Ferenczi e a clínica psicanalítica contemporânea: uma revisão sobre suas contribuições ao papel do analista / Ferenczi and the contemporary psychoanalytic clinic: a review of his contributions to the role of the analyst / Ferenczi et la clinique psychanalytique contemporaine: une revue de ses contributions au rôle de l'analyste / Ferenczi y la clínica psicoanalítica contemporánea: Una revisión de sus contribuciones al papel del analista

Objetivou-se fazer uma revisão sistemática da produção científica nacional e internacional, no período de 2015 a 2020, sobre a obra de Sándor Ferenczi e suas contribuições à clínica psicanalítica na contemporaneidade, no que concerne ao papel do analista. Os seguintes descritores foram utilizados: "Ferenczi" "clínica psicanalítica" e "analista". As bases de dados pesquisadas foram: P@rthenon, SciELO e Pepsic. Foi utilizada a metodologia da Análise de Conteúdo. O processo de análise levou a leitura dos títulos, resumos e textos completos, e 52 artigos preencheram os critérios. A pesquisa compreendeu que a retomada dos trabalhos de Ferenczi quanto ao papel do analista evidenciam uma nova configuração de relação analítica baseada em uma ética do cuidado. O papel do analista apresenta-se como uma possibilidade de contorno e sustentação às experiências traumáticas, colaborando com o paciente, na produção de sentidos e elaborações dessas experiências

This is a systematic review of national and international scientific papers published between 2015 and 2020 on Sándor Ferenczi's work and his contributions to the contemporary psychoanalytic clinic, mainly regarding the role of the analyst. Search was conducted on the P@rthenon, Scielo and Pepsic databases using "Ferenczi," "psychoanalytic clinic" and "analyst" as search descriptors. After reading the titles, abstracts and full texts a total of 52 articles met the inclusion criteria. Resumption of Ferenczi's work on the role of the analyst reveals a new configuration of analytical relations based on an ethics of care. The analyst presents a possibility of shaping and underpinning traumatic experiences, collaborating with the patient to produce meanings and elaborations of these experiences

Il s'agit d'une revue systématique des articles scientifiques nationaux et internationaux publiés entre 2015 et 2020 sur l'œuvre de Sándor Ferenczi et ses contributions à la clinique psychanalytique contemporaine, notamment en ce qui concerne le rôle de l'analyste. La recherche a été effectuée sur les bases de données P@rthenon, Scielo et Pepsic en utilisant « Ferenczi ¼, « clinique psychanalytique ¼ et « analyste ¼ comme descripteurs. Après la lecture des titres, des résumés et des textes intégraux, 52 articles répondaient aux critères d'inclusion. La reprise des travaux de Ferenczi sur le rôle de l'analyste révèle une nouvelle configuration des relations analytiques fondées sur une éthique du soin. L'analyste offre la possibilité de concevoir et d'étayer les expériences traumatiques, en collaborant avec le patient pour produire de significations et d'élaborations de ces expériences

El objetivo fue realizar una revisión sistemática de la producción científica nacional e internacional, en forma de artículo científico, de 2015 a 2020, sobre la obra de Sándor Ferenczi y sus aportes a la clínica psicoanalítica en la contemporaneidad, en torno al papel del analista. Se utilizaron los siguientes descriptores: "Ferenczi", "clínica psicoanalítica" y "analista". Las bases de datos buscadas fueron: P@rthenon, Scielo y Pepsic. Se utilizó la metodología de Análisis de Contenido. El proceso de análisis condujo a la lectura de títulos, resúmenes y textos completos y 52 artículos cumplieron los criterios. La investigación entendió que la reanudación del trabajo de Ferenczi sobre el rol del analista revela una nueva configuración de relación analítica basada en una ética del cuidado. El rol del analista se presenta como una posibilidad de modelar y sostener experiencias traumáticas, colaborando con el paciente, en la producción de significados y elaboraciones de estas experiencias

COVID-Inconfidentes - SARS-CoV-2 seroprevalence in two Brazilian urban areas during the pandemic first wave: study protocol and initial results

Background: A population study is an important tool that can be used to understand the actual epidemiological scenario of the Covid-19 in different territories, identify its magnitude, understand its transmission dynamics, and its demographic, geographical, and social distribution. Objective: The aim of this study was to determine the prevalence and dynamics of SARS-CoV-2 infection in the population of two Brazilian cities during the pandemic first wave and subsequent socioeconomic and health effects. Materials & methods: This paper described the methodological procedures adopted and the prevalence of the SARS-CoV-2 infection in the population. A household survey was conducted between October and December 2020, in two historic cities of Brazil's mining region. Anti-SARS-CoV-2 antibody was detected using the Wondfo® rapid test. The face-to-face interview consisted of administration of a questionnaire containing registration data, sociodemographic and economic variables, living habits, general health condition, mental health, sleep habits, and eating and nutrition. Results: We evaluated 1,762 residents, of which 764 (43.4%) were in Mariana and 998 (56.6%) in Ouro Preto. For both cities, 51.9% of the interviewees were female, with a predominance of the age range 35 to 59 years old (47.2%). The prevalence of the SARS-CoV-2 infection was 5.5% in all cities, 6.2% in Ouro Preto, and 4.7% in Mariana. The prevalence was similar between cities (P>0.05). Conclusion: The study was effective in verifying the seroprevalence of infection by the virus and its findings will enable further analyses of the health conditions of the population related to social isolation and the risk of infection with SARS-CoV-2.

Direct Immobilization of Engineered Nanobodies on Gold Sensors.

Single-domain antibodies, known as nanobodies, have great potential as biorecognition elements for sensors because of their small size, affinity, specificity, and robustness. However, facile and efficient methods of nanobody immobilization are sought that retain their maximum functionality. Herein, we describe the direct immobilization of nanobodies on gold sensors by exploiting a modified cysteine strategically positioned at the C-terminal end of the nanobody. The experimental data based on secondary ion mass spectrometry, circular dichroism, and surface plasmon resonance, taken together with a detailed computational work (molecular dynamics simulations), support the formation of stable and well-oriented nanobody monolayers. Furthermore, the nanobody structure and activity is preserved, wherein the nanobody is immobilized at a high density (approximately 1 nanobody per 13 nm2). The strategy for the spontaneous nanobody self-assembly is simple and effective and possesses exceptional potential to be used in numerous sensing platforms, ranging from clinical diagnosis to environmental monitoring.

Processing level and diet quality of the US grocery cart: is there an association?

OBJECTIVE: The majority of groceries purchased by US households are industrially processed, yet it is unclear how processing level influences diet quality. We sought to determine if processing level is associated with diet quality of grocery purchases. DESIGN: We analysed grocery purchasing data from the National Household Food Acquisition and Purchase Survey 2012-2013. Household grocery purchases were categorized by the NOVA framework as minimally processed, processed culinary ingredients, processed foods or ultra-processed foods. The energy share of each processing level (percentage of energy; %E) and Healthy Eating Index-2015 (HEI-2015) component and total scores were calculated for each household's purchases. The association between %E from processed foods and ultra-processed foods, respectively, and HEI-2015 total score was determined by multivariable linear regression. Foods purchased by households with the highest v. lowest ultra-processed food purchases and HEI-2015 total score <40 v. ≥60 were compared using linear regression. SETTING: USA. PARTICIPANTS: Nationally representative sample of 3961 households. RESULTS: Processed foods and ultra-processed foods provided 9·2 (se 0·3) % and 55·8 (se 0·6) % of purchased energy, respectively. Mean HEI-2015 score was 54·7 (se 0·4). Substituting 10 %E from minimally processed foods and processed culinary ingredients for ultra-processed foods decreased total HEI-2015 score by 1·8 points (ß = -1·8; 95 % CI -2·0, -1·5). Processed food purchases were not associated with diet quality. Among households with high ultra-processed food purchases, those with HEI-2015 score <40 purchased less minimally processed plant-foods than households with HEI-2015 score ≥60. CONCLUSIONS: Increasing purchases of minimally processed foods, decreasing purchases of ultra-processed foods and selecting healthier foods at each processing level may improve diet quality.

Alimentos ultraprocessados: a classificação nova, descrição e associação com indicadores de posição socioeconômica no Estudo Longitudinal de Saúde do Adulto / Não possui

Introdução: o consumo de alimentos ultraprocessados é elevado em países ricos e tem crescido nos países de média e baixa renda. O maior consumo desses alimentos parece influenciar negativamente a qualidade da dieta. Grupos em desvantagens na posição social estão mais suscetíveis a exposições prejudiciais à saúde e têm menor acesso a determinados recursos que favoreçam melhores condições de saúde, como o acesso a alimentação mais saudável. Objetivos: os objetivos da presente tese compreenderam realizar a classificação dos itens alimentares do Questionário de Frequência Alimentar do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) segundo a classificação NOVA, descrever os alimentos mais consumidos em cada grupo de alimentos da classificação NOVA e estimar o percentual de contribuição calórica de cada grupo de alimentos da NOVA no total consumido pelos participantes do ELSA-Brasil. Além disso, foi investigado se indicadores de posição socioeconômica estão associados ao maior consumo de alimentos ultraprocessados em participantes ELSA-Brasil. Métodos: utilizou dados da linha de base (2008-2010) do ELSA-Brasil, uma coorte multicêntrica de servidores públicos, ativos e aposentados, com idade entre 35 e 74 anos de instituições de ensino e pesquisa de seis capitais brasileiras. Os alimentos consumidos foram obtidos por questionário de frequência alimentar e classificados segundo a NOVA por meio de processo de construção juntamente com pesquisadores que foram responsáveis pela sua concepção. A associação entre o percentual de contribuição calórica de alimentos ultraprocessados e indicadores de posição socioeconômica (escolaridade, renda domiciliar per capita e classe social ocupacional) foi estimada por modelos lineares generalizados, ajustados por sexo e idade. Resultados: obteve-se a classificação segundo o nível de processamento do questionário de frequência alimentar aplicado aos participantes do ELSA-Brasil. Além disso, observou-se que os alimentos UP contribuíram com 22,7% da ingestão calórica total. As frutas, arroz e carne de boi e derivados e de aves contribuíram com mais de 30% do consumo da energia. O pão francês (5,0%) foi o alimento que contribuiu com maior percentual de energia entre os alimentos processados, seguido dos queijos brancos e dos queijos amarelos. Os pães ultraprocessados (3,8%) foram os alimentos ultraprocessados que mais contribuíram para as calorias totais consumidas neste grupo de alimentos, seguidos dos doces e guloseimas (3,1%) pizzas e salgados (2,4%), refrigerantes e sucos industrializados ou artificiais (2,3%). Após os ajustes por idade e sexo, observou-se redução da média aritmética da contribuição calórica percentual dos UP com o decréscimo da escolaridade, da renda familiar per capita e da classe social ocupacional. Todas as associações sugeriram um gradiente dose-resposta. Conclusões: a classificação NOVA foi inserida na linha de base do ELSA-Brasil, 2008-2010 e será importante para que se possa produzir evidências científicas entre a relação do consumo de alimentos ultraprocessados e desfechos na saúde. Além disso, observou-se que a contribuição calórica dos UP foi maior entre os indivíduos de nível socioeconômico mais alto entre os participantes do estudo

Introduction: Theconsumptionof ultra-processed foods is highinrich countries and has increased in middleand low-income countries.The higher consumption of this foods seems to negatively influencein the diet quality. Groups in disadvantages in social position are more susceptible to exposures detrimental to health and have less access to certain resources that favor better health conditions, such as access to healthier food.Objectives:the objectives were to perform the classification of food items in the Food Frequency Questionnaire of the Longitudinal Health Study of Adult (ELSA-Brazil) according to the NOVA classification, to describe the foods most consumed in each food group of the NOVA classification and to estimate the percentage of caloric contribution of each NOVA food group in the total consumed by ELSA-Brazil participants. In addition, it was investigated whether socioeconomic status indicators are associated with higher consumption of ultra-processed foods in participants in the Longitudinal Study of Adult Health (ELSA-Brazil).Methods:it used data from the baseline (2008-2010) of ELSA-Brazil, a multicentric cohort of public servants, active and retired, aged 35-74 years of teaching and research institutions from six Brazilian capitals. The foods consumed were obtained by food frequency questionnaire and classified according to NOVA by means of a construction process together with researchers who were responsible for its design. The association between the percentage of caloric contribution of ultra-processed foods and indicators of socioeconomic position (schooling, per capita household income and occupational social class) was estimated by generalized linear models, adjusted for sex and age.Results: The classification according to the processing level of the food frequency questionnaire applied to ELSA-Brazil participants was obtained. In addition, it was observed that UP foods contributed 22.7% of the total caloric intake. Fruits, rice and beef and poultry and poultry contributed more than 30% of energy consumption. Bread roll (5.0%) was the food that contributed the highest percentage of energy among processed foods, followed by white cheeses and yellow cheeses. Ultraprocessed breads (3.8%) were the ultra-processed foods that contributed the most to the total calories consumed in this group of foods, followed by sweets and sweets (3.1%) pizzas and salted (2.4%), soft drinks and juices industrialized or artificial (2.3%).After adjustments, there was areduction in the arithmetic mean of the percentage of caloric contribution of the UP with the decrease in schooling, family income per capita and occupational social class. All associations suggested a dose-response gradient.Conclusions:the NOVA classification was inserted in the baseline of the ELSA-Brazil, 2008-2010 and will be important so that scientific evidence can be produced between the relationship of UP food consumption and health outcomes. In addition, it was observed that the caloric contribution of ultra-processed food was higher among individuals of higher socioeconomic level among ELSA-Brazil participants

Consumption of ultra-processed foods and socioeconomic position: a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

The objective of the study was to estimate the contribution of ultra-processed foods to total caloric intake and investigate whether it differs according to socioeconomic position. We analyzed baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil 2008-2010; N = 14.378) and data on dietary intake using a food frequency questionnaire, assigning it into three categories: unprocessed or minimally processed foods and processed culinary ingredients, processed foods, and ultra-processed foods. We measured the associations between socioeconomic position (education, per capita household income, and occupational social class) and the percentage of caloric contribution of ultra-processed foods, using generalized linear regression models adjusted for age and sex. Unprocessed or minimally processed foods and processed culinary ingredients contributed to 65.7% of the total caloric intake, followed by ultra-processed foods (22.7%). After adjustments, the percentage of caloric contribution of ultra-processed foods was 20% lower among participants with incomplete elementary school when compared to postgraduates. Compared to individuals from upper income classes, the caloric contribution of ultra-processed foods was 10%, 15% and 20% lower among the ones from the three lowest income, respectively. The caloric contribution of ultra-processed foods was also 7%, 12%, 12%, and 17% lower among participants in the lowest occupational social class compared to those from high social classes. Results suggest that the caloric contribution of ultra-processed foods is higher among individuals from high socioeconomic positions with a dose-response relationship for the associations.

Consumption of ultra-processed foods and socioeconomic position: a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health / O consumo de alimentos ultraprocessados e nível socioeconômico: uma análise transversal do Estudo Longitudinal de Saúde do Adulto, Brasil / Consumo de comida ultraprocesada y nivel socioeconómico: un análisis transversal del Estudio Longitudinal Brasileño sobre Salud en la Edad Adulta

The objective of the study was to estimate the contribution of ultra-processed foods to total caloric intake and investigate whether it differs according to socioeconomic position. We analyzed baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil 2008-2010; N = 14.378) and data on dietary intake using a food frequency questionnaire, assigning it into three categories: unprocessed or minimally processed foods and processed culinary ingredients, processed foods, and ultra-processed foods. We measured the associations between socioeconomic position (education, per capita household income, and occupational social class) and the percentage of caloric contribution of ultra-processed foods, using generalized linear regression models adjusted for age and sex. Unprocessed or minimally processed foods and processed culinary ingredients contributed to 65.7% of the total caloric intake, followed by ultra-processed foods (22.7%). After adjustments, the percentage of caloric contribution of ultra-processed foods was 20% lower among participants with incomplete elementary school when compared to postgraduates. Compared to individuals from upper income classes, the caloric contribution of ultra-processed foods was 10%, 15% and 20% lower among the ones from the three lowest income, respectively. The caloric contribution of ultra-processed foods was also 7%, 12%, 12%, and 17% lower among participants in the lowest occupational social class compared to those from high social classes. Results suggest that the caloric contribution of ultra-processed foods is higher among individuals from high socioeconomic positions with a dose-response relationship for the associations.

O estudo teve como objetivo estimar a contribuição dos alimentos ultraprocessados à ingestão calórica total e investigar se essa contribuição difere de acordo com nível socioeconômico. Analisamos os dados da linha de base do Estudo Longitudinal de Saúde do Adulto-Brasil (ELSA-Brasil 2008-2010; N = 14.378) e os de ingestão alimentar, usando um questionário sobre frequência de consumo alimentar, em três categorias: alimentos não processados ou minimamente processados e ingredientes culinários processados, alimentos processados e alimentos ultraprocessados. Estimamos as associações entre nível socioeconômico (escolaridade, renda domiciliar per capita e classe social ocupacional) e o percentual da contribuição calórica dos ultraprocessados, usando modelos lineares generalizados, ajustados por idade e sexo. Os alimentos não processados ou minimamente processados e ingredientes culinários processados representaram 65,7% da ingestão calórica total, seguidos pelos ultraprocessados (22,7%). Depois dos ajustes, a contribuição dos ultraprocessados foi 20% mais baixa entre participantes com ensino fundamental incompleto, quando comparados aos indivíduos com pós-graduação. Quando comparados aos indivíduos das classes de renda mais alta, a contribuição calórica dos ultraprocessados foi 10%, 15% e 20% mais baixa entre aqueles pertencentes aos três quintis de renda mais baixos, respectivamente. Além disso, a contribuição calórica dos ultraprocessados foi 7%, 12%, 12% e 17% mais baixa entre os participantes da classe social ocupacional mais baixa, comparados aos das classes sociais mais altas. Os resultados sugerem que a contribuição calórica dos alimentos ultraprocessados é mais alta entre os indivíduos de nível socioeconômico mais alto, com gradiente de dose e resposta nas associações.

El objetivo del estudio fue estimar la contribución de las comidas ultraprocesadas en la ingesta total calórica e investigar si difiere según el nivel socioeconómico. Analizamos datos de referencia, procedentes del Estudio Longitudinal Brasileño sobre Salud en la Edad Adulta (ELSA-Brasil 2008-2010; N = 14.378) y datos de la ingesta nutricional, usando un cuestionario de frecuencia sobre comidas, asignándole tres categorías: comida sin procesar o mínimamente procesada e ingredientes culinarios procesados, comidas procesadas, y comidas ultraprocesadas. Medimos las asociaciones entre el nivel socioeconómico (educación, ingreso por hogar per cápita, y clase ocupacional social) y el porcentaje de la contribución calórica de la comida ultraprocesada, usando modelos de regresión lineal generalizada, ajustados por edad y sexo. Las comidas sin procesar o mínimamente procesadas con ingredientes culinarios procesados contribuyeron al 65,7% del total de la ingesta calórica, seguidos de la comida ultraprocesada (22,7%). Tras los ajustes, el porcentaje de la contribución calórica de la comida ultraprocesada fue un 20% menor entre los participantes con la escuela elemental incompleta, cuando se compararon con los postgraduados. Comparados con los individuos de las clases con ingresos superiores, la contribución calórica de las comidas ultraprocesadas fue un 10%, 15% y 20% menor entre quienes pertenecían a las tres categorías de ingresos más bajas, respectivamente. La contribución calórica de la comida ultraprocesada fue también un 7%, 12%, 12%, y 17% más baja entre los participantes en el nivel ocupacional social más bajo, comparados con aquellos de las clases sociales altas. Los resultados sugieren que la contribución calórica de la comida ultraprocesada es más alta entre quienes proceden de niveles socioeconómicos más altos con una relación dosis-respuesta para las asociaciones establecidas.

Evaluation of a web-based registry of inherited bleeding disorders: a descriptive study of the Brazilian experience with HEMOVIDAweb Coagulopatias.

BACKGROUND: Inherited bleeding disorders (IBD) consist of a group of rare heterogeneous diseases, which require treatment for life. Management of these disorders is complex and costly. Therefore, good quality data of the affected population is crucial to guide policy planning. The aim of this manuscript is to describe the impact of a national, web-based registry - the Hemovidaweb Coagulopatias (HWC) - in the management of the IBD in Brazil. METHODS: The system was developed in PHP 5.0 language and is available on the internet at http://coagulopatiasweb.datasus.gov.br . The system was validated in September 2008 and launched nationally with input from January 1, 2009. HWC collects variables related to socio-demographic, clinical, laboratory and treatment data of patients with IBD. RESULTS: Within 7 years, there was an increment of 90.8% on the diagnosis of IBD altogether, which increased from 11,040 in December 2007 to 21,066 in December 2014. This is now the fourth and third largest world population of patients with haemophilia and von Willebrand's disease (vWD), respectively, according to the most recent (2015) Annual Global Survey of the World Federation of Hemophilia. The data collected provided the basis for planning and implementing home therapy, prophylaxis and immune tolerance induction (ITI), recently initiated in Brazil. CONCLUSION: HWC was an effective tool in the increment of registration of patients with IBD in Brazil. Furthermore, it was essential to support policy planning, monitoring, evaluation and treatment. Future development should focus on surveillance, health outcomes and research. Every country should implement a national registry on IBD.

[Environmental conditions and prevalence of parasitic infection in Xukuru-Kariri indigenous people, Caldas, Brazil]. / Condições ambientais e prevalência de infecção parasitária em indígenas Xukuru-Kariri, Caldas, Brasil.

OBJECTIVE: To describe the environmental conditions and the parasitic infection status of Xukuru-Kariri individuals living in the municipality of Caldas, state of Minas Gerais, Brazil. METHODS: A cross-sectional study was carried out in March 2009. Sociodemographic and environmental data were collected through interviews. Water and fecal samples were collected for determination of environmental contamination and parasitic infection status. RESULTS: The Xukuru-Kariri population living in Caldas included 86 people divided into 22 families. Of 22 heads of household, 81.8% had low schooling (not higher than elementary education). Of 26 water samples collected for microbiological analysis, 77.0% were positive for total coliforms and 4.0% for Escherichia coli. Residents of 27.3% of households defecated in the open. Trash was scattered in the yard of 54.5% of households. Fecal samples were collected from 60 individuals, with parasitic infection in 66.6%. The following prevalence rates were recorded: Entamoeba histolytica/dispar, 6.7%; Entamoeba coli, 60.0%; Endolimax nana, 1.8%; and Giardia duodenalis, 6.6%. CONCLUSIONS: The people included in this study faced environmental characteristics that contributed to their health vulnerability. Health actions as well as the implementation of public policies to provide sanitation, with quality water and adequate collection and treatment of human and household waste, are essential to prevent environmental degradation and improve the quality of life of these individuals.

Condições ambientais e prevalência de infecção parasitária em indígenas Xukuru-Kariri, Caldas, Brasil / Environmental conditions and prevalence of parasitic infection in Xukuru-Kariri indigenous people, Caldas, Brazil

OBJETIVO: Descrever as condições ambientais e o quadro de infecção parasitária dos indígenas Xukuru-Kariri residentes no município de Caldas (MG), Brasil. MÉTODOS: Foi realizado um estudo transversal em março de 2009. Dados sociodemográficos e ambientais foram coletados através de entrevista. Amostras de água e fezes foram coletadas para determinação da contaminação ambiental e parasitológica. RESULTADOS: A população foi composta por 86 indivíduos, divididos em 22 famílias, sendo 81,8% dos chefes de baixa escolaridade (primeiro grau incompleto). Das 26 amostras de água coletadas para análise microbiológica, 77,0% foram positivas para coliformes totais e 4,0% para Escherichia coli. Em 27,3% dos domicílios, os moradores defecavam na parte exterior da casa, e 54,5% dos domicílios possuíam lixo espalhado pelo quintal. Foram coletadas amostras fecais de 60 indivíduos, com positividade em 66,6%. As prevalências registradas foram: Entamoeba histolytica/dispar, 6,7%; Entamoeba coli, 60,0%; Endolimax nana, 1,8%; e Giardia duodenalis, 6,6%. CONCLUSÕES: As pessoas incluídas na pesquisa estavam sujeitas a características ambientais que as tornavam vulneráveis nos aspectos relacionados à saúde. É primordial a promoção de ações de saúde e a implementação de políticas públicas de saneamento, com fornecimento de água de qualidade adequada e recolhimento e tratamento de dejetos humanos e rejeitos domiciliares para evitar a degradação ambiental e melhorar a qualidade de vida desses indivíduos.

OBJECTIVE: To describe the environmental conditions and the parasitic infection status of Xukuru-Kariri individuals living in the municipality of Caldas, state of Minas Gerais, Brazil. METHODS: A cross-sectional study was carried out in March 2009. Sociodemographic and environmental data were collected through interviews. Water and fecal samples were collected for determination of environmental contamination and parasitic infection status. RESULTS: The Xukuru-Kariri population living in Caldas included 86 people divided into 22 families. Of 22 heads of household, 81.8% had low schooling (not higher than elementary education). Of 26 water samples collected for microbiological analysis, 77.0% were positive for total coliforms and 4.0% for Escherichia coli. Residents of 27.3% of households defecated in the open. Trash was scattered in the yard of 54.5% of households. Fecal samples were collected from 60 individuals, with parasitic infection in 66.6%. The following prevalence rates were recorded: Entamoeba histolytica/dispar, 6.7%; Entamoeba coli, 60.0%; Endolimax nana, 1.8%; and Giardia duodenalis, 6.6%. CONCLUSIONS: The people included in this study faced environmental characteristics that contributed to their health vulnerability. Health actions as well as the implementation of public policies to provide sanitation, with quality water and adequate collection and treatment of human and household waste, are essential to prevent environmental degradation and improve the quality of life of these individuals.

Condições ambientais e prevalência de infecção parasitária em indígenas Xukuru-Kariri, Caldas, Brasil / Environmental conditions and prevalence of parasitic infection in Xukuru-Kariri indigenous people, Caldas, Brazil

Objetivo. Descrever as condições ambientais e o quadro de infecção parasitária dos indígenas Xukuru-Kariri residentes no município de Caldas (MG), Brasil. Métodos. Foi realizado um estudo transversal em março de 2009. Dados sociodemográficos e ambientais foram coletados através de entrevista. Amostras de água e fezes foram coletadas para determinação da contaminação ambiental e parasitológica. Resultados. A população foi composta por 86 indivíduos, divididos em 22 famílias, sendo 81,8% dos chefes de baixa escolaridade (primeiro grau incompleto). Das 26 amostras de água coletadas para análise microbiológica, 77,0% foram positivas para coliformes totais e 4,0% para Escherichia coli. Em 27,3% dos domicílios, os moradores defecavam na parte exterior da casa, e 54,5% dos domicílios possuíam lixo espalhado pelo quintal. Foram coletadas amostras fecais de 60 indivíduos, com positividade em 66,6%. As prevalências registradas foram: Entamoeba histolytica/dispar, 6,7%; Entamoeba coli, 60,0%; Endolimax nana, 1,8%; e Giardia duodenalis, 6,6%. Conclusões. As pessoas incluídas na pesquisa estavam sujeitas a características ambientais que as tornavam vulneráveis nos aspectos relacionados à saúde. É primordial a promoção de ações de saúde e a implementação de políticas públicas de saneamento, com fornecimento de água de qualidade adequada e recolhimento e tratamento de dejetos humanos e rejeitos domiciliares para evitar a degradação ambiental e melhorar a qualidade de vida desses indivíduos.

Objective. To describe the environmental conditions and the parasitic infection status of Xukuru-Kariri individuals living in the municipality of Caldas, state of Minas Gerais, Brazil. Methods. A cross-sectional study was carried out in March 2009. Sociodemographic and environmental data were collected through interviews. Water and fecal samples were collected for determination of environmental contamination and parasitic infec¬tion status. Results. The Xukuru-Kariri population living in Caldas included 86 people divided into 22 families. Of 22 heads of household, 81.8% had low schooling (not higher than elementary education). Of 26 water samples collected for microbiological analysis, 77.0% were positive for total coliforms and 4.0% for Escherichia coli. Residents of 27.3% of households defecated in the open. Trash was scattered in the yard of 54.5% of households. Fecal samples were collected from 60 individuals, with parasitic infection in 66.6%. The following prevalence rates were recorded: Entamoeba histolytica/dispar, 6.7%; Entamoeba coli, 60.0%; Endolimax nana, 1.8%; and Giardia duodenalis, 6.6%. Conclusions. The people included in this study faced environmental characteristics that contributed to their health vulnerability. Health actions as well as the implemen-tation of public policies to provide sanitation, with quality water and adequate collec¬tion and treatment of human and household waste, are essential to prevent environ¬mental degradation and improve the quality of life of these individuals.

Perfil nutricional dos indígenas Xukuru-Kariri, Minas Gerais, de acordo com diferentes indicadores antropométricos e de composição corporal / Nutritional profile of the Xukuru-Kariri indigenous people in the state of Minas Gerais in accordance with different anthropometric and body composition indicators

O objetivo deste artigo foi avaliar o perfil nutricional dos indígenas Xukuru-Kariri entre 7 anos e 78 anos aldeados em Minas Gerais de acordo com os diferentes indicadores antropométricos e de composição corporal . As medidas aferidas foram: peso, estatura, circunferência da cintura (CC) e percentual de gordura corporal (%GC). Foram calculadas a sensibilidade e a especificidade para os índices antropométricos com intervalo de confiança de 95% e o valor preditivo positivo (VPP) e negativo (VPN). A população foi constituída por 58 indivíduos, sendo 56,9% (n = 33) do sexo masculino e 43,1% (n = 25) do sexo feminino. A especificidade foi superior à sensibilidade em relação a todos os índices. Observou-se que 29% dos indivíduos foram classificados com excesso de adiposidade corporal quando avaliados pelo IMC e pela bioimpedância mão a mão e 50% dos indivíduos apresentaram alta adiposidade corporal em relação ao IMC e a CC. É necessário que sejam realizados estudos com diferentes etnias a fim de se construir indicadores nutricionais específicos para orientação de serviços de saúde indígenas.

The scope of this study was to evaluate the nutritional profile of indigenous Xukuru-Kariri villagers in the state of Minas Gerais between seven and seventy-eight years of age in accordance with the different anthropometric and body composition indicator. The measurements were: weight, height, waist circumference (WC) and body fat percentage (BF%). The sensitivity and specificity of anthropometric indices were calculated with a confidence interval of 95% and positive predictive value (PPV) and negative predictive value (NPV). A total of 58 individuals was evaluated, of which 56.9% (n =33) were male and 43.1% (n =25) were female. Specificity was greater than sensitivity in all indices. It was seen that 29% of individuals were classified as having excess body fat as assessed by BMI and hand-to-hand bioimpedance and 50% of subjects had high body fat in relation to BMI and WC. Studies need to be conducted with different ethnic groups in order to construct indicators for specific nutritional guidance of indigenous health services.

[Nutritional profile of the Xukuru-Kariri indigenous people in the state of Minas Gerais in accordance with different anthropometric and body composition indicators]. / Perfil nutricional dos indígenas Xukuru-Kariri, Minas Gerais, de acordo com diferentes indicadores antropométricos e de composição corporal.

The scope of this study was to evaluate the nutritional profile of indigenous Xukuru-Kariri villagers in the state of Minas Gerais between seven and seventy-eight years of age in accordance with the different anthropometric and body composition indicator. The measurements were: weight, height, waist circumference (WC) and body fat percentage (BF%). The sensitivity and specificity of anthropometric indices were calculated with a confidence interval of 95% and positive predictive value (PPV) and negative predictive value (NPV). A total of 58 individuals was evaluated, of which 56.9% (n =33) were male and 43.1% (n =25) were female. Specificity was greater than sensitivity in all indices. It was seen that 29% of individuals were classified as having excess body fat as assessed by BMI and hand-to-hand bioimpedance and 50% of subjects had high body fat in relation to BMI and WC. Studies need to be conducted with different ethnic groups in order to construct indicators for specific nutritional guidance of indigenous health services.

Hemovida Web Coagulopatias: um relato do seu processo de desenvolvimento e implantação. / Hemovida Web Coagulophaties: a report of its development andimplementation.

As coagulopatias hereditárias são doenças hemorrágicas decorrentes da deficiência de um ou mais fatores de coagulaçãosanguínea. A Coordenação da Política Nacional de Sangue e Hemoderivados, responsável pelo Programa Nacional deCoagulopatias Hereditárias, em parceria com o Departamento de Informática do Sistema Único de Saúde (SUS), desenvolveuo sistema informatizado Hemovida Web Coagulopatias, cujo objetivo é a sistematização do cadastro nacional dospacientes com coagulopatias e outras doenças hemorrágicas hereditárias. Esse cadastro reúne dados sobre o diagnóstico,tratamento e complicações das doenças, bem como o perfil sociodemográfico dos pacientes e os quantitativos de fatoresde coagulação a eles dispensados. Este artigo apresentou um relato sobre o desenvolvimento e implantação desse Sistema,considerando a descrição dos antecedentes, desenvolvimento, processamento dos dados, treinamento de pessoal esituação atual da implantação, além de apontar as potencialidades e perspectivas previstas para o seu aperfeiçoamento. Osistema está disponível na Internet desde janeiro de 2009 e conta com a adesão das Unidades da Federação, em estágiosdiferenciados de utilização. O uso potencial das informações produzidas nesse sistema é de grande necessidade, devido àpossibilidade de se realizar uma gestão eficiente às políticas públicas voltadas a essa população, em função de um gastopúblico de elevado valor na aquisição de hemoderivados.

Inherited coagulopathies are bleeding disorders characterized by the deficiency of one or more coagulation factors. The Coordenaçãoda Política Nacional de Sangue e Hemoderivados, in charge of the National Program of Inherited Coagulopathieshas developed, in conjunction with the Departamento de Informática do Sistema Único de Saúde (SUS), the system named Hemovida Web Coagulopatias, which role is to organize the national registry of patients with inherited coagulopathies and other bleedingdisorders. The registry compiles data on diagnosis, treatment and complications of the disorders, as well as the socioeconomic profile of thepatients and detailed treatment used. This article presented an evaluation of the development and implantation of this system, considering therational for its development, data processing, training of human resources and present situation of implantation. It also discussed its powerand perspectives for improvement. The system is available on the Internet since January 2009 with implantation in all States with differentlevels of utilization. The potential use of the system information is enormous, due to the need of implementing political actions directed to thispopulation of patients, due to a high value of public spending on the purchase of blood products.

Avaliação do sistema nacional de hemovigilância dos anos 2002 a 2005. / Brazilian National Hematologic Vigilance System Assessment from 2002 to 2005.

Hemovigilância é um sistema de avaliação e alerta, com o objetivo de coletar e avaliar informações sobre eventos adversos pós-transfusionais. No Brasil, a hemovigilância iniciou-se em 2002, sob responsabilidade da Agência Nacional de Vigilância Sanitária, tendo hospitais sentinelascomo unidades notificadoras. Este trabalho apresenta uma avaliação do Sistema Nacional de Hemovigilância do Brasil (SNH), de 2002 a 2005, utilizando o Guia para Avaliação de Sistemas de Vigilância em Saúde Pública do CDC-Atlanta. Foram avaliados os atributos simplicidade,aceitabilidade, qualidade dos dados, oportunidade e representatividade. Foram notificados 3.237 eventos adversos pós-transfusionais; 73% confirmados. O SNH mostrou-se complexo, em especial pela quantidade excessiva de campos na ficha de notificação. Apresentoubaixa aceitabilidade com 30% dos hospitais sentinelas notificando. A representatividade foi classificada como regular, pois esse atributo não foi satisfatório nas regiões centro-oeste, norte e nordeste. Por outro lado, a qualidade dos dados e a oportunidade foram consideradas boas.Recomenda-se a reformulação da ficha de notificação, com redução no número de campos e melhor organização e a ampliação do número de unidades notificadoras. A Anvisa adotou as recomendações para o novo Sistema Nacional de Vigilância de Eventos Adversos e QueixasTécnicas de Produtos sob Vigilância Sanitária.

Hematologic vigilance is a system of evaluation and alert that aims to collect and analyze information regarding post-transfusion adverse events. Brazilian Hematologic Vigilance System (BHS) was established in 2002, under responsibility of Agência Nacional de Vigilância Sanitária(Anvisa ? national sanitary vigilance agency). Sentinel hospitals were targeted as notification units. This article presents an evaluation of BHS attributes, from 2002 to 2005, based on Guidelines for Evaluating Public Health Surveillance Systems, from CDC-Atlanta. We evaluatedsimplicity, acceptability, data quality, opportunity and representative ness. A total of 3237 reports of adverse events were notified; 73% confirmed events. BHS is complex, mainly regarding the notification form, composed by an excessive number of s to be filled. The acceptabilitywas low, and only 30% of the sentinel hospitals notified frequently. The representative ness was average, because of its unsatisfactory evaluation on central-west, north and northeast Brazilian geographic regions. Data quality and opportunity were considered good. Recommendations as changes in report form and to increase the number of notifies were suggested to improve simplicity, acceptability and representative ness. Some of the recommendations were effectively put in practice by Anvisa.