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To assess the reasons to use, reasons they liked, satisfaction with, and possibilities of recommendation to other women of the levonorgestrel 52-mg intrauterine system (LNG-IUS) by users.A cross-sectional study was conducted at the University of Campinas, Campinas, Brazil from January to July 2021. We enrolled users who came to the clinic, and we applied a pre-tested structured questionnaire with open-ended questions. We performed descriptive analyses of the variables, assessing the level of satisfaction with, and the reasons regarding the possibility of continuing to use, the IUS.Of the 517 enrolled women, 251 (48%) were aged 35 years or older (mean age 33.9 ± 9.0 years), 276 (53%) were white, 14 (3%) were adolescents, 155 (30%) were nulligravidas, and 307 (59.4%) reported experiencing amenorrhea in the last 90 days. Common reasons why women liked to use the LNG-IUS included both the reduction of menstrual bleeding (419 women; 81%) and dysmenorrhea (290 women; 56.1%). Nine out of 10 users (517 women; 91%) were satisfied with the method, and the majority would recommend it to other women.We found a high satisfaction rate among LNG-IUS users mainly due to the reduction of both menstrual bleeding and dysmenorrhea.

Introduction: Soccer is the most played sport in the world and the one that causes more injuries. Imbalance between knee flexor and extensor is the main cause of muscle injuries in soccer players. Objective: The aim of this study was to verify the asymmetry and the correlation between the strength and flexibility of knee flexor and extensor as well as the difference of these variables between the right and left limbs in youth soccer players. Method: The sample consisted of 45 male youth soccer players for at least a year, aged between 13 and 16 years (14.7+0.86). The athletes underwent an assessment of flexibility of the posterior chain through the sit and reach test on Wells’ Bench and an assessment of flexibility of the quadriceps using the Ely’s test, with measurement of passive range of motion by goniometry. The peak of muscle strength was measured using a load cell (EMG  System, Brazil). Results: Data analysis showed difference between the values obtained in the Ely’s test of right and left leg (p=0,03), which did not happen for flexion strength (p=0.45), extension (p=0.41) and H:Q ratio (p = 0.40) when comparing the two members. It was observed a significant negative correlation between the H:Q ratio and the flexibility of the posterior chain test either for the right side (r=-0.40; p=0.006) or left side (r=-0.50; p=0.0004). Also a significant positive correlation was observed between quadriceps strength and flexibility of the posterior chain, both for the right (r=0.31; p=0.03) and the left side (r=0.32; p=0.02). Just for the left side a significant positive correlation was observed when compared the flexor muscle strength with the flexibility of the quadriceps (r=0.30; p=0.03). Conclusion: We conclude from this study that the flexibility of the posterior chain may be related to the strength of the antagonists, however, when the two physical qualities were compared in the same muscles, it showed no correlation.

Resumo O parto domiciliar planejado (PDP) tem crescido cada vez mais no Brasil, especialmente nos grandes centros urbanos, frente à crescente insatisfação das mulheres com o sistema obstétrico hospitalar vigente. Estudos internacionais demonstram a segurança do PDP, porém a produção nacional ainda é limitada nesta área. Desta maneira, este estudo objetivou revisar a produção bibliográfica nacional acerca de parto domiciliar entre os anos de 2008 e 2018, a fim de compilar dados relacionados ao PDP no Brasil. Após levantamento, 18 estudos foram incluídos na revisão, sendo subdivididos nas seguintes categorias: “Desfechos maternos e neonatais dos PDP”, “Sentimentos, motivação e perfis associados à escolha pelo PDP”, “Percepção dos profissionais que atendem PDP” e “Abordagem teórica do PDP”. Concluiu-se que o PDP tem crescido entre parcelas privilegiadas da população, representando importante prática de exercício da autonomia da mulher em contraponto ao modelo obstétrico vigente, apresentando-se como alternativa segura de local de parto, com alto grau de satisfação para as mulheres e famílias. Este modelo de assistência, entretanto, apresenta-se como opção limitada, uma vez que o PDP não é oferecido pelo Sistema Único de Saúde, ainda inacessível para a maioria das mulheres no país. Abstract Planned home birth (PHB) has grown in Brazil, especially in large urban centers, in the face of women’s dissatisfaction with the current obstetric system. International studies have demonstrated the security of PHB, but national production about this area is still limited. Thus, this study aimed to review the national bibliographic production about PHB between 2008 and 2018, in order to compile data related to PHB in Brazil. After survey, 18 studies were included in the review, and then subdivided into the following categories: “Maternal and neonatal outcomes of PHB”, “Feelings, motivation and personal characteristics of women that choose PHB”, “Perception of professionals that practice PHB” and “Theoretical approach to PHB”. It was concluded that the PHB has grown between privileged portions of Brazilian population, representing the important practice of women’s autonomy, presenting itself as a safe alternative place of birth, with a high degree of satisfaction of women and families. However, this model of assistance presents itself as a limited option, since the PHB is not offered by the Health System, still unaccessible to most of women in the country.

Komunitas Semesta Tari hadir dengan fokus pada kreativitas anak rentang usia 2-14 tahun pada proses dan pertunjukan tari anak dengan stimulus lingkungan. Lingkungan di sini adalah situs yang konteks ruang sosial dan budayanya spesifik. Elaborasi interaksi dialektis antara performer dan arenanya dilihat dari kerangka site-specific performance. Kehadiran meraka berdasar pada perkembangan wacana saat ini yang terbangun adalah benteng tinggi pemisah antara pola dari institusi seni dengan lembaga pendidikan seni dengan segala konstruksi kesepakatannya. Penelitian akan praktik Semesta Tari ini sedang melihat bagaimana kesadaran diri, keterikatan kajian seni dengan pengalaman ketubuhan, interaksi dan intervensi ruang serta pendidikan dan presentasi kesenian yang merdeka. Penelitian ini akan menelusuri fragmen prinsip site-specific performance yang dijadikan Semesta Tari sebagai pendekatan metode. Rumusan tersebut akan diwacanakan dengan Pedagogi Kritis oleh Paulo Freire. Participatory action research digunakan sebagai metodologi karena peneliti menjadi bagian dari objek material. Temuan penelitian ini, conscientization pada praktik site-specific performance Semesta Tari untuk kembali menjawab apa yang individu tanyakan secara sadar mengenai konstruksi kesepakatan, melalui atau dengan seni.

The aims of the study were to assess the number of insertions per month of the 52 mg levonorgestrel-releasing intrauterine system (LNG-IUS) and gauge the knowledge and opinions of health care providers with regard to some of its characteristics and the reasons why women liked using the method.An online questionnaire survey was conducted between January and July 2021 at the University of Campinas, Brazil. The survey comprised physicians and nurses from centres that had requested and received donated devices.A total of 65 health care providers answered the questionnaire (41 physicians and 24 nurses). The main misconceptions were related to insertion after an ectopic pregnancy: 60/65 (92.3%) answered that users with previous ectopic pregnancy must have frequent follow-up. Wrong answers were also given on the occurrence of acne (37/65, 56.9%) and depression (32/65, 49.2%). Participants reported that the LNG-IUS was highly effective (100%), long-acting (93.9%) and an appropriate method for controlling uterine bleeding (90.8%) and that it had few side effects (86.2%).Our study suggests that health care providers from centres that requested and received LNG-IUS donations, even though they reported adequate knowledge about the device, still had misconceptions with regard to its clinical management.

Resumo A política externa brasileira tem uma estrutura lógica condicionada pela geografia, que se concretiza de maneiras diferentes em função da relação conjuntural entre os contextos interno e externo, mas mantém certos níveis de definição relacionados com escalas geográficas distintas. Neste trabalho é aplicado o método do raciocínio geográfico multiescalar para analisar como essa lógica estrutural se configurou em dois momentos históricos distintos, separados por um século: a política externa do barão do Rio Branco (no início do século XX) e a do primeiro Governo Lula (no início do século XXI).

Objetivo: Desenvolver uma revisão sistemática sobre a prevalência das principais desordens musculoesqueléticas que ocorrem durante a gestação e os fatores possivelmente associados a cada desordem musculoesquelética. Métodos: Foi realizada uma busca em maio de 2019, atualizada em julho de 2021, nas bases de dados PubMed, Embase, CINAHL e SPORTDiscus. Foram incluídos estudos observacionais com informações sobre prevalência e/ou fatores associados das principais desordens musculoesqueléticas que ocorrem em gestantes de risco habitual. A avaliação do risco de viés foi realizada por um instrumento especialmente adaptado para este estudo. Os dados foram organizados de acordo com o desfecho do estudo (prevalência ou fatores associados à desordem musculoesquelética na gestante) e separados por desordem musculoesquelética e por desenho de estudo. Os dados de prevalência foram agrupados em metanálises de acordo com a desordem musculoesquelética e o período de prevalência. Os dados de fatores associados foram analisados de forma descritiva, agrupando os fatores mais recorrentes, com significância estatística em dois ou mais estudos, para cada desordem musculoesquelética. Resultados: Foram incluídos 194 artigos nesta revisão sistemática, dos quais 158 artigos continham dados de prevalência e 116 continham dados de fatores associados às desordens musculoesqueléticas, sendo que um mesmo artigo poderia conter mais de um desfecho de interesse. A maioria dos estudos incluídos nas análises principais dessa revisão (92%) foram classificados como moderado e baixo risco de viés. As desordens musculoesqueléticas mais prevalentes durante a gestação foram: dor lombopélvica (738/1000 gestantes; IC 95%: 655 a 814), dor lombar (593/1000 gestantes; IC 95%: 533 a 650), dor na coluna (560/1000 gestantes; IC 95%: 438 a 678), incontinência urinária de esforço (400/1000 gestantes; IC 95%: 299 a 506), cãibra muscular (390/1000 gestantes; IC 95%: 255 a 558), dor pélvica (347/1000 gestantes; IC 95 %: 164 a 558) e síndrome do túnel do carpo (255/1000 gestantes; IC 95%: 110 a 435). Dor lombopélvica, dor lombar e incontinência urinária de esforço apresentaram taxas crescentes de prevalência com o avanço da idade gestacional. A maioria das metanálises apresentou alta heterogeneidade entre os estudos. Em relação aos fatores associados, a multiparidade, presença prévia da desordem musculoesquelética e alto índice de massa corpórea foram associados com a maioria das desordens musculoesqueléticas relacionadas a coluna vertebral e pelve e incontinência urinária de esforço. Redução da densidade mineral óssea e síndrome do túnel do carpo apresentaram fatores associados exclusivos, como presença de edema e menor índice de massa corporal, respectivamente. Conclusão: As desordens musculoesqueléticas apresentam significativa prevalência durante a gestação e não devem ser negligenciadas. A dor lombopélvica foi a desordem musculoesquelética mais prevalente em todos os períodos de prevalência. A multiparidade foi o principal fator associado à maioria das desordens musculoesqueléticas analisadas nessa revisão. Objective: To develop a systematic review about the prevalence of the main musculoskeletal disorders that occur during pregnancy and factors possibly associated to each musculoskeletal disorder. Methods: A search was performed in May 2019, updated in July 2021, in the PubMed, Embase, CINAHL and SPORTDiscus databases. Observational studies with information on the prevalence and/or associated factors of the main musculoskeletal disorders that occur in habitual-risk pregnant women were included. The risk of bias assessment was performed using an instrument specially adapted for this study. Initially, data were reported and analyzed descriptively. Data were organized according to the study outcome (prevalence or associated factors with musculoskeletal disorder in pregnant women) and separated by musculoskeletal disorder and study design. Prevalence data were pooled in metanalysis according to the musculoskeletal disorder and period of prevalence. Data on associated factors were descriptively analyzed, pooling the most recurrent factors, with statistical significance in two or more studies, for each musculoskeletal disorder. Results: In this systematic review 194 studies were included. Of these, 158 articles contained prevalence data and 116 contained data on associated factors with musculoskeletal disorders, considering that one article could contain more than one outcome of interest. Most of the studies included in the main analyzes of this review (92%) were classified as having moderate and low risk of bias. The most prevalent musculoskeletal disorders during pregnancy were: lumbopelvic pain (738/1000 pregnant women; 95% CI: 655 to 814), low back pain (593/1000 pregnant women; 95% CI: 533 to 650), back pain (560/1000 pregnant women; 95% CI: 438 to 678), stress urinary incontinence (400/1000 pregnant women; 95% CI: 299 to 506), muscle cramp (390/1000 pregnant women; 95% CI: 255 to 558), pelvic girdle pain (347/1000 pregnant women; 95% CI: 164 to 558), and carpal tunnel syndrome (255/1000 pregnant women; 95% CI: 110 to 435). Lumbopelvic pain, low back pain, and stress urinary incontinence showed increased prevalence rates with advanced gestational age. The majority of the metanalyses showed high heterogeneity between studies. Regarding associated factors, multiparity, previous presence of the musculoskeletal disorder and high body mass index were associated with most musculoskeletal disorders related to the spine and pelvis and stress urinary incontinence. Reduction in bone mineral density and carpal tunnel syndrome had unique associated factors, such as the presence of edema and lower body mass index, respectively. Conclusion: Musculoskeletal disorders show a significant prevalence during pregnancy and should not be neglected. Lumbopelvic pain was the most prevalent musculoskeletal disorder in all periods of prevalence. Multiparity was the main associated factor with most musculoskeletal disorders analyzed in this review.

OBJECTIVE To assess the efficacy of ulipristal acetate (UPA) for reducing abnormal bleeding among women using the 52-mg levonorgestrel intrauterine system (LNG-IUS). METHODS A randomized, double-blind, placebo-controlled pilot study conducted from September 1, 2016 to September 30, 2018, at the University of Campinas, Brazil. LNG-IUS users reporting prolonged or frequent uterine bleeding for at least 1 year were randomized to receive 5 mg UPA per day for 5 days or placebo at an identical regimen. Bleeding was recorded for 90 days after treatment began and was compared between the groups. RESULTS Of 94 eligible women, 64 with abnormal bleeding associated with LNG-IUS use declined treatment or device removal after counselling regarding anticipated bleeding patterns. For the 25 study participants, differences were nonsignificant between the UPA and placebo groups for number of days before bleeding stopped and days free of bleeding; however, UPA users displayed a trend for shorter duration before bleeding stopped and longer time free of bleeding. A similar trend for mean number of bleeding days at 30-, 60-, and 90-day follow-up was observed. CONCLUSION A nonsignificant trend in reduction of abnormal bleeding was observed among LNG-IUS users taking 5 mg UPA per day for 5 days compared with placebo; however, further research is needed. CLINICALTRIALS.GOV: NCT03186586.

Human agency leaves several marks on the environment, which includes deep modifications on the geological surficial layers of the planet, including the formation of technogenic ground. In the last decades, urban expansion has been accompanied by an increase in the extension of degraded lands, which includes modifications in the ground by the introduction of anthropogenic materials and actions such as cutting, revolving and compaction, which affects ecosystem functions of these substrates. In Brazil, this process has intensified since the second half of the 20th Century. Thus, the objective of this work was to investigate the changes in the ground geochemical properties of the city of Santa Maria (RS) and how it may affect the possible ecosystem services provided by these soils. For this purpose, a morphological description of soil profiles to identify the existence of anthropogenic layers was carried out and laboratory tests were conducted to determine pHwater, pHKCl, Ca2, Mg2, K, Na, Al3, H+Al, Cu, Zn and calculation of S, Al% and V%. The results pointed out that there is an enormous variation of anthropogenic constituents in the material, which are capable of altering both the properties of the ground surficial layers as well as their functions and the provided ecosystem services.

Apresentam-se neste trabalho as questões conceituais fundamentais referentes ao campo que denominamos Análise de Terrenos Tecnogênicos, que envolve o estudo de processos, depósitos e modelados criados direta ou indiretamente pela agência geológico-geomorfológica humana, caracterizando um enfoque multidisciplinar que, conquanto fundamentado nas Ciências da Terra, dialoga fortemente com as Humanidades. Esta abordagem teórica visa fornecer os subsídios metodológicos para o estudo da época geológica contemporânea, o Antropoceno, bem como dos registros antropogênicos quaternários (holocênicos e, eventualmente, pleistocênicos).

Tulisan ini secara umum bertujuan untuk memperoleh data dan mendeskripsikan tentang pengaruh pembelajaran dance pattern design terhadap kecerdasan spasial siswa. Penelitian ini terfokus pada siswa kelas VIII C di SMP Pasundan 2 Bandung. Hal ini diawali dengan adanya beberapa ketimpangan dalam diri siswa, khususnya kurangnya kepekaan individu dalam hal mengantri, kurangnya kontrol diri dalam menyesuaikan diri dengan ruang yang ada, hilangnya kepekaan akan sesama, sempitnya gaya berpikir dalam mengembangkan, menuangkan dan menyesuaikan imajinasi terhadap kehidupan sehari-hari, yang mana hal-hal tersebut termasuk kedalam ranah visual-spasial siswa. Desain penelitian yang digunakan adalah Kuantitaif Pre- Experimental dengan jenis metode One-Group Pre-test – Post-test Design, yaitu eksperimen yang dilaksanakan pada satu kelompok saja tanpa kelompok pembanding, populasi penelitian ini adalah siswa kelas VIII C SMP Pasundan 2 Bandung dengan sampel yang berjumlah 31 orang. Hasil dari penelitian ini menunjukan terdapat pengaruh yang signifikan dari pembelajaran dance pattern design (dalam beberapa tari kelompok nusantara). Hasil tersebut dapat dilihat dari hasil t hitung t tabel yaitu 8,346 1,697 yang mana menjadikan Ha diterima atau adanya pengaruh. Kesimpulan dari penelitian ini bahwa pembelajaran dance pattern design (desain pola lantai) berpengaruh cukup signifikan terhadap kecerdasan spasial siswa yang terlihat dari perubahan siswa dalam hal memahami hubungan spasialnya, menyesuaikan diri serta menempatkan diri terhadap akan ruang fisik dan imajiner dari setiap individu.

Orientador: Carlos Alberto Petta Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas Resumo: As alterações no padrão de sangramento são praticamente universais em usuárias de métodos contraceptivos contendo somente progestógenos, sendo uma importante causa de descontinuação destes métodos. Este estudo foi desenvolvido com o intuito de se avaliar as quimiocinas Interleucina 8 e 6 CKine no endométrio de usuárias do sistema intra-uterino liberador de levonorgestrel e correlacioná-las com as populações de leucócitos, células natural killer uterinas e mastócitos. Amostras de endométrio foram obtidas de dois grupos de usuárias do sistema intra-uterino liberador de levonorgestrel: 11 mulheres em amenorréia e 15 mulheres com algum tipo de sangramento. Os leucócitos foram determinados através de anticorpos específicos para neutrófilos, células natural killer uterinas e mastócitos. Foi realizada imuno-histoquimica para identificação das quimiocinas. Os neutrófilos encontravam-se em pequeno número, não havendo diferença entre os dois grupos. As células natural killer uterinas encontravam-se em número maior no grupo com sangramento (p

Mammalian inner ear and fish lateral line sensory hair cells depend on fluid motion to transduce environmental signals and elicit a response. In mammals, actively maintained ionic homeostasis of the cochlear and vestibular fluid (endolymph) is essential for hair cell function and numerous mammalian hearing and vestibular disorders arise from disrupted endolymph ion homeostasis. Lateral line hair cells, however, are openly exposed to the aqueous environment with fluctuating ionic composition. How sensory transduction in the lateral line is maintained during environmental changes of ionic composition is not fully understood. Using lineage labeling,in vivotime lapse imaging and scRNA-seq, we discovered highly motile skin-derived cells that invade mature mechanosensory organs of the zebrafish lateral line and differentiate into Neuromast-associated (Nm) ionocytes. Furthermore, the invasive behavior is adaptive as it is triggered by drastic fluctuations in environmental stimuli. Our findings challenge the notion of an entirely placodally-derived lateral line and identify Nm ionocytes as regulators of mechanosensory hair cell function by modulating the ionic microenvironment. The discovery of lateral line ionocytes provides an experimentally accessiblein vivosystem to study cell invasion and migration, as well as the physiological adaptation of vertebrate organs to changing environmental conditions.