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Introdução:A conjuntura socioeconômica e cultural da mulher negra a coloca em tripla vulnerabilidade, que se explica pelo fato de que ela é vítima do racismo, do preconceito de classe e da discriminação de gênero, e essa interação de diferentes tipos de opressão é explicada pela teoria da interseccionalidade. Esse negligenciamento precariza-se ainda mais quando se reporta para a atenção àsaúde. Objetivo:Compreender como o contexto social da interseccionalidade de raça, classe e gênero refletem no atendimento obstétrico em Saúde Pública de mulheres negras residentes em comunidade quilombola. Metodologia:Trata-se de pesquisa qualitativa de caráter descritivo-exploratório, realizada com duas mulheres negras residentes em comunidade quilombola, localizada em município no interior do estado do Ceará. Como instrumento para coleta de dados, utilizou-se a entrevista semiestruturada, sendo os dados submetidos à análise do discurso. Resultados:Os sujeitos desta investigação conseguem, a partir de situações do quotidiano vivenciadas nos serviços de saúde públicos, identificar exemplos de racismo e/ou preconceito relacionados ao fato de serem mulheres negras e pobres. Assim, a vulnerabilidade interseccional (raça ­gênero ­classe social) implica em desigualdades no acesso aos serviços de saúde, o que se materializa em violência obstétrica, negligência em relação ao direito da mulher negra sobre o próprio corpo, além de negação da sua subjetividade, o que viola os pressupostos do Sistema Único de Saúde (SUS), particularmente os princípios da universalidade, equidade e integralidade da assistência. Conclusões:Constata-se, portanto, que as iniquidades quanto ao atendimento obstétrico, que afetam majoritariamente as mulheres negras e pobres, apresentam-se como problemática de gestão, denotando o déficit na efetivação de políticas públicas de saúde, ou a sua ausência. Há também a necessidade de que os profissionais de saúde, a partir de educação continuada, tenham um olhar mais holístico, a fim de produzir um atendimento equânime e integral (AU).

Introduction:Black women's socioeconomic and cultural conjuncture puts them into a three-fold vulnerability, which is explained by the fact that they are victims of racism, class prejudice and gender discrimination, and this interaction of different types of oppression is explained by the theory of intersectionality. Such negligence is even more precarious when it comes to healthcare. Objective:To understand how the social context of the intersectionality of race, class and gender reflects on the obstetric care in public healthcare provided to black women residing in quilombola communities. Methodology:This is a qualitative research work of a descriptive-exploratory nature, carried out with two black women residing in a quilombola community located in the a rural areain the state of Ceará. As a data collection instrument, we used semi-structured interviews, and the data was submitted to discourse analysis. Results:The subjects of this investigation can, from daily situations experienced in public healthcare services,identify examples of racism and/or prejudice related to the fact that they are poor black women. Therefore, intersectional vulnerability (race ­gender ­social class) leads to inequalities in the access to healthcare services, which materializes as obstetric violence, negligence to black women's right to their own bodies, as well as denial of their subjectivity, which violates the presuppositions of the Brazilian Unified Health System (SUS), especially the principles of universality, equity, and integrality of care. Conclusions:It is therefore verified that the inequities of obstetric care, which mostly affect poor black women, present themselves as a management problem, denoting the deficit in the application of public healthcare policies, or their absence. There is also a need for healthcare providers, through continued education, to have a more holistic view in order to provide more equanimous and integral healthcare (AU).

Introducción:La coyuntura socioeconómica y cultural de la mujer negra la coloca en una triple vulnerabilidad, que se explica por el hecho de que es víctima del racismo, del prejuicio de clase y de la discriminación de género, y esa interacción de diferentes tipos de opresión es explicada por la teoría dela interseccionalidad. Esta negligencia se precariza mucho más cuando se trata de la atención médica. Objetivo:Comprender cómo el contexto social de la interseccionalidad de raza, clase y género se refleja en la atención obstétrica en la Salud Pública de mujeres negras que viven en una comunidad quilombola. Metodología:Investigación cualitativa de carácter descriptivo-exploratorio, realizada con dos mujeres negras residentes en comunidad quilombola, Ceará, Brazil. Para la recolección de datos, se utilizaron entrevistas semiestructuradas y los datos fueron sometidos a análisis del discurso. Resultados:Los sujetos son capaces, a partir de situaciones vividas en los servicios públicos de salud, de identificar ejemplos de racismo y/o prejuicios por el hecho de ser mujeres negras y pobres. Así, la vulnerabilidad interseccional (raza ­género ­clase social) implica en desigualdades en el acceso a los servicios de salud, que se materializan en violencia obstétrica, negligencia en relación a los derechos de las mujeres negras sobre sus propios cuerpos, además de la negación de su subjetividad, que viola los supuestos del Sistema Único de Salud, en particular los principios de universalidad, equidad e integralidad de la atención. Conclusiones: Se puede observar que las inequidades en la atención obstétrica, que afectanmayormente a mujeres negras y pobres, se presentan como un problema de gestión, denotando el déficit en la implementación de políticas públicas de salud, o su ausencia. También es necesario que los profesionales de la salud, basados en la educación continua, tengan una visión más holística, para producir una atención equitativa e integral (AU).

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Os sentidos atribuídos ao corpo estão comumente relacionados a sua limitação de nascer, viver e morrer. À vista disso, essas concepções atravessam todos os ciclos geracionais do indivíduo, desde antes do nascimento, na simbiose do binômio mãe-filho, até a morte. Sendo assim, há uma limitação da compreensão corporal na sua totalidade e a perpetuação da desinformação. Nesse sentido, o estudo tem como objetivo assimilar as percepções acerca da imagem corporal no decorrer dos ciclos de vida. Sendo adotada a abordagem qualitativa de um estudo comparativo e narrativo de casos múltiplos, constitui-se como cenário da pesquisa, uma unidade básica de saúde do município de Aracati/ CE, situado no litoral leste. A população foi estratificada em quatro grupos: infância, adolescência, adultos e velhice. Seguidamente, elencou-se a amostra pela escolha de dois indivíduos, masculino e feminino, de cada estrato etário. A aplicação das quatro oficinas ocorreu entre setembro e novembro de 2021, baseadas nas dinâmicas de sensibilidade e criatividade do método criativo sensível, alicerçado nas ideias de educação problematizadora de Paulo Freire. Já a análise foi realizada através da técnica de Análise do Discurso de Pêcheux. No decorrer desse estudo, percebeu-se que o corpo sofre representações mutáveis de signos e símbolos durante as gerações. Durante toda a pesquisa, a identificação da imagem corporal transitou nas experiências recentes e armazenadas de cada indivíduo. Sendo assim, a contribuição desta investigação para a atuação do profissional de saúde refere-se ao fato de que a comunicação é fundamental na relação entre profissional e cliente.

The meanings attributed to the body are commonly related to its limitation of being born, living and dying. Given this, these conceptions cross all the individual's generational cycles, from before birth, in the symbiosis of the mother-child binomial, until death. Therefore, there is a limitation of bodily understanding in its entirety and the perpetuation of misinformation. In this sense, the study aims to assimilate perceptions about body image throughout life cycles. The qualitative approach of a comparative and narrative study of multiple cases was adopted, the research setting was a basic health unit in the municipality of Aracati/CE, located on the east coast. The population was stratified into four groups: childhood, adolescence, adulthood and old age. Next, the sample was selected by choosing two individuals, a male and a female, from each age group. The implementation of the four workshops took place between September and November 2021, based on the dynamics of sensitivity and creativity of the sensitive creative method, based on the ideas of problematizing education by Paulo Freire. The analysis was carried out using the Pêcheux Discourse Analysis technique. During this study, it was noticed that the body undergoes changing representations of signs and symbols over the generations. Throughout the research, the identification of body image was reflected in the recent and stored experiences of each individual. Therefore, the contribution of this investigation to the performance of health professionals refers to the fact that communication is fundamental in the relationship between professional and client.

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OBJECTIVE: To describe 4 subgroups of pediatric patients treated with splenectomy, hydroxychloroquine, azathioprine, or rituximab as the first-option, second-line treatment for chronic immune thrombocytopenia. STUDY DESIGN: Selection of patients with chronic immune thrombocytopenia from the French national prospective cohort of pediatric autoimmune cytopenia OBS'CEREVANCE and VIGICAIRE study, treated by splenectomy, hydroxychloroquine, azathioprine, or rituximab as a first second-line treatment. RESULTS: For 137 patients, treated between 1989 and 2016, the median follow-up after diagnosis and after treatment initiation was 8.5 (2.8-26.4) years and 4.7 (1.1-25.1) years, respectively. Median age at diagnosis and at initiation of treatment were 9 (0.7; 16) and 12 (2; 18.1) years, respectively without significant difference between subgroups. For the whole cohort, 24-month event-free survival was 62% (95% CI 55; 71). It was 85% (95% CI 77; 95) for the 56 patients treated with splenectomy, 60% (95% CI 44; 84) for the 23 patients treated with rituximab, 46% (95% CI 30; 71) for the 24 patients treated with azathioprine, and 37% (95% CI 24; 59) for the 34 patients treated with hydroxychloroquine (log-rank P < .0001). For the splenectomy subgroup, being older than 10 years at splenectomy tended to improve event-free survival (P = .05). Female teenagers with antinuclear antibody positivity benefited from hydroxychloroquine therapy. CONCLUSIONS: This national study, limiting pitfalls in the analysis of the effects of second-line therapies, showed that splenectomy remains the treatment associated with the better response at 24 months.

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The aim of this study was to determine the effects of Pilates-based mat exercises on functional autonomy and life satisfaction among elderly women. A randomized controlled trial was conducted in Caxias do Sul, Brazil in 2015, in which 61 healthy older women were randomized into two groups (experimental group, EG = 31 participants with 64.25 mean years of age, SD = 0.14, and a control group, CG = 30 participants, 63.75 mean years of age; SD = 0.08). The EG participants performed the mat Pilates twice per week, 60-min per session. The same measurements were performed at baseline and after 16 weeks. No significant differences were found between groups at baseline (p > 0.05). In the EG, the following factors were increased after the 16-weeks training period: flexibility of lower limbs, flexibility of upper limbs, strength in lower and upper limbs, aerobic endurance and dynamic balance. This study revealed significant improvements on the life satisfaction scale's score for the EG when compared to the CG, after 16 weeks of intervention. No differences were found between baseline and after 16 weeks on the functional autonomy and life satisfaction scores for the CG. According to the results of this study, it was found that functional autonomy and life satisfaction for elderly women was improved after exposure to 16 weeks of the PM, suggesting this practice helps with healthy aging.

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This study had the following aims: (i) to translate the Spiritual Health and Life-Orientation Measure (SHALOM) into Brazilian Portuguese and adapt it to ensure the semantic/conceptual equivalence and content validity of the Brazilian version and (ii) to analyse the psychometric properties-reliability, convergent validity, discriminant validity and factorial validity-of the lived experience component, also called the Spiritual Well-Being Questionnaire (SWBQ), in a calibration sample and in a validation sample of Brazilian adults. The calibration sample comprised 436 subjects, 159 men and 277 women, aged between 18 and 79 years (mean age = 32.20 years; SD = 11.46); the validation study sample comprised 388 subjects, 253 women and 135 men, aged between 18 and 59 years (mean age = 30.59 years; SD = 9.44). All subjects completed a sociodemographic questionnaire, the Brazilian SWBQ and the Psychological Well-being Scale (PWBS). The results provide evidence of the reliability and factorial validity of an oblique four-factor model of a reduced 17-item version but revealed some problems with the convergent validity of the communal and personal factors (average variance extracted < .50). Nonetheless, these results provide evidence that the Brazilian version of the lived experience component of SHALOM (or SWBQb) has good psychometric properties and is a valid method of evaluating the spiritual health of Brazilian adults. Further research is required to establish the convergent and discriminant validity of this reduced version.

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Abstract This study had the following aims: (i) to translate the Spiritual Health and Life-Orientation Measure (SHALOM) into Brazilian Portuguese and adapt it to ensure the semantic/conceptual equivalence and content validity of the Brazilian version and (ii) to analyse the psychometric properties—reliability, convergent validity, discriminant validity and factorial validity—of the lived experience component, also called the Spiritual Well-Being Questionnaire (SWBQ), in a calibration sample and in a validation sample of Brazilian adults. The calibration sample comprised 436 subjects, 159 men and 277 women, aged between 18 and 79 years (mean age = 32.20 years; SD = 11.46); the validation study sample comprised 388 subjects, 253 women and 135 men, aged between 18 and 59 years (mean age = 30.59 years; SD = 9.44). All subjects completed a sociodemographic questionnaire, the Brazilian SWBQ and the Psychological Well-being Scale (PWBS). The results provide evidence of the reliability and factorial validity of an oblique four-factor model of a reduced 17-item version but revealed some problems with the convergent validity of the communal and personal factors (average variance extracted < .50). Nonetheless, these results provide evidence that the Brazilian version of the lived experience component of SHALOM (or SWBQb) has good psychometric properties and is a valid method of evaluating the spiritual health of Brazilian adults. Further research is required to establish the convergent and discriminant validity of this reduced version.

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Resumo O estudo teve por objetivo analisar o efeito da adição do equivalente energético do lactato sanguíneo com a medida de VO2 durante a corrida em esteira horizontal (0%) e inclinada (10,5%), como forma de estimativa do custo energético da corrida. Treze corredores de meia e longa distância (idade 28,1 ± 4,2 anos; estatura 1,75 ± 0,07 m; massa corporal 65,2 ± 4,9 kg; VO2max 70,3 ± 4,9 ml·kg-1·min-1) cumpriram dois testes em esteira rolante (0% e 10,5%) que incluíram vários estágios em intensidade constante. Foram calculadas para cada atleta as regressões VO2-velocidade, bem como regressões alternativas com a adição de um equivalente energético de 3 ml O2 Eq·kg-1·mM [La-] às medições de VO2. Não se verificou interação significativa entre a adição do equivalente do lactato e a inclinação da esteira. A ANOVA indicou um efeito significativo da adição do equivalente do lactato na inclinação da reta de regressão e na estimativa do custo energético. Os tamanhos do efeito obtidos indicam que este efeito é mais forte na corrida horizontal. Estes resultados sugerem que em testes laboratoriais com corredores treinados se deverá considerar a adição dos valores de VO2 com os equivalentes energéticos do lactato.(AU)

Abstract This study aimed to analyze the influence of adding blood lactate ([La-]) energy equivalent (Eq) to the VO2 measurements during running exercise at different grades (0% and 10.5%) in order to estimate energy cost of running. Thirteen male highly-trained middle- and long-distance runners (age 28.1 ± 4.2 years; stature 1.75 ± 0.07 m; body mass 65.2 ± 4.9 kg; and maximal oxygen uptake 70.3 ± 4.9 ml·kg-1·min-1) volunteered after medical approval and performed two treadmill tests (0% and 10.5% grade) which included several bouts at a constant speed. Individual VO2-speed regressions were determined for each subject and alternative regressions were established by adding an energy equivalent of 3 ml O2 Eq·kg-1·mM [La-] to the mean VO2 values. No significant interaction between [La-] O2 equivalent inclusion and grade running was found. Results of within-subjects ANOVAs indicated a significant effect of [La-] inclusion in the regression slope and in the estimated energy cost of running at both level and grade running. However, the obtained effect sizes suggest that this effect is considerably higher at level compared with grade running. These findings indicate that the inclusion of [La-] measurements in VO2-intensity regression estimates at sub maximal running should be considered when testing highly trained runners on the treadmill.(AU)

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Este estudo tem como objetivos proceder à tradução e adaptação transcultural (equivalência semântica/conceitual e validade de conteúdo) do Test of Performance Strategies (TOPS), assim como, verificar as suas propriedades psicométricas (confiabilidade e validade fatorial) em atletas brasileiros. A amostra foi constituída por 413 atletas (295 homens e 118 mulheres) com idades compreendidas entre os 16 e 69 anos (M = 25,87, DP = 7,82). As propriedades psicométricas foram avaliadas através do alpha de Cronbach e da análise factorial confirmatória (AFC). Na análise da confiabilidade dos fatores, foram obtidos valores entre 0,41 e 0,82. Os resultados das AFC dos modelos multidimensionais revelaram índices de adequação insatisfatórios tanto para a situação de treino (GFI = 0,832; CFI = 0,761 e RMSEA = 0,058), como de competição (GFI = 0,855; CFI = 0,843 e RMSEA = 0,054). Quando analisadas as dimensões individualmente, verificaram-se problemas de validade fatorial (GFI e CFI < 0,90; RMSEA > 0,06) em quatro dos dezesseis fatores (ativação em situação de treino e ativação, controle emocional e pensamentos negativos em situação de competição). Em conclusão, os resultados providenciam evidências relativamente às propriedades psicométricas do TOPS em atletas brasileiros, sugerindo-se, contudo, precaução na interpretação dos escores de certas dimensões.

This study aimed to provide the translation and cultural adaptation (semantic/conceptual equivalence and content validity) of the Test of Performance Strategies (TOPS) as well as to investigate its psychometric properties (reliability and factorial validity) in Brazilian athletes. The sample consisted of 413 athletes (295 men and 118 women) aged between 16 and 69 years (M = 25.87, SD = 7.82). The psychometric properties were assessed by means of reliability (Cronbach's alpha) and confirmatory factor analysis (CFA). The internal consistency of the factors ranged between .41 and .82. The results of the CFA of the multidimensional models showed unsatisfactory levels of adequacy for both training (GFI = .832, CFI = .761 and RMSEA = .058) and competition situations (GFI = .855, CFI = .843 and RMSEA = .054). At the individual level subscale, four of the sixteen subscales showed unacceptable fit (GFI and CFI < .90; RMSEA > .06) (training activation and activation, emotional control and negative thinking in competition situations). In conclusion, the results provide evidence of support for the psychometric properties of the TOPS in Brazilian athletes, although some caution is warranted particularly regarding the interpretation of some scales' scores.

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Este estudo tem como objetivos proceder à tradução e adaptação transcultural (equivalência semântica/conceitual e validade de conteúdo) do Test of Performance Strategies (TOPS), assim como, verificar as suas propriedades psicométricas (confiabilidade e validade fatorial) em atletas brasileiros. A amostra foi constituída por 413 atletas (295 homens e 118 mulheres) com idades compreendidas entre os 16 e 69 anos (M = 25,87, DP = 7,82). As propriedades psicométricas foram avaliadas através do alpha de Cronbach e da análise factorial confirmatória (AFC). Na análise da confiabilidade dos fatores, foram obtidos valores entre 0,41 e 0,82. Os resultados das AFC dos modelos multidimensionais revelaram índices de adequação insatisfatórios tanto para a situação de treino (GFI = 0,832; CFI = 0,761 e RMSEA = 0,058), como de competição (GFI = 0,855; CFI = 0,843 e RMSEA = 0,054). Quando analisadas as dimensões individualmente, verificaram-se problemas de validade fatorial (GFI e CFI < 0,90; RMSEA > 0,06) em quatro dos dezesseis fatores (ativação em situação de treino e ativação, controle emocional e pensamentos negativos em situação de competição). Em conclusão, os resultados providenciam evidências relativamente às propriedades psicométricas do TOPS em atletas brasileiros, sugerindo-se, contudo, precaução na interpretação dos escores de certas dimensões.(AU)

This study aimed to provide the translation and cultural adaptation (semantic/conceptual equivalence and content validity) of the Test of Performance Strategies (TOPS) as well as to investigate its psychometric properties (reliability and factorial validity) in Brazilian athletes. The sample consisted of 413 athletes (295 men and 118 women) aged between 16 and 69 years (M = 25.87, SD = 7.82). The psychometric properties were assessed by means of reliability (Cronbach's alpha) and confirmatory factor analysis (CFA). The internal consistency of the factors ranged between .41 and .82. The results of the CFA of the multidimensional models showed unsatisfactory levels of adequacy for both training (GFI = .832, CFI = .761 and RMSEA = .058) and competition situations (GFI = .855, CFI = .843 and RMSEA = .054). At the individual level subscale, four of the sixteen subscales showed unacceptable fit (GFI and CFI < .90; RMSEA > .06) (training activation and activation, emotional control and negative thinking in competition situations). In conclusion, the results provide evidence of support for the psychometric properties of the TOPS in Brazilian athletes, although some caution is warranted particularly regarding the interpretation of some scales' scores.(AU)

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