Risk factors for and protective factors against breastfeeding interruption before 2 years : a birth cohort study

Background: Little is known about the factors associated with the World Health Organization (WHO) recommendation of breastfeeding for at least 2 years. The objective of this study was to identify risk factors for and protective factors against breastfeeding interruption before 2 years of age. Methods: In this live birth cohort, mother and infant dyads were followed for 2 years. Data collection was performed at the maternity ward and subsequently at the children’s homes, monthly during the first 6months of life and then at 9, 12, 18, and 24 months. The outcome of interest was breastfeeding interruption before 2years of age. Median duration of breastfeeding was estimated using Kaplan-Meier’s survival analysis, and the associations were tested using Cox’s hierarchical multivariate model. Significance was set at 5%. Results: Data from a total of 1344 dyads were assessed. Median breastfeeding duration was 385 days. The following risk factors for breastfeeding interruption were identified: white skin color (adjusted hazard ratio [HRa]: 1.31; 95% confidence interval [95%CI]: 1.10–1.56), primiparity (HRa: 1.21; 95%CI: 1.05–1.40), working outside the home (HRa: 1.52; 95%CI: 1.30– 1.77), child sex male (HRa: 1.18; 95%CI: 1.03–1.35) and use of a pacifier (HRa: 3.46; 95%CI: 2.98–4.01). Conversely, the following protective factors were identified: lower family income (HRa: 0.81; 95%CI: 0.71–0.94), mother-infant bed-sharing (HRa:0.61, 95%CI: 0.52–0.73), on-demand breastfeeding in the first month (HRa: 0.64; 95%CI: 0.47–0.89) and exclusive breastfeeding at 4 months (HRa: 0.58, 95%CI: 0.48–0.70). Conclusions: The findings allowed to identify both risk factors for and protective factors against breastfeeding interruption before 2 years of age. Knowledge of these factors may help prevent this event and aid in the development of programs that help women maintain breastfeeding for at least 2 years, as recommended by the WHO

EFEITOS DA HIDROTERAPIA EM PACIENTES IDOSOS COM OSTEOARTROSE DE JOELHO

A hidroterapia é um recurso importante para reabilitação de alterações funcionais e tem como principio os efeitos físicos, fisiológicos e cinesiológicos. Este estudo tem como objetivo pesquisar os efeitos das técnicas hidroterapêuticas aplicadas a intercorrências em pacientes idosos com osteoartrose de joelho que ocasionam a diminuição da amplitude de movimento, déficit de equilíbrio e diminuição de tônus. Foi realizada revisão bibliográfica utilizando artigos científicos onde foi possível concluir que estas técnicas proporcionam benefícios significativos como: ganho de força e flexibilidade muscular e restauração de amplitude de movimento

In-Depth Genomic Characterization of a Meropenem-nonsusceptible Pseudomonas otitidis Strain Contaminating Chicken Carcass

Background: The indiscriminate use of antibiotics in food-animal production has a major impact on public health, particularly in terms of contributing to the emergence and dissemination of antimicrobial resistant bacteria in the food-animal production chain. Although Pseudomonas species are recognized as important spoilage organisms in foodstuff, they are also known as opportunistic pathogens associated with hospital-acquired infections. Furthermore, Pseudomonas can play a role as potential reservoirs of antimicrobial resistance genes, which may be horizontally transferred to other bacteria. Considering that cephalosporins (3rd and higher generations) and carbapenems are critically important beta-lactam antimicrobials in human medicine, this study reports the occurrence and genomic characterization of a meropenem-nonsusceptible Pseudomonas otitidis strain recovered from a chicken carcass in Brazil.Materials, Methods & Results: During the years 2018-2019, 72 frozen chicken carcasses were purchased on the retail market from different regions in Brazil. Aliquots from individual carcass rinses were screened for Extended Spectrum Beta-lactamase (ESBL)-producing bacteria in MacConkey agar supplemented with 1mg.L-1 cefotaxime. Phenotypically resistant isolates were further tested for resistance to other antimicrobials and confirmed as ESBL-producers by means of disk-diffusion method using Müller-Hinton agar. Only one meropenen-nonsusceptible isolate was detected and submitted to whole genome sequencing (WGS) in Illumina Miseq. The strain was identified as Pseudomonas otitidis by local alignment of the 16S rRNA sequence using BLASTn and confirmed by Average Nucleotide Identity (ANI) analysis using JspeciesWS database. Genes encoding for antimicrobial resistance were detected by means of Resfinder and Comprehensive Antibiotic Resistance Database (CARD) databases. The phenotypic non-susceptibility to meropenen was attributed to the gene blaPOM-1. A total of 192 different genes encoding for quorum sensing system, antiphagocytosis, iron uptake, efflux pump, endotoxin and toxin, adherence, and secretion systems were detected by means of Virulence Factor Database (VFDB). Pseudomonas otitidis-pan genome was built using Roary-rapid large-scale prokaryote pan genome analysis using the present strain (K_25) and other two P. otitidis genomes (PAM-1, DSM 17224) publicly available at the NCBI. The core genome analysis of the two human strains resulted in similar percentages.Discussion: Carbapenems are critically important drugs for human health and bacterial strains resistant to these antimicrobials pose a public health problem. The blaPOM-1 gene harbored by the Pseudomonas otitidis K_25 strain encodes a metallo-beta-lactamase (MBL) conferring resistance to carbapenems. Pseudomonas otitidis was the first confirmed pathogenic Pseudomonas species expressing MBL constitutively in the absence of inducible beta-lactamase genes. Furthermore, the several virulence genes associated with the capacity of the P. otitidis K_25 to colonize, evade the immune system and cause lesions in the human host confirm this strain as a potential opportunistic pathogen contaminating foodstuff. These reinforce the need to address antimicrobial resistance in a One Health perspective, in which resistant bacteria and resistance determinants circulate among environment, animals and humans

Uso e percepção de licitude de práticas ilegais ou antiéticas de sobrevivência de micro e pequenas empresas

According to Sebrae (2013), Brazil’s Micro and Small Enterprises (MSE) survival rate has been improving, with survival of 75.6% in the first two years of life. Many of the survivors, faces difficulties in the market, sometimes, opt for the use of illegal or unethical practices, but still not considered themselves "outlaws". In this context, the general objective was to identify the illegal or unethical practices used by SMEs to survive and the illegality perception of such practices. This is a descriptive and quantitative research type. The research process consisted of four steps: literature review, initial survey with 10 companies, pre-tests with seven companies, and field research with 102 MSEs. The field research was conducted through a questionnaire with 33 variables of illegal or unethical practices, where practices should be assessed by the respondents based on their competitors’ behavior, using a four-points Likert scale. We concluded that all investigated practices are being used to some degree by entrepreneurs, pointing out that for only four of the 33 practices the illegality perception appeared lower than the sense of legality, showing that the majority (29 of 33 practices) are used even though there is illegality awareness. Also, we conclude that five from the nine most used practices are related to tax avoidance.Segundo o Sebrae (2013), a taxa de sobrevivência das Micro e Pequenas Empresas (MPE) no Brasil vem melhorando, com sobrevivência de 75,6% nos primeiros dois anos de vida. Das sobreviventes, muitas enfrentam dificuldades no mercado, tendo que por vezes optar para o uso de práticas ilícitas ou antiéticas e ainda não se considerando “fora da lei”. Nesse contexto, o objetivo geral é relacionar o uso das práticas ilegais ou antiéticas utilizadas pelas MPE para sobreviverem com a percepção de ilicitude dessas práticas. Esta pesquisa é do tipo descritiva e quantitativa. Após levantamento bibliográfico e pesquisa exploratória com 17 MPE foi realizada uma pesquisa de campo com 102 MPE, com a aplicação de um questionário com 33 variáveis de práticas ilegais ou antiéticas, onde as práticas deveriam ser avaliadas pelo respondente com base no comportamento observado de seus concorrentes, por meio de uma escala Likert, de cinco pontos. Pode-se concluir que todas as práticas investigadas estão sendo utilizadas em algum grau pelos empreendedores, cabendo destacar que para apenas quatro das 33 práticas a percepção de ilicitude se apresentou menor que a de licitude, evidenciando que a maioria (29 de 33 práticas) vem sendo utilizada mesmo tendo-se a consciência de que são ilícitas. Pode-se concluir também que das nove práticas destacadas, cinco delas referem-se à evasão fiscal. Percebeu-se que as práticas que ferem diretamente o interesse do consumidor não são vistas como “ilícitas” pelos empreendedores

In-depth genomic characterization of a meropenem-nonsusceptible Pseudomonas otitidis strain contaminating chicken carcass

Background: The indiscriminate use of antibiotics in food-animal production has a major impact on public health, particularly in terms of contributing to the emergence and dissemination of antimicrobial resistant bacteria in the food-animal production chain. Although Pseudomonas species are recognized as important spoilage organisms in foodstuff, they are also known as opportunistic pathogens associated with hospital-acquired infections. Furthermore, Pseudomonas can play a role as potential reservoirs of antimicrobial resistance genes, which may be horizontally transferred to other bacteria. Considering that cephalosporins (3rd and higher generations) and carbapenems are critically important beta-lactam antimicrobials in human medicine, this study reports the occurrence and genomic characterization of a meropenem-nonsusceptible Pseudomonas otitidis strain recovered from a chicken carcass in Brazil. Materials, Methods & Results: During the years 2018-2019, 72 frozen chicken carcasses were purchased on the retail market from different regions in Brazil. Aliquots from individual carcass rinses were screened for Extended Spectrum Beta-lactamase (ESBL)-producing bacteria in MacConkey agar supplemented with 1mg.L-1 cefotaxime. Phenotypically resistant isolates were further tested for resistance to other antimicrobials and confirmed as ESBL-producers by means of disk-diffusion method using Müller-Hinton agar. Only one meropenen-nonsusceptible isolate was detected and submitted to whole genome sequencing (WGS) in Illumina Miseq. The strain was identified as Pseudomonas otitidis by local alignment of the 16S rRNA sequence using BLASTn and confirmed by Average Nucleotide Identity (ANI) analysis using JspeciesWS database. Genes encoding for antimicrobial resistance were detected by means of Resfinder and Comprehensive Antibiotic Resistance Database (CARD) databases. The phenotypic non-susceptibility to meropenen was attributed to the gene blaPOM-1. A total of 192 different genes encoding for quorum sensing system, antiphagocytosis, iron uptake, efflux pump, endotoxin and toxin, adherence, and secretion systems were detected by means of Virulence Factor Database (VFDB). Pseudomonas otitidis-pan genome was built using Roary-rapid large-scale prokaryote pan genome analysis using the present strain (K_25) and other two P. otitidis genomes (PAM-1, DSM 17224) publicly available at the NCBI. The core genome analysis of the two human strains resulted in similar percentages. Discussion: Carbapenems are critically important drugs for human health and bacterial strains resistant to these antimicrobials pose a public health problem. The blaPOM-1 gene harbored by the Pseudomonas otitidis K_25 strain encodes a metallo-beta-lactamase (MBL) conferring resistance to carbapenems. Pseudomonas otitidis was the first confirmed pathogenic Pseudomonas species expressing MBL constitutively in the absence of inducible beta-lactamase genes. Furthermore, the several virulence genes associated with the capacity of the P. otitidis K_25 to colonize, evade the immune system and cause lesions in the human host confirm this strain as a potential opportunistic pathogen contaminating foodstuff. These reinforce the need to address antimicrobial resistance in a One Health perspective, in which resistant bacteria and resistance determinants circulate among environment, animals and humans

Pyroligneous Acid Controls Aphis craccivora (Hemiptera: Aphididae) and Increases Cowpea [Vigna unguiculata (L., Walp)] Productivity

The aphid Aphis craccivora Koch (Hemiptera: Aphididae) is a major pest of cowpea crops [Vigna unguiculata (L., Walp.)]. Adults and nymphs feed on leaves, stems, flowers, and pods, leading to a reduction in plant productivity. Botanical insecticides can be an alternative for the control of A. craccivora, but studies under field conditions are necessary to evaluate these substances. We assessed the mortality of A. craccivora in cowpea crops for two seasons (dry and wet) using pyroligneous acid in three concentrations (2, 4 and 6 mL/L). Water was used as the control. Crop productivity was also evaluated. We performed the experiment using a completely randomized block design with four replications. Pyroligneous acid at 4 and 6 mL/L caused higher mortalities (p < 0.0001) and productivity was higher in plots sprayed with pyroligneous acid at these concentrations in both experimental seasons (p < 0.0001). In summary, pyroligneous acid controls A. craccivora and increases cowpea productivity

Alternative tourism and environmental impacts: perception of residents of an extractive reserve in the Brazilian Amazonia

Alternative tourism (AT) contributes to conservation, valuing the environment and recipient cultures with minimal impact, especially in protected areas. In this context, this article identified, considering the residents’ perception, the possible environmental impacts resulting from alternative tourism in communities of the Tapajós-Arapiuns Extractive Reserve (RESEX), Brazilian Amazonia. Thus, between February and April 2019 a semi-structured interview was conducted with 122 residents of three communities of RESEX (Anã, Maripá, and São Miguel). The interview script was divided into three groups of questions: (i) interviewee data, (ii) socioeconomic data, and (iii) perception of the concept and environmental impacts of alternative tourism. We used a snowball sampling method, which consists of a form of a non-probabilistic sample. The majority (91.8%) of the informants did not know how to explain the concept of alternative tourism; however, for 87.7% of them, this tourism does not generate negative impacts. Income is the most used expression (53%) by RESEX residents to demonstrate what alternative tourism positively impacts. About 74.6% of respondents reported that tourists do not influence local customs change, and 94.3% do not identify tourism-related violence. Finally, 89.3% say that tourists do not pollute the environments. The research carried out in this Conservation Unit deserves the attention of decision-makers, managers, technicians, and researchers. It provides subsidies for management programs to provide real bases for the analysis, interpretation, and planning of sustainable tourist spaces.info:eu-repo/semantics/publishedVersio

CONTRIBUIÇÕES DE UMA LIGA ACADÊMICA DO TRAUMA E EMERGÊNCIA PARA A FORMAÇÃO EM ENFERMAGEM

Este estudo tem o objetivo de socializar a experiência da contribuição da Liga Acadêmica do Trauma e Emergência para a formação em Enfermagem. Trata-se de um estudo do tipo relato de experiência sobre a contribuição da Liga acadêmica  do Trauma e Emergência da Faculdade Nobre de Feira de Santana, Bahia, para a formação acadêmica em Enfermagem. O lócus de ação deste relato foi extraído do cotidiano acadêmico dos discentes do 10º período do Curso de Graduação em Enfermagem. Quanto a questão temporal, o mesmo delimita-se na experiência acadêmica vivenciada entre os anos de 2013 e 2014.  O cenário do relato concentra-se tanto no espaço acadêmico quanto as ações extensionistas desenvolvidas pela Liga. São relatados sobre a fundação da liga, realização de atividades de educação para a saúde, de ensino, pesquisa e extensão. Observou-se que a liga, tem atingindo o seu potencial de contribuição para a formação em Enfermagem em seu lócus de atuação, ampliando o conhecimento e as experiências acadêmicas, por meio do desenvolvimento de atividades de ensino, pesquisa e extensão