Abstract Considering the reduced Brazilian participation in the world production of organic food and its potential in the traditional farming, we used cross-section data (based on organic producers, registered in January/2022) to analyses which local characteristics would explain the number of organic producers in Brazilian’s municipalities. The OLS, Poisson and Negative Binomial estimators, including “zero inflated” and endogeneity corrections (via instruments), were considered. It was found that organic producers would rather be in cities that are near from state capital, which are populous, rich, with a stable climate, slightly rainy, mild temperatures, better education, predominantly rural population, whose rural producers are between 25-55 years old, and which have organic producers in the neighborhood. Furthermore, they prefer places with more rural properties between 5-50 hectares, with their own irrigation, family-labor activity and that usually avoid pesticides. Alternatively, cities with strong agricultural production and high public expenditures in this area, whose properties have their own storage systems and receive more technical assistance, would be neglected. Finally, it was found a substitution relationship between traditional and organic foods and a more favorable environment to this segment in South and Northeast regions, with an indicative of barrier to organic’s entry in the Midwest.

Resumo Dada a reduzida participação brasileira na produção mundial de alimentos orgânicos e seu potencial no ramo alimentício, avaliou-se, via dados cross-section (baseados nos produtores orgânicos, cadastrados em janeiro/2022), quais características locais explicariam o número de empreendimentos orgânicos nos municípios brasileiros. Para tanto, consideraram-se os estimadores de MQO, Poisson e Binomial Negativo, inclusive “zero inflated”, com correções (via instrumentos) para variável endógena. Verificou-se que os produtores orgânicos seriam atraídos para os municípios mais próximos à capital estadual, populosos, ricos, de clima estável, levemente chuvosos, de temperatura amena, com melhor educação, população predominantemente rural, cujos produtores rurais têm entre 25-55 anos e que possuem produtores orgânicos na vizinhança. Ademais, eles parecem preferir locais com mais propriedades rurais entre 5-50 hectares, com irrigação própria, mão-de-obra familiar e que evitam agrotóxicos. Alternativamente, cidades com forte produção agropecuária, elevados gastos públicos nesta área e em transportes, cujas propriedades possuem sistemas próprios de armazenagem e recebem mais assistência técnica, seriam preteridos. Por fim, verificou-se que os alimentos convencionais e orgânicos seriam bens substitutos, que as regiões Sul e Nordeste são mais propícias a este ramo e que o Centro-Oeste quase não possui cidades promissoras, sugerindo que os produtores (convencionais) locais impõem barreiras à entrada de orgânicos.

ABSTRACT Purpose: To investigate the antibiotic susceptibility as well as the clinical, epidemiological, and microbiological profiles of microbial keratitis. Methods: This was a longitudinal retrospective study, and we retrospectively reviewed medical and laboratory records from 2015 to 2019. Results: In total, 380 pathogens (321 bacteria and 59 fungi) were isolated from the corneas of 352 patients. Staphylococcus species (45%) were most abundant within the organisms that were isolated, followed by Pseudomonas (18.4%), fungi (15.5%), Streptococcus (7.9%), and Serratia species (3.2%). The isolated gram-positive bacteria were not resistant to amikacin or vancomycin, although 14.8% of the gram-positive isolates were resistant to ciprofloxacin (p<0.05). All the gram-negative isolates were susceptible to amikacin. Male patients represented 62.8% of the 129 cases with accessible clinical data. The mean age of the patients was 53.17 ± 21 years. The time to presentation (from onset of symptoms) was 14.9 ± 19.4 days (median: 7 days). Large ulcers (>5 mm in any dimension) were present in 49.6% (64 eyes) of the cases. The duration of treatment was 49 ± 45.9 days (median: 38 days). Direct ocular trauma was reported by 48 (37.2%) patients, and 15 patients (11.6%) reported using contact lenses. For 72 (55.8%) patients, topical treatment had been previously prescribed, and 16 (12.4%) patients reported using other classes of drugs. Hospitalizations were required for 79 (61.2%) patients, and in terms of major complications, 53 (41.1%) patients had corneal perforations. A total of 40 patients (31%) underwent tectonic penetrating keratoplasty, and 28 (21.7%) developed secondary glaucoma. A progression to endophthalmitis occurred in 8 (6.2%) patients, with 50% of those patients’ (3.1% of the total) endophthalmitis evolving to evisceration. The patients’ microbial keratitis was largely treated empirically, with 94 (72.9%) patients prescribed moxifloxacin and 56 (43.4%) prescribed ciprofloxacin before receiving their culture results. Conclusions: For the most part, our hospital treated patients with severe microbial keratitis. Despite identifying gram-positive bacteria in most of the isolates, we also frequently identified gram-negative rods and fungi. Our susceptibility results support prescribing a combination of vancomycin and amikacin as an effective empirical therapeutic regimen to treat microbial keratitis.

RESUMO Objetivo: Investigar a susceptibilidade a antibióticos, o perfil clínico, epidemiológico e microbiológico das ceratites infecciosas. Métodos: Estudo retrospectivo longitudinal. Registros médicos e laboratoriais de 2015 a 2019 foram revisados retrospectivamente. Resultados: Trezentos e oitenta patógenos (321 bactérias e 59 fungos) foram isolados das córneas de 352 pacientes. As espécies de Staphylococcus foram os microorganismos mais isolados (45%), seguidos de Pseudomonas (18,4%), fungos (15,5%), Streptococcus (7,9%) e Serratia (3,2%). Não houve resistência das bactérias Gram-positivas à amicacina ou vancomicina, enquanto 14,8% isolados Gram-positivos foram resistentes à ciprofloxacina (p<0,05). Todos os organismos Gram-negativos eram suscetíveis à amicacina. Pacientes do sexo masculino representaram 62,8% de 129 casos com dados clínicos acessíveis. A média de idade foi 53,17 ± 21 anos. O tempo até a apresentação (desde o início dos sintomas) foi de 14,9 ± 19,4 dias (mediana: 7 dias). Úlceras grandes (>5mm em qualquer extensão) representaram 49,6% (64 olhos) dos casos. A duração do tratamento foi de 49 ± 45,9 dias (mediana: 38 dias). Trauma ocular direto foi relatado por 48 (37,2%) pacientes e uso de lentes de contato por 15 (11,6%) pacientes. Foi prescrito tratamento prévio para 72 (55.8%) pacientes. Outras classes de medicamentos foram prescritas para 16 (12.4%). Setenta e nove (61,2%) pacientes tiveram que ser hospitalizados. Como complicações maiores, 53 (41,1%) pacientes apresentaram perfuração corneana, 40 pacientes (31%) foram submetidos à ceratoplastia penetrante tectônica e 28 (21,7%) desenvolveram glaucoma secundário. Oito pacientes (6,2%) evoluíram para endoftalmite. O tratamento empírico da ceratite microbiana foi amplamente empregado, com 94 (72,9%) pacientes em uso de moxifloxacina e 56 (43,4%) em uso de ciprofloxacina antes do resultado da cultura. Conclusões: Nosso hospital tratou predominantemente de pacientes com úlceras microbianas graves. Embora bactérias Gram-positivas constituíssem a maioria dos isolados, bacilos e fungos Gram-negativos também foram frequentemente identificados nas ceratites microbianas. Os resultados de suscetibilidade sugerem a combinação de vancomicina e amicacina como um regime terapêutico empírico eficaz para essa condição grave com risco de perda visual permanente.

SUMMARY OBJECTIVE: The aim of this study was to evaluate the perception of the aesthetic result of breast reconstruction surgery from the perspective of plastic surgeons compared with physicians who are not specialists in plastic surgery. METHODS: Twenty patients who underwent breast reconstruction after mastectomy had their aesthetic results evaluated by 16 plastic surgeons and 16 nonplastic physicians, yielding a total of 620 ratings (320 ratings from plastic surgeons and 320 ratings from other specialists). For all analyses, the level of rejection adopted for the null hypothesis was 5% (p-value <0.05). RESULTS: Significant differences were observed between the two groups. On average, medical professionals who specialized in plastic surgery always obtained higher scores than other physicians. However, no significant differences were found in the assessment of the aesthetic outcome of breast reconstruction according to the sex of the rating medical professional for any of the assessments considered in this study. A strong positive linear correlation between the time since training in the medical specialty of plastic surgery (r=0.750, p=0.001) and the mean aesthetic outcome score was observed in this study. CONCLUSION: Plastic surgeons assessed the aesthetic results of breast reconstruction more positively than nonplastic physicians.

RESUMO Objetivo: Investigar a susceptibilidade a antibióticos, o perfil clínico, epidemiológico e microbiológico das ceratites infecciosas. Métodos: Estudo retrospectivo longitudinal. Registros médicos e laboratoriais de 2015 a 2019 foram revisados retrospectivamente. Resultados: Trezentos e oitenta patógenos (321 bactérias e 59 fungos) foram isolados das córneas de 352 pacientes. As espécies de Staphylococcus foram os microorganismos mais isolados (45%), seguidos de Pseudomonas (18,4%), fungos (15,5%), Streptococcus (7,9%) e Serratia (3,2%). Não houve resistência das bactérias Gram-positivas à amicacina ou vancomicina, enquanto 14,8% isolados Gram-positivos foram resistentes à ciprofloxacina (p<0,05). Todos os organismos Gram-negativos eram suscetíveis à amicacina. Pacientes do sexo masculino representaram 62,8% de 129 casos com dados clínicos acessíveis. A média de idade foi 53,17 ± 21 anos. O tempo até a apresentação (desde o início dos sintomas) foi de 14,9 ± 19,4 dias (mediana: 7 dias). Úlceras grandes (>5mm em qualquer extensão) representaram 49,6% (64 olhos) dos casos. A duração do tratamento foi de 49 ± 45,9 dias (mediana: 38 dias). Trauma ocular direto foi relatado por 48 (37,2%) pacientes e uso de lentes de contato por 15 (11,6%) pacientes. Foi prescrito tratamento prévio para 72 (55.8%) pacientes. Outras classes de medicamentos foram prescritas para 16 (12.4%). Setenta e nove (61,2%) pacientes tiveram que ser hospitalizados. Como complicações maiores, 53 (41,1%) pacientes apresentaram perfuração corneana, 40 pacientes (31%) foram submetidos à ceratoplastia penetrante tectônica e 28 (21,7%) desenvolveram glaucoma secundário. Oito pacientes (6,2%) evoluíram para endoftalmite. O tratamento empírico da ceratite microbiana foi amplamente empregado, com 94 (72,9%) pacientes em uso de moxifloxacina e 56 (43,4%) em uso de ciprofloxacina antes do resultado da cultura. Conclusões: Nosso hospital tratou predominantemente de pacientes com úlceras microbianas graves. Embora bactérias Gram-positivas constituíssem a maioria dos isolados, bacilos e fungos Gram-negativos também foram frequentemente identificados nas ceratites microbianas. Os resultados de suscetibilidade sugerem a combinação de vancomicina e amicacina como um regime terapêutico empírico eficaz para essa condição grave com risco de perda visual permanente.

ABSTRACT Purpose: To investigate the antibiotic susceptibility as well as the clinical, epidemiological, and microbiological profiles of microbial keratitis. Methods: This was a longitudinal retrospective study, and we retrospectively reviewed medical and laboratory records from 2015 to 2019. Results: In total, 380 pathogens (321 bacteria and 59 fungi) were isolated from the corneas of 352 patients. Staphylococcus species (45%) were most abundant within the organisms that were isolated, followed by Pseudomonas (18.4%), fungi (15.5%), Streptococcus (7.9%), and Serratia species (3.2%). The isolated gram-positive bacteria were not resistant to amikacin or vancomycin, although 14.8% of the gram-positive isolates were resistant to ciprofloxacin (p<0.05). All the gram-negative isolates were susceptible to amikacin. Male patients represented 62.8% of the 129 cases with accessible clinical data. The mean age of the patients was 53.17 ± 21 years. The time to presentation (from onset of symptoms) was 14.9 ± 19.4 days (median: 7 days). Large ulcers (>5 mm in any dimension) were present in 49.6% (64 eyes) of the cases. The duration of treatment was 49 ± 45.9 days (median: 38 days). Direct ocular trauma was reported by 48 (37.2%) patients, and 15 patients (11.6%) reported using contact lenses. For 72 (55.8%) patients, topical treatment had been previously prescribed, and 16 (12.4%) patients reported using other classes of drugs. Hospitalizations were required for 79 (61.2%) patients, and in terms of major complications, 53 (41.1%) patients had corneal perforations. A total of 40 patients (31%) underwent tectonic penetrating keratoplasty, and 28 (21.7%) developed secondary glaucoma. A progression to endophthalmitis occurred in 8 (6.2%) patients, with 50% of those patients’ (3.1% of the total) endophthalmitis evolving to evisceration. The patients’ microbial keratitis was largely treated empirically, with 94 (72.9%) patients prescribed moxifloxacin and 56 (43.4%) prescribed ciprofloxacin before receiving their culture results. Conclusions: For the most part, our hospital treated patients with severe microbial keratitis. Despite identifying gram-positive bacteria in most of the isolates, we also frequently identified gram-negative rods and fungi. Our susceptibility results support prescribing a combination of vancomycin and amikacin as an effective empirical therapeutic regimen to treat microbial keratitis.

Resumo Objetivo Analisar as estratégias, os desafios e os enfrentamentos dos profissionais de enfermagem que trabalhavam nas emergências obstétricas no contexto da pandemia de COVID-19. Método Estudo exploratório descritivo, qualitativo, realizado com nove profissionais de enfermagem de uma emergência obstétrica de alto risco, em Fortaleza-CE. Os dados foram coletados através da técnica grupo focal, em novembro de 2021, posteriormente foram organizados em temáticas e analisados de acordo com a literatura. Resultados A partir das experiências dos participantes emergiram três temas, a saber: 1) Estratégias de enfrentamento adotadas na pandemia por COVID-19; 2) Vivências experienciadas pelos profissionais de enfermagem durante suas atividades assistenciais na pandemia; 3) Desafios e reflexos experienciados pelos profissionais de enfermagem durante as atividades assistenciais. Os profissionais relataram condições inseguras e conflituosas em que os fluxos assistenciais sofreram mudanças inesperadas e dificuldades para agilizar um cuidado com segurança e empatia às usuárias do serviço. Considerações finais e implicações para a prática Percebeu-se ainda a fragilidade emocional e psicológica dos profissionais decorrente das extensas jornadas de trabalho, das constantes modificações dos fluxos e protocolos assistenciais, sobrecarga de trabalho, equipes insuficientes ocasionadas pelo afastamento de profissionais contaminados pelo vírus e por licença médica por desenvolver depressão ou outro distúrbio psicológico.

Abstract Objective To analyze the strategies, challenges, and coping mechanisms of nursing professionals who worked in obstetric emergencies in the context of the COVID-19 pandemic. Method This was a qualitative descriptive exploratory study with nine nursing professionals who worked at a high-risk obstetric emergency service in Fortaleza, Ceará, Brazil. Data were collected using a focus group carried out in November 2021. The data were organized into themes and analyzed according to the current literature. Results Based on the experiences of the participants, three themes emerged: 1) coping mechanisms adopted in the COVID-19 pandemic; 2) challenges experienced by nursing professionals in their care activities in the pandemic; and 3) challenges and repercussions experienced by nursing professionals in care activities. The professionals reported unsafe and conflicting conditions in which care flows suffered unexpected changes and which created challenges to provide users with safe and empathetic care. Final considerations and implications for practice The professionals presented emotional and psychological fragility because of long work periods, constant changes in care flows and protocols, work overload, understaffing due to professionals infected with COVID-19 or medical leaves of absence due to depression or other psychological disorders.

Resumen Objetivo Analizar estrategias, desafíos y enfrentamientos de profesionales de enfermería que actuaron en emergencias obstétricas en el contexto de la pandemia de COVID-19. Método Estudio exploratorio, descriptivo, cualitativo, realizado con nueve profesionales de enfermería de una emergencia obstétrica de alto riesgo en Fortaleza-CE. Datos recolectados a través de la técnica de grupos focales, en noviembre/2021, posteriormente organizados en temas y analizados según la literatura. Resultados De las experiencias, emergieron tres temas: 1) Estrategias de enfrentamiento adoptadas en la pandemia de COVID-19; 2) Experiencias vividas por profesionales de enfermería durante sus actividades de cuidado en la pandemia; 3) Desafíos y reflejos experimentados por profesionales de enfermería durante las actividades de cuidado. Los profesionales relataron condiciones inseguras y conflictivas en las que los flujos de atención sufrieron cambios inesperados y dificultades para agilizar la atención con seguridad y empatía para los usuarios del servicio. Consideraciones finales e implicaciones para la práctica También se percibió la fragilidad emocional y psicológica de los profesionales, resultante de la extensa jornada laboral, constantes cambios en los flujos y protocolos de atención, sobrecarga de trabajo, equipos insuficientes por la baja de contaminados por el virus y de licencia médica por enfermedad, como depresión u otro trastorno psicológico.

RESUMO A ludoterapia de orientação humanista de Axline se baseia no pressuposto de que o jogo é a maneira natural da criança se expressar. Contudo, essa abordagem parece apresentar algumas lacunas éticas no que diz respeito à relação da criança com o Outro. Tais lacunas foram discutidas a partir do pensamento do filósofo Emmanuel Lévinas, que tratou da ética da alteridade radical. Neste sentido, este trabalho reflete como a ética levinasiana pode se manifestar não só na ludoterapia, mas também na prática clínica, por meio de uma pesquisa qualitativa com metodologia de estudo de caso. O grupo terapêutico aconteceu em 14 sessões de aproximadamente uma hora e era formado por três crianças de 5 a 7 anos. As sessões foram descritas de forma narrativa e a terapeuta escreveu, a partir delas, as suas Versões de Sentido. Ademais, foram realizadas anamneses, devolutivas, entrevistas com outros profissionais da saúde e visitas escolares. As sessões foram analisadas a partir da descrição e compreensão dos sentidos. Verificou-se que o processo grupal pareceu caminhar para uma maior abertura e proximidade entre os participantes do grupo e que a terapeuta precisou ir em direção à criança, isto é, demonstrar abertura à sua diferença. Concluiu-se que, ao entrar na brincadeira junto à criança, o psicoterapeuta não pôde apreender o mundo infantil, mas apenas cumprir com o seu dever ético e inferir que o encontro com as crianças em terapia significa descobrir a diferença pela via traumática. Ressaltou-se, além disso, a dificuldade em teorizar sobre a criança ou a infância, visto que ambas só têm sentido enquanto for fomentado o respeito à alteridade.

ABSTRACT Axline's humanistic-oriented Play Therapy assumes that play is a child's natural way of expressing herself. However, this approach seems to present some ethical gaps when thought concerning the relationship with others. Such gaps were discussed based on Emmanuel Lévinas' thoughts, a philosopher who wrote about radical otherness ethics. In this sense, it was necessary to reflect on how Levinasian ethics can be manifested in Play Therapy, including clinical practice. The research was qualitative, with a case study methodology. The therapeutic group took place in 14 sessions and consisted of three children, aged 5 to 7, with a one-hour meeting. The sessions were described narratively, and the Sense's Version of the therapist was written. Anamnesis, feedback, interviews with other health professionals and school visits were also conducted. The sessions were analyzed based on the description and understanding of meanings. It was found that the group process seemed to move towards greater openness and proximity among the participants and that the therapist needed to move towards the children, opening up to their differences. It was concluded that, when entering the play with the child, the psychotherapist cannot apprehend the child's world but only fulfill her ethical duty and meeting herself with the children in therapy was facing the difference through a traumatic via. It is noteworthy that it is difficult to theorize about childhood, and the theory will only make sense while promoting respect to otherness.

RESUMEN La Terapia de Juego humanista de Axline se basa en la suposición de que jugar es la forma natural del niño de expresarse. Sin embargo, este enfoque parece presentar lagunas éticas con respecto a la relación del niño con los demás. Estas lagunas se discutieron a partir de los pensamientos de Emmanuel Lévinas, un filósofo que escribió sobre la ética de la alteridad radical. En este sentido, se discutió cómo la ética de Lévinas puede verse en la terapia de juegos, incluida la práctica clínica. La investigación fue cualitativa con una metodología de estudio de caso. El grupo se realizó en 14 reuniones terapéuticas de una hora de duración y estuvo formado por tres niños de 5 a 7 años. Las reuniones se describieron en forma narrativa y la terapeuta escribió, a partir de ellas, sus Versiones de Significado. Además, se realizó anamnesis, devolutivos, entrevistas con otros profesionales de la salud y visitas escolares. Las sesiones se analizaron a partir de la descripción y comprensión de los sentidos. Fue posible verificar que el proceso del grupo se dirigió hacia una mayor apertura y proximidad entre los participantes del grupo, y que la terapeuta tuvo que dirigirse hacia los niños,es decir, demostrar apertura a su diferencia. Se concluyó que, al entrar en el juego con el niño, el psicoterapeuta no puede apoderarse del mundo de los niños, sino cumplir el deber ético; y reunirse con los niños en terapia era encontrar la diferencia a través de una forma traumática. Además, se destacó la dificultad para teorizar sobre el niño o la infancia, ya que ambos solo tienen sentido si se fomenta el respeto por la alteridad.

Resumo A Ludoterapia humanista de Axline postula que as vivências terapêuticas se dão através do brincar. Este artigo buscou refletir possíveis lacunas éticas e o lugar da alteridade na relação ludoterapêutica, a partir do filósofo Emmanuel Lévinas. A alteridade em Lévinas exige sensibilidade que se afeta com a diferença e remete à escuta ética. Encontrar a criança em atendimento é lidar com uma alteridade absoluta, em uma comunicação lúdica. Conclui-se que o ludoterapeuta precisa ir em direção à criança, por vias de afetação e responsabilidade. Ademais, embora existam desencontros entre a LCC e a ética levinasiana, postula-se que há caminhos de aproximação no acolhimento oferecido e na consideração da criança enquanto pessoa, ativa em seu processo terapêutico.

Abstract Axline's Humanist Playtherapy postulates that the therapeutic experiences are given through play. This article sought to reflect possible ethical gaps and the place of alterity in the playterapeutic relationship, from the philosopher Emmanuel Lévinas. The otherness in Lévinas requires sensitivity that affects difference and refers to ethical listening. Meeting the child in session is to deal with an absolute otherness, in a ludic communication. It is concluded that the therapist must go towards the child, through affectation and responsibility. In addition, although there are disagreements between the LCC and the Levinasian ethics, it is postulated that there are ways of approach in the reception offered and in the consideration of the child as a person, active in its therapeutic process.

RESUMO Objetivo analisar, na literatura, as melhores práticas de enfermeiros acerca do manejo da Incontinência Fecal em contexto hospitalar. Método trata-se de uma revisão integrativa da literatura com busca realizada em setembro de 2021 nas bases de dados MEDLINE/PubMed, Web of Science e no banco de dados da Biblioteca Virtual em Saúde, que incluiu as bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde, Base de Dados de Enfermagem e Índice Bibliográfico Español en Ciencias de la Salud. A análise considerou os métodos descritivos e a elaboração de um corpus textual mediante o software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Resultados foram incluídos 11 estudos (e a análise destes permitiu evidenciar a prevalência do idioma inglês) publicados entre os anos de 1977 e 2021 e que apresentaram, em maior ocorrência, delineamento metodológico observacional com nível de evidência 2C. Os resultados foram agrupados em duas categorias: “Evidências de cuidados para gerenciamento da Incontinência Fecal”, tendo como maior predominância o uso dos sistemas de drenagem fecal, e “Dispositivos de apoio e prevenção de complicações”, apresentando, com maior ocorrência, os dispositivos de contenção. Conclusão identificou-se que as melhores práticas adotadas pelos enfermeiros no contexto hospitalar estão associadas ao uso de sistemas de drenagem e dispositivos de contenção do conteúdo fecal. Evidenciou-se a limitação da equipe de Enfermagem quanto ao uso de outras práticas benéficas ao paciente com Incontinência Fecal.

ABSTRACT Objective to analyze, in the literature, the nurses' best practices towards management of Fecal Incontinence in the hospital context. Method this is an integrative literature review with a search carried out in September 2021 in the MEDLINE/PubMed and Web of Science, as well as in the Biblioteca Virtual em Saúde database, which included the Literatura Latino-Americana e do Caribe em Ciências da Saúde, Base de Dados de Enfermagem and Índice Bibliográfico Español en Ciencias de la Salud databases. The analysis considered the descriptive methods and elaboration of a textual corpus in the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software program. Results a total of 11 studies were included (and their analysis allowed evidencing prevalence of the English language) published between 1977 and 2021 and which presented, in a greater proportion, an observational methodological design with level of evidence 2C. The results were grouped into two categories: “Care evidence for the management of Fecal Incontinence”, with greater predominance of the use of fecal drainage systems; and “Support devices and prevention of complications”, presenting, in a greater proportion, the containment devices. Conclusion it was identified that the best practices adopted by nurses in the hospital context are associated with the use of drainage systems and fecal content containment devices. A limitation was evidenced in the nursing team regarding use of other beneficial practices for patients with Fecal Incontinence.

RESUMEN Objetivo analizar, en la literatura, las prácticas de Enfermería recomendadas con respecto al manejo de la Incontinencia Fecal en el contexto hospitalario. Método se trata de una revisión integradora de la literatura en la que la búsqueda se realizó en septiembre de 2021 en las bases de dados MEDLINE/PubMed y Web of Science y en el banco de datos de la Biblioteca Virtual en Salud, que incluyó a las bases de datos Literatura Latino-Americana y del Caribe en Ciencias de la Salud, Base de Datos de Enfermería e Índice Bibliográfico Español en Ciencias de la Salud. En el análisis se consideraron los métodos descriptivos y la elaboración de un corpus textual por medio del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Resultados se incluyeron 11 estudios (y su análisis permitió evidenciar prevalencia del idioma inglés) publicados entre 1977 y 2021 y que, en mayor proporción, presentaron diseños metodológicos observacionales con nivel de evidencia 2C. Los resultados se agruparon en dos categorías: “Evidencias de medidas de atención para el manejo de la Incontinencia Fecal”, con mayor predominancia del empleo de sistemas de drenaje fecal, y “Dispositivos de apoyo y prevención de complicaciones”, con mayor proporción de dispositivos de contención. Conclusión se identificó que las prácticas recomendadas adoptadas por los enfermeros en el contexto hospitalario están asociadas al uso de sistemas de drenaje y dispositivos de contención del contenido fecal. Se puso en evidencia una limitación del personal de Enfermería en relación al uso de otras prácticas beneficiosas para los pacientes con Incontinencia Fecal.

Abstract INTRODUCTION: This study estimated the seroprevalence and risk factors of Chagas disease (CD) in a population of the Quixeré municipality, Ceará. METHODS: We conducted serological methods to detect the Trypanosoma cruzi infection. The other variables were evaluated by a standardized questionnaire. RESULTS: The estimated prevalence of CD was 3.7%. Male sex, age >40 years, being farmers, low education level, origin from rural areas, and being born in Quixeré were significantly associated with infection. CONCLUSION: CD persists in this rural population of Northeast Brazil. Poverty, low education, and limited information regarding CD are critical issues that need to be addressed.

BACKGROUND During routine Coronavirus disease 2019 (COVID-19) diagnosis, an unusually high viral load was detected by reverse transcription real-time polymerase chain reaction (RT-qPCR) in a nasopharyngeal swab sample collected from a patient with respiratory and neurological symptoms who rapidly succumbed to the disease. Therefore we sought to characterise the infection. OBJECTIVES We aimed to determine and characterise the etiological agent responsible for the poor outcome. METHODS Classical virological methods, such as plaque assay and plaque reduction neutralisation test combined with amplicon-based sequencing, as well as a viral metagenomic approach, were performed to characterise the etiological agents of the infection. FINDINGS Plaque assay revealed two distinct plaque phenotypes, suggesting either the presence of two severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains or a productive coinfection of two different species of virus. Amplicon-based sequencing did not support the presence of any SARS-CoV-2 genetic variants that would explain the high viral load and suggested the presence of a single SARS-CoV-2 strain. Nonetheless, the viral metagenomic analysis revealed that Coronaviridae and Herpesviridae were the predominant virus families within the sample. This finding was confirmed by a plaque reduction neutralisation test and PCR. MAIN CONCLUSIONS We characterised a productive coinfection of SARS-CoV-2 and Herpes simplex virus 1 (HSV-1) in a patient with severe symptoms that succumbed to the disease. Although we cannot establish the causal relationship between the coinfection and the severity of the clinical case, this work serves as a warning for future studies focused on the interplay between SARS-CoV-2 and HSV-1 coinfection and COVID-19 severity.

Abstract Background: The presence of nucleated red blood cells (NRBCs) and increases in mean platelet volume (MPV) and neutrophil to lymphocyte ratio (NLR) in peripheral circulation are associated with poorer prognosis in patients with acute coronary disease. Objective: We developed a scoring system for in-hospital surveillance of all-cause mortality using hematological laboratory parameters in patients with acute myocardial infarction (AMI). Methods: Patients admitted for AMI were recruited in this prospective study. Exclusion criteria were age younger than 18 years, glucocorticoid therapy, cancer or hematological diseases and readmissions. NRBCs, MPV and NLR were measured during hospitalization. The scoring system was developed in three steps: first, the magnitude of the association of clinical and laboratory parameters with in-hospital mortality was measured by odds ratio (OR), second, a multivariate logistic regression model was conducted with all variables significantly (p < 0.05) associated with the outcome, and third, a β-coefficient was estimated by multivariate logistic regression with hematological parameters with a p < 0.05. Results: A total of 466 patients (mean age were 64.2 ± 12.8 years, 61.6% male) were included in this study. A hematological scoring system ranging from 0 to 49, where higher values were associated with higher risk of in-hospital death. The best performance was registered for a cut-off value of 26 with sensitivity of 89.1% and specificity of 67.2%, positive predictive value of 26.8% (95% CI: 0.204 - 0.332) and negative predictive value of 97.9% (95% CI: 0.962 - 0.996). The area under the curve for the scoring system was 0.868 (95% CI: 0.818 - 0.918). Conclusions: Here we propose a hematological scoring system for surveillance tool during hospitalization of patients with acute myocardial infarction. Based on total blood count parameters, the instrument can evaluate inflammation and hypoxemia due to in-hospital complications and, consequently, predict in-hospital mortality.

RESUMO Objetivou-se avaliar o efeito do estresse salino e da adubação silicatada no crescimento e valor nutritivo da Brachiaria brizantha cv. MG5. O experimento foi em delineamento inteiramente casualizado, sob o esquema fatorial 4 x 5 x 3, com quatro repetições, onde os tratamentos foram quatro concentrações de cloreto de sódio (0; 20; 40 e 60 mmol L-1), com cinco concentrações de silício (0; 1; 2; 3 e 4 mmol L-1) na solução nutritiva e três épocas de corte (30; 60 e 90 dias). A concentração de 4 mmol L-1 de silício minimizou os efeitos deletérios do cloreto de sódio na rebrota. Entretanto, as aplicações dos níveis de silício não foram suficientes para atenuar os efeitos prejudiciais do cloreto de sódio no valor nutritivo e na produção de massa seca da Brachiaria brizantha cv. MG5.

ABSTRACT The aim of this study was to evaluate the effect of salt stress and silicon fertiliser on growth and nutritional value in Brachiaria brizantha ‘MG5’. The experimental design was completely randomised in a 4 x 5 x 3 factorial scheme with four replications; the treatments consisted of four concentrations of sodium chloride (0, 20, 40 and 60 mmol L-1), with five concentrations of silicon (0, 1, 2, 3 and 4 mmol L-1) in the nutrient solution, and three cutting periods (30, 60 and 90 days). The concentration of 4 mmol L-1 silicon minimised the detrimental effects of the sodium chloride on regrowth. However, the levels of silicon application were not sufficient to reduce the harmful effects of the sodium chloride on nutritional value or on dry-matter production in Brachiaria brizantha ‘MG5’.

ABSTRACT CONTEXT AND OBJECTIVE: Chronic diseases are the main cause of death among adults and are responsible for most outpatient and hospital care expenses in Brazil. The objective here was to determine the prevalence of hypertension and diabetes and to analyze the associations with risk and protection factors among adults. DESIGN AND LOCAL: Cross-sectional study in a state capital in northeastern Brazil. METHODS: Data on adults of both sexes aged ≥ 45 years who were interviewed in the Vigitel telephone survey in 2014 were analyzed. Prevalence ratios were estimated using Poisson regression, to identify associated factors. RESULTS: Among women, the prevalence of hypertension was 48.4% and of diabetes, 12.7%; among men, the prevalences were 41.9% and 13.8%, respectively. Multivariate analysis showed that for women, age group ≥ 65 years, overweight, self-assessed poor health and dyslipidemia remained associated with higher prevalence of hypertension. For men, overweight and self-assessed poor health remained associated with higher prevalence of hypertension. Regarding diabetes, in the multivariate model for women, age group 55-64 years, schooling level between zero and four years and no regular consumption of beans remained associated with higher prevalence. For men, age groups 55-64 years and ≥ 65 years and being married or in a stable partnership were associated with higher prevalence of diabetes. CONCLUSIONS: The results indicated that the prevalences of hypertension and diabetes were high and that preventable factors were associated with this situation, thus providing support for public policies aimed towards coping with this.

Resumo Este trabalho apresenta resultados de uma investigação realizada junto a estudantes universitários que cursavam 0 3° e o 4° semestre de licenciatura em matemática de duas universidades públicas do estado do Pará (Brasil). Objetivamos investigar as imagens conceituais desses sujeitos acerca da relação entre limite e continuidade de uma função, por meio de um estudo exploratório realizado em duas etapas, cujos resultados foram relacionados às pesquisas de Tall e Vinner (1981), Vinner (1991) que, por sua vez, compuseram a base da fundamentação teórica de nosso estudo. Dentre as imagens conceituais evocadas pelos sujeitos investigados, ressaltamos aquelas voltadas para a ideia de que o fato de uma função não estar definida em determinado ponto do domínio implica, necessariamente, na não existência do limite da função naquele ponto. Ou seja, de acordo com os sujeitos, a existência do limite depende da continuidade da função.

Abstract This paper presents the results of an investigation that was made with university students enrolled in the 3rd and 4th semester of graduation in mathematics at two public universities in the state of Pará (Brazil). We aimed to investigate the concept image of these subjects about the relation between limit and continuity of a function, through an exploratory study done in two stages. The results were related to the researches of Tall and Vinner (1981), Vinner (1991) that composed our theoretical framework. Among the evoked concept images, we emphasize the idea that when a function is not defined in one point of the domain implies, necessarily, in the non-existence of the limit of that function in that point. That is, according to them, the limit's existence depends on the continuity of the function.

RESUMO Objetivo Investigar o risco de suicídio nos pacientes com transtorno de ansiedade generalizada (TAG). Métodos Estudo transversal com 253 pacientes dos ambulatórios de Psiquiatria, Nefrologia e Cardiologia do Hospital Universitário da Universidade Federal de Alagoas. O instrumento utilizado foi o MINI 5.0.0 (Mini-International Neuropsychiatric Interview). Resultados Os indivíduos com TAG corresponderam a 16,6% da amostra, sendo 30,8% nos pacientes entrevistados no ambulatório de psiquiatria e 11,3% nos pacientes entrevistados nos demais ambulatórios. A maioria é do sexo feminino (83,3%), casada (53,8%), sendo a média de idade de 44 (±12,2) anos. Houve comorbidade psiquiátrica em 88,1% dos entrevistados; 54,8% possuíam duas ou mais e 33,3% tinham apenas uma. A mais prevalente foi depressão maior (53,7%), seguida de distimia (21,4%) e depressão recorrente (14,6%). O risco de suicídio foi observado em 54,8% dos indivíduos com TAG. Conclusão A prevalência de TAG foi significativamente maior que na população geral, principalmente no ambulatório de psiquiatria. A maioria dos pacientes apresentou comorbidade psiquiátrica, especialmente transtornos de humor, além de risco de suicídio. O TAG mostrou elevada correlação com transtornos de humor e significativa associação com o risco de suicídio.

ABSTRACT Objective Investigate the risk of suicide in patients with generalized anxiety disorder (GAD) Methods Cross-sectional study with 253 outpatients from the Psychiatry, Nephrology, and Cardiology units of the University Hospital of the Federal University of Alagoas. The instrument used was MINI 5.0.0 (Mini-International Neuropsychiatric Interview). Results GAD was present in 16.6% of the sample, which were 30.8% from the psychiatric unit and 11.3% in the outpatients of the other clinics. The majority were females (83.3%), married (53.8%), with a mean age of 44 (±12.2) years old. There was psychiatric comorbidity in 88.1% of the evaluated patients, of which 54.8% had two or more and 33.3% had only one. Major depression was the most prevalent (53.7%), followed by dysthymia (21.4%) and recurrent depression (14.6%). The risk of suicide was observed in 54.8% of subjects with GAD. Conclusion The prevalence of GAD in outpatient clinical samples was significantly higher than in the general population, mainly in the psychiatric clinic. The majority of the patients presented psychiatric comorbidity, especially mood disorders besides presenting risk of suicide. GAD showed high correlation with mood disorders and significant association with risk of suicide.