Guava (Psidium guajava) and pitanga (Eugenia uniflora) belong to the Myrtaceae family and the essential oils extracted from their leaves have antimicrobial, antiinflammatory and antioxidant properties. These characteristics give them great potential for application in the food, cosmetics and pharmaceutical industries. However, the application of essential oils is often limited due to their volatility, low water solubility and instability under various environmental conditions. To overcome these challenges, nanoemulsions have emerged as an innovative solution, capable of improving the stability and bioavailability of essential oils. The aim of this study was to develop gel nanoemulsions of guava and pitanga essential oils and to determine the antioxidant and antimicrobial activity of the essential oils and nanoemulsions. The chemical characterization of the guava and pitanga essential oils was carried out using gas chromatography coupled with mass spectrometry, the quantification of total phenolic compounds was determined using the Folin-Ciocalteau method and the antioxidant activity using the ABTS (2,2-diphenyl-1-picrylhydrazyl) and DPPH (2,2-azinobs-3- ethylbenzthiazoline-6-sulfonic acid) methods. The nanoemulsions were prepared and characterized using analyses of droplet size, polydispersity index (PDI), zeta potential and pH. The stability of the nanoemulsions was studied for 30 days at different temperatures (4°C, 40°C and 25°C). The antimicrobial activity of the essential oils and nanoemulsions was determined using the following methodologies: agar diffusion method; determination of the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC). The tests to inhibit microbial growth over time of the essential oils and nanoemulsions were carried out against Staphylococcus aureus and Escherichia coli. The main chemical compounds in pitanga essential oil were curzerene (34.80%) and germacrene B (11.92%), while guava essential oil showed β-caryophyllene (25.92%), β-selinene (22.64%) and γ-selinene (19.13%). The pitanga and guava nanoemulsions had droplet sizes of 105.30 and 99.50 nm, PDI values of 0.32 and 0.43 and zeta potential of -9.29 and -7.34 mV, respectively. These nanoemulsions remained stable for 30 days of storage at 25 °C, with droplet sizes of 104.7 and 103.8 nm, PDI values below 0.50 and no phase separation. The pitanga nanoemulsion exhibited inhibition zones ranging from 8.41 to 15.13 mm against the bacteria S. aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii. In addition, the pitanga nanoemulsion showed the largest zones of inhibition against Candida albicans (20.97 mm) and Candida krusei (15.20 mm), along with low values of minimum inhibitory concentration (MIC) (0.54-1.22 mg/mL) and minimum bactericidal concentration (MBC) (4.84-11.02 mg/mL) against these potentially pathogenic yeasts. The guava nanoemulsion showed low MIC (1.26 mg/mL) and MBC (11.35 mg/mL) values for C. krusei. The microbial growth inhibition test over time also suggested the efficacy of the nanoemulsions against S. aureus and E. coli, highlighting their potential as a new alternative therapeutic agent.

Introduction: The main objective of clinical services provided by pharmacists is to promote the safe, effective, and rational use of medicines, contributing to improving people's health and quality of life. Despite their importance and expansion in recent decades, there is still no validated list of key performance indicators (KPIs) that include clinical, economic, and humanistic results capable of comprehensively assessing the impact of these services in the hospital environment. Objective: To define an agreed list of KPIs for monitoring the clinical, economic, and humanistic outcomes of clinical services provided by pharmacists in the hospital environment. Method: This study used a two-stage approach. First, a systematic literature review was carried out to identify KPIs proposed for the evaluation of clinical services provided by pharmacists in a hospital environment. This review served as the basis for drawing up a proposal for KPIs, which was used as the starting point for the second phase, in which a consensus study using the Delphi technique was employed. This survey involved healthcare professionals and representatives of patient associations to establish consensus on a core set of KPIs. Results: The systematic review identified 225 KPIs, of which 19 (8.4%) were structure indicators, 193 (85.8%) were process indicators, and only 13 (5.7%) were related to outcomes, highlighting a gap in the development of outcome-based metrics. Based on this trial, a proposal was drawn up for 12 outcome KPIs, seven of which were clinical, three economic, and one humanistic. The Delphi survey, carried out in three rounds, involved 49 internationally recruited stakeholders from all continents. Throughout the rounds, the stakeholders evaluated the proposed KPIs regarding relevance, and the KPIs were improved based on the stakeholders’ suggestions. New KPIs could also be suggested. The final consensus consisted of five KPIs: three clinical (“Adverse drug event rate”, “Medication-related near miss event rate”, and “Medication goal achievement rate”), one economical (“Average optimized treatment cost difference”), and one humanistic (“Patient satisfaction survey results”). Conclusion: The study found a low prevalence of outcome indicators among the KPIs described in the literature addressing the performance evaluation of clinical services provided by pharmacists in the hospital environment. This study defined a consensus of KPIs composed of clinical, economic, and humanistic outcome indicators. This core set of KPIs aims to support the management and continuous improvement of clinical services provided by clinical pharmacists in hospitals, highlighting their impact on both patient care and the performance of health services.

This doctoral thesis follows a scientific article format, adhering to the norms of both University of Brasília, and Hasselt University. The central theme of the thesis is aerobic exercise intensity prescription in cardiovascular rehabilitation (CR), addressing challenges and optimization strategies across four published articles. In the first article, we studied exercise responses at ventilatory thresholds (VTs) in individuals with cardiovascular diseases assessed during treadmill cardiopulmonary exercise test (CPET), comparing these responses to guideline-directed intensity domains. We identified inconsistencies and proposed a solution to enhance indirect intensity prescriptions by developing pioneering equations to predict heart rate (HR) at VTs using parameters obtained in exercise tests without gas exchange analysis. In the second article, we examined a multicentric CR database from eight European countries and introduced cycle-ergometer predictive equations for HR at VTs, along with an adjusted percentual for HR reserve (%HRR) prescription. We externally validated our approaches using a South American database with both ergometers, comparing performance to guideline-based exercise intensity domains and exploring ergometer interchangeability. The third article explored sex-specific responses at VTs to determine whether differences in percentages of peak effort and %HRR justify distinct prescription recommendations. The fourth paper offered an updated perspective on prescribing aerobic exercise intensity for CR, examining international guidelines, the accuracy of various approaches, and practical applicability in diverse clinical settings. The thesis’ conclusion points out that current international guidelines vary significantly in their recommendations and show notable inconsistencies with the individual thresholdbased responses. Another challenge is the high inaccuracy of the commonly used percentage of peak HR prescription method, emphasizing a significant mathematical limitation in its applicability, previously unreported. When the optimal CPET threshold-based approach is unavailable, our studies revealed that the validated HR at VTs predictive equations and the adjusted %HRR range (42–77%) are the most accurate alternatives for approximating VTs in the CR population. These methods surpass guideline-based HR approaches and demonstrate minimal ergometer-specific effects on HR at VTs estimation. Moreover, current recommended intensity prescription methods for CR populations using percentages of peak effort and %HRR may not require significant sex-based adjustments. Finally, in lower-resource settings, conducting at least a submaximal functional test is essential for assessing individual exercise responses and quantifying physical condition. Subjective methods (e.g., Borg rating of perceived exertion, talk test) should complement objective ones to refine intensity prescriptions.

The water kefir is a beverage resulting from the fermentation process of a sugary solution by the microorganisms present in kefir grains and has probiotic properties. The aim of this study was to genetically identify the microorganisms isolated from water kefir and assess their antagonistic activity, as well as analyze the physicochemical aspects of the beverage. For the beverage production, 10 % (w/v) of kefir grains were added to a solution of water and brown sugar at 5ºBrix, and fermentation occurred for 24 and 48 hours at 30°C. After the fermentation process, analyses were conducted for pH determination, acidity, sugars, and phenolic compounds. The antioxidant activity was assessed using the DPPH (2,2-diphenyl-1-picrylhydrazyl) and ABTS (2,2'-azino-bis-3-ethylbenzo-thiazoline-6-asulfonic acid) methods. For the isolation of kefir microorganisms, samples were inoculated on Yeast Malt agar (YM), All Purpose Tween agar, M17 agar, Man, Rogosa and Sharpe agar, and Hestrin-Schamm agar, and then incubated at 28°C. After 48 hours, colonies with different morphologies were isolated. For the antagonistic activity test, 5 mm agar discs containing the isolated kefir microorganisms were placed on YM agar plates previously inoculated with Acinetobacter baumannii ATCC 19606, Pseudomonas aeruginosa ATCC 9027, Enterococcus faecalis ATCC 51299, and Listeria monocytogenes ATCC 7644. After 24 hours of incubation at 37°C, the inhibition zones of bacterial growth (in millimeters in diameter) were measured. The genetic identification of microorganisms was carried out by DNA sequencing of the V3/V4 region of the 16S rRNA gene for bacteria and the ribosomal ITS1 spacer region for yeast. The water kefir fermented with brown sugar for 48 hours exhibited a pH of 3.69, 0.50 % acidity, 3.43 % total sugars, 1.40 g.L^-1 of phenolic compounds, and an antioxidant activity of 57.8 mM TEAC.100 mL^-1 by the DPPH method and 227.16 mM TEAC.100 mL^-1 by the ABTS method. Out of the 105 microorganisms isolated from kefir,63.80 % showed inhibition against A. baumannii (11.28 to 32.63 mm), 62.85 % against P. aeruginosa (10.81 to 26.87 mm),72.38 %against E. faecalis (7.57 to 29.35 mm), and 53.33 % against L. monocytogenes (10.77 to 27.93 mm). The genetic sequencing of 40 kefir microorganisms identified 65.0 % acetic acid bacteria (AAB), 17.5 % lactic acid bacteria (LAB), and 15 % yeast. The AAB consisted of the genera Gluconabacter, Acetobacter, and Komagataeibacter. LAB were identified as Lactobacillus, and the yeast were identified as Brettanomyces, Hanseniaspora, Pichia, and Saccharomyces cerevisiae.

Introduction: Post-Acute COVID-19 Syndrome (PASC) is characterized by the persistence of symptoms beyond the acute phase. Literature emphasizes the need for in-depth investigation to understand the demands in this population. The International Classification of Functioning, Disability, and Health (ICF) is a crucial tool to assess the functional impact of these sequelae, providing a comprehensive view of health components. However, ICF underuse persists due to a lack of standardization in its application. Objectives: To describe the functional profile of patients with PASC based on the ICF undergoing a cardiorespiratory rehabilitation program. To assess inter-rater agreement in linking evaluation instruments and complementary exams to ICF codes. To compare the effects before and after a cardiorespiratory rehabilitation program using ICF qualifiers. Materials and Methods: This retrospective study that used records from 52 patients undergoing rehabilitation. The study comprised three stages: 1) linking instruments and clinical measures to ICF codes by two evaluators independently; 2) Inter-rater agreement using Kappa coefficient and resolution of discrepancies between the raters; 3) Qualification of codes based on established qualification standards for each instrument or clinical measure and comparing qualifiers before and after rehabilitation. Results: The instrument with the lowest agreement was anxiety and depression (k=0.57). Forty ICF codes were linked to instruments and clinical measures. The fatigue instrument exhibited a higher degree of impairment, from severe to complete, in the linked codes. No statistically significant differences were observed in qualifiers before and after rehabilitation in codes b4552 (p=0.096), d920 (p=0.198), b1603 (p=0.251), b1264 (p=0.40), d2 (p=0.20), d163 (p=0.20), b1600 (p=0.20), b1601 (p=0.20), b1263 (p=0.14). Conclusion: Patients with PASC presents disabilities in respiratory, emotional, and aerobic functions, resulting in limitations in daily activities and restrictions in social participation. Cardiorespiratory rehabilitation shows improvements in certain aspects. Inter-rater agreement in linking instruments to the ICF suggests moderate to good agreement. Further studies are necessary to establish functional measurement as a practical indicator in healthcare services.

Obesity is characterized as a challenge for global public health and is associated with several complications for human health, such as cardiovascular diseases and diabetes. Different strategies have been highlighted in the literature for the prevention and treatment of obesity, highlighting the need for holistic approaches. In this context, educational gamification emerges as an approach that integrates playful elements and game characteristics into the learning process, aiming to engage the participant in search of more engaging learning. This study aimed to verify the effect of using gamification as a learning strategy about obesity and eating habits for nutrition students. This is a qualitative research, using the Taquette and Minayo methodology for content analysis, and quantitative for frequency analysis of the categories. A gamification educational tool was applied as a digital intervention, aiming to compare the active methodology of the teaching and learning process compared to a traditional methodology. The results show signs of improvement in learning content in both approaches (digital and traditional), with progress in students' vocabulary and greater understanding of the questions proposed about eating habits and obesity in the post-test moment. It was concluded that gamification, as an active methodology, has a positive effect as a learning strategy about obesity and eating habits for nutrition students.

Abstract Introduction: The scenario of mental illness in Brazil reinforces the urgency of funding research to address knowledge gaps and contribute to the development of new interventions. Objective: The aim of this study was to analyze the funding of mental health research carried out by the Department of Science and Technology of the Ministry of Health (DECIT/MS) and institutional partners, including analysis of the intersection with race and ethnicity, and to analyze research on depressive, anxiety, and suicide disorders from 2002 to 2022. Methodology: Data were analyzed regarding the distribution of financial resources across regions and federated units; beneficiary institutions; funding modalities; and types and themes of research. For this purpose, a quantitative, descriptive, and retrospective research was conducted on mental health research funding, according to the classification of the International Classification of Diseases (ICD-11), using data from the Health Research repository. Results: A total of 408 mental health research projects were funded with an investment of R$121.3 million and 71 research projects on depressive, anxiety, and suicide disorders with a funding value of R$21.8 million. Among the mental health research projects, 12 adopted an ethnic-racial perspective with an investment of R$1.7 million. The analysis of funding by Prais-Winster generalized linear regression showed a stationary trend for both mental health research and research on depressive, anxiety, and suicide disorders. Using the Kruskal-Wallis UNIVERSIDADE DE BRASÍLIA/Faculdade de Ceilândia Programa de Pós-Graduação em Ciências e Tecnologias em Saúde test, corrected by the Bonferroni test, it was found: a difference in resource distribution by funding modality and among regions (p<0.05). Funding by National Funding stood out (54.2% - mental health and 83.0% - depressive, anxiety, and suicide disorders). Resources were predominantly allocated to the South and Southeast regions (75.1% - mental health and 82.8% - depressive, anxiety, and suicide disorders) and to institutions in these regions (São Paulo, Minas Gerais, and Rio Grande do Sul). Regarding types of research, there was a predominance of funding for clinical research (50.1% - mental health and 70.2% - depressive, anxiety, and suicide disorders) and for population and public health research for research with an ethnic-racial focus (69.6%). The most studied research lines were related to the magnitude, dynamics, and understanding of mental health problems (47.5% - mental health; 37.5% - depressive, anxiety, and suicide disorders; and 36.7% - mental health with a focus on race and ethnicity). Conclusion: Funding for mental health research and research on depressive, anxiety, and suicide disorders show stability, are concentrated in the South-Southeast axis, and in the National Funding contracting modality. Mental health research with an intersection with race and ethnicity differs in distribution by type of research. Increasing research on mental health research funding can contribute to improving mental health care for the population, but it is necessary to reduce regional and ethnic-racial disparities. Keywords: Health research, research funding, mental health, depressive disorders, anxiety disorders, suicide, race, ethnicity

Introduction: Realistic simulation is an active methodology strategy that uses scenarios that simulate practice in a controlled environment and as close as possible to real situations¹. General objective: Build and validate a scenario to carry out a realistic, high-fidelity simulation, focusing on nursing care for patients with pain in the Post-Anesthetic Recovery Room (PACU). Methodology: This is a methodological study, with a cross-sectional design, with a quantitative approach. The project was approved by the Research Ethics Committee of the Faculty of Ceilândia – CEP/FCE (CAAE 58822422.6.0000.8093). Results: The work was developed in three phases. In the first construction and description of the scenario based on literature review and selection of experts. In the second phase, scenario validation, the experts evaluated the proposed scenario based on previously established items. Each item could receive ratings of “inadequate; reformulate; adequate, but has the possibility of revision; or appropriate”, they also made suggestions for the inclusion of references, textual clarity, functionality and relevance of the proposed item. In the validation phase, all scenario evaluation items by experts reached Content Validity Index (CVI)  ≥0.80, Proportion of Items with Agreement per Unanimity (S-CVI/U) of 85, and Average Content Validity Index of the Scale (S-CVI/Ave) of 0.98. In the third phase, the scenario was tested, allowing the identification of the fidelity of the proposal with the practical scenario and making final adjustments. At this stage, the scenario test also achieved a CVI of 80%, S-CVI/U of 85 and S-CVI/Ave of 0.97. Conclusion: The high-fidelity realistic simulation scenario treating pain in the PACU by nursing staff was validated and tested. It is expected that this can be an instrument to facilitate and implement the teaching process, and can be replicated in the area of nursing for undergraduate students and professionals trained within the scope of training.

The bioactive compounds present in propolis extracts confer antimicrobial and antioxidant properties to these products. Therefore, the aim of this study was to perform the physicochemical characterization and evaluate the antimicrobial activity of green propolis extracts from Apis mellifera and from stingless bees, including mandaçaia (Melipona quadrifasciata), jataí (Tetragonisca angustula), borá (Tetragona clavipes), and tubuna (Scaptotrigona bipunctata), produced in the Midwest and Southern regions of Brazil. For this purpose, 11 samples were obtained, comprising 9 commercial propolis extracts (green TB, A, PC, and PW, mandaçaia MM and MPC, jataí JPC, borá, and tubuna) and 2 samples of raw propolis (mandaçaia M and jataí J) which were prepared into extracts in the laboratory. Physicochemical analyses were determined by the content of dry extract, phenolic compounds, and antioxidant activity. The antibacterial activity was determined by disk diffusion assay, Minimum Inhibitory Concentration (MIC) determination, and Minimum Bactericidal Concentration (MBC). It was observed that 7 samples (63.63%) had a dry extract content above 11%, while 4 commercial samples (36.36%) had quantities below 11%, thus not complying with Brazilian legislation. All green propolis extracts showed phenolic compound values above 0.50%, complying with Brazilian legislation. Regarding the stingless bee samples, there was considerable variation in phenolic compound values (ranging from 0 to 2.66%). In Brazil, there is still no official regulation regarding minimum values of phenolic compounds and antioxidant activity for propolis extracts from stingless bees. The propolis extracts with the highest phenolic compound values also exhibited the highest antioxidant activity (green TB and borá), showing a positive correlation between the concentration of phenolic compounds and antioxidant activity. In the disk diffusion assay, the samples did not show inhibition zones against Gram-negative bacteria. For Gram-positive bacteria, 3 samples (27.27%) that were jataí (J and JPC) and tubuna did not exhibit inhibition zones, while the other 8 samples (72.73%) showed inhibition zones ranging from 19.0 to 49.0 mm. For Gram-positive bacteria, the MIC of the samples ranged from 0.001 to 0.20 mg/mL, and the MBC ranged from 0.02 to 0.50 mg/mL. The highest antimicrobial activities were obtained for green propolis extracts (TB, PW, A), and borá. The mandaçaia sample (M) also stood out for its efficient antimicrobial activity. For Gram-negative bacteria, the MIC of the propolis extracts ranged from 0.03 to 0.20 mg/mL, and the MBC ranged from 0.15 to 0.50 mg/mL. In this study, it became evident that very low levels of phenolic compounds and antioxidant activity impaired the antimicrobial activity of the propolis extracts from tubuna and jataí. Another noteworthy result was that the propolis extracts from the native bees mandaçaia (M) and borá exhibited antimicrobial activity comparable to that of green propolis extracts (TB, PW, and A), and these were the samples with the best antibacterial activities in the study.

Introduction: Heart failure (HF) is characterized by the inability of the heart to pump blood efficiently to supply tissue metabolic demands or to do so at high filling pressures. It is estimated that there are 23 million people with HF worldwide. Due to the high rates of hospitalizations and mortality, this condition is seen as a serious public health problem. Considering that one of the main causes of readmissions is poor adherence to treatment, that adherence to treatment is a multidimensional specificity and that there is a clear need for a multidisciplinary approach for these patients, we realized the need to develop an instrument to comprehensively assess adherence to treatment in patients with heart failure. Objective: To develop and validate a multidimensional scale for assessment treatment adherence in patients with heart failure. Method: A methodological study conducted at a reference cardiology hospital in the Federal District, involving 9 specialists and 36 patients. The process followed 5 stages: establishment of the conceptual framework, definition of objectives and target population; 1st stage - Construction of domains, items, and response scale; 2nd stage - Selection and organization of items, and structuring the questionnaire; 3rd stage - Content validity; 4th stage - Pre-testing; 5th stage – Post pre-test content validity. For analysis, the content validity was calculated using the agreement rate (TC > 90%) and content validity index (CVI > 0.9). Results: The instrument was developed based on literature review, clinical practices, and content validation by specialists and patients. The final scale included 32 items distributed across four dimensions, allowing for the stratification of adherence as high, medium, or low. Content validation showed a concordance rate above 90% and a content validity index of 1.0. Conclusion: This study contributes with a new instrument to identify adherence barriers and adherence to the therapeutic plan. With this scale, it is possible to promote personalized interventions, improving treatment adherence and clinical outcomes for patients with heart failure.

INTRODUCTION: The common marmoset (Callithrix jacchus) stands out as a versatile animal model for biomedical research. The genetic and physiological similarities between marmosets and humans, coupled with their ease of laboratory management, make this species ideal for exploring the effects of aging on swallowing function, a process known as presbyphagia. Unlike studies in humans, where the influence of multiple factors affects the neurobiology of aging, the use of marmosets allows for greater control of variables, enabling a more precise characterization of the physiological changes associated with healthy aging. OBJECTIVE: To describe the characteristics of masticatory and swallowing physiology in healthy captive marmosets, and to elucidate how these functions transform with age. METHODS: Twenty-five marmosets (0-19 years old) were evaluated for mastication and swallowing functions through cineradiographic recordings. The animals were divided into the following age groups: infant (0-4 months), young (>1 year), old (>10 years), and very old (>14 years). For the experimental procedure, we used a microfocal Xray source apparatus and a beryllium fast-response image intensifier. Image analysis was performed using ImageJ software. RESULTS: In our analysis of 44 recordings, encompassing 80 feeding events and 784 visible swallows, we identified significant differences in the physiology of mastication and swallowing among the age groups. Older animals demonstrated a feeding pattern characterized by larger portions, faster ingestion rates, and fewer mastications and swallows per bolus, compared to adults and young individuals. Additionally, age-related anatomical changes were described. Esophageal retention was present in all individuals. CONCLUSION: The feeding physiology of marmosets demonstrated remarkable plasticity throughout life, adapting to age-related changes in a manner similar to that observed in humans. Older animals developed compensatory strategies to maintain feeding efficiency, even in the face of age-related anatomical and functional changes. Esophageal retention, present in all individuals, suggests an intrinsic physiological characteristic of the species. Cineradiography proved to be an indispensable tool for the non-invasive and detailed evaluation of swallowing in marmosets, ensuring animal welfare. The results obtained in this study consolidate the marmoset as a promising model for investigating the aging process and the mechanisms involved in swallowing. In addition to enriching our knowledge of the species, our findings open new perspectives for understanding the natural adaptations of the organism throughout life and may have relevant implications for human health in the near future.

INTRODUCTION: Running as a hobby and component of exercise routines has become increasingly popular due to its proven positive health effects. Therefore, the number of injuries associated with this exercise method has increased. One of the most frequent injuries is medial tibial stress syndrome (MTSS). The main hypothesis of the causes for MTSS are centered in excessive muscle eccentric contraction, which could lead to periosteal traction. Considering the increased incidence of lower limb pain in these populations, our study aimed to understand the tenting effect theory on the posteromedial tibial fascia insertion through morphological leg deep posterior compartment (DPC) muscles magnetic resonance imaging (MRI) analysis and their tendons of individuals presenting MTSS. METHODS: An observational measure and blinded raters’ MRI study was conducted to determine the presence or absence of difference in the morphological aspects of the DPC muscles and tendons. An MRI descriptive muscle volume and tendons axial cross-sectional area (ACSA) measurement was conducted using PHILIPS Ingenia 3 Tesla HP (Amsterdam, NL) device. Forty individuals were separated into two groups: MTSS group and Control group. RESULTS: There was no association in gender with MTSS in our study (X2 (1) = 0.100; p = 0.752). Presence of posteromedial lower leg pain was associated with MTSS (X2 (1) = 6.465; p = 0.006). The FHL demonstrated 539.26 superior normalized volume in the MTSS group compared to Control group through the independent t-test (t (38) = 2.957; p = 0.003). CONCLUSION: The Deep compartment muscle FHL showed an increased muscle volume, which could corroborate the possible tenting effect of posteromedial tibial fascia

The pandemic of new coronavirus (COVID-19) has challenged citizens, governments, and researchers to change their habits. One strategy adopted in much of Brazil and the world was social distancing, aiming to reduce social interactions physically. However, the pandemic and the coping tools caused results beyond the biological health spectrum. Changes in habits and routines caused by the pandemic have brought about psychosocial effects, such as increased anxiety, depression, and lower mental well-being. As a result, health organizations are concerned about the increase in substance abuse, such as alcohol, and mental health problems. One of the groups of people most exposed to the various health problems caused by COVID-19 is health care professionals. Thus, the objective of this research was to analyze the perception of primary care health professionals about mental health problems during the pandemic of COVID-19 comparing two health regions in the Federal District of Brazil with different socio-demographic and economic profiles that were differently affected by the pandemic. This is a mixed-type study, with quantitative and qualitative data. An online questionnaire was applied, with objective and subjective questions. It was found that the only variable with statistical significance was that of feeling angry, where the professionals in the most vulnerable region showed more anger than the other professionals. It was also observed that fear was the main driving feeling for a negative perception of one's mental health. An important finding was the professionals' loss of empathy for the users of the health services, as well as an increase in the consumption of psychotropic medications. We conclude that the mental health of all the health professionals surveyed was affected, regardless of the region where they work, due to the fear of the news and the feeling of helplessness about the government's handling of the pandemic. It is necessary to care for those who care, carrying out actions and initiatives of welcoming and professional valorization

This study aims to analyze the occurrences of sexual crimes, identify the individual profile of perpetrators and victims, as well as map the places where sexual crimes occurred and the means used to commit the acts. This study also aims to verify the association of epidemiological aspects and social determinants with the practice of crime. This is a retrospective, descriptive and longitudinal study, using official documents registered by the Civil Police of the Federal District (PCDF) as a source of information. The records contained in the Occurrence Bulletins (BO), issued by the 90 Police Stations, and in the Forensic Examination Reports (Lawful Acts and Bodily Injury), produced by the Legal Medical Institute (IML), were used. The study covers the months from January to December in the period from 2018 to 2019. 2,108 occurrences of crimes against sexual dignity were identified, in the consummated and attempted modalities, and 1,274 expert reports in the research period. In 2019, there was an increase of 3.5% in occurrence records when compared to the same period in 2018, possibly due to underreporting cases that occurred in previous years. Of these occurrences, sexual crimes committed in other states, occurring in previous years, but registered in the period studied, and cases of doubtful characterization or proven false allegations were discarded. Thus, there was a significant decline of 9.2% in the number of crimes actually committed in 2019. The study points out, on average, that the prevalence of sexual crimes committed in public areas is 5 times higher among people without a victim relationship -author when compared to those who are related. There is evidence of an association between the victim's age and the author-victim relationship. It is observed that the proportion of cases among adults without relationship between victim-perpetrator is higher, while most cases with relationship are associated with children and adolescents. It is also estimated that, on average, the consummated act occurs with an 18% lower prevalence among people without a victim-perpetrator relationship when compared to those who have a relationship. Of the Administrative Regions that had the most records of occurrences, both in victims who had a link with the aggressor and those who did not, Ceilândia is the most vulnerable.

falls are a serious public health problem, as they are the main traumatic events that occur to elderly people. Most falls occur at home and during the COVID-19 pandemic, the population had to follow social isolation, which had an impact on the biopsychosocial aspect of elderly people, increasing the risk of falls. OBJECTIVE: to evaluate the outcome of elderly victims of falls assisted by the Unified PreHospital Care Service (SUAPH) in the Federal District (DF). METHOD: descriptive, retrospective study carried out based on a document analysis of data from elderly people who were victims of falls in the year 2021, assisted by the SUAPH of the Federal District during the months of August to October 2021. Data collection took place in the period of January 2022 to April 2022 and was carried out in two stages: analysis of the 231 records of care selected to assess pre-hospital, clinical and care variables and, finally, consultation in the trackcare electronic medical record system to assess intra-hospital variables -hospital and final outcome. Descriptive statistical analysis was performed using SPSS 25.0 and the significance level considered was 5%. RESULTS: the majority of the sample was female (60.6%) aged between 60 and 65 years (20.8%), and among those aged over 85 years, females prevailed (p=0.01) . There was a greater number of occurrences in August, in the morning and at night there was a greater number of falls on weekends. Most falls occurred at the home of the elderly person (84.4%), who had SAH (50.2%) and used medications related to the cardiovascular system for continuous use (55.4%), significantly higher among those aged between 81 and 85 years old (p<0.01). Most occurrences were attended by the basic support team (65.3%) and referred to the hospital (97.0%). Most had blood pressure above acceptable limits (53.7%), significantly higher in females (p<0.001). 75.8% were conscious and 11.7% were drunk. The complaint of pain in two or more sites was prevalent in females (p<0.01) and most men did not complain of pain (p<0.01). In 23.4%, complete immobilization was performed and in 74.5% of the records, Glasgow was not reported. Elderly people aged over 85 years and those aged 76 to 80 years had a longer hospital stay. Women aged between 76 and 80 years had a longer hospital stay (p<0.001). The length of stay was longer in those who underwent surgery (p<0.001). Fracture was the most prevalent consequence (33.5%), followed by TBI (22.7%) and surgery (14.3%). Femur fracture was the most prevalent (44.0%), followed by Upper Limbs (32.0%). The fracture was prevalent in females (p<0.001) and between 81 and 85 years old (p<0.05). The median length of hospital stay for those with fractures was significantly higher (p<0.01). Female elderly people had a 3.02 times greater risk of having fractures (p<0.001). Finally, 74.5% were discharged from the hospital, 17.0% dropped out and 4.0% died. CONCLUSION: the results of this study showed the importance of the complete completion of the forms by the teams in pre-hospital care, since these can be used by managers with the purpose of obtaining data for new studies preventing health problems

Nanobiotechnology is an area that brings together various scientific fields such as biology, chemistry, physics, optics, mechanics and technology, in a way that aims at its performance and application in the life sciences. Its purpose is to synthesize and structure systems on a nanometric scale (1 to 100 nanometers) that can act in medicine, diagnostics, gene therapies and other branches that target health and the environment. Currently, one of the classes of diseases in which there are studies that work on the action of nanobiotechnological structures are neurodegenerative diseases, characterized by the deterioration of the central nervous system, which can present in different ways depending on the location or neural groups affected. Within this variety of diseases, there is a category called tauopathies that correspond to neurodegenerative disorders caused by the accumulation of a protein called tau. Therefore, one of the forms of treatment for this class of pathologies is carried out using acetylcholinesterase inhibitors, an enzyme that degrades acetylcholine, a neurotransmitter responsible for regulating memory, reasoning, sleep and attention, whose accumulation results in intoxication and the manifestation of the cholinergic syndrome depending on the stimulated receptor. In this way, the objective of this work is to report the process of synthesis and characterization of a nanotechnological system constituted by the junction of two polymers considered inert to the organism, being chitosan and gellan gum in association with gallocyanine, a dye commonly used to stain Nissl corpuscles, which forms a complex with acetylcholine, in which they have recently discovered the possibility of binding to LRP5/LRP6 receptors in the WNT pathway and inhibiting their interaction with a protein called DKK1 to prevent tau protein phosphorylation. As a synthesis methodology, we created a polyelectrolyte complex, which is the electrostatic interaction between two polymers of opposite charges and biodegradable to be the matrix of the formed system, coupling gallocyanine, binding to acetylcholine. Additionally, we performed hydrodynamic mean diameter tests, zeta potential, fourier transform infrared spectroscopy, differential scanning calorimetry and release profile by UV/visible spectroscopy. The results showed that the produced system has an average diameter > 400 nm and < 1000 nm swollen, does not have an electrostatic charge, exhibits an isoelectric point, good thermal resistance and in relation to the continuous release it presents a better dispersion at pH 10.3 and 7,4 respectively. Thus demonstrating fundamental characteristics to be a promising system to be used for a possible treatment model as described in the literature.

Emerging and reemerging infectious diseases are an ongoing challenge for global world health. In 2019, cases of pneumonia of unknown origin reported in Wuhan, China, led to the discovery of a new type of Coronavirus (2019-nCoV). The Covid-19 pandemic resulted in unprecedented challenges for health services and systems worldwide. Although science, technology and innovation (ST&I) played a key role in coping with the disease, knowledge gaps remain. The aim of this study was to propose an agenda of Covid-19 research priorities.

Methods: This was a qualitative study performed in two stages. The first was a broad-based consultation to identify research priorities cited by researchers, health, science and technology administrators, healthcare professionals and health system users via an electronic questionnaire. These priorities were organized according to the four categories of the COVID-END initiative (COVID-19 Evidence Network to support Decision-making): I. Public health measures, II. Clinical management, III. Health system arrangements, and IV. Economic and social responses. In the second stage, the proposed priorities were submitted to two rounds of analysis by a panel of Covid-19 experts using the Delphi method on a Likert scale, with a view to achieving consensus. Results: There were 71 participants in the first stage and 20 in the second, with 186 responses received in the broadbased consultation, consolidated into 161 priority lines of Covid-19 research. Of these, 139 achieved consensus in the first round of the Delphi method, with another 41 lines proposed and included for assessment in round two, resulting in 179 Covid-19 research lines. Issues related to the assessment, impact and sequelae of Covid-19 and long Covid predominated, particularly mental diseases and immunodepression. The population that attracted the most interest among participants was children. Conclusions: This study contributes by proposing an agenda of Covid-19 research priorities aimed at strengthening science and technology and guiding the allocation of investments by government institutions and research support agencies in Brazil.

Introduction: Major Depressive Disorder is a disabling illness that affects millions of people annually. Its characteristic symptoms are lack of pleasure in carrying out daily activities and depressed mood for a period of 2 weeks or more. The monoamine theory is one of the most studied to try to explain the origin of depression and dopamine is inserted in this context, being responsible for motivation and the reward process when it binds to its receptors. One of them, the D2 receptor, is encoded by the DRD2 gene, which is located on chromosome 11q22. a thymine, consequently leading to a decrease in the bioavailability of dopamine D2 receptors. Objective: To analyze whether the DRD2TaqIA polymorphism is associated with Major Depressive Disorder through a scientific production in the form of a systematic review and from molecular analyzes in the laboratory. Methodology: The systematic review carried out followed the PECOS methodology, used to define the inclusion and exclusion criteria of the works. The search was carried out in 4 databases: PubMed, Web Of Science, Scopus and Virtual Health Library. Afterwards, the works were evaluated more specifically in the Rayyan tool and finally a table was created with the articles included. Molecular analyzes were performed from biological samples collected from patients with MDD who are followed up at the Psychosocial Care Center III, located in Samambaia Sul. DNA extraction was performed using the Polymerase Chain Reaction technique and samples were digested for genotyping using the TaqI restriction enzyme. Results: The systematic review obtained a final result of five articles and in two of them an association of the DRD2TaqIA variant with major depressive disorder and depressive symptoms was found, with the A1(T) allele being more present in the Chinese and American populations and the A2 allele (C) more present in the Russian population. Through molecular analysis, no statistical significance was found between the polymorphism studied in this work and major depressive disorder. Conclusion: The article revealed that the frequency of genotypes and alleles varies according to the population studied, but further studies are needed on this subject and the gene in question, for a better understanding of the impact of this polymorphism on the pathophysiology of depression.

ABSTRACT Environmental contamination by heavy metals can represent a serious public health problem. This reality is often found in unhealthy environments, such as open-air dump sites, and predominantly affects individuals in situations of extreme social vulnerability. Human teeth are competent biological matrices to demonstrate long-term environmental exposure to metals. The objective of this study was to analyze the presence of Chromium (Cr), Arsenic (As), Cadmium (Cd) and Lead (Pb) in deciduous teeth of children between 6 and 12 years old, whose parents were collectors of recyclable materials from the dump Structural (G1) and compare with teeth of children living in two other Administrative Regions of the Federal District: Plano Piloto (G2) and Ceilândia (G3). A total of 305 teeth were collected and analyzed by ICP-MS. The concentration values of the analyzed metals were compared using the Kruskal-Wallis and Mann - Whitney test, after verifying the normality of the data using the Kolmogorov - Smirnov test. Dunn's Post Hoc multiple comparison test was used for pairwise comparison. The highest values of concentrations of Cr, As, Cd and Pb were respectively (0.142ppm),(0.003ppm), (0.127ppm) and (0.184ppm). P< 0.001. The results suggest that children from Group G3 are more exposed to Lead than the other two groups and that children from Group G1 are more exposed to Arsenic. Furthermore, the concentration of Chromium was significantly higher in Ceilândia (G3) and lower in Plano Piloto (G2), Cadmium was significantly higher in Plano Piloto and lower in Plano Piloto (G2). Chromium and Arsenic concentrations were significantly higher among children whose fathers and mothers were collectors. The concentration of As was higher in the children's teeth when the mother worked as a pregnant scavenger. More studies are needed to better understand the possible causes of certain groups having higher concentrations of heavy metals than others, so that protective actions can be taken for these children and their families.

Introduction: The Hematopoietic Cell Transplant (HCT) is a highly complex procedure and requires extensive patient care, including pharmaceutical care services, to support the effectiveness and safety of the treatment. Objective: To develop the proposition of a pharmaceutical care service in the hematopoietic cell transplant (HCT) sector of a pediatric hospital in Distrito Federal, Brazil. Methods: This is a multi-method study divided into four steps. Steps 1 and 2 included the data analysis from the national scenario, regarding both to hematopoietic cell transplantation centers and to pharmaceutical care services in HCT. These steps consisted in document analysis, questionnaire application and semi-structured interviews. In Step 3, the local scenario was examined regarding the perception and necessities for the pharmaceutical care service at the HCT sector of the pediatric proponent hospital, a focus group and a semi-structured interview were used. Finally, in Step 4, the proposal for a pharmaceutical care service at the HCT sector of the hospital under study was made. Results: There were 82 HCT centers and 3991 transplant (autologous and allogeneic) procedures were performed during the year 2022, according to the Brazilian Association of Organ Transplantation (ABTO). The Southeast and South regions of Brazil stood out with the highest number of transplant centers and HCT performed in 2022, on the other hand, the North region of Brazil had the lowest results. The pharmaceutical care services are mainly developed on an outpatient and inpatient basis, focusing on: medication reconciliation, pharmacotherapeutic monitoring, review of pharmacotherapy, participation in multidisciplinary meetings, discharge guidance and outpatient consultation. The proposal for structuring the service highlights the recommendation of pharmacists working across the entire line of HCT care, from pre-HCT to post-HCT (D+100). Furthermore, the interviewees' speeches highlighted the need for process indicators, therefore, to improve the service the inclusion of result indicators (clinical, economic and humanistic) is suggested. Conclusion: It was possible to identify strategic points for the construction of the pharmaceutical care service in the HCT sector of the proponent pediatric hospital, considering structural, human and logistical aspects, processes and results, intending to promote effectiveness and safety during the usage of the complex medication adopted in all phases of HCT, furthermore the qualification of the care provided and the strategies for monitoring/evaluating the service

Introduction: Pain is a frequent stage in the postoperative period, anxiety, depression and emotional suffering can also be observed in this period, these outcomes can influence postoperative responses. The objective of the study was to analyze the impact of pain neuroscience education (PNE), carried out preoperatively, on the psychosocial postoperative stages in individuals undergoing general surgery and without a history of chronic pain. Methods: This dissertation was divided into two sessions with the presentation of the results of a systematic review and part of a clinical trial. In the systematic review, were included studies in English that carried out intervention with PNE and their consequences in the perioperative period, interventional and observational studies were included, the databases were Pubmed, Virtual Health Library, Cochrane and Science Direct, the review was registered on the website Center for Open Science (10.17605/OSF.IO/ZTNEJ). A parallel open randomized controlled clinical trial was also carried out, following the recommendations of CONSORT, Brazilian Registry of Clinical Trials (RBR-23mr7yy), performed in hospitals in the Federal District and approved by the Research Ethics Committee of the School of Ceilândia, University of Brasília (CAAE 28572420.3.0000.8093), patients over 18 years old were included and an educational intervention on END was carried out. Results: Through the systematic review, fourteen studies were found with benefits for END in psychosocial outcomes, all of which presented a low risk of bias. The findings regarding the clinical trial showed that the intervention group had benefits in scores for depression (p=0.007), anxiety (p=0.035) and rumination (p=0.011) (pain catastrophizing subscale). Conclusion: From the systematic review it can be suggested that END brings additional benefits, beyond those obtained with conventional treatment, for psychosocial outcomes. In agreement with these findings, data from the clinical trial showed benefits for depression, anxiety and pain catastrophizing for the intervention group.

Objective: Investigate the costs and profile of patients who sued in court onasemnogene abeparvovec (Zolgensma®) for the treatment of spinal muscular atrophy (SMA) in the Ministry of Health. Method: Cross-sectional study, descriptive in nature and census design, based on records of legal actions filed against the Ministry of Health from January 2019 to September 2022. The data was requested from the Ministry of Health, via the Access to Information Law. Information was extracted on the epidemiological profile of the beneficiaries of the legal actions, as well as the expenses spent by the Ministry of Health in cases of granting the requests. Results: 136 legal cases were identified, all with a single beneficiary, of which 113 (83%) were favorable to patients at a cost of R$944.8 million (USD $192 M) in the period analyzed. Demographic (sex and age), clinical characteristics (SMA subtypes, use of ventilatory or nutritional support) and judicial process (type of legal service) were not associated with the granting of legal actions. Previous use of medication (nusinersen or ridisplam) was associated with the dismissal of legal proceedings. Of the 113 legal actions granted in favor of patients, only 6 (5.3%) would meet the criteria currently established by the National Commission for the Incorporation of Technologies – Conitec (children up to six months without ventilatory and nutritional support). There was an expenditure of R$ 146 million (USD $29,76 M) on the supply of onasemnogene abeparvoveque for children over 2 years of age, which is outside the recommendation contained in the drug leaflet. Conclusions: The Ministry of Health incurs a high cost with the judicialization of onasemnogene abeparvovec for AME, representing 3.06% of total spending on medicines in the SUS in 2019, including expenses from the three administrative spheres. Part of the legal demands have been granted in disagreement with the criteria established by health technology assessment agencies and recommendations from the drug manufacturer. 

Background: With the increase in the population of preterm infants, new concerns have occur about the development of the central nervous system. The immaturity of the systems makes preterm infants susceptible to negative functional outcomes, such as changes in neuropsychomotor development. Another aggravating factor is associated with harmful stimuli caused by the external environment, which generate acute and chronic stress and pain in premature situations. In this way, supporting therapies that help control the stress and pain of preterm infants and contribute positively to the neuropsychomotor development gain singular regard. Objectives: To analyze and compare the influence of motor stimulation and functional positioning on pain and stress in preterm newborns (PTNB) through heart rate variability, the NIPS scale and through vital signs; suggest motor stimulation techniques, frequency and intensity with positive gains in preterm infants admitted to the Neonatal Intensive Care Unit. Methods: a randomized, double-blind study, including preterm infants aged between 32 and 36 weeks, using the CONSORT method. PTNBs with other associated pathologies, such as malformations, congenital heart diseases, pneumonia, sepsis, genetic syndromes, use of invasive ventilatory devices, need for surgical intervention, need for vasoactive drugs, among others that affect HRV, were excluded. It contains two sampling groups: 1) Intervention group (motor stimulation protocol intervention and functional positioning) and 2) Control Group (functional positioning only). ECG recording was analyzed through frequency variability, stress and pain scale (NIPS) and vital signs for 5 consecutive days. The HRV parameters and other data were statistically analyzed in a parametric or non-parametric way, using central and dispersion measures (means and standard deviation or medians and quartiles), and the corresponding Wilcoxon and Mann-Whitney statistical tests (p < 0.05). Results:There was a significant difference in linear (AF, rMSSD, pNN20) and non-linear (SD1, SD2/SD1) variables of the Intervention between groups analysis. Observed a tendency of the same results in the intergroup analysis. There was a difference in the reduction of stress and pain, evaluated by NIPS, in the Intervention group when compared to the control. Regarding vital signs, there was no difference in the parameters evaluated (respiratory frequency and oxygen saturation).

Home care comprehend a multidisciplinary team health care combined with formal or informal caregivers for people with stable, chronic and aggravated conditions. Few studies have explored mobility strategies used by home care users. Hence, the present study aimed to explore limits and possibilities in proposing user-centered technological solutions on the West Health Region of Distrito Federal. We designed a crosssectional observational study, using visits to home care patients in this region. Among the 95 current registrations in 2018, we successfully scheduled 49 visits, mainly in the urban centers of Ceilândia and Brazlândia. The sample had a higher prevalence of male and married adults that were assisted by informal caregivers. Altogether, we recorded a total of 142 disease codes, where diseases of the circulatory system combined with head, neck and lower limbs pain prevailed. WHODAS evaluation revealed a moderate general disability score (25 to 49%), although with a significant aggravation of the mobility (80%) and improvement in the interpersonal relationships (20%). Among the Assistive Technology devices in use, those used to assist daily life activities and mobility prevailed, composing almost half of the devices identified during the visits. The perception of the patients provided valuable possibilities, limitations and requirements for improving mobility devices– inspiring the conception of ideas and the improvement of existing solutions, contributing to technological innovation. Finally, we concluded that the lack of device maintenance facilities, individual and personalized adjustments and adaptations, as well as environmental barriers and difficulties in acquiring technologies were limitations. The creation or acquisition of devices for transferring and changing positions in bed, along with adaptations and personalized adjustments in existing devices, provided subsidies and possibilities revealed by the perception of the home care user.

Lifelong education is constantly cited as a tool for boosting autonomy and well-being in old age, with educational programs as one of the main approach strategies, as a proposal for social transformation and improvements in quality of life, among other aspects. The growth and high demand for these programs indicates the important social role of these interventions in contributing to dignified, active and healthy aging. However, when it comes to the evaluation of effectiveness, the path is challenging, since the objectives of these interventions, focus of the effectiveness evaluation, have a social nature of difficult measurement. In this context, this thesis aimed to analyse the effectiveness of educational programmes for 45+ implemented in Brazil and in European countries, using lifelong education and three basic aspects contained in the objectives of the programmes as a common thread: fidelity, effects and social validity. To this end, the methodology was mixed, using the scales of behaviour change, subjective well-being, fidelity, normalization, satisfaction with the programme and skills assessment, interviews with the participants of the study and with the coordination of the programmes, documentary analysis of official documents and calculation of the dropout rate. The results were presented in the format of manuscripts and book chapters published or in the process of publication, being 5 manuscripts and 3 book chapters in first authorship and 1 manuscript and 2 book chapters in co-authorship, totaling 11 publications related to the results of this thesis. It was identified the fulfillment of the fidelity of the programs in more than 50%, the effects related to the improvement of subjective well-being, changes in behavior and specific skills, normalization of educational practices and social validity declared by the participants as well as the elaboration of plans for the future before and after the covid-19 pandemic under effect of educational proposal. With this study, it was possible to identify elements of effectiveness in the analyzed educational programs and point out improvement proposals for future actions with the description of evaluative methodologies.

The present study, duly approved by the Ethics Committee, under number CAAE: 96840718.9.0000.8093, is part of the Graduate Program in Health Sciences and Technologies of the Faculty of Ceilandia (FCE) of the University of Brasilia (UnB), in scope of the Academic Doctorate, area of concentration in Promotion, Prevention and Intervention in Health - Line of research: Socio-Biological Determinants and Health Care - and has as general objective to analyze the existence of educational institutional policies for the elderly in the Federal Public Universities of the Central Region -West, having UnB as a case of analysis, from the University of Aging Program (UniSER) — Arte de Viver, of this university, in the course of 2015 to 2020. It is a bibliographic, exploratory study, with documentary collection of data extracted from the Institutional Development Plans (PDI's) of the 08 IFES, the application of questionnaires to the graduates and the execution of semi-structured interviews with the ges program, based on the mixed method and dialectical view. The data confirm that none of the PDIs analyzed with the Federal under study contain educational public policies, but specific actions. In turn, with regard to graduates, of the 489 certificates, 129 participated in the survey, representing a percentage of 26.4%, the maximum age was 84 years, the average age was 63.3 years and the average age 65 years. 86.80% were women and 13.20% were men. With regard to education, 31% completed high school and 31% have specialization. Of the respondents, 93% understand that UniSER is outlined as an educational public policy, and an extension action and that it marks itself as a possibility of access and permanence of the elderly in the university space. So much so that 84.5% of them considered themselves UnB students. Regarding the themes they proposed for the organization of their own curriculum, mental health, violence, intergenerationality, among others, emerged, however, it is necessary to institutionalize the program. From the point of view of managers, 05 understand that it is constituted as an educational public policy and 08 understand that it is not, and that the role of education in the face of aging must be inclusive and that UnB has a unique role in this scenario. Through the understanding that everyone can learn, the four pillars of education for the elderly and the seven knowledges emerge and, finally, the proposal for a national policy for aging. At the end of it all, it is expected that, in addition to building UNIVERSIDADE DE BRASÍLIA/Faculdade de Ceilândia a policy, something else will occur, there will be a change in the institutional culture that will substantiate a differentiated educational public policy for the elderly, made with the elderly and of which they are a conscious protagonist. That UnB assumes this vanguard role, which suits it so well. The present study is a small seed, in the field of higher education and ageing, that new studies and research come, that the old man finds his place of respect and grows old as a right and not as a privilege of some.

The evaluation of tone reveals deficiencies in neuromusculoskeletal functions related to movement that better direct people's motor recovery after stroke injuries. This study aimed to explore the pendulum test using inertial sensors, intending to improve the technology for the diagnosis of stroke deficiencies and their repercussions on muscle tone. We carried out an evaluation model of passive stiffness in the affected upper limb in post-stroke people, chronic phase, using the inertial sensor during the pendulum test, correlating it with the Fugl Meyer (FM), Modified Ashworth Score (MAS) and Motor Activity Log (MAL) scales, in search of parameters that help with the differentiation of stiffness and spasticity. The results show that the FM scale is significantly correlated with natural frequency (p = 0.024). The amount of use MAL score correlates with natural frequency (p = 0.024). The variables E1 amp, F1 amp, IR, and ERI did not correlate with the clinical scales, but they correlated with each other; the variable E1 amp correlates with F1 amp (p = 0.024) and IR (p = 0.024), while F1 amp correlates with ERI (p = 0.024). There was also a correlation between natural frequency and K (r = 0.96, p = 0.003). Nonlinear results were found for the elbow joint properties during the pendulum test, which may be due to the presence of neural and non-neural factors. These results can serve as a reference for future studies if alternative scales do not provide an accurate reflection

Background: Patellofemoral Pain (PFP) is one of the main injuries in runners. Consistent evidence support strengthening programs to modulate symptoms, however, few studies investigated the effects of gait retraining. Objective: to compare the effects of two partially supervised gait retraining programs on pain, function, and lower limb kinematics of runners with PFP. Methods: Randomized controlled trial. Thirty runners were allocated to gait retraining groups focusing on impact or cadence, or to a control group. Impact group received guidance to reduce tibial acceleration by 50%, while cadence group was asked to increase cadence by 7.5-10%. The control group did not receive any intervention. Usual and running pain, knee function, and lower limb kinematics were evaluated before (T0), immediately after the intervention (T2), and six months after the protocol (T24). Data were analyzed using a 2-way analysis of variance. Results: A significant group x time interaction was found for running pain (p=0.010) and knee function (p=0.019). Both programs had greater improvements in running pain (p=0.001; p=0.002) compared to no intervention at T24. Participants of the impact group had greater improvements in knee function (p=0.027) compared to no intervention at T2. No between-group differences in usual pain and lower limb kinematics were found (p>0.05). Conclusion: Compared to no intervention, both programs were more effective in improving running pain six months after the protocol. The program focused on impact was more effective in improving knee function immediately after the intervention. Reductions in symptoms occurred regardless of changes in lower limb kinematics.

Introduction: Spinal cord injury (SCI) is any injury to the structures contained in the spinal canal, which can lead to motor, sensory, autonomic and psycho-affective changes. The lung function of patients with cervical SCI is compromised by changes in the biomechanics of the rib cage due to paralysis of the abdominal and intercostal muscles and, in some cases, due to total or partial loss of diaphragm function. Objective: to evaluate the effect of specificity of inspiratory muscle training (IMT) in individuals with spinal cord injury and chronic quadriplegics. Methodology: Randomized, blind and controlled clinical trial with individuals diagnosed with complete motor SCI, classified as chronic tetraplegia. Participants were randomized into three groups: GI (TMI 30% S-Index), GII (TMI 50% S-Index) and GIII (conventional physiotherapy), evaluated before and after the TMI protocol using manovacuometry, spirometry, peak cough flow, maximum sustained pressure, pulmonary resistance, S-Index, quality of life questionnaire (WHOQOL-BREF) and functional capacity (SCIM – SR). The IMT was performed twice a day, 5 days a week, lasting 30 minutes. Conventional physiotherapy was performed in all groups, twice a day, five days a week, with 30-minute sessions. The duration of the intervention in both groups was 4 weeks. Results: 10 individuals participated in the study, all male, with an average age of 31.80±9.59 years. GI presented better values for Maximum Inspiratory Pressure (MIP) when compared to GII and CG (-90.00 ± 30.00 vs -55.00 ± 13.23, p=0.11, -66.25 ± 11.09 vs -55.00 ± 17.32, p=0.11, -78.33 ± 24.66 vs -70.00 ± 17.32, p=0.18, respectively). There was no difference between respiratory variables, quality of life and functionality. The S-Index measured weekly showed a significant difference for the GI when compared to the others. Conclusion: Individuals with quadriplegic SCI, chronic complete motors can benefit from training with lower loads. The SIndex can be increased with 4 weeks of training in the low load TMI group. Quality of life and functionality did not show significant changes after IMT.

Introduction: The promotion of safe practices for the use of medicines in hospital environments is part of one of the protocols established by the National Health Surveillance Agency (ANVISA) for patient safety in the country. In this context, the investigation of medication errors has gained notoriety among pharmacovigilance studies, as they are included among preventable adverse events (AEs), the most common causes of which are associated with unsafe and inefficient processes within the health services. Objective: Identify the number of medication errors and verify their association with the costs of hospitalization of patients admitted to the Intensive Care Unit (ICU). Method: This is a retrospective crosssectional cohort study of hospitalizations that occurred in the years 2018 to 2019 in the ICU. The information was obtained from medical records and the hospital's electronic system. The independent variables were related to health and sociodemographic conditions; and the dependent variables were: days of hospitalization, cost of hospitalization and medication errors. The outcomes were discharge and death. Hospitalizations lasting less than 24 hours, incomplete medical records and those under 18 years of age were excluded. The Statistical Package for Social Sciences, version 20, was used for statistical analyzes that included calculation of medication error rates, descriptive analysis and simple and multivariate regression. The project was approved by the Research Ethics Committee of the Faculty of Ceilândia of the University of Brasília with opinion No. 4,055,318. Results: 50 medical records were analyzed and 14,248 doses of medication were identified, of which 15,123 errors were made. The rate of errors due to omission presented the highest number of errors per dose of medication (59.8%) and total errors observed in the sample (55.31%), followed by the rate of errors per time (26.97%; 24. 95%). The omission error had the highest average when analyzing the entire hospitalization (170.40) and day of hospitalization (13.79). Hospitalization costs were significantly and positively correlated with scheduling errors, with an increase of R$ 121.92 (95% CI 43.09; 200.74), and with prescriptions, with an increase of R$ 63.51 (95% CI 29.93; 97.09). Conclusion: The results suggest a positive association between two types of error (scheduling error and prescription error) and the increased costs of patient hospitalization in the Adult ICU.

The set of behavioral signs that characterize autism spectrum disorder (ASD) was first described in the mid-1940s by the Austrian psychiatrist Leo Kanner, who coined the term autistic affective contact disorders for a set of specific behaviors. ASD is characterized by marked deficits in the behavioral area and in language, covering a whole spectrum of signs and symptoms, which vary according to the need for support. Its diagnosis is essentially clinical, based on criteria defined in manuals. The etiology of ASD is not defined, but its varied presentation reinforces the hypothesis of a multifactorial cause with a strong genetic component, linked mainly to polygenic inheritance patterns, with different types of alterations being responsible for the expression of a phenotype with characteristics compatible with the ASD. description of the TEA. Among the various changes that individuals with autism can be affected, we can mention genetic polymorphisms, which when present can be associated with susceptibility to various conditions. In addition, despite evidence pointing to the existence of a neuroinflammatory process in ASD, studies with cytokine polymorphisms are scarce - existing publications commonly address the IL1 and IL6 genes responsible for pro-inflammatory cytokines, however evidence points to altered levels of anti-inflammatory cytokines. -inflammatory in the Central Nervous System of people with autism, and among these cytokines interleukin 4 can be highlighted. A polymorphism described in the IL4 gene is a variable number tandem repeat (VNTR), located in intron 3 (a 70bp repeat), and may lead to an increase in IL-4 transcriptional activation, which could affect the duration and magnitude of the immune response. In this context, this study aims to evaluate the VNTR-type genetic polymorphism in the IL4 gene and its association with ASD. For this, genotyping of 35 children diagnosed with autism from 40 healthy controls was performed. Allele frequencies were determined using qualitative PCR, and analyzes of susceptibility to ASD and the prognosis of pediatric patients according to the presence of the polymorphism, stratified according to the Childhood Autism Rating Scale (CARS), were performed considering a significance level of 5%. There is no statistical association between the development of ASD and the IL4 VNTR intron 3 polymorphism (p=0.642). The presence of the polymorphism was also not associated with the severity of ASD (p=0.897) nor with any clinical characteristics presented. Therefore, the IL4 VNTR Intron 3 polymorphism is not associated with ASD susceptibility or prognosis

To identify whether the dopamine D3 receptor (DRD3) Ser9Gly
(rs6280) polymorphism affects susceptibility to papillary thyroid carcinoma
(PTC) and/or its prognosis. Methods: This descriptive observational case-
control study with patients with PTC who underwent thyroidectomy and sodium
iodide (131I) radiopharmaceutical treatment and unrelated healthy volunteers.
DRD3 SNP Ser9Gly (rs6280) genotyping was performed by PCR-RFLP, and
results were observed, compiled and analyzed using SPSS version 28.0.
Results: The genotype frequencies of the healthy volunteers were in Hardy-
Weinberg equilibrium. No statistical difference was found between the
genotypes and allele frequencies between the PTC and control groups,
although the PTC group had proportionally fewer ancestral S alleles compared
with polymorphic G. Similarly, there was no association between the
polymorphism and the clinical characteristics of PTC patients. Conclusion: The
DRD3 Ser9Gly polymorphism (rs6280) was not associated with PTC
susceptibility in the Brazilian population studied, nor with other PTC
characteristics and prognoses. Further studies should be conducted in other

populations with different genetic makeup to help understand the possible
effects.

In the present laboratory study, 9 essential oils (EOs) derived from 6 plant species and their main components were selected for their larvicidal properties against Aedes aegypti, a mosquito species responsible for significant epidemics in recent years and of great medical importance. Thus, the activity of different essential oils from native and cultivated plants in the Cerrado against Aedes aegypti larvae was evaluated: Alpinia zerumbet (Pers.) B.L.Burtt & R.M.Sm., Baccharis retusa DC., Blepharocalyx salicifolius (Kunth) O. Berg, Cymbopogon densiflorus (Steud.) Stapf, Eugenia langsdorffii O. Berg., Myracrodruon urundeuva Allemão. Of the species evaluated in the screening, the most potent larvicides were from essential leaf oils of A. zerumbet and E. langsdorffii, which resulted in 100% mortality at 100μL/mL. These essential oils were then tested at different concentrations. The major components of essential oils were identified and quantified by gas chromatography. A. zerumbet had 1,8-cineol, sabinene, terpinen4-ol and γ-terpinene and E. langsdorffii, α-limonene, δ-cadinol, β- mircee and (+) – Spathulenol. The lethal concentrations of A. zerumbet were (LC50 = 36,644μL / mL, LC90 = 66,318 μL / mL), and for E. langsdorffii (LC50 = 53,522 μL / mL, LC90 = 103,932 μL / mL). This suggests that there is significant potential for the EOs of these species to control mosquitoes as larvicides.

Objective: describe and analyze the prioritization of care in the fight against Covid-19 in relation to the systematic care of DM and SAH. Methods: a cross-sectional study that used secondary data on care for hypertensives, diabetics, pregnant women and children patients at four Basic Health Units (UBS), UBS 02 and UBS 10 in Samambaia, in the Southwest Health Region, and UBS 12 and UBS 18 in Ceilândia, in the of Health West of the Federal District, during the years 2018, 2019 and 2020. Results: There was a significant and negative effect of time, specifically at the beginning of 2020 and the pandemic, which shows an immediate reduction in the number of visits made to the over the period. Conclusion: The findings highlighted the importance of developing strategies that enable the effectiveness of PHC, demonstrating the relevance of evaluating responses to health emergencies and the need for continuity in the supply of services. 

Excessive accumulation of visceral adipose tissue (VAT) may contribute to a higher risk of comorbidities and reflect an early or advanced state of metabolic disorder when compared to other types of obesity, while a decreased muscle mass (MM) may contribute to the manifestation. of metabolic diseases and dyslipidemia. Evidences indicate that anthropometric indicators and serum biochemical analyzes are correlated with visceral fat and muscle mass in isolation, but few studies compare these indicators as predictive factors of changes in visceral fat and in the relationship between muscle mass and visceral adipose tissue (MM/TAV). Therefore, the objective of this study was to evaluate the correlation between visceral adiposity and the development of health problems and changes in serum biochemical parameters in middle-aged and elderly adults through a literature review, and to identify and analyze possible variables predictors of change in visceral fat and MM/TAV ratio in low-income adult women through two studies of original data. For the review, articles from the Virtual Health Library (BVS) database published between 2009 and 2019 were used and selected after applying preestablished inclusion and exclusion criteria. As for the original data studies, information on anthropometric measurements and biochemical tests were collected from the medical records of women aged 18 to 59 years in nutritional consultation at the Centro Universitário de Brasília (CEUB), and analyzed in a univariate logistic regression model to identify the possible predictors of risk factors for the presence of altered TAV and altered MM/TAV. Regarding the results, it was observed that the bibliographic search found at the end 14 publications that correlated VAT with serum biochemical parameters and several comorbidities (such as pancreatitis, depression, cancer and coronary heart disease) , while the logistic regression model considered the body mass index (BMI) greater than 25 kg/m 2 , lipid accumulation product (LAP) and waist-hip ratio (WHR) as predictors of altered TAV, and WHR greater than 0,8 as a predictor of altered MM/TAV ratio. Therefore, it is understood that WHR has a robust predictive capacity for changes in visceral fat and the relationship between muscle mass/visceral fat, while LAP and BMI have a predictive capacity only for TAV, which makes these variables effective in the evaluation. of the risk of alterations in body composition and its essential inclusion in individual and collective clinical practice