RESUMO O presente estudo teve por objetivo investigar a presença dos fármacos Cafeína, Genfibrozila, Bezafibrato, Metformina, Prometazina e Loratadina em manancial superficial e em água para consumo. Para determinar a ocorrência desses fármacos, foram realizadas seis campanhas amostrais durante o período chuvoso e seis durante o período seco, em três pontos de coleta localizados no Complexo Bolonha, cidade de Belém, região Norte do Brasil: reservatório Bolonha (captação) e estação de tratamento de água Bolonha (câmara de água filtrada e reservatório de água tratada). Para a avaliação das remoções dos fármacos nas etapas de filtração e desinfecção (com gás cloro) foram calculadas as eficiências de cada um desses processos e foi avaliada a remoção ao fim do tratamento. Como esperado, a água bruta apresentou maiores concentrações de fármacos do que a água tratada. As concentrações dos reguladores lipídicos Bezafibrato e Genfibrozila variaram de 11,4 a 1364,9 ng·L-1 na água bruta e de 15,7 a 435,9 ng·L-1 na água tratada. Já o antialérgico Loratadina foi o fármaco com maior frequência de ocorrência, e sua concentração variou de 15,7 a 45,0 ng·L-1 na água bruta e de 15,2 a 24,3 ng·L-1 na água tratada. Os resultados indicam a influência antrópica que o reservatório e a estação de tratamento de água vêm sofrendo e mostram que o tratamento de ciclo completo utilizado na estação de tratamento de água Bolonha não foi eficiente para a remoção completa dos compostos de preocupação emergente investigados. As remoções médias anuais foram de 5% para Genfibrozila, 26% para Loratadina e 52% para Bezafibrato, sendo a cloração particularmente importante para a remoção de Genfibrozila e Cafeína.

ABSTRACT The present study aimed to investigate the occurrence of the drugs Caffeine, Gemfibrozil, Bezafibrate, Metformin, Promethazine, and Loratadine in water supply and water for human consumption. To determine the occurrence of drugs, six sampling campaigns were carried out during the rainy season and six during the dry season, at three collection points located in the Bolonha Complex, Belém city, Northern Brazil: Bolonha reservoir (catchment) and Bolonha filtered water chamber and treated water reservoir. To evaluate the removal of drugs in the filtration and disinfection stages, the efficiencies of each of these processes were calculated, in addition to the removal evaluation at the end of the treatment. The raw water was the one with the highest concentrations of drugs, while the treated water had lower concentrations. The concentrations of lipid regulators Bezafibrate and Gemfibrozil ranged from 11.4 to 1,364.9 ng·L-1 in raw water and from 15.7 to 435.9 ng·L-1 in treated water. The antiallergic Loratadine was the drug with the highest frequency of occurrence whose concentration ranged from 15.7 to 45.0 ng·L-1 in raw water and from 15.2 to 24.3 ng·L-1 in treated water. The results indicate the anthropic influence that the reservoir and the filtered water chamber and treated water reservoir have been suffering and show that the full cycle treatment used in Bolonha filtered water chamber and treated water reservoir was not efficient for the complete removal of the compounds of emerging concern investigated. The average annual removals were, respectively, 5% for Gemfibrozil, 26% for Loratadine, and 52% for Bezafibrate. The chlorination step seemed to be particularly important for the removal of Gemfibrozil and Caffeine.

ABSTRACT BACKGROUND: Low back pain (LBP) has emerging as an epidemic, multifactorial and multidimensional condition in older age. Assessment of attitudes and beliefs of patients with back pain is necessary for understanding the impact of psychosocial factors on pain perception and management. OBJECTIVES: To cross-culturally adapt and examine the validity and reproducibility (intra and interrater reliability and agreement) of the Back Beliefs Questionnaire (BBQ) in older Brazilians with acute LBP. DESIGN AND SETTING: Cross-sectional methodological report conducted at the Department of Physical Therapy of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. METHODS: The present study was conducted for translating, adapting, and examining the psychometric properties of a questionnaire. Participants aged ≥ 60 years experiencing an acute episode of LBP were recruited. Coefficients of internal consistency, reliability and agreement were obtained using Cronbach’s α, intraclass correlations, and standard error of measurement and the smallest detectable change, respectively. RESULTS: Twenty-six participants aged between 60-84 years and reporting a mean of 9.8 (4.3) years of schooling completed the study. The Brazilian Portuguese-language version of the BBQ (BBQ-Brazil) was proposed and presented with adequate conceptual, semantic, operational, and measurement equivalence from the original version. Intra and interrater evaluations showed moderate (0.74) and excellent (0.91) intraclass correlation coefficients, respectively, with small standard error of measurement for both evaluations. Internal consistency was considered adequate (0.70). CONCLUSION: BBQ-Brazil had consistent measurements of validity and reproducibility, and proved to be a valuable tool in clinical practice for addressing attitudes and beliefs of older patients with acute LBP.

Abstract The incorporation of citizens in the public sphere emerged as a democratic innovation, which gave rise to several institutions, in different environments. Several democratic systems in the world have begun to develop institutional spaces for citizen participation. Although different, Participatory Institutions (PIs) have become a reality in several countries and have brought the promise of a democracy with greater distributive capacity. In Brazil, the process was institutionalized in the three levels of the federation and in several thematic areas. Despite the diversity of approaches in participatory research, empirical research on its effects is scarce. The objective of this paper is to present and discuss the architecture of social participation in Brazil, pointing out the gaps in relations established with traditional institutions of democracy.

Resumo A incorporação de cidadãos na esfera pública emergiu como uma inovação democrática, que fez surgir diversas instituições, nas mais diferentes realidades. Vários sistemas democráticos no mundo começaram a desenvolver espaços institucionais para a participação de cidadãos. Embora diferentes, as Instituições Participativas (IPs) tornaram-se uma realidade em diversos países e trouxeram a promessa da democracia com maior capacidade distributiva. No Brasil, o processo foi institucionalizado nos três níveis da federação e em várias áreas temáticas. Apesar da diversidade de enfoques nas investigações sobre a participação, a pesquisa empírica sobre os seus efeitos ainda é escassa. O objetivo deste trabalho é apresentar e discutir a arquitetura de participação social no Brasil, apontando lacunas nas relações estabelecidas com as instituições tradicionais da democracia.

ABSTRACT Background The attitudes and beliefs that older people have about acute low back pain (LBP) may influence the coping mechanisms and the adoption of treatment strategies in this population. Objective The aim of this study was to identify the factors associated with the attitudes and beliefs of elderly patients with acute low back pain using the Back Beliefs Questionnaire. Method This is a cross-sectional study with a subsample of the study “Back Complaints in the Elders” (BACE), composed of 532 older Brazilians of both genders with acute LBP. We investigated sociodemographic and clinical aspects, self-perceived health, psychosocial and emotional state, falls, and functional capacity. Multiple regression models were constructed to measure possible associations. Results The percentage of female participants was 85.7% and the mean age was 69.04 (SD=6.2). Disability, symptoms of depression, and expectation of return to activities were independently associated with attitudes and beliefs concerning LBP. Conclusion Screening of psychosocial factors is essential to the prevention of persistent and recurrent LBP. Early signs of these factors can help identify symptoms and behaviors for effective interventions.

CONTEXTUALIZAÇÃO: Fatores relacionados a quedas em idosos com diferentes níveis de atividade física, por meio de uma abordagem multidimensional, não têm sido amplamente investigados. OBJETIVO: Explorar os fatores relacionados a quedas em idosos com diferentes níveis de atividade física. MÉTODOS: Estudo transversal exploratório com 118 pacientes idosos ambulatoriais. Participantes que relataram ao menos uma queda nos últimos 12 meses foram considerados caidores. O nível de atividade física foi avaliado por meio do Perfil de Atividade Humana (PAH). O ponto de corte de 54 pontos foi usado para definir o grupo menos ativo e o grupo mais ativo. Um questionário multidimensional e uma bateria de testes físico-funcionais foram utilizados. RESULTADOS: A prevalência de quedas foi menor no grupo de idosos mais ativos (47,4%) quando comparada à dos idosos menos ativos (71,4%) (p<0,013). A análise de regressão logística multivariada identificou que, no grupo mais ativo, ter caído estava associado a sintomas depressivos (OR=0,747, IC95%=0,575-0,970; p=0,029), preocupação em cair (OR=1,17, IC95%=1,072-1,290; p=0,001) e velocidade de marcha autosselecionada (OR=0,030, IC95%=0,004-0,244; p=0,001). Para o grupo menos ativo, o modelo foi composto de idade (OR=1,197, IC95%=1,032-1,387; p=0,017) e incapacidade funcional (OR=14,447, IC95%=1,435-145,45; p=0,023). CONCLUSÃO: Para os idosos mais ativos, a redução na autoeficácia pode sugerir que cair desencadeia alguns comportamentos protetores, tais como lentidão na marcha e sintomas depressivos, mas a relação causal entre quedas e esses desfechos devem ser mais investigados. Esses dados enfatizam que os fisioterapeutas devem ficar atentos ao fato de que há diferenças nos fatores relacionados a quedas, dependendo do nível de atividade física dos pacientes idosos, e isso deve ser considerado ao se planejarem intervenções para tal população.

BACKGROUND: Fall-related factors in older adults with different levels of physical activity, within a multidimensional approach, have not been widely investigated. OBJECTIVE: To explore fall-related factors among older adults with different physical activity levels. METHODS: A cross-sectional, exploratory study with 118 older adult outpatients. Participants who reported at least one fall in the previous 12 months were considered fallers. The activity level was assessed through the Human Activity Profile. A cutoff of 54 points was used to define the less active group and the more active group. A multidimensional questionnaire and a set of physical functioning tests were applied. RESULTS: Fall prevalence was lower among the more active older adults (47.4%) when compared with the less active older adults (71.4%) (p<0.013). Logistic regression analysis showed that, among the more active group, falls were associated with: depressive symptoms (OR=0.747, 95%CI=0.575-0.970; p=0.029), concern about falling (OR=1.17, 95%CI=1.072-1.290; p=0.001), and self-selected walking speed (OR=0.030, 95%CI=0.004-0.244; p=0.001). For the less active group, the model was composed of age (OR=1.197, 95%CI=1.032-1.387; p=0.017) and functional disability (OR=14.447, 95%CI=1.435-145.45; p=0.023). CONCLUSION: For the more active older adults, reduced self-efficacy suggests that falling can trigger some protective behavior, such as slower gait and depressive symptoms, but the casual link between falls and these outcomes should be further investigated. These data emphasize that physical therapists should be aware that there are differences in fall-related factors depending on the older patients' physical activity level, and this must be considered when planning interventions for this population.