberes fragmentados, así como la construcción de nuevas estrategias de intervención en la comunidad.

Factors associated with the discontinuance of outpatient follow-up in neonatal units / Factores asociados con la interrupción del seguimiento ambulatorio de recién nacidos tras el alta de unidades neonatales / Fatores associados à descontinuidade do seguimento ambulatorial de egressos de unidades neonatais

ABSTRACT Objectives: to identify predisposing and enabling factors as well as the health needs associated with the discontinuance of outpatient follow-up of newborns who were hospitalized at neonatal intensive care unit. Methods: cross-sectional study, using the behavioral model of health services use. The study was composed of 358 mothers and newborns referred to the outpatient follow-up after discharge. Characterization, perception of social support, postnatal depression, and attendance to appointments data were collected, analyzed by the R software (3.3.1). Results: outpatient follow-up was discontinued by 31.28% of children in the first year after discharge. In multiple regression analysis, the chance of discontinuance was higher for newborns who used mechanical ventilation (OR = 1.68; 95%CI 1.04-2.72) and depended on technology (OR = 3.54; 95%CI 1.32-9.5). Conclusions: predisposing factors were associated with the discontinuance of follow-up; enabling factors and health needs did not present a significant association. Children with more complex health conditions require additional support to participate in follow-up programs, thus ensuring the continuity of care.

RESUMEN Objetivso: identificar los factores predisponentes y facilitadores, y las necesidades de salud asociadas a la interrupción del seguimiento ambulatorio de recién nacidos tras el alta de unidades de cuidados intensivos neonatais. Métodos: estudio transversal, que utilizó el modelo conductual de utilización de servicios de salud. Participaron 358 madres y recién nacidos, que fueron orientados al seguimiento ambulatorio para el alta hospitalaria. Se recogieron los datos de caracterización, de percepción de apoyo social, de depresión posparto y de asiduidad a las consultas, siendo analizados en el software R (3.3.1). Resultados: el siguimiento ambulatorio fue interrumpido por el 31,28% de los niños durante el primer año tras el alta. En el análisis de regresión múltiple, la probabilidad de interrumpir el seguimiento fue mayor entre los recién nacidos que utilizaron ventilación mecánica (OR = 1,68; IC 95% 1,04-2,72) y dependían de la tecnología (OR = 3,54; IC 95% 1,32-9,5). Conclusión: los factores predisponentes fueron asociados con la interrupción del seguimiento; sin embargo, los factores facilitadores y las necesidades de salud no presentaron una asociación significativa. Los niños que presentaban condiciones de salud más complejas requirieron apoyo adicional para participar en los programas de seguimiento y garantizar la continuidad del cuidado.

RESUMO Objetivos: identificar fatores predisponentes e capacitantes e necessidades de saúde associados à descontinuidade do seguimento ambulatorial de recém-nascidos egressos de terapia intensiva neonatal. Métodos: estudo transversal, utilizando o modelo comportamental de utilização de serviços de saúde. Participaram 358 mães e recém-nascidos encaminhados ao seguimento ambulatorial à alta hospitalar. Foram coletados dados de caracterização, percepção de apoio social, depressão pós-parto e assiduidade às consultas, sendo analisados no software R (3.3.1). Resultados: o seguimento ambulatorial foi descontinuado por 31,28% das crianças no primeiro ano após a alta. Em análise de regressão múltipla, a chance da descontinuidade foi maior nos recém-nascidos que utilizaram ventilação mecânica (OR = 1,68; IC 95% 1,04-2,72) e dependiam de tecnologia (OR = 3,54; IC 95% 1,32-9,5). Conclusões: fatores predisponentes estiveram associados à descontinuidade do seguimento; fatores capacitantes e necessidades de saúde não apresentaram associação significativa. Crianças com condições de saúde mais complexas requerem suporte adicional para participação nos programas de seguimento e garantia da continuidade do cuidado.

O consumo excessivo de álcool e a insatisfação com a imagem corporal por adolescentes e jovens de um município baiano, Brasil / Excessive alcohol intake and dissatisfaction with body image among adolescents and young adults in a municipality in Bahia State, Brazil / El consumo excesivo de alcohol y la insatisfacción con la imagen corporal por parte de adolescentes y jóvenes de un municipio bahiano, Brasil

Resumo: O estudo tem como objetivo analisar a associação entre o consumo excessivo de álcool e a insatisfação com a imagem corporal em população de adolescentes e jovens. Trata-se de um estudo transversal, tipo inquérito domiciliar, realizado com 1.582 indivíduos entre a faixa etária de 15 a 24 anos, residentes em Camaçari, Bahia, Brasil. O consumo excessivo de álcool foi identificado pelo Alcohol Use Disorder Identification Test (AUDIT), e a insatisfação com a imagem corporal, pela Escala de Figura de Silhuetas. As variáveis confundidoras foram: sexo, idade, raça, escolaridade, trabalho, religião, composição familiar, número de amigos próximos, estado conjugal e filhos. A associação entre consumo excessivo e insatisfação corporal foi estimada por meio de regressão logística. A prevalência para o consumo excessivo de álcool foi de 21,9%, sendo maior entre o sexo masculino, e, para a insatisfação com a imagem corporal, foi de 79,5%, sendo maior entre o sexo feminino. Não foi encontrada associação estatisticamente significante entre consumo excessivo de álcool e insatisfação com a imagem corporal. Após ajuste do modelo final, as variáveis que permaneceram associadas com o consumo excessivo foram: religião (OR = 2,02), escolaridade (OR = 1,63), composição familiar (OR = 1,61), idade (OR = 0,55) e trabalho (OR = 0,61). Ainda que as análises não evidenciassem a associação entre o consumo excessivo de álcool e a insatisfação com a imagem corporal, os resultados deste estudo chamam a atenção para as altas prevalências em relação aos dois fenômenos. Dessa forma, evidencia-se a necessidade de desenvolvimento de intervenções voltadas às práticas de cuidado para essa população específica.

Abstract: The study aimed to analyze the association between excessive alcohol intake and dissatisfaction with one's body image in a population of adolescents and young adults. This was a cross-sectional study with a household survey design in a sample of 1,582 individuals 15 to 24 years of age living in Camaçari, Bahia State, Brazil. Excessive alcohol intake was identified by the Alcohol Use Disorder Identification Test (AUDIT), and dissatisfaction with body image was measure with the Silhouette Figure Scale. Confounding variables were: sex, age, race, schooling, work, religion, family composition, number of close friends, marital status, and children. The association between excessive alcohol intake and body dissatisfaction was estimated by logistic regression. Prevalence of excessive alcohol intake was 21.9% (higher in males), and prevalence of body image dissatisfaction was 79.5% (higher in females). No statistically significant association was found between excessive alcohol intake and dissatisfaction with body image. After adjustment of the final model, the variables that remained associated with excessive alcohol intake were religion (OR = 2.02), schooling (OR = 1.63), family composition (OR = 1.61), age (OR = 0.55), and work (OR = 0.61). Although the analyses did not show an association between excessive alcohol intake and dissatisfaction with body image, the study's results call attention to the high prevalence rates for the two phenomena. This shows the need to develop interventions focused on practices of care for this specific population.

Resumen: El estudio tiene como objetivo analizar la asociación entre el consumo excesivo de alcohol y la insatisfacción con la imagen corporal en una población de adolescentes y jóvenes. Se trata de un estudio transversal, de tipo encuesta domiciliaria, realizada a 1.582 individuos en la franja etaria de 15 a 24 años, residentes en Camaçari, Bahía, Brasil. El consumo excesivo de alcohol fue identificado por el Alcohol Use Disorder Identification Test (AUDIT) y la insatisfacción con la imagen corporal mediante la Escala de Figura de Siluetas. Las variables confusoras fueron: sexo, edad, raza, escolaridad, trabajo, religión, estructura familiar, números de amigos cercanos, estado conyugal e hijos. La asociación entre el consumo excesivo y la insatisfacción corporal se estimó mediante regresión logística. La prevalencia del consumo excesivo de alcohol fue de un 21,9%, siendo mayor entre el sexo masculino, y de insatisfacción con la imagen corporal fue de un 79,5%, siendo mayor entre el sexo femenino. No se encontró una asociación estadísticamente significativa entre consumo excesivo de alcohol e insatisfacción con la imagen corporal. Tras el ajuste del modelo final, las variables que permanecieron asociadas con el consumo excesivo fueron: religión (OR = 2,02), escolaridad (OR = 1,63), estructura familiar (OR = 1,61), edad (OR = 0,55) y trabajo (OR = 0,61). A pesar de que los análisis no evidenciaron la asociación entre el consumo excesivo de alcohol e insatisfacción con la imagen corporal, los resultados de este estudio llaman la atención por las altas prevalencias respecto a los dos fenómenos. De esta forma, se evidencia la necesidad del desarrollo de intervenciones dirigidas a prácticas de cuidado para esta población específica.

Hass avocado (Persea americana Mill.) oil enriched in phenolic compounds and tocopherols by expeller-pressing the unpeeled microwave dried fruit.

This study investigated how the quality of avocado oil is affected by the fruit ripening stage and peeling, and the drying process used. Expeller pressed avocado oils were obtained from unripe or ripe pitted avocados after drying peeled or unpeeled pulps by convection oven, microwave or freeze-drying. Oils from the unpeeled microwave dried pulp (from unripe or ripe avocados) showed the highest induction period (54.2-83.6 h) and antioxidant capacity (4.07-5.26 mmol TE/kg), and high amounts (mg/100 g) of α-tocopherol (11.6-21.0), ß-carotene (0.49-0.65) and chlorophyll (44.3-54.0), and unsaponifiable matter (2.48-2.99 g/100 g). Pulp drying process and avocado (un)peeling were the major contributors to the induction period (R2 = 0.61; p = 0.0139) and antioxidant capacity (R2 = 0.62; p = 0.011), and the oils from microwave dried unpeeled pulp were those that presented the best performance. The phenolic composition of these oils improved with ripening and keeping the peel during the pressing process.

[Excessive alcohol intake and dissatisfaction with body image among adolescents and young adults in a municipality in Bahia State, Brazil]. / O consumo excessivo de álcool e a insatisfação com a imagem corporal por adolescentes e jovens de um município baiano, Brasil.

The study aimed to analyze the association between excessive alcohol intake and dissatisfaction with one's body image in a population of adolescents and young adults. This was a cross-sectional study with a household survey design in a sample of 1,582 individuals 15 to 24 years of age living in Camaçari, Bahia State, Brazil. Excessive alcohol intake was identified by the Alcohol Use Disorder Identification Test (AUDIT), and dissatisfaction with body image was measure with the Silhouette Figure Scale. Confounding variables were: sex, age, race, schooling, work, religion, family composition, number of close friends, marital status, and children. The association between excessive alcohol intake and body dissatisfaction was estimated by logistic regression. Prevalence of excessive alcohol intake was 21.9% (higher in males), and prevalence of body image dissatisfaction was 79.5% (higher in females). No statistically significant association was found between excessive alcohol intake and dissatisfaction with body image. After adjustment of the final model, the variables that remained associated with excessive alcohol intake were religion (OR = 2.02), schooling (OR = 1.63), family composition (OR = 1.61), age (OR = 0.55), and work (OR = 0.61). Although the analyses did not show an association between excessive alcohol intake and dissatisfaction with body image, the study's results call attention to the high prevalence rates for the two phenomena. This shows the need to develop interventions focused on practices of care for this specific population.

O estudo tem como objetivo analisar a associação entre o consumo excessivo de álcool e a insatisfação com a imagem corporal em população de adolescentes e jovens. Trata-se de um estudo transversal, tipo inquérito domiciliar, realizado com 1.582 indivíduos entre a faixa etária de 15 a 24 anos, residentes em Camaçari, Bahia, Brasil. O consumo excessivo de álcool foi identificado pelo Alcohol Use Disorder Identification Test (AUDIT), e a insatisfação com a imagem corporal, pela Escala de Figura de Silhuetas. As variáveis confundidoras foram: sexo, idade, raça, escolaridade, trabalho, religião, composição familiar, número de amigos próximos, estado conjugal e filhos. A associação entre consumo excessivo e insatisfação corporal foi estimada por meio de regressão logística. A prevalência para o consumo excessivo de álcool foi de 21,9%, sendo maior entre o sexo masculino, e, para a insatisfação com a imagem corporal, foi de 79,5%, sendo maior entre o sexo feminino. Não foi encontrada associação estatisticamente significante entre consumo excessivo de álcool e insatisfação com a imagem corporal. Após ajuste do modelo final, as variáveis que permaneceram associadas com o consumo excessivo foram: religião (OR = 2,02), escolaridade (OR = 1,63), composição familiar (OR = 1,61), idade (OR = 0,55) e trabalho (OR = 0,61). Ainda que as análises não evidenciassem a associação entre o consumo excessivo de álcool e a insatisfação com a imagem corporal, os resultados deste estudo chamam a atenção para as altas prevalências em relação aos dois fenômenos. Dessa forma, evidencia-se a necessidade de desenvolvimento de intervenções voltadas às práticas de cuidado para essa população específica.

El estudio tiene como objetivo analizar la asociación entre el consumo excesivo de alcohol y la insatisfacción con la imagen corporal en una población de adolescentes y jóvenes. Se trata de un estudio transversal, de tipo encuesta domiciliaria, realizada a 1.582 individuos en la franja etaria de 15 a 24 años, residentes en Camaçari, Bahía, Brasil. El consumo excesivo de alcohol fue identificado por el Alcohol Use Disorder Identification Test (AUDIT) y la insatisfacción con la imagen corporal mediante la Escala de Figura de Siluetas. Las variables confusoras fueron: sexo, edad, raza, escolaridad, trabajo, religión, estructura familiar, números de amigos cercanos, estado conyugal e hijos. La asociación entre el consumo excesivo y la insatisfacción corporal se estimó mediante regresión logística. La prevalencia del consumo excesivo de alcohol fue de un 21,9%, siendo mayor entre el sexo masculino, y de insatisfacción con la imagen corporal fue de un 79,5%, siendo mayor entre el sexo femenino. No se encontró una asociación estadísticamente significativa entre consumo excesivo de alcohol e insatisfacción con la imagen corporal. Tras el ajuste del modelo final, las variables que permanecieron asociadas con el consumo excesivo fueron: religión (OR = 2,02), escolaridad (OR = 1,63), estructura familiar (OR = 1,61), edad (OR = 0,55) y trabajo (OR = 0,61). A pesar de que los análisis no evidenciaron la asociación entre el consumo excesivo de alcohol e insatisfacción con la imagen corporal, los resultados de este estudio llaman la atención por las altas prevalencias respecto a los dos fenómenos. De esta forma, se evidencia la necesidad del desarrollo de intervenciones dirigidas a prácticas de cuidado para esta población específica.

Discontinuity of outpatient follow-up of risk children: perspective of mothers / Descontinuidad del seguimiento ambulatorial de niños de riesgo: perspectiva de las madres / Descontinuidade do seguimento ambulatorial de crianças de risco: perspectiva das mães

ABSTRACT Objective: to identify aspects that contribute to the discontinuation of outpatient follow-up of newborns from Neonatal Intensive Care Units (NICU) from the perspective of mothers. Method: exploratory, qualitative study, whose theoretical framework was Symbolic Interactionism. Fifteen mothers of children with NICU who discontinued outpatient follow-up in Belo Horizonte-MG were included in a semi-structured interview. Data were analyzed based on the proposal of Hsieh and Shannon. Results: distance from the health service, absence of family support, difficulty in leaving work, maternal health status, organization of the health service itself and deficiency of public transportation were predisposing factors for outpatient abandonment. Mothers understand that their children do not need differentiated care of children at usual risk. Conclusion: service organization, socioeconomic status of the family and social support perceived by mothers were related with the lack of compliance with outpatient follow-up.

RESUMEN Objetivo: identificar aspectos que contribuyen a la discontinuidad del seguimiento ambulatorio de niños egresados de Unidades de Terapia Intensiva Neonatal (UTIN) bajo la perspectiva materna. Método: estudio exploratorio, cualitativo, cuyo referencial teórico fue el Interaccionismo Simbólico. Se incluyó, por medio de una entrevista semiestructurada, 15 madres de niños egresados de UTIN que discontinuaron el seguimiento ambulatorial en la ciudad de Belo Horizonte, estado de Minas Gerais. Los datos fueron analizados basados en la propuesta de Hsieh y Shannon. Resultados: la distancia del servicio de salud, ausencia de apoyo familiar, dificultad para ausentarse del trabajo, condición de salud materna, organización del propio servicio de salud y deficiencia del transporte público fueron aspectos predisponentes para el abandono ambulatorial. Las madres entienden que sus hijos no necesitan los cuidados diferenciados de niños de riesgo habitual. Conclusión: la organización del servicio, la condición socioeconómica de la familia y el apoyo social percibido por las madres estuvieron conexo a la falta de adhesión al seguimiento ambulatorial.

RESUMO Objetivo: identificar aspectos que contribuem para a descontinuidade do seguimento ambulatorial de crianças egressas de Unidades de Terapia Intensiva Neonatal (UTIN), sob a perspectiva materna. Método: estudo exploratório, qualitativo, cujo referencial teórico foi o Interacionismo Simbólico. Incluiu-se, por meio de entrevista semiestruturada, 15 mães de crianças egressas de UTIN que descontinuaram o seguimento ambulatorial em Belo Horizonte-MG. Os dados foram analisados baseados na proposta de Hsieh e Shannon. Resultados: a distância do serviço de saúde, ausência de apoio familiar, dificuldade de se ausentar do trabalho, condição de saúde materna, organização do próprio serviço de saúde e deficiência do transporte público foram aspectos predisponentes para o abandono ambulatorial. As mães entendem que seus filhos não precisam de cuidados diferenciados de crianças de risco habitual. Conclusão: a organização do serviço, a condição socioeconômica da família e apoio social percebido pelas mães esteve relacionado à falta de adesão ao seguimento ambulatorial.

Symbiodinium-Induced Formation of Microbialites: Mechanistic Insights From in Vitro Experiments and the Prospect of Its Occurrence in Nature.

Dinoflagellates in the genus Symbiodinium exhibit a variety of life styles, ranging from mutualistic endosymbioses with animal and protist hosts to free-living life styles. In culture, Symbiodinium spp. and naturally associated bacteria are known to form calcifying biofilms that produce so-called symbiolites, i.e., aragonitic microbialites that incorporate Symbiodinium as endolithic cells. In this study, we investigated (i) how algal growth and the combined physiological activity of these bacterial-algal associations affect the physicochemical macroenvironment in culture and the microenvironment within bacterial-algal biofilms, and (ii) how these interactions induce the formation of symbiolites. In batch culture, calcification typically commenced when Symbiodinium spp. growth approached stationary phase and when photosynthetic activity and its influence on pH and the carbonate system of the culture medium had already subsided, indicating that symbiolite formation is not simply a function of photosynthetic activity in the bulk medium. Physical disturbance of bacteria-algal biofilms, via repeated detaching and dispersing of the developing biofilm, generally impeded symbiolite formation, suggesting that the structural integrity of biofilms plays an important role in generating conditions conducive to calcification. Microsensor measurements of pH and O2 revealed a biofilm microenvironment characterized by high photosynthetic rates and by dynamic changes in photosynthesis and respiration with light intensity and culture age. Ca2+ microsensor measurements confirmed the significance of the biofilm microenvironment in inducing calcification, as photosynthesis within the biofilm induced calcification without the influence of batch culture medium and under environmentally relevant flow conditions. Furthermore, first quantitative data on calcification from 26 calcifying cultures enabled a first broad comparison of Symbiodinium-induced bacterial-algal calcification with other calcification processes. Our findings support the idea that symbiolite formation is a typical, photosynthesis-induced, bacterial-algal calcification process that is likely to occur under natural conditions.

Interlaboratory study for the establishment of Brazilian Bothrops Reference Venom and Antivenom for potency evaluation of Bothrops antivenom.

A collaborative study was performed for the establishment of the 5th lot of Brazilian Bothrops Reference Venom and the 1st lot of Brazilian Bothrops Reference Antivenom. All Brazilian manufacturers of Antibothrops Immunoglobulins and the National Control Laboratory participated of the study. The declared potency of the 5th lot of the Bothrops Reference Venom is 40.29 µg/0.5 ml, and the potency of the 1st lot of Bothrops Reference Antivenom is 6.51 mg/ml. For the potency evaluation of Bothrops Reference Venom the inter assay precision (gCV) was 3.25% in lab 01; 3.51% in INCQS; 4.71% in lab 03 and 25.11% in lab 02, and the inter laboratory precision was 13.76%. The intra assay precision of Bothrops Reference Antivenom determinations was 4.38% in INCQS; 8.47% in lab 02; 10.51% in lab 03 and 20.05% in lab 01. The inter assay precision was 3.51% in INCQS; 9.65% in lab 02; 18.03% in lab 01 and 20.23% in lab 03. The inter laboratory precision was 15.85%. Despite the high number of invalid results (55.6% for the pharmacopoeial method and 69.4% for the proposed method) the parallel line assay, have better inter laboratorial precision (gCV = 16.62%) than the pharmacopoeial potency assay (gCV = 38.28%).

Healthcare-Associated Infections in Pediatric and Neonatal Intensive Care Units: Impact of Underlying Risk Factors and Antimicrobial Resistance on 30-Day Case-Fatality in Italy and Brazil.

OBJECTIVES To describe trends in the epidemiology of healthcare-associated Infections (HAIs) in pediatric/neonatal intensive care units (ICUs) and to evaluate risk factors and impact of multidrug resistance in children admitted to ICUs. DESIGN Multicenter, retrospective, cohort study with a nested case-control study conducted from January 1, 2010, through December 31, 2014. SETTING Three tertiary care pediatric hospitals in Italy and Brazil with a total of 103 ICU beds. PATIENTS Inclusion criteria were admission to ICU during the study period, age at onset less than 18 years, and microbiologically confirmed HAI. RESULTS A total of 538 HAIs in 454 children were included; 93.3% of patients had comorbidities. Bloodstream infections were the leading pattern (45.4%). The cumulative incidence of HAI was 3.6/100 ICU admissions and the crude 30-day fatality rate was 5.7/1,000 admissions. The most frequently isolated pathogens were Enterobacteriaceae, followed by Pseudomonas aeruginosa and Staphylococcus aureus. Forty-four percent of isolates were multidrug-resistant (MDR). Two multivariate logistic regressions were performed. Factors independently associated with an MDR-HAI were country, previous antibiotics, transplantation, major surgery, and colonization by an MDR strain. Factors independently associated with 30-day case fatality were country, previous transplantation, fungal infection, bloodstream infection, lower respiratory tract infection, and infection caused by MDR strains. CONCLUSIONS Infection control and prevention can limit the spread of MDR strains and improve outcomes. Targeted surveillance programs collecting neonatal and pediatric HAI/bloodstream infection data and outcomes would allow global benchmarking. The next step is to identify methods to monitor key HAIs and integrate these into affordable intervention programs. Infect Control Hosp Epidemiol 2016;1-8.

Characterization of symptoms and edema distribution in premenstrual syndrome.

BACKGROUND: Premenstrual syndrome is a group of symptoms linked to the menstrual cycle, and edema is among these symptoms. Physiotherapy is often sought by many patients for the treatment of edema; however, for an adequate prescription of physiotherapeutic procedures, the distribution of edema throughout the body has yet to be characterized. OBJECTIVE: To determine the most frequent symptoms and body regions that present with edema in women during the premenstrual period. SUBJECTS AND METHODS: Sixty women with a mean age of 24.6±4.7 years were evaluated during their premenstrual (between days 21 and 28) and menstrual period (between days 1 and 3), and the collected data included body mass, height, biotype (body-fat distribution), face, breast, limb-circumference measurements, and limb-volume estimate, and an adapted version of the Premenstrual Symptoms Screening Tool was used. Statistical analysis was performed using Student's t-test and the test for equality of two proportions (P≤0.05). RESULTS: Premenstrual syndrome was identified in 91.7% of the women, and the most frequent symptoms were irritability (73.33%) and physical symptoms, including swelling (65%), and anxiety (58.3%). Edema was detected in the following areas: facial, epigastric, mammary, umbilical, and pubic, the mid-third of the arms, distal forearm, in both thighs and in the mid-third of the legs determined by circumference measurements, and in both upper and lower limbs, according to the estimated volume. CONCLUSION: In this study population, the most frequent symptoms were irritability, physical symptoms, and anxiety, with distribution of edema in the face, breast, abdomen, pubic area, distal upper limb, and proximal lower limb.