Resumo: A agricultura biológica cria um mercado para bens e serviços ambientais, e os produtores podem ser recompensados pela sua gestão agroambiental através de preços premium e pela Política Agrícola Comum (PAC). O objetivo deste trabalho foi caracterizar os agricultores da Região Centro de agricultura do ponto de vista socioeconómico, além de avaliar a propensão para a mudança do modo produtivo para a agricultura biológica e identificar as principais dificuldades para a mudança. Foi realizado o estudo dos efeitos das políticas agrícolas na evolução da agricultura biológica. Foram realizados estudos através de entrevistas presenciais resultando em dois estudos de caso. Os estudos de caso apresentam metodologias distintas, mas complementares. O trabalho revelou que a PAC contribuiu para o desenvolvimento deste setor e os dados alcançados permitem aos investigadores desenvolver técnicas para que os agricultores possam superar os obstáculos e aumentar a competitividade da cadeia de valor. A renovação geracional e o aumento da dimensão da exploração são factores a considerar para o progresso da agricultura biológica. É necessário gerar formação adequada às necessidades e fornecer informações precisas e reais sobre as dificuldades e benefícios desse modo de agricultura.

Abstract: Organic farming creates a market for environmental goods and services, and farmers can be rewarded for their agri-environment management through premium prices and the Common Agricultural Policy (CAP). The objective of this work was to characterize the farmers of the Center Region from the socioeconomic point of view and to evaluate the willingness to change the productive mode for organic farming and to identify the main difficulties for change. The study of the effects of agricultural policies on the evolution of organic farming was carried out. Studies were conducted through face-to-face interviews resulting in two case studies. The case studies present different but complementary methodologies. The work revealed that CAP has contributed to the development of this sector and the data obtained allow researchers to develop techniques for farmers to overcome obstacles and increase the competitiveness of the value chain. Generational renewal and increased farm size are factors to consider for the progress of organic farming. It is necessary to generate training appropriate to the needs, to provide accurate and real information about the difficulties and benefits of this mode of agriculture.

OBJECTIVE: To evaluate the relationship between cognitive performance and long-latency auditory evoked potentials in an elderly population. METHODS: The sample consisted of adults between 20 and 58 years of age and elderly adults between 60 and 70 years of age. The screening procedures adopted were an inspection of the external auditory canal, tonal and vocal audiometry, tympanometry, brain stem auditory evoked potential, the Montreal Cognitive Assessment test, and long-latency auditory evoked potential. RESULTS: The latency and amplitude values of cortical components by age group showed significant differences under the following conditions: (i) signals evoked by the speech stimulus /da/ and by the pure-tone stimulus at 2,000 Hz for the N2 amplitude (p=0.008 and p=0.001, respectively) , which were both higher for adults, and (ii) signals evoked by the speech stimulus /da/ for N1 latency (p=0.018) and by the pure-tone stimulus at 2,000 Hz for P2 latency (p=0.017), which were both higher in the elderly population. The cognitive component (P300) showed a significant difference when evoked by speech stimuli, with higher latency in the elderly population (p=0.013). When correlated with cognitive processes, the latency and amplitude of cortical potentials showed direct and medium-strength correlations between abnormal scores obtained on the Montreal Cognitive Assessment test and P2 amplitude (p<0.001 and r=0.452). CONCLUSION: There is a relationship between long-latency potentials and cognitive performance in the elderly, which was observed by the increase in the P2 amplitude and the impairment of the process of sound decoding.

Abstract INTRODUCTION: This study estimated the seroprevalence and risk factors of Chagas disease (CD) in a population of the Quixeré municipality, Ceará. METHODS: We conducted serological methods to detect the Trypanosoma cruzi infection. The other variables were evaluated by a standardized questionnaire. RESULTS: The estimated prevalence of CD was 3.7%. Male sex, age >40 years, being farmers, low education level, origin from rural areas, and being born in Quixeré were significantly associated with infection. CONCLUSION: CD persists in this rural population of Northeast Brazil. Poverty, low education, and limited information regarding CD are critical issues that need to be addressed.

Resumo Fundamento A doença de Chagas (DC) é considerada um problema de saúde pública na América Latina. A região nordeste, principalmente o estado do Ceará, ainda representa grande preocupação em termos de risco de transmissão da doença. Objetivo Estimar a prevalência de T. cruzi em doadores de sangue do estado do Ceará. Métodos Trata-se um de estudo retrospectivo descritivo realizado no período de 2010 a 2015, a partir de dados registrados no sistema informatizado do Centro de Hematologia e Hemoterapia do Ceará (HEMOCE). Resultados Dos 763.731 potenciais doadores de sangue, 14.159 foram considerados impedidos de fazer a doação devido à sorologia, sendo que 1.982 (0,33%) o foram devido à positividade/inconclusão para doença de Chagas. Compareceram à Hemorrede para a repetição 425 indivíduos, sendo confirmados 28,2% (120/425) como impedidos de doar devido a DC. Conclusão Não houve redução significativa das sorologias positivas/inconclusivas no período entre 2010-2015, porém foi observada redução em relação a 1996/1997 no estado. A determinação da prevalência da doença de Chagas em bancos de sangue pode ser relevante como indicador do risco de transmissão transfusional em determinada região. Novos testes sorológicos para triagem com melhor acurácia são necessários, reduzindo o descarte desnecessário de bolsas de sangue, os custos para o Sistema Único de Saúde e a insegurança para os pacientes e familiares. (Arq Bras Cardiol. 2020; 115(6):1082-1091)

Abstract Background Chagas disease (CD) is considered a public health problem in Latin America. The northeastern region, especially the state of Ceará, still represents a major concern in terms of the risk of transmission of CD. Objective To estimate the prevalence of T. cruzi in blood donors from the state of Ceará. Methods This is a retrospective descriptive study that was performed in the period from 2010 to 2015 from data recorded in the computerized system of the Hematology and Hemotherapy Center of Ceará (HEMOCE in Portuguese). Results Of the 763,731 potential blood donors, 14,159 were serologically ineligible; 1,982 (0.33%) were serologically ineligible due to positive / inconclusive diagnosis for CD. A total of 425 individuals came to the HEMOCE to repeat the test, with 28.2% (120/425) declared ineligible for donations due to CD. Conclusion No significant reduction of positive / inconclusive serology was observed in the period between 2010 and 2015, but a reduction was observed when compared to 1996/1997 in the state. The determination of the prevalence of CD in blood banks may be relevant as an indicator of the risk of CD transmission through blood transfusions in a given region. New serological tests for triage with better accuracy in screening are needed, in an attempt to reduce the unnecessary disposal of blood bags, reduce costs for the Brazilian Unified Health System, and diminish insecurity for the patient and family members. (Arq Bras Cardiol. 2020; 115(6):1082-1091)

ABSTRACT We studied the leaf anatomy of 15 species of Byrsonima and a single species of Diacidia as an outgroup to test the relevance of leaf anatomical characters to the complicated taxonomy of this genus. We present complete anatomical descriptions for petioles and leaf blades, together with an anatomical matrix, dendrogram and an identification key for the studied taxa. The most informative characters were the presence of stomatal crest, trichome type, epidermis type, contour and conformation of the vascular system in the diaphragm and medium petiole and number of accessory bundles. The aforementioned characters revealed that the anatomy of the petioles in the genus differs from that of petioles in the outgroup taxon with regard to vascular system conformation and the absence of cortical sclereids. Furthermore, the anatomy of the leaf blade appears to be quite informative in Byrsonima, especially in synonymized species. The anatomical features evaluated here have great value for Byrsonima taxonomy. These features may be used in an evolutionary approach to the group, especially for proposing a new classification system based on morphoanatomical characters of the genus.

Abstract Due to the good silvicultural characteristics of Schizolobium amazonicum (parica) and its versatility (planting and use), the species has become an alternative in commercial exploitation. Aiming to verify the influence of irrigation depth and substrate on the germination and growth of Parica seedlings, a greenhouse experiment was conducted using randomized blocks in a 2 × 4 bifactorial scheme, with two types of substrates (washed sand and commercial substrate) and four irrigation depths corresponding to 50%, 100%, 150% and 200% of the reference evapotranspiration (ETo), with five replications. Germination rate, emergency speed index and biometric variables were evaluated. The commercial substrate combined with the irrigation level of 50% of ETo favored a higher emergence speed and germination rate. In the growing phase, the irrigation level of 150% of ETo combined with the commercial substrate produced better results, indicating greater survival and development in the field.

Neste estudo foram analisados o perfil e adequação pedagógica e técnica de software que tratam do tema evolução. Software foram identificados em duas bases de dados educacionais, classificados quanto a taxonomia e avaliados com um checklist. Foram identificados 35 software. A maioria foi tutorial (48,6%), seguida de multimídia (22,9%), exercício e prática e processadores de texto (8,6%) e jogos e simuladores (5,7%). Sete foram comportamentalistas, seis construtivistas e cinco construtivista-sociointeracionistas. Dezoito foram adequados quando a forma de apresentação do conteúdo, 29 mostraram-se robustos, 12 apresentaram portabilidade, 26 empregaram adequadamente as imagens, 30 apresentaram adequadamente as informações, 17 tiveram ótima orientação e navegação, 32 foram esteticamente adequados, 16 apresentaram afetividade e apenas um jogo mostrou-se interativo. Houve maior semelhança entre multimídias e processadores de texto, com relevância da orientação e navegação, portabilidade e adequação da apresentação do conteúdo. Exercícios e prática, jogos e tutoriais apresentaram maior semelhança entre si e todos tiveram pouca relevância da orientação e navegação, portabilidade e adequação da apresentação do conteúdo, mas apresentaram maior afetividade. Tutoriais tiveram grande relevância do emprego de imagens. Apesar da importância do uso de software educacionais para a promoção da aprendizagem, todos os tipos analisados mostraram deficiências em alguns dos critérios analisados, indicando que eles devem ser utilizados de maneira complementar.

The present study analyzed the profile and pedagogical and technical adequacy of software dealing with the subject of evolution. The software packages were identified from two educational databases, classified in terms of taxonomy and evaluated with a checklist. A total of 35 software packages were identified. The majority were tutorial (48.6%), followed by multimedia (22.9%), exercises and practical programs and word processors (8.6%) and games and simulators (5.7%). Seven were behaviorist, six were constructivist and five were constructivist-socio-interactionist. Eighteen were adequate in terms of the form of their content presentation, 29 were robust, 12 were portable, 26 used images adequately, 30 presented information adequately, 17 had excellent orientation and navigation, 32 were aesthetically adequate, 16 demonstrated affectivity and only one game was interactive. The greatest similarity was between the multimedia software packages and word processors, with relevance from orientation and navigation, portability and content presentation. The exercises and practical, games and tutorials had the smallest relevance of the orientation and navigation, portability and content presentation, but showed affectivity. Tutorials had greatest relevance of the image use. Despite the importance of using educational software to promote learning, all the types of program analyzed exhibited deficiencies in some of the criteria, indicating that they should be used in a complementary manner.

Abstract: Psoriasis is a chronic inflammatory disease that affects 1.3% of the Brazilian population. The most common clinical manifestations are erythematous, scaling lesions that affect both genders and can occur on any anatomical site, preferentially involving the knees, elbows, scalp and genitals. Besides the impact on the quality of life, the systemic nature of the disease makes psoriasis an independent risk factor for cardiovascular disease, especially in young patients with severe disease. By an initiative of the Brazilian Society of Dermatology, dermatologists with renowned clinical experience in the management of psoriasis were invited to form a work group that, in a partnership with the Brazilian Medical Association, dedicated themselves to create the Plaque Psoriasis Diagnostic and Treatment Guidelines. The relevant issues for the diagnosis (evaluation of severity and comorbidities) and treatment of plaque psoriasis were defined. The issues generated a search strategy in the Medline-PubMed database up to July 2018. Subsequently, the answers to the questions of the recommendations were devised, and each reference selected presented the respective level of recommendation and strength of scientific evidence. The final recommendations for making up the final text were worded by the coordinators.

Abstract INTRODUCTION: The transmission of Chagas disease (CD) through blood transfusion, organ transplantation, and oral transmission has gained greater visibility as a result of intensified vector control activities in endemic regions and to control CD in non-endemic regions. In Brazil, Ceará is one of the states that perform the most organ transplants. Therefore, the objective of this study was to assess the prevalence of Trypanosoma cruzi infection in organ donor candidates. METHODS: A retrospective analysis was performed on data from potential organ donors at the Center of Transplantation of the State of Ceará from 2010 - 2015. RESULTS: Data from a total of 2,822 potential donors were obtained, of which 1,038 were effective donors and 1,784 were excluded, likely due to lack of family authorization or medical contraindication. The prevalence of T. cruzi infection among these potential donors was 1.3% (n = 29). The majority of infected donors were males aged 41 - 60 years, residing in the interior of the state. Interestingly, 72.4% (n = 21) had positive or inconclusive serology for additional infections, such as cytomegalovirus, hepatitis B and C, and toxoplasmosis. Probability analysis revealed that stroke was the most common cause of death among potential donors with CD. CONCLUSIONS: There was a high prevalence of CD and other coinfections among potential solid organ donors in Ceará, and statistical tests have shown that these individuals are at increased risk of stroke when compared to potential non-reactive donors. This work highlights the importance of screening DC infection in potential donors.

Resumo O Serviço de Atenção Farmacêutica ao paciente com doença de Chagas do estado do Ceará foi criando em 2005, com a finalidade de proporcionar seguimento farmacoterapêutico àqueles com esta morbidade. Decorridos 10 anos de atuação, objetivou-se avaliar a satisfação dos pacientes atendidos no serviço. Tratou-se de um estudo prospectivo, empregando um questionário subdividido nas seções: dados socioeconômicos; infraestrutura, localização e funcionamento; cuidado farmacêutico e importância do serviço. Foram entrevistados 70 pacientes de ambos os sexos e acima de 18 anos, entre agosto de 2014 e maio de 2015. Quanto à infraestrutura, localização e funcionamento, as notas obtidas mostraram que os pacientes estão satisfeitos com os parâmetros analisados. Com relação ao cuidado farmacêutico, a maioria dos pacientes mostrou-se satisfeita, tendo o “ser bem atendido” como aspecto mais importante durante o atendimento. Em relação à importância do serviço, 100% o considerou muito importante e o indicaria para outras pessoas. De modo geral, o estudo demonstrou um alto nível de satisfação com o serviço. Há muito a ser trabalhado neste serviço, como promover maior acesso e qualificação do atendimento, contribuindo para a concretização de um modelo humanizado, centrado nas necessidades do paciente.

Abstract In 2005, a pharmaceutical care service was created in the State of Ceará to provide pharmacotherapeutic follow-up for individuals infected with Trypanosoma cruzi (Chagas Disease). After 10 years of operation, an evaluation was conducted to assess the degree of satisfaction of patients treated under the service. This prospective study used a questionnaire comprising the following sections: socioeconomic data; infrastructure, facilities and operations; pharmaceutical care; and importance of the service. Seventy patients of both sexes and over 18 years of age were interviewed between August 2014 and May 2015. As for infrastructure, location and operation, the average grades show a high level of patient satisfaction. Regarding pharmaceutical care, most patients reported being satisfied and considered “being well treated” to be the most important aspect during treatment. In addition, all patients (100%) rated the service as very important and would recommend it to other individuals. Overall, the study showed a high level of patient satisfaction with the service. There is, however, still much to work to be done on this service in order to promote greater access and qualified care to fully achieve a humanized model focused on patient needs.

Resumo O Serviço de Atenção Farmacêutica ao paciente com doença de Chagas do estado do Ceará foi criando em 2005, com a finalidade de proporcionar seguimento farmacoterapêutico àqueles com esta morbidade. Decorridos 10 anos de atuação, objetivou-se avaliar a satisfação dos pacientes atendidos no serviço. Tratou-se de um estudo prospectivo, empregando um questionário subdividido nas seções: dados socioeconômicos; infraestrutura, localização e funcionamento; cuidado farmacêutico e importância do serviço. Foram entrevistados 70 pacientes de ambos os sexos e acima de 18 anos, entre agosto de 2014 e maio de 2015. Quanto à infraestrutura, localização e funcionamento, as notas obtidas mostraram que os pacientes estão satisfeitos com os parâmetros analisados. Com relação ao cuidado farmacêutico, a maioria dos pacientes mostrou-se satisfeita, tendo o “ser bem atendido” como aspecto mais importante durante o atendimento. Em relação à importância do serviço, 100% o considerou muito importante e o indicaria para outras pessoas. De modo geral, o estudo demonstrou um alto nível de satisfação com o serviço. Há muito a ser trabalhado neste serviço, como promover maior acesso e qualificação do atendimento, contribuindo para a concretização de um modelo humanizado, centrado nas necessidades do paciente.

Abstract In 2005, a pharmaceutical care service was created in the State of Ceará to provide pharmacotherapeutic follow-up for individuals infected with Trypanosoma cruzi (Chagas Disease). After 10 years of operation, an evaluation was conducted to assess the degree of satisfaction of patients treated under the service. This prospective study used a questionnaire comprising the following sections: socioeconomic data; infrastructure, facilities and operations; pharmaceutical care; and importance of the service. Seventy patients of both sexes and over 18 years of age were interviewed between August 2014 and May 2015. As for infrastructure, location and operation, the average grades show a high level of patient satisfaction. Regarding pharmaceutical care, most patients reported being satisfied and considered “being well treated” to be the most important aspect during treatment. In addition, all patients (100%) rated the service as very important and would recommend it to other individuals. Overall, the study showed a high level of patient satisfaction with the service. There is, however, still much to work to be done on this service in order to promote greater access and qualified care to fully achieve a humanized model focused on patient needs.

Abstract INTRODUCTION: Chagas disease remains a public health problem in the rural and urban areas of 19 countries in the Americas. METHODS: The aim of the present study was to investigate the Trypanosoma cruzi infection rate of triatomines collected from both intra- and peridomiciliary areas in eleven municipalities of Southeastern Ceará, Brazil, from 2009 to 2015. RESULTS: A total of 32,364 triatomine specimens, including nymphs and adults, were collected, and 31,736 (98.06%) of these were examined. More nymphs were collected than adults, and the greatest number of triatomines (n = 8,548) was collected in 2010, for which the infection rate was 1.3%, with the highest rate of infections observed for specimens from Quixere. The species collected during the study were identified as Triatoma pseudomaculata, Triatoma brasiliensis, Panstrongylus megistus, Panstrongylus lutzi, and Rhodnius nasutus, with T. pseudomaculata being the most abundant (n = 19,962). CONCLUSIONS: These results verify the presence of triatomines in both intra- and peridomiciliary areas, thereby ensuring persistence of the pathogen and consequently, the disease, as the presence of infected vectors in households is an important risk factor. According to these findings, the Chagas Disease Control Program should intensify its efforts in order to prevent the spread of the disease.

RESUMO JUSTIFICATIVA E OBJETIVOS: Dor facial idiopática persistente é uma condição crônica cujas etiologia e fisiopatologia permanecem obscuras. Os critérios diagnósticos dependem da exclusão de todas as possíveis causas somáticas de dor orofacial. Vários estudos investigaram frequentes comorbidades psiquiátricas como ansiedade e depressão, mas há carência de estudos que tenham observado aspectos de personalidade nesses doentes. O objetivo deste estudo foi descrever três casos de pacientes com dor facial idiopática persistente que foram avaliados quanto a traços de personalidade e de caráter, bem como a associação desses traços com as características da dor e o comportamento doloroso. Os instrumentos utilizados foram a entrevista livre e o Inventário de Caráter e Temperamento de Cloninger. RELATO DOS CASOS: O caso 1 apresentava traços de proatividade e altos índices de cooperatividade e autotranscendência, correspondentes com seu perfil de bom enfrentamento. Por outro lado, os casos 2 e 3 apresentaram similaridades quanto à evitação de dor, busca por novidades e enfrentamento pobre, o que correspondeu a uma personalidade insegura e autoprotetora. CONCLUSÃO: Esses casos mostram a importância de abordar a personalidade do paciente para que estratégias de enfrentamento adequadas sejam estabelecidas para a dor facial crônica complexa.

ABSTRACT BACKGROUND AND OBJECTIVES: Idiopathic facial pain is a chronic condition with unknown etiology and pathophysiology. Its diagnostic criteria depend on the exclusion of any somatic cause of orofacial pain. Several studies have investigated anxiety and depression, but there is a lack of publications about personality. The objective of this study was to describe three cases of patients with idiopathic facial pain that had their temperament and character evaluated in order to verify the relation between the findings with pain behavior and pain characteristics. The instruments used were a free interview and the Temperament and Character Inventory. CASE REPORTS: Case 1 was proactive and had high scores of cooperativity and self-transcendence correspondent to the well-coping behavior. On the other side, cases 2 and 3 showed similarities about their harm avoidance, novelty seeking and poor coping, correspondent to a self-protective insecure personality. CONCLUSION: These cases show the importance of personality assessment in order to determine coping strategies in complex chronic facial pain such as idiopathic facial pain.

Abstract INTRODUCTION Benznidazole (BNZ) is a drug available for the etiological treatment of Chagas disease. However, this drug is toxic and has a limited effectiveness on the chronic phase of this disease, often leading to poor treatment adherence. METHODS: This is a descriptive and exploratory study conducted at the Pharmaceutical Care Service for Chagas disease patients of the Federal University of Ceará. Drug-related problems (DRPs) and pharmaceutical interventions (PIs) were classified according to the Second Consensus of Granada. RESULTS: The average age of patients with Chagas disease was 62 years, with the majority residing in the Ceará countryside (86.7%), and having low education levels (63.3% with elementary school education). Regarding family income, most patients belonged to a household that earned ≤1-2 times the minimum wage per month. Approximately 73% of these patients complied with the BNZ treatment, and nearly 7% underwent therapy interruption after medical evaluation. A total of 189 DRPs were identified, of which 51.9% (n=98) were classified as potential, and 48.1% (n=91) as actual. The most frequent DRPs were related to safety (qualitative safety; n=70; 37%), necessity (non-adherence; n=52; 27.5%), and effectiveness (qualitative effectiveness/non-optimal drug selection; n=45; 23.8%). Among the 216 PIs conducted, the majority were related to patient education (n=168; 77.8%) and pharmacological strategy (n=42; 19.4%). CONCLUSIONS: This study indicates the need for pharmacotherapeutic monitoring in patients with Chagas because of the high number of therapeutic interventions, DRPs (approximately 3 DRPs/patient), BNZ adherence, and polypharmacy.