Adaptation and applicability of the "mistreatment" component in Integrated Management of Childhood Illness in Brazil

OBJETIVOS: descrever o processo de adaptação ao contexto brasileiro e da aplicabilidade do conteúdo do módulo de maus-tratos no âmbito da estratégia Atenção Integrada às Doenças Prevalentes na Infância (AIDPI), a partir do original proposto pela Organização Pan-Americana da Saúde. MÉTODOS: O protocolo original foi traduzido para o português, retro-traduzido e revisado de forma independente. Foram incorporados aspectos relativos à legislação, contexto de saúde e organização dos serviços brasileiros. O material foi discutido por especialistas de diferentes áreas até obter consenso a respeito de compreensão e correspondência sobre os conceitos e os instrumentos propostos. A versão preliminar foi testada com grupo de monitores da estratégia AIDPI. Sugestões foram incorporadas ao texto. O módulo final foi aplicado com sucesso em treinamento para monitores em AIDPI na Região Nordeste. RESULTADOS: o material mostrou-se útil, claro e coerente. A classificação de gravidade para maus tratos psicológicos e negligência, além de textos com orientações aos profissionais e pais sobre o desenvolvimento psicomotor e emocional normais da criança foram incluídos. CONCLUSÕES: A incorporação desse módulo de maus-tratos em treinamentos formais na estratégia AIDPI pode preencher uma lacuna na educação do profissional de saúde na atenção primária, onde problemas relacionados à violência contra a criança são frequentes. _________________________________________________________________________________________ ABSTRACT: OBJECTIVES: to describe the process of adaptation to the Brazilian context and the applicability of the "mistreatment" module in the Integrated Mana-gement of Childhood Illness (IMCI) strategy, based on the Pan American Health Organization (PAHO) proposal. METHODS: the original protocol was translated into Portuguese, back-translated and reviewed by an independent observer. Features relating to legislation, the health context and the way Brazilian services are organized were incorporated. The materials were discussed by specialists from various areas until consensus was achieved with regard to the comprehensibility of the text and the correspondence between the wording and the intentions. The preliminary version was tested with a group of IMCI strategy monitors and suggestions arising from this were incorporated into the text. The final module was successfully applied during training of IMCI monitors in the Northeast region of the country. RESULTS: the material was found to be useful, clear and coherent. The ranking of degrees of severity of psychological mistreatment and negligence and texts providing guidelines for health workers and parents on the normal psychomotor and emotional deve-lopment of children were included. CONCLUSIONS: the incorporation of this module on mistreatment in the IMCI strategy's formal training sessions may fill a gap in the education of primary care health workers, who encounter problems relating to violence against children on a regular basis

Seroprevalence of Chikungunya virus and living conditions in Feira de Santana, Bahia-Brazil.

BACKGROUND: Chikungunya is an arbovirus, transmitted by Aedes mosquitoes, which emerged in the Americas in 2013 and spread rapidly to almost every country on this continent. In Brazil, where the first cases were detected in 2014, it currently has reached all regions of this country and more than 900,000 cases were reported. The clinical spectrum of chikungunya ranges from an acute self-limiting form to disabling chronic forms. The purpose of this study was to estimate the seroprevalence of chikungunya infection in a large Brazilian city and investigate the association between viral circulation and living condition. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a population-based ecological study in selected Sentinel Areas (SA) through household interviews and a serologic survey in 2016/2017. The sample was of 1,981 individuals randomly selected. The CHIKV seroprevalence was 22.1% (17.1 IgG, 2.3 IgM, and 1.4 IgG and IgM) and varied between SA from 2.0% to 70.5%. The seroprevalence was significantly lower in SA with high living conditions compared to SA with low living condition. There was a positive association between CHIKV seroprevalence and population density (r = 0.2389; p = 0.02033). CONCLUSIONS/SIGNIFICANCE: The seroprevalence in this city was 2.6 times lower than the 57% observed in a study conducted in the epicentre of the CHIKV epidemic of this same urban centre. So, the herd immunity in this general population, after four years of circulation of this agent is relatively low. It indicates that CHIKV transmission may persist in that city, either in endemic form or in the form of a new epidemic, because the vector infestation is persistent. Besides, the significantly lower seroprevalences in SA of higher Living Condition suggest that beyond the surveillance of the disease, vector control and specific actions of basic sanitation, the reduction of the incidence of this infection also depends on the improvement of the general living conditions of the population

Solidification thermal parameters and dendritic growth during the horizontal directional solidification of Al-7wt.%Si alloy

The main purpose of this work is to investigate the influence of thermal parameters such as growth rate (V L) and cooling rate (T R) on the primary dendrite arm spacings (λ1) during the horizontal transient directional solidification of Al-7wt.%Si hypoeutectic alloy. The primary dendrite spacings were measured along the length of the samples and correlated with these thermal parameters. The variation of dendrite spacings is expressed as a power law function of V L and T R given by the formulas λ1 = 55(V L)-1.1 and λ1 = 212 (T R)-0.55, respectively. A comparative study between the results of this work and those from the literature proposed to investigate these dendrite spacings during the upward and downward vertical directional solidification of Al-7wt.%Si alloy is also conducted. Finally, the experimental data are compared with some predictive dendritic models from the literature

A deficiência como expressão da diferença Disability as an expression of difference

Este trabalho destaca o debate sobre as diferenças que dá fundamento às propostas inclusivistas na contemporaneidade. Tomamos como referenciais fundamentais estudos que não consideram ser a deficiência uma condição estática, natural e definitiva, posto que ela está inscrita nas relações e interações que determinam seu entendimento na sociedade. É, portanto, uma diferença que emerge no processo de produção da existência dos povos, em locais e momentos históricos distintos, assim como são, nesse sentido, as diferenças étnicas, os códigos lingüísticos ou as crenças religiosas. Em síntese, a diferenciação e individuação que dão substância à emancipação humana ainda são promessas, pois o indivíduo que se diferencia é um outro negado socialmente, freqüentemente perseguido para ser moldado, incluído e adaptado.<br>This work emphasizes the debate about differences which gives support to the inclusive proposal in the contemporaneity. We have taken as fundamental references the studies who do not consider the disability a stetic, natural, or definitive condition, since it is inserted in the relationships and interactions which determine its comprehension in the society. It is, therefore, a difference which emerges in the production process of people's existence at defined historical moments and places, as the ethnic differences, the linguistic codes , or the religious beliefs are in the same sense. In short, the diferenciation and the individuation which give substance to the human emancipation are still promises, for the individual who is different is someone socially denied, frequently pursued to be molded, included, and adapted