Alojamento conjunto e parto cesáreo em maternidades do Estado do Rio de Janeiro, Brasil

OBJECTIVE: To disclose the existence of rooming-in (RI) in public and government contracted private hospitals that offer obstetric beds, in the State of Rio de Janeiro, Brazil, and to examine whether there is any association between RI and another quality care indicator which influences breastfeeding, namely the rate of cesarean section operations performed in these hospitals. METHOD: A survey was made of the existence of RI through a questionnaire sent to the Municipal Health Offices, the information collected being confirmed by telephone with each maternity hospital. The C-section rate data was obtained from the Rio de Janeiro State Health Office and divided into 2 groups: "below 40%" and "40% and above". The prevalence ratio was applied to the measurement of the association between the variables. RESULTS: A rooming-in rate of 65.2% was found for the State as a whole, with regional variations: a better situation in the capital (84.8%), an intermediate one in the interior (69.9 %), and a worse one in the metropolitan belt (44.2%). The public maternity hospitals revealed a higher rate (89.7%) than that of the government contracted private hospitals (53.3%). A direct relation between the practice of RI and low C-section rates was found in the hospitals. However, this association did not present the same weight in all regions of the State. The lowest proportion of hospitals adopting RI was verified in the metropolitan belt, whereas the highest relative number of hospitals with high C-section rates was observed in the interior. CONCLUSION: It is concluded that to reverse the observed status, government authorities must fulfil their gerencial role within their own health system, as well as in the government contracted private hospitals.OBJETIVO: Conhecer a existência de alojamento conjunto (AC) nos hospitais que possuem leitos obstétricos da rede pública e conveniada do Estado do Rio de Janeiro e verificar se o AC guarda associação com outro indicador de qualidade de assistência que tem influência sobre o aleitamento materno: as taxas de cesárea (TC) praticadas por esses hospitais. METODOLOGIA: Procedeu-se a um levantamento sobre a existência de AC através de questionário enviado às Secretarias Municipais de Saúde, informação validada por inquérito telefônico. As TC foram obtidas junto à Secretaria Estadual de Saúde-RJ. Foi utilizada a razão de prevalência para a medida da associação entre as variáveis. RESULTADOS: Foi encontrada uma proporção de 65,2% das maternidades com AC, no Estado. Verificou-se relação direta entre a presença de AC e baixas taxas de cesárea no conjunto dos hospitais, porém essa associação não se confirmou com o mesmo peso em todas as regiões. A menor proporção de hospitais com AC foi verificada no cinturão metropolitano (44,2%), enquanto a maior proporção de hospitais com elevadas taxas de cesárea está no interior (73,1%)

Oral health related quality of life in pregnant and post partum women in two social network domains; predominantly home-based and work-based networks

<p>Abstract</p> <p>Background</p> <p>Individuals connected to supportive social networks have better general and oral health quality of life. The objective of this study was to assess whether there were differences in oral health related quality of life (OHRQoL) between women connected to either predominantly home-based and work-based social networks.</p> <p>Methods</p> <p>A follow-up prevalence study was conducted on 1403 pregnant and post-partum women (mean age of 25.2 ± 6.3 years) living in two cities in the State of Rio de Janeiro, Brazil. Women were participants in an established cohort followed from pregnancy (baseline) to post-partum period (follow-up). All participants were allocated to two groups; 1. work-based social network group - employed women with paid work, and, 2. home-based social network group - women with no paid work, housewives or unemployed women. Measures of social support and social network were used as well as questions on sociodemographic characteristics and OHRQoL and health related behaviors. Multinomial logistic regression was performed to obtain OR of relationships between occupational contexts, affectionate support and positive social interaction on the one hand, and oral health quality of life, using the Oral Health Impacts Profile (OHIP) measure, adjusted for age, ethnicity, family income, schooling, marital status and social class.</p> <p>Results</p> <p>There was a modifying effect of positive social interaction on the odds of occupational context on OHRQoL. The odds of having a poorer OHIP score, ≥4, was significantly higher for women with home-based social networks and moderate levels of positive social interactions [OR 1.64 (95% CI: 1.08-2.48)], and for women with home-based social networks and low levels of positive social interactions [OR 2.15 (95% CI: 1.40-3.30)] compared with women with work-based social networks and high levels of positive social interactions. Black ethnicity was associated with OHIP scores ≥4 [OR 1.73 (95% CI: 1.23-2.42)].</p> <p>Conclusions</p> <p>Pregnant and post-partum Brazilian women in paid employment outside the home and having social supports had better OHRQoL than those with home-based social networks.</p

Xanthenedione derivatives, new promising antioxidant and acetylcholinesterase inhibitor agents

Natural and synthetic xanthone derivatives are well-known for their ability to act as antioxidants and/or enzyme inhibitors. This paper aims to present a successful synthetic methodology towards xanthenedione derivatives and the study of their aromatization to xanthones. Additionally their ability to reduce Fe(III), to scavenge DPPH radicals and to inhibit AChE was evaluated. The results demonstrated that xanthenedione derivative 5e, bearing a catechol unit, showed higher reduction capacity than BHT and similar to quercetin, strong DPPH scavenging activity (EC50 = 3.79 ± 0.06 μM) and it was also showed to be a potent AChEI (IC50 = 31.0 ± 0.09 μM) when compared to galantamine (IC50 = 211.8 ± 9.5 μM)

O lugar do corpo na escola: uma revisão da abordagem psicomotora direcionada a crianças de 4 a 6 anos

O presente trabalho tem como tema “O lugar do corpo na escola: uma abordagem psicomotora direcionada a crianças de 4 a 6 anos”. Trata-se de uma revisão do conhecimento sobre o que é psicomotricidade, sua origem e como interfere na Educação Infantil. Seu principal objetivo é enfatizar a importância do movimento na aprendizagem dos alunos de 4 a 6 anos, seguido pelos objetivos específicos; organizar uma fonte de orientação para professores da Educação Infantil, relacionar a pratica psicomotora à aprendizagem cognitiva, evidenciar a formação do professor da Educação Infantil quanto a vivencia e a pratica de atividades psicomotoras e abordar a relação entre afetividade e aprendizagem. Com isso pode-se constatar que o universo da psicomotricidade é único é muito mais amplo do que os professores imaginam. Este estudo vem afirmar que a psicomotricidade quando contemplada em sua totalidade possibilita o desenvolvimento amplo e global da criança, coordenando mente e corpo

Action of cholecalciferol and alpha-tocopherol on Staphylococcus aureus efflux pumps

Alpha-tocopherol is one the most abundant and biologically active isoforms of vitamin E. This compound is a potent antioxidant and one of most studied isoforms of vitamin E. Vitamin D3 (cholecalciferol) is an important nutrient for calcium homeostasis and bone health, that has also been recognized as a potent modulator of the immune response. Methicillin-resistant Staphylococcus aureus (MRSA) is the most important causative agent of both nosocomial and community-acquired infections. The aim of this study was to evaluate the inhibitory effect of alpha-tocopherol and cholecalciferol on both S. aureus and multidrug resistant S. aureus efflux pumps. The RN4220 strain has the plasmid pUL5054 that is the carrier of gene that encodes the macrolide resistance protein (an efflux pump) MsrA; the IS-58 strain possesses the TetK tetracycline efflux protein in its genome and the 1199B strain resists to hydrophilic fluoroquinolones via a NorA-mediated mechanism. The antibacterial activity was evaluated by determining the Minimal Inhibitory Concentration (MIC) and a possible inhibition of efflux pumps was associated to a reduction of the MIC. In this work we observed that in the presence of the treatments there was a decrease in the MIC for the RN4220 and IS-58 strains, suggesting that the substances presented an inhibitory effect on the efflux pumps of these strains. Significant efforts have been done to identify efflux pump inhibitors (EPIs) from natural sources and, therefore, the antibacterial properties of cholecalciferol and alphatocopherol might be attributed to a direct effect on the bacterial cell depending on their amphipathic structure

Volto Já - Programa de Intercâmbio Sénior:Projeto na Área do Turismo Social Sénior

O Volto Já pretende operacionalizar um programa de cooperação entre organizações de Economia Social que promova o intercâmbio de seniores institucionalizados, proporcionando lhes experiências culturais, turísticas e artísticas. Os seus principais objetivos são: (i) fomentar o envelhecimento ativo e melhorar a qualidade de vida (bem estar, satisfação com a vida, felicidade, etc.) dos seniores institucionalizados; (ii) desenvolver um modelo de negócio de turismo social dirigido aos seniores institucionalizados em lares ou centros de dia, na região do Alentejo; (iii) desenvolver uma plataforma informática que permita às instituições de Economia Social aderir ao programa de intercâmbio sénior, divulgar as experiências socioculturais oferecidas e estabelecer parcerias que efetivem o intercâmbio. A participação no Volto Já permite aos seniores: (a) terem acesso a experiências turísticas e culturais de elevada qualidade, demasiado dispendiosas se adquiridas individualmente; (b) expandirem o seu círculo social; (c) combaterem o isolamento social; (d) contactarem com a cultura e as tradições de outras regiões do país; (e) promoverem a estimulação cognitiva; (f) melhorarem a sua qualidade de vida; (g) contribuírem para práticas de consumo sustentáveis. Para as instituições de Economia Social, participar no projeto permite-lhes: (a) acederem a uma oferta de serviços diferenciada a baixo custo; (b) expandirem a sua rede de parceiros; (c) melhorarem o reconhecimento social; (d) fortalecerem a ligação à academia; (e) inovarem socialmente; (f) aumentarem o seu capital reputacional. O projeto é suportado por uma equipa multidisciplinar do Instituto Politécnico de Santarém e do Instituto Politécnico de Beja, com a colaboração da Santa Casa da Misericórdia de Santarém. Os outputs previstos são: (a) diversas parcerias entre a academia e as instituições de Economia Social; (b) um modelo de negócio de turismo social sénior; (c) realizar uma prova de conceito/teste piloto; (d) uma plataforma informática para dinamização do modelo de negócio; (e) uma conferência internacional.info:eu-repo/semantics/publishedVersio

Associations between cesarean delivery and child mortality: A national record linkage longitudinal study of 17.8 million births in Brazil.

BACKGROUND: There is an increasing use of cesarean delivery (CD) based on preference rather than on medical indication. However, the extent to which nonmedically indicated CD benefits or harms child survival remains unclear. Our hypothesis was that in groups with a low indication for CD, this procedure would be associated with higher child mortality and in groups with a clear medical indication CD would be associated with improved child survival chances. METHODS AND FINDINGS: We conducted a population-based cohort study in Brazil by linking routine data on live births between January 1, 2012 and December 31, 2018 and assessing mortality up to 5 years of age. Women with a live birth who contributed records during this period were classified into one of 10 Robson groups based on their pregnancy and delivery characteristics. We used propensity scores to match CD with vaginal deliveries (1:1) and prelabor CD with unscheduled CD (1:1) and estimated associations with child mortality using Cox regressions. A total of 17,838,115 live births were analyzed. After propensity score matching (PSM), we found that live births to women in groups with low expected frequencies of CD (Robson groups 1 to 4) had a higher death rate up to age 5 years if they were born via CD compared with vaginal deliveries (HR = 1.25, 95% CI: 1.22 to 1.28; p < 0.001). The relative rate was greatest in the neonatal period (HR = 1.39, 95% CI: 1.34 to 1.45; p < 0.001). There was no difference in mortality rate when comparing offspring born by a prelabor CD to those born by unscheduled CD. For the live births to women with a CD in a prior pregnancy (Robson group 5), the relative rates for child mortality were similar for those born by CD compared with vaginal deliveries (HR = 1.05, 95% CI: 1.00 to 1.10; p = 0.024). In contrast, for live births to women in groups with high expected rates of CD (Robson groups 6 to 10), the child mortality rate was lower for CD than for vaginal deliveries (HR = 0.90, 95% CI: 0.89 to 0.91; p < 0.001), particularly in the neonatal period (HR = 0.84, 95% CI: 0.83 to 0.85; p < 0.001). Our results should be interpreted with caution in clinical practice, since relevant clinical data on CD indication were not available. CONCLUSIONS: In this study, we observed that in Robson groups with low expected frequencies of CD, this procedure was associated with a 25% increase in child mortality. However, in groups with high expected frequencies of CD, the findings suggest that clinically indicated CD is associated with a reduction in child mortality