O COMÉRCIO ELETRÔNICO NA REGIÃO DO PAMPA: UMA INVESTIGAÇÃO NO SETOR DE MODA E CONFECÇÃO DE SANTANA DO LIVRAMENTO, RS

Com a frequente utilização da internet e das diversas redes existentes, os negócios estão se tornando cada vez mais digitalizados. Frente a essas mudanças e necessidades, este artigo tem como foco responder ao seguinte problema: “Em qual estágio se encontra o comércio eletrônico nas empresas do setor de moda e confecção na cidade de Santana do Livramento, RS?” O trabalho traz como objetivos específicos: mapear as empresas de Santana do Livramento do segmento do varejo de moda e confecções que atuam no comércio eletrônico; verificar as vantagens obtidas com o uso do comércio eletrônico; verificar as desvantagens do comércio eletrônico; identificar os motivos pelos quais algumas empresas não adotam o comércio eletrônico; e, identificar o atual uso da internet nas empresas do segmento. A pesquisa foi realizada por meio de duas etapas de coleta de dados, sendo utilizados tanto dados quantitativos quanto qualitativos, gerando, assim, uma importante interação dos resultados. O método utilizado foi a amostragem probabilística. A primeira parte da coleta de dados ocorreu por meio de questionários aplicados com empresas da cidade de Santana do Livramento, RS; logo após a tabulação dos dados foi feita a aplicação de uma entrevista semiestruturada para aprofundar os resultados. Estes mostram que as empresas de moda e confecção da cidade estão em um estágio muito inicial de comércio eletrônico, estando apenas uma empresa da amostra inserida no comércio virtual. As demais empresas, apesar de não utilizarem comércio eletrônico, quando utilizam a internet atualizam redes sociais e buscam informações. Palavras-chave: Moda e confecção. Comércio eletrônico. Negócios virtuais

INTEGRALIDADE E HUMANIZAÇÃO

Integralidade e Humanização são assuntos de total importância pra quem estuda e pretende atuar na área da saúde. O objetivo deste trabalho foi conhecer um pouco mais a Integralidade e a Humanização no Sistema Único de Saúde. Foi realizado um levantamento bibliográfico com os descritores Integralidade, Humanização e Sistema Único de Saúde em bases de dados e no site do ministério da Saúde. A integralidade e a humanização fazem parte do Sistema Único de Saúde, e cada um tem a sua função dentro desse sistema. A Integralidade busca garantir atenção e assistência completa ao indivíduo, desde o atendimento mais básico até tratamentos mais específicos. Ela se baseia em ações de promoção a saúde e se encontra dividida em três etapas: a prevenção das doenças, com campanhas de vacinação por exemplo; cura, no caso de o individuo já estar doente e precisar do tratamento com toda a assistência necessária; e  a reabilitação após o tratamento do paciente, para que ele consiga retornar ao convívio normal na sociedade. Já a Politica nacional de Humanização (Humaniza SUS) foi instituída pelo Ministério da saúde em 2003, com o intuito de melhorar o atendimento a saúde no país, fazendo com que o atendimento básico seja mais acessível a todos, qualificando a prestação de serviços e incentivando as trocas solidarias entre gestores, usuários e trabalhadores. A Humanização busca facilitar a vida do cidadão, diminuindo filas, oferecendo um atendimento mais acolhedor e que mostra resultados satisfatórios e garantindo os direitos dos usuários. Os profissionais que trabalham na área também são beneficiados, pois são mais valorizados e conseguem desempenhar seu trabalho atingindo melhores resultados com seus pacientes. Ambos os princípios são importantíssimos dentro do nosso sistema único de saúde, pois ressaltam a importância da população receber um tratamento digno, mais humanizado e em todos os níveis de complexidade

Meta-analysis of neural systems underlying placebo analgesia from individual participant fMRI data

The brain systems underlying placebo analgesia are insufficiently understood. Here we performed a systematic, participant-level meta-analysis of experimental functional neuroimaging studies of evoked pain under stimulus-intensity-matched placebo and control conditions, encompassing 603 healthy participants from 20 (out of 28 eligible) studies. We find that placebo vs. control treatments induce small, widespread reductions in pain-related activity, particularly in regions belonging to ventral attention (including mid-insula) and somatomotor networks (including posterior insula). Behavioral placebo analgesia correlates with reduced pain-related activity in these networks and the thalamus, habenula, mid-cingulate, and supplementary motor area. Placebo-associated activity increases occur mainly in frontoparietal regions, with high between-study heterogeneity. We conclude that placebo treatments affect pain-related activity in multiple brain areas, which may reflect changes in nociception and/or other affective and decision-making processes surrounding pain. Between-study heterogeneity suggests that placebo analgesia is a multi-faceted phenomenon involving multiple cerebral mechanisms that differ across studies

Infecções sexualmente transmissíveis em mulheres privadas de liberdade em Roraima

OBJECTIVE: To evaluate the prevalence of HIV, syphilis and hepatitis B infection among women deprived of liberty in the state of Roraima, Brazil, and its correlation with perceptions, knowledge and behavioral factors. METHOD: This is a cross-sectional study, with simple systematic sampling, conducted at the Public Female Prison in Boa Vista, State of Roraima, in 2017. A total of 168 inmates (93.8% of the population) were evaluated by in-person interviews and rapid tests. RESULTS: The prevalence of sexually transmitted infections (STI) was 20.2%, being 4.7% HIV, 15.5% syphilis, and 0.0% hepatitis B. Multivariate analysis confirmed as risk factors for acquiring an STI: being over 30 years of age [adjusted odds ratio (OR): 2.57; 95%CI 1.03–6.40); low schooling (adjusted OR: 2.77; 95%CI 1.08–5.05); little knowledge about condom use (adjusted OR: 2.37; 95%CI 1.01–7.31); and believing that there is no risk of contracting syphilis (adjusted OR: 2.36; 95%CI 1.08–6.50). CONCLUSION: The population deprived of liberty is a group of highly vulnerable to STI. The high prevalence of these infections can be explained by knowledge deficits on the subject, distorted perceptions and conditions peculiar to imprisonment, which result in risky behavior. We emphasize the need to implement educational programs for preventing, diagnosing and treating STI for this population.OBJETIVO: Avaliar a prevalência de infecção por vírus da imunodeficiência humana (HIV), sífilis e hepatite B entre mulheres privadas de liberdade do estado de Roraima e sua correlação com percepções, conhecimento e fatores comportamentais. MÉTODO: Trata-se de estudo de corte transversal, com amostragem sistemática simples, realizado na Cadeia Pública Feminina de Boa Vista, estado de Roraima, no ano de 2017. Foram avaliadas 168 detentas (93,8% da população) por meio de entrevista face a face e testes rápidos. RESULTADOS: A prevalência de alguma infecção sexualmente transmissível (IST) foi de 20,2%, sendo 4,7% de HIV, 15,5% de sífilis, e 0,0% de hepatite B. A análise multivariada confirmou como fatores de risco para adquirir uma IST: ter mais de 30 anos de idade [odds ratio (OR) ajustada: 2,57; IC95% 1,03–6,40); baixa escolaridade (OR ajustada: 2,77; IC95% 1,08–5,05); pouco conhecimento sobre o uso da camisinha (OR ajustada: 2,37; IC95% 1,01–7,31); e achar que não há risco de contrair sífilis (OR ajustada: 2,36; IC95% 1,08–6,50). CONCLUSÃO: A população privada de liberdade constitui um grupo de alta vulnerabilidade às IST. A elevada prevalência dessas infecções pode ser explicada por déficits de conhecimento sobre o assunto, percepções distorcidas e condições peculiares ao aprisionamento, que resultam em comportamento de risco. Ressalta-se a necessidade de implantar programas educativos de prevenção, diagnóstico e tratamento de IST para essa população

Case Report: Post-COVID-19 Vaccine Recurrence of Guillain–Barré Syndrome Following an Antecedent Parainfectious COVID-19–Related GBS

Guillain–Barré syndrome (GBS) is an autoimmune neurological disorder often preceded by viral illnesses or, more rarely, vaccinations. We report on a unique combination of postcoronavirus disease 2019 (COVID-19) vaccine GBS that occurred months after a parainfectious COVID-19–related GBS. Shortly after manifesting COVID-19 symptoms, a 57-year-old man developed diplopia, right-side facial weakness, and gait instability that, together with electrophysiology and cerebrospinal fluid examinations, led to a diagnosis of post-COVID-19 GBS. The involvement of cranial nerves and IgM seropositivity for ganglioside GD1b were noteworthy. COVID-19 pneumonia, flaccid tetraparesis, and autonomic dysfunction prompted his admission to ICU. He recovered after therapy with intravenous immunoglobulins (IVIg). Six months later, GBS recurred shortly after the first dose of the Pfizer/BioNTech vaccine. Again, the GBS diagnosis was confirmed by cerebrospinal fluid and electrophysiology studies. IgM seropositivity extended to multiple gangliosides, namely for GM3/4, GD1a/b, and GT1b IgM. An IVIg course prompted complete recovery. This case adds to other previously reported observations suggesting a possible causal link between SARS-CoV-2 and GBS. Molecular mimicry and anti-idiotype antibodies might be the underlying mechanisms. Future COVID-19 vaccinations/revaccinations in patients with previous para-/post-COVID-19 GBS deserve a reappraisal, especially if they are seropositive for ganglioside antibodies

Implications of Placebo and Nocebo Effects for Clinical Practice: Expert Consensus

Background: Placebo and nocebo effects occur in clinical or laboratory medical contexts after administration of an inert treatment or as part of active treatments and are due to psychobiological mechanisms such as expectancies of the patient. Placebo and nocebo studies have evolved from predominantly methodological research into a far-reaching interdisciplinary field that is unravelling the neurobiological, behavioural and clinical underpinnings of these phenomena in a broad variety of medical conditions. As a consequence, there is an increasing demand from health professionals to develop expert recommendations about evidence-based and ethical use of placebo and nocebo effects for clinical practice. Methods: A survey and interdisciplinary expert meeting by invitation was organized as part of the 1st Society for Interdisciplinary Placebo Studies (SIPS) conference in 2017. Twenty-nine internationally recognized placebo researchers participated. Results: There was consensus that maximizing placebo effects and minimizing nocebo effects should lead to better treatment outcomes with fewer side effects. Experts particularly agreed on the importance of informing patients about placebo and nocebo effects and training health professionals in patient-clinician communication to maximize placebo and minimize nocebo effects. Conclusions: The current paper forms a first step towards developing evidence-based and ethical recommendations about the implications of placebo and nocebo research for medical practice, based on the current state of evidence and the consensus of experts. Future research might focus on how to implement these recommendations, including how to optimize conditions for educating patients about placebo and nocebo effects and providing training for the implementation in clinical practice. (C) 2018 S. Karger AG, Base

Guillain-Barre syndrome after SARS-CoV-2 infection in an international prospective cohort study

In the wake of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, an increasing number of patients with neurological disorders, including Guillain-Barre syndrome (GBS), have been reported following this infection. It remains unclear, however, if these cases are coincidental or not, as most publications were case reports or small regional retrospective cohort studies. The International GBS Outcome Study is an ongoing prospective observational cohort study enrolling patients with GBS within 2 weeks from onset of weakness. Data from patients included in this study, between 30 January 2020 and 30 May 2020, were used to investigate clinical and laboratory signs of a preceding or concurrent SARS-CoV-2 infection and to describe the associated clinical phenotype and disease course. Patients were classified according to the SARS-CoV-2 case definitions of the European Centre for Disease Prevention and Control and laboratory recommendations of the World Health Organization. Forty-nine patients with GBS were included, of whom eight (16%) had a confirmed and three (6%) a probable SARS-CoV-2 infection. Nine of these 11 patients had no serological evidence of other recent preceding infections associated with GBS, whereas two had serological evidence of a recent Campylobacter jejuni infection. Patients with a confirmed or probable SARS-CoV-2 infection frequently had a sensorimotor variant 8/11 (73%) and facial palsy 7/11 (64%). The eight patients who underwent electrophysiological examination all had a demyelinating subtype, which was more prevalent than the other patients included in the same time window [14/30 (47%), P = 0.012] as well as historical region and age-matched control subjects included in the International GBS Outcome Study before the pandemic [23/44 (52%), P = 0.016]. The median time from the onset of infection to neurological symptoms was 16 days (interquartile range 12-22). Patients with SARS-CoV-2 infection shared uniform neurological features, similar to those previously described in other post-viral GBS patients. The frequency (22%) of a preceding SARS-CoV-2 infection in our study population was higher than estimates of the contemporaneous background prevalence of SARS-CoV-2, which may be a result of recruitment bias during the pandemic, but could also indicate that GBS may rarely follow a recent SARS-CoV-2 infection. Consistent with previous studies, we found no increase in patient recruitment during the pandemic for our ongoing International GBS Outcome Study compared to previous years, making a strong relationship of GBS with SARS-CoV-2 unlikely. A case-control study is required to determine if there is a causative link or not

Anti-NF155 chronic inflammatory demyelinating polyradiculoneuropathy strongly associates to HLA-DRB15

Background: The aim of the research is to study the human leukocyte antigen (HLA) class II allele frequencies in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) associated with anti-neurofascin 155 (NF155) antibodies. Methods: Thirteen anti-NF155+ and 35 anti-NF155 negative (anti-NF155neg) CIDP patients were included in a casecontrol study. The frequencies of the DRB1 HLA allele were analyzed in all patients while DQ frequencies were only studied in patients sharing the DRB1*15 allele. In silico HLA-peptide binding and NF155 antigenicity, predictions were performed to analyze overlap between presented peptides and antigenic regions. Results: DRB1*15 alleles (DRB1*15:01 and DRB1*15:02) were present in 10 out of 13 anti-NF155+ CIDP patients and in only 5 out of 35 anti-NF155neg CIDP patients (77 vs 14%; OR = 20, CI = 4.035 to 99.13). DRB1*15 alleles appeared also in significantly higher proportions in anti-NF155+ CIDP than in normal population (77 vs 17%; OR = 16.9, CI = 4.434 to 57. 30). Seven anti-NF155+ CIDP patients (53%) and 5 anti-NF155neg CIDP patients had the DRB1*15:01 allele (OR = 7, p = 0.009), while 3 anti-NF155+ CIDP patients and none of the anti-NF155neg CIDP patients had the DRB1*15:02 allele (OR = 23.6, p = 0.016). In silico analysis of the NF155 peptides binding to DRB1*15 alleles showed significant overlap in the peptides presented by the 15:01 and 15:02 alleles, suggesting functional homology. Conclusions: DRB1*15 alleles are the first strong risk factor associated to a CIDP subset, providing additional evidence that anti-NF155+ CIDP patients constitute a differentiated disease within the CIDP syndrome