ABSTRACT BACKGROUND AND OBJECTIVES: Home-based exercises can improve function and quality of life in shoulder pain patients. Knowing the facilitators and barriers is crucial for adherence to shoulder pain treatment. It is believed that individuals who adhere to home exercises have fewer environmental barriers, pain intensity and shoulder disability. The aim of this study is to identify facilitators and barriers for adherence to a home-based exercise program in shoulder pain individuals, and to investigate the influence of environmental barriers, shoulder pain and disability, and kinesiophobia on adherence to a program. METHODS: This is a cross-sectional study. Shoulder pain individuals performed home-based exercises for eight weeks based on a booklet in addition to supervised physical therapy or as their sole therapy. They reported the perceived facilitators and barriers to home exercises adherence and answered the Craig Hospital Inventory of Environmental Factors (CHIEF), Shoulder Pain and Disability Index (SPADI), and the Tampa Scale for Kinesiophobia (TSK) questionnaires. Logistic regression models analyzed the scores of the CHIEF, SPADI, and TSK as predictors of adherence. RESULTS: Fifty individuals participated in this study and 88% adhered to the program. The most frequent facilitator and barrier were “having guidance from a professional,” and “lack of available time,” respectively. Pain and disability were the only predictor of adherence (p=0.044), and an increase of one point in SPADI reduced the likelihood of adherence to home exercises by 14% (Exp(B) =0.86). CONCLUSION: Individuals reported facilitators and barriers to the exercise program. Environmental barriers assessed using the CHIEF and kinesiophobia were not predictors of adherence. OBJECTIVES Homebased Home patients treatment homebased METHODS crosssectional cross sectional , (CHIEF) (SPADI) (TSK questionnaires RESULTS 88 having professional, professional lack time, time respectively p=0.044, p0044 p p=0.044 0 044 (p=0.044) 14 ExpB Exp B (Exp(B =0.86. 086 =0.86 . 86 =0.86) CONCLUSION (CHIEF (SPADI 8 p004 p=0.04 04 (p=0.044 1 08 =0.8 p00 p=0.0 (p=0.04 =0. p0 p=0. (p=0.0 =0 p=0 (p=0. = p= (p=0 (p= (p

RESUMO JUSTIFICATIVA E OBJETIVOS: Os exercícios domiciliares podem melhorar a função e a qualidade de vida de pacientes com dor no ombro. Conhecer facilitadores e barreiras é fundamental para adesão ao tratamento da dor no ombro. Acredita-se que indivíduos que aderem aos exercícios domiciliares apresentem poucas barreiras ambientais, baixa intensidade de dor e incapacidade do ombro. O objetivo deste estudo foi identificar facilitadores e barreiras para a adesão a um programa de exercícios domiciliares em indivíduos com dor no ombro e investigar a influência de barreiras ambientais, da dor e incapacidade no ombro, e da cinesiofobia na adesão ao programa. MÉTODOS: Neste estudo transversal, indivíduos com dor no ombro realizaram exercícios domiciliares por oito semanas com base em uma cartilha além da fisioterapia supervisionada ou como sua única terapia. Os indivíduos relataram facilitadores e barreiras percebidos para a adesão aos exercícios em casa e responderam ao Craig Hospital Inventory of Environmental Factors-Brasil (CHIEF-Br), Shoulder Pain and Disability Index-Brasil (SPADI-Br) e Escala Tampa de Cinesiofobia (TAMPA). Os escores do CHIEF-Br, SPADI-Br e TAMPA foram analisados como preditores de adesão por meio de modelos de regressão logística. RESULTADOS: Participaram do estudo 50 indivíduos e 88% aderiram ao programa. O facilitador e a barreira mais frequentes foram “receber orientação de um profissional” e “falta de tempo disponível”, respectivamente. Dor e incapacidade foram os únicos preditores de adesão (p=0,044), e o aumento de um ponto no SPADI-Br reduziu a probabilidade de adesão aos exercícios domiciliares em 14% (Exp(B) =0,86). CONCLUSÃO: Os indivíduos relataram facilitadores e barreiras ao programa de exercícios. A barreiras ambientais avaliadas por meio do CHIEF-Br e a cinesiofobia não foram preditores da adesão. OBJETIVOS Acreditase Acredita se MÉTODOS transversal terapia FactorsBrasil Factors Brasil CHIEFBr, CHIEFBr CHIEF Br , (CHIEF-Br) IndexBrasil Index SPADIBr SPADI (SPADI-Br TAMPA. . (TAMPA) Br, logística RESULTADOS 5 88 receber profissional falta disponível, disponível disponível” respectivamente p=0,044, p0044 p p=0,044 0 044 (p=0,044) 14 ExpB Exp B (Exp(B =0,86. 086 =0,86 86 =0,86) CONCLUSÃO (CHIEF-Br (TAMPA 8 p004 p=0,04 04 (p=0,044 1 08 =0,8 p00 p=0,0 (p=0,04 =0, p0 p=0, (p=0,0 =0 p=0 (p=0, = p= (p=0 (p= (p

ABSTRACT BACKGROUND AND OBJECTIVES: Home-based exercises can improve function and quality of life in shoulder pain patients. Knowing the facilitators and barriers is crucial for adherence to shoulder pain treatment. It is believed that individuals who adhere to home exercises have fewer environmental barriers, pain intensity and shoulder disability. The aim of this study is to identify facilitators and barriers for adherence to a home-based exercise program in shoulder pain individuals, and to investigate the influence of environmental barriers, shoulder pain and disability, and kinesiophobia on adherence to a program. METHODS: This is a cross-sectional study. Shoulder pain individuals performed home-based exercises for eight weeks based on a booklet in addition to supervised physical therapy or as their sole therapy. They reported the perceived facilitators and barriers to home exercises adherence and answered the Craig Hospital Inventory of Environmental Factors (CHIEF), Shoulder Pain and Disability Index (SPADI), and the Tampa Scale for Kinesiophobia (TSK) questionnaires. Logistic regression models analyzed the scores of the CHIEF, SPADI, and TSK as predictors of adherence. RESULTS: Fifty individuals participated in this study and 88% adhered to the program. The most frequent facilitator and barrier were “having guidance from a professional,” and “lack of available time,” respectively. Pain and disability were the only predictor of adherence (p=0.044), and an increase of one point in SPADI reduced the likelihood of adherence to home exercises by 14% (Exp(B) =0.86). CONCLUSION: Individuals reported facilitators and barriers to the exercise program. Environmental barriers assessed using the CHIEF and kinesiophobia were not predictors of adherence.

RESUMO JUSTIFICATIVA E OBJETIVOS: Os exercícios domiciliares podem melhorar a função e a qualidade de vida de pacientes com dor no ombro. Conhecer facilitadores e barreiras é fundamental para adesão ao tratamento da dor no ombro. Acredita-se que indivíduos que aderem aos exercícios domiciliares apresentem poucas barreiras ambientais, baixa intensidade de dor e incapacidade do ombro. O objetivo deste estudo foi identificar facilitadores e barreiras para a adesão a um programa de exercícios domiciliares em indivíduos com dor no ombro e investigar a influência de barreiras ambientais, da dor e incapacidade no ombro, e da cinesiofobia na adesão ao programa. MÉTODOS: Neste estudo transversal, indivíduos com dor no ombro realizaram exercícios domiciliares por oito semanas com base em uma cartilha além da fisioterapia supervisionada ou como sua única terapia. Os indivíduos relataram facilitadores e barreiras percebidos para a adesão aos exercícios em casa e responderam ao Craig Hospital Inventory of Environmental Factors-Brasil (CHIEF-Br), Shoulder Pain and Disability Index-Brasil (SPADI-Br) e Escala Tampa de Cinesiofobia (TAMPA). Os escores do CHIEF-Br, SPADI-Br e TAMPA foram analisados como preditores de adesão por meio de modelos de regressão logística. RESULTADOS: Participaram do estudo 50 indivíduos e 88% aderiram ao programa. O facilitador e a barreira mais frequentes foram “receber orientação de um profissional” e “falta de tempo disponível”, respectivamente. Dor e incapacidade foram os únicos preditores de adesão (p=0,044), e o aumento de um ponto no SPADI-Br reduziu a probabilidade de adesão aos exercícios domiciliares em 14% (Exp(B) =0,86). CONCLUSÃO: Os indivíduos relataram facilitadores e barreiras ao programa de exercícios. A barreiras ambientais avaliadas por meio do CHIEF-Br e a cinesiofobia não foram preditores da adesão.

Abstract Objective: To investigate the prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life in a sample of women in the first 24 h postpartum during the hospital stay. Methods: Cross-sectional study with data from screening phase of a birth cohort. The proportion of mothers who did not intend to breastfeed exclusively for 6 months (primary outcome) derived from a negative response to the question “Would you be willing to try to breastfeed exclusively for the first 6 months?”, in an interview conducted by previously trained interviewers. Crude and adjusted prevalence ratios (PR) with 95% confidence intervals were obtained by Poisson regression with robust variance. Results: A total of 2964 postpartum women were interviewed. The overall prevalence of mothers who did not intend to breastfeed exclusively for 6 months was 17.8% (16.4–19.1%). After adjusting for maternal age and type of pregnancy (singleton or multiple), no intention to exclusively breastfeed was higher in mothers with a monthly household income < 3 minimum wages (PR, 1.64; 1.35–1.98) and in those who intended to smoke 4–7 days/week after delivery (PR, 1.42; 1.11–1.83). The presence of significant newborn morbidity (PR, 0.32; 0.19–0.54) and intention to breastfeed up to 12 months (PR, 0.46; 0.38–0.55) had a protective effect against not intending to breastfeed exclusively for 6 months. Conclusions: Approximately 1 in every 5 mothers did not intend to breastfeed exclusively for 6 months. Strategies aimed at promoting exclusive breastfeeding should focus attention on mothers from lower economic strata and smokers.

Abstract Background: Rheumatoid arthritis (RA) is a common autoimmune systemic inflammatory disease. In addition to joint involvement, RA patients frequently have other comorbidities, such as cardiovascular diseases. Drugs used for RA treatment may increase or decrease the risk of a cardiovascular event. This study aims to analyze cardiovascular risk comorbidities in patients with RA and the correlation with the use of anti-rheumatic drugs. Methods: Cross-sectional study conducted based on the real-life rheumatoid arthritis study database - REAL, a prospective observational cohort study. Associations between the use of anti-rheumatic drugs and the presence of comorbidities were represented by their prevalence ratio and evaluated using the Chi-square or Fisher’s Exact tests. Results: We assessed 1116 patients, 89.4% women, mean age of 55.15 years and predominance of seropositive disease. 63.3% had some cardiovascular comorbidity, predominantly hypertension (49.9%). The use of glucocorticoids was observed in 47.4% of patients and there was a significant tendency of lower use of these drugs in the presence of dyslipidemia (PR: 0.790; p = 0.007). We observed that the presence of cardiovascular comorbidities was associated with higher use of bDMARDs (PR:1.147; p = 0.003). Conclusions: The presence of cardiovascular risk comorbidities was confirmed to be higher in RA patients. Different treatment strategies using less glucocorticoids in the presence of dyslipidemia and more common use of bDMARDs in patients with cardiovascular comorbidities suggest that rheumatologists are aware of the potential influence of the DMARDs in the risk of cardiovascular event. Reinforcing these results, we highlight the need for a better baseline assessment to guide the choice of anti-rheumatic drugs in RA patients who have comorbidities.

OBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected from 371 patients (age<18 years) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study group comprised 66/371 (18%) laboratory-confirmed pediatric COVID-19 patients: 61 (92.5%) patients tested positive on real-time reverse transcription-polymerase chain reaction tests for SARS-CoV-2, and 5 (7.5%) patients tested positive on serological tests. MIS-C was diagnosed according to the criteria of the Center for Disease Control. RESULTS: MIS-C was diagnosed in 6/66 (9%) patients. The frequencies of diarrhea, vomiting, and/or abdominal pain (67% vs. 22%, p=0.034); pediatric SARS (67% vs. 13%, p=0.008); hypoxemia (83% vs. 23%, p=0.006); and arterial hypotension (50% vs. 3%, p=0.004) were significantly higher in patients with MIS-C than in those without MIS-C. The frequencies of C-reactive protein levels >50 mg/L (83% vs. 25%, p=0.008) and D-dimer levels >1000 ng/mL (100% vs. 40%, p=0.007) and the median D-dimer, troponin T, and ferritin levels (p<0.05) were significantly higher in patients with MIS-C. The frequencies of pediatric intensive care unit admission (100% vs. 60%, p=0.003), mechanical ventilation (83% vs. 7%, p<0.001), vasoactive agent use (83% vs. 3%, p<0.001), shock (83% vs. 5%, p<0.001), cardiac abnormalities (100% vs. 2%, p<0.001), and death (67% vs. 3%, p<0.001) were also significantly higher in patients with MIS-C. Similarly, the frequencies of oxygen therapy (100% vs. 33%, p=0.003), intravenous immunoglobulin therapy (67% vs. 2%, p<0.001), aspirin therapy (50% vs. 0%, p<0.001), and current acute renal replacement therapy (50% vs. 2%, p=0.002) were also significantly higher in patients with MIS-C. Logistic regression analysis showed that the presence of MIS-C was significantly associated with gastrointestinal manifestations [odds ratio (OR)=10.98; 95%CI (95% confidence interval)=1.20-100.86; p=0.034] and hypoxemia [OR=16.85; 95%CI=1.34-211.80; p=0.029]. Further univariate analysis showed a positive association between MIS-C and death [OR=58.00; 95%CI=6.39-526.79; p<0.0001]. CONCLUSIONS: Pediatric patients with laboratory-confirmed COVID-19 with MIS-C had a severe clinical spectrum with a high mortality rate. Our study emphasizes the importance of investigating MIS-C in pediatric patients with COVID-19 presenting with gastrointestinal involvement and hypoxemia.

<title>Resumo</title><p>O exame ultrassonográfico é um meio de diagnóstico preciso para avaliação da gestação, além de ser totalmente inócuo para fêmea e fetos. Objetivou-se com este estudo determinar os valores de referência para a ecobiometria gestacional em cadelas de diferentes raças. Foram utilizadas 25 fêmeas multíparas, sendo cinco cadelas Bulldog inglês, cinco Pugs e 15 Shih Tzu, pesando de 4 a 25 kg e com idade entre 4 a 6 anos. As avaliações ecobiométricas como diâmetro da vesícula gestacional, comprimento femoral, espessura da placenta, diâmetro parietal, diâmetro e área abdominal, hepática e cardíaca foram realizadas durante as 2ª, 5ª, 6ª, 7ª e 8ª semanas gestacionais das cadelas. O estudo ecobiométrico em cadelas gestantes foi precocemente iniciado a partir da segunda semana gestacional. Mensurações pouco estudadas como o diâmetro e área hepática e valores ecobiométricos do coração fetal, podem fornecer informações úteis para a detecção precoce de anomalias congênitas que podem comprometer a viabilidade gestacional. Os resultados significativos (P < 0.001), obtidos para a biometria do diâmetro parietal (r² = 81%) e abdominal (r²= 86%), área abdominal (r² = 80%), comprimento do fêmur (r² = 84%), comprimento (r² = 79%), largura (r² = 79%), área (r² = 82%) e volume (r² = 72%) cardíaco e área hepática (r² = 71%) em conceptos braquiocefálicos, podem ajudar a avaliação do desenvolvimento dos fetos, complementando a ultrassonografia gestacional de cadelas e como modelo para o estudo em outras raças de cães e espécies animais.</p>

<title>Abstract</title><p>Ultrasonography is an accurate pregnancy diagnostic method, besides being completely innocuous for female and fetuses evaluation. The objective of this paper was to determine the reference values for gestational echo biometry of different breeds of bitches. A total of 25 multiparous females were included in the experiment, five English Bulldog bitches, five Pugs and 15 Shih Tzu, weighing 4-25 kg and aged 4-6 years. The echo biometric assessments were performed during the 2nd, 5th, 6th, 7th and 8th weeks of pregnancy, including gestational vesicle diameter, femur length, placenta thickness, parietal diameter, liver, heart and abdominal diameter and area. Early echo biometric study started at the second week of gestation. Measurements like fetal heart and liver diameter and area are still poorly studied, but can provide useful information for early detection of congenital anomalies that may reduce the viability of pregnancy. The significant results (P < 0.001) obtained for biometrics (P < 0.001) of the parietal (r² = 81%) and abdominal diameter (r² = 86%), abdominal area (r² = 80%), femur length (r² = 84%), cardiac length (r² = 79%), width (r² = 79%), area (r² = 82%) and volume (r²= 72%) and liver area (r² = 71%) in brachycephalic conceptus may help to assess the development of fetuses, complementing the conventional gestational ultrasound of bitches and become a model for the study in other breeds of dogs and alternative animal species.</p>

The aim of this ethnographic study was to understand the meanings of social support according to a group of people submitted to coronary artery bypass graft surgery. Semi structured interview and direct observations were the techniques used for data collection, which took place at the participants' homes and during outpatient return appointments. Data were collected between April/2010 and April/2011, involving eleven individuals, mostly married, between 49 and 73 years of age. The main reported source of support came from relatives. Religious support was another type mentioned, considered fundamental when making decisions about the surgery. The meaning of support was related to direct help from relatives, concerning instrumental (accomplishment of domestic and self-care activities) as well as emotional and religious help (focus on coping with the disease and surgery and explanations for the disease and surgery as a moment of threat and rupture).

Estudio etnográfico con objeto de comprender los significados de apoyo social según un grupo de personas sometidas a la revascularización miocárdica. Las técnicas usadas en la recolecta de datos fueron la entrevista semi estructurada y observaciones directas, llevadas a cabo en la residencia de los participantes y durante el regreso ambulatorio. Los datos fueron recolectados entre abril/2010 y abril/2011, con once individuos, la mayoría casada, con edad entre 49 y 73 años. La principal fuente de apoyo reportada fue de los familiares. Otro tipo de apoyo mencionado fue el religioso, considerado fundamental en el momento de toma de decisión sobre la cirugía. El significado del apoyo fue relacionado al auxilio directo de los familiares, tanto instrumental (realización de actividades domésticas y de autocuidado) como emocional y religioso (focalización en el enfrentamiento de la enfermedad y cirugía y explicaciones para la enfermedad y cirugía como un momento de amenaza y ruptura).

Estudo etnográfico com objetivo de compreender os significados de apoio social segundo um grupo de pessoas submetidas a revascularização do miocárdio. As técnicas empregadas na coleta de dados foram entrevista semiestruturada e observações diretas, realizadas na residência dos participantes e durante o retorno ambulatorial. Os dados foram coletados no período de abril/2010 a abril/2011, com onze indivíduos, a maioria casada, com idade entre 49 e 73 anos. A principal fonte de apoio reportada foi os familiares. Outro tipo de apoio mencionado foi o religioso, considerado fundamental no momento de tomada de decisão sobre a cirurgia. O significado do apoio foi relacionado ao auxílio direto dos familiares, tanto instrumental (realização de atividades domésticas e de autocuidado) quanto emocional e religioso (focalização no enfrentamento da doençae da cirurgia e nas explicações para a enfermidade e cirurgia, um momento de ameaça e ruptura).

Estudo etnográfico com objetivo de compreender os significados de apoio social segundo um grupo de pessoas submetidas a revascularização do miocárdio. As técnicas empregadas na coleta de dados foram entrevista semiestruturada e observações diretas, realizadas na residência dos participantes e durante o retorno ambulatorial. Os dados foram coletados no período de abril/2010 a abril/2011, com onze indivíduos, a maioria casada, com idade entre 49 e 73 anos. A principal fonte de apoio reportada foi os familiares. Outro tipo de apoio mencionado foi o religioso, considerado fundamental no momento de tomada de decisão sobre a cirurgia. O significado do apoio foi relacionado ao auxílio direto dos familiares, tanto instrumental (realização de atividades domésticas e de autocuidado) quanto emocional e religioso (focalização no enfrentamento da doençae da cirurgia e nas explicações para a enfermidade e cirurgia, um momento de ameaça e ruptura).

The aim of this ethnographic study was to understand the meanings of social support according to a group of people submitted to coronary artery bypass graft surgery. Semi structured interview and direct observations were the techniques used for data collection, which took place at the participants' homes and during outpatient return appointments. Data were collected between April/2010 and April/2011, involving eleven individuals, mostly married, between 49 and 73 years of age. The main reported source of support came from relatives. Religious support was another type mentioned, considered fundamental when making decisions about the surgery. The meaning of support was related to direct help from relatives, concerning instrumental (accomplishment of domestic and self-care activities) as well as emotional and religious help (focus on coping with the disease and surgery and explanations for the disease and surgery as a moment of threat and rupture).

Estudio etnográfico con objeto de comprender los significados de apoyo social según un grupo de personas sometidas a la revascularización miocárdica. Las técnicas usadas en la recolecta de datos fueron la entrevista semi estructurada y observaciones directas, llevadas a cabo en la residencia de los participantes y durante el regreso ambulatorio. Los datos fueron recolectados entre abril/2010 y abril/2011, con once individuos, la mayoría casada, con edad entre 49 y 73 años. La principal fuente de apoyo reportada fue de los familiares. Otro tipo de apoyo mencionado fue el religioso, considerado fundamental en el momento de toma de decisión sobre la cirugía. El significado del apoyo fue relacionado al auxilio directo de los familiares, tanto instrumental (realización de actividades domésticas y de autocuidado) como emocional y religioso (focalización en el enfrentamiento de la enfermedad y cirugía y explicaciones para la enfermedad y cirugía como un momento de amenaza y ruptura).

AIMS: The aims of the study were to describe the epidemiology of home injuries (HI) among Italian students' mothers and to identify the possible predictors of having HI. METHODS: An anonymous questionnaire was used in several Italian schools. In order to identify predictors of having HI, a multivariate analysis was performed. RESULTS: In our sample (3,610 women), the prevalence of HI was 18%; 6.2% of the interviewed had a severe HI. The multivariate analyses showed that increasing age, to spend more than 13 hours a day at home and to be housewife are risk factors for having HI. CONCLUSIONS: This study reports a high prevalence of HI, highlighting an urgent need for undertaking interventions to develop an adequate culture of safety and prevention.

A reação de NaBH4 com RuCl3 dissolvido no líquido iônico 1-n-butil-3-metilimidazólio hexafluorfosfato (BMI.PF6) é um método simples e reprodutível para a síntese de nanopartículas de RuO2 estáveis com distribuição estreita e diâmetro da partícula entre 2-3 nm. As nanopartículas de RuO2 foram caracterizadas por XRD, XPS, EDS e TEM. Estas nanopartículas mostraram alta atividade catalítica tanto na catálise heterogênea quanto na hidrogenação bifásica líquido-líquido de olefinas e arenos sob condições moderadas de reação. Experimentos de envenenamento com Hg(0) e CS2, e análises de XRD e TEM de partículas isoladas após a catálise indicaram a formação de nanopartículas de Ru(0). As nanopartículas podem ser reutilizadas em condições de catálise heterogênea até 10 vezes na hidrogenação de 1-hexeno rendendo um número total de ciclos catalíticos de 175.000 para átomos de Ru expostos.

The reaction of NaBH4 with RuCl3 dissolved in 1-n-butyl-3-methylimidazolium hexafluorophosphate (BMI.PF6) ionic liquid is a simple and reproducible method for the synthesis of stable RuO2 nanoparticles with a narrow size distribution within 2-3 nm. RuO2 nanoparticles were characterized by XRD, XPS, EDS and TEM. These nanoparticles showed high catalytic activity either in the solventless or liquid-liquid biphasic hydrogenation of olefins and arenes under mild reaction conditions. Hg(0) and CS2 poisoning experiments and XRD and TEM analysis of particles isolated after catalysis indicated the formation of Ru(0) nanoparticles. The nanoparticles could be re-used in solventless conditions up to 10 times in the hydrogenation of 1-hexene yielding a total turnover number for exposed Ru atoms of 175,000.