Desafios e possibilidades na reorientação do processo de trabalho dos terapeutas ocupacionais nos núcleos ampliados de saúde da família e atenção básica em meio à pandemia da covid-19 / Challenges and possibilities in the reorientation of the work process of occupational therapists in the extended family health centers and basic care in the middle of the Covid-19 pandemic

Contextualização: O trabalho dos profissionais dos Núcleos Ampliados de Saúde da Família e Atenção Básica (NASF-AB), durante a pandemia da Covid-19, objetiva reformular as práticas e garantir o cuidado à população. Processo de intervenção: Os terapeutas ocupacionais neste cenário necessitaram realinhar seus modos de produzir saúde. Análise crítica da prática: No município de Jaboatão dos Guararapes-PE, as estratégias de reformulação da atuação se deram por meio remoto e presencial, utilizando-se desde teleatendimentos, redes sociais e divulgação de vídeos à realização de reuniões on-line com equipe das unidades de saúde. Síntese das considerações: Foi necessário se apropriar do evento, refletir, adaptar, para propor estratégias de continuidade do cuidado em saúde.Palavras-chave: Terapia Ocupacional. Atenção básica. Covid-19. Equipe multiprofissional. AbstractContextualization: The work of professionals from the Extended Family Health and Primary Care Centers, in the context of the Covid-19 pandemic, aims to reformulate practices and ensure care for the population. Intervention process: Occupational therapists in this scenario needed to realign their ways of producing health. Practice analysis: In the municipality of Jaboatão dos Guararapes-PE, the strategies for reformulating the performance took place remotely and in person, using call centers, social networks and the dissemination of videos to online meetings with staff from the health units. Summary of considerations: It was necessary to appropriate the event, reflect, adapt, in order to provide continuity of health care.Keywords: Occupational Therapy. Basic care. Covid-19. Multiprofessional team. ResumenContextualización: La labor de los profesionales de los Centros de Salud de la Familia Extendida y Atención Primaria (Nasf-AB), en el contexto de la pandemia Covid-19, tiene como objetivo reformular las prácticas y asegurar la atención a la población. Proceso de intervención: Los terapeutas ocupacionales en este escenario necesitaban realinear sus formas de producir salud. Análisis crítico de la práctica: En el municipio de Jaboatão dos Guararapes-PE, las estrategias para reformular la actuación se llevaron a cabo de forma remota y presencial, utilizando call center, redes sociales y la difusión de videos a reuniones en línea con el personal de las unidades de salud. Resumen de consideraciones: Era necesario apropiarse del evento, reflexionar, adaptarse, para dar continuidad a la atención de salud.Palabras clave: Terapia Ocupacional. Cuidados básicos. COVID-19. Equipo multiprofesional

DEPRESSION SYMPTOMS IN NURSING PROFESSIONALS DURING THE COVID-19 PANDEMIC

Objetivo: identificar sintomas de depressão em profissionais de enfermagem durante a pandemia de covid-19.Método: estudo transversal e observacional, via formulário eletrônico, nas cinco regiões do Brasil, entre profissionais de enfermagem. Utilizou-se instrumento com informações gerais e o Patient Health Questionnaire-9 para identificar sintomas de depressão. Adotaram-se testes de hipóteses t de Student e Análise de Variância.Resultados: participaram 3249 profissionais. Destes, 2092 (64,4%) não apresentaram ou apresentaram sintomas mínimos de depressão, 603 (18,6%) moderados, 330 (10,2%) sintomas de moderado a severos e 224 (6,9%) sintomas severos. Mulheres, trabalhadores da região Norte, adultos jovens, solteiros e com renda de até quatro salários apresentaram escore de depressão mais elevados (p<0,05).Conclusão: os profissionais de enfermagem não apresentaram ou apresentaram sintomas leves de depressão. Variáveis como sexo, faixa etária, estado civil, região do país, ter contato com pessoas com covid-19 e não usar máscaras tiveram diferenças significativas com sintomas de depressão.Objective: to identify depression symptoms in Nursing professionals during the COVID-19 pandemic.Method: a cross-sectional and observational study, conducted with Nursing professionals through an electronic form in the five Brazilian regions. An instrument with general information was used, as well as the Patient Health Questionnaire-9 to identify depression symptoms. The Student’s t hypothesis and Analysis of Variance tests were adopted.Results: the participants were 3,249 professionals. Of these, 2,092 (64.4%) did not present depression symptoms or presented minimal symptoms; 603 (18.6%) presented moderate symptoms; 330 (10.2%) had moderate to severe symptoms; and 224 (6.9%), severe symptoms. Women, workers from the North region, young adults, single and with an income of up to four minimum wages presented higher depression scores (p<0.05).Conclusion: the Nursing professionals did not present depression symptoms, or presented mild symptoms of the disease. Variables such as gender, age group, marital status, region of the country, having contact with people infected by COVID-19, and not using masks presented significant differences with depression symptoms.Objetivo: identificar síntomas de depresión en profesionales de Enfermería durante la pandemia de COVID-19. Método: estudio transversal y observacional, realizado con profesionales de Enfermería por medio de un formulario electrónico, en las cinco regiones de Brasil. Se utilizó un instrumento con información general y el Patient Health Questionnaire-9 para identificar síntomas de depresión. Se adoptaron las pruebas de hipótesis t de Student y Análisis de Variancia. Resultados: participaron 3249 profesionales. De ellos, 2092 (64,4%) no presentaron síntomas de depresión o tuvieron síntomas mínimos, 603 (18,6%) moderados, 330 (10,2%) de moderados a graves y 224 (6,9%) síntomas graves. Las mujeres, los trabajadores de la región Norte, los adultos jóvenes, las personas solteras y con un ingreso de hasta cuatrosalarios presentaron puntajes de depresión más elevados (p<0,05). Conclusión: los profesionales de Enfermería no presentaron síntomas de depresión o tuvieron síntomas leves. Variables como el sexo, el grupo etario, el estado civil, la región del país, tener contacto con personas infectadas por COVID-19 y no usar máscaras evidenciaron diferencias significativas con los síntomas de depresión

Role of enamel and dentin on color changes after internal bleaching associated or not with external bleaching

Objective: To evaluate the effect of the association between external and internal tooth bleaching on color changes in dentin and enamel, individually or recombined, previously stained with triple antibiotic paste (TAP). Methodology: Forty enamel-dentin specimens from bovine incisors were separated into ten blocks according to similarity in their whiteness index (WID). Three specimens within each block were stained by dentin exposure to TAP, and the remaining specimen was used as control to estimate color changes. Specimens were sectioned to separate tissues, and dentin and enamel colors were measured individually and after being recombined. Alterations in color (CIEDE2000 - ΔE00) and translucency parameter (TP) resulting from staining were estimated by color difference between stained and control specimens. The contribution of each tissue to the color change (CTCC) was also calculated. Non-sectioned stained specimens were bleached by applying sodium perborate on dentin, associated or not with 35% hydrogen peroxide on enamel. Color changes caused by bleaching procedures were estimated and data were analyzed using the paired t-test or Two-way repeated measures ANOVA.&nbsp;Results: TAP caused more pronounced changes in dentin, but enamel color was also affected. Both protocols presented a similar ΔE00, and dentin showed the greater color change. After exposure to TAP, we observed a reduction in WID; WID values were the same for bleached and control specimens regardless of protocol. We found no significant effect of substrate and bleaching technique on TP. Enamel played a more critical role in color changes caused by either staining or bleaching procedures.&nbsp;Conclusion: Enamel color played a greater role on tooth color changes than dentin. External and internal bleaching association did not improve bleaching effect on specimens stained with TAP

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Prediction of postoperative facial swelling, pain and trismus following third molar surgery based on preoperative variables

Objective: This paper investigates the relationship between preoperative findings and short-term outcome in third molar surgery. Study design: A prospective study was carried out involving 80 patients who required 160 surgical extractions of impacted mandibular third molars between January 2009 and December 2010. All extractions were performed under local anesthesia by the same dental surgeon. Swelling and maximal inter-incisor distance were measured at 48 h and on the 7th day postoperatively. Mean visual analogue pain scores were determined at four different time periods. Results: One-hundred eight (67.5%) of the 160 extractions were performed on male subjects and 52 (32.5%) were performed on female subjects. Median age was 22.46 years. The amount of facial swelling varied depending on gender and operating time. Trismus varied depending on gender, operating time and tooth sectioning. The influence of age, gender and operating time varied depending on the pain evaluation period (p < 0.05). Conclusions: Short-term outcomes of third molar operations (swelling, trismus and pain) differ depending on the patients' characteristics (age, gender and body mass index). Moreover, surgery characteristics such as operating time and tooth sectioning were also associated with postoperative variables

Soroprevalência da infecção pelo vírus da hepatite B em indivíduos com evidência clínica de hepatite em Goiânia, Goiás: detecção do DNA viral e determinação dos subtipos

The presence of serological markers for hepatitis B virus (HBsAg, anti-HBc IgM and Anti-HBc total) was investigated in the serum of 1,396 individuals who had clinical suspect of hepatitis. It was observed that 50.7% of the individuals were positive and, from the total of the studied individuals, 14.5% were positive for HBsAg. From these, 8.5% were also positive for anti-HBc IgM. The analysis in relation to gender showed a higher seroprevalence index among male individuals (p < 0.0001). It was observed the occurrence of subtypes adw2 (62.7%), ayw3 (23.5%), ayw2 (9.8%) and adw4 (3.9%). The viral DNA was detected in 61 (33.9%) HBsAg positive samples and in one sample positive only for anti-HBc total. These results indicate an important incidence of the HBV infection in this population, and reinforce previous studies regarding this virus in the central west region of Brazil.Investigou-se a presença dos marcadores sorológicos AgHBs, anti-HBc IgM e anti-HBc total no soro de 1.396 indivíduos com suspeita clínica de hepatite. Observou-se uma soroprevalência para a infecção pelo VHB de 50,7%, sendo que do total dos 1.396 indivíduos, 14,5% eram positivos para AgHBs e 8,5% eram também positivos para anti-HBc IgM, tendo ainda sido observado que a soroprevalência foi maior em indivíduos do sexo masculino (p < 0,0001). Por subtipagem foram identificados os seguintes subtipos: adw2 (62,7%), ayw3 (23,5%), ayw2 (9,8%) e adw4 (3,9%). O DNA viral foi detectado em 61 (33,9%) amostras positivas para o AgHBs e em uma amostra positiva somente para anti-HBc total. Estes resultados indicam importante índice de ocorrência da infecção pelo VHB nesta população e reforça dados de estudos anteriores a respeito da importante circulação do vírus na região Centro-Oeste do Brasil

Huntington's Disease: Two-Year Observational Follow-Up of Executive Function Evaluation with CNS Vital Signs Test in an Adult Patient

Huntington's disease (HD) is a genetic, degenerative, and progressive central nervous system disease. It is characterized by motor abnormalities and cognitive and psychiatric symptoms. Objective. To describe the precise degree of clinical severity of patients with HD through a new neurocognitive assessment. Methods. Unprecedented battery of computerized tests, CNSVS (Central Nervous System Vital Signs), was applied at three different moments in 2008, 2009, and 2010. The accurate and reliable CNSVS objectively provided the cognitive state of patients and allowed for the evaluation of disease progression. Case Report. P., 26, female, without any medication, with normal psychomotor development is a parent carrier of HD. In 2008, she was diagnosed with HD in accordance with the Medical Genetics Laboratories. Conclusion. The tests may be useful to reveal the exact measure of the current evolutionary stage of HD patients, allowing for more efficient planning of treatment and future procedures, such as the medication, therapy, and physical activity to be administered

Perfil de ácidos graxos, índices de lipídios aterogênicos e trombogênicos em carne de cordeiros alimentados com grãos de canola

Objetivou-se avaliar a composição dos ácidos graxos e as características qualitativas da carne de cordeiros terminados com níveis crescentes de canola grão na dieta. Foram estudadas amostras de carne provenientes de 27 cordeiros, confinados por 45 dias e alimentados com 00, 08 e 16% de inclusão de canola grão. Houve efeito para os ácidos graxos saturados (AGS): laurico, heptadecanoico e esteárico; ácidos graxos monoinsaturados (AGMI): palmitoleico e oleico; e ácidos graxos polinsaturados (AGPI): eicosatrienoico. Estes ácidos reduziram à medida que os níveis da canola grão aumentaram. Para os AGMI, houve efeito com maior concentração no músculo dos cordeiros alimentados sem a canola grão (49,80%). Houve uma redução linear para o ácido ω3 e para a relação ω3:ω6, enquanto que a relação ω6:ω3 aumentou. A canola grão influenciou o índice de aterogenicidade, com média de 0,57 para o tratamento com 0% de inclusão e 0,58 para os tratamentos com 8% e 16% de inclusão. Observou-se aumento linear para o índice de trombogenicidade com a inclusão da canola grão, cujas médias foram, respectivamente, 0,16, 0,17 e 0,18 para os tratamentos 0%, 8% e 16% de inclusão. Houve redução para a relação hipocolesterolêmicos hipercolesterolêmicos, com médias de 2,09 para a dieta com 0% de inclusão, e 2,06 para 8% e 16% de inclusão da canola em grão na dieta. A canola grão não influenciou a análise instrumental, composição centesimal e atributos sensoriais da carne.This study evaluated the fatty acid composition and qualitative characteristics of meat from lambs feed in feedlot with increasing levels of canola grain. Meat obtained from 27 lambs fed 0, 8 and 16% inclusion of canola grain were analyzed. There was a reduction in the content of saturated fatty acids (SFA): lauric, heptadecanoic, and stearic; and unsaturated fatty acids (UFA): palmitoleic, oleic, and eicosatrienoic, with the increasing levels of canola grain. There was a linear reduction for the ω3 acid and the ω3: ω6 ratio, while the ω6: ω3 ratio increased. But the values observed for this ratio (ω6: ω3) were lower than 4, which is considered a satisfactory value. There was a slight increase (~2%) for the thrombogenicity index and atherogenicity index with the inclusion of canola grain. There was a reduction in the hypocholesterolemic: hypercholesterolemic ratio, with mean values of 2.09 for the diet with 0% inclusion, and 2.06 for 8 and 16% inclusion of canola. Although the inclusion of canola grain for lambs decreased the content of some UFA, reflecting alterations in the correlated nutritional properties, there is a reduction of SFA. The results for instrumental analysis, proximate composition, and sensory acceptance of the lamb meat were similar among the treatments

Genetic diversity and population structure of Musa accessions in ex situ conservation

Abstract\ud \ud \ud \ud Background\ud \ud Banana cultivars are mostly derived from hybridization between wild diploid subspecies of Musa acuminata (A genome) and M. balbisiana (B genome), and they exhibit various levels of ploidy and genomic constitution. The Embrapa ex situ Musa collection contains over 220 accessions, of which only a few have been genetically characterized. Knowledge regarding the genetic relationships and diversity between modern cultivars and wild relatives would assist in conservation and breeding strategies. Our objectives were to determine the genomic constitution based on Internal Transcribed Spacer (ITS) regions polymorphism and the ploidy of all accessions by flow cytometry and to investigate the population structure of the collection using Simple Sequence Repeat (SSR) loci as co-dominant markers based on Structure software, not previously performed in Musa.\ud \ud \ud \ud Results\ud \ud From the 221 accessions analyzed by flow cytometry, the correct ploidy was confirmed or established for 212 (95.9%), whereas digestion of the ITS region confirmed the genomic constitution of 209 (94.6%). Neighbor-joining clustering analysis derived from SSR binary data allowed the detection of two major groups, essentially distinguished by the presence or absence of the B genome, while subgroups were formed according to the genomic composition and commercial classification. The co-dominant nature of SSR was explored to analyze the structure of the population based on a Bayesian approach, detecting 21 subpopulations. Most of the subpopulations were in agreement with the clustering analysis.\ud \ud \ud \ud Conclusions\ud \ud The data generated by flow cytometry, ITS and SSR supported the hypothesis about the occurrence of homeologue recombination between A and B genomes, leading to discrepancies in the number of sets or portions from each parental genome. These phenomenons have been largely disregarded in the evolution of banana, as the “single-step domestication” hypothesis had long predominated. These findings will have an impact in future breeding approaches. Structure analysis enabled the efficient detection of ancestry of recently developed tetraploid hybrids by breeding programs, and for some triploids. However, for the main commercial subgroups, Structure appeared to be less efficient to detect the ancestry in diploid groups, possibly due to sampling restrictions. The possibility of inferring the membership among accessions to correct the effects of genetic structure opens possibilities for its use in marker-assisted selection by association mapping.This work was funded by FAPESP [2008/03470-0] and CNPq. Technical assistance by Luis Eduardo Fonseca was greatly appreciated. The authors (ONJ, SSO, EP, AF) are grateful for the fellowships provided by CNPq and GGS to FAPESP [2010/01398-0]