Search

Resumo Neste artigo, analisa-se o acesso ao cuidado da saúde que produz vulnerabilidades, bem como as estratégias de resistência de usuários(as). No estudo, fruto de pesquisa qualitativa com abordagem cartográfica, recorre-se ao conceito-ferramenta “usuária-guia”, ao analisar a trajetória de uma mulher de 48 anos de idade com deficiência visual, acompanhada em pesquisa num centro especializado em reabilitação da cidade de João Pessoa, Paraíba, Brasil. Entre outubro de 2020 e abril de 2021, foram realizados 12 encontros virtuais com a usuária e duas entrevistas com profissionais do serviço, registrados em diários de campo. A análise gerou os seguintes eixos de interpretação: Várias mortes em vida, Severina; A fabricação de um corpo Severina: marcas de uma saúde prescritora do viver; e Teima a vida Severina, em sua produção de redes vivas de cuidado. Evidenciou-se que a organização da atenção à saúde direcionada a certos grupos leva à produção de vulnerabilidades e promove a morte (ou mesmo muitas mortes) em vida. Ao mesmo tempo, identificaram-se possibilidades de construção de outros fluxos, em que seria possível constituir, para si, meios de romper com o que se estrutura para nossas rotas, permitindo produzir furos nos muros.

O estudo buscou compreender a influência da estratégia do Pay for Performance (P4P), por meio do Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ-AB), na atuação do(a)s trabalhadore(a)s. Trata-se de um estudo de caso qualitativo realizado com o(a)s trabalhadore(a)s das Estratégias de Saúde da Família. A análise foi realizada mediante a técnica de construção de narrativas. Constatou-se que o P4P contribuiu para qualificação do processo de trabalho, ao mesmo tempo que estimulou competição e conflito entre as equipes, aflorando sentimentos de culpa e injustiça e, devido à precarização do trabalho, o estímulo financeiro se descaracteriza, tornando-se complemento salarial. Problemas macroestruturais afetam as condições de trabalho e a motivação do(a)s trabalhadore(a)s, de modo que modelos de incentivo financeiro, isoladamente, não são suficientes para reverter tal cenário.

O texto constitui-se de uma atividade elaborada e aplicada com o auxílio da Robótica Educacional, um recurso que pode ser utilizado na prática pedagógica dos educadores que trabalham com a Física. Para o desenvolvimento deste estudo, fundamentou- se em trabalhos que tratam da aprendizagem a partir da construção de robôs. Esta, por sua vez, verificou se as atividades desenvolvidas colaboraram para o promover do pensamento crítico. O público alvo foram 20 alunos do Ensino Médio de uma escola pública estadual de Campo Mourão. O objetivo foi construir e programar utilizando o Arduino, um circuito com sensor ultrassônico para compreender como um carro-robô funcionaria, um importante processo para o ensino e aprendizagem dos alunos. Os resultados mostram que houve uma melhora no pensamento crítico dos discentes envolvidos.

A conservação do solo é etapa fundamental dos sistemas agrícolas, notadamente quando se visa equilíbrio entre produtividade e meio ambiente. Quando não realizada, o solo fica susceptível à ação dos processos erosivos, que pode culminar em grandes áreas impactadas denominadas voçorocas, cuja recuperação depende de projeto de dispêndio financeiro e de tempo. A mensuração e geração cartográfica digital evoluíram muito, quando comparado aos métodos convencionais de medição, nesse sentido, a utilização de Aeronaves Remotamente Pilotadas (RPA’s) se constitui técnica com maior crescimento no mercado de mapeamento. Este trabalho visa validar metodologia de mapeamento e cálculo de volume de solo erodido em voçoroca a partir de modelo digital do terreno elaborado através de aerofotogrametria obtida por RPA, utilizando técnicas convencionais de topografia como tratamento testemunha. Em área rural com voçoroca com área de aproximadamente 8,32 hectares, foi realizado levantamento topográfico de 940 pontos com estação total laser, por caminhamento e poligonal encravada georreferenciada por receptor GNSS L1/L2. Foram realizadas 2 missões com RPA de baixo custo, com alteração de 90º nos planos de voo. As fotos obtidas serão processadas no Agisoft Metashape seguindo diferentes rigores na geração da nuvem de pontos. O volume de material erodido da voçoroca a aportado no manancial à jusante foi de 638641,5 m3, equivalente à 212880 caçambas convencionais de transporte entulho de 3 m3.

COVID-19 primarily affects the respiratory system and can cause changes in other systems. Early identification of patients with a higher potential for complications is critical to provide the best possible treatment to reduce the disease's lethality. This study aimed to analyze the behavior of hematologic biomarkers in predicting mortality in patients hospitalized with COVID-19. This retrospective cohort study used data from the medical records of patients hospitalized with COVID-19 between March and August 2020 in two referral hospitals for treatment of the disease in the city of Cuiabá (in the state of Mato Grosso, Brazil). Clinical and laboratory characteristics related to cardiovascular involvement and death during hospitalization were evaluated. Neutrophils, lymphocytes, and monocytes, as well as the neutrophil-to-lymphocyte ratio (NLR) and the monocyte-to-lymphocyte ratio (MRL), were used as potential biomarkers of death. A total of 199 patients were included (male: 113; mean age: 51.4 years). Leukocyte, neutrophil, and lymphocyte counts showed a statistically significant association with death, as did NLR and MRL. Satisfactory accuracy in predicting death was observed for leukocyte, neutrophil, lymphocyte, NLR, and MLR counts. The hematologic biomarkers studied may be useful for prognosticating hospitalized patients for the possibility of death from COVID-19.

This study evaluated three orthophotos, generated from aerial surveys configured at 80 m, 100 m and 120 m in height with multirotor RPA, model Phantom 4 Pro from the company DJI coupled to Complementary Metal Oxide Semiconductor (CMOS) sensor of 1 inch of 20 megapixels, on a property located on the banks of Rodovia Agostinho Ducci (PR-218), rural area of ​​the municipality of São Sebastião da Amoreira in the state of Paraná, Brazil. Of remotely piloted aircraft (RPA) using support points in the georeferencing of images. Accuracy was assessed based on trend and precision analysis, and the results were classified according to the Cartographic Accuracy Standard for Digital Cartographic Products (PEC-PCD) for a scale of 1:1.000.

O declínio global das coberturas vacinais levou a Organização Mundial da Saúde (OMS), em 2019, a definir a hesitação vacinal como uma das dez maiores ameaças mundiais à saúde pública. No Brasil, a queda da cobertura vacinal teve início em 2012, acentuando-se a partir de 2016, e sendo agravada pela pandemia de COVID-19. O alerta da baixa cobertura vacinal vem acompanhado pela reintrodução de doenças imunopreveníveis como o sarampo. O retorno de doenças até então eliminadas, como a poliomielite, pode agravar a crise sanitária ainda em curso. Mesmo sendo reconhecido como um dos mais efetivos programas de imunizações do mundo e dos esforços permanentes, o Programa Nacional de Imunizações enfrenta um cenário extremamente adverso no que tange às coberturas vacinais. Este artigo descreve o Projeto pela Reconquista das Altas Coberturas Vacinais (PRCV) e a estratégia de trabalhar na ponta do sistema, executada nos territórios, que vem sendo implementada desde 2021 e já começa a apresentar resultados promissores. O PRCV foi organizado em três eixos temáticos com atuação compartilhada e ações específicas, a saber: vacinação; sistemas de informação; comunicação e educação. Os resultados já alcançados permitem afirmar que é possível conseguir a reversão das baixas coberturas vacinais, a partir da articulação de ações estruturais e interinstitucionais, com o fortalecimento das políticas públicas e desenvolvimento de medidas de curto, médio e longo prazos. Os fatores mais potentes do PRCV são sua abordagem junto aos profissionais da ponta, o pacto social pela vacinação, e a estruturação de redes locais de apoio às imunizações.

RESUMO O objetivo do estudo foi compreender como se deu o uso do recurso do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) em nível municipal, como estratégia de pagamento por desempenho, no estado da Paraíba. Trata-se de um estudo descritivo, com abordagem quantitativa. Participaram do estudo 219 municípios, de um total de 223 existentes no estado, com os quais realizou-se um inquérito com os gestores municipais em 2018. Os dados sofreram análise estatística descritiva. Os resultados apontam que a maioria dos municípios adotou lei municipal como normativa para regulamentar o uso dos incentivos financeiros do PMAQ-AB. A avaliação externa foi o principal critério de repasse dos recursos financeiros às equipes de saúde. No decorrer dos ciclos, mais atores receberam recursos além da equipe mínima da estratégia de saúde da família e o repasse foi feito de forma semestral e anual, sendo cerca de 40% a 50% do valor destinado às equipes e o restante investido em melhorias das condições de trabalho. Conclui-se que os recursos do PMAQ-AB foram utilizados com uma tendência homogênea nos municípios da Paraíba, repassando incentivos financeiros para os trabalhadores, mas se preocupando também com investimentos nas condições de trabalho das equipes.

Resumo Este artigo é produto de uma pesquisa sobre o cuidado em saúde mental em uma Unidade Integrada de Saúde da Família (USF) do município de João Pessoa-PB. Ela ocorreu no segundo semestre de 2015 e utilizou a cartografia como dispositivo para o rastreamento de acontecimentos, afetos e encontros que servissem de analisadores para a produção desse cuidado. Suas micronarrativas foram produzidas através de consultas individuais, reuniões de equipe e visitas domiciliares, que foram debatidas em discussões coletivas e registradas em diários de campo. Sua síntese se dá aqui, na Narrativa em Quatro Atos de um Acontecimento do Cuidado produzido, significado e capturado por todos os envolvidos na pesquisa. Discutem-se, através dela, as potencialidades da atenção básica na Rede de Atenção Psicossocial (RAPS) e os ainda persistentes equívocos da centralidade do saber-poder psiquiátrico na reprodução de práticas manicomiais. Conclui-se, assim, que a imersão num território afetivo-existencial amplia e enriquece de potencialidades tanto a produção do cuidado quanto a pesquisa em saúde.

Este artigo analisa a execução do PMAQ-AB a partir de sua contextualização em um cenário político nacional de profundas transformações, desde o reformismo fraco que promoveu lenta extensão de direitos até o contrarreformismo forte da restauração neoliberal. Para debater os elementos relacionados ao trabalho e às disputas pela distribuição dos recursos públicos, foi realizado estudo de caso com trabalhadores, gestores e conselheiros de saúde em duas capitais do nordeste brasileiro. Os resultados evidenciam o acirramento do conflito distributivo e o resultado desfavorável aos trabalhadores no contexto pós-golpe parlamentar de 2016. As dinâmicas locais expõem processos de contração salarial e individualização das relações de trabalho e a reafirmação da meritocracia como justificativa ideológica da precarização. A isso, trabalhadores se contrapõem pela reafirmação de sua condição coletiva de classe, em favor de benefícios derivados do PMAQ, como recomposição salarial para todos.

BackgroundPay-for-performance (P4P) programmes to incentivise health providers to improve quality of care have been widely implemented globally. Despite intuitive appeal, evidence on the effectiveness of P4P is mixed, potentially due to differences in how schemes are designed. We exploited municipality variation in the design features of Brazil's National Programme for Improving Primary Care Access and Quality (PMAQ) to examine whether performance bonuses given to family health team workers were associated with changes in the quality of care and whether the size of bonus mattered.Methods and findingsFor this quasi-experimental study, we used a difference-in-differences approach combined with matching. We compared changes over time in the quality of care delivered by family health teams between (bonus) municipalities that chose to use some or all of the PMAQ money to provide performance-related bonuses to team workers with (nonbonus) municipalities that invested the funds using traditional input-based budgets. The primary outcome was the PMAQ score, a quality of care index on a scale of 0 to 100, based on several hundred indicators (ranging from 598 to 660) of health care delivery. We did one-to-one matching of bonus municipalities to nonbonus municipalities based on baseline demographic and economic characteristics. On the matched sample, we used ordinary least squares regression to estimate the association of any bonus and size of bonus with the prepost change over time (between November 2011 and October 2015) in the PMAQ score. We performed subgroup analyses with respect to the local area income of the family health team. The matched analytical sample comprised 2,346 municipalities (1,173 nonbonus municipalities; 1,173 bonus municipalities), containing 10,275 family health teams that participated in PMAQ from the outset. Bonus municipalities were associated with a 4.6 (95% CI: 2.7 to 6.4; p < 0.001) percentage point increase in the PMAQ score compared with nonbonus municipalities. The association with quality of care increased with the size of bonus: the largest bonus group saw an improvement of 8.2 percentage points (95% CI: 6.2 to 10.2; p < 0.001) compared with the control. The subgroup analysis showed that the observed improvement in performance was most pronounced in the poorest two-fifths of localities. The limitations of the study include the potential for bias from unmeasured time-varying confounding and the fact that the PMAQ score has not been validated as a measure of quality of care.ConclusionsPerformance bonuses to family health team workers compared with traditional input-based budgets were associated with an improvement in the quality of care.

Background: Rising healthcare costs demand a transition from the current fee-for-service to a Value-Based Health Care (VBHC) Model. This requires that all future doctors to understand the VBHC Model. We aimed to evaluate the VBHC awareness among Brazilian medical students and to identify it’s associated intrinsic/extrinsic factors through a survey-based, cross-sectional study. Methods: An online survey was sent to students from Brazilian medical schools. A descriptive analysis based on participants' level of awareness about VBHC was performed. The categorical variables included were absolute and relative frequencies using chi-square tests. A multivariate binary logistic regression analysis was performed by calculating the odds ratio (OR) and 95% confidence intervals (95%CI) to compare each response according to VBHC awareness. Results: We collected 3030 responses from 148 Medical Schools across all Brazilian states. Medical students were compared into 2 groups; 1 was familiar with VBHC (14%; 426); 2 were not (86%; 2575). The univariate analysis showed that group 1 was more willing to share clinical outcomes/costs data related to their practice (57.04%) compared to 2 (48.12%), p

Introduction: For the elderly, cultural factors and social paradigms predispose to the rejection of condom use, which favors human immunodeficiency virus (HIV) transmission. The North region was the last area for the spread of HIV in Brazil. Rondônia, although with a slight decline in the HIV detection rate in recent years, is still among the states with high mortality rate due to HIV/acquired immunodeficiency syndrome (AIDS) in Brazil. Objective: To describe the demographic and clinical characteristics of the elderly patients who were hospitalized for reasons related to HIV infection in the state of Rondônia, Brazil. Methods: Descriptive study of secondary data recorded from 2010 to 2018. The cause of hospitalization was identified in the field referring to the main and secondary diagnoses of the hospitalization authorization form. Results: Between 2010 and 2018, Rondônia recorded 1,073,932 hospitalizations for any cause in the state’s public hospitals. Out of these, 183,803 (17.1%) were of elderly patients over 60 years of age and 249 (0.13%) were due to HIV/AIDS. There was a progressive increase in the number of hospitalizations during the study period, as well as a predominance of younger elderly men (67.1±6.0 years old). The mean length of hospitalizations was 21.3±21.1 days and 57 (24.1%) elderly patients died. Conclusion: Despite all the progress made in HIV prevention and treatment, the state of Rondônia still has a progressive increase in hospitalizations of elderly people for reasons related to HIV/ AIDS. HIV transmission prevention strategies should be emphasized in the elderly population in the state.

Abstract This work investigates the effect of eco-friendly chemical treatments on the mechanical and physical properties of composite laminates based on sisal fibres. A 2231 full-factorial design is conducted to test the influence of chemical solution types, fibre treatment time, and polymer matrix type on the mechanical and morphological characterisation of the composites. Chemical treatments remove impurities from fibre surfaces, and enhance fibre-matrix adhesion. The treatments, especially with sodium carbonate (Na2CO3), also progressively reduce the hemicellulose fibre content. Polyester composites made with sisal fibres treated with Na2CO3 for 96h achieve enhanced strength and stiffness under tensile, compressive and impact loads. The results evidence the feasibility and efficiency of the proposed eco-friendly treatments for natural fibres and the application of renewable fibre laminates in secondary structural applications.

As aeronaves remotamente pilotada (RPA) têm sido amplamente utilizadas na geração de ortofotos e modelos digitais de elevação (MDE), que subsidiam as análises geoespaciais. Ocasionalmente, estas análises requerem levantamentos rápidos, o que inviabiliza o uso de RPA associado a pontos de apoio para a correção da posição, ajuste e avaliação da qualidade dos ortofotos e MDE. Atualmente é possível a geração automatizada destes produtos por meio do uso de rotinas preestabelecidas disponíveis em programas especializados na manipulação das imagens obtidas com RPA. Dessa forma, a presente pesquisa se justifica pela carência de análises efetivas do processamento de imagens coletadas com RPA, em que poderá contribuir metodologicamente com a qualidade do mapeamento. Portanto, o objetivo deste trabalho foi extrair a informação posicional de pontos de projeção cartográfica geradas em rotinas de processamento para a geração de ortofotos no software Agisoft Metashape. Após o processamento das imagens, os resultados com ambas rotinas se mostraram satisfatórias para extração das informações geográficas, porém apenas as rotinas de alto rigor de qualidade se mostram como uma importante ferramenta no auxílio na atualização cadastral. Contudo, para o mapeamento de áreas rurais o processamento pode ser realizado nas cinco rotinas de processamento (Lowest, Low, Medium, High e UltraHigh).

Green plastics are constantly being used to minimize the negative impacts of the polymers made of fossil fuels such as petroleum. Non-renewable petroleum-based products are employed in wide range of human activities, yet plastic waste accumulation represents a serious issue for the environment (Mohd Rafee et al., 2019). On the other hand, the use of natural fibres in composite materials, such as sisal fibres, in substitution for synthetic fibres, has increased considerably. The aim of this study was to develop a low-cost manufacturing process of composites with reuse of polyethylene bags made of sugarcane ethanol (green polyethylene) reinforced with sisal fibres. The hot compression moulding (185 °C) was used to mould composite structural board. Tensile tests were conducted to evaluate the influence of the reinforcement configuration on the mechanical properties of the composites, considering two arrangements: woven fibres in (0°/90°) and randomly arranged. The results indicated that the use of woven sisal fibres in (0°/90°) as reinforcement of the green HDPE showed an increase in the tensile strength (33.30%) in contrast to the pure traditional HDPE. Randomly arranged sisal fibre-reinforced green HDPE composites showed higher modulus of elasticity than pure traditional HDPE (76.83%). Composites with woven sisal fibres showed higher values for tensile strength and ultimate strain, and lower modulus of elasticity than composites with randomly arranged sisal fibres. In addition, failure modes of the composites were observed. The results showed the viability of producing these composites by the developed equipment and the potential use of these materials as structural components.

In recent years, the number of cases with severe Plasmodium vivax malaria has shown an increasing trend. It is, therefore, important to identify routine laboratory markers that best characterize the acute disease phase and can serve as a tool for clinical follow-up of patients. In a cohort study, we followed 87 patients with acute P. vivax monoinfection acquired in an endemic region of the Brazilian Amazon. Forty-two different biochemical and hematological parameters frequently tested in clinical routine were evaluated at the acute phase and the convalescent phase. A total of 42 laboratory tests were performed: biochemical parameters measured were serum lipids levels, aminotransferases, bilirubin, amylase, glucose, urea, creatinine, albumin, globulin, uric acid, C-reactive protein, and alpha-1-acid glycoprotein. Hematological parameters included total and differential white blood cell and platelet counts, hemoglobin concentration, mean platelet volume, platelet width distribution, and plateletcrit. Our results show that several biochemical and hematological parameters were associated with acute phase P. vivax malaria and these parameters reverted to normal values in the convalescent phase. The use of these parameters during diagnosis and follow-up of the infection is a useful clinical tool to evaluate the clinical course and therapeutic response of patients with uncomplicated vivax malaria.

Introduction: For the elderly, cultural factors and social paradigms predispose to the rejection of condom use, which favors human immunodeficiency virus (HIV) transmission. The North region was the last area for the spread of HIV in Brazil. Rondônia, although with a slight decline in the HIV detection rate in recent years, is still among the states with high mortality rate due to HIV/acquired immunodeficiency syndrome (AIDS) in Brazil. Objective: To describe the demographic and clinical characteristics of the elderly patients who were hospitalized for reasons related to HIV infection in the state of Rondônia, Brazil. Methods: Descriptive study of secondary data recorded from 2010 to 2018. The cause of hospitalization was identified in the field referring to the main and secondary diagnoses of the hospitalization authorization form. Results: Between 2010 and 2018, Rondônia recorded 1,073,932 hospitalizations for any cause in the state’s public hospitals. Out of these, 183,803 (17.1%) were of elderly patients over 60 years of age and 249 (0.13%) were due to HIV/AIDS. There was a progressive increase in the number of hospitalizations during the study period, as well as a predominance of younger elderly men (67.1±6.0 years old). The mean length of hospitalizations was 21.3±21.1 days and 57 (24.1%) elderly patients died. Conclusion: Despite all the progress made in HIV prevention and treatment, the state of Rondônia still has a progressive increase in hospitalizations of elderly people for reasons related to HIV/ AIDS. HIV transmission prevention strategies should be emphasized in the elderly population in the state.

Background Evidence on the effect of pay-for-performance (P4P) schemes on provider performance is mixed in low-income and middle-income countries. Brazil introduced its first national-level P4P scheme in 2011 (PMAQ-Brazilian National Programme for Improving Primary Care Access and Quality). PMAQ is likely one of the largest P4P schemes in the world. We estimate the association between PMAQ and hospitalisations for ambulatory care sensitive conditions (ACSCs) based on a panel of 5564 municipalities.Methods We conducted a fixed effect panel data analysis over the period of 2009–2018, controlling for coverage of primary healthcare, hospital beds per 10 000 population, education, real gross domestic product per capita and population density. The outcome is the hospitalisation rate for ACSCs among people aged 64 years and under per 10 000 population. Our exposure variable is defined as the percentage of family health teams participating in PMAQ, which captures the roll-out of PMAQ over time. We also provided several sensitivity analyses, by using alternative measures of the exposure and outcome variables, and a placebo test using transport accident hospitalisations instead of ACSCs.Results The results show a negative and statistically significant association between the rollout of PMAQ and ACSC rates for all age groups. An increase in PMAQ participating of one percentage point decreased the hospitalisation rate for ACSC by 0.0356 (SE 0.0123, p=0.004) per 10 000 population (aged 0–64 years). This corresponds to a reduction of approximately 60 829 hospitalisations in 2018. The impact is stronger for children under 5 years (−0.0940, SE 0.0375, p=0.012), representing a reduction of around 11 936 hospitalisations. Our placebo test shows that the association of PMAQ on the hospitalisation rate for transport accidents is not statistically significant, as expected.Conclusion We find that PMAQ was associated with a modest reduction in hospitalisation for ACSCs.

This article presents an analysis of the production of care networks for persons with disabilities in the state of Paraíba, Brazil. We employed a qualitative methodology with a cartographic approach, involving the participation of four users-citizens-guides. Weekly virtual meetings were held throughout the second half of 2020, in which we were able to collect, systematize, and theorize on four issues: 1) guilt and (non) life expectancy on the part of persons with disabilities; 2) the place of disability in family dynamics; 3) the production of specific core relational dependency networks; and 4) the public vs. private care offerings for persons with disabilities. Based on these findings, we were able to lend visibility to and explicitly affirm the ways in which these user-citizens participate in the complex process of care building for persons with disabilities and their families.

RESUMO O estudo problematiza o lugar das famílias na produção do cuidado em saúde mental. De caráter qualitativo, foi desenvolvido a partir da produção de narrativas e vivências em um Centro de Atenção Psicossocial (Caps), tipo III, de João Pessoa-PB, entre fevereiro e novembro de 2015. Os pesquisadores acompanharam a produção de cuidado para um usuário denominado ‘o Capoeirista’. A partir de então, produziram-se novas visibilidades para a família na produção do cuidado: 1. Família como espaço de disputa de plano de cuidado; 2. Família que também precisa ser cuidada; e 3. Família como parte da vida social do usuário. Nesse sentido, o Caps precisa redefinir o perfil do seu usuário, extrapolando do âmbito individual para o familiar.

Abstract Cancer is one of the leading causes of death around the world and although the different clinical approaches have helped to increase survival rates, incidence is still high and so its mortality. Chemotherapy is the only approach which is systemic, reaching cancer cells in all body tissues and the search for new potent and selective drugs is still an attractive field within cancer research. Naphthoquinones, natural and synthetic, have garnered much attention in the scientific community due to their pharmacological properties, among them anticancer action, and potential therapeutic significance. Many mechanisms of action have been reported which also depend on structural differences among them. Here, we describe some of the most relevant mechanisms of action reported so far for naphthoquinones and highlight novel targets which are being described in the literature. Furthermore, we gather some of the most impressive efforts done by researchers to harness the anticancer properties of these compounds through specifically designed structural modifications.

Este trabalho apresenta os resultados de um estudo cujo objetivo foi identificar e analisar as estatégias utilizadas por professores de Física sobre os conceitos da Termodinâmica presente em periódicos e eventos nacionais do Ensino de Física, além de apresentar estratégias que venha tornar este ensino mais significativo ao aluno. Os dados foram construídos primeiramente por uma seleção dos periódicos por meio do portal de periódicos da CAPES que apresentassem qualis A1 e A2 no novo qualis, e posteriormente realizou-se um levantamento de trabalhos publicados e apresentados em eventos no período de 2010 a 2020. Os trabalhos foram analisados com base na Análise de Conteúdo. Entre os conceitos mais estudados está o de calor, temperatura e processos de transferência, e as estratégias vão desde experimentos, simulações, problematizações, textos e questionários. Os resultados apontam para a necessidade da exploração dos significados e diferenciação dos conceitos de calor e temperatura, por se tratar dos conceitos base da Termodinâmica e apesar da eficiência de algumas abordagens, destaca-se a necessidade da clareza dos objetivos e focos pretendidos com o recurso utilizado e os delineamentos após sua utilização para que estes não recaiam em apenas ludicidade.

ABSTRACT Objective: To analyze the influence of socioeconomic, demographic, epidemiological factors, and the health system structure in the evolution of the COVID-19 pandemic in Brazil. Methods: Ecological study with variables extracted from databases, having the incidence and mortality by COVID-19 until August 23, 2020, in Brazilian states, as response variables. The magnitude of the associations was estimated using Spearman's correlation coefficient and multiple regression analysis. Results: In the Brazilian states, 59.8% of variation in the incidence of COVID-19 was justified by income inequality, significant home densification, and higher mortality. In the case of mortality, those same variables explained 57.9% of the country's variations in federal units. Conclusion: Our results indicate that socioeconomic factors influenced the evolution and impact of COVID-19 in Brazil. Thus, we suggest comprehensive actions to ensure economic conditions and strengthening of health networks for populations with socioeconomic vulnerability.

The monitoring of partial discharges (PDs) is one of the main methods used worldwide for evaluation and diagnosis of the insulation conditions in equipment powered by medium and high voltages. The occurrence of PDs is usually an indication of the appearance of insulation defects, which over time can compromise the dielectric withstand of the material used, increasing the probability of complete breakdown. In general, laboratory tests for detecting and registering PDs are carried out using purely sinusoidal voltages. However, it is very common for an electrical asset to be subjected at some point in its operating life to voltages distorted by harmonic components. Some studies reported in the literature reveal that harmonic distortions can affect the PDs’ characteristics, nevertheless, the effects of individual harmonic components on PDs still need to be analyzed. In this context, this paper proposes to evaluate the impacts of harmonic voltage distortions on the dynamic behavior and the phase-resolved partial discharge (PRPD) patterns of PDs in an air cavity within a solid dielectric material. For this, a simulation model was implemented, which was used to analyze the effects of applying distorted voltages composed of different harmonic orders (third, fifth, and seventh) and distinct levels of distortion (1%, 3%, 5%, 10%, 15%, and 20%). In addition, the influence of the third harmonic phase angle on PDs is also analyzed. The results extracted from the simulations revealed that the harmonic distortions caused changes in the numbers of PDs per cycle, in the mean apparent charges of the PDs per cycle, and in the PRPD patterns’ characteristics. These changes were very significant for higher distortion levels, which in practice may impair the interpretation of PD measurement records for the diagnosis of the condition of the insulation system.

Fibre metal laminates (FMLs) are lightweight structures with high structural performance and are suitable for many industrial applications. This work describes the impact behaviour of novel sisal fibre-reinforced aluminium laminates (SiRAL) and their dependence upon the orientations of the fibres, the composite core used and the surface treatment of the metal skins. A cold-pressing technique is used to produce SiRALs in six configurations. The FMLs here also have treated or untreated aluminium skins (2024 T3) and three different types of core materials (0°/90° fabric, ±45° fabric and random matt). The ±45° core treated SiRAL provides the highest energy absorption and deflection properties. The pre-treatment of aluminium skins using sandpaper, deep cleaning and primer significantly affects the delamination of the panels under bending impact. The findings reveal that the SiRAL concept is a promising multifunctional FML suitable for different applications that require lightweight, bending and impact performance, together with sustainability characteristics.

Introduction: Leprosy reactions, classified as type 1 and type 2 reactions, are acute clinical conditions of exacerbation of localized or systemic inflammatory response inpatients with leprosy. No laboratory biomarker is available to predict the emergence of these reactions. Neutrophil-to-lymphocyte ratio (NLR) is an accurate biomarker for diagnosis and prognosis of various inflammatory and neoplastic diseases. Objective: This study aimed to investigate the accuracy of the NLR in the diagnosis of leprosy reactions. Materials and methods: NLR was calculated for all patients and a receiver operating characteristic curve (ROC) were generated to identify the NLR cut-off point. Results: A total of 123 patients with leprosy were included, 98 with leprosy reactions of which 56 (45.5%) had type 1 and 42 (34.1%) with type 2. Mean NLR was higher among patients with reactions than among those without. It was also statistically higher among patients with type 2 reactions than in those with type 1 reactions. Receiver operating characteristic curves were generated to identify the NLR cut-off point. The area under the ROC curve was 0.794 for diagnosis of any leprosy reaction and 0.796 for the diagnosis of type 2 reaction. The NLR cut-off points for diagnosis of any leprosy reaction and for type 2 reaction were 2.75 (sensitivity 61.0%, specificity 92.0%, accuracy 77.0%) and 2.95 (sensitivity 81.0%, specificity 74.0%, accuracy 78.0%), respectively. Conclusion: These results suggest that NLR could be a potential biomarker for diagnosis of leprosy reaction and useful for discriminating patients with type 2 reactions from those with type 1 leprosy reactions.

O crescimento populacional somado à urbanização e ao desenvolvimento econômico são causas incontestáveis do aumento da geração de resíduos. No Brasil a gestão dos resíduos gerados apresenta dificuldades quanto a disposição inadequada, coleta informal e insuficiência do sistema de coleta pública (Linhares et al. 2012).O lodo de esgoto, que é um resíduo, é um produto inevitável do tratamento de águas residuárias, e sua disposição de forma inadequada é um problema existente em várias partes do mundo. No panorama nacional existe uma carência de informação oficial a respeito da disposição do lodo de esgoto, no entanto, são vários os autores que estudaram e/ou estudam alternativas para o uso deste biossolido. Nesse sentido o objetivo do presente estudo foi mapear as principais tendências do uso e disposição do lodo de esgoto no Brasil, tomando por base os trabalhos técnicos-científicos publicados do ano de 2004 à 2014, sendo para isso utilizada a metodologia Mapping Study, foram realizadas buscas a em publicações eletrônicas nos bancos de dados dos Portais Scielo, CAPES, e no sitio do Google Acadêmico. De acordo com análise cienciométrica de dados proposta por este estudo, a realidade do Brasil para a disposição do lodo de esgoto, é a produção vegetal ou a recomposição de áreas degradadas com 276 artigos (91,7%), com destaque na aplicação agrícola (82,1%) e, em especial na produção de milho (19,9%). Porém, mesmo em menor número, já começa a aparecer vertentes de pesquisa do uso deste biossólido para produção de artefatos cerâmicos, construção civil e geração de energia (25 artigos).

This paper aimed to carry out an analysis of Joule’s original texts, written in the middle of the XIX century, trying to understand how the changes in heat concept occurred throughout his work. To support the theoretical analysis, a literature review was made with texts about the Science history and the study of alternative conceptions about heat. Guided by this literature review, the Discursive Textual Analysis was used as the methodology to examine which factors influenced Joule in changing his conception of the nature of heat. Joule initially accept the caloric theory and, instigated by internal aspects of his research and work by other researchers such as: Rumford, Davy and Herapath, he begins to understand the heat as a state of motion of the particles. We believe this work has the potential to serve as a subsidy for the teaching of Physics, where the study of Joule’s work can contribute so that there is a reframing of the heat concept for the students.