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The pulp and paper industry, a major global sector, supports economies and jobs while contributing to various products. While providing valuable products, and despite Best Available Techniques (BAT) being used, managing wastewater effectively remains a key area for developing technologies and alternatives for environmental protection. Activated sludge (AS) systems are commonly used for effluent treatment, where microorganisms composition influences reactor efficiency. Current monitoring strategies show limited correlation with chemical parameters. Metabarcoding, a DNA sequencing approach, offers a promising alternative to profile microbial communities comprehensively. Utilizing MinION and Illumina sequencing, this study reveals the prokaryotic and eukaryotic microbial communities in AS from an extended aeration-activated sludge reactor from a pulp mill for the first time. Eukaryotic composition evaluated by 18S amplicon sequencing revealed Protists as the dominant group, followed by Animalia and Fungi. Within these groups, the most abundant phyla detected were Ciliophora (75 % on average), Rotifera (90 % on average), and Cryptomycota (60 % on average), respectively. Genera like Prorodon and Limnias stand out due to their high relative abundance within the Protist and Animalia group, respectively. A comparative analysis with routine microorganism composition assessment by microscopy revealed consistent taxonomic trends, affirming the feasibility of amplicon sequencing for routine microbial community surveillance. Furthermore, the incorporation of metabarcoding enhanced the depth of results. Prokaryotic composition analyzed by 16S amplicon sequencing revealed microorganisms previously described as relevant to the wastewater treatment process but highlighted dominant specific groups even when compared to other pulp facilities. Genera like Terrimonas, Defluviicoccus, and Methylocaldum appear as the most abundant among the identified genera. For proper reactor operation, microorganisms must aggregate around organic matter in flocs, which reflect reactor health and are composed of 5 % eukaryotes and 95 % prokaryotes. Hence, the characterization of both groups of microorganisms is crucial. Differences in communities between the wastewater treatment plant's aeration zones emphasize the importance of comprehensive community characterization. The study underscores metabarcoding's potential as a monitoring tool, for future linking of microbial communities with process patterns for improved environmental management in the pulp and paper industry and emphasizes the importance of establishing unique baselines for microbial communities in activated sludge systems.

Background: The cutoff point of an instrument is a valuable clinical reference. Objective: To study the cutoff point of the Informal Caregiver Burden Assessment Questionnaire (QASCI). Methodology: A methodological cross-sectional study was conducted using secondary data analysis. The predictive validity of the instrument was assessed by measuring sensitivity and specificity, positive and negative predictive values, and the area under the ROC curve (AUC). The Portuguese versions of the Medical Outcomes Study 36-Item Short Form Survey Instrument (MOS SF36) and the Hospital Anxiety and Depression Scale (HADS) were used. Results: Caregivers exhibited elevated levels of anxiety and depression. The cutoff point 40 yielded the highest Youden Index score (0.59), indicating that the model has an 84% accuracy for predicting anxiety and depression disorders. In addition, the model demonstrated a sensitivity of 78% and a specificity of 81%. Conclusion: This study demonstrates that the QASCI effectively identifies caregivers at risk of anxiety and depression disorders and can inform interventions to enhance their mental health.

Enquadramento: o apoio prestado pelos enfermeiros aos familiares cuidadores na transição para o papel, acarreta desafios na preparação para a mestria no cuidar e no processo documental. Os sistemas de informação devem ser uma ferramenta imprescindível na tomada de decisão destes profissionais, permitindo a continuidade e qualidade dos cuidados prestados e a obtenção de ganhos em saúde. Objetivo: avaliar as mudanças na documentação dos enfermeiros relativa aos familiares cuidadores, após intervenção. Metodologia: estudo quase-experimental antes e após intervenção, com recurso à consulta da documentação realizada pelos enfermeiros nas suas atividades com os familiares cuidadores. Resultados: os focos do Papel de Prestador de cuidados revelam aumento significativo na fase final, bem como os enunciados de diagnóstico que envolvem o Papel de Prestador de Cuidados. As intervenções mais documentadas mantem-se as do tipo Avaliar e Ensinar, mas este aumento não é significativo. As intervenções do tipo Incentivar revelam-se marginalmente significativas e as do tipo Treinar e Instruir apresentam uma diminuição estatisticamente significativa. Conclusão: o estudo revelou melhorias nas áreas do Papel de Prestador de cuidados, no entanto ainda revela áreas de subnotificação do cuidador, com necessidade de um investimento superior.

Enquadramento: A abordagem aos cuidadores informais coloca novos desafios à enfermagem, que deve sustentar a conceção de cuidados na melhor evidência científica. A documentação dos sistemas de informação deve gerar indicadores que espelhem o papel dos enfermeiros como facilitadores de uma transição saudável. Objetivo: Redefinir a conceção de cuidados ao familiar cuidador a partir da análise dos registos que espelha a atividade dos enfermeiros com os cuidadores. Metodologia: Estudo com abordagem qualitativa assente na pesquisa ação participativa em saúde, desenvolvido com uma amostra de 16 enfermeiros em atividade de cuidados de saúde primários. Recorreu-se às notas de campo e considerou-se os pressupostos defendidos por Bardin para a análise de conteúdo. Resultados: Emergiram três categorias, organização do trabalho dos enfermeiros, limitações à documentação em enfermagem e uniformização dos registos. Em conjunto com os participantes desenvolveu-se um modelo de acompanhamento aos familiares cuidadores. Conclusão: Os pressupostos da pesquisa-ação participativa em saúde facilitaram a redefinição do modelo assistencial conducente a melhoria na qualidade de cuidados e documentação nos sistemas de informação em enfermagem.

Resumo A música utilizada em denominações religiosas neopentecostais está passando por diversas transformações na atualidade, deixando ver fissuras e heterogeneidades no que comumente se pensa ser um conjunto doutrinário relativamente coeso em torno de certos pressupostos tidos como indiscutíveis. Sustentamos aqui que a euforia em torno de um gênero musical surgido recentemente em certas igrejas neopentecostais, conhecido como "corinho de fogo" - aqui estudado em uma das primeiras abordagens na literatura acadêmica, senão a primeira -, representa uma tendência de grande propagação entre os fiéis dessas igrejas, e que envolve inclusive questionamentos à exclusão racial e desigualdade de classe. Como evidência, apresentamos o caso da igreja dirigida pela pastora Ana Lúcia. Localizada na cidade de Belford Roxo (Baixada Fluminense, RJ), em região de extrema pobreza, a igreja atrai principalmente fiéis de famílias de baixa renda, predominantemente de raça negra. Nos cultos da pastora, uma exuberante corporalidade negra se alia a uma música fortemente percussiva que é, juntamente com a dança, bastante evocativa dos rituais religiosos afro-brasileiros. Justamente por isso, a igreja, a pastora e seus fiéis e colaboradores sofrem críticas violentas, sem se deixar intimidar por isso, de fiéis e pastores de outras vertentes protestantes. Os resultados desta pesquisa evidenciam um caso específico de uma nova tendência entre as denominações neopentecostais, que vem acirrando de maneira verificável a heterogeneidade existente entre estas denominações, possibilitando que seus fiéis questionem fundamentos doutrinários em favor de lutas sociais e culturais que consideram urgentes. A agência coletiva de fiéis, músicos e pastores constituiu a igreja da pastora Ana Lúcia em um território social produzido ativa e afirmativamente como resposta e desafio à exclusão e preconceito, no qual a música é parte fundamental. A partir deste espaço musical e religioso, esse coletivo luta simbolicamente pelos direitos de inclusão e cidadania, e pelo respeito por suas crenças e práticas.

Objective: The present report aims to describe an activity of health education conducted at a university hospital in the Federal District. Methodology: This is an experience report , which discusses the final work of the discipline " Administration Applied to Nursing and Stage " , offered by the Department of Nursing , Faculty of Health Sciences , University of Brasilia on the strategy to guide the nursing staff of a university hospital in the types and forms of precautionary isolation which patients undergo , before observing the students about the discipline of careless actions of professional nursing teams across the cases of patients requiring isolation or care using appropriate precautions. Results: Based on these, the students held a strategy orientation in order to avoid transmission of multiresistant bacteria or pathogens between patients and also among professionals, with the objective of promoting a decreased incidence of nosocomial infections. Conclusion: It is understood the validity of the lecture held at the expense of scientific studies that highlight the need for health education activities that address prevention of infection among patients and health professionals .

Introduction: Health services are composed of complex work environments. For this reason, they present several risks to the health of workers and also of people being treated at these places. Among these risks, one that is peculiar to health services is the risk of occupational accidents with biological material involving sharps. Objective: This study aimed to describe a health education activity conducted in a Health Center of the Federal District, Brazil. Methods: This is an experience report that discusses the final paper of the discipline “Administration Applied to Nursing and Internship”, offered by the Department of Nursing, Faculty of Health Sciences, University of Brasilia. A lecture was prepared, aimed at health workers and support staff, on general aspects of occupational accidents involving sharps, as well as preventive aspects. Results: In each clinical room of the Health Center were fixed two posters: the first discussing the proper disposal of sharps and the second, in turn, was a message of reflection. 31 professionals attended the lecture as listeners. Conclusion: We understand the validity of the lecture delivered, based on scientific studies that highlight the need and shortage of health education activities that address the prevention of occupational accidents involving sharps among Health Professionals. Additionally, it is important mentioning that such activity demand was estimated by the workers of the Health Center in study.

Composites of recycled high density polyethylene (HDPE-R) and coffee dregs (COFD) were elaborated. The blends were made at the proportions of 100-0, 90-10, 80-20, 70-30, 60-40, 50-50 and 40-60% polymer-filler ratio. The materials were evaluated through scanning electron microscopy (SEM), differential scanning calorimetry (DSC), thermogravimetry/derivative thermogravimetry (TGA), and compressive resistance test. The compounding was done using a two-stage co-kneader system extruder, and then cylindrical specimens were injection molded. All composites had a fine dispersion of the COFD into the polymeric matrix. The composites degraded in two steps. The first one was in a temperature lower than the neat HDPE, but higher than the average processing temperature of the polymer. The melting temperature and the degree of crystallinity of the composites resulted similar to the neat HDPE ones. The compressive moduli of the composites resulted similar to the neat polymer one. The results show that these composites have interesting properties as a building material.

Este estudio tuvo como objetivo identificar y describir el proceso histórico de la formación profesional de los agentes comunitarios de salud, mediante el análisis de documentos relativos a la formación técnica en salud. Es una investigación documental realizada en documentos normativos e instrumentales en los registros administrativos y de gestión del Departamento de Atención Primaria, con investigación bibliográfica en las bases de datos Medline y LILACS, de publicaciones orientadas a la política de formación profesional, en el período de 1986 a 2006, y de lectura con análisis temático. En respuesta a las demandas políticas y económicas, el agente comunitario de salud se convirtió en profesión en 2002. Sus funciones fueron ampliadas, motivo por el cual, en 2006 ya había en Brasil más de 200 mil profesionales trabajando según el nuevo reglamento: la Ley 11.350, que revocó la ley anterior. El agente comunitario se convirtió en un elemento importante para la promoción de cambios en el modelo asistencial y el fortalecimiento de la atención primaria en salud.

Introduction: The objective of the study was to reduce, by a bundle of interventions, the global bloodstream infections and catheterrelated bloodstream infections rates in neutropenic hematology patients with a long-term central venous catheter. Material and Methods: This was a non-randomized prospective study. It was conducted in a 20-bed hematology oncology unit (Portuguese Institute of Oncology, Porto, Portugal) between 1st of August 2010 and 31st of January 2012. In this period we introduced a bundle of interventions (study group) and compared the results with the six months prior to implementation (control group). The interventions consisted in the use of a neutral pressure mechanical valve connector instead of a positive pressure mechanical valve connector, a more frequent change of this connector and a more efficient clean solution. One hundred and sixteen hematology patients with a long-term central venous catheter at time superior of 72 h, with 8 867 central venous catheter days [6 756 central venous catheter days in the study group and 2 111 central venous catheter days in the control group] were included in the study. Results: A significant reduction in bloodstream infections rates and catheter-related bloodstream infections rates was achieved. Bloodstream infections rates: [32.69 (control group) vs. 9.43 (study group)], incidence reduction 71% [relative risk 0.2886, CI 95% (0.1793 – 0.4647), p < 0.001] and catheter-related bloodstream infections rates: [17.53 (control group) vs. 4.73 (study group)], incidence reduction 71% [relative risk 0.2936, CI 95% (0.1793 – 0.5615), p < 0.014]. No significant difference (p > 0.05) was found in the neutrophil count at the time of blood culture samples between groups: 69% (< 500 neutrophils/mm3) [71% (study group) vs. 68% (control group)]. Conclusions: The introduction of this bundle of interventions based on the variables of patient, product and practice, supported by the Healthcare and Technology Synergy framework, quickly resulted in a significant reduction of bloodstream infections and catheterrelated bloodstream infections rates.

Este documento reflecte a ligação da evolução da tecno-ciência e da obstinação terapêutica. Seguindo esta ideia, rapidamente se avança para a importância da auto-determinação do doente e da possível realidade das directivas antecipadas de vontade na forma do testamento vital e da nomeação de um representante legal em termos de cuidados de saúde.