Padrão de atividade física em gestantes usuárias do Sistema Público de Saúde

Objetivos: Descrever o padrão de atividade física de gestantes usuárias de Unidades Básicas de Saúde, investigar a média do gasto energético relacionados aos domínios de atividade física. Métodos: Trata-se de um estudo transversal conduzido entre 799 gestantes atendidas nas Unidades Básicas de Saúde de Ribeirão Preto, SP. A prática de atividade física foi avaliada por meio do questionário de “frequencia de  atividade física diária” específico para gestantes, no qual foram obtidas a frequência, duração e o equivalentes metabólicos das atividades físicas. Resultados: A maioria das gestantes apresentaram o padrão sedentário (57%) seguido pelo padrão leve (43%). Em relação aos domínios de atividades físicas, o domínio doméstico teve a maior média de gasto energético (733,7), enquanto que, o domínio de lazer apresentou a menor média (20,5). Verificou-se que as variáveis idade acima de 30 anos , escolaridade baixa , solteira, não ser chefe de família, não trabalhar fora, e ter filhos, tiveram associações com o padrão sedentário. Conclusões: Elevada prevalência de sedentarismo foi observada entre as gestantes estudadas, sugerindo a necessidade de ações de promoção de atividade física neste público, principalmente no domínio de lazer

Cuidados de enfermagem para mulheres no climatério: promoção da autoestima e o autocuidado através da teoria de Orem: Nursing care for women in climate: promotion of self-esteem and self-care through Orem's theory

A enfermagem é essencial para auxiliar a mulher no climatério na promoção do autocuidado e da autoestima. O objetivo deste trabalho é retratar que através da teoria de Orem é plausível detalhar a importância da enfermagem na promoção da autoestima e autocuidado para a mulher no climatério. A metodologia aplicada se estabeleceu através de pesquisas bibliográficas, em português, utilizando artigos de revisão em bases de dados como Scielo, BVS e leis brasileiras, com período de publicação de 2012 a 2022. Com o avolumamento do envelhecimento populacional existe uma notável elevação de mulheres na senilidade, sendo destinadas a vivenciar o processo de envelhecer e experenciar a fase do climatério trazendo diversos sintomas decorrentes dessa nova fase, e com isso, acaba-se necessitando de um autocuidado, e neste contexto, a teoria de Orem relata a interação do enfermeiro que através de suas habilidades técnico-cientificas é capaz de auxiliar a mulher na fase do climatério concebendo a visibilidade de promover a autoestima e autocuidado através de suas ações

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Physical activity pattern in pregnant women users of the Unified Health System of the city of Ribeirão Preto

A atividade física realizada durante a gestação vem sendo discutida pela comunidade científica devido seus efeitos benéficos tanto para saúde materna como para os desfechos gestacionais. Atualmente, estudos mostram que os padrões de atividade física em gestantes oscilam de sedentário a leve, sendo que os padrões moderados ou intensos quase não são observados nas pesquisas. O objetivo deste estudo é descrever o padrão de atividade física das gestantes usuárias do Sistema Único de Saúde do município de Ribeirão Preto, SP. Trata-se de um estudo transversal no qual foram entrevistadas 799 gestantes saudáveis através de um questionário estruturado. As variáveis de interesse foram condições sociodemográficas, morbidades, estilo de vida, estado nutricional e atividade física. A avaliação da atividade física foi realizada através de um questionário específico para gestantes em que foram obtidos a frequência (semanal) e a duração (em minutos), posteriormente, a intensidade desta foi convertida em MET (equivalente metabólico). As atividades cotidianas foram divididas de acordo com o contexto em que foram realizadas em domínio: doméstico, ocupacional, de locomoção, de lazer e inatividade. As gestantes foram classificadas de acordo com o padrão da atividade física alcançado em: sedentário, leve, moderado ou intenso. Verificou-se o padrão sedentário em 57% das gestantes e o padrão leve em 43%. As características sociodemográficas das gestantes estudadas indicaram majoritariamente mulheres com poder aquisitivo e escolaridade média, alta porcentagem de mulheres casadas e metade das gestantes não trabalhavam fora de casa. O estudo mostrou que as gestantes tendem a economizar energia principalmente nas atividades correspondentes aos domínios de lazer e no de locomoção, enquanto que, as atividades do domínio doméstico, ocupacional e inatividade são mantidas durante a gravidez. Verificou-se que apesar do mesmo ter encontrado uma percentagem menor de gestantes com o padrão sedentário quando comparado a outros estudos, o padrão predominante é o padrão sedentário e seguido pelo padrão leve, e que o padrão moderado considerado ideal pela WHO, ainda não é realidade entre as gestantes brasileiras.Physical activity during pregnancy has been discussed by the scientific community because of its beneficial effects on both maternal health and gestational outcomes. Currently, studies show that the patterns of physical activity in pregnant women fluctuate from sedentary to mild, and moderate or intense patterns are almost not observed in the research. The objective of this study is to describe the physical activity pattern of pregnant women users of the Unified Health System of the city of Ribeirão Preto, SP. It is a cross-sectional study in which 799 healthy pregnant women were interviewed through a structured questionnaire. The variables of interest were sociodemographic conditions, morbidities, lifestyle, nutritional status and physical activity. The physical activity evaluation was performed through a specific questionnaire for pregnant women in which the frequency (weekly) and the duration (in minutes) were obtained, later the intensity of this was converted into MET (metabolic equivalent). The daily activities were divided according to the context in which they were carried out in domains: domestic, occupational, locomotion, leisure and inactivity. The pregnant women were classified according to the pattern of physical activity achieved in: sedentary, mild, moderate or intense. The sedentary pattern was found in 57% of pregnant women and the mild pattern in 43%. The sociodemographic characteristics of the pregnant women studied indicated that women with purchasing power and average schooling had a high percentage of married women and half of the pregnant women did not work outside the home. The study showed that pregnant women tend to save energy mainly in the activities corresponding to the leisure and locomotion domains, while the activities of the domestic, occupational and inactivity domains are maintained during pregnancy. It was found that although it found a lower percentage of pregnant women with the sedentary pattern when compared to other studies, the predominant pattern is the sedentary pattern followed by the mild pattern and that the moderate pattern considered ideal by the WHO is not yet reality among Brazilian pregnant women