Abstract Systemic Arterial Hypertension is a multifactorial clinical condition associated with severe outcomes such as stroke and death. One of the main modifiable risk factor for hypertension is an unhealthy diet, often characterized by the consumption of ultraprocessed foods such as sweetened beverages. We aimed to investigate the relationship between the consumption of sweetened beverages, both sugar-sweetened and artificially sweetened, and the prevalence of hypertension in adults. A cross-sectional, household, population-based study with 1,162 adults from two Brazilian cities were carried out. The consumption of food groups and sweetened beverages was obtained by food frequency questionnaire and other data were self-reported. Weight, height, and waist circumference were measured. The association between sweetened beverages consumption and hypertension was analyzed using Poisson regression models, expressed as Prevalence Ratio. The prevalence of hypertension was 16.7%, with no significant difference between genders. The prevalence of consumption of sweetened beverages was 70.3% in men and 54.6% in women, being significantly higher in men. Women who consumed sugar-sweetened and artificially sweetened beverages 6 to 7 days per week had 92% higher prevalence of hypertension compared to those who did not consume or consumed at a lower frequency. Furthermore, women who consumed artificially sweetened beverages at least 1 time per week had 3.36 times higher prevalence of hypertension. The habitual consumption of sweetened beverages may be an important risk factor for hypertension, especially the consumption of diet beverages, which are often marketed as healthier than sugar-sweetened beverages.

Resumen La Hipertensión Arterial Sistémica es una condición clínica multifactorial asociada a resultados graves como el ictus y la muerte. Uno de los principales factores de riesgo modificables de la hipertensión es una dieta poco saludable, a menudo caracterizada por el consumo de alimentos ultraprocesados como las bebidas endulzadas. Nuestro objetivo fue investigar la relación entre el consumo de bebidas endulzadas, tanto azucaradas como edulcoradas artificialmente, y la prevalencia de hipertensión en adultos. Se realizó un estudio transversal, domiciliario y poblacional con 1,162 adultos de dos ciudades brasileñas. El consumo de grupos de alimentos y bebidas endulzadas se obtuvo mediante cuestionario de frecuencia de alimentos y los demás datos fueron autoinformados. Se midieron el peso, la talla y el perímetro de la cintura. La asociación entre el consumo de bebidas endulzadas y la hipertensión se analizó mediante modelos de regresión de Poisson, expresados como Ratio de Prevalencia. La prevalencia de hipertensión fue del 16,7%, sin diferencias significativas entre géneros. La prevalencia de consumo de bebidas endulzadas fue del 70,3% en los hombres y del 54,6% en las mujeres, siendo significativamente mayor en los hombres. Las mujeres que consumían bebidas azucaradas y edulcoradas artificialmente entre 6 y 7 días a la semana tenían 92% mayor prevalencia de hipertensión que las que no consumían o consumían con una frecuencia menor. Además, las mujeres que consumían bebidas edulcoradas al menos 1 vez por semana tenían una prevalencia de hipertensión 3,36 veces mayor. Así pues, el consumo habitual de bebidas endulzadas puede ser un importante factor de riesgo de hipertensión, especialmente el consumo de bebidas dietéticas, que a menudo se comercializan como más saludables que las bebidas azucaradas.

ABSTRACT: Leptospirosis, a disease of significant economic impact on livestock and public health concern, may exhibit unique epidemiological characteristics in indigenous villages, particularly those located within semiarid climates such as the Caatinga biome in Brazil. This environment often presents conditions unfavorable for leptospire survival. This study conducted serological diagnoses of livestock in indigenous villages within the Caatinga biome, Northeastern Brazil. The survey was carried out in the Mãe Maria and Santa Helena indigenous villages, home to the Xukuru de Cimbres tribe, in the county of Pesqueira, Pernambuco State, Brazil, within the Caatinga biome. Blood samples were collected from cattle (n = 42), goats (n = 41), and sheep (n = 19). Out of the 102 samples tested, 73 (71.6%; 95% CI = 62.8% - 80.3%) were seroreactive (cut-off ≥ 100). The seropositivity rates for cattle, goats, and sheep were 54.8%, 80.5%, and 89.5%, respectively. A statistically significant difference was observed in the proportion of seropositive animals between cattle and goats and cattle and sheep (P < 0.05). Icterohaemorrhagiae was identified as the most probable serogroup across all animal species. The study revealed that livestock in indigenous villages within the Caatinga biome are frequently exposed to leptospires. This finding underscores the importance of a One Health approach, emphasizing the need for comprehensive studies in areas where large human and animal populations coexist. Such studies are crucial for investigating zoonotic infections and for planning and implementing control measures against livestock-associated leptospirosis.

RESUMO: A leptospirose causa perdas econômicas na pecuária e é um problema de saúde pública, sendo possível que existam peculiaridades na epidemiologia dessa doença em aldeias indígenas, principalmente naquelas de áreas de clima semiárido, como o bioma Caatinga no Nordeste do Brasil, onde o ambiente é frequentemente adverso à sobrevivência de leptospiras. Assim, o objetivo deste estudo foi realizar o diagnóstico sorológico em rebanhos de aldeias indígenas no bioma Caatinga. A pesquisa foi realizada nas aldeias indígenas Mãe Maria e Santa Helena, tribo Xukuru de Cimbres, município de Pesqueira, estado de Pernambuco, Brasil, dentro do bioma Caatinga. Amostras de sangue foram colhidas de bovinos (n = 42), caprinos (n = 41) e ovinos (n = 19). No geral, das 102 amostras testadas 73 (71,6%; IC 95% = 62,8% - 80,3%) foram sororreativas (ponto de corte ≥ 100). Para bovinos, caprinos e ovinos as taxas de soropositividade foram de 54,8%, 80,5% e 89,5%, respectivamente. Houve diferença estatística na proporção de animais soropositivos entre bovinos e caprinos e bovinos e ovinos (P < 0,05). Icterohaemorrhagiae foi o sorogrupo mais provável em todas as espécies animais. O estudo mostra que animais de produção de aldeias indígenas são comumente expostos a leptospiras no bioma Caatinga, o que constitui uma preocupação do ponto de vista de Saúde Única e demonstra a importância de estudos amplos em que coexistem grandes números de humanos e animais na investigação de infecções zoonóticas e no planejamento e implementação de medidas de controle da leptospirose associada a animais de produção.

Abstract Objectives: To review and provide evidence-based recommendations for the diagnosis and treatment of otosclerosis. Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on otosclerosis were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results: The topics were divided into 2 parts: 1) Diagnosis – audiologic and radiologic; 2) Treatment – hearing AIDS, pharmacological therapy, stapes surgery, and implantable devices - bone-anchored devices, active middle ear implants, and Cochlear Implants (CI). Conclusions: The pathophysiology of otosclerosis has not yet been fully elucidated, but environmental factors and unidentified genes are likely to play a significant role in it. Women with otosclerosis are not at increased risk of worsening clinical condition due to the use of contraceptives or during pregnancy. Drug treatment has shown little benefit. If the patient does not want to undergo stapedotomy, the use of hearing aids is well indicated. Implantable systems should be indicated only in rare cases, and the CI should be indicated in cases of profound deafness.

Recognizing the significant effects of the New Information and Communication Technologies (NICTs), the work reports the experience of a reflection group on the following question: does the massive and pervasive use of technologies in life, and therefore in health, deserve its own concept for analytical and sociopolitical emphasis? Through the experience systematization proposed by Holliday (2006), we propose the concept of Digital Determinants of Health (DDH) as it reflects the need to better highlight NICTs’ actions in the production of health - both from an epistemological and sociopolitical point of view. By suggesting the DDH concept, we urge the academic community to a more specific debate on the consequences of NICTs in contemporary life, in order to guide actions capable of mitigating negative effects and leveraging the benefits of new technologies in healthcare.

Reconociendo los efectos significativos de las Nuevas Tecnologías de la Información y la Comunicación (NTIC), este artículo relata la experiencia de un grupo sobre la cuestión: ¿merece el uso masivo y omnipresente de las tecnologías en la vida, y en consecuencia en la salud, un concepto propio para su prominencia analítica y sociopolítica? Utilizando la sistematización de Holliday (2006), el grupo propuso el concepto de Determinantes Digitales de la Salud (DDS) por la necesidad de destacar la acción de las NTIC en la salud, tanto desde el punto de vista epistemológico como sociopolítico. Con el concepto de DDS, instamos a la comunidad académica a mantener un debate más específico sobre las consecuencias de las NTIC en la vida contemporánea para orientar acciones capaces de mitigar los efectos negativos y maximizar los beneficios de las nuevas tecnologías en la salud.

Reconhecendo os efeitos significativos das Novas Tecnologias de Informação e Comunicação (NTICs), o trabalho relata a experiência de um grupo de reflexão sobre a seguinte questão: a utilização de tecnologias de modo massivo e pervasivo na vida e, consequentemente, na saúde, merece conceito próprio para destaque analítico e sociopolítico? Por meio da sistematização de experiências de Holliday (2006), o grupo propõe o conceito de Determinantes Digitais da Saúde (DDS) por entender a necessidade de evidenciar com mais força a ação das NTICs na produção da saúde — tanto do ponto de vista epistemológico, quanto do sociopolítico. Com a sugestão do conceito de DDS, exortamos a comunidade acadêmica a um debate mais específico sobre as consequências das NTICs na vida contemporânea para a orientação de ações capazes de mitigar os efeitos negativos e potencializar os benefícios das novas tecnologias na saúde.

Objective: This paper presents the results of a study that addressed the perception of a group of teachers regarding the Accelerated Learning Program -in the context of the pandemic- in a rural school in northern Colombia. Methodology: using a qualitative methodology, through a phenomenological design, in which 17 interviews were analyzed. The results allowed to establish that the participants have knowledge about the program, however, they evidenced particulars that indicate difficulties in its development. In spite of the fact that the participants recognize the criteria to be taken into account to carry out the program, the need for training was identified as a relevant aspect. It was evidenced that the participants throughout the pandemic did not receive follow-up from governmental agencies. The digital gaps, evidenced by the students adhered to the program, played an important role in this imbalance.

Objetivo: El presente artículo presenta los resultados de un estudio que abordó la percepción de un grupo de profesores frente al Programa de Aceleración del Aprendizaje -en el marco de la pandemia- en una escuela rural de la zona norte de Colombia. Metodología: mediante una metodología cualitativa, a través de un diseño fenomenológico, en el que se analizaron 17 entrevistas. Resultados: los resultados permitieron establecer que los participantes tienen conocimiento sobre él programa, no obstante, evidencian particulares que indican dificultades en su desarrollo. Pese a que los participantes reconocen los criterios a tener en cuenta para llevar a cabo el programa, se determinó como un aspecto relevante la necesidad capacitación. Se evidenció que los participantes a lo largo de la pandemia no recibieron el seguimiento de los organismos gubernamentales. Las brechas digitales, que evidencian los estudiantes adheridos al programa, jugaron un papel importante en este desequilibrio.

Objetivo: Este artigo apresenta os resultados de um estudo cujo objetivo era conhecer a percepção de um grupo de professores a respeito do programa de aceleração do aprendizado no contexto da pandemia em uma escola rural na parte norte da Colômbia. Metodologia: utilizando uma metodologia qualitativa, através de um projeto fenomenológico, no qual foram analisadas 17 entrevistas. Resultados: Os resultados mostram que os participantes estão cientes do programa, mas há evidência de deficiências particulares em seu desenvolvimento adequado. Apesar de os participantes reconhecerem os critérios a serem levados em conta para realizar o programa, a necessidade de treinamento foi identificada como um aspecto relevante, que para aqueles entrevistados em meio à pandemia não receberam, e também lhes faltou a presença e o monitoramento das organizações responsáveis, além das lacunas digitais que os estudantes envolvidos no programa apresentam

Resumen: Esta investigación analiza los imaginarios de excombatientes guerrilleros sobre el posacuerdo colombiano. El diseño de investigación fue cualitativo en la modalidad de análisis del discurso. Participaron 20 excombatientes de quienes se exploraron repertorios interpretativos, tales como: de la guerra como pesadez a la reincorporación y reintegración como ligereza; la tensión entre normalidad y anormalidad, y el excombatiente como portador de la guerra, recogidos en la metáfora de la carga. Estos relatos presentan funciones dilemáticas asociadas a tensiones, obstáculos y oportunidades imaginadas sobre el posacuerdo, comprendiendo un sinnúmero de retos sociopolíticos que trascienden la prescripción de programas estatales para la reincorporación y la reintegración.

Abstract: This study analyzed the imaginaries of former guerrilla combatants about the Colombian post-agreement. The research design was qualitative in the modality of discourse analysis, with the participation of 20 former-combatants whose interpretative repertoires were explored, such as: From war as a heaviness to reincorporation as a lightness; The tension between normality and abnormality; and The former-combatant as a bearer of war, collected in the metaphor of the burden; these narratives present dilemmatic functions associated with tensions, obstacles and imagined opportunities on the post-agreement, comprising a myriad of socio-political challenges, transcending the prescription of state programs for reincorporation.

RESUMO: O transtorno de acumulação de animais, principalmente de cães e gatos, é uma questão complexa que ocorre em quase todas as comunidades, sendo necessário o levantamento de dados que contribuam para a compreensão da leptospirose dentro da iniciativa Saúde Única. Com o objetivo de determinar a soroprevalência deLeptospirasp. em cães e gatos provenientes de acumuladores de animais foram utilizados 71 cães e 39 gatos de 33 acumuladores do município de Patos, estado da Paraíba, semiárido do Nordeste brasileiro, utilizando-se o teste de soroaglutinação microscópica (SAM) como teste de diagnóstico. Trinta e oito animais (34,5%; IC 95% = 25,7 - 43,4%) foram sororreativos, sendo 46,5% em cães e 12,8% em gatos (P < 0,01), com maior frequência do sorogrupo Icterohaemorrhagiae em ambas as espécies. A alta soroprevalência encontrada sugere a necessidade de políticas públicas para esta população vulnerável no sentido de prevenir a transmissão de zoonoses.

ABSTRACT: Animal hoarding disorder, especially dogs and cats, is a complex issue that occurs in almost all communities, and it is necessary to collect data that contribute to the understanding of leptospirosis within the One Health initiative. In order to determine the seroprevalence of Leptospirasp., 71 dogs and 39 cats from 33 people with animal hoarding profile in the municipality of Patos, state of Paraíba, semi-arid region of Northeastern Brazil were evaluated by using the microscopic serum agglutination test (MAT) as diagnostic test. Thirty-eight animals (34.5%; 95% CI = 25.7 - 43.4%) were seroreactive, with 46.5% in dogs and 12.8% in cats (P < 0.01), with the highest frequency of the Icterohaemorrhagiae serogroup in both species. The high seroprevalence reported suggests the need for public policies for this vulnerable population in order to prevent the transmission of zoonoses.

Abstract Systemic microvascular dysfunction has been shown to be present in COVID-19, and serum cytokines are known to be involved in the regulation of vascular function. We sought to evaluate systemic microvascular endothelial function, with laser doppler perfusion monitoring (LDPM), and plasma levels of cytokines after acute COVID-19. Individuals admitted to a Cardiology hospital with acute COVID-19 and followed for 12-15 months after recovery underwent noninvasive evaluation of systemic endothelium-dependent microvascular reactivity by cutaneous LDPM with local thermal hyperemia (LTH). A multiplex biometric immunoassay panel was used to assess 48 serum cytokines and chemokines. Twenty patients and 14 control volunteers were enrolled. The areas under the curves of vasodilation induced by LTH were significantly increased after recovery (P=0.009) and were not different from values obtained in healthy volunteers (P= 0.85). The peak microvascular flow during LTH did also significantly increase (P= 0.02), and was not different form values obtained in healthy volunteers (P= 0.55). Several cytokines displayed significantly reduced serum concentrations after recovery from COVID-19. In conclusion, endothelium-dependent systemic microvascular reactivity improved after recovery from COVID-19 in patients with cardiovascular diseases, in parallel with a reduction in the levels of several serum cytokines and chemokines involved in the regulation of vascular function and inflammation.

ABSTRACT: Leptospirosis is a zoonosis that can infect buffaloes and other mammalians, and it’s caused by Gram-negative bacteria of the genus Leptospira spp. The infection occurs through contact with urine or a contaminated environment with the mucous membranes of the animals, and the disease has two phases: leptospiremia and leptospiruria. The objective of this study was to determine the frequency of leptospirosis in buffaloes in the state of Paraná, Brazil, as well as the main serovars present in this area. A total of 276 blood samples were collected from buffaloes from 18 properties located in different cities and mesoregions of Paraná state. A microscopic agglutination test (MAT) was performed to detect the presence of anti-Leptospira spp. antibodies and to identify its serovars. The prevalence was 77.17% (213/276) of buffaloes seropositive for at least one serovar. The most frequent serovar was Icterohaemorrhagiae, followed by the Pomona serovar and serovar Hardjo. This study seems to be the first to determine the frequency of buffaloes with leptospirosis in the state of Paraná. Prevention and control measures are important to control the disease in herds.

RESUMO: Leptospirose é uma zoonose que infecta búfalos e outros mamíferos e é causada por bactérias Gram-negativas do gênero Leptospira spp. A infecção ocorre por meio do contato com a urina ou ambiente contaminado com as membranas mucosas dos animais e a doença possui duas fases: leptospiremia e leptospirúria. O objetivo deste trabalho foi determinar a frequência da leptospirose em bubalinos provenientes do estado do Paraná, assim como determinar os principais sorovares presentes no estado. Um total de 276 amostras de sangue foram coletados de búfalos provenientes de 18 propriedades localizadas em 14 municípios de diferentes mesorregiões do estado do Paraná. O teste de soroaglutinação microscópica (SAM) foi realizado para detecção da presença de anticorpos anti-Leptospira spp. e identificação dos respectivos sorovares. A prevalência de búfalos soropositivos para ao menos um sorovar foi de 77,17% (213/276). O sorovar mais frequente identificado nestes búfalos foi o Icterohaemorrhagiae, seguido pelos sorovares Pomona e Hardjo. Este é o primeiro estudo a determinar a frequência de búfalos com leptospirose no estado do Paraná. Medidas de controle e prevenção são importantes para o controle do agente nos rebanhos.

Abstract Pain is common in orthodontic treatment, is subject to individual variation, and is associated with anxiety and stress, which can potentially become catastrophizing. The aim of the present study was to determine the variability of pain response after the insertion of orthodontic separators and to assess the association of pain levels with dental anxiety, catastrophizing, tooth sensitivity, and genetic expression of cytokines. To this end, 70 patients of both genders were divided into two equal groups according to the elastomeric separator used: G1 (Dentaurum) and G2 (Orthometric). Two separators were inserted in the mesial and distal sides of the lower right first molar. Participants were instructed to rate the level of pain at T0 (before insertion), T1 (just after insertion), and T2 (24 hours after insertion) on a visual analog scale. The gingival crevicular fluid was collected at T0 and T2. The levels of anxiety, catastrophizing, tooth sensitivity, and cytokine expression were also assessed. Statistical analysis was performed with the Fisher-Freeman-Halton, chi-squared, Spearman’s correlation, and dependent and independent t tests (α=5%). Pain intensity was higher at T2 than at T1, in both groups (P<.05). An association was established (P<.05) between pain intensity at T1 and catastrophizing, and at T2 with anxiety and catastrophizing. Within-group differences in cytokine expression were found between T0 and T2. There was no correlation between cytokine expression and pain levels, anxiety, catastrophizing, and sensitivity at T2. Tooth separation produced variable pain levels, which were influenced by anxiety and catastrophizing, however, pain level was not correlated with increased cytokine expression.

Abstract Background The Telehealth Brazil Program aims to improve the quality of Primary Health Care. Objective This cross-sectional study evaluated the Telehealth Brazil Networks Program’s dental teleconsulting in Minas Gerais state to elucidate the prevalent questions in endodontics. Method Secondary databases of offline dental teleconsulting from the Clinical Hospital and Medical School of the Universidade Federal de Minas Gerais from July 2015 to July 2017 were used. The variables analyzed were telehealth center, dental specialty and sub-area, and question type. The results were descriptively analyzed using the SPSS v.22.0 program. Results A total of 3,920 teleconsulting sessions were carried out. Endodontics was the field with the sixth-highest demand for questions (7.4%). The most prevalent endodontic questions were related to pulpal and periapical alterations (32.3%), being more related to diagnosis, followed by dental trauma (15.6%), endodontic emergencies (11.4%), and intracanal medication (7.3%), all of them with most questions related to clinical conduct. Conclusion The endodontic field questions were related to prevalent conditions in the daily activities of the primary health care professionals. It is crucial to continuously update the professionals through continuing education programs and the search for new knowledge to reinforce these competencies.

Resumo Introdução O Programa de Telessaúde tem o objetivo de aprimorar a qualidade da Atenção Primária em Saúde. Objetivo Este estudo transversal avaliou as teleconsultorias odontológicas do Programa Telessaúde Brasil Redes em Minas Gerais para elucidar as dúvidas prevalentes em endodontia. Método Bancos de dados das teleconsultorias offline de odontologia do Hospital das Clínicas e Faculdade de Medicina da Universidade Federal de Minas Gerais de Julho de 2015 a Julho de 2017 foram utilizados. As variáveis analisadas foram: núcleo de telessaúde, especialidade odontológica e subárea, e tipo de dúvida. Resultados Os resultados foram analisados descritivamente utilizando o programa SPSS v.22.0. Um total de 3920 teleconsultorias foi realizada. A Endodontia foi a área com a sexta maior demanda por dúvidas (7,4%). As dúvidas endodônticas mais prevalentes foram relacionadas às alterações pulpares e perirradiculares (32,3%), sendo mais relacionadas ao diagnóstico, seguidas por trauma dentário (15,6%), emergências endodônticas (11,4%) e medicação intracanal (7,3%), sendo a maioria das dúvidas relacionadas à conduta clínica. Conclusão As dúvidas na área endodôntica foram relacionadas a condições prevalentes nas atividades diárias dos profissionais da atenção primária a saúde. É crucial a atualização constante dos profissionais, por programas de educação continuada e pela busca por novos conhecimentos, reforçando essas competências.

ABSTRACT Environmental surveillance of water sources is important to monitoring viral hepatitis transmission in clinical settings. This study investigated the circulation of hepatitis A (HAV) and E (HEV) viruses in sewage and clinical samples from Argentina. Between 2016 and 2017, 80 raw sewage samples and 86 clinical samples (stool and serum) from suspected cases of hepatitis A and hepatitis E were obtained. HAV and HEV were tested by both real-time and nested PCR. Positive samples were sequenced for genotype determination and phylogenetic analysis. Overall, HAV was recovered in 39% of sewage samples and 61.1% of clinical samples. HEV was detected in 22.5% of sewage samples and 15.9% of clinical samples. HAV was found more frequently in sewage during the winter and in clinical samples in spring; HEV was more prevalent in sewage during summer and in clinical samples in autumn. All HAV isolates belonged to genotype IA and HEV isolates belonged to genotype 3, the most prevalent genotypes in South America. High prevalence of HAV and HEV in environmental and clinical samples in Mendoza, Argentina was observed. These findings reinforce the importance of environmental surveillance and implementation of health strategies to control the spread of HAV and HEV in developing countries.

ABSTRACT Objective: To analyze the perception of patients and health professionals regarding patients’ participation in surgical site infection prevention. Methods: Cross-sectional study conducted in two hospitals in the city of São Paulo, with a convenience sample of 123 patients in the postoperative period of elective surgeries and 92 health professionals (physicians and nurses) acting in direct care of surgical patients. Results: Patients (78.9%) and professionals (79.4%) fully agreed with the importance of patient participation to prevent surgical site infection. The impact of patient participation on infection rates was significant for those undergoing previous surgery (p = 0.021). Patients and professionals disagreed about the best time to prepare the patient about the topic (p<0.001). The participation strategies considered most effective by patients and professionals were, respectively, oral presentation (47.2% and 75%), videos (40.7% and 58.7%) and leaflets (30.9% and 58.7%). Conclusion: Patients and health professionals believe that patient participation in surgical site infection prevention is important.

RESUMEN Objetivo: Analizar la percepción de pacientes y profesionales de salud sobre la participación de los pacientes en la prevención de la infección del sitio quirúrgico. Método: Estudio transversal realizado en dos hospitales de la ciudad de São Paulo, con una muestra de conveniencia de 123 pacientes en el postoperatorio de cirugías electivas y 92 profesionales de salud (médicos y enfermeros) que actúan en el cuidado directo de pacientes quirúrgicos. Resultados: Los pacientes (78,9%) y los profesionales (79,4%) estuvieron totalmente de acuerdo con la importancia de la participación de los pacientes para prevenir la infección del sitio quirúrgico. El impacto de la participación de los pacientes en las tasas de infección fue significativo para los sometidos a cirugía previa (p = 0,021). Pacientes y profesionales discreparon sobre el mejor momento para preparar al paciente sobre el tema (p < 0,001). Las estrategias de participación consideradas más eficaces por pacientes y profesionales fueron, respectivamente, la presentación oral (47,2% y 75%), los vídeos (40,7% y 58,7%) y los folletos (30,9% y 58,7%). Conclusión: Los pacientes y los profesionales de salud creen que la participación de los pacientes en la prevención de la infección del sitio quirúrgico es importante.

RESUMO Objetivo: Analisar a percepção de pacientes e profissionais de saúde sobre a participação dos pacientes na prevenção de infecção do sítio cirúrgico. Método: Estudo transversal realizado em dois hospitais da cidade de São Paulo, com amostra por conveniência de 123 pacientes no período pós-operatório de cirurgias eletivas e 92 profissionais de saúde (médicos e enfermeiros) atuantes no cuidado direto a pacientes cirúrgicos. Resultados: Pacientes (78,9%) e profissionais (79,4%) concordaram totalmente com a importância da participação do paciente para a prevenção de infecção do sítio cirúrgico. O impacto da participação do paciente nas taxas de infecção foi significativo para aqueles submetidos à cirurgia prévia (p = 0,021). Pacientes e profissionais discordaram quanto ao melhor momento para preparar o paciente sobre a temática (p<0,001). As estratégias de participação consideradas mais efetivas pelos pacientes e profissionais foram, respectivamente, exposição oral (47,2% e 75%), vídeos (40,7% e 58,7%) e panfletos (30,9% e 58,7%). Conclusão: Pacientes e profissionais de saúde julgam ser importante a participação do paciente na prevenção de infecção do sítio cirúrgico.

ABSTRACT: Brazilian Special Education has historical marks of privatization, one of which is focused on this article, which aims to analyze the transfer of public financial resources from education to the private sphere in a large municipality in São Paulo, between 2012 and 2017. Adopting a qualitative approach, the amounts settled in favor of Special Education directed to the private sphere are analyzed based on documentary sources, covering contracts with outsourced companies, terms of collaboration and additions, reports on remuneration of Special Education professionals and documents for the transfer of funds to the private sphere. The results indicate an increase in resources allocated to this modality in the private sphere, mainly due to the need to hire caregivers, until that moment without filling a position in this teaching network. They also express that school inclusion reproduces funding modes that mark the history of Special Education in Brazil. The partnership with non-profit private institutions and the contracting of outsourced companies are in line with the managerial perspective of public administration. On the one hand, in the analyzed case, the school inclusion policy outsourced the maintenance of services from the concession to the private sphere, on the other hand, there was a growing increase in funding from the municipal public sector.

RESUMO: A Educação Especial brasileira tem marcas históricas da privatização, uma delas é focalizada neste artigo, que tem por objetivo analisar o repasse de recursos financeiros públicos da educação para a esfera privada em um município paulista de grande porte, entre 2012 e 2017. Adotando abordagem qualitativa, são analisados os valores liquidados em favor da Educação Especial direcionados à esfera privada a partir de fontes documentais, abrangendo contratos com empresas terceirizadas, termos de colaboração e aditamento, relatórios de remuneração de profissionais da Educação Especial e documentos de repasse de recursos à esfera privada. Os resultados indicam aumento dos recursos destinados a essa modalidade na esfera privada em decorrência, principalmente, da necessidade de contratação de cuidadoras(es), até aquele momento sem provimento de cargo nessa rede de ensino. Também expressam que a inclusão escolar reproduz modos de financiamento que marcam a história da Educação Especial no Brasil. A parceria com instituições privadas sem fins lucrativos e a contratação de empresas terceirizadas vão ao encontro da perspectiva gerencial da administração pública. No caso analisado, por um lado, a política de inclusão escolar terceirizou a manutenção dos serviços a partir da concessão para a esfera privada; por outro lado, houve crescente aumento do financiamento do setor público municipal.

ABSTRACT Purpose To verify the association between caregivers' and teachers' perceptions of the changes imposed by social isolation and the impact on students' learning. Methods This is an analytical observational and longitudinal study, with the participation of 19 caregivers (family members) of 2nd-grade students from a public financing school and their respective teachers. The caregivers were submitted to interviews by means of the questionnaires: Abilities and Difficulties Questionnaire, Family Environment Resources Inventory and COVID-19 monitoring questionnaire that checks the behavior of schoolchildren and families. The collection took place in two moments by telephone call: the first moment (M1) was started in June 2020, and the second, (M2) in December 2020. The progress reports prepared by the regular teachers were received in January 2021. Results A negative implication was observed in the change of routine and an impact on the parents' lives. In parents' perceptions, significant and negative issues were also present in children's mental health, such as changes in routine. Teacher evaluation reports showed a similar pattern, with the vast majority of them lacking information about learning performance. Conclusion This study pointed out the importance of accompanying schoolchildren and families in a period of social withdrawal, in order to guide and intervene together with parents and teachers.

RESUMO Objetivo Verificar a associação entre a percepção dos cuidadores e professores acerca das mudanças impostas pelo isolamento social e o impacto na aprendizagem de estudantes. Método Trata-se de um estudo observacional analítico e longitudinal, com participação de 19 cuidadores (familiares) dos escolares do 2º ano do ensino fundamental de uma escola de financiamento público e seus respectivos professores. Os cuidadores foram submetidos a entrevistas por meio dos questionários: Questionário de Capacidades e Dificuldades, Inventário de Recursos do Ambiente Familiar e Questionário de monitoramento COVID-19 que verifica o comportamento dos escolares e famílias. A coleta aconteceu em dois momentos por ligação telefônica: o primeiro momento (M1) foi iniciado em junho de 2020, e o segundo, (M2) em dezembro de 2020. Os relatórios evolutivos elaborados pelos professores regentes foram recebidos em janeiro de 2021. Resultados Foi observada uma implicação negativa na mudança de rotina e um impacto na vida dos pais. Na percepção dos pais, questões significativas e negativas também estiveram presentes na saúde mental das crianças, como por exemplo, mudanças na rotina. Os relatórios de avaliação dos professores mostraram um padrão similar, com a grande maioria deles sem informação sobre o desempenho da aprendizagem. Conclusão: Este estudo apontou a importância de acompanhar escolares e famílias em período de distanciamento social, para que possa orientar e intervir juntamente com pais e professores