ASSOCIAÇÃO ENTRE PERINEORRAFIA, PROBLEMAS PERINEAIS, ATIVIDADES HABITUAIS E NECESSIDADES FISIOLÓGICAS AFETADAS

Eixo temático: Produção, publicação e utilização de evidências científicas.Introdução: Durante o trabalho de parto e parto os tecidos que compõe a região perineal podem ser lesados, seja por lacerações espontâneas ou por episiotomia, que podem ou não necessitar suturação. A presença da sutura perineal pode interferir na realização de atividades comuns nos primeiros dias do pós-parto ou das necessidades fisiológicas da puerpéra

INTERVENÇÕES NO PROCESSO PARTURITIVO DE MULHERES DE RISCO HABITUAL E SEUS RECÉM-NASCIDOS

Eixo temático: Produção, publicação e utilização de evidências científicas.Introdução: O respeito à fisiologia do processo parturitivo e o uso das melhores evidências científicas a mulher no parto é importante para a redução de eventos adversos e desfechos desfavoráveis na prática clínica, potencializando o cuidado respeitoso e segurança do paciente. O uso rotineiro e desnecessário de intervenções altera o curso fisiológico do parto e pode desencadear uma cascata de eventos, em que uma intervenção condiciona a outra de maneira sucessiva, ocasionando um aumento no nível de complexidade dos procedimentos dessa forma elevando o risco dessa mulher e do neonato

ASSISTÊNCIA A PARTURIENTES DE RISCO HABITUAL E SEUS RECÉM-NASCIDOS

Eixo Temático: Produção, publicação e utilização de evidências científicasIntrodução: o respeito à fisiologia do processo parturitivo e o uso das melhores evidências cientificas a mulher no parto e seu recém-nascido é importante para a redução de eventos adversos e desfechos desfavoráveis na prática clínica, potencializando o cuidado respeitoso e a segurança do paciente

Síndrome de burnout nos técnicos de enfermagem do estado de Sergipe atuantes no período da pandemia de Covid-19: prevalência e fatores de risco associados

Introduction: Health professionals are constantly dealing with death and difficult decisions that can affect their physical and mental well-being. Burnout Syndrome (BS) is a psychosocial illness that appears as a response to chronic interpersonal stressors related to the work environment. The COVID-19 pandemic has therefore brought new challenges, especially in the health sector, causing burnout among health professionals and culminating in an increase in BS in this group. Objective: To identify and evaluate the prevalence and risk factors for Burnout Syndrome in nursing technicians in the state of Sergipe working during the COVID-19 pandemic. Methodology: This was a cross-sectional, quantitative study of 150 nursing technicians and assistants working with COVID-19 patients in Sergipe (2021-2022), carried out via Google Forms, using the Informed Consent Form (ICF). A sociodemographic and professional profile was assessed, and the Lipp Inventory of Stress Symptoms for Adults (ISSL) was applied. A chi-square or Fisher's exact test was used, with the effect size based on the odds ratio (OR). Approved by the Research Ethics Committee under protocol number 4.578.896. Results: Regarding the risk of burnout, the prevalence was low (44.7%), followed by moderate (36.7%) and severe (18.7%). The variables analyzed that were most associated with Burnout Syndrome in nursing technicians and assistants were : age group (p=0.03), the association between feeling anxious or not when working with COVID-19 patients (p<0.001), with anxiety increasing the chances of having a moderate risk of burnout by 2.46 times (95%CI=1.16; 5.25) and the chances of having a high risk by 4.62 times (95%CI=1.80; 11.87), impaired sleep quality (p=0.06), with a 2.16 times (95%CI=1.01; 4.64) of being at moderate risk of burnout, professionals who had experienced some family conflict were 4 times (95%CI=1.56; 10.23) more likely to be at high risk of burnout compared to those who had not experienced any conflict, professionals who had experienced some conflict with the team were 4.62 times (95%CI=1.80; 11.87) more likely to be at high risk and 3.34 times (95%CI=1.53; 7.30) more likely to be at moderate risk of burnout. Conclusion: All levels of burnout risk were found among nursing technicians and assistants, most of whom were at low risk, followed by moderate and severe risk, with a significant association with age, having had family and team conflicts, loss of sleep and feeling anxious when working during the pandemic.Introdução: Os profissionais de saúde lidam a todo o tempo com a morte e com as decisões difíceis que podem afetar seu bem estar físico e mental. A  Síndrome  de Burnout (SB) trata-se  de  uma  doença  de  ordem  psicossocial  que  aparece  como  resposta  aos estressores interpessoais de natureza crônica que estão relacionados ao meio laboral. A pandemia da COVID 19 trouxe, portanto, novos desafios, em especial no âmbito da saúde, causando o esgotamento de profissionais da área e culminando com o aumento da SB neste grupo. Objetivo: Identificar e avaliar a prevalência e os fatores de risco para Síndrome de Burnout nos técnicos de enfermagem do estado de Sergipe atuantes no período da pandemia de COVID-19. Metodologia: Estudo transversal, quantitativo, com 150 técnicos e auxiliares de enfermagem que trabalhavam com pacientes com COVID-19, em Sergipe (2021-2022), realizado via Google Forms, mediante Termo de Consentimento Livre e Esclarecido (TCLE). Avaliou-se perfil sociodemográfico e profissional, e aplicou-se o Inventário de Sintomas de Stress para Adultos de Lipp – ISSL. Adotou-se teste Qui-Quadrado ou Exato de Fisher, com tamanho de efeito por Razão de Chances (RC). Aprovado pelo Comitê de Ética e Pesquisa sob o parecer número 4.578.896. Resultados: Tratando-se do risco de burnout, a prevalência foi de risco reduzido (44,7%), seguido do risco moderado (36,7%) e grave (18,7%). As variáveis analisadas mais associados a Síndrome de Burnout em técnicos e auxiliares de enfermagem foram : a faixa etária  (p=0,03), a associação entre sentir-se ou não ansioso ao estar com pacientes com COVID-19 (p<0,001) sendo que a ansiedade aumenta em 2,46 vezes (IC95%=1,16; 5,25) mais chances de terem risco moderado de burnout e 4,62 vezes (IC95%=1,80; 11,87) mais chances de terem risco elevado, o prejuízo na qualidade do sono (p=0,06) tendo 2,16 vezes (IC95%=1,01; 4,64) de apresentarem risco moderado de burnout, profissionais que passaram por algum conflito familiar possuem 4 vezes (IC95%=1,56; 10,23) mais chances de risco elevado de burnout comparados àqueles que não tiveram conflitos, profissionais que passaram por algum conflito com a equipe possuem 4,62 vezes (IC95%=1,80; 11,87) mais chances de risco elevado e 3,34 vezes (IC95%=1,53; 7,30) mais chances de terem risco moderado de burnout. Conclusão: Verificou- se a presença de todos os níveis de risco de burnout nos técnicos e auxiliares de enfermagem, em que a maioria apresentou risco reduzido, seguido de moderado e grave, tendo associação significativa com faixa etária, ter tido conflito familiar e com a equipe, prejuízo no sono e sentir-se ansioso ao atuar na pandemia

Universidade e redes de atenção à saúde: uma produção de conhecimento no Sistema Único de Saúde

Prefácio de Flávio Adriano Borges MeloComo promover uma formação em saúde sensível e eticamente compromissada com a implementação e o fortalecimento do Sistema Único de Saúde? Como aproximar a formação profissional da realidade da rede de atenção à saúde local? Quais os desafios encontrados na integração entre ensino e serviços? Quais as potencialidades de aprendizagem no contexto do Sistema Único de Saúde? Neste livro são apresentados relatos produzidos por participantes do PET-Saúde e do Pró-Saúde do CCS/UFRB no município de Santo Antônio de Jesus, ao longo dos quais se busca responder a estas e outras questões relevantes para o debate nacional sobre as políticas de saúde

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved