Enfermeira: a construção de um modelo de comportamento a partir dos discursos médicos do início do século

El objetivo es trazar un paralelo entre el contenido de los discursos medicos y el comportamiento esperado y esteriotipado de las enfermeras del inicio del siglo. Tiene un abordaje hsitórico-social que utilizó como fuentes los discursos médicos y de enfermeras proferidos en las escuela de enfermagen y de medicina. El analisis de los discursos médicos comparada a los discursos de las enfermeras reflejan la formación de una mentalidad intrinsecamente modelada y socilizada por el poder médico que las deseaba santas y sometidas y sirvientes.O objetivo é traçar um paralelo entre o conteúdo dos discursos médicos e o comportamento esperado e estereotipado das enfermeiras do início do século. É uma abordagem histórico-social que utilizou como fontes os discursos médicos e de enfermeiras proferidos nas escolas de enfermagem e de medicina. A análise dos discursos médicos comparada aos discursos das enfermeiras refletem a formação de uma mentalidade intrinsecamente modelada e docilizada pelo poder médico que as desejava santas e subservientes.The purpose of this study is to trace a parallel between the medical discourse content and the expected and stereotyped nurses behavior at the beginning of the twentieth century. It is a historic-social approach in which authors analysed the speeches used by nurses and physicians at nursing and medicine schools. The analysis of the physicians discourse compared to nurses discourse revealed the formation of a mentality shaped by the medical power that wanted them "holy" and servile

Multimorbidity profile of COVID-19 deaths in Portugal during 2020

Background: COVID-19 is caused by SARS-CoV-2 infection and has reached pandemic proportions. Since then, several clinical characteristics have been associated with poor outcomes. This study aimed to describe the morbidity profile of COVID-19 deaths in Portugal. Methods: A study was performed including deaths certificated in Portugal with “COVID-19” (ICD-10: U07.1 or U07.2) coded as the underlying cause of death from the National e-Death Certificates Information System between 16 March and 31 December 2020. Comorbidities were derived from ICD-10 codes using the Charlson and Elixhauser indexes. The resident Portuguese population estimates for 2020 were used. Results: The study included 6701 deaths (death rate: 65.1 deaths/100,000 inhabitants), predominantly males (72.1). The male-to-female mortality ratio was 1.1. The male-to-female mortality rate ratio was 1.2; however, within age groups, it varied 5.0–11.4-fold. COVID-19 deaths in Portugal during 2020 occurred mainly in individuals aged 80 years or older, predominantly in public healthcare institutions. Uncomplicated hypertension, uncomplicated diabetes mellitus, congestive heart failure, renal failure, cardiac arrhythmias, dementia, and cerebrovascular disease were observed among COVID-19 deceased patients, with prevalences higher than 10%. A high prevalence of zero morbidities was registered using both the Elixhauser and Charlson comorbidities lists (above 40.2%). Nevertheless, high multimorbidity was also identified at the time of COVID-19 death (about 36.5%). Higher multimorbidity levels were observed in men, increasing with age up to 80 years old. Zero-morbidity prevalence and high multimorbidity prevalences varied throughout the year 2020, seemingly more elevated in the mortality waves’ peaks, suggesting variation according to the degree of disease incidence at a given period. Conclusions: This study provides detailed sociodemographic and clinical information on all certificated deaths from COVID-19 in Portugal during 2020, showing complex and extreme levels of morbidity (zero-morbidity vs. high multimorbidity) dynamics during the first year of the pandemic in Portugal.info:eu-repo/semantics/publishedVersio

Alguns dados sobre a Fauna entomológica da ilha das Flores - Açores

IV Expedição Científica do Departamento de Biologia - Flores 1989Com este trabalho, realizado em Julho de 1989 nas Flores - a ilha mais ocidental do Arquipélago dos Açores -, acrescentaram-se onze espécies de Lepidópteros à lista referenciada para aquela ilha, pertencendo uma à família Lycaenidae (Lampides boeticus L.), oito a familia Noctuidae (Agrotis ipsilon HFN., Brotolomia meticulosa L., Chrysodeixis chalcites ESPER., Heliothis armigera HBN., Noctua atlantica WARREN, Noctua pronuba L., Peridroma saucia HBN., Sesamia nonagrioides LEF.), uma à família Nymphalidae (Vanessa atalanta L.) e uma a família Pyralidae (Glyphodes unionalis HBN.). Entre os demais insectos, foram identificadas cerca de duas dezenas e meia de espécies, distribuídas pelas Ordens Dermaptera, Orthoptera, Dictyoptera, Heteroptera, Homoptera, Coleoptera, Neuroptera, Diptera, Hymenoptera e Collembola. Salienta-se ainda a importância, do ponto de vista agronómico, das pragas Mythimna unipuncta (HAWORTH) e Xestia c-nigrun L. naquela ilha.RÉSUMÉ: Avec ce travail, réalisé en Juillet 1989 a Flores - l'île plus occidental de l'archipel des Açores, onze espèces de Lépidoptères ont été ajoutées à la liste des espèces connus pour cette île, dont une appartient a la famille Lycaenidae (Lampides boelicus L.), huit à la famille Noctuidae (Agrotis ipsilon HFN., Brotolomia meticulosa L. Chrysodeicis chalcites ESPER., Heliothis armigera HBN., Noctua atlantica WARREN, Noctua pronuba L., Peridroma saucia HBN., Sesamia nonagrioides LEF.), une à la famille Nymphalidae (Vanessa atalanta L.) et une à la famille Pyralidae (Glyphodes unionalis HBN.). Parmi les autres insects ont été identifiés environ deux dizaines et demie d'espèces, lesquelles sont réparties par les Ordres Dermaptera, Orthoptera, Dictyoptera, Heteroptera, Homoptera, Coleoptera, Neuroptera, Diptera, Hymenoptera et Collembola. On remarque I'importance, du point de vue agronomique, des ravageurs Mythimna unipuncra (HAWORTH) et Xestia c-nigrum L. dans cette île

Whole-genome sequencing of 1,171 elderly admixed individuals from Brazil

As whole-genome sequencing (WGS) becomes the gold standard tool for studying population genomics and medical applications, data on diverse non-European and admixed individuals are still scarce. Here, we present a high-coverage WGS dataset of 1,171 highly admixed elderly Brazilians from a census-based cohort, providing over 76 million variants, of which ~2 million are absent from large public databases. WGS enables identification of ~2,000 previously undescribed mobile element insertions without previous description, nearly 5 Mb of genomic segments absent from the human genome reference, and over 140 alleles from HLA genes absent from public resources. We reclassify and curate pathogenicity assertions for nearly four hundred variants in genes associated with dominantly-inherited Mendelian disorders and calculate the incidence for selected recessive disorders, demonstrating the clinical usefulness of the present study. Finally, we observe that whole-genome and HLA imputation could be significantly improved compared to available datasets since rare variation represents the largest proportion of input from WGS. These results demonstrate that even smaller sample sizes of underrepresented populations bring relevant data for genomic studies, especially when exploring analyses allowed only by WGS

Trajetórias truncadas, trabalho e futuro: jovens fora de série na escola pública de ensino médio

Resumo O artigo discute resultados da etapa quantitativa da pesquisa Jovens fora de série: trajetórias truncadas de estudantes do ensino médio na cidade do Rio de Janeiro. A investigação tem como objetivo geral depreender e compreender trajetórias de escolarização e percursos biográficos de jovens estudantes de ensino médio de escolas públicas que se encontram em situação de defasagem escolar. Neste artigo, apresenta-se o perfil que emerge da aplicação do questionário estruturado a um universo de 593 jovens. A amostra exploratória e não probabilística foi distribuída entre 14 escolas localizadas nas zonas sul, centro, oeste e norte da cidade do Rio de Janeiro. Os jovens participantes da pesquisa fazem parte de classes de Educação de Jovens Adultos (EJA) e do programa de correção de fluxo denominado Autonomia. Enfoque especial de análise é dado à combinação entre trabalho, estudo e constituição de projetos de futuro. Verificou-se que o abandono escolar cria mais problemas para o fluxo da escolarização do que as reprovações. Os dados apontam para a existência de uma superposição entre os tempos de trabalho e escola na vida dos jovens. Nesse sentido, ocorre um duplo efeito do trabalho nas trajetórias dos estudantes. Se, por um lado, trabalhar e estudar representam um desafio para a continuidade dos estudos sem truncamentos do fluxo da escolarização, por outro, a experiência de trabalho cria disposições relacionadas com a independência, a conquista da autonomia e o delineamento de projetos de futuro

Doenças crônicas, problemas crônicos: encontros e desencontros com os serviços de saúde em itinerários terapêuticos de homens rurais

Apresenta-se uma análise do sistema de cuidado profissional a partir de itinerários terapêuticos de homens em situação de adoecimento crônico. Trata-se de uma pesquisa qualitativa, descritiva e exploratória realizada em uma comunidade rural, situada num município da metade Sul do Rio Grande do Sul. Para a geração de dados, empregaram-se entrevistas semiestruturadas, grupo focal, diários de campo e observação não participante, no decorrer dos meses de janeiro a julho de 2011. Como técnica de análise, utilizou-se análise temática com triangulação de dados. Os achados apresentam diferentes itinerários terapêuticos traçados de acordo com a doença crônica vivenciada ou agudizada. Também evidenciam questões que permeiam as construções sociais da masculinidade e problemas crônicos de acesso aos serviços de saúde pela população rural. Revelou-se ao longo dos itinerários terapêuticos que o cuidado requerido pela situação de adoecimento crônico pode repercutir em diversas interfaces do cotidiano, tornando esse vivenciar um problema crônico que extrapola as dimensões biológicas da doença. Para os comentários finais, aponta-se a necessidade de mobilizar esforços para melhorar o acesso e principalmente para promover acessibilidade dos homens rurais aos serviços de saúde. Além disso, ressalta-se a necessidade de investir em ações e práticas que trabalhem com as questões que permeiam a masculinidade e sua relação com o cuidado em saúde, especialmente no vivenciar uma doença crônica, assim como mobilizar esforços para promoção de posturas profissionais mais inclusivas e humanizadas, que possibilite que os sujeitos masculinos sintam-se pertencentes aos espaços de saúde.An analysis of the professional system of care is presented from therapeutic itineraries of men in situations of chronic illness. It is a qualitative, descriptive and exploratory research held in a rural community, located in a town of the southern half of Rio Grande do Sul. To generate data, semi-structured interviews, focus groups, field diaries and non-participant observation were used, during the months of January to July 2011. As analysis technique, thematic analysis was used with data triangulation. The findings show different therapeutic itineraries drawn according to experienced chronic or acute disease. They also evidence issues that permeate the social constructions of masculinity and chronic problems of access to health services for the rural population. It was revealed over the therapeutic itineraries that the care required by the situation of chronic illness can impact on various interfaces of everyday life, making this experience a chronic problem that extrapolates the biological disease. For final comments, the need to mobilize efforts is pointed to improve the access and mainly to promote accessibility of rural men to health services. Moreover, it emphasizes the need to invest in actions and practices that work with issues that permeate masculinity and its relationship to health care, especially in experiencing a chronic disease, as well as mobilize efforts to promote professional attitudes more inclusive and humanized, enabling the male subjects feel owned to health areas

The Microcephaly Epidemic Research Group Paediatric Cohort (MERG-PC): A Cohort Profile.

This cohort profile aims to describe the ongoing follow-up of children in the Microcephaly Epidemic Research Group Paediatric Cohort (MERG-PC). The profile details the context and aims of the study, study population, methodology including assessments, and key results and publications to date. The children that make up MERG-PC were born in Recife or within 120 km of the city, in Pernambuco/Brazil, the epicentre of the microcephaly epidemic. MERG-PC includes children from four groups recruited at different stages of the ZIKV microcephaly epidemic in Pernambuco, i.e., the Outpatient Group (OG/n = 195), the Microcephaly Case-Control Study (MCCS/n = 80), the MERG Pregnant Women Cohort (MERG-PWC/n = 336), and the Control Group (CG/n = 100). We developed a comprehensive array of clinical, laboratory, and imaging assessments that were undertaken by a 'task force' of clinical specialists in a single day at 3, 6, 12, 18 months of age, and annually from 24 months. Children from MCCS and CG had their baseline assessment at birth and children from the other groups, at the first evaluation by the task force. The baseline cohort includes 711 children born between February 2015 and February 2019. Children's characteristics at baseline, excluding CG, were as follows: 32.6% (184/565) had microcephaly, 47% (263/559) had at least one physical abnormality, 29.5% (160/543) had at least one neurological abnormality, and 46.2% (257/556) had at least one ophthalmological abnormality. This ongoing cohort has contributed to the understanding of the congenital Zika syndrome (CZS) spectrum. The cohort has provided descriptions of paediatric neurodevelopment and early epilepsy, including EEG patterns and treatment response, and information on the frequency and characteristics of oropharyngeal dysphagia; cryptorchidism and its surgical findings; endocrine dysfunction; and adenoid hypertrophy in children with Zika-related microcephaly. The study protocols and questionnaires were shared across Brazilian states to enable harmonization across the different studies investigating microcephaly and CZS, providing the opportunity for the Zika Brazilian Cohorts Consortium to be formed, uniting all the ZIKV clinical cohorts in Brazil

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe