Repositório RCAAP

Health care environments are permeated by factors that can interfere with the occupational health of professionals, among them are anxiety, stress and burnout. Auriculotherapy is effective in reducing these problems, although there is no consensus about the technique to be used, nor is there a study in the Brazilian reality with the practice for the three conditions, concomitantly. Accordingly, the aim is to analyze the effectiveness of auriculotherapy compared to control group, placebo or usual treatment for anxiety, stress or burnout in health professionals. A systematic literature review was developed, following the JBI methodology, based on the review question: What is the effectiveness of auriculotherapy in reducing anxiety, stress or burnout in health professionals, comparing the intervention with control, placebo or usual treatment groups? The reference search was carried out in the following sources: SCOPUS/Elsevier, EMBASE/Elsevier, MEDLINE/PUBMED, LILACS/VHL, MTCI Americas/VHL, WoS/Clarivate Analytics, CINAHL/EBSCO, PsycINFO/APA and Cochrane Library. Eligible studies were retrieved in full and their citation details imported into JBI SUMARI. The phases of selection, critical evaluation and data extraction of the included studies took place in a double-independent manner and with a third reviewer for dissents. The analysis was developed with methodological quality assessment with the JBI instruments, descriptive analysis and network meta-analysis. The corpus of this review was composed of 15 articles, published between 2009 and 2021, with 11 surveys developed in Brazil, three in the United States of America and one in Italy. As for the auriculotherapy technique, most studies used needle intervention (n=7), with the number of sessions ranging from one to 12, and most did not perform follow-up (n=7). The auricular points shen men (n=14), brain stem (n=9), kidney (n=9), sympathetic (n=4), lung (n=3) and liver (n=2) were the most used for the evaluated outcomes. As for side effects, one case of nightmare, one case of pruritus and another of pain were reported. Through the critical evaluation of the methodological quality, it was found that four of the randomized clinical trial studies were of reasonable quality, and six were of moderate quality; furthermore, all quasi-experimental studies and the multiple case study were of moderate quality. It was evidenced that auriculotherapy is effective in reducing anxiety, stress or burnout in health professionals. Any auriculotherapy intervention, regardless of the used material, is more effective than none. Interventions with semi-permanent needles reduce, on average, stress by 24 points and anxiety by 7 points, when compared to no interventions. It is concluded that auriculotherapy, compared to control or placebo groups, is effective in reducing anxiety and stress in health professionals. For burnout, meta-analysis was not feasible; however, there was a significant reduction in burnout in studies that used auriculotherapy. There are no studies comparing the intervention with usual treatment. The evidence found in this review corroborates the literature, since auriculotherapy helps in the treatment of disorders of the human body. Furthermore, considering the health care settings, it is verified that the health of workers is favored with auriculotherapy. PROSPERO Registration: CRD42020222009.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Introduction: The senior immobility constitutes one of the greatest geriatric syndromes, being responsible for causing adverse outcomes in seniors’ health. Among the outcomes, it is observed that it generates longer hospitalization time, hospitalizations and death. Among the environments with more concern regarding the immobility, it is the hospital environment, which due to its own characteristics as bed dispositions, less mobility, acquired comorbidities, and underlying diseases, increase the frequency of this syndrome. Objective: Evaluate the predictors of intrahospital immobility in seniors. Methods: It is a quantitative study, longitudinal, and descriptive constituted by a prospective cohort. This study is derived from a portion of the project named “Development of a hospitalized senior health care in HUSM” under CAAE “48212915.50000.5346”. The data collection occurred between the months of September 2015 and July 2016, at the Santa Maria’s University Hospital/RS (HUSM). It was included seniors that entered hospital emergency by varying causes and that accepted to participate the study. It was excluded the individuals who were not capable to answer the survey (by cognitive or communication deficit), or by not having a companion at the survey time to provide the necessary data. It was used as descriptive variables: age, sex, admission pathology, period of hospitalization, and complications (pneumonia, fallings, urinary tract infection, deep vein thrombosis, delirium, and urinary incontinence), and as variable of study the intra-hospital immobility, the Identification of Seniors At Risk, Confusion Assessment Method, Edmonton Frail Scale , and calf circumference measurement. The descriptive analysis was performed (frequency, mean and median), chi-squared test, Backward Wald multivariate logistic regression, and Kaplan-Meier survival curve, significant values were considered when p≤ 0,05 (SPSS 21.0). Results: Among the 397 evaluated individuals, it was observed a predominance in early seniors between 60 and 69 (39.7%), male (53.7%). It was observed that the age (p=0.007), fragility indicators (p=0.007), and delirium (p=0.001) during the hospitalization increased the seniors’ chance to have intra-hospital immobility. Conclusion: These data suggest that the intra-hospital immobility is associated with the age, admissions’ pathology, CC values, frail scores, senior risk index, and comorbidity presence and the predictive variables to immobility were the age, frail, and admission delirium indication. In conclusion, it is suggested to consider these in the implementation of prevent measures as for senior’s intra-hospital immobility.

Osteoporosis is characterized by low bone mass associated with abnormalities in bone microarchitecture, increasing the risk of fragility fractures. Although there are guidelines for the diagnosis and treatment of osteoporosis, which could reduce the incidence of fractures by more than 70%, this disease continues to be underdiagnosed and undertreated. Knowledge of the epidemiology of fractures is essential for planning preventive actions and treatment strategies. Body mass index (IMC) is a major determinant of bone mineral density (BMD) and obesity is widely believed to protect against fracture. However, studies have challenged this assumption and have shown that fractures in obese people contribute substantially to the total number of fractures. Therefore, the aims of this study were to establish the incidence of bone fractures in the population of postmenopausal women attending the primary care in the municipality of Santa Maria, to evaluate their epidemiological characteristics, to access the FRAX algorithm utility is this population, and to evaluate the association between obesity and fractures. A cohort study was carried out in the municipality of Santa Maria, in women aged 55 years or older, in the post-menopause and who attended the basic health unit. The recruitment period was from March 1 to August 31, 2013. Participants were followed from September 1, 2013 until July 31, 2018. In the initial contact, a questionnaire was carried out and weight and height were measured. The follow-up was carried out on 854 women who contributed to 2732 people/year. It was done by annual telephone contact for 5 years. Information that included occurrence of bone fractures, diagnosis or treatment of osteoporosis, new comorbidities and use of medications was collected. In the fifth year of the study, visits were made to the basic heath unit to review the fracture incidence of the study participants. The average follow-up time was 3.2 years (SD 1.05; minimum follow-up 1.1 years and maximum 5.6 years). During this period, 62 fractures occurred in 58 women. The incidences of total fractures and major fractures in our study were 22.3 and 15.0 fractures per 1000 people/year, respectively. The most frequent fracture sites were 1) wrist, 2) shoulder, 3) ribs and, 4) hip. Hip fractures were the fourth most frequent site with an incidence of 3.3 fractures per 1000 people / year. Rheumatoid arthritis, previous fracture and use of glucocorticoids were risk factors for fractures in our study. Women who fractured had absolute 10-year fracture risk scores calculated by the higher FRAX algorithm than women who did not fracture. The incidence of fractures was similar among obese and non-obese women (24.2 per 1000 person/year vs. 22.9 per 1000 person/year, respectively; p=0.864 – Kaplan Meier). It is concluded that the incidence of fractures in postmenopausal women in Santa Maria was high and similar to other studies of Brazilian and Latin American populations and obesity is not a protective factor to bone fractures.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

In order to control the impacts caused by societies the Protected Areas are created, as areas that are instituted by the need to protect certain priority territorial spaces for conservation, with the intention of promoting a healthier society and a balanced environment by managing the use of natural resources in a broader and more democratic manner (BENSUSAN, 2006). To this end, Brazil has created Conservation Units (UCs) that have different categories, at the federal, state, and municipal levels. One of the types of UCs belonging to the category of full protection are the National Parks. The parks seek to preserve natural ecosystems of great ecological relevance and scenic beauty, enabling scientific research and the development of environmental education and interpretation activities, recreation in contact with nature and ecological tourism (BRASIL, 2000). Given the above, the Municipal Natural Park of the Hills arises in the municipality of Santa Maria as an attempt to preserve the forest remnants of the Atlantic Forest Biome present in the urban area of the municipality, in addition to water resources and scenic beauty of the site, thus enabling recreation and contact with nature, contemplation of the city of Santa Maria and the development of educational activities, scientific research and environmental interpretation. Based on this, the present research sought to value the proximity to nature of seventh grade students of schools in the Buffer Zone of the Municipal Natural Park of Morros through the analysis of perception. To this end, the research methodology relied on the application of a photo-test using the Likert (1932) school of evaluation in which the students attributed grades as to the proximity of images of the city of Santa Maria presented. From then on, the results pointed out that there is a distancing of the students in relation to images related to nature captured within the UC. Therefore, an instrument was designed to synthesize some information about the Parque Natural Municipal dos Morros to be sent to the schools that participated in the photo-test. The research included the preparation of a booklet containing information to help teachers and students, especially in the seventh grade of elementary school, which, according to the BNCC (2017), aims to learn about and work with the municipal CUs. Despite being inserted primarily in the contents of the seventh grade, the material is presented in a playful and objective way so that it can be understood by different audiences as well, aiming to seek the support and knowledge of the surrounding population for the preservation and conservation of the Parque dos Morros in the municipality.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Agroecology is a scientific field that guides sustainable practice of agriculture, which is a process of conversion from traditional to more sustainable practices based on adoption of conservation management techniques and the optimized use of inputs. Straw over the soil is one basic practice, although not prevalent due to the farmers habit of preparing the soil between crops for weed removal, soil decompaction and incorporation of fertilizers. Therefore, this study aims to identify the effects of management and land cover on soil quality and socioeconomic aspects in a horticultural production system going through agroecological transition. The experiment was carried out on a farm in Santana do Livramento – RS. The treatments used were based on combinations between the use of cover crops straw and preparation of the soil: i) without cover and with tillage (T1); ii) no cover and no tillage (T2); iii) covered and no tillage (T3); and iv) covered and with tillage (T4). For soil cover, black oat straw (Avena strigosa Schreb.) was used in winter and alexandergrass (Brachiaria plantaginea) in summer. The chemical evaluation consisted of analyzing the attributes of acidity and nutrient availability. The microbiological variables analyzed were microbial activity (basal respiration) and population of free-living nematodes and phytoparasites. Soil loss was analyzed by height lowering beds measurements. Productivity and labor costs were analyzed in each treatment. P and K soil contents, the acidity components, and sum of bases were sensitive chemical indicators to measure soil changes. No tillage and soil cover (T3) showed greater activity of microorganisms and a higher population density of free-living nematodes, as opposed to treatment with tillage and without soil cover (T1). The covering maintenance protected against soil loss and without impact on labor or productivity. Soil management strategies with maintenance of cover and no till, based on agroecological transition, improved soil quality and provided socioeconomic benefits.

Pharmacological treatments for adults with post-traumatic stress disorder: A network meta-analysis of comparative efficacy and acceptability. Background: The purpose of this study was to compare efficacy and acceptability among drug treatments for adults with post-traumatic stress disorder (PTSD) through a systematic review, random-effects pairwise and network meta-analyses. Methods: Double-blind randomized controlled trials comparing pharmacological interventions for adults with PTSD were searched from database inception through Aug. 28, 2018, on Cochrane (Central), Embase, LILACS, PILOTS, PsycINFO, PubMed, and Web of Science. Clinical trial registries and the websites of pharmaceutical companies were also searched. The GRADE system was used to assess the quality of the evidence. Results: The systematic review included 58 studies comprising 6766 patients randomized to 26 different interventions. Regarding efficacy, topiramate (SMD=-0.57;95%CrI: -1.07,-0.10), risperidone (SMD=-0.53;95%CrI: -0.93,-0.15), quetiapine (SMD=-0.59;95%CrI: -1.06,-0.11), paroxetine (SMD=-0.35;95%CrI: -0.48,-0.21), venlafaxine (SMD=-0.25;95%CrI: -0.44,-0.05), fluoxetine (SMD=-0.28;95%CrI: -0.46,-0.08), and sertraline (SMD=-0.21;95%CrI: -0.33,-0.09) outperformed placebo. Moreover, phenelzine (RR=3.39;95%CrI: 1.43,11.09), lamotrigine (RR=4.39;95%CrI: 1.18,26.38), and fluoxetine (RR=1.28%CrI: 1.01,1.59) outperformed placebo in terms of acceptability. Conclusions: The NMA supports topiramate, risperidone, quetiapine, paroxetine, venlafaxine, fluoxetine and sertraline as effective pharmacological choices for the treatment of PTSD. Quetiapine and topiramate have the shortcoming of relying on a few small studies, but the clinically meaningful change in symptoms is noteworthy and merits further investigation. Among the pharmacological treatments with evidence of efficacy compared to placebo, fluoxetine achieved a relatively high rank regarding acceptability. To the best of our knowledge, this is the largest contemporary NMA on the subject and the addition of new medications is an important extension of previous meta-analyses, enabling a larger number of drug comparisons.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

This dissertation deals with issues that correspond to education and the world of youth work. The proposed research aimed to investigate the influence of the institutions the family and school on the professional expectations of young people belonging to two schools, namely, a public and a private in Santa Maria city, Rio Grande do Sul state, based on students who are in the third grade of high school. Was studied and sought to understand the influences of private and public schools and in what reason and grade this happens. The research was supported by the concepts developed by Pierre Bourdieu about habitus and cultural capital, as well as that of favorable dispositions concept developed by Bernard Lahire. The study sought to observe the class habitus of students from different institutions and the extent to which the school reinforces and / or alters this, based on objective and subjective elements present in the moment that young people choose by a career. It is worth considering that some students from public institutions have expectations / choices / success in professions that contradict their predictable habitus. In this sense, the purpose was to analyze the extent to which the school reinforces and / or changes the occupational probabilities already present in the family life of students and their original community. Finally, this dissertation show the extent to which habitus, as well as knowledge, skills, information, that is, the set of intellectual qualifications transmitted by families and reproduced in schools, has a singular influence on the lives of these social agents. The research made use of a qualitative methodology and was guided by the perspective that subjectivities, both from an individual and collective point of view, are strongly marked by family and school experiences.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

This paper aims to discuss the proposal of institutional arrangements and territorial management measures for better use of the geotouristic potential of the Aspirant Geopark Quarta Colonia. It also analyzes the network actions between the social actors with activities related to tourism present in the territory. The feasibility of different institutional arrangements used in consolidated geoparks and thus explaining the guidelines for strengthening the social capital present in the Quarta Colonia. The research is guided by qualitative and quantitative research and as instruments, bibliographic research, fieldwork, structured highlights, and documentary research were used. The results indicate that the territory is constituted by several social actors, responsible for strategies with great potential for development, however, the actors behave in a disconnected way and consequently, their initiatives are presented in an isolated way. Still, it is noteworthy that institutions such as UFSM and CONDESUS have been carrying out actions to organize the application of the territory as a UNESCO geopark. Concerning the analysis of management applied by the global network geoparks, considerably varied forms are observed in the management processes. Most associations are composed of a public entity, with a partnership between public and private associations. Given the reflections on the territory, its characteristics, and possible management strategies, it is understood that the best management strategy for the Aspirant Geopark Quarta Colonia is through a participatory management model. In this way, social empowerment is sought, and so it focuses on actions for greater articulation and integration of the networks of actors present in the territory and partnership with UFSM and CONDESUS. Yet, the need for more integration among institutional actors with the territory is emphasized, for better understanding of the potential and thus for planning aimed at the development of geotourism in the territory, with investments in infrastructure, dissemination, and conservation strategy in general.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq