ABSTRACT The use of cold plasma is effective in overcoming seed dormancy. However, its effects, both in the long-term and during storage, is still not fully understood. The aim of this study, therefore, was to evaluate the immediate and post-storage effect of atmospheric plasma on the seeds of Pityrocarpa moniliformis in overcoming seed coat dormancy. The seeds were treated with plasma for 0, 1.0, 2.0, 3.0, 4.0 and 5.0 minutes. Following application, 50% of the seeds were stored for two years while the remainder were submitted to immediate analysis. The seeds were evaluated for germination and the germination speed index, in addition to seedling length and dry weight. The experimental design was completely randomised, and included regression analysis. The plasma treatment resulted in an increase in the germination rate and vigour of the seeds, both immediately after exposure and after two years of storage. In particular, the seeds treated for five minutes showed around 39% germination, which was outstanding compared to seeds from other exposure times. Plasma is effective in overcoming seed coat dormancy in seeds of P. moniliformis treated for five minutes and tested immediately. The effect of plasma on the seeds of P. moniliformis after storage was less for all the conditions under test. However effects longterm long term understood study therefore poststorage post 0 10 1 1.0 20 2 2.0 30 3 3.0 40 4 4. 50 5 5. application analysis index weight randomised particular 39 times P test 1. 2. 3.

The study of adsorption kinetics has been gaining ground, due to the fact that adsorption is an operation used in several areas, which drives the development of software for calculating kinetic parameters. In this context, the work aims to develop and validate a free software, with an intuitive interface and easy operation, for processing adsorption kinetic analysis data. The Adsorption Kinetics Calculation (AKC) software was developed in Java language, using Apache Netbeans IDE (integrated development environment) and has three kinetic equations implemented in a non-linear way: pseudo-first order, pseudo-second order and intraparticle diffusion implemented and also generates the parameters statistical coefficient of determination (R2) and ARE (average relative error). The software was successful in programming the algorithms, because the parameter values (Qe and C) were similar to the experimental values and the error values (R2 and ARE) were within those predicted by the literature. The software has the ability to plot the results and all results showed reliability in the data generated, and it can be concluded that it is validated and ready to be made available for users to use in their research. ground areas context AKC (AKC language integrated environment nonlinear non linear way pseudofirst pseudo first pseudosecond second R2 R average error. . error) algorithms Qe C (R literature generated research

Resumo Enquadramento: A literacia em saúde (LS) é a capacidade da pessoa obter e traduzir informações a fim de manter e melhorar a saúde. Objetivo: Caracterizar o nível de LS da pessoa internada num hospital oncológico; avaliar a fiabilidade do instrumento European Health Literacy Survey in Portuguese (HLS-EU-PT). Metodologia: Estudo transversal, quantitativo, descritivo e metodológico. Amostra de 188 pessoas internados num serviço de cirurgia oncológica entre maio e setembro de 2020, os dados foram colhidos através de formulário de caracterização sociodemográfica, de saúde e instrumento de avaliação da LS. Resultados: O HLS-EU-PT apresentou elevado nível de consistência interna. Todos os domínios e níveis de processamento do instrumento se correlacionam positivamente entre si. Os participantes apresentam em média um nível problemático de LS. Conclusão: Os resultados indiciam a necessidade de um maior investimento na capacitação da LS. São necessários mais estudos nesta e noutras populações e contextos de prestação de cuidados de saúde, de forma a direcionar a prática de cuidados na resposta eficaz aos problemas de saúde.

Abstract Background: Health literacy (HL) is the ability of an individual to obtain and translate information in order to maintain and improve their health. Objective: To characterize the level of HL of patients admitted to an oncology hospital and assess the reliability of the Portuguese version of the European Health Literacy Survey (HLS-EU-PT). Methodology: Cross-sectional, quantitative, descriptive, and methodological study. Sample of 188 patients admitted to a surgical oncology unit between May and September 2020. Data were collected through a sociodemographic and health characterization form and a HL assessment tool. Results: The HLS-EU-PT had a high level of internal consistency. All domains and information-processing levels correlated positively with each other. Participants had on average a problematic level of HL. Conclusion: The results indicate the need for greater investment in HL training. Further studies are needed in this population and in other populations and healthcare settings to provide an effective response to health problems.

Resumen Marco contextual: La alfabetización en salud (AS) es la capacidad de una persona para obtener y traducir información con el fin de mantener y mejorar su salud. Objetivo: Caracterizar el nivel de AS de las personas ingresadas en un hospital oncológico; evaluar la fiabilidad del instrumento European Health Literacy Survey in Portuguese (HLS-EU-PT). Metodología: Estudio transversal, cuantitativo, descriptivo y metodológico. Muestra de 188 personas ingresadas en un servicio de cirugía oncológica entre mayo y septiembre de 2020, se recogieron datos mediante un formulario de caracterización sociodemográfica y de salud, y una herramienta de evaluación de AS. Resultados: El HLS-EU-PT mostró un alto nivel de consistencia interna. Todos los dominios y niveles de procesamiento del instrumento correlacionaron positivamente entre sí. Por término medio, los participantes tienen un nivel problemático de AS. Conclusión: Los resultados indican la necesidad de una mayor inversión en formación en AS. Son necesarios más estudios en esta y otras poblaciones, y en entornos sanitarios para orientar la práctica asistencial hacia una respuesta eficaz a los problemas de salud.

Abstract School readiness (SR), the ability or preparedness of children to start schooling, depends on multiple factors, such as personal traits, sociocultural and familiar aspects, school context, education regulation and inclusion policies. Children who start schooling more prepared are most likely to achieve a higher academic level. Our objectives was to identify which preschool skills predict SR and to summarize general recommendations to consider when assessing SR. Research in data base PubMed, using the key words: ”preschool”, ”school readiness”, ”social functioning”, “motor skills”, ”mathematics”, ”language”, “comprehension of the world”, “attention”. Consultation of the following Education and Health guidance: “Orientações Curriculares para a Educação Pré-Escolar da DGE”, ”Norma Técnica da DGS para o PNSIJ”, ”Children’s social and emotional skills in preschool impact positively their academic skills. Visual perception, visual motor integration and motor coordination are essential to SR, namely to Reading, Writing and Mathematics. Global and fine motor skills cause longitudinal effects to Speech, Reading and Mathematics. Phonological awareness predict success in learning how to read. Numeral system acuity, mapping accuracy and the ability to control and keep attention at preschool are predictable of school success. Comprehension of the world is the strongest predictor for Reading and Science skills. It is important to assess SR on several occasions throughout children’s development, in a multidisciplinary approach. Prognosis is better when difficulties are detected at an early stage, thus allowing a directed intervention. The decision of delaying schooling must always consider biological, psychological and social variables, as well as school resources.

Resumo A aptidão para o início da escolaridade (AIE) depende de fatores pessoais, socioculturais, familiares, do meio escolar, da legislação em vigor e das políticas de inclusão. O objetivo foi identificar competências pré-escolares preditoras da AIE em consulta médica e sintetizar recomendações gerais a ter em conta. Foi efectuada uma pesquisa na base de dados PubMed com as palavras-chave: “preschool”, ”school readiness”, “social functioning”, ”motor skills”, ”mathematics”, “language”, ”comprehension of the world”, “attention”. Também foram consultadas as Orientações Curriculares para a Educação Pré-Escolar da DGE e da Norma Técnica da DGS para o PNSIJ. As competências socio-emocionais no pré-escolar têm um impacto positivo nas competências académicas. A perceção visual, a integração visuo-motora e a coordenação motora são fundamentais para AIE, da Leitura, Escrita e Matemática. A motricidade global demonstrou efeitos longitudinais ao nível da Linguagem, Leitura e Matemática. A consciência fonológica parece predizer o sucesso na Leitura. A acuidade do sistema numérico aproximado, a precisão de mapeamento e a capacidade de controlar e manter a atenção, têm um carácter preditivo de sucesso escolar. O conhecimento geral do mundo é o preditor mais forte para as competências futuras em Ciências e Leitura. A avaliação da AIE deve ser feita em várias ocasiões ao longo do desenvolvimento da criança, de forma multidisciplinar. Quanto mais precoce for a identificação de dificuldades e a intervenção dirigida, melhor o prognóstico. A decisão de optar pelo adiamento do início da escolaridade deve ter em consideração as variáveis biopsicossociais da criança e os recursos do meio escolar.

RESUMEN Introducción: Los brotes recurrentes de dengue subrayan la necesidad de abordajes más efectivos en la prevención y control de vectores. A menudo, las intervenciones se centran en un enfoque biomédico y de promoción de la salud desde un enfoque individual, sin integrar factores socioambientales ni ser evaluados científicamente Objetivo: Evaluar el impacto de la recolección de residuos domésticos de gran tamaño sobre potenciales criaderos de mosquitos transmisores del dengue en Asunción, Paraguay durante los años 2017 a 2021. Material y métodos: Estudio cuasiexperimental, longitudinal, donde se encuestaron 350 hogares, como línea de base durante el 2017 y una línea de cierre en 108 hogares en 2021. Se utilizó el método de Diferencia en Diferencia (DID) para comparar la presencia de criaderos antes y después de la intervención en 43 hogares intervenidos y 65 no intervenidos. Resultados: La recolección diferenciada fue utilizada principalmente por aquellos hogares que tenían una gran cantidad de residuos sólidos de gran tamaño, pero no para deshacerse de todos estos objetos, sino sólo de una parte (DID de -52% en el número total de criaderos y DID de 1% en número de hogares con criaderos). Encontramos una reducción significativa en el número de total de criaderos de gran tamaño, pero no observamos diferencias en el número total de hogares con criaderos. Factores subjetivos, como la creencia de que los objetos en desuso podrían llegar a ser útiles en el futuro explicaban en gran medida su presencia en los hogares, incluso con el servicio disponible. Conclusiones: El enfoque de la gestión municipal en los residuos voluminosos puede contribuir a la prevención del dengue por el hecho de que no constituyen residuos de generación rápida en los hogares, y su eliminación puede tener un impacto relativamente duradero. El factor subjetivo relacionado con la presencia de estos criaderos en los hogares debe ser objeto de mayores estudios.

ABSTRACT Introduction: Recurrent dengue outbreaks underscore the need for more effective approaches to vector prevention and control. Often, interventions focus on a biomedical and health promotion approach from an individual approach, without integrating socio-environmental factors or being scientifically evaluated. Objetive: To evaluate the impact of large household waste collection on potential breeding sites of dengue-transmitting mosquitoes in Asuncion, Paraguay during the years 2017 to 2021. Material and methods: Quasi-experimental, longitudinal study, where 350 households were surveyed, as a baseline during 2017 and a closing line in 108 households in 2021. The Difference-in-Difference (DID) method was used to compare the presence of breeding sites before and after the intervention in 43 intervened and 65 non-intervened households. Results: Differentiated collection was mainly used by those households that had a large amount of large solid waste, but not to dispose of all these objects, but only part of them (DID of -52% in the total number of breeding sites and DID of 1% in the number of households with breeding sites). We found a significant reduction in the total number of large breeding sites but did not observe differences in the total number of households with breeding sites. Subjective factors, such as the belief that disused objects could become useful in the future, were largely responsible for the reduction in the number of large breeding sites. Conclusions: The municipal management approach to bulky waste can contribute to dengue prevention because it does not constitute rapidly generated waste in households, and its disposal can have a relatively long-lasting impact. The subjective factors related to the presence of these breeding sites in households warrant further study.

Resumo O estudo analisa o acesso ao cuidado em saúde de mulheres encarceradas no estado do Ceará, rastreando transtornos mentais comuns. Estudo analítico, transversal, de natureza quantitativa, desenvolvido na única penitenciária feminina do Ceará. Participaram 90 detentas, todas com alguma das seguintes questões de saúde: gestantes, puérperas, portadoras de hipertensão arterial sistêmica, diabetes mellitus, tuberculose, sífilis, hepatite B ou HIV/Aids. Os dados foram coletados por entrevista estruturada. Evidenciou-se acesso limitado à atenção à saúde das detentas, violando direitos básicos sob tutela do Estado. Foram constatadas limitações de exames de rastreamento de doenças nas presidiárias na ocasião de seu acesso ao cárcere, principalmente as que não se encontravam grávidas no momento do encarceramento. Houve diferenças entre as distintas condições de saúde analisadas, com prioridade da atenção às gestantes e puérperas. Entre as detentas, 68,24% apresentavam risco de transtornos mentais comuns (SRQ > 7). Houve correlação positiva entre idade e saúde mental (p = 0,0002). Embora exista legislação pertinente de garantia de acesso à saúde no cárcere, o sistema prisional está despreparado para atender às necessidades de portadoras de comorbidades, gestantes e puérperas.

Abstract This study investigated access to health care among female prisoners in the state of Ceará, Brazil, and screened for common mental disorders. We conducted an analytical cross-sectional study in the only female prison in the state. Ninety detainees participated in the study. All participants were either pregnant or postpartum women or had one or more of the following health problems: hypertension, diabetes mellitus, tuberculosis, syphilis, hepatitis B, HIV/AIDS. The data were collected using a structured questionnaire. The findings reveal that access to health care was limited, violating the fundamental rights of the prisoners. Screening for diseases on admission to prison was limited, especially among non-pregnant women. Differences in health care were found between health conditions, with priority being given to pregnant and postpartum women. Most of the inmates (68.24%) were found to be at risk for common mental disorders (SRQ score > 7). A positive correlation was found between age and mental health problems (p = 0.0002). Despite legislation guaranteeing access to health care in prisons, the prison system is unprepared to meet the health needs of female prisoners with comorbidities and pregnant and puerperal women.

Abstract Introduction: Autoimmune hepatitis (AIH) has a spectrum of symptoms ranging from asymptomatic disease to acute severe hepatitis, chronic hepatitis, and decompensated cirrhosis. The acute presentation is not rare and could represent genuine acute AIH (GAAIH) or acute exacerbation of chronic autoimmune hepatitis. We aimed to identify the prevalence, clinical features, and prognostic factors associated with GAAIH and compare these cases with acute exacerbation of chronic AIH. Methods: This cross-sectional observational study evaluated patients with acute AIH presentation, defined as total bilirubin >5 times the upper limit of normality (xULN) and/or alanine aminotransferase >10 xULN, and no prior history of liver disease. Histology findings of acute disease defined GAAIH. Bivariate analyses were performed to identify factors associated with the GAAIH, when compared with acute exacerbation of chronic AIH. Results: Seventy-two patients with acute presentation of AIH were included and six (8.3%) of them presented GAAIH. Comparative analysis between patients with GAAIH and patients with acute exacerbation of chronic AIH revealed that prothrombin activity (96% [74-100] vs. 61% [10-100]; p = 0.003) and albumin levels (3.9 ± 0.2 g/dL vs. 3.4 ± 0.5 g/dL; p < 0.001) were higher in patients with GAAIH. The International Autoimmune Hepatitis Group score was higher in patients with acute exacerbation of chronic AIH (18.5 [8-23] vs. 16.5 [15-17]; p = 0.010). Compared to 15.2% of acute exacerbation of chronic AIH, complete therapeutic response to treatment was achieved in 67.7% of cases with GAAIH (p = 0.018). Conclusions: GAAIH was rare (8.3%), and patients with this presentation exhibited more preserved liver function tests, suggesting that most cases presenting with loss of function are acute exacerbation of chronic AIH. Additionally, patients with GAAIH had a better complete therapeutic response, suggesting a more preserved liver function at presentation, and early diagnosis has a positive therapeutic implication.

Resumo Introdução: A hepatite autoimune (HAI) apresenta um espectro de sintomas que varia de doença assintomática a hepatite aguda grave, hepatite crónica e cirrose descompensada. A apresentação aguda não é rara e pode representar hepatite autoimune aguda genuína (HAIAG) ou exacerbação aguda de hepatite autoimune crónica (EAHAIC). O nosso objetivo foi identificar a prevalência, caraterísticas clínicas e fatores prognósticos associados à HAIAG, e comparar esses casos com EAHAIC. Métodos: Estudo observacional, transversal, incluindo doentes com apresentação aguda de HAI, definida como bilirrubina total > 5 vezes o limite superior da normalidade (xLSN) e/ou ALT > 10 xLSN, e sem história prévia de doença hepática. HAIAG foi definida pela presença de achados histológicos de doença aguda. Análises bivariadas foram realizadas para identificar fatores associados à HAIAG, quando comparado com o EAHAIC. Resultados: Foram incluídos setenta e dois doentes com apresentação agu-da de HAI, dos quais seis (8.3%) com HAIAG. A análise comparativa entre doentes com HAIAG e doentes com EAHAIC mostrou que a atividade de protrombina (96%(74-100) versus 61% (10-100; p=0.003) e os níveis de albumina (3,9 ± 0,2 g/dL vs. 3,4 ± 0,5 g/dL; p < 0,001) foram significativamente mais elevados em pacientes com HAIAG. O score do Grupo Internacional de Hepatite Autoimune foi mais elevado em doentes com EAHAIC (18.5 (8-23) versus 16.5 (15-17); p=0.010). A resposta terapêutica completa ao tratamento foi alcançada em 66.7% dos casos de HAIAG (vs. 15,2% na EAHAIC, p=0,018). Conclusões: A HAIAG é rara (8.3%), e os doentes com esta apresentação mostraram testes de função hepática mais preservados, sugerindo que a maioria dos casos com perda de função são EAHAIC. Além disso, os doentes com HAIAG tiveram maior taxa de resposta terapêutica completa, sugerindo que uma função hepática mais preservada na apresentação e o diagnóstico precoce tem uma implicação terapêutica positiva.

Abstract Medical communication skills are treated as innate abilities, without the need for training and evaluation. However, they play a very important role in the doctor-patient relationship. Communication deficits are a cause of dissatisfaction and litigation. Quality communication is associated with greater adherence to proposed procedures and increases patient satisfaction and safety. Effective communication is particularly important in Gynecology-Obstetrics and justifies specific training. Formal teaching of communication skills should be included at all levels of medical education, just like technical-scientific skills.

Resumo As capacidades comunicacionais dos médicos são tratadas como habilidades inatas, sem a necessidade de treino e avaliação. Desempenham, no entanto, um papel da maior importância na relação médico-doente. Os déficits de comunicação são causa de descontentamento e motivo de litigância. A comunicação de qualidade está associada a maior adesão aos procedimentos propostos, aumenta a satisfação e segurança do doente. A comunicação eficaz assume particular acutilância em Ginecologia-Obstetrícia e justifica que seja objeto de treino específico. O ensino formal da competência em comunicação deve ser incluído em todos os níveis da educação médica, à semelhança das competências técnico-científicas.

Resumo O estudo analisa o acesso ao cuidado em saúde de mulheres encarceradas no estado do Ceará, rastreando transtornos mentais comuns. Estudo analítico, transversal, de natureza quantitativa, desenvolvido na única penitenciária feminina do Ceará. Participaram 90 detentas, todas com alguma das seguintes questões de saúde: gestantes, puérperas, portadoras de hipertensão arterial sistêmica, diabetes mellitus, tuberculose, sífilis, hepatite B ou HIV/Aids. Os dados foram coletados por entrevista estruturada. Evidenciou-se acesso limitado à atenção à saúde das detentas, violando direitos básicos sob tutela do Estado. Foram constatadas limitações de exames de rastreamento de doenças nas presidiárias na ocasião de seu acesso ao cárcere, principalmente as que não se encontravam grávidas no momento do encarceramento. Houve diferenças entre as distintas condições de saúde analisadas, com prioridade da atenção às gestantes e puérperas. Entre as detentas, 68,24% apresentavam risco de transtornos mentais comuns (SRQ > 7). Houve correlação positiva entre idade e saúde mental (p = 0,0002). Embora exista legislação pertinente de garantia de acesso à saúde no cárcere, o sistema prisional está despreparado para atender às necessidades de portadoras de comorbidades, gestantes e puérperas. Ceará analítico transversal quantitativa 9 detentas puérperas sistêmica mellitus tuberculose sífilis HIVAids HIV Aids HIV/Aids estruturada Evidenciouse Evidenciou Estado cárcere encarceramento analisadas 6824 68 24 68,24 SRQ 7. 7 . 7) p 0,0002. 00002 0,0002 0 0002 0,0002) comorbidades 682 6 2 68,2 0000 0,000 000 68, 0,00 00 0,0 0,

Abstract This study investigated access to health care among female prisoners in the state of Ceará, Brazil, and screened for common mental disorders. We conducted an analytical cross-sectional study in the only female prison in the state. Ninety detainees participated in the study. All participants were either pregnant or postpartum women or had one or more of the following health problems: hypertension, diabetes mellitus, tuberculosis, syphilis, hepatitis B, HIV/AIDS. The data were collected using a structured questionnaire. The findings reveal that access to health care was limited, violating the fundamental rights of the prisoners. Screening for diseases on admission to prison was limited, especially among non-pregnant women. Differences in health care were found between health conditions, with priority being given to pregnant and postpartum women. Most of the inmates (68.24%) were found to be at risk for common mental disorders (SRQ score > 7). A positive correlation was found between age and mental health problems (p = 0.0002). Despite legislation guaranteeing access to health care in prisons, the prison system is unprepared to meet the health needs of female prisoners with comorbidities and pregnant and puerperal women. Ceará Brazil crosssectional cross sectional hypertension mellitus tuberculosis syphilis B HIVAIDS HIV AIDS HIV/AIDS questionnaire limited nonpregnant non conditions 68.24% 6824 68 24 (68.24% SRQ 7. 7 . 7) p 0.0002. 00002 0.0002 0 0002 0.0002) prisons 68.24 682 6 2 (68.24 0000 0.000 000 68.2 (68.2 0.00 00 68. (68. 0.0 (68 0. (6 (

ABSTRACT Pressure ulcers (PUs) are related to a prolonged process of disability, an indicator of frailty, functional decline and dependence, and malnutrition is a major factor in their development. The aim of this study was to correlate the risk of developing PUs with the nutritional status and frailty of elderly people institutionalized in Residential Facilities for the Elderly. A cross-sectional, quantitative and descriptive study was carried out. A questionnaire was used which included questions for sociodemographic characterization, the Braden scale, the Mini Nutritional Assessment and the Groningen Frailty Index. The participants were 134 institutionalized elderly people, 64.2% female, with an average age of 85.0 years (SD= 7.9), 70.1% widowed and 58.2% had not completed primary school. The results show that 35.8 per cent of the elderly were at high risk of developing UPP, 57.4 per cent were malnourished or at risk of malnutrition and 82.1 per cent were frail. Assessing the risk of PUs, frailty and malnutrition in institutionalized elderly people makes it possible to institute preventive measures with the aim of improving their quality of life. The prevention of pressure ulcers is an indicator of the quality of nursing care that requires evaluation and updating for clinical practice based on innovation and the best evidence.

RESUMO As Úlceras Por Pressão (UPP) estão relacionadas com o processo prolongado de incapacidade, indicador de fragilidade, declínio funcional e dependência, constituindo a desnutrição fator preponderante para a sua evolução. O objetivo do presente estudo foi relacionar o risco de desenvolvimento de UPP com o estado nutricional e a fragilidade de idosos institucionalizados em Estruturas Residenciais para Pessoas Idosas. Realizou-se um estudo transversal, quantitativo e descritivo. Aplicou-se um questionário que integrava questões para caracterização sociodemográfica, a escala de Braden, o Mini Nutricion Assessment e o Índice de Fragilidade de Groningen. Participaram 134 idosos institucionalizados, 64,2% do sexo feminino, com média de idades de 85,0 anos (DP= 7,9), 70,1% viúvos e 58,2% não concluíram o 1º ciclo de escolaridade. Os resultados mostram que 35,8% dos idosos apresentam alto risco de desenvolvimento de UPP, 57,4% encontram-se desnutridos ou em risco de desnutrição e 82,1% apresentam fragilidade. A avaliação do risco de UPP, da fragilidade e da desnutrição nos idosos institucionalizados permite instituir medidas preventivas com objetivo de melhorar a sua qualidade de vida. A prevenção de Úlceras Por Pressão constitui um indicador de qualidade dos cuidados de enfermagem que requer avaliação e atualização para uma prática clínica fundamentada na inovação e melhor evidência.

ABSTRACT Health care must respond to individual and family needs, making existing health resources available to meet citizens’ needs. People in a situation of dependence require care from family members who require specific training to perform the role of caregiver. The objective of the study was to analyze how health literacy influences the relationship between satisfaction with social support and informal caregiver burden. A cross-sectional, quantitative and descriptive-correlational study was carried out. Data collection was carried out through a questionnaire. 51 informal caregivers participated, 78.4% were women, 29.4% had a medium/low level of education, 52.9% had assumed the role of informal caregiver for five or more years. It was found that 80.4% of informal caregivers had a high level of overload, with a greater impact on those who had been providing care for around 1-2 years. Regarding the necessary help, 76.5% of informal caregivers mentioned social support for economic support and 49% support for caring for a family member. The need for nurses to implement interventions to improve caregivers’ knowledge, promote health literacy, social support and dynamics that allow informal caregivers to share experiences and achieve a healthy transition process was highlighted.

RESUMO Os cuidados de saúde devem dar resposta às necessidades individuais e familiares, disponibilizando os recursos de saúde existentes para suprir as carências dos cidadãos. As pessoas em situação de dependência requerem cuidados dos familiares, Cuidadores Informais, que necessitam de formação específica para o desempenho do papel de cuidador. O objetivo do estudo foi analisar de que forma a literacia em saúde influência a relação entre a satisfação com o suporte social e a sobrecarga do Cuidador Informal. Realizou-se um estudo transversal, quantitativo e descritivo-correlacional. A recolha de dados foi efetuada através de um questionário. Participaram 51 Cuidadores Informais, 78,4% eram mulheres, 29,4% apresentava nível médio/baixo de escolaridade, 52,9% assumiu o papel de Cuidador Informal há cinco ou mais anos. Verificou-se que 80,4% dos Cuidadores Informais apresentavam nível de sobrecarga elevado, com maior impacto nos que prestavam cuidados há cerca de 1-2 anos. Quanto às ajudas necessárias, 76,5% dos Cuidadores Informais referiram o suporte para apoio económico e 49% suporte para cuidar do familiar. Evidenciou-se necessidade de o enfermeiro implementar intervenções para melhorar os conhecimentos dos cuidadores, promover a literacia em saúde, o suporte social e dinâmicas que permitam ao Cuidador Informal partilhar experiências e alcançar um processo de transição saudável.

Abstract To date, hydroxyurea is the only effective and safe drug that significantly reduces morbidity and mortality of individuals with Sickle cell disease. Twenty years of real-life experience has demonstrated that hydroxyurea reduces pain attacks, vaso-occlusive events, including acute chest syndrome, the number and duration of hospitalizations and the need for transfusion. The therapeutic success of hydroxyurea is directly linked to access to the drug, the dose used and adherence to treatment which, in part, is correlated to the availability of hydroxyurea. This consensus aims to reduce the number of mandatory exams needed to access the drug, prioritizing the requesting physician's report, without affecting patient safety. date disease reallife real life attacks vasoocclusive vaso occlusive events syndrome transfusion which part physicians physician s report safety

Abstract Within households, bulky solid waste serves as the predominant breeding ground for mosquitoes that transmit dengue fever. The aim of this study is to identify and describe the relationship between material and subjective factors, using socioecological theoretical frameworks for health prevention. A descriptive cross-sectional study is conducted, using a simple random sample of 350 households in Asunción, Paraguay. To compare households based on the presence or absence of large breeding sites, the chi-square test, non-parametric Mann-Whitney-Wilcoxon statistical test, and Yuen's robust T statistical test is employed. Additionally, a multivariate logistic regression analysis was carried out to determinate the Odd Ratio (OR). The study concludes that individualistic approaches in dengue prevention must be transcended and management capacities in homes must be increased by addressing environmental barriers and social beliefs, given the factor that most significantly explaines the presence of obsolete objects in homes is the belief that these items could prove useful in the future. In the multivariate analysis, the perception of usefulness of the potential breeding sites was one of the two significant variables that explain this behavior. The other significant variable was the low coverage of waste collection.

Resumen Dentro de los hogares, los residuos sólidos voluminosos constituyen el tipo de criadero más frecuente del mosquito transmisor del dengue. El objetivo de este estudio es identificar y describir la relación entre factores materiales y subjetivos, a través de un marco teórico socioecológico de prevención de la salud. Se realiza un estudio transversal descriptivo, mediante una muestra aleatoria simple de 350 hogares en Asunción, Paraguay. Para comparar los hogares, según la presencia o no de criaderos de gran tamaño, se usa la prueba de chi cuadrado, en el caso de variables categóricas, el test estadístico no paramétrico Mann-Whitney-Wilcoxon, el test estadístico robusto T de Yuen y un análisis multivariado de regresión logística, para el cálculo del Odd Ratio (OR). El estudio concluye que se deben trascender los enfoques individualistas en la prevención del dengue y aumentar las capacidades de gestión en los hogares. Abordalas barreras del entorno y las creencias sociales, dado que el factor que explica con mayor fuerza estadística la existencia de objetos en desuso dentro de los hogares es la creencia de considerarlos de utilidad en el futuro. En el análisis multivariado, la percepción de utilidad del potencial criadero fue la variable que más explicaba la conducta. La otra variable significativa fue la baja cobertura de recolección de residuos.

Abstract Background: Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors. Objective: The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis. Methods: The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and inter-leukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model. Results: The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01–1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29–3.08; p = 0.002) were associated with treatment interruption. Study limitations: The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation. Conclusions: Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response. Background Realworld, Realworld Real world, world Real-world scarce Objective Th1Th17 ThTh Th1 Th17 Th Th1/Th1 Methods years interferonα, interferonα interferon α, α interferon-α factorα, factorα factor factor-α interleukin inter leukin IL2, IL2 IL 2, 2 (IL)-2 IL4, IL4 4, 4 IL-4 IL6, IL6 6, IL10, IL10 10, 10 IL-10 IL17A ILA 17A A array assessed HRs (HRs model Results 26 biologics HR 1.04 104 1 04 95 1.01–1.07 101107 01 07 0.012 0012 0 012 IL- 1.99 199 99 1.29–3.08 129308 29 3 08 0.002 0002 002 limitations evaluation Conclusions environment response Th1Th1 Th1/Th (IL)- IL1 IL-1 1.0 9 1.01–1.0 10110 0.01 001 1.9 19 1.29–3.0 12930 0.00 000 00 Th1Th (IL) 1. 1.01–1. 1011 0.0 1.29–3. 1293 (IL 1.01–1 101 0. 1.29–3 129 1.01– 1.29– 12 1.01 1.29 1.2

Resumo Objetivou-se realizar uma análise espacial da taxa de mortalidade hospitalar (TMH) por síndrome respiratória aguda grave (SRAG) atribuída à COVID-19 em crianças e adolescentes no Brasil no período de 2020 a 2021. Utilizou-se o método de cluster para agrupar as unidades federativas (UFs) com base na TMH. Em 2020, clusters com altas TMHs foram formados por UFs Norte/Nordeste. Em 2021, houve redução na TMH. Os clusters com maiores taxas permaneceram na região N/NE. Diferenças regionais foram observadas nas TMHs. Os achados podem refletir as desigualdades sociais e o acesso à atenção hospitalar, principalmente na faixa etária de menores de 1 ano pela gravidade da doença neste grupo.

Abstract The objective was to perform a spatial analysis of the hospital mortality rate (HMR) due to severe acute respiratory syndrome (SARS) attributed to COVID-19 among children and adolescents in Brazil from 2020 to 2021. A cluster method was used to group federal units (FUs) based on HMR. In 2020, clusters with high HMRs were formed by north/northeast FUs. In 2021, there was a reduction in HMR. Clusters with higher rates remained in the N/NE region. Regional differences were observed in the HMR. The findings may reflect social inequalities and access to hospital care, especially in the under 1-year-old age group due to the severity of the disease in this group.