ABSTRACT Dementia is an emerging public health issue resulting from population aging and epidemiological transition. Therefore, this research aimed to analyze the living networks woven by a user with dementia and her family in the path of seeking health care and support, through the existential connections established in their journey, from the perspective of a guiding team. To achieve this, a qualitative cartographic approach was applied using techniques such as focus groups, analyzer flowchart, and field diary. The analysis of the results allowed identifying home visits as a tool of soft technology in the movement of living networks and the need for ongoing education to ensure the comprehensive care of users with dementia syndromes. It is concluded that there is a need to better articulate care technologies in order to make actions more effective.

Resumo A demência é um problema de Saúde Pública emergente, consequente ao envelhecimento populacional e à transição epidemiológica. Assim sendo, a pesquisa teve como objetivo analisar as redes vivas tecidas por um usuário com demência e sua família no percurso em busca de Atenção à Saúde e cuidado, por meio das conexões existenciais que vão estabelecendo em sua trajetória sob a ótica de uma equipe-guia. Para tal, aplicou-se a metodologia qualitativa de abordagem cartográfica com base nas técnicas de grupo focal, no fluxograma analisador e no diário de campo. A análise dos resultados possibilitou identificar a visita domiciliar como instrumento de tecnologia leve no movimento de redes vivas, e a necessidade de Educação Permanente para garantir a integralidade do cuidado dos usuários com síndromes demenciais. Conclui-se que há necessidade de melhor articular tecnologias do cuidado para tornar as ações mais efetivas.

Resumen La demencia es un problema de salud pública emergente, consecuencia del envejecimiento poblacional y de la transición epidemiológica. Por esa razón, la investigación tuvo el objetivo de analizar las redes vivas tejidas por un usuario con demencia y su familia, en la jornada de la búsqueda de atención de la salud y el cuidado, desde el punto de vista de un equipo guía. Para ello, se aplicó la metodología cualitativa de abordaje cartográfico, a partir de las técnicas de grupo focal, diagrama de flujo analizador y diario de campo. El análisis de los resultados posibilitó la identificación de la visita a domicilio como instrumento de tecnología leve en el movimiento de redes vivas y la necesidad de educación permanente para asegurar la integralidad del cuidado de los usuarios con síndromes demenciales. Se concluyó que existe la necesidad de articular mejor las tecnologías del cuidado para que las acciones sean más efectivas.

ABSTRACT Traditional agroecosystems (TA) are considered more resilient to climatic extremes due to higher crop diversity and agroecological approach. The TA of Tének were studied to evaluate their drought tolerance. Open-ended questionnaire surveys, field visits, and botanical collections, with the participation of local farmers, were considered. Cultivated plant diversity was analyzed using the Shannon-Wiener diversity index (H’), and the Morisita-Horn index (CMH) in ten different agroecosystems in April and August. Remote sensing methods included the triangular greenness index (TGI). Additionally, normalized difference vegetation index (NDVI) and standardized precipitation index (SPI) were determined, covering the period from 2013 to 2022. The cultivated plant richness (P > 0.5382) and their abundance (P > 0.3622) did not change from April to August considering the total analyzed parcels. However, differences between types of agroecosystems were observed because higher diversity corresponded to managed jungle (teʼlom) (Hʼ = 1.5-1.7), and some parcels cultivated with maize (milpa) (Hʼ = 1.02-1.54). Nevertheless, in August, lower similarity was observed in milpa (CMH = 0.23-0.87) due to the absence of maize (Zea mays L.) and other herbaceous annual crops. Landscape interconnection can be affirmed with TGI correlations obtained by comparison of different TA. The negative SPI values were associated with a decrease of NDVI, but Tének polyculture agroecosystems maintained higher NDVI values compared to rainfed monocropping during the analyzed period. Tének polyculture agroecosystems exhibited higher drought tolerance, although maize and other herbaceous plants are susceptible to disappearing during prolonged drought events, thereby increasing food insecurity.

Resumen: Este artículo analiza la centralidad de las políticas públicas de seguridad y justicia en América Latina y el Caribe a partir de diversas técnicas de investigación teórico (análisis documental y bibliográfico) y trabajo de campo (visitas “in loco” y observaciones participantes), realizadas entre 2015 y 2021. Se parte del supuesto de que la violencia y las inseguridades son abordadas como un obstáculo flagrante para el desarrollo humano y la consolidación del estado de derecho en la región. Se identifica, basado en la literatura especializada y estudio comparado de estas políticas públicas, la relevancia del papel que juega el liderazgo político del estado y el compromiso cívico de varios actores sociales en torno a una gobernanza territorial integrada e integral de políticas de seguridad pública Ciudadana dedicados a salvar y preservar vidas. Resumen análisis bibliográfico visitas in loco participantes, participantes , participantes) 201 2021 región identifica vidas 20 202 2

Abstract: This article analyzes the centrality of public security and justice policies in Latin America and the Caribbean based on various theoretical research techniques (documental and bibliographical analysis) and fieldwork (“in loco” visits and participant observations), undertaken between 2015 and 2021. It starts from the assumption that violence and insecurities are approached as a flagrant obstacle to human development and the consolidation of the rule of law in the region. It is identified, in the comparison of the specialized literature and in the comparative study of these public policies, the relevance of the role played by the political leadership of the State and the civic engagement of several social actors around an integrated and integral territorial governance of citizen public security policies. Despite a punitive political culture and a history of authoritarian governments in the region, there are, after all, key principles and concepts for a new type of governance of citizen security (and justice) in Brazil and in the region aimed at saving and preserve lives. Abstract documental analysis loco observations, observations , observations) 201 2021 identified all lives 20 202 2

Resumo: Este artigo analisa a centralidade das políticas públicas de segurança e justiça na América Latina e no Caribe com base em diversas técnicas de pesquisa teórica (análise documental e bibliográfica) e de campo (visitas “in loco” e observações participantes), empreendidas entre 2015 e 2021. Parte-se do pressuposto de que as violências e inseguranças são abordadas como um flagrante obstáculo ao desenvolvimento humano e à consolidação do estado de direito na região. Identifica-se, no cotejo da literatura especializada e no estudo comparado dessas políticas públicas, a relevância do papel desempenhado pela liderança política do estado e pelo engajamento cívico de diversos atores sociais em torno de uma governança territorial integrada e integral das políticas de segurança pública cidadã. Inobstante a uma cultura política punitiva e a um histórico de governos autoritários na região, vislumbram-se, afinal, princípios e conceitos-chave para uma governança de novo tipo da segurança cidadã (e justiça) no Brasil e na região voltada a salvar e a preservar vidas. Resumo análise bibliográfica visitas in loco participantes, participantes , participantes) 201 2021 Partese Parte se Identificase, Identificase Identifica se, Identifica-se vislumbramse, vislumbramse vislumbram vislumbram-se afinal conceitoschave conceitos chave vidas 20 202 2

Abstract This work aims to model per capita water consumption in schools in the city of Joinville-SC. As the school environment is largely responsible for the transmission of knowledge, including information on water conservation, 26 public schools were selected for this research. A survey was carried out on the use of water, through visits and a questionnaire to the management team of each school. The data collected allowed the characterization of schools and a preliminary diagnosis of water use. A descriptive analysis of per capita water consumption was performed, with values ranging from 5.15 to 18.59 liters/student/day. Correlation analysis, multiple linear regression, Bayesian linear regression and geographically weighted regression were used. The results of the correlation analysis reveal that the higher the average income in the neighborhood where the school is located and the area per student ratio, the higher the per capita water consumption. On the other hand, the number of students has a negative correlation with per capita consumption. In the statistical modeling, the independent variable area per student ratio was significant. JoinvilleSC. JoinvilleSC Joinville SC. SC Joinville-SC knowledge conservation 2 research performed 515 5 15 5.1 1859 18 59 18.5 litersstudentday liters day liters/student/day used hand modeling significant 51 1 5. 185 18.

Resumo Este artigo tem como objetivo a modelagem estatística do consumo de água per capita em escolas da cidade de Joinville, SC. Levando em consideração que o ambiente escolar é grande responsável pela transmissão de conhecimentos, inclusive acerca da conservação da água, foram selecionadas para objetos de estudo desta pesquisa 26 escolas públicas da rede estadual de ensino fundamental e médio. Efetivou-se um levantamento sobre a utilização da água, por meio de visitas e questionário à direção de cada escola. Os dados coletados permitiram a caracterização das escolas e um diagnóstico preliminar do uso da água, com valores de indicador de consumo variando entre 5,15 e 18,59 litros/aluno/dia. Foi feita a análise de correlação entre as variáveis e posterior modelagem do consumo de água nas escolas, usando regressão linear múltipla, regressão linear Bayesiana e regressão geograficamente ponderada. Os resultados da análise de correlação revelam que quanto maior a renda média no bairro em que a escola está localizada e a razão área por aluno, maior o indicador de consumo. Por outro lado, o número de alunos apresenta correlação negativa com o indicador de consumo. Na modelagem estatística, a variável independente razão área por aluno apresentou-se significativa. Joinville SC conhecimentos 2 médio Efetivouse Efetivou se 515 5 15 5,1 1859 18 59 18,5 litrosalunodia litros dia litros/aluno/dia múltipla ponderada lado apresentouse apresentou significativa 51 1 5, 185 18,

Resumen El acceso equitativo y permanente a servicios públicos no siempre es una prioridad para la gestión local, en especial en territorios y poblaciones históricamente rezagadas. Esta contribución sostiene que en Copoya, localidad mayoritariamente ejidal de la Zona Metropolitana de Tuxtla Gutiérrez, el servicio estatal y comunitario por el suministro de agua potable no es eficiente. El problema se agudizó con el crecimiento urbano y la demanda por la tierra durante el siglo XX. A partir de entrevistas, recorridos de campo y notas de prensa, se destaca que la escasez del líquido lleva a sus residentes a buscar alternativas como la compra de pipas, pozos de traspatio y sistemas de agua no tratada que no resuelven el tema de fondo y que profundizan la pobreza y la desigualdad socioterritorial. Se concluye que la inexistencia de proyectos de inversión no permite una salida para el abastecimiento en el corto y mediano plazo.

Abstract Equitable and permanent access to public services is not always a priority for local management, especially in those territories and historically neglected populations. This contribution argues that in Copoya, a mostly ejido locality in the Metropolitan Zone of Tuxtla Gutiérrez, state and community service for drinking water supply is inefficient. The situation has worsened with urban growth and demand for land throughout the twentieth century. Interviews, field visits and press releases show that residents, due to the lack of water, look for alternatives such as purchasing pipes, backyard wells and untreated water systems. These alternatives do not solve the underlying issue and deepen their poverty and socio-territorial inequality. The article concludes that poor investment in projects does not allow a solution for the supply in the short and medium term.

Resumen (Objetivo). Se evaluó el manglar de Chacarita en el Pacífico Central de Costa Rica, a través de la composición florística y las poblaciones de moluscos asociados de interés comercial, con el fin de proponer actividades de aprovechamiento sustentables en el manglar. (Metodología). Mensualmente y durante un año, se realizaron visitas al área de estudio, con el propósito de establecer una base florística de árboles de mangle y medir el almacenamiento de carbono en el lugar, además, de recolectar moluscos bivalvos para analizar el estado de las poblaciones, con base en las abundancias de organismos hallados y otras características como las longitudes y la masa de estos. En los mangles, se obtuvo el diámetro de la altura de pecho (DAP en cm), la altura (m), el índice de valor de importancia (IVI) y las reservas de carbono (Mg C·ha-1). En cuanto a los moluscos, se examinaron cuatro especies de interés comercial, evaluando la longitud (cm), la masa (g) y el índice gonadosomático. Finalmente, se realizaron valoraciones económicas de los datos obtenidos en el manglar, del turismo e información histórica de pesca para el acopio de Chacarita. (Resultados). Se hallaron cinco especies de mangles, Rhizophora mangle, Rizophora racemosa, Laguncularia racemosa, Avicennia germinans y Pelliciera rhizophorae; P. rhizophorae fue la de mayor índice de valor de importancia. Se obtuvo un almacenamiento de carbono equivalente a 78.49 Mg C·ha-1. Se contabilizaron 357 organismos, de los cuales el 18 % correspondió a Anadara similis, 37.5 % a Anadara tuberculosa, 41.46 % a Leukoma spp. y 3.08 % a Mytella guyanensis. Tomando en cuenta el valor económico de las reservas de carbono y los moluscos bivalvos presentes en los muestreos, se obtuvieron valoraciones económicas de 9812.63 USD·ha-1 y 28 USD·ha-1, respectivamente. (Conclusiones). Las bajas densidades poblacionales de moluscos, especialmente del género Anadara, hacen necesario establecer medidas de gestión que permitan recuperar las poblaciones de estos. La presente investigación propone actividades de aprovechamiento sustentables, como turismo comunitario con fines educativos y culturales.

Resumo (Objetivo). O mangue de Chacarita, no Pacífico Central da Costa Rica, foi avaliado por meio da composição florística e das populações de moluscos associados de interesse comercial, com o objetivo de propor atividades de uso sustentável no mangue. (Metodologia). Foram feitas visitas mensais à área de estudo durante um ano para estabelecer uma base florística de árvores do mangue e medir o armazenamento de carbono no local, bem como para coletar moluscos bivalves para analisar o status das populações, com base na abundância de organismos encontrados e em outras características, como comprimento e massa de tais organismos. Nos manguezais, foram obtidos o diâmetro à altura do peito (DAP em cm), a altura (m), o índice de valor de importância (IVI) e as reservas de carbono (Mg C-ha-1). No que diz respeito aos moluscos, foram examinadas quatro espécies de interesse comercial., avaliando o comprimento (cm), a massa (g) e o índice gonadossomático. Por fim, foram feitas avaliações econômicas de dados de mangue, turismo e informações históricas de pesca para a coleção Chacarita. (Resultados). Foram encontradas cinco espécies de mangue, Rhizophora mangle, Rizophora racemosa, Laguncularia racemosa, Avicennia germinans e Pelliciera rhizophorae; a P. rhizophorae apresentou o índice de valor de importância mais alto. Foi obtido um armazenamento de carbono equivalente a 78.49 Mg C-ha-1. Foram calculados um total de 357 organismos, dos quais 18% correspondeu a Anadara similis, 37.5% Anadara tuberculosa, 41.46% Leukoma spp. e 3.08% Mytella guyanensis. Levando em conta o valor econômico das reservas de carbono e dos moluscos bivalves presentes nas amostras, foram obtidas avaliações econômicas de US$ 9812.63 ha-1 e US$ 28 ha-1, respectivamente. (Conclusões). As baixas densidades populacionais de moluscos, especialmente do gênero Anadara tornam necessário o estabelecimento de medidas de manejo para permitir a recuperação dessas populações. Esta pesquisa propõe atividades de uso sustentável, como o turismo comunitário para fins educacionais e culturais.

Abstract (Objective). The floristic composition and populations of associated molluscs of commercial interest of the Chacarita mangrove forest on the Central Pacific of Costa Rica were evaluated to guide proposals for sustainable exploitation activities in the mangrove forest. (Methodology). Monthly visits to the study area were conducted for one year to establish a floristic baseline of mangrove trees and measure carbon storage. Additionally, bivalve molluscs were collected to analyze the state of their populations based on the abundances of organisms found, as well as other characteristics such as length and mass. Data regarding the mangrove trees included their diameter at breast height (DBH, cm), height (m), importance value index (IVI), and carbon reserves (Mg C·ha-1). Four mollusc species of commercial interest were analyzed, using data on their length (cm), weight (g), and gonodosomatic index. Economic evaluations were also conducted using data obtained from the mangrove forest, as well as tourism and historical fishing data for the collection of Chacarita. (Results). Five species of mangroves were identified: Rhizophora mangle, Rizophora racemosa, Laguncularia racemosa, Avice germinans, and Pelliciera rhizophorae, while P. rhizophorae had the highest importance value index. The study revealed a carbon storage equivalent to 78.49 Mg C·ha-1. A total of 357 organisms were counted, with Anadara similis accounting for 18% of the total count, followed by Anadara tuberculosa (37.5%), Leukoma spp. (41.46%), and Mytella guyanensis (3.08%). When considering the economic value of carbon stocks and the bivalve molluscs obtained from the samples, economic valuations of 9,812.63 USD·ha-1 and 28 USD·ha-1 were determined, respectively. (Conclusions). The low population densities of molluscs, particularly those belonging to the Anadara genus, necessitate the establishment of management measures to facilitate the recovery of these mollusk populations. This research proposes sustainable use activities such as community tourism for educational and cultural purposes.

BACKGROUND. Interpersonal violence is a major cause of morbidity and mortality in low- and upper-middle-income countries. It is postulated that a significant portion of these patients have repeated presentations to an already overburdened healthcare system. Data describing the burden of interpersonal violence recidivism are poor. OBJECTIVE. To determine and describe the burden of emergency centre recidivism for interpersonal violent injury presenting to Khayelitsha Hospital, Cape Town, over a 2-year period. METHODS. An analysis of a prospectively collected observational database combined with a retrospective chart review was conducted of all trauma patients who presented to Khayelitsha Hospital from 1 October 2020 to 30 September 2022. All patients (aged >14 years) with >2 presentations for interpersonal violence-related injuries were included. Cases were limited to the inclusion of mechanisms of injury attributable to stab wounds, blunt assault, firearm injury and gender-based violence. Recidivist cases were identified by repeat hospital number on the electronic hospital patient system. Repeat cases were manually reviewed for inclusion. Summary statistics are used to describe all variables. RESULTS. In total, 10 218 interpersonal violence presentations were identified over the study period, and 1 125 (11.0%) were attributed to recidivists (522 patients). The mean (standard deviation) age was 30 (7.7) years, and most were male (n=463, 88.7%). Stab wounds (n=583, 51.8%) and blunt assault injuries (n=456, 40.5%) were the main mechanisms of injury. Repeat presentation occurred within a median of 198 (25th - 75th percentile, 81.5 - 373.9) days. A total of 337 (64.6%) patients presented with higher acuity at one of their subsequent visits. CONCLUSION. Recidivist presentations represent a significant proportion of interpersonally violently injured patients, and are likely to be under-documented. Recidivism poses a measurable burden, and further research is needed to facilitate the identification of at-risk individuals, and specific secondary prevention strategies should be developed to prevent or reduce escalating patterns of injury associated with interpersonal violence.

ABSTRACT Introduction: The importance of dietitians in dialysis units is indisputable and mandatory in Brazil, but little is known about the practices adopted by these professionals. Objective: To know practices adopted in routine nutritional care, focusing on nutritional assessment tools and treatment strategies for people at risk or diagnosed with malnutrition. Methodology: Electronic questionnaire disseminated on social media and messaging applications. It included questions that covered dietitians’ demographic and occupational profile characteristics and of the dialysis unit, use and frequency of nutritional assessment tools, nutritional intervention strategies in cases of risk or diagnosis of malnutrition, prescription and access to oral supplements. Results: Twenty four percent of the Brazilian dialysis units (n = 207) responded electronically. The most used nutritional assessment tools with or without a pre-established frequency were dietary surveys (96%) and Subjective Global Assessment (83%). The strategies in cases of risk or presence of malnutrition used most frequently (almost always/always) were instructions to increase energy and protein intake from foods (97%), and increasing the frequency of visits (88%). The frequency of prescribing commercial supplements with standard and specialized formulas was quite similar. The availability of dietary supplements by the public healthcare system to patients varied between regions. Conclusion: Most dietitians use various nutritional assessment tools and intervention strategies in cases of risk or malnutrition; however, the frequency of use of such tools and strategies varied substantially. Introduction Brazil professionals Objective care Methodology applications unit Results n 207 electronically preestablished pre established 96% 96 (96% 83%. 83 83% . (83%) almost always/always alwaysalways always 97%, 97 97% , (97%) 88%. 88 88% (88%) similar regions Conclusion however substantially 20 9 (96 8 (83% (97% (88% 2 (9 (83 (97 (88 ( (8

Resumo Introdução: A importância da atuação do nutricionista em unidades de diálise é indiscutível e obrigatória no Brasil, porém pouco sabemos sobre as práticas adotadas por esses profissionais. Objetivo: Conhecer práticas adotadas na rotina dos atendimentos nutricionais, com foco nas ferramentas de avaliação nutricional e nas estratégias de tratamento das pessoas com risco ou diagnóstico de desnutrição. Metodologia: Questionário eletrônico divulgado em mídias sociais e aplicativos de mensagens. Incluiu questões que abrangiam características do perfil demográfico e ocupacional do profissional e da unidade de diálise, utilização e frequência de ferramentas de avaliação nutricional, estratégias de intervenção nutricional em casos de risco ou diagnóstico de desnutrição e prescrição e acesso a suplementos alimentares orais. Resultados: Foram recebidos eletronicamente o equivalente a 24% das unidades de diálise brasileiras (n = 207). As ferramentas de avaliação nutricional mais utilizadas com ou sem frequência pré-estabelecida foram inquéritos dietéticos (96%) e Avaliação Global Subjetiva (83%). As estratégias em casos de risco ou presença de desnutrição utilizadas com mais frequência (quase sempre/sempre) foram a orientação de incremento energético e proteico por meio de alimentos (97%) e o aumento da periodicidade das visitas (88%). A frequência de prescrição de suplemento industrializado de fórmula padrão e especializada foi bastante semelhante. A disponibilização de suplementos alimentares pelo Sistema Único de Saúde aos pacientes variou entre as regiões. Conclusão: A maior parte dos nutricionistas utiliza diversas ferramentas de avaliação nutricional e estratégias de intervenção em casos de risco ou desnutrição, porém a frequência de utilização de tais ferramentas e estratégias foi bastante variada. Introdução Brasil profissionais Objetivo nutricionais Metodologia mensagens orais Resultados 24 n 207. 207 . 207) préestabelecida pré estabelecida 96% 96 (96% 83%. 83 83% (83%) quase sempre/sempre sempresempre sempre 97% 97 (97% 88%. 88 88% (88%) semelhante regiões Conclusão variada 2 20 9 (96 8 (83% (97 (88% (9 (83 (88 ( (8

Abstract Introduction: The role of the Advanced Practice Nurse (APN) is emerging in Chile. This study compared the satisfaction of patients evaluated by an orthopedic surgeon (OS) in conjunction with a nurse practitioner versus OS only through a self-administered survey. Material and method: This study was conducted as a quasi-experimental study, ensuring a rigorous and comprehensive approach. Patients aged 18 and above who attended an orthopedic surgeon visit in an outpatient center between 2020 and 2023 were included. In the intervention group, patients were assessed by the APN, who provided treatment and education; the orthopedic surgeon confirmed the diagnosis. In the control group, patients received standard care from the orthopedic surgeon. Satisfaction was assessed with a ten-question survey. The quality of care, diagnosis, and treatment were evaluated, as were the patients' preferences for visits and whether they recommended this model of care or not. The analysis was conducted using the Shapiro-Wilk test to evaluate the distribution of numerical variables, summarized with means or medians. Categorical variables were described with absolute and relative frequencies. The chi-square test evaluated differences in proportions, and the Mann-Whitney test compared independent medians. Results: 108 patients were evaluated, 83% female, with an average age of 54 years (±16). 49% were assigned to the intervention group (n=53). No differences in age or gender were observed between groups. The satisfaction score was 96.5 points (range 79-100), with no differences between both groups (p= 0.26). No significant differences were observed in the questionnaire satisfaction scores. Conclusion: The study's findings, which show no differences in patient satisfaction between the two groups, suggest a potential opportunity for healthcare improvement in Chile. This model could potentially reduce waiting lists and bridge healthcare gaps, offering a promising future for advanced practice nursing in the country.

Resumen Introducción: el rol de la Enfermera de Práctica Avanzada (EPA) es emergente en Chile. Nuestro objetivo fue comparar la satisfacción de los pacientes atendidos por una EPA, en conjunto con un traumatólogo subespecialista de cadera, con la de pacientes atendidos por un traumatólogo de cadera, mediante un cuestionario autoadministrado. Material y método: estudio cuasi-experimental, exploratorio. Se incluyeron pacientes mayores de 18 años que consultaron en un centro ambulatorio docente-asistencial entre los años 2020-2023. Se comparó un grupo intervención, cuya la modalidad de atención fue mixta (EPA en conjunto a un traumatólogo de cadera) con un grupo control donde los pacientes fueron atendidos únicamente por un traumatólogo de cadera. Se evaluó satisfacción mediante una encuesta de diez preguntas (0-100 puntos). El instrumento midió la calidad de la atención, diagnóstico y tratamiento, si el paciente volvería a consultar bajo esta modalidad de atención y si la recomendaría a otras personas. Para el análisis estadístico se describieron las variables y se utilizó chi-cuadrado y Mann-Whitney. Resultados: se evaluaron 108 pacientes. El 49% participó en el grupo intervención (n=53). La mediana del puntaje de satisfacción total fue 96,5 puntos (rango 79-100), sin diferencias entre ambos grupos (p 0,26). No se observaron diferencias en la satisfacción en ninguna de las diez preguntas. Conclusión: la mediana del puntaje de satisfacción fue cercano a 100 en ambos grupos. No hubo diferencias en los puntajes de satisfacción entre ambas modalidades de atención. Este modelo podría reducir las listas de espera y disminuir brechas de atención de salud.

ABSTRACT Introduction: The importance of dietitians in dialysis units is indisputable and mandatory in Brazil, but little is known about the practices adopted by these professionals. Objective: To know practices adopted in routine nutritional care, focusing on nutritional assessment tools and treatment strategies for people at risk or diagnosed with malnutrition. Methodology: Electronic questionnaire disseminated on social media and messaging applications. It included questions that covered dietitians’ demographic and occupational profile characteristics and of the dialysis unit, use and frequency of nutritional assessment tools, nutritional intervention strategies in cases of risk or diagnosis of malnutrition, prescription and access to oral supplements. Results: Twenty four percent of the Brazilian dialysis units (n = 207) responded electronically. The most used nutritional assessment tools with or without a pre-established frequency were dietary surveys (96%) and Subjective Global Assessment (83%). The strategies in cases of risk or presence of malnutrition used most frequently (almost always/always) were instructions to increase energy and protein intake from foods (97%), and increasing the frequency of visits (88%). The frequency of prescribing commercial supplements with standard and specialized formulas was quite similar. The availability of dietary supplements by the public healthcare system to patients varied between regions. Conclusion: Most dietitians use various nutritional assessment tools and intervention strategies in cases of risk or malnutrition; however, the frequency of use of such tools and strategies varied substantially. Introduction Brazil professionals Objective care Methodology applications unit Results n 207 electronically preestablished pre established 96% 96 (96% 83%. 83 83% . (83%) almost always/always alwaysalways always 97%, 97 97% , (97%) 88%. 88 88% (88%) similar regions Conclusion however substantially 20 9 (96 8 (83% (97% (88% 2 (9 (83 (97 (88 ( (8

Resumo Introdução: A importância da atuação do nutricionista em unidades de diálise é indiscutível e obrigatória no Brasil, porém pouco sabemos sobre as práticas adotadas por esses profissionais. Objetivo: Conhecer práticas adotadas na rotina dos atendimentos nutricionais, com foco nas ferramentas de avaliação nutricional e nas estratégias de tratamento das pessoas com risco ou diagnóstico de desnutrição. Metodologia: Questionário eletrônico divulgado em mídias sociais e aplicativos de mensagens. Incluiu questões que abrangiam características do perfil demográfico e ocupacional do profissional e da unidade de diálise, utilização e frequência de ferramentas de avaliação nutricional, estratégias de intervenção nutricional em casos de risco ou diagnóstico de desnutrição e prescrição e acesso a suplementos alimentares orais. Resultados: Foram recebidos eletronicamente o equivalente a 24% das unidades de diálise brasileiras (n = 207). As ferramentas de avaliação nutricional mais utilizadas com ou sem frequência pré-estabelecida foram inquéritos dietéticos (96%) e Avaliação Global Subjetiva (83%). As estratégias em casos de risco ou presença de desnutrição utilizadas com mais frequência (quase sempre/sempre) foram a orientação de incremento energético e proteico por meio de alimentos (97%) e o aumento da periodicidade das visitas (88%). A frequência de prescrição de suplemento industrializado de fórmula padrão e especializada foi bastante semelhante. A disponibilização de suplementos alimentares pelo Sistema Único de Saúde aos pacientes variou entre as regiões. Conclusão: A maior parte dos nutricionistas utiliza diversas ferramentas de avaliação nutricional e estratégias de intervenção em casos de risco ou desnutrição, porém a frequência de utilização de tais ferramentas e estratégias foi bastante variada. Introdução Brasil profissionais Objetivo nutricionais Metodologia mensagens orais Resultados 24 n 207. 207 . 207) préestabelecida pré estabelecida 96% 96 (96% 83%. 83 83% (83%) quase sempre/sempre sempresempre sempre 97% 97 (97% 88%. 88 88% (88%) semelhante regiões Conclusão variada 2 20 9 (96 8 (83% (97 (88% (9 (83 (88 ( (8

Abstract Introduction Unplanned hospital returns are frequent and may be preventable. Objective To comprehend the reasons for unplanned hospital readmission and return to the Outpatient Department (OPD) and Emergency Department (ED) within 60 days after discharge following head and neck surgery (HNS) at a tertiary care center in Saudi Arabia. Methods In the present retrospective study, the medical records of all patients who underwent HNS for benign and malignant conditions between January 2015 and June 2022 were reviewed in terms of demographic data, comorbidities, and reasons for hospital return. Results Out of 1,030 cases, 119 (11.55%) returned to the hospital within 60 days after discharge, 19 of which (1.84%) were readmitted. In total, 90 (8.74%) patients returned to the OPD, and 29 (2.82%), to the ED. The common reasons for readmission included infections (26.32%) and neurological symptoms (21.05%). For OPD visits, the common causes were hematoma (20%) and neurological symptoms (14.44%). For ED returns, the frequent causes were neurological symptoms (20.69%) and equipment issues (17.24%). Compared with nonreadmitted patients, readmitted patients had a higher preoperative baseline health burden when examined using the American Society of Anesthesiologists (ASA) score (p = 0.004) and the Cumulative Illness Rating Scale (CIRS; p = 0.002). Conclusion The 60-day rates of unplanned hospital return to the OPD and ED were of 8.74% and 2.82% respectively, and 1.84% of the patients were readmitted. Hematoma, infections, and neurological symptoms were common causes. Addressing the common reasons may be beneficial to decrease postoperative hospital visits. preventable (OPD (ED 6 (HNS Arabia study 201 202 data comorbidities 1030 1 030 1,03 cases 11 11.55% 1155 55 (11.55% 184 84 (1.84% total 9 874 8 74 (8.74% 2 2.82%, 282 , 82 (2.82%) 26.32% 2632 26 32 (26.32% 21.05%. 2105 21.05% . 21 05 (21.05%) visits 20% 20 (20% 14.44%. 1444 14.44% 14 44 (14.44%) 20.69% 2069 69 (20.69% 17.24%. 1724 17.24% 17 24 (17.24%) ASA (ASA 0.004 0004 0 004 CIRS (CIRS 0.002. 0002 0.002 002 0.002) 60day day 8.74 2.82 respectively 1.84 Hematoma 103 03 1,0 11.55 115 5 (11.55 18 (1.84 87 7 (8.74 28 (2.82% 26.32 263 3 (26.32 210 21.05 (21.05% (20 144 14.44 4 (14.44% 20.69 206 (20.69 172 17.24 (17.24% 0.00 000 00 8.7 2.8 1.8 10 1, 11.5 (11.5 (1.8 (8.7 (2.82 26.3 (26.3 21.0 (21.05 (2 14.4 (14.44 20.6 (20.6 17.2 (17.24 0.0 8. 2. 1. 11. (11. (1. (8. (2.8 26. (26. 21. (21.0 ( 14. (14.4 20. (20. 17. (17.2 0. (11 (1 (8 (2. (26 (21. (14. (17. (21 (14 (17

Resumen Introducción. La información publicada sobre la correlación entre la magnitud del efecto de todo el espectro de la calidad de vida y la gravedad de la enfermedad en pacientes con dermatitis atópica es escasa. Objetivos. Evaluar la calidad de vida con tres instrumentos diferentes y los índices de gravedad de la enfermedad en pacientes con dermatitis atópica para determinar su correlación y el tamaño del efecto del cambio. Materiales y métodos. Los datos de los pacientes se obtuvieron a partir de dos visitas. Se evaluó la información sociodemográfica y los datos relacionados con la distribución y la gravedad de la enfermedad (mediante de las escalas BSA, EASI, SCORAD, POEM, prurito) y el impacto de la dermatitis atópica en la calidad de vida utilizando el Dermatology Life Quality Index, Skindex-29 y EQ-5D. También se evaluó la correlación entre el cambio en las puntuaciones de calidad de vida y las de gravedad de la enfermedad, además del tamaño del efecto estandarizado. Resultados. Solo 139 de los 212 pacientes completaron la visita de seguimiento. El área de superficie corporal se correlacionó fuertemente con el SCORAD y el EASI, y la correlación más débil fue con el POEM. La mejor correlación del prurito medido con la escala visual análoga se halló con la alteración del sueño. El puntaje SCORAD se correlacionó altamente con el EASI mientras que la correlación más baja se encontró con el POEM. La magnitud del efecto al inicio del estudio respecto al seguimiento fue en promedio de moderada a importante. Conclusiones. Los pacientes con dermatitis atópica experimentan una carga sustancial en la calidad de vida. La actividad de la enfermedad se correlaciona mejor con las mediciones de calidad de vida cuando esta es menos grave, después de comenzar la terapia. Los índices POEM y Skindex-29 parecen ser óptimos para determinar la gravedad de la enfermedad y la calidad de vida en adultos con dermatitis atópica.

Abstract Introduction. Reports regarding the correlation and effect size of change of the full spectrum of quality of life and disease severity measures applied in-person to patients with atopic dermatitis are scarce. Objectives. To assess quality-of-life with 3 different instruments and to evaluate disease severity indices and to determine their correlation and effect size of change between two measurements. Materials and methods. Patient-level data were obtained through two in-person visits. Sociodemographic information and data related to disease distribution, severity (through the BSA, EASI, SCORAD, POEM, and itching scales), and the impact of atopic dermatitis on quality of life using the DLQI and Skindex-29, and EQ-5D, were assessed. The correlation between change in quality-of-life scores and disease severity scores in addition to the standardized effect size were also evaluated. Results. Only 139 out of 212 patients completed the follow-up visit. BSA highly correlated with SCORAD and EASI, and the lowest correlation was found with POEM. The best correlation of pruritus VAS was found with sleep disturbance. The SCORAD score highly correlated with EASI, and the lowest correlation was found with POEM. The magnitude of the effect at initiation of the study vs follow-up was in average moderate to important. Conclusions. Patients with atopic dermatitis experience a substantial burden on quality of life. Disease activity correlates better with quality-of-life measurements when the disease is less severe after starting therapy. POEM and Skindex-29 seem to be optimal to determine disease severity and quality of life in adults with atopic dermatitis.

Abstract The article exposes the public policy of closing the border of the Dominican Republic against the Haitian population since 1937, a situation that has been beneficial for global corporations that have increased their profit margins by taking advantage of the context of poverty, violence, and racism experienced by the Haitian population. The case of the textile corporation Compagnie Développement Industriel (CODEVI) is studied, which has placed an industrial site on the Haitian-Dominican border line. Methodologically, an anthropological and geographical study was carried out, consisting of interviews and visits to both workers and company officials, in addition to a documentary review of the economic policy of both countries and the legislation regulating transnational corporations. In this way, the creative political, legal, technical, and territorial devices used to exploit cheap Haitian labor are exposed, evidencing the national and racial segregation imposed by the textile company. It is concluded that this system of labor exploitation generates great economic profits in exchange for a minimal investment that does not contribute significantly to overcome the extreme poverty experienced by workers living in the impoverished Haitian border town of Ouanaminthe.

Resumen En el presente artículo se analiza la política racial de cierre de frontera que desde 1937 se ha instaurado en la zona dominico-haitiana, situación que ha resultado beneficiosa para corporativos globales que han incrementado sus márgenes de ganancia aprovechando el contexto de pobreza, violencia y racismo que vive la población haitiana. Se estudia el caso de la empresa textil Compagnie Développement Industriel (CODEVI), la cual ha desarrollado un sofisticado emplazamiento industrial sobre esta línea fronteriza. Metodológicamente se realiza un trabajo antropológico y geográfico que consistió en entrevistas y visitas tanto a personas trabajadoras como funcionarias de la empresa, además de una revisión documental de la política económica de ambos países y de legislaciones de corporaciones trasnacionales. De este modo, se exponen los ingeniosos dispositivos políticos, legales, técnicos y territoriales utilizados para explotar la mano de obra barata haitiana, evidenciando la segregación nacional y racial que impone la empresa textil. Se concluye que este sistema de explotación laboral obtiene grandes ganancias económicas a cambio de una mínima inversión que no contribuye significativamente a superar la extrema pobreza que viven trabajadores y trabajadoras que residen en la depauperada ciudad fronteriza haitiana de Ouanaminthe.

Resumen Introducción: El 90% de las lumbalgias agudas son de causa inespecífica. Existen guías internacionales que permiten identificar a aquellos pacientes que requieren atención especializada. En nuestro país la orientación a la atención primaria de la salud es escasa, centrada prin cipalmente en la atención en los hospitales. El objetivo del presente estudio fue describir los recursos de salud, diagnósticos y terapéuticos, utilizados en la atención inicial de pacientes con dolor lumbar que acuden a la consulta del médico especialista Métodos: Estudio descriptivo y transversal, con re colección prospectiva de los datos a través de un cues tionario destinado a pacientes con dolor lumbar que acuden por primera vez a la consulta especializada. Resultados: Se incluyeron 44 pacientes, edad media 53 años; 50% concurrió por dolor crónico. La derivación informal se asoció con: especialidad de derivación (no traumatólogo), pacientes con mayor número de consul tas a guardia y mayor demora en obtener la consulta. El 52% concurrió con al menos un estudio complementario. Conclusión: La mayor parte de las derivaciones fueron correctas, sin embargo, predominó la derivación infor mal. Solo 1/5 de los pacientes fue examinado y menos del 30% de los pacientes con banderas rojas acudió con estudios complementarios adecuados. La mediana del tiempo de espera para la consulta fue 24 días.

Abstract Introduction: 90% of cases of acute low back pain have no specific underlying cause. International guide lines are available to help identify those individuals who require specialized care. However, in our country, there is a limited emphasis on primary healthcare, with the primary focus on hospital-based care. The aim of this study is to provide an overview of the diagnostic and therapeutic resources utilized in the initial care of patients experiencing low back pain at their first con sultation with a specialist physician. Methods: Descriptive and cross-sectional study, with prospective data collection through a questionnaire administered to patients experiencing low back pain during their first visit to a specialist’s office. Results: A total of 44 patients were included, with an average age of 53 years; 50% sought medical atten tion for chronic pain. Informal referrals were associated with the referring physician’s specialty (non-orthopedic), patients with a higher number of emergency depart ment visits, and longer waiting times to obtain the consultation; 52% of patients arrived with at least one complementary study. Conclusion: Most of the referrals were appropriate; however, informal referrals were more common. Only 1/5 of the patients underwent an physical examination, and less than 30% of those with red flag symptoms presented with suitable complementary studies. The median wait ing time for the consultation was 24 days.

RESUMO A pandemia de covid-19 se impôs de modo mais agudo e dramático aos grupos políticos e socialmente mais vulnerabilizados, como a População em Situação de Rua (PSR). A literatura sobre as respostas às demandas de saúde e de assistência social dos mais vulnerabilizados, durante a pandemia, ainda é escassa. Neste artigo, descreve-se a rede de cuidado à PSR, considerando os caminhos formalmente instituídos e aqueles produzidos durante a pandemia de covid-19, no município de Belo Horizonte. Para tanto, realizaram-se análise documental, visitas técnicas a serviços assistenciais, entrevistas em profundidade e grupos focais com atores que compõem a rede de cuidado. Os resultados mostraram que a rede é composta por quatro componentes com interseções: pela rede da saúde, da assistência social, da Pastoral Nacional do Povo da Rua (sociedade civil organizada) e a rede criada para cuidado de sintomáticos respiratórios. As mudanças de fluxos impostas pela pandemia repercutiram em dificuldades no acesso aos serviços de cuidado da PSR. Contudo, observou-se a potencialidade para a oferta da integralidade do cuidado, mediante articulações realizadas na pandemia entre a saúde, a assistência social e a sociedade civil organizada. covid19 covid 19 covid-1 vulnerabilizados PSR . (PSR) escassa artigo descrevese descreve covid19, 19, Horizonte tanto realizaramse realizaram documental assistenciais interseções organizada respiratórios Contudo observouse observou covid1 1 covid- (PSR

ABSTRACT The COVID-19 pandemic has imposed itself in a acutely and dramatically way, particularly on politically and socially vulnerable groups, such as the homeless population (HP). The literature on health emergency and response and social care needs of the most vulnerable during the pandemic is scarce. This article describes the network of care for HP, including formally instituted pathways of care and those produced during the pandemic of COVID-19, in the city of Belo Horizonte. The methodological path used documentary analysis, technical visits to care services, in-depth interviews and focus groups with the care network stakeholders. The results showed that the network is composed of four components with intersections: the health network, the social care network, the ‘National Pastoral Care of the Homeless People’ (non-governmental organization) and the network created to care for people with respiratory symptoms. The workflow changes imposed by the pandemic resulted in access barriers in different centers offering care for HP. However, it was observed the potentiality of the integral care offer, through the connections built during the pandemic between health, social care, and the non-governmental organizations. COVID19 COVID 19 COVID-1 way HP . (HP) scarce COVID19, 19, Horizonte analysis services indepth depth stakeholders intersections National People nongovernmental non governmental organization symptoms However offer organizations COVID1 1 COVID- (HP