Emancipatory practices of nurses in primary health care: the home visit as an instrument of health needs assessment

Objetivo Identificar las prácticas emancipadoras de enfermeras en Unidad de Salud Familiar fueron el objeto de este estudio. Método La investigación social cualitativa tipo estúdio de caso. Fueron entrevistados enfermeros de una Unidad de Salud Familiar en Sao Paulo. Resultados Se identificó que la Visita Domiciliaria ha ampliado su alcance y identificado determinantes del proceso salud-enfermedad, lo que provocó en la Unidad de Salud Familiar prácticas emancipadoras. Esta expansión se produjo debido a que el diseño de la atención en propósito por la USF amplió el tradicional objeto de los servicios de salud. Conclusión Se aboga que las directrices de las políticas sociales basen proyectos que tengan como fin el mejoramiento de las necesidades de salud y que el trabajo diario proporcione la reflexión y discusión de los proyectos de atención, para proponer prácticas que enfoquen en los determinantes del proceso salud-enfermedad, tanto cuanto en sus resultados - la enfermedad en el cuerpo individual.Objetivo Identificar as práticas emancipatórias de enfermeiros da Atenção Primária, com a finalidade de contribuir para o aprimoramento do cuidado em saúde. Método Pesquisa social de natureza qualitativa, do tipo estudo de caso. Foram entrevistados os enfermeiros de uma Unidade de Saúde da Família em São Paulo. Resultados Identificou-se que a visita domiciliária, prática protocolar, ampliou seu escopo e identificou determinantes do processo saúde-doença, desencadeando na Unidade de Saúde da Família práticas emancipatórias. Essa ampliação ocorreu porque o projeto de cuidado intencionalizado ampliou o objeto tradicional dos serviços de saúde. Conclusão Advoga-se que as diretrizes das políticas sociais ancorem projetos que tomem como finalidade o aprimoramento das necessidades de saúde e que o cotidiano do trabalho proporcione reflexão e discussão dos projetos de cuidado, para intencionalizar práticas que incidam nos determinantes do processo saúde-doença, tanto quanto nos resultados - a doença expressa no corpo individual.Objective Identify nurses’ emancipatory practices in primary care, to contribute to the improvement of health care. Method A case study type social research of qualitative nature, in which nurses of a primary health care service unit in São Paulo were interviewed. Results The home visit was identified as a nursing practice possible to be expanded in order to identify social determinants of health, triggering emancipatory practices in the service. This expansion occurred because the design of health care labour intended by the service team changed its focus from the traditional object of health services, the disease. Conclusion First, it is advocated that social policies lead projects with the purpose of improving health needs. On the other hand, the daily labour needs to provide opportunities for reflection and discussion of healthcare projects, leading workers to propose labour-processes targeted to both the social determinants of health and people’s illness

Seroprevalence of Hepatitis E virus (HEV) in domestic non-commercial pigs reared in small-scale farms and wild boar in South of Brazil

Hepatitis E is a zoonotic emerging disease distributed worldwide. The domestic swine and wild boars (Sus scrofa) are known as important reservoirs of HEV although HEV infections have been detected in other animal species. The southern region of Brazil has the largest swine productions in the country, ranging from highly-specialized commercial swine productions to small-scale non-commercial pig farms. The small-scale farms allow interactions between wild boars and domestic pigs, when occasionally pathogens transmission can occur between these populations. The aim of this study was to determine HEV seroprevalence in non-commercial domestic pigs and wild boars from two southern Brazilian states (RS: Rio Grande do Sul; SC: Santa Catarina), and discuss if the consumption of raw or undercooked meat from these animals is a potential risk to public health. Animals from RS and SC States were sampled. Serum was harvested from wild boar hunted between 2012 and 2016, and from non-commercial small-scale pig farms in 2014. Overall 249 wild boars (56 from RS and 193 from SC) and 382 pigs (261 from RS and 121 from SC) were tested to detect anti-HEV IgG antibodies using a commercial HEV antibody ELISA kit (Thermo fisher), specific for swine. Overall difference was observed (P\u3c0.0001) regarding HEV seroprevalence between wild boar 4.42% (n=249) and non-commercial domestic pigs 46.60% (n=382). In relation to wild boars samples, higher seroprevalence for Hepatitis E was observed in RS (14.29%; n=56) and lower in SC (1.55%; n=193; P\u3c0.0004). In relation to pigs, RS had also higher seroprevalence (53.26%; n=261) than SC (32.23%; n=121; P\u3c0.0002). Although interactions between wild boar and non-commercial domestic pigs are known to occur, the lowest antibody detection in wild boar suggest that these contact may not be sufficient to explain seroprevalence in studied populations. Our results indicate that non-commercial pigs are a more likely source of infection for the human population than wild boar

Análise das internações devido á realização do fechamento da comuniação interventricular e interatrial no Brasil entre 2010 e 2018

Introdução: A comunicação interventricular (CIV) e a comunicação interatrial (CIA) são as principais e mais prevalentes cardiopatias congênitas (CC). Estima-se que 20% dos lactentes morrem no primeiro ano de vida e que 30% não são diagnosticadas nas primeiras semanas de vida. A ecocardiografia possui extrema importância no diagnóstico e prognóstico das CC, seja fetal ou após nascimento. O fechamento das comunicações é o tratamento ideal, evitando futuras complicações, como: insuficiência cardíaca, arritmias e hipertensão pulmonar. Objetivo: Analisar as internações devido à realização do fechamento da comunicação interventricular e interatrial, com enfoque nos aspectos epidemiológicos, clínica cirúrgica e situação do estado de Goiás. Material e método: O estudo é quantitativo, retrospectivo e com delineamento transversal realizado no Brasil entre os anos 2010-2018, utilizando-se uma população de estudo nacional composta por ambos sexos, todas faixas etárias totalizando 17180 registros. Os dados foram obtidos através do sistema DATASUS, de ordem secundária, na categoria de base de dados no Sistema de Informações Hospitalares do SUS (SIH/SUS). Os dados obtidos foram reorganizados e analisados por meio do programa SPSS 13.0. Foram utilizadas as variáveis: óbito e o tempo médio de permanência hospitalar. Resultados: Houve 13455 cirurgias para tratamento de CIA e 3725 de CIV entre 2010 e 2018 no Brasil. A média anual foi de 1908 procedimentos por ano, 51% corresponderam ao regime privado de atendimento. Observou-se que 69% dessas intervenções foram eletivas e que a média de tempo de internação por procedimento foi maior que 9 dias. Registraram 388 (2,2%) óbitos em relação a todos os procedimentos. O Estado de Goiás durante o mesmo período foi responsável por 1150 (6,7%) procedimentos, 38 (3,3%) desses pacientes faleceram, a média de permanência foi de menor que 8 dias. O Estado de Goiás foi responsável por 1150 (6,7%) das cirurgias de fechamento CIV e CIA em âmbito nacional, possuindo apenas 3,2% da população, porém obteve uma taxa de mortalidade maior que a nacional. Conclusão: Apesar de existir em Goiás uma quantidade relativamente satisfatória de procedimentos, observa-se um predomínio deles no setor privado 64% e apenas 14 procedimentos foram realizados pelo regime público, sendo bem menor em proporção aos realizados no território brasileiro na mesma data. Esse fato revela uma situação preocupante, uma vez que se sabe que grande parte da população depende do SUS para se tratar. Desse modo, fica evidente que essa conjuntura precisa ser revista, uma vez que os custos dos procedimentos são relativamente pequenos se comparado com as perdas sociais

Jogos Interativos: uma abordagem metodológica para auxiliar no processo ensino aprendizagem dos alunos do 6º e 7º anos na Escola Campos Sales em Juscimeira/MT

The use of conventional methodology is still quite routine in the discipline of Science for Elementary Education. From this assumption, this study aimed to present the playful as a new methodological tool to assist in the teaching / learning process. The playful approach more attractive and exciting features such as: creativity, emotion, drawing up, socialization and inclusion, giving the student a learning environment. The study was conducted in a public school in the city of Juscimeira / MT for two weeks in September 2014 with a group of 6th grade, based on the content "Water on Planet Earth." Games and rules were drafted and developed by the students during the lessons. During the search very positive reactions were observed students in the following aspects: motivation, interaction and socialization, as well as the assimilation of content. With the results we can see that playfulness is a valuable support for à successful work in the classroom.O uso de metodologia convencional é ainda bastante rotineiro na disciplina de Ciências, para o Ensino Fundamental. A partir desse pressuposto, o presente trabalho teve como objetivo apresentar o lúdico como uma nova ferramenta metodológica para auxiliar no processo ensino/aprendizagem. O lúdico aborda características mais atrativas e estimulantes, tais como: criatividade, emoção, elaboração de regras, socialização e inclusão, proporcionando ao estudante um ambiente de aprendizagem. O trabalho foi desenvolvido numa escola pública da  cidade de Juscimeira/MT, durante duas semanas do mês de setembro de 2014 com uma turma do 6º ano, com base no conteúdo “Agua no Planeta Terra”. Os jogos e regras foram elaborados e desenvolvidos pelos próprios estudantes, durante as aulas. No decorrer da pesquisa foram verificadas reações bastante positivas dos estudantes quanto aos seguintes aspectos: motivação, interação e socialização, bem como, a assimilação do conteúdo. Com os resultados obtidos foi possível perceber que o lúdico constitui num suporte valioso para um trabalho bem sucedido em sala de aula

Hookah Smoking among Brazilian University Students: An Exploratory Survey on the Prevalence and Perceptions of Addiction and its Harmfulness

Background: This study aimed to determine the prevalence, beliefs, attitudes, and perceptions of hookah use in a population of undergraduate students at a large public university in Brazil. Methods: The sample consisted of 1348 undergraduate students aged over 18-year-old. They completed structured questionnaires on demographic information and close-ended questions on the past and current experiences of smoking hookah. The data underwent descriptive analysis and binary logistic regression.Findings: Finally, 1298 valid survey forms were obtained from printed and digital questionnaires. More than half (53.9%) of participants reported having tried hookah at least once, however, only 10.8% reported they had experienced it within the last 30 days. The majority of the studied population presented acceptable beliefs about the harmfulness and addictive capacity of hookah smoking. However, when comparing the perceptions of those who had smoked and those who had never smoked hookah, and also, the perceptions of users and non-users, significant differences were observed. Students who were users or had already tried hookah showed a tendency to underestimate the deleterious effects of this type of smoking.Conclusion: It could be concluded that hookah smoking was common among Brazilian university students. In addition, preoccupying misperceptions of hookah’s harmfulness and addictive capacity were found. The results showed that the epidemic of hookah smoking, especially among young people, has spread far beyond the Arab world and the Persians. Accordingly, preventive measures must be taken if this population is to be protected from addiction and other serious health problems

Outcomes of the first 54 pediatric patients on long-term home parenteral nutrition from a single Brazilian center

Objectives: Data on multidisciplinary programs dedicated to home parenteral nutrition (HPN) in Latin America are limited. This study describes the results of the first multidisciplinary pediatric intestinal rehabilitation program for HPN at a public tertiary hospital in Brazil. Methods: We retrospectively reviewed patients aged 0–18 years with intestinal failure (IF) who required parenteral nutrition (PN) for >60 days between January/2014 and December/2020. Results: Fifty-four patients were discharged on HPN (15 achieved enteral autonomy, 34 continued on HPN at the end of the study, 1 underwent intestinal transplantation, and 4 died). The median (IQR) age at the study endpoint of patients who achieved enteral autonomy was 14.1 (9.7–19) versus 34.7 (20.4–53.9) months in those who did not achieve enteral autonomy. Overall prevalence of catheter-related thrombosis was 66.7% and catheterrelated bloodstream infection rate was 0.39/1000 catheter-days. Intestinal failure-associated liver disease (IFALD) was present in 24% of all patients; none of the patients who achieved enteral autonomy had IFALD. All patients showed significant improvement in anthropometric parameters during the HPN period. The sociodemographic characteristics of the patients’ family members were mothers less than 20 years old (7.5%), schooling time more than 10 years (55.5%), and household income between 1 and 3 times the minimum wage (64.8%). The 5-year survival rate for HPN is 90%, and 27.7% of patients achieve enteral autonomy. Conclusion: The treatment of pediatric patients with IF followed by a multidisciplinary pediatric intestinal rehabilitation program with HPN is feasible and safe in the Brazilian public health system

Genotype by environment interaction in Nelore cattle from five Brazilian states

Records from 75,941 Nelore cattle were used to determine the importance of genotype by environment interaction (GEI) in five Brazilian states. (Co)variance components were estimated by single-trait analysis (with yearling weight, W450, considered to be the same trait in all states) and multiple-trait analysis (with the record from each state considered to be a different trait). The direct heritability estimates for yearling weight were 0.51, 0.39, 0.44, 0.37 and 0.41 in the states of Goiás, Mato Grosso, São Paulo, Mato Grosso do Sul and Minas Gerais, respectively. The across-state genetic correlation estimates between Goiás and Mato Grosso, Goiás and Minas Gerais, São Paulo and Minas Gerais, and Mato Grosso do Sul and Minas Gerais ranged from 0.67 to 0.75. These estimates indicate that GEIs are biologically important. No interactions were observed between Goiás and São Paulo, Goiás and Mato Grosso do Sul, Mato Grosso and São Paulo, Mato Grosso and Mato Grosso do Sul, Mato Grosso and Minas Gerais, or São Paulo and Mato Grosso do Sul (0.82 to 0.97). Comparison of single and multiple-trait analyses showed that selection based on the former was less efficient in the presence of GEI, with substantial losses (up to 10%) during selection

Mass-rearing of Mediterranean fruit fly using low-cost yeast products produced in Brazil

Ceratitis capitata is one of the most important pests of fruits for exportation, and Sterile Insect Technique (SIT) has been the most efficient and environmental friendly technique used to control fruit fly populations around the world. A key goal in achieving a successful SIT program is a mass rearing system producing high quality insects at low cost. Providing adults with an artificial diet containing hydrolysed protein has been the major obstacle for bio-production facilities in Brazil, because it is expensive and has to be imported. Two other commercial products, autolysed yeast (AY) and yeast extract (YE), of domestic origin and low cost, were tested as substitutes of the imported hydrolyzed protein. To compare their efficiency we observed the female fecundity, adult survival and egg viability of flies raised on diets containing one of each of the different protein products. Flies reared on the domestic yeast products had equivalent or superior performance to the flies reared on imported protein. Both AY and YE can be a possible substitute for imported hydrolyzed protein for C. capitata mass-rearing, as they are cheaper and are readily available in the national market

Tuberculose abdominal de apresentação atípica acometendo próstata e fígado, com disseminação miliar pulmonar: relato de caso / abdominal tuberculosis of atypical presentation accompeting prostate and phygum, with pulmonary mile dissemination: case report

A tuberculose tem como principais órgãos acometidos os pulmões, com o comprometimento abdominal ocorrendo em cerca de 12% dos pacientes com acometimento extrapulmonar (pleural e ganglionar são os mais frequentes). A forma abdominal pode envolver diversas estruturas, como os tratos gastrintestinal e geniturinário, fígado, baço, pâncreas, peritônio e linfonodos, afetando órgãos sólidos em cerca de 10% dos casos, com o comprometimento hepático ocorrendo em menos de 1% de todas as infecções tuberculosas. Este trabalho tem como objetivo apresentar um caso raro de tuberculose macronodular no fígado e próstata, com apresentação radiológica atípica pseudotumoral, em um paciente com tuberculose miliar pulmonar.