RESUMO

AIM: This scoping review aimed to identify and appraise the effectiveness and impact of breastfeeding promotion interventions conducted across Portuguese-speaking sovereign countries. METHODS: Using the PRISMA-ScR guidelines, we searched 14 electronic databases for publications published through 31 July 2023. The search terms were designed to find studies promoting breastfeeding or exclusive breastfeeding in pre-defined Portuguese-speaking countries. RESULTS: Of the 5263 papers initially retrieved, 30 interventional studies on breastfeeding met the inclusion criteria across three countries: Brazil (N = 26), Portugal (N = 2) and Guinea Bissau (N = 2). Participants ranged from pregnant women, mothers, mother-infant pairs, healthcare professionals, and school children. Overall, the interventions increased exclusive breastfeeding and better breastfeeding practices, such as a higher duration of breastfeeding. The interventions positively affected maternal breastfeeding self-efficacy, knowledge and perception. Only four studies used a theoretical framework. CONCLUSION: While the results were often statistically significant, no study had an outcome close to the recommended UNICEF and WHO goal of 70% breastfeeding at six months. The need to determine what works for the recommended six months postpartum period is critical for maximising children's health in Portuguese-speaking countries.

Assuntos

RESUMO

Introducción: El Régimen Subsidiado (RS) del sistema de salud colombiano tiene problemáticas estructurales que no han sido solucionadas y son pocos los estudios que profundizan en la explicación de estas. Objetivo: Explorar la experiencia en la dirección estratégica y gestión operativa y financiera de este régimen, sus aspectos operativos y de gestión del riesgo en esta población, así como las diferencias percibidas frente al Régimen Contributivo. Metodología: Estudio cualitativo. Se utilizó el análisis del discurso desde la perspectiva sociohermenéutica como técnica analítica. Se entrevistaron diez participantes, entre directivos de aseguradoras del RS y gestores del sistema de salud. Las entrevistas fueron grabadas y anonimizadas, previo consentimiento informado. Resultados: Emergen tres patrones discursivos que explican la gestión del riesgo en el RS y su diferenciación con el contributivo. Estos patrones se conectan por medio del rol de los determinantes sociales de la salud como ordenador principal de los procesos de salud-enfermedad y de atención en este régimen. A su vez, estas condiciones de vida son las que determinan de manera importante el perfil epidemiológico, acceso, costo de la atención y en general la forma cómo se consumen los servicios de salud por la población afiliada. Discusión: La literatura del aseguramiento en salud reporta que la gestión del riesgo es una función central y supone un ejercicio estratégico para el adecuado manejo de la siniestralidad para optimizar el uso de la Unidad de Pago por Capitación (UPC) asignada. Los hallazgos muestran que los determinantes sociales de la salud no están siendo tenidos en cuenta como ordenador para la atención, por lo tanto, la gestión del riesgo se centra en la atención de patologías en estados avanzados. Conclusiones: los actores perciben que en general, la situación de salud de los afiliados en este régimen es más grave, más complicada y con mayor carga, lo cual genera una tensión en materia de suficiencia de la unidad per cápita. Existe una ausencia discursiva sobre el rol del modelo de atención y su correlación con las necesidades de esta población.

Introduction: The subsidized regime (SR) of the Colombian health system has structural problems that have not yet been resolved and there is a lack of studies that allow the understanding of most of them. The aim of this study was to explore with stakeholders of the subsidized regime the experience about strategic, financial, and health risk management and the differences perceived with the contributory regime. Methods: A qualitative study was performed; the analytic technique used was the discourse analysis under socio-hermeneutic perspective. 10 participants were interviewed, among them directors of insurance companies of SR and health care system managers. The interviews were recorded, prior informed consent, and analyzed according to the discourse analysis. Finding: Three discursive patterns emerged that explain risk management in SR and its differentiation from contributory regime. These patterns are connected through the role of the social determinants of health as the main axis that explain the health-disease and care processes in this regimen. At the same time, these living conditions are what determine the epidemiological profile, access, cost of care and, in general, the way in which health services are consumed by the affiliated population. Discussion: The health insurance literature reports that risk management is a central function, and it is a strategic exercise for the proper management of claims to optimize the use of resources, however, the findings show that the social determinants of health are not being taken into account as a key element for healthcare organization, therefore, risk management focuses on care for pathologies in advanced stages. Conclusions: The actors perceive that the health situation in this regime is more severe, more complicated and with a greater burden disease, which generates a tension in terms of sufficiency of the Per Capita Unit. There is a discursive absence on the role of the care model and its correlation with the needs of this population.

RESUMO

Resumen Introducción: La ansiedad ante los exámenes (AE) es común entre universitarios e implica manifestaciones cognitivas, motoras y fisiológicas de tensión y preocupación permanente ante la evaluación que puede afectar su desempeño académico. Objetivo: Evaluar si el engagement, la inteligencia emocional y los factores asociados con la realización de pruebas académicas predicen las manifestaciones de AE en una muestra de 400 estudiantes universitarios. Método: Mediante un diseño predictivo transversal se evaluó el engagement (Vigor, Dedicación, Absorción), la inteligencia emocional (Atención, Claridad, Reparación) y diversos factores relacionados con pruebas académicas, analizando su relación con las manifestaciones de AE, y se construyeron modelos de regresión categórica para definir el nivel predictivo de las variables. Resultados: Se descartó la relación entre engagement y AE (p>0,05) mientras que Claridad y Reparación se asociaron inversamente con las manifestaciones de AE, excepto las fisiológicas. Diferentes factores asociados con la realización de exámenes como control docente, temor a la evaluación y tipo de preguntas predicen las respuestas de ansiedad fisiológica (R2=0,10, p<0,01), motora (R2=0,09, p<0,01) y cognitiva (R2=0,12, p<0,01). La Claridad predice negativamente la ansiedad motora (β=-0,131, p<0,01). Conclusiones: Engagement académico y AE se registran como variables independientes una de la otra, entre tanto, la Claridad emocional regula débilmente la ansiedad motora. Factores cognitivos y situacionales al momento de realizar exámenes son relevantes en el desencadenamiento de la respuesta ansiosa.

Abstract Introduction: Test Anxiety (TA) is common among university students and involves cognitive, motor, and physiological manifestations of tension and permanent concern about exams that may affect their academic performance. Objective: Assess whether engagement, emotional intelligence and factors associated with academic test solving predict the manifestations of TA in a sample of 400 university students. Method: Using a cross-sectional predictive design, engagement (Vigor, Dedication, Absorption), emotional intelligence (Attention, Clarity, Repair) and several factors related to academic test solving were evaluated, analyzing their relationship with the manifestations of TA, and categorical regression models were constructed to define the predictive level of the variables. Results: The relationship between engagement and TA was discarded (p>0,05) while Clarity and Repair were inversely associated with TA manifestations, except the physiological ones. Different factors associated with exams such as professor control, fear of exams and the question type predict physiological (R2=0,10, p<0,01), motor (R2=0,09, p<0,01) and cognitive (R2=0,12, p<0,01) anxiety responses. Clarity predicts motor anxiety (β=-0,131, p<0,01) negatively. Conclusions: Academic engagement and TA are registered as independent variables of each other; meanwhile, emotional Clarity regulates motor anxiety weakly. Cognitive and situational factors at the time of exams are relevant in the triggering of the anxious response.

RESUMO

Objetivo: investigar o conhecimento da equipe de Saúde do Trabalhador, sobre a Síndrome de Burnout. Métodos: pesquisa exploratória, qualitativa, realizada com nove trabalhadores de um hospital universitário. Aplicaram-se para a coleta de dados, um questionário e um roteiro de entrevista semiestruturado, analisados por meio da técnica de Análise de conteúdo. Resultados: emergiram-se, pelo material empírico oriundo das entrevistas, as seguintes categorias: Conhecimento sobre a Síndrome de Burnout; Sinais e sintomas do burnout; Vulnerabilidade ocupacional para o desenvolvimento de Burnout; Consequências do burnout para a saúde do trabalhador. Conclusão: é imprescindível disseminar o conhecimento sobre o burnout entre os trabalhadores, para se propor estratégias eficazes de prevenção e promoção de saúde em um hospital universitário

Objective: to evaluate the knowledge of an occupational health team about Burnout Syndrome of a university hospital. Method: exploratory research, qualitative, perfomed with nine workers. A questionnaire and a semistructured interview script were used for data collection, analyzed through the technique of Content Analysis. Results: empirical material from the interviews emerged as follows: Knowledge about Burnout Syndrome; Signs and symptoms of burnout; Occupational vulnerability for the development of Burnout; Consequences of burnout for occupational health. Conclusion: it is imperative to disseminate knowledge about burnout among workers in order to propose effective strategies for prevention and health promotion in a university hospital

Objetivo: evaluar el conocimiento del equipo de enfermería obstétrica acerca del Síndrome de Burnout. Método: Investigación exploratoria, cualitativo, realizada con nueve trabajadores de un hospital universitário. Se aplicaron para la recolección de datos, un cuestionario y un guión de entrevista semiestructurado, analizados por medio de la técnica de Análisis de contenido. Resultados: se surgieron, por el material empírico oriundo de las entrevistas, las siguientes categorías: Conocimiento sobre el síndrome de Burnout; Signos y síntomas del burnout; Vulnerabilidad ocupacional para el desarrollo de Burnout; Consecuencias del burnout para la salud del trabajador. Conclusión: es imprescindible diseminar el conocimiento sobre el burnout entre los trabajadores, para proponer estrategias eficaces de prevención y promoción de salud en un hospital universitario

Assuntos

RESUMO

RESUMEN El síndrome de Sjögren es una enfermedad autoinmune sistémica caracterizada clínicamente por ojo y boca secos, acompañados de manifestaciones extraglandulares como edema de glándulas submandibulares y parotidomegalia. La prevalencia varía en diferentes estudios epidemiológicos del 5 al 30%, dependiendo de la población estudiada. La xeroftalmia es más común en mujeres y su frecuencia incrementa con la edad. Cuando evaluamos un paciente con síndrome de Sjögren, debemos tener en cuenta diagnósticos diferenciales que pueden simular esta patología, como causas locales, sistémicas que incluyen metabólicas, infecciosas, medicamentosas, infiltrativas y malignas. Es necesario el estudio de otras causas para decidir si la terapia dirigida puede ser benéfica y evitar riesgos de eventos adversos en pacientes con síndrome sicca no autoinmune. Se realizó una revisión narrativa sobre los diagnósticos diferenciales en el espectro de paciente con síndrome seco a través de búsqueda de la literatura en las bases de datos PubMed y Google Scholar.

ABSTRACT Sjögren's syndrome is a systemic autoimmune disease clinically characterised by dry eye and mouth accompanied by extra-glandular manifestations such as oedema of the sub-mandibular glands and parotidomegaly. The prevalence of dry eye varies from 5% to 30% in different epidemiological studies, depending on the studied population. Xerophthalmia is more common in women and its frequency increases with age. When evaluating a patient with Sjogrens syndrome, differential diagnoses with disease that can simulate this pathology must be taken into account, such as local, systemic causes that include metabolic, infectious, medicinal, infiltrative, and malignancy. The study of other causes is necessary to decide whether targeted therapy can be beneficial and avoid risks of adverse events in patients with non-autoimmune sicca syndrome. A narrative review was conducted on the differential diagnoses in the spectrum of patients with 'dry syndrome' using a literature search in the PubMed and Google Scholar databases.

Assuntos

RESUMO

BACKGROUND: Low national immunization coverage (44.64%) requires strengthening the vaccination campaign to improve knowledge about HPV and its vaccine among adolescents and parents/guardians. Our aim is to evaluate factors related to knowledge about HPV, its vaccine, acceptability and divergences among Brazilian adolescents and parents/guardians. METHODS: A cross-sectional study was performed at a health unit of Sao Paulo University, Brazil, from 2015 to 2016. The convenience sample comprised 1047 individuals, including 74% (n = 776) adolescents and 26% (n = 271) parents/guardians, who answered a survey (knowledge about HPV, its vaccine, barriers and acceptability). RESULTS: The main source of information for adolescents was school (39%, n = 298); for parents/guardians, it was health professionals (55%, n = 153). Parents/guardians were 2.48 times more likely than adolescents to know that HPV caused changes in the Pap smear test [RR 2.48, 95% CI 2.03-3.01 (p < 0.001)], 1.43 times likely to be aware that HPV was a sexually transmitted infection [RR 1.43, 95% CI 1.22-1.68 (p < 0.001)], and 2.77 times likely to be informed that the HPV vaccine decreased the chance of having genital warts [RR 2.77, 95% CI 2.22-2.47 (p < 0.001)]. Girls knew more about the topic than boys (RR 1.67; 95% CI 1.10-2.60); education increased parents' knowledge [(RR 3.38; 95% CI 1.71-6.69)]. CONCLUSION: Female adolescents and parents/guardians with a higher level of education are factors related to suitable knowledge about HPV and its vaccine among Brazilian respondents. There were differences between parents/guardians and adolescents in HPV awareness, clinical implications, vaccine knowledge and vaccine acceptance.

Assuntos

RESUMO

O crack é uma potente droga ilícita que traz grave sintomatologia. A ingestão não é a forma habitual de utilização da droga, e sim pelo fumo. Quando o sistema nervoso é estimulado por essa substância ocorre vasoconstrição, aumento da pressão arterial, taquicardia e pode haver arritmias ventriculares, mas os efeitos no organismo são agravados quando ocorre a ingestão, devido a ação ionizante do suco gástrico no estômago. As consequências para o intestino podem ser de isquemia por conta da vasoconstrição e consequentemente necrose, por diminuição do fluxo sanguíneo. Esse artigo tem como objetivo relatar o caso de um cão da raça Bull Terrier com três anos de idade que ingeriu duas pedras da droga acidentalmente e foi submetido ao tratamento clínico de suporte, medicamentos adsorventes, protetores gástricos e hepáticos, associado a fármacos anticonvulsivos, promovendo o restabelecimento de sua saúde.(AU)

Crack is a powerful and illegal drug which causes a severe symptomatology. Its ingestion is not the common way of its use, which is through smoking. When the nervous system is stimulated by this substance, there are vasoconstriction, increase of arterial pressure, tachycardia and there might be ventricular arrhythmia, but the effects on the organism are worse when there is drug ingestion, because of the stomach gastric juices ionizing action. The consequences for the stomach may be ischemia caused by vasoconstriction and, later then, necrosis caused by low blood irrigation. This paper has the goal to relate the case of a three-year-old Bull Terrier, who accidently ingested two rocks of the drug and was submitted to clinical support treatment, adsorbent drugs, gastric and hepatic protective drugs, associated to antiseizures drugs, providing the dogs health improvement.(AU)

El crack es una droga ilegal de gran alcance que trae síntomas graves. La ingestión no es la forma habitual de usar el medicamento, pero a través del humo. Cuando el sistema nervioso es estimulado por la sustancia se produce vasoconstricción, aumento de la presión sanguínea, taquicardia y arritmias ventriculares, pero los efectos en el cuerpo se agravan cuando la ingesta se produce por la acción ionizante de los jugos gástricos en el estómago. El efecto sobre la isquemia intestinal puede ser debido a la vasoconstricción y de este modo necrosis, por disminución del flujo sanguíneo. Este artículo tiene como objetivo informar el caso de un perro de raza Bull Terrier con tres años de edad que ingirió dos piedras de la droga accidentalmente y fue sometido a un tratamiento doctor de apoyo, adsorbentes medicamentos, protectores gástricos y hepáticos, asociados con los fármacos anticonvulsivos, promoviendo la restauración de su salud.(AU)

Assuntos

RESUMO

O crack é uma potente droga ilícita que traz grave sintomatologia. A ingestão não é a forma habitual de utilização da droga, e sim pelo fumo. Quando o sistema nervoso é estimulado por essa substância ocorre vasoconstrição, aumento da pressão arterial, taquicardia e pode haver arritmias ventriculares, mas os efeitos no organismo são agravados quando ocorre a ingestão, devido a ação ionizante do suco gástrico no estômago. As consequências para o intestino podem ser de isquemia por conta da vasoconstrição e consequentemente necrose, por diminuição do fluxo sanguíneo. Esse artigo tem como objetivo relatar o caso de um cão da raça Bull Terrier com três anos de idade que ingeriu duas pedras da droga acidentalmente e foi submetido ao tratamento clínico de suporte, medicamentos adsorventes, protetores gástricos e hepáticos, associado a fármacos anticonvulsivos, promovendo o restabelecimento de sua saúde.

Crack is a powerful and illegal drug which causes a severe symptomatology. Its ingestion is not the common way of its use, which is through smoking. When the nervous system is stimulated by this substance, there are vasoconstriction, increase of arterial pressure, tachycardia and there might be ventricular arrhythmia, but the effects on the organism are worse when there is drug ingestion, because of the stomach gastric juice’s ionizing action. The consequences for the stomach may be ischemia caused by vasoconstriction and, later then, necrosis caused by low blood irrigation. This paper has the goal to relate the case of a three-year-old Bull Terrier, who accidently ingested two rocks of the drug and was submitted to clinical support treatment, adsorbent drugs, gastric and hepatic protective drugs, associated to antiseizure’s drugs, providing the dog’s health improvement.

El crack es una droga ilegal de gran alcance que trae síntomas graves. La ingestión no es la forma habitual de usar el medicamento, pero a través del humo. Cuando el sistema nervioso es estimulado por la sustancia se produce vasoconstricción, aumento de la presión sanguínea, taquicardia y arritmias ventriculares, pero los efectos en el cuerpo se agravan cuando la ingesta se produce por la acción ionizante de los jugos gástricos en el estómago. El efecto sobre la isquemia intestinal puede ser debido a la vasoconstricción y de este modo necrosis, por disminución del flujo sanguíneo. Este artículo tiene como objetivo informar el caso de un perro de raza Bull Terrier con tres años de edad que ingirió dos piedras de la droga accidentalmente y fue sometido a un tratamiento doctor de apoyo, adsorbentes medicamentos, protectores gástricos y hepáticos, asociados con los fármacos anticonvulsivos, promoviendo la restauración de su salud.

Assuntos

RESUMO

Las competencias en estadística responden al desarrollo de habilidades esenciales para la comprensión de la realidad y la toma de decisiones personales y profesionales. Un gran número de profesiones emplea la estadística como elemento esencial en investigación y análisis de información, pero también es común la respuesta de ansiedad ante estos contenidos. El objetivo de este estudio fue analizar las estrategias metacognitivas implicadas en procesos de ansiedad ante la estadística, así como el papel de la ansiedad ante los exámenes en este fenómeno. Se analizó una muestra de universitarios habituados al tratamiento de información cuantitativa, en ellos se observaron bajos niveles de estrategias metacognitivas para el aprendizaje y niveles moderados de ansiedad. En un modelo de regresión se identificó que la ansiedad estadística se predice débilmente por la falta de depuración y fuertemente por la ansiedad ante los exámenes

Statistics competencies respond to the development of essential skills for understanding reality and making personal and professional decisions. A lot of professions use statistics as an essential element in research and information analysis, but anxiety about statistical content is also common. The objective of this study was to analyze the metacognitive strategies involved in processes of statistics anxiety, as well as the role of test anxiety in this phenomenon. We analyzed a sample of university students accustomed to the treatment of quantitative information, in which low levels of metacognitive strategies for learning and moderate levels of anxiety were observed. In a regression model, it was identified that statistics anxiety is weakly predicted due to the lack of depuration and strongly by test anxiety

Assuntos