Resumen Objetivo Comprender los desafíos enfrentados por la educación permanente para lograr mejorar la calidad y la seguridad del paciente en un hospital público sometido a acreditación hospitalaria. Métodos Estudio descriptivo, transversal y con enfoque cualitativo. Se realizaron entrevistas semiestructuradas a 22 profesionales, con duración promedio de 22 minutos, que luego se analizaron e interpretaron mediante el análisis de contenido temático de Bardin. Se utilizaron los softwares Iramuteq para el análisis de corpus textual y BioEstat 5.3 para el análisis del perfil de los participantes. La recopilación de datos se llevó a cabo en junio de 2022, después de la aprobación de los Comités de Ética en Investigación. Resultados Se aplicó el análisis de clasificación jerárquica descendente, generado por Iramuteq. Se obtuvieron tres categorías: Desafíos de la educación permanente mediante el proceso de mejora continua, Educación permanente para la promoción de la calidad y de la seguridad del paciente en el contexto de la acreditación hospitalaria, y Estrategias educativas para la mejora de la calidad y la seguridad del paciente. Conclusión Se identificaron desafíos inherentes a las acciones de educación permanente en salud, tales como resistencia a cambios de cultura, adherencia a las actividades, alta rotación de profesionales y dificultad de autorizar al equipo de enfermería para participar en las actividades relacionadas con la demanda de trabajo. hospitalaria descriptivo cualitativo 2 minutos Bardin 53 5 3 5. participantes 2022 Investigación descendente categorías continua salud cultura trabajo 202 20

Resumo Objetivo Compreender os desafios enfrentados pela educação permanente para o alcance da melhoria da qualidade e da segurança do paciente em um hospital público submetido à acreditação hospitalar. Métodos Estudo descritivo, transversal e com abordagem qualitativa. Realizaram-se entrevistas semiestruturadas com 22 profissionais, durando, em média, 22 minutos, as quais posteriormente foram analisadas e interpretadas por meio da análise de conteúdo temática de Bardin. Adotaram-se os softwares Iramuteq para a análise de corpus textual, e o BioEstat 5.3, para análise do perfil dos participantes. A coleta de dados ocorreu em junho de 2022, após aprovação nos Comitês de Ética em Pesquisa. Resultados Aplicou-se a análise de classificação hierárquica descendente, gerada pelo Iramuteq. Obtiveram-se três categorias: Desafios da Educação Permanente mediante o Processo de Melhoria Contínua; Educação Permanente para a Promoção da Qualidade e da Segurança do Paciente no Contexto da Acreditação Hospitalar; e Estratégias Educativas para a Melhoria da Qualidade e da Segurança do Paciente. Conclusão Identificaram-se desafios inerentes às ações de educação permanente em saúde, tais como resistência à mudança de cultura, adesão às atividades, alta rotatividade de profissionais e dificuldade para liberação da equipe de enfermagem para participar das atividades relacionadas à demanda de trabalho. hospitalar descritivo qualitativa Realizaramse Realizaram se 2 durando média minutos Bardin Adotaramse Adotaram textual 53 5 3 5.3 participantes 2022 Pesquisa Aplicouse Aplicou descendente Obtiveramse Obtiveram categorias Contínua Hospitalar Identificaramse Identificaram saúde cultura trabalho 5. 202 20

Abstract Objective To understand the challenges faced in terms of permanent education in health, for achieving quality improvements and patient safety at a public hospital undergoing hospital accreditation. Methods This was a descriptive, cross-sectional study with a qualitative approach. Semi-structured interviews were conducted with 22 professionals, lasting an average of 22 minutes. The interviews were subsequently analyzed and interpreted using Bardin’s thematic content analysis. The software Iramuteq was used to analyze the textual corpus, and BioEstat 5.3 was used to analyze the profile of the participants. The data collection took place in June 2022, following approval by the Research Ethics Committees. Results The descending hierarchical classification analysis, generated by Iramuteq, was applied, resulting in three categories: Challenges of Permanent Education through the Continuous Improvement Process, Permanent Education for the Promotion of Quality and Patient Safety in the Context of Hospital Accreditation, and Educational Strategies for Improving Quality and Patient Safety. Conclusion Challenges inherent to the actions of permanent education in health were identified, such as resistance to cultural change, adherence to activities, high turnover of professionals, and difficulty in releasing the nursing team to participate in activities, due to work demand. accreditation descriptive crosssectional cross sectional approach Semistructured Semi structured 2 professionals minutes Bardins Bardin s analysis corpus 53 5 3 5. participants 2022 Committees applied categories Process Accreditation identified change activities demand 202 20

RESUMEN Introducción: El triatlón puede considerarse uno de los deportes de resistencia de mayor éxito a nivel mundial debido a la gran difusión de información, ampliación de la oferta de competiciones y mayor popularidad. Objetivo: Analizar el perfil sociodemográfico, socioeconómico y motivacional de los triatletas brasileños. Métodos: Participaron en el estudio 411 triatletas, 127 mujeres [37,87 ± 9,34 años] y 284 hombres [36,02 ± 9,23 años]. Se enviaron electrónicamente tres cuestionarios para evaluar datos sociodemográficos, socioeconómicos y de motivación. Se realizaron análisis descriptivos y pruebas estadísticas para comparar la motivación entre grupos de edad, sexo y nivel técnico. Resultados: Se encontró que existe un predominio de triatletas masculinos, amateurs, con edades entre 30-40 años, empleados y económicamente favorecidos. Los deportistas aficionados tienen la carrera como deporte base para el Triatlón y los profesionales inician su carrera deportiva a través de la natación. Entre las distancias más practicadas se encuentran el Triatlón sprint y el medio Ironman. Respecto a la motivación, las mujeres difieren en las dimensiones actividad grupal (p=0,020), emoción (p=0,002) y competencia técnica (p=0,007). Los triatletas profesionales obtuvieron puntuaciones más altas en las dimensiones de reconocimiento social (p=0,001) y competición (p=0,001) y puntuaciones más bajas en la dimensión de condición física (p=0,005). Los triatletas con edades comprendidas entre 35 y 49 años tuvieron medias más bajas en la dimensión reconocimiento social (p=0,007), (p=0,012) y (p=0,004) y competición (p=0,028), (p=0,008) y (p=0,044) en comparación con atletas de 20 a 29 años. Conclusión: el perfil de los triatletas brasileños es diverso y las diferencias de sexo, edad y nivel técnico impactaron en la motivación de los triatletas evaluados. Nivel de Evidencia III; Estudios diagnósticos - Investigación de un diagnóstico prueba; Estudio de pacientes no consecutivos, sin un “patrón oro” aplicado uniformemente. Introducción información popularidad Objetivo sociodemográfico Métodos 41 12 37,87 3787 37 87 [37,8 934 9 34 9,3 28 36,02 3602 36 02 [36,0 923 23 9,2 . sociodemográficos Resultados masculinos amateurs 3040 30 40 30-4 favorecidos natación Ironman p=0,020, p0020 p p=0,020 , 0 020 (p=0,020) p=0,002 p0002 002 (p=0,002 p=0,007. p0007 p=0,007 007 (p=0,007) p=0,001 p0001 001 (p=0,001 p=0,005. p0005 p=0,005 005 (p=0,005) 3 4 p=0,007, p=0,012 p0012 012 (p=0,012 p=0,004 p0004 004 (p=0,004 p=0,028, p0028 p=0,028 028 (p=0,028) p=0,008 p0008 008 (p=0,008 p=0,044 p0044 044 (p=0,044 2 Conclusión evaluados III prueba consecutivos patrón oro uniformemente 1 37,8 378 8 [37, 93 9, 36,0 360 [36, 92 304 30- p002 p=0,02 (p=0,020 p=0,00 p000 00 (p=0,00 (p=0,007 (p=0,005 p=0,01 p001 01 (p=0,01 (p=0,028 p=0,04 p004 04 (p=0,04 37, [37 36, [36 p00 p=0,0 (p=0,02 (p=0,0 [3 p0 p=0, (p=0, [ p=0 (p=0 p= (p= (p

ABSTRACT Introduction: Triathlon can be considered one of the most successful endurance sports worldwide due to the wide dissemination of information, expansion of the offer of competitions, and greater popularity. Objective: To analyze Brazilian triathletes’ sociodemographic, socioeconomic, and motivational profiles. Methods: 411 triathletes participated in the study, 127 women [37.87 ± 9.34 years] and 284 men [36.02 ± 9.23 years]. Three questionnaires were sent electronically to assess sociodemographic, socioeconomic, and motivational data. In addition, descriptive analyses and statistical tests were performed to compare motivation between age, sex, and technical level groups. Results: It was found that there is a prevalence of male triathletes, amateurs, aged between 30-40 years, employed and economically favored. Amateur athletes have running as a base sport for Triathlon, and professionals start their sports career through swimming. Among the most practiced distances are the sprint Triathlon and half Ironman. Regarding motivation, women differ in the dimensions of group activity (p=0.020), emotion (p=0.002), and technical competence (p=0.007). Professional triathletes had higher scores in the dimensions of social recognition (p=0.001) and competition (p=0.001) and lower scores in the physical fitness dimension (p=0.005). Triathletes aged between 35 and 49 years had lower averages in the social recognition dimension (p=0.007), (p=0.012) and (p=0.004) and competition (p=0.028), (p=0.008) and (p=0.044) when compared to athletes aged 20 to 29 years. Conclusion: the profile of Brazilian triathletes is diverse, and differences in sex, age, and technical level impacted the motivation of the evaluated triathletes. Level of Evidence III; Diagnostic studies - Investigation of a diagnosis test; Study of non-consecutive patients, with no uniformly applied “gold standard”. Introduction information competitions popularity Objective sociodemographic socioeconomic profiles Methods 41 study 12 37.87 3787 37 87 [37.8 934 9 34 9.3 28 36.02 3602 36 02 [36.0 923 23 9.2 . data addition age sex groups Results amateurs 3040 30 40 30-4 favored swimming Ironman p=0.020, p0020 p p=0.020 , 0 020 (p=0.020) p=0.002, p0002 p=0.002 002 (p=0.002) p=0.007. p0007 p=0.007 007 (p=0.007) p=0.001 p0001 001 (p=0.001 p=0.005. p0005 p=0.005 005 (p=0.005) 3 4 p=0.007, p=0.012 p0012 012 (p=0.012 p=0.004 p0004 004 (p=0.004 p=0.028, p0028 p=0.028 028 (p=0.028) p=0.008 p0008 008 (p=0.008 p=0.044 p0044 044 (p=0.044 2 Conclusion diverse III test nonconsecutive non consecutive patients gold standard. standard standard” 1 37.8 378 8 [37. 93 9. 36.0 360 [36. 92 304 30- p002 p=0.02 (p=0.020 p000 p=0.00 00 (p=0.002 (p=0.007 (p=0.00 (p=0.005 p=0.01 p001 01 (p=0.01 (p=0.028 p=0.04 p004 04 (p=0.04 37. [37 36. [36 p00 p=0.0 (p=0.02 (p=0.0 [3 p0 p=0. (p=0. [ p=0 (p=0 p= (p= (p

RESUMO Introdução: O Triathlon pode ser considerado um dos esportes endurance de maior sucesso mundialmente devido à grande disseminação de informações, ampliação da oferta de competições e maior popularidade. Objetivo: Analisar o perfil sociodemográfico, socioeconômico e motivacional de triatletas brasileiros. Métodos: Participaram da pesquisa 411 triatletas, sendo 127 mulheres [37,87 ± 9,34 anos] e 284 homens [36,02 ± 9,23 anos]. Foram enviados eletronicamente três questionários que avaliam dados sociodemográficos, socioeconômicos e a motivação. Foram realizadas análises descritivas e testes estatísticos para comparar a motivação entre grupos de idade, sexo e nível técnico. Resultados: Verificou-se que há prevalência de triatletas homens, amadores, com faixa etária entre 30-40 anos, empregados e economicamente favorecidos. Atletas amadores possuem a corrida como esporte de base para o Triathlon e profissionais iniciam sua carreira esportiva pela natação. Entre as distâncias mais praticadas estão o Triathlon sprint e meio Ironman. Sobre a motivação, mulheres diferem nas dimensões de atividade de grupo (p=0,020), emoção (p=0,002) e competência técnica (p=0,007). Triatletas profissionais apresentaram maiores pontuações nas dimensões de reconhecimento social (p=0,001) e competição (p=0,001) e menores pontuações na dimensão aptidão física (p=0,005). Triatletas com idades entre 35 a 49 anos obtiveram menores médias na dimensão reconhecimento social (p=0,007), (p=0,012) e (p=0,004) e competição (p=0,028), (p=0,008) e (p=0,044) quando comparados com atletas de 20 a 29 anos. Conclusão: o perfil de triatletas brasileiros é diverso e as diferenças de sexo, idade e nível técnico impactaram na motivação dos triatletas avaliados. Nível de Evidência III; Estudos diagnósticos - Investigação de um diagnóstico este; Estudo de pacientes não consecutivos, sem “padrão ouro” aplicado de maneira uniforme. Introdução informações popularidade Objetivo sociodemográfico Métodos 41 12 37,87 3787 37 87 [37,8 934 9 34 9,3 28 36,02 3602 36 02 [36,0 923 23 9,2 . sociodemográficos Resultados Verificouse Verificou se 3040 30 40 30-4 favorecidos natação Ironman p=0,020, p0020 p p=0,020 , 0 020 (p=0,020) p=0,002 p0002 002 (p=0,002 p=0,007. p0007 p=0,007 007 (p=0,007) p=0,001 p0001 001 (p=0,001 p=0,005. p0005 p=0,005 005 (p=0,005) 3 4 p=0,007, p=0,012 p0012 012 (p=0,012 p=0,004 p0004 004 (p=0,004 p=0,028, p0028 p=0,028 028 (p=0,028) p=0,008 p0008 008 (p=0,008 p=0,044 p0044 044 (p=0,044 2 Conclusão avaliados III este consecutivos padrão ouro uniforme 1 37,8 378 8 [37, 93 9, 36,0 360 [36, 92 304 30- p002 p=0,02 (p=0,020 p=0,00 p000 00 (p=0,00 (p=0,007 (p=0,005 p=0,01 p001 01 (p=0,01 (p=0,028 p=0,04 p004 04 (p=0,04 37, [37 36, [36 p00 p=0,0 (p=0,02 (p=0,0 [3 p0 p=0, (p=0, [ p=0 (p=0 p= (p= (p

ABSTRACT From the theoretical perspective of the cartography of the micropolitics of living labor in action, the objective was to analyze the work process of the “street clinic” team based in a primary care unit in the city of Rio de Janeiro, Brazil, in the management of tuberculosis cases in the context of the Covid-19 pandemic. This is an exploratory qualitative research. Between May and December 2021, seven professionals from the street clinic team were interviewed, and participant observation was conducted with field diary records. Three thematic axes emerged from the interviews related to people experiencing homelessness in the context of the Covid -19 pandemic: 1) Challenges, potentialities, and weaknesses of tuberculosis care; 2) Building intersectoral care networks for monitoring individuals with tuberculosis; and 3) The street as a space for care production: the work process of the street clinic in tuberculosis management. It is concluded that caring for people experiencing homelessness with tuberculosis in the context of the Covid -19 pandemic requires not only managing clinical protocols but also building shared work with the intra and intersectoral network. In addition to the task of being in the territory, the outpatient service in the territory must also be a street outpatient service, especially regarding tuberculosis treatment.

RESUMEN Desde la perspectiva teórica de la cartografía de la micropolítica del trabajo vivo en acto, el objetivo fue analizar el proceso de trabajo del equipo del “consultorio en la calle” con sede en una unidad de atención básica de la ciudad de Río de Janeiro, Brasil, en el manejo de casos de tuberculosis, en el contexto de la pandemia de covid-19. Se trata de una investigación exploratoria con enfoque cualitativo. Entre mayo y diciembre de 2021, se entrevistaron a siete profesionales del equipo consultorio en la calle, y se realizó observación participante con registros en diario de campo. De las entrevistas surgieron tres ejes temáticos relacionados con la población en situación de calle en el contexto de la pandemia covid-19: 1) Desafíos, potencialidades y fragilidades del cuidado de la tuberculosis; 2) Construcción de redes de cuidados intersectoriales para el seguimiento de las personas con tuberculosis; y 3) La calle como espacio de producción de cuidado: el proceso de trabajo del consultorio en la calle en el manejo de la tuberculosis. Se concluye que la atención a personas en situación de calle con tuberculosis en el contexto de la pandemia covid-19 requiere no solo de la gestión de protocolos clínicos, sino también de la construcción de un trabajo compartido con la red intra e intersectorial. Además de la tarea de estar en el territorio, el servicio ambulatorio del territorio también debe ser un servicio ambulatorio de la calle, especialmente en lo que respecta al tratamiento de la tuberculosis.

Resumo Este estudo tem como objetivo apresentar o processo de elaboração e validação do modelo lógico do plano de contingência para enfrentamento da covid-19 do Hospital Universitário de Brasília (HUB-UnB/Ebserh). É parte de um estudo de avaliabilidade, de metodologia qualitativa, desenvolvido de forma participativa, com os interessados pela avaliação (gestores e profissionais de saúde) no hospital e foi realizado entre julho 2020 e fevereiro de 2021. Todos os produtos foram validados pelos interessados. O modelo lógico validado é composto por sete componentes e 18 atividades e 109 produtos. Os componentes foram ‘Gestão’, ‘Assistência’, ‘Força de Trabalho’, ‘Vigilância’, ‘Apoio e Insumos Estratégicos’, ‘Ensino, Pesquisa e Extensão’ e ‘Comunicação’. A cultura da avaliação em saúde tem grande importância para demonstrar a efetividade e o impacto das intervenções e apoiar os gestores na tomada de decisão. O uso de modelos lógicos permite a visualização da racionalidade da intervenção, apresentando seu funcionamento e o vínculo entre as relações causais e seus elementos.

Abstract This study aimed to present the process to develop and validate the logical model of the Contingency Plan to face COVID-19 at the University Hospital of Brasília (HUB-UnB/Ebserh). It is part of an evaluability study, with a qualitative methodology, developed in a participatory way, with those interested in the evaluation (managers and health professionals) at the hospital and was carried out between July 2020 and February 2021. All products were validated by interested parties. The validated logical model is composed of seven components and 18 activities and 109 products. The components were ‘Management’, ‘Assistance’, ‘Workforce’, ‘Surveillance’, ‘Support and Strategic Supplies’, ‘Teaching, Research and Extension’ and ‘Communication’. The culture of health assessment is of great importance to demonstrate the effectiveness and impact of interventions and support managers in decision-making. The use of logical models allows the visualization of the rationality of the intervention, presenting its operation and the link between the causal relations and its elements.

Abstract This research project investigated the relationship between sociodemographic characteristics of girls and women who were the victims of rape of in Minas Gerais between 2013 and 2021, and the likelihood of receiving emergency treatment as stipulated in Law No. 12,845/2013, known as the "Minute-After" (Minuto Seguinte) Law. Data from the Notifiable Diseases Information System (SINAN) for rape cases were used to estimate binary choice models. The results indicate that the sociodemographic factors of the victims, aligned with the theory and practice of intersectionality (race, age, place of residence within health regions, relationship with the perpetrator, and year of crime registration), negatively influence the probability of receiving emergency treatment. Specifically, indigenous victims, minors, those raped by acquaintances, and residents in certain health regions, were found to have a lower probability of receiving immediate medical care after rape. Furthermore, it was found that the implementation of public policy did not result in an improvement, as there has been a decrease in the number of medical appointments since the enactment of the law in 2013 through to the year 2021.

Resumo Esta pesquisa investigou a relação entre características sociodemográficas das meninas e mulheres vítimas de estupro em Minas Gerais, no período de 2013 a 2021, e a probabilidade de receberem tratamentos de emergência, conforme estabelecido na Lei nº 12.845/2013, conhecida como Lei do Minuto Seguinte. Utilizou-se os dados do Sistema de Informação de Agravos de Notificação (SINAN) para casos de estupro para estimação de modelos de escolhas binárias. Os resultados indicam que fatores sociodemográficos das vítimas, alinhados à teoria e à prática da interseccionalidade (raça, idade, local de residência dentro das regiões de saúde, relação com o agressor e ano do registro do crime) influenciam, negativamente, a probabilidade de receberem o tratamento de emergência. Em particular, vítimas indígenas, menores de idade, agredidas por conhecidos e residentes em determinadas regiões de saúde demonstraram ter menor probabilidade de receber cuidados médicos imediatos. após o estupro. Além disso, constatou-se que a implementação da política pública não resultou em melhoria, já que, desde a promulgação da Lei, em 2013, até o ano 2021, houve diminuição no número de atendimentos médicos realizados.

RESUMEN Desde la perspectiva teórica de la cartografía de la micropolítica del trabajo vivo en acto, el objetivo fue analizar el proceso de trabajo del equipo del “consultorio en la calle” con sede en una unidad de atención básica de la ciudad de Río de Janeiro, Brasil, en el manejo de casos de tuberculosis, en el contexto de la pandemia de covid-19. Se trata de una investigación exploratoria con enfoque cualitativo. Entre mayo y diciembre de 2021, se entrevistaron a siete profesionales del equipo consultorio en la calle, y se realizó observación participante con registros en diario de campo. De las entrevistas surgieron tres ejes temáticos relacionados con la población en situación de calle en el contexto de la pandemia covid-19: 1) Desafíos, potencialidades y fragilidades del cuidado de la tuberculosis; 2) Construcción de redes de cuidados intersectoriales para el seguimiento de las personas con tuberculosis; y 3) La calle como espacio de producción de cuidado: el proceso de trabajo del consultorio en la calle en el manejo de la tuberculosis. Se concluye que la atención a personas en situación de calle con tuberculosis en el contexto de la pandemia covid-19 requiere no solo de la gestión de protocolos clínicos, sino también de la construcción de un trabajo compartido con la red intra e intersectorial. Además de la tarea de estar en el territorio, el servicio ambulatorio del territorio también debe ser un servicio ambulatorio de la calle, especialmente en lo que respecta al tratamiento de la tuberculosis.

ABSTRACT From the theoretical perspective of the cartography of the micropolitics of living labor in action, the objective was to analyze the work process of the “street clinic” team based in a primary care unit in the city of Rio de Janeiro, Brazil, in the management of tuberculosis cases in the context of the Covid-19 pandemic. This is an exploratory qualitative research. Between May and December 2021, seven professionals from the street clinic team were interviewed, and participant observation was conducted with field diary records. Three thematic axes emerged from the interviews related to people experiencing homelessness in the context of the Covid -19 pandemic: 1) Challenges, potentialities, and weaknesses of tuberculosis care; 2) Building intersectoral care networks for monitoring individuals with tuberculosis; and 3) The street as a space for care production: the work process of the street clinic in tuberculosis management. It is concluded that caring for people experiencing homelessness with tuberculosis in the context of the Covid -19 pandemic requires not only managing clinical protocols but also building shared work with the intra and intersectoral network. In addition to the task of being in the territory, the outpatient service in the territory must also be a street outpatient service, especially regarding tuberculosis treatment.

Abstract Background Patients with psoriatic arthritis (PsA) experience reduced physical function and impaired quality of life. Better patient-reported functional outcomes are found when lower disease activity is achieved. Objectives To evaluate the variation of physical function by HAQ-DI over time in PsA patients treated with standard therapy in a real-life setting: to verify predictors of achieving a minimum clinically important difference (MCID) in function by HAQ-DI (ΔHAQ-DI ≤ − 0.35) and to measure the impact of achieving REM/LDA on long-term function by HAQ-DI. Methods This is a longitudinal analysis of a real-life retrospective cohort. Data from PsA patients with at least 4 years of follow-up in the PsA clinic from 2011 to 2019 were extracted from electronic medical records. The variations of physical function by HAQ-DI and disease activity by DAPSA over time were calculated. A multivariate hierarchical regression model was applied to verify predictors of MCID in HAQ-DI. A comparison of HAQ-DI variation between patients with DAPSA REM, LDA, moderate and high disease activity was made using the generalized estimating equation model (GEE), adjusted by Bonferroni test. The Spearman correlation method was applied to verify the correlation of ΔDAPSA and ΔHAQ-DI over time. Statistical analysis was performed in SPSS program version 21.0. Results Seventy-three patients were included in the analysis. Physical function measured by HAQ-DI was determined by PsA disease activity measured by DAPSA (p < 0.000). A moderate and statistically significant correlation between ΔDAPSA and ΔHAQ-DI was observed (rs = 0.60; p < 0.001). Only patients in DAPSA REM demonstrated a constant decline in HAQ-DI scores during the follow-up. White ethnicity and older age at baseline were predictors for not achieving MCID in HAQ-DI [RR 0.33 (0.16–0.6795% CI p = 0.002) and RR 0.96 (0.93–0.9895% CI p < 0.000), respectively, while higher scores of HAQ-DI at baseline were predictors of achieving MCID [RR 1.71 (1.12–2.6095%CI p = 0.013)]. Conclusion In PsA, patients who maintained DAPSA REM/LDA over time had better long-term functional outcomes. Higher HAQ-DI scores at baseline, non-white ethnicity and younger age were predictors for achieving a clinical meaningful improvement of HAQ-DI. (PsA life patientreported patient reported achieved HAQDI HAQ DI reallife real setting (MCID ΔHAQDI ΔHAQ 0.35 035 0 35 REMLDA LDA longterm long term HAQDI. DI. cohort followup follow up 201 records calculated GEE, GEE , (GEE) test 210 21 21.0 Seventythree Seventy three 0.000. 0000 0.000 . 000 0.000) rs 0.60 060 60 0.001. 0001 0.001 001 0.001) followup. up. 033 33 0.3 0.16–0.6795% 01606795 16 6795 (0.16–0.6795 0.002 0002 002 096 96 0.9 0.93–0.9895% 09309895 93 9895 (0.93–0.9895 0.000, respectively 171 1 71 1.7 1.12–2.6095%CI 11226095CI 12 2 6095 0.013. 0013 0.013 013 0.013)] nonwhite non white 03 3 20 (GEE 21. 0.00 00 0.6 06 6 0. 0.16–0.6795 0160679 679 (0.16–0.679 09 9 0.93–0.9895 0930989 989 (0.93–0.989 17 7 1. 609 0.01 01 0.013) 0.0 0.16–0.679 016067 67 (0.16–0.67 0.93–0.989 093098 98 (0.93–0.98 0.16–0.67 01606 (0.16–0.6 0.93–0.98 09309 (0.93–0.9 0.16–0.6 0160 (0.16–0. 0.93–0.9 0930 (0.93–0. 0.16–0. 016 (0.16–0 0.93–0. 093 (0.93–0 0.16–0 (0.16– 0.93–0 (0.93– 0.16– (0.16 0.93– (0.93 0.16 (0.1 0.93 (0.9 0.1 (0. (0 (

RESUMO Paciente do sexo masculino, 36 anos, negro, apresentou baixa acuidade visual progressiva em ambos os olhos por 7 anos. Possuía antecedentes de descolamento tracional de retina no olho direito e hemorragia vítrea, seguida de descolamento de retina no olho esquerdo. Negava doenças sistêmicas, trauma ou abuso de drogas. Após investigação clínica, foi diagnosticado com hemoglobinopatia S-C e retinopatia falciforme proliferativa estágio V em ambos os olhos. masculino 3 anos negro vítrea esquerdo sistêmicas drogas clínica SC S C

ABSTRACT A 36-year-old black male presented with a progressive loss of visual acuity in both eyes for 7 years. He had a history of tractional retinal detachment in the right eye and vitreous hemorrhage followed by retinal detachment in the left eye. He denied any systemic illness, trauma, or drug abuse. After clinical investigation, he was diagnosed with SC hemoglobinopathy and proliferative sickle cell retinopathy stage V in both eyes. 36yearold yearold 36 year old years illness trauma abuse investigation 3

RESUMO Objetivo: Avaliar as características da pele e a qualidade de vida de pacientes com câncer de mama submetidas à radioterapia. Método: Estudo transversal com 60 mulheres. Foram aplicadas as escalas de classificação das alterações cutâneas decorrentes da exposição à radiação ionizante (RTOG) e as versões validadas em português das que classificaram os tipos de pele (Fitzpatrick), os sintomas (RISRAS) e a qualidade de vida (DLQI), no período entre dezembro de 2021 e outubro de 2022. Para a análise de dados, foram utilizados os Testes Exato de Fisher, Qui-Quadrado e Teste de Independência Geral Assintótica. Resultados: 100% das pacientes apresentaram irritação na pele. À medida que o tratamento avançou e que a radiodermatite surgiu ou se agravou, houve maior tendência de intensidade de sinais e sintomas, como: sensibilidade, desconforto ou dor, coceira, queimação e calor, descamação seca e úmida, o que pode ter impactado na qualidade de vida e refletido em outros aspectos, como: atividades de compras ou passeios (p=0,0020), programação social ou atividade de lazer (p=0,0420). Conclusão: A radiodermatite é uma condição comum que afeta as mulheres com câncer de mama submetidas à radioterapia, as características da pele e a qualidade de vida das pacientes são afetadas durante esse tratamento. Objetivo radioterapia Método 6 RTOG (RTOG Fitzpatrick, Fitzpatrick , (Fitzpatrick) RISRAS (RISRAS DLQI, DLQI (DLQI) 202 2022 dados Fisher QuiQuadrado Qui Quadrado Assintótica Resultados 100 agravou como sensibilidade dor coceira calor úmida aspectos p=0,0020, p00020 p p=0,0020 0 0020 (p=0,0020) p=0,0420. p00420 p=0,0420 . 0420 (p=0,0420) Conclusão (Fitzpatrick (DLQI 20 10 p0002 p=0,002 002 (p=0,0020 p0042 p=0,042 042 (p=0,0420 2 1 p000 p=0,00 00 (p=0,002 p004 p=0,04 04 (p=0,042 p00 p=0,0 (p=0,00 (p=0,04 p0 p=0, (p=0,0 p=0 (p=0, p= (p=0 (p= (p

ABSTRACT Objective: To evaluate the skin characteristics and quality of life of patients with breast cancer undergoing radiotherapy. Method: Cross-sectional study conducted with 60 women. The classification scales of skin changes resulting from exposure to ionizing radiation (RTOG) and the validated versions in Portuguese of those that classified skin types (Fitzpatrick), symptoms (RISRAS) and quality of life (DLQI) were applied. in the period between December 2021 and October 2022. For data analysis, Fisher’s Exact Test, Chi-Square and Asymptotic General Independence Test were used. Results: 100% of patients had skin irritation. As the treatment progressed and the radiodermatitis appeared or worsened, there was a tendency for the intensity of signs and symptoms to increase, such as: sensitivity, discomfort or pain, itching, burning and heat, dry and wet desquamation, which may have impacted the quality of life and reflected in other aspects, such as: shopping activities or outings (p=0.0020), social activities or leisure activities (p=0.0420). Conclusion: Radiodermatitis is a common condition that affects women with breast cancer undergoing radiotherapy, skin characteristics and quality of life of patients affected during this treatment. Objective radiotherapy Method Crosssectional Cross sectional 6 RTOG (RTOG Fitzpatrick, Fitzpatrick , (Fitzpatrick) RISRAS (RISRAS DLQI (DLQI applied 202 2022 analysis Fishers Fisher s ChiSquare Chi Square used Results 100 irritation worsened increase as sensitivity pain itching heat desquamation aspects p=0.0020, p00020 p p=0.0020 0 0020 (p=0.0020) p=0.0420. p00420 p=0.0420 . 0420 (p=0.0420) Conclusion (Fitzpatrick 20 10 p0002 p=0.002 002 (p=0.0020 p0042 p=0.042 042 (p=0.0420 2 1 p000 p=0.00 00 (p=0.002 p004 p=0.04 04 (p=0.042 p00 p=0.0 (p=0.00 (p=0.04 p0 p=0. (p=0.0 p=0 (p=0. p= (p=0 (p= (p

RESUMEN Objetivo: Evaluar las características de la piel y la calidad de vida de pacientes con cáncer de mama en tratamiento con radioterapia. Método: Estudio transversal con 60 mujeres. Se aplicaron la escala de clasificación de alteraciones cutáneas por exposición a radiaciones ionizantes (RTOG) y las versiones validadas en portugués de las que clasificaban tipos de piel (Fitzpatrick), síntomas (RISRAS) y calidad de vida (DLQI) en el período comprendido entre diciembre 2021 y octubre de 2022. Para el análisis de los datos se utilizaron el Test Exacto de Fisher, Chi-Cuadrado y el Test de Independencia General Asintótica. Resultados: El 100% de los pacientes evaluados sobre la piel. A medida que avanzaba el tratamiento y aparecía o empeoraba la radiodermatitis, hubo tendencia a aumentar la intensidad de los signos y síntomas, tales como: sensibilidad, malestar o dolor, visualización, ardor y calor, descamación seca y húmeda, que pudieron haber tenido una impacto en la calidad de vida y reflejado en otros aspectos, como: actividades de compra o salidas (p=0,0020), actividades sociales o de ocio (p=0,0420). Conclusión: La radiodermatitis es una afección común que afecta a mujeres con cáncer de mama, sometidas a radioterapia, las características de la piel y la calidad de vida de las pacientes afectadas durante este tratamiento. Objetivo radioterapia Método 6 RTOG (RTOG Fitzpatrick, Fitzpatrick , (Fitzpatrick) RISRAS (RISRAS DLQI (DLQI 202 2022 Fisher ChiCuadrado Chi Cuadrado Asintótica Resultados 100 como sensibilidad dolor visualización calor húmeda aspectos p=0,0020, p00020 p p=0,0020 0 0020 (p=0,0020) p=0,0420. p00420 p=0,0420 . 0420 (p=0,0420) Conclusión (Fitzpatrick 20 10 p0002 p=0,002 002 (p=0,0020 p0042 p=0,042 042 (p=0,0420 2 1 p000 p=0,00 00 (p=0,002 p004 p=0,04 04 (p=0,042 p00 p=0,0 (p=0,00 (p=0,04 p0 p=0, (p=0,0 p=0 (p=0, p= (p=0 (p= (p

Objective: To ascertain whether sociodemographic and health-related characteristics known from previous research to have a substantive impact on recovery from depression modified the effect of a digital intervention designed to improve depressive symptoms (CONEMO). Methods: The CONEMO study consisted of two randomized controlled trials, one conducted in Lima, Peru, and one in São Paulo, Brazil. As a secondary trial plan analysis, mixed logistic regression was used to explore interactions between the treatment arm and subgroups of interest defined by characteristics measured before randomization – suicidal ideation, race/color, age, gender, income, type of mobile phone, alcohol misuse, tobacco use, and diabetes/hypertension – in both trials. We estimated interaction effects between the treatment group and these subgroup factors for the secondary outcomes using linear mixed regression models. Results: Increased effects of the CONEMO intervention on the primary outcome (reduction of at least 50% in depressive symptom scores at 3-month follow-up) were observed among older and wealthier participants in the Lima trial (p = 0.030 and p = 0.001, respectively). Conclusion: There was no evidence of such differential effects in São Paulo, and no evidence of impact of any other secondary outcomes in either trial. Clinical trial registration: NCT02846662 (São Paulo, Brazil – SP), NCT03026426 (Lima, Peru – LI). Funded by the U.S. National Institute of Mental Health (grant U19MH098780). Objective healthrelated health related CONEMO. . (CONEMO) Methods trials Paulo analysis ideation racecolor race color race/color age gender income phone misuse use diabeteshypertension diabetes hypertension models Results reduction 50 3month month 3 followup follow up follow-up 0030 0 030 0.03 0001 001 0.001 respectively. respectively respectively) Conclusion registration NCT NCT0284666 SP, SP , SP) NCT0302642 (Lima LI. LI LI) US U S U.S grant U19MH098780. U19MH098780 UMH MH U19MH098780) (CONEMO 5 003 03 0.0 000 00 0.00 NCT028466 NCT030264 U19MH09878 0. NCT02846 NCT03026 U19MH0987 NCT0284 NCT0302 U19MH098 NCT028 NCT030 U19MH09 NCT02 NCT03 U19MH0 NCT0 U19MH

Abstract Background Congenital heart diseases (CHD) are one of the most prevalent malformations, and the screening tests to identify critical congenital heart disease (CCHD) is the pulse oximetry test, with subsequent investigation and treatment. Objective To quantify positive pulse oximetry tests and verify the prevalence of CCHD detected by it in asymptomatic newborns, ≥35 gestational weeks, in a Brazilian maternity hospital. Methodology This is an observational, retrospective, quantitative, analytical and cross-sectional study, conducted from October 2020 to May 2022, in a maternity hospital in southern Brazil, through the collection of records of positive oximetry pulse tests, following the norms of screening CCHD test of the Brazilian Society of Pediatrics (SBP), after they were evaluated with echocardiography for confirmation or exclusion of CHD. Results A total of 5,667 newborns were evaluated in this study, according to the inclusion criteria; 0.17% (n = 10) had a positive pulse oximetry test. Regarding the results of the echocardiography of the neonates with a positive test, two were normal, seven were cases of patent foramen ovale (PFO), and one was a case (0,017%) with interatrial communication (IAC) diagnosis. In the same period, five neonates with CCHD were born, symptomatic, diagnosed by physical examination, and referred to neonatal intensive care units (NICU) before taking the neonatal cardiac screening (< 24 hours of life). Conclusion The prevalence of positive pulse oximetry tests was 0.17% and none CCHD was detected. Five cases of CCHD were born in this period, but they were diagnosed before the recommend time to perform the screening test. CHD (CHD malformations (CCHD treatment 35 ≥3 weeks observational retrospective quantitative crosssectional cross sectional study 202 2022 Brazil SBP, SBP , (SBP) 5667 5 667 5,66 criteria 017 0 17 0.17 n 10 normal PFO, PFO (PFO) 0,017% 0017 (0,017% IAC (IAC diagnosis period symptomatic examination NICU (NICU < ( 2 life. life . life) 3 ≥ 20 (SBP 566 66 5,6 01 1 0.1 (PFO 0,017 001 (0,017 56 6 5, 0. 0,01 00 (0,01 0,0 (0,0 0, (0, (0

ABSTRACT BACKGROUND: The Positive Aspects of Caregiving (PAC) scale is used to assess psychosocial benefits provided to caregivers by the task of caring. The PAC scale consists of nine items, assessed using a five-point Likert scale, with higher values indicating greater positive perceptions and gains from the caregiving experience. OBJECTIVE: To translate and culturally adapt the PAC scale for informal Brazilian caregivers of people with dementia. DESIGN AND SETTING: A methodological study was conducted at the Federal University of São Carlos. METHODS: The following stages were carried out: Translation; Synthesis of the translations; Back-translation; Evaluation by an experts’ committee; and Pre-test. RESULTS: Two independent professionals translated the PAC scale. The consensus version was obtained by merging both translations, which were back-translated into English by a third translator. The expert committee comprised three specialists in the area and project researchers. All scale items presented a Content Validity Index of 1 (CVI = 1.0), and thus remained in the pre-final version of the instrument. The instrument was pre-tested with seven caregivers of people with dementia, the majority of whom were women (57.1%), with a degree of kinship corresponding to sons/daughters (57.1%) and an average age of 55.2 (± 4.1) years. The caregivers considered it clear and understandable and made no suggestions for changes. CONCLUSION: The PAC scale was translated and culturally adapted for use by informal caregivers of people with dementia in Brazil. However, a psychometric analysis of the instrument is necessary to provide normative data for this population group. BACKGROUND (PAC caring fivepoint five point experience OBJECTIVE SETTING Carlos METHODS out Translation translations Backtranslation Back translation Back-translation experts Pretest. Pretest Pre test. test Pre-test RESULTS backtranslated back translator researchers CVI 1.0, 10 1.0 , 0 1.0) prefinal pre final pretested tested 57.1%, 571 57.1% 57 sonsdaughters sons daughters (57.1% 552 55 2 55. ± ( 4.1 41 4 years changes CONCLUSION Brazil However group 1. 57.1 5 (57.1 4. 57. (57. (57 (5

RESUMO O senso de domínio é conceituado como um aspecto positivo do cuidado voltado às pessoas que vivem com demência, um mecanismo de enfrentamento para reduzir a sobrecarga e que pode representar um fator protetor para a saúde mental e física do cuidador. Objetivo: Traduzir e adaptar culturalmente a Pearlin Mastery Scale para o Brasil. Métodos: Estudo metodológico conduzido na Universidade Federal de São Carlos, em que foram seguidas as etapas de tradução inicial; síntese; retrotradução; revisão pelo comitê de juízes pela análise do Índice de Validade de Conteúdo (IVC); e teste da versão pré-final. Resultados: Dois especialistas traduziram a escala para o português brasileiro e definiram uma versão consensual com os pesquisadores. Posteriormente, outros dois especialistas retrotraduziram a versão consensual, que foi revisada por três juízes doutores na área, considerando todos os itens da escala como muito equivalentes (IVC=1,0), mantendo-os na versão pré-final do instrumento. Esta foi testada em um primeiro grupo de cuidadores, a fim de se apontarem adequações. As sugestões foram acatadas mediante a modificação de três itens e, depois, a escala foi testada em um segundo grupo, o qual não apresentou dificuldades em responder ao instrumento. Conclusão: A Pearlin Mastery Scale foi traduzida e adaptada culturalmente para o Brasil, demonstrando equivalência. Entretanto, análises psicométricas futuras do instrumento são necessárias para disponibilizá-lo para uso entre essa população. demência cuidador Objetivo Brasil Métodos Carlos inicial síntese retrotradução IVC (IVC) préfinal. préfinal pré final. final Resultados pesquisadores Posteriormente área IVC=1,0, IVC10 IVC=1,0 , 1 0 (IVC=1,0) mantendoos mantendo cuidadores adequações depois Conclusão equivalência Entretanto disponibilizálo disponibilizá lo população (IVC IVC1 IVC=1, (IVC=1,0 IVC=1 (IVC=1, IVC= (IVC=1 (IVC=

ABSTRACT The sense of mastery is conceptualized as a positive aspect of care targeted at people living with dementia, a coping mechanism to reduce burden, and may represent a protective factor for caregivers’ mental and physical health. Objective: To translate and culturally adapt the Pearlin Mastery Scale for Brazil. Methods: A methodological study was conducted at the Federal University of São Carlos in which the initial translation stages were followed; synthesis; back-translation; review by the committee of judges by analyzing the Content Validity Index (CVI); and test of the pre-final version. Results: Two specialists translated the scale into Brazilian Portuguese and defined a consensus version with the researchers. Subsequently, another two specialists back-translated the consensus version, which was reviewed by three judges who are PhDs in the area, considering all scale items as very equivalent (CVI=1.0), and maintaining them in the pre-final version of the instrument. This was tested in a first group of caregivers for them to point out adjustments. The suggestions were accepted by modifying three items and, afterward, the scale was tested in a second group, which did not present difficulties answering the instrument. Conclusion: The Pearlin Mastery Scale was translated and culturally adapted for Brazil, showing equivalence. However, future psychometric analyses of the instrument are required to make it available for use in this population. dementia burden health Objective Brazil Methods followed synthesis backtranslation back back-translation CVI (CVI) prefinal pre final Results researchers Subsequently backtranslated area CVI=1.0, CVI10 CVI=1.0 , 1 0 (CVI=1.0) adjustments afterward Conclusion equivalence However population (CVI CVI1 CVI=1. (CVI=1.0 CVI=1 (CVI=1. CVI= (CVI=1 (CVI=

ABSTRACT Objective: To evaluate symptoms, lung function, and quality of life of a cohort of patients hospitalized for severe COVID-19 12 months after hospital admission. Methods: This was a cross-sectional study. We included severe COVID-19 survivors hospitalized in one of three tertiary referral hospitals for COVID-19 in the city of Belo Horizonte, Brazil. Participants were submitted to lung function and six-minute walk tests and completed the EQ-5D-3L questionnaire. Results: The whole sample comprised 189 COVID-19 survivors (mean age = 59.6 ± 13.4 years) who had been admitted to a ward only (n = 96; 50.8%) or to an ICU (n = 93; 49.2%). At 12 months of follow-up, 43% of patients presented with dyspnea, 27% of whom had a restrictive ventilatory disorder and 18% of whom presented with impaired DLCO. There were no significant differences in FVC, FEV1, and TLC between the survivors with or without dyspnea. However, those who still had dyspnea had significantly more impaired DLCO (14.9% vs. 22.4%; p < 0.020) and poorer quality of life. Conclusions: After one year, survivors of severe COVID-19 in a middle-income country still present with high symptom burden, restrictive ventilatory changes, and loss of quality of life. Ongoing follow-up is needed to characterize long COVID-19 and identify strategies to mitigate its consequences. Objective symptoms COVID19 COVID 19 COVID-1 1 admission Methods crosssectional cross sectional study Horizonte Brazil sixminute six minute EQ5D3L EQDL EQ 5D 3L D L questionnaire Results 18 mean 596 59 6 59. 134 13 4 13. years n 96 50.8% 508 50 8 93 49.2%. 492 49.2% . 49 2 49.2%) followup, followup follow up, up 43 27 FVC FEV1 FEV However 14.9% 149 14 9 (14.9 vs 22.4% 224 22 0.020 0020 0 020 Conclusions year middleincome middle income burden changes consequences COVID1 COVID- 5 50.8 49.2 14.9 (14. 22.4 0.02 002 02 50. 49. 14. (14 22. 0.0 00 (1 0. (

Abstract Background: Trimethylamine N-oxide (TMAO), a gut microbiota metabolite, is associated with cardiovascular disease (CVD) development. TMAO can trigger an inflammatory response by inducing the nuclear factor-kappa B (NF-κB) signaling cascade and increasing the expression of pro-inflammatory cytokines, contributing to the worsening of CVD. This study aimed to evaluate the association between TMAO plasma levels and inflammation in patients with coronary artery disease (CAD). Methods: A cross-sectional study was carried out including 29 patients with CAD. Peripheral blood mononuclear cells (PBMC) were isolated from fasting blood samples, and NF-κB and vascular cell adhesion protein 1 (VCAM1) mRNA expression were estimated using real-time quantitative PCR. We determined TMAO plasma levels by LC-MS/MS and TNF-α by ELISA. Routine biochemical parameters were evaluated using an automatic biochemical analyzer. Correlations were estimated by Spearman or Pearson test. Statistical significance was set at the level of p < 0.05. Results: All patients presented TMAO levels within the normal range according to EUTox (normal range: 2.83 ± 1.53 mg/L; CAD patients: 0.2 [0.1 to 0.2] ng/μL). TMAO plasma levels were positively correlated with NF-κB mRNA expression (0.555; p = 0.002). Conclusion: TMAO plasma levels may be associated with NF-κB mRNA expression in patients with CAD and may contribute to the pathogenesis of this disease. Background Noxide N oxide TMAO, , (TMAO) metabolite CVD (CVD development factorkappa factor kappa NFκB NF κB (NF-κB proinflammatory pro cytokines . (CAD) Methods crosssectional cross sectional 2 PBMC (PBMC samples VCAM1 VCAM (VCAM1 realtime real time PCR LCMS/MS LCMSMS LC MS/MS MS TNFα TNF α ELISA analyzer test 005 0 05 0.05 Results 283 83 2.8 153 53 1.5 mg/L mgL mg L 02 0. 0.1 01 [0. ng/μL. ngμL ng/μL ng μL ng/μL) 0.555 0555 555 (0.555 0.002. 0002 0.002 002 0.002) Conclusion (TMAO (CAD (VCAM LCMS MSMS 00 0.0 28 8 2. 15 5 1. [0 0.55 055 55 (0.55 000 0.00 [ 0.5 (0.5 (0. (0 (