Emancipatory practices of nurses in primary health care: the home visit as an instrument of health needs assessment

Objective Identify nurses’ emancipatory practices in primary care, to contribute to the improvement of health care. Method A case study type social research of qualitative nature, in which nurses of a primary health care service unit in São Paulo were interviewed. Results The home visit was identified as a nursing practice possible to be expanded in order to identify social determinants of health, triggering emancipatory practices in the service. This expansion occurred because the design of health care labour intended by the service team changed its focus from the traditional object of health services, the disease. Conclusion First, it is advocated that social policies lead projects with the purpose of improving health needs. On the other hand, the daily labour needs to provide opportunities for reflection and discussion of healthcare projects, leading workers to propose labour-processes targeted to both the social determinants of health and people’s illness.

Educational Group Practices in Primary Care: Interaction Between Professionals, Users and Knowledge

OBJECTIVE To investigate the concept understood by Family Healthcare Strategy (ESF) professionals of knowledge, education and subjects participating in learning activities. METHOD Qualitative study carried out with the ESF professionals with university degree, members of the healthcare staff who undertook educational health group activities at Basic Healthcare Units (UBS) in Belo Horizonte. The following triangulation techniques were used: participant observation, photos and field notes; interviews with professionals; and document analysis. RESULTS We identified three interaction patterns that are different from each other. Firstly, the professional questions, listens and provides information to users, trusting in the transmission of knowledge; secondly, the professional questions and listens, trusting that users can learn from each other; thirdly, the professional questions, listens, discusses and produces knowledge with users, both teaching and learning from each other. CONCLUSION There are educational practices that include unique methods capable of creating a militant space for citizenship engagement.

Implementation methodology of practices based on scientific evidence for assistance in natural delivery: a pilot study

AbstractOBJECTIVEPresenting methodology for transferring knowledge to improve maternal outcomes in natural delivery based on scientific evidence.METHOD: An intervention study conducted in the maternity hospital of Itapecerica da Serra, SP, with 50 puerperal women and 102 medical records from July to November 2014. The PACES tool from Joanna Briggs Institute, consisting of pre-clinical audit (phase 1), implementation of best practice (phase 2) and Follow-up Clinical Audit (phase 3) was used. Data were analyzed by comparing results of phases 1 and 3 with Fisher's exact test and a significance level of 5%.RESULTSThe vertical position was adopted by the majority of puerperal women with statistical difference between phases 1 and 3. A significant increase in bathing/showering, walking and massages for pain relief was found from the medical records. No statistical difference was found in other practices and outcomes. Barriers and difficulties in the implementation of evidence-based practices have been identified. Variables were refined, techniques and data collection instruments were verified, and an intervention proposal was made.CONCLUSIONThe study found possibilities for implementing a methodology of practices based on scientific evidence for assistance in natural delivery.

Adherence to best care practices in normal birth: construction and validation of an instrument

Abstract OBJECTIVE To describe the stages of construction and validation of an instrument in order to analyze the adherence to best care practices during labour and birth. METHOD Methodological research, carried out in three steps: construction of dimensions and items, face and content validity and semantic analysis of the items. RESULTS The face and content validity was carried out by 10 judges working in healthcare, teaching and research. Items with Content Validity Index (CVI) ≥ 0.9 were kept in full or undergone revisions as suggested by the judges. Semantic analysis, performed twice, indicated that there was no difficulty in understanding the items. CONCLUSION The instrument with three dimensions (organization of healthcare network to pregnancy and childbirth, evidence-based practices and work processes) followed the steps recommended in the literature, concluded with 50 items and total CVI of 0.98.

Mothers' perceptions of care practices for children who underwent heart transplantation

Abstract OBJECTIVE To learn mothers' perceptions of the main care practices that are to be administered after their children's heart transplantation, as well as the main difficulties they experience. METHOD A descriptive qualitative study conducted in March and April 2014, using the focus group technique for data gathering. Participants were 12 mothers who were monitoring their children in a hospital that is a reference for treating cardiopulmonary diseases. Speeches were recorded, transcribed, and organized around the care practices that the mothers performed after the children's heart transplantations, the mothers' main difficulties, their perceptions of their children's quality of life, and the use of educational materials to disseminate post-transplantation care practices. For data analysis, we used the content analysis technique. RESULTS The following were clarified: the schedule of immunosuppressive medication; food, environmental, and bodily and oral hygiene; the use of surgical masks; and keeping the children away from crowds. CONCLUSION The study contributed to the situational diagnosis of the care administered by the mothers of transplanted children.

Influence of Apion sp. (Brentidae, Apioninae) stem-galls on induced resistance and leaf area of Diospyros hispida (Ebenaceae)

We addressed the influence of the stem galls induced by an unidentified species of Apion sensu lato (Brentidae, Apioninae) on the host plant, Diospyros hispida (Ebenaceae) leaf area and induced resistance against a Cecidomyiidae (Diptera) leaf galls. The study was performed in a cerrado vegetation in Serra do Cipó, southeastern Brazil. Although the number of leaves produced on galled and ungalled shoots did not differ statically (p>0.05), the presence of the apionid galls influenced the area of the leaves on the attacked shoots of D. hispida. Leaves on galled stems were approximately 50% smaller compared to leaves in healthy stems. The average of the cecidomyiid leaf galls successfully induced on healthy shoots was higher compared to galls successfully induced on shoots galled by the apionid. The same pattern was found for the abundance of hypersensitive reactions against the cedidomyiid gall induction. Therefore, the ability of the cecidomyiid to successfully induce galls was not influenced by the apionid galler.

Fitness cost of resistance to Bacillus thuringiensis in velvetbean caterpillar Anticarsia gemmatalis Hübner (Lepidoptera, Noctuidae)

Selection pressure to obtain resistant genotypes can result in fitness cost. In this study, we report the effects of the selection pressure of a commercial formulation of Bacillus thuringiensis on biological aspects of a Dipel-resistant strain of velvetbean caterpillar, Anticarsia gemmatalis Hübner. Comparisons of Dipel-resistant and susceptible individuals revealed significant differences in pupal weight and larval development time. Both strains (Dipel-resistant and susceptible) were susceptible to Cry1Ac toxin expressed in foliar cotton tissues. Resistant and susceptible strains showed low survival rates of 22.5% and 51.2%, respectively, when fed with Greene diet containing Bt-cotton. Larvae bioassayed after three laboratory generations presented lower survival and less instar numbers than individuals maintained in the laboratory for more than 144 generations. Pupal weight was 9.4% lower and larval development time was 1.9 days longer in the resistant population than in the susceptible strain. Other parameters, such as duration of pupal stage, adult longevity, number of eggs per female, oviposition period, and egg fertility, remained unaffected.

Contrasting patterns of insecticide resistance and knockdown resistance (kdr) in Aedes aegypti populations from Jacarezinho (Brazil) after a Dengue Outbreak

ABSTRACT After a dengue outbreak, the knowledge on the extent, distribution and mechanisms of insecticide resistance is essential for successful insecticide-based dengue control interventions. Therefore, we evaluated the potential changes to insecticide resistance in natural Aedes aegypti populations to Organophosphates (OP) and Pyrethroids (PY) after chemical vector control interventions. After a Dengue outbreak in 2010, A. aegypti mosquitoes from the urban area of Jacarezinho (Paraná, Brazil) were collected in 2011 and 2012. Insecticide resistance to OP Temephos was assessed in 2011 and 2012 by dose–response bioassays adopting WHO-based protocols. Additionally, in both sampling, PY resistance was also investigated by the Val1016Ile mutation genotyping. In 2011, a random collection of mosquitoes was carried out; while in 2012, the urban area was divided into four regions where mosquitoes were sampled randomly. Bioassays conducted with larvae in 2011 (82 ± 10%; RR95 = 3.6) and 2012 (95 ± 3%; RR95 = 2.5) indicated an incipient altered susceptibility to Temephos. On the other hand, the Val1016IIe mutation analysis in 2011, presented frequencies of the 1016Ilekdr allele equal to 80%. Nevertheless, in 2012, when the urban area of Jacarezinho was analyzed as a single unit, the frequency of the mutant allele was 70%. Additionally, the distribution analysis of the Val1016Ile mutation in 2012 showed the mutant allele frequencies ≥60% in all regions. These outcomes indicated the necessity of developing alternative strategies such as insecticide rotations for delaying the evolution of resistance.

The use of total luminescence spectroscopy in the investigation of the effects of different rice management practices on humic substances of a planosol

In the Earth's carbon cycle, C stocks in the soil are higher than in vegetation and atmosphere. Maintaining and conserving organic C concentrations in the soil by specific management practices can improve soil fertility and productivity. The aim of this study was to evaluate the impact of agricultural management techniques and influence of water regime (flooded or drained) on the structure of humic substances by excitation/emission matrix fluorescence. Six samples of a Planosol (Planossolo by the Brazilian System of Soil Classification) were collected from a rice field. Humic substances (HS) were extracted from flooded and drained soil under different agricultural management techniques: conventional tillage, reduced tillage and grassland. Two peaks at a long emission wavelength were observed in the EEM spectra of HA whereas those of the corresponding FA contained a unique fluorophore at an intermediate excitation/emission wavelength pair (EEWP) value. The fluorescence intensity measured by total luminescence (FI TL) of HA was lower than that of the corresponding FA. A comparison of all samples (i.e., the HA values compared to each other) revealed only slight differences in the EEWP position, but the FI TL values were significantly different. In this soil, anoxic conditions and reduced tillage (little plowing) seem to favor a higher degree of humification of the soil organic matter compared with aerated conditions and conventional tillage.

Recovery of soil physical properties by green manure, liming, gypsum and pasture and spontaneous native species¹

Inadequate usage can degrade natural resources, particularly soils. More attention has been paid to practices aiming at the recovery of degraded soils in the last years, e.g, the use of organic fertilizers, liming and introduction of species adapted to adverse conditions. The purpose of this study was therefore to investigate the recovery of physical properties of a Red Latosol (Oxisol) degraded by the construction of a hydroelectric power station. In the study area, a soil layer about 8m thick had been withdrawn by heavy machines leading not only to soil compaction, but resulting in high-degree degradation. The experiment was arranged in a completely randomized design with nine treatments and four replications. The treatments consisted of: 1- soil mobilization by tilling (to ensure the effect of mechanical mobilization in all treatments) without planting, but growth of spontaneous vegetation; 2- Black velvet bean (Stizolobium aterrimum Piper & Tracy); 3- Pigeonpea (Cajanus cajan (L.) DC); 4- Liming + black velvet bean; 5-Liming + pigeonpea until 1994, when replaced by jack bean (Canavalia ensiformis); 6- Liming + gypsum + black velvet bean; 7- Liming + gypsum + pigeonpea until 1994, when replaced by jack bean; and two controls as reference: 8- Native Cerrado vegetation and 9- bare soil (no tilling and no planting), left under natural conditions and in this situation, without spontaneous vegetation. In treatments 1 through 7, the soil was tilled. Treatments were installed in 1992 and left unmanaged for seven years, until brachiaria (Brachiaria decumbens) was planted in all plots in 1999. Seventeen years after implantation, the properties soil macroporosity, microporosity, total porosity, bulk density and aggregate stability were assessed in the previously described treatments in the soil layers 0.00-0.10; 0.10-0.20 and 0.20-0.40 m, and soil Penetration Resistance and soil moisture in 0.00-0.15 and 0.15-0.30 m. The plants were evaluated for: brachiaria dry matter and spontaneous growth of native tree species in the plots as of 2006. Results were analyzed by variance analysis and Tukey´s test at 5 % for mean comparison. In all treatments, except for the bare soil (no recovery measures), ongoing recovery of the degraded soil physical properties was observed. Macroporosity, soil bulk density and total porosity were good soil quality indicators. The occurrence of spontaneous native species indicated the soil recovery process. The best adapted species was Machaerium acutifolium Vogel, with the largest number of plants and most advanced development; the dry matter production of B. decumbens in recovering soil was similar to normal conditions, evidencing soil recovery.

Implications of the variability in soil penetration resistance for statistical analysis

Soil penetration resistance (PR) is a measure of soil compaction closely related to soil structure and plant growth. However, the variability in PR hampers the statistical analyses. This study aimed to evaluate the variability of soil PR on the efficiency of parametric and nonparametric analyses in indentifying significant effects of soil compaction and to classify the coefficient of variation of PR into low, medium, high and very high. On six dates, the PR of a typical dystrophic Red Ultisol under continuous no-tillage for 16 years was measured. Three tillage and/or traffic conditions were established with the application of: (i) no chiseling or additional traffic, (ii) additional compaction, and (iii) chiseling. On each date, the nineteen PR data (measured at every 1.5 cm to a depth of 28.5 cm) were grouped in layers with different thickness. In each layer, the treatment effects were evaluated by variance (ANOVA) and Kruskal-Wallis analyses in a completely randomized design, and the coefficients of variation of all analyses were classified (low, intermediate, high and very high). The ANOVA performed better in discriminating the compaction effects, but the rejection rate of null hypothesis decreased from 100 to 80 % when the coefficient of variation increased from 15 to 26 %. The values of 15 and 26 % were the thresholds separating the low/intermediate and the high/very high coefficient variation classes of PR in this Ultisol.

Soil physical properties and sugarcane root growth in a red oxiso

Sugarcane, which involves the use of agricultural machinery in all crop stages, from soil preparation to harvest, is currently one of the most relevant crops for agribusiness in Brazil. The purpose of this study was to investigate soil physical properties and root growth in a eutroferric red Oxisol (Latossolo Vermelho eutroférrico) after different periods under sugarcane. The study was carried out in a cane plantation in Rolândia, Paraná State, where treatments consisted of a number of cuts (1, 3, 8, 10 and 16), harvested as green and burned sugarcane, at which soil bulk density, macro and microporosity, penetration resistance, as well as root length, density and area were determined. Results showed that sugarcane management practices lead to alterations in soil penetration resistance, bulk density and porosity, compared to native forest soil. These alterations in soil physical characteristics impede the full growth of the sugarcane root system beneath 10 cm, in all growing seasons analyzed.

Modelling of soil penetration resistance for an oxisol under no-tillage

Soil penetration resistance is an important property that affects root growth and elongation and water movement in the soil. Since no-till systems tend to increase organic matter in the soil, the purpose of this study was to evaluate the efficiency with which soil penetration resistance is estimated using a proposed model based on moisture content, density and organic matter content in an Oxisol containing 665, 221 and 114 g kg-1 of clay, silt and sand respectively under annual no-till cropping, located in Londrina, Paraná State, Brazil. Penetration resistance was evaluated at random locations continually from May 2008 to February 2011, using an impact penetrometer to obtain a total of 960 replications. For the measurements, soil was sampled at depths of 0 to 20 cm to determine gravimetric moisture (G), bulk density (D) and organic matter content (M). The penetration resistance curve (PR) was adjusted using two non-linear models (PR = a Db Gc and PR' = a Db Gc Md), where a, b, c and d are coefficients of the adjusted model. It was found that the model that included M was the most efficient for estimating PR, explaining 91 % of PR variability, compared to 82 % of the other model.

Estimating subsoil resistance to nitrate leaching from easily measurable pedological properties

Leaching of nitrate (NO3-) can increase the groundwater concentration of this anion and reduce the agronomical effectiveness of nitrogen fertilizers. The main soil property inversely related to NO3- leaching is the anion exchange capacity (AEC), whose determination is however too time-consuming for being carried out in soil testing laboratories. For this reason, this study evaluated if more easily measurable soil properties could be used to estimate the resistance of subsoils to NO3- leaching. Samples from the subsurface layer (20-40 cm) of 24 representative soils of São Paulo State were characterized for particle-size distribution and for chemical and electrochemical properties. The subsoil content of adsorbed NO3- was calculated from the difference between the NO3- contents extracted with 1 mol L-1 KCl and with water; furthermore, NO3- leaching was studied in miscible displacement experiments. The results of both adsorption and leaching experiments were consistent with the well-known role exerted by AEC on the nitrate behavior in weathered soils. Multiple regression analysis indicated that in subsoils with (i) low values of remaining phosphorus (Prem), (ii) low soil pH values measured in water (pH H2O), and (iii) high pH values measured in 1 moL L-1 KCl (pH KCl), the amounts of surface positive charges tend to be greater. For this reason, NO3- leaching tends to be slower in these subsoils, even under saturated flow condition.

Correction of resistance to penetration by pedofunctions and a reference soil water content

The soil penetration resistance is an important indicator of soil compaction and is strongly influenced by soil water content. The objective of this study was to develop mathematical models to normalize soil penetration resistance (SPR), using a reference value of gravimetric soil water content (U). For this purpose, SPR was determined with an impact penetrometer, in an experiment on a Dystroferric Red Latossol (Rhodic Eutrudox), at six levels of soil compaction, induced by mechanical chiseling and additional compaction by the traffic of a harvester (four, eight, 10, and 20 passes); in addition to a control treatment under no-tillage, without chiseling or additional compaction. To broaden the range of U values, SPR was evaluated in different periods. Undisturbed soil cores were sampled to quantify the soil bulk density (BD). Pedotransfer functions were generated correlating the values of U and BD to the SPR values. By these functions, the SPR was adequately corrected for all U and BD data ranges. The method requires only SPR and U as input variables in the models. However, different pedofunctions are needed according to the soil layer evaluated. After adjusting the pedotransfer functions, the differences in the soil compaction levels among the treatments, previously masked by variations of U, became detectable.