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O impacto da avaliação pré-anestésica na ansiedade dos pacientes ortopédicos: um ensaio clpinico randomizado

2026-03-27T20:29:39Z

Título: O impacto da avaliação pré-anestésica na ansiedade dos pacientes ortopédicos: um ensaio clpinico randomizado Autor(es): Lopes, Iuri Ferreira Primeiro Orientador: Fagundes Júnior, Antônio Aurélio Abstract: Reference: The Impact of Pre-anesthetic Evaluation on Anxiety in Orthopedic Patients: A Randomized Clinical Trial. Background: Pre-anesthetic evaluation (PAE) is an essential process that prepares patients for surgery and may reduce anxiety and associated risks. It is a patient right and a medical duty, according to the resolutions of the Federal Council of Medicine (CFM). The relationship between PAE and anxiety reduction still requires robust evidence in the Brazilian scenario, a gap this study seeks to fill within the context of orthopedic trauma. Objective: To evaluate the impact of PAE timing on perioperative anxiety levels in patients undergoing orthopedic surgery. Secondary objectives included performing a concurrent validation of the Likert scale (self-declaration) against the short-form STAI scale and determining the prevalence of clinically significant anxiety in the sample compared to data available in national and international literature. Method: A randomized clinical trial was conducted with inpatients for orthopedic surgery at a tertiary hospital. Patients with a previous diagnosis of anxiety or depression disorders were excluded. Participants were allocated into two groups: Group 1 Control (PAE a few minutes before surgery) or Group 2 Intervention (PAE up to 12 hours before the surgical procedure). Anxiety was measured upon admission to the preoperative room using the short-form STAI scale and a Likert scale. Results: A total of 99 patients were analyzed, predominantly male (72%), lowincome (58%), and accident victims (75%). The mean short-form STAI score was 20.6 (moderate anxiety). The Likert scale was validated against the short-form STAI, showing a discriminative accuracy of 0.914. An anxiety prevalence of 24.2% was identified, a value lower than global averages, potentially influenced by the sample's resilience profile and the exclusion criteria. There was no statistically significant difference in global scores between groups; however, the variable "I am tense" showed a significant reduction in the intervention group (p=0.023). Discussion: The results indicate that the timing of the evaluation did not alter global anxiety scores, diverging from part of the international literature. However, the specific reduction in tension suggests that early PAE modulates extreme emotional states. The low prevalence found reflects the intrinsic characteristics of the treated trauma population and the impact of excluding patients with a psychiatric history from the sample. Conclusion: PAE does not suppress basal anxiety, a legitimate emotional response, but it modulates its most extreme peaks, such as tension. The validation of the Likert scale as a rapid screening tool demonstrates practical utility for clinical workflow. The equivalence between groups validates the logistic flexibility of the service in public hospitals, allowing for schedule organization according to demand without compromising the measured emotional well-being. Editor: Escola Superior de Ciências da Saúde Tipo: Dissertação

Alimentação escolar no Distrito Federal: uma análise socioambiental das refeições oferecidas nas escolas públicas

2026-03-19T17:54:07Z

Título: Alimentação escolar no Distrito Federal: uma análise socioambiental das refeições oferecidas nas escolas públicas Autor(es): Mello, Julia Serejo Primeiro Orientador: Hargreaves, Shila Minari Abstract: Introduction: School feeding in Brazil is guided by the National School Feeding Programme (PNAE), which establishes directives for providing healthy, balanced, and culturally appropriate meals that promote beneficial and sustainable eating habits. The Program also aims to foster local economic and social development by supporting family farming and contributing to environmental and social sustainability. In the Federal District, the PNAE is implemented by the State Department of Education (SEEDF), which serves multiple educational modalities and provides approximately 97 million meals per year to more than 400,000 students. In 2024, school menus showed a substantial presence of animal-based foods, raising concerns about the socioenvironmental impacts associated with their production and consumption. Consequently, there is a clear need to promote food offerings in schools that are both healthy and environmentally sustainable, in alignment with national and international recommendations advocating for reduced consumption of animal-derived products to safeguard human and environmental health. Objective: To evaluate the environmental impact and nutritional quality of school meals provided to students in the public education system of the Federal District. Methodology: The research was structured in two stages, beginning with the analysis of a sample comprising 130 daily menus provided by the School Feeding Programme of the Federal District in 2024, considering both nutritional quality and environmental impact through the assessment of water and carbon footprints. Subsequently, a theoretical model of a strict vegetarian menu was developed with the aim of comparing it to the current menu, enabling an analysis of the nutritional and environmental implications of both. Results: The 2024 public school meals demonstrated adequate nutritional composition in most assessed aspects, with a variety of food groups and low levels of ultra-processed products. Nutritional inadequacies identified included excessive levels of saturated fat and protein, both surpassing recommended values. Moreover, animal-based foods were found to have the highest environmental impact, accounting for more than 86% of the water and carbon footprints despite contributing less than 30% of the diet’s total caloric content. To mitigate these impacts, the implementation of the “Meatless Monday” campaign is proposed, consisting of the introduction of a strictly vegetarian menu once per week. This measure has the potential to generate numerous benefits, particularly by increasing dietary fiber, reducing saturated fat intake, and significantly lowering environmental footprints compared with those observed in the analyzed sample. Conclusion: The findings highlight the need to invest in strategies that reduce the environmental impacts of public-school meals while simultaneously improving student health outcomes. The primary recommendation is the adoption of the “Meatless Monday” initiative. Finally, food and nutrition education initiatives are essential for raising awareness within the school community, improving student acceptance of legume-based dishes, and training school food service staff. Editor: Escola Superior de Ciências da Saúde Tipo: Dissertação

Dimensões psicossociais da obesidade: explorando interconexões da solidão, depressão e estigma internalizado do peso

2026-03-27T20:47:16Z

Título: Dimensões psicossociais da obesidade: explorando interconexões da solidão, depressão e estigma internalizado do peso Autor(es): Santana, Clarissa Bezerra de Primeiro Orientador: Hargreaves, Shila Minari Abstract: Introduction: Obesity is a complex and prevalent public health condition in which multifactorial etiology has a strong interface with mental health. Psychosocial factors such as depression, loneliness, and weight stigma present interrelationships that can negatively impact quality of life and treatment adherence. Objective: To analyze the relationship between obesity, loneliness, depression, and weight stigma, describing the frequency of these conditions in patients with and without obesity and associating the variables. Method: A cross-sectional, quantitative, and analytical study was conducted with patients from a Primary Health Care Unit in the Federal District, Brazil. The BDI-PC (depression), UCLA Loneliness Scale (loneliness), and Weight Bias Internalization Scale (WBIS) (internalized stigma) questionnaires were applied, and self-reported sociodemographic and anthropometric data were collected. The WBIS was administered only to individuals who responded positively to the statement "I consider myself to be overweight." Participants were classified into "without obesity" (Body Mass Index <30kg/m²) and "with obesity" (Body Mass Index >30kg/m²). Analyses were performed to verify the relationship between obesity and depression risk, and between obesity and loneliness, using Pearson's chi-square test. The influence of biological sex on the evaluated parameters was also assessed via Pearson's chi-square test. The association between internalized weight stigma and (a) risk of depression, (b) loneliness, and (c) sex was evaluated using Student's t-test (p < 0,05). Results: The final sample consisted of 260 participants. The prevalence of depression risk (67.3% vs 46.7%; p=0.005) and loneliness (70.3% vs 54.1%; p=0.009) was significantly higher in patients with obesity. Internalized weight stigma, assessed only among individuals who considered themselves overweight (n = 138), was higher in those at risk of depression (p<0.001) and in those experiencing loneliness (p<0.001). Females showed a higher frequency of risk of depression (p = 0.018) and loneliness (p=0.004), as well as higher internalized weight stigma scores (p<0.001). Conclusion: People with obesity showed a higher risk of depression and loneliness, and internalized weight stigma was associated with both outcomes. Females exhibited greater psychosocial vulnerability and higher levels of internalized weight stigma. These findings reinforce the need for biopsychosocial approaches to obesity care, incorporating mental health support and strategies to address weight stigma. Editor: Escola Superior de Ciências da Saúde Tipo: Dissertação

Método Ponseti no tratamento do pé torto congênito idiopático em um serviço de assistência pública à saúde

2025-12-05T18:51:53Z

Título: Método Ponseti no tratamento do pé torto congênito idiopático em um serviço de assistência pública à saúde Autor(es): Brito, André Thiago Scandiuzzi de Primeiro Orientador: Reis, Carmélia Matos Santiago Abstract: Introduction: Congenital Clubfoot (CF) is the most common congenital musculoskeletal deformity in humans. Inadequate treatment can lead to severe functional limitations in adulthood and reduced quality of life. The Ponseti Method, a minimally invasive approach, has demonstrated global success, but data on its effectiveness in public healthcare services in Brazil are still sparse. Objective: To evaluate the effectiveness of the Ponseti method in the treatment of idiopathic CF in a public medical assistance healthcare service. Method: A retrospective longitudinal cohort study was conducted with individuals admitted up to 2 years of age at the Brasília hospital of the Sarah Rehabilitation Hospitals Network between January 6, 1997, and November 22, 2023. Epidemiological data were collected, and the application of the Ponseti method was evaluated in two periods: 2009-2017, with the use of ankle-foot orthosis (AFO), and 2017-2023, with the use of abduction orthosis. Results were assessed using recurrence rates, residual deformities, and the modified Laaveg-Ponseti scale. Results: From 1997-2009, 1,386 individuals were treated with the traditional method, with 93.5% undergoing posteromedial surgery. From 2009-2023, 552 individuals underwent the Ponseti method, comprising 72.7% male, 27.3% female, and 52.5% with bilateral involvement, totaling 842 treated feet. The Pirani classification was used from 2017-2023, with an average score of 5.5 at admission. 92.5% of cases underwent Achilles tenotomy after cast changes. The mean follow-up time was 10.3 years in the first period and 5.3 years in the latter, with an average number of cast changes of 7.4 and 6.2, respectively. Comparing the AFO and abduction orthosis groups, a p-value< 0.05 was found for recurrence (71.9% vs. 31.2%), a p-value< 0.05 for modified Laaveg (good/excellent 69.3% vs. 81.8%), and a p-value < 0.05 for residual deformity (67.7% vs. 43%). Conclusion: The Ponseti method is effective in correcting CF, consistent with existing literature. The use of AFO results in more recurrence, residual deformity, and worse functionality, thus advocating for the routine use of abduction orthosis. Editor: Escola Superior de Ciências da Saúde Tipo: Dissertação