Abstract The informal caregiver provides non-remunerated permanent or regular care to dependent older adults. This qualitative study aimed to identify the perceptions of informal caregivers about motivations, needs, and benefits of caring for dependent older adults. It was conducted with ten Portuguese informal caregivers, based on an instrument with questions about the care provided to older adults and their perceptions about performing this role. The results revealed the following motivations for care: proximity and trust relationship, duty of care, more available family members, home proximity, lack of vacancies, high cost of shelter institutions, and older adults’ desire to remain in their homes. The primary care activities for older adults are hydration, hygiene, food, therapeutic administration, companionship, emotional support, comfort, entertainment, and promoting autonomy and dignity. The needs identified by the caregivers were home, social security, and the caregiver’s employer support, financial help, psychological support, and training to care for the older adults. The benefits of informal care for dependent older adults were prompt family support, physical and emotional security, affection, and companionship. This study gives voice to crucial citizens. nonremunerated non remunerated role relationship members vacancies institutions homes hydration hygiene food administration companionship support comfort entertainment dignity security s help affection citizens

Resumo O cuidador informal presta cuidados permanentes ou regulares a pessoas idosas em situação de dependência, sem remuneração. Objetivou-se identificar as percepções de cuidadores informais sobre motivações, necessidades e benefícios do cuidado ao idoso dependente. Estudo qualitativo realizado com 10 cuidadoras informais portuguesas, a partir de um instrumento com questões sobre o cuidado prestado ao idoso e suas percepções sobre o exercício dessa função. Os resultados revelaram como motivações para o cuidado: relação de proximidade e confiança, dever de cuidar, familiar mais disponível, proximidade da residência, inexistência de vagas e elevado custo das instituições de acolhimento e desejo do idoso permanecer na sua habitação. Os principais cuidados aos idosos são: hidratação, higiene, alimentação, administração terapêutica, companhia, apoio emocional, conforto, entretenimento, promoção da autonomia e dignidade. As necessidades identificadas pelas cuidadoras foram: apoio domiciliário, da segurança social e da entidade empregadora do cuidador, ajuda financeira, suporte psicológico e capacitação para cuidar do idoso. Os benefícios do cuidado informal para o idoso dependente apontados foram: celeridade do apoio familiar, segurança física e emocional, afeto e companheirismo. Este estudo dá voz a cidadãos cruciais. dependência remuneração Objetivouse Objetivou se 1 portuguesas função confiança disponível residência habitação são hidratação higiene alimentação terapêutica companhia emocional conforto entretenimento dignidade foram domiciliário financeira companheirismo cruciais

ABSTRACT The Yunguyo coastline has been subject to a growing process of severe contamination as a result of anthropic action. The study analyzes the pro-environmental concerns and behaviors of the Yunguyo population regarding environmental management, coastal pollution and effects on human health. The research design is non-experimental, transversal; the approach is quantitative, of a descriptive and correlational nature, level of micro analysis and socio-environmental dimension. The study population comprises 17,343 people over 18 years of age; the sample determined at simple random was 332 heads of family. The data collection technique is the survey through a structured questionnaire. Results: The environmental concerns of the majority of the population are positive regarding sanitation, sources of contamination of the coastal coastline and negative effects on human health. The pro-environmental behaviors of the majority of the urban population of Yunguyo are adequate in environmental management, sanitation and hygiene conditions at home, and access to public social services. Conclusion: There is a relationship between concerns and pro-environmental behaviors of the population regarding environmental management and contamination of the coastal coastline.

RESUMEN El litoral costero de Yunguyo viene siendo objeto de un proceso creciente de contaminación severa producto de la acción antrópica. El estudio analiza las preocupaciones y comportamientos proambientales de la población de Yunguyo sobre gestión ambiental, contaminación del litoral costero y efectos en la salud humana. El diseño de investigación es no experimental, transversal; el enfoque es cuantitativo, de carácter descriptivo y correlacional, nivel de análisis micro y dimensión socioambiental. La población del estudio comprende 17 343 personas mayores de 18 años; la muestra determinada al azar simple fue de 332 jefes de familia. La técnica de recolección de datos es la encuesta a través de un cuestionario estructurado. Resultados: Las preocupaciones ambientales de la mayoría de la población son positivas respecto a saneamiento, fuentes de contaminación del litoral costero y efectos negativos en la salud humana. Los comportamientos proambientales de la mayoría de la población urbana de Yunguyo son adecuados en gestión ambiental, condiciones de sanidad e higiene en el hogar y acceso a servicios sociales públicos. Conclusión: Existe relación entre preocupaciones y comportamientos proambientales de la población respecto a gestión ambiental y contaminación del litoral costero.

Resumen Durante las últimas décadas en Puno, Perú, la problemática de la contaminación se fue agudizando por la acción combinada del crecimiento desordenado de la población urbana, gestión deficiente de residuos sólidos, descarga de aguas servidas sin tratamiento en la bahía del lago Titicaca y prácticas de sanidad e higiene inadecuadas; situaciones que afectan severamente el ambiente y la salud humana. El objetivo del estudio fue caracterizar las actitudes y comportamientos proambientales de la población de la ciudad de Puno en relación al saneamiento, la contaminación y la gestión ambiental. La investigación es no experimental, cuantitativa, trans¬versal, descriptiva, correlacional y nivel de análisis micro. El universo de estudio fue la población mayor de 18 años del área urbana, que comprende 97.264 habitantes; la muestra, deter¬minada al azar simple, fue de 382 personas. Se aplicó un cuestionario estructurado. El análisis descriptivo, inferencial y prueba de hipótesis se realizó con el software estadístico SPSS. Los resultados señalan que las actitudes ambientales de la mayoría de la población son positivas respecto a factores y fuentes de contaminación y efectos en la salud humana; contrariamente, las prácticas ambientales son inadecuadas en gestión ambiental en el hogar y condiciones de sanidad e higiene en la vivienda. Se concluye, que la mejora sostenible de actitudes y comportamientos proambientales, demanda de una nueva política pública de educación ambiental, cuya implementación incorpore la participación efectiva de la sociedad civil con base a un sistema de incentivos.

Abstract During the last decades in Puno, Peru, the problem of contamination has worsened due to the combined action of the disorderly growth of the urban population, poor management of solid waste, discharge of untreated sewage into the bay of Lake Titicaca and practices of inadequate sanitation and hygiene, severely affecting the environment and human health. The objective of the study was to characterize the pro-environmental attitudes and behaviors of the city’s population of Puno in relation to sanitation, pollution and environmental management. The research is nonexperimental, quantitative, cross-sectional, descriptive, correlational and micro level of analysis. The universe of study was the population over 18 years of age in the urban area, which comprises 97,264 inhabitants; the sample, determined at simple random, was 382 people. A structured questionnaire was applied. Descriptive and inferential analysis and hypothesis testing were performed with SPSS statistical software. The results indicate that the environmental attitudes of the majority of the population are positive regarding factors and sources of pollution and effects on human health. On the contrary, environmental practices are inadequate in environmental management in the home and health and hygiene conditions in the home. It is concluded that the sustainable improvement of pro-environmental attitudes and behaviors demands a new public policy of environmental education, whose implementation incorporates the effective participation of civil society based on an incentive system.

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.

RESUMEN Introducción: El envejecimiento poblacional y el aumento de enfermedades crónicas han incrementado la prevalencia de discapacidad en adultos mayores. Evaluar la capacidad funcional en actividades básicas de la vida diaria (ABVD) es esencial para mantener la independencia y calidad de vida. Este estudio se enfocó en evaluar la capacidad funcional de adultos mayores en ABVD en el ámbito familiar de Asunción en el año 2023. Materiales y métodos: Se realizó un estudio observacional, descriptivo, de corte transversal, en noviembre del 2023, con 91 adultos mayores (≥65 años) de Asunción, en hogares familiares. Se aplicaron encuestas mediante Google Formulario y se utilizó el Índice de Barthel para medir la capacidad funcional. El muestreo fue no probabilístico por bola de nieve. Se empleó estadística descriptiva e inferencial, con un nivel de significancia de p≤0,05. Se respetaron los aspectos éticos de la investigación. Resultados: Participaron 91 adultos mayores, con una edad promedio de 79 años±8,2. El 62,6% fueron mujeres y 41,8% del grupo de edad de 75 a 84 años. Según el Índice de Barthel, el 59,3% necesita ayuda para cortar alimentos y el 34,1% depende de otra persona para la higiene personal. El 28,6% tiene incontinencia en deposiciones y el 30,8% en micción. La puntuación promedio del Índice de Barthel fue 68,5±33,9, indicando dependencia leve en el 61,5% de los participantes. El 77% de los adultos mayores reciben cuidados de un familiar. Conclusión: Un alto porcentaje de los adultos mayores mostró algún grado de dependencia, especialmente en actividades de alimentación e higiene. La edad avanzada y el sexo femenino se asociaron con mayores niveles de dependencia. La mayoría de los adultos mayores dependieron de familiares para su cuidado, destacando la necesidad de fortalecer las redes de apoyo y capacitar a los cuidadores informales.

ABSTRACT Introduction: Population aging and the increase in chronic diseases have raised the prevalence of disability in older adults. Evaluating functional capacity in basic activities of daily living (BADL) is essential to maintaining independence and quality of life. This study focused on evaluating the functional capacity of older adults in BADL within the family setting of Asunción in 2023. Material and methods: An observational, descriptive, cross-sectional study was conducted in November 2023, with 91 older adults (≥65 years) from Asunción, in family homes. Surveys were administered via Google Forms, and the Barthel Index was used to measure functional capacity. The sampling was non-probabilistic snowball sampling. Descriptive and inferential statistics were employed, with a significance level of p≤0.05. Ethical aspects of the research were respected. Results: Ninety-one older adults participated, with an average age of 79 years±8.2. Of these, 62.6% were women and 41.8% were in the age group of 75 to 84 years. According to the Barthel Index, 59.3% needed help cutting food, and 34.1% depended on another person for personal hygiene. Additionally, 28.6% had bowel incontinence, and 30.8% had urinary incontinence. The average Barthel Index score was 68.5±3.9, indicating mild dependence in 61.5% of participants. Furthermore, 77% of older adults received care from a family member. Conclusion: A high percentage of older adults showed some degree of dependence, especially in activities related to feeding and hygiene. Advanced age and female sex were associated with higher levels of dependence. Most older adults relied on family members for care, highlighting the need to strengthen support networks and train informal caregivers.

RESUMEN Introducción: La salud bucal en niños es esencial para su desarrollo, habla, nutrición y autoestima. Además, previene problemas odontológicos graves en la edad adulta y evita costosos tratamientos futuros. Objetivo: Determinar el nivel de conocimiento, actitud y práctica sobre salud oral en niños de 6 a 12 años de una escuela del área metropolitana de Asunción. Resultado: Participaron 202 niños, donde el 51,0% correspondió al sexo masculino, con edad media de 9 ± 4,24 años. El 55% de los niños presentó gingivitis. El 35,6% posee caries en dientes primarios mientras que el 48,9% presenta caries en dientes permanentes. El 98,02% de los participantes respondió correctamente la pregunta sobre alimentos perjudiciales para los dientes. Sobre la práctica de higiene bucal, en la mayoría de los niños la enseñanza de la técnica de cepillado estuvo a cargo de los padres, sin embargo, reportan que estos no siempre los controlan. Conclusión: Los niños tuvieron buen conocimiento, actitud positiva y prácticas adecuadas de higiene bucal, sin embargo, la mitad de ellos presentaba caries en dientes permanentes. Se sugiere que la falta de supervisión diaria por parte de los padres en la técnica de cepillado podría ser un factor contribuyente.

ABSTRACT Introduction: Oral health is crucial for children's development, speech, nutrition, and self-esteem. Maintaining good oral health during childhood prevents serious dental issues in adulthood and reduces the need for costly treatments later on. Objective: To assess the knowledge level, attitudes, and practices regarding oral health among children aged 6 to 12 years at a school located in the metropolitan area of Asunción. Results: A total of 202 children participated in the study, of whom 51.0% were male, with a mean age of 9 years (SD = 4.24 years). Approximately 55% of the children had gingivitis. Primary teeth cavities were present in 35.6% of the participants, while 48.9% had cavities in their permanent teeth. Regarding dietary knowledge, 98.02% of the participants correctly identified foods harmful to dental health. Most children learned brushing techniques from their parents; however, consistent parental supervision was reportedly lacking. Conclusion: Despite demonstrating good knowledge and generally adequate oral hygiene practices, nearly half of the children had cavities in their permanent teeth. The data suggest that the lack of regular parental supervision of brushing techniques could be a significant contributing factor to dental caries.

RESUMEN El lavado de manos de los trabajadores de la salud es esencial para prevenir Infecciones Asociadas a la Atención de la Salud. La falta de cumplimiento con esta práctica correcta favorece a la propagación de Microorganismos patógenos. El objetivo fue identificar la situación de Higiene de manos del profesional de la salud del servicio de Urología. Hospital de Clínicas 2023. El estudio fue observacional, correlacional, se llevó a cabo en Hospital de Clínicas. La población de estudio fue de 27 personales de salud. En cuanto a los datos sociodemográficos el 52% son hombres y mujeres 48%. La edad promedio se sitúa predominantemente en los rangos de 20 a 29 años 33% y 45% de 40-49 años. En lo que respecta a la presencia de bacterias comunes en las manos del profesional de la salud, se identificó principalmente la presencia del 54% de Staphylococcus spp., mientras que Pseudomonas se encontró en cantidades mínimas 4% y que no desarrollaron Bacterias a los 6 días de incubación un promedio de 42%. En cuanto a la resistencia a los antibióticos por parte del profesional de la salud el 28% corresponde a Eritromicina el 24% Clindamicina, el 17% Oxacilina el 9% a Rifampicina el 7% Trimeroprima+Sulfametazol y con 5% los siguientes: Ciprofloxacina, Tetraciclina, Gentamicina, la gran mayoría con resistencia a Microorganismos Gram (+) como *Staphylococcus aureus. El profesional de la salud demuestra un desempeño aceptable en la prevención de la presencia bacteriana, aunque aún existe margen de mejora, se recomienda revisar y fortalecer prácticas para prevenir la presencia bacteriana.

ABSTRACT Healthcare workers' handwashing is essential for preventing Healthcare-Associated Infections. Non-compliance with this correct practice promotes the spread of pathogenic microorganisms. The objective was to identify the hand hygiene situation of healthcare personnel in the Urology service at Clinics Hospital in 2023. The study was observational, correlational, and conducted at Clinics Hospital. The study population consisted of 27 healthcare personnel. Regarding sociodemographic data, 52% are male and 48% are female. The average age predominantly falls within the ranges of 20 to 29 years (33%) and 40 to 49 years (45%). Regarding the presence of common bacteria on the hands of healthcare personnel, Staphylococcus spp. was identified in 54% of cases, while Pseudomonas was found in minimal amounts (4%), and there was no development of bacteria after 6 days of incubation on average (42%). Regarding antibiotic resistance among healthcare personnel, 28% corresponded to Erythromycin, 24% to Clindamycin, 17% to Oxacillin, 9% to Rifampicin, 7% to Trimethoprim+Sulfamethoxazole, and 5% to the following: Ciprofloxacin, Tetracycline, Gentamicin, with the vast majority showing resistance to Gram-positive microorganisms like Staphylococcus aureus. Healthcare personnel demonstrate acceptable performance in preventing bacterial presence, although there is still room for improvement. It is recommended to review and strengthen practices to prevent bacterial presence.

ABSTRACT: The aim of this study is the determination some quality parameters of grape and mulberry pestils (leathers) sold in Elazig. For this purpose, a total of 45 fruit pestil samples, of which 23 were grape pestils and 22 were mulberry pestils, were analyzed for their physical properties, chemical properties, and microbiological characteristics. In grape and mulberry pestils, the average L* (lightness/darkness) values were 42.72 and 44.81, a* (redness) values were 10.29 and 9.07, and b* (yellow) values were 20.90 and 20.90, respectively. In grape and mulberry fruit pestil samples, the thickness values were 1.62 and 1.34, pH values were 3.82 and 4.75, acidity values (as citric acid) were 0.63 and 0.22%, aw values were 0.602 and 0.627, dry matter values were 68.78% and 72.99 %, ash values were 2.25% and 0.64%, insoluble ash values in 10% HCl were 0.20 and 0.29, and Brix values were 18.83 and 19.36, respectively. TMAB, coliform, Staphylococcus-Micrococcus, and yeast-mold counts were found to be 4.72 and 4.48, 1.30 and 1.89, 2.11 and 2.12, and 2.04 and 2.11 log10 cfu/g, respectively, in all samples examined. In 14 of the samples (31.11%), the total number of mesophilic aerobic microorganisms was found to be >5 log10 cfu/g. Escherichia coli and Salmonella spp. were not found in any of the samples. However, the samples were found to contain significant levels of yeast-mold. There was no difference between the groups in microbiological terms in statistical analysis (P > 0.05). According to the current study, there was no standard production and not enough hygiene rules were observed in the pestil production process in family businesses in Elazig. On the other hand, essential information was obtained on some physical, chemical and microbiological quality parameters of grape and blackberry pulps sold in markets and stores in Elazig. ABSTRACT leathers (leathers Elazig purpose 4 2 properties characteristics L lightness/darkness lightnessdarkness lightness darkness (lightness/darkness 4272 42 72 42.7 4481 44 81 44.81 redness (redness 1029 10 29 10.2 907 9 07 9.07 b yellow (yellow 2090 20 90 20.9 respectively 162 1 62 1.6 134 34 1.34 382 3 82 3.8 475 75 4.75 as acid 063 0 63 0.6 022 0.22% 0602 602 0.60 0627 627 0.627 6878 68 78 68.78 7299 99 72.9 % 225 25 2.25 064 64 0.64% 020 0.2 029 0.29 1883 18 83 18.8 1936 19 36 19.36 TMAB coliform StaphylococcusMicrococcus, StaphylococcusMicrococcus Staphylococcus Micrococcus, Micrococcus Staphylococcus-Micrococcus yeastmold yeast mold 472 4.7 448 48 4.48 130 30 1.3 189 89 1.89 211 11 2.1 212 12 2.12 204 04 2.0 log log1 cfug cfu g cfu/g examined 31.11%, 3111 31.11% , 31 (31.11%) 5 spp However yeastmold. mold. P 0.05. 005 0.05 . 05 0.05) hand 427 7 42. 8 44.8 102 10. 9.0 209 20. 16 6 1. 13 38 3. 47 06 0. 02 0.22 060 60 062 0.62 687 68.7 729 72. 2.2 0.64 188 18. 193 19.3 4. 4.4 1.8 21 2. 311 31.11 (31.11% 00 0.0 44. 9. 68. 19. 31.1 (31.11 31. (31.1 (31. (31 (3 (

RESUMO: O objetivo deste estudo é a determinação de alguns parâmetros de qualidade de pestilos de uva e amoreira (couros) vendidos em Elazig. Para tanto, um total de 45 amostras de pestil de frutas, sendo 23 de uva e 22 de amoreira, foram analisadas quanto às suas propriedades físicas, químicas e microbiológicas. Em pestils de uva e amoreira, os valores médios de L* (claridade/escuridão) foram 42.72 e 44.81, os valores de a* (vermelhidão) foram 10.29 e 9.07, e os valores de b* (amarelo) foram 20.90 e 20.90, respectivamente. Nas amostras de pestil de uva e amoreira, os valores de espessura foram 1.62 e 1.34, os valores de pH foram 3.82 e 4.75, os valores de acidez (como ácido cítrico) foram 0.63 e 0.22%, os valores de aw foram 0,602 e 0.627, os valores de matéria seca foram 68.78% e 72.99%, os valores de cinzas foram 2.25% e 0.64%, os valores de cinzas insolúveis em HCl a 10% foram 0.20 e 0.29, e os valores Brix foram 18.83 e 19.36, respectivamente. As contagens de TMAB, coliformes, Staphylococcus-Micrococcus e fungos de levedura foram 4.72 e 4.48, 1.30 e 1.89, 2.11 e 2.12 e 2.04 e 2.11 log10 ufc/g, respectivamente, em todas as amostras examinadas. Em 14 das amostras (31.11%), o número total de microrganismos aeróbios mesófilos foi >5 log10 ufc/g. Escherichia coli e Salmonella spp. não foram encontrados em nenhuma das amostras. No entanto, verificou-se que as amostras continham níveis significativos de bolor de levedura. Não houve diferença entre os grupos em termos microbiológicos na análise estatística (P > 0,05). De acordo com o estudo atual, não houve produção padrão e não foram observadas regras de higiene suficientes no processo de produção de pestil em empresas familiares em Elazig. Por outro lado, foram obtidas informações essenciais sobre alguns parâmetros físicos, químicos e microbiológicos de qualidade das polpas de uva e amora-preta comercializadas em mercados e lojas de Elazig. RESUMO couros (couros Elazig tanto 4 frutas 2 físicas microbiológicas L claridade/escuridão claridadeescuridão claridade escuridão (claridade/escuridão 4272 42 72 42.7 4481 44 81 44.81 vermelhidão (vermelhidão 1029 10 29 10.2 907 9 07 9.07 b amarelo (amarelo 2090 20 90 20.9 respectivamente 162 1 62 1.6 134 34 1.34 382 3 82 3.8 475 75 4.75 como cítrico 063 0 63 0.6 022 0.22% 0602 602 0,60 0627 627 0.627 6878 68 78 68.78 7299 99 72.99% 225 25 2.25 064 64 0.64% 020 0.2 029 0.29 1883 18 83 18.8 1936 19 36 19.36 TMAB coliformes StaphylococcusMicrococcus Staphylococcus Micrococcus 472 4.7 448 48 4.48 130 30 1.3 189 89 1.89 211 11 2.1 212 12 204 04 2.0 log log1 ufcg ufc g ufc/g examinadas 31.11%, 3111 31.11% , 31 (31.11%) 5 spp entanto verificouse verificou se P 0,05. 005 0,05 . 05 0,05) atual lado físicos amorapreta amora preta 427 7 42. 8 44.8 102 10. 9.0 209 20. 16 6 1. 13 38 3. 47 06 0. 02 0.22 060 60 0,6 062 0.62 687 68.7 729 72.99 2.2 0.64 188 18. 193 19.3 4. 4.4 1.8 21 2. 311 31.11 (31.11% 00 0,0 44. 9. 0, 68. 72.9 19. 31.1 (31.11 72. 31. (31.1 (31. (31 (3 (

ABSTRACT In the food industry, hygiene is a key condition to ensure food safety. That is why this work aimed to describe the visual, microbiological and bioluminescence methods used by food industries to verify sanitation procedures. The methodology was based on the review of the literature in the databases of Google Scholar, Scielo, Latindex, Dialnet, Redalyc and in food regulatory entities. The results showed that the food industries use the different cleaning and disinfection verification methods, either separately or jointly, to achieve compliance with the standards established by the reference regulations. In conclusion, the method used to verify the sanitation procedure resulted from the size of the company, the nature of the food, the processes applied and a series of factors that define the very identity of the industry, to guarantee quality. and food safety.

RESUMEN En la industria alimentaria, la higiene es una condición clave para asegurar la inocuidad de los alimentos. Es por ello, que este trabajo tuvo como objetivo describir sobre los métodos visual, microbiológico y de bioluminiscencia utilizados por las industrias de alimentos para la verificación de los procedimientos de saneado. La metodología se basó en la revisión de la literatura en las bases de datos de Google Académico, Scielo, Latindex, Dialnet, Redalyc y en entes reguladores de alimentos. Los resultados demostraron que las industrias de alimentos utilizan los diferentes métodos de verificación de limpieza y desinfección, ya sea de manera separada o conjunta para lograr cumplir con los estándares establecidos por las normativas de referencia. En conclusión, el método utilizado para la verificación del procedimiento de saneado dependerá de la envergadura de la empresa, la naturaleza del alimento, los procesos aplicados y de una serie de factores que definen la misma identidad de la industria, a fin de garantizar la calidad e inocuidad de los alimentos.

Abstract The choice of menstrual hygiene method, like all health decisions, should be informed, based on the best available evidence regarding risks and benefits. The menstrual cup is a reusable device designed to be inserted into the vagina during menstruation. Seen as a more sustainable option, as well as potentially safer, there has been an increasing interest in it. This Scoping Review aims to analyze the available evidence on the advantages and disadvantages associated with the menstrual cup, exploring variations associated with different contexts, as well as alternative uses of this device.

Resumo A escolha do método de higiene menstrual, tal como todas as decisões em saúde, deve ser informada, baseada na melhor evidência disponível sobre os riscos e benefícios. O copo menstrual é um dispositivo reutilizável, projetado para ser inserido na vagina durante o período menstrual. Por ser visto como uma opção mais sustentável, bem como potencialmente mais segura, tem-se vindo a assistir a um aumento do interesse pelo mesmo. Esta Scoping Review pretende analisar a evidência disponível sobre as vantagens e desvantagens associadas ao copo menstrual, explorando variações associadas a diferentes contextos, bem como usos alternativos deste dispositivo.

Resumen Introducción: Las infecciones relacionadas con catéteres venosos centrales son unas de las infecciones asociadas a la atención de salud con mayor relevancia epidemiológica. La técnica aséptica «no tocar» es una práctica estandarizada que se utiliza para prevenir estas infecciones. En un hospital pediátrico, la tasa de infecciones relacionadas con catéteres venosos centrales fue de 1.92/1000 días de catéter. Sin embargo, en una de las unidades la tasa fue de 5.7/1000 días de catéter. Método: Se capacitaron enfermeras en la técnica aséptica «no tocar». Para la implementación se cumplieron ciclos de planificar-hacer-estudiar-actuar (PHEA). Se realizaron seguimiento de la adherencia a la técnica y vigilancia epidemiológica. Resultados: Se logró una adherencia a la técnica aséptica «no tocar» del 95% después de seis ciclos. La higiene de manos y la limpieza general alcanzaron un 100% de cumplimiento. La desinfección de los puertos y la recolección de material alcanzaron la menor adherencia, con un 76.2% y un 84.7%, respectivamente. La tasa de infecciones relacionadas con catéteres venosos centrales disminuyó de 5.7 a 1.26 por 1000 días de catéter. Conclusiones: La implementación de la técnica aséptica «no tocar» ayudó en la reducción de infecciones relacionadas con catéteres venosos centrales. La capacitación y el seguimiento continuo son clave para mantener el cumplimiento de la técnica.

Abstract Background: Central line-associated bloodstream infections (CLABSIs) are among the most epidemiologically relevant health care-associated infections. The aseptic non-touch technique (ANTT) is a standardized practice used to prevent CLABSIs. In a pediatric hospital, the overall CLABSI rate was 1.92/1000 catheter days (CD). However, in one unit, the rate was 5.7/1000 CD. Methods: Nurses were trained in ANTT. For the implementation, plan-do-study-act (PDSA) cycles were completed. Adherence monitoring of the ANTT and epidemiological surveillance were performed. Results: ANTT adherence of 95% was achieved after 6 PDSA cycles. Hand hygiene and general cleaning reached 100% adherence. Port disinfection and material collection had the lowest adherence rates, with 76.2% and 84.7%, respectively. The CLABSI rate decreased from 5.7 to 1.26/1000 CD. Conclusion: The implementation of ANTT helped reduce the CLABSI rate. Training and continuous monitoring are key to maintaining ANTT adherence.

Abstract Objectives: To analyze the patient profile and characterize the oral health status, oral habits, and daily oral hygiene difficulties of individuals with rare diseases. Methods: Data were collected from records of the clinic for people with disabilities at the Faculdade de Medicina Dentária da Universidade de Lisboa, using the Decayed, Missing, and Filled Teeth index, the simplified debris index, and the bleeding index. Results: The sample comprised 64 individuals with 33 different rare diseases, with a mean age of 31.5(±10.29) years, predominantly male (54.7%). Most could move without difficulty (51.6%), required assistance in activities of daily living (60.9%), and were cooperative in oral hygiene (54.7%). Also, 40.6% could not communicate. Half of the sample brushed their teeth twice a day, with 18.8% being independent in this activity, and the most common toothbrushing difficulty was not being able to rinse (53.1%). The Decayed, Missing, and Filled Teeth index was 8.81 (±7.54), with a higher number of filled teeth (4.47; ±5.35). The bleeding índex had a mean of 1.23 (±0.56), and the simplified debris index had a mean value of 1.62 (±0.78). Conclusions: The population studied expresses care for oral health and treatment.

Re s u m o Objetivos: Analisar o perfil dos pacientes e caracterizar o estado de saúde oral, os hábitos orais e as dificuldades na higiene oral diária de indivíduos com doenças raras. Métodos: Os dados foram recolhidos dos registos da Clínica para Pessoas com Deficiência da Faculdade de Medicina Dentária da Universidade de Lisboa, utilizando o índice de dentes permanentes cariados, perdidos e obturados, o índice de higiene oral simplificado e o índice de hemorragia. Resultados: A amostra foi constituída por 64 indivíduos com 33 doenças raras diferentes, com uma média de idades de 31,5 (±10,29) anos, predominantemente do género masculino (54,7%). A maioria era capaz de se deslocar sem dificuldade (51,6%), era dependente nas atividades de vida diária (60,9%) e era cooperante nas consultas de higiene oral (54,7%). Além disso, 40,6% eram incapazes de comunicar. A escovagem dos dentes duas vezes por dia era feita por metade da amostra, sendo que 18,8% eram independentes nesta atividade, e a dificuldade mais comum era não conseguir bochechar (53,1%). O índice de dentes cariados, perdidos e obturados foi de 8,81 (±7,54), com maior número de dentes obturados (4,47; ±5,35). O índice de hemorragia teve um valor médio de 1,23 (±0,56) e o índice de higiene oral simplificado teve um valor médio de 1,62 (±0,78). Conclusões: A população estudada manifesta preocupação com a saúde e o tratamento oral.

Abstract Objectives: To study the perception of young Portuguese adults about using mobile applications as a complement to oral health motivation. Methods: This cross-sectional descriptive study applied an online questionnaire to Portuguese individuals between 18 and 20 years old. The questionnaire was developed based on a literature review and assessed by a panel of experts before its application. It collected information about oral hygiene behaviors and the perception of using mobile apps for oral health motivation, including opinions on important functionalities. Variables’ absolute and relative frequencies were calculated. Results: The sample included 213 participants. About 73.2% of the participants considered oral health motivational mobile apps useful, but only 6.1% indicated having already used one. The most valued functionalities were information about oral diseases (86.9%), appointment reminders (85.4%), and a toothbrushing timer (84.5%). Conclusions: Most of the participants found oral health apps useful as a complement to oral health motivation. However, only a small minority reported having used these apps before. The functionalities evidenced in this study may be helpful for the development of mobile apps since they can be more directed to the population's expectations. Apps may be another way for healthcare professionals to motivate their patients to engage in oral health selfcare.

Resumo Objetivos: Estudar a perceção de jovens adultos portugueses sobre o uso das aplicações móveis como complemento da motivação para a saúde oral. Métodos: Estudo descritivo transversal, com aplicação de um questionário online a indivíduos portugueses, com idade entre os 18 e os 20 anos. O questionário foi desenvolvido com base numa revisão da literatura e avaliado por um painel de peritos antes da sua aplicação. Recolheu informação sobre os comportamentos de higiene oral e sobre a perceção da utilização de aplicações móveis para a motivação para a saúde oral, incluindo opiniões sobre funcionalidades mais ou menos importantes. Foram calculadas as frequências absolutas e relativas das variáveis. Resultados: A amostra incluiu 213 participantes. Cerca de 73,2% dos participantes consideraram as aplicações móveis de motivação para a saúde oral úteis, no entanto apenas 6,1% referiu já ter utilizado uma. As funcionalidades mais valorizadas foram: informação sobre doenças orais (86,9%), lembretes de consulta (85,4%) e temporizador de escovagem dos dentes (84,5%). Conclusões: A maioria dos participantes considerou a utilização de uma aplicação de saúde oral útil como complemento à motivação para a saúde oral, no entanto apenas uma pequena minoria referiu ter utilizado estas aplicações anteriormente. As funcionalidades evidenciadas neste estudo podem ser úteis para o desenvolvimento de aplicações móveis, de modo a serem mais direcionadas para as expectativas da população. A utilização de aplicações pode ser mais uma forma de os profissionais de saúde motivarem os seus pacientes para o autocuidado em saúde oral.

Resumen Introducción: El sueño es una de las necesidades primordiales del ser humano, cuyo papel fundamental es relajar y restablecer el organismo para un nuevo ciclo. La falta de sueño y el trabajo por turnos pueden empeorar las condiciones de salud física y mental de las enfermeras que trabajan por turnos. Objetivo: Analizar la calidad del sueño de las enfermeras que trabajan en urgencias de un hospital del norte de Portugal y su relación con el trabajo por turnos. Metodología: Estudio descriptivo-correlacional, transversal y cuantitativo. Se aplicó el Índice de Calidad del Sueño de Pittsburgh, muestra compuesta por 60 enfermeras. El tratamiento de los datos se elaboró mediante estadística descriptiva e inferencial. Resultados: La mayoría de los participantes eran enfermeras (68,3%), con edades entre los 31 y 40 años (61,7%). Observamos que tanto las enfermeras como las que tienen la categoría profesional de enfermeras de cuidados generales perciben uma mala calidad del sueño. Los participantes con horario fijo, que trabajan en turnos nocturnos y que tienen hasta dos turnos nocturnos por semana tuvieron una menor calidad de sueño, (80%) dos enfermeras tuvieron dificultad para conciliar el sueño y percibieron mala calidad del sueño. Conclusión: Es necesario intervenir a nivel individual y organizacional de forma a adoptar medidas que mejoren la calidad del sueño de los enfermeros que trabajan por turnos. Del mismo modo es importante generar conciencia sobre la adopción de estrategias de higiene del sueño, para que se puedan promover hábitos de vida saludables, y así mejorar la calidad del sueño de las enfermeras, lo que se traducirá en una mejora de la atención médica brindada.

Abstract Introduction: Sleep is one of the primordial needs of human beings, and plays a fundamental role in relaxing and reestablishing the body for a new cycle. Sleep deprivation and shift work can have negative consequences for the physical and mental health of nurses working shifts. Objective: To analyze the sleep quality of nurses in an emergency department at a hospital in the north of Portugal and its relationship with shift work. Methodology: Descriptive-correlational, cross-sectional and quantitative study. The Pittsburgh Sleep Quality Index was applied to a sample of 60 nurses. Data processing was performed using descriptive and inferential statistics. Results: The majority of participants were nurses (68.3%), aged between 31 and 40 years old (61.7%). We found that both female nurses and those with the professional category of general care nurses perceived poor sleep quality. Participants with a fixed schedule, who work night shifts and who work up to two-night shifts per week had a lower quality of sleep, (80%) of nurses had difficulty falling asleep and perceived poor quality of sleep. Conclusion: It is necessary to intervene at an individual and organizational level to promote the adoption of measures to improve the quality of sleep of nurses who work shifts. It is important to raise awareness about the adoption of sleep hygiene strategies, promoting healthy lifestyle habits, with the aim of improving the quality of sleep of nurses, which will translate into an improvement in the health care provided.

Resumo Introdução: O sono é uma das necessidades primordiais do ser humano, cujo papel fundamental é relaxar e restabelecer o organismo para um novo ciclo. A privação de sono e o trabalho por turnos podem agravar as condições de saúde física e mental dos enfermeiros que trabalham por turnos. Objetivo: Analisar a qualidade do sono de enfermeiros de um serviço de urgência de um hospital da região norte de Portugal e a sua relação com o trabalho por turnos. Metodologia: Estudo descritivo-correlacional, transversal e quantitativo. Aplicou-se o Índice de Qualidade de Sono de Pittsburgh, amostra constituída por 60 enfermeiros. Tratamento de dados foi elaborado com recurso à estatística descritiva e inferencial. Resultados: A maioria dos participantes foram enfermeiras (68,3%), idade entre 31 e 40 anos (61,7%). Verificámos, quer os enfermeiros do sexo feminino quer os com a categoria profissional de enfermeiros de cuidados gerais percecionaram uma má qualidade de sono. Os participantes com horário fixo, que trabalham em turnos noturnos e que têm até dois turnos noturnos por semana apresentaram uma qualidade de sono mais baixa, (80%) dos enfermeiros evidenciaram dificuldade em adormecer e percecionaram má qualidade de sono. Conclusão: É necessário intervir a nível individual e organizacional, para adoção de medidas que visem melhorar a qualidade de sono de enfermeiros que trabalham por turnos. Importa sensibilizar a adoção de estratégias de higiene do sono, promovendo hábitos de vida saudáveis, tendo em vista melhorar a qualidade do sono dos enfermeiros, o que se traduzirá numa melhoria dos cuidados saúde prestados.

Abstract Introduction: Screen use among adolescents has increased, with excessive screen time associated with poor sleep. Isolation due to the COVID-19 pandemic may have exacerbated these problems. This study aimed to characterize adolescents’ sleep and screen use behaviors during the COVID-19 pandemic lockdown. Methods: This was a multicenter, cross-sectional, descriptive study of adolescents aged 10 to 18 years evaluated in an Adolescent Medicine outpatient visit of four hospitals in northern Portugal between January and March 2021. Adolescents completed a survey with questions about screen use and sleep and the Pediatric Daytime Sleepiness Scale (Portuguese version). Results: A total of 131 adolescents (66.4% female; median age 15 years) were enrolled during the study period. Participants reported a median sleep duration of nine hours on weekdays and 10 hours on weekends, with 25.9% sleeping less than eight hours on weekdays. Approximately 80% reported good or very good sleep quality. Onset insomnia was identified in 39.7% and excessive daytime sleepiness (EDS) in 13.7%. Most adolescents (74.0%) reported screen time of ≥6 hours/day. Screens were mainly used for attending classes and talking to friends. Smartphones were available in the bedroom at night for 83.2%, while 61.1% had televisions, 57.3% had computers, and 16.0% had gaming consoles in their bedrooms. Fifty-five percent used screens within an hour of bedtime every day. Screen time ≥6 hours/day and having a computer or smartphone in the bedroom at night were associated with shorter sleep duration on weekdays and EDS. Screen use within an hour of bedtime ≥4 times/week was associated with sleep-onset insomnia, shorter weekday sleep duration, and EDS. Discussion: Online classes during the COVID-19 lockdown may explain the use of devices ≥6 hours/day. Although most adolescents reported normal median sleep time and subjective good or very good sleep quality, screen use ≥6 hours/day and within one hour before bedtime was associated with sleep deprivation on weekdays and EDS. Conclusions: Excessive screen time during the pandemic appears to have had a negative impact on adolescents’ sleep. These findings underscore the importance of identifying and intervening in these issues when addressing adolescent global health.

Resumo Introdução: O uso de ecrãs tem vindo a aumentar entre os adolescentes, estando descrita a associação entre tempo excessivo de ecrã e menor quantidade e pior qualidade de sono. A pandemia de COVID-19 poderá ter agravado estes problemas. Este estudo pretendeu caracterizar o comportamento dos adolescentes relativamente ao sono e uso de ecrãs durante o confinamento imposto pela pandemia de COVID-19. Métodos: Estudo descritivo, transversal, multicêntrico de adolescentes dos 10 aos 18 anos avaliados numa consulta externa de Medicina do Adolescente de quatro hospitais do norte de Portugal entre janeiro e março de 2021. Os adolescentes preencheram um questionário com perguntas sobre o uso de ecrãs e o sono e a Pediatric Daytime Sleepiness Scale (versão portuguesa). Resultados: Foram incluídos 131 adolescentes (66,4% do género feminino; idade mediana de 15 anos) durante o período de estudo. Os participantes relataram uma mediana de duração do sono de 9 horas durante a semana e 10 horas ao fim-de-semana, com 25,9% a dormir menos do que oito horas diárias durante a semana. Cerca de 80% referiu ter um sono de boa ou muito boa qualidade. Foi identificada insónia inicial em 39,7% e sonolência diurna excessiva (SDE) em 13,7% dos participantes. A maioria (74,0%) referiu um tempo de ecrã ≥6 horas/dia. Os ecrãs foram usados maioritariamente para assistir a aulas e conversar com amigos. Um total de 83,2% dos adolescentes referiu dormir com o telemóvel no quarto e 61,1% referiu ter televisão, 57,3% computador e 16,0% consola de jogos no quarto. Cinquenta e cinco por cento usava ecrãs todos os dias na hora antes de dormir. Um tempo de ecrã ≥6 horas/dia e ter computador ou telemóvel no quarto durante a noite associou-se a uma menor duração do sono durante a semana e SDE. O uso de ecrãs na hora antes de dormir associou-se a insónia inicial, menor duração do sono durante a semana e SDE. Discussão: As aulas online poderão explicar o uso frequente de ecrãs (≥6 horas/dia). Embora a mediana de duração do sono tenha sido normal e a maioria dos adolescentes tenha referido ter um sono de boa ou muito boa qualidade, o uso de ecrãs ≥6 horas/dia e na hora antes de dormir associou-se a privação de sono durante a semana e SDE. Conclusão: O uso excessivo de ecrãs durante a pandemia parece ter tido um impacto negativo no sono dos adolescentes. Estes dados reforçam a necessidade de identificar e intervir nestes problemas durante a abordagem de saúde global do adolescente.