Instrumento para mensurar habilidades culinárias domésticas na atenção primária à saúde

OBJETIVO Desenvolver e validar instrumento para mensuração de habilidades culinárias domésticas de profissionais de saúde envolvidos com orientações de promoção da alimentação adequada e saudável da atenção primária à saúde. MÉTODOS Estudo metodológico com abordagem psicométrica, realizado no município de São Paulo entre janeiro e novembro de 2020, para desenvolvimento e validação de instrumento on-line autoaplicável. Os dados dos 472 participantes foram apresentados por estatística descritiva. A validação de conteúdo foi realizada por julgamento de especialistas utilizando técnica Delphi de dois rounds e estatísticas empíricas para evidência de consenso. Empregou-se análise fatorial exploratória para validação de constructo e análise de confiabilidade, analisados índices de ajuste do modelo e fidedignidade composta. RESULTADOS O instrumento apresentou validade de conteúdo satisfatória para índices de CVRc e nos dois rounds da técnica Delphi. Após análise fatorial, o modelo final da Escala de Habilidades Culinárias Domésticas da Atenção Primária à Saúde apresentou 29 itens com cargas fatoriais adequadas (> 0,3). Os testes de esfericidade de Bartlett e Kaiser-Meyer-Olkin (KMO) realizados em análise fatorial exploratória sugeriram interpretabilidade na matriz de correlação, a análise paralela indicou quatro domínios e variância explicada de 64,1%. A fidedignidade composta dos fatores foi adequada (> 0,70) e o índice H sugeriu fatores replicáveis em estudos futuros. Todos os índices de ajustes mostraram-se adequados. CONCLUSÕES A Escala de Habilidades Culinárias Domésticas da Atenção Primária à Saúde apresentou evidências de validade e confiabilidade. É curta e de fácil aplicação e possibilitará a averiguação de forma fidedigna da necessidade de qualificação da força de trabalho, favorecendo o planejamento de ações e políticas públicas de promoção da alimentação adequada e saudável na atenção primária à saúde.OBJECTIVE To develop and validate an instrument for measuring the home cooking skills of health professionals involved with guidelines for promoting adequate and healthy food in primary health care. METHODS This is a methodological study with a psychometric approach, carried out in the city of São Paulo between January and November 2020, to develop and validate a self-applied online instrument. The data of the 472 participants were presented by descriptive statistics. Content validation was performed by expert judgment using the two round Delphi technique and empirical statistics for consensus evidence. Exploratory factor analysis was used for construct validation and reliability analysis, and the model adjustment rates and composite reliability were analyzed. RESULTS The instrument presented satisfactory content validity for CVRc indices and in the two rounds of the Delphi technique. After the factor analysis, the final model of the Primary Health Care Home Cooking Skills Scale presented 29 items with adequate factorial loads (> 0.3). Bartlett’s and Kaiser-Meyer-Olkin’s (KMO) tests of sphericity performed in exploratory factorial analysis suggested interpretability in the correlation matrix, the parallel analysis indicated four domains and explained variance of 64.1%. The composite reliability of the factors was adequate (> 0.70) and the H-index suggested replicable factors in future studies. All adjustment rates proved to be adequate. CONCLUSIONS The Primary Health Care Home Cooking Skills Scale presented evidence of validity and reliability. It is short and easy to apply and will make it possible to reliably ascertain the need for qualification of the workforce, favoring the planning of actions and public policies of promotion of adequate and healthy food in primary health care

Candiduria in a public hospital of São Paulo (1999-2004): characteristics of the yeast isolates

The study involved 100 yeast isolates, obtained from urine samples provided by a Public Pediatric Hospital of São Paulo, Brazil, from 1999 to 2004. The most frequent species was Candida albicans, followed by C. tropicalis, C. glabrata and C. parapsilosis. In regard to virulence, 97% of the isolates showed index 3 for proteinase and 63% index 2 for phospholipase. The most frequent killer biotypes were 511 and 888.Estudou-se 100 amostras de leveduras, isoladas de urina, provenientes de Hospital Público Infantil de São Paulo Brasil, no período de 1999-2004. A espécie mais freqüente foi Candida albicans, seguida de C. tropicalis, C. glabrata e C. parapsilosis. Em relação à virulência, 97% dos isolados apresentaram índice 3 para proteinase e, 63% índice 2 para fosfolipase. Os biótipos "killer" mais freqüentes foram o 511 e 888

Avaliação dos testes rápidos para diagnóstico da dengue no Brasil

Introduction: The increasing number of dengue cases worldwide has stimulated the interest to develop products for the diagnosis of this disease in national and international markets. Objective: To evaluate the sensitivity and diagnostic specificity of immunochromatographic Rapid Tests (RT) for the detection of NS1 antigen (Ag), antibodies (Ab) IgG and IgM of dengue virus (DENV), and for the detection of combined AgNS1/AbIgG/IgM received from May 2016 to December 2018 at the National Institute for Quality Control in Health from Oswaldo Cruz Foundation for previous analysis and registration by the National Health Surveillance Agency (Anvisa) from Brazil. Method: The evaluation was performed using true positive and true negative samples for Ag NS1, Ab IgM and IgG to DENV, commercial performance panels and international standard of the National Institute for Biological Standards and Control/ World Health Organization (NIBSC/WHO). RT that presented sensitivity and/or specificity values higher than or equal to those stated by the manufacturers were considered satisfactory and those with lower values were unsatisfactory. Results: A total of 32 RT were evaluated, 23 (71.9%) were satisfactory for sensitivity and specificity, 9 (39.1%) for NS1, 11 (47.8%) for IgG/IgM and 3 (13.0%) for the combined detection NS1/IgG/IgM. From 9 RT considered unsatisfactory, 4 (44.4%) were for the detection of NS1; 2 (22.2%) for IgG/IgM and 3 (33.3%) for NS1/IgG/IgM. Unsatisfactory RT were not registered by Anvisa in Brazil. Conclusions: The previous analysis as foreseen in Brazilian regulation is important for the maintenance of RT quality offered to the national market.Introdução: O aumento do número de casos de dengue no mundo estimulou o desenvolvimento  e a disponibilização no mercado nacional e internacional de testes de execução rápida e simples para o diagnóstico da doença. Objetivo: Avaliar a sensibilidade e especificidade diagnóstica de Testes Rápidos (TR) imunocromatográficos para detecção de antígeno (Ag) NS1 e de anticorpos (Ac) das classes G (IgG) e M (IgM) e detecção combinada de Ag e Ac (NS1/ IgG/IgM) do vírus da dengue (DENV), encaminhados para análise prévia no INCQS/Fiocruz, no período de maio de 2016 a dezembro de 2018 para obtenção de registro junto à Anvisa do Brasil. Método: A sensibilidade  e a especificidade foram avaliadas frente a painéis de amostras verdadeiramente positivas e verdadeiramente negativas para Ag NS1, Ac IgM e IgG do DENV, painéis de desempenho e padrão internacional do National Institute for Biological Standards and Control/Organização Mundial da Saúde (NIBSC/OMS). Os TR que apresentaram valores de sensibilidade e especificidade superiores ou iguais aos declarados pelos fabricantes foram considerados satisfatórios e os com valores inferiores, insatisfatórios. Resultados: Do total de 32 TR  avaliados, 23 (71,9%) foram satisfatórios para sensibilidade e especificidade, destes, nove (39,1%), para NS1, 11 (47,8%) para IgG/IgM e três (13,0%), para os testes combinados NS1/IgG/IgM. Dos nove TR insatisfatórios, quatro (44,4%) foram para detecção de NS1; dois (22,2%), para IgG/IgM e três (33,3%), para NS1/IgG/IgM. Os TR considerados insatisfatórios não foram registrados no Brasil. Conclusões: A análise prévia como prevista na legislação brasileira é de grande importância para a manutenção  da qualidade dos TR ofertados ao mercado nacional

Biopolítica, Governamentalidade Digital e Tanatopolítica: idosos e a pandemia de covid-19

 Este artigo é um ensaio que aborda a pandemia pelo Covid-19, a partir de uma perspectiva biopolítica e biodigital, assinalando aspectos da precariedade acirrada vivida por idosos frente ao contágio pelo novo coronavírus e os efeitos nefastos deste em suas existências. Busca-se pensar elementos da sociedade de controle e os enquadramentos da política de morte dirigida a este grupo social quanto ao deixar morrer e ao estigma voltado aos idosos como estratégia de gestão da população, no presente. Portanto, visamos analisar práticas sociais que produzem quadros de ausência de proteção, de reconhecimento e expansão da vida de grupos marcados pelo envelhecimento, constituindo-os como um peso e problema para a sociedade contemporânea. Com efeito, utiliza-se a velhice como figura de um viver que não tem valor e não é digno de comoção nem passível de luto durante a gestão da pandemia por Covid-19.Palavras-chave: Idosos. Pandemia de Covid-19. Biopolítica. Biovigilância. Precariedade. Biopolitics, Digital and Tanatopolitical Governance: elderly people and the pandemic of covid-19ABSTRACT This article is an essay that addresses the Covid-19 pandemic, from a biopolitical and biodigital perspective, pointing out aspects of the severe precariousness experienced by the elderly in the face of contagion by the new coronavirus and its harmful effects on their lives. It seeks to think about elements of the control society and the framework of the death policy directed at this social group regarding the letting die and the stigma towards the elderly as a population management strategy, at present. Therefore, we aim to analyze social practices that produce situations of lack of protection, recognition and expansion of the lives of groups marked by aging, constituting them as a weight and problem for contemporary society. Indeed, old age is used as a figure of living that has no value and is not worthy of commotion or mourning during the pandemic management by Covid-19. Keywords: Elderly. Covid-19 Pandemic. Biopolitics. Biovigilance. Precariousness

Clinical evaluation of dental alignment and leveling with three different

INTRODUCTION: A wide variety of orthodontic wires made of different alloys is available to be used in orthodontic practice and may produce different clinical responses during tooth movement. OBJECTIVE: This research evaluated the alignment and leveling of lower dental arches after the use of three types of orthodontic wires. METHODS: A sample of 36 patients was randomly divided into 3 groups: stainless steel, multistranded steel and superelastic nickel-titanium, according to the first leveling arches used. In order to observe differences in tooth position and axial inclination of the lower incisors, all patients had lateral cephalometric radiographs taken before the insertion of the first arches and 2 months later. The irregularity index and the curve of Spee were measured, compared between groups and considered influential on the proclination of incisors during the initial phase of alignment and leveling. The Reflex microscope was used to measure the irregularity index, whereas the ANOVA analysis of variance was used to verify differences between groups with regard to the degree of dental alignment and leveling. RESULTS: There were significant differences between groups only at T2 for the irregularity index. CONCLUSION: The NiTi and multistranded steel wires showed greater aligning capacity when compared with stainless steel wires.INTRODUÇÃO: uma grande variedade de fios ortodônticos, compostos por diferentes ligas, está disponível para utilização ortodôntica, podendo gerar respostas clínicas diversas, durante a movimentação dentária. OBJETIVO: este trabalho visa a avaliar o alinhamento e nivelamento das arcadas dentárias inferiores, após a utilização de três tipos de fios ortodônticos. MÉTODOS: uma amostra de 36 pacientes foi aleatoriamente dividida em três grupos, de acordo com os primeiros arcos utilizados para o alinhamento e nivelamento: aço inoxidável convencional, aço multifilamentado e de níquel-titânio superelástico. Para se avaliar as diferenças relacionadas ao posicionamento dentário e inclinação axial dos incisivos inferiores, foram obtidas radiografias cefalométricas de perfil, de todos os pacientes, em duas fases do tratamento: antes da inserção dos primeiros arcos e dois meses após a inserção dos mesmos. O índice de irregularidade dentária (IID) e a profundidade inicial de curva de Spee, fatores influentes sobre a projeção de incisivos durante a fase inicial de alinhamento e nivelamento, foram avaliados e comparados intra- e intergrupos. Para a medição do IID, foi utilizado o Reflex Microscope, possibilitando a mensuração do grau de alinhamento e nivelamento dentário em terceira dimensão. A análise de variância (ANOVA) foi utilizada para se avaliar as diferenças intergrupos em relação ao grau de alinhamento e nivelamento dentário. RESULTADOS: diferenças estatisticamente significativas intergrupos somente foram encontradas em T2, em relação ao índice de irregularidade dentária, já que os fios de NiTi e aço multifilamentado apresentaram maior capacidade de alinhamento do que os fios de aço inoxidável convencionais

We Are...Marshall, August 14, 2019

Objective: We investigate the quality of life (QoL) of subjects with alcohol abuse/dependence, and we focus on aspects that are associated with alcohol consumption. Methods: We included inpatients and outpatients (n=174) of an addiction treatment program. All of the patients had had problems related to alcohol within the last 30 days. We used the WHOQOL-BREF to measure the patients’ QoL, and we used the ASI-6 to investigate the severity of problems related to alcohol and substance use. The main outcome measures considered for the linear regression analyses were the WHOQOL-BREF domains. The independent factors were the scores in the ASI-6 areas. Results: We found a negative correlation between the WHOQOL-BREF and the ASI-6. Significant correlations were included in the multiple linear regression pattern, which considered p<0.05 to be the cut off of statistical significance. We examined the regression analyses between the ASI-6 summary scores and the WHOQOL-BREF domains using variables that presented statistical significance in the correlation analysis. All ASI-6 problem areas showed negative correlations with domains. Conclusion: The decrease in QoL was not directly linked to the severity of alcohol use but rather with its consequences. The ASI-6 medical area was associated with a lower QoL in all of its domains. Measures of the problems related to alcohol misuse seem to be a significant predictor of QoL scores; the more often that alcohol is a problem in a patient’s life, the worse the patient’s QoL will be. Instead of treatment, other strategies should be developed to address these problem areas to not only reduce substance use but also to significantly improve the QoL of alcoholics

Percepção sobre qualidade de vida dos idosos de Portugal e do Brasil

Este estudo objetivou avaliar a percepção sobre qualidade de vida dos idosos de Portugal e do Brasile identificar a faceta do instrumento Whoqol-Old com maior escore avaliativo.Método:O estudo foi realizado com 508 idosos de Portugal e 349 idosos do Brasil. Para avaliação da qualidade de vida utilizou-se o instrumentoWhoqol-Old da OMS. Resultados:Identificou-se que as facetas com melhores escores avaliativos foram Família/Vida Familiar(74,05) para os idosos de Portugal e Morte e Morrer (75,37) para os idosos do Brasil.Conclusão:Os idosos que participaram deste estudo, tanto em Portugal quanto no Brasil, percepcionaram positivamente a sua qualidade de vida.Objective:This study aimed to evaluate the perception of life quality of the elderly in Portugal and Brazil, and to identify the facet of the WHOQOL-Old instrument with a higher evaluation score. Method:The study was conducted with 508 elderly from Portugal and 349elderly from Brazil. To evaluate the quality of life it was used the WHOQOL-Old instrument of WHO. Results:It was found that the facets with the best evaluative scores were Family/ FamilyLife(74.05) for the elderly in Portugal and DeathandDying(75.37) for the elderly in Brazil. Conclusion:The elderly in this study, both in Portugal and in Brazil, positively perceived their quality of life.Objetivo:Este estudio ha objetivado evaluar la percepción sobre calidad de vida de los viejos de Portugal y Brasil e identificar la faceta del instrumento WHOQOL-OLD con mayor puntuación de evaluación. Método:El estudio ha sido realizado con 508 viejos en Portugal y 349 en Brasil. Para evaluación de calidad de vida se ha utilizado el instrumento WHOQOL-OLD. Resultados:Se ha identificado que las facetas con mejores puntuaciones de evaluación han sido Familia/Vida familiar (74,05) para los de Portugal y Muerte y Morir (75,37) para los de Brasil. Conclusión:Los que han participado de este estudio, tanto en Portugal cuanto en Brasil, han tenido una percepción positiva en su calidad de vida.info:eu-repo/semantics/publishedVersio

Chronic treatment with ivabradine does not affect cardiovascular autonomic control in rats.

A low resting heart rate (HR) would be of great benefit in cardiovascular diseases. Ivabradine-a novel selective inhibitor of hyperpolarization-activated cyclic nucleotide gated (HCN) channels- has emerged as a promising HR lowering drug. Its effects on the autonomic HR control are little known. This study assessed the effects of chronic treatment with ivabradine on the modulatory, reflex and tonic cardiovascular autonomic control and on the renal sympathetic nerve activity (RSNA). Male Wistar rats were divided in 2 groups, receiving intraperitoneal injections of vehicle (VEH) or ivabradine (IVA) during 7 or 8 consecutive days. Rats were submitted to vessels cannulation to perform arterial blood pressure (AP) and HR recordings in freely moving rats. Time series of resting pulse interval and systolic AP were used to measure cardiovascular variability parameters. We also assessed the baroreflex, chemoreflex and the Bezold-Jarish reflex sensitivities. To better evaluate the effects of ivabradine on the autonomic control of the heart, we performed sympathetic and vagal autonomic blockade. As expected, ivabradine-treated rats showed a lower resting (VEH: 362 ? 16 bpm vs. IVA: 260 ? 14 bpm, p = 0.0005) and intrinsic HR (VEH: 369 ? 9 bpm vs. IVA: 326 ? 11 bpm, p = 0.0146). However, the chronic treatment with ivabradine did not change normalized HR spectral parameters LF (nu) (VEH: 24.2 ? 4.6 vs. IVA: 29.8 ? 6.4; p > 0.05); HF (nu) (VEH: 75.1 ? 3.7 vs. IVA: 69.2 ? 5.8; p > 0.05), any cardiovascular reflexes, neither the tonic autonomic control of the HR (tonic sympathovagal index; VEH: 0.91? 0.02 vs. IVA: 0.88 ? 0.03, p = 0.3494). We performed the AP, HR and RSNA recordings in urethane-anesthetized rats. The chronic treatment with ivabradine reduced the resting HR (VEH: 364 ? 12 bpm vs. IVA: 207 ? 11 bpm, p < 0.0001), without affecting RSNA (VEH: 117 ? 16 vs. IVA: 120 ? 9 spikes/s, p = 0.9100) and mean arterial pressure (VEH: 70 ? 4 vs. IVA: 77 ? 6 mmHg, p = 0.3293). Our results suggest that, in health rats, the long-term treatment with ivabradine directly reduces the HR without changing the RSNA modulation and the reflex and tonic autonomic control of the heart

Genomic Characterization of mcr-1.1-Producing Escherichia coli Recovered From Human Infections in São Paulo, Brazil

Polymyxins are one of most important antibiotics available for multidrug-resistant Gram-negative infections. Diverse chromosomal resistance mechanisms have been described, but the polymyxin resistance phenotype is not yet completely understood. The objective of this study was to characterize colistin resistant mcr-1-producing strains isolated from human infections over one year in a hospital setting (Hospital das Clínicas, São Paulo, Brazil). We isolated 490 colistin-resistant Gram-negative rods, of which eight were mcr-1.1-positive Escherichia coli, the only species with this result, indicating a low incidence of the mcr-1 production mechanism among colistin-resistant isolates. All mcr-1.1 positive isolates showed similarly low MICs for colistin and were susceptible to most antibiotics tested. The isolates showed diversity of MLST classification. The eight mcr-1.1-positive E. coli genomes were sequenced. In seven of eight isolates the mcr-1.1 gene is located in a contig that is presumed to be a part of an IncX4 plasmid; in one isolate, it is located in a contig that is presumed to be part of an IncHI2A plasmid. Three different genomic contexts for mcr-1.1 were observed, including a genomic cassette mcr-1.1-pap2 disrupting a DUF2806 domain-containing gene in six isolates. In addition, an IS1-family transposase was found inserted next to the mcr-1.1 cassette in one isolate. An mcr-1.1-pap2 genomic cassette not disrupting any gene was identified in another isolate. Our results suggest that plasmid dissemination of hospital-resident strains took place during the study period and highlight the need for continued genomic surveillance