Navegando por Data de Publicação, começando com "2024-02-27"

Filtrar resultados por ano ou mês

Agora exibindo 1 - 12 de 12

Modelagem fuzzy-cinética e monitoramento espectrofotométrico da hidrólise enzimática do bagaço de cana-de-açúcar em sistema de reatores com separação de fases
(Universidade Federal de São Carlos, 2024-02-27) Souza, Daniel de Castro; Ribeiro, Marcelo Perencin de Arruda; https://lattes.cnpq.br/0381402687491195; https://lattes.cnpq.br/0730367989562450; https://orcid.org/0009-0003-1172-5197
The decrease in fossil fuel reserves combined with the growing global energy demand fosters the search for alternatives. Within this scope, a possible solution may arise from the use of biofuels, such as ethanol, produced based on renewable sources. In Brazil, in alignment with such efforts, this alcohol is already produced on a large scale from the fermentation of sugarcane juice. This process can have its yield increased by using the remaining sugarcane bagasse itself as a substrate in alcoholic fermentation. The ethanol produced in this way is called second-generation ethanol (2G). To enable this process, the bagasse must be pretreated, exposing its fibers and allowing its hydrolysis. Hydrolysis is responsible for breaking the cellulose molecules into monosaccharides that can be consumed by yeast during fermentation. Enzymatic hydrolysis occurs under mild conditions and releases fewer compounds that inhibit fermentation, which, despite the high cost of the enzyme, makes it more attractive compared to chemical hydrolysis. Based on this context, the present project aimed to study a non-conventional reaction system built in the research group, using experimental data from liquid chromatography and infrared absorption spectroscopy obtained previously. Due to the complexity of the reaction system, the application of phenomenological models is impractical, and semi-mechanistic approaches are presented as an alternative. Therefore, a fuzzy-kinetic model based on Michaelis-Menten kinetics was developed aiming to obtain an equation system capable of describing the process for different feed conditions. This study presents significant results, highlighting the creation of an innovative kinetic model for the enzymatic hydrolysis of sugarcane bagasse in reactors with phase separation. The identifiability analysis of the model parameters revealed its robustness in describing the reaction kinetics. Anticipating possible deviations between the model and the real reaction, it was chosen to develop a monitoring system using near-infrared spectroscopy. In this work, a predictive concentration model based on spectra was developed through a combination of variable selection by genetic algorithm and partial least squares regression, resulting in a model with cross-validation errors of ±0, 012 g/L for cellobiose, ±0, 650 g/L for glucose, and ±0, 072 g/L for xylose.
Efeito da intervenção remota realizada pelos pais, direcionado à tarefa motora específica, participação, enriquecimento ambiental e interação mãe-filho (protocolo STEP) sobre a funcionalidade de lactentes com risco biológico: ensaio clínico randomizado controlado
(Universidade Federal de São Carlos, 2024-02-27) Lima, Camila Resende Gâmbaro; Rocha, Nelci Adriana Cicuto Ferreira Rocha; https://lattes.cnpq.br/2035754554780009; https://orcid.org/0000-0002-3191-3086; https://lattes.cnpq.br/3685225233951929; https://orcid.org/0000-0002-1461-1588
The main objective of this PhD dissertation was to verify the effect of a telehealth protocol carried out by parents, involving motor stimulation of specific tasks, environmental enrichment, mother-child interaction and participation on the functionality of infants at biological risk. In order to answer the question of this main objective, five studies were developed. Study I consisted of an analysis of the feasibility of applying the Alberta Infant Motor Scale (AIMS) remotely, in a home environment. 30 infants aged 3 to 10 months, with biological risk for developmental delay, were included. The AIMS was applied using videos recorded asynchronously by parents, with family members instructed by therapists through standardized instructions in booklets and texts. In this study, the quality of remote assessment, inter-examiner reliability and the association between contextual factors and the quality of assessments were analyzed. As a result, a high quality of images was found, of the stimuli performed by the caregiver to elicit motor skills, an adequate physical environment for the evaluations, and excellent reliability between evaluators in all AIMS postures, demonstrating the feasibility of this remote evaluation carried out by the caregiver. In Study II, the STEP protocol was presented, and the objective was to describe in detail all stages of this telehealth protocol carried out by parents, involving specific motor tasks, environmental enrichment, mother-child interaction and participation for infants at risk of developmental delay. Thus, all stages and details of evaluation, intervention, randomization, recruitment and blinding were described, to guarantee the reproducibility of this intervention. Study III focused on verifying the feasibility and preliminary effects of the STEP protocol. 28 infants at risk of developmental delay were included (14 in the control group and 14 in the experimental group), who completed the 10 weeks of intervention. The therapy for each group was based on the following principles: 1) Control group: guidelines for stimulating motor tasks; 2) Experimental group (STEP Protocol): guidelines for stimulating motor tasks, participation, mother-child interaction and environmental enrichment, with goals established by the parents. The outcomes presented in this study were: motor skills (AIMS); frequency and involvement of participation (Young Children’s Participation and Environment Measure - YC-PEM) and affordances of the home environment (Affordances in the Home Environment for Motor Development – Infant Scale - AHEMD-IS). After the end of the intervention, the change in each outcome was compared between the groups. The protocol showed good feasibility and high acceptance by parents. The STEP group showed significantly higher results after the intervention, regarding the AIMS percentile; frequency and involvement of participation at home, when compared to the control group. No differences were found in relation to AHEMD-IS. In Study IV, the randomized controlled clinical trial was presented. 52 infants at risk of developmental delay were included, who were also randomized into a control group and an experimental group (STEP Protocol). The intervention processes were the same as those carried out in Study III. In addition to the outcomes assessed in Study III, motor skills outcomes were also assessed using the Infant Motor Profile (IMP), mother-child interaction using items based on the Parent-Child Early Relational Assessment and the environmental part of the YC-PEM. After the 10 weeks of intervention, the STEP Protocol group showed a more evident and significant improvement in the AIMS percentile, Adaptability and IMP Performance, and frequency and involvement of participation at home. Finally, Study V aimed to verify which environmental, family and infant factors impacted adherence to the STEP protocol. Adherence to treatment was calculated by summing the total minutes of therapy performed during the 10 weeks, and the predictors were the type of intervention received; AHEMD-IS; maternal age; number of adults in the house; number of children; paternal and maternal education; family income; level of maternal stress, depression and anxiety and AIMS percentile. Through a regression analysis, it was found that lower values of maternal age, number of adults in the house and levels of maternal depression, higher paternal and maternal education, and being part of the experimental group were associated with greater adherence to therapy. Thus, this thesis concludes the positive effects of the STEP protocol on the functionality of at-risk infants. The results suggest the feasibility of assessment and intervention practices delivered via telehealth and reinforce the importance of including biopsychosocial aspects in early intervention, as well as parental involvement.
Protagonismo, juventudes e o Programa Ensino Integral do estado de São Paulo: entre discursos e práticas
(Universidade Federal de São Carlos, 2024-02-27) Cavicchioni, Sendy Carollina; Pan, Lívia Celegati; https://lattes.cnpq.br/0693096333786616; https://lattes.cnpq.br/7794449697344256
In view of the expansion of the Integral Education Program of the state of São Paulo (PEI) in public schools, accompanied by criticisms of its teaching model, and the goal of the National Education Plan to expand integral education in Basic Education in Brazil, this research aimed to the objective is to understand protagonism, seen as a pedagogical axis and objective to be developed with young people in PEI, in the dimensions of discourse and practice from the perspective of professionals working in the Program. The methodology included the analysis of the Integral Education Program Guidelines and for data collection, interviews were carried out with five teachers from a school that is part of the Program in the city of São Carlos-SP. The discussions supported by data analysis allowed us to design some categories, which are: “The Integral Education Program of the State of São Paulo”; “The Idealized Youth in the Integral Education Program of the State of São Paulo”; “Protagonism in the Integral Education Program” and “Paths to Democracy?”. These categories revealed obstacles in the integral education model in force in PEI, which idealizes the formation of youth as protagonists in accordance with their academic productivity criteria, in addition to being very restricted to new methodologies, ideas and the possibility of teaching work, preventing the alignment of different youth realities with school, influencing the lack of perception of forms of authentic protagonism among young people. Furthermore, an interface was created with social occupational therapy to understand public schools in a broader sense and the political processes that take place there. It was indicated that the Program requires schools with adequate infrastructure that surpass the adaptations commonly made in spaces intended for other purposes. As a proposal to think about a viable and humanizing protagonism, the discussion “For an Emancipating Protagonism” was produced, which brings us the vision and hope of possibilities. It is concluded that the protagonism brought by the PEI, in its practice, is very far from its discourse of freedom, initiative and commitment, as young people live their school lives en masse within the school and classroom, following the same teaching standards and learning from a traditional school, differing only by the extended length of stay, presenting itself as contradictory to a democratic and inclusive education, especially with regard to the comprehensive training of young people, since this involves all spheres of life, making it necessary to experience of real situations and not just the classroom. It is hoped that new paths will be charted in school education in PEI towards democracy and inclusion and that this research will open doors for new discussions, especially regarding the alignment of youth with public schools.
Política de educação especial: um estudo comparado crítico entre Brasil e Portugal
(Universidade Federal de São Carlos, 2024-02-27) Ribeiro, Érika Rosa Rodrigues; Martins, Marcos Francisco; https://lattes.cnpq.br/4515924584428591; https://orcid.org/0000-0002-8220-2030; Dainez, Débora; https://lattes.cnpq.br/4671868444231806; https://orcid.org/0000-0002-8223-098X; https://lattes.cnpq.br/6503845095776522; https://orcid.org/0009-0008-1878-9077
The present work aims to analyze, through a critical comparative study, the educational policy of Brazil and Portugal, based on special education legislation, highlighting the similarities and speci-ficities that mark the regulations of these two countries, having as reference the main political documents that mark the trajectory of these nations. The analysis was anchored in studies by Gramsci (1999), which make it possible to understand the political and economic determinants that involve the pedagogical discourse of political texts and documents. As a reference in the area of special education, we will dialogue with the studies of Jannuzzi (2004), to discuss the relationship between special education policies and the historical and social context. We advance the discus-sion with the contextualization of the guidelines and regulations in the two education systems, in order to elucidate the trajectories of educational policies. We used as a reference the studies by Sobrinho, Sá, Pantaleão and Jesus (2015) on international comparative research and reflections on public policies, by Shiroma, Morais and Evangelista (2007), Shiroma, Campos and Garcia (2004), with the purpose of producing a critical qualitative study on special education in Brazil and Portu-gal. To develop the work, official documents and data made available by the Brazilian Ministry of Education and the Directorate-General of Education of Portugal were consulted. The analysis of educational policies permeated the social, historical and cultural contexts of the constitution of special education in both nations. Among the results obtained by the research, it is worth highlight-ing the fact that special education policies in the countries analyzed are close and distant. As points of contact: a historical trajectory of the school system, which went through exclusion, inte-gration, philanthropy and is currently considered inclusive; dialogue with international movements and declarations, especially UNESCO; the development of individual planning to serve the target student of inclusive education. Taking as a reference the current documents from Brazil and Portu-gal, the Special Education Policy from the Perspective of Inclusive Education of 2008 and Decree-Law No. 54/2018, we highlight as distancing aspects: the methodological focus of the Portuguese document, from the perspective of a multilevel and universal learning design, which universalizes the way in which specialized educational service work must be carried out, while in the Brazilian case, the focus is on the specialized educational service service, and the performance of the special education professional in the classroom resources and the diversity of applied methodologies, ac-cording to the specificities of the students served; and the way they identify the target audience for special education, in Brazil students with disabilities, giftedness and high abilities and disorders are considered, in the Portuguese document the target audience students for inclusive education are those with learning difficulties, whether due to disability issues or social, cultural and economic conditions.
O processo de tornar-se mãe: uma perspectiva ocupacional da maternidade
(Universidade Federal de São Carlos, 2024-02-27) Bolissian, Annie Mellem; Joaquim, Regina Helena Vitale Torkomian; https://lattes.cnpq.br/7719481657895650; https://lattes.cnpq.br/3843420166008807; https://orcid.org/0000-0002-0442-4922
In the experience of motherhood, we can observe abrupt changes in women's occupational roles, with the acquisition of a new role: the maternal role. These occupational roles are not innate, but socially determined and influenced. The occupational therapy professional analyzes and intervenes in occupations and their relationship with occupational roles and identity, aspects which are commonly impacted on in women's lives from pregnancy to the puerperium. In this sense, it is necessary to analyze the daily lives, desires and expectations of these women, taking into account the transformations due to the new family dynamics that are now emerging. Based on knowledge of occupation, the aim of this study was to reflect on women who have acquired the role of mother, identifying the physical, emotional, social and occupational process of becoming a mother from the perspective of occupation. This is a qualitative, exploratory study that used semi-structured interviews with six women assisted by a pilot project to support human breastfeeding, carried out between October 2022 and April 2023. The interviews were analyzed using Thematic Analysis. The results of the data analysis revealed four thematic categories: I - The birth of the baby: feelings, expectations and realities; II - Co-occupation in motherhood: insecurities and challenges; III - The social idealization of the maternal role; IV - Where is the puerperal women's support network? It should be noted that the particularities of each pregnancy and childbirth can have an influence on characteristics in the postpartum period, and that adapting to the new routine of the puerperium challenges mothers in carrying out co-occupations in caring for the newborn. The acquisition of the maternal occupational role is a process fraught with social pressures, influenced by a sense of responsibility and obligation, generating the "mother" identity. The construction of motherhood is also influenced by the mother's ability to perform, and the so-called "maternal instinct" is questioned. This highlights the need to make spaces available for listening to and caring for women, helping them to develop, organize and perform their new role in society. It is therefore hoped that this study will contribute to broadening discussions and actions on Maternal and Child Health in occupational therapy, given that there is a tendency for academics and professional practices to focus their attention on this public only in atypical situations, linked to illnesses and disorders.
Impressão 3D de scaffolds de PLDLA-TMC como modelo para engenharia tecidual de cartilagem: da reologia ao biorreator
(Universidade Federal de São Carlos, 2024-02-27) Pedrini, Flavia Maria Morais; Duek, Eliana Aparecida de Rezende; https://lattes.cnpq.br/4147198882685212; https://orcid.org/0000-0001-6327-7363; https://lattes.cnpq.br/7911576559387696; https://orcid.org/0000-0003-1411-428X
The increase in life expectancy and the practice of physical activities have impacted the number of traumatic injuries and degenerative diseases, such as meniscal tears and osteoarthritis. The meniscus is composed of fibrocartilaginous tissue subjected to significant mechanical stresses, with low intrinsic repair capacity. When injured, it is often partially or completely removed, leading to future joint complications. Despite available commercial devices, finding a solution for total meniscectomy remains a challenge. In order to explore solutions that may mitigate the problems associated with meniscal injuries, a study was conducted to characterize the Poly(L-co-D,L lactic acidco-trimethylene carbonate) (PLDLA-TMC) terpolymer in proportions of 60/40 and 70/30 regarding its physicochemical, thermal, and rheological properties, aiming for the printing of three-dimensional (3D) scaffolds. Rheological tests revealed the pseudoplastic behavior of the materials, which is indispensable for the printing process. From the characterization of the scaffolds, printing temperature was the factor that most influenced material degradation. When subjected to mechanical compression testing, PLDLA-TMC 60/40 scaffolds showed an elastic modulus (2.9 MPa) similar to the human meniscus (1 MPa), making them eligible for application as meniscal prostheses, as opposed to PLDLA-TMC 70/30 scaffolds. Printing speed proved to be less significant in reducing the molecular weight of the scaffolds, while the material residence time in the printer impacted this property. In vitro degradation testing demonstrated the material's stability over the 4-week study period. Citocompatibility and differentiation assays on PLDLATMC 60/40 printed scaffolds, both in static and dynamic culture, demonstrated their potential as cell carriers in cartilage tissue engineering approaches.
Levantamento de correlações de solidificação da liga A356 para aplicação em simulação computacional e projetos de rodas automotivas
(Universidade Federal de São Carlos, 2024-02-27) Santos, Pedro Gabriel Benedito de Oliveira; Gomes, Leonardo Fernandes; https://lattes.cnpq.br/6904883156193838; https://orcid.org/0000-0003-0648-2672; Spinelli, José Eduardo; https://lattes.cnpq.br/8882038118634925; https://orcid.org/0000-0003-0611-1038; https://lattes.cnpq.br/7830820641203040; https://orcid.org/0000-0002-3597-1099
Wheels are safety items with high structural demand. AlSi alloys stand out due to their good ratio between density and strength. The use of A356 alloy processed by Low-Pressure Die Casting (LPDC) and T6 heat treatment arises from the need for adequate mechanical properties and ease of cyclic processing on a large scale. The high competitiveness of the sector demands a shorter time-tomarket and better performance. Casting numerical simulations assist in predicting thermal and microstructural parameters resulting from the solidification process of the alloy in metallic molds. Understanding thermal parameters is essential for predicting either the phase morphologies or the dendritic length-scale of the casting, as these characteristics have a direct impact on the alloy’s strength. This Master’s work aims to define theoretical equations for application in commercial casting software, to predict the tensile properties of cast and heat-treated wheels. For this purpose, directional solidification (DS) experiments were conducted with A356 alloy to determine equations relating solidification time and cooling rate along the cast part. The part generated by DS was subsequently divided into sections – treated and untreated. Each half was examined in tensile tests, and the secondary dendrite arm spacing (SDAS or λ2) was determined using an optical microscope. This allowed the development of experimental equations relating SDAS to solidification time and tensile properties to SDAS. Finally, simulation with the equations was validated using real tensile test data of wheels before and after T6 treatment. This test involved two methods of correlating tensile properties with SDAS: Hall-Petch (HP) type and Ludvig model (LM). The HP model more accurately represented the tensile strength data from various regions of the wheels, with an average error of approximately 5.6% for tensile strength.
Adaptação escolar de crianças com deficiência visual na educação infantil na perspectiva das famílias
(Universidade Federal de São Carlos, 2024-02-27) Ramos, Victoria do Valle; Cia, Fabiana; https://lattes.cnpq.br/5999108571365402; https://orcid.org/0000-0002-0155-3331; https://lattes.cnpq.br/6628735638075855
Children Education is considered a fundamental stage for the integral development of children. In the process of entering school, they go through school adaptation, which is also experienced directly by families and education professionals. It can be experienced with more intensity and challenges by families of children with disabilities, as is the case of families with children who are blind or have low vision. Given this, the present study aimed to: describe the process of school adaptation of children with visual impairments in Children Education, according to the family's opinion; analyze the feelings experienced by families in the process of school adaptation in Children Education for children with visual impairments; identify the services offered by the school and the adaptations made for children with visual impairments in Children Education, according to the families' opinion; identify the gains in the development of children with visual impairments, after entering Children Education. Three mothers of visually impaired children of preschool age enrolled in regular Children Education participated in the research. Participants responded to an online interview based on a semi-structured script. The research had a descriptive and exploratory nature and underwent content analysis. The results showed that all children entered daycare before the age of three and that the main reasons for enrolling were the parents' need to return to the job market, clinical indication, and parents' desire or convictions. Regarding the enrollment process, all mothers provided some information about the children's needs, but only one school agreed to schedule a meeting with the mother, the pedagogical team and a specialized professional to discuss the demands and adaptations for the child, as the other mothers were not called even though they requested or delivered the report. The main feelings experienced by the participants in this process were enthusiasm, insecurity, anguish, fear, acceptance, security, hope and happiness. The three children experienced the adaptation in a unique way, just as the three schools conducted this process in different ways. Only one school had a Special Education team and offered assistance in the multifunctional resource room, a service classified as being of excellent quality by the mother. None of the schools made any type of change to the structure for physical accessibility. A3 papers, inclined planes, tactile materials, sensory adaptations and differentiated attention were some of the strategies mentioned by two participants to make classes more accessible to their children. All mothers observed positive changes in their children's development after entering school, with a focus on socialization and exploration, and agreed that a good relationship between family and school was an essential factor for successful school adaptation, especially when it involved children with visual impairment. It is concluded that the scenario of inclusion of children with visual impairment in Children Education still requires improvements in practice, such as greater awareness among school teams and investment in the training and preparation of teachers, support services, resources and physical accessibility, as well as such as greater openness of schools to agreements with specialized teams.
Continuidade do cuidado a crianças e adolescentes com Diabetes Mellitus Tipo 1 durante a pandemia da Covid-19
(Universidade Federal de São Carlos, 2024-02-27) Santos, Alyne Lorys Amaral; Okido, Aline Cristiane Cavicchioli; https://lattes.cnpq.br/4358128584478380; https://orcid.org/0000-0003-4309-5612; https://lattes.cnpq.br/8102509006680481
Children and adolescents with Type 1 Diabetes Mellitus require specialized attention and long-term follow-up in healthcare services. The Covid-19 pandemic raised concerns for families and healthcare professionals involved in the care of these children, particularly due to the temporary suspension of physical and leisure activities, scarcity of medical supplies, and reduction in the number of in-person appointments. Objective: To analyze how the continuity of care for children and adolescents with Type 1 Diabetes Mellitus unfolded in the context of the Covid-19 pandemic from the perspective of family caregivers and healthcare professionals. Method: This is a descriptive and exploratory study with a qualitative approach guided by the concept of continuity of care from the World Health Organization. It was carried out in a pediatric endocrinology outpatient clinic in the interior of the state of São Paulo, with family caregivers and professionals from the clinic (physician, nutritionist, and nurse). Data collection was conducted through the application of a sociodemographic characterization instrument and semi-structured interviews. Participant characterization was organized into tables of absolute (n) and percentage frequency. The interviews were transcribed in full and analyzed using the inductive thematic content analysis process. Results: 21 caregivers and three healthcare professionals participated. The results of the interviews were organized around two themes: (1) Interpersonal and longitudinal (dis)continuity and (2) Managerial (dis)continuity. Final considerations: Overall, family caregivers perceived a discontinuity in interpersonal relationships, exacerbating feelings of insecurity and resulting in glycemic control loss. The lack of supplies also emerged as a factor impacting care continuity.
Adaptação transcultural do instrumento The Flow State Scale for Occupational Task (FSSOT)
(Universidade Federal de São Carlos, 2024-02-27) Ramos, Luis Paulo Alves; Carrijo, Débora Couto de Melo; https://lattes.cnpq.br/9096851520328385; https://orcid.org/0000-0002-2463-6690; https://lattes.cnpq.br/5440376695263549
Introduction: The use of Occupational Therapy instruments in Brazil that measure engagement in meaningful occupations is still scarce. Flow is a mental state in which there is harmony between consciousness and the activity performed, thus achieving happiness through control of inner life. Objective: To carry out the translation, back-translation and evaluation stages of the expert committee of the instrument The Flow State Scale for Occupational Tasks (FSSOT), for the Portuguese language (Brazil). Methodology: The stages of cross-cultural adaptation carried out were based on two documents, namely: Guidelines for the Process of Cross-Cultural Adaptation of Self- Report and in the Report of the ISPOR Task Force for Translation and Cultural Adaptation. The present steps were carried out with the approval of the instrument's author. Results: The instrument was broken down into 20 sentences and during the translation, 16 discrepancies were identified between the translators. After analysis, 11 sentences (55%) from T-1 were chosen and 5 sentences (25%) were chosen for the translation of T-2. In the back-translation, discrepancies were found in 15 sentences, with 11 sentences being chosen (73.36%) from the RT-2, two sentences (13.32%) from the T-2 translation, and the remaining two sentences (13.32%), it was decided to combine the two back-translations. In the Expert Committee, 07 sentences presented an agreement level below 80%. Of these, 3 sentences (42.85%) obtained an agreement level below 80% in conceptual equivalence (ECO), 2 sentences (28.57) corresponded below 80% in semantic equivalence (ES) and in terms of cultural equivalence (ECU), only 2 sentences (28.57) corresponded below 80%. After submitting the instrument to the authors, the phrase “It took me a significant amount of time to complete the activity.” Accordingly, the item asks how significant the activities carried out were and not about the time spent performing them. Discussion: All steps carried out faithfully followed the manuals that provide guidance on cross-cultural adaptation, requiring a pre-test to complete the cross-cultural adaptation process of the State of Flow Scale for Occupational Performance for Brazil. This conclusion will contribute to filling the gap regarding the Flow perspective within the clinical practice of Occupational Therapy.
Relação entre os índices de variabilidade da frequência cardíaca, força muscular periférica, funcionalidade e aspectos nutricionais de idosos hospitalizados, sarcopênicos e frágeis
(Universidade Federal de São Carlos, 2024-02-27) Oliveira, Marcelo Olímpio de; Garcia-Araujo, Adriana Sanches; https://lattes.cnpq.br/0104886088821769; https://orcid.org/0000-0002-6491-6240; https://lattes.cnpq.br/1203126503871496; https://orcid.org/0000-0002-2535-4038
Introduction: The prevalence of sarcopenia and frailty is common in the elderly, making them vulnerable, with functional impairment and increasing the incidence of hospitalizations. Cardiovascular consequences, such as changes in heart rate variability (HRV) are frequent, with an even more negative impact on hospitalization. Our study aims to evaluate and verify whether there is a correlation between HRV behavior and factors that condition sarcopenia and frailty in hospitalized elderly people. Objectives: To evaluate the HRV response after postural changes and its relationship with factors contributing to sarcopenia and frailty in hospitalized elderly people. Screen for the presence of sarcopenia and frailty. Methods: This is a cross-sectional, observational study, carried out at the University Hospital of the Federal University of São Carlos (HU-UFSCar). Participants were approached to present the study within the first 72 hours of hospital admission, in the ward or emergency room. Elderly people aged 60 years or over were included, with preserved cognition to understand and carry out the proposed interventions, in addition to hemodynamic and respiratory stability. Clinical data was collected, heart rate (HR) was recorded to evaluate HRV, Charlson and Barthel comorbidity indices, questionnaires such as Sarc-f, International Physical Activity Questionnaire (IPAQ) and reduced Mini Nutritional Assessment (MANr) , Appendicular Skeletal Muscle Mass Index (IMMEA), handgrip dynamometry (FPP) and gait speed test (MVT). For statistical analysis, the Shapiro-Wilk test was applied to verify data normality, the Anova One Way or Kruskal-Wallis tests to compare data between groups, the T or MannWhitney tests to compare two groups and the Pearson or Spearman correlation. For significance, a p less than or equal to 0.05 was adopted. Results: 40 hospitalized elderly people were evaluated, with a mean age of 70.28±7.06 years, 20 men and 20 women (50% each). HRV behavior in sarcopenic and frail elderly people was correlated with IMMEA (rs 0.82, p 0.04), Barthel (rs 0.83, p 0.01), TVM (rs 0.88, p 0.01 ), FPP (rs 0.67, p 0.04), IPAQ (rs 0.92, p 0.01), MANr (rs 0.79, p 0.01) and Charlson (rs -0.59, p 0.04). The participants' HRV behavior showed similar characteristics at rest, however, given the postural change, sarcopenic elderly people showed differences in HRV values (Low Frequency - LF p 0.01; High Frequency - HF p 0.01; Low Frequency/ High Frequency - LF/HF p 0.03; Alpha 1 p 0.01). Among the participants, 31 (77.5%) met criteria for sarcopenia and 29 (72.5%) for frailty, and only 6 participants (15%) did not meet criteria for sarcopenia and/or frailty. Hospitalized elderly people had worse nutritional conditions [MANr 6.00 (5.70 - 8.79)], peripheral muscle weakness [FPP 20.00 (19.18 - 25.30)], reduced functionality [MVT 0.78 m /s (0.69 - 1.06)] and low physical activity [IPAQ 140.00 min/week (122.19 - 503.40)]. Conclusion: The results of this sample identified that better HRV indices in sarcopenic and frail elderly people were associated with greater independence, peripheral muscle strength, physical activity, functional capacity and nutritional aspects, on the other hand, worse indices were associated with a greater number of comorbidities and increased risk of mortality. HRV values at rest were similar between the sarcopenia and frailty subgroups. However, after postural variation, significant differences were found in the LF, HF, LF/HF and Alpha 1 indices between the sarcopenic subgroups, regardless of severity. The frailty subgroups did not demonstrate significant differences, suggesting a worse impairment of HRV. The majority of participants in this study presented characteristics of sarcopenia and/or frailty.
A interseccionalidade de gênero e classe na atenção à saúde: discurso de profissionais e mulheres em situação de rua
(Universidade Federal de São Carlos, 2024-02-27) Araújo, Débora Cherchiglia de Moraes; Protii-Zanatta, Simone Teresinha; https://lattes.cnpq.br/6772128930979370; https://orcid.org/0000-0002-3891-0080; https://lattes.cnpq.br/0680023029610203; https://orcid.org/0000-0003-4900-4806
Introduction: Homelessness represents a serious global public health problem. When analyzing gender issues, studies show that women living on the streets are faced with several challenges, including low health care coverage and the scarcity of policies with an emphasis on health care. Objective: To analyze the meanings produced by homeless women and professionals regarding health care for this population. Methods: Qualitative study; theoretical framework: Intersectionality; methodology: French-based Discourse Analysis. It was developed at the Centro Pop and Casa de Acolhimento in the municipality of Arararaquara, São Paulo, from October to December 2022. 15 subjects participated, 08 women living on the streets for at least six months; and 07 professionals working in the care network for homeless women in the municipality, with at least 6 months of experience in the position answered the questions in a semi-structured script that were audio-recorded, transcribed in full and analyzed with the help of the Atlas.Ti software version 23.2.1. Results: Three discursive blocks emerged, “Being on the streets is not a fatality, but a process”, “Unveiling the markers: Gender and Poverty in health aspects”, “Duality between frustration and empathy: the daily life of professionals in caring for homeless women”. In the first block, the discourses produced by homeless women are presented, highlighting that living on the streets refers to darkness, an environment full of suffering; in addition to being considered a place of deprivation of food, sleep and rest, hygiene and water, which causes greater susceptibility to diseases. Furthermore, the interdiscourse of violence and gender permeates the ideological construction of these women, being more susceptible to Sexually Transmitted Infections and other pathologies with greater emphasis on mental disorders. In the second block, the meanings produced by homeless women about the intersection of gender and class from a health perspective are presented, highlight the need for a more comprehensive look at these women in full of their needs, given the low coverage of preventive exams for cervical and breast cancer; the association of care only being given during the pregnancy-puerperal cycle, in addition to the interdiscourse of drug use interpellated by mental illnesses. In the third block, the meanings produced by professionals are presented, showing that the work aimed at homeless women is challenging but at the same time interesting. Despite the actions aimed at women's health being of an immediate nature, professionals are concerned about the health of these women, and emphasize the need for improvements in the coordination between health and social assistance services, in addition to highlighting that the The implementation of Street Clinic Teams is necessary. Conclusion: In view of the above, we highlight the need of expanding the perspective of federal, state and municipal managers towards homeless women, as, despite being fewer in number, they have different health needs that need to be seen in full.