Effects of Access to a Naturally Reinforcing Activity on the Acquisition of Repertoires in Autistic Learner

Applied Behavior Analysis (ABA) to Autism Spectrum Disorder is concerned in arranging reinforcing contingencies, which favor the learning of important repertoires. In the literature, the use of preferred arbitrary reinforcers is emphasized to shape and strengthen impaired targets. This may increase the likelihood that learners will cooperate with demands. Once a child is more exposed to learning contingencies, and becomes more fluent in certain repertoires, access to arbitrary reinforcers should be made more intermittently. It is possible, this way, that engaging in a given activity be now maintained by a natural or automatic reinforcing effect, depending solely on the learner. This research had the purpose of assessing if, by allowing access to a task, which previously became motivating for a child with ASD (pairing colored blocks), other non-verbal skills could be shaped (visually pairing similar pictures; motor imitation with toys; pairing pictures to their corresponding dictated names). The study was conducted in a laboratory from a private University in Brazil. A multiple probe design, across different target repertoires, was used to ensure experimental control by the task of pairing similar colored blocks. As a result, it was demonstrated that all target repertoires were learned, suggesting that access to the previously mastered task, possibly maintained by natural reinforcement, solely established three different repertoires. When the child's parents were interviewed to give their perception on the use of pairing blocks as reinforcer, they were more satisfied than in the case that other reinforcers, such as videos and edibles, are used. Keywords: autism spectrum disorder, arbitrary reinforce, natural reinforcer DOI: 10.7176/RHSS/10-22-06 Publication date: November 30th 202

Evaluation of the Quality of Perinatal Assistance in the Municipality of São Luís-Ma

Women and newborns must receive quality care during the perinatal period. Prenatal care is important for health care, including health promotion, screening, diagnosis, and disease prevention. This study aimed to evaluate the quality of perinatal care in the city of São Luís-MA. A cross-sectional analytical study was carried out with 201 pregnant women in three Health Districts of São Luís-MA, from January to December of 2019. For data collection, the perinatal form, which is attached to the medical records of pregnant and postpartum women, was used. Regarding the data, it was observed that in the age variable, there was a predominance of the age group between 21-34 years (71.64%), with a higher prevalence for 6 appointments performed: 96 (75.00%) (p = 0.31). Regarding marital status, 82.59% were married, with a higher prevalence for 6 appointments performed: 106 (82.81%) (p=0.91). As for education, high school predominated (68.18%) and with a higher prevalence for 6 appointments performed: 92 (71.88%) (p=0.28). 83.08% did not plan the pregnancy, with a higher prevalence for 6 appointments performed: 103 (80.47%) (p = 0.19). As for the beginning of prenatal care, 85.07% in a timely manner, with a higher prevalence for 6 appointments performed: 122 (95.31%) (p=0.00). 90.55% were immunized, with a higher prevalence for 6 appointments performed: 124 (96.88%) (p=0.00). Only 5.47% had a postpartum appointment, with statistical significance (p≤ 0.10). The study allowed us to observe that some indicators are satisfactory, such as immunization and timely start of prenatal care. As for unsatisfactory indicators, there is the puerperal appointment, the values of which ​​are below the recommended. Keywords: Quality of Assistance. Perinatal Assistance. Primary Care. DOI: 10.7176/RHSS/11-22-04 Publication date: November 30th 2021

SOROPOSITIVIDADE PARA HIV/AIDS E CARACTERÍSTICAS SOCIOCOMPORTAMENTAIS EM ADOLESCENTES E ADULTOS JOVENS / HIV/AIDS AND SOCIOCOMPORTAMENTAL CHARACTERISTICS OF YOUNG ADOLESCENTS AND ADULTS

Introdução: O aumento no número de casos de infecção pelo HIV/AIDS entre a população de adolescentes e adultos jovens,caracteriza um fenômeno chamado de juvenização da epidemia de HIV/AIDS. Desenvolver estudos voltados à compreensãodos aspectos que favorecem a propagação do HIV neste segmento, torna-se importante mecanismo de controle do avançodesta doença. Objetivo: Verificar associação entre as características sóciocomportamentais e prevalência de HIV/AIDS entreadolescentes e adultos jovens. Métodos: Estudo quantitativo de corte transversal, realizado nos centros de testagem sorológicaanti-HIV, da capital maranhense, com 5.786 adolescentes e adultos jovens, baseado nos dados do sistema SI-CTA. Realizou-se teste Qui-quadrado de Pearson para verificar a associação entre soropositividade e características sócio comportamentais.Os resultados foram interpretados ao nível de significância de 5,0% (p≤0, 05). Resultados: Verificou-se maior proporçãode soropositivos entre indivíduos com faixa etária entre 20 e 24 anos de idade. Associou-se ao HIV variáveis como: sexo(p<0,01), escolaridade (p<0,001), uso de drogas (p<0,01), doença sexualmente transmissível (p=0,01), orientação sexual(p<0,01) e uso de preservativo com parceiro eventual no último ano (p<0,01). Conclusões: Conclui-se que a infecção peloHIV/AIDS se associou a variáveis sociocomportamentais, destacando-se o comportamento sexual de risco como elemento devulnerabilidade entre os pesquisados.Palavras-chave: Adolescente. Adulto Jovem. AIDS. HIV. Fatores de risco.AbstractIntroduction: The increase in the number of cases of HIV/AIDS infection among adolescents and young adults, characterizes aphenomenon known as juvenization of the HIV / AIDS epidemic. Developing studies aimed at understanding the epidemiologicalprofile of HIV/AIDS infection is essential for understanding aspects that favor the spread of the virus. Object: To analyzethe association of socio-behavioral variables to HIV/AIDS among adolescents and young adults. Methods: It is a crosssectionalstudy, quantitative, conducted in the centers of serologic centers for HIV, the capital of Maranhão, with 5,786 adolescentsand young adults, based on the data in the SI system (CTA). Held Pearson Chi-square test to verify the associationbetween seropositivity and socio-behavioral characteristics. The results were interpreted at the 5% level of significance (p≤0,05). Results: There was a greater proportion of HIV among individuals aged between 20 and 24 years. Joined the HIV factorssuch as: sex (p <0.001), education (p<0.001), drug use (p<0.001), sexually transmitted disease (p=0.001), sexual orientation(p <0.001) and condom use with casual partner in the last year (p<0.001). Conclusion: It is concluded that the HIV/AIDS infectionis associated to socio-behavioral variables, highlighting the high-risk sexual behavior as an element of vulnerabilityamong respondents.Keywords: Adolescent. Young Adult. AIDS. HIV. Risk Factors

Prevalence and factors associated to dysphonia and laryngeal lesions: a study among teachers in a region of the Brazilian Legal Amazon

Objective: to investigate the prevalence and factors associated with dysphonia and laryngeal lesions in teachers of basic education in a region of the Amazonian region. Methods: cross-sectional study with collection of sociodemographic variables, occupational, environmental and clinics. Laryngeal lesions were evaluated by laryngoscopy. Was used a logistic regression to determine factors associated. Results: the prevalence of dysphonia and laryngeal lesions was 68.9% and 53.3%, respectively. There was association between self-reported dysphonia and respiratory problems (OR=3.00; CI95%=1.25-7.22), use of drugs (OR= 2.31, CI95%= 1.19-4.49) and noise in the internal environment (OR= 2.43; CI95%=1.24-4.73). Easy access to water was a protection factor against self-reported dysphonia (OR=0.09; CI95%: 0.01-0.79).  We found a significant association between dysphonia diagnosed and digestive problems (OR= 6.09; CI95%=2.79-13.30), external noise (OR=5.20, CI95%=1.99-13.57) and inadequate ventilation (OR=3.24; CI95%=1.36-7.74). The variables associated with higher chance of laryngeal lesions in dysphonic teachers were lighting (OR=3.74; CI95%=1.15-12.14%), acoustics (OR= 4.14; CI95%=1.32-12.95) and inadequate room size (OR= 3.76; CI95%=1.29-10.91). The use of drugs (OR=0.34; CI95%=0.12-0.92), respiratory problems (OR=0.21; CI95%=0.06-0.76) and easy access to water (OR= 0.12; CI95%=0.04-0.38) were protection factors for laryngeal lesions. Conclusion: occupational environmental factors aggravated the vocal health of this professional category. Access to water in the work impacted positively

Screening for Chronic Kidney Disease in Relatives of Hemodialysis Patients

Objective: To estimate the prevalence and socioeconomic characteristics of Chronic Kidney Disease (CKD) in first and second-degree relatives of patients on hemodialysis Method: A questionnaire was applied on socioeconomic conditions, lifestyle, and personal pathological background. The formula of CKD-EPI and/or proteinuria greater than or equal to 1+ was used to characterize CKD. Analysis using the logistic regression model. Results: 408 individuals were evaluated and 12% had CKD. 6.61% had a glomerular filtration rate (GFR) ≤ 60 mL / min / 1.73 m2 and 5.39% proteinuria in the urine. The variables associated with the presence of CKD were age (OR = 1,60; 95% IC = 1,31-1,96), PAS (OR: 1,69; 95% IC: 1,24-2,28), PAD (OR: 1,52; 95% IC: 1,18- 1,96) and blood glucose (OR: 2,03; 95% IC: 1,38-2,99). Conclusion: It is necessary to implement routines for systematic evaluation that prevent or delay the loss of renal function, in addition to measures that improve the pre-dialysis clinical conditions of this population. Keywords: Chronic kidney disease, Family, Glomerular filtration rate. DOI: 10.7176/RHSS/11-10-06 Publication date:May 31st 202

REVISITANDO O CUIDADO EM SAÚDE: REVISÃO DE LITERATURA / NEW LOOK AT THE HEALTH CARE: LITERATURE REVIEW

Introdução: O cuidado é atitude, característica e necessidade própria do ser humano. Cuidadores em saúde (profissional ou não), estão suscetíveis a adoecer e sofrerem suas implicações biopsicossociais. Muitos trabalhos enfatizam a importância do cuidado com a saúde do cuidador familiar, entretanto, poucos são direcionados para o profissional de saúde enquanto pessoa que cuida e demanda cuidados. Objetivo: Realizar levantamento bibliográfico sobre o cuidar e as conseqüências para aquele que cuida, enfocando sobre saúde e estresse profissional. Métodos: Estudo descritivo e bibliográfico em revistas e artigos científicos, sites especializados e livros técnicos sobre o tema. Resultados: O cuidado como profissão requer atenção quanto às experiências, muitas vezes antagônicas, vivenciadas. Os profissionais de saúde convivem com dor e sofrimento humano, doença e morte em suas rotinas laborais. Além disso, a nível hospitalar, possuem carga horária de trabalho excessiva e tem contato constante com situações limites de tensão e perigo de vida para si e para os outros. Assim, associando-se o comprometimento laboral e estresse crônico, o cuidador profissional pode desenvolver a Síndrome de Burnout, caracterizada por sinais e sintomas de ordem física e emocional, identificada por três elementos: Exaustão, Despersonalização e Baixo rendimento profissional. Esta síndrome tem implicações na saúde dos cuidadores em si e naquele que é cuidado. Conclusão: Pesquisas sobre a saúde dos cuidadores em saúde precisam ser estimuladas a fim de que se direcionem as políticas assistências à saúde destes profissionais.Palavras-chave: Cuidados em saúde. Cuidadores. Estresse profissional.AbstractIntroduction: Care is attitude, character and need as a human being. Health caregivers (professional or otherwise), characters - key health - disease process, are likely to suffer illness and biopsychosocial implications. Many studies stress the importance of health care of the family caregiver, however, few are directed to health professionals as a person who cares and demands care. Objective: literature on caring and the consequences for those who care, focusing on health and professional stress. Methods: This descriptive study and bibliographical and scientific articles in magazines, websites and specialized technical books on the subject. Results: The profession requires careful attention as to the experiences, often antagonistic, experienced. Health professionals live with pain and human suffering, disease and death in their daily work. In addition, the hospital level, have excessive workload and has constant contact with extreme situations of tension and danger of life for themselves and others. So, associating the work and commitment chronic stress, the caregiver can develop the professional Burnout Syndrome, characterized by signs and symptoms of physical and emotional, identified by three elements: exhaust you, depersonalization and low employment income. This syndrome has implications for the health of caregivers themselves and the one which is taken care of. Conclusion: Research on the health of caregivers in healthcare need to be encouraged to ensure that policies are to target assistance to the health of these professionals.Keywords: health care. Caregivers. Professional stress

Percentual de gordura corporal e fatores associados em usuários de centro de atenção psicossocial

Introdução: Usuários de crack apresentam composição corporal diferenciada quando estão em tratamento e/ou abstinência de drogas. Objetivo:Avaliar o percentual de gordura corporal e seus fatores associados em usuários de um Centro de Atenção Psicossocial de Álcool e Droga (CAPS AD) em São Luís -MA. Material e métodos:Esuto retrospectivo e analítico, realizado com prontuários de usuários adultos, do sexo masculino, atendidos em 2015 a 2017. O dados foram analisados no programa Stata® versão 16.0 por meio da regressão de Poisson. A variável desfecho foi o percentual de gordura corporal, calculado de acordo com o índice de adiposidade corporal (IAC).Resultados: Dos 120 prontuários analisados, 73,4% pertenciam à faixa etária de 20 a 39 anos, 80% viviam sem companheira e 49,1% possuíam ensino fundamental completo e incompleto. Com relação ao IAC, 18,3% estavam acima da média. Viver com companheira (OR: 3,32; IC= 1,07-10,2) foi fator de risco para o IAC. Discussão: O IAC é um índice que permite diagnosticar o excesso na composição corporal, visto que o IMC se mostra divergente ao definir o perfil nutricional da população brasileiraConclusão: Foi identificado um número expressivo de dependentes químicos com percentual de adiposidade acima da média

VIVÊNCIAS LÚDICAS DE PRÉ-ESCOLARES NASCIDOS COM MUITO BAIXO PESO / PLAYFUL EXPERIENCES OF PRESCHOOL CHILDREN WHO ARE BORN WITH VERY LOW BIRTHWEIGHT

Introdução: O brincar é constituído de valores e normas culturais representativos das relações sociais estabelecidas no processo de integração da criança na comunidade. As vivências lúdicas além das influências culturas dependem do ambiente e de características das crianças. Objetivo: Avaliar vivências lúdicas de crianças em idade pré-escolar nascidas com muito baixo peso. Métodos: Pesquisa do tipo estudo de casos, com amostra constituída por 36 crianças que foram acompanhadas no Ambulatório de Seguimento do Hospital Universitário da Universidade Federal do Maranhão. Dois instrumentos foram utilizados: Entrevista Inicial com os Pais e Avaliação do Comportamento Lúdico (adaptada por Sant'anna et al., 2008). Os dados foram processados nos programas de bioestatística Epi Info® 3.4.1 e SPSS® 16.0. Resultados: Verificou-se que o extremo baixo peso e o desenvolvimento atípico influenciam a atitude lúdica; o prazer e a curiosidade foram características mais frequentes nas brincadeiras, e senso de humor e gosto pelo desafio foram atitudes menos presentes nas crianças do estudo. Conclusão: Pais de crianças com baixo peso ao nascer devem ser orientados precocemente em relação às necessidades específicas relacionadas à importância das vivências lúdicas.Palavras-chave: Recém-nascido de baixo peso. Criança. Crescimento e Desenvolvimento.AbstractIntroduction: Playing is comprised of cultural norms and values which represent the social relationships established in the integration process of the child in the community. Playful experiences as well as the cultural values depend on characteristics of the environment and children. Objective: To evaluate playful experiences of preschool children who are born with very low birth weight. Methods: Case-control study with 36 children who were followed up in the University Hospital of Federal University of Maranhão. Two instruments were used: initial interview with parents and evaluation of playful behavior (adapted by Sant'anna et al., 2008). The statistical programs Epi Info® 3.4.1 and SPSS® 16.0 were used for data processing. Results: We found that the extremely low birth weight and atypical development influence the playful attitude. Pleasure and curiosity were features more frequent seen in the games. Sense of humor and taste for challenge attitudes were less prevalent. Conclusion: Parents of children with low birth weight should be advised early in relation to the specific needs related to the importance of playful experiences.Keywords: Newborns with low birth weight. Child. Growth and Development