The present study aimed to evaluate the precision of the torque applied by 0.022" self-ligating brackets of different brands, the precision of parallelism between the inner walls of their slots, and precision of their slot height. Eighty brackets for upper central incisors of eight trademarked models were selected: Abzil, GAC, American Orthodontics, Morelli, Orthometric, Ormco, Forestadent, and Ortho Organizers. Images of the brackets were obtained using a scanning electron microscope (SEM) and these were measured using the AutoCAD 2011 software. The tolerance parameters stated in the ISO 27020 standard were used as references. The results showed that only the Orthometric, Morelli, and Ormco groups showed results inconsistent with the ISO standard. Regarding the parallelism of the internal walls of the slots, most of the models studied had results in line with the ISO prescription, except the Morelli group. In assessing bracket slot height, only the Forestadent, GAC, American Orthodontics, and Ormco groups presented results in accordance with the ISO standard. The GAC, Forestadent, and American Orthodontics groups did not differ in relation to the three factors of the ISO 27020 standard. Great variability of results is observed in relation to all the variables.

Physical distancing was used to prevent transmission of COVID-19, however there are concerns that this may promote harmful impacts on health, such as reduced levels of physical practice and changes in food intake and gut microbiota composition. This study evaluated the impacts of 6 months physical distancing on Brazilian older women upon body mass index (BMI), strength, physical activity level (IPAQ), eating habits, neurological markers (brain-derived neurotrophic factor-BDNF and cortisol), cytokines (IL-2, IL-5, IL-6, IL-10, interferon-IFN-γ, tumor necrosis factor-TNF-α), aging-associated markers (vascular endothelial growth factor-VEGF, insulin-like growth factor-IGF-1, klotho and thymic stromal lymphopoietin-TSLP), besides specific groups of fecal microbiota. Fifteen women, over 60 years old, residents of São Paulo state (Brazil), were evaluated in March and in September 2020. The older adult women, with a mean age 66 ± 6.2 years presented significantly increased BMI and high effect size for non-protective foods consumption, reduced light physical activity and strength 6 months following the physical distancing. Furthermore, the serum concentration of IFN-γ, IGF-1, and IFN-γ/IL-5 were significantly higher, while lower concentration of IL-2 and IL-5 were observed 6 months after the physical distancing. Significant increase was noted only to Blautia spp. abundance after 6 months of physical distancing. Several correlations were observed at both before and after physical distancing, however, interestingly, many of them were lost or inverted 6 months following, while new ones emerged. Taken together, these results showed that lifestyle changes and stress conditions addressed by physical distancing from the COVID-19 pandemic impacted the health of older women included in the present study. Therefore, future follow-up studies are essential to propose interventions in order to restore the health conditions observed before the pandemic period, and thus to maintain the quality of life of older adults in different socioeconomic contexts.

At this moment 'shared leadership' is in discussion. This means to delegate more autonomy to those who work on all levels of organizations as well as to give them the chance to become individuals and also citizens capable of changing things and assuming reponsibilities in order to direct their actions in search of the already planned objectivities. The structure of the old administration has to make room to new ones which should be more flexible, wider and more decentralized, thus creating autonomy, pro-activity, and conditions for every single one to assume leadership. The hospital is not an outsider in this process and goes also through a renewed form of thinking and planning. In this sense, both Medicine and the other multidisciplinary areas of health has assumed different roles within its care activities linked to the patient until health management, thinking not only about managing with leadership skills, but also interacting with new times and methods, becoming audacious from mechanisms like a lot of attention and emotion, intelligence and self-development to break paradigms of a professional profile. This study sought to analyze the Leadership Competencies as tools for the promotion of quality in health care, based on Explanatory Research and meta-analysis in a hospital, with 37 graduated and specialized health professionals.

Atualmente, a liderança compartilhada é tema de debate; significa delegar mais autonomia a pessoas que atuam em todos os níveis organizacionais, bem como dar- lhes a oportunidade de assumir um papel de sujeito transformador e de cidadão a fim de assumir a responsabilidade de direcionar suas ações em busca de objetivos já planejados. A estrutura da velha gestão dá lugar a estruturas mais flexibilizadas, mais horizontais e descentralizadas, gerando autonomia, pró-atividade e condições do indivíduo assumir a “dianteira”. O hospital não está à margem deste processo, e também vive um novo repensar de liderança. Neste sentido, tanto a Medicina quanto as demais áreas multiprofissionais de saúde tem assumido diferentes papéis dentro de suas atividades assistenciais ligadas ao paciente até a gerência de saúde, pensando não apenas em gerenciar com competências de liderança, mas também interar-se aos novos tempos e métodos, tornando-se audaciosa a partir de mecanismos como muita atenção e emoção, inteligência e auto-desenvolvimento para quebrar paradigmas de um perfil profissional. Este estudo buscou analisar as Competências de Liderança para a promoção da qualidade na assistência à saúde, a partir de Investigação Explicativa e Metanálise em unidade hospitalar, com 37 profissionais de saúde graduados e especializados.

Durante o processo de desenvolvimento e maturação, o ser humano passa por várias transformações que estabelecem um constante aprendizado e envolve aquisições e perdas de funções. A senelidade é um processo patológico que pode surgir com o envelhecimento. Portanto a senelidade acomete os idosos, mas algumas patologias que aparecem na senilidade também podem acometer pacientes mais jovens e são caracterizadas pela perda de capacidade de memorização, déficit de atenção, discursos incoerentes e desorientação. Esses déficits são reflexos do envolvimento da formação do hipocampo. Quando estas são danificadas, várias capacidades e competências podem ser afetadas. Objetivo: Este projeto tem como avaliar o efeito neuroprotetor da atividade física regular, na evolução da saúde do idoso. Método: avaliar o estudo partir de uma revisão sistemática. Resultado: Através deste estudo conseguimos analisar a taxa de envelhecimento em alguns estados do Brasil. Conclusão: A partir dos resultados obtidos vimos que diversos fatores influenciam sim a qualidade de vida das pessoas em diferentes estados de um único país, por isso a importância de estudos como esses serem feitos constantemente pelos pesquisadores.

Objectives To describe obstetric and neonatal outcomes, the profile of antiseizure medication (ASM), and types of seizures in pregnant women with epilepsy (PWWE) in Alagoas. Methods In this retrospective cohort study using data collected from the medical records of PWWE and pregnant women without epilepsy (control group) between 2008 and 2020, PWWE/PWNE aged < 40 years (controlled seizures or refractory epilepsy) were included. Medical records were obtained from high-risk maternity hospitals in Alagoas. Results The obstetric and neonatal outcomes observed in PWWE were pregnancy-related hypertension (PrH) (odds ratio [OR] = 6.29; 95% confidence interval (CI) = 3.50–11.30), vaginal bleeding (OR = 2.54; 95% CI = 1.15–5.59), preeclampsia (OR = 8.04; 95% CI = 2.22–29.10), oligohydramnyos OR = 4,57; 95% CI = 2.24–9,31), polyhydramnios (OR = 7.55; 95% CI = 1.55–36.65), miscarriage (OR = 1.75;95% CI = 1.16–2.63), stillbirth (OR = 11,16; 95% CI = 2.22–29.10), greater likelihood of PrH in those with generalized tonic-clonic seizures (GTCS) (OR = 8.05; 95% CI = 3.47–18.64), greater likelihood of maternal ICU admission in those with GTCS and status epilepticus (OR = 11.73; 95% CI = 2.44–56.37 vs. OR = 37.50; 95% CI = 8.32–168.84, respectively) and phenytoin and lamotrigine use (OR = 17.75; 95% CI = 1.95–160.77 vs. OR = 7.10; 95% CI = 1.03–48.64). PWWE with GTCS had a higher chance for stillbirth (OR = 3.41; 95% CI = 1.03–11.28). and status epilepticus were more likely to deliver prematurely (OR = 2.22; 95% CI = 1.05–4.69). PWWE with status epilepticus had higher odds of using lamotrigine (OR = 21,91; 95% CI = 2.07–231.60). Phenobarbital(PB) with diazepam was the most commonly used drug by PWWE with GTCS and status epilepticus (OR = 12.04; 95% CI = 1.43–101.47). Only 14% of PWWE did not use, 50.2% used monotherapy, and 35.8% used polytherapy. Phenobarbital was the most commonly used ASM (60.9%), followed by carbamazepine (25.2%). Conclusion This study described adverse obstetric and neonatal outcomes in PWWE. Many pregnant women with epilepsy used ASM, showing a positive association with adverse outcomes and more severe seizure types.

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