Qualidade de vida de pais e crianças autistas portuguesas

Curso de mestrado em enfermagem de reabilitaçãoIntrodução: Actualmente os estudos realizados tendo em conta a qualidade de vida (QDV) dos pais de crianças autistas são escassos. O que reforça a necessidade de novas investigações para que se consiga perceber o real impacto que uma criança autista provoca no seio familiar, para posteriormente se conseguirem desenvolver novas estratégias de actuação. Neste pressuposto, o presente estudo teve como objectivos: conhecer a QDV dos pais de crianças autistas e determinar variáveis o efeito de variáveis de contexto sociodemográfico, familiar e psicossocial nos diferentes domínios desta mesma QDV. Métodos: Realizou-se um estudo transversal, descritivo-correlacional, de natureza analítica e quantitativa, no qual participaram 56 pais de crianças autistas pertencentes à APPDA-Viseu, com idades entre 26 e 47 anos. Para a mensuração das variáveis utilizaram-se os seguintes instrumentos: uma ficha sóciodemográfica, escala de Apgar Familiar, escala de avaliação da QDV WHOQOL-Bref, Escala de Satisfação com o Suporte Social (ESSS) e o Inventário da Personalidade de Eysenck. Resultados: Relativamente à QDV dos pais de crianças autistas concluímos que os homens apresentam melhor QDV face às mulheres com uma ordenação média de 34.50 vs 24.62 respectivamente. Os dados revelam que existem influências significativas das variáveis sóciodemográficas: género, zona de residência e estado civil sobre a QDV dos pais de crianças autistas. Obtêm-se também a existência de influências significativas das variáveis sóciofamiliares: género do filho, tempo de institucionalização do filho e funcionalidade familiar e por fim influências significativas tanto da variável suporte social como da personalidade (em relação às variáveis psicossociais). Conclusão: As evidências encontradas neste estudo convidam-nos para a elaboração e reflexão sobre novas estratégias que possibilitem a obtenção de um melhor conhecimento que facilite o desenho de programas de intervenção formativos e informativos, visando a promoção da QDV destes sujeitos. Palavras-chave: QDV, pais, autismo, funcionalidade familiar, suporte social, personalidadeABSTRACT Introduction: Currently studies regarding the quality of life (QOL) of parents of autistic children are scarce. This reinforces the need for further investigations in order to realize the real impact of an autistic child in the family environment. So our objectives are to understand the QOL of parents of autistic children and to establish whether there is any kind of connection between the different domains of QOL and socio-demographic, psychosocial and social-familial aspects. Method: We conducted a cross-sectional study, descriptive-correlational, analytical and quantitative, attended by 56 parents of autistic children belonging to APPDA-Viseu, aged between 26 and 47 years. To measure the variables we used the following instruments: a socio-demographic data sheet, family Apgar scale, WHOQOL-Bref scale, Satisfaction with Social Support scale and the Eysenck Personality Inventory. Results: we found that men have better QOL compared to women with an average ranking of 34,50 vs. 26,72 respectively. The data reveal that there are significant influences of socio-demographic variables: gender, area of residence and marital status on QOL of parents of autistic children. We also obtained a significant influence of social-familial variables: child’s gender, Length of institutionalization of the child and family functioning and ultimately we also obtain significant influences of both the variable of Social Support and personality (in relation to psychosocial). Conclusion: Evidences found in this study invite us to create and reflect on strategies to achieve a better knowledge to facilitate the design of intervention programs and training information aiming at promoting QOL of parents of autistic children. Key Words: Quality Of Life, Parents, Autism, Family Function, Social Support, Personality

Prevalence and monthly distribution of head lice using two diagnostic procedures in several age groups in Uberlândia, State of Minas Gerais, Southeastern Brazil

Some epidemiological characteristics of head lice, Pediculus capitis, were studied using two procedures: cut hair analysis and head inspection. Higher prevalence rates were observed in the middle and at the end of the school terms. Both procedures indicated that children were the main reservoir for this type of pediculosis in Uberlândia

A prospective multicenter portuguese study

Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.This prospective multicentric study aiming to determine the incidence of complications (malignant transformation, torsion or rupture) during conservative management of adnexal masses was performed in two Portuguese tertiary referral hospitals. It included ≥18-year-old, non-pregnant patients with asymptomatic adnexal masses (associated IOTA ADNEX risk of malignancy < 10%) sonographically diagnosed between January 2016 and December 2020. Conservative patient management consisted of serial clinical and ultrasound assessment up to 60 months of follow-up, spontaneous resolution of the formation or surgical excision (median follow-up: 17.8; range 9–48 months). From the 573 masses monitored (328 premenopausal and 245 postmenopausal adnexal masses), no complications were observed in 99.5%. The annual lesion growth rates and increases in morphological complexity were similar in the premenopausal and postmenopausal patients. Spontaneous resolu-tion, evidenced in 16.4% of the patients, was more common in the premenopausal group (p < 0.05). Surgical intervention was performed in 18.4% of the cases; one borderline and one invasive FIGO IA stage cancer were diagnosed. There was an isolated case of ovary torsion (0.17%). These data support conservative management as a safe option for sonographically benign, stable and asymp-tomatic adnexal masses before and after menopause and highlight the need for expedite treatment of symptomatic or increased-morphological-complexity lesions.publishersversionpublishe

Sinergia Coworking:uma alternativa de espaço multiprofissional para paço do lumiar – MA / Synergy Coworking:a multidisciplinary alternative space for paço do lumiar - MA

Os espaços vêm passando por transformações e mudanças para adaptar aos novos anseios e demandas da sociedade. No ramo corporativo, surge o coworking para suprir a necessidade do trabalho flexível. Diante disso, o presente trabalho tem o objetivo de propor um anteprojeto de coworking como uma alternativa de espaço de trabalho no atual período pandêmico para o município de Paço do Lumiar, visto que a utilização do home office foi acentuada com a pandemia de COVID-19 e com isso muitos profissionais foram prejudicados por não terem recursos próprios adequados para exercerem suas atividades laborais. Além disso, a falta de espaços coorporativos flexíveis, com baixo custo no município, proporciona o deslocamento de muitos profissionais para o polo atrativo São Luís, gerando movimento pendular e consequentemente aumento do congestionamento, devido à distância e grande fluxo de pessoas. Por meio do projeto proposto foi possível oferecer espaços de trabalho flexíveis de baixo custo com salas diversificadas para suprir a necessidade de cada usuário, seguindo os protocolos contra a COVID-19 e adotando soluções projetuais visando o conforto bioclimático da edificação para influenciar positivamente o ambiente de trabalho. Dessa forma, notou-se o benefício de espaços de trabalho adaptados para as necessidades globais atuais, conectando assim o bem-estar com produtividade e reduzindo desvantagens do teletrabalho

Acute effects of a typical rhythmic gymnastic training session on physiological parameters in Olympic athletes

The aim of this study was to evaluate the effects of a day with two separate training sessions (morning and afternoon) of rhythmic gymnastics on erythrocytes, leukocytes, muscle damage, oxidative stress, and hydration of Brazilian team [age 17.7 (±1.1) years; body height 165 (±0.5) cm; body mass 49.7 (±4.2) kg]. Heart rate and session-ratings of perceived exertion were used to monitor training intensity. Blood samples were collected immediately before (M1) and after (M2) the training day for analyzing erythrocytes, leukocytes, plasma creatine kinase activity, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, ferric reducing ability plasma, thyroid-stimulating hormone, and free T4. Saliva was collected for cortisol analysis. After 24 hours rest (M3), blood collection was performed to analyze creatine kinase and lactate dehydrogenase. The moderate-intensity training day induced significant elevations of total leukocytes (5,163.3 to 9,617.8), lymphocytes (1,752.7 to 2,729.7), neutrophils (2,873.9 to 6,163.6), monocytes (255.7 to 519.1), platelets (280,000.0 to 300,666.7), aspartate aminotransferase (13.1 to 25.6), lactate dehydrogenase (102.5 to 249.1), thyroid-stimulating hormone (1.0 to 3.2), and ferric reducing ability plasma (136.8 to 165.4), as well as significant reductions in red cells (4,691,111.1 to 4,497,777.8), hematocrit (42.1 to 39.3), and hemoglobin (12.9 to 12.5) at M2. There were also significant increases in creatine kinase (144.2 to 519.3) and lactate dehydrogenase (102.5 to 538.2) at M3. The average dehydration rate was 1.3%. A moderate-intensity day of training in rhythmic gymnastics of 8h21min duration caused hemolysis, leukocytosis, muscle damage, redox status perturbations, and insufficient hydration status. These findings show that athletes are exposed to physiological vulnerabilities that can possibly harm their performance and health

Ineffective penicillin treatment and absence of partner treatment may drive the congenital syphilis epidemic in Brazil

BACKGROUND: Reducing congenital syphilis has been the focus of Brazilian health programs for decades, yet the cases continue to increase. Although health interventions have targeted HIV screening and treatment, syphilis management continues to be challenging. Syphilis during pregnancy may enhance the HIV maternal seroconversion risk. The potential factors fueling the syphilis epidemic were evaluated in south Brazil, an area of high HIV or syphilis endemicity. OBJECTIVE: We hypothesized that ineffective treatment because of a lack of partner treatment, late presentation to care, and reinfection of previously treated mothers were potential drivers of syphilis mother-to-child transmission. STUDY DESIGN: Data on women diagnosed with syphilis during pregnancy between January 1, 2008 and December 31, 2018 were obtained from a large urban hospital in Porto Alegre, Brazil. The patients were stratified into effective vs ineffective treatment groups according to the World Health Organization guidelines. Crude and adjusted risk ratios for the prediction of congenital syphilis and adverse fetal or neonatal outcomes were computed using Poisson regression. RESULTS: Nearly 56,000 pregnant women delivered over the 11-year period; 1541 (2.8%) had confirmed syphilis during pregnancy, with 934 (61%) receiving ineffective syphilis treatment because of late presentation and diagnosis, delayed treatment initiation, and loss to follow-up with no treatment recorded. Ineffective treatment was associated with maternal education, prenatal care, timing of syphilis diagnosis, venereal diseases research laboratory titers, and maternal HIV coinfection. On multivariate regression analysis, ineffective treatment (adjusted risk ratio, 4.52; 95% confidence interval, 2.35–8.69), absence of prenatal care (adjusted risk ratio, 9.31; 95% confidence interval, 3.77–23.0), syphilis diagnosis at delivery (adjusted risk ratio, 3.08; 95% confidence interval, 2.07–4.58), and maternal nontreponemal titers ≥1:64 (1.09–1.93) were associated with an increased risk of fetal loss. Ineffective treatment (adjusted risk ratio, 1.71; 95% confidence interval, 1.59–1.84), year of diagnosis 2014 to 2016 (adjusted risk ratio, 1.07; 95% confidence interval, 1.02–1.13), absence of prenatal care (adjusted risk ratio, 1.44; 95% confidence interval, 1.17–1.76), and maternal nontreponemal titers >1:4 were associated with an increased risk of congenital syphilis. Although partner treatment reduced the congenital syphilis risk (adjusted risk ratio, 0.60; 95% confidence interval, 0.55–0.66), only 31.8% of partners received treatment. Maternal HIV coinfection was not associated with an increased risk of fetal loss, low birthweight, preterm birth, congenital syphilis, or symptomatic neonatal infection. CONCLUSION: Public health initiatives promoting effective syphilis treatment in pregnancy, increased access to high-quality prenatal care, and partner treatment should be considered to reduce congenital syphilis.Revisión por pare

Antimicrobial Resistance and Biofilms Underlying Catheter-Related Bloodstream Coinfection by Enterobacter cloacae Complex and Candida parapsilosis

Biofilm-associated infections are a public health concern especially in the context of healthcare-associated infections such as catheter-related bloodstream infections (CRBSIs). We evaluated the biofilm formation and antimicrobials resistance (AMR) of Enterobacter cloacae complex and Candida parapsilosis co-isolated from a CRBSI patient. Antimicrobial susceptibility of central venous catheters (CVCs) and hemoculture (HC) isolates was evaluated, including whole genome sequencing (WGS) resistome analysis and evaluation of gene expression to obtain insight into their AMR determinants. Crystal violet assay was used to assess dual biofilm biomass and microscopy was used to elucidate a microorganism’s distribution within biofilms assembled on different materials. Bacteria were multidrug-resistant including resistance to colistin and beta-lactams, likely linked to the mcr-9-like phosphoethanolamine transferase and to an ACT family cephalosporin-hydrolyzing class C beta-lactamase, respectively. The R398I and Y132F mutations in the ERG11 gene and its differential expression might account for C. parapsilosis resistance to fluconazole. The phenotype of dual biofilms assembled on glass, polystyrene and polyurethane depends on the material and how biofilms were initiated by one or both pathogens. Biofilms assembled on polyurethane were denser and richer in the extracellular polymeric matrix, and microorganisms were differently distributed on the inner/outer surface of the CVC.publishedVersio

Minimal intervention in dentistry : which is the best approach for silorane composite restoration repairs?

This study aimed to evaluate surface treatments, adhesives and composites for repairing silorane based restorations. One hundred and twenty truncated cones (2 mm smaller diameter and 4 mm larger diameter) made of silorane composite were divided in 12 g