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Bovine parasitic otitis poses challenges in diagnosis, treatment and involves various agents, such as bacteria, fungi, mites, and nematodes. This study focused on the nematodes and bacteria isolated from the auditory canals of dairy cattle. A total of twenty samples were collected from dairy cattle in two states of Brazil. The results showed that Metarhabditis freitasi and M. costai nematodes were identified in 75% of samples. Bacterial species from the ear, identified via mass spectrometry, revealed that different strains were present in 65% of the cattle. Mycoplasma spp. were identified in 45% of samples through molecular techniques. Gram-negative bacteria and Mycoplasma spp. were exclusively found in nematode-infected cattle. Furthermore, the bacteria exhibited resistance to multiple antimicrobial classes, and demonstrating multiresistance. Electron microscopy revealed biofilm aggregates on the cuticle of Metarhabditis spp., suggesting a potential role of these nematodes in bacterial migration and interaction with nervous tissue. Thirteen bacterial strains demonstrated biofilm formation ability, indicating their potential pathogenic role. This research highlights the persistent and complex nature of parasitic otitis, emphasizing the significant role of nematode-bacteria associations in its pathogenicity. The presence of resistant strains and biofilm formation underscores the challenges in managing the diagnosis and treatment of bovine parasitic otitis.

Objective: To analyze the spatial distribution of mortality from cardiovascular diseases in the municipalities of the state of Ceará, Brazil, between 2009-2019., Methods: This is an ecological study with a spatial focus on the state of Ceará, considering the period from 2009 to 2019. Death data from the Brazilian Mortality Information System and population data from the Brazilian Institute of Geography and Statistics were used to calculate crude and standardized mortality rates from cardiovascular diseases. Temporal analysis was carried out using the Joinpoint Regression Program 4.9.0 software and spatial analysis of the municipalities' average mortality. The values were smoothed by the local empirical Bayesian method using QGIS 3.16. For spatial clusters, the Global and Local Moran Index was used through Moran Map and LISA Map, with analyses carried out in TerraView 4.2.2., Results: A total of 132,145 deaths from cardiovascular diseases were recorded in the period, with an average increase of 3% per year. Higher mortality rates were observed in men, people aged ≥80 years, mixed-race ethnicity/skin color, married, and with lower level of education. There was the formation of clusters of municipalities with high mortality rates in the regions of Vale do Jaguaribe, Sertão Central, Centro Sul, Sertão dos Inhamuns and Serra da Ibiapaba., Conclusion: This study identified municipalities with high mortality and exposed the need for strategies aligned with the reality and particularities of these locations.

Purpose: to identify a set of requirements for the development of an auditory-perceptual training simulator (APT) based on the experience of professors who provide APT., Methods: This is a cross-sectional, descriptive study with a quantitative approach. Twenty-two professors answered an online questionnaire containing 31 items related to APT, involving items about the professional profile, conditions for APT in undergraduate and postgraduate courses in Speech Therapy, APT structure, and evaluation of the APT effect., Result: it was observed that there is a variation in APT procedures performed in Brazil. The main requirements indicated by the respondents for the APT involve the use of synthesized voices in the initial moments, followed by human voices later; the use of speech tasks with sustained vowels and connected speech; the insertion of complementary information such as gender, age, the profession of the speaker and the spectrography of the vocal signal; training with a minimum time of six hours; the evaluation of the training effect by comparing intra- and inter-judge agreement before and after training; the addition of the parameters of general degree of vocal deviation, roughness, breathiness, and strain; the use of validated continuous and numerical scales; and offering it from the second year of the undergraduate program., Conclusion: although there is variability in the response of experts, a minimum set of requirements indicated for performing APT with new judges was identified.

Objective: to construe and validate a podcast for teen sexual and reproductive health education., Method: a methodological study was conducted based on Freire's perspective. The podcast was construed based on the Knowledge about Sexuality Questionnaire applied to 60 adolescents and an integrative literature review. Eleven experts conducted the validation process. Internal consistency was evaluated using Item-level Content Validity Index ≥0.78 and Cronbach's alpha ≥0.700., Results: four podcast episodes were produced with the adolescents' participation using the radio play format, addressing sex and sexuality, contraceptive methods, human immunodeficiency virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) and other sexually transmitted infections. The podcast episodes last between 8 and 11 minutes and was validated with Item-level Content Validity Index = 0.87 and Cronbach's alpha = 0.951., Conclusion: the podcast was validated for teen sexual and reproductive health education and constitutes a tool for health professional practices, particularly nurses, as well as autonomous use by adolescents., (1) Adolescents helped construct the technology. (2) Podcast is an easy-to-access, low-cost educational resource. (3) The radio play format emulates the target audience’s style and language. (4) The podcast format is little used by nursing, especially in health education. (5) The unpublished and judge-validated podcast is available for free.

Objectives: to recognize the competencies for health promotion and their magnitude of expression in undergraduate health education based on the analysis of the pedagogical projects of the courses and from the teaching perspective., Methods: research with a mixed approach, carried out at a public university. The data collected from the pedagogical projects of the Nursing and Physical Education courses and through interviews and application of a matrix of Competencies in Health Promotion with 31 professors of the referred courses were analyzed in the light of Competencies Health Promotion., Results: all competencies investigated were recognized in the curricula and reports of nursing professors, but the possibility of changes was not identified in the pedagogical project of Physical Education, although this competency was recognized as extremely important by the professors, with a mode of 4.5., Final Considerations: the training process in the courses studied has favored the development of skills for health promotion.

Athletic urinary incontinence is characterized by urinary loss during sports practice. This condition occurs in the case of CrossFit®, a modality based on high intensity training and functional movements, it can also be considered as having a high impact on the pelvic floor. This study aimed to compare the force and the contraction capacity of the pelvic floor musculature and urinary incontinence between female CrossFit® practitioners (AG) and non-practitioners (CG). We performed a cross-sectional observational study in the period from December 2018 and May 2019. Complaints of urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF); the functional evaluation of the pelvic floor was performed by digital palpation; resting tone, maximum voluntary contraction, fast contractions and sustained contraction of the pelvic floor muscles was tested by electromyography. The prevalence of urinary incontinence was significantly higher in AG compared with CG ( p < .001). Nevertheless, we did not find significant differences between the two groups for functional assessment and electromyographic parameters. The AG presented a prevalence 60% of UI, while CG only 9,5 ( p < 0,001). Considering this point, tailored prevention strategies seem mandatory in this population, in order to allow early identification and management of urinary incontinence.

Objective: To recognize the domains of competencies in promoting health in the environmental education practices performed by community health agents., Method: A mixed study, which adopted the Developing Competencies and Professional Standards for Health Promotion Capacity Building in Europe (CompHP) as a theoretical framework, conducted in Crato, Ceará, with 16 community health agents, based on semi-structured interviews and data organization through the ALCESTE software., Results: The following domains of competencies in health promotion were evidenced: partnership, possibility of changes, and diagnosis. We recognize evidence signaling other domains, although with less statistical significance, such as: communication, planning and implementation, with a view to developing environmental education activities., Final Considerations: There is a mobilization of a limited number of health promotion competences in the environmental education practices developed by community health agents, which requires the wholeness of these elements to implement health promotion practices and, thus, positive transformations on the environment and health.

Hoplias malabaricus (Characiformes, Erythrinidae), trahira, is a neotropical freshwater fish of economic and public health significance. A total of 45 specimens of H. malabaricus commercialized in the municipality of Magé, state of Rio de Janeiro, Brazil, were acquired between April 2016 and April 2018 to investigate the presence of nematode larvae. Twenty of the fish were found parasitized by 347 fourth-stage nematode larvae identified taxonomically as Eustrongylides sp. using morphological, morphometric and molecular data. The parasitic indices were: prevalence 44.44%, mean intensity 17.35, mean abundance 7.71, and range of infection 2-40. Infection sites were musculature, mesentery, abdominal cavity, and serosa of intestine, stomach and liver. This is the first report of Eustrongylides sp. larvae parasitizing H. malabaricus in the state of Rio de Janeiro.

Objective: To evaluate the social representations of residents regarding the pedagogical strategies of a Multiprofessional Health Residency program., Method: A case study with a qualitative approach supported by the Theory of Social Representations. Data collection was performed by applying a questionnaire to the resident professionals. ALCESTE software was used for the lexical content analysis., Results: Questionnaires were applied to 15 resident professionals. The analysis showed the educational potential of a Distance Education tool, the need to prioritize theoretical content and its planning, aligning it with the experience in the territory, and the preference of the subjects for dynamic spaces that favor communication and critical-reflective analysis of day-to-day routines., Conclusion: There is a need to value strategies and teaching-learning methodologies that are significant for the resident professional and which contribute to health education.

The National Program for Access and Quality Improvement in Primary Care (Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica, PMAQ-AB) aimed to improve healthcare public service quality and satisfaction of health service users. This study's objective was to identify the main factors influencing user satisfaction with primary care (PC) services by region in Brazil. Using secondary data from the 1st Cycle of PMAQ-AB, logistic regression models were developed by region, with user satisfaction as the dependent variable, as defined by cluster analysis. Based on the obtained models, the health unit's ability to solve users' problems and feeling respected by the health providers were the most important factors for user satisfaction in all regions in Brazil. However, other important factors by region included the following: the health unit's hours of operation meeting the user's needs (Northeast); providers asking about family members (North); providers asking about other health needs (Midwest); users being seen without an appointment (South); and users asking questions after the appointment (Southeast). In conclusion, the factors influencing user satisfaction with PC vary according to region and are mainly associated with access quality, meeting users' needs, and work process organization.