(Re)significando o filho prematuro por meio da musicoterapia / (Re)signifying the premature child through music therapy

Objetivo: Apreender as representações dos pais sobre o significado do filho prematuro por meio da intervenção musical. Método: Trata-se de um estudo qualitativo, fundamentado no referencial teórico das Representações Sociais, realizado com cinco pais de recém-nascidos prematuros hospitalizados em unidade de terapia intensiva que tiveram a oportunidade de realizar intervenções musicais, por meio de entrevista semiestruturada. A coleta de dados ocorreu de junho a julho de 2020, por meio de contato telefônico. Resultados: Dos cinco pais participantes, ocorreu predominância do sexo feminino (80%). A faixa etária variou de 21 a 30 anos. Em relação aos recém-nascidos, três apresentavam idade gestacional de nascimento menor que 28 semanas, um com 31 semanas e outro com 32 semanas e a média de internação foi de 59 dias. Das falas dos pais emergiram quatro ideias centrais: 1) O primeiro contato com o filho prematuro; 2) O primeiro canguru e a música; 3) Só dorme com música e 4) A música e a pandemia: aproximações e distanciamentos. Considerações Finais: Foi possível identificar a música como forma de vínculo, ocasionando benefícios não apenas para o recém-nascido prematuro, mas para seus pais. Possibilitando momentos agradáveis e que foram mantidos após a alta dos filhos por seus pais. 

O CONSTITUCIONALISMO SOB O VIÉS DA PÓS-MODERNIDADE

The research starts methodologically on the concepts of paradigm, modernity and paradigmatic transition to post-modernity; and, based on that premise, it intends to confront neoconstitutionalism and guaranteeism as proposals for overcoming the positivism, opposing both theories and the modernity constitutionalism in general, (is) a new perspective, which attempts to rescue the collective, that is, by a postmodern Law theory; such theory is inspired by the Roman Republic experience with direct democracy, which is based on the participatory dimension of sovereignty, concerning the collective legal interests and self-resolution of collective disputes. It concludes that the modern constitutionalism has no solution to properly handle the complexity of post-modern conflicts.O artigo parte metodologicamente dos conceitos de paradigma, modernidade e de transição paradigmática à pós-modernidade; e com base nesse aporte procura confrontar neoconstitucionalismo e garantismo como propostas de superação do positivismo, contrapondo a ambas as teorias e ao constitucionalismo da modernidade em geral, uma nova perspectiva, pela via do resgate do coletivo, ou seja, por uma teoria pós-moderna do Direito; teoria inspirada na experiência romana de república com democracia direta, a qual parte da dimensão participativa da soberania, relativamente aos bens coletivos e à autocomposição dos conflitos coletivos. Conclui-se que a vertente do constitucionalismo da modernidade não tem solução para enfrentar adequadamente a complexidade dos conflitos pós-modernos

PERCEPÇÃO DA MASSOTERAPEUTA E DA MÃE SOBRE A INTERVENÇÃO DA MASSAGEM TUI NA COMO TERAPIA COMPLEMENTAR NA MELHORA DA SINTOMATOLOGIA DO TRANSTORNO DE DÉFICIT DE ATENÇÃO COM HIPERATIVIDADE: UM ESTUDO DE CASO

Attention Deficit Hyperactivity Disorder (ADHD) is a disorder characterized by inattention, restlessness, impulsivitythat can lead to emotional and relationship issues, as well as poor school performance. The treatment of children with ADHD involves a multiple approach, involving psychosocial and psychopharmacological interventions,and requires a coordinated effort among health professionals together with educators and parents. The aim of this study was to analyse the massage therapist and mother’s perception about the effectiveness of Tui Na massage in a child’s behavior with ADHD. This is a descriptive case study with qualitative approach. Data were collected through a semistructured interview which was recorded, transcribed and subjected to content analysis. The massage was a way of complementary treatment important in improving ADHD symptomatology,letting the child calmer, more relaxed, focused and sociable, improving his family and social relationship. It is believed that the touch provided by massage technique has been a major tool to create a link between therapist and child-family-school by strengthening the necessary trust for the establishment of positive social relationship.O Transtorno de Déficit de Atenção e Hiperatividade (TDAH) é um distúrbiocaracterizado pela falta de atenção, agitação, impulsividade podendolevar a dificuldades emocionais e de relacionamento, bem como o baixo desempenho escolar. O tratamento de crianças com TDAH envolve uma abordagem múltipla, englobando intervenções psicossociais e psicofarmacológicas,e exige um esforço coordenado, entre os profissionais da área da saúde em conjunto com educadores e pais. O objetivo deste trabalho foi analisar a percepção da massoterapeuta e da mãe sobre o comportamento de uma criança com TDAH do tipo desatento, após a participação da criança nas sessões de massagem Tui Na. Trata-se de um estudo de caso, descritivo com abordagem qualitativa. Os dados foram coletados por meio de uma entrevista semiestruturada que foi gravada e transcrita posteriormente, sendo submetidos a análise de conteúdo. A massagem foi uma forma de tratamento complementar importante na melhora da sintomatologia do TDAH, deixando a criança mais calma, relaxada,concentrada e sociável, melhorando o seu relacionamento familiare social. Acredita-se que o toque proporcionado por meio da técnica de massagem tenha sido uma das principais ferramentas para a criação de vínculo entre terapeuta-criança-família-escola, fortalecendo a confiançanecessária para o estabelecimento das relações sociais positivas

Cadastramento de doadores voluntários de Medula Óssea no REDOME

Anais do 35º Seminário de Extensão Universitária da Região Sul - Área temática: SaúdeO transplante de medula óssea consiste na substituição de uma medula óssea doente ou deficitária por células normais, com o objetivo de reconstituição de uma nova medula. Um fator que dificulta a realização do procedimento é a falta de doador compatível. Assim, quanto maior o número de novos doadores voluntários cadastrados no REDOME (Registro Brasileiro de Doadores Voluntários de Medula Óssea), maiores são as possibilidades de o paciente encontrar um doador compatível. Nosso projeto de extensão tem como objetivo a conscientização da população sobre o cadastramento de doadores voluntários de medula óssea nas regiões de Maringá, Cianorte e Paranavaí, por meio de campanhas de captação de doadores, palestras de conscientização e divulgação sobre a doação e o transplante de medula óssea. O projeto vem colaborando no crescimento do REDOME com doadores mais conscientes sobre a responsabilidade do cadastro no banco. Assim, nossa equipe deve continuar realizando o trabalho de conscientização da população, pois quanto maior o número de doadores, maior é a possibilidade de se encontrar um doador compatíve

Consultas neurológicas e diagnósticos em um grande hospital universitário dedicado a COVID-19

Background: More than one-third of COVID-19 patients present neurological symptomsranging from anosmia to stroke and encephalopathy. Furthermore, pre-existingneurological conditions may require special treatment and may be associated with worseoutcomes. Notwithstanding, the role of neurologists in COVID-19 is probablyunderrecognized. Objective: The aim of this study was to report the reasons forrequesting neurological consultations by internists and intensivists in a COVID-19-dedicated hospital. Methods: This retrospective study was carried out at Hospital dasClínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bedCOVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosiswas confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurologyconsultations between March 23rd and May 23rd, 2020 were analyzed. Neurologistsperformed the neurological exam, assessed all available data to diagnose theneurological condition, and requested additional tests deemed necessary. Difficultdiagnoses were established in consensus meetings. After diagnosis, neurologists wereinvolved in the treatment. Results: Neurological consultations were requested for 89 outof 1,208 (7.4%) inpatient COVID admissions during that period. Main neurologicaldiagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurologicaldiseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brainlesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Mostneurological consultations in a COVID-19-dedicated hospital were requested for severeconditions that could have an impact on the outcome. First-line doctors should be able torecognize neurological symptoms; neurologists are important members of the medicalteam in COVID-19 hospital care.Introdução: Mais de um terço dos pacientes com COVID-19 apresentam sintomasneurológicos que variam de anosmia a AVC e encefalopatia. Além disso, doençasneurológicas prévias podem exigir tratamento especial e estar associadas a pioresdesfechos. Não obstante, o papel dos neurologistas na COVID-19 é provavelmentepouco reconhecido. Objetivo: O objetivo deste estudo foi relatar os motivos para solicitarconsultas neurológicas por clínicos e intensivistas em um hospital dedicado à COVID-19. Métodos: Estudo retrospectivo realizado no Hospital das Clínicas da Faculdade deMedicina da Universidade de São Paulo, Brasil, um centro dedicado à COVID-19 com900 leitos (incluindo 300 leitos para unidades de terapia intensiva). O diagnóstico deCOVID-19 foi confirmado por SARS-CoV-2-RT-PCR em swabs nasais. Todas asinterconsultas de neurologia hospitalar entre 23 de março e 23 de maio de 2020 foramanalisadas. Os neurologistas realizaram o exame neurológico, avaliaram todos os dadosdisponíveis para diagnosticar a patologia neurológica e solicitaram exames adicionaisconforme necessidade. Diagnósticos difíceis foram estabelecidos em reuniões deconsenso. Após o diagnóstico, os neurologistas participaram da condução dos casos.Resultados: Foram solicitadas consultas neurológicas para 89 de 1.208 (7,4%) empacientes internados por COVID-19 durante o período. Os principais diagnósticosneurológicos incluíram: encefalopatia (44,4%), acidente vascular cerebral (16,7%),doenças neurológicas prévias (9,0%), crises epilépticas (9,0%), transtornosneuromusculares (5,6%), outras lesões encefálicas agudas (3,4%) e outros sintomasleves inespecíficos (11,2%). Conclusões: A maioria das consultas neurológicas em umhospital dedicado à COVID-19 foi solicitada para condições graves que poderiam afetaro desfecho clínico. Os médicos na linha de frente devem ser capazes de reconhecersintomas neurológicos. Os neurologistas são membros importantes da equipe médica noatendimento hospitalar à COVID-19

Longer-term effectiveness of a heterologous coronavirus disease 2019 (COVID-19) vaccine booster in healthcare workers in Brazil

Abstract Objective: To compare the long-term vaccine effectiveness between those receiving viral vector [Oxford-AstraZeneca (ChAdOx1)] or inactivated viral (CoronaVac) primary series (2 doses) and those who received an mRNA booster (Pfizer/BioNTech) (the third dose) among healthcare workers (HCWs). Methods: We conducted a retrospective cohort study among HCWs (aged ≥18 years) in Brazil from January 2021 to July 2022. To assess the variation in the effectiveness of booster dose over time, we estimated the effectiveness rate by taking the log risk ratio as a function of time. Results: Of 14,532 HCWs, coronavirus disease 2019 (COVID-19) was confirmed in 56.3% of HCWs receiving 2 doses of CoronaVac vaccine versus 23.2% of HCWs receiving 2 doses of CoronaVac vaccine with mRNA booster (P < .001), and 37.1% of HCWs receiving 2 doses of ChAdOx1 vaccine versus 22.7% among HCWs receiving 2 doses of ChAdOx1 vaccine with mRNA booster (P < .001). The highest vaccine effectiveness with mRNA booster was observed 30 days after vaccination: 91% for the CoronaVac vaccine group and 97% for the ChAdOx1 vaccine group. Vacine effectiveness declined to 55% and 67%, respectively, at 180 days. Of 430 samples screened for mutations, 49.5% were SARS-CoV-2 delta variants and 34.2% were SARS-CoV-2 omicron variants. Conclusions: Heterologous COVID-19 vaccines were effective for up to 180 days in preventing COVID-19 in the SARS-CoV-2 delta and omicron variant eras, which suggests the need for a second booster

Geographic patterns of tree dispersal modes in Amazonia and their ecological correlates

Aim: To investigate the geographic patterns and ecological correlates in the geographic distribution of the most common tree dispersal modes in Amazonia (endozoochory, synzoochory, anemochory and hydrochory). We examined if the proportional abundance of these dispersal modes could be explained by the availability of dispersal agents (disperser-availability hypothesis) and/or the availability of resources for constructing zoochorous fruits (resource-availability hypothesis). Time period: Tree-inventory plots established between 1934 and 2019. Major taxa studied: Trees with a diameter at breast height (DBH) ≥ 9.55 cm. Location: Amazonia, here defined as the lowland rain forests of the Amazon River basin and the Guiana Shield. Methods: We assigned dispersal modes to a total of 5433 species and morphospecies within 1877 tree-inventory plots across terra-firme, seasonally flooded, and permanently flooded forests. We investigated geographic patterns in the proportional abundance of dispersal modes. We performed an abundance-weighted mean pairwise distance (MPD) test and fit generalized linear models (GLMs) to explain the geographic distribution of dispersal modes. Results: Anemochory was significantly, positively associated with mean annual wind speed, and hydrochory was significantly higher in flooded forests. Dispersal modes did not consistently show significant associations with the availability of resources for constructing zoochorous fruits. A lower dissimilarity in dispersal modes, resulting from a higher dominance of endozoochory, occurred in terra-firme forests (excluding podzols) compared to flooded forests. Main conclusions: The disperser-availability hypothesis was well supported for abiotic dispersal modes (anemochory and hydrochory). The availability of resources for constructing zoochorous fruits seems an unlikely explanation for the distribution of dispersal modes in Amazonia. The association between frugivores and the proportional abundance of zoochory requires further research, as tree recruitment not only depends on dispersal vectors but also on conditions that favour or limit seedling recruitment across forest types

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

AimAmazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types.LocationAmazonia.TaxonAngiosperms (Magnoliids; Monocots; Eudicots).MethodsData for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran's eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny.ResultsIn the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R2 = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R2 = 28%). A greater number of lineages were significant indicators of geographic regions than forest types.Main ConclusionNumerous tree lineages, including some ancient ones (&gt;66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

Aim: Amazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types. Location: Amazonia. Taxon: Angiosperms (Magnoliids; Monocots; Eudicots). Methods: Data for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran\u27s eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny. Results: In the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R$^{2}$ = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R$^{2}$ = 28%). A greater number of lineages were significant indicators of geographic regions than forest types. Main Conclusion: Numerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions