A produção subjetiva acerca da maternidade em ambiente prisional / The subjective production about motherhood in a prison environment

A literatura atinente à gravidez em um ambiente prisional demostra que ela é acarretada de inúmeros estigmas, visto que, dentro do sistema penal brasileiro, as mulheres encarceradas ainda estão a dar à luz em situações constrangedoras, sofrem com a violência obstétrica, não possuem acesso às medicações básicas e a segurança de qualidade. Deste modo, esse artigo tem como objetivo dar a voz à subjetividade e ao sofrimento de pessoas cumprindo penas, por meio de um estudo de caso com abordagem qualitativa, descritiva apoiando-se na teoria da subjetividade desenvolvida por Fernando Rey. Estudou-se à questão da mulher que vivenciou o processo de gravidez tanto em cárcere privado quanto fora dele, perpassando em pontos que vão desde a concepção do feto ao parto. Conclui-se que o apego à família e visão de futuro são elementos que impulsionam e contribuem para uma vivência mais positiva do processo de gestação em cárcere

Sexual and reproductive rights of women in a sexual violence situation: what do the managers, professionals and users of reference services say

This study aimed to analyze the access to care and the guarantee of sexual and reproductive rights of women in a sexual violence situation, from October to November 2016. from the perspective of managers, professionals and users of reference services. The participants of this study were managers, professionals and women in a VS assisted at a reference center for women’s care and at the Women Police Station. Social constructionism and organization based on thematic analysis were used in the analysis. Three categories emerged: (1) barriers to access to services and to consolidation of public policies; (2) institutional violence as an obstacle to care for women; and (3) advances, setbacks and resistance in the area of attention and public policies aimed at women in a sexual violence situation. The scarcity of human and material resources, the structural precariousness and slowness of police and legal processes, the fragility of the care network, the revictimization of care spaces and the creation of specific laws for the protection of women, dialogue on gender inequalities and human rights, and low participation of women in political decisionmaking spaces were disclosed.Este estudo analisa o acesso à atenção e a garantia dos direitos sexuais e reprodutivos de mulheres em situação de violência sexual, de outubro a novembro de 2016. Participaram do estudo gestores, profissionais e mulheres em situação de violência sexual atendidas no Centro de Referência ao Atendimento à Mulher e na Delegacia de Defesa da Mulher. Na análise, foi utilizado o construcionismo social e organização baseada na análise temática. Emergiram três categorias: (1) barreiras no acesso aos serviços e na consolidação das políticas públicas; (2) violência institucional como obstáculo à assistência da mulher; e (3) avanços, retrocessos e resistências no âmbito da atenção e das políticas públicas direcionadas à mulher em situação de violência sexual. Revelou-se a escassez de recursos humanos e materiais, precariedade estrutural e morosidade dos processos policiais e jurídicos, a fragilidade da rede de atenção, a revitimização nos espaços de atendimento e a criação de leis específicas para a proteção da mulher, apesar da ausência de diálogo acerca das desigualdades de gênero e dos direitos humanos e a escassa participação da mulher nos espaços políticos decisórios

Fatores associados à leishmaniose visceral na área endêmica de Codó, estado do Maranhão, Brasil

Background and Objectives: Visceral leishmaniasis (VL) is a disease with a high impact on public health. This study describes the epidemiological situation of VL in the Municipality of Codó, state of Maranhão, Brazil, between the years 2007-2012. Method: Initially, an analytical study was performed between the years 2007-2011, which assessed the characteristics of individuals with VL, such as: gender, age, ethnicity, area of occurrence of the disease, signs and symptoms, co-infection with the virus Human immunodeficiency Virus/ visceral leishmaniasis (HIV/VL), work-related disease, indigenous and imported cases, criteria for VL confirmation, parasitological and immunological diagnoses, type of entry and the evolution of confirmed VL cases. In 2012, a survey was carried out in households, according to the systematic sampling process, in order to verify the characteristics of the households, the peridomiciliary area and knowledge of the assessed families on VL. Results: The incidence rate of the disease in the county was 86.31 cases/100,000 inhabitants and the mortality rate was 3.68%. The male gender was more affected, with 56% (t = 0.5023, p = 0.31), as well as mixed-race individuals, 88% (M = 17.9622; p = 0.00); the most reported symptoms were fever (16.3%), splenomegaly (15.3%) and pallor (14.4%) (M = 50.8473; p = 0.00). Five cases (3%) (M = 12.5673; p = 0.00) of HIV/VL coinfection were found, 166 (87%) were indigenous cases (M = 11.8600; p = 0.00) and 18 (9%) cases were work-related (M = 10.9768; p = 0.00). The parasitological diagnosis was made in 60.5% (M = 8.2986, p = 0.01). 100.00% of the residents had heard about the disease; however, 41.7% did not explain the form of transmission. Conclusion: Female individuals aged 5 to 19 years showed a higher record of the disease, while males aged 20 to 59 showed the same proportion of VL cases.Justificativa e Objetivos: A leishmaniose visceral é uma endemia no município de Codó, pelo risco da gravidade e o impacto na saúde de grande parcela da comunidade. Por isso, a realização deste estudo, para levantar a situação epidemiológica da doença nos últimos anos. Investigou-se ainda o aspecto clínico, epidemiológico e o conhecimento das famílias pesquisadas sobre a leishmaniose visceral. Métodos: Foram incluídas no estudo as fichas de notificação que apresentaram o diagnóstico de LV humana no referido período, de ambos os sexos e idades. Foram investigadas variáveis sociodemográficas (sexo, faixa etária, raça, área da ocorrência da doença), dados clínicos (manifestações clínicas, coinfecção com o HIV/LV, doença relacionada ao trabalho, relação de casos autóctones e importados), dados laboratoriais e classificação dos casos (critérios de confirmação para LV, diagnósticos parasitológico e imunológico, tipo de entrada e evolução dos casos confirmados). Resultados: No período de estudo, o coeficiente de incidência da doença no município foi 86,31 casos/100.000 habitantes e o coeficiente de letalidade foi 3,68%. O sexo masculino foi o mais acometido com 56% (t=0,5023; p=0,3105), a raça parda 88% (H=17,9622; p=0,0004); os sintomas foram: febre (16,3%), esplenomegalia (15,3%) e palidez (14,4%) (H=50,8473;

A (des)valorização social do SUS e os aspectos relacionados

Introduction: The SUS - Unified Health System - enabled profound changes in the health scenario, guaranteeing access to sectors not included in the previous regime, however, although some services have a prominent position worldwide, others still face several difficulties. In this sense, this article aims to analyze the satisfaction of SUS users and explore its reflexes in the valorization of the System. Methodology: This is a narrative review study covering published articles and studies, for which searches were carried out in the PubMed databases and in the CAPES Periodicals Portal, using descriptors such as "Brazil", "Consumer Behavior", "Health Evaluation”, “Patient Preference”, “Patient Satisfaction”, “Perception”, “Satisfaction”, “SUS”, “User”, “Unified Health System”, “User Perception AND Unified Health System”, “Sistema Único de Saúde” Health AND Patient Satisfaction, “SUS AND User Perception” and “SUS AND Valuation”. Results: After analysis, it was observed that user dissatisfaction with the services provided by the SUS varies according to the region of the country, social class and perception of their own health status. In addition, 57.9% of users listed the lack of doctors as the biggest general problem. Discussion: It was possible to analyze that the Unified Health System, in part, managed to offer health services in an integral and universal way. However, despite important achievements, problems still persist such as: long waiting time for care, lack of humanization in the work of professionals, among others. Added to these problems, the lack of knowledge about the SUS contributes decisively to the devaluation on the part of the user. Conclusion: In this way, there was a general dissatisfaction of users with the system, which, along with the population's misinformation about SUS actions and the partial performance of the media, generate an impact on society's view of the health system, leading to its devaluation.Introdução: O SUS possibilitou profundas mudanças no cenário da saúde, garantindo acesso aos setores não incluídos no regime anterior. Entretanto, ainda que alguns serviços tenham posição de destaque mundial, outros ainda enfrentam diversas dificuldades. Nesse sentido, esse artigo tem como objetivo analisar a satisfação dos usuários e explorar os seus reflexos na valorização do Sistema. Metodologia: Trata-se de uma revisão narrativa abrangendo trabalhos publicados, para isso foi utilizado o PubMed e o Portal de Periódicos CAPES, com os descritores: “Brazil”, “Consumer Behavior”, “Health Evaluation”, “Patient Preference”, “Patient Satisfaction”, “Perception”, "Satisfaction", “SUS”, “User”, “Unified Health System”, “Percepção do usuário AND Sistema Único de Saúde”, “Sistema Único de Saúde AND Satisfação do paciente”, “SUS AND Percepção do usuário” e “SUS AND valorização”. O critério para inclusão desses trabalhos foi: trabalhos relacionados ao tema, em Português, Espanhol ou Inglês e com o texto completo disponível. Assim, foram selecionados 13 textos. Resultados: Após análises, observou-se que a insatisfação do usuário com os serviços do SUS varia conforme a região do país, a classe social e com a percepção sobre seu próprio estado de saúde. Além disso, 57,9% dos usuários elencaram como o maior problema geral a falta de médicos. Discussão: Foi possível analisar que o SUS, em parte, conseguiu oferecer serviços de forma integral e universal. Porém, ainda persistem problemas como: elevado tempo de espera para atendimentos e a falta de humanização. Somado a essas lacunas, o desconhecimento sobre o SUS contribui decisivamente para a desvalorização. Conclusão: Apesar de limitações como a falta de estudos mais recentes e a dificuldade metodológica, foi possível constatar uma insatisfação geral dos usuários, que atrelado à desinformação da população sobre as ações do SUS e a atuação parcial da mídia, geram um impacto na visão da sociedade sobre o sistema de saúde, levando a sua desvalorização

Nutrient intake, digestibility, performance, carcass traits and sensory analysis of meat from lambs fed with co-products of Amazon oilseeds

Introduction:The increase in availability and nutritional composition of oilseed co-products has made it essential to study the use of this biomass.Methods:The objective of this work was to investigate the effects of including oilseed cakes on intake and digestibility, performance, carcass characteristics and meat sensory in feedlot lambs. Twenty-four crossbred Dorper × Santa Inês lambs, with initial body weight of 30 ± 1.3 kg, male, castrated, aged 4–5 months, were distributed in a completely randomized experimental design with four treatments (diets) and six replications (animals), confined in individual stalls for 70 days.Results:The inclusion of tucuma cake (Tuc) reduced dry matter intake (p < 0.01) and diets with cupuassu cake (Cup) and palm kernel cake (Palm) reduced dry matter digestibility (p < 0.05). The Tuc diet also provided the lowest final body weight (p = 0.02); lower average daily gain (p = 0.03); lower feed efficiency (p = 0.03) and lower carcass weight (p < 0.01). However, diets did not influence carcass yield (%), fat thickness (mm) and loin eye area (cm2; p > 0.05). Meat from lambs on the control diet was rated as less fibrous and more tender (p < 0.05).Conclusion:The inclusion of tucuma cake does not influence digestibility, but reduces intake, performance and influences carcass characteristics and meat texture. Diets with cupuassu cake or palmiste cake reduced digestibility, however, intake, performance and carcass characteristics were similar to the control diet

Temporal patterns of cytokine and injury biomarkers in hospitalized COVID-19 patients treated with methylprednisolone

BackgroundThe novel coronavirus disease 2019 (COVID-19) presents with complex pathophysiological effects in various organ systems. Following the COVID-19, there are shifts in biomarker and cytokine equilibrium associated with altered physiological processes arising from viral damage or aggressive immunological response. We hypothesized that high daily dose methylprednisolone improved the injury biomarkers and serum cytokine profiles in COVID-19 patients.MethodsInjury biomarker and cytokine analysis was performed on 50 SARS-Cov-2 negative controls and 101 hospitalized severe COVID-19 patients: 49 methylprednisolone-treated (MP group) and 52 placebo-treated serum samples. Samples from the treated groups collected on days D1 (pre-treatment) all the groups, D7 (2 days after ending therapy) and D14 were analyzed. Luminex assay quantified the biomarkers HMGB1, FABP3, myoglobin, troponin I and NTproBNP. Immune mediators (CXCL8, CCL2, CXCL9, CXCL10, TNF, IFN-γ, IL-17A, IL-12p70, IL-10, IL-6, IL-4, IL-2, and IL-1β) were quantified using cytometric bead array.ResultsAt pretreatment, the two treatment groups were comparable demographically. At pre-treatment (D1), injury biomarkers (HMGB1, TnI, myoglobin and FABP3) were distinctly elevated. At D7, HMGB1 was significantly higher in the MP group (p=0.0448) compared to the placebo group, while HMGB1 in the placebo group diminished significantly by D14 (p=0.0115). Compared to healthy control samples, several immune mediators (IL-17A, IL-6, IL-10, MIG, MCP-1, and IP-10) were considerably elevated at baseline (all p≤0.05). At D7, MIG and IP-10 of the MP-group were significantly lower than in the placebo-group (p=0.0431, p=0.0069, respectively). Longitudinally, IL-2 (MP-group) and IL-17A (placebo-group) had increased significantly by D14. In placebo group, IL-2 and IL-17A continuously increased, as IL-12p70, IL-10 and IP-10 steadily decreased during follow-up. The MP treated group had IL-2, IFN-γ, IL-17A and IL-12p70 progressively increase while IL-1β and IL-10 gradually decreased towards D14. Moderate to strong positive correlations between chemokines and cytokines were observed on D7 and D14.ConclusionThese findings suggest MP treatment could ameliorate levels of myoglobin and FABP3, but appeared to have no impact on HMGB1, TnI and NTproBNP. In addition, methylprednisolone relieves the COVID-19 induced inflammatory response by diminishing MIG and IP-10 levels. Overall, corticosteroid (methylprednisolone) use in COVID-19 management influences the immunological molecule and injury biomarker profile in COVID-19 patients

Methane emission, intake, digestibility, performance and blood metabolites in sheep supplemented with cupuassu and tucuma cake in the eastern Amazon

The use of co-products as a feed supplement for ruminants makes livestock sustainable and optimizes the use of available areas and animal performance. Furthermore, when cakes are used, the residual fat composition can influence ruminal metabolism and methane (CH4) production. This study aimed to assess the effects of a diet containing cupuassu (CUP; Theobroma grandiflorum) and tucuma (TUC; Astrocaryum vulgare Mart.) cakes on intake, digestibility, serum metabolites, performance, and CH4 emissions in confined sheep in the Amazon. Approximately 28 animals, Dorper-Santa Inês, castrated, with an average initial live weight (ILW) of 35 ± 2.3 kg, were distributed in metabolic cages, in a completely randomized design, with four treatments and seven replications: (1) Control (C40), without the addition of Amazonian cake and with 40 g of ether extract (EE)/kg of dietary dry matter (DM); (2) CUP, the inclusion of the CUP cake and 70 g of EE/kg; (3) TUC, the inclusion of the TUC cake and 70 g of EE/kg; and (4) Control (C80), without the addition of Amazonian cake and with 80 g of EE/kg of dietary DM, with roughage to concentrate ratio of 40:60. The use of the TUC cake as a feed supplement reduced the intake of DM, crude protein (CP), and EE compared to the inclusion of the CUP cake (p < 0.05); however, it increased the intake of neutral detergent fiber (NDF) by 32% (p < 0.01). The highest averages of DM (732 g/kg) and CP (743 g/kg) digestibility were presented in C40, while the highest digestibility of NDF was presented in TUC (590 g/kg). Albumin levels stayed above and protein levels were below the reference values, and the C40 diet also obtained below results for cholesterol, triglycerides and High Density Lipoprotein (HDL) (P < 0.05). Sheep fed CUP (91 g) and TUC (45 g) had lower daily weight gains (DWGs) than those fed with diets without the inclusion of cakes (C40 = 119 g; C80 = 148 g), and feed efficiency (FE) was also lower in CUP (84) and TUC (60) diets than in C40 (119) and C80 (137) diets. CH4 emissions were lower in animals fed TUC (26 L/day) and higher in C40 (35 L/day); however, TUC resulted in higher CH4 emissions in grams/body live weight (BW) gain/day (353 g/BW/day) vs. 183 g/BW/day (C40), 157 g/BW/day (C80), and 221 g/BW/day (CUP). The supplementation with cakes did not improve intake, digestibility and performance, did not compromise blood metabolites and did not reduce the enteric CH4 emission in confined sheep in the Amazon; however, the use of CUP cake showed similar results to the control treatments and did not increase CH4 emissions, as occurred with the inclusion of TUC cake