To verify the measurement properties of the Brazilian versions of Fear-avoidance Beliefs Questionnaire (FABQ) and Tampa Scale of Kinesiophobia (TSK) in individuals with shoulder pain.
Individuals ...with shoulder pain (>18 years) were included in this study. Structural validity was verified by exploratory factor analysis, which was used to identify dimensionality of the FABQ and TSK. Test-retest reliability was assessed with intraclass correlation coefficient(3,1) and internal consistency with Cronbach's alpha. Floor or ceiling effects were also investigated. Responsiveness was verified by effect sizes and area under the receiver operating characteristic curve (AUC).
Exploratory factor analysis identified two and one factor in the FABQ and TSK, respectively. FABQ and TSK presented moderate to good reliability and adequate internal consistency (Cronbach's alpha > 0.70). The floor effect was present in one factor of the FABQ. The FABQ and TSK showed small to moderate effect sizes and did not show adequate AUC.
FABQ and TSK are multidimensional and unidimensional instruments, respectively. Those instruments presented moderate to good reliability and the responsiveness was considered to be suboptimal in individuals with shoulder pain.
Este estudo analisa o modo como a permanência de docentes da rede pública é afetada pelo entrincheiramento nas três dimensões, de Carson, Carson e Bedeian (1995). Para tanto, buscou-se, inicialmente, ...compreender a trajetória dos docentes por meio de sua inserção na carreira, para assim investigar como os investimentos realizados pelo professor provocam a sua permanência no ofício, identificar aspectos emocionais que podem estar relacionados a essa permanência e analisar as possíveis opções de permanência na profissão docente. Esta pesquisa é caracterizada como qualitativa e descritiva, realizada mediante entrevistas semiestruturadas com 15 docentes da rede básica de ensino do Estado do Ceará, Brasil. Os resultados apontam que a inserção se deu, principalmente, por meio da familiaridade com a disciplina escolhida e do sentimento de vocação com o trabalho desenvolvido na docência, mas que muitas vezes era permeado pela facilidade do ingresso no curso de licenciatura; o investimento mais significativo que os faz manterem-se no caminho docente é a segurança proporcionada pelo fato de ocuparem um cargo público. Os aspectos emocionais positivos foram os que mais se destacaram, como a possibilidade de transformar a vida dos discentes, sobrepondo-se, inclusive, às situações negativas vivenciadas em sala de aula. Por fim, percebeu-se que os professores vislumbram várias opções de evolução profissional na docência e que, caso deixassem de lecionar, as motivações estariam relacionadas aspecto financeiro e a reformas no ensino provenientes de decisões político-educacionais.
IgA nephropathy (IgAN) is the most common primary glomerulopathy worldwide. According to the Oxford Classification, changes in the kidney vascular compartment are not related with worse outcomes. ...This paper aims to assess the impact of thrombotic microangiopathy (TMA) in the outcomes of Brazilian patients with IgAN.
Analysis of clinical data and kidney biopsy findings from patients with IgAN to assess the impact of TMA on renal outcomes.
The majority of the 118 patients included were females (54.3%); mean age of 33 years (25;43); hypertension and hematuria were observed in 67.8% and 89.8%, respectively. Median creatinine: 1.45mg/dL; eGFR: 48.8ml/min/1.73m2; 24-hour proteinuria: 2.01g; low serum C3: 12.5%. Regarding to Oxford Classification: M1: 76.3%; E1: 35.6%; S1: 70.3%; T1/T2: 38.3%; C1/C2: 28.8%. Average follow-up: 65 months. Histologic evidence of TMA were detected in 21 (17.8%) patients and those ones presented more frequently hypertension (100% vs. 61%, p <0.0001), hematuria (100% vs 87.6%, p = 0.0001), worse creatinine levels (3.8 vs. 1.38 mg/dL, p = 0.0001), eGFR (18 vs. 60 ml/min/1.73m2), p = 0.0001), low serum C3 (28.5% vs. 10.4%, p = 0.003), lower hemoglobin levels (10.6 vs. 12.7g/dL, p<0.001) and platelet counts (207,000 vs. 267,000, p = 0.001). Biopsy findings of individuals with TMA revealed only greater proportions of E1 (68% vs. 32%, p = 0.002). Individuals with TMA were followed for less time (7 vs. 65 months, p<0.0001) since they progressed more frequently to chronic kidney disease (CKD) requiring kidney replacement therapy (KRT) (71.4% vs. 21,6%, p<0.0001). Male sex, T1/T2, and TMA were independently associated with progression to CKD-KRT.
In this study patients with TMA had worse clinical manifestations and outcomes. In terms of histologic evidence, E1 distinguished patients with TMA from other patients. Further studies are necessary to analyze the impact of vascular lesions on IgAN prognosis.
O estudo objetivou investigar como ocorre a construção da identidade do policial militar a partir do estigma social, baseado na teoria de Slay e Smith (2011). Esta pesquisa foi realizada mediante ...entrevistas semiestruturadas com 14 aspirantes a oficial da Polícia Militar e analisadas por meio de análise de conteúdo. Os resultados apontam que as influências iniciais foram de familiares policiais e pelo imaginário do policial-herói. Em relação as experiências profissionais, foi possível averiguar que o curso é um momento de transformação para a superação de seus limites e da cultura da abordagem policial violenta. A redefinição do eu ocorreu por meio da mudança de postura e desenvolvimento de responsabilidades. A redefiniçao da profissão ocorreu por meio do reconhecimento da comunidade e de seus pares. Por fim, a redefinição do estigma ocorreu por meio da compreensão da origem do estigma e assimilação da missão de servir e proteger.
Background The biological maturation (BM) analyzed by peak height velocity (PHV) and bone age (BA), and lean body mass has been associated with the strength and muscle power of young athletes. ...However, the ability of BM (PHV and BA) and LM markers to predict muscle strength and power in young athletes remains uncertain. Objective The Aim was determine the predicting power of BM markers (PHV and BA) and LM in relation to muscle power of upper and lower limbs and muscle strength of upper limbs in adolescent athletes at puberty. Methods Ninety-two adolescent athletes (both sexes; age 12.4 ± 1.02 years) were assessed for body composition by dual-energy X-ray absorptiometry (DXA). Power of upper limbs (ULP), force handgrip (HG), vertical jump (VJ) and countermovement jump (CMJ) were recorded. BM was predicted by mathematical models to estimate PHV and BA. Multilayer artificial neural network analyses (MLP's) were used to determine the power of prediction of LM, PHV and BA on muscle power and strength of upper- and lower-limbs of the athletes. Results LM, BA and PHV were associated with HG (r>0.74, p0.60, p0.55, p0.53, p0.60, p<0.05) with BA and with PHV (r<0.83, p 72% of probability to predict the muscle power of upper- and lower-limbs, and the strength of the upper limbs; whereas PHV provides > 43% and bone age >64% in both female and male adolescent athletes. Conclusion We identified that, like PHV and BA, LM is a strong predictor of low cost of both upper limbs muscle strength and upper and lower limbs power in adolescent athletes.
Background
Data on the risk factors for chronic kidney disease in children with immunoglobulin A nephropathy (IgAN) are scarce. This study was aimed at investigating whether glomerular C4d ...immunostaining is a prognostic marker in pediatric IgAN.
Methods
In this retrospective cohort study, 47 patients with IgAN biopsied from 1982 to 2010 were evaluated. Immunohistochemistry for C4d was performed in all cases. For analysis, patients were grouped according to positivity or not for C4d in the mesangial area. Primary outcome was a decline in baseline estimated glomerular filtration rate (eGFR) by 50% or more.
Results
Median follow-up was 8.3 years. Median renal survival was 13.7 years and the probability of a 50% decline in eGFR was 13% over 10 years. Nine children exhibited the primary outcome and 4 developed end-stage renal disease (ESRD). Compared with C4d-negative patients (
n
= 10), C4d-positive patients (
n
= 37) presented higher baseline proteinuria (1.66 ± 0.68 vs 0.47 ± 0.19 g/day/1.73 m
2
,
p
< 0.001), a progressive decline in eGFR (−10.04 ± 19.38 vs 1.70 ± 18.51 ml/min/1.73 m
2
/year;
p
= 0.045), and more frequently achieved the primary outcome (50.0 vs 10.8%,
p
= 0.013), and ESRD (30.0 vs 2.7%,
p
= 0.026). No difference was observed in Oxford classification variables. Baseline proteinuria, endocapillary hypercellularity and mesangial C4d deposition were associated with primary outcome in univariate analysis. Proteinuria and mesangial C4d deposition at baseline independently predicted the decline in eGFR. Renal survival was significantly reduced in C4d-positive patients (8.6 vs 15.1 years in C4d-negative patients,
p
< 0.001).
Conclusions
In this exclusively pediatric cohort, positivity for C4d in the mesangial area was an independent predictor of renal function deterioration in IgAN.
Nas últimas décadas, como consequência dos esforços em reduzir o tempo de internação hospitalar, da preferência dos pacientes e familiares por receber atendimento em casa e, recentemente, da pandemia ...de COVID-19 observou-se um aumento crescente da modalidade de terapia antimicrobiana parenteral ambulatorial (OPAT).
Avaliar a densidade de incidência e consumo de antimicrobiano por OPAT após janeiro de 2020 e sua correlação com a pandemia de COVID-19. Metodologia: Estudo realizado pela Comissão de Controle de Infecção Domiciliar (CCID) do Serviço de Atenção Domiciliar (AD) de uma operadora de saúde em Belo Horizonte (BH) entre janeiro de 2020 e agosto de 2021. Foram calculados densidade de incidência de OPAT, dose diária definida (DDD) e dias de terapia (DOT) por 1000 pacientes-dia. Correlações entre número de OPAT, DDD e DOT e número de casos notificados de SG, SRAG, casos confirmados e doses de vacina distribuídas também foram realizadas.
Entre janeiro de 2020 a agosto de 2021, foram realizadas 4.784 OPAT em 2.566.502 pacientes-dia em AD. A densidade de incidência média no período foi de 1,87 OPAT por 1.000 pacientes/dia. A DDD total por 1000 pacientes-dia apresentou tendência a redução a partir de maio de 2021 quando comparada com o mesmo período de 2020, o DDD total em agosto de 2021 foi de 11,09; 26,7% menor quando comparado ao mesmo período de 2020. O DOT também apresentou queda no mesmo período, após maio de 2020 houve queda média de 16,7%, com agosto de 2021 registrando DOT de 13,49 por 1.000 pacientes-dia em atenção domiciliar, 24,9% menor do que o mesmo período de 2020. Após análises de correlação entre número de OPAT, DDD total e DOT com número de notificações de SG, notificações de SRAG, casos confirmados de COVID-19 e vacinas recebidas em BH, encontramos uma correlação moderada entre a quantidade de vacinas recebidas em BH e o DDD total e DOT entre janeiro e agosto de 2021 (r de -0,68 e -0,57, respectivamente).
A pandemia de COVID-19 impôs diversos desafios ao serviço de atenção domiciliar. A necessidade de racionalização da ocupação do leito de internação catalisou a reestruturação do serviço de OPAT e a criação de CCID. As taxas de OPAT sofreram influência de indicadores epidemiológicos locais e apresenta tendência a redução na medida que avança o controle da pandemia. Nosso estudo demonstrou que a vacinação contra COVID-19 impactou positivamente o consumo de antibióticos no serviço.
Interspecific hybridization of oil palms (E. guineensis × E. oleifera) was initially exploited to provide disease resistance and, consequently, increased oleic acid content. Besides the growing ...importance of this cultivar to the market, there is little information about this oil’s properties. In this context, this study aimed to determine a comprehensive physicochemical and thermal characterization of hybrid palm oil (HOPO) compared with the better-known African palm oil (APO). Differences in the distribution of fatty acids, carotenoids, and tocols were observed. Minor differences in density and viscosity were found between the oils, with no relevance for the materials’ processing design. Nevertheless, HOPO showed unique crystallization behavior, which potentially can affect industrial operations, such as fractionation. HOPO did not present the two thermal characteristic regions of APO, attributed to olein and stearin fractions. The HOPO demonstrated a decrease in the melting point of more than 3 °C in relation to APO, and a reduction in the crystallization point of more than 6 °C. Furthermore, besides the higher content of unsaturated fatty acids, HOPO was more stable than APO due to a higher antioxidant content. These results could be useful to establish operation conditions for processes using palm oil from hybrid oil palm.
•Doses of Pb and Pb+Fe did not interfere with the predawn leaf water potential (ΨWL) of plants.•There was a differential accumulation of Pb and Fe in the roots and leaves.•Most of Fe and Pb uptake by ...the root system predominantly accumulated in the roots and only a small fraction was translocated to the shoot.•Leaf enzymatic antioxidant metabolism was altered, mainly by flooding, in relation to Pb and Pb+Fe doses applied in soil.•Flooding and doses of Pb affected proteins related to photosynthesis, DNA, antioxidative system and carbohydrate metabolism.
Under natural conditions, plants can be affected by several types of abiotic stresses, such as flooding and the accumulation of toxic metals in the soil. Pb is a non-essential metallic element for plants and is highly toxic for living beings. Fe, as an essential micronutrient, is involved in fundamental plant processes, such as photosynthesis. The main objective of this work was to evaluate the proteomic profiles and the activity of key enzymes of leaf antioxidant metabolism in juvenile plants of the CCN 51 cacao genotype, grown in flooding soil and subjected to a dose of Pb and to different equimolar doses of Pb+Fe. Doses of Pb and Pb+Fe did not interfere with the predawn leaf water potential (ΨWL) of plants, but soil flooding was a key factor for the decline of ΨWL. There was a differential accumulation of Pb and Fe in the roots and leaves, both in flooded soil and non-flooded. Most of Fe and Pb uptake by the root system predominantly accumulated in the roots and only a small fraction was translocated to the shoot, regardless of the water content in the soil. Flooding and the variation of Pb+Fe doses in the soil did not change the transport of Pb to the plant shoot since there were no major alterations in the levels of Pb in the leaves. Leaf enzymatic antioxidant metabolism was altered, mainly by flooding, in relation to Pb or Pb+Fe doses applied in soil. The time of exposure of plants to stressor factors was important for the changes in the activity of key enzymes of the leaf antioxidant metabolism. Soil flooding, with doses of 2 mmol Pb kg−1 soil + 0.5 mmol Fe kg−1 soil, at 6 and 24 h after treatment application, had a greater influence on ΨWL, antioxidant enzymatic metabolism and leaf proteome, and affected proteins related to photosynthesis, DNA, antioxidative system and carbohydrate metabolism, whose abundance was overexpressed or repressed compared to the control.
Cactus pear is used in large proportions in diets for small ruminants in semiarid regions. However, its exclusive use is not recommended due to the low fiber and crude protein content and the high ...water and mineral content, leading to metabolic disorders, low dry matter intake, and weight loss. The use of mixed cactus silage associated with protein and fibrous sources seeks to overcome the deficits in dry matter, fiber and crude protein, aiming to improve the nutritional quality of the diets that will be offered to ruminants. Thus, the use of gliricidia hay in cactus pear silages could represent an important alternative to improve the nutritional and fermentative characteristics of the ensiled material. Therefore, our aim was to evaluate the fermentation dynamics, nutritional characteristics, and aerobic stability of mixed silages of cactus pear combined with different levels of gliricidia hay. This was a completely randomized experimental design with five treatments and five repetitions. The treatments consisted of different levels of inclusion of gliricidia hay (0, 10, 20, 30, and 40% on a dry matter basis) in the composition of mixed cactus pear silages. The inclusion of gliricidia hay in the composition of mixed silages of cactus pear resulted in a quadratic effect for dry matter recovery, pH, NH
-N, buffering capacity, aerobic stability, ether extract, P, K, Na, and Zn (
< 0.05). There was a reduction in density, effluent losses, maximum pH, mineral matter, non-fiber carbohydrates, Ca, Mg, Fe, and Mn (
< 0.05), and an increase in the time to reach maximum pH as well as an upward trend in pH, dry matter, organic matter, crude protein, neutral detergent fiber, acid detergent fiber, and B (
< 0.05). Under experimental conditions, the inclusion of gliricidia hay between 20 and 30% in cactus pear-based silage provided an improvement to the chemical composition and fermentation parameters of the silages.
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