Birth plan: a look of the health professionals in Portugal

Introduction: The birth plan (BP) is a written document prepared by the couple to express their wishes regarding birth. It has been the subject of health studies, although in Portugal there is a lack of research. Objective: To identify the perception of health professionals (HP) about the BP in Portugal. Methods: qualitative, exploratory, descriptive study with self-completed questionnaire on an online platform. Anonymity and confidentiality guaranteed. We used the content analysis according to Bardin and the INVivo12 tool. The non-probabilistic, intentional sample with 44 nurses midwives. Results and discussion: The BP was associated with the descriptors: empowerment and decision, humanization, choice and respect. 72.7% informed the woman/couple during the prenatal appointment and in childbirth classes. 47.7% assisted in its construction; 50% reported difficulties due to lack of model, non-acceptance and fears of HP reactions. 93.1% thought that their presentation to the team is important; 63.6% considered that BP isn’t respected in maternities for institutional and professional reasons; 90.9% considered that the HP reacts in several ways to the presentation of the BP, from the devaluation to the need for its institutionalization. The results show that, although we are in different stages of BP implementation, the difficulties presented are similar to those developed in Europe. Conclusions: The results show that the HP recognize the advantages of the BP as a facilitating and reorientation strategy for women/couples in childbirth, promoting respectful and citizen-centered care. From conception to implementation, the BP seems to be a still incipient practice in Portugal. The HP considers necessary to create policies for the implementation and development of BP, important for citizens as well as for the HP.info:eu-repo/semantics/publishedVersio

Endemicity Analysis of the Ichtyofauna of the Rio Doce Basin, Southeastern Brazil

The Rio Doce is a very important freshwater system in Brazil running through the Atlantic Forest, however available information about its biodiversity is scarce. In 2015, the Rio Doce basin was damaged by a burst of Fundão tailing dam in Mariana (Minas Gerais) causing an extraordinary environmental damage, with consequences still incompletely known. In the present paper we analyzed 6042 latitude/longitude records of 208 fish species from the Rio Doce deposited in collections prior to November 2015, in order to identify areas of endemism in the river before the burst. Several areas of endemism were identified along the basin, most of them describing small and novel patterns. Our analyses helped to identify areas of major diversity along the basin as well as information gaps concerning fish sampling. We hope this contribution will help obtaining quantitative measures on the impact caused by the Fundão dam catastrophe on fish biodiversity and will be useful to orient general actions towards the restoration of the basin.Fil: Sarmento Soares, Luisa M.. Universidade Estadual de Feira de Santana; Brasil. Universidade Federal do Espírito Santo; Brasil. Instituto Nossos Riachos; BrasilFil: Martins Pinheiro, Ronaldo F.. Instituto Nossos Riachos; BrasilFil: Casagranda, Maria Dolores. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; Argentin

Aspergillus Species and Antifungals Susceptibility in Clinical Setting in the North of Portugal: Cryptic Species and Emerging Azoles Resistance in A. fumigatus

Aspergillus spp. are agents of a broad-spectrum of diseases among humans. Their growing resistance to azoles, the cornerstone in the management of human aspergillosis, is a worrisome problem around the world. Considering lack of data from Portugal on this topic, particularly from the northern region, a retrospective surveillance study was planned to assess frequency of cryptic Aspergillus species and azoles resistance. A total of 227 clinical isolates, mainly from the respiratory tract (92.1%), collected from three hospitals serving a population of about three million people, were studied for their epidemiology and antifungal susceptibility patterns determined by the E.DEF.9.3 protocol of EUCAST. Employing molecular methods, seven Aspergillus complexes were identified; Aspergillus fumigatus sensu stricto was the most frequent isolate (86.7%). A 7.5% prevalence of cryptic species was found; A. welwitschiae (A. niger complex-3.1%) and A. lentulus (A. fumigatus complex-2.2%) were the most frequent. Amongst cryptic species, it was found a percentage of resistance to voriconazole, posaconazole and isavuconazole of 47.1, 82.4, and 100%, respectively. Five A. fumigatus sensu stricto showed pan-azole resistance. Sequencing their cyp51A gene revealed the presence of one isolate with TR46/Y121F/T289A mutation and two isolates with TR34/L98H mutation. This study emphasizes the need to identify strains to the species level and to evaluate their antifungal susceptibility in all human originated Aspergillus spp. isolates, particularly those from invasive aspergillosis.This work was supported by Grant IN-PT-131-1755 from Gilead Sciences.info:eu-repo/semantics/publishedVersio

Vereadoras de Belém do Pará: indicadores quali-quanti sobre as eleitas entre 2000-2020

Este trabalho apresenta as vereadoras eleitas na Câmara Municipal de Belém do Pará entre as eleições de 2000 e de 2020, objetivando identificar o quantitativo das mulheres nomeadas. A metodologia utilizada foi de pesquisa qualitativa, do tipo análise documental de documentos públicos, disponíveis no site do Tribunal Superior Eleitoral (TSE), contendo os dados oficiais das eleições; e de materiais informativos jornalísticos, em que as fontes foram portais de notícias, redes sociais. Os dados foram coletados no mês de abril de 2021, de forma online. As análises resultaram na criação das categorias: Capital familiar; Capital político e Outsiders. Concluímos que o capital familiar está relacionado à trajetória das mulheres que fazem parte da história política do município de Belém, portanto, dispõe de um capital político; enquanto as outsiders e as que possuem capital familiar dispõe de outros aportes logísticos, como iniciar as carreiras políticas em movimentos sociais

Análisis de Endemismo de la fauna de peces de la Cuenca del Rio Dulce, Minas Gerais y Espírito Santo, Sudoeste de Brasil

La Cuenca del Rio Dulce es uno de los mayores sistemas de agua dulce del sudestebrasilero y representa la principal provisión de agua de la región. Esta cuenca ha sido intensamente explotada por diversas industrias, constituyéndose en un recurso económico central. En 2015, la explosión de dos diques de contención de la minera Samarco en Mariana- Minas Gerais liberó 60 millones de toneladas de residuos mineros que llegaron al Rio dulce contaminándolo en todo su recorrido y desembocando en el océano Atlántico. Los alcances del daño ocasionado por esta catástrofe y las perspectivas de recuperación ambiental continúan siendo evaluados. A pesar de su importancia, el conocimiento acerca la biodiversidad y las dinámicas biológicas de la cuenca del Rio Dulce es escaso y disperso. En el presente trabajo analizamos la distribución de 208 especies de peces de la cuenca a fin de identificar áreas de endemismos (AE) mediante un Análisis de Endemicidad. Los datos fueron obtenidos antes del evento ambiental mencionado, a partir de revisiones y colectas directas. Nuestros resultados identifican 9 AEs a lo largo de la cuenca, en concordancia con las unidades de análisis propuestas por el ?Plano Integrado de Recursos Hídricos da Bacia do Rio Doce?, y permiten reconocer áreas de máxima diversidad y áreas habitadas por especies en peligro. Esperamos que esta contribución represente el primer paso hacia un esquema biográfico completo de la cuenca del Rio Dulce, y que los datos presentados contribuyan al desarrollo de planes de manejo y recuperación de la cuenca.Fil: Casagranda, Maria Dolores. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; ArgentinaFil: Sarmento Soares, Luisa María. Universidade Federal do Espírito Santo; Brasil. Instituto Nacional da Mata Atlântica; Brasil. Universidade Estadual de Feira de Santana; BrasilFil: Martins Pinheiro, Ronaldo Fernando. Instituto Nossos Riachos; BrasilXIII Reunión Argentina de Cladística y BiogeografíaSan Miguel de TucumánArgentinaConsejo Nacional de Investigaciones Científicas y Técnicas. Unidad Ejecutora LilloFundación Miguel Lill

O internato rural do curso de graduação em nutrição da Universidade Federal de Viçosa (Brasil)

With the aim of evaluating the results obtained in a new experiment in Internato Rural (rural internship) during its first three years of existence, 22 reports, which had been submitted by 46 student-trainees who participated in this program, were analyzed. Internato Rural involves the transfer of the student from the college campus to a rural community where he stays for a certain period of time. This Internato Rural course program differs from the structure proposed by other universities mainly in that it aims at stimulating the community to identify its problems and to organize itself to solve them. It was observed, at the end of the above mentioned period, that the objectives proposed had not been satisfactorily met. The difficulty in stimulating the community members to identify their own problems and to take the necessary steps to try to solve them was the fundamental obstacle faced. Additional problems were posed by lack of resources to keep the students in the field and program discontinuity, basically due to school vacations and to the limited number of students enrolled in the Internato Rural program, which is elective. It has been realized, however, that as a form of professional practice in the field of Public Health and as an opportunity of experiencing everyday life in a rural community Internato Rural is of fundamental importance for the students. It was concluded that this constitutes a worthwhile experience in accordance with the new proposal which will have to be an improvement so as to meet the initial objectives, and which may also contribute to other graduate programs in nutrition in the country.Com a finalidade de se avaliarem os resultados alcançados numa experiência de internato rural, foram analizados os relatórios dos estudantes que dela participaram. Considera-se internato rural a modalidade de estágio que se caracteriza pela transferência do estudante do "campus" universitário para uma comunidade rural, onde permanecerá por tempo determinado. O internato rural no curso da Universidade Federal de Viçosa distingue-se da estrutura de outras universidades principalmente pela proposta que leva de estimular a comunidade a reconhecer seus problemas, e a organizar-se para solucioná-los. Observou-se ao término desse período que os objetivos traçados não foram satisfaloriamenle alingidos. A dificuldade em estimular os habitantes para identificarem os seus próprios problemas e se organizarem no sentido de solucioná-los, a escassez de recursos para manter os estudantes no campo e a desconlinuidade do programa foram os entraves fundamentais. Entretanto, constatou-se que, como prática do exercício profissional na área de Saúde Pública e possibilidade de vivenciar o cotidiano de uma comunidade rural, o estágio é de fundamental importância para os estudantes. Concluiu-se tratar-se de uma experiência válida, de acordo com a nova proposta que deverá ser aprimorada para atingir os objetivos iniciais, podendo contribuir como ponto de reflexão para outros cursos de graduação em nutrição do país

População com risco cardiovascular elevado em uso de medicamento e aconselhamento: a situação do Brasil em relação à meta mundial, 2014-2015

Objective: To estimate the prevalence of high cardiovascular risk (CVR) and the proportion of people with high CVR who receive treatment and counseling, to investigate the sociodemographic factors associated with this outcome, in Brazil. Methods: Cross-sectional study, using subsample data from the National Health Survey, collected by biochemical tests, in 2014-2015. Poisson regression was used. Results: The proportion of high CVR in men was 11.2% (95%CI 9.6;12.9), and in women 10.4% (95%CI 9.2;11.8%). In the group with high CVR, 68.8% (95%CI 63.7;73.4%) received counseling, 59.3% (95%CI 54.2;64.3%) medication, and 55.6% (95%CI 50.4;60.7%) both. In the multivariate analysis, receiving treatment and counseling was associated with age 50 years and over, and poor/very poor health self-assessment (PR=1.26 – 95%CI 1.06;1.51). Conclusion: The proportion of people with elevated CVR who received treatment and counseling was over 50%.Objetivo: Estimar a prevalência de risco cardiovascular (RCV) elevado, a proporção de pessoas com RCV elevado que recebem tratamento e aconselhamento, e investigar os fatores sociodemográficos associados ao desfecho, no Brasil. Métodos: Estudo transversal, com dados de subamostra da Pesquisa Nacional de Saúde, coletados por exames bioquímicos, em 2014-2015. Empregou-se regressão de Poisson. Resultados: A proporção de RCV elevado em homens foi de 11,2% (IC95% 9,6;12,9) e em mulheres de 10,4% (IC95% 9,2;11,8%). No grupo com RCV elevado, 68,8% (IC95% 63,7;73,4%) receberam aconselhamento, 59,3% (IC95% 54,2;64,3%) medicamento e 55,6% (IC95% 50,4;60,7%) ambos. Na análise multivariável, receber tratamento e aconselhamento mostrou associação com a idade de 50 anos e mais, e com autoavaliação de saúde ruim/muito ruim (RP=1,26 – IC95% 1,06;1,51). Conclusão: A proporção de pessoas com RCV elevada que receberam tratamento e aconselhamento foi superior a 50%.&nbsp

Etest® versus broth microdilution for ceftaroline MIC determination with Staphylococcus aureus: results from PREMIUM, a European multicentre study

Objectives: To compare the concordance of ceftaroline MIC values 24 by reference broth microdilution (BMD) and Etest (BioMérieux, France) for MSSA and MRSA isolates, respectively, in isolates from PREMIUM (D372SL00001), a European multi-centre study.  Methods: Ceftaroline MICs were determined by reference BMD and by Etest for 1,242 MSSA and MRSA from adult patients with community-acquired pneumonia or complicated skin and soft tissue infections collected between February and May 2012; tests were performed across six European laboratories. Selected isolates with ceftaroline resistance in broth (MIC >1 mg/L) were retested in three central laboratories to confirm their behaviour.  Results: Overall concordance between BMD and Etest was good, with >97% essential agreement and >95% categorical agreement. Nevertheless, 12 of the 26 MRSA isolates found resistant by BMD scored as susceptible by Etest, with MICs ≤1 mg/L, thus counting as very major errors, whereas only five of 380 MRSA found ceftaroline susceptible in BMD were mis-categorised as resistant by Etest. Twenty-one of the 26 isolates with MICs of 2 mg/L by BMD were then re-tested twice by each of three central laboratories: BMD MICs of 2 mg/L were consistently found for 19 of the 21 isolates. Among 147 Etest results for these 21 isolates (original plus six repeats per isolate) 112 were >1 mg/L.  Conclusions: BMD and Etest have good overall agreement for ceftaroline against Staphylococcus aureus; nevertheless, reliable Etest-based discrimination of the minority of ceftaroline-resistant (MIC 2 mg/L) MRSA is extremely challenging, requiring careful reading of strips, ideally with duplicate testing

Avaliação da motivação e análise dos fatores motivacionais da gravida para amamentar

Objetivos: Identificar os tipos de motivação das grávidas para amamentar; Analisar a relação entre fatores que influenciam a motivação para amamentar e os diferentes tipos de motivação. Métodos: Estudo quantitativo, descritivo, correlacional. Amostra intencional, 300 mulheres, com 20 ou mais semanas de gestação. Questionário de autopreenchimento: variáveis sociodemográficas, obstétricas, situacionais e aplicação da Escala de Motivação Intrínseca e Extrínseca para Amamentar – versão portuguesa. Utilizado SPSS/27 no tratamento estatístico. O estudo aprovado pelo comitê de ética, participantes assinaram termo de consentimento informado, assegurada a confidencialidade. Resultados: A média de idades foi 30,2 anos; casadas; ensino básico e secundário; média do 1º contacto 32,6s de gestação; 75% sem filhos, com vigilância da gravidez. 23,3% experiência e 61% formação amamentação. 99% indicou motivação para amamentar, mas a escala revelou que 72,7% das grávidas tinham motivação total moderada e 14,4% baixa. 63,3% nível moderado para a motivação extrínseca e 69,7% nível moderado de motivação intrínseca total. Dos fatores estudados apenas habilitações literárias, renda familiar mensal, tipo de parto, idade gestacional 1ª consulta e a formação em amamentação foram estatisticamente significativos em relação aos scores da motivação total. Conclusões: É fundamental avaliar precocemente e durante a gravidez, o nível de motivação para amamentar, bem como, identificar fatores que interferem na motivação para apoiar a decisão. O apoio na decisão de amamentar deve atender a fatores situacionais, socioeconómicos e aos tipos de motivação para evitar o abandono precoce e obter maiores ganhos em saúde.info:eu-repo/semantics/publishedVersio