Bridging the Gap: Exploring the Preclinical Potential of Pereskia grandifolia in Metabolic-Associated Fatty Liver Disease.

Metabolic-associated fatty liver disease (MAFLD) is a complex condition characterized by steatosis and metabolic disturbances. Risk factors such as diabetes, cigarette smoking, and dyslipidaemia contribute to its development and progression. Effective and safe therapies for MAFLD are urgently needed. Pereskia grandifolia has shown potential as an alternative treatment, but its effectiveness against liver disease remains unexplored. This research aims to determine the hepatoprotective properties of P. grandifolia using a model of MAFLD. The study was carried out through various phases to assess the safety and efficacy of the ethanol-soluble fraction of P. grandifolia. Initially, an in vitro assay was performed to assess cell viability. This was followed by an acute toxicity test conducted in rats to determine the safety profile of the extract. Subsequently, the anti-inflammatory properties of P. grandifolia were examined in macrophages. For the MAFLD study, diabetic Wistar rats were made diabetic and exposed to a high fat diet and cigarette smoke, for 4 weeks. During the last 2 weeks, the rats were orally given either the vehicle (negative control group; C-), P. grandifolia (30, 100, and 300 mg/kg), or insulin in addition to simvastatin. A basal group of rats not exposed to these risk factors was also assessed. Blood samples were collected to measure cholesterol, triglycerides, glucose, ALT, and AST levels. Liver was assessed for lipid and oxidative markers, and liver histopathology was examined. P. grandifolia showed no signs of toxicity. It demonstrated anti-inflammatory effects by inhibiting phagocytosis and macrophage spreading. The MAFLD model induced liver abnormalities, including increased AST, ALT, disrupted lipid profile, oxidative stress, and significant hepatic damage. However, P. grandifolia effectively reversed these changes, highlighting its potential as a therapeutic agent. These findings emphasize the significance of P. grandifolia in mitigating hepatic consequences associated with various risk factors.

Teleworking as a work modality: reflections from institutional analysis.

This opinion article addresses teleworking, which has gained momentum in Brazil due to the COVID-19 pandemic. The discussions arose from a course in the Professional Master's Degree in Health Services Management at a nursing school in the state of Minas Gerais, Brazil. The authors raised teleworking-related questions, which are not only affecting their lives, but also the lives of workers in general, causing problems socially, economically, and related to workers' health. The reflections were drawn up using some concepts from institutional analysis. This article aimed to analyze teleworking as an analyzer of work in the context of the COVID-19 pandemic. As teleworking rapidly took off, the benefits were envisioned, but the potential detriments of this type of work were not considered. As a result, many professionals working from home began to work in unsuitable conditions, lacking the necessary infrastructure and support to perform their activities, such as ergonomic furniture, equipment, materials, internet access, technical assistance, training, and support. However, teleworking should not be overlooked, as many workers have identified with this type of work and many organizations have benefited from it becoming institutionalized. However, we cannot remain "numb," waiting for some miraculous reversion to pre-pandemic conditions, in order to organize the new type of "normal" in the world of work in a less alienated way.

O presente artigo de reflexão aborda a modalidade de trabalho home office, que se intensificou no Brasil a partir do contexto da pandemia da covid-19. As reflexões foram originárias de discussões realizadas em uma disciplina do Curso de Mestrado Profissional em Gestão de Serviços de Saúde, de uma Escola de Enfermagem do estado de Minas Gerais. Os autores problematizaram questões relacionadas ao home office, que estão interferindo em suas vidas, mas, também, na vida dos trabalhadores de modo geral, ocasionando problemas sociais, econômicos e relativos à saúde do trabalhador. As reflexões foram elaboradas em articulação com alguns conceitos da Análise Institucional. O objetivo é analisar o home office considerando-o como analisador do trabalho no contexto da pandemia da covid-19. A partir da célere instalação do trabalho remoto, idealizou-se os benefícios e não foram considerados os possíveis prejuízos dessa modalidade de trabalho. Assim, diversos profissionais em home office passaram a trabalhar em condições inadequadas, sem a infraestrutura necessária e o suporte para a realização das atividades, como a disponibilização de mobiliário ergonômico, equipamentos, materiais, acesso à internet, assistência técnica, capacitações e acompanhamentos. Entretanto, não se pode desprezar a alternativa do home office, pois diversos trabalhadores se identificaram com essa modalidade de trabalho e muitas organizações se beneficiam com a sua institucionalização. Ao mesmo tempo, não se pode ficar "entorpecido", à espera de um milagroso regresso à realidade pré-pandêmica, para organizar de forma menos alienada o novo tipo de "normalidade" no mundo do trabalho.

Tecnologias sociais para ações de gestão de risco em desastres: uma revisão de escopo / Social technologies for disaster risk management actions: a scoping review

RESUMO Objetivou-se mapear a literatura técnico-científica sobre o desenvolvimento de tecnologias sociais em processos de gestão de risco de desastres em comunidades vulneráveis. Trata-se de uma revisão de escopo, conforme metodologia do Joanna Briggs Institute, cujas buscas foram realizadas de agosto a dezembro de 2021 em 11 bancos de dados e na literatura cinzenta. Revisores independentes participaram da seleção, extração e síntese dos dados. Após a triagem de 1.291 publicações, foram incluídos 6 estudos na revisão. Os critérios de elegibilidade basearam-se na sigla PCC (População, Conceito e Contexto). Evidenciou-se que o conceito de tecnologia social traz em sua essência a transformação social e o empoderamento, elementos estratégicos para o enfrentamento sistematizado dos desastres em populações vulneráveis. Novos estudos mais robustos são importantes para analisar o impacto das tecnologias sociais nos desastres, especialmente levando em consideração o desenvolvimento de políticas públicas e a busca pela resiliência comunitária orientada pelos Objetivos de Desenvolvimento Sustentável e pelo Marco de Sendai para a Redução do Risco de Desastres. O número limitado de estudos identificados aponta para a necessidade de apropriação de tecnologias sociais que possam melhorar efetivamente o padrão de gestão de risco perante tais eventos, tanto de origem natural quanto tecnológica.

ABSTRACT The objective was to map the technical-scientific literature on the development of social technologies in disaster risk management processes with vulnerable communities. This is a scoping review, according to the JBI (Joanna Briggs Institute) methodology, whose searches were carried out from August to December 2021 in eleven databases and gray literature. Independent reviewers participated in the selection, extraction, and synthesis of the data. After screening 1,291 publications, six studies were included in the review. Eligibility criteria were based on the acronym PCC (Population, Concept, and Context). It was evidenced that the concept of social technology brings in its essence social transformation and empowerment, strategic elements for the systematic confrontation of disasters with vulnerable populations. New, more robust studies are important to analyze the impact of social technologies on disasters, especially taking into account the development of public policies and the search for community resilience guided by the Sustainable Development Goals and the Sendai Framework for Disaster Risk Reduction. The limited number of studies identified points to the need for the appropriation of social technologies that can effectively improve the standard of risk management in the face of such events, whether of natural or technological origin.

Implementation of mentoring in a medical school - mentors and students' perceptions / Implantação de mentoria em uma faculdade de medicina - perspectiva de mentores e estudantes

Abstract: Introduction: In medical education, mentoring has the important function of supporting and complementing student's education through their relationship with a teacher, which fosters student's global development. Objective: to assess the strengths and weaknesses of a mentoring program in a private school from the perspective of mentors and mentees; to identify, among students who did not participate in mentoring, the reason for not participating, knowledge about the concept of mentoring and the desire to participate in the future. Method: Cross-sectional, descriptive study with a qualitative approach. The study participants included mentors, mentees and students who did not participate in the mentoring program. All participants answered a semi-structured questionnaire and the answers were submitted to a qualitative approach analysis. Results: The answers were divided into two broad categories: strengths - bonding, exposing feelings/self-disclosure, mentoring as a two-way street, space for integration - and weaknesses - organization and scheduling difficulties, conducting group dynamics and addressed topics, of integration between group members. The students who did not participate in mentoring attributed their non-participation to lack of time and reported they wanted to participate in the future. Conclusion: the reports showed strengths and weaknesses of mentoring for mentors and mentees, as well as aspects to be improved. Prospective studies of mentoring programs are needed to identify aspects that promote the development of participants and reduce their suffering, as well as their impact on medical education.

Resumo: Introdução: Mentoria, em escolas médicas, tem a importante função de apoiar e complementar a formação do aluno por meio da sua relação com um professor, que fomenta o desenvolvimento global do estudante. Objetivo: Este estudo teve como objetivos avaliar pontos fortes e fragilidades da mentoria de um curso de Medicina de uma instituição privada sob a perspectiva de mentores e mentorados, e identificar, entre os discentes que não fizeram parte do programa, o motivo da ausência, o conhecimento sobre o conceito de mentoria e o desejo de participar no futuro. Método: Trata-se de estudo transversal, descritivo, com abordagem qualitativa. Participaram do estudo mentores, mentorados e alunos que não participavam do programa. Todos os participantes responderam a um questionário semiestruturado, cujas repostas foram analisadas na abordagem qualitativa. Resultados: As respostas foram divididas em duas amplas categorias: pontos fortes - vínculo, exposição de sentimentos/autorrevelação, mentoria como via de mão dupla e espaço de integração - e fragilidades - dificuldades de organização, de horários, de conduzir a dinâmica de grupos e os temas abordados, e de integração entre membros do grupo. Os estudantes que não fizeram parte da mentoria atribuíram a ausência à falta de tempo e relataram que desejam participar no futuro. Conclusão: Os relatos revelaram pontos fortes e fragilidades da mentoria para mentores e mentorados, bem como aspectos a serem aprimorados. Estudos prospectivos de programas de mentoria são necessários para identificar os aspectos que promovem o desenvolvimento dos participantes e reduzem seu sofrimento, bem como o seu impacto sobre a formação médica.

Microaeration improves the removal/biotransformation of organic micropollutants in anaerobic wastewater treatment systems.

This work assessed the effect of increasing microaeration flow rates (1-6 mL min-1 at 28 °C and 1 atm, equivalent to 0.025-0.152 L O2 L-1 feed) on the removal/biotransformation of seven organic micropollutants (OMPs) (three hormones, one xenoestrogen, and three pharmaceuticals), at 200 µg L-1 each, in a lab-scale upflow anaerobic sludge blanket reactor operated at a hydraulic retention time (HRT) of 7.4 h. Additionally, the operational stability of the system and the evolution of its microbial community under microaerobic conditions were evaluated. Microaeration was demonstrated to be an effective strategy to improve the limited removal/biotransformation of the evaluated OMPs in short-HRT anaerobic wastewater treatment systems. The rise in the airflow rate considerably increased the removal efficiencies of all OMPs. However, there seems to be a saturation limit for the biochemical reactions. Then, the best results were obtained with 4 mL air min-1 (0.101 L O2 L-1 feed) (~90%) because, above this flow rate, the efficiency increase was negligible. The long-term exposure to microaerobic conditions (249 days) led the microbiota to a gradual evolution. Consequently, there was some enrichment with species potentially associated with the biotransformation of OMPs, which may explain the better performance at the end of the microaerobic term even with the lowest airflow rate tested.

Ações de enfermagem na atenção ao portador de feridas na atenção básica em saúde / Nursing actions in the care of patients with wounds in primary health care / Actuaciones de enfermería en la atención de pacientes con heridas en atención primaria de salud

Objetivo: Descrever as ações do enfermeiro no atendimento ao portador de feridas na atenção básica em saúde. Método: Revisão integrativa estruturada em seis etapas a partir da busca de artigos de livre acesso nas bases de dados publicados no intervalo de 10 anos (2009-2019), baseado em critérios de elegibilidade estabelecidos e no nível de evidência das publicações. Resultados: Os estudos incluídos para análise apontam a atuação do enfermeiro centrada na garantia de espaço físico em conformidade com as normas sanitárias, na educação em saúde como ação de promoção da autonomia e autocuidado e na observação dos aspectos sociais e culturais do usuário no contexto da melhoria da cicatrização das lesões. Conclusões: Entende-se como necessária a inserção deste profissional enquanto participante ativo da assistência para desenvolvimento de ações respaldadas e na possibilidade da redução do tempo de tratamento do usuário e dos custos da assistência junto ao sistema de saúde.(AU)

Objective: To describe the actions of nurses in the care of patients with wounds in primary health care. Method: Integrative review structured in six stages based on the search for freely accessible articles in the databases published over a 10-year period (2009-2019), based on established eligibility criteria and the level of evidence of the publications. Results: The studies included for analysis point out the role of nurses focused on guaranteeing physical space in accordance with health standards, in health education as an action to promote autonomy and self-care and in observing the social and cultural aspects of the user in the context of improvement of wound healing. Conclusions: It is understood as necessary to insert this professional as an active participant in the assistance for the development of supported actions and in the possibility of reducing the user's treatment time and the costs of assistance with the health system.(AU)

Objetivo: Describir las acciones del enfermero en la atención de pacientes con heridas en la atención primaria de salud. Método: Revisión integradora estructurada en seis etapas a partir de la búsqueda de artículos de libre acceso en las bases de datos publicadas durante un período de 10 años (2009-2019), en base a los criterios de elegibilidad establecidos y al nivel de evidencia de las publicaciones. Resultados: Los estudios incluidos para análisis señalan el rol del enfermero enfocado en garantizar el espacio físico de acuerdo con los estándares de salud, en la educación para la salud como una acción para promover la autonomía y el autocuidado y en la observación de los aspectos sociales y culturales del usuario en el contexto de mejora de la cicatrización de heridas. Conclusiones: Se entiende necesario insertar a este profesional como participante activo en la asistencia para el desarrollo de acciones apoyadas y en la posibilidad de reducir el tiempo de tratamiento del usuario y los costos de asistencia con el sistema de salud.(AU)

Avaliação da adesão à terapia medicamentosa na Atenção Primária à Saúde: um relato de caso / Assessment of adherence to drug therapy in Primary Health Care: a case report

Objetivo: avaliar a adesão à terapia medicamentosa de um idoso portador de doença crônica, por meio de um estudo de caso. Método: foi aplicado o Brief Medication Questionaire e o questionário de Morisky Green a um paciente portador de HAS e DM2, previamente diagnosticado e polimedicado. Resultados: paciente em uso seguintes medicamentos: Metformina 850mg, Hidroclorotiazida 25mg, Ácido Acetil Salicílico 100mg, Maleato de Enalapril 10mg, Besilato de Anlodipino 10mg, Sinvastatina 20mg e Levotiroxina Sódica 25mcg. Observou­se provável baixa adesão e comportamento de adesão mediano. Conclusões: a baixa adesão medicamentosa prejudica o controle das doenças crônicas.

Objective: to evaluate the adherence to drug therapy of an elderly person with chronic disease, through a case study. Method: was applied the Brief Medication Questionaire and the Morisky Green questionnaire were applied to a patient with SAH and DM2, previously diagnosed and polymedicated. Results: patient taking the following medications: Metformin 850mg, Hydrochlorothiazide 25mg, Acetyl Salicylic Acid 100mg, Enalapril Maleate 10mg, Amlodipine Besylate 10mg, Simvastatin 20mg and Levothyroxine Sodium 25mcg. It was observed a probable low adherence and median adherence behavior. Conclusions: low drug adherence impairs the control of chronic diseases.

Eight-week equipment-based Pilates exercises positively affects quality of life, and functional capacity in non-active adult women: a randomized controlled trial.

BACKGROUND: The Pilates exercises are popular for muscle conditioning among women. However, the effects on conditioning of healthy non-active adult women due to Pilates practicing are not fully explained. The aim of this randomized controlled trial was to assess the effects of equipment-based Pilates exercises on the percentage of body fat, weight, body mass index (BMI), functional capacity, and quality of life of adult healthy women. METHODS: Seventy-eight non-active women were randomly assigned to 2 groups (Pilates or Control). The Pilates group performed a total of 16 exercise sessions (60 minutes each, performed twice a week for 8 consecutive weeks). The control group was instructed to perform no exercise. Percentage of body fat (DXA scans), weight, BMI, distance covered in the incremental shuttle walk test, maximal oxygen uptake (VO2max), and quality of life (SF-36 scores) were analyzed. RESULTS: There were no significant between-group differences at baseline, but significant group-by-time interaction was observed for Pilates group postintervention. Higher distance covered (P=0.01), VO2max (P=0.04), and quality of life (P=0.04) were observed after the intervention compared to the control group. No differences were observed for body composition. CONCLUSIONS: Two months of equipment-based Pilates training improved functional capacity and quality of life in healthy adult women.

Cuidados de enfermagem ao paciente renal crônico em hemodiálise em uso de cateter duplo lúmen / Nursing care of the chronic renal patient on hemodialysis using double lumen catheter / Cuidados de enfermería al paciente renal crónico en hemodiálisis en uso de Catéter Doble Lumen

Objetivo: Avaliar o cuidado de Enfermagem prestado ao paciente renal crônico em hemodiálise durante o manuseio do Cateter Duplo Lúmen. Métodos: Trata-se de um estudo descritivo, transversal realizado em uma clínica de hemodiálise de uma cidade de médio porte do nordeste brasileiro. Participaram do estudo 14 profissionais de enfermagem. A coleta dos dados ocorreu em setembro de 2016 subsidiada em checklist de adequação as normas vigentes de manuseio do cateter. Resultados: A maioria dos cuidados foi executada pelos técnicos de enfermagem, com 88,9% a 92,0% de frequência. Houve algumas falhas nos cuidados, e a mais presente foi a falta de higienização das mãos, presente em menos de 30% das observações. Conclusão O estudo evidenciou que existem lacunas na assistência de enfermagem ao paciente em uso de cateter, e que é necessário do enfermeiro orientação e supervisão constante da equipe para evitá-las

Objective: To evaluate the nursing care provided to chronic renal patients on hemodialysis during the handling of the double lumen catheter. Methods: This is a descriptive cross-sectional study conducted in a hemodialysis clinic in a medium-sized city in northeastern Brazil. Fourteen nursing professionals participated in the study. Data collection took place in September 2016, supported by a checklist of compliance with current catheter handling standards. Results: Most care was performed by nursing technicians, with 88.9% to 92.0% frequency. There were some failures in care, and the most common was the lack of hand hygiene, present in less than 30% of the observations. Conclusion: The study showed that there are gaps in nursing care for patients using catheters, and that the nurse needs constant guidance and supervision of the team to avoid them

Objetivo: Evaluar la atención de enfermería brindada a pacientes renales crónicos en hemodiálisis durante el manejo del catéter de doble luz. Métodos: Este es un estudio descriptivo transversal realizado en una clínica de hemodiálisis en una ciudad mediana en el noreste de Brasil. Catorce profesionales de enfermería participaron en el estudio. La recopilación de datos tuvo lugar en septiembre de 2016, respaldada por una lista de verificación del cumplimiento de los estándares actuales de manejo de catéteres. Resultados: La mayoría de los cuidados fueron realizados por técnicos de enfermería, con una frecuencia del 88,9% al 92,0%. Hubo algunas fallas en la atención, y la más común fue la falta de higiene de las manos, presente en menos del 30% de las observaciones. Conclusión: El estudio mostró que existen vacíos en la atención de enfermería para pacientes que usan catéteres, y que la enfermera necesita orientación y supervisión constantes del equipo para evitarlos

Expiratory Flow Limitation at Different Exercise Intensities in Coronary Artery Disease.

INTRODUCTION: Expiratory flow limitation (EFL) during moderate intensity exercise is present in patients with myocardial infarction (MI), whereas in healthy subjects it occurs only at a high intensity. However, it is unclear whether this limitation already manifests in those with stable coronary artery disease (CAD) (without MI). MATERIALS AND METHODS: Forty-one men aged 40-65 years were allocated into (1) recent MI (RMI) group (n = 8), (2) late MI (LMI) group (n = 12), (3) stable CAD group (n = 9), and (4) healthy control group (CG) (n = 12). All participants underwent two cardiopulmonary exercise tests at a constant workload (moderate and high intensity), and EFL was evaluated at the end of each exercise workload. RESULTS: During moderate intensity exercise, the RMI and LMI groups presented with a significantly higher number of participants with EFL compared to the CG (p < 0.05), while no significant difference was observed among groups at high intensity exercise (p > 0.05). Moreover, EFL was only present in MI groups during moderate intensity exercise, whereas at high intensity all groups presented EFL. Regarding the degree of EFL, the RMI and LMI groups showed significantly higher values at moderate intensity exercise in relation to the CG. At high intensity exercise, significantly higher values for the degree of EFL were observed only in the LMI group. CONCLUSION: The ventilatory limitation at moderate intensity exercise may be linked to the pulmonary consequences of the MI, even subjects with preserved cardiac and pulmonary function at rest, and not to CAD per se.

Heart rate variability: are you using it properly? Standardisation checklist of procedures.

BACKGROUND: Heart rate variability is used as an assessment method for cardiac autonomic modulation. Since the Task Force's publication on heart rate variability in 1996, the European Heart Rhythm Association Position Paper in 2015 and a recent publication in 2017, attention has been paid to recommendations on using heart rate variability analysis methods, as well as their applications in different physiological conditions and clinical studies. This analysis has proved to be useful as a complementary tool for clinical evaluation and to assess the effect of non-pharmacological therapeutic interventions, such as physical exercise programmes, on cardiac autonomic modulation. OBJECTIVE: The aim of this article is to make recommendations and to develop a checklist of normalisation procedures regarding the use of heart rate variability data collection and analysis methodology, focusing on the cardiology area and cardiac rehabilitation. METHODS: Based on previous heart rate variability publications, this paper provides a description of the most common shortcomings of using the analysis methods and considers recommendations and suggestions on how to minimise these occurrences by using a specific checklist. CONCLUSIONS: This article includes recommendations and a checklist regarding the use of heart rate variability collection and analysis methods. This work could help improve reporting on clinical evaluation and therapeutic intervention results and consequently, disseminate heart rate variability knowledge.

Effects of aquatic training and detraining on women with fibromyalgia: controlled randomized clinical trial.

BACKGROUND: Aquatic physical training (APT) promotes improvement of clinical symptoms and aerobic functional capacity in women with fibromyalgia syndrome (FMS). However, there are controversial studies that refer to the maintenance of adaptations obtained from APT after a detraining period. AIM: To evaluate variables oxygen uptake (VO2) relative to lean body mass (LBM) and clinical symptomatology in women with FMS submitted to APT and after 16 weeks of detraining period, and to evaluate the association between the magnitude of VO2 improvement relative to LBM and clinical symptomatology. DESIGN: Blind randomized controlled trial. SETTING: Department of Physical Therapy of the Federal University of São Carlos. POPULATION: Fifty-four women with FMS were randomly assigned into trained group (27) and control group (27). METHODS: All women underwent cardiopulmonary exercise test (CPET) and body composition assessment to estimate VO2 and LBM respectively, and clinical symptoms were assessed before and after 16 weeks of training and detraining. trained group was submitted to APT program, performed twice a week for 16 weeks. RESULTS: After APT, trained group presented an increase in VO2 relative to LBM (P=0.01), in addition to an increase in pressure pain threshold (PPT) (P=0.02) and Visual Analogue Scale (VAS) pain (P=0.01), VAS well-being (P<0.01) well-being and lower Fibromyalgia Impact Questionnaire Score (FIQ) (P=0.04). However, these improvements were not maintained after the 16-week detraining period (P>0.05). In addition, no significant correlations were observed between improvement of clinical manifestations and increased VO2 relative to LBM after APT (P>0.05). CONCLUSIONS: APT contributed both to increase VO2 at VAT and peak CPET, and improved clinical symptoms, but no association was observed. However, after 16 weeks of detraining, these variables were reduced near baseline. CLINICAL REHABILITATION IMPACT: The results of the present study suggest that APT should be continuously performed in order to improve clinical symptomatology and increase the aerobic functional capacity in women with FMS.

Age is the main factor related to expiratory flow limitation during constant load exercise.

OBJECTIVE: The objective of this study was to investigate the interaction among the determinants of expiratory flow limitation (EFL), peak oxygen uptake (VO2peak), dysanapsis ratio (DR) and age during cycling at different intensities in young and middle-aged men. METHODS: Twenty-two (11 young and 11 middle-aged) men were assessed. Pulmonary function tests (DR), cardiopulmonary exercise tests (VO2peak) and two constant load tests (CLTs) at 75% (moderate intensity) and 125% (high intensity) of the gas exchange threshold were performed to assess EFL. EFL was classified using the percentage of EFL determined from both CLTs (mild: 5%-30%, moderate: 30%-50%, severe: >50%). RESULTS: Only the middle-aged group displayed EFL at both exercise intensities (p<0.05). However, the number of participants with EFL and the percentage of EFL were only associated with age during high-intensity exercise. CONCLUSIONS: There was no interaction between the determinants. However, age was the only factor that was related to the presence of EFL during exercise in the age groups studied.

Perceptions of occupational therapy students about experience of teaching-service-community integration / Percepções dos discentes de terapia ocupacional sobre a experiência de integração ensino-serviço-comunidade

Abstract The present article tries understand the perceptions of students of the professional internship in occupational therapy on the experience of teaching-service-community integration experienced in a laboratory of daily life activity. It was a qualitative and exploratory study, conducted through semi-structured interviews. Content analysis was used with the thematic category: teaching-service-community integration. The sample consisted of 14 students who were enrolled in the course. The similarities, distinctions between the contents and the central ideas of the narratives about the thematic category were observed. The speeches generated the units of analysis: expectation of integrated practices, reality of teamwork, organizational process, exchange of experiences and suggestions. The results obtained pointed to the distance between students' expectations and reality. The perceptions of the interviewees revealed that the work dynamics occurs without collective planning of the care actions and without interlocution with the teaching. The students suggested strategies to improve the teaching-service-community integration and to promote the formative process.

Resumo O presente artigo procura compreender as percepções de discentes do estágio profissionalizante em terapia ocupacional sobre a experiência de integração ensino-serviço-comunidade vivenciada em um laboratório de atividade de vida diária. Tratou-se de um estudo qualitativo e exploratório realizado através de entrevistas semiestruturadas. Foi utilizada a análise de conteúdo com a categoria temática: integração ensino-serviço-comunidade. A amostra foi composta por 14 discentes que estavam matriculados na disciplina. Foram observadas as semelhanças, distinções entre os conteúdos e identificadas as ideias centrais das narrativas sobre a categoria temática. As falas geraram as unidades de análise: expectativa de práticas integradas, realidade do trabalho em equipe, processo organizacional, troca de experiências e sugestões. Os resultados obtidos apontaram distanciamento entre as expectativas dos discentes e a realidade. As percepções dos entrevistados revelaram que a dinâmica de trabalho ocorre sem planejamento coletivo das ações de cuidado e sem interlocução com o ensino. Os discentes sugeriram estratégias para melhoria da integração ensino-serviço-comunidade e para favorecer o processo formativo.

Associations Between Heart Rate Recovery Dynamics With Estradiol Levels in 20 to 60 Year-Old Sedentary Women.

It is hypothesized that estradiol levels, as well as aging, influence cardiac autonomic function in women. The main aim of this study was to test the correlations between heart rate recovery (HRR) dynamics, as a proxy of cardiac autonomic function, with estradiol levels and age in women. This cross-sectional study involved 44 healthy women. Heart rate (HR) data were obtained beat-by-beat during the entire experiment. Maximal incremental exercise testing (IET) on a cycle ergometer was performed followed by 6 min of recovery. During the IET recovery period, the overall HRR dynamics were evaluated by exponential data modeling (time constant "τ") where shorter τ indicates faster HRR adjustment. Considering the cardiac autonomic complexity, HRR dynamics were also evaluated by delta (Δ) analysis considering different HR data intervals. The relationship between HRR dynamics, estradiol levels and age was tested by Pearson product-moment correlation. The overall HRR dynamics (i.e., τ) were statistically correlated with age (r = 0.58, p < 0.001) and estradiol levels (r = -0.37, p = 0.01). The Δ analysis showed that the slower overall HRR associated with aging was a consequence of slower dynamics occurring within the 45-210 s interval, indicating slower sympathetic withdrawal. In conclusion, aging effects on HRR in women seems to be correlated with a slower sympathetic withdrawal. In addition, the cardioprotective effect previously associated with estradiol seems not to influence the autonomic modulation during exercise recovery periods in women.

Linear and Nonlinear Analyses of the Cardiac Autonomic Control in Children With Developmental Coordination Disorder: A Case-Control Study.

Children with Developmental Coordination Disorder (DCD) and children at risk for DCD (r-DCD) present motor impairments interfering in their school, leisure and daily activities. In addition, these children may have abnormalities in their cardiac autonomic control, which together with their motor impairments, restrict their health and functionality. Therefore, this study aimed to assess the cardiac autonomic control, by linear and nonlinear analysis, at supine and during an orthostatic stimulus in DCD, r-DCD and typically developed children. Thirteen DCD children (11 boys and 2 girls, aged 8.08 ± 0.79 years), 19 children at risk for DCD (13 boys and 6 girls, aged 8.10 ± 0.96 years) and 18 typically developed children, who constituted the control group (CG) (10 boys and 8 girls, aged 8.50 ± 0.96 years) underwent a heart rate variability (HRV) examination. R-R intervals were recorded in order to assess the cardiac autonomic control using a validated HR monitor. HRV was analyzed by linear and nonlinear methods and compared between r-DCD, DCD, and CG. The DCD group presented blunted cardiac autonomic adjustment to the orthostatic stimulus, which was not observed in r-DCD and CG. Regarding nonlinear analysis of HRV, the DCD group presented lower parasympathetic modulation in the supine position compared to the r-DCD and CG groups. In the within group analysis, only the DCD group did not increase HR from supine to standing posture. Symbolic analysis revealed a significant decrease in 2LV (p < 0.0001) and 2UV (p < 0.0001) indices from supine to orthostatic posture only in the CG. In conclusion, r-DCD and DCD children present cardiac autonomic dysfunction characterized by higher sympathetic, lower parasympathetic and lower complexity of cardiac autonomic control in the supine position, as well as a blunted autonomic adjustment to the orthostatic stimulus. Therefore, cardiovascular health improvement should be part of DCD children's management, even in cases of less severe motor impairment.

Age is the main factor related to expiratory flow limitation during constant load exercise

OBJECTIVE: The objective of this study was to investigate the interaction among the determinants of expiratory flow limitation (EFL), peak oxygen uptake (VO2peak), dysanapsis ratio (DR) and age during cycling at different intensities in young and middle-aged men. METHODS: Twenty-two (11 young and 11 middle-aged) men were assessed. Pulmonary function tests (DR), cardiopulmonary exercise tests (VO2peak) and two constant load tests (CLTs) at 75% (moderate intensity) and 125% (high intensity) of the gas exchange threshold were performed to assess EFL. EFL was classified using the percentage of EFL determined from both CLTs (mild: 5%-30%, moderate: 30%-50%, severe: >50%). RESULTS: Only the middle-aged group displayed EFL at both exercise intensities (p<0.05). However, the number of participants with EFL and the percentage of EFL were only associated with age during high-intensity exercise. CONCLUSIONS: There was no interaction between the determinants. However, age was the only factor that was related to the presence of EFL during exercise in the age groups studied.

Desafíos de la Inclusión Digital: antecedentes, problemáticas y medición de la Brecha Digital de Género / Challenges on Digital Inclusion: Background, questions, and measurement of the Gender Digital Divide / Desafios da Inclusão Digital: antecedentes, problemáticas e medição da Exclusão Digital de Gênero

Resumen Los avances tecnológicos aplicados a la información son rápidos y masivos. Los cambios que producen afectan a la interacción del sujeto con el mundo, lo cual exige una constante desconstrucción tecnológica en las rutinas básicas de las personas. Quien no domina estos ciclos queda en desventaja, en comparación con aquellos que consiguen articularse. Apartarse de las Tecnologías de la Información, en la mayoría de los casos, es un estado de restricción derivado de recursos económicos, la infraestructura del contexto, limitaciones en educación y alfabetización informacional, restricciones de acceso a mercados laborales o paradigmas mentales socioculturales. Estas desigualdades crean brechas complejas de naturaleza multidimensional y desarticulan de las TIC a los grupos afectados, uno de los cuales son las mujeres. Este fenómeno se ha denominado la Brecha Digital de Género (BDG). Este artículo presenta esta problemática, introduciendo una recapitulación sobre los antecedentes de la exclusión de la mujer en la historia de la informática, los problemas existentes en cuanto al ingreso femenino en carreras de ingeniería e ingeniería informática y la existencia de condiciones sexistas en el mercado laboral de la industria de la computación. Posteriormente se recapitulan modelos teóricos relevantes referentes a la exclusión digital de género, para finalmente discutir la cuestión sobre la medición de la BDG, debatir sus características, y plantear una propuesta complementaria basada en el mapeo de imaginarios.

Abstract Technological advances applied to information are fast and massive. The consequent changes affect the subject's interaction with the world, demanding a constant technological deconstruction in the basic routines of people. Whoever does not master these cycles is disadvantaged in comparison to those who manage to articulate themselves. Being excluded from Information Technology, in most cases, is a state of constraint derived from economic resources, context infrastructure, information literacy and educational limitations, restrictions of access to labor markets, or socio-cultural paradigms. These inequalities create complex divides as their nature is multidimensional, and disarticulate the affected groups from ICT, i.e. women. Such phenomenon has been called Gender Digital Divide (GDD). This article makes a recapitulation on the antecedents of the exclusion of women from the history of computing, the existing problems regarding female entry in engineering and computer engineering careers, and the existence of sexist conditions in the labor market of the computer industry. Then we summarize relevant theoretical models concerning digital gender exclusion and discuss the measurement of GDG, proposing a complementary perspective based on the mapping of imaginaries.

Resumo Os avanços tecnológicos aplicados à informação são rápidos e maciços. As mudanças que produzem afetam a interação do sujeito com o mundo, o que requer uma constante desconstrução tecnológica nas rotinas básicas das pessoas. Quem não domina esses ciclos é prejudicado, em comparação com aqueles que conseguem se articular. Afastar-se das Tecnologias da Informação, na maioria dos casos, é um estado de restrição derivado dos recursos econômicos, da infraestrutura do contexto, limitações na educação e letramento informacional, restrições ao acesso aos mercados de trabalho ou paradigmas mentais socioculturais. Essas desigualdades criam lacunas complexas de natureza multidimensional e desarticulam os grupos afetados das TIC; um deste grupos são as mulheres. Esse fenômeno é chamado de Exclusão Digital de Gênero (EDG). Este artigo apresenta esta problemática, por meio de uma recapitulação do contexto da exclusão das mulheres na história da informática, dos problemas existentes quanto a entrada feminina em carreiras de engenharia e engenharia da computação, e da existência de condições sexistas no mercado de trabalho da indústria de computação. A continuação, são recapitulados os modelos teóricos relevantes referentes à exclusão digital de gênero, para finalmente debater a questão sobre a medição da EDG, discutir suas características, e propor uma abordagem complementar baseada no mapeamento de imaginários.

The Borg CR-10 scale is suitable to quantify aerobic exercise intensity in women with fibromyalgia syndrome / A escala CR-10 de Borg é viável para quantificar a intensidade do exercício aeróbio em mulheres com síndrome fibromiálgica / La escala Borg CR-10 es adecuada para cuantificar la intensidad del ejercicio aeróbico en mujeres con síndrome de fibromialgia

ABSTRACT Patients with Fibromyalgia syndrome (FMS) report higher ratings of perceived exertion (RPE) compared to healthy individuals for the same exercise intensity; however, to our knowledge, no studies have evaluated RPE at the ventilatory anaerobic threshold (VAT) for this population. This study aimed to assess RPE using the Borg CR-10 scale during a cardiopulmonary exercise test (CPET) in women with FMS. Twenty-four women with FMS and twenty healthy control subjects (HC) voluntarily participated in this study. Near the end of every 1-minute period during CPET, subjects were asked to report their RPE for fatigue in the lower limbs (RPE-L) and dyspnea (RPE-D), respectively, according to the Borg CR-10 scale. FMS subjects showed higher RPE-L and RPE-D compared to HC subjects at free wheel and at the first load increment. However, no significant difference was observed between groups for power output. There was no significant difference between groups for RPE-L and RPE-D reported at VAT and peak CPET. However, FMS subjects showed lower power output compared to HC subjects. The present results showed that FMS subjects present higher RPE compared to HC subjects. However, RPE reported at VAT and at peak CPET was not different between groups. The Borg CR-10 scale scores obtained at VAT can be used as an additional parameter for prescribing exercise intensity in aerobic training protocols for women with FMS.

RESUMO Pacientes com síndrome fibromiálgica (SFM) relatam elevados níveis de percepção subjetiva de esforço (PSE) em comparação com indivíduos saudáveis para a mesma intensidade de exercício; no entanto, a nosso conhecimento, nenhum estudo avaliou a PSE no limiar de anaerobiose ventilatório (LAV) para essa população. Este estudo buscou avaliar PSE usando a escala CR-10 de Borg durante um teste de exercício cardiopulmonar (TECP) em mulheres com SFM. Vinte e quatro mulheres com SFM e vinte indivíduos saudáveis (GS) participaram deste estudo voluntariamente. Perto do final de cada período de 1 minuto durante CPET, os indivíduos foram convidados a relatar sua PSE para fadiga nos membros inferiores (PSE-MMII) e dispneia (PSE-D), respectivamente, de acordo com a escala CR-10 de Borg. Os indivíduos com SFM mostraram maior PSE-MMII e PSE-D, em comparação com indivíduos GS tanto na carga livre como no primeiro incremento de carga. No entanto, não houve diferença significativa entre os grupos para a potência e nem para PSE-MMII e PSE-D relatado no LAV e no pico TECP. No entanto, indivíduos com SFM mostraram baixa potência em comparação com indivíduos GS. Esses resultados mostraram que indivíduos com SFM apresentam a PSE mais elevada em comparação com indivíduos GS. No entanto, a PSE relatada no LAV e no pico TECP não foi diferente entre os grupos. As pontuações de escala CR-10 de Borg obtidas no LAV podem ser usadas como um parâmetro adicional para a prescrição da intensidade de exercício nos protocolos de treinamento aeróbio para mulheres com SFM.

RESUMEN Los pacientes con síndrome de fibromialgia (FMS) reportan índices más altos de esfuerzo percibido (RPE) en comparación con individuos sanos para la misma intensidad de ejercicio; sin embargo, a nuestro conocimiento, ningún estudio ha evaluado el RPE en el umbral ventilatorio anaeróbico (VAT) para estas personas. Este estudio tuvo como objetivo evaluar el RPE utilizando la escala Borg CR-10 durante un test de ejercicio cardiopulmonar (CPET) en mujeres con FMS. Veinticuatro mujeres con FMS y veinte individuos de control sanos (HC) participaron voluntariamente en este estudio. Cerca del final de cada período de 1 minuto durante el CPET, se pidió a los individuos que informaran su RPE para la fatiga en los miembros inferiores (RPE-L) y disnea (RPE-D), respectivamente, según la escala Borg CR-10. Los individuos con FMS mostraron mayores RPE-L y RPE-D comparados con los individuos HC en la rueda libre y en el primer incremento de carga. Sin embargo, no se observó diferencia significativa de potencia de salida entre los grupos. No hubo diferencias significativas entre los grupos en los RPE-L y RPE-D reportados en el VAT y en el máximo CPET. No obstante, los individuos FMS mostraron una menor potencia en comparación con los individuos HC. Los resultados actuales mostraron que los individuos con FMS presentan RPE más alto en comparación con los individuos HC. De todos modos, el RPE reportado en el VAT y en el CPET máximo no fue diferente entre los grupos. Las puntuaciones de la escala Borg CR-10 obtenidas en el VAT se pueden utilizarse como un parámetro adicional para prescribir la intensidad del ejercicio en protocolos de entrenamiento aeróbico para mujeres con FMS.

The degree of cardiac baroreflex involvement during active standing is associated with the quality of life in fibromyalgia patients.

Fibromyalgia syndrome (FMS) is a rheumatologic disorder characterized by chronic widespread pain, fatigue and other symptoms. Baroreflex dysfunction has been observed in women with FMS. However, it is unknown whether the limited involvement of the baroreflex control during an orthostatic stimulus has some impact on the quality of life of the FMS patient. Therefore, the aim of the study is evaluate the relationship between the quality of life of the FMS patient and indexes of the cardiovascular autonomic control as estimated from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP). We enrolled 35 women with FMS (age: 48.8±8.9 years; body mass index: 29.3±4.3 Kg/m2). The electrocardiogram, non-invasive finger blood pressure and respiratory activity were continuously recorded during 15 minutes at rest in supine position (REST) and in orthostatic position during active standing (STAND). Traditional cardiovascular autonomic control markers were assessed along with a Granger causality index assessing the strength of the causal relation from SAP to HP (CRSAP→HP) and measuring the degree of involvement of the cardiac baroreflex. The impact of FMS on quality of life was quantified by the fibromyalgia impact questionnaire (FIQ) and visual analog score for pain (VAS pain). No significant linear association was found between FIQ scores and the traditional cardiovascular indexes both at REST and during STAND (p>0.05). However, a negative relationship between CRSAP→HP during STAND and FIQ score was found (r = -0.56, p<0.01). Similar results were found with VAS pain. In conclusion, the lower the degree of cardiac baroreflex involvement during STAND in women with FMS, the higher the impact of FMS on the quality of life, thus suggesting that Granger causality analysis might be clinically helpful in assessing the state of the FMS patient.