Leishmaniose visceral no Brasil: fundamentos e preocupações em relação ao controle de reservatórios

O controle da leishmaniose visceral zoonótica representa grande desafio, particularmente no Brasil, onde um paulatino processo de expansão geográfica da doença vem sendo verificado há mais de 30 anos. Nesse contexto, humanos não são considerados relevantes para manutenção da transmissão. Assim, as estratégias usualmente utilizadas com vistas à redução do risco de transmissão se baseiam no controle das populações de vetores e reservatórios. Dentre essas estratégias, a eliminação de cães infectados, correntemente utilizada no Brasil, tem sido das mais questionadas. Neste comentário, apresentam-se os fundamentos que justificam diferentes estratégias de controle orientadas para a população de reservatórios, assim como os limites e preocupações associadas a cada abordagem.The control of zoonotic visceral leishmaniasis is a challenge, particularly in Brazil, where the disease has been gradually spreading across the country over the past 30 years. Strategies employed for decreasing the transmission risk are based on the control of vector populations and reservoirs; since humans are considered unnecessary for the maintenance of transmission. Among the adopted strategies in Brazil, the sacrifice of infected dogs is commonly performed and has been the most controversial measure. In the present study, we provide the rationale for the implementation of different control strategies targeted at reservoir populations and highlight the limitations and concerns associated with each of these strategies

O dia em que o mundo abraçou a chape : análise da cobertura jornalística do acidente com a Chapecoense

Trabalho de conclusão de curso (graduação)—Universidade de Brasília, Faculdade de Comunicação, Departamento de Comunicação Organizacional, 2017.Em virtude da repercussão nacional e internacional do acidente aéreo envolvendo a Associação Chapecoense de Futebol (ACF) ao final de 2016, este trabalho tem como objetivo o mapeamento da cobertura jornalística da tragédia. Para tanto, foram avaliados dois portais de notícias online com maior número de acessos no Brasil, de acordo com Instituto Brasileiro de Opinião Pública e Estatística (IBOPE): G1 e UOL. E, ainda, por tratar-se de um acontecimento de amplitude internacional, envolvendo também Colômbia e Bolívia, foram analisados respectivamente: EL Colombiano e La Razón, a fim de identificar como foi noticiado a tragédia. O procedimento metodológico utilizado na pesquisa inclui pesquisa bibliográfica relacionada a estudos culturais, futebol e comunicação, particularmente jornalismo esportivo, seguido por análise de conteúdo da cobertura jornalística dos portais citados, no período de 29 de novembro/2016 a 29 de dezembro/2016. Por fim, foram feitas entrevistas em profundidade com dirigentes da ACF. Com os resultados obtidos, observamos o grande destaque dado ao assunto na mídia online, com prioridade nos gestos de homenagens e atos de solidariedade ao acidente em si. As entrevistas evidenciaram o abalo causado pela tragédia, que trouxe mudanças significativas para o cenário e expectativas do clube nos próximos anos.Due to the national and international repercussion of the air crash involving the Associação Chapecoense de Futebol (ACF) at the end of 2016, this work has the objective of mapping the journalistic coverage of the tragedy. For this purpose, two online news portals with the highest number of accesses in Brazil were evaluated, according to the Instituto Brasileiro de Opinião Pública e Estatística (IBOPE): G1 and UOL. Also, since it is an international event involving Colombia and Bolivia, EL Colombiano and La Razón were analyzed, respectively, in order to identify how the tragedy was reported. The methodological procedure used in the research includes bibliographical research related to cultural studies, football and communication, particularly sports journalism, followed by content analysis of journalistic coverage of the aforementioned portals, from November 29, 2016 to December 29, 2016. Finally, in-depth interviews were conducted with ACF officials. With the results obtained, we observe the great emphasis given to the subject in the online media, with priority in the gestures of tributes and acts of solidarity to the accident itself. The interviews highlighted the shock caused by the tragedy, which brought significant changes to the club's setting and expectations in the coming years

Demarcation of local neighborhoods to study relations between contextual factors and health

<p>Abstract</p> <p>Background</p> <p>Several studies have highlighted the importance of collective social factors for population health. One of the major challenges is an adequate definition of the spatial units of analysis which present properties potentially related to the target outcomes. Political and administrative divisions of urban areas are the most commonly used definition, although they suffer limitations in their ability to fully express the neighborhoods as social and spatial units.</p> <p>Objective</p> <p>This study presents a proposal for defining the boundaries of local neighborhoods in Rio de Janeiro city. Local neighborhoods are constructed by means of aggregation of contiguous census tracts which are homogeneous regarding socioeconomic indicators.</p> <p>Methodology</p> <p>Local neighborhoods were created using the SKATER method (TerraView software). Criteria used for socioeconomic homogeneity were based on four census tract indicators (income, education, persons per household, and percentage of population in the 0-4-year age bracket) considering a minimum population of 5,000 people living in each local neighborhood. The process took into account the geographic boundaries between administrative neighborhoods (a political-administrative division larger than a local neighborhood, but smaller than a borough) and natural geographic barriers.</p> <p>Results</p> <p>The original 8,145 census tracts were collapsed into 794 local neighborhoods, distributed along 158 administrative neighborhoods. Local neighborhoods contained a mean of 10 census tracts, and there were an average of five local neighborhoods per administrative neighborhood.</p> <p>The local neighborhood units demarcated in this study are less socioeconomically heterogeneous than the administrative neighborhoods and provide a means for decreasing the well-known statistical variability of indicators based on census tracts. The local neighborhoods were able to distinguish between different areas within administrative neighborhoods, particularly in relation to squatter settlements.</p> <p>Conclusion</p> <p>Although the literature on neighborhood and health is increasing, little attention has been paid to criteria for demarcating neighborhoods. The proposed method is well-structured, available in open-access software, and easily reproducible, so we expect that new experiments will be conducted to evaluate its potential use in other settings. The method is thus a potentially important contribution to research on intra-urban differentials, particularly concerning contextual factors and their implications for different health outcomes.</p

Intoxicações exógenas em crianças menores de seis anos atendidas em hospitais da região metropolitana do Rio de Janeiro

OBJETIVO: Descrever o perfil dos casos de intoxicações exógenas de crianças admitidas em hospitais de emergência da região metropolitana do Rio de Janeiro, durante três anos. MÉTODOS: Realizou-se levantamento dos dados a partir dos boletins de atendimento de emergência, tendo sido identificados os casos suspeitos ou confirmados de intoxicação nas seguintes categorias: drogas, medicamentos e substâncias biológicas; solventes orgânicos e hidrocarbonetos halogenados; produtos químicos; monóxido de carbono e outros gases, fumaças e vapores; e pesticidas. RESULTADOS: Foram registrados 1.574 casos de intoxicação entre crianças até cinco anos de idade, sendo que cerca de 40% dos casos envolveu produtos químicos de uso doméstico, 35% os medicamentos, e 15% algum tipo de pesticida. Mais da metade das intoxicações por pesticidas envolveu o chumbinho, um produto ilegalmente vendido como raticida, que frequentemente contém o agrotóxico carbamato. A distribuição dos agentes envolvidos variou significativamente segundo sexo, sendo a frequência relativa das intoxicações por medicamentos e chumbinho maior no sexo feminino em comparação ao masculino. Observou-se que a participação dos produtos químicos de uso doméstico decresceu com a idade, enquanto aumentou a dos medicamentos como agentes da intoxicação. No período analisado não observou-se redução significativa no número total de casos registrados anualmente. CONCLUSÃO: Fortalecer a rede de Centros de Controle de Intoxicações, intervir na linha de produção de embalagens para medicamentos e produtos químicos, aumentar a fiscalização sobre a comercialização ilegal do chumbinho, e enfatizar atividades de educação em saúde são ações que podem contribuir para mudar este panorama.OBJECTIVE: To describe the profile of poisoning cases among children attended during three years at emergency hospitals in the metropolitan area of Rio de Janeiro, Brazil. METHODS: All confirmed or suspected poisoning cases, due to drugs and biological substances; organic solvents and hydrocarbons; chemical products; carbon monoxide and other gases; and pesticides, were collected. RESULTS: 1,574 cases of poisoning in children up to 5 years of age were detected. Around 40% of the cases involved chemical products of domestic use, 35% were caused by drugs, and 15% by pesticides. More than half of pesticide poisonings involved the "chumbinho", an illegal product sold as a rodenticide, and usually including in its formulation a carbamate. Distribution of agents varied significantly by gender, the relative frequency of poisonings due to drugs and "chumbinho" being higher among females than males. Participation of chemical products of domestic use decreased with age, but the role of drugs increased as agents of poisoning. During the observation period there was no significant reduction in the total number of annual cases. CONCLUSION: Supporting the expansion of the network of Poison Control Centers, developing intervention for the production of safer packaging devices for drugs chemical products, suppressing the illegal commerce of "chumbinho", and fostering health education activities might contribute to modify this situation

Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the VSP-A (Vécu et Santé Perçue de l'Adolescent), a health-related quality of life (HRQoL) instrument for adolescents, in a healthy Brazilian population

<p>Abstract</p> <p>Background</p> <p>Health-related quality of life (HRQoL) assessment, encompassing the adolescents' perceptions of their mental, physical, and social health and well-being is increasingly considered an important outcome to be used to identify population health needs and to provide targeted medical care. Although validated instruments are essential for accurately assessing HRQoL outcomes, there are few cross-culturally adapted tools for use in Brazil, and none designed exclusively for use among adolescents. The Vécu et Santé Perçue de l'Adolescent (VSP-A) is a generic, multidimensional self-reported instrument originally developed and validated in France that evaluates HRQoL of ill and healthy adolescents.</p> <p>Purpose</p> <p>To cross-culturally adapt and validate the Brazilian-Portuguese version of the VSP-A, a generic HRQoL measure for adolescents originally developed in France.</p> <p>Methods</p> <p>The VSP-A was translated following a well-validated forward-backward process leading to the Brazilian version. The psychometric evaluation was conducted in a sample of 446 adolescents (14-18 years) attending 2 public high schools of São Gonçalo City. The adolescents self-reported the Brazilian VSP-A, the validated Psychosomatic Symptom Checklist and socio-demographic information. A retest evaluation was carried out on a sub-sample (n = 195) at a two-week interval.</p> <p>The internal construct validity was assessed through confirmatory factor analysis (CFA), multi-trait scaling analyses, Rasch analysis evaluating unidimensionality of each scale and Cronbach's alpha coefficients. The reproducibility was evaluated by intra-class correlation coefficients (ICC). Zumbo's ordinal logistic regression analysis was used to detect differential item functioning (DIF) between the Brazilian and the French items. External construct validity was investigated testing expected differences between groups using one-way analysis of variance (ANOVA), Mann-Whitney tests and the univariate general regression linear model.</p> <p>Results</p> <p>CFA showed an acceptable fit (RMSEA=0.05; CFI=0.93); 94% of scaling success was found for item-internal consistency and 98% for item discriminant validity. The items showed good fit to the Rasch model except 3 items with an INFIT at the upper threshold. Cronbach's Alpha ranged from 0.60 to 0.85. Test-retest reliability was moderate to good (ICC=0.55-0.82). DIF was evidenced in 4 out of 36 items. Expected patterns of differences were confirmed with significantly lower physical, psychological well being and vitality reported by symptomatic adolescents.</p> <p>Conclusions</p> <p>Although DIF in few items and responsiveness must be further explored, the Brazilian version of VSP-A demonstrated an acceptable validity and reliability in adolescents attending school and might serve as a starting point for more specific clinical investigations.</p

Uso de imagens de satélite e do sistema Openstreetmap no ensino universitário para \ud produção e atualização de mapas digitais livres e abertos na Internet.

This study analyzed Internet free and open map systems and elected OpenStreetMap as appropriate for undergraduate students who have studied and tested it. To confirm the applicability, we performed a test of data update of OpenStreetMap system. The test consisted in the introduction of some data generated by GPS; digitization of satellite image made available on the system itself by Bing and insertion of other spatial \ud information, known by the authors of the work, on some internal roads of the studied area and its surroundings in the OpenStreetMap, and the verification of the existence of such data in other systems, as Google Earth and Wikimapia by viewing the maps available. We also analyzed the level of difficulty of using these systems for undergraduates. OpenStreetMap proved easy to be used by students. The adoption of tasks such as mapping \ud towns by disciplines of Geography, Cartography, Environmental Management or related disciplines contribute to student learning and could leverage the production and updating of Internet free and open map. There is the need for disclosure and learning among young people from local communities, from small towns, inclusion in the curricula of undergraduated courses as to graduates who in the future will be using and enjoying this tool

Maternal mental health and nutritional status of six-month-old infants

OBJECTIVE To analyze if maternal mental health is associated with infant nutritional status at six month of age. METHODS A cross-sectional study with 228 six-month-old infants who used primary health care units of the city of Rio de Janeiro, Southeastern Brazil. Mean weight-for-length and mean weight-for-age were expressed in z-scores considering the 2006 World Health Organization reference curves. Maternal mental health was measured by the 12-item General Health Questionnaire. The following cutoff points were used: ≥ 3 for common mental disorders, ≥ 5 for more severe mental disorders, and ≥ 9 for depression. The statistical analysis employed adjusted linear regression models. RESULTS The prevalence of common mental disorders, more severe mental disorders and depression was 39.9%, 23.7%, and 8.3%, respectively. Children of women with more severe mental disorders had, on average, a weight-for-length 0.37 z-scores lower than children of women without this health harm (p = 0.026). We also observed that the weight-for-length indicator of children of depressed mothers was, on average, 0.67 z-scores lower than that of children of nondepressed women (p = 0.010). Maternal depression was associated with lower mean values of weight-for-age z-scores (p = 0.041). CONCLUSIONS Maternal mental health is positively related to the inadequacy of the nutritional status of infants at six months.OBJETIVO Analisar se saúde mental materna associa-se ao estado nutricional infantil no sexto mês de vida. MÉTODOS Estudo seccional com 228 crianças aos seis meses atendidas em unidades básicas de saúde do município do Rio de Janeiro. Médias de peso-para-comprimento e peso-para-idade foram expressas em escores z considerando as curvas de referência do World Health Organization 2006. A saúde mental materna foi aferida pelo General Health Questionnaire com 12 itens. Foram empregados os pontos de corte ≥ 3 para transtornos mentais comuns, ≥ 5 para transtornos mentais mais graves e ≥ 9 para depressão. Na análise estatística empregaram-se modelos de regressão linear ajustados. RESULTADOS As prevalências de transtornos mentais comuns, transtornos mentais mais graves e depressão foram de 39,9%, 23,7% e 8,3%, respectivamente. Para peso-para-comprimento, filhos de mulheres com transtornos mentais mais graves tinham, em média, 0,37 escores z mais baixos do que filhos de mulheres sem este agravo (p = 0,026). Também para o indicador peso-para-comprimento observou-se que, em relação aos filhos de mulheres não deprimidas, crianças de mães deprimidas apresentaram, em média, 0,67 escores z mais baixos (p = 0,010). Depressão materna esteve associada com valores médios mais baixos de escore z de peso-para-idade (p = 0,041). CONCLUSÕES A saúde mental materna está positivamente relacionada à inadequação do estado nutricional de crianças aos seis meses

Comunicação e saúde: humanização, significado e ação comunicativa

O objetivo deste artigo é analisar o binômio comunicação-saúde sob a perspectiva do agir comunicativo de Jürgen Habermas. Em um país com cerca de 191 milhões de habitantes, a comunicação deve subsidiar as políticas públicas de promoção da saúde, para tornar democráticas as práticas gerenciais e sanitárias. A humanização dos serviços e a atuação das equipes multiprofissionais exigem interação e acordo entre os sujeitos. O agir comunicativo pode trazer esse significado, com sustentação do diálogo e da cooperação, apontando nova direção baseada nos acordos sociais para produção dos serviços de saúde.This article aims at analyzing the relation between communication and health under the communicative action perspective of Jürgen Habermas. In a country with almost 191 million inhabitants communication must support the health promotion public policies in order to organize democratically the management and sanitary practices. The humanization of the services and the work of the multi-professional teams demand integration and agreement among the subjects. Habermas’ communicative action can offer this meaning, thereby sustaining dialogue and cooperation, pointing in a new direction based on the social agreements for production of health services.El objetivo de este artículo es analizar el binomio comunicación-salud a partir de la perspectiva de la acción comunicativa de Jürgen Habermas. En un país con cerca de 191 millones de habitantes, la comunicación debe subsidiar las políticas públicas de promoción de la salud, para volver democráticas las prácticas gerenciales y sanitarias. La humanización de los servicios y la actuación de los equipos multiprofesionales exigen interacción y alianzas entre los sujetos. El actuar comunicativo puede traer ese significado, con la sustentación del diálogo y la cooperación, señalando una nueva dirección basada en los acuerdos sociales para la producción de los servicios de salud