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To analyze nurses' motivation to learn, motivation to transfer, knowledge acquisition, and satisfaction with an e-Learning course about neonatal pain assessment.Quantitative, longitudinal, quasi-experimental study, conducted in a university affiliated hospital in São Paulo, Brazil, between April and October 2018.Upon consent, nurses received two questionnaires electronically ("Demographics Survey" and "Motivation to Learn Survey") and were granted access to the e- Learning environment. During the 10-module course, nurses completed a "Pre-Test Questionnaire" (in unit one), and the "Post-Test Questionnaire", "Satisfaction Evaluation Survey", and "Motivation to Transfer Knowledge Survey" at completion of the course. Data were analyzed using R, version 3.6.2.30 nurses were enrolled, the majority were female (93.33%), mean age 42.8 years (±7.6). The motivation to transfer knowledge (mean 4.09, ±0.53) was greater than the motivation to learn (mean 3.44, ±0, 33). There was significant increase in nurses' knowledge (p0.0001) when comparing Post- and Pre-Test scores. Participants' satisfaction was overall positive regarding tutoring, virtual environment, self-evaluation, contents and activities, visual communication/layout.e-Learning allows nurses to increase their knowledge, to access evidence-based information, while offering a space for critical thinking, clinical reasoning, and decision-making in nursing care, ultimately contributing to quality of care and patient safety.The e-Learning course contributed to participants' knowledge acquisition, resulting in a positive impact on nurses' motivation to implement new knowledge about neonatal pain assessment in their clinical practice. The course was considered to be in a suitable environment, easy to handle, interactive and dynamic.

Objectives: To characterize a group of university students in social isolation regarding their eating behaviors and to investigate whether dieters have a tendency to engage in binge-eating. Study Design: Cross-sectional study carried out during Brazil’s first months of social isolation. Methods: University students filled out the Eating Attitudes Test—EAT, the Binge-eating Scale—BES, and the Hay questionnaire. In addition, the current research also evaluated food cravings (FC) and intuitive eating. Student’s t-test was used to compare the effect sizes (Cohen’s d) between groups. Results: More than 90% of participants were isolated from academic activities, and 68% reported significant dietary change. Those who dieted (n = 57) were less confident in signs of hunger and satiety (d = −0.9, p < 0.001) and had higher binge-eating and FC levels than those who did not diet. Conclusions: Data reinforces the high prevalence of risk for eating disorders in university students, the impact of dieting on FC, and intuitive eating during social isolation.

A pandemia da COVID-19 impactou diversas esferas da sociedade e alterou dinâmicas na gestão das empresas. O presente estudo tem o objetivo de compreender de que modo a pandemia da COVID-19 afetou a gestão das empresas de chocolate artesanal no Brasil, especificamente as empresas de chocolates bean to bar – ou seja, feitos pelos mesmos produtores desde a amêndoa até a barra de chocolate. Para tanto, desenvolveu-se uma revisão de literatura sobre o mercado de chocolates artesanais no Brasil e as dificuldades enfrentadas por empresas a partir da crise mundial causada pela pandemia da COVID19, que baseou a pesquisa qualitativa. Foram feitas, então, entrevistas semiestruturadas com quatorze membros de quatro associações de chocolates artesanais no Brasil. Os dados coletados foram submetidos à técnica de análise de vídeos de Denzin (2004). A partir das análises, observou-se que as empresas foram impactadas de diferentes maneiras a partir das vivências dos proprietários, da localização de suas fábricas, dos recursos disponíveis e das iniciativas tomadas a partir do conhecimento da crise. A mais significativa mudança na gestão foi a necessidade de adaptação às redes sociais digitais, bem como a profissionalização da presença online e de e-commerce para viabilização da continuidade de operação.

As afecções odontológicas que causam dor aos equinos refletem inadequada trituração do alimento, prejudicando a digestão e predispondo o animal a um emagrecimento progressivo. O presente estudo teve por objetivo avaliar a influência do tratamento odontológico preventivo sobre a deposição de gordura subcutânea e peso de éguas criadas em sistema extensivo. Foram utilizadas 16 éguas, sem raça definida, com idade entre 5 e 15 anos, apresentando escore de condição corporal entre 3 e 4 (escala de 1 a 9), sem histórico de tratamento odontológico prévio. Estes animais foram distribuídos igualmente em dois grupos, sendo o grupo tratado (GT) e o grupo controle (GC). No GT, foi realizada inspeção da cavidade oral e tratamento odontológico. No GC, foi realizada apenas inspeção da cavidade oral. Todos os animais foram pesados com fita torácica e a mensuração da camada de gordura subcutânea foi realizada através do exame ultrassonográfico na base da cauda a cada 30 dias durante cinco meses. Para a avaliação das variáveis, foi utilizado um delineamento inteiramente casualizado, e as médias entre os grupos foram comparadas pelo teste F a 5% de probabilidade para análise de variância (ANOVA). Não foi observada diferença no ganho de peso nem variação na espessura de gordura subcutânea na base da cauda entre os grupos tratado e controle no período de 5 meses. Conclui-se que embora os animais do GT não ganhassem peso comparado ao GC, o tratamento odontológico é considerado um método benéfico na prevenção de muitas afecções do sistema digestivo que poderiam culminar em cólica, também proporciona um melhor aproveitamento dos componentes contidos na dieta, e ainda favorecer o bem-estar animal.

Objective: The study aimed to evaluate how neonatal blood pressure measurement with the oscillometric method is performed by a nursing team, including patient preparation, documentation, materials, and equipment. Method: This cross-sectional study was conducted in a neonatal intensive care unit (NICU) through direct observation of procedures performed by nursing staff. A systematic script was used for observation and documentation of the procedure, patient reparation, and handling of equipment. The results were analyzed through inferential statistics. Results: In a total of 150 observations, 60% or more of steps were classified as correct in 13 of the 26 target items. There was no difference between RNs and nurse technicians concerning the procedure´s success rate (p = 0.3933). Blood pressure measurement was obtained in the first attempt, according to the procedure´s adequacy (p

Made available in DSpace on 2022-05-01T09:31:02Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 The Atlantic Forest, a hotspot for biodiversity conservation, harbours five forest deer species (Mazama spp.). Due to their elusiveness, there is a severe scarcity of occurrence data to support ecological studies and conservation planning. Thus, we assembled an occurrence dataset of Atlantic Forest deer with reliable taxonomic information aggregating data from scat and camera traps surveys, and opportunistic data collection over the last 20 years. From 2002 to 2019, we surveyed 77 protected areas using scats detection dogs and genetically identifying the faecal samples. We successfully identified 1,147 out of 1,450 collected samples. From 2000 to 2020, we sampled six protected areas in 92 sampling points with 13,328 camera trap days of sampling effort. In addition, we established an active search for potential contributors within the scientific community and environmental consultants since 2010, offering a taxonomic identification service for camera traps images, and biological field-collected samples. With our efforts, we assembled a dataset with 1,456 records of forest deer occurrence at the Atlantic Forest. Of these records, 494 are from M. americana, 350 from M. bororo, 309 from M. gouazoubira, 268 from M. nana and 35 from M. nemorivaga. The faecal sampling was the most predominant method in these records (n = 1043) followed by photographs from camera traps (n = 388); both methods represent 98.2% of our dataset records. Most of the records (79.5%) in the dataset are inside protected areas (n = 1,130). Our dataset is the most comprehensive source of information on Neotropical forest deer occurrence to date. Deer Research and Conservation Center São Paulo State University, SP Federal University of Latin American Integration, PR Neotropical Institute: Research and Conservation, PR Programa de Pós-Graduação Em Biodiversidade Universidade Federal Do Oeste Do Pará Santarém, PA Caipora Cooperativa, SC Wildlife Ecology Management and Conservation Lab (LEMaC) Forest Science Department “Luiz de Queiroz” College of Agriculture University of São Paulo, SP Manacá Institute, SP Programa de Pós-Graduação Em Ecologia E Conservação Universidade Federal Do Paraná Instituto de Pesquisas Cananéia, SP Pró-Tapir Institute for Biodiversity, ES Instituto Nacional da Mata Atlântica, ES Federal University of Espírito Santo, ES Federal University of Maranhão, MA Laboratório de Biodiversidade Conservação e Ecologia de Animais Silvestres (LABCEAS) Programa de Pós-Graduação E Ecologia E Conservação Departamento de Zoologia Universidade Federal Do Paraná (UFPR), SP Deer Research and Conservation Center São Paulo State University, SP

Resumo: A pandemia da COVID-19 impactou diversas esferas da sociedade e alterou dinâmicas na gestão das empresas. O presente estudo tem o objetivo de compreender de que modo a pandemia da COVID-19 afetou a gestão das empresas de chocolate artesanal no Brasil, especificamente as empresas de chocolates bean to bar - ou seja, feitos pelos mesmos produtores desde a amêndoa até a barra de chocolate. Para tanto, desenvolveu-se uma revisão de literatura sobre o mercado de chocolates artesanais no Brasil e as dificuldades enfrentadas por empresas a partir da crise mundial causada pela pandemia da COVID19, que baseou a pesquisa qualitativa. Foram feitas, então, entrevistas semiestruturadas com quatorze membros de quatro associações de chocolates artesanais no Brasil. Os dados coletados foram submetidos à técnica de análise de vídeos de Denzin (2004). A partir das análises, observou-se que as empresas foram impactadas de diferentes maneiras a partir das vivências dos proprietários, da localização de suas fábricas, dos recursos disponíveis e das iniciativas tomadas a partir do conhecimento da crise. A mais significativa mudança na gestão foi a necessidade de adaptação às redes sociais digitais, bem como a profissionalização da presença online e de e-commerce para viabilização da continuidade de operação. Abstract: The COVID-19 pandemic impacted different spheres of society and changed dynamics in the management of companies. This study aims to understand how the COVID-19 pandemic affected artisanal chocolate businesses in Brazil, specifically bean to bar chocolate companies - that is, made by the same producer from almond to bar of chocolate. Therefore, a literature review was developed on the artisanal chocolate market in Brazil and on the difficulties faced by companies during the global crisis caused by the COVID19 pandemic. Qualitative research was developed with semi-structured interviews with fourteen members from four artisan chocolate associations in Brazil. The data collected were analyzed using the video analysis technique by Denzin (2004). From the analyses, it was observed that companies were impacted in different ways based on the experiences of the owners, the location of their companies, available resources and initiatives based on knowledge of the crisis. The biggest change in management was the need to adapt to digital social networks, as well as the professionalization of the online and e-commerce presence to enable continuity of operation. Resumen: La pandemia de COVID-19 afectó a diversos ámbitos de la sociedad y cambió la dinámica en la gestión de las empresas. O presente estudo tem o objetivo de compreender que modo a pandemia do COVID-19 afetou a gestão das empresas de chocolate artesanal no Brasil, especificamente como empresas de chocolates bean to bar - ou seja, feitos pelos mesmos produtores desde a amêndoa até a barra de chocolate. Por lo tanto, se descubrió una revisión de la literatura sobre el mercado del chocolate artesanal en Brasil y las dificultades que enfrentan las empresas ante la crisis global provocada por la pandemia COVID19, en la que se basó la investigación cualitativa. Luego se realizaron selecciones semiestructuradas con catorce miembros de cuatro asociaciones artesanales de chocolate en Brasil. Los datos recolectados fueron recolectados utilizando la técnica de análisis de video de Denzin (2004). A partir de los análisis, se observó que las empresas fueron impactadas de diferentes formas en función de las experiencias de los propietarios, la ubicación de sus empresas, los recursos disponibles y las iniciativas basadas en el conocimiento de la crisis. El mayor cambio en la gestión fue la necesidad de adaptarse a las redes sociales digitales, así como la profesionalización de la presencia online y del comercio electrónico para permitir la continuidad operativa.

The COVID-19 pandemic impacted different spheres of society and changed dynamics in the management of companies. This study aims to understand how the COVID-19 pandemic affected artisanal chocolate businesses in Brazil, specifically bean to bar chocolate companies - that is, made by the same producer from almond to bar of chocolate. Therefore, a literature review was developed on the artisanal chocolate market in Brazil and on the difficulties faced by companies during the global crisis caused by the COVID19 pandemic. Qualitative research was developed with semi-structured interviews with fourteen members from four artisan chocolate associations in Brazil. The data collected were analyzed using the video analysis technique by Denzin (2004). From the analyses, it was observed that companies were impacted in different ways based on the experiences of the owners, the location of their companies, available resources and initiatives based on knowledge of the crisis. The biggest change in management was the need to adapt to digital social networks, as well as the professionalization of the online and e-commerce presence to enable continuity of operation. La pandemia de COVID-19 afectó a diversos ámbitos de la sociedad y cambió la dinámica en la gestión de las empresas. O presente estudo tem o objetivo de compreender que modo a pandemia do COVID-19 afetou a gestão das empresas de chocolate artesanal no Brasil, especificamente como empresas de chocolates bean to bar - ou seja, feitos pelos mesmos produtores desde a amêndoa até a barra de chocolate. Por lo tanto, se descubrió una revisión de la literatura sobre el mercado del chocolate artesanal en Brasil y las dificultades que enfrentan las empresas ante la crisis global provocada por la pandemia COVID19, en la que se basó la investigación cualitativa. Luego se realizaron selecciones semiestructuradas con catorce miembros de cuatro asociaciones artesanales de chocolate en Brasil. Los datos recolectados fueron recolectados utilizando la técnica de análisis de video de Denzin (2004). A partir de los análisis, se observó que las empresas fueron impactadas de diferentes formas en función de las experiencias de los propietarios, la ubicación de sus empresas, los recursos disponibles y las iniciativas basadas en el conocimiento de la crisis. El mayor cambio en la gestión fue la necesidad de adaptarse a las redes sociales digitales, así como la profesionalización de la presencia online y del comercio electrónico para permitir la continuidad operativa. A pandemia da COVID-19 impactou diversas esferas da sociedade e alterou dinâmicas na gestão das empresas. O presente estudo tem o objetivo de compreender de que modo a pandemia da COVID-19 afetou a gestão das empresas de chocolate artesanal no Brasil, especificamente as empresas de chocolates bean to bar – ou seja, feitos pelos mesmos produtores desde a amêndoa até a barra de chocolate. Para tanto, desenvolveu-se uma revisão de literatura sobre o mercado de chocolates artesanais no Brasil e as dificuldades enfrentadas por empresas a partir da crise mundial causada pela pandemia da COVID19, que baseou a pesquisa qualitativa. Foram feitas, então, entrevistas semiestruturadas com quatorze membros de quatro associações de chocolates artesanais no Brasil. Os dados coletados foram submetidos à técnica de análise de vídeos de Denzin (2004). A partir das análises, observou-se que as empresas foram impactadas de diferentes maneiras a partir das vivências dos proprietários, da localização de suas fábricas, dos recursos disponíveis e das iniciativas tomadas a partir do conhecimento da crise. A mais significativa mudança na gestão foi a necessidade de adaptação às redes sociais digitais, bem como a profissionalização da presença online e de e-commerce para viabilização da continuidade de operação.

O objetivo deste artigo é compreender como o storytelling, ou a contação de histórias, é relevante para a autenticidade. Para tanto, foi desenvolvida revisão de literatura sobre autenticidade em experiências turísticas e sobre storytelling, o que deu base para as discussões teóricas deste estudo. Para que se pudesse alcançar o objetivo proposto, optou-se por uma abordagem interpretativista e qualitativa com trabalho de campo aplicado ao contexto do turismo cacaueiro e chocolateiro na Ilha do Combu, Pará. A coleta de dados se deu por meio de observação e de entrevistas semiestruturadas, e os dados - depois de organizados e transcritos - foram analisados por meio de análise de conteúdo. A partir do acesso aos dados, observou-se que o storytelling proporcionou conexão entre os objetos, o local, as pessoas (incluindo comunidade e prestadores de serviço) e a experiência turística. Nesse sentido, o estudo foi capaz de demonstrar a relação existente entre os elementos da abordagem relacional da autenticidade (Rickly-Boyd, 2012) com o storytelling. Ainda, o estudo permite perceber que as histórias conectam os envolvidos na experiência e seus repertórios, legitimam processos de produção, ilustram aspectos físicos e dão significados a ações.

Objetivo do estudo: o presente trabalho teve o objetivo de analisar como consumidores de meios de hospedagem sao influenciados por midias sociais digitais em seus processos de decisao de compra. Metodologia/abordagem: A pesquisa desenvolvida foi exploratoria e quantitativa, utilizando coleta de dados por meio de questionarios aplicados online em midias sociais digitais com consumidores de meios de hospedagem. O questionario foi composto por questoes de multipla escolha e uma questao discursiva. Os dados foram analisados por meio de estatistica descritiva e, para a questao discursiva, foi utilizada a analise de conteudo e, depois, construiu-se uma word cloud (nuvem de palavras). Originalidade/Relevância: Com a facilidade de acesso a internet que ha atualmente, os consumidores estao assumindo papeis mais ativos no processo de decisao de compra, incluindo as suas cinco etapas: reconhecimento do problema, busca de informacoes, analise de alternativas, decisao de compra e, por fim, o pos-compra. As midias sociais digitais possibilitam grande diversidade de possibilidades de busca e acesso as informacoes diversas, o que gera um novo comportamento de compra nos consumidores diante das mudancas que estao ocorrendo na sociedade. Principais resultados : De acordo com os resultados, os respondentes fazem uso frequente das midias sociais digitais principalmente para realizarem pesquisas e trocarem informacoes com outros consumidores, uma vez que as experiencias vividas por outros acabam influenciando o processo de decisao de compra de meios de hospedagem. Contribuicoes teoricas/metodologicas: Para embasar a discussao, foi desenvolvida uma revisao de literatura a respeito de marketing digital e midias sociais digitais, comportamento do consumidor online e processo de decisao de compra. Concluiu-se que a etapa mais influenciada pelas midias sociais e a de busca de informacoes, na qual os consumidores buscam referencias para suas decisoes de compra de meios de hospedagem. As midias sociais mais utilizadas para que esses usuarios obtenham informacoes sao o WhatsApp, o Instagram e o Facebook, respectivamente.

Albinism is the absence of pigmentation or coloration and is rarely found in nature. In this study we examined photos and videos obtained by cameras traps in the Legado das Águas Reserve. In the images, we identified two albino lowland tapirs. The results highlight the necessity of understanding the genetic diversity of lowland tapir populations and the important role of the professional photography associated with scientific research.

The Implementation of Infant Pain Practice (ImPaC) Resource is an eHealth tool designed to support infant pain practice change and ultimately enhance pain outcomes. The aim of this study was to determine users' perspectives on usability, acceptability, and feasibility of the ImPaC Resource. A descriptive prospective mixed-methods quality improvement study was conducted at a pediatric hospital in Canada. Individual "think aloud" interviews were conducted in a nonclinical environment (Phase A); "near live" testing was conducted while users interacted with the Resource in clinical setting (Phase B); individual "think-aloud" interviews were conducted in a nonclinical environment (Phase C). Outcomes included usability (System Usability Scale-SUS), acceptability (Acceptability E-Scale-AES), and feasibility. Interview transcripts were coded per a priori themes using deductive content analysis to create a structured categorization matrix. In Phase A, 10 clinicians interacted with the Resource in individual sessions. Median SUS score was 73.75 (range 52.5-92.5). In Phase B, four clinicians implemented the Resource in the neonatal intensive care unit (NICU) over 4 months. Median SUS score was 85 (82.5-92.5), and median AES score was 24 (21-24). In Phase C, an enhanced prototype was produced, and the same users from Phase B navigated the Resource in individual sessions. Median SUS score was 88.75 (85-95), and median AES score was 27.5 (25-29). Users considered the Resource as feasible for implementation, easy to navigate, engaging, intuitive, comprehensive, and evidence-based. Users highlighted the potential transferability of the Resource to other contexts and settings. The enhanced version of the ImPaC Resource was usable, acceptable, feasible, and met users' expectations and requirements. Results lead the way for evaluation of the Resource in a nationwide cluster randomized trial including 18 NICUs. This knowledge-rich platform is expected to enhance infant pain practices and outcomes in diverse clinical settings.

The "Be sweet to babies" video is a knowledge translation tool targeted at parents on the use of analgesic strategies during painful procedures performed in neonates. This study aimed to evaluate the effectiveness of the Portuguese version of this video on maternal involvement in neonatal pain management during the newborn screening blood test. Nonrandomized, pragmatic clinical trial. The study was conducted in a rooming-in unit. All mothers received a pamphlet regarding neonatal pain management and were invited to participate in daily education sessions conducted by nurses, which included the video. The intervention group included mothers who voluntarily watched the video, while the control group was comprised of mothers who did not attend the education sessions or left the session before watching the video. Data were collected by interviews conducted by the research team. Descriptive and inferential analysis considered a confidence interval of 95%. A total of 73 mothers were included in the study. Analgesic strategies were used in 14 (40%) of the procedures in the intervention group and 9 (24%) in the control group, a clinically important difference of 16% points between groups, although no statistically significant difference was found (

Resumo Objetivo Identificar os principais biomarcadores salivares descritos, assim como as técnicas empregadas para coleta das amostras de saliva, em estudos relacionados à avaliação da dor em pacientes submetidos a procedimentos dolorosos ou portadores de patologias dolorosas. Métodos Revisão integrativa da literatura, realizada pelas buscas bibliográficas nas bases Biblioteca Virtual em Saúde (BVS), MEDLINE/PubMed, CINAHL e EMBASE, com recorte temporal de 2009 a 2019 e período de coleta de dados entre outubro e novembro de 2019. Foram utilizados Descritores em Saúde (DeCs)e Medical SubjectHeadings (MeSH), para responder à pergunta norteadora: Quais são e como são utilizados os biomarcadores salivares na avaliação da dor? Foi realizada uma análise descritiva dos artigos, sendo os dados extraídos e registrados em uma planilha desenvolvida para o presente estudo. Resultados Das 126 publicações identificadas, 22 artigos foram incluídos para a análise. Constatou-se que os artigos são, majoritariamente, desenvolvidos com adultos durante realização de procedimentos dolorosos ou portadores de patologias dolorosa. Os principais biomarcadores salivares avaliados foram a alfa-amilase e o cortisol, e as principais técnicas para coleta de saliva foram o Salivette® e a coleta passiva. Conclusão Os estudos indicam que a mensuração objetiva da dor é um desafio. Os principais biomarcadores salivares descritos são o cortisol e a alfa-amilase, sendo o Salivette®a principal técnica utilizada para coleta das amostras de saliva. A dosagem das moléculas salivares é incipiente e empregada de forma complementar na avaliação da dor em pacientes de diferentes faixas estárias, submetidos à procedimentos dolorosos ou portadores patologias dolorosas.

A enfermagem enquanto ciǦncia tem como objetivo expandir o conhecimento acerca das experiǦncias humanas por intermǸdio de pesquisa e cria��ǜo de conceitos. E embora enfermeiros pesquisadores estejam constantemente engajados na cria��ǜo e difusǜo do conhecimento, reconhece-se a necessidade de traduzir seus achados de pesquisa em a����es na prǭtica cl��nica, com vistas a melhorar a saǧde e a qualidade de vida de indiv��duos assistidos por enfermeiros em diferentes contextos.

Não se aplica

Objective: To characterize painful procedures, analgesic strategies, vital signs, and pain scores in hospitalized newborns. Method: This is a primary, observational, prospective clinical study, developed in a Brazilian public hospital. Demographic data, painful procedures, pain relief measures, vital signs, and pain scores were collected from the clinical records of 90 newborns admitted to the intensive care unit and evaluated between admission and the third day of admission. For statistical analysis, the software Statistic Package for the Social Sciences and the R Software were used. Results: Newborns underwent 2,732 painful procedures, 540 non-pharmacological and 216 pharmacological strategies. The most frequently performed procedure was the heel prick (20.96%). The most commonly recorded non-pharmacological strategy was dim lighting (28.33%) and continuous fentanyl (48.83%) was the main pharmacological measure adopted. Pain score and vital signs show variability in the period evaluated. Conclusion: Despite the high number of painful procedures, pain assessment records do not reflect procedural pain and the use of analgesic strategies was insufficient. RESUMEN Objetivo: Caracterizar los procedimientos dolorosos, estrategias analgésicas, señales vitales y los scores de dolor en recién nascidos hospitalizados. Método: Estudio clínico primario, de observación, prospectivo, desarrollado en un hospital público brasileño. Datos demográficos, procedimientos dolorosos, medidas de alivio del dolor, señales vitales y scores de dolor fueron seleccionados de las historias clínicas de 90 recién nacidos admitidos en la unidad de cuidados intensivos y evaluados entre la admisión y el tercer día de hospitalización. Para el análisis estadístico fueron utilizados el programa Statistic Package for the Social Sciences y el Software R. Resultados: Los recién nacidos fueron sometidos a 2.732 procedimientos dolorosos, 540 estrategias no farmacológicas y 216 farmacológicas. El procedimiento más realizado fue la punción del talón (20,96%). La estrategia no farmacológica más común fue la reducción de luminosidad (28,33%) y el fetanyl continuo (48,83%) fue la principal medida farmacológica adoptada. Conclusión: A pesar del número elevado de procedimientos dolorosos, los registros de evaluación del dolor no reflejan el dolor procedural y el uso de las estrategias analgésicas fue insuficiente. RESUMO Objetivo: Caracterizar os procedimentos dolorosos, estratégias analgésicas, sinais vitais e os escores de dor em recém-nascidos hospitalizados. Método: Estudo clínico primário, observacional, prospectivo, desenvolvido em um hospital público brasileiro. Dados demográficos, procedimentos dolorosos, medidas de alívio da dor, sinais vitais e escores de dor foram coletados dos prontuários clínicos de 90 recém-nascidos admitidos na unidade de terapia intensiva e avaliados entre a admissão e o terceiro dia de internação. Para a análise estatística foram utilizados o programa Statistic Package for the Social Sciences e o Software R. Resultados: Os recém-nascidos foram submetidos a 2.732 procedimentos dolorosos, 540 estratégias não farmacológicas e 216 farmacológicas. O procedimento mais realizado foi a lancetagem de calcâneo (20,96%). A estratégia não farmacológica mais comumente registrada foi a redução de luminosidade (28,33%) e o fentanil contínuo (48,83%) foi a principal medida farmacológica adotada. O escore de dor e os sinais vitais apresentam variabilidade no período avaliado. Conclusão: A despeito do número elevado de procedimentos dolorosos, os registros de avaliação da dor não refletem a dor procedural e o uso das estratégias analgésicas foi insuficiente.

Resumo: Existem fatores que interferem na atuação docente relacionados a questões ligadas aos sexos, mas faltam estudos no contexto de Programas de Pós-Graduação em Turismo (PPGTurs). O objetivo deste artigo é compreender como a inserção feminina de docentes de turismo acontece no âmbito da Associação Nacional de Pesquisa e Pós-Graduação em Turismo (Anptur). A pesquisa é quantitativa, baseada em dados secundários e análises estatísticas utilizando o software SPSS. Os resultados apontam equilíbrio entre o número de docentes dos dois sexos atuando em programas de pós-graduação em turismo. Os cargos de coordenação e vice coordenação dos PPGTurs têm maioria masculina (60%), assim como em cargos de diretoria da Anptur (62%). Há diferenças na média de citação de mulheres, que é inferior à citação de homens em todos os índices existentes na plataforma Google Scholar. Sobre a autoria de trabalhos publicados em anais da Anptur entre 2005 e 2019, tem-se que há maioria de autoras do sexo feminino (60%). Sobre a premiação, há um número equilibrado de prêmios concedidos aos dois sexos. O estudo contribui ao apresentar um recorte sobre a atuação docente em programas de pós-graduação em turismo, colaborando para o entendimento da representatividade e influência feminina na área. Abstract: Some factors interfere in the teaching performance related to sex issues, but studies in the context of Post Graduate Programs in Tourism (PPGTurs) are still a gap. The purpose of this article is to understand how the female insertion of tourism professors happens within the scope of the National Association for Research and Graduate Studies in Tourism (Anptur - Brazil). The research is quantitative, based on secondary data and statistical analysis using the SPSS software. The results indicate a balance between the number of professors of both sexes working in post graduate programs in tourism. The coordination and vice-coordination positions of the PPGTurs have a male majority (60%) and management positions at Anptur (62%). There are differences in the average number of women, which is lower than that of men in all indexes on the Google Scholar platform. About the authorship of works published in Anptur's annals between 2005 and 2019, there is a majority of female authors (60%). Regarding the awards, there is a balanced number of prizes awarded to both sexes. The study contributes by presenting an excerpt on the teaching performance in post graduate programs in tourism, contributing to understanding the representativeness and female influence in the area. Resumen: Existen factores que interfieren en el desempeño docente relacionados com sus sexos, pero faltan estudios en el contexto de los Programas de Posgrado en Turismo (PPGTurs). El propósito de este artículo es comprender cómo se da la inserción femenina de profesoras de turismo en el ámbito de la Asociación Nacional de Investigación y Posgrado en Turismo (Anptur - Brasil). La investigación es cuantitativa, basada en datos secundarios y análisis estadístico utilizando el software SPSS. Los resultados indican un equilibrio entre el número de profesores de ambos sexos que trabajan en programas de posgrado en turismo. Los puestos de coordinación y vicecoordinación de los PPGTurs tienen mayoría masculina (60%), así como en los puestos directivos de Anptur (62%). Existen diferencias en el número medio de citas de mujeres, que es inferior al de los hombres en todos los índices de la plataforma Google Scholar. Sobre la autoría de las obras publicadas en los anales de Anptur entre 2005 y 2019, hay una mayoría de autoras (60%). En cuanto al premio, existe un número equilibrado de premios otorgados a ambos sexos. El estudio contribuye presentando un extracto sobre el desempeño docente en programas de posgrado en turismo, contribuyendo a la comprensión de la representatividad e influencia femenina en la zona.

Background The clinical Pandemic Practice Champion (PPC) role was created in a large tertiary pediatric hospital as a knowledge translation (KT) strategy for implementing COVID-19 evidence-based knowledge. We aimed to describe the core components of the PPC role, the process of implementing the role, and the factors that hindered or facilitated role implementation. Methods An exploratory case study was undertaken. Semi-structured interviews were conducted virtually with stakeholders including PPC, managers, and front-line health care professionals (HCP). A directed approach to qualitative content analysis consistent with the Consolidated Framework for Implementation Research (CFIR) guided the analytic process. Inductive analyses and three stages of thematic synthesis were also conducted. Results Four PPC, 3 managers, and 6 HCP were interviewed. The core components of the PPC role consisted of (a) acting as knowledge experts and educators, (b) problem-solving for complex patient care issues, (c) conducting crisis management, and (d) acting as a resource to management, HCP, and families. Facilitators for successful implementation included access to external information, a supportive organizational context and culture, dedicated time and resources, and leadership support. Lack of clarity of role definition, insufficient time, pandemic uncertainty and fatigue, inability to change infrastructure, and access to external information hindered implementation. Conclusion The PPC role was successfully implemented within a crisis context. Key barriers (role clarity, time, resources) and facilitators (organizational and leadership support) need to be considered when implementing the PPC role in practice. Future studies are needed to determine the intervention effectiveness of the champion role in changing HCP behavior and health outcomes and further examine implementation processes and mechanisms.

Background Electronic health (e-health) learning is a potential avenue to educate health professionals about accurately using infant pain assessment tools, although little is known about the impact of e-health interventions on clinical competence. Purpose To evaluate whether an e-health learning module for teaching the accurate use of the Premature Infant Pain Profile-Revised (PIPP-R) pain assessment tool results in immediate and sustained competency to assess infant pain. Methods Neonatal intensive care unit (NICU) nurses who participated in a larger study across 2 tertiary NICUs in Canada examining the implementation and clinical utility of the PIPP-R e-learning module completed 2 follow-up evaluations at 1 week and 3 months. Participants were asked to view a video recording of an infant undergoing a painful procedure and to assess the infant's pain intensity response using the PIPP-R measure. Immediate and sustained competency was assessed via interrater consensus of participant-reported PIPP-R scores compared with those of an experienced trained coder. Results Of the 25 eligible nurses, 22 completed 1-week and 3-month follow-up evaluations. At the 1-week follow-up, 84% of nurses scored the video accurately compared with 50% at 3 months. Behavioral pain indicators were more likely to be scored incorrectly than physiological indicators. Implications for practice Follow-up training after completion of the initial e-learning module training may improve competency related to the clinical use of the PIPP-R tool to assess infant pain over time. Implications for research Additional study regarding the need and timing of e-health training to optimize sustained competency in infant pain assessment is warranted.

Pain assessment is an essential foundation to mitigate pain and its consequences in the developing child. However, pain assessment in neonates and infants is challenging and, to date, there is no “gold standard” infant pain indicator, measure, or approach. This chapter encompasses (1) a comprehensive evaluation of the most current and well validated neonatal/infant pain assessment measures; (2) an overview on biomarkers and cortical indicators on neonatal/infant pain; (3) the integration of recommendations on pain-assessment measures and practices within clinical practice guidelines, policies, and procedures; and (4) challenges associated with neonatal and infant pain assessment in terms of research, clinical, and knowledge translation issues.

Abundant published evidence demonstrates the pain-reducing effects of sweet solutions in human infants and animals. Analgesic effects persist up to around 1 year of age in human infants, though there is less research to support analgesic effects in older infants and, for the existing research, effects are more moderate than seen in the neonatal period. Though the exact mechanisms are unclear, analgesic effects are believed to be due to the relationship between sweet taste and the endogenous opiate system. Based on the extensive evidence to support sweet solutions, their use can be recommended prior to commonly performed short-lasting minor painful procedures in newborn and young infants. Despite extensive research, knowledge gaps and controversies remain relating to the mechanisms of analgesia; the effectiveness and safety of sweet solutions when given over prolonged periods to preterm and sick infants; the effectiveness in sick infants receiving concomitant analgesics; and the effectiveness in children older than 12 months of age.

Objective To identify the type and frequency of stressful and painful procedures, the use of pharmacological and non-pharmacological strategies; to identify relationships between demographic and clinical variables with frequency of procedures and pain management. Design A prospective longitudinal study was conducted in neonatal intensive care units (NICU) of two hospitals in the city of Belo Horizonte, Brazil. 140 newborns admitted to the NICU between June 2014 and January 2015 were included. Results A total of 21,291 procedures were documented, 18,131 (85.2%) stressful procedures and 3,160 (14.8%) invasive skin-breaking painful procedures. Each day of hospitalization increased by 10.9 the number of stressful procedures and by 2.2 the number of painful procedures. Furthermore, for each day of hospitalization, non-pharmacological strategies registered increased by 3.4% and pharmacological strategies, increased by 9.3%. Conclusion Neonates underwent a high number of stressful and painful procedures and with infrequent use of pharmacological and non-pharmacological strategies during the entire hospitalization.

Este ensaio tem o objetivo de fornecer uma lente alternativa para interpretação do construto autenticidade no contexto das experiências turísticas. A revisão de literatura realizada apresenta os principais autores que tratam do tema e suas diferentes perspectivas a respeito de autenticidade, dentre estas a autenticidade objetiva, a construtivista e a existencial. A análise e reflexão dessas diferentes perspectivas oferecem as bases para a proposição da adoção de um solo epistemológico alternativo à interpretação da autenticidade nas experiências turísticas, que pode levar a uma melhor compreensão desse fenômeno. Assim, propõe-se que o Pensamento Complexo de Edgar Morin pode oferecer uma forma complementar para o entendimento da autenticidade no contexto do turismo, na medida em que pode permite ao pesquisador uma alternativa frente ao pensamento fragmentado tradicional que está atrelado a essa temática, e possibilitar reflexões a partir de uma visão mais holística do fenômeno. Essa discussão resultou em proposições, que são discutidas ao final deste trabalho.

This study aims to: (1) conduct a systematic review of YouTube videos showing newborn infants undergoing blood tests and (2) ascertain the use of recommended pain treatment strategies and infant pain during the filmed blood test. The pain was assessed using: (1) Neonatal Facial Coding System (NFCS) scores before, during and following the procedure; (2) Cry duration before and during the procedure. A total of 55 videos showing 63 procedures were included. Over half the babies cried and most babies scored the highest NFCS score of 4 at time of the poke as well as 15 s after the poke. YouTube videos of newborn infants undergoing blood sampling showed that recommended effective pain management interventions were rarely used and most infants were distressed during and following the procedure.

Objective: to analyze skin-to-skin contact practice in full-term newborns after birth. Method: a cross-sectional study carried out in São Paulo-SP with 78 mother-child binomials. Data were obtained from medical records and by non-participant observation. Maternal, neonatal and care conditions, length of skin-to-skin contact and breastfeeding attachment were analyzed. Results: skin-to-skin contact was performed in 94.9% of births, with a mean length of 29 minutes. Births with intact perineum took longer, neonates with Apgar 10, without upper airway aspiration, assisted by a nurse-midwife and with neonatal assistance by a resident in pediatrics. The variables that favor breastfeeding attachment were perineal integrity, newborn with good vitality, without upper airway aspiration and who received professional assistance for breastfeeding attachment. Conclusion: skin-to-skin contact was performed in almost all births, but with less time than recommended as best practice. RESUMEN Objetivo: analizar la práctica del contacto piel-a-piel en recién-nacidos a término durante el parto normal. Método: estudio transversal, realizado en São Paulo-SP, con 78 binomios madre-hijo. Los datos provienen de historias clínicas y observación no participante. Se analizaron las condiciones maternas, neonatales y del parto, la duración del contacto piel-a-piel y el acople mamario. Resultados: el contacto piel-a-piel se realizó en el 94,9% de los partos, con duración media de 29 minutos, que fue mayor en partos con perineo intacto, neonatos con Apgar 10, sin aspiración de vía aérea superior, asistidos por enfermera obstétrica y con atención neonatal por médico pediatra residente. Las variables que favorecieron el acople fueron integridad perineal y neonatos con buena vitalidad, sin aspiración de la vía aérea superior, que recibieron ayuda profesional para el acople. Conclusión: el contacto piel-a-piel se realizó en casi todos los partos, con menos tiempo del recomendado como buena práctica. RESUMO Objetivo: analisar a prática do contato pele-a-pele em recém-nascidos a termo no parto normal. Método: estudo transversal, realizado em São Paulo-SP, com 78 binômios mãe-filho. Os dados foram obtidos nos prontuários e por observação não participante. Foram analisadas as condições maternas, neonatais e assistenciais, duração do contato pele-a-pele e pega da mama materna. Resultados: o contato pele-a-pele foi realizado em 94,9% dos nascimentos, com duração média de 29 minutos. A duração foi maior em partos com períneo íntegro, neonatos com Apgar 10, sem aspiração das vias aéreas superiores, assistidos por enfermeira obstétrica e com assistência neonatal por médico residente em pediatria. As variáveis que favorecem a pega da mama foram integridade perineal, neonato com boa vitalidade, sem aspiração das vias aéreas superiores e que receberam ajuda profissional para a pega. Conclusão: o contato pele-a-pele foi realizado na quase totalidade dos nascimentos, mas com tempo inferior ao recomendado como boa prática.

O artigo tem por objetivo compreender o movimento de (re)posicionamento da marca de Ilhéus, de destino tradicional de sol e mar para um destino de turismo experiencial chocolateiro. Como base teórica para dar suporte à interpretação dos dados foram adotados os construtos marca de destinos turísticos e turismo experiencial. Para tanto, foi desenvolvida uma pesquisa qualitativa com coleta de dados realizada por meio de entrevistas com quatro gestores locais: o vice-prefeito da cidade, um empresário e presidente do Costa do Cacau Convention and Visitors Bureau, a proprietária da agência de turismo responsável pela comercialização da Costa do Cacau e, por fim, o proprietário de uma fazenda de cacau que recebe turistas. Os dados foram interpretados a partir de uma Análise Temática, que possibilitou observar que o movimento de reposicionamento da marca Ilhéus existe, mas ainda em fase inicial e tímida de mudança. Fez-se, ainda, a partir das entrevistas, um levantamento histórico do turismo na região. Observou-se, por fim, que: a) há concordância entre os entrevistados sobre a relevância do chocolate e do cacau para a identidade do destino; b) há percepção unânime de que Ilhéus possui muita atividade de turismo de massa, em que os visitantes tem pouco conhecimento sobre a cultura e história da região; c) há um movimento de consumidores que visam experiências mais diferenciadas, de busca pelo cacau e pelo chocolate da região; d) há, também, um movimento de criação de oferta de produtos turísticos voltados ao cacau e ao chocolate e ao turismo experiencial na região.

The genus Ehrlichia includes tick-borne bacterial pathogens affecting humans, domestic and wild mammals. Ehrlichia minasensis has been identified in different animal species and geographical locations, suggesting that this is a widely distributed and generalist Ehrlichia. In the present study, we evaluated Ehrlichial infection in 148 Equidae presented to the Medical Clinic Department of a Veterinary Hospital from a midwestern region of Brazil. Blood samples and ticks collected from the animals were tested by Polymerase Chain Reaction (PCR) for the presence of Ehrlichia spp. A multigenic approach including Anaplasmataceae-specific (i.e., 16S rRNA, groEL, gltA) and Ehrlichia-specific (i.e., dsb and trp36) genes was used for accurate bacteria identification. Sera samples were also collected and evaluated for the detection of anti-Ehrlichia antibodies by indirect fluorescent antibody test (IFA). Possible associations between molecular and serological diagnostics and clinical and hematological manifestations were tested using chi-squared or Fisher’s exact tests. Sequence analysis of the dsb fragment revealed that three horses (2.03%) were exposed to E. minasensis. Sixty-one (41.2%) Equidae (58 equines and three mules), were seropositive for Ehrlichia spp., with antibody titers ranging between 40 and 2560. Seropositivity to ehrlichial antigens was statistically associated with tick infestation, rural origin, hypoalbuminemia and hyperproteinemia (p ≤ 0.05). The present study reports the first evidence of natural infection by E. minasensis in horses from Brazil.

Objective: To determine the prevalence of recurrent wheezing (RW) in preterm infants who received prophylaxis against severe infection with respiratory syncytial virus (RSV) and to identify genetic susceptibility (atopy or asthma) and risk factors for RW. Methods: This was a cross-sectional study involving preterm infants who received prophylaxis with palivizumab at a referral center in Brazil during the first two years of age. A structured questionnaire was administered in a face-to-face interview with parents or legal guardians. Results: The study included 410 preterm infants (median age = 9 months [0-24 months]). In the sample as a whole, 111 children (27.1%; [95% CI, 22.9-31.5]) had RW. The univariate analysis between the groups with and without RW showed no differences regarding the following variables: sex, ethnicity, maternal level of education, gestational age, birth weight, breastfeeding, number of children in the household, day care center attendance, pets in the household, and smoking caregiver. The prevalence of RW was twice as high among children with bronchopulmonary dysplasia (adjusted OR = 2.08; 95% CI, 1.11-3.89; p = 0.022) and almost five times as high among those with a personal/family history of atopy (adjusted OR = 4.96; 95% CI, 2.62-9.39; p < 0.001) as among those without these conditions. Conclusions: Preterm infants who received prophylaxis with palivizumab but have a personal/family history of atopy or bronchopulmonary dysplasia are more likely to have RW than do those without these conditions. RESUMO Objetivo: Determinar a prevalência de sibilância recorrente (SR) em crianças pré-termo que receberam profilaxia contra infecção grave pelo vírus sincicial respiratório (VSR) e identificar susceptibilidade genética (atopia ou asma) e fatores de risco para SR. Métodos: Estudo transversal envolvendo crianças pré-termo que receberam profilaxia com palivizumabe em um centro de referência no Brasil durante os primeiros dois anos de vida. Um questionário estruturado foi aplicado em entrevista presencial com os pais ou responsáveis. Resultados: O estudo incluiu 410 crianças pré-termo (mediana de idade = 9 meses [0-24 meses]). Na amostra total, 111 crianças (27,1%; IC95%: 22,9-31,5) apresentavam SR. A análise univariada entre os grupos com e sem SR não mostrou diferenças em relação às seguintes variáveis: sexo, etnia, escolaridade materna, idade gestacional, peso ao nascer, aleitamento materno, número de crianças no domicílio, frequência em creche, presença de animais de estimação no domicílio e cuidador tabagista. A prevalência de SR foi duas vezes maior entre crianças com displasia broncopulmonar (OR ajustada = 2,08; IC95%: 1,11-3,89; p = 0,022) e quase cinco vezes maior entre aquelas com história pessoal/familiar de atopia (OR ajustada = 4,96; IC95%: 2,62-9,39; p < 0,001) do que entre aquelas sem essas condições. Conclusões: Crianças pré-termo que receberam profilaxia com palivizumabe, mas apresentam história pessoal/familiar de atopia ou displasia broncopulmonar, têm maior probabilidade de apresentar SR do que aquelas sem essas condições.

Objectives The Premature Infant Pain Profile-revised (PIPP-R) is a well-established measure for infant pain assessment. The aim of this study was to evaluate the implementation and clinical utility of the PIPP-R electronic learning (e-Learning) module to promote standardized health care training for nurses. Materials and methods A descriptive mixed-methods study was conducted in 2 tertiary Neonatal Intensive Care Units in Canada. Nurses were recruited and asked to complete the PIPP-R e-Learning Module and evaluate it. A 26-item questionnaire was used to describe nurse demographics and clinical experience and to evaluate implementation success (ie, acceptability, feasibility, usability) and clinical utility. Results In all, 98 nurses from 2 settings in Central and Eastern Canada participated; most were registered nurses highly experienced in neonatal nursing care. The majority had received previous training on the PIPP-R (61.2%) and routinely used it in practice (67.4%). They considered the e-Learning module as acceptable and feasible as it was easy to access (94.9%) and to navigate (94.8%). Content was considered clear (98.9%) and met users' learning needs (99.0%). Nurses agreed that completing the module improved their understanding of neonatal pain (96.0%) and was clinically useful in improving their ability to assess pain in neonates (97.9%). The module was accessed primarily from work settings (77.8%) using desktop computers (49.0%) or tablets (28.0%) and was usually completed in a single session (75.7%). Discussion Nurses' evaluation of the PIPP-R e-Learning module was overwhelmingly positive. The module was perceived as easy to implement, clinically useful, and was considered as a promising online educational tool. Further testing in clinical practice is needed to build on the results of this study and support the importance of dissemination of this module for standardized training purposes.

Objectives: to identify predisposing and enabling factors as well as the health needs associated with the discontinuance of outpatient follow-up of newborns who were hospitalized at neonatal intensive care unit. Methods: cross-sectional study, using the behavioral model of health services use. The study was composed of 358 mothers and newborns referred to the outpatient follow-up after discharge. Characterization, perception of social support, postnatal depression, and attendance to appointments data were collected, analyzed by the R software (3.3.1). Results: outpatient follow-up was discontinued by 31.28% of children in the first year after discharge. In multiple regression analysis, the chance of discontinuance was higher for newborns who used mechanical ventilation (OR = 1.68; 95%CI 1.04-2.72) and depended on technology (OR = 3.54; 95%CI 1.32-9.5). Conclusions: predisposing factors were associated with the discontinuance of follow-up; enabling factors and health needs did not present a significant association. Children with more complex health conditions require additional support to participate in follow-up programs, thus ensuring the continuity of care. RESUMEN Objetivso: identificar los factores predisponentes y facilitadores, y las necesidades de salud asociadas a la interrupción del seguimiento ambulatorio de recién nacidos tras el alta de unidades de cuidados intensivos neonatais. Métodos: estudio transversal, que utilizó el modelo conductual de utilización de servicios de salud. Participaron 358 madres y recién nacidos, que fueron orientados al seguimiento ambulatorio para el alta hospitalaria. Se recogieron los datos de caracterización, de percepción de apoyo social, de depresión posparto y de asiduidad a las consultas, siendo analizados en el software R (3.3.1). Resultados: el siguimiento ambulatorio fue interrumpido por el 31,28% de los niños durante el primer año tras el alta. En el análisis de regresión múltiple, la probabilidad de interrumpir el seguimiento fue mayor entre los recién nacidos que utilizaron ventilación mecánica (OR = 1,68; IC 95% 1,04-2,72) y dependían de la tecnología (OR = 3,54; IC 95% 1,32-9,5). Conclusión: los factores predisponentes fueron asociados con la interrupción del seguimiento; sin embargo, los factores facilitadores y las necesidades de salud no presentaron una asociación significativa. Los niños que presentaban condiciones de salud más complejas requirieron apoyo adicional para participar en los programas de seguimiento y garantizar la continuidad del cuidado. RESUMO Objetivos: identificar fatores predisponentes e capacitantes e necessidades de saúde associados à descontinuidade do seguimento ambulatorial de recém-nascidos egressos de terapia intensiva neonatal. Métodos: estudo transversal, utilizando o modelo comportamental de utilização de serviços de saúde. Participaram 358 mães e recém-nascidos encaminhados ao seguimento ambulatorial à alta hospitalar. Foram coletados dados de caracterização, percepção de apoio social, depressão pós-parto e assiduidade às consultas, sendo analisados no software R (3.3.1). Resultados: o seguimento ambulatorial foi descontinuado por 31,28% das crianças no primeiro ano após a alta. Em análise de regressão múltipla, a chance da descontinuidade foi maior nos recém-nascidos que utilizaram ventilação mecânica (OR = 1,68; IC 95% 1,04-2,72) e dependiam de tecnologia (OR = 3,54; IC 95% 1,32-9,5). Conclusões: fatores predisponentes estiveram associados à descontinuidade do seguimento; fatores capacitantes e necessidades de saúde não apresentaram associação significativa. Crianças com condições de saúde mais complexas requerem suporte adicional para participação nos programas de seguimento e garantia da continuidade do cuidado.

Made available in DSpace on 2020-12-11T15:32:27Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-03-09 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Acinetobacter baumannii is the main species of the Acinetobacter genus; however, non-baumannii Acinetobacter (NBA) species causing infections have been described for the past years, as well as antimicrobial resistance. In this study, we describe the occurrence of two multidrug-resistant (MDR) IMP-1-producing Acinetobacter bereziniae isolates recovered from bloodstream infections in different patients but in the same intensive care unit among 134 carbapenem-resistant Acinetobacter screened. Antimicrobial susceptibility testing revealed resistance to carbapenems, extended spectrum, and antipseudomonad cephalosporins, amikacin, and trimethoprim-sulfamethoxazole. Both A. bereziniae isolates shared the same ApaI-pulsed-field gel electrophoresis (PFGE) pattern. Whole-genome sequencing of both isolates revealed that bla(IMP-1) was embedded into an In86 Class I integron carrying also sul1, aac(6 ')-31, and aadA genes. A new sequence type (ST1309 Pasteur) was deposited. The virulence genes lpxC and ompA, seen in A. baumannii, were detected in the A. bereziniae strains. Recognition of A. bereziniae causing invasive MDR infection underscores the role of NBA species as human pathogens especially in at-risk patients. Adolfo Lutz Inst, Ctr Bacteriol, Ave Dr Arnaldo 355,9 Andar, BR-01246902 Sao Paulo, Brazil Adolfo Lutz Inst, Lab Estrateg, Sao Paulo, Brazil Univ Sao Paulo, Fac Med, Sao Paulo, Brazil Univ Sao Paulo, Fac Med Vet & Zootecnia, Sao Paulo, Brazil Univ Estadual Paulista, Fac Med Botucatu, Botucatu, SP, Brazil Univ Estadual Paulista, Inst Biociencias Botucatu, Botucatu, SP, Brazil Univ Estadual Paulista, Fac Med Botucatu, Botucatu, SP, Brazil Univ Estadual Paulista, Inst Biociencias Botucatu, Botucatu, SP, Brazil FAPESP: 2015/13179-4 FAPESP: 2016/20727-0 FAPESP: 2017/16988-6

Incluye contenido parcial de los autores Abstract.Mammalian carnivores are considered a key group in maintaining ecologicalhealth and can indicate potential ecological integrity in landscapes where they occur. Carni-vores also hold high conservation value and their habitat requirements can guide managementand conservation plans. The order Carnivora has 84 species from 8 families in the Neotropicalregion: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; andUrsidae. Herein, we include published and unpublished data on native terrestrial Neotropicalcarnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTRO-PICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data wereobtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organi-zations, and private consultants. Data were collected using several methods including cameratrapping, museum collections, roadkill, line transect, and opportunistic records. Literature(peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated inthis compilation. Most of the data set consists of detection data entries (n=79,343; 79.7%) butalso includes non-detection data (n=20,262; 20.3%). Of those, 43.3% also include count data(n=43,151). The information available in NEOTROPICAL CARNIVORES will contribute tomacroecological, ecological, and conservation questions in multiple spatio-temporal perspec-tives. As carnivores play key roles in trophic interactions, a better understanding of their distri-bution and habitat requirements are essential to establish conservation management plans andsafeguard the future ecological health of Neotropical ecosystems. Our data paper, combinedwith other large-scale data sets, has great potential to clarify species distribution and relatedecological processes within the Neotropics. There are no copyright restrictions and no restric-tion for using data from this data paper, as long as the data paper is cited as the source of theinformation used. We also request that users inform us of how they intend to use the data.

Background:Actinobacillosis in adult horses is rare, and is often associated with infection due to Actinobacillus equuli subsp. equuli, which is a commensal organism inhabiting the oral cavity of healthy animals. It is an opportunistic pathogen, and the infection usually occurs secondary to another primary disease or due to predisposing factors such as pre-existing lesions, mainly in the oral cavity. Infection may be associated with peritonitis, bacterial endocarditis, pneumonia, enteritis, infectious periorchitis, abortion, and septicemia. This paper aims to describe the clinical, microbiological, and pathological aspects of actinobacillosis in the oral cavity of a horse.Case:A case of actinobacillosis has been reported in a 22-year-old gelding Quarter Horse. According to the owner, the animal presented with progressive weight loss during the previous three months, and leakage of food from the oral cavity. Examination of the oral cavity revealed sharp enamel overgrowths, which had been corrected during a previous dental procedure. However, five days after the procedure, the animal developed halitosis. Ceftiofur sodium (4.4 mg/kg intramuscularly, every 24 h) was prescribed; two days after the commencement of antimicrobial therapy, the animal presented with sialorrhea, bilateral submandibular lymphadenomegaly, protrusion of the tongue, edema of the base of the tongue, cheeks, and gums, in addition to black-colored sores and scales in the oral mucosa, particularly affecting the base of the tongue and gums. Samples from ulcerative lesions found at the base of the tongue and gums were collected using sterile swabs, and culture and antibiogram were requested. Microbiological culture led to the growth of small colonies measuring less than 5 mm in diameter, that were non-hemolytic, slightly whitish in color but non-opaque, smooth and bright in appearance. These were identified as gram-negative rods on microscopy, and further characterized as Actinobacillus equuli subsp. equuli based on the phenotypic and biochemical findings. The antibiogram revealed sensitivity of the organisms to cephalothin and doxycycline, intermediate sensitivity to amoxicillin, and resistance to florfenicol, metronidazole, clindamycin, and sulfazotrim. The complete blood count revealed anemia with a reduction in hemoglobin (10.1 g/dL) and hematocrit (27.9%), neutrophilia (10.670 x 10³ /mm³), and lymphopenia (330 x 10³ /mm³). Decrease in serum albumin (2.0 g/dL) and alkaline phosphatase (91 IU/L), and increase in globulin (4.9 g/dL), aspartate aminotransferase (361 4 IU/L), and urea (123.8 mg/dL) were noted on biochemical analyses. Two days after the onset of acute clinical signs, the animal died; necropsy revealed severe, subacute, fibronecrotic glossitis associated with myriads of basophilic bacteria.Discussion:This report describes an infection of the oral cavity by Actinobacillus equuli subsp. equuli following a dental procedure, a finding compatible with the opportunistic nature of these bacteria. The presence of enamel overgrowths resulted in the formation of traumatic lesions on the oral mucosa and tongue that favored colonization of the bacteria. The case of equine glossitis reported in this study had a similar clinical presentation to the classic actinobacillosis in cattle, also known as “wooden tongue”, an infection caused by Actinobacillus lignieresii; common symptoms in cattle include oral edema, sialorrhea, and dysphagia.

BackgroundHospitalized infants undergo multiple painful procedures daily. Despite the significant evidence, procedural pain assessment and management continues to be suboptimal. Repetitive and untreated pain at this vital developmental juncture is associated with negative behavioral and neurodevelopmental consequences. To address this knowledge to practice gap, we developed the web-based Implementation of Infant Pain Practice Change (ImPaC) Resource to guide change in healthcare professionals’ pain practice behaviors. This protocol describes the evaluation of the intervention effectiveness and implementation of the Resource and how organizational context influences outcomes.MethodsAn effectiveness-implementation hybrid type 1 design, blending a cluster randomized clinical trial and a mixed-methods implementation study will be used. Eighteen Neonatal Intensive Care Units (NICUs) across Canada will be randomized to intervention (INT) or standard practice (SP) groups. NICUs in the INT group will receive the Resource for six months; those in the SP group will continue with practice as usual and will be offered the Resource after a six-month waiting period. Data analysts will be blinded to group allocation. To address the intervention effectiveness, the INT and SP groups will be compared on clinical outcomes including the proportion of infants who have procedural pain assessed and managed, and the frequency and nature of painful procedures. Data will be collected at baseline (before randomization) and at completion of the intervention (six months). Implementation outcomes (feasibility, fidelity, implementation cost, and reach) will be measured at completion of the intervention. Sustainability will be assessed at six and 12 months following the intervention. Organizational context will be assessed to examine its influence on intervention and implementation outcomes.DiscussionThis mixed-methods study aims to determine the effectiveness and the implementation of a multifaceted online strategy for changing healthcare professionals’ pain practices for hospitalized infants. Implementation strategies that are easily and effectively implemented are important for sustained change. The results will inform healthcare professionals and decision-makers on how to address the challenges of implementing the Resource within various organizational contexts.Trial registrationClinicalTrials.gov,NCT03825822. Registered 31 January 2019.

Objectives: to assess layout quality, visual identity and content of the “Neonatal Pain Assessment Program” (Programa de Avaliação da Dor Neonatal) online course. Methods: a descriptive exploratory study. The course was assessed by 24 experts in pain, neonatology and education. A form containing 20 questions on technical, interface and educational aspects was used. For each item, the score ranged from 0 to 1. Mean scores above 0.7 were considered indicative of high quality of the items. Descriptive statistics were used for data analysis. Results: navigation, clarity, ease of localization, content relevance, contextualization, content correction, multiple windows, ease of use, ease of return, ergonomics, esthetics, special brands, audiovisual resources, information and portability were assessed. All aspects obtained a mean ≥ 0.70 and no changes were required. Conclusions: the Neonatal Pain Assessment Program is considered as quality educational technology and promising strategy for health education. RESUMEN Objetivos: evalúe la calidad del diseño, la identidad visual y el contenido del curso en línea “Programa de Evaluación del Dolor Neonatal” (Programa de Avaliação da Dor Neonatal). Métodos: estudio exploratorio descriptivo. El curso fue evaluado por 24 especialistas en las áreas de dolor, neonatología y educación. Se utilizó un formulario con 20 preguntas sobre aspectos técnicos, de interfaz y educativos. Para cada ítem, los puntajes variaron de 0 a 1. Los puntajes promedio por encima de 0.7 se consideraron indicativos de alta calidad de ítems. Se utilizaron estadísticas descriptivas para el análisis de datos. Resultados: se evaluaron: navegación libre, claridad, facilidad de localización, relevancia de contenido, contextualización, corrección de contenido, ventanas múltiples, facilidad de uso, facilidad de retorno, ergonomía, estética, marcas especiales, recursos audiovisuales, información y portabilidad. Todos los aspectos obtuvieron una media ≥ 0,70 y no se requirieron cambios. Conclusiones: el Programa de Evaluación del Dolor Neonatal se considera una tecnología educativa de calidad y una estrategia prometedora para la educación para la salud. RESUMO Objetivos: avaliar a qualidade do layout, da identidade visual e do conteúdo do curso online “Programa de Avaliação da Dor Neonatal”. Métodos: estudo exploratório descritivo. O curso foi avaliado por 24 especialistas nas áreas de dor, neonatologia e educação. Foi utilizado um formulário contendo 20 questões sobre aspectos técnicos, de interface e educacionais. Para cada item, a pontuação variou de 0 a 1. Escores médios acima de 0,7 foram considerados indicativos de alta qualidade dos itens. Utilizou-se estatística descritiva para análise dos dados. Resultados: foram avaliados: navegação livre, clareza, facilidade de localização, pertinência do conteúdo, contextualização, correção de conteúdo, múltiplas janelas, facilidade de aprendizagem, eficiência de utilização, facilidade de retorno, ergonomia, estética, marcas especiais, recursos audiovisuais, informações e portabilidade. Todos os aspectos obtiveram média ≥ 0,70, não sendo necessárias modificações. Conclusões: considera-se o Programa de Avaliação da Dor Neonatal como tecnologia educacional de qualidade e estratégia promissora para a educação em saúde.

Objective: to identify evidence available in the literature on educational strategies used in the teaching of insulin therapy to children and adolescents with Type 1 diabetes mellitus. Method: systematic review undertaken in five databases, using the descriptors Insulin/therapeutic use, Patient education as topic, Diabetes mellitus type 1, Child, Infant, Adolescent and keywords, without any time limit. Primary studies on insulin therapy teaching were included, while research on insulin pumps was excluded. Results: 243 studies were identified, 13 of which were included. The results present educational strategies focused on children, adolescents and young people of up to 24 years of age, applied individually or in groups; by telephone contact or text messages by mobile phone; dramatization and educational camps; by a single professional or a multidisciplinary team. The strategies described in the analyzed studies addressed the adjustment of insulin dosages in everyday situations and education for insulin management, associated with the nutritional strategy of carbohydrate counting, diabetes education with a specific module on insulin therapy and intensive insulin use. The studies analyzed the effect of the educational intervention on several clinical and behavioral outcomes, such as glycated hemoglobin and self-efficacy. Conclusion: this review could not identify a single educational strategy able to improve metabolic and psychosocial outcomes. In most cases, nurses are the professionals responsible for the development of educational strategies focused on insulin therapy in children and adolescents with diabetes, regardless of the context in which they will be deployed. This confirms their role as educators. RESUMEN Objetivo: identificar la evidencia disponible en la literatura sobre las estrategias educativas utilizadas para enseñar la terapia con insulina a niños y adolescentes con diabetes mellitus tipo 1. Método: revisión sistemática, realizada en cinco bases de datos, con los descriptores Insulina / uso terapéutico, Educación del paciente como tema, Diabetes mellitus tipo 1, Niño, Lactante, Adolescente y palabras clave, sin delimitación de períodos. Se incluyeron estudios primarios sobre la enseñanza de la terapia con insulina y se excluyó la investigación sobre la bomba de insulina. Resultados: se identificaron 243 estudios, de los cuales se incluyeron 13. Los resultados presentan estrategias educativas dirigidas a niños, adolescentes y jóvenes hasta los 24 años, aplicadas individualmente o en grupos; por contacto telefónico o mensajes de texto por teléfono celular; juegos de rol y campamentos educativos; por un solo equipo profesional o multidisciplinar. Las estrategias descritas en los estudios analizados abordaron el ajuste de la insulina en situaciones cotidianas y la educación para el manejo de la insulina, asociadas a la estrategia nutricional de conteo de carbohidratos, educación en diabetes con módulo específico sobre terapia insulínica y uso intensivo de insulina. Los estudios analizaron el efecto de la intervención educativa sobre varios resultados clínicos y conductuales, como la hemoglobina glucosilada y la autoeficacia. Conclusión: no fue posible determinar una única estrategia sobre la terapia con insulina capaz de mejorar el control metabólico y psicosocial. El desarrollo de estrategias educativas orientadas a la terapia con insulina para niños y adolescentes con diabetes, independientemente del contexto en el que se implementen, tiene, en su mayor parte, al enfermero como profesional responsable, lo que reafirma su rol educativo. RESUMO Objetivo: identificar evidências disponíveis na literatura sobre estratégias educativas utilizadas no ensino da insulinoterapia às crianças e adolescentes com diabetes mellitus tipo 1. Método: revisão sistemática, realizada em cinco bases de dados, com os descritores Insulin/therapeutic use, Patient education as topic, Diabetes mellitus type 1, Child, Infant, Adolescent e palavras-chave, sem delimitação de período. Incluídos estudos primários acerca do ensino da insulinoterapia e excluídas pesquisas sobre bomba de insulina. Resultados: identificados 243 estudos, dos quais foram incluídos 13. Os resultados apresentam estratégias educativas direcionadas às crianças, adolescentes e jovens de até 24 anos de idade, aplicadas de forma individual ou em grupos; por contato telefônico ou mensagens de texto por celular; dramatização e acampamentos educativos; por um único profissional ou equipe multidisciplinar. As estratégias descritas nos estudos analisados abordaram ajuste da insulina em situações cotidianas e educação para manejo da insulina, associados com a estratégia nutricional de contagem de carboidratos, educação em diabetes com módulo específico sobre insulinoterapia e uso da insulina de forma intensiva. Os estudos analisaram o efeito da intervenção educativa sobre diversos desfechos clínicos e comportamentais, como a hemoglobina glicada e autoeficácia. Conclusão: não foi possível determinar uma única estratégia sobre a insulinoterapia capaz de melhorar o controle metabólico e psicossocial. O desenvolvimento de estratégias educativas voltadas à insulinoterapia de crianças e adolescentes com diabetes, independentemente do contexto em que serão implementadas, tem, em sua maioria, o enfermeiro como profissional responsável, o que reafirma seu papel educador.

Aims To assess parents’ knowledge on breastfeeding, skin to skin care, and sweet solutions as neonatal analgesic strategies, and to evaluate parents’ perception on the feasibility, acceptability, and usefulness of the Portuguese version of the ‘Be Sweet to Babies’ video. Background Neonatal pain management during blood sampling is suboptimal and knowledge translation strategies are needed to improve clinical practices. The ‘Be Sweet to Babies’ video is a parent-targeted knowledge translation tool that shows the effectiveness of breastfeeding, skin to skin contact, and sweet solutions for procedural pain relief. Design Cross-sectional study. Methods Parents of infants hospitalized in an intensive care unit watched the video during their infants’ hospitalization and then answered a survey. Descriptive analyses of the data were performed. Results 100 parents were included. The majority did not know about the analgesic effects of breastfeeding (80%), skin to skin contact (69%), and sweet solutions (93%), and a limited number of parents stated their infants had received the strategies during painful procedures (7%, 11%, 2%, respectively). After watching the video, all (100%) parents intended to use or to advocate for one of the strategies; most (90%) of the parents would use any of the methods. All parents (100%) would recommend the video, and considered the video useful, easy to understand, easy to apply in real scenarios. Length of the video was considered as ideal by 92%. Conclusions The Portuguese version of the ‘Be Sweet to Babies’ video is feasible, acceptable, and useful for parental education and is a persuasive knowledge translation tool. Further studies are needed to evaluate the effects of this parent-targeted intervention on the implementation of the analgesic strategies during clinical care. This article is protected by copyright. All rights reserved.

O presente artigo tem como objetivo analisar se ha diferenca significativa quanto as caracteristicas empreendedoras entre os alunos que estudaram e os que nao estudaram a disciplina de empreendedorismo, com o intuito de identificar se os alunos que estudaram a formacao empreendedora desenvolveram tais caracteristicas. Para tanto, foi necessario a criacao de um questionario que foi validado e testado. Os testes das hipoteses foram feitos por meio de estatisticas nao parametricas que sao aplicaveis a variaveis ordinais qualitativas. Espera-se que esses resultados sejam de grande valia para auxiliar as instituicoes de ensino profissionalizante na analise do conteudo programatico da competencia, modulo ou disciplina de empreendedorismo.

To assess the reach, acceptability, and effect of the BSweet2Babies video showing breast-feeding, skin-to-skin care, and sucrose during blood sampling on intention to recommend the video or advocate for use of the interventions. In July 2014, the video and an electronic survey were produced and posted. After 1 year, the online viewer survey responses and YouTube analytics were analyzed. One year after posting, the BSweet2Babies video had 10 879 views from 125 countries and 187 (1.7%) viewers completed the survey. Most respondents were aware of the analgesic effects of breast-feeding, skin-to-skin care, and sucrose. Nearly all respondents (n = 158, 92%) found the BSweet2Babies video to be a helpful resource and 146 (84%) answered that they would recommend the video to others. After viewing the video, 183 (98%) respondents answered that they would advocate for 1 or more of the interventions. The BSweet2Babies video showing effective pain treatment during blood sampling had a large reach but a very small response rate for the survey. Therefore, analysis of acceptability and effect on intention to recommend the video and advocate for the interventions depicted are limited. Further research is warranted to explore how to best evaluate videos delivered through social media and to determine the effect of the video to promote knowledge translation into clinical practice.

This paper aims to determine whether, through Orishas and entities, holy fathers and mothers can influence the sacred and profane consumption behavior of the followers of Candomblé and Umbanda in Brazil. With a qualitative research approach, interviews were conducted with practitioners of these religions. The results indicate that holy fathers and mothers directly influence the purchase of sacred and profane by religious followers. However, this influence tends to be stronger in those followers with high involvement with religion. Those with moderate involvement, also buy and follow the guidelines of their deities and entities, if such purchases are related to the sacred aspect. The question that remains is how far these consumers are vulnerable to the guidance given by holy fathers and mothers and are aware of these purchasing choices.

Incluye contenido parcial de los autores Biological invasion is one of the main threats to native biodiversity. For a speciesto become invasive, it must be voluntarily or involuntarily introduced by humans into a nonna-tive habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this dataset, we make available occurrence and abundance data on mammal species that (1) transposeda geographical barrier and (2) were voluntarily or involuntarily introduced by humans into theNeotropics. Our data set is composed of 73,738 historical and current georeferenced recordson alien mammal species of which around 96% correspond to occurrence data on 77 speciesbelonging to eight orders and 26 families. Data cover 26 continental countries in the Neotrop-ics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Floridain the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 coun-tries of Caribbean islands. Our data set also includes neotropical species (e.g.,Callithrixsp.,Myocastor coypus,Nasua nasua)considered alien in particular areas of Neotropics. The mostnumerous species in terms of records are fromBossp. (n=37,782),Sus scrofa(n=6,730), andCanis familiaris(n=10,084); 17 species were represented by only one record (e.g., Syncerus caf-fer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of spe-cies in the data set (n=20 species), partly because of uncertainties regarding taxonomicidentification of the generaCallithrix,which includes the speciesCallithrix aurita, Callithrixflaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, andtheir hybrids. This unique data set will be a valuable source of information on invasion riskassessments, biodiversity redistribution and conservation-related research. There are no copy-right restrictions. Please cite this data paper when using the data in publications. We alsorequest that researchers and teachers inform us on how they are using the data