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 Introdução O Agente Comunitário de Saúde (ACS), assim como o fisioterapeuta, desencadeia funções fundamentais na Atenção Primária à Saúde (APS), sendo ele-mento importante na transformação de políticas públicas. Inexistem estudos que investiguem o conhecimento dos ACS sobre as condições de saúde sensíveis à inter-venção da fisioterapia na APS. Objetivo Construir um questionário de investigação da percepção dos ACS sobre as condições de saúde sensíveis à intervenção da fisioterapia na APS. Métodos Trata-se de um estudo metodológico no qual, inicialmente, construiu-se uma matriz de análise com o intuito de englobar as ideias contempladas no questionário. Para a construção do instrumento, realizou-se uma revisão da literatura, sendo eleitas condições de saúde sensíveis à intervenção da fisioterapia na APS. Para a validação de conteúdo e aparente dos itens, 12 fisioterapeutas especialistas em APS julgaram a adequação dos itens contidos. Utilizou-se o índice de validade de conteúdo para verificar o grau de concordância durante o processo de análise das respos-tas. Posteriormente, realizou-se análise semântica por meio da compreensão dos itens por 15 ACS. Na etapa de validação, foram realizadas duas rodadas de avaliação. Foram feitos ajustes em 17 questões. Resultados O estudo resultou em um questionário com 20 questões contendo situações hipotéticas de visitas domiciliares, cuja situação do morador poderia ou não configurar um risco à saúde sensível à intervenção fisioterapêutica. Conclusão O instrumento de percepção dos ACS sobre as condições de saúde sensíveis à intervenção da fisioterapia na APS mostrou-se válido para ser utilizado no contexto da APS. A utilização do instrumento poderá contribuir na elaboração de programas de capacitação dos ACS, com o intuito de facilitar a comunicação da equipe. , (ACS) fisioterapeuta APS, (APS) elemento ele mento públicas inter venção Tratase Trata se qual inicialmente construiuse construiu realizouse realizou literatura 1 contidos Utilizouse Utilizou respostas. respostas respos tas. tas respos-tas Posteriormente avaliação 2 domiciliares fisioterapêutica mostrouse mostrou equipe (ACS (APS

Abstract Introduction Community health workers, like the physiotherapist, perform essential functions in primary health care, being an important element in the transformation of public policies. There are no reported studies investigating the knowledge of community health workers about health conditions amenable to physiotherapy intervention in primary health care. Objective To construct a questionnaire to investigate the perception of community health workers about health conditions that could be remedied by physiotherapy intervention in primary health care. Methods This was a methodological study in which it was initially an analysis matrix with the aim of encompassing the ideas contemplated in the questionnaire. To construct the instrument, a literature review was carried out, and health conditions treatable with physiotherapy in primary health care were chosen. To validate the content and appearance of the items, twelve physiotherapists specialized in primary health care judged the suitability of the items contained. The content validity index was used to determine the degree of agreement during the response analysis process. Subsequently, a semantic analysis was carried out through the understanding of the items by 15 community health workers. In the validation stage, two rounds of evaluation were carried out. Adjustments were made to 17 questions. Results The study investigated a questionnaire with 20 questions containing hypothetical situations of home visits, in which the resident's situation could or could not constitute a health risk amenable to physiotherapeutic intervention. Conclusion The community health workers perception instrument on health conditions amenable to physiotherapy intervention in primary health care proved to be valid for use in this context. The use of the instrument may contribute to the development of community health worker training programs, with the aim of facilitating team communication. physiotherapist policies chosen contained process Subsequently 1 stage 2 visits residents resident s context programs communication

Abstract Sjogren’s disease (SjD) is an autoimmune disease that is characterized not only by the sicca symptoms it causes but also by its systemic nature, which is capable of several and not yet fully understood extraglandular manifestations. To gain a clearer understanding of these manifestations as well as a better practical approach, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of the extraglandular manifestations present in ESSDAI (EULAR Sjogren´s syndrome disease activity index), followed by a voting panel with recommendations for clinical practice. This publication is complementary to others already published and covers cutaneous and hematological manifestations, with prevalence data generated by a meta-analysis of 13 clinical or laboratory manifestations and 6 clinical management recommendations. Sjogrens Sjogren s SjD (SjD nature approach metaanalysis meta analysis EULAR index, index , index) practice 1

ABSTRACT Introduction: Cardiac surgery is a frequent surgical procedure and may present a high risk of complications. Among the prophylactic strategies studied to decrease the rates of negative outcomes, respiratory care seems to reduce pulmonary complications. Incentive spirometry (IS) is a low-cost, respiratory exercise technique, used for the prevention and treatment of postoperative pulmonary complications (PPC). The aim of this review was to evaluate whether IS is superior to respiratory care, mobilization exercises, and noninvasive ventilation on PPC, and clinical outcomes. Methods: Systematic review. Medical Literature Analysis and Retrieval System Online (or MEDLINE®), Embase®, Cochrane Central Register of Controlled Trials (or CENTRAL), Physiotherapy Evidence Database (or PEDro), Cumulative Index of Nursing and Allied Health (or CINAHL®), Latin American and Caribbean Health Sciences Literature (or LILACS), Scientific Electronic Library Online (or SciELO), Allied, Scopus®, and OpenGrey databases, clinical trial registration sites, conferences, congresses, and symposiums were searched. Results: Twenty-one randomized trials and one quasi-randomized trial (1,677 participants) were included. For partial pressure of oxygen (PaO2), IS was inferior to respiratory care (mean difference [MD] -4.48; 95% confidence interval [CI] -8.32 to -0.63). Flow-oriented IS was inferior to respiratory care on PaO2 (MD -4.53; 95% CI -8.88 to -0.18). However, compared to respiratory care, flow-oriented IS was superior on recovery vital capacity. Conclusions: This meta-analysis revealed that IS was not superior to standard respiratory care for PPCs and clinical outcomes, therefore its use should not be widely recommended until further studies with high quality be performed to ensure this clinical guidance. Introduction outcomes (IS lowcost, lowcost low cost, cost low-cost technique PPC. PPC . (PPC) exercises Methods or MEDLINE®, MEDLINE MEDLINE® , MEDLINE®) Embase Embase® CENTRAL, CENTRAL CENTRAL) PEDro, PEDro PEDro) CINAHL®, CINAHL CINAHL® CINAHL®) LILACS, LILACS LILACS) SciELO, SciELO SciELO) Scopus Scopus® databases sites conferences congresses searched Results Twentyone Twenty quasirandomized quasi 1,677 1677 1 677 (1,67 participants included PaO2, PaO (PaO2) mean MD [MD 4.48 448 4 48 -4.48 95 [CI 8.32 832 8 32 -8.3 0.63. 063 0.63 0 63 -0.63) Floworiented Flow oriented 4.53 453 53 -4.53 8.88 888 88 -8.8 0.18. 018 0.18 18 -0.18) However floworiented flow capacity Conclusions metaanalysis meta analysis guidance (PPC 1,67 167 67 (1,6 (PaO2 4.4 44 -4.4 9 8.3 83 3 -8. 06 0.6 6 -0.63 4.5 45 5 -4.5 8.8 01 0.1 -0.18 1,6 16 (1, (PaO 4. -4. 8. -8 0. -0.6 -0.1 1, (1 -4 - -0. ( -0

Resumo Introdução: A Atenção Primária à Saúde (APS) representa o primeiro elemento de uma rede de processos de atenção à saúde que tem na Estratégia Saúde da Família o alicerce para a sua reorganização, expansão e consolidação. Objetivo: Investigar a efetividade do apoio matricial (AM) realizado pelos fisioterapeutas para os agentes comunitários de saúde (ACS) em relação ao nível de conhecimento sobre condições de saúde sensíveis à atuação da fisioterapia na APS. Métodos: Trata-se de um estudo quase-experimental realizado com dois grupos de ACS, divididos em controle (n = 6) e intervenção (n = 7), totalizando 13 profissionais pertencentes a um município de pequeno porte. O AM aconteceu por meio de oficinas educativas, abordando os temas maternoinfantil, adulto, idoso e desordens musculoesqueléticas. Para a avaliação inicial foram aplicados um questionário semiaberto com dados sociodemográficos e questões relacionadas ao trabalho, um questionário estruturado contendo questões relacionadas à atuação da fisioterapia na APS, que apresentava situações da rotina de trabalho do ACS, e um inquérito semiaberto de investigação de pacientes a serem encaminhados para a fisioterapia. Para a avaliação final, os mesmos instrumentos foram reaplicados, exceto o questionário sociodemográfico. Resultados: Após o AM, na comparação entre os grupos, houve diferença estatística no índice de percepção de risco no eixo das desordens musculoesqueléticas (p = 0,032) e na identificação de casos de alterações infantis (p = 0,012). Na comparação intragrupo, o grupo intervenção apresentou diferença estatística na percepção de risco na saúde do idoso e na maioria dos itens do inquérito de encaminhamentos (p < 0,05 para todos). Conclusão: O AM pode contribuir para a construção compartilhada de saberes, bem como para o acionamento da fisioterapia na APS pelos ACS. Introdução (APS reorganização consolidação Objetivo (AM ACS (ACS Métodos Tratase Trata se quaseexperimental quase experimental n 6 7, 7 , 7) 1 porte educativas maternoinfantil adulto final reaplicados sociodemográfico Resultados p 0,032 0032 0 032 0,012. 0012 0,012 . 012 0,012) intragrupo 005 05 0,0 todos. todos todos) Conclusão saberes 0,03 003 03 001 0,01 01 00 0,

Abstract Introduction: Primary health care (PHC) represents the first step of a network of health care processes that have the Family Health Strategy as their foundation for reorganization, expansion and consolidation. Objective: To investigate the effectiveness of the matrix support provided by the physical therapist to the community health agents (CHAs) regarding the level of knowledge about health conditions responsive to the performance of physiotherapy in PHC. Methods: We conducted a quasi-experimental study with two groups of CHAs, divided into control (n = 6) and intervention (n = 7), totaling 13 professionals belonging to a small municipality. Matrix support took place through educational workshops, addressing the axes of maternal and child health, adult health, health of older people and musculoskeletal disorders. For the initial assessment, a semi-open questionnaire was administered with sociodemographic data and work-related questions, a structured questionnaire containing questions related to the performance of physiotherapy in PHC that presents situations from the CHA's work routine, and a semi-open survey investigating patients to be referred to physiotherapy. For the final assessment, the same instruments were reapplied, except for the sociodemographic questionnaire. Results: After the intervention, in the comparison between groups, there was a difference in the risk perception index in the axis of musculoskeletal disorders (p = 0.032) and in the identification of cases of childhood changes (p = 0.012). In the intragroup comparison, the intervention group showed a difference in risk perception in the health of the older persons and in most of the items of the referral survey (p < 0.05 for all). Conclusion: Matrix support can contribute to the shared construction of knowledge, as well as to the activation of physiotherapy in PHC by CHAs. Introduction (PHC reorganization consolidation Objective CHAs (CHAs Methods quasiexperimental quasi experimental n 6 7, 7 , 7) 1 municipality workshops assessment semiopen semi open workrelated CHA s routine reapplied Results p 0.032 0032 0 032 0.012. 0012 0.012 . 012 0.012) 005 05 0.0 all. all all) Conclusion 0.03 003 03 001 0.01 01 00 0.

Abstract Introduction The COVID-19 pandemic has disproportionately affected individuals residing in Long-Term Care Facilities (LTCFs), necessitating tailored strategies to manage outbreaks. This study examines the outcomes of the ILPI BH project, a collaborative effort between the Municipal Health Department and the Hospital das Clínicas of the Federal University of Minas Gerais, designed to mitigate COVID-19 spread within LTCFs. Methods Prospective cohort of secondary data: 1,794 old residents in 99 long-term care facilities of Belo Horizonte, Brazil, were followed from May 2020 to January 2021. The study analyzed the prevention strategies, residents’ clinical data, and the characteristics of the long-term care facilities, correlating these variables with the number of infections, hospitalizations, and deaths from COVID-19. It checked absolute numbers and rates of incidence, hospitalization, mortality, and lethality. Results There have been 58 COVID-19 outbreaks in long-term care facilities. There were 399 cases among residents, 96 hospitalizations for COVID-19 and 48 deaths from COVID-19 (2.7 % of the cohort), with a case fatality rate of 12 %. After multivariate analysis, the intrinsic variables to residents associated with higher mortality risk were higher degree of frailty (OR=1.08; p = 0.004) and the fact of living in a long-term care facility with a considerable proportion of residents’ coverage by health plans (OR = 1.01; p = 0.028). Early geriatric follow-up showed an association with a reduction in the number of hospitalizations due to COVID-19. Conclusion The correct classification of the degree of frailty of institutionalized older people seems to have been relevant for predicting mortality from COVID-19. The extensive assistance by private health plans, contrary to what is supposed, did not result in better health protection. Early geriatric follow-up was beneficial and may be an attractive strategy in the face of health emergencies that affect long-term care facilities to reduce hospital admissions. COVID19 COVID 19 COVID-1 LongTerm Long Term LTCFs, LTCFs , (LTCFs) project Gerais data 1794 1 794 1,79 9 longterm long term Horizonte Brazil 202 2021 infections COVID19. 19. incidence hospitalization lethality 5 39 4 2.7 27 2 7 (2. cohort, cohort) analysis OR=1.08 OR108 OR 08 (OR=1.08 0.004 0004 0 004 1.01 101 01 0.028. 0028 0.028 . 028 0.028) followup follow up supposed protection admissions COVID1 COVID- (LTCFs 179 79 1,7 20 3 2. (2 OR=1.0 OR10 (OR=1.0 0.00 000 00 1.0 10 002 0.02 02 17 1, ( OR=1. OR1 (OR=1. 0.0 1. OR=1 (OR=1 0. OR= (OR=

BACKGROUND The immunological response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and immunisation is variable. OBJECTIVES To describe the humoral immune response by correlating IgA and IgG antibodies with NAbs titration following CoronaVac® immunisation and an mRNA (Comirnaty®) booster among healthcare workers (HCWs) and to compare the cytokine and interleukin profiles between HCWs vaccinated with CoronaVac and coronavirus disease 2019 (COVID-19) infected patients. METHODS Samples from 133 HCWs collected at 20 (T1) and 90 (T2) days after CoronaVac immunisation and 15 (T3) days after a booster dose with the Comirnaty vaccine were analysed for IgA and IgG EIA and neutralisation assay. Cytokine levels from vaccinated individuals at T1 day and COVID-19 patients were compared. FINDINGS Neutralising antibodies (NAbs) were observed in 81.7% of participants at T1, but only 49.2% maintained detectable NAbs after 90 days. The booster dose increased NAbs response in all participants. The cytokines with the highest levels post-vaccination were IL-6 and MCP-1. The MCP-1, IL-18, and IFN- γ levels were higher in COVID-19 patients than in vaccinated HCWs, while IL-22 levels increased in the vaccinated HCWs group. MAIN CONCLUSIONS The neutralisation titres in the T2 samples decreased, and antibody levels detected at T2 showed a more significant reduction than the neutralisation. The higher IL-22 expression in immunised individuals compared to those with COVID-19 suggests that IL-22 may be beneficial in protecting against severe disease. SARSCoV2 SARSCoV SARS CoV (SARS-CoV-2 variable Comirnaty® (Comirnaty® (HCWs 201 COVID19 COVID 19 (COVID-19 13 T (T1 9 (T2 1 T3 (T3 assay COVID-1 (NAbs 817 81 7 81.7 492 49 49.2 postvaccination post vaccination IL6 IL 6 IL- MCP1. MCP1 MCP 1. MCP-1 MCP1, 1, IL18, IL18 18, 18 IL-18 IFN IL22 22 IL-2 group decreased (SARS-CoV- (Comirnaty COVID1 (COVID-1 (T COVID- 8 81. 4 49. MCP- IL1 IL-1 IL2 (SARS-CoV (COVID- (COVID

RESUMO Objetivo: avaliar o conhecimento sobre transtornos de aprendizagem entre professores da educação básica e estudantes de estágio docente em escolas públicas e privadas brasileiras. Métodos: dois questionários foram administrados a professores de diversas instituições educacionais brasileiras, selecionados por amostragem aleatória. O primeiro questionário coletou dados sociodemográficos, enquanto o segundo avaliou o conhecimento sobre transtornos de aprendizagem. Para a investigação dos fatores associados ao conhecimento dos transtornos de aprendizagem, utilizou-se o Teste Qui-quadrado com nível de significância de 5%. Resultados: dos 158 professores inscritos, 51 responderam ao questionário e concluíram as etapas da pesquisa. A maioria era do sexo feminino (90,2%) com tempo médio de profissão de 13,6 anos. Das 1020 respostas obtidas no questionário sobre os transtornos da aprendizagem, 757 (74%) foram adequadas e 263 (26%) incorretas. Observou-se relação estatisticamente significante entre o maior conhecimento dos transtornos de aprendizagem e a realização anterior de palestras/cursos sobre o tema (p = 0,02). Conclusão: o treinamento de professores aumenta significativamente o conhecimento sobre transtornos de aprendizagem, sugerindo a necessidade de mais programas de desenvolvimento profissional focados nesse tema. Compreender o conhecimento dos professores sobre transtornos de aprendizagem é crucial para desenvolver intervenções educacionais eficazes e apoiar estudantes com dificuldades de aprendizagem. Objetivo brasileiras Métodos aleatória sociodemográficos utilizouse utilizou se Quiquadrado Qui quadrado 5 5% Resultados 15 inscritos pesquisa 90,2% 902 90 2 (90,2% 136 13 6 13, anos 102 75 74% 74 (74% 26 26% (26% incorretas Observouse Observou palestrascursos palestras cursos p 0,02. 002 0,02 . 0 02 0,02) Conclusão 1 90,2 9 (90,2 10 7 (74 (26 00 0,0 90, (90, (7 (2 0, (90 ( (9

ABSTRACT Purpose: to assess knowledge about learning disorders among basic education teachers and intern teachers in Brazilian public and private schools. Methods: two questionnaires administered to teachers from several Brazilian schools, selected by random sampling. The first questionnaire collected sociodemographic data, and the second assessed knowledge about learning disorders. The chi-square test investigated factors regarding knowledge about learning disorders, with a 5% significance level. Results: 51 of the 158 registered teachers responded to the questionnaire and completed the research stages. They were mostly females (90.2%) with a mean length of service of 13.6 years. The questionnaire on learning disorders obtained 1,020 responses, of which 757 (74%) were adequate, and 263 (26%) were incorrect. Greater knowledge of learning disorders was statistically significantly related to previous lectures/courses on the topic (p = 0.02). Conclusion: teacher training significantly increases knowledge about learning disorders, suggesting the need for more professional development programs focused on this topic. Understanding teachers' knowledge on learning disorders is crucial to developing effective educational interventions and supporting students with such difficulties. Purpose schools Methods sampling data chisquare chi square 5 level Results 15 stages 90.2% 902 90 2 (90.2% 136 13 6 13. years 1020 1 020 1,02 responses 75 74% 74 (74% adequate 26 26% (26% incorrect lecturescourses lectures courses p 0.02. 002 0.02 . 0 02 0.02) Conclusion difficulties 90.2 9 (90.2 102 1,0 7 (74 (26 00 0.0 90. (90. 10 1, (7 (2 0. (90 ( (9

Este artículo analiza la realización del PMAQ-AB a partir de su contextualización en un escenario político nacional de profundas transformaciones, desde el reformismo débil que promovió una lenta extensión de derechos contra el reformismo fuerte de la restauración neoliberal. Para discutir los elementos relacionados al trabajo y a las disputas por la distribución en los recursos públicos se realizó un estudio de caso con trabajadores, gestores y consejeros de salud en dos capitales del nordeste brasileño. Los resultados ponen en evidencia el recrudecimiento del conflicto distributivo y el resultado desfavorable para los trabajadores en el contexto post-golpe parlamentario de 2016. Las dinámicas locales exponen procesos de contracción salarial e individualización de las relaciones de trabajo y la reafirmación de la meritocracia como justificativa ideológica de la precarización. A eso se contraponen los trabajadores por medio de la reafirmación de su condición colectiva de clase, en favor del beneficio derivado del PMAQ con la recomposición salarial para todos. PMAQAB AB transformaciones neoliberal brasileño postgolpe post golpe 2016 precarización clase todos 201 20 2

Este artigo analisa a execução do PMAQ-AB a partir de sua contextualização em um cenário político nacional de profundas transformações, desde o reformismo fraco que promoveu lenta extensão de direitos até o contrarreformismo forte da restauração neoliberal. Para debater os elementos relacionados ao trabalho e às disputas pela distribuição dos recursos públicos, foi realizado estudo de caso com trabalhadores, gestores e conselheiros de saúde em duas capitais do nordeste brasileiro. Os resultados evidenciam o acirramento do conflito distributivo e o resultado desfavorável aos trabalhadores no contexto pós-golpe parlamentar de 2016. As dinâmicas locais expõem processos de contração salarial e individualização das relações de trabalho e a reafirmação da meritocracia como justificativa ideológica da precarização. A isso, trabalhadores se contrapõem pela reafirmação de sua condição coletiva de classe, em favor de benefícios derivados do PMAQ, como recomposição salarial para todos. PMAQAB PMAQ AB transformações neoliberal públicos brasileiro pósgolpe pós golpe 2016 precarização isso classe todos 201 20 2

This article analyzes the implementation of the Program for Improving Access and Quality of Primary Care (PMAQ-AB) in the context of a national political scenario of deep transformations, from the weak reformism that promoted slow extension of rights to the strong counter-reformism of neoliberal restoration. It is a case study with health workers, managers, and counselors in two capital cities in northeastern Brazil, discussing matters of work and distributive disputes of public resources. Results show the intensification of these conflicts in health and the unfavorable outcome for workers after the parliamentary coup in 2016 political context. Local dynamics expose the wage contraction and individualization of labor relations and the reassertion of meritocracy as an ideological ground for precariousness. Workers oppose this, reaffirming their collective class condition, favoring the benefit derived from PMAQ for fully regaining their group wages. PMAQAB AB (PMAQ-AB transformations counterreformism counter restoration managers Brazil resources 201 precariousness this condition wages 20 2

Abstract Propolis is a resinous product collected by honeybees with a complex chemical composition. Sodium carboxymethylcellulose is a polymer commonly used in wound care. The goal of the present work was to produce and characterize NaCMC membranes loaded with extract of Brazilian brown propolis (CMC-P). Flavonoids and phenolic acids were identified in the propolis extracts, where the main identified substance was kaempferide. The brown propolis extracted was active against S. aureus. The low swelling capacity and high gel fraction of CMC-P would be the consequence of propolis (responsible for a hydrophobic barrier) filling the pores of the membrane. Propolis could be anchoring the NaCMC chains (as observed by FTIR) due to interaction between components, which is corroborated by the CMC-P sample degrading less than the CMC sample (>400ºC). There was non-linear diffusion release kinetics for most phenolic substances of the propolis extract. The CMC-P sample presents potential as a dressing material. composition care CMCP. CMCP P . (CMC-P) extracts kaempferide S aureus responsible barrier membrane FTIR components >400ºC. 400ºC ºC >400ºC (>400ºC) nonlinear non linear material (CMC-P (>400ºC

RESUMEN Objetivos: proporcionar fuentes de evidencia de validación de contenido para el Manual de Orientación y Seguimiento Post-Accidentes Cerebrovascular. Métodos: abordaje cuantitativo-cualitativo, utilizando dos rondas del método Delphi y análisis de contenido. El Instrumento de Validación de Contenido de Educación en Salud fue enviado a 53 jueces independientes. Se consideró un Índice de Validez de Contenido superior a 0,90. Resultados: de los 14 enfermeros que participaron, el 64,3% tiene experiencia en el cuidado del ictus, el 35,7% en la atención primaria y el 64,3% en la producción de material educativo. En el análisis de contenido, las sugerencias de los jueces fueron estratificadas en cuatro categorías: conformación, objetividad, precisión y percepción del material. Se realizaron cambios ortográficos a las imágenes, adición de escala de funcionalidad, adecuación de términos técnicos y lenguaje. El Índice de Validez de Contenido en la segunda ronda mostró una concordancia de 0,97. Conclusiones: la cartilla presentó fuentes de evidencia de validez de contenido satisfactorias. Objetivos PostAccidentes Post Accidentes Cerebrovascular Métodos cuantitativocualitativo, cuantitativocualitativo cuantitativo cualitativo, cualitativo cuantitativo-cualitativo 5 independientes 090 0 90 0,90 Resultados 1 participaron 643 64 3 64,3 ictus 357 35 7 35,7 educativo categorías conformación objetividad imágenes funcionalidad lenguaje 097 97 0,97 Conclusiones satisfactorias 09 9 0,9 6 64, 35, 0,

ABSTRACT Objectives: to provide sources of content validity evidence for the Post-Stroke Guidance and Follow-up Booklet. Methods: a quantitative-qualitative approach, using two Delphi method and content analysis rounds. The Educational Content Validation Instrument in Health was sent to 53 independent judges. A Content Validity Index above 0.90 was considered. Results: of the 14 nurses who participated, 64.3% have experience with stroke care, 35.7% with primary care and 64.3% with educational material production. In content analysis, judges’ suggestions were stratified into four categories: material conformation, objectivity, accuracy and perception. Spelling changes were made to the images, addition of functionality scale, adequacy of technical terms and language. The Content Validity Index in the second round showed a concordance of 0.97. Conclusions: the booklet presented satisfactory content validity sources of evidence. Objectives PostStroke Post Stroke Followup Follow up Booklet Methods quantitativequalitative quantitative qualitative approach rounds 5 judges 090 0 90 0.9 considered Results 1 participated 643 64 3 64.3 357 35 7 35.7 production categories conformation objectivity perception images scale language 097 97 0.97 Conclusions 09 9 0. 6 64. 35.

RESUMO Objetivos: prover fontes de evidências de validação de conteúdo para a Caderneta de Orientação e Acompanhamento Pós-Acidente Vascular Cerebral. Métodos: abordagem quanti-qualitativa, utilizando duas rodadas do método Delphi e análise de conteúdo. O Instrumento de Validação de Conteúdo Educativo em Saúde foi enviado para 53 juízes independentes. Considerou-se um Índice de Validade de Conteúdo acima de 0,90. Resultados: dos 14 enfermeiros que participaram, 64,3% têm experiência com atendimento a Acidente Vascular Cerebral, 35,7% com atenção primária e 64,3% com produção de material educativo. Na análise de conteúdo, as sugestões dos juízes foram estratificadas em quatro categorias: conformação, objetividade, precisão e percepção do material. Foram realizadas alterações ortográficas nas imagens, adição de escala de funcionalidade, adequação de termos técnicos e linguagem. O Índice de Validade de Conteúdo na segunda rodada demonstrou concordância de 0,97. Conclusões: a caderneta apresentou fontes de evidências de validade de conteúdo satisfatórias. Objetivos PósAcidente Pós Cerebral Métodos quantiqualitativa, quantiqualitativa quanti qualitativa, qualitativa quanti-qualitativa 5 independentes Considerouse Considerou se 090 0 90 0,90 Resultados 1 participaram 643 64 3 64,3 357 35 7 35,7 educativo categorias conformação objetividade imagens funcionalidade linguagem 097 97 0,97 Conclusões satisfatórias 09 9 0,9 6 64, 35, 0,

Abstract Background: Religiosity and Spirituality (R/S), despite being different entities, are multidimensional constructs, whose influence on cardiovascular health has been increasingly studied in recent decades. Objectives: To discriminate patients into subgroups according to R/S levels, in order to compare them regarding the distribution of cardiovascular comorbidities and clinical events. Methods: This is an observational, cross-sectional, analytical study. Two R/S scales were applied to a sample of patients seen at cardiology outpatient clinics. A cluster analysis was used to discriminate individuals into subgroups regarding R/S levels, which were subsequently compared regarding the frequencies of clinical variables related to cardiovascular health. A significance level of 5% was set for the statistical tests. Results: The sample included 237 patients with a mean age of 60.8 years (±10.7), of which 132 were female (55.7%). Cluster analysis (C) distinguished two groups: C1, with lower levels of R/S, and C2, with higher levels of R/S (p<0.001). C2 had a lower frequency of alcohol consumption (29.5% vs. 76.0%; p<0.001), smoking (12.9% vs. 51.0%; p<0.001), systemic arterial hypertension (SAH — 65.5% vs. 82.3%; p=0.005), dyslipidemia (58.3% vs. 77.1%; p=0.003), chronic coronary syndrome (36.7% vs. 58.3%; p=0.001), and prior cardiovascular events (15.8% vs. 36.5%; p<0.001) when compared to C1. There was also a higher frequency of females in C2 (82.0% vs. 17.7%; p<0.001). Conclusions: A better cardiovascular morbidity profile was observed in the group of patients with higher R/S levels, suggesting a probable positive relationship between R/S and cardiovascular health. Background RS , R S (R/S) entities constructs decades Objectives Methods observational crosssectional, crosssectional cross sectional, sectional cross-sectional study clinics 5 tests Results 23 608 60 8 60. ±10.7, 107 ±10.7 10 7 (±10.7) 13 55.7%. 557 55.7% . 55 (55.7%) C (C groups C1 p<0.001. p0001 p p<0.001 0 001 (p<0.001) 29.5% 295 29 (29.5 vs 76.0% 760 76 p<0.001, 12.9% 129 12 9 (12.9 51.0% 510 51 SAH 655 65 65.5 82.3% 823 82 3 p=0.005, p0005 p=0.005 005 p=0.005) 58.3% 583 58 (58.3 77.1% 771 77 1 p=0.003, p0003 p=0.003 003 p=0.003) 36.7% 367 36 (36.7 p=0.001, p=0.001 p=0.001) 15.8% 158 15 (15.8 36.5% 365 82.0% 820 (82.0 17.7% 177 17 Conclusions (R/S 2 6 ±10. (±10.7 55.7 (55.7% p000 p<0.00 00 (p<0.001 29.5 (29. 76.0 12.9 (12. 51.0 65. 82.3 p=0.00 58.3 (58. 77.1 36.7 (36. 15.8 (15. 36.5 82.0 (82. 17.7 ±10 (±10. 55. (55.7 p00 p<0.0 (p<0.00 29. (29 76. 12. (12 51. 82. p=0.0 58. (58 77. 36. (36 15. (15 (82 17. ±1 (±10 (55. p0 p<0. (p<0.0 (2 (1 p=0. (5 (3 (8 ± (±1 (55 p<0 (p<0. ( p=0 (± p< (p<0 p= (p< (p

RESUMO Objetivo: verificar a influência do ambiente familiar, percepção parental e condições socioeconômicas no vocabulário receptivo de escolares do ensino fundamental. Métodos: trata-se de estudo observacional transversal analítico. Os escolares, selecionados por amostragem proporcional estratificada, realizaram o Teste de Vocabulário Receptivo. Os responsáveis responderam à anamnese e ao Inventário de Recursos do Ambiente Familiar. Inicialmente, realizou-se análise bivariada pelo teste Qui-quadrado, considerando p<0,20. Na análise multivariada de regressão logística binária, considerou-se o valor p<0,05 e a qualidade do modelo foi avaliada pelo método Hosmer-Lemeshow. Resultados: dos 263 escolares, 131 são do sexo masculino, 142 do terceiro ano, possuem idade média de 7,6 anos (±0,57) e 111 apresentam vocabulário receptivo rebaixado. Na análise bivariada, observou-se relação entre percepção parental acerca do aprendizado da leitura, da escrita, repetência escolar e o desfecho (p<0,05). Também foram para análise multivariada as variáveis recursos do ambiente e estabilidade da vida familiar (p<0,20). Conclusão: a percepção parental de dificuldade de leitura e de escrita e a falta de estabilidade familiar foram fatores associados ao pior vocabulário receptivo. Objetivo fundamental Métodos tratase trata se analítico estratificada Receptivo Familiar Inicialmente realizouse realizou Quiquadrado, Quiquadrado Qui quadrado, quadrado Qui-quadrado p020 p 0 20 p<0,20 binária considerouse considerou p005 05 p<0,0 HosmerLemeshow. HosmerLemeshow Hosmer Lemeshow. Lemeshow Hosmer-Lemeshow Resultados 26 13 masculino 14 ano 76 7 6 7, ±0,57 057 57 (±0,57 11 rebaixado observouse observou p<0,05. . (p<0,05) (p<0,20) Conclusão p02 2 p<0,2 p00 p<0, 1 ±0,5 5 (±0,5 (p<0,05 (p<0,20 p0 p<0 ±0, (±0, (p<0,0 (p<0,2 p< ±0 (±0 (p<0, ± (± (p<0 ( (p< (p

ABSTRACT Purpose: to examine the influence of familial environment, parental perception, and socioeconomic conditions on the receptive vocabulary of elementary school children. Methods: an analytical cross-sectional observational study. The students were selected by stratified proportional sampling, using the Receptive Vocabulary Test. Those responsible for the children answered the anamnesis and the inventory of family environmental resources. Initially, a bivariate analysis was performed using the chi-square test, considering p<0.20. In the multivariate analysis of binary logistic regression, p<0.05 was considered, and the quality of the model was evaluated through the Hosmer-Lemeshow method. Results: out of the 263 students, 131 were males, 142 were in the third grade and were on average 7.6 years old (±0.57), and 111 had a low receptive vocabulary. In the bivariate analysis, there was a relationship between parental perception about learning to read and write, school failure, and the outcome (p<0.05). The variables environment, resources, and stability of family life were also used for multivariate analysis (p<0.20). Conclusion: Parental perception of difficulty in reading and writing and a lack of family stability were factors associated with poor receptive vocabulary. Purpose environment Methods crosssectional cross sectional study sampling Test resources Initially chisquare chi square test p020 p 0 20 p<0.20 regression p005 05 p<0.0 considered HosmerLemeshow Hosmer Lemeshow method Results 26 13 males 14 76 7 6 7. ±0.57, 057 ±0.57 , 57 (±0.57) 11 write failure p<0.05. . (p<0.05) (p<0.20) Conclusion p02 2 p<0.2 p00 p<0. 1 ±0.5 5 (±0.57 (p<0.05 (p<0.20 p0 p<0 ±0. (±0.5 (p<0.0 (p<0.2 p< ±0 (±0. (p<0. ± (±0 (p<0 (± (p< ( (p

Este artigo analisa a execução do PMAQ-AB a partir de sua contextualização em um cenário político nacional de profundas transformações, desde o reformismo fraco que promoveu lenta extensão de direitos até o contrarreformismo forte da restauração neoliberal. Para debater os elementos relacionados ao trabalho e às disputas pela distribuição dos recursos públicos, foi realizado estudo de caso com trabalhadores, gestores e conselheiros de saúde em duas capitais do nordeste brasileiro. Os resultados evidenciam o acirramento do conflito distributivo e o resultado desfavorável aos trabalhadores no contexto pós-golpe parlamentar de 2016. As dinâmicas locais expõem processos de contração salarial e individualização das relações de trabalho e a reafirmação da meritocracia como justificativa ideológica da precarização. A isso, trabalhadores se contrapõem pela reafirmação de sua condição coletiva de classe, em favor de benefícios derivados do PMAQ, como recomposição salarial para todos.

This article analyzes the implementation of the Program for Improving Access and Quality of Primary Care (PMAQ-AB) in the context of a national political scenario of deep transformations, from the weak reformism that promoted slow extension of rights to the strong counter-reformism of neoliberal restoration. It is a case study with health workers, managers, and counselors in two capital cities in northeastern Brazil, discussing matters of work and distributive disputes of public resources. Results show the intensification of these conflicts in health and the unfavorable outcome for workers after the parliamentary coup in 2016 political context. Local dynamics expose the wage contraction and individualization of labor relations and the reassertion of meritocracy as an ideological ground for precariousness. Workers oppose this, reaffirming their collective class condition, favoring the benefit derived from PMAQ for fully regaining their group wages.

Este artículo analiza la realización del PMAQ-AB a partir de su contextualización en un escenario político nacional de profundas transformaciones, desde el reformismo débil que promovió una lenta extensión de derechos contra el reformismo fuerte de la restauración neoliberal. Para discutir los elementos relacionados al trabajo y a las disputas por la distribución en los recursos públicos se realizó un estudio de caso con trabajadores, gestores y consejeros de salud en dos capitales del nordeste brasileño. Los resultados ponen en evidencia el recrudecimiento del conflicto distributivo y el resultado desfavorable para los trabajadores en el contexto post-golpe parlamentario de 2016. Las dinámicas locales exponen procesos de contracción salarial e individualización de las relaciones de trabajo y la reafirmación de la meritocracia como justificativa ideológica de la precarización. A eso se contraponen los trabajadores por medio de la reafirmación de su condición colectiva de clase, en favor del beneficio derivado del PMAQ con la recomposición salarial para todos.

RESUMO Objetivo: Analisar experiências de puérperas sobre saúde sexual após o parto na perspectiva do interacionismo simbólico. Método: Estudo descritivo, qualitativo. Realizadas 20 entrevistas semiestruturadas por videoconferência com mulheres no puerpério remoto, captação por “snowball” e busca das “sementes” pelo Instagram®. Utilizou-se a análise de conteúdo de Bardin e o Interacionismo Simbólico como referencial. Resultados: As puérperas significam saúde sexual numa perspectiva de integralidade dos cuidados em saúde. Contudo, pela dualidade entre o “ser mulher” e o “ser mãe”, reconhecem o medo, as transformações corporais e as mudanças de foco da relação amorosa para os cuidados com o bebê como fatores que interferem na saúde sexual. E, escolhem se deixar de lado, priorizando o cuidado com os outros. Ressignificam saúde sexual pelo reconhecimento da importância de cuidar de si nos aspectos biopsicossociais e tentam resgatar o autocuidado para vivência sexual saudável. Conclusão: Apesar dos significados atribuídos, as interações sociais das mulheres com o puerpério interferem negativamente na saúde sexual. Profissionais devem ser sensibilizados quanto à inclusão de ações que promovam mudanças da ação social dessas mulheres para o cuidado de si. Objetivo simbólico Método descritivo qualitativo 2 remoto snowball “snowball sementes “sementes Instagram Instagram® Utilizouse Utilizou referencial Resultados Contudo mulher mãe, mãe , mãe” medo E lado outros saudável Conclusão atribuídos

ABSTRACT Objective: To analyze puerperal women’s experiences of sexual health after childbirth from the perspective of symbolic interactionism. Method: Descriptive, qualitative study. Twenty semi-structured interviews were conducted by videoconference with women in the remote puerperium, captured by snowball technique and searched for “seeds” on Instagram®. Bardin’s content analysis and Symbolic Interactionism were used as references. Results: The puerperal women signify sexual health from a perspective of comprehensive healthcare. However, due to the duality between “being a woman” and “being a mother”, they recognize fear, bodily transformations and changes in focus from the love relationship to caring for the baby as factors that interfere with sexual health. And they choose to put themselves aside, prioritizing caring for others. They re-signify sexual health by recognizing the importance of taking care of themselves in biopsychosocial aspects and try to recover self-care for a healthy sexual experience. Conclusion: Despite the meanings attributed, women’s social interactions with the puerperium interfere negatively with sexual health. Professionals should be sensitized to the inclusion of actions that promote changes in the social action of these women towards self-care. Objective womens s interactionism Method Descriptive study semistructured semi structured seeds “seeds Instagram Instagram® Bardins Bardin references Results healthcare However being woman mother, mother , mother” fear aside others resignify re selfcare self experience Conclusion attributed selfcare. care.

RESUMEN Objetivo: Analizar las experiencias de salud sexual de las puérperas después del parto desde la perspectiva del interaccionismo simbólico. Método: Estudio descriptivo y cualitativo. Se realizaron 20 entrevistas semiestructuradas por videoconferencia con mujeres puérperas a distancia, captadas mediante bola de nieve y búsqueda de las “semillas” a través de Instagram®. Se utilizaron como referencias el análisis de contenido de Bardin y el Interaccionismo Simbólico. Resultados: Las puérperas significan la salud sexual desde una perspectiva de atención sanitaria integral. Sin embargo, debido a la dualidad entre “ser mujer” y “ser madre”, reconocen el miedo, las transformaciones corporales y los cambios de enfoque de la relación amorosa al cuidado del bebé como factores que interfieren en la salud sexual. Y deciden dejarse a un lado, dando prioridad al cuidado de los demás. Resignifican la salud sexual reconociendo la importancia de cuidarse en los aspectos biopsicosociales e intentan recuperar el autocuidado para una experiencia sexual saludable. Conclusión: A pesar de los significados atribuidos, las interacciones sociales de las mujeres con el puerperio interfieren negativamente en la salud sexual. Los profesionales deben ser sensibilizados para la inclusión de acciones que promuevan cambios en las acciones sociales de estas mujeres hacia el autocuidado. Objetivo simbólico Método cualitativo 2 distancia semillas “semillas Instagram Instagram® Simbólico Resultados integral embargo mujer madre, madre , madre” miedo lado demás saludable Conclusión atribuidos