ABSTRACT The usefulness of physical recreation with a playful character for this group of people is a fundamental means to improve their health, their cognitive functions and their quality of life. From a diagnosis applied to a sample of 19 older adults, it was possible to know the insufficiencies in memoristic events that these subjects had. In this sense, it was also found that the proposal of physical-recreational activities aimed at this age group in the community are very general and do not take into account their morpho-functional characteristics. They are limited in terms of the variety of recreational offers for this population group. The objective of this research is to improve cognitive functions, which are related to memorization, in older adults of the "Matahambre" community of the Songo la Maya municipality through orientation walking. For the solution of the objective, theoretical methods such as: analytical-synthetic and inductive-deductive were used. Among the empirical methods, documentary analysis, observation, survey and interview were used to obtain the necessary data and information for the correct implementation of the orientation walk, taking into account the characteristics of this population group. The proposal showed that the orientation walk is an important tool that stimulates the memory and memory capacities of these people, by taking into account their tastes, preferences, needs and preferences.

RESUMO A utilidade da recreação física de caráter recreativo é um meio fundamental para melhorar a saúde, as funções cognitivas e a qualidade de vida. A partir de diagnóstico aplicado a uma amostra de 19 idosos, estes apresentavam insuficiências nos processos de memória; Neste sentido, constatou-se que as propostas de atividades físico-recreativas dirigidas a esta faixa etária eram muito generalistas, não tinham em conta as características morfofuncionais e limitavam-se na variedade de ofertas recreativas. O objetivo desta pesquisa foi melhorar as funções cognitivas relacionadas à memorização em idosos da comunidade Matahambre, no município de Songo la Maya, por meio da caminhada de orientação. Os métodos analítico-sintético e indutivo-dedutivo foram utilizados como métodos teóricos; e empírica, análise documental, observação, inquérito e entrevista que permitiram obter os dados e informações necessários à correta implementação da marcha de orientação tendo em conta as características deste grupo populacional. A proposta demonstrou a caminhada de orientação como uma importante ferramenta que estimulou habilidades de memória e lembranças, ao levar em conta os gostos, preferências, necessidades e interesses do idoso, tornando-a atrativa para ele e permitindo-lhe relembrar aspectos vitais ou emoções de sua vida. vida pessoal.

RESUMEN La utilidad de la recreación física con carácter lúdico resulta un medio fundamental para mejorar la salud, las funciones cognitivas y la calidad de vida. A partir de un diagnóstico aplicado a una muestra de 19 adultos mayores, estos presentaron insuficiencias en los procesos de la memoria; en tal sentido, se comprobó que las propuestas de actividades físico-recreativas dirigidas a este grupo etario fueron muy generales, no atendieron las características morfofuncionales y estuvieron limitadas en la variedad de ofertas recreativas. La presente investigación tuvo como objetivo mejorar las funciones cognitivas, que se relacionan con la memorización, en los adultos mayores de la comunidad Matahambre, del municipio Songo la Maya, a través de la marcha de orientación. Se emplearon como métodos teóricos el analítico-sintético e inductivo-deductivo; y empíricos, el análisis documental, la observación, la encuesta y la entrevista que permitieron obtener los datos e informaciones necesarias para la correcta realización de la marcha de orientación al tomar en cuenta las características de este grupo poblacional. La propuesta demostró la marcha de orientación como una importante herramienta que estimuló las capacidades memorísticas y los recuerdos, al tomar en cuenta los gustos, preferencias, necesidades e intereses del adulto mayor, resultarles atractiva y permitirles recordar aspectos o emociones vitales de su vida personal.

BACKGROUND. Pathology of the hand causes functional impairment, with downstream effects for patient occupation, and consequently presents a socioeconomic burden. Investigation of the epidemiology of hand pathology in KwaZulu-Natal (KZN) can help reduce the burden of disease. Identifying where the greatest need is can direct patient awareness initiatives, medical training and appropriate allocation of resources. OBJECTIVES. To establish the prevalence of hand pathology at regional hospitals that offer orthopaedic services in KZN, to describe the patients most commonly affected by these pathologies and to identify the most common pathologies. METHODS. A cross-sectional investigation of hospital records and charts of patients presenting for orthopaedic care across all 10 regional hospitals in KZN that offer orthopaedic services was undertaken for 1 week's duration (June 2022). Patients were categorised into hand pathology (HP) and general orthopaedic pathology (OP) groups, which were each subdivided into trauma and non-trauma subgroups. Demographic details were collected for all patients. For HP patients, additional detail was collected regarding diagnosis, mechanism, admission and management. The prevalence of HP was calculated as a factor of all orthopaedic presentations. RESULTS. During the investigation, 2 335 patients presented to orthopaedic services. HP represented 21% of these cases. The majority (17%, 406/2 335) were related to trauma and represented 23% of all the traumatic orthopaedic presentations. Distal radius (DR) fractures were the most common hand injury (46%, 188/406) and a large proportion of trauma to the bony elements of the hand were open injuries (23%, 93/406). The remainder of HP cases comprised the non-traumatic group (4%, 91/2 335) and were predominantly infections (68%, 62/91), and many patients with non-traumatic hand pathology required surgery (60%, 55/91) and admission (56%, 52/91). CONCLUSION. HP represents approximately one-fifth of all orthopaedic presentations to regional health facilities in KZN offering orthopaedic care, and close to a quarter of orthopaedic trauma occurs in the hand. Based on these findings, targeted efforts to improve community awareness of precautions against trauma to the hand, osteopaenia and hand hygiene are suggested as preventive measures. Medical training should emphasise the appropriate management of DR fractures and hand infections, and resources should be differentially allocated to the management of these debilitating HPs to decrease the burden of disease.

Abstract Introduction: Community-acquired pneumonia (CAP) is one of the most common diagnoses in clinical practice, an important reason for unscheduled consultations in primary health care and emergency departments, with an increasing incidence in recent years. In patients with chronic comorbidities, the suspicion threshold should be even lower, as the form of presentation is often different from the classic one. Case description: We present the case of a 39-year-old man with a previous history of diabetes and cardiovascular disease, who attended the emergency department for low back pain and fever and was diagnosed with renal colic. He subsequently consulted his primary care physician, to obtain a prescription for an imaging examination. However, due to persistent low back pain, fatigue, dyspnea, and crackles in the left lung base, we considered the alternative diagnostic hypothesis of community-acquired pneumonia. The patient was treated empirically with amoxicillin 1000 mg every 8 hours for seven days, together with azithromycin 500 mg 1 id for five days, and a chest X-ray was ordered. The patient had no complaints at the reassessment visit and was clinically stable. Comment: The main goal of this case report is to raise awareness of the less common presentations of pneumonia in primary healthcare and to state the importance of quality post-hospital care follow-up, which works as a safety net, ensuring favorable clinical outcomes and early detection of possible complications.

Resumo Introdução: A pneumonia adquirida na comunidade (PAC) é um dos diagnósticos mais frequentes na prática clínica e um motivo frequente de consultas não programadas nos cuidados de saúde primários (CSP) e serviços de urgência. No caso dos doentes com patologia crónica, o índice de suspeição deve ser ainda mais elevado já que a forma de apresentação é muitas vezes diferente da clássica. Descrição do caso: É descrito o caso de um homem de 39 anos com antecedentes de diabetes e doença cardiovascular, que recorreu ao serviço de urgência por dor lombar e febre, tendo sido diagnosticada cólica renal. Posteriormente dirigiu-se aos CSP com o objetivo de obter requisição para exame imagiológico. No entanto, por manutenção da lombalgia, cansaço, sensação de falta de ar e presença de fervores na base esquerda à auscultação pulmonar foi proposta a hipótese diagnóstica alternativa de pneumonia adquirida na comunidade. Foi instituída antibioterapia com amoxicilina 1000 mg de 8 em 8 horas por sete dias, juntamente com azitromicina 500 mg 1 id durante cinco dias e requisitada radiografia torácica. Na consulta de reavaliação, o doente apresentava-se sem queixas e clinicamente melhorado. Comentário: Este relato de caso tem como objetivo principal sensibilizar para apresentações menos comuns de pneumonia nos CSP, relembrar o papel indispensável do exame objetivo e reforçar a importância do seguimento pós-hospitalar atento e cuidado nos CSP, que funcionam como uma rede de segurança, permitindo confirmar diagnóstico hospitalar, assegurar a evolução clínica favorável e detetar precocemente eventuais complicações.

Ciara Goslett's account of childhood tuberculosis (TB) sheds light on the challenges faced by children diagnosed with TB in South Africa (SA). Children are particularly vulnerable to TB infection and to dangerous forms of disseminated TB such as TB meningitis, which can cause death or major lifelong disability. They have distinct challenges with diagnosis, and TB treatment for adults is not necessarily child-friendly. In the absence of a child-friendly formulation, adult tablets are broken into the correct dosage and used to treat children. Crushed and dissolved in water, the pieces are not very palatable for children. There are therefore issues that may be neglected if the voices of children are not included in the TB response in SA. These include delays in the development and accessibility of child-friendly medication, vaccine shortages and a lack of educational support for hospitalised children under school-going age. Some positive progress has been made through the establishment of the paediatric working group in the TB Think Tank, and SA's contribution to pivotal childhood TB research studies. Additional steps could be the inclusion of children's feedback in community-led monitoring efforts and engagement between child TB activists and the SA TB Caucus, a collective of parliamentarians.

ABSTRACT Introduction: Intersectorality still shows potential for perfecting its conceptualization in the managerial and technological context to achieve improvements in programs. Objective: Design and evaluate a strategy for intersectoral technological management improvement, to improve the family medicine program. Methods: A quasi-experimental before and after intervention study was carried out, through an intersectoral improvement strategy. From the universe of 771 health users, a sample of 389 was chosen by proportional stratified sampling; It was made up of 330 from health, 38 community actors and 21 from other sectors. It was carried out in 4 stages: diagnosis, design and validation, implementation and evaluation. The variables were studied: level of knowledge, organizational climate and intersectoral actions. Absolute frequencies and percentages were used for the analysis of qualitative data and the McNemar test for the results of the intervention. Results: The application of the strategy in social practice was pertinent due to the results of the expected effectiveness (9.5). The level of knowledge of professionals improved (92.5%), the organizational climate in the 3 dimensions (8.1, 8.2 and 9.3). 90% (9) of the intersectoral actions were satisfactory with a significant association between the intervention and the results (p= 0.001). Conclusions: The designed strategy optimizes managerial technological intersectorality, and improves the family medicine program in the level of knowledge of professionals, the organizational climate and intersectoral actions.

RESUMEN Introducción: La intersectorialidad aún muestra potencial para el perfeccionamiento de su conceptualización en el contexto gerencial y tecnológico, para alcanzar mejoras en los programas de salud. Objetivo: Diseñar y evaluar una estrategia de perfeccionamiento intersectorial tecnológica gerencial para mejorar el programa de medicina familiar. Métodos: Se realizó un estudio cuasiexperimental de intervención de tipo antes y después, a través de una estrategia perfeccionamiento intersectorial. Del universo de 771 usuarios de la salud se escogió una muestra de 389 por muestreo estratificado proporcional; quedó constituida por 330 de la salud, 38 actores de la comunidad y 21 de otros sectores. Fue realizado en 4 etapas: diagnóstico, diseño y validación, implementación y evaluación. Se estudiaron las variables: nivel de conocimientos, clima organizacional y acciones intersectoriales. Se emplearon frecuencias absolutas y porcentajes para el análisis de los datos cualitativos y la prueba de McNemar para los resultados de la intervención. Resultados: Resultó pertinente la aplicación de la estrategia en la práctica social por los resultados de la efectividad esperada (9,5). Mejoró el nivel de conocimientos de los profesionales (92,5 %), el clima organizacional en las 3 dimensiones (8,1, 8,2 y 9,3). El 90 % (9) de las acciones intersectoriales resultaron satisfactorias con una asociación significativa entre la intervención y los resultados (p= 0,001). Conclusiones: La estrategia diseñada optimiza la intersectorialidad tecnológica gerencial y mejora el programa de medicina familiar en el nivel de conocimiento de los profesionales, el clima organizacional y las acciones intersectoriales.

Resumo O diagnóstico de demência de um dos cônjuges da díade tem implicações na forma como os idosos se expressam sexualmente. Estudos anteriores focam-se na atividade sexual, negligenciando o amplo espetro da sexualidade. Este estudo tem como objetivo identificar o conceito de expressão sexual e perceber de que forma a díade de idosos expressa a sua sexualidade, após o diagnóstico de demência. A amostra, não probabilística, por conveniência e bola de neve, é constituída por dez idosos, cônjuges do parceiro com demência a residirem na comunidade. Os dados qualitativos foram recolhidos através de um questionário sociodemográfico e entrevistas semiestruturadas, posteriormente submetidos à análise de conteúdo. Para o conceito de expressão sexual identificaram-se oito categorias: Afetividade; Relações sexuais; Expressão amorosa; Comunicação; Suporte e cuidado; Bem-estar; Companheirismo e Atitudes. Relativamente a formas de expressão sexual obtiveram-se seis categorias: Manifestações de afeto e de cuidado; Diminuição do interesse sexual; Desejo sexual; Existência de relações sexuais; Surgimento de outros interesses e Impacto da menopausa na expressão sexual. Este estudo oferece uma representação diversificada da expressão sexual, enfatiza a importância do afeto e do cuidado para os idosos se manterem sexualmente ativos e contribui para o desenvolvimento de programas e intervenções de promoção de saúde e bem-estar sexual.

Abstract The diagnosis of dementia in one of the spouses in the dyad has implications for the way elderly people express themselves sexually. Previous studies focus on sexual activity, neglecting the broad spectrum of sexuality. This study aims to identify the concept of sexual expression and understand how the elderly dyad expresses their sexuality, after the diagnosis of dementia. The non-probabilistic, convenience and snowball sample consists of ten elderly people, spouses of a partner with dementia living in the community. Qualitative data were collected through a sociodemographic questionnaire and semi-structured interviews, subsequently subjected to content analysis. For the concept of sexual expression, 8 categories were identified: Affection; Sexual relations; Loving expression; Communication; Support and care; Well-being; Companionship and Attitudes. Regarding forms of sexual expression, 6 categories were obtained: Manifestations of affection and care; Decreased sexual interest; Sexual desire; Existence of sexual relations; Emergence of other interests and Impact of menopause on sexual expression. This study offers a diverse representation of sexual expression, emphasizes the importance of affection and care for older adults to remain sexually active, and contributes to the development of programs and interventions to promote sexual health and well-being.

Abstract Introduction: Cannabis is the illicit drug with the highest rate of abuse over a lifetime in Portugal. Although its medicinal use due to its antiemetic properties, a new and paradoxical clinical entity has been recognized - cannabinoid hyperemesis syndrome (CHS) - characterized by chronic cannabinoid consumption, cyclic episodes of difficult-to-treat nausea and vomiting, and compulsive hot showers for symptom relief. Case report: 36-year-old woman, with a history of multiple visits to primary health care center complaining about nausea and cyclic vomiting, still under investigation. She presented to the emergency department (ER) with complaints of epigastric pain, nausea, and vomiting for three days. Laboratory and imaging studies were carried out and did not show any significant alterations. Antiemetic medication and pantoprazole were given, with little improvement in the complaints. During her stay in the ER, she was found several times taking hot showers, repeatedly asking to do so, stating that it was the only measure that alleviated her complaints. In addition, a history of chronic cannabinoid use was found and consequently, the diagnosis of CHS was hypothesized. Comment: There is a common delay in the diagnosis of this syndrome, which leads to multiple hospitalizations, complementary diagnostic tests, and therapeutics. Thus, we aim to raise awareness of CHS among the medical community as a differential diagnosis of difficult-to-treat recurrent vomiting in individuals with a history of cannabinoid use. This case report aims to promote knowledge about CHS, enabling a timely identification and appropriate therapeutic approach to this diagnosis.

Resumo Introdução: A canábis constitui a substância ilícita com maior prevalência de consumo ao longo da vida em Portugal. Apesar do seu uso medicinal pelas suas propriedades antieméticas tem sido reconhecida uma entidade clínica paradoxal - o síndroma de hiper-emese por canabinoides (SHC) - caracterizada pelo consumo crónico de canabinoides (habitualmente diário), episódios cíclicos de náuseas e vómitos refratários a terapêuticas convencionais e o recurso a banhos quentes compulsivos para alívio sintomático. Descrição do caso: Mulher de 36 anos, com múltiplas idas aos cuidados de saúde primários por queixas de náuseas e vómitos cíclicos, ainda em investigação. Recorreu ao serviço de urgência (SU) por queixas de epigastralgias, náuseas e vómitos com três dias de evolução. Realizou estudo complementar que não revelou alterações de relevo. Administrada medicação antiemética e pantoprazol com reduzida melhoria das queixas. Durante a permanência no SU foi encontrada por diversas vezes a tomar duches quentes, solicitando recorrentemente para o fazer, afirmando que era a única medida que aliviava as suas queixas. Adicionalmente apurou-se ainda história de consumo crónico de canabinoides, levando à hipótese diagnóstica de SHC. Comentário: É comum registar-se um atraso importante no diagnóstico desta síndroma e associar-se frequentemente à realização de diversos exames complementares de diagnóstico (ECD), terapêuticas e internamentos hospitalares. Assim, procurou-se sensibilizar a comunidade médica para a SHC, enquanto diagnóstico diferencial de vómitos recorrentes difíceis de tratar, em indivíduos com história de consumo de canabinoides. O presente relato de caso visa promover o conhecimento sobre a SHC, possibilitando a sua atempada identificação e adequada abordagem terapêutica.

RESUMEN Fundamento: el cuidado del medio ambiente para la supervivencia de la especie humana y demás especies que pueblan el planeta reviste gran importancia, sin embargo, existe poca divulgación de los resultados de investigaciones relacionadas con el tema. Objetivo: evaluar los resultados preliminares de un proyecto de investigación sobre el cuidado del medio ambiente. Métodos: se realizó un estudio cualitatitivo, en el período comprendido entre enero de 2021 a julio de 2023. La información primaria se obtuvo a través del modelo de informe semestral del Proyecto de investigación Gestión integrada para el cuidado y conservación del medio ambiente; y mediante la evaluación del cumplimiento del cronograma de este. Resultados: derivadas del proyecto, se presentaron 9 ponencias en eventos, las cuales fueron representativas del impacto científico. El el orden social, se destacó el aporte a la formación de recursos humanos mediante la ejecución de 6 trabajos de terminación de la especialidad de Estomatología General Integral. Como impacto medioambiental, se elaboró el diagnóstico del estado técnico y comportamiento estructural ante multiamenazas del inmueble ocupado por la Facultad, en virtud de lo cual fue diseñada y aprobada una estrategia de gestión ambiental. Conclusiones: el proyecto de investigación constituye una fortaleza que se evidencia en los resultados alcanzados. A pesar de las transformaciones realizadas, aún falta perfeccionar la gestión para el cumplimiento del cronograma propuesto en beneficio del medio ambiente y la salud de la comunidad.

ABSTRACT Foundation: caring for the environment, the survival of the human species and other species that populate the planet is of great importance, however, there is a few dissemination of the research related to the topic’s results. Objective: evaluate the preliminary results of a research project on environmental care. Methods: a qualitative study was carried out from January 2021 to July 2023. The primary information was obtained through the semiannual report model of the Integrated Management research project for the care and conservation of the environment; and by evaluating achievement with its schedule. Results: from the project, 9 papers were presented at events, which were of the scientific impact. In the social order, the contribution to the training of human resources was highlighted through the execution of 6 completion projects in the specialty of Comprehensive General Stomatology. As an environmental impact, a diagnosis of the Faculty property technical state and structural behavior of multi-dangers was developed, by virtue of which an environmental management strategy was designed and approved. Conclusions: the research project constitutes a strength that is evident in the results achieved. Despite the transformations carried out, management still needs to be improved to comply with the proposed schedule for the benefit of the environment and the health of the community.

Abstract Background: Early detection of suspected neurodevelopmental delay allows for timely diagnosis and appropriate intervention, for which numerous screening tests have been developed. However, most are complex and impractical for health-care workers at the community level. This study aimed to validate the KARVI scale in the neurodevelopment assessment of children under 1 year of age. Methods: We conducted an observational, longitudinal, comparative, inferential, and prospective study. Healthy children without risk factors for developing neurodevelopmental delay from 0 to 12 months of age were evaluated remotely using the Zoom® application. The Child Development Evaluation Test and the KARVI scale were applied once a month for four consecutive months. Results: Fifty individuals were analyzed, with a predominance of males in 52%. Adequate percentages for a screening test were obtained in the first evaluation with a sensitivity of 70% (confidence interval [CI] 95% 34.75-93.33) and a specificity of 75% (CI 95% 58.8-87.31), and in the fourth evaluation with a sensitivity of 100% (CI 95% 29.4-100) and a specificity of 78.72% (CI 95% 64.34-89.3), being significant in both evaluations (p = 0.007 and p = 0.001, respectively). Conclusions: The KARVI scale has the elements to be an effective screening test for suspected neurodevelopmental delay, but more extensive studies are needed to obtain more reliable results.

Resumen Introducción: La identificación temprana de retraso en el neurodesarrollo permite un diagnóstico oportuno y una intervención apropiada. Para ello, se han creado diversas pruebas de tamizaje; sin embargo, la mayoría son complejas y poco prácticas para el personal de la salud a nivel comunitario. El objetivo del estudio fue realizar la validación de la escala KARVI en la valoración del neurodesarrollo en niños menores de un año. Métodos: Se realizó un estudio observacional, longitudinal, comparativo inferencial y prospectivo, en el cual se evaluaron, vía remota mediante la aplicación Zoom®, niños sanos de 0 a 12 meses de edad sin factores de riesgo para desarrollar retraso en el neurodesarrollo. Se aplicaron la prueba EDI (Evaluación del Desarrollo Infantil) y la escala KARVI una vez al mes por cuatro meses consecutivos. Resultados: Se analizaron 50 individuos, con predominio del sexo masculino en el 52%. Se obtuvieron porcentajes adecuados para una prueba de tamizaje tanto en la primera evaluación, con sensibilidad de 70% (IC 95% 34.75-93.33) y especificidad de 75% (IC 95% 58.8-87.31), como en la cuarta, con sensibilidad de 100% (IC 95% 29.4-100) y especificidad de 78.72% (IC 95% 64.34-89.3), con significación estadística en ambas evaluaciones (p = 0.007 y p = 0.001, respectivamente). Conclusiones: Se considera que la escala KARVI cuenta con los elementos para considerarla como una prueba de tamizaje efectiva para detectar retraso del neurodesarrollo, sin embargo. Sin requieren estudios más extensos para obtener resultados más confiables.

Abstract Nowadays, obesity has become one of the biggest public health challenges worldwide. This scenario includes Colombia as well. Against this background, the university environment constitutes a key scenario for addressing this situation. Research Objective: To characterize the food environment of a university in Medellín, Colombia. Materials and methods: A cross-sectional descriptive study was carried out through direct observation. Additionally, it was used structured forms for recording the data of the food establishments. The research considers the following variables: food supply, prices, advertising, facilitators and barriers. Results: No establishment was classified as healthy. In 76% of the establishments, the food-sets or promotions were cheaper. In 62% of the places under inspection, the healthy dishes were more expensive. Only in two establishments there was direct advertising that promoted healthy eating. In general, mainly ultra-processed edible products (53%) were offered. Conclusion: The results of the study generally paint a picture of an unhealthy food environment. This diagnosis is configured as an important input for decision-making within the institution to improve and promote a healthier diet that reduces the risk of developing chronic diseases in the university community.

Resumen La obesidad se ha convertido en una de las mayores problemáticas de salud pública a nivel mundial, y Colombia no es ajena a esta situación. El entorno universitario constituye un escenario clave para el abordaje de esta problemática. Objetivo: Caracterizar el entorno alimentario de una universidad en Medellín, Colombia. Materiales y métodos: Se realizó un estudio descriptivo transversal mediante la observación directa y registro en formularios estructurados de todos los establecimientos de venta de alimentos. Se consideraron las siguientes variables: oferta de alimentos, precio, publicidad, facilitadores y barreras. Resultados: Ningún establecimiento se clasificó como saludable. En el 76% de los establecimientos, los paquetes o promociones eran más económicos. En el 62% de los establecimientos se observó que los platos saludables eran más costosos. Solo en dos establecimientos se observó publicidad directa para fomentar una alimentación saludable. Se ofrecían principalmente productos ultraprocesados (53%). Conclusión: los resultados del estudio muestran en general un panorama de un entorno alimentario poco saludable. Este diagnóstico se configura como un insumo importante para la toma de decisiones al interior de la institución para mejorar y promover una alimentación más saludable que permita disminuir el riesgo de desarrollar enfermedades crónicas en la comunidad universitaria.

Resumo O Seybouse é um rio no nordeste da Argélia, é o segundo maior rio, tem uma área de captação de cerca de 6.500 km2 que acolhe cerca de 1,5 milhões de habitantes. Importantes atividades agrícolas e industriais são desenvolvidas nesta bacia hidrográfica. O uso de macroinvertebrados bentônicos como indicadores biológicos tem uma longa tradição em países desenvolvidos e está integrado em todas as avaliações da qualidade ecológica dos sistemas fluviais. O objetivo deste estudo foi revisar o inventário e o papel ecológico dos macroinvertebrados bentônicos nas águas interiores do rio Seybouse e determinar o impacto da poluição em suas distribuições. Resultados semelhantes foram relatados para outros países e rios argelinos. Este estudo enfoca a macrofauna bentônica de Wadi Seybouse e seus afluentes. Foram prospectados 03 locais, um no alto Seybousse Bouhamdane em Medjez Amar e dois no meio Seybousse Salah Salah Salah e Oued Zimba. Entre dezembro de 2019 e maio de 2020, dez parâmetros físico-químicos (pH, CE, DO, velocidade da água, NO3, Salinidade, NO2, MES, turbidez, deth) foram medidos para estabelecer um diagnóstico do estado de saúde desses ecossistemas aquáticos. A abordagem biológica complementar pela análise de populações de macroinvertebrados identificou 7.482 indivíduos e 40 táxons divididos em cinco classes: Crustáceos que são os mais dominantes, Insetos com as ordens principais (Ephemeroptera, Diptera, Trichoptera, Heteroptera e Odonata), Moluscos, Nematóides e Anelídeos. As análises físico-químicas e a aplicação dos índices de poluição orgânica, indicaram uma poluição forte a excessiva para todos os locais especialmente Salah Salah Salah.

Abstract The Seybouse is the second largest river basin in Algeria, hosting an important biodiversity and providing various ecosystem services. This watershed is highly influenced by agricultural and industrial activities, which threaten its biodiversity and ecosystem integrity. The use of benthic macroinvertebrates as biological indicators has a long tradition in developed countries and integrated into all assessments of the ecological quality of river systems. However, the macroinvertebrates of many North African regions are still not well studied, including those of the Seybouse river. The aim of this study is to assess the inventory and ecological role of benthic macroinvertebrates in inland waters of the Seybouse River and determine the impact of pollution on their spatial distributions. We sampled the benthic macrofauna of Wadi Seybouse and its affluents using regular surveys in three sites, of which one was in the upper Seybouse Bouhamdane in Medjez Amar and two in the middle Seybouse. Between December 2019 and May 2020, 10 physico-chemical parameters (pH, EC, OD, water speed, NO3, Salinity, NO2, MES, turbidity, depth) were measured in order to establish a health state diagnosis of these aquatic ecosystems. The complementary biological approach by the analysis of populations of macroinvertebrates identified 7482 individuals and 40 taxa divided into five classes: Crustaceans which were the most dominant, insects with the main orders (Ephemeroptera, Diptera, Trichoptera, Heteroptera and Odonata), Molluscs, Nematodes and Annelids. The physico-chemical analyzes and the application of the organic pollution indices indicated a strong to excessive pollution for all sites, especially in Seybouse upstream

Abstract This study evaluated factors associated with hospitalization related to the mental health of people undergoing follow-up in Psychosocial Care Centers (CAPS, in Portuguese) in the city of São Paulo, Brazil, referred from Primary Health Care (PHC). This was an evaluative study conducted with 297 individuals in 24 adult CAPS. This study analyzed the prevalence ratios (PR) and their respective 95% confidence intervals (95% CI), obtained through Poisson Regression with robust variance. A statistically significant association was found with hospitalization during follow-ups in CAPS: having health insurance and/or medical plan; waiting time between the diagnosis and the first consultation with a non-medical professional of more than seven days; not having received medical advice regarding how long to use medication; not having received a psychopharmaceutical prescription at PHC; and having a medical history of the hospitalization due to mental health. The results warn of the need to expand access to the more socially vulnerable population, in addition to a restructuring of the services in order to provide more interactive and inclusive practices geared toward the singularities of the users. followup follow up CAPS, CAPS (CAPS Portuguese Paulo Brazil PHC. PHC . (PHC) 29 2 PR (PR 95 (95 CI, CI , CI) variance followups ups andor or plan nonmedical non days medication population users (PHC 9 (9 (

Resumo Avaliaram-se os fatores associados à internação relacionadas à saúde mental de pessoas em acompanhamento nos Centros de Atenção Psicossocial (CAPS) do município de São Paulo, encaminhadas pela atenção primária (APS). Pesquisa avaliativa com 297 pessoas em 24 CAPS Adulto. Analisaram-se as razões de prevalência (RP) e seus respectivos intervalos de confiança de 95% (IC), obtidas por meio da regressão de Poisson com variância robusta. Mostraram associação estatisticamente significativa com a internação durante o acompanhamento no CAPS: ter plano de saúde/convênio médico; tempo de espera entre diagnóstico e primeiro atendimento com profissional não médico maior que sete dias; não ter sido orientado sobre o tempo de uso da medicação; não receber prescrição de psicofármaco na APS; e ter histórico de ocorrência de internação por saúde mental. Os resultados alertam para a necessidade de ampliação do acesso à população com maior vulnerabilidade social, além de uma reestruturação dos serviços para a oferta de prática mais articuladas e inclusivas, voltadas às singularidades dos usuários. Avaliaramse Avaliaram se (CAPS Paulo APS. APS . (APS) 29 2 Adulto Analisaramse Analisaram RP (RP 95 IC, IC , (IC) robusta saúdeconvênio convênio dias medicação social inclusivas usuários (APS 9 (IC

Entender as contribuições que diferentes atores sociais e institucionais podem fazer para a resposta ao HIV. A pesquisa qualitativa foi realizada usando uma técnica de entrevista semiestruturada. Foram realizadas 15 entrevistas, identificando quatro áreas principais para o trabalho com o HIV: educação, promoção e prevenção combinada do HIV; diagnóstico precoce e atendimento abrangente do HIV; participação social e comunitária na resposta ao HIV; e redução do estigma e da discriminação do HIV. Foram evidenciadas algumas barreiras que os cidadãos têm para acessar determinados serviços e as limitações existentes na implementação de projetos de saúde sexual no município, devido à falta de articulação entre os atores sociais e a administração municipal, o que restringe o impacto dos programas de HIV.

Comprender los aportes que desde los diferentes actores sociales e institucionales se pueden generar alrededor de la respuesta al VIH. Se desarrolló una investigación cualitativa, empleándose como técnica de investigación la entrevista semiestructurada. Se realizaron 15 entrevistas, donde se identificaron cuatro áreas fundamentales para el trabajo en VIH, a saber: educación, promoción y prevención combinada del VIH; diagnóstico temprano y atención integral del VIH; participación social y comunitaria en la respuesta al VIH y disminución del estigma y la discriminación frente al VIH. Se evidenciaron algunas barreras que tienen los ciudadanos para acceder a determinados servicios y las limitaciones que existen en la implementación de proyectos de salud sexual en el municipio, debido a la falta de articulación entre los actores sociales y la administración municipal, lo que restringe el impacto de los programas de VIH.

To understand the contributions that can be generated from the different social and institutional actors around the response to HIV. A qualitative research was developed, using a semi-structured interview as a research technique. Fifteen interviews were conducted, where four fundamental areas for HIV work were identified, namely: education, promotion and combined HIV prevention; early diagnosis and comprehensive HIV care; social and community participation in the response to HIV; and reduction of HIV stigma and discrimination. Some barriers that citizens have to access certain services and the limitations that exist in the implementation of sexual health projects in the municipality were evidenced, due to the lack of articulation between social actors and the municipal administration, which restricts the impact of HIV programs.

Entender as contribuições que diferentes atores sociais e institucionais podem fazer para a resposta ao HIV. A pesquisa qualitativa foi realizada usando uma técnica de entrevista semiestruturada. Foram realizadas 15 entrevistas, identificando quatro áreas principais para o trabalho com o HIV: educação, promoção e prevenção combinada do HIV; diagnóstico precoce e atendimento abrangente do HIV; participação social e comunitária na resposta ao HIV; e redução do estigma e da discriminação do HIV. Foram evidenciadas algumas barreiras que os cidadãos têm para acessar determinados serviços e as limitações existentes na implementação de projetos de saúde sexual no município, devido à falta de articulação entre os atores sociais e a administração municipal, o que restringe o impacto dos programas de HIV. HIV semiestruturada 1 entrevistas educação município municipal

To understand the contributions that can be generated from the different social and institutional actors around the response to HIV. A qualitative research was developed, using a semi-structured interview as a research technique. Fifteen interviews were conducted, where four fundamental areas for HIV work were identified, namely: education, promotion and combined HIV prevention; early diagnosis and comprehensive HIV care; social and community participation in the response to HIV; and reduction of HIV stigma and discrimination. Some barriers that citizens have to access certain services and the limitations that exist in the implementation of sexual health projects in the municipality were evidenced, due to the lack of articulation between social actors and the municipal administration, which restricts the impact of HIV programs. developed semistructured semi structured technique conducted identified namely education prevention care discrimination evidenced administration programs

Comprender los aportes que desde los diferentes actores sociales e institucionales se pueden generar alrededor de la respuesta al VIH. Se desarrolló una investigación cualitativa, empleándose como técnica de investigación la entrevista semiestructurada. Se realizaron 15 entrevistas, donde se identificaron cuatro áreas fundamentales para el trabajo en VIH, a saber: educación, promoción y prevención combinada del VIH; diagnóstico temprano y atención integral del VIH; participación social y comunitaria en la respuesta al VIH y disminución del estigma y la discriminación frente al VIH. Se evidenciaron algunas barreras que tienen los ciudadanos para acceder a determinados servicios y las limitaciones que existen en la implementación de proyectos de salud sexual en el municipio, debido a la falta de articulación entre los actores sociales y la administración municipal, lo que restringe el impacto de los programas de VIH. cualitativa semiestructurada 1 entrevistas saber educación municipio municipal

Abstract This study evaluated factors associated with hospitalization related to the mental health of people undergoing follow-up in Psychosocial Care Centers (CAPS, in Portuguese) in the city of São Paulo, Brazil, referred from Primary Health Care (PHC). This was an evaluative study conducted with 297 individuals in 24 adult CAPS. This study analyzed the prevalence ratios (PR) and their respective 95% confidence intervals (95% CI), obtained through Poisson Regression with robust variance. A statistically significant association was found with hospitalization during follow-ups in CAPS: having health insurance and/or medical plan; waiting time between the diagnosis and the first consultation with a non-medical professional of more than seven days; not having received medical advice regarding how long to use medication; not having received a psychopharmaceutical prescription at PHC; and having a medical history of the hospitalization due to mental health. The results warn of the need to expand access to the more socially vulnerable population, in addition to a restructuring of the services in order to provide more interactive and inclusive practices geared toward the singularities of the users.

Resumo Avaliaram-se os fatores associados à internação relacionadas à saúde mental de pessoas em acompanhamento nos Centros de Atenção Psicossocial (CAPS) do município de São Paulo, encaminhadas pela atenção primária (APS). Pesquisa avaliativa com 297 pessoas em 24 CAPS Adulto. Analisaram-se as razões de prevalência (RP) e seus respectivos intervalos de confiança de 95% (IC), obtidas por meio da regressão de Poisson com variância robusta. Mostraram associação estatisticamente significativa com a internação durante o acompanhamento no CAPS: ter plano de saúde/convênio médico; tempo de espera entre diagnóstico e primeiro atendimento com profissional não médico maior que sete dias; não ter sido orientado sobre o tempo de uso da medicação; não receber prescrição de psicofármaco na APS; e ter histórico de ocorrência de internação por saúde mental. Os resultados alertam para a necessidade de ampliação do acesso à população com maior vulnerabilidade social, além de uma reestruturação dos serviços para a oferta de prática mais articuladas e inclusivas, voltadas às singularidades dos usuários.