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Background: Injuries resulting from surgical positioning are preventable, yet they remain prevalent, causing temporary or permanent harm, extending hospital stays, and increasing the risk of hospital-acquired infections. Identifying patients at risk for these injuries is critical. This study aimed to assess the risk of developing surgical positioning injuries in orthopedic surgeries within teaching hospitals. Methods: This cross-sectional study was conducted between February and July 2023 in two teaching hospitals in Brazil. It involved a convenience sample of 147 patients who underwent orthopedic surgery. The study used the Risk Assessment Scale for the Development of Injuries Due to Surgical Positioning. Data analysis was performed using SPSS software, version 21, with the Chi-squared test applied to assess significance at the 0.05 level. Results: Most participants were male (51.70%), with a mean (±SD) age of 54.52±20.34 years. Of the total sample, 85% were at low risk of developing injuries. Women were three times more likely to be at high risk (OR=3.39, 95% CI=1.24 to 9.24). The presence of comorbidities increased the likelihood of high risk approximately sixfold (OR=5.56, 95% CI=2.06 to 15.57). Spinal anesthesia increased the likelihood of high risk fourfold (OR=4.08, 95% CI=1.14 to 14.53). Conclusion: Identifying risk factors allows for a more targeted approach to preventing surgical positioning injuries. Incorporating this knowledge into the development of institutional protocols is essential for improving patient safety and outcomes.

ABSTRACT Objective: To analyze the reach and engagement on the history of nursing on social media of the Memory Center of the School of Nursing, Federal University of Minas Gerais (CEMENF/UFMG), in light of Pierre Lévy. Methods: Documentary study carried out on CEMENF’s Instagram and on the YouTube of the School of Nursing of UFMG, from September to December 2021. The findings were analyzed according to Pierre Lévy’s concepts. Results: Publications on social media, in the years 2020 and 2021, resulted in an average of 6.79 feed posts and 1.42 Reels on Instagram, with an average of 25.54 comments on feed posts and 512.17 views on Reels. As for YouTube, an average of 1.58 posts was observed, with 2164.08 views and 101.58 likes. Conclusions: Cyberspace can be a powerful instrument for bringing university museums closer to society and for disseminating extension and research projects.

Abstract The nasal cavity of living mammals is a unique structural complex among tetrapods, acquired along a series of major morphological transformations that occurred mainly during the Mesozoic Era, within the Synapsida clade. Particularly, non-mammaliaform cynodonts document several morphological changes in the skull, during the Triassic Period, that represent the first steps of the mammalian bauplan. We here explore the nasal cavity of five cynodont taxa, namely Thrinaxodon, Chiniquodon, Prozostrodon, Riograndia, and Brasilodon, in order to discuss the main changes within this skull region. We did not identify ossified turbinals in the nasal cavity of these taxa and if present, as non-ossified structures, they would not necessarily be associated with temperature control or the development of endothermy. We do, however, notice a complexification of the cartilage anchoring structures that divide the nasal cavity and separate it from the brain region in these forerunners of mammals.

Scientific evidence on loneliness shows that this feeling can act as a decisive negative factor in maintaining health. In this sense, an editorial on the subject stated that the damage to health is clear and associated loneliness with an increased risk of cardiovascular diseases, hypertension, diabetes, infectious diseases, impaired cognitive function, depression and anxiety. The editorial also highlighted that this is an issue that requires society's attention and, as a result, a committee was created to study loneliness and social isolation.(1) Due to the evidence of the harm it can cause or worsen, loneliness has become one of the major health concerns in the 21st century. As a result, initiatives have been developed and the governments of the United Kingdom and Japan created Ministries of Loneliness in 2018 and 2021, respectively.(2) Also, a health authority in the United States showed the consequences of insufficient connection for physical health and highlighted a 29% higher risk of heart disease, a 32% higher occurrence of stroke and a 50% higher chance of developing dementia in older people. In addition, it estimated that the lack of social connection increases the risk of premature death by more than 60%.(3) . . .

The Amazonian region covers a significant part of the South American continent and harbors outstanding biodiversity. However, much of its history is still unknown. This situation has begun to change with paleontological field efforts over the last decades, which have been proving that fossils can be common in this region. Despite their great current species richness and abundance in the area today, marsupials have a sparse fossil record, restricted to a few specimens from handful Cenozoic Amazonian localities. Here we present new records of fossil marsupial teeth from the Solimões Formation (lower Eocene–Pliocene), on the Juruá and Envira riverbanks (Acre, Northwestern Brazil). The localities investigated yield at least four distinct didelphid didelphimorphians at PRE 06 (Ponto Rio Envira: Marmosini ?Marmosa sp., Didelphis cf. D. solimoensis, Thylamys? colombianus, plus unidentified didelphids), and two paucituberculatans from the Juruá River localities (Ponto Rio Juruá: the palaeothentid Palaeothentinae indet. at PRJ 25 and PRJ 33’, and Abderitidae indet. from PRJ 33). In agreement with the associated mammalian faunas, most of the didelphids, except for Thylamys? colombianus from PRE 06, indicate a (?early) Late Miocene age for this locality. Conversely, the abderitid specimens found in situ at PRJ 33 would match a Middle Miocene age. The palaeothentids found at PRJ 25 and PRJ 33’ localities cannot be considered for biostratigraphic inferences, since they were found outside a stratigraphic context. Nevertheless, these paucituberculatans considerably add to our knowledge, as they are the first ever recorded in Brazilian Amazonia.

Introdução: A sífilis é uma infeção de notificação obrigatória, maioritariamente transmitida por via sexual, causada pela bactéria Treponema pallidum. As manifestações clínicas variam conforme o estadio da doença: sífilis precoce (doença primária e secundária) e sífilis tardia (latente ou terciária). A doença secundária é sistémica e desenvolve-se, após semanas ou meses, em aproximadamente 1/4 dos indivíduos com infeção primária não tratada. Neste estadio, a doença pode manifestar-se através de sintomas constitucionais, adenopatias, erupções cutâneas maculopapulares palmoplantares, manifestações hepáticas, renais ou neurológicas, entre outras. A serologia fornece um diagnóstico presuntivo, sendo necessários testes não treponémicos e treponémicos para estabelecer o diagnóstico de sífilis. A difícil interpretação dos achados serológicos associada a uma grande variedade de manifestações clínicas e a uma incidência crescente nos últimos anos torna o seu diagnóstico um desafio. Descrição do caso: Os autores descrevem o caso clínico de um adulto que apresenta um quadro de edema inaugural dos membros inferiores, cansaço e noção de distensão abdominal. Objetivamente apresenta lesões maculopapulares eritematosas, com descamação periférica, não pruriginosas, nas palmas das mãos e plantas dos pés. Após entrevista clínica completa coloca-se a hipótese de descompensação de doença hepática em contexto de sífilis secundária/hepatite sifilítica e envia-se o doente ao serviço de urgência, onde é confirmada a infeção. Comentário: Este caso demonstra que a grande variedade de manifestações clínicas torna o diagnóstico de sífilis um desafio. Uma vez feito o diagnóstico deve ser instituído tratamento com dose única de penicilina intramuscular, evitando potenciais consequências graves decorrentes da doença sistémica. Em suma, um médico de família deve ser capaz de reconhecer esta infeção, interpretando corretamente os testes serológicos e instituindo o tratamento recomendado.

ABSTRACT Objective: To analyze the prevalence and factors associated with external causes in elderly people attended by the mobile emergency care service. Method: Cross-sectional study with 1,972 pre-hospital care records of elderly victims of external causes from 2019 to 2020. A descriptive and bivariate analysis was performed, with a significance level of 5% (p

One of the main “databases”, on which palaeontologists carry on their studies, is constituted by palaeontological collections. These collections are the final result of fieldwork and surveys, sampling activities, preparation and curatorial processes, and analyses. However, the content of a palaeontological collection can also be strongly biased, leading researchers to post-collection skewed results. Post-collection biases (e.g., breakage, loss of fragments, etc.) are directly linked to human activities, occurring during excavation, transport, preparation, and storage. Here, we present the case of the vertebrate remains from the Brazilian lower Carnian Santacruzodon Assemblage Zone (Santa Cruz Sequence, Santa Maria Supersequence, Paraná Basin). The studied specimens came from the Schoenstatt Sanctuary fossil site, a key outcrop for both the sequence and Santacruzodon AZ. We evaluated vertebrate remains from three Brazilian scientific collections, compiled through more than 25 years of fieldwork. The specimens housed in the three collections present high degrees of post-collection fragmentation, as well as significant differences in the bone elements present, when comparing cranial vs. post-cranial elements. Moreover, some differences in curatorial attitude have also been noticed, especially in restoration choices, leading to “discrimination” in post-collection fossil quality and highlighting the existence of the “craniocentrism” problem.

Objective: to analyze the prevalence of traffic accidents attended at an urgent and emergency referral hospital, in the context of the COVID-19 pandemic. Methods: cross-sectional study with a sample of 364 adult victims of traffic accidents, aged between 18 and 60 years, of both sexes. A sociodemographic characterization form and accident characteristics were used to collect data. The variables were analyzed using descriptive statistics, bivariate analysis, and Fisher's Exact test, with a significance level of 5% (p

Resumo Objetivo Identificar as evidências científicas sobre os cuidados de enfermagem à pessoa idosa em instituição de longa permanência no contexto da pandemia covid-19. Método Trata-se de revisão de escopo baseada nas orientações do Manual para Revisões do Joanna Briggs Institute (JBI). A formulação da questão ocorreu a partir do acrônimo PCC, em que o “P” correspondeu a “pessoa idosa”, o “C” a “cuidados de enfermagem” e o “C” a “covid-19”. A busca das evidências cientificas foi realizada nas bases de dados LILACS, MEDLINE®, CINAHL® e Web of ScienceTM. Foram analisados artigos recuperados ao se empregar os descritores controlados e não controlados, e aqueles provenientes da literatura cinzenta, sites e repositórios. A análise deu-se por estatística descritiva e crítica dos estudos. Resultados A amostra final do estudo foi composta por 14 evidências cientificas. Verificou-se que a maioria das produções pertenciam a modalidade relatório técnico (35,7%) publicadas no Brasil (64,28%). Os cuidados de enfermagem foram organizados em: intervenções gerenciais; intervenções educacionais; intervenções assistenciais em especial aquelas voltadas à prevenção e controle da disseminação do SARS-CoV-2, residentes com quadro suspeito ou confirmado de covid-19 e ao corpo em caso de óbito; intervenções voltadas a facilitar a comunicação entre os residentes e seus familiares/amigos e entre esses e o enfermeiro; além de intervenções de apoio emocional aos profissionais/cuidadores e aos residentes. Conclusão Diante da pandemia covid-19, os cuidados de enfermagem são imprescindíveis para prevenir e controlar a disseminação do SARS-CoV-2.

Objetivo: analizar los efectos de las tecnologías educativas en la prevención y tratamiento de la úlcera diabética. Método: revisión sistemática realizada en siete bases de datos, un índice bibliográfico, una biblioteca electrónica y literatura gris. La muestra estuvo compuesta por 11 ensayos clínicos controlados aleatorizados. La síntesis de los resultados fue descriptiva y mediante metaanálisis. Resultados: las tecnologías educativas predominantes fueron la capacitación y la orientación verbal, se destacaron las tecnologías blandas-duras. En comparación con la atención habitual, las tecnologías educativas demostraron ser un factor protector para prevenir la incidencia de úlcera diabética (RR=0,40; IC 95%=0,18-0,90; p=0,03) y la evaluación de certeza de evidencia fue baja. Las tecnologías educativas también demostraron ser un factor protector para prevenir la incidencia de amputación en miembros inferiores (RR=0,53; IC 95%=0,31-0,90; p=0,02) y la certeza de evidencia fue muy baja. Conclusión: tecnologías educativas blandas-duras, como orientación verbal estructurada, juegos educativos, clase expositiva, capacitación teórico-práctica, video educativo, folder, rotafolio educativo y dibujos lúdicos, y tecnologías duras, como calzado terapéutico, plantillas, termómetro infrarrojo digital, kits para el cuidado de los pies, aplicación de telemedicina y teléfono móvil, resultaron efectivas para la prevención y el tratamiento de la úlcera diabética, sin embargo, es necesario que se realicen estudios más robustos.

Resumo Objetivo Construir e validar uma história em quadrinhos para adolescentes sobre reanimação cardíaca. Métodos Estudo metodológico de abordagem quantitativa realizado em três fases: 1) revisão integrativa, 2) identificação das necessidades de aprendizagem (mediante inquérito transversal com 84 adolescentes) e 3) construção e validação de storyboard feito sob considerações da Teoria da Aprendizagem Significativa. A história obedeceu aos seis passos do quadrinista Mccloud, e foi validada por 23 juízes que julgaram os quadrinhos pelo Instrumento de Validação de Conteúdo Educacional em Saúde. Utilizou-se o Índice de Validade de Conteúdo e o Teste Binomial para verificar se a proporção de concordância foi, estatisticamente, igual ou superior a 80%. Resultados A revisão integrativa justificou ser necessária a construção de tecnologias educacionais sobre Suporte Básico de Vida. Os 84 adolescentes apontaram necessidade de aprendizagem sobre os três primeiros elos de atendimento a uma parada cardíaca. A tecnologia trouxe, na narrativa da personagem Dara, instruções para aplicar Suporte Básico de Vida somente com as mãos em vítimas de Parada Cardíaca. Na validação, 17 (dezessete) dos 18 (dezoito) itens avaliados receberam nota máxima, a avaliação global da tecnologia obteve o valor 0,99. Conclusão Os juízes consideraram válida a tecnologia educacional do tipo história em quadrinhos para ensinar reanimação cardiopulmonar.

Resumo Objetivo Caracterizar a proficiência digital e a aprendizagem de estudantes de enfermagem sobre a história das entidades de classe da enfermagem brasileira. Métodos Estudo exploratório-descritivo, transversal, realizado no curso de bacharelado em enfermagem, de três campi de uma instituição de ensino superior pública federal do Nordeste brasileiro. Aplicou-se, de novembro de 2020 a maio de 2021, questionário, via Google Forms, aos estudantes de enfermagem regularmente matriculados no segundo e terceiro períodos do curso. Realizou-se a análise estatística descritiva e inferencial. Resultados Participaram 56 estudantes de enfermagem, sendo 55,4% vinculados ao campus 1; 53,6% cursavam o terceiro semestre; 83,9% do sexo feminino; média idade de 20,55 (+3,32) anos; 55,4% pardos; 94,6% sem vínculo empregatício; 73,2% residindo com os pais; 92,9% com renda familiar mensal equivalente a três salários-mínimos. O grau de proficiência digital básico médio foi considerado baixo. Quanto às tecnologias digitais no ensino e à aprendizagem sobre história das entidades de classe, 62,5% acreditaram que contribuiria para aprendizagem, além do espaço da sala de aula, e facilitaria o acesso aos conteúdos; e 78,6% consideraram importante para desenvolver o senso crítico-reflexivo e a conscientização sobre a participação nessas entidades. Evidenciaram fundamental conhecer história da criação, contribuições, lutas, desafios e primeiras diretoras da Associação Brasileira de Enfermagem, além da criação dos Conselhos Federal e Regionais de Enfermagem e das respectivas atribuições. Conclusão As ações de ensino-aprendizagem, mediadas por tecnologias digitais, precisam considerar as competências digitais e os interesses dos estudantes na aprendizagem remota sobre história das entidades de classe da enfermagem.

Objetivo: identificar os tipos de intervenções educativas existentes e ou utilizadas em adolescentes com risco para síndrome metabólica. Método: trata-se de revisão integrativa nas seguintes bases: MEDLINE, CINAHL, Embase, Web of Science e LILACS, BDENF e Ibecs. A busca por referência cruzadas também foi realizada, a partir dos descritores: Adolescent, Health Education, Risk Factors e Metabolic Syndrome. Resultados: dezenove artigos ​​foram identificados, revisados, sintetizados e analisados ​criticamente, sendo que os tipos de intervenções educativas para público-alvo foram as não medicamentosas e as medicamentosas e ou orientações no estilo de vida. Considerações finais: os resultados da revisão mostraram que as intervenções educativas, sejam elas medicamentosas ou não medicamentosas, associadas às orientações no estilo de vida, demostraram melhorias nos cinco fatores determinantes da síndrome metabólica e em outros não determinantes, influenciando diretamente a saúde e o bem-estar dos adolescentes.

Objetivo: analizar el perfil sociodemográfico y la situación de cuidado de los adultos mayores dependientes y sus cuidadores familiares en Brasil y Colombia. Método: investigación comparativa mixta y de tipo exploratorio, la cual sigue las fases de estudios comparativos propuestos por Bereday: descripción, interpretación, yuxtaposición y comparación. Se utilizó una entrevista semiestructurada. Se tuvieron en cuenta los principios éticos nacionales e internacionales dentro del estudio, con la aprobación de cada comité de ética en cada país. Resultados: fueron entrevistados 250 participantes: 52 adultos mayores dependientes en Brasil y 56 en Colombia, y 70 cuidadores familiares en Brasil y 72 en Colombia. El 68,5 % de los adultos mayores y el 83,8 % de los cuidadores eran mujeres. Se construyeron doce categorías a partir del discurso de los participantes, seis en los adultos mayores dependientes y seis en los cuidadores. Conclusión: hubo predominio de las mujeres e hijas como la mayoría de las cuidadoras familiares, así como la religión católica como la más prevalente en ambos países. Respecto a la situación de cuidado, en ambos países destaca que los adultos mayores dependientes y los cuidadores familiares sienten la presencia de un ser superior ayudándolos a superar los desafíos en las actividades de cuidado.

Objetivo: mapear os protocolos clínicos para atenção a idosos vítimas de violência. Métodos: revisão de escopo desenvolvida nas seguintes bases de dados/bibliotecas/buscadores: Biblioteca Virtual em Saúde, PubMed; Web of Science e Portal de Teses e Dissertações da CAPES. As buscas foram conduzidas por meio descritores constantes no MeSH e no DeCS, combinados com os operadores booleanos AND e OR. Resultados: foram selecionados nove artigos. Verificou-se iniciativas pontuais de protocolos estaduais e municipais, bem como a necessidade de constante atualização dos profissionais de saúde para o manejo e abordagem dos casos de violência contra o idoso. Considerações finais: a escassa quantidade de protocolos para a atenção a pessoa idosa vítima de violência deixa claro a necessidade da condução de pesquisa metodológicas para a elaboração e validação de protocolo, destinados a especificidade de atuação de diferentes profissionais que possam atuar frente a violência, possibilitando assim o trabalho baseado em evidências.

ABSTRACT Objective: To analyze the contributions of the Brazilian Nursing Association and the Federal and Regional Nursing Councils in the literature for the professionalization of nursing in the light of Eliot Freidson’s theoretical conceptions. Methods: Integrative review of the literature, of socio-professional historical interest, carried out from June to November 2021, through the question: How did professional associations contribute to the professionalization of Brazilian nursing according to the literature from 2010 to 2020? The evidence were organized in a synoptic table, which allowed the construction of a conceptual map. Results: In the 23 selected studies, the professional associations presented scientific, social and political contributions, which shape the professional field of nursing, enabling knowledge/expertise, autonomy and self-regulation. Final considerations: The efforts of these institutions reaffirm nursing as an academic and consulting profession, capable of exerting control over the essence of nursing work. They strive to consolidate nursing as a legitimate professional field of health in Brazil.

ABSTRACT Objective Translate and culturally adapt the Hospital Emergency Suitability Protocol (HESP) to Brazilian Portuguese. Method Methodological study, developed from 2019 to 2021, in an emergency hospital, and which followed the stages of translation, synthesis of translations, back-translation, review by an expert committee, pre-test and submission to the authors of the protocol. The sample included four translators, five experts, who assessed conceptual, semantic, cultural, and idiomatic equivalence, 21 nurses and nine physicians, who participated in the pre-test. Content Validity Index (CVI), Cronbach’s alpha and Kendall’s coefficient of concordance were used. Results The final version of the adaptation presented Content Validity Index that ranged from 0.40 to 1.0. The internal consistency, according to Cronbach’s alpha coefficient, showed Semantic Equivalence (α=0.815), Idiomatic Equivalence (α=0.924), Experiential Equivalence (α=0.682), Conceptual Equivalence (α=0.71), which presented acceptable values, except for the experiential equivalence. Kendall W’s coefficient (W=0.14 to 0.58) revealed good reliability. Conclusion The translation and cultural adaptation process of the HESP originated an instrument applicable to the Brazilian context.

Summary: Background: Recent evidence indicates a potential therapeutic role of fluvoxamine for COVID-19. In the TOGETHER trial for acutely symptomatic patients with COVID-19, we aimed to assess the efficacy of fluvoxamine versus placebo in preventing hospitalisation defined as either retention in a COVID-19 emergency setting or transfer to a tertiary hospital due to COVID-19. Methods: This placebo-controlled, randomised, adaptive platform trial done among high-risk symptomatic Brazilian adults confirmed positive for SARS-CoV-2 included eligible patients from 11 clinical sites in Brazil with a known risk factor for progression to severe disease. Patients were randomly assigned (1:1) to either fluvoxamine (100 mg twice daily for 10 days) or placebo (or other treatment groups not reported here). The trial team, site staff, and patients were masked to treatment allocation. Our primary outcome was a composite endpoint of hospitalisation defined as either retention in a COVID-19 emergency setting or transfer to tertiary hospital due to COVID-19 up to 28 days post-random assignment on the basis of intention to treat. Modified intention to treat explored patients receiving at least 24 h of treatment before a primary outcome event and per-protocol analysis explored patients with a high level adherence (>80%). We used a Bayesian analytic framework to establish the effects along with probability of success of intervention compared with placebo. The trial is registered at ClinicalTrials.gov (NCT04727424) and is ongoing. Findings: The study team screened 9803 potential participants for this trial. The trial was initiated on June 2, 2020, with the current protocol reporting randomisation to fluvoxamine from Jan 20 to Aug 5, 2021, when the trial arms were stopped for superiority. 741 patients were allocated to fluvoxamine and 756 to placebo. The average age of participants was 50 years (range 18–102 years); 58% were female. The proportion of patients observed in a COVID-19 emergency setting for more than 6 h or transferred to a teritary hospital due to COVID-19 was lower for the fluvoxamine group compared with placebo (79 [11%] of 741 vs 119 [16%] of 756); relative risk [RR] 0·68; 95% Bayesian credible interval [95% BCI]: 0·52–0·88), with a probability of superiority of 99·8% surpassing the prespecified superiority threshold of 97·6% (risk difference 5·0%). Of the composite primary outcome events, 87% were hospitalisations. Findings for the primary outcome were similar for the modified intention-to-treat analysis (RR 0·69, 95% BCI 0·53–0·90) and larger in the per-protocol analysis (RR 0·34, 95% BCI, 0·21–0·54). There were 17 deaths in the fluvoxamine group and 25 deaths in the placebo group in the primary intention-to-treat analysis (odds ratio [OR] 0·68, 95% CI: 0·36–1·27). There was one death in the fluvoxamine group and 12 in the placebo group for the per-protocol population (OR 0·09; 95% CI 0·01–0·47). We found no significant differences in number of treatment emergent adverse events among patients in the fluvoxamine and placebo groups. Interpretation: Treatment with fluvoxamine (100 mg twice daily for 10 days) among high-risk outpatients with early diagnosed COVID-19 reduced the need for hospitalisation defined as retention in a COVID-19 emergency setting or transfer to a tertiary hospital. Funding: FastGrants and The Rainwater Charitable Foundation. Translation: For the Portuguese translation of the abstract see Supplementary Materials section.

ABSTRACT Objective: to analyze the available evidence in the nursing literature about financial-patrimonial elder abuse. Method: integrative review of articles indexed in the databases CINAHL, Scopus, Web of Science, LILACS and MEDLINE, from 2007 to 2017. The combination of controlled and uncontrolled descriptors was used in Portuguese, English and Spanish. Results: 15 studies developed in seven countries were included. In the thematic analysis, three categories emerged: epidemiological data, risk factors and institutions providing services to the elderly. The occurrence of this type of violence concomitantly to the other subtypes was highlighted among the most frequent. Final considerations: the literature points to important epidemiological data, risk factors and characteristics of this type of violence, including within institutions providing services to the elderly, in different countries, essential aspects for structuring and rethinking public policies for protection and appreciation of the elderly.

ABSTRACT Objective: to evaluate, in emergency hospital service and at home, the functional independence of elderly people who fell. Method: longitudinal study with 151 elderly. Functional Independence Measure (FIM) was used. Statistical tests were performed with univariate and bivariate analysis. Results: mean of total FIM value in the hospital was 70.4; and at home 84.3 (p

Hypsodonty is a durable pattern of dentition seen in mammals with abrasive diets. Here, Melo and colleagues describe new fossils of the stem-mammal Menadon besairiei from the Late Triassic, which show the convergent evolution of hypsodonty before mammals.

Resumo Objetivo: Avaliar a qualidade de vida de pessoas com feridas crônicas. Métodos: Estudo transversal realizado com 176 pessoas com feridas crônicas em acompanhamento ambulatorial e domiciliar em um serviço público de saúde. Foram utilizados: formulário para a caracterização sociodemográfica, clínica e terapêutica e o questionário Cardiff Wound Impact Schedule para a mensuração da qualidade de vida. As análises foram descritivas e inferenciais empregando-se os testes t de Student, ANOVA, Mann Whitney e Kruskal-Wallis. Resultados: Dentre as pessoas acompanhadas em domicílio, predominaram lesões de origem vasculogênicas, com tempo de existência superior a 12 meses e área de até 25 cm2. No ambiente ambulatorial, prevaleceram feridas vasculogênicas e traumáticas, com tempo máximo de seis meses e extensão de até 25 cm2. Os fatores clínicos associados à qualidade de vida foram: tempo de duração da lesão, etiologia da lesão, grande extensão, aspecto do exsudato, presença de odor e de dor. O domínio de QV “bem-estar” apresentou maior impacto negativo decorrente da presença de lesão. Conclusão: Os fatores clínicos influenciaram diretamente os domínios de QV, sendo necessária a utilização de estratégias diferenciadas com o intuito de reduzir o impacto na QV por se tratarem de aspectos que poderiam ser atenuados ou evitados mediante a avaliação da lesão e a escolha do tratamento adequado.

Abstract Background The mosquito Anopheles (Kerteszia) cruzii is the main vector of human and simian malaria in the Atlantic Forest. This species is usually abundant in the forests where it occurs, preferring to live and feed on canopies, behaviour known as acrodendrophily. However, in several studies and locations this species has been observed in high density near the ground in the forest. In this study, it was hypothesized that factors associated with anthropogenic landscape changes may be responsible for the variation in abundance and acrodendrophily observed in An. cruzii. Methods The study was conducted in a conservation unit in the city of São Paulo, Brazil. Monthly entomological collections were performed from March 2015 to April 2017, and the resulting data were used with data from another study conducted in the same area between May 2009 and June 2010. Mosquitoes were collected from five sites using CDC and Shannon traps. Landscape composition and configuration metrics were measured, and generalized linear mixed-effect models were used to investigate the relationship between these metrics and variations in the abundance and acrodendrophily of An. cruzii. Results The model that showed the best fit for the relationship between landscape metrics and An. cruzii abundance suggests that an increase in the proportion of forest cover leads to an increase in the abundance of this mosquito, while the model that best explained variations in An. cruzii acrodendrophily suggests that an increase in total forest-edge length leads to greater activity by this species at ground level. Conclusion While the data indicate that changes in landscape due to human activities lead to a reduction in An. cruzii abundance, such changes may increase the contact rate between this species and humans living on the edges of forest fragments where An. cruzii is found. Future studies should, therefore, seek to elucidate the effect of these landscape changes on the dynamics of Plasmodium transmission in the Atlantic Forest, which according to some studies includes the participation of simian hosts.

RESUMO Objetivo Analisar os fatores associados ao risco de pé diabético em pessoas com diabetes mellitus atendidas na Atenção Primária. Método Estudo observacional, analítico e transversal realizado em Teresina, Piauí, com pessoas diabéticas atendidas na Atenção Primária. A coleta de dados ocorreu mediante entrevista, exame clínico dos pés e análise do prontuário. Os dados foram analisados utilizando os testes estatísticos Mann-Whitney, Qui quadrado de Pearson e regressão logística múltipla. A força de associação entre as variáveis categóricas foi aferida pela Odds Ratio . Resultados Participaram 322 pessoas. A situação conjugal com companheiro apresentou fator de proteção (p = 0,007). A hipertensão arterial (p = 0,045), obesidade (p = 0,011), tabagismo (p = 0,027), não ter sido submetido ao rastreamento (p = 0,046), o controle inadequado da glicemia capilar (p < 0,001), a não disposição para cuidar dos pés (p = 0,014) e a não realização do autoexame dos pés com frequência (p = 0,040) se mostraram fatores de risco para o desenvolvimento do pé diabético. Conclusão Os aspectos sociodemográficos, clínicos e autocuidado interferem no risco de desenvolvimento do pé diabético, destacando a necessidade do rastreamento e de intervenções educativas eficientes para pessoas com diabetes mellitus na Atenção Primária.

Abstract Recently, the morphology and encephalization of the brain endocast of the Triassic non-mammaliaform probainognathian cynodont Riograndia guaibensis were studied. Here, we analyzed the brain endocast of an additional specimen of this species. The new endocast shows well-defined olfactory bulbs and a median sulcus dividing the hemispheres, traits that were not clearly observed in the first studied specimen. Encephalization quotients were also calculated, revealing similar values to other non-mammaliaform cynodonts and lower than those of the first analyzed specimen. The analyzed cranium is slightly larger than the first studied one and may represent an advanced ontogenetic stage. Hence, these differences may be related to the intraspecific variation of this cynodont or alternatively, to the preservation of each specimen.

ABSTRACT Objective: to identify how health technologies contribute to risk assessment for suicidal behavior. Methods: an integrative review carried out on the MEDLINE, CINAHL, Web of Science, SCOPUS, LILACS and BDENF databases. The sample consisted of 12 primary studies, with no temporal or language delimitation. Analysis of results occurred descriptively. Results: the technologies included assistance and teaching aspects favorable to data screening, monitoring and navigation, capable of predicting individual, biological, clinical, psychological, environmental and social markers for suicidal behavior. Thus, measurement scale, software and computational algorithms constituted valid and sensitive instruments for improving performance, expanding skills and knowledge, good care practices, effective communication and assistance planning. Conclusion: the identified technologies proved to be effective in identifying risk states for suicidal behavior, representing effective resources for directing care and necessary interventions.

Plasmodium malariae and Plasmodium vivax are protozoan parasites that can cause malaria in humans. They are genetically indistinguishable from, respectively, Plasmodium brasilianum and Plasmodium simium, i.e. parasites infecting New World non-human primates in South America. In the tropical rainforests of the Brazilian Atlantic coast, it has long been hypothesized that P. brasilianum and P. simium in platyrrhine primates originated from P. malariae and P. vivax in humans. A recent hypothesis proposed the inclusion of Plasmodium falciparum into the transmission dynamics between humans and non-human primates in the Brazilian Atlantic tropical rainforest. Herein, we assess the occurrence of human malaria in simians and sylvatic anophelines using field-collected samples in the Capivari-Monos Environmental Protection Area from 2015 to 2017. We first tested simian blood and anopheline samples. Two simian (Aloutta) blood samples (18%, n = 11) showed Plasmodium cytb DNA sequences, one for P. vivax and another for P. malariae. From a total of 9,416 anopheline females, we found 17 pools positive for Plasmodium species with a 18S qPCR assay. Only three showed P. cytb DNA sequence, one for P. vivax and the others for rodent malaria species (similar to Plasmodium chabaudi and Plasmodium berghei). Based on these results, we tested 25 rodent liver samples for the presence of Plasmodium and obtained P. falciparum cytb DNA sequence in a rodent (Oligoryzomys sp.) liver. The findings of this study indicate complex malaria transmission dynamics composed by parallel spillover-spillback of human malaria parasites, i.e. P. malariae, P. vivax, and P. falciparum, in the Brazilian Atlantic forest.

Justificativa e Objetivo: analisar o Golden time desenvolvido pelo serviço de atendimento móvel de urgência - SAMU da cidade de Floriano em situações clínicas, traumáticas e cirúrgicas. Métodos: trata-se de um estudo documental, descritivo com abordagem quantitativa realizado na base descentralizado do SAMU de Floriano – PI, no período compreendido entre fevereiro e março de 2019. Resultados: o Golden time mais frequentemente desenvolvido pelo SAMU foi de 15 a 30 minutos. O que se verificou em 58,50% dos casos. As urgência/emergência clínicas em adultos foram os tipos de eventos mais comumente atendidos (35,50%). Conclusão: em Floriano- o SAMU tem sido eficiente naquilo que se refere a atendimentos aos casos de trauma originados de acidentes automobilísticos.

ABSTRACT Objective: to build and validate educational video for elderly individuals about fall risks. Methods: methodological study with video building. validated by 22 judges and assessed by 22 elderly individuals. Content was selected from the Fall Prevention Model and items from the Falls Risk Awareness Questionnaire. Items with an agreement greater than 0.80 were considered valid. verified through Content Validation Index (CVI) and binomial test. Results: building the video was guided by the Cognitive Theory of Multimedia Learning. Digital animation and audio narration were used. It lasted ten minutes and five seconds and included biological. socioeconomic. behavioral and environmental risks as well as precautions to avoid them. The CVI of judges had an average of 0.99. and of elderly individuals. an average of 1.0. Conclusion: the video was built and validated for content and understanding and can be used to prevent falls in elderly individuals.

DOI: https://doi.org/10.26694/reufpi.v3i1.1811 A Associação Brasileira de Enfermagem (ABEn) comemora, neste ano, 75 anos que realiza a Semana Brasileira de Enfermagem (SBEn), evento que propicia a socialização do conhecimento e a discussão da prática profissional da categoria. Acredita-se terem sido os debates e as reflexões acerca de questões emergentes na profissão uma das razões para a realização em 1940, da 1ª Semana de Enfermagem por enfermeiras da Escola de Enfermagem Anna Nery. Até 1958, esse evento denominou-se Semana da Enfermeira, sendo o primeiro, dessa natureza, que se tem registro na categoria. Em 1960 o Presidente Juscelino Kubitschek oficializou a semana por meio do Decreto Federal nº 48.202, estabelecendo o período de 12 a 20 de maio para a Semana da Enfermagem. No entanto, o dia 12 de maio já tinha sido reconhecido como Dia do Enfermeiro, pelo Decreto Federal n.º 2.956, assinado pelo então Presidente Getúlio Vargas em 10 de agosto de 1938 (1). A partir da década de 1960, anualmente, a SBEn vem discutindo, em todo o território nacional, questões que preocupam a categoria, por meio de atividades científicas e culturais e neste ano de 2014 adotou como eixo temático “Protagonismo da enfermagem no processo de cuidar”. Ressalta-se que nestas quase oito décadas a enfermagem brasileira avançou muito, considerando-se ter ocorrido no ano de 1963, a apresentação da primeira tese de enfermagem na América Latina, defendida pela professora Glete de Alcântara da Escola de Enfermagem de Ribeirão Preto, da Universidade de São Paulo(2), constata-se que em 2012 o Centro de Estudos e Pesquisa em Enfermagem (CEPEn) já catalogou 806 estudos, divididos em 610 dissertações de mestrado e 196 teses de doutorado apresentadas em 43 universidades brasileiras(3). Merece destaque ainda a luta constante dos profissionais de enfermagem por uma prática interdisciplinar e transformadora em saúde, na qual buscam relacionar-se com os demais profissionais que compõem a equipe de saúde e representam a voz que comunica e traduz informações entre todas as categorias profissionais e entre estas e os pacientes(4) . Entretanto, para que a enfermagem mantenha esse ritmo de crescimento e essa proposta de ação faz-se necessário uma formação sólida dos seus profissionais. Por esta razão a ABEn tem liderado uma luta em favor da qualidade da formação, destacando-se a construção do “Movimento em defesa da qualidade da formação dos profissionais de enfermagem”, iniciado em 2010 (5). Nesse sentido, recomenda-se que o currículo dos cursos de graduação em enfermagem incentive a prática baseada em evidências, estimule a busca de informação científica atualizada, reconheça esse papel no cuidado seguro e competente para que seus profissionais utilizem adequadamente essas evidências, valorizando o conhecimento científico para atender às demandas de saúde, com respeito a diversidade cultural de cada ser humano(6). Em nosso estado, no ano de 2013, o Departamento de Enfermagem da Universidade Federal do Piauí (UFPI) comemorou também grandes conquistas destacando-se entre elas os 40 anos do Curso de Bacharelado em Enfermagem, a obtenção do conceito quatro pelo Curso de Mestrado na avaliação trienal, a aprovação pela CAPES do Curso de Doutorado em Enfermagem e a indexação da Revista de Enfermagem da UFPI a Cuiden, Latindex e Diadorim, conquistando assim a inserção no Qualis/Capes no estrato B4 para a Enfermagem e para a área de Serviço Social (7). Portanto, temos muito a comemorar, mas sem esquecer que são muitos os desafios para este século XXI. Sigamos incentivando o conhecimento científico entre nossos pares e socializando aqueles já adquiridos. Parabéns a todos que fazem a Enfermagem, celebremos a 75 SBEn com alegria, almejando que as questões que nos afligem hoje se transformem em grandes certezas amanhã.

Este estudo teve como objetivo conhecer os fatores associados à qualidade de vida (QV) de cuidadores de idosos diagnosticados com doença de Alzheimer na perspectiva desses indivíduos. Foi um estudo descritivo, com abordagem qualitativa, baseado no método do Discurso do Sujeito Coletivo. Vinte cuidadores de idosos com diagnóstico de doença de Alzheimer participaram, durante um mês, no período de 18 de setembro a 18 de outubro de 2017. A coleta de dados foi realizada por meio de entrevistas com cuidadores de idosos com doença de Alzheimer. As perguntas foram feitas e gravadas em gravador, com a permissão do entrevistado. Os dados foram analisados ​​pela Classificação Hierárquica Descendente (DHC). Foram obtidas cinco classes: Conceito de qualidade de vida do cuidador idoso; Comportamento do idoso com Alzheimer; Problemas de memória do idosos e repercussões no trabalho do cuidador; Mudança no estilo de vida do cuidador familiar; e Repercussão de "ser cuidador" na qualidade de vida. A QV esteve relacionada a uma série de fatores (emocional, físico, financeiro, estado da doença dos idosos e o grau de conhecimento do cuidador sobre a doença). Os cuidadores apontaram que a não harmonia entre esses fatores pode ser crucial para afetar sua vida pessoal e profissional, bem como sua QV.

Sacisaurus agudoensis is the only silesaurid known from the Triassic beds of the Santa Maria Supersequence and the correlation of its type locality to the other Triassic deposits of south Brazil has always been controversial. In an attempt to improve this, a handful of dinosaur and cynodont remains found associated to S. agudoensis are here described and compared. The anatomy of the sauropodomorph is more similar to that of Norian forms such as Pantydraco caducus and Unaysaurus tolentinoi than to that of Carnian taxa such as Saturnalia tupiniquim and Pampadromaeus barberenai. The cynodonts recovered based on isolated teeth include a brasilodontid and a Riograndia-like form. This assemblage is consistent with a Norian age, as is also suggested by local stratigraphic correlation, which positions the site in the Caturrita Formation.

Abstract Background The hypotheses put forward to explain the malaria transmission cycle in extra-Amazonian Brazil, an area of very low malaria incidence, are based on either a zoonotic scenario involving simian malaria, or a scenario in which asymptomatic carriers play an important role. Objectives To determine the incidence of asymptomatic infection by detecting Plasmodium spp. DNA and its role in residual malaria transmission in a non-Amazonian region of Brazil. Methods Upon the report of the first malaria case in 2010 in the Atlantic Forest region of the state of Espírito Santo, inhabitants within a 2 km radius were invited to participate in a follow-up study. After providing signed informed consent forms, inhabitants filled out a questionnaire and gave blood samples for PCR, and thick and thin smears. Follow-up visits were performed every 3 months over a 21 month period, when new samples were collected and information was updated. Results Ninety-two individuals were initially included for follow-up. At the first collection, all of them were clearly asymptomatic. One individual was positive for Plasmodium vivax, one for Plasmodium malariae and one for both P. vivax and P. malariae, corresponding to a prevalence of 3.4% (2.3% for each species). During follow-up, four new PCR-positive cases (two for each species) were recorded, corresponding to an incidence of 2.5 infections per 100 person-years or 1.25 infections per 100 person-years for each species. A mathematical transmission model was applied, using a low frequency of human carriers and the vector density in the region, and calculated based on previous studies in the same locality whose results were subjected to a linear regression. This analysis suggests that the transmission chain is unlikely to be based solely on human carriers, regardless of whether they are symptomatic or not. Conclusion The low incidence of cases and the low frequency of asymptomatic malaria carriers investigated make it unlikely that the transmission chain in the region is based solely on human hosts, as cases are isolated one from another by hundreds of kilometers and frequently by long periods of time, reinforcing instead the hypothesis of zoonotic transmission.

Abstract Background The transmission of malaria in the extra-Amazonian regions of Brazil, although interrupted in the 1960s, has persisted to the present time in some areas of dense Atlantic Forest, with reports of cases characterized by particular transmission cycles and clinical presentations. Bromeliad-malaria, as it is named, is particularly frequent in the state of Espírito Santo, with Plasmodium vivax being the parasite commonly recognized as the aetiologic agent of human infections. With regard to the spatial and temporal distances between cases reported in this region, the transmission cycle does not fit the traditional malaria cycle. The existence of a zoonosis, with infected simians participating in the epidemiology, is therefore hypothesized. In the present study, transmission of bromeliad-malaria in Espírito Santo is investigated, based on the complete mitochondrial genome of DNA extracted from isolates of Plasmodium species, which had infected humans, a simian from the genus Allouata, and Anopheles mosquitoes. Plasmodium vivax/simium was identified in the samples by both nested PCR and real-time PCR. After amplification, the mitochondrial genome was completely sequenced and compared with a haplotype network which included all sequences of P. vivax/simium mitochondrial genomes sampled from humans and simians from all regions in Brazil. Results The haplotype network indicates that humans and simians from the Atlantic Forest become infected by the same haplotype, but some isolates from humans are not identical to the simian isolate. In addition, the plasmodial DNA extracted from mosquitoes revealed sequences different from those obtained from simians, but similar to two isolates from humans. Conclusions These findings strengthen support for the hypothesis that in the Atlantic Forest, and especially in the state with the highest frequency of bromeliad-malaria in Brazil, parasites with similar molecular backgrounds are shared by humans and simians. The recognized identity between P. vivax and P. simium at the species level, the sharing of haplotypes, and the participation of the same vector in transmitting the infection to both host species indicate interspecies transference of the parasites. However, the intensity, frequency and direction of this transfer remain to be clarified.

Os notoungulados são ungulados nativos sul-americanos registrados do Paleoceno ao Pleistoceno, e cuja diversidade declinou drasticamente durante o Plioceno, alcançando a América Central e América do Norte durante o Pleistoceno. Notoungulados evoluíram sob influência climática e ambiental, de linhagens arcaicas, com sistema mastigatório generalizado, com dentição completa, sem diastema, com molares e pré-molares braquiodontes, a formas especializadas com incisivos hipertrofiados, padrões oclusais da coroa simplificados e formas proto-hipsodontes e eu-hipsodontes. Estas comunidades viveram primeiramente em hábitats florestais quentes e úmidos, e posteriormente, em pastagens relativamente temperadas de hábitats abertos, com forte tendência à aridização e ao resfriamento ao longo do Cenozoico. Além da evolução da morfologia macroscópica dentária observada em Notoungulata, também é possível evidenciar a evolução dos tipos de microestrutura do esmalte, através da presença de características mais derivadas em formas eu-hipsodontes, indicando adaptação funcional e conferindo maior resistência ao consumo de vegetação mais abrasiva.

A pot trial in greenhouse conditions was carried out to identify at which defoliation height Mulato II grass (Urochloa hibrida cv. Mulato II) should be managed and to determine whether potassium fertilization is necessary in soil with high potassium content. The experiment was carried out in a greenhouse in a randomized block design with six treatments and five replications. Treatments consisted of a 3 × 2 factorial arrangement, with three defoliation heights (50, 65, and 80 cm) and with or without potassium maintenance fertilization. The production characteristics and chemical composition of the forage plant were evaluated. There was no interaction effect between defoliation height and fertilization with or without potassium on any of the analyzed variables, except for mineral content in Mulato II grass. The tillers and leaves number, shoot dry matter, leaf+sheath, root system, and residue were influenced by defoliation heights and potassium fertilization, except for the leaf blades and root dry matter, leaf blade/stem+sheath ratio, and leaves number, which were not influenced by potassium fertilization. Higher shoot dry matter was observed at the heights of 65 and 80 cm; however, comparing these two heights, leaf + sheath dry matter was lower at 65 cm. Regarding the grass’s chemical composition, there was an increase in neutral and acid detergent fiber and indigestible neutral detergent fiber contents as the defoliation height increased, which resulted in lower production of potentially digestible dry matter, which can compromise the potential use of the forage by animals. Among evaluated treatments, Mulato II grass defoliation is recommended for a maximum height of 65 cm. Potassium fertilization increases the yield and the potentially digestible dry matter content of Mulato II grass, even when cultivated in soil with high potassium content.

Objetivo identificar na literatura científica as tecnologias desenvolvidas para a educação em saúde de idosos na comunidade. Método revisão integrativa que incluiu artigos originais indexados nas bases de dados Literatura Latino Americana e do Caribe em Ciências da Saúde, Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Science Direct e Cochrane, sem restrição de tempo e idioma. A análise dos resultados ocorreu na forma descritiva, em cinco categorias analíticas. Resultados foram selecionados 15 artigos, publicados em revistas nacionais e internacionais, com predomínio de estudos experimentais que testaram os efeitos das tecnologias. Os tipos de tecnologia educacional desenvolvidos foram material impresso, software e vídeo, além de maquete e suporte telefônico. O tema mais abordado foi a queda. Os estudos mostraram que os tipos de tecnologia encontrados são viáveis para a educação em saúde de idosos na comunidade. Conclusão as tecnologias desenvolvidas para a educação em saúde de idosos foram múltiplas e mostraram-se eficazes para serem utilizadas em intervenções na comunidade.

Objetivo : analizar los traumas por accidentes de tránsito en ancianos atendidos en Emergencias de hospital municipal de referencia en 2010 y 2011. Metodo : estudio longitudinal, retrospectivo, realizado en hospital de urgencias y en Delegación de Represión a Crímenes de Tránsito sobre población de 524 ancianos. Se efectuó análisis descriptivo para todas las variables. Resultados : se determinó riesgo de participación en accidente, ocurrencia de lesión y fallecimiento utilizando riesgo relativo. Se verificó asociación estadísticamente significativa en accidentes con lesión provocada por atropello de motocicleta. Se constató asociación entre sexo masculino, ocurrencia de accidente, lesión y fallecimiento, particularmente entre ancianos menores. De los 524 ancianos accidentados, prevaleció sexo masculino, casados, con escolarización primaria. El 78,6% presentó lesión, siendo mayoría los peatones. Conclusión : entre ancianos jóvenes, la posibilidad de fallecimiento derivada de lesión se mostró 3,4 veces mayor en 2010.

The aim of this study was to analyze the sociodemographic and clinical profile of elderly people with heart failure in an emergency hospital. This is a descriptive, quantitative study with a convenience sample of 83 elderly people hospitalized in an emergency reference hospital from September to November, 2015. The results showed an epidemiological profile represented mostly by men aged 60 to 79 years, who were married, illiterate, with monthly income of one to two minimum wages. Regarding etiology, the hypertensive type was found as the main cause, with greater frequency in the age group of 60 to 79 years. Of the total, 54 elderly people (65.1%) used three to five medications daily. Among the associated chronic diseases, arterial hypertension was present in 80 (96.4%) patients, followed by diabetes, diagnosed in 35 (42.2%) of the elderly. The study population was vulnerable to cardiovascular risk factors, with a predominance of arterial hypertension and diabetes.

This integrative review aimed to identify the main patient safety issues addressed in the hospital context. The search occurred in three electronic databases, covering the period 2009 to 2015, with the following descriptors: “Patient safety”, “Risk control” and “Hospitalization”. The study sample consisted of 34 articles. There was a significant increase in the number of publications on the subject in 2013, more than 100% compared to the year 2009. Of the studies, 22.22% dealt with adverse events and 18.52% with errors in the administration of medication. Among preventive measures, 37.93% highlighted continuing education and 13.79% handwashing and the correct identification of the patient. The strategic option for safety has been included in the agendas of health institutions, organizations and systems as a priority. Therefore, it is suggested to expand the focus of research to improve the quality of care.

Resumo Objetivo: Analisar os acidentes de trânsito envolvendo idosos em que ocorreu desfecho fatal, segundo condição do acidentado, local de ocorrência e causa do óbito, elaborando mapas de distribuição geográfica. Métodos: Estudo transversal realizado na Delegacia de Repressão aos Crimes de Trânsito de Teresina, em uma população de 68 boletins de registro de acidente e inquéritos policiais de idosos nos anos de 2010 e 2011. Na análise espacial utilizaram-se o Índice Local de Moran e a densidade de Kernel. Resultados: Em relação à condição do idoso no momento do acidente, comprovou-se que 57,3% dos óbitos foram de pedestres. Considerando o local de ocorrência e a primeira causa registrada, constatou-se que 49,6% ocorreram no local do acidente, a maior causa o politraumatismo. Conclusão: Os óbitos concentraram-se na área urbana, com aglomerado de bairros com alta ocorrência de acidente, apresentando correlação positiva, evidenciando também a existência de regiões com maior densidade de ocorrências.

The fossil rodents from the southwestern Amazonia of Brazil have been studied since the first half of the 20th century. Several caviomorph rodents were reported for the Neogene of this region, mainly neoepiblemids and dinomyids. Until recently, the record of dinomyids in the Solimões Formation (Late Miocene) was predominantly based on a few isolated teeth, which made it difficult to make more accurate taxonomic identifications due to the scarcity of diagnostic characters. Here, new remains, more complete than those previously reported, of potamarchine dinomyids from the Neogene of Brazil are described. A new species of Potamarchus and a new genus and species of a Potamarchinae are erected. In addition, new material of Potamarchus murinus and Potamarchus sp. is identified. These data suggest a higher diversity of dinomyids in in the western Amazonia than previously supposed.

In the south and southeast regions of Brazil, cases of malaria occur outside the endemic Amazon region near the Atlantic Forest in some coastal states, where Plasmodium vivax is the recognized parasite. Characteristics of cases and vectors, especially Anopheles (Kerteszia) cruzii, raise the hypothesis of a zoonosis with simians as reservoirs. The present review aims to report on investigations of the disease over a 23-year period. Two main sources have provided epidemiological data: the behavior of Anopheles vectors and the genetic and immunological aspects of Plasmodium spp. obtained from humans, Alouatta simians, and Anopheles spp. mosquitoes. Anopheles (K.) cruzii is the most captured species in the forest canopy and is the recognized vector. The similarity between P. vivax and Plasmodium simium and that between Plasmodium malariae and Plasmodium brasilianum shared between simian and human hosts and the involvement of the same vector in the transmission to both hosts suggest interspecies transfer of the parasites. Finally, recent evidence points to the presence of Plasmodium falciparum in a silent cycle, detected only by molecular methods in asymptomatic individuals and An. (K.) cruzii. In the context of malaria elimination, it is paramount to assemble data about transmission in such non-endemic low-incidence areas.

Non-human primates (NHPs) have been shown to be infected by parasites of the genus Plasmodium, the etiological agent of malaria in humans, creating potential risks of zoonotic transmission. Plasmodium brasilianum, a parasite species similar to P. malariae of humans, have been described in NHPs from Central and South America, including Brazil. The merozoite surface protein 1 (MSP1), besides being a malaria vaccine candidate, is highly immunogenic. Due to such properties, we tested this protein for the diagnosis of parasite infection. We used recombinant proteins of P. malariae MSP1, as well as of P. falciparum and P. vivax, for the detection of antibodies anti-MSP1 of these parasite species, in the sera of NHPs collected in different regions of Brazil. About 40% of the NHP sera were confirmed as reactive to the proteins of one or more parasite species. A relatively higher number of reactive sera was found in animals from the Atlantic Forest than those from the Amazon region, possibly reflecting the former more intense parasite circulation among NHPs due to their proximity to humans at a higher populational density. The presence of Plasmodium positive NHPs in the surveyed areas, being therefore potential parasite reservoirs, needs to be considered in any malaria surveillance program.

Identification of mosquito species is necessary for determining the entomological components of malaria transmission, but it can be difficult in morphologically similar species. DNA sequences are largely used as an additional tool for species recognition, including those that belong to species complexes. Kerteszia mosquitoes are vectors of human and simian malaria in the Neotropical Region, but there are few DNA sequences of Kerteszia species in public databases. In order to provide relevant information about diversity and improve knowledge in taxonomy of Kerteszia species in Peru, we sequenced part of the mitochondrial genome, including the cytochrome c oxidase I (COI) barcode region. Phylogenetic analyses structured all species of mosquitoes collected in Peru into a single clade, separate from the Brazilian species. The Peruvian clade was composed of two lineages, encompassing sequences from Anopheles (Kerteszia) boliviensis and Anopheles (Kerteszia) pholidotus. An. pholidotus sequences were recorded for the first time in Peru, whereas An. boliviensis sequences were for the first time published in the GenBank database. Sequences generated from specimens morphologically identified as Anopheles (Kerteszia) cruzii clustered into three separate clades according to the collection localities of Serra do Mar, Serra da Mantiqueira, and Serra da Cantareira, confirming An. cruzii as a species complex, composed of at least three putative species.

This study analyses the multiple abuse against older adults reported to the elder abuse police units of three Brazilian cities from 2009 to 2013. This is a longitudinal and retrospective study carried out through the analysis of police reports (PRs) in the elder abuse police units of three Brazilian cities: Ribeirão Preto (SP), Teresina (PI), and João Pessoa (PB). Descriptive statistical analysis consisted of absolute and percentage frequencies. The chi-square test, Fisher's Exact test, and Relative Risk (RR) were used to analyze the data, with a 95% Confidence Interval (CI) and a significance of 5%. A total of 2,313 reports of older adult abuse were analyzed, of which 245 (10.6%) were related to reports of multiple abuse, 49.4% in Ribeirão Preto, São Paulo, 22.9% in João Pessoa, Paraíba, and 27.8% in Teresina, Piauí. Most of the victims of recurrent older adult abuse are female and younger elderly. Psychological abuse was the most recurrent, followed by financial abuse, occurring in the victim's own home. In João Pessoa, older women and elderly living with their abusers were at a higher risk of report of multiple abuse acts. In Ribeirão Preto, living with the aggressor was a risk factor for multiple violent acts. In the total population of the study, living without companion and not living with the aggressor were identified as protective factors against recurrent violence. The need to implement social and legal actions to improve safety for the more vulnerable groups is emphasized.

ABSTRACT Objective: To analyze economic-financial and patrimonial cases of elder abuse, recorded in the specialized police station for security and protection of the elderly of a capital city in the northeast region of Brazil. Method: A cross-sectional study was carried out with data extracted from police reports and inquiries recorded in the abovementioned police station. Descriptive and inferential statistics were carried out by means of Pearson’s chi-square test or Fisher’s exact test, and multivariate logistic regression. Results: The sample was made up of 555 police reports. The data showed that financial abuse presented a prevalence of 58.9%, and that older elderly people (67.9%), men (70.4%), and single (75.0%) presented a higher percentage of financial abuse compared with other types of violence, often occurring in public places, with 3.1 more chances of occurrence than at the elderly’s home. Regarding aggressors, women (73.5%), without suspicion of alcohol use (66.4%), and non-family members committed more financial abuse, evidencing 2.97 more chances of practicing it. Conclusion: In the period studied, financial abuse increased in its magnitude when compared with other types of violence, a fact that justifies researching the theme in order to prevent it.

RESUMO Reflexão teórica na qual se buscou refletir sobre as demandas e responsabilidades da sociedade e do poder público frente aos altos índices de acidentes de trânsito envolvendo idosos. Percebeu-se que, para a melhor compreensão desse agravo, é preciso necessário que sejam repensadas as transformações inerentes ao processo de envelhecimento e suas influências no indivíduo como pedestre e/ou condutor, bem como a infraestrutura e a logística de trânsito capazes de agravar ou minimizar a vulnerabilidade desse grupo aos acidentes. A sociedade civil e o poder público são responsáveis pela garantia da saúde e da segurança da população, com destaque para os idosos, especialmente em relação à sua mobilidade. Nesse sentido, fazem-se necessários o planejamento e a execução de obras de acessibilidade que respeitem as particularidades da pessoa idosa, bem como a fiscalização e penalização das infrações por parte do poder público. A sociedade civil, por sua vez, tem como grande responsabilidade assumir e cumprir com o papel social na construção de um trânsito sem violência e mais seguro para as pessoas idosas.

Objetivo: A suplementação materna com ácido fólico tem um efeito positivo na prevenção de defeitos do tubo neural. É controversa a relação entre a suplementação com altas doses de ácido fólico (5mg) e a asma na criança. O objetivo desta revisão é conhecer a evidência da associação entre a suplementação com altas doses de ácido fólico durante a gravidez e o risco de desenvolvimento de asma na infância. Fontes de dados: National Guideline Clearinghouse, Canadian Medical Association Pratice Guidelines, Cochrane Library, DARE, Bandolier, PubMed e Índex de Revistas Médicas Portuguesas. Métodos de revisão: Pesquisa de meta-análises, revisões sistemáticas, estudos originais e normas de orientação clínica publicados entre julho/2006 e julho/2016 nas línguas portuguesa, inglesa, espanhola e francesa, utilizando os termos MeSH: Folic Acid, Asthma e Pregnancy. Foi utilizada a escala SORT (Strength of Recommendation Taxonomy), da American Academy of Family Physicians, para atribuição do nível de evidência e forças de recomendação. Resultados: Foram selecionados cinco estudos de um total de 29 artigos encontrados: duas meta-análises e três estudos originais. As meta-análises não sustentam a associação entre a suplementação periconcecional com ácido fólico e o aumento do risco do desenvolvimento de asma na infância. No entanto, nenhum dos estudos incluídos nas meta-análises estratificam os resultados de acordo com a dose de ácido fólico fornecida à gestante durante a gestação e o risco de asma. Por outro lado, os estudos originais sugerem que a suplementação com altas doses de ácido fólico durante a gravidez pode aumentar o risco de desenvolvimento de asma na infância. Conclusões: A evidência da associação entre a suplementação com ácido fólico durante a gravidez e o risco de desenvolvimento de asma durante a infância é controversa. Os estudos com resultados estratificados por dose de ácido fólico mostraram que altas doses de suplementação (>800mg) estão associadas ao aumento do risco de desenvolvimento de asma na infância (SORT B).