Dificuldades de mães adolescentes com a amamentação no contexto brasileiro: revisão integrativa

Estudo com objetivo de descrever as dificuldades de mães adolescentes com a amamentação no contexto brasileiro. Pesquisa bibliográfica, descritiva, tipo revisão integrativa da literatura, realizada na Biblioteca Virtual de Saúde e no Google Acadêmico entre os meses de Agosto e Setembro de 2021. Usados como descritores: ‘‘Adolescente’’, ‘‘Amamentação’’, ‘‘Adolescência’’ e ‘‘Aleitamento Materno’’, associados com o operador booleano AND. Tendo   como critérios de inclusão: artigos completos, disponíveis gratuitamente em português,   publicados na íntegra, no período de 2016 a 2021 e exclusão trabalhos de conclusão de curso, dissertações, teses, documentos ministeriais, estudos duplicados e que não atendiam ao objetivo proposto. A coleta de dados foram organizados a partir de um instrumento criado pelas pesquisadoras e analisados de forma descritiva. Os resultados apontaram que as dificuldades vivenciadas pelas mães adolescentes para amamentar , tiveram destaque para os problemas mamários, fatores culturais, sociais e econômicos, desconhecimento do manejo da lactação, influência dos familiares e profissionais de saúde, bem como a falta de apoio destes atores sociais, levando as mães adolescentes a introduzirem precocemente outros alimentos  a dieta infantil. Portanto, é essencial que haja melhorias  na assistência concedida pelos profissionais de saúde, no que concerne a realização de ações educativas e assistenciais nos diversos contextos trilhados pelas mães adolescentes e seus familaires em processo de amamentação, com vistas a promoção, proteção e apoio ao aleitamento materno. Palavras-chave: Adolescente; Adolescência; Amamentação; Aleitamento Materno; Revisão Integrativa; Enfermagem

Impact of Parkinson’s disease in the performance of balance with different attentional demands

O objetivo deste estudo foi avaliar o equilíbrio de pacientes com doença de Parkinson (DP) na posição de tandem com os olhos abertos (OA), olhos fechados (OF) e em condição de dupla tarefa (DT). Trata-se de um estudo transversal composto por 19 indivíduos com DP nos estágios leve a moderado. Os pacientes foram avaliados em uma plataforma de força Biomec400. Os parâmetros analisados foram a área do centro de pressão dos pés (COP) e a amplitude e velocidade do COP nas direções anteroposterior (AP) e mediolateral (ML). Foram encontrados resultados estatisticamente significantes para amplitude AP e ML do COP e da área do COP, com valores maiores para as posições em tandem de OF e tandem com DT, quando comparados com a posição em tandem de OA. Os valores de velocidade média AP e ML foram maiores na posição em tandem de OF em comparação ao tandem de OA (p=0,009 e p=0), respectivamente. Concluiu-se que indivíduos com DP, quando submetidos a desafios cognitivos, comportam-se de forma semelhante à retirada do recurso visual no que diz respeito às alterações de equilíbrio. Isso reforça a necessidade de introduzir no plano terapêutico desses indivíduos atividades que requeiram o treino dessas habilidades.El propósito de este estudio fue evaluar el equilibrio de pacientes con enfermedad de Parkinson (DP) en la posición tándem con los ojos abiertos (OA), ojos cerrados (OC) y en condición de doble tarea (DT). Se trata de un estudio transversal, del cual participaron 19 personas con DP en etapas leve a moderada. Se evaluaron a los pacientes en una plataforma de fuerza Biomec400. Los parámetros evaluados fueron el área del centro de presión de los pies (COP) y la amplitud y velocidad del COP en las direcciones anteroposterior (AP) y mediolateral (ML). Se encontraron resultados estadísticamente significativos para la amplitud AP y ML del COP y del área del COP, con mayores valores para las posiciones tándem con OC y tándem en DT, en comparación a la posición tándem con OA. Los valores de la velocidad media AP y ML fueron mayores en la posición tándem de OC comparados a la tándem de OA (p=0,009 y p=0, respectivamente). Se concluye que los sujetos con DP, en el momento que se les sometieron a los desafíos cognitivos, se portaron de manera semejante cuando se les taparon los ojos en lo que se refiere a las alteraciones de equilibrio. Este resultado señala la necesidad de introducir en la fisioterapia de los pacientes con DP actividades que les exigen el entrenamiento de estas habilidades.This study aimed to evaluate the balance of Parkinson’s disease (PD) patients in Tandem stance with eyes open (EO), eyes closed (EC), and in dual task condition (DT). This is a cross-sectional study, composed of 19 individuals with mild to moderate PD. Patients were evaluated in a BIOMEC400 force platform. The parameters analyzed were: area of the foot center of pressure (COP), COP amplitude and speed, in the anteroposterior (AP) and mediolateral (ML) directions. We found statistically significant results for AP and ML amplitude of the COP and COP area, with higher values for the stances EC Tandem and DT Tandem, when compared with EO Tandem. The values of AP and ML average speed were higher in EC Tandem when compared with EO Tandem (P=0.009 and P=0.000), respectively. We concluded that, when individuals with PD undergo cognitive challenges, they behave as if they were with eyes closed regarding balance changes. This reinforces the need to introduce, in the therapeutic plan of these individuals, activities that require the practice of these skills

Hair Analysis of Mammals of Brazilian Wildlife for Forensic Purposes

Wildlife trafficking is classified as the fourth largest illegal commerce in the world. Taxonomic identification of wildlife is an ordinary process for forensics experts. The aim of this study was to analyze animal’s hair from Brazilian’s wildlife through microscopic and compare morphology of bristle among species analyzed. Hair samples of nine species were analyzed. Glass slides were analyzed through optical microscopy and following measurements were obtained: total length, medulla diameter, overall diameter and overall ratio diameter of the medulla’s diameter. The images obtained at identification of animals through the morphology of hair and the statistics analysis corroborates in favor for the validation of the technique

O saber sexual na adolescência

Objective: To investigate the knowledge of elementary school students concerning sexually transmitted infections (STIs) and the prevention of unwanted pregnancy, before and after the participation of the students in workshops. Methods: This extension project involved weekly meetings with 25 adolescents in the ninth year of elementary education in a public school in the city of Uberaba (Minas Gerais). A questionnaire was used to assess the knowledge of students on the first (pre-test) and final (post-test) days of the activities, in order to evaluate the effectiveness of the workshops. Results: The results of the tests revealed improvements in the intellectual and personal knowledge of these adolescents after the workshops. Conclusion: The application of the questionnaire confirmed the effectiveness of workshops, since the questions answered incorrectly in the pre-test showed better results in the post-test. Comparison of the two surveys showed that at the end of the activities, information had been absorbed and doubts had been clarified.Objetivo: Investigar el conocimiento de los estudiantes de primaria acerca de las infecciones de transmisión sexual (ITS) y la prevención de embarazos no deseados, antes y después del desarrollo de los talleres. Métodos: se trata de un estudio descriptivo vinculado a un Proyecto de Extensión Universitaria, se llevaron a cabo reuniones semanales con 25 adolescentes  del nono año de la educación primaria en una escuela pública en la ciudad de Uberaba-MG. Se utilizó un cuestionario para evaluar los conocimientos de los estudiantes en el primer (pre-test) y en el final (post-test) se llevan a cabo las actividades con el fin de comparar la eficacia de los talleres. Resultados: Ante las actividades lúdicas propuestas y la implementación de una prueba previa y otra posterior fue posible percibir un crecimiento intelectual y personal de estos adolescentes. Conclusión: La aplicación del cuestionario ha permitido demostrar la eficacia de los talleres, ya que las preguntas contestadas de forma incorrecta en el pre-test se evidenció mejores resultados en el post-test. Por lo tanto, la comparación de las dos encuestas muestran una absorción de información y aclaración de las dudas al final de las actividades.Objetivo: investigar o conhecimento dos estudantes do ensino fundamental a respeito das doenças sexualmente transmissíveis (DST) e a prevenção da gravidez indesejada, antes e depois do desenvolvimento de oficinas de trabalho. Métodos: trata-se de uma atividade de extensão na qual foram realizados encontros semanais com 25 adolescentes ingressos no ensino fundamental em uma escola pública, no município de Uberaba-MG. Foi aplicado um questionário para avaliação dos conhecimentos dos alunos no primeiro (pré-teste) e no último (pós-teste) dia de realização das atividades, no intuito de comparar a eficácia das oficinas de trabalho. Resultados: O uso de oficinas em sala de aula com adolescentes, nos permitiu realizar uma intervenção psicológica. Diante das atividades lúdicas propostas e com a aplicação de um pré e pós-teste, foi possível perceber um crescimento intelectual e pessoal desses adolescentes. Conclusão:a aplicação do questionário possibilitou comprovar a eficácia das oficinas realizadas, uma vez que as questões respondidas de forma incorreta no momento do pré-teste, apresentaram um melhor resultado no pós-teste. Portanto, a comparação dos dois questionários revela uma absorção das informações e esclarecimento das dúvidas ao término das atividades realizadas.

O saber sexual na adolescência

Objective: To investigate the knowledge of elementary school students concerning sexually transmitted infections (STIs) and the prevention of unwanted pregnancy, before and after the participation of the students in workshops. Methods: This extension project involved weekly meetings with 25 adolescents in the ninth year of elementary education in a public school in the city of Uberaba (Minas Gerais). A questionnaire was used to assess the knowledge of students on the first (pre-test) and final (post-test) days of the activities, in order to evaluate the effectiveness of the workshops. Results: The results of the tests revealed improvements in the intellectual and personal knowledge of these adolescents after the workshops. Conclusion: The application of the questionnaire confirmed the effectiveness of workshops, since the questions answered incorrectly in the pre-test showed better results in the post-test. Comparison of the two surveys showed that at the end of the activities, information had been absorbed and doubts had been clarified.Objetivo: Investigar el conocimiento de los estudiantes de primaria acerca de las infecciones de transmisión sexual (ITS) y la prevención de embarazos no deseados, antes y después del desarrollo de los talleres. Métodos: se trata de un estudio descriptivo vinculado a un Proyecto de Extensión Universitaria, se llevaron a cabo reuniones semanales con 25 adolescentes  del nono año de la educación primaria en una escuela pública en la ciudad de Uberaba-MG. Se utilizó un cuestionario para evaluar los conocimientos de los estudiantes en el primer (pre-test) y en el final (post-test) se llevan a cabo las actividades con el fin de comparar la eficacia de los talleres. Resultados: Ante las actividades lúdicas propuestas y la implementación de una prueba previa y otra posterior fue posible percibir un crecimiento intelectual y personal de estos adolescentes. Conclusión: La aplicación del cuestionario ha permitido demostrar la eficacia de los talleres, ya que las preguntas contestadas de forma incorrecta en el pre-test se evidenció mejores resultados en el post-test. Por lo tanto, la comparación de las dos encuestas muestran una absorción de información y aclaración de las dudas al final de las actividades.Objetivo: investigar o conhecimento dos estudantes do ensino fundamental a respeito das doenças sexualmente transmissíveis (DST) e a prevenção da gravidez indesejada, antes e depois do desenvolvimento de oficinas de trabalho. Métodos: trata-se de uma atividade de extensão na qual foram realizados encontros semanais com 25 adolescentes ingressos no ensino fundamental em uma escola pública, no município de Uberaba-MG. Foi aplicado um questionário para avaliação dos conhecimentos dos alunos no primeiro (pré-teste) e no último (pós-teste) dia de realização das atividades, no intuito de comparar a eficácia das oficinas de trabalho. Resultados: O uso de oficinas em sala de aula com adolescentes, nos permitiu realizar uma intervenção psicológica. Diante das atividades lúdicas propostas e com a aplicação de um pré e pós-teste, foi possível perceber um crescimento intelectual e pessoal desses adolescentes. Conclusão:a aplicação do questionário possibilitou comprovar a eficácia das oficinas realizadas, uma vez que as questões respondidas de forma incorreta no momento do pré-teste, apresentaram um melhor resultado no pós-teste. Portanto, a comparação dos dois questionários revela uma absorção das informações e esclarecimento das dúvidas ao término das atividades realizadas.

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men