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Introdução: O estado nutricional de crianças é considerado um instrumento importante na aferição das condições de saúde e qualidade de vida de uma população. A prevalência crescente da obesidade em crianças é um problema de saúde pública significante, pois é um fator de risco importante para a obesidade na vida adulta. Objetivo: Avaliar a prevalência e os fatores associados à obesidade infantil no município de Rio Branco – Acre. Método: Realizou-se análise de banco de dados provenientes do Inquérito de Fatores de Risco e Morbidade por Doenças Não-Transmissíveis no Município de Rio Branco / Saúde e Nutrição de Adultos e Crianças em 2008. Trata-se de um estudo transversal onde foram examinadas 687 crianças na faixa de 0 a 60 meses nas zonas urbana e rural. A análise estatística considerou a expansão e o desenho da amostra. A prevalência da obesidade infantil segundo os índices antropométricos P/I (peso-para-idade), P/E (peso-para-estatura), e IMC/I (Índice de Massa Corporal-para-idade) foram respectivamente de 6,85% (IC95% = 5,30 – 8,80), 6,66% (IC95% = 3,22 – 13,27) e 6,61% (IC95% = 3,25 – 12,98). Resultados: O modelo final apresentou maior prevalência de obesidade para o índice IMC/I nas seguintes condições: local de domicílio na zona urbana (RP=6,81; IC95% = 1,27 – 36,38), iluminação elétrica sem medidor (RP=2,10; IC95% = 1,22 – 3,59), altura da mãe maior que 163cm (RP=2,24; IC95% = 1,12 – 4,47) e obesidade materna (RP=2,37; IC95% = 1,19 – 4,72). Conclusão: A prevalência da obesidade do índice IMC/I foi elevada e está relacionada à fatores socioeconômicos e características maternas específicas. É necessária a promoção de ações que levem a formação de um estilo de vida saudável ainda na infância.

Blindness affect the daily life activities and the causes and prevalence are different worldwide. This study aimed to investigate the pattern of the autonomic nervous system modulation on the heart in blind and normal vision subjects submitted acutely to low vision. Normal vision (NV) subjects (N = 32) and blind patients (N = 24) were submitted to HRV analysis during resting, intervention and recovery periods. Intervention consisted of handling objects, short walking, and cognitive activities performed with pedagogic games while using sleeping masks. No difference was observed in indexes in the time and frequency domain, and in the geometric indexes comparing blind and NV subjected to acute low vision during resting and recovery. Nevertheless, during intervention, RMSSD, pNN50, and SD1were found lower in blind than in NV subjects. Therefore, blind patients showed similar HRV at resting or upon possible stressful challenges compared to NV subjects acutely subjected to low vision, indicating absence of differences in the cardiovascular risk between groups. In addition, blind patients show a smaller reduction in parasympathetic modulation on the heart during possible stressful challenges than NV individuals submitted to low vision, which is likely an important physiological adaptation for an adequate function of the cardiovascular system in blindness.

Introduction: The safety culture of the patient is a contributing factor for the maintenance of the user’s well-being in the health system because, through it, an organized systematization and quality of patient care are obtained, preventing possible intercurrences that can cause damages. Objective: To analyze the Patient Safety Culture (PSC) from the perspective of health professionals at the Reference Hospital of the Upper Juruá River, in the Brazilian Western Amazon. Methods: This is a cross-sectional study developed in a medium-sized public hospital in a municipality in Western Amazonia. The Survey for Patient Safety Culture survey of the Agency for Healthcare Research and Quality was applied to 280 professionals from December 2016 to February 2017. Descriptive analysis of the data and the internal consistency of the instrument were performed. Results: The results indicate the best evaluations in the dimensions of Teamwork in the scopes of the units (60%) and Organizational learning (60%). The aspects with the worst results were the dimensions of non-punitive responses to errors (18%) and frequency of events reported (32%). The internal reliability (Cronbach’s Alpha) analysis of the dimensions ranged from 0.35 to 0.90. Conclusion: The "culture of fear" seems to predominate in this hospital, however, the study showed that there is scope for improvement in all dimensions of CSP. The values of Cronbach’s Alpha presented similarity to the results obtained by the validation process.

We aimed to evaluate the accuracy of deterministic and stochastic statistical models by means of a protocol developed in a free programming environment for monthly time-series analysis of the incidence of confirmed dengue cases in the states and federal district of Brazil from January 2000 to December 2017. This was an ecological time-series study conducted to evaluate and validate the accuracy of 10 statistical models for predicting the new cases of dengue. Official data on the monthly cases of dengue from January 2000 to December 2016 were used to train the statistical models, while those for the period January&ndash, December 2017 were used to test the predictive capacity of the models by considering three forecasting horizons (12, 6, and 3 months). Deterministic models proved to be reliable for predicting dengue in a 12-month forecasting horizon, while stochastic models were reliable for predicting the disease in a 3-month forecasting horizon. We were able to reliably employ models for predicting dengue in the states and federal district of Brazil. Hence, we strongly recommend incorporating these models in state health services for predicting dengue and for decision-making with regard to the advanced planning of interventions before the emergence of epidemics.

To analyze risk factors for death in individuals with severe acute respiratory syndrome due to COVID-19.This was a retrospective cohort study, comprised of adult individuals with COVID-19, from March to September 2020, notified by the Epidemiological Surveillance System in the state of Acre, Brazil. Cox regression was used.Among 57,700 individuals analyzed, the incidence was 2,765.4/100,000 inhabitants, and mortality was, 61.8/100,000 inhabitants. The risk factors for death were: being male (HR=1.48 -95% CI 1.25;1.76), age ≥60 years (HR=10.64 -95% CI 8.84;12.81), symptom of dyspnea (HR=4.20 -95% CI 3.44;5.12) and multimorbidity (HR=2.23 -95% CI 1.77;2.81), with emphasis on heart disease and diabetes mellitus. 'Sore throat' and 'headache' were symptoms present in mild cases of COVID-19.Being male, elderly, having heart disease, diabetes mellitus and dyspnea were characteristics associated with death due to COVID-19.Analisar fatores de risco para óbito em indivíduos com síndrome respiratória aguda grave por COVID-19.Coorte retrospectiva, constituída de indivíduos adultos com COVID-19, de março a setembro de 2020, notificados pelo sistema de vigilância epidemiológica do estado do Acre, Brasil. Empregou-se regressão de Cox.Entre 57.700 indivíduos analisados, a incidência foi de 2.765,4/100 mil habitantes, e a mortalidade, de 61,8/100 mil hab. Os fatores de risco para o óbito foram ser do sexo masculino (HR=1,48 - IC95% 1,25;1,76), ter idade ≥60 anos (HR=10,64 - IC95% 8,84;12,81), sintoma de dispneia (HR=4,20 - IC95% 3,44;5,12) e apresentar multimorbidade (HR=2,23 - IC95% 1,77;2,81), com destaque para cardiopatas e diabetes mellitus. Os sintomas ‘dor de garganta’ e ‘cefaleia’ estavam presentes nos casos leves da doença.Ser homem, idoso, apresentar cardiopatia, diabetes mellitus e dispneia foram características associadas ao óbito pela COVID-19.Analizar los factores de riesgo de muerte en individuos con Síndrome Respiratorio Agudo Grave por COVID-19.Cohorte retrospectiva, con individuos adultos con COVID-19, entre marzo y septiembre 2020, notificado pelo Sistema de Vigilancia Epidemiológica en el estado de Acre, Brasil. Se utilizó la regresión de Cox.57.700 individuos evaluados, la incidencia fue de 2.765,4/100.000 habitantes y la mortalidad 61,8/100.000 habitantes. Los factores de riesgo de muerte fueron: sexo masculino (HR=1,48 - IC95% 1,25;1,76), edad ≥60 años (HR=10,64 - IC95% 8,84;12,81), disnea (HR=4,20 - IC95% 3,44;5,12), multimorbidad (HR=2,23 - IC95% 1,77;2,81), incluidos problemas cardíacos y diabetes. Los síntomas dolor de garganta y de cabeza estuvieron presentes en casos leves de la enfermedad.Hombres, ancianos, personas com enfermedades cardíacas, diabetes y disnea fueron características asociadas com la muerte por COVID-19.

To evaluate the predictive power of different malaria case time-series models in the state of Amapá, Brazil, for the period 1997-2016.This is an ecological time series study with malaria cases recorded in the state of Amapá. Ten deterministic or stochastic statistical models were used for simulation and testing in 3, 6, and 12 month forecast horizons.The initial test showed that the series is stationary. Deterministic models performed better than stochastic models. The ARIMA model showed absolute errors of less than 2% on the logarithmic scale and relative errors 3.4-5.8 times less than the null model. It was possible to predict future malaria cases 6 and 12 months in advance.The ARIMA model is recommended for predicting future scenarios and for earlier planning in state health services in the Amazon Region.Avaliar a capacidade preditiva de diferentes modelos de série temporal de casos de malária no estado do Amapá, Brasil, no período 1997-2016.Estudo ecológico de séries temporais com casos de malária registrados no Amapá. Foram utilizados dez modelos estatísticos determinísticos ou estocásticos para simulação e teste em horizontes de previsão de 3, 6 e 12 meses.O teste inicial mostrou que a série é estacionária. Os modelos determinísticos apresentaram melhor desempenho do que os modelos estocásticos. O modelo ARIMA apresentou erros absolutos menores do que 2% na escala logarítmica e erros relativos 3,4-5,8 vezes menores em relação ao modelo nulo. A predição de casos futuros de malária nos horizontes de 6 e 12 meses de antecedência foi possível.Recomenda-se o uso de modelo ARIMA para a previsão de cenários futuros e para a antecipação do planejamento nos serviços de saúde dos estados da Região Amazônica.Evaluar el poder predictivo de diferentes modelos de series de temporales de casos de malaria en el estado de Amapá, Brasil, en el periodo 1997-2016.Se trata de un estudio ecológico de series de temporales con casos de malaria registrados en el estado de Amapá. Se utilizaron diez modelos estadísticos determinísticos o estocásticos para la simulación y la prueba en horizontes de predicción de 3, 6 y 12 meses.La prueba inicial mostró que la serie es estacionaria. Los modelos determinísticos mostraron mejor desempeño que los modelos estocásticos. El modelo ARIMA mostró errores absolutos menores al 2% en la escala logarítmica y errores relativos 3,4-5,8 veces menores que el modelo nulo. La predicción de casos futuros en horizontes de 6 y 12 meses de antelación fue posible.Se recomienda utilizar el modelo ARIMA para predecir escenarios futuros y anticipar la planificación en los servicios de salud en los estados de la Región Amazónica.

Objetivo: Descrever as dimensões da Cultura de Segurança do Paciente, identificando áreas fortes e frágeis na percepção dos profissionais de enfermagem, em dois complexos hospitalares assistenciais públicos em Rio Branco, Acre. Métodos: Estudo epidemiológico observacional, descritivo, transversal. A coleta de dados ocorreu no período de novembro de 2016 a maio de 2017, com amostra de 290 profissionais de enfermagem, que aceitaram participar do estudo respondendo ao questionário intitulado Hospital Survey on Patient Safety Culture (HSOPSC), elaborado pela Agency for Healthcare Research and Quality (AHRQ), amplamente utilizado no mundo para mensurar a cultura de segurança do paciente, traduzido, adaptado e validado para o português brasileiro. A análise de dados foi realizada por meio de estatística descritiva e a confiabilidade do instrumento foi verificada pelo coeficiente de Alpha de Cronbach. Resultados: As dimensões que apresentaram maior percentual de respostas positivas foram: “Aprendizado organizacional” (63%), “Trabalho em equipe no âmbito das unidades” (60%), “Expectativas e ações de segurança dos supervisores e gerentes” (54%) e “Abertura para comunicação” (54%). No entanto, das 12 dimensões avaliadas pelo questionário, sete obtiveram percentual abaixo de 50%, sendo consideradas áreas frágeis e que necessitam de melhoria. Os itens identificados com menor percentual foram: “Respostas não punitivas aos erros” (15%), “Quadro de funcionários” (31%), “Frequência de eventos relatados” (34%) e “Retorno de informações e comunicação sobre erros” (35%). Conclusão: Nenhumas das dimensões alcançou 75% de respostas positivas evidenciando uma necessidade de mudanças organizacionais e culturais que promovam a Cultura de Segurança nas instituições pesquisadas.

Among the main types of neoplasms in the female population, breast and cervical cancers are the most important due to their high morbidity and mortality rates. The mortality has been proportionally higher in developing countries. Analysis of the trend of cancer mortality in Brazil revealed a considerable difference in the pattern of deaths between the regions. To analyze the trend of mortality due to breast and cervical cancers in women. Retrospective study of a series of death cases, using secondary data from the mortality information system (SIM) of the Ministry of Health. The deaths were identified as the underlying cause of breast and cervical cancers, including malignant neoplasms of the uterus without other specifications, occurring from 1980 to 2014. Thus, the annual standardized age-specific mortality rates by the world population were applied. For trend analysis, regression models were utilized in which the mortality rates were considered dependent variables and years the independent variable. Polynomial regression models and a Prais–Winsten regression model were adopted. Cervical cancer presented a mortality rate ranging from 2.15 to 10.69 per 100,000 women from 1980 to 2014, with a tendency for stability. Breast cancer mortality rate varied from 3.81 to 11.47 per 100,000 women from 1981 to 2014, indicating a growing trend. There is a significant increase in the mortality rate for breast cancer and stability of cervical cancers in the State of Acre from 1980 to 2014, evidencing a concern in their care and monitoring. Above all, guaranteed access, especially to the population of women at social risk, and the search for effective screening should be emphasized in the formation of the care line and the Health Care Network in the State of Acre.

Background Plasmodium falciparum malaria is a threat to public health, but Plasmodium vivax malaria is most prevalent in Latin America, where the incidence rate has been increasing since 2016, particularly in Venezuela and Brazil. The Brazilian Amazon reported 193,000 cases in 2017, which were mostly confirmed as P. vivax (~ 90%). Herein, the relationships among malaria incidence rates and the proportion of accumulated deforestation were contrasted using data from the states of Acre and Rondônia in the south-western Brazilian Amazon. The main purpose is to test the hypothesis that the observed difference in incidence rates is associated with the proportion of accumulated deforestation. Methods An ecological study using spatial and temporal models for mapping and modelling malaria risk was performed. The municipalities of Acre and Rondônia were the spatial units of analysis, whereas month and year were the temporal units. The number of reported malaria cases from 2009 until 2015 were used to calculate the incidence rate per 1000 people at risk. Accumulated deforestation was calculated using publicly available satellite images. Geographically weighted regression was applied to provide a local model of the spatial heterogeneity of incidence rates. Time-series dynamic regression was applied to test the correlation of incidence rates and accumulated deforestation, adjusted by climate and socioeconomic factors. Results The malaria incidence rate declined in Rondônia but remained stable in Acre. There was a high and positive correlation between the decline in malaria and higher proportions of accumulated deforestation in Rondônia. Geographically weighted regression showed a complex relationship. As deforestation increased, malaria incidence also increased in Acre, while as deforestation increased, malaria incidence decreased in Rondônia. Time-series dynamic regression showed a positive association between malaria incidence and precipitation and accumulated deforestation, whereas the association was negative with the human development index in the westernmost areas of Acre. Conclusion Landscape modification caused by accumulated deforestation is an important driver of malaria incidence in the Brazilian Amazon. However, this relationship is not linearly correlated because it depends on the overall proportion of the land covered by forest. For regions that are partially degraded, forest cover becomes a less representative component in the landscape, causing the abovementioned non-linear relationship. In such a scenario, accumulated deforestation can lead to a decline in malaria incidence.

Simple Summary We screened Aedes mosquitoes in an urban area in southeastern Brazil for emerging arboviruses using RT-PCR assays and sequencing. We detected DENV-2 RNA in Aedes albopictus and Guadeloupe mosquito virus RNA in Aedes aegypti. Abstract In 2018–2019, we conducted mosquito collections in a municipal vehicle impound yard, which is 10 km from the Serra do Mar Environmental Protection Area in Santo André, SP, Brazil. Our aim is to study arboviruses in the impound yard, to understand the transmission of arboviruses in an urban environment in Brazil. We captured the mosquitoes using human-landing catches and processed them for arbovirus detection by conventional and quantitative RT-PCR assays. We captured two mosquito species, Aedes aegypti (73 total specimens; 18 females and 55 males) and Ae. albopictus (34 specimens; 27 females and 7 males). The minimum infection rate for DENV-2 was 11.5 per 1000 (CI95%: 1–33.9). The detection of DENV-2 RNA in an Ae. albopictus female suggests that this virus might occur in high infection rates in the sampled mosquito population and is endemic in the urban areas of Santo André. In addition, Guadeloupe mosquito virus RNA was detected in an Ae. aegypti female. To our knowledge, this was the first detection of the Guadeloupe mosquito virus in Brazil.

Made available in DSpace on 2020-12-12T02:24:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Heart Rate Variability (HRV) represents cardiac autonomic behavior and have been related to menopausal symptoms, mainly vasomotor symptoms and their imbalance to cardiovascular risk. It is not clear in the literature which index represents this imbalance and what is their involvement with the menopausal state. The aim of this study was to evaluate HRV in menopausal transition and post-menopausal symptoms with different intensities. This cross-sectional study was conducted in Rio Branco, State of Acre, Brazil from October 2016 to July 2017. We used Kupperman-Blatt Menopausal Index (KMI) to measure menopausal symptoms intensity. HRV analysis was performed based on the guidelines of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. HRV is lower in the group with moderate/intense menopausal symptoms compared to mild symptoms. (RMSSD: p = 0.005, Cohen’s d = 0.53, pNN50: p = 0.0004, Cohen’s d = 0.68; HF: p = 0.024, Cohen’s d = 0.44). There was association between HRV and KMI (RMSSD: r = -1.248, p = 0.004; and pNN50: r = -0.615, p: 0.029) in inverse relation to the intensity of vasomotor symptoms in women in TM. In conclusion, HRV was able to distinguish menopausal symptoms, indicating reduced vagal control in women with more intense symptoms. Laboratório de Delineamento de Estudos e Escrita Científica Centro Universitário Saúde ABC Laboratório de Delineamento de Estudos e Escrita Científica do Laboratório de Práticas Cientíticas Centro Universitário Uninorte Disciplina de Ginecologia Faculdade de Medicina Universidade de São Paulo (USP) Graduate Entry Medical School University of Limerick Centro de Estudos do Sistema Nervoso Autônomo (CESNA) UNESP Centro de Estudos do Sistema Nervoso Autônomo (CESNA) UNESP

Introduction : Maturation is a biological phenomenon inherent to the human being that acts alongside environmental factors in its relationship with the development of children and adolescents. Objective : To analyse the motor skills during maturational stages of female adolescents. Methods : This study included 133 female adolescents aged between 10 and 17 years from federal schools in the city of Rio Branco, State of Acre, Brazil. Sexual maturation was evaluated using Tanner’s self-assessment. Motor skills were assessed using the following tests: strength (Jump Test); coordination (Burpee Test); balance (Flamingo Test); flexibility (Sit and Reach Test); agility (Shuttle Run Test). The data were analysed using R software through analysis of variance. The significance level was fixed at 5%. Result : No significant statistical results were found for strength, agility, balance and flexibility, evidencing that maturational advances did not influence these skills. In the coordination variable, significant results were obtained. Conclusion : The results of this study suggest that maturational advancement in adolescents does not influence strength, agility, balance or flexibility. However, it does influence coordination, presenting better performance at stage P2.

The zika virus is an emerging and important world health problem. In public health its harmful effects have stimulated various legal interests. The Federal Government of Brazil recently adopted several social and health surveillance measures, extending the instruments of possibilities to combating the virus transmitter in Brazil. Law No. 13.306/2016 brought incisive determinations about action awareness policies and educational campaigns, and at the same time authorizes the highest authorities of the Uni fi ed Health System (SUS) within federal, state, county and municipal governments to establish and implement the necessary measures to control the diseases caused by the virus, i.e. dengue, chikungunya and zika. The published legislation has created a motivating environment for researchers to develop projects aimed at the mosquito that transmits the dengue virus, the chikungunya virus and the zika virus . Therefore, studies on A. aegypti have led to greater scienti fi c knowledge about its habitat, reproduction and development and a description of means to combat it, as a precondition for the ful fi lment of the social purposes of Law No. 13.301, of June 27, 2016, mainly if researches about more ef fi cient management models and management of public fi nances, contributing to unveiling impacts on public health and growth and human development.