Relatório de estágio

A presente dissertação reflete toda a atividade letiva e não letiva realizada no presente ano letivo, no âmbito do estágio às disciplinas de português e Espanhol, no agrupamento de Escolas do Fundão. O relatório inclui a contextualização do estágio, abordando-se a descrição da escola, a caracterização das turmas e uma análise crítica dos principais materiais de trabalho, nomeadamente os programas e os manuais. Segue-se a descrição da atividade letiva, incluindo as planificações e as reflexões sobre as aulas dadas. Devido ao fato de o papel do professor se remeter cada vez menos ao espaço de sala de aula, há uma abordagem às atividades extracurriculares realizadas durante este ano letivo, no âmbito quer do português, quer do espanhol. Por fim, serão incluídas também a referência a algumas ações de formação, dado que a docência exige uma constante atualização de saberes

Repercussion of pelvic girdle pain on pregnant women's functionality evaluated through the Brazilian version of the Pelvic Girdle Questionnaire (PGQ-Brazil): a cross-sectional study

To analyze the impact of pelvic girdle pain on pregnant women's functionality, a cross-sectional study involving pregnant women, aged between 18 and 30 years, with a clinical diagnosis of pregnancy-related pelvic girdle pain (PGPP) was performed. Clinical data were collected followed by the application of the Brazilian version of the Pelvic Girdle Questionnaire (PGQ-Brazil). One hundred and five pregnant women participated, of which 62.9% were multiparous. The most frequent diagnostic was the unilateral sacroiliac syndrome. About the onset of pain, 45.7% of them reported that pain occurred on movement and the activities that had greater limitation were sitting, standing, and walking for more than 60 minutes. The average pain according to the Visual Analog Scale (VAS) was 6.59 (SD 1.8), considered a moderate pain. Pregnant women with pelvic girdle syndrome had a mean of 54.86 (SD 22.39) for the total score of PGQ-Brazil; with unilateral sacroiliac syndrome, 31.11 (SD 17.37); and bilateral sacroiliac syndrome, 40.32 (SD 17.46). When the average pain was compared among the groups assessed by the VAS, the pelvic girdle syndrome had the highest average pain (7.67; SD 1.72), followed by bilateral sacroiliac syndrome (6.86; SD 1.95), and the unilateral sacroiliac syndrome (6.21; SD 1.72). By correlating the average VAS with the total score of PGQ-Brazil, there was a positive correlation (r=0.458, p=0.01), indicating that the greater the pain, the greater the level of disability of the pregnant woman. The findings suggest that PGPP may result in different levels of disability, which may directly affect the pregnant women's functionality.A fin de evaluar la repercusión del dolor pélvico en la funcionalidad de embarazadas, se realizó un estudio transversal con mujeres embarazadas, entre 18 y 30 años de edad y diagnosticadas clínicamente con dolor pélvico en el embarazo (DPE). Se recolectaron datos clínicos, después de aplicado la versión brasileña del Pelvic Girdle Questionnaire (PGQ-Brasil). Han participado del estudio 105 embarazadas, de las cuales 62,9% eran multíparas. El diagnóstico más común fue el síndrome sacroilíaco unilateral. Al respecto de la aparición del dolor, un 45,7% dijeron que este dolor ocurría en movimientos y las actividades que les presentaban una mayor limitación eran estar sentada, de pie y caminar por más de 60 minutos. El promedio del dolor en la escala visual analógica (EVA) fue de 6,59 (1,8 DP), considerado un dolor moderado. Las embarazadas con el síndrome pélvico presentaron el promedio de 54,86 (22,39 DP) para la puntuación total del PGQ-Brasil, las con síndrome sacroilíaco unilateral 31,11 (17,37 DP) y con síndrome sacroilíaco bilateral 40,32 (17,46 DP). Al compararse el promedio de dolor entre los síndromes utilizando la EVA, el síndrome pélvico presentó el promedio mayor (7,67; 1,72 DP), enseguida del síndrome sacroilíaco bilateral (6,86; 1,95 DP) y del síndrome sacroilíaco unilateral (6,21; 1,72 DP). Al correlacionarse el promedio de EVA con la puntuación total del PGQ-Brasil, se ha observado una correlación positiva (r=0,458, p=0,01), que muestra que cuanto mayor es el dolor, mayor será la incapacidad de la embarazada. De esta manera, los resultados mostraron que el DPE puede resultar en diversos niveles de incapacidad y puede afectar directamente a la funcionalidad de las embarazadas.Com o objetivo de analisar a repercussão da dor da cintura pélvica na funcionalidade de gestantes, foi realizado um estudo transversal envolvendo mulheres grávidas, com idade entre 18 e 30 anos e diagnóstico clínico de dor da cintura pélvica relacionada à gravidez (DCPG). Foram coletados dados clínicos, seguidos da aplicação do Pelvic Girdle Questionnaire versão brasileira (PGQ-Brasil). Participaram do estudo 105 gestantes, das quais 62,9% eram multíparas. O diagnóstico mais frequente foi o de síndrome sacroilíaca unilateral. Quanto ao aparecimento da dor, 45,7% relataram que a dor ocorria durante os movimentos e as atividades que apresentaram maior limitação eram ficar sentada, em pé e andar por mais de 60 minutos. A média da dor na Escala Visual Analógica (EVA) foi 6,59 (1,8 DP), considerada dor moderada. As gestantes com síndrome da cintura pélvica apresentaram uma média de 54,86 (22,39 DP) para o escore total do PGQ-Brasil, as com síndrome sacroilíaca unilateral, 31,11 (17,37 DP) e com síndrome sacroilíaca bilateral 40,32 (17,46 DP). Quando comparada a média de dor entre as síndromes mediante a EVA, a síndrome da cintura pélvica apresentou a maior média (7,67; 1,72 DP), seguida pela síndrome sacroilíaca bilateral (6,86; 1,95 DP) e síndrome sacroilíaca unilateral (6,21; 1,72 DP). Ao correlacionar a média da EVA com o escore total do PGQ-Brasil, observou-se uma correlação positiva (r=0,458, p=0,01), indicando que quanto maior a dor, maior a incapacidade da gestante. Dessa forma, os achados sugerem que a DCPG pode acarretar diversos níveis de incapacidade e afetar diretamente a funcionalidade das gestantes

Sensitive nerve function measurement in facial trauma : an observational study

Facial trauma is responsible for various types of health damage and may be functional or aesthetic. Depending on the degree of energy released in this type of trauma, sometimes an irreversibility degree is obtained. This study aimed to perform an objecti

Paralytic rabies in swine

Rabies transmitted by vampire bats was diagnosed in pigs with paralysis of the pelvic limbs. Diffuse nonsuppurative encephalomyelitis, affecting mainly the spinal cord, was observed histologically. Despite the various diagnosis of rabies in pigs this is the first report of clinical signs and pathology of rabies transmitted by vampire bats

Cross-cultural adaptation of “Pelvic Girdle Questionnaire” (PGQ) to Brazil

O Pelvic Girdle Questionnaire (PGQ) possui boa confiabilidade teste-resteste, consistência interna e validade de construto. O instrumento é composto de 25 itens distribuídos em duas subescalas (atividades e sintomas). Objetivo: Adaptar transculturalmente para a população brasileira o “Pelvic Girdle Questionnaire” (PGQ). Método: O processo de adaptação transcultural ocorreu em 5 etapas: tradução, retrotradução, análise do comitê de especialistas, Estudo Delphi e pré-teste. Um Estudo Delphi foi adicionado ao processo para a submissão do instrumento à opinião de 17 fisioterapeutas especialistas de diversas regiões do país. Resultados: A partir dos resultados da tradução e retrotradução foi desenvolvida uma versão do PGQ sintetizada em português. Durante a etapa do comitê de especialistas não foram observadas diferenças semânticas entre a versão sintetizada quando comparada à original. Após consenso de mais de 80% dos especialistas do estudo Delphi, a versão do PGQ-Brasil foi aplicada na população-alvo durante o pré-teste. Sem mais alterações, a versão final do PGQ-Brasil foi concluída. Conclusão: O PGQ-Brasil demosntrouse bem adaptado para a realidade cultural da população brasileira, acrescentando-se, inclusive, o Estudo Delphi como ferramenta adicional para assegurar ainda mais a confiabilidade desse processoThe Pelvic Girdle Questionnaire (PGQ) has good test-retest reliability, internal consistency and construct validity. The instrument consists of 25 items divided into two subscales (activities and symptoms). Objective: The aim of this study was cross-culturally adapted for the Brazilian population “Pelvic Girdle Questionnaire” (PGQ). Method: The process of cross cultural adaptation occurred in 5 stages: translation, back translation, analysis of the expert committee, Delphi Study and pretest. A Delphi study was added to the process for submission of the instrument to the opinion of 17 physiotherapists experts from different regions of the country. Results: From the results of translation and back translation was developed a version of the PGQ synthesized in Portuguese. During the stage of the expert committee not semantic differences between the synthesized compared to the original version were observed. After consensus of more than 80% of the Delphi experts, study the version of PGQ-Brazil was applied to the target population during the pretest. Without further changes, the final version of the QMP-Brazil was completed. Conclusion: The PGQ-Brazil proved to be well adapted to the cultural reality of the Brazilian population, adding up, including the Delphi study as an additional tool to further ensure the reliability of this proces

The Role of Gender Inequality and Health Expenditure on the Coverage of Demand for Family Planning Satisfied by Modern Contraceptives: A Multilevel Analysis of Cross-Sectional Studies in 14 LAC Countries

BACKGROUND: Despite international efforts to improve reproductive health indicators, little attention is paid to the contributions of contextual factors to modern contraceptive coverage, especially in the Latin America and the Caribbean (LAC) region. This study aimed to identify the association between country-level Gender Inequality and Health Expenditure with demand for family planning satisfied by modern contraceptive methods (DFPSm) in Latin American sexually active women. METHODS: Our analyses included data from the most recent (post-2010) Demographic and Health Survey or Multiple Indicator Cluster Survey from 14 LAC countries. Descriptive analyses and multilevel logistic regressions were performed. Six individual-level factors were included. The effect of the country-level factors Gender Inequality Index (GII) and Current Health Expenditure on DFPSm was investigated. FINDINGS: DFPSm ranged from 41.8% (95% CI: 40.2-43.5) in Haiti to 85.6% (95% CI: 84.9-86.3) in Colombia, with an overall median coverage of 77.8%. A direct association between the odds of DFPSm and woman\u27s education, wealth index, and the number of children was identified. Women from countries in the highest GII tertile were less likely (OR: 0.32, 95% CI: 0.13-0.76) to have DFPSm than those living in countries in the lowest tertile. INTERPRETATION: Understanding the contribution of country-level factors to modern contraception may allow macro-level actions focused on the population\u27s reproductive needs. In this sense, country-level gender inequalities play an important role, as well as individual factors such as wealth and education. FUNDING: Bill and Melinda Gates Foundation and Associação Brasileira de Saúde Coletiva (ABRASCO)

Anatomy and evolution of telomeric and subtelomeric regions in the human protozoan parasite Trypanosoma cruzi

Background: the subtelomeres of many protozoa are highly enriched in genes with roles in niche adaptation. T. cruzi trypomastigotes express surface proteins from Trans-Sialidase (TS) and Dispersed Gene Family-1 (DGF-1) superfamilies which are implicated in host cell invasion. Single populations of T. cruzi may express different antigenic forms of TSs. Analysis of TS genes located at the telomeres suggests that chromosome ends could have been the sites where new TS variants were generated. the aim of this study is to characterize telomeric and subtelomeric regions of T. cruzi available in TriTrypDB and connect the sequences of telomeres to T. cruzi working draft sequence.Results: We first identified contigs carrying the telomeric repeat (TTAGGG). of 49 contigs identified, 45 have telomeric repeats at one end, whereas in four contigs the repeats are located internally. All contigs display a conserved telomeric junction sequence adjacent to the hexamer repeats which represents a signature of T. cruzi chromosome ends. We found that 40 telomeric contigs are located on T. cruzi chromosome-sized scaffolds. in addition, we were able to map several telomeric ends to the chromosomal bands separated by pulsed-field gel electrophoresis. the subtelomeric sequence structure varies widely, mainly as a result of large differences in the relative abundance and organization of genes encoding surface proteins (TS and DGF-1), retrotransposon hot spot genes (RHS), retrotransposon elements, RNA-helicase and N-acetyltransferase genes. While the subtelomeric regions are enriched in pseudogenes, they also contain complete gene sequences matching both known and unknown expressed genes, indicating that these regions do not consist of nonfunctional DNA but are instead functional parts of the expressed genome. the size of the subtelomeric regions varies from 5 to 182 kb; the smaller of these regions could have been generated by a recent chromosome breakage and telomere healing event.Conclusions: the lack of synteny in the subtelomeric regions suggests that genes located in these regions are subject to recombination, which increases their variability, even among homologous chromosomes. the presence of typical subtelomeric genes can increase the chance of homologous recombination mechanisms or microhomology-mediated end joining, which may use these regions for the pairing and recombination of free ends.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Escola Paulista Med, Dept Microbiol Imunol & Parasitol, São Paulo, BrazilFIOCRUZ MG, Ctr Pesquisas Rene Rachou, Belo Horizonte, MG, BrazilUniv Fed Minas Gerais, ICB, Dept Parasitol, Belo Horizonte, MG, BrazilUCLA, Barquisimeto, VenezuelaFdn Inst Estudios Avanzados IDEA, Caracas, VenezuelaUniversidade Federal de São Paulo, Escola Paulista Med, Dept Microbiol Imunol & Parasitol, São Paulo, BrazilWeb of Scienc

A NATUROLOGIA NO BRASIL: AVANÇOS E DESAFIOS

Naturology is a new profession in Brazil, one which seeks to understand the human being in a multi-dimensionalway, and respect human singularity in its search for well-being, quality of life and health through a relationship of interagency and Complementary and Integrative Practices. The present dossier addresses a brief history of Complementary and Integrative Practices and Naturology in Brazil, the process of recognizing the occupation and regulation of the profession. The paper also explores the fields in which the naturologist is active, the bodies of professional representation, the main scientific events and important publications in the field. Finally, important documents are presented: the approval by the Brazilian Ministry of Education (MEC) of the existing courses, Statement of Purpose for opening undergraduate-level major in Naturology by a FederalUniversity, notices for public tendering, Proceedings of Brazilian Naturology Conferences and the Charter of Pedra Branca, which sets future guidelines for Naturology in Brazil.A naturologia é uma profissão recente no Brasil, a qual busca entendero ser-humano multidimensionalmente e respeitar a singularidade humana na busca de bem-estar, qualidade de vida e saúde através da relação de interagência e das Práticas Integrativas e Complementares.Este dossiê aborda um breve histórico das Práticas Integrativas e Complementares e Naturologia no Brasil, o processo de reconhecimentoda ocupação e regulamentação da profissão. O texto também explora os campos de atuação do naturólogo, órgãos de representação profissional, principais eventos científicos e publicações importantes da área. Por fim, são apresentados documentos importantes: Aprovaçãodo MEC dos cursos existentes, Carta de Intenção de abertura de curso superior de Naturologia por uma Universidade Federal, Editais de concursos públicos, Relatos de experiências de trabalhos de Naturólogosem instituições de renome nacional, Anais dos Congressos Brasileiros de Naturologia e Carta da Pedra Branca, a qual traça diretrizesfuturas para a Naturologia no Brasil

Strengthening therapeutic adherence and pharmacovigilance to antimalarial treatment in Manaus, Brazil: a multicomponent strategy using mHealth

Background: Public health initiatives for improving adherence to primaquine based regimens and enhancing effective pharmacovigilance are needed to support the efforts for malaria elimination in real world conditions. Methods: A multicomponent patient-oriented strategy using a Smart Safety Surveillance (3S) approach including: (1) educational materials for treatment counselling and identification of warning symptoms of haemolytic anaemia; (2) an mHealth component using Short Message Service (SMS) treatment reminders and (3) development and implementation of follow-up phone surveys three days after treatment completion, using a web-based platform linked to the local information system of malaria. Adherence was measured using the Morisky Medication Adherence Scale. Self-reported events were registered using a structured questionnaire and communicated to the Brazilian Health Regulatory Agency. Results: Educational materials were disseminated to 5594 patients, of whom 1512 voluntarily entered the mHealth component through the local information system; 7323 SMS were sent, and 1062 participants completed a follow-up survey after treatment. The mean age of patients was 37.36 years (SD 13.65), 61.24% were male, 98.54% were infected with. Plasmodium vivax and 95.90% received a short regimen of chloroquine plus primaquine (CQ + PQ 7 days), as per malaria case management guidelines in Brazil. From the 1062 surveyed participants 93.31% were considered adherent to the treatment. Most of the patients (95.20%) reported at least one adverse event. Headache, lack of appetite and nausea/vomiting were the most frequently reported adverse events by 77.31%, 70.90% and 56.78% of the patients respectively. A quarter of the patients reported anxiety or depression symptoms; 57 (5.37%) patients reported 5 to 6 warning symptoms of haemolytic anaemia including jaundice and dark urine in 44 (4.14%). Overall, three patients presenting symptoms of haemolytic anaemia attended a hospital and were diagnosed with G6PD deficiency, and one had haemolysis. All of them recovered. Conclusions: Under real world conditions, a multicomponent patient-oriented strategy using information and communication technologies allowed health care providers to reinforce treatment adherence and enhance safety surveillance of adverse events associated with regimens using primaquine. Active monitoring through phone surveys also reduced under-reporting of ADRs. This approach is low-cost, scalable and able to support prioritized activities of the national malaria programme.Fil: Macías Saint Gerons, Diego. Universidad de Valencia; EspañaFil: Rodovalho, Sheila. Universidad Federal del Amazonas.; BrasilFil: Barros Dias, Ádila Liliane. Universidad Federal del Amazonas.; BrasilFil: Lacerda Ulysses de Carvalho, André. Pan American Health Organization; BrasilFil: Beratarrechea, Andrea Gabriela. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Monteiro, Wuelton Marcelo. Universidad Federal del Amazonas.; BrasilFil: Barata Machado, Myrna. State of Amazonas Health Surveillance Foundation; BrasilFil: Fernandes da Costa, Cristiano. State of Amazonas Health Surveillance Foundation; BrasilFil: Yoshito Wada, Marcelo. No especifíca;Fil: Maximiano Faria de Almeida, Márcia Helena. No especifíca;Fil: Silva de Matos Fonseca, Rayanne. Fundação de Medicina Tropical Dr. Heitor Vieira Dourado; BrasilFil: Mota Cordeiro, Jady Shayenne. Fundação de Medicina Tropical Dr. Heitor Vieira Dourado; BrasilFil: Rodrigues Antolini, Alinne Paula. No especifíca;Fil: Nepomuceno, João Altecir. No especifíca;Fil: Fleck, Karen. Brazilian Health Regulatory Agency; BrasilFil: Simioni Gasparotto, Fernanda. Brazilian Health Regulatory Agency; BrasilFil: Lacerda, Marcus. Fundação de Medicina Tropical Dr. Heitor Vieira Dourado; BrasilFil: Rojas Cortés, Robin. Pan American Health Organization; Estados UnidosFil: Pal, Shanthi Narayan. No especifíca;Fil: Porrás, Analía I.. Pan American Health Organization; Estados UnidosFil: Ade, María de la Paz. Pan American Health Organization; Estados UnidosFil: Castro, José Luis. Pan American Health Organization; Estados Unido

Strategic approaches to restoring ecosystems can triple conservation gains and halve costs.

International commitments for ecosystem restoration add up to one-quarter of the world's arable land. Fulfilling them would ease global challenges such as climate change and biodiversity decline but could displace food production and impose financial costs on farmers. Here, we present a restoration prioritization approach capable of revealing these synergies and trade-offs, incorporating ecological and economic efficiencies of scale and modelling specific policy options. Using an actual large-scale restoration target of the Atlantic Forest hotspot, we show that our approach can deliver an eightfold increase in cost-effectiveness for biodiversity conservation compared with a baseline of non-systematic restoration. A compromise solution avoids 26% of the biome's current extinction debt of 2,864 plant and animal species (an increase of 257% compared with the baseline). Moreover, this solution sequesters 1 billion tonnes of CO2-equivalent (a 105% increase) while reducing costs by US$28 billion (a 57% decrease). Seizing similar opportunities elsewhere would offer substantial contributions to some of the greatest challenges for humankind