Atuação de enfermeiros da Estratégia Saúde da Família na prevenção e controle do HIV e sífilis durante o pré-natal

Este trabalho teve como objetivo avaliar as práticas dos enfermeiros das equipes de saúde da família durante as consultas de pré-natal, na prevenção e controle do HIV e sífilis gestacional. Estudo transversal, descritivo e exploratório, com aplicação de questionário estruturado a 27 enfermeiros atuantes em unidades de saúde da zona urbana do município de Aracaju, Sergipe, entre setembro e outubro de 2019. A distribuição das variáveis foi analisada por meio do teste de qui-quadrado de Pearson. Constatou-se que 85,2% dos enfermeiros conheciam o manual do ministério da saúde para consulta de pré-natal e 96,3% o utilizavam, porém, 25,9% solicitavam os testes rápidos no período inadequado e 18,5% conduziam erroneamente o tratamento para gestantes com teste para HIV. Houve maior proporção de conduta assertiva dos profissionais que fizeram capacitação há menos de um ano quanto aos testes rápidos de HIV (p=0,001) e sífilis (p=0,046), testes não treponêmicos solicitados no pré-natal (p=0,003), mês que devem ser solicitados o exame de VDRL e o HIV (p=0,046) e trimestre da gestação que oferece o teste de HIV (p=0,046). Evidenciou-se a importância de capacitações sobre à temática para a proporção de atuação condizente com os manuais preconizados pelos Ministério da Saúde na Estratégia de Saúde da Família. ABSTRACTThis study aimed to evaluate the practices of nurses in family health teams, during prenatal consultations, in the prevention and control of HIV and gestational syphilis. Crosssectional study, descriptive and exploratory study, with the application of a structured questionnaire, to 27 nurses working in health units in the urban area of the municipality of Aracaju, Sergipe, between September and October 2019. The distribution of variables was analyzed using Pearson’s chi-square test. It was found that 85.2% of nurses knew the Ministry of Health for prenatal consultation and 96.3% used it, however, 25.9% requested rapid tests in the wrong period and 18.5% conducted erroneously treatment for pregnant women with an HIV test. There was a greater proportion of assertive conduct among professionals who had been trained less than a year ago regarding rapid tests for HIV (p = 0.001) and syphilis (p = 0.046), non treponemal tests requested in prenatal care (p = 0.003), month that the VDRL and HIV test (p = 0.046) and trimester of pregnancy that offers the HIV test (p = 0.046) should be requested. The importance of training on the theme was evidenced for the proportion of performance consistent with the manuals recommended by the Ministry of Health in the Family Health Strategy.Keywords: HIV; Gestational syphilis; Primary care nursing; Prenatal. RESUMENEste estudio tuvo como objetivo evaluar las prácticas de los enfermeros en los equipos de salud de la familia durante las consultas prenatales, en la prevención y control del VIH y la sífilis gestacional. Estudio transversal, descriptivo y exploratorio, con la aplicación de un cuestionario estructurado a 27 enfermeros que laboran en unidades de salud del área urbana del municipio de Aracaju, Sergipe, entre septiembre y octubre de 2019. La distribución de variables se analizó mediante la prueba de Chi Cuadrado de Pearson. Se encontró que el 85,2% de las enfermeras conocía el manual del Ministerio de Salud para la consulta prenatal y el 96,3% lo usaba, sin embargo, el 25,9% solicitó pruebas rápidas en el período inadecuado y el 18,5% realizó erróneamente tratamiento a gestantes con prueba de VIH. Hubo una mayor proporción de conducta asertiva por parte de profesionales que se habían formado hace menos de un año en cuanto a pruebas rápidas de VIH (p = 0,001) y sífilis (p = 0,046), pruebas no treponémicas solicitadas en atención prenatal (p = 0,003), mes en que se debe solicitar la prueba VDRL y VIH (p = 0,046) y trimestre de embarazo que ofrece la prueba VIH (p = 0,046). Se resaltó la importancia de la capacitación en el tema por la proporción de desempeño acorde con los manuales recomendados por el Ministerio de Salud en la Estrategia Salud de la Familia.Palabras clave: Sífilis gestacional; Enfermería de atención primaria; Prenatal

ESTUDO DA TOXICIDADE CAUSADA PELO USO INDISCRIMINADO DO CIGARRO ELETRÔNICO: UMA REVISÃO SISTEMÁTICA

Introduction: Electronic cigarettes were developed to replace conventional cigarettes, with the promise of reducing harm to health and as a device to help stop smoking. Given their rapid and widespread worldwide spread, studies have emerged discussing the possible toxic potential of these devices. Objective: Understand the toxicity caused by excessive use of electronic cigarettes. Methodology: This is a systematic review study, carried out on the platforms PubMed®, BIREME, LILACS, SciELO, and IBECS, with the indexing terms: “ELECTRONIC CIGARETTE”; “TOXICITY”; “EVALI”; “LUNG INJURIES” with the Boolean operator “AND”. Studies published in the last 10 years were selected, with the text available in full, and duplicate articles that did not address the proposed topic were disregarded, thus 12 articles constituted the final sample. Results: According to the studies discussed, most electronic cigarette users showed a relationship between their use and respiratory diseases, such as increased respiratory symptoms, acute eosinophilic pneumonia, recurrent spontaneous pneumothorax, bronchiolitis and acute hypersensitivity pneumonitis. An association between its use and the emergence of gastrointestinal and constitutional complaints and changes in the oral cavity, with the presence of local pain, wounds, gingivitis and gingival bleeding has been reported. A new condition was found: Lung Injury Associated with Electronic Cigarette Use, which presents a set of similar signs and symptoms, and presents the use of these devices as a history. Conclusion: It is concluded, therefore, that although the general effects of electronic devices on health are limited, pulmonary toxicity is established. In view of this, further studies are necessary to better understand the long-term impacts of toxicity and elucidate the mechanisms linked to the emergence of lung lesions.Introdução: Os cigarros eletrônicos foram desenvolvidos visando substituir o cigarro convencional, através da promessa de reduzir os malefícios à saúde e como artifício para auxiliar a cessação do tabagismo. Diante da sua rápida e grande disseminação mundial, surgiram estudos discutindo o possível potencial tóxico desses dispositivos. Objetivo: Compreender a toxicidade causada pelo uso excessivo de cigarro eletrônico. Metodologia: Trata-se de um estudo tipo revisão sistemática, realizado nas plataformas PubMed®, BIREME, LILACS, SciELO, e IBECS, com os termos de indexação: “ELECTRONIC CIGARETTE”; “TOXICITY”; “EVALI”; “LUNG INJURIES” com o operador booleano “AND”. Foram selecionados estudos publicados nos últimos 10 anos, texto disponível na íntegra, e desconsiderados os artigos duplicados e que não abordavam o tema proposto, assim, 12 artigos constituíram a amostra final. Resultados: Segundo estudos abordados, grande parte dos usuários de cigarros eletrônicos apresentaram uma relação entre seu uso e doenças respiratórias, como o aumento dos sintomas respiratórios, a pneumonia eosinofílica aguda, pneumotórax espontâneo recorrente, bronquiolite e pneumonite de hipersensibilidade aguda. Uma associação entre seu uso e o surgimento de queixas gastrointestinais, constitucionais e alterações na cavidade oral, com a presença de dor local, feridas, gengivite e sangramento gengival foram relatadas. Foi encontrado uma nova condição: Lesão Pulmonar Associada ao Uso de Cigarro Eletrônico, que apresenta um conjunto de sinais e sintomas semelhantes, e apresentam como histórico o uso desses dispositivos. Conclusão: Conclui-se, portanto, que apesar dos efeitos gerais dos dispositivos eletrônicos sobre a saúde sejam limitados, a toxicidade pulmonar está estabelecida. Em vista disso, a realização de novos estudos se torna necessária, para compreender com mais propriedade os impactos a longo prazo da toxicidade e elucidar os mecanismos ligados ao surgimento das lesões pulmonares

Perceived quality of life and associated factors in long COVID syndrome among older Brazilians: A cross‐sectional study

Funding information Ministério da Ciência, Tecnologia, Inovações e Comunicações - Brazil; Ministério da Saúde - Brazil; Conselho Nacional de Desenvolvimento Científico Tecnológico (CNPq) - Brazil, Grant/Award Number: 402882/2020–2; FCT—Fundação para a Ciência e a Tecnologia - Portugal: Scientific Employment Stimulus-Institutional Call, Grant/Award Number: CEECINST/00051/2018Aims and objectives This paper aims to: (a) determine the personal, sociodemographic, clinical, behavioural, and social characteristics of older Brazilians with clinical evidence of long COVID; (b) evaluate perceived quality of life and determine its association with personal, sociodemographic, behavioural, clinical and social variables; and (c) assess significant predictors of high perceived QoL. Background Given the inherent vulnerabilities of the ageing process, the older people are an at-risk group for both contagion of SARS-CoV-2 and the perpetuation of residual symptoms after infection, the so-called long COVID or post-COVID syndrome. Design A cross-sectional survey design using the STROBE checklist. Methods Brazilian older people with long COVID syndrome (n = 403) completed a phone survey measuring personal, sociodemographic, behavioural, clinical, and social characteristics, and perceived Quality of Life (QoL). Data were collected from June 2021–March 2022. A multiple linear regression model was performed to identify salient variables associated with high perceived QoL. Results The mean age of participants was 67.7 ± 6.6 years old. The results of the multivariate regression model showed that race, home ownership, daily screen time, musculoskeletal and anxiety symptoms, and work situation were the significant predictors of QoL among COVID-19 survivors. Conclusions Knowledge about the persistence of physical, emotional, and social symptoms of COVID-19 can help nurses and other healthcare providers to improve the management of survivors, bringing benefits to the whole society. Relevance to clinical practice Given the novelty of long-COVID and its heterogeneous trajectory, interventions focusing on the repercussions and requirements unique to more vulnerable older persons should be developed and these aspects should be included in public health recommendations and policymakers' concerns. Patient or Public Contribution No patient or public contribution was required to design, to outcome measures or undertake this research. Patients/members of the public contributed only to the data collection.info:eu-repo/semantics/publishedVersio

The temporal mutational and immune tumour microenvironment remodelling of HER2-negative primary breast cancers.

The biology of breast cancer response to neoadjuvant therapy is underrepresented in the literature and provides a window-of-opportunity to explore the genomic and microenvironment modulation of tumours exposed to therapy. Here, we characterised the mutational, gene expression, pathway enrichment and tumour-infiltrating lymphocytes (TILs) dynamics across different timepoints of 35 HER2-negative primary breast cancer patients receiving neoadjuvant eribulin therapy (SOLTI-1007 NEOERIBULIN-NCT01669252). Whole-exome data (N = 88 samples) generated mutational profiles and candidate neoantigens and were analysed along with RNA-Nanostring 545-gene expression (N = 96 samples) and stromal TILs (N = 105 samples). Tumour mutation burden varied across patients at baseline but not across the sampling timepoints for each patient. Mutational signatures were not always conserved across tumours. There was a trend towards higher odds of response and less hazard to relapse when the percentage of subclonal mutations was low, suggesting that more homogenous tumours might have better responses to neoadjuvant therapy. Few driver mutations (5.1%) generated putative neoantigens. Mutation and neoantigen load were positively correlated (R2 = 0.94, p = 2 = 0.16, p = 0.02). An enrichment in pathways linked to immune infiltration and reduced programmed cell death expression were seen after 12 weeks of eribulin in good responders. VEGF was downregulated over time in the good responder group and FABP5, an inductor of epithelial mesenchymal transition (EMT), was upregulated in cases that recurred (p < 0.05). Mutational heterogeneity, subclonal architecture and the improvement of immune microenvironment along with remodelling of hypoxia and EMT may influence the response to neoadjuvant treatment

Exploring low-energy neutrino physics with the Coherent Neutrino Nucleus Interaction Experiment

The Coherent Neutrino-Nucleus Interaction Experiment (CONNIE) uses low-noise fully depleted charge-coupled devices (CCDs) with the goal of measuring low-energy recoils from coherent elastic scattering ( CE ν NS ) of reactor antineutrinos with silicon nuclei and testing nonstandard neutrino interactions (NSI). We report here the first results of the detector array deployed in 2016, considering an active mass 47.6 g (eight CCDs), which is operating at a distance of 30 m from the core of the Angra 2 nuclear reactor, with a thermal power of 3.8 GW. A search for neutrino events is performed by comparing data collected with the reactor on (2.1 kg-day) and reactor off (1.6 kg-day). The results show no excess in the reactor-on data, reaching the world record sensitivity down to recoil energies of about 1 keV (0.1 keV electron equivalent). A 95% confidence level limit for new physics is established at an event rate of 40 times the one expected from the standard model at this energy scale. The results presented here provide a new window to low-energy neutrino physics, allowing one to explore for the first time the energies accessible through the low threshold of CCDs. They will lead to new constraints on NSI from the CEνNS of antineutrinos from nuclear reactors.Fil: Aguilar Arevalo, Alexis. Universidad Nacional Autónoma de México; MéxicoFil: Bertou, Xavier Pierre Louis. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; Argentina. Comisión Nacional de Energía Atómica. Centro Atómico Bariloche; Argentina. Universidad Nacional de Cuyo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Bonifazi, Carla Brenda. Universidade Federal do Rio de Janeiro; Brasil. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Cancelo, Gustavo Indalecio. Fermi National Accelerator Laboratory; Estados UnidosFil: Castañeda, Alejandro. Universidad Nacional Autónoma de México; MéxicoFil: Cervantes Vergara, Brenda. Universidad Nacional Autónoma de México; MéxicoFil: Chavez, Claudio. Universidad Nacional de Asunción; ParaguayFil: D’Olivo, Juan C.. Universidad Nacional Autónoma de México; MéxicoFil: Dos Anjos, João C.. Centro Brasileiro de Pesquisas Físicas; BrasilFil: Estrada, Juan. Fermi National Accelerator Laboratory; Estados UnidosFil: Fernandes Neto, Aldo R.. Centro Federal de Educacão Tecnológica Celso Suckow Da Fonseca; BrasilFil: Fernández Moroni, Guillermo. Fermi National Accelerator Laboratory; Estados Unidos. Universidad Nacional del Sur; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Foguel, Ana. Universidade Federal do Rio de Janeiro; BrasilFil: Ford, Richard. Fermi National Accelerator Laboratory; Estados UnidosFil: Gonzalez Cuevas, Juan. Universidad Nacional de Asunción; ParaguayFil: Hernández, Pamela. Universidad Nacional Autónoma de México; MéxicoFil: Hernandez, Susana. Fermi National Accelerator Laboratory; Estados UnidosFil: Izraelevitch, Federico Hernán. Comisión Nacional de Energía Atómica; Argentina. Universidad Nacional de San Martín; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Kavner, Alexander R.. University of Michigan; Estados UnidosFil: Kilminster, Ben. Universitat Zurich; SuizaFil: Kuk, Kevin. Fermi National Accelerator Laboratory; Estados UnidosFil: Lima, H.P.. Centro Brasileiro de Pesquisas Físicas; BrasilFil: Makler, Martín. Centro Brasileiro de Pesquisas Físicas; BrasilFil: Molina, Jorge. Universidad Nacional de Asunción; ParaguayFil: Mota, Philipe. Centro Brasileiro de Pesquisas Físicas; BrasilFil: Nasteva, Irina. Universidade Federal do Rio de Janeiro; BrasilFil: Paolini, Eduardo Emilio. Universidad Nacional del Sur; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca; ArgentinaFil: Romero, Carlos. Universidad Nacional de Asunción; ParaguayFil: Sarkis, Y.. Universidad Nacional Autónoma de México; MéxicoFil: Sofo Haro, Miguel Francisco. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; Argentina. Comisión Nacional de Energía Atómica; Argentina. Universidad Nacional de Cuyo; Argentina. Fermi National Accelerator Laboratory; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnol.conicet - Patagonia Norte. Unidad de Adm.territorial; ArgentinaFil: Souza, Iruatã M. S.. Centro Brasileiro de Pesquisas Físicas; BrasilFil: Tiffenberg, Javier Sebastian. Fermi National Accelerator Laboratory; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Wagner, Stefan. Centro Brasileiro de Pesquisas Físicas; Brasil. Pontifícia Universidade Católica do Rio de Janeiro; Brasi

Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory

The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30 to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy -- corrected for geometrical effects -- is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO

Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy

We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8 \pm 0.7 (stat) \pm 6.7 (sys) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principle calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.Comment: Replaced with published version. Added journal reference and DOI. Supplemental material in the ancillary file

Práticas artísticas no ensino básico e secundário

As técnicas de expressão são processos de expansão. A humanidade alargou o seu perímetro de retenção de ideias, de impressão ritual, de invocação memorial, através dos primeiros materiais plásticos, incisões, manchas, escarificações, desenhos. Assim o homem cresceu, dentro da sua mente, e a sua mente cresceu fora do homem: a linguagem sobrevive-nos, permite a transmissão de aquisições, veicula a cultura de geração em geração, está na base da civilização. A expansão humana consolida-se pelas técnicas de reprodução, mas com um preço: o da emancipação das coisas em relação aos homens. A linguagem pensa-nos. Os artefactos que produzimos exercem sobre nós estranhos poderes, as mercadorias são valorizadas tanto ou mais que as pessoas, o humano é desvalorizado na razão inversa. As pessoas querem parecer-se com imagens, mapas de bits que encantam. As tecnologias, essas expansões, sabem para onde se dirigem, sem olhar aos humanos: o vivo é dispensado, em benefício de um algoritmo de computação, de um bot, de um ser sem corpo e por isso sem necessidades. Um ser que ganha sempre. A interrogação sobre os conteúdos é hoje a interrogação sobre um real digitalizado, transformado em código. Este é um dos espaços que merece uma atenção particular na Educação Artística: pode-se pensar do outro lado do código?info:eu-repo/semantics/publishedVersio